Pulmonary embolus

Iko pulmonary embolus kuvharika kwetsinga mumapapu. Chikonzero chakanyanya kuvharika ndeyekuvhara ropa.

Iyo pulmonary embolus inowanzo kuve inokonzerwa neropa rinovhara iro rinobuda mutsinga iri kunze kwemapapu. Ropa rakajairika zvikuru nderimwe riri mutsinga yakadzika yehudyu kana muchiuno (munzvimbo yehudyu). Rudzi urwu rwegumbeze runodaidzwa kunzi yakadzika vein thrombosis (DVT). Ropa rinotsemuka roenda kumapapu kwarinogara.

Zvishoma zvikonzero zvinozivikanwa zvinosanganisira mabhuru emhepo, madonhwe emafuta, amniotic fluid, kana clumps ezvipembenene kana maseru emota.

Iwe uri mukana wekuwana mamiriro aya kana iwe kana yako mhuri uine nhoroondo yekugwamba kweropa kana kumwe kuomesa kusagadzikana. Iyo pulmonary embolus inogona kuitika:

• Mushure mekusununguka
• Mushure mekurwadziwa kwemoyo, kuvhiyiwa kwemoyo, kana sitiroko
• Mushure mekukuvara kwakanyanya, kutsva, kana kutsemuka kwechiuno kana pfupa rehudyu
• Mushure mekuvhiyiwa, kazhinji kacho kuvhiya kwepfupa, kwekubatana, kana kwehuropi
• Munguva kana mushure mekureba ndege kana kutasva mota
• Kana uine kenza
• Kana iwe ukatora mapiritsi ekudzivirira kubereka kana estrogen kurapwa
• Kurara-kwenguva refu kwemubhedha kuzorora kana kugara munzvimbo imwechete kwenguva refu

Kukanganisika kunogona kutungamira mukugwamba kweropa kunosanganisira:

• Zvirwere zvemuviri zvinoita kuti ropa rishaike kugwamba.
• Dambudziko rekugara nhaka rinoita kuti ropa riwedzere kuvhara. Imwe yeakadai kusagadzikana antithrombin III kushomeka.

Zviratidzo zvikuru zvepurmonary embolism zvinosanganisira kurwadziwa kwepfupa kunogona kuve chero kweanotevera:

• Pasi pechifuva kana padivi
• Kupinza kana kubaya
• Kupisa, kurwadza, kana kusviba, kunzwa kunorema
• Kazhinji zvinowedzera kuwedzera nekufema kwakadzika
• Iwe unogona kukotama kana kubata chipfuva chako mukupindura kurwadziwa

Zvimwe zviratidzo zvinogona kusanganisira:

• Dzungu, hurema, kana kupera simba
• Low oxygen level muropa (hypoxemia)
• Kukurumidza kufema kana kufema
• Kukurumidza kurova kwemoyo
• Kunzwa kushushikana
• Kurwadziwa kwegumbo, kutsvuka, kana kuzvimba
• Kuderera kweropa
• Kamwe kamwe kamwe chikosoro, pamwe kukosora kumusoro kweropa kana reropa mamota
• Kufema kwekufema kunotanga kamwe kamwe panguva yekurara kana pakuedza
• Low fever fever
• Bluish ganda (cyanosis) - zvishoma zvakajairika

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezve ako zviratidzo uye nhoroondo yekurapa.

Aya anotevera maedzo ebhu anogona kuitwa kuti uone kuti mapapu ako ari kushanda zvakadii:

• Arterial eropa magasi
• Pulse oximetry

Iyi inotevera miedzo yekufungidzira inogona kubatsira kuona kuti iro ropa rinovhara riri kupi:

• Chest x-ray
• CT angiogram yechipfuva
• Pulmonary kufefetedza / perfusion scan, inonziwo V / Q scan
• CT pulmonary angiogram

Mimwe bvunzo inogona kuitwa inosanganisira:

• Chest CT scan
• D-dimer ropa bvunzo
• Doppler ultrasound bvunzo yemakumbo
• Echocardiogram
• ECG

Kuongororwa kweropa kunogona kuitwa kuti utarise kana iwe uine mukana wakawanda wekuvhara ropa, kusanganisira:

• Antiphospholipid antibodies
• Genetic kuyedza kutarisa shanduko dzinoita kuti iwe ugone kuwedzera maronda eropa
• Lupus anticoagulant
• Mapuroteni C uye mapuroteni S mazinga

Iyo pulmonary embolus inoda kurapwa ipapo ipapo. Ungangoda kugara muchipatara:

• Iwe unozogamuchira mishonga yekutetepa ropa uye nekuita kuti riite shoma kuti ropa rako riumbe kuwanda kwakawanda.
• Muzviitiko zveakakomba, anotyisidzira hupenyu pulmonary embolism, kurapwa kunogona kusanganisira kupwanya iyo clot. Izvi zvinonzi thrombolytic therapy. Iwe unozogamuchira mishonga yekunyungududza iro clot.

Kunyangwe iwe kana kuti kwete zvaunoda kugara muchipatara, iwe ungangoda kutora mishonga kumba kudzikisira ropa:

• Unogona kupihwa mapiritsi ekunwa kana ungazoda kuzvibaya majekiseni.
• Kune mimwe mishonga, iwe uchada kuongororwa kweropa kuti utarise muyero wako.
• Inguva yakareba sei yaunoda kutora iyi mishonga inoenderana zvakanyanya nechikonzero uye kukura kweropa rako rinovhara.
• Mupiki wako achataura newe nezvedambudziko rekubuda ropa paunotora mishonga iyi.

Kana iwe usingakwanise kutora vatete veropa, mupi wako anogona kupa zano rekuvhiyiwa kuisa mudziyo unonzi wakaderera vena cava firita (IVC firita). Chigadzirwa ichi chinoiswa mutsinga huru mudumbu rako. Iyo inochengetedza kuwanda kukuru kubva mukufamba kuenda mumidziyo yeropa yemapapu. Dzimwe nguva, firita yechinguvana inogona kuiswa uye kubviswa gare gare.

Kuti munhu anonaya zvakanaka sei kubva muchiumbwa chemapapu chingave chakaoma kufanotaura. Zvinowanzoenderana ne:

• Chii chakakonzera dambudziko pakutanga (semuenzaniso, gomarara, kuvhiyiwa kukuru, kana kukuvara)
• Hukuru hweropa rinovhara mumapapu
• Kana iro reropa rakanyungudika nekufamba kwenguva

Vamwe vanhu vanogona kukura kwenguva yakareba matambudziko emoyo nemapapu.

Rufu runogoneka muvanhu vane yakaoma pulmonary embolism.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (senge 911), kana iwe uine zviratidzo zvepulmonary embolus.

Ropa rakapfava rinogona kunyoreswa kubatsira kudzivirira DVT muvanhu vari panjodzi huru, kana avo vari kuvhiyiwa vane njodzi huru.

Dai iwe uine DVT, mupi wako anonyorera kumanikidza masokisi. Vapfekedze sekurairwa. Ivo vanozovandudza kuyerera kweropa mumakumbo ako uye vadzikise njodzi yako yekugwamba kweropa.

Kufambisa makumbo ako kazhinji mukati merwendo rurefu rwekufamba nendege, kufamba kwemotokari, uye mamwe mamiriro ezvinhu awakagara kana kurara pasi kwenguva yakareba zvinogona kubatsira kudzivirira DVT. Vanhu vari panjodzi yakanyanya yekugwamba kweropa vangangoda kupfura kweropa rakatetepa rinonzi heparin pavanotora nendege inogara kwenguva inopfuura maawa mana.

Usapute. Kana uchisvuta, rega. Vakadzi vari kutora estrogen vanofanira kurega kusvuta. Kusvuta kunowedzera mukana wako wekukura kweropa.

Venous thromboembolism; Mapapu eropa; Ropa clot - mapapu; Embolus; Tumor embolus; Embolism - pulmonary; DVT - pulmonary embolism; Thrombosis - pulmonary embolism; Pulmonary thromboembolism; PE

• Yakadzika tsinga thrombosis - kubuda
• Kutora warfarin (Coumadin, Jantoven) - chii chekubvunza chiremba wako
• Kutora warfarin (Coumadin)

• Mapapu
• Kufuridzira system
• Pulmonary embolus

Goldhaber SZ. Pulmonary embolism. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 84.

Kline JA. Pulmonary embolism uye yakadzika vein thrombosis. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 78.

Morris TA, Fedullo PF. Pulmonary thromboembolism. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray naNadel Chinyorwa cheRefiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 57.