Edema yepulmonary chirwere chinokonzerwa nehutachiona hunokonzerwa nekupindira kwekusina kuvhiringidza mvura kubva kumaploriri emaplora kusvika mukati me interstitium uye alveoli. Nemhaka yeizvi, pane kupesana kwakakosha kwekugovana kwegesi, oksijeni nzara inotanga, kunopedza maviri uye nhengo.
Mhando dzeplmmary edema
OL ndiyo mamiriro ekubatsira kunofanira kupiwa pakarepo. Iyo inogona kubuda semugumisiro wekushingaira kwenyama, uye usiku - pazororo. Dzimwe nguva mapurmita edema anova nharo, iyo inokurwisana nechekuita kwekuputsa kwekupararira kwemvura inhengo. Zvikepe hazvigoni kurarama nekuwedzerwa kweropa kunosvibiswa kubva mumapapillaries, uye mvura iri pasi pekudzvinyirira inopfuura ichienda mu-alveoli. Nemhaka yeizvi, mapapu anomira zvakanaka kuita mabasa avo ekutanga.
Kubudirira kwe OL kunoitika muzvikamu zviviri. Kutanga ropa rinopinda mukati me interstitium. Ichi chiitiko chinonzi interstitial pulmonary edema. Neyo, parenchyma yakanyatsorongedzwa nemvura, asi lumen ye alveoli haipindi mutrudate. Kubva kumativi epakati, kana kukamanikidzwa kusingaderedzi, ropa rinopinda mukati mearveoli. Muchiitiko ichi, alveolar pulmonary edema inowanikwa.
Chirwere chemaremu chinogona kuenzanisirwa nenguva yekufambiswa:
- Zvakanaka zvinowanikwa mumaawa 2-4.
- Zvinotora maawa akawanda kuti uwedzere nguva inopera. Inogona kugara kwezuva kana kupfuura.
- Mheni inokurumidza ndiyo yakaipisisa. Inotanga kamwe kamwe, uye maminetsi mashomanana mushure mokutanga kwekufa kunoitika.
Cardiogenic pulmonary edema
Zvirwere zvakasiyana-siyana zvinogona kukonzera dambudziko reA. Cardiac pulmonary edema inogadzika apo mwoyo unobatanidzwa mukugadzirisa zvirwere. Zvirwere izvo zvinokonzera kukanganisa mu systolic uye diastolic mabasa echokusiya ventricle. Tambudzika kubva kune dambudziko revanhu vakawanda vane ischemic heart disease. Mukuwedzera, pulmonary edema ine myocardial infarction, chirwere chepfungwa, chirwere chemwoyo chinoitika. Kuti uone kuti OL ndeyechokwadi, unofanirwa kutarisa pulmonary capillary pressure. Inofanira kunge inopfuura 30 mm Hg. Art.
Noncardiogenic pulmonary edema
Rudzi urwu rwe OL runogona kukonzerwa nehutano hwakasiyana-siyana, huchitungamirira kune rimwe dambudziko - kutyora kwezvakakosha zvealveolar membrane. Zvirwere zvinokonzera kusina-cardiogenic edema:
- pneumonia (zvose mabhakitiriya uye utachiona);
- DIC chirwere;
- chimiro chakanyanya chekushaya simba kwepamuviri;
- dambudziko remapapu.
Dambudziko guru nderekuti mwoyo uye kwete-mapaimia yemapemmasa edema yakaoma kusiyanisa pakati pemumwe. Kuti zvive zvakanyatsosiyanisa dambudziko racho, nyanzvi inofanira kufungisisa nhoroondo yezvokurapa kwevarwere, kuongorora myocardial ischemia, uye kuenzanisa pakati pehumodynamics. Muchizivo chekuongorora, chirwere chakasiyana-siyana chinoshandiswawo-chiyero chejamu rinodzvinyirira. Kana nhamba yacho iri pamusoro pe 18 mm Hg. Art. Ive edema yemwoyo. Nechinetso chekusava nemoyo wakabva, kupikisa kunoramba kuripo.
Dhiyabhorosi edema edema
Nyika inouya nekuda kwe:
- kuwedzera capillary kukwana;
- kuputsa kwekuvimbika kwavo;
- kukanganisa kwemashoko makuru anoitika mu-neurovegetative arc;
- oksijeni nenzara.
Edema inotyisa ine zvimwe zvakasarudzwa. Ane nguva yakajeka yokufungidzira. Mukuwedzera, zviratidzo zvacho zve OL zvinosanganiswa nezviratidzo zvekemikisi yekupisa yemapapu uye mapfupa ekufema maitiro. Mishonga inoparadzanisa nguva huru huru yekukura kwedambudziko:
- Kune chekutanga, kuratidzwa kwezvirwere zvinonzwisisika chiratidzo: kukanganiswa, dyspnea yakaoma, kusagadzikana kwechrymation. Mumatambudziko akaoma, kumira kunofadza kwemoyo uye kupumha kunogona kuitika.
- Munguva yechipfuva, nguva yekushungurudza yakaderera. Inotora kubva mumaawa mashomanana kusvika kumazuva mashomanana (asi semitemo, haisati yapera maawa 4 kusvika ku6). Kunyange zvazvo hupenyu huripo hwemurwere huri hwakasimba, zviratidzo zvekuongorora zvinogona kugadzirisa zviratidzo zvekusvika edema: kufema kunowanzogara, iko kunoterera kunoderedza.
- Chikamu chechitatu chinoratidza kuzvimba. Anorara pamusoro pezuva. Munguva iyi, kutonhora kunomuka, neutrophilic leukocytosis inokura.
- Mukupedzisa, pane zviratidzo zvezvinetso, izvo zvinogona kuva zvirwere zvakadaro, sepumumonia kana pneumosclerosis.
Chii chinokonzera pulmonary edema?
Zvikonzero nei mapapu achizununguka, akawanda. Pakati pezvinhu zvikuru ndeizvi:
- sepsis (kazhinji kacho kuchinana nechekuguma kwekupinda kwehupfu muropa);
- kunyanya kuderedza zvinodhaka;
- pneumonia ;
- kunyanya kuderedza mamwe mishonga (iyo inotyisa zvikuru inopesana nezvokuvhiringidza zvinodhaka uye mishonga inonzi cytotoxic);
- kuora kwemavara kumapapu;
- kutyisa nehupfu;
- stasis mumutambo wekutanga wekupararira (wakaona ne-bronchial asthma, emphysema nezvimwe zvirwere zvemapapu);
- chisingagumi kana kuti chichiderera zvishoma nezvishoma muhuwandu hweprotini muropa (sekusvika ku cirrhosis, nephrotic syndrome nezvimwe zvirwere zvepfungwa);
- enteropathy;
- chimiro chakanyanya chekushaya simba kwepamuviri;
- kutyisa nehini ;
- aspirations of the stomach;
- pneumothorax ;
- gara pakakwirira;
- kunyanyisa kusingadzorwi kusvitsa kwehuwandu hwemvura.
Pulmonary edema ane mwoyo kusakatika
Ichi chirwere ndicho chikwata chekupedzisira chekuwedzera kwehutano muhutachiona. Edema yepulmonary inechirwere chepfungwa inokura mumhando dzakashata dzemwoyo kusakatika nekuvhiringidzika kwegadziriro yacho yose. Cardiogenic edema inoratidzirwa nekukanganiswa nekubuda kwechivara chinopenya. Mune zviitiko zvakanyanya zvakaoma, murwere anoona kushaya kwakanyanya kwe okisijeni uye kurasikirwa nekuziva. Kuporesa kwevarwere kunowedzera pasina uye kusingabatsiri, naizvozvo, kuputika kwemapapu kunodiwa.
Pulmonary edema pakakwirira
Kukundwa kwepamusoro-soro mutambo unotyisa uye kwete nekuda kwekuda kwekutendeuka kwezvipembenene. Kukurira kwemapapu mumakomo kwakajairika. Uye inogona kutomuka mune vane ruzivo kukwira uye kukwira. Iyo yakakwirira iwe unokwira makomo, iyo oxygen shoma muviri wako unogamuchira. Pakukwirira, kupera kunowira pasi, uye ropa rinopfuura nemapapu harina kuwana yakakwana yemhepo inobatsira. Somugumisiro, mvura yacho inowedzera mumapapu. Uye kana iwe usingabatsiri nekuputika kwemapapu, munhu angafa.
Edema yemapulmonary muvete vakarara
Muviri womunhu hauna kuenzaniswa kuti uve munzvimbo yakanyanyisa kwenguva yakareba. Nokudaro, vamwe vanokanganisa varwere vanotanga kusangana nenzira ye OL. Zviratidzo zvechinetso chacho zvakafanana nematambudziko anokonzerwa nezvirwere zvakakomba, asi zvishoma nyore kubata chirwere ichi chemapemmine, nokuti inonyatsozivikanwa nei yakaratidzwa.
Uye pamubhedha varwere, pulmonary edema inokonzera zvikonzero zvinotevera: munzvimbo yeupine zvishoma nemhepo inoputirwa. Nemhaka yeizvi, ropa riri mumapapu rinoderera, uye zviratidzo zvinowedzera zvinokura. Sputum, iyo ine zvipembenene zvinokonzera, inowedzera, uye inogadzirisa iyo yakananga yakaoma. Somugumisiro, kusagadzikana kwezvirongwa hunobudirira, humwe hunyoro hunokura.
Pulmonary edema - zviratidzo, zviratidzo
Zviratidzo zvebudiriro uye zvekare ndezvimwe zvakasiyana. Iyo yekupedzisira inokura zvishoma nezvishoma. Yokutanga "kumedza", inonyevera pamusoro pechinetso, inopera kufema. Pakutanga inomuka bedzi panguva yekuedza, asi nekufamba kwenguva, kufema kuchave kwakaoma kunyange mune imwe nzvimbo yekuzorora zvakakwana. Muvarwere vakawanda, zvakafanana nekupererwa kwepfufu, zviratidzo zvepemmayadema zviratidzo zvinoratidzirwa, semuenzaniso, kufema nekukurumidza, dutu, kubata, kushaya simba. Kuratidza kuti njodzi inogona kuva iyo nzira yekuteerera kumapapu - kushamisa, kugurisa uye mhere-mhere inonzwika mu stethoscope.
Acute pulmonary edema haisi nyore kuona. Inowanzoratidzwa usiku, panguva yokurara. Mumwe murume anomuka kubva pakurwiswa kwekurwadziwa kukuru. Inobatanidza nhamo, nekuda kwekuti kurwisa kunowedzera. Pashure penguva, kukohwa, pallor, kutumidzwa cyanosis, kutonhora kunotonhora, kudedera, kupenya kurwadziwa mubhokisi kunowedzera kune zviratidzo zviripo. Muchiitiko chekuwedzera edema, kuvhiringidzika kunogona kuitika, kukanda kweropa kunogona kuwira, kana kuderedza - kana kusatongedzerwa zvachose - nehutachiona.
Edema yemapulmonary - kurapwa
Therapy ye AL inofanira kuve yakagadzirirwa kuderedzwa kuitira kuti zvizobvisa zvachose zvikonzero zvikuru zvakakonzera kuitika kwayo.
Heino nzira yekurapa pulmonary edema:
- Kutanga, zvose zvinogona kuyerwa zvinofanira kutorwa kuti kuderedze kuputika kweropa kumapapu. Kuita izvi kunobatsira vasodilator, diuretics, nzira yekuisa ropa kana kushandisa tourniquet.
- Kana izvi zvichibvira, zvakakosha kupa mamiriro ezvinhu ekubuda kweropa-mashoma - kuburikidza nekukurumidza kuparadzaniswa kwepfungwa uye kuderedza chirwere chepachiviri chemaitiro.
- Oxygen therapy inobatsira kubvisa zviratidzo zvepermmary edema.
- Zvakakosha kupa murwere nerunyararo uye kumudzivirira kubva mumamiriro ezvinhu anonetsa.
- Mumatambudziko akaoma zvikuru, musanganiswa we 5 ml wemawa 96% ewaini uye 15 ml ye 5% glucose solution mumutambo kana intravenously inobvumirwa.
Pulmonary edema - rubatsiro rwekukurumidza, algorithm
Pangopera kuratidzwa kwekutanga kweA AL kunoonekwa, munhu anofanira kubatsirwa nguva isati yasvika. Kana zvisina kudaro, kurwisa kunogona kuunza rufu.
Emergency care for pulmonary edema inoitwa maererano nezvinoenderana nehgorgorithm inotevera:
- Munhu akakwidziridzwa anofanira kuiswa munzvimbo imwechete-akagara.
- Geza tsvina yepamusoro kubva kumapombi ne oxygen inhalation.
- Kutambudzika kwakanyanya kumira ne antipsychotics.
- Dzorerai mwoyo wekura.
- Normalize electrolyte uye balance-base base.
- Nekubatsira kweanorganics, kudzorera hydrostatic pressure mumutsara muduku.
- Chengetedza inzwi remidziyo uye ivhu re plasma ye intrathoracic.
- Kubatsira kokutanga kumapurmari edema kunosanganisira kuiswa kwegungwa glycosides.
Pulmonary edema - therapy
Kushungurudza kwakanyanya kunoenderera mberi muchipatara. Kurwisa dambudziko rakadaro semapurmari edema mishonga inoda zvinotevera:
- Morphine;
- Fentanyl;
- Furosemide ;
- Korglikon;
- Strofantin;
- Eufillin ;
- Aminophylline;
- antibiotics (munyaya yezvinetso zvebhakitiriya).
Pulmonary edema - mhinduro
OL anogona kuva nemigumisiro yakasiyana. Kana kutarisirwa kwekukurumidzira kwakapiwa panguva uye nenzira yakarurama uye inotevera inorapwa inoshandiswa neyanyanzvi vakagadzirirwa, kunyange dema yakawanda yeodema ichachengetwa zvakachengeteka. Nguva yakawanda hypoxia inogona kuguma nenzira dzisingagadziriswi munharaunda yepamusoro yenherera uye uropi. Asi mumatambudziko akaipisisa, kusangana kamwe kamwe kweedema yakaoma kunokonzera kukanganisa kwakaipa.
Pulmonary edema - kufungidzira
Zvakakosha kunzwisisa kuti AL inetso iyo inofanirwa kutarisana nayo isingakanganwi. Maererano nehuwandu, anenge 50% yevarwere vanopona. Asi kana zvaive zvichikwanisa kuongororwa kutanga kwepermmary edema, mikana yekuwedzera kuwedzera. Kuzvikudza, kukura nehupenyu hwemyocardial infarction, kunotungamirira kurufu mu 90% emhosva. Kudzorerwa mushure mekurwiswa kwevarwere kwemwedzi mishomanana kunofanira kuonekwa navanachiremba.