Ukuqonda Indlela Ukuguquka Kwegazi Okuthinta Ukuzinza Kwezokwelapha
Lapho kunqunywa inkambo yokwelashwa kwezifo eziningi zezokwelapha-ikakhulukazi izimo zenhliziyo-abahlinzeki bezempilo bavame ukululekwa ukuba bacabangele ukuthi isiguli sibhekene nokungazinzi kwesimo se-hemodynamic noma cha. Liyinto ejwayelekile kakhulu, kepha ingaba nezincazelo ezihlukene kubasebenzi abahlukene bezempilo, kuye ngokuthi izinga labo lemfundo futhi, kwezinye izimo, lapho baqeqeshwe khona.
Ukuqonda ukuthi kusho ukuthini nokuthi kubonakala kubalulekile ukuqonda ngokugcwele inhloso yomlobi oyisebenzisayo esiqondisweni sezokwelapha noma ukuxilongwa.
Phezulu, leli gama lichaza. I-Hemo- ibhekisela egazini ngenkathi - ishukumisayo ibhekisela ekuhambeni kwegazi emzimbeni. Ukuhamba kwegazi kungumsebenzi omkhulu wendlela yokujikeleza . Ukusho ukungazinzeki nakho kuyichaza. Kusho ukuthi ngaphandle uma abahlinzeki bezempilo bekwenza okuthile, inqubo ayizinzile futhi isengozini yokungaphumeleli.
Ezinye izimpawu ezivamile zokungazinzeki kwe-hemodynamic zihlanganisa ukuwa kwegazi , ukushaqeka ( ukushaqeka okukodwa ), hypoperfusion , nokuhluleka kwenhliziyo . Ngaphezu kwalokho, eminye imibhalo ichaza izimbangela zokungazinzi kwe-hemodynamic ngenkathi futhi isebenza njengamazwibela, njenge- hypovolemia ne- hypotension .
Iziguli ezingenakuzivikela ezingenasifo azikwazi ukucindezela ngokwanele ohlelweni lokujikeleza ukuze igazi ligeleza ngokuthembekile kuzo zonke izingxenye zomzimba lapho kudingeka khona ngesikhathi esifanayo.
Kubalulekile ukuqonda ukuthi ukungenzi ukucindezela okwanele akuyona into efanayo nokukwazi ukukala ukucindezelwa kwegazi okuphansi.
Izimpawu ze-Hemodynamic Instability
Lokhu akukwenzeki yodwa. Iziguli azigcini nje ukuba zizinzile ezingenasisekelo. Lesi yisifo esihamba njalo (noma satshela) enye inkinga, njengesihlasela senhliziyo noma ukushaqeka okukhulu.
Uma ubhekene nezinye izimo, nansi izimpawu ze-telltale zesiguli esingenakuqina kwesimiso (sithatha kuphela ukuthi lezi zinto zikhathazeke):
- Isikhumba esidala futhi esiphundu
- I-Diaphoresis (ukujuluka)
- Ukukhathala
- Ukushayela okusheshayo noma okusheshayo kakhulu (okusheshayo kungaba ukuphendula noma imbangela yokungazinzile; kancane kancane kuyisizathu)
- Umfutho wegazi ophansi (isibonakaliso sekwephuzile kakhulu)
- Ukuphefumula (hhayi okwanele igazi ukuya emaphashini)
- Ubuhlungu besifuba (kungahle buhlobene nokugeleza kwegazi okwanele enhliziyweni)
- Ukudideka (mhlawumbe kuza ngemuva kokucindezela kwegazi)
- Ukulahlekelwa kokwazi (i- syncope , engalungile)
Odokotela baye baba nencazelo ebanzi yokungazinzi kwe-hemodynamic kunabanye abahlinzeki bezempilo abaningi. Ukuqonda ama-nuances wezenzo zomzimba ohlelweni lokujikeleza olungabonakali kubaluleke kakhulu uma uzama ukukhomba isiguli esingaqiniseki se-hemodynamically. Odokotela, njengeqembu, bavame ukuqonda kahle kakhulu kulawo mazwana.
I-Hypotension (ukucindezela kwegazi ephansi) kuyisibonakaliso sokungazinzi kahle kwe-hemodynamic, kodwa akuyona into yokuqala okuzobona umuntu ogulayo engaqiniseki. Ngokuvamile, ukucindezeleka kwegazi okuphansi kuye kwasetshenziselwa ukungazinzi kwesimo se-hemodynamic ngabanye abahlinzeki bezempilo, kodwa umzimba uzoba nokuphendula ukuguquguquka komfutho wegazi isikhathi eside ngaphambi kokuba lowo mbonakaliso obalulekile ungabonakaliswa.
Ukulwa noma i-Flight Syndrome
Njengoba isimiso se-circulatory sihluleka, kunezibonakaliso eziningana zomzamo womzimba wokulungisa inkinga ebonisa inkinga. Cishe zonke lezi zivela ohlelweni lomzwelo oluzwelayo, idivayisi yokusheshisa komzimba kanye nokuphendula kwethu ekucindezelekeni. Isistimu yomzwelo enozwela iqhutshwa, phakathi kwezinye izinto, i-epinephrine (eyaziwa nangokuthi i-adrenaline) futhi ngokuvamile ibizwa ngokuthi "ukulwa noma i-flight syndrome." Lokhu kuyindlela yokwenza umzimba umzimba womuntu uvame lapho izwa sengathi isongelwa. Umqondo wukuthi umzimba ulungele ukulwa noma ukugijima kusuka kudonsa.
Impi noma i-flight syndrome iningi ngokuphathelene nokusakaza. Njengoba isistimu yomzwelo ezwelayo ivuselelwa, ibangela ukugeleza kwegazi kugxilwe emaqenjini amakhulu emisipha nasemilenzeni, ngakho ukulwa noma ukugijima kungaqala. Ukugeleza kwegazi nomsebenzi ohlelweni lwamathumbu kuncishiswe okwesikhashana (ungakwazi ukugaya ukuthi u-cheeseburger uma uhlala ngalolu daba nebhubesi lezintaba). Ukugeleza kwegazi kuya amehlo, impumu, nobuchopho banda, konke kungcono ukuzwa nokukubona nawe, othandekayo wami. I-airways emaphashini iyancipha ukuvumela ukugeleza komoya futhi ukushaya kwenhliziyo okusheshayo kuqinisekisa ukuthi igazi ligeleza ngokushesha emaphashini ukuze lihlale lihlanzekile futhi liqhutshwa umoya. Okokugcina, uma kwenzeka ukuthi ihlosi lezinyosi likwazi ukuthola izibhamu ezimbalwa, ukugeleza kwegazi kukhishwa kude kwesikhumba ukuze kuncishiswe ukuphuma kwegazi futhi izigulane zithuthuka zizosiza ukupholisa izinto lapho isimo sishisa.
Iningi lempendulo yokuzwelana nokucindezeleka, okufana nalokho ukuthi ukucindezeleka kuvela ekunciphiseni i-perfusion (ukugcwala igazi) ebuchosheni noma ngenxa yokuthi ubuchopho becabanga ukuthi buzodliwa yi-zombie, kuyasiza nje ngesikhathi sezokwelapha njengoba ku-zombie apocalypse.
Izimpawu zesikhumba-ziphaphathekile futhi zipholile ngenxa yokuthi igazi aligeleza phezulu futhi limanzi ngenxa yokujuluka (i-diaphoresis) -kunikeza iqiniso lokuthi kukhona ukuphendula okucindezelekayo okwenzekayo. Qaphela ukuthi akukho lutho lapha oludinga ukucindezelwa kwegazi eliphansi. Eqinisweni, empini ejwayelekile noma impendulo yezindiza, ukucindezeleka kwegazi kuyakhuphuka, okwenza ukulwa noma i-flight syndrome kube impendulo enkulu ezimweni zokwelapha eziholela ekulahlekelweni kwegazi.
Nini ukusebenzisa i-Hemodynamic Instability
Lapho ukwelashwa kwezimo zezokwelapha ezihlobene nenhliziyo, ukuzinza kwe-hemodynamic yikhombisi enkulu lapho sekuyisikhathi sokungenelela. Isiguli esine- bradycardia noma i- tachycardia kufanele siphathwe kabi kakhulu phambi kokungazinzi kwe-hemodynamic kunokuba ibonakale iqinile.
Imihlahlandlela eminingi isebenzisa lokhu njengokuhlolwa kwe-litmus, okwenza kube konke okubaluleke kakhulu ukuyiqaphela ngokucacile. Kunezindlela zokuhlola ukusimama kwe-hemodynamic nokuqapha okungenasidingo, kodwa akuyona inkinga enzima yokwelashwa ukukhomba ukuhlola okusemtholampilo efanele.
Shock vs. Hemodynamic Instability
Ukungazinzeki kwe-Hemodynamic kulula ukudideka ngokushaqeka, kodwa ukushaqeka yimizwi enezincazelo eziningana futhi eyodwa kuphela yayo inokuthi noma ngabe isiguli sikwazi ukuhambisa igazi ngokuzungezile umzimba wakhe. Ezinye ezimbili zihlobene nokucindezeleka ngokomzwelo noma ugesi.
Ukwethuka yisimo sezokwelapha ngezinhlobo ezichazweyo namazinga, ngokungafani nokungazinzi kwe-hemodynamic. Kunezinhlobo ezine zokwethuka: i-cardiogenic, isakaza (ihlanganisa i-neurogenic, i-anaphylactic, ne-septic), i-hypovolemic (ifaka phakathi i-hemorrhagic), kanye nokuphefumula (abanye abahlinzeki bezempilo abangavumelani kuyisifo se-syckrome). Ngesilinganiso sobubi esibi nakakhulu, ukushaqeka kungahle kuhlawuliswe (ukucindezelwa kwegazi kusekhona ebangeni elijwayelekile) noma kuqhathaniswa (ukucindezelwa kwegazi kuphansi). Kungase kuthiwe ukushaqeka okuxhaswe yisiguli esithuthumayo esingenakunyakaziswa.
Ngokuqondene nokukhomba imbangela eyinhloko yesimo sezempilo yesiguli, ukuqonda izinhlobo zokushaqeka nokukwazi ukuwabona kuzokwenza okuningi kunokumane uqonde ukungazinzi kwe-hemodynamic.
Izwi Mayelana Ne-Hypoperfusion
I-Perfusion ingenye yale migomo endala esebenzela ochwepheshe bezokwelapha ngemuva kokulahlekelwa ukubamba kwayo yonke i-lexicon yesimanje. Kusho ukugcwalisa ngegazi futhi kuvame ukusetshenziselwa ngqo ukubhekisela egazini eligcwalisa ama-capillaries. Ama-capillari ngokuyinhloko amashaneli angenalutho lapho amangqamuzana abomvu egazi angangena kuphela kwifayela elilodwa. Imibhede yama-Capillary ifana namapongipi futhi azogcwalisa ngegazi kuphela uma kunesimo esanele sokwehlisela igazi ezitsheni ezincane.
Ukuphefumula kakhulu (okuncane kakhulu) (ukugcwalisa) kubhekisela ekungeneni igazi elanele lokugcwalisa imibhede ye-capillary emzimbeni. Lokhu kungumphumela wokungazinzi kwe-hemodynamic kodwa kufana nokushaqeka. Eqinisweni, amagama ashaqekayo kanye ne-hypoperfusion ayashintsha ngokuphelele.
> Imithombo:
> Bonanno FG. I-pathology ye-clinical ye-syndromes eshaqisayo. Journal of Emergency, Trauma kanye Shock . 2011; 4 (2): 233-243. i-doi: 10.4103 / 0974-2700.82211.
> Sevransky, J. (2009). Ukuhlolwa kwemitholampilo yeziguli ezingenakunyakaziswa. Umbono wamanje ngokunakekelwa okubalulekile , 15 (3), 234-238. i-doi: 10.1097 / mcc.0b013e32832b70e5