Wakhala igazi

Ukuphuma kwegazi ngamakhala ukulahleka kwegazi ezicubwini ezisemakhaleni. Ukopha kaningi kwenzeka ekhaleni elilodwa kuphela.

Ukuphuma kwamakhala emzimbeni kujwayelekile kakhulu. Iningi lokopha kwamakhala livela ngenxa yokucasuka okuncane noma imikhuhlane.

Impumulo iqukethe imithambo yegazi eminingi emincane ephuma kalula igazi. Umoya ohamba ngamakhala ungoma futhi ucasule ulwelwesi olungaphakathi kwekhala. Ama-crust angakha igazi lapho licasulwa. Ukuphuma kwamakhala emzimbeni kwenzeka kaningi ebusika, lapho amagciwane abandayo ejwayelekile futhi umoya wasendlini uvame ukoma.

Iningi lokopha kwamakhala livela ngaphambili kwe-septum yamakhala. Lesi isiqeshana sesicubu esihlukanisa izinhlangothi ezimbili zekhala. Lolu hlobo lwegazi oluphuma amakhala kungaba lula ukuthi uchwepheshe oqeqeshiwe ayeke. Okungajwayelekile, ukuphuma kwamakhala kungaba khona ngaphezulu ku-septum noma kujule ekhaleni njengasesonweni noma phansi kogebhezi. Ukuphuma kwegazi elinjalo kungaba nzima ukulawula. Kodwa-ke, ukopha ngamakhala akuvamile ukusongela impilo.

Ukuphuma kwamakhala kungabangelwa:

• Ukuthukuthela ngenxa yokungezwani komzimba, imikhuhlane, ukuthimula noma izinkinga zesono
• Umoya obanda kakhulu noma owomile
• Ukushaya ikhala kanzima, noma ukukhetha ikhala
• Ukulimala ekhaleni, kufaka phakathi ikhala eliphukile, noma into enamathele ekhaleni
• Ukuhlinzwa kwesinus noma kwe-pituitary (transsphenoidal)
• I-septum ephambukisiwe
• Amakhemikhali acasulayo afaka phakathi imithi noma izidakamizwa ezifuthwayo noma ezifuthwayo
• Ukusetshenziswa ngokweqile kwezifutho zamakhala eziqeda amandla
• Ukwelashwa kwe-oksijeni ngokusebenzisa ama-cannulas acinene

Ukopha okuphindaphindiwe kungaba uphawu lwesinye isifo esifana nomfutho wegazi ophakeme, isifo sokopha, noma isimila ekhaleni noma esonweni. Ama-thinner egazi, njenge-warfarin (Coumadin), i-clopidogrel (i-Plavix), noma i-aspirin, angadala noma abhebhethekise ukuphuma kwamakhala.

Ukumisa ukuphuma kwegazi:

• Hlala phansi bese ucindezela ngobumnene ingxenye ethambile yekhala phakathi kwesithupha nomunwe (ukuze amakhala avalwe) imizuzu eyi-10 ephelele.
• Ncika phambili ukugwema ukugwinya igazi uphefumule ngomlomo wakho.
• Linda okungenani imizuzu eyi-10 ngaphambi kokubheka ukuthi ukopha kumile yini. Qiniseka ukuthi uvumela isikhathi esanele sokuphuma kwegazi.

Kungasiza ukufaka izingcindezi ezibandayo noma iqhwa ngaphesheya kwebhuloho lekhala. Ungafaki ngaphakathi kwekhala nge-gauze.

Ukulala phansi ngegazi akukhuthazwa. Kufanele ugweme ukuhogela noma ukushaya ikhala lakho amahora ambalwa ngemuva kokuphuma kwegazi. Uma ukuphuma kwegazi kuqhubeka, i-nasal spray decongestant (i-Afrin, i-Neo-Synephrine) kwesinye isikhathi ingasetshenziswa ukuvala imikhumbi emincane nokulawula ukopha.

Izinto ongazenza ukuvimbela ukuphuma kwamakhalavuza kaningi kufaka:

• Gcina ikhaya lipholile bese usebenzisa i-vaporizer ukwengeza umswakama emoyeni wangaphakathi.
• Sebenzisa i-nasal saline spray ne-jelly encibilikiswa ngamanzi (njenge-Ayr gel) ukuvikela amalinisi ekhaleni ukuthi angomi ebusika.

Thola ukunakekelwa okuphuthumayo uma:

• Ukopha akuyeki ngemuva kwemizuzu engama-20.
• Ukuphuma kwamakhala kwenzeka ngemuva kokulimala ekhanda. Lokhu kungaphakamisa ukuphuka kogebhezi, futhi ama-x-ray kufanele athathwe.
• Impumulo yakho ingahle yephuke (ngokwesibonelo, ibukeka isigwegwile ngemuva kokushaya ekhaleni noma kokunye ukulimala).
• Uthatha imithi yokuvikela igazi lakho ekunqandeni (izinciphisi zegazi).
• Uke waba nokopha ngamakhala esikhathini esidlule okwakudinga ukunakekelwa ngochwepheshe ukwelapha.

Shayela umhlinzeki wakho wezempilo uma:

• Wena noma ingane yakho uphuma kaningi emakhaleni
• Amakhala okuphuma emakhaleni awahlotshaniswa nokubanda noma okunye ukucasuka okuncane
• Ukuphuma kwamakhala kuvela ngemuva kwesono noma okunye ukuhlinzwa

Umhlinzeki uzokwenza ukuhlolwa ngokomzimba. Kwezinye izimo, ungabhekelwa izimpawu nezimpawu zomfutho wegazi ophansi ekulahlekelweni yigazi, okubizwa nangokuthi ukushaqeka kwe-hypovolemic (lokhu akuvamile).

Ungaba nokuhlolwa okulandelayo:

• Qedela ukubalwa kwegazi
• I-Nasal endoscopy (ukuhlolwa kwekhala usebenzisa ikhamera)
• Izilinganiso zesikhathi ze-thromboplastin eziyingxenye
• Isikhathi se-Prothrombin (PT)
• I-CT scan yekhala nezinsimbi

Uhlobo lokwelashwa olusetshenzisiwe luzosuselwa embangela yokopha kwamakhala. Ukwelashwa kungafaka:

• Ukulawula umfutho wegazi
• Ukuvala isitsha segazi usebenzisa ukushisa, amandla kagesi, noma izinti ze-nitrate zesiliva
• Ukupakisha kwamakhala
• Ukunciphisa ikhala eliphukile noma ukususa umzimba wangaphandle
• Ukunciphisa inani lomuthi omncane wegazi noma ukumisa i-aspirin
• Ukwelapha izinkinga ezigcina igazi lakho linganqwabeki ngokujwayelekile

Ungadinga ukubona indlebe, ikhala, nomphimbo (ENT, otolaryngologist) uchwepheshe wokuhlola okwengeziwe nokwelashwa.

Ukopha okuphuma emakhaleni; I-Epistaxis

• Wakhala igazi
• Wakhala igazi

UPfaff JA, Moore GP. I-Otolaryngology. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 62.

USavage S.Ukuphathwa kwe-epistaxis. Ku: Fowler GC, ed. Izinqubo zikaPfenninger noFowler zokuNakekela okuyisisekelo. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 205.

USimmen DB, uJones NS. I-Epistaxis. Ku: Flint PW, Haughey BH, Lund V, et al, ama-eds. I-Cummings Otolaryngology: Ukuhlinzwa Kwekhanda Nentamo. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 42.