Igumbi lesifo

I-Acute compartment syndrome yimeko enzima ebandakanya uxinzelelo olwandayo kwigumbi lezihlunu. Ingakhokelela ekonakaleni kwemisipha nakwimithambo-luvo kunye neengxaki zokuhamba kwegazi.

Uluhlu olungqindilili lweethishu, ebizwa ngokuba yi-fascia, amaqela ahlukeneyo ezihlunu ezingalweni nasemilenzeni enye kwenye. Ngaphakathi kwinqanaba ngalinye le-fascia yindawo evaliweyo, ebizwa ngokuba ligumbi. Igumbi libandakanya izicubu zemisipha, imithambo-luvo kunye nemithambo yegazi. I-Fascia ijikeleze ezi zakhiwo, ngokufanayo nendlela yokugquma igquma iingcingo.

I-Fascia ayandisi. Nakuphi na ukudumba kwigumbi kuya kukhokelela kuxinzelelo olonyukayo kuloo ndawo. Oku kuphakamisa uxinzelelo, kucinezela izihlunu, imithambo yegazi, kunye nemithambo-luvo. Ukuba olu xinzelelo luphezulu ngokwaneleyo, ukuhamba kwegazi kwigumbi kuya kuvalwa. Oku kunokukhokelela ekonzakaleni okusisigxina kwizihlunu nakwiimvakalelo. Ukuba uxinzelelo luhlala ixesha elide ngokwaneleyo, izihlunu zisenokufa kwaye ingalo okanye umlenze awusayi kuphinda usebenze. Utyando okanye nokunqunyulwa kunokwenziwa ukulungisa ingxaki.

Isifo esinegumbi elibukhali sinokubangelwa ngu:

• Umothuko, njengokulimala okanye uqhaqho
• Ithambo elaphukileyo
• Imisipha eyonzakeleyo
• Uxinzelelo olukhulu
• Isamente okanye ibhandeji exineneyo
• Ukuphulukana nokunikezelwa kwegazi ngenxa yokusetyenziswa kwetoni okanye ukubeka indawo ngexesha lotyando
  

Ixesha elide (elingapheliyo) gumbi lesifo linokubangelwa yimisebenzi ephindaphindayo, enjengokubaleka. Uxinzelelo kwigumbi elonyukayo kuphela ngexesha laloo msebenzi kwaye uyehla emva kokuba umsebenzi umisiwe. Le meko ihlala iphantsi kakhulu kwaye ayikhokeleli ekuphulukaneni nomsebenzi okanye ilungu lomzimba. Nangona kunjalo, iintlungu zinokunciphisa umda womsebenzi kunye nonyamezelo.

I-syndrome yegumbi liqheleke kakhulu kumlenze ongezantsi nakwingalo yangaphambili. Inokuthi yenzeke nakwisandla, unyawo, ithanga, iimpundu, kunye nengalo ephezulu.

Iimpawu zesifo secandelo akulula ukufumanisa. Ngokulimala kakhulu, iimpawu zinokuba nzima kwiiyure ezimbalwa.

Iimpawu zingabandakanya:

• Intlungu ephezulu kakhulu kunokuba bekulindelwe ngenzakalo
• Intlungu ebuhlungu engapheliyo emva kokuthatha iyeza lentlungu okanye ukuphakamisa indawo echaphazelekayo
• Ukuncipha kwemvakalelo, ukuba ndindisholo, ukurhawuzelela, ubuthathaka bommandla ochaphazelekayo
• Ubumdaka besikhumba
• Ukudumba okanye ukungakwazi ukuhambisa icandelo elichaphazelekayo

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu, egxile kwindawo echaphazelekayo. Ukuqinisekisa ukuxilongwa, umboneleli unokufuna ukulinganisa uxinzelelo kwigumbi. Oku kwenziwa kusetyenziswa inaliti ebekwe kwindawo yomzimba. Inaliti incanyathiselwe kwimitha yoxinzelelo. Uvavanyo lwenziwa ngexesha nasemva komsebenzi obangela iintlungu.

Injongo yonyango kukuthintela umonakalo ongapheliyo. Kwisifo sekhomputha esibuhlungu, utyando luyafuneka kwangoko. Ukulibaziseka kotyando kungakhokelela kumonakalo osisigxina. Olu tyando lubizwa ngokuba yi-fasciotomy kwaye lubandakanya ukusika i-fascia ukunciphisa uxinzelelo.

Isifo esinganyangekiyo segumbi:

• Ukuba isamente okanye ibandage ixinene kakhulu, kufuneka isikwe okanye ikhululwe ukunciphisa uxinzelelo
• Ukuyeka umsebenzi ophindaphindiweyo okanye umthambo, okanye ukutshintsha indlela owenziwe ngayo
• Ukuphakamisa indawo echaphazelekayo ngaphezulu kwenqanaba lentliziyo ukunciphisa ukudumba

Ngokuchongwa kwangoko kunye nonyango, imbonakalo intle kwaye izihlunu kunye neerves ngaphakathi kwigumbi ziya kuphila. Nangona kunjalo, imbonakalo iyonke ichazwe kukonzakala okukhokelele kwisifo.

Ukuba ukuxilongwa kulibazisekile, ukulimala kwentsholongwane engapheliyo kunye nokulahleka komsebenzi wemisipha kunokubangela. Oku kuqheleke ngakumbi xa umntu owenzakeleyo engazi okanye ehleli kakhulu kwaye engakwazi ukukhalaza ngentlungu. Ukulimala ngokusisigxina kunokubakho emva kweeyure ezingaphantsi kwe-12 ukuya kwezi-24 zoxinzelelo. Ukulimala kwezihlunu kunokwenzeka ngokukhawuleza.

Iingxaki zibandakanya ukonzakala okusisigxina kwimithambo-luvo kunye nezihlunu ezinokuthintela umsebenzi ngokungummangaliso. Oku kubizwa ngokuba sisivumelwano seVolkmann ischemic ukuba senzeka kwingalo yangaphambili.

Kwiimeko ezinzima kakhulu, kunqunyulwa ilungu.

Fowunela umboneleli wakho ngoko nangoko ukuba wenzakele kwaye unokudumba okukhulu okanye iintlungu ezingaphuculiyo ngamayeza entlungu.

Ngokuqinisekileyo akukho ndlela yakuthintela le meko. Ukuchongwa kwangoko kunye nonyango kunceda ukuthintela uninzi lweengxaki. Ngamaxesha athile, ii-fasciotomies zenziwa kwangoko ukuthintela isifo sekhomputha ukuba singenzeki kwimeko yengozi enkulu.

Ukuba unxibe isamente, jonga umboneleli wakho okanye uye kwigumbi likaxakeka ukuba iintlungu phantsi kwesamente ziyenyuka, nasemva kokuba uthathe amayeza eentlungu kwaye uphakamise indawo.

Ukwaphuka - igumbi lesifo; Utyando - gumbi syndrome; Trauma - gumbi syndrome; Ukutyumka izihlunu - isifo gumbi; I-Fasciotomy-gumbi lesifo

• Ukunqunyulwa umlenze - ukubhobhoza
• Ukunqunyulwa komlenze okanye unyawo - ukunxiba

• I-anatomy yesihlahla

Jobe MT. Igumbi lesifo kunye nesivumelwano seVolkmann. Ku: Azar FM, Beaty JH, Kanale ST, ii-eds. Umsebenzi weCampbell's Orthopedics. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 74.

IModrall JG. Igumbi lesifo kunye nolawulo lwalo. Ku: Sidawy AN, Perler BA, ii-eds. URutherford ngeeVascular and Endovascular Surgery. Umhla we-9. IPhiladelphia, PA: Elsevier; 2019: isahl. 102.

I-Stevanovic MV, i-Sharpe F.Igumbi lesifo kunye neVolkmann ischemic contracture. Ku: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, ii-eds. Utyando lwesandla esisebenzayo sikaGreen. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 51.