Iimpawu, unyango, kunye nokujongana nePlatelet Low Low ngexesha le-Chemo
I-Thrombocytopenia (isibalo esiphantsi seplatelet egazini) esenzeka njengempembelelo ecaleni ye-chemotherapy yinto engaphantsi kwengxaki kunexesha elidlulileyo, kodwa isenokubakho nkxalabo. Yintoni omele uyayizi malunga neempawu zeplatelet ephantsi kunye nento ongayenza ukuze unciphise umngcipheko wakho kule nkcenkceshela ye- chemotherapy ?
Sibanzi
I-Thrombocytopenia ichazwa njengenani elinciphile leeplatelet egazini.
Inani elisezantsi leplatelet lingakhokelela ekuphumeni kwegazi kunye / okanye imfuneko yokulibaziseka i-chemotherapy. I-Thrombocytopenia ivame ukuchazwa njengeeplatelets ezingaphantsi kwama-150,000 nganye nge-cubic millimeter yegazi, nangona ukuphuma kwamanzi okuqhelekileyo akufane kwenzeke de nqanaba elingaphantsi kwe-20,000 okanye ye-10,000. Oku kuthetha, kubalulekile ukwazi ukuba akukho buhlobo obucacileyo phakathi kweplatelet level kunye nokuthambekela kokuphuma kwegazi. Ukuba unayo nayiphi na impawu efana nokwehla okanye ukutyumla, kubalulekile ukuvumela ugqirha wakho ukuba azi, kungakhathaliseki ukuba ungakanani inani leplatelet yakho.
Ukuxilongwa
Ugqirha wakho uya kulawula inani elipheleleyo legazi (CBC) ngaphambi nangemva kwe-chemotherapy ukuze ubone ukuba unesilinganiselo esiphantsi seplatelet. Inani eliqhelekileyo leplatelet (isibalo se-thrombocytes) ngokuqhelekileyo lichazwe njengama-platelet ayi-150,000 ukuya kuma-400,000 nganye ngeyubhijimitha yegazi. Inqanaba elingaphantsi kwe-150,000 lithathwa njengelingaqhelekanga, okanye i-thrombocytopenia.
Ininzi yexesha iiplatelets ezingaphezulu kwama-50,000 ayihambelani naziphi na iingxaki ezinkulu.
Kwinqanaba elingu-10 ukuya kwi-20,000 ngamanye amaxesha lingahle lenze igazi, kodwa amaninzi amaninzi anokuhlahlela ukuya kuma-10 000 okanye ngaphantsi ngaphambi kokubangelwa ukuphuma kwamanzi.
Ngokuqhelekileyo, amanqanaba angaphantsi kwama-10 aqhele ukuphathwa (amaninzi ahlala kunye ne-platelet transfusion) kodwa amanqanaba angaphantsi kwe-20,000 nawo angaphathwa, ngakumbi xa ehambelana nomkhuhlane.
Kulabo abahamba nge-chemotherapy, amazinga angama-50 000 ukuya kwi-100,000 angabangela ukulibaziseka kwe-chemotherapy. Kubalulekile ukuba uqaphele ukuba wonke umntu uhlukile, kwaye inani elifanayo kubantu ababini abahlukeneyo linokukhathaza enye kunye nokukhathazeka kancinane kwenye.
Iiplatesti egazini zihlala malunga neentsuku ezili-8 ukuya kwi-10 kwaye zizaliswa ngokukhawuleza.
Iingxaki Ngexesha Lokunyanga Kwemhlaza
Isizathu esivangekileyo sesifo se-thrombocytopenia kubantu abanomhlaza ngumnxeba wokunciphisa umongo we- chemotherapy. (Jonga ezinye izimbangela ezingezansi.) I-Chemotherapy ibhubhisa iiseli ngokukhawuleza, ezafana neentlanga zamathambo eziba iplatelet. Ukongezelela kwi-thrombocytopenia, ukunyuswa komnatha we-bone kwi-chemotherapy kungabangela inani elibomvu lamathambo egazi (i- chemotherapy-induced anemia ) kunye neqondo eliphantsi lohlobo lwegazi elimhlophe elibizwa ngokuba yi-neutrophils (i-neutrophils -induced neutropenia ) ekhusela ukusuleleka kwiibhaktheriya .
Uninzi lwamachiza e-chemotherapy aluchaphazeli amanqanaba eeplatelet ukuya kwizinga elibalulekileyo ngokwaneleyo lokufuna unyango, kodwa ezinye iziyobisi zingaphezu kwamanye ukunciphisa inani. Iziyobisi eziqhelekileyo ezinxulumene ne-thrombocytopenia ziquka:
- Izidakamizwa ezisekelwe kwiPlatinum ezifana neParaplatin (carboplatin) nePlatinol (cisplatin)
- Gemzar (gemcitabine)
- I-Taxol (paclitaxel)
I-Thrombocytopenia enxulumene nekhemotherapy idla ingxaki yesikhashana. Amanqanaba ePlatelet aqala ukuhlalisa ngeveki emva kweseshoni ye-chemotherapy kwaye afinyelele kwisigaba esiphantsi (i-nadir) malunga neentsuku ezili-14 emva kwe-infusion. Amanqanaba abuyela kwizinto eziqhelekileyo kwiintsuku ezingama-28 ukuya kwezi-35 zilandelayo kodwa zingathatha iintsuku ezingama-60 ukufikelela kumazinga angaphambi kokunyanga.
Ezinye izizathu zeThrombocytopenia kubantu abaneCarcer / Diagnosis ezahlukeneyo
Kukho ezinye izizathu ezininzi zokuba iiplatelet zibalo zingaphantsi kubantu abanomdlavuza. Ukongezelela ekunciphiseni komnatha wethambo njengoko kuphawuliwe ngasentla, oku kungabandakanya:
- I-immune thrombocytopenia (i-ITP) - I-immune thrombocytopenia iyenzeka xa umzimba wakho wenza iziza-antibodies malunga neeplatelets zakho. Oku kuqheleke kakhulu kumagciwane anesifo seHodgkin kunye ne-lymphocytic leukemia
- Izifo, ikakhulukazi izifo zentsholongwane
- Amanye amayeza anokubangela iiplatelets eziphantsi ezifana ne-anticomotic vancomycin, kunye neyeza-anti-virus
- Ukuqhaqhazela kwandwendwela kwintolongo yethambo (ngokuqhelekileyo i-lymphomas, umdlavuza webele, umhlaza wamaphaphu)
- I-microangiopathy ye-thrombotic (imeko apho iiselingi zangaphakathi zeetayiti zegazi zonakaliswe ngamanye amaxesha zenziwa ngamachiza e-chemotherapy njenge-Mitomycin C kunye ne-gemcitabine.)
Iimpawu
Izibonakaliso onokuzifumana nge-thrombocytopenia ziquka:
- Ukululaza
- Ukutyhila - Ukusuka ekhaleni lakho, umlomo wakho (ngokukodwa ngokuxubha,) umxube (ukunyuka kwamnyama okanye igazi), okanye isisu (ukuhlanza igazi okanye izinto ezibonakalayo ngekhofi)
- I-Petechiae - Iibala ezibomvu kwesikhumba (eziqhelekileyo kwimilenze ephantsi), ezingaguquki ezimhlophe xa ucinezela ngeminwe yakho
- I-Ecchymosis - Izilwanyana ezinobomvu obomvu ngokubanzi (izibhamu) kwesikhumba sakho
- Kubasetyhini, amaxesha anzima ngaphezu kwesigqirha
- Intlungu ehlangeneyo kunye neentlungu
- Ubuthathaka
- Intloko
Unyango / ukukhusela
Kubalulekile ukuba uqale uqonde imbangela ye-thrombocytopenia yakho njengoko kunokubakho izizathu ezahlukileyo zezinga lakho leplatelet eliphantsi eziphathekayo ngeendlela ezahlukeneyo. Ngokomzekelo, ukuba kuhlobene neziyobisi ze-chemotherapy, unyango lunokubandakanya ukulibaziseka i-chemotherapy, kanti xa lihambelana nezizathu zokuzivikela kumzimba, i-steroids inokuba yinxalenye yonyango olucetywayo.
Ngokuxhomekeke kwinqanaba leeplatelets zakho, nokuba ngaba unayo nayiphi na impawu, ugqirha wakho unokuncoma unyango ukuphakamisa inani lakho leplatelet. Khetha ziquka:
- Ukuxilongwa kwePlatelet - Ukuponyelwa kwePlatelet yindlela eqhelekileyo yokuphatha i-thrombocytopenia, ingakumbi i-thrombocytopenia yexeshana elifutshane kunye neyeza-chemotherapy. Ukutshintshiswa kunokusetyenziswa njengonyango (ukwandisa amaplatelet kulabo abaphuma ngegazi) okanye ukuthintela (kulabo abanomlinganiselo ophantsi okanye olindelekileyo weplatelet kodwa abangapheliyo). Umphumo oqhelekileyo wesiganeko ngumkhuhlane wesikhashana. Imiphumo emibi echaphazelekayo ingabandakanya ukuphendulwa kwegazi okanye ukutshatyalaliswa kwezifo ezifana ne-hepatitis.
- Ukulahla i-chemotherapy - Ukuyeka i-chemotherapy, okanye ukuguqula umthamo ngamanye amaxesha kunokuba kuyimfuneko.
- Amachiza anokukhuthaza ukubunjwa kwamaplatelet - ngamanye amaxesha asetyenziswa ukukhuthaza umongo wethambo ukwenza iiplatelet ezingaphezulu. Umphumo oqhelekileyo wesigxina ukugcinwa komzimba (ukuvuvukala).
- Izilingo zezonyango - Izilingo zonyango ziyaqhubeka, zijonga ezinye iindlela zokunciphisa ingozi ye-thrombocytopenia ngexesha le-chemotherapy.
Ukujamelana
Ukongeza kwiphina unyango olukhuthazwa ngugqirha wakho, ukuba usengozini ye-thrombocytopenia zama:
- Gwema i-aspirin kunye neyeza-anti-inflammatory medication ezifana ne-ibuprofen kunye ne-naproxen. Buza ugqirha wakho malunga nayiphi na i-counter-counter-counter or medal you take, kuba ezinye zazo ziyakwandisa ukuphuma kwegazi.
- Gwema utywala njengoko oku kunokwandisa umngcipheko wegazi.
- Sebenzisa i-brush yozinyo. Uninzi lwe-oncologists uncoma ukuba ugweme ukusebenzisa i-dental floss kwakhona, kodwa oku kungakabonakaliswa ukunceda.
- Sebenzisa i-razor kagesi ukuze ugweme ukusika.
- Vula impumlo yakho ngobumnene.
- Zama ukuba ungagqithwa, kwaye ukuba wenza ntoni, thintela ukuxhatshaza okanye ukusebenzisa i-suppositories. Ezinye iilwimi zentlungu, kunye neenguqu zokutya, zingabangela ukutyikitya, kwaye ugqirha wakho unokuncoma isilathisi okanye isinye imithi kuwe ngexesha le-chemotherapy ukukhusela oku.
- Gwema iimeko apho unokulimala okanye uzilimaze ngokwakho. Thatha ngononophelo xa usebenzisa i-scissors, ngelixa upheka, kwaye usebenzisa izixhobo. Gwema imidlalo yokuthintana.
Ngexesha lokuya kubiza ugqirha
Umele uvumele ugqirha wakho ukuba wazi ukuba uphila naziphi na iimpawu ze-thrombocytopenia. Mfonele ngokukhawuleza ukuba unayo igazi ongenakukwazi ukumisa, intloko entsha yentloko, umbono omnyama okanye ubuthathaka.
> Imithombo:
> Estcourt, L., Stanworth, S., Doree, C., Hopewell, S., Trivella, M., noM M. Murphy. Ukuthelekiswa kwee-Different Platelet Count Countresholds ku-Ulawulo loLawulo lweProphylactic Platelet Transfusion ekukhuseleni ukuhlanjululwa kubantu abaneengxaki ze-Haematological emva kwe-Myelosuppressive Chemotherapy okanye Ukutshintshwa kweeStem Cell. I-Cochrane Database yeeNkqubo eziPhezulu . 2015. 18 (11): CD010983.
> Kuter, D. Ukulawula i-Thrombocytopenia edibene neCarcer Chemotherapy. I-Oncology (Williston Park) . 2015. 29 (4): 282-94.
> Liebman, H. Thrombocytopenia kwizigulane zeCancer. Uphando lwezoThutho . 2014. 133 Isondlo 2: S63-9.