fyaat embolism syndrome

kovvu raktapravaahamloki (kovvu embolism) pravesinchi, lakshanaalaku daariteesinappudu kovvu embolism syndrome sambhavistundi. lakshanaalu saadhaaranamgaa oka rojulopu praarambhamavutaayi. indulo petechiyal daddurlu, spruha sthaayi taggadam mariyu swaasa aadakapovadam vantivi undavacchu. itara lakshanaalalo jwaram mariyu moothram utpatti taggadam undavacchu. maraninche pramaadam daadaapu 10 saatam untundi.
kovvu embolism saadhaaranamgaa emukalu ledhaa pottikadupu vanti emukala pagulla phalitamgaa sambhavistundi. itara sambhaavya kaaranaalalo pancreatitis, keella shastrachikitsa, emuka majja marpidi mariyu liposuction unnaayi. antarleena yantraamgamlo vistrutamaina vaapu untundi. rooga nirdhaarana anedi lakshanaala aadhaaramgaa untundi.
chikitsa anedi ekkuvagaa sahayaka samrakshana. indulo oxygen therapy, intravenous fluids, albumin mariyu mechanical ventilation undavacchu. emuka pagulu tarvaata raktamlo saadhaaranamgaa kovvu chinna mottamlo sambhavistundi, kovvu embolism syndrome arudu. eee paristhitini paristhitini jenkar modatisaarigaa nirdhaarinchaaru.
sankethaalu mariyu lakshanaalu.
kovvu embolism syndrome (fes) lakshanaalu antarleena clinical vyaadhi nirdhaarana tarvaata 12 gantala nundi 3 rojula varaku praarambhamavutaayi. moodu atyanta lakshana lakshanaalu swaasakosha baadha, naraala lakshanaalu mariyu charma petechia. swaasakosha baadha (75 saatam kesulalo untundi) telikapati baadha nundi anubandha oxygen avasaramayye teevramaina baadha varaku maaravacchu, dheeniki yaantrika ventilation avasaram. naraala lakshanaala kosam, medadu ischemia kante mastishka edema kaaranamgaa glassgo coma scale (zii. sii. ess) loe taggudalatoe, phes unnavaaru alasatatho, viramam lekunda maaravacchu. anduvalla, naraala sankethaalu sariiraaniki oka vaipuku pakkaku pettabadavu. mastishka vaapu yokka teevramaina roopamlo, oka vyakti spandinchani vyakti kaavacchu. petechia daddurlu saadhaaranamgaa 50 saatam mandhi rogulalo sambhavistaayi. atuvanti charmam yokka abhivyakti taatkaalikam mariyu oka rojulopu adrusyamavutundi. kovvu embolism syndromenu moodu rakaluga vibhajinchavachhuh
kaaranaalu.
keella gayalu mukhyamgaa podavaina emukala pagullu fyaat embolism syndrome (fes) kuu atyanta saadhaarana kaaranam. podavaina emuka pagullalo kovvu embolism raetlu 1 saatam nundi 30 saatam varaku untaayi. kovvu-embolism syndrome yokka maranaala raetu sumaru 10-20%. ayithe, keella gaayam unna vaarilo 67 saatam mandiloo kovvu golakaralu kanugonabaddayi mariyu raktam fracture sait sameepamlo namuunaa teesukunte 95 saatam varaku cheravacchu. podavaina emuka pagulla prarambha operation fixation oka saadhaarana abhyasamga maarinanduna, phes sambhavam 0.9% mariyu 11% madhya tagginchabadindi.
kovvu embolism syndrome yokka itara arudaina kaaranaalu
pathophysiology.
kovvu emboli rakta prasaranaloki pravesinchina tarvaata, avi sariiramlooni vividha pradaesaalaloo, saadhaaranamgaa oopiritittulalo (75 saatam varaku) unchavacchu. ayithe, idhi medadu, charmam, kallu, moothrapindaalu, kaaleyam mariyu gunde prasaranaloki kooda pravesinchi, kesanaalika debbatinavacchu, tadanantaram eee praantaalalo avayava nashtam kaliginchavacchu. kovvu embolus erpadataanni vivarinche rendu siddhaantaalu unnaih
rooga nirdhaarana.
kovvu embolism anedi sareeram yokka suukshma prasaranalo kovvu kanaala uniki. intalo, kovvu embolism syndrome anedi sareeramlo suukshma prasaranalo unde kovvu kanaala phalitamgaa clinical abhivyakti. kovvu embolism syndrome kosam moodu pradhana roganirdhaarana pramaanaalu pratipaadinchabaddaayi, ayithe, vaatilo edhee dhruvikarinchabadaledu mariyu vishwavyaaptamgaa aamodinchabadaledu. ayithe, itara rendu roganirdhaarana pramaanaalatoo poliste kovvu embolism kosam gurd mariyu willson yokka pramaanaalu saadhaaranamgaa upayoginchabadataayi.
gurd mariyu willson yokka pramaanaalu.
"pradhana pramaanaalu"
"chinna pramaanaalu"
kaneesam rendu saanukuula pradhana pramaanaalu mariyu oka chinna pramaanam ledhaa naalugu saanukuula chinna pramaanaalu kovvu embolism syndromenu suuchistaayi. fyaat embolism syndrome anedi oka clinical roganirdhaarana. rooga nirdhaaranaku taginanta sunnitamaina ledhaa nirdishtamaina prayogasaala pareekshalu laevu. ituvanti prayogasaala pareekshalu clinical rooga nirdhaaranaku matrame maddatu ivvadaaniki matrame upayoginchabadataayi. chaatii ex-rae diffuse interstitial intriltratesnu chuupavachchu, ayithe chaatii siti skaan diffuse vascular consengetion mariyu pulmonary edimaanu chooputundi. swaasanaalaala macrophaselalo kovvu binduvula kosam chuudataaniki bronchoalviolar lavage pratipaadinchabadindi, ayithe idhi samayam teesukuntundi mariyu kovvu embolism syndromeku pratyekamainadi kaadu. kapham mariyu moothramlo kovvu golakarala kosam vetakadam kooda vyaadhi nirdhaaranaku taginanta nirdishtamainadi kaadu.
nivaarana.
podavaina emuka pagulla sthireekaranhatho chikitsa pondina vaariki, phes sambhavam 22 saatam untundi. podavaina emuka pagulla prarambha operation fixation mukhyamgaa antargata fixation parikaraala vaadakamtho phes sambhavinche pramaadaanni taggistundi. podavaina emuka pagullanu atyavasaramgaa saricheyadam dwara 24 gantala tarvaata saricheyadam dwara (ardsto 39 saatam) badhapaduthunna rogulatho poliste teevramaina swaasakosha baadha syndrome (ard) 7 saatam raetu kaligi untundi. ayithe, operation samayamlo podavaina emukala fracture chivarala kadalika rakta prasaranalo kovvu emboli yokka taatkaalika perugudalaku kaaranamavutundi. podavaina emuka pagullanu sthirathvaanni upayoginchi sampradaayabaddhamgaa chikitsa chesthe saitokinlu nirantaram paiki lestaayi. operative fixation tarvaata cytokine sthaayilu saadhaarana sthithiki tirigi vastaayi. reim neyil podavaina emukala medullary kuharamlo ottidini penchinappatikee, idhi phes retlanu penchadu. emuka valkalam loe randhraalanu travvadam, sthireekaranaku mundu emuka majjanu subhram cheyadam mariyu embolisation nivaarinchadaaniki tornicuetlanu upayoginchadam vanti itara paddhatulu phes retlanu tagginchavani choopabadaledu.
methyl prednisolone (6 nundi 90 mii. graa/kejee) vanti carticosteroid therapyni phes chikitsa kosam pratipaadinchaaru, ayithe, idhi vivadaspadamga undhi. carticosteroidnu uchita kovvu aamlam sthaayilanu parimitam cheyadaaniki, poranu sthireekarinchadaaniki mariyu leukocyte agregationnu nirodhinchadaaniki upayoginchavacchu. upayoginchavacchu nirvahinchina meta-vislaeshanha prakaram roganirodhaka carticosteroids valla phes pramaadaanni 77 saatam tagginchavachhu. ayithe, niyantrana samuuhamtoe polchinappudu maranaala raetu, sankramana mariyu avascular necrosis loe etuvanti vyatyaasam undadu. ayithe, ayithe nirvahinchina yaadruchchika vichaaranalo niyantrana samuuhamtoe chikitsanu polchinappudu vyaadhi sambhavinche vishayamlo etuvanti thedaalu levani nivedinchindi. 2 nundi 3 rojula paatu carticosteroids yokka paripalana sankramana yokka perigina retlatho sambandham kaligi undadu. ayithe, okasari phes sthaapinchabadina tarvaata methyprednisolone vaadakaaniki maddatu ivvadaaniki taginanta dayta ledhu.
shastrachikitsa tarvaata rogulalo sirala raktam gaddakattadam nivaaranaloo heparin upayoginchabadindi; ayithe polytrama unnavaarilo raktasraavam vachhe pramaadam peragadam valla phes unnavaarilo daani kramam tappakunda upayoginchadam viruddhamgaa undhi. oopiritittula vascular vyavasthaloki velle emboli mottaanni tagginchadaaniki takkuva sthaayi vena cava filterlanu unchaalani pratipaadinchabadindi, ayithe, eee paddhatini vivaramgaa adhyayanam cheyaledu.
chikitsa.
okasari phes abhivruddhi chendina tarvaata, vyaktini intensive cair unit (ii. sii. yuu) loe chaerchaali, pradhaanyamgaa central veenus pressure (sii. vii. pii) paryavekshanhatho. sii. vii. pii paryaveekshanha anedi valume punarujjeevanaaniki maarganirdesam cheyadaaniki sahaayapadutundi. sahayaka chikitsa anedi niroopitamaina chikitsa paddhati matrame. oka vyaktiki telikapati swaasakosha baadha unte anubandha praanavaayuvu ivvavacchu. ayithe, oka vyaktiki teevramaina swaasakosha baadha unte, nirantara saanukuula ottidi ventilation (sii. pii. eah. pii) ledhaa saanukuula end-expiratory pressure (peep) upayoginchi yaantrika ventilation suuchimchabadavachchu. shacknu nivaarinchadaaniki dravam marpidi avasaram. maanava albumintho valume punarujjeevanam sifaarsu cheyabadindi endukante idhi oopiritittula gayalanu tagginchadaaniki rakta prasarana vyavasthalo rakta parimaanaanni punaruddharinchagaladu, adhe samayamlo uchita kovvu aamlaalatoe kooda bandhistundi. teevramaina sandarbhaallo, kudi ventricular vaiphalyaaniki maddatugaa dobutamainnu upayoginchaali. festo badhapaduthunna vyakti yokka naraala purogatini anchanaa vaeyadaaniki tarachugaa glassgo coma scale (zii. sii. ess) charting avasaram. mastishka odema chikitsanu nirdesinchadaaniki intracronial pressure monetor unchadam sahaayapadavachhu.
charitra.
charitra, teevramaina thoraco-pottikadupu noppitho maraninchina railway karmikudi oopiritittulalo kanugonna kovvu binduvula shavapareeksha phalitaalapai jenkar modatisaari nivedinchaaru. nivedinchaaru, bergman virigina todatho badhapaduthunna rogilo kovvu embolismnu vaidyaparamgaa nirdhaarinchaadu. nirdhaarinchaadu, eee drugvishayam yokka lakshanaalanu gurud nirvachinchaaru. taruvaata willson thoo kalisi kovvu embolism pramaanaalanu savarinchina gurd, gurd kovvu embolism syndrome kosam gurd mariyu willson pramaanaalanu utpatti chesindi. chesindi, scanfeld kovvu embolism syndrome nirdhaarana kosam scoring vyavasthanu suuchimchaadu. suuchimchaadu, lindec swaasa sambandhita maarpulanu matrame upayoginchi kovvu embolism syndromenu nirdhaarinche maroka scoring vyavasthanu pratipaadinchindi. ayithe, vaatilo edhee vaidya samaajamlo vishwavyaaptamgaa aamodinchabadaledu.
aamodinchabadaledu, roney petterson oka racing pramaadamloo bahula pagullu sambhavinchina taruvaata, phes kaaranamgaa maraninchaadu.
maraninchaadu, singapur janta puva hock chuwan mariyu thaan huyy jhenlapai anee eee yuu lyon yokka durviniyogam mariyu hatya abhiyogaalu mopabaddaayi, aame maranaaniki enimidi nelala mundu aneka saareeraka vedhimpula kaaranamgaa maraninchindi. maranaaniki kaaranam teevramaina kovvu embolism anie velladaindi, idhi kottadam valla kalige moddubaarina shakti prabhavam phalitamgaa, idhi kovvu kanajaalam raktapravaahamloki pravesinchadaaniki daariteesindi mariyu chivariki oopiritittulalo rakta naalaalaloki pravesinchadaaniki daariteesindi, idhi addanki mariyu oxygenated rakta prasarananu kattirinchadaaniki daariteesindi mariyu swaasakosha mariyu hridaya vaiphalyam dwara eee yokka maranaaniki daariteesindi. rendu samvatsaraala taruvaata, swachchandamgaa aayudhamtho teevramaina gayanni kaliginchinanduku tagginchina aaropanalapai, thaan kuu 16 samvatsaraalu mariyu aaru nelala jailu siksha vidhinchabadindi, ayithe puva kuu 14 samvatsaraala jailu siksha mariyu 14 karra strokelu vachayi.

