Mí katã míetoa ɣeyiɣi siwo me míesena le mía ɖokui me zi ɖeka be míaƒe lãme mesẽ o, alo? Ne èse le ɖokuiwò me be yegbɔdzɔ, yeƒe ta mekɔ o, alo be yele agbagba dzem be yeagbɔ ya ate ŋu ado vɔvɔ̃ na ame vavã. Seselelãme siawo ate ŋu anye dzesi siwo fia be wò ŋutilã le nya vevi aɖe si le ete la me tom. Egbea la, Nirogi Lanka di be yeakpe ɖe ŋuwò nàse atikewɔwɔ kpata aɖe si ate ŋu ade ame ƒe agbe afɔku me si woyɔna be ‘Distributive Shock’ gɔme. Ne èkpɔ dzesi siawo gbeɖeka la, taflatse yi atikewɔƒe enumake to kaƒoƒo na 911 alo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ le mia gbɔ me.
Nukae nye ‘Distributive Shock’? Kpuie ko la...
Kpuie ko la, Distributive Shock nye atikewɔwɔ kpata vevi aɖe. Edzɔna ne wò ʋukawo keke zi ɖeka—alo keke—gbɔ eme abe rababa ƒe hose si keke akpa ene. Woyɔa esia ɣeaɖewoɣi be ‘Vasodilatory Shock’ . Ne ʋuka siawo keke la, wò ʋu ƒe sisi dzi ɖena kpɔtɔna ŋutɔ. Bu eŋu abe abɔ me hose ene: ne eƒe didime dzi ɖe edzi akpa la, tsi si le eme ƒe nyaƒoɖeamenu dzi ɖena kpɔtɔna, eye tsi si sina toa eme la megawɔa dɔ nyuie o.
Nukae dzɔna le esia ta? Wò ŋutinu veviwo abe wò dzi, ahɔhɔ̃, kple ayiku ene mexɔa ʋu si hiã be woawɔ dɔ o . Tsɔ kpe ɖe eŋu la, le go aɖewo me la, ʋuka sue siawo (capillaries) dzea tsi dodo gɔme, si wɔnɛ be wò ʋu ƒe agbɔsɔsɔ bliboa dzi ɖena kpɔtɔna ɖe edzi. Esia nye nɔnɔme si ate ŋu ade wò agbe afɔku me elabena wò ŋutinuwo nɔa te ɖe ʋu si nana wò ɣesiaɣi si nɔa anyi ɖaa dzi hafi woate ŋu anɔ agbe.
Vevietɔ ŋutɔ: Ne èsusu be nɔnɔme aɖe si me dzidziƒoame le le ŋuwò la, di atikewɔla kpata enumake. Ƒo ka na 911 alo yi xɔ si te ɖe ŋuwò si kpɔa nudzɔdzɔ kpatawo gbɔ zi ɖeka, elabena heheɖemegbe ate ŋu awu ame.
Nukawoe nye Distributive Shock ƒomevi veviwo?
Distributive Shock ƒomevi vevi etɔ̃e li, eye nya vovovo aɖe si le ete gbɔe wo dometɔ ɖesiaɖe tsona:
1. Septic Shock: Esiae nye ƒomevi si bɔ wu. Dɔlékui ƒe dɔléle sesẽ aɖe gbɔe wòtsona. Le kpɔɖeŋu me, ne abi aɖe xɔ dɔ eye dɔlékuiawo kaka ɖe wò ŋutilã katã me (nɔnɔme aɖe si woyɔna be Sepsis), eye ŋutilãa ƒe ŋuɖoɖo megate ŋu ɖua edzi o la, àte ŋu axɔ Septic Shock. Aklãdɔ sesẽ alo dɔlékui bubu siwo le ɖoɖo nu hã ate ŋu ahe esia vɛ.
2. Anaphylactic Shock: Esia tsoa nulɔdɔ sesẽ aɖe si ate ŋu ade ame ƒe agbe afɔku me gbɔ. Le kpɔɖeŋu me, ame aɖewo toa esia me ne woɖu atikutsetsewo alo nudzodzoe aɖewo ɖu wo vɔ. Ne amesi ŋu asrã sesẽ le la ƒe gbɔgbɔ sesẽ kpata la, dzidziƒoame sia ƒomevi hã ate ŋu adzɔ.
3. Ahɔhɔ̃mekawo ƒe Ʋuʋu:Esia dzɔna le nusiwo gblẽ le wò aklã ŋu ta. Ne èxɔ abi le ta alo aklã me, abe tsi me nɔnɔ ƒe afɔku alo gege/ʋu ƒe gododo gã aɖe ene la, nusiwo gblẽ le wò lãmekawo ŋu ate ŋu ana ŋutilãa nagalé ʋukawo ƒe ɖiɖi me ɖe asi o, si ahe Neurogenic Shock vɛ.
Vovototo kae le Distributive Shock kple Hypovolemic Shock dome?
Wo ame evea siaa nye dzidziƒoame ƒomevi aɖe, si fia be wo ame evea siaa wɔnɛ be ŋutinu veviwo megakpɔa ɔksidzin kple nunyiame veviwo o. Ke hã, nu siwo gbɔ wòtsona la to vovo.
- Distributive Shock dzɔna elabena wò ʋukawo megaɖina o eye wokekena akpa, eye zi geɖe la, Sepsis alo nulɔdɔ sesẽ aɖee hea esia vɛ.
- Hypovolemic Shock dzɔna elabena wò lolome ŋutɔŋutɔ bu—to ʋu si dona le ŋuwò vevie alo tsi si mesɔ gbɔ o, abe aɖuɖɔtoe alo aɖuɖɔtoe si nɔa anyi ɖaa ene, si naa tsi vɔna le wò ŋutilã me.
Kpuie ko la: Distributive shock ku ɖe ʋukawo ƒe keke ŋu; Hypovolemic shock ku ɖe ʋu alo ŋutilã me tsi ƒe bu le ŋutilã me ŋu. Èse vovototo si le wo dome gɔmea?
Aleke gbegbee Distributive Shock bɔe?
Dzidziƒoame ƒomevi vevi ene li: Hypovolemic, Cardiogenic, Obstructive, kple Distributive. Distributive Shock ye nye esi bɔ wu le esiawo dome , vevietɔ Septic Shock. Le dukɔwo abe U.S. ene me la, ame siwo ade miliɔn ɖeka xɔa Sepsis/Septic Shock ƒe sia ƒe. Enye nɔnɔme si ate ŋu adze ame sia ame dzi, le ƒe ɖesiaɖe me.
Nukae Distributive Shock wɔna na wò ŋutilã?
Abe alesi míegblɔe va yi ene la, ne ʋukawo keke la, wò ʋu ƒe sisi dzi ɖena kpɔtɔna. Esia wɔe be wò ŋutinuwo mexɔa ʋu wòsɔa gbɔ o. Bu wò ŋutinuwo abe mɔ̃wo ene; wohiãa mɔ̃memi si nɔa anyi ɖaa—ʋu kple ɔksidzin—be woate ŋu awɔ dɔ. Ne wotso tsi sia la, ŋutinuwo dzea nutsitsi gɔme ɖekaɖeka. Woyɔa esia be ŋutinuwo ƒe dɔmawɔmawɔ nyuie , si nye afɔku na wò agbe enumake.
Nukawoe nye dzesiawo?
Distributive Shock ƒe dzesiwo ate ŋu ato vovo le nusi gbɔ wòtso nu. Gake nuxlɔ̃amedzesi siwo bɔ dometɔ aɖewoe nye:
- Ŋutilã ƒe ʋuʋu alo bibi
- Dzi ƒe tsotso kabakaba kple gbɔgbɔ kabakaba
- Ʋu ƒe sisi ƒe ɖiɖi (dzesi aɖe si ɖe dzesi) .
- Le gɔmedzedzea me la, ŋutigbalẽa xɔa dzo, si ate ŋu atrɔ ava fa eye wòazu lãgbalẽ emegbe
- Asrã
- Vuvɔ kple ʋuʋudedi
- Ƒodo ƒe vevesese
- Tɔtɔ alo susu ƒe tɔtɔ
- Kɔdzidede
- Yagbɔgbɔ kpuie
- Xeɖeɖe
- Ʋuʋudedi
- Vevesese le aɖuɖɔɖɔɖɔɣi
Ne èkpɔ dzesi siawo dometɔ ɖeka alo esi wu nenema zi ɖeka la, taflatse mègabu eŋu nu tsɛe o.
Nukae hea Distributive Shock vɛ?
Le ƒomevi etɔ̃ siwo ŋu míeƒo nu tsoe va yi megbe la, nu bubu geɖewo ate ŋu ahe nɔnɔme sia vɛ:
- Sepsis si dona tso dɔlékui ƒe dɔléle gbɔ (esiae nye nusi gbɔ wòtsona wu).
- Anaphylaxis le nulɔdɔ sesẽwo ta (le kpɔɖeŋu me, atikutsetse, nudzodzoewo ƒe ƒoƒo, atike aɖewo, alo asrã ƒe amedzidzedze sesẽ).
- Dzobibi sesẽwo.
- Dɔdzẽ (dɔdzẽ si le dɔgboa me).
- Toxic Shock Syndrome (si ate ŋu adzɔ, le kpɔɖeŋu me, tso tampon zazã ɣeyiɣi didi me).
- Abi si woxɔ le aklã me.
- Dɔlékui aɖewo siwo le lãmenugbagbeviwo me.
- Adrenal insufficiency (nusi mebɔ o).
- Capillary leak syndrome (afisi tsi sina tso ʋukawo me; ƒã hã).
- Atikewo zazã fũ akpa si me ʋukawo kekeɖenudɔlékuiwo le (mebɔ o).
Aleke ɖɔktawo wɔa dea dzesi dɔléle siae?
Ne èva kple dzesi siawo la, ɖɔkta aɖe ado wò kpɔ enumake eye wòaŋlɔ ŋutinya tsitotsito. Esi wònye be ame aɖe si ƒe mo wɔ yaa mate ŋu aɖo dze o ta la, ele vevie ŋutɔ be ƒometɔwo alo xɔlɔ̃wo nana atikewɔlawo nanya nulɔdɔ siwo nènya, anaphylaxis ƒe ŋutinya, alo atike siwo zãm nèle fifia. Nyatakaka sia le vevie ŋutɔ na dɔlélea didi.
Le esia megbe la, wò ɖɔkta ate ŋu aɖe gbe be woawɔ dodokpɔ geɖe:
- Ʋudodokpɔ: Be woalé ŋku ɖe dɔlékuiwo ŋu ahada ŋutinuwo ƒe dɔwɔwɔ kpɔ.
- Electrocardiogram (EKG/ECG): Be nàlé ŋku ɖe wò dzi ƒe elektrikŋusẽ ƒe dɔwɔwɔ ŋu.
- Akɔta ƒe X-ray: Be nàda wò lãkusiwo kpɔ.
- Ultrasound: Be woakpɔ dzi, lãkusi, kple ƒodo ƒe ŋutinuwo le susu me; zi geɖe la, wozãa xɔtunu siwo woate ŋu atsɔ adzoe le wò aba gbɔ tututu.
Aleke wowɔa atike nɛ?
Esi wònye be atikewɔwɔ kpatae esia nye ta la, zi geɖe la, wodzea atikewɔwɔ gɔme le Dɔwɔƒe si Kpɔa Dɔléle Kpatawo Gbɔ eye zi geɖe la, woyia edzi le Dɔnɔdzikpɔƒe (ICU).
1. Afɔɖeɖe enumakee nye be nàna tsi si wodona ɖe ʋuka me: Wodoa dze alo tsi bubuwo ɖe ʋuka me be wòakpe ɖe ŋuwò nàna wò ʋu ƒe sisi nali ke.
2. Atikewɔwɔ si ŋu woɖo taɖodzinu ɖo: Ðɔktawo ade dzesi nusi koŋ gbɔ dzidziƒoamea tso eye woana atike be woatsɔ akpɔ egbɔe.
3. Nunyiame ƒe kpekpeɖeŋu: Le go aɖewo me la, ahiã be nàna nuɖuɖu to mɔ̃ me be nàkpɔ egbɔ be ŋusẽ si wò ŋutilã hiã be wòahaya la le esi.
Le ICU la, atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe wò dzesi veviwo (dzi ƒe tsotso, ʋu ƒe sisi, oxygen ƒe agbɔsɔsɔ, kple dzoxɔxɔ) ŋu ɣesiaɣi. Woakpɔ atikewɔwɔ ƒe nugbegblẽ ɖesiaɖe hã gbɔ. Ne èle agbagba dzem be yeagbɔ ya la, woate ŋu atsɔ wò ade yagbɔgbɔmɔ̃ dzi.
Atike kawoe wozãna?
Atikewɔwɔ nɔ te ɖe nusi gbɔ wò mama ƒe dzidziɖedzi tso dzi:
- Vasopressors: Atikewo abe epinephrine, vasopressin, norepinephrine, alo phenylephrine ene be woatsɔ ado ʋu ƒe sisi ɖe dzi.
- Dɔlékuiwutikewo: Be woatsɔ ada dɔlékui ɖesiaɖe si le ete.
- Antihistamines: Be woatsɔ akpɔ nusiwo ŋu nulɔdɔ le gbɔ.
- Steroids: Wozãnɛ na nulɔdɔ alo dɔlékuiwutike sesẽwo.
- Albuterol inhalers: (le kpɔɖeŋu me, Accuneb® alo Proair®HFA) ne asrã sesẽ gbɔe dzidziƒoamea tso.
Ðe atikewɔwɔa ƒe nugbegblẽ le ame ŋua?
Ẽ, atike aɖewo ate ŋu agblẽ nu le ame ŋu, siwo dometɔ aɖewoe nye:
- Vasopressors: Dzi ƒe tsotso ƒe masɔmasɔ (arrhythmia), dzimaɖitsitsi, tsi si le lãkusi me (aklã me ʋuʋu), akɔtave, alo dzitodzito me ʋukawo ƒe ʋuʋu.
- Dɔlékuiwutikewo: Aɖuɖɔtoe alo aɖuɖɔtoe.
- Albuterol: Ʋuʋudedi, taɖuame, alo ʋuʋudedi.
- Antihistamines: Alɔ̃dɔdɔ, taɖuame, taɖuame, alo dzi ƒe tsotso kabakaba.
Taflatse kakaɖedzi nenɔ asiwò be wò ɖɔktawo da afɔku siawo kpɔ nyuie kple alesi wòhiã be woaɖe wò agbe eye woana atike si le dedie wu, si wɔa dɔ wu ɖesiaɖe le Nirogi Lanka.
Aleke nàwɔ aɖe afɔkua dzi akpɔtɔ?
Togbɔ be menye nusiwo katã hea mama ƒe dzidziɖedzi vɛ, abe dɔlékui aɖewo ene, ye woate ŋu axe mɔ na o hã la, àte ŋu aɖe afɔ aɖewo atsɔ akpɔ afɔku siwo wonya gbɔ:
- Ne nuɖuɖu ƒe nulɔdɔ sesẽ aɖe le ŋuwò la, tsɔ epinephrine auto-injector (abe EpiPen® alo Adrenalin® ene) ɖe asi ɣesiaɣi eye nànya alesi nàzãe nyuie.
- Ne asrãdɔ le fu ɖem na wò enuenu la, ke tsɔ wò Albuterol alo Salbutamol gbɔgbɔtsixetsixe ɖe asi ɣesiaɣi. Mègana wòawu enu o.
- Ne èzãa tampons la, trɔ wo enuenu be nàxe mɔ ɖe Toxic Shock Syndrome ƒe afɔkua nu.
- Ƒo asa na tsi si me goglo alo esi mènya o me nɔnɔ, elabena esia ate ŋu ana ame naxɔ abi le aklã ŋu.
- No atikewo ɣesiaɣi abe alesi wò ɖɔkta gblɔe ene pɛpɛpɛ.
Nukae dzɔna ne èxɔ Distributive Shock?
Ne nusi gbɔ wò ‘dzidziƒoame’ tsoe nye sepsis , la, àte ŋu ado go kuxi siwo nɔa anyi didi abe ɖeɖiteameŋu, drɔ̃e siwo ɖea fu na ame, alo nuɖuɖumadzroame ene. Eɖanye nuka kee gbɔ wòtso o, ele vevie ŋutɔ be nàde wò ɣeyiɣi siwo katã woawɔ be nàkplɔ wò ɖo eye nàwɔ ɖe atikewɔmɔnu si wò ɖɔkta ŋlɔ na wò dzi pɛpɛpɛ.
Wò hayahaya ƒe ɣeyiɣi ɖoɖo tso Distributive Shock me nɔ te ɖe wò nuteƒekpɔkpɔa ƒe sesẽ dzi bliboe. Ðewohĩ ahiã be nànɔ kɔdzi tso ŋkeke geɖe va ɖo kwasiɖa geɖe.
Alesi wòanya wɔ be wòahaya bliboe la toa vovo tso 20% va ɖo 80%, le nusi gbɔ wòtso nu. Ne atikewɔlawo mede nu nyaa me o la, zi geɖe la, nɔnɔme sia wua ame. De dzesii kaba kple atikewɔwɔ kabae nye wò ametakpɔnu nyuitɔ kekeake be nàtsi agbe.Afɔkua lolo ŋutɔ na ame tsitsiwo, ame ɖekaɖeka siwo noa aha atraɖii, kple amesiwo ŋu ŋutinu vovovowo ƒe kuxiwo le.
Ne wò ŋutilã wɔa nu nyuie ɖe tsi siwo wodona ɖe ʋuka me (IV) ŋu eye wò ŋutinuwo léa woƒe dɔwɔwɔ me ɖe asi la, wò nyagblɔɖi be yeahaya la nu sẽna wu sã.
Aleke mawɔ akpɔ ɖokuinye dzi ne megbɔ va aƒeme ?
Ne wonya ɖe asi le ŋuwò le kɔdzi ko la, wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ. Ðewohĩ ahiã be nàɖi ɖe eme le aƒeme ŋkeke alo kwasiɖa geɖe hafi nàsu te atrɔ ayi dɔme. Taflatse kpɔ egbɔ be yede sasrãkpɔ siwo katã woawɔ atsɔ akplɔe ɖo eye yewu yeƒe atike bliboa nu.
Ne èse le ɖokuiwò me be yeƒe nɔnɔmea le sesẽm ɖe edzi le ɣeyiɣi ɖesiaɖe me esime nèle aƒeme la, te ɖe wò ɖɔkta ŋu enumake.
Le nɔnɔme kpata aɖe me: Ele be woatsɔ amesiame si ɖe Distributive Shock ƒe dzesiwo fia la ayi dɔwɔƒe si te ɖe eŋu kpata. Esi nèle lalam na dɔwɔƒe siwo kpɔa nudzɔdzɔ kpatawo gbɔ (yɔ 911) la, na amea namlɔ anyi, na dzoxɔxɔ nanɔ eŋu kple avɔ, eye nàkɔ eƒe afɔwo ɖe dzi abe sentimeta 12 ene be wòade ʋu ƒe sisi ƒe dzi ƒo.
Nya siwo wòle be nàbia wò ɖɔkta
Ne èto nɔnɔme sia me kpɔ la, anyo be nàdzro nya siwo gbɔna me kple wò ɖɔkta:
- Ðe mele afɔku me be magakpɔ Distributive Shock akea?
- Zi nenie wòhiã be made ɣeyiɣi siwo woɖo ɖi be makplɔe ɖo?
- Ðe Distributive Shock akpɔ ŋusẽ aɖe ɖe nye lãmesẽ dzi ɣeyiɣi didi aɖea?
Gbedasi Vevi Si Wotsɔ Yi Aƒeme
Distributive shock nye atikewɔwɔ kpata vevi aɖe si hiã be woakpɔ egbɔ enumake. Kpekpeɖeŋu didi kaba ale si wòanya wɔe naa mɔnukpɔkpɔ nyuitɔ kekeake be woatsi agbe. Hahaya xɔa ɣeyiɣi, eyata taflatse gbɔ dzi ɖi na wò ŋutilã. Le aƒeme la, wɔ ɖe wò atikewo zazã ƒe ɖoɖoa dzi eye nàde ŋgɔdonyawo katã gbɔ. Le Nirogi Lanka la, míedi be nànya nu tso eŋu nyuie elabena lãmesẽnyawo ŋuti wɔna vevi aɖee nye esia.
👩🏽 ⚕️ Nyabiase Siwo Wobiana Enuenu (FAQs)
💬 Ðe Distributive Shock kple elektrikŋusẽ ƒe ʋuʋu sɔa?
Ao, le atikewɔwɔ me la, ‘dzidziƒoame’ fia nɔnɔme si dea ame ƒe agbe afɔku me si me ʋu ƒe sisi yi ŋutinu veviwo (abe ahɔhɔ̃ kple ayiku ene) me dzi ɖena kpɔtɔna ŋutɔ. Le nɔnɔme sia koŋ me la, togbɔ be dzia ate ŋu anɔ pɔmpim hã la, ʋukawo kekena le mɔ si dzi womate ŋu aɖu o nu, si wɔnɛ be ʋu ƒe sisi dzi ɖena kpɔtɔna va ɖoa afisi afɔku le.
💬 Nukatae ʋukawo kekena eye ʋu ƒe sisi ɖiɖina?
Nu vevi etɔ̃e li: 1. Nulɔdɔ sesẽ (Anaphylaxis, abe esi tso anyi ƒe ƒoƒo me ene), 2. Ʋu ƒe dɔléle sesẽ (Sepsis/Septic shock), alo 3. Lãmetsiŋusẽ ƒe gbegblẽ le akɔta ŋu le abi aɖe ta (Neurogenic shock).
💬 Aleke nàwɔ ade dzesi ame aɖe si le afɔku me?
Dzesiawo dometɔ aɖewoe nye alɔ̃madɔmadɔ, dzi ƒe tsotso kabakaba si mesɔ o (tachycardia), ŋutigbalẽ ƒe ɣie, kple gbɔgbɔ sesẽ ŋutɔ. Esi wònye be esia ate ŋu ana wòaku le aɖabaƒoƒo ʋɛ aɖewo ko me ta la, ele be woaxɔ dɔnɔa ɖe ICU hena atike siwo wozãna kpata (abe vasopressors abe epinephrine ene) xɔxɔ.
Nya veviwo: Distributive shock, septic shock, anaphylactic shock, ahɔhɔ̃mekawo ƒe ʋuʋu, ʋu ƒe sisi, dzidziƒoame ƒe atikewɔwɔ, sepsis ƒe hayahaya
