Izimpawu, Ukwelapha, Nokubhekana Ne-Low Platelet Count Ngesikhathi se-Chemo
I-Thrombocytopenia (inani eliphansi leplatelet egazini) elivela njengomphumela ohlangothini lwe-chemotherapy aliyona inkinga kunesikhathi esedlule, kepha kungase kube nokukhathazeka okukhulu. Yini okufanele uyazi mayelana nezimpawu zezinga eliphansi leplatelet nokuthi yini ongayenza ukuze unciphise ingozi yakho kule nkinga ye- chemotherapy ?
Sibutsetelo
I-Thrombocytopenia ichazwa ngokuthi inani elinciphile lama-platelets egazini.
Ukubalwa kweplatelet ephansi kungabangela ukuphuma kwegazi kanye / noma isidingo sokulibaziseka i-chemotherapy. I-Thrombocytopenia ivame ukuchazwa njengama-platelets angaphansi kuka-150,000 per cubic millimeter yegazi, nakuba ukuphuma okuphawulekayo kungenzeki kuze kube sezingeni eliphansi kwezingu-20,000 noma ngisho no-10 000. Lokho kusho, kubalulekile ukwazi ukuthi abukho ubuhlobo obucacile phakathi kwezinga leplatelet kanye nokuthambekela kokuphuma kwegazi. Uma uneminye izimpawu ezifana nokweqa noma ukulimaza, kubalulekile ukuvumela udokotela wakho wazi, kungakhathaliseki ukuthi libala kangakanani inani lakho leplatelet.
Ukuxilongwa
Udokotela wakho uzoyala inani eliphelele legazi (CBC) ngaphambi nangemva kwe-chemotherapy ukuze ubone ukuthi unesilinganiso seplatelet esincane. Inani elivamile leplatelet (count thrombocyte) ngokuvamile lichazwa ngokuthi linamaplatelet angu-150 000 kuya ku-400,000 ngamakhilomitha ayizigidi zamakhilogremu. Izinga elingaphansi kuka-150,000 libhekwa njengelingajwayelekile, noma i-thrombocytopenia.
Isikhathi esiningi izinga lamaplatele amakhulu kunama-50,000 alihlotshaniswa nanoma yiziphi izinkinga ezinkulu.
Izinga elingaba ngu-10 000 kuya ku-20,000 ngezinye izikhathi lingabangela ukuphuma kwegazi, kodwa ngokuvamile okubalwayo kungase kube phansi kungu-10 000 noma ngaphansi ngaphambi kokuba kubangele ukuphuma okukhulu.
Ngokuvamile, amazinga angaphansi kuka-10 000 avame ukuphathwa (ngokuvamile avame ukumpontshelwa platelet) kodwa amazinga angaphansi kuka-20,000 nawo angaphathwa, ikakhulu uma ehambisana nomkhuhlane.
Kulabo abahamba nge-chemotherapy, amazinga ngisho nama-50,000 kuya ku-100 000 angabangela ukubambezeleka kwe-chemotherapy. Kubalulekile ukuqaphela ukuthi wonke umuntu uhlukile, futhi ukulingana okufanayo kubantu ababili abahlukene kungabangela ukukhathazeka okukodwa nokukhathazeka okuncane kwenye.
Ama-Platelets egazini ahlala cishe ezinsukwini ezingu-8 kuya kwezingu-10 futhi asheshe agcwaliswe.
Izimbangela Ngesikhathi Ukwelashwa Kwemdlavuza
Isizathu esivame kakhulu se-thrombocytopenia kubantu abanomdlavuza ukuxoshwa kwamathambo okuhlobene namakhemikhali. (Bheka ezinye izimbangela ezingezansi.) I-Chemotherapy ibhubhisa ngokushesha amaseli, afana nalawo asemnothweni we-bone owaba amaplatelets. Ngaphandle kwe-thrombocytopenia, ukususwa komnyoba wamathambo e-chemotherapy kungaholela ekubaleni kwegazi elibomvu elincane (i- chemotherapy-induced anemia ) kanye nezinga eliphansi lohlobo lwamaseli egazi amhlophe aziwa ngokuthi i-neutrophils (i-neutrophils eyenziwa yi-chemotherapy-induced-induced neutropenia ) evikela ngokutheleleka kwebhaktheriya .
Imithi eminingi ye-chemotherapy ayithinti amazinga weplatelet ngezinga elibalulekile ngokwanele lokudinga ukwelashwa, kodwa ezinye izidakamizwa ziningi kakhulu kunezinye ukunciphisa ukubalwa. Izidakamizwa ezivame ukuhambisana ne-thrombocytopenia zifaka:
- Izidakamizwa ezisekelwe ePlatinum njengeParaplatin (carboplatin) nePlatinol (cisplatin)
- I-Gemzar (gemcitabine)
- I-Taxol (paclitaxel)
I-Thrombocytopenia ehlobene ne-chemotherapy ngokuvamile iyinkinga yesikhashana. Amazinga e-Platelet aqala ukwehla isonto elilodwa emva kwesimiso se-chemotherapy futhi afinyelele ezingeni eliphansi kunazo zonke (i-nadir) ezinsukwini ezingu-14 ngemuva kokungeniswa. Amanqanaba abuyele evamile ezinsukwini ezingu-28 kuya kwezingu-35 ezilandelayo kodwa zingathatha izinsuku ezingafika ku-60 ukufinyelela amazinga okulashwa ngaphambilini.
Ezinye izimbangela ze-Thrombocytopenia kubantu abane-Cancer / Diagnosis ezahlukene
Kunezinye izizathu eziningana ukuthi izibalo zeplatelet zingase zibe ngaphansi kubantu abanomdlavuza. Ngaphezu kokucindezelwa komnyofu njengokwenziwe ngenhla, lokhu kungafaka:
- I-thrombocytopenia ye-Immune (i-ITP) - I-immune thrombocytopenia eyenzeka lapho umzimba wakho wenza ama-antibodies ngokumelene namaplatelets akho. Lokhu kuvame kakhulu ngamagciwane efana ne-Hodgkin nesifo esingelapheki se-lymphocytic leukemia
- Izifo, ikakhulukazi izifo ezithathelwanayo
- Eminye imithi engabangela amapleletthi aphansi anjenge-vancomycin yama-antibiotic, nemithi elwa namagciwane
- I-tumor isakazeka emthinini wethambo (ngokuvamile i-lymphomas, umdlavuza webele, umdlavuza wamaphaphu)
- I-microangiopathy ye-thrombotic (isimo lapho amangqamuzana angaphakathi angena emithanjeni yegazi ewonakele khona ngezinye izikhathi eyenziwa ngezidakamizwa zamakhemikhali ezifana ne-Mitomycin C ne-gemcitabine.)
Izimpawu
Izimpawu ongase uzibonele nge-thrombocytopenia zifaka:
- Ukulimala kalula
- Ukuphuza - Kusuka ekhaleni lakho, umlomo wakho (ikakhulukazi ngokuxubha,) ukuphuma (ukunyakaza kwamathumbu amnyama noma amagazi), noma isisu (ukuhlanza igazi noma ikhofi ebonakalayo)
- I-Petechiae - Izindawo ezibomvu esikhumbeni sakho (ezivame kakhulu emilenzeni ephansi), ezingaphenduki ezimhlophe uma ucindezela ngazo ngeminwe yakho
- I-Ecchymosis - Izilonda ezibomvu-ezibomvu ezinkulu (iziphazamiso) esikhumbeni sakho
- Kwabesifazane, izikhathi ezilukhuni kunokujwayelekile
- Ubuhlungu obuhlangene nobunzima
- Ukungabi namandla
- Izinsizwa
Ukwelapha / Ukuvimbela
Kubalulekile ukuthi uqale uqonde imbangela ye-thrombocytopenia yakho njengoba kungase kube nezizathu ezahlukene zezinga lakho eliphansi leplatelet eliphathwa ngezindlela ezahlukene. Isibonelo, uma kuhlotshaniswa nezidakamizwa ze-chemotherapy, ukwelashwa kungafaka phakathi ukubambezeleka kwe-chemotherapy, kanti uma kuhlobene nezimbangela zokuzivikela, i-steroids ingase ibe yingxenye yokwelashwa okunconyiwe.
Ngokuya ngezinga lamaplatelethi akho, nokuthi ngabe unayo yini izimpawu noma cha, udokotela wakho angancoma ukwelashwa ukuphakamisa isibalo sakho seplatelet. Izinketho zihlanganisa:
- Ukumpontshelwa kweplatelet - Ukumpontshelwa kweplatelet yindlela ejwayelekile kakhulu yokwelapha i-thrombocytopenia, ikakhulukazi i-thrombocytopenia yesikhathi esifushane ehlobene nezidakamizwa zamakhemikhali. Ukuguqulwa kungasetshenziswa njengendlela yokwelapha (ukwandisa amaplatelets kulabo abaphuma ngokweqile) noma ukuvimbela (kulabo abanomthamo weplatelet ophansi noma olindelekile kodwa abangaphumi). Umphumela ovame ukwedlula wonke umkhuhlane wesikhashana. Imithelela emibi ingabandakanya ukusabela kwegazi noma ukudluliselwa kwezifo ezinjenge-hepatitis.
- Ukwehla kwe-chemotherapy - Ukulahla i-chemotherapy, noma ukulungisa umthamo kungase kudingeke ngezinye izikhathi.
- Imithi ekhuthaza ukwakheka kwamaplatelets - Ngezinye izikhathi imithi isetshenziselwa ukugqugquzela umongo wethambo ukwenza amaplatelets amaningi. Umphumela ovame ukwedlula wonke ukugcinwa kwamanzi (ukuvuvukala).
- Izivivinyo zemitholampilo - Izivivinyo zemitholampilo ziyaqhubeka, zibheke ezinye izindlela zokunciphisa ingozi ye-thrombocytopenia ngesikhathi samakhemikhali.
Ukubhekana
Ngaphezu kwanoma yikuphi ukwelashwa okuphakanyiswe udokotela wakho, uma usengozini ye-thrombocytopenia zama:
- Gwema i-aspirin nemithi elwa nokuvuvukala njenge-ibuprofen ne-naproxen. Buza udokotela wakho mayelana nanoma yimiphi imithi engaphezu kwe-counter noma i-herbal oyithathayo, ngoba ezinye zazo zingandisa ukwanda kwegazi.
- Gwema utshwala njengoba lokhu kungandisa ingozi yokuphuma kwegazi.
- Sebenzisa i-toothbrush emnene. Abaningi be-oncologists batusa ukuthi ugweme ukusebenzisa i-dental floss futhi, kodwa lokhu kungakabonakali ukusiza.
- Sebenzisa i-razor kagesi ukuze ugweme ukusikeka.
- Vula ekhaleni lakho ngobumnene.
- Zama ukuthi ungaqedwa, futhi uma wenza kanjalo, gwema ukucindezela noma ukusebenzisa ama-suppository. Ezinye imithi yobuhlungu, kanye nezinguquko zokudla, kungabangela ukuqotshwa, futhi udokotela wakho angase ancoma isithandwa sesebe noma enye imithi kuwe ngesikhathi samakhemikhali ukuvimbela lokhu.
- Gwema izimo lapho ungalimala noma uzilimaze ngokwakho. Thatha ukunakekelwa okwengeziwe uma usebenzisa izikhali, ngenkathi upheka, futhi usebenzisa amathuluzi. Gwema imidlalo yokuxhumana.
Nini Ukubiza Udokotela
Kufanele uvumele udokotela wakho wazi uma uthuthukisa noma yiziphi izimpawu ze-thrombocytopenia. Mshayela ngokushesha uma uphepha ukuthi awukwazi ukuyeka, ikhanda elisha, umbukiso obonakalayo noma ubuthakathaka.
> Imithombo:
> Estcourt, L., Stanworth, S., Doree, C., Hopewell, S., Trivella, M., noMnu Murphy. Ukuqhathaniswa kwama-Different Platelet Count Countresholds to Guide Management of Prophylactic Platelet Transfusion yokuvimbela ukukhipha abantu kubantu abanezinkinga ze-Haematological emva kwe-Myelosuppressive Chemotherapy noma ukuguqulwa kwamagatsha eStem. I-Cochrane Database yezibuyekezo ezihleliwe . 2015. 18 (11): CD010983.
> Kuter, D. Ukuphatha i-Thrombocytopenia Ehlobene neCanscer Chemotherapy. I-Oncology (i-Williston Park) . 2015. 29 (4): 282-94.
> Liebman, H. Thrombocytopenia ezigulini zeCanscer. Ukucwaninga kwe-Thombosis . 2014. 133 Suppl 2: S63-9.