The kumberi uye shure mhino tamponade: zvairatidza uye rondedzero nzira

nasal tamponade inoshandiswa kunotevera uye pfava kumisa nasal ropa pamusoro etiologies siyana. Uye kana pamberi tamponade - nevakawanda muitiro, rwemberi chete "vakasarudzwa." Avo vane ropa haadi kurega upi chikonzero, kana kune avo vane kukuvadza zvakawanda zvakakomba kupfuura zvinoita pakutanga kuaona.

epistaxis

Akadana nasal ropa kubva nasal mhango, apo mvura runoyerera kuburikidza wemhino pachiso kana kuburikidza choanae pamusoro seri huro. Kune mhando mbiri ropa: mberi uye neshure. Mune zvimwe zviitiko, ropa anopinda nasolacrimal mutsinga dzinofamba nemukaka (nokuda kubvisa migumisiro), uye runoyerera nokupira ziso rimwe. Izvi zvinogona kutsausa zvapupu Fani iyi uye varapi pakupa rubatsiro rwekutanga.

Fresh ropa uye ropa clots anogona kuwira kuburikidza yegurokuro mudumbu, kukonzera kunzwa svoto kana kurutsa kunyange. Very kashoma nosebleeds kunogona kuurayisa. Mabhuku anotaura mutungamiri Attila, uyo ndokuvhungwa pamusoro ropa rake varere nezvomuchato usiku wavo.

nasal tamponade kunodiwa kumisa nasal kubuda ropa. Zvichida kurasikirwa mvura panguva imwe chete duku, asi kuvapo yematambudziko anoita mamiriro ichi yokukurumidzira.

zvikonzero

Selection nzira (Anterior kana posterior nasal tamponade kunoda murwere) zvinoenderana iyo midziyo wakaremara. Ndicho chete chokuratidza. Asi pano zvinogona kunetsa ropa zvikuru zvizhinji. Vari rakakamurwa omunharaunda uye systemic.

Local dzinosanganisira:

• mhino zvinokuvadza;
• miviri vatorwa;
• kuzvimba uye mumatenhere mucous Kamudzira ari nasal ndima.

Ava vatatu rakajairika zvinhu kuti anokonzera nosebleeds. Kune zvakawanda zvekumwe:

• anatomical deformation;
• inhalation zvinodhaka;
• kenza pezvakaitwa ari nasal mhango;
• chando uye akaoma mhepo;
• kushandisa samadonhwe kubva vanhuwo chando;
• barotrauma uye kuvhiyiwa.

Systemic zvinhu zvinosanganisira Kurwara, zvachose kuwedzera BP, kuvapo chikosoro. Uyezve, ropa mumhuno kunogona nonsteroidal Anti-anogumbura zvinodhaka, doro, pane matambudziko pamwe coagulation maitiro, mavhitaminzi C uye K kushaikwa, systemic autoimmune zvirwere.

pathophysiology

Kuvhura kubuda, unofanira kuparadza mudziyo rusvingo. The mucous Kamudzira mhino ndiko kwazvo vascularized, saka kunyange chiduku kushandiswa simba zvakakwana akadurura ropa.

Kakawanda nosebleeds kuitika mune vana pasi nemakore gumi uye vanhu vanopfuura makumi matanhatu, kazhinji varume.

Tikafunga yakakwirira kumanikidzwa kubuda kunoitika nomuzvarirwo uye zvinogona refu zvikuru, kana nguva asingadi kuita. In akwegura ari mucous zvitete zvokuti kunyange utsanana maitirwo ezvinhu anogona kutsamwisa atsamwira ari mudziyo.

Muna 95% of panobva ropa ndiro nasal septum anteroinferior vakaparadzana. Pane inonzi Kisselbahovo plexus. Panewo "mureza" ropa. Vari kuzivikanwa spontaneity, uye profusion pfupi refu. Zvikamu izvi zvingava zvakafanira kukuvadza kune midziyo makuru pachiso, aneurysm atsamwira kana bundu kuora.

The kumberi mhino tamponade

The pamberi mhino tamponade kuti ropa anowanzodanwa kushandiswa. Kwakadaro "rudo" vezvokurapa nzira kuti kwakakonzerwa ndechokuti kazhinji, zvakakanganisa pamberi nhumbi nasal mhango, uye kudiwa dzimwe nzira vasingadaro.

Kazhinji, ropa kwakadaro Havazvimiririri zvirwere. Ivo - chete zviratidzo yose dzomuviri kuchinja. Saka, pamwe kakawanda idzokororo ropa vanofanira kufunga nezvechii vamwe kuchinja vakatora nzvimbo mune utano hwako uye kuti pane chikonzero kuti atarire chiremba.

etiology

Govera yaizoitika zvinokonzera ropa. Zvinosanganisira kukuvadzwa upi mavambo, kusanganisira kuvhiya. Uyewo pane symptomatic zvikonzero kuti chokuita kuratidzwa systemic zvirwere ne anatomical nasal kuvimbika.

Women akacherekedza konkomentiruyuschie (kureva achimhanya Panguva pamwe kumwedzi) uye zvazova (ndiko, kutsiva mashandiro yekutevera) ropa. The mashandiro pamusoro inotungamirwa yavo asi havaratidzi kunzwisisa.

Zvisinei, chero mhaka ropa kubva nasal ndima, iva nechokwadi kuti kurega kuregedza kushanda kwayo.

Nzira kumisa ropa mumhuno

Nhasi, kune nzira dzakawanda kumisa kubuda kweropa. Kusarudza kunobva massiveness uye zvinokonzera chirwere ichi. Kwete hazvo sezvo nzira chikuru kushandiswa mhino tamponade. Mufananidzo ropa algorithm ine anotevera:

1. wanikidza ropa.
2. Sarudza chikonzero.
3. Ziva ukama mudziyo.
4. Stop ropa zvikuru yokuita uye nokukurumidza nenzira.
5. Monitor mamiriro murwere.

Kugadzirisa chero zvishomanana nosebleeds nenzira dzinotevera:

1. mhino tamponade. Nzira iri nyore kwazvo; lumen turbinate iri kufurwa kana donje gauze akaiswa mushonga wokuuraya 3% rehydrogen peroxide.

2. inyorovese mumwe donje turunda mu vasoconstrictor anodonhedza, agozopinda ari nasal ndima, iro ropa inoyerera.

3. Bvunza murwere kutora befu mumhino, exhale nomuromo wako uye panguva imwe chete kuisa chando pamusoro zambuko mhino uye mutsipa.

Paaiita chero nzira murwere unofanira kugara kana kutora nehafu akarurama nechinzvimbo uye akakotamisa musoro wake mberi. Izvi kuitira kuti ropa asingadi bindira seri huro kuti mudumbu.

Equipment mberi tamponade

Kana vose pamusoro nzira hadzibatsiri, anomhanyira mberi mhino tamponade. Equipment zviri nyore zvikuru kuti dzika. Zvikurukuru chiremba anofanira kuita omunzvimbo yokutindivadza ari nasal mhango lidocaine kana novocaine (kare inoitwa allergoproby Chokwadi). Ipapo chiremba inoisa kuva ropa sitiroko chena gauze zvakakangwa mu hemostatic zvinodhaka kana Vaseline mafuta. gauze urefu kungava anenge makumi manomwe masendimita, asi nohupamhi - chete hafu. Turunda wakaiswa muchimiro ane akodhiyoni kuti vazadze zvachose nasal mhango.

tampon kwakadaro chinosara anenge matatu mazuva, uye akabvisa pakupera iyi. In kunyanya kuoma ropa, gauze inogona kusiya kwemazuva manomwe, asi muchiitiko chino zvinofanira yakakanyiwa kugadzirisa inorwisa mabhakitiriya uye aminocaproic acid.

Zvinokonzera shure tamponade

The pamberi mhino tamponade kurege kupa inotarisirwa zvabuda. Kana panobva ropa kunogona kupfuura pakutanga chiya. Muzviitiko zvakadaro kushandisa yakawanda nguva unoparadza, asi nzira inoshanda.

Seri mhino tamponade rinoitwa kurega nasal ropa, kana:

1. Murwere raiva rakananga kurwadzisa kuti mhuno kana nasal ndima angosimuka yokumwe muviri.
2. Kana ropa kunokonzerwa refu ruchiyerera rhinitis kana sinusitis.
3. Muzviitiko apo mukuru systemic BP hakurevi zvawira pasi ngarava masvingo uye kunodzivisa paumbwe ropa clot.
4. chinokonzera ropa - ane kuora bundu.
5. Murwere ane ropa chirwere.

Chidobi nasal tamponade

Mhanyai bata iyi chete inokwanisa munhu vakadzidziswa munhu, usaedza kuzvinzwira medicate pamba. Kuwedzera chiremba ari chiito ichi zvinobatanidzwa vanhu vaviri kana vatatu. Mumwe wavo chinodiwa kuti tirambe akarurama chinzvimbo murwere musoro. Wechipiri anotora swabs uye kunovabatsira kugadzira, uye wechitatu ari kufanogadzirira itsva swabs chena, kana zvichidikanwa.

Usati kutanga muitiro, murwere chinotarisirwa chero kunyaradza kuzorora iye uye kuderedza gag dzepanguva. Zvadaro, dzaiita zvokutaurwa mhango kuburikidza nyoro anobudisa mushonga zvishoma nezvishoma akaiswa mhino, wezvakakora chena mafuta vaseline. Pakazopera chubhu ichi yakasungirwa gauze kuti zvakakodzera saizi. On the swab ane tambo nhatu: maviri ngadzirambe pamusoro anobudisa mushonga zvishoma nezvishoma, uye mumwe anoramba ari muromo, uye ipapo kuda padama chigamba. Danho rinotevera - dzichibvisa anobudisa mushonga zvishoma nezvishoma achishandisa mhino. Panyaya iyi, iyo swab rikazvisundira naJoan zvakazara anovhara nasopharynx. Pashure paizvozvo, kuti pamberi tamponade uye knotted mberi vakasarira misara miviri. Bvisai swab uye pashure pemazuva maviri kana matatu.

yematambudziko

Tamponade of nasal mhango, uyewo mamwe evanhu anogona kukonzera matambudziko. Pakati zviitiko izvi zvakadai necrosis yacho nasal mucosa. Izvi kunoitika nokuda mazhinji compression midziyo uye tsinga panguva turundy chokupfeka. Dambudziko rechipiri zvingava purulent exacerbation kana kukura zvirwere sinuses (maxillary sinusitis, sinusitis), sezvo ropa uye gauze vanomirira svikiro wakanaka kwemabhakitiriya kukura.

Munyaya dzakaoma kunzwisisa, veshure tamponade kungaita deformation mhino uye nasal septum. Mukuwedzera, kurapa kunogumawo paumbwe imwe hematoma kana septic septum nokuda kunyunguduka pakubatana chirwere yechipiri.