Ingqwalasela yeCandelo loPhezulu lwe-Thrombocythemia ebalulekileyo
I-Thrombocythemia ye-Essential (ET) yinye yeqela leengxaki zegazi ezibizwa ngokuba yi-myeloproliferative neoplasms. Ezinye iintlobo ze-neoplasms ze-myeloproliferative ziquka i- myelofibrosis ephambili kunye ne- polycythemia vera .
Utshintsho lwe-Genetic kwi-thrombocythemia ebalulekileyo lukhokelela kwizibalo eziphezulu kakhulu (iprombocytosis). Abantu abaninzi abanalo iimpawu ngexesha lokuxilongwa kwaye baya kuba nexesha eliqhelekileyo lokuphila.
Iingxaki zibandakanya ukwakheka kwe-clot (okukhokelela ekubetheni, ukuhlaselwa intliziyo, i-clot emapapu, okanye i-thrombosis enzulu), ukuphuhliswa kwe- myelofibrosis , okanye utshintsho kwi-leukemia ye-myeloid (AML). Enye ingxaki engaqhelekanga ye-thrombocythemia ebalulekileyo kukuphuhliswa kwe- von Willebrand Disease , i-bleeding disorder.
Uninzi lwabantu luya kufuna unyango ngexesha elithile ukukhusela iingxaki. Nangona kunjalo, ukuhlala kwexesha eliqhelekileyo akuqhelekanga.
Izinyango Zonyango
Ukuba ufumanisa ukuba unentsholongwane ebalulekileyo ye-thrombocythemia umbuzo olandelayo wendalo, "ziphi iindlela zam unyango?" Kukho iindlela ezininzi ogqirha wakho anokuthetha ngazo. Unyango lwakho ugqirha luncomeka lusekelwe kwiziganeko eziliqela: iimpawu zakho, iminyaka yakho, kunye neempawu zakho zelabhoratri. Uninzi lwabantu luya kwiminyaka emininzi ngaphandle kokufuna unyango, oluvakalayo ukuba luqaliswe ukuba uvelise i-clot.
- I-Aspirin: I-aspirin yansuku zonke i-aspirin iyasetyenziswa ukuphatha abantu abaneempawu ze-vasomotor. Izimpawu ze-Vasomotor ziquka intloko, isisu, intlungu yesifuba, ukutshiswa kwezandla kunye neenyawo kunye nokutshintsha okubonakalayo. Akuqhelekanga ukuba unyango lwe-aspirin lusetyenziswe namanye amachiza. I-high dose yonyango lwe-aspirin inxulumene nomngcipheko wokukhupha igazi kwaye ayikhuthazwa.
- I-Hydroxyurea: I-agent ye-chemotherapy e-hydroxyurea yomlomo iyanciphisa umngcipheko we-thrombosis kwi-thromobcytosis ebalulekileyo ngokunciphisa inani leplatelet. I-Hydroxyurea iqaliswa kwiqondo eliphantsi kwaye liye lakhula kwaze kwaba yilapho isibalo seplatelet sisondele (i-100,000 - 400,000 iseli nganye nge-microliter). I-Hydroxyurea ivame ukunyamezeleka kakuhle ngaphandle kwemiphumo emibi. Imiphumo emibi ibandakanya ukuhluthwa (ukuthunjwa) kwesikhumba, utshintsho lwesikhonkwane (ngokuqhelekileyo imigca emnyama phantsi kwepiki), ukugqithisa kwesikhumba, kunye nezilonda zomlomo. I-Hydroxyurea iyanciphisa inani le-white cell (ngokukodwa inani le-neutrophil) kunye ne-hemoglobin efuna ukuvavanya okufutshane kunye neengxelo zegazi ezipheleleyo (CBC).
- I-Anagrelide: I- Anagrelide yonyango lomlomo elinciphisa inani leplatelet ngokumvimbela ukuveliswa kweeplatelet kwintolongo yethambo. Ngokuqhelekileyo kusetyenziswa xa i-hydroxyurea ingasebenzi. Efana ne-hydroxyurea, i-anagrelide iqalwa kwiqondo eliphantsi kwaye linyuka de kube yimpembelelo efunwayo. Iziphumo ezichaphazelekayo zibandakanya intloko, iipilpitations (ixabiso lentliziyo elikhawulezayo), ukugcinwa kwamanzi kunye nesifo sohudo. Ezi ziphumo zempembelelo zixazulula ngokuqhubekayo unyango.
- I-interferon ye-Alpha: I-interferon ye- Alpha ingasetyenziselwa ukulawula inani leplatelet kwi-thrombocythemia ebalulekileyo, i-polycythemia vera kunye ne-myelofibrosis ephambili. Inokunciphisa ubukhulu bepen. I-interferon ye-Alpha ilawulwa ngaphantsi (ngaphantsi kwesikhumba) imihla ngemihla. I-interferon ye-Alpha ifumaneka kwifom yexesha elide elibizwa ngokuba yi-interferon ye-pegylated enganikwa kanye ngeveki. I-interferon yonyango igcinwa kubasetyhini abakhulelweyo okanye abantu abangaphenduliyo kunyango lwe-hydroxyurea.
- I-Plateletpheresis: I- Plateletpheresis yinkqubo eshenxisa iiplatelet ukusasazwa. Igazi lisuswe nge-intravenous (IV) catheter kwaye liqokelelwe kumatshini apho iiplatelet zihlukaniswa kwezinye iindawo zegazi (iiseli zegazi ezimhlophe, iiseli zegazi ezimnyama kunye ne-plasma). Igazi, unciphise iiplatelet, ibuyiselwa emzimbeni nge-IV okanye isisombululo saline okanye iplasma. I-Plateletpheresis igcinelwe abantu abanomlinganiselo ophezulu kakhulu weplatelet, i-clot form formation (kumaphaphu, ubuchopho), okanye ukuphuma. Impembelelo yeplletletpheresis yesikhashana kwaye olunye unyango luya kufuneka luqaliswe ukulawula ixesha elide le-platelet count.
Zonke iindlela zokwelapha ezixutyushwa apha ngasentla aziphilisa i-thrombocythemia ebalulekileyo. Bayeke ukunciphisa inani leplatelet ngaloo ndlela banciphisa umngcipheko wokuphuhlisa i-clot okanye isifo se-von Willebrand. Ngeli xesha, akukho lonyango olukhuselweyo lwe-thrombocythemia ebalulekileyo. Ngethamsanqa, nangona kunqongophala kolunye unyango, uninzi lwabantu abane-thrombocythemia ebalulekileyo lunokuphila ubomi obugcwele ubomi.
Imithombo:
I-Teferri A. I-Prognosis kunye noTyango lwe-Essential Thrombocythemia. Ku: U-UpToDate, i-Post TW (Ed), UpToDate, i-Waltham, MA. (Kufumaneka ngoJuni 15, 2016)