Decompression disease (chirwere chechiisson): kurapa, zvinokonzera, zviratidzo, kudzivirira

Sezvaunoziva, musiyano uri mukati memhepo inokonzera hutano hunoita hutano hwomunhu. Kunyatsonyatsoziva vanhu ava vanofarira kukwira makomo kana kuburuka pasi pasi pemvura. Kugadziriswa kwemhepo yepakati pemuganhu kwechinguva chiduku hakuwanzofambidzana nekushungurudzika kukuru kwemuviri. Kunyange zvakadaro, kugara kwenguva refu mumhepo "yakasunungurwa" kune ngozi. Vamwe vanhu vane kamwe-kamwe madhimoni anokonzera mamiriro ezvinhu akadai sokudzvinyirira chirwere. Kuoma kwemamiriro acho kunotsanangurwa nehuwandu hwemasimba kune munhu, simba rekuchengetedza remuviri, pamwe chete nezviito zvakakodzera panguva yakatorwa nachiremba. Pasinei nokuti kudengenyeka kwechigodhi mumatambudziko akawanda kunopa mukurapa, pane dzakawanda zviitiko zvemugumo unouraya. Kubatana kwekumanikidzwa kwemukati nehutano uku kwakagadzirwa pakati pezana remakore rechi17 neasayendisiti Boyle. Kunyange zvakadaro, ichi chiitiko chekurapa chiri chichiri kuongororwa.

Chii chinonzi kuora mwoyo kwechirwere?

Izvi zvirwere zvinosanganiswa nehupenyu hwekushanda mumuviri. Pasinei nokuti R. Boyle ndomumwe wevasayendisiti vekutanga kusimbisa ukama huri pakati pekuderera mukati memhepo yakasviba uye kuchinja mumaviri ezvisikwa zvipenyu (nyoka yeziso renyoka), chirwere chekunyengedzera chakazozivikanwa kunyika yose gare gare. Izvi zvakaitika munguva yekupera kwezana ramakore remakore rechi19, apo yekutanga mapampu emhepo uye mabhokisi akaumbwa. Panguva iyoyo, hutachiona hwakatanga kuve hunoonekwa kune ngozi dzebasa. Vanhu vakashanda mumamiriro ezvinhu emhepo yakamanikidzirwa kuitira kuti vavake tunnels pasi pemvura, pakutanga havana kuona chero kuchinja. Kuora kwemamiriro ezvinhu ose kwakaonekwa panguva iyo kudengenyeka kwepasi kwakaderedzwa kusvika kuhuwandu hwemashoko. Nokuda kwechikonzero ichi, hutachiwana hune zita rechipiri - chirwere che caisson. Kunyura ndicho chikamu chikuru chehurumende iyi, nokuti iripo iyo isingawanzoiti mumuviri wedu kudzvinyirira. Izvo zvinoenderana nekukwirira. Zvichipa kuti zviratidzo zvehutachiona hunoonekwa nehutano hwakasiyana (kubva kumusoro kusvika pasi), kuongororwa hakusi nyore kune unyanzvi ane ruzivo.

Ndiani anotsanangurwa nekudzvinyirira chirwere?

Caisson chirwere hachiitiki kamwe kamwe uye pasina chikonzero. Kune boka rekukuvadza - kureva, vanhu vanowanzoita izvi. Mabasa evanhu ava anofanirwa kuwirirana zvakananga nekushandurwa mukati memhepo yakamanikidzwa. Pakupedzisira, chirwere chacho chakanga chichiratidzwa kune vashandi vekiisson uye kukwira. Munyika yanhasi, boka rekukuvadza rakanyanya kuwedzera - rakatanga kusanganisira vanogadzira ndege, vanofambisa ndege uye vamwe. Pasinei nokuti izvo zvidzidzo izvi zvine ngozi, chirwere ichi nechirwere chechivharo hachisi chimiro. Inobata chete avo vanorega kuchengetedza nzira dzekuchengetedza kana kuti vane ngozi dzezvinhu. Pakati pavo zvinokuvadza zvinotevera zvinozivikanwa:

1. Zvinodzikisa kupararira kweropa mumuviri wose. Izvi zvinoitika panguva yekudonha mvura uye hypothermia. Uyewo, kunonoka kwekuyerera kweropa kunoonekwa nekukwegura uye nehutano hwepfungwa.
2. Kuumbwa kwepasi-kudzvinyirira nzvimbo muropa. Ichi chinoshamisa chinopindirana nechitarisiko chemhepo shoma duku. Chinhu chinokonzera ngozi ichi chichiita kuti chirwere ichocho chiwedzere kuita muviri usati wasvika mumvura kana kuti uchikwira kumusoro.
3. Kuwedzerwa muviri. Ichi ndicho chimwe chinhu chinokonzera kuunganidzwa kwemhepo inoputika muropa.
4. Kugamuchirwa kwezvinwiwa zvinotapira vasati vashamba kana kukwira kusvika pakakwirira. Doro rinokurudzira kusanganiswa kwemhepo shoma shoma, zvichiwedzera kuwedzera kwehukuru hwavo.

Kumusoro-kukwirira kudengenyeka kwezvirwere: iyo nzira yekusimudzira

Sezvo inozivikanwa kubva mumitemo yefizikiki, dambudziko remhepo rinokonzera kusagadzikana kwemagesi mune mvura. Mutemo uyu wakagadzirwa nesayenzi Henry. Maererano nemashoko ake, yepamusoro yekumanikidzirwa kwepamusoro, zviri nani mafuta anoputika mumvura. Tipei mutemo uyu, tinogona kupedzisa kuti kuora mwoyo kunowedzera sei kuvanhu vari kumusoro. Nokuda kwekugara kwenguva yakareba mumuganhu wekumanikidzika kwepamhepo, mhuka dzevatyairi nevashambadziri, pamwe chete nevashambadziri, vanoshandiswa kumamiriro ezvinhu aya. Saka, kubva kumhepo yakajairika kwatiri kunokonzera kuora kwakanyanya mumamiriro avo ezvinhu. Pamusana pekudzvinyirira kunodonha, magasi eropa anotanga kuparara, kuunganidza mumhepo. Chii chinokuvadza kukanganiswa kwechirwere chevatyairi vengarava uye sei? Mhepo inobhururuka yakaumbwa muropa inogona kukura muhukuru uye inodzivirira mudziyo, nokudaro inokonzera mhuka yekrisiti munzvimbo ino. Mukuwedzera, vane simba rekufamba-famba mumuviri uye kupinda mishonga inokosha uye mitsipa (brain, coronary, pulmonary). Izvi zvinoputika mumhepo zvinoshanda mubasa rekubatana, kana thrombus, izvo zvinogona kukonzera kwete kukanganisa kukuru kwechiitiko chacho, asiwo mhedzisiro inouraya.

Kubudirira kwekuderedzwa kwehutano mune zvakasiyana

Denda re diver diver ine nzira imwechete yekusimudzira. Nokuda kwekuti pakunaya kwakadzika mumhepo yepamhepo yakakwirira kudarika pamusoro, neine kupera kwakaputika mairi, magasi eropa anotanga kuparara. Zvisinei, nekuchengeta kuchengetedzwa kwekuchengeteka uye kusavapo kwezvipingamupinyi, izvi zvinogona kudziviswa. Kuti mutambi wacho haana kurwara nechirwere chekasi, mamiriro ezvinhu anotevera akadikanwa:

1. Shandisa cylinder yeakisijeni ine zvinyorwa zvinokonzerwa negasi izvo zvinoderedza kushandiswa pakadzika.
2. Zvishoma nezvishoma zvinokwira pasi. Pane nzira dzakasiyana-siyana dzinodzidzisa zvakasiyana-siyana kushambira kubva pakadzika. Nemhaka yekusimudza zvishoma nezvishoma muzinga we nitrojeni muropa, mabhudzi haagadzi.
3. Kukwidza mu bathyscaphe inokosha inonzi hermetic capsule. Iko inokubvumira kuti udzivise kudonha kwakaderera mukudzvinyirira.
4. Kuchengetedza muzvikamu zvakasiyana-siyana zvekuvhiringidza. Pamusana pekuwedzera kwe nitrogen kubva mumuviri, kukwira hakuiti kukanganisa kwekugadzikana kwemagesi eropa.

Mhando dze decompression chirwere

Kune marudzi maviri ekudengenyeka kwezvirwere. Ivo vanozivikanwa nemhando yemiti ine mhepo inoputika. Maererano neizvi, mumwe nomumwe wavo anozivikanwa nekliniki yake yemifananidzo. Nechirwere chema 1 caisson, gesi inounganidza mune zviduku zvema-capillary, mishonga uye mitsetse, ichipa ropa kune ganda, masisita uye manhengo. Mukuwedzera, mhepo inoputika inogona kuunganidzwa mumidziyo ye lymphatic.

Pasi pemvura uye kureka kubvisa chirwere chinokonzera chirwere chechipiri chine ngozi huru. Nezvo, gasi inowanikwa inobata midziyo yemwoyo, mapapu, uropi nemutsipa wesipinha. Izvi zvikamu zvinokosha, naizvozvo kuputsa mukati mavo kwakakomba.

Clinical picture

Chirwere chemakiriniki chechirwere chinobva pane imwe mudziyo inorohwa nemhepo inoputika. Zviratidzo zvakadai sa pruritus, kusvetwa, kurwadziwa mumasumbu uye manhengo, izvo zvinokurudzirwa nekushanduka kwechitima, kufamba, kunoratidzira 1 rudzi rwechirwere chirwere. Saka kusagadzikana kudengenyeka kwezvirwere kunoratidza. Zviratidzo zvinoratidzirwa rwechipiri 2 zvakanyanya kuoma. Kana zviyo zvehutachiona zvichitambudzwa, zvinotevera zvipatara zvinoratidzika zvinogona kuitika: kurasikirwa kwezvinhu zvinoratidzwa, kuderedzwa kwehukuru hwahwo, dutu, kuwirirana kwezvinhu mumaziso, tinnitus. Embolism of the coronary arteries inoratidzwa ne stenocardia uye kupera kwekufema. Apo mishonga yemapammonari inobatwa nemhepo shoma shoma, kukwezva, kuora mwoyo, nekushayikwa kwemhepo kunoonekwa. Zvose izvi zviratidzo zvinowanzoenderana nehuwandu hwechidimbu chekudengenyeka kwezvirwere. Mune mamwe maitiro akaoma, pane zvinokonzera kukanganisika kwepakati uye nechiitiko chinogona kuuraya.

Degrees of gravity of the caisson disease

Kune zvidimbu, zvidimbu uye zvakaoma zvidimbu zvekuderedzwa kwezvirwere. Muchiitiko chekutanga, kuora kwacho hakusi kukosha uye kunodzokorora kwenguva pfupi. Chirwere chakareruka chinoratidzirwa neutera, hutumbu uye hutano hwakabatana, hunowanzoitika nguva nenguva, ganda rinopisa uye rinhes pamuviri. Kazhinji zvinhu izvi zvinowanzoitika zvishoma nezvishoma uye zvinopfurikidza pachavo. Pakati pepakati pekuwedzera kwepamusoro, kukanganiswa kukuru kunoitika. Nhamo muzvibatanidzwa nemisungo zvinogara zvichinyanya uye zvakanyanya, dyspnea, kukohwa, kusagadzikana kwekunzwa mumoyo, zviratidzo zvehutano. Iyi fomu inoda kurapwa nokukurumidza. Chimiro chakanyanya chechivharo chinogona kuratidzirwa nehutano hwekudzimara, kufungidzika kwemasimba, paresis uye kupera simba, myocardial infarction, nezvimwewo. Kuita kunogona kukonzera OHMC mumidziyo mikuru yeuropi, pamwe nemaplmm embolism.

Kuongororwa kwechirwere chirwere

Kuongororwa kwekudengenyeka kwezvirwere hakusi kwakaoma zvikuru, sezvo hutachiona hunova huri mumaawa ekutanga mushure mokumusoro kubva pakadzika kana kumhanyira. Chirwere chemakiriniki chinokubvumira kunyatsoongorora mamiriro evanhu mune dzimwe nguva. Kana uchifungidzirwa kuti unoshandiswa nemidziyo yepakati uye huru, inobatsira nzira yekuongorora inodiwa. Zvinonyanya kukosha kuti uite coronary angiography, MRI yeuropi, ultrasound yemaketeni uye arteri pamigumo.

X-ray kufungidzirwa kana pane chirwere chinokonzera

Nechirwere chekasiki chepakati nepakati uye yakaoma, mapfupa nemajoini anowanzobatwa. Mune zvimwe zviitiko, muromo wespelinha unobatanidzwa mukugadzirisa. X-ray nzira yekutsvakurudza inobvumira kunyatsoongorora chirwere chinodzvinyirira. Izvo zvinotevera zvinoshandiswa muhutachiona hwehutano hwakasiyana: nzvimbo dzekuwedzera ossification kana calcification, kuchinja mumamiriro e vertebrae (kuwedzera kwemuviri uye kuderera mukukwirira) - breviscondylia. Neizvi, disks dzinoramba dzakasimba. Kana mutsara wemutsara unobatanidzwa mukugadzirisa chirwere, munhu anogona kuwana kuverengwa kwayo, muhumi hwakafanana nemahombe kana makore.

Kuchengetedzwa kwekudzivirirwa kwechirwere chirwere

Inofanira kurangarirwa kuti nerubatsiro rwakakodzera panguva iyo, chirwere chekasi chinogona kurapwa mu80% yematambudziko. Nechinangwa ichi, makamuri ekumanikidzwa anoshandiswa, umo oxygen inowanikwa pasi pekumanikidzika. Kuvonga kwavari, mhuka inotarisana nekudzorerwa, uye zvikamu zve nitrogen zvabviswa muropa. Kushingaira mumakamuri ekudzvinyirira kunoderedzwa zvishoma nezvishoma, kuitira kuti murwere agadzirise kusvika kune mamiriro matsva. Mumamiriro ezvinhu akaoma, zvakakosha kuita chirwere chemhepo, kutanga kutora "pure" okisijeni ne mask.

Kudzivirirwa kwekudzivirirwa kwechirwere chirwere

Kuti udzivise kukurudzirwa kwekudzivirirwa kwechirwere, unofanirwa kutevedzera nzira dzekuchengetedza yakadzika uye yakakwirira mumhepo. Panguva yekukwira kubva kumvura, gadzirai kuitira kuti muviri unogona kutarisana nemhepo yepamhepo. Zvakakoshawo kushandisa zvishandiso zvakasiyana-siyana - suti yekudonha uye magirairi ane oxygen.