He tohu mate kino te hekenga o te toto toto i te wā e manawa ana? (Pulsus Paradoxus)

Kua rongo koe i tētahi tākuta, i a ia e tirotiro ana i tō toto toto, e kī ana, "Hopukia he manawa hōhonu ki roto... inaianei, he manawa ki waho..."? I ētahi wā ka whakaaro tātou he kīwaha noa iho. Engari i roto i te ao tūturu, i ētahi wā kei te tirotiro te tākuta mēnā he huringa motuhake kei roto i tō toto toto me tō āhua manawa. He take tino nui tēnei mō tēnei. I tēnei rā ka kōrero tātou mō tētahi tohu hauora motuhake, ko 'Pulsus Paradoxus'. Tērā pea he ahua uaua tēnei ingoa ina rongo koe, engari me whakamārama noa iho.

He aha rawa te Pulsus Paradoxus?

Ki te kī māmā noa, ko te Pulsus Paradoxus te wā e tino heke ai tō toto, inā koa te tau runga (te pēhanga systolic), i te nui atu i te mea e whakaarohia ana ina manawa koe.

Inaianei pea kei te whakaaro koe, "He aha te mea rerekē mō tēnā?" Ko te mea whakapohehe i konei, ko te tikanga, ina manawa te tangata hauora, me piki noa te toto toto, kāore rānei e nui te rerekētanga. Engari i tēnei wā, ko te ritenga kē te mea ka puta. Arā, ka heke ohorere te toto toto. Ehara tēnei i te mate, engari he tohu tino nui e whakaatu ana kei te hē tetahi mea i roto i tō tinana, inā koa i roto i te ngākau, i ngā pukahukahu rānei.

Whakaarohia, ko tō tātou ngākau te mea e pupuhi ana i te toto puta noa i tō tātou tinana. Ina manawa tātou, ka rerekē te pēhanga o roto i tō tātou uma. He iti noa te pānga o ēnei huringa ki te pai o te whakakī o te ngākau ki te toto. Heoi, ki te kore e taea e te ngākau te whānui tika nā tētahi mate hauora, ki te nui rānei te pēhanga huri noa i te ngākau, ka tino heke te nui o te toto e tomo ana ki te ngākau ina manawa tātou. Nō reira, ka heke anō hoki te nui o te toto e pupuhihia ana e te ngākau ki te tinana, koia te take e kite ai tātou i te hekenga ohorere o te pēhanga toto.

Me pēhea te ine a te tākuta i tēnei?

Ehara tēnei i te mea ka taea te ine mā te whakamahi i te mita pēhanga matihiko i te kāinga. Nā te mea he mea tēnei me tino āta ine. Mō tēnei, ka whakamahia e te tākuta he poroporo pēhanga ā-ringa me te stethoscope (poroporo pēhanga toto ā-ringa).

Anei te mahi:

1. Tuatahi, ka whakatakotoria e te tākuta he poroporo pēhanga ki tō ringa, ka pupuhi kia kore ra ano koe e rongo i tō pā o te manawa.

2. Kātahi, i a koe e whakangawari ana i te poroporo ihu (i te tere o te 2 mirimita o te mercury ia hekona), ka whakamahia te stethoscope hei kimi i te wāhi tuatahi ka rangona te tangi o te pā. I tēnei wā, ka rangona te tangi ina whakapūha koe (whakapūha). Ka tuhia taua uara.

3. Muri iho, i a koe e pupuhi ana i te poroporo, ka kitea e koe te wāhi e rongo tonu ai koe i te pā o te manawa i a koe e manawa ana ki roto, ki waho hoki . Ka tuhia hoki e koe taua uara.

4. Hei whakamutunga, ka tatauhia te rerekētanga i waenga i ēnei uara pēhanga o runga e rua kua tuhia.

I te nuinga o te wā, ki te nui ake tēnei rerekētanga i te 10 mirimita o te mercury (10 mmHg), ka kiia he āhuatanga e kiia nei ko te Pulsus Paradoxus. I roto i ngā wāhi pēnei i ngā wāhanga tiaki nui (ICU), ka inehia tēnei i ētahi wā mā te raina uaua e whakatakotoria tika ana ki roto i te uaua.

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He aha ngā tino take o te Pulsus Paradoxus?

Ki te kite koe i te tohu Pulsus Paradoxus, he tohu tēnei kei te aukati tetahi mea i te mahi tika o te ngākau. He maha ngā take mō tēnei.

Ko te take matua, ko te take tino noa ko te kohikohinga o te wai i te taha o te ngākau, e puta ai te cardiac tamponade. Me whakamārama ake tēnei. Kei roto i tētahi uhi angiangi rite ki te pēke e kiia nei ko te 'pericardium' tō tātou ngākau. He iti noa te wai kei roto i tēnei hei tiaki me te whakahinuhinu i te ngākau. Heoi, ki te mea nā tētahi āhuatanga hauora, he nui rawa te wai (pērā i te wai) e kohikohi ana i roto i tēnei pēke, ka kiia ko te Pericardial Effusion . Ki te piki ake tēnei wai, ka totoro te pēke pericardial, ā, ka mutu ka puta te cardiac tamponade . He āhuatanga kino tēnei e hiahia ana kia rongoatia wawetia. Koinei te take tino noa o te Pulsus Paradoxus.

Haunga tēnei, kei te ripanga i raro nei ētahi atu take pea o te Pulsus Paradoxus.

Me pēhea te rongoā mō tēnei?

Ko te mea nui rawa atu me mārama tātou katoa ki konei, kāore he rongoā tika mō te tohu e kiia nei ko te Pulsus Paradoxus. Nā te mea ehara i te mate. He rite ki te rama whakatūpato e kā ana i runga i te papaaho ina he raruraru kei te miihini o te motuka. Ko tā tātou mahi ehara i te whakaweto i te rama, engari ko te whakatika i te raruraru o te miihini.

Waihoki, ehara te tākuta i te rongoā i te tohumate Pulsus Paradoxus, engari ko te mate hauora taketake i puta ai. Mā tēnei tohumate ka āwhina te tākuta ki te whakatau i te kino o te mate, me te mea me tīmata tonu te rongoā.

Ko te tikanga maimoatanga ka whakatauhia e te take.

• Mena ko te Cardiac Tamponade te take, ko te maimoatanga ohorere ko te tango i te wai tāpiri i te taha o te ngākau mā te whakamahi i te ngira me te pūwero (pericardiocentesis). Tērā pea ka hiahiatia he pokanga.
• Mena he mate huango kino te pūtake, ka whakaratohia he rongoā me he maimoatanga nebulizer hei whakahaere i te mate huango.
• Mena ko te pneumothorax (he pukahukahu kua hinga), ka whakauruhia he ngongo ki roto i te uma hei tango i te hau taikaha.
• I ngā take pēnei i te Constrictive Pericarditis , me tango pea te pericardium matotoru mā te pokanga.

Mā tēnei, ka kitea tuatahitia e te tākuta te tino take, ā, ka hoatu ki a koe te maimoatanga pai rawa atu e tika ana mōna. Nō reira, ki te kōrero mai tō tākuta ki a koe mō tētahi tohu pēnei, he mea nui kia kaua e wehi, kia mahi tahi hoki me ngā whakamātautau me ngā maimoatanga e mahia ana hei kimi i te take.