Usulelo lwe-Necrotizing izicubu ezithambileyo

Usulelo lwe-Necrotizing soft tissue sisifo esinqabileyo kodwa esibi kakhulu sosulelo lwebacteria. Inokutshabalalisa izihlunu, ulusu kunye nezicwili ezingaphantsi. Igama elithi "necrotizing" lithetha into ebangela ukuba inyama yomzimba ife.

Iindidi ezininzi zebacteria zinokubangela esi sifo. Uhlobo olubi kakhulu kwaye oluqhelekileyo oluyingozi lokusuleleka kwithishu ethambileyo ngenxa yentsholongwane IStreptococcus pyogenes, ngamanye amaxesha ebizwa ngokuba "yibhaktiriya etya inyama" okanye istrep.

Usulelo lwe-Necrotizing izicubu ezithambileyo luyenzeka xa ibhaktiriya ingena emzimbeni, ngesiqhelo ngokusika okuncinci okanye ukukrwela. Iibhaktheriya ziqala ukukhula kwaye zikhuphe izinto eziyingozi (ityhefu) ebulala izicwili kwaye ichaphazele ukuhamba kwegazi kuloo ndawo. Nge-strep yokutya inyama, iibhaktheriya zenza iikhemikhali ezivimba amandla omzimba okuphendula kwinto ephilayo. Njengokuba inyama isifa, intsholongwane ingena egazini kwaye isasazeka ngokukhawuleza emzimbeni.

Iimpawu zingabandakanya:

• Incinci, ibomvu, iqhuma elibuhlungu okanye iqhubu kulusu olusasazekayo
• Indawo ebuhlungu kakhulu efana nokukrala emva koko iyakhula kwaye ikhule ngokukhawuleza, ngamanye amaxesha ingaphantsi kweyure
• Iziko liye libe mnyama kwaye libe mnyama emva koko lijike libe mnyama kwaye izicwili ziyafa
• Ulusu lungaqhekeka luvuleke luphume ulwelo

Ezinye iimpawu zingabandakanya:

• Ndiziva ndigula
• Ifiva
• Ukubila
• Ukugodola
• Isicaphucaphu
• Ukuba nesiyezi
• Ubuthathaka
• Umothuko

Umboneleli wezempilo unokukwazi ukuxilonga le meko ngokujonga ulusu lwakho. Okanye, imeko inokuchongwa kwigumbi lotyando ngugqirha wotyando.

Uvavanyo olunokwenziwa lunokubandakanya:

• I-Ultrasound
• X-ray okanye CT scan
• Uvavanyo lwegazi
• Inkcubeko yegazi ukukhangela intsholongwane
• Ukusikwa kolusu ukubona ukuba ubofu bukho na
  
• I-biopsy yolusu kunye nenkcubeko

Unyango luyafuneka kwangoko ukuthintela ukufa. Uya kudinga ukuhlala esibhedlele. Unyango lubandakanya:

• Ii-antibiotics ezinamandla zinikwa ngomthambo (IV)
• Utyando ukukhupha isilonda kunye nokususa izicwili ezifileyo
• Amayeza awodwa abizwa ngokuba yi-donor immunoglobulins (izilwa-buhlungu) zokunceda ukulwa usulelo kwezinye iimeko

Olunye unyango lunokubandakanya:

• Ukufakelwa kolusu emva kokuba usuleleko luye ukunceda ulusu lwakho luphole kwaye lubukeka ngcono
• Ukunqunyulwa amalungu xa isifo sisasazeka ngengalo okanye ngomlenze
• Amakhulu eepesenti yeoksijini kuxinzelelo oluphezulu (unyango lwehyperbaric oksijini) kwiintlobo ezithile zosulelo lwebacteria

Uqhuba kakuhle kangakanani kuxhomekeke:

• Impilo yakho iyonke (ngakumbi ukuba unesifo seswekile)
• Ukhawuleze wafumanisa ukuba ulufumene njani unyango
• Uhlobo lweebhaktheriya ezibangela usulelo
• Ngokukhawuleza ukusasazeka kwintsholongwane
• Lisebenza kakuhle kangakanani unyango

Esi sifo sihlala sibangela ukonakala kunye nokonakala kolusu.

Ukufa kunokwenzeka ngokukhawuleza ngaphandle konyango olufanelekileyo.

Iingxaki ezinokubangelwa yile meko zibandakanya:

• Usulelo lusasazeka kuwo wonke umzimba, lubangele usulelo lwegazi (sepsis), olunokubulala
• Ukuqhawuka nokungaziphathi kakuhle
• Ukuphulukana nokukwazi kwakho ukusebenzisa ingalo okanye umlenze
• Ukufa

Esi sifo siqatha kwaye sisongela ubomi. Nxibelelana nomboneleli wakho kwangoko ukuba iimpawu zosulelo zenzeka malunga nokwenzakala kolusu, kubandakanya:

• Ukufunxa ubomvu okanye igazi
• Ifiva
• Intlungu
• Ubomvu
• Ukudumba

Soloko ucoceka isikhumba kakuhle emva kokunqunyulwa, okokukhuhla, okanye ukonzakala kolusu.

Ukucoca i-fasciitis; Fasciitis - necrotizing; Iibhaktheriya ezitya inyama; Izicwili ezibolileyo; Imigulukudu - ithishu ethambileyo

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IPasternack MS, iSwartz MN. I-Cellulitis, i-necrotizing fasciitis, kunye nosulelo lwangaphantsi kwesikhumba. 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 Saunders; 2020: isahl. 93.

UStevens DL, uBisno AL, uChambers HF, et al. Ziqhelanise nezikhokelo zokuchonga nokulawula ulusu kunye nosuleleko lwezihlunu ezithambileyo: Uhlaziyo luka-2014 nguMbutho weSifo seZifo esosulelayo [ulungiso olupapashiweyo luyavela Iiklinikhi ezisulelayo iDis. 2015; 60 (9): 1448. Impazamo yomthamo kwisicatshulwa senqaku]. KwiKlinikhi yosulelo lweDis. Ngo-2014; 59 (2): e10-e52. IINKCUKACHA: 24973422 pubmed.ncbi.nlm.nih.gov/24973422.