Zomwe makolo ayenera kudziwa za Reye's syndrome

Maphunziro a Zaumoyo

Kodi Reye's syndrome ndi chiyani? | Zizindikiro | Matendawa | Mankhwala | Kupewa

Ngati ndinu kholo, mungadziwe kuti simuyenera kupereka aspirin kwa mwana yemwe ali ndi nthomba kapena chimfine. Chifukwa cha izi ndikuchepetsa chiopsezo cha matenda aakulu komanso matenda owopsa omwe amatchedwa Reye's syndrome, kapena Reye syndrome, omwe amatha kuyambitsa kuwonongeka kwa chiwindi ndi kutupa muubongo ndipo adalumikizidwa ndi kugwiritsa ntchito aspirin mwa ana ndi achinyamata omwe ali ndi ma virus Matenda monga fuluwenza, varicella (yomwe imayambitsa nkhuku), matenda opatsirana apamwamba, ndi COVID-19, yomwe imayambitsidwa ndi buku la coronavirus.

Mu 1980, Centers for Disease Control and Prevention (CDC) idalemba milandu 555 ya Matenda a Reye ku United States. Mwamwayi, chaka chomwecho machenjezo ambiri okhudza kugwiritsa ntchito ma aspirin kwa ana adayamba , ndipo chiyambire 1994 milandu yochepera pawiri yakhala ikudziwika chaka chilichonse m'dziko lonselo.

M'zaka za m'ma 80, pafupifupi mwana mmodzi mwa ana 100,000 aliwonse anachipeza — tsopano, ndi mwana m'modzi miliyoni, akuti Amy Cram, MD, dokotala wa ana Gulu Lachipatala chakumpoto . Izi zili choncho makamaka chifukwa tikudziwa kuti kugwiritsa ntchito aspirin monga kuchepetsa kutentha thupi kapena anti-inflammatory kumawonjezera ngozi.

Ana ambiri (pafupifupi 80%) omwe amapeza Reye's syndrome amakhala ndi moyo, koma amafunika kuthandizidwa mwachangu, nthawi zambiri kuchipatala. Ngati sachiritsidwa, Reye's syndrome imatha kubweretsa kuwonongeka kwaubongo kapena kufa m'masiku ochepa okha.

ZOKHUDZA: Kodi njira yabwino kwambiri yochepetsera ululu kapena yochepetsera malungo kwa ana ndi iti?

Kodi Reye's syndrome ndi chiyani?

Matenda a Reye ndi matenda omwe nthawi zambiri amapezeka mwa ana ndi achinyamata azaka zosakwana 18 - makamaka omwe ali ndi zaka 4 mpaka 12 —Koma limakhudza anthu amisinkhu iliyonse. Madokotala sakudziwa ndendende zomwe zimayambitsa Reye's syndrome, koma nthawi zonse zimatsata matenda ena ndipo nthawi zambiri zimalumikizidwa ndikugwiritsa ntchito mankhwala omwe ali ndi aspirin mwa ana omwe ali ndi kachilombo ka HIV.

Aspirin, yemwenso amadziwika kuti acetylsalicylic acid, salicylic acid, kapena acetylsalicylate, ndiye mankhwala osokoneza bongo omwe amagwiritsidwa ntchito kwambiri m'mbiri . Zimagwira ntchito poletsa kupanga thupi kwa ma prostaglandin, omwe ndi mankhwala opangidwa ndi michere mthupi yomwe imathandizira kwambiri pakhungu lakutupa kwa thupi ku matenda kapena kuvulala.

Pogwiritsidwa ntchito pa matenda a ma virus, aspirin imatha kukhudza mitochondria ya munthu, yomwe ndi tinthu tating'onoting'ono m'maselo omwe amatchedwa omwe amapanga mphamvu yoyendetsera selo.

Aspirin pakakhala matenda amtundu, monga fuluwenza kapena nkhuku, imayambitsa kuvulala kwa mitochondrial, atero a Nathan Friday, Pharm.D., Wamankhwala Kroger . Ndipo izi zimayambitsa kufooka kwa chiwindi.

Kulephera kwa mitochondrial kumatha kubweretsa kuchuluka kwa ammonia -kuchokera kwa kagayidwe kake - m'magazi. Vutoli, lotchedwa hyperammonemia, limatha kubweretsa kutupa muubongo ndikuwonjezera kukoka kwaubongo pamene likukanikizana ndi chigaza. Kuchuluka kwa kutupa ndi kukakamizidwa kumatsimikizira kuopsa kwa zizindikiritso zamitsempha ya munthu.

Zizindikiro za matenda a Reye

Ngakhale zimakhudza ziwalo zonse za thupi, Reye's syndrome imavulaza kwambiri ubongo ndi chiwindi. Ndicho chifukwa chake, m'mawu azachipatala, amatanthauzidwa ngati: pachimake chosapsa mtima chopanda mafuta ndi chiwindi chamafuta. Encephalopathy, vuto lomwe limasinthira magwiridwe antchito a ubongo kapena mawonekedwe ake, ndichizindikiro chowopsa kwambiri cha Reye's syndrome, koma ndizovuta kwambiri kuzindikira mpaka kuwonongeka kwayamba kale kuubongo ndipo zizindikilo za matendawa zikuwonekera.

Zizindikiro zimawoneka patatha masiku atatu kapena asanu chiyambireni kachilomboka ndipo nthawi zambiri zimayamba ndi kusanza mwadzidzidzi, mosalekeza, ngakhale kwa ana ochepera zaka ziwiri, chizindikiro choyamba chingakhale kutsegula m'mimba . Kusanza nthawi zambiri kumatsatiridwa ndi kuchuluka kwa ulesi kapena kugona kwachilendo; komabe, ana ochepera miyezi 12 amatha kupezeka osasanza. Zizindikiro za Neurologic zimayamba kuwonekera mkati mwa maola 24 mpaka 48 otsatira ndipo atha kukhala:

• kupsa mtima
• kusakhazikika
• kusokonezeka
• kusintha kwa umunthu
• kukumbukira kukumbukira

Matendawa akamakulirakulira ndipo ubongo ukupitilira kuwonongeka chifukwa cha kutupa ndi kukakamizidwa, zizindikilo zina zimatha:

• ana otayirira
• chisokonezo kapena kusokonezeka
• kuyerekezera zinthu m'maganizo
• kupuma pang'ono kapena mofulumira
• kugunda kwamtima mwachangu
• kutaya chidziwitso

Kuphatikiza pa zizindikiro zake zamitsempha, Reye's syndrome imatha kupangitsanso kuchuluka kwa mafuta m'chiwindi ndi ziwalo zina. Kukula kwa zizindikiritso komanso kuyerekezera kuti munthu akhoza kuchira zimasiyanasiyana ndipo zimadalira kuchuluka kwa kuwonongeka kwaubongo. Anthu ena ali ndi zizindikiro zochepa ndipo amachira kwathunthu. Ena amakhala ndi vuto la m'maganizo kapena mwakuthupi.

Nthawi zambiri, kuwonongeka kwa ubongo kumatha kubweretsa kugwa, kufooka m'manja ndi miyendo, kukomoka, ndipo pamapeto pake kumwalira. Pulogalamu ya Kufa kwa matenda a Reye anali pafupifupi 50%, koma chiwerengerocho chatsika mpaka ochepera 20% mzaka zaposachedwa.

Kodi matenda a Reye's syndrome amapezeka bwanji?

Kupeza ndi kulandira chithandizo koyambirira ndikofunikira kwambiri ndi Reye's syndrome, kotero khanda, mwana, kapena wachinyamata aliyense yemwe ali ndi kachilombo koyambitsa matendawa ndikuwonetsa zizindikilo zilizonse za Reye's syndrome ayenera kupita naye kuchipatala mwachangu mwachangu momwe angathere. Kuti mupeze matenda oyenera, ndikofunikira kuti osamalira odwala azipereka mbiri yakale yazachipatala ya zonse mankhwala, kuphatikizapo owerengera, zowonjezera, ndi mavitamini, omwe wodwala adamwa.

Kuzindikira kumayambira poyesa magazi komanso kuyesa kwamkodzo kuti muwone ngati mafuta-acid kapena ammonia m'magazi. Mayeso am'magazi a chiwindi, makamaka, atha kukhala othandiza. Zotsatirazo zitha kukhala zokonzeka patangopita maola ochepa, ndipo kuyezetsa kumatha kuzindikira kuchuluka kwa michere yopanga chiwindi m'magazi. Mulingo wambiri wa michereyi ndi chizindikiro cha Reye's syndrome.

Zovuta zina zingapo zimatha kuyambitsa zizindikilo zomwe zikufanana ndi Reye's syndrome, chifukwa chake gawo lina la matendawa limakhala ndi zochitika monga:

• Matenda a mafuta-acid okosijeni ndi zina zokhudzana ndi chiwindi
• zolakwika zobadwa zamagetsi ndi zovuta zina zamagetsi
• kugwiritsa ntchito mankhwala, kumeza, kapena kuwonetsa poizoni
• Matenda apakatikati amanjenje monga encephalitis (kutupa kwa ubongo) ndi meningitis (kutupa kwa zoteteza kuzungulira ubongo ndi msana)
• matenda amisala

Nthawi zina, pampu yamtsempha imatha kuchitidwa kuti izindikire kukakamizidwa kowonjezera kwa thupi kwa cerebrospinal fluid (CSF). Mwa njirayi, yotchedwanso kuti lumbar puncture, singano imalowetsedwa m'munsi kumbuyo kumtunda pambali pamtsempha wam'mimba, ndipo CSF ​​yaying'ono imachotsedwa kuti ikayesedwe. Kuwonjezeka kwapanikizika kwina nthawi zina kumatha kuzindikirika ndi kujambula kwa maginito (MRI) kapena kusanthula kwamakompyuta a tomography (CT), ndipo madotolo amatha kuyitanitsa chimodzi mwazoyeserera izi kuti awone chomwe chikuyambitsa.

Mankhwala a Reye's syndrome

Chithandizo cha Reye's syndrome chiyenera kuyamba posachedwa kuti zithandizire kuchepetsa kukula kwa matendawa.

Pofika nthawi yomwe ana omwe ali ndi matenda a Reye [kapena mwana yemwe ali ndi zilizonse matenda] ali ndi kusintha kwa malingaliro awo (kuchuluka kwawo kukhala tcheru ndi kuzindikira), ayenera kupita kuchipatala, Dr. Cram akuti. Ndipo mwina atha kukhala mchipinda cha anthu odwala mwakayakaya kuyang'aniridwa ndikukhazikika ndi chisamaliro cha usana ndi usiku.

Palibe mankhwala a Reye's syndrome, chifukwa chake mankhwalawa amateteza ubongo kuti usawonongeke, kuyesera kusintha zovuta zomwe zimapangitsa ubongo kufufuma, kuwonetsetsa kuti mapapo akupitilizabe kugwira ntchito ngati chubu lopumira kapena chopumira, ndipo Kuchepetsa kupsinjika kwakuthupi komwe kumatha kubweretsa kumangidwa kwamtima.

Mutha kugwiritsa ntchito makina opumira kuti munthu asatengeke ndi matenda a Reye, omwe angathandize ndi kutupa kwa ubongo, akutero Dr. Cram. Palinso mankhwala (monga mannitol kapena dexamethasone ) mutha kuwapatsa omwe atha kuthandiza ndi kutupa.

Chithandizo chitha kuthandiza kuchepetsa kukula kwa Reye's syndrome, ndipo milandu yofatsa yomwe siyiyenda bwino imatha kubweretsa zovuta zazitali.

Momwe mungapewere Reye's syndrome

1. Mankhwala oyenera kupewa (kuwonjezera pa aspirin)

Sizingatheke kupewa matenda onse a Reye's syndrome, chifukwa zina sizimagwirizana ndi aspirin. Komabe, mwayi wotenga matenda achilendowa umachepa kwambiri powonetsetsa kuti ana omwe ali ndi matenda a tizilombo samamwa mankhwala aliwonse omwe ali ndi acetylsalicylic acid, salicylic acid, acetylsalicylate, kapena salicylate mankhwala. Kuphatikiza pa aspirin, izi zimaphatikizaponso mankhwalawa:

• Alka-Seltzer
• Anacin
• Zotsatira
• Chotsitsa
• Doan's
• Ecotrin
• Excedrin
• Kaopectate
• Maalox
• Pamprin
• Pepto-Bismol

Ili si mndandanda wathunthu. Lankhulani ndi omwe amapereka ana anu kapena wamankhwala kuti mumve zambiri. Ndikofunikira kuti makolo ndi achinyamata aziwerenga zolemba zonse zamankhwala asanagwiritse ntchito.

2. Katemera

Kuphatikiza pa kupewa mankhwalawa, mutha kuchepetsa mwana wanu kutenga kachilombo koyambitsa matendawa poyambitsa ana anu kumatenda opewera katemera, makamaka chimfine (fuluwenza) kapena varicella (nkhuku) monga awa katemera wambiri wotetezedwa ndi katemera. Ana amalandira katemera wa varicella ali ndi miyezi 12 ndi zaka 4 ndipo amayenera kulandira katemera wa chimfine chaka chilichonse.

3. Kuchepetsa ululu ndikuchepetsa malungo

Kupatula lamulo la no-aspirin ndi ana omwe ali ndi mikhalidwe yomwe imayankha bwino mankhwala a aspirin, monga matenda a Kawasaki. Pazochitikazi, makolo ayenera kukaonana ndi dokotala asanapereke mankhwala opha ululu kapena odana ndi zotupa. Za ana ena, acetaminophen (Tylenol) kapena ibuprofen (Motrin) amalangizidwa nthawi zonse m'malo mwa aspirin, makamaka ndi matenda a ma virus.