I-Ecchymosis, edume ngokuthi "indawo ensomi" noma "ukulimala," ukulimala okubonakala ngokubonakala kombala onsomi esikhumbeni ngenxa yokuvuza kwegazi lisuka emithanjeni yegazi liye ezicutshini eziseduze. Lesi simo singenzeka ngenxa yokulimala, ukushaywa, ukuwa, ukuhlinzwa, noma ukuphazamiseka kwegazi. Kulesi sihloko, sizoxoxa ngezimpawu, izimbangela, kanye nokwelashwa kwe-ecchymosis, ngenhloso yokuhlinzeka ngolwazi oluwusizo mayelana nendlela yokuphatha lolu hlobo lokulimala.
Yiziphi izimbangela ezingenzeka zokulimaza emzimbeni womuntu?
Imivimbo, edume ngokuthi "amabala ansomi" noma "imihuzuko," izilonda esikhumbeni ezenzeka ngenxa yokuqhekeka kwemithambo emincane yegazi, okuholela ekuvuzeleni kwegazi ezicubu ezingaphansi kwesikhumba. Zingabangelwa izici ezihlukahlukene, njengokuhlukumezeka, ukuphazamiseka kwegazi, kanye nokusetshenziswa kwemithi ye-anticoagulant, phakathi kokunye.
Enye yezimbangela eziyinhloko zokulimala ukuhlukumezeka ngokomzimba, njengokushaywa, ukuwa, noma ukulimala phakathi nemidlalo. Kulezi zimo, imithambo yegazi iyalimala, okuholela ekuhlanganisweni kwegazi endaweni ethintekile bese kuba khona imihuzuko.
Ukwengeza, ukuphazamiseka kokujiyisa kwegazi, njengokushoda kwe-platelet noma i-clotting factor, kungase kubangele ukuba umuntu abe nemihuzuko kalula. Ukuthatha imishanguzo ye-anticoagulant, njenge-warfarin noma i-aspirin, nakho kungandisa ingozi yokulimaza.
Ezinye izimbangela ezingajwayelekile zokulimaza zihlanganisa izifo ezizimele, njenge-idiopathic thrombocytopenic purpura, kanye nokuphazamiseka kofuzo, njenge-Ehlers-Danlos syndrome. Kulezi zimo, kubalulekile ukufuna iseluleko sezokwelapha ukuze uphenye imbangela ewumsuka futhi uqale ukwelashwa okufanele.
Ukwelashwa kuzoncika kumsuka wembangela futhi kungase kuhlanganise izinyathelo ezilula njengokuminyanisa amakhaza, noma ukungenelela okuqondile okufana nokumpontshelwa igazi ezimeni zokuphazamiseka kwamahlule.
Imuphi umuthi engingawusebenzisa ukwelapha imihuzuko namahematoma emzimbeni?
Imivimbo, edume ngokuthi "amabala ansomi," izilonda zesikhumba ezibangelwa ukuvuza kwegazi emithanjeni yegazi. Imihuzuko ngokuvamile iwumphumela wokuhlukumezeka, njengokushaywa noma ukuwa, futhi kungabangela ukungakhululeki nokukhathazeka. Kulesi sihloko, sizoxoxa ngezimpawu, izimbangela, kanye nokwelashwa kokulimaza.
Izimpawu eziyinhloko zokulimala zihlanganisa indawo ensomi noma eluhlaza okwesibhakabhaka esikhumbeni, ukuzwela lapho uthinta, nokuvuvukala endaweni ethintekile. Imihuzuko ingathatha izinsuku ezimbalwa ukunyamalala ngokuphelele, kodwa kunezinyathelo ezithile ezingasheshisa inqubo yokululama.
Izimbangela ezivame kakhulu zokulimaza ukuhlukumezeka okuqondile esikhumbeni, njengokushaywa, ukuwa, noma ukulimala kwezemidlalo. Ukwengeza, abantu abathatha imithi yokunciphisa igazi banamathuba amaningi okuba nemihuzuko.
Ukwelapha imihuzuko nama-hematomas emzimbeni, kunezinketho ezithile zemithi ezingasiza ukusheshisa ukululama. anti-inflammatories Imithi ye-over-the-counter efana ne-ibuprofen noma i-diclofenac ingasetshenziswa ukunciphisa ukuvuvukala nobuhlungu endaweni ethintekile. Ukwengeza, amaphakethe eqhwa asetshenziswa endaweni elimele angasiza ekunciphiseni ukuvuvukala nobuhlungu.
Kubalulekile ukugcizelela ukuthi ezimeni zokulimaza okungapheli noma ubuhlungu obukhulu, kunconywa ukuthi ufune iseluleko sezokwelapha ukuze uhlole ubucayi bokulimala futhi utuse ukwelashwa okufanele kakhulu. Ezimweni ezimbi kakhulu, izinqubo zezokwelapha zingase zidingeke ukukhipha i-hematoma nokusheshisa ukululama.
Ubude besikhathi sokulimala: yisiphi isikhathi esilinganiselwe sokuphulukiswa okuphelele?
Ubude besikhathi sokulimaza bungahluka kuye ngobukhulu bokulimala kanye nesimo sempilo yesiguli. Ngokuvamile, imihuzuko ethambile ivame ukunyamalala ngaphakathi isonto elilodwa kuya kwamabili, kuyilapho ezibucayi kakhulu zingafinyelela amasonto amathathu ukuphulukisa ngokuphelele.
Kubalulekile ukuqaphela ukuthi iminyaka yesiguli, indawo lapho ukulimala khona, nokwelashwa okufanele nakho kuthonya isikhathi sokuphulukiswa. Kwezinye izimo, kungase kudingeke ukunakekelwa okukhethekile, njengokucindezelwa okubandayo, ukuphumula, nemithi ukuze ululame ngokushesha.
Uma imihuzuko iqhubeka isikhathi eside kunokulindelekile, noma uma kuvela ezinye izimpawu ezihambisanayo, kubalulekile ukubonana nodokotela ukuze ahlolwe futhi aqondiswe ngendlela efanele. Ukuphulukiswa okuphelele kokulimala kubalulekile ukuze ugweme izinkinga futhi uqinisekise impilo yesikhumba.
Izigaba zokulimaza: funda ngezigaba zalesi silonda sesikhumba nge-hematoma.
Ukulimala kuwukulimala kwesikhumba okuvamile okubangelwa ukuvuza kwegazi ezicutshini ezingaphansi kwesikhumba. Okuvame ukwaziwa ngokuthi "amabala ansomi," ukulimala kungenzeka ngemva kokulimala, njengokushaywa noma ukuwa. Ukuze usiqonde kangcono lesi simo, kubalulekile ukuqonda izigaba zaso.
Ngokuvamile, ukulimaza kuhamba ngezigaba ezintathu eziyinhloko: eyokuqala, ephakathi, neyokugcina. Esigabeni sokuqala, indawo ethintekile ngokuvamile ibonakala ibomvu ngenxa yokuba khona kwegazi elisanda kuchithwa. Ngokuhamba kwesikhathi, ukulimaza kuqhubekela esigabeni esimaphakathi, lapho umbala onsomi noma oluhlaza okwesibhakabhaka uba sobala kakhulu. Ekugcineni, esigabeni sokugcina, ukulimaza kuthola umbala ohlaza okwesibhakabhaka noma ophuzi, okubonisa ukumuncwa kabusha kwegazi elingaphezulu.
Kubalulekile ukuqaphela ukuthi ukulimaza kungabangela ukungakhululeki nobuhlungu endaweni ethintekile, futhi kungaba uphawu oluyisixwayiso lokulimala okubi kakhulu. Ngakho-ke, kubalulekile ukubonana nodokotela uma imihuzuko ingathuthuki ngokuhamba kwesikhathi noma uma ihambisana nezinye izimpawu, njengokuvuvukala noma ubunzima bokunyakaza.
Ukwelapha imihuzuko ngokuvamile kuhilela izinyathelo ezilula, ezifana nokucindezelwa okubandayo nokuphakamisa indawo ethintekile. Ezimweni ezimbi kakhulu, ukungenelela kwezokwelapha kungase kudingeke ukukhipha i-hematoma. Kuzo zonke izimo, kubalulekile ukulandela imiyalelo yochwepheshe bezempilo ukuze uqinisekise ukululama okufanele futhi uvimbele izinkinga.
I-Bruise: Izimpawu, Izimbangela, Nokwelashwa
A inxeba Umbala we-violet isikhumba esithathayo ngenxa yokukhishwa kwegazi emithanjeni yegazi kuya esiculweni se-interstitial. Kuyaziwa ngokuthi "i-bruise," "purpura," noma "black," kubhekisela embala indawo ethathayo lapho ukulimala kuvela.
Ngaphezu kwesifo, i-ecchymosis iwuphawu lomtholampilo olubonisa ukuthi imithambo yegazi emincane ilimele, okuvumela igazi ukuba ligeleze lisuka esikhaleni se-intravascular lingene esicutshini se-interstitial.
Imivimbo ivamise ukuhlotshaniswa nokuhlukumezeka, nakuba ingase yenzeke ngokuzenzakalelayo, ikakhulukazi ezigulini ezithatha ama-anticoagulants.
i-pathophysiology
I-pathophysiology ngemuva kwe-ecchymosis ilula ngempela. Ngemuva kokuhlukumezeka, imithambo yegazi emincane (ama-capillaries e-arterial kanye ne-venous, ama-arterioles, nama-venous) iqhuma ngokuphelele noma ingxenye endaweni yokulimala, okuvumela igazi ukuthi ligeleze lisuka endaweni ye-intravascular kuya endaweni ye-interstitial.
Kuyinqubo yokuzibekela umkhawulo, njengoba kungathathi isikhathi eside ukuthi izindlela ezijwayelekile ze-hemostasis zilawule isimo; Nokho, igazi elishiye imithambo yegazi lihlala endaweni ephakathi nendawo, okuholela ecchymosis.
Ku-ecchymosis, igazi "lingena" izicubu zeselula ezingaphansi kwesikhumba, zakha lokho okungachazwa ngokuthi "izingqimba", okungukuthi, izicubu ezinempilo zishintshana ngegazi elingaphezulu ngendlela engahlelekile.
Ukuvela kombala wokulimala
Esinye sezici ezigqama kakhulu zokulimaza yizinguquko zemibala ehlukene isikhumba esibhekana nazo phakathi nokuvela kwaso.
Nakuba igazi libomvu, lo mbala uyadlula futhi awuthathi isikhathi eside ukufiphala, udedela isici esinsomi. Lokhu kwenzeka ngoba uma i-hemoglobin esegazini ilahlekelwa umoya-mpilo (okwenzeka ngokushesha kakhulu egazini eligcwele ngokweqile), ishintsha isuke ekubenibomvu ngokugqamile ibebomvu kakhulu.
Ngobuningi, igazi elingenayo umoya-mpilo libonakala linsomi esikhumbeni.
Njengoba isikhathi sihamba futhi inxeba liyaphola, umbala uyaqhubeka nokushintsha. Lokhu kwenzeka ngoba umzimba uqala ukudiliza i-hemoglobin egazini elingaphezulu, uyiguqule ibe yimibala ehlukahlukene.
Ngakho, ezinsukwini ezimbalwa ngemva kokuvela kokulimala, umbala uyashintsha usuka onsomi ube luhlaza okwesibhakabhaka; lokhu kwenzeka ngoba iqembu le-heme le-hemoglobin liguqulwa libe i-pigment eyaziwa ngokuthi i-biliverdin.
Kamuva, i-biliverdin iguqulwa ibe yi-bilirubin, okwenza indawo ibe nombala ophuzi. Ekugcineni, i-bilirubin ihlukaniswa ibe i-hemosiderin, enikeza isikhumba endaweni ethintekile umbala onsundu ngokukhanyayo.
Ekugcineni, i-hemosiderin ikhishwa esicutshini ngama-macrophages, ngaleso sikhathi isikhumba sibuyela embala waso ovamile.
Umehluko phakathi kwe-ecchymosis ne-hematoma
I-Ecchymosis ivame ukudideka nokulimaza, njengoba kuzo zombili izimo isikhumba sithatha i-violet hue; ngisho neminye imihuzuko ingahlotshaniswa ne-ecchymosis, kodwa lezi izikhungo ezimbili zomtholampilo ezihlukene.
Ku-hematomas, igazi liqoqa endaweni echazwe kahle, lenza uhlobo "lwesikhwama," olungenakuhlukaniswa ngokucacile nezicubu ezizungezile, kodwa lungaphinde lukhishwe ngokubhoboza.
Ngaphezu kwalokho, umthamo wegazi okhona ku-hematomas mkhulu kakhulu kune-ecchymosis, njengoba iyingxenye yokulimala emithanjeni emikhulu; ngenxa yalesi sizathu esifanayo, ama-hematomas avame ukutholakala ezindizeni ezijulile kune-ecchymosis.
Isizathu sokuthi kungani okunye ukulimala (ikakhulukazi okukhulu) kuhlotshaniswa nokulimaza ukuthi elinye legazi eliqukethwe "esakeni" elikhawulela ukuvuza kokulimala (ngenxa yokucindezela) ezicutshini ezizungezile, lingene ngokuhlukana.
Ngokuvamile, i-eczymosis ivame ukwenzeka ezindaweni ezicindezelekile kakhulu, ngoba igazi livame ukuncipha ngenxa yesisindo salo, okusho ukuthi indawo ye-eczyotic ihlanganisa indawo yokuhlukumezeka kanye nesandiso esingaphezu kwayo, ngokuqondile Ngokuya ezindaweni ezicindezelekile.
Izimpawu
Ukuzilimaza kuwuphawu, oluvame ukuhlotshaniswa nobuhlungu nokuvuvukala kwendawo ethintekile, ikakhulukazi ezimeni zokuhlukumezeka.
Kwezinye iziguli ezine-ecchymosis ezenzakalelayo ngenxa yokwelashwa kwe-anticoagulant noma izifo ezizimele, ubuhlungu nokuvuvukala kungase kungabibikho noma kube kuncane.
Ngokuya ngobunzima bokuhlukumezeka, kungase kube nokwanda kwezinga lokushisa endaweni ethintekile, kanye nobuhlungu nokuvuvukala (ukwanda kwendawo ngevolumu), nakuba lokhu ngokuvamile akubalulekile futhi akuhlali isikhathi eside.
Izimbangela
Isizathu esiyinhloko sokulimala ukuhlukumezeka okuphakathi, okungukuthi, ukuhlukumezeka okungalimaza imikhumbi emincane esikhumbeni kanye nezicubu ezingaphansi kwesikhumba ngaphandle kokuphazamisa imikhumbi emikhulu.
Ngokufanayo, i-ecchymosis ingenzeka ezigulini ezinokuphuka kwamathambo amade, izinyembezi zemisipha, ngisho nokuphuka kwe-tendon ne-ligament. Kulezi zimo, igazi ligeleza lisuka ezakhiweni ezilimele liye esicutsheni esingaphansi kwesikhumba, lingene ngaphandle kokuqoqwa (njengoba lingase likhiqize i-hematoma).
Ezigulini ezihlinzwa, i-postoperative ecchymosis ingase futhi yenzeke ngenxa yokulimala kwemikhumbi emincane endaweni yokusikeka, ukuphatha okungalungile kwezicubu, noma isigaba samathambo, njengoba kwenzeka ku-orbital, nasal, nokunye ukuhlinzwa kwamazinyo. Esimweni sokugcina, i-ecchymosis ivela ku-mucosa yomlomo kunesikhumba.
Okokugcina, kungenzeka ukuthi imihuzuko ezenzakalelayo yenzeke ezigulini ezinokuphazamiseka kwe-coagulation, noma ngenxa yokusetshenziswa kwemithi ye-anticoagulant (i-warfarin, i-heparin, njll.) noma ngenxa yezimo zezokwelapha eziphazamisa ukuhlangana (i-purpura, i-hemophilia, njll.).
Kulezi zimo, isiguli ngokuvamile asibiki noma yikuphi ukuhlukunyezwa kodwa nokho kukhona ukulimaza, ngoba amandla adingekayo ukulimaza imikhumbi aphansi kakhulu; ngakho-ke, ukukhwehlela, ukuthimula, noma nje izingubo eziqinile zanele ukulimaza izitsha futhi kubangele ukulimaza "ngokuzenzakalelayo."
Ukwelashwa
Ngokuvamile, akukho ukwelashwa okuqondile okudingekayo ukuze kukhishwe ukulimala; ezimweni eziningi, ukusebenzisa amakhaza wendawo (iphakethe leqhwa, amaphakethe eqhwa) kwanele ukukhulula izimpawu, kuhlanganiswe ezimweni ezinzima kakhulu nama-analgesics athambile njenge-acetaminophen.
Abanye ochwepheshe bezokwelapha bayeluleka ukusetshenziswa kwamafutha e-heparinoid ukusheshisa ukuxazulula ukulimaza, noma kunjalo, azikho izifundo zesayensi ezibonisa ukuthi leli su lokwelapha liyasebenza.
Okubalulekile ukulungisa imbangela ezimweni zokulimaza okuzenzakalelayo noma nini lapho kunokwenzeka.
Ezimeni ze-anticoagulation, lokhu kuhilela ukulungisa imithamo yama-anticoagulants ukuze isiguli sibe ngaphakathi kwebanga le-anticoagulation, kodwa ngaphandle kwengozi yokopha, kuyilapho ezifweni ezibangelwa ukukhubazeka kokuhlangana, kufanele kuthathwe izinyathelo ezifanele zokwelapha ukuze kuvinjelwe izinkinga zokopha.
Izinkomba
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- Vachharajani, A., & Paes, B. (2001). Ukuphuka kwesibindi okuzenzakalelayo okuveza njenge-scrotal hematoma.Iphephabhuku laseMelika le-perinatology , 18 (03), i-147-150.
- Thomson, J. A. (1977). I-Hematomas ku-thyrotoxicosis.I-British Medical Journal , 2 (6093), i-1027.
- Braun, E. H., & Stollar, D. B. (1960). I-hemophilia ezenzakalelayo kowesifazane.I-Thrombosis kanye ne-Hemostasis , 4 (01), i-369-375.
- Qiu-nian, S. (1988). Ukuhlaziywa kwe-Pathological of cotusions yezicubu ezithambile ezisabalele.Jo