Puas muaj xwm txheej ceev vim yog cov ntshav/kua dej tsawg hauv lub cev? Cia peb kawm txog qhov kev poob siab hypovolemic no!

Koj puas tau muaj ib zaug koj cia li tsis nco qab, kiv taub hau, thiab ua pa nyuaj? Los yog koj puas tau pom ib tug neeg raug mob hnyav thiab los ntshav ntau heev? Ib qho ntawm cov mob txaus ntshai tshaj plaws uas tuaj yeem tshwm sim hauv cov xwm txheej zoo li no yog hypovolemic shock, uas peb yuav tham txog hnub no. Qhov no yog ib qho mob uas xav tau kev kho mob ceev, yog li nws tseem ceeb heev uas yuav tsum paub txog nws.

Kev poob siab thaum lub cev tsis muaj zog yog dab tsi? Cia peb nkag siab yooj yim!

Hais yooj yim xwb, qhov kev poob siab hypovolemic yog thaum cov ntshav lossis cov kua dej hauv koj lub cev poob qis sai heev ua rau koj lub plawv tsis tuaj yeem tso ntshav mus thoob plaws koj lub cev tau zoo. Xav txog nws zoo li lub tsheb tas roj. Ntshav zoo li roj rau peb lub cev.

Feem ntau qhov teeb meem no tshwm sim thaum ntau tshaj 20%, lossis ib feem tsib, ntawm tag nrho cov ntshav hauv peb lub cev poob. Qhov no tsis yog tsuas yog tshwm sim los ntawm kev los ntshav ntau dhau vim raug mob loj xwb. Qee zaum, raws plab hnyav, ntuav tas li, lossis tawm hws ntau dhau kuj tuaj yeem ua rau muaj qhov teeb meem no, ua rau ntau cov kua dej poob ntawm lub cev.

Qhov no yog xwm txheej ceev hauv kev kho mob, yog li ntawd, yog tias koj pom cov tsos mob, nws yog ib qho tseem ceeb uas yuav tsum hu rau 1190 lossis 1990 tam sim ntawd thiab nrhiav kev kho mob.

Muaj dab tsi tshwm sim rau ntshav siab thaum lub sijhawm no?

Thaum muaj kev poob siab hypovolemic, tus lej qis tshaj plaws ntawm koj cov ntshav siab, hu ua diastolic pressure, yuav pib nce me ntsis. Tab sis thaum cov ntshav lossis cov kua dej txuas ntxiv tawm hauv koj lub cev, tus lej siab tshaj plaws, hu ua systolic pressure, yuav maj mam pib txo qis.

Leej twg yuav muaj feem ntau dua los tsim qhov no?

Tus mob no tuaj yeem tshwm sim rau txhua tus neeg, tshwj xeeb tshaj yog ib tus neeg uas tau raug xwm txheej loj thiab poob ntshav ntau. Tsis tas li ntawd, zoo li peb tau hais ua ntej, ib tus neeg uas ntuav ntau, raws plab, lossis hws ntau kuj tuaj yeem qhuav dej.

Tus mob no feem ntau tshwm sim li cas?

Feem ntau, txhua yam kev poob siab tshwm sim rau tsawg dua 1 ntawm 1,000 tus neeg. Txawm li cas los xij, kev poob siab hypovolemic yog hom kev poob siab thib ob uas pom ntau tshaj plaws. Hauv qee lub tebchaws uas tseem tab tom txhim kho, nws feem ntau tshwm sim rau cov menyuam yaus vim yog raws plab.

Muaj dab tsi tshwm sim rau lub cev thaum lub sijhawm hypovolemic shock?

Kev poob siab Hypovolemic tshwm sim thaum cov kabmob tseem ceeb tshaj plaws hauv peb lub cev (piv txwv li, lub hlwb, lub plawv, lub raum) tsis tau txais cov ntshav thiab oxygen txaus. Qhov no zoo li tsob ntoo tuag yog tsis muaj dej. Peb cov kabmob kuj ua haujlwm tsis tau yog tsis muaj ntshav.

Lub sijhawm no, peb lub cev ua haujlwm ntse heev. Vim tias cov ntshav tsawg hauv lub cev, nws muab cov ntshav rau ob lub cev tseem ceeb tshaj plaws rau kev ciaj sia, lub hlwb thiab lub plawv . Yog vim li ntawd cov ntshav mus rau ceg txo qis, thiab ceg txias.

Qhov nruab nrab, ib tug neeg uas hnyav li ntawm 70 kilograms muaj li ntawm 5 liv ntshav hauv lawv lub cev. Qhov ntawd yog li ntawm 7% ntawm lawv qhov hnyav. Thaum muaj kev poob siab hypovolemic, ib feem tseem ceeb ntawm cov ntshav no ploj mus.

Plaub theem ntawm kev poob siab yog dab tsi?

Muaj plaub qhov xwm txheej tseem ceeb hauv qhov xwm txheej no, nyob ntawm seb qhov hnyav npaum li cas.

• Theem 1: Qhov no yog thaum koj poob li ntawm 15% ntawm koj cov ntshav (kwv yees li 750 milliliters (750 mL) - qhov ntawd yog li ntawm ib lub raj mis dej loj). Koj cov ntshav siab thiab lub plawv dhia yuav zoo li qub rau lub sijhawm no.
• Theem 2: Qhov no yog thaum cov ntshav ntim txo qis 15% txog 30% (750 mL txog 1,500 mL - kwv yees li ob lub raj mis dej loj). Lub plawv dhia pib nce, thiab kev ua pa nce ntxiv.
• Theem 3: Ntawm 30% thiab 40% ntawm lub cev cov ntshav (1,500 mL txog 2,000 mL - kwv yees li peb lub raj mis loj!) poob. Ntshav siab poob qis heev, lub plawv dhia thiab ua pa nce ntxiv. Cov zis tso tawm kuj txo qis heev.
• Theem 4: Qhov no yog theem hnyav tshaj plaws. Ntau tshaj 40% ntawm lub cev cov ntshav (>2,000 mL) tau ploj mus. Ntshav siab qis heev, lub plawv dhia ceev, thiab yuav luag tsis muaj zis tawm.

Peb yuav tsum paub txog cov tsos mob twg?

Cov ntshav los yog kua dej ntau npaum li cas ntawm lub cev poob, cov tsos mob yuav hnyav zuj zus. Nov yog qee cov tsos mob ntawm kev poob siab hypovolemic:

• Ua pa ceev dua: Zoo li koj ua pa sai dua li qub.
• Xav tias tsis meej pem lossis tsis nyob twj ywm: Nws nyuaj rau tsom ntsoov, thiab koj yuav xav tias tsis nyob twj ywm.
• Tawm hws ntau dhau: Tam sim ntawd, lub cev txias thiab pib tawm hws.
• Tsis nco qab (tsaim nplooj): Tej zaum koj yuav tsis nco qab tam sim ntawd yog tias koj tsis ua ub ua no dab tsi li.
• Tawv nqaij txias: Cov ceg tawv nqaij yuav txias thaum kov.
• Kev xav tias tsis muaj zog: Lub cev qaug zog heev ua rau nws ua tsis tau dab tsi.
• Txo qhov kub thiab ntshav siab ntawm lub cev.
• Lub plawv dhia ceev zuj zus (lub plawv dhia ceev zuj zus).

Yog tias pom ib lossis ntau yam ntawm cov tsos mob no nrog kev los ntshav hnyav, nws yuav yog hypovolemic shock.

Cov laj thawj tseem ceeb rau qhov no yog dab tsi?

Qhov ua rau mob no yog vim lub cev poob ntshav lossis kua dej ntau dhau. Qhov kev los ntshav no tuaj yeem tshwm sim sab hauv (hauv txoj kev uas peb tsis pom) lossis los ntawm qhov txhab uas pom tseeb. Tsis tas li ntawd,

• Kub hnyiab
• Mob Pancreatitis
• Cov ua rau muaj xws li tawm hws ntau dhau, ntuav, lossis raws plab kuj tuaj yeem yog cov yam ua rau muaj.

Muaj tej txoj kev twg uas yuav ua rau los ntshav?

Cov xwm txheej tseem ceeb ntawm kev los ntshav uas tuaj yeem ua rau hypovolemic shock yog:

• Kev raug mob los ntawm qhov xwm txheej loj heev: Tej yam xws li qhov xwm txheej ntawm txoj kev, poob ntawm qhov siab, thiab lwm yam.
• Thaum lub sijhawm phais lossis tom qab phais (kev phais): Qee qhov kev phais tuaj yeem ua rau los ntshav ntau dua me ntsis.
• Cev xeeb tub tsis muaj menyuam: Qhov no yog ib qho mob txaus ntshai heev, vim nws tuaj yeem ua rau los ntshav hauv lub cev.
• Aneurysm tawg: Qhov no txhais tau tias cov hlab ntsha tsis muaj zog, o zoo li lub npas, thiab tam sim ntawd tawg.
• Teeb meem ntawm txoj hnyuv zom zaub mov: Piv txwv li, los ntshav vim yog mob plab.

Tus kws kho mob yuav kuaj pom qhov no li cas?

Thaum koj raug coj mus rau tsev kho mob, thawj qhov uas tus kws kho mob lossis tus nais yuav ua yog kuaj koj. Tom qab ntawd, lawv yuav ua ob peb qhov kev kuaj mob kom paub meej tias koj muaj mob dab tsi.

• Kev kuaj ntshav: Xyuas kom pom tias koj cov ntshav qis npaum li cas thiab seb cov kabmob xws li koj lub raum puas tau raug cuam tshuam.
• Electrocardiogram (ECG): Saib seb lub plawv ua haujlwm li cas.
• Echocardiogram: Kev tshuaj xyuas lub plawv.
• Kev ntxig catheter rau hauv lub plawv sab xis (Swan-Ganz): Ib qho kev kuaj tshwj xeeb uas ntsuas qhov siab hauv lub plawv.
• Kev kuaj mob CT (Computed tomography - CT) lossis lwm yam kev kuaj mob hluav taws xob: Txhawm rau nrhiav qhov twg cov ntshav ntws hauv lub cev.
• Endoscopy: Kev kuaj xyuas txoj hnyuv plab siv ib lub raj uas muaj lub koob yees duab.

Yuav kho li cas? Tej yam uas yuav tsum ua tam sim ntawd!

Tom qab koj raug coj mus rau tsev kho mob los ntawm lub tsheb thauj neeg mob lossis lwm txoj kev, thawj qhov uas cov kws kho mob ua yog muab koj tso rau hauv txoj kab IV thiab muab dej rau koj (xws li saline) . Tom qab ntawd lawv muab ntshav rau koj yog tias tsim nyog. Lawv kuj muab tshuaj rau koj kom koj cov ntshav siab rov qab mus rau qhov qub.

Qhov tseem ceeb tshaj plaws yog kho qhov teeb meem uas ua rau muaj kev poob siab. Piv txwv li, txwv tsis pub ntshav, lossis phais yog tias koj raug mob hauv qhov xwm txheej. Tom qab ntawd, koj yuav raug khaws cia rau hauv Chav Saib Xyuas Mob Hnyav (ICU) rau kev soj ntsuam.

Cov tshuaj twg muab rau?

Qee cov tshuaj tseem ceeb uas tau muab rau kev poob siab hypovolemic yog:

• Epinephrine (Epinephrine - Adrenalin®)
• Norepinephrine (Norepinephrine - Levophed®)
• Dopamine
• Dobutamine (Dobutamine - Inotrex®)

Cov tshuaj no pab kho lub plawv dhia thiab ntshav siab.

Puas muaj tej yam tshwm sim ntawm kev kho mob?

Cov tshuaj no qee zaum tuaj yeem ua rau muaj kev phiv me me.

• Ntshav siab thiab lub plawv dhia nce ntxiv
• Ua pa nyuaj
• Mob taub hau (mob taub hau)
• Lub plawv dhia tsis xwm yeem

Peb ua tau dab tsi los txo qhov kev pheej hmoo no?

Nws nyuaj rau kwv yees thiab tiv thaiv cov xwm txheej loj. Txawm li cas los xij, muaj tej yam uas peb ua tau los txo qhov kev pheej hmoo ntawm kev poob siab hypovolemic los ntawm lwm yam ua rau:

• Yog koj noj tshuaj diuretics , noj raws li koj tus kws kho mob tau hais. Tsis tas li ntawd, haus dej ntau kom tsis txhob qhuav dej.
• Yog tias koj raws plab lossis ntuav, haus dej ntau lossis kua dej zoo li Jeevani kom rov qab tau cov kua dej uas koj lub cev poob.
• Yog koj tawm hws ntau, haus dej ntau kom rov qab tau cov kua dej uas koj poob.

Qhov tseem ceeb tshaj plaws: Yog tias koj pom ntshav ntau heev, lossis yog tias koj muaj qhov txiav uas tsis tuaj yeem nres, hu rau 1190 lossis 1990 tam sim ntawd, lossis mus rau chav kho mob ceev ntawm koj lub tsev kho mob ze tshaj plaws. Kev nrhiav kev pab sai sai tuaj yeem pab tswj qhov xwm txheej ua ntej cov ntshav ntau dhau ploj mus.

Yog koj muaj mob hypovolemic shock, yuav ua li cas? Yuav siv sijhawm ntev npaum li cas mam li rov zoo?

Seb koj puas dim thiab rov zoo los nyob ntawm ntau yam. Koj cov ntshav lossis kua dej poob ntau npaum li cas, nws tshwm sim sai npaum li cas, lwm yam mob uas koj muaj, thiab dab tsi ua rau koj poob siab kuj tseem muaj feem cuam tshuam.

Yog koj pib kho mob rau qhov poob siab thaum ntxov, nws cov teebmeem tuaj yeem thim rov qab. Yog tias koj tseem hluas thiab qhov poob siab tsis hnyav dhau, koj muaj feem ntau yuav ciaj sia. Txawm li cas los xij, qee zaum kev puas tsuaj ntawm cov kabmob tuaj yeem ua rau mob plawv nres. Yog tias ntau tshaj ib lub kabmob tsis ua haujlwm, qhov mob no yuav ua rau tuag taus. Txawm tias tau kho mob los xij, qhov poob siab hypovolemic qee zaum tuaj yeem ua rau tuag taus.

Kuv yuav ua li cas thiaj saib xyuas kuv tus kheej kom txog thaum kuv zoo rov qab los?

Tom qab koj mus txog tsev kho mob, koj yuav tsum ua raws li tus kws kho mob cov lus qhia kom meej. Koj lub cev tau raug mob ntau heev, yog li koj yuav tsum so thiab rov zoo hauv tsev ua ntej mus ua haujlwm. Noj tshuaj uas koj tus kws kho mob tau sau tseg kom meej, thiab saib xyuas txhua qhov txhab kom zoo.

Kuv yuav tsum mus ntsib kws kho mob dua thaum twg?

Tus kws kho mob yuav hais kom koj rov qab los ntsib koj dua kom paub seb koj zoo li cas. Tsis txhob mus ntsib cov kev teem caij no, vim tias yog lub sijhawm ntawd tus kws kho mob thiaj li paub sai txog tej teeb meem tshiab uas yuav tshwm sim.

Thaum twg koj yuav tsum mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) ?

Yog koj pom ib tug neeg muaj cov tsos mob ntawm hypovolemic shock, hu rau 1190 lossis 1990 tam sim ntawd. Tus neeg ntawd tau txais kev pab sai npaum li cas, qhov zoo dua. Txog thaum kev pab tuaj txog, muab tus neeg pw nrog lawv ob txhais ceg tsa li ib ko taw saum toj ntawm lawv lub cev. Tsis txhob txav lub cev, tsuas yog tsa ob txhais ceg xwb. Yog tias muaj kev los ntshav, sim ua kom nws tsis txhob los, thiab ua kom lub cev sov.

Yog tias koj tau muaj kev poob siab hypovolemic ua ntej lawm, yog tias koj cov qhov txhab pib los ntshav dua, lossis yog tias lawv zoo li ntws tawm, mus rau chav kho mob ceev dua.

Cov lus nug tseem ceeb uas yuav nug tus kws kho mob yog dab tsi?

Thaum koj mus ntsib kws kho mob, tsis txhob hnov ​​qab nug cov lus nug no:

• Qhov kev poob siab hypovolemic no puas yuav ua rau muaj kev cuam tshuam mus sij hawm ntev rau kuv?
• Yuav siv sijhawm ntev npaum li cas rau kuv kom rov zoo tag nrho?
• Kuv yuav tsum noj tshuaj uas koj tau sau ntawv kom noj ntev npaum li cas?

Thaum kawg, cov lus coj mus tsev

Kev poob siab Hypovolemic yog ib qho xwm txheej ceev hauv kev kho mob. Txawm li cas los xij, kev kho mob sai sai tuaj yeem cawm koj txoj sia. Cov kws kho mob tuaj yeem kho qhov mob no, tab sis nws yuav siv sijhawm rau koj kom rov zoo. Tshwj xeeb tshaj yog tias qhov kev poob siab yog qhov tshwm sim ntawm qhov xwm txheej loj, nws yuav siv sijhawm ntev dua kom rov zoo. Yog li, ua raws li koj tus kws kho mob cov lus qhia kom meej thiab saib xyuas koj tus kheej thiab koj cov kev raug mob. Ib txwm ceev faj!

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