Kuphatikiza kwamapapo

Kuphatikizika kwamapapu ndi kutseka kwa mtsempha m'mapapu. Chifukwa chodziwika kwambiri cha kutsekeka ndi magazi.

Kuphatikizika kwamapapu kumachitika nthawi zambiri ndi magazi omwe amatuluka m'mitsempha kunja kwa mapapo. Mitsempha yamagazi yofala kwambiri ndi imodzi mumitsempha yakuya ya ntchafu kapena m'chiuno (m'chiuno). Mtundu uwu umatchedwa deep vein thrombosis (DVT). Magazi amatsekemera ndikupita kumapapu komwe amakhala.

Zomwe zimayambitsa zochepa zimaphatikizira ma thovu ampweya, madontho amafuta, amniotic madzimadzi, kapena matumbo a tiziromboti kapena maselo otupa.

Mutha kukhala ndi izi ngati inu kapena banja lanu muli ndi mbiri yokhudzana ndi magazi kapena zovuta zina zotseka. Kuphatikizika kwamapapu kumatha kuchitika:

• Pambuyo pobereka
• Pambuyo pa matenda a mtima, opaleshoni ya mtima, kapena stroke
• Pambuyo povulala kwambiri, kutentha, kapena kuthyoka m'chiuno kapena fupa la ntchafu
• Pambuyo pa opaleshoni, nthawi zambiri opaleshoni ya mafupa, olowa, kapena ubongo
• Pakati kapena pambuyo paulendo wautali kapena pagalimoto
• Ngati muli ndi khansa
• Mukamwa mapiritsi oletsa kubereka kapena mankhwala a estrogen
• Kupuma kwa nthawi yayitali kapena kukhala pamalo amodzi kwa nthawi yayitali

Zovuta zomwe zingayambitse magazi ndi monga:

• Matenda a chitetezo cha mthupi omwe amalepheretsa magazi kuundana.
• Matenda obwera nawo omwe amachititsa kuti magazi aziundana. Vuto lina lotere ndi kusowa kwa antithrombin III.

Zizindikiro zazikulu za kuphatikizika kwamapapu zimaphatikizapo kupweteka pachifuwa komwe kungakhale izi:

• Pansi pa chifuwa kapena mbali imodzi
• Wakuthwa kapena wobaya
• Kutentha, kupweteka, kapena kuzimiririka, kumverera kwakukulu
• Nthawi zambiri zimawonjezeka ndikupumira kwambiri
• Mutha kugwada kapena kugwira chifuwa poyankha ululu

Zizindikiro zina zitha kuphatikiza:

• Chizungulire, mutu wopepuka, kapena kukomoka
• Mulingo wochepa wa oxygen m'magazi (hypoxemia)
• Kupuma mofulumira kapena kupuma
• Kuthamanga kwa mtima
• Kukhala ndi nkhawa
• Kupweteka kwa mwendo, kufiira, kapena kutupa
• Kuthamanga kwa magazi
• Kutsokomola mwadzidzidzi, mwina kutsokomola magazi kapena ntchofu zamagazi
• Kupuma pang'ono komwe kumayambira modzidzimutsa mutagona kapena poyesetsa
• Malungo ochepa
• Khungu la Bluish (cyanosis) - locheperako

Wothandizira zaumoyo adzakuyesani ndikufunsani za zidziwitso zanu komanso mbiri yazachipatala.

Mayeso otsatirawa a labu atha kuchitidwa kuti muwone momwe mapapu anu akugwirira ntchito:

• Mitsempha yamagazi yamagazi
• Kutulutsa oximetry

Mayesero otsatirawa angathandize kudziwa komwe magazi amagawira:

• X-ray pachifuwa
• CT angiogram ya chifuwa
• Kutulutsa mpweya m'mapapo mwanga / perfusion scan, kotchedwanso V / Q scan
• CT pulmonary angiogram

Mayesero ena omwe angachitike ndi awa:

• Chifuwa cha CT
• Kuyesa magazi kwa D-dimer
• Kuyesa kwa Doppler ultrasound kwamiyendo
• Zojambulajambula
• ECG

Kuyezetsa magazi kumatha kuchitidwa kuti muwone ngati muli ndi mwayi wowonjezera magazi, kuphatikiza:

• Mankhwala a Antiphospholipid
• Kuyesedwa kwa majeremusi kuti muwone zosintha zomwe zimakupangitsani kuti mukhale ndi magazi
• Lupus anticoagulant
• Mapuloteni C ndi milingo ya mapuloteni S

Kuphatikizika kwamapapu kumafuna chithandizo nthawi yomweyo. Mungafunike kukhala mchipatala:

• Mudzalandira mankhwala ochepetsa magazi ndikupangitsa kuti magazi anu asapangike.
• Pakakhala zovuta, zowopsa m'mapapo mwanga, chithandizo chitha kuphatikizira kusungunuka kwa mutu. Izi zimatchedwa mankhwala a thrombolytic. Mukalandira mankhwala osungunulira magazi.

Kaya mukufunika kukhala mchipatala kapena ayi, mufunika kumwa mankhwala kunyumba kuti muchepetse magazi:

• Mutha kupatsidwa mapiritsi oti muzimwa kapena mungafunike kudzipatsa jakisoni.
• Kwa mankhwala ena, mudzafunika kuyesa magazi kuti muwone kuchuluka kwanu.
• Kutenga nthawi yayitali bwanji kumwa mankhwalawa kumadalira chifukwa komanso kukula kwa magazi anu.
• Wothandizira anu azikambirana nanu za kuopsa kokhala ndi mavuto otaya magazi mukamwa mankhwalawa.

Ngati simungathe kumwa magazi ochepetsa magazi, omwe akukuthandizani angafunse opareshoni kuyika chida chotchedwa inferior vena cava fyuluta (fyuluta ya IVC). Chida ichi chimayikidwa mumitsempha yayikulu m'mimba mwanu. Imalepheretsa kuundana kwakukulu kumitsempha yamagazi yamapapu. Nthawi zina, fyuluta yakanthawi imatha kuyikidwa ndikuchotsedwa pambuyo pake.

Zimakhala zovuta kuneneratu kuti munthu akuchira bwanji m'mimba ya m'mapapo. Nthawi zambiri zimatengera:

• Zomwe zidayambitsa vutoli poyamba (mwachitsanzo, khansa, opaleshoni yayikulu, kapena kuvulala)
• Kukula kwa magazi m'mapapo
• Ngati magazi atsekeka pakapita nthawi

Anthu ena amatha kukhala ndi mavuto amtima komanso am'mapapo okhalitsa.

Imfa imatheka mwa anthu omwe ali ndi vuto lalikulu la m'mapapo mwanga.

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911), ngati muli ndi zizindikilo za m'mapapo mwanga.

Ochepetsa magazi atha kulembedwa kuti athandize kupewa DVT mwa anthu omwe ali pachiwopsezo chachikulu, kapena omwe akuchitidwa opaleshoni yoopsa.

Mukadakhala ndi DVT, omwe amakupatsani mwayi amakupatsani masokosi okakamiza. Valani monga mwalangizidwa. Zidzakuthandizani kuti magazi aziyenda bwino m'miyendo mwanu ndikuchepetsa chiopsezo chamagazi.

Kusuntha miyendo yanu nthawi zambiri mukamayenda maulendo ataliatali, kuyenda pagalimoto, ndi zina zomwe mukukhala kapena kugona kwa nthawi yayitali kungathandizenso kupewa DVT. Anthu omwe ali pachiwopsezo chachikulu chotseka magazi angafunike kuwombera magazi wocheperako wotchedwa heparin akakwera ndege yomwe imatenga nthawi yayitali kuposa maola 4.

Osasuta. Mukasuta, siyani. Azimayi omwe akutenga estrogen ayenera kusiya kusuta. Kusuta kumawonjezera chiopsezo chokhala ndi magazi m'magazi.

Venous thromboembolism; Mapapu magazi; Kuundana kwamagazi - mapapu; Kuphatikiza; Chotupa; Embolism - m'mapapo mwanga; DVT - kuphatikizika kwamapapu; Thrombosis - m'mapapo mwanga embolism; Thromboembolism m'mapapo mwanga; Pe

• Mitsempha yakuya - kutulutsa
• Kutenga warfarin (Coumadin, Jantoven) - zomwe mungafunse dokotala wanu
• Kutenga warfarin (Coumadin)

• Mapapo
• Dongosolo kupuma
• Kuphatikiza kwamapapo

Goldhaber SZ. Embolism ya pulmonary. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 84.

Kline JA. Kuphatikizika kwa pulmonary ndi thrombosis yakuya yamitsempha. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 78.

Morris TA, Fedullo PF. Matenda oyenda m'mapapo. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 57.