Kuvulala kwapweteka kumachitika pamene mankhwala ouma kapena mankhwala amawotchedwa kapena kumeza, mwina mwadala kapena mwangozi. Ana omwe ali ndi zaka zapakati pa 1 mpaka 3 ali ndi mwayi wowonongeka mwachisawawa mankhwala osokoneza bongo. Komabe, ana osakwana zaka zisanu amaimira pafupi theka la zochitikazo. Okalamba omwe ali ndi kuvulala koopsa kumayenderana ndi ntchito kapena kudzipha.
Kuvulala kwapweteka kumapezeka pamutu wanu wam'mwamba (mphuno, pakamwa, khosi kapena pharynx, ndi bokosi la mawu kapena larynx) ndi chapamwamba chapamwamba cha m'mimba (esophagus, m'mimba, ndi duodenum). Kuopsa kwa ngozi kumaphatikizapo kuchuluka kwa momwe phi (kapangidwe ka hydrogen) imakhala yogwira kapena yofunikira. PH yandale ndi 7. Pansi pH ndi, pomwe phindu limakhala, pamene pH yoposa ndi yofunika kwambiri. Zakudya zamchere zimaphatikizapo 70 peresenti ya milandu yowonongeka; Malamulo otsalawa amaimiridwa ndi kugwiritsa ntchito mankhwala ovomerezeka.
Caustic vs. Kuvulaza Kwambiri
Kawirikawiri, mawu amodzi ndi achinyengo ndi othandizira amagwiritsidwa ntchito mosiyana. Komabe, ndizo ziganizo zomwe zingagwiritsidwe ntchito kusiyanitsa mtundu wa mankhwala mankhwala omwe anavulaza. Caustic amatanthauza mankhwala amphamvu omwe ali ofunika kapena amchere. Kuphwanya kwina kumatanthawuza mankhwala omwe amapangidwa mwamphamvu kwambiri.
Mankhwala osokoneza bongo komanso othandizira angakhalenso owopsa, komabe sikuti mankhwala onse owopsa komanso owotcha amakhala owopsa. Poizoni zimatenga nthawi kuti zisawonongeke, pamene opaleshoni ndi othandizira amatha kuwononga minofu ya thupi nthawi yomweyo. Poizoni kawirikawiri sizimapangitsa kuti anthu awonongeke, koma m'malo mwake amachititsa kuti thupi lanu liwonongeke.
Monga momwe zilili ndi mabuku ambiri, tizitha kunena kuti mankhwalawa ndi "oopsa".
Zizindikiro
Pali zizindikiro zosiyanasiyana zomwe zingatsatire kuyamwa kwa mankhwala osokoneza bongo. Izi ndi chifukwa cha pH zosiyanasiyana za mankhwala, kuchuluka kwa chakudya, ndi nthawi yothandizira ndi minofu ya thupi. Kawirikawiri, ngati mulibe zizindikiro zilizonse, simungapweteke kwambiri. Komabe, izi sizikutanthauza kuti simunapweteke ndikutsatiridwa ndi dokotala angakhale akufunikabe. Ngati muli ndi zizindikiro zitatu kapena zingapo, kuvulala koopsa kumalo anu kungasonyezedwe. Mukhoza kukhala ndi zizindikiro nthawi yomweyo mukamadya, kapena mutha kuona zizindikiro maola angapo pambuyo pake. Mafinya amatha kusonyeza zizindikiro pambuyo pa kuyamwa kwa mankhwala osokoneza bongo. Zizindikiro zomwe mungakumane nazo ndi izi:
- Kuthamanga - chizindikiro chofala kwambiri
- Dysphagia (zovuta kumeza) - 2 ndizofala kwambiri
- Odynophagia (kumeza kowawa)
- Kupuma pang'ono
- Tachycardia (kuthamanga kwa mtima mwamsanga)
- Kupweteka pachifuwa
- Kupweteka m'mimba
- Kuwonjezeka kwa mankhwala
Mavuto akuluakulu okhudzana ndi kuvulaza amatha kuchitika kuphatikizapo kuwonongeka kwa thupi ndipo zingaphatikizepo imfa. Chifukwa cha kuopsa kwa chiopsezo, nthawi zonse muyenera kuwonana ndi Poizoni Control (800) 222-1222 .
Zida Zopewera
Zamakina Zamchere
Zambiri zoyeretsa m'nyumba zimakhala zamchere kapena mankhwala oyenera. Zogulitsa zomwe zimayambitsa vuto la caustic ngati zakumwa zili mu pH ya 11 mpaka 14, komabe ngakhale mankhwala omwe ali ndi pH ya 8-10 akhoza kuvulaza ena. Zinthu zamchere zimene muyenera kuzipewa kwa ana ndizo:
- Kusamba kutsuka: Madzi Omwe Amadziwika ndi Drano
- Oyeretsa mavuni: Easy-Off
- Otsitsimutsa tsitsi: Revlon Creme Relaxer
- Wodziyeretsa wa Ammonia: Lysol All-Purpose, Windex
- Zofufuta zovala: Mafunde, Purex
Zomwe zimagwiritsidwa ntchito pazoyeretsa ndi sodium hydroxide. Lye ndi soda zowonjezera ndi maina ena a sodium hydroxide, komanso angagwiritsidwe ntchito monga potaziyamu hydroxide.
Sodium hydroxide ndi wotsika mtengo komanso wothandizira kwambiri.
Kuvulala kwa m'mimba sikungakhale kochepa kwambiri ndi mankhwala a alkaline chifukwa mimba yanu ya m'mimba imatha kuchepetsa kapena kusinthanitsa zamchere. Komabe, pakamwa ndi pamimba, mankhwala amchere amayamba kuwononga minofu mpaka madzi omwe ali mkati mwa minofu amathira mankhwalawa. Zowonongeka chifukwa cha mankhwala a alkaline amatchedwa liquefactive necrosis , zomwe zikutanthauza kuti kuwonongeka kumene kumapha maselo kumachititsa mawonekedwe ena kukhala mawonekedwe osakanikirana.
Zida Zogulitsa
Kuvulala kwachilendo kumachitika kawirikawiri chifukwa mankhwala opangidwa ndi acidic amachititsa ululu pakamwa. Zida zamakono zimakhalanso zochepa kwambiri, zomwe zimapangitsa kuti chiwonongeko chochepa chiwonongeke pamphuno ngati madzi akufika mimba mofulumira. Mimba ya m'munsi (yomwe imadziwikanso kuti antrum) ndi yowonjezereka chifukwa cha kuwonongeka kwakukulu komwe kumachitika pamene kutuluka kwa mankhwala a acidic akuyima apa. Zakudya m'mimba zingathandize kuchepetsa kuwonongeka kumene chakudya chimatha kutenga acid. Zopangira mankhwala ndi pH zosachepera 2 ndizoopsa kwambiri. Zida zomwe muyenera kusamala ndi ana ndizo:
- Zosamba zophika mbale: Lysol, Kaboom
- Otsuka padziwe losambira
- Kuchotsa dzimbiri: CLR (Calcium, Lime, Rust), Evapo-Rust
Zida zomwe zimagwiritsa ntchito mankhwalawa zimayambitsa kuwonongeka kumene kumatchedwa necrosis yothandizira , yomwe imapanga mazenera ndi minofu pamalo owonongeka. Amakhulupirira kuti chifukwa cha cholepheretsa chilema ndipo zochepetsetsa kawirikawiri zimayamwa chifukwa cha ululu wa acidikiti m'kamwa kumene kuchepa kwakukulu kumachitika ndi ingestion ya zidulo poyerekeza ndi alkali.
Nanga Bwanji Kuphulika?
Kuchotsa nyongolotsi ndi mankhwala osokoneza bongo, komabe, kawirikawiri, amadziwika bwino ngati akuvulaza kwambiri. Kuwotcha kumagulitsidwa kawirikawiri monga mankhwala osatetezeka a pH (kutanthauza kuzungulira pH ya 7). Chifukwa cha pH kulowerera ndale, buluji imayesedwa kuti ndi yowopsya kuposa mankhwala. Kawirikawiri, kumeza kwa bleach kumafuna kuyang'anitsitsa pafupi zizindikiro zomwe tazitchula pamwambapa. Ngakhale zimangokhala zovuta, zovuta kupuma ndi zotsatira zina zovulaza zingatheke ngati kuchuluka kuli kokwanira kapena kupumula kumachitika.
Kuwopsa Kwambiri
Kuopsa kwake kwa kuwonongeka kwa caustic kumawerengedwa mofananako ndi dongosolo lomwelo loyaka . Komabe, madokotala ena akhoza kuwonjezera kalasi ya 4 kuvulala koopsa kwambiri.
- Kutupa (edema) ndi kufiira (hyperemia)
- Kuchepetsa
- 2a - zilonda zam'mimba zowonongeka ndi kutuluka magazi
- 2b - zilonda zam'mimba ndi kutuluka kwa magazi komwe kumapitirira kuposa momwe mungalankhulire
- Kuwonongeka kwa minofu
- 3a - malo ochepa omwe anabalalika minofu
- 3b - malo ambiri omwe minofu yafa
- Kutsekemera - kutuluka kapena kudulidwa minofu yotsogolera kumalo ena a thupi
Kuchuluka kwa kuvulaza kungadziŵike mwa kuwonetsa deralo panthawi ya njira yotchedwa endoscopic yotchedwa EGD. Zotsatira zabwino zimakhala zikuchitika ngati mwakhala mukukalamba koyamba 1 kapena 2a; nthawi zambiri amachira. Ngati muli ndi vuto lachiwiri la 2b kapena lachitatu 3a, mutha kukhala ndi chiletso chokhazikika ( sitepe ) ku malo ovulala. Kalasi ya 3b kapena 4 imakhala ndi chiopsezo chachikulu choyambitsa imfa; pafupifupi 65 peresenti. Kufotokozera kwina kumaperekedwa pansi pa Treatment of Caustic Ingestion .
Chithandizo
- MUSAMAMEKEZE makala amakala, chifukwa sagwiritsanso ntchito zinthu zowononga
- MUSAMASULITSA kusanza; kuopsa kwachidziwitso chachiwiri cha mitsempha, mpweya, pakamwa, ndi mphuno kwa mankhwala osokoneza bongo
Pambuyo pozindikiratu kuti kumeza kwa mankhwala osokoneza bongo (kapena choopsa) chachitika, nthawi zonse muyenera kuyanjana ndi Poizoni Control. Amakhalanso otetezeka kumwa madzi kapena mkaka pokhapokha atayamwa mankhwala amchere kapena acidic kuti athetse mankhwalawo. Komabe, muyenera kupewa kumwa mopitirira muyeso mwa kupewa mamitala khumi ndi awiri a madzi olemera pa kilogalamu iliyonse.
Mosakayikitsa mumakhala mantha chifukwa mumadziwa zomwe zinachitika. Kudziwa zomwe mungayembekezere kungathandize kuchepetsa mantha ndikukuchititsani kuchita kanthu. Dziwani kuti chirichonse chimene chimachitika chikuchitika chifukwa-kukuthandizani kuti mupeze bwino ndikupitiriza kukhala ndi moyo wabwino. Kuwopsa kwa poizoni kukuthandizani kusankha ngati mukufuna kupita kuchipatala kapena ayi. Komabe ngati kupuma kumawoneka kovuta, nthawi zonse muzitchula EMS - Emergency Medical Services (911 ku United States), ndipo pitani kuchipatala mwamsanga. Ngati mungathe kukhala ndi nkhawa, EMS kapena dokotala wodetsa (ED) dokotala adzaika chubu lopuma.
Akafika pa dipatimenti yowonjezereka, kufunika kwa pamwamba kumapeto kwa (EGD) kudzayesedwa. Kawirikawiri, EGD idzachitidwa ngati chiwonetsero chikuchitika pakati pa maola 12 ndi 48. Ngati mayeserowa akuchitidwa mofulumira kwambiri, kuwonongeka kwakukulu sikungathe kuwonetsedwa. Pambuyo maola 48 ndipo mumakhala ndi chiopsezo choyipitsa choipa mwa kuwonetsa chiwopsezocho.
Malinga ndi kuopsa kwake, mungathe kumasulidwa, kuwonetseredwa kwa maola osachepera 24, kapena kuloledwa kupita kuchipatala kuti mupitirize kuwongolera kuvulala kwanu. Ngati kuvulala kwanu kuli kokwanira, tizilombo toyambitsa matenda tingathe kuika pa EGD kuti tisapitirize kuvulazidwa "malo opanda ntchito". Mukhozanso kukhala ndi chubu yamagetsi yomwe imayikidwa pambuyo pake pansi pa fluoroscopy . Mankhwala opha tizilombo amatha kuyambiranso molingana ndi kuchuluka kwa kuvulazidwa ndi chiopsezo cha matenda. Iko pakali pano sikulangizidwa kwakukulu kwa steroids, komabe, mukhoza kuwona iyo ikuyankhidwa mwapadera ena.
Ngati mwavulala kwambiri kapena simunathe kukhala ndi EGD pasanathe maola 48, ndiye kuti mudzakhala ndi mayamilo omeza kuyesera kuti muyese zoletsedwa (zilembo) kapena kuponyedwa kwapadera (perforation). Ngati zizindikiro zimadziwika, nthawi zambiri zimakhala zowonongeka . Ngati mukutsatira, mungayembekezere kuti mayesero apangidwe patatha milungu itatu.
Kuvulala kwakukulu kwambiri, opaleshoni yokonzanso ya mimba yanu kapena kuchotsa mbali ina ya esophagectomy ingafunike.
> Zotsatira:
> Mbalame, JH, Kumar, S, Paul, C & Ramsden, JD. (2016). Mikangano mu kayendetsedwe ka kuwonongeka kwa kuwonongeka kwapweteka: ndemanga yozikidwa pa umboni. Clin Otolaryngol. lembani: 10.1111 / coa.12819.
> Schoem, SR, Rosbe, KW & Bearelly S. (2015). Kuwongolera Otolaryngology: Mabungwe Achilendo Othandizira ndi Zowonongeka Kwambiri. 6 th . Elsevier
> Triadafilopoulos, G. (2016). Kuvulala koopsa kwa anthu akuluakulu. Idapezeka pa 1/11/2017 kuchokera ku UpToDate (Kulembetsa Kufunikira).
> Weigert, A. (2005). Kusokoneza ana kumayambitsa matenda. Pitirizani Maphunziro a Anaesth Crit Care Pain. 5 (1): 5-8. lembani: 10.1093 / bjaceaccp / mki007
> Wightman RS, Werengani KB, Hoffman RS. (2016). Umboni Wopereka Umboni Wa Zowonongeka Zakale Mu Dipatimenti ya Emergency. Emerg Med Pract. 18 (5), 1-17