Ingabe kukhona isimo esiphuthumayo ngenxa yamazinga aphansi egazi/uketshezi emzimbeni? Ake sifunde ngalokhu kushaqeka kwe-hypovolemic!

Wake waquleka ngokuzumayo, waba nesiyezi, futhi waba nobunzima bokuphefumula? Noma wake wambona umuntu olimele kakhulu futhi opha igazi kakhulu? Esinye sezimo eziyingozi kakhulu ezingase zenzeke ezimweni ezinjalo ukushaqeka kwe-hypovolemic, esizokhuluma ngakho namuhla. Lesi yisimo esidinga ukwelashwa okuphuthumayo, ngakho-ke kubaluleke kakhulu ukuqaphela.

Kuyini ukushaqeka kwe-hypovolemic? Masikuqonde kalula!

Kalula nje, ukushaqeka kwe-hypovolemic kwenzeka lapho inani legazi noma uketshezi emzimbeni wakho lincipha ngokuzumayo kangangokuthi inhliziyo yakho ayikwazi ukupompa igazi emzimbeni wakho ngendlela efanele. Cabanga ngakho njengemoto ephelelwa uphethiloli. Igazi lifana nophethiloli emizimbeni yethu.

Lesi simo sivame ukwenzeka lapho kulahleka okungaphezu kwama-20%, noma ingxenye eyodwa kwezinhlanu, komthamo wegazi ophelele emzimbeni wethu. Lokhu kungenzeka hhayi kuphela ngenxa yokopha ngokweqile ngenxa yokulimala okukhulu. Ngezinye izikhathi, isifo sohudo esibi, ukuhlanza okuqhubekayo, noma ukujuluka ngokweqile nakho kungabangela lesi simo, okubangela ukuba kulahleke uketshezi oluningi emzimbeni.

Lesi yisimo esiphuthumayo sezokwelapha, ngakho-ke uma ubona izimpawu, kubalulekile ukushayela ucingo ku-1190 noma ku-1990 ngokushesha bese ucela usizo lwezokwelapha.

Kwenzekani ngomfutho wegazi ngalesi sikhathi?

Uma kwenzeka ukushaqeka kwe-hypovolemic, inani eliphansi lomfutho wegazi lakho, elibizwa ngokuthi i-diastolic pressure, lingase likhuphuke kancane ekuqaleni. Kodwa njengoba igazi noma uketshezi luqhubeka luphuma emzimbeni wakho, inani eliphezulu, elibizwa ngokuthi i-systolic pressure, lizoqala ukwehla kancane kancane.

Ubani onamathuba amaningi okuthuthukisa lokhu?

Lesi simo singenzeka kunoma ubani, ikakhulukazi umuntu oye waba sengozini enkulu futhi olahlekelwa igazi eliningi. Futhi, njengoba sishilo ngaphambili, umuntu ohlanza kakhulu, onesifo sohudo, noma ojuluka kakhulu naye angaphelelwa amanzi emzimbeni.

Sivame kangakanani lesi simo?

Sekukonke, noma yiluphi uhlobo lokushaqeka lwenzeka kubantu abangaphansi koyedwa kwabayi-1,000. Kodwa-ke, ukushaqeka okungenawo umoya omncane uhlobo lwesibili oluvame kakhulu lokushaqeka. Kwamanye amazwe asathuthuka, kuvame kakhulu ezinganeni ezincane ngenxa yohudo.

Kwenzekani emzimbeni ngesikhathi sokwethuka kwe-hypovolemic?

I-Hypovolemic Shock yenzeka lapho izitho ezibaluleke kakhulu emzimbeni wethu (isibonelo, ubuchopho, inhliziyo, izinso) zingatholi inani elidingekayo legazi nomoya-mpilo. Lokhu kufana nomuthi ofayo ngaphandle kwamanzi. Izitho zethu azikwazi ukusebenza ngaphandle kwegazi.

Ngalesi sikhathi, imizimba yethu isebenza ngokuhlakanipha okukhulu. Njengoba inani legazi liphansi emzimbeni, libeka phambili ukuhlinzeka ngegazi ezithweni ezimbili ezibaluleke kakhulu ukuze ziphile, ubuchopho nenhliziyo . Yingakho inani legazi eliya ezithweni lincipha, futhi izitho ziba makhaza.

Ngokwesilinganiso, umuntu onesisindo esingamakhilogremu angu-70 unegazi elingamalitha angu-5 emzimbeni wakhe. Lokho kungama-7% esisindo somzimba wakhe. Uma umuntu eshaqekile ngenxa yokuntuleka kwegazi, ingxenye enkulu yaleli nani iyalahleka.

Yiziphi izigaba ezine zokushaqeka?

Kunezimo ezine eziyinhloko kulesi simo, kuye ngokuthi sibucayi kangakanani.

• Isigaba 1: Lokhu kwenzeka lapho ulahlekelwa cishe yi-15% yenani legazi lakho (cishe amamililitha angu-750 (750 mL) – lokho kucishe kube usayizi webhodlela elikhulu lamanzi). Umfutho wegazi lakho kanye nokushaya kwenhliziyo kungase kube okuvamile kuleli qophelo.
• Isigaba sesi-2: Lokhu kwenzeka lapho umthamo wegazi wehliswa ngo-15% kuya ku-30% (750 mL kuya ku-1,500 mL – cishe amabhodlela amabili amakhulu amanzi). Isilinganiso senhliziyo siqala ukwanda, futhi isilinganiso sokuphefumula siyanda.
• Isigaba 3: Kulahleka phakathi kuka-30% no-40% womthamo wegazi lomzimba (1,500 mL kuya ku-2,000 mL – cishe amabhodlela amathathu amakhulu amanzi!). Umfutho wegazi wehla kakhulu, izinga lokushaya kwenhliziyo kanye nezinga lokuphefumula kuyanda. Ukuphuma komchamo nakho kwehla kakhulu.
• Isigaba 4: Lesi yisigaba esinzima kakhulu. Kulahlekelwe ngaphezu kwama-40% omthamo wegazi lomzimba (>2,000 mL). Umfutho wegazi uphansi kakhulu, izinga lokushaya kwenhliziyo liphezulu, futhi ukuphuma komchamo cishe akukho.

Yiziphi izimpawu okufanele siziqaphele?

Uma igazi noma uketshezi luphuma kakhulu emzimbeni, izimpawu ziba zimbi kakhulu. Nazi ezinye zezimpawu ezivamile zokushaqeka kwe-hypovolemic:

• Izinga lokuphefumula elikhuphukile: Ukuzizwa sengathi uphefumula ngokushesha kunokujwayelekile.
• Ukuzizwa udidekile noma ungahlaliseki: Kunzima ukugxila, futhi ungase uzizwe ukhathazekile.
• Ukujuluka ngokweqile: Ngokungazelelwe, umzimba uqala ukugodola bese uqala ukujuluka.
• Ukulahlekelwa ukwazi (ukuquleka): Ungase ulahlekelwe ukwazi ngokuzumayo ngaphandle kokusebenza ngokomzimba.
• Isikhumba esibandayo: Izitho zomzimba zizizwa zibanda uma uzithinta.
• Ukuzizwa ubuthakathaka: Umzimba uba buthakathaka kangangokuthi awukwazi ukwenza lutho.
• Ukwehla kwezinga lokushisa lomzimba kanye nomfutho wegazi.
• Ukwanda kwesilinganiso senhliziyo (ukwanda kwesilinganiso senhliziyo).

Uma eyodwa noma ngaphezulu yalezi zimpawu ibonakala ngokuphuma kwegazi okukhulu, kungaba ukushaqeka kwe-hypovolemic.

Yiziphi izizathu eziyinhloko zalokhu?

Imbangela eyinhloko ukulahleka kwegazi noma uketshezi oluningi emzimbeni. Lokhu kuphuma kwegazi kungenzeka ngaphakathi (ngendlela esingenakuyibona) noma enxebeni elibonakalayo. Ngaphezu kwalokho,

• Ukusha
• I-Pancreatitis
• Izimbangela ezinjengokujuluka ngokweqile, ukuhlanza, noma isifo sohudo nazo zingaba yizimbangela ezibangela lokhu.

Yiziphi izindlela ezingenzeka zokopha igazi?

Izehlakalo eziyinhloko zokopha ezingaholela ekushaqekeni kwe-hypovolemic yilezi:

• Ukulimala okubangelwe yingozi enkulu: Izinto ezifana nengozi emgwaqweni, ukuwa usuka endaweni ephakeme, njll.
• Ngesikhathi noma ngemva kokuhlinzwa (ukuhlinzwa): Okunye ukuhlinzwa kungabangela ukopha okwengeziwe.
• Ukukhulelwa kwesisu: Lesi yisimo esiyingozi kakhulu, njengoba singabangela ukopha emzimbeni.
• Ukuqhuma kwe-Aneurysm: Lokhu kusho ukuthi umthambo wegazi uba buthakathaka, uvuvukale njengebhaluni, bese uqhuma ngokuzumayo.
• Izinkinga zomgudu wokugaya ukudla: Isibonelo, ukopha okubangelwa isilonda esiswini.

Udokotela ukubona kanjani lokhu?

Uma ulethwa esibhedlela, into yokuqala udokotela noma umhlengikazi azokwenza ukukuhlola. Ngemuva kwalokho, bangenza izivivinyo ezimbalwa ukuqinisekisa isimo.

• Ukuhlolwa kwegazi: Hlola ukuthi inani legazi lakho liphansi kangakanani nokuthi izitho zomzimba ezifana nezinso zakho zithintekile yini.
• I-Electrocardiogram (ECG): Buka ukusebenza kwenhliziyo.
• I-Echocardiogram: Ukuskena kwenhliziyo.
• Ukufakwa kwe-catheter kwenhliziyo yesokudla (i-Swan-Ganz): Ukuhlolwa okukhethekile okulinganisa ukucindezeleka enhliziyweni.
• I-CT scan (i-computed tomography - i-CT) noma ezinye izivivinyo ze-X-ray: Ukuthola ukuthi igazi livuza kuphi emzimbeni.
• I-Endoscopy: Ukuhlolwa komgudu wokugaya ukudla kusetshenziswa ipayipi elinekhamera.

Ungayiphatha kanjani? Izinto okufanele uzenze ngokushesha!

Ngemva kokuba ulethwe esibhedlela nge-ambulensi noma ngezinye izindlela, into yokuqala odokotela abayenzayo ukukufaka emgqeni we-IV bese bekunika uketshezi (njengosawoti) . Bese bekunika igazi uma kudingeka. Baphinde bakunike imithi yokubuyisela umfutho wegazi lakho esimweni esijwayelekile.

Into ebaluleke kakhulu ukwelapha inkinga ebangele ukushaqeka. Isibonelo, ukuvimba ukopha, noma ukuhlinzwa uma ulimele engozini. Ngemva kwalokho, uzogcinwa eYunithi Yokunakekelwa Okujulile (ICU) ukuze ubhekwe.

Yiziphi izinhlobo zemithi ezinikezwayo?

Eminye yemithi eyinhloko enikezwayo yokushaqeka kwe-hypovolemic yile:

• I-Epinephrine (i-Epinephrine - i-Adrenalin®)
• I-Norepinephrine (i-Norepinephrine - i-Levophed®)
• I-Dopamine
• I-Dobutamine (i-Dobutamine - i-Inotrex®)

Le mithi isiza ukubuyisela izinga lokushaya kwenhliziyo kanye nomfutho wegazi.

Ingabe ikhona imiphumela emibi yokwelashwa?

Le mithi ngezinye izikhathi ingabangela imiphumela emibi emincane.

• Ukwanda komfutho wegazi kanye nesilinganiso senhliziyo
• Ubunzima bokuphefumula
• Ikhanda elibuhlungu (ikhanda elibuhlungu)
• Ukuphazamiseka kwenhliziyo

Yini esingayenza ukuze sinciphise le ngozi?

Kunzima ukubikezela nokuvimbela izingozi ezinkulu. Kodwa-ke, kunezinto esingazenza ukuze sinciphise ingozi yokushaqeka kwe-hypovolemic okuvela kwezinye izimbangela:

• Uma uthatha imithi yokukhipha isisu , yithathe njengoba nje udokotela wakho ekuyalele. Futhi, phuza amanzi amaningi ukuze ugweme ukuphelelwa amanzi emzimbeni.
• Uma unesifo sohudo noma uhlanza, phuza amanzi amaningi noma uketshezi olufana noJeevani ukuze ugcwalise uketshezi olulahlekile emzimbeni wakho.
• Uma ujuluka kakhulu, phuza amanzi amaningi ukuze ubuyisele uketshezi olulahlekayo.

Okubaluleke kakhulu: Uma ubona ukopha okuningi, noma uma unenxeba elingenakuvinjelwa, shayela ku-1190 noma ku-1990 ngokushesha, noma uye emnyangweni wezimo eziphuthumayo wesibhedlela esiseduze nawe. Ukuthola usizo ngokushesha kungasiza ekulawuleni isimo ngaphambi kokuba kulahleke igazi eliningi.

Kwenzekani uma uthola ukushaqeka kwe-hypovolemic? Kuthatha isikhathi esingakanani ukululama?

Ukuthi uyasinda yini kulesi simo futhi uyalulama kuncike ezintweni eziningana. Ukuthi igazi noma uketshezi olungakanani olulahlekile, ukuthi kwenzeke ngokushesha kangakanani, ezinye izimo zezokwelapha onazo, kanye nokuthi yini ebangele ukwethuka nakho kungaba nendima.

Uma uqala ukwelashwa kokushaqeka kusenesikhathi, imiphumela yako ingabuyiselwa emuva. Uma usemncane futhi ukushaqeka kungekubi kakhulu, unethuba elihle lokusinda. Kodwa-ke, ngezinye izikhathi ukulimala kwezitho zomzimba kungaholela ekuhlaselweni yinhliziyo. Uma izitho ezingaphezu kwesisodwa zehluleka, lesi simo singaba yingozi kakhulu. Ngisho noma selashwa, ukushaqeka kwe-hypovolemic ngezinye izikhathi kungaba yingozi.

Ngingazinakekela kanjani ngize ngilulame?

Ngemva kokufika ekhaya uvela esibhedlela, kufanele ulandele imiyalelo kadokotela ngqo. Umzimba wakho udlule ekuhluphekeni okukhulu, ngakho-ke kufanele uphumule futhi ululame ekhaya ngaphambi kokuya emsebenzini. Thatha umuthi owunikezwe udokotela wakho ngqo, futhi unakekele kahle noma yimaphi amanxeba.

Kunini lapho ngidinga ukubona udokotela futhi?

Udokotela uzokucela ukuthi ubuye ukuze uthole ama-aphoyintimenti okulandelela ukuze abone ukuthi unjani. Ungaphuthelwa yila ma-aphoyintimenti, ngoba yilapho udokotela engakwazi khona ukubona ngokushesha noma yiziphi izinkinga ezintsha ezingase zivele.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma ubona umuntu ekhombisa izimpawu zokushaqeka kwe-hypovolemic, shayela ku-1190 noma ku-1990 ngokushesha. Uma umuntu eshesha ukuthola usizo, kungcono. Kuze kube yilapho kufika usizo, mlalise phansi imilenze yakhe iphakeme cishe ngonyawo ngaphezu komzimba wonke. Ungawushukumisi umzimba, ngaphandle kokuphakamisa imilenze. Uma kukhona ukopha, zama ukukuvimba, futhi ugcine umzimba ufudumele.

Uma uke waba nokushaqeka kwe-hypovolemic ngaphambilini, uma amanxeba akho eqala ukopha futhi, noma uma ebonakala sengathi ayaphuma, phinde uye egumbini lezimo eziphuthumayo.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

Uma ubona udokotela, ungakhohlwa ukubuza le mibuzo:

• Ingabe lokhu kushaqeka kwe-hypovolemic kuzongibangela imiphumela yesikhathi eside?
• Kuzongithatha isikhathi esingakanani ukuthi ngilulame ngokugcwele?
• Kudingeka ngithathe isikhathi esingakanani umuthi onginike wona?

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Ukushaqeka kwe-Hypovolemic kuyisimo esiphuthumayo sezokwelapha. Kodwa-ke, ukuthola ukwelashwa ngokushesha kungasindisa impilo yakho. Odokotela bangasiguqula lesi simo, kodwa kuzothatha isikhathi ukuthi ululame. Ikakhulukazi uma ukushaqeka kuwumphumela wengozi enkulu, kungathatha isikhathi eside ukuthi ululame. Ngakho-ke, landela imiyalelo kadokotela wakho kahle futhi uzinakekele kahle wena kanye nokulimala kwakho. Qaphela njalo!

ukushaqeka kwe- hypovolemic, ukulahleka kwegazi, ukulahleka koketshezi, ukushaqeka, ukwelashwa okuphuthumayo, umfutho wegazi, izimpawu