Thaum muaj xwm ceev kho mob nyob rau hauv anaphylactic poob siab

Cov tseem ceeb heev lub xeev ntawm lub cev uas tshwm sim thaum raug rau ib tug allergen thiab yog nrog los ntawm kev cuam tshuam ntawm qhov tseem ceeb heev systems ntawm lub cev, hu ua anaphylactic poob siab. Qhov no yog ib tug mob los yog txawm xob cov tshuaj tiv thaiv mus rau lub allergen yog muaj ib tug lub caij nplooj zeeg nyob rau hauv cov ntshav siab, impaired nco qab, ib tug tsis ua hauj lwm ntawm lub hauv paus poob siab system, DIC thiab spasm ntawm tus nqaij ntshiv ntawm hauv nruab nrog cev. Yog li ntawd nws yog tsim nyog los paub hais tias ib tug zoo los muab thaum muaj xwm ceev kev pab nyob rau hauv anaphylactic poob siab thiaj yuav cawm tau tib neeg lub neej. Nyob rau hauv thiaj li yuav ua tau cov kev kho mob algorithm, nws yog tsim nyog los paub qhov ua rau thiab pathogenesis ntawm poob siab.

Cov ua rau tus kab mob

By xws mob loj heev tshua kab mob ua rau yus txoj kev saib xyuas tshuaj noj, tshuaj tua kab tom ntawm cov nab muaj taug los yog tuav diagnostic kho mob nrog cov kev taw qhia ntawm contrast agents. Ntau tsawg ib anaphylactic cov tshuaj tiv thaiv kev noj. Foremost ntawm cov causative yam yog tshuaj. Qhov no, saum toj no tag nrho, tshuaj tua kab mob, tshuaj tiv thaiv, ntshav, protein tshuaj, immunoglobulins, cov tshuaj hormones. Tshwj xeeb yog sai anaphylaxis tshwm sim thaum parenteral thawj coj ntawm cov tshuaj, es thaum nws yog coj hais lus. Tus ceev tshaj txoj kev (instantly) poob siab tshua muaj tshwm sim thaum muab intravenously. Nyob rau hauv lwm tus neeg mob, lub cev lo lus teb rau ib tug allergen yog tsim rau ib teev. Heev ntawm kab nyob rau cov kev ceev ntawm cov tshuaj tiv thaiv. Yog li ntawd, thaum muaj xwm ceev kho mob nyob rau hauv anaphylactic poob siab yuav tsum tau muab sai li sai tau, txwv tsis pub txoj kev tuag yuav tshwm sim. Cov laus cov neeg, qhov ntau dua kev pheej hmoo ntawm kev tsim ua xua, txawm hais tias anaphylactic mob kuj tshwm sim nyob rau hauv cov me nyuam.

Soj ntsuam ces ntawm tus kab mob

Thawj zaug tsos mob ntxhov siab vim, ua mob taub hau los yog kiv kiv taub hau, ringing nyob rau hauv lub pob ntseg, cov tsos mob khaub thuas thiab nplaum hws. Tsis tas li ntawd ntawm lub qhov koob los yog ib tug tom nquag cai mob loj heev khaus thiab cov tsos mob ntawm urticaria (o thiab ua pob ua xyua). Ntxiv koom ua tsis taus pa, mob hauv siab, qhuav paroxysmal hnoos, uas tshwm sim vim spasm ntawm cov pa nqaij. Feem ntau cim dyspepsia li ntuav thiab dej quav, ntswj mob plab. Nyob rau hauv loj heev zaum, ntshav siab ntog, tus neeg tsis nco, convulsions zaum yuav tshwm sim.

Thaum muaj xwm ceev kho mob nyob rau hauv anaphylactic poob siab yog, ua ntej ntawm tag nrho cov, kom raug ntsuam xyuas lub hnyav ntawm tus mob, qhia hais tias tus ua rau kev tsis haum tshuaj , thiab txoj cai kauj ruam yog kauj ruam kev kho mob. Thaum saib ntawm tus tib neeg mloog yog twv rau lub daj ntseg thiab txias qhov kov cov tawv nqaij, akrozianoz, impaired nco qab. Mem tes heev thiab tsaus muag. Lub siab yog sharply txo qis. Mob yog ib qhov nyuaj thaum lub poob siab tsis nco qab, thiab muaj tsis muaj lwm yam tshwm sim ntawm kev tsis haum tshuaj. Pervasive xwm tsis muaj kom tau kev pab, pib irreversible hloov nyob rau hauv lub nruab nrog cev, thiab kev tuag tshwm sim nyob rau hauv lub thawj teev. Tej zaum lawv kuj yuav tshwm sim lig teeb meem ua rau pathological dab nyob rau hauv lub ob lub raum, lub plawv, lub hlwb thiab lwm yam kabmob. Vim li no, cov neeg mob uas tau muaj ib tug anaphylactic cov tshuaj tiv thaiv yuav tsum nyob twj ywm nyob rau hauv kev kho mob saib xyuas tsawg kawg yog ob lub lim piam.

Kev kho mob ntawm anaphylactic poob siab

Txawm tias cov kev loj hlob ntawm tsawg anaphylactic tshua, kev kho mob cov neeg ua yuav tsum paub qhov yooj yim cov kev ua ub yuav tsum tau rau cov nyem ntawm kev tsis haum cov tshuaj tiv thaiv thiab tswj kom lub cev tseem ceeb heev functions. Nyob rau hauv txhua lub tsev kho mob los yog obstetric units muaj ib tug txheej rau thawj pab nrog rau cov tsim nyog cov tshuaj nyob rau hauv qhov teeb meem no. Thaum muaj xwm ceev kev pab nyob rau hauv anaphylactic poob siab yog ib qho tam sim ntawd cessation ntawm koom haum saib xyuas ntawm cov tshuaj nyob rau hauv cov thawj cov cim qhia ntawm ib tug tsis haum cov tshuaj tiv thaiv. Yog hais tias qhov tshuaj tiv thaiv yog tshwm sim los ntawm parenteral thawj coj ntawm lub substance los yog cov tom, txhaj tshuaj site yuav tsum tau txhaj li epinephrine daws nyob rau hauv ib tug npaum li ntawm 0.5 ml. Cov nqi qub ntawm cov tshuaj muab subcutaneously. Yog hais tias muaj yog tsis nco qab thiab mob raug ntes, epinephrine yog xeem intravenously, kis nws glucose tshuaj. Yuav kom restore lub qub ntshav ntim ib txhij nqa Txoj kev lis ntshav txoj kev kho nrog lub koom haum saib xyuas ntawm saline daws teeb meem, poly- thiab reopoliglyukina zib supplemented nrog glucocorticosteroids. Ntxiv tas muab antihistamine (Tavegilum, Suprastinum li al.), Calcium npaj. Taw los ntawm lub sedative thiab anticonvulsant tshuaj, heparin. Nrog cov tsos mob ntawm spasm ntawm cov pa nqaij yog tsim nyog rau taw eufillin. Lub siab yuav tsum tau khaws cia nyob rau hauv tsis muaj tsawg tshaj li 110/70 hli. Hg. v. kom muaj ntshav txaus rau siab ntsws tseem ceeb. No Txoj kev lis ntshav muab cov tshuaj hormones, caffeine, kordiamin thiab piam thaj nrog insulin. Thaum muaj xwm ceev kho mob nyob rau hauv anaphylactic poob siab nyob rau hauv cov me nyuam muaj xws li ib tug zoo xws li cov kho kev ua ub no, tab sis nyob rau hauv ib tug muaj hnub nyoog tsim nyog koob tshuaj ntawm cov tshuaj.

Thaum koj nres ua pa thiab lub plawv dhia ntawm tus neeg mob yog pauv mus rau ib theem nrab pulmonary chaw dim pa thiab muab resuscitation.

Peb yuav tsum nco ntsoov hais tias ib tug paaj sij hawm yog nyob rau ntawm raws sij hawm kev kho mob.