Ukulimala kwezemidlalo
1K 1 20.04.2019 (kugcine ukubuyekezwa: 20.04.2019)
Ukulimala kwemithambo yegazi kungukuphula ubuqotho bemithambo yegazi nemithambo yegazi ngaphansi kwethonya lomenzeli ohlukumezayo. Kubhekwe ngokulimala okuvulekile nokuvaliwe. Kungase kuhambisane nokwephulwa kokunikezwa kwegazi engxenyeni engezansi, kanye nokopha kwangaphandle noma kwangaphakathi.
Izimpawu zomtholampilo zezinhlobo ezahlukene
Ubungozi bokulimala kwemithambo yegazi buyahluka ngokuya ngobukhulu nohlobo.
Izimpawu zokulimala okuvulekile
Ukubonakaliswa kwabo okuyinhloko ukuphuma kwegazi kwangaphandle. Uma iphutha lomkhumbi limbozwe yi-clot yegazi noma izicubu eziseduze, kungahle kungabikho ukulahleka kwegazi.
Isici sokulimala okunjalo ukusabalala kwegazi kuzicubu ezithambile nokwakheka okulandelayo kwemivimbo. Ngokulimala okuphawulekayo, imingcele ye-hemodynamic iyawohloka, futhi isimo sokushaqeka singakhula.
Izinkinga ezibucayi kakhulu zivela ekuhlukumezeni kuya emikhunjini emikhulu kanye nasekwenziweni kokuphuma kwegazi emithanjeni.
Ubukhulu bokulimala kwemithambo yegazi ekulimaleni okuvulekile:
- ukwephula ubuqotho begobolondo langaphandle, kuyilapho izingqimba zangaphakathi zingonakalanga;
- ngokusebenzisa isilonda sodonga lomkhumbi;
- ukuqhekeka kwesitsha somthambo noma semithambo yegazi.
Izimpawu zokulimala okuvalekile
Izilonda ezivaliwe zemithambo zihambisana nokubhujiswa kwe-intima yomkhumbi. Uma kwenzeka ukulimala okuncane kubangelwa izinto ezingacacile, imifantu yakha ungqimba lwangaphakathi lomkhumbi. Akukho ukopha ngaphandle. Ingozi ilele ekutheni kungenzeka ukwakheka kwegazi emithanjeni yegazi, engacasula ischemia.
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Isimo sobukhali obulinganiselayo sikhombisa ubukhona bokudilika okuyindilinga kwe-intima nengxenye yesendlalelo esiphakathi. Ukulimala okufanayo kwenzeka engozini, lapho kwakhiwa isaka le-aneurysmal endaweni ye-aortic isthmus ngenxa yokushayeka okucijile.
Ukuhlukumezeka okukhulu kubonakaliswa ukopha okukhulu okucindezela izicubu eziseduze.
Ukulimala okuvaliwe kubonakala ngezimpawu ezilandelayo zomtholampilo:
- izimpawu ezinzima zobuhlungu, ezingancishiswa isenzo se-analgesics nangemva kokuncipha kwethambo;
- ukungabi khona kwe-pulse emithanjeni engezansi kwendawo yokulimala;
- i-pallor noma i-cyanosis yesikhumba;
- umhuzuko ohlanganisa indawo enkulu.
Imithambo yegazi
Ngokulimala kwemikhumbi yemithambo, kuvela lezi zimpawu ezilandelayo zomtholampilo:
- umfudlana wegazi elibomvu;
- ukopha kakhulu;
- i-hematoma ekhula ngokushesha nge-pulsation;
- akukho pulse ngezansi kokulimala;
- okukhanyayo, nangemuva kombala oluhlaza okwesibhakabhaka;
- ukulahlekelwa ukuzwela;
- izinhlungu ezingashintshi ukuqina kwazo lapho zishaya noma zilungisa isitho;
- ukuqina kwemisipha, ukunyakaza okulinganiselwe, okuphenduka isivumelwano.
I-Ven
Ukulimala kwesitsha se-venous kubonakala ngokutholakala kwegazi elinombala ogcwele ogqamile, i-edema yesitho, nokuvuvukala kwemithambo eseceleni. Ama-hematomas amancane akhiwa ngaphandle kwe-pulsation. Akukho ukubonakaliswa kwe-ischemia, isikhumba somthunzi ojwayelekile nezinkomba zokushisa, ukunyakaza kwezitho zomzimba akukhawulelwe.
Izitsha zekhanda nezentamo
Ukulimala okuhambisana nengozi yokufa ngenxa ye:
- indawo eseduze yemigwaqo yomoya kanye nama-plexuses ezinzwa;
- ingozi yokwehliswa komsoco wobuchopho ngenxa yesifo sohlangothi, i-thrombosis, ischemia;
- ukutholakala kokulahleka kwegazi okukhulu.
Ukuqhekeka komkhumbi we-arterial kuhambisana nokuphuma kakhulu kwegazi noma i-hematoma eshayayo eseceleni kwentamo. Umhuzuko umboza ngokushesha indawo engaphezulu, ubeka ingcindezi emqaleni. Kwesinye isikhathi kuba nokungena emgodini wokuncenga. Lesi simo singase sihambisane nomonakalo emthanjeni.
Izitho
Ukubonakaliswa komkhumbi oqhekekile kuyahlukahluka kuye ngokujula nosayizi wesilonda. Njengoba kuneziqu ezinkulu zemithambo nemithambo ezithweni, ukuphuma kwegazi okugazini kungenzeka. Lesi simo yisimo esiphuthumayo sezokwelapha.
Ukopha okuvela emithanjeni kuncane kakhulu, kepha kusadinga ukunakekelwa kwezokwelapha. Umphumela omuhle kakhulu ukulimala kwama-capillaries. Ngokuvalwa kwegazi okujwayelekile, kufanele kusetshenziswe ibhandishi le-aseptic kulowo ohlukunyeziwe.
Ngubani ophilisayo
Ukwelashwa kokulimala kwemithambo, ngokuya ngezimo zokutholwa kwabo, kungamakhono we-traumatologist, udokotela wezempi noma udokotela ohlinzayo wemithambo.
Usizo lokuqala indlela yokwenza
Ukukhathazeka okuyinhloko lapho kwenzeka ukulimala kokopha ukunqanda ukulahleka kwegazi. Inani losizo lokuqala lincike ebukhulwini nasezinhlotsheni zazo:
- IHematoma. Ukusetshenziswa kwecompress ebandayo kusayithi lokulimala.
- Ukudabuka kwemithambo emincane noma yemithambo yemithambo yegazi. Ukufaka ibhandishi lengcindezi.
- Okubalulekile. Ukucindezela indawo yokulimala ngomunwe nokufaka i-tourniquet ngaphezulu kwezingubo, lapho kufanele kuboshwe khona inothi nesikhathi esiqondile. Isikhathi esiphezulu sesicelo se-tourniquet akufanele sidlule ihora kubantu abadala nemizuzu engama-20 yezingane.
Isitho esilimele kumele singasebenzi ngaphambi kokufika kwe-ambulensi. Isisulu kufanele sibe sendaweni evundlile. Ngokulimala entanyeni, ibhandishi eligingqiwe kufanele lisetshenziswe esilondeni.
Ukuxilongwa
Ukuqashelwa kwalesi sifo, ubukhulu baso nendawo okuyo kusekelwe kudatha evela ezifundweni zokuxilonga:
- I-Doppler ultrasound. Ikuvumela ukuthi uhlole isimo sezindonga nokukhanya kwemithambo yegazi.
- I-serial angiography. Kusetshenziselwa ukuthola ukugeleza kwegazi okungavamile.
- Ukuhlolwa kwegazi elebhu. Ingasetshenziselwa ukuxilonga ukulahleka kwegazi nezinye izinkinga.
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Uma isiguli sinomlando wezifo zenhliziyo nemithambo yegazi, kuyadingeka ukuthi kuqashwe inhlalakahle yesiguli ngumelaphi noma udokotela wenhliziyo. Ukuba khona kokubonakaliswa kwe-aneurysm kudinga ukunakekelwa ngokushesha kwezokwelapha.
Ukwelashwa
Lapho wamukelwa emnyangweni we-traumatology noma wokuhlinzwa, kusetshenziswa lezi zindlela zokwelapha kulowo ohlukunyeziwe:
- ukuyeka ukopha;
- ukuhlinzwa okuphuthumayo;
- ukuhlinzwa okwakha kabusha, kusiza ukubuyisela ukugeleza kwegazi nokubuyisela ukusebenza ezitsheni ezinkulu;
- i-fasciotomy;
- ukusikwa kwendawo ethintekile kanye ne-autoplasty.
