Sickle cell chirwere

Sickle cell chirwere chirwere chinopfuura nemumhuri. Masero matsvuku eropa ayo anowanzo kuve akaumbwa sedisk anotora jeko kana chimiro checrescent. Masero matsvuku eropa anotakura okisijeni mumuviri wese.

Chirwere chemasero chinokonzerwa nerudzi rwehemoglobin inonzi hemoglobin S. Hemoglobin ipuroteni iri mukati memasero matsvuku eropa anotakura oxygen.

• Hemoglobin S inoshandura masero matsvuku eropa. Masero matsvuku eropa anova asina kusimba uye akaumbwa secrescent kana mahesera.
• Masero asina kujairika anounza oxygen shoma kumatumbu emuviri.
• Vanogona zvakare kunamatira mumidziyo midiki yeropa uye kutsemuka kuita zvidimbu. Izvi zvinogona kukanganisa kuyerera kweropa kune hutano uye kucheka zvakatonyanya pahuwandu hweokisijeni inoyerera ichienda kumatumbu emuviri.

Sickle cell chirwere chakagara nhaka kubva kuvabereki vese. Kana iwe ukawana iyo jeko maseru geni kubva kumubereki mumwe chete, iwe unenge uine jeko masero maitiro. Vanhu vane jeko masero maitiro havana zviratidzo zvejeko masero chirwere.

Sickle cell chirwere chinonyanya kuwanikwa muvanhu vanobva kuAfrica neMediterranean. Inoonekwa zvakare muvanhu vanobva kuSouth neCentral America, Caribbean, uye Middle East.

Zviratidzo kazhinji hazviitike kusvika mushure memakore mana emwedzi.

Vanenge vese vanhu vane chirwere chemajeko maseru vane zvikamu zvinorwadza zvinonzi matambudziko. Izvi zvinogona kugara kubva maawa kusvika mazuva. Njodzi dzinogona kukonzera marwadzo muzasi kwezasi, gumbo, majoini, uye chipfuva.

Vamwe vanhu vane episode imwe chete makore mashoma. Vamwe vane zvikamu zvakawanda gore rega. Iwo matambudziko anogona kuve akaomarara zvakakwana kuti ade kugara muchipatara.

Kana kupererwa neropa kukanyanya, zviratidzo zvinogona kusanganisira:

• Kuneta
• Ruvara
• Kukurumidza kurova kwemoyo
• Kufema kwekufema
• Kupenya kweziso uye ganda (jaundice)

Vana vadiki vane chirwere chesero rechirwere vane kurwiswa kwekurwadziwa mudumbu.

Zviratidzo zvinotevera zvinogona kuitika nekuti tsinga diki dzeropa dzinovharwa nemasero asina kujairika:

• Inorwadza uye yakareba erection (priapism)
• Kusaona zvakanaka kana kusaona
• Matambudziko nekufunga kana kuvhiringidzika kunokonzerwa netiroko diki
• Maronda pamakumbo epasi (muvachiri kuyaruka nevakuru)

Nekufamba kwenguva, iyo spleen inomira kushanda. Nekuda kweizvozvo, vanhu vane chirwere chesero renhare vanogona kuve nezviratidzo zvehutachiona senge:

• Utachiona hwepfupa (osteomyelitis)
• Utachiona hweGallbladder (cholecystitis)
• Utachiona hwemapapu (pneumonia)
• Urinary turakiti hutachiona

Zvimwe zviratidzo nezviratidzo zvinosanganisira:

• Kunonoka kukura uye kuyaruka
• Majoini anorwadza anokonzerwa neArthritis
• Moyo kana chiropa kutadza nekuda kwesimbi yakawandisa (kubva kuwedzerwa ropa)

Miedzo inowanzoitwa kuongorora uye kuongorora vanhu vane chirwere chesero masero inosanganisira:

• Bilirubin
• Ropa okisijeni kuzadza
• Yakazara kuverenga ropa (CBC)
• Hemoglobin electrophoresis
• Serum creatinine
• Serum potasium
• Sickle cell bvunzo

Chinangwa chekurapa ndechekugadzirisa uye kudzora zviratidzo, uye kudzikamisa huwandu hwematambudziko. Vanhu vane chirwere chesero rechirwere vanoda kurapwa kwakapfuurira, kunyangwe kana vasina dambudziko.

Vanhu vane chirwere ichi vanofanira kutora folic acid zvinowedzera. Folic acid inobatsira kugadzira masero matsvuku eropa.

Kurapa kwechirwere chesero chinosanganisira:

• Kuwedzerwa ropa (kunogona zvakare kupihwa kazhinji kudzivirira sitiroko)
• Mishonga yemarwadzo
• Mvura zhinji

Mimwe mishonga yekurapa chirwere chesero inogona kusanganisira:

• Hydroxyurea (Hydrea), iyo inobatsira kudzikisa huwandu hwezvikamu zvekurwadziwa (kusanganisira kurwadziwa kwepfupa uye matambudziko ekufema) kune vamwe vanhu
• Mishonga inorwisa mabhakitiriya, iyo inobatsira kudzivirira hutachiona hutachiona hunowanzoitika muvana vane chirwere chesero rechirwere
• Mishonga inoderedza huwandu hwesimbi mumuviri
• Mitsva yekurapa yekudzora kuwanda uye kuomarara kwematambudziko ekurwadziwa akagamuchirwa

Mishonga inogona kudikanwa kugadzirisa matambudziko echirwere chesero masero anosanganisira:

• Dialysis kana itsvo kuisirwa chirwere cheitsvo
• Counselling yezvinetso zvepfungwa
• Gallbladder kubviswa muvanhu vane chirwere chenduru
• Hip kutsiva yeavascular necrosis yehudyu
• Kuvhiya kwematambudziko eziso
• Kurapa kwekunyanyisa kana kushungurudzwa kwemarwadzo ekurwadziwa
• Ronda kutarisirwa kwemaronda emakumbo

Bone marora kana stem masero anoiswa anogona kurapa sickle cell chirwere, asi kurapwa uku hakusi sarudzo kune vanhu vazhinji. Vanhu vane sickle cell chirwere kazhinji havagone kuwana anowirirana-zvakanaka masero eseni vanopa.

Vanhu vane chirwere chesero rechirwere vanofanirwa kuve nemajekiseni anotevera kudzikisa njodzi yekutapukirwa.

• Mushonga weHaemophilus influenzae (Hib)
• Pneumococcal conjugate jekiseni (PCV)
• Pneumococcal polysaccharide jekiseni (PPV)

Kubatana neboka rekutsigira uko nhengo dzinogovana zvakajairika nyaya kunogona kudzikamisa kushushikana kwechirwere chisingaperi.

Munguva yakapfuura, vanhu vane chirwere chejeko rechirwere vaiwanzofa pakati pemakore makumi maviri nemakumi mana. Nekuda kwekuchengetwa kwemazuva ano, vanhu ikozvino vanogona kurarama kusvika pamakore makumi mashanu zvichikwira.

Zvikonzero zvekufa zvinosanganisira kutadza kwemuviri uye hutachiona.

Fonera wako mupi wezvehutano kana iwe uine:

• Chero zviratidzo zvekutapukirwa (fivha, muviri kurwadza, kurwadziwa nemusoro, kupera simba)
• Kushungurudzika kunorwadza
• Inorwadza uye yakareba-refu erection (mune varume)

Kupererwa neropa - jeko cell; Hemoglobin SS chirwere (Hb SS); Sickle cell anemia

• Masero matsvuku eropa, jeko masero
• Masero matsvuku eropa - akajairwa
• Masero matsvuku eropa - akawanda masero masero
• Masero matsvuku eropa - masero masero
• Masero matsvuku eropa - jeko uye Pappenheimer
• Akaumba zvinhu zveropa
• Masero eropa

Howard J. Sickle chirwere chesero uye mamwe mahemoglobinopathies. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 154.

Meier ER. Kurapa sarudzo yechirwere chesero. Pediatr Clin North Am. 2018; 65 (3) 427-443. PMID 29803275 pubmed.ncbi.nlm.nih.gov/29803275/.

National Heart Lung uye Ropa Institute webhusaiti. Uchapupu-hwakavakirwa manejimendi yechirwere chesero rechirwere: nyanzvi yemapurisa, 2014. www.nhlbi.nih.gov/health-topics/evidence-based-management-sickle-cell-disease. Yakagadziridzwa Nyamavhuvhu 2014. Yakasvika muna Ndira 19, 2018.

Saunthararajah Y, Vichinsky EP. Sickle cell chirwere: kiriniki maficha uye manejimendi. Muna: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chitsuwa 42.

Smith-Whitley K, Kwiatkowski JL. Hemoglobinopathies. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsipa 489.