Kumanikidzwa kwakanyanya mukati medumbu kune njodzi here? (Abdominal Compartment Syndrome) Ngatidzidzei nezvazvo zviri nyore!

Tose tinoziva nezvekurwadziwa kwemudumbu, kuzvimba, nezvimwe zviratidzo. Kunyange zvazvo izvi zvichiwanzoitika, wakambonzwa here nezvemamiriro ezvinhu apo kumanikidzwa mukati memudumbu kunowedzera zvakanyanya zvekuti kunogona kukuvadza nhengo dzinokosha uye kutoisa upenyu panjodzi? Ndizvo zvinonzi navanachiremba chirwere chakakomba chinonzi ``Abdominal Compartment Syndrome.'' Zita racho ringanzwika serakaoma zvishoma, asi ngatirambei takariverenga. Kuziva zvinhu izvi kunogona kukosha zvikuru kwauri nevadikanwi vako.

Chii chinonzi Abdominal Compartment Syndrome?

Zvichitaurwa zviri nyore, "Abdominal Compartment Syndrome" chirwere chinokurumidzira . Chinoitika kana kumanikidzwa kuri mukati medumbu redu, kana mudumbu, kuchipfuura nzvimbo yachinogona kubata. Fungidzira kuti chii chinoitika kana tikafuridzira mweya wakawandisa mubharumu? Saizvozvowo, kana kumanikidzwa kuri mukati medumbu kukawedzera nekuda kwekuzvimba, kubuda ropa, kana zvimwe zvikonzero, nhengo dzinokosha dzakadai sematumbu edu, chiropa, neitsvo dzinotanga kudzvanywa.

Kazhinji, kumanikidzwa kuri mukati medumbu remunhu ane hutano kuri pakati pe 0 ne 5 mm ye mercury (mmHg). Zvisinei, muvarwere vanorwara zvakanyanya vari mumakamuri ekuchengetwa kwakanyanya, kukosha uku kunogona kuva pakati pe 5 ne 7 mmHg. Kana kumanikidzwa uku kwawedzera ndipo panotanga matambudziko:

• Hypertension yemukati medumbu (IAH): Muizvi, kumanikidzwa kuri pakati pe12 ne20 mmHg.
• Dambudziko reAbdominal Compartment Syndrome (ACS): Apa ndipo panotanga kuva nengozi. Kumanikidzwa kwemuviri kunowedzera kusvika pa20 mmHg.

Kumanikidzwa kwakanyanya uku kunodzivirira nhengo netsandanyama dziri mudumbu kuti dzisawane ropa rakakwana. Panguva imwe chete, okisijeni inodererawo. Izvi zvinotungamira kukundikana kwenhengo imwe mushure meimwe (kukundikana kwenhengo dzakawanda). Kana izvi zvikasaonekwa uye kurapwa nenguva, murwere anogona kufa. Saka, ichi chirwere chinofanira kuzivikanwa uye kurapwa nekukurumidza .

Izvi zvinoitika kakawanda here?

Kwete, `(Abdominal Conpartment Syndrome)` chirwere chisingawanzoitiki . Chinonyanya kubata vanhu vari muzvipatara, kunyanya mumakamuri ekuchengetwa kwakanyanya `(ICU)` avo vatova nematambudziko akakomba ehutano. Hazviwanzoitiki kuti munhu anorarama hupenyu hwakanaka uye hwakanaka azviwane.

Chii chinokonzera Abdominal Compartment Syndrome?

Pane zvikonzero zvakawanda zvinoita kuti kumanikidzwa kwemuviri mukati medumbu kukwire zvine njodzi. Zvikuru kubuda ropa kana kuzvimba zvakanyanya mudumbu. Ngatitarisei kuti zvirwere izvi ndezvipi:

• Kuvhiyiwa kwakanyanya mudumbu mako: Dzimwe nguva kuzvimba kunogona kuitika mukati medumbu mushure mekuvhiyiwa kukuru.
• Utachiona mudumbu mako:Utachiona hwakanyanya hunogonawo kukonzera BP.
• Kuvharika kwedumbu: Kana ura hukavharika pane imwe nzvimbo, zvinogonawo kuwedzera kumanikidzwa kwemuviri.
• Huwandu hwakawanda hwemvura inobuda mudumbu (IV fluid resuscitation): Munguva yekuvhiyiwa, kana muzviitiko zvehutachiona hwakakomba hwakadai se sepsis, muviri unofanirwa kupihwa huwandu hwakawanda hwemvura inokosha. Izvi zvinogona dzimwe nguva kuwedzera kumanikidzwa mudumbu.
• Kutsva kukuru: Dambudziko iri rinogonawo kuitika nekuda kwekuita kwemuviri kana nzvimbo yakakura yemuviri yatsva.
• Kuwedzerwa ropa rakawanda: Njodzi iyi iripo kunyangwe ropa rakawanda rikawedzerwa panguva imwe chete.
• Pancreatitis: Ichi chimwe chikonzero chekumanikidzwa kwedumbu.
• Kuputika kweaneurysm yemudumbu: Aorta ndiyo tsinga huru yeropa inotakura ropa kubva pamwoyo wedu kuburikidza nepachipfuva kuenda kudumbu. Kana bundu (aneurysm) rikabuda muchikamu chetsinga iyi yemudumbu uye rikabvaruka, zvinogona kukonzera kubuda ropa zvakanyanya uye kuwedzera kumanikidzwa mukati medumbu.
• Kukuvara kwedumbu: Dambudziko iri rinogona kuitika kana dumbu rako rikakuvara zvakanyanya, zvakaita setsaona yemotokari kana kudonha.

Ndezvipi zviratidzo zve `(Abdominal Compartment Syndrome)`?

Apa ndipo pane njodzi. Zviratidzo zve "Abdominal Compartment Syndrome" zvinowanzoonekwa kunonoka , mushure mekunge kwave nekukuvadzwa. Ndosaka vanachiremba nevashandi vekuchengeta varwere vari panjodzi yechirwere ichi.

Heano mamwe emhando dzinogona kuzivikanwa:

• Dumbu rakazvimba: Dumbu rinogona kunzwa sekunge rakazvimba uye rakaoma .
• Kurwadziwa mudumbu: Murwere anogona kunzwa kurwadziwa kwakanyanya mudumbu.
• Kuoma kwekufema: Kana kumanikidzwa mudumbu kukawedzera, chipfuva chinogonawo kukanganiswa, zvichiita kuti zviome kufema.
• Kuderera kweropa (hypotension): Kuderera kweropa chiratidzo cheizvi.
• Kuderera kwehuwandu hweweti (oliguria): Nekuda kwekukanganiswa kweitsvo, huwandu hweweti inogadzirwa hunogona kudzikira zvakanyanya.

Vanachiremba vanosimbisa sei izvi?

Munhu ane "Abdominal Compartment Syndrome" anogona kuona zviratidzo zvakaita se:

• Kuderera kweropa.
• Kubuda kweweti kwakaderera.
• Kana wakabatana nemuchina wekufema, kumanikidzwa kwawo kunogona kuwedzera.

Zvisinei, zviratidzo izvi chete hazvigone kushandiswa pakuongorora ACS. Nzira chete yekuziva chirwere ichi ndeyekuyera kumanikidzwa kwemuviri mukati medumbu.Chiremba anongogumisa kuti une ACS kana kumanikidzwa uku kuri kupfuura 20 mmHg uye paine zviratidzo zvekukundikana kwenhengo.

Nzira huru iri kushandiswa pari zvino kuyera kumanikidzwa kwemuviri mudumbu ndeyekuyera kumanikidzwa kwedundira . Nemashoko akareruka, iyi ndiyo nzira yazvinoitwa nayo:

1. Kutanga, chubhu yakatetepa, inochinjika (catheter) inopinzwa mudundira. Izvi zvinoitwa kuburikidza neurethra.

2. Zvadaro chubhu iyi (catheter) inopinzwa mudundira.

3. Iye zvino bhegi rine mvura rakabatana nechubhu iyi.

4. Uchishandisa sirinji, mvura shoma inopinzwa mudundira.

5. Pakupedzisira, kumanikidzwa ikoko kunoyerwa.

Bvunzo iyi inodzokororwa nguva nenguva nechikwata chevanachiremba kuti vaone kana mamiriro acho ari kuvandudzika kana kuti ari kuipa.

Pamusoro pezvo, chiremba wako anogonawo kuita mimwe miedzo kuti aone kana nhengo dzako dziri kushanda nemazvo. Semuenzaniso:

• Kuongororwa kweropa: Izvi zvinogona kuyera huwandu hwemakemikari akasiyana-siyana nemagasi mumuviri. Semuenzaniso, bvunzo ye creatinine clearance inogona kupa pfungwa yekuti itsvo dzako dziri kushanda zvakanaka sei.
• Kuongororwa kwemifananidzo: Izvi zvinogona kutora mifananidzo yemukati medumbu rako. Semuenzaniso, CT scan kana abdominal ultrasound zvinogona kuitwa.
• Kuyerwa kweoxygen saturation: Izvi zvinosanganisira kuisa chimwe chinhu chakaita se clip iri nyore pamunwe wako kuti uone kana muviri wako uri kuwana oxygen yakakwana.

Chirwere cheAbdominal Compartment Syndrome chinorapwa sei?

Mushonga unoshanda zvikuru wechirwere ichi kuvhiyiwa kubvisa kumanikidzwa kwemuviri. Chiremba anovhiya anoita nzira yakakosha inonzi decompressive laparotomy. Izvi zvinosanganisira kugadzira ganda nemadziro edumbu, kuvhura dumbu, uye kuderedza kumanikidzwa kwakanyanya mukati .

Kumanikidzwa kwemudumbu kuchatanga kudzikira mukati memaawa mashoma mushure mekuvhiyiwa. Zvisinei, zvinogona kutora mazuva akati wandei kuti kumanikidzwa kudzoke pakare. Kusvika panguva iyoyo, ronda rekuvhiyiwa rinogona kunge risati ravharwa zvachose. Vamwe varwere vangada kuvhiyiwa uku kunoderedza kumanikidzwa zvakare.

Mamiriro ezvinhu aya haagone kudzivirirwa here?

Usati wasvika padanho rekuti `(Abdominal Compartment Syndrome - ACS)`, kureva kuti, kana paine intra-abdominal hypertension (IAH), unogona kuedza kugadzirisa dambudziko racho pasina kuvhiyiwa. Kurapa uku kusingashandisi kuvhiyiwa kunogona kubatsira kudzivirira `(IAH)` kubva pakufambira mberi kuenda ku`(ACS)`. Kurapa kwakadaro kunosanganisira:

• Kuchinja chimiro chemuviri: Kuisa murwere panzvimbo inoderedza kumanikidzwa uye inoita kuti anzwe akasununguka.
• Mishonga inobvisa mvura mumuviri: Mishonga iyi inobatsira kubvisa mvura yakawandisa mumuviri.
• Kubvisa mvura mudumbu nepachubhu.
• Kubvisa zvinhu muura: Izvi zvinogona kuderedza kumanikidzwa mukati medumbu uye kugadzira nzvimbo yakakura.
• Kupa mishonga inoderedza marwadzo.
• Kuderedza huwandu hwemvura inopihwa mumuviri.

Mwero wekupora kwevarwere vane ``Abdominal Compartment Syndrome'' uri sei?

Iyi inyaya inokosha zvikuru. Kana chirwere che "Abdominal Compartment Syndrome" chikasarapwa zvakanaka, chinogona kuuraya. Nekuti, sezvo kumanikidzwa mukati medumbu kuchiramba kuchiwedzera, imwe neimwe nhengo dzemuviri dzinotanga kutadza kushanda. Uyewo, kana kuongororwa uye kurapwa zvikanonoka, mikana yekupora inodzikirawo.

Zvisinei, kana chirwere ichi chikaonekwa nekukurumidza uye kurapwa kwacho kukatanga nekukurumidza, zvinokwanisika kupora zvachose kubva muAbdominal Compartment Syndrome.

Zvisinei, zvinogona kutora mavhiki, kunyange mwedzi, kuti chirwere chakakonzera ACS chipere. Munguva iyoyo, murwere angafanira:

• Kurapa kweDialysis kunoita kuti itsvo dzishande.
• Kurapwa kwenguva refu muchipatara.
• Kurambidzwa kwemvura kana mishonga inobvisa mvura mumuviri.
• Kugara uchitarisa mashandiro emoyo.
• Muchina wekufema wekugadzira (mechanical ventilation) unobatsira pakufema.

Abdominal Compartment Syndrome chirwere chekurapa chinogona kuitika kuvanhu vanorwara zvakanyanya. Idambudziko rekuti kuzvimba nekumanikidzwa mukati medumbu zvinosvika padanho rine njodzi. Kuongororwa nekukurumidza uye kurapwa kwakakosha kudzivirira matambudziko akakomba nerufu.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, saka ikozvino wava kunzwisisa zviri nani zvatiri kutaura nezvazvo, Abdominal Compartment Syndrome. Kunyangwe ichi chiri chirwere chakakomba, zvakakosha kuti uzive nezvacho.

• Kumanikidzwa kwakanyanya kwemukati medumbu (ACS) chirwere chinokonzereswa nekumanikidzwa kwakanyanya mukati medumbu. Izvi zvinogona kukuvadza nhengo dzemuviri.
• Kunyangwe izvi zvisingawanzoitiki , zvinogona kuitika kuvarwere vari mumakamuri ekuchengetwa kwakanyanya.
• Kuziva zviratidzo nekukurumidza, kuyerwa kweBP, kusimbiswa kwechirwere, uye kutanga kurapwa nekukurumidza zvinoponesa hupenyu. Kurapa kukuru ndekwekuvhiya.
• (IAH) , zvinoreva kuti kumanikidzwa kwacho kwakakwira zvishoma asi kwete kwakanyanya se ``(ACS)``, kunogona kudzorwa pasina kuvhiyiwa.
• Kupora kunoenderana nekuti kurapwa kunotanga nekukurumidza sei.

Tinovimba kuti ruzivo urwu ruchakubatsira. Kana mumwe munhu waunoziva ari muchikamu chevarwere vanorwara zvakanyanya, ruzivo urwu ruchakubatsira kunzwisisa kana vanachiremba vachitaura nezvezvirwere izvi. Gara uchitevera mirairo yachiremba wako uye bvunza chiremba wako kana uine mibvunzo.

'Dambudziko remudumbu, kumanikidzwa kwemudumbu, BP iri mukati medumbu, kuvhiyiwa, imba yekuchengetedza varwere zvakanyanya, kutadza kushanda kwenhengo, emergency yekurapa