Tonsefe timakumana ndi nthawi zomwe mwadzidzidzi timamva kudwala, sichoncho? Kumva kufooka, kufooka mutu, kapena kuvutika kupuma kungakhale koopsa kwambiri. Kumva izi kungakhale chizindikiro chakuti thupi lanu likukumana ndi vuto lalikulu, loyambitsa. Masiku ano, Nirogi Lanka ikufuna kukuthandizani kumvetsetsa zadzidzidzi zoopsa komanso zoopsa zomwe zimatchedwa 'Distributive Shock' . Ngati mukumana ndi zizindikirozi, chonde funani thandizo lachipatala mwachangu poyimbira 911 kapena ogwira ntchito zadzidzidzi zapafupi.
Kodi 'Distributive Shock' ndi chiyani? Mwachidule…
Mwachidule, Distributive Shock ndi vuto lalikulu lachipatala. Limachitika pamene mitsempha yanu yamagazi ikukulirakulira mwadzidzidzi—kapena kukulirakulira—mochuluka, mofanana ndi payipi ya rabara yotambasulidwa kwambiri. Izi nthawi zina zimatchedwa 'Vasodilatory Shock' . Mitsempha iyi ikakulirakulira, kuthamanga kwa magazi anu kumatsika kwambiri. Taganizirani ngati payipi ya m'munda: pamene kukula kwake kukukwera kwambiri, kuthamanga kwa madzi mkati kumatsika, ndipo kuyenda kwake kumakhala kosagwira ntchito.
Zotsatira zake n’zakuti chimachitika n’chiyani? Ziwalo zanu zofunika kwambiri, monga mtima wanu, ubongo, ndi impso, sizilandira magazi omwe amafunika kuti zigwire ntchito . Kuphatikiza apo, nthawi zina, mitsempha yaing’ono iyi (ma capillaries) imayamba kutulutsa madzi, zomwe zimachepetsanso kuchuluka kwa magazi anu onse. Izi ndi zoopsa chifukwa ziwalo zanu zimadalira magazi okhazikika komanso okhazikika kuti zikhale ndi moyo.
Chofunika kwambiri: Ngati mukukayikira kuti muli ndi vuto la kugwedezeka, funani chithandizo chamankhwala mwachangu. Imbani 911 kapena pitani kuchipinda chadzidzidzi chapafupi nthawi yomweyo, chifukwa kuchedwa kungaphe.
Kodi mitundu ikuluikulu ya Distributive Shock ndi iti?
Pali mitundu itatu yayikulu ya Distributive Shock, iliyonse yomwe imayamba chifukwa cha vuto lina:
1. Septic Shock: Iyi ndi mtundu wofala kwambiri. Umayambitsidwa ndi matenda oopsa a bakiteriya. Mwachitsanzo, ngati bala latenga kachilombo ndipo majeremusi afalikira m'thupi lanu lonse (vuto lotchedwa Sepsis), ndipo momwe thupi limayankhira sizingayende bwino, mutha kudwala Septic Shock. Chibayo chachikulu kapena matenda ena a m'thupi angayambitsenso izi.
2. Anaphylactic Shock: Izi zimachitika chifukwa cha ziwengo zoopsa zomwe zimaika moyo pachiswe. Mwachitsanzo, anthu ena amakumana ndi izi akadya mtedza kapena kulumidwa ndi tizilombo tina. Ngati munthu amene ali ndi mphumu yayikulu akumana ndi vuto la kupuma mwadzidzidzi, vutoli likhoza kuchitikanso.
3. Kugwedezeka kwa Mitsempha:Izi zimachitika chifukwa cha kuwonongeka kwa msana wanu. Ngati mwavulala mutu kapena msana, monga ngozi yodumphira m'madzi kapena kugwa/kugundana kwakukulu kwa galimoto, kuwonongeka kwa mitsempha yanu kungalepheretse thupi kusunga kamvekedwe ka mitsempha yamagazi, zomwe zimapangitsa kuti muyambe kugwidwa ndi Neurogenic Shock.
Kodi kusiyana pakati pa Distributive Shock ndi Hypovolemic Shock ndi kotani?
Zonsezi ndi mitundu ya mantha, zomwe zikutanthauza kuti zonsezi zimapangitsa kuti ziwalo zofunika kwambiri zisapeze mpweya ndi michere yofunika. Komabe, zomwe zimayambitsa matendawa zimasiyana.
- Kusokonezeka kwa magazi kumachitika chifukwa chakuti mitsempha yanu yamagazi imataya kamvekedwe kake ndipo imakula kwambiri, zomwe nthawi zambiri zimayambitsa Sepsis kapena vuto lalikulu la ziwengo.
- Kugwedezeka kwa Hypovolemic kumachitika chifukwa chakuti mwataya voliyumu yeniyeni—kaya kudzera m'magazi ambiri kapena kutaya madzi ambiri, monga kutsegula m'mimba kosalekeza kapena kusanza, komwe kumanyowetsa thupi lanu.
Mwachidule: Kugwedezeka kwa magazi kumakhudza kukulitsa kwa mitsempha yamagazi; Kugwedezeka kwa magazi m'thupi kumakhudza kutayika kwa magazi kapena madzi amthupi. Kodi mukumvetsa kusiyana kwake?
Kodi Distributive Shock ndi yofala bwanji?
Pali mitundu inayi ikuluikulu ya shock: Hypovolemic, Cardiogenic, Obstructive, ndi Distributive. Distributive Shock ndiyo yofala kwambiri mwa izi , makamaka Septic Shock. M'maiko ngati US, anthu pafupifupi miliyoni imodzi amadwala Sepsis/Septic Shock pachaka. Ndi vuto lomwe lingakhudze aliyense, pa msinkhu uliwonse.
Kodi Distributive Shock imachita chiyani pa thupi lanu?
Monga tanenera kale, mitsempha yamagazi ikakula, kuthamanga kwa magazi kumatsika. Chifukwa chake, ziwalo zanu sizilandira magazi okwanira. Ganizirani ziwalo zanu ngati makina; zimafuna mafuta nthawi zonse—magazi ndi mpweya—kuti zigwire ntchito. Pamene izi zatha, ziwalo zimayamba kutseka chimodzi ndi chimodzi. Izi zimadziwika kuti kulephera kwa ziwalo , komwe ndi chiwopsezo cha moyo wanu nthawi yomweyo.
Kodi zizindikiro zake ndi ziti?
Zizindikiro za Distributive Shock zimatha kusiyana kutengera chomwe chimayambitsa. Komabe, zizindikiro zodziwika bwino ndi izi:
- Kutupa pakhungu kapena kufiira
- Kugunda kwa mtima mwachangu komanso kupuma mwachangu
- Kuthamanga kwa magazi kotsika (chizindikiro chodziwika bwino)
- Poyamba khungu limafunda, lomwe pambuyo pake limakhala lozizira komanso lofewa
- Malungo
- Kuzizira ndi kunjenjemera
- Kupweteka m'mimba
- Kusokonezeka maganizo kapena kusokonezeka maganizo
- Kutsokomola
- Kupuma movutikira
- Kusanza
- Kusanza
- Ululu pokodza
Ngati mwadzidzidzi mukumana ndi chimodzi kapena zingapo mwa zizindikirozi, chonde musachitenge mopepuka.
Kodi n’chiyani chimayambitsa kusokonezeka kwa zinthu m’thupi?
Kupatula mitundu itatu yomwe takambirana kale, zinthu zina zingapo zingayambitse vutoli:
- Sepsis yomwe imabwera chifukwa cha matenda a bakiteriya (ichi ndiye chifukwa chofala kwambiri).
- Anaphylaxis chifukwa cha zovuta kwambiri (monga mtedza, kulumidwa ndi tizilombo, mankhwala enaake, kapena matenda oopsa a mphumu).
- Kupsa kwambiri.
- Pancreatitis (kutupa kwa kapamba).
- Matenda a Toxic Shock (omwe angachitike, mwachitsanzo, chifukwa chogwiritsa ntchito tampon kwa nthawi yayitali).
- Kuvulala kwa msana.
- Matenda ena a endocrine.
- Kulephera kwa adrenal (chifukwa chosowa kwambiri).
- Matenda a capillary leak syndrome (kumene madzi amatuluka m'mitsempha yamagazi; komanso osowa kwambiri).
- Kugwiritsa ntchito mankhwala mopitirira muyeso pogwiritsa ntchito ma vasodilator (osazolowereka).
Kodi madokotala amazindikira bwanji vutoli?
Mukawonetsa zizindikirozi, dokotala adzakuyang'anirani nthawi yomweyo ndikulemba mbiri yanu ya matenda. Popeza munthu amene wagwidwa ndi mantha sangathe kulankhulana nanu, ndikofunikira kuti abale kapena abwenzi adziwitse gulu lachipatala za ziwengo zomwe mukudziwa, mbiri ya anaphylaxis, kapena mankhwala omwe mukumwa panopa. Izi ndizofunikira kwambiri pozindikira matenda.
Pambuyo pa izi, dokotala wanu akhoza kulamula mayeso angapo:
- Kuyezetsa magazi: Kufufuza ngati pali matenda ndi kuwona momwe ziwalo zimagwirira ntchito.
- Electrocardiogram (EKG/ECG): Kuyang'anira momwe mtima wanu umagwirira ntchito.
- X-ray ya pachifuwa: Kuyesa mapapu anu.
- Ultrasound: Kuti muone ngati mtima, mapapo, ndi ziwalo zam'mimba zili bwino; nthawi zambiri zimagwiritsidwa ntchito pafupi ndi bedi lanu.
Kodi chimachiritsidwa bwanji?
Popeza izi ndi zadzidzidzi zachipatala, chithandizo nthawi zambiri chimayambira m'chipinda chadzidzidzi ndipo nthawi zambiri chimapitilira mu chipinda cha Intensive Care Unit (ICU).
1. Gawo lachangu ndikupereka madzi m'mitsempha: Madzi amchere kapena madzi ena amaperekedwa kudzera m'mitsempha kuti athandize kukhazikika kwa kuthamanga kwa magazi.
2. Chithandizo cholunjika: Madokotala adzazindikira chomwe chimayambitsa kugwedezeka ndikupereka mankhwala ochithetsera.
3. Thandizo la zakudya: Nthawi zina, kudyetsa mwana pogwiritsa ntchito chubu kungakhale kofunikira kuti thupi lanu likhale ndi mphamvu zomwe likufunikira kuti libwezeretsedwe.
Mu ICU, gulu lachipatala lidzayang'anira zizindikiro zanu zofunika kwambiri (kugunda kwa mtima, kuthamanga kwa magazi, kuchuluka kwa mpweya, ndi kutentha). Adzathandizanso kuthana ndi mavuto aliwonse okhudzana ndi chithandizo. Ngati mukuvutika kupuma, mutha kuyikidwa pa chopumira.
Ndi mankhwala ati omwe amagwiritsidwa ntchito?
Chithandizo chimadalira chifukwa chachikulu cha kugwedezeka kwanu kogawa:
- Mankhwala Ochepetsa Kupanikizika kwa Magazi: Mankhwala monga epinephrine, vasopressin, norepinephrine, kapena phenylephrine owonjezera kuthamanga kwa magazi.
- Mankhwala opha tizilombo: Kuchiza matenda aliwonse omwe ali mkati mwake.
- Mankhwala oletsa ziwengo: Kuchepetsa ziwengo.
- Ma Steroid: Amagwiritsidwa ntchito pa matenda a ziwengo kapena matenda oopsa a sepsis.
- Mankhwala opumira a Albuterol: (monga Accuneb® kapena Proair®HFA) ngati kugwedezeka kwachitika chifukwa cha mphumu yoopsa.
Kodi pali zotsatirapo zoyipa pa chithandizochi?
Inde, mankhwala ena akhoza kukhala ndi zotsatirapo zoyipa, kuphatikizapo:
- Vasopressors: Kusakhazikika kwa kayimbidwe ka mtima (arrhythmia), nkhawa, madzi m'mapapo (pulmonary edema), kupweteka pachifuwa, kapena kutsekeka kwa mitsempha ya mtima.
- Mankhwala opha tizilombo: Kusanza kapena kutsegula m'mimba.
- Albuterol: Kugwedezeka, chizungulire, kapena nseru.
- Mankhwala oletsa kupweteka mutu: Kugona, chizungulire, mutu, kapena kugunda kwa mtima mofulumira.
Dziwani kuti madokotala anu akuyang'ana mosamala zoopsazi poyerekeza ndi kufunika kopulumutsa moyo wanu ndipo apereka chithandizo chotetezeka komanso chothandiza kwambiri ku Nirogi Lanka.
Kodi mungachepetse bwanji chiopsezocho?
Ngakhale kuti si zonse zomwe zimayambitsa kusokonezeka kwa magazi, monga matenda ena, zomwe zingapeweke, mungathe kuchitapo kanthu kuti muchepetse zoopsa zomwe zimadziwika:
- Ngati muli ndi vuto lalikulu la chakudya, nthawi zonse tengani epinephrine auto-injector (monga EpiPen® kapena Adrenalin®) ndipo mudziwe momwe mungagwiritsire ntchito moyenera.
- Ngati mukudwala mphumu pafupipafupi, nthawi zonse khalani ndi Albuterol kapena Salbutamol inhaler yanu. Musalole kuti itha.
- Ngati mugwiritsa ntchito ma tampons, asintheni pafupipafupi kuti mupewe chiopsezo cha Toxic Shock Syndrome.
- Pewani kulowa m'madzi osaya kapena osadziwika, chifukwa izi zingayambitse kuvulala kwa msana.
- Nthawi zonse imwani mankhwala monga momwe dokotala wanu wanenera.
Kodi chimachitika ndi chiyani ngati mutakhala ndi Distributive Shock?
Ngati chifukwa cha 'kugwedezeka' kwanu ndi sepsis , mungakumane ndi mavuto monga kutopa, maloto ovutitsa, kapena kusowa chilakolako cha chakudya. Mosasamala kanthu za chifukwa chake, ndikofunikira kuti mupite kukaonana ndi dokotala nthawi zonse ndikutsatira mosamala malangizo a mankhwala omwe dokotala wanu wakupatsani.
Nthawi yomwe mudzachira ku Distributive Shock imadalira kwambiri kuopsa kwa zomwe mwakumana nazo. Mungafunike kukhala m'chipatala kuyambira masiku angapo mpaka milungu ingapo.
Mwayi woti munthu achire mokwanira umasiyana pakati pa 20% ndi 80%, kutengera chifukwa chake. Popanda chithandizo chamankhwala, vutoli nthawi zambiri limakhala loopsa. Kuzindikira msanga komanso kulandira chithandizo mwachangu ndiye njira yabwino kwambiri yodzitetezera kuti mupulumuke.Chiwopsezochi n'chokwera kwambiri kwa okalamba, anthu omwe amamwa mowa nthawi zonse, komanso omwe ali ndi mavuto a ziwalo zambiri.
Ngati thupi lanu limayankha bwino ku madzi a m'mitsempha (IV) ndipo ziwalo zanu zimagwira ntchito bwino, ndiye kuti chiyembekezo chanu chochira chimakhala champhamvu kwambiri.
Kodi ndimadzisamalira bwanji ndikabwerera kunyumba ?
Mukatuluka m'chipatala, tsatirani malangizo a dokotala wanu molondola. Mungafunike kupuma kunyumba kwa masiku angapo kapena milungu ingapo musanayambe kubwerera kuntchito. Chonde onetsetsani kuti mwapita kukaonana ndi dokotala nthawi zonse ndikumaliza kumwa mankhwala anu onse.
Ngati mukuona kuti vuto lanu likuipiraipira nthawi iliyonse mukakhala kunyumba, funsani dokotala nthawi yomweyo.
Pakagwa ngozi: Aliyense amene akusonyeza zizindikiro za Distributive Shock ayenera kuthamangitsidwa ku dipatimenti yapafupi yadzidzidzi. Pamene mukudikira thandizo ladzidzidzi (imbani 911), muuzeni munthuyo kuti agone pansi, muzimufunda ndi bulangeti, ndikukweza miyendo yake pafupifupi mainchesi 12 kuti magazi aziyenda bwino.
Mafunso oti mufunse dokotala wanu
Ngati mwakumanapo ndi vutoli, ndi bwino kukambirana ndi dokotala wanu mfundo zotsatirazi:
- Kodi ndili pachiwopsezo chokumananso ndi Distributive Shock ?
- Kodi ndiyenera kupezekapo nthawi zambiri bwanji pamisonkhano yotsatira?
- Kodi Distributive Shock ingakhale ndi zotsatirapo zilizonse pa thanzi langa kwa nthawi yayitali?
Uthenga Wofunika Wopita Nawo Kunyumba
Kusokonezeka maganizo ndi vuto lalikulu lachipatala lomwe limafuna chisamaliro chadzidzidzi. Kufunafuna thandizo mwachangu momwe mungathere kumapereka mwayi wabwino wopulumuka. Kuchira kumatenga nthawi, choncho chonde khalani oleza mtima ndi thupi lanu. Kunyumba, tsatirani ndondomeko yanu ya mankhwala ndipo pita kukaonana ndi dokotala nthawi zonse. Ku Nirogi Lanka, tikufuna kuti mudziwe zambiri chifukwa ichi ndi chochitika chachikulu chaumoyo.
👩🏽⚕️ Mafunso Ofunsidwa Kawirikawiri (Mafunso Ofunsidwa Kawirikawiri)
💬 Kodi Distributive Shock ndi yofanana ndi yamagetsi?
Ayi. Mu mawu azachipatala, 'shock' imatanthauza mkhalidwe womwe ungawopseze moyo pomwe magazi amapita ku ziwalo zofunika kwambiri (monga ubongo ndi impso) amachepa kwambiri. Pankhani imeneyi, pamene mtima ungakhale ukupopa, mitsempha yamagazi imakula mosalamulirika, zomwe zimapangitsa kuti kuthamanga kwa magazi kuchepe kwambiri.
💬 N’chifukwa chiyani mitsempha ya magazi imakula ndipo kuthamanga kwa magazi kumatsika?
Pali zifukwa zitatu zazikulu: 1. Kusamva bwino kwa thupi (Anaphylaxis, monga kulumidwa ndi njuchi), 2. Matenda oopsa m'magazi (Sepsis/Septic shock), kapena 3. Kuwonongeka kwa mitsempha ya msana chifukwa cha kuvulala (Neurogenic shock).
💬 Kodi mumamuzindikira bwanji munthu amene ali pachiwopsezo?
Zizindikiro zake ndi monga kukomoka, kugunda kwa mtima mofulumira kwambiri (tachycardia), khungu loyera, ndi kuvutika kupuma kwambiri. Chifukwa izi zitha kubweretsa imfa pasanathe mphindi zambiri, wodwalayo ayenera kugonekedwa ku ICU kuti akalandire mankhwala adzidzidzi (monga vasopressors monga epinephrine).
Mawu Ofunika: Kugwedezeka kogawa, kugwedezeka kwa septic, kugwedezeka kwa anaphylactic, kugwedezeka kwa mitsempha, kuthamanga kwa magazi kochepa, chithandizo cha kugwedezeka, kuchira kwa sepsis
