Necrotizing matenda ofewa

Matenda opatsirana ochepetsa matendawa ndi achilendo koma ndi owopsa kwambiri. Ikhoza kuwononga minofu, khungu, ndi minofu yoyambira. Mawu oti "necrotizing" amatanthauza chinthu chomwe chimapangitsa kuti thupi lifa.

Mitundu yambiri yamabakiteriya imatha kuyambitsa matendawa. Matenda owopsa kwambiri omwe nthawi zambiri amakhala owopsa chifukwa cha mabakiteriya Streptococcus pyogenes, yomwe nthawi zina amatchedwa "mabakiteriya odyetsa mnofu" kapena strep.

Matenda opatsirana otsekemera amakula mabakiteriya akamalowa m'thupi, nthawi zambiri kudzera pakucheka pang'ono. Mabakiteriya amayamba kukula ndikutulutsa zinthu zovulaza (poizoni) zomwe zimapha minyewa ndipo zimakhudza magazi kupita kuderalo. Ndikudya kanyama, mabakiteriya amapanganso mankhwala omwe amalepheretsa thupi kuyankha chamoyo. Minofu ikamwalira, mabakiteriya amalowa m'magazi ndipo amafalikira thupi lonse.

Zizindikiro zimaphatikizapo:

• Khungu laling'ono, lofiira, lopweteka kapena chotupa pakhungu lomwe limafalikira
• Dera longa zovulaza limakula ndikukula mofulumira, nthawi zina osakwana ola limodzi
• Pakatikati pamakhala mdima komanso dusky kenako nkukhala wakuda ndipo minofu imamwalira
• Khungu limatha kutseguka ndikutuluka madzi

Zizindikiro zina zitha kuphatikiza:

• Kumva kudwala
• Malungo
• Kutuluka thukuta
• Kuzizira
• Nseru
• Chizungulire
• Kufooka
• Chodabwitsa

Wothandizira zaumoyo amatha kuzindikira vutoli poyang'ana khungu lanu. Kapenanso, vutoli limatha kupezeka kuchipatala ndi dotolo.

Mayeso omwe angachitike ndi awa:

• Ultrasound
• X-ray kapena CT scan
• Kuyesa magazi
• Chikhalidwe cha magazi kuti chifufuze mabakiteriya
• Matenda a khungu kuti awone ngati mafinya alipo
  
• Ziphuphu zakhungu ndi chikhalidwe

Chithandizo chimafunikira nthawi yomweyo kuti tipewe imfa. Muyenera kuti mukhale mchipatala. Chithandizo chimaphatikizapo:

• Maantibayotiki amphamvu amaperekedwa kudzera mumtsempha (IV)
• Kuchita opaleshoni kukhetsa zilondazo ndikuchotsa minofu yakufa
• Mankhwala apadera otchedwa donor immunoglobulins (ma antibodies) othandiza kulimbana ndi matenda nthawi zina

Mankhwala ena atha kukhala:

• Ankalumikiza khungu pakatha kachilomboka kutha kuti khungu lanu lizichira ndikuwoneka bwino
• Kudula ngati matendawa afalikira kudzera m'manja kapena mwendo
• Mazana zana a oksijeni kuthamanga kwambiri (hyperbaric oxygen therapy) yamitundu ina yamatenda a bakiteriya

Mumachita bwino bwanji zimadalira:

• Thanzi lanu lonse (makamaka ngati muli ndi matenda ashuga)
• Mwapezeka bwanji mwachangu komanso mwachangu momwe mumalandirira chithandizo
• Mtundu wa mabakiteriya omwe amayambitsa matendawa
• Matendawa amafalikira mwachangu
• Momwe mankhwala amathandizira

Matendawa amayambitsa zipsera komanso khungu.

Imfa imatha kuchitika mwachangu popanda chithandizo choyenera.

Zovuta zomwe zingachitike chifukwa cha izi ndi monga:

• Matendawa amafalikira mthupi lonse, ndikupangitsa matenda amwazi (sepsis), omwe amatha kupha
• Scarring ndi mawonekedwe
• Kutaya mphamvu yanu yogwiritsa ntchito mkono kapena mwendo
• Imfa

Vutoli ndilolimba ndipo litha kupha moyo. Lumikizanani ndi omwe amakupatsani nthawi yomweyo ngati zizindikiro za matendawa zimachitika povulala pakhungu, kuphatikizapo:

• Kukhetsa mafinya kapena magazi
• Malungo
• Ululu
• Kufiira
• Kutupa

Nthawi zonse yeretsani khungu bwinobwino mukadulidwa, kuduladula, kapena kuvulala pakhungu lina.

Necrotizing fasciitis; Fasciitis - necrotizing; Tizilombo toyambitsa matenda; Zofewa minofu chilonda; Maphokoso - minofu yofewa

Abbas M, Uçkay I, Ferry T, Hakko E, Pittet D. Matenda opatsirana kwambiri. Mu: Bersten AD, Handy JM, eds. Buku Lopatsa Chidwi la Oh. 8th ed. Philadelphia, PA: Elsevier; 2019: chap 72.

Fitzpatrick JE, High WA, Kyle WL. Matenda akhungu ndi zilonda zam'mimba. Mu: Fitzpatrick JE, High WA, Kyle WL, olemba., Eds. Dermatology Yosamalira Mwachangu: Kuzindikira Kwazizindikiro. Philadelphia, PA: Elsevier; 2018: mutu 14.

Pasternack MS, Swartz MN (Adasankhidwa) Cellulitis, necrotizing fasciitis, ndi matenda opatsirana amkati. 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 Saunders; 2020: chap 93.

Stevens DL, Bisno AL, Chambers HF, ndi al. Tsatirani malangizo pofufuza ndikuwunika matenda opatsirana pakhungu ndi zofewa: Kusinthidwa kwa 2014 ndi Infectious Diseases Society of America [kukonzanso kofalitsidwa kumapezeka mu Clin Infect Dis. 2015; 60 (9): 1448. Cholakwika cha mlingo pamutu wazolemba]. Clin Infect Dis. 2014; 59 (2): e10-e52. PMID: 24973422 pubed.ncbi.nlm.nih.gov/24973422. (Adasankhidwa)