Mendelson ka maʻi pale hoike ana. Loa naehana maʻi

A hailona no complications ke hana i nā mea maʻi e noho ana ma ka mālama nui mālama. I kekahi o kēia mau Hawaii o ka loa loa Mendelson ka maʻi pale.

He aha ke ano o ka pathology?

By Mendelson ka maʻi pale ka loa pinepine i manaoia obstructive pulmonary maʻi me lesions o ke akemāmā'aʻaʻa (pneumonitis), ulu ma ke kāʻei kua o ka haule ana mai o gastric wai i loko o ka Air. Keia ano i ho'ākāka 'ia ma mua i loko o 1946. Ua Ua mālama i loko o loi ino e hoomanawanui i ka poe i loaa i ka poo 'eha, abdominalʻoki kino (oi abdominal) a me ka nahunahu hanau. Ma ka hapanui o na hihia, ka originator o keia ano keia ano o ka pathology ua anesthetized (ma muli o ia mea, relaxes laumania nāʻiʻo). E kū'ē i ka backdrop o nanea wale, a lilo aku Muscle leo ia lŘlŘ wehena (Inhalation) gastric Contents (IeAUPIIe, IAa IO wale gastric wai). Ka hopena o ka make e like me ka laau bronchial a me ka akemāmā'aʻaʻa. ʻAno o ka loa nui, ke alakai i ka make, inā hoʻokō 'ole' ia i kōkua kūpono. Ua mea e maopopo i ka nui au mamuli no ke aha la he mea ia he nasty maʻi, a me ia mea e pono ai ke hana.

kumu

Ma ka hooulu ana o Mendelssohn ka maʻi pale hiki i kekahi mau maʻi. Mau nā:

• Pathology o ka'emi'ōnaehana (loa lolo poino, pōʻino i ka glossopharyngeal nā aʻalolo, e hooikaika ana i ka ua'emi rula o gastric parietal keena a me motility o loko nā loko o ka gastrointestinal'āpana).
• Maʻi o ka digestive'āpana (hiatal hernia, achalasia).
• Maʻi o ka naehana'āpana (trachea pōkole, fistulas ma waena o ka esophagus a me ka windpipe).

Ma waho aʻeo ia mau maʻi, e pneumonitis hiki i loa ka maʻi. Nui ole ma ka ulu a me ka wehena i abdominalʻoki kino (ma ka mana o ka hoemi Muscle leo nā loko, a ka ho'ēmiʻana i loko aʻe ala peristaltic nalu) a me ka hāpai keiki (ma muli o ka diaphragm pohupani hale). No ka laʻana, ma ka like ana o keʻoki lāʻau lapaʻau uao ai 'i ka 70% o ka hihia.

Naʻe, i ka loa e like me ka kumu o gastric wai ke komo i ka lalo naehana'āpana mea he OE leaking no ka mea, o ka mea hewa kulana o ke ahonui, a me ka nawaliwali o ka cardiac sphincter.

Ke pathogenesis o ka wehena pneumonitis

I ka maʻi e hoʻomōhala ana i aie i ka lesions o pulmonary a me ka bronchial'aʻaʻa hydrochloricʻakika na i loko o ka'ōpū. Incidentally e hoʻomōhala ana i coagulative necrosis (a, hou, ka aie i ka hana o kaʻakika ma ka bronchial mucosa). E like me ka hopena o bronchial secretory nona iho ua hoemi, i hiki aku ai i kā lākou issushivaniyu. Lauaʻakika komo i loko o ka maʻiʻaʻai, kumu o ka hooulu ana o ka pneumonitis - aseptic li nui o ka akemāmā'aʻaʻa. Hoemiia akemāmā naehana ili, emi hanauna o ka surfactant. A pau i kēia hiki aku ai i ka hua ma ka mama o ka la kino (ma muli o i keia palapala, a pee mau pathologies: asthmatic -ʻano nui ka heluna o ka bronchus, a me ka obstructive - me ka lesion o ka akemāmā'aʻaʻa a me ka ulu iaʻi maʻi pale). Ka nui me ka nānā 'ana i ka pH o ka gastric wai (ka lalo ia mea, no ka nui i kia i kaʻakika, ka nui pōʻino). Nā loli loa nui e ike i na alveoli.

Hoike ana i ka nui o na alveoli

Loa pinepine i loko o ka kūkā o ka ua maʻi, a pili symptoms Readers i kono i ka Hawaii photo. Maʻi e like me pneumonitis, IeAUPIIe, IAa IO me kekahi mau hana i ho'ākāka 'mawaho hiʻona e ole oko. Akā, inā e nānā i ka hoʻohuli ai i nā 'āpana o ke'aʻaʻa ma ka microscope (i ua ana hanaʻia ma ka puka), he mea hiki, e huai ae i kekahi mau loli.

E like me ka hopena o ka luna o keʻano o ka hanaʻana, a ma lalo o ka aoao o ka umekaumaha kulu hydrochloricʻakika i loko o ka alveoli. Aia, no ka mea, o ka mea kūloko hopena ma luna o ka alveolar'aʻaʻa, i ke kahua o ka effusion (pinepine hemorrhagic). E like me ka hopena, ka mea, ua ulu ka hemorrhagic pulmonary edema. Ma lalo o ka aoao o ka hoʻololi iho i loko o ka alveoli malama poho o ka fibrin, e like me ka anal o ke koko keena ma ka hale ilaloʻili lahilahi (i ka pau leukocytes a me macrophages). E like me ka hopena,? Iecaianoaaiiie o nā'ūhū ulu necrosis o alveolar pā aie i ka akemāmā 'ole i ka pilikia. Ma kekahi wahi kahi i ka moku i malama endothelial poino, a me ka ho okumu ana o microthrombi. Kēia a pau hele aku ai i māhuahua exudation o ka wai ma kaʻili lahilahi, a me ka ho okumu ana o atelectasis. I hookuu ka mea, i ke kumu o ka mea e ulu obstructive pulmonary maʻi. Inā kaʻakika i loko o nā maʻiʻaʻai kiʻi'āpana o undigested ai 'ole kekahi' ē aʻe kino, e like me ka kahua o ka hemorrhagic edema hui me ka hooulu ana o ka kali naoh o granuloma ho okumu a puni i komo i ke kino. ua kēiaʻano o ka maʻi i holopono nō oi lohi, akā, oi loa.

Lapaʻau hoikeana o ka maʻi

Pehea oe hooholo i ka hoʻomanawanui i wehena pneumonitis? I Kekahi Mau "maʻi Hawaii photo" hiki ke hoʻokū 'ia penei:

• Ke? Aaieou mua e e ku pono ana i ka pololei hopena o kaʻakika ma ka mucousʻili lahilahi. Aia He He lapaʻau kiʻi o ka huʻi a me ka loa naehana hanu 'ole - bronchospasm, mahuahua cyanosis, naehana hanu ole.
• Cardio-vascular'ōnaehana ua malama tachycardia, kulu i loko o ke koko,. Ma kekahi mau hihia, ia mea naʻau e hemahema 'ole ka hoʻohuikau' o ka pāpana. Incidentally ua hoʻemi cardiac auaiaea a maoli he i ka puʻe i loko o ka pulmonary arteries. Ma muli o ke kinoea mail abnormalities malama i ka hooulu ana o ka ÷ naehana hanu a me ka metabolic alkalosis. I ka nui o ka buke o ke akemāmā'aʻaʻa pepehi aku, i ke kaumaha ke ahonui, a me ka paʻakikī i ka mea, e lilo ia i ka hana ia.
• Nō kāu, hōʻike lesions a me na hoailona o ka ÷ naehana hanu ole no 2 hola, ma ka liʻiliʻi loa - hope. I kekahi manawa symptoms hiki ke holoiia, a me ooieoeiiaeuiiai hoʻopilikia hiki ole i hoʻomaka ai i nā mea a pau.

lapaʻau '

'Ike Mendelson ka maʻi pale - he pilikia hana, mai ka pathology e hoʻomōhala ana i IeAUPIIe, IAa IO ma debilitated nā mea maʻi, aʻaʻole manawa, e like me mākou i'ōlelo ma luna, ke lapaʻau kiʻi ke kānāwai. Ka mua ka mea, e hooholo i ke alo o naehana hanu ole (pokole o ka hanu, maʻi o, cyanosis). Mau symptoms mea hiki ke kuhikuhi i na nā mea maʻi e noho ana ma luna o mechanical e hoʻokomo ea mau ole. Ka loa pololei iaoiaeii o diagnosing Mendelson ka maʻi pale o ka radiography a fluorography ia maʻiʻaʻai. Ma ke kiʻi hiki ole e ike i ke alo o ka exudate i loko o nā maʻiʻaʻai, mahuahua lākou airiness. Ma kekahi mau hihia, Hoʻonui i ke Akä naÿe o na bronchi (maʻamau ma ka radiograph i loko o ka pololei wānana o na bronchi i ole i nanaia, a me oe e lepili ia, wale ina oe e kekahiʻaoʻao pana pua aku makou). Inā pono fluorography hoomanawanui kēiaʻeleu maʻi pale ka pono, e hoʻoikaika i necrosis, omo lala o ka trachea e e māʻaloʻalo, a ma luna o ka laina radiograph.

wehena maʻi pale lapaʻau

Inā, akā naʻe, ua wehena o gastric Contents, lapaʻau e hoʻomaka koke. Ke anu u mua mea e hookaawale ia mai ka hou-komo i kaʻakika i loko o ka lalo Air. E hana i kēia (inā i ka hoʻomanawanuiʻanaʻano) ua koi 'ia e hoʻokiʻekiʻe hoʻi i ka headboard o kona wahi moe. Koke pono e hoʻomaʻa hoʻokomo ea i loko o ka maʻiʻaʻai, a hoomakaukau i maikai koko oxygenation. Nō kāu, hoakaka ventilator ma lalo o intermittent maikaʻi puʻe, a hyperbaric oxygen ma saturation (i ka hoʻohana 'ana o ka ventilator nenoaiu, ka mālamaʻana o ke koko kinoea). A pau i kēia, e kōkua ole acidosis.

E emi i ka buke o ke akemāmā'aʻaʻa lesion hoonohoia glucocorticosteroids intravenously, a he uuku mahele lāʻau o - intrabronhialno. Hormones ae i ke kaʻina hana e ke wehe 'ia i ka puunaue, a kaupalena ia. antibiotics (IeAUPIIe, IAa IO cephalosporins a me macrolides) hoʻohana no ka Kāohiʻana. Ua E hoi e sympathomimetics (ma ka mea e emi i ke kahua o secretions ma ka bronchi a me ka ia maʻiʻaʻai).

maʻi pale complications

I ka manawa hoomaka lapaʻau complications i ana käpae '. Inā hopena, wehena maʻi pale ke alakai i ka mea pepehi a me ka undesirable hopena.

Pinepine ma hope o ka maʻi ina ka mea, ua hele aku la ia me ka hālāwai hope uku, hiki a laila hoʻomaka ai atrial fibrillation a paʻa ano o ka ventricular fibrillation. Inā kona hopu mea,ʻaʻole e hiki, akā, i ka hoʻomanawanui, aole ia e hoohewa aku, e hiki ke haʻalele i ka hoʻomanawanui ma lalo o ka hooponopono ana o wale kūloko kino.

Kekahi complication o ka hooulu ana o pulmonary atelectasis a maʻi iaʻi. Ma keia hihia, ke kaʻina hana o ka noaaeeecaoee e iaʻano lōʻihi, a me ke kākauʻana ua ana hana ma luna o ka noʻonoʻo i ka symptoms, mai keia maʻi mea maʻi.

Ka loa loa complication mea ona e pneumonitis. No pinepine ia ia lŘlŘ ma ka hihia a pau ma ka ulu wehena maʻi pale i keiki na kamalii uuku.

Kāohiʻana a me ka prognosis o ka maʻi

E pale aku wehena pneumonia, ka mea pono, e lawe mai i ka luna 'o kekahi mau hanana. Kuhikuhi, a pau nā mea maʻi a me nā wāhine i loko o ka hana, i hōʻike 'ākeʻakeʻa ma lalo mau anesthesia E e kahe'ōpū a me ka naʻau liʻiliʻi. Kēia eliminates ka papa kuhikuhiE ololi i loko o ka ulu ana o ka pneumonitis.

Ma mua o anesthesia ua? Aeiiaiaoaony e undergo umauma X-kukuna i mea e hookaawale ia i nā mea o ka gastric wai i loko o ka Air. Intubating ka hoʻomanawanui e halihaliia oia iwaho, a hiki i ka wa a ka hoʻomanawanui ka manao. Man waiho no laila, i ka luna o ke kino, ua hoalaia iki. Kēia Ua loaʻa ma ka hōʻoiaʻana i ka poo o ka moe a me ka pae'ōnaehanaʻaina (ana ae ho'āʻo ana i ka manawa kūpono o ka OE poe hewa Contents o ka digestive'ōnaehana i loko o ka naehana'āpana).

Ke kumuhana Ke intubation a me ka pono hoʻomākaukau 'ana i kūpono ahonui noʻoki kino, ka pilikia o ko Mendelson ka maʻi pale ka palena haʻahaʻa.

Ke prognosis o keia maʻi, ua like penei: IeAUPIIe, IAa IO make i 56 pakeneka o ka hoʻomanawanui iki mai me ka hookupaa airway pneumonitis. Inā remedial ana i ua hoʻomaka 'ia ma ka' eleu kūpono, i ka pilikia o ka complications a me ka make hoemi i Aʻohe.