Mendelson engqondweni: iimpawu, unyango, uthintelo

Kukho uluhlu zizifo musa ukunika izigulane ithuba ukuqhubeka ubomi babo ngokuqhelekileyo. Evelayo ngequbuliso, betshintsha ngokupheleleyo umntu, yaye ufumana ithuba elincinane kakhulu ubomi obuqhelekileyo kwaqhubeka. Enye ezinjalo iimeko zophendlo lwezifo yi wolangazelelo syndrome asidi, nto leyo nayo eyaziwa phantsi igama mendelson engqondweni.

incazelo

Livela kwesi sifo ngenxa inhalation yejusi asidi esiswini, kangangokuba umntu iphuhlise nokudumba oyingozi. Amatyala amaninzi karhulumente engaqhelekanga ezaziwayo Ukubulawa yokubelekisa. Xa izigulane iSifo ezahlukeneyo, izinto ezo phantsi zomzimba okanye hayi, kule nkqubo ukungaphefumli unokufumana zizityebi kwi enqanda imixholo emuncu esiswini.

Mendelson kaThixo syndrome i ingxaki esibulalayo zomzimba. Nendlela eqhelekileyo phantse ama-60% yezehlo zokufa. Xa zomzimba yokubelekisa, eli nani ifikelela 70%.

izizathu

Eyona nto ephambili ukuba Uxhokonxwa asidi-yokulangazelela uphawu yi regurgitation okanye ukugabha, yenzekile ngexesha zomzimba xa kwanciphisa ukusebenza ingqondo ibakhusela kwingqula. Mendelson engqondweni kubangwa regurgitetsiey, kokuphela angenzi imixholo esiswini kungena oropharynx.

Kwandisa ubungozi iingxaki kwenzeka xa isisu epheleleyo, ukudandatheka iziyobisi, ukunxila okanye utywala, silale. Regurgitation kunokwenzeka ngexesha lokukhulelwa (ukususela 22-23 kwiiveki), nini, ngenxa yeenguqu hormone kunciphisa ukwenziwa gastrin, nto leyo ekhokelela kuphuhliso nomfutho esiswini. Phakathi kwezinye izinto: ukwanda intragastric kunye noxinzelelo intra-esiswini, ukuqumba, ukudumba kuvuleke iminxunya, ukutyeba, ubukho izifo ezihlasela zosulele zoqhaqho kwinkqubo yokwetyisa. Ingozi omkhulu onaso lwenzeka xa unikezelo lwentsebenziswano kwi nokubeleka okanye kulo mkhuba kotyando engxamisekileyo.

Pathogenesis

Mendelson engqondweni iyakwazi ukukunyanzela eyodwa yophuhliso. Ukhetho lokuqala - ngayo xa amasuntswana ukutya undigested ufake iphecana nokuphefumla kunye juice esiswini. Kwinqanaba occlusion lesibini ngomatshini ye umkhondo bronchi kuphuhliso ukusilela ezihlasela zosulele ngokuphefumla. Kwimeko yesibini ngayo incindi esiswini asidi kakhulu xa ukurhogele kunokubangela zokutsha eekhemikhali inwebu kwiinwebu le bronchi kunye noqhoqhoqho. nokudumba Further mucosal kuphakamisa ukuphuhliswa kokuphazamiseka inyumoniya.

syndrome mendelson esithi: Iimpawu

Lo mfanekiso kwezonyango sifo kunye phantse twatse iimpawu ukusilela kakhulu zemiphunga. imeko yomguli luphawulwa nokudumba yemiphunga, tachycardia, dyspnea, cyanosis, bronchospasm. Ngokuchasene imvelaphi utshintsho ngendlela kakhulu okokuqala kwenzeka zokuma. Ngokubanzi emzimbeni wakhe ukuba yaphulwe kunye nokuhamba kwegazi pulmonary, umfutho wegazi iqhubeka. Bekunye hypoxemia kakhulu kwandisa uxinzelelo kwi pulmonary kunye nokwanda ngaxeshanye resistance yemiphunga nezengekho nemithambo. lactic umzimba kunye alkalosis zokuphefumla kukhulise ngenxa kwephulwa esiqwini perfusion.

utshintsho Clinical kunye pathophysiological ezinxulumene ukuphazamiseka ze ezitshangubeni lung kwithishyu. Ngamanye amaxesha iimpawu kangako kubi. utshintsho Morphological kwisiqwenga sokuphefumla ngonyuka wabonakalaliswa imini emva Eskom. Kuphela usuku okanye iintsuku ezimbini ukususela kwixesha apho kwakukho mendelson engqondweni, iimpawu ukusilela sokuphefumla zingaqalisa ukuba ngcono. Ukugcina umntu kuphela phantsi imeko yonyango olungxamisekileyo yakhe.

syndrome mendelson xa nokubeleka

Xa abafazi kunye nemisebenzi yokubelekisa okanye ukunikezelwa zomzimba ngokubanzi rhoqo oko kwenzeka kwesi sifo. Njengeminqweno yoluntu ibe ngokuma kufuneka iimeko ezimbini. Lokuqala - jikelele zomzimba (kuba imisebenzi yokubelekisa, ekuzaleni, ngezifo zoqhaqho esiswini), owesibini - ephula balo matshinana bulbar apha isiqaqa, regurgitation, ukugabha. Kwiimeko ezininzi, isigulana ilinde ukuba afe, ukuba mendelson engqondweni. Loo nto inika ilungelo lokuba ukubeka sifo kwi belingana iingxaki kakhulu yingozi, ezibulalayo ze zomzimba, ngaphandle kwamathandabuzo.

Ukutya esiswini abasetyhini abakhulelweyo bakholisa ukuba kulibaziseke ngenxa zokunciphisa isicatshulwa wayo ukukhulelwa ngenxa kumanqanaba asezantsi gastrin kunye nokwanda koxinzelelo intra-esiswini. It gastrin ilawula motility esiswini, kwaye kunyuswa zaneleyo kukhokelela kuphuhliso acid yokulangazelela syndrome in zomzimba.

likaxakeka

Into yokuqala kufuneka ukubamba isigulane kunye syndrome ka Mendelssohn - liyasuswa yomoya aspirated imixholo isisu. Ngoko kwisisu Oral nyulu sokufunxa okanye igozi. Tracheal ekumfakeni kufuneka engenziwa kwisigaba prehospital. Okulandelayo, kufuneka wenze bronchoscopy engxamisekileyo phantsi zomzimba jikelele kunye nezo isitofu kwezindlela umoya semiphunga. Kuba lavage inyumoniya usebenzisa sodium hydrogen carbonate isisombululo (2%) kunye nokulungisa "hydrocortisone" solution sodium chloride efudumeleyo okanye isotonic. Emva tracheal ekumfakeni, wahlamba kakuhle isisombululo isisu obrak yi gavage. Yegazi ilawulwa izisombululo "atropine" yaye "Eufillin".

Kwimeko apho imeko yesigulane abangaxhalabisiyo, yomatshini ukuze kufakwe ukunganyangeki nomphunga uphefumlayo kulogo. Ngenxa yale nkqubo, uya kufuneka imaski ekhethekileyo ukuba ayisekho, kuyimfuneko ukuba bafundise exhales nomonde ngalo isiphelo evulekileyo ityhubhu yerabha amanzi.

syndrome mendelson kaThixo (ifoto ngasentla ibonisa inxalenye yenkqubo ukubandezeleka kwindawo yokuqala) kunokukhokelela kokufa isigulane, ukuba swi nga pfuna ixesha naye. Nokuba isiqabu ngokukhawuleza bronchospasm laringo- nomonde kufuneka balaliswe esibhedlele ukuze iyaluthintela uphuhliso iingxaki ezinzulu.

unyango

Ukuba isigulane ifumaneka mendelson engqondweni, unyango kufuneka ukuba ibandakanye amanyathelo aza kukunceda ukuba uyeke ukusilela ezihlasela zosulele ngokuphefumla kwaye iyaluthintela uphuhliso iingxaki esosulelayo. yomatshini lwenziwa xa hypoxia esimbaxa liqhubeka neemeko nokuphefumla ezizenzekelayo. Xa imeko ebalulekileyo inkqubo isigulane ikhutshwa phandle iintsuku eziliqela, kude kube nezikhombisi kunaniselwano igesi yemiphunga abazange ngcono. Ngamanye amaxesha usebenzisa oxygenation hyperbaric, leyo kwezinye iimeko ivelisa iziphumo ezihle. unyango Drug kukusetyenziswa kweziyobisi kwangumqondiso, elwa corticosteroids ngeedosi ezinkulu.

syndrome mendelson ngo-30-60% yamatyala ekhokelela ekufeni isigulane. Kuba abo babandezeleka kuyo, ungenza nokuphuhlisa wavakalisa ukuphazamiseka ethintelayo okanye obstructive ngokwamazinga awohlukeneyo.

ukuvimbela

Kukho iqela lamanyathelo ezinokuthi iyaluthintela uphuhliso yeengxaki ezinkulu ezifana mendelson engqondweni. Uthintelo luquka amanyathelo aliqela. Lokuqala - ukusetyenziswa kweziyobisi isenzo sakhe sibhekiswe ekunciphiseni secretion esiswini ( "Ranitidine", "cimetidine"). Ukuthintela kukuvela iingxaki ingaba zikhona kunye nezenzo ezichanekileyo i anesthesiologist. "Atropine" ichiza kufuneka kufakwe esebenzisa "Metacin" isigulana zibe kwimeko zomzimba kufuneka ufakwe kakuhle kwaye ngokukhawuleza. Ugqirha kufuneka babe sele bekwazi ukulusebenzisa ngokufanelekileyo ubuchule ekumfakeni laryngoscopy kunye nokusetyenziswa tracheal reception Selick.

Ngamanye amaxesha ngokwazisa ityhubhu esiswini, ishiyela wonke umsebenzi ukuthintela inhalation kwiziqulatho esiswini. Ezinye iingcali nxamnye ukwamkelwa enjalo, kuba uphenyo inokufana umsonto kwaye mandundu imeko. Xa nokubeleka zothintelo kufuneka ibe kwindawo echanekileyo indawo umfazi omithiyo phezu kwetafile yokusebenza, isiphelo intloko leyo kufuneka iphakame kancinci.