Mendelson ee syndrome, calaamadaha, daaweynta, ka hortagga

Waxaa jiro liis ku cudurrada aan bukaanka ma siin fursad uu ku sii noloshooda caadiga ah. Muuqashada arrin lama filaan ah, waxay si buuxda u bedeli qof, oo uu helo fursad aad u yar ee nolosha caadiga ah ayaa sii waday. Mid ka mid ah xaaladaha cudur sida waa himilada syndrome acid, kaas oo sidoo kale loo yaqaan magaca Mendelson ee syndrome.

description

Dhacdooyinkaa cudurka sabab u neefsasho casiir gastric acidic, oo sababtay in qof uu yeesho caabuq ba'an. Xaaladaha intooda badan gobolka aan caadi ahayn loo yaqaan ee suuxinta ee uurreyda iyo umulaha. In bukaanka qaba cudurka kala duwan, taas oo hoos suuxdinta ama aan ahayn, in nidaamka neef-mareenka hoose ka heli kartaa hodan on falgalka ka kooban acidic ee caloosha.

Mendelson ee syndrome waa dhibaatooyin dilaaga ah ee suuxdinta. dhaqanka guud ee dhowaad 60% ee kiisaska dhimashada. In suuxinta ee uurreyda iyo umulaha, tiradaasi gaadho 70%.

sababaha

Arrinta ugu muhiimsan ee in dhirfinaya calaamad acid-rajo gelin darteed waa regurgitation ama matag, dhacay suuxinta marka hoos shaqeynta hummaag nabadgeli karaan dhuun ah. Mendelson ee syndrome inta badan regurgitetsiey keena, dhicitaanka dadban ku jira gastric galay anitenatus.

halis kordhaysa oo ah dhibaatooyinka dhacaa marka caloosha ay ka buuxaan, murugada daroogada, sarkhaan khamriga, feejignaan xumo. Regurgitation dhici kartaa inta lagu guda jiro uurka (ka 22-23 asbuuc), marka, ay sabab u tahay isbedelka hormoon yaraynaysaa wax soo saarka ee gastrin, taas oo horseedaysa horumarinta hypertension gastric. Ka mid ah arrimo kale: kordhay intragastric iyo cadaadiska intra-caloosha, dibiro, caabuq hunguriga, cayilka ah, jiritaanka cudurada qalliinka ba'an ee nidaamka dheefshiidka. Qatarta ugu weyn ee syndrome ay dhacdaa marka gaarsiinta operative in dhalmada ama dhaqanka ee qalliin degdeg ah.

pathogenesis

Mendelson ee syndrome uu leeyahay hab gaar ah oo ka mid ah horumarinta. Ikhtiyaarka hore - waa marka Qurub cunto nuxurrada u geli mareenka-mareenka la juice gastric. At heerka of qabsamin farsamo sare oo ka mid ah raad hawomareenno horumarinta ee failure ba'an ee neef-mareenka. In kiiska labaad waa casiir gastric aad u acidic marka la neefsado waxay keeni kartaa gubasho kiimikada ee xuub-axaleedka of hawomareenno iyo hawomareen ah. bararka xuubka dheeraad ah dhirfinaya horumarinta xirma bronki.

Mendelson ee syndrome: Calaamadaha

Sawirka caafimaad ee cudurka iyada oo ku dhowaad isku mid ah in calaamadaha neefta dhibeyso. xaaladda bukaanka waxa lagu gartaa barar sambabada, tachycardia, dyspnea, dhiigrooraan, bronchospasm. Against asalka ah isbedel hore aadka u muujiyay dhici kara wadnaha. In guud ahaan jirka bukaanka waa jabtay iyo socodka dhiigga pulmonary, hypertension halbowlaha sii darayo. Wada jir ah ula hypoxemia daran kordhiyaa cadaadiska ee halbowlaha pulmonary la koror isku mar in iska caabin vascular pulmonary. aysiidh dheefshiidka iyo alkalosis neefsashada yeesho sabab u ah xadgudubyada perfusion unugyada.

isbedel Clinical iyo pathophysiological la xiriira xanuunada ah lesions unugyada sambabada. Mararka qaar calaamadaha yar fahmayaan. isbedel Morphological ku jirta marinka neefsashada sicad maalin muujiyey ka dib rajo gelin. Kaliya maalin ama laba maalmood laga bilaabo wakhtiga marka waxaa jiray Mendelson ee syndrome, calaamadaha neefta bilaabi si loo hagaajiyo. Si loo badbaadiyo qof noqon karaa oo kaliya ka yar xaaladda uu degdegga ah ee caafimaadka.

Mendelson ee syndrome ee dhalmada

In haweenka la hawlgallada ee uurreyda iyo umulaha ama bixinta suuxinta guud inta badan waxay dhacdaa cudurkan. Aspiration galay haweedka waa in uu ahaado laba xaaladaha. suuxinta guud (hawlgallada ee uurreyda iyo umulaha, dhalmada, cudurada qalliin caloosha), kii labaadna wuxuu ahaa - - The ugu horeysay xadgudub ku ah hab bulbar ee kooma, regurgitation, matag. Xaaladaha intooda badan, bukaanka waxaa sugaya dhimasho, haddii uu Mendelson ee syndrome. Taasi waxay siinaysaa xaq u leeyahay inuu ku riday cudurka on par leh ugu khatarsan, dhibaatooyinka dilaaga ah ee suuxdinta, shaki ku jirin.

Cuntada caloosha haweenka uurka leh u muuqdaan in dib loo dhigo sababo la gaabis ay marinka ee uurka ay sabab u tahay heerka hoose ee gastrin oo kordhay cadaadiska intra-caloosha. Waxaa gastrin dejisa motility ee caloosha, iyo tiro aan ku filnayn keenaysaa in horumarka acid syndrome rajo gelin in suuxinta.

xaaladaha degdegga ah

Waxa ugu horeeya ee aad u baahan tahay si uu u qabto qofka bukaanka ah la syndrome ee Mendelssohn - laga saaro hawo aspirated ku jira caloosha. saabka Oral sidaas ku daahir yeelay nuugid ama faashad. intubation Dhuunta waa in la sameeyaa xataa wajiga prehospital. Next, waxaad u baahan tahay in la sameeyo Bronchoscopy degdeg ah hoos suuxinta guud ee isku dhafan oo la duray of hawo sambabada aan dabiici ahayn. Waayo, lavage bronki isticmaalaya sodium xal carbonate hydrogen (2%) diyaarinta "hydrokortisoni" xal diiran ama isotonic sodium chloride. Ka dib markii intubation cunaha, si fiican maydhay ah caloosha xal xumadoodu by gavage. Intravenously xal "atropine" iyo "Eufillin" maamulo.

In kiiska halkaas oo xaaladda bukaanka ee dhexdhexaad ah, hawo si farsamaysan la bedelay laga yaabaa in la neefsashada lama filaan ah iska caabin ah oo katimaada. Waayo, nidaamka this, waxaad u baahan doontaa maaskaro gaar ah haddii aysan ka jirin, waxaa lagama maarmaan ah in la baro exhales bukaanka ilaa dhammaadka furan in tube caag biyo ah.

Mendelson ee syndrome (photo kor ku xusan ayaa muujinaya qayb ka mid ah nidaamka ka cabanaya in meesha ugu horeysa) keeni kartaa dhimasho of bukaanka, haddii uusan waqtigu ku caawiyaan. Xitaa gargaarka deg deg ah ee laringo- bronchospasm iyo bukaanka u baahan in la dhigey cusbitaalka si looga hortago horumarinta dhibaatooyin daran.

daaweynta

Haddii bukaanka waxaa laga helaa Mendelson ee syndrome, daaweynta waa in ka mid ah tallaabooyinka oo kaa caawin doona in ay joojiyaan failure ba'an ee neef-mareenka iyo ka hortagga horumarinta dhibaatooyin faafa. hawo Farsamada waxaa la sameeyaa marka hypoxia halbowlaha ay sii socoto in xaalad ka mid ah neefsashada oo lama filaan ah. Marka xaaladda halista ah ee nidaamka bukaan waxaa lagu fuliyaa muddo dhowr maalmood ah, ilaa tilmaamayaasha sarrifka gaaska pulmonary ma hagaajiyo. Mararka qaarkood iyadoo la isticmaalayo Oxygen hyperbaric, taas oo mararka qaarkood lagu edbiyey natiijo wanaagsan. daaweynta daroogada waa isticmaalka daroogada astaamaha, antibiotics iyo corticosteroids in qiyaasood oo waaweyn.

Mendelson ee syndrome in 30-60% ee kiisaska kaxeeya xagga dhimashada bukaanka. Waayo, kuwa ku xanuunsaday, sameeyo sheegi karaa xanuunada dhibka ama obstructive darajooyin kala duwan.

ka hortagga

Waxaa jira tiro ka mid ah falalka ka hortagi kara horumarinta dhibaatooyin daran sida Mendelson ee syndrome. Ka Hortagga ka kooban yahay dhowr tallaabo. Midkii kowaad wuxuu u - isticmaalka daroogada, kuwaas oo tallaabo ayaa la faray in ay hoos u of dheecaan gastric ( "ranitidine", "cimetidine"). Looga hortago dhacdo dhibaatooyinka karto iyo tallaabooyinka saxda ah suuxiyaha ah. Drug "Atropine" waa in la bedelay hab "Metacin" bukaanka galaan xaalad ah suuxinta waa in si habsami leh oo si degdeg ah ay maamusho. dhakhtar waa in ay u yaqaana in farsamo ee intubation iyo laryngoscopy iyo isticmaalka cunaha dhaweynta Selick.

Mararka qaarkood soo bandhigid tuubo gastric, waxay ambabixin hawlgalka oo dhan si looga hortago in la neefsado waxa ku jira gastric. Qaar ka mid ah khubarada ka dhanka ah soo dhawaynta noocan oo kale ah, sababtoo ah baaritaan ku noqon kara dubaalad oo sii darayaan xaaladda. In dhalmada ka hortagga waa in ay booska naag saxda ah uurka miiska qalliinka, dhamaadka madaxa kaas waa in lagu wax yar ka sara kiciyey.