Cabanga nje, bekuzokwenzekani uma indlela yemvelo yomzimba wakho yokuvimba ukuphuma kwegazi ingalawuleki ngokuzumayo bese ima ngokuphelele? Amahlule egazi amancane akheka emzimbeni wakho wonke, zonke izinto ezidingekayo kuwo seziphelile, bese ungakwazi ukuyeka ukuphuma kwegazi ngisho noma ulimele kancane. Leso ngesinye sezifo ezimbi kakhulu neziyinkimbinkimbi esikhuluma ngazo namuhla , i-DIC (Disseminated Intravascular Coagulation) . Nakuba lokhu kuzwakala njengegama elithusayo, masiliqonde kalula.
Iyini ngempela i-DIC?
Kalula nje, i-DIC yisimo esibi esithinta ikhono legazi lakho lokujiya. Okwenzekayo ukuthi uhlelo lokujiya kwegazi lomzimba wakho luyaphazamiseka ngokuphelele. Lesi simo singavela ngezigaba ezimbili eziyinhloko.
1. Isigaba 1 (Isigaba Sokwakheka Kwamahlwili): Kulesi sigaba, izinkulungwane zamahlwili egazi amancane ziqala ukwakheka emzimbeni wakho wonke, ngaphakathi kwemithambo yegazi yakho . Ukuze sakhe la mahlwili, sisebenzisa ama-platelet amaningi kanye nezinto ezibangela ukujiya kwegazi. Kufana nokusebenzisa amabhulokhi amaningi esimende ukwakha izindonga ezincane ezingadingekile kulo lonke idolobha. Ngale ndlela, lezi zinto zisetshenziswa ngokushesha.
2. Isigaba 2 (Isigaba Sokopha): Manje, umzimba usuphelelwe ama-platelet namaprotheni adingekayo ukuze kugoqe igazi. Kuleli qophelo, ngisho nokulimala okuncane akukwazi ukuvimba ukuphuma kwegazi . Lokhu kungenxa yokuthi umzimba awusenawo “usimende” odingekayo ukuze kwakheke i-blood clot. Lokhu kubangela ukopha okukhulu okungalawuleki. Lesi yisigaba esiyingozi kakhulu salesi sifo futhi sidinga ukwelashwa ngokushesha.
Okubalulekile, i-DIC ayizenzeki yodwa. Ihlala ivela ngenxa yesinye isimo esibucayi sezokwelapha noma inkinga. Kubikwa ukuthi iyenzeka cishe ku-1% weziguli ezibhedlela.
Yini ebangela i-DIC?
Njengoba sishilo ngaphambili, i-DIC ibangelwa yisimo sezokwelapha esiyisisekelo. Imbangela iyahlukahluka kuye ngesifo. Ngokuvamile iqala ngokuthile okungajwayelekile (isib. ubuthi bamagciwane , izingcezu zezicubu ezonakele) okungena egazini. Ake sibheke izimbangela eziyinhloko.
| Uhlobo lwesizathu | Izibonelo nezincazelo |
|---|---|
| Izimbangela ze-DIC engazelelwe (ebukhali) |
|
| Izimbangela ze-DIC Engapheli |
|
Yiziphi izimpawu ezingaba khona ze-DIC?
Izimpawu ozibonayo zincike ekutheni isimo se-DIC sivela ngokuzumayo (esibucayi) noma kancane kancane (esingamahlalakhona).
Izimpawu ze-Acute DIC
Uphawu oluyinhloko noluyingozi kakhulu lwalokhu ukopha okungalawuleki.
- Ukopha ngokweqile okuvela endaweni yokuhlinzwa, endaweni yokungena kwe-IV, ekhaleni, noma ezinsinini.
- Imivimbo ivele emzimbeni wonke ngaphandle kwesizathu.
- Ukuhlanza igazi.
- Ukuphalaza igazi ngendle.
- Ukopha kuya ebuchosheni, emgudwini wokugaya ukudla, emisipheni, noma emigodini yomzimba.
Izimpawu ze-DIC Engapheli
Ingozi enkulu kulolu hlobo ayibangelwa ukopha, kodwa amahlule egazi aqala ekuqaleni. La mahlule egazi angahamba futhi avale imithambo yegazi ezithweni ezibalulekile.
- Ukwehluleka kwezitho zomzimba: Uma ihlule legazi livimba ukugeleza kwegazi liye esithweni esifana nezinso, isibindi, noma amaphaphu.
- Ukuhlaselwa yisifo sohlangothi: Uma ihlule legazi livimba umthambo wegazi ebuchosheni.
- Ukuhlaselwa yinhliziyo: Uma umthambo wegazi ohambisa igazi enhliziyweni uvaleka.
- I-Deep Vein Thromboembolism (DVT): Amahlule egazi akhiwa ngaphakathi kwemithambo yemilenze noma izingalo, okubangela ukuvuvukala nobuhlungu kulezo zindawo.
- Ubunzima bokuphefumula: Uma ihlule legazi liya emaphashini.
Ngezinye izikhathi, i-DIC eqala kancane ingase ingabingeli zimpawu. Futhi, ukuphuma kwegazi ezindaweni ezintathu ezingahlobene ngesikhathi esisodwa (isib., ukuphuma kwegazi ekhaleni, ezinsinini, kanye nomchamo) kungaba uphawu lwe-DIC.
Yiziphi izindlela zokwelapha i-DIC?
Into yokuqala nebaluleke kakhulu odokotela abayenzayo uma umuntu ene-DIC ukwelapha isimo sezokwelapha esiyisisekelo esibangele i-DIC. Isibonelo, uma i-DIC ibangelwa ukutheleleka (i-sepsis), kuzonikezwa ama-antibiotic aleso sifo.
Ngaphezu kwalokho, ukwelashwa kunikezwa futhi ukulawula izimpawu ezibangelwa yi-DIC.
- Ukumpontshelwa nge-plasma: Uma kube nokulahleka kwegazi okukhulu, i-plasma yegazi inikezwa ukuze ithathe indawo yamaprotheni (izici zokujiya) adingekayo ukuze igazi lijiye.
- Ukumpontshelwa ama-platelet: Lokhu kunikezwa ukubuyisela inani lama-platelet anciphile ngenxa yokopha.
- Ukwelashwa nge-oksijini: Uma ukuphakelwa kwegazi esithweni kuphazamiseka ngenxa yokuqhekeka kwegazi, kunikezwa i-oksijini ukuze kuvinjelwe umonakalo kuleso sitho.
- Imithi yokuvimbela ukuminyana kwegazi: Imithi yokunciphisa igazi efana ne -heparin ingasetshenziswa. Ungase uzibuze, “Hawu, kungani umuntu osophayo kakade edinga imithi yokunciphisa igazi eyengeziwe?” Lezi zisetshenziswa ngokuqapha okukhulu. Zinikezwa ukuvimbela ukwakheka kwamahlule egazi ayingozi kakhulu, ikakhulukazi ku-DIC engapheli noma ezigabeni zokuqala zesifo. Lesi yisinqumo esingathathwa udokotela wakho kuphela.
I-Acute DIC iyisimo esiphuthumayo sezokwelapha. Idinga ukwelashwa egunjini lokunakekela abagula kakhulu esibhedlela (ICU) noma egunjini lokwelapha abaphuthumayo (ETU). Kodwa ungakhathazeki, isikhathi esiningi lokhu kwenzeka ngesikhathi sokuhlinzwa noma sokubeletha, futhi ithimba lezokwelapha likhona lapho nawe.
Ngemva kokuphuma esibhedlela, udokotela wakho uzoqhubeka nokukuqapha futhi akuqaphe noma yiziphi izimo zezokwelapha eziyisisekelo kanye nezinkinga ezibangelwa yi-DIC.
Umlayezo Wokuya Nawe Ekhaya
- I-DIC akuyona isifo esizenzekela sodwa. Ihlala iyinkinga yesinye isimo sezokwelapha esibucayi (isib. i-sepsis, umdlavuza, ukulimala okukhulu).
- Okwenzekayo kulesi simo ukuthi okokuqala, amahlule egazi akheka ngokungadingekile kuwo wonke umzimba, bese kuthi izinto ezidingekayo ukuze kuqhekeke igazi ziphume, okuholela ekuphumeni kwegazi okungalawuleki.
- Ukwelashwa kugxile ekwelapheni isimo esiyisisekelo esibangele i-DIC, kanye nokulawula izimpawu.
- Uma uzwa ukopha okungazelelwe noma ukuphuka okukhulu okuvela ezindaweni eziningi zomzimba wakho ngaphandle kwesizathu esicacile, ikakhulukazi uma unesinye isifo esibi, bona udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
I-DIC, Ukujiya Kwemithambo Yegazi Okusabalalisiwe, Igazi Eligobile, Ukopha, Ukopha, I-Sepsis, Izimpawu
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