Hemolytic-uremic lefu

Ho hlahisa chefo e kang Shiga E coli hemolytic-uremic syndrome (STEC-HUS) ke lefu le atisang ho hlaha ha ts'oaetso tsamaisong ea tšilo ea lijo e hlahisa lintho tse chefo.Lintho tsena li senya lisele tse khubelu tsa mali ebe li baka kotsi ea liphio.

Hemolytic-uremic syndrome (HUS) hangata e hlaha kamora tšoaetso ea mala le E coli libaktheriaEscherichia coli O157: H7). Leha ho le joalo, boemo bona bo boetse bo hokahantsoe le mafu a mang a tsoang ka mpeng, ho kenyeletsoa shigella le salmonella. E boetse e amana le tšoaetso ea nongastrointestinal.

HUS e atile haholo ho bana. Ke lona sesosa se atileng haholo sa ho hloleha ha liphio tse matla baneng. Ho phatloha ho 'maloa ho hoholo ho hokahantsoe le nama ea hamburger e sa butsoang e silafalitsoeng ke E coli.

E coli e ka fetisoa ka:

• Ikopanye le motho e mong
• Ho ja lijo tse sa phehoang, joalo ka lihlahisoa tsa lebese kapa nama ea khomo

STEC-HUS ha ea lokela ho ferekanngoa le HUS (aHUS) e sa amaneng le tšoaetso. E tšoana le lefu le leng le bitsoang thrombotic thrombocytopenic purpura (TTP).

STEC-HUS hangata e qala ka ho hlatsa le letshollo, tse ka bang le madi. Pele beke e fela, motho a ka fokola 'me a teneha kapele. Batho ba nang le boemo bona ba ka ntša metsi ka tlase ho tloaelehileng. Phallo ea moroto e kanna ea emisa.

Ho senngoa ha lisele tse khubelu tsa mali ho lebisa matšoao a phokolo ea mali.

Matšoao a pele:

• Mali malulong
• Ho teneha
• Feberu
• Lethargy
• Ho hlatsa le letshollo
• Bofokoli

Matšoao a morao-rao:

• Ho rohakana
• Ho fokotseha ha tsebo
• Phallo e tlase ea moroto
• Ha ho na tlhahiso ea moroto
• Pallor
• Ho oa - ho sa tloaelehang
• Ho phatloha ha letlalo ho shebahala joalo ka matheba a khubelu (petechiae)

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Sena se ka bontša:

• Ho ruruha ha sebete kapa spleen
• Tsamaiso ea methapo ea fetoha

Liteko tsa laboratori li tla bontša matšoao a phokolo ea mali ea hemolytic le ho hloleha ho matla ha renal. Liteko li ka kenyelletsa:

• Liteko tsa ho koala mali (PT le PTT)
• Karolo e pharalletseng ea metabolic e ka bonts'a maemo a eketsehileng a BUN le creatinine
• Palo e felletseng ea mali (CBC) e ka bonts'a palo e eketsehileng ea lisele tse tšoeu tsa mali le ho fokotsa palo ea lisele tse khubelu tsa mali
• Hangata palo ea liplatelete ea fokotseha
• Ho hlahlojoa ha urinalysis ho ka senola mali le protheine morotong
• Teko ea protheine ea moroto e ka bonts'a palo ea protheine morong

Liteko tse ling:

• Moetlo oa setuloana o kanna oa ba motle bakeng sa mofuta o itseng oa E coli libaktheria kapa libaktheria tse ling
• Colonoscopy
• Phofo ea liphio (maemong a sa tloaelehang)

Kalafo e ka kenyelletsa:

• Dialysis
• Meriana, e kang corticosteroids
• Tsamaiso ea maro le li-electrolyte
• Litšelo tsa lisele tse khubelu tsa mali le liplatelete

Bona ke bokuli bo tebileng ho bana le ho batho ba baholo, mme bo ka baka lefu. Ka kalafo e nepahetseng, batho ba fetang halofo ea batho ba tla fola. Sephetho se betere ho bana ho feta batho ba baholo.

Mathata a ka kenyelletsa:

• Mathata a ho koala mali
• Phokolo ea mali ea hemolytic
• Ho hloleha ha liphio
• Hypertension e lebisang ho hoholeha, ho teneha habonolo, le mathata a mang a sistimi ea methapo
• Liplatelete tse fokolang haholo (thrombocytopenia)
• Uremia

Bitsa mofani oa hau haeba u ba le matšoao a HUS. Matšoao a tšohanyetso a kenyelletsa:

• Mali ka setuloaneng
• Ha ho ntša metsi
• Ho fokotsa ho falimeha (tsebo)

Bitsa mofani oa hau haeba u bile le sekhetho sa HUS 'me tlhahiso ea hau ea moroto e fokotseha, kapa u hlahisa matšoao a mang a macha.

O ka thibela sesosa se tsebahalang, E coli, ka ho pheha hamburger le nama tse ling hantle. Hape o lokela ho qoba ho kopana le metsi a sa hloekang mme o latele mekhoa e nepahetseng ea ho hlapa matsoho.

HUS; STEC-HUS; Hemolytic-uremic lefu

• Tsamaiso ea monna ea ho ntša metsi

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Mele C, Noris M, Remuzzi G. Hemolytic uremic lefu. Ka: Ronco C, Bellomo R, Kellum JA, Ricci Z, bahlophisi. Tlhokomelo e Bohlokoa Nephrology. 3rd ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 50.

Schneidewend R, Epperla N, Friedman KD. Thrombotic thrombocytopenic purpura le hemolytic uremic syndromes. Ka: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Melao-motheo le Tloaelo ea Motheo. La 7th. Philadelphia, PA: Elsevier; 2018: khaolo ea 134.