Igazi lethu lakhiwe uketshezi olubizwa ngokuthi i-plasma, amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi nama- platelet. Amangqamuzana ethu amhlophe egazi ayingxenye yamasosha ethu omzimba futhi alwa nezifo kanye nezifo.
Sinezinhlobo ezahlukene zamangqamuzana amhlophe egazi, ngalinye linesibopho sokulwa nezinhlobo ezahlukene zezifo. Ama-neutrophils amangqamuzana amhlophe egazi esinawo kakhulu. Bangabokuqala ukubona nokulwa nezifo.
I-Neutropenia yigama lezokwelapha elisetshenziswa uma ungenawo ama-neutrophils anele - okukubeka engcupheni yokutheleleka.
Odinga ukukwazi ngama-neutrophils
Ama-neutrophils akha iningi lamangqamuzana ethu amhlophe egazi. Ingxenye engaphezudlwana kwengxenye yawo wonke amangqamuzana ethu amhlophe egazi angama-neutrophils.
Ama-neutrophils enziwa emnkantsheni wethu - ingxenye ephakathi eyisipontshi yamathambo ethu. Bachitha izinsuku ezingaba ngu-14 emnkantsheni wethu ngaphambi kokuba bangene egazini.
Angaphuma emgudwini wegazi lethu uma edinga ukulwa nokutheleleka endaweni ehlukile yomzimba wethu.
Ama-neutrophils amangqamuzana okuqala aqaphela futhi alwe namagciwane, ukutheleleka kanye nezifo.
Amagciwane, ukutheleleka kanye nezifo kukhona amagciwane. Amagciwane ayinoma yini engeyona ingxenye yethu, enamandla okusigulisa. I-pathogen ingase ibe ngelinye lamangqamuzana ethu athuthuke ngendlela eyingozi kithi, njengengqamuzana eliye laba nomdlavuza.
Amazinga e-neutrophil egazini lethu angashintshashintsha (ashintshe) usuku lonke njengoba kwenziwa amasha futhi amanye afa.
Umzimba wethu wenza ama-neutrophil angaba yizigidi eziyizinkulungwane eziyikhulu nsuku zonke! (Lokho cishe isigidi esingu-100 umzuzwana ngamunye). Kodwa ngayinye iphila amahora angu-1-8 kuphela uma ingena emgudwini wethu wegazi. Abanye bangase baphile kuze kube usuku.
Ngokungafani namanye amangqamuzana amhlophe egazi alwa namagciwane athile, ama-neutrophils awaqondile. Lokhu kusho ukuthi bangalwa nanoma iyiphi i-pathogen. Nokho, ngokwabo abakwazi ukuqeda ngaso sonke isikhathi i-pathogen.
Ama-neutrophils akhiqiza amakhemikhali abizwa ngokuthi ama-cytokines lapho belwa namagciwane. Lawa ma-cytokines athumela imiyalezo kwamanye amangqamuzana amhlophe egazi, ukuze azi ukuthi kunegciwane elidinga ukuqedwa. Amangqamuzana egazi amhlophe aklanyelwe ukulwa nalelo gciwane abe eseqala ukusebenza futhi aliqede.
Imizimba yethu ihlangana namagciwane ngaso sonke isikhathi! Ama-neutrophils ethu ayisizathu sokuthi singaguli ngaso sonke isikhathi.
Ama-neutrophils ethu yenza amasosha ethu omzimba asebenze ukuqeda i-pathogen, ngokuvamile nangaphambi kokuba bathole ithuba lokusigulisa.
Leli khasi ligxile ku-neutropenia - ama-neutrophils aphansi. Nokho, ngezinye izikhathi ungase ube namazinga aphezulu e-neutrophil ongase ube nemibuzo ngawo. Ama-neutrophils aphezulu angabangelwa yizi:
- ama-steroids (njenge-dexamethasone noma i-prednisolone)
- umuthi wokukhula (ofana ne-GCSF, filgrastim, pegfilgrastim)
- ukutheleleka
- ukuvuvukala
- izifo ezifana ne-leukemia.
Izinga lakho elivamile lama-neutrophils lincike ezintweni ezimbalwa. Lokhu kungafaka:
- iminyaka yakho (izingane, izingane, intsha, abadala, nabantu abadala asebekhulile bayoba namazinga ahlukene “avamile”).
- Ukwelashwa okutholayo - eminye imithi izobanga amazinga aphezulu, kanti eminye ingase ibangele amazinga aphansi.
- kungakhathaliseki ukuthi ulwa nesifo noma ukuvuvukala.
- imishini esetshenziswa ku-pathology nezindlela zokubika.
Yunelungelo lokucela ikhophi ephrintiwe yemiphumela yegazi lakho. Ezimweni eziningi, umbiko uzobonisa izinga lakho lama-neutrophils bese kubakaki (….) ubonise ububanzi obujwayelekile. Lokhu kuzokusiza ukuthi uthole ukuthi imiphumela yakho ijwayelekile noma cha. Kodwa-ke, uzodinga udokotela wakho ukuthi akuchazele lokhu, ngoba umbiko we-pathologist akazazi izimo zakho ngazinye. Udokotela wakho uzokwazi ukukwazisa uma amazinga ajwayelekile esimweni sakho somuntu ngamunye.
Ungase uqaphele ukuthi umphumela awuveli phakathi kwemikhawulo evamile. Lokhu kungabangela ukukhathazeka nokukhathazeka - bese kuba nokudideka lapho udokotela wakho engabonakali ekhathazekile. Kubalulekile ukukhumbula ukuthi ukuhlolwa kwegazi lakho kuyingxenye encane yephazili enkulu kakhulu ethi WENA. Udokotela wakho uzobheka ukuhlolwa kwegazi lakho kanye nalo lonke olunye ulwazi abanalo ngawe, ngaphambi kokuthatha izinqumo mayelana nokuthi ukuhlolwa kwegazi kuyinto okufanele ukhathazeke ngayo.
Cela udokotela wakho ukuthi akuchazele imiphumela yakho, ngokusekelwe ezimeni zakho zomtholampilo.
Odinga ukukwazi nge-Neutropenia
I-Neutropenia iwumphumela ovame kakhulu we-lymphoma. Imithi eminingi yokwelapha isebenza ngokuhlasela amaseli akhula ngokushesha. Khumbula ukuthi sishilo ngenhla, umzimba wethu wenza ama-neutrophils ayizigidi eziyizinkulungwane eziyi-100 nsuku zonke? Lokhu kusho ukuthi bangaphinde baqondiswe yimithi elwa ne-lymphoma.
I-Neutropenia yilapho amazinga akho e-neutrophils ephansi kakhulu. Uma une-neutropenia, ukhona i-neutropenic. Ukuba neutropenic kukubeka engcupheni eyengeziwe yokutheleleka.
Ukuba yi-neutropenic akukona nje ukubeka ukuphila engozini. Kodwa-ke, uma uthola ukutheleleka ngenkathi i-neutropenic, lezi zifo zingabeka impilo engozini ngokushesha. Udinga ukuthola usizo lwezempilo ngokushesha. Ulwazi olwengeziwe ngalokhu luqhubeka phansi ekhasini ngaphansi kwe-Febrile Neutropenia.
Kungenzeka ukuthi ube neutropenic ezinsukwini ezingu-7-14 ngemva kokuba uthole i-chemotherapy. Kodwa-ke, i-neutropenia ingenzeka nganoma yisiphi isikhathi phakathi nokwelashwa kwakho kwe-lymphoma. Uma ama-neutrophils akho ephansi kakhulu, kungase kudingeke ukuthi ukwelashwa kwakho okulandelayo kubambezeleke kuze kube yilapho efika ezingeni eliphephile. Lapho uthola ukwelashwa kwe-lymphoma, izinga eliphephile lokwelashwa lingase libe izinga eliphansi kuneleveli evamile.
I-Neutropenia ingase futhi ibe umphumela oseceleni wekwephuzile kwamanye amasosha omzimba we-monoclonal njenge-rituximab ne-obinutuzumab. Imiphumela engemihle ephuzile ingenzeka ezinyangeni noma iminyaka ngemuva kokuqeda ukwelashwa.
Uma ukwelashwa kwakho kungase kukwenze ube ne-neutropenic, i-hematologist yakho noma i-oncologist ingase ikuqale ngomuthi othile wokuvimbela. I-Prophylactic isho ukuvimbela. Lezi zinikezwa ngisho noma ungenayo isifo, ukuzama ukukuvimba ukugula kamuva.
Ezinye izinhlobo zemithi ongase uqalise ngazo zihlanganisa:
- Imithi elwa nesikhunta njenge-fluconazole noma i-posaconazole. Lokhu kuvikela noma ukwelapha izifo zokukhunta njenge-thrush, ongangena emlonyeni noma ezithweni zakho zangasese.
- Imithi elwa namagciwane efana ne-valacyclovir. Lokhu kuvimbela ukuqubuka noma ukwelapha izifo ezibangelwa amagciwane njenge-herpes simplex virus (HSV), ebangela izilonda ezibandayo emlonyeni wakho noma izilonda ezithweni zakho zangasese.
- Imithi elwa namagciwane njenge-trimethoprim. Lokhu kuvimbela izifo ezithile zamagciwane njenge-bacterial pneumonia.
- Izici zokukhula zokukhulisa amaseli akho amhlophe egazi njenge-GCSF, pegfilgrastim noma i-filgrastim ukusiza amaseli akho amhlophe egazi ukuthi alulame ngokushesha ngemva kokwelashwa ngamakhemikhali.
Ezimweni eziningi i-neutropenia ayikwazi ukuvinjelwa ngesikhathi sokwelashwa. Nokho, kukhona ongakwenza ukuze unciphise umthelela enawo kuwe.
- Thatha imithi yakho ye-prophylactic (yokuvimbela) ngendlela udokotela wakho akuyala ngayo.
- Ibanga emphakathini. Gcina amamitha angu-1 -1.5 phakathi kwakho nabanye abantu uma ungaphandle esidlangalaleni. Gqoka imaski uma ungakwazi ukuqhelelana nabantu.
- Gcina okokuhlanza izandla esikhwameni sakho noma emotweni, noma geza izandla zakho ngensipho namanzi. Hlanza izandla ngaphambi nangemuva kokudla, noma ukuthinta noma yini engcolile noma esetshenziswa abantu abaningi - njengezinqola zokuthenga, amaswishi nezibambo zeminyango nangemuva kokuya endlini yangasese noma ukushintsha inabukeni.
- Sebenzisa okokuthambisa okuhle ezandleni ezomile nasesikhunjeni ukuvikela imifantu engangenisa amagciwane emzimbeni wakho.
- Uma uyothenga, hamba ngesikhathi esithule sosuku lapho kunabantu abambalwa eduze kwakho.
- Gwema abantu uma besanda kuthola umgomo ophilayo - njengemithi eminingi yokugoma izingane kanye ne-shingles.
- Tshela abangani nomndeni ukuthi bangavakashi uma benezimpawu zokugula ezinjengokugeleza kwekhala, ukukhwehlela, imfiva, ukuqubuka noma ukuzizwa bengaphilile kahle futhi bekhathele. Cela izivakashi ukuthi zigeze izandla uma zifika.
- Gwema amathreyi kadoti wezilwane noma imfucuza. Geza noma uhlanze izandla zakho ngemva kokuthinta izilwane.
- Bamba noma yikuphi ukusikeka ngaphansi kwamanzi agobhozayo imizuzwana engu-30-60 ukuze ususe noma yimaphi amagciwane, sebenzisa isibulala-magciwane uma uhlanzekile futhi womile, bese ufaka ibhande noma enye isambatho esiyinyumba phezu kokusikwa kuze kuphole.
- Uma unomugqa omaphakathi njenge-PICC, ichweba eligxilile noma ama-HICKMANS qiniseka ukuthi noma yiziphi izigqoko zigcinwa zihlanzekile futhi zomile, futhi azisusi esikhumbeni sakho. Bika noma yibuphi ubuhlungu noma ukuphuma kumhlengikazi wakho ngokushesha. Uma ukugqoka kwakho phezu komugqa omaphakathi kuba ngcolile, noma kunganamatheli esikhumbeni sakho, bika kumhlengikazi wakho ngokushesha.
- Yidla ukudla okunempilo okucebile amaprotheni. Umzimba wakho udinga amandla engeziwe ukuze ungene esikhundleni samangqamuzana anempilo ehlanganisa ama-neutrophils, alimele noma acekelwe phansi ukwelashwa kwakho. Amaprotheni ayadingeka ukwenza la maseli.
- Geza izithelo nemifino ngaphambi kokudla noma ukupheka. Yidla kuphela ukudla okusanda kulungiswa noma lokho okuqandisiwe ngemva nje kokupheka. Shisisa kabusha ukuze ukudla kushise yonke indlela. Gwema ama-buffet nakho konke ongakudla izindawo zokudlela.
- Yidla ukudla okunamathuba amancane okudala izifo - Bheka ithebula elingezansi.
I-Neutropenic Diet | |
Ingabe Yidla | VULA |
Ubisi olunamathiselwe I-Pasteurized yoghurt Ushizi onzima U-ayisikhilimu oqinile jelly Isinkwa esisha (akukho zinhlamvu ezikhuntile) I-Cereal Ukudla okuphelele chips I-Pasta ephekiwe Amaqanda - aphekwe Inyama - iphekwe ukuze yenziwe kahle Inyama efakwe ethini Water Ikhofi esheshayo noma ephekiwe kanye netiye Izithelo nemifino esanda kugezwa. | Ubisi olungenayo i-pasteurized kanye neyogathi Ushizi othambile noshizi abanesikhunta (njenge-brie, feta, cottage, ushizi oluhlaza okwesibhakabhaka, i-cammbert) I-ayisikhilimu ethambile Amaqanda agijimayo I-egg nog noma ama-smoothies namaqanda aluhlaza Inyama engaphekiwe kahle - Inyama enegazi noma izingxenye eziluhlaza Inyama ebandayo Inyama ebhenyiwe Sushi Izinhlanzi ezingavuthiwe shellfish Izithelo ezomile Ama-buffets nama-salad bar Amasaladi awasanda kwenziwa Izinsalela I-Apple cider Ama-Probiotics namasiko aphilayo. |
Ukuphatha ukudla
- Hlamba izandla njalo ngaphambi kokudla.
- Hlamba izandla njalo ngaphambi nangemuva kokulungisa ukudla.
- Ngaso sonke isikhathi sebenzisa amabhodi okunquma ahlukene ukuze uthole inyama, izinkukhu, nenhlanzi.
- Gcina inyama eluhlaza, ukudla kwasolwandle, namaqanda kude nokudla okulungele ukudliwa. Gwema inyama eluhlaza nengaphekiwe kahle noma izinkukhu. Ungakudli ukudla okuneqanda eliluhlaza. Ungayidli inyama ebhenywayo noma inhlanzi.
- Lahla izipontshi futhi uwashe amathawula ezitsha njalo.
- Pheka ukudla kahle emazingeni okushisa afanele.
- Goqa futhi ufake efrijini okusalayo noma umise ihora elilodwa lokulungiselela ukuze ukhawulele ukukhula kwamagciwane.
- Qinisekisa ukuthi uju nobisi kufakwe i-pasteurised. Gwema ushizi ovuthiwe, oshizi oluhlaza okwesibhakabhaka noshizi othambile.
- Ungakudli ukudla osekudlule izinsuku zokuphelelwa yisikhathi.
- Ungathengi noma usebenzise ukudla emathini anamazinyo noma alimele.
- Gwema ukudla okuvela ezitolo zokudla.
Ukutheleleka kanye ne-neutropenia
Amagciwane angaqala noma yikuphi emzimbeni wakho uma une-neutropenic. Izifo ezivame kakhulu ongazithola zihlanganisa izifo ezitholakala kuwe:
- imigudu yomoya - efana ne-infuenza (Flu), umkhuhlane, inyumoniya kanye ne-COVID
- uhlelo lokugaya ukudla - njengobuthi ekudleni, noma ezinye izimbungulu ezingabangela isifo sohudo noma ukuhlanza
- izifo zesinye noma zomchamo
- imigqa emaphakathi noma amanye amanxeba.
Ukuba yi-neutropenic kusho ukuthi umzimba wakho awukwazi ukulwa nokutheleleka ngendlela obujwayele ukwenza ngayo. Izimpawu eziningi esizitholayo lapho sinokutheleleka zisuka ekuphenduleni kwamasosha omzimba ekuthelelekeni kunegciwane ngokwalo. Ungase ungazitholi zonke izimpawu zokutheleleka ngendlela obujwayele ukuthola ngayo.
Izimpawu ezijwayelekile zokutheleleka
Ukusabela okujwayelekile kwamasosha omzimba ekuthelelekeni kukhulula ama-cytokines namanye amakhemikhali kumaseli ethu omzimba kanye namagciwane acekeleke phansi. Le nqubo, kanye nokususwa kwamaseli acekeleke phansi yikho okubangela izimpawu zethu eziningi. Izimpawu ezijwayelekile zale nqubo zihlanganisa:
- ububomvu nokuvuvukala.
- ubovu – ukuphuma okujiyile okuphuzi noma okumhlophe.
- izinhlungu.
- imfiva (ukushisa okuphezulu) - Izinga lokushisa elivamile lingama-36 degrees kuya ku-37.2 degrees. Okunye ukushintshashintsha kuvamile. Kodwa uma izinga lokushisa lakho linjalo 38 degrees noma ngaphezulu, yazisa udokotela wakho noma unesi ngokushesha.
- umkhuhlane ophansi ongaphansi kwama-35.5 degrees kungabonisa futhi ukutheleleka.
- iphunga elibi.
I-neutropenia ye-febrile
I-febrile neutropenia ehambisana nokutheleleka yi-a eziphuthumayo zezokwelapha. I-Febrile neutropenia isho ukuthi une-neutropenic, futhi unezinga lokushisa elingaphezu kuka-38 degrees. Nokho, ukuba nezinga lokushisa elingaphansi kuka-35.5 degrees nakho kungabonisa ukutheleleka futhi kungaba yingozi empilweni.
Yazisa unesi noma udokotela wakho uma izinga lokushisa lingama-38 degrees noma ngaphezulu, noma uma izinga lokushisa lingaphansi kwama-36 degrees.
Nokho, akuzona zonke izimo ze-febrile neutropenia ezibangelwa izifo. Kwezinye izimo, ungase ube nomkhuhlane ongaphezu kwama-degree angu-38, ngisho noma ungenalo ukutheleleka. Uma lokhu kwenzeka ngenkathi une-neutropenic, kuzophathwa njengokungathi une-infection kuze kukhishwe ukutheleleka. Eminye imithi efana ne-chemotherapy cytarabine ingabangela ukukhuphuka kwezinga lokushisa lakho, ngisho nangaphandle kokutheleleka.
Nini ukuya ekamelweni lezimo eziphuthumayo
Njengoba kushiwo ngenhla, i-febrile neutropenia iyisimo esiphuthumayo sezokwelapha. Ungangabazi ukubiza i-ambulensi noma uthole othile ukuthi akuhambise egumbini lezimo eziphuthumayo esibhedlela esiseduze uma uye welashelwa i-lymphoma yakho futhi unanoma yiziphi izimpawu ezilandelayo:
- umkhuhlane we 38 degrees noma ngaphezulu – noma ngabe lehlile kusukela ugcine ukuhlola
- izinga lokushisa lakho liyi ngaphansi kwama-36 degrees
- izinga lokushisa lakho lishintshile ngaphezu kwe-1 degree kusukela kulokho okujwayelekile - Isibonelo - Uma izinga lokushisa lakho lijwayelekile lingu-36.2 degrees futhi manje selingama-37.3 degrees. Noma uma ivamise ukuba ngu-37.1 degrees futhi manje isingu-35.9 degrees
- ukuqina - (ukuqhaqhazela) noma amakhaza
- isiyezi noma izinguquko ekuboneni kwakho - lokhu kungase kubonise ukuthi umfutho wegazi wakho uyehla okungaba uphawu lokutheleleka
- izinguquko ekushayeni kwenhliziyo yakho, noma ukuzwa inhliziyo yakho ishaya ngaphezu kokujwayelekile
- isifo sohudo, isicanucanu noma ukuhlanza
- ukukhwehlela, ukuphelelwa umoya noma ukushaywa umoya
- noma yiziphi izimpawu zokutheleleka njengoba zibalwe ngenhla
- uzizwa ungaphathekile kahle
- ube nomuzwa wokuthi kukhona okungalungile.
Yini ongayilindela uma uya esibhedlela
Uma ushayela i-ambulensi noma ufika emnyangweni wezimo eziphuthumayo, bazise:
- Une-lymphoma (kanye ne-subtype)
- Yiziphi izindlela zokwelapha oye wazithola futhi nini
- Ungase ube neutropenic
- Unomkhuhlane
- Noma yiziphi ezinye izimpawu onazo.
Cishe uzohlolwa igazi ukuze uhlole amazinga akho e-neutrophils, kanye nesikrini se-septic.
Isikrini se-septic yigama elisetshenziselwa iqembu lokuhlola ukuhlola izifo. Lokhu kufaka ngezansi:
- Ukuhlolwa kwegazi okubizwa ngokuthi “amasiko egazi”. Lokhu cishe kuzothathwa kuwo wonke ama-lumens omugqa wakho omaphakathi uma unayo, kanye ngqo nengalo yakho ngenaliti.
- I-X-ray yesifuba.
- Isampula yomchamo.
- Isampula yendle (poo) uma unesifo sohudo.
- Ama-swabs kunoma yiziphi izilonda emzimbeni wakho noma emlonyeni wakho.
- Ama-swabs azungeze umugqa wakho omaphakathi uma kubonakala sengathi unegciwane.
- Ama-swabs okuphefumula uma unezimpawu ze-COVID, amakhaza, umkhuhlane noma inyumoniya.
Uma kusolakala ukuthi kukhona ukutheleleka, uzoqaliswa ngama-antibiotics ngisho nangaphambi kokuba kuvele imiphumela. Uzoqaliswa ngesibulala-magciwane esisebenza ngempumelelo ekwelapheni izinhlobo eziningi zezifo. Ungase ube nezinhlobo ezingaphezu koyedwa zama-antibiotic.
Uzongeniswa esibhedlela ukuze ama-antibiotics anikezwe ngomthambo (emgudwini wegazi lakho nge-cannula noma umugqa omaphakathi) ukuze asebenze ngokushesha.
Uma imiphumela ye-swabs yakho, ukuhlolwa kwegazi kanye namanye amasampula efika, udokotela wakho angase ashintshe ama-antibiotics akho. Lokhu kungenxa yokuthi uma sebesazi ukuthi yiliphi igciwane elikugulisayo, bangakhetha isibulala-magciwane esihlukile esisebenza ngempumelelo ekulweni nalelo gciwane. Kodwa-ke, kungathatha izinsuku ezimbalwa ukuthi le miphumela ingene, ngakho uzohlala kuma-antibiotic abanzi phakathi nalesi sikhathi.
Isifinyezo
- I-Neutropenia iwumphumela ovame kakhulu wokwelashwa kwe-lymphoma.
- Kungenzeka ukuthi ube neutropenic ezinsukwini ezingu-7-14 ngemva kokwelashwa ngamakhemikhali, nokho, i-neutropenia ingaba umphumela ongaseceleni wakamuva wezinye izindlela zokwelapha, eziqala izinyanga ngisho neminyaka ngemva kokwelashwa.
- Kungenzeka ukuthi uthole izifo uma une-neutropenic.
- Thatha yonke imishanguzo yakho ye-prophylactic njengoba uyaliwe, futhi uthathe izinyathelo zokugwema izifo.
- Uma une-neutropenic, gwema ukudla okungenzeka ukuthi kuthwale amagciwane.
- Ukutheleleka ngenkathi une-neutropenic kungasongela ukuphila ngokushesha.
- Uma uke welashelwa i-lymphoma, noma wazi ukuthi une-neutropenic, thola usizo lwezokwelapha ngokushesha uma unezimpawu zokutheleleka. Shayela i-ambulensi noma uye emnyangweni wezimo eziphuthumayo oseduze nawe
- Ungase ungatholi izimpawu ezivamile zokutheleleka ngenkathi i-neutropenic.
- Uma une-febrile neutropenia, uzongeniswa esibhedlela ukuze uthole ama-antibiotic emithanjeni.
- Uma ungaqiniseki, uma unemibuzo, ungangabazi ukuxhumana nabahlengikazi bethu beLymphoma Care ngoMsombuluko - NgoLwesihlanu Isikhathi Esijwayelekile SaseMpumalanga.
