Pneumothorax: Zizindikiro, Zoyambitsa ndi Chithandizo

Pathological mkhalidwe umene pleural M'mimbamo (danga kudula woboola pakati pa parietal ndi choipidwa pleura ozungulira lililonse m'mapapo) amasonkhana mpweya kapena mafuta ena zosakaniza chikudziwika ngati pneumothorax. Zizindikiro, zimayambitsa ndi chithandizo cha chikhalidwe ichi, m'nkhani.

mwachidule

Pakuti M'mimbamo pleural m'chigawo yachibadwa yodziwika ndi makhalidwe oipa, izi zikupereka kupuma limagwirira chokwanira. Ngati mapepala ndi kuonongeka pleura (mwachitsanzo, chifukwa cha m'dera kusiyana ya m'mapapo kapena bronchus) ndipo angamachite mu pleural kuthamanga M'mimbamo mpweya equalized kuti mumlengalenga kapena kuposa izo. Mpweya umene aloŵa mu M'mimbamo pleural kumabweretsa psinjika ya phapo, izo amakwiya spadenie ndi ku kupuma. Ndi buku lalikulu mpweya labwinobwino kuwala ndi ankakakamizika amphamvu, powonjezera, pali kusintha kosangalatsa ziwalo mediastinal (ziwiya lalikulu kwa mtima). Zonsezi kusokoneza kwambiri magazi ndi kupuma.

zizindikiro matenda: Pneumothorax

matenda akuwonetseredwa ndi mbali zotsatirazi:

• Mwadzidzidzi zikuchitika ululu chifuwa - pachimake, kuwonjezeka pa kudzoza. zomverera chowawa ingafalire umodzi mbali akhudzidwa.

• Mwadzidzidzi osauka dyspnea - kupuma movutikira, mofulumira osaya kupuma.

• Youma chifuwa.

• Kufulumizitsa kwa kugunda kwa mtima.

• Maonekedwe a khungu mu thukuta ozizira.

• General kufooka.

• Tikuyenera mantha.

• Cyanosis wa khungu (ngati chakhungu aziyenda ndi kupuma kutchulidwa).

mitundu ya matenda

• Open pneumothorax. Zizindikiro za chikhalidwe izi: atagonjetsa kuti patsekeke pleural mpweya mwa bronchi kuonongeka lalikulu kapena bala la chifuwa amalankhulira ndi chilengedwe pa inhalation mpweya akulowa M'mimbamo pleural ndi kubwerera kwa nthawi atapita. Kuthamanga mu M'mimbamo pleural poyerekeza ndi yozungulira, umene ukuchititsa atelectasis ndipo kumbali ya kupuma kwake.

• Tatseka pneumothorax akufotokozera mu mlengalenga malowedwe kuti patsekeke pleural chifukwa chilema cha pleura lapansi. Pakati M'mimbamo pleural ndi chilengedwe palibe uthenga, ndi atsekerezedwa mpweya voliyumu si kuonjezera. chatsekedwa pneumothorax ndi chophweka kwa mfundo matenda a maganizo. Mpweya pang'ono akhoza kuyimisa okha. Ngati panali chatsekedwa pneumothorax, zizindikiro mu nkhani iyi, zotsatirazi: Ululu mbali zowonongeka a chifuwa, wotumbululuka khungu, kupuma movutikira.

• Voteji (vavu) pneumothorax. Mtundu wa kudwala kwambiri. Zizindikiro vavu pneumothorax - ndi mapangidwe pa bala ndiponso kuwonongeka kwa lalikulu bronchi pafupifupi mtengo wa kapangidwe valavu amene amalola mpweya M'mimbamo pleural pa kudzoza ndiponso kupewa kuchoka ake kwa malo kunja. Voliyumu ya mpweya wa M'mimbamo pleural pamene kukula. Izi amakwiya ndi kusamutsidwa ndi psinjika a ziwalo mediastinal ndi matenda aakulu a magazi ndi kupuma.

Pneumothorax: Zimayambitsa matenda

Malinga ndi zimene zimayambitsa matenda apeza nambala ya zamoyo.

mowiriza pneumothorax

Zizindikiro za kudwala anayambitsa ndi chotupa gawo bronchus kapena m'mapapo amene si kugwirizana ndi kuwononga makina a thorax kapena m'mapapo. Mowiriza pneumothorax kungakhale:

1. Pulayimale (idiopathic) akuwuka popanda chifukwa chenicheni. Kodi sitichedwa boma ngati anyamata zaka 20-40 kukula mkulu. kudwala zambiri akufotokozera chifukwa cha:

• chibadwa anachititsa akusowa wa enzyme alpha-1-antitrypsin, ndipo imautsa kusintha pathological mu phapo;

• kobadwa nako kufooka kwa pleura, zimene mosavuta amaphulika kuseka, wamphamvu chifuwa, kwambiri thupi thupi, kwambiri kupuma;

• masiyanidwe kuthamanga chifukwa kumiza akuya mu madzi, kuk ndege mu ndege.

2. Secondary (symptomatic), pamene maziko a matenda kale m'mapapo akufotokozera mowiriza pneumothorax. Zizindikiro zimachitika chifukwa cha:

• matenda kupuma Mwachitsanzo, angakhale aakulu obstructive m'mapapo mwanga matenda (aakulu yotupa matenda a dongosolo kupuma, amene akufotokozera mchikakamizo cha zinthu zosiyanasiyana zachilengedwe, ndi akuluakulu - ndi kusuta, n'zothandiza chitukuko cha kulephera aakulu m'mapapo), enaake fibrosis (matenda tinatengera kwa amene yodziwika ndi kusokonezeka kwa exocrine zopangitsa), aakulu exacerbation mphumu;

• matenda a m'mapapo Mwachitsanzo, TB (matenda opatsirana chifukwa cha mycobacteria), mapapo abscess (okha focal kutupa minofu m'mapapo, amene amakhala ndi kusungunuka kwa m'mapapo minofu ndi M'mimbamo mapangidwe wodzazidwa ndi purulent okhutira), inflammations mapapo (chibayo) ndi HIV;

• matenda a m'mapapo yodziwika ndi zotupa minofu connective fibrosing alveolitis, lymphangioleiomyomatosis, sarcoidosis, histiocytosis X;

• zokhudza zonse pathologies a minofu connective ndi matenda a m'mapapo: zokhudza zonse za matendawa, nyamakazi, dermatomyositis;

• zotupa (m'mapapo khansa).

traumatopnea

Chifukwa zodabwitsazi - ichi ndi kuwonongeka kwa chifuwa:

• mwakayakaya yosamveka;

• ozama bala.

iatrogenic pneumothorax

kudwala Ichi ndi chifukwa cha kayendetsedwe ka mankhwala:

• pleural kapena m'mapapo biopsy;

• puncture;

• Choyenera subclavian catheter;

• mawotchi mpweya wabwino.

diagnostics

Pofuna kuti matenda "pneumothorax" zizindikiro matenda ayenera ankaphunzira ndi katswiri pa kumupima zachipatala. Matendawa zikuphatikizapo zinthu zotsatirazi:

• Wodwala Kupenda: auscultation (auscultation) m'mapapo Kupenda thorax lapansi.

• Pachifuwa radiography, njira imene n'zotheka kudziwa mpweya m'dera pleural. ndondomeko ndi njira yaikulu Kupeza Vuto pneumothorax.

• Magazi mafuta zikuchokera.

• Yopangidwa tomography, amene amalola kudziwa zimene zimayambitsa sekondale mowiriza pneumothorax. njira yodziwira ntchito pamene X-ray sachita nkhani.

• Electrocardiography, ntchito zomwe n'zotheka kudziwa chosayenerera mtima valavu (wotanganidwa) pneumothorax.

• Kufunsa Thoracic opaleshoni.

zadzidzidzi

Muyenera mudziwa kupatsa thandizo kwa chikhalidwe ichi pathological, monga pneumothorax. Zizindikiro tiyenera kukhala chizindikiro kanthu pangozi. Wodwalayo choyamba pofuna kumafika mpweya kudzilimbitsa iye pansi ndi dokotala nthawi yomweyo.

Panja pneumothorax ikukhudza imposition wa Mavalidwe occlusive, amene sealingly atseka gawo kuonongeka kwa mpanda pachifuwa. Bandeji amene sadzapita mpweya, akhale wa polyethylene kapena cellophane ndi nkhungu wosanjikiza wa thonje-gauze.

Pamene valavu pneumothorax amafuna likhale atangochimwa puncture pleural, umene akufalitsa m'mapapo, kuthetsa ufulu mpweya ndi kuteteza kusamutsidwa a ziwalo mediastinal.

Njira kuthana ndi kudwala

Ngati anapezeka ndi pneumothorax, chithandizo ikukhudza zinthu zotsatirazi:

• Pleural needling, pa zimene suction mpweya M'mimbamo pleural.

• Opaleshoni suturing bronchial mipata, m'mapapo, kuvulala pachifuwa khoma.

• Kukhetsa M'mimbamo pleural ndi kukhazikitsidwa kwa chubu ngalande imene kuchotsa mpweya M'mimbamo pleural zidzachitika.

• Ngati ululu kutchulidwa ndi pathologies monga pneumothorax, mankhwala monga kugwiritsa ntchito mankhwala opha.

• Mpweya (machitidwe mosalekeza mpweya okwanira ndi machubu wapadera).

• Pleurodesis - maphatikizidwe ndondomeko pleura ntchito opaleshoni kapena kulowetsa M'mimbamo pleural mankhwala apadera (ngati mobwerezabwereza pafupipafupi pneumothorax).

Zovuta ndi zotsatira

Pneumothorax - chikhalidwe kwambiri zomwe zingachititse:

• Intrapleural magazi.

• Pleurisy - kutupa pleura, amene amakhala ndi mapangidwe adhesions, n'zothandiza chisokonezo kudzifutukula kuwala.

• Subcutaneous ndiko kumayambitsa - chodabwitsa imene mpweya anapulumuka mu mafuta subcutaneous. Kudziwa boma mbali ya kutupa, kutupa minofu subcutaneous: pamene inu alemba pa iwo, pali phokoso chosiyana ofanana ndi crunch wa chisanu youma.

• Air kulowa minofu mediastinal. Pankhaniyi, pali psinjika ziwiya kwambiri ndi mtima.

• Zikavuta (ndi lalikulu chotupa buku, kwambiri ozama mabala a chifuwa) ndi salamulidwa mu imfa.

kupewa

Pofuna kupewa pneumothorax, ayenera kutsata malamulo ena:

• Nthawi ochizira matenda a m'mapapo.

• Kusiya kusuta.

• Pewani kuvulala pachifuwa.

• Ngati pneumothorax zimachitika nthawi zambiri ndi bwino kuchita pleurodesis ndondomeko (msoko pleura).

Pomaliza

M'nkhaniyi, tinakambirana matenda monga pneumothorax. Zizindikiro, zimayambitsa ndi mfundo chithandizo cha kudwala ankafunsidwa ndi ife. Mu pneumothorax aliyense amafuna hospitalization yomweyo wodwalayo kwa opaleshoni. Ndi chokwanira ano mankhwala madokotala ananena zawo za pneumothorax mowiriza ndi zambiri yabwino. Bwino chithandizo cha pneumothorax zoopsa amakhudza chikhalidwe cha ina kuwonongeka kwa pachifuwa. Dzisamalire ndi kukhala wathanzi!