Mau faaiteraa syndrome o Mendelson. mate romahā Taumaha

He rota o pōauautanga taea puta i roto i tūroro e te hunga i roto i te whāomo. Ko tētahi o ēnei āhua he syndrome tino nui o te Mendelson.

He aha te momo o te māuiuitanga?

Na roto i te syndrome o Mendelson te tino maha auraa mate pūkahukahu taunutia ki pāpaka o te kiko pūkahukahu (pneumonitis), te whakawhanake i runga i te whakamārama o hinga o wai pekitīlia ki te Airways. I whakaahuatia tuatahi tenei huru i roto i te 1946. Kei te kitea te reira i roto i tūroro arohaehae mate nei kua i te whara matenga, pokanga puku (rawa puku) me te whanau. I roto i te nuinga o te wā, pohe to te Take o tenei ahua o te māuiuitanga te (e tika ana ki te whakakahore i te reira uaua maeneene). Ki te puipuitua o āhua uaua māhorahora, me te ngaro puta wawata (inhalation) tirotiro pekitīlia (te tikanga wai pekitīlia anake). Ko te hua ko te hinga rite te rakau arahau , me te pukapuka kiko. Ko te tino nui Herenga, taea arahi ki te mate, ki te ki te kore whakarato āwhina e tika ana. Ko reira ki matau i roto i te taipitopito atu aha i reira he he taua mate tohe, a kia kia meatia ai.

take

Na roto i te whanaketanga o te syndrome o Mendelssohn taea meinga e rave rahi mate. Ko ētahi o ēnei:

• Māuiuitanga o te pūnaha io (nui whara roro, kino ki te karere glossopharyngeal, e whakakaha ana i te ture manavasii o ngā pūtau kōpako pekitīlia me motility o whekau tuwhera o te wahi gastrointestinal).
• Diseases o te wahi kūnatu (whaturama hiatal, achalasia).
• Diseases o te wahi romahā (pukorokoro poto, fistulas i waenganui i te pū kai, me te pūkorokoro).

I tua atu ki enei mate, ki pneumonitis kia meinga mate kino. mana nui i runga i te whanaketanga me te te wawata i tafa puku (i te viivii ore o te whakaiti okana āhua uaua, me te whakaiti i roto i te ahunga whakamuri ngaru peristaltic) me te hapū (e tika ana ki te HWM displacement). Hei tauira, i te rahi o ngä mahinga hāparapara ake ki 70% o te wā.

Heoi, ko te take tino noa o te wai pekitīlia tomo i te wahi romahā raro ko te turuturu hāngū no o te tūranga he o te manawanui, me te ngoikore o te sphincter cardiac.

Ko te pathogenesis o wawata pneumonitis

whakawhanake te mate e tika ana ki pāpaka o te waikawa pūmāota kiko pūkahukahu, me te arahau i roto i roto i te kopu. Ratau whakawhanake necrosis coagulative (e, ano, ko e tika ana ki te mahi o te waikawa i runga i te mucosa arahau). Ka rite ki te hua o te kaha secretory arahau te iti, e arata'i ki ratou issushivaniyu. waikawa whakarara ngoto ki te pūkahukahu, ai te whanaketanga o te pneumonitis - mumura iroiti o pūkahukahu kiko. pūkahukahu iti mata romahā, heke whakatupuranga o surfactant. arata'i tenei katoa ki te hua i roto i te otinga o te tinana mea (e tika ana ki tenei puka me te huna e rua pathologies: huangō - e pa ana i te ngōrahi, me taunutia te nuinga - ki te lesion o te kiko pūkahukahu me te whanaketanga tukuna ai syndrome). takoto te whānuitanga e te pH o te wai pekitīlia (te raro ko reira, te atu hāngai te waikawa, te atu kino). Kua kitea nga huringa tino nui i roto i te alveoli.

Faaiteraa i runga i te taumata o te alveoli

Tino maha i roto i te kōrero o te mate ngā me e pā ana tohu Readers e karangatia ki te whakaahua. Mate pērā i pneumonitis, te nuinga o ki etahi āhuatanga motuhake waho e kore e rerekē. Otiia ki te tirohia e koe i te wāhi kua pā o kikokiko i roto i te karu (e te nuinga o mahi i te kuwaha), he reira taea ki te kitea etahi huringa.

Ka rite ki te hua o te tukanga i runga, me te i raro i te mana o te mahara makaka waikawa pūmāota ki te alveoli. I reira, no te mea o te pānga rohe i runga i te kiko kauae, te hanganga o te effusion (maha hemorrhagic). Ka rite ki te hua, kei te whakawhanake i te reira i te edema pūkahukahu hemorrhagic. I raro i te mana o te kinonga i roto i nga alveoli kitea mate o pūtōtepe, me te te kătahi o ngā pūtau toto i roto i te membrane basement (i roto i ngā leukocytes me macrophages). Ka rite ki te hua, hanga o whākōkī whakawhanake necrosis o taiepa kauae tika ki hanganga pūkahukahu ohorere nei te. I roto i te wahi i reira e kitea nga oko kino endothelial me te hanganga o microthrombi. arata'i tenei katoa ki nui haere exudation o wai i roto i te membrane me te hanganga o te atelectasis. Ko te tikanga ko ratou te take o te mea kei te whakawhanake mate pūkahukahu taunutia. Ki te te waikawa i roto i te pūkahukahu whiwhi mongamonga o kai pukupuku atu tinana ke ranei, rite te hanganga o te edema hemorrhagic ngā ki te whanaketanga o te tauhohenga puhoi o granuloma hanganga a tawhio noa kua tomo te tinana. Kei te ahu whakamua atu āta tenei ahua o te mate, engari atu kino.

faaiteraa haumanu o mate

Me pēhea e whakatau koutou e te manawanui e wawata pneumonitis? Motuhake "mate whakaahua" taea te māngai e whai ake:

• ka kia e tika ana ki te pānga tika o te waikawa i runga i te membrane mucous te whare hauora tuatahi. He he he pikitia haumanu o te kore whakapeka, me te nui matehā - bronchospasm, te whakanui ake i cyanosis, kore romahā.
• kitea pūnaha manawa-iaia te tachycardia, te maturuturunga iho i roto i te pēhanga toto. I roto i ētahi wā, he reira kore ngakau tauwhatinga o te manawataki ranei. Ratau heke putanga cardiac me whakanuia ana te pēhanga i roto i te pera pūkahukahu. Nā ki abnormalities utu hau kitea te whanaketanga o te alkalosis romahā me te pūkoro tinana. Ko te nui te rōrahi o te pūkahukahu kikokiko patua, te taimaha te manawanui, me te uaua ka waiho te reira ki te hamani i te reira.
• Tikanga, puta pāpaka me tohu o te kore romahā mō te 2 haora, i te iti rawa - i muri mai. I te tahi taime e taea kia murua tohu, a kahore e waimaerotanga mahi puta i te katoa.

tātaringa

syndrome Tāutunga Mendelson o - te mahi uaua, mai whakawhanake te māuiuitanga te tikanga i roto i ngā tūroro debilitated, a kahore tonu, rite mea i runga matou, kia puta te pikitia haumanu. Ko te mea tuatahi ki te whakatau i te aroaro o te kore romahā (hāhā o te manawa, wheezing, cyanosis). e kore e taea e ki te tautuhi i te tūroro e kei i runga i ventilation aunoa tonu ēnei tohumate. Ko te tikanga tika te nuinga o Tātarihia te syndrome o Mendelson ko te Radiography pūkahukahu fluorography ranei. I roto i te pikitia e kore e taea e te kite koe i te aroaro o te exudate i te pūkahukahu, te whakanui ake i to ratou airiness. I roto i ētahi wā, rerekē whakarei o te bronchi (e kore e noa i runga i te radiograph i roto i te ngä tika o te bronchi he kitea, a taea e koe te tapa ratou, anake, ki te hanga koe i te pupuhi taha). Ki te tika manawanui fluorography whakapae syndrome kaha he tika ki te whakawhanake i necrosis, ka kia kitea me i te radiograph raina peka tubular o te pukorokoro.

wawata maimoatanga syndrome

Ki te, Heoi, i reira ko wawata o tirotiro pekitīlia, kia timata tonu maimoatanga. Ko te mahi tuatahi, ko te ki te aukati i te anō-tomo i te waikawa ki te Airways raro. Ki te mahi i tenei (ki te huru o te manawanui) hiahiatia te ki ara te papahamo o tona moenga. tika tonu ki te whakatika i ventilation i roto i te pūkahukahu, me te whakarato i oxygenation toto pai. Tikanga, i whakaritea ventilator raro taratahi pēhanga pai, me te hāora hyperbaric waiwai (te whakamahi o te pūnaha ventilator, aroturuki o hau toto). Ka āwhina i tenei katoa ārai acidosis.

Ki te whakaiti i te rōrahi o te pūkahukahu kiko lesion whakaritea glucocorticosteroids pâmuhia me te horopeta iti o - intrabronhialno. Hormones tukua te tukanga ki te whakatarewa i te tohatoha, me te whakawhāiti i te reira. paturopi (te tikanga cephalosporins me macrolides) e whakamahia ana mō te ārai. kia hoki kia te reira i sympathomimetics (i roto i te tikanga ki te whakaiti i te hanganga o secretions i te bronchi me pūkahukahu).

fifi syndrome

A, no te e te nuinga o karohia wā timata pōauautanga maimoatanga. Ki te mutunga, ka taea e wawata syndrome arahi ki hopearaa kino, me te houhou.

E mea pinepine i muri i te mate, ki te te puta ai ki te auau rärangi, taea muri puta fibrillation Atrial ahua tūturu ranei o ventricular fibrillation. Ki te kore e taea tona hopu, engari e kore e te manawanui amuamu, ka taea e koe te waiho i te manawanui i raro i te mātakitaki o kaihaumanu rohe anake.

Ko tētahi atu pōauautanga Ko te whanaketanga o te atelectasis pūkahukahu tukuna ai ma'i ranei. I roto i tenei take, ka waiho kaua roa te tukanga o te stabilization, a kei te nuinga o te aronga mahi i runga i kairīwhi i te tohu, mai tenei mate e kore e mahu.

Ko te pōauautanga tino nui ko te pneumonitis mate. Rawa maha puta te reira i roto i te wā i reira te wawata syndrome whakawhanake i roto i nga tamariki whanau hou.

Prevention me te waitohunga o te mate

Kia kore ai wawata kakā, me te reira ki te kawe i roto i te matatini o te tahi mau mahi. Mua roa, kia riringi tūroro katoa me nga wahine i roto i te mahi, e whakaatu ana pokanoa i raro i rehunga whānui puku, me te paru. Faaore i te take matua i roto i te whanaketanga o te pneumonitis.

I mua i tūtohutia rehunga te ki mamae pouaka X-hihi i roto i te tikanga ki te aukati i te tirotiro o te wai pekitīlia i roto i te Airways. Intubating te manawanui kia kawea i roto i ara ina he mohio o te manawanui. whakatakotoria te tangata kia kua i te wahi o runga o te tinana kua whakaarahia paku. tutuki tēnei mā te huri i te matenga o te moenga ranei te tepu whakahaere (i te aperaa i te taea o tirotiro wicking hāngū o te pūnaha kūnatu i roto i te wahi romahā).

intubation Subject me tika faaineineraa technique manawanui mo te pokanga, te mōrea o te syndrome o Mendelson iti.

Ko te waitohunga o tenei mate ko e whai ake: te tikanga mate ki 56 ōrau o tūroro ki pneumonitis airway whakapumautia. Ki te mea kua kua tīmataria pitihana i roto i te wā, te mōrea o pōauautanga me te mate heke ki te kore.