Boloetse bo kotsi ba kankere ea lefuba (TEN) ke boloetse bo kotsing ba letlalo bo bakang bophelo bo kotsing tlas'a letlalo (erythema), lefu la sele ea letlalo ( necrosis ), le ho phatloha ha letlalo le likokoana-hloko. TEN ha e amane le morabe ofe kapa ofe kapa bong bo itseng. Le hoja boemo bo ka bakoa ke tšoaetso kapa lihlahala, maemong a mangata a amana le liketso tsa lithethefatsi.
Meriana e Tsejoang ho Etsa TEN
Lithethefatsi tse tsebahalang ho etsa hore TEN li kenye:
- Likokoana-hloko tse kang sulfonamide, penicillin , macrolides le quinolones
- Lithethefatsi tsa Anticonvulsant (antiseizure)
- Lithethefatsi tse seng tsa steroidal tse khahlanong le ho ruruha (NSAIDs)
- Allopurinol
- Matšoao a mokokotlo oa kankere (TNF) -alpha lithethefatsi tse kang Remicade (infliximab), Enbrel (etanercept), le Humira (adalimumab)
Lintho tse sebelisoang ke lithethefatsi li atisa ho etsahala libeke tse ling ho isa ho tse tharo ho qala kalafo. Ho tloaelehile hore liphetoho tsa lithethefatsi li etsahale ka mor'a libeke tse robeli. Hoo e ka bang karolo ea boraro ea linyeoe li bakoa ke lintho tse sa tsejoeng.
Matšoao
Chefo e kotsi ea kankere ea kankere e tloaelehileng e qala ka matšoao a kang a feberu, ho khohlela, mohoete, nko ea metsi, le boikutlo bo sa thabiseng ka matsatsi a mabeli ho isa ho a mararo. Matšoao ana a ka 'na a tsoela pele ho kenyeletsa:
- Libaka tse nyenyane tse khubelu tse fetohang lihlopha tse kholo tsa letlalo le khubelu tse koahelang karolo ea 30 lekholong kapa 'mele o eketsehileng
- Ho phatloha ho hoholo le ho pholletsa le letlalo
- Libaka tse nang le mongobo, tse khubelu, tse bohloko moo letlalo le hlahlathetseng
- Ho kheloha, melomo e tsoa mali e etsang li-crusts
- Mahlo a bohloko ( conjunctivitis )
- Ho utloa bohloko haholo
Hangata matšoao ana a nka matsatsi a robeli ho isa ho a 12. Ka lebaka la matla a matšoao ana, mathata a ka 'na a hlaha, a kang pneumonia ; ho fokotseha ha likokoanyana ka molomong, mohoong le mokokotlong; maloetse a letlalo; ho hloleha ha liphio , chefo ea mali ( sepsis ), le ho tsosoa.
Ntle le phekolo e nepahetseng, tse ngata tsa litla-morao tsena li ka bolaea.
Tsejoa
TEN e tloaelehile e fumanoa e thehiloe matšoao a mokuli hammoho le tlhahlobo ea 'mele ea letlalo. Mathata a mang a letlalo, a kang staphylococcal scalded skin disease, a ka ba le matšoao a tšoanang. Hangata, sampho ea letlalo (biopsy) e tla nkoa ho netefatsa TEN le ho laola mathata leha e le afe a mang.
Phekolo ea meriana
Boloetse bo kotsi ba kankere ea kankere e ka baka mathata a bophelo. Haeba u nahana hore u ka ba le lilemo tse leshome, batla phekolo ea meriana. TENO e nkoa e le tšohanyetso ea bongaka 'me e hloka phekolo e potlakileng. Nakong e fetileng boemo boo bo alafshoa, ho molemo hore ho hlajoe ke lefu lena. Mekhoa ea phekolo e kenyeletsa:
- Ho tlohela meriana leha e le efe e ka bakang TEN
- Li-intravenous (IV) le li-electrolyte
- Ho tlosa mahlaseli a letlalo la letlalo (ho senyeha)
- Li-bandage tse sireletsang
- Likokoana-hloko ho thibela kapa ho alafo ea mafu
- Meriana ea bohloko
- Ho sebetsana le mathata a kang pneumonia kapa ho hloleha ha liphio
- Ho sebelisa sesebelisoa sa phepo ho fana ka limatlafatsi
Kalafo e ka boela ea kenyelletsa IV immunoglobulin, cyclosporine, plasmapheresis , kapa oksijene ea hyperbaric. Liphuputso li bontšitse hore ba fetisetsoang molikong o chesang kapa o nang le tlhokomelo e matla ba pele ba theola litekanyetso tsa tšoaetso hammoho le ho fokotseha ha tekanyo ea ho shoela le ho fokotseha ha bolulo.
Meriana efe kapa efe e ka etsang hore TEN e eme hang-hang. Phuputso e 'ngoe e bontšitse hore lefu le amanang le li-TEN le ka fokotsoa ka karolo ea 5 ho ea ho 25 haeba meriana e khopisang e emisoa hang ha ho phatloha.
Lisebelisoa:
Ngan, Vanessa. Boloetse bo bakoang ke chefo ea necrolysis. Boitšoaro ba Letlalo ho Baemeli ba ka ntle. 26 Dec 2006 New Zealand Dermatological Society.
"Toxic Epidermal Necrolysis." Letlalo la ho ruruha (li-Rashes). 31 Jan 2008 Setsi sa Bongaka sa Univesithi ea Maryland.
Toxic Epidermal Necrolysis. Index ea Mathata a Tloaelehileng. Mokhatlo oa Sechaba oa Mathata a Tloaelehileng.
Medscape. "Toxic Epidermal Necrolysis" (2015).