Ukubola kwegesi

I-gas gangrene iyindlela ebulalayo yokufa kwezicubu (i-gangrene).

Ukulimala kwegesi kuvame ukubangelwa amagciwane abizwa ngokuthi I-Clostridium perfringens. Futhi kungabangelwa yi-group A streptococcus, UStaphylococcus aureus, futhi IVibrio vulnificus.

IClostridium itholakala cishe yonke indawo. Njengoba amabhaktheriya ekhula ngaphakathi emzimbeni, enza igesi nezinto eziyingozi (ubuthi) ezingalimaza izicubu zomzimba, amaseli, nemithambo yegazi.

Ukulimala kwegesi kuvela ngokushesha. Imvamisa kwenzeka endaweni yokuhlukumezeka noma enxebeni lokuhlinzwa lakamuva. Kwezinye izimo, kwenzeka ngaphandle komcimbi ocasulayo. Abantu abasengozini enkulu yokubola kwegesi imvamisa banezifo zomthambo wegazi (i-atherosclerosis, noma ukuqina kwemithambo), isifo sikashukela, noma umdlavuza wamathumbu.

Ukulimala kwegesi kubangela ukuvuvukala okubuhlungu kakhulu. Isikhumba siphenduka saphaphatheka sibe bomvu nsundu. Lapho indawo evuvukile icindezelwe, kuzwakala igesi (futhi kwesinye isikhathi izwakale) njengokuzwa okuqhekezayo (i-crepitus). Imiphetho yendawo ethelelekile ikhula ngokushesha okukhulu kangangokuthi izinguquko zingabonakala ngaphezu kwemizuzu. Indawo ingabhujiswa ngokuphelele.

Izimpawu zifaka:

• Umoya ngaphansi kwesikhumba (i-emphysema engaphansi)
• Amabhamuza agcwele uketshezi olubomvu onsundu
• Ukugeleza okuvela ezicutshini, uketshezi olunephunga elibi olunsundu ngokubomvu noma olunegazi (ukukhishwa kwe-serosanguineous)
• Ukunyuka kwenhliziyo (tachycardia)
• Kumaphakathi kuya kumkhuhlane omkhulu
• Ubuhlungu obulinganiselwe kuya kabuhlungu obuzungeze ukulimala kwesikhumba
• Umbala wesikhumba okhanyayo, ngokuhamba kwesikhathi uba mnyama futhi ushintshe ubomvu obomvu noma nsomi
• Ukuvuvukala okuya ngokuya kulimale isikhumba
• Ukujuluka
• Ukwakheka kwe-Vesicle, ukuhlanganiswa kube ngamabhamuza amakhulu
• Umbala ophuzi esikhunjeni (i-jaundice)

Uma isimo singelashwa, lowo muntu angashaqeka ngokwehla komfutho wegazi (hypotension), ukwehluleka kwezinso, ikhoma, nokugcina ngokufa.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Lokhu kungaveza izimpawu zokwethuka.

Ukuhlolwa okungenziwa kufaka phakathi:

• Izicubu namasiko oketshezi ukuhlola amabhaktheriya kufaka phakathi izinhlobo ze-clostridial.
• Isiko legazi lokunquma amagciwane abangela ukutheleleka.
• Ibala le-Gram loketshezi oluvela endaweni enegciwane.
• I-X-ray, i-CT scan, noma i-MRI yendawo ingakhombisa igesi ezicutshini.

Ukuhlinzwa kuyadingeka ngokushesha ukuze kususwe izicubu ezifile, ezilimele nezinegciwane.

Ukususwa kokuhlinzwa (ukunqunywa) kwengalo noma komlenze kungadingeka ukulawula ukusabalala kwesifo. Ukunqunywa kwesinye isikhathi kufanele kwenziwe ngaphambi kokuba yonke imiphumela yokuhlolwa itholakale.

Kunikezwa nama-antibiotic. Le mithi inikezwa ngomthambo (ngemithambo yegazi). Imithi yezinhlungu nayo ingabekwa.

Kwezinye izimo, ukwelashwa kwe-oxygen ye-hyperbaric kungazama.

Ukulimala kwegesi kuvame ukuqala ngokuzumayo futhi ngokushesha kubhebhetheke. Kuvame ukubulala.

Izinkinga ezingaba nomphumela zifaka:

• I-Coma
• I-Delirium
• Ukulimaza noma ukukhubaza ukulimala kwezicubu unomphela
• I-jaundice enomonakalo wesibindi
• Ukuhluleka kwezinso
• Ukushaqeka
• Ukusabalala kokutheleleka emzimbeni (sepsis)
• Isiphukuphuku
• Ukufa

Lesi yisimo esiphuthumayo esidinga usizo lwezokwelapha ngokushesha.

Shayela umhlinzeki wakho uma unezimpawu zokutheleleka ezungeze isilonda sesikhumba. Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911), uma unezimpawu zokulimala kwegesi.

Hlanza noma yikuphi ukulimala kwesikhumba ngokuphelele. Bheka izimpawu zokutheleleka (njengokubomvu, ubuhlungu, ukudonsa noma ukuvuvukala okuzungeze isilonda). Bona umhlinzeki wakho ngokushesha uma lokhu kwenzeka.

Ukutheleleka kwezicubu - i-clostridial; I-Gangrene - igesi; I-Myonecrosis; Ukutheleleka kwezicubu zomzimba; Ukutheleleka okunezicubu ezithambile

• Ukubola kwegesi
• Ukubola kwegesi
• Amagciwane

UHenry S, uKayin C. Ukulimala kwegesi komkhawulo. Ku: UCameron AM, uCameron JL, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 862-866.

I-Onderdonk AB, iGarrett WS. Izifo ezibangelwa yi-clostridium. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 246.