Ukudluliswa kwegazi kanye nezifo zesifo seSickle

Ukumpontshelwa kwegazi okubomvu kungukuthi ukwelashwa isikhathi eside ku- sickle cell isifo (SCD) . Ngokufanayo nezinye izindlela zokwelashwa, ukumpontshelwa igazi kunezingozi nezinzuzo ngakho kubalulekile ukuqonda ukuthi kungani ukumpontshelwa ngegazi kukwenzelwe wena noma othandekayo wakho nge- SCD . Ake sibuyekeze ezinye zezizathu ezivamile lapha.

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Isibungu

Ukwelashwa okuqondile kwe-stroke ku-sickle cell isifo sokumpontshelwa kwegazi elibomvu. Ukwelashwa kwesifo kulesi simo kudinga ukumpontshelwa okhethekile okubizwa nge-transfusion exchange noma i-erythrocytaphresis. Kule nqubo, igazi lizosuswa esigulini libe ngumshini ozohlukanisa amaseli egazi abomvu avela kuma platelet, amangqamuzana egazi amhlophe, ne-plasma. Amaseli egazi abomvu wesiguli azolahlwa futhi konke okunye kuzokwenziwa emuva futhi bayothola amanye amangqamuzana egazi abomvu. Umgomo walokhu ukwelashwa ukunciphisa amaphesenti e-sickle hemoglobin kusuka kuma-95% ukuya kuma-30%.

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Ukuhlinzwa

Iziguli ezine-SCD ziyingozi enkulu yezinkinga zokuhlinzwa ezihlanganisa izinkinga zobuhlungu kanye nesifo se-acute chestrome. Ingozi yalezi zinkinga ingancipha ngokumpontshelwa ngaphansi kwesonto elilodwa ngaphambi kokuhlinzwa. Isiphakamiso esiphezulu ukuletha i-hemoglobin kufika ku-10 g / dL. Lokhu kungafinyelelwa ngokumpontshelwa okulula kodwa ezinye iziguli ezine-hemoglobins ezisezingeni eliphakeme zingase zidingeke ukuba zithole ukudluliselwa kwegazi njengokukhulunywe ngenhla. Isidingo sokumpontshelwa igazi sinqunywe yi-sickle cell severity, i-hemoglobin eyisisekelo, kanye nenengozi enkulu yokuhlinzwa. Ezinye iziguli ezithintekayo ezincane zingase zingadingi ukudluliselwa ngaphambi kokuhlinzwa. Lokhu kufanele kukhulunywe nomhlinzeki wakho wezempilo we-sickle cell.

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I-Acute Chest Syndrome

I-syndrome yesifuba esiyinkimbinkimbi iyinkinga eyingqayizivele etholakala ku-SCD. Kunezimbangela eziningana zesifo se-chest syndrome ezibandakanya izifo ezithathelwanayo ezifana ne-pneumonia. Ukuguqulwa ngokuvamile kuvame ukusetshenziswa uma isiguli sidinga oksijini noma uma i-hemoglobin iphansi kunejwayelekile. Ukumpontshelwa kuqala kungavimbela ukuqhubeka kwezinye iziguli. Uma isifo sofuba esifubeni siba nzima, sidinga ukwelashwa okunamandla (unit of care) (i-ICU), ukudluliselwa kwe-exchange kunconywa ngemigomo efana ne-stroke enzima.

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Inkinga Ye-Aplastic Crisis

Inkinga yezinsizakalo ezincane ezibangelwa ukutheleleka nge-parvovirus B19 (ifomu lomuntu, hhayi izinja ezifanayo). I-Parvovirus iyimbangela yokutheleleka kwengane okuthiwa i-Fifth Disease. I-Parvovirus ivimbela umnyofu wethambo ekwenzeni amangqamuzana amasha wegazi abomvu izinsuku ezingu-7 kuya kwezingu-10 ezingabangela i-anemia enamandla kubantu abane-SCD. Lesi sifo esinamandla kakhulu singadinga ukumpontshelwa kuze kube yilapho ukukhiqizwa komnto we-bone. Iziguli ezine-hemoglobin SC noma i-sickle beta kanye ne-thalassemia kungenzeka ingadingi ukumpontshelwa njengoba i-hemoglobin yabo esisekelo iphakeme kune-hemoglobin SS.

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Ukulandelwa Kwe-Splenic Okumangalisayo

Ukwehliswa kwe-splenic ngumcimbi lapho amangqamuzana egazi abomvu agwetshiwe abanjwe esitheni futhi akakwazi ukuphuma. Lokhu kuvame kakhulu ezinganeni ezingaphansi kweminyaka emihlanu ubudala. I-spleen ikhulisa ngesayizi ukuze ihambise amaseli egazi abomvu futhi lokhu kungabangela i-anemia enamandla. Uketshezi lwe-IV kanye nokumpontshelwa kubonakala kukhuthaza i-spleen ukukhulula amangqamuzana aphuzi egazi. Uma i-spleen ikhulula amangqamuzana egazi abomvu, abuyele ekujikelezeni abuyele i-hemoglobin kuya kwesisekelo.

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Ukuvimbela isisu

Ezigulini eziye zabhekana nokushaywa isifo noma iziguli ezisengozini enkulu yokushaywa yisifo (njengoba kukhonjiswe kwi-transcranial doppler, i-TCD), kunconywa uhlelo lokumpontshelwa okungapheli. Ukuhlolwa kocwaningo lwezokwelapha kuye kwabonisa ukuthi ukumpontshelwa kwansuku zonke kungavimbela ukushaywa kwezibhamu okuphindaphindiwe noma okuvela kuzo zonke iziguli ezingozi kakhulu. Lezimpompo eziphindaphindiwe zinciphisa amaphesenti e-sickle hemoglobin ekusakazeni, ukuvimbela izenzakalo ezengeziwe.

> Imithombo:

> Inhliziyo kaZwelonke, iLung, ne-Blood Institute. Ukuphathwa okusekelwe ebufakazini beSickle Cell Disease: Umbiko wePhaneli wochwepheshe, 2014.

Ukudluliswa kwegazi kuyindlela yokwelapha evamile ekuguleni kwezifo ezigulayo

Kunezici eziningi ezithatha isinqumo sokunikeza igazi futhi lolu hlu alufihli zonke izinkomba. Ukumpontshelwa igazi akusetshenziselwa ukwelapha i-anemia engaphansi ebonwe ku-SCD njengoba ngokuvamile ibekezelela kahle. I-Hydroxyurea, imithi yomlomo, ifaneleka kangcono ekunciphiseni i-anemia. Njengazo zonke izifo zokwelapha, kubalulekile ukuxoxa ngezinhlekelele kanye nezinzuzo zokwelapha nodokotela wakho.