Kev tiv tauj ntawm amniotic kua hauv cov hlab ntshav ntawm leej niam lub caij ua haujlwm hu ua embolism. Qhov no yog ib qho kev pheej hmoo obstetric pathology uas tuaj yeem ua rau tuag taus ntawm niam thiab tus menyuam hauv plab, tseem hu ua amniotic embolism lossis thromboembolism.
Ua rau muaj embolism nrog amniotic kua
Qhov nkag ntawm amniotic kua mus rau hauv cov hlab ntsha loj thiab cov hlab ntsws pulmonary yog ua tau vim yog:
- rupture ntawm lub ncauj tsev menyuam thaum lub sijhawm yug menyuam lossis lub tsev menyuam;
- quav ntsej muag;
- anomalies nyob rau hauv kev loj hlob ntawm shells;
- kev sib txuas lus ntawm cov vascular thiab amniotic raws ntawm leej niam.
Cov xwm txheej ua kom muaj tus kab mob pathology no yog:
- xoos qhwv plab;
- pluag-zoo kawm txog amniotic kua;
- thaum plab hnyuv plab thaum plab zaw, uas ua ntej los ntawm amniotic kua nrog ntshav;
- nce siab nyob rau hauv lub tsev menyuam nrog polyhydramnios, ntau yam cev xeeb tub, tsis ua haujlwm, ua haujlwm ntxhib.
Pathogenesis ntawm embolism los ntawm amniotic kua
Cov phaj nyaj, kua roj, cov tawv nqaij, lub plab hauv plab, cov kua qaub thiab cov hlab ntsha amniotic los ntawm cov hlab ntsha los ua cov hlab ntsha loj loj. Tsis ntev tom qab lawv pom lawv tus kheej nyob rau hauv txoj kev atrium thiab cov hlab ntsig. Feem ntau, xws li cov teebmeem tshwm sim tom kawg hnub yug. Tej lub sij hawm txaus ntshai tshwm sim:
- txawv teb chaws lub cev ua rau cov tshuaj tiv thaiv anaphylactic los yog xiam oob qhab ;
- cov ntsiab lus ntawm cov dej, ua yeeb yam ua rog rog, cuam tshuam kev ua haujlwm ntawm lub plawv;
- Amniotic kua nce ntshav cov coagulability, uas ua rau kom tawm hauv cov txheej txheem tawm ntws tawm.
Kev mob tshwm sim ncaj qha nyob ntawm seb:
- mechanism thiab ua rau cov dej tsis huv;
- qhov ntim ntawm cov dej raug daig hauv cov ntshav;
- nruab zog ntawm cov poj niam;
- lub sijhawm yug me nyuam;
- cov kab mob ua ke.
Cov tsos mob thiab ntau hom kev nyab xeeb nrog amniotic kua
Cov kev mob tshwm sim ntawm tus kab mob no yog cov hauv qab no:
- txog kev ua tsis taus pa;
- lub siab ntshai, kev tuag;
- mob tom qab lub plab;
- ntxiv zog kub cev;
- qhov tsos ntawm kev ua daus no;
- hnoos;
- kiv taub hau thiab tsis muaj zog;
- ntiav, tab sis tsis muaj zog pulse;
- qhia cyanosis ntawm lub hauv siab thiab lub ntsej muag;
- tsis nco qab.
Raws li cov tsos mob, cov poj niam obstetric tau qhia qhov txawv ntawm ntau yam kev ua kom muaj amniotic embolism:
- collaptoid;
- convulsive;
- edematous;
- hemorrhagic;
- xob laim sai, uas yog yus lub luag haujlwm tam sim no.
Kev kuaj mob ntawm cov roj ntsha muaj zog nrog cov kua amniotic
Kev kuaj mob ntawm txoj kev kuaj qog feem ntau yog:
- ua ib qho kev ntsuam xyuas electrocardiographic (ECG) uas muaj peev xwm nrhiav tau qhov qhia tau hais tias yog sinus tachycardia, ib lub plawv mob ntsws, mob hypoxia ntawm myocardium;
- nqa lub hauv siab xoo hluav taws xob kom pom cov kab mob sib kis kab mob uas ua rau lub npauj npaim tis;
- kuaj ntshav.
Kev kho mob ntawm embolism nrog amniotic kua
Kev pab rau kev kuaj cov amniotic embolism muaj xws li:
- kev ua pa ntawm kev ua pa;
- poob siab;
- kev tiv thaiv thiab kev kho kev kho mob sai sai ntawm cov mob hnyuv;
- nqa tawm cov haujlwm tsim nyog.
Kev kho mob thaum muaj xwm ceev muaj cov tshuaj tua kab mob ntawm cov tshuaj dimedrol, promedol, diazepam, antispasmodics, cardiac glycosides thiab corticosteroids nyob rau hauv kev saib xyuas qhov tsis tu ncua ntawm Diuresis, CVP, AD, ECG, CBS, hematocrit thiab electrolyte tshuav. Tom qab ua tiav cov lus ceeb toom ceev ceev, yuav tsum ceev faj kom ceev ceev, tab sis ceev ceev cesarean. Yog hais tias lub paj hlwb pib nyob rau theem ob ntawm kev ua haujlwm, siv obstetric forceps. Kev tiv tauj ntawm amniotic kua hauv cov poj niam cev xeeb tub hauv cov hlab ntsha yog qhov tseem ceeb ntawm kev yug menyuam. Vim li no, kev tiv thaiv ntawm embolism yog ib qho tseem ceeb, uas yog siv nrog coagulologist siv txoj kev los cuam tshuam cov txheej txheem coagulation.