Ukuvuselelwa

I-Rhabdomyolysis ukuwohloka kwezicubu zemisipha okuholela ekukhishweni kokuqukethwe kwemisipha yegazi egazini. Lezi zinto ziyingozi ezinso futhi zivame ukudala ukulimala kwezinso.

Lapho imisipha yonakele, kukhishwa iprotheni ebizwa ngokuthi i-myoglobin egazini. Ibe seyicwengeka emzimbeni ngezinso. I-Myoglobin yehlela ezintweni ezingalimaza amangqamuzana ezinso.

I-Rhabdomyolysis ingabangelwa ukulimala noma esinye isimo esilimaza imisipha yamathambo.

Izinkinga ezingaholela kulesi sifo zifaka:

• Ukuhlukumezeka noma ukulimala kokulimala
• Ukusetshenziswa kwezidakamizwa ezifana ne-cocaine, amphetamines, statins, heroin, noma i-PCP
• Izifo zemisipha zofuzo
• Ukushisa okukhulu komzimba
• Ischemia noma ukufa kwezicubu zemisipha
• Amazinga aphansi e-phosphate
• Ukuquleka noma ukuthuthumela kwemisipha
• Ukuzikhandla okukhulu, njengokugijima kwe-marathon noma i-calisthenics
• Izinqubo zokuhlinza ezinde
• Ukuphela kwamanzi emzimbeni

Izimpawu zingafaka:

• Umchamo omnyama obomvu, obomvu, noma we-cola
• Ukwehla kokukhishwa komchamo
• Ubuthakathaka obujwayelekile
• Ukuqina kwemisipha noma ukuqaqamba (myalgia)
• Ubumnene bemisipha
• Ubuthakathaka bemisipha ethintekile

Ezinye izimpawu ezingase zivele ngalesi sifo:

• Ukukhathala
• Ubuhlungu obuhlangene
• Ukuquleka
• Ukuzuza kwesisindo (ngokungenhloso)

Ukuhlolwa komzimba kuzobonisa imisipha yamathambo noma eyonakele.

Ukuhlolwa okulandelayo kungenziwa:

• Izinga le-Creatine kinase (CK)
• I-calcium yeserum
• I-serum myoglobin
• I-potassium yeSerum
• Ukuhlolwa komchamo
• Ukuhlolwa kwe-myoglobin yomchamo

Lesi sifo singathinta nemiphumela yokuhlolwa okulandelayo:

• Ama-isoenzymes we-CK
• I-serum creatinine
• I-creatinine yomchamo

Uzodinga ukuthola uketshezi oluqukethe i-bicarbonate ukusiza ukuvimbela ukulimala kwezinso. Ungadinga ukuthola uketshezi ngomthambo (IV). Abanye abantu bangadinga i-dialysis yezinso.

Umhlinzeki wakho wezokunakekelwa kwempilo angakunikeza imithi efaka i-diuretics ne-bicarbonate (uma kunokukhishwa okwanele komchamo).

I-Hyperkalemia namazinga we-calcium ephansi egazi (i-hypocalcemia) kufanele alashwe ngokushesha. Ukuhluleka kwezinso nakho kufanele kulashwe.

Umphumela uncike enanini lokulimala kwezinso. Ukwehluleka okukhulu kwezinso kwenzeka kubantu abaningi. Ukwelashwa ngokushesha ngemuva kwe-rhabdomyolysis kuzonciphisa ubungozi bokulimala ngokuphelele kwezinso.

Abantu abanamacala amabi bangabuyela emisebenzini yabo ejwayelekile kungakapheli amasonto ambalwa kuya enyangeni. Kodwa-ke, abanye abantu bayaqhubeka nokuba nezinkinga zokukhathala nobuhlungu bemisipha.

Izinkinga zingafaka:

• I-necrosis enamandla ye-tubular
• Ukwehluleka okukhulu kwezinso
• Ukungalingani kwamakhemikhali okuyingozi egazini
• Ukushaqeka (umfutho ophansi wegazi)

Shayela umhlinzeki wakho uma unezimpawu ze-rhabdomyolysis.

I-Rhabdomyolysis ingagwenywa ngu:

• Ukuphuza uketshezi oluningi ngemuva kokuzivocavoca kanzima.
• Ukususa izingubo ezengeziwe nokufaka umzimba emanzini abandayo uma kwenzeka ukushisa.

• Ukwakheka kwezinso

UHaseley L, uJefferson JA. I-Pathophysiology kanye ne-etiology yokulimala kanzima kwezinso. Ku: Feehally J, Floege J, Tonelli M, Johnson RJ, abahleli. I-Nephrology Yomtholampilo Ephelele. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2019: isahluko 66.

U-O'Connor FG, uDeuster PA. Ukuvuselelwa. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier; 2020: isahluko 105.

UParekh R.Rhabdomyolysis. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 119.