Kumvetsetsa Momwe Kuyenda kwa Magazi Kumakhudzira Kupirira Kwachipatala
Posankha njira yopangira chithandizo chamankhwala ambiri-makamaka matenda a mtima-opereka chithandizo chaumoyo nthawi zambiri amalangizidwa kulingalira ngati wodwala akuvutika ndi "kusasinthika kwa chilengedwe" kapena ayi. Ndilo lodziwikiratu, koma lingakhale ndi tanthauzo losiyana kwa akatswiri othandizira zaumoyo, malinga ndi msinkhu wa maphunziro awo, ndipo nthawi zina, kumene amaphunzitsidwa.
Kumvetsetsa tanthauzo lake ndi momwe zikuwonekera ndikofunikira kumvetsetsa cholinga cha wolemba yemwe amachigwiritsa ntchito mu malangizo azachipatala kapena matenda.
Pamwamba, mawuwo ndi ofunikira. Hemo - imatanthawuza magazi pamene - mphamvu imatanthawuza kusuntha kwa magazi padziko lonse lapansi. Kuthamanga kwa magazi ndibwino kwambiri ntchito yokha ya circulation . Kutchula kusakhazikika kumadziŵikiranso. Zimatanthauza kuti pokhapokha ngati ogwira ntchito zachipatala akuchita chinachake, njirayi ndi yosakhazikika ndipo ili pangozi yolephera.
Zina zomwe zimagwiritsidwa ntchito ponena za kusagwirizana kwa hemodynamic zimaphatikizapo kugwa kwa mlengalenga, mantha (makamaka kukhumudwa kwakukulu ), hypoperfusion , ndi kulephera kwa mtima . Kuwonjezera apo, mawu ena amalembetsa zomwe zimayambitsa kusagwirizana kwa hemodynamic komanso amachita monga zizindikiro monga hypovolemia ndi hypotension .
Odwala osasunthika omwe sangathe kukhala nawo osasinthasintha amatha kusunga magazi moyenera ku mbali zosiyanasiyana za thupi zomwe zimayenera kukhala panthawi yomweyo.
Ndikofunika kumvetsetsa kuti kusapanikizika kokwanira sikuli kofanana ndi kuchepetsa kuthamanga kwa magazi.
Zizindikiro za Kutha kwa Hemodynamic
Izi sizichitika zokha. Odwala samangokhala osakhazikika popanda chifukwa. Uwu ndi matenda omwe amayenda nthawi zonse (kapena otsogolera) vuto linalake, monga matenda a mtima kapena mantha oopsa.
Polimbana ndi zovuta zina, apa pali zizindikiro zonena za wodwalayo wosasunthika (zomwe zimangotengera zokhudzana ndi izi):
- Khungu labwino komanso lozizira
- Diaphoresis (thukuta)
- Kutopa
- Kupita mofulumira kwambiri kapena pang'onopang'ono kwambiri (kuthamanga kungakhale mwina kuchitapo kanthu kapena chifukwa cha kusakhazikika; pang'onopang'ono nthawi zonse ndi chifukwa)
- Kuthamanga kwa magazi (chizindikiro chochedwa kwambiri)
- Kupuma pang'ono (osati magazi okwanira kufika m'mapapo)
- Kupweteka kwa chifuwa (kungagwirizane ndi kuchepa kwa magazi m'mtima)
- Kusokonezeka (mwinamwake kumabwera madontho a kupsyinjika kwa magazi)
- Kutaya chidziwitso ( syncope , choipa)
Madokotala akhala ndi malingaliro ochuluka a kusasinthika kwa chilengedwe kwa anthu ambiri omwe amapereka chithandizo chamankhwala. Kumvetsetsa ziganizo za momwe thupi limakhudzidwira kumalo osayendera ndi ofunika kwambiri poyesera kuzindikira mthupi wosatetezeka. Madokotala, monga gulu, amakonda kukhala omveka bwino pazithunzizo.
Kusakanikirana (kutsika kwa magazi) kumakhala kosavuta kumva, koma si chinthu choyamba chomwe munthu angawone mthupi lolimba. Kawirikawiri, kuthamanga kwa magazi kwagwiritsidwa ntchito monga chilolezo cha kusatetezeka kwa magazi kwa azimayi ena othandizira zaumoyo, koma thupi lidzakhala ndi kusintha kwa kusintha kwa magazi nthawi yaitali chisanafike chizindikirochi.
Nkhondo kapena Ndege Syndrome
Pamene kayendedwe kake kakulephera, pali zizindikiro zambiri za kuyesera kwa thupi kuti athetse vuto lomwe limasonyeza vuto. Pafupifupi zonsezi zimachokera ku dongosolo lamanjenje lachisokonezo, chipangizo chachangu cha thupi ndi momwe timayankhira kupsinjika. Mchitidwe wamanjenje wachifundo umayendetsedwa, mwa zina, epinephrine (amadziwika kuti adrenaline) ndipo nthawi zambiri amatchedwa "nkhondo kapena matenda a ndege." Izi ndizimene thupi limapangidwira pamene zimakhala ngati zikuopsezedwa. Lingaliro ndilo kuti thupi likukonzekera kuti limenyane kapena kuthamanga kuchokera ku nyama.
Nkhondoyo kapena vuto la kuthawa makamaka ndilokusindikizidwa. Monga momwe mchitidwe wamanjenje wachifundo umalimbikitsira, umayambitsa magazi kuthamangira ku magulu akuluakulu a minofu mmanja ndi miyendo, kotero kumenyana kapena kuthamanga kungayambe. Kuyenda kwa magazi ndi ntchito m'matumbo amachepetsedwa kwa kanthawi (mungathe kukumba kuti cheeseburger ngati mukukhala mukukumana ndi mkango wa phiri). Kuthamanga kwa magazi kumaso, mphuno, ndi ubongo kumakula, ndibwino kuti ndimve ndikukuwonani inu, wokondedwa wanga. Mphepete mwa mpweya m'mapapu amatha kutulutsa mpweya wambiri komanso kuthamanga kwa mtima kumatsimikizira kuti magazi amayenda mofulumira m'mapapu kuti akhale atsopano komanso okosijeni. Pomalizira, ngati kambuku kakang'ono kameneka kamalowa m'magazi pang'ono, magazi amachotsedwa pamwamba pa khungu kuti achepetse kutuluka magazi ndipo matumbo a thukuta amalowetsa kuti athandizidwe ngati zinthu zikuwotha.
Zambiri zakumvera chisoni ndi zovuta, zomwe zimakhala chimodzimodzi ngati zovuta zimabwera chifukwa cha kuchepa kwa magazi (ubweya wambiri) mu ubongo kapena chifukwa ubongo umaganiza kuti zatsala pang'ono kudyedwa ndi zombie, ndizothandiza pa nthawi yachipatala monga ziri mu zombie apocalypse.
Zizindikiro za khungu zimakhala zozizira komanso zoziziritsa chifukwa magazi samathamanga pamwamba ndipo amanyowa chifukwa cha thukuta (diaphoresis) -kupereka kuti pali vuto lakumverera. Zindikirani kuti palibe chilichonse mkati muno chomwe chimafuna kuthamanga kwa magazi. Zoonadi, pamagulu omwe amamenyana kapena kuthawa, kuthamanga kwa magazi kukupita, zomwe zimapangitsa kuti nkhondoyo kapena vuto la kuthawa likhale labwino kwambiri ku matenda omwe amachititsa kuti magazi asatayike.
Nthawi Yomwe Mungagwiritsire Ntchito Mphamvu ya Hemodynamic
Pochiza matenda okhudzana ndi mtima wa mtima, kulemera kwa chilengedwe ndi chizindikiro choyamba cha nthawi yoti athandizidwe. Wodwala ali ndi bradycardia kapena tachycardia ayenera kuchiritsidwa mwamphamvu kwambiri pamaso pa kusakhazikika kwa hemodynamic kusiyana ngati akuoneka kuti ali wodekha.
Malangizo ambiri amagwiritsira ntchito izi monga mayesero a litmus, omwe amachititsa kuti zonsezi zikhale zofunika kwambiri kuzizindikira bwino. Pali njira zowunika bata la hemodynamic ndi kuyang'ana kosavuta, koma si matenda ovuta kuti adziwe ngati ali ndi chithandizo choyenera cha kuchipatala.
Kusokonezeka ndi Machitidwe a Hemodynamic
Kusakhazikika kwa chikhalidwe cha Hemodynamic ndikosavuta kusokoneza ndi mantha, koma kudodometsedwa ndi mawu omwe ali ndi matanthawuzo angapo ndipo imodzi yokha ikukhudzana ndi ngati wodwala angathe kusuntha magazi mozungulira thupi lake. Zina ziwiri zimakhudzana ndi kukhumudwa kapena magetsi.
Kudodometsedwa ndi matenda omwe ali ndi mawonekedwe ndi maulendo, mosiyana ndi kusasinthika kwa magazi. Pali mitundu inayi yodabwitsa: matenda a mtima, kupatsirana (kumaphatikizapo ubongo, anaphylactic, ndi septic), hypovolemic (imaphatikizapo kutaya magazi), ndi kupuma (zomwe othandizira ena samagwirizana ndi matenda owopsya). Powonjezera powonjezereka, mantha amatha kuwomboledwa (kuthamanga kwa magazi akadakali koyenera) kapena kutaya magazi (kuthamanga kwa magazi kumakhala kochepa). Zinganene kuti kudabwa kwakukulu ndi wodwala wosasunthika wosadziwika bwino.
Pofuna kuzindikira chomwe chimayambitsa matenda a wodwalayo, kumvetsa mitundu ya mantha ndi kuzindikiritsa izo zidzapita zambiri kuposa kungomvetsa kusasinthika kwa chilengedwe.
Mawu Okhudza Hypoperfusion
Perfusion ndi imodzi mwa mawu akale omwe amagwira ntchito yachipatala atasiya kugwira ntchito yonse ya lexicon yamakono. Zimatanthauza kudzazidwa ndi magazi ndipo nthawi zambiri amagwiritsidwa ntchito makamaka kutchula magazi akudzaza ma capillaries. Ma capillaries ndiwo makamaka njira zopangira maselo ofiira omwe angalowe mu fayilo imodzi. Mabedi a capilla ali ngati masiponji ndipo adzadzaza ndi magazi pokhapokha ngati pali kukakamizidwa kokwanira kukankhira magazi m'mitsuko yaying'ono.
Kuchulukirapo (pang'ono) (kukhuta) kumatanthawuza kuti palibe magazi okwanira odzaza mabedi a capillary mu thupi. Izi ndi zotsatira za kusagwirizana kwa hemodynamic koma ndizofanana ndi mantha. Ndipotu, mawuwa amawopsya komanso hypoperfusion amasinthasintha.
> Zotsatira:
> Bonanno FG. Matenda a chipatala a syndromes oopsa. Journal of Emergencies, Trauma ndi Shock . 2011; 4 (2): 233-243. lembani: 10.4103 / 0974-2700.82211.
> Sevransky, J. (2009). Kusamalira anthu odwala matenda osadziwika. Malingaliro Amakono Mu Chisamaliro Chofunika , 15 (3), 234-238. do: 10.1097 / mcc.0b013e32832b70e5