Ukuhlolwa kwe-Skin Prick (SPT)

I-SPT ukuvivinywa kokungezwani komzimba okwenziwa kakhulu. Ukuhlolwa kwesikhumba kungaba yindlela enembe kakhulu futhi engabizi kakhulu yokuqinisekisa okokungezwani komzimba. I-SPT isivivinyo esilula, esiphephile nesheshayo, esihlinzeka ngemiphumela kungakapheli imizuzu eyi-15-20.

I-SPT ivamise ukwenziwa engalweni yangaphakathi, kodwa kwezinye izimo ingase yenziwe kwenye ingxenye yomzimba, njengomhlane (Izingane/izingane ezincane). Izinto ezingezwani nokuhlolwa zikhethwa ngemuva kokuhlolwa ngudokotela wakho. Ama-allergener amathathu kuphela noma ama-3 noma afika kwangama-4 angahlolwa.

Udokotela noma umhlengikazi ubeka iconsi elincane le-allergen engenzeka esikhumbeni. Bazobe sebehlaba isikhumba sakho nge-lancet ngokusebenzisa iconsi. Uma uzwela entweni, uzothuthukisa ukusabela kwendawo okungezwani nayo, ngendlela yokuvuvuka (iqhubu/i-wheal) ububomvu, kanye nokuluma endaweni yokuhlolwa phakathi nemizuzu eyi-15. Imvamisa, uma isondo lilikhulu, maningi amathuba okuthi ungezwani ne-allergen. I-SPT ingenziwa kuwo wonke amaqembu eminyaka, kuhlanganise nezingane.

Kubalulekile ukwazi:

  • Umphumela omuhle wokuhlolwa kwesikhumba awuzihlolisisi ngokwawo ukungezwani komzimba.
  • Ukuhlolwa kwesikhumba okuhle akubikezeli ubunzima bokusabela okweqile.
  • Ukuhlolwa kwesikhumba okungekuhle ngokuvamile kusho ukuthi awunalo igciwane. Ukusabela okungekuhle kungenzeka ngenxa yezinye izizathu, isibonelo; uma isiguli sithatha ama-antihistamine noma imishanguzo evimba umphumela we-histamine.

Isiguli kufanele siyeke ukuthatha ama-antihistamines kanye neminye imithi ethile ngaphambi kokuhlolwa. Ama-antihistamine asebenza isikhathi eside (lawo angabangeli ukozela) kufanele amiswe isonto elilodwa; ama-antihistamine asebenza okwesikhashana angamiswa amahora angama-1 ngaphambi kwesikhathi. Izingxube eziningi zokukhwehlela ziqukethe i-antihistamine; ngakho-ke ngicela utshele udokotela wakho noma imuphi umuthi owuphuzile.

Ukuhlolwa Kwesikhumba Kwangaphakathi

Isivivinyo siqukethe ukujova inani elincane lokukhishwa kwe-allergen esikhunjeni, ngesirinji nenaliti. Ukufundwa kwenziwa ngemuva kwemizuzu eyi-10-15 kuhlolwa isondo elibomvu nokubomvu. Odokotela bangasebenzisa lokhu kuhlolwa uma imiphumela yokuhlolwa kwesikhumba ingatholakali kodwa basasola ukuthi une-allergies. Udokotela wakho angasebenzisa lesi sivivinyo ekuhloleni ukungezwani komzimba nomuthi noma i-venom. Ukuhlolwa kwesikhumba akunembile ngo-100%. Ezinye iziguli zinemiphumela emihle ngezinto ezizibekezelelayo ngaphandle kwezimpawu. Kulokhu, sithi ziyakhuthazwa nje kepha azilwisi. Ngalesi sikhathi, kunezinkomba ezimbalwa kakhulu zokuhlolwa kwesikhumba se-intradermal ukuthola ukungezwani kokudla.

Isivivinyo se-Allergy Patch noma i-Epicutaneous Test

Lokhu kuhlolwa kwenziwa ngokubeka iziqeshana ezithile ngezinto ezahlukahlukene (imithi, izithako zezimonyo, izinsimbi, amakhemikhali enjoloba, ukudla,) esikhumbeni sangemuva. Isivivinyo sinquma ukuthi i-allergen ingahle ibangele i-dermatitis yokuxhumana. Amachashazi asuswa ngemuva kwamahora angama-48, kepha ukufundwa kokugcina kwenziwa ngemuva kwamahora angama-72-96. Uma uzizwa ngalokhu, kufanele uhlakulele ukuqubuka kwasendaweni. Inani lamachashazi lincike ezintweni ezisolwayo udokotela wakho afuna ukuziphenya. Yazisa udokotela wakho ngayo yonke imithi oyitholayo. Ama-corticosteroids noma ama-immunomodulators angashintsha imiphumela yokuhlolwa. Amabhati nokujuluka kungasusa iziqeshana, ngakho-ke qaphela.

Izivivinyo zegazi

Ingqikithi yeserum IgE

Wonke umuntu une-Immunoglobulin E (IgE), i-antibody ebandakanyeka ekuphendukeni okudala kokungezwani komzimba. Lokhu kuhlolwa kukala yonke i-IgE egazini. Ukuhlolwa akusizi kakhulu, ngoba ezinye izimo eziningi zidala amazinga aphezulu e-IgE njengezinye izifo ezithathelwanayo, amagciwane noma ukutheleleka ngegciwane, izifo zesikhumba, ubungozi, isikhunta,…. Abanye abantu abane-IgE ephelele ngokuphelele ngeke bathuthukise ukungezwani komzimba; abanye abantu abanamazinga ajwayelekile bangakwazi ngisho nokuthuthukisa ukungezwani komzimba. Amazinga e-IgE awahlobene neze nokungezwani kokudla. Ingqikithi yeserum IgE akusho ukuthi isiguli asinazwani nento ethile. Kuyadingeka ukukala i-IgE ethile.

I-IgE ethile

Ekuhlaziyeni igazi udokotela wakho angakala i-serum isiyonke IgE, kodwa futhi angakala i-IgE ethile. I-Specific IgE i-IgE eqondiswe kuzinto ezingezwani nezinto (isib. Impova yotshani, izimbuzane zothuli lwasendlini noma ukudla okufana nekinati noma i-penicillin). Uma unesimo sesikhumba noma uthatha umuthi ophazamisa ukuhlolwa kwesikhumba, kungase kusetshenziswe ukuhlolwa kwegazi okungezwani nomzimba. Angase futhi asetshenziselwe izingane okungenzeka zingakubekezeleli ukuhlolwa kwesikhumba. Udokotela wakho uzothatha isampula yegazi alithumele elabhorethri. Ilebhu yengeza into engezwani negazi kusampula yegazi lakho bese ikala inani lamasosha omzimba akhiqizwa yigazi lakho ukuze ahlasele izinto ezingezwani nomzimba.

Abanye abantu banaleyo IgE ethile, kodwa bangakwazi ukubekezelela into ethile - isibonelo, bane-IgE eqondile ngokumelene nekinati kodwa bayakwazi ukudla amantongomane ngaphandle kokusabela. Ziyazwela, kodwa aziguliswa. Abanye abantu bane-IgE ethile futhi basabela entweni. Awezwani, hhayi nje ukuzwela. Imvamisa, ukuphakama kwamazinga e-IgE ethile kuba namandla kakhulu izimpawu zokungezwani komzimba nezinto ezithile. Kunezinkampani eziningana ezithuthukise izindlela zokulinganisa i-IgE ethile, futhi ngezinye izikhathi lokhu kuhlaziya kungathola amagama afana ne-RAST, CAP, ELISA noma amanye. Akukho ukuhlola okunganquma ukuthi kubi kangakanani ukungezwani nothile.

Ukuhlolwa Kwenselele Yokudla

Lokhu kuhlola kuvamise ukwenziwa ngemithi engase ibe khona noma ukungezwani nokudla. Ngezinye izikhathi, ngisho nangemva kokwenza ukuhlolwa kwesikhumba nokuhlolwa kwegazi, i-allergist ayikwazi ukunikeza ukuxilongwa okuqondile. Kulokhu, udokotela wakho uzophakamisa ukuhlolwa kwenselelo yokudla ngomlomo (i-OFC), ukuhlolwa okunembe kakhulu kokungezwani nokudla. Ngesikhathi sokuphonselwa inselelo kokudla, i-allergist ikupha ukudla okusolwayo ngemithamo elinganiselwe, eqala ngamanani amancane kakhulu okungenzeka abangele izimpawu. Ukulandela umthamo ngamunye, ubhekwa isikhathi esithile nganoma yiziphi izimpawu zokusabela. Uma zingekho izimpawu, kancane kancane uzothola imithamo emikhulu. Uma ubonisa noma yiziphi izimpawu zokusabela, inselele yokudla izomiswa.

Ngalolu hlobo lwemithi, ukusabela okuningi kuthambile, njengokushaywa noma ukuqubuka, futhi ukusabela okunamandla akuvamile. Uma kunesidingo, uzonikezwa imithi, ngokuvamile i-antihistamine, ukuze ukhulule izimpawu. Uma ungenazo izimpawu, ukungezwani nokudla kungakhishwa. Uma ukuhlolwa kuqinisekisa ukuthi unokungezwani nokudla, udokotela wakho uzokunikeza ulwazi mayelana namasu okugwema ukudla kanye/noma akunikeze imithi efanele. Lokhu kuhlola kunamandla okubangela ukusabela okubi. Inselele kufanele yenziwe ngaphakathi kwesikhungo sezokwelapha esinemishini nabasebenzi ukuze kubhekwane nokusabela okungaba yingozi empilweni. Ithimba lezokwelapha lizobheka isiguli izimpawu kuze kube amahora ambalwa ngemva kwenselelo. Ngaphambi kokuhlolwa kwenselele yokudla, iziguli kufanele zikugweme ukudla okusolisayo okungenani amaviki ama-2. Imithi ejwayelekile ye-antihistamine nayo iyahoxiswa.

Kunezinhlobo ezintathu zezinselelo zokudla ngomlomo:

Inselelo Yokudla Elawulwa Ngezindawo Ezimbili (i-DBPCFC)

I-DBPCFCt “izinga legolide” lokuxilonga ukungezwani nokudla. Isiguli sithola imithamo ekhulayo yalokho okusolakala ukuthi kungezwani nokudla noma i-placebo. Ukungaboni kabili kusho ukuthi i-allergen ne-placebo kubukeka ngokufanayo, wena noma udokotela wakho ngeke nazi ukuthi iyiphi oyitholayo. Le nqubo iqinisekisa ukuthi imiphumela yokuhlolwa inenjongo ngokuphelele.

Inselelo Yokudla Okuyimpumputhe

Kulesi sivivinyo, i-allergist iyazi ukuthi uthola i-allergen, kepha awuthandi.

Inselele Yokudla Okuvulekile

Kokubili wena nodokotela wakho niyazi ukuthi uthola i-allergen noma cha. Lapho inselelo yezinsana nezingane ezincane akudingekile ukuthi ukufihle ukudla. Inselelo evulekile inqubo ejwayelekile kula maqembu eminyaka yobudala.

Ukuhlolwa kwezinambuzane

Lokhu kuhlolwa kusetshenziselwa iziguli ezinokungezwani komzimba nezinyosi noma isihlungu somnyovu, ukuhlola ukuthi ukwelashwa kube yimpumelelo yini. Ukutinyelwa yinyosi noma umuvi kungase kucasule futhi kube buhlungu. Ungase ubone iqhubu elibomvu elilumayo noma elivuvukalayo. Uma ungezwani nobuthi lapho ulunywa isinambuzane, ungase ube nokusabela okubucayi okufana nesifuba, ukuvuvukala, noma ubunzima bokuphefumula. Imithi yokugomela i-Immunotherapy/allergies isetshenziswa ukushintsha inkambo yemvelo yezifo ezingezwani nomzimba. Endabeni yokungezwani nokulunywa yizinambuzane, imithi yokugoma isetshenziselwa ukunxenxa ukubekezelela ubuthi bezinyosi noma umnyovu, ukuze isiguli sibe nokusabela kwendawo kuphela, endaweni lapho luntinyele khona, njengabantu abangenalo i-allergy.

Imithi yokugoma yokungezwani komzimba ngokuvamile inikezwa iminyaka emithathu kuya kwemihlanu. Ngemva kwalesi sikhathi, udokotela angase asikisele ukuba kwenziwe ukuhlolwa kokuluma kwezinambuzane ukuze azi ukuthi isiguli siyabekezelela yini. Inyosi noma umnyovu ubanjwa engalweni yesiguli kuze kube yilapho isiguli sihlatshwa. Isiguli sibe sesibhekwa ukuze kubonakale ukuthi izimpawu ziyavela yini. Kuye ngohlobo nobukhulu bezimpawu, umuntu angahlola ukusebenza kwe-immunotherapy futhi anqume ukuqhubeka noma ukuyiyeka.

Intuthwane yomlilo

Ubunzima be- intuthwane yomlilo ukusabela kokuluma kuyahlukahluka kumuntu nomuntu. Umcimbi ojwayelekile wokuluma izintuthwane zomlilo uhlanganisa izintuthwane zomlilo eziningi ezihlabayo. Lokhu kungenxa yokuthi lapho indunduma yentuthwane yomlilo iphazanyiswa amakhulu kuya ezinkulungwaneni zezintuthwane zomlilo ziyasabela. Ngaphezu kwalokho, intuthwane ngayinye ingaluma ngokuphindaphindiwe. Cishe bonke abantu abalunywe izintuthwane zomlilo baba nesidleke esilumayo, esihlala endaweni lapho okuntinyela khona, okuvamise ukudamba phakathi nemizuzu engama-30 kuya kwengama-60. Lokhu kulandelwa i-blister encane phakathi namahora amane. Lokhu ngokuvamile kubonakala kugcwalisa izinto ezinjengobovu ngamahora ayisishiyagalombili kuya kwangu-24. Kodwa-ke, okubonwayo kuyizicubu ezifile ngempela, futhi i-blister inamathuba amancane okutheleleka ngaphandle kokuthi ivuliwe. Lapho zelashwa, lezi zilonda zingashiya izibazi.

Ukwelashwa kwezintuthwane zomlilo kuhloswe ukuvimbela ukutheleleka kwebhaktheriya yesibili, okungenzeka uma i-pustule iklwejwa noma iphukile. Ukwelashwa isikhathi eside kokungezwani nezintuthwane zomlilo kubizwa ngokuthi i-whole-body extract immunotherapy equkethe wonke umzimba wentuthwane, hhayi nje ubuthi, njengoba kwenzeka kwezinye izinambuzane ezilumayo. Kuwuhlelo olusebenza kahle kakhulu, olungavimbela ukungezwani nokungezwani nomlilo esikhathini esizayo ekulumeni kwezintuthwane.