Ropa redu rinoumbwa nemvura inonzi plasma, masero matsvuku eropa, masero machena eropa uye maplatelet. Masero edu machena eropa chikamu chegadziriro yedu yekudzivirira zvirwere uye anorwisa utachiona nezvirwere.
Tine marudzi akasiyana emasero machena eropa, rimwe nerimwe rine basa rekurwisa marudzi akasiyana ezvirwere. Neutrophils ndiwo masero machena eropa atinawo akawanda. Ndivo vekutanga kuziva nekurwisa zvirwere.
Neutropenia izwi rezvokurapa rinoshandiswa kana usina ma<em>neutrophils akakwana – zvinokuisa panjodzi yekutapukirwa.
Zvamunoda kuziva nezve neutrophils
Neutrophils inoumba ruzhinji rwemasero machena eropa. Inopfuura zvishoma hafu yemasero edu machena eropa maneutrophils.
Neutrophils inogadzirwa mumwongo wedu - iyo spongey yepakati chikamu chemapfupa edu. Vanopedza anenge mazuva 14 mumwongo wedu vasati vabudiswa muropa redu.
Vanogona kubva muropa redu kana vachida kurwisa utachiona mune imwe nhengo yemuviri wedu.
Neutrophils ndiwo masero ekutanga anoziva nekurwisa utachiona, utachiona uye zvirwere.
Majemusi, utachiona uye zvirwere zviri utachiona. Utachiona chero chinhu chisiri chikamu chedu, chine mukana wekutirwarisa. Utachiona hunogonawo kuva rimwe remasero edu pachedu akakura nenzira inotikuvadza, sesero rava kenza.
Neutrophil mazinga muropa redu anogona kuchinja (kuchinja) zuva rose sezvo zvitsva zvinogadzirwa uye vamwe vanofa.
Muviri wedu unogadzira ma<em>neutrophils anenge mabhiriyoni zana zuva rega rega! (Ndiyo inenge miriyoni imwe sekondi yega yega). Asi imwe neimwe inongorarama kwemaawa 100-1 kana yangopinda muropa redu. Vamwe vanogona kurarama kusvika zuva rimwe chete.
Kusiyana nemamwe masero machena eropa anorwisa utachiona hwakasiyana, neutrophils haina-yakananga. Izvi zvinoreva kuti vanogona kurwisa chero pathogen. Zvisinei, ivo pachavo havagoni kubvisa pathogen nguva dzose.
Neutrophils inobereka makemikari anonzi cytokines pavanorwisa utachiona. Aya ma cytokines anotumira meseji kune mamwe masero machena eropa, kuti vazive kuti kune hosha inoda kubviswa. Masero machena eropa akagadzirirwa kurwisa chirwere ichocho anobva apinda mukuita uye ochibvisa.
Miviri yedu inosangana nehutachiona nguva dzese! Maneutrophils edu ndiwo anoita kuti tisarware nguva dzese.
Neutrophils yedu ita kuti immune system yedu ishande kubvisa pathogen, kazhinji kunyange vasati vawana mukana wekutiita kuti tirware.
Peji ino iri kutarisa nezve neutropenia - low neutrophils leves. Nekudaro, iwe dzimwe nguva unogona kunge uine akakwira neutrophil mazinga aungave uine mibvunzo nezvawo. High neutrophils inogona kukonzerwa ne:
- steroids (yakadai sedexamethasone kana prednisolone)
- kukura chinhu mushonga (zvakadai seGCSF, filgrastim, pegfilgrastim)
- chirwere
- kuzvimba
- zvirwere zvakadai leukemia.
Yako yakajairika mwero yeutrophils inotsamira pane akati wandei. Izvi zvinogona kusanganisira:
- zera rako (vacheche, vana, pwere, vanhu vakuru, uye vakura vachange vaine mwero “wenguva dzose” wakasiyana).
- marapirwo auri kuita - mimwe mishonga inokonzeresa mwero wepamusoro, uye mimwe inogona kukonzera kudzikira.
- zvisinei kuti uri kurwisa utachiona kana kuzvimba.
- midziyo inoshandiswa mune pathology uye nzira dzekubika.
Yune kodzero yekukumbira kopi yakadhindwa yezvabuda muropa rako. Kazhinji, rondedzero icharatidza nhanho yako yemaneutrophils uyezve mumabhuraketi (….) kuratidza zvakajairika. Izvi zvinokubatsira kuona kana zvawawana zviri normal kana kuti kwete. Nekudaro, iwe unozoda chiremba wako kuti akutsanangurire izvi, nekuti iyo pathologist yekuzivisa haizive mamiriro ako ega. Chiremba wako achakwanisa kukuzivisa iwe kana mazinga ari akajairika kune yako wega mamiriro.
Iwe unogona kuona kuti chigumisiro hachioneki mukati memiganhu yakajairika. Izvi zvinogona kukonzera kushushikana uye kunetseka - uyezve kuvhiringa kana chiremba wako asingaite seane kunetseka. Zvakakosha kuyeuka kuti ongororo yeropa rako inongova chidimbu chimwe chete chepuzzle hombe chinova IWE. Chiremba wako anotarisa kuongororwa kweropa rako pamwe chete nerumwe ruzivo rwese rwavanarwo pamusoro pako, asati aita sarudzo pamusoro pekuti kuongororwa kweropa chinhu chekunetseka nezvazvo.
Kumbira chiremba wako kuti atsanangure zvaunenge wawana newe, zvichienderana nemamiriro ako ekiriniki.
Chii chaunoda kuziva nezveNeutropenia
Neutropenia ndiyo yakajairika mhedzisiro yekurapa lymphoma. Mishonga mizhinji inoshanda nekurwisa maseru anokura nekukurumidza. Rangarira isu tataura pamusoro, muviri wedu unogadzira 100 bhiriyoni neutrophils zuva rega rega? Izvi zvinoreva kuti vanogonawo kunangwa nemishonga inorwisa lymphoma.
Neutropenia ndeye apo mazinga ako neutrophils akaderera zvakanyanya. Kana uine neutropenia, uri neutropenic. Kuve neutropenic kunoisa iwe panjodzi yakawedzera yehutachiona.
Kuve neutropenic hakusi iko kutyisidzira hupenyu. Nekudaro, kana ukawana hutachiona uchiri neutropenic, hutachiona uhu hunogona kukurumidza kuve hunotyisa hupenyu. Unofanira kuwana rubatsiro rwekuchipatara nekukasika. Ruzivo rwakawanda pane izvi rwuri kuwedzera pasi peji pasi peFebrile Neutropenia.
Iwe unogona kunge uine neutropenic mazuva 7-14 mushure mekunge waita chemotherapy. Zvisinei, neutropenia inogona kuitika chero nguva panguva yekurapa kwako lymphoma. Kana neutrophils yako yakadzikira, ungangoda kuti kurapwa kwako kunotevera kunonoke kusvika vasvika padanho rakachengeteka. Paunenge uchirapa lymphoma, mwero wakachengeteka wekurapa unogona kunge uchiri mwero wakaderera pane wenguva dzose.
Neutropenia inogona zvakare kunonoka mhedzisiro yemamwe ma monoclonal antibodies akadai se rituximab uye obinutuzumab. Kunonoka mhedzisiro inogona kuitika mwedzi kana makore mushure mekupedza kurapwa.
Kana kurapwa kwako kungangoita kuti uve neutropenic, wako haematologist kana oncologist anogona kutanga iwe pamumwe mushonga weprophylactic. Prophylactic zvinoreva kudzivirira. Izvi zvinopihwa kunyangwe usina hutachiona, kuedza nekukumisa kurwara gare gare.
Mamwe marudzi emishonga aungatangirwe anosanganisira:
- Anti-fungal mushonga wakadai sefluconazole kana posaconazole. Izvi zvinodzivirira kana kubata hosha dzefungal senge thrush, dzaunogona kupinda mumuromo mako kana kunhengo.
- Anti-viral mushonga wakadai seValacyclovir. Izvi zvinodzivirira kupisa kana kurapa hutachiona hwehutachiona hwakadai seherpes simplex virus (HSV), izvo zvinokonzeresa maronda anotonhora pamuromo wako kana maronda panhengo yako yesikarudzi.
- Anti-bacterial mishonga yakadai se trimethoprim. Izvi zvinodzivirira zvimwe zvirwere zvebhakitiriya zvakadai sebhakitiriya pneumonia.
- Zvinhu zvinokura zvekuwedzera masero machena eropa seGCSF, pegfilgrastim kana filgrastim kubatsira masero machena eropa kupora nekukurumidza mushure mechemotherapy.
Ini zviitiko zvakawanda neutropenia haigone kudzivirirwa panguva yekurapa. Zvisinei, pane zvimwe zvaungaita kuti uderedze kukanganisa kwazvinoita pauri.
- Tora mishonga yako yeprophylactic (yekudzivirira) nenzira iyo chiremba wako anokurayira iwe.
- Kugarisana kure. Chengetedza 1 -1.5 metres pakati pako nevamwe vanhu kana uri paruzhinji. Pfeka mask kana iwe usingakwanise kushamwaridzana kure.
- Chengeta sanitiser yemaoko mubhegi rako kana mota, kana kugeza maoko ako nesipo nemvura. Geza maoko usati wadya uye wapedza kudya, kana kubata chero chinhu chine tsvina kana kushandiswa nevanhu vakawanda – zvakadai sematrolley ekutengera zvinhu, ma switch emwenje nezvibatiso zvemadhoo uye mushure mekuenda kuchimbuzi kana kuchinja napukeni.
- Shandisa yakanaka moisturizer pamaoko akaoma uye ganda kudzivirira kutsemuka kunogona kupinza utachiona mumuviri wako.
- Kana iwe uchienda kunotenga, enda panguva yakanyarara yezuva apo kune vanhu vashoma vari pedyo.
- Dzivisa vanhu kana vachangobva kuwana jekiseni mhenyu - semijekiseni yakawanda yevacheche uye yekudzivirira shingles.
- Udza shamwari nemhuri kuti vasashanyire kana vaine chero zviratidzo zvehurwere zvakaita semhuno inomhanya, kukosora, fivha, mapundu kana kuti kazhinji vasinganzwe zvakanaka uye kuneta. Kumbira vashanyi kuti vageze maoko avo pavanosvika.
- Dzivisa marara emhuka kana marara. Geza kana kuchenesa maoko ako mushure mekubata mhuka.
- Bata chero kucheka pasi pemvura inoyerera kwemasekonzi 30-60 kubvisa chero utachiona, shandisa mushonga unouraya kana wakachena uye wakaoma, uye isa bhandi rekubatsira kana imwe yekupfeka isina hutachiona pamusoro pecheka kusvika apora.
- Kana uine mutsara wepakati sePICC, Yakasimwa chiteshi kana HICKMANS ita shuwa kuti chero mapfekero anochengetwa akachena uye akaoma, uye usasimudze kubva paganda rako. Taura chero kurwadziwa kana kubuda kune mukoti wako nekukurumidza. Kana kupfeka kwako pamusoro pemutsara wepakati kukasviba, kana kusanamatira paganda rako, taurira mukoti wako nekukurumidza.
- Idya chikafu chine mapuroteni ane hutano. Muviri wako unoda simba rakawedzerwa kutsiva masero ane hutano anosanganisira neutrophils, akakuvadzwa kana kuparadzwa nekurapwa kwako. Mapuroteni anodiwa kugadzira masero aya.
- Geza michero nemuriwo usati wadya kana kubika. Idya zvichangobva kugadzirwa zvekudya kana zviya zvakaomeswa mushure mekubika. Dzorerazve kuti chikafu chipise kwese. Dzivisa buffets uye zvese zvaunogona kudya maresitorendi.
- Idya zvokudya zvine mukana wakaderera wekukonzera utachiona - Ona tafura iri pasi apa.
Neutropenic Diet | |
Do Eat | DZIDZA |
Pasteurized Mukaka Pasteurized yoghurt Cheki zvakaoma Aizikirimu yakaoma mondo Chingwa chitsva (hapana moldy bits) Cereal Whole grains Chips Yakabikwa Pasta Mazai - akabikwa Nyama - yakabikwa zvakanaka Nyama dzakabikwa Mvura Instant kana yakabikwa kofi uye tii Michero nemiriwo zvichangobva kugezwa. | Unpasteurized mukaka uye yoghurt Chizi dzakapfava nemachizi ane mold (senge brie, feta, cottage, blue cheese, camembert) Aizikirimu yakapfava Runny mazai Egg nog kana smoothies ine mazai mbishi Nyama isina kubikwa - Nyama ine ropa kana zvikamu mbishi Nyama inotonhora Nyama dzekuputa Sushi Hove mbishi dzemugungwa Michero yakaomeswa Buffets uye saladi mabara Salads haisati yagadzirwa Zvasara Apple cider Probiotics uye kurarama tsika. |
Kubata chikafu
- Nguva dzose geza maoko zvakakwana usati wadya.
- Nguva dzose geza maoko usati wagadzira chikafu uye wapedza.
- Nguva dzose shandisa mapuranga akaparadzana enyama, huku, nehove.
- Chengetedza nyama mbishi, hove dzegungwa, uye mazai kure nezvokudya zvakagadzirirwa kudyiwa. Dzivisa nyama mbishi uye isina kuibva kana huku. Usadye chikafu chine zai mbishi mukati. Usadya nyama inopfungaira kana hove.
- Rasa masiponji uye wacha matauro endiro nguva dzose.
- Nyatsobika zvokudya patembiricha yakafanira.
- Putira uye uise mufiriji zvakasara kana kuomesa mukati meawa imwe yekugadzirira kuderedza kukura kwebhakitiriya.
- Iva nechokwadi chekuti huchi nemukaka zvakaiswa pasteurised. Dzivisa mold yakaibva cheeses, blue cheese uye soft cheeses.
- Usadye chikafu chakapfuura mazuva ekupera.
- Usatenga kana kushandisa zvekudya mumagaba ane mazino kana akakuvadzwa.
- Dzivisa chikafu kubva kune deli-counters.
Utachiona uye neutropenia
Utachiona hunogona kutanga chero kupi zvako mumuviri wako kana uine neutropenic. Zvirwere zvinowanzoitika zvaunogona kuwana zvinosanganisira kutapukira mukati mako:
- nzira dzemhepo - senge infuenza (Flu), dzihwa, mabayo uye COVID
- digestive system - senge chepfu yechikafu, kana zvimwe zvipembenene zvinogona kukonzera manyoka kana kurutsa
- dundira kana weti zvirwere
- mitsetse yepakati kana mamwe maronda.
Kuve neutropenic zvinoreva kuti muviri wako haugone kurwisa hutachiona sezvawaiwanzoita. Zvizhinji zvezviratidzo zvatinowana kana tine hutachiwana zvinobva mukupindura kwezvirwere kune utachiona kwete kutapukira pachayo. Iwe unogona kusawana zviratidzo zvese zvakafanana zvehutachiona sezvawaiwanzoita.
Kazhinji zviratidzo zvehutachiona
Yakajairika immune immune kuhutachiona inoburitsa ma cytokines nemamwe makemikari kubva mumasero edu ekudzivirira uye hutachiona hwakaparadzwa. Iyi nzira, pamwe nekubviswa kwemasero akaparadzwa ndizvo zvinokonzera zviratidzo zvedu zvakawanda. Zvakajairika zviratidzo zvemuitiro uyu zvinosanganisira:
- kutsvuka uye kuzvimba.
- ura - kubuda kweyero kana kuchena kwakakora.
- kurwadziwa.
- fivha (tembiricha yakakwira) - Tembiricha yakajairika i36 madhigirii kusvika 37.2 madhigirii. Kumwe kuchinjika kwakajairika. Asi kana tembiricha yako iri 38 madhigirii kana kupfuura, zivisa chiremba wako kana mukoti nekukurumidza.
- low fever isingasviki 35.5 degrees inogonawo kuratidza utachiona.
- kunhuwa.
Febrile neutropenia
Febrile neutropenia yakabatana nehutachiona ndeye kurapwa. Febrile neutropenia zvinoreva kuti une neutropenic, uye une tembiricha inodarika 38 degrees. Nekudaro, kuve nekudziya kwepasi pe35.5 madhigirii kunogona kuratidzawo hutachiona uye kunogona kuve nenjodzi yehupenyu.
Rega mukoti wako kana chiremba azive kana uine tembiricha ye38 degrees kana kupfuura, kana tembiricha yako iri pasi pe36 degrees.
Zvisinei, hazvisi zvose zviitiko zvefebrile neutropenia zvinokonzerwa nehutachiona. Mune zvimwe zviitiko, unogona kuva nefivha inopfuura 38 degrees, kunyange iwe usina utachiona. Kana izvi zvikaitika iwe uri neutropenic, inobatwa sekunge une hutachiona kusvika hutachiona hwabviswa. Mimwe mishonga yakadai sechemotherapy cytarabine inogona kukonzera kukwira kwekushisa kwako, kunyangwe pasina hutachiona.
Nguva yekuenda kukamuri yekukurumidzira
Sezvataurwa pamusoro apa, febrile neutropenia injodzi yekurapa. Usazeza kufonera amburenzi kana kuwana mumwe munhu kuti akutakure kuenda kukamuri yekukurumidzira pachipatara chiri pedyo newe kana wakarapwa lymphoma yako uye uine chero chezvinotevera zviratidzo:
- fever ye 38 degrees kana kupfuura - kunyangwe kana yadzika kubva pawakapedzisira kutarisa
- tembiricha yako iri asingasviki makumi masere emadhigirii
- tembiricha yako yachinja kupfuura 1 degree kubva pane zvazvinowanzoita - Semuyenzaniso - Kana tembiricha yako iri 36.2 madhigirii uye ikozvino 37.3 madhigirii. Kana kuti kana yakajairika 37.1 madhigirii uye yava 35.9 madhigirii
- kuoma - (kubvunda) kana kupindwa nechando
- dzungu kana shanduko pakuona kwako - izvi zvinogona kuratidza kuti BP yako iri kuderera zvinova chiratidzo cheutachiona
- kuchinja mukurova kwemoyo wako, kana kunzwa mwoyo wako uchirova kupfuura nguva dzose
- manyoka, kuda kurutsa kana kurutsa
- kukosora, kutadza kufema kana kufema
- chero zviratidzo zvehutachiona sezvakanyorwa pamusoro
- kazhinji unonzwa usinganzwe zvakanaka
- iva nepfungwa yekuti pane chakaipa.
Chii chekutarisira kana waenda kuchipatara
Paunofonera amburenzi kana kusvika kudhipatimendi rekukurumidzira, vazivise:
- Iwe une lymphoma (uye iyo subtype)
- Ndeapi marapirwo awakaitwa uye rinhi
- Iwe unogona kunge uri neutropenic
- Une fivha
- Chero zvimwe zviratidzo zvaunazvo.
Iwe unogona kunge uine kuongororwa ropa kunoitwa kuti utarise mazinga ako neutrophils, uye septic skrini.
Septic screen izwi rinoshandiswa kuboka rebvunzo kutarisa utachiona. Izvi zvinosanganisira zvinotevera:
- Kuongororwa ropa kunonzi "tsika dzeropa". Izvi zvinogona kutorwa kubva kune ese malumens epakati mutsara wako kana iwe uine imwe, uye zvakare kubva paruoko rwako netsono.
- Chifuva X-Ray.
- Weti muenzaniso.
- Chituru (poo) sampuli kana uine manyoka.
- Swabs kubva kune chero maronda pamuviri wako kana mumuromo mako.
- Swabs kubva kwakatenderedza mutsara wako wepakati kana ichiita kunge ine hutachiona.
- Kufema swabs kana uine zviratidzo zveCOVID, kutonhora, furuu kana mabayo.
Kana uchifungirwa kuti une utachiona, unotangwa pamishonga inorwisa mabhakitiriya kunyange zvisati zvabuda. Muchatangwa pamushonga unorwisa mabhakitiriya unoshanda mukurapa mhando dzakawanda dzakasiyana dzezvirwere. Unogona kuva nemhando inopfuura imwe yemishonga inorwisa mabhakitiriya.
Uchapinzwa muchipatara kuitira kuti mishonga inorwisa mabhakitiriya ipiwe netsinga (muropa rako kuburikidza necannula kana mutsara wepakati) kuitira kuti ishande nekukurumidza.
Kana mhedzisiro yemaswabhu ako, kuongororwa ropa uye mamwe masampuli auya, chiremba wako anogona kushandura maantibioti ako. Izvi zvinodaro nekuti kana vangoziva kuti utachiona hurikuita kuti urware, vanogona kutora mumwe mushonga unorwisa mabhakitiriya unoshanda zvakanyanya pakurwisa utachiona ihwohwo. Zvakadaro, zvinogona kutora mazuva akati wandei kuti mhedzisiro iyi iuye, saka iwe uchagara pane yakakura-spectrum antibiotics panguva ino.
pfupiso
- Neutropenia ndiyo yakajairika mhedzisiro yekurapa lymphoma.
- Iwe unowanzo kuve neutropenic 7-14 mazuva mushure mechemotherapy zvisinei, neutropenia inogona zvakare kuve yakanonoka mhedzisiro yemamwe marapirwo, kutanga mwedzi kusvika kunyange makore mushure mekurapwa.
- Iwe unogona kuwana hutachiona kana iwe uri neutropenic.
- Tora mishonga yako yose yeprophylactic sezvaunorayirwa, uye tora matanho ekudzivirira zvirwere.
- Kana iwe uri neutropenic, dzivisa chikafu chinogona kutakura utachiona.
- Utachiona uchiri neutropenic hunogona kukurumidza kutyisa hupenyu.
- Kana wakamborapwa lymphoma, kana uchiziva kuti uri neutropenic, tsvaga rubatsiro rwekurapa nekukurumidza kana uine chero zviratidzo zvehutachiona. Fonera amburenzi kana kuenda kudhipatimendi riri pedyo newe
- Iwe haugone kuwana zvakajairika zviratidzo zvehutachiona nepo neutropenic.
- Kana uine febrile neutropenia, uchapinzwa muchipatara nokuda kwemishonga inorwisa mabhakitiriya.
- Kana iwe usina chokwadi, nezve chero mibvunzo, usazeza kubata yedu Lymphoma Care Nurses Muvhuro - Chishanu Eastern Standard Time.
