Pneumothorax: ndichiyani? Zoyambitsa, zizindikiro ndi mankhwala a pneumothorax

Pneumothorax - chikhalidwe imene mpweya pang'ono ndi pang'ono atasunga M'mimbamo pleural. chikhalidwe ichi amafuna hospitalization yomweyo. Nkhaniyi ili ndi mfundo zokhudza "pneumothorax: ndichiyani?" Amayesa zimayambitsa ndi zizindikiro za matenda.

Kufotokozera za matenda

Kuyatsa munthu amene adzipereka ntchito atamupanikiza ndi apamwamba kuposa M'mimbamo pleural. Ngati otsiriza chifukwa ena zifukwa akulowa mlengalenga, chithunzi ichi kwambiri kuchuluka. Easy pa kuphwanya anatani resizing, zomwe zimabweretsa kufupika kwa mpweya ndi zizindikiro zina chifukwa cha kuperewera kwa mpweya.

Mu mankhwala, chikhalidwe wotchedwa pneumothorax. Nthawi zambiri amapezeka achinyamata pansi ndi zaka 40. Ngati muli zizindikiro za kuwonongeka kwa matenda ambiri wodwala ayenera kuchipatala mwachangu. Apo ayi, zikuchulukirachulukira chiopsezo cha matenda oyamba moyo pachiswe.

Zimayambitsa ndi mawonekedwe a matenda

Kodi pneumothorax, ndichiyani? Matendawa amapezeka pa maziko a zifukwa zosiyanasiyana kuti kudziwa maonekedwe ake makamaka. Pachifukwa chimenechi, madokotala zimatulutsa gulu zotsatirazi kudwala:

1. Mowiriza pneumothorax. Akufotokozera chifukwa chosadziwika (chachikulu) kapena matenda maziko (sekondale). Nthawi zambiri anapezeka anthu a zaka zapakati pa 20 ndi 40 zaka sikelo. Matendawa ndi chibadwa chimene chingawapangitse kukhala zidakwa kapena m'mapapo chilema. Komanso, TB kapena chibayo zingachititse mtundu wa kudwala.
2. Mantha pneumothorax. Akufotokozera chifukwa choipa thoracic, zochokera ozama mabala, ndi zisaonongeke mkati. Pankhani zakale, mpweya zimapita mwachindunji ku M'mimbamo pleural kudzera pachilonda, ndipo amagwiritsa ntchito atachotsedwa. Mu chophukacho mlandu chachiwiri matenda a m'mapapo a. Chifukwa matenda mpweya momasuka akulowa malo pleural.
3. Iatrogenic pneumothorax. Akufotokozera chifukwa cha kapena yochizira matenda mpheto (m'mapapo biopsy, puncture, catheterization).

Anapereka gulu amalola bwino oterewa "pneumothorax" ndi mankhwala chithandizo chokwanira.

The matenda chithunzi cha matenda

The kudwala akuyamba chitukuko ndi zikamera wa ululu waukulu pachifuwa, zimene kuperekedwa khosi kapena chapamwamba dera pamimba. kusapeza ndi anamvera pamene kupuma kapena zofuna kukhetsa thukuta. Monga kudwala matendawa pali stiffness mu chifuwa anthu amaona kuchepa kwa mpweya. Ichi ndi chifukwa amayamba kuthamanga mu M'mimbamo pleural ndi psinjika ya phapo. Komanso, pali kufupika kwa mpweya, osaya kupuma, zomwe wosatenga thandizo ankafuna.

Pachimake kusowa kwa mpweya kumayambitsa pallor. Komanso, pali kugunda kwambiri kwa mtima ndi thukuta kwambiri.

mawonekedwe a pneumothorax

Kupezeka / pakalibe kulankhulana ndi chilengedwe limachititsa m'kagulu matenda m'njira zotsatirazi:

• Zokhoma. Akufotokozera pamene mpweya likulowerera mu dera pleural. Kukomoka, mawonekedwe a matenda wofanana ndi wofatsa kwambiri. wochepa mpweya akhoza kuyimisa paokha.
• Open. Pali m'bulu wa mpweya owonjezera mu M'mimbamo pleural, imene pachifuwa mpanda wa bronchus kapena bala kuonongeka amalankhulira ndi chilengedwe. Aliyense mpweya inspiratory akudutsa mu M'mimbamo pleural, ndi kubwerera pa mpweya. Zimakhala wofanana zoipazi mumlengalenga, zomwe zimachititsa atelectasis.
• Valavu. mawonekedwe pneumothorax imatengedwa ovuta kwambiri. Ngati chilonda chachikulu, zovuta dongosolo vavu aumbike. Pamene wina akapuma mpweya akulowa M'mimbamo pleural pa mpweya koma sangathe kutuluka kumbuyo. voliyumu yake pang'onopang'ono kuwonjezeka. Matendawa kumabweretsa kusamutsidwa ndi psinjika a ziwalo mediastinal, kusokonezeka kupuma ndi magazi.

Malinga ndi kuchuluka kwa mpweya anapambulwa m'dera pleural okha, ndi chiyerekezo okwana pneumothorax. Zikatero, ndi kuunika osachepera theka la buku yachibadwa.

Zochita za matenda ana

Pneumothorax mu akhanda angayambe yomweyo pambuyo mpweya oyambirira angapo. Pankhaniyi, ndi apitirize mawonekedwe a matenda. Akufotokozera ndi m'goli-kukula kwa mapapo, zomwe kawirikawiri kumachitika chifukwa kupunduka kwa mwana. Ana kwa zaka zitatu, chikhalidwe ichi kungakhale vuto la chibayo. Mu unyamata, matenda zidzachitika kutsokomola pa lotsatira mphumu kuukira.

Pneumothorax ana akhoza kukwaniritsa kukomoka. Nthawi zina pali yochepa kutha kupuma, mu nkhani yaikulu kwambiri - cyanosis wa khungu, khunyu, kugunda kwambiri kwa mtima. Mfundo za mankhwala ndi amodzi mwa akulu.

diagnostics

matenda zolondola yake n'kofunika kuti amaganiziridwa pneumothorax, chifukwa chakuti boma amapanga zosokonezeka. Pakuti chitsimikiziro cha matenda n'chofunikira wapadera maonekedwe a mtima, zomwe kawirikawiri Chili onse zizindikiro pamwamba pa kudwala. Komanso, munthu ayenera kutenga kaimidwe ena (atakhala kapena accumbency), ndiye kuthamanga danga pleural ndi ankaonera kwambiri.

Kuika kudzifufuza thupi, matenda si kokwanira, kotero wodwala Kwalamulidwa pachifuwa X-ray kwa amaganiziridwa pneumothorax. Ndi chiyani icho? Phunziro ili kwambiri nkhani Zimathandizanso kudziwa malo anakhudzidwa, anakomoka dera m'mapapo.

Radiography - si njira yokhayo matenda. Ngati mukukayikira kuti munthu pneumothorax waperekedwanso ndi CT jambulani, atayezetsa pamaso mpweya, electrocardiography.

choyamba-chithandizo

Pneumothorax imatengedwa chikhalidwe mwamsanga. Munthu aliyense ayenera kukhala kuti athe kuthandizapo mwadzidzidzi wathuyo: kudzilimbitsa iye pansi, kuonetsetsa mwayi wa mpweya chifukwa timu ya zachipatala.

Ngati pali panja pneumothorax kuvala umagwiritsidwa kuti asindikize chilema mpanda wa sternum lapansi. Mu zochitika mwadzidzidzi, pakalibe zipangizo wosabala angagwiritsidwe ntchito njira improvised (malaya, thanki nsonga). Mbali choyeretsetsa cha nsalu ayenera kugwiritsidwa ntchito mwachindunji mweni mweni mwa chilondacho. Kuti asindikize chotupa pamwamba pa kuvala ndi Akutsatira cellophane kapena polyethylene.

Pamene vavu pneumothorax mtima amafuna pleural puncture Jaji ufulu mpweya jitter mediastinal ndi ziwalo m'mapapo kuwongola.

Nkofunika wosalira ndondomeko ya kupuma mtima. Chifukwa chaichi m'pofunika kuyala pa pamwamba okwera. Pankhani ya kukomoka ukapatse munthu moyo. Pamene dzanja si amoniya, kuti akhoza m'malo mwa njira iliyonse ndi fungo Fungo lamphamvu lamankhwala (mafutawo, mafuta). Pambuyo thandizo ayenera kuyembekezera magulu a zachipatala.

Chithandizo kuchipatala

Odwala pneumothorax imvera hospitalization kuvomerezedwa. M'chipatala akatswiri akuchitadi puncture wa M'mimbamo pleural, choncho mpweya kuti owonjezera kunja. Chithandizo kumatengera mawonekedwe enieni matenda.

chithandizo ndiwofatsa ndi okhudzidwa ngati ndi chatsekedwa yaing'ono pneumothorax. Wodwala ayenera kuonetsetsa bedi zina Kwalamulidwa othetsa ululu ngati n'koyenera.

Pamene okwana chimake matenda pleural akonzedwa M'mimbamo ngalande. Izi ndi zofunika popewa ayankhe mantha ndi kuchira mosavuta.

Ngati wodwalayo ndi pneumothorax lotseguka, thandizo anapereka isanafike magulu a zachipatala, amalola kupulumutsa moyo wa wodwalayo. Ntchito yaikulu ya madokotala - kudwala kumasulira mu nkhungu chatsekedwa. Chifukwa chaichi, chilonda ndi sutured, umene malowedwe a mpweya M'mimbamo pleural wa siteji. Otsatidwa ndi mpheto, ofanana ndi chofunika kwa matenda a "chatsekedwa pneumothorax."

Pambuyo pa opaleshoni, wodwalayo akulimbikitsidwa masabata anayi kusiya kwathunthu womberani. Siimakupiza pa ndege yoletsedwa kwa masiku 14 pambuyo chithandizo. Madokotala akulangizidwa osati kuchita kusambira komanso ena masewera yogwira. Izi zikutipatsa madontho kuthamanga.

Kuti madokotala ananena zawo mankhwala

Zotsatira za matenda chimadalira pa msinkhu ndi kugonana wodwalayo, pamaso pa mavuto komanso matenda okhudzana. Mowiriza pneumothorax m'mapapo kuti amapezeka pa maziko a chiwopsezo majini amakhala ndi zotsatira zabwino.

20% milandu, odwala kuona matenda muyambirenso, makamaka ngati amayamba ndi matenda choyambirira. Koopsa ndi boma la munthu, pamene M'mimbamo pleural ladzala ndi mpweya kuchokera mbali ziwiri. Childs, izi kumatanthauza ndi pachimake kupuma kulephera ndi imfa. Ziwiri mawonekedwe pneumothorax amakhala ndi zotsatira zabwino% 50 okha milandu. Pa mlingo uwu ndimaziko a Timeliness ndi khalidwe thandizo.

zosokonezeka pneumothorax

Pafupifupi theka ndi matenda kukhala mavuto osiyanasiyana. Mwa iwo amaona magazi ambiri kuti patsekeke pleural, zomwe nthawi zambiri ali ndi zotsatira zabwino. Ndi magazi yaikulu imfa madokotala kukonza imfa wodwalayo. Ngakhale ngati n'zotheka matenda mkhalidwe wa mtima, kumaonjezera ngozi ya kulephera mtima ndi kupuma. Onse a zikhalidwe ndi moyo pachiswe.

Mantha pneumothorax zosinthika kusatetezeka chilonda ndi mapangidwe subcutaneous ndiko kumayambitsa. Mpweya pang'onopang'ono likulowerera mu mafuta subcutaneous, umene ndi chikhalidwe oopsa. Vuto lina la matenda ankaona kuti kutupa kwa pamakhala pleura. Iwo limodzi ndi chithunzi chowala matenda ndipo amafuna chithandizo mokwanira.

zodzitetezera

Specific njira zopewera matenda kulibeko. Pofuna kupewa matenda, madokotala analimbikitsa n'kudziphatika kwa moyo wathanzi, kusiya zizolowezi zoipa, nthawi kuchiza matenda ndi nthawi yambiri panja.

Ku zipangizo za nkhaniyi, mwaphunzirapo chiyani otukuka pneumothorax, chimene icho chiri, kodi zizindikiro zake zazikulu. Pamene zizindikiro yaikulu ya kudwala sayenera mantha. Pneumothorax - si chilango, odwala ambiri kulimbana ndi matenda amenewa. Panthawi yake ndiponso moyenera mankhwala chingaimitse kudwala, kupewa chitukuko cha matendawo.