Kodi kuchepa kwa kuthamanga kwa magazi mukapuma ndi chizindikiro cha matenda oopsa? (Pulsus Paradoxus)

Kodi mudamvapo dokotala, akamayesa kuthamanga kwa magazi anu, akunena mawu ngati akuti, "Pumirani mpweya wakuya mkati... tsopano pumirani kunja..."? Nthawi zina timaganiza kuti ndi mwambi chabe. Koma zoona zake n'zakuti, nthawi zina dokotala amafufuza kuti aone ngati pali kusintha kwina kwa kuthamanga kwa magazi anu ndi kapumidwe kanu. Pali chifukwa chofunikira kwambiri cha izi. Lero tikambirana za chizindikiro chimodzi chapadera chachipatala, chomwe ndi 'Pulsus Paradoxus'. Dzinali lingamveke lovuta pang'ono mukalimva, koma tiyeni tilifotokoze mwachidule.

Kodi Pulsus Paradoxus kwenikweni ndi chiyani?

Mwachidule, Pulsus Paradoxus ndi pamene kuthamanga kwa magazi anu, makamaka chiwerengero chapamwamba (systolic pressure), kumatsika kwambiri kuposa momwe mumayembekezera mukamapuma.

Tsopano mwina mukuganiza kuti, "Ndiye n’chiyani chachilendo kwambiri pa zimenezo?" Chodabwitsa apa n’chakuti nthawi zambiri, munthu wathanzi akapuma, kuthamanga kwa magazi ake kuyenera kukwera pang’ono kapena kusasintha kwambiri. Koma pankhaniyi, zosiyana kwambiri zimachitika. Izi zikutanthauza kuti kuthamanga kwa magazi kumatsika mwadzidzidzi. Ichi si matenda, koma chizindikiro chofunika kwambiri chomwe chimatiuza kuti pali vuto mkati mwa thupi lanu, makamaka mumtima kapena m’mapapo.

Taganizirani izi, mtima wathu ndi umene umapopa magazi m'thupi lathu lonse. Tikamapuma, pamakhala kusintha kwa kuthamanga kwa magazi pachifuwa chathu. Kusinthaku kumakhudza pang'ono momwe mtima umadzazira magazi. Komabe, ngati mtima sungathe kukula bwino chifukwa cha matenda, kapena ngati pali kuthamanga kwambiri kuzungulira mtima, kuchuluka kwa magazi komwe kumalowa mumtima tikamapuma kumachepa kwambiri . Zotsatira zake, kuchuluka kwa magazi komwe mtima umapopa kupita ku thupi kumachepanso, ndichifukwa chake timawona kutsika kwadzidzidzi kwa kuthamanga kwa magazi.

Kodi dokotala amayesa bwanji izi?

Ichi si chinthu chomwe mungachiyeze ndi chipangizo choyezera kuthamanga kwa magazi kunyumba. Chifukwa ichi ndi chinthu chomwe chiyenera kuyezedwa mosamala kwambiri. Pachifukwa ichi, dokotala nthawi zambiri amagwiritsa ntchito chopopera kuthamanga kwa magazi chomwe chimapopedwa ndi manja ndi stethoscope (chopopera kuthamanga kwa magazi ndi manja).

Umu ndi momwe mungachitire:

1. Choyamba, dokotala adzaika chogwirira cha pressure pa mkono wanu ndikuchifukiza mpaka mutatha kumva kugunda kwa mtima wanu.

2. Kenako, pamene mukutulutsa mpweya mwachangu kwambiri (pa liwiro la pafupifupi mamilimita awiri a mercury pa sekondi imodzi), stethoscope imagwiritsidwa ntchito kupeza malo oyamba pomwe phokoso la kugunda kwa mtima limamveka. Pa nthawiyi, phokoso limamveka mukatulutsa mpweya (kutulutsa). Mtengo umenewo umalembedwa.

3. Kenako, pamene mukuwonjezera mphamvu ya cuff pang'ono, mudzapeza malo omwe mungathe kumvabe kugunda kwa mtima pamene mukupuma ndi kutuluka . Mudzalembanso mtengo umenewo.

4. Pomaliza, kusiyana pakati pa mitengo iwiri yapamwamba yolembedwayi kumawerengedwa.

Kodi zifukwa zazikulu za Pulsus Paradoxus ndi ziti?

Ngati muwona chizindikiro cha Pulsus Paradoxus, zikutanthauza kuti pali chinachake chomwe chikulepheretsa mtima kugwira ntchito bwino. Pakhoza kukhala zifukwa zingapo za izi.

Chifukwa chachikulu komanso chofala kwambiri ndi kuchulukana kwa madzi ozungulira mtima, zomwe zimayambitsa cardiac tamponade. Tiyeni tifotokoze izi pang'ono. Mtima wathu uli mkati mwa chivundikiro chopyapyala chonga thumba chotchedwa 'pericardium'. Izi nthawi zambiri zimakhala ndi madzi ochepa kwambiri oteteza ndikupatsa mafuta mtima. Komabe, ngati chifukwa cha matenda ena, madzi ambiri (monga madzi) amasonkhana mkati mwa thumba ili, amatchedwa Pericardial Effusion . Ngati madzi awa akuwonjezeka, pericardial sac imatambasuka, ndipo pamapeto pake imayambitsa cardiac tamponade . Ili ndi vuto lalikulu lomwe limafuna chithandizo chadzidzidzi. Ichi ndiye chifukwa chofala kwambiri cha Pulsus Paradoxus.

Kupatula izi, palinso zifukwa zina zingapo zomwe zingayambitse Pulsus Paradoxus mu tebulo ili m'munsimu.

Kodi izi zimachiritsidwa bwanji?

Chofunika kwambiri chomwe tonse tiyenera kumvetsetsa apa ndichakuti palibe chithandizo chachindunji cha chizindikiro chotchedwa Pulsus Paradoxus. Chifukwa si matenda. Ali ngati nyali yochenjeza yomwe imayatsidwa pa dashboard pakakhala vuto ndi injini ya galimoto. Chomwe tikuchita si kuzimitsa ndi kuyatsa nyali, koma kukonza vuto mu injini.

Njira yochizira imatsimikiziridwa ndi chifukwa chake.

• Ngati chifukwa chake ndi Cardiac Tamponade , chithandizo chadzidzidzi chimaphatikizapo kuchotsa madzi owonjezera ozungulira mtima pogwiritsa ntchito sirinji ndi singano (pericardiocentesis). Opaleshoni ingafunikenso.
• Ngati chifukwa chake ndi mphumu yoopsa , mankhwala ndi nebulizer zimaperekedwa kuti athetse mphumu.
• Ngati chifukwa chake ndi pneumothorax (mapapo omwe agwa), chubu chimayikidwa pachifuwa kuti chichotse mpweya wochuluka.
• Pa milandu ngati Constrictive Pericarditis , pericardium yokhuthala ingafunike kuchotsedwa opaleshoni.

Mwanjira imeneyi, dokotalayo adzayamba wapeza chomwe chikuyambitsa matendawa ndikukupatsani chithandizo chabwino kwambiri chomwe chikugwirizana nacho. Chifukwa chake, ngati dokotala wanu akukuuzani za chizindikiro ngati ichi, ndikofunikira kwambiri kuti musachite mantha nacho ndikugwirizana mokwanira ndi mayeso ndi chithandizo chomwe chikuchitika kuti mupeze chomwe chikuyambitsa matendawa.