Pane chimwe chinhu chinovhara kuyerera kweropa richipinda nekubuda mumoyo mako here? Izvi zvinogona kunge zviri (Obstructive Shock)!

Kana ropa risingafambi zvakanaka mumuviri wedu wese, zvichireva kuti nhengo dzedu hadzigamuchire huwandu hunodiwa hweokisijeni, tinowanzoti 'shock'. Izvi zvinoitika kamwe kamwe. Nhasi tichataura nezverudzi rwakakosha, asi rusingawanzoitiki rwe'shock'. Runonzi '(Obstructive Shock)'. Zvichitaurwa zviri nyore, zvinoitika munyaya iyi ndechekuti chimwe chinhu chinovhara kuyerera kweropa kuenda kumoyo wedu uye ropa richibuda mumoyo, kureva kuti, 'obstruction' inoitika. Nekuda kwekuvharika uku, moyo haugone kushanda zvakanaka, BP inogona kudonha kamwe kamwe, uye muviri unogona kushaya okisijeni. Iyi inyaya yekukurumidzira , saka zvakakosha kuti uwane kurapwa nekukurumidza.

Saka chii ichi chinonzi `(Obstructive Shock)`? Tingachitsanangure zvishoma here?

Fungidzira, mwoyo wedu wakaita sepombi yemvura. Pombi iyi ndiyo inotumira ropa mumuviri wese. Zvino, chii chinoitika kana mvura inopinda mupombi iyi ikavharika mupombi, kana kana pombi ichibva mupombi ikavharika? Mvura haifambi zvakanaka, handiti? Ndizvo zvinoitika mu '(Obstructive Shock)'.

Pane chinovhara kufamba kweropa kuburikidza netsinga huru dzeropa (dzinonzi 'tsinga huru') dzinobatanidza moyo. Izvi zvinodzivirira mwoyo kuti usawane ropa rakakwana, uye haugone kuripombawo. Mugumisiro wacho ndewekuti nhengo dzakakosha mumuviri wedu, uropi, itsvo, nemapapu, hadziwani oxygen yakakwana. Iyi injodzi inotyisidzira hupenyu.

Ndeupi musiyano uripo pakati pe `(Cardiogenic Shock)` ne `(Obstructive Shock)`?

Zvese izvi inyaya dzehutano, asi zvinoitika nekuda kwezvikonzero zviviri.

Kuvhunduka kwemwoyo kunoitika kana tsandanyama dzemwoyo dzikakuvara, senge kurwara nemoyo, uye moyo usingakwanise kupomba ropa rakakwana mumuviri. Mwoyo unopera simba.

Asi mu `(Obstructive Shock)` tsandanyama yemwoyo inogona kugara yakanaka. Dambudziko harisi remoyo, asi nechimwe chinhu chiri kukanganisa mashandiro emoyo. Funga nezvezvinhu izvi:

• Kana uine ropa rakagwamba mutsinga huru yeropa (pulmonary artery) inoenda kumapapu ako.
• Kana moyo ukadzvanywa nebhegi rine mvura rakatenderedza moyo (pericardial tamponade).
• Kana paine kukuvara kwemapapu uye kumanikidzwa mukati mechipfuva kunowedzera zvakanyanya, semuenzaniso, mune chirwere chinonzi ``Tension pneumothorax''.

Kuvhunduka kwemoyo (Obstructive Shock) kunoitika kana moyo usingakwanise kushanda zvakanaka nekuda kwechimwe chikonzero chakadai.

Dambudziko iri rinonzi "Obstructive Shock" rakajairika zvakadii? Rinokanganisa sei muviri?

Obstructive Shock chirwere chinowanzoitika kana tichienzanisa nedzimwe mhando dze shock. Chinowanzo kanganisa 1% kana 2% yevarwere vane shock. Mashoko akanaka ndeekuti chinowanzo poreswa kupfuura mamwe marudzi e shock, asi chete kana chikarapwa nekukasika.

Kana ikasarapwa nekukurumidza, Obstructive Shock inobvisa okisijeni nezvinovaka muviri munhengo dzinokosha dzemuviri. Izvi zvinogona kukonzera kukuvara kwenhengo uye dzimwe nguva kutofa. Ndosaka zvichikosha kutsvaga kurapwa nekukurumidza.

Ndezvipi zviratidzo zve `(Obstructive Shock)`?

Zviratidzo zveizvi zvinogona kunge zvakafanana nezve "Cardiogenic Shock." Ona kana izvi zvichinzwika sekunge zvakajairika kwauri:

• Kufema kunowedzera zvisina kujairika.
• Kuderera kweropa (hypotension) kunoderera zvakanyanya.
• Kurova kwemoyo kunowedzera zvakanyanya (`Tachycardia`). Sekunge wangobva kumhanya.
• Mafungiro anochinja, pamwe kuora mwoyo kana kuzvidya mwoyo zvinogona kuitika.
• Huwandu hweweti inogadzirwa hunoderera zvakanyanya, kana kuti hausipo zvachose.
• Ganda rinonzwa kutonhora uye kudikitira.
• Dzimwe nguva mhepo inogona kuungana pasi peganda (`Subcutaneous emphysema`). Izvi zvinoreva kuti inonzwa semabhuru madiki pasi peganda.
• Unogona kunzwa kurwadziwa muchipfuva kana mudumbu.

Kana uine chimwe chezviratidzo izvi kana kupfuura, zvakakosha kuti utsvage rubatsiro rwechiremba nekukasika.

Ndezvipi zvinokonzera `(Obstructive Shock)`?

Pane zvikonzero zvakawanda zve `(Obstructive Shock)`. Ngationei kuti ndezvipi zvikuru:

• `(Kupwanyika kwemapapu netsinga)` (kudonha kwemapapu): Izvi zvinoitika kana mweya uchipinda mumapapu usingakwanise kubuda, zvichiita kuti uvharwe mukati memapapu. Mapapu anobva adonha, zvichiita kuti pave nekumanikidzwa kwakanyanya mukati mechipfuva uye zvichiita kuti mwoyo utange kurova.
• Vena cava compression syndrome: Kudzvinyirirwa kwetsinga huru mumuviri wedu (vena cava). Izvi zvinogona kuitika pakupera kwepamuviri, apo huremu hwemwana hunodzvinyirirwa tsinga iyi yeropa.
• Chirwere chekumanikidzwa kwemapapu: Chirwere chekumanikidzwa kwemapapu.
• `(Kufefetera kwakanyanya)`: Mamiriro ezvinhu apo kumanikidzwa mumapapu kwakanyanya kukwira kune munhu akabatana nemuchina wekufema.
• Mamota: Mamwe marudzi emamota anokura mukati mechipfuva anogonawo kuvharira mwoyo kana mitsipa mikuru yeropa.
• Kuputika kweropa mutsinga dzemapapu: Izvi zvine njodzi huru. Kana ropa rakagwamba panzvimbo yakaita segumbo rikabuda robva ranamatira mutsinga yeropa iri mumapapu, rinomisa ropa kuti risayerere kubva pamoyo kuenda kumapapu.
• Pericardial tamponade: Saga rakatetepa rakatenderedza moyo (pericardium) rinozadzwa nemvura, richidzvanya moyo. Izvi zvinodzivirira moyo kuti usazvimba zvakanaka.
• Kutsemuka kwetsinga yeropa: Kubvaruka kwetsinga yeropa, iyo tsinga huru yeropa inobuda mumoyo.
• Kuoma kwetsinga dzeropa: Kuoma kwetsinga dzeropa mumoyo. Izvi zvinoita kuti ropa risabude mumoyo.
• Hypertrophic cardiomyopathy: Kuvharika kweropa nekuda kwekukora kwakanyanya kwetsandanyama yemwoyo.
• Kuvharika kwemoyo: Saga rakatenderedza moyo rinokora, zvichiita kuti zviomere mwoyo kushanda zvakanaka.

Zvakakosha: Zvese izvi zvinokonzera njodzi, saka enda kuna chiremba nekukurumidza kana uine zviratidzo.

Nzira yekuziva `(Obstructive Shock)`?

Chiremba wako achatanga akuongorora. Vachateerera mwoyo wako nemapapu ne stethoscope. Kuvhunduka kwemudumbu chirwere chinogona kukurumidza kuipa, saka zvakakosha kuti uzive chirwere nekukurumidza.

Kuti unyatsoongorora chirwere ichi, bvunzo dzinotevera dzinogona kuitwa:

• Ultrasound: Izvi zvinogona kutarisa zvinhu zvakaita semoyo, mitsipa mikuru yeropa, uye kana paine mvura yakakomberedza mapapu.
• Echocardiogram (Echo): Izvi zvakafanana neultrasound yemoyo. Zvinogona kuona zvakajeka mashandiro emoyo, mamiriro emavharuvhu, uye kana paine mvura yakakomberedza moyo.
• Kuongororwa kweCT (computed tomography): Izvi zvinogona kutora mifananidzo yakadzama yechipfuva. Zvinogona kubatsira kuona zvinhu zvakaita sekugwamba kweropa, bundu, uye kupatsanurwa kweaorta.
• Electrocardiogram (ECG kana EKG): Izvi zvinoedza mashandiro emagetsi emwoyo. Zvinogona kubatsira kuona kana paine chimwe chinhu chisina kumira zvakanaka pamoyo wako.

Obstructive Shock inorapwa sei?

Kutanga, muchapihwa mvura yemutsinga (senge mvura yesaline - IV crystalloid) uye BP yenyu nemazinga eoxygen zvichaongororwa nguva nenguva. Zvadaro, chinhu chakakosha ndechekutsvaga chikonzero cheObstructive Shock uye kurapa chikonzero chacho.

Nzira dzekurapa dzinosiyana zvichienderana nechikonzero. Ngatitarisei mienzaniso mishoma:

• Kana paine ropa rakagwamba (embolism), rinobviswa kungave nekuvhiyiwa kana nekuisa cannula (catheter).
• Kana iri vharuvhu yeaorta yakamanikana zvakanyanya, ichatsiviwa.
• Kana tsandanyama dzemwoyo dzakakora (hypertrophic cardiomyopathy), ukobvu hwacho hunogona kuderedzwa kuburikidza nekuvhiyiwa kana nzira yakakosha uchishandisa doro (catheter-based alcohol ablation).
• Vanokupa mushonga wekunyungudutsa ropa rakagwamba.
• Kana paine mvura yakakomberedza mwoyo (pericardial tamponade) kana kuti tension pneumothorax, mvura kana mweya zvinobviswa (zvichida uchishandisa chubhu diki).
• Kana uri pamuchina wekufema, unogona kuchinja marongero awo.
• Mumamiriro akaita se "Vena cava compression syndrome", chimiro chemuviri chinochinjwa.
• Kana kumanikidzwa mumapapu kwakanyanya, kumanikidzwa kunoderedzwa netsono kana chubhu.

Mishonga ipi inoshandiswa?

Paunenge uchirapwa chikonzero chacho, unogona kupihwa mishonga yakaita seiyi kuti ugare wakadzikama:

• Mvura yakaita se `IV` saline (`IV crystalloid fluids`).
• Mishonga yekuwedzera BP: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® kana Biorphen®))`.
• Kana ropa rako riine huwandu hushoma, uchapihwa ropa kana zvinhu zveropa (zvakaita semasero matsvuku eropa neplasma).

Ndichakurumidza sei kupora mushure mekurapwa?

Zvizhinji zvezvikonzero zveObstructive Shock zvinoda kurapwa nekukurumidza , sezvo apa ndipo panowanikwa mikana yakawanda yekupona. Nerombo rakanaka, kurapwa uku kunoshanda nekukurumidza. Zvisinei, kunyangwe mushure mekurapa chikonzero chacho, zvinotora nguva kuti muviri upore kubva kumigumisiro yeObstructive Shock. Haugone kungomhanya-mhanya woita basa rako.

Ndeipi tarisiro ye `(Obstructive Shock)`?

Kana ikasarapwa, "Obstructive Shock" chirwere chinogona kuuraya vanhu vazhinji. Kupora kwako mushure mekurapwa kunoenderana nezvinhu zvakati wandei, zvinosanganisira:

• Chii chinokonzera `(Obstructive Shock)`?
• Zvakatora nguva yakareba sei kuti kurapwa kuitwe?
• Ndezvipi zvimwe zvirwere zvaunazvo?
• Kurapwa kwacho kwakabudirira sei kwauri?

Zvisinei, sezvambotaurwa, mikana yekupora kubva ku "Obstructive Shock" yakakwira kupfuura kubva kumhando dze "Shock" dzakajairwa dzakadai se "Septic Shock". Nokudaro, pane tariro.

Ndinozvitarisira sei?

Mushure mekunge chiremba akuburitsa muchipatara, unofanira kutevedzera mirairo yavo nemazvo.

• Uchafanira kuzorora kumba kwenguva yakati usati wadzokera kubasa.
• Unofanira kutora mushonga wawakanyorerwa nachiremba wako panguva chaiyo . Usarega kutora chero mushonga chero upi zvawo paunoda.
• Endai kumisangano yekutevera nguva nenguva .

Ndinofanira kuona chiremba zvakare riini? Ndoita sei kana paine emergency?

Iye zvino wava kuziva chakakonzera '(Obstructive Shock)' yako. Chenjerera kana zviratidzo zvine chekuita nedambudziko iroro zvikadzokazve. Kana uine zviratidzo zvakadaro zvakare, kana mumwe munhu mumhuri yako akaona shanduko iyi mauri, fonera 1990 (Wind) Ambulance Service nekukasika, kana kuenda kuchipatara chiri pedyo. Nguva ndiyo inokosha.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Unogona kubvunza mibvunzo yakaita seiyi:

• Ndinofanira kutora mushonga wamakanyorera kwenguva yakareba sei?
• Mikana yekuti ndive nechirwere ichi zvakare ndeipi?
• Izvi zvichakanganisa hupenyu hwangu kwenguva refu here?
• Ndezvipi zvandinofanira kuchinja pakudya kwangu uye maekisesaizi angu?

Pakupedzisira, zvekurangarira (Mharidzo Yekuenda Kumba)

Obstructive Shock chirwere chisingawanzoitiki asi chakakomba zvikuru chinoda kurapwa nekukurumidza. Saka, zvakakosha kuziva zviratidzo uye kutsvaga kurapwa nekukurumidza. Kana vanachiremba vangowana chikonzero cheObstructive Shock, vanobva vatanga kurapwa kwakakodzera.

Yeuka kuti vanhu vazhinji vanogona kupora kubva kuObstructive Shock, asi zvinotora nguva. Iva nemoyo murefu, tevera mirairo yachiremba wako, uye uzvitarisire. Hausi wega, uye kune vanachiremba, vanamukoti, nevadikanwi vako vanogona kukubatsira.

Kuvhunduka, kuvhunduka, chirwere chemwoyo, BP, okisijeni, kuvharika , kurapwa kwekukurumidzira, mapapu, moyo