Daliilka syndrome Mendelson ee. cudurka daran ee neefsashada

Dad badan oo dhibaatooyin ku dhici kara dadka bukaanka ku jira daryeelka degdegga ah. Mid ka mid ah dalalka waa Mendelson ugu daran ee syndrome.

Waa maxay nooca cudurada?

By Mendelson ee syndrome waxaa inta badan loogu tala galay obstructive pulmonary disease la lesions unugyada sambabada (pneumonitis), horumarinta ku saabsan asalka ah ka dhicin oo casiir gastric galay hawo. Xaaladani waxay markii ugu horaysay la tilmaamay in 1946. Waxaa la arkay in bukaanka u daran kuwaas oo lahaa dhaawac madaxa ah, qalliin caloosha (gaar ahaan caloosha) iyo dhalmada. Xaaladaha intooda badan, abuuray ee noocan oo kale ah cudurada waxaa la kabuubyeyn (sabab u ah waxay dejineysaa muruqyada siman). Loogana hortegi ee cabirida xaalada muruqa dabacsan iyo lumin dhacaa rajo gelin (la neefsado) ku jira gastric (sida caadiga ah casiir gastric oo kaliya). Natiijadu waxay tahay guuldarro sida geedka bronki iyo unugyada sambabada. Xaaladda waa mid aad u halis ah, keeni kartaa dhimasho haddii ku fashilmeen in ay bixiyaan gargaar ku haboon. Waa in ay fahmaan in faahfaahin dheeraad ah sababta ay jirto sida cudur xun, iyo in ay tahay in la qabto.

sababaha

By horumarinta Mendelssohn ee syndrome keeni karaa cuduro dhowr ah. Kuwaas waxaa ka mid ah:

• Pathology ee habka dareemayaasha jirka (dhaawaca maskaxda oo daran, dhaawac soo gaara dareen sidaha glossopharyngeal, xoojinta qaanuunka dareemayaasha jirka unugyada parietal gastric iyo motility xubnaha godkii of mareenka caloosha iyo mindhicirka).
• Cudurada of mareenka dheefshiidka (Sheelada hiatal, achalasia).
• Cudurada of mareenka-mareenka (dhuunta gaaban, furma dhexeeya hunguriga iyo hunguriga).

Waxa intaa dheer in cuduradan, si pneumonitis keeni kara cuduro daran. saamayn badan ku saabsan horumarinta gelin iyo rajo gelin qalliin caloosha (by Samo falku of yaraynta xubnaha muruq iyo hoos jihada dambe hirarka peristaltic) iyo uurka (sabab u ah barakaca diaphragm). Tusaale ahaan, at saamiga qalliin ilaa 70% ee kiisaska.

Si kastaba ha ahaatee, sababta ugu badan oo casiir gastric galaya mareenka hoose waa wax yaabaha a dadban, sababtoo ah boos qaldan ee bukaan-socodka oo itaaldarrada endetarms- wadnaha.

pathogenesis ee pneumonitis Doonidba

Cudurku wuxuu ku yeesho sabab u lesions unugyada pulmonary iyo bronki Aashito ku jira caloosha. Waxana uu yeesho galleeyda coagulative (kaas oo, mar kale, waxaa sabab u ah tallaabada of acid on xabka bronki). Sidaas darteed awoodda secretory bronki waa la dhimay, taas oo horseedaysa in ay issushivaniyu. acid isku midka ah daalaeday galay sambabada, wuxuu keenaa horumarinta pneumonitis - caabuq aseptic unugyada sambabada. sambabada jaban dusha neefsashada, hoos jiilka of surfactant. Waxaas oo dhan waxay keenaysaa in la kordhiyo fudaydkii ee jirka ku yidhi (sabab u foomkan iyo qarsan laba heley: neef - inta badan saamayn ku sambabbada ah, iyo obstructive - la nabar ah oo unug sambabada iyo horumarinta xirma syndrome). ilaa xad waxaa go'aamiya pH ah oo casiir gastric (hoose waa, ka acid dheeraad ah ku urursan, dhaawaca uu ka badan). The isbedel ugu daran waxaa lagu arkay Alfiyoli ah.

Eebbe on heerka Alfiyoli ah

Inta badan wada hadal cudurka gaar ah iyo Readers calaamadaha la xiriira waxaa lagu martiqaadayaa inay sawir. Cudurada sida pneumonitis, sida caadiga ah qaar ka mid ah sifooyinka dibadda gaar ah ma kala duwan yihiin. Laakiin hadii aad fiiriso meesha ay dhibaatadu saameysey oo unug dhex microscope ah (taas oo badanaa laga sameeyaa furitaanka), waxaa suurto gal ah si loo ogaado isbedel qaarkood.

Sidaas darteed ka mid ah hababka kor ku xusan iyo sarkhaansan cuf dhibciyo Aashito galay Alfiyoli ah. Waxaa, sababta oo ah saamaynta degaanka on nudaha alveolar, formation of effusion (inta badan dhiigbaxa). Sidaas darteed, waxaa la soo koraya a barar sambabada dhiigbaxa. Under saameynta ay nabaad in Alfiyoli arkay luma fibrin, iyo sidoo kale wax lays ee unugyada dhiigga dhex xuub dhulka hoostiisa (in leukocytes gaar ah iyo macrophages). Sidaas darteed, wax soo saarka ee falgalka horumarinta galleeyda oo derbiyadaada alveolar ay sabab u tahay qaab-dhismeedka sambabka oo loo jeediyo. In meel weelasha lagu arkay dhaawac endothelial iyo formation of microthrombi. Waxaas oo dhan waxay keenaysaa in maadoyinka kordhay ee dareeraha ah iyada oo loo marayo xuub iyo formation of atelectasis. Sida caadiga ah ay sabab u yihiin waxa soo koraya obstructive pulmonary disease. Haddii acid ah ee sanbabada ayaa waxaa ka heli gogo 'oo cunto nuxurrada ama hay'adaha kale ee ajnabiga ah, sida dhismaha bararka dhiigbaxa weheliso horumarinta falcelinta tartiib ah u formation granuloma ku wareegsan ayaa galay jidhka. Noocan cudurka horumar dheeraad ah si tartiib ah, laakiin ka sii daran.

daliilka Clinical cudurka

Sidee baad u go'aamiyo in bukaanka uu leeyahay pneumonitis rajo gelin? Gaar ah "photo cudurka" matali karaa sida soo socota:

• Rugta ugu horrayn doona ay sabab u tahay saamaynta tooska ah ee acid on xuub-axaleedka. Waxaa jira sawir caafimaad ee ba'an oo aad u daran ay neefta - bronchospasm, dhiigrooraan sii kordhaya, neefta.
• nidaamka wadnaha-vascular lagu arkay tachycardia, dhibic ee cadaadiska dhiigga. Xaaladaha qaarkood, waa wadnaha ama carqalad ah laxanka. Dhacdo hoos u wax soo saarka wadnaha iyo kordhiyaa cadaadiska gudaha halbowleyaasha pulmonary. Sababo la aan caadi ahayn sarrifka gaaska arkay horumarinta alkalosis neefsashada iyo dheefshiidka. The ka weyn mugga unugyada sambabka ku dhuftay, ka culus ee bukaan-socodka, iyo adag waxa ay noqon doontaa in la daaweeyo.
• Sida caadiga ah, lesions iyo calaamadaha neefta muuqdaan 2 saacadood, ugu yaraan - dambe. Mararka qaar calaamadaha laga tirtirayaa karo, iyo laxaadka ma dhacaan oo dhan.

Baadhista xanuunada

Aqoonsiga Mendelson ee syndrome - shaqo adag, tan iyo cudurada sida caadiga ah in bukaanka xoog u jilcay, oo ma uu yeesho had iyo jeer, sida aan kor ku sheegay, sawirka caafimaad oo laga yaabaa inuu dhaco. Waxa ugu horeeya si loo ogaado jiritaanka neefta (neefta oo ku qabata, hinraagid, dhiigrooraan). calaamadaha Hadalladaasu ma aha kuwa mar walba ay awoodaan in ay aqoonsadaan bukaannada ku jira hawo farsamo. The habka ugu saxsan ee lagu ogaado Mendelson ee syndrome waa raajada ama sambabada fluorography. Sawirka ma waxaad ka arki kartaa joogitaanka exudate ee sambabada, kordhinta ay airiness. Xaaladaha qaarkood, bedelkeeda wanaajiyey ee bronkie (caadi on radiograph ee qiyaas si toos ah hawomareenno ma la arki karo, oo waxaad iyaga ku calaamadee kartaa, kaliya haddii aad ka dhigi a darbo kooxda). Haddii bukaanka kaliya fluorography looga shakisan yahay firfircoon syndrome waxaa sabab u ah horumarinta galleeyda, laan embriyaha ee dhuunta wuxuu noqon doonaa arki karo iyo radiograph khadka.

daaweynta syndrome Doonidba

Haddii, si kastaba ha ahaatee, waxaa jiray rajo gelin ku jira gastric, daaweynta waa in ay bilaabaan isla markiiba. Tallaabada ugu horreysa waa in la saaro ka dib-u-galaya acid galay marinnada hawadu ee hoose. Si arrintan loo sameeyo (haddii xaalad bukaan-socodka) ayaa loo baahan yahay in kor headboard ee sariirta. Isla markiiba loo baahan yahay si ay ula qabsadaan hawo ee sambabada iyo in la siiyo oxygen dhiig wanaagsan. Sida caadiga ah, soo qoray qalabka neefsashada cadaadis wanaagsan go'aysa iyo ogsiijinka hyperbaric (isticmaalka nidaamka qalabka neefsashada, la socodka gaasas dhiig). All this ka hortagi doontaa aysiidh sumaysan.

Si loo yareeyo mugga unugyada sambabada nabar magacaabay glucocorticosteroids intravenously iyo qiyaas yar oo ah - intrabronhialno. Hormoonnada ogolaan habka ay joojiso qaybinta iyo waxa la xadido. antibiotics (sida caadiga ah cephalosporins iyo macrolides) ee loo isticmaalo ka hortagga. Waxaa sidoo kale waa in ay ahaataa sympathomimetics (si loo yareeyo formation of dheecaanka ee hawomareenno iyo sambabada).

dhibaatooyin syndrome

Marka dhibaatooyinka daaweyn wakhti bilaabay waxaa sida caadiga ah laga fogaadaa. Haddii goor dambe, rajo gelin syndrome waxay keeni kartaa cawaaqib khatar ah oo aan loo baahnayn.

Inta ka dib markii cudurka haddii la gudbey heerka burburka, markii danbe ku dhici kara wadne ama qaab joogto ah ee aamba ventricular. Haddii iyada xiray suurtogal ma aha, laakiin ma caban, waxaad ka bixi kartaa bukaanka iyada oo ay kormeerayaan therapist hoose oo keliya.

Dhibaatada kale waxay tahay horumarinta atelectasis pulmonary ama xirma chronic. Xaaladdan oo kale, habka of xasilinta noqon doonaa halkii dheer, iyo xoogga waxaa badanaa laga sameeyaa on yareeya calaamadaha, tan iyo markii cudurka tani waa mid aan bogsan karin.

Dhibka ugu daran waa pneumonitis dilaa. Gaar ahaan inta badan waxa ay ka dhacdaa kiisaska soo koraya syndrome Doonidba carruurta dhasha.

Ka Hortagga iyo saadaasha cudurka

Si looga hortago pneumonia rajo gelin darteed, waxaa loo baahan yahay si ay u fuliyaan adag oo ah ka mid ah hawlaha qaar ka mid ah. Ugu horayn, dhammaan bukaanka iyo dumarka ee shaqada, taas oo muujinaysa faragelinta hoos suuxinta guud waa in la faaruqiyo caloosha iyo mindhicirrada. Tani waxay tiraa arrin weyn ee horumarinta pneumonitis.

Ka hor inta suuxinta waxaa lagu talinayaa in ay ku mari xabadka X-rays si loo saaro ka kooban juice gastric hawo. Intubating bukaanka waa in la qaadeen xataa marka qofka bukaanka ah uu miyir qabo. Man dhigay si ay qaybta sare ee jirka ayaa wax yar ka soo sara kiciyey. Taana waxaa lagu gaarayaa by qabsado madaxa sariirta ama miiska qalliinka (halka laga fogaado suurtagalnimada ee ku jira wicking dadban ee nidaamka dheefshiidka ee mareenka neefsashada).

intubation Subject oo ku habboon diyaarinta bukaanka farsamada qaliinka, khatarta of Mendelson ee syndrome yar.

saadaasha cudurka waa sida soo socota: inta badan dhinto in 56 boqolkiiba bukaannada qaba pneumonitis marinka hawada la aasaasay. Haddii tallaabooyin sixid ah ayaa la bilaabay in hab wakhti, halista jahawareerka iyo dhimashada oo hoos u eber.