Obubonakala syndrome mendelson kaThixo. nezifo ezimandundu izifo

A lot of iingxaki angenzeka izigulane aba labagula kakhulu. Enye yezi ithi na mendelson bumandundu engqondweni.

Luhlobo luni zokugula?

Ngu mendelson engqondweni amaninzi kwakuthetha isifo obstructive pulmonary kunye izitshanguba ze inwebu semiphunga (pneumonitis), ukuphuhlisa kwisiqalo ukuwa yejusi esiswini kwi yomoya. Le meko wachazwa kuqala ngo-1946. Oku waphawula kwizigulane ugula kakhulu abaye baba ukwenzakala entloko, utyando esiswini (ingakumbi esiswini) nokuzala. Kwiimeko ezininzi, umsunguli olu hlobo kwezimilo nto anesthetized (ngenxa kuyo buyasikhulula izihlunu agudileyo). Sizoku lwisana kwezihlunu ekhululekile kwaye ulahlekelwe kwenzeka yokulangazelela (Inhalation) imixholo esiswini (ngokuqhelekileyo juice esiswini kuphela). Isiphumo ukoyiswa njengoko umthi inyumoniya kunye inyama semiphunga. Condition kuyingozi kakhulu, kunokukhokelela ekufeni ukuba ukusilela ukunika uncedo olufanelekileyo. Kubalulekile ukuqonda kabanzi kutheni kukho isifo ezimbi ngolo hlobo, kwaye oko kufuneka kwenziwe.

izizathu

Ngu kuphuhliso Mendelssohn engqondweni kunokubangela izifo ezininzi. Ezi ziquka:

• Pathology-luvo (yokulimala ingqondo, umonakalo luvo glossopharyngeal, esomeleza ummiselo ukoyika iiseli Parietal esiswini kunye motility wamalungu nakumgongxo phecana zesisu).
• Izifo wokugaya (Ithemba hiatal, achalasia).
• Izifo iphecana nokuphefumla (uqhoqhoqho elifutshane, fistulas phakathi kuvuleke iminxunya kunye uqhoqhoqho).

Ukongeza kwezi zifo, ukuba pneumonitis kunokubangela izifo kakhulu. nempembelelo kuphuhliso kunye yokulangazelela wenze utyando esiswini (ngenxa yokunciphisa izihlunu amalungu imvakalozwi kunye nokuncitshiswa kwicala reverse amaza peristaltic) kunye nokukhulelwa (ngenxa uvalo ukufuduka). Ngokomzekelo, xa inani ungenelelo zoqhaqho ukuya kwi-70% amatyala.

Noko ke, oyena nobangela uqhelekileyo ijusi esiswini nghena iphecana ukungaphefumli i ngokungekho isixando ngenxa yemeko embi yomguli kunye lububuthathaka sphincter intliziyo.

Le Pathogenesis yokulangazelela pneumonitis

Esi sifo senzeka ngenxa izitshanguba kwithishyu zehydrochloric acid yemiphunga nezengekho inyumoniya eziqulethwe esiswini. Kwenzeka iphuhlisa necrosis coagulative (leyo, kwakhona, kungenxa sisenzo acid kwi isifo inyumoniya). Ngenxa umthamo inyumoniya secretory lifinyele, nto leyo ekhokelela issushivaniyu zabo. Parallel acid eyangena emiphungeni, ebangela uphuhliso pneumonitis - ukudumba aseptic esiqwini semiphunga. lung Ukuncipha umphezulu yokuphefumla, wehlise isizukulwana lunezinto. Konke oku kukhokelela ekwandeni yesandi yibhodi (ngenxa kule fom uze cell ezimbi ezimbini: abanesifuba - ikakhulu achaphazela bronchus, kunye obstructive - kunye sisilonda esidumbileyoesingaphakathi lwe inwebu kwemiphunga kunye nophuhliso isithintelo syndrome). Ubungakanani ujongwa-pH yejusi esiswini (i ngaphantsi oko kukuthi, kokukhona kanzulu esiti, umonakalo ngaphezulu). Utshintsho kakhulu kuvandlakanywa kwi alveoli.

Ezibonisa kwinqanaba le-alveoli

rhoqo kakhulu kwingxoxo sisifo ethile enxulumene mpawu Abafundi bamenywa ukuba ifoto. Izifo ezifana pneumonitis, ngokuqhelekileyo ezinye iimpawu ezithile lwangaphandle musa zahlukile. Kodwa ukuba ujonga kummandla ochaphazelekayo kwithishyu ngemicroscope (leyo idla ngokwenziwa emnyango), unako ukubona utshintsho ezithile.

Ngenxa yokuba le nkqubo ngasentla yaye phantsi kwempembelelo womxhuzulane sihlisa zehydrochloric acid kungena alveoli. Apho, ngenxa yokuba ifuthe lendawo kwi izihlunu alveolar, ukuyilwa effusion (ngokufuthi ukopha). Ngenxa yoko, ukuba uphuhlisa nokudumba ukopha miphungeni. Phantsi impembelelo ukuthotywa kwi alveoli baphawula ukulahleka fibrin, ngokunjalo kwii kwiiseli ngokusebenzisa inwebu ongaphantsi (in leukocytes ezithile kunye macrophage). Ngenxa yoko, imveliso enqanda asakhasayo necrosis yeendonga alveolar ngenxa isakhiwo lung leyo egxobhekile. Kwindawo apho iimpahla baqondisiswa umonakalo endothelial kwaye ukuyilwa microthrombi. Oku bonke kukhokelela ekwandeni exudation bolwelo ngokusebenzisa inwebu kunye nokusekwa atelectasis. Ngokuqhelekileyo ke unobangela yintoni na nesifo obstructive miphungeni. Ukuba acid emiphungeni ukufumana amaqhekeza ukutya undigested okanye namanye amaqumrhu amazwe, ngathi ukuyilwa nokudumba ukopha kudityaniswe kunye nophuhliso indlela ecothayo granuloma ukubunjwa ngeenxa zonke kuye wangena umzimba. Olu hlobo sifo inkqubela ngokucotha ngakumbi, kodwa kakhulu ngakumbi.

obubonakala Clinical zezifo

Njani ukuqinisekisa ukuba isigulana na wolangazelelo pneumonitis? Ezithile "photo sifo" angamelwa ngolu hlobo lulandelayo:

• Ikliniki yokuqala iya kuba ngenxa isiphumo ngqo acid kwi inwebu yangaphakathi. Kukho umfanekiso kwezonyango ahlekise kwaye yababuhlungu ukusilela zokuphefumla - bronchospasm, cyanosis okwandayo, ukusilela sokuphefumla.
• inkqubo Cardio-nemithambo emsebenzini tachycardia, yokuncipha kwenani uxinzelelo lwegazi. Kwezinye iimeko, loo nto sisifo sentliziyo okanye ukuphazamiseka kwisingqi. Kwenzeka lehla output ezesifuba kwandisa uxinzelelo kwi imithambo miphungeni. Ngenxa ezingaqhelekanga exchange igesi waphawula uphuhliso alkalosis bokuphefumla metabolic. I elikhulu umthamo esiqwini kwemiphunga wambetha, ihlamvu kwisigulana, yaye kuya kuba nzima ukunyanga kuyo.
• Ngokuqhelekileyo, izilonda iimpawu ukusilela nokuphefumla kuvela iiyure ezi-2, ubuncinane - kamva. Ngamanye amaxesha iimpawu acinywe, kwaye lomonakalo esebenza ingabi kwaphela.

ekuxilongweni

Identification mendelson kaThixo syndrome - umsebenzi onzima, ukususela leengxaki iphuhlisa ngokuqhelekileyo izigulane ephelile, kwaye azisoloko, njengoko besisithi ngasentla, umfanekiso lwezonyango zingenzeka. Into yokuqala ukufumanisa ubukho ukusilela nokuphefumla (ukuphelelwa umoya, ukutswina, cyanosis). Ezi mpawu azisoloko nako ukuchonga kwizigulane asendleleni umoya ngomatshini. Indlela ichanekileyo zokufumanis mendelson engqondweni i ray okanye imiphunga fluorography. Kulo mfanekiso awukwazi ukubona ubukho exudate emiphungeni, ukwanda airiness zabo. Kwezinye iimeko, umahluko oluncediswayo le bronchi (eqhelekileyo kwi radiograph kwi ezayo ngqo bronchi azibonakali, kwaye bazibize, kuphela ukuba wenze kuqhume kwicala). Ukuba nomonde nje fluorography kukrokrelwa esebenzayo syndrome kungenxa ukuphuhlisa necrosis, isebe tubular ye uqhoqhoqho iya kuba ezibonakalayo phezu radiograph emgceni.

unyango syndrome mgomo

Noko ke, ukuba, kwakukho ngeminqweno imixholo esiswini, unyango kufuneka uqale ngoko nangoko. Inyathelo lokuqala kukuba singasondeli kwakhona nghena acid ibe yomoya asezantsi. Ukwenza oku (ukuba imeko yomguli) iyafuneka ukuze uphakamise headboard yesingqengqelo. Kwangoko mfuneko yokuba amanqaku makalungiswe umoya emiphungeni nokubonelela oxygenation igazi elungileyo. Ngokuqhelekileyo, emiselweyo mpilo phantsi koxinzelelo uveza eyakhayo hyperbaric oxygen Ukwanda (ukusetyenziswa kwenkqubo mpilo, iliso iigesi igazi). Konke oku kuya kunceda ukuthintela-asidi eninzi.

Ukunciphisa umthamo lung inyama sisilonda esidumbileyoesingaphakathi elimisiweyo glucocorticosteroids butofelwe kanye umthamo omncinane - intrabronhialno. Hormone kuvumela inkqubo gxotha lonikezelo kunye ukunciphisa ngayo. antibiotics (idla cephalosporins kunye macrolides) isetyenziselwa zokuthintela. Kufuneka kwakhona babe sympathomimetics (ukwenzela ukunciphisa ukuyilwa netuwa kwi bronchi kunye nemiphunga).

ukungaphili syndrome

Xa ixesha uqalile iingxaki zonyango ngokuqhelekileyo iphetshwe. Ukuba emva kwexesha, ngeminqweno emihle syndrome kunokukhokelela nemiphumo eyingozi nengathandekiyo.

Amaxesha amaninzi emva isifo ukuba kuqhutyekwe ngazo izinga nokwaphuka, unako koko kwenzeka fibrillation atrial okanye uhlobo esisigxina ye ventricular fibrillation. Ukuba kokubanjwa kwakhe akwenzeki, kodwa isigulane akuthethi ukukhalaza, unako ushiye isigulana phantsi kweliso ingcali zasekuhlaleni kuphela.

Enye ingxaki ke uphuhliso atelectasis yemiphunga okanye kokuphazanyiswa engapheliyo. Kulo mzekelo, inkqubo uzinziso iya kuba imide, yaye kugxininiswa idla ngokwenziwa kwi kothula iimpawu, ekubeni kwesi sifo nokuba uyabulala.

Obona bunzima kakhulu kukuba pneumonitis obulalayo. Ngakumbi rhoqo oko kwenzeka kwiimeko apho ekuphuhliseni wolangazelelo syndrome kwiintsana kuzalwa.

Uthintelo abane sifo

Ukuthintela Eskom inyumoniya, kufuneka ukwenza entsokothileyo eminye imisebenzi. Ngokuyintloko, zonke izigulane kunye nabafazi nasemigudwini, nto leyo ebonisa uphazamiseko phantsi zomzimba jikelele kufuneka kuqongqothwa isisu kwakunye namathumbu. Oku kushenxisa into eziphambili kuphuhliso pneumonitis.

Phambi zomzimba Kucetyiswa ukuba bangenele esifubeni X-ray ukuze ngaphandle imixholo ijusi esiswini kwi yomoya. Intubating isigulane kufuneka wenziwe xa isigulane lisezingqondweni na. Namnye umsa ukuze nakumphezulu umzimba uvusiwe kancinci. Oku kuphunyezwa ngokulungisa kwentloko yesingqengqelo okanye itafile zokusebenza (siwuyeke amathuba imixholo wicking isixando yenkqubo zokwetyisa iphecana sokuphefumla).

ekumfakeni ngezifundo efanelekileyo ukulungiselela indlela nomonde kutyando, ubungozi mendelson engqondweni encinci.

I-ALS yale sifo ngolu hlobo lulandelayo: ngokuqhelekileyo uzifelayo 56 ekhulwini lezigulane emileyo ngokuma pneumonitis. Ukuba amanyathelo olungiso sele iqaliswe ngendlela ngexesha, ubungozi iingxaki nokufa wayicola zero.