Ukuhluleka okunamandla kokulahlekelwa yinhlamba ukulahlekelwa ngokuzumayo nokuphindaphindiwe kwezinso zezinso. Kuyinto isimo esiphuthuma ngokushesha phakathi kwamahora amaningana noma izinsuku futhi ngokuvamile kwenzeka kubantu abagula kakhulu futhi sebevele besesibhedlela.
Njengoba izinso ziyeka ukusebenza, imikhiqizo yokudoba okuhloswe ukuba ihlungwe egazini iqala ukuqoqa, isusa ukuphuma kwezimpawu kuhlanganise nokunciphisa ukuchama, ukunxanxathela, ukukhathala, ukuphefumula, nokuvuvukala ngenxa yokugcina uketshezi.
Ezinye izimo ze-ARF zizoba nezimpawu ezicashile ezingacabangi neze. Ezinye zingase zibe nzima futhi zisongela ukuphila.
Izimpawu Ezivamile
Ukuhluleka okunamandla okweqileko (ARF) , okubizwa nangokuthi ukulimala kwezinso ezinzima (AKI), akulona njalo kubangela izimpawu futhi kungatholakala kuphela ngokuhlolwa kwebhu noma ukuguqulwa okungazelelwe emkhathini wokukhipha. Uma izimpawu zivela, zivame ukwenza njalo phakathi nesonto lokukhubazeka noma ukulimala futhi ngezinye izikhathi zingakapheli amahora.
Izimpawu eziningi zezici ze-ARF zihlobene nesimo esaziwa ngokuthi u-uremic encephalopathy lapho ukuqoqwa kwe- urea , i- creatinine , nezinye izinto eziphazamisekile egazini ebuchosheni, okungathinti imisebenzi yomzimba kuphela kodwa nezinqubo zengqondo.
Ezinye izimpawu zibangelwa ukungalingani emazingeni e- potassium noma ama-fluid okuthinta ngqo inhliziyo, ukujikeleza, nokucindezelwa kwegazi.
Izimpawu ezivamile kanye nezimpawu ze-ARF zingabandakanya:
- Ukunciphisa umkhiqizo we-urine
- Ukuvuvukala kwemilenze, izinyawo, nezinyawo (i- edema )
- Ukuphefumula ( dyspnea )
- Ukukhathala
- Ukulahlekelwa kwesifiso
- I-nausea nokuhlanza
- Izinhliziyo ezingavamile ( arrhythmia )
- Ubuhlungu besifuba noma ukucindezelwa
- Ukusuka okulula noma okungavamile (okubangelwa amapulelet aphansi )
- Ukudideka
- Ukuzizwa
- I-Coma
Amacala amakhulu angaholela ekufeni, ikakhulukazi ngenxa yezinkinga ze- sepsis , ukwehluleka kokuphefumula, noma ukwehluleka komzimba okuningi.
Ingozi yokufa ikhulu uma ukuhluleka kwezinso kubangelwa ukuhlukumezeka, ukutheleleka, noma ukuhlinzwa (ikakhulukazi ukuhlinzwa kwengqondo).
Izimpawu ze-ARR Prerenal
Ukungaphumeleli okunamandla okubangelwa yinkohlakalo kungahle kwenzeke kunoma yiziphi izizathu kodwa kuhlukaniswa ngokubanzi njenge-prerenal (okubangelwa ukunciphisa ukugeleza kwegazi kuzo zonke izinso), ukungena ngaphakathi (okubangelwa ukulimala kwezinso), noma i-postrenal (ngenxa yokuvame ukuvimbela ukuvinjelwa kwamagciwane ).
Yilowo nalowo eyoholela emiphumeleni efanayo-ukwakheka kwemfucumfucu enobuthi emzimbeni-ukukhubazeka okuyisisekelo kuzothatha izimpawu zezimpawu, i-ARF ezobhekwa njengeyinkimbinkimbi.
Izimbangela ezivame kakhulu zezimbangela zangaphambi kwe-ARF (eyaziwa ngokuthi i-azotemia ye-prerenal) yi-déshydration ejulile, ukwehluleka kwenhliziyo , nesibindi se-forhosis , konke okungaphazamisa ukugeleza kwegazi ezintsheni. Izimbangela eziyinhloko zivame ukuhlukaniswa yizimpawu zabo.
Izibonelo zalokhu zihlanganisa:
- Izimpawu ezinzima zokungcoliswa kwemvelo zingabandakanya amehlo aqhekekile, isikhumba esomile, ukunciphisa isikhumba somzimba, umlomo owomile namehlo, izinga lokushaya kwenhliziyo elisheshayo ( tachycardia ), kanye nesizungu noma ukukhanya okuncane lapho umile noma uhlezi phezulu ( hypotension orthostatic ).
- Izimpawu zokwehluleka kwenhliziyo zingabandakanya ukuvuthwa kwemisipha yentamo, ukuqhekeka noma ukugubha umsindo emaphashini (imigqa yamapulmonary), i-tachycardia, i-palpitations yenhliziyo, ukuphefumula okuncane uma ulele phansi, ukuvuvukala kwesisu ( ascites ), nokukhwehlela okuqhubekayo noma ukuqhuma nge-phlegm ene-pink .
- Izimpawu ze-cirrhosis zesibindi zingabandakanya ama-ascites, i-yellowing yamehlo nesikhumba (i- jaundice ), imivimbo ye-spider angioma, i-sweet-or-ammonia-smelling urine, futhi ihlanganise umvuthwandaba ebusweni besisu esisuka kwinkaba (caput medusae).
Izimpawu ze-ARF zangaphakathi
Isizathu esivame kakhulu se-ARF yangaphakathi siwumonakalo wezinso ezihlobene nemibandela enjenge-glomerulonephritis, i-necrosis ye-tubular ejulile, nephritis ephakathi kwamakhemikhali.
Phakathi kwezinye zezibonakaliso ezihlukile:
- I-Glomerulonephritis , ukuvuvukala kwemithambo yegazi ezintsheni, kungabangela izimpawu ezifana ne-pink noma umchamo wamanzi (i- hematuria ), umchamo we-foamy kusuka kwamaprotheni amaningi ( proteinuria ), nokuvuvukala ubuso, izandla, izinyawo, nesisu.
- I-necrosis ye-tubular enamandla (ATN) , isimo lapho izicubu zezinso ziqala ukufa ngenxa yokuntuleka kwe-oksijeni, zingabonakalisa ngezimpawu ezifana nobuhlungu obunzima obuphikisayo nobuhlungu obuqhubekayo, ubuhlungu be-muscle, ukuzwa kwezikhonkwane nezinaliti (i- neuropathy ), i-generalized ukuvuvukala komzimba, nokudideka noma ukudilizwa.
- I-nephritis ejwayelekile ye-interstitial (AIN) , ukuvuvukala kwezicubu phakathi kwama-tubules wezinso (ngokuvamile okubangelwa ukuphendula kwezidakamizwa noma isifo se-autoimmune ), kungase kuhambisane nomkhuhlane, i-hematuria, ukuvuvukala komzimba, ukuhlanza nokudideka ( uma kuhlobene nezidakamizwa).
Izimpawu ze-ARF ze-Postrenal
I-imbangela evamile kakhulu ye-ARF yangemva kwe-postrenal isithiyo sokuvimbela umchamo okungabangelwa i-prostate gland (i- benign prostatic hyperplasia ), amatshe ensolo , amatshe ashisayo , noma umdlavuza wezinso , isisu noma isicathulo .
- Izimpawu ze-Benign ze-prostatic hyperplasia (BPH) zibandakanya ukuqhuma ngemva kokuchama, ukuvuthwa okwedlulele ebusuku ( nocturia ), ukuvuthwa okuvamile, umqondo wokuphelela kwesinye isikhathi, ukugqugquzela okuqhubekayo ukuchama ( ukuphuthuma komchamo ), noma ukugeleza komchamo obuthakathaka.
- Izimpawu zezinso nezinso zesibindi zifaka ubuhlungu obukhulu obuphansi kwesisu esiswini noma i-flank, i-hematuria, i-urine emvuleni, inzwa evuthayo ngesikhathi sokuvuthwa ( dysuria ), ubunzima bokuvuthwa, nobuhlungu noma ukunganaki emagqeni noma ipeni emadodeni.
- Izimpawu zesifo somdlavuza zingase zihlanganise ukulahlekelwa isisindo, i-hematuria, i-dysuria, ukuphuthuma komchamo, ukugeleza kwamanzi, ukuhluleka ukuvuthwa, ubuhlungu obuncane obungakapheli kolunye uhlangothi, nobuhlungu be-bone.
Nini Ukubona Udokotela
Ngenkathi i-ARF ingase ingabangeli izimpawu futhi itholakale kuphela lapho ihlola isifo esingavumelani, kunezibonakaliso ezithile nezimpawu ezingase ziphakamise ukuhluleka kwezinso. Xhumana nodokotela wakho uma ubona izimpawu ezilandelayo:
- Ukwandisa ukugcinwa kwamanzi ngokuvuvukala kwemilenze, ubuso, noma izandla
- Ukuphefumula okungazelelwe
- Ukukhathala okungazelelwe noma ukushintsha izinguquko emazingeni kagesi
- Ukunciphisa okukhipha umchamo, izikhathi eziningi ngokuvamile nomchamo omnyama kakhulu
- Ukulimala kalula
- Ukuzondeka okuqhubekayo noma okuphindaphindiwe nobunzima obukhulu
Nakuba lezi zimpawu zingabangelwa yinoma iyiphi inombolo yezimo zezokwelapha, akekho okufanele kuthathwe ngokuthi "evamile." Kubalulekile ukuba bahlole.
Ngakolunye uhlangothi, kufanele ufune ukunakekelwa okuphuthumayo ngokushesha uma uhlangabezana nalokhu okulandelayo:
- Izinguquko ezingeni lokuqaphela, kuhlanganise nokulala okungapheli, ubunzima bokuvuka, noma ukuphelelwa amandla
- Ubuhlungu besifuba
- Ukuphefumula okunzima
- I-neusea ejulile nokuhlanza
- Ayikwazi ukuvota
- Ukuphuma kwegazi kunoma yiluphi uhlobo
> Imithombo:
> Rahman, M .; Shad, F .; no-Smith, M. Ukulimala Kwezinso: Umhlahlandlela Wokuphathwa Nokuhlolwa. Amer Fam Phys. 2012; 86 (7): 631-9.
> Hertzberg, D .; Ryden, L .; Pickering, J. et al. Ukulimala okusobala kwezinso-ukubuka kabanzi ngezindlela zokuxilonga nokuphathwa kwemitholampilo. Clin Kidney J. 2017 10 (3): 323-331. I-DOI: 10.1093 / ckj / sfx003.