dizzy
Introduction
Introduction Head dizziness is the clinical manifestation of crush syndrome. The diseases associated with head-sickness are acute renal failure, coma, crush syndrome, and depression. Symptoms associated with head dizziness include constipation, trauma, metabolic acidosis, proteinuria, azotemia, nausea, bloating, and sensory disturbances. Squeeze syndrome is a serious surgical disease, it should be rescued in time, to achieve early diagnosis, early injury and reduction of the limbs and prevention of renal failure. If the squeezing state lasts for a long time, there may be a risk of ischemic necrosis of the organism tissue, so it should be actively rescued.
Cause
Cause
Squeeze syndrome refers to the fact that a person is buried by stone, especially when the muscles are full of limbs for more than one hour (such as the thigh), and then cause a series of pathological changes in the body. The clinical manifestations are oliguria or even no urine. It is characterized by renal failure, which occurs in accidental injuries such as house collapse, project collapse, and traffic accidents. In the event of a serious disaster such as a war or a strong earthquake, it can appear in batches. In addition, occasionally in patients with coma and surgery, the limbs are prolonged by the self-pressure of the fixed position.
Examine
an examination
Related inspection
Brain CT examination blood pressure
1. History: Learn more about the causes and methods of injury, the time of limb compression and swelling, and the corresponding systemic and local symptoms. Pay attention to whether there is "red brown", "dark brown" or "brown" urine and urine volume after injury. If less than 400ml is oliguria per day, less than 50ml is urinary closure.
2. Clinical manifestations
(1) Local symptoms: blood damage, blood stasis, blood stasis, qi stasis, meridian occlusion, local pain, limb swelling, skin indentation, hardening, subcutaneous blood stasis, skin tension increased, in Blisters are formed around the compressed skin. When examining the blood circulation state of the limb, it is worth noting that if the distal end of the limb does not weaken, there is still a risk of ischemic necrosis in the muscle tissue. Attention should be paid to the examination of the muscles and nerve functions of the limbs. Active activity and passive traction can cause pain, which is helpful for judging the affected muscle compartment of the fascia.
(2) systemic symptoms: due to internal injuries, blood, meridians, viscera, patients with head dizziness, loss of appetite, facelessness, chest tightness, abdominal distension, constipation and other symptoms. The accumulation of heat can express fever, red face, yellow urine, red tongue, yellow greasy moss, pulse frequency and so on. Severe palpitations, shortness of breath, and even pale, cold limbs, sweat out of oil and other symptoms (shock).
The main characteristics of the crush syndrome are described as follows:
1 shock: some casualties may not have shock in the early stage, or the shock period is short and not found. Some wounded people have strong nerve stimulation due to crush injury, extensive tissue destruction, and a large amount of blood loss, which can quickly produce shock and increase.
2 myoglobinuria: This is an important condition for the diagnosis of crush syndrome. After the injured person relieves the pressure, brown urine or self-reported hematuria appears within 24 hours, and myoglobinuria should be considered. The concentration of myoglobinuria in the blood and urine reaches a peak 3 to 12 hours after decompression of the injured limb, and then gradually decreases, and can be cleared after 1 to 2 days.
3 Hyperkalemia: Because of muscle necrosis, a large amount of intracellular potassium enters the circulation, and it is difficult to excrete potassium in renal failure. In the oliguria period, potassium can rise 2mmol/L per day, and even rise to a fatal level within 24 hours. Hyperkalemia is accompanied by high blood phosphorus, high blood magnesium and low blood calcium, which can aggravate the effect of blood potassium on myocardial inhibition and toxicity.
4 Acidosis and azotemia: After muscle ischemic necrosis, a large amount of acidic substances such as phosphate and sulfate are released, which lowers the pH value of body fluid and causes metabolic acidosis. After severe trauma, tissue catabolism is vigorous, a large number of intermediate metabolites accumulate in the body, non-protein nitrogen is rapidly increased, clinical manifestations such as unconsciousness, deep breathing, irritability, polydipsia, nausea and other acidosis, uremia and other manifestations. The daily intake and output should be recorded daily, and the urine specific gravity should be measured frequently. If the urine specific gravity is less than 1.018, it is the main indicator of diagnosis.
Diagnosis
Differential diagnosis
Dizzy: the mind is faint and the eyes are blooming. It means sitting for a long time, squatting up or lying up, standing up, dizzy, black in front of me, standing unstable.
Head Shen: The first weight is a kind of self-conscious symptom of the head heavy, commonly known as "head sinking." Clinically, the first serious illness is often associated with headache and dizziness.
Dizziness: Dizziness is a subjective symptom, a movement sensation or an illusion of movement. It is a patient's directional sensory disturbance or balance sensation disorder for spatial relationship. The patient feels that the external environment or itself is rotating, moving or shaking, which is caused by vestibular nervous system lesions. Different from dizziness, in general, dizziness has no external environment or a sense of rotation of its own rotation, that is, the patient's chief complaint is top-heavy and the mind is unclear.
