Whakarōpū o whakamāramatanga ru

I roto i te ora e taea tupu te reira rau o ngā āhuatanga e taea meinga he ru. pāhono i te nuinga o te iwi i te reira anake ki te ru kaha manavasii, engari ko te wahi pono anake tenei. I roto i te rongoā, i reira te mea he whakarōpūtanga ru, tautuhi tona pathogenesis, pakeke, te āhua o ngā rerekētanga i roto i nga okana me huarahi ki te whakatutuki ia ratou. Tuatahi whakaahuatia tenei huru neke atu i te 2 mano tau ki muri, te Hipokeletisí rongonui, me te wā "ru" i roto i te mahi o te rongoā whakaurua i roto i 1737 taote Parisian Henri Ledran. matapaki ana tēnei tuhinga i roto i taipitopito nga take e meinga ru, whakarōpū, whare hauora, tiaki ohotata i te hui o tenei huru haaparuparu me matapae.

Ko te ariā o te ru

Ki te taea te whakamaoritanga te ru o te Ingarihi rite ru pai, e kore te mea e he mate, e kore te tohu, me te kore he tātaritanga. I roto i te mahi ao tuku tenei wā te whakautu o te rauropi, me ona pūnaha ki te faaitoitoraa kaha (waho ā ranei), e poka ki te mahi o te pūnaha io, pākia, respiration me te toto tohanga. Tenei ko te kau he faaotiraa ru. Me te whakarōpū o tenei kāwanatanga ki te tautuhi i te take o te ru, te tohu o tona pakeke, me te timata maimoatanga whai hua. Ka kia 'aonga te matapae anake, ki te te tātaritanga tika, me te tīmatanga tonu o te whakaora.

whakarōpū

kairangahau mate Canadian tāutuhia Selye toru ngā wāhanga, pakeke te taua hoki nga mea katoa o te ru:

1.Obratimaya (utua), i roto i nei kua pakaru te supply toto ki te roro, ngakau, pūkahukahu, me te tahi atu okana, engari e kore e mutu. Ko te waitohunga hoki tenei wā ko te tikanga pai.

2.Chastichno reversible (huangō). I te ofatiraa ano o te supply toto (perfusion) nui, engari wawaotanga akiaki, me te tika hauora he wāhi ki te whakaora i te taumahinga.

3.Neobratimaya (kāpeka). Ko te wā tino kino i roto i e kore e taea te whakahokia raruraru i roto i te tinana noa ki te pānga hauora tino nui tenei. Matapae ka 95% kino.

Ko tētahi atu whakarōpū tuwhatuwhaia taahiraa wāhanga reversible e 2 - subkompensatsionnuyu me dekompensatsionnuyu. Ka rite ki te hua, whiwhi ratou 4:

• 1 utua (te he waitohunga pai marama).
• 2 subcompensated (waenganui-taimaha e titau whakaora tonu. Matapae tautohetia).
• dekompensatsionnaya Tuatoru (rawa taimaha, ara, ki te te whakatinanatanga tonu o nga mehua tika katoa whakaaroa he uaua rawa).
• 4 tina heke (he rawakore waitohunga).

To tatou Pirogov rongonui tohaina i roto i te āhua o te ru wāhanga e rua:

-torpidnaya (te manawanui i roto i te hiamoe ranei tino puhoi, e kore te urupare ki te whakaohooho whawhai, e kore e whakahoki te pātai);

-erektilnaya (Ko te tino oaoa te manawanui, hamama, hanga he rota o nekehanga whakakeke mauri).

momo o te ru

Tei runga i te take i arahina ki te tāne i roto i ngā pūnaha o te tinana, he maha nga wehewehenga o te ru. Whakarōpū i roto i ngā o disorders circulatory taua:

-gipovolemichesky;

-distributivity;

-kardiogenny;

-obstruktivny;

-dissotsiativny.

Whakarōpū o te pathogenesis o ru ko tenei:

-gipovolemichesky;

-travmatichesky;

-kardiogenny;

-septichesky;

-anafilaktichesky;

-infektsionno-paitini;

-neyrogenny;

Pūmau-pahekotanga.

ru hypovolemic

He ngāwari wā matatini ki te matau, i mohio hoki ki hypovolemia - he huru i reira te toto honotanga roto i te oko i roto i iti iho i te rōrahi e hiahiatia ana. take:

-obezvozhivanie;

weranga -Extensive (ngaro te rota o te wē);

-pobochnye hohenga tarukino, pērā i vasodilators;

mate toto -large, ai riro okana iti hāora me ngā matūkai, i.e. perfusion pakaru.

Ka taea te kite i ru Hypovolemic tika ki mate toto tiketike rite hemorrhagic ru. Ko te whakarōpū o tenei huru ko te taua rite taua whakawhanakehia Selye, me i te wā kotahi i whakaritea e te nui o te toto e kore e farii i te tino. Ko nga wa katoa e hikitia he ahua o te tiaki o te tinana i roto i te āhuatanga tino. E ko, tīmata reira he raupapa o ngā tukanga, e whai ana ki te tiaki i te mahi o whekau faufaa, me te reira whakaora i nga ora o te pūnaha katoa. I roto i ngā, i te mate toto i roto i te oko toto ringihia ana toto tārua (āhua 10% o te katoa) i te ate, me te kōateate. Ki te kore te mea nui tenei, ranei mutu rere toto heke ki iti nui mo te oranga o nga tari tinana, mo te tauira, ki te topito, a he nui hoki perfusion o te ngakau, roro me te pūkahukahu te toto toe. tautuhi ru Classification enei kaupae e rua rite wāhanga reversible me invertible. I roto i tenei take, ki te ki te wa te tango i mahi, ka taea e koe te whakaatu i te tangata i te āhua o te ru, a ka pupuri ia ia ora.

mahi roa i runga i te tārua o perfusion toto, me te whakarato i te tahi mau whekau i te utu o ētahi atu rauropi e taea kore. Na reira, ki te kore koe e tīmata whakaora, mai whakamutunga (tina heke) atamira. kite ka pāpāngia oko, te pēhanga ki reira nui heke, toto e rere ki te taha, piki ki ngā taumata tino o te perfusion takarepa roro, ngakau me pūkahukahu.

maroketanga

Ko te wai i roto i te tinana tangata, i runga i tau me te ira, i te 60 ki te 80%. Ko te mate o te% 20 anake o tenei moni e taea e whakamate, a kua tae nga parekura 10%, meinga ru hypovolemic, i roto i tenei take whakaaro nei te rite te maroketanga, tohu he whakaiti i roto i te komuhumuhu oko toto e tika ana ki te maroketanga tiketike. take:

-zabolevaniya, ārahi ki korere, ruaki, urination auau nui;

tinana te wai -nedopoluchenie (nedopivanie) i raro i ngā āhuatanga tino, pērā i te wera tino, ngā i te itoito tinana tiketike;

kai -nerazumnye.

maroketanga Rawa pea i roto i ngā tamariki taitamariki, me te kaumātua.

Whakarōpū o te ru, puta rite ki te hua o te kore o te wai, miramira te takahanga o:

-invertible;

he reversible āhua;

-neobratimuyu.

I tua atu, kua wehea maroketanga ki enei kāwai e toru:

1.Izotonicheskoe (ngaronga o ngā katote Na ko K). Te inu i roto i to tatou tinana ko te intracellular me intercellular. A, no te parekura isotonic meinga e korere nuinga excreted whakaaturia nui pāhare pāporo me te konutai, e ko te māraa ļa matua i roto i te inu wahopūtau haere ki te pūtau ki te hanga ake te pāhare pāporo ngaro roto.

2.Gipotonicheskoe, i te mea he hopearaa o isotonic. Kei te kï hoki, parekura tiketike i roto i te inu wahopūtau (no te mea haere te konutai ki ngā pūtau). E whakaaro ana te wāhanga tuatahi e rua ki te kia reversible rite taea ki te utu mo te mate o electrolytes. Wāhanga i muri i roto i te whakarato te horomanga inu manawanui, rawa kei roto katote konutai.

3.Gipertonicheskoe e whakawhanake ka haere tahi retching korere ārai rere inu i roto i te tinana waha tuwhena rawa ranei o te tahi mau matū e whakapataritari urination atu. haere ano te wai i ngā pūtau ki te wāhi wahopūtau i roto i te tikanga ki te mau tonu i te kaha osmotic. ofati rua pūtau dehydrated ratou mahi, me te heke i roto i te rōrahi. heke rawa mōrearea i roto i te rōrahi roro, e tika ana ki te toto subdural.

tohu

Kua whakaaro matou e te vai whakaahua i te whakarōpū o ru hypovolemic. Hauora tenei ahua, ahakoa o nga take, meinga ana e ia e pā ana ki te taua. I runga i te atamira reversible, te manawanui kei roto i te tūranga te maungārongo, kia ngaro tohu korerotia. timata tohu o te raruraru e:

- palpitations;

-small tukupu pēhanga toto;

kiri tou kanohi pupuha'iá i runga i nga topito (e tika ana ki te perfusion iti iho);

Te kaihanga hoki reira he maroketanga ngutu whakamaroke, mucous i roto i te mangai, te kore o roimata.

I te toru o nga wā, paorooro riro tohu tuatahi atu korerotia.

E tuhia tūroro:

-tahikardiya;

-Reduction pēhanga toto i raro uara tino;

-Violation manawa;

-oliguriya;

tou kanohi ki te pa (i te wahi e kore e anake);

kiri -mramornost me / ranei te huri to ratou tae i noa ki te koma cyanotic;

pini -nitevidny;

pēhanga -'i i runga i nga matimati, he ha ma me te tae ratou i muri iti tango o te kawenga e neke atu i te 2 hēkona hoatu te täkupu. Ko te taua whare hauora he hemorrhagic ru. Whakarōpū o ona wāhanga, i runga i te rōrahi o te toto komuhumuhu i roto i te oko āhuatanga anō ngā rānei:

koia reversible tachycardia wāhanga ki 110 kapakapa ki te meneti;

koia wāhanga reversible - tachycardia o 140 ngā patu / min;

koia tina heke - auau ngakau i runga 160 ngā patu / min. I te pini tūranga nui e kore e taea te rongo, a ka taka te pēhanga toto systolic ki 60 mm HG iti ranei. tīwae.

A, no te maroketanga e taea ki te tohu ru hypovolemic e tapiritia:

mucous -suhost;

nenewha reo -reduction;

y pēpi mahuetanga o te fontanelle nui.

Te reira i ahua waho katoa, engari ki te tika te whakatau i te whānuitanga o te raruraru, te whakahaere i te rangahau taiwhanga. I whakamana tonu te manawanui matū toto, whakatau i te taumata o te hematocrit, acidosis, i roto i ngā take matatini, te tirotiro i te kiato wē. I tua atu, tākuta he mana konurehu taumata, nga electrolytes matua, creatinine, Urea toto. Ki te tukua e tikanga, meneti ako me te rōrahi patu ngakau, me te pēhanga venous pokapū.

ru pāmamae

Tenei momo o te ru i roto i te maha ngā huarahi rite ki te hemorrhagic, engari tona take ka taea e mahi patunga anake waho (wero, te pū, weranga) ranei ā-(whaturama o te kopa me okana, mo te tauira, i te patu kaha). Kei te haere tahi tata tonu ru pāmamae i te mamae mama pakeke, kē atu atu te āhuatanga o te patunga. I roto i te tahi mau puna huaina reira ko te ru mauiui, maha ārahi ki te mate. whakaritea te pakeke o te ru pāmamae te kore pera nui te nui o toto ngaro, te nui o tenei mate o te tere. Ko, ki te rau te toto āta te tinana, te pārurenga he wāhi pai ki te mawhiti. aggravates hoki te āhuatanga me te tohu o te faufaa o te okana pakaru ki te tinana. Ko, ora te pere i roto i te ringa, ka waiho i te reira māmā atu i marutanga ki te matenga. Ko nga āhuatanga o te ru pāmamae enei. Whakarōpū o te kāwanatanga o te pakeke e whai ake:

ru primordial (puta tata tonu i muri i te whara);

ru -vtorichny (puta i muri i te pokanga, tango o paihere, i raro i kawenga atu i runga i te pāngia, mo te tauira, tona waka).

I tua atu, kite ru pāmamae rua wāhanga - erectile me torpid.

Tohu o erectile:

mamae -strong;

whanonga -neadekvatnoe (karanga, overexcitation, manukanuka, i ētahi wā fakaaoao);

-tremor;

werawera tou kanohi;

tamariki -Advanced;

-tahikardiya;

-tahipnoe.

Tohu torpid:

riro tau'a -bolnoy;

Kaitirotiro, i reira, engari e kore e te tangata urupare ki reira;

koi heke pēhanga -arterialnoe;

-glaza memeha;

-poyavlyaetsya koma kiri, cyanosis o nga ngutu;

-oliguriya;

reo -oblozhennost;

mucous -suhost;

tou kanohi werawera kore e mahi, engari te kiri mona tona turgor;

-puls thready;

whakakoi mata -cherty.

ru paitini, whakarōpū

puta ana tēnei huru e tika ana ki te kătahi ki te tinana o te mate, arā, huaketo me huakita e meinga haurangi nui o ratou mahi. More maha atu i te kore hara i roto i te whakaeke ru streptococcus, staphylococcus, Salmonella, Pseudomonas aeruginosa. tomo ratou te tinana, kia rite ki na tikanga o tuwhera tunga (sepsis puerperal, weranga, pokanga) kahore (taipō, AIDS, tracheitis, pakohu kakā, kakā, rewharewha, me ētahi atu mate) ranei.

microorganisms pathogenic hua superantigens e whakahohe T pūtau, me ētahi atu pūtau T. Ko te hunga, i roto i te tahuri, te huna hoki cytokines, meinga tāmia pūnaha ārai o te manawanui kei, me te nui nui o tāoke tukua ki tona toto, meinga ru paitini. Ko te whakarōpū o tenei huru titore e toru ngā wāhanga:

1.Obratimaya. I roto i kia tonu tenei pēhanga toto, tonu reira mahara mārama, riro māwhero whero ranei kiri. Kei te maha tutu te puehu i te manawanui, amuamu o mamae i roto i te tinana ranei i roto i te puku, kite ia korere, kirika, me te ētahi wā ruaki.

2.Chastichno reversible. Tohu: kirika, pini ngoikore, tachycardia, heke pēhanga, te manawanui lethargic, leva tona tauhohenga.

3.Neobratimaya. Tohu: hāhā o manawa, haehae, cyanosis kiri, pini he ngoikore, te pēhanga toto i raro i te tino, he mauri te manawanui.

Whakarōpū o ru anaphylactic

puta te huru taua ka ingested paihana i nakahi ngau, pūngāwerewere, patia me ētahi atu mea ora, i tango etahi inu, me te kai, me te taha te whakahaere o te raau taero e kua hoatu ki allergens o te manawanui. Kei te tino maha homai he tauhohenga taua procaine rongoā paturopi, organic. Ka taea e ru puta i roto i te torutoru hēkona i muri i te whakapā atu ki te whakapāwera te tinana rānei i roto i roa te wa, me te wawe puta te tauhohenga, te kino te waitohunga. He maha ngā momo o te takanga o te ru anaphylactic:

-tipichnaya (whero i te pae ngau (te pae werohia), ranei mamae puku, korokoro i allergen whakapā-waha, decompression, kōpeketanga o nga rara i raro i korere taea ruaki ranei);

-gemodinamicheskaya (i roto i te wahi tuatahi disorders Cardiovascular);

-asfiksicheskaya (kore romahā, dyspnea);

-tserebralnaya (arā o te pūnaha pokapū io, haehae, aita, hopu romahā);

-abdominalnaya (puku whakapeka).

maimoatanga

Hoki te mahi akiaki he faufaa te whakarōpū tika o puranga. tiaki ohotata akiaki i roto i ia take he ona ake pau, engari te wawe haamata te reira ki te kia whakaratohia, te manawanui he tupono pai. I taahiraa kitea mate tina heke te i roto i neke atu i te 90% o te wā. Ngaukino nui e hikitia ki te aukati tonu te mate toto (pāpuni) ka whakaorangia te whara ki te hōhipera. He kawea saline rō-uaua me rongoā colloidal, huhu toto, wē, pohe to, ki te tika, hono ki te respirator.

I roto i te ru anaphylactic epinephrine whakahaerea tonu, intubated te manawanui kei ki asphyxia. Muri whakahaere corticosteroids me antihistamines.

A, no te kawea ru paitini therapy inu nui ki paturopi kaha, immunomodulators glucocorticoid wē.

A, no te ru hypovolemic mahi matua ko ki whakahoki te supply toto o whēkau katoa, whakakorenga o hypoxia, me te māori o te pēhanga o te ngakau. A, no te te ru meinga e te maroketanga, kua ato'a te reira e hiahiatia te hë o te rōrahi ngaro o inu, me electrolytes katoa.