SDS - refu compression chirwere: zviratidzo, kurapwa uye ekudzivirira

Chinenge munhu wose akachengeteka netsaona siyana. anogona kuva ichi chinhu kubva tsaona kuendesa kune kudengenyeka kwenyika uye kuparara kwangu. In chipi Muzviitiko izvi zvinogona kuva SDS. The chirwere ane zvinokonzera siyana, pathogenesis, zvinoda madikanwa kurapwa. Funga nezvemibvunzo iyi mberi.

Pfungwa SDS

Somugumisiro, nyoro zvinyama compression angatanga SDS. Syndrome vakadzi kuitika pamwe chete kakawanda sezvo kuti ngakuite vemo. It ane mamwe mazita, akadai apwanye chirwere, kana compression kukuvara. urwere, chikonzero chingava:

• Dzvinya nhengo dzomuviri pamwe rinorema zvinhu.
• Emergency ezvinhu.

mamiriro ezvinhu akadaro zvinowanzoitika pashure kudengenyeka, semubairo tsaona dzemotokari, kuputika, collapses mumigodhi. Simba compression hapasi kuva mukuru, asi pane basa reDare ya ezvinhu akadaro. Kazhinji, asi VTS (apwanye chirwere) zvinoitika kana sei kuripo pamusoro nyoro rinenge yemanyorero anopfuura 2 maawa. rubatsiro First unokosha Danho iri iyo upenyu hwevanhu zvinobva. Ndokusaka zvichikosha kuti kukwanisa kusiyanisa pakati kuratidzwa ichi.

Mhando dzakasiyana-siyana SDS

In okurapa, pane nzira dzakawanda kuti kupatsanura pakati mupanda syndrome. Akapiwa mhando compression, zvakadai oga syndromes:

• Kukudziridza somugumisiro pokuwa ivhu. It kunoitika somugumisiro mazhinji kugara pasi chesamende rakanyorwa kana siyana inorema zvinhu.
• SDS chinzvimbo hwapedyo nokuda compression zvikamu muviri wake pachake.

Localization kunogonawo zvakasiyana, saka kungogara PIF:

• Nemakumbo.
• Head.
• Dumbu.
• Chest.
• Cup.

Mushure yedambudziko vanowanzopedzisira vava SDS. The chirwere kunowanzoguma mamwe makuvaro, saka anokudzwa:

• Kamuri chirwere achabatsirwa kukuvara nhengo dzomukati.
• Kuchikuvadza mhou hurongwa muviri.
• VTS kukuvadza tsinga harinzwi nemidziyo ropa.

The mwero kwokuomerwa ari chirwere angava akasiyana. Kubva musi chokwadi ichi, emit:

• A nyoro chimiro urwere, izvo anova apo kudzvinya pabazi kwenguva pfupi nguva. Kutyorwa kumwoyo inowanzopiwa asina chirwere.

• Kana kumanikidzwa pamusoro jira iri maawa anopfuura 5-6, paavhareji chimiro hwapedyo SDS panguva iyo renal kukundikana kungava vanyoro.
• Zvakakomba chirwere kana kusvinwa pamusoro maawa 7. Ataurwa zviratidzo itsvo kukundikana.
• Kana nyoro zvinyama pasi kumanikidzwa kwemaawa anopfuura 8, zvinokwanisika kutaura pamusoro kukura ane zvikuru kwazvo SDS. Zvinokwanisika rokuongorora congestive mwoyo kukundikana, izvo kazhinji zvinouraya.

Kazhinji, kana PIF (apwanye chirwere) achiperekedzwa yematambudziko siyana:

• Myocardial infarction.
• Zvirwere zvakasiyana nenhengo dzawo hwakazara SDS. A chirwere vakadzi inokanganisa rezasi chikamu chomuviri, kureva pelvic zvomukati, ngozi zvakakomba yematambudziko uye nokuvhiringidzirwa kunowanzoitika kushanda zvekutepfenyura ichi.
• Pyoseptic pathologies.
• Wakuvara ischemia.

Mugumisiro mupfungwa: SDS

zvinokonzera kuti chirwere ndeinotevera:

• Rwadza kuvhunduka.

• Kurasikirwa plasma, chinokambaira kuburikidza nhumbi muimba dzaparadzwa tishu. Somugumisiro, ropa anova makobvu uye kunokonzera thrombosis.
• The disintegration kuti munyama kunoitika kudhaka. Myoglobin, creatine, potassium uye phosphorus kubva akakuvara munyama kupinda ropa uye kukonzera hemodynamic nenyonganiso. Free myoglobin iri kutendeukira hydrochloric iine acid hematin uye chinokurwadzai kukura chakasimba renal kukundikana.
• Zvose izvi zvinofanira kubviswa nokukurumidza sezvinobvira, saka kuti zvakakwanisika kuponesa upenyu.

The nguva ari kurapwa weboka SDS

Panguva kwokuputsika chirwere ane dzakawanda nguva:

• Chokutanga - ndiye pacharo zvakananga kudzvinya zvinyoronyoro zvinyama pamwe kukura wakapona kuvhunduka.
• In yechipiri nguva pane dzemunharaunda zvakasiyana munzvimbo vakuvara uye kutanga kudhaka. Anogona kukwira mazuva matatu.
• Wechitatu nguva kunoratidzwa kukura yematambudziko kuti kuitika maronda-siyana nenhengo dzawo.
• The nguva wechina - convalescence. Kubvira panguva yaro kudzorerwa itsvo chaitika.
• Next, vakabirwa vakaona zvinhu vanotaura immunological reactivity, ari bactericidal basa ropa.

Symptomatology of urwere pakati compression of tishu

Kana kwete pakarepo zvachose yakawanda vomanikidza zvinyoronyoro munyama, ipapo zvishoma nezvishoma mberi SDS. Zviratidzo zviri chirwere rinoratidza zvinotevera:

• The ganda pazuva constricted richiripo anova zvacheneruka.
• Rinooneka edema, izvo pamusoro nguva iri kuwedzera.
• Not detectable vascular pulsation.
• Total sei ezvinhu Zvinoipisisa.
• Pane kurwadziwa syndrome.
• Muvanhu, psycho-mupfungwa.

Blood bvunzo inoratidza kuwedzera fibrinogen kunoderedza fibrinolytic basa ropa coagulation gadziriro iri nokukurumidza.

Zvinowanikwa weti mapuroteni, masero matsvuku eropa kuoneka uye sepombi.

Ndivo kuratidzwa angava SDS. The chirwere kunoratidzwa nekaupenyu zvakajairika mamiriro sei kana kubvisa compression kuti munyama. Asi pashure penguva yakati ikoko:

• Cyanosis uye pallor yacho integument.
• Variegated coloring ganda.
• Mukati mangwana kuzvimba kunowedzera.

• Matema kuoneka, infiltration, uye necrosis wamativi kuitika Muzviitiko zvakaipisisa.
• Kukudziridza zvemwoyo insufficiency.
• Blood bvunzo rinoratidza ayo thickening uye neutrophilic kusuduruka.
• Propensity kuti thrombosis.

Panguva iyi zvakakosha nenguva ndichibvunza aizomupa kurapa ne kumanikidzwa diuresis uye detoxification.

Symptomatology wechitatu nguva

Chechitatu pavaipfuura Kugadzirwa syndrome (VTS) kunoratidzwa pave yematambudziko, akaenda achibva 2 kusvika 15 mazuva.

Zviratidzo panguva kuonekwe sezvinotevera:

• The kukundwa-siyana nenhengo dzawo.
• The Kugadzirwa renal kukundikana.
• Kuzvimba kunova huru.
• Paganda, chimiro matema anogona kuonekwa ne pachena kana Hemorrhagic kugutsikana.
• Bright anotanga kuratidza kupererwa neropa.
• Shoma weti goho.
• Kana bvunzo ropa anowedzera wevasungwa pamusoro urea, creatinine uye potassium.
• Akaratidza dzenhoroondo mufananidzo uremia pamwe hypoproteinemia.
• Pane kuwedzera muviri tembiricha rechipfuwo.
• General ezvinhu Zvinoipisisa.
• Kune kuvhiringidzika uye lethargy.
• Zvinogona kurutsa.
• Staining sclera chinoratidza chiropa kubatanidzwa mune pathological muitiro.

Kunyange ndichibvunza kurapa havangagoni kuponesa munhu, kana akaonekwa SDS. Syndrome, kana kunosvika nguva iyi, muna 35% nyaya kunoguma rufu vakaurayiwa.

Muzviitiko zvakadaro, unogona chete kubatsira extracorporeal detoxification.

Pakuzadzisa of SDS

The nguva chechina - a convalescence. Rinotanga pashure netsvo vawanezve nemabasa avo. Panguva iyi, kuchinja emo kuikunda zvavo.

Zviratidzo zvacho zvingasanganisira:

• Kana pane yakazaruka kukuvara, ipapo akacherechedza rwarisa matambudziko.
• Zvichida kukura sepsis.
• Kana pasina matambudziko, mumatenhere anotanga kuserera.
• nokukurumidza sei kupora kwemajoini mufambo achavaponesa kwokuomerwa kukuvara.
• Sezvo tsandanyama rinenge vanourayiwa, vari kutanga kutsiva connective zvinyama, izvo haana kugona kuderedza, saka gumbo atrophy hwapedyo.
• Kupererwa neropa zvakare anoramba.
• I kutendera kudya.
• Pane kuramba kuchinja homeostasis, uye kana ukashandisa chinhu ndichibvunza aizomupa-ropa mushonga, vanogona kubviswa pashure mwedzi mumwe zvakasimba kurapwa.

Munguva yokupedzisira nguva kuderera mune vakafa dzinoratidza zvinhu dzinongoitika nemishonga, bactericidal basa ropa. Leukocyte indekisi rebei anochinjwa.

A nguva vawirwa refu vasisafari uye nepfungwa kusagadzikana. Kakawanda kuora mwoyo, psychosis uye chemaneka.

How kuziva SDS?

Syndrome, nechirwere izvo zvinofanira kuitwa chete ruzivo nyanzvi, zvinoda vainyatsotarisirwa uye kurapwa. Kuona kuvapo chirwere chinogona inobva zvinotevera zviratidzi:

• It anofunga kunotoda mufananidzo uye ezvinhu zvinokuvadza.
• Regai kuramba pasina kutarisirwa weti pachisara ropa.
• Held Diagnostics chishandiso, izvo zvinoita kuti kuenzanisa rinomutsa rabhoritari zviratidzo uye itsvo marongerwo.

Vanhu kuwana chirwere cardiac dzimwe nguva kunzwa chirwere ichi, asi kwete vose anonzwisisa zvakaita syndrome. SDS mwoyo ECG anogona kuratidza kuvapo kwezvirwere, hunobata pachipfuva. Kuva pasi marara aigona yekudyidzana kukanganisa kushanda pomwoyo.

Laboratory chirwere rinoitwa kuti:

• Ziva padanho myoglobin uye plasma, kazhinji mumamiriro ezvinhu akadaro, izvozvo yekudyidzana inowedzerwa.
• Pakusarudza wevasungwa kuti myoglobin iri weti. Kana nhamba dzakasvikira 1000 kumar / ML, zvinokwanisika kutaura kuva chakasimba renal kukundikana muna VTS.
• The chirwere kungazviratidza sezvo nokuwedzera transaminases muropa.
• Inosimudzira creatinine uye urea.

Nokuongorora weti vanachiremba kuona ukuru renal kukuvara. Ari kudzidza zvinoratidza:

• Zvakawanikwa leukocytes kana paine rakaoma ne VTS.
• Anowedzera wevasungwa kuti munyu.
• Inosimudzira urea kugutsikana.
• Pane ipombi.

Rairira chirwere achibvumira vanachiremba taurira chinobudirira kurapa nekukurumidza kuti abatsire munhu kupora zvose mashandiro muviri.

How kupa rubatsiro rwekutanga?

Kubva ruyamuro napo mamiriro akuvara, uye zvichida upenyu hwake, kana kuwedzera VTS. The urwere, rubatsiro rwekutanga anofanira akapa nekukurumidza, haizoiti kuti zvakakomba yematambudziko kana kubatsira munhu achishandisa inotevera algorithm:

1. Ipa rufimbi zvinodhaka.
2. Zvadaro chitanga kusunungura zvakakanganisa nzvimbo muviri.

Sezvo mari ava yakakodzera, "Analgin", "Promedol", "Morphine". zvinodhaka All vari kutarisirwa chete intramuscularly.

Vanhu vakawanda vanobvunza sei apo SDS-kushandisa tourniquet chirwere? Izvi zvinoitwa pamberi chakakomba arterial ropa kana dzinokuvadza mutezo akuvara vakafa kubva kurasikirwa neropa.

• Wongorora ukama nzvimbo.
• Bvisa wiring.
• All maronda vanofanira kubatwa akambozvishandisa kuuraya utachiona uye vhara ane chena jira.
• Kuedza zvichitonhorera pabazi.
• The Anofumurwa kupa kudhakwa, zvakakodzera tii, mvura, kofi, kana rimwe chete-sesaline.
• Warm akuvara.
• Kana pane zvakavhara, vanhu vanoda nokukurumidza sezvinobvira kupa oxygen.
• Kudzivirira mwoyo kukundikana, kupinda munhu "Prednisolone".

• Tumirai wacho kuchipatara pedyo.

Therapy mupanda chirwere

Inogona kusiyanisa inosiyana nekuomarara SDS. Syndrome, mishonga izvo zvinofanira kuva nzwisisika, kwete kukonzera zvakakomba matambudziko, kufunga pathogenesis kuti maronda. Complex basa - iri rinoreva:

• Kuti aite mabasa kugadzirisa homeostasis abnormalities.
• Kupa mishonga zvainoita pathological kukuvara centre.
• Normalize ari microflora mumaronda.

Kuchirapa matanho yaifanira anenge dzose, kubvira musi rwekutanga uye azere kupora rechipfuwo.

Kana nouchapupu Kukuvara, kurapwa rine mumatanho akawanda:

• Wokutanga anotanga pakarepo panzvimbo.
• Chechipiri - nderokubatsira mune zvokurapa Zvivako, izvo zvinogona kwazvo kure paitikira tsaona, saka aiwanzoshandisa "ichibhururuka zvipatara", "zvipatara mavhiri". Zvakakosha chaizvo kuti zvakakodzera midziyo kubatsira kana kuzotadzira zvetsandanyama nemapfupa emuviri uye nhengo dzomukati.

• In pachikuva wechitatu unyanzvi hanya. Izvi yemanyorero kunoitika nenzira zvomusejari kana kunotevera centre. Pane zvose zvakafanira midziyo kupa rubatsiro kana hombe kuvadza zvetsandanyama nemapfupa gadziriro, kana zvomukati. Pane nokumutswa basa kubvisa munhu kubva mamiriro nehana, sepsis kana renal kukundikana.

zvinodhaka kurapa

Mukakurumidza kutanga Danho iri yokurapa, kwakondiko murwere vapukunyuke. Kurapwa panguva ino sezvinotevera:

• Kwakaitwa akasarudzei aizomupa yavaibvisa chloride muvhenganiswa uye 5% yavaibvisa bicarbonate ari inorwara 4: 1.
• Kana pane chakakomba chimiro urwere, vakaurayiwa ane Anti-kuvhunduka matanho vakasuma 3-4 litres ropa uye ropa vokutsiva.
• Kudzivisa kukura yematambudziko, vanopedza diuresis pakatanga "Furosemide" kana "Mannitol".
• Kuderedza muviri kudhaka kubudirira nokuda dzinomiririra ropa uye kushandiswa mangwanani wegamma-hydroxybutyric acid. It ane inhibitory zvainoita CNS uye ane chirwere cheBP nomugumisiro.

Kana zvose kuchinja dzokurapa musapa kutsvakwa mugumisiro, zvinoda kuvhiya kurapwa, iyo inobva kushandisa nzira idzi detoxification:

• Sorption nzira.
• Dialysis uye filtration (dialysis, ultrafiltration).
• Fereticheskie (plasmapheresis).

Uye kungada kudimurwa, izvo hazvibviri kudzokera hwandaiva upenyu.

Zvinoita kudzivisa SDS?

Kana kudzivisa kukuvara haana kuitika, zvino kakawanda vakudziridze SDS. The urwere, izvo zvaida chokudzivirira Nokuraramisa, haizoiti kuti taisireva, kana, pakarepo kutanga kuita. Nokuti ichi unoda mushonga penicillin. Kushandiswa inorwisa mabhakitiriya varege kuvaponesa kubva chinoda kugadziriswa, asi kudzivirira gasi neronda rinonyenga saka ingangodaro.

Asati mokusvinwa akuvara kubva marara rinokosha kutanga Urume kurapa kuti normalize ari Nyorera mumwe zvisingaoneke. Inowanzoshandiswa nokuda kwezvinangwa izvi "Mannitol", 4% magnesium bicarbonate mhinduro.

Kana isu tiite zviito zvose izvi zvakananga pamusoro pachivara, zvinokwanisika kudzivirira kukura zvakakomba zviome SDS, akadai gasi neronda rinonyenga uye itsvo kukundikana.

Takurukura muudzame SDS (apwanye chirwere), nhengo dzomukati muviri wake, kana rinorema zvinhu. Ichi chirwere rinowanzoberekera panguva yedambudziko. Zvinofanira kucherechedzwa kuti timeliness kuti vabatsirwe anogona kuponesa upenyu. Asi mabhuku uye mumapeji magazini nhasi unogona kuwana akasiyana chaizvo dudziro. Rine chete zita - SDS chirwere - hadzi chirwere remakore. Pfungwa iyi siyanei nzvimbo uye haufaniri kuvhiringidza nayo chirwere chakadaro chakakura. Uyu musoro mumwe nyaya zvachose, asi munguva pfupi zvinofanira kucherechedzwa kuti izvi zvinoreva kuti syndrome. kazhinji chinobata vakadzi kuvaremedza hurumende. Udyire, dzokuzviona kutsoropodzwa, kusarura vanhu, kuvimba kwake kusakundika uye "zviratidzo" zvakafanana chakanangana chirwere vakadzi SDS.