Mendelson ta ciwo: cututtuka, magani, yin rigakafi

Akwai jerin cututtuka da cewa kada a ba da marasa lafiya da damar ci gaba da rayukansu kullum. Bayyana quite kwatsam, sai su canja gaba daya da mutum, da kuma ya samun sosai kadan dama a al'ada rayuwa ci gaba. Wata irin wannan pathological yanayi ne acid tsammãni ciwo, wanda aka sanshi a karkashin sunan Mendelson ta ciwo.

description

Abin da ya faru da cutar saboda da inhalation na acidic na ciki ruwan 'ya'yan itace, tare da sakamakon cewa wani mutum tasowa m kumburi. Mafi yawan lokuta na mahaukaci jihar da aka sani a obstetric maganin sa barci. A marasa lafiya da daban-daban diagnoses, wanda suke karkashin maganin sa barci ko ba, a cikin ƙananan numfashi tsarin iya samun arziki a enzymes acidic abinda ke ciki na ciki.

Mendelson ta ciwo ne m wahala da maganin sa barci. A general yi a kusan 60% na lokuta mutuwa. A obstetric maganin sa barci, wannan adadi ya kai 70%.

dalilai

Babban factor cewa tsokani acid-tsammãni alama ne regurgitation ko amai, ya faru a lokacin da maganin sa barci a lokacin da rage aiki m reflexes na maƙogwaro. Mendelson ta ciwo , yafi sa regurgitetsiey, da m karewa na ciki abinda ke ciki a cikin oropharynx.

An ƙãra hadarin rikitarwa faruwa a lokacin wani cikakken ciki, ciki miyagun ƙwayoyi, barasa, abin mãye, lethargy. Regurgitation iya faruwa a lokacin daukar ciki (daga 22-23 makonni), a lokacin da, saboda hormonal canje-canje rage samar da gastrin, wadda take kaiwa zuwa cin gaban na ciki da hauhawar jini. Daga cikin wasu dalilai: karuwa a intragastric da ciki-ciki matsa lamba, bloating, kumburi daga cikin esophagus, kiba, gaban m m cututtuka na narkewa kamar tsarin. A mafi girma hadarin da ciwo faruwa a lokacin da gudanar da ceto a cikin cutukan ko a yi na gaggawa tiyata.

pathogenesis

Mendelson ta ciwo yana da wani musamman inji na ci gaba. Na farko wani zaɓi - shi ne a lokacin da undigested abinci barbashi shigar da numfashi fili da na ciki da ruwan 'ya'yan itace. A matakin na sakandare inji occlusion na bronchi take kaiwa zuwa ga ci gaba na m na numfashi gazawar. A karo na biyu idan yana da matukar acidic na ciki ruwan 'ya'yan itace a lokacin da inhaled iya haifar da wani sinadaran kuna da mucous membrane na bronchi da trachea. Bugu da ari mucosal edema tsokani ci gaban Bronchial shãmakacẽwa.

Mendelson ta ciwo: Alamun

The asibiti hoto da cutar tare da kusan m zuwa cututtuka na tsanani numfashi gazawar. A haƙuri da yanayin halin da na huhu edema, tachycardia, dyspnea, cyanosis, bronchospasm. Kan bango na sosai bayyana farko canje-canje na iya faruwa sakamakon bugun zuciya. A general haƙuri ta jiki ne karye da na huhu jini ya kwarara, jijiya hauhawar jini ci gaba. Tare da m hypoxemia qara matsa lamba a cikin huhu jijiya da wani lokaci daya karuwa a huhu jijiyoyin bugun gini juriya. Rayuwa acidosis da numfashi alkalosis tasowa a sakamakon keta nama perfusion.

Clinical da pathophysiological canje-canje a hade da cuta daga cikin huhu nama raunuka. Wani lokacin bayyanar cututtuka su ne kasa pronounced. Morphological canje-canje a cikin numfashi fili markedly bayyana ranar bayan tsammãni. Kawai a yini ɗaya ko biyu daga lokacin akwai Mendelson ta ciwo, na numfashi gazawar cututtuka fara inganta. Don ajiye wani mutum na iya zama kawai a karkashin yanayin da likita gaggawa.

Mendelson ta ciwo a cutukan

A mata da obstetric ayyukan, ko janar maganin sa barci ceto sau da yawa da shi ya auku da wannan cuta. Tsammãni cikin airway ya zama biyu yanayi. A farko - janar maganin sa barci (ga obstetric ayyukan, haihuwa, m Pathology na ciki), na biyu - a take hakkin da bulbar inji a coma, regurgitation, amai. A mafi yawan lokuta, da haƙuri da aka jiran mutuwa, idan ya Mendelson ta ciwo. Wannan yana bada dama don sa da cuta a cikin layi tare da mafi m, m rikitarwa da maganin sa barci, ba shakka.

Abinci a ciki na mata masu ciki sukan yi jinkiri saboda slowing ta nassi a ciki saboda ƙananan matakan gastrin kuma Ya ƙãra ciki-ciki matsa lamba. Yana gastrin shirya motility na ciki, da kuma a kasa yawa take kaiwa zuwa cin gaban acid tsammãni ciwo a maganin sa barci.

gaggawa

Abu na farko da za ka bukatar ka rike da haƙuri da ciwo na Mendelssohn - an cire daga Airways aspirated ciki abinda ke ciki. Baka rami haka tsarkake tsotsa ko gauze. Tracheal intubation ya kamata a yi ko da a cikin prehospital lokaci. Next, kana bukatar ka yi gaggawa bronchoscopy karkashin janar maganin sa barci a hade tare da allura na wucin gadi huhu iska. Domin Bronchial lavage amfani sodium hydrogen carbonate bayani (2%) da shirye-shiryen "hydrocortisone" dumi ko isotonic sodium chloride bayani. Bayan tracheal intubation, sosai wanke tare da wani alkaline bayani ciki da gavage. Intravenously gudanar mafita "atropine" da "Eufillin".

A cikin akwati inda haƙuri da yanayin moderately, inji iska iya maye gurbinsu da maras wata-wata numfashi exhalation juriya. Domin wannan hanya, za ka bukatar wani musamman mask idan shi ba ya wanzu, shi wajibi ne don ya koyar da haƙuri exhales ta hanyar bude karshen a cikin ruwa roba tube.

Mendelson ta ciwo (photo sama nuna wani sashe na tsarin fama da fari) na iya kai ga mutuwa na haƙuri, idan lokaci bai taimake shi ba. Ko da tare da m taimako na bronchospasm laringo- da haƙuri bukatar da za a asibiti domin hana ci gaban tsanani da rikitarwa.

magani

Idan haƙuri aka same Mendelson ta ciwo, magani ya kamata hada da matakan da za su taimake su daina m na numfashi gazawar da kuma hana ci gaban dauke da kwayar cutar rikitarwa. Inji iska aka yi a lokacin da jijiya hypoxia ci gaba a cikin yanayi na maras wata-wata numfashi. Lokacin da mawuyacin hali na haƙuri hanya ne da za'ayi domin kwanaki da dama, har sai da Manuniya na huhu gas musayar bai inganta. Wani lokacin ta amfani da hyperbaric oxygenation, wanda a wasu lokuta da ake samu sakamako mai kyau. Drug magani ne da yin amfani da symptomatic kwayoyi, da magungunan rigakafi da corticosteroids a manyan allurai.

Mendelson ta ciwo a 30-60% na lokuta take kaiwa zuwa mutuwa daga mãsu haƙuri. Ga waɗanda suka sha wahala da shi, zai iya ci gaba bayyana hana ko obstructive cuta a cikin sãɓãwar launukansa digiri.

rigakafin

Akwai da dama daga ayyuka da cewa zai iya hana ci gaban mai tsanani da rikitarwa kamar Mendelson ta ciwo. Rigakafin kunshi dama matakai. A farko - da amfani da kwayoyi wanda mataki ne zuwa ga rage na ciki da mugunya ( "Ranitidine", "cimetidine"). Hana da ya faru na rikitarwa iya share kuma daidai ayyuka wani anesthesiologist. Drug "Atropine" Ya kamata a maye gurbin ta wajen "Metacin" haƙuri a cikin wani na maganin sa barci da ya kamata a gudanar smoothly kuma da sauri. A likita ya kamata zama m, a da dabara na intubation da laryngoscopy da tracheal amfani liyafar Selick.

Wani lokacin gabatar da wani na ciki da tube, ya bar shi ga dukan aiki da su hana inhalation na ciki abinda ke ciki. Wasu masana da irin wannan liyafar, saboda bincike zai iya aiki a matsayin mai lagwani, kuma tsananta yanayin. A cutukan rigakafin dole ne a daidai wuri ciki mace a kan aiki tebur, da shugaban karshen abin da ya kamata a tãyar da dan kadan.