Imibuzo Nezilingo Udokotela Wakho Angasebenzisa
Ikhanda ngokwayo akuyona njalo isifo esiyinkimbinkimbi , kodwa kunalokho isibonakaliso senye inqubo yesifo esiyisisekelo. Isibonelo, esimweni sezempilo okuthiwa i-giant cell arteritis (eyaziwa nangokuthi i-arteritis yesikhashana) inhloko yekhanda yisikhalazo sokuqala sokuqala.
Incazelo ye-Giant Cell Arteritis
I-giant cell arteritis noma i-GCA iyinhlangano ye- vasculitis yegazi enkulu futhi ephakathi, futhi igama elithi "vasculitis" lisho ukuthi ezinye izitsha zegazi emzimbeni ziyavutha.
I-GCA ithinta kakhulu amagatsha we-artery carotid yangaphandle, umthambo omkhulu entanyeni. Ukuvuvukala kwemithambo ethile e-GCA kuphazamisa ukugeleza kwegazi, okwenza izimpawu ezihlukahlukene zifana nekhanda, izinguquko zombono, nokubuhlungu komhlathi lapho kuhlafuna.
Ukuthola i-GCA
Ukuthola umlando ophelele wezokwelapha kubalulekile ekuhloleni i-GCA. Yingakho udokotela wakho ebuza imibuzo ethize ngaphambi kokuqhubeka nokuhlolwa okuqhubekayo noma ukwelashwa. Ngenxa yokuthi i-GCA ayitholakali kubantu abasha, udokotela wakho cishe uzongena kule mibuzo ethize uma uneminyaka engu-50 noma ngaphezulu.
Ezinye imibuzo udokotela wakho angazibuza zihlanganisa:
Isifo sakho sekhanda sisha?
Kubantu abaningi abadala ababhekene ne-GCA, ikhanda labo alinzima nje kuphela kodwa elisha, okusho ukuthi abazange bazizwe lolu hlobo lobuhlungu bekhanda ngaphambili.
Uphi Amakhanda Akho?
Ngokuvamile, ikhanda le-GCA litholakala kuthempelini, kodwa lingenziwa ngokubanzi noma lendawo ebunzini noma emuva kwekhanda.
Ngaphezu kwalokho, kungase kwenzeke nhlangothi zombili zekhanda noma ngakolunye uhlangothi. Njengoba ubuhlungu besethempelini, abantu bangase bakhononde kabi lapho begqoka isigqoko noma beboya izinwele zabo.
Ingabe Unomkhuhlane Noma Ama-Chills?
Udokotela wakho uzothatha ukushisa kwakho, njengoba umkhuhlane uvame ukubonakala kulabo abaneGCA, kodwa hhayi njalo.
Uzizwa kanjani?
Abantu abane-GCA bathambekele ekuzizwa bebukeka sengathi bethanda. Ngaphezu kwekhanda, bangase babone ukulahlekelwa isisindo, ukukhathala, ukulahlekelwa ukudla, kanye nokukhwehlela.
Ingabe Unayo Ama-Aches?
Isimo esibizwa ngokuthi i- polymyalgia rheumatic (PMR) , esibangele ama-aches ekuseni nokuqina kozinqunu, amahlombe, nentamo, iye yahlanganiswa ne-GCA. Ngakho-ke uma uthola ukuthi une-PMR futhi unekhanda elisha, udokotela wakho angabeka ndawonye ababili futhi abese esola ukuxilongwa kwe-GCA.
Ingabe Umhlathi Wakho Ubuhlungu Lapho Uhlafuna?
Lesi sibonakaliso sabizwa ngokuthi i-jaw claudication futhi sibonakala cishe engxenyeni yabantu abaphethe i-GCA. Ubuhlungu bomhlathi buvame ukuzwa eduze kwe - temporomandibular joint (TMJ) futhi kwenzeka ngemuva kokudla ukudla okudinga ukuhlafuna okunamandla, njengokudla okubomvu noma i-bagel.
Ingabe Unayo Noma Yimuphi Ushintsho Lombono?
Kunezinguquko eziningi ezibukwayo ezingase zenzeke ezigulini ezine-GCA, kanye nesisindo esinzima kakhulu sokulahlekelwa okuphelele kombono. Yingakho uma udokotela ephikisa i-GCA, uzoyiphatha ngokushesha ukulawula ukuvuvukala nokuvimbela ukuphunga.
Ukwelapha i-GCA
Uma udokotela wakho esho ukuthi i-GCA iyimbangela yekhanda lakho kunokuba ingase ihlele isilinganiso se- erythrocyte sedimentation (ESR) , okuyisimakalo sokuvuvukala komzimbeni futhi sinomqondo ophezulu kulabo abane-GCA.
Wena udokotela uzophinde akubheke ngombono we-artery biopsy ukuze uqinisekise ukuxilongwa. Lokhu kusho ukuthi isampula encane yesisindo se-artery yakho yesikhashana iyosuswa ukuze ihlolwe ngaphansi kwe-microscope ngezibonakaliso ze-vasculitis.
Ukwelashwa kwalesi sifo kuhlanganisa inkambo ende ye- glucocorticoids , efana ne-prednisone. Isikhathi sokwelashwa singasuka ezinyangeni eziningana kuya eminyakeni, ukuze kuvinjelwe izinkinga ezinkulu ezihlobene ne-GCA, njengokulahlekelwa kombono okungenakuphikiswa. Ingxenye eyinselele yokwelapha i-GCA ngesilinganiso esiphezulu se-oral steroids, ngenxa yalesi sikhathi, ukuthi i-steroids ingabangela imiphumela emibi njengengcindezi ephezulu yegazi kanye noshukela wegazi, izifo, kanye nokwahlukana kwamathambo.
Ukuze unciphise umthamo kanye nobude bokusetshenziswa kwe-glucocorticoid ku-GCA, isifundo esisodwa esincane ku- Arthritis Rheumatism sihlolisise ukwelashwa kokuqala kwe-GCA nge-glucocorticoid enesifo esilandelayo esilandelwa ukusetshenziswa komlomo we-glucocorticoid. Lokhu kwavumela ngempumelelo umthamo ophansi futhi wehlisa ngokushesha ama-steroids, uma kuqhathaniswa nabantu abawathatha i-oral steroids ngaphandle kwesilinganiso sokuqala esine-intravenous.
Abanye odokotela bangase bacabange ukusetshenziswa kwezidakamizwa zokuzivikela (isibonelo, methotrexate noma i-azathioprine) njengemithi yokwengeza ukuze kutholakale ukukhululwa okusheshayo ukuze umuntu angabi namiphumela emibi yokusebenzisa isikhathi eside steroid . Lokho kusho, ubufakazi besayense kulezi zindlela zokwelapha namanje.
Izwi elivela
Yiqiniso, uma unekhanda lokushaywa ikhanda noma ukushintsha kwiphethini lekhanda, bheka umhlinzeki wakho wezempilo ukuze uthole ukuxilongwa okufanele. Kunezinkinga eziningi zezempilo ezingase ziqhubeke, futhi izimpawu zingalingisa lezo ze-GCA.
Lokho kusho ukuthi uma uthola ukuthi unesifo se-GCA, wazi ukuthi yisifo esingelashwa, kodwa sidinga ukuphathwa ngaso leso sikhathi. Njengenjwayelo, lalela izintandokazi zakho futhi usebenze ekunakekeleni kwezempilo.
Imithombo:
Caylor TL, Perkins A. Ukuqashelwa nokuphathwa kwe-polymyalgia rheumatica ne-giant cell arteritis. Am Fam Physician . 2013 Nov 15; 88 (10): 676-84.
UPonte C, uRodrigues AF, u-O'Neill L, uLuqmani RA. I-giant cell arteritis: Ukwelashwa kwamanje kanye nokuphathwa. I-World J Clin Cases . 2015 Jun 16; 3 (6): 484-94.