Koj puas tau hnov ib tug kws kho mob, thaum koj ntsuas koj cov ntshav siab, hais ib yam dab tsi zoo li, "Ua pa tob tob rau hauv... tam sim no ua pa tawm..."? Qee zaum peb xav tias nws tsuas yog ib lo lus hais xwb. Tab sis qhov tseeb, qee zaum tus kws kho mob tab tom kuaj xyuas seb puas muaj kev hloov pauv tshwj xeeb hauv koj cov ntshav siab nrog koj tus cwj pwm ua pa. Muaj ib qho laj thawj tseem ceeb heev rau qhov no. Hnub no peb yuav tham txog ib qho cim tshwj xeeb ntawm kev kho mob, uas yog 'Pulsus Paradoxus'. Lub npe no yuav zoo li nyuaj me ntsis thaum koj hnov nws, tab sis cia peb piav qhia nws yooj yim.
Pulsus Paradoxus yog dab tsi tiag?
Hais yooj yim xwb, Pulsus Paradoxus yog thaum koj cov ntshav siab, tshwj xeeb tshaj yog tus lej sab saud (systolic pressure), poob qis dua li qhov xav tau thaum koj nqus pa.
Tam sim no koj yuav xav tias, "Yog li ntawd, muaj dab tsi txawv txawv txog qhov ntawd?" Qhov txawv txav ntawm no yog tias feem ntau, thaum ib tus neeg noj qab haus huv nqus pa, lawv cov ntshav siab yuav tsum nce me ntsis lossis tsis hloov pauv ntau. Tab sis hauv qhov no, qhov txawv kiag li tshwm sim. Ntawd yog, cov ntshav siab poob qis tsis tau xav txog. Qhov no tsis yog kab mob, tab sis yog ib qho cim tseem ceeb heev uas qhia peb tias muaj qee yam tsis raug hauv koj lub cev, tshwj xeeb tshaj yog hauv lub plawv lossis lub ntsws.
Xav txog nws, peb lub plawv yog lub uas tso ntshav thoob plaws peb lub cev. Thaum peb ua pa, muaj kev hloov pauv ntawm qhov siab hauv peb lub hauv siab. Cov kev hloov pauv no muaj qhov cuam tshuam me me rau qhov zoo ntawm lub plawv uas muaj ntshav. Txawm li cas los xij, yog tias lub plawv tsis tuaj yeem nthuav dav kom zoo vim muaj mob, lossis yog tias muaj ntau qhov siab nyob ib puag ncig lub plawv, qhov ntau ntawm cov ntshav uas nkag mus rau hauv lub plawv thaum peb ua pa txo qis heev . Yog li ntawd, qhov ntau ntawm cov ntshav uas lub plawv tso rau lub cev kuj txo qis, yog vim li cas peb pom qhov poob qis sai sai ntawm cov ntshav siab.
Tus kws kho mob ntsuas qhov no li cas?
Qhov no tsis yog ib yam dab tsi uas koj ntsuas tau nrog lub ntsuas siab digital hauv tsev. Vim tias qhov no yog ib yam dab tsi uas yuav tsum tau ntsuas kom zoo zoo. Rau qhov no, tus kws kho mob feem ntau siv lub tes tuav siab thiab lub stethoscope (lub tes tuav ntshav siab).
Nov yog yuav ua li cas:
1. Ua ntej, tus kws kho mob yuav muab ib lub cuff nias rau ntawm koj txhais caj npab thiab tshuab nws kom txog thaum koj tsis hnov koj lub plawv dhia lawm.
2. Tom qab ntawd, thaum lub cuff raug tso tawm sai sai (ntawm qhov nrawm li ntawm 2 millimeters ntawm mercury ib ob), lub stethoscope raug siv los nrhiav qhov chaw uas hnov lub suab pulse thawj zaug. Thaum lub sijhawm no, lub suab raug hnov thaum koj ua pa tawm (exhaling). Tus nqi ntawd raug kaw cia.
3. Tom ntej no, thaum koj tshuab lub cuff ntxiv me ntsis, koj yuav pom qhov chaw uas koj tseem hnov lub plawv dhia thaum koj ua pa nkag thiab tawm . Koj kuj tseem yuav sau cov nqi ntawd.
4. Thaum kawg, qhov sib txawv ntawm ob qhov ntsuas siab sab saud no tau suav.
Feem ntau, yog tias qhov sib txawv no ntau dua 10 millimeters ntawm mercury (10 mmHg), nws raug suav hais tias yog ib qho mob hu ua Pulsus Paradoxus. Hauv cov chaw xws li cov chav kho mob hnyav (ICUs), qhov no qee zaum ntsuas tau zoo dua los ntawm txoj kab hlab ntsha uas muab tso ncaj qha rau hauv cov hlab ntsha.
Cov ua rau muaj Pulsus Paradoxus yog dab tsi?
Yog koj pom lub cim Pulsus Paradoxus, nws txhais tau tias muaj qee yam tab tom tiv thaiv lub plawv kom tsis txhob ua haujlwm zoo. Muaj ntau yam ua rau qhov no.
Qhov ua rau mob plawv thiab lub plawv dhia ceev heev yog vim muaj kua dej ntau dhau nyob ib puag ncig lub plawv, uas ua rau lub plawv dhia ceev heev. Cia peb piav qhia ntxiv me ntsis. Peb lub plawv nyob hauv ib lub hnab nyias nyias uas zoo li lub hnab hu ua 'pericardium'. Feem ntau qhov no muaj cov kua dej me me los tiv thaiv thiab ua kom lub plawv ntub. Txawm li cas los xij, yog tias vim muaj qee yam mob, muaj kua dej ntau dhau (xws li dej) ntau dhau los hauv lub hnab no, nws hu ua Pericardial Effusion . Yog tias cov kua dej no nce ntxiv, lub hnab pericardial yuav ncab, thiab thaum kawg ua rau lub plawv dhia ceev heev. Qhov no yog ib qho mob hnyav uas xav tau kev kho mob thaum muaj xwm txheej ceev. Qhov no yog qhov ua rau mob plawv dhia ceev heev.
Sib nrug ntawm qhov no, muaj ntau lwm yam ua rau Pulsus Paradoxus nyob rau hauv lub rooj hauv qab no.
| Mob | Hais yooj yim xwb... |
|---|---|
| Kab mob Pericarditis uas nruj | Lub hnab nyob ib puag ncig lub plawv (pericardium) yuav tuab thiab tawv, tiv thaiv lub plawv kom tsis txhob nthuav dav. |
| Mob hawb pob hnyav lossis COPD | Kev hloov pauv ntau dhau ntawm lub siab hauv siab thaum lub sijhawm ua pa vim yog txoj hlab pa nqaim heev. |
| Kev ntws ntawm cov kua hauv lub ntsws | Cov kua dej ntau dhau nyob ib puag ncig lub ntsws. |
| Pneumothorax (Lub ntsws tawg) | Cua tawm hauv lub ntsws, muab kev nyuaj rau lub ntsws thiab lub plawv. |
| Kev txwv tsis pub muaj Cardiomyopathy | Lub plawv tsis tuaj yeem puv nrog cov ntshav kom zoo vim yog cov leeg nqaij plawv tawv. |
| Kev rog dhau | Muaj kev nyuaj siab sab nraud rau ntawm lub hauv siab thiab lub plawv vim yog qhov hnyav ntawm lub cev ntau dhau. |
Qhov no kho li cas?
Qhov tseem ceeb tshaj plaws uas peb txhua tus yuav tsum nkag siab ntawm no yog tias tsis muaj kev kho mob ncaj qha rau cov tsos mob hu ua Pulsus Paradoxus. Vim tias nws tsis yog kab mob. Nws zoo li lub teeb ceeb toom uas ci ntsa iab ntawm lub dashboard thaum muaj teeb meem nrog lub cav ntawm lub tsheb. Qhov peb tab tom ua tsis yog tua thiab qhib lub teeb, tab sis kho qhov teeb meem hauv lub cav.
Tsis tas li ntawd xwb, tus kws kho mob tsis kho tus tsos mob Pulsus Paradoxus, tab sis kho tus mob uas ua rau nws. Tus tsos mob no pab tus kws kho mob txiav txim siab seb tus mob hnyav npaum li cas thiab seb puas yuav tsum pib kho tam sim ntawd.
Txoj kev kho mob yog txiav txim siab los ntawm qhov ua rau.
- Yog tias qhov ua rau yog Cardiac Tamponade , kev kho mob thaum muaj xwm txheej ceev yuav tsum tau siv lub koob txhaj tshuaj thiab koob txhaj tshuaj los rho cov kua dej seem tawm ntawm lub plawv (pericardiocentesis). Tej zaum yuav tsum tau phais mob.
- Yog tias qhov ua rau mob hawb pob hnyav heev , yuav muab cov tshuaj thiab cov tshuaj nebulizer los tswj qhov mob hawb pob.
- Yog tias qhov ua rau yog pneumothorax (lub ntsws tawg), yuav muab ib lub raj ntsaws rau hauv lub hauv siab kom tshem tawm cov pa ntau dhau.
- Hauv cov rooj plaub zoo li Constrictive Pericarditis , cov pericardium tuab yuav tsum tau phais tshem tawm.
Ua li no, tus kws kho mob yuav xub nrhiav qhov ua rau muaj qhov teeb meem thiab muab kev kho mob zoo tshaj plaws rau koj. Yog li ntawd, yog tias koj tus kws kho mob qhia koj txog cov tsos mob zoo li no, nws yog ib qho tseem ceeb heev uas yuav tsum tsis txhob ntshai nws thiab koom tes tag nrho nrog kev kuaj mob thiab kev kho mob uas tau ua los nrhiav qhov ua rau muaj qhov teeb meem.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Pulsus Paradoxus tsis yog ib qho tsos mob uas koj ntsib ntawm koj tus kheej. Nws yog ib qho cim uas tus kws kho mob yuav pom thaum lub sijhawm kuaj mob.
- Qhov no tsis yog ib yam kab mob, tab sis tej zaum yuav yog ib qho cim ntawm lwm yam, tej zaum yuav yog ib qho mob hnyav, hauv lub plawv lossis lub ntsws.
- Yog koj tus kws kho mob pom cov cim no, tsis txhob ntshai. Nws yog ib qho tseem ceeb rau kev nrhiav thiab kho qhov ua rau muaj qhov teeb meem no.
- Pulsus Paradoxus tsis raug kho, tab sis kho qhov mob uas ua rau nws. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia kom zoo.
💬 Comments (0)
Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus