Laryngospasm yog cov txheej txheem pathological uas yog tus cwj pwm los ntawm kev npaj txhij txog ntawm cov leeg nqaij laryngeal. Qhov no contraction yog tsis nco qab. Feem ntau, laryngospasm hauv cov neeg laus tuaj yeem tshwm sim ib txhij nrog tracheospasm. Tus mob no yog nrog los ntawm ib txhij contraction ntawm cov leeg du ntawm lub trachea. Kev qaug dab peg yam no txaus ntshai heev, ua rau neeg ntshai.
Pathogenesis
Tam sim no, ua tsaug rau kev tshawb fawb, ntau qhov laj thawj tseem ceeb ntawm laryngospasm hauv cov neeg laus tau raug txheeb xyuas:
- hloov cov reactivity ntawm tib neeg lub cev;
- nce excitability ntawm neuromuscular reflex apparatus ntawm lub larynx;
- ib qho tsis txaus hauv tus neeg mob lub cev ntawm vitamin D thiab calcium ntsev;
- kev ua txhaum ntawm kev sib pauv khoom ib txwm muaj.
Tus kab mob tuaj yeem tshwm sim ntawm keeb kwm ntawm chorea, tehlwb, spasmophilia, rickets, bronchopneumonia, puas siab puas ntsws trauma.
Tsis tas li ntawd, laryngospasm hauv cov neeg laus feem ntau tshwm sim nrog kev hloov pauv ntawm cov kab mob hauv nruab nrog cev: trachea, pharynx, ntsws, pleura, larynx, gallbladder. Tsis tas li ntawd, nrog rau kev nkag siab ntawm lub cev vim yog pathologies ntawm hom kab mob sib kis, nrog rau kev cuam tshuam ntawm ntau yam tshuaj ntawm lub qhov ntswg mucosa, piv txwv li, adrenaline.
Yog li, cov laj thawj tseem ceeb ntawm tus kab mob hauv cov neeg laus yog raws li hauv qab no:
- Metabolic ntshawv siab.
- Calcium thiab vitamin deficiency.
- Kev muaj qee yam kab mob.
- Vim kev raug mob ntau yam.
- mob hnyav, hnoos, mob hlwb.
- Kev ua pa tsis zoo.
- Kev tsis haum.
- o, o lossis khaus ntawm lub larynx.
- Aneurysm.
- Kev ntxhov siab lossis ntxhov siab.
Etiology
Laryngospasm kuj tseem muaj lwm qhov chaw tseem ceeb ntawm qhov tshwm sim:
- Cov nyhuv ntawm huab cua uas muaj cov khoom ua rau khaus (xws li hmoov av).
- Kev ua txhaum ntawm qog hom formations.
- Cov nyhuv ntawm txhua yam tshuaj los ntawm lubrication ntawm lub larynx.
- txheej txheem mob thiab edematous hauv lub larynx.
- Ntau yam kab mob: eclampsia, tetanus, kev tsis sib haum xeeb, tabes dorsalis, hysteria.
- Irritation ntawm lub laryngeal recurrent los yog vagus paj (aneurysm, qog, goiter).
daim duab kho mob hauv qhov kev mob no
Nrog laryngospasm hauv cov neeg laus, nyuaj, hawb pob, tsis hnov tsw, cyanosis lossis pallor ntawm daim tawv nqaij epithelium tuaj yeem tshwm sim tam sim ntawd, muaj kev sib txuas ntawm cov leeg ntawm lub ntsws ntawm lub ntsws, nro hauv cov leeg nqaij ntawm caj dab.
Lwm qhov kev tawm tsam ntawm laryngospasm feem ntau tshwm sim los ntawm lub taub hau thim rov qab, qhib qhov ncauj, lub cev muaj zog, zoo li hws txias, txawm tias nres ua pa ib ntus.
Nyob rau hauv lub neej yav tom ntej, vim muaj cov pa roj carbon dioxide nyob rau hauv lub cev, muaj ib tug muaj zog irritation ntawm qhov chaw ntawm kev ua pa, nws yog rov qab. Kev tawm tsam ntawm laryngospasm thaum hnoos hauv cov neeg laus hauv cov neeg mob yooj yim tsis ntev hauv lub sijhawm thiab thaum kawg los txog rau ob peb feeb, xaus nrog ua pa elongated, tom qab ntawd pib ua pa sib sib zog nqus, qee zaum pw tsaug zog. Thaum lub sij hawm laryngoscopy thaum lub sij hawm laryngospasm, koj tuaj yeem pom yuav ua li cas lub suab folds yog nias nruj rau ib leeg thiab txawm pw ib leeg rau ntawm lwm tus, thaum lub suab nrov ntawm cov pob txha mos arytenoid feem ntau mus dhau ntawm sab laug.
Thaum twg qaug dab peg?
Hauv qhov no, kev tawm tsam tuaj yeem rov ua ntu zus ob peb zaug hauv ib hnub, feem ntau thaum nruab hnub. Tsis tas li ntawm cov laj thawj uas tuaj yeem ua rau laryngospasm yog cov kab mob hauv qab no: ntau yam pathologies ntawm pleura, pharynx, gallbladder, larynx, trachea; chorea; spasmophilia.
Tus neeg laus laryngospasm yog ib qho mob hnyav uas tuaj yeem muaj ntau yam ua rau. Tus kws kho mob, nws qhov kev sab laj yog yuav tsum tau, tuaj yeem txiav txim siab txog keeb kwm ntawm pathology.
Cov tsos mob ntawm tus kab mob no
thawj cov tsos mob ntawm laryngospasm hauv cov neeg laus yog ua pa nrov, uas yog qhov nyuaj heev. Tawm tsam keeb kwm yav dhau los ntawm cov tsos mob no, daim tawv nqaij cyanosis yog tsim (tshwj xeeb tshaj yog nyob rau thaj tsam ntawm daim di ncauj), uas ua rau cov leeg ntawm caj dab. Cov tsos mob thaum qaug dab peg: tus neeg mob lub qhov ncauj qhib tas li; muaj hws ntau dhau; thready xwm ntawm mem tes; Vim tias cov ntsiab lus ntawm cov pa roj carbon dioxide tau nce sai hauv tib neeg lub cev, kev ua xua ntawm qhov chaw ua pa tshwm sim, thiab kev ua pa ua pa nws tus kheej tau ruaj khov.
Thaum laryngospasm ua rau mob hnyav, ntxiv rau daim duab kho mob tseem ceeb, cov cim hauv qab no tau ntxiv: convulsive syndrome, uas kis thoob plaws tag nrho cov leeg pob txha; qaug zog; muaj qhov tso tawm ntawm cov npuas dej ntawm qhov ncauj; tus neeg mob tuaj yeem ua rau lub plab tsis ua haujlwm ntawm lub zais zis thiab cov hnyuv; mob plawv.
Nyob rau hauv cov neeg mob hysteria
Hauv cov neeg laus, cov tsos mob ntawm laryngospasm yog qhov tshwj xeeb. Tus kab mob hysterical yog tus cwj pwm los ntawm kev kawm ib txhij nrog kev ua rau ntawm cov ceg ceg, txoj hlab pas, thiab pharynx. Hauv cov neeg mob hysteria thiab lwm yam neuroses, laryngospasm tuaj yeem tshwm sim thaum daim iav laryngeal ntxig rau hauv lub pharynx, tab sis qhov kev tawm tsam nws tus kheej dhau mus sai. Qee zaum nws zoo li qaug dab peg. Yog hais tias qhov teeb meem tsis tshua muaj hnyav, laryngospasm tuaj yeem tshwm sim los ntawm lub sij hawm luv luv ntawm glottis, kev tshoov siab ntev nrog lub suab nrov txawv,xiav lossis daj ntseg, ua pa nrov, quaj qw, ua tsis taus pa sai.
Kev saib xyuas xwm txheej ceev rau cov neeg laus laryngospasm yog qhov tseem ceeb heev.
Pathology tuaj yeem tshwm sim nrog rau tracheospasm, uas cov leeg du ntawm thaj tsam membranous posterior ntawm lub trachea kuj cog lus. Tshwj xeeb tshaj yog txaus ntshai yog laryngospasm vim muaj peev xwm tuag los ntawm asphyxia nrog kev tawm tsam ntev heev. Tsuas yog vim li no, koj yuav tsum paub tias cov txheej txheem pab thawj zaug muaj dab tsi rau laryngospasm.
Kev tawm tsam hauv cov neeg laus tuaj yeem ua rau lub ntsej muag tawm thiab hnoos hnyav.
Supposed pathological teeb meem
Yog qhov qaug dab peg hnyav thiab ntev txaus, qhov mob hnyav tuaj yeem tshwm sim vim qhov no. Thaum tsis muaj qhov tsim nyog tau txais kev pab raws sijhawm, qhov kev tawm tsam yooj yim tuaj yeem ua rau tuag taus vim qhov pib ua pa. Txhua tus neeg nyob ze, qhov tseeb vim tias muaj kev phom sij, yuav tsum paub txog kev tiv thaiv kev nyuaj thiab cov cai rau kev pab tiv thaiv keeb kwm yav dhau los ntawm laryngospasm. Txawm li cas los xij, txawm hais tias tus mob no muaj qhov tshwm sim hnyav, kev tuag feem ntau tau sau tseg hauv cov neeg mob tsis muaj zog. Yog vim li cas koj thiaj li yuav tsum txhawb koj txoj kev tiv thaiv.
Yuav ua li cas txo qis laryngospasm hauv tus neeg laus?
Kev pab ib zaug
Thawj thiab qhov tseem ceeb tshaj plaws hauv kev muab lub tsheb thauj neeg mob tawm tsam keeb kwm ntawm laryngospasm hauv cov neeg laus cov neeg mob tau qhia raws li hauv qab no: koj yuav tsum muab tus neeg mob tso rau ntawm lub tiaj tiaj; ces cia cua nkag muslub ntsws, ntxiv rau, tau tshem tawm cov khaub ncaws sab nraud ntawm tus neeg; tsim tej yam kev mob rau huab cua ntshiab nkag mus rau hauv, ventilate lub chav nyob qhov twg tus neeg mob nyob (ventilate lub chav). Tshem tawm cov kev cuam tshuam ntawm qhov ua tau irritants thiab xyuas kom meej qhov ntsiag to. Qhov kev tawm tsam tuaj yeem cuam tshuam los ntawm kev txau dej ntawm lub ntsej muag, ua rau gag reflex. Tom qab ntawd koj yuav tsum hu rau qhov xwm txheej ceev.
Cov kws kho mob tshwj xeeb rau laryngospasm hauv cov neeg laus yuav siv cov kev ntsuas tsim nyog rau cov neeg raug tsim txom, nws yuav ua raws li hauv qab no: txhaj tshuaj calcium gluconate tau muab tso rau hauv cov hlab ntsha; intubation lossis tracheotomy yog siv yog tias tag nrho cov kev ntsuas yav dhau los tsis zoo; ib qho indirect cardiac massage yog ua thaum lub cev nres; Kev kho cov pa oxygen tab tom ua.
Kev kho mob
Yuav ua li cas kho laryngospasm hauv cov neeg laus nrog tshuaj? Yog hais tias tus kab mob tshwm sim vim tsis txaus cov ntsiab lus ntawm vitamin D thiab calcium nyob rau hauv lub cev, koj yuav tsum tau kho cov zaub mov, raws li zoo raws li kev noj haus. Yog tias qhov kev tawm tsam ntau zaus, tom qab ntawd noj cov da dej sov thiab siv cov tshuaj potassium bromide zoo kawg nkaus rau kev tshem tawm ntawm exacerbation. Nws yog ib qho tseem ceeb kom nkag siab tias hauv cov neeg laus, kev tshem tawm ntawm laryngospasm yog kho thiab tswj los ntawm tus kws kho mob tshwj xeeb. Ib txoj hauv kev zoo los tiv thaiv kev tawm tsam ntau zaus yog nqus tau siv tshuaj lossis dej ntxhia. Cov tshuaj yog kws kho mob tau sau tseg:
- nqus cov ammonia vapors los ntawm tus neeg mob;
- tshuaj anticonvulsant tau nkag rau hauv lub cev (chloral hydrate enema - los ntawm 0.3 mus rau 0.5 grams ib khobdej).
Yog tias mob ntev, siv da dej sov.
ob zaug hauv ib hnub, ib teaspoon ntawm cov tshuaj potassium bromide (0.5%) yog siv sab hauv.
Khoom noj
Cov nyiaj ntau npaum li cas ntawm cov nyiaj tau teev tseg rau cov menyuam yaus yog txiav txim los ntawm hnub nyoog. Ob tus neeg laus thiab cov menyuam yaus yuav tsum tau noj cov khoom uas muaj cov calcium ntau, lawv kuj tau sau cov txheej txheem kev kho lub cev (ultraviolet irradiation), tawv tawv ntawm tus neeg mob lub cev thiab taug kev ntev hauv huab cua ntshiab. Tsis tas li ntawd, koj yuav tsum tau noj zaub tshiab thiab khoom noj siv mis kom ntau li ntau tau.
tshuaj ntsuab
Kev tawm tsam ntawm laryngospasm tuaj yeem raug tshem tawm los ntawm cov txheej txheem ntawm cov tshuaj ib txwm siv. Lub ntsiab tseem ceeb thaum xaiv cov tshuaj yog kev nyab xeeb thiab ua tau zoo.
Kev nqus pa. Yog tias muaj kev tawm tsam ntau zaus, lawv tuaj yeem raug tshem tawm nrog kev pab ntawm dej qab zib inhalations: rau cov txheej txheem, dej qab zib (ob dia) yuav tsum tau ntxiv rau dej kub (ib khob dej kub npau npau). Inhale zoo kho chav rau tsawg kawg kaum tsib feeb, txoj kev no yog siv rau ib lub hlis.
Kev nqus tau tuaj yeem ua tiav thaum zaum hauv lub dab da dej uas muaj chav dej. Rau cov hom phiaj no, nws yog ib qhov tsim nyog los sau ib lub phiab los yog da dej nrog cov dej kub npau npau, tos kom txog thaum cov pa sib kis thoob plaws hauv chav. Txhawm rau txhim kho cov nyhuv, koj yuav tsum tau ntxiv tshuaj ntsuab xws li thyme, sage, mint rau hauv chav dej. Hauv qhov no, qhov nqus tau pa yuav kho tau. Thaum hnoos, nqus tau los ntawm Ambrobene.
Tincture. wine tshuaj ntsuabtincture pab txhawb kev ua pa thiab tshem tawm ntau yam ua rau laryngospasm. Ua noj nws, koj xav tau: thyme; tshuaj ntsuab; ib sprig ntawm rosemary; nplooj mint; mariannika nyom; grated Ginger paus; av kua txob liab; fortified liab caw (ib liter). Tag nrho cov tshuaj yog tov, ncuav nrog warmed caw, ces lawv hais rau ob hnub, lim thiab haus 50 milliliters ua ntej mus pw. Kev kho mob rov qab nrog kev so rau ib hlis.
Pine resin. Nws yog ib advisable mus yaj nyob rau hauv thaum sawv ntxov thiab yav tsaus ntuj nyob rau hauv lub qhov ncauj Pine resin (tshiab). Cov txheej txheem yog zoo dua nqa tawm ntawm lub plab khoob. Rau ib tug neeg laus, tus nqi yuav tsum sib npaug rau ib teaspoon. Tsis tas li ntawd, resin tuaj yeem yaj hauv cov mis nyuj sov thiab haus cawv txhua hnub thaum hmo ntuj.
Y Chamomile. Ib qho yooj yim thiab siv tshuaj yej chamomile yuav ntxiv dag zog rau lub paj hlwb thiab lub cev tag nrho. Nrog laryngospasm, nws raug nquahu kom haus dej haus tsis yog dej dawb, tab sis nrog mis nyuj kub.
Kub mis nyuj. Muab cov mis nyuj sov rau tus neeg mob txhua hmo, ntxiv ib tablespoon ntawm zib mu, nutmeg, cinnamon, propolis los yog cloves (rau koj saj).
Txhua yam ntawm cov khoom no pab ua kom lub ntsws ua pa, lub cev muaj zog. Txhua daim ntawv qhia ntawm cov tshuaj ib txwm siv yog tsom rau kev tshem tawm cov hauv paus hauv paus ntawm pathology, thiab tsis yog nws qhov tshwm sim.
ntsuas kev tiv thaiv
Hauv kev kho mob ntawm laryngospasm, kev tiv thaiv yog ib qho tseem ceeb tshaj plaws. Nws raug nquahu kom ua txhua yam kev ntsuas tsim nyog tas li, txawm tias kev tawm tsam tsis muaj zog.los yog tsis tuaj tag nrho. Lawv suav nrog: noj cov khoom siv mis nyuj; noj cov vitamins; qhov cua ntawm qhov chaw; balanced diet.
Peb tau saib cov tsos mob thiab kev kho mob ntawm laryngospasm hauv cov neeg laus.
