Clots toto i roto i te pūkahukahu. Embolism pūkahukahu: take, tohu, hopearaa, maimoatanga

mate Life-whakawehi he Embolism pūkahukahu (PE). Kei te korero tatou e pā ana ki te clots toto i hanga. I roto i nga pathologies katoa o Embolism pūkahukahu tukua te tatauranga ohorere. clots toto i roto i te pūkahukahu e taea i tetahi taime ki te ārai i te uaua. Kia aroha mai, tino maha he reira mate. Tata kotahi toru o tūroro mate ohorere katoa tupu rite ki te hua o blockage o te iatuku pūkahukahu i te katinga toto.

Ngā āhuatanga o te mate

e kore ko PE he mate motuhake. Ka rite ki te ingoa kōrero, ko te putanga o te Thrombosis tenei.

Toto katinga, titiro ake i tona wahi o te mātauranga, kawea i runga i roto i te pūnaha toto. E mea pinepine, clots toto puta i roto i te topito o raro. I te tahi taime paetata reira i roto i te ngakau tika. He katinga toto e tika ana i te marae tika, ana roro me ki te tohanga pūkahukahu. neke ia i roto i te uaua korohū tinana kotahi ki te toto venous - tana pukapuka.

huaina haere katinga ko te embolus. te wiwi ia ki te pūkahukahu. Ko te tukanga tino mōrearea tenei. ohorere ai te katinga toto i roto i te pūkahukahu te ārai i te manga uaua. He maha i roto i te maha enei oko. Heoi, heke ratou diameter. Kia i roto i te oko i roto i nei e kore e taea e te katinga toto tika, reira rere poraka toto. Ko te mea maha arata'i ki te mate.

Ki te he manawanui whawhati te katinga toto i roto i te pukapuka, whakawhirinaki nga pānga i runga i te mea ka tahuri atu ki te kia tanumia oko. Embolus faanane te supply toto noa ki nga kopa, me te taea o te utu hau i te taumata o manga iti, pera nui ranei. puta te manawanui hypoxia.

Ko te pakeke o te mate

clots toto i roto i te pūkahukahu hua i pōauautanga o te mate tinana i muri i whakawhanau, me te whakahaere tikanga. Te tahuti nei i tenei mate ko te tiketike rawa. Ko te reira i te 3 take ārahi o te mate, te rua anake ki aorangia Cardiovascular me te mate pukupuku.

whakawhanakehia teie mahana PE te nuinga i runga i te whakamārama o te āhuatanga e whai ake nei:

• māuiuitanga nui;
• pokanga matatini;
• te whara.

huru no te mate e kino, he momo o tohu rerekē, hāhā o te tātaritanga, he mōrea tiketike o te tahuti nei. whakaatu tatauranga, i runga i te pūtake o te whakamātautau pou-tūpāpaku, clots toto i roto i te pūkahukahu kihai i e wā pāngia tata 50-80% o te taupori i mate e tika ana ki te Embolism pūkahukahu.

puta rawa tere te mate. Ko Ko te aha e mea faufaa ki hohoro a tika whakatau abnormalities. I tua atu i te maimoatanga tika e taea te whakaora ora tangata.

Ki te i wā i reira kitea he katinga toto i roto i te pukapuka, kei te tino nui haere ki te ōrau oranga. Ko te auau te tahuti nei i roto i tūroro e riro te maimoatanga tika, he pā ana ki 10%. Kahore tātaritanga me te tika maimoatanga, tae reira 40-50%.

Ko te take o te mate

He katinga toto i roto i te pūkahukahu, he whakaahua o nei kei te i roto i tenei tuhinga, ko te hua o:

• Thrombosis rua hohonu o te topito o raro;
• te hanganga o te katinga toto i roto i tetahi rohe o te pūnaha venous.

He nui iti maha, e taea te paetata tenei māuiuitanga i te uaua o te peritoneum, topito o runga ranei.

āhuatanga Risk, kï te whanaketanga o te Embolism pūkahukahu o te manawanui e 3 huru triggering. E huaina ratou "te topu- o Virchow." Ēnei āhuatanga ngā:

1. Heke tere rere toto i roto i te pūnaha venous. Stagnation i roto i te oko. rere toto Pōturi.
2. Ko te nui haere keno ki Thrombosis. toto Gipersvertyvaemost.
3. Injuries ranei tūkino te taiepa venous.

Ko te kupu, i reira e etahi āhuatanga e whakapataritari nga āhuatanga i runga, kitea nei te rite ki te hua o te katinga i te pukapuka. kia huna nga take i raro i te mau huru e whai ake nei.

Na roto i te tērā ki raro o te rere toto venous taea hua i roto i:

• ngā haerenga roa, haere, kia rite ki te hua o nei he tangata kua hoki te wa roa ki te noho i runga i te waka rererangi, motokā, tereina;
• hohipera i roto i nei te moenga okiokinga hiahiatia hoki te wa roa.

Na roto i te toto gipersvertyvaemosti taea meinga:

• paowa;
• te whakamahi o pire mana whanau, estrogen;
• predisposition ira;
• matepukupuku;
• polycythemia - he maha nui o ngā pūtau toto whero;
• pokanga;
• hapūtanga.

Ki te mata whara taiepa venous:

• Thrombosis rua hohonu;
• wharanga waewae kāinga;
• pokanga o nga wahi o raro.

āhuatanga mōrearea

Physicians Ko nga āhuatanga predisposing e whai ake i nei kitea maha te katinga toto mōrahi i roto i te pūkahukahu. He tino kino nga hopearaa o te mate. Na reira ko te reira e tika ana ki te aro ki te hauora o te hunga iwi i kite nei i nga āhuatanga kī i raro:

• heke mahi tinana;
• tau i runga i 50 tau;
• māuiuitanga oncologic;
• pokanga;
• kore ngakau, myocardial;
• whara pāmamae;
• uaua tīponapona;
• whakamahi o te whakawhānau hormonal;
• pōauautanga whakawhanau;
• erythremia;
• taumaha;
• mate ira;
• erythematosus lupus pūnahanaha.

I te tahi taime e taea te pāngia reira clots toto i roto i te pūkahukahu o wahine i muri i whanau ana, rawa hunga taimaha. Ka rite ki te tikanga, mua he āhua taua e te hanganga o te katinga i te huha kuao kau ranei. hanga e ia ite ano te mamae, kirika, whero ngawhatanga ranei. Mō kia korerotia tenei mate ki te tākuta tonu, kia rite kore ki te whakahōhā i te tukanga mate.

Ko te tohu āhuatanga

I roto i te tikanga ki te tātari i te katinga toto i roto i te pūkahukahu, kia kia mārama nga tohu o te mate. E tika ana kia tino tupato ki te whanaketanga taea o tenei mate. Kia aroha mai, Ko te tino kanorau te pikitia haumanu o Embolism pūkahukahu. Kei te whakaritea te reira e te pakeke o te māuiuitanga, tere o te whanaketanga me te huringa i roto i tohu pūkahukahu o te mate e whāriki ana i whakapataritari e tenei pōauautanga.

Ki te reira te mea he katinga toto i roto i te pūkahukahu, tohu (aromatawaitia) i roto i te manawanui e whai ake nei:

1. Hāhā o te manawa, te ohorere hoki kahore take kitea.
2. He he he hua i roto i auau ngakau (ia tetahi meneti o neke atu i te 100 nga whiu).
3. kiri koma ki te kauruku hina āhuatanga.
4. Mamae, tupu i roto i ngā wāhanga rerekē o te whaturei.
5. motility whēkau waimaero.
6. Koi uaua hyperemia kaki, me te plexus solar, kite ratou kua ngawha, otu'itu'iraa kitea o te haoraora.
7. peritoneum amuamu - he kukū he taiepa nui, i reira he mamae i roto i te mana'o puku.
8. amuamu Heart.
9. heke kaha pēhanga te.

Tūroro e kua kitea he katinga toto i roto i te pukapuka, e kitea nga tohu i runga ake tika. Heoi, e kore te tetahi o enei tohu e pā ana ki te motuhake.

I tua atu ki te āhuatanga faufaa, kia whakawhanake i te āhua e whai ake nei:

• kirika;
• maremare ake toto;
• kaihapai;
• mamae i roto i te whaturei;
• ruaki;
• mahi ärai;
• wai ki roto ki te whaturei;
• pōroa.

Ko te akoranga o te mate

Mai pā ana te māuiuitanga ki te mate tino kino, e kore hāunga te mate, kia whakaaro i roto i atu taipitopito puta tohumate.

I te tīmatanga, whanake te manawanui hāhā o te manawa. e kore te Ko tōna takanga mua e tetahi tohu. He tino ngaro nga take mo te whakakitenga mai o tohu manukanuka. Hāhā o te manawa puta i runga i te exhale. Kei te āhuatanga i te reira e te tangi ata, aru e te whakamarumaru kapakapa. Heoi, he reira tonu reira.

Haunga ia, haere tahi PE e auau ngakau nui haere. Patapata i runga ake 100 kapakapa ki te meneti.

Ko te āhuatanga nui i muri ko te hekenga koi i roto i te pēhanga toto. Ko inversely hautanga ki te pakeke o te mate te tohu o te whakaiti o tenei taupū. Ko te pata pēhanga o raro, i whakapataritari nga pāpaka atu nui PE.

tei mamae i runga i te pakeke o te mate, me te nui o disorders iaia papaka taumata tupu i roto i te tinana:

1. Mamae i muri te whaturei, e kua he koi, pūāhua ka motu. āhuatanga tēnei hūhi te uaua blockage. Ko te hua te mamae i karere kōpeketanga o te taiepa oko.
2. hūhi Stenokardicheskie. Kei te te kōpeke Pain pūāhua. Kei roto i te rohe o te ngakau. E mea pinepine homai ki te peke, ea.
3. hūhi fakamamahi i roto i te whaturei katoa. Ka taea e tēnei māuiuitanga tohu pōauautanga - infarction pūkahukahu. Kei te nui whakareia te hūhi ka tetahi kaupapa - manawa hohonu, te maremare, te tihe.
4. Mamae i raro i te rara i runga i te tika. He nui e taea iti hūhi puta i roto i te rohe ate, ki te he clots toto i roto i te pūkahukahu te manawanui.

rere toto iti kitea i roto i te oko. Ka taea e whakapataritari te reira i te manawanui:

• hiccups mamae;
• mānukanuka i roto i te taiepa puku;
• paresis o te whēkau;
• kua ngawha o te uaua nui i roto i te kaki, me te waewae.

riro te mata kiri te tae ha ma. E mea pinepine whakawhanake tai ashy hina ranei. I muri, te hono pea ngutu puru. Ko te āhuatanga whakamutunga fokotu'u he Embolism nui.

I te tahi taime, kitea te manawanui e taea rongo te amuamu ngakau āhuatanga te arrhythmia. I roto i te take o pūkahukahu hemoptysis infarction Kia, ngā ki te mamae koi i roto i te pouaka, me te pāmahana feunga tiketike. kia tūāhuruiti puta hoki te maha nga ra i, me te ētahi wā he wiki me te hawhe.

I roto i te tūroro i roto i nei thrombus ki te pūkahukahu, e taea te kite maumaui o tohanga roro. Ēnei tūroro maha nei:

• kaihapai;
• haehae;
• whanoke;
• coma;
• hiccups.

I te tahi taime e taea tohumate whakaahuatia uru tohu o täkihi, puka whakapeka.

fifi o te Embolism pūkahukahu

Ko pathologies tino mōrearea i roto i nei paetata katinga toto i roto i te pūkahukahu tenei. Ka taea te rerekē te mau hopearaa mo te tinana. whakatau te reira i te akoranga o pōauautanga o te mate, te kounga me te roanga o te ora o te manawanui.

Ko te mau hopearaa matua o PE ko:

1. Chronically haafaufaahia pēhanga i roto i te oko pūkahukahu.
2. infarction pūkahukahu.
3. Embolism ihoa i roto i te oko o te porowhita nui.

Heoi, e kore katoa i pouri, ki te wā pāngia clots toto i roto i te pūkahukahu. Matapae rite tuhia i runga ake, he pai taua mea, ki te ka riro i te manawanui te maimoatanga tika. I roto i tenei take, he tiketike te whai wāhi ki te whakaiti i te tūponotanga o hopearaa kino.

Kei raro ko nga mate matua e tākuta pāngia rite ki te hua o pōauautanga o Embolism pūkahukahu:

• kiripūkahu;
• infarction pūkahukahu;
• kakā;
• empyema;
• pūkahukahu whēwhē;
• täkihi;
• pneumothorax.

Embolism pūkahukahu recurrent

taea ki te kia toutou i roto i tūroro e rave rahi mau taime, puta noa te ora tenei māuiuitanga ko. I roto i tenei take, he mea he ahua o te thromboembolism recurrent. Tata 10-30% o tūroro i muri i tetahi taua mate, e pängia ana ki wāhanga recurrent o Embolism pūkahukahu. kia kotahi manawanui he maha o whakaeke rerekē. I te toharite, ratou tokomaha rerekē i 2 ki te 20. He tokomaha wāhanga māuiuitanga heke tohu blockage o manga iti. I muri mai arata'i tenei māuiuitanga ki te embolization uaua nui. hanga e te reira i te Embolism pūkahukahu nui.

Ko te take o ngā puka recurrent taea e:

• mate mau o te romahā me ngā pūnaha Cardiovascular;
• mate oncologic;
• wawaotanga hāparapara i roto i te rohe puku.

e kore tohu haumanu mārama tēnei puka. Kei te āhuatanga i te reira e te peroo runga. Tika tātari Ko te tino uaua tenei huru. E mea pinepine tohu parau- ore- pohehe hoki tohu o ētahi atu mate.

Ka taea e recurrent Embolism pūkahukahu puta te tikanga e whai ake nei:

• kakā tamau, puta hoki kahore take kitea;
• kaihapai;
• kiripūkahu tupu i runga i te maha ra;
• huangō;
• tiango Cardiovascular;
• hāhā o te manawa;
• auau ngakau nui haere;
• kirika, e kore e faaore i te raau taero antibacterial;
• kore ngakau, mate ma'i i roto i te ngaro o te pūkahukahu ngakau ranei.

Ka taea e te mate arahi ki nga pōauautanga e whai ake nei:

• emphysema ;
• whakakapi kiko pūkahukahu e tūhonohono - pūkahukahu kakakīrehe;
• rahunga ngakau;
• takawhita pūkahukahu.

He mōrearea recurrent Embolism pūkahukahu no te mea e taea e tetahi wāhanga muri hua i roto i te mate.

tātaritanga o te mate

Nga tohu i runga ake, pera kua whakahuatia kore he motuhake,. Na reira, i runga i enei tohu e kore e taea te pāngia. Heoi, ka tika tapaea Tuhinga tohumate āhuatanga 4:

• hāhā o te manawa;
• tachycardia - nui haere auau ngakau;
• mamae pouaka;
• hāhā o te manawa.

Ki te kahore he tohu o te wha te manawanui, na kua ia kahore thromboembolism.

Ko he pera ngāwari kore katoa. Ko te tino uaua māuiuitanga tātaritanga. Hei kia whakapae kia tātari PE te taea o te whakawhanake i te mate. Na reira, ko te tākuta te tīmatanga kumea whakarongo ki te āhuatanga mōrearea taea: te aroaro o te whakaeke ngakau, Thrombosis, pokanga. Tenei taea ki a koe te whakatau i te take o te mate, te rohe i nei te katinga ki te pūkahukahu.

rangahau whakahauanga mō te kite aukati o Embolism pūkahukahu ranei e te whai ake akoranga:

1. ECG. tikanga Tino mōhiohio o te tātaritanga. homai hiko-he whakaaro o te tohu o te mate pakeke. Ki te ngā koe i tenei kōrero ki te hītori o te mate, pāngia Embolism pūkahukahu ki pū tiketike.
2. X-ray. Tenei ako mo te hanga o PE tātaritanga he uninformative. Heoi, he mea ka taea ki te wehewehe i te mate i maha atu pathologies e whai rite tohu. Hei tauira, i te kakā lobar, kiripūkahu, pneumothorax, aneurysm te pūtahi o, pericarditis.
3. Echocardiography. heheu te ako te vahi papu o te thrombus, puka, rahi, rōrahi.
4. Lung scintigraphy. Tenei tikanga e homai te tākuta he 'pikitia' o te oko pūkahukahu. Ia mārama tohua wāhi o tohanga toto ohorere. Otiia ki te kitea e te wahi i reira paetata clots i roto i te pūkahukahu, e kore e taea. Ko te ako he uara tātaritanga tiketike anake ka nui māuiuitanga iaia. Te tāutu raruraru i roto i te manga iti ki te awhina o tenei tikanga taea.
5. Ultrasonography o uaua waewae.

Ki te tika, e taea te whakaritea te manawanui ki tikanga atu o te rangahau.

tokoni akiaki

Kia mahara, ki te haere mai koe atu i te katinga toto i roto i te pūkahukahu, kia whakawhanake i tohu o te manawanui i tere uira. A tika rite hohoro arahi ki te mate. Na reira, ki te mea i reira he kia whakaratohia taunakitanga o Embolism pūkahukahu ki te manawanui i okiokinga me te karanga tonu te mafatu "waka tūroro." uru te manawanui e ki te wae whāomo.

hāngai tiaki ohotata kei i runga i te takahanga e whai ake nei:

1. Emergency pū tōngāmimi rua pokapū, me te tomo tarukino "Reopoligljukin" ranei ranunga kūhuka-novocaine.
2. Whakahaere taero e pâmuhia whakahaere, "Heparin", "dalteparin", "Enoxaparin".
3. pānga mamae whakakorea Pë whakapōauau, pērā i "Promedol," "Fentanyl", "Morin," "Leksir", "Droperidol".
4. therapy hāora.
5. Ko te manawanui e whakahaere thrombolytics: tikanga "Streptokinase", "Urokinase".
6. I roto i te wā o te arrhythmia hono whai taero: "Konupora pūkawa", "Digoxin", "ATP", "Ramipril", "Panangin".
7. Ki te whakahaere i te manawanui ko te tauhohenga ru ki reira "Prednisolone" "Hydrocortisone" ranei, me antispasmodics, "kahore-pākoro", "Eufillin", "papaverine".

Ara ki te mahi ki a PE

Ka taea e whakaora whakahoki rere toto ki te pūkahukahu, ki te ārai i te whanaketanga o te sepsis i roto i te manawanui, me te tiaki ki te hanganga o te takawhita pūkahukahu.

Heoi, i muri i te āwhina tuatahi he manawanui i roto i te hiahia o te maimoatanga tonu. hāngai Fighting māuiuitanga te i ārai te hohokitanga o te mate, oti resorption o te katinga toto.

Ki te rā, i reira e rua ara ki te tango clots toto i roto i te pūkahukahu. Methods o te maimoatanga o te pathologies e whai ake nei:

• therapy thrombolytic;
• pokanga.

therapy thrombolytic

hāngai ana maimoatanga Drug te i runga i ngā rongoā pērā i:

• "Heparin";
• "Streptokinase";
• "Fraksiparin";
• kiko activator plasminogen;
• "Urokinase."

Ka taea e taua taero tareka ia clots toto, me te ārai i te hanganga o clots hou.

Ko te tarukino "Heparin" whakahaere ki te manawanui e pâmuhia runga 7-10 ra. I roto i tenei tawhā āta te mana o te upoo- toto. Hoki 3-7 ra i mua ki te maimoatanga faaterehia te manawanui i tetahi o nga taero e whai ake nei i roto i te puka papa:

• "Fafati";
• "Trombostop";
• "Cardiomagnyl";
• "ACC Thrombotic."

tonu Mana o te upoo- toto. Te fariiraa i te hoê ohipa pumau papa (i muri i te mamae i te Embolism pūkahukahu) e pā ana ki te 1 tau.

Rongoā "Urokinase", "streptokinase" whakahaerea e pâmuhia i roto i te ra. toutou tēnei whawhe te 1 wa ia marama. whakamahi rō-uaua, me te kiko plasminogen activator. Ko te horopeta kotahi ki te kia whakahaerea i runga i te maha o ngā hāora.

e kore te therapy Thrombolytic kawea i roto i muri pokanga. Kei te rāhuitia hoki reira i roto i te take o pathologies, e taea te uaua e toto. Hei tauira, whewhe keté. No te mea ka taea e taero thrombolytic ake i te mōrea o te toto.

maimoatanga hāparapara

whakaarahia he pātai taua te anake i roto i te mate o te wāhi nui. I roto i tenei take, me tango tere koe katinga toto paetata i roto i te pūkahukahu. tūtohutia Treatment o te whai ake te. nekehia atu taputapu Special te i te thrombus oko. Tenei mahi taea ki te whakakore he tutukitanga ki te ara rere toto.

whakamana wawaotanga hāparapara matatini te ki te manga nui kātua uaua tanumia ranei. I roto i tenei take, ko te mea e tika ana ki te whakahoki rere toto i roto i tata katoa ngā wāhanga o te pukapuka.

Prevention o Embolism pūkahukahu

mate thromboembolism mea he ki te akoranga recurrent. Na reira, ko te mea nui ki te kore e wareware e pā ana ki te āraihia motuhake e taea te tiaki ki te hohokitanga o māuiuitanga nui, me te te whakawehi.

E tino nui ki te whai te iwi ki te mōrea tiketike o te whakawhanake i tēnei mate taua mehua. Tenei kāwai ngā tangata:

• pakeke atu i te 40 tau;
• Stroke whakaeke ngakau ranei;
• he taumaha;
• e Kei roto hītori wāhanga o Thrombosis rua hohonu Embolism pūkahukahu ranei;
• pokanga pehia i runga i te pouaka, waewae, whekau papatoiake, te puku.

Prevention ngā mahi tino nui:

1. Ultrasonography o uaua waewae.
2. whakahaerea te wā i raro i te taka kiri patia "Heparin", "Fraksiparin" rongoā ranei ki te rua "Reopoligljukin".
3. Superimposition o takai raru i runga i ona waewae.
4. Pēpēhinga motuhake Holy uaua kuao kau.
5. Here waewae uaua nui.
6. Implantation o whiriwhiringa vena cava iahoki.

Ko te tikanga whakamutunga ko te ārai pai o thromboembolism. E hangaia he momo o whiriwhiringa iahoki i tenei ra:

• "Mobin-Uddin";
• "Gunther Tulip";
• "Greenfield";
• "Punga".

I te wa ano, mahara e he tino uaua ki te whakapumautia tenei tikanga. Te tātari iahoki hē kore anake hei ārai pono, engari e taea ki te meinga i te mōrearea hua o Thrombosis hanganga me te whanaketanga o te Embolism pūkahukahu muri. Na reira, anake kia whakamana i tenei mahi i roto i te pokapū hauora pai-rite rawa, anake i te kaitoi tohu.