Pahu kinoea

ʻO ke kinoea kikrrene kahi ʻano make paha o ka make o nāʻiʻo (gangrene).

Hoʻokumu pinepine ʻia ka gangrene gas e nā bacteria i kapa ʻia ʻO nā perfringens Clostridium. Hiki iā ia ke kumu ʻia e ka hui A streptococcus, ʻO Staphylococcus aureus, a ʻO Vibrio vulnificus.

Loaʻa ʻo Clostridium ma kahi o nā wahi āpau. Ke ulu nei nā bacteria i loko o ke kino, hana ia i ke kinoea a me nā mea ʻino (toxins) i hiki ke hōʻino i nā kino o ke kino, nā hunaola, a me nā kīʻaha koko.

Hoʻomohala koke ka ʻōpala gangrene. Hana ʻia ia ma ke kahua o ka trauma a i ʻole kahi ʻoki ʻoki ʻana. I kekahi mau hihia, hana ʻia me ka hanana ʻole o ka hanana hoʻonāukiuki. ʻO ka poʻe e makaʻu nui nei i ka gangrene gas i loaʻa pinepine i ka maʻi o ke kīʻaha koko (atherosclerosis, a i ʻole ka paʻakikī ʻana o nā aʻa), diabetes, a i ʻole ka maʻi ʻaʻai kolone.

ʻO ke kumu lāʻau ʻōpala ke kumu o ka pehu ʻeha loa. Huli ʻia ka ʻili i ʻulaʻula. Ke kaomi ʻia ka wahi pehu, hiki ke ʻike ʻia ke kinoea (a i kekahi manawa lohe ʻia) ma ke ʻano he sensible (crepitus). Ulu koke nā kihi o ka wahi i loaʻa i ʻike ʻia i hiki ke ʻike ʻia nā loli ma mua o nā minuke. E luku loa ʻia paha ia wahi.

ʻO nā hōʻailona me:

• Ka ea ma lalo o ka ʻili (subcutaneous empysema)
• Hoʻopiha nā pāhū i ka wai ʻulaʻula-ʻulaʻula
• Kahe mai nāʻaʻaʻa, pilau-ʻaʻala a ʻulaʻula a me ke kahe koko (hoʻokuʻu maoli ʻia)
• Hoʻonui i ka helu o ka puʻuwai (tachycardia)
• Kaha i ke kunu kiʻekiʻe
• Lawe i ka ʻehaʻeha a puni kahi ʻeha o ka ʻili
• ʻO kaʻili o kaʻili pale, ma hope lilo i dusky a hoʻololi i ʻulaʻula a i poni
• ʻO ka pehu ʻana e mānoanoa a puni kahi ʻeha o ka ʻili
• Hoʻoulu
• ʻO ka hoʻokumu ʻana o Vesicle, e hui pū ana i loko o nā pā nui
• Waihoʻoluʻu melemele i ka ʻili (jaundice)

Inā mālama ʻole ʻia ke ʻano, hiki i ke kanaka ke hele i ka pīhoihoi me ka hoʻēmi ʻana o ke koko (hypotension), ka holo ʻana o ka puʻupaʻa, koma, a me ka make loa.

E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia i nā hōʻailona o ka haʻalulu.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• ʻO ka moʻomeheu a me nā moʻomeheu wai e hoʻāʻo no ka bacteria a me nā ʻano clostridial.
• ʻO ka moʻomeheu koko e hoʻoholo i nā bacteria e hōʻeha i ka maʻi.
• Pākuʻi Gram o ka wai mai ka maʻi i loaʻa.
• Hōʻike ka X-ray, CT scan, a i ʻole MRI o ka wahi i ka gas i loko o nā aʻa.

Pono koke ke ʻoki e wehe i nā mea make, ʻino, a me nā maʻi maʻi.

Lawe ka hana ʻoki (amputation) o kahi lima a wāwae paha e kāohi ai i ka hoʻolaha ʻana o ka maʻi. Pono e hana i ka hoʻololi i kekahi manawa ma mua o ka loaʻa ʻana o nā hopena hōʻike.

Hāʻawi ʻia nā antibiotic. Hāʻawi ʻia kēia mau lāʻau i loko o ke aa (intravenously). Kauoha ʻia nā lāʻau ʻeha.

I kekahi mau hihia, e hoʻāʻo ʻia ka mālama ʻana i ka oxygen hyperbaric.

Hoʻomaka hoʻomaka ka ʻōpala gas a hoʻomaka koke i ka ʻino. Make pinepine ia.

Nā pilikia e hopena paha me:

• Koma
• Delirium
• Hoʻopiʻi a hoʻopau ʻole paha i ka hōʻino kūlohelohe mau
• ʻO Jaundice me ka hōʻino o ke ake
• Hewa ʻole nā ​​hakuʻala
• Pāhaʻi
• Ka hohola ʻana o ka maʻi ma o ke kino (sepsis)
• Kāhāhā
• Make

He kūlana pilikia kēia e koi koke ana i ka lāʻau lapaʻau.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā hōʻailona o ka maʻi a puni ka ʻeha o ka ʻili. E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911), inā he ʻōuli kou o ka gas gangrene.

E hoʻomaʻemaʻe pono i nā ʻeha o ka ʻili. Nānā i nā hōʻailona o ka maʻi (e like me ka ʻulaʻula, ʻeha, kahe, a i ʻole ka pehu ʻana a puni kahi ʻeha). E ʻike koke i kāu mea hāʻawi inā kū kēia.

Maʻi ʻaʻai - maʻi lele; Gangrene - ʻenekini; Myonecrosis; Maʻi Clostridial o nāʻaʻaʻa; Necrotizing palupalu maʻi maʻiʻaʻai

• Pahu kinoea
• Pahu kinoea
• ʻO bacteria

ʻO Henry S, ʻo Kainā C. Gas gangrene o ka hope. I: Cameron AM, Cameron JL, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 862-866.

Onderdonk AB, Garrett WS. Nā maʻi i hoʻokumu ʻia e clostridium. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 246.