Kodi pali china chake chomwe chikuletsa kutuluka kwa magazi mumtima mwanu? Izi zitha kukhala (Obstructive Shock)!

Magazi akamalephera kuyenda bwino m'thupi lathu lonse, zomwe zikutanthauza kuti ziwalo zathu sizilandira mpweya wofunikira, nthawi zambiri timatcha kuti 'shock'. Izi zimachitika mwadzidzidzi. Lero tikambirana za mtundu wapadera, koma wosowa kwambiri wa 'shock'. Umatchedwa `(Obstructive Shock)'. Mwachidule, chomwe chimachitika pankhaniyi ndichakuti china chake chimatseka kuyenda kwa magazi kupita kumtima mwathu ndipo magazi amatuluka mumtima, kutanthauza kuti, 'choletsa' chimachitika. Chifukwa cha kutsekeka kumeneku, mtima sungagwire ntchito bwino, kuthamanga kwa magazi kumatha kutsika mwadzidzidzi, ndipo thupi limatha kusowa mpweya. Izi ndi nkhani yofunika kwambiri , choncho ndikofunikira kwambiri kupeza chithandizo mwachangu.

Ndiye kodi '(Obstructive Shock)' iyi ndi chiyani? Kodi tingafotokoze zambiri?

Tangoganizani, mtima wathu uli ngati pampu yamadzi. Pampu iyi ndi yomwe imatumiza magazi m'thupi lonse. Tsopano, chimachitika ndi chiyani ngati madzi olowa mu pampu iyi atsekeka mu pampu, kapena ngati pampu yotuluka mu pampu yatsekeka? Madzi sakuyenda bwino, sichoncho? Ndicho chimene chimachitika mu `(Obstructive Shock)`.

Chinachake chimaletsa kuyenda kwa magazi kudzera m'mitsempha ikuluikulu yamagazi (yotchedwa 'mitsempha ikuluikulu') yomwe imalumikiza mtima. Izi zimalepheretsa mtima kupeza magazi okwanira, ndipo sungathenso kuutulutsa. Zotsatira zake n'zakuti ziwalo zofunika kwambiri m'thupi lathu, ubongo, impso, ndi mapapo, sizilandira mpweya wokwanira. Izi ndi ngozi yowopsa kwambiri.

Kodi kusiyana kwa `(Cardiogenic Shock)` ndi `(Obstructive Shock)` ndi kotani?

Zonsezi ndi zadzidzidzi zachipatala, koma zimachitika pazifukwa ziwiri.

Kugwedezeka kwa mtima kumachitika pamene minofu ya mtima yawonongeka, monga matenda a mtima, ndipo mtima sungathe kupopera magazi okwanira kupita ku thupi. Mtima umafooka.

Koma mu `(Obstructive Shock)` minofu ya mtima nthawi zambiri imakhala bwino. Vuto silili ndi mtima, koma ndi chinthu china chomwe chikusokoneza ntchito ya mtima. Taganizirani izi:

• Ngati muli ndi magazi ambiri oundana m'mitsempha yayikulu yamagazi (pulmonary artery) yomwe imatsogolera ku mapapo anu.
• Ngati mtima wapanikizika ndi thumba lodzaza madzi mozungulira mtima (pericardial tamponade).
• Ngati pali kuvulala m'mapapo ndipo kupanikizika mkati mwa chifuwa kumawonjezeka kwambiri, mwachitsanzo, mu vuto lotchedwa ``Tension pneumothorax''.

Kugwedezeka Kosagwira Ntchito (Obstructive Shock) ndi pamene mtima sungathe kugwira ntchito bwino chifukwa cha chinthu china chakunja monga ichi.

Kodi vuto limeneli lotchedwa ``Obstructive Shock'' ndi lofala bwanji? Kodi limakhudza bwanji thupi?

Kugwedezeka kwa Obstructive kwenikweni ndi vuto losowa kwambiri poyerekeza ndi mitundu ina ya kugwedezeka. Nthawi zambiri limakhudza 1% kapena 2% yokha ya odwala kugwedezeka. Nkhani yabwino ndi yakuti nthawi zambiri imatha kuchiritsidwa kuposa mitundu ina ya kugwedezeka, koma pokhapokha ngati itachiritsidwa mwachangu.

Ngati sichilandira chithandizo mwachangu, Obstructive Shock imachotsa mpweya ndi michere m'thupi. Izi zitha kuwononga ziwalo ndipo nthawi zina zimapha. Ndicho chifukwa chake ndikofunikira kufunafuna chithandizo mwachangu.

Kodi zizindikiro za `(Obstructive Shock)` ndi ziti?

Zizindikiro za izi zitha kukhala zofanana pang'ono ndi za ``Cardiogenic Shock.'' Onani ngati izi zikumveka zachilendo kwa inu:

• Kuthamanga kwa mpweya kumawonjezeka modabwitsa.
• Kuthamanga kwa magazi kumatsika kwambiri (hypotension).
• Kugunda kwa mtima kumawonjezeka kwambiri (`Tachycardia`). Ngati kuti mwangothamanga kumene.
• Kusintha kwa maganizo, mwina kukhumudwa kapena nkhawa zingachitike.
• Kuchuluka kwa mkodzo wopangidwa kumachepa kwambiri, kapena kulibe konse.
• Khungu limamva kuzizira komanso thukuta.
• Nthawi zina mpweya ukhoza kusonkhana pansi pa khungu (`Subcutaneous emphysema`). Izi zikutanthauza kuti umamveka ngati thovu laling'ono pansi pa khungu.
• Mungamve kupweteka pachifuwa kapena m'mimba.

Ngati muli ndi chimodzi kapena zingapo mwa zizindikirozi, ndikofunikira kwambiri kupeza upangiri wa dokotala nthawi yomweyo.

Kodi zifukwa za `(Obstructive Shock)` ndi ziti?

Pali zifukwa zingapo zomwe zimayambitsa `(Obstructive Shock)`. Tiyeni tiwone zomwe zikuluzikulu ndi izi:

• `(Kupsinjika kwa mapapo)` (kugwa kwa mapapo): Izi zimachitika pamene mpweya umalowa m'mapapo ndipo sungathe kutuluka, zomwe zimapangitsa kuti utsekedwe mkati mwa mapapo. Kenako mapapo amagwa, zomwe zimapangitsa kuti pakhale kupanikizika kwambiri mkati mwa chifuwa ndikupangitsa mtima kuyamba kugunda.
• Matenda a Vena cava compression: Kupsinjika kwa mtsempha waukulu kwambiri m'thupi lathu (vena cava). Izi nthawi zambiri zimachitika kumapeto kwa mimba, pamene kulemera kwa mwana kumakanikizira mtsempha wamagazi.
• Matenda a m'mapapo: Matenda a m'mapapo.
• `(Kupuma mpweya kwapamwamba kwambiri)`: Matenda omwe kuthamanga kwa mpweya m'mapapo kumakhala kwakukulu kwambiri kwa munthu wolumikizidwa ndi makina opumulira mpweya.
• Ziphuphu: Mitundu ina ya zotupa zomwe zimakula mkati mwa chifuwa zimatha kutsekereza mtima kapena mitsempha yayikulu yamagazi.
• Kutupa kwa magazi m'mitsempha ya m'mapapo: Izi ndi zoopsa kwambiri. Ngati magazi oundana omwe amapangika pamalo ngati mwendo asweka n'kukakamira mumtsempha wamagazi m'mapapo, amaletsa magazi kuyenda kuchokera mumtima kupita m'mapapo.
• Pericardial tamponade: Thumba lopapatiza lozungulira mtima (pericardium) limadzaza ndi madzi, zomwe zimafinya mtima. Izi zimalepheretsa mtima kuti usakoke ndikukula bwino.
• Kung'ambika kwa mtsempha wamagazi: Kung'ambika kwa mtsempha wamagazi, womwe ndi mtsempha waukulu kwambiri wamagazi womwe umatuluka mumtima.
• Kuchepa kwa valavu ya mtsempha wamagazi: Kuchepa kwa valavu ya mtsempha wamagazi mumtima. Izi zimapangitsa kuti magazi azituluka mumtima kukhala ovuta.
• Hypertrophic cardiomyopathy: Kutsekeka kwa magazi chifukwa cha kukhuthala kwa minofu ya mtima.
• Kutsekeka kwa mtima: Thumba lozungulira mtima limakhuthala, zomwe zimapangitsa kuti mtima ugwire ntchito momasuka.

Chofunika: Zonsezi ndi zinthu zadzidzidzi, choncho pitani kwa dokotala nthawi yomweyo ngati muli ndi zizindikiro.

Kodi mungazindikire bwanji `(Obstructive Shock)`?

Dokotala wanu adzakuyesani kaye. Adzamvetsera mtima ndi mapapo anu pogwiritsa ntchito stethoscope. Kugwedezeka kwa mtima ndi vuto lomwe lingakule mofulumira, choncho ndikofunikira kupeza matenda mwachangu.

Kuti mudziwe matendawa molondola, mayeso otsatirawa atha kuchitidwa:

• Ultrasound: Izi zitha kuwona zinthu monga mtima, mitsempha ikuluikulu yamagazi, komanso ngati pali madzi m'mapapo.
• Echocardiogram (Echo): Ichi chili ngati ultrasound ya mtima. Chimatha kuona bwino momwe mtima umagwirira ntchito, momwe ma valve alili, komanso ngati pali madzi ozungulira mtima.
• Kujambula kwa CT (computed tomography): Izi zitha kujambula zithunzi za mwatsatanetsatane za m'mimba mwa chifuwa. Zingathandize kuzindikira zinthu monga magazi kuundana, zotupa, ndi kusweka kwa mtsempha wamagazi.
• Electrocardiogram (ECG kapena EKG): Izi zimayesa momwe magetsi a mtima amagwirira ntchito. Zingathandize kudziwa ngati pali vuto ndi mtima wanu.

Kodi Obstructive Shock imachiritsidwa bwanji?

Choyamba, mudzapatsidwa madzi a IV (monga madzi a saline - IV crystalloid) ndipo kuthamanga kwa magazi ndi mpweya wanu zidzayang'aniridwa nthawi zonse. Kenako, chofunika kwambiri ndikupeza chomwe chimayambitsa Obstructive Shock ndikuchiza chomwe chimayambitsa.

Njira zochiritsira zimasiyana malinga ndi chomwe chimayambitsa vutoli. Tiyeni tiwone zitsanzo zingapo:

• Ngati pali magazi oundana (embolism), amachotsedwa opaleshoni kapena poika cannula (catheter).
• Ngati ndi valavu ya aorta yopapatiza kwambiri, idzasinthidwa.
• Pankhani ya minofu ya mtima yokhuthala (hypertrophic cardiomyopathy), makulidwe ake amatha kuchepetsedwa kudzera mu opaleshoni kapena njira yapadera pogwiritsa ntchito mowa (catheter-based alcohol ablation).
• Amakupatsirani mankhwala osungunula magazi oundana.
• Ngati pali madzi ozungulira mtima (pericardial tamponade) kapena tension pneumothorax, madziwo kapena mpweyawo udzachotsedwa (mwina pogwiritsa ntchito chubu chaching'ono).
• Ngati muli ndi makina opumulira mpweya, mutha kusintha makonda ake.
• Mu vuto ngati ``Vena cava compression syndrome'', malo a thupi amasinthidwa.
• Ngati kuthamanga kwa magazi m'mapapo kuli kwakukulu, kuthamanga kwa magazi kumachepa ndi singano kapena chubu.

Ndi mankhwala ati omwe amagwiritsidwa ntchito?

Pamene chifukwa cha matendawa chikuchiritsidwa, mungapatsidwe mankhwala ngati awa kuti mukhazikitse bwino vuto lanu:

• Madzi monga `IV` saline (`IV crystalloid fluids`).
• Mankhwala owonjezera kuthamanga kwa magazi: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® kapena Biorphen®))`.
• Ngati muli ndi magazi ochepa, mudzapatsidwa magazi kapena zinthu zina za m'magazi (monga maselo ofiira a magazi ndi plasma).

Kodi ndidzachira msanga bwanji nditalandira chithandizo?

Zambiri mwa zifukwa zomwe zimayambitsa Obstructive Shock ziyenera kuthandizidwa mwachangu , chifukwa apa ndi pomwe mwayi wopulumuka umakhala waukulu. Mwamwayi, mankhwala awa amagwira ntchito mwachangu. Komabe, ngakhale mutachiza chomwe chayambitsa, zimatenga nthawi kuti thupi lichiritse ku zotsatira za Obstructive Shock. Simungangothamanga ndikuchita ntchito yanu.

Kodi chiyembekezo cha `(Obstructive Shock)` ndi chiyani?

Ngati sichinachiritsidwe, "Obstructive Shock" ndi vuto lomwe lingathe kupha anthu ambiri. Kuchira kwanu mutalandira chithandizo kumadalira zinthu zingapo, kuphatikizapo:

• Kodi chifukwa cha `(Obstructive Shock)` n'chiyani?
• Zinatenga nthawi yayitali bwanji kuti munthu alandire chithandizo?
• Ndi matenda ena ati omwe muli nawo?
• Kodi chithandizocho chinali chothandiza bwanji kwa inu?

Komabe, monga tanenera kale, mwayi wochira ku ``Obstructive Shock`` ndi wokwera kuposa mitundu yodziwika bwino ya ``Shock`` monga ``Septic Shock``. Chifukwa chake, pali chiyembekezo.

Kodi ndimadzisamalira bwanji?

Dokotala akakutulutsani kuchipatala, muyenera kutsatira malangizo awo molondola.

• Muyenera kupuma kunyumba kwakanthawi musanabwerere kuntchito.
• Muyenera kumwa mankhwala omwe dokotala wanu wakupatsani panthawi yake . Musasiye kumwa mankhwala aliwonse nthawi iliyonse yomwe mukufuna.
• Pitani ku misonkhano yotsatira nthawi zonse .

Kodi ndiyenera kupitanso kwa dokotala liti? Kodi ndiyenera kuchita chiyani pakagwa ngozi?

Tsopano mukudziwa chomwe chinayambitsa '(Obstructive Shock)' yanu. Samalani ngati zizindikiro zokhudzana ndi vutoli zikubwereranso. Ngati muli ndi zizindikiro zotere kachiwiri, kapena ngati wina m'banja mwanu akuwona kusinthaku mwa inu, imbani nthawi yomweyo ku 1990 (Wind) Ambulance Service, kapena pitani ku chipinda chadzidzidzi cha chipatala chapafupi. Nthawi ndi yofunika kwambiri.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Mungathe kufunsa mafunso monga awa:

• Kodi ndiyenera kumwa mankhwala omwe mwandipatsa kwa nthawi yayitali bwanji?
• Kodi pali mwayi wotani woti ndikhalenso ndi vutoli?
• Kodi izi zidzakhudza moyo wanga kwa nthawi yayitali?
• Ndi kusintha kotani komwe ndiyenera kusintha pa zakudya zanga ndi masewera olimbitsa thupi?

Pomaliza, zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Kugwedezeka kwa Obstructive ndi vuto losowa koma loopsa kwambiri lomwe limafuna chithandizo chadzidzidzi. Chifukwa chake, ndikofunikira kudziwa zizindikiro ndikupeza chithandizo mwachangu. Madokotala akangopeza chomwe chimayambitsa Kugwedezeka kwa Obstructive, amayamba kulandira chithandizo choyenera.

Kumbukirani, anthu ambiri amatha kuchira ku Obstructive Shock, koma zimatenga nthawi. Khalani oleza mtima, tsatirani malangizo a dokotala wanu, ndipo dzisamalireni nokha. Simuli nokha, ndipo pali madokotala, anamwino, ndi okondedwa anu omwe angakuthandizeni.

` Kugwedezeka, kugwedezeka, matenda a mtima, kuthamanga kwa magazi, mpweya, kutsekeka, chithandizo chadzidzidzi, mapapo, mtima