Anaphylaxis

Wake wazibuza ukuthi kwenzekani lapho umzimba wakho usabela ngokweqile entweni ebonakala ingenabungozi? I-Anaphylaxis iwukungezwani komzimba okunzima futhi okungase kube yingozi empilweni okungase kuthuthuke emizuzwaneni embalwa yokuchayeka ezibangeli ezithile. Lesi simo sithinta izigidi emhlabeni wonke futhi sidinga usizo lwezokwelapha ngokushesha. Ukuqonda i-anaphylaxis kubalulekile ekuboneni izimpawu zayo nokwazi ukuthi ungasabela kanjani ngempumelelo.

Ake siqonde izici ezihlukahlukene zokubonakaliswa kwe-anaphylaxis, izimbangela, ukuxilongwa kanye nezindlela zokwelashwa. Sizohlola izigaba ezihlukene zalokhu kungezwani komzimba, sixoxe ngezinto ezivamile zobungozi, futhi sigqamise izinkinga ezingaba khona. 

Iyini i-Anaphylaxis?

I-Anaphylaxis, ebizwa nangokuthi ukushaqeka kwe-anaphylactic, iwukungezwani komzimba okunzima, okusongela ukuphila okuthonya izinhlelo eziningi zomzimba. Kwenzeka lapho amasosha omzimba esabela ngokweqile ku-trigger, ekhulula amakhemikhali abangela ukusabela okusheshayo nokusabalele. Lesi simo singase sithuthuke emizuzwini embalwa noma emizuzwini embalwa ngemva kokuchayeka ezintweni ezingezwani nomzimba ezifana nokudla, ukulunywa yizinambuzane, imithi, noma i-latex. 

Izimpawu ze-anaphylaxis ngokuvamile zihlanganisa ukusabela kwesikhumba, ubunzima bokuphefumula, nokwehla okuyingozi komfutho wegazi. Ngaphandle kokwelashwa ngokushesha, i-anaphylaxis ingaholela ekuweni kokuphefumula ngisho nokufa. Odokotela manje basebenzisa igama elithi 'anaphylaxis' ukuchaza kokubili ukusabela kwe-IgE-mediated kanye ne-non-IgE-mediated, njengoba isethulo somtholampilo nokwelashwa kuyefana kungakhathaliseki ukuthi iyiphi indlela eyisisekelo.

Izigaba ezi-4 ze-Anaphylaxis

I-anaphylaxis ngokuvamile iqhubeka ngezigaba ezihlukene, ngasinye sinobunzima obandayo. 

• Isigaba 1: Esigabeni sokuqala, izimpawu ezithambile njenge ukulunywa, isikhumba esibomvu, noma ikhala eligijimayo kungenzeka. 
• Isigaba 2: Njengoba ukusabela kuthuthuka, izimpawu ezisabalele ziyakhula, okuhlanganisa ukuqunjelwa, ukuvuvukala ebusweni, nobunzima bokugwinya. 
• Isiteji sesi-3: Isigaba sesithathu sibonisa ukukhuphuka okukhulu, nobunzima bokuphefumula, ukushaya kwenhliziyo okubuthakathaka, kanye nokulahlekelwa ukwazi. Lesi sigaba sivame ukubizwa ngokuthi ukushaqeka kwe-anaphylactic. 
• Isigaba 4: Kowamanqamu, ukushaya kwegazi lehla ngendlela eyingozi, futhi imigudu yokuphefumula iyaqhubeka nokuvuvukala, okungase kuholele ekuhlaselweni yinhliziyo. 

Ukuqaphela lezi zigaba ngokushesha ngangokunokwenzeka kubalulekile, njengoba i-anaphylaxis ingathuthuka ngokushesha phakathi nehora lokuchayeka, okwenza ukwelashwa ngokushesha kubaluleke kakhulu ukuvimbela izinkinga ezinzima.

Izinkinga ze-Anaphylaxis

I-Anaphylaxis ithinta izinhlelo eziningi zomzimba futhi ingabangelwa izinto ezihlukahlukene. Izimbangela ezivamile ze-anaphylaxis zihlanganisa: 

• Ukwaliwa Ukudla: Amakinati, ubisi, ukolweni, amakhowe, amaqanda, amantongomane esihlahla, inhlanzi, nezimbaza 
• Imithi: Ama-antibiotic athile, ama-NSAID, nama-radiocontrast agents 
• Ukulunywa kwezinambuzane: Ukulunywa yizinambuzane ezinyosi kanye neminyovu kungabangela ukusabela okunzima kwabanye abantu. 
• Impova: I-Ragweed, utshani, nempova yezihlahla
• I-Latex Exposure: Kungenye imbangela engaba khona yokushaqeka kwe-anaphylaxis, ethinta odokotela nabanye abavame ukuhlangana nemikhiqizo yenjoloba. 
• I-Anaphylaxis Ebangelwa Ukuzivocavoca: Ezimweni ezingavamile, ukuvivinya umzimba noma inhlanganisela yezinto kungase kubangele i-anaphylaxis. 
• Ukukhomba imbangela ethile kubalulekile ukuvimbela ukusabela okuzayo.

Izimpawu ze-Anaphylaxis

I-anaphylaxis ngokuvamile iqala ngezimpawu zesikhumba ezifana nokushaya noma ukulunywa. Emaminithini ambalwa, kungase kuvele ukubonakaliswa okunamandla kakhulu, okuhlanganisa: 

• Ukuvuvukala emphinjeni, ezindebeni, nolimi 
• Ukuphelelwa umoya
• Kunzima ukugwinya
• Ukuqubuka okubomvu
• Ubuhlungu besisu
• Ukuqina kwesifuba
• Ama-Cramps
• Uhudo
• Ukuvota.
• Umuzwa wenhlekelele ezayo uvame ukuhambisana nalezi zimpawu. 

Ezimweni ezimbi kakhulu, izimpawu ezisongela ukuphila zingenzeka, kuhlanganise: 

• Ukukhanya okukhanyayo
• Ukudideka
• Ukwandisa izinga lenhliziyo
• Ubuthakathaka obungazelelwe
• Ukungazi

Izimpawu zivame ukuqala phakathi kwemizuzu emihlanu kuya kwengama-30 yokuchayeka kumbi kangako kodwa kwesinye isikhathi zingaqala ngaphezu kwehora kamuva. I-Biphasic anaphylaxis, ethinta cishe u-20% wamacala, ihilela igagasi lesibili lezimpawu amahora noma izinsuku ngemuva kokusabela kokuqala.

Ukuxilongwa kwe-Anaphylaxis

Ukuxilongwa kwe-anaphylaxis kungokomtholampilo ngokuyinhloko, okusekelwe ezimpawini zesiguli kanye nokuchayeka kwakamuva ezintweni ezingase zibe yizimbangela. Odokotela bavame ukuthembela eqoqweni lezinqubo zokuhlonza i-anaphylaxis. Lokhu kufaka phakathi ukuvela ngokushesha kwezimpawu ezihlanganisa izinhlelo eziningi zomzimba, njengokusabela kwesikhumba, izinkinga zokuphefumula, noma ukwehla kungazelelwe komfutho wegazi. 

Ngezinye izikhathi, i-allergist ingase enze izivivinyo zesikhumba noma zegazi ukuze aqinisekise ukungezwani okuthile okuthile. Nokho, lezi zivivinyo azisetshenziselwa ukuxilonga i-anaphylaxis ngokwayo. Kubalulekile ukuqaphela ukuthi ucwaningo lwaselabhorethri ngokuvamile aludingeki ukuze kutholakale isifo ngokushesha, njengoba ukuqashelwa ngokushesha nokwelashwa kubalulekile ekulawuleni lesi simo esingase sibe sengozini yokuphila.

Ukwelashwa kwe-Anaphylaxis

I-Epinephrine iyisisekelo sokwelashwa kwe-anaphylaxis. Kufanele iphathwe ngokushesha ngomjovo we-intramuscular ethangeni. Lo muthi we-anaphylaxis uphikisana nemiphumela yabaxhumanisi bokuzivikela komzimba futhi uzinzisa ama-mast cells. Ezinye izindlela zokwelapha zihlanganisa:

• Ama-Antihistamine nama-corticosteroids avame ukusetshenziswa njengemithi yokwengeza, kodwa akuzona izindlela zokwelapha zomugqa wokuqala. 
• Umoya-mpilo kanye noketshezi olufakwa emthanjeni kungase kudingeke ukusekela ukuphefumula nomfutho wegazi kanye nokuvuvukala okuphansi.
• Ezimweni ezimbi kakhulu, odokotela banganikeza imithamo eyengeziwe ye-epinephrine noma ukumnika okuqhubekayo. 
• I-Vasopressors noma i-glucagon (ezigulini ezivinjwe i-beta) ingabhekwa njenge-anaphylaxis ephikisayo. 
• Ngemuva kokwelashwa, iziguli kufanele ziqashelwe ukusabela okungenzeka kwe-biphasic futhi zinikezwe uhlelo lokunakekelwa kwezimo eziphuthumayo.

Izingozi Zezingozi

Kunezici eziningana ezandisa amathuba okuba ne-anaphylaxis enzima, njenge: 

• Abantu abanesifuba somoya, ikakhulukazi labo abanezimpawu ezingalawuleki kahle, basengozini enkulu. 
• Umlando wokusabela kwe-anaphylactic kwangaphambilini uphakamisa namathuba eziqephu zesikhathi esizayo. 
• Iminyaka yobudala idlala indima, lapho intsha kanye nabantu abadala abasengozini enkulu. 
• I-cardiovascular izifo kanye nesifo se-chronic obstructive pulmonary (COPD) singaba sibi kakhulu imiphumela ye-anaphylaxis. 
• Ukwengeza, ukuphuza imithi efana ne-beta-blockers noma i-angiotensin-converting enzyme inhibitors kungase kwandise ubungozi. 
• Ukuba khona kwama-cofactor, njengokuvivinya umzimba, ukuphuza utshwala, noma izifo ezithathelwanayo, kungakhulisa ukusabela kwe-anaphylactic ngokwehlisa umkhawulo wokuchayeka ku-allergen.

Izinkinga

I-Anaphylaxis ingaholela ezinkingeni ezinkulu, ikakhulukazi uma ingelashwa ngokushesha. Umphumela onzima kakhulu ukufa, okungenzeka ngenxa yokwehluleka ukuphefumula noma ukuwohloka kwenhliziyo nemithambo yegazi. Ezinye izinkinga zihlanganisa:

• I-Hypoxemia, lapho amazinga komoyampilo wegazi ehla ngokuyingozi
• I-Hypotension, okubangela ukugeleza kwegazi okunganele ezithweni ezibalulekile 
• Ukushisa futhi i-stridor ingase ithuthuke, okubonisa ukuvimbeka okukhulu kwendlela yokuphefumula. 
• Ukungasebenzi kahle kwesitho sokugcina kungathinta amasistimu amaningi, okungadala umonakalo wesikhathi eside. 
• Abantu abanezimo ezingaphansi njengesifo senhliziyo noma isifuba somoya babhekana nengozi enkulu yezinkinga ezinzima. 
• Ukuqashelwa ngokushesha kanye nokwelashwa kwe-anaphylaxis kubalulekile ukuze kuvinjelwe le miphumela esongela ukuphila futhi kunciphise ubungozi bezinkinga zempilo zesikhathi eside.

Uzoyibona Nini Udokotela

Abantu abaye bahlangabezana nanoma yikuphi ukungezwani komzimba, ngisho nokuncane, kufanele babonane nodokotela. Lesi sinyathelo sibalulekile ukuvikela impilo futhi okungenzeka sisindise izimpilo. Udokotela angakwazi ukuxilonga i-anaphylaxis ngokusekelwe ezimpawini futhi athumele iziguli kudokotela ogulayo ukuze zihlolwe okwengeziwe. Ama-Allergist adlala indima ebalulekile ekuhlonzeni izinto ezibangisayo, ekufundiseni amasu okugwema, nasekunikezeni uhlelo lokuphatha lokuchayeka ngengozi. Ngemuva kokusabela okunamandla kwe-anaphylactic, ukufuna usizo lwezokwelapha ngokushesha kubalulekile. Labo abanezimpawu ezingabeki impilo yabo engozini bangabonwa amahora angu-4-6, kuyilapho izimo ezinzima zingadinga ukulaliswa esibhedlela noma ukunakekelwa kwe-ICU. Ukufuna usizo lochwepheshe kuqinisekisa ukuphathwa okufanele futhi kunciphisa ubungozi bokusabela okuphindelelayo.

Prevention

Ukuvimbela i-anaphylaxis kugxile ekugwemeni izimbangela ezaziwayo. Lokhu kubandakanya:

• Ngokwaliwa ukudla, lokhu kusho ukufunda ngokucophelela amalebula nokwazisa abanye mayelana nokungezwani komzimba nezinto ezithile. 
• Abantu abangezwani nemithi kufanele bazise odokotela babo futhi bahlole ezinye izindlela eziphephile. 
• Labo abazwelayo ekulunyweni kwezinambuzane kufanele bagweme izingubo ezikhanyayo futhi bahambe bengafake zicathulo otshanini. Ubuthi immunotherapy inganciphisa ngempumelelo ukusabela ekulunyweni kwezinambuzane. 
• Ukuze uthole i-anaphylaxis ebangelwa ukuvivinya umzimba, ukuhlonza nokugwema izimbangela ezihlangene kubalulekile. 
• Iziguli ezinomlando we-anaphylaxis kufanele ziphathe i-epinephrine autoinjector futhi zigqoke ubucwebe bezaziso zezokwelapha. 
• Imfundo idlala indima ebalulekile ekuvimbeleni, isiza iziguli ukuthi ziqonde izifo ezifihliwe, ukusabela okuphambene, kanye nokusetshenziswa kahle kwemithi yezimo eziphuthumayo.

Amakhambi Asekhaya E-Anaphylaxis

I-Anaphylaxis njalo idinga ukunakekelwa kwezokwelapha okuphuthumayo futhi akufanele ilashwe ngamakhambi asekhaya kuphela. Kodwa-ke, ezinye izindlela zokwelapha ezihambisanayo zingasiza ekwehliseni ukuqina kokungezwani komzimba. Lokhu kubandakanya:

• Ama-antihistamine atholakala ngaphandle kwe-counter angadambisa izimpawu ezincane ezifana nezinyosi noma ukulunywa, kodwa awakwazi ukuvimbela i-anaphylaxis. 
• Amaphakethe eqhwa kanye nama-topical creams aqukethe i-corticosteroids anganciphisa ukuvuvukala nokuluma. 
• Ukuze uthole i-allergies yokudla, indlela engcono kakhulu ukugwema ukudla okubangela ukudla ngokuphelele. 
• Kubalulekile ukuqaphela ukuthi lezi zinyathelo aziyithathi indawo yokwelashwa kochwepheshe. Noma ubani obona izimpawu ze-anaphylaxis kufanele afune usizo oluphuthumayo oluphuthumayo futhi asebenzise i-epinephrine autoinjector uma inqunyiwe.

Isiphetho

I-Anaphylaxis inomthelela omkhulu kubantu emhlabeni wonke, yethula inselele engaba yingozi empilweni edinga ukuqashelwa nokwenziwa ngokushesha.

Ukuqonda izigaba ze-anaphylaxis, ukuhlonza izici eziyingozi, kanye nokwazi ukuthi ungasivikela futhi usilawule kanjani lesi simo kuyizinyathelo ezibalulekile zokuzivikela wena kanye nabanye emiphumeleni yaso engase ibe yingozi.

Behlome ngolwazi olwanele, abantu ngabanye bangakwazi ukubhekana kangcono nezimo eziphuthumayo ze-anaphylactic futhi bathathe izinyathelo ezisheshayo zokugwema izibangeli. Ukunakekelwa ngokushesha kwezokwelapha kuyadingeka njalo lapho ubhekene ne-anaphylaxis, futhi amakhambi asekhaya akufanele athathe indawo yokunakekelwa kochwepheshe. Ngokuhlala sinolwazi futhi sizilungiselele, singasebenza ndawonye ukuze sinciphise izingozi ezihlobene nalesi simo esibucayi sezokwelapha futhi siqinisekise imiphumela engcono kulabo abathintekile.

FAQ sika

1. Ngingazibona kanjani izimpawu ze-anaphylaxis kimina noma kwabanye?

Izimpawu eziyinhloko ze-anaphylaxis zihlanganisa:

• Ukuphefumula kanzima noma ukushaywa umoya
• Ukuvuvukala komphimbo, izindebe, noma ulimi
• Ama-Hives noma ukuqubuka okusabalele
• isiyezi noma ukuquleka
• Ukushaya kwenhliziyo okusheshayo, okubuthakathaka
• Isicanucanu, ukuhlanza, noma isifo sohudo

2. Yini ebangela i-anaphylaxis?

Izimbangela ezivamile zihlanganisa:

• Ukudla (isb., amakinati, amantongomane esihlahla, igobolondo, amaqanda)
• Ukuluma noma ukulunywa yizinambuzane
• Imithi
• Latex
• Ukuzivocavoca (akuvamile)

3. Kuthatha isikhathi esingakanani ukushaqeka kwe-anaphylactic?

Ukusabela kwe-anaphylactic kuvame ukubanda kakhulu phakathi kwemizuzu engu-5-30 yokuchayeka ku-trigger. Ingahlala amahora ambalwa noma izinsuku ezimeni ezinzima ngaphandle kokwelashwa.

4. Yiziphi izigaba ezine ze-anaphylaxis?

I-Anaphylaxis ayihlali ilandela izigaba ezihlukene, kodwa ingachazwa ngezigaba ezine:

• Isigaba sokuqala: ukulunywa, ukuqunjelwa, ukukhathazeka
• Isigaba esiqhubekayo: Ukuphefumula kanzima, ubuhlungu besisu
• Isigaba esibeka impilo engozini: Umfutho wegazi ophansi, ukushaqeka
• Ukusabela kwesigaba sekwephuzile: Ukuphindaphinda kwezimpawu ngemva kokululama kokuqala

5. Kwenzekani phakathi ne-anaphylaxis?

Ngesikhathi se-anaphylaxis, amasosha omzimba asabela ngokweqile ku-allergen, akhiphe amakhemikhali abangela:

• Imithambo yegazi iyavuleka, okuholela ekwehleni komfutho wegazi
• I-Airways iyancipha, okwenza ukuphefumula kube nzima
• Uketshezi olungena ezicutshini, lubangele ukuvuvukala

6. Ingabe i-anaphylaxis ingazihambela yodwa?

Cha, i-anaphylaxis idinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba izimpawu ezithambile zingase zehle ngezikhathi ezithile, kunengozi yokuqhubekela phambili ekuphenduleni okukhulu, okusongela ukuphila. Njalo funa usizo oluphuthumayo.

7. Uyini umehluko phakathi kokungezwani komzimba kanye ne-anaphylaxis?

• Ukungezwani nomzimba: Ngokuvamile kuvela endaweni, izimpawu ezithambile (isb., ukuqunjelwa, ukulunywa)
• I-Anaphylaxis: Ukusabela okunamandla, okungase kube yingozi empilweni okuthinta izinhlelo eziningi zomzimba

UDkt Ather Pasha

MBBS, MD, FACP
I-CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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