Indlela Yokunqoba Ukwehluleka Kwezitho Ezilwaneni
Ukwehluleka kwezitho zomzimba ezilwaneni kuyisimo esibi lapho isitho esisodwa noma ngaphezulu esibalulekile—njengezinso, isibindi, inhliziyo, amaphaphu, noma i-pancreas—sihluleka ukusebenza kahle. Lesi simo singase senzeke ezifuyweni (izinja, amakati, onogwaja), imfuyo (izinkomo, izimbuzi, izinkukhu), kanye nezinye izilwane. Ngenxa yokuthi lezi zitho zidlala indima ebalulekile ekugcineni ibhalansi yomzimba, ukwehluleka kwezitho zomzimba kungathuthuka ngokushesha futhi kube yingozi empilweni uma kungelashwa. Lesi sihloko sixoxa ngezindlela ezisebenzayo zokuphatha ukwehluleka kwezitho zomzimba ezilwaneni: kusukela ekuboneni izimpawu nokunikeza usizo lokuqala, ukwelashwa, ukunakekelwa ekhaya, kanye nokuvimbela.
1. Ukuqonda Ukwehluleka Kwezitho: Okubukhali vs. Okungalapheki
Ngokuvamile, ukwehluleka kwezitho zomzimba kuhlukaniswe kabili:
1. Ukwehluleka okukhulu kwezitho zomzimba
Kwenzeka ngokuzumayo, isibonelo ngenxa yobuthi, ukutheleleka okukhulu, ukuphelelwa amanzi emzimbeni okukhulu, ukulimala, ukopha, noma ukuvaleka komchamo. Lesi simo sivame ukudinga ukunakekelwa okusheshayo ngoba izinguquko ekusebenzeni kwezitho zomzimba zingavela emahoreni noma ezinsukwini.
2. Ukwehluleka kwezitho zomzimba okungapheli
Ikhula kancane kancane ngemva kwamasonto kuya ezinyangeni, ngokuvamile ngenxa yokuwohloka, izifo ezingamahlalakhona, umdlavuza, izinkinga ze-metabolic, noma izifo ezithathelwanayo isikhathi eside. Ezimweni ezingamahlalakhona, imigomo yokwelapha ivame ukugxila ekunciphiseni umonakalo, ekugcineni ikhwalithi yokuphila, kanye nokuvimbela izinkinga.
Ukuqonda uhlobo lokwehluleka kwezitho zomzimba kubalulekile ngoba kunquma amasu okwelapha. Ukwehluleka okukhulu kudinga ukuzinza ngokushesha, kanti ukwehluleka okungapheli kudinga ukuphathwa kwesikhathi eside.
2. Izimpawu Ezivamile Zokwehluleka Kwezitho Ezilwaneni
Izimpawu zingahluka kuye ngezitho ezithintekile, kodwa ezinye izimpawu ezivamile okufanele uziqaphele zifaka:
– Izilwane zibonakala zibuthakathaka, zingasebenzi, noma zilala njalo
- Ukuncipha kwesifiso sokudla noma ukungafuni ukudla nhlobo
– Ukuhlanza kanye/noma isifo sohudo
- Ukwehlisa isisindo kakhulu
- Ukuphefumula okusheshayo, ukuphelelwa umoya, noma ukukhwehlela
– Izinsini eziphaphathekile noma eziluhlaza okwesibhakabhaka (uphawu lokuntuleka komoya-mpilo/ukujikeleza kwegazi okungekuhle)
– Isisu esikhulu (kungenzeka sibangelwa uketshezi/ama-ascites)
- Ukuquleka, ukudideka, ukukhungatheka
– Ukoma kakhulu kanye nokuchama njalo (ngokuvamile ezinkingeni zezinso noma isifo sikashukela)
– Ukungachami noma ukuhluza (okuphuthumayo, kungaba ukuvaleka)
Uma izimpawu zivela ngokuzumayo noma ziba zimbi ngokushesha, zibheke njengesimo esiphuthumayo bese uthatha isilwane sakho usiyise kudokotela wezilwane ngokushesha.
3. Usizo Lokuqala Ekhaya (Ngesikhathi Ulinde Udokotela Wezilwane)
Ukwehluleka kwezitho zomzimba akukwazi "ukwelashwa" ngokunakekelwa ekhaya kuphela, kodwa kunezinyathelo zokuqala ezingasiza ekuvimbeleni lesi simo ukuba singabi sibi:
1. Gcina isilwane sifudumele futhi sizolile
Ukucindezeleka kwenza isimo sibe sibi kakhulu. Gcina isilwane sakho endaweni ekhululekile, ethule, nepholile.
2. Qinisekisa ukuthi amanzi ayangena emzimbeni, kodwa ungakuphoqeleli.
Uma isilwane sisakwazi futhi sikwazi ukugwinya, sinikeza amanzi ahlanzekile. Ungasiphoqi ukuphakela isilwane esihlanza kakhulu, esingakwazi ukuqonda kahle, noma esisengozini yokuminza.
3. Yeka ukunikeza imithi yabantu
Imithi eminingi yabantu (isib. i-ibuprofen, i-paracetamol emakati, noma imithi yomkhuhlane) ingenza umonakalo wesibindi nezinso ube mubi kakhulu.
4. Unganiki ukudla "okunzima"
Gwema ukudla okunamafutha amaningi, okunosawoti omningi, noma izithasiselo ezingahleliwe. Kwezinye izimo, kunconywa ukuzila ukudla okwesikhashana, kodwa kuphela ngaphansi kwesiqondiso sikadokotela wezilwane.
5. Qopha izimpawu nomlando
Qaphela ukuthi izimpawu zaqala nini, ukuvama kokuhlanza/uhudo, inani lokuphuza, ukuchama, uhlobo lokudla, ukuchayeka okungenzeka ku-toxin, kanye nanoma yimiphi imithi enikezwayo. Lolu lwazi lubalulekile kudokotela wakho wezilwane ukuze enze isinqumo esisheshayo.
Okubaluleke kakhulu: usizo lokuqala aluthathi indawo yokuhlolwa. Ukwehluleka kwezitho zomzimba kudinga ukuxilongwa okukhethekile.
4. Ukuxilongwa Kwezokwelapha: Isihluthulelo Sokuthola Ukwelashwa
Ukuze kulungiswe ukwehluleka kwezitho zomzimba, odokotela bezilwane ngokuvamile benza inhlanganisela yalezi zivivinyo ezilandelayo:
– Ukuhlolwa okuphelele ngokomzimba (ukuphelelwa amanzi emzimbeni, izinga lokushisa lomzimba, ukushaya kwenhliziyo, umbala wezinsini, ubuhlungu)
– Ukuhlolwa kwegazi (umsebenzi wezinso: i-urea/i-creatinine; umsebenzi wesibindi: i-ALT/AST; ama-electrolyte; ushukela egazini; amaseli egazi abomvu/amhlophe)
– Ukuhlolwa komchamo (ukuminyana komchamo, amaprotheni, ukutheleleka, amakristalu)
– I-Ultrasound noma i-X-ray (ukubona isakhiwo sezitho, ukuvaleka, izimila, uketshezi)
– Ukuhlolwa okwengeziwe njengoba kudingeka (ukuhlolwa kwama-hormone, ukukhuliswa kwezifo, i-EKG, ukuhlolwa kwezinambuzane)
Uma kutholakala ukuthi isifo singelapheka, singalawuleka, noma sidinga izinyathelo eziphuthumayo njengokuhlinzwa.
5. Ukuphathwa Okuvamile Kokwehluleka Kwezitho: Izimiso Zokuzinza Nokusekela
Nakuba ukwelashwa okuthile kuncike esithweni esihlulekayo, izimiso zokuphatha ezijwayelekile zifaka:
a) Ukwelashwa ngoketshezi kanye ne-electrolyte
Ukwehluleka kwezitho eziningi kuhambisana nokuphelelwa amanzi emzimbeni kanye nokungalingani kwama-electrolyte. Uketshezi olufakwa nge-intravenous lungasiza ekuthuthukiseni ukujikeleza kwegazi, ukusekela izinso, kanye nokuzinzisa umfutho wegazi. Kodwa-ke, ekuhlulekeni kwenhliziyo, ukuphathwa koketshezi kumele kuqaphe kakhulu ngenxa yengozi yokuqongelela koketshezi emaphashini.
b) Lawula isicanucanu, ukuhlanza, kanye nobuhlungu
Kungase kunikezwe imithi yokulwa nokugabha, izivikeli zesisu, kanye nemithi yokunciphisa ubuhlungu eqondene nezilwane. Ubuhlungu obungelashwanga buzonciphisa isifiso sokudla futhi bukhulise ukucindezeleka kwe-metabolic.
c) Ukudla okunempilo okwelaphayo
Ukudla okukhethekile—njengokudla kwezinso okune-phosphorus ephansi, ukudla kwesibindi, noma ukudla kwenhliziyo okune-sodium ephansi—kudlala indima ebalulekile ekusizeni izitho ezibuthakathaka ukuthi zisebenze kahle kakhulu. Ezimweni ezimbi kakhulu, odokotela bangase batuse ipayipi lokudla ukuze baqinisekise ukuthi ukudla okunama-calorie aphephile kanye namaprotheni kuphephile.
d) Umoya-mpilo kanye nokusekelwa kokuphefumula
Uma kuvela izinkinga zamaphaphu noma zenhliziyo, ukwelashwa nge-oxygen kungandisa amazinga e-oxygen egazini futhi kunciphise umthwalo womsebenzi wezitho zomzimba.
e) Ukubhekana nembangela eyinhloko
Lena yingxenye ebaluleke kakhulu. Isibonelo:
– Ubuthi: ukuphathwa kwemithi yokulwa noshevu/amalahle asebenzayo (ngohlobo lobuthi), ukwelashwa okunamandla okusekelayo
– Ukutheleleka okukhulu: ama-antibiotic asekelwe ekusolweni noma emiphumeleni yokwelashwa
– Ukuvaleka komchamo: ukufakwa kwe-catheter ngokushesha (okuphuthumayo)
– Ukopha: ukumpontshelwa igazi uma kudingeka
– Isimila/ithumba: ukuhlinzwa noma ezinye izinqubo
Ngaphandle kokubhekana nembangela, ukwelashwa okusekelayo kungokwesikhashana nje.
6. Ukwelashwa Okusekelwe Ezithweni Ezivame Ukwehluleka
1) Ukwehluleka kwezinso
– Ukufakwa kanye nokulungiswa kwe-electrolyte yizona zinsika eziyinhloko.
– Ukudla okune-phosphorus ephansi kanye namaprotheni alawulwayo ezinso.
– Imithi yokwehlisa i-phosphorus (izihlanganisi) uma kudingeka.
– Ukuphathwa komfutho wegazi kanye ne-anemia (ezimweni ezingamahlalakhona).
– Ezimweni ezithile, ukwelashwa nge-dialysis (kuyatholakala ezindaweni ezilinganiselwe).
2) Ukwehluleka kwesibindi
– Thola imbangela: ukutheleleka, ubuthi, izinkinga zesibindi esinamafutha, noma i-bile duct.
– Ukudla kwesibindi okunephrotheni esezingeni eliphezulu kodwa ephephile.
– Ama-Hepatoprotectors njengoba kunconywe udokotela wakho (isib. i-SAMe/silymarin kwezinye izimo).
– Lawula i-hepatic encephalopathy (ukuphazamiseka kwemizwa okubangelwa ubuthi) ngokwelashwa okukhethekile.
3) Ukwehluleka kwenhliziyo
– Imithi yokwehlisa uketshezi oluningi (ikakhulukazi uma kukhona ukuvuvukala kwamaphaphu).
– Imithi esekela ukufinyela kwenhliziyo futhi elawula umfutho wegazi ngokuya ngesifo.
– Ukudla okunosawoti omncane.
– Imikhawulo yemisebenzi kanye nokulawula ukucindezeleka.
4) Ukwehluleka kokuphefumula/ukuphefumula
– I-oksijini, i-nebulization, kanye nemithi yokulwa nokuvuvukala/ama-antibiotic ngokuya ngembangela.
– Ukuphathwa koketshezi esifubeni (isib. ukususwa koketshezi/i-thoracentesis).
Ngenxa yokuthi isitho ngasinye siyathintana, odokotela bavame ukwelapha izilwane ngendlela "yokusekela izitho eziningi".
7. Ukunakekelwa Ngemva Kokuzinza: Ukuphathwa Kwekhaya
Uma isimo esibi sesixazululiwe noma samacala angapheli, umnikazi wesilwane unendima enkulu empumelelweni yokwelashwa:
– Landela isimiso semithi (ungayeki ngokuzumayo ngaphandle kokubonisana).
– Sebenzisa ukudla okukhethekile okunconywayo; gwema ukudla okulula okunosawoti noma ukudla kwasetafuleni.
– Qaphela ukuphuza nokuchama: izinguquko ezincane zingabonisa ukubuyela emuva kokuphuza.
– Ukuhlolwa njalo ukuze kuqashwe igazi/umchamo futhi kulungiswe umthamo wemithi.
– Gcina isisindo somzimba esifanele; ukukhuluphala kubeka ingcindezi enkulu enhliziyweni, esibindini nasemalungeni.
– Nciphisa ukuchayeka ebuthini: izibulala-zinambuzane, imithi yabantu, izitshalo ezinobuthi, kanye nokudla okuyingozi (isib. ushokoledi wezinja, u-anyanisi wamakati).
8. Ukuvimbela: Kushibhile futhi Kuphephile
Amacala amaningi okwehluleka kwezitho zomzimba angavinjelwa ngezinyathelo ezilula:
1. Ukugoma nokuvimbela amagciwane ukuze kuncishiswe ingozi yokutheleleka ngezifo ezihambisana nohlelo lomzimba.
2. Amanzi ahlanzekile kanye nokudla okunekhwalithi kuye ngezinhlobo kanye nezidingo zobudala.
3. Ukuhlolwa kwempilo njalo (okungenani izikhathi ezingu-1-2 ngonyaka), ikakhulukazi ezilwaneni ezindala.
4. Lawula izifo ezingamahlalakhona ezifana nesifo sikashukela, umfutho wegazi ophakeme, noma izifo eziphindaphindayo zomgudu womchamo.
5. Fundisa abanikazi ngokudla okuyingozi kanye nobuthi ekhaya.
Isiphetho
Ukwelapha ukwehluleka kwezitho zomzimba ezilwaneni kudinga inhlanganisela yesenzo esisheshayo, ukuxilongwa okunembile, ukwelashwa okuqinile okusekelayo, kanye nokwelashwa kwembangela eyinhloko. Izimpawu ezinjengobuthakathaka obukhulu, ukuhlanza okuqhubekayo, ukuphelelwa umoya, ukungakwazi ukuchama, noma ukuxhuzula kufanele kubhekwe njengesimo esiphuthumayo. Uma sekuzinzile, ukunamathela ekudleni nasemithini, ukuhlolwa njalo, kanye nokuvimbela ukuvezwa okunobuthi kubalulekile ekugcineni ikhwalithi yokuphila kwesilwane. Ekugcineni, ukubambisana phakathi komnikazi nodokotela wezilwane kubalulekile ekwandiseni isikhathi sokuphila kanye nokunciphisa ukuhlupheka ezilwaneni ezibhekene nokwehluleka kwezitho zomzimba.
