Irhasi ebilayo

I-gas gangrene yindlela ebulalayo yokufa kwezicubu (ukubola).

Irhasi ebolileyo idla ngokubangelwa ziintsholongwane IClostridium perfringens. Inokubangelwa liqela le-streptococcus, I-Staphylococcus aureus, kwaye IVibrio vulnificus.

IClostridium ifumaneka phantse kuyo yonke indawo. Njengoko ibacteria ikhula ngaphakathi emzimbeni, yenza igesi kunye nezinto eziyingozi (ityhefu) ezinokonakalisa izicwili zomzimba, iiseli, kunye nemithambo yegazi.

Irhasi ebolileyo ikhula ngesiquphe. Ihlala yenzekile kwindawo yomothuko okanye inxeba lotyando lwamva nje. Kwezinye iimeko, kwenzeka ngaphandle kwesiganeko esicasulayo. Abantu abasemngciphekweni wokuhlaselwa sisifo segesi bahlala benesifo semithambo yegazi (i-atherosclerosis, okanye ukuqina kwemithambo), isifo seswekile, okanye umhlaza wekolon.

Irhasi ebolileyo ibangela ukudumba okubuhlungu kakhulu. Ulusu lujika lube bomvu bumdaka ngombala. Xa indawo edumbileyo icinezelwe, igesi inokuvakala (kwaye ngamanye amaxesha iviwe) njengoluvo oluqhekezayo (i-crepitus). Imiphetho yendawo eyosulelekileyo ikhula ngokukhawuleza kangangokuba utshintsho lubonwe kwimizuzu. Indawo inokutshatyalaliswa ngokupheleleyo.

Iimpawu zibandakanya:

• Umoya phantsi kolusu (i-emphysema yangaphantsi)
• Amadyungudyungu azaliswe lulwelo olubomvu lumdaka
• Umjelo wamanzi aphuma kwizicubu, onevumba elimdaka ngombala omdaka-bomvu-bomvu okanye olunegazi (ukuphuma kwegazi)
• Ukunyuka kwenhliziyo (tachycardia)
• Ukumodareyitha ukuya kumkhuhlane ophezulu
• Ukumodareyitha kwiintlungu ezibuhlungu ezimalunga nokwenzakala kolusu
• Umbala wesikhumba omdaka, kamva uba dusky kwaye utshintshe ubomvu bumfusa okanye mfusa
• Ukudumba okuba mandundu kukulimala kolusu
• Ukubila
• Ukwakhiwa kweVesicle, ukudibanisa kwiiblisters ezinkulu
• Umbala otyheli kulusu (i-jaundice)

Ukuba imeko ayinyangwa, umntu angothuka ngokuncipha koxinzelelo lwegazi (hypotension), ukusilela kwezintso, isiqaqa, kunye nokufa ekugqibeleni.

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Oku kungabonakalisa iimpawu zothuko.

Uvavanyo olunokwenziwa lunokubandakanya:

• Izicubu kunye neenkcubeko ezinamanzi ukuvavanya intsholongwane kubandakanya iintlobo ze-clostridial.
• Inkcubeko yegazi ukumisela ibhaktiriya ebangela usulelo.
• Ibala legram yeencindi zommandla osulelekileyo.
• I-X-ray, i-CT scan, okanye i-MRI yendawo ingabonisa igesi kwizicubu.

Utyando luyafuneka ngokukhawuleza ukuze kususwe izicwili ezifileyo, ezonakalisiweyo nezosulelekileyo.

Ukususa ngotyando (ukunqunyulwa) kwengalo okanye umlenze kunokufuneka ukulawula ukusasazeka kosulelo. Ukunqunyulwa ngamanye amaxesha kufuneka kwenziwe ngaphambi kokuba zonke iziphumo zovavanyo zibekhona.

Amachiza okubulala iintsholongwane nawo anikiwe. La mayeza anikezwa ngomthambo (ngaphakathi). Amayeza eentlungu nawo anokumiselwa.

Kwezinye iimeko, unyango lwe-hyperbaric oxygen lunokuzama.

Irhasi ebilayo idla ngokuqala ngesiquphe kwaye ngokukhawuleza iba mbi. Ihlala ibulala.

Iingxaki ezinokubangela zibandakanya:

• Coma
• Delirium
• Ukonakalisa okanye ukukhubaza ukonakala kwethishu ngokusisigxina
• I-jaundice enomonakalo wesibindi
• Ukungaphumeleli kwezintso
• Umothuko
• Ukusasazeka kosulelo emzimbeni (sepsis)
• Isiporho
• Ukufa

Le yimeko engxamisekileyo efuna unyango kwangoko.

Fowunela umnikezeli wakho ukuba unempawu zosulelo ejikeleze inxeba lolusu. Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911), ukuba unempawu zerhasi ebilayo.

Coca nakuphi na ukwenzakala kolusu. Jonga iimpawu zosulelo (njengokubomvu, iintlungu, idreyina, okanye ukudumba ujikeleze inxeba). Jonga umboneleli wakho ngokukhawuleza ukuba oku kuyenzeka.

Usulelo lweethishu - clostridial; Gangrene - irhasi; Myonecrosis; Usulelo Clostridial kwezihlunu; Usulelo lwe-Necrotizing izicubu ezithambileyo

• Irhasi ebilayo
• Irhasi ebilayo
• Iintsholongwane

UHenry S, uKayin C. Irhasi ebilayo yesiphelo. Ku: ICameron AM, uCameron JL, ii-eds. Unyango lwangoku lonyango. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2020: 862-866.

I-Onderdonk AB, iGarrett WS. Izifo ezibangelwa yi-clostridium. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2020: isahluko 246.