Hemorrhage hi eng nge a nih chiang takin i zir ang u, chhungril emaw pawn lam emaw pawh nise.

Hliam te tak te pawhin thisen chhuah a titawp lo tih i hre ngai em? A nih loh leh, a châng chuan i taksa chhûnga khawi emaw lai aṭangin thisen chhuak ang maiin i inhria em, a nih loh leh chutiang chhinchhiahna chu i nei tawh em? Dik tak chuan he thisen chhuahna, chu chu `(Hemorrhage)` an tih dinhmun hi a chang chuan i ngaihtuah aiin a na deuh thei a ni. Chuvangin, vawiinah hian he thu hi chipchiar takin i sawi ang u, Sinhala tawngin i hriatthiam theih tur.

Thisen chhuah emaw ``Hemorrhage'' emaw chu eng nge ni?

A awlsam zawngin kan taksa chhunga thisen kalna (thisen kalna) pakhat a chhia a, chuta tang chuan thisen a chhuak a, chu chu `(Hemorrhage)` kan tih chu a ni. He thisen chhuahna hi taksa chhungah pawh a awm thei a, chutiang a nih chuan ``internal hemorrhage`` kan ti a ni. A lehlamah chuan thisen chu pawnah, hliam emaw, taksaa inhawng emaw atanga hmuh theih a nih chuan ``pawn lam thisen chhuahna`` a ni. He thisen chhuahna hi a tlem thei hle a, nunna nghawng thei khawpa lian pawh a ni thei bawk.

A tam zawkah chuan heng ``Hemorrhage'' tia koh te hi medical emergency, damdawi hmanhmawh taka enkawl ngai angin kan ngai thin .

Thisen chhuah chi hrang hrangte chu engte nge ni?

Kan taksa pumpuiah thisen kalna kawng a awm avangin he `(Hemorrhage)` hi kawng hrang hrangin a thleng thei a ni. Entirna thenkhat chu hetiang hi a ni:

• I rilru chhunga thisen (`Hemothorax`): I lung leh i rilru chhunga rib cage (`pleural space`) inkar hmun chu thisenin a khat ang tih han ngaihtuah teh. Chuti a nih chuan eng nge thleng? I lung chu a compress a , chu chuan thawk a ti harsa a, i rilru a na thei bawk. Hetiang dinhmun hi `(Hemothorax)` an ti a.
• Intracranial hemorrhage (or brain bleed): Hei hi a hlauhawm deuh deuh a ni. I thluak chhungah emaw, a chhehvela membrane nalh tak takte inkarah emaw thisen chhuak thunun loh vang a ni. Thisen chhuah hi thluak chhungah a awm chuan hemorrhagic stroke an ti a. Hetiang stroke chi hi a na hle a, rang takin nunna atana hlauhawm a ni thei. Stroke chi dang, ischemic stroke chu thluaka thisen kalna a block hian a ni a, mahse hei hi a danglam hle. Hetah hian thisen chhuah hi a thleng thin.
• Postpartum hemorrhage (PPH): Hei hi nu tan chuan thil pawimawh tak a ni. Postpartum hemorrhage, a tawi zawngin PPH tih hi nau neih hnua vagina atanga thisen chhuak tam lutuk hi a ni. Hei hi natna khirh tak, nunna atana hlauhawm tak a ni. Hetiang dinhmun hi nau neih atanga darkar tlemte chhung emaw, nau neih hnu kar 12 thleng emaw a awm thei.
• Subarachnoid hemorrhage (SAH): Thluak meninges leh a chhehvel venhimna membrane inkara thisen chhuak chu subarachnoid hemorrhage (SAH) an ti a. Hei pawh hi medical emergency a ni.
• Mit var a thisen chhuak (`Subconjunctival hemorrhage`):Mi thenkhat chu an mit var chungah thisen sen hring an awm tih i hmu tawh ngei ang. Chu chu ``Subconjunctival hemorrhage'' an ti a, hei hi mit vel membrane te tak te ``conjunctiva'' an tih ah thisen a inkhawm thin a ni.Hei hi thisen chhuah chi dang angin a na lo tlangpui.

Bruises , kan tawn vek thin vun hnuaia thisen awmkhawm hi a takah chuan ``hemorrhage`` entirnan tlemte a ni.`` a kaihhnawih thumal dang chu ``hematoma`` tih hi a ni.

Thisen chhuahna chhinchhiahnate chu engte nge ni?

Thisen chhuah laia i rilru put hmang chu a inang lo thei a, chu chu thisen chhuahna hmun leh a nasat dan azirin a inang lo thei.

Doctor-te sawi dan chuan taksa thisen zawng zawng 15% vel a bo (Class I hemorrhage) hma chuan symptom lian tham a lang lo tlangpui.

Mahse, i taksain a thisen volume 15% atanga 30% a hloh chuan (Class II hemorrhage) , heng symptoms te hi a lo lang tan thin:

• Luak chhuak emaw, lu hah emaw (hei hi thisen sang hniam vang a ni).
• Chauhna leh rilru hahna.
• Nausea leh luak chhuak.
• Thâwk harsa (dyspnea) leh thawk chakna a sang.
• Lung chakna (tachycardia) a sang.

Nangmah emaw, i hnaih ber emaw pawhin heng symptoms te hi i neih chuan 1990 ah call nghal tur a ni a, damdawi in hnai ber emergency department ah i kal nghal tur a ni.

I thisen zawng zawng atanga 30% aia tam i hloh chuan i natna hi a na zual thei a ni. Chutiang hunah chuan a hnuaia mi hi a thleng thei a ni:

• Rilru tibuai.
• Seizures a awm thin.
• Thil hriatna hloh.
• Hypovolemic shock (thisen tlahniam nasa lutuk avanga shock).

Internal bleeding symptoms chiang tak tak

Taksa hmun thenkhata chhungril lama thisen chhuah hian symptom bik a thlen thei a:

• Lu na: Sudden , severe headache , mit hmuhna danglam, buai, leh taksa sir khatah rilru hah lutuk.
• Chest: Thâwk harsa , rilru na, leh thisen chhuak.
• Pum (abdomen): Pum a hring emaw, a khat emaw, pum a zau, thisen a chhuak, zun emaw ek emaw a thisen.
• Ruh, ruh leh ruh: A hliam, a hring, leh a na. Mahse hriat reng tur pawimawh ber chu hmun inkharkhip (e.g., kut emaw ke emaw ruh inkar)-a thisen a punkhawm leh tissue-a pressure sang zawng zawng chu medical emergency a ni.Hei hian nerve leh thisen kalna kawngte a tichhe thei a, chu hmunah chuan hnathawh a bo vek thei a ni.

Hetiang symptoms i neih chuan, a hmaa kan sawi tawh ang khan, doctor lam pan vat a pawimawh hle.

Engtin nge thisen a chhuak tih chiang taka i hriat theih ang?

Dik tak chuan a chang chuan thisen chhuah hi a pawi zia hi kan hriatthiam a har thin. Entirnan, hnar thisen chhuak. A tam zawkah chuan an pangngai a, thil lian tak a ni lo. Mahse, thisen chhuak hi thisen kalna kawng lian tak emaw, thisen kalna kawng lian tak atanga lo chhuak a nih chuan a na hle thei a, tihtawp a harsa thei bawk. Sawi tawh ang khan nau neih hnua vaginal bleeding pawh hi a tam hle. A pangngaiin beisei a ni. Mahse, a tam lutuk chuan natna hlauhawm tak, postpartum hemorrhage an tih a ni thei.

A tha ber chu i taksa leh i symptoms te ngaihven hi a ni. Tin, thisen chhuah zat chungchangah ngaihtuahna i neih chuan doctor lam pan ngei ngei tur a ni. Thisen chhuak nasa tak (luak, hah, leh thawk hah te ang chi) chhinchhiahnate chu fimkhur hle ang che. Thisen chhuah chungchangah ngaihtuahna tlemte pawh i neih chuan damdawi lam tanpuina zawng hreh suh.

Engvangin nge hetiang hian thisen a chhuah? A chhan engte nge ni?

Hetiang thisen chhuahna hi thisen kalna kawng khat emaw a aia tam emaw a chhiat chuan a thleng thin. Thisen chhuah nasat dan hi taksaa khawiah nge a awm tih leh thisen kalna kawng chhia chu engzat nge a lian tih ah a innghat fo thin.

Thisen chhuah theihna tur emaw, a tipung thei emaw chhan leh dinhmun tam tak a awm a. Entirna tlemte chu hetiang hi a ni:

• Zu insualna: Hei hi risk factor lian tak a ni a, a bik takin subarachnoid hemorrhage tan chuan a hlauhawm hle.
• Thisen zam natna: Entirnan, antiphospholipid syndrome ang chi natna.
• Thisen lama harsatna: Pianpui natna, hemophilia leh Von Willebrand natna te.
• Ngawt.
• Damdawi thenkhat: Entirnan thisen tithianghlimtu `warfarin (Coumadin®), `aspirin` (nausen aspirin te pawh tel), `clopidogrel (Plavix®)` leh `apixaban (Eliquis®) te hi a ni.
• Vascular natna thenkhat: hereditary hemorrhagic telangiectasia leh aneurysms (thisen kalna kawng a chak lo va, balloon ang maia a bulh na) ang chi dinhmun.
• Damdawi hmanga enkawlna lama harsatna awm thei: Surgery ang chi thil hnua harsatna awm thei.
• Internal organ tihchhiat: Entirnan, hun rei tak chhung natna tidamtu damdawi ibuprofen (Advil®) hman hian intestine-ah ulcer a siam thei a, thisen a chhuak thei bawk.
• Hliam: Cut, ruh tliak lian tak, thluak hliam na tak.
• Trauma: Thil chi hrang hrang, silai kah hliam, hliam tuar, etc.
• Viral hemorrhagic fevers: Heng natna hi virus pawl khat atanga lo chhuak a ni. Heng virus te hian thisen kalna kawng a tichhe thei a, thisen chhuahna nasa tak a thlen thei bawk. Entirnan, Ebola, dengue fever, Marburg, leh yellow fever te hi a ni.

Engtin nge doctor-te hian `(Hemorrhage)` an hriat chhuah?

Doctor-te chuan i natna lan chhuah dan (e.g., luak chhuak) leh taksa enfiahnaa i hmuhchhuah (e.g., heart rate sang, thisen sang tlahniam) a\angin thisen chhuak tih an hmuchhuak ang. A dawt leh tur chu khawi atanga thisen chhuak nge tih chiang taka hriat a ni a, eng thil nge a chhan tih hriat a ni. Pawn lam thisen chhuak hi a langsar fo thin. Mahse, chhungril lama thisen chhuah hi a harsa deuh thei.

Doctor chuan taksa enfiahna a nei ang a, i natna lan chhuah dan leh i damdawi lam chanchin a zawt ang a, imaging test (scan ang chi) leh laboratory test pawh a ti thei bawk.

Thisen chhuah enkawlna tur engte nge ni?

Thisen chhuak enkawlna chu thil engemaw zatah a innghat a:

• Thisen chu khawiah nge a kal a, taksa chhungah nge pawnah a awm em tih te.
• A nasatzia chu.
• Thisen chhuah chhan bulpui ber.
• Natna dang leh hliam dang i nei em?

A chhan hriat loh leh/ emaw thisen chhuahna a nasat chuan damdawi inah enkawl i ngai mai thei. I medical team chuan a chhan an hmu ang a, a \ul angin an enkawl ang. Hetiang thil hi i mamawh mai thei:

• Inzai.
• Vitamin K injection: (A bik takin warfarin ang damdawi i ei a nih chuan, thisen chhuah tihtawp nan).
• Thisen chhunga tui (`IV fluids`) te.
• Thisen pek a ni.

Thisen chhuak mek tan first aid

Thisen chhuak nasa tak tan pawh first aid i pe thei bawk – nangmah emaw, midang emaw pawh nise. Hengte hi zawm rawh:

1. 1990 emaw, i awmna hmuna emergency number emaw call nghal rawh.

2. Hliam tuar chu mu rawh. An kut emaw, an ke emaw-ah hliam a awm chuan a theih chuan a hliam chu thinlung level aia sangin chawi sang rawh.

3. Damdawi lam thil i neih chuan hliam chu sterile gauze emaw puan fai emaw hmangin khuh tur a ni.

4. Hliam tuar chu a kut (kut) hmanga hliam chu chelh turin hrilh rawh. A tih theih loh chuan i ti tur a ni.

5. Thil pakhat (e.g. glass phek, thinghnah) chu hliamah a tang a nih chuan la chhuak suh. A chhehvel bandage chu khauh takin khih rawh.

6. Tourniquet (thisen chhuak tawh lo tura hliam chunga band nghet taka khin) i hman chuan, tih dan dik i hriat chauhvin ti la, thisen chhuak nasa tak a awm chuan a tawp ber atan chauh hmang ang che.(Hei hi thisen chhuah tihtawp dan a ni a, thing emaw, puan emaw ang chi thil hmanga hliam chungah press a ni. Amaherawhchu, hei hi tih tur dik tak hretu chauhin tih tur a ni, tih dik loh chuan harsatna a thlen thei a ni.)

Thisen chhuak tawh tan chuan dam lehna tur chu eng nge ni?

Thisen chhuak i neih chuan i prognosis (outlook) hi thil engemaw zatah a innghat a ni:

• Chu chu eng ang `(Hemorrhage)` nge ni?
• A nasatzia chu.
• Engtiang chiahin nge enkawlna i dawng thuai.
• I kum leh i hriselna zawng zawng.

Damdawi lam pan hmasak hi damna tha zawk neih theihna tur kawng pawimawh tak a ni. Enkawlna i hmuh veleh i medical team chuan hmalam hun atana i beisei tur chu a tha hle ang.

`(Hemorrhage)` avanga harsatna awm thei te

Thisen chhuak avanga harsatna lo awm chhan ber chu i taksa peng hrang hranga thisen a thlen tlem vang a ni. Hei hian a tawpah chuan tissue leh cell te a thih tir thei a, chu chuan harsatna a thlen thei a, chungte chu:

• Organ a chhiat avangin.
• Seizures a awm thin.
• Coma ah a awm.
• Thihna.

Thisen chhuah hi ven theih thihna thlentu lian ber a ni a, a bik takin trauma injury na tak tuar te zingah a ni.

Thisen chhuah chi hrang hrang thenkhat chuan harsatna bik a nei thei. Entirnan, thluaka thisen chhuak hian thluak a tichhe reng thei a, thluak lam harsatna a thlen thei bawk. Postpartum hemorrhage hian Sheehan syndrome an tih natna a thlen thei a, chu chu thisen chhuah tam lutuk avanga i pituitary gland a chhiat vang a ni.

Harsatna dang awm fo chu thisen chhuak leh damdawi ina awm avanga harsatna (e.g., deep venous thrombosis, leh infection) te a ni.

Kan taksa hian kan thisen kalna kawnga a awm reng theih nan thisen a mamawh a. A leak chuan, a bik takin a tam chuan harsatna lian tak a thlen thei a ni. Thisen chhuak chungchang sawi dawn chuan damdawi lam pan nghal hi a pawimawh ber a ni. Nangmah emaw, i hmangaih tak emaw chu thunun theih lohvin thisen a chhuak a nih chuan, emaw, i chhungril lamah thisen a chhuak nia i rinhlelh chuan damdawi in thlen chu tihkhawtlai suh.

A tawp berah chuan i hriat reng tur thilte

Okay, tunah chuan kan sawi thin, ``(Hemorrhage)'' tih hi i hrethiam tawhin ka hria, chu chu thisen chhuah tihna a ni. A pawimawh ber chu thil danglam deuha thisen chhuak i nih chuan ngaihthah mai mai suh, "Aw, thil tlemte chauh a ni," tiin ngaihtuah la, damdawi lam thurawn zawng nghal mai rawh.Tin, i taksa chhung hmun dangah thisen a chhuak thei tih hriat theihna symptom i neih chuan (e.g., lu na nghal, na tak, thisen chhuak, bawlhhlawh dum), chu pawh chu a dik a, doctor i pan nghal tur a ni.

Enkawlna kan hmuh hma chuan natna khirh tak tak tam tak kan veng thei tih hre reng ang che. Chuvangin, i taksa hi ngaihven reng ang che. Harsatna emaw rinhlelhna emaw i neih chuan hlau lo la, hreh lo la, doctor rawn la, thurawn la rawh. Hrisel takin awm rawh!

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