Ukopha Kwangaphakathi: Izimpawu, Izimpawu, Izimbangela Nokwelashwa

Ukopha kwangaphakathi kwenzeka uma kunokopha ngaphakathi emzimbeni okungabonakali ngaphandle. Kuyi-a eziphuthumayo zezokwelapha lokho kudinga ukungenelela kwezokwelapha ngokushesha. Ngokungafani nokopha kwangaphandle, lapho igazi ligeleza ngokusobala livela emzimbeni, ukopha kwangaphakathi kwenzeka ngaphakathi, okwenza kube nzima ukukubona ngaphandle kokungenelela kodokotela. Kungenzeka noma yikuphi emzimbeni wethu, ezithweni, ezicutshini, nasemigodini futhi kungase kubangele ukuhlukumezeka, izimo zezokwelapha, noma izinkinga zempilo ezikhona. Imiphumela yokopha kwangaphakathi ingahluka kusukela ekubonakalisweni okuncane kuya ezimweni ezisongela ukuphila, kuye ngobukhulu kanye nendawo yokopha. Ukuqonda izimpawu zayo, izimpawu, izimbangela, kanye nezinketho zokwelapha kubalulekile ekungeneleleni kwezokwelapha okufika ngesikhathi kanye nemiphumela ethuthukisiwe.

Izimpawu Nezimpawu Zokopha Ngaphakathi

Ukuqaphela izimpawu nezimpawu zokopha kwangaphakathi kubalulekile ekuxilongweni nasekulashweni ngokushesha. Okunye ukubonakaliswa kungase kucashe noma kuthuthuke kancane kancane, kuyilapho okunye kugqame kakhulu. Izinkomba ezithile zingahluka kuye ngendawo nezinga lokopha; ezinye izimpawu ezivamile ukopha kwangaphakathi zihlanganisa:

• Ubuhlungu besisu: Ukopha kwangaphakathi esiswini kungabangela ubuhlungu obunzima, ngokuvamile obuchazwa ngokuthi i-ache ebuhlungu noma ukuzwa kwe-cramping. Kungase kuhambisane nokuzwela noma ukuqina endaweni ethintekile. Ukopha kwangaphakathi ku uhlelo lwesisu kungase kubangele isicanucanu, ukuhlanza, noma ukuhlanza okunegazi.
• Ubuthakathaka obujwayelekile kanye nokukhathala: Ukulahlekelwa igazi kwangaphakathi kungaholela ekwehleni kwamandla okuthwala umoya-mpilo kanye nomfutho wegazi, okuholela ekubeni buthaka, ukukhathala, nokuba nekhanda elilula.
• Ukubhoboza nokuvuvukala: Imihuzuko noma ukuvuvukala okungaqondakali ebusweni bomzimba kungase kubonise ukopha kwangaphakathi. Ukunqwabelana kwegazi ngaphansi kwesikhumba kungabangela ukushintsha kombala noma iqhubu elikhuphukile.
• Izinguquko esimweni sengqondo: Ukopha kwangaphakathi ebuchosheni kungabangela izinguquko zengqondo, okuhlanganisa ukudideka, isiyezi, noma ukulahlekelwa ukwazi. Kufanele njalo unake lezi zimpawu futhi ufune usizo lwezokwelapha ngokushesha.
• Ukuphefumula kanzima: Ukopha kwangaphakathi emgodini wesifuba noma emaphashini kungaholela ukuphelelwa umoya noma ukuphefumula ngokushesha.
• Ukwenyuka kwezinga lenhliziyo: Ukushaya kwenhliziyo okusheshayo noma i-tachycardia ingase yenzeke njengoba umzimba unxephezela ukuncipha kwevolumu yegazi okubangelwa ukopha.
• Igazi esigqikini noma emchameni: Ukopha kwangaphakathi emgudwini wokugaya ukudla noma ipheshana lomchamo ingase ibonakale njengegazi esitulweni noma emchameni. Lesi sibonakaliso singethusa futhi kufanele sihlolwe uchwepheshe wezempilo.
• Isikhumba esibandayo, esijulukayo: Isikhumba esiphaphathekile, esibandayo, esicwebezelayo singabangelwa ukungahambi kahle kwegazi ngenxa yokulahleka kwegazi okukhulu.

Izimbangela Zokopha Kwangaphakathi

Kunezici eziningana ezingabangela ukopha kwangaphakathi, ngayinye idinga izindlela ezithile zokwelapha. Ezinye izimbangela ezivamile zihlanganisa:

• Ukuhlukumezeka: Izingozi, ukuwa, noma ukulimala ngokomzimba ngezinye zezimbangela ezivamile zokophela ngaphakathi. I-Blunt force trauma, efana nengozi yemoto noma ukulimala kwezemidlalo, kungabangela ukuqhekeka kwemithambo yegazi, okuholela ekopheni kwangaphakathi.
• Izimo zesisu: Izimo ezithile zesisu, njengezilonda ze-peptic, i-diverticulosis, noma isifo samathumbu esivuthayo, singabangela ukopha kwangaphakathi emgudwini wokugaya ukudla.
• Imithi nezinqubo zokwelapha: Imithi ethile, njengemithi enciphisa igazi, ingandisa ingozi yokopha kwangaphakathi. Ukwengeza, izinqubo zokwelapha ezihlaselayo, ezinjengokuhlinzwa noma ama-biopsies, zinengozi engaba khona yokopha kwangaphakathi.
• Ukuphuka kwesitho: Ukuphuka kwezitho, njengobende noma isibindi, kungabangela ukopha okukhulu kwangaphakathi. Kungenzeka ngenxa yokulimala noma izimo zezempilo ezingaphansi. 
• I-Liver Disorder: Izifo zesibindi ezifana ne-cirrhosis zingabangela ukucindezeleka okwenyuka emithanjeni (portal hypertension), okuholela emithanjeni evuvukele engase iqhume futhi ibangele ukopha kwangaphakathi.
• Isifo sokopha: Izimo ezifana ne-haemophilia, thrombocytopenia, noma isifo se-Von Willebrand zingaphazamisa ikhono legazi lokujiyisa kahle, zandise ingozi yokopha okuzenzakalelayo kwangaphakathi.
• Izimo ze-Vascular: Izimo ezithile zemithambo yegazi, njenge-aneurysm noma i-aortic dissection, zingaholela ekuphumeni kwangaphakathi ngaphakathi kodonga lwemithambo yegazi noma i-aorta. 
• Umdlavuza: Eminye imidlavuza, njengomdlavuza wesikhumba, umdlavuza wesisu, noma i-leukemia, ingahlasela imithambo yegazi noma yenze buthaka izicubu, okubangele ukopha ngaphakathi.

Ukuxilongwa Kokopha Kwangaphakathi

Ukuxilonga ngokushesha ukopha kwangaphakathi kubalulekile ekulawuleni ngempumelelo. Odokotela baqasha abahlukahlukene amathuluzi okuxilonga nezindlela zokuhlonza nokuthola ukopha kwangaphakathi, okuhlanganisa:

• Umlando wezokwelapha kanye nokuhlolwa komzimba: Odokotela bazobuza mayelana nezimpawu zesiguli, umlando wezokwelapha, nanoma yikuphi ukulimala kwakamuva noma ukuhlukumezeka. Bazokwenza ukuhlola okujulile ngokomzimba ukuze bahlole izimpawu ezibalulekile, bahlole izimpawu zokopha kwangaphakathi, futhi bahlole indawo ethintekile.
• Ukuhlolwa kwesithombe: Odokotela bangase benze izivivinyo ezimbalwa zezithombe, njenge-X-ray, i-computed tomography (CT) scan, i-ultrasound, i-magnetic resonance imaging (MRI), noma i-angiography, ukuze babone ngeso lengqondo izakhiwo zangaphakathi futhi babone ukungahambi kahle noma izimpawu zokuphuma kwegazi ngaphakathi.
• Ukuhlolwa kwaselabhorethri: Ukuhlolwa kwegazi, okuhlanganisa isibalo segazi eliphelele (CBC) kanye nezifundo zokuhlangana, kusiza ukuhlola izibalo zamangqamuzana egazi, izici zokujiyisa, kanye nempilo yegazi iyonke. Lokhu kuhlola kunganikeza ulwazi olubalulekile mayelana nokuba khona kanye nobukhulu bokopha kwangaphakathi.
• Ukuhlolwa kokusebenza kwesibindi: Lezi zivivinyo zingase zihlole ukusebenza kwesibindi, njengoba isifo sesibindi singandisa ingozi yokopha.
• Ukuhlolwa kokusebenza kwezinso: Odokotela bangenza lezi zivivinyo uma kukhona izinsolo zokopha okuhlobene nokulimala kwezinso noma izifo. 
• I-Endoscopy noma I-Colonoscopy: Uma kusolwa ukopha kwamathumbu, odokotela bangase benze izinqubo ze-endoscopic ezifana ne-endoscopy ephezulu noma i-colonoscopy ukuze babone ngeso lengqondo umgudu wokugaya futhi bahlonze umthombo wokuphuma kwegazi.

Ukwelashwa

Indlela yokwelapha yokopha kwangaphakathi incike endaweni, ubunzima, kanye nembangela ewumsuka. Ezimweni ezimbi kakhulu, ukungenelela kwezokwelapha ngokushesha kuyadingeka. Izinketho zokwelapha zingabandakanya:

• Ukushintsha uketshezi: Uketshezi olufakwa emthanjeni (IV) lubuyisela umthamo wegazi futhi lusimamise isimo sesiguli. Basiza ukunxephezela ukulahleka kwegazi nokugcina ukusebenza kwesitho esibalulekile.
• Ukumpontshelwa igazi: Ezimweni zokulahlekelwa okukhulu kwegazi, odokotela bangase basikisele ukumpontshelwa igazi ukuze kuthathelwe indawo amangqamuzana abomvu egazi alahlekile futhi kuthuthukiswe amandla okuthwala umoya-mpilo.
• Ukungenelela ngokuhlinzwa: Ezimweni ezithile, ukungenelela kokuhlinzwa kungase kudingeke ukuze kumiswe ukopha. Le ndlela ingabandakanya izinqubo ezifana ne-laparotomy (ukuhlinzwa kwesisu), i-embolisation (ukuvimbela imithambo yegazi), noma i-endoscopy (ukufaka ishubhu eliguquguqukayo elinekhamera emzimbeni).
• Imithi: Odokotela bangase banikeze imithi yokuphatha izimo ezingaphansi noma ukulawula ukopha. Isibonelo, ama-proton pump inhibitors noma ama-antibiotic angasiza ekwelapheni ukopha kwamathumbu okubangelwa izilonda noma izifo.

Izinkinga

Ukopha kwangaphakathi kungaholela ezinkingeni ezihlukahlukene, ezinye zazo ezingaba yingozi uma zingalungiswa ngokushesha. Lezi zinkinga zingabandakanya:

• Ukushaqeka kwe-Hypovolemic: Ukulahlekelwa igazi kakhulu kungabangela ukushaqeka kwe-hypovolemic, lapho umzimba ungakwazi ukugcina umfutho wegazi owanele kanye nokugcwaliswa kwezitho zomzimba. Kungadala ukwehluleka kwezitho ngisho nokufa uma kungelashwanga ngokushesha.
• Ukulimala kwesitho: Ukopha kwangaphakathi kobuchopho, inhliziyo, amaphaphu, noma ezinye izitho ezibalulekile kungalimaza lezi zakhiwo, kubeke engcupheni umsebenzi wazo futhi okungase kuholele ezinkingeni zezempilo zesikhathi eside.
• I-anemia: Ukopha okungapheli noma okuphindelelayo kwangaphakathi kungabangela i-anemia, kubangele ukukhathala, ubuthakathaka, kanye nokuphefumula.

Uzoyibona Nini Udokotela

Kubalulekile ukufuna usizo lwezempilo ngokushesha uma kusolwa ukopha kwangaphakathi. Ezinye izinkomba ezidinga ukuhlolwa okuphuthumayo kwezokwelapha zihlanganisa:

• Ubuhlungu obukhulu noma ukungakhululeki: Ubuhlungu obukhulu noma obuqhubekayo, ikakhulukazi esiswini noma ekhanda, akufanele nanini bunganakwa futhi bugunyaza ukuhlolwa kwezokwelapha ngokushesha.
• Ubuthakathaka obungachazeki noma ukukhathala: Ukuqala ngokuzumayo kobuthakathaka, isiyezi, noma ukukhathala kungase kube izimpawu zokulahlekelwa okukhulu kwegazi futhi kudinga ukunakekelwa ngokushesha kwezokwelapha.
• Ushintsho esimweni somqondo: Noma yikuphi ukuguqulwa kokuqaphela, ukudideka, noma ukulahlekelwa ukwazi kufanele kuthathwe njengesimo esiphuthumayo sezokwelapha futhi kudinge ukungenelela kwezokwelapha ngokushesha.
• Igazi esindle, emchameni, noma emhlanzweni: Igazi elisemanzini omzimba, njengendle, umchamo, noma ukuhlanza, lidinga uphenyo lwezokwelapha.

Isiphetho

Ukopha kwangaphakathi kuyisifo esibi sezempilo futhi ungalokothi ububuke ubucayi baso. Ukuqashelwa ngokushesha kwezimpawu nezimpawu, ukungenelela kwezokwelapha okufika ngesikhathi, kanye nokwelashwa okufanele kubalulekile ukuze kuvinjelwe imiphumela esongela ukuphila. Uma usola ukopha kwangaphakathi noma uba nanoma yiziphi izimpawu, kubalulekile ukufuna usizo lwezokwelapha ngokushesha. Khumbula, ukuqwashisa nokuthatha isinyathelo kusenesikhathi kungenza umehluko omkhulu ekusindiseni izimpilo.

Imibuzo Evame Ukubuzwa

1. Ingabe ukopha kwangaphakathi kuphephile?

Cha, ukopha kwangaphakathi akuphephile. Kungaholela ezinkingeni ezinzima zempilo futhi kube yingozi empilweni uma kungelashwa. Thola usizo lwezempilo uma usola ukopha kwangaphakathi.

2. Ingabe ukopha kwangaphakathi kuyaziphilisa?

Kwezinye izimo, ukopha okuncane kwangaphakathi kungase kuzixazulule ngokwako. Kodwa-ke, ukuphuma kwegazi okuphawulekayo noma okuphindaphindiwe kwangaphakathi kudinga ukungenelela kwezokwelapha kanye nokwelashwa okufanele ukuvimbela izinkinga. Kubalulekile ukubonana nodokotela ukuze uthole ukuhlolwa nokuphathwa okufanele.