Ityhefu Epidermal Necrolysis: yintoni, iimpawu kunye nendlela yokwenziwa kwonyango

Umxholo

• Iimpawu ze-NET
• Izizathu eziphambili
• Unyango lwenziwa njani
• Uxilongo lwenziwa njani

Inkqubo ye-epidermal necrolysis, okanye i-NET, sisifo esinqabileyo sesikhumba esibonakaliswa bubukho bezilonda kuwo wonke umzimba ezinokukhokelela ekuxobeni ngokusisigxina kwesikhumba. Esi sifo sibangelwa kukusetyenziswa kwamayeza afana neAllopurinol kunye neCarbamazepine, kodwa inokuba sisiphumo sosulelo lwebhaktiriya okanye lweentsholongwane, umzekelo.

I-NET ibuhlungu kwaye inokubulala ukuya kuthi ga kwiipesenti ezingama-30 zamatyala, kwangoko zakuqala iimpawu zokuqala, kubalulekile ukuba uqhagamshelane nodokotela wesikhumba ukuze uxilongo luqinisekiswe kwaye kuqalwe unyango.

Unyango lwenziwa kwiCandelo loKhathalelo oluKhulu kwaye lwenziwa ikakhulu ngokunqunyanyiswa kwamayeza abangela isifo. Ukongeza, ngenxa yokuvezwa kolusu kunye ne-mucosa, kuthathwa amanyathelo othintelo ukunqanda ukosuleleka esibhedlele, okunokuthi ngakumbi kuthintele imeko yesigulana.

Iimpawu ze-NET

Olona phawu luphawu lwe-epidermal necrolysis enetyhefu ngumonakalo wolusu ngaphezulu kwe-30% yomzimba enokuphapha kwaye ikhuphe ulwelo, ikhetha ukuphelelwa ngamanzi emzimbeni kunye nosulelo.

Iimpawu eziphambili ziyafana nomkhuhlane, umzekelo:

• Malaise;
• Umkhuhlane ophezulu;
• Khohlela;
• Imisipha kunye nentlungu edibeneyo.

Ezi mpawu, nangona kunjalo, ziyanyamalala emva kweentsuku ezingama-2-3 kwaye zilandelwa:

• Irhashalala, enopha kwaye ibuhlungu;
• Iindawo ze-Necrosis ezijikeleze izilonda;
• Ukuxobuka kolusu;
• Ukutshaya;
• Utshintsho kwinkqubo yokwetyisa ngenxa yobukho bezilonda kwi-mucosa;
• Ukuvela kwezilonda emlonyeni, emqaleni nasemngxunyeni, ngaphantsi;
• Ukudumba kwamehlo.

Izilonda ezivela kwi-epidermal necrolysis enetyhefu zenzeka phantse kuwo wonke umzimba, ngokungafaniyo neStevens-Johnson Syndrome, ethi ngaphandle kokubonakala kwezonyango, isifo kunye nonyango, izilonda zigxile esiqwini, ebusweni nasesifubeni. Funda ngakumbi malunga neStevens-Johnson Syndrome.

Izizathu eziphambili

I-epidermal necrolysis enetyhefu ikakhulu ibangelwa ngamayeza, anje nge-Allopurinol, Sulfonamide, anticonvulsants okanye antiepileptics, ezinje ngeCarbamazepine, iPhenytoin kunye nePhenobarbital, umzekelo. Ukongeza, abantu abanezifo ezizimela komzimba, ezinje ngeSystemic Lupus Erythematosus, okanye amajoni omzimba abuthathaka, anjengoGawulayo, kunokwenzeka ukuba abe nezilonda kulusu.

Ukongeza kokubangelwa ngamayeza, izilonda zesikhumba zingenzeka ngenxa yosulelo lweentsholongwane, ifungi, iprotozoa okanye ibacteria kunye nobukho bamathumba. Esi sifo sinokuchaphazeleka kukwaluphala kunye nemfuza.

Unyango lwenziwa njani

Unyango lwe-epidermal necrolysis enetyhefu lwenziwa kwiCandelo loKhathalelo oluCokisekileyo lokutsha kwaye lubandakanya ukupheliswa kwamayeza asetyenziswa sisigulana, kuba ngesiqhelo i-NET sisiphumo sokungalunganga kumayeza athile.

Ukongeza, ukutshintshwa kotywala kunye neelectrolyte ezilahlekileyo ngenxa yezilonda zolusu ezenziweyo kwenziwa ngokujova i-serum emthanjeni. Ukhathalelo lwemihla ngemihla lokonzakala lwenziwa ngumongikazi ukunqanda ulusu okanye usulelo ngokubanzi, olunokuba lubi kakhulu kwaye lubeke engozini impilo yesigulana.

Xa izilonda zifikelela kwi-mucosa, ukondla kunokuba nzima emntwini kwaye, ke, ukutya kulawulwa ngaphakathi ngaphakathi kude kufumaneke inwebu yangaphakathi.

Ukunciphisa ukungonwabi okubangelwa zizilonda, uxinzelelo lwamanzi abandayo okanye ukusetyenziswa kweekhrim ezingathathi hlangothi nazo zinokusetyenziselwa ukukhuthaza ukufudumala kolusu. Ukongeza, ugqirha unokucebisa ukuba kusetyenziswe i-anti-allergen, i-corticosteroids okanye i-antibiotics, umzekelo, ukuba i-NET ibangelwa yi-bacteria okanye ukuba isiguli sifumene isifo ngenxa yesifo kwaye oko kunokubangela imeko yezonyango ibe mandundu .

Uxilongo lwenziwa njani

Uxilongo lwenziwa ikakhulu ngokusekwe kwiimpawu zezilonda. Akukho luvavanyo lwaselebhu olunokubonisa ukuba leliphi iyeza elijongene nesi sifo kwaye iimvavanyo zovuselelo aziboniswanga kule meko, njengoko kunokubangela ukuba esi sifo sibe mandundu. Yiyo loo nto kubalulekile ukuba umntu amxelele ugqirha ukuba ngaba unesifo okanye usebenzisa naliphi na iyeza, ukuze ugqirha akwazi ukuqinisekisa ukuba esi sifo siyachaphazeleka kwaye achonge umntu osisifo.

Ukongeza, ukuqinisekisa ukuxilongwa, ugqirha uhlala ecela i-biopsy yolusu, ukongeza kubalo olupheleleyo lwegazi, kuvavanyo lwe-microbiological lwegazi, umchamo kunye nokufihlwa kwenxeba, ukukhangela naluphi na usulelo, kunye nomthamo wezinto ezithile ezinoxanduva lomzimba impendulo.