Wake wezwa udokotela, ngesikhathi ehlola umfutho wegazi lakho, ethi into efana nokuthi, "Phefumula kakhulu... manje khipha umoya..."? Ngezinye izikhathi sicabanga ukuthi kumane kuyisaga. Kodwa empeleni, ngezinye izikhathi udokotela uhlola ukuze abone ukuthi kukhona yini ushintsho oluthile ekucindezelweni kwegazi lakho ngendlela ophefumula ngayo. Kunesizathu esibaluleke kakhulu salokhu. Namuhla sizokhuluma ngesibonakaliso esisodwa esikhethekile sezokwelapha, okuyi-'Pulsus Paradoxus'. Leli gama lingase lizwakale liyinkimbinkimbi uma ulizwa, kodwa ake silichaze kalula.
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Iyini ngempela i-Pulsus Paradoxus?
Kalula nje, i-Pulsus Paradoxus yilapho umfutho wegazi lakho, ikakhulukazi inani eliphezulu (umfutho we-systolic), wehla kakhulu kunalokho obekulindelekile uma uphefumula.
Manje ungase ucabange, "Pho yini exakile ngalokho?" Indida lapha ukuthi ngokuvamile, lapho umuntu ophilile ephefumula, umfutho wegazi lakhe kufanele ukhuphuke kancane noma ungashintshi kakhulu. Kodwa kulokhu, kwenzeka okuphambene nalokho. Okusho ukuthi, umfutho wehla ngokungazelelwe. Lokhu akusona isifo, kodwa uphawu olubaluleke kakhulu olusitshela ukuthi kukhona okungahambi kahle emzimbeni wakho, ikakhulukazi enhliziyweni noma emaphashini.
Cabanga ngakho, inhliziyo yethu yiyo epompa igazi emzimbeni wethu wonke. Uma siphefumula, kuba nezinguquko ekucindezelweni esifubeni sethu. Lezi zinguquko zinomthelela omncane ekutheni inhliziyo igcwalisa kahle kangakanani igazi. Kodwa-ke, uma inhliziyo ingakwazi ukukhula kahle ngenxa yesimo sempilo, noma uma kunengcindezi enkulu ezungeze inhliziyo, inani legazi elingena enhliziyweni lapho siphefumula liyancipha kakhulu . Ngenxa yalokho, inani legazi inhliziyo elipompa emzimbeni nalo liyancipha, yingakho sibona ukwehla okungazelelwe komfutho wegazi.
Udokotela ukukala kanjani lokhu?
Lokhu akuyona into ongayilinganisa nge-digital pressure meter ekhaya. Ngoba lokhu kuyinto edinga ukukalwa ngokucophelela okukhulu. Kulokhu, udokotela uvame ukusebenzisa i-pressure cuff epompiwa ngesandla kanye ne-stethoscope (i-blood pressure cuff manual).
Nansi indlela yokukwenza:
1. Okokuqala, udokotela uzobeka i-pressure cuff engalweni yakho bese eyifutha kuze kube yilapho ungasakwazi ukuzwa ukushaya kwenhliziyo yakho.
2. Ngemuva kwalokho, ngenkathi ukhipha umoya ngokushesha okukhulu esikhumbeni (ngesivinini esingamamilimitha amabili e-mercury ngomzuzwana), i-stethoscope isetshenziswa ukuthola indawo yokuqala lapho kuzwakala khona umsindo we-pulse. Kuleli qophelo, umsindo uzwakala uma ukhipha umoya (ukhipha umoya). Lelo nani liyaqoshwa.
3. Okulandelayo, njengoba ufutha i-cuff kancane, uzothola iphuzu lapho usakwazi ukuzwa khona ukushaya kwenhliziyo njengoba uphefumula ungena futhi uphuma . Uzoqopha futhi lelo nani.
4. Okokugcina, umehluko phakathi kwalezi zindinganiso ezimbili zokucindezela okuphezulu ezirekhodiwe uyabalwa.
Ngokuvamile, uma lo mehluko ungaphezu kwamamilimitha ayi-10 e-mercury (10 mmHg), kubhekwa njengesimo esibizwa ngokuthi i-Pulsus Paradoxus. Ezimweni ezifana namayunithi okunakekelwa okujulile (ama-ICU), lokhu ngezinye izikhathi kulinganiswa ngokunembe kakhulu ngomugqa wemithambo obekwe ngqo emthanjeni.
Yiziphi izimbangela eziyinhloko ze-Pulsus Paradoxus?
Uma ubona uphawu lwe-Pulsus Paradoxus, kusho ukuthi kukhona okuvimbela inhliziyo ukuthi isebenze kahle. Kungaba nezizathu eziningana zalokhu.
Imbangela eyinhloko nevame kakhulu ukunqwabelana koketshezi oluzungeze inhliziyo, okubangela i-cardiac tamponade. Ake sichaze lokhu kabanzi. Inhliziyo yethu itholakala ngaphakathi kwesembozo esincane esifana nesikhwama esibizwa ngokuthi 'i-pericardium'. Lokhu kuvame ukuqukethe inani elincane kakhulu loketshezi lokuvikela nokugcoba inhliziyo. Kodwa-ke, uma ngenxa yesimo esithile sezokwelapha, uketshezi oluningi kakhulu (njengamanzi) luqongelela ngaphakathi kwalesi sikhwama, lubizwa ngokuthi i-Pericardial Effusion . Uma lolu ketshezi lukhula, i-pericardial sac iyanwebeka, futhi ekugcineni ibangele i-cardiac tamponade . Lesi yisimo esibi esidinga ukwelashwa okuphuthumayo. Lesi yimbangela evame kakhulu ye-Pulsus Paradoxus.
Ngaphandle kwalokhu, kunezinye izimbangela eziningana ezingaba khona ze-Pulsus Paradoxus kuthebula elingezansi.
| Isimo | Kalula nje... |
|---|---|
| I-Cirstrictive Pericarditis | Isikhwama esizungeze inhliziyo (i-pericardium) siba sikhulu futhi siqine, sivimbele inhliziyo ukuthi ikhule. |
| I-asthma Enzima noma i-COPD | Izinguquko eziningi ekucindezelweni kwesifuba ngesikhathi sokuphefumula ngenxa yokuthi izindlela zokuphefumula ziba zincane kakhulu. |
| Ukuphuma kwe-Pleural | Ukuqongelela uketshezi ngokweqile emaphashini. |
| I-Pneumothorax (Iphaphu Eliwile) | Umoya uyavuza emaphashini, ucindezela amaphaphu nenhliziyo. |
| I-Cardiomyopathy Evimbelayo | Inhliziyo ayikwazi ukugcwala igazi kahle ngenxa yokuqina kwemisipha yenhliziyo. |
| Ukukhuluphala ngokweqile | Ukucindezeleka kwangaphandle esifubeni nasenhliziyweni ngenxa yesisindo somzimba esiningi. |
Kuphathwa kanjani lokhu?
Into ebaluleke kakhulu okudingeka siyiqonde lapha ukuthi akukho ukwelashwa okuqondile kwalesi sifo esibizwa ngokuthi i-Pulsus Paradoxus. Ngoba akusona isifo. Kufana nesibani esixwayisayo esikhanya kudeshibhodi uma kunenkinga ngenjini yemoto. Esikwenzayo akusikho ukucima nokuvula isibani, kodwa ukulungisa inkinga enjinini.
Futhi, udokotela akalaphi uphawu lwe-Pulsus Paradoxus, kodwa isimo sezokwelapha esiyisisekelo esibangele lokhu. Lolu phawu lusiza udokotela ukuthi anqume ukuthi lesi simo sibucayi kangakanani nokuthi kufanele yini aqale ukwelashwa ngokushesha.
Indlela yokwelapha inqunywa yimbangela.
- Uma imbangela kuyi- Cardiac Tamponade , ukwelashwa okuphuthumayo kuhilela ukususa uketshezi olungeziwe oluzungeze inhliziyo kusetshenziswa isirinji nenaliti (pericardiocentesis). Kungadingeka nokuhlinzwa.
- Uma imbangela kuyi -asthma enzima , imithi kanye nokwelashwa nge-nebulizer kunikezwa ukulawula i-asthma.
- Uma imbangela kuyi- pneumothorax (iphaphu eliwile), kufakwa ipayipi esifubeni ukuze kususwe umoya ongaphezulu.
- Ezimweni ezifana ne -Constrictive Pericarditis , i-pericardium eqinisiwe ingadinga ukususwa ngokuhlinzwa.
Ngale ndlela, udokotela uzoqala athole imbangela eqondile futhi akunikeze ukwelashwa okungcono kakhulu okufanelana nayo. Ngakho-ke, uma udokotela wakho ekutshela ngesifo esinjengalesi, kubaluleke kakhulu ukungesabi futhi ubambisane ngokugcwele nokuhlolwa nokwelashwa okwenziwayo ukuthola imbangela.
Umlayezo Wokuya Nawe Ekhaya
- I-Pulsus Paradoxus akuyona uphawu oluba khona wedwa. Kuyisibonakaliso udokotela azosibona ngesikhathi sokuhlolwa kwezokwelapha.
- Lesi akusona isifo, kodwa kungaba uphawu lwesinye isimo, okungenzeka sibe sibi kakhulu, enhliziyweni noma emaphashini.
- Uma udokotela wakho ebona lesi sibonakaliso, ungesabi. Kuyinkomba ebalulekile yokuthola nokwelapha imbangela eyinhloko.
- I-Pulsus Paradoxus ayelashwa, kodwa ingelashwa yisimo esiyisisekelo esiyimbangela. Ngakho-ke, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngokucophelela.
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