Nhengo dzakawanda dziri mumuviri wako dziri kutadza kushanda panguva imwe chete here? Ngatikurukurei nezvechirwere ichi chinonzi Multiple Organ Dysfunction Syndrome (MODS)!

Pamwe wakambonzwa kuti kana mumwe munhu akangoerekana arwara zvikuru uye ari muchipatara che intensive care unit (ICU), vanoti, "Vanachiremba vakati zvimwe zvikamu zvemuviri wavo hazvisi kushanda zvakanaka." Kana kuti, "Vari kuchengetwa vari vapenyu nemichina." Kutaura zvazviri, panguva iyoyo, munhu iyeye anogona kunge aine chirwere chakakomba. Mukurapa, tinodana chirwere ichi kuti Multiple Organ Dysfunction Syndrome, kana muchirungu, ``Multiple Organ Dysfunction Syndrome - MODS.'' Zita racho rinonzwika serinotyisa zvishoma, asi ngatitaurei kuti chii, nei zvichiitika, uye kuti ungararama sei nenzira iri nyore yaunogona kunzwisisa.

Chii chaizvo chinonzi MODS?

Zvichitaurwa zviri nyore, MODS chirwere chakakomba chinongoerekana chaitika (chakanyanya) . Chinoitika apa ndechekuti miviri kana kupfuura yenhengo dzemuviri wedu dzakabatana dzinongoerekana dzamira kushanda zvakanaka. Funga nezvazvo, muviri wedu une nzira dzakawanda dzakadai senzira yekufema, nzira yekugaya chikafu, uye nzira yeweti. Izvi zvinoshanda pamwe chete kuti tirambe tiine hutano. Kana MODS yaitika, nhengo idzi hadzigone kushanda dzoga. Zvadaro michina inotsigira hupenyu ('life support') inodiwa kuti iite basa renhengo idzodzo.

MODS inogona kukanganisa chero nhengo mumuviri, asi inonyanya kuzivikanwa ndeiyi:

• Mapapu
• Mwoyo
• Uropi
• Itsvo
• Chiropa
• Ropa (ropa)

MODS inogona kuva nezvikonzero zvakawanda. Chikonzero chinowanzoonekwa chirwere chakakomba (sepsis) . Pakurapa MODS, vanachiremba vanotanga vaedza kudzora chirwere chakakonzera chirwere chacho. Vanotorawo matanho ekudzivirira kukuvara kwemamwe masisitimu enhengo dzemuviri.

MODS chirwere chine njodzi zvikuru . Chinogona kuuraya kana chikarapwa nekukurumidza. Vanhu vazhinji vane MODS vanopinda muchikamu chevarwere vane chirwere chakanyanya (ICU) uye vanoda kugara vachiongororwa uye vachitsigirwa nehupenyu hwavo.

Dambudziko iri rinodanwa nemamwe mazita akati wandei, anosanganisira:

• Kukundikana kwenhengo dzakawanda
• Kukundikana kwenhengo dzakawanda dzemuviri

Ndeapi masisitimu enhengo anogona kukanganiswa neMODS?

MODS inogona kukanganisa maviri kana kupfuura enhengo dzemuviri dzinotevera:

1. Masisitimu ekufema (mapapu)

Kana mapapu edu asingakwanise kupa muviri huwandu hweokisijeni hwaunoda, zvichireva kuti nhengo dzemuviri hadzisi kuwana okisijeni yakakwana (hypoxia) kana kuti muviri hausi kuwana carbon dioxide yakakwana (CO2) (hypercapnia), tinozviti kutadza kufema. MuMODS, unonetseka kufema uye ungatoda mhepo yekufema kuti ikubatsire kufema. Kukuvadzwa kwakanyanya mumapapu muMODS iAcute Respiratory Distress Syndrome (ARDS).Mumamiriro ezvinhu aya eARDS, mapapu anooma, zvichiita kuti zviome kuchengetedza mwero weokisijeni muropa.

2. Sistimu yemwoyo (mwoyo)

Sisitimu yedu yemwoyo ndiyo inopomba ropa mumuviri wese. Kukundikana kwemoyo uye kutenderera kweropa muropa mamiriro ezvinhu apo tsandanyama dzemwoyo dzinova dzisina simba kana kuti dzakaoma, zvichidzivira kuti dzisapombe ropa rakakwana mumuviri wese. Kuzvimba kwakanyanya kunoitika neMODS kunogona kukonzera kuti mitsipa yeropa iwedzere, zvichideredza huwandu hweropa rinosvika munyama nenhengo. Izvi zvinogona kukonzera kuderera kweropa (kuderera kweropa kana kushamisika) muMODS. Mvura inogonawo kubuda kubva mumitsipa iyi yeropa, zvichikonzera kuzvimba (edema).

3. Sisitimu yeropa (ropa)

MODS inogona kukonzera kusawirirana mune mamwe mapuroteni muropa. Izvi zvinogona kukonzera matambudziko ekubuda ropa uye kugwinha kweropa . Unogona kuona mavanga paganda kana kubuda ropa mudumbu mako. Dambudziko guru rinogona kukanganisa hurongwa hweropa rako iDisseminated Intravascular Coagulation (DIC) . Mumamiriro ezvinhu aya, ropa rinogona kutanga kubuda kubva mumacatheters kana machubhu ari paganda rako.

4. Tsinga (uropi)

Uropi hwedu inhengo inokosha inodzora hurongwa hwese mumuviri. Kana chikamu kana uropi hwese hukamira kushanda nekuda kwekukuvara kweuropi kana zvimwe zvikamu zvehurongwa hwepakati hwetsinga (kusanganisira musana netsinga dzakabatana nadzo), tinozviti 'kukundikana kwetsinga'. MuMODS, kuzvimba, kugonya kweropa nekuda kwematambudziko nehurongwa hweropa, uye kuderera kweropa kunogona kuderedza huwandu hweropa rinoyerera kuenda kuuropi. Izvi zvinogona kukuvadza uropi uye kukonzera kuvhiringidzika (`delirium`) .

5. Tsinga dzeitsvo (itsvo)

Kukundikana kweitsvo kunoitika kana itsvo dzikasakwanisa kuita mamwe mabasa adzo kana ese, kusanganisira kusefa tsvina kubva muropa. Sisitimu yeitsvo inosefa ropa redu, inogadzira weti, uye inobvisa mvura isina kufanira mumuviri. MuMODS, maitiro aya anogona kukanganisika.

6. Sisitimu yechiropa (chiropa)

Kukundikana kwechiropa kunoitika kana chiropa chikatadza kuita mamwe mabasa acho akawanda, akadai sekubvisa chepfu muropa, kusefa masero matsvuku eropa ekare, uye kugadzira bile (asidhi yeyero/girini inobatsira kugaya chikafu). Kuzvimba uye kudzikira kweropa kuenda kuchiropa kunogona kukonzera kuti chiropa chisashande zvakanaka. Izvi zvinogona kukonzera kuti ganda ne/kana maziso zviite yero (jaundice). Kukundikana kwechiropa kunogonawo kukonzera kuti dzimwe nhengo dzisashande zvakanaka.

MODS yakajairika zvakadii?

MODS chirwere chinowanzoitika muzvirwere zvakakomba uye zvine njodzi. Ongororo dzinoratidza kuti pakati pe28% ne88% yevarwere vari mumakamuri evarwere vane chirwere chemwoyo vanogona kuva neMODS. Ndiyo imwe yezvikonzero zvikuru zverufu mumakamuri evarwere vane chirwere chemwoyo (ICUs).

Ndezvipi zviratidzo zveMODS zvinotanga?

Nekuti MODS inogona kukanganisa chero nhengo mumuviri, zviratidzo zvinoenderana nenhengo yakakanganiswa. Zviratidzo izvi zvinogona kunge zvisina kunyanya kuoma pakutanga kwechirwere chinokonzera MODS, kana kuti zvinogona kunge zvakanyanya . MODS painokura kubva pachirwere chakakomba, unogona kusangana ne:

• Kusvotwa nekurutsa
• Kuda kudya
• Kunzwa kusina simba kana kuneta zvakanyanya
• Kupindwa nechando
• Kutonhodza
• Kuvhiringidzika kana kuoma kuisa pfungwa pachinhu chimwe chete
• Kufema nekukurumidza, kusina kudzika
• Kurova kwemoyo nekukurumidza kana kusina kurongeka
• Kurwadziwa kwenguva refu kwechipfuva uye/kana mudumbu
• Kuzvimba mudumbu
• Kuzvimba kwemakumbo
• Kutsvuka kweganda kana maziso (jaundice)
• Kuchinja kweruvara rwebhuruu kana grey/chena kweganda, miromo, rurimi, mazino, nzara, kana maziso (cyanosis)
• Kurasikirwa nepfungwa

Chii chinokonzera MODS?

MODS inogona kukonzerwa nechero chirwere chikuru, kukuvara, kana hutachiona. Vanachiremba nevaongorori havasati vaziva chikonzero chaicho cheMODS. Zvisinei, tsvakiridzo yazvino inoratidza kuti kuzvimba uye kuderera kweropa zvinowanzo kukonzera MODS. MODS haisi chirwere chimwe chete chakavanzika. Inobva muzviitiko zvakatevedzana zvinokanganisa akawanda kana ese masisitimu emuviri. Kuderera kweropa neokisijeni kunogona kukonzera kukuvara.

Fungidzira, kana munhu achirwara zvakanyanya, panogona kuva nezviitiko zvakawanda zvinotungamira kuMODS.

1. Chiitiko chikuru: Ichi ndicho chikonzero chekutanga. Semuenzaniso, hutachiona hwakanyanya (sepsis), tsaona huru (yakaita tsaona yemotokari), kana kurwara nemoyo kwakanyanya.

2. Chiitiko chechipiri: Apa ndipo apo masoja emuviri wako anotanga kuita zvinhu zvakawandisa, zvichikonzera kuzvimba kwakanyanya mumuviri wese.

3. Chiitiko chechitatu: Kana ukawana hutachiona hutsva, kana kuti uchifanira kuvhiyiwa kuti urapwe chirwere chekutanga, ichocho chingave chiitiko chechitatu.

Zvimwe zvikonzero zvinowanzoonekwa zveMODS ndeizvi:

• Sepsis kana septic shock: Izvi zvinogona kunge zviri kuzvimba kwakanyanya kunokonzerwa nehutachiona hwakakomba hwebhakitiriya kana hwehutachiona.
• Kukuvara nekukuvara: Zvinhu zvakaita setsaona yemotokari, kutsva zvakanyanya, kubaiwa nebanga, kana kupfurwa.
• Pancreatitis: Kuzvimba kwepancreas. Izvi zvinogona kukonzerwa nematombo emunduru, kunwa doro zvakanyanya, mimwe mishonga, nezvimwe zvinhu.
• Kurwara kukuru kwemoyo: Kunokonzerwa nekuvharika kwetsinga yeropa inoendesa ropa kumoyo.
• Kukundikana kwechiropa: Izvi zvinogona kukonzerwa neHepatitis B, Hepatitis C, chirwere chechiropa chine mafuta akawanda, kunwa doro zvakanyanya, uye cirrhosis.
• Kukuvara nehupfu uye chepfu:Zvinokonzerwa nekusangana nehupfu. Semuenzaniso, kushandisa zvinodhaka kana doro zvakanyanya kana kwenguva refu, makemikari ane chepfu akadai semishonga yekuuraya zvipembenene nezvinhu zvekare zvinodzivirira kupisa (asbestos), uye hutachiona hwebhakitiriya.

Matambudziko aya anokonzera shanduko huru mumasoja emuviri wako nemasoja eropa, izvo zvinokanganisawo dzimwe nhengo dzemuviri.

Ndeipi nhengo yekutanga kukundikana muMODS?

Vanhu vose vane MODS vanotanga vasangana nematambudziko emapapu , asi vanachiremba nevaongorori havasati vanyatsonzwisisa kuti sei kutadza kwemapapu kuchiwanzoitika MODS isati yasvika.

Ndiani anonyanya kukanganiswa neMODS?

Munhu wese anogona kuva neMODS, asi une mukana wekuva neMODS kana uine chimwe chinhu chauri kuda kuita, chakadai sechirwere chisingaperi kana kuti immune deficiency.

Nzira yekuziva sei MODS?

Vanachiremba vanoshandisa nzira dzakasiyana-siyana dzekuyedza kuti vaone kutadza kushanda kwenhengo dzemuviri wako wese. Izvi zvinogona kusanganisira:

• Kuongororwa kweropa
• Kuongororwa kwegasi reropa re arterial
• Kuongororwa kwebasa rechiropa
• Kuongororwa kwebasa reitsvo
• Tsika dzeropa nenyama
• Echocardiogram (ultrasound yemoyo)
• Miedzo yekufungidzira yakaita se ultrasound kana CT scan

MODS inorapwa sei?

Kurapwa kweMODS kunoenderana nechikonzero chacho uye nhengo dzemuviri dzakakanganiswa. Dzimwe sarudzo dzekurapa dzinosanganisira:

• Rapa ropa shoma nekupa mvura inoyerera mutsinga (IV) .
• Kupa mishonga yekuwedzera kuyerera kweropa mutsinga dzeropa nematishu (kuyerera kweropa mumatishu).
• Ipai mishonga inorwisa utachiona kurapa hutachiona uye/kana sepsis.
• Kuwedzerwa ropa kuti kutsiva ropa rakarasika kubva pakukuvara kana kuvhiyiwa.
• Kurapa neokisijeni kuti muviri uwane okisijeni yakawanda.
• Kana usingakwanise kufema wega, ungangoda mhepo inofema kuti ikubatsire kufema.
• Dialysis inobatsira kubvisa tsvina nemvura yakawandisa mumuviri wako.
• Kugadzira oxygenation yemuviri (ECMO) yekuwedzera okisijeni muropa uye kubvisa kabhoni dhayokisaidhi.
• Sisitimu inodzikamisa chiropa (MARS) inobvisa mamorekuru mumuviri.
• Kuvhiyiwa kwevarwere vane kukuvara kwakanyanya.
• Kuvhiyiwa kwekuisirwa nhengo yemuviri kunoreva kutsiviwa kwenhengo ine chirwere kana kuti isina kushanda zvakanaka nenhengo ine hutano inobva kumupi.
• Kana uine kubuda ropa mudumbu (GI) kana chirwere chemudumbu chinokutadzisa kudya, kana kuti kana usingakwanisi kudya, ungangoda kuwana zvinovaka muviri kuburikidza ne IV (intravenous) kana enteral nutrition (parenteral nutrition).

Ndichakurumidza sei kunzwa zviri nani mushure mekurapwa?

Kupora kwako kunoenderana nechikonzero chaicho uye kurapwa kwacho. Chiremba anogona kukupa pfungwa iri nani yekuti ungatarisira kuona riini kuvandudzwa mushure mekurapwa.

Remangwana reMODS nderei?

Remangwana reMODS rinoenderana nechikonzero chayo. Dzimwe nguva dzimwe pfungwa dzako kana kuti dzese dzinogona kudzokera pakare, asi ungangoda rutsigiro rwehupenyu kwenguva pfupi kusvika wapora.

Kuzivikanwa nekukurumidza uye kurapwa kweMODS pamwe nechikonzero chayo chakakosha pakugadzirisa chirwere ichi zvinobudirira.

Kufanotaura kweMODS kunosiyana zvichienderana nemakamuri ekuchengetwa kwevarwere vane chirwere chakanyanya (ICUs). Vanachiremba vanoona chirwere ichi sechikonzero chinowanzo kukonzera rufu kuvarwere vanobvumirwa mumakamuri ekuchengetwa kwevarwere vane chirwere chakanyanya.

Kana chirwere chikawedzera kusvika padanho rakakomba, nhengo dzemuviri dzinogona kukuvara zvachose. Ungangoda rutsigiro rwehupenyu hwako hwese kana kuisirwa nhengo. Zvinogonawo kuuraya.

Kutsvagurudza kwakawanda kunodiwa kuti kuonekwe zvinhu zvinogona kukanganisa MODS, izvo zvinogona kutungamira kune ramangwana riri nani kune varwere.

Chii chinonzi mwero wekurarama kubva kuMODS?

Vanachiremba nevaongorori vanofungidzira kuti mwero wekurarama kweMODS uri pakati pe50% ne60% .

MODS inogona kudzivirirwa here?

Zvimwe zvezvinhu zvinokonzera MODS hazvigone kudzivirirwa. Uye parizvino hapana mushonga chaiwo unogona kubatsira kudzivirira MODS. Vaongorori vanga vachitsvaga nzira dzekurapa MODS pakutanga kwayo kudzivirira chirwere ichi kuti chisanyanya kuipa. Zvidzidzo zvakati wandei zviri kuitwa pari zvino muchikamu ichi.

Unogona kubatsira kudzivirira nhengo dzako dzemuviri nekuita zvinhu zvakaita se:

• Dzivirira nhengo dzako dzemuviri kuti dzisavhunduke nekupfeka mabhandi ekuchengetedza paunenge uri mumotokari uye pfeka nhumbi dzekudzivirira paunenge uchitamba mitambo ine simba guru.
• Baiwa majekiseni ekudzivirira kutapurirana kwakakomba kana vanachiremba vakurudzira.
• Deredza kana kurega kutora mishonga isina kunyorerwa nachiremba, yakadai semishonga isingarwisi kuzvimba (NSAIDs), iyo inogona kukuvadza itsvo.
• Deredza kana kurega kutora mishonga kana zvimwe zvinhu zvinogona kukonzera maronda emudumbu, zvakaita seNSAIDs, kusvuta, uye doro .
• Tora kurapwa kweBP (BP) .

Kana uri muchipatara uine chirwere chakakomba, vanachiremba vako vanogona kuita zvinhu zvakaita seizvi kudzivirira MODS kuti isanyanya kuipa:

• Kuderedza kukuvara kwemapapu ako nekuda kwemhepo inofefetera.
• Deredza kuwedzerwa ropa kusvika zvanyatsokosha.
• Kushandisa mishonga inodzikisa ropa kana zvichidikanwa kudzivirira kuumbwa kweropa.

Ndinofanira kuona chiremba rini?

Kana uine chirwere chisingaperi uye uine zviratidzo zveMODS, izvo zvinogona kukonzera kurwara kwakanyanya uye kutadza kushanda kwenhengo dzemuviri, chinhu chakanaka nguva dzose kuona chiremba. Vanogona kukuudza zviratidzo kana zviratidzo zvekutarisa uye maitiro ekugadzirisa chero mamiriro ezvinhu.

Ndinofanira kuenda kuDhipatimendi reEmergency (ETU) riini?

Kana uine zviratidzo zveMODS, enda kuchipatara chiri pedyo kana kufonera 911. Izvi zvinogona kuuraya kana zvikasarapwa nekukasika.

Mibvunzo ipi yandinofanira kubvunza chiremba?

Heano mimwe mibvunzo yaungada kubvunza chiremba wako:

• Chii chinokonzera MODS?
• Ndedzipi nzira dzekurapa dzandinadzo?
• Mishonga ipi yaunokurudzira?
• Ndezvipi zvinangwa zvekutarisira kwangu?
• Ndinowanzoda kurapwa kangani?

Pfupiso neshoko rekupedzisira

Zvakanaka, saka ikozvino wava kuziva kuti multiple organ dysfunction syndrome (MODS) chirwere chakakomba chinokanganisa nhengo mbiri kana kupfuura mumuviri wako. Kunyangwe MODS ichigona kukanganisa chero nhengo, inowanzo kukanganisa mapapu, moyo, itsvo, chiropa, uropi, neropa. Pane zvikonzero zvakawanda zvinogona kukonzera izvi. Zvinowanzoitika kukuvara kwakanyanya, kurwara kwakanyanya, uye hutachiona hwakapararira. Kurapa kunotarisa pakurapa chirwere chiripo uku uchidzivirira kukuvara kwedzimwe nhengo.

Zvakajairika kuti unzwe kutya paunonzwa kuti nhengo dzako kana dzemumwe wako hadzisi kushanda. Asi vanachiremba nevashandi vari muEmergency Treatment Unit (ETU) neIntensive Care Unit (ICU) vakadzidziswa kutsigira nhengo dzako dzese, kudzivirira kukuvara kwakawanda, uye kubatsira muviri wako kupora. Saka usarasa tariro. Nekurapwa nekukurumidza uye mazano akakodzera ekurapa, unogona kuedza kubuda mumamiriro ezvinhu aya.

Kukundikana kwenhengo dzakawanda , MODS, kutadza kwenhengo, sepsis, kutarisirwa kwakanyanya, kutadza kwenhengo, rutsigiro rwehupenyu