M a ch m au
- Bi ap luc trong khoang chen ep, ban d lu lam cho mach mau bi co that, neu de muon mach khong con dap.
T h a n k in h
Than kinh bi chen ep: dku tien la thieu mau nuoi. ve sau bj chen ep hoan toan gay nen mat cam giac va liet van dong.
3. SINH LY BENH
3.1. Ton thtfdng than kinh
Khi ap ltfc khoang tang cao: dau tien phan nhay cam nhat bi chen ep la cac dong vi quan nuoi than kinh, tti do than kinh bi thieu mau trtfdc. Vi the, cac dau hieu lam sang sdm nhat va quan trong nhat cua hoi chting chen ep khoang la dau hieu ve th&n kinh: te bi, tang cam giac dau va liet van dong.
3.2. Ap lire khoang
• M atsen dila ra cong thiic
Pa-Pv LBF = ---
R LBF: dong mau nuoi ha ltfu Pa: ap ltic dong mach
Pv: ap ltic tlnh mach R: stic can
Nhu vay, stic can tai khoang cang tang, mau xuong nuoi ha ltfu cang kem lam cho cd cang thieu dtfdng, phti ne, xuat tiet. Cang phu ne, xuat tiet cang gay nen tang ap ltic khoang. Day la mot vdng luan quan benh ly.
3.3. Hau qua cua hoi chumg chen ep khoang
3.3.1. Toan than
Tang ap ltfc trong khoang cd xtfdng, gay chen ep tuan hoan m ao m ach d in den hoai tti to chtic nhtf trong tac mach do nh ilm khuan
Hoi chting chen ep khoang qua 4 gid, co the gay nen dai ra m yoglobin va gay ra suy than.
Sau 8 gid chen ep khoang khong dtidc xti ly thi coi nhtf da c6 tdn thtfdng chi khong hoi phuc.
Phan chi phia dtfdi ton thtfdng bi hoai tti: cac mo chuyln hoa dd dang va trong moi trtfdng yem khi, sinh ra cac chat doc, tti do di v&o h§ tu£n hoan, lam giam pH mau. Benh nhan bi toan chuyen hoa, nguy cd td vong rift cao.
3.3.2. Tai chd
Neu hoi cluing chen ep khoang d nhflng vung chi co vong noi cua mach tot thi benh nhan co the thoat dUdc cut chi, nhUng ve sau chiic nang cua chi kem vi thieu mau cuc bo, lam cho gan-cd va cac khdp bi xd ciing. Dien hinh cho benh canh nay la W olkm ann cAng tay sau gay hai xUdng c^ng tay.
Neu hoi chiing chen ep khoang n&ng va khong dUdc xii tri rach can kip thdi thi phai cat cut chi.
4. HOI CHLTNG CHEN EP KHOANG CANG - BAN TAY CAP TINH4.1. Lam sang 4.1. Lam sang
— Xay ra sau mot chan thUdng, co the co gay xUdng hoac khong (xem hinh 6.4) - Ca c&ng tay cang cting, tron nhu mot cai o'ng
- Tang cam giac dau ngoai da, nhat la khi van dong thu dong cac ngon tay — Cac ngon tay ne to, tim va lanh hdn binh thUdng
— Liet van dong va mat cam giac cac ngon tay
- Mach quay va mach tru kho bat roi nang hdn la khong bat dUdc (giai doan muon).
Hinh 6.4. Cd the chan thi/dng gay nen hoi chung chen ep khoang cSng tay
4.2. Can lam sang
4.2.1. Do ap luc khoang (Pk) bang phuung phap W hiteside (xem hinh 6.5)
Choc kim to vao khoang, do ap luc thuy tinh cua cot nUdc dung dich sinh ly bdm vao trong khoang.
Dung cu do: vdi 3 chac, o'ng tiem 20ml, 2 o'ng nhiJa, 1 kim cd 18, ap ke thuy ngan, chai huyet thanh man dang trUdng.
0 moi khoang can do it nhat 2 ndi.