Ukushaywa yisisu kukhona into eningi abantu abahlobana ngayo nezihlobo ezikhulile, ngakho-ke kungase kusabise ukuthi izingane zingaba nazo. Izibhamu zenzeka ezinganeni ezisanda kuzalwa nezingane, kodwa ngenhlanhla, isengozini siphansi (ngaphansi kwamaphesenti angu-1 ezingane). Izifo ze-cardia (heart) kanye ne- sickle cell anemia (i-hemoglobin SS noma i-sickle beta zero thalassemia) yizimbangela ezivame kakhulu zokushaya isisu ebuntwaneni.
Ngaphandle kokuhlolwa okufanele, amaphesenti ayishumi nesishiyagalolunye wezingane ezine-sickle cell anemia zizobhekana nokushaywa yisifo seminyaka engu-20 ubudala. Cishe oyedwa kwabaguli abane bazoba nesifo sokushaywa yisifo seminyaka engama-45. Ukuzwa lolu hlobo lwezindaba mayelana nomntanakho omncane kungasabisa, kepha ngokuhlola okufanele, lokhu kungabonakaliswa kakhulu.
Kungani Abantu Abagulayo I-Cell Anemia Esemngciphekweni We-Stroke?
Iningi lezingane ezine-anemia ye-sickle cell ihlangabezana nokushaywa kwe-ischemic , okusho ukuthi ukugeleza kwegazi akukwazi ukufinyelela endaweni eyodwa yobuchopho. Amangqamuzana omzimba awonakalisa uketshezi lwe-arteries enkulu (izitsha zegazi ezithwala umoya-mpilo kuya kwezicubu) zobuchopho, ezibangela ukuba zibe mncane kakhulu. Lezi zingxube ezincane zegazi cishe zivinjelwe yi-clump ye-cellle cells. Uma lokhu kwenzeka, ukugeleza kwegazi kuvinjelwe futhi i-oksijini ayikwazi ukuhanjiswa endaweni ethile yobuchopho, okwenza kube nomonakalo.
Izimpawu
Izibhamu ezinganeni ezine-sickle cell anemia zibukeka zifana nokushaywa kwabantu abadala.
Izingane zingase zibone:
- Ubuthakathaka kolunye uhlangothi lomzimba
- I-droop ebusweni
- Inkulumo emisiwe
- Izinguquko ezibonakalayo kumbono ongeziwe noma umbono ophindwe kabili
- Kunzima ukuhamba noma ukunciphisa ukusebenzisana
Yini Okufanele Ngiyenze Uma Ngicabanga Ngomunye Umuntu Othole Isifo?
Shayela u-911. Ukushaywa yisisu, kungakhathaliseki ukuthi kuyini imbangela, kuyisimo esiphuthumayo sezokwelapha.
Ukwelashwa kokuqala kuyisihluthulelo sokuvimbela izinkinga zesikhathi eside.
Izingozi Zezingozi
Ingozi ye-ischemic stroke iphakeme kakhulu ezinganeni ezingaphansi kweminyaka eyishumi ubudala. Le ngozi inganciphisa kuze kube sekupheleni kweminyaka engama-30, kanti ingozi iyanda futhi. Ingozi yemivimbo ephazamisayo (imivimbo ebangelwa ukuphuma kwegazi) iphezulu kakhulu kubantu abasha kanye nabantu abadala.
Ingozi yokushaywa isifo iphakeme kakhulu kwiziguli ezine-hemoglobin SS kanye ne-sickle beta zero thalassemia. Ingozi ezigulini ezine-hemoglobin SC ne-sickle beta kanye ne-thalassemia (ikakhulukazi ezinganeni ezincane) zingaphansi kakhulu, ngakho ukuhlola akunconywa kulezi ziguli ngaphandle kokuba kunezikhathazo ezengeziwe.
Ukuvimbela
Ngasekupheleni kweminyaka engama-1980 kanye ekuqaleni kwawo-1990, abacwaningi banquma ukuthi i-transcranial doppler (TCD) ingasetshenziselwa ukuhlola iziguli ezine-anemia ye-sickle cell ukunquma ingozi ye-ischemic stroke. I-TCD iyi-ultrasound engenasidlangalaleni esetshenziselwa ukukala ukugeleza kwegazi ngokusebenzisa izimbangela ezinkulu zobuchopho. Ukuze wenze lokhu, iphenyo le-ultrasound libekwe emahekthempheni lapho ithambo le-skull lincane khona, okuvumela ochwepheshe ukuba alinganise ijubane lokugeleza kwegazi. Ngokusekelwe kulezi zindinganiso, ama-TCD angabhalwa njengokujwayelekile, okunemibandela, nokungavamile. Nakuba izingane ezinama-TCD amanani anemibandela zengozini encane yokuba nesifo sohlangothi, labo abane-TCD engavamile basengozini enkulu futhi kufanele babekwe ohlelweni lokulashwa lokuvimbela.
Nakuba i-TCD ibonakala sengathi ivivinyo olulula, akulula njengokuzwakalayo. Kunezici eziningi ezingathinta izilinganiso phakathi kwe-TCD. I-fever nezifo ziphakamisa okwesikhashana amanani we-TCD. Ngakolunye uhlangothi, ukumpontshelwa igazi kwehlisa amanani we-TCD okwesikhashana. Ngokuyinhloko, ingane yakho kufanele ibe sempilo yawo eyisisekelo uma i-TCD isenziwa.
Ukulala nakho kuthinta igazi ukugeleza kuya ebuchosheni kangaka sedation (ukunikeza imithi ukusiza isiguli ukuphumula / ukulala ngenkathi inqubo) noma ukulala ngesikhathi ukuhlolwa ayinconywa. Izingane ezincane zingase zikuthole kunzima ukusebenzisana nokuhlala, kepha abazali bangasiza ngokudlala i-movie noma ukufunda izincwadi ngesikhathi senqubo.
Kulungile kangakanani i-TCD ekuboneni iziguli ezisengozini yokushaya isisu?
Ukubonwa kwe-TCD engavamile elandelwa ukuqaliswa kokwelashwa okusheshayo kuncishise ingozi yokushaya isifo kubantwana abane-sickle cell anemia kusuka kumaphesenti angu-11 kuya ku-1 amaphesenti. Akuzona zonke izingane ezine-TCD ezingavamile ezizoqhubeka zine-stroke ngaphandle kokwelashwa, kodwa ngenxa yokuthi isifo singaba nemiphumela emibi kakhulu yesikhathi eside, zonke iziguli ziphathwa ngendlela efanayo.
I-Strokes ivinjelwe kanjani uma i-TCD ingavamile?
Uma ingane yakho ene-sickle cell anemia ine-TCD engavamile, kunconywa ukuthi i-TCD iphindwe kabili emasontweni amabili. Uma futhi i-TCD iphinda ingavamile, kunconywa ukuba iqaliswe ohlelweni lokumpontshelwa okungapheli.
Ucwaningo lwesifo se-STOP-1 lubonise ukuthi ukuqaliswa kohlelo lokugoma okungapheli kuncishise kakhulu ingozi yokushaywa yisifo. Ukwelashwa okungapheli kokumpontshelwa igazi kuhlanganisa ukufaka igazi njalo ngemva kwamasonto amathathu kuya kwamane. Umgomo wokumpontshelwa ukuletha amaphesenti we-hemoglobin S ngaphansi kwamaphesenti angaba ngu-95 kuya ngaphansi kwamaphesenti angama-30, ukunciphisa ingozi yamangqamuzana egulisa ukuvimbela ukugeleza kwegazi emithanjeni yobuchopho.
Ingabe Ingane Yami Iyohlale Inesidingo Sokuguqulwa Okungapheli?
Mhlawumbe hhayi. Esivivinyweni samanje se-multi-institution okuthiwa i-TWiTCH, iziguli ezithile (ezisekelwe ezintweni ezinjengezibalo ze-hemoglobin S, ukucabangela kobuchopho, amanani we-TCD abuyela emuva evamile) akwazi ukuguqulwa kusuka ekutheleleni okutheleleka kokumpontshelwa ukwelashwa kwe- hydroxyurea . Lezi ziguli zanconywa kancane kancane ukugonywa njengoba ukwelashwa kwe-hydroxyurea kwanda kancane.
Iziguli ezinezinguquko eziphawulekayo emithanjeni yegazi ebuchosheni zingadinga ukwelapha okungapheli isikhathi eside, okufana neziguli eziye zabhekana nesifo sohlangothi.
Imithombo:
UGeorge A. Ukuvimbela isifo (ukuqala noma okuphindaphindiwe) kwisifo se-sickle cell. Ku: Phezulu, I-post TW (Ed), UpToDate, Waltham, MA. (Kufinyelelwe ngo-Meyi 11, 2016.)