Chotupa cha mpweya

Chiwindi cha gasi ndimtundu wowopsa wakufa (chilonda).

Chotupa cha mpweya nthawi zambiri chimayambitsidwa ndi mabakiteriya otchedwa Clostridium perfringens. Ikhozanso kuyambitsidwa ndi gulu la streptococcus, Staphylococcus aureus, ndipo Vibrio vulnificus.

Clostridium imapezeka pafupifupi kulikonse. Mabakiteriya akamakula m'thupi, amapanga gasi ndi zinthu zina (poizoni) zomwe zitha kuwononga minyewa ya thupi, maselo, ndi mitsempha yamagazi.

Chiwindi cha gasi chimayamba mwadzidzidzi. Nthawi zambiri zimachitika pamalo opwetekedwa mtima kapena pachilonda chaposachedwa cha opaleshoni. Nthawi zina, zimachitika popanda chochitika chokhumudwitsa. Anthu omwe ali pachiwopsezo chachikulu chotupa ndi gasi nthawi zambiri amakhala ndi matenda amitsempha yamagazi (atherosclerosis, kapena kuuma kwa mitsempha), matenda ashuga, kapena khansa ya m'matumbo.

Chotupa cha gasi chimayambitsa kutupa kowawa kwambiri. Khungu limasanduka lotumbululuka kukhala lofiira. Dera lotupa likapanikizika, mpweya umatha kumveka (ndipo nthawi zina umamveka) ngati chisangalalo chosakhazikika (crepitus). Mphepete mwa malo omwe ali ndi kachilomboka amakula mwachangu kwambiri kotero kuti kusintha kumatha kuwonedwa mphindi. Malowa atha kuwonongekeratu.

Zizindikiro zake ndi izi:

• Mpweya pansi pa khungu (subcutaneous emphysema)
• Matuza odzaza ndi madzi ofiira ofiira
• Ngalande kuchokera kumatumba, zonunkhira zofiirira zofiirira kapena madzimadzi amwazi (kutulutsa kwa serosanguineous)
• Kuchuluka kwa kugunda kwa mtima (tachycardia)
• Wofulumira kutentha kwambiri
• Kupweteka pang'ono pang'ono povulala pakhungu
• Mtundu wakhungu loyera, pambuyo pake limakhala dusky ndikusintha kukhala lofiira kapena lofiirira
• Kutupa komwe kumafalikira pozungulira kuvulala pakhungu
• Kutuluka thukuta
• Mapangidwe a Vesicle, kuphatikiza matuza akulu
• Mtundu wachikaso pakhungu (jaundice)

Ngati vutoli silichiritsidwa, munthuyo akhoza kudodometsedwa ndi kuchepa kwa magazi (hypotension), impso kulephera, kukomoka, kenako kufa.

Wothandizira zaumoyo adzayesa. Izi zitha kuwulula zakusokonekera.

Mayeso omwe angachitike ndi awa:

• Minofu ndi zikhalidwe zamadzimadzi zoyesera mabakiteriya kuphatikiza mitundu yama clostridial.
• Chikhalidwe chamagazi kudziwa mabakiteriya omwe akuyambitsa matendawa.
• Mafuta a gramu amadzimadzi ochokera m'deralo.
• X-ray, CT scan, kapena MRI ya malowa atha kuwonetsa mpweya m'matumba.

Kuchita opaleshoni kumafunika mwachangu kuti muchotse minofu yakufa, yowonongeka, komanso yomwe ili ndi kachilombo.

Kuchotsa opaleshoni (kudula) mkono kapena mwendo kungafunike kuti muchepetse kufalikira kwa matenda. Kudulidwa nthawi zina kumayenera kuchitika mayeso onse asanapezeke.

Maantibayotiki amaperekedwanso. Mankhwalawa amaperekedwa kudzera mumitsempha (kudzera m'mitsempha). Mankhwala azopweteka amathanso kulembedwa.

Nthawi zina, chithandizo cha hyperbaric oxygen chitha kuyesedwa.

Chotupa cha gasi chimayamba mwadzidzidzi ndipo chimayamba kukulira. Nthawi zambiri imapha.

Zovuta zomwe zingakhalepo ndi izi:

• Coma
• Delirium
• Kuwononga kapena kulepheretsa kuwonongeka kosatha kwa minofu
• Jaundice ndi kuwonongeka kwa chiwindi
• Impso kulephera
• Chodabwitsa
• Kufalikira kwa matenda kudzera mthupi (sepsis)
• Wopusa
• Imfa

Izi ndizadzidzidzi zomwe zimafunikira chithandizo chamankhwala mwachangu.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo zatenda kuzungulira khungu. Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911), ngati muli ndi zizindikilo zakupha kwa mpweya.

Sambani khungu lililonse. Onetsetsani zizindikiro za matenda (monga kufiira, kupweteka, ngalande, kapena kutupa mozungulira bala). Onani wothandizira wanu ngati izi zichitika.

Matenda a minofu - clostridial; Chigawenga - mpweya; Myonecrosis; Clostridial matenda a zimakhala; Necrotizing matenda ofewa

• Chiwindi cha mpweya
• Chotupa cha mpweya
• Mabakiteriya

Henry S, Cain C. Gesi yovulala kumapeto. Mu: Cameron AM, Cameron JL, olemba., Eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 13. Philadelphia, PA: Elsevier; 2020: 862-866.

Onderdonk AB, Garrett WS. Matenda omwe amabwera chifukwa cha clostridium. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 246.