I-Rhabdomyolysis: yintoni, imbangela, iimpawu, unyango lwezempilo

Imiphumo yengozi ye-muscle iyaziwa ngabantu abachaphazelekayo kwimidlalo yobugcisa. Abo bafumana umsebenzi wokuhlala rhoqo kwaye banengcamango yeenzuzo kunye nengozi, bayaziqhelanisa nomxholo we "rhabdomyolysis". Izimpawu zesi sifo zinzulu kakhulu. Nangona ikhondo elincinane, ukukhubazeka kungaholela kwimiphumo emibi emzimbeni. I-Rhabdomyolysis - yintoni na? Lo mbuzo ungaphendulwa nje kuphela ngugqirha, kodwa nangomnye umqeqeshi ofanelekileyo kwimidlalo nganye. I-Pathology iyingozi kwaye kwinqanaba elinzima lingaholela ekufeni. Nangona kunjalo, ukuba itholakala ngexesha, kukho unyango olupheleleyo.

Izifo zeRhabdomyolysis - yintoni na?

Le ntsholongwane idla ngokugqithiswa ngokuxhatshazwa kwamathunjwa. Iquka ukutshabalaliswa kwezicubu kunye nokukhutshwa kwezinto ezinobungozi egazini. Ngoko, ngokucacileyo, ungachaza intsingiselo yesifo esibizwa ngokuba yi-rhabdomyolysis. Yintoni oku, kuya kuqondakala ngakumbi xa sifunda ukuphuhliswa kwesi sifo kunye nemiphumo yalo mzimba. Kufuneka kukhunjulwe ukuba akusiyo yonke into ephazamisayo okanye ubunzima bomzimba obangela isifo. I-Rhabdomyolysis yi-syndrome apho ukutshatyalaliswa kwezicubu ze-muscle kwenzeka. Njengomphumo wokutshatyalaliswa kwemisipha yamathambo, into engena egazini, elingafaneli libe khona. Yiprotheyini ebizwa ngokuthi i-myoglobin. Liyinto ebalulekileyo kwimisipha. Ngokuqhelekanga ayinakwenziwa yizintso kwaye ayilonakalisi umzimba. Kodwa ngokutshatyalaliswa nokuphuka kwemisipha, isixa sayo egazini sifinyelela kwixinzelelo eliphezulu. Ngenxa yoko, i-myoglobin ijikeleza emzimbeni ixesha elide, ikhulula i-nephrotoxic ezamahala radicals. Ezi zinto ziyingozi kakhulu kwizicubu zeetulules ze-renal. Ukuqhubela phambili kulo, kunokwenzeka ukuphendula umbuzo: "I-Rhabdomyolysis - yintoni na kwaye yingozi?" Ukongeza kokutshatyalaliswa kwezihlunu, le syndrome ingakhokelela kwimeko enzima kangangoko ukuhluleka kwe-renal. Xa kunokwenzeka uncedo olungalindelekanga, i-OPN inakho ukudala umphumo obulalayo.

I-Rhabdomyolysis: izizathu zesifo

Kukho amaqela amabini ebangela ukuba kuphuhliswe i-rhabdomyolysis. Kwiimeko zokuqala, ezi ziimfucuza zamathambo ezisiphako. Abafaki imiphumo emincinci kwiimisipha (izibhamu). Phakathi kwezinto ezilimazayo kukuba:

1. Izingozi ezinkulu.
2. Inkulu kwindawo kunye nobunzulu bokutshisa (ukufikelela kumgca we-muscle).
3. Isiphumo sombane wamandla emzimbeni.
4. Izenzo ezidlobongela ezikhokelela ekukhuselweni kwamasculoskeletal.
5. I-toxicosis ebangelwa kukutshatyalaliswa ngokukrakra.
6. Ukungenelela ngoncedo olude.

Enye imbangela ye-rhabdomyolysis yintlukwano enzima yezicubu ze-muscle. Zingakhokelela ekuziphatheni okunzima ngokomzimba (okungavamile kumzimba), isifo soxinzelelo.

Ukongezelela, kukho ezinye izinto ezikhokelela kwi-rhabdomyolysis. Ayeqhelekanga, kodwa isenokubangela ukuphuhliswa kwesi sifo. Ezi ziquka ukuphulwa kwe-electrolyte balance, izifo zebhakteria kunye neentsholongwane, kunye nokuxiliswa kweziyobisi. Zonke ezi zinto zibangela ukungakwazi kwe-ATP. Njengoko uyazi, ukungabikho kwezi zinto ezichaphazela ukuphuhliswa kwe-rhabdomyolysis. Inani elincane le-ATP lubangela ukuhla kwe-electrolytes emzimbeni. Ezi ziquka izinto ezifana ne-calcium, i-phosphates ne-potassium. Ukungabikho kwezi zinto kubonwa ngushisa kunye nefuthe lelanga, i-hypothermia. Kwezinye iimeko, ukutshatyalaliswa kwezicubu zomzimba kuholela ekuphumeni komntu osesikweni kwindawo yokulala - ukungafihli.

Inkqubo ye-rhabdomyolysis

I-Pathogenesis kwi-rhabdomyolysis incike kwisizathu sokutshatyalaliswa kwemisipha yamathambo. Ukuba iimisipha zonakaliswe yimiphumo emibi okanye ingxaki yokuxilonga, ke iiseli zikhula. Oku kwenzeka ngenxa yokungena kwe-fluid ukusuka kwindawo ejikelezileyo ukuya kwi-membrane ye-myocytes. Ngenxa yesi sifo, iiseli zikhula kwaye zibe zikhulu. Ukutshintsha i-myocytes cinezela kwiimfucu ezijikelezileyo kunye neentambo ze-nerve. Ngaloo ndlela, ukuhamba kwegazi ukuya kumaseli omzimba onempilo kuphazamiseka, oku kubangela ukutshatyalaliswa kwabo. Ngenxa yokutshatyalaliswa kwemisipha yomzimba, ukukhululwa kweprotheni-myoglobin. Ngokuqhelekileyo, le nto ayinayo isetyhi kumzimba. Nangona kunjalo, iprotheni ingabangela ukungasebenzi kwezintso. Oku kwenzeka ngolu hlobo lulandelayo: i-myoglobin ibopha kwizinto ezikhoyo kwiiseli zezintso. Eli qela likhokelela ekubunjweni kweendlela eziqinileyo eziphazamisa ukuhamba kwegazi. Ukongeza, i-myoglobin inefuthe le-nephrotoxic.

Iimpawu zonyango zezilwanyana

Kukho iimpawu ezinzima kunye nobumnene be-rhabdomyolysis. Kwimeko yokuqala, i-syndrome yokutshatyalaliswa kwemisipha ihlanganiswe nokungaqiniseki komntu. I-Rhabdomyosis ayixinzelelwanga kakhulu nge-arthritis. Izibonakaliso zeklinikhi zokugula ziquka:

1. Ubuthakathaka obuthathaka.
2. Ubumnyama bombala womchamo. Lo mqondiso ubonisa ukuphulwa komsebenzi wezintso kwaye luyi-diagnostic criterion ye-rhabdomyolysis.
3. I-Edema kunye nokukhathazeka kwezihlunu zamathambo.

Xa ukuthobela ukungaphumeleli kwindlala, imeko yesigulane ihla kakhulu. Iimpawu ze-ARF ziquka:

1. I-Edema yemida.
2. Ukukhutshwa kwamancinci omncinci, kuze kube yilapho engekhoyo.
3. Isifo soxinzelelo. Kungenxa yokuvuvukala kwezicubu zomzimba. Kungakhokelela ekucinyeni izitho ezibalulekileyo. Iimpawu zeli ngxaki zi: ukuphefumula okufutshane, ukunciphisa uxinzelelo lwegazi, ukutshatyalaliswa.
4. I-Tachycardia, kule ilandelayo-i-puls-like pulse.
5. Ukuchithwa kwe-electrolyte balance.
6. I-coma.

Inkqubo yokuchonga i-rhabdomyolysis

Kunokwenzeka ukukrokreza eso sifo ngeendlela ezilandelayo: i-traum edluliselweyo kwimizimba yesisu, isisa kunye nokuvuvukala kwezihlunu, ukumnyama komchamo. Ezi zimpawu zivumela ukuba ubeke uvavanyo lokuqala lwe "rhabdomyolysis." Esi sifo sihlala sihamba kunye neenguqu kwigazi kunye nomchamo. Ukuxilongwa kuqinisekiswa ukuba ezi ziphumo eziqhelekileyo zifunyenwe kwizifundo zebhubhoratri:

1. Ukwandisa izinga lokudala i-phosphokinase.
2. Ukubonakala kwe-myoglobin egazini.
3. Ukwandiswa kwamanqanaba e-phosphorus kunye ne-potassium, ukuncipha kwee-calcium ions.
4. Ngophuhliso lokungaphumeleli kwenkunzi - inani elikhulu le-creinine kunye ne-urrea.
5. I-Myoglobinuria (ukubonakala kweprotheni emcini).

Ukongezelela, utshintsho luboniswa kwi-ECG (ukwandiswa kwee-ventricular complexes, ukubonakala kwamaza eT). Nge-syndrome ye-compression syndrome, kunokuthi kubekho umonakalo kwizitho zangaphakathi, amathambo. Ngoko ke, ukuba ukuxilongwa kwephulo kuyimfuneko ukuqhuba i-X-ray.

Izindlela zokonyango lwe-rhabdomyolysis

Nceda isigulane sifune ukuqala ngokukhawuleza, emva kokuxilongwa kwe "rhabdomyolysis". Unyango lwe-pathology kufuneka lwenziwe esibhedlele, ekubeni kwiimeko zesibhedlele kunokwenzeka ukubeka iliso kwinqanaba le-electrolytes. Ukuhlanjululwa komzimba, ukulungiswa komzimba kuyenziwa. Kwimeko ye-rhabdomyolysis enamandla, unyango lwe-infusion kunye ne- saline physiological luyimfuneko. Ukulungiswa kwetyuwa yamanzi kunye ne-electrolyte metabolism kubalulekile. Ukuqhelanisa i-diuresis, iziyobisi ze-diuretic "iFurosemide" okanye "i-Mannitol" ilawulwa. Kwiimeko ezinzima kakhulu, i-hemodialysis isetyenziswa. Ukuba uxinzelelo lwemisipha lufikelela kuma-30 mm. Gt; Ubugcisa, ukuchithwa kwezithambo - i-fasciotomy. Kule ndlela kuphela ukupheliswa koxinzelelo oluqhubekayo lwezitho kuya kuphunyezwa.

Ingxaki ezinokubakho zokugula

Kufuneka uqonde ukuba uncedo olufike ngexesha elifanelekileyo kunye ne-degree degree of pathology luya kunceda ukumisa i-rhabdomyolysis. Iifoto zezigulane ezijongene nale syndrome zimelelwe ngokubanzi kumaphepha achaphazelekayo ngolwazi lwezonyango. Yazi indlela iimfudu ezichaphazelekayo zibonakala zibaluleke kakhulu kubantu ababenomsebenzi onzima. Xa kunokukrokrelwa kwe-rhabdomyolysis, iimvavanyo zelabhoratri zegazi kunye nomchamo kufuneka zenziwe. Ukuba eso sifo siphumelele kwisiganga esinzima, kuyingozi emva kweengxaki:

1. Ukulimala kwamalungu kunye nezicubu. Ivela ngenxa yesifo soxinzelelo.
2. Ukungaphumeleli kweengtso.
3. I-DIC-syndrome. Ivela ngenxa yokucima igazi kwegazi. Kwiimeko ezinzima, kukhokelela ekufeni.

Ukuxela kubomi kwi-rhabdomyolysis

Ukuxhomekeka kokuxhomekeka kukuxhomekeke kubunzima be-pathology. Kwinqanaba lokuqala, isifo sifanelekile unyango lweziyobisi. Ukubuyiselwa kwakhona kuboniswa kuphela xa kwenzeka ukuphazamiseka okuphindaphindiweyo. Ukuba isifo sifinyelele kwisiganeko esinzima, ukuxela kwangaphambili akunakulungele. Nangona kunjalo, unyango lunokwenzeka ngokudibanisa unyango lwezonyango kunye nokungenelela okucwangcisiweyo. Kwimeko yokuphuhlisa i-ARF, izinga lokufa li-20%.