Paradigm Hloov hauv Cov Qauv Thiab Kev Tshaj Tawm Ntawm Cov Tshuaj Yeeb Thaum Muaj Kab Mob Khaus Viv-19
Jul 07, 2022
Lub Hom Phiaj: Txhawm rau ntsuas tus qauv, qhov tshwm sim, thiab qhov tshwm sim ntawm cov neeg mob lom tau tshaj tawm rau tsev kho mob hauv North Is Nrias teb thaum lub sijhawm COVID-19 kis thoob qhov txhia chaw. Cov Khoom Siv thiab Cov Txheej Txheem: Kev soj ntsuam, kev tshawb fawb yav tom ntej tau ua rau 100 tus neeg mob qhia txog kev kho mob xwm txheej ceev nrog keeb kwm ntawm kev haus tshuaj lom thaum lub Plaub Hlis 2020 txog Lub Ib Hlis 2021. Lub hnub nyoog yog 14-85 xyoo. Cov ntaub ntawv tau txais raug txheeb xyuas siv cov ntaub ntawv txheeb cais thiab cov txiaj ntsig tau nthuav tawm raws li feem pua thiab txhais tau tias. Cov txiaj ntsig: Tawm ntawm 100 tus neeg mob (77M, 33F), txhais tau tias muaj hnub nyoog 32.6 xyoo, feem ntau yog cov neeg muaj hnub nyoog 20-30 xyoo thiab 50 feem pua tau raug matriculated thiab feem ntau ntawm cov neeg mob koom nrog Punjab thiab Himachal Pradesh. Cov tshuaj lom neeg siv ntau tshaj plaws yog corrosives (34 feem pua) ua raws li Aluminium Phosphide (24%). Kev ntxhov siab ua pa (53 feem pua ), tsis nco qab (43 feem pua ) thiab mob raum raug mob (36 feem pua) yog cov kev nthuav qhia kho mob. PSS (Poisoning Severity Score) yog nruab nrab ntawm 52 feem pua ntawm cov neeg mob, hnyav hauv 14 feem pua, tuag hauv 16 feem pua, thiab me me hauv PSS hauv 18 feem pua ntawm cov neeg mob. 16 tus neeg mob uas tuag taus PSS thiab 16 tus neeg mob uas muaj mob hnyav rau PSS tau tas sijhawm. Kev tuag siab ntawm 33 feem pua tau pom hauv peb txoj kev tshawb fawb. Cov ntsiab lus: Cov pab pawg uas muaj kev pheej hmoo tshaj plaws hauv peb txoj kev tshawb fawb yog cov txiv neej hluas hauv pawg hnub nyoog 21-30 xyoo thiab tsis muaj kev kawm tsawg, uas tau poob haujlwm vim yog COVID-19 kev sib kis thoob qhov txhia chaw. Corrosives yog feem ntau haus tshuaj lom thaum lub sij hawm kaw. Peb txoj kev tshawb fawb pom tau tias cov qhab nia PSS thiab GCS yog cov cuab yeej ntsuas zoo rau qib ntawm qhov hnyav ntawm kev lom thaum ntxov.
Nyem rau herba Cistanche cov txiaj ntsig rau lub raum raug mob
Ashish Behera, Neeraj Singla, Nalin Sharma, Navneet Sharma
Post Graduate Institute of Medical Education & Kev Tshawb Fawb, Chandigarh, Is Nrias teb
Taw qhia
Tshuaj lom thiab tshuaj ntau dhau yog qhov xwm txheej kho mob uas tseem ceeb rau kev txheeb xyuas qhov xwm txheej, qauv thiab qhov tshwm sim los ua cov kauj ruam tseem ceeb rau kev npaj nruj tsis yog hauv tsev kho mob nkaus xwb tab sis kuj tseem nyob hauv zej zog rau kev tiv thaiv thiab kev tswj hwm. Kev kis thoob qhov txhia chaw tam sim no ntawm COVID-19 tau muaj kev cuam tshuam loj heev rau lub xeev puas siab ntsws ntawm tib neeg.[1] Cov xwm txheej uas muaj kev puas siab puas ntsws loj heev rau cov neeg hauv lub tebchaws thaum lub sijhawm nyuaj no yog kev ntshai ntawm lub neej yav tom ntej, kev lag luam poob qis, poob haujlwm, poob peev nyiaj, tsis paub meej, poob ntawm tsev neeg, kev kho siab thiab lwm yam. Ntxiv rau qhov no, nquag hloov tsoomfwv cov lus qhia txog kev txwv, nthuav tawm sai thiab qee lub sijhawm cov ntaub ntawv tsis sib haum xeeb los ntawm cov xov xwm loj, thiab cov lus xaiv / xov xwm tsis tseeb hauv kev tshaj xov xwm txog COVID-19 ntxiv ua rau muaj kev ntshai ntawm cov tib neeg uas ua rau muaj kev nyuaj siab thiab kev ntxhov siab. Nws ntshai tias tag nrho cov teeb meem kev puas siab puas ntsws yuav muaj kev puas tsuaj ntau dua nyob rau lub sijhawm tom ntej.[2] Txawm hais tias cov menyuam yaus muaj kev pheej hmoo tsawg tshaj plaws ntawm kev tuag los ntawm COVID-19 kev kis tus kab mob kis thoob qhov txhia chaw rau lawv lub hlwb vim poob ntawm cov sij hawm kawm ntawv thiab cov sij hawm ua phooj ywg, kev sib cav nrog cov niam txiv, kev xav ntawm kev nyob ib leeg thiab lwm yam, tseem yog ib qho kev hem thawj loj.[3]
Raws li pom los ntawm cov kev tshawb fawb yav dhau los, ua ntej COVID-19 kis thoob qhov txhia chaw, kev lom neeg yog qhov thib plaub feem ntau ua rau tuag nyob rau hauv Is Nrias teb nyob deb nroog uas cov neeg tuag txawv ntawm 15-30 feem pua .[4] Hauv Is Nrias teb, cov neeg mob lom muaj ntau heev vim mus rau qhov yooj yim nkag tau ntawm cov tshuaj lom, nce kev siv tshuaj rau kev lag luam thiab kev lag luam hauv tsev thiab tus nqi qis ntawm cov tshuaj lom neeg txaus ntshai.[5] Qee yam uas yuav tsum tau ua rau tib neeg noj tshuaj lom muaj xws li kev tsim txom hauv tsev, keeb kwm ntawm kev quav tshuaj, kev nyuaj siab, kev nyuaj siab, kev sib cais lossis kev poob nyiaj txiag thiab cov no tuaj yeem raug daws los ntawm kev tiv thaiv kev noj qab haus huv thiab kev siv zog hauv zej zog[6] siv kev hais txog qhov tseem ceeb ntawm kev cob qhia. Cov neeg ua haujlwm saib xyuas kev noj qab haus huv hauv zej zog los pib tshuaj xyuas kev puas hlwb thiab kev cuam tshuam rau cov neeg tsis muaj zog thaum lub sijhawm COVID-19 kis thoob qhov txhia chaw.
Vim muaj ntau yam kev txwv thaum lub sij hawm kaw, cov pej xeem muaj kev ntxhov siab loj heev. Cov neeg nyob hauv tsev thiab tau yooj yim nkag mus rau hauv tsev khaws cov tshuaj tua kab, tshuaj tua kab thiab tshuaj corrosive, yog li pom muaj qhov tshwm sim ntawm cov tshuaj lom ntau ntxiv. Tsis tas li ntawd, qhov txwv tsis pub thauj cov chaw thauj khoom thaum lub sijhawm kaw tau ncua sijhawm ntawm kev nthuav qhia ntawm cov neeg mob no mus rau qhov chaw kho mob kom raug, yog li ua rau muaj teeb meem thiab ua rau muaj qhov tsis zoo.
Tus kws kho mob thawj zaug yog thawj tus neeg rau kev sib cuag thaum muaj xwm txheej ceev thiab muaj lub luag haujlwm tseem ceeb hauv kev kho sai thiab tsim nyog rau feem ntau cov tshuaj lom. Yog li kev hloov kho raws sij hawm ntawm cov xwm txheej tam sim no tshwj xeeb tshaj yog nyob rau lub sijhawm COVID-19 muaj thoob qhov txhia chaw yog qhov xav tau tshaj plaws ntawm lub sijhawm hauv kev tswj hwm cov xwm txheej tshuaj lom neeg kom zoo dua qub uas tau lees paub los ntawm kev tshawb fawb los ntawm Keller EL li al. [7] Yog li, txoj kev tshawb fawb tam sim no yog txhawm rau txheeb xyuas tus qauv, qhov tshwm sim thiab qhov tshwm sim ntawm cov neeg mob lom uas tau tshaj tawm rau tsev kho mob thaum muaj tus kab mob COVID-19.
Khoom siv thiab cov txheej txheem
Txoj kev tshawb no tau pom zoo los ntawm Pawg Saib Xyuas Kev Tshawb Fawb thiab Kev Ncaj Ncees thiab tau ua dhau 9 lub hlis txij lub Plaub Hlis 2020 txog Lub Ib Hlis 2021 vide reference no. INT/IEC/2020/SPL-984 hnub tim 25/07/2020. Tag nrho ntawm 100 tus neeg mob uas muaj hnub nyoog tshaj 12 xyoos, keeb kwm ntawm kev noj tshuaj lom, thiab yuav tsum tau txais kev tso cai raug xaiv rau txoj kev tshawb fawb tom qab tau txais kev pom zoo los ntawm tus neeg mob / cov txheeb ze. Lub proforma tau npaj nrog cov ntsiab lus ntawm tus neeg mob cov pej xeem, kev ua haujlwm, keeb kwm kev kawm, ntau thiab lub npe ntawm cov tshuaj lom neeg, kev nthuav qhia kev kho mob, kev quav tshuaj, kev pheej hmoo, thiab cov teeb meem tsim. Cov theem ntawm kev nco qab thiab lub siab lub ntsws ntawm tus neeg mob tau soj ntsuam los ntawm Glasgow Coma Scale (GCS) thiab txhua tus neeg mob raug ntsuas ntawm qhov ntsuas ntawm 15; Cov neeg mob tau muab faib ua hnyav (GCS 3-8), nruab nrab (GCS 9-13), thiab mob hlwb me (GCS 14-15).[8] Qhov hnyav ntawm kev lom tau raug soj ntsuam siv Poisoning Severity Score (PSS) thiab cov neeg mob tau muab qhab nia raws li me, nruab nrab, hnyav, thiab tuag taus.[9] Hauv kev tshawb fawb GCS thiab PSS tau siv los kwv yees qhov kev tuag ntawm cov neeg mob thiab kev sib raug zoo ntawm GCS thiab PSS kuj tau muab piv.
Kev txheeb cais
Categorical variables tau tshaj tawm raws li suav thiab feem pua. Kev sib piv pab pawg tau ua nrog Chi-Square test / Fisher's Exact test. Cov ntaub ntawv txuas ntxiv tau muab raws li qhov txhais tau tias ± SD thiab ntau yam lossis qhov nruab nrab thiab qhov sib txawv, raws li qhov tsim nyog. Lub normality ntawm ntau cov ntaub ntawv tau soj ntsuam los ntawm kev ntsuas ntawm Kolmogorov Smirnov kev ntsuam xyuas ntawm normality. Rau skewed cov ntaub ntawv sib piv rau ob pawg tau ua los ntawm Mann-Whitney xeem. Rau ib txwm faib cov ntaub ntawv, Tub Ntxhais Kawm t-test tau siv los sib piv 2 pawg. Rau kev sib piv cov ntaub ntawv uas tsis yog ib txwm faib raws li PSS tau tsim los ntawm Kruskal-the Wallis kev xeem ua raws li Mann-the Whitney test.
Txhawm rau txiav txim siab, tus kws tshaj lij ywj pheej rau kev tuag; Kev ntsuam xyuas Logistic Regression tau ua tiav. Cov xwm txheej pom tau tias yog qhov tseem ceeb hauv kev txheeb xyuas bivariate los ntawm Chi-Square test / Fisher qhov kev xeem tiag tiag, Mann –Whitney test tau muab tso rau Bivariate Logistic Regression Analysis thiab Odds Ratios tau xam. rhiab heev, qhov tshwj xeeb, tus nqi kwv yees zoo thiab tus nqi kwv yees tsis zoo raug xam rau kev tuag raws li PSS Score.
AP tus nqi<0.05 was="" considered="" signifificant.="" analysis="" was="" conducted="" using="" ibm="" spss="" statistics="" (version="">
Cov txiaj ntsig
Cov ntaub ntawv serial ntawm 100 tus neeg mob uas muaj keeb kwm muaj tshuaj lom thaum lub sijhawm COVID-19 kis thoob qhov txhia chaw tau txheeb xyuas thiab kev sib raug zoo tau ua tiav ntawm ntau yam. Kev nthuav qhia pej xeem thiab kev kho mob rau cov neeg mob no muaj nyob rau hauv Table 1. Ntawm 100 tus neeg mob, 77 yog txiv neej thiab 23 yog poj niam [Daim duab 1] thiab qhov nruab nrab hnub nyoog ntawm kev nthuav qhia yog 32.6 xyoo nrog lub hnub nyoog ntawm 14 txog 85 xyoo. Hauv peb txoj kev tshawb fawb, qhov tshwm sim ntau tshaj plaws ntawm kev lom tau pom nyob rau hauv pawg hnub nyoog ntawm 20-30 xyoo [Daim duab 2].
Cov neeg mob yog los ntawm cov xeev nyob sib ze ntawm Punjab (45 feem pua), Himachal Pradesh (22 feem pua), Haryana (14%), thiab Chandigarh UT (16 feem pua), [Daim duab 3]. Raws li kev kawm keeb kwm yav dhau los, nws tau pom tias ntawm 100 tus neeg mob, 50 feem pua tau kawm txog kev kawm tiav thiab 8 feem pua tau nyeem tsis tau [Daim duab 4]. Raws li kev ua haujlwm ntawm cov neeg mob, nws tau pom tias 42 feem pua tau poob haujlwm thaum lub sijhawm COVID kis thoob qhov txhia chaw, 13 feem pua tau ua lwm txoj haujlwm ib nrab hnub kom khwv tau nyob, 11 feem pua tau poob haujlwm, 14 feem pua yog cov neeg ua haujlwm hauv tsev, 14 feem pua tau ua haujlwm. , 6 feem pua yog cov tub ntxhais kawm [Daim duab 5]. Cov tshuaj lom neeg uas siv ntau tshaj plaws yog corrosives (34 feem pua) ua raws li Aluminium Phosphide (24 feem pua) thiab organophosphates (22 feem pua) [Daim duab 6].
Hais txog qhov muaj feem cuam tshuam rau kev noj tshuaj lom, 83 feem pua muaj keeb kwm ntawm kev xav tua tus kheej, 19 feem pua tau muaj keeb kwm ntawm kev puas siab puas ntsws yav dhau los, thiab 13 feem pua muaj keeb kwm ntawm kev sim tshuaj lom yav dhau los. Nws tau pom tias tawm ntawm 100, tsuas yog 3 tus neeg mob tau kuaj pom zoo rau COVID-19. Kev quav yeeb quav tshuaj ntau tshaj plaws ntawm cov neeg mob no yog cawv (47 feem pua) tom qab haus luam yeeb (26 feem pua) thiab narcotics (16 feem pua). Hauv peb txoj kev tshawb fawb, cov kev kho mob tshwm sim uas cov neeg mob tau nthuav tawm yog cov tsos mob plab hnyuv (90 feem pua), tom qab ntawd los ntawm kev ua pa nyuaj (53 feem pua), tsis nco qab (43 feem pua), kev raug mob mucosal (44 feem pua), mob raum mob (36 feem pua) , cov hlab plawv tsis ua hauj lwm tau pom nyob rau hauv 21 feem pua thiab cov tsos mob los ntshav tau pom nyob rau hauv 19 feem pua cov neeg mob. Thaum nyob hauv tsev kho mob, 49 feem pua ntawm cov neeg mob tau tsim ua pa tsis ua haujlwm, 42 feem pua ntawm CNS kev koom tes, thiab 25 feem pua ntawm cov hlab plawv tsis ua haujlwm [Table 1].
GCS (Glasgow Coma Scale) tau qhab nia tsawg dua lossis sib npaug li 8 tau pom hauv 17 tus neeg mob, qhov qhab nia nruab nrab ntawm 9 thiab 12 tau pom hauv 23 thiab qhov qhab nia nruab nrab ntawm 13 thiab 15 tau pom hauv 60 tus neeg mob. PSS (Poisoning Severity Score) uas yog raws li kev ntsuas ntshav PH, Serum HCO3, K ntxiv, qib qabzib thiab ntsuas kub, tau tuag rau 16 feem pua ntawm cov neeg mob, hnyav hauv 14 feem pua, nruab nrab hauv 52 feem pua ntawm cov neeg mob thiab 18 feem pua. ntawm cov neeg mob muaj me PSS [Daim duab 7].
Hauv kev tshawb fawb tam sim no, tag nrho cov neeg mob uas tas sij hawm yog 33 [Daim duab 8]. Los ntawm kev siv logistic regression rau ntau qhov sib txawv hauv kev kwv yees ntawm qhov hnyav ntawm kev tuag, kev nyuaj siab ua pa (P-tus nqi. 018) thiab cov hlab plawv tsis ua haujlwm (P-tus nqi <.001) tau="" pom="" tias="" yog="" qhov="" tseem="" ceeb="" nrog="" qhov="" sib="" txawv="" ntawm="" qhov="" sib="" txawv="" ntawm="" 7.2="" thiab="" 16.50="" raws="" li.="" [table="" 2].="" ntawm="" cov="" kab="" mob="" ua="" rau,="" hauv="" peb="" txoj="" kev="" tshawb="" fawb,="" nws="" tau="" pom="" tias="" aluminium="" phosphide="" lom="" tau="" tshwm="" sim="" loj="" heev="" piv="" rau="" lwm="" yam="" tshuaj="" lom="" nrog="" corrosives="" thiab="" organophosphates="" [table="" 2].="" kev="" sib="" raug="" zoo="" ntawm="" gcs="" (glasgow="" coma="" scale)="" nrog="" kev="" tuag="" yog="" qhov="" tseem="" ceeb.="" tawm="" ntawm="" 17="" tus="" neeg="" mob="" uas="" tau="" qhab="" nia="" tsawg="" dua="" lossis="" sib="" npaug="" ntawm="" 8,12="" tas="" sijhawm="" (p="">< .0001),="" 12="" ntawm="" 23="" tus="" neeg="" mob="" uas="" tau="" qhab="" nia="" nruab="" nrab="" ntawm="" 9="" thiab="" 12="" tuag="" (p="">< .05)="" thiab="" 9="" cov="" neeg="" mob="" tawm="" ntawm="" 60,="" nrog="" cov="" qhab="" nia="" nruab="" nrab="" ntawm="" 13="" thiab="" 15="" tuag="" (p="">< .0001).="" kev="" sib="" raug="" zoo="" ntawm="" pss="" nrog="" kev="" tuag="" tau="" qhia="" tias="" tag="" nrho="" 16="" tus="" neeg="" mob="" uas="" muaj="" tus="" qhab="" nia="" tuag="" tau="" tas="" sij="" hawm="" nrog="" p-tus="" nqi=""><0.0001 which="" was="" significant="" by="" chi-square="" test,="" 8="" patients="" with="" moderate="" and="" 8="" with="" severe="" score="" got="" expired="" (p="" <="" 0.0001)="" and="" only="" 1="" patient="" with="" minor="" pss="" expired="" with="" a="" p-value="" of=""><0.05. [table="" 3].="" prediction="" of="" mortality="" in="" patients="" with="" moderate="" and="" severe="" grades="" of="" pss="" had="" a="" sensitivity="" of="" 75.35%="" and="" specificity="" of="" 95.47%="" and="" accuracy="" of="" 87.89%.="" for="" the="" correlation="" between="" gcs="" and="" pss="" score,="" the="" p-value="" was.="" 001,="" which="" was="" very="" significant="" [table="">
Kev sib tham
COVID-19 ua rau qhov kev kaw loj tshaj plaws tshwm sim hauv keeb kwm ntawm kev vam meej uas ua rau muaj kev nyuaj siab ntawm cov neeg ua haujlwm niaj hnub, cov neeg ua haujlwm tsiv teb tsaws chaw thiab cov neeg nyob hauv slum thoob plaws Is Nrias teb. Kev poob haujlwm ua rau cov tib neeg no tsis tuaj yeem ua kom tiav ob qho tib si thiab qhov kev txom nyem tam sim no ntxiv rau lawv txoj kev tu siab thiab kev poob siab, thaum kawg ua rau kev ua haujlwm tsis zoo thiab nce tus nqi tua tus kheej.[10]
Hauv cov tebchaws tsim kho xws li Is Nrias teb, kev lom lom ua rau muaj kev nyuaj siab rau kev noj qab haus huv, nrog rau kev tua tus kheej lom ntau ntau dua li kev siv tshuaj lom neeg raug mob lawm.[11] Cov txiaj ntsig kev lag luam ntawm tus kabmob kis tau zoo yuav ua rau muaj kev tua tus kheej ntxiv ntxiv raws li qhia thaum lub sijhawm muaj teebmeem nyiaj txiag yav dhau los.[12] Nordt et al[13] taw qhia txog kev tua tus kheej nce ntxiv vim muaj kev kub ntxhov nyiaj txiag los ntawm kev poob haujlwm. Lub Chaw Saib Xyuas Kev Lag Luam Indian tau kwv yees tias 27 lab tus tub ntxhais hluas hnub nyoog ntawm 20-30 xyoo tau poob lawv txoj haujlwm thaum lub Plaub Hlis 2020 thaum lub sijhawm kaw.[14] Lwm qhov kev tshawb fawb tshawb fawb tau tshaj tawm txog qhov nce ntawm 2 mus rau 7 zaug hauv ntau qhov kev tua tus kheej nyob rau sab qaum teb xeev; Punjab, Uttar Pradesh, Haryana, Himachal Pradesh, thiab Rajasthan.[15]
Nws yog qhov tsim nyog los hais tias txoj kev tshawb fawb no tau pib thaum lub Plaub Hlis 2020, thaum muaj kev kaw tag nrho hauv Is Nrias teb txhawm rau rhuav tshem cov saw hlau sib kis. Yog li, lub hom phiaj tseem ceeb ntawm txoj kev tshawb no yog txhawm rau nrhiav tus qauv, cov pej xeem thiab cov txiaj ntsig ntawm cov neeg mob uas muaj keeb kwm ntawm kev noj tshuaj lom thaum lub sijhawm kaw vim qhov kev sib kis ntawm COVID-19. Lub tswv yim yog kom paub cov kws kho mob nrog cov xwm txheej ntawm kev lom neeg thaum muaj kev sib kis thoob ntiaj teb los npaj rau cov tswv yim tswj kom zoo dua. 100 tus neeg mob uas tuaj rau kev kho mob xwm txheej ceev nrog keeb kwm ntawm kev noj tshuaj lom thaum lub Plaub Hlis 2020 txog Lub Ib Hlis 2021 tau muab tso rau hauv peb txoj kev tshawb fawb. Hauv peb txoj kev tshawb fawb, cov txiv neej tau pom tias koom nrog ntau dua (77 feem pua) zoo ib yam li kev tshawb fawb los ntawm Shah li al.[5] nyob rau hauv uas txiv neej (63.53 feem pua) preponderance tau pom. Qhov tshwm sim ntau ntxiv ntawm kev lom hauv cov txiv neej tuaj yeem yog vim cov txiv neej yog tib neeg cov neeg noj khoom haus ntawm tsev neeg, thiab tau ntxhov siab heev vim poob haujlwm vim kev kaw haujlwm. Raws li peb cov kev soj ntsuam, 42 feem pua ntawm cov neeg mob poob lawv txoj haujlwm thaum muaj kev sib kis thoob ntiaj teb thiab 11 feem pua tau poob haujlwm, yog li kwv yees li 50 feem pua ntawm cov neeg poob haujlwm, hais ntxiv tias kev poob haujlwm yog qhov tseem ceeb ntawm kev tua tus kheej thaum muaj kev sib kis.
Tsis tas li ntawd, qhov tshwm sim ntawm kev lom neeg ntau dua hauv cov neeg mob hauv pawg hnub nyoog 20-30 xyoo (38 feem pua) hauv kev pom zoo nrog lwm cov kev tshawb fawb. Shah et al. [5] pom tias feem ntau ntawm cov neeg mob lom yog nyob nruab nrab ntawm 13-40 xyoo ntawm hnub nyoog (77.64 feem pua), ntawm cov uas 38.82 feem pua ntawm cov neeg mob koom nrog pawg hnub nyoog 21-30 xyoo thiab kawm los ntawm Singh li al.[16] pom tias 41.82 feem pua ntawm tag nrho cov neeg mob muaj nyob hauv pawg hnub nyoog 21-30 xyoo. Qhov kev hloov ntawm cov tub ntxhais hluas raug cuam tshuam ntau dua vim tias pawg hnub nyoog 20-30 xyoo no muaj kev ntxhov siab loj heev los ua nyiaj txiag ywj pheej ntxiv rau tsev neeg teeb meem, kev sib yuav, thiab lwm yam teeb meem hauv lub neej. Lwm qhov laj thawj rau pawg hnub nyoog yau raug cuam tshuam ntau dua tuaj yeem yog vim tias feem ntau ntawm cov neeg mob hluas hauv peb txoj kev tshawb fawb tau ua haujlwm raws li kev siv nyiaj ua haujlwm txhua hnub thiab tau kawm tiav thiab tsis paub ntawv (58 feem pua), tab sis vim yog kev kaw thiab kaw cov chaw lag luam, lawv tuaj yeem ua tau. tsis tawm mus khwv tau lawv lub neej. Ib qho kev tshawb pom zoo sib xws tau pom los ntawm Churi li al.[17] uas qhia tau hais tias lom tau pom nyob rau hauv kwv yees li 50 feem pua ntawm cov neeg tsis nyeem ntawv thiab cov chav kawm tsawg dua.
Hauv kev tshawb fawb tam sim no, nws tau pom tias 83 feem pua muaj keeb kwm ntawm kev xav tua tus kheej, 19 feem pua tau muaj keeb kwm ntawm kev puas siab puas ntsws yav dhau los, thiab 13 feem pua muaj keeb kwm ntawm kev sim tshuaj lom yav dhau los. Qhov kev tshawb pom no qhia tias cov kev pab cuam hais txog cov teeb meem kev puas siab puas ntsws yuav tsum tau tuav ntau zaus kom tsis txhob muaj kev phom sij rau kev tuag.[18]
Ntawm kev txheeb xyuas cov ntaub ntawv rau cov neeg ua haujlwm ua rau muaj kev cuam tshuam, nws tau pom tias corrosives (30 feem pua) yog cov tshuaj lom neeg feem ntau noj, uas yog ntxiv los ntawm lwm txoj kev tshawb fawb uas corrosive tau pom hauv 27 feem pua ntawm cov neeg mob.[19] Qhov no piav qhia txog kev hloov pauv ntawm kev noj tshuaj lom thaum lub sijhawm kaw vim tias feem ntau ntawm cov khoom siv tau yooj yim hauv tsev neeg tau siv, sib piv rau lwm cov kev tshawb fawb los ntawm North Is Nrias teb uas muaj tshuaj lom nrog tshuaj tua kab ntau dua.[20-22] Qhov no yog vim qhov yooj yim. muaj cov corrosives, feem ntau yog siv los ua cov tshuaj ntxuav tais diav hauv lub raj mis yas yam tsis muaj kev ntim khoom thiab cov cim ceeb toom. Txawm hais tias tsoomfwv Indian tau tshaj tawm cov lus qhia rau kev ua raws li kev muag khoom ntawm corrosives; kev ua nruj dua tseem xav tau ntawm lub sijhawm.
Qhov kev tshawb pom tias qhov kev nthuav qhia kev kho mob ntawm cov neeg mob uas muaj tshuaj lom yog ua pa nyuaj (53 feem pua ) yog corroborated los ntawm lwm txoj kev tshawb fawb uas ua pa nyuaj siab tau pom nyob rau hauv 57 feem pua .[23]
Kev tuag tag nrho hauv peb txoj kev tshawb fawb yog 33 feem pua uas piv rau 15-30 feem pua ntawm cov neeg tuag hauv cov teb chaws tsim kho xws li Is Nrias teb.[24] Kev tuag yog 6 npaug ntau dua rau cov txiv neej (84.8 feem pua) piv rau cov poj niam, hauv kev pom zoo nrog kev tshawb fawb los ntawm Ahuja li al.[25] nyob rau hauv uas tau tshaj tawm ob zaug kev tuag ntxiv rau cov txiv neej, uas yog qhov cuam tshuam txog kev puas siab puas ntsws ntawm cov txiv neej uas nyob hauv tsev thaum lub sijhawm COVID-19 kis thoob qhov txhia chaw thiab pom tias nws nyuaj rau kev tiv thaiv kev puas siab puas ntsws nrog kev kaw.
Tsis tas li ntawd, nyob rau hauv txoj kev tshawb no, 51.5 feem pua ntawm cov neeg tuag tau tshaj tawm los ntawm kev ua xua ntawm txhuas phosphide. Qhov no kuj tau sau tseg hauv kev tshawb fawb yav dhau los uas cov neeg tuag nrog txhuas phosphide tau pom hauv 53.2 feem pua ntawm cov neeg mob.[26] tab sis nyob rau hauv sib piv rau cov kev tshawb fawb tau ua nyob rau hauv Nepal los ntawm Shrestha li al., [27] qhov twg cov tshuaj tua kab feem ntau siv nyob rau tib lub sij hawm.
Qhov no tuaj yeem yog vim tias cov neeg mob tau tshaj tawm lig thaum lub sijhawm kaw thiab tsis muaj cov tshuaj tiv thaiv tshwj xeeb muaj rau txhuas phosphide uas tau lees paub los ntawm kev tshawb fawb los ntawm Fayed MM li al.[28] uas tau lees paub tias muaj kev ncua sij hawm los ntawm kev raug tshuaj lom rau kev nkag mus rau cov kev pabcuam xwm txheej ceev thaum lub sijhawm COVID 19 kaw.
Hauv kev tshawb fawb los ntawm Churi et al., [17] feem ntau ntawm cov neeg mob uas muaj PSS Scoring xeev tau mob me (77 feem pua ), nruab nrab (18 feem pua) thiab tsis muaj ib tus neeg mob tas sij hawm nyob rau hauv qeb nrab.[15] Qhov no, txawm li cas los xij, yog qhov sib piv rau peb txoj kev tshawb fawb uas 18 feem pua ntawm cov mob me, 52 feem pua nyob rau hauv qeb nrab, 14 feem pua nyob rau hauv qeb hnyav, thiab 16 feem pua nyob rau hauv pawg neeg tuag. Kev tuag tau pom nyob rau hauv cov neeg mob uas tau qhab nia nruab nrab PSS vim qhov kev nthuav qhia qeeb rau lub tsev kho mob thaum lub sij hawm kaw vim muaj kev nyuaj rau kev nkag mus rau qhov chaw thauj mus los. Yog li, tus mob ntawm cov neeg mob deteriorate sai. Raws li qhov tshwm sim, ntau tus neeg mob tau nthuav tawm ntau lub cev tsis ua haujlwm. Vim tias qib siab dua ntawm PSS pom hauv peb cov neeg mob thaum lub sijhawm nthuav qhia kev tuag yog 33 feem pua piv rau lwm cov kev tshawb fawb uas kev tuag tsuas yog 1.5 feem pua thiab 1.3 feem pua. thiab al.[31] nyob rau hauv uas PSS cov qhab nia ua tiav tshwj xeeb rau organophosphorus lom yog qib hnyav hauv 52.1 feem pua, qib nruab nrab hauv 28.2 feem pua thiab tuag hauv 14 feem pua ntawm cov qauv, yog li qhia qhov mob hnyav ntawm cov neeg mob tam sim no.[32]
GCS score was similar to the study by Churi et al.[17] as 60% of patients had scores more than 13 and patients with GCS >8 yog 17. Qhov no tej zaum yuav yog vim hais tias nyob rau hauv lawv txoj kev tshawb no cov neeg mob tau nthuav tawm nrog organophosphorus lom nyob rau hauv sib piv rau peb txoj kev tshawb no cov neeg mob feem ntau hais nrog corrosives thiab txhuas phosphide lom.
Kev txwv kev kawm
PSS raug xam ib zaug nkaus xwb thaum lub sijhawm nthuav qhia, qhov uas nws yuav tsum tau muab sau tseg ntawm 24, 48, thiab 72 teev kuj rau kev soj ntsuam zoo dua thiab cov txiaj ntsig ntawm tus neeg mob. Qhov thib ob, txij li PSS tsuas yog tso siab rau qhov ntsuas qhov ntsuas, yog li qee qhov kev kuaj mob yuav tsum tau txheeb xyuas hauv peb txoj kev tshawb fawb hypotension, tus neeg ua pa, Spo2, thiab creatinine tau pom tias yog qhov tseem ceeb. nrog ib tug high odds ratio.
Cov lus xaus
• Cov pab pawg uas muaj kev phom sij tshaj plaws hauv peb txoj kev tshawb fawb yog cov tub ntxhais hluas hauv pawg hnub nyoog 20-30 xyoo, tsis muaj kev kawm tsawg thiab cov uas tau poob haujlwm vim yog COVID-19 kev sib kis thoob qhov txhia chaw.
• Peb kuj tau pom tias feem ntau ntawm cov neeg mob lom yog txhob txwm ua, yog li qhia txog qhov yuav tsum tau muaj kev sab laj txog kev puas siab puas ntsws ntawm cov neeg raug mob.
• Corrosives ua raws li cov txhuas phosphide yog cov tshuaj lom neeg siv ntau tshaj plaws uas siv thaum lub sij hawm kaw.
• Cov neeg tuag coob tau pom nyob rau hauv peb txoj kev tshawb fawb vim qhov kev nthuav qhia qeeb ntawm cov neeg mob vim yog kev kaw thiab kuj vim tsis muaj tshuaj tiv thaiv rau Aluminium Phosphide.
• Cov qhab nia kho mob, GCS thiab PSS tau pom tias muaj kev cuam tshuam zoo heev rau cov txiaj ntsig kho mob, yog li qhia txog lawv cov txiaj ntsig los kwv yees qhov hnyav hauv cov chaw kho mob xwm txheej ceev.
• Cov kev cai nruj me ntsis yuav tsum raug tsim kom zam kom tsis txhob yooj yim nkag tau yooj yim ntawm cov tshuaj lom xws li corrosives & tshuaj tua kab, tshwj xeeb tshaj yog nyob rau hauv cov teb chaws tsis muaj nyiaj txiag kom tsis txhob siv lawv cov tshuaj lom neeg tsis raug.
Hauv peb txoj kev tshawb fawb, 51.5 feem pua ntawm cov neeg tuag tau tshaj tawm los ntawm kev ua xua ntawm txhuas phosphide tej zaum vim tias tsis muaj cov tshuaj tiv thaiv tshwj xeeb muaj rau txhuas phosphide. Qhov no yuav tsum muaj kev tshawb fawb yav tom ntej txhawm rau nrhiav cov tshuaj tua kab mob tshwj xeeb thiab cov kev cai nruj tshaj li kev muag ntawm cov neeg sawv cev no.
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