I-Toxic Epidermal Necrolysis: kuyini, izimpawu nokuthi kwenziwa kanjani ukwelashwa

-Delile

• Izimpawu ze-NET
• Izimbangela eziyinhloko
• Yelashwa kanjani
• Ukuxilongwa kwenziwa kanjani

ISystemic epidermal necrolysis, noma i-NET, isifo esingajwayelekile sesikhumba esivezwa ubukhona bezilonda emzimbeni wonke ezingaholela ekuhlubukeni unomphela kwesikhumba. Lesi sifo sibangelwa ukusetshenziswa kwemithi efana ne-Allopurinol ne-Carbamazepine, kepha futhi kungaba ngumphumela wokutheleleka ngamagciwane noma igciwane, isibonelo.

I-NET ibuhlungu futhi ingabulala amacala angafika kuma-30%, ngakho-ke ngokushesha lapho izimpawu zokuqala zivela, kubalulekile ukuxhumana nodokotela wesikhumba ukuze ukuxilongwa kuqinisekiswe bese kuqala ukwelashwa.

Ukwelashwa kwenziwa egumbini labagula kakhulu futhi kwenziwa ikakhulukazi ngokumiswa komuthi obanga lesi sifo. Ngaphezu kwalokho, ngenxa yokuvezwa kwesikhumba kanye ne-mucosa, kuthathwa izinyathelo zokuvimbela ukutheleleka esibhedlela, okungaqhubeka nokubeka engcupheni isimo somtholampilo sesiguli.

Izimpawu ze-NET

Uphawu oluphawuleka kakhulu lwe-epidermal necrolysis enobuthi ukulimala kwesikhumba ngaphezulu kuka-30% womzimba ongopha futhi ukhiphe uketshezi, okuvumela ukuphelelwa amandla kwamanzi nokutheleleka.

Izimpawu eziyinhloko zifana nomkhuhlane, isibonelo:

• Malaise;
• Umkhuhlane omkhulu;
• Khwehlela;
• Ubuhlungu bemisipha namalunga.

Lezi zimpawu, noma kunjalo, ziyanyamalala ngemuva kwezinsuku ezingama-2-3 bese zilandelwa:

• Ukuqhuma kwesikhumba, okungopha futhi kube buhlungu;
• Izindawo ze-Necrosis ezizungeze izilonda;
• Ukuxebuka kwesikhumba;
• Ukushaya;
• Ukuguqulwa kohlelo lokugaya ukudla ngenxa yobukhona bezilonda ku-mucosa;
• Ukuqhamuka kwezilonda emlonyeni, emphinjeni nasendunu, akuvamile;
• Ukuvuvukala kwamehlo.

Izilonda ezivela ku-epidermal necrolysis enobuthi zenzeka cishe kuwo wonke umzimba, ngokungafani neStevens-Johnson Syndrome, okuthi noma inezimpawu ezifanayo zomtholampilo, ukuxilonga nokwelashwa, izilonda zigxile kakhulu esiqwini, ebusweni nasesifubeni. Funda kabanzi ngeStevens-Johnson Syndrome.

Izimbangela eziyinhloko

I-epidermal necrolysis enobuthi ikakhulukazi ibangelwa yimithi, efana ne-Allopurinol, iSulfonamide, ama-anticonvulsants noma ama-antiepileptics, njengeCarbamazepine, iPhenytoin nePhenobarbital, ngokwesibonelo. Ngaphezu kwalokho, abantu abanezifo ezizimele, njengeSystemic Lupus Erythematosus, noma abanamasosha omzimba abekeke engcupheni, njengengculaza, maningi amathuba okuthi babe nezilonda zesikhumba ezifana necrolysis.

Ngaphezu kokubangelwa yimithi, izilonda zesikhumba zingenzeka ngenxa yokutheleleka ngamagciwane, isikhunta, i-protozoa noma ama-bacteria kanye nokuba khona kwezimila. Lesi sifo singaphinde sithonywe ukuguga nezici zofuzo.

Yelashwa kanjani

Ukwelashwa kwe-epidermal necrolysis enobuthi kwenziwa e-Intensive Care Unit yokusha futhi kuqukethe ukuqedwa kwemithi esetshenziswa yisiguli, ngoba imvamisa i-NET ingumphumela wokungathandi okuthile emithini ethile.

Ngaphezu kwalokho, ukufaka okunye oketshezi kanye nama-electrolyte okulahlekile ngenxa yezilonda zesikhumba eziningi kwenziwa ngokujova i-serum emthanjeni. Ukunakekelwa kwansuku zonke kokulimala kwenziwa ngumhlengikazi ukugwema isikhumba noma izifo ezijwayelekile, ezingaba zimbi kakhulu futhi ziqhubeke nokubeka engozini impilo yesiguli.

Lapho izilonda zifika kwi-mucosa, ukondla kungaba nzima kumuntu futhi, ngakho-ke, ukudla kufakwa ngaphakathi kwemithambo kuze kutholakale ulwelwesi lwamafinyila.

Ukunciphisa ukungaphatheki kahle okubangelwa izilonda, ukucindezela kwamanzi abandayo noma ukusetshenziswa kokhilimu abathathi hlangothi nakho kungasetshenziselwa ukukhuthaza ukufuthwa kwesikhumba. Ngaphezu kwalokho, udokotela futhi angancoma ukusetshenziswa kwama-anti-allergen, ama-corticosteroids noma ama-antibiotic, ngokwesibonelo, uma i-NET ibangelwa amagciwane noma uma isiguli sithole ukutheleleka ngenxa yesifo futhi lokho kungahle kube kubi isimo somtholampilo .

Ukuxilongwa kwenziwa kanjani

Ukuxilongwa kwenziwa ikakhulukazi ngokuya ngezici zezilonda. Akukho kuhlolwa kwelabhorethri okungakhombisa ukuthi imuphi umuthi obhekene nalesi sifo futhi izivivinyo zesikhuthazi azikhonjisiwe kuleli cala, ngoba zingadala ukuthi lesi sifo sibe sibi kakhulu. Ngakho-ke, kubalulekile ukuthi umuntu azise udokotela uma enanoma yisiphi isifo noma uma esebenzisa noma imuphi umuthi, ukuze udokotela akwazi ukuqinisekisa ukutholakala kwalesi sifo futhi akhombe nomuntu odala lesi sifo.

Ngaphezu kwalokho, ukuqinisekisa ukuxilongwa, udokotela uvame ukucela i-biopsy yesikhumba, ngaphezu kokubalwa kwegazi okuphelele, ukuhlolwa kwegazi, umchamo nokuvikeleka kwesilonda, ukubheka noma yikuphi ukutheleleka, kanye nomthamo wezinto ezithile ezibhekele amasosha omzimba impendulo.