Puas muaj ib yam dab tsi thaiv cov ntshav ntws mus rau hauv thiab tawm ntawm koj lub plawv? Qhov no yuav yog '(Obstructive Shock)'!

Thaum cov ntshav tsis ncig thoob plaws peb lub cev kom zoo, uas txhais tau tias peb cov kab mob tsis tau txais cov pa oxygen txaus, feem ntau peb hu nws ua 'kev poob siab'. Qhov no tshwm sim sai sai. Hnub no peb yuav tham txog ib hom 'kev poob siab' tshwj xeeb, tab sis tsis tshua muaj. Nws hu ua '(Obstructive Shock)'. Hais yooj yim, qhov tshwm sim hauv qhov no yog tias muaj qee yam thaiv cov ntshav ntws mus rau peb lub plawv thiab cov ntshav ntws tawm ntawm lub plawv, uas yog, 'kev thaiv' tshwm sim. Vim yog qhov kev thaiv no, lub plawv tsis tuaj yeem ua haujlwm zoo, cov ntshav siab tuaj yeem poob qis tam sim ntawd, thiab lub cev tuaj yeem tsis muaj oxygen. Qhov no yog qhov xwm txheej ceev heev , yog li nws tseem ceeb heev kom tau txais kev kho mob sai sai.

Yog li ntawd, qhov no yog dab tsi (Obstructive Shock)? Peb puas yuav piav qhia ntxiv me ntsis?

Xav txog seb, peb lub siab zoo li lub twj tso dej. Lub twj tso dej no yog qhov xa ntshav mus thoob plaws lub cev. Tam sim no, yuav ua li cas yog tias cov dej nkag mus rau hauv lub twj tso dej no raug thaiv hauv cov yeeb nkab, lossis yog tias cov yeeb nkab tawm ntawm lub twj tso dej raug thaiv? Cov dej tsis ntws zoo, puas yog? Qhov ntawd yog qhov tshwm sim hauv '(Obstructive Shock)'.

Muaj ib yam dab tsi thaiv cov ntshav ntws los ntawm cov hlab ntsha loj (hu ua 'cov hlab ntsha loj') uas txuas lub plawv. Qhov no tiv thaiv lub plawv kom tsis txhob tau txais ntshav txaus, thiab nws tsis tuaj yeem tso nws tawm zoo. Qhov tshwm sim yog tias cov kabmob tseem ceeb tshaj plaws hauv peb lub cev, lub hlwb, lub raum, thiab lub ntsws, tsis tau txais oxygen txaus. Qhov no yog qhov xwm txheej ceev uas txaus ntshai rau lub neej.

Qhov txawv ntawm '(Cardiogenic Shock)' thiab '(Obstructive Shock)' yog dab tsi?

Ob qho no yog xwm txheej ceev kho mob, tab sis lawv tshwm sim rau ob qho laj thawj.

Kev poob siab ntawm lub plawv tshwm sim thaum cov leeg nqaij plawv raug puas tsuaj, xws li mob plawv nres, thiab lub plawv tsis tuaj yeem tso ntshav txaus mus rau lub cev. Lub plawv qaug zog.

Tiam sis thaum muaj '(Obstructive Shock),' cov leeg nqaij plawv feem ntau yuav zoo. Qhov teeb meem tsis yog nrog lub plawv, tab sis nrog lwm yam uas cuam tshuam rau lub plawv ua haujlwm. Xav txog cov no:

• Yog tias koj muaj cov ntshav txhaws loj hauv cov hlab ntsha loj (pulmonary artery) uas mus rau koj lub ntsws.
• Yog tias lub plawv raug nias los ntawm lub hnab dej uas puv nkaus lub plawv (pericardial tamponade).
• Yog tias muaj kev raug mob rau lub ntsws thiab qhov siab hauv lub hauv siab nce ntxiv ntau, piv txwv li, hauv qhov mob hu ua "Tension pneumothorax".

Kev poob siab thaum lub plawv tsis ua haujlwm zoo vim muaj lwm yam teeb meem sab nraud zoo li no.

Tus mob no hu ua "Obstructive Shock" tshwm sim ntau npaum li cas? Nws cuam tshuam li cas rau lub cev?

Kev poob siab thaum lub sij hawm muaj kev cuam tshuam (obstructive shock) yog ib qho mob uas tsis tshua muaj piv rau lwm hom kev poob siab. Feem ntau nws tsuas cuam tshuam rau 1% lossis 2% ntawm cov neeg mob uas muaj kev poob siab xwb. Qhov xov xwm zoo yog tias nws yuav kho tau zoo dua li lwm hom kev poob siab, tab sis tsuas yog kho sai xwb.

Yog tias tsis kho sai sai, Kev Poob Siab yuav ua rau lub cev tsis muaj pa oxygen thiab cov as-ham tseem ceeb. Qhov no tuaj yeem ua rau lub cev puas tsuaj thiab qee zaum tuag taus. Yog vim li ntawd nws thiaj li tseem ceeb uas yuav tsum nrhiav kev kho mob yam tsis ncua sijhawm.

Cov tsos mob ntawm '(Obstructive Shock)' yog dab tsi?

Cov tsos mob ntawm qhov no yuav zoo ib yam li cov tsos mob ntawm "Cardiogenic Shock." Saib seb cov no puas zoo li koj paub:

• Tus nqi ua pa nce ntxiv tsis zoo li qub.
• Ntshav siab poob qis dhau (hypotension).
• Lub plawv dhia ceev heev ('Tachycardia'). Zoo li koj nyuam qhuav khiav.
• Kev hloov pauv ntawm lub siab, tej zaum yuav muaj kev tu siab lossis kev ntxhov siab.
• Cov zis uas tsim tawm tau txo qis heev, lossis tsis muaj kiag li.
• Daim tawv nqaij txias thiab hws.
• Qee zaum cua tuaj yeem sib sau ua ke hauv qab daim tawv nqaij ('Subcutaneous emphysema'). Qhov no txhais tau tias nws zoo li cov npuas me me hauv qab daim tawv nqaij.
• Tej zaum koj yuav mob hauv siab lossis mob plab.

Yog tias koj muaj ib lossis ntau yam ntawm cov tsos mob no, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev pab kho mob tam sim ntawd.

Dab tsi yog cov ua rau muaj '(Obstructive Shock)'?

Muaj ntau yam ua rau muaj '(Obstructive Shock)'. Cia peb saib seb cov ua rau muaj yog dab tsi:

• `(Tension pneumothorax)` (lub ntsws tawg): Qhov no tshwm sim thaum cua nkag mus rau hauv lub ntsws thiab tsis tuaj yeem tawm mus, ua rau nws raug kaw hauv lub ntsws. Lub ntsws ces tawg, tsim kom muaj kev nyuaj siab ntau hauv lub hauv siab thiab ua rau lub plawv pib dhia.
• Kab mob Vena cava compression syndrome: Kev nias ntawm cov leeg ntshav loj tshaj plaws hauv peb lub cev (vena cava). Qhov no feem ntau tshwm sim thaum kawg ntawm cev xeeb tub, thaum qhov hnyav ntawm tus menyuam nias cov hlab ntshav no.
• Kab mob ntsws (lub ntsws) nias: Kab mob ntsws nias.
• `(Kev ua pa siab-PEEP)`: Ib qho mob uas lub siab hauv lub ntsws siab dhau rau ib tus neeg uas txuas nrog lub tshuab ua pa.
• Cov qog nqaij hlav: Qee hom qog nqaij hlav uas tsim nyob rau hauv lub hauv siab kuj tseem tuaj yeem thaiv lub plawv lossis cov hlab ntsha loj.
• Kev mob ntshav txhaws hauv cov hlab ntsha hauv lub ntsws: Qhov no txaus ntshai heev. Yog tias cov ntshav txhaws uas tsim nyob rau hauv ib qho chaw zoo li ceg tawg thiab daig hauv cov hlab ntsha hauv lub ntsws, nws yuav ua rau cov ntshav tsis ntws los ntawm lub plawv mus rau lub ntsws.
• Pericardial tamponade: Lub hnab nyias nyias nyob ib puag ncig lub plawv (pericardium) puv nrog cov kua dej, nias lub plawv. Qhov no tiv thaiv lub plawv kom tsis txhob cog thiab nthuav dav zoo.
• Kev txiav tawm ntawm lub plawv (Aorta dissection): Kev txiav tawm ntawm lub plawv (aorta), uas yog cov hlab ntsha loj tshaj plaws uas tawm hauv lub plawv.
• Aortic stenosis: Kev nqaim ntawm lub plawv aortic valve. Qhov no ua rau nws nyuaj rau cov ntshav ntws tawm ntawm lub plawv.
• Hypertrophic cardiomyopathy: Kev thaiv cov ntshav ntws vim yog cov leeg nqaij plawv tuab dhau.
• Kab mob pericarditis nruj: Lub hnab nyob ib puag ncig lub plawv yuav tuab zuj zus, ua rau lub plawv nyuaj ua haujlwm tau yooj yim.

Tseem Ceeb: Tag nrho cov ua rau muaj no yog xwm txheej ceev, yog li mus ntsib kws kho mob tam sim ntawd yog tias koj muaj cov tsos mob.

Yuav paub txog '(Obstructive Shock)' li cas?

Koj tus kws kho mob yuav kuaj koj ua ntej. Lawv yuav mloog koj lub plawv thiab lub ntsws nrog lub stethoscope. Kev poob siab yog ib qho mob uas tuaj yeem hnyav zuj zus sai, yog li nws yog ib qho tseem ceeb kom tau txais kev kuaj mob sai.

Yuav kom paub tseeb tias tus kab mob yog dab tsi, cov kev kuaj mob hauv qab no yuav ua tau:

• Ultrasound: Qhov no tuaj yeem saib tej yam xws li lub plawv, cov hlab ntsha loj, thiab seb puas muaj kua dej nyob ib puag ncig lub ntsws.
• Echocardiogram (Echo): Qhov no zoo li kev siv ultrasound ntawm lub plawv. Nws tuaj yeem pom tseeb heev txog kev ua haujlwm ntawm lub plawv, qhov xwm txheej ntawm cov valve, thiab seb puas muaj kua dej nyob ib puag ncig lub plawv.
• Kev thaij duab computer tomography (CT): Qhov no tuaj yeem thaij tau cov duab ntxaws ntxaws ntawm lub hauv siab. Nws tuaj yeem pab nrhiav cov khoom xws li cov ntshav txhaws, cov qog nqaij hlav, thiab kev txiav cov hlab ntsha hauv lub plawv.
• Kev kuaj hluav taws xob ntawm lub plawv (ECG lossis EKG): Qhov no kuaj xyuas qhov ua haujlwm hluav taws xob ntawm lub plawv. Nws tuaj yeem pab txiav txim siab seb puas muaj qee yam tsis raug nrog koj lub plawv.

Yuav kho tus mob Obstructive Shock li cas?

Ua ntej, koj yuav tau txais cov kua dej IV (xws li saline - IV crystalloid fluids) thiab koj cov ntshav siab thiab cov pa oxygen yuav raug kuaj xyuas tsis tu ncua. Tom qab ntawd, qhov tseem ceeb tshaj plaws yog nrhiav qhov ua rau muaj Kev Poob Siab thiab kho qhov ua rau ntawd.

Cov kev kho mob sib txawv nyob ntawm seb ua rau muaj li cas. Cia peb saib ob peb yam piv txwv:

• Yog tias muaj cov ntshav txhaws (embolism), nws yuav raug tshem tawm los ntawm kev phais lossis los ntawm kev ntxig lub cannula (catheter).
• Yog tias nws yog lub plawv aortic nqaim heev, nws yuav raug hloov.
• Yog tias cov leeg nqaij plawv tuab (hypertrophic cardiomyopathy), qhov tuab ntawm cov leeg plawv no yuav raug txo kom tsawg los ntawm kev phais lossis siv txoj kev tshwj xeeb uas siv cawv (catheter-based alcohol ablation).
• Lawv muab tshuaj rau koj kom yaj cov ntshav txhaws.
• Yog tias muaj kua dej nyob ib puag ncig lub plawv (pericardial tamponade) lossis muaj tension pneumothorax, cov kua dej lossis cua yuav raug tshem tawm (tej zaum siv ib lub raj me me).
• Yog koj siv lub tshuab ua pa, koj tuaj yeem hloov nws cov chaw teeb tsa.
• Hauv ib qho mob zoo li "Vena cava compression syndrome", qhov chaw ntawm lub cev hloov pauv.
• Yog tias lub siab nyob hauv lub ntsws siab, ces yuav muab koob los yog raj txo lub siab.

Cov tshuaj twg siv?

Thaum lub sijhawm kho qhov ua rau muaj qhov teeb meem no, koj yuav tau txais cov tshuaj xws li cov no los tswj koj tus mob:

• Cov kua dej zoo li `IV` saline (`IV crystalloid fluids`).
• Cov tshuaj uas ua rau ntshav siab ntxiv: (Norepinephrine (Levophed®))`, (Vasopressin (Vasostrict®))`, (Phenylephrine (Vazculep® lossis Biorphen®))`.
• Yog koj cov ntshav tsawg, koj yuav tau txais cov ntshav lossis cov khoom ntshav (xws li cov qe ntshav liab thiab cov plasma).

Kuv yuav zoo sai npaum li cas tom qab kho tas?

Muaj ntau yam ua rau mob Obstructive Shock yuav tsum tau kho sai sai , vim tias qhov no yog lub sijhawm uas muaj feem yuav ciaj sia ntau tshaj plaws. Zoo hmoo, cov kev kho mob no ua haujlwm sai. Txawm li cas los xij, txawm tias tom qab kho qhov ua rau mob lawm los, nws yuav siv sijhawm rau lub cev kom rov zoo los ntawm cov teebmeem ntawm Obstructive Shock. Koj tsis tuaj yeem khiav ib ncig thiab ua koj txoj haujlwm xwb.

Yuav ua li cas thiaj nrhiav tau tus kab mob "(Obstructive Shock)"?

Yog tias tsis kho, "Obstructive Shock" yog ib yam mob uas tuaj yeem ua rau ntau tus neeg tuag taus. Koj txoj kev rov zoo tom qab kev kho mob nyob ntawm ntau yam, suav nrog:

• Dab tsi yog qhov ua rau muaj '(Obstructive Shock)'?
• Siv sijhawm ntev npaum li cas los kho mob?
• Koj muaj lwm yam kab mob dab tsi ntxiv?
• Kev kho mob no ua tau zoo npaum li cas rau koj?

Txawm li cas los xij, raws li tau hais ua ntej lawm, qhov muaj feem yuav rov zoo los ntawm "Obstructive Shock" siab dua li ntawm cov hom "Shock" xws li "Septic Shock". Yog li ntawd, muaj kev cia siab.

Kuv yuav saib xyuas kuv tus kheej li cas?

Tom qab tus kws kho mob tso koj tawm hauv tsev kho mob lawm, koj yuav tsum ua raws li lawv cov lus qhia kom meej.

• Koj yuav tsum tau so hauv tsev ib pliag ua ntej rov qab mus ua haujlwm.
• Koj yuav tsum noj cov tshuaj uas koj tus kws kho mob tau sau tseg raws sijhawm . Tsis txhob tsum noj tshuaj thaum twg koj xav tau.
• Mus rau cov kev teem caij tom qab tsis tu ncua .

Thaum twg kuv mam li rov qab mus ntsib kws kho mob dua? Kuv yuav tsum ua li cas thaum muaj xwm txheej ceev?

Tam sim no koj paub tias yog dab tsi ua rau koj '(Obstructive Shock)'. Ceev faj yog tias cov tsos mob cuam tshuam nrog qhov teeb meem ntawd rov tshwm sim. Yog tias koj muaj cov tsos mob zoo li no dua, lossis yog tias ib tug neeg hauv koj tsev neeg pom qhov kev hloov pauv no hauv koj, hu rau 1990 (Wind) Ambulance Service tam sim ntawd, lossis mus rau chav kho mob ceev ntawm tsev kho mob ze tshaj plaws. Lub sijhawm yog qhov tseem ceeb.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Koj tuaj yeem nug cov lus nug zoo li no:

• Kuv yuav tsum noj tshuaj uas koj tau sau ntawv kom noj ntev npaum li cas?
• Muaj feem yuav muaj tus mob no dua li cas?
• Qhov no puas yuav muaj feem cuam tshuam rau kuv lub neej mus sij hawm ntev?
• Kuv yuav tsum hloov dab tsi rau kuv cov zaub mov noj thiab kev tawm dag zog?

Thaum kawg, yuav tsum nco ntsoov li cas (Cov Lus Coj Mus Tsev)

Kev Poob Siab Yog ib yam mob uas tsis tshua muaj tab sis mob hnyav heev uas yuav tsum tau kho mob ceev. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum paub txog cov tsos mob thiab nrhiav kev kho mob sai sai. Thaum cov kws kho mob pom qhov ua rau muaj Kev Poob Siab, lawv yuav pib kho mob kom raug.

Nco ntsoov tias, feem ntau cov neeg tuaj yeem rov zoo los ntawm Kev Mob Hlwb Tsis Ua Haujlwm, tab sis nws yuav siv sijhawm. Ua siab ntev, ua raws li koj tus kws kho mob cov lus qhia, thiab saib xyuas koj tus kheej. Koj tsis nyob ib leeg, thiab muaj cov kws kho mob, cov kws tu mob, thiab cov neeg koj hlub uas tuaj yeem pab koj.

Kev Poob Siab, kev poob siab, kab mob plawv, ntshav siab, oxygen, kev txhaws, kev kho mob thaum muaj xwm txheej ceev, ntsws, lub plawv