Ukuphazamiseka okwemvelo

Ngenxa yokuphuma kwezinto ezihlukahlukene (ukuhlukumeza, ukuhlinzwa, ukulimala kwangaphakathi), ivolumu yokujikeleza igazi (BCC) yehla. Kuncike ekutheni izinga lokulahlekelwa kwezinto eziphilayo lilahlekile, i- oksijeni yindlala iyakhula, futhi uma kungaphezu kuka-500 ml ukulahleka kwegazi okwenzekayo, kwenzeka ukwethuka okukhulu. Lesi yisimo esiyingozi kakhulu, esibhekene nomphumela obulalayo ngenxa yokuphela kwesigungu segazi emathinjeni ebuchopho nasemaphashini.

Ukwehliswa kokushaqeka okukhulu

Ngaphezu kokuqina, esimweni sokulahleka kwegazi, izinga lokugeleza kwezidakamizwa eziphilayo zibaluleke kakhulu. Ngezinga eliphansi, ukulahlekelwa ngisho negazi elimangalisayo (kuze kube ku-1.5 amalitha) akuyona into eyingozi njengokuphuma kwegazi ngokushesha.

Ngokuvumelana nalokhu, lezi zigaba ezilandelayo zokuphazamiseka okukhulu zihlukaniswa:

1. Isigaba sokuqala sihlawulelwa. Ukuncipha kwe-BCC akugcini kuka-25%. Njengomthetho, isisulu siyazi, ukucindezelwa kwegazi kuncishisiwe, kodwa ngokulinganisela, ukushaywa komzimba kubuthakathaka, i-tachycardia - kuze kufike ku-110 beats ngomzuzu. Isikhumba sibhekile futhi sibanda kakhulu.
2. Isigaba sesibili sivuzwa. Ukulahleka kwegazi kufinyelela ku-40% we-BCC. Kukhona i-acrocyanosis, ukuphazamiseka kuyaphazamiseka, ukucindezelwa kuncishiswe kakhulu, ukushaywa komzimba kuyinto yocingo, i- tachycardia - kuze kufike ku-140 ukushaya ngomzuzu. Ngaphezu kwalokho, kungacaciswa ukuthi u-oliguria, i-dyspnea, ubanda obunzima.
3. Isigaba sesithathu singenakuphikiswa. Ukuphazamiseka okukhulu kwezinga elibi kunezibonakaliso zesimo esiyingozi kakhulu esigulini: ukulahlekelwa okuphelele, umbala we-marble wesikhumba (i-pallor enezingcaphuno ezibonakala kahle zemithwalo yegazi). Ukulahlekelwa kwegazi kudlula u-50% we-BCC yonke. I-Tachycardia izuza izikhathi eziyi-160 ngomzuzu, ukucindezela kwe-systolic ingaphansi kuka-60 mm Hg. I-pulse inzima kakhulu ukuthola.

Isigaba sokugcina sihilela ukusebenzisa izindlela zokuphuthumayo eziphuthumayo.

Ukunakekelwa okuphuthumayo kokushaqeka okukhulu

Ngemuva kokubizelwa kwethimba lezokwelapha, kuphakanyiswa ukuthatha izinyathelo ezinjalo:

1. Yeka ukuphuma kwegazi, uma kubonakala, yizo zonke izindlela ezitholakalayo (ukuvutha, ukufaka amabhande, ukumbumbuluza isilonda).
2. Ukuqedwa kwanoma yiziphi izinto eziphazamisa ukuphefumula okuvamile. Kubalulekile ukuguqula ikholomu eqinile, ukususa emlonyeni womcucu wamazinyo, ukuhlanza, izidumbu zangaphandle (ngokuvamile emva kwengozi yemoto), vimbela ulimi ukuba lungangeni nasopharynx.
3. Uma kungenzeka, unikeza abantu imithi yokwelashwa okungenayo i-narcotic (Fortral, Lexir, Tramal), engathinti ukujikeleza kwegazi nomsebenzi wokuphefumula.

Akusiluleka ukuhambisa umuntu omele, ikakhulukazi uma ukuphuma kungaphakathi.

Ukwelashwa kokushaqeka kwamanzi ngesikhathi sokulala esibhedlela

Ngemuva kokuhlola isimo sesiguli, ukukala umfutho wegazi, izinga lokushaya kwenhliziyo, ukuphefumula, ukuqina komqondo, ukuvinjelwa kuvinjelwe. Imisebenzi eqhubekayo:

1. Ukwenyuka kwe-oksijeni ngamacatheters (intranasal) noma imaski.
2. Ukuhlinzeka ukufinyelela embhedeni wamathambo. Kulokhu, i-vein central is catheterized. Ngokulahlekelwa okungaphezu kwama-40% we-bcc, kusetshenziselwa umvuthwandaba omkhulu wesifazane.
3. Ukwelapha ukumnika ukumiswa ngokusungulwa kwezixazululo ze-crystalloid noma i-colloidal, uma ukuphuma kwegazi kunesisindo esikhulu futhi esiningi - u-erythrocyte.
4. Ukufakwa komgodlagodla we-Foley ukulawula ukuvota kwamahora ngamahora kanye nokwesaba (ukuhlola ukuphumelela kwe-infusions).
5. Ukuhlolwa kwegazi.
6. Inhloso yokudambisa (sedative) kanye nezidakamizwa ze-analgesic.

Uma ukulahlekelwa kwegazi kungaphezu kuka-40% wevolumu yamanzi aphilayo, ukwelapha ukukhipha imfucumfucu kufanele kwenziwe ngo-2-3 emithanjeni ngesikhathi esifanayo, ngokuhambisana nokuvuthwa kwe-100% oksijini nge-mask anesthetic. Futhi, ukujozwa kwezidakamizwa ezine-dopamine noma i-epinephrine kuyadingeka.