Nhazi ọkwa nke ujo definition

Na ndụ ọ pụrụ ime ọtụtụ narị ọnọdụ ndị nwere ike ime ka a na-akpata. Ọtụtụ ndị na-akpakọrịta ọ bụ naanị na a siri ike ụjọ ujo, ma nke a bụ naanị bụchaghị eziokwu. Na nkà mmụta ọgwụ, e nwere a ujo nhazi ọkwa, akọwapụta ya pathogenesis, ogo, ọdịdị nke mgbanwe ndị na-akụkụ na ụzọ ilebara ha. First kọwara ọnọdụ a ihe karịrị 2 puku afọ gara aga, ama Hippocrates, na okwu ahụ bụ "ujo" na omume nke na nkà mmụta ọgwụ ẹkenam ke 1737 Paris dọkịta na-awa Henri Ledran. Isiokwu a tụlere n'ụzọ zuru ezu na ihe ndị mere na-eme ka ujo, nhazi ọkwa, ụlọ ọgwụ, na mberede na-elekọta ihe omume nke a na-agwụ ike ọnọdụ na amụma.

Echiche nke ujo

Na ujo nke English nwere ike sụgharịrị dị elu ujo, na-abụghị nke a ọrịa, ọ bụghị ihe mgbaàmà na bụghị a nchoputa. Na ụwa omume a okwu na-ezo omume nke organism na ya na usoro na a siri ike mkpali (mpụga ma ọ bụ esịtidem), nke na-emetụtakarị na-arụ ọrụ nke ụjọ usoro, metabolism, respiration na ọbara ekesa. Ebe a bụ oge a ujo mkpebi siri ike. The nhazi ọkwa nke steeti a mkpa ịmata ihe na-akpata nke ujo, ogo ya n'ogo na-amalite irè ọgwụgwọ. The amụma ga-aba uru naanị ma ọ bụrụ na ihe na-arịa na ozugbo mmalite nke iji tụtee mmadụ.

Classifications

Canadian pathologist Selye mata atọ, Olee ihe enyemaka otu ihe nile di iche iche nke ujo:

1.Obratimaya (ụgwọ atụrụ), nke inweta ọbara ụbụrụ, obi, akpa ume na ndị ọzọ na akụkụ a na-agbajikwa, ma ọ bụghị kwụsịrị. The prognosis a ogbo bụ n'ozuzu mma.

2.Chastichno reversible (ụkwara ume ọkụ). N'otu mebiri nke ọbara ọkọnọ (perfusion) ịrịba ama, ma ihe ngwa ngwa na ihe kwesịrị ekwesị ọgwụ aka nwere ohere iji weghachi arụmọrụ.

3.Neobratimaya (ọnụ). Nke a bụ ihe kasị oké ogbo nke na-enwe nsogbu ahụ na-apụghị weghachiri eweghachi ọbụna na kasị oké ike mmetụta. Prediction mgbe 95% ọjọọ.

Ọzọ nhazi ọkwa abahade ikpe reversible nzọụkwụ site 2 - subkompensatsionnuyu na dekompensatsionnuyu. N'ihi ya, ha na-4:

• 1st ụgwọ atụrụ (ìhè na-enwe a mma prognosis).
• 2nd subcompensated (ufọt ufọt ibu na-achọ ozugbo iji tụtee mmadụ. Amụma controversial).
• Nke atọ dekompensatsionnaya (nnọọ arọ, ọbụna ma ọ bụrụ na ozugbo mmejuputa iwu niile dị mkpa jikoro Eburu amuma a nnọọ mgbagwoju).
• 4th irreversible (prognosis bụ ogbenye).

Anyị ma ama Pirogov ekenyela na a ala nke ujo abụọ n'ụzọ:

-torpidnaya (onye ọrịa na a stupor ma ọ bụ oké umengwụ, bụghị anabatakwa stimuli ọgụ, anaghị aza ajụjụ);

-erektilnaya (onye ọrịa bụ nnọọ obi ụtọ, na-eti mkpu, na-eme a otutu amaghị ihe ọ bụla na-achịkwaghị achịkwa mmegharị).

ụdị ujo

Dabere na ihe ndị mere na ada otu ahaghị nhata na ahụ na usoro, e nwere ụdị dị iche iche nke ujo. Nhazi ọkwa na okwu nke ọbara ọrịa dị otú ahụ:

-gipovolemichesky;

-distributivity;

-kardiogenny;

-obstruktivny;

-dissotsiativny.

Nhazi ọkwa nke pathogenesis nke ujo bụ nke a:

-gipovolemichesky;

-travmatichesky;

-kardiogenny;

-septichesky;

-anafilaktichesky;

-infektsionno-egbu egbu;

-neyrogenny;

Ofu-Nchikota.

hypovolemic ujo

Mgbagwoju okwu dị mfe ịghọta, ebe ọ maara na hypovolemia - a ọnọdụ ebe ọbara circulates site na arịa na-erughị achọrọ olu. ihe mere:

-obezvozhivanie;

-Extensive Burns (efu a otutu plasma);

-pobochnye ọgwụ Jeremaya mere, dị ka vasodilators;

-large ọbara na ọnwụ, adịru akụkụ-enweta obere oxygen na nri, i.e. gbajiri perfusion.

Hypovolemic ujo ruru elu ọbara na ọnwụ nwere ike hụrụ dị hemorrhagic ujo. The nhazi ọkwa nke a ọnọdụ bụ otu ihe ahụ dị ka na emepe Selye, ma n'otu ogbo kpebisiri ike site ego nke ọbara adịghị enweta ozu. Shock bụ mgbe a ụdị nchebe nke ahụ n'ọnọdụ dị oké njọ. Ya bụ, ọ na-amalite a na usoro nke Filiks, na-achọ iji chebe ọrụ nke dị oké mkpa akụkụ na otú ịzọpụta ndụ nke dum usoro. Karịsịa, na ọbara na ọnwụ na ọbara arịa akwafuo ndabere ọbara (ihe dị ka 10% nke ngụkọta) si na imeju na splin. Ọ bụrụ na nke a bụ ezughị, ma ọ bụ belata ọbara na-akwụsị na obere mkpa maka ihe oriri ahụ ngalaba, n'ihi na ihe atụ, na nsọtụ, nke mere na ndị fọdụrụ n'ọbara bụ ezuru perfusion obi, ụbụrụ na akpa ume. Nhazi ọkwa ujo akowa abụọ ndị a nzọụkwụ dị ka ikpe reversible na invertible. Na nke a, ma ọ bụrụ na oge na-eme ihe, ị pụrụ igosipụta a onye a ala nke ujo, na-edebe ya ndụ.

Long ọrụ na nkwado ndabere na mpaghara nke ọbara perfusion na-enye ụfọdụ akụkụ na-efu nke ọzọ ntule ike. Ya mere, ọ bụrụ na ị na-amalite iji tụtee mmadụ, na-abịa ikpeazụ (irreversible) ogbo. Mkpọnwụ hụrụ arịa, nrụgide nime ya nke ukwuu-ebelata, ọbara-eru na mpụta, na-abawanye na oké egwu-etoju nke perfusion mpe ụbụrụ, obi na akpa ume.

akpịrị ịkpọ nkụ

The mmiri na ahụ mmadụ, dabere na afọ na mmekọahụ, 60 ruo 80%. Ọnwụ nke naanị 20% nke a ego nwere ike ịbụ na-egbu egbu, na weere ruru 10%, ime ka hypovolemic ujo, nke na nke a na-ewere dị ka akpịrị ịkpọ nkụ, na-egosi a gụnyere ya ná ekesa ọbara arịa ruru akwa akpịrị ịkpọ nkụ. ihe mere:

-zabolevaniya, na-eduga afọ ọsịsa, vomiting, Ugboro urination ukwuu;

-nedopoluchenie mmiri ahu (nedopivanie) n'okpuru oké ọnọdụ, dị ka oké okpomọkụ, karịsịa na elu ahụ exertion;

-nerazumnye nri.

Karịsịa kwesiri akpịrị ịkpọ nkụ na-eto eto na ụmụaka na ndị agadi.

Nhazi ọkwa nke ujo, mere ka a n'ihi nke na enweghị mmiri, na-egosi na nzọụkwụ nke:

-invertible;

a ikpe reversible;

-neobratimuyu.

Ke adianade do, akpịrị ịkpọ nkụ na-ekewa ndị a atọ ige:

1.Izotonicheskoe (ọnwụ nke Na na K ion). The ọmụmụ anyị ahu bụ intracellular na intercellular. Mgbe isotonic losses mere site afọ ọsịsa tumadi anyụpụ egosiputara potassium na sodium, nke bụ isi cation na extracellular ọmụmụ na-aga n'ime mkpụrụ ndụ na-eme ka elu nke furu efu potassium nime ya.

2.Gipotonicheskoe, nke bụ na ya pụta nke isotonic. Ọ na-e kwuru na elu weere na extracellular ọmụmụ (n'ihi na sodium ebe n'ime mkpụrụ ndụ). The mbụ nkebi abụọ na-ahụta ka reversible dị ka o kwere chefuo maka ọnwụ nke electrolytes. Ikpe ejiri na-enye ndidi ọmụmụ oriri, karịsịa nwere sodium ion.

3.Gipertonicheskoe na-amalite mgbe afọ ọsịsa so retching egbochi ọmụmụ eruba ke idem ọnụ ma ọ bụ ovadozu nke ụfọdụ bekee akpasu ọzọ urination. The mmiri mmiri ọzọ na-aga site na mkpụrụ ndụ n'ime extracellular ohere iji nọgide na-enwe osmotic nsogbu. Ugboro abụọ dehydrated mkpụrụ ndụ na-emerụ ha na-arụ ọrụ na-ebelata ke olu. Karịsịa dị ize ndụ ọnụ ke ụbụrụ olu, nke na-eduga subdural hemorrhage.

mgbaàmà

Anyị na-ewere na dị akọwa nhazi ọkwa nke hypovolemic ujo. Clinic steeti a, irrespective nke ihe mere, ọ na-akpata banyere otu. Na reversible ogbo, onye ọrịa bụ na supine ọnọdụ, akpọ mgbaàmà nwere ike ịbụ na-anọghị. mbido ihe ịrịba ama nke nsogbu ndị ahụ bụ:

- palpitations;

-small ẹsụhọde ọbara mgbali;

coldly clammy ikpa ke nsọtụ (n'ihi a ọnụ perfusion);

-n'ụzọ sara mbara e akpịrị ịkpọ nkụ ihicha egbugbere ọnụ, mucous ke inua, enweghị mmiri.

Na-atọ ogbo, ujo mbụ mgbaàmà ghọọ ndị ọzọ akpọ.

Ọrịa na-kwuru, sị:

-tahikardiya;

-Reduction ọbara mgbali n'okpuru oké egwu ụkpụrụ;

-Violation ume;

-oliguriya;

coldly na aka (ọ bụghị nanị na aka na ụkwụ);

-mramornost akpụkpọ / ma ọ bụ ịgbanwe ha na agba nkịtị ka icha mmirimmiri cyanotic;

-nitevidny usu;

-mụ nsogbu na aka, ha na-acha na agba mgbe mwepụ nke ibu na-belata ihe karịrị 2 sekọnd-etinye norm. Otu ọgwụ nwere hemorrhagic ujo. Nhazi ọkwa nke ya nkebi, dabere na olu nke ọbara na-ekesa na arịa e ji mara n'ihu na-agụnye:

-on reversible adọ tachycardia ka 110 gafere kwa nkeji;

-on ikpe reversible - tachycardia nke 140 gafere / min;

-on irreversible - obi ọnụego n'elu 160 gafere / min. Na a dị oké egwu ọnọdụ usu-apụghị nụrụ, na systolic ọbara mgbali dara 60 mm HG ma ọ bụ obere. kọlụm.

Mgbe akpịrị ịkpọ nkụ bụ ike hypovolemic ujo mgbaàmà na-kwukwara, sị:

-suhost mucous;

-reduction ụda eyeballs;

y ụmụ ọhụrụ omission nke a nnukwu fontanelle.

Ọ niile mpụga anya, ma n'ụzọ ziri ezi ekpebi ókè nke nsogbu, na-eduzi laabu nnyocha. Onye ọrịa ozugbo rụrụ ọbara onwu, chọpụta larịị nke hematocrit, acidosis, na mgbagwoju ikpe, chọpụta ihe plasma njupụta. Ọzọkwa, ndị dọkịta na-potassium larịị akara, isi electrolytes, creatinine, ọbara urea. Ọ bụrụ na ọnọdụ ikike, ekpep nkeji na obi ọrịa strok olu na etiti venous nsogbu.

traumatic ujo

Nke a na ụdị nke ujo na ọtụtụ ụzọ yiri hemorrhagic, ma ya na-akpata nwere ike na-eme naanị mpụga ọnyá (ima, gunshot, Burns) ma ọ bụ esịtidem (agbawa nke anụ ahụ na akụkụ, n'ihi na ihe atụ, site na a siri ike igbu). Akpasasị uche ujo na-fọrọ nke nta mgbe esonyere a ike mfe mgbu, n'ihu njọ ọnọdụ nke aja. Na ụfọdụ ndị si na-akpọ a na-egbu mgbu ujo, na-eduga na ọnwụ. Ogo traumatic ujo kpebisiri ike ọ bụghị nke ukwuu ego nke furu efu ọbara, ole nke a ọnwụ nke na-agba. Nke ahụ bụ, ọ bụrụ na ọbara doo ahụ ji nwayọọ nwayọọ na, na aja a mma ohere gbapụ. Ọzọkwa ka njọ ọnọdụ na ogo mkpa nke mebiri emebi ngwa nke ahu. Nke ahụ bụ, na-adị ndụ na-shot na ogwe-aka-ya ga-adị mfe karịa na ọnya ahụ n'isi. Ndị a bụ ndị na atụmatụ nke a na-akpasasị uche na-akpata. Nhazi ọkwa nke ala nke ogo ka ndị a:

Primordial ujo (emee fọrọ nke nta ozugbo mgbe ihe ọjọọ);

-vtorichny ujo (egosi mgbe ịwa ahụ, mwepụ nke bundles, n'okpuru ọzọ ibu na otụk ihe atụ, ya iga).

Ke adianade do, traumatic ujo hụrụ abụọ n'ụzọ - erectile na torpid.

Mgbaàmà nke erectile:

-strong mgbu;

-neadekvatnoe agwa (ákwá, overexcitation, nchegbu, mgbe ụfọdụ, mbuso agha);

-tremor;

Ọsụsọ coldly;

-Advanced ụmụ akwụkwọ;

-tahikardiya;

-tahipnoe.

Mgbaàmà torpid:

-bolnoy aghọ indifferent;

-Over n'ebe ahụ, ma onye ahụ ikwu ya;

-arterialnoe mgbali sharply mbelata;

-glaza agwụ;

-poyavlyaetsya icha mmirimmiri anụ ahụ, cyanosis egbugbere ọnụ;

-oliguriya;

-oblozhennost asụsụ;

-suhost mucous;

coldly ajirija anaghị eme ihe, ma na akpụkpọ tụfuru ya turgor;

-puls thready;

-cherty ihu mụwo.

Nsí Achọ ujo, nhazi ọkwa

Nke a ọnọdụ emee ya ruru ka penetration n'ime ahu nke ọrịa, ie, nje na nje bacteria na-eme ka oké mmenaanya nke ha na-eme. Ọtụtụ mgbe ikpe mara na agha ujo streptococcus, Staphylococcus, Salmonella, pseudomonas aeruginosa. Ha na-abanye ahụ, dị ka site na-emeghe ọnyá (puerperal sepsis, Burns, ịwa ahụ) ma ọ bụ na-enweghị (ịba, ọrịa AIDS, tracheitis, Sinusitis, oyi baa, influenza, na ọrịa ndị ọzọ).

Pathogenic microorganisms emepụta superantigens na rụọ ọrụ T mkpụrụ ndụ, na ndị ọzọ T mkpụrụ ndụ. Ndị, n'aka, secrete cytokines, na-eme ka onye ọrịa ahụ dịghịzi usoro na-ewute ya, ma a nnukwu ego nke nsị tọhapụrụ ghọọ ọbara ya, na-eme na-egbu egbu na-akpata. The nhazi ọkwa nke a ọnọdụ gosiri ọdịiche atọ nkebi:

1.Obratimaya. Na nke a ọbara mgbali nwere ike nkịtị, ọ na-anọgide doro anya nsụhọ, anụ na-aghọ pink ma ọ bụ ọbara ọbara. Onye ọrịa na-erughị ya ala, mkpesa nke mgbu na ahụ ma ọ bụ na afo, ọ hụrụ afọ ọsịsa, ahụ ọkụ na mgbe ụfọdụ vomiting.

2.Chastichno reversible. Mgbaàmà: fever, adịghị ike usu, tachycardia, ebelata nrụgide, ọrịa lethargic, ya mmeghachi omume gbochie.

3.Neobratimaya. Mgbaàmà: mkpụmkpụ nke ume, ụfụ, anụ cyanosis, usu-adịghị ike, ọbara mgbali n'okpuru oké egwu, onye ọrịa bụ amaghị ihe ọ bụla.

Nhazi ọkwa nke anaphylactic ujo

Ndị dị otú ahụ a ọnọdụ na-adị mgbe ingested nsị si agwọ ata aru, spiders, ghọsịrị ebu ndị ọzọ dị ndụ, site na-ewere ụfọdụ ọṅụṅụ na nri, na site na ochichi nke ọgwụ ọjọọ na-nyere ndị ọrịa allergens. ndị dị otú ahụ a mmeghachi omume esiwak nyere procaine penicillin, organic. Shock nwere ike ime n'ime sekọnd ole na ole mgbe na kọntaktị na allergen aru ma obu site na a ogologo oge, na mee elu mee mmeghachi omume mere, na njọ prognosis. E nwere ọtụtụ iche nke omume nke anaphylactic ujo:

-tipichnaya (nācha ọbara-ọbara na aru na saịtị (injection saịtị), ma ọ bụ abdominal mgbu, akpịrị na-edeghị ede kọntaktị allergen, decompression, mkpakọ nke ọgịrịga n'okpuru ekwe omume afọ ọsịsa ma ọ bụ vomiting);

-gemodinamicheskaya (na akpa ebe obi ọrịa);

-asfiksicheskaya (akụkụ okuku ume na ọdịda, dyspnea);

-tserebralnaya (malfunction nke Central ụjọ usoro, ụfụ, amagh onwe, akụkụ okuku ume na njide);

-abdominalnaya (nnukwu afo).

ọgwụgwọ

N'ihi na ihe ngwa ngwa edinam bụ oké mkpa na ezi nhazi ọkwa nke ịtụnanya. Ngwa Ngwa mberede elekọta na nke ọ bụla nwere ya kpọmkwem, ma mee elu mee ya amalite-nyere, onye ọrịa a mma ohere. Na nzọụkwụ irreversible ọnwụ a hụrụ na ihe karịrị 90% nke ikpe. Akpasasị uche ujo mkpa ozugbo igbochi ọbara ọnwụ (tourniquet) napụtanụ merụrụ ụlọ ọgwụ. E buru igba ogwu n'akwara saline na colloidal ngwọta, mmịnye ọbara, plasma, anesthetized, ma ọ dị mkpa, ejikọrọ a ume.

Na anaphylactic ujo ozugbo ndinọ epinephrine, onye ọrịa na-intubated na asphyxia. Ekemende ndinọ corticosteroids na Antihistamines.

Mgbe na-egbu egbu ujo rụrụ oke ọmụmụ ọgwụ na ike ọgwụ nje, immunomodulators glucocorticoid plasma.

Mgbe hypovolemic ujo isi ihe aga-eme bụ iji weghachi ọbara ọkọnọ nke niile akụkụ, mkpochapu hypoxia, na normalisation nke mgbali nke obi. Mgbe ujo kpatara akpịrị ịkpọ nkụ, ọ na-Ọzọkwa chọrọ resumption nke furu efu olu nke ọmụmụ na electrolytes niile.