He aha te mea te tauira Ruvilua-Grégoire?

I roto i te ao i reira e he maha nui o mate, e pā ana ki nei e kore e ara whakapae maha iwi. Ko reira he take ina hiahia noa koe ki te mohio e pā ana ki te tohu o te tangata whakapeka ki te taea ki te whakarato tonu āwhina tuatahi ki te manawanui. Otiia e kore e he tonu reira he mate nui ranei e taea te whakaritea māuiuitanga e ngā, engari i roto i tenei take, haere mai ki te āwhina o hou tikanga tātaritanga, mo te tauira, pērā i te tauira Ruvilua-Grégoire. Ko taea te takoto whakawhetai ki tenei tauira, me e he reira te tikanga mo te tātari?

Tauira Ruvilua-Grégoire: he aha te mea te reira?

Tenei tamataraa - Ko tetahi o nga tikanga o te tātaritanga tenei, tuku rawa hohoro whakatau mehemea toto intrapleural kore ranei i hemothorax. whakamātautau pai o Ruvilua-Grégoire ta e tonu te toto i roto i te kiripūkahu, me te taunakitanga tōraro o tona mutu, ranei ahakoa he reira, engari e kore e rite ki hohe.

Ko te aha te mea hemothorax, me pehea ki te hamani i te reira, he aha te mau hopearaa o te ngoikore o roto i te huru o tenei manawanui?

Hemothorax: he aha te mea te reira?

Hemothorax - te toto e puta i roto i te kiripūkahu me arata'i ki te meka e piki reira he nui nui o te toto, e te mutunga haere tahi e kōpeketanga o te pukapuka. Tauira Ruvilua-Grégoire taea rite wawe tonu ki te whakatau i te aroaro o te toto, me tona kaha. I tua atu ki tātaritanga, e taea te mohio mate toto e tohu:

• mamae pouaka;
• pēhanga iti;
• whanoke;
• koma kiri me ētahi atu.

Ki te tapaea te manawanui taua mau faaiteraa, me tino rerenga reira ki te hōhipera ki te hanga i te tātaritanga me te ki te tango i mehua katoa ki te aukati i te toto. Ko e taea tīmata hemothorax?

Take māuiuitanga

kia tātaritanga o hemothorax tika mō ngā tūroro e riro pouaka whētuki, he pai ki pathologies, take iatrogenic o toto ranei.

I raro i tākuta wharanga ngā kino ki te ãpoko o ngā momo. kia whakawhanake Hemothorax rite ki te hua o ngā aituā waka, te pū, rara pakaru, he hinga i te tiketike nui, me ētahi atu āhuatanga.

Ka taea e taua whara meinga e kore kino nga pūkahukahu anake, engari ētahi atu whēkau:

• ngakau;
• ate;
• kōateate;
• te HWM;
• oko intercostal;
• iatuku rei;
• pūkahukahu.

Hemothorax a taea meinga mate i roto i te manawanui, pērā i:

• aneurysm te pūtahi o;
• kohi;
• repara i roto i te pūkahukahu pleural ranei;
• pūkahukahu whēwhē;
• hemorrhagic diathesis;
• coagulopathy, me ētahi atu.

āhuatanga Iatrogenic ārahi ki hemothorax (ki te whakatau i tona aroaro, ka whāwhā Ruvilua-Grégoire) puta pōauautanga i muri i te pokanga i runga i te pukapuka ranei kiripūkahu, waikeri pleural, whakanohonga o te pū tōngāmimi i roto i te rua pokapū.

hemothorax pathogenesis

haaputuputuraa o te toto i roto i te kiripūkahu taea meinga kōpeketanga o te pūkahukahu, me te displacement o whekau, e tika ana ki te tino heke mata romahā o te pūkahukahu, i reira he disorders o te romahā me te hemodynamic. Hoki tenei take, maha whakawhanake hemothorax whakaaturanga haumanu o hemorrhagic me te ru manawa-pūkahukahu e arata'i ki te ngakau me te pūnaha romahā kore e mahi tika.

I roto i te haora tuatahi i muri i eke te toto ki te kiripūkahu, whakawhanake te whakamutunga he tukanga inflammatory. A, no te tauturu i te hemothorax whakatau tona tauira Ruvilua-Grégoire (puta edema, kookuhutanga leukocytic, pupuhi me exfoliated pūtau mesothelial). Ko kahore rerekē i te toto piringa hoki te wa tuatahi runga i te rohe o te toto pleural roto i toto, a muri heke taumata pūtoto, te taupū o erythrocytes me leukocytes.

A, no te patia ki te kiripūkahu, clots toto, engari i muri i te wa poto haamata te tukanga o te fibrinolysis, e tika ana ki nei liquefies ano reira. whai wāhi ana tēnei tukanga ki ngā āhuatanga anticoagulant. He maha ngā akomanga o hemothorax. He aha e, a he aha te rerekētanga i waenganui ia ratou?

akomanga hemothorax

Kua kua mea matou e taea hemothorax e ngaukino, pathological me iatrogenic. I tua atu, tango ki pūkete te kaha o tona toto, me kua wehea ki te maha akomanga:

• iti - i reira he whakaeminga o toto i roto i te pakohu, a kahore he mate toto neke atu i te 500 ml;
• Kua maturuturu iho toto ki te taumata o te rara 4, me tona rōrahi ko e pā ana ki tetahi me te rita hawhe - reo;
• tapekeroto - toto i maturuturu iho te ki te raro tara taumata 2, me te nui o te mate toto ko e pā ana ki e rua rita;
• katoa - i runga i x-ray e kitea pouri i te hinga o te kiripūkahu, a he nui atu i te wairua o rita mate toto.

I tua atu, hemothorax, e tauturu whakatau i te tauira Ruvilua-Grégoire me ētahi atu tikanga tātaritanga taea e apical, interlobar, parakostalnym, supradiaphragmatic, paramediastinalnym, tei katoa i runga i te localization. Hoki i roto i taua take, ki te haere tonu te toto, ka karanga hemothorax ahu whakamua, me te mea kua mutu te reira - pūmau. Ki te hipokina te kiripūkahu i te wa taua toto e kore anake, engari ano hoki te rangi, i roto i tenei take e korero tatou e pā ana ki gemopnevmotorakse. Ko te aha tohumate e taea tohu hemothorax?

tohu o te hemothorax

Tei tika te pikitia haumanu i runga i te kaha o te toto, mongamonga kiko pūkahukahu me okana nuku. e kore ai e haere tahi hemothorax iti e tohu, te nuinga amuamu te manawanui o te mamae pouaka, e kia kino ake ngaa ai ka maremare, me hāhā o te manawa kia puta.

Ko te akomanga waenganui, me te tiketike, e taea te whakapumautia te whakamahi i te tauira Ruvilua-Grégoire, tahi e disorders romahā, disorders Cardiovascular, me ētahi atu. e kore e tohu tuhia i te wāhi tika e kore e mahi, no te mea kia riro koe mamae kino e faarahi ki maremare, ngoikore i roto i te tinana katoa, te pēhanga toto iti. Ki te mahi tinana iti e hë katoa o nga tohu. whiriwhiri te manawanui he tūranga whakamarie - e noho ana hawhe-nohoanga ranei.

Otiia i roto i te hemothorax nui i reira he he ngoikore, e kore nei e tuku i ara te ara, āmai, whakawhanake tachycardia, kiri ha ma, i mua i te kanohi tarenga ngaro, te tupu pinepine syncope. Otiia e kore e tonu e taea e tohu akatainuia te hemothorax, na he reira pai ki te kite i te tākuta, ko wai e whakarite te tokomaha o nga akoranga, tae atu tauira me Ruvilua-Grégoire. I hemothorax - ko te tikanga pai, i roto i te wa poto, ka tohu i te aroaro ngaro ranei o te toto tenei.

tātaringa

I roto i āta tika tākuta tātaritanga nga kōrero katoa o te mate, kua whakaritea e te tikanga-tinana, me te tahi atu o te whakamātautau, tae atu ki taiwhanga. I hemothorax tonu kia takoto ranei i reira ko te takamuri o te taha pāngia i roto i te nekehanga romahā, ahakoa taimaha o tangi percussion runga te wahi i reira te wai kohia, whakawarea ki te he manawa ki reira quavers.

Pouaka x-ray heheu marama kollabirovanie, te aroaro o te inu (manawanui i roto i te tūnga whakapae i roto i te ako) ranei clots i roto i te kiripūkahu. I roto i te tikanga ki te whakamārama i te tātaritanga me te tātaritanga taea te whakaritea poka pleural i hemothorax, i roto i tenei take whiwhi toto fakapapau'i te tātaritanga. Hei mōhio ana hemothorax horomata me te huaketo hanga tauira Petrova ko Efendiyev, e aromatawai te mārama, me te aspirate hohenga.

ka whakatau whakamātautau taiwhanga toto te maha o leukocytes me erythrocytes. E taea hoki te whakamana te reira, a te tahi atu tikanga tātaritanga pērā i ultrasound, X-hihi, uma CT, thoracoscopy tātaritanga.

E taea ki a koe te whakapūtā te tauira?

Hei whakaū e tonu te toto, ranei e kua kua mutu reira, tika e kore te mahi akiaki ki te whakahaere i te ako pēnei i te tauira Ruvilua-Grégoire. tikanga tātaritanga o tenei ahua tā toto tīpako o te kiripūkahu, a ka titiro ki reira. Ki te tahuri reira atu i roto i te ipuipu pūwero ranei, te auraa e tonu te toto, me te mea he ngaro coagulation, ka kahore. Na ka tono tangata nga tauira ki te taiwhanga ana kia whakawakia ano, a ka kua whakaritea kua reira i te nui o pūtoto.

whakamātautau pai o Ruvilua-Grégoire - he tohu mo te thoracotomy ohorere, e ka tauturu i mutu i te toto. Tenei tikanga tātaritanga kōrero, engari he pai ki te kawe i roto i atu me ētahi atu rangahau, ki te kia tino ki te 100% i roto i te tātaritanga. Otiia me pehea ki te mahi i whakamātautau?

Tikanga poka taiepa i hemothorax

whakamātautau haerea kia anake kia he tākuta tohu, no te mea he tino matatini tenei ako, a ki te mea mau koe he he he tauira toto, e taea e te reira atu ara kino ki te manawanui. Poka i te hemothorax - he tikanga ahurei o te tātaritanga, kawea nei i roto i waenganui i te rara 6 me 7 i runga i te reo me te aho zadnepodmyshechnoy. I tenei wāhi, kia waiho te manawanui i roto i te tūranga e noho ana. Kei te tonoa toto ki te otinga antibacterial ako tarukino whakahaere.

therapy momo

āwhina ki te haemothorax ngawari maimoatanga momo, i roto i nei take Pë me āpiha hemostatic. Hoki pai pānga whakakapinga therapy ki he huhu totó akiaki, ki te haemothorax āhua ara nui ranei. Hoki e faaterehia te maimoatanga o te mate Te Henare āpiha fibrinolytic, kua tohua e ratou ano mo te ārai me te therapy o hemothorax coagulated, a taea tonu te whakamahi immunocorrecting me maimoatanga symptomatic.

hemothorax Iti rawa hohoro a kahore hopearaa taea te whakakorea e te tikanga momo o te maimoatanga. Otiia i roto i taua take, ki te whakakitea te re-whakamātautau te whakamātautau pai Ruvilua-Grégoire, ka e taea kore mahi kahore pokanga.

maimoatanga hāparapara o hemothorax

tohua pokanga te ki te manawanui i roto i ngā take pēnei i:

• Ki te haere tonu toto roto kiripūkahu;
• manehau haemothorax ka whakawhānui Haukarotia ki te pūkahukahu;
• ki te mea i reira kua anō-whakaeminga o toto i muri i tango i te poka;
• toto haere i roto i te kōwhiringa waikeri pleural, me tona rōrahi ko e pā ana ki 500 mL mō te 2-3 haora;
• pakaru whekau faufaa.

hāngai ana maimoatanga hemothorax te i runga i nga āhuatanga o nga āhuatanga etiological o toto, me te pakeke o te hemorrhagic ru. Whakatuwheratia kino ongó ki te pükahukahu me ētahi atu whēkau o te pouaka rapu wawaotanga hāparapara akiaki i runga i te whakamārama o te therapy anti-ru whānui, e ngā analgesia hauora kore anake, engari uaua ano ki te anemia whakapeka, me te hypoxia.

he tika te mahi mo te taua take:

• mutu i te toto;
• whakakore kino ki whekau;
• tango toto taikaha;
• ki te takoto pana wai mo te whakatere tupu o te pūkahukahu;
• mo whakanohonoho o te kōhao pleural ki antiseptics.

Ko te aha matapae hoatu kaiwhakaako kawea te tūroro e Nōna ka tafa i te hemothorax i waho?

Matapae me te ārai o te hemothorax

Ko te angitu o te maimoatanga mō hemothorax tei runga i te āhua o te whara ranei mate, toto kaha me te āwhina wā e whakaratohia ana. waitohunga pai mō ngā tūroro ki hemothorax ngawari āhua ranei. kia whakawehi hemothorax Hotua te whanaketanga o empyema pleural, engari tonu toto ranei te mate nui kotahi o te toto e taea arahi ki te mate.

Ko te putanga o te hemothorax kia hanganga nui o adhesions pleural e hua i whāiti te nekeneke o te HWM. I roto i tenei take, e tūtohu ana e ki tūroro katoa te hunga i i te kāwanatanga kauhoe me te mahi i ia te wā mahi manawa.

whakarato Prevention hemothorax whakatūpato o whara ki te pouaka, kōrero i te tūroro tākuta ki whētuki thoracoabdominal, mana o te hemostasis i te pokanga i runga i te pūkahukahu, me te mediastinum.

mutunga

Hei whakarāpopoto, ka taea e tatou te mea e te tauira Ruvilua-Grégoire - ko tetahi o nga rangahau tino nui i hemothorax. Toto ki te rohe pleural - he tu'unga tino nui e titau tuku akiaki ki te tākuta. Ko Ko te aha i te tohu tuatahi i muri i ranei tonu ko te whētuki pai ki te rapu i te tauturu tohu, kia kia awerenga mate ranei.