Nau'in buga definition

A rayuwa shi zai iya faruwa daruruwan yanayi da zai iya sa a buga. Mafi yawan mutane shirki da shi ne kawai tare da wani karfi juyayi buga, amma wannan shi ne kawai jera gaskiya. A magani, akwai wani tura rarrabuwa, ma'ana ta pathogenesis, mai tsanani, da yanayin canje-canje a cikin gabobin da kuma hanyoyin da za a magance su. Da farko aka bayyana a wannan yanayin fiye da 2 shekara dubu da suka wuce, sanannen Hippocrates, kuma da kalmar "tura" a cikin yi da magani gabatar a 1737 manyan mukaman likita Henri Ledran. Wannan labarin ya tattauna a daki-daki cikin dalilan da suka haddasa tura, rarrabuwa, asibitin, gaggawa kula a taron na wannan debilitating yanayin da kintace.

A ra'ayi na buga

Tare da bugu na Turanci za a iya fassara ta a matsayin m buga, cewa ba wata cuta, ba da alama kuma ba a ganewar asali. A duniya yi wannan lokaci ake mayar da martani da kwayoyin da tsarin wani karfi mai kara kuzari (external ko ciki), wanda tsarè aikin juyayi tsarin, metabolism, numfasawa da jini wurare dabam dabam. A nan ne lokacin da wani tura shiba. A rarrabuwa na wannan jiha bukatar gano hanyar buga, da mataki na ta mai tsanani da kuma fara tasiri magani. A hasashen za su zama da amfani kawai idan daidai ganewar asali da kuma nan da nan fara farfado da.

rabensu

Canada sani akan cututtuka Selye gano matakai uku, wajen guda ga kowane irin buga:

1.Obratimaya (sakamakon), a cikin abin da jinin samar da kwakwalwa, zuciya, huhu da kuma sauran gabobin da aka karya, amma bai daina ba. A hangen nesa ga wannan mataki ne kullum m.

2.Chastichno reversible (asma). A daidai wannan take hakkin jinin samar (perfusion) gagarumin, amma gaggawa da ta dace likita shiga tsakani yana da damar sabunta aiki.

3.Neobratimaya (m). Wannan shi ne mafi tsanani mataki a cikin abin da disturbances a cikin jiki ba za a iya mayar da har ma da mafi tsanani kiwon lafiya tasiri. Hasashen sa'an nan 95% fi karfinsu.

Wani rarrabuwa raba partially reversible mataki da 2 - subkompensatsionnuyu da dekompensatsionnuyu. A sakamakon haka, sun samu 4:

• 1st cika (da haske da ciwon m hangen nesa).
• 2nd subcompensated (tsakiyar nauyi cewa bukatar nan da nan farfado. Hasashen rigima).
• Uku dekompensatsionnaya (nauyi sosai, ko da nan da nan aiwatar da duk matakan da suka dace hasashen wani hadadden).
• 4th komowar (hangen nesa ne matalauta).

Our shahara Pirogov kasaftawa a Jihar buga biyu bulan:

-torpidnaya (da mãsu haƙuri a cikin mãyen ko musamman kasãla, ba ta amsawa ga samuwar kasashe yãƙi, ba amsa tambaya);

-erektilnaya (da mãsu haƙuri ne sosai m, ihu, yin yawa sume uncontrolled ƙungiyoyi).

daban na buga

Dangane da dalilan da ya kai ga wani rashin daidaituwa a cikin jikin ta tsarin, akwai daban-daban iri iri na buga. Nau'in cikin sharuddan Sistem sakulasan cuta irin:

-gipovolemichesky.

-distributivity.

-kardiogenny.

-obstruktivny.

-dissotsiativny.

Nau'in na pathogenesis na buga ne wannan:

-gipovolemichesky.

-travmatichesky.

-kardiogenny.

-septichesky.

-anafilaktichesky.

-infektsionno-mai guba.

-neyrogenny.

Kafaffen-hade.

hypovolemic buga

Complex lokaci ne sauki fahimta, da sanin cewa hypovolemia - a yanayin da jini circulates ta hanyar tasoshin a kasa da ake bukata girma. dalilai:

-obezvozhivanie.

-Extensive konewa (rasa mai yawa jini).

-pobochnye miyagun ƙwayoyi halayen, kamar vasodilators.

-large jini asara, inda gabobin sami kasa oxygen da kuma gina jiki, Ina nufin ya karye perfusion.

Hypovolemic tura saboda high jini da asarar za a iya gani a matsayin hemorrhagic buga. A rarrabuwa na wannan yanayin ne guda a matsayin cewa ci gaba Selye, kuma a wannan mataki ƙaddara da adadin jini ba sami gawarwakin. Shock ne ko da yaushe wani irin kariya na jiki a cikin wani matsanancin halin da ake ciki. Wancan ne, shi yana farawa jerin matakai, kuma sunã nẽman tsare da ayyukan da muhimmanci gabobin da shi ba, fãce da rayukan dukan tsarin. A musamman, tare da jini da asarar a jini spills madadin jini (kamar 10% na jimlar) daga hanta da saifa. Idan wannan bai isa ba, ko rage jini ya kwarara tsaya a nan ba to kasa muhimmanci ga arziki na jiki sassan, misali, zuwa extremities, don haka da cewa sauran jini ya isa ga perfusion na zuciya, kwakwalwa da kuma huhu. Nau'in buga ma'anar wadannan matakai biyu a matsayin partially reversible da invertible. A wannan yanayin, idan lokacin da za a dauki mataki, za ka iya nuna wani mutum daga wani Jihar buga, da kuma ci gaba da shi da rai.

Long aiki a kan madadin na jini perfusion da kuma samar da wasu gabobin a kudi na wasu kwayoyin iya ba. Saboda haka, idan ba ka fara farfado da, ya zo karshe (komowar) mataki. Inna lura da kayayyakin Haikalin, da matsa lamba a cikinta ƙwarai rage, jini gudãna zuwa periphery, ƙaruwa to m matakan perfusion gaira kwakwalwa, zuciya da kuma huhu.

dehydration

The ruwa a jikin mutum, dangane da shekaru da kuma jima'i, daga 60 zuwa 80%. A asarar kawai 20% na wannan adadin na iya zama na mutuwa, da kuma asarar da suka kai 10%, sa hypovolemic buga, wanda a cikin wannan yanayin da ake gani a matsayin dehydration, ta nuna muhimmancin raguwa a zagawa da jini saboda da high dehydration. dalilai:

-zabolevaniya, abu don zawo da amai, m urination m.

-nedopoluchenie ruwa jiki (nedopivanie) a karkashin matsananci yanayi, kamar matsananci zafi, musamman a high jiki exertion.

-nerazumnye rage cin abinci.

Musamman m dehydration a matasa da yara da kuma tsofaffi.

Nau'in buga, ya faru a sakamakon rashin ruwa, Highlights da matakai na:

-invertible.

a partially reversible.

-neobratimuyu.

Bugu da kari, dehydration ne zuwa kashi wadannan sassa uku:

1.Izotonicheskoe (asarar Na kuma K ions). The ruwa a jikin mu ne kwayuka da intercellular. Lokacin da isotonic asarar sa da zawo yafi excreted nuna yawa potassium da sodium, wanda shi ne babban cation a extracellular ruwa wuce a cikin sel yi har da rasa potassium a cikinta.

2.Gipotonicheskoe, wanda shi ne wani sakamako na isotonic. An lura high hasarori a cikin extracellular m (saboda sodium shige cikin Kwayoyin). A farko matakai biyu suna dauke su reversible kamar yadda zai yiwu a madadinsa na Wutan. Partially nasara a samar da haƙuri m ci, musamman dauke da sodium ions.

3.Gipertonicheskoe cewa tasowa a lokacin da zawo tare retching hana ruwa ya kwarara a cikin jikin baki ko yawan abin sama na wasu abubuwa da tsokane ƙarin urination. The ruwa sake wuce daga Kwayoyin a cikin extracellular sarari domin ya kula da osmotic matsa lamba. Biyu dehydrated Kwayoyin karya su aiki da kuma rage a juz'i. Musamman m karu a kwakwalwa girma, wadda take kaiwa zuwa subdural hemorrhage.

cututtuka

Mun gani cewa akwai kwatanta rarrabuwa na hypovolemic buga. Clinic wannan jiha, ba tare da la'akari da dalilai, shi ya sa game da wannan. A cikin reversible mataki, da mãsu haƙuri ne a cikin supine matsayi, ya furta cututtuka iya zama mãsu fakowa ba. farko alamun matsalar ne:

- palpitations.

-small ragewan jini;

coldly clammy fata a kan extremities (saboda wani karu perfusion).

-Lokacin akwai dehydration bushewa lebe, mucous a bakinsa, rashin hawaye.

A na uku mataki, bugu na farko bayyanar cututtuka zama mafi pronounced.

Marasa lafiya suna lura:

-tahikardiya.

-Reduction jini a kasa m dabi'u;

-Violation numfashi.

-oliguriya.

coldly ga tabawa (ba kawai da wata gabar jiki).

-mramornost fata da kuma / ko canza su launi daga al'ada zuwa kodadde cyanotic.

-nitevidny bugun jini.

-with matsa lamba a kan sauki, su ne kodadde da kuma launi bayan kau na kaya an rage ta fiye da 2 seconds sa na kullum. A wannan asibitin yana hemorrhagic buga. Nau'in ta, saukarwa, dangane da girma na jini circulating a tasoshin halaye kara hada da:

, waɗannan reversible lokaci tachycardia zuwa 110 lashe minti daya.

-A partially reversible - tachycardia na 140 lashe / min.

, waɗannan komowar - zuciya rate sama da 160 lashe / min. A wani mawuyacin matsayi bugun jini ba za a iya ji, kuma systolic jini da dama zuwa 60 mm Hg ko kasa. shafi.

Lokacin da dehydration ne iya hypovolemic buga bayyanar cututtuka suna kara da cewa:

-suhost mucous.

-reduction sautin eyeballs.

y jariran tsallake wani babban fontanelle.

Yana duk waje bugawa, amma a daidai ƙayyade da har na matsalar, gudanar da dakin gwaje-gwaje da bincike. A haƙuri aka nan da nan ya yi jini sunadarai, sanin da matakin na hematocrit, acidosis, a halaye da wuya, gudanar da bincike da jini yawa. Bugu da ƙari kuma, likitoci ne potassium matakin iko, babban Wutan, creatinine, jini urea. Idan yanayin yarda, karatu minti daya da kuma zuciya da shanyewar jiki girma da kuma tsakiyar venous matsa lamba.

traumatic buga

Wannan irin buga a hanyoyi da dama kama da hemorrhagic, amma ta hanyar za su iya aiki ne kawai na waje raunuka (soka, harbin bindiga, konewa) ko ciki (katsewa na tsokoki da kuma gabobin, misali, daga wani karfi duka). Traumatic buga ne kusan ko da yaushe tare da wani wuya m zafi, m exacerbates halin da ake ciki na azabtar. A wasu kafofin shi ne ake kira mai raɗaɗi a buga, sau da yawa abu don mutuwa. A tsanani daga traumatic tura aka ƙaddara ba sosai da adadin rasa jini, nawa wannan asarar gudun. Wannan shi ne, idan jini ya fita daga jiki sannu a hankali, aka azabtar mafi damar tserewa. Har ila yau aggravates halin da ake ciki da kuma digiri na muhimmancin da lalace sashin jiki ga jiki. Wannan shi ne, tsira da harbi a hannu zai kasance da sauki fiye da a rauni da kai. Wadannan su ne siffofin da wani traumatic buga. Nau'in Jihar mai tsanani kamar haka:

Bigiren buga (auku kusan nan da nan bayan rauni).

-vtorichny buga (bayyana bayan tiyata, kau na daure, a karkashin ƙarin load a kan abin ya shafa, misali, ta kai).

Bugu da kari, traumatic buga lura biyu bulan - erectile da torpid.

Alamun erectile:

-strong zafi.

-neadekvatnoe halayyar (kuka, overexcitation, juyayi, wani lokacin tsokana).

-tremor.

gumi coldly.

-Advanced ƴan;

-tahikardiya.

-tahipnoe.

Alamun torpid:

-bolnoy zama sha'aninsu dabam.

-Over akwai, amma mutum bai karɓa wa shi;

-arterialnoe matsa lamba sharply rage-rage.

-glaza Fade;

-poyavlyaetsya kodadde fata, cyanosis na lebe.

-oliguriya.

-oblozhennost harshe.

-suhost mucous.

coldly gumi ba aiki, amma fata hasarar da turgor.

-puls thready.

-cherty fuska wasa.

Mai guba buga, rarrabuwa

Wannan yanayin ya auku saboda shigar azzakari cikin farji cikin jiki na kamuwa da cuta, watau, ƙwayoyin cuta da kwayoyin da suka haddasa tsanani maye abubuwan da suke yi. More sau da yawa fiye laifi ba a harin buga streptococcus, staphylococcus, Salmonella, Pseudomonas aeruginosa. Sun shigar da jiki, kamar yadda ta hanyar bude raunuka (puerperal sepsis, konewa, tiyata) ko ba tare da (typhoid, AIDS, tracheitis, sinusitis, ciwon huhu, mura, da kuma sauran cututtuka).

Pathogenic microorganisms nuna superantigens cewa kunna T Kwayoyin, da kuma sauran T Kwayoyin. Wadanda, bi da bi, asirce cytokines, haddasa haƙuri da rigakafi da tsarin da aka mur, da kuma wata babbar adadin gubobi saki a cikin jininsa, haddasa guba buga. A rarrabuwa na wannan yanayin bambanta matakai uku:

1.Obratimaya. A wannan jini na iya zama al'ada, shi ya kasance a sarari sani, fata ya zama ruwan hoda, ko ja. A haƙuri ne sau da yawa agitated, na fara jin ciwo a jiki ko a cikin ciki, ya lura zawo, zazzabi, kuma wani lokacin amai.

2.Chastichno reversible. Alamun: zazzabi, rauni bugun jini, tachycardia, rage matsa lamba, da mãsu haƙuri lethargic, ya dauki hana.

3.Neobratimaya. Alamun: shortness na numfashi, convulsions, fata cyanosis, bugun jini ne mai rauni, jini a kasa da m, da mãsu haƙuri ne sõmamme.

Nau'in anaphylactic buga

Irin wannan yanayin na faruwa a lokacin da ingested poisons daga macizai ciji, gizo-gizo, wasps da sauran halittu masu rai, daga shan wasu drinks da abinci, da kuma ta hanyar gwamnatin kwayoyi da aka bai wa haƙuri ta allergens. irin wannan dauki da aka fi sau da yawa ba procaine penicillin, Organic. Shock iya faruwa cikin yan dakikoki kadan bayan lamba tare da allergen jiki ko dai ta hanyar wani tsawon lokaci, da kuma jima da dauki faru, da muni da hangen nesa. Akwai da dama siffofin da ya faru na anaphylactic buga:

-tipichnaya (redness a cizo site (allura site), ko ciwon mara, makogwaro a baka lamba allergen, decompression, matsawa daga cikin hakarkarinsa karkashin yiwu zawo ko amai).

-gemodinamicheskaya (a cikin na farko wuri zuciya da jijiyoyin jini cuta).

-asfiksicheskaya (numfashi gazawar, dyspnea).

-tserebralnaya (malfunction na tsakiya m tsarin, convulsions, unconsciousness, na numfashi kama);

-abdominalnaya (m ciki).

magani

Domin gaggawa mataki yana da muhimmanci daidai da rarrabuwa na tunkaro. Gaggawa gaggawa kula a kowane hali na da ƙayyadaddu, amma da jima da shi zai fara zuwa a bayar, da mãsu haƙuri mafi damar. A mataki komowar mutuwa ne lura a fiye da 90% na lokuta. Traumatic buga da muhimmanci a nan da nan toshe jini hasãra (tourniquet) da kuma isar da suka ji rauni zuwa asibiti. Akwai kwashe igiyar jini Saline da colloidal mafita, jini, jini, anesthetized, idan ya cancanta, haɗa wani respirator.

A anaphylactic buga nan da nan gudanar epinephrine, da mãsu haƙuri ne intubated da asphyxia. Daga bisani an gudanar corticosteroids da antihistamines.

Lokacin da mai guba buga kwashe m ruwa far da karfi maganin rigakafi, immunomodulators glucocorticoid jini.

Lokacin da hypovolemic buga babban ayyuka ne don mayar da jinin samar dukkan gabobin, kawar da hypoxia, da kuma daidaita da matsa lamba na zuciya. Lokacin da tura lalacewa ta hanyar dehydration, shi ne bugu da žari bukata zaman majalisar na bata girma na ruwa da kuma Wutan duk.