Ukuhlukumezeka kwesifuba kungenye yezimo ezivame kakhulu zosizo lokuqala kanye nezimo ze-ambulensi zokungenelela kwezokwelapha: kufanele kwaziwe ngokunembile, ngakho-ke.

Umuntu uzotholakala ukuthi unokulimala kwesifuba uma elimele kakhulu esifubeni, futhi kufanele kutholakale ngendlela efanele, ngoba kuyimbangela yesithathu yokufa kwabantu ngenxa yokuhlukumezeka ngokomzimba emazweni aseNtshonalanga.

Ukuhlukumezeka kwesifuba kuhlanganisa amanxeba okudutshulwa, kungase futhi kwenzeke ngenxa yokuwa, ngemva kokugwazwa, ukushaywa noma ukushaywa.

Ukuxilongwa kungenziwa udokotela, ngokuvamile nge-X-ray.

Ukuhlukumezeka kwesifuba kungahlukaniswa ngezinhlobo ezimbili:

• Ukuhlukumezeka okujulile okwenzeka lapho isisulu sithola ukulimala okuphuka isikhumba, njengommese esifubeni noma inxeba lokudutshulwa;
• Ukulimala okulimazayo kuzoholela ekuqhekekeni okuthile kwesikhumba, ukudabuka akuyona imbangela yokulimala ngokwako futhi umonakalo ngokuvamile awubonakali endaweni. Ukukhahlelwa yisilwane esikhulu noma ukuba sengozini yemoto kungabangela ukuhlukumezeka okubuhlungu.

Ukuhlukumezeka okungaqondile kubala u-25% wabo bonke abashona ngenxa yezimo eziphuthumayo zezokwelapha.

Ukuhlukumezeka kwesifuba kuzoveza izimpawu ezimbalwa, okuvame kakhulu ubuhlungu obukhulu kanye nobunzima bokuphefumula

Ezinye izimpawu zizohlanganisa ukopha, ukushaqeka, ukuphelelwa umoya, ukopha, imihuzuko nokulahlekelwa ukwazi, okuzokwenzeka kuye ngokuthi imbangela yokulimala esifubeni.

Amathambo aphukile angase avele ngenxa yokulimala kwe-thoracic.

Ukuhlukumezeka kwesifuba kuzolashwa kuye ngembangela; kungase kudingeke ukungenelela ukuze kugezwe indlela yokuphefumula, kungaba uma kwenzeka ukuwa kwamaphaphu noma ukuvimbela ukuhlukumezeka ukuba kubangele umonakalo omkhulu futhi ngaleyo ndlela kubangele izifo.

Ukuhlukumezeka kwesifuba kungabangela izinhlobo ezihlukahlukene zokulimala kwenhliziyo, njengokungena komzimba wangaphandle, ukuphuka, i-tamponade, i-laceration kanye nokuvinjelwa kwemithambo ye-coronary, i-myocardial contusion, i-pericardial effusion, ukukhubazeka kwe-septal, izilonda ze-valvular, nokuqhuma kwemikhumbi emikhulu.

Lokhu kulimala kuvame ukubulala.

Ukulimala kwenhliziyo okugqobhozayo kuvame ukubangelwa izikhali ezibuthuntu noma izibhamu futhi kubangela izinga lokufa eliphakathi kuka-50% no-85%.

Ukuhlukumezeka okuvalekile kuvame ukuhlotshaniswa nokuqhekeka kwenhliziyo, i-ventricle engakwesokudla ithinteke kaningi kunesokunxele, futhi kubangele izinga lokufa elibalelwa ku-50% ezigulini ezifika esibhedlela. igumbi lokuphuthumayo uyaphila.

Ngemva kokuphuka kwekamelo lenhliziyo noma ukudabuka emithanjeni yenhliziyo noma imithambo emikhulu, igazi ligcwalisa ngokushesha isikhwama se-pericardial futhi kubangele i-tamponade yenhliziyo.

Ngisho nokuncane okungama-60-100 ml wegazi kungabangela i-tamponade yenhliziyo kanye nokushaqeka kwe-cardiogenic, okubangelwa ukuncipha kokugcwaliswa kwe-diastolic.

Amanxeba okudutshulwa angena esikhwameni se-pericardial futhi ngaphakathi kwenhliziyo aphumela ekuphumeni kwegazi ngokushesha, okuyikona okubusa isithombe somtholampilo.

I-tamponade yenhliziyo elandela inxeba lokudutshulwa enhliziyweni ihlotshaniswa nokwanda kokusinda ngenxa ye-systemic hypotension kanye nomfutho okhuphukile endaweni ye-pericardial, okusiza ukunciphisa ukopha.

I-tamponade yenhliziyo ivame ukuhlotshaniswa nezimpawu zomtholampilo ze-Beck's triad (i-jugular venous distension, hypotension kanye nokunciphisa amathoni enhliziyo).

Le triad ingase ingabi khona ezigulini eziye zaba ne-hypovolaemic ngenxa yokopha.

Ubufakazi be-radiographic bokwandiswa kwethunzi le-mediastinal bungaphakamisa ukukhishwa kwe-mediastinum kanye/noma i-tamponade.

Ukuqinisekiswa kokuphuma kwe-pericardial kungase kuhlinzekwe nge-echocardiography.

I-thoracotomy yokuhlola izimo eziphuthumayo, nge-cardiopulmonary bypass kanye nokulungiswa kokuhlinzwa, kanye nokumpontshelwa njengoba kudingwa yisimo somtholampilo kuzokwenziwa.

Izinguquko ze-anatomopathological zenhliziyo ephukile zihlanganisa ukopha kwe-intramyocardial, i-myocardial edema, i-coronary occlusion, ukuwohloka kwe-myofibrillar kanye ne-necrosis ye-myocardiocytes.

Lezi zilonda ziholela ku-arrhythmias kanye nokungazinzi kwe-hemodynamic okufana nalokhu okubonwa ngemva kwe-myocardial infarction.

Intubation, ventilation noma ezinye izindlela oxygenation kungase kudingeke; ukuhlinzwa, ukwelashwa ngezidakamizwa, ukuphumula okuphelele futhi kwezinye izimo kungase kudingeke ukwelashwa ngokomzimba.

Ngenxa yokuqina kobuhlungu, izinzwa zendawo zizosetshenziselwa ukunciphisa izinga lobuhlungu. Ama-analgesics azophathwa nge-epidural.

Iziguli ezingapheli noma ezingelapheki zingase zinikezwe ukumnika okuzilawulayo ukuze kusetshenziswe ngokufunwa ukuphatha ubuhlungu.

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