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Iimpawu kunye neempawu zokothuka: njani kwaye nini ukungenelela

By UCristiano Antonino On Ngo-Apr 22, 2022

Ukothuka kuthetha izinto ezininzi ezahlukeneyo kwilizwe lezonyango. Ngaphandle komothuko wombane (osetyenziselwa ukuqalisa kwakhona intliziyo) kunye negama lemeko yengqondo egqithisileyo (efana nengxaki yoxinzelelo lwasemva koxinzelelo), ukothuka kukwabhekisa kwimeko apho umzimba ungakwazi ukufumana ioksijini eyaneleyo kunye nezondlo kumalungu abalulekileyo. kunye neenkqubo

Umothuko, imeko yonyango enxulumene nokuhamba kwegazi okwaneleyo, ithatha iindlela ezininzi kwaye ineepatheni ezahlukeneyo zeempawu kunye neempawu ezixhomekeke kuluphi uhlobo lomothuko isigulane esifumanayo.

Kukho iindidi ezine eziphambili zomothuko: i-hypovolemic, i-cardiogenic, i-distributive, kunye ne-obstructive.1

Nganye kwiindidi ezahlukeneyo zinezizathu ezininzi, kwaye unobangela ngamnye uza neempawu ezahlukeneyo kunye neempawu.

iimpawu

Olona phawu luxhaphakileyo kuko konke ukothuka-ubuncinci ekugqibeleni-luxinzelelo lwegazi oluphantsi.2

Njengoko umothuko onganyangwanga usiba mbi, uxinzelelo lwegazi luyehla. Ekugqibeleni, uxinzelelo lwegazi luwela phantsi kakhulu ukugcina ubomi (okubizwa ngokuba kukungazinzi kwe-hemodynamic) kwaye umothuko uyabulala.

Ngokuxhomekeke kunobangela, kunokuthatha ixesha elide okanye kunokukhawuleza kakhulu.

Ngelixa uxinzelelo lwegazi olusezantsi iluphawu kuphela olukhoyo ekupheleni koluhlu ngalunye lokothuka, ezinye iindidi zomothuko zixhaphake kakhulu kunezinye.

Oko kuthetha ukuba iimpawu zabo nazo zixhaphake kakhulu. Nazi iindidi zomothuko ngokolandelelwano lwezihlandlo, kunye neempawu zabo eziqhelekileyo.

Ukothuka kweHypovolemic

Ukungabi nolwelo olwaneleyo okanye umthamo wegazi (hypovolemia), lolona hlobo luxhaphakileyo lokothuka.

Inokuvela ekopheni (ekwaziwa ngokuba yi-hemorrhagic shock) okanye kolunye uhlobo lokulahleka kolwelo kunye nokuphelelwa ngamanzi emzimbeni.

Njengoko umzimba uzama ukuhlawulela ukulahleka kwegazi okanye ulwelo kunye nokuzama ukugcina uxinzelelo lwegazi luphezulu, ezi mpawu ziyenzeka:

Isantya sentliziyo esikhawulezayo (ipulse ekhawulezayo)
Ukuphefumla ngokukhawuleza
Abafundi abahluthayo
Ibala, ulusu olupholileyo
Ukubila (diaphoresis)

Njengoko umothuko we-hypovolemic uya usiba mbi ngakumbi, isigulana siyaba buthathaka, sibhideke, size ekugqibeleni singabikho zingqondweni.

Ukuba ukopha kwangaphandle kungunobangela, kuya kubakho igazi. Ukuba ukopha kwisistim sesisu kungunobangela, isigulane sinokuthi ukugabha igazi okanye urhudo olunegazi.

Ukuba kushushu okanye isigulana besizibhokoxa, cinga ngokuphelelwa ngamanzi emzimbeni.

Ukothuka kokusasaza

Olu lolona didi lunzima lokothuka ukuqonda, kodwa luxhaphake kakhulu.

Xa i-artery emzimbeni iba yi-flaccid kwaye ingasakwazi ukuxinana ngokufanelekileyo, uxinzelelo lwegazi lunzima kakhulu ukulawula kwaye luya kuwa.

Abona nobangela babini baxhaphakileyo bolu hlobo lomothuko kukwalana kakhulu (anaphylaxis) kunye nosulelo olumandla (sepsis).

Iimpawu ziyahluka ngokuxhomekeke kunobangela.

Iimpawu zeAnaphylaxis ziquka:3

Iimbuzi
Ukutshiza
Ukudumba, ingakumbi ebusweni
Ukuphefumla
Ubomvu besikhumba
Iqondo lentliziyo ekhawulezayo

Iimpawu ze-Sepsis ziquka: 4

Umkhuhlane (hayi rhoqo)
I-Flush, ulusu olubomvu
Umlomo omile
Ukwelula kwesikhumba esibi (i-turgor), okuthetha ukuba ukuba ulususile ulusu luhlala lucolile kwaye lubuyela kancinci kwisiqhelo, ukuba kunjalo.

I-Sepsis ihlala iyindibaniselwano ye-distributive kunye ne-hypovolemic shock kuba ezi zigulana zihlala ziphelelwe ngamanzi.

Umothuko weNeurogenic (ukusuka kophukile Umgudu intambo kwaye ihlala ibizwa ngokuba yi-spinal shock) ngunobangela onqabileyo womothuko osasazekileyo, kodwa unepateni eyahlukileyo yeempawu:5

Uxinzelelo lwegazi olusezantsi luphawu lwakwangoko (ngokungafaniyo nezinye iindlela zomothuko)
Izinga lentliziyo eliqhelekileyo (linokunyuswa, kodwa luhlobo lomothuko olunokuba nesantya esiqhelekileyo)
"Umgca" emzimbeni apho ulusu luluthuthu phezulu kwaye lube bomvu ngaphantsi

Umothuko weNeurogenic uza emva kohlobo oluthile lomonzakalo, njengokuwa okanye ingozi yemoto.

Umothuko weCargiogenic

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I-Airbus-H145 728 × 90 ngaphandle kweLogo

Xa intliziyo inobunzima bokumpompa igazi ngokwaneleyo, kwaziwa ngokuba yi-cardiogenic shock.

Inokuthi yenzeke emva kokuhlaselwa kwe-myocardial infarction (ukuhlaselwa yintliziyo), ukungasebenzi kakuhle kwevalve yentliziyo, i-cardiac arrhythmias, usulelo lwentliziyo, kunye nokwenzakala kwentliziyo.1

Iimpawu ze-cardiogenic shock ziquka:

I-pulse ebuthathaka kwaye ihlala ingaqhelekanga
Ngamanye amaxesha i-pulse ecothayo kakhulu
Ukuphefumula okunzima
Ukhohlokhohlo luvelisa isikhohlela esinamagwebu, simhlophe okanye ngamanye amaxesha pink ngombala
Ukudumba ezinyaweni nasemaqatheni

Ukutshatyalaliswa kweCardiogenic kunokukhatshwa yimiqondiso kunye neempawu zokuhlaselwa yintliziyo.

Umothuko Ongumqobo

Mhlawumbi olona didi luncinci luqhelekileyo lokothuka (i-neurogenic lolona hlobo luncinci luqhelekileyo), umothuko othintelayo uvela kwinto ecinezela imithambo yegazi ngaphakathi emzimbeni.

Oyena nobangela uxhaphakileyo we-obstructive shock ivela kwi-tension pneumothorax (umphunga owileyo).2

Uxinzelelo lwegazi oluphantsi lunokwenzeka ngokukhawuleza, kodwa umzimba uya kuzama ukubuyisela (ngokungafaniyo ne-neurogenic shock)
Ukubetha kwentliziyo ngokukhawuleza
Izandi zomoya ezingalinganiyo (ukuba zibangelwa yipneumothorax)
Ukuphefumla

Ngaphandle kwetension pneumothorax, omnye oyena nobangela wokothusayo kukuthintelwa yi-cardiac tampenade, imeko enqabileyo ebangelwa ligazi elivaleleke engxoweni ejikeleze intliziyo, liyicinezele kwaye iligcine ekumpompeni igazi ngokwaneleyo.

Masiye Nini Esibhedlele

Umothuko yimeko engxamisekileyo yezonyango yokwenyani kwaye kufuneka inyangwe ngokukhawuleza njengoko inokubonwa. Ukuba ukrokrela ukothuka, tsalela umnxeba ku-911 okanye inombolo yakho kaxakeka ngoko nangoko uze uye esibhedlele.2

Logama nje umzimba ukwazile ukugcina uxinzelelo lwegazi luphezulu, abezonyango baluthatha njengomothuko ohlawulelwayo.

Xa uxinzelelo lwegazi lusihla-kwanakwiimeko xa oko kusenzeka kwangethuba, njengokuphazamiseka kwe-neurogenic okanye i-obstructive-uluntu lwezonyango lubhekisela kuyo njengomothuko othotyiweyo.

Ukuba umothuko othotyiweyo uyekiwe unganyangwanga, unethuba eliphezulu lokufa.

Iingxelo:

Standl T, Annecke T, Cascorbi I, Heller AR, Sabashnikov A, Teske W. I-nomenclature, inkcazo kunye nomahluko weentlobo zomothuko. I-Dtsch Arztebl Int. 2018;115(45):757–768. doi:10.3238/arztebl.2018.0757
Haseer Koya H, uPaul M. Ukutshitshiswa. StatPearls.
I-American Academy ye-Asma ye-Alergy kunye ne-Immunology. I-Anaphylaxis.
Amacandelo okuLawula nokuKhuselwa kwezifo. Yintoni i-sepsis?
Summers RL, Baker SD, Sterling SA, Porter JM, Jones AE. Ubume be-spectrum yeeprofayili ze-hemodynamic kwizigulane ezixinzelelekileyo ezinomothuko onzima we-neurogenic. Ijenali yoNyango oluPhakamileyo. 2013;28(4):531.e1-531.e5. doi:10.1016/j.jcrc.2013.02.002