I-necrosis ebulalayo

I-acute tubular necrosis (ATN) sisifo sezintso esibandakanya ukonakala kweeseli ze-tubule zezintso, ezinokuthi zikhokelele ekusileleni kwezintso. Iityhubhu yimibhobho emincinci kwizintso ezinceda ukucoca igazi xa lidlula kwizintso.

I-ATN ihlala ibangelwa kukungabikho kwegazi kunye neoksijini kwizicubu zezintso (ischemia yezintso). Inokwenzeka kwakhona ukuba iiseli zezintso zonakaliswe yityhefu okanye into eyingozi.

Ulwakhiwo lwangaphakathi lwezintso, ngakumbi izicwili zesifo sezintso, ziyonakala okanye zonakaliswe. I-ATN lolunye lwezona zinto zixhaphakileyo kulwakhiwo olunokukhokelela kukusilela kwezintso.

I-ATN ingunobangela oqhelekileyo wokungaphumeleli kwezintso kubantu abasesibhedlele. Iingozi ze-ATN zibandakanya:

• Ukuphendula ngokutofelwa igazi
• Ukwenzakala okanye ukwenzakala okulimaza izihlunu
• Uxinzelelo lwegazi olusezantsi (hypotension) oluhlala ixesha elide kunemizuzu engama-30
• Utyando olukhulu lwamva nje
• Umothuko o-Septic (imeko enzima eyenzekayo xa usulelo olubanzi emzimbeni lukhokelela kuxinzelelo lwegazi oluyingozi)

Isifo sesibindi kunye nokonzakala kwezintso okubangelwa sisifo seswekile (isifo seswekile, nephropathy) kunokwenza ukuba umntu athambekele ekubeni ne-ATN.

I-ATN nayo inokubangelwa ngamayeza ayityhefu kwizintso. La mayeza aquka aminoglycoside antibiotics kunye ne-antifungal drug amphotericin.

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ukwehla kwengqondo, isiqaqa, ukuphazamiseka kwengqondo okanye ukudideka, ukozela nokudinwa
• Ukwehla kwemveliso yomchamo okanye akukho mveliso yokuchama
• Ukudumba ngokubanzi, ukugcinwa kolwelo
• Isicaphucaphu, ukugabha

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Umboneleli unokuva izandi ezingaqhelekanga xa umamele intliziyo kunye nemiphunga ngestethoscope. Oku kungenxa yolwelo oluninzi emzimbeni.

Uvavanyo olunokwenziwa lunokubandakanya:

• I-BUN kunye ne-serum creatinine
• Ukuchithwa kwe-sodium
• Isifo sezintso
• Uhlalutyo lomchamo
• Umchamo wesodiyam
• Umchamo othile womxhuzulane kunye nomchamo osmolarity

Kwinkoliso yabantu, i-ATN inokubuyiselwa umva. Injongo yonyango kukuthintela iingxaki ezisongela ubomi

Unyango lujolise ekuthinteleni ukwakhiwa kwamanzi kunye nenkunkuma, ngelixa ivumela izintso ukuba ziphilise.

Unyango lunokubandakanya nayiphi na kwezi zilandelayo:

• Ukuchonga nokunyanga oyena nobangela wengxaki
• Ukuthintela ukutya okungafunekiyo
• Ukuthatha amayeza ukunceda ukulawula inqanaba le potassium egazini
• Amayeza athathwe ngomlomo okanye nge-IV ukunceda ukususa ulwelo emzimbeni

I-dialysis yexeshana inokususa inkunkuma egqithisileyo kunye nolwelo. Oku kunokunceda ukuphucula iimpawu zakho ukuze uzive ungcono. Inokwenza ukuba ukusilela kwezintso kube lula ukulawula. I-Dialysis isenokungabi yimfuneko kubo bonke abantu, kodwa ihlala isindisa ubomi, ngakumbi ukuba i-potassium iphezulu ngokuyingozi.

I-Dialysis inokufuneka kwezi meko zilandelayo:

• Ukuhla kwengqondo
• Ulwelo olukhulu
• Ukunyuka kwenqanaba le potassium
• I-Pericarditis (ukudumba kwengxowa efana nokugubungela intliziyo)
• Ukususwa kweetyhefu eziyingozi kwizintso
• Ukusilela ngokupheleleyo kwemveliso yomchamo
• Ulwakhiwo olungalawulwayo lweemveliso zenkunkuma ye-nitrogen

I-ATN inokuhlala iintsuku ezimbalwa ukuya kwiiveki ezi-6 okanye ngaphezulu. Oku kunokulandelwa ziintsuku ezi-1 okanye ezi-2 zokwenza umchamo omkhulu ngokungaqhelekanga njengoko izintso ziphila. Umsebenzi wezintso uhlala ubuyela esiqhelweni, kodwa kunokubakho ezinye iingxaki ezinzulu kunye neengxaki.

Fowunela umboneleli wakho ukuba ukuphuma kwakho komchamo kuyehla okanye kuyekile, okanye ukuba uphuhlisa ezinye iimpawu ze-ATN.

Ukunyanga ngokukhawuleza iimeko ezinokukhokelela ekunciphiseni ukuhamba kwegazi kunye nokwehla kweoksijini kwizintso kunokunciphisa umngcipheko we-ATN.

Utofelo-gazi luyahambelana ukuze kuncitshiswe ukungahambelani.

Isifo seswekile, ukuphazamiseka kwesibindi, kunye neengxaki zentliziyo kufuneka zilawulwe kakuhle ukunciphisa umngcipheko we-ATN.

Ukuba uyazi ukuba uthatha amayeza anokuzenzakalisa izintso zakho, buza umboneleli wakho malunga nokuba igazi lakho lijongiwe rhoqo na.

Sela amanzi amaninzi emva kokuba unayo nayiphi na idayi eyahlukileyo yokuvumela ukuba isuswe emzimbeni kunye nokunciphisa umngcipheko wokonzakala kwezintso.

Necrosis - isifo sezintso; I-ATN; Necrosis - etsolo tubular

• I-anatomy yezintso
• Izintso - ukuhamba kwegazi kunye nomchamo

Ukujika JM, Coca SG. Ukulimala okuqatha kunye necrosis ebulalayo. Ku: Gilbert SJ, Weiner DE, ii-eds. Isiseko seZintso seSizwe seZintso. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 32.

I-Weisbord SD, iNkulumbuso yePalevsky. Ukuthintela kunye nokulawulwa kokulimala kwezintso. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 29.