I-Purpura

-Delile

• Izithombe ze-purpura
• Yini ebangela i-purpura?
• I-purpura itholakala kanjani?
• I-purpura iphathwa kanjani?
• Ama-Corticosteroids
• I-immunoglobulin efakwa ngaphakathi
• Ezinye izindlela zokwelapha
• I-Splenectomy
• Uyini umbono we-purpura?
• Ukuphila ne-purpura
• Q:
• A:

Yini i-purpura?

I-Purpura, ebizwa nangokuthi amabala egazi noma ukopha kwesikhumba, ibhekisa ezindaweni ezinombala onsomi ezibonakala kakhulu esikhunjeni. Amabala angavela nakwizitho noma ulwelwesi lwamafinyila, kufaka phakathi ulwelwesi olungaphakathi emlonyeni.

I-Purpura yenzeka lapho kuqhuma imithambo yegazi emincane, okwenza igazi lizibandakanye ngaphansi kwesikhumba. Lokhu kungadala amabala ansomi esikhunjeni ahluka ngosayizi kusuka kumachashazi amancane kuya emapheshini amakhulu. Amabala we-Purpura ngokuvamile ahlelekile, kepha angakhombisa isimo sezempilo esibi kakhulu, njengokuphazamiseka kwegazi.

Kwesinye isikhathi, amazinga aphansi weplatelet angadala ukulimaza ngokweqile nokopha. Ama-platelet amangqamuzana asiza igazi lakho. Izinga eliphansi leplatelet lingazuzwa njengefa noma ufuzo, kepha futhi kungenzeka lihlobene nokwakamuva:

• ukufakelwa umnkantsha
• umdlavuza
• ukwelashwa ngamakhemikhali
• ukufakelwa kwe-stem cell
• Ukutheleleka nge-HIV
• ukushintshwa kwehomoni
• izindlela zokwelapha ze-estrogen
• ukusetshenziswa kwemithi ethile

Kufanele uxhumane nodokotela wakho njalo uma ubona noma ikuphi ukukhula noma ushintsho esikhunjeni sakho.

Izithombe ze-purpura

Yini ebangela i-purpura?

Kunezinhlobo ezimbili ze-purpura: i-nonthrombocytopenic ne-thrombocytopenic. I-nonthrombocytopenic isho ukuthi unamazinga weplatelet ejwayelekile egazini lakho. I-Thrombocytopenic isho ukuthi unesibalo seplatelet esiphansi kunokujwayelekile.

Okulandelayo kungadala i-nonthrombocytopenic purpura:

• ukuphazamiseka okuthinta ukujiya kwegazi
• ukuphazamiseka okuthile kokuzalwa, okukhona noma ngaphambi kokuzalwa, okufana ne-telangiectasia (isikhumba esibuthakathaka nezicubu ezixhuma) noma i-Ehlers-Danlos syndrome
• imishanguzo ethile, kufaka phakathi i-steroids kanye naleyo ethinta ukusebenza kweplatelet
• imithambo yegazi ebuthakathaka
• ukuvuvukala emithanjeni yegazi
• iscurvy, noma ukushoda okukhulu kwe-vitamin C

Okulandelayo kungadala i-thrombocytopenic purpura:

• imishanguzo evimbela ama-platelet ekwakheni noma aphazamise ukujiya okujwayelekile
• izidakamizwa ezenza ukuthi umzimba uqalise ukuzivikela komzimba kuma-platelets
• ukumpontshelwa igazi muva nje
• ukuphazamiseka komzimba njenge-idiopathic thrombocytopenic purpura
• ukutheleleka egazini
• ukutheleleka nge-HIV noma i-Hepatitis C, noma ezinye izifo ezibangelwa amagciwane (Epstein-Barr, rubella, cytomegalovirus)
• Umkhuhlane obonwe yi-Rocky Mountain (kusuka ngokulunywa umkhaza)
• i-lupus erythematous ehlelekile

I-purpura itholakala kanjani?

Udokotela wakho uzohlola isikhumba sakho ukuthola i-purpura. Bangase babuze ngomndeni wakho nomlando wezempilo yomuntu siqu, njengokuthi aqala nini ukufika amabala. Udokotela wakho angenza futhi i-biopsy yesikhumba ngaphezu kokuhlolwa kokubalwa kwegazi neplatelet.

Lezi zivivinyo zizosiza ukuhlola ukuthi i-purpura yakho ingumphumela wesimo esibi kakhulu, njengeplatelet noma ukuphazamiseka kwegazi. Amaleveli ama-platelet angasiza ekuboneni imbangela ye-purpura futhi azosiza udokotela wakho ukuthi anqume indlela engcono yokwelashwa.

I-Purpura ingathinta kokubili izingane kanye nabantu abadala. Izingane zingayithuthukisa ngemuva kokutheleleka ngegciwane futhi imvamisa zingalulama ngokuphelele ngaphandle kokungenelela. Iningi lezingane ezine-purpura ye-thrombocytopenic zilulama ngokuphelele ezinyangeni ezimbalwa zokuqala kwalesi sifo. Kodwa-ke, kubantu abadala, izimbangela ze-purpura zihlala zingamahlalakhona futhi zidinga ukwelashwa ukusiza ukuphatha izimpawu nokugcina ukubalwa kweplatelet ngaphakathi kwebanga eliphilile.

I-purpura iphathwa kanjani?

Uhlobo lwezokwelapha udokotela wakho azolunquma lincike embangela ye-purpura yakho. Abantu abadala okutholwe ukuthi bane-thrombocytopenic purpura emnene bangalulama ngaphandle kokungenelela.

Uzodinga ukwelashwa uma ukuphazamiseka okubangela i-purpura kungahambi ngokwakho. Ukwelashwa kufaka phakathi imithi futhi kwesinye isikhathi i-splenectomy, noma ukuhlinzwa ukususa ubende. Ungacelwa futhi ukuthi uyeke ukuthatha imishanguzo ephazamisa ukusebenza kweplatelet, njenge-aspirin, i-blood thinner, ne-ibuprofen.

Ama-Corticosteroids

Udokotela wakho angakuqala ngemithi ye-corticosteroid, engakusiza ukukhulisa isibalo seplatelet lakho ngokunciphisa ukusebenza kohlelo lwakho lokuzivikela komzimba. Imvamisa kuthatha amasonto amabili kuya kwayisithupha ukubalwa kweplatelet yakho ukubuyela ezingeni eliphephile. Uma kwenzeka, udokotela wakho uzoyeka lesi sidakamizwa.

Kubalulekile ukukhuluma nodokotela wakho ngezingozi zokuthatha i-corticosteroids isikhathi eside. Ukwenza kanjalo kungadala imiphumela emibi kakhulu, njengokuzuza kwesisindo, uketshezi lwamehlo, nokulahleka kwamathambo.

I-immunoglobulin efakwa ngaphakathi

Uma uhlobo lwakho lwe-purpura lubangela ukopha okukhulu, udokotela wakho angakunika umuthi we-intravenous obizwa nge-intravenous immunoglobulin (IVIG). Bangakunika ne-IVIG uma udinga ukwandisa isibalo seplatelet yakho ngokushesha ngaphambi kokuhlinzwa. Lokhu kwelashwa kuvame ukusebenza ngempumelelo ekwandiseni ukubalwa kweplatelet yakho, kepha umphumela uvame ukwenziwa esikhathini esifushane kuphela. Kungadala imiphumela emibi efana nekhanda, isicanucanu, nomkhuhlane.

Ezinye izindlela zokwelapha

Izidakamizwa zakamuva ezisetshenziselwa ukwelashwa ukubalwa kweplatelet ephansi kubantu abane-immune immune (idiopathic) thrombocytopenic purpura (ITP) yi-romiplostim (Nplate) ne-eltrombopag (Promacta). Le mithi idala ukuthi umnkantsha ukhiqize amaplatelet amaningi, anciphisa ubungozi bokulimala nokopha. Imiphumela emibi engaba khona ibandakanya:

• ikhanda
• isiyezi
• isicanucanu
• ubuhlungu obuhlangene noma besisipha
• ukuhlanza
• ingozi eyengeziwe yamahlule egazi
• isifo sengcindezi ephathelene nenkinga yokuphefumula engamahlalakhona
• ukukhulelwa

Ukwelashwa kwe-Biologic, njenge-drug rituximad (Rituxan), kungasiza ukunciphisa ukuphendula kwamasosha omzimba. Isetshenziselwa kakhulu ukwelapha iziguli ezine-purpura enzima ye-thrombocytopenic kanye neziguli ukwelashwa kwe-corticosteroid okungasebenzi kuzo. Imiphumela emibi ingafaka:

• umfutho wegazi ophansi
• Umphimbo obuhlungu
• ukuqubuka
• imfiva

I-Splenectomy

Uma imishanguzo ingasebenzi ekwelapheni i-thrombocytopenic purpura, udokotela wakho. Ukususa ubende kuyindlela esheshayo yokwandisa inani lakho leplatelet. Lokhu kungenxa yokuthi ubende yingxenye enkulu yomzimba ebhekele ukuqeda ama-platelet.

Kodwa-ke, ama-splenectomies awasebenzi kuwo wonke umuntu. Ukuhlinzwa nakho kuza nezingozi, njengengozi eyengeziwe yokutheleleka. Ezimweni eziphuthumayo, lapho i-purpura ibanga ukopha ngokweqile, izibhedlela zizofaka ukumpontshelwa kwama-platelet concentrate, i-corticosteroids, ne-immunoglobulin.

Uma ukwelashwa sekuqaliwe, udokotela wakho uzoqapha inani lakho leplatelet ukusiza ukuthola ukuthi liyasebenza noma cha. Bangashintsha imishanguzo yakho kuye ngokusebenza kwayo.

Uyini umbono we-purpura?

Umbono we-purpura uncike esimweni esiyimbangela esiyibangelayo. Lapho udokotela wakho eqinisekisa ukuxilongwa, bazoxoxa ngezindlela zokwelashwa kanye nombono wesikhathi eside wesimo sakho.

Ezimweni ezingavamile, i-purpura ye-thrombocytopenic eshiywe ingalashwa ingadala ukuthi umuntu akhule ngokweqile engxenyeni ethile yomzimba wakhe. Ukopha ngokweqile ebuchosheni kungaholela ekonakaleni kwegazi elibulalayo.

Abantu abaqala ukwelashwa ngokushesha noma abanecala elincane kaningi benza ukululama okugcwele. Kodwa-ke, i-purpura ingaba yisifo esingalapheki ezimweni ezinzima noma lapho ukwelashwa kubambezeleka. Kufanele ubone udokotela wakho ngokushesha okukhulu uma usola ukuthi une-purpura.

Ukuphila ne-purpura

Kwesinye isikhathi amabala avela ku-purpura awapheli ngokuphelele. Imithi ethile nemisebenzi kungenza lezi zindawo zibe zimbi kakhulu. Ukunciphisa ubungozi bokwakha izindawo ezintsha noma ukwenza izindawo zibe zimbi kakhulu, kufanele ugweme imishanguzo enciphisa inani leplatelet. Le mithi ifaka i-aspirin ne-ibuprofen. Kufanele futhi ukhethe imisebenzi enomthelela ophansi kunemisebenzi enomthelela omkhulu. Imisebenzi enomthelela omkhulu ingakhuphula ubungozi bokulimala, ukulinyazwa, nokopha.

Kungaba nzima ukubhekana nesimo esingalapheki. Ukwelula isandla nokukhuluma nabanye abanesifo kungasiza. Bheka ku-inthanethi ukuthola amaqembu okusekela angakuxhumanisa nabanye abane-purpura.

Q:

Ngabe kukhona amakhambi emvelo noma amakhambi asebenza nge-purpura?

A:

Ngoba i-purpura ivela ezinhlotsheni ezahlukahlukene, ayikho indlela yokwelashwa "ngosayizi owodwa ofanela konke". Kubalulekile ukuthola isizathu senkinga. Njengamanje, awekho amakhambi emvelo noma amakhambi okungathenjelwa kuwo ukuphatha lesi simo.

Uma unentshisekelo yokuhlola ukwelashwa kwemvelo noma okunye ukwelashwa kwakho, kuvame ukuba ngcono ukuxhumana nodokotela ohlanganisayo. Laba ngodokotela abaqeqeshwe ngokukhethekile kuyo yomibili imishanguzo yendabuko kanye nokuhambisana. Ukugxila kwabo kusendleleni yokwelashwa komzimba. Ungathola ongoti bezempilo abahlanganayo abafanelekayo lapha: http://integrativemedicine.arizona.edu/alumni.html