Ukulimala kwezemidlalo
1K 14 04/20/2019 (kugcine ukubuyekezwa: 04/20/2019)
Kunezizathu eziningi zokuphuma kwamakhala (i-epistaxis). Noma kunjalo, indlela esebenza ngayo ye-pathogenetic iyafana. Okusemqoka wukulinyazwa kwemikhumbi ye-mucosa yamakhala. Ukopha okuphuma kaningi kuyingozi ekukhuleni kwe-anemia.
Ukuhlukaniswa kokulahleka kwegazi
Ngokuya ngenani lokulahleka kwegazi, kuyisiko ukuhlukanisa kube:
- okungabalulekile (ama-ml ambalwa) - akunangozi empilweni;
- ngokulinganisela - kufika ku-200;
- okukhulu - kufika ku-300;
- inzuzo - ngaphezu kwama-300.
Ngokuya ngezici zesimo sendawo, i-epistaxis ingaba:
- i-anterior - ngo-90-95% (okwenziwa kwasendaweni komthombo engxenyeni engaphansi ye-antero-inferior of the nasal passage, imvamisa kungenxa yokulimala emithanjeni evela ku-Kisslbach plexus);
- ngemuva - ngo-5-10% (phakathi nendawo nangemuva kwamaphaseji acinene).
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Izizathu
Ukopha kungabangelwa:
- ukulimala ngomshini (ukushaqeka);
- i-barotrauma (ukwenyuka okungazelelwe ngemuva kokuntywila);
- ukulimala kwamathambo okubangelwa umoya owomile ofudumele noma obandayo;
- ukwanda kwengcindezi yegazi (ukopha emakhaleni kungenye yezindlela zokuzivikela) ngenxa yezizathu eziningi, ezivame kakhulu kuzo yilezi:
- isifo se-hypertonic;
- pheochromocytoma;
- VSD;
- ukucindezeleka;
- izinguquko kumazinga we-hormonal noma ukuthatha izidakamizwa eziqukethe i-hormone;
- i-rhinitis yesimo esithathelwanayo nesiphikisayo;
- Ama-polyps (ama-papillomas) we-mucosa yamakhala;
- i-atherosclerosis (imikhumbi iba buthakathaka);
- i-hypovitaminosis C, i-PP ne-K;
- ukuthatha ama-anticoagulants.
Ukucabangela isici esiyimbangela, ukuphuma kwegazi kuhlukaniswe kwaba:
- okwendawo;
- okujwayelekile (okubangelwa ukugula komzimba wonke).
I-Epistaxis kubasubathi
Imisebenzi yezemidlalo idinga ukugqugquzelwa okuphezulu kwezinsiza zomzimba. Ngalesi sizathu, abasubathi bangabhekana nokushoda okulinganiselwe kwamavithamini i-PP, K no-C. Ukushoda kwandisa ubungozi be-epistaxis.
Abasubathi bahlangabezana nengcindezi ehambisana nomfutho wegazi ophakeme, okuyingozi engozini yokuphuma kwamakhala.
Ngaphezu kwalokho, abagijimi bathambekele ekulimaleni (ukulimala ekhaleni okuqhubekayo ngesikhathi sokuqeqeshwa nokuncintisana).
Usizo lokuqala lwe-epistaxis
Lapho unquma ukukhululeka kokuphuma kwegazi, kufanele uzame ukusungula uhlobo lwesimo sokugula.
Igazi elivela emakhaleni elinomfutho wegazi ophakeme
Uma i-epistaxis ibonwa ngokumelene nesimo senkinga yomfutho wegazi ophakeme, akufanele imiswe. Kuyindlela yokuzivikela ebambezela ukwanda komfutho wegazi futhi inciphise ubungozi bokutheleleka okunamandla nokushaywa yisifo sohlangothi. Kulokhu, kufanele uzame ukwehlisa umfutho wegazi ngokuthatha izidakamizwa ezinomfutho wegazi ophakeme noma umeme udokotela.
Ngaphambili i-tamponade yamakhala
Kwezinye izimo, kukhonjiswa i-tamponade yangaphakathi yamaphaseji acinene, ngokuthinta nge-gauze noma ngoboya bekotini, okungcono ngaphambili obekuswakanyiswe ngesisombululo se-hydrogen peroxide. Ngemuva kwalokho kubanda kufanele kufakwe ebhulohweni lasekhaleni imizuzu engu-5-10 (ithawula lifakwe emanzini e-ice noma izingcezu zeqhwa ezibekwe esikhwameni sepulasitiki). Ngesikhathi esifanayo, ikhala elopha igazi lingacindezelwa. Kungcono ukugcina ikhanda liqonde, hhayi ukuliphonsa emuva, ukuze uvikele igazi elingena emgudwini wokuphefumula.
Lapho kukhona imithi efanelekile ngaphambi kwe-tamponade, ukunisela kwe-mucosa yamakhala kufanelekile:
- amaconsi e-vasoconstrictor emkhuhlane ovamile (iGalazolin);
- 5% aminocaproic acid.
Uma ukopha kunganqamuki kungakapheli imizuzu eyi-10-15, kufanele kubizwe i-ambulensi.
Amakhambi abantu e-epistaxis
Ukwehlisa amathamponi, ungasebenzisa:
- ujusi:
- imbabazane;
- i-yarrow;
- isikhwama sikamalusi;
- i-decoction ye-viburnum bark (ngesilinganiso se-10 g yamagxolo ngama-200 ml wamanzi).
Ukubonana nodokotela nini
Kudingeka ukunakekelwa okufanele kwezokwelapha uma:
- ukopha kakhulu okungapheli nge-tamponade yangaphakathi engaphakathi;
- kukhona ukusola kokuphuka kwamathambo ekhaleni;
- kuyatholakala:
- izimpawu ze-cerebral noma zokugxila (ikhanda, i-diplopia, isiyezi, i-paresis yemikhawulo);
- ubudlelwano phakathi kokopha nama-anticoagulants noma izidakamizwa zehomoni ezithathwe ngayizolo;
- kukhona ukutholakala kwento engaziwa emakhaleni engane.
Ukuvimbela
Ukuze uvimbele i-epistaxis ephindaphindwayo, kuyadingeka ukuthi usungule i-etiology yayo bese uzama ukuqeda izinto eziyimbangela. Ochwepheshe bangasiza ngalokhu.
Imisebenzi yokuqinisa ihlanganisa:
- ukubhucungwa ngesimo sokuthinta ukukhanya ngamaphiko ekhaleni;
- ukuvimbela i-hypovitaminosis PP, K, C;
- ukuhlanza i-mucosa yamakhala ngezixazululo zikasawoti wasolwandle, i-baking soda, i-herbal infusions (chamomile).
Qiniseka ukuthi izingane azilimazi ulwelwesi lwamafinyila ngeminwe noma ngezinto zasendlini.
