Cabanga ngokuzumayo ukopha ngokungalawuleki emzimbeni wakho wonke, ngisho nokubhoboka yonke indawo. Lokhu kuyesabeka ngempela, akunjalo? Namuhla sizokhuluma ngesimo esibi kangaka, kodwa esingavamile kakhulu. Lokhu ngokwezokwelapha kubizwa ngokuthi i-Disseminated Intravascular Coagulation, noma i-DIC ngamafuphi. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kalula nje, iyini i-DIC?
I-DIC iyinkinga eyinkimbinkimbi kakhulu futhi engathi sína eyenzeka ohlelweni lwethu lokujiya kwegazi. Kwenzeka into exakile kulokhu. Ngakolunye uhlangothi, inani elikhulu lamaqhubu egazi amancane liqala ukwakheka ngokungadingekile ngaphakathi kwemithambo yegazi yomzimba. Ngakolunye uhlangothi, lokhu kubangela ukuthi into ebaluleke kakhulu esiza ukuthi iqhubu legazi liphele, okubangela ukuphuma kwegazi okungalawuleki .
Into ebalulekile ukuthi i-DIC akuyona isifo esenzeka sodwa. Ihlala ivela njengenkinga yesinye isifo esingathi sína noma ingozi enkulu. Ngakho-ke, uma ingelashwa ngokushesha, ingaba yingozi empilweni.
Ziyini izimpawu ze-DIC?
Kulesi simo, kokubili ukujiya kwegazi kanye nezinqubo zokopha kwenzeka ngesikhathi esisodwa, ngakho-ke kungase kuvele izimpawu ezihlobene nakho kokubili.
| Isibonakaliso | Incazelo |
|---|---|
| Ukopha okungalawuleki | Ukopha okuvela ezingxenyeni eziningi zomzimba ngesikhathi esisodwa. Isibonelo, ukopha okungenakuvinjelwa kungavela ekhaleni, ezinsinini, ezindaweni zokujova, noma emanxebeni okuhlinzwa. |
| Imivimbo yesikhumba | Imivimbo eluhlaza okwesibhakabhaka/onsomi ebonakala emzimbeni ngaphandle kwesizathu esibonakalayo. |
| Ubunzima bokuphefumula | Ukuqhekeka kwegazi emithanjeni yegazi eholela emaphashini kungabangela ubunzima bokuphefumula (ukuphelelwa umoya). |
| Ukudideka kwengqondo | Ukuphazamiseka kokunikezwa kwegazi ebuchosheni kungabangela ukudideka, ukulahlekelwa yinkumbulo, noma izinguquko zokuziphatha. |
| Umkhuhlane ophezulu | Ukuba nomkhuhlane ongaphezu kwama-degree Celsius angu-39.4 (103 Fahrenheit). |
Kungani le DIC yenzeka? Ake sibheke ngokuningiliziwe.
Ukuze siqonde lokhu, sidinga kuqala ukuqonda okuncane ngendlela imizimba yethu evame ukugoba ngayo. Ake sithi unenxeba elincane engalweni yakho. Ngaleso sikhathi, ama-platelet egazini lethu kanye nezinto ezijiyayo ezenziwe yisibindi ziyahlangana ukuze zivale inxeba futhi zimise ukopha. Kufana nokusebenzisa izitini (ama-platelet) kanye nesamente (amaprotheni) ukuze kuboshwe imbobo odongeni.
Kodwa endabeni ye-DIC, le nqubo iphazamiseke ngokuphelele.
Isigaba sesibili sesimo se-DIC
1. Isigaba 1 (Amahlule Egazi): Ngenxa yesimo esibucayi sezokwelapha, izinkulungwane zamahlule amancane egazi ziqala ukwakheka emithanjeni yegazi emincane kuwo wonke umzimba. Lokhu kuvimbela ukuhlinzekwa kwegazi ezithweni ezibalulekile njengobuchopho, izinso namaphaphu. Kunjengokungathi yonke imigwaqo emincane edolobheni ivalwe ngokuzumayo.
2. Isigaba 2 (Ukopha): Ngokwenza amahlule egazi angadingekile, umzimba wethu usebenzisa wonke ama-platelet namaprotheni okujiya kwegazi. Manje, uma kwenzeka inxeba ngempela, umzimba awunazo "izitini nosimende" ezidingekayo ukuze ulivale. Umphumela uba ukopha okukhulu, okungalawuleki.
Ubani osengozini enkulu yokuthola i-DIC?
Njengoba sishilo ngaphambili, lokhu kuwumphumela wesinye isimo esibucayi. Ngakho-ke, abantu abanezimo ezilandelayo basengozini enkulu yokuthola i-DIC:
| Izinto ezandisa ingozi ye-DIC | |
|---|---|
| Izimo zezokwelapha ezingathi sína | |
| |
| Izizathu ezihlobene nokwelashwa kwezokwelapha | |
|
Odokotela bakuthola kanjani lokhu?
I-DIC ivame ukwenzeka kumuntu osesibhedlela kakade futhi othola ukwelashwa kwesimo esibucayi sezokwelapha. Udokotela wakho uzobuyekeza ngokucophelela izimpawu zakho kanye nomlando wezokwelapha. Ngaphezu kwalokho, bazokwenza ukuhlolwa kwegazi okukhethekile okuningana ukuqinisekisa isimo.
- I-Complete Blood Count (CBC): Hlola ukuthi inani lama-platelet liphansi yini.
- Isikhathi se-Prothrombin (PT) kanye nesikhathi se-Partial Thromboplastin (PTT): Linganisa isikhathi esithathwayo ukuze igazi lijiye.
- Ukuhlolwa kwe-Fibrinogen: Kuhlola izinga leprotheni esiza ukujiya kwegazi.
- Ukuhlolwa kwe-D-dimer: Into ekhiqizwa lapho amahlule egazi ehlukana emzimbeni. Amazinga aphezulu alokhu ayisibonakaliso esibalulekile se-DIC.
Yiziphi izindlela zokwelapha lokhu?
Isinyathelo esibaluleke kakhulu nesiqalayo ekwelapheni i-DIC ukwelapha isimo sezokwelapha esiyisisekelo (isb., i-sepsis) esibangele lesi simo. I-DIC yodwa ayinakwelapheka ngaphandle kokwelapha lokho.
Ngesikhathi benikeza ukwelashwa kokuqala, odokotela benza okulandelayo ukulawula i-DIC:
- Ukumpontshelwa nge-plasma: Ukubuyisela amaprotheni (izici zokujiya) adingekayo ukuze igazi lijiye.
- Ukunikezwa kwama-platelet namaseli abomvu egazi: Buyisela ama-platelet namaseli abomvu egazi anciphile ngenxa yokopha.
- Ama-anticoagulant:Kwezinye izimo, le mithi (imithi yokunciphisa igazi) inikezwa ukulawula amahlule egazi angadingeki.
Lokhu kwelashwa kunikezwa ngokucophelela okukhulu, kuqashwe njalo isimo sesiguli, ngoba lesi yisimo esiyinkimbinkimbi kakhulu.
Kunini lapho udinga ukubona udokotela ngokuzumayo?
Uma wena noma othile omaziyo egula kakhulu futhi kuvela izimpawu ezilandelayo ngokuzumayo, hamba uye e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha .
- Uma kukhona ukopha okukhulu okungenakuvinjelwa .
- Uma uba nezimpawu zokuhlaselwa yinhliziyo (ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula).
- Uma kuvela izimpawu zokuhlaselwa yisifo sohlangothi (ukugoba kolunye uhlangothi lobuso, ubunzima bokukhuluma, ukulahlekelwa umuzwa engalweni).
Ingabe i-DIC ingalapheka ngokuphelele?
Yebo, kungenzeka nakanjani. Uma imbangela eyinhloko ye-DIC ilawulwa ngempumelelo , isiguli singalulama ngokuphelele. Ukwelashwa okusekelayo, njengokumpontshelwa igazi nge-plasma kanye nokumpontshelwa igazi, kungasiza ekubuyiseleni uhlelo lokujiya kwegazi.
Ukuba ne-DIC kusho ukuthi usuvele ulwa nesinye isimo sezokwelapha esibucayi. Ngakho-ke, kungaba ukucindezeleka ukubhekana nale nselele eyengeziwe. Kodwa, landela imiyalelo kadokotela wakho ngqo.
- Thatha imithi ebhalwe phansi ngesikhathi esibekiwe kanye nomthamo obekwe eceleni. Ungayeki ukuthatha noma yimuphi umuthi noma ushintshe umthamo ngaphandle kweseluleko sikadokotela wakho.
- Ungasebenzisi imithi yokubulala izinhlungu, amavithamini, noma ezinye izithako ezithengwa ekhemisi ngaphandle kokubonisana nodokotela wakho.
- Uma uthatha ama-anticoagulant, yazisa wonke udokotela okuxilongayo.
Kuvamile ukuzizwa wesaba uma uthola ngesimo esibucayi kangaka. Kodwa khumbula, izwe lethu linodokotela abanekhono kanye nabasebenzi basesibhedlela abaqeqeshwe ukuphatha izimo eziyinkimbinkimbi kangaka. Ngakho-ke, kubaluleke kakhulu ukubathemba nokufuna ukwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- I-DIC akuyona isifo esizenzekela sodwa. Ihlala ivela njengenkinga yesinye isimo sezokwelapha esibucayi .
- Kulesi simo, kwenzeka izinto ezimbili eziphikisanayo ngesikhathi esisodwa: ukujiya kwegazi okungadingekile emzimbeni kanye nokopha okungalawuleki.
- Umgomo oyinhloko wokwelashwa ukwelapha imbangela eyisisekelo ye-DIC.
- Uma kuvela izimpawu ezinzima njengokuphuma kwegazi okungenakunqandeka noma izimpawu zesifo sohlangothi, kufanele uye e-Emergency Treatment Unit (ETU) esibhedlela ngokushesha .
- Ngokwelashwa okufanele, i-DIC ingalawulwa futhi isifo esiyisisekelo selashwe, okuholela ekululameni okuphelele.
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