Sjs

I-Stevens-Johnson syndrome (SJS) yisifo esingavamile, esinzima sesikhumba nemicu ye-mucous membranes. Ngokuvamile liyisici sokwelashwa ngemithi okuqala ngezimpawu ezifana ne-influenza, okulandela ukukhishwa okubuhlungu okusakazwayo futhi kube namabhabhu. Ngemuva kwalokho, ingxenye engaphezulu yesikhumba esithintekile iyafa, iwa bese iqala ukulapha ngemva kwezinsuku ezimbalwa.

I-Stevens-Johnson syndrome yiphuthuma lokudingeka ukwelashwa ngokwezokwelapha okuvamile kudinga ukungena esibhedlela. Ukwelashwa kugxile ekususeni imbangela, ukunakekela amanxeba, ukulawula ubuhlungu nokunciphisa izinkinga njengoba isikhumba siphulukana. Kungathatha amasonto kuya ezinyangeni ukuphulukana.

Uhlobo olukhulu lalesi simo lubizwa ngokuthi i-toxic epidermal necrolysis (TEN). Ihilela ngaphezu kwe-30% yendawo yesikhumba kanye nokonakala okukhulu kwemicro ye-mucous membranes.

Uma isimo sakho sabangelwa yimithi, kuzodingeka ugweme leyo mithi nabanye abafana nayo unomphela.

Izinsuku ezingu-1 kuya kwezintathu ngaphambi kokuba kuvele isihlungu, ungase ubonise izimpawu zokuqala ze-Stevens-Johnson syndrome, ezihlanganisa:\n\n* Ukuvuvukala\n* Umlomo nohlangothi oluhlungayo\n* Ukukhathala\n* Amehlo ashisa\n\Njengoba isimo sikhula, ezinye izimpawu nezimpawu zihlanganisa:\n\n* Ubuhlungu besikhumba obusabalalayo obungachazwanga\n* Isihlungu esibomvu noma esimnyama esisabalayo\n* Amabhabhu esikhumbeni nakwimicu yomlomo, impumulo, amehlo nezitho zangasese\n* Ukulahleka kwesikhumba ezinsukwini ezimbalwa ngemuva kokuba amabhabhu ephumelele

I-Stevens-Johnson syndrome idinga ukunakekelwa kwangaphambi komkhuba ngokushesha. Funani ukunakekelwa kwangaphambi komkhuba uma uhlangabezana nezimpawu zalesi simo. Ukusebenza kwemithi kungase kwenzeke ngesikhathi sokusebenzisa imithi noma kuze kube amasonto amabili ngemva kokuyekisa ukusebenzisa imithi.

I-Stevens-Johnson syndrome yisifo esingavamile nesingenakubikezelwa. Umhlinzeki wakho wezempilo angase angakwazi ukuqonda imbangela yaso eqondile, kodwa ngokuvamile le simo sibangelwa yimithi, ukutheleleka noma kokubili. Ungase ube nokuqina komuthi ngesikhathi usisebenzisa noma kuze kube amasonto amabili ngemva kokuba uye wayeka ukuwusebenzisa.

Imithi engabangela i-Stevens-Johnson syndrome ihlanganisa:

• Imithi yokwelapha isifo se-gout, efana ne-allopurinol
• Imithi yokwelapha ukuhlushwa yi-seizures nokuhlupheka kwengqondo (i-anticonvulsants ne-antipsychotics)
• I-antibacterial sulfonamides (kuhlanganise ne-sulfasalazine)
• I-Nevirapine (Viramune, Viramune XR)
• Imithi yokunciphisa ubuhlungu, efana ne-acetaminophen (Tylenol, nabanye), i-ibuprofen (Advil, Motrin IB, nabanye) ne-naproxen sodium (Aleve)

Ukutheleleka okungabangela i-Stevens-Johnson syndrome kuhlanganisa i-pneumonia ne-HIV.

Izici ezandisa ingozi yakho yokuthuthukisa i-Stevens-Johnson syndrome zihlanganisa:

• Ukutheleleka yi-HIV. Phakathi kwabantu abane-HIV, izinga le-Stevens-Johnson syndrome lingaphezulu kakhulu kaningi ngokuqhathaniswa nabantu abavamile.
• Isimo sokuqina komzimba esibuthakathaka. Isimo sokuqina komzimba singathinteka yisifuba somzimba, i-HIV / AIDS nezifo zokuziphatha komzimba.
• Umgwala. Abantu abane-kansa, ikakhulukazi i-kansa legazi, banengozi enkulu yokuthola i-Stevens-Johnson syndrome.
• Umlando we-Stevens-Johnson syndrome. Uma uke waba nale meko ehlobene nemithi, usengozini yokubuyela uma usebenzisa leyo mithi futhi.
• Umlando womndeni we-Stevens-Johnson syndrome. Uma ilungu lomndeni oluseduze liye laba ne-Stevens-Johnson syndrome, ungase ube sengozini enkulu yokuyithola nawe.
• Izici ze-genetic. Ukuba nezinguquko ezithile ze-genetic kukubeka engozini enkulu ye-Stevens-Johnson syndrome, ikakhulukazi uma uthatha imithi yokubamba, i-gout noma ukugula kwengqondo.

Izinkinga zeStevens-Johnson syndrome zihlanganisa:

• Ukuphelelwa amanzi emzimbeni. Izindawo lapho isikhumba siqothuke khona zilahlekelwa amanzi. Futhi amanxeba emlonyeni nasehlombe angenza kube nzima ukungena kwamanzi, okubangela ukuphelelwa amanzi emzimbeni.
• Ukutheleleka kwegazi (sepsis). I-sepsis kwenzeka lapho ibhaktheriya evela ekuthelelekeni ingena egazini futhi isakazeka kulo lonke umzimba. I-sepsis iyimo eliqhubeka ngokushesha, eliyingozi elikwazi ukubangela ukushayisana nokungasebenzi kahle kwamalungu.
• Izinkinga zamehlo. Ukukhishwa okubangelwa yiStevens-Johnson syndrome kungabangela ukuvuvukala kwamehlo, ukumomotheka kwamehlo nokuzwela ekukhanyeni. Emacaleni aqatha, kungabangela ukuphambuka kobono, futhi, ngokungavamile, ubuthakathaka bobono.
• Ukuhileleka kwamaphaphu. Lesi simo singabangela isimo esiphuthumayo lapho amaphaphu engazuzi oksijini olukhulu egazini (ukwehluleka kokuphefumula okukhulu).
• Ukonakala okungapheli kwesikhumba. Lapho isikhumba sakho sikhuphuka emva kweStevens-Johnson syndrome, singaba namabhontshisi nokumelana okungavamile (ukungahambisani kombala). Futhi ungaba namabala. Izinkinga zesikhumba ezihlala njalo zingabangela ukuba ukuwa kwezinwele zakho, futhi iinzipho zakho nezinzipho zezinyawo zingase zingakhula kahle njengoba zazenza ngaphambili.

• Cabanga ngokuhlola kwezakhi zofuzo ngaphambi kokuthatha amanye amakhambi. I-U.S. Food and Drug Administration incoma ukuhlolwa kwabantu base-Asia nabaseNingizimu Asia ngeguquko lofuzo olubizwa ngokuthi HLA-B*1502 ngaphambi kokuqala ukwelashwa. * Uma uke waba nalesi simo, gwema umuthi owadala sona. Uma uke waba ne-Stevens-Johnson syndrome futhi umphathi wakho wezempilo ekutshele ukuthi kwadala umuthi, gwema lowo muthi kanye namanye afana nawo. Lokhu kubalulekile ekuvimbeleni ukuphindeka, okuvame ukuba nzima kakhulu kunokokuqala futhi kungabulala. Izihlobo zakho ezingomzimba zingahle zifune ukugwema lo muthi ngoba kwesinye isikhathi lesi simo sihamba emindenini.

Izivivinyo nezinqubo ezisetshenziswa ekutholakala kwe-Stevens-Johnson syndrome zihlanganisa:

• Ukuhlaziywa komlando wakho wezokwelapha nokuhlolwa komzimba. Abanikezeli bezempilo bavame ukukwazi ukubona i-Stevens-Johnson syndrome ngokusekelwe emlandweni wakho wezokwelapha, kuhlanganise nokuhlaziywa kwemithi yakho yangoku neyakuyeka kusanda, nokuhlolwa komzimba.
• I-biopsy yesikhumba. Ukuqinisekisa ukuxilongwa, nokukhipha ezinye izimbangela ezingaba khona, umhlinzeki wakho wezempilo ukhumula isampula yesikhumba ukuze kuhlolwe elabhoratri (i-biopsy).
• Ukukhulisela. Ukuqeda ukutheleleka, umhlinzeki wakho wezempilo uthatha isampula yesikhumba, ithishu noma i-fluid ukuze kuhlolwe elabhoratri (ukukhulisela).
• Izithombe. Kuye ngezimpawu zakho, umhlinzeki wakho wezempilo angase akwenze ukuthi wenze isithombe njenge-X-ray yesifuba ukuze ahlole i-pneumonia.
• Izivivinyo zegazi. Lezi zisetshenziswa ukuqinisekisa ukutheleleka noma ezinye izimbangela ezingaba khona.

Ukuphatha i-Stevens-Johnson syndrome kudinga ukungena esibhedlela, mhlawumbe kwindawo yokunakekelwa okukhulu noma kwindawo yokwelapha ukushisa.

Isinyathelo sokuqala nesibaluleke kakhulu ekwelapheni i-Stevens-Johnson syndrome kukuyeka ukuthatha noma iyiphi imithi engase ibe yimbangela yayo. Uma uthatha imithi engaphezu kwemithi enye, kungase kube nzima ukwazi ukuthi iyiphi imithi ebangela inkinga. Ngakho-ke, umhlinzeki wakho wezempilo angase akucela ukuba uyeke ukuthatha yonke imithi engekho okubalulekile.

Ukukhathalela okusekayo okuzoliswa esibhedlela kuhlanganisa:

Imithi esetshenziswa ekwelapheni i-Stevens-Johnson syndrome ihlanganisa:

Uma imbangela yokuqala ye-Stevens-Johnson syndrome ingasuswa futhi ukusabela kwesikhumba kuphelile, isikhumba esisha singaqala ukukhula ezinsukwini ezimbalwa. Kumacala abunzima, ukuphulukiswa okugcwele kungathatha izinyanga eziningi.

• Ukufakwa kwamanzi nokudla. Ngenxa yokulahleka kwesikhumba kungabangela ukulahleka okukhulu kwamanzi emzimbeni wakho, ukufaka amanzi kuyisigaba esibalulekile sokwelapha. Ungase uthole amanzi nezondlo ngompompi ofakwe ekhaleni futhi uqondiswe esiswini (umpompi we-nasogastric).

• Ukukhathalela izilonda. Ukucindezela okubandayo, okunemanzi kungasiza ekuthambiseni amabhisita ngesikhathi ephulukana. Iqembu lakho lokukhathalela impilo lingase lisuse isikhumba esifile ngobumnene futhi lifake ijeli yepetroliyam (i-Vaseline) noma i-dressing enomuthi ezindaweni ezibuhlungu.

• Ukukhathalela amehlo. Ungase futhi udinga ukunakekelwa ochwepheshe wamehlo (ophthalmologist).

• Imithi yokunciphisa ubuhlungu ukunciphisa ukungakhululeki.

• Imithi yokunciphisa ukuvuvukala kwamehlo ne-mucous membranes (ama-steroids aphezulu).

• Ama-antibiotics ukulawula ukutheleleka, uma kudingeka.

• Eminye imithi yomlomo noma eyenziwe ngokuqondile (isystemic), njenge-corticosteroids ne-intravenous immune globulin. Izifundo zibonisa ukuthi imithi i-cyclosporine (i-Neoral, i-Sandimmune) ne-etanercept (i-Enbrel) ziwusizo ekwelapheni lesi sifo.

Uma uke waba neStevens-Johnson syndrome, qiniseka ukuthi:

• Yazi ukuthi yini ebangelwe ukusabela kwakho. Uma isimo sakho sabangelwa yi-medication, funda igama layo kanye nezinye ezifana nayo. Zigweme.
• Tshela abahlinzeki bakho bezempilo. Tshela bonke abahlinzeki bakho bezempilo ukuthi unomlando weStevens-Johnson syndrome. Uma ukusabela kwabangelwa yi-medication, batshele ukuthi iyiphi.
• Gqoka ibhulukwe noma i-necklace yolwazi lwezokwelapha. Yenza ulwazi mayelana nesimo sakho nokuthi yini eyabangela lube lolu lwazi olulotshwe ebhlukweni noma e-necklace yolwazi lwezokwelapha. Lugqoke njalo.