Kodi ziwalo zingapo m'thupi lanu zikulephera kugwira ntchito nthawi imodzi? Tiyeni tikambirane za vuto ili lotchedwa Multiple Organ Dysfunction Syndrome (MODS)!

Mwina mwamvapo kuti munthu akadwala mwadzidzidzi ndipo ali mu chipinda chosamalira odwala kwambiri (ICU) cha chipatala, amati, "Madokotala anati ziwalo zina za thupi lawo sizikugwira ntchito bwino." Kapena, "Akusungidwa ndi makina." Ndipotu, panthawiyo, munthuyo akhoza kukhala ndi vuto lalikulu kwambiri. Mu zamankhwala, timatcha Multiple Organ Dysfunction Syndrome, kapena mu Chingerezi, ``Multiple Organ Dysfunction Syndrome - MODS.'' Dzinalo limamveka loopsa pang'ono, koma tiyeni tikambirane za chomwe chili, chifukwa chake chimachitika, komanso momwe mungapulumukire m'njira yosavuta yomwe mungamvetse.

Kodi MODS ndi chiyani kwenikweni?

Mwachidule, MODS ndi matenda oopsa mwadzidzidzi (oopsa) . Chomwe chimachitika pamenepa ndi chakuti ziwalo ziwiri kapena zingapo m'thupi lathu zomwe zimagwira ntchito limodzi sizigwira ntchito bwino nthawi imodzi. Taganizirani izi, thupi lathu lili ndi ziwalo zambiri monga kupuma, kugaya chakudya, ndi mkodzo. Izi zimagwira ntchito limodzi kuti tikhale ndi thanzi labwino. MODS ikachitika, ziwalozi sizingagwire ntchito zokha. Kenako zida zothandizira moyo ('zothandizira moyo') zimafunika kuti zigwire ntchito ziwalozo.

MODS ingakhudze chiwalo chilichonse m'thupi, koma zomwe zimakhudzidwa kwambiri ndi izi:

• Mapapu
• Mtima
• Ubongo
• Impso
• Chiwindi
• Magazi (magazi)

MODS ikhoza kukhala ndi zifukwa zambiri. Choyambitsa chachikulu ndi matenda oopsa (sepsis) . Pochiza MODS, madokotala amayesa kaye kuwongolera vuto lomwe layambitsa vutoli. Amachitanso zinthu zina kuti apewe kuwonongeka kwa ziwalo zina.

MODS ndi matenda oopsa kwambiri . Imatha kupha ngati sichitha kuchiritsidwa mwachangu. Anthu ambiri omwe ali ndi MODS amaloledwa ku chipinda chosamalira odwala kwambiri (ICU) ndipo amafunika kuyang'aniridwa nthawi zonse komanso kuthandizidwa kuti apulumuke.

Vutoli limatchedwa ndi mayina ena angapo, kuphatikizapo:

• Kulephera kwa ziwalo zingapo
• Kulephera kwa ziwalo zingapo

Ndi ziwalo ziti zomwe zingakhudzidwe ndi MODS?

MODS ingakhudze ziwalo ziwiri kapena zingapo zotsatirazi:

1. Mapapo (mapapo)

Pamene mapapo athu sangakwanitse kupatsa thupi mpweya wokwanira womwe limafunikira, zomwe zikutanthauza kuti minofu ya thupi silikupeza mpweya wokwanira (hypoxia) kapena thupi silikupeza mpweya wokwanira wa carbon dioxide (CO2) (hypercapnia), timatcha kulephera kupuma. Mu MODS, mumavutika kupuma ndipo mungafunikenso mpweya wopumira kuti mupume. Kuwonongeka kwakukulu kwa mapapo mu MODS ndi Acute Respiratory Distress Syndrome (ARDS).Mu mkhalidwe uwu wa ARDS, mapapo amauma, zomwe zimapangitsa kuti zikhale zovuta kwambiri kusunga mpweya wabwino m'magazi.

2. Matenda a mtima (mtima)

Thupi lathu la mtima ndi lomwe limapopa magazi m'thupi lonse. Kulephera kwa mtima ndi kugwedezeka kwa magazi ndi zinthu zomwe minofu ya mtima imakhala yofooka kapena yolimba, zomwe zimalepheretsa kuti ipope magazi okwanira m'thupi lonse. Kutupa kwambiri komwe kumachitika ndi MODS kungayambitse kuti mitsempha yamagazi ikule, zomwe zimachepetsa kuchuluka kwa magazi omwe amafika m'minofu ndi ziwalo. Izi zingayambitse kutsika kwa kuthamanga kwa magazi (kutsika kwa kuthamanga kwa magazi kapena kugwedezeka) mu MODS. Madzi amathanso kutuluka m'mitsempha iyi yamagazi, zomwe zimayambitsa kutupa (edema).

3. Dongosolo la magazi (magazi)

MODS ingayambitse kusalingana kwa mapuloteni ena m'magazi. Izi zingayambitse mavuto a kutuluka magazi ndi kutsekeka kwa magazi . Mutha kuwona mabala pakhungu kapena kutuluka magazi m'mimba mwanu. Vuto lalikulu kwambiri lomwe lingakhudze dongosolo lanu la magazi ndi Disseminated Intravascular Coagulation (DIC) . Pa vutoli, magazi amatha kuyamba kutuluka kuchokera m'ma catheter kapena machubu pakhungu lanu.

4. Thupi la mitsempha (ubongo)

Ubongo wathu ndi chiwalo chofunikira kwambiri chomwe chimalamulira dongosolo lililonse m'thupi. Pamene gawo kapena ubongo wonse wasiya kugwira ntchito chifukwa cha kuwonongeka kwa ubongo kapena ziwalo zina za dongosolo lapakati la mitsempha (kuphatikizapo msana ndi mitsempha yogwirizana nayo), timatcha 'kulephera kwa mitsempha'. Mu MODS, kutupa, kutseka magazi chifukwa cha mavuto ndi dongosolo la magazi, komanso kuthamanga kwa magazi kutsika kungachepetse kuchuluka kwa magazi omwe amapita ku ubongo. Izi zitha kuwononga ubongo ndikuyambitsa chisokonezo (`delirium`) .

5. Matenda a impso (impso)

Kulephera kwa impso kumachitika pamene impso sizingathe kuchita zina kapena zonse, kuphatikizapo kusefa zinyalala kuchokera m'magazi. Dongosolo la impso limasefa magazi athu, limapanga mkodzo, ndikuchotsa madzi osafunikira m'thupi. Mu MODS, njirayi imatha kusokonekera.

6. Chiwindi (chiwindi)

Kulephera kwa chiwindi ndi pamene chiwindi sichingathe kuchita zina kapena ntchito zake zonse, monga kuchotsa poizoni m'magazi, kusefa maselo ofiira akale, ndikupanga ndulu (asidi wachikasu/wobiriwira womwe umathandiza kugaya chakudya). Kutupa ndi kuchepa kwa magazi kupita ku chiwindi kungayambitse chiwindi kulephera. Izi zingayambitse khungu ndi/kapena maso kusanduka achikasu (jaundice). Kulephera kwa chiwindi kungayambitsenso ziwalo zina kulephera.

Kodi MODS ndi yofala bwanji?

MODS ndi vuto lofala lomwe limapezeka m'matenda oopsa komanso oopsa. Kafukufuku akusonyeza kuti pakati pa 28% ndi 88% ya odwala omwe ali m'zipinda zosamalira odwala kwambiri akhoza kukhala ndi MODS. Ndi chifukwa chachikulu cha imfa m'zipinda zosamalira odwala kwambiri (ICUs).

Kodi zizindikiro zoyambirira za MODS ndi ziti?

Popeza MODS ingakhudze chiwalo chilichonse m'thupi, zizindikiro zimadalira chiwalo chomwe chakhudzidwa. Zizindikirozi zitha kukhala zochepa kumayambiriro kwa matendawa omwe amayambitsa MODS, kapena zitha kukhala zoopsa . Pamene MODS ikupita patsogolo kuchokera ku matenda oopsa, mutha kukumana ndi izi:

• Kusanza ndi kusanza
• Chilakolako cha chakudya
• Kumva kufooka kwambiri kapena kutopa
• Malungo
• Kuziziritsa
• Kusokonezeka kapena kuvutika kuganizira kwambiri
• Kupuma mwachangu komanso mopanda kuzama
• Kugunda kwa mtima mwachangu kapena kosasinthasintha
• Kupweteka pachifuwa ndi/kapena m'mimba kwa nthawi yayitali
• Kutupa m'mimba
• Kutupa kwa miyendo
• Kuoneka kwachikasu pakhungu kapena m'maso (jaundice)
• Kusinthika kwa khungu, milomo, lilime, nkhama, misomali, kapena maso kukhala abuluu kapena imvi/oyera (cyanosis)
• Kutaya chidziwitso

Kodi n’chiyani chimayambitsa MODS?

MODS imatha kuyambitsidwa ndi matenda aakulu, kuvulala, kapena matenda. Madokotala ndi ofufuza sakudziwabe chomwe chimayambitsa MODS. Komabe, kafukufuku waposachedwapa akusonyeza kuti kutupa ndi kuchepa kwa magazi nthawi zambiri zimayambitsa MODS. MODS si matenda amodzi okha. Imayamba chifukwa cha zochitika zosiyanasiyana zomwe zimakhudza ziwalo zambiri kapena zonse za thupi. Kuchepa kwa magazi ndi mpweya kungayambitse kuwonongeka.

Tangoganizirani, mu matenda aakulu, pakhoza kukhala zochitika zingapo zomwe zimayambitsa MODS.

1. Chochitika chachikulu: Ichi ndiye chifukwa choyamba. Mwachitsanzo, matenda oopsa (sepsis), ngozi yaikulu (monga ngozi ya galimoto), kapena matenda oopsa a mtima.

2. Chochitika chachiwiri: Apa ndi pamene chitetezo cha mthupi lanu chimachita zinthu mopitirira muyeso, zomwe zimayambitsa kutupa kwakukulu m'thupi lonse.

3. Chochitika chachitatu: Ngati mwayamba matenda atsopano, kapena muyenera kuchitidwa opaleshoni kuti muchiritse vuto loyamba, limenelo likhoza kukhala chochitika chachitatu.

Zina mwa zifukwa zofala za MODS ndi izi:

• Sepsis kapena septic shock: Ichi chikhoza kukhala kutupa kwakukulu komwe kumachitika chifukwa cha matenda oopsa a bakiteriya kapena kachilombo.
• Kuvulala koopsa: Zinthu monga ngozi ya galimoto, kupsa kwambiri, kubayidwa, kapena kuwombera.
• Pancreatitis: Kutupa kwa kapamba. Izi zitha kuchitika chifukwa cha miyala ya m'ndulu, kumwa mowa mopitirira muyeso, mankhwala ena, ndi zinthu zina.
• Kudwala mtima kwakukulu: Kumachitika chifukwa cha kutsekeka kwa mtsempha wamagazi womwe umatumiza magazi kumtima.
• Kulephera kwa chiwindi: Izi zitha kuchitika chifukwa cha Hepatitis B, Hepatitis C, matenda a chiwindi onenepa, kumwa mowa mopitirira muyeso, komanso matenda a chiwindi.
• Kuvulala ndi poizoni:Zimayambitsidwa ndi poizoni. Mwachitsanzo, kugwiritsa ntchito mankhwala osokoneza bongo kapena mowa mwadzidzidzi kapena kwa nthawi yayitali, mankhwala oopsa monga mankhwala ophera tizilombo ndi zinthu zakale zotetezera kutentha (asbestos), ndi matenda a bakiteriya.

Matendawa amayambitsa kusintha kwakukulu m'thupi lanu komanso m'magazi, zomwe zimakhudzanso ziwalo zina.

Ndi chiwalo chiti chomwe chili choyamba kulephera mu MODS?

Pafupifupi aliyense amene ali ndi MODS amakumana ndi mavuto a m'mapapo poyamba , koma madokotala ndi ofufuza sakudziwa bwino chifukwa chake kulephera kwa m'mapapo kumachitika MODS isanachitike.

Ndani amene amakhudzidwa kwambiri ndi MODS?

Aliyense akhoza kukhala ndi MODS, koma mumakhala ndi mwayi waukulu wokhala ndi MODS ngati muli ndi vuto linalake, monga matenda osatha kapena vuto la chitetezo chamthupi.

Kodi mungazindikire bwanji MODS?

Madokotala amagwiritsa ntchito mayeso osiyanasiyana kuti adziwe kulephera kwa ziwalo m'thupi lanu lonse. Izi zingaphatikizepo:

• Kuyezetsa magazi
• Kuyesa mpweya wa m'magazi a mitsempha
• Mayeso a ntchito ya chiwindi
• Mayeso a ntchito ya impso
• Magazi ndi minofu ya thupi
• Echocardiogram (ultrasound ya mtima)
• Mayeso ojambulira zithunzi monga ultrasound kapena CT scan

Kodi MODS imachiritsidwa bwanji?

Chithandizo cha MODS chimadalira chomwe chimayambitsa komanso ziwalo zomwe zakhudzidwa. Njira zina zochiritsira ndi izi:

• Chiritsani magazi ochepa mwa kupereka madzi m'mitsempha (IV) .
• Kupereka mankhwala oletsa magazi kuti magazi aziyenda bwino kudzera m'mitsempha yamagazi ndi minofu (kutuluka kwa magazi m'mitsempha).
• Perekani maantibayotiki kuti muchiritse matenda ndi/kapena sepsis.
• Kuika magazi m'malo mwa magazi omwe anatayika chifukwa cha kuvulala kapena opaleshoni.
• Chithandizo cha okosijeni kuti thupi lipereke mpweya wambiri.
• Ngati simungathe kupuma nokha, mungafunike mpweya wopumira kuti mupume.
• Dialysis kuti ikuthandizeni kuchotsa zinyalala ndi madzi ochulukirapo m'thupi lanu.
• Kutulutsa mpweya m'magazi kudzera mu extracorporeal membrane oxygenation (ECMO) kuti muwonjezere mpweya m'magazi ndikuchotsa mpweya woipa.
• Dongosolo lothandizira kubwerezabwereza kwa maselo (MARS) lothandizira chiwindi.
• Opaleshoni kwa odwala omwe avulala kwambiri.
• Opaleshoni yoika ziwalo m'malo mwa chiwalo chodwala kapena chosagwira ntchito bwino ndi chiwalo chathanzi chochokera kwa wopereka.
• Ngati muli ndi vuto la kutuluka magazi m'mimba (GI) kapena vuto la m'mimba lomwe limakulepheretsani kudya, kapena ngati simungathe kudya, mungafunike kulandira zakudya kudzera mu IV (intravenous) kapena enteral nutrition (parenteral nutrition).

Kodi ndidzamva bwino msanga bwanji nditalandira chithandizo?

Kuchira kwanu kudzadalira chomwe chimayambitsa komanso chithandizo. Dokotala angakupatseni lingaliro labwino la nthawi yomwe mungayembekezere kuwona kusintha mukatha kulandira chithandizo.

Kodi tsogolo la MODS ndi lotani?

Tsogolo la MODS limadalira chomwe chimayambitsa vutoli. Nthawi zina zina kapena zonse zomwe mumamva zimatha kubwerera mwakale, koma mungafunike thandizo la moyo kwakanthawi mpaka mutachira.

Kuzindikira msanga ndi kuchiza matenda a MODS ndi chifukwa chake ndikofunikira kwambiri kuti muthane ndi vutoli bwino.

Kuyezetsa kwa matenda a MODS kumasiyana malinga ndi malo osamalira odwala kwambiri (ICUs). Madokotala amaona kuti vutoli ndi lomwe limayambitsa imfa mwa odwala omwe amaloledwa m'malo osamalira odwala kwambiri.

Ngati matendawa afika pamlingo waukulu, ziwalo zokhazikika zimatha kuwonongeka. Mungafunike chithandizo cha moyo wanu wonse kapena kuikidwa chiwalo china. Zingathenso kupha.

Kafukufuku wowonjezereka akufunika kuti adziwe zinthu zomwe zingakhudze MODS, zomwe zingapangitse odwala kukhala ndi tsogolo labwino.

Kodi kuchuluka kwa moyo kuchokera ku MODS ndi kotani?

Madokotala ndi ofufuza akuyerekeza kuti kuchuluka kwa moyo wa MODS kuli pakati pa 50% ndi 60% .

Kodi MODS ingapewedwe?

Zina mwa zinthu zomwe zimayambitsa matenda a MODS sizingapeweke. Ndipo pakadali pano palibe mankhwala enieni omwe angathandize kupewa matenda a MODS. Ofufuza akhala akuyang'ana njira zochiritsira matenda a MODS pachiyambi chake kuti apewe matendawo. Maphunziro angapo akuchitika pakadali pano.

Mungathandize kuteteza ziwalo zanu pochita zinthu monga:

• Tetezani ziwalo zanu ku mantha povala malamba achitetezo mukamayendetsa galimoto komanso zida zodzitetezera mukamasewera masewera amphamvu kwambiri.
• Katemerani kuti mupewe matenda oopsa ngati dokotala wakupatsani katemera.
• Chepetsani kapena siyani kumwa mankhwala osaperekedwa ndi dokotala, monga mankhwala oletsa kutupa omwe si a steroidal (NSAIDs), omwe angawononge impso.
• Chepetsani kapena siyani kumwa mankhwala kapena zinthu zina zomwe zingayambitse zilonda zam'mimba, monga NSAIDs, kusuta fodya, ndi mowa .
• Pezani chithandizo cha kuthamanga kwa magazi (kuthamanga kwa magazi) .

Ngati muli kuchipatala ndi matenda aakulu, madokotala anu angachite zinthu ngati izi kuti MODS isakule kwambiri:

• Kuchepetsa kuwonongeka kwa mapapo anu chifukwa cha mpweya wopuma wamakina.
• Chepetsani kuthiridwa magazi mpaka pakufunikadi.
• Kugwiritsa ntchito mankhwala ochepetsa magazi ngati pakufunika kuti magazi asaundane.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muli ndi matenda osatha ndipo mukukumana ndi zizindikiro za MODS, zomwe zingayambitse matenda aakulu komanso kulephera kwa ziwalo, nthawi zonse ndi bwino kuonana ndi dokotala. Angakuuzeni zizindikiro kapena zizindikiro zomwe muyenera kuziyang'anira komanso momwe mungathanirane ndi matenda aliwonse.

Kodi ndiyenera kupita ku Dipatimenti Yothandiza Anthu Odwala Pangozi (ETU) liti?

Ngati muli ndi zizindikiro za MODS, pitani ku chipinda chapafupi chadzidzidzi kapena imbani 911. Izi zitha kupha ngati simulandira chithandizo mwachangu.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Nazi mafunso ena omwe mungafune kufunsa dokotala wanu:

• Kodi n’chiyani chimayambitsa MODS?
• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Ndi mankhwala ati omwe mumalimbikitsa?
• Kodi zolinga za chisamaliro changa ndi ziti?
• Kodi ndimafunika chithandizo kangati?

Chidule ndi uthenga womaliza

Chabwino, tsopano mukudziwa kuti matenda a multiple organ dysfunction syndrome (MODS) ndi matenda oopsa omwe amakhudza ziwalo ziwiri kapena zingapo m'thupi lanu. Ngakhale kuti MODS ingakhudze ziwalo zilizonse, nthawi zambiri imakhudza mapapo, mtima, impso, chiwindi, ubongo, ndi magazi. Pali zifukwa zambiri zomwe zimayambitsa izi. Zofala kwambiri ndi kuvulala kwambiri, matenda oopsa, ndi matenda opatsirana. Chithandizo chimayang'ana kwambiri kuchiza vuto lomwe limayambitsa matendawa komanso kupewa kuwonongeka kwina kwa ziwalo zina.

Ndizachibadwa kuchita mantha mukamva kuti ziwalo zanu kapena za wokondedwa wanu sizikugwira ntchito. Koma madokotala ndi ogwira ntchito mu Emergency Treatment Unit (ETU) ndi Intensive Care Unit (ICU) aphunzitsidwa kuthandizira ziwalo zanu zonse, kupewa kuwonongeka kwina, komanso kuthandiza thupi lanu kuchira. Choncho musataye mtima. Ndi chithandizo chachangu komanso upangiri woyenera wachipatala, mutha kuyesa kuchoka mu vutoli.

Kulephera kwa ziwalo zambiri , MODS, kulephera kwa ziwalo, sepsis, chisamaliro chapadera, kulephera kwa ziwalo, chithandizo cha moyo