I-Rhabdomyolysis yigama elivamile elibonisa ukubhujiswa kwezicubu zemisipha. Kunezimbangela eziningi zale rhabdomyolysis, imiphumela yayo ibe mibi kakhulu ngokuya ngomsuka wesifo.

Igama elithi rhabdomyolysis lakhiwa isijobelelo -lyse esisho ukubhujiswa, igama elithi rhabdomyo- elichaza umsipha ohlakazekile wamathambo, okusho ukuthi yonke imisipha yomzimba womuntu ngaphandle kwemisipha yenhliziyo (myocardium) kanye nemisipha ebushelelezi (esetshenzisiwe. ngamakhono emoto angenakuzikhethela njengamakhono okunyakaza kwamathumbu noma imithambo yegazi).

Lapho amangqamuzana emisipha ebhujiswa, ama-molecule amaningi akhululwa egazini. Enye yalezi i-enzyme etholakala kuphela kumaseli emisipha. Kuyi-creatine phosphokinase, okubhekiselwa kuyo kalula nje ngokuthi i-CPK. Le molecule ihlolwa ngokusebenza kwamanje. Lapho umthamo uphakeme, i-rhabdomyolysis iyanda.

Izimbangela ze-rhabdomyolysis zihluke kakhulu. Sizophinda siqalise lapha uhlu olungaphelele lwezimbangela ezivame kakhulu ze-rhabdomyolysis:

Ukuhlukumezeka / ukucindezela

Ukucindezelwa kwesitho, isibonelo i-crush syndrome, lapho umuntu ebhajwa ngaphansi kwemoto noma ngaphansi kwemfucumfucu yokuzamazama komhlaba, kubangela i-rhabdomyolysis evame ukuba nzima.

Ukunganyakazi isikhathi eside kubangela ukucindezelwa kwemisipha okungaholela ku-rhabdomyolysis (ukulahlekelwa ukwazi, ukuhlinzwa isikhathi eside, njll.).

Ukufinyela kwemisipha ngokweqile

• Inkinga yesithuthwane
• Umsebenzi wezemidlalo oweqile (imarathon, i-ultra-trail)

Izifo

• Viral: umkhuhlane
• Amagciwane: i-legionellosis, i-tularemia
• I-Parasitic: umalaleveva, i-trichinellosis

Umkhuhlane omkhulu

• I-Neuroleptic malignant syndrome
• I-Heatstroke
• I-hyperthermia ebulalayo

Toxic

• Utshwala
• cocaine
• Heroin
• Amphetamine

Ukwelapha

• Neuroleptics
• Izitatimende

Zenza ngokuzenzekelayo

• I-Polymyosite
• I-Dermatomyosite

Ufuzo

Kwezinye izimo, umongo usobala, isibonelo ngesikhathi sokuchotshozwa kwesitho noma i-coma ende.

Kwezinye izimo, izimpawu zokubhujiswa kwemisipha kungase kube nzima kakhulu ukuzibona. Ubuhlungu bemisipha bungabandakanya ubuhlungu bohlobo lokuqina noma ubuhlungu bemisipha ku-palpation. Kungase kube ne-muscle edema engaholela ku-compartment syndrome. Ngezinye izikhathi okuwukuphela kwesibonakaliso semisipha umuzwa wobuthakathaka bemisipha.

Kwesinye isikhathi isibonakaliso sikadokotela wukushintsha kombala womchamo. Eqinisweni, i-myoglobin ekhishwa amangqamuzana emisipha inemibala yomchamo ibe bomvu ibe nsundu (kusukela ku-Ice-Tea kuya ku-Coca-Cola).

Ukuxilongwa kwe-rhabdomyolysis kusungulwa ngokuhlolwa kwe-CPK. Sikhuluma nge-rhabdomyolysis uma ama-CPK ephakeme ngokuphindwe kahlanu kunokuvamile.

Inkinga eyinhloko ye-rhabdomyolysis ukwehluleka okukhulu kwezinso. Lokhu ku-multifactorial kodwa siyaqaphela ubuthi be-myoglobin nokunqwabelana kwayo kumashubhu ezinso okuholela ekuvinjweni kokugeleza komchamo. Ukuhluleka kwezinso kungase kuhambisane nezinye izinkinga ze-metabolic kuhlanganise ne-hyperkalemia. I-Hyperkalemia ukwanda kwe-potassium egazini. Le nkinga ingaholela ekufeni uma i-potassium ingabuyiselwa ezingeni elivamile egazini ngokushesha ngangokunokwenzeka. Lokhu ngokuvamile kudinga ukusetshenziswa kwe-dialysis.

Omunye umphumela, esesiwushilo kakade i-compartment syndrome. Ukuqina kwezingxenye zemisipha. Lokhu kubonakaliswa ubuhlungu obukhulu kakhulu kanye ne-edema ebuhlungu yemisipha. I-decompression yokuhlinzwa ebizwa ngokuthi "i-aponeurotomy yokukhipha" kufanele yenziwe ngokushesha ngangokunokwenzeka, uma i-compartment syndrome iqinisekisiwe.

Njengoba sesibonile ngaphambili, izimbangela ze-rhabdomyolysis zihluke kakhulu. Ukwelashwa ngokusobala kuncike kumbangela.

Ngokuvamile, ukwelashwa kwe-rhabdomyolysis kuhloswe ukugwema izinkinga.

Ukuze ugweme ukwehluleka okukhulu kwezinso, ukubuyisela amanzi emanzini okwanele kufanele kuqinisekiswe njengoba ukuphelelwa amanzi emzimbeni kuyisimo esiyingozi sezinkinga zezinso. Esimeni esibucayi kuyadingeka ukuhlola njalo ukuthi i-potassium egazini ingaphakathi kwemingcele evamile. Okokugcina, ukuqapha ubuhlungu bemisipha kwenza kube nokwenzeka ukuphakamisa i-compartment syndrome.

Ekuphetheni, singacacisa ukuthi kukhona i-rhabdomyolysis ne-rhabdomyolysis. I-rhabdomyolysis ebukhali ngokucindezelwa kwesitho, isibonelo, ingaholela ekufeni. Ngokuphambene, i-rhabdomyolysis ngesikhathi somkhuhlane imane nje "i-epiphenomenon" okungekho muntu ozokhathazeka ngayo. Izifo ezihlobene ne-rhabdomyolysis zihlala zingavamile, ukuvivinya umzimba ngokweqile yikho okuvame kakhulu. Hlala ucabanga ngakho futhi uveze i-rhabdomyolysis phambi kobuhlungu bemisipha obungavamile noma umbala obomvu obomvu womchamo.