Hemolytic-uremic ọrịa
Nsí nsị dị ka Shiga E coli hemolytic-uremic syndrome (STEC-HUS) bụ ọgba aghara nke na-apụtakarị mgbe nrịanrịa na usoro nsị na-emepụta ihe na-egbu egbu.Ihe ndị a na-ebibi mkpụrụ ndụ ọbara uhie ma na-ebute mmerụ ahụ.
Hemolytic-uremic syndrome (Hus) mgbe mgbe emee mgbe a eriri afọ ọrịa na E coli nje (Escherichia coli O157: H7). Ma, ọnọdụ a jikọtara ya na ọrịa ndị ọzọ na-efe efe, gụnyere shigella na salmonella. O jikọtakwara ya na ọrịa nongastrointestinal.
HUS na-ahụkarị ụmụaka. Ọ bụ ihe kachasị akpata nnukwu ọdịda akụrụ na ụmụaka. Ejikọtara ọtụtụ ọnụọgụ dị ukwuu na anụ hamburger na-adịghị mma E coli.
E coli nwere ike ibunye site na:
- Ikpọtụrụ onye ọzọ
- Na-eri nri esighị esi, dịka mmiri ara ehi ma ọ bụ anụ ehi
STEC-HUS agagh enwe mgbagwoju anya ya na ulo aturu puru iche (aHUS) nke n’enweghi oria. O yitere oria ozo nke ana akpo thrombotic thrombocytopenic purpura (TTP).
STEC-HUS na-amalitekarị site na ịgbọ agbọ na afọ ọsịsa, nke nwere ike ịbụ ọbara. N’ime otu izu, onye ahụ nwere ike ịmalite inwe ume ọkụ na iwe. Ndị nwere ụdị ọrịa a nwere ike isi na mamịrị na-epe mpe. Ihe mmamịrị nwere ike ịkwụsị.
Mbibi nke mkpụrụ ndụ ọbara uhie na-ebute mgbaàmà nke anaemia.
Mgbaàmà mbụ:
- Ọbara na stool
- Iwe
- Ahụ ọkụ
- Ike ọgwụgwụ
- Akpịrị na afọ ọsịsa
- Adịghị ike
Mgbaàmà ndị ọzọ:
- Na-akụda
- Mbelata nke uche
- Mmiri mmamịrị dị ala
- Enweghị mmamịrị ọ bụla
- Okpokoro
- Ọdịdọ - obere
- Akpụkpọ anụ ahụ dị ka ọmarịcha uhie uhie (petechiae)
Onye nlekọta ahụike ga-eme nyocha anụ ahụ. Nke a nwere ike igosi:
- Imeju ma ọ bụ splin ọzịza
- Erjọ na-agbanwe agbanwe
Laboratory ule ga-egosi ihe ịrịba ama nke hemolytic anaemia na nnukwu gbasara akụrụ odida. Ule nwere ike ịgụnye:
- Nnwale ọbara na-acha ọbara ọbara (PT na PTT)
- Comprehensive metabolic panel nwere ike igosi mmụba nke BUN na creatinine
- Ọnụọgụ ọbara zuru oke (CBC) nwere ike igosi ọnụọgụ ọbara ọcha na-arị elu ma belata ọnụ ọgụgụ ọbara uhie
- A na-ebelata ọnụ ọgụgụ platelet
- Urinalysis nwere ike ikpughe ọbara na protein na mmamịrị
- Mmamịrị protein ịmịkọrọ nwere ike igosi ọnụọgụ protein dị na mmamịrị
Ule ndị ọzọ:
- Omenala stool nwere ike ịdị mma maka otu ụdị E coli nje ma ọ bụ nje ndị ọzọ
- Nnyocha
- Akụrụ biopsy (na obere okwu)
Ọgwụgwọ nwere ike ịgụnye:
- Ọrịa
- Ọgwụ, dị ka corticosteroids
- Nchịkwa nke mmiri na electrolytes
- Mmịnye nke mkpụrụ ndụ ọbara uhie na platelet jupụtara n'ọtụtụ
Nke a bụ ajọ ọrịa ma ụmụaka ma ndị toro eto, ọ na-akpatakwa ọnwụ. Site na ọgwụgwọ kwesịrị ekwesị, ihe karịrị ọkara mmadụ ga-agbake. Nsonaazụ dị mma karịa ụmụaka karịa ndị okenye.
Nsogbu nwere ike ịgụnye:
- Nsogbu ọgbụgba ọbara
- Ọbara Hemolytic
- Akụrụ ọdịda
- Ọbara mgbali elu nke na-eduga njide, mgbakasị, na nsogbu sistemụ ụjọ ndị ọzọ
- Obere platelet (thrombocytopenia)
- Uremia
Kpọọ onye na-eweta ọrụ gị ma ọ bụrụ na ị mepee mgbaàmà nke HUS. Ihe mgbaàmà mberede gụnyere:
- Ọbara na stool
- Enweghị urination
- Belata ịmụrụ anya (nsụhọ)
Kpọọ onye na-eweta gị ma ọ bụrụ na ị nweela oge nke HUS na mmamịrị gị na-ebelata, ma ọ bụ ị mepee mgbaàmà ọhụụ ndị ọzọ.
Nwere ike igbochi ihe kpatara amara, E coli, site na isi nri hamburger na anụ ndị ọzọ nke ọma. I kwesịkwara izere ịkpọtụrụ mmiri na-adịghị ọcha ma soro usoro ịsa aka kwesịrị ekwesị.
OKWU; STEC-HUS; Hemolytic-uremic ọrịa
- Usoro urinary nwoke
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Mele C, Noris M, Remuzzi G. Hemolytic uremic syndrome. Na: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Nlekọta Na-adịghị Anya Nephrology. Nke atọ ed. Philadelphia, PA: Elsevier; 2019: isi 50.
Schneidewend R, Epperla N, Friedman KD. Thrombotic thrombocytopenic purpura na hemolytic uremic syndromes nwere nkwupụta ụda. Na: Hoffman R, Benz EJ, Silberstein LE, et al, ndị ọzọ. Hematology: ickpụrụ na Omume. Nke 7. Philadelphia, PA: Elsevier; 2018: isi 134.