Kutsogolo ndi kumbuyo kwa mphuno tamponade: zizindikiro ndi malongosoledwe a ndondomeko

tamponade m'mphuno ntchito zoopsa ndi ENT kusiya magazi m'mphuno a etiologies zosiyanasiyana. Ndipo ngati kutsogolo tamponade - ndondomeko sizachilendo, kumbuyo ndi kokha "osankhidwa omwe." Anthu amene ali ndi magazi sakufuna kusiya chifukwa chirichonse, kapena anthu amene kuwonongeka ndi lalikulu kwambiri kuposa zikuoneka pa koyamba.

epistaxis

Otchedwa m'mphuno magazi kuchokera m'mphuno, kumene madzimadzi umayenda mwa mphuno pa nkhope kapena kudzera choanae kumbuyo kwa mmero. Pali mitundu iwiri ya magazi: kutsogolo ndi kumbuyo. Nthawi zina, magazi limalowera mu nasolacrimal ritsa (chifukwa mmene suction), ndipo ugwira kupyola zitsulo diso. Izi akusokeretsa mboni za zodabwitsazi ndi madokotala kupereka chithandizo choyamba.

Mwatsopano magazi ndi kuundana amagwa mwa kholingo m'mimba, ndi kuchititsa maganizo nseru kapena kusanza. kawirikawiri nosebleeds akhoza chakupha. mabuku watchula mtsogoleri Attila, amene kutsamwa magazi ake take pa ukwati usiku awo.

tamponade m'mphuno chofunika kuchepetsa kutaya mwazi m'mphuno. Mwina imfa ya madzimadzi nthawi yomweyo ndi ochepa, koma pamaso pa mavuto amachita boma mwachangu.

zifukwa

Kusankha ndondomeko (zapambuyo kapena zapambuyo m'mphuno tamponade amafuna wodwala) zimadalira zimene ziwiya kuonongeka. Izi muyeso yekha. Koma apa zinthu zimene imfayo magazi ndithu kwambiri. Iwo anawagawa m'dera ndi zokhudza zonse.

Local monga:

• mphuno choipa;
• matupi yachilendo;
• kutupa ndi kutupa kwa Kakhungu mucous mavesi amene m'mphuno.

Awa ndi zitatu ziti ambiri amene amayambitsa nosebleeds. Pali zambiri zosowa:

• anatomical mapindikidwe;
• inhalation mankhwala;
• njira khansara mu m'mphuno;
• ozizira ndi youma mpweya;
• nkhanza za madontho chimfine;
• barotrauma opaleshoni.

zinthu zokhudza zonse monga chifuwa, kuwonjezeka okhazikika magazi, pamaso pa chimfine. Komanso, magazi kuchokera mphuno ungabweretse mankhwala nonsteroidal odana ndi yotupa, mowa, pali mavuto ndi dongosolo coagulation, mavitamini C ndi K akusowa, zokhudza zonse matenda autoimmune.

pathophysiology

Kutsegula kwa magazi, muyenera kuwononga khoma chotengera. Nembanemba mucous mphuno bwino vascularized, ngakhale ntchito ka mphamvu zokwanira magazi anatsanulira.

Nthawi zambiri nosebleeds zimachitika ana osaposa zaka khumi ndi anthu pa makumi asanu, kawirikawiri anthu.

Against maziko a magazi kuthamanga kumachitika zokha ndipo kungakhale yaitali ndithu, ngati nthawi yanji kanthu. Mu ukalamba ndi mucous kotero woonda kuti ngakhale osavuta njira zaukhondo kungakhale chotupa chombocho.

Mu 95% ya gwero la magazi ndi m'mphuno septum anteroinferior kulekanitsidwa. Pali otchedwa Kisselbahovo plexus. Palinso "chizindikiro" magazi. Iwo yodziwika ndi akulembayo, ndi profusion wa nthawi yochepa. Makanema awa mwina chifukwa kuwononga sitima yaikulu pa nkhope, aneurysm chotupa kapena kuvunda chotupa.

Kutsogolo mphuno tamponade

Kutsogolo mphuno tamponade kwa magazi ambiri amangoti ntchito. Amene amasonyeza "chikondi" chamankhwala kuti chifukwa cha chakuti nthawi zambiri kuonongeka ziwiya kutsogolo kwa m'mphuno, ndipo kufunika kwa njira zina satero.

Monga ulamuliro, kutaya magazi amenewa matenda palokha. Iwo - yekha zizindikiro za kusintha thupi lonse ndi. Choncho, magazi pafupipafupi kobwereza muyenera kuganizira zimene kusintha zina zachitika mu thanzi lanu ndiponso ngati pali chifukwa kuyang'ana kwa dokotala.

etiology

Kuonetsetsa zimayambitsa zoopsa magazi. Zikuphatikizapo choipa chiyambi aliyense, kuphatikizapo opaleshoni. Ndipo pali zifukwa symptomatic kuti imakhudzana ndi maonekedwe a matenda zokhudza zonse ndi anatomical m'mphuno okhulupirika.

Akazi amalembedwa konkomentiruyuschie (ie akuthamanga pamodzi ndi kusamba) ndi imfa yoopsa (kutanthauza kuchotsa ntchito ya msambo) magazi. Limagwirira mapangidwe awo koma bwino bwino bwino.

Lang'anani, chirichonse chifukwa cha magazi ndime m'mphuno, onetsetsani kuti asiye atapita ake.

Njira kuti magazi asiye kutuluka kwa mphuno

Masiku ano, pali njira zambiri kuti magazi asiye kutuluka. Chisankho zimadalira massiveness ndi zifukwa chikhalidwe ichi. Sikuti monga njira yaikulu ku ntchito mphuno tamponade. mpumulo wa magazi aligorivimu imakhala njira zotsatirazi:

1. kudziwa magazi.
2. kudziwa chifukwa chake.
3. Dziwani chotengera kuonongeka.
4. Lekani magazi yabwino kwambiri ndipo mofulumira unsembe.
5. Muziona udindo wa wodwalayo.

Kukonza nosebleeds aliyense pang'ono m'njira zotsatirazi:

1. mphuno tamponade. njira ndi losavuta: pa lumen turbinate ndi kupisa kapena thonje gauze impregnated ndi 3% hydrogen peroxide.

2. Moisten ndi thonje turunda mu vasoconstrictor akutsikira, ndipo amalowa mu amphuno ndime, imene magazi umayenda.

3. Funsani wodwalayo kupuma kwambiri mphuno, kutulutsa kudzera pakamwa pako ndipo nthawi yomweyo kuika ayezi pa mlatho wa mphuno ndi khosi.

Pogwira iliyonse ya njira wodwala ayenera kukhala kapena kutenga theka woongoka udindo ndipo anatsitsanso mutu wake patsogolo. Izi ndi kuonetsetsa kuti magazi si dzanzi kumbuyo kwa khosi kuti m'mimba.

Zida kutsogolo tamponade

Ngati zonse njira pamwamba ndi osamveka, athamanga kutsogolo mphuno tamponade. Zida ndi wosavuta kuzitsatira. Makamaka dokotala ayenera kupanga mankhwala oletsa ululu pamalopo wa m'mphuno lidocaine wa kapena novocaine (poyamba imachitika allergoproby Inde). Kenako dokotalayu amaika mu magazi sitiroko wosabala gauze ankawaviika mankhwala hemostatic kapena Vaselini mafuta. gauze kutalika pafupifupi makumi masentimita, koma m'lifupi - theka. Turunda anaika mu mawonekedwe a accordion kotero monga kwathunthu mudzaze m'mphuno.

Chotero tampon ndi yatsala pang'ono masiku atatu, ndi kuchotsedwa pa mapeto a nthawi ino. Mu magazi makamaka kwambiri, gauze akhoza anachoka kwa masiku asanu ndi awiri, koma mu nkhani iyi ayenera wothira ndi yankho la mankhwala ndi asidi aminocaproic.

Zimayambitsa tamponade kumbuyo

Kutsogolo mphuno tamponade chisathe zotsatira kuyembekezera. Kapena gwero la magazi kungakhale kuposa poyamba kuyembekezera. Zikatero amachita nthawi zambiri kudya, koma njira.

Kumbuyo kwa mphuno tamponade imagwiridwa kusiya magazi m'mphuno, ngati:

1. Wodwala zinandipweteka mwachindunji kwa mphuno kapena amphuno ndime ali ndi thupi lina.
2. Ngati magazi a amayamba ndi yaitali madzi rhinitis kapena sinusitis.
3. Mu nthawi imene mkulu zokhudza zonse magazi Kodi agwa pansi makoma chotengera ndiponso kupewa mapangidwe nthinthi magazi.
4. chifukwa cha magazi - chotupa kuvunda.
5. wodwalayo matenda magazi.

Njira m'mphuno tamponade

Thamangani mpheto ichi ndi waluso mwa munthu ophunzitsidwa, musayese kudzimvera medicate kunyumba. Kuwonjezera dokotala mu zimenezi zachititsa kuti anthu awiri kapena atatu. Mmodzi wa iwo athe kukhala malo olondola a mutu wa wodwalayo. The yachiwiri swabs ndipo amawathandiza kukonza, ndi wachitatu akukonza latsopano swabs wosabala, ngati n'koyenera.

Musanayambe ndondomeko, wodwalayo chikuyendetsedwera sedative aliyense kuti asangalale naye ndi kuchepetsa gag reflex. Ndiye, kuti patsekeke m'kamwa mwa catheter zofewa anaikapo mphuno, wothira mafuta wosabala Vaselini mafuta. Pakutha chubu izi womangidwa gauze a yoyenera kukula. Pa swab ali m'magawo atatu: awiri kuliika pa catheter, ndipo munthu akhalabe mwa mkamwa, ndiyeno Ufumuyo tsaya chigamba. Chotsatira - kuchotsa catheter mwa mphuno. Mu nkhani iyi, swab ndi anakakamizidwa Joan ndi kwathunthu atseka ndi nasopharynx. Pambuyo pake, kupanga tamponade kutsogolo ndi knotted kutsogolo otsala mizere iwiri. Chotsani swab ndipo patapita masiku awiri kapena atatu.

zosokonezeka

Tamponade za m'mphuno, komanso mpheto ina zingachititse zosokonezeka. Mwa zinthuzo monga necrosis wa amphuno mucosa. Izi zimachitika chifukwa psinjika yaitali ziwiya ndi misempha pa kukhudzana turundy. The vuto lina kungakhale purulent exacerbation kapena chitukuko cha matenda a sinuses ndi (maxillary sinusitis, sinusitis), chifukwa magazi ndi gauze kuimira sing'anga wabwino kukula bakiteriya.

Pa nkhani zikuluzikulu, ndi tamponade kumbuyo zikhoza mapindikidwe wa mphuno ndi m'mphuno septum. Komanso, chithandizocho kungapangitse mapangidwe hematoma kapena septic septum chifukwa limatsogolera wokalamulira matenda sekondale.