Gangrene

Ukuqothuka yi-gangrene ukufa kwenyama yomzimba ngenxa yokuswela igazi noma ukutheleleka okubi ngamabhaktheriya. I-gangrene ivame ukubangela izandla nezinyawo, kuhlanganise neminwe yezinyawo neminwe yesandla. Ingase futhi ibonakale ezibungwini nasezitho ezingaphakathi komzimba, njengesibeletho.

Isimo esingalimaza imithambo yegazi futhi sibe nomthelela ekusabalaleni kwegazi, njengoshukela noma ukuqina kwama-arteri (atherosclerosis), kwandise ingozi ye-gangrene.

Izindlela zokwelapha i-gangrene zingafaka ama-antibiotics, ukwelashwa nge-oksijini, nokuhlinzwa ukuze kuphinde kuqaliswe ukusabalala kwegazi nokususa inyama efile. Uma i-gangrene itholakala futhi iwelashwe ngokushesha, kuba khona amathuba angcono okubuyela esimweni esiqondile.

Uma i-gangrene ithinta isikhumba, izimpawu kanye nezimpawu zingafaka:

• Ukushintsha kombala wesikhumba — kusukela kokumhlophe okumnyama kuya kobuluhlaza, oluhlaza okwesibhakabhaka, oluhlaza okumnyama, oluhlaza okubhedu noma olubomvu
• Ukukhula
• Amabhabhu
• Ubuhlungu obukhulu ngokuzumayo obuyelwa yimvakalelo yokungabi namandla
• Ukukhishwa okunuka kabi okuphuma ehlombe
• Isikhumba esincinci, esicwebezelayo, noma isikhumba esingenayo izinwele
• Isikhumba esinomuzwa opholile noma opholile uma siqondwa

Uma i-gangrene ithinta izicubu ezingaphansi komhlaba wesikhumba sakho, njenge-gangrene yegesi noma i-gangrene yangaphakathi, ungaba ne-fever ephansi futhi uzizwe ungaphili kahle.

Uma amagciwane abangele i-gangrene esakazeka emzimbeni, isimo esibizwa ngokuthi yi-septic shock singenzeka. Izimpawu nezimpawu ze-septic shock zifaka:

• Uxinzelelo lwegazi oluphansi
• Ukuqina, nakuba abanye abantu bangaba nomzimba opholile kunama-98.6 F (37 C)
• Ukushaya kwenhliziyo okusheshayo
• Ukukhanya ekhanda
• Ukuphefumula okufushane
• Ukuphazamiseka

Ukuqothuka kwenyama kuyisimo esinzima futhi kudinga ukwelashwa okusheshayo. Shaya udokotela wakho ngokushesha uma unokubuhlungu okungapheli, okungachazeki kunoma iyiphi ingxenye yomzimba wakho kanye nokunye noma ngaphezulu kwalokhu okulandelayo izimpawu nezibonakaliso:

• Ukuqina komkhuhlane
• Ukushintsha kwesikhumba — kufaka phakathi ukuguquka kombala, ukufudumeka, ukukhula, amabhabha noma izilonda — okungapheli
• Ukukhishwa okunuka kabi okuphuma esilondeni
• Ubuhlungu obungalindelekile endaweni yokuhlinzwa kwamuva noma ukulimala
• Isikhumba esimhlophe, esiqinile, esibandayo nesithule

Izimbangela ze-gangrene zihlanganisa:

• Ukwehluleka kokunikezwa kwegazi. Igazi linikeza umzimba i-oksijini kanye nezakhamzimba. Linikela futhi isimiso somzimba samandla okumelana nezifo ngama-antibodies okuqeda ukutheleleka. Ngaphandle kokunikezwa kwegazi okufanele, amangqamuzana awakwazi ukuphila, bese kuthi izicubu zife.
• Ukutheleleka. Ukutheleleka ngamabhaktheriya okungaphathwe kungabangela i-gangrene.
• Ukulimala okuthintayo. Ukulimala okuvela ekuqotsheni ngesibhamu noma ezingozini zezimoto kungabangela amanxeba avulekile avumela amabhaktheriya ukuba angene emzimbeni. Uma amabhaktheriya ethelelela izicubu futhi engaqondwa, i-gangrene ingase ibe khona.

Izinto ezingandisa ingozi ye-gangrene zihlanganisa:

• Ubuhlungu bomdlavuza. Amazinga aphezulu kashukela egazini ekugcineni angalimaza imithambo yegazi. Ukulimala kwemithambo yegazi kungaphansi noma kuvimbe ukugeleza kwegazi kwengxenye yomzimba.
• Isifo semithambo yegazi. I-arteries eqinile necinyiwe (atherosclerosis) kanye neziqu zegazi zingavimba ukugeleza kwegazi endaweni yomzimba.
• Ukulimala okukhulu noma ukuhlinzwa. Noma iyiphi inqubo ebangela ukulimala kwesikhumba nezinsimbi ezingezansi, kuhlanganise nokuqandwa, ikhuphula ingozi ye-gangrene. Ingozi inkulu uma unesimo esingaphansi esithinta ukugeleza kwegazi endaweni elimele.
• Ukubhema. Abantu ababhema banengozi enkulu ye-gangrene.
• Ukukhuluphala. Isisindo esengeziwe singacindezela i-arteries, siphazamise ukugeleza kwegazi futhi sikhulise ingozi yokutheleleka nokuphulukiswa okubi kwezindawo ezilimele.
• Ukucindezelwa kwe-immunosuppression. I-Chemotherapy, i-radiation nezinye izifo, ezifana ne-human immunodeficiency virus (HIV), zingathinta ikhono lomzimba lokulwa nezifo.
• Izinjoloba. Ngokungavamile, imithi eyenziwa ngezinjoloba iye yahlotshaniswa nokutholakala kwezifo ngamabhaktheriya abangela i-gangrene.
• Izinkinga zesifo se-coronavirus 2019 (COVID-19). Kuye kwaba nemiphumela embalwa yabantu abatholana ne-gangrene yomile eminweni nasezinzwini zabo ngemuva kokuba behlushwe yizinkinga zokugqwala kwegazi ezihlobene ne-COVID-19 (coagulopathy). Ucwaningo olwengeziwe luyadingeka ukuqinisekisa lobuxhulumene.

Ukuqothuka kwenyama kungabangela izinkinga ezingathi sína uma kungelaphi ngokushesha. Iintsholongwane zingasakazeka ngokushesha kwenye imisipha namalungu. Kungadingeka ukuba ukhishwe ingxenye yomzimba (ukusika) ukuze usindiswe. Ukususa inyama eyonakele kungabangela amabala noma ukudingeka kokuhlinzwa kabusha.

Naziindlela ezimbalwa zokusiza ukunciphisa ingozi yokuthuthukisa i-gangrene:

• Lawula isifo sikashukela. Uma une-diabetes, kubalulekile ukulawula amazinga akho okusanhlamvu. Futhi qiniseka ukuthi uhlola izandla zakho nezinyawo zakho nsuku zonke ngokuqashwa, amaqhubu kanye nezimpawu zokutheleleka, njengokubomvu, ukuvuvukala noma ukuqothuka. Cela umhlinzeki wakho wezempilo ukuthi ahlole izandla zakho nezinyawo zakho okungenani kanye ngonyaka.
• Lahla isisindo. Amakhilogremu engeziwe andisa ingozi ye-diabetes. Isisindo siphinde sibeke uxinzelelo emithanjeni yegazi, sichaphazele ukugeleza kwegazi. Ukugeleza kwegazi okunciphisiwe kukhuphula ingozi yokutheleleka futhi kubangela ukululama okuhamba kancane kwezindawo eziqotshiwe.
• Ungabhemi noma usebenzisi utshaba. Ukusetshenziswa kwetshaba isikhathi eside konakalisa imithambo yegazi.
• Geza izandla zakho. Sebenzisa ukuhlanzeka okuhle. Geza noma yiziphi izingqala ezivulekile ngensipho ebile namanzi. Gcina izandla zicocekile futhi zomile kuze ziphulukile.
• Hlola ukubanda. Ukubanda kunciphisa ukugeleza kwegazi endaweni yomzimba ethintekile. Uma unalezi zikhathi ezimhlophe, ezinzima, ezibandayo neziqhaqhazile ngemuva kokuba usezingeni lokushisa elipholile, shayela umhlinzeki wakho wokunakekelwa.

Izivivinyo ezisetshenziswa ukusiza ekutholakala kwengqamuzana zihlanganisa:

• Izivivinyo zegazi. Inani eliphezulu leeseli ezimhlophe zegazi liyabonakala njengophawu lokutheleleka. Ezinye izivivinyo zegazi zingase zenziwe ukuhlola ukuba khona kweentsholongwane ezithile kunye nezinye izinto eziphilayo ezingabonakaliyo.
• Ukukhula kwesicubu okanye ukukhula kwelakhiwo. Izivivinyo zingase zenziwe ukukhangela iintsholongwane kwisampula yephukuthe lesikhumba. Isampula yesicubu ingahlolwa phantsi komboniso ukuze kubonwe izimpawu zokufa kweseli.
• Izivivinyo zokubonisa izithombe. I-X-ray, i-computerized tomography (CT) scans kunye ne-magnetic resonance imaging (MRI) scans zingabonisa amalungu omzimba, imithambo yegazi kunye namagagasi. Ezi zivivinyo zingasiza ukubonisa ukuba ingqamuzana isasazwe kangakanani emzimbeni.
• Ukuhlinzwa. Ukuhlinzwa kungase kwenziwe ukuze kubonwe ngcono ngaphakathi komzimba nokufunda ukuba yimalini ithishu etheleleke.