Kunzwisisa Kuti Ropa Rokuyerera Runoita Sei Kurapa Kwekurapa
Kana uchitarisa nzira yekurapa kwezvirwere zvakawanda zvehutano-kunyanya mamiriro emwoyo-vatapi vezvehutano vanowanzopiwa zano kuti vafunge kana murwere ari kutambura ne "hemodynamic instability" kana kwete. Ndiyo nguva yakajairika, asi inogona kuva nemanzwiro akasiyana kune vadzidzisi vehutano vakasiyana, zvichienderana nehuwandu hwavo hwedzidzo uye, pane dzimwe nguva, kwavakadzidziswa.
Kunzwisisa zvinorehwa uye maonero azvo zvakakosha sei kunyatsonzwisisa chinangwa chemunyori anochishandisa mune imwe nzira yekurapa kana kuongororwa.
Pasi, izwi iri rinotsanangurwa. Hemo - rinoreva ropa panguva- simba rinoreva kutenderera kweropa kumativi ose mumuviri. Kufambisa kweropa kwakanaka kwazvo mutoro wega wehurongwa hwekufamba . Kurondedzera kusagadzikana zvakare kunotsanangurwa. Zvinoreva kuti kunze kwekuti isu vatapi vezvehutano vanoita chimwe chinhu, iyo nzira haina kugadzikana uye iri pangozi yekukundikana.
Zvimwe zvinowirirana zvakafanana zvehutodynamic kusagadzikana zvinosanganisira kuparara kwekuparara , kushungurudza (kunyanya kubhadhara kushungurudzika ), hypoperfusion , nekushaya simba kwepfungwa . Mukuwedzera, mamwe mazwi anorondedzera zvinokonzera kusagadzikana kwehemodynamic uye achiita seanonyanya kushandiswa, zvakadai sa hypovolemia uye hypotension .
Hemodynamically vasingagoni kugadzirirwa varwere havana kukwana kwakakwana mumutambo wekufamba-shanduka kuchengetedza ropa richiyerera zvakavimbika kumativi ose akasiyana emuviri apo inoda kuva panguva imwe chete.
Zvakakosha kunzwisisa kuti kusaita kukwana zvakakwana hakusi chinhu chakafanana nekukwanisa kuyera ropa rakaderera .
Zviratidzo zveHemodynamic Kuchengetedza
Izvi hazviitiki chete. Varwere havasi kungoita kuti muviri usingagadzikane pasina chikonzero. Ichi chirwere chinogara chichienda (kana vanoridza) imwe dambudziko, rakadai sekurwadziwa kwepfungwa kana kushungurudzika kukuru.
Mukusangana nemamwe mamiriro ezvinhu, heanoi zviratidzo zvinotaura nezvemurwere asingagoni kugadzikana (zvinongotora zvishoma izvi kuti zvive nehanya nazvo):
- Pale uye inononoka ganda
- Diaphoresis ( kuruka )
- Kuneta
- Kunyanya kunonoka kana kunonoka kunonoka (kukurumidza kunogona kunge kuitika kana kuti chikonzero chekusagadzikana; kunonoka nguva dzose inenge chikonzero)
- Low blood pressure (chiratidzo chekupedzisira kwazvo)
- Kusuruvara kwepfufu (kwete ropa rakakwana kusvika pamapapu)
- Kurwadziwa kwepachifu (kunogona kuwirirana nekushaya kukwana kweropa mumoyo)
- Kukanganisa (zvichida kunouya mushure mekuderedzwa kweropa)
- Kurasikirwa kwekuziva ( syncope , yakaipa)
Vanachiremba vane zvinyorwa zvakajeka zvinoreva kusagadzikana kwehemodynamic kupfuura vamwe vakawanda vanopa utano hwehutano. Kunyatsonzwisisa maitiro emagadziro emuviri kune imwe nzira isingaoneki yakakosha paanenge achiedza kuziva murwere ane simba asingagoni kugadzikana. Vanachiremba, seboka, vanowanzova nekunaka kwakasimba pane iyo mavara.
Hypotension (kuderera kwemuviri weropa) inonyanya kuratidza kusagadzikana kwehemodynamic, asi haisi chinhu chokutanga chaanoona mumurwere asina kugadzikana. Kazhinji kacho, kuderera kwemuviri kwepasi kwakashandiswa sechimiro-muhutano hwehutodynamic nevamwe vanopa utano hwehutano, asi muviri uchange uine maitiro kune kuchinja kwehuwandu hwemvura nguva refu chisati chaitika chiratidzo ichocho chinokosha chinogona kujekeswa zvakajeka.
Kurwisa kana Flight Syndrome
Sezvo chirwere chekuzungunuka chinokundikana, pane zviratidzo zvakawanda zvekuedza kwemuviri kugadzirisa dambudziko rinoratidza dambudziko. Zvinenge zvose izvi zvinouya kubva kune hurongwa hwekutya tsitsi, chikwata chekukurumidza kwemuviri uye mhinduro yedu kudzvinyirira. Tsitsi dzinotyisa dzinotungamirirwa, pakati pezvimwe zvinhu, epinephrine (inozivikanwawo se adrenaline) uye inowanzotumidzwa se "kurwisana kana kuti chirwere chendaneti." Iyi ndiyo nzira yehupenyu iyo muviri wemunhu inobvunza kana inonzwa seyo inotyisidzirwa. Mhedziso ndeyokuti muviri uri kugadzirira kurwisana kana kuti kumhanya kubva kumhuka.
Hondo kana ndege syndrome inonyanya kuparadzirwa. Sezvo mutsa unonzwira tsitsi unogadziriswa, unoita kuti ropa riyerere kuti riongororwe mumapoka makuru emasumbu mumaoko nemakumbo, saka kurwisana kana kumhanya kunogona kutanga. Ropa rinoyerera uye basa mukati memakumbo emitambo rakaderedzwa kwechinguva (unogona kudya cheeseburger kana iwe uchirarama kuburikidza neiyi inosangana negomo regomo). Ropa rinoyerera kumeso, mhino, uye uropi hunowedzera, zvose zviri nani kunzwa uye kukuona iwe, shamwari yangu. Mhepo inobuda mumapapu inotenderera kuitira kuti humwe hunobuda mumhepo uye kukurumidza kwemhepo kunotenderera kuti ropa rinoyerera nekukurumidza kumapapu kuti agare atsva uye oksijeni. Pakupedzisira, kungofanana kana tiger-ino tiger inowanikwa shoma shoma mukati, ropa rinoputika richibva kure peganda kunodzora kubuda ropa uye mafoshoro ekutuka anotasva mukati kuti abatsire zvinhu zvinotonhorera apo mamiriro acho ezvinhu anopisa.
Zvakawanda zvekunzwira tsitsi zvinopindira kudzvinyirira, izvo zvakafanana kana kunyanya kunetseka kunobva pakaderera kupisa (kuzadza neropa) muuropi kana kuti uropi hunofunga kuti hwava kuda kudyiwa ne zombie, hunongobatsira panguva yekurapa sezvazviri mu zombie apocalypse.
Zviratidzo izvi zvinotonhora uye zvinotonhorera nokuti ropa harifaniri kuputika pasi uye rinonaya nekuda kwekutuka (diaphoresis) -kupa kureva kuti kune chinetso chekunetseka chiri kuitika. Cherechedza kuti hapana chinhu chiri muno chinodikanwa nekutapisa kweropa. Zvechokwadi, mune imwe nguva kurwisana kana kupindura kwebhururuka, ropa redu rinokwira kumusoro, izvo zvinokonzera kurwisana kana kuti chirwere chendaneti chinopindurwa zvikuru kune zvehutano izvo zvinokonzera kurasikirwa kweropa.
Nguva Yokushandisa Hemodynamic Kuchengetedza
Mukurapa kwehutano hwehupenyu hwehutano hwepfungwa, hukama hwehumodynamic ndiyo chiratidzo chikuru chekuti inguva ipi yekupindira. Mumwe murwere ane bradycardia kana tachycardia anofanira kurapwa zvakanyanya muhupo hwekushaya simba kwehemodynamic kupfuura kana achiita seakasimba.
Nhungamiro dzakawanda dzinoshandisa izvi sechiedza chetmus, chinoita kuti zvive zvakanyanya kukosha kuti zvionekwe zvakajeka. Kune nzira dzekuongorora humodynamic hukama nehuwandu hwekutarisa, asi haisi chirwere chakaoma kuti chionekwe nekodini yakanaka yekuongorora.
Kushungurudza vs. Hemodynamic Instability
Hemodynamic kusagadzikana zviri nyore kupesana nekutyisidzika, asi kushamiswa izwi rinoreva zvinyorwa zvishoma uye rimwe chete razvo rinobata nechokuita kana kana kwete murwere anokwanisa kuchinja zvakakwana ropa mukati memuviri wake. Mamwe maviri ane chokuita nekunetseka mupfungwa kana nemagetsi.
Kushungurudzika mune zvehutano nemararamiro anorondedzerwa uye mazinga, kusiyana nekusagadzikana kwehemodynamic. Kune marudzi mana ekutyisidzika: chirwere chemwoyo, kuparadzanisa (chinosanganisira neurogenic, anaphylactic, uye septic), hypovolemic (inosanganisira hemorrhagic), uye kuporesa (izvo vamwe vashandi vehutano vasingabvumirane ishoko rinotyisa). Pamwero wezvakaipa kusvika pakuipisisa, kushamisika kunogona kubhadharwa (kuwedzera kweropa kuchiri mukati mehutano hwakanaka) kana kubhadharwa (ropa redu riri pasi). Zvinogona kutaurwa kuti kushungurudzika kunokonzerwa nechirwere chinotyisa chisingachinji.
Nekuda kuziva chikonzero chinokonzera chirwere chemurwere, kunzwisisa nhando dzekutyisidzika uye kukwanisa kuzviona zvichaenda zvakanyanya kupfuura kungonzwisisa kusagadzikana kwehumodynamic.
Shoko pamusoro peHypoperfusion
Perfusion ndechimwe chemashoko akare anotsigira mune zvehutano mushure mekunge warasikirwa nezvose zvemazuva ano lexicon. Zvinoreva kuzadza neropa uye rinowanzoshandiswa zvakananga kureva kuropa kuzadza ma-capillaries. Capillaries inonyanya kushandisa nzira apo masero matsvuku eropa anogona kupinda mufaira imwe chete. Makanda emapapiro akafanana nemaponji uye achazadza neropa bedzi kana paine kukwana kwakakwana kusundira ropa mumidziyo miduku.
Hypo- (zvishoma) kupera (kuzadza) kunoreva kusava neropa rakakwana kuzadza mabheji epillary mumuviri. Ichi chigumisiro chekushaya simba kwehemodynamic asi inofananidzwa nekutyisa. Muzvokwadi, mazwi anoshamisika uye hypoperfusion anonyatsopindirana.
> Sources:
> Bonanno FG. Clinical pathology ye shock syndromes. Zvinyorwa zvekukurumidza, Trauma uye Shock . 2011; 4 (2): 233-243. doi: 10.4103 / 0974-2700.82211.
> Sevransky, J. (2009). Chipatori chekuongorora zvirwere zvevanhu vasingagoni kugadzikana. Ikozvino Maonero Mukunyatsotarisirwa , 15 (3), 234-238. doi: 10.1097 / mcc.0b013e32832b70e5