Atelectasis - ndi chiyani ichi? Matenda, mankhwala ndi madokotala ananena zawo

Atelectasis - ndi chiyani ichi? Yankho nkhaniyi mankhwala amadziwika okhawo aluso. Koma chifukwa kudziwa safuna dokotala. Tsatanetsatane wa atelectasis, mungaphunzire pa zipangizo za nkhaniyi.

tanthawuzo

Atelectasis - chikhalidwe pathological amene amakhala ndi imfa ya airiness kuwala konse kapena malo enieni. Ankaona akuti amachokera Greek. Ikumasuliridwa Russian, amatanthauza "analephera" kapena "chosakwanira nsalu Tambasula."

zimayambitsa

Atelectasis - kuchepa kwa gawo m'mapapo. Kukhala chikhalidwe chotere pathological angachotsedwe zifukwa zingapo. Tikungotchula ofunikira kwambiri pompano:

• Kuchuluka mavuto padziko anaona pa makoma a alveoli lapansi. Childs, kudwala izi amayamba ndi edema m'mapapo mwanga kapena cardiogenic chiyambi noncardiogenic, komanso kusowa kwa surfactant kapena njira opatsirana.
• Psinjika a Airways kapena m'mapapo, amene amayamba ndi zinthu zosiyanasiyana Link (mwachitsanzo, mediastinal chotupa, ndi anomaly mu chitukuko ziwiya lalikulu magazi, lymphadenopathy, m'mnyewa wamtima hypertrophy , etc.).
• Kudwala mucosa (mumtima) mpanda wa bronchus ndi (mwachitsanzo bronhomalyatsiya, mapindikidwe, kutupa kapena edema).
• Kutsekeka kapena occlusion wa lumen wa otchedwa matupi bronchial yachilendo, ntchofu, caseous misa (mwachitsanzo, TB), ndi mucosal edema.
• Kuyan'anila za ulendowu chilengedwe cha pachifuwa, amene uka chifukwa ziwalo za mitsempha phrenic, ochititsa dzanzi ambiri, kupindika msana kapena matenda neuromuscular.
• Kuwonjezeka kuthamanga mkati mwa M'mimbamo pleural (kuphatikizapo hemothorax, hydrothorax, empyema, pneumothorax).

Chifukwa adakali angayambe atelectasis? Zimayambitsa matenda kawirikawiri kubisala mu pachimake kugwa yaikulu ya phapo, lomwe likutuluka monga vuto postoperative chifukwa kulephera kuyenda yaitali wodwala, mpweya ambiri osokoneza, hypothermia, ntchito mlingo waukulu wa mankhwala ndi opioids, komanso vasodilating wothandizira.

Zina mwa zifukwa

Amene nthawi zambiri anati atelectasis? matenda izi zimapezeka mu anthu ndi kunenepa, enaake fibrosis ndi mphumu. Ndiponso atengeke osuta.

Gawo

Ndi chiyambi atelectasis a m'mapapo Lobe kungakhale kobadwa nako (ie, yaikulu) kapena kugula (ie, sekondale).

Mu matenda a chiyambidwe anatanthauza boma pamene mwana wakhanda palibe kuwongola mosavuta. Koma atelectasis yotengedwa, mu nkhani iyi pali spadenie m'mapapo minofu, amene anali kale nawo mbali kupuma.

Sitingathe kunena kuti zinthu ziyenera wolemekezeka ku atelectasis akalandire chithandizo, mwachitsanzo airless boma la mapapu, amene asunga mwa mwana wosabadwayo, ndi thupi (ie, hypoventilation kuti akupezeka anthu mwinamwake wathanzi ndipo ngati malo zinchito a minofu ya m'mapapo).

mitundu ya matenda

Malinga ndi kuchuluka kwa minofu ya m'mapapo chochokera ndondomeko ya kupuma, matenda amenewa anawagawa:

• acinar;
• segmental;
• lobular;
• kwathunthu;
• mowongoka.

Komanso, kungakhale amgwirizano kapena unilateral. Zodabwitsa ndizakuti, mtundu woyamba ndi woopsa kwambiri ndipo akhoza mosavuta kungachititse kuti imfa ya wodwala.

mitundu matenda

Malinga zinthu etiopathogenic wa kudwala ili a dongosolo m'mapapo mwanga lagawidwa mitundu zotsatirazi:

• Psinjika atelectasis, kapena kugwa kwa phapo. Matenda amayamba ndi psinjika a m'mapapo minofu kuchokera kunja, ndipo kudzikundikira mu M'mimbamo pleural wa madzimadzi, mpweya, magazi kapena mafinya.
• Obstructive atelectasis. zodabwitsazi amagwirizana ndi kuphwanya makina ya trachea ndi kutsekeka bronchial.
• Discoid atelectasis m'mapapo. kudwala amenewa amachititsa akufotokozera pambuyo contusion thorax kapena nthiti fractures.
• Chidule - amayamba ndi psinjika a minofu fibrous wa alveoli (mu mapapo subpleural).
• Acinar - kugwirizana ndi kusowa kwa surfactant (nthawi zambiri amapezeka mu akulu ndi ana ndi kupuma matenda masautso).

Iwo ayenera kukumbukira kuti matenda akhoza ankaona reflex ndi postoperative, ndipo pang'onong'ono pachimake, wopepuka ndi zovuta, chosakhalitsa ndi kulimbikira.

zizindikiro

Mwamphamvu m'mapapo atelectasis chipatala zimadalira voliyumu ndi mathamangidwe amavala kutali nonfunctioning m'mapapo minofu. Mikroatelektazy, umodzi segmental atelectasis ndi matenda srednedolevoy zambiri asymptomatic.

Pankhani ya pachimake-isanayambike matenda, iyenera matenda. Pankhaniyi, wodwala akumva kupweteka mwadzidzidzi, paroxysmal dyspnea, cyanosis, chifuwa youma, tachycardia ndi hypotension. Mu kuwonjezeka lakuthwa kupuma kulephera kumachitika ngakhale chakupha.

Kuzionetsetsa wodwalayo anawulula backlog wa Lobe akhudzidwa a m'mapapo pa kupuma, komanso m'munsi kupuma nyamuka pachifuwa. Komanso, pa moto atelectasis anatsimikiza yosamveka percussion phokoso kapena adzafupikitsidwa. Pa mpweya chomwecho zikuchepa attenuated (sangathe kumveka).

mavuto a atelectasis

Ndi pang'onopang'ono zigawo shutdown m'mapapo mpweya wa zizindikiro za matenda anasonyeza Pamlingo wamng'ono. Koma mu chibayo atelektaticheskaya wotsatira akufotokozera mu gipopnevmatoza.

Maonekedwe a chifuwa ndi sputum, malungo, ndi zizindikiro kuchuluka kwa kuledzera nkhani za inalowa kutupa. Pankhaniyi, matenda amenewa ndi kobvuta ndi chitukuko cha m'mapapo abscess kapena abscess chibayo.

diagnostics

Matenda a m'mapapo atelectasis ikuchitika ndi X-ray Kupenda wa limba kupuma mu lateral ndi mazunzo ziyerekezo. Izi limafotokoza homogeneous kumathima m'mapapo kumunda ndi mediastinum kuchepetsa kwa kachigawo woterowu kwa ndondomekoyi kupuma. Komanso, X-ray chinali malo apamwamba a zakulera mzikiti ndi kuchuluka mpweya m'mapapo.

Nthawi wa chikaiko, njira imeneyi kuphunzira mwachindunji ndi CT lapansi. Komanso, kudziwa zimayambitsa obstructive atelectasis ntchito bronchoscopy ndi nthawi yaitali atelectasis zokolola angiopulmonography ndi bronhografii.

chithandizo

Kudziwika m'mapapo atelectasis liyenela dokotala (pulmonologist, neonatology, zoopsa kapena thoracic dokotala) machenjerero yogwira. Wangobadwa ana ndi m'mapapo mwanga atelectasis yaikulu zokolola suctioning nkhani za dongosolo kupuma kupyolera catheter mphira. Ngati chofunika, achite tracheal intubation ndi kuwongola m'mapapo.

Mu mtundu wa matenda monga atelectasis obstructive kuti chifukwa cha thupi yachilendo, m'zigawo ake ikuchitika zamankhwala matenda bronchoscopy.

Ngati m'mapapo spadenie chifukwa cha kudzikundikira wamakani chinsinsi, ndiye zimathera ziŵalo endoscopic wa mtengo bronchial.

Pofuna kuthetsa postoperative atelectasis anagwira tracheal aspirate, kupuma kokoka, kutikita pachifuwa percussion, postural ngalande, komanso inhalation ndi enzyme ndi bronchodilator mankhwala.

Sitingathe kunena kuti pa zonse atelectasis chiyambi phunziro kwa kukhazikitsa kuvomerezedwa njira odana ndi yotupa mankhwala.

kaonedwe

Kupambana kuwala kukodzedwa zimadalira nthawi ya chiyambi cha mankhwala ndi zifukwa atelectasis. Pamene kuwonongedwa kwathunthu yamasika mu masiku atatu oyambirira a Mapa mu ulemu wa kupuma limba malo pochira yabwino.

Pamene Zikavuta sangathe kukusalani chitukuko cha kusintha sekondale kugona nawo. Mofulumira kusanduka ndi chachikulu atelectasis angachotsedwe imfa.