Rhabdomyolysis: ukuthi kuyini, kubangela, izimpawu, ukwelapha lesi sifo

Imiphumela ukubheduka ezicutshini izicubu kahle kwaziwe abantu babandakanywe ku lezemidlalo. Labo abamukela umsebenzi njalo futhi isithombe izinzuzo zabo kanye nezingozi ujwayelene welithi "rhabdomyolysis". Izimpawu zalesi sifo kuyingozi kakhulu. Naphezu netyazholoe ngoba zokugula kungaholela kokubhekana nemiphumela ebuhlungu ngoba umzimba. Rhabdomyolysis - kuyini? Ukuze siphendule lo mbuzo odokotela akufanele kuphela, kodwa yimuphi umqeqeshi afanelekayo ngamunye kwezemidlalo. I zokugula isigaba kuyingozi kakhulu futhi ezinzima kungaholela ekufeni. Nokho, uma kutholwa ngesikhathi, mhlawumbe ikhambi eliphelele.

Izifo rhabdomyolysis - kuyini?

Lokhu zokugula is kaningi ebonwe ukulimala kwemisipha. Luhilela ukubhujiswa kwezicubu futhi aphume izinto eziyingozi egazini. Ngakho ungakwazi ukuchaza kafushane okushiwo syndrome ngokuthi rhabdomyolysis. Ukuthi kuyini, kuyokhanya ngaphezulu uma utadisha inqubo yentuthuko lesi sifo futhi imiphumela yalo ukuze umzimba. Khumbula ukuthi akuwona wonke ukulimala noma umsebenzi ngokomzimba kuholela sifo. Rhabdomyolysis - a syndrome lapho kukhona nokucekelwa phansi izicubu kwemisipha. Ngenxa ukubhujiswa imisipha lwamathambo e igazi lingena into evamile akufanele kube khona. Lokhu - the myoglobin amaprotheni. He is iyisici esibalulekile ngoba imisipha. Iziso evamile is inactivated futhi akusho ukulimaza umzimba. Kodwa imisipha nokucekelwa nokubuna lemali egazini ifinyelela emakamu eliphezulu. Ngenxa yalokho, ukhiphela myoglobin eside ngomzimba, ukukhulula nephrotoxic radicals khulula. Lezi izinto ziyingozi kakhulu ukuba izicubu tubules kwezinso. Kulesi sisekelo, kungenzeka ukuba uphendule umbuzo othi: "? Rhabdomyolysis - kuyini nokuthi kuyingozi" Ngaphezu ukubhujiswa imisipha, yilesi sifo kungaholela isimo esinjalo sina njengoba ukwehluleka oyingozi kwezinso. Lapho usizo kungakabi yisikhathi enikeziwe arrester abangela ukufa.

Rhabdomyolysis: Izimbangela isifo

Kukhona 2 amaqembu izimbangela eziholela ukuthuthukiswa rhabdomyolysis. Esimweni sokuqala - kuba ukulimala kwemisipha lwamathambo. Abanaso zihlanganisa imiphumela ezincane imisipha (nemihuzuko). Phakathi izici elimazayo ahlukanisa

1. Heavy traffic yengozi.
2. Elikhulu endaweni ukusha nokujula (ukufinyelela ungqimba kwemisipha).
3. Imiphumela kagesi emzimbeni.
4. izenzo zobudlova eziholela imisipha ukulimala.
5. Toxicosis kubangelwa ukushaqeka esibuhlungu.
6. Yesikhathi eside ukungenelela kuhlinzwa.

Enye imbangela rhabdomyolysis kukhona ukusikwa namandla kwemisipha izicubu. Lezi kungabangela ukucindezeleka ngokomzimba okukhulu (engajwayelekile umzimba), Ukudlikizela.

Ngaphezu kwalokho, kunezinye izici eziholela rhabdomyolysis. Mancane ezivamile, kodwa namanje kungabangela kakhulu ekuthuthukeni kwale egunjini lokuhlolwa kwezifo. Lezi zihlanganisa electrolyte ukungalingani, izifo ezibangelwa amagciwane kanye ezibangelwa amagciwane, kanye izidakamizwa ukudakwa. Zonke lezi zici neqhaza yokungabi ATP. Kuyaziwa ukuthi ukuntula yalolu ketshezi kuthinta ukuthuthukiswa rhabdomyolysis. Inani elincane ATP kubangela ukwehla emzimbeni electrolyte. Lezi zihlanganisa izinto ezifana ne-calcium, phosphate kanye potassium. Ububi lezi izinto is nasemkhakheni hypothermia ezishisayo kanye ukuguliswa yilanga,. Kwezinye izimo, lapho kubhujiswa kwemisipha izicubu okuholela ukuhlala komuntu isikhathi eside kulesi sikhundla lisalele - immobilization.

Lo mshini rhabdomyolysis

I pathogenesis ka rhabdomyolysis lapho kuxhomeke kulokho okubangelwa imbangela ukubhujiswa imisipha lwamathambo. Uma imisipha abalinyazwe imiphumela ebuhlungu noma iziyaluyalu umzimba, bese kukhona ukuvuvukala amaseli. Lokhu kwenzeka ngenxa ingress uketshezi imvelo ku ulwelwesi of myocytes. Ngenxa yalokhu kuhlukumeza kwamaseli bandisa futhi babe ezinkudlwana. myocytes Altered siqhubeke enyameni ezungezile kanye nezinzwa. Ngakho, ukugeleza kwegazi ukuze amaseli kwemisipha enempilo iphazamisekile, eziyoholela ekubhujisweni kwabo. Ngenxa nokwehliswa kwesithunzi lwamathambo imisipha amaprotheni ukukhululwa kwenzeka - myoglobin. Ngokuvamile, ketshezi akuyona enobuthi emzimbeni. Noma kunjalo, amaprotheni kungabangela umsebenzi kwezinso. Lokhu kwenzeka ngale ndlela: myoglobin sibopha nge into ekhona kumaseli kwezinso. Le ngxube kuholela ekwakhekeni okuqinile Ukuvimba ukugeleza kwegazi. Ngaphezu kwalokho, myoglobin kunemiphumela nephrotoxic.

izimpawu Clinical yesifo

Ukwabela izimpawu esindayo futhi ukukhanya rhabdomyolysis. Esimweni sokuqala ukubhujiswa imisipha syndrome kuhlangene esingamahlalakhona kwezinso. Rabdomioz omnene ukwehluleka oyingozi kwezinso akuyona sisindwa. I ukubonakaliswa basemtholampilo isifo zihlanganisa:

1. Ubuthakathaka bemisipha.
2. Dark umchamo umbala. Lesi sici kubonisa umsebenzi izinso kuyinto umbandela inkinga rhabdomyolysis.
3. Ukuvuvukala nesisa we imisipha yohlaka.

Lapho ukubusa, isimo kwezinso ukwehluleka lesiguli liwohloka. Izimpawu ukwehluleka oyingozi kwezinso zihlanganisa:

1. esitho edema.
2. Okuphansi umchamo okukhipha, kuze ukungezwakali kwawo.
3. syndrome Gumbi. Kuyinto ngenxa kwemisipha izicubu ukuvuvukala. Kungaholela kokucindezelwa kwezitho ezibalulekile. Izimpawu ngamandla kwalesi sifo yilezi: iphika, kunciphisa umfutho wegazi, ukushaqeka.
4. Tachycardia, kamuva - ishayela thready.
5. Electrolyte ukungalingani.
6. Coma.

zindlela sokuxilonga ukuze rhabdomyolysis

isifo Suspect kungenziwa okusekelwe: uhlukunyezwe wahlupheka nezicubu imisipha, imisipha soreness, nokuvuvukala, umchamo ukuhwalala. Lezi izimpawu ukuvumela ukuxilongwa kwangaphambilini "rhabdomyolysis". Lesi sifo ngaso sonke isikhathi sihambisana izinguquko egazi noma omchamo. Imiphumela yaloku kuhlola okungenhla kuqinisekisiwe uma ukwephulwa elandelayo zikhonjwe izifundo laboratory:

1. Amazinga aphakeme creatine kinase.
2. Ukubukeka myoglobin egazini.
3. phosphorus kanye potassium Ukwandiswa amazinga, encishisiwe calcium ion.
4. With ukuthuthukiswa ukwehluleka kwezinso - semali creatinine kanye urea.
5. Myoglobinuria (iphrotheni umchamo).

Ngaphezu kwalokho, izinguquko kuyagcinwa ku-electrocardiogram (isandiso ventricular izakhiwo, okuvela kuyo T-amagagasi). Ngo kokucindezelwa okuphawulekayo lesi sifo kungase kube ukulimala kwezitho ezingaphakathi, amathambo. Ngakho-ke, ukuze kuhlonzwe izifo kuyadingeka ukuze ukuqhuba-X-ray.

Izindlela kokuphatha rhabdomyolysis

Siza ogulayo ukuba aqale ukunikeza ngokushesha, ngokushesha nje lapho kwatholakala "rhabdomyolysis". ukuphathwa isifo kufanele kwenziwe esibhedlela, njengoba esibhedlela ukubeka kungenzeka ukuqapha ezingeni electrolyte. Ukuze ahlanze umzimba labetibambile rehydration. Endabeni ka ezinzima rhabdomyolysis kwakudingeka uketshezi yokwelapha nge nosawoti. Lokunye lokubaluleke kakhulu ukulungiswa yamanzi-usawoti kanye electrolyte umzimba. isisu "Furosemide" sivela ngenxa ukuzinza of diuresis noma "Mannitol". Ezimweni ezinzima kakhulu, hemodialysis isetshenziswa. Uma imisipha ingcindezi ifinyelela 30 mm. HG. . Art, Udinga excision kuhlinzwa kwezicubu - fasciotomy. Okuwukuphela kwendlela aqede zlib okwengeziwe yemizimba.

yezinkinga olungenzeka isifo

You azi ukuthi isikhathi ukusiza isifo omnene uzoyeka rhabdomyolysis. iziguli Photo ngedatha syndrome, ngobuningi emakhasini efanele ulwazi izinsiza ngezihloko yezokwelapha. Ukuze ukwazi ukubheka kanjani imisipha ethintekile kubaluleke kakhulu abantu behileleka okhandlayo esindayo. Endabeni rhabdomyolysis esolwa idingekile ukuze ukuhlolwa laboratory wegazi kanye nomchamo. Uma lesi sifo isungule ngokwezinga elithile sina, kuyingozi ukuba nezinkinga ezilandelayo:

1. Ukulimala kwezitho nezicubu. Kwenzeka ngenxa gumbi syndrome.
2. Ukwehluleka oyingozi kwezinso.
3. DIC. Kuyinto ngenxa abampofu igazi ekunqandeni. Ezimweni ezimbi kakhulu, kwayo kamuva kuyizindlela zokufa.

Isibikezelo ziphile rhabdomyolysis

Onalesi sifo kuncike degree of isifo zaba namandla kakhulu. Ngesikhathi sokuqala isifo iyaphendula kahle imithi. Recurrences kuyagcinwa kuphela endabeni kabusha traumatization. Uma zokugula ifinyelele degree sina, onalesi sifo ezingenawo la mathuba. Noma kunjalo, umuntu angalulama nge inhlanganisela yokwelapha izidakamizwa futhi zilekelele kuhlinzwa. Endabeni ukwehluleka oyingozi kwezinso izinga lokufa 20%.