Ngaba uxinzelelo oluphezulu ngaphakathi esiswini luyingozi? (Isifo se-Abdominal Compartment Syndrome) Masifunde ngayo ngokulula!

Sonke siyazi ngeentlungu zesisu, ukudumba, kunye nezinye iimpawu. Nangona ezi ziqhelekile, ngaba wakha weva ngemeko apho uxinzelelo ngaphakathi esiswini lukhula kakhulu kangangokuba lunokonakalisa amalungu abalulekileyo kwaye lude lube yingozi ebomini? Yiloo nto oogqirha bayibiza ngokuba yimeko enzima ebizwa ngokuba yi-"Abdominal Compartment Syndrome." Eli gama lisenokuvakala linzima kancinci, kodwa masiligcine lilula. Ukuzazi ezi zinto kunokuba yinto ebalulekileyo kuwe nakubantu obathandayo.

Yintoni i-Abdominal Compartment Syndrome?

Ngamafutshane, "Isifo seSifo seSisu " yingxamiseko yezonyango . Sivela xa uxinzelelo olungaphakathi esiswini sethu, okanye kwisisu, ludlula indawo esinokuyibamba. Khawuthelekelele ukuba kwenzeka ntoni ukuba sivuthela umoya omninzi kakhulu kwibhaluni? Ngokufanayo, xa uxinzelelo olungaphakathi esiswini lusanda ngenxa yokudumba, ukopha, okanye ezinye izizathu, amalungu abalulekileyo anjengamathumbu ethu, isibindi, kunye nezintso aqala ukuxinana.

Ngokwesiqhelo, uxinzelelo olungaphakathi esiswini somntu ophilileyo luphakathi kwe-0 kunye ne-5 milimitha ye-mercury (mmHg). Nangona kunjalo, kwizigulana ezigula kakhulu kwiindawo zokhathalelo oluphezulu, eli xabiso linokuba phakathi kwe-5 kunye ne-7 mmHg. Kuxa olu xinzelelo lusanda apho iingxaki ziqala khona:

• Uxinzelelo lwegazi oluphakathi kwesisu (IAH): Kule meko, uxinzelelo luphakathi kwe-12 kunye ne-20 mmHg.
• Isifo seSigulo seSisu (ACS): Kulapho imeko iba yingozi khona. Uxinzelelo lunyuka luye ngaphaya kwe-20 mmHg.

Olu xinzelelo luphezulu luthintela amalungu kunye nemisipha engaphakathi kwesisu ukuba ingafumani igazi elaneleyo. Kwangaxeshanye, ukunikezelwa kweoksijini nako kuyancitshiswa. Oku kukhokelela ekungasebenzini kwelungu elinye emva kwelinye (ukungasebenzi kakuhle kwamalungu amaninzi). Ukuba oku akuqatshelwa kwaye akunyangwa ngexesha, isigulana sinokufa. Ke ngoko, le yimeko ekufuneka iqatshelwe kwaye inyangwe ngokukhawuleza .

Ingaba le meko ixhaphakile?

Hayi, `(Isifo seGumbi lesisu)` sisifo esingaqhelekanga kakhulu . Sichaphazela kakhulu abantu abasezibhedlele, ingakumbi kwiindawo zokhathalelo oluphezulu `(ICU)` abasele beneengxaki zempilo ezinzulu. Akunakwenzeka ukuba umntu ophila ubomi obuqhelekileyo nobusempilweni afumane esi sifo.

Yintoni ebangela i-Abdominal Compartment Syndrome?

Kukho izizathu ezahlukeneyo zokuba uxinzelelo lwangaphakathi esiswini lunokuba phezulu ngendlela eyingozi. Ezona ziphambili kukopha okanye ukudumba okugqithisileyo esiswini. Makhe sijonge ukuba zeziphi ezi meko:

• Utyando olukhulu esiswini sakho: Ngamanye amaxesha ukudumba kunokwenzeka ngaphakathi esiswini emva kotyando olukhulu.
• Usulelo esiswini sakho:Usulelo oluqatha lunokubangela uxinzelelo lwegazi oluphezulu.
• Ukuvaleka kwamathumbu: Ukuba amathumbu avalekile ndaweni ithile, kunokunyusa uxinzelelo.
• Izixa ezininzi zolwelo lwe-IV (ukuvuselelwa kolwelo): Ngexesha lotyando oluthile, okanye kwiimeko zosulelo olunzima olufana ne-sepsis, umzimba kufuneka unikwe izixa ezininzi zolwelo oluyimfuneko. Oku ngamanye amaxesha kunokunyusa uxinzelelo esiswini.
• Ukutsha okukhulu: Le meko inokwenzeka ngenxa yempendulo yomzimba xa indawo enkulu yomzimba itsha.
• Utofelo-gazi olukhulu: Olu mngcipheko ukho nokuba igazi elininzi litofelwa ngaxeshanye.
• I-Pancreatitis: Le yenye imbangela yokunyuka koxinzelelo lwesisu.
• Ukuqhekeka kwe-aortic aneurysm yesisu: I-aorta ngumthambo wegazi oyintloko othwala igazi lisuka entliziyweni yethu lisiya esifubeni ukuya esiswini. Ukuba kuvela ukudumba (i-aneurysm) kwinxalenye yalo mthambo wesisu kwaye kuqhekeke, kunokubangela ukopha okukhulu kunye noxinzelelo oluphezulu ngaphakathi esiswini.
• Ukulimala kwesisu sakho: Le meko inokwenzeka ukuba kukho umonakalo omkhulu esiswini sakho, njengengozi yemoto okanye ukuwa.

Zithini iimpawu ze-`(Abdominal Conpartment Syndrome)`?

Nanku apho ingozi ikhona khona. Iimpawu ze-"Abdominal Conpartment Syndrome" zihlala zibonakala emva kwexesha , emva kokuba kubekho umonakalo othile. Yiyo loo nto oogqirha kunye nabasebenzi babongikazi bebeka esweni ngokusondeleyo izigulana ezisengozini yale meko.

Nazi ezinye zeempawu ezinokuchongwa:

• Ukudumba kwesisu: Isisu sinokuvakala ngathi sidumbile kwaye siqinile .
• Intlungu yesisu: Isigulana sinokuziva sibuhlungu kakhulu esiswini.
• Ubunzima bokuphefumla: Xa uxinzelelo esiswini lusanda, isifuba naso sinokuchaphazeleka, nto leyo eyenza kube nzima ukuphefumla.
• Uxinzelelo lwegazi oluphantsi (uxinzelelo oluphantsi kwegazi): Uxinzelelo lwegazi oluphantsi nalo luphawu loku.
• Ukuncipha kokuphuma komchamo (i-oliguria): Ngenxa yempembelelo kwizintso, ubungakanani bomchamo oveliswayo bunokwehla kakhulu.

Oogqirha bakuqinisekisa njani oku?

Umntu one-"Abdominal Conpartment Syndrome" unokufumana iimpawu ezifana nezi:

• Uxinzelelo lwegazi oluphantsi.
• Ukuphuma komchamo okuphantsi.
• Ukuba uqhagamshelwe kwi-ventilator, amaxabiso ayo oxinzelelo anokunyuka.

Nangona kunjalo, ezi mpawu zodwa azinakusetyenziswa ukuxilonga i-ACS. Eyona ndlela ikuphela kwayo yokuxilonga le meko kukulinganisa uxinzelelo lwangaphakathi esiswini.Ugqirha uza kugqiba kwelokuba une-ACS kuphela ukuba olu xinzelelo lungaphezulu kwe-20 mmHg kwaye kukho iimpawu zokungasebenzi kakuhle kwamalungu omzimba.

Indlela ephambili esetyenziswayo ngoku ukulinganisa uxinzelelo lwangaphakathi kwesisu kukulinganisa uxinzelelo lwesinyi . Ngamazwi alula, le yindlela eyenziwa ngayo:

1. Okokuqala, kufakwa umbhobho omncinci noguquguqukayo (i-catheter) kwisinyi. Oku kwenziwa nge-urethra.

2. Emva koko le tube (catheter) idluliselwa kwisinyi.

3. Ngoku ingxowa equlethe ulwelo iqhagamshelwe kule tube.

4. Kusetyenziswa isirinji, intwana yolwelo ifakwa kwisinyi.

5. Okokugqibela, olo xinzelelo luyalinganiswa.

Olu vavanyo luphindaphindwa rhoqo liqela lezonyango ukuze kubonwe ukuba imeko iyaphucuka okanye iyawohloka.

Ukongeza, ugqirha wakho angenza nezinye iimvavanyo ukuze abone ukuba amalungu akho omzimba asebenza kakuhle na. Umzekelo:

• Uvavanyo lwegazi: Olu vavanyo lunokulinganisa amanqanaba eekhemikhali ezahlukeneyo kunye neegesi emzimbeni. Umzekelo, uvavanyo lwe-creatinine clearance lunokunika umbono wokuba izintso zakho zisebenza kakuhle kangakanani.
• Uvavanyo lokufota: Olu vavanyo lungathatha imifanekiso yesisu sakho ngaphakathi. Umzekelo, kunokwenziwa i-CT scan okanye i-ultrasound yesisu.
• Ukulinganisa ukugcwala kweoksijini: Oku kuquka ukubeka into efana nekliphu elula emnweni wakho ukujonga ukuba umzimba wakho ufumana ioksijini eyaneleyo na.

Iphathwa njani i-Abdominal Compartment Syndrome?

Unyango olusebenzayo kakhulu kule meko kukususa uxinzelelo ngotyando. Ugqirha wenza inkqubo ekhethekileyo ebizwa ngokuba yi-decompressive laparotomy. Oku kubandakanya ukwenza ukusika ulusu nodonga lwesisu, ukuvula umngxuma wesisu, kunye nokunciphisa uxinzelelo olugqithisileyo ngaphakathi .

Uxinzelelo olungaphakathi esiswini luya kuqala ukwehla kwiiyure ezimbalwa emva kotyando. Nangona kunjalo, kungathatha iintsuku ezininzi ukuba uxinzelelo lubuyele esiqhelweni. Kude kube ngoko, inxeba lotyando lisenokungavalwanga ngokupheleleyo. Ezinye izigulana zinokufuna ukuba nolu tyando lokunciphisa uxinzelelo kwakhona.

Ngaba le meko ayinakuthintelwa?

Ngaphambi kokuba ifikelele kwinqanaba le-`(Abdominal Compartment Syndrome - ACS)`, oko kukuthi, xa kukho uxinzelelo lwegazi oluphezulu olungaphakathi kwesisu (IAH), ungazama ukulawula imeko ngaphandle kotyando. Olu nyango lungasetyenziswa ngotyando lunokunceda ekumiseni i-`(IAH)` ekubeni iqhubeke iye kwi-`(ACS)`. Olu nyango luquka:

• Ukutshintsha indawo yomzimba: Ukubeka isigulana kwindawo enciphisa uxinzelelo kwaye isenze sikhululeke.
• I-Diuretics: La mayeza anceda ekususeni ulwelo olugqithisileyo emzimbeni.
• Ukususa ulwelo esiswini ngetyhubhu.
• Ukukhupha amathumbu: Oku kunokunciphisa uxinzelelo ngaphakathi esiswini kwaye kwenze indawo engakumbi.
• Ukunika amayeza okudambisa iintlungu.
• Ukunciphisa ulwelo olunikwa umzimba.

Injani izinga lokuchacha kwezigulane ezine-"Abdominal Compartment Syndrome"?

Eli linqaku elibaluleke kakhulu. Ukuba i-"Abdominal Conpartment Syndrome" ayinyangwa ngokufanelekileyo, inokubulala. Kuba, njengoko uxinzelelo ngaphakathi esiswini luqhubeka lusanda, amalungu omzimba aqala ukungasebenzi kakuhle. Kwakhona, ukuba ukuxilongwa kunye nonyango kulibaziseka, amathuba okuchacha nawo ayancipha.

Nangona kunjalo, ukuba isifo siqatshelwa kwangethuba kwaye unyango luqala ngokukhawuleza, kunokwenzeka ukuba umntu aphile ngokupheleleyo kwi-Abdominal Compartment Syndrome.

Nangona kunjalo, kungathatha iiveki, kwaneenyanga, ukuba imeko yezonyango ebangele ukuba i-ACS iphele. Ngeli xesha, isigulana sinokufuna:

• Unyango lwe-Dialysis ukuze lwenze umsebenzi wezintso.
• Unyango lwexesha elide esibhedlele.
• Izithintelo zolwelo okanye amayeza okukhupha umchamo.
• Ukujonga rhoqo ukusebenza kwentliziyo.
• Umatshini wokuphefumla owenziweyo (umoya woomatshini) ukunceda ekuphefumleni.

I-Abdominal Compartment Syndrome yimeko engxamisekileyo yezonyango enokwenzeka kubantu abagula kakhulu. Yimeko apho ukudumba kunye noxinzelelo ngaphakathi esiswini kufikelela kumanqanaba ayingozi. Ukuxilongwa ngokukhawuleza kunye nonyango kubalulekile ukuthintela iingxaki ezinkulu kunye nokufa.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoku unombono ongcono wento ebesithetha ngayo, i-Abdominal Compartment Syndrome. Nangona esi sisifo esibi kakhulu, kubalulekile ukuba usiqaphele.

• Uxinzelelo olukhawulezileyo olungaphakathi kwesisu (ACS) yimeko engxamisekileyo ebangelwa luxinzelelo olugqithisileyo olungaphakathi kwesisu. Oku kungonakalisa amalungu omzimba.
• Nangona oku kungaqhelekanga , kunokwenzeka kwizigulana ezikwiiyunithi zokhathalelo oluphezulu.
• Ukuqaphela iimpawu kwangethuba, ukulinganiswa koxinzelelo lwegazi, ukuqinisekiswa kwesi sifo, kunye nokuqaliswa konyango ngokukhawuleza kuyasindisa ubomi. Unyango oluphambili kukunciphisa uxinzelelo ngotyando.
• (IAH) , oko kuthetha ukuba uxinzelelo luphezulu kancinci kodwa alunzima njenge ``(ACS)``, lunokulawulwa ngaphandle kotyando.
• Ukuchacha kuxhomekeke ekubeni unyango luqalwa ngokukhawuleza kangakanani.

Siyathemba ukuba olu lwazi luza kukunceda. Ukuba umntu omaziyo ukwiyunithi yokhathalelo oluphezulu, olu lwazi luza kukunceda uqonde xa oogqirha bethetha ngezi meko. Landela imiyalelo kagqirha wakho rhoqo kwaye ubuze ugqirha wakho ukuba unemibuzo.

"Isifo sendawo yesisu, uxinzelelo lwesisu, uxinzelelo lwegazi oluphezulu olungaphakathi kwesisu, utyando, iyunithi yokhathalelo olunzulu, ukungasebenzi kakuhle kwamalungu omzimba, imeko engxamisekileyo yezonyango