Ziziphi iidokotela kunye nabahlengikazi abakhangeleyo
Izigulane ezinezifo zengqondo zihluke kwezinye iintlobo zezigulane. Ngenxa yokuba iingxaki zabo zibandakanya inkqubo yabo yeentlanzi, ziyakwazi ukuhlakulela iintlobo ezithile zeengxaki. Inzuzo ye-ICU ye-neurological kukuba oogqirha kunye nabahlengikazi banokuqeqeshwa okukhethekileyo okubavumela ukuba baqonde kwaye baphathe iingxaki ezinjalo xa bevela.
Hyponatremia
Izifo ze-neurological zingenza ukukhululwa kwama-hormone okutshintsha i-sodium egazini, ebizwa ngokuba yi- hyponatremia . Oku kuyinkinga kuba i-concentrations ye-sodium ephantsi iyakwenza ukuba umlambo ungene kwiiyununu zengqondo kunye ne-edema kunye nokuvuvukala. Kukho iindlela ezimbini eziphambili zokulimala kwengqondo ezikhokelela kwi-hyponatremia: isifo se-hormone ye-diuretic hypersecretion engafanelekanga (i-SIADH) kunye ne-cerebral ityuwa yokuchitha i-syndrome (CSWS).
I-SIADH ihambelana nemilinganiselo ephakamileyo engamanzi emzimbeni, kwaye ii-CSWS zenza amazinga aphantsi asemzimbeni we-sodium. Ngamanye amagama, ngelixa iingxaki ezimbini zingabangela ixabiso leeb lab elifanayo, ngokwenene bahluke kwaye bafuna unyango oluhlukile.
I-Vein Deep Thongsis
Kukho izinto ezintathu ezisemngciphekweni ekuphuhliseni ama-blood clots: i-stasis, umonakalo we-vascular, kunye ne-hypercoagulability.
U-Stasis uthetha nje ukuba awuhambeli kakhulu.
Yingakho iindiza zikhuthaza abagibeli ukuba bavuke ngoku kunye neenqwelo ezide kwaye bahambe ngeenxa zonke. Ukuhlala ixesha elide kungenza ukuba ama-clots egazi ayenze kwimifuno yemilenze yakho. Ukuba la maqhekeza aphuka emilenzeni, ayenokungena kwiimiphunga aze aqhube i- pulmonary danger .
Ukulimala eludongeni lweesitya segazi kungenza ukuba ama-clots enze, njengokuba kunjalo nangomngcipheko wesifo . Ekugqibeleni, abanye abantu banegazi elithandwa ngokukodwa ekuveleni amaqhosha kwaye, ngoko ke, kwingozi yobunzima be-thrombosis kunye ne-pulmonary embolism.
Izigulane ze-ICUs ze-neurology zixhomekeke ngakumbi ekuphuhliseni ama-blood clots. Ngenxa yokugula kwabo, abantu abakhubazekile okanye kwi- coma abahambeli. Ukongezelela, ezinye ixhoba lalabo bahlaselwe isifo sokukhwabanisa ngenxa yokuba banegazi elinokukwazi ukwenza ama-clots. Amaxhoba entlekele entle ayenokufumana umonakalo owongezelelweyo kwiindonga zeempahla zegazi.
Ukuqhubezela ngakumbi le ngxaki ngumbuzo wento oyenzayo xa umntu ehlamba i-clot yegazi ngelixa e-ICU ukuba aphuluze kwiingqondo zawo. Ngokomzekelo, i-subarachnoid i-hemorrhage idibene nomngcipheko omkhulu kakhulu we-thrombosis. Amacwecwe egazi ayenqatshelwa ngokunikezela ngegazi njenge-heparin, kodwa ezi ziyobisi zingonakalisa ukwanda kwamanzi. Indlela yokulawula le mngcipheko onokukhuphisana ingaba isigqibo esinzima.
Ukuphefumula
Xa bejamelene neemeko ezingxamisekileyo, oogqirha bafundiswa ukuba bagxininise kwi-ABCs - i-airway, ukuphefumula kunye nokujikeleza. Okubaluleke kakhulu kwezi zinto kuhamba ngomoya.
Ngaphandle kokuba iindinyana ezivumela ukuba siphefumle zivulekile, akukho nto enye into ebalulekileyo. Nokuba intliziyo idla ngokubaluleke kakhulu. Ukufakela into emiphakeni engaphelelanga ukuba ibekho eyaziwa ngokuba yi- aspiration , kwaye inokumisela umntu ukusuleleka kwiintsholongwane ezinzulu.
Ininzi yethu yenza izinto ezincinci kwiiyure nganye ukuqinisekisa ukuba indlela yethu yokuhamba umoya iya kuhlala ivulekile. Isenzo esilula esingenzi lutho sokugwinya ummatha, umzekelo, siqinisekisa ukuba iibhaktheriya ezisuka emlonyeni wethu azithengi emiphakeni yethu kwaye ziqhumane zibe yiphunga . Sibubula ngezinye izihlandlo ukugcina imihlaba emincinci yemiphophu yethu iwa. Ukuba siziva siphula emqolo emqaleni, sihlahlela.
Abantu abonakalise izibilini ezilawula udonga lwaso lwesifuba, isithintelo, ulwimi okanye umphimbo unokuba nengxaki yokwenza ezi zenzo ezilula, ezingaziwayo. Omnye umntu kwi-coma akakwazi ukwenza naluphi na kwezi zinto. Kwiyunithi yonyango enzulu, ezi zinto zenziwa ngabo ochwephesha kunye nabongikazi ngeendlela ezifana nokutshatyalaliswa, unyango lokuphefumula, kunye nokukhwehlela kokukhwehlela.
Sulelo
Iiyunithi zokunyamekela ezinzulu apho abantu abagulayo kakhulu banakekelwa khona. Oko kuthetha ukuba ii-ICU zihlala zihlala apho kubonakala khona iibhaktheriya ezinobungozi kwaye zinobungozi. Ngenxa yokusetyenziswa rhoqo kwee-antibiotics ezinamandla kuma-ICU, ezinye zezi bhaktheriya ziye zaguqukela ukulwa neziza-antibiotics , okwenza kube lula kunzima ukusulela unyango.
Abasebenzi bezonyango baqeqeshwe ukusebenzisa zonke izicwangciso zokukhusela ukusasazeka kwentsholongwane, kubandakanywa ukuhlamba izandla kunye namaxesha amathotho kunye nemaski. Nangona kunjalo, akukho khuselo lisebenza ngekhulu leepesenti zexesha, kwaye ngamanye amaxesha ukusuleleka kwintsholongwane kwandiswa naphezu kwezi ziqaphelo. Ngenxa yesi sizathu, abasebenzi bezonyango bajonge izigulane ngokukhawuleza malunga nemiqondiso yesifo. Ngaphezu koko, kwenziwa iinzame zokuhambisa isigulane kwindawo engacinci, njengesiqhelo sesibhedlele esiqhelekileyo, ngokukhawuleza.
State Acute Confusional
Iimeko ezidibeneyo zokudideka, ezaziwa nangokuthi i- delirium okanye i-encephalopathy, yenye yezinto eziphazamisayo kakhulu izigulane okanye abo bathandekayo abanamava esibhedlele. Ngelishwa, yile enye yezona ziqhelekileyo. Abaninzi abangama-80% kwizigulane ezingenayo i-ICUs bafumana le meko. Umntu uyadideka malunga nokuba bakuphi, liphi ixesha, kwaye kwenzekani. Basenokungazi ukuba ngabahlobo okanye intsapho. Baya kuhlenga, okanye babe yi-paranoid. Ngamanye amaxesha oku kukukhokelela ekubalekeni esibhedlele okanye ukukhupha ii-tubes kunye ne-IV ezifunekayo ukuze kugcinwe isigulane.
Ukunyangwa kwemoya edidekileyo yinkxalabo kunokubandezeleka njengokuba ingxaki kuba ingabandakanya ukunikezela ngamachiza okanye ukukhusela isigulane. Nangona kunjalo, kukho amanyathelo amaninzi amaninzi angathatyathwa ukulawula ukudideka ngaphambi kokuphuma.
Isiqendu se-Epilepticus
Xa abaninzi abantu bacinga ngokubamba, batyhafaza umntu echukumisayo. Kukho iintlobo ezingakumbi zokubamba, nangona kunjalo, apho umntu engabonakali wenza into eninzi nantoni na, okanye unokubonakala edidekile.
Nangona kunjalo, aba bantu banokuzuza kwiyeza elifanelekileyo. Ezinye izifundo zicebise ukuba abaninzi abantu abayi-10% kwii-ICU banokubanjwa kweempawu ezivame ukungazifumani, kwaye eli nqanaba liphezulu kakhulu kwizigulane ezinengxaki zeengxaki.
IDysautonomia
Inkqubo ye-nervousic nerveous is aware and often appreciated. Le nxalenye yenkqubo ye-nervous elawula intlawulo yenhliziyo, ukuphefumla, uxinzelelo lwegazi, kunye nokunye. Njengokuba izifo zengqondo zitshintshe imisebenzi esiyicinga ngayo ngokuqhelekileyo, njengokunyakaza nokuthetha, ezinye iingxaki ziyakuchaphazela inkqubo ye-neon autonomic system.
Iingxaki ezibhalwe apha ngasentla zifumaneka kwiintlobo ezininzi zezifo ezahlukileyo ezizisa umntu kwi- ICU ye-neurological . Ngoxa zifumaneke kwezinye iiyunithi ezinonophelo ezinzulu, ezinye iingcali zingenako ukuqhelanisa nokuchonga nokulawula ezi ntlobo zeengxaki. Ngenxa yoko, ii-neuro-ICUs zibonakalise zibalulekile ekuphatheni abantu abanezifo ezinzulu zeengqondo.
Imithombo:
UAllan H. Ropper, uDaryl R. Gress, uMichael .UDiringer, uDeborah M. Green, uStephan A. Mayer, uTomas P. Bleck, u-Neurological ne-Neurosurgical Care Care, I-Fourth Edition, uLippincott Williams noWilkins, ngo-2004
Braunwald E, Fauci ES, et al. Iinqununu zeHarrison zeMithi yoPhakathi. 16th. 2005.