Ukutheleleka okunezicubu ezithambile

Ukutheleleka nge-Necrotizing izicubu ezithambile uhlobo olungajwayelekile kepha olunzima kakhulu lokutheleleka ngamagciwane. Ingabhubhisa imisipha, isikhumba nezicubu ezingaphansi. Igama elithi "necrotizing" lisho into ebangela ukuthi izicubu zomzimba zife.

Izinhlobo eziningi ezahlukahlukene zamagciwane zingadala lesi sifo. Uhlobo olunzima kakhulu futhi oluvame ukubulala lokutheleleka kwezicubu ezithambile kungenxa yegciwane IStreptococcus pyogenes, kwesinye isikhathi ebizwa ngokuthi "ama-bacteria adla inyama" noma i-strep.

Ukutheleleka kwezicubu ezithambile kwe-Necrotizing kwenzeka lapho amabhaktheriya engena emzimbeni, imvamisa ngokusebenzisa ukusika okuncane noma ukusika. Amagciwane aqala ukukhula akhiphe izinto eziyingozi (ubuthi) obulala izicubu futhi zithinte ukugeleza kwegazi ukuya endaweni. Nge-strep yokudla inyama, amabhaktheriya abuye enze amakhemikhali avimba amandla omzimba okuphendula emzimbeni. Lapho izicubu zifa, amabhaktheriya angena egazini futhi asakazeka ngokushesha emzimbeni wonke.

Izimpawu zingafaka:

• Isigaxa esincane, esibomvu, esibuhlungu noma isigaxa esikhunjeni esisakazekayo
• Indawo efana nokulimala kabuhlungu bese iyakhula futhi ikhule ngokushesha, kwesinye isikhathi ingaphansi kwehora
• Isikhungo siba mnyama futhi kube mnyama bese siba mnyama bese izicubu zifa
• Isikhumba singavuleka futhi siphume uketshezi

Ezinye izimpawu zingafaka:

• Ukuzizwa ngigula
• Imfiva
• Ukujuluka
• Amakhaza
• Isicanucanu
• Isiyezi
• Ubuthakathaka
• Ukushaqeka

Umhlinzeki wezokunakekelwa kwempilo angakwazi ukuxilonga lesi simo ngokubheka isikhumba sakho. Noma, isimo singatholakala egumbini lokuhlinza ngudokotela ohlinzayo.

Ukuhlolwa okungenziwa kufaka phakathi:

• I-Ultrasound
• I-X-ray noma i-CT scan
• Ukuhlolwa kwegazi
• Isiko legazi ukuhlola amagciwane
• Ukusikwa kwesikhumba ukubona ukuthi ubomvu bukhona yini
  
• Isikhumba se-biopsy namasiko

Ukwelashwa kuyadingeka ngokushesha ukuvimbela ukufa. Kuzodingeka uhlale esibhedlela. Ukwelashwa kufaka:

• Ama-antibiotic anamandla anikezwa ngomthambo (IV)
• Ukuhlinzwa ukukhipha isilonda nokususa izicubu ezifile
• Imithi ekhethekile ebizwa ngama-donor immunoglobulins (amasosha omzimba) ukusiza ukulwa nokutheleleka kwezinye izimo

Ezinye izindlela zokwelashwa zingafaka:

• Okufakwe esikhunjeni ngemuva kokutheleleka kusuke kusiza isikhumba sakho ukuba siphole futhi sibukeke singcono
• Ukunqunywa uma isifo sisakazeka engalweni noma emlenzeni
• Amakhulu amaphesenti oksijini ekucindezelweni okuphezulu (i-hyperbaric oxygen therapy) yezinhlobo ezithile zezifo ezibangelwa amagciwane

Ukwenza kahle kangakanani kuya ngokuthi:

• Impilo yakho iyonke (ikakhulukazi uma unesifo sikashukela)
• Uhlolwe ngokushesha kangakanani nokuthi uthole ukwelashwa masinyane kangakanani
• Uhlobo lwamabhaktheriya abangela ukutheleleka
• Kusabalala ngokushesha kangakanani ukutheleleka
• Impatho isebenza kahle kangakanani

Lesi sifo sivame ukudala isikhumba nokukhubazeka kwesikhumba.

Ukufa kungenzeka ngokushesha ngaphandle kokwelashwa okufanele.

Izinkinga ezingavela kulesi simo zifaka:

• Ukutheleleka kusakazeka emzimbeni wonke, kubangele ukutheleleka kwegazi (sepsis), okungabulala
• Ukuqhuma nokukhubazeka
• Ukulahleka kwekhono lakho lokusebenzisa ingalo noma umlenze
• Ukufa

Lesi sifo sinzima futhi singasongela impilo. Xhumana nomhlinzeki wakho khona manjalo uma izimpawu zokutheleleka zenzeka ngokulimala kwesikhumba, kufaka phakathi:

• Ukukhipha ubomvu noma igazi
• Imfiva
• Ubuhlungu
• Ububomvu
• Ukuvuvukala

Hlanza isikhumba ngaso sonke isikhathi ngemuva kokusikeka, ukuklwebheka noma okunye ukulimala kwesikhumba.

I-fasciitis enecrotizing; I-Fasciitis - i-necrotizing; Amagciwane adla inyama; Izicubu ezibolile; I-Gangrene - izicubu ezithambile

U-Abbas M, Uçkay I, Ferry T, Hakko E, Pittet D. Ukutheleleka okunamandla kwezicubu ezithambile. Ku: Bersten AD, Handy JM, eds. Ibhukwana Lokunakekela Abagula Ngokujulile. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 72.

UFitzpatrick JE, High WA, uKyle WL. Izinkinga zesikhumba se-Necrotic and ulcerative. Ku: Fitzpatrick JE, High WA, Kyle WL, ama-eds. I-Dermatology Yokunakekelwa Okuphuthumayo: Ukuxilongwa Okusekelwe Ezimpawu. IPhiladelphia, PA: Elsevier; 2018: isahluko 14.

IPasternack MS, iSwartz MN. I-cellulitis, i-necrotizing fasciitis, kanye nezifo ezingaphansi kwesikhumba. 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 Saunders; 2020: isahluko 93.

UStevens DL, uBisno AL, uChambers HF, et al. Imihlahlandlela yokuzilolongela ukuxilongwa nokuphathwa kwezifo zesikhumba nezithambile: Ukubuyekezwa yi-Infectious Diseases Society of America ngo-2014 I-Clin Infect Dis. 2015; 60 (9): 1448. Iphutha lesilinganiso embhalweni we-athikili]. I-Clin Infect Dis. 2014; 59 (2): e10-e52. I-PMID: 24973422 pubmed.ncbi.nlm.nih.gov/24973422.