Ingabe izitho eziningana emzimbeni wakho ziyahluleka ngesikhathi esisodwa? Ake sixoxe ngalesi simo esibizwa ngokuthi i-Multiple Organ Dysfunction Syndrome (MODS)!

Cishe uke wezwa ukuthi uma umuntu egula kakhulu ngokuzumayo futhi esegumbini lokunakekelwa okujulile esibhedlela (ICU), bathi, "Odokotela bathi ezinye izingxenye zomzimba wakhe azisebenzi kahle." Noma, "Bagcinwa bephila ngemishini." Eqinisweni, ngaleso sikhathi, lowo muntu angase abe nesimo esibi kakhulu. Kwezokwelapha, sibiza lokhu ngokuthi i-Multiple Organ Dysfunction Syndrome, noma ngesiNgisi, ``Multiple Organ Dysfunction Syndrome - MODS.'' Igama lizwakala liyesabeka kancane, kodwa ake sixoxe ngokuthi liyini, kungani lenzeka, nokuthi ungasinda kanjani ngendlela elula ongayiqonda.

Iyini ngempela i-MODS?

Kalula nje, i-MODS yisimo sezokwelapha esibi kakhulu (esibi kakhulu) . Okwenzekayo kulokhu ukuthi izinhlelo ezimbili noma ngaphezulu zezitho zomzimba wethu ezixhumene ziyayeka ukusebenza kahle ngokuzumayo. Cabanga ngakho, imizimba yethu inezinhlelo eziningi ezifana nohlelo lokuphefumula, uhlelo lokugaya ukudla, kanye nohlelo lomchamo. Lokhu kusebenza ndawonye ukuze kusigcine siphilile. Uma kwenzeka i-MODS, lezi zinhlelo zezitho azikwazi ukusebenza zodwa. Khona-ke imishini yokusekela impilo ('ukusekela impilo') iyadingeka ukuze kwenziwe umsebenzi walezo zitho.

I-MODS ingathinta noma yisiphi isitho emzimbeni, kodwa ezivame kakhulu yilezi:

• Amaphaphu
• Inhliziyo
• Ubuchopho
• Izinso
• Isibindi
• Igazi (igazi)

I-MODS ingaba nezimbangela eziningi. Imbangela evame kakhulu ukutheleleka okukhulu (i-sepsis) . Lapho belapha i-MODS, odokotela baqala ngokuzama ukulawula isimo esiyisisekelo esibangele lesi simo. Baphinde bathathe izinyathelo zokuvimbela ukulimala kwezinye izinhlelo zezitho zomzimba.

I-MODS iyisimo sezokwelapha esiyingozi kakhulu . Ingabulala uma ingelashwa ngokushesha. Abantu abaningi abane-MODS bangeniswa egunjini lokunakekelwa okujulile (ICU) futhi badinga ukubhekwa njalo nokusekelwa kokuphila.

Lesi simo sibizwa ngamanye amagama amaningana, afaka phakathi:

• Ukwehluleka kwezitho eziningi
• Ukwehluleka kwesistimu yezitho eziningi

Yiziphi izinhlelo zomzimba ezingathinteka yi-MODS?

Ama-MODS angathinta izinhlelo ezimbili noma ngaphezulu zezitho ezilandelayo:

1. Uhlelo lokuphefumula (amaphaphu)

Uma amaphaphu ethu engakwazi ukunikeza umzimba inani lomoya-mpilo olidingayo, okusho ukuthi izicubu zomzimba azitholi umoya-mpilo owanele (i-hypoxia) noma umzimba awutholi i-carbon dioxide eyanele (i-CO2) (i-hypercapnia), sikubiza ngokuthi ukwehluleka kokuphefumula. Ku-MODS, unenkinga yokuphefumula futhi ungase udinge ngisho nokuphefumula ngomshini ukuze kukusize uphefumule. Umonakalo omkhulu wamaphaphu ku-MODS yi- Acute Respiratory Distress Syndrome (ARDS).Kulesi simo se-ARDS, amaphaphu ayaqina, okwenza kube nzima kakhulu ukugcina amazinga ajwayelekile omoya-mpilo egazini.

2. Isistimu yenhliziyo (inhliziyo)

Uhlelo lwethu lwenhliziyo nemithambo yegazi yilona olupompa igazi emzimbeni wonke. Ukwehluleka kwenhliziyo kanye nokushaqeka kokujikeleza kwegazi yizimo lapho imisipha yenhliziyo iba buthakathaka noma iqine, okuyenza ingakwazi ukupompa igazi elanele emzimbeni wonke. Ukuvuvukala okweqile okwenzeka nge-MODS kungabangela ukuba imithambo yegazi ivuleke, kunciphise inani legazi elifinyelela ezicutshini nasezithweni zomzimba. Lokhu kungaholela ekucindezelekeni kwegazi okuphansi (umfutho wegazi ophansi noma ukushaqeka) ku-MODS. Uketshezi lungavuza futhi kule mithambo yegazi, okubangela ukuvuvukala (i-edema).

3. Uhlelo lwegazi (igazi)

I-MODS ingabangela ukungalingani kwamaprotheni athile egazini. Lokhu kungaholela ezinkingeni zokopha nokujiya kwegazi . Ungase uqaphele ukuphuka esikhumbeni noma ukopha ngaphakathi esiswini sakho. Inkinga enkulu kakhulu engathinta uhlelo lwakho lwegazi yi- Disseminated Intravascular Coagulation (DIC) . Kulesi simo, igazi lingaqala ukuvuza kuma-catheter noma amapayipi esikhumbeni sakho.

4. Uhlelo lwezinzwa (ubuchopho)

Ubuchopho bethu buyisitho esibalulekile esilawula yonke isimiso emzimbeni. Lapho ingxenye noma yonke ingcondo iyeka ukusebenza ngenxa yomonakalo ebuchosheni noma kwezinye izingxenye zesimiso sezinzwa esiyinhloko (kufaka phakathi intambo yomgogodla kanye nemithambo ehambisana nayo), sikubiza ngokuthi 'ukwehluleka kwemizwa'. Ku-MODS, ukuvuvukala, ukujiya kwegazi ngenxa yezinkinga zesistimu yegazi, kanye nomfutho wegazi ophansi kunganciphisa inani legazi eligeleza ebuchosheni. Lokhu kungalimaza ubuchopho futhi kubangele ukudideka (`delirium`) .

5. Uhlelo lwezinso (izinso)

Ukwehluleka kwezinso kwenzeka lapho izinso zingakwazi ukwenza eminye noma yonke imisebenzi yazo, okuhlanganisa nokuhlunga imfucuza egazini. Uhlelo lwezinso luhlunga igazi lethu, lwenze umchamo, futhi lususe uketshezi olungadingekile emzimbeni. Ku-MODS, le nqubo ingaphazamiseka.

6. Uhlelo lwesibindi (isibindi)

Ukwehluleka kwesibindi yilapho isibindi singakwazi ukwenza eminye noma yonke imisebenzi yaso eminingi, njengokususa ubuthi egazini, ukuhlunga amangqamuzana abomvu egazi amadala, nokukhiqiza i-bile (i-asidi ephuzi/eluhlaza esiza ekugayeni ukudla). Ukuvuvukala nokuncipha kokugeleza kwegazi esibindini kungabangela ukuthi isibindi sihluleke. Lokhu kungabangela isikhumba kanye/noma amehlo ukuba aphenduke aphuzi (i-jaundice). Ukwehluleka kwesibindi kungabangela nezinye izitho ukuba zihluleke.

Ivame kangakanani i-MODS?

I-MODS yisimo esivamile esibonakala ezifweni ezibucayi nezibucayi. Izifundo ziphakamisa ukuthi phakathi kuka-28% no-88% weziguli ezisezigungwini zokunakekelwa okujulile zingase zibe ne-MODS. Futhi iyimbangela ehamba phambili yokufa ezigungwini zokunakekelwa okujulile kokuhlinzwa (i-ICU).

Ziyini izimpawu zokuqala ze-MODS?

Ngenxa yokuthi i-MODS ingathinta noma yisiphi isitho emzimbeni, izimpawu zincike esithweni esithintekile. Lezi zimpawu zingaba zincane ezigabeni zokuqala zesifo esibangela i-MODS, noma zingaba zimbi kakhulu . Njengoba i-MODS iqhubeka isuka ekuguleni okukhulu, ungase ubhekane nalokhu:

• Isicanucanu nokuhlanza
• Isifiso sokudla
• Ukuzizwa ubuthakathaka kakhulu noma ukhathele
• Imfiva
• Ukupholisa
• Ukudideka noma ubunzima bokugxilisa ingqondo
• Ukuphefumula okusheshayo, okungajulile
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• Ubuhlungu besifuba kanye/noma isisu isikhathi eside
• Ukuqunjelwa kwesisu
• Ukuvuvukala kwamalungu
• Ukuphuzi kwesikhumba noma amehlo (i-jaundice)
• Ukushintsha kombala wesikhumba, izindebe, ulimi, izinsini, izinzipho, noma amehlo kube luhlaza okwesibhakabhaka noma okumpunga/okumhlophe (cyanosis)
• Ukulahlekelwa ingqondo

Yini ebangela ama-MODS?

I-MODS ingabangelwa yinoma yikuphi ukugula okukhulu, ukulimala, noma ukutheleleka. Odokotela nabacwaningi abakayazi imbangela eqondile ye-MODS. Kodwa-ke, ucwaningo lwamanje lusikisela ukuthi ukuvuvukala nokuncipha kokunikezwa kwegazi kuvame ukuba yimbangela ye-MODS. I-MODS ayibangelwa yisimo esisodwa sezokwelapha esiyisisekelo. Ivela ochungechungeni lwezehlakalo ezithinta eziningi noma zonke izinhlelo zomzimba. Ukuncipha kokunikezwa kwegazi nomoya-mpilo kungaholela ekulimaleni.

Cabanga nje, ekuguleni okukhulu, kungaba nezenzakalo eziningana eziholela ku-MODS.

1. Isigameko esiyinhloko: Lesi yimbangela yokuqala. Isibonelo, ukutheleleka okukhulu (i-sepsis), ingozi enkulu (njengengozi yemoto), noma ukuhlaselwa yinhliziyo okukhulu.

2. Isenzakalo sesibili: Lokhu kwenzeka lapho amasosha omzimba wakho esabela ngokweqile, okubangela ukuvuvukala okukhulu emzimbeni wonke.

3. Isigameko sesithathu: Uma uthola ukutheleleka okusha, noma kufanele uhlinzwe ukuze welaphe isimo sokuqala, lokho kungaba yisigameko sesithathu.

Ezinye zezimbangela ezivamile ze-MODS yilezi:

• I-Sepsis noma i-septic shock: Lokhu kungaba ukuvuvukala okukhulu okubangelwa ukutheleleka okukhulu kwebhaktheriya noma igciwane.
• Ukulimala okubuhlungu: Izinto ezifana nengozi yemoto, ukusha okukhulu, ukugwazwa, noma ukudubula.
• I-Pancreatitis: Ukuvuvukala kwe-pancreas. Lokhu kungabangelwa amatshe enyongo, ukuphuza utshwala ngokweqile, imithi ethile, nezinye izici.
• Ukuhlaselwa yinhliziyo okukhulu: Kubangelwa ukuvaleka komthambo wegazi ohambisa igazi enhliziyweni.
• Ukwehluleka kwesibindi: Lokhu kungabangelwa yi-Hepatitis B, i-Hepatitis C, isifo sesibindi esinamafutha, ukusebenzisa utshwala ngokweqile, kanye ne-cirrhosis.
• Ukulimala okunobuthi kanye nobuthi:Kubangelwa ukuchayeka ebuthi. Isibonelo, ukusetshenziswa kwezidakamizwa noma utshwala okuphuthumayo noma okungamahlalakhona, amakhemikhali anobuthi njengezibulala-zinambuzane nezinto zokuvikela ezindala (i-asbestos), kanye nokutheleleka ngamagciwane.

Lezi zimo zibangela izinguquko ezinkulu ohlelweni lwakho lokuzivikela komzimba kanye nohlelo lwegazi, okuphinde kuthinte nezinye izitho zomzimba.

Yisiphi isitho esiqala ukwehluleka ku-MODS?

Cishe wonke umuntu one-MODS ubhekana nezinkinga zamaphaphu kuqala , kodwa odokotela nabacwaningi abakaqondi kahle ukuthi kungani ukwehluleka kwamaphaphu kuvame ukwenzeka ngaphambi kwe-MODS.

Ubani othinteka kakhulu yi-MODS?

Noma ubani angaba ne-MODS, kodwa kungenzeka kakhulu ukuthi ube ne-MODS uma unesifo esingaphansi kwaso, njengesifo esingamahlalakhona noma ukuntuleka kwamasosha omzimba.

Ungayibona kanjani i-MODS?

Odokotela basebenzisa izinhlobo ezahlukene zokuhlola ukuthola ukwehluleka kwezitho zomzimba wonke. Lokhu kungafaka:

• Ukuhlolwa kwegazi
• Ukuhlolwa kwegesi yegazi le-arterial
• Ukuhlolwa kokusebenza kwesibindi
• Ukuhlolwa kokusebenza kwezinso
• Amasiko egazi nezicubu
• I-Echocardiogram (i-ultrasound yenhliziyo)
• Ukuhlolwa kwezithombe njenge-ultrasound noma i-CT scan

Iphathwa kanjani i-MODS?

Ukwelashwa kwe-MODS kuncike embangela eyinhloko kanye nezinhlelo zezitho ezithintekile. Ezinye izinketho zokwelapha zifaka:

• Yelapha ukutholakala kwegazi okuphansi ngokunikeza uketshezi olufakwa ngemithambo yegazi (IV) .
• Ukunikeza imithi yokucindezela igazi ukuze kwandiswe ukugeleza kwegazi emithanjeni yegazi nasezicutshini (ukugeleza kwegazi ezicutshini).
• Nikeza ama-antibiotic ukwelapha izifo kanye/noma i-sepsis.
• Ukumpontshelwa igazi ukuze kuthathelwe indawo igazi elilahlekile ngenxa yokulimala noma ukuhlinzwa.
• Ukwelashwa nge-oxygen ukuze kuhlinzekwe umoya-mpilo owengeziwe emzimbeni.
• Uma ungakwazi ukuphefumula wedwa, ungadinga umoya womoya ukuze ukusize uphefumule.
• I-Dialysis ukusiza ukususa imfucuza kanye noketshezi oluningi emzimbeni wakho.
• Ukuphefumula kolwelwesi olungaphandle komzimba (i-ECMO) ukuze kufakwe umoya-mpilo egazini futhi kususwe i-carbon dioxide.
• Uhlelo lokujikeleza kwegazi olumunca ama-molecule (i-MARS) lokusekela isibindi.
• Ukuhlinzwa kweziguli ezilimele kakhulu.
• Ukuhlinzwa kokufakelwa izitho zomzimba ukufaka isitho esinempilo esivela kumnikeli esikhundleni sesitho esigulayo noma esingasebenzi kahle.
• Uma unesifo sokopha esiswini (GI) noma unesifo sokugaya ukudla esikuvimbela ukudla, noma uma ungakwazi ukudla ngokomzimba, kungadingeka uthole izakhamzimba nge-IV (intravenous) noma i-enteral nutrition (parenteral nutrition).

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Ukululama kwakho kuzoncika embangela kanye nokwelashwa okuyisisekelo. Udokotela angakunikeza umbono ongcono wokuthi ungalindela nini ukubona intuthuko ngemva kokwelashwa.

Liyini ikusasa lama-MODS?

Ikusasa le-MODS lincike embangela eyisisekelo. Ngezinye izikhathi ezinye noma zonke izinzwa zakho zingase zibuyele esimweni esijwayelekile, kodwa ungase udinge ukwesekwa kokuphila kwesikhashana uze ululame.

Ukuhlonza kanye nokwelashwa kusenesikhathi kwe-MODS kanye nembangela yayo eyisisekelo kubalulekile ekuphatheni ngempumelelo lesi simo.

Ukubikezela kwe-MODS kuyahlukahluka kuye ngamayunithi okunakekelwa okujulile (ama-ICU). Odokotela babheka lesi simo njengembangela evamile yokufa kweziguli ezilaliswe emayunithi okunakekelwa okujulile okuhlinzwa.

Uma lesi sifo siqhubekela esigabeni esibi kakhulu, umonakalo ohlala njalo wezitho zomzimba ungavela. Ungadinga ukwesekwa impilo yakho yonke isikhathi eside noma ukufakelwa isitho. Kungaba yingozi futhi.

Kudingeka ucwaningo olwengeziwe ukuze kutholakale izici ezibangela ukugula ezingase zithonye ama-MODS, okungaholela ekusaseni elingcono kweziguli.

Lingakanani izinga lokusinda elivela ku-MODS?

Odokotela nabacwaningi balinganisela ukuthi izinga lokusinda kwe-MODS liphakathi kuka-50% no-60% .

Ingabe ama-MODS angavinjelwa?

Ezinye zezinto ezibangela i-MODS azinakuvinjelwa. Futhi okwamanje akukho muthi othize ongasiza ekuvimbeleni i-MODS. Abacwaningi bebelokhu bebheka izindlela zokwelapha i-MODS ezigabeni zayo zokuqala ukuvimbela lesi sifo ukuthi singabi sibi kakhulu. Izifundo eziningana ziyaqhubeka njengamanje kulo mkhakha.

Ungasiza ekuvikeleni izitho zakho zomzimba ngokwenza izinto ezifana nalezi:

• Vikela izitho zakho zomzimba ekushaqekeni ngokugqoka amabhande esihlalo uma ugibele imoto kanye nezingubo zokuzivikela uma udlala imidlalo enamandla.
• Goma ukuze uvimbele izifo ezinkulu uma kunconywa odokotela.
• Yehlisa noma uyeke ukuthatha imithi engabhalwanga ngudokotela, njengemithi elwa nokuvuvukala engeyona eye-steroidal (ama-NSAID), engalimaza izinso.
• Nciphisa noma uyeke ukuthatha imithi noma ezinye izinto ezingabangela izilonda esiswini, njenge-NSAID, ukubhema, notshwala .
• Thola ukwelashwa komfutho wegazi ophakeme (umfutho wegazi ophakeme) .

Uma usesibhedlela unesifo esibi kakhulu, odokotela bakho bangenza izinto ezinjengalezi ukuvimbela i-MODS ukuthi ibe yimbi kakhulu:

• Ukunciphisa umonakalo emaphashini akho ngenxa yomoya womoya owenziwe ngomshini.
• Nciphisa ukumpontshelwa igazi kuze kube yilapho kudingeka ngempela.
• Ukusebenzisa izinto zokunciphisa igazi uma kudingeka ukuvimbela ukuqhekeka kwegazi.

Kufanele ngimbone nini udokotela?

Uma unesifo esingamahlalakhona futhi ubhekene nezimpawu ze-MODS, okungaholela ekuguleni okukhulu nasekuhlulekeni kwezitho zomzimba, kuhlale kungumqondo omuhle ukubona udokotela. Bangakutshela ukuthi yiziphi izimpawu noma izimpawu ezithile okufanele uziqaphele nokuthi ungazisingatha kanjani noma yiziphi izimo.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma unezimpawu ze-MODS, iya ekamelweni eliphuthumayo eliseduze noma ushayele u-911. Lokhu kungaba yingozi uma kungelashwa ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Nazi ezinye imibuzo ongase ufune ukubuza udokotela wakho:

• Yini ebangela ama-MODS?
• Yiziphi izindlela zokwelapha enginazo?
• Yimiphi imithi oyincomayo?
• Yiziphi izinhloso zokunakekelwa kwami?
• Ngidinga ukwelashwa kangaki?

Isifinyezo nomyalezo wokugcina

Kulungile, manje usuyazi ukuthi i-multiple organ dysfunction syndrome (MODS) yisimo esibucayi esithinta izinhlelo ezimbili noma ngaphezulu zezitho zomzimba wakho. Nakuba i-MODS ingathinta noma yiluphi uhlelo lwezitho, ivame ukuthinta amaphaphu, inhliziyo, izinso, isibindi, ubuchopho kanye negazi. Kunezimbangela eziningi ezingaba khona zalokhu. Ezivame kakhulu ukulimala okukhulu, ukugula okukhulu, kanye nokutheleleka okusabalele. Ukwelashwa kugxile ekwelapheni lesi simo esiyisisekelo ngenkathi kuvimbela ukulimala okwengeziwe kwezinye izinhlelo zezitho.

Kuvamile ukuzizwa wesaba uma uzwa ukuthi izitho zakho noma zomuntu omthandayo azisebenzi. Kodwa odokotela nabasebenzi e-Emergency Treatment Unit (ETU) kanye nase-Intensive Care Unit (ICU) baqeqeshwe ukusekela zonke izinhlelo zakho zezitho, ukuvimbela umonakalo owengeziwe, nokusiza umzimba wakho ululame. Ngakho ungalilahli ithemba. Ngokwelashwa okusheshayo kanye neseluleko esifanele sezokwelapha, ungazama ukuphuma kulesi simo.

Ukwehluleka kwezitho eziningi , i-MODS, ukwehluleka kwezitho, i-sepsis, ukunakekelwa okujulile, ukwehluleka kwezitho, ukwesekwa kokuphila