Ukuthi yini i-Hemolytic Uremic Syndrome? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Hemolytic uremic syndrome (HUS) iyisimo esinzima esithinta igazi lakho nezinso zakho. Kwenzeka lapho imithambo emincane yegazi ezinzweni zakho yonakele futhi ibe buhlungu, okuholela ezinkingeni zokugqwala kwegazi nokusebenza kwezinso.

Cabanga nge-HUS njengendlela umzimba wakho ophawula ngayo ukutheleleka okuthile noma izinto ezibangela ukuba amaseli egazi abomvu aphule ngokushesha kakhulu. Uma lokhu kwenzeka, izingcezu zamaseli aphukile zingagcwala imithambo emincane yegazi ezinzweni zakho, okwenza kube nzima ukuba zihlole udoti egazini lakho kahle.

Ziyini izimpawu ze-Hemolytic Uremic Syndrome?

Izimpawu ze-HUS zivame ukuqala ngokuzumayo futhi zingazizwa zinzima kakhulu. Leli simo livame ukuthuthuka ngemuva kwalokho okubonakala njengokuhlupheka okubi kokudla okungcolile noma isifo sohlangothi.

Nazi izimpawu eziyinhloko ongaziqaphela:

• Ukhukhula olukhulu olungaba negazi noma ukhukhu
• Ubuhlungu besisu nobuhlungu besisu
• Ukugabha nokuphefumula
• Ukuqabuka okuza nokubuyela
• Ukukhathala okungavamile nobuthakathaka
• Isikhumba esimhlophe, ikakhulukazi ezindlebeni nasezansi kwezinzipho
• Ukunciphisa ukumthamba noma ukungamthamba nhlobo
• Ukukhula ebusweni, ezandleni, ezinyaweni, noma ezinyaweni
• Ukukhuluphala kalula noma amabala angachazeki
• Ukudideka noma ukucasuka

Abanye abantu nabo baye bahlangabezana nezimpawu ezingavamile njengokuhlinzwa, ubunzima bokuqeda umoya, noma ukukhuluphala kwesikhumba namehlo. Lezi zimpawu zenzeka ngoba izinso zakho azisebenzi kahle futhi imikhiqizo yokulimala yakha egazini lakho.

Izimpawu zivame ukuvela ngezigaba, ziqale ngezinkinga zokugaya bese ziqhubekela ezinkingeni ezihlobene nezinso negazi ezinsukwini eziningi.

Ziyini izinhlobo ze-Hemolytic Uremic Syndrome?

Kunezinhlobo ezintathu eziyinhloko ze-HUS, nokuqonda ukuthi yiluphi uhlobo olukuyo kusiza odokotela ukuba bakhethe indlela yokwelapha engcono kakhulu.

Uhlobo oluvamile kakhulu yi-HUS evamile, ebizwa nangokuthi i-STEC-HUS. Leli fomu lithuthuka ngemuva kokutheleleka ngamabhaktheriya athile afana ne-E. coli, akhiqiza izinto ezonakalisa imithambo yegazi yakho. Cishe ama-90% amacala e-HUS kubantwana awekuleli qembu.

I-HUS engavamile ayivamile kodwa ivame ukuba nzima kakhulu. Lolu hlobo alubangelwa ukutheleleka kwamabhaktheriya kodwa kunalokho ngezinkinga zesistimu yakho yokulwa nokutheleleka yokulawula ukuvuvukala. Kungenzeka kunoma yimuphi ubudala futhi kuvame ukubaleka emindenini.

I-HUS yesibili ithuthuka njengokuphazamiseka kwezinye izimo zezokwelapha noma ukwelashwa. Lokhu kungafaka imithi ethile, izifo zokulwa nokutheleleka, noma ukuphazamiseka okuvela ezindleleni zezokwelapha njengokuhlinzwa kwamathambo.

Yini ebangela i-Hemolytic Uremic Syndrome?

I-HUS ithuthuka lapho okuthile kubangela ukonakala kwemithambo emincane yegazi ezinzweni zakho. Isisusa esivamile kakhulu ukutheleleka ngamabhaktheriya akhiqiza izinto ezithile ezibuhlungu.

Nazi izimbangela eziyinhloko ngemuva kwesigaba ngasinye:

• Amabhaktheriya e-E. coli (ikakhulukazi uhlobo lwe-O157:H7) ekudleni okungcolile noma emanzini
• Amabhaktheriya eShigella asuka ekuhlanzekeni okubi noma ekudleni okungcolile
• Ukuguqulwa kwe-genetic okuthinta ukulawulwa kokugqwala kwegazi
• Imithi ethile njengomuthi othile wokwelapha umdlavuza noma imithi yokunciphisa ukulwa nokutheleleka
• Isimo sokulwa nokutheleleka lapho isistimu yakho yokulwa nokutheleleka ihlasela izicubu eziphilile
• Ukuphazamiseka okuvela ezindleleni zezokwelapha noma ekuhlinzweni
• Ukutheleleka okungavamile kwezifo, nakuba lokhu kungavamile
• Ukuphazamiseka kokukhulelwa ezimweni ezingavamile

Nge-HUS evamile, uvame ukugula ngokudla inyama yengwe eyingcolile, imifino engageziwe, noma ukuphuza ubisi olungaphansi.

I-HUS engavamile ivame ukuba nezingxenye ze-genetic, okusho ukuthi uzuza ama-gene asekela isistimu yakho yokugqwala igazi ukuba isebenze ngokuhlukile kunokujwayelekile.

Nini okufanele ubheke udokotela nge-Hemolytic Uremic Syndrome?

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma wena noma ingane yakho inokukhukhula okukhulu okunegazi, ikakhulukazi ngemuva kokudla ukudla okungaba yingcolile. Ukuqaphela nokwelashwa kwasekuqaleni kungavimbela ukuphazamiseka okukhulu.

Shaya udokotela wakho ngokushesha uma uqaphela ukunciphisa ukumthamba, ukukhula ebusweni noma ezinyaweni, noma ukukhathala okungavamile ngemuva kokugula kwesisu. Lezi zimpawu zibonisa ukuthi izinso zakho zingase zingasebenzi kahle.

Hamba e-emergency room ngokushesha uma uhlangabezana nokudideka, ukuhlinzwa, ubunzima bokuqeda umoya, noma uma ingane iba nomdlavuza noma ivila kakhulu. Lezi zimpawu zibonisa ukuthi i-HUS ingase ibe yithinta ezinye izitho ngaphandle kwezinso.

Ungalindi ukubona uma izimpawu ziphucuka zodwa. I-HUS ingathuthuka ngokushesha, futhi ukunakekelwa kwezokwelapha okusheshayo kuphucuka kakhulu imiphumela.

Ziyini izinto ezingase zikhulise ingozi ye-Hemolytic Uremic Syndrome?

Izinto ezithile zingandisa amathuba akho okukhula kwe-HUS. Ukuqonda lezi zinto ezingase zikhulise ingozi kungakusiza ukuba uthathe izinyathelo zokuvikela futhi uqaphele izimpawu kwasekuqaleni.

Ubudala buqala indima ebalulekile engcupheni ye-HUS:

• Abantwana abaneminyaka engaphansi kwengu-5 banengozi enkulu
• Abantu abadala abadala abangaphezu kweminyaka engu-65 nabo bayathinteka kakhulu
• Abantu abadala abanesistimu yokulwa nokutheleleka ebuthakathaka babhekene nengozi enkulu
• Abantu abanesifo sezinso esingapheli bayathinteka kakhulu
• Labo abasebenzisa imithi ethile ethinta ukusebenza kwesistimu yokulwa nokutheleleka
• Abantu abane-family history ye-HUS engavamile
• Abantu abane-genetic mutations ethinta ukugqwala kwegazi
• Labo abake baba nokuhlinzwa kwezitho

Izinto ezingokwemvelo nezokuphila nazo ziyabaluleka. Ukuphila ezindaweni ezingenakuhlambalaza, ukudla inyama yengwe engaphekwe kahle, noma ukuphuza ubisi olungaphansi kukhuphula ukubonakala kwakho kumabhaktheriya abulalayo.

Kuthiwa kanjalo, noma ubani angathuthukisa i-HUS uma ehlangana nezinto ezifanele, kungakhathaliseki ubudala noma isimo sempilo.

Ziyini izinkinga ezingase zenzeke nge-Hemolytic Uremic Syndrome?

I-HUS ingathinta izitho eziningi emzimbeni wakho, okuholela ezinkingeni zesikhathi esifushane nangesikhathi eside. Ubunzima buxhomeke ekutheni uthole ukwelashwa ngokushesha kangakanani nokuthi umzimba wakho uphendula kanjani.

Izinkinga eziyingozi kakhulu eziqala ngokushesha zifaka:

• Ukuntuleka kokusebenza kwezinso okudinga i-dialysis
• I-anemia enkulu evela kumaseli egazi abomvu abonakele
• Ukuwa okubi kwenani le-platelet okuholela ekopha
• Uxinzelelo lwegazi oluphakeme oluyinkimbinkimbi ukulawula
• Ukuhlinzwa noma isifo sobuchopho ngenxa yokuthinteka kobuchopho
• Izinkinga zenhliziyo kufaka phakathi izindlela ezingavamile
• Ukugcwala kwamanzi emaphashini okwenza kube nzima ukuqeda umoya
• Ukungahambelani okukhulu kwama-electrolyte okuthinta ukusebenza kwenhliziyo nobuchopho

Izinkinga zesikhathi eside zingathuthuka ngisho nangemuva kokuba isigaba esibuhlungu siphelile. Abanye abantu bahlangabezana nesifo sezinso esingapheli esithuthuka kancane eminyakeni eminingi. Abanye bangase bathuthukise uxinzelelo lwegazi oluphakeme oludinga imithi eqhubekayo.

Ukuphazamiseka kobuchopho njengokunzima kokufunda noma izinkinga zokukhumbula kungenzeka, ikakhulukazi kubantwana. Noma kunjalo, ngokwelashwa okufanele, abantu abaningi bayaphila ngokuphelele ngaphandle kwemiphumela ehlala njalo.

Ungavimbela kanjani i-Hemolytic Uremic Syndrome?

Unganciphisa kakhulu ingozi yakho yokukhula kwe-HUS evamile ngokusebenzisa imikhuba emihle yokuphepha kokudla nokwenhlanzeko. Amacala amaningi angavikeleka ngezinyathelo ezifanele.

Ukuphepha kokudla yilona lokhu okuqala lokuvikela. Pheka inyama yengwe okungenani ku-160°F (71°C) futhi gwema ukudla inyama eluhlaza noma engaphekwe kahle. Geza zonke izithelo nemifino ngokucophelela, ngisho noma uhlela ukuziqothula.

Nazi izindlela eziyinhloko zokuvikela:

• Gwema imikhiqizo yobisi engaphansi namajusi
• Geza izandla zakho njalo, ikakhulukazi ngemuva kokusebenzisa igumbi lokugezela
• Ungalumi amanzi uma ugeza emachibini, ezihlahleni, noma emifuleni
• Hlambulula izindawo zokupheka nezinto zokupheka ngemuva kokulungiselela inyama eluhlaza
• Gcina ukudla okonakala ngokushesha efrijini
• Gwema ukungcolisana phakathi kokudla okuluhlaza nokuphekwe
• Qaphela kakhulu ezihlahleni zezilwane nasemapulazini lapho izilwane zikhona khona
• Phuza amanzi aphathwe noma amanzi abotshwe uma uhamba

Nge-HUS engavamile, ukuvimbela kunzima kakhulu ngoba ivame ukuba nezingxenye ze-genetic. Noma kunjalo, ukugwema izinto ezibangelayo ezaziwayo njengomuthi othile nokulawula izimo zempilo ezihlala njalo kungasiza ekuqedeni ingozi.

I-Hemolytic Uremic Syndrome ihlonishwa kanjani?

Ukuhlola i-HUS kuhilela ukuhlolwa kwegazi okuningi futhi ngezinye izikhathi izifundo ezengeziwe ukuqinisekisa isimo nokubona ubunzima balo. Udokotela wakho uzoqala ngokubuza ngezimpawu zakho zakamuva nanoma yikuphi ukubonakala okungenzeka kokudla okungcolile noma amanzi.

Ukuhlolwa okuyinhloko kokuxilonga kufaka ukubalwa kwegazi okuphelele ukuhlola i-anemia kanye nenani eliphansi le-platelet. Udokotela wakho uzo-oda futhi ukuhlolwa ukuze alinganise ukuthi izinso zakho zisebenza kahle kangakanani futhi abuke izimpawu zokubhujiswa kwamaseli egazi abomvu.

Ukuhlolwa okuthile udokotela wakho angakukhetha kufaka:

• Ukuhlolwa kwegazi ukuze uhlole inani lamaseli egazi abomvu nesisindo
• Inani le-platelet ukuze uhlole ikhono lokugqwala igazi
• Ukuhlolwa kokusebenza kwezinso kufaka i-creatinine ne-blood urea nitrogen
• Ukuhlolwa kwamathumba ukuze ubuke igazi neprotheni
• Amakhambi e-stool ukuze ubone ukutheleleka kwamabhaktheriya
• Ukuhlolwa kwezinto ezithile ezibuhlungu zamabhaktheriya
• Ukuhlolwa kwe-genetic kwe-HUS engavamile uma kubonakala kuyadingeka
• Ukuhlolwa kwe-complement ukuze uhlole ukusebenza kwesistimu yokulwa nokutheleleka

Udokotela wakho angase futhi akukhuthaze izifundo zokuthwebula izithombe njengokuhlolwa kwe-ultrasound kwezinso zakho ukuze ahlole noma yiziphi izinkinga zesakhiwo. Ezimweni ezithile, ukuhlolwa okuqhubekayo kusiza ekuqondeni ukuthi une-HUS evamile noma engavamile, okuthinta izinqumo zokwelapha.

Ukuphathwa kwe-Hemolytic Uremic Syndrome kuyini?

Ukuphathwa kwe-HUS kugxile ekusekeleni umzimba wakho ngenkathi uphila futhi kulawula ukuphazamiseka. Ayikho indlela yokwelapha ethile, kodwa ukunakekelwa kwezokwelapha okufanele kungakusiza ukuba uphulukiswe ngokushesha futhi uvikele izinkinga ezinzima.

Ukuphathwa okuyinhloko kufaka ukuqapha ngokucophelela ukusebenza kwezinso zakho namanani egazi. Ungase udinga i-dialysis uma izinso zakho ziyeka ukusebenza kahle, kodwa lokhu kuvame ukuba okwesikhashana ngenkathi izinso zakho ziphulukana.

Izindlela zokwelapha ezivamile zifaka:

• Amanzi e-IV ukuze ugcine uketshezi nokujwayelekile kwama-electrolyte
• Ukugeleza kwegazi uma i-anemia iba nzima kakhulu
• Ukugeleza kwe-platelet uma ukuphuza kuba yinkinga
• Imithi ukuze ulawule uxinzelelo lwegazi oluphakeme
• I-dialysis ukususa imikhiqizo yokulimala uma izinso zihluleka
• I-plasma exchange therapy ye-HUS engavamile
• Ukusekelwa kokudla nokuguqulwa kokudla
• Imithi ukuze uvikele ukuhlinzwa uma kuyadingeka

Nge-HUS engavamile, udokotela wakho angase anikeze imithi ebizwa nge-eculizumab, esiza ukulawula isenzo sesistimu yokulwa nokutheleleka esonakalisa imithambo yegazi. Lokhu ukwelashwa kuye kwathuthukisa kakhulu imiphumela yabantu abaneli fomu le-HUS.

Abantu abaningi abane-HUS evamile bayaphila ngokuphelele ezinsukwini ezimbalwa ngokunakekelwa okusekela, nakuba abanye bangase badinge ukuqapha okuqhubekayo kokusebenza kwezinso.

Indlela yokuphatha ukunakekelwa ekhaya ngesikhathi sokuphulukana ne-Hemolytic Uremic Syndrome?

Ukunakekelwa ekhaya ngesikhathi sokuphulukana ne-HUS kugxile ekusekeleni inqubo yokwelapha yomzimba wakho nokuvimbela ukuphazamiseka. Udokotela wakho uzonikeza imiyalo ethile ngokususelwa esimweni sakho nezidingo zokwelapha.

Ukuphumula kubalulekile ngesikhathi sokuphulukana. Umzimba wakho usebenza kanzima ukuze uphulukise imithambo yegazi eyonakele futhi ubuyisele ukusebenza okujwayelekile kwezinso, ngakho-ke gwema imisebenzi enzima kuze kube yilapho udokotela wakho ekukhulula.

Landela lezi zinkombandlela zokunakekelwa ekhaya:

• Thatha yonke imithi ngokuqondile njengoba kulotshiwe
• Qapha ukungena nokuphuma kwamanzi njengoba kuqondiswe
• Landela noma yikuphi ukunciphisa kokudla, ikakhulukazi ngokuqondene neprotheni nesawoti
• Hlola uxinzelelo lwakho lwegazi njalo uma une-monitor ekhaya
• Bheka izimpawu zokuphazamiseka njengokukhuluphala noma ukunciphisa ukumthamba
• Hamba kuyo yonke imiqhudelwano yokulandelela
• Gcina idayari yezimpawu ukuze wabelane neqembu lakho lezokwelapha
• Hlala uthambile kodwa ungagcini uma unezinkinga zezinso

Uzodinga ukuhlolwa kwegazi okujwayelekile ukuze uqaphele inqubo yakho yokwelapha. Ungadangali uma ukuthuthuka kubonakala kuhamba kancane – ukuphulukana kwezinso kuthatha isikhathi, futhi abantu abaningi ekugcineni babuyela ekusebenzeni okujwayelekile.

Kufanele ulungiselele kanjani ukubheka udokotela wakho?

Ukulungiselela ukuvakashela udokotela wakho kusiza ukuqinisekisa ukuthi uthola ukunakekelwa okuphelele ngangokunokwenzeka. Letha isikhathi esiningi sezimo zakho nanoma yikuphi ukubonakala kwamuva okungase kube yiyona.

Bhala phansi ukuthi izimpawu zakho zaqala nini nokuthi ziye zathuthuka kanjani. Faka imininingwane mayelana nanoma yikuphi ukuhamba kwamuva, ukudla okungavamile okuye wakudla, noma ukuxhumana nezilwane noma imithombo yamanzi engcolile.

Letha lolu lwazi emhlanganweni wakho:

• Uhlu oluphelele lwemithi yamanje nezinhlanganisela
• Isikhathi sezimo ngezinsuku nobunzima
• Umbiko wokudla kwamuva, ikakhulukazi emasontweni amabili adlule
• Noma yikuphi umlando womndeni wesifo sezinso noma izifo zegazi
• Amarekhodi ezempilo adlule uma ubona udokotela omusha
• Ulwazi loku-inshorensi nokubona
• Uhlu lwemibuzo ofuna ukuyibuza
• Ulwazi loxhumano lwamalungu omndeni angakusiza ngokunakekelwa

Cabanga ngokuletha ilungu lomndeni noma umngani ukuze akusize ukukhumbula ulwazi olukhulu futhi unikeze ukwesekwa ngesikhathi sokuvakasha. Bangakwazi futhi ukukusekela izidingo zakho uma uzizwa ungaphili kahle.

Iyini into ebalulekile mayelana ne-Hemolytic Uremic Syndrome?

I-HUS iyisimo esinzima kodwa esivame ukwelashwa esithinta igazi lakho nezinso zakho. Nakuba kungaba yinto eyenzeka ukubona noma ukubuka umuntu omthandayo ehamba ngayo, abantu abaningi bayaphila ngokuphelele ngokunakekelwa kwezokwelapha okufanele.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuqaphela nokwelashwa kwasekuqaleni kwenza umehluko omkhulu kwimiphumela. Unganqikazi ukufuna ukunakekelwa kwezokwelapha uma uthuthukisa ukukhukhula okukhulu okunegazi, ikakhulukazi ngemuva kokudla ukudla okungaba yingcolile.

Ukuvikela kuhlala kuyisivikelo sakho esihle kakhulu e-HUS evamile. Sebenzisa ukuphepha kokudla okuhle, geza izandla zakho njalo, futhi qaphela imithombo yokudla, ikakhulukazi uma uhamba noma udle ngaphandle.

Ngokuthuthuka kokwelashwa, ikakhulukazi kwe-HUS engavamile, ukubuka kuqhubeka kuthuthuka. Hlala unolwazi, landela izincomo zedokotela wakho, futhi unganqikazi ukubuza imibuzo mayelana nokunakekelwa kwakho.

Imibuzo evamile ebuzwa mayelana ne-Hemolytic Uremic Syndrome

Ingabe abantu abadala bangathola i-HUS, noma ingathinta kuphela abantwana?

Abantu abadala ngokuqinisekile bangathola i-HUS, nakuba ivame kakhulu kubantwana abancinyane. Abantu abadala abangaphezu kweminyaka engu-65 banengozi enkulu, futhi labo abanesistimu yokulwa nokutheleleka ebuthakathaka nabo bayathinteka kakhulu. Amacala abantu abadala avame ukuba nezimbangela ezihlukile kunamacala e-HUS ebuntwaneni, ngezinye izikhathi ezihlobene nemithi noma ezinye izimo zezokwelapha kunokudla okungcolile.

Ingabe i-HUS iyadluliseka?

I-HUS ngokwayo ayidluliseki, kodwa ukutheleleka kwamabhaktheriya okubangela i-HUS evamile kungadluliselwa komunye umuntu. Amabhaktheriya e-E. coli angadluliselwa ngokudla okungcolile, amanzi, noma ukuxhumana ngqo nabantu abathelelekile. Sebenzisa ukuhlanzeka okuhle, ikakhulukazi ukugeza izandla, ukuvimbela ukusabalala kokutheleleka okubangelayo.

Kuthatha isikhathi esingakanani ukuphulukana ne-HUS?

Isikhathi sokuphulukana sihluka kuye ngobunzima nohlobo lwe-HUS. Abantu abaningi abane-HUS evamile baqala ukuzizwa bephulukile phakathi kwamasonto angu-1-2, nakuba ukuphulukana okuphelele kwezinso kungathatha amasonto amaningana kuya ezinyangeni. Abanye abantu badinga ukuqapha okuqhubekayo izinyanga noma iminyaka ukuqinisekisa ukuthi izinso zabo ziqhubeka zisebenza kahle.

Ingabe ngizodinga i-dialysis uma ngine-HUS?

Akuwona wonke umuntu one-HUS odinga i-dialysis. Cishe ama-50-60% abantu abane-HUS enkulu badinga i-dialysis yesikhashana ukuze basize izinso zabo ngenkathi ziphulukana. Izindaba ezinhle ukuthi abantu abaningi abadinga i-dialysis ekugcineni bangayekisa uma ukusebenza kwezinso zabo kuphucuka. Udokotela wakho uzoqapha ukusebenza kwezinso zakho ngokucophelela ukuze aqonde ukuthi i-dialysis iyadingeka yini.

Ingabe i-HUS ingenzeka ngaphezu kwesikhathi esisodwa?

I-HUS evamile ebangelwa ukutheleleka kwamabhaktheriya ayibuyi. Noma kunjalo, i-HUS engavamile ingabuya, ikakhulukazi uma unezinto ezingase zikhulise ingozi noma izinto ezibangelayo eziqhubekayo. Abantu abane-HUS engavamile bavame ukudinga ukwelashwa okwesikhathi eside ukuvimbela ukubuya. Udokotela wakho uzoxoxa ngezinto zakho ezithile ezingase zikhulise ingozi futhi enze uhlelo lokuqapha olusekelwe ekuhlolweni kwakho kwe-HUS.