Atelectasis - Iyini? Sifo, ukwelashwa kanye Izibikezelo

Atelectasis - Iyini? Impendulo le nkinga yezokwelapha kuphela eyaziwa kulabo onekhono. Kodwa-ke ukunquma awudingi udokotela. Imininingwane atelectasis, ungafunda izinto kwe-athikili.

Inchazelo

Atelectasis - isimo sokugembula esibonakala ngokuba nokulahlekelwa airiness ukukhanya zonke noma endaweni ethize. elithi Okubukwe has imvelaphi ngesiGreki. Njengoba yahunyushelwa olimini isiRashiya, kusho "kuhlulekile" noma "akuphelele elula Indwangu."

izimbangela

Atelectasis - ukwehla we ingxenye wamaphaphu. Ukuthuthukisa ezifana isimo sokugembula kungaholela ezicini eziningana. Sibala kwamasonto ayinhloko njengamanje:

• Ukwandiswa ebusweni ukungezwani baphawula phezu kwezindonga alveoli. Ngokuvamile, lokhu zokugula kubangelwa edema yamaphaphu noma cardiogenic imvelaphi noncardiogenic, kanye ukuntuleka surfactant noma izinqubo ezithathelwanayo.
• Kokucindezela we yomoya noma wamaphaphu, okuyinto kubangelwa izici ezihlukahlukene yangaphandle (isb, isimila mediastinal, anomaly kakhulu ekuthuthukeni imikhumbi emikhulu igazi, lymphadenopathy, hypertrophy esivimba amanzi , njll).
• Pathology mucosa (kwangaphakathi) Ugange bronchus (isb bronhomalyatsiya, ukusonteka, ukuvuvukala noma edema).
• Isimiso noma occlusion we Isikhala sayo esingaphakathi we okuthiwa emizimbeni bronchial angaphandle, isikhwehlela, mass caseous (isb, isifo sofuba), kanye mucosal edema.
• Ukuphulwa uhambo engokwemvelo esifubeni, okuyinto kuphakama ngenxa ukukhubazeka we emsipheni phrenic, ukubulawa kwezinzwa okuvamile, ukugobeka komhlandla noma izifo kwamanyuroni.
• Senyusa izinga lomfutho womoya yangaphakathi in the ingaphakathi pleural (kuhlanganise hemothorax, hydrothorax, empyema, pneumothorax).

Kungani namanje atelectasis? Izimbangela kulesi simo ngokuvamile ecasha acute nciphisa omkhulu yamaphaphu, okuyinto kuphakama njengoba kwetintfo nasezinkingeni ezilandela ngemva kokuhlinzwa ngenxa baxhashazwe eside isiguli, umoya-mpilo ukweqisa izidakamizwa, hypothermia, isicelo ebulilini sedatives futhi opioids, kanye ejenti vasodilating.

engcupheni

Ubani uvame baphawula atelectasis? Lesi sifo ezitholakala kubantu ukukhuluphala, cystic fibrosis futhi somoya. Futhi-ke singangena ababhemayo.

ngezigaba

Ngu umsuka atelectasis ka wamaphaphu Lobe kungaba azalwa naso (ie, okuyinhloko) noma atholwe (ie, zesibili).

Ngaphansi isifo eyinhloko kwakusho isimo lapho ingane esanda kuzalwa kungekho bushelelezi lula. Ngokuqondene atelectasis aluthola, kulesi simo kukhona spadenie wamaphaphu izicubu, okuyinto wayeke waxoxa ngaphambili abahilelekile ukuphefumula.

Asinakusho ukuthi izenzakalo ezinjalo kufanele zihlukaniswa kusukela atelectasis kokubeletha, ie isimo airless kwamaphaphu, okuyinto okubonakale ezingenzeka embungwini, bokuphila (ie, hypoventilation ezenzeka kubantu ngenye enempilo futhi uhlobo reserve obusebenzayo ijwabu namaphaphu).

izinhlobo izifo

Kuye inani wamaphaphu izicubu elisukela inqubo ukuphefumula, isifo okukhulunywa uhlukaniswe:

• acinar;
• segmental;
• lobular;
• Imininingwane;
• nokulingana.

Futhi, kungenzeka zamazwe amabili noma sohlangothi olulodwa. Phela, uhlobo lokuqala kuyingozi kakhulu futhi kungaba ngempela kalula ekufeni isiguli.

izinhlobo isifo

Kuye izici etiopathogenic lokhu zokugula kohlelo yamaphaphu sehlukaniswe lezi zinhlobo ezilandelayo:

• Kokucindezela atelectasis, noma ukuwohloka yamaphaphu. Lesi simo sibangelwa kokucindezelwa ijwabu wamaphaphu kusukela ngaphandle, futhi sokuzuza ngalo ingaphakathi pleural uketshezi, emoyeni, igazi noma ubomvu.
• atelectasis Obstructive. Lesi simo esiyingqayizivele sibangelwa lihlotshaniswa ukuhlukumeza mechanical uqhoqhoqho futhi isimiso bronchial.
• Discoid atelectasis wamaphaphu. zokugula okunjalo ngokuvamile eba ngemva contusion thorax noma ubambo waphuka.
• Ukusikwa - kubangelwa kokucindezelwa ijwabu fibrous we-alveoli (emaphashini subpleural).
• Acinar - elihlobene ne ukuntula surfactant (ngokuvamile iningi kwenzeka abadala nezinsana zabo nge zokuphefumula ukucindezeleka syndrome).

Kufanele kuqashelwe ukuthi le isifo angabhekwa reflex kanye nasezinkingeni ezilandela ngemva kokuhlinzwa, futhi kancane kancane acute, ayinzima futhi eyinkimbinkimbi lezivakashi nokuphikelelayo.

izimpawu

Ukugxila wamaphaphu atelectasis umtholampilo kuncike umthamo kanye velocity othwala off wamaphaphu nonfunctioning izicubu. Mikroatelektazy, olulodwa segmental atelectasis futhi srednedolevoy syndrome ngokuvamile asymptomatic.

Ngokuphathelene acute-nokuqala isifo, it has izimpawu ezinamandla. Kulokhu, isiguli uzizwa ubuhlungu okungazelelwe, dyspnea paroxysmal, cyanosis, isifuba esomile lapho tachycardia futhi hypotension. Ngo ukwanda okukhulu kwezincwadi nokuvaleka kwemigudu yokuphefumula kungenzeka ngisho ukubulala.

On luhlolo isiguli wembula ukusalela namanoni aphezu ethintekile yamaphaphu ngesikhathi ukuphefumula, kanye zokucinana esifubeni kuyanda. Ngaphezu kwalokho, phezu atelectasis umlilo kunqunywa blunt eshaywayo umsindo noma mfushane. Ngesikhathi umoya ofanayo ngokucijile attenuated (ayikwazi wezwa).

yezinkinga atelectasis

Nge kancane kancane ukuvala shaqa wamaphaphu ukupholisa izingxenye izimpawu zesifo kuvetwa ngezinga elincane. Kodwa okwalandela atelektaticheskaya inyumoniya eba gipopnevmatoza.

Ukubukeka ukukhwehlela ne isikhwehlela, imfiva, futhi izimpawu ukwanda lokudakwa inkulumo mayelana ukubusa ukuvuvukala. Kulokhu, lesi sifo umbuzo nzima ukuthuthukiswa wamaphaphu ithumba noma ithumba nenyumoniya.

ukuhlola

Ukuxilongwa wamaphaphu atelectasis eyenziwa -X-ray luhlolo isitho zokuphefumula e Iwumbono ezilingene engaphelele. Lokhu kwembula eyohlobo Ukufiphala wamaphaphu emkhakheni kanye mediastinum offset bubheke ingxenyenamba ukugqashuka yenqubo ukuphefumula. Ngaphezu kwalokho, ama-X-ray kwasho isikhundla eliphezulu Dome diaphragm futhi ngakhula emoyeni wamaphaphu.

Ezimweni ukungaqondi kahle, lo indlela yokutadisha eshiwo CT. Futhi, ukucacisa izimbangela obstructive atelectasis ukusetshenziswa bronchoscopy futhi ngesikhathi isikhathi eside atelectasis umkhiqizo angiopulmonography futhi bronhografii.

ukwelashwa

Ukuthola wamaphaphu atelectasis kudinga udokotela (Pulmonologist, neonatology, ukuhlukumezeka noma udokotela ohlinzayo thoracic) amacebo asebenzayo. izingane nje wazalwa ene-primary atelectasis yamaphaphu iveza suctioning okuqukethwe umgudu wokuphefumula ngokusebenzisa ipayipi zenjoloba. Uma kudingeka, afeze tracheal intubation futhi ahlelembe wamaphaphu.

Kulesi hlobo izifo ezifana atelectasis obstructive ukuthi kwabangelwa nomzimba angaphandle, isizinda yayo Kwenziwa yezokwelapha bronchoscopy zokuxilonga.

Uma wamaphaphu spadenie kwabangelwa ukunqwabelana imfihlo nenkani ke bachitha kabusha endoscopic sesihlahla som bronchial.

Ukuze angahlupheki atelectasis nasezinkingeni ezilandela ngemva kokuhlinzwa eyenziwa tracheal aspirate, ukuphefumula umzimba ukubhucungwa esifubeni eshaywayo, amanzi postural, kanye ephefumula nge-enzyme kanye bronchodilator izidakamizwa.

Asinakusho ukuthi ngaso sonke atelectasis Lokudabuka kuncike ukuqaliswa esiyisibopho zokuvimbela ukwelashwa eqeda ukuvuvukala.

ukuba nombono ongafani ngeke

Impumelelo ekukhanyeni enwetshiwe incike isikhathi kuqale ukwelashwa kanye izimbangela atelectasis. Lapho ukuqedwa ephelele yokugcina ezinsukwini zokuqala ezintathu umhlahlo maqondana zokuphefumula isitho indawo yokutakula sisihle.

Lapho izimo ezinzima ayikwazi ukubeka eceleni ukuthuthukiswa izinguquko yesibili kwisabelo ingalali. Ngokushesha savela futhi atelectasis omkhulu kungaholela ekufeni.