Ngaba ukuhamba kwegazi lakho kuphazamisekile uze ube 'kwi-shock'? Masithethe 'nge-distributive shock'!

Owu, ngamanye amaxesha singangena ngequbuliso engxakini enkulu, akunjalo? Kukho amaxesha apho sivakalelwa kukuba silahlekelwa bubomi bethu kwaye kunzima ukuphefumla. Ngamaxesha anje, kusenokwenzeka into embi eyenzeka emizimbeni yethu. Namhlanje siza kuthetha ngemeko engxamisekileyo, esongela ubomi. Leyo yimeko ebizwa ngokuba yi -'Distributive Shock' .

Yintoni le 'i-distributive shock'? Ngamafutshane...

Ngamafutshane, ukothuka okusasazwayo yingxamiseko yezonyango. Okwenzekayo apha kukuba imithambo yegazi emzimbeni wakho (apho igazi lihamba khona) ngequbuliso iba nkulu kakhulu, njengetyhubhu yerabha eyoluliweyo. Ngamanye amaxesha oku kukwabizwa ngokuba yi-vasodilatory shock . Ngoko ke, xa imithambo yegazi iba nkulu ngolu hlobo, uxinzelelo lwegazi luyehla kakhulu ngequbuliso. Cinga ngayo ngathi ukuba umbhobho wamanzi ukhula, amanzi aya kuhamba kancinci.

Kwenzeka ntoni xa oku kusenzeka? Amalungu akho aphambili, njengentliziyo yakho, ingqondo, kunye nezintso, awafumani igazi elaneleyo . Akunjalo kuphela, kodwa ngamanye amaxesha elinye igazi liqala ukuvuza kule mithambo yegazi mincinci (ii-capillaries). Oku kunokubangela ukuba inani legazi emzimbeni wakho lehle. Le yimeko eyingozi kakhulu, kuba amalungu ethu afuna ukunikezelwa kwegazi rhoqo ukuze asebenze.

Kubaluleke kakhulu: Ukuba ufumana 'umothuko' onje, kubalulekile ukufuna unyango ngokukhawuleza. Kungenjalo, lunokuba yingozi ebomini.

Ziziphi iintlobo eziphambili 'zee-distributive shocks'?

Kukho iintlobo ezintathu eziphambili 'zokothuka okusasazwayo', nganye kuzo yenzeka ngesizathu esahlukileyo.

1. I-Septic Shock: Olu lolona hlobo luqhelekileyo. Lubangelwa lusulelo lwebhaktiriya. Khawuthelekelele, unesilonda, siba sibi kakhulu, iintsholongwane zisasazeka emzimbeni wakho, kwaye iba yimeko ebizwa ngokuba yi-"Sepsis", kwaye awukwazi ukuyilawula. Ngamanye amaxesha, nento efana ne-pneumonia inokubangela le meko.

2. I-Anaphylactic Shock: Oku kubangelwa yi-allergy enzima. Umzekelo, abanye abantu banee-allergy ezinzima kwinto efana neepinati, akunjalo? Okanye kwenzeka xa belunywa zizinambuzane ezithile. Umntu one-asthma naye unokuba nale meko, nokuba unengxaki enkulu yokuphefumla.

3. Umothuko weNeurogenic: Oku kubangelwa kukonakala komqolo wakho. Umzekelo, ukuba ubetheka entloko ngelixa utsiba emanzini uze wonzakale umqolo wakho, okanye ukuba wenze ingozi enkulu eyonakalisa umqolo wakho, olu 'mothuko weneurogenic' lunokwenzeka ngenxa yempembelelo kwinkqubo yeneurological.

Yintoni umahluko phakathi kwe-'Distributive Shock' kunye ne-'Hypovolemic Shock'?

Zombini ziintlobo 'zokothuka'. Oku kuthetha ukuba kuzo zombini iimeko, amalungu ethu abalulekileyo awafumani igazi neoksijini eyaneleyo. Nangona kunjalo, unobangela wahlukile.

• Ukwaphuka komoya , njengoko bekutshiwo ngaphambili, kubangelwa kukuba imithambo yegazi iba mikhulu kakhulu. Oku kudla ngokubangelwa lusulelo olubizwa ngokuba yi-sepsis okanye i-allergy enzima.
• Ukothuka kwe-Hypovolemic kuxa inani legazi okanye olunye ulwelo emzimbeni liphantsi kakhulu. Umzekelo, oku kunokwenzeka ukuba ulahlekelwa ligazi elininzi ngenxa yokwenzakala okukhulu, okanye ukuba ulahlekelwa lulwelo oluninzi ngenxa yorhudo oluqatha okanye ukuhlanza.

Ngamafutshane, kwi-'distributive' imithambo yegazi iba mikhulu, kwi-'hypovolemic' igazi/ulwelo emzimbeni luyancipha. Uyaqonda?

Ixhaphake kangakanani le 'nto yokusasaza'?

Kukho iintlobo ezine zomothuko esizaziyo (`Hypovolemic`, `Cardiogenic Shock`, `Obstructive Shock` kunye `Distributive Shock`). Kwezi zine , ezona zixhaphakileyo yi`Distributive Shock` . Ingakumbi uhlobo olubizwa ngokuba yi`Septic Shock`. Kwanakwilizwe elifana neMelika, malunga nesigidi sabantu siba ne`Septic Shock` minyaka le. Inokwenzeka nakubani na.

Kwenzeka ntoni emzimbeni xa kukho 'uxinzelelo lokusasaza'?

Njengoko benditshilo ngaphambili, xa imithambo yegazi iba mikhulu kakhulu, uxinzelelo lwegazi luyehla. Emva koko inani legazi eliya kwizitho zomzimba liyaba linganelanga. Izitho zethu zomzimba zifana noomatshini. Zifuna ukufumana umlinganiselo ofanelekileyo wamafutha (oko kukuthi igazi kunye neoksijini) ukuze zisebenze. Xa zingafumani igazi elaneleyo, ioksijini, kunye nezondlo, izitho zomzimba ziyayeka ukusebenza kancinci kancinci. Oku sikubiza ngokuba 'kukusilela kwezitho zomzimba' . Ukuba izitho zomzimba ziyasilela ngolu hlobo, kuba sisongelo esikhulu ebomini.

Zithini iimpawu zoku?

Iimpawu zokothuka okusasazekayo zingahluka kancinci ngokuxhomekeke kwisizathu. Nangona kunjalo, kukho iimpawu eziqhelekileyo:

• Ukuqhambuka kwesikhumba
• Ukubetha kwentliziyo ngokukhawuleza kunye nokuphefumla
• Uxinzelelo lwegazi oluphantsi (olu luphawu oluphambili)
• Izandla neenyawo ziqala zifudumele, emva koko zibanda kwaye zibile.
• Ifiva
• Ukugodola (ukuziva ubanda kwaye uqhaqhazela)
• Isisu esibuhlungu
• Ukudideka, ukuziva ngathi ulahlekelwa zingqondo
• Ukukhwehlela
• Ukuqhawukelwa ngumphefumlo
• Isicaphucaphu
• Ukuhlanza
• Intlungu xa uchama

Ukuba olunye okanye ngaphezulu kwezi mpawu luvela ngequbuliso, kungcono ukuba ungazithathi lula, akunjalo?

Zithini izizathu 'zoMngcipheko woSasazo'?

Ukongeza kwiintlobo ezintathu esizixubushileyo ngaphambili, kukho ezinye izizathu ezininzi ezikhokelela kule meko.

• I-Sepsis ebangelwa lusulelo lwebhaktiriya (le yeyona nto iphambili)
• I-Anaphylaxis, ebangelwa zi-allergies ezinzima (umz., ukutya okufana namandongomane, ukutyiwa zizinambuzane, amayeza athile, ukugula kakhulu yi-asthma)
• Ukutsha
• I-Pancreatitis
• I-Toxic Shock Syndrome (enokwenzeka, ingakumbi kubasetyhini, ngenxa yokusebenzisa i-tampon)
• Ukulimala komqolo
• Iingxaki ze-endocrine
• Ukungakwazi ukusebenza kakuhle kwee-adrenal (oku akuqhelekanga kangako)
• I-Capillary leak syndrome ( ukuvuza kolwelo oluvela kwimithambo yegazi, oku nako akuxhaphakanga kangako)
• Ukusela amayeza okwandisa imithambo yegazi kakhulu (Ukusebenzisa amayeza ngokugqithisileyo) (oku nako kunqabile)

Oogqirha bayibona njani le nto?

Xa unezi mpawu, into yokuqala ugqirha aza kuyenza kukuxilonga kakuhle aze akubuze ngembali yakho yezonyango. Nangona kunjalo, umntu othukileyo usenokungakwazi ukukunika naluphi na ulwazi. Kwimeko enjalo, umntu ohamba nawe angamxelela ugqirha malunga ne-allergies yakho, nokuba ukhe waba ne-anaphylaxis ngaphambili, kunye namayeza owasebenzisayo. Olu lwazi lunokuba luncedo kakhulu ekuxilongeni imeko.

Emva koko, ugqirha uya kuyalela iimvavanyo ezininzi, ezifana nezi:

• Uvavanyo lwegazi: Jonga ukuba azikho na izifo kunye nendlela amalungu omzimba asebenza ngayo.
• I-ECG (i-Electrocardiogram - i-EKG): Ijonga ukusebenza kwentliziyo.
• I-X-ray yesifuba: Jonga imeko yemiphunga.
• I-ultrasound scan: Jonga intliziyo, imiphunga, kunye namalungu omzimba esiswini. Ezinye zezi zinto zingenziwa ecaleni kwebhedi.

Iphathwa njani?

Ngenxa yokuba le yimeko engxamisekileyo, unyango luqala kwigumbi likaxakeka. Emva koko, ungadluliselwa kwiYunithi yoKhathalelo oluPhezulu (ICU).

1. Into yokuqala oyenzayo kukunika ulwelo lwe-IV. Ulwelo olufana ne-saline lufakwa emthanjeni. Oku kwenzelwa ukunciphisa uxinzelelo lwegazi kancinci.

2. Okulandelayo, siza kufumanisa unobangela 'wokothuka' size sinike amayeza afanelekileyo.

3. Ngamanye amaxesha , ukondla ngetyhubhu kunokusetyenziswa , kuba umzimba udinga amandla.

Kwiyunithi yokhathalelo oluphezulu, oogqirha kunye nabahlengikazi baya kuqhubeka nokujonga iimpawu zakho ezibalulekileyo (isantya sentliziyo, uxinzelelo lwegazi, ukuphefumla, ubushushu). Baza kujonga nemiphumo emibi evela kunyango. Ukuba unengxaki yokuphefumla wedwa, ungaqhagamshelwa kumatshini wokuphefumla (i-ventilator) .

Luhlobo luni lwamayeza asetyenziswayo?

Amayeza anikwa 'i-Distributive Shock' ayahluka ngokuxhomekeke kwisizathu:

• IiVasopressors:Ezi zinikwa ukonyusa uxinzelelo lwegazi. Umzekelo, amayeza afana ne-`epinephrine`, `vasopressin`, `norepinephrine` okanye `phenylephrine`.
• Ii-antibiotics : Ukuba kukho usulelo.
• Ii-Antihistamines: Ukuba kungenxa ye-allergy reaction.
• IiSteroids: Kwi-allergies okanye i-sepsis enzima.
• I-Albuterol inhaler (efana ne-Accuneb® okanye i-Proair®HFA): Ukuba ukothuka kubangelwa sisifo sesifuba.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Ewe, amanye amayeza anokubangela iziphumo ebezingalindelekanga ezincinci.

• IiVasopressors: ukubetha kwentliziyo okungahambelaniyo (i-arrhythmia), ukungazinzi, ukudumba kwamaphaphu, iintlungu zesifuba, ukucutheka kwemithambo yentliziyo (oku kunokukhokelela ekuhlaselweni yintliziyo).
• Ii-antibiotics : Isicaphucaphu, ukuhlanza.
• I-Albuterol: Ixhala, isiyezi, isicaphucaphu.
• Ii-Antihistamines: Ukulala, isiyezi, intloko ebuhlungu, ukubetha kwentliziyo ngokukhawuleza.

Kodwa, oogqirha baza kujonga konke oku baze bakunike unyango olufanelekileyo. Eyona nto ibalulekileyo kukusindisa ubomi bakho.

Singayinciphisa njani le ngozi?

Sisenokungakwazi ukuphepha yonke into ebangela ukothuka okusasazekayo. Umzekelo, usulelo kunye nokutsha. Nangona kunjalo, kukho izinto esinokuzenza ukunciphisa umngcipheko wokothuka ngenxa yeengxaki ezithile ezaziwayo:

• Ukuba une-allergy enkulu yokutya , njengeepinati, soloko uphethe i-epinephrine auto-injector (efana ne-EpiPen® Auto-Injector okanye i-Adrenalin®). Yazi kakuhle indlela yokuyisebenzisa.
• Ukuba usoloko uhlaselwa sisifo sesifuba , hlala unaso i-albuterol okanye i-salbutamol inhaler yakho ngamaxesha onke. Musa ukuyivumela iphele.
• Ukuba usebenzisa ii-tampons, musa ukuzishiya ixesha elide, kuba oku kunokubangela i-Toxic Shock Syndrome, enokuthi iqhubeke ibe yi-Distributive Shock.
• Musa ukutsiba emanzini anganzulu okanye emanzini anganzulu angaziwayo. Oku kunokubangela umonakalo kwintambo yomqolo.
• Ukuba usela amayeza avula imithambo yegazi yakho, musa ukuwasela kakhulu. Thatha kuphela umlinganiselo ochazwe ngugqirha wakho.

Kuza kwenzeka ntoni xa kukho 'umothuko wokusasaza'?

Ukuba unobangela wokothuka yi-sepsis, unokuba neengxaki ezihlala ixesha elide. Izinto ezifana nokudinwa, amaphupha amabi, kunye nokuphelelwa ngumdla wokutya. Nokuba yintoni na unobangela, kufuneka uqhubeke ubona ugqirha wakho ukuze ufumane amadinga okulandela. Kufuneka uthathe amayeza achazwe ngugqirha wakho ngqo.

Ixesha elithathwayo ukuze uphile emva kokuphazamiseka kokusasazwa lixhomekeke ekubeni bekukubi kangakanani. Kusenokufuneka uhlale esibhedlele iintsuku ezimbalwa ukuya kwiiveki ezimbalwa.

Izinga lokusinda kwesi sifo linokwahluka ukusuka kwi-20% ukuya kwi-80%, kuxhomekeke kwisizathu. Ukuba asinyangwa, sinokukhokelela ekufeni. Ukuxilongwa kwangoko kunye nonyango yeyona ndlela ilungileyo yokusindisa ubomi. Abantu abadala, abo basela utywala, kunye nabo baneengxaki ezininzi zamalungu omzimba basengozini enkulu.

Ukuba umzimba wakho usabela kakuhle kulwelo lwe-IV kwaye amalungu akho aqhubeka nokusebenza, unethuba elihle lokuchacha.

Ndingazinyamekela njani emva kokuba ndifikile ekhaya?

Emva kokuba ufikile ekhaya uvela esibhedlele, zinyamekele njengoko ugqirha wakho ekuxelela. Kusenokufuneka uhlale ekhaya iintsuku ezimbalwa okanye iiveki ukuze uphumle kakuhle ngaphambi kokuba ubuyele emsebenzini. Gcina amadinga akho okulandela. Sela amayeza akho njengoko uyalelwe.

Ukuba uziva ngathi unengxaki kwakhona xa usekhaya, fowunela ugqirha wakho ngoko nangoko.

Kwimeko kaxakeka: Nabani na oneempawu zokothuka okubangelwa kukusasazwa kwezifo kufuneka asiwe kwigumbi likaxakeka ngoko nangoko. Ide ifike i-ambulensi, cela umntu osothukileyo ukuba alale phantsi. Mgqume ngengubo ukuze ahlale efudumele, kwaye uphakamise imilenze yakhe malunga nonyawo ukuphucula ukujikeleza kwegazi.

Yeyiphi imibuzo omele uyibuze ugqirha?

Ukuba uhlangabezana nale meko, kungcono ukubuza ugqirha wakho ngezinto ezifana nezi:

• Ngaba ndisengozini yokuphinda ndibe 'nomothuko wokusasaza'?
• Kufuneka ndize kangaphi kwixesha lokulandela?
• Ngaba ndiza kuba nemiphumo yexesha elide ngenxa ye-'Distributive Shock'?

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

I-Distributive Shock yimeko engxamisekileyo yezonyango efuna unyango olukhawulezileyo. Ukufumana uncedo ngokukhawuleza lelona thuba lilungileyo lokusindisa ubomi bakho. Kuthatha ixesha ukuba uphile, ngoko ke yiba nomonde kuwe. Xa usekhaya, thatha amayeza akho njengoko ugqirha wakho ekuyalele, kwaye uye kuhlolo rhoqo. Njengoko ubona, le yimeko enzulu kakhulu. Ngoko ke kubalulekile ukuqaphela oku.

Umothuko osasazwayo, umothuko we-septic, umothuko we-anaphylactic, umothuko we-neurogenic, uxinzelelo lwegazi oluphantsi, unyango lomothuko, i-sepsis