Koj puas tau xav tias koj muaj ntshav ntau npaum li cas hauv koj lub cev? Qhov no tsis yog tsuas yog ib qho teeb meem ntawm kev paub xwb, qee zaum nws tuaj yeem qhia koj cov ntaub ntawv tseem ceeb heev txog koj txoj kev noj qab haus huv. Qhov ntawd yog qhov peb hu ua "Kev Ntsuas Ntshav", ib qho kev xeem uas ntsuas qhov ntau ntawm cov ntshav. Qhov no yog "Kev Ntsuas Tshuaj Nuclear", uas txhais tau tias nws siv me ntsis ntawm cov khoom siv radioactive los saib kev ua haujlwm ntawm lub cev. Tsis txhob txhawj, qhov no muaj kev nyab xeeb heev. Cia peb tham txog qhov no kom ntxaws ntxiv, puas yog?
Ntshav txhais li cas tiag?
Txawm hais tias peb hais tias "ntshav," muaj ntau yam khoom nyob hauv. Yog hais kom meej, ntawm no yog cov no:
- Plasma: Qhov no yog cov kua ntawm cov ntshav. Tsis txhob xav tsis thoob, nws yog dej tshaj 90%!
- Cov Platelets: Cov no yog cov qe ntshav me me uas pab kom cov ntshav khov. Lawv tseem ceeb heev rau kev tiv thaiv kev los ntshav thaum koj raug mob.
- Cov Qog Ntshav Liab: Cov no zoo li cov pob puag ncig. Cov no yog cov uas nqa cov pa oxygen mus rau cov nqaij thoob plaws lub cev.
- Cov Qog Ntshav Dawb: Cov no zoo li cov neeg saib xyuas kev ruaj ntseg ntawm lub cev. Lawv yog cov uas tiv thaiv peb ntawm cov kab mob thiab kev kis kab mob.
Koj puas paub tias txawm hais tias cov platelets thiab cov qe ntshav dawb no tseem ceeb heev, lawv tsuas yog tsawg dua 1% ntawm peb cov ntshav tag nrho. Qhov "Kev Ntsuas Ntshav" feem ntau ntsuas qhov ntau ntawm cov plasma thiab cov qe ntshav liab. Yog vim li ntawd qee zaum nws thiaj li hu ua "Kev Ntsuas Plasma Volume" lossis "Kev Ntsuas Red Cell Mass".
Yuav tswj tau cov ntshav hauv peb lub cev li cas?
Qhov no yog ib txoj kev ua haujlwm zoo kawg nkaus. Peb lub cev yeej ib txwm tsim thiab rhuav tshem cov qe ntshav liab. Peb cov pob txha ua cov qe ntshav liab , thiab peb lub siab rhuav tshem lawv. Tab sis cov txheej txheem no qeeb me ntsis. Xav txog, yog tias koj poob ntshav ntau vim muaj mob, raug mob, lossis raug mob, nws yuav siv sijhawm ntau hnub, tej zaum ntau lub hlis, los tsim cov qe ntshav liab tshiab.
Tab sis kev tswj cov plasma yog sai dua. Vim tias plasma feem ntau yog dej. Lub cev tau txais nws cov kua dej los ntawm cov dej peb haus thiab cov khoom noj peb noj. Cov kua dej kuj poob los ntawm cov zis, quav, hws, thiab ua pa. Thaum koj noj qab nyob zoo, koj lub raum khaws cov kua dej no kom sib npaug.
Muaj tej yam dab tsi cuam tshuam rau qhov ntim ntawm cov ntshav? Feem ntau yuav tsum muaj pes tsawg?
Feem ntau lub cev ntawm ib tug neeg laus muaj li ntawm 5 liv ntshav. Txawm li cas los xij, qhov ntau no tuaj yeem hloov pauv vim ntau yam. Qee zaum qhov ntau ntawm cov ntshav tuaj yeem ntau dhau (Hypervolemia) lossis tsawg dhau (Hypovolemia).
Ntshav ntau ntxiv (Hypervolemia)
Qee yam uas ua rau muaj tus mob no yog:
- Qee yam mob plawv (Congestive Heart Failure)
- Noj ntsev ntau dhau (sodium)
- Teeb meem raum, piv txwv li, ua tsis tau haujlwm raum thiab mob nephrotic syndrome
- Kev ua haujlwm tsis zoo ntawm daim siab
Thaum cov ntshav ntim ntau ntxiv (Hypervolemia), cov tsos mob xws li:
- Mob plab thiab tsis xis nyob (Ascites)
- Kev Mob Plawv Tsis Ua Haujlwm
- Ntshav Siab
- Ua pa nyuaj vim yog kua dej puv lub ntsws
- O (Edema) - Feem ntau ob txhais ceg, pob luj taws, dab teg , lossis lub ntsej muag o.
Cov ntshav tsawg zuj zus (Hypovolemia)
Muaj ob qho laj thawj tseem ceeb uas ua rau cov ntshav tsawg:
- Kev los ntshav (raug mob, phais, los ntshav sab hauv)
- Kev qhuav dej - Qhov no txhais tau tias tsis muaj dej txaus hauv lub cev.
Yog tias koj cov ntshav ntws poob qis dhau, koj tuaj yeem mus rau hauv qhov xwm txheej txaus ntshai hu ua "Hypovolemic Shock." Qhov no yog thaum peb lub cev ua cov hauv qab no los them rau qhov txo qis ntawm cov ntshav ntws hauv lub cev:
- Txo cov ntshav siab.
- Ua rau lub plawv dhia ceev dua.
- Ua rau ua pa sai dua.
Yog tias cov ntshav ntws tsawg zuj zus, ces peb cov kab mob sab hauv thiab lub hlwb yuav raug kev puas tsuaj uas tsis rov qab kho tau. Yog li qhov no tsis yog lus tso dag!
Puas muaj kev sib raug zoo ntawm qhov ntim ntawm cov ntshav thiab ntshav siab?
Muaj tseeb tiag! Lub siab nyob hauv peb cov hlab ntsha yog qhov ua rau cov ntshav ntws mus rau txhua cov nqaij thiab cov cell hauv lub cev. Thaum cov ntshav ntim tsawg zuj zus, cov ntshav siab kuj txo qis. Tom qab ntawd lub cev sim rov qab cov ntshav ntws los ntawm kev ua rau cov hlab ntsha nqaim. Tab sis yog tias cov ntshav poob hnyav heev (Hnyav Hypovolemia), lub cev tsis tuaj yeem tswj nws.
Ib yam li ntawd, thaum cov ntshav ntim ntau ntxiv, nws ua rau peb cov hlab ntsha (cov hlab ntsha thiab cov leeg ntshav), ncab, uas ua rau cov ntshav siab ntxiv. Hypervolemia feem ntau tshwm sim thaum lub cev tsis tuaj yeem tswj tau cov kua dej vim yog lub raum lossis lub siab ua haujlwm tsis zoo.
Yuav tsum ua qhov no (Kev Ntsuas Ntshav Ntim) thaum twg?
Cov kws kho mob siv qhov kev sim no, tshwj xeeb tshaj yog rau cov neeg mob hauv cov chav kho mob hnyav . Piv txwv li:
- Cov neeg uas tau poob ntshav ntau heev
- Cov neeg uas lub cev qhuav dej
- Cov neeg uas muaj teeb meem plawv tsis ua haujlwm
- Cov neeg uas muaj mob raum lossis siab tsis ua haujlwm
- Cov neeg uas muaj kev kub hnyiab loj heev
- Cov neeg poob siab
Ntxiv rau qhov no, muaj lwm lub sijhawm uas cov kws kho mob siv qhov kev xeem no.
- Soj ntsuam seb puas muaj anemia.
- Nrhiav qhov ua rau koj tsaus muag ntau zaus (syncope).
- Soj ntsuam seb puas muaj ntshav siab thiab orthostatic hypotension.
- Ua ib qho kev kuaj mob ua ntej phais mob.
Qhov kev xeem no ua nyob qhov twg?
Qhov no ua tau thaum koj nyob hauv txaj pw hauv tsev kho mob, lossis nws ua tau hauv tsev kho mob "Chav Kho Mob Nuclear".
Qhov no (Kev Ntsuas Ntshav Ntim) ua haujlwm li cas? Puas nyuaj heev?
Tsis yog, nws tsis nyuaj ua luaj. Hais yooj yim xwb, nws mus li no:
Yuav ntsuas qhov ntau ntawm cov ntshav hauv koj lub cev, yuav muab ib qho tshuaj radioactive iodine tracer txhaj rau hauv koj cov leeg ntshav. Cov tshuaj tracer zoo li no tso cai rau cov kws kho mob saib qee yam kev ua haujlwm ntawm lub cev.
Tom qab cov "(Tracer)" no sib xyaw nrog koj cov ntshav tag, tus kws kho mob yuav coj cov ntshav ntawm koj thiab ntsuas cov radioactivity hauv nws.
Koj cov ntshav ntim tau suav los ntawm kev siv cov lej lej yooj yim li no: 'C1V1 = C2V2'.
Qhov no txhais tau tias:
- `C1` yog qhov concentration ntawm radioactivity nyob rau hauv `(Tracer)` uas tau txhaj tshuaj.
- `V1` yog qhov ntim ntawm `(Tracer)` uas txhaj tshuaj.
- `C2` yog qhov concentration ntawm radioactivity hauv koj cov ntshav tom qab `(Tracer)` sib xyaw nrog koj cov ntshav.
- `V2` yog qhov ntau ntawm cov ntshav hauv koj lub cev (qhov peb tab tom sim nrhiav).
Xav txog seb, thaum peb muab tshuaj rau lub cev ntau npaum li cas, peb xam tag nrho cov ntshav los ntawm kev saib seb nws sib xyaw nrog cov ntshav ntau npaum li cas thiab ua kom yaj.
Tiamsis yog koj xav paub seb qhov ntshav uas ntsuas tau li no puas yog qhov ib txwm muaj, siab, lossis qis rau koj, koj yuav tsum muab piv rau koj qhov ntshav ib txwm muaj. Txhua tus neeg qhov ntshav sib txawv. Koj qhov ntshav ib txwm muaj yog xam raws li koj qhov siab, qhov hnyav, thiab poj niam txiv neej.
Koj yuav tsum npaj li cas ua ntej qhov kev xeem?
Koj tus kws kho mob yuav qhia koj txog qhov no. Feem ntau, nws yog qhov zoo tshaj plaws kom tsis txhob noj lossis haus dab tsi li ob peb teev ua ntej qhov kev kuaj mob.
Thaum hnub uas koj yuav kuaj mob, koj yuav tsum tsis txhob haus dej uas muaj caffeine (xws li kas fes thiab tshuaj yej). Caffeine yog ib yam tshuaj diuretic, uas txhais tau tias nws ua rau koj tso zis ntau ntxiv thiab tshem cov kua dej tawm ntawm lub cev. Qee cov tshuaj kuj muaj caffeine. Yog li ntawd, nws yog ib lub tswv yim zoo los tham nrog koj tus kws kho mob txog cov tshuaj uas koj noj ua ntej kuaj mob thiab nug seb puas yuav tsum tau hloov lawv, yog tias tsim nyog.
Muaj dab tsi tshwm sim ua ntej qhov kev xeem?
Ib tug kws kho mob yuav ntsuas koj qhov siab thiab qhov hnyav. Tom qab ntawd, yuav muab ib txoj kab txhaj tshuaj (IV) ntxig rau hauv cov hlab ntsha hauv koj txhais caj npab, dab teg, lossis qhov chaw mos. Qhov no yog ib lub cuab yeej zoo li cannula.
Thaum koj xeem tas, yuav muaj dab tsi tshwm sim?
Cov hauv qab no tshwm sim thaum lub sijhawm xeem:
- Koj yuav raug yuam kom pw rau ntawm lub rooj kuaj mob.
- Tus kws kho mob txhaj tshuaj radioactive tracer hu ua Iodine-131 Human Serum Albumin (HSA) los ntawm txoj kab IV.
- Tom qab ntawd koj yuav tsum tos li 12 feeb kom cov '(Tracer)' sib xyaw zoo nrog cov ntshav.
- Tom qab ntawd, yuav muab cov ntshav kuaj ntau zaus txhua rau feeb thiab xa mus rau chav kuaj mob.
- Feem ntau, tag nrho qhov kev xeem yuav siv sijhawm tsis pub dhau 90 feeb.
Tom qab qhov kev xeem?
Tus kws kho mob yuav tshem cov IV tawm, thiab tom qab ntawd koj tuaj yeem mus tsev. Ib feem ntawm cov tshuaj radioactive tracer yuav raug tso tawm hauv koj cov zis, thiab lwm qhov yuav tawg ua tej daim me me hauv koj lub cev.Koj yuav tsum haus dej ntau tom qab kuaj, uas yuav pab cov tracer tawm hauv koj lub cev sai sai.
Puas muaj tej yam txaus ntshai hauv qhov no?
- Nws tsis yog lub tswv yim zoo los ua qhov kev kuaj no yog tias koj cev xeeb tub lossis pub niam mis. Yog li ntawd, koj tus kws kho mob yuav xav ua qhov kev kuaj cev xeeb tub ua ntej qhov kev kuaj.
- Muaj feem me me uas yuav ua xua. Koj yuav tsum qhia rau koj tus kws kho mob yog tias koj ua xua rau iodine, shellfish, lossis qe. Yog tias koj ua xua rau dab tsi, koj tus kws kho mob yuav hloov kho qhov kev kuaj kom tsis txhob ua xua.
- Cov tshuaj iodine uas muaj zog "(Tracer)" tuaj yeem ua rau koj lub qog thyroid puas tsuaj. Yuav kom tiv thaiv qhov no, tus kws kho mob yuav muab tshuaj iodine rau koj ua ntej kuaj. Thaum koj lub qog thyroid nqus cov iodine lawm, nws yuav tsum tsis nqus cov iodine uas muaj zog lawm.
Cov txiaj ntsig qhia li cas? Koj ua li cas rau lawv?
Cov txiaj ntsig ntawm kev kuaj yuav qhia seb koj cov ntshav suav li qub, qis, lossis siab. Koj tus kws kho mob siv tau cov ntaub ntawv no los soj ntsuam koj tus mob thiab txiav txim siab seb yuav tsum tau kho dab tsi.
Hais yooj yim xwb, "Kev Ntsuas Ntshav" ntsuas seb cov ntshav hauv koj lub cev puas yog qhov ib txwm muaj los tsis yog. Kev hloov pauv ntawm cov ntshav ntim muaj feem cuam tshuam nrog ntau yam kab mob, thiab lawv tuaj yeem ua rau muaj teeb meem loj. Kev kuaj no feem ntau ua rau cov neeg mob hauv chav kho mob hnyav. Nws tuaj yeem pab lawv kom lawv cov kua dej rov qab mus rau qhov ib txwm muaj, thiab pab lawv rov zoo sai dua.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Ib qho "Kev Ntsuas Ntshav" yog ib qho kev ntsuas uas ntsuas tag nrho cov ntshav hauv koj lub cev.
- Qhov no feem ntau saib ntawm qhov ntau ntawm cov qe ntshav dawb thiab cov qe ntshav liab.
- Ob qho tib si qhov nce ntxiv ntawm cov ntshav ntim (Hypervolemia) thiab qhov txo qis ntawm cov ntshav ntim (Hypovolemia) tuaj yeem ua rau muaj teeb meem kev noj qab haus huv.
- Cov kws kho mob siv qhov kev kuaj no los kuaj mob ntau yam mob thiab npaj kev kho mob, tshwj xeeb tshaj yog thaum muaj xwm txheej ceev.
- Qhov kev kuaj no siv me ntsis cov khoom siv radioactive (Radioactive Tracer), thiab nws muaj kev nyab xeeb. Txawm li cas los xij, nws tsis haum rau cov niam cev xeeb tub thiab cov niam pub niam mis.
- Yog koj muaj kev ua xua, tsis txhob hnov qab qhia rau kws kho mob ua ntej.
Yog li, cov no yog cov yam tseem ceeb tshaj plaws uas koj yuav tsum paub txog '(Kev Ntsuas Ntshav Ntim)'. Yog tias koj muaj lus nug ntxiv txog qhov no, tsis txhob ntshai nug koj tus kws kho mob, puas yog?
` Ntshav Ntim, Ntshav Ntim, Kev Ntsuas Ntshav Ntim, Hypervolemia, Hypovolemia, Plasma, Cov Qe Ntshav Liab, Kev Ntsuas Kev Noj Qab Haus Huv
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus