Ukuqiniswa Kwamehlo Okuhlala Isikhathi Eside? Izimpawu, Izimbangela, Nokwelashwa

Ukuqiniswa kwamehlo okuhlala isikhathi eside kuyiqiniswa elihlala isikhathi eside, ebuhlungu elihlala amahora angaphezu kwamanne ngaphandle kokuvusa kobulili noma ukukhuthazwa. Lokhu kudinga ukunakekelwa okusheshayo kwezokwelapha ngoba kungalimaza ilungu lobulili futhi kuholele ezinkingeni ezihlala njalo ngokuqiniswa kwamehlo uma kushiywa kungelashwa.

Cabanga ngakho njengesistimu yokujikeleza kwegazi lomzimba yakho ebanjelwe endaweni 'evuliwe' lapho kufanele ibuye ezingeni elijwayelekile. Nakuba lokhu kungase kubonakale kuyihlazo ukukhuluma ngakho, kuyisimo esibuhlungu sezempilo esiphathwa njalo ngamadokotela ngokuchwephesha nangokuhle.

Ziyini izimpawu zokuqiniswa kwamehlo okuhlala isikhathi eside?

Isimpawu esiyinhloko ukuqiniswa okungapheli ngokwalo, ngokuvamile kuhlala amahora amane noma ngaphezulu. Uzoqaphela ukuthi ukuqiniswa kuyaqhubeka ngisho noma kungekho imicabango yobulili, ukukhuthazwa, noma ukukhuthazwa.

Nazi izimpawu ezibalulekile ezibonisa ukuthi ungase ube nokuqiniswa kwamehlo okuhlala isikhathi eside:

• Ukuqiniswa okuhlala ngaphezu kwamahora angu-4
• Ukuqiniswa okungaxhunyanisiwe nokuvusa kobulili noma ukukhuthazwa
• Ulukhuni oluqinile lwelungu lobulili ngenhloko ebushelelezi (uhlobo oluvamile)
• Ubuhlungu obuqhubekayo obuvame ukuba bube sibi ngokuhamba kwesikhathi
• Ubunzima bokuthamba ngezinye izikhathi
• Ilungu lobulili elibuhlungu noma elibuhlungu uma lithintwa

Ubuhlungu ngokuvamile buqala njengokungakhululeki okuncane kodwa bungaba sibi kakhulu njengoba isikhathi sihamba. Lokhu kuqhubeka kwenzeka ngoba igazi libanjelwe futhi amazinga oksijini ezihlangwini ezincipha.

Ziyini izinhlobo zokuqiniswa kwamehlo okuhlala isikhathi eside?

Kunezinhlobo ezimbili eziyinhloko zokuqiniswa kwamehlo okuhlala isikhathi eside, nokuqonda umehluko kusiza odokotela ukuba bakhethe indlela yokwelapha efanele. Uhlobo olukhona lunomthelela kokubili ekuphuthumeni kokwelashwa nendlela ethile yezokwelapha edingekayo.

Ukuqiniswa kwamehlo okuhlala isikhathi eside okungekho-gazi (okubizwa nangokuthi ukuqiniswa kwamehlo okuhlala isikhathi eside okune-low-flow) kuyilona uhlobo oluvamile futhi olukhulu. Igazi libanjelwe elungwini lobulili futhi alinakho ukugeleza kahle, okubangela ukuthi izicubu zilahle oksijini. Lolu hlobo lubangela ubuhlungu obukhulu futhi ludinga ukwelashwa okusheshayo ukuvimbela ukulimala okungapheli.

Ukuqiniswa kwamehlo okuhlala isikhathi eside okune-gazi (okubizwa nangokuthi ukuqiniswa kwamehlo okuhlala isikhathi eside okune-high-flow) kwenzeka lapho igazi eliningi ligeleza elungwini lobulili, ngokuvamile ngenxa yokulimala. Lolu hlobo ngokuvamile alubuhlungu kakhulu futhi aludingi ukunakekelwa okusheshayo, nakuba lusadinga ukunakekelwa kwezokwelapha. Ilungu lobulili lingase lizwakale liqinile kodwa lingaqinile ngokuphelele.

Yini ebangela ukuqiniswa kwamehlo okuhlala isikhathi eside?

Ukuqiniswa kwamehlo okuhlala isikhathi eside kungathuthukiswa ezimweni eziningi eziyisisekelo nezici ezihlasela ukugeleza kwegazi elungwini lobulili. Ngezinye izikhathi imbangela eqondile ihlala ingacaci, kodwa odokotela ngokuvamile bangakwazi ukubona izici ezinikezela ngesikhathi sokulingwa.

Izimbangela ezivamile zihlanganisa:

• Isifo se-sickle cell (sibalwa cishe amaphesenti angu-40 ezikhathini)
• Imithi yokwelapha ukuqiniswa kwamehlo uma isebenziswa ngokungalungile
• Imithi yokuncipha kwegazi njenge-warfarin noma i-heparin
• Imithi yokucindezela ukudangala, ikakhulukazi i-trazodone
• Imithi yokucindezela igazi
• Izidakamizwa zokuzilibazisa, ikakhulukazi i-cocaine
• Ukusebenzisa kabi utshwala
• Ukulimala noma ukulimala elungwini lobulili noma emathangeni

Izimbangela ezingavamile kodwa ezingase zenzeke zihlanganisa i-leukemia, ezinye izifo zegazi, ukulimala komgogodla, nokutheleleka okuthile. Ngezinye izikhathi, ukuqiniswa kwamehlo okuhlala isikhathi eside kwenzeka ngaphandle kwesici esibonakalayo, odokotela abakubiza ngokuthi ukuqiniswa kwamehlo okuhlala isikhathi eside okungaziwa.

Nini okufanele ubone udokotela ngokuqiniswa kwamehlo okuhlala isikhathi eside?

Kufanele ufuna ukunakekelwa kwezokwelapha okusheshayo ngokushesha uma uneqiniswa elihlala amahora angaphezu kwamanne. Lokhu akuyona isimo ongasilwa ekhaya noma ulinde, njengoba ukwelashwa okulile kukhuphula kakhulu ingozi yokulimala okungapheli.

Iya endaweni yokwelapha ngokushesha uma uhlangabezana nokuqiniswa okuhlala njalo ngebuhlungu, ngisho noma kungakafiki amahora amane. Ukwelashwa kwasekuqaleni kukunika ithuba elihle kakhulu lokuvikela umsebenzi ojwayelekile nokugwema izinkinga.

Ungavumeli ihlazo likuvimbele ekufuneni usizo. Abasebenzi bendawo yokwelapha kanye nochwepheshe bezifo ze-urology baphatha lezi zimo njalo futhi bazokuphatha ngokuchwephesha nangokuthula. Khumbula, lokhu kuyisimo esibuhlungu sezempilo, hhayi inkinga yempilo yobulili okufanele uzizwe ukhona ngayo.

Ziyini izici ezibeka ingozi yokuqiniswa kwamehlo okuhlala isikhathi eside?

Izimo ezithile nezimo zenza ukuqiniswa kwamehlo okuhlala isikhathi eside kube lula ukwenzeka. Ukuqonda izici zakho ezibeka ingozi kungakusiza ukuba uqaphele isimo ngokushesha futhi ufuna ukunakekelwa kwezokwelapha okufanele uma kudingeka.

Nazi izici eziyinhloko ezibeka ingozi okufanele uzazi:

• Isifo se-sickle cell noma i-sickle cell trait
• Ezinye izifo zegazi njenge-leukemia noma i-thalassemia
• Ukuthatha imithi yokwelapha ukuqiniswa kwamehlo
• Ukusebenzisa izidakamizwa zokuzilibazisa, ikakhulukazi i-cocaine noma i-marijuana
• Ukuba nokulimala komgogodla
• Ukulimala kwakamuva endaweni yobulali
• Ukuthatha imithi ethile
• Ukuba nomlando wokuqiniswa kwamehlo okuhlala isikhathi eside

Ubudala buphinde bube nomthelela, ngokuqiniswa kwamehlo okuhlala isikhathi eside okuvamile kakhulu emaqenjini amabili ebudala: abantwana abaneminyaka eyi-5-10 (ngokuvamile kuhlobene nesifo se-sickle cell) nabesilisa abaneminyaka eyi-20-50. Uma unezinye zalezi zici ezibeka ingozi, xoxa ngamasu okuvimbela nodokotela wakho.

Ziyini izinkinga ezingase zenzeke ngokuqiniswa kwamehlo okuhlala isikhathi eside?

Inkinga ebuhlungu kakhulu yokuqiniswa kwamehlo okuhlala isikhathi eside okungelashwanga ukuqiniswa kwamehlo okuhlala njalo, okuvela lapho ukushoda koksijini kulimaza izicubu elungwini lobulili. Lokhu kulimala kungabuyekezi uma ukwelashwa kulibazise ngaphezu kwamahora angu-24-48.

Izinkinga ezingase zenzeke zihlanganisa:

• Ukungenakho ukufinyelela noma ukugcina ukuqiniswa kwamehlo okuhlala njalo
• Ukwenza amabala ezicubwini zelungu lobulili
• Ukuguquka kwesimbo selungu lobulili
• Ubuhlungu obuhlala njalo
• Ukucindezeleka kwengqondo nokukhathazeka
• Ubunzima bobuhlobo
• I-Gangrene ezimweni ezingavamile kakhulu nezibulalayo

Izindaba ezinhle ukuthi ukwelashwa okusheshayo kunciphisa kakhulu lezi zingqinamba. Abesilisa abaningi abamukela ukwelashwa phakathi kwamahora angu-24 bokuqala bagcina umsebenzi ojwayelekile wokuqiniswa kwamehlo ngemuva kwalokho. Kungakho ukunakekelwa kwezokwelapha okusheshayo kubaluleke kakhulu.

Ukuqiniswa kwamehlo okuhlala isikhathi eside kunqunywa kanjani?

Odokotela ngokuvamile bangakwazi ukunquma ukuqiniswa kwamehlo okuhlala isikhathi eside ngokusekelwe ezimpawu zakho nokukhethwa komzimba. Ukuxilongwa ngokuvamile kulula, kodwa ukuthola imbangela eyiyisisekelo nohlobo kudinga ukuhlolwa okwengeziwe.

Udokotela wakho uzokubuza ngomlando wakho wezokwelapha, imithi oyithathayo njengamanje, nokusetshenziswa kwemithi kwakamuva. Bazokwenza ukuhlolwa komzimba ukuhlola ubukhulu bokuqiniswa nokuhlola izimpawu zokulimala noma ukutheleleka.

Ukuhlolwa okwengeziwe kungase kuhlanganise ukuhlolwa kwegazi ukuhlola isifo se-sickle cell, ukutheleleka, noma izinkinga zokugqwala kwegazi. Ngezinye izikhathi, odokotela basebenzisa i-ultrasound ukulinganisa ukugeleza kwegazi elungwini lobulili, okusisiza ukwahlukanisa phakathi kwezinhlobo ezimbili zokuqiniswa kwamehlo okuhlala isikhathi eside futhi kuqondise izinqumo zokwelapha.

Yikuphi ukwelashwa kokuqiniswa kwamehlo okuhlala isikhathi eside?

Ukwelashwa kuncike kuhlobo lokuqiniswa kwamehlo okuhlala isikhathi eside onalo nokuthi ukuqiniswa kuhlale isikhathi esingakanani. Umgomo ukubuyisela ukugeleza kwegazi okujwayelekile nokugwema ukulimala okungapheli elungwini lobulili.

Ngokuqiniswa kwamehlo okuhlala isikhathi eside okungekho-gazi, odokotela ngokuvamile baqala ngokukhipha igazi ngenhlanzi, lapho basebenzisa khona inhlanzi encane ukukhipha igazi elibambekele elungwini lobulili. Le nqubo ngokuvamile inikeza impumuzo ngokushesha futhi ingenziwa endaweni yokwelapha ngokusebenzisa ukulutha okukodwa.

Uma ukukhipha igazi kungasebenzi, udokotela wakho angase afake imithi ngokuqondile elungwini lobulili ukusiza ukunciphisa imithambo yegazi nokunciphisa ukugeleza kwegazi. Imithi evamile ihlanganisa i-phenylephrine noma i-epinephrine, evame ukuba iphephile futhi isebenza kahle.

Ezimweni ezinkulu ezingaphenduli kulezi zindlela zokwelapha, ukucutshungulwa kungase kudingeke. Izinketho zokucutshungulwa zihlanganisa ukudala i-shunt yesikhashana (ukudlula) ukuqondisa kabusha ukugeleza kwegazi noma, ezimweni ezingavamile, izinqubo eziyinkimbinkimbi ukubuyisela ukujikeleza okujwayelekile.

Ukuqiniswa kwamehlo okuhlala isikhathi eside okune-gazi ngokuvamile kuziqondisa ngokwalo ngokuhamba kwesikhathi, ngakho odokotela bangase bancoma ukulinda ngokuqapha okujwayelekile. Noma kunjalo, uma kuqhubeka, izinketho zokwelapha zihlanganisa imithi noma izinqubo zokunciphisa ukugeleza kwegazi kule ndawo.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokuqiniswa kwamehlo okuhlala isikhathi eside?

Nakuba ukuqiniswa kwamehlo okuhlala isikhathi eside kudinga ukwelashwa kwezokwelapha kwezobuchwepheshe, kunezinto ezimbalwa ongazenza ngenkathi uya esibhedlela ezingase zinikeze impumuzo yesikhashana. Noma kunjalo, lezi azisiwona ama-substitutes wokunakekelwa kwezokwelapha okusheshayo.

Ungazama ukuthatha ishawa elifudumele noma ukubhukuda, okungase kusize ekuphumuleni imithambo yegazi nokwenza ukujikeleza kube ngcono. Abanye abesilisa bathola ukuthi ukuzivocavoca okukhanyayo, njengokuhamba noma ukukhuphuka izitebhisi, kusiza ekuqondisweni kabusha kwegazi kude nendawo yobulali.

Faka ama-ice packs emathangeni angaphakathi noma e-perineum (indawo phakathi kwelungu lobulili nesihlalo) imizuzu engu-10-15 ngesikhathi. Ungalokothi ufake iqhwa ngokuqondile elungwini lobulili, njengoba lokhu kungalimaza izicubu ezengeziwe.

Gwema noma yiluphi ubulili noma ukukhuthazwa, njengoba lokhu cishe kuzokwenza isimo sibe sibi. Gwema futhi imithi noma ukwelashwa ongakuthola ku-inthanethi, njengoba lokhu kungaba yingozi futhi kulibazise ukunakekelwa kwezokwelapha okufanele.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ngokuqiniswa kwamehlo okuhlala isikhathi eside, cishe uzoqonda ngokuqondile endaweni yokwelapha kunokuhlela i-aphoyintimenti ejwayelekile. Noma kunjalo, ukulungiselela ngolwazi kungasiza odokotela ukuba bakwelaphe ngokuphumelelayo.

Bhala phansi noma ukhumbule yonke imithi oyithathayo njengamanje, kuhlanganise imithi yokwelapha, imithi yokuthengwa ngaphandle kwesikripthi, kanye nezinye izinto. Faka izidakamizwa zokuzilibazisa uma kufanele, njengoba lolwazi lubalulekile ekuxilongweni nasekwelapheni.

Lungiselela umlando omfushane wezokwelapha kuhlanganise noma yiziphi izifo zegazi, izikhathi zangaphambili zokuqiniswa kwamehlo okuhlala isikhathi eside, ukulimala kwakamuva endaweni yobulali, nanoma yiziphi izimo ezihlala njalo onazo. Qaphela futhi ukuthi ukuqiniswa kwaqala nini nanoma yiziphi imisebenzi noma izenzakalo ezazikuqhubeka.

Letha uhlu lwabakwa-dokotela bakho njengamanje nolwazi lokuxhumana, ikakhulukazi uma uthola ukwelashwa ngesifo se-sickle cell, izifo zegazi, noma uthatha imithi yokwelapha ukuqiniswa kwamehlo. Lokhu kusiza iqembu lesimo esiphuthumayo ukuhlanganisa ukunakekelwa kwakho ngokuphumelelayo.

Ukuqiniswa kwamehlo okuhlala isikhathi eside kungavikeleka?

Nakuba ungakwazi ukuvimbela zonke izimo zokuqiniswa kwamehlo okuhlala isikhathi eside, ungathatha izinyathelo zokunciphisa ingozi yakho, ikakhulukazi uma unezici eziyaziwayo ezibeka ingozi. Amasu okuvimbela agxila ekulawuleni izimo eziyisisekelo nokugwema izici ezaziwayo.

Uma unesifo se-sickle cell, sebenzisana eduze nodokotela wakho we-hematologist ukulawula isimo sakho ngokuphumelelayo. Hlala unamanzi, gwema izimo zokushisa okukhulu, bese ulandela uhlelo lwakho lokwelashwa oluqokiwe ukuze unciphise ingozi ye-sickle cell crises engase ibe yimbangela yokuqiniswa kwamehlo okuhlala isikhathi eside.

Sebenzisa imithi yokwelapha ukuqiniswa kwamehlo ngokuqondile njengoba kuqokiwe udokotela wakho. Ungalokothi udlule inani eliqokiwe noma uhlanganise imithi ehlukene yokuqiniswa kwamehlo. Uma usebenzisa imithi yokuthombisa yokuqiniswa kwamehlo, landela izindlela ezifanele zokuthombisa kanye nemiyalo yokulinganisa ngokucophelela.

Gwema izidakamizwa zokuzilibazisa, ikakhulukazi i-cocaine notshwala oluningi, okungase kukhuphule ingozi yakho. Uma uthatha imithi eyaziwayo ngokubangela ukuqiniswa kwamehlo okuhlala isikhathi eside njengomphumela ohlangothini, xoxa ngezinye izinketho nodokotela wakho uma uhlangabezana nanoma yiziphi izimpawu ezinkulu.

Iyini into ebalulekile ngokuqiniswa kwamehlo okuhlala isikhathi eside?

Ukuqiniswa kwamehlo okuhlala isikhathi eside kuyisimo esibuhlungu sezempilo esidinga ukunakekelwa okusheshayo, kodwa ngokwelashwa okusheshayo, abesilisa abaningi bayaphila ngokuphelele ngaphandle kwezinkinga zesikhathi eside. Okubalulekile ukuqaphela izimpawu ngokushesha nokufuna usizo ngaphandle kokulibala.

Khumbula ukuthi noma yiliphi iqiniswa elihlala amahora angaphezu kwamanne lidinga ukunakekelwa kwezokwelapha okusheshayo, kungakhathaliseki ukuthi libuhlungu noma cha. Ungavumeli ihlazo likuvimbele ekufuneni ukwelashwa okudingayo – abahlinzeki bezempilo baphatha lezi zimo ngokuchwephesha nangokuthula.

Uma unezici ezibeka ingozi njengesifo se-sickle cell noma uthatha imithi ethile, xoxa ngamasu okuvimbela nodokotela wakho. Ukuba nolwazi nokulungiselela kungakusiza ukuba uphendule ngokushesha uma ukuqiniswa kwamehlo okuhlala isikhathi eside kwenzeka futhi kungasiza ukuvimbela ukwenzeka kwakho.

Imibuzo evamile ebuzwa ngokuqiniswa kwamehlo okuhlala isikhathi eside

Q: Ingabe ukuqiniswa kwamehlo okuhlala isikhathi eside kuhlala kuhlupha?

Akuhlali kunjalo, kodwa izimo eziningi zokuqiniswa kwamehlo okuhlala isikhathi eside okungekho-gazi (uhlobo oluvamile) ziyaqhubeka zibuhlungu ngokuhamba kwesikhathi. Ukuqiniswa kwamehlo okuhlala isikhathi eside okune-gazi kungase kube nobuhlungu obuncane noma ukungakhululeki, kodwa noma yiliphi iqiniswa elihlala amahora angaphezu kwamanne lidinga ukunakekelwa kwezokwelapha kungakhathaliseki izinga lobuhlungu.

Q: Ingabe ukuqiniswa kwamehlo okuhlala isikhathi eside kungenzeka ngaphezu kwesikhathi esisodwa?

Yebo, abanye abesilisa bahlangabezana nokuqiniswa kwamehlo okuhlala isikhathi eside okuphindaphindayo, ikakhulukazi labo abanesifo se-sickle cell noma ezinye izifo zegazi eziyisisekelo. Uma uke waba nokuqiniswa kwamehlo okuhlala isikhathi eside ngaphambili, ukhona engcupheni enkulu yezikhathi ezizayo, ngakho kubalulekile ukusebenzisana nodokotela wakho ngamasu okuvimbela futhi ube neqembu lesimo esiphuthumayo.

Q: Ingabe ngizokwazi ukuba nokuqiniswa okujwayelekile kwamehlo ngemuva kokuqiniswa kwamehlo okuhlala isikhathi eside?

Abesilisa abaningi abamukela ukwelashwa okusheshayo phakathi kwamahora angu-24 bagcina umsebenzi ojwayelekile wokuqiniswa kwamehlo. Noma kunjalo, ukwelashwa okulile kukhuphula ingozi yokuqiniswa kwamehlo okuhlala njalo. Ngokushesha uthola ukwelashwa, izikhathi zakho ezinhle zokulondoloza umsebenzi ojwayelekile wobulili.

Q: Ingabe ukuqiniswa kwamehlo okuhlala isikhathi eside kungathinta ukukhulelwa?

Ukuqiniswa kwamehlo okuhlala isikhathi eside ngokwalo ngokuvamile akukuthinti ukukhulelwa noma ikhono lakho lokuba noyise. Isimo sihilela ukugeleza kwegazi elungwini lobulili kunokukhiqizwa kwesidoda, okwenzeka emathangeni. Noma kunjalo, izinkinga ezinkulu ezivela ekuqinisweni kwamehlo okuhlala isikhathi eside okungelashwanga zingase zithinte umsebenzi wobulili nobuhlobo.

Q: Ingabe kufanele ngibe namahloni ekufuneni ukwelashwa ngokuqiniswa kwamehlo okuhlala isikhathi eside?

Akulona neze. Ukuqiniswa kwamehlo okuhlala isikhathi eside kuyisimo esibuhlungu sezempilo, futhi abahlinzeki bezempilo bayeqeqeshwe ukuphatha lezi zimo ngokuchwephesha nangomusa. Abasebenzi bendawo yokwelapha kanye nochwepheshe bezifo ze-urology babona lezi zimo njalo, kanti impilo yakho nokuphulukisa kwakho kuyizinto zabo eziyinhloko, hhayi ukwahlulela isimo sakho.