Izimo Ezivamile Ezingaba Nkulu

Nsuku zonke iningi lethu lihlushwa yiyiphi inkinga yempilo evamile elinganiselwe ukuthi ingakanani umonakalo ongayenza. Kodwa-ke, ngezinye izikhathi, izinkinga zempilo ezincane ezibonakala sengathi zincane noma izimo ezivame kakhulu zingase zibe yingozi futhi zidinga ukunakekelwa kwezokwelapha. Kodwa okuvamile, nangubukeka izinto ezimbalwa ezingathí sina ezingase zibangelwe izifo eziyisihlanu ezijwayelekile nezimo ezivamile.

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Necrotizing Fasciitis

Abantu abaningi abenza ukuhlanzeka okuhle futhi banempilo ngesistimu ye-immune eqinile akukaze bahlakulele i-fasciitis enomdlavuza (ngamanye amazwi, amabhaktheriya "inyama yokudla"). Kodwa-ke, kwezinye izifo, ukutheleleka kwesikhumba okulula kungasakazeka kuwo wonke umzimba oholela ekutheleleni kwegazi, ukukhishwa kwesigungu, njalonjalo.

Nge-fasciitis ene-necrotizing, amabhaktheriya asakazeka emthonjeni othobekile kuya emathanjeni, noma izingcezu ezinamathele ezixhumayo ezizungeze imithwalo yegazi, izinzwa, amafutha nezihlungulu. I-toxins ekhiqizwa la mabhaktheriya nayo ibuye ibulale izicubu ezizungezile.

Kunezinhlobo ezimbili ezivamile ze- fasciitis enesandulela .

Thayipha i-fasciitis ye-necrotizing yi-infection ye-polymicrobial, ebangelwa izinhlobo ezahlukene zebhaktheriya, kokubili i-aerobic ne-anaerobic. Ngokuphawula, amabhaktheriya aerobic akhule ezindaweni okwenziwe umoya ophefumulayo; kanti, amabhaktheriya anaerobic ayidingi i-oksijini ukuze ikhule. Amanxeba abulalayo, afana nalawo abangelwa yizilwane nokulunywa kwabantu, ngokuvamile aqukethe ukuxuba kwamabhaktheriya aerobic ne-anaerobic.

Thayipha i-fasciitis ye-2 ye-necrotizing ngenxa yokutheleleka ngama-bacteria esikhumba, okufaka phakathi i-Staphylococcus aureus, i-Staphylococcus aureus engamelana ne-methicillin ( MRSA ), ne- Streptococcus pyogenes .

Nge-fasciitis ene-necrotizing, ukutheleleka kwesikhumba kungaba obomvu kakhulu (i-erythematous) ngokubunjwa kwezilwane ezinobuthi (bubble-like) nokulimala (ecchymosis). Ngaphezu kwalokho, kutholakala amanzi amaningi okushisa ama-serosanguinous or pus. Ekugcineni, isikhumba sigcina sekufa (siba necrotic) futhi singaba yizigebengu.

I-fasciitis ye-Necrotizing ingathinta noma yikuphi ingxenye yomzimba-kuhlanganise nomkhawulo ophezulu nangesisu-noma kunjalo, lesi sifo sithinta kakhulu emaphethelweni aphansi. Ngaphezu kwezinguquko zesikhumba, nansi ezinye izibonakaliso nezimpawu ze-fasciitis enomtholampilo:

• Ubuhlungu obukhipha ngokulingana nokubonakala kwesifo
• Ukuvuvukala nokugubha endaweni engakuzungezile
• Umkhuhlane omkhulu
• I-Crepitus, noma i-gas in tishu

Ukwelashwa kwe-fasciitis ene-necrotizing kwenzeka endaweni yezibhedlela futhi kuhilela lokhu okulandelayo:

• Ama-antibiotic afaka i-MRSA nezinye izinhlobo zemithi ezingamelana nezidakamizwa
• Ukukhipha noma ukukhishwa kwezicubu ezifile, okungasho ukuthintwa
• Ukuvuselela kwe-flux (cabanga ngamanzi ahlanzekile)
• Ukulawulwa kwezinxeba (cabanga ukwelashwa okulimazayo okucindezelayo okungalungile)

Nazi ezinye izici ezingozini ezenza umuntu aqhubekele phambili ekuthuthukiseni i-fasciitis ene-necrotizing:

• Isifo sikashukela
• Ukudla okunomsoco
• Ukusebenza kwamuva
• I-Decubitus ulcer, noma isilonda sesilonda, esivame ukuphumela kumuntu olele immobile isikhathi eside
• Ukusetshenziswa kwezidakamizwa ezingapheli
• Utshwala

Indlela engcono kakhulu yokubhekana ne-fasciitis ye-necrotizing ukuwugwema kuqala, ikakhulukazi uma unesifo sengculaza. Ngokwesibonelo, uma uhlakulela ukutheleleka kwesikhumba noma isilonda, gcina uhlanganiswe amabhandeshi ahlanzekile newomile. Kumele futhi ugeze izandla zakho njalo futhi ugweme ukufaka phansi lesi sifo emachibini, ama-whirlpools nezinye izidumbu zamanzi.

Ngombhalo wokugcina, i-fasciitis ene-necrotizing ethinta isitho sofuzo (ikakhulukazi) wesilisa esibizwa ngokuthi i-Fournier gangrene.

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Izifo Eziphezulu Zokuphefumula

Ukutheleleka okuphezulu kokuphefumula (i-URIs) kuvame kakhulu futhi isizathu esivamile abantu abaningi abafuna ukunakekelwa kudokotela. Sonke sithola ama-URI ngezikhathi ezithile.

Ama-URIs amaningi abangwa yizigciwane futhi azinqunyiwe, okusho ukuthi bazohamba bodwa ngaphandle kokwelashwa. Ngokuvamile, i-URI ingaba yinkimbinkimbi futhi ingase ibe ukubonakaliswa kwe-superinfection, noma ukutheleleka ngamagciwane ezithathelwanayo ezengeziwe. Ngokuphawula, i-URIs yebhaktheriya iyaphathwa ngama-antibiotic, njenge-amoxicillin, i- penicillin , i- ceftriaxone njalonjalo.

Nazi ezinye ze-URI ezijwayelekile:

• Ukushisa okuvamile
• I-Pharyngitis
• I-Otitis media (ukutheleleka kwezindlebe eziphakathi)
• Sinusitis enamandla
• Croup
• Laryngitis
• I-Epiglottitis

Ngokwengxenye enkulu, ama-URIs angaphathwa ngendlela yokuphulukisa noma isilungiselelo sokuvotela. Ngezinye izikhathi, i-URIs inhle kakhulu futhi idinga ukwelashwa esibhedlela-ikakhulukazi ezinganeni.

Uhlobo olulodwa lwe-URI oludinga ukwelashwa okusheshayo yi- epiglottitis . I-epiglottis iyinqwaba ye-cartilage ehlanganisa i-trachea, noma i-windpipe uma ugwinya (ukuze ungafisi noma uthola ukudla ku-trachea). I-Epiglottitis ibhekisela ukuvuvukala kwalezi zicubu ezincane ukuya ekutheleleni ngebhaktheriya noma igciwane.

I-epiglottitis ingabangela ukuphazamiseka kwe-epiglottis noma kungavimbela ukulandelana kwe-trachea futhi inqamule umoya ophazamise emaphashini, okubangelwa ukuboshwa komzimba ngisho nokufa. Ukwelashwa kwe-epiglottitis kufaka ukufakwa kwesikhala, lapho ithubhu ibekwe khona emthonjeni, emanzini amanzi kanye namagciwane, kanye ne-corticosteroids ukusiza ngokuvuvukala.

Ngenhlanhla, i-epiglottitis iyinto engavamile kakhulu ngoba manje sinomgomo we- H. influenzae uhlobo B (Hib), okuyinto imbangela evame kakhulu yalesi simo.

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Izinwele

Ukuphathwa ikhanda kuyisifo esivame kakhulu sezinzwa, ngamaphesenti angu-50 kubo bonke abantu abanesifo sengqondo ngesikhathi esithile ngonyaka, futhi amaphesenti angu-90 abantu abhekene nokuphathwa ikhanda ngesikhathi esithile empilweni yabo.

Esikhathini esiningi, izinsizwa ziyingozi futhi zihamba ngokwazo noma zithatha iTylenol (i- acetaminophen ) noma ezinye izinkinga zokuphulukisa ubuhlungu. Ngezinye izikhathi, noma kunjalo, ikhanda lingase libonise okuthile okunye ngokuphathelene nokushaywa komzimba. Cishe amaphesenti angu-25 abantu abanochoko obuhlungu futhi banamakhanda ahlobene.

Ukushaya isisu kuyimbangela yesihlanu yokufa e-United States. Ngokusho kwe-CDC, abantu abangu-795,000, unyaka ngamunye bane-stroke futhi abantu abayi-130 000 bafa ngesifo sohlangothi.

Nazi ezinye izimpawu ezivamile nezibonakaliso zesifo sokushaya, okwenzeka ngokungazelelwe:

• Ubumbano noma ubuthakathaka bendalo, umlenze noma ingxenye yonke yomzimba, okuxhomeke endaweni yokushaya
• Ukuhluleka ukubona
• Ukukhathazeka ukuhamba ngenxa yesisu noma ukulahlekelwa ibhalansi
• Ukudideka
• Kunzima ukukhuluma
• Ikhanda

Kuzo zonke lezi zibonakaliso nezimpawu, ukuphathwa ikhanda okwesikhashana kuya kwesifo sokushaya isifo kungenakucatshangwa kakhulu odokotela lapho behlushwa isifo. Ngokujwayelekile, odokotela baqaphele kwezinye (izimpawu) izimpawu ezinjenge-numbness noma ubuthakathaka futhi bakhathazekile ngokuphathwa okusheshayo kwesifo. Sicela ukhumbule ukuthi nge-stroke, isikhathi sisekuseni futhi ukwelashwa okusheshayo kungavimbela ukukhubazeka esikhathini esizayo.

Ikhanda lingahlotshaniswa nezinhlobo eziningana zesifo esihlanganisa nokulandelayo:

• Ukuzibulala kwesisu
• Ukumiswa kwesimiso esinqunyiwe
• I-giant cell arteritis
• Ukuphazamiseka kwesifo se-carotid noma se-vertebral
• I-sinus thrombosis ye-venus intracranial.

Kubantu abahlangabezana nesifo sokushaya isisu, ubuhlungu bekhanda abuhlangene nobukhulu bendawo ehlukanisiwe. Ngaphezu kwalokho, ukuphathwa ikhanda okungenalutho, noma ikhanda elibangelwa ohlangothini olulodwa lwekhanda, ngokuvamile kubangelwa ukushaywa ngecala ohlangothini olufanayo lwekhanda. Inothi, ucwaningo olwengeziwe luzodingeka lwenziwe ukuhlola ukubaluleka komtholampilo wekhanda elihlobene ne-stroke.

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Ukucindezeleka

Ngaphambi kokuba sibheke ukucindezeleka njengengozi yokuzibulala, sicela uqonde ukuthi iningi labantu abathola ukucindezeleka alisoze lazibulala.

Ngokuqondile, ngokusho kweNational Institute of Mental Health (NIMH) ngo-2014, izigidi ezingama-15.7 zaseMelika zathola isiqephu esisodwa esikhulu sokucindezeleka; kanti ngo-2011 ngokusho kwamaCenter for Disease Control, kwaba nokufa okungu-41 149 okubangelwa ukuzibulala.

Ngaphezu kwalokho encwadini ethi "Ukucindezeleka: Okudingeka Ukwazi," i-NIMH igcizelela lokhu okulandelayo:

• Ukucindezeleka ukugula kwangempela
• Ukucindezeleka kuthinta abantu ngezindlela ezahlukene
• Ukucindezeleka kuyaphathwa
• Uma unesifo sokucindezeleka, awuwedwa

Noma kunjalo, ingozi yokuzibulala kufanele ihlolwe kubo bonke abantu abanezimpawu zokucindezeleka. Ukuzibulala kuyinkinga enkulu futhi kuyisizathu esiyinhloko sokufa kuzo zonke izigaba.

Nazi ezinye zezingozi zokuzibulala:

• Ubulili (amadoda amadala amadala asengozini enkulu)
• Utshwala
• Ukugula ngokomzimba
• Ukungabi nokusekelwa komphakathi
• I-Psychosis
• Ukuthotshiswa kwamuva

Ngaphezu kwalokho, intsha enokucindezeleka kanye nentsha ye-LGBT enokucindezeleka ingozi enkulu.

Izimpawu ezibuhlungu zokuzibulala zihlanganisa ukucacisa okuhloswe ngokuzibulala, ukuphelelwa ithemba (ukucindezeleka) kanye nesakhiwo esenziwe kahle.

Uma wena noma umuntu owaziyo uzizwa uzibulala, kufanele utshele udokotela wakho, umngane, ilungu lomndeni noma ubiza i-National Suicide Prevention Hotline ngo-1-800-273-TALK noma ku-1-800-273-8255.

Enye inothi lokugcina mayelana nokucindezeleka: Nakuba ukucindezeleka kuhlanganisiwe kulolu hlu kanye nezinye izinto ezingase zibhekwe njengezimpikiswano ezincane-ezifana nesifo socansi noma ikhanda-kubantu abaningi ababhekana nokucindezeleka, akukho lutho oluncane ngalesi simo.

Ukucindezeleka kuhlanganisiwe kulolu hlu ngoba ukucindezeleka kuvame kakhulu kunabantu abaningi abaqaphelayo. Ngaphezu kwalokho, kufanele ngaso sonke isikhathi sizame ukuthola ukuqonda noma yiziphi izimpawu ezicindezelayo esizizwayo noma izimpawu ezicindezelayo ezithandwa ngabathandekayo.

Uma ukucindezeleka nokungathembeki kuhambisana nezinye izinkomba zokuzibulala, sicela ucele usizo ngokushesha. Ukucindezeleka kuyaphathwa, futhi ezimweni eziningi, ukuzibulala kungagwenywa ngokuphathwa kahle nokunakekelwa.

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Ubuhlungu besifuba

Lapho abantu abaningi becabanga ngokuthi "ubuhlungu besifuba," ukuhlasela kwenhliziyo, noma i-infarction ye-myocardial, kuza engqondweni. Kodwa-ke, kunezimbangela eziningi ezinobungozi zokuhlunguphazwa kwesifuba; Ngakho-ke, akekho omele acabange ngokuzenzakalelayo ukuthi zonke izinhlungu zesifuba kusho ukuhlasela kwenhliziyo.

Izinhlungu zenhliziyo ezibonisa ukuhlaselwa kwenhliziyo zivame ukuba zingapheli, zihlukanise futhi zikhanye uma ziqala. Ngamanye amazwi, lobu buhlungu abuvamile ukuphumula. Ngaphezu kwalokho, izimpawu zesifo senhliziyo zingase zibe "ezingokoqobo" futhi zihlanganisa okungaphezu nje kokubuhlungu kwesifuba noma ukungahambi kahle ngesinye. Bangabonisa njengobuhlungu, ukunganaki noma ukucindezeleka esiswini, izingalo, emuva nokunye. Okokugcina, izimpawu ezinjalo zihlotshaniswa nezinye izibonakaliso izimpawu, kufaka phakathi ukujuluka, ukuhlukumeza, ukukhathala, kanye ne-syncope (ukuphelelwa amandla).

Ubuhlungu besifuba obuseduze, ukukhomba, ukukhiqiza kabusha noma ukuthuthukisa kungabonisa imbangela enobungozi efana nokunye

• Umhlubu ophukile
• Imisipha evuthelekile edongeni lesifuba
• I-Herpes zoster (ama-shingles)
• I-asthma
• I-pneumonia
• Isifo se-reflux ye-gastroesophageal (GERD) ("ukushaya inhliziyo")

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Akuyona Yonke Umbono Omubi Ukubona Udokotela Wakho

Yebo, kuyiqiniso ukuthi ngisho neminye yezindaba zezempilo ezingapheli sonke esizizwayo ngezikhathi ezithile, kufaka phakathi ikhanda noma i-abscess, kungenzeka ukuthi kube nzima kakhulu. Ngenhlanhla, izikhalazo zempilo eziningi esizixazulula ngazo izinkinga zansuku zonke.

Noma kunjalo, uma uzizwa isidingo sokufuna usizo noma ukwelashwa ngisho neyinkinga ebonakala iyincinjana kakhulu, ngaso sonke isikhathi umqondo omuhle ukwenza i-aphoyintimenti nodokotela wakho wokunakekela oyinhloko.

Sicela ukhumbule ukuthi akukaze kube khona into enjengokuqokwa kukadokotela "owachitha". Ngisho noma umhlinzeki wakho ephetha ngokumane ekuqinisekisayo, uzokukwenza uzizwe ungcono futhi ngokuvamile uhlolwe impilo yakho nenhlalakahle yakho. Okokugcina, ukuvakashelwa okunjalo kungasetshenziswa njengengqungquthela yempilo yakho yonyaka noma yokuhlola.

_Imithombo

_{Izifo ezithathelwanayo ze-Chin-Hong P. Ku: Levinson W. eds. Ukubuyekezwa kwe-Medical Microbiology ne-Immunology, ngo-13. ENew York, NY: McGraw-Hill; 2014.}

_{Eisendrath SJ, Cole SA, Christensen JF, Gutnick D, Cole M, Feldman MD. Ukucindezeleka. Ku: Feldman MD, Christensen JF, Satterfield JM. ama-eds. Imithi Yokuziphatha: Umhlahlandlela Wokuzivocavoca, 4e. ENew York, NY: McGraw-Hill; 2014.}

_{U-Raghunathan S, uRichard, B, uKhanna B. Izimbangela kanye nezici zomtholampilo zekhanda lokushaya ischemic. Intuthuko e-Neurology and Psychiatry 2008.}

_{Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr. Isahluko 122. I-Fecciitis ne-Necrotizing. Ku: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. Umbala we-Atlas of Family Medicine, u-2e. ENew York, NY: McGraw-Hill; 2013.}

_{UVestergaard K, Andersen G, uNielsen MI, uJensen TS. Ikhanda lokushaya ikhanda. Stroke 1993.}