Ciwon kirji: bayyanar cututtuka, ganewar asali da kuma kula da majiyyaci tare da mummunan rauni a kirji

By Cristiano Antonino On Mar 31, 2023

Za a gano mutum yana da rauni a ƙirji lokacin da ya sami mummunan rauni a ƙirjin

Har ila yau, da aka sani da ciwon kirji, wannan yanayin zai haifar da nakasa kuma mutuwa na iya faruwa a sakamakon haka; shi ne na uku da ke haifar da mutuwa daga raunin jiki.

Ciwon ƙirji na iya faruwa a sakamakon raunuka iri-iri; Daga cikin abubuwan da ke haifar da rauni a kirji akwai hadurran ababen hawa.

Raunin haɗari ko ƙeta zai iya haifar da rauni na thoracic

Raunin ƙirji ya haɗa da raunin harbin bindiga, kuma yana iya faruwa a sakamakon faɗuwa, bayan an caka masa wuka, duka ko duka.

Likita na iya yin ganewar asali, yawanci tare da X-ray.

Tabbas, rauni na thoracic yana daya daga cikin batutuwa masu rikitarwa, kuma a cikin labarin mai zurfi zai yiwu a koyi game da wasu al'amura na musamman: ba shi yiwuwa a taƙaita batun a cikin rubutu ɗaya.

Za a iya raba ciwon kirji zuwa nau'i biyu:

Ratsa jiki, wanda ke faruwa a lokacin da wanda aka azabtar ya sami rauni da ke karya fata, kamar wuka a kirji ko a raunin harbin bindiga;
Ƙunƙarar rauni zai haifar da wasu tsagewar fata, hawaye ba shine dalilin raunin da kansa ba kuma lalacewa sau da yawa ba a bayyana ba. Babban dabba ya harba shi ko kasancewa a cikin a hadarin mota na iya haifar da rauni a fili.

Rashin raunin da ya faru yana da kashi 25% na duk mace-mace saboda bala'in gaggawa na likita.

Raunin ƙirji zai gabatar da alamu da yawa, mafi yawan abin da zai zama zafi mai tsanani da wahalar numfashi.

Sauran alamomin za su haɗa da zubar jini, girgiza, ƙarancin numfashi, zub da jini, ɓarnawa da kuma asarar sani, wanda zai faru dangane da dalilin raunin ƙirjin.

Har ila yau, karayar kashi na iya faruwa saboda rauni na thoracic.

Za a yi maganin ciwon ƙirji dangane da sanadin

Ana iya buƙatar shiga tsakani don share hanyar iska, duka a cikin yanayin rugujewar huhu da kuma hana rauni daga haifar da mummunar lalacewa kuma ta haka haifar da kamuwa da cuta.

Raunin ƙirji na iya haifar da nau'i daban-daban na raunin zuciya, kamar shiga jikin wani waje, fashewa, tamponade, laceration da occlusion na arteries na jijiyoyin jini, ciwon zuciya na zuciya, zubar da jini na pericardial, lahani, raunin valvular, da rushewar manyan tasoshin.

Wadannan raunuka sau da yawa suna mutuwa.

Raunukan da ke shiga cikin zuciya galibi ana haifar da su ta hanyar manyan makamai ko bindigogin harbi kuma suna haifar da adadin mace-mace tsakanin 50% zuwa 85%.

Rushewar raunin da ya faru yawanci ana danganta su da fashewar zuciya, tare da ventricle na dama yana shafar sau da yawa fiye da hagu, kuma yana haifar da adadin mace-mace kusan kashi 50% a cikin marasa lafiya da suka isa wurin. ɗakin gaggawa da rai.

Bayan fashewar ɗakin zuciya ko hawaye a cikin jijiyoyin jini ko manyan tasoshin, jini da sauri ya cika jakar pericardial kuma yana haifar da tamponade na zuciya.

Ko da kadan kamar 60-100 ml na jini na iya haifar da tamponade na zuciya da bugun jini, sakamakon raguwar cikawar diastolic.

Raunin huda da ke shiga cikin jakar pericardial da kuma cikin zuciya yana haifar da saurin zubar jini, wanda ke mamaye hoton asibiti.

Tamponade na zuciya bayan harbin harbin bindiga a zuciya yana da alaƙa da haɓakar rayuwa saboda hauhawar jini na tsarin jiki da kuma ƙara matsa lamba a cikin sarari na pericardial, wanda ke taimakawa iyakance zubar jini.

A zuciya tamponade sau da yawa yana hade da asibiti bayyanar cututtuka na Beck's triad (jugular venous distension, hypotension da attenuation na zuciya sautunan).

Wataƙila wannan triad ɗin ba ya kasancewa a cikin marasa lafiya waɗanda suka zama hypovolaemic saboda zubar jini.

Shaidar radiyo na faɗaɗa inuwar mediastinal na iya ba da shawarar zubar da jini a cikin mediastinum da/ko tamponade.

Tabbatar da zubar da jini na pericardial na iya bayar da echocardiography.

Ƙwayoyin binciken gaggawa na gaggawa, tare da kewayawa na zuciya da gyare-gyaren tiyata, da zubar da jini kamar yadda ake bukata ta yanayin asibiti za a yi.

Canje-canjen anatomopathological na ƙwayar zuciya sun ƙunshi zubar jini na intramyocardial, edema na myocardial, occlusion na jijiyoyin jini, lalatawar myofibrillar da necrosis na myocardium.

Wadannan raunuka suna haifar da arrhythmias da rashin kwanciyar hankali na haemodynamic kwatankwacin wanda aka gani bayan ciwon zuciya na zuciya.

Bugu da ƙari, ana iya buƙatar intubation, samun iska ko wasu hanyoyin oxygenation, da kuma tiyata, magani na miyagun ƙwayoyi, cikakken hutawa da kuma a wasu lokuta magungunan jiki.

Saboda tsananin zafin, za a yi amfani da magungunan kashe qwari don rage yawan zafin.