Slight bruising on lips and nail bed

Introduction The lips and nail bed are slightly bluish for the early performance of shock. The lips and nail bed are slightly cyanotic, which is caused by the increase of reduced hemoglobin in the blood of the body. The reason is mainly caused by hypoxia in the body during shock. Shock is a clinical syndrome characterized by acute and effective circulating blood volume caused by various serious pathogenic factors, with neuro-humoral factor imbalance and acute circulatory disorder. These pathogenic factors include major bleeding, trauma, poisoning, burns, asphyxia, infection, allergies, and heart pump failure.

Cause

The lips and nail bed are slightly cyanotic, which is caused by the increase of reduced hemoglobin in the blood of the body. The reason is mainly caused by hypoxia in the body during shock.

an examination

Related inspection

Urine pathogen examination blood routine

The lips and nail bed are slightly blue-green, and accompanied by conscious waking, but irritability, anxiety or agitation, pale complexion and pale skin, decreased urine output, etc., indicating that the patient enters early shock and needs attention.

1, laboratory inspection

Shock laboratory tests should be performed as soon as possible and pay attention to the extensive nature of the examination. General attention items include: 1 blood picture; 2 blood biochemistry (including electrolytes, liver function, etc.) examination and blood gas analysis; 3 renal function tests and urine routine and specific gravity determination; 4 out, coagulation index examination; 5 serum enzymology examination and muscle Calcin, myoglobin, D-dimer, etc.; 6 culture of various body fluids, excretions, etc., pathogen examination and drug sensitivity measurement.

2, hemodynamic monitoring

It mainly includes central venous pressure (CVP), pulmonary capillary wedge pressure (PWAP), cardiac output (CO) and cardiac index (CI). When using a floating catheter for invasive monitoring, a mixed venous blood sample can also be taken for measurement, and the oxygen metabolism index can be calculated by calculation.

3. pH measurement in gastric mucosa (pHi)

This non-invasive detection technology helps to determine the visceral blood supply status, timely detection of early visceral ischemic manifestations of "hidden compensatory shock", and can also accurately reflect the improvement of gastrointestinal mucosal ischemia and hypoxia, and guide The thoroughness of shock resuscitation treatment.

4, serum lactate concentration

The normal value is 0.4 to 1.9 mmol/L. Serum lactate concentration is associated with a prognosis of shock.

5. Serological examination of infections and inflammatory factors

Blood procalcitonin (PCT), C-reactive protein (CRP), Candida or Aspergillus specific antigen markers or antibodies, and factors such as LPS, TNF, PAF, IL-1, etc. It helps to quickly determine whether shock has infectious factors, possible types of infection, and inflammatory response disorders in the body.

Differential diagnosis

Clinical attention to identification, to prevent the early symptoms of shock, misdiagnosed as general blood dysfunction, and delay the disease.

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