Rhabdomyolysis

Rhabdomyolysis ke ho senyeha ha lisele tsa mesifa tse lebisang ho lokolloeng ha mesifa ea fiber e kenang maling. Lintho tsena li kotsi liphio 'me hangata li baka tšenyo ea liphio.

Ha mesifa e senyehile, protheine e bitsoang myoglobin e tsoa maling. E ntan'o sefa ka 'mele ke liphio. Myoglobin e fetoha lintho tse ka senyang lisele tsa liphio.

Rhabdomyolysis e ka bakoa ke kotsi kapa boemo bofe kapa bofe bo senyang mesifa ea masapo.

Mathata a ka lebisang ho lefu lena a kenyelletsa:

• Trauma kapa likotsi tse sithabetseng
• Ts'ebeliso ea lithethefatsi tse kang cocaine, amphetamines, statins, heroin kapa PCP
• Maloetse a liphatsa tsa lefutso
• Mocheso o feteletseng oa 'mele
• Ischemia kapa lefu la lisele tsa mesifa
• Maemo a tlase a phosphate
• Ho tsieleha kapa ho thothomela ha mesifa
• Ho ikitlaetsa ka matla, joalo ka marathone ho matha kapa calisthenics
• Mekhoa e mengata ea ho buoa
• Ho felloa ke metsi 'meleng haholo

Matšoao a ka kenyelletsa:

• Moroto o lefifi, o mofubelu kapa oa 'mala oa cola
• Ho fokotsa tlhahiso ea moroto
• Bofokoli bo akaretsang
• Ho thatafala ha mesifa kapa ho opeloa (myalgia)
• Bonolo ba mesifa
• Bofokoli ba mesifa e amehileng

Matšoao a mang a ka hlahang ka lefu lena:

• Mokhathala
• Bohloko bo kopaneng
• Ho oa
• Boima ba 'mele (e seng ka boomo)

Tlhahlobo ea 'mele e tla bontša mesifa e bonolo kapa e senyehileng.

Liteko tse latelang li ka etsoa:

• Sebaka sa Creatine kinase (CK)
• Khalase ea serum
• Serum myoglobin
• Potassium ea seramu
• Ho hlahloba urinal
• Teko ea myoglobin ea moroto

Lefu lena le ka ama liphetho tsa liteko tse latelang:

• CK isoenzymes
• Serum creatinine
• Creatinine ea moroto

O tla hloka ho fumana maro a nang le bicarbonate ho thusa ho thibela tšenyo ea liphio. U kanna ua hloka ho fumana maro ka mothapo (IV). Batho ba bang ba ka hloka dialysis ea liphio.

Mofani oa hao oa tlhokomelo ea bophelo a ka u fa litlhare ho kenyelletsa diuretics le bicarbonate (haeba ho na le moroto o lekaneng).

Hyperkalemia le maemo a tlase a calcium ea mali (hypocalcemia) a lokela ho phekoloa hanghang. Ho hloleha ha liphio le hona ho lokela ho phekoloa.

Sephetho se latela bongata ba tšenyo ea liphio. Ho hloleha ho matla ha liphio ho etsahala ho batho ba bangata. Ho fumana kalafo haufinyane kamora rhabdomyolysis ho tla fokotsa kotsi ea tšenyo e sa feleng ea liphio.

Batho ba nang le linyeoe tse bobebe ba ka khutlela mesebetsing ea bona e tloaelehileng nakong ea libeke tse 'maloa ho isa khoeling. Leha ho le joalo, batho ba bang ba ntse ba na le mathata a mokhathala le bohloko ba mesifa.

Mathata a ka kenyelletsa:

• Necrosis e bohloko ea tubula
• Ho hloleha ho matla ha renal
• Ho se leka-lekane ha lik'hemik'hale tse kotsi maling
• Makala (khatello e tlase ea mali)

Bitsa mofani oa hau haeba u na le matšoao a rhabdomyolysis.

Rhabdomyolysis e ka qojoa ke:

• Ho noa maro a mangata ka mor'a ho ikoetlisa ka thata.
• Ho tlosa liaparo tse eketsehileng le ho qoelisa 'mele ka metsing a batang haeba ho ka ba le mocheso.

• Anatomy ea liphio

Haseley L, Jefferson JA. Pathophysiology le etiology ea kotsi e mpe ea liphio. Ho: Feehally J, Floege J, Tonelli M, Johnson RJ, bangoli. Kakaretso ea Nephrology ea Kliniki. La 6th. Philadelphia, PA: Elsevier; 2019: khaolo ea 66.

O'Connor FG, Deuster PA. Rhabdomyolysis. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 105.

Parekh R. Rhabdomyolysis. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 119.