Hauv kev kho mob, lo lus "fainting" tsis siv lawm. Nws tau piav qhia hauv lub koom haum thoob ntiaj teb: ICD-10 code - R55. Syncope yog lub npe official. Cov neeg laus thiab cov menyuam yaus tuaj yeem ntsib luv luv syncope uas tshwm sim tshwm sim. Lawv yog cov txaus ntshai tshwj xeeb rau cov neeg uas twb laus lawm. Qhov tseeb yog qhov no tuaj yeem ua rau muaj ntau yam kev raug mob thiab pob txha.
Qhov no yog dab tsi?
Syncope yog ib qho mob tshwm sim los ntawm lub sijhawm luv luv ntawm kev nco qab. Qhov no tshwm sim vim qhov txo qis hauv cov leeg nqaij. Tom qab ib tug neeg los rau ntawm nws lub siab, nws lub siab xav rov qab los sai heev. Yog li, lub xeev syncopal (peb twb tau hu ua ICD-10 code ua ntej) yog ib qho syncope uas kav ntev li 60 vib nas this.
Thaum ib tug neeg los cuag nws,Nws tsis muaj kab mob neurological. Tom qab kev tawm tsam, tej zaum yuav muaj mob hauv lub taub hau, lub siab xav mus pw, nrog rau lub cev tsis muaj zog. Feem ntau, syncope tshwm sim hauv cov menyuam yaus thiab cov poj niam, tshwj xeeb tshaj yog cov uas nyob hauv lawv cov hluas. Txawm li cas los xij, nws kuj tuaj yeem pom hauv cov txiv neej noj qab haus huv. Hauv cov neeg laus, nws tshwm sim nws tus kheej hauv qhov tseeb tias ob peb feeb ua ntej tus mob poob ntawm lawv lub cim xeeb.
Thaum tus neeg qaug zog, nws cov leeg tau so, nws lub plawv dhia qeeb, thiab nws ua pa tawm tsawg. Tus neeg mob tsis teb rau stimuli, daim tawv nqaij pib daj ntseg. Nws txawm tshwm sim thaum tus txheej txheem tso zis tshwm sim thaum muaj kev tawm tsam.
Yog vim li cas
Tom ntej, xav txog qhov ua rau syncope. Nws yog dab tsi, peb twb paub lawm. Tab sis vim li cas thiaj tshwm sim?
Lub hlwb tib neeg yuav tsum tau muab cov ntshav mus tas li. Txhawm rau ua nws txoj haujlwm zoo, nws xav tau txog 13% ntawm tag nrho cov ntshav ntws. Yog hais tias ib tug neeg lub cev loads lub cev, yog tshaib plab los yog nyob rau hauv ib tug stressful teeb meem, ces cov zauv no hloov heev. Xav tias qhov nruab nrab ntawm lub hlwb hnyav txog 1500 g, xav tau txog 750 ml ntawm cov ntshav ib feeb. Yog tias qhov ntsuas no tsawg dua, tus neeg yuav pib qaug zog.
Qhov ua rau tus mob no yuav tsum raug hu ua ischemic attacks, me me ntawm cov piam thaj, vegetative-vascular dystonia, trauma ntawm craniocerebral txoj kev npaj, qaug dab peg, hysteria los yog mob hlwb, neurology, teeb meem nrog lub plawv dhia, lub cev qhuav dej,vagus hlab ntsha ua haujlwm, lom thiab lwm yam. Cov npe tuaj yeem mus ntxiv, tab sis cov no yog cov laj thawj feem ntau.
Kev faib tawm
Kev faib tawm ntawm lub xeev syncopal (ICD-10 tus lej paub rau peb) qhia txog kev faib raws li qee yam. Tus mob no tau muab faib ua 5 yam.
- Cerebrovascular syncope. Nws tuaj yeem tshwm sim yog tias lub hlwb tsis txaus. Feem ntau, nws yog txuam nrog qhov tseeb hais tias lub cev muaj cerebrovascular pathologies. Raws li txoj cai, cov neeg mob muaj lub suab nrov ntawm cov hlab ntsha carotid, nrog rau qhov tsis muaj brachial mem tes.
- Kev mob plawv arrhythmia. Yog hais tias ib tug neeg muaj asystole, bradycardia, los yog tachycardia, ces tus neeg mob muaj teeb meem nrog cov ntshav tso zis. Raws li txoj cai, nws cov ntsuas txo qis. Cov laj thawj uas ua rau syncope hauv cov ntaub ntawv no yog cov kab mob pathologies, xws li txo qis hauv atrioventricular conduction.
- Reflex saib. Hauv qhov no, qhov tseem ceeb uas ua rau tus mob no yuav yog bradycardia. Nws tshwm sim vim hypoperfusion lossis hypotension. Nyob rau tib lub sijhawm, tus neeg tsis nco qab vim lub suab tsis zoo, mob, hnoos, lub dab tshos nruj, tig lub caj dab ntau dhau, nrog rau kev xav.
- Orthostatic collapse. Tus mob no tshwm sim nyob rau hauv ib tug neeg yog hais tias nws nyob rau hauv cov neeg coob coob, nyob rau hauv ib tug kub qhov chaw, los yog yog hais tias nws yog loaded heev. Lub paj hlwb tsis teb zoo rau kev hloov pauv tam sim ntawd. Yog li ntawd, muaj ib tug malfunction nyob rau hauv lub ua hauj lwm ntawm lub plawv, thiab ib tug neeg muaj syncopemob (ICD-10 code: R55). Nws kuj tuaj yeem tshwm sim los ntawm tus kab mob Parkinson, noj qee yam tshuaj, thiab lwm yam.
- kab mob plawv ntawm cov yam ntxwv. Qhov no yuav tsum muaj xws li myxomas ntawm lub plawv, teeb meem nrog lub aorta thiab lwm yam. Yog hais tias ib tug neeg muaj ntau lub plawv tso zis, feem ntau nws yuav muaj ib tug syncope (ICD-10 code: R55).
Diagnosis
txhawm rau kuaj xyuas tus mob, nws yuav tsum tau ua tib zoo saib xyuas cov txheej txheem ua pa. Tus neeg yuav muaj cov menyuam kawm ntawv dilated, ntshav siab, tsis muaj zog, thiab lub plawv dhia tsis zoo. Yog li ntawd, tus neeg mob yuav tsum tau kuaj tam sim ntawd los ntawm ib tug kws kho plawv thiab ib tug neurologist. Nws tseem yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas cov tsos mob, txij li yog tias ib tus neeg tsuas muaj ib rooj plaub ntawm kev qaug zog, ces kev kuaj mob yuav nyuaj. Yog tias muaj kev ntog ntau zaus, nrog rau cov teeb meem ntawm kev taw qhia hauv qhov chaw, ces yuav tsum pib kho tus kab mob sai.
Tus kws kho mob yuav xav paub seb tus neeg tawm hauv lub xeev no li cas. Cov txheej txheem ntawm kev kho dua tshiab ntawm lub luag haujlwm tseem ceeb yog ntsuas, uas yog, rov qab mus rau kev nco qab thiab normalization ntawm lub plawv voj voog. Tus neeg mob yuav tsum tau ua ECG, x-ray ntawm lub plawv, nrog rau cov kab mob ua pa. Koj yuav tsum tau kuaj ntshav thiab zis. Yog tias qhov laj thawj nyuaj los txheeb xyuas, ces X-ray ntawm pob txha taub hau, electroencephalography, phonocardiography, nrog rau kev kuaj mob los ntawm tus kws kho qhov muag raug sau tseg.
Tus neeg mob yuav tsum ua li cas?
Yogib tug neeg muaj fainting syncope thiab lub cev qhuav dej (hauv ICD-10 nws muaj tus lej R55), nws yuav tsum tau muab kev saib xyuas xwm txheej ceev tam sim ntawd. Txhawm rau kom tus neeg mob tsis txhob raug mob, nws yuav tsum ua tib zoo saib xyuas cov tsos mob ntawm tus mob no.
Yog tias tus neeg mob pib hnov mob hauv pob ntseg, qhov pom ntawm yoov, kiv taub hau, tawm hws, tsis muaj zog hauv lub cev, ces nws yuav tsum tau muab cov khaub ncaws nruj tam sim ntawd. Nws yog ib qho tsim nyog yuav tau siv ammonia, nrog rau pw ntawm ib qho chaw tiaj tus. Ob txhais ceg yuav tsum tau tsa 50 degrees. Yog hais tias tus neeg tseem tsis tau poob kev nco qab, ces yuav tsum tau massage qhov chaw ntawm lub tuam tsev thiab daim di ncauj.
Kev pab ib zaug
Thaum tus neeg mob nyob hauv lub xeev syncopal (tam sim no peb paub tus lej ICD-10 rau cov kab mob no), cov neeg nyob ib puag ncig nws yuav tsum qhib qhov rais lossis qhov rooj kom huab cua ntshiab nkag. Txhawm rau coj mus rau lub neej, koj yuav tsum siv ntau yam receptor stimuli, uas yog, koj tuaj yeem rub koj pob ntseg, tshuaj tsuag koj lub ntsej muag nrog dej khov, lossis tsuas yog pleev koj lub plhu. Lub taub hau yuav tsum tig mus rau sab kom tus nplaig tsis cuam tshuam nrog kev ua pa. Nco ntsoov tshem cov nyees khawm ntawm koj cov khaub ncaws yog tias nws nruj.
