Ingabe ukucindezela okukhulu ngaphakathi esiswini kuyingozi? (Isifo Segumbi Lesisu) Ake sifunde ngakho kalula!

Sonke siyazi ngezinhlungu zesisu, ukuqunjelwa, nezinye izimpawu. Nakuba lokhu kuvamile, wake wezwa ngesimo lapho ingcindezi ngaphakathi esiswini ikhula kakhulu kangangokuthi ingalimaza izitho ezibalulekile futhi ibeke ngisho nempilo engcupheni? Yilokho odokotela abakubiza ngokuthi isimo esibi esibizwa ngokuthi "i-Abdominal Compartment Syndrome." Igama lingase lizwakale liyinkimbinkimbi kancane, kodwa masigcine kulula. Ukuqaphela lezi zinto kungabaluleka kakhulu kuwe nakubantu obathandayo.

Iyini i-Abdominal Compartment Syndrome?

Kalula nje, "Isifo Segumbi Lesisu" siyisimo esiphuthumayo sezokwelapha . Sivela lapho ingcindezi engaphakathi kwesisu sethu, noma umgodi wesisu, idlula inani lesikhala esingasibamba. Cabanga ukuthi kwenzekani uma siphefumula umoya omningi kakhulu ebhaluni? Ngokufanayo, lapho ingcindezi engaphakathi kwesisu ikhula ngenxa yokuvuvukala, ukopha, noma ezinye izimbangela, izitho ezibalulekile njengamathumbu ethu, isibindi, nezinso ziqala ukucindezelwa.

Ngokuvamile, ingcindezi ngaphakathi esiswini somuntu ophilile iphakathi kwamamilimitha angu-0 nangu-5 e-mercury (mmHg). Kodwa-ke, ezigulini ezigula kakhulu ezigumbini zokunakekelwa okujulile, leli nani lingaba phakathi kuka-5 no-7 mmHg. Kulapho le ngcindezi ikhula khona lapho kuqala khona izinkinga:

• Umfutho wegazi ophakeme wangaphakathi kwesisu (IAH): Kulokhu, ingcindezi iphakathi kuka-12 no-20 mmHg.
• I-Abdominal Compartment Syndrome (ACS): Yilapho isimo siba yingozi khona. Umfutho ukhuphuka ufike ngaphezu kuka-20 mmHg.

Lokhu kucindezela okuphezulu kuvimbela izitho nemisipha engaphakathi kwesisu ukuthi ithole igazi elanele. Ngesikhathi esifanayo, ukutholakala komoya-mpilo nakho kuyancishiswa. Lokhu kuholela ekuhlulekeni kwesitho esisodwa ngemva kwesinye (ukwehluleka kwezitho eziningi). Uma lokhu kungaqashelwa futhi kwelashwa ngesikhathi, isiguli singase sife. Ngakho-ke, lesi yisimo okumele siqashelwe futhi siphathwe ngokushesha .

Ingabe lesi simo sivamile?

Cha, `(Isifo Segumbi Lesisu)` empeleni siyisimo esingavamile kakhulu . Sithinta kakhulu abantu abasezibhedlela, ikakhulukazi ezindaweni zokunakekelwa okujulile `(ICU)` asebevele benezimo zezokwelapha ezibucayi. Akulula ukuthi umuntu ophila impilo evamile nenempilo abe naso.

Yini ebangela i-Abdominal Compartment Syndrome?

Kunezizathu eziningana ezenza ukuthi ukucindezeleka kwangaphakathi kwesisu kube phezulu ngendlela eyingozi. Eziyinhloko ukopha noma ukuvuvukala okukhulu esiswini. Ake sibheke ukuthi ziyini lezi zimo:

• Ukuhlinzwa okukhulu esiswini sakho: Ngezinye izikhathi ukuvuvukala kungenzeka ngaphakathi esiswini ngemva kokuhlinzwa okukhulu.
• Ukutheleleka esiswini sakho:Ukutheleleka okukhulu nakho kungabangela umfutho wegazi ophakeme.
• Ukuvaleka kwamathumbu: Uma amathumbu evaleka ndawana thize, kungandisa nokucindezeleka.
• Inani elikhulu loketshezi lwe-IV (ukuvuselelwa koketshezi): Ngesikhathi sokuhlinzwa okuthile, noma ezimweni zokutheleleka okukhulu njenge-sepsis, umzimba udinga ukunikezwa inani elikhulu loketshezi olubalulekile. Lokhu ngezinye izikhathi kungandisa ingcindezi esiswini.
• Ukusha okukhulu: Lesi simo singase senzeke ngenxa yempendulo yomzimba lapho indawo enkulu yomzimba isha.
• Ukumpontshelwa igazi okukhulu: Le ngozi ikhona ngisho noma igazi eliningi limpontshelwa ngesikhathi esisodwa.
• I-Pancreatitis: Lena enye imbangela yokwanda kwengcindezi yesisu.
• Ukuqhuma kwe-aortic aneurysm yesisu: I-aorta iwumthambo wegazi oyinhloko othwala igazi lisuka enhliziyweni yethu lidlule esifubeni liye esiswini. Uma kuvela ukuvuvuka (i-aneurysm) engxenyeni yalo mthambo wesisu bese kuqhuma, kungabangela ukopha okukhulu kanye nokucindezeleka okukhulu ngaphakathi kwesisu.
• Ukulimala esiswini sakho: Lesi simo singase senzeke uma kukhona umonakalo omkhulu esiswini sakho, njengengozi yemoto noma ukuwa.

Yiziphi izimpawu ze-`(Abdominal Conpartment Syndrome)`?

Nakhu lapho ingozi ikhona khona. Izimpawu ze-"Abdominal Conpartment Syndrome" zivame ukuvela sekwephuzile , ngemva komonakalo othile. Yingakho odokotela kanye nabasebenzi abahlengikazi beqapha ngokucophelela iziguli ezisengozini yalesi simo.

Nazi ezinye zezici ezingabonakala:

• Ukukhukhumala kwesisu: Isisu singase sizwakale sengathi sivuvukele futhi siqinile .
• Ubuhlungu besisu: Isiguli singase sizizwe sinobuhlungu obukhulu esiswini.
• Ubunzima bokuphefumula: Lapho ingcindezi esiswini ikhuphuka, isifuba naso singathinteka, okwenza kube nzima ukuphefumula.
• Umfutho wegazi ophansi (ukwehla komfutho wegazi): Umfutho wegazi ophansi nawo uwuphawu lwalokhu.
• Ukwehla kokukhishwa komchamo (i-oliguria): Ngenxa yomthelela ezinso, inani lomchamo okhiqizwayo lingase lehle kakhulu.

Odokotela bakuqinisekisa kanjani lokhu?

Umuntu one-"Abdominal Conpartment Syndrome" angase abe nezimpawu ezifana nalezi:

• Umfutho wegazi ophansi.
• Ukukhishwa komchamo okuphansi.
• Uma uxhunywe kumshini wokuphefumula, amanani okucindezela kwawo angakhuphuka.

Kodwa-ke, lezi zimpawu zodwa azikwazi ukusetshenziselwa ukuxilonga i-ACS. Okuwukuphela kwendlela yokuxilonga lesi simo ngokuphelele ukukala ingcindezi yangaphakathi kwesisu.Udokotela uzophetha ngokuthi une-ACS kuphela uma lo mfutho ungaphezu kuka-20 mmHg futhi kunezimpawu zokwehluleka kwezitho zomzimba.

Indlela eyinhloko esetshenziswa njengamanje ukukala ingcindezi yangaphakathi kwesisu ukukala ingcindezi yesinye . Kalula nje, nansi indlela okwenziwa ngayo:

1. Okokuqala, kufakwa ipayipi elincane neliguquguqukayo (i-catheter) esinyeni. Lokhu kwenziwa nge-urethra.

2. Bese leli payipi (i-catheter) lidluliselwa esinyeni.

3. Manje isikhwama esinoketshezi sixhunywe kule payipi.

4. Kusetshenziswa isirinji, kufakwa uketshezi oluncane esinyini.

5. Ekugcineni, lokho kucindezela kuyalinganiswa.

Lokhu kuhlolwa kuphindaphindiwe yithimba lezokwelapha ukuze kubonakale ukuthi isimo siyathuthuka noma siyaba sibi.

Ngaphezu kwalokho, udokotela wakho angase enze nezinye izivivinyo ukuze abone ukuthi izitho zakho zomzimba zisebenza kahle yini. Isibonelo:

• Ukuhlolwa kwegazi: Lokhu kungalinganisa amazinga amakhemikhali namagesi ahlukahlukene emzimbeni. Isibonelo, ukuhlolwa kwe-creatinine clearance kunganikeza umbono wokuthi izinso zakho zisebenza kahle kangakanani.
• Ukuhlolwa kwezithombe: Lokhu kungathatha izithombe zengaphakathi lesisu sakho. Isibonelo, kungenziwa i-CT scan noma i-ultrasound yesisu.
• Ukulinganisa ukugcwala komoya-mpilo: Lokhu kuhilela ukubeka into efana nesiqeshana esilula emunweni wakho ukuze uhlole ukuthi umzimba wakho uthola umoya-mpilo owanele yini.

Iphathwa kanjani i-Abdominal Compartment Syndrome?

Ukwelashwa okusebenza kahle kakhulu kwalesi simo ukukhipha ukucindezeleka ngokuhlinzwa. Udokotela ohlinzayo wenza inqubo ekhethekile ebizwa ngokuthi i-decompressive laparotomy. Lokhu kuhilela ukwenza ukusika esikhumbeni nasodongeni lwesisu, ukuvula umgodi wesisu, nokunciphisa ingcindezi enkulu ngaphakathi .

Ingcindezi engaphakathi kwesisu izoqala ukwehla zingakapheli amahora ambalwa ngemva kokuhlinzwa. Kodwa-ke, kungathatha izinsuku eziningana ukuthi ingcindezi ibuyele esimweni esijwayelekile. Kuze kube yileso sikhathi, inxeba lokuhlinzwa lingase lingavalwa ngokuphelele. Ezinye iziguli zingadinga ukwenza lokhu kuhlinzwa okunciphisa ingcindezi futhi.

Ingabe lesi simo asinakuvinjelwa?

Ngaphambi kokuthi iqhubekele esigabeni se-`(Abdominal Compartment Syndrome - ACS)`, okungukuthi, lapho kukhona umfutho wegazi ophakeme wangaphakathi kwesisu (IAH), ungazama ukuphatha lesi simo ngaphandle kokuhlinzwa. Lokhu kwelashwa okungekona ukuhlinzwa kungasiza ekumiseni i-`(IAH)` ekubeni iqhubekele phambili iye kwi-`(ACS)`. Ukwelashwa okunjalo kufaka phakathi:

• Ukushintsha isimo somzimba: Ukubeka isiguli endaweni enciphisa ingcindezi futhi isenze sikhululeke.
• Imithi yokwehlisa uketshezi: Le mithi isiza ekususeni uketshezi oluningi emzimbeni.
• Ukukhipha uketshezi esiswini ngepayipi.
• Ukuthulula amathumbu: Lokhu kunganciphisa ingcindezi ngaphakathi esiswini futhi kudale isikhala esengeziwe.
• Ukunikeza imithi yokwelapha izinhlungu.
• Ukunciphisa inani loketshezi olunikezwa umzimba.

Linjani izinga lokululama kweziguli ezine-"Abdominal Compartment Syndrome"?

Leli iphuzu elibaluleke kakhulu. Uma i-"Abdominal Conpartment Syndrome" ingelashwa kahle, ingaba yingozi. Ngoba, njengoba ingcindezi ngaphakathi esiswini iqhubeka nokwanda, izitho zomzimba ziqala ukwehluleka. Futhi, uma ukuxilongwa nokwelashwa kuyephuza, amathuba okululama nawo ayancipha.

Kodwa-ke, uma lesi sifo sibonakala kusenesikhathi futhi ukwelashwa kuqala ngokushesha, kungenzeka ukuthi ululame ngokuphelele kwi-Abdominal Compartment Syndrome.

Kodwa-ke, kungathatha amasonto, ngisho nezinyanga, ukuthi isimo sezokwelapha esiyisisekelo esibangele i-ACS siphele. Phakathi naleso sikhathi, isiguli kungadingeka:

• Ukwelashwa nge-dialysis ukuze kwenziwe umsebenzi wezinso.
• Ukwelashwa isikhathi eside esibhedlela.
• Imikhawulo yoketshezi noma imithi yokukhipha isisu.
• Ukuqapha njalo ukusebenza kwenhliziyo.
• Umshini wokuphefumula owenziwe (umoya womshini) ukusiza ngokuphefumula.

I-Abdominal Compartment Syndrome iyisimo esiphuthumayo sezokwelapha esingaba khona kubantu abagula kakhulu. Yisimo lapho ukuvuvukala nokucindezeleka ngaphakathi esiswini kufinyelela emazingeni ayingozi. Ukuxilongwa nokwelashwa ngokushesha kubalulekile ukuvimbela izinkinga ezinkulu nokufa.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, manje usunombono ongcono ngalokho ebesikhuluma ngakho, i-Abdominal Compartment Syndrome. Nakuba lesi kuyisimo esibucayi, kubalulekile ukuqaphela.

• Umfutho ophakeme wangaphakathi kwesisu (i-ACS) yisimo esiphuthumayo esibangelwa umfutho ophakeme wangaphakathi kwesisu. Lokhu kungalimaza izitho zomzimba.
• Nakuba lokhu kungavamile , kungenzeka ezigulini ezisezindlini zokunakekelwa okujulile.
• Ukuqaphela izimpawu kusenesikhathi, ukukalwa komfutho wegazi, ukuqinisekiswa kwesifo, kanye nokuqala ukwelashwa ngokushesha kusindisa impilo. Ukwelashwa okuyinhloko ukuqeda ukucindezeleka ngokuhlinzwa.
• (IAH) , okusho ukuthi ingcindezi iphakeme kancane kodwa ayinzima njenge-``(ACS)``, ingalawulwa ngaphandle kokuhlinzwa.
• Ukululama kuncike ekutheni ukwelashwa kuqala ngokushesha kangakanani.

Sithemba ukuthi lolu lwazi luzokusiza. Uma othile omaziyo esegumbini lokunakekelwa okujulile, lolu lwazi luzokusiza uqonde ukuthi odokotela bakhuluma nini ngalezi zimo. Landela njalo imiyalelo kadokotela wakho futhi ubuze udokotela wakho uma unemibuzo.

'Isifo se-abdominal compartment, ingcindezi yesisu, umfutho wegazi ophakeme wangaphakathi kwesisu, ukuhlinzwa, iyunithi yokunakekelwa okujulile, ukwehluleka kwezitho zomzimba, isimo esiphuthumayo sezokwelapha