Mendelson ka maʻi pale: symptoms, lapaʻau, Kāohi

Aia ka he papa inoa o ka maʻi i mai e haawi hoʻomanawanui iki mai i ka manawa, e hoʻomau 'ana i kā lākou mau ola maʻamau. E hōʻike 'muli o kona kulana koke, ka mea, loa hoʻololi i kekahi kanaka, a loaʻaʻo ia i mea uuku wale no ka maʻamau ola hoomauia. One ia pathological rula o kaʻakika wehena maʻi pale, i ua iʻikeʻia ma lalo o ka inoa Mendelson ka maʻi pale.

hōʻikeʻano

Ka hanana o ka maʻi aie a hiki i ka inhalation oʻakika gastric wai, a me ka hopena i kekahi kanaka e hoʻomōhala ana i huʻi li nui. Ka hapanui o na hihia o'āno'ē moku'āina ikeia ma obstetric anesthesia. Ma nā mea maʻi me ka okoa diagnoses, i mea ma lalo o anesthesia paha ole, ma ka lalo naehana'ōnaehana hiki kiʻi waiwai ma luna o nā'ūhūʻakika Contents o ka'ōpū.

Mendelson ka maʻi pale mea he make complication o anesthesia. Ke mau hana i loko o aneane 60% o ka hihia make. Ma obstetric anesthesia, keia huahelu ihoiho 70%.

kumu

I ka papa kuhikuhiE ololi e hoʻonāukiukiʻana mai oʻakika-wehena symptom ka regurgitation a me ka luaʻi, hang nei i anesthesia ka wā hoemi functionality aiiay reflexes o ka larynx. Mendelson ka maʻi pale ʻano nui, kena ae la regurgitetsiey, ka OE pau o gastric Contents i loko o ka oropharynx.

An māhuahua pilikia o complications ia lŘlŘ ka wā i ka piha opu, kaumaha lāʻau, ka waiʻona intoxication, lethargy. Regurgitation hiki hana ana i hāpai keiki (mai ka 22-23 pule), ka wā, ma muli o ke hormonal loli ho'ēmi i kā ka? Iecaianoaaiiie o gastrin, e hiki aku ai i ke kūpono 'ana o gastric hypertension. I waena o nā aʻe: mahuahua ma ka intragastric a me ke kūʻai '-abdominal puʻe, bloating, li nui o ka esophagus, obesity, imua o ka huʻiʻoki lāʻau lapaʻau maʻi o ka digestive nenoaiu. Ka pilikia nui o ka maʻi pale ia lŘlŘ ka wā o ka operative haawi i loko o obstetrics a ma ka hana ana i ka manaʻoʻoki kino.

pathogenesis

Mendelson ka maʻi pale mai i ka hananaʻano papa hana o ka? Acaeoey. Ke koho mua - ka mea, o ka wā undigested ai (particles) e komo aku ai i ka ÷ naehana hanu'āpana me gastric wai. Ma ka nui o nā haumāna me mechanical occlusion o ka bronchi hele aku ai a hiki i ka ulu ana o ka huʻi naehana hanu ole. I ka lua o ka hihia ia ka loaʻakika gastric wai, i ka wa ana hiki i ka Nine Inch kuni i ka mea o ka mucousʻili lahilahi o ka bronchi a me ka trachea. E möakäka hou mucosal edema hoʻonāukiukiʻana mai o ka ulu ana o bronchial iaʻi.

Mendelson ka maʻi pale: Symptoms

Ka lapaʻau kiʻi o ka maʻi me ka aneane'ālike i na symptoms o loa naehana hanu ole. Ke hoomanawanui i ka ke ano ua wehewehe aku ma pulmonary edema, tachycardia, dyspnea, cyanosis, bronchospasm. E kū'ē i ke kāʻei kua o ka mahaloʻia maila ka loiloi mua loli kānāwai cardiac hopu. I mau ke hoʻomanawanui i ka kino ka mea i haki, a me ka pulmonary koko, arterial hypertension progresses. Together me ka loa hypoxemia maoli i ka puʻe i loko o ka pulmonary artery me kekahi i ka wā hoʻokahi mahuahua ma pulmonary vascular e kū'ē'ē mai. Metabolic acidosis a me ka ÷ naehana hanu alkalosis e hoʻomōhala ana i like me ka hopena o ka 'aʻe' ana o'aʻaʻa perfusion.

Lapaʻau a pathophysiological loli pili me kāna hana o ke akemāmā'aʻaʻa lesions. I kekahi manawa, na symptoms i emi hai. Morphological loli ma ka naehana'āpana markedly hoikeia mai ka lā ma hope wehena. Wale i ka lā a 'elua, mai ka manawa o ua Mendelson ka maʻi pale, naehana hanu ole symptoms hoʻomaka i ka hoʻoikaika' ana. E hoola i ke kanaka hiki ia ma lalo o ke ano o kona 'inikua pilikia wale nō.

Mendelson ka maʻi pale i loko o obstetrics

Ma na wahine me ka obstetric hana a mau anesthesia haawi pinepine ia ia lŘlŘ i kēia maʻi. Wehena i loko o ka airway e e mau aku ana. Ka mua - mau anesthesia (no ka obstetric ana, ka nahunahu hanau,ʻoki lāʻau lapaʻau pathology o ka opu), i ka lua o ka - he 'aʻe' ana o ka bulbarʻano papa hana i loko o coma, regurgitation, ka luaʻi. Ma ka hapanui o na hihia, ke ahonui e kali ana no ka make, ina oia Mendelson ka maʻi pale. I ka mea i hāʻawi mai i ka pono, e kau i ka maʻi ma luna o ka par me ka noho pilikia loa, make complications o anesthesia, i lana ai.

Food i loko o ka'ōpū o ka hapai wahine kamaʻilioʻana no e hoopanee no ka mea, o ka meheu o kona hooholo ia ma ka hāpai keiki ma muli o ka haahaa pae o ka gastrin, a mahuahua ke kūʻai '-abdominal puʻe. gastrin Ua regulates motility o ka opu, a me ka lawa na mea hiki aku ai i ke kūpono 'ana o kaʻakika wehena maʻi pale ma ka anesthesia.

pilikia

Ka mua ka mea e pono ai, e paa i ka hoʻomanawanui me ka maʻi pale o Mendelssohn - ua wehe 'ia mai ka Hawaiian Airlines aspirated'ōpū Contents. Una lua pela hoomaemaeia omo ole gauze. Tracheal intubation E hanaʻia nō ia a hiki i ka prehospital pae. Next, e pono e hana i kaʻenaʻena bronchoscopy ma lalo mau anesthesia ma ka hui pu ana, me ka ka pahu kui o kaʻimi hoʻopunipuni akemāmā hoʻokomo ea. No ka bronchial lavage hoʻohana paʻakai hydrogen kalepona pāʻoihana (2%) me ka makaukau "hydrocortisone" mehana a isotonic paʻakai koloriside pāʻoihana. Ma hope o tracheal intubation, holoi leʻa me ka'ākilikai pāʻoihana'ōpū ma gavage. Intravenously lawelawe pāʻoihana "atropine" a me ka "Eufillin".

Ma ka hihia ma ka hoʻomanawanui ka kanawai moderately, i ke auou caiaiai me mechanical hoʻokomo ea me ka noho'na makaainana i ulu hanu exhalation e kū'ē'ē mai. No keia ina hana, oe, e pono i ka kūikawā ea paha ina mea hakuʻole, ka mea i pono, e ao aku i ka hoʻomanawanui exhales ma ka hopena e hamama ana ma ka wai laholio Tube.

Mendelson ka maʻi pale (ka Hawaii photo luna hōʻike i ka mahele o ka'ōnaehana e loaa ana i loko o ka wahi mua) ke alakai i ka make ana o ka hoomanawanui, ina manawa 'aʻole i kōkua iā ia. E like me ka mea kokololio kokua o ka bronchospasm laringo- a me ka hoomanawanui pono ia e hospitalized i mea e pale aku i ke kūpono 'ana o ka hoʻoponopono ulia pōpilikia' complications.

lapaʻau

Inā ua loaʻa ke hoʻomanawanui Mendelson ka maʻi pale, lapaʻau e hoʻohui ana i, e kōkua i ka pau ana huʻi naehana hanu ole, a pale aku i ka ulu ana o infectious complications. Mechanical hoʻokomo ea ua hana i ka wa a ka arterial hypoxia pilikia i loko o kumu o ka noho'na makaainana i ulu hanu. A pau ka pilikia ana o ka hoʻomanawanui kaʻina hana ua lawe mai i kekahi mau lā, a na nā hoailona o pulmonary kinoea launa like i ole hoʻoikaika 'ana. I kekahi manawa, hoʻohana hyperbaric oxygenation, a ma kekahi mau hihia e haawi i ko maikaʻi i nā hualoaʻa. Uluwehi O lapaau o ka hoʻohana 'ana o symptomatic ai', antibiotics a me corticosteroids i loko o nā māhele nui.

Mendelson ka maʻi pale i loko o 30-60% o ka hihia hiki aku ai i ka make ana o ka hoʻomanawanui. No ka poe i ae ia, hiki hoʻomōhala kaheaia restrictive paha obstructive kāna hana i loko o loli iki degere.

Kāohi

Aia nō i ka helu o ka hana i hiki ke pale aku i ka ulu ana o ka loa e like me complications Mendelson ka maʻi pale. Kāohi ninoieo o kekahi mau kapuwai. Ka mua - ka hoʻohana a ai 'kona' ana ua kuhikuhi i ka ho'ēmiʻana o gastric secretion ( "Ranitidine", "cimetidine"). Pale aku i ka hanana o complications hiki loa a me ka pololei hana i anesthesiologist. Uluwehi O "Atropine" E auou caiaiai ma ka mea o "Metacin" i ka hoʻomanawanui i loko o ka moku'āina o ka anesthesia ai e haawiia mai smoothly a koke. Ke kauka E e makaukau ma keʻano hana o ka intubation a me ka laryngoscopy a me ka tracheal hoʻohana? Eaia Selick.

I kekahi manawa, i hoʻolaunaʻia ma ka gastric Tube, waiho ia no ka hana holoʻokoʻa, e pale aku i ka inhalation o gastric Contents. Kekahi poe akamai e ku e ia i? Eaia, no ka mea, keʻimi hiki ke hana i ka mea hewa a me ka aggravate i ke ano. Ma obstetrics Kāohi pono ia i loko o ka pololei kulana hapai wahine ma ka pae'ōnaehana papa, i ke poo hope a e e hoalaia iki.