I-Arthritis ye-Septic: Izimpawu, Izimbangela, Ukwelashwa kanye Nezinkinga

I-Septic arthritis idinga ukunakekelwa kwezokwelapha ngokushesha njengoba lokhu kutheleleka kwamalunga kungadala umonakalo unomphela uma kungelashwa. Iziguli ezine-septic arthritis ngokuvamile ziba nobuhlungu obungalindelekile, obunzima bamalunga, ukuvuvukala kanye nobunzima bokuhambisa ilunga elithintekile. Lesi sihloko sihlola izici ezibalulekile ze-septic arthritis, okuhlanganisa izimbangela zayo, izimpawu, izindlela zokuxilonga, nezinketho zokwelapha ezisebenzayo, isiza abafundi ukuthi baqonde ukuthi bangalufuna nini usizo lwezokwelapha nokuthi yini okufanele bayilindele ngesikhathi sokululama.

Iyini i-Septic Arthritis?

I-Septic arthritis yisimo esibucayi sezokwelapha lapho ukutheleleka kwenzeka ngaphakathi kwelunga elilodwa noma ngaphezulu, okubangela ukuvuvukala endaweni ye-cartilage kanye ne-synovial fluid. Lolu hlobo lwesifo sokuqaqamba kwamalunga lwenzeka lapho izinto eziphilayo eziyingozi zifika endaweni ehlangene, okuholela ekulimaleni okukhulu kwamalunga uma kungelashwanga ngokushesha.

Ukutheleleka ngokuvamile kuthinta amalunga amakhulu, kanti idolo elihlangene liyindawo evame ukuthinteka (i-septic arthritis ye-knee joint). Kodwa-ke, amanye amalunga amakhulu, okuhlanganisa inqulu, ihlombe, neqakala, nawo angaba ne-septic arthritis.

Izingozi Nezimbangela Ze-Septic Arthritis

Ukuthuthukiswa kwe-septic arthritis kuvela ezinhlobonhlobo zezinto ezithathelwanayo ezingena endaweni ehlangene. Nakuba amagciwane amaningi engabangela lesi simo, i-Staphylococcus aureus isalokhu iyimbangela yamagciwane evame kakhulu ezinganeni nakubantu abadala. Ukutheleleka ngokuvamile kungena ejoyintini ngokusebenzisa:

• Ukusabalala okuqondile okuvela ezifweni eziseduze
• Ngokuhamba kwegazi kusuka ezindaweni ezikude zokutheleleka
• Ukulandela ukuhlinzwa ngokuhlanganyela noma ukulimala
• Ngezinaliti ezingcolile ezimweni zokusetshenziswa kwezidakamizwa ngomthambo

Izimo eziningana zandisa kakhulu ingozi yokuthuthukisa isifo samathambo. Lokhu kubandakanya:

• I-arthritis ye-rheumatoid kanye ne-osteoarthritis  
• Abantu abanamalunga okwenziwa 
• Izimo zezempilo ezenza amasosha omzimba abe buthaka, okuhlanganisa isifo sikashukela, ukutheleleka nge-HIV, nokuphazamiseka kwesibindi
• Izinsana kanye nabantu abadala abangaphezu kweminyaka engama-80 
• Izimo zesikhumba ezifana ne-psoriasis ne-eczema ziyanda 
• Ukuhlinzwa ngokuhlanganyela kwakamuva noma ukuhlukumezeka, okuhlanganisa ukulunywa kwezilwane namanxeba okubhoboza

Izimpawu ze-Septic Arthritis

Izimpawu ezivame kakhulu ze-septic arthritis zihlanganisa:

• Ubuhlungu obukhulu obuhlangene obuba bubi nganoma yikuphi ukunyakaza
• Ukuvuvukala okubonakalayo eduze kwelunga elithintekile
• Ukufudumala nokubomvu endaweni ehlangene
• Ukunyakaza kwamalunga okulinganiselwe ngenxa yobuhlungu nokuvuvukala
• Fever izimpawu ezihambisanayo
• Ukungakhululeki okwedlulele lapho ubeka isisindo elunga elithintekile
• Abantu abanamalunga okwenziwa bangase babe nokuvuvukala okuncane okuba kube yizinyanga noma ngisho neminyaka ngemva kokuhlinzwa okuhlangene kanye nobuhlungu obuba ngcono ngesikhathi sokuphumula kodwa bube bubi nakakhulu ngokunyakaza noma imisebenzi yokuthwala isisindo. 

Izinkinga ze-Septic Arthritis

Lesi simo singaholela ezinkingeni ezinkulu eziningana:

• Ukulimala Okuhlangene Okungunaphakade: Ukutheleleka kungabhubhisa i-cartilage ehlangene, okuholela ekungasebenzi kahle kwamalunga
• I-Osteomyelitis: Ukutheleleka kwethambo okunzima okungaba kubi noma okungamahlalakhona
• Ubuhlungu obungapheli: Iziguli zingase zithole ubuhlungu obuqhubekayo endaweni ehlangene ethintekile, ukunciphisa imisebenzi yansuku zonke
• I-Osteonecrosis: Isimo esibonakala ngokufa kwezicubu zethambo ngenxa yokungatholakali kwegazi elanele
• Ukwehluka kobude bomlenze: Kwezinye izimo, ikakhulukazi ezinganeni, ukutheleleka kungathinta ukukhula kwamathambo
• i-sepsis: Isimo esisongela ukuphila lapho ukutheleleka kubangela impendulo eyeqisayo emzimbeni wonke

Sifo

Udokotela wamathambo uqala inqubo yokuxilonga ngokuhlola okujulile ngokomzimba kwelunga elithintekile.

Izinqubo zokuxilonga eziyinhloko zihlanganisa:

• Ukuhlaziywa kwe-Synovial Fluid: Odokotela bakhipha uketshezi oluhlangene ngenqubo ebizwa ngokuthi i-arthrocentesis ukuze bahlole amagciwane kanye nezimpawu zokutheleleka
• Ukuhlolwa kwegazi: Lezi zikala amazinga okuvuvukala futhi zihlole ukuphendula kwamasosha omzimba
• Isithombe se-X-ray: Ibonisa ukunwetshwa kwesikhala esihlanganyelwe kanye nokuvuvukala kwezicubu ezithambile
• Izikena ze-Ultrasound: Isiza ukubona ngeso lengqondo ukuvuvukala kwamalunga futhi iqondise ukukhishwa koketshezi
• I-MRI Scans: Inikeza izithombe ezinemininingwane ukuze kutholwe izimo zangaphambi kwesikhathi nokuhlola ukulimala okuhlangene

Ukwelashwa kwe-Septic Arthritis

Izingxenye eziyinhloko zokwelapha zihlanganisa:

• Ukwelashwa Kwamagciwane: Odokotela banikeza ama-antibiotic emithanjeni okungenani izinsuku eziyishumi nane, kulandelwe ama-antibiotic omlomo amanye amaviki angu-1-2.
• I-Joint Fluid Drainage: Odokotela bakhipha uketshezi olunegciwane besebenzisa i-need aspiration, okungase kudinge ukuphinda izikhathi ezimbalwa ezinsukwini ezimbalwa zokuqala
• Ukungenelela Ngokuhlinzwa: Ezinye izimo zidinga ukuchithwa ngokuhlinzwa ukuze kukhishwe izicubu ezithelelekile, ikakhulukazi uma ukugeleza kwezinaliti kukhombisa ukungenele
• Ukwelashwa Kwemvelo: Ukuzivocavoca umzimba kusiza ukubuyisela ukusebenza okuhlangene futhi kuvimbele ubuthakathaka bemisipha
• Ukumiselela Okuhlanganyelwe Okwenziwayo: Ezigulini ezinamajoyinti okwenziwa, ukwelashwa ngokuvamile kuhilela izinyathelo ezibanzi. Lezi zimo ngokuvamile zidinga ukususwa kwe-prosthesis ethelelekile futhi kufakwe endaweni yesikhala sikasimende esifakwe ngamagciwane. Ngemva kokuba ukutheleleka sekuphelile, ngokuvamile ngemva kwezinyanga ezimbalwa, odokotela abahlinzayo bangafaka ilunga elisha lokwenziwa.

Uzoyibona Nini Udokotela

Iziguli kufanele ziyothola usizo lwezempilo oluphuthumayo uma zibona:

• Ubuhlungu obukhulu bamalunga obuhlangene nomkhuhlane
• Ukufudumala okungazelelwe kanye nokubabomvu eduze kwelunga
• Umkhawulo obalulekile ekuhambeni okuhlangene
• Ubumnene obukhulu lapho uthinta indawo ehlangene
• Noma yiziphi izimpawu zamalunga ngemva kokutheleleka kwakamuva

Prevention

Izinyathelo ezimbalwa ezibalulekile zokuvimbela zingasiza ukunciphisa ingozi yokuthuthukisa isifo samathambo se-septic:

• Nakekela Ukunakekelwa Kwezilonda: Gcina wonke amanxeba namanxeba kuhlanzekile futhi kugqokwe ngendlela efanele ukuze uvimbele ukutheleleka. Iziguli kufanele ziqaphele izimpawu zokutheleleka (ubomvu, ukufudumala, noma ubomvu).
• Phatha Izimo Ezingamahlalakhona: Abantu abanezimo ezifana nesifo sikashukela noma ukuphazamiseka kokuzivikela komzimba kufanele balawule impilo yabo ngemithi efanele kanye nokuhlolwa kwezokwelapha okuvamile.
• Zijwayeze Ukuziphatha Kocansi Okuphephile: Sebenzisa ukuvikeleka okufanele ngesikhathi sokuya ocansini futhi ugcine ukuxhumana okuvulekile mayelana nomlando wempilo yezocansi.
• Gwema Ukusebenzisa kabi Izidakamizwa: Gwema ukusetshenziswa kwezidakamizwa ngomjovo, njengoba kwandisa kakhulu ingozi yokutheleleka ngezinaliti ezingcolile.
• Gada Amalunga Okwenziwa: Labo abanamalunga okufakelwa kufanele banake ngokukhethekile noma yiziphi izinguquko ekusebenzeni kwamalunga noma ukunethezeka.

Isiphetho

I-Septic arthritis yisimo esibucayi esidinga ukuqashelwa ngokushesha nokwelashwa. Odokotela bangakwazi ukuphatha ngempumelelo lokhu kutheleleka okuhlangene ngokusebenzisa ama-antibiotic ahlosiwe, izinqubo ezifanele zokudonsa amanzi, nokuzivocavoca kokuvuselela. Ukwelashwa okuphumelelayo kwalesi simo kuncike kakhulu ekutheni iziguli zisheshe zilufune kanjani usizo lwezokwelapha ngemva kokuqaphela izimpawu ezinjengobuhlungu obunzima bamalunga, ukuvuvukala, noma imfiva.

Izindlela zokuvimbela ezifanele zisiza ukunciphisa ingozi yokuthuthukisa isifo samathambo, ikakhulukazi kubantu abanezimo zempilo ezikhona noma amalunga okwenziwa. Ukunakekelwa kwamanxeba okuvamile, ukuphathwa kwezimo ezingamahlalakhona, nokunaka impilo ehlangene kudlala indima ebalulekile ekugwemeni lesi sifo esibi kakhulu. Noma ubani obona ubuhlungu bamalunga obungazelelwe obuhlangene nomkhuhlane noma ukuvuvukala okukhulu kufanele afune usizo lwezokwelapha ngokushesha, njengoba isinyathelo esisheshayo sihlala siyisivikelo esingcono kakhulu emonakalweni wamalunga unomphela.

Imibuzo Evame Ukubuzwa

1. I-septic arthritis ithinta bani?

I-Septic arthritis ingathinta abantu banoma iyiphi iminyaka, nakuba ibonisa ukusabalala okuthile ezinganeni ezingaphansi kweminyaka engu-3 kanye nabantu abadala abangaphezu kuka-80. Abesilisa banamathuba aphindwe kabili okuthola lesi simo uma kuqhathaniswa nabesifazane.

2. Kuvame kangakanani isifo samathambo?

Lesi simo senzeka cishe ezimweni ezi-2 kuye kwezi-6 kubantu abayi-100,000 ngonyaka. Izinga lezigameko likhuphuka kakhulu kubantu abanezici ezithile eziyingozi, njenge-rheumatoid arthritis, lapho izimo zingafinyelela ku-70 kubantu abayi-100,000 ngonyaka.

3. Sibi kangakanani isifo samathambo?

I-Septic arthritis imele isimo esiphuthumayo sezokwelapha ngezinga lokufa lika-7% kuya ku-15% naphezu kokwelashwa ngama-antibiotic. Ubunzima buyahlukahluka kuye nge-causative organism, kanti izifo ze-Staphylococcus aureus zithwala izinga lokufa elifika ku-50%.

4. Ingabe isifo samathambo siyathelelana?

Nakuba isifo samathambo singatheleleki, amabhaktheriya ayibangelayo, njenge-MRSA noma i-Neisseria gonorrhoeae, angasakazeka ngokuthintana nomuntu nomuntu.

5. Ungakwazi yini ukululama ku-septic arthritis?

Ukululama kuncike ekwelapheni ngokushesha nasezicini eziningana:

• Uhlobo lwento ephilayo ethathelwanayo
• Ubude besikhathi sokutheleleka
• Iminyaka yesiguli kanye nempilo iyonke
• Isikhathi sokungenelela kwezokwelapha

6. Yiziphi izigaba ezintathu ze-septic arthritis?

Lesi simo siqhubeka ngezigaba ezintathu ezihlukene:

• I-serous exudation: Ukuvuvukala kokuqala ngokuminyana kwe-synovial
• I-serous fibrinous exudation: Ukwanda kwamangqamuzana amhlophe egazi kanye nokulimala koqwanga
• Ukukhishwa kwe-purulent: Ukuvuvukala okukhulu ngokulimala kwamalunga angenakulungiseka

7. Ubani osengozini ye-septic arthritis?

Izici zobungozi ziyahlukahluka ngokweqembu lobudala, nezingane ezisengozini enkulu uma:

• Yizingane ezisanda kuzalwa ezinamasotsha omzimba akhulayo
• Yiba ne-haemophilia
• Iyaqhubeka imiphumela emibi yokwelashwa ngamakhemikhali
• Yiba ne-sickle cell anemia

8. Ingabe isifo samathambo singalapheka unomphela?

Ngokuxilonga kusenesikhathi nokwelashwa okufanele, iziguli eziningi zithola ukululama ngokuphelele. Kodwa-ke, cishe ingxenye eyodwa kwezintathu yeziguli zithola uhlobo oluthile lokungasebenzi kahle kwamalunga noma ubuhlungu obungapheli.

9. Yiminyaka emingaki isifo samathambo?

Ngenkathi i-septic arthritis ingenzeka kunoma yisiphi isikhathi, ibonisa izehlakalo eziphezulu phakathi kweminyaka engu-2 no-3 ezinganeni nangemva kweminyaka engu-80 kubantu abadala. Lesi simo sithinta abesilisa kaningi, ngesilinganiso esingu-2:1 uma kuqhathaniswa nabesifazane.