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Teri rezorbtiv t a ’siri Z M bilan zararlangan jarohatlarning
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- Bu sahifa navigatsiya:
- Nerv-paralitik t a ’sirli Z M tavsifi
- A ralash kim yoviy jarohatlanganda tibbiy k o ‘ch irish bosqichlarida yordam hajmi
- T eri-rezorbtiv t a ’sirli Z M bilan zararlangan jarohatlarga jarrohlik ishlovi berishning o ‘ziga x o s xususiyatlari
Teri rezorbtiv t a ’siri Z M bilan zararlangan jarohatlarning k ech ish id agi o ‘ziga xos xususiyatlar B u n d a ja ro h a t va a t r o f t o ‘qim alard a o g ‘ir d e g e n e ra tiv n e k ro tik o ‘z g a rish la r ro ‘y b e ra d i. Y irin g li, ch irik li, a n a e ro b infeksiyali a so ra t- la r, q o q sh o ln in g o g ‘ir tu r i k o ‘p o ‘ch raydi. J a r o h a t b itish ja ra y o n i ju d a se k in b o ra d i. J a r o h a t tu sh g a n Z M q o n g a o ‘tib , o rg a n iz m g a u m u m iy rez o rb tiv t a ’s ir k o ‘rsa ta d i. S h ik astlan g an t o ‘q im a la r q a y n a - g a n g o 's h t tu sli. M u s h a k la r d a n q o n o q a d i, q is q a ris h x u su siy a tin i y o ‘q o tg a n , o so n y iitilu v c h a n b o ‘lib qoladi. J a r o h a t yuzasi ra n g p a r, s u v li, q o n s iz g r a n u l a t s i y a b ila n q o p la n g a n . J a r o h a t a t r o f te ris i d a g ‘alla sh g a n , u n in g o s tid a e sa yiringli o q m a la r o ‘ch ra y d i. Y u m sh o q t o ‘q im a la r n in g Z M b ilan z a ra rla n is h i c h u q u r d e g e n e ra - tiv - n e k r o tik ja ra y o n la rg a , m u sh a k la ra ro fle g m o n a g a , u z o q v aq t tu z a l- m a y d ig a n y a ralarg a o lib k e la d i. T urli organ va t o ‘qim a !a rg a yiringli m e ta s ta z la r va se p sis k u z a tilis h i m um kin. S u y ak lar s h ik a s tla n g a n d a n e k ro tik ostit riv o jla n a d i, o ste o m iy e litik ja ra y o n la r va s e k v e s trla r n in g k o ‘ch ish i kech y u z b e ra d i. B o‘g ‘im la r sh ik astlan ish i b o ‘g ‘im to g ‘ay la ri va b o ‘g ‘im a tro f t o ‘q im alarin in g n e k ro - z i b ila n k u zatilad i. U n d a o g ‘ir a rtritla r va p a ra a rtik u la r fle g m o n a la r riv o jla n a d i, q o n t o m i r l a r tro m b o z i, agar in fek siy a q o ‘sh ilsa, tro m b e rib ik k ilam ch i q o n k e tis h la r b o ‘lishi m um kin. B o sh m iya s u y a k la rin in g sh ik astlan ish i k o ‘p h o lla rd a m iya q a ttiq p a rd a s i n e k ro z ig a , o ‘lim g a , m e n in g itg a, m e n in g o e n tse fa litg a , m iya ab sse sslarig a o lib k e la d i. K o 'k ra k qafasi va q o r in d e v o rla ri sh ik a stla n g a n d a d iffu z p e rito n it y o k i o g ‘ir e m p iy e m a riv o jla n a d i. Ip rit bilan z a ra rla n g a n ja ro h a tla rg a quyidagilar xos: ip ritn in g spesifik (y o n g a n re z in a , s a r im s o q ) h id i k elad i, og‘riq reak siy asi k u z a tilm a y d i, ja r o h a t y u zasid a t o ‘q q o ‘n g ‘ir Z M t o ‘plangan d o g ‘larn i k o ‘rish m u m - k in , t o ‘q im la r q o ‘n g ‘ir ja g a r r a n g tu sg a kirgan b o l a d i . Z a ra rla n is h in in g y a s h ir in davri 2 - 3 so at d a v o m e ta d i. 3 - 4 so a t- d a n k ey in ja r o h a t a tro fi s h is h a d i va teri g ip e re m iy a si k u zatilad i. 1 s u tk a n in g o x irid a te r id a m a y d a p u fa k c h a la r p a y d o b o ‘ladi va u la r b ir- b irig a q o ‘sh ilib k e ta d i. Z a ra rla n g a n d a n 2—3 k u n d a n keyin ja r o - h a td a n e k ro z o ‘c h o q la r i p a y d o b o ‘ladi. Ip ritg a b o ‘lg an kim yoviy si- n a m a 48 so at ic h id a m u s b a t b o l a d i . Ja ro h a tg a k o ‘p m iq d o rd a ip rit tu s h s a rez o rb tiv t a ’s ir n a m o y o n boMishi m u m k in : a p a tiy a , u y q u c h a n - www.ziyouz.com kutubxonasi lik, u m u m iy h o lsiz lik . T a n a h a ro ra ti 38 — 3 9 d a ra ja g a c h a k o ‘ta r ila d i, puls 110 — 120 ta , siydikda oqsil, e r itro ts itla r, g ialin va d o n ali s ilin d r - la r to p ila d i. O g ‘ir h o lla rd a tu tq a n o q , o ‘p k a s h is h i, a rte ria l b o s im n in g p asay ish i, k o m a h o la ti rivojlanishi m u m k in . Ip rit b ila n z a ra rla n g a n ja r o h a tla r n in g b itis h i ju d a sek in b o r a d i. J a r o h a t o ‘r n id a k a tta , a tro f t o ‘q im a la r g ip e r p ig m e n t d o g ‘la r q o la d i. K o ‘p in c h a c h a n d iq la r y a ra la n a d i. Y a r a la r u z o q v a q t tu z a lm a y d i, k o ‘p in c h a y irin g la b k etad i. O d d iy ja r o h a t l a r 7 1 0 k u n d a b itsa , ip r it b ila n z a ra rla n g a n la rd a b u n in g u c h u n 2 0 - 4 0 k u n , b a ’za n u n d a n h a m k o ‘p v aq t ta la b q ilin a d i. A g ar ja r o h a tg a lyuizit tu sh sa , k u c h li k u y d iru v c h i qisqa m u d d a tli o g ‘riq b o l a d i , g e ra n hidi keladi, ja r o h a t t o ‘q im a la ri o c h k u lra n g tu s li b o la d i, ja r o h a td a n ku ch ii q o n k etad i. 10—20 d a q iq a d a n keyin j a r o h a t atro fid a g ip e re m iy a , shish, p u fa k c h a la r h o sil b o i a d i , p u fa k c h a la r s u tk a oxiriga kelib b ir-b irig a q o 'sh ilib k e ta d i. S h u v a q tg a kelib t o ‘q im a la r d a c h u q u r n e k ro z y u z be rad i. S h u b ila n b i r q a to r d a ja r o h a t y irin g la s h i t o ‘q im a la rd a y irin g li m e tasta zla r va se p s is k u z a tilis h i m u m k in . Z M o rg an izm g a tushgandan b ir n e c h a so a t o ‘tib u m u m iy re z o rb tiv reaksiya vujudga k elad i, u s o la k o q ish i, k o ‘ngil ay n ish i, qusish, x a v o tir hissi, q o ‘zg ‘alu v ch an lik bilan n am o y o n b o i a d i . K linik sim p to m la r riv o j- lana borishi b ilan arterial bosim pasay ad i, x a n sira sh , c h u q u r to r m o z la - nish kuzatiladi, ta n a harorati tushib k eta d i. K ollaps tipidagi o ‘tk ir y u ra k yetishm ovchiligi, o ‘pka shishi kuzatiladi. A g ar d av o m uolajalari o ‘z v a q tid a b o sh lan m asa, o i i m 1 - 2 k u n d a yuz b e rish i m u m k in . Nerv-paralitik t a ’sirli Z M tavsifi N e r v -p a ra litik t a ’siriga ega b o l g a n Z M e fir fo sfo r k is lo ta la rd ir. U larg a z a rin , z o m a n , V -gaz tip id ag i m o d d a la r k ira d i. B u lar Z M n in g e n g to k sik la rid ir. U la r suyuq to m c h i, a e r o z o l, b u g 's im o n h o la tla r d a q o lla n ila d i, o ‘z to k sik xususiyatlari q o l l a n i l g a n h u d u d d a b ir n e c h a s o a td a n k u n la b , h a fta la b , oylab s a q ia b q o la d i. V -g a z la r h a m m a d a n h a m tu rg ‘u n h iso b la n ad i. Z a rin - ra n g s iz , h idsiz, te z u c h u v c h a n su y u q lik , s o lis h tir m a o g ‘irligi !,0 0 5 , su v d a oson eriydi. V -gaz fo sfo rilx o lin va fo sfo riltio x o lin lar g u ru h ig a kiradi. U la r r a n g siz su y u q lik la r b o l i b , suvda y o m o n e riy d i, a m m o eritu v c h ila rd a j u d a yaxshi eriy d i. T oksikligi b o ‘yicha z a rin va z o m a n d a n u stu n tu ra d i, F o sfo ro rg a n ik z a h a r m o d d a ( F Z M ) te r i, sh illiq q a v a tla r, n a fa s y o lla r i, m e ’d a - ic h a k tizim in i ja r o h a t k u y g a n y u z a o rq ali z a ra r la y d i. O rg a n iz m g a tu s h ib , u la r q o n g a s o ‘rila d i v a b u tu n o rg a n iz m o r g a n v a t o ‘q im a la rig a ta rq a la d i. F Z M to k s ik t a ’sirining m e x a n iz m i. U la r a so sa n a ts e tilx o lin v a www.ziyouz.com kutubxonasi uk su s k islo ta g a c h a p a rc h a lo v c h i x o lin este raza fe rm e n tin in g in a k tiv a t- siyasini c h a q ira d i. A tse tilx o lin m arkaziy n erv s is te m a d a n periferik nerv siste m a g a im p u ls u z a tu v c h i asosiy m e d ia to rla rd a n b in h iso b la n a d i. F Z M t a ’sirid a a ts e tilx o lin k o ‘p m iq d o rd a t o ‘p la n ib q o la d i, b u n in g n atija sid a x o lin e rg ik s is te m a o ‘ta ta ’sirlan ad i. B u n d a n t a s h q a r i F Z M b e v o s ita x o lin e rg ik r e ts e p to r la r b ila n t a ’sirlashib, u la rn in g x o lin o m im e tik efTektini k u c h a y tira d i va atsetilxolin t o ‘p lan ad i. F Z M b ilan z a ra rla n g a n d a g i asosiy sin ip to m la r: m io z , p esh a n a g a u zatilu v ch i k o 'z d a g i o g ‘riq la r, jig ‘ildon q a y n ash i, k o ‘rish qo b iliy atin in g p asay ish i, rin o rey a. B u ru n sh illiq qavati g ip e re m iy a si, k o ‘krak qafasida siqilish hissi, b r o n x o re y a , b ro n x o sp a z m , n a fa s o lis h in in g q iy in lash ish i, h u sh ta k sim o n x irilla s h la r, n a fa s o lish n in g k e sk in b u z ilish i n atijasid a s ia n o z yuzaga k e la d i. B radikardiya, a rte ria l b o sim in in g pasayishi, k o ‘ngil ay n ash i, qusish, o sh q o z o n d a o g ‘irlik h issi, z a rd a qaynashi, k e k irish , te n e z m la r, d iarey a, b e ix tiy o r d e fe k a tsiy a , b e ix tiy o r siyish h am k u z a tilis h i m u m k in . K o ‘p te rla s h , saliv atsiy a, q o ‘rq u v hissi, u m u m iy q o ‘z g ‘alu v c h a n lik , e m o t- sio n a l labillik, a la h s ir a s h la r boMadi. K e y in c h a lik e s a d e p re s s iy a , u m u m iy h o lsiz lik , u y q u c h a n lik yoki u y q u sizlik , x o tira n in g p a s a y is h i, ataksiya riv o jla n a d i. O g ‘ir h o la tla rd a tu tq a n o q la r , k o lla p to id h o la t, nafas va q o n to m ir m a rk a z la ri faoliya- tin in g susayishi k u z a tila d i. F Z M b ilan z a ra rla n g a n ja ro h a tla rd a u m u m iy k o ‘rin ish o 'zg arish siz, ja ro h a t a tro fid a y a llig ‘la n is h yoki d e g e n e ra tiv n e k ro tik o ‘z g a rish la r y o ‘q , ja ro h a td a g i m u s h a k to la la rin in g fib rilly ar q isq a rish la ri u m u m iy tiris h is h la r b ila n a lm a s h in a d i. B ro n x o sp a zm , la rin g o sp a z m va m io z rivojlanadi. O g ‘ir h o la tla r d a k o m a to z holat va asfiksiya n atijasida o ‘lim k e lib c h iq a d i. F Z M n in g ja r o h a t o rq ali re z o rb siy a si ju d a te z b o ‘la d i, 3 0 - 4 0 d a q iq a d a n k e y in ja r o h a td a F Z M n in g q o ld iq la rin ig in a to p ish m u m k in . A ralash kim yoviy jarohatlanganda tibbiy k o ‘ch irish bosqichlarida yordam hajmi 1. B irinchi tib b iy y o r d a m o ‘z - o ‘ziga va b ir-b irig a y o rd am ta rzid a o ‘tk aziladi. B u n d a q u y id a g i m u o lajalar b ajarilad i:p ro tiv o g a z kiydirish, spesefik t a ’sirli a n tid o t y u b o rish , teri va kiyim laiga q ism a n san itar ishlov b e ris h (d eg a z a tsiy a), s u n ’iy n afas o ld irish , q o n k e tis h in i v a q tin c h a t o ‘x ta tish , ja ro h a tg a h im o y a b o g la m in i q o ‘yish , ja r o h a tla n g a n o yoq y o k i q o ‘l im m o b iliz a tsiy a si, sh p ris-ty u b ik d a o g ‘riq siz la n tim v c h i v o sita- la m i y u b o rish , s h ik a s tla n g a n h u d u d d a n tez o lib c h iq ish . 2. V ra c h g a c h a b o ‘lg a n tib b iy y o rd am q u y id a g i m u o la ja la m i o ‘z www.ziyouz.com kutubxonasi ichiga o lad i: s u n ’iy nafas o ld irish , n a fa s i fu n k s io n a l b u z ilg a n b e m o r - la rd a n p ro tiv o g a z n i y e c h ish , iprit va ly u iz it b ila n z a ra rla n g a n d a k o ‘z n i suv d a yoki 2% li n a triy b ik a rb o n a t e r itm a s i b ila n y u v ish , o s h q o z o n n i z o n d siz yuvish va a d so rb e n t b e rish . Y u r a k va n a fa s fu n k siy alari b u - zilg an d a d o rila r b e rish , b o g ‘la m la m i a lm a s h tir is h , q o ‘yilg an j g u t n i n a z o ra t q ilish, ja ro h a tla n g a n so h a im m o b iliz a tsiy a si, o g ‘riq q o ld iru v c h i d o rila r va a n tib io tik la r berish. 3. B irinchi v rach lik y o rd am i: F Z M b ila n z a ra rlan g a n d a a n tid o t yub o rish , talvasaga qarshi v o sitalar y u b o ris h , k o ‘zni suv yoki 2% li natriy b ik a ib o n a t e ritm a si,2% li b o r kislotasi e ritm a si, 0,5% li x lo ra m in suvli e ritm a si, 1:2000 kaliy p e rm a n g a n a t e ritm a s i b ilan yuvish. O s h q o - zo n ich a k tra k ti sh ik astlan g an d a o s h q o z o n n i z o n d y o rd a m id a iliq s u v yoki 0 ,5 % li kaliy p e rm a n g a n a tg a 1 litr su v g a 25 g. aktiv lan g an k o ‘m ir q o ‘sh ib yuviladi. F Z M b ilan z a ra rla n g a n d a m ax su s m a y d o n c h a d a y o k i b o g ‘lov x o n asid a quyidagi d e g azatsio n ta d b ir la r o ‘tkaziladi: - F Z M b ila n z a ra rla n g a n d a 8% li n a tr iy b ik a rb o n a t e ritm a s i va 5 % li p e re k is v o d o ro d e ritm a la r id a n te n g m iq d o rd a o lib is h lo v b erilad i. - [p rit b ilan z a ra rla n g a n d a le r i q o p la m la r in i 10% ii x io r a m in in g sp irtli e ritm a si, ja ro h a tn i esa 5% li x lo r a m in B n in g suvli e r itm a s i b ila n artilad i. - L yuizit b ila n z a ra rla n g a n d a j a r o h a t a tro fld a g i te ri 5% li y o d tin d irm a si, ja r o h a tn i esa lyugol e r itm a s i y o k i 5% li p e rek is v o d o r o d b ila n a rtila d i. K o ‘p so n li ja r o h a t l a n g a n l a r o q im id a ish lo v b e r i s h fa q atg in a h a y o tiy k o ‘rsa tm a la r a so sid a q ilin a d i. 4. M alak ali tib b iy y o rd am . Z M b ila n z a ra rla n g a n d a aso siy v a z ifa ja ro h a tg a im k o n q a d a r e rta ja rro h lik is h lo v in i b e rish d ir. J a r o h a t d e - gazatsiyasi va u n i 3 —6 so at ic h id a k e n g k e sish yaxshi n a tija b e r a d i. J a rro h lik ishlovi b e rish n i o rq ag a su rish fa q a tg in a favqulodda h o la tla r d a m u m k in d ir. O p e ra tsiy a va bogMov x o n a la rid a g i x o d im la r steril x a la t- la rd a , m a sk a la rd a , fa rtu k la rd a , q o ‘lq o p la rd a ish o lib b o ra d ila r. T ib b iy x o d im la m i h im o y a la sh m a q sad id a esk i b o g 'la m la r m ax su s p a la ta la r d a yechiladi. O p eratsiy a m ah alid a b a rc h a a ra la s h u v la m i iloji b o ric h a m a x sus a sb o b la r b ila n o lib b o rish k erak . A g a r q o ‘lq o p la r y irtilib k e ts a u la rn i d a rh o l y e c h ish , q o ‘lni x lo ra m in , s p jr t b ilan a rtish va y a n g i q o ‘lq o p kiyish k erak . A sb o b lar b e n z in d a h o ‘lla n g a n p ax ta y o r d a m id a y ax sh ilab a rtila d i, s o ‘ng 1 so at d a v o m id a 2% li n atriy b ik a r b o n a t e ritm a sid a q a y n a tila d i. Ishlatilgan ja rro h lik q o lq o p la ri issiq su v d a so v u n lab yuviladi, k e y in 2 0 - 3 0 daqiqaga 5% li xloram in B n in g sp irtli eritm asig a solib q o ‘y ila d i va suvda 20—30 d a q iq a q a y n a tila d i. I s h la tilg a n b o g ‘lov m a te r ia lla r i o p eratsiy a m a h a lid a d e g a z a to r so lin g an q o p q o q li idishga so lin a d i, o p e - ra tsiy ad a n k ey in y o q ib ta sh la n a d i. www.ziyouz.com kutubxonasi J a rro h lik ishlovi m a h a lliy o g ‘riq siz la n tirish d a yoki u m u m iy n ark o z o s tid a bajarilishi m u m k in . M a h a liy o g ‘riqsizlantirishga k o ‘rsatm a b o ‘lib, te rin in g k o ‘p q ism in i re z o rb tiv t a ’sirli Z M b ila n shikastlanishi hisobla- n a d i. V ishnevskiy b o ‘y ic h a m a h alliy o g ‘riq sizlan tirish n i og‘riq qoldiruv- c h i va talv asag a q a rs h i x u su siy a tg a ega b o ‘lg an n e y ro le p tik vo sitalar b ila n o ‘tk a z ish m u m k in . E n g effektiv n a rk o z u su li, en d o tra x e a l usul h iso b la n a d i. U n g a q a rs h i k o ‘rsa tm a o ‘p k a s h is h i, arte ria l b o sim n in g k e sk in k a m a y g a n lig i, m a rk a z iy n e rv sistem a si fao liy atin in g susayishi h is o b la n a d i. F Z M b ila n z a r a r la n g a n d a t o m i r ic h i n a rk o z i k e n g q o ‘lla n ila d i. T eri-rezorbtiv t a ’sirli Z M bilan zararlangan jarohatlarga jarrohlik ishlovi berishning o ‘ziga x o s xususiyatlari B a rc h a h o lla rd a , a w a la m b o r , a t r o f t e n d e g a z a tsiy a o 'tk a z ilish i va ja ro h a tn i 5% li x lo r a m in n in g suvli e ritm a si b ila n yuviladi. J a rro h lik ish lo v i a n iq k e tm a - k e tlik d a b a ja rilish i kerak. A w a l ja ro h a td a g i o ‘lgan te ri q is m la ri, y o t j is m la r , q o n q u y q a la ri o lib ta s h la n a d i. A sb o b la r a lm a s h tirilib , te ri o s ti y o g ‘ k le tc h a tk a s i k e n g k esilad i va h a y o tg a n o lo y iq m u s h a k t o ‘q im a la r i o lib ta s h la n a d i. J a r o h a tn in g q a y ta d e - g a z a tsiy a si o ‘tk a z ila d i. 0 ‘q te k k a n va Z M b ila n z a ra rla n g a n j a r o h a tla rg a ra d ik a l is h lo v b e rila d i. S u y a k p a rc h a la ri Z M ni a d so rb siy a - la y d i va u z o q v a q t o ‘z id a s a q la b q o la d i, n a tija d a c h u q u r n e k ro z , o s te o m iy e lit, fle g m o n a , se p s is riv o jla n ish i m u m k in . S h u n in g u c h u n t o 'l i q d e g a z a ts iy a d a n s o ‘n g s u y a k p a rc h a la rin i t o ‘liq o lib ta sh la sh k e ra k . S in g a n s u y a k n in g u c h la rin i so g ‘ t o ‘q im a g a c h a arra la b o lib ta sh la n a d i. T o m ir d e v o rla ri Z M g a o ‘ta se z g ir h is o b la n a d i, sh u n in g u c h u n u la rn i b o g ‘lash ta v siy a e tila d i. N e rv tu ta m la ri Z M ga u n c h a lik sezg ir b o lm a g a n lig i sa b a b li, 2% li x lo ra m in n in g suvli e ritm a si b ilan yuviladi va so g ‘lom t o ‘q im a la r b ila n y o p ilad i. Bu h o la td a b irla m c h i c h o k la r q o kyilm aydi. O peratsiya ja ro h a tn i y u - v ish , y ak u n lo v ch i d e g a z a tsiy a , a n tib io tik la r b ilan infiltratsiya, rezina tru b k a la r va a se p tik b o g ‘la m q o ‘yish b ilan y a k u n la n a d i, q o ‘l va o y o q lar im m obilizatsiyasi s h in a la r va g ip s lan g etalarin i q o ‘yish b ilan am alga o sh irilad i. Z ie h s irk u ly a r b o g ‘la m la r q o ‘yish b irin c h i k u n lard a m an e tila d i, c h u n k i to ‘q im a la r sh ish ib , ishem ik b u zilish lar ro ‘y berishi m u m k in. A gar b e m o r k e c h o lib k elin g a n b o ‘lsa va t o ‘qim alari sh ish g an b o ‘lsa, u h o ld a f a q a t d e g a z a ts iy a va ja r o h a tn i k en g ay tirish b ila n c h e k la n ish m u m k in . Z M b ilan z a ra rla n g a n b o ‘sh liq la rd ag i ja ro h a tla rg a ja rro h lik ishlovi b e rish . A g ar ja r o h a t m iy a b o ‘sh lig ‘id a b o ‘lsa, o p e ra tsiy a m axsus g o s- p ita lla rd a b aja rila d i. H a y o tiy k o ‘rs a tm a la r b o ‘y ic h a m alakali v ra c h lik www.ziyouz.com kutubxonasi y o rd a m i b o s q ic h id a h a m o p e ra tsiy a q ilis h m u m k in . K alla su y a g i s h i - k a stla n g a n d a x iru rg ik ishlov b e rish q o ‘y id a g ic h a bajariladi: d e g a z a ts i- y a d a n so ‘ng ja r o h a t ch e tid a g i t e n va s u y a k q o ld iq la ri o lib ta s h la n a d i. S u y u d u ral g e m a to m a b o ‘lsa, m iy a q a ttiq p a rd a si o c h ilad i va g e m a t o - m a asta o lib ta sh la n a d i. A g a r ja r o h a t z a ra rla n g a n b o ‘lsa, y u m s h o q k a te te r y o rd a m id a 1% li x lo ra m in B e r itm a s i, 0,1% li riv a n o l y o k i iz o to n ik e ritm a b ilan yu v ilad i, s o 'n g k a n a m its in a n tib io tik i y u b o r iia - di. K o ‘k rak q a fa si ja ro h a tla rid a ja r r o h lik ishlovi u m u m iy q o i d a l a r b o ‘y ich a b a ja rila d i. O c h iq p n e v m o to ra k s so h a sid a g i ja ro h a t d e g a z a t - siya q ilin a d i, ja ro h a tla n g a n t o ‘q im a la r k e sib o lin a d i va 2% li x lo - ra m in n in g suvli e ritm a sid a yuviladi. Q o v u rg ‘a suyaklari p a rc h a la ri o lib tash lan ad i, Z M b ilan zara rlan g a n q o v u ig ‘a la r rezeksiya q ilin ad i. 0 ‘p k a sh ik astlan ish x a ra k te rig a q a ra b lo b e k to m iy a yoki p n e v m o n e k to m iy a bajarilad i. P lev ra b o ‘sh lig ‘i 5% li p e rik is v o d o r o d e ritm a si, k e y in 1% li x lo ra m in e r itm a s i b ila n y u v ila d i. O c h iq p n e v m o to ra k s n i ti k i s h u m u m iy q o i d a l a r b o ‘y ic h a a m a l g a o s h i r i l a d i - T e r ig a c h o k l a r q o ‘yilm aydi. P lev ra ichiga a n tib io tik la r y u b o rib tu rila d i. A g a r j a r o - h a tn i tik is h n in g iloji b o im a s a , b o s h q a t o ‘q im a la r b ilan p la s tik a q i lish m u m k in . G e m o to ra k s b o 'lg a n ho llard a q o n asp iratsiy asi o ‘tkaziladi va p le v r a - ga a n tib io tik la r e ritm a si y u b o rila d i. Q o r in b o ‘sh lig ‘i j a r o h a tla r in in g Z M b ilan z a ra rlan ish i k e c h ik tirib b o 'lm a y d ig a n m alakali ja r r o h lik y o r - d a m in i Calnb q ilad i. P a re n x im a to z a ’z o la r Z M g a n isb a ta n c h i d a m l i - ro q d ir. S h u n in g u c h u n b u o rg a n la r ja r o h a t i d a d e g a z atsiy ad an s o ‘n g ja rro h lik ishlovi o d d iy ja r o h a tla r is h lo v id a n farq q ilm ay d i. I n g ic h k a ich a k n in g a y rim q ism i z a ra rla n g a n b o 'ts a , d e g a z a tsiy a d an s o ‘n g s h u so h a o lib ta s h la n a d i, ka tta s o h a la rd a e s a rez e k siy a d a n s o ‘ng a n a s t o - m o z q o ‘yiladi. Y o ‘g ‘o n ic h a k s h ik a s tla n g a n d a a n a sto m o z q o ‘y ilm a y d i. Y o ‘g ‘o n ic h a k u c h la ri q o rin d e v o r id a n ta s h q i m u h itg a n o ta b iiy a n u s sifatid a o c h ib q o ‘yilad i. Q o rin b o ‘s h lig ‘i 1% li x lo ra m in B n in g su v li eritm asi b ilan y uviladi. K atta m iq d o rd a a n tib io tik la r y u b o rilad i. Q o r i n b o ‘sh lig ‘iga a n tib io tik la r y u b o rish m a q s a d id a rezin a n a y c h a q o ‘y ila d i. J a r o h a t q a v a tm a - q a v a t t i k ila d i ( t e n tik ilm a y d i) . J a r o h a t l a n g a n b o ‘g lim la rd a b irla m c h i ja rro h lik ish lo v i ja r o h a t d eg azatsiy asi, o 'f g a n t o ‘q im a la rn i o lib ta s h la s h , q o n q u y q a la r i v a yot j is m la r n i o l i b ta sh la sh d a n ib o ra t. B o lg ‘im b o ‘sh lig ‘i 2 % li x lo ra m in B n in g su v li e ritm asi b ilan yu v ilad i, a n tib io tik la r y u b o rila d i. B o ‘g ‘im s h ik a s tla n g a n b o ‘lsa, b o ‘g ‘im rezeksiyasi yoki a m p u ta ts iy a o ‘tk aziladi. F Z M b ila n z a ra rla n g a n ja ro h a fla c g a b irla m c h i ja rro h lik ish lo v i b e rish. J a ro h a tg a F Z M ning tu s h is h i h a y o t u c h u n o ‘ta xavfli, c h u n k i u te z re z o rb siy a la n a d i, s h u n in g u c h u n b irla m c h i ja rro h lik ish lo v i Z M t a ’sirin i t o ‘x ta tu v c h i d o rila r y u b o rilg a n d a n k ey in a m alg a o s h ir ila d i. B em o r m alak ali tib b iy y o rd a m b o s q ic h ig a y e tib k e lg u n ch a j a r o h a t d a www.ziyouz.com kutubxonasi Z M q o lm a y d i, s h u n in g u c h u n o d d iy ja r o h a t sin g ari ja rro h lik ishlovi o ‘tk a z ila d i. A rala sh k im y o v iy sh ik a stla n ish la rd a s h o k rivojlansa, u m u - m iy sh o k k a q a rs h i v o s ita la r b ilan b ir q a to rd a a n tid o tla r yub o rilad i. Z M n in g q o n d a g i m iq d o rin i k am ay tirish m a q s a d id a q o n yoki q o n o ‘ r n in i b o s u v c h i s u y u q lik la r q u y ish ta v s iy a e tila d i. Q o n o ‘rn in i b o s u v c h i s u y u q lik la r s if a tid a p a s t m o le k u ly a r p o lig ly u k in k e n g qoM Ianiladi. A ralash kim yoviy sh ik a stla n ish la rid a k o ‘p h o lla rd a yiringli a so ra tla r riv o jla n a d i. S h u sa b a b li a n tib io tik la r va su lfa n ila m id p re p a ra tla rin i k e n g ish latish m a q s a d g a m u v o fiq d ir. Ix tiso slash g an ja r r o h lik y o rd a m i g o sp ita lla rd a k o ‘rsatiladi. Bu b o s- q ic h g a y etib k elg an d a b e m o rla rd a Z M n atijasid a u m u m iy intoksikatsiya b e lg ila ri yu zag a c h iq a d i. S h u sababli ja rro h lik y o rd a m i b ilan b ir q a to r d a ilk k u n la rd a n o q in to k sik a tsiy a g a q a rsh i c h o r a la r n i h a m k o ‘rish d a rk o r. H o la tiy m a s a la la r I. A sk ar A . B rT P g a k im y o v iy z a r a rla n g a n o ‘c h o q d a n k elgan. S o ‘z id a n a v ia b o m b a p o rtla s h i n a tijasid a o ‘ng b o ld ir so h asi ja r o h a t- la n g a n , k ey in k im y o v iy q u ro l t a ’siriga u c h ra g a n , ja ro h a tid a o g ‘riq n in g k e sk in k u ch a y g a n lig in i h is q ilgan. P rotivogaz kiy g an . M axsus suy u q lik b ila n ja ro h a tig a is h lo v b e rg a n . BogMam q o ‘y ilg a n . O y o q ta x ta b ilan im m o b iliz a tsiy a q ilin g a n . K e lg a n d a u m u m iy a h v o li q o n iq a rli. B o ld ir o ‘rta 1 /3 d a bogM am , q o n b ila n sh im ilg an . BogM am u stid a sa rim so q h id i b o r, dogMar, k a tta b o ld ir suyagining p a to lo g ik h a ra k a ti a n iq la n d i. 1. Q ay si Z M b ila n z a ra rla n g a n ? N im a u c h u n ? 2. B rT P d a b e m o r g a q a n d a y m u o la ja la r o ‘tk a z ila d i? 3. E v a k o tra n s p o rt s a ra la s h in i o 'tk a z in g . II. K im y o v iy z a r a r la n g a n o ‘c h o q d a n B r T P g a a s k a r k elg an . Q oM dagi o g 'riq la r, k o 'r is h in in g pasayganligi, b u m id a n sh illiq ajralishi, k o 'k r a k q afasid a s iq ilis h , h a n s ira s h b e lg ila rid a n sh ik o y a t q ilad i. K o ‘p te r la s h , q o ‘zg ‘a lu v c h a n lik , q o ‘rquv k u zatild i. P u is 50 ta , AB 9 0 /5 0 . 1. Z M n in g tu r in i a n iq la n g . 2. Q a n d a y y o rd a m k o ‘rsa tish kerak? 3. E v a k o tra n s p o rt s a ra la s h in i o ‘tkazing. Savol va topshiriqlar 1. Z M ta sn ifin i a y tin g . 2. T e ri- re z o rb tiv t a ’sirig a ega boMgan Z M n i tavsiflang. 3. T e ri-re z o rb tiv t a ’sirii Z M n in g toksik t a ’siri m e x an izm in i ayting. www.ziyouz.com kutubxonasi 4. Ip ritn in g u m u m iy re z o rb tiv t a ’siri k lin ik s im p to m la rin i sa n a b o ‘ting. 5. Ip rit b ila n m a h a lliy z a ra rla n is h h a q id a g a p r ib b erin g . 6. N e rv p a ra litik t a ’sirli Z M ga x a ra k te ris tik a b e rin g . 7. F Z M n in g to k sik t a ’sirin i ayting. 8. T e ri-re z o rb tiv t a ’sirli Z M bilan z a ra rla n g a n ja r o h a tla r k e c h ish in - ing x u su siy atlarin i ayting. 9. A ralash k im yoviy sh ik a stla n ish d a b irin c h i tib b iy y o rd a m h a jm i h a q id a gapiring. 10. A K S h d a b irin c h i v ra c h lik y o rd a m i h a jm in i ayting. 11. A K S h d a m alak a li tib b iy y o rd a m h a jm i h a q id a g apiring. 12. T e ri-re z o rb tiv Z M b ila n z a ra rla n g a n ja r o h a tla r g a ja rro h lik ishlovi b e rish n in g o ‘ziga x o s x u su siy atlarin i g a p irin g . www.ziyouz.com kutubxonasi |
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