Ingabe kukhona into evimba ukugeleza kwegazi enhliziyweni yakho? Lokhu kungaba (Obstructive Shock)!

Uma igazi lingajikelezi kahle emzimbeni wethu wonke, okusho ukuthi izitho zethu azitholi inani elidingekayo lomoya-mpilo, sivame ukukubiza ngokuthi 'ukushaqeka'. Lokhu kwenzeka ngokuzumayo. Namuhla sizokhuluma ngohlobo olukhethekile, kodwa olungavamile 'lokushaqeka'. Lubizwa ngokuthi '(Obstructive Shock)'. Kalula nje, okwenzekayo kulokhu ukuthi kukhona okuvimba ukugeleza kwegazi enhliziyweni yethu bese igazi liphuma enhliziyweni, okungukuthi, kwenzeka 'ukushaqeka'. Ngenxa yalokhu kushaqeka, inhliziyo ayikwazi ukusebenza kahle, umfutho wegazi ungehla ngokuzumayo, futhi umzimba ungantula umoya-mpilo. Lesi yisimo esiphuthumayo kakhulu , ngakho-ke kubaluleke kakhulu ukuthola ukwelashwa ngokushesha.

Ngakho-ke kuyini lokhu `(Obstructive Shock)`? Singayichaza kakhudlwana?

Cabanga nje, inhliziyo yethu ifana nephampu yamanzi. Le phampu yiyo ethumela igazi emzimbeni wonke. Manje, kwenzekani uma amanzi angena kule phampu evaleka epayipini, noma uma iphampu ephuma epayipini ivaleka? Amanzi awagelezi kahle, akunjalo? Yilokho okwenzeka ku-`(Obstructive Shock)`.

Kukhona into evimba ukugeleza kwegazi ngemithambo yegazi emikhulu (ebizwa ngokuthi 'imithambo emikhulu') exhumanisa inhliziyo. Lokhu kuvimbela inhliziyo ekutholeni igazi elanele, futhi ayikwazi ukulikhipha kahle. Umphumela uba ukuthi izitho ezibaluleke kakhulu emzimbeni wethu, ubuchopho, izinso, namaphaphu, azitholi umoya-mpilo owanele. Lesi yisimo esiphuthumayo esisongela ukuphila.

Uyini umehluko phakathi kwe-`(Cardiogenic Shock)` kanye ne-`(Obstructive Shock)`?

Zombili lezi ziyizimo eziphuthumayo zezokwelapha, kodwa zenzeka ngezizathu ezimbili.

Ukushaqeka kwenhliziyo kwenzeka lapho imisipha yenhliziyo yonakele, njengokuhlaselwa yinhliziyo, futhi inhliziyo ingakwazi ukupompa igazi elanele emzimbeni. Inhliziyo iba buthakathaka.

Kodwa ku-`(Obstructive Shock)` imisipha yenhliziyo ivame ukuba ngcono. Inkinga ayikho enhliziyweni, kodwa ingokunye okuphazamisa ukusebenza kwenhliziyo. Cabanga ngalezi zinto:

• Uma une-blood clot enkulu emthanjeni wegazi omkhulu (umthambo wamaphaphu) oholela emaphashini akho.
• Uma inhliziyo icindezelwa yisikhwama esigcwele uketshezi esizungeze inhliziyo (i-pericardial tamponade).
• Uma kukhona ukulimala emaphashini kanye nokucindezela ngaphakathi kwesifuba kukhula kakhulu, isibonelo, esimweni esibizwa ngokuthi ``Tension pneumothorax''.

I-Obstructive Shock yilapho inhliziyo ingakwazi ukusebenza kahle ngenxa yesizathu sangaphandle esinjengalesi.

Sivame kangakanani lesi simo esibizwa ngokuthi "Obstructive Shock"? Sithinta kanjani umzimba?

I-Obstructive Shock empeleni iyisimo esingavamile uma siqhathaniswa nezinye izinhlobo zokushaqeka. Ngokuvamile ithinta kuphela i-1% noma i-2% yeziguli ezishaqekile. Izindaba ezinhle ukuthi kungenzeka ukuthi yelapheke kakhulu kunezinye izinhlobo zokushaqeka, kodwa kuphela uma yelashwa ngokushesha.

Uma kungelashwa ngokushesha, i-Obstructive Shock iphuca izitho ezibalulekile zomzimba umoya-mpilo kanye nezakhamzimba. Lokhu kungaholela ekulimaleni kwezitho futhi ngezinye izikhathi ngisho nokufa. Yingakho kubalulekile ukufuna ukwelashwa ngokushesha.

Ziyini izimpawu ze-`(Obstructive Shock)`?

Izimpawu zalokhu zingase zifane kancane nalezo ze-"Cardiogenic Shock." Bona ukuthi lezi zizwakala zijwayelekile yini kuwe:

• Izinga lokuphefumula likhuphuka ngendlela engavamile.
• Umfutho wegazi wehla kakhulu (hypotension).
• Isilinganiso senhliziyo sikhuphuka kakhulu (`i-Tachycardia`). Njengokungathi usanda kugijima.
• Ukushintsha kwesimo sengqondo, mhlawumbe ukudabuka noma ukukhathazeka kungase kwenzeke.
• Inani lomchamo okhiqizwayo linciphile kakhulu, noma alikho nhlobo.
• Isikhumba sizizwa sibanda futhi sijuluka.
• Ngezinye izikhathi umoya ungaqongelela ngaphansi kwesikhumba (`i-Subcutaneous emphysema`). Lokhu kusho ukuthi kuzwakala njengamabhamuza amancane ngaphansi kwesikhumba.
• Ungase uzwe ubuhlungu esifubeni noma esiswini.

Uma unesinye noma ngaphezulu salezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Yiziphi izimbangela ze-`(Obstructive Shock)`?

Kunezimbangela eziningana ze-`(Obstructive Shock)`. Ake sibone ukuthi yiziphi eziyinhloko:

• `(I-Tension pneumothorax)` (ukuwa kwephaphu): Lokhu kwenzeka lapho umoya ungena emaphashini futhi ungakwazi ukuphuma, okubangela ukuba uvaleleke ngaphakathi emaphashini. Iphaphu liyawa, lidale ingcindezi enkulu ngaphakathi esifubeni futhi libangele inhliziyo ukuthi iqale ukushaya ngamandla.
• I-Vena cava compression syndrome: Ukucindezelwa komthambo omkhulu emzimbeni wethu (i-vena cava). Lokhu kungenzeka kaningi ngasekupheleni kokukhulelwa, lapho isisindo somntwana sicindezela lo mthambo wegazi.
• Isifo sokucindezeleka kwamaphaphu: Isifo sokucindezeleka kwamaphaphu.
• `(Umoya ongenisa umoya ophezulu)`: Isimo lapho ingcindezi emaphashini iphezulu kakhulu kumuntu oxhumene nomshini womoya.
• Izimila: Ezinye izinhlobo zezimila ezikhula ngaphakathi kwesifuba zingavimba nenhliziyo noma imithambo yegazi emikhulu.
• I-Thromboembolism emthanjeni wamaphaphu: Lokhu kuyingozi kakhulu. Uma ihlule legazi elakheka endaweni efana nomlenze liphuka bese libhajwa emthanjeni wegazi emaphashini, livimba igazi ukuthi lingagelezi lisuka enhliziyweni liye emaphashini.
• I-Pericardial tamponade: Isikhwama esincane esizungeze inhliziyo (i-pericardium) sigcwele uketshezi, sicindezela inhliziyo. Lokhu kuvimbela inhliziyo ukuthi inciphe futhi ikhule kahle.
• Ukuqhekeka kwe-aorta: Ukudabuka kwe-aorta, umthambo wegazi omkhulu kunayo yonke ophuma enhliziyweni.
• I-Aortic stenosis: Ukuncipha kwevalvu ye-aortic enhliziyweni. Lokhu kwenza kube nzima ukuthi igazi liphume enhliziyweni.
• I-Hypertrophic cardiomyopathy: Ukuvaleka kwegazi ngenxa yokuqina ngokweqile kwemisipha yenhliziyo.
• I-Constrictive pericarditis: Isikhwama esizungeze inhliziyo siyaqina, okwenza kube nzima ngenhliziyo ukusebenza ngokukhululeka.

Okubalulekile: Zonke lezi zimbangela ziyizimo eziphuthumayo, ngakho-ke bonana nodokotela ngokushesha uma unezimpawu.

Ungayibona kanjani i-`(Obstructive Shock)`?

Udokotela wakho uzokuhlola kuqala. Uzolalela inhliziyo namaphaphu akho nge-stethoscope. Ukushaqeka okuvimbelayo yisimo esingaba sibi kakhulu ngokushesha, ngakho-ke kubalulekile ukuthola ukuxilongwa ngokushesha.

Ukuze kutholakale ngokunembile lesi sifo, kungenziwa izivivinyo ezilandelayo:

• I-Ultrasound: Lokhu kungabheka izinto ezifana nenhliziyo, imithambo yegazi emikhulu, nokuthi kukhona yini uketshezi oluzungeze amaphaphu.
• I-Echocardiogram (Echo): Lokhu kufana ne-ultrasound yenhliziyo. Kungabona ngokucacile ukusebenza kwenhliziyo, isimo sama-valve, nokuthi kukhona yini uketshezi oluzungeze inhliziyo.
• I-computed tomography (CT) scan: Lokhu kungathatha izithombe ezinemininingwane zesifuba. Kungasiza ekutholeni izinto ezifana namahlule egazi, izimila, kanye nokuhlukaniswa kwe-aorta.
• I-Electrocardiogram (ECG noma EKG): Lokhu kuhlola ukusebenza kukagesi kwenhliziyo. Kungasiza ekunqumeni ukuthi kukhona yini okungahambi kahle enhliziyweni yakho.

Iphathwa kanjani i-Obstructive Shock?

Okokuqala, uzonikezwa uketshezi lwe-IV (njenge-saline - IV crystalloid fluids) futhi amazinga akho omfutho wegazi kanye nomoya-mpilo azohlolwa njalo. Ngemuva kwalokho, into ebaluleke kakhulu ukuthola imbangela ye-Obstructive Shock bese welapha leyo mbangela.

Izindlela zokwelapha ziyahlukahluka kuye ngembangela. Ake sibheke izibonelo ezimbalwa:

• Uma kukhona ihlule legazi (i-embolism), lisuswa ngokuhlinzwa noma ngokufaka i-cannula (i-catheter).
• Uma kuyivalvu ye-aorta encishisiwe kakhulu, izoshintshwa.
• Ezimweni zemisipha yenhliziyo ejiyile (hypertrophic cardiomyopathy), ukujiya kungancishiswa ngokuhlinzwa noma ngendlela ekhethekile esebenzisa utshwala (i-catheter-based alcohol ablation).
• Bakunikeza umuthi wokuncibilikisa amahlule egazi.
• Uma kukhona uketshezi oluzungeze inhliziyo (i-pericardial tamponade) noma i-tension pneumothorax, uketshezi noma umoya kuzosuswa (mhlawumbe kusetshenziswa ipayipi elincane).
• Uma usebenzisa umshini wokuphefumula, ungashintsha izilungiselelo zawo.
• Esimweni esifana ne-"Vena cava compression syndrome", isimo somzimba siyashintsha.
• Uma ingcindezi emaphashini iphezulu, ingcindezi incishiswa ngenaliti noma ngepayipi.

Yimiphi imithi esetshenziswayo?

Ngesikhathi imbangela yelashwa, ungase unikezwe imithi efana nalena ukuze uzinzise isimo sakho:

• Uketshezi olufana ne-`IV` saline (`IV crystalloid fluids`).
• Imithi yokwandisa umfutho wegazi: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® noma Biorphen®))`.
• Uma unenani eliphansi legazi, uzonikezwa igazi noma imikhiqizo yegazi (njengamaseli abomvu egazi kanye ne-plasma).

Ngizolulama ngokushesha kangakanani ngemva kokwelashwa?

Izimbangela eziningi ze-Obstructive Shock zidinga ukwelashwa ngokushesha , njengoba kulapho amathuba okusinda eba makhulu khona. Ngenhlanhla, lezi zindlela zokwelapha zisebenza ngokushesha. Kodwa-ke, ngisho nangemva kokwelapha imbangela, kuthatha isikhathi ukuthi umzimba ululame emiphumeleni ye-Obstructive Shock. Awukwazi nje ukugijima nje wenze umsebenzi wakho.

Iyini inhloso ye-`(Obstructive Shock)`?

Uma ingelashwa, i-"Obstructive Shock" iyisimo esingaba yingozi kubantu abaningi. Ukululama kwakho ngemva kokwelashwa kuncike ezintweni eziningana, okuhlanganisa:

• Iyini imbangela `(Obstructive Shock)`?
• Kwathatha isikhathi esingakanani ukuthola ukwelashwa?
• Yiziphi ezinye izifo onazo?
• Ukwelashwa kwakho kube nempumelelo engakanani?

Kodwa-ke, njengoba kushiwo ngaphambili, amathuba okululama ku-"Obstructive Shock" aphezulu kunasezinhlotsheni ezivamile ze-"Shock" njenge-"Septic Shock". Ngakho-ke, kunethemba.

Ngizinakekela kanjani?

Ngemva kokuba udokotela ekukhiphe esibhedlela, udinga ukulandela imiyalelo yakhe ngqo.

• Kuzodingeka uphumule ekhaya isikhashana ngaphambi kokuba ubuyele emsebenzini.
• Kufanele uthathe umuthi onikezwe udokotela wakho ngesikhathi esifanele . Ungayeki ukuthatha noma yimuphi umuthi ngokuthanda kwakho.
• Yiya njalo kuma-aphoyintimenti okulandelela .

Kufanele ngiphinde ngimbone nini udokotela? Kufanele ngenzeni uma kunesimo esiphuthumayo?

Manje usuyazi ukuthi yini ebangele '(Ukwethuka Okungavimba)' kwakho. Qaphela uma izimpawu ezihlobene naleyo nkinga ziphinde zivele. Uma unezimpawu ezinjalo futhi, noma uma othile emndenini wakho ebona lolu shintsho kuwe, shayela ngokushesha i-1990 (Wind) Ambulance Service, noma uye egumbini lezimo eziphuthumayo esibhedlela esiseduze. Isikhathi sibaluleke kakhulu.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungabuza imibuzo efana nale:

• Kudingeka ngithathe isikhathi esingakanani imithi oyinikezile?
• Angakanani amathuba okuba ngiphinde ngibe nalesi simo?
• Ingabe lokhu kuzoba nomthelela wesikhathi eside ezingeni lempilo yami?
• Yiziphi izinguquko okufanele ngizenze ekudleni nasekuzivocavoceni kwami?

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

I-Obstructive Shock yisimo esingavamile kodwa esibucayi kakhulu esidinga ukwelashwa okuphuthumayo. Ngakho-ke, kubalulekile ukuqaphela izimpawu nokufuna ukwelashwa ngokushesha. Uma odokotela sebethole imbangela ye-Obstructive Shock, bazoqala ukwelashwa okufanele.

Khumbula, abantu abaningi bangalulama ekushayweni yi-Obstructive Shock, kodwa kuthatha isikhathi. Yiba nesineke, landela imiyalelo kadokotela wakho, futhi uzinakekele. Awuwedwa, futhi kukhona odokotela, abahlengikazi, kanye nabathandekayo bakho abangakusiza.

` Ukushaqeka okuvimbelayo, ukushaqeka, isifo senhliziyo, umfutho wegazi, umoya-mpilo, ukuvaleka, ukwelashwa okuphuthumayo, amaphaphu, inhliziyo