mob ntshav qab zib mob ntshav qab zib ntau tshwm sim hauv yuav luag 80% ntawm cov neeg mob tus kab mob no. Nws tshwm sim los ntawm kev poob ntshav hnyav. Anemia yog tus cwj pwm los ntawm qhov tsis muaj cov ntsiab lus muaj hlau. Tib lub sijhawm, cov qe ntshav liab txo qis, thiab hemoglobin tseem nyob rau tib theem.
Mob ntshav qab zib mob ntshav qab zib hom 2 (ICD 10 D62) yog hais txog qhov teeb meem ntawm cov kab mob txawv txav hauv lub sijhawm postoperative ntawm gastric, gynecological thiab cardiac pathologies, nrog rau cov kab mob ntshav. Yog tias muaj qhov ua txhaum cai no, nws yuav tsum mus ntsib kws kho mob kom kuaj xyuas thiab kho.
Tus kab mob no
Mob ntshav qab zib mob ntshav qab zib hom 2 (ICD code 10 D62) yog hais txog kab mob nyuaj heev uas ua rau muaj kev hem thawj rau tib neeg lub neej. Nws loj hlob sai heev, ua haujlwm nyuaj thiab tuaj yeem ua rau tus neeg mob tuag. Yog tias koj muaj teeb meem zoo sib xws, koj yuav tsum sab laj nrog kws kho mob.
Kev poob ntshav ntawm 500 ml yog suav tias yog qhov tseem ceeb. Nws ua rau tib neeg lub neej zoo heev. Los ntshav tsis tu ncua kuj tseem tuaj yeem qhia txog kev txhim kho ntawm gynecological, mob plawv thiab gastroenterological teeb meem.
theem ntawm tus kab mob
Cov kws kho mob paub qhov txawv 3 theem ntawm mob ntshav qab zib mob ntshav qab zib, xws li:
- vascular-reflex;
- hydremia;
- pob txha hloov pauv.
Cia peb saib txhua yam ntxiv.
Lub vascular-reflex theem txhais tau hais tias suav nrog cov txheej txheem tiv thaiv nyiaj txiag. Muaj qhov txo qis hauv siab, tachycardia, pallor ntawm daim tawv nqaij, ua tsis taus pa.
theem thib ob ntawm mob ntshav qab zib hemorrhagic anemia, lossis hydremia, pib li ntawm 3-5 teev. Cov kua dej nkag mus rau hauv plasma los ntawm qhov chaw intercellular. Cov theem no kav 2-3 teev. Hauv cov ntshav, cov qe ntshav liab thiab hemoglobin txo qis heev.
pob txha hloov pauv tshwm sim txij li 4-5 hnub tom qab raug mob. Qhov no yog vim qhov tshwm sim thiab kev loj hlob ntawm hypoxia. Kev kho mob thiab rov zoo tag nrho yuav siv sij hawm tsawg kawg yog ob lub hlis.
Kev tshwm sim
Qhov ncaj qha ua rau mob ntshav qab zib ntau dhau yog hemorrhage, uas tuaj yeem ua rau sab hauv thiab sab nraud. Tus kab mob tshwm sim nws tus kheej nyob rau hauv xws li mob:
- kev ua txhaum ntawm kev ncaj ncees ntawm cov hlab ntsha loj thiab cov hlab ntsha;
- lub plawv tawg thaum lub plawv nres;
- ruptured aneurysm;
- ntshav hauv lub ntsws;
- cev xeeb tub nrog ruptured fallopian raj;
- mob khaub thuaslos ntshav;
- ruptured spleen;
- xiav los ntshav ntawm plab zom mov.
Hauv tus menyuam yug tshiab, mob ntshav qab zib mob ntshav qab zib hom 2 (ICD 10 D61.3) tuaj yeem tshwm sim los ntawm kev raug mob thaum yug los lossis los ntshav hnyav heev. Qee zaum tus kab mob no tau kuaj pom thaum cev xeeb tub.
Cov tsos mob tseem ceeb
Mob ntshav qab zib thiab mob ntev tom qab mob ntshav siab txawv me ntsis ntawm cov tsos mob, qib ntshav poob, nrog rau cov yam ntxwv ntawm tib neeg lub cev. Txij thaum pib los ntshav hnyav, tib neeg lub cev siv tag nrho cov peev txheej los them nyiaj rau qhov poob. Kev tsim cov hlwb ua ntej cov qe ntshav liab nce ntau heev.
Cov phab ntsa ntawm cov hlab ntsha spasm, txwv cov ntshav ntws mus rau cov leeg thiab tawv nqaij. Nyob rau tib lub sijhawm, kev muab cov qog adrenal, lub plawv thiab lub paj hlwb nrog cov as-ham yog khaws cia rau lub sijhawm ntev tshaj plaws. Ntawm cov tsos mob tseem ceeb ntawm mob ntshav qab zib mob ntshav qab zib hom 2, cov hauv qab no yuav tsum paub qhov txawv:
- tib neeg mem tes nrawm;
- ua pa yuav ntiav thiab hnyav;
- daim tawv nqaij tig daj;
- pom tsis muaj zog hauv cov ceg, kiv taub hau, tinnitus;
- feces tig liab los yog xim av tsaus.
theem ntawm ntshav ntshav no cuam tshuam nrog lub cev cov lus teb tam sim rau kev poob ntshav. Nws siv sijhawm li 12 teev, thiab tom qab ntawd nws mus rau theem tom ntej.
Nyob rau theem no, lub cev tshem tawm cov qe ntshav liab ntau tshaj plaws, thiab cov kua dej sib txuas nkag mus rau hauv cov hlab ntsha. Cov khoom pom ntawm lub raum tau them nyiaj, vim tias cov dej khaws cia hauv lub cev yuav tsum tau ua, uas ua rau txo qis cov zis tso tawm. Cov qe ntshav liab tau muab faib rau hauv plasma, ua rau txo qis ntawm hemoglobin.
Yog tias mob ntshav qab zib mob ntshav qab zib hom 2 ntshav poob qis heev, ces hemorrhagic collapse. Nyob rau tib lub sijhawm, lub siab poob qis heev rau qhov tseem ceeb, kev ua pa yog ntiav thiab nrawm, lub plawv dhia yog thready. Muaj cov leeg nqaij tsis muaj zog mus txog qhov ua tiav ntawm lub cev muaj zog, tsis nco qab, ntuav thiab nqos tau.
Kev tsis txaus ntshav maj mam ua rau cov pa oxygen tshaib plab hauv lub cev thiab lub cev. Kev tuag tshwm sim vim mob plawv thiab ua pa. Ib qho kev qhia ntawm cov ntshav los yog qhov ncauj qhuav. Tawm tsam keeb kwm yav dhau los ntawm kev mob hnyav heev ntawm tib neeg lub cev, qhov kub tuaj yeem nce. Tus neeg mob yws yws ntawm kev nyem lub cev sab hauv.
Tus kws kho mob hu rau
Hauv mob ntshav qab zib mob ntshav qab zib hom 2, qhov ua rau, kab mob thiab cov duab ntshav tuaj yeem sib txawv heev, yog vim li cas thaum thawj cov tsos mob tshwm sim, koj yuav tsum hu rau lub tsheb thauj neeg mob mus kuaj mob. Qhov kev pab sai dua yog muab rau ib tug neeg, ntau dua qhov yuav ua tau zoo ntawm kev kho mob. Kev sab laj ntawm tus kws phais thiab tus kws kho mob traumatologist yuav tsum tau.
Ntxiv rau, koj yuav tsum tau sab laj nrog kws kho mob plab, kws kho mob, kws kho mob hematologist thiab gynecologist. Tus kws kho mob thawj zaug tau mloog txhua qhov kev tsis txaus siab ntawm tus neeg mob. Tom qabThaum lub sijhawm kuaj, tus kws kho mob nug ntau yam lus nug kom meej, uas yog:
- thaum pom muaj mob tshwm sim;
- muaj teeb meem zoo sib xws ua ntej;
- xav txog kab mob ntev;
- muaj lwm qhov tsis txaus siab;
- yog tus neeg noj tshuaj.
Daim ntawv ntsuam xyuas tso cai rau koj ua daim duab kho mob tag nrho ntawm cov kab mob. Nws kuj tso cai rau koj mus nrhiav qhov tseeb ua rau anemia. Tus kws kho mob yuav tsum xa tus neeg mob mus kuaj kom paub meej tias qhov kev kuaj mob.
Diagnostics
Kev kuaj mob ntshav qab zib mob ntshav qab zib yog txhawm rau txiav txim siab cov cim tseem ceeb ntawm cov kab mob thiab qhov chaw ntawm cov hemorrhages tas li. Nws suav nrog kev sim thiab ntsuas ntsuas, tshwj xeeb hauv qab no:
- hemogram;
- electrocardiogram;
- tshuaj ntsuam biochemical ntawm cov zis thiab ntshav;
- ultrasound;
Thaum kuaj tus neeg mob, tus kws kho mob yuav tsum ua tib zoo saib xyuas cov ntshav siab, ua pa nrawm, tsis tshua pom kev, lub plawv yws yws, lub plawv dhia tsis zoo. Raws li cov duab ntshav ntawm mob ntshav qab zib mob ntshav qab zib hom 2, qhov txo qis ntawm tag nrho cov erythrocytes thiab hemoglobin raug kuaj pom. Hauv qhov no, yuav tsum tswj cov zis, electrolytes, platelets, siab.
Kev txiav ntawm medulla nrog nws txoj kev tshawb fawb tom ntej tsuas yog yuav tsum tsis muaj peev xwm tsim kom muaj kev kuaj mob kom raug. NtawmHom kev tshawb fawb no qhia tau tias muaj kev nce hauv kev ua haujlwm ntawm cov hlwb liab medulla hauv cov pob txha.
Thaum kuaj pom ntawm cov hemorrhages sab hauv, cov tsos mob ntawm qhov tsis txaus ntawm cov kua roj ntsha lom thiab kev kuaj sim yog qhov tseem ceeb. Tsis tas li ntawd, cov chaw ntawm cov ntshav tsim tau pom nyob rau hauv cov kab mob hauv nruab nrog cev, uas yog suav tias yog ib qho anomaly. Cov hlau txo qis. Nrog kev los ntshav sab nraud, kev kuaj mob kom raug yog yooj yim heev.
Txoj kev kho mob
Kev kho mob ntshav qab zib mob ntshav qab zib hom 2 tuaj yeem muaj qee qhov sib txawv, txhua yam nyob ntawm theem ntawm chav kawm. Yog tias ib tug neeg tau kuaj pom tus kab mob no, ces nws yuav tsum tau mus pw hauv tsev kho mob sai. Txhua qhov kev siv zog ntawm tus kws kho mob yog tsom rau kev tshem tawm los ntshav. Txhawm rau ua qhov no, nws tuaj yeem ua tiav:
- hnav khaub ncaws;
- vascular kaw;
- nce ntshav khov;
- resection thiab suturing ntawm lub cev puas tsuaj.
Yav tom ntej, mob ntshav qab zib mob ntshav qab zib tsis tas yuav tsum tau kho txhua yam, vim lub cev yuav rov qab cov ntshav ploj ntawm nws tus kheej. Qhov no tshwm sim thaum koj qhib koj tus kheej cov ntshav cia, uas nyob hauv lub ntsws, daim siab thiab tus po.
Yog tias ib tug neeg poob ntshav ntau, ces nws yuav tsum tau txhaj tshuaj sai. Hauv cov mob hnyav, tus neeg mob kuj tuaj yeem nkag mus:
Vitamin B;
Txhua yam tshuaj no yuav tsum tau nojua ke nrog ascorbic acid. Ua tsaug rau qhov no, hlau yog nqus sai dua los ntawm lub cev. Cov ntaub so ntswg acidosis raug tshem tawm los ntawm kev siv dej qab zib. Txawm hais tias ntshav poob tseem ceeb, cov tshuaj "Heparin" tau raug sau tseg kom tshem tawm cov thrombosis. Tus neeg mob tau txuas nrog cov pa oxygen hauv cov hlab pa.
Kev tiv thaiv kev tiv thaiv yog qhov yuav tsum tau ua thaum lub sijhawm rov zoo, vim cov neeg muaj tus kab mob no kis tau los ntawm ntau yam kab mob. Ua li no, koj yuav tsum noj cov vitamins thiab immunostimulants.
Txoj kev mob ntawm cov menyuam yaus
mob ntshav qab zib mob ntshav qab zib hauv cov menyuam yaus muaj ntau heev. Nws tshwm sim los ntawm kev raug mob thaum yug menyuam, nrog rau kev kuaj ntshav ntau rau kev tshuaj xyuas. Hauv cov menyuam yaus, tus kab mob no tuaj yeem ua rau muaj kab mob.
Cov tsos mob ntawm hemorrhages nyob rau hauv cov me nyuam mos tshwm nyob rau hauv ib nrab ib teev, thiab cov laus - txhua hnub. Ntawm cov cim tseem ceeb ntawm cov kab mob, nws yog ib qho tsim nyog yuav tsum tau hais txog:
- tsis qab los;
- sluggish, apathetic state;
- kev loj hlob qeeb thiab hnyav.
thawj kos npe yuav yog qhov kev hloov ntawm saj. Tsis tas li ntawd, tus cwj pwm coj txawv txawv, capriciousness, tearfulness los yog, conversely, apathy tshwm sim. Tsis tas li ntawd, tus me nyuam cov rau tes ua nkig, tawv nqaij qhuav, thiab tus nplaig du.
Kev pab xub thawj yog mus pw hauv tsev kho mob tus menyuam thiab tshem tawm cov hemorrhages. Thaum pib, ib pab pawg tau txiav txim siab, ces cov ntshav hloov pauv tau nchuav rau hauv. Ntawmkev kho mob yuav tsum tau saib xyuas kev ua haujlwm ntawm lub plawv. Kev noj zaub mov muaj vitamin thiab protein ntau.
Tus kab mob hauv cov poj niam cev xeeb tub
Mob ntshav qab zib ntau dhau thaum cev xeeb tub qhia tias muaj teeb meem txaus ntshai. Cov no muaj xws li placental hematomas, exfoliation, rupture ntawm umbilical kwj dej.
Ntawm no, thaum thawj cov tsos mob tshwm sim, koj yuav tsum sab laj nrog kws kho mob kom kuaj xyuas thiab kho.
Khoom noj khoom haus rau ntshav qab zib thiab tshuaj kho pej xeem
Nyob ntawm qhov pathogenesis ntawm mob ntshav qab zib posthemorrhagic thiab cov yam ntxwv ntawm cov kab mob, tus kws kho mob xaiv cov kev kho mob cais. Nco ntsoov thaum xub thawj tshem tawm qhov ua rau los ntshav. Tom qab siv tshuaj kho mob, yuav tsum muaj kev rov qab los ntev ntawm lub cev. Txhawm rau ntxiv hemoglobin, cov khoom noj tshwj xeeb raug xaiv. Nws lub hom phiaj tseem ceeb yog muab lub cev nrog cov ntsiab lus tseem ceeb thiab cov vitamins, yog li kev noj haus yuav tsum muaj calorie ntau ntau thiab sib npaug, tab sis nrog cov ntsiab lus roj tsawg kawg nkaus.
Hauv tus neeg mob noj zaub mov, yuav tsum muaj cov khoom noj uas muaj hlau, xws li daim siab thiab nqaij ntshiv. Txhawm rau ua kom cov zaub mov muaj microelements, cov protein thiab cov amino acids tseem ceeb, tsev cheese, ntses thiab qe yuav tsum tau ua. Cov khoom tseem ceeb ntawm cov vitamins yog kua txiv hmab txiv ntoo, txiv hmab txiv ntoo thiab zaub.
Kev poob dej tuaj yeem rov ntxiv los ntawm kev haus tsawg kawg 2 litres dej ib hnub. Txhawm rau txhim kho lub zog thiab txhawb lub cev, koj tuaj yeem siv cov tshuaj ib txwm siv.
Yuav nyob hauvraws li tshuaj yej, haus ib qho infusion ntawm qus sawv berries, uas strawberry nplooj ntxiv ntxiv. Nyem kua txiv los ntawm beets, radishes thiab carrots, sib tov nyob rau hauv sib npaug proportions. Ncuav rau hauv ib lub thawv tsaus, npog nrog lub hau thiab ci hauv qhov cub rau 3 teev. Haus kua txiv 1 tbsp. l. txhua hnub rau 3 lub hlis. Nrog ntshav poob, kev tiv thaiv raug kev txom nyem heev, yog li txhawm rau ntxiv dag zog rau nws, koj yuav tsum noj decoctions raws li ginseng, echinacea, marshmallow, lemongrass.
Huab cua
Kev kuaj mob rau mob ntshav qab zib mob ntshav qab zib ntau ntau nyob ntawm seb cov ntshav tau ploj mus ntau npaum li cas. Txo nws cov ntim los ntawm 10% yog zam tau yooj yim heev. Kev poob ntawm 1/5 ntawm cov ntshav tsis zoo cuam tshuam rau tus neeg mob txoj kev noj qab haus huv. Txo nws los ntawm qhov thib peb hem tus neeg mob tuag.
Kev kho mob ncua sij hawm tuaj yeem ua rau muaj mob ntshav qab zib ntau dua, nrog rau kev sib ntxiv ntawm cov txheej txheem sib kis. Thaum tsis muaj kev kho mob thiab kev nce ntshav ntxiv, hemorrhagic shock tuaj yeem tshwm sim. Cov mob no ua rau mob hypoxia. Cov ntshav tsis txaus rau lub hlwb nrog oxygen tuaj yeem ua rau tuag tes tuag taw ntawm qhov chaw ua pa.
Muaj Teeb Meem
Thaum mob ntshav qab zib mob ntshav qab zib tshwm sim, cov ntshav cov duab feem ntau tsis zoo, vim tias nws poob qis heev. Nws tag nrho cov nyiaj nyob rau hauv lub cev yog 3.5-5 litres. Circulating los ntawm lub cev, nws ua tau ntau yam sib txawv, uas yog:
- faib cov pa thiab cov as-ham;
- hloov cov tshuaj hormones raulub cev rhiab heev;
- tshem tawm cov khoom lwj ntawm cov ntaub so ntswg;
- koom nrog txheej txheem ntawm kev rov qab los thiab kho;
- tswj qhov kub thiab txias;
- enables tiv thaiv tawm tsam sab nraud.
Yog tias cov ntshav txo qis dua 10%, tus neeg mob pom meej meej. Muaj qhov txo qis hauv tag nrho nws cov txiaj ntsig zoo.
Txij thaum pib, cov ntaub so ntswg hauv hlwb uas muaj oxygen tshaib plab raug kev txom nyem. Tom qab ntawd muaj kev cuam tshuam loj dua hauv kev ua haujlwm ntawm lub cev hauv nruab nrog cev.
Kev tiv thaiv kab mob no
Kev xaiv kev tiv thaiv kom raug yuav pab tiv thaiv kev txhim kho ntawm cov ntshav qab zib thiab nws rov tshwm sim dua. Thaum tus kab mob dhau mus rau theem ntev, nws yog ib qho tsim nyog yuav tsum tau saib xyuas koj txoj kev noj qab haus huv tas li, mus kuaj thiab noj tshuaj. Yog tias tus kws kho mob hais kom ua haujlwm, tsis tas yuav tsum tsis kam lees, vim qhov no yuav tshem tawm qhov ua rau mob ntshav qab zib.
Kev noj haus ntawm cov neeg laus thiab menyuam yaus yuav tsum muaj cov khoom noj uas muaj cov vitamins, hlau, nrog rau cov kab mob uas xav tau rau lub cev. Cov poj niam cev xeeb tub yuav tsum tau sau npe raws sijhawm, vim qhov no yuav kuaj ntshav ntshav thiab tiv thaiv qhov tshwm sim ntawm cov teeb meem uas txaus ntshai rau kev noj qab haus huv ntawm tus poj niam thiab tus menyuam mos.
Yog tias tus menyuam tau kuaj pom tias muaj kab mob txaus ntshai no, nws raug nquahu kom pub niam mis ntxiv. Tus me nyuam zoo li no yuav tsum tau muab zaub mov zoo, noj qab nyob zoo, ib puag ncig txhawb nqa thiab khoom noj khoom haus raws sij hawm. Kev taug kev tsis tu ncua yog qhov tseem ceeb rau kev noj qab haus huv zoo, thiab cov tshuaj xav taumuab tsuas yog raws li kws kho mob qhia.
Txhawm rau tiv thaiv kev txhim kho ntawm dystrophy, nrog rau rickets, koj yuav tsum tau saib xyuas tas li los ntawm tus kws kho mob. Kev saib xyuas tshwj xeeb yog them rau cov menyuam yug los rau cov poj niam uas muaj ntshav qab zib thiab cov uas tau noj lub raj mis. Kuj tseem muaj kev pheej hmoo yog cov menyuam mos los ntawm ntau lub cev xeeb tub, maj mam nce qhov hnyav, ntxov ntxov.
Tsis txhob hnov qab txog kev ntsuas kev nyab xeeb, vim qhov no yuav pab txo qis kev raug mob. Yog tias nws tsis tuaj yeem zam kev puas tsuaj, ces txhawm rau tiv thaiv kev poob ntshav tseem ceeb, koj yuav tsum sab laj nrog kws kho mob tam sim ntawd.
Posthemorrhagic anemia tuaj yeem kho tau yog tias cov tsos mob ntawm tus kab mob raug lees paub raws sijhawm thiab mus ntsib kws kho mob. Qhov no yuav rov qab kho cov qauv ntshav yam tsis muaj qhov tshwm sim thiab ua kom muaj kev noj qab haus huv zoo.
