Pneumothorax: Izimpawu, Izimbangela Nezingozi Ukwelashwa

isimo Pathological lapho ingaphakathi pleural (isikhala umqhewu emise phakathi le parietal futhi pleura visceral ezizungezile wamaphaphu ngamunye) aqoqana emoyeni noma ezinye igesi Izingxube is njengoba pneumothorax ezaziwayo. Izimpawu, izimbangela kanye nokwelashwa kulesi simo, esihlokweni.

Uhlolojikelele

Ukuze ingaphakathi pleural esimweni esejwayelekile elinesimo ingcindezi negative, lokhu kunikeza ezanele ukuphefumula indlela. Uma amashidi zilimele pleura (isib ngenxa esifundeni igebe yamaphaphu noma bronchus), ageje ku pleural ingcindezi ingaphakathi emoyeni equalized ukuba asemkhathini noma idlula ke. Umoya eye ukungena ngaphakathi komgodi pleural kuholela kokucindezelwa yamaphaphu, ke kuphakamisa spadenie futhi ngiwunqume kwesenzo sokuphefumula. Nge umthamo omkhulu emoyeni ekukhanyeni njengoba yayinjalo liphinde kuncike nengcindezi enamandla, ngaphezu kwalokhu, kukhona shift kwezitho mediastinal (imikhumbi emikhulu wenhliziyo). Konke lokhu ukuphazamisa kakhulu kwegazi igazi nokuphefumula kwezimila.

izimpawu isifo: Pneumothorax

Lesi sifo livezwa izici ezilandelayo:

• Kungazelelwe okwenzeka ubuhlungu besifuba - acute, okwandisa ngesikhathi ugqozi. emizweni Buhlungu ungasabalalisa nehlombe ohlangothini ethintekile.

• Kungazelelwe ekuthuthukiseni dyspnea - iphika, okusheshayo ukuphefumula engajulile.

• isifuba esomile.

• Ukushaya of ukushaya kwenhliziyo.

• Ukubukeka kwesikhumba endaweni izithukuthuku abandayo.

• ubuthakathaka Jikelele.

• Umuzwa yokwesaba.

• Cyanosis kwesikhumba (uma kwegazi kahle nokuphefumula kwezimila liphinyiselwe).

izinhlobo isifo

• Vula pneumothorax. Izimpawu zalesi simo kuthiwa: ukungena ngaphakathi komgodi pleural lomoya ngokusebenzisa ezilimele bronchi ezinkulu noma isilonda kwesifuba baxhumana imvelo ngesikhathi ephefumula umoya ongena ngaphakathi komgodi pleural futhi itholakala ngokuba sibuyele emuva esikhathini isikhathi. Ingcindezi ku ingaphakathi pleural eqhathaniswa kuma, okuyinto kuphakamisa atelectasis kanye nokuvala emishinini yokuphefumula yakhe.

• pneumothorax Kuvaliwe eba Ukungena komoya phakathi komgodi pleural ngenxa isici we pleura. Phakathi komgodi pleural futhi imvelo akukho umyalezo, futhi emoyeni sibhajwe ivolumu ayikhuphuki. pneumothorax avaliwe iyona elula iphuzu basemtholampilo umbono. Emoyeni esincane kungaba chaza ngokwabo. Uma kwakuba khona pneumothorax avaliwe, izimpawu kuleli cala, okulandelayo: ubuhlungu kuthabathela ecaleni ezilimele kwesifuba, ukuphaphatheka isikhumba, iphika.

• Voltage (valve) pneumothorax. Lolu hlobo lwe-pathology sekukaningi. Uphawu umphini pneumothorax - ukwakheka ngesikhathi isilonda kanye ukulimala enkulu bronchi value isilinganiso isakhiwo valve esikuvumela umoya ngaphakathi komgodi pleural ngesikhathi ugqozi futhi kuvimbela ophumayo yayo imvelo ngaphandle. Umthamo emoyeni ngalo ingaphakathi pleural ngenkathi ekhula. Lokhu kuphakamisa ukufuduka kanye kokucindezelwa kwezitho mediastinal iziyaluyalu sina kwegazi nokuphefumula kwezimila.

Pneumothorax: Izimbangela isifo

Kuye izimbangela zesifo ziye zakhomba eziningana zezinto eziphilayo.

pneumothorax nokuguqulwa

Izimpawu a zokugula kubangelwa ukudabuka ingxenye bronchus noma wamaphaphu okuyinto awahlobene ne umonakalo mechanical of the thorax noma wamaphaphu. pneumothorax okuzenzekelayo kungaba:

1. eyisisekelo (idiopathic) ezivele ngaphandle kwesizathu. Bethambekele ekubeni isimo esinjalo bezinsizwa iminyaka 20-40 zokukhula okusezingeni eliphezulu. zokugula ngokuvamile eba ngenxa:

• zofuzo kubangelwa ukuntula enzyme-alpha-1-antitrypsin nokuvuselela izinguquko sokugembula kule wamaphaphu;

• ubuthakathaka azalwa naso we pleura, okuyinto kalula amabhomu uhleko, ukukhwehlela eqinile, umsebenzi okukhulu ngokomzimba, ukudonsa umoya;

• ingcindezi umehluko okuholela ukucwiliswa ezijulile amanzi, indiza diving endizeni.

2. Okwesibili (lingaze), lapho isizinda isifo osuvele wamaphaphu eba pneumothorax nokuguqulwa. Izimpawu zenzeka ngenxa:

• nezifo zokuphefumula, isibonelo, kungenzeka ezingamahlalakhona obstructive isifo samaphaphu (isifo ukuvuvukala umgudu wokuphefumula, okuyinto eba ngaphansi kwethonya izici ezihlukahlukene kwemvelo, ayinhloko - kuyinto ukubhema, ingqondo ekuthuthukiseni ezingamahlalakhona nokuvaleka kwemigudu yokuphefumula), cystic fibrosis (isifo ngofuzo okuyiwona libhekene ukuphazamiseka nezindlala exocrine), exacerbation okunzima somoya;

• izifo ezithathelwanayo kwamaphaphu, isibonelo, isifo sofuba (isifo esithathelwanayo esibangelwa mycobacteria), wamaphaphu ithumba (kunomkhawulo ukuvuvukala ebalulekile wamaphaphu izicubu, esibonakala by ukuncibilika iphaphu kwezicubu ingaphakathi kumiswa egcwele ubovu okuqukethwe), inflammations yamaphaphu (pneumonia) yokulwa neHIV;

• isifo samaphaphu libhekene izilonda sezicubu zezinzwa fibrosing alveolitis, lymphangioleiomyomatosis, sarcoidosis, histiocytosis X;

• pathologies letindzala we ezicutshini nge isifo samaphaphu: scleroderma letindzala, i-rheumatoid arthritis, dermatomyositis;

• izimila (umdlavuza wamaphaphu).

traumatopnea

Izizathu zalokhu mkhuba - lena umonakalo yesifuba:

• ukuhlukumezeka blunt;

• ifinyelela inhliziyo isilonda.

pneumothorax iatrogenic

Lokhu zokugula kuwumphumela izinqubo ezithile zokwelapha:

• pleural noma wamaphaphu biopsy;

• lubhoboze;

• Onengqondo ipayipi subclavian;

• ukupholisa lokukhanda.

ukuhlola

Ukuze lokwenza ukuxilongwa "pneumothorax" izimpawu nesifo kumele ngokucophelela ufundwa uchwepheshe ngihlolwa. Sifo kuhlanganisa imisebenzi elandelayo:

• luhlolo Sibekezele: auscultation (auscultation) wamaphaphu luhlolo le thorax.

• Chest esimweni, ngayo nefunda ngayo kungenzeka ukuthola umoya endaweni pleural. Inqubo indlela eyinhloko ekuxilongweni pneumothorax.

• Igazi igesi kwengoma.

• computed tomography, okuyinto ikuvumela ukuba ukuhlonza izimbangela yesibili pneumothorax nokuguqulwa. Le ndlela zokuxilonga isetshenziswa lapho X-ray abanaso ulwazi.

• Electrocardiography, usebenzisa okuyinto kungenzeka ukuthola okuthile okungavamile enhliziyweni valve (matasa) pneumothorax.

• Ukubonisana thoracic ohlinzayo.

eziphuthumayo

Kufanele nazi ukubapha usizo lokuqala lalesi sifo sokugembula, njengoba pneumothorax. Izimpawu ze-ke kufanele kube uphawu esenzweni oluphuthumayo lwezokwelapha. Isiguli okokuqala kudingekile ukuqinisekisa ukufinyelela mahhala umoya-mpilo bekwazi ukumehlisa ulaka futhi ushayele udokotela ngokushesha.

pneumothorax Outdoor kuhilela ukunqunywa kusaladi occlusive, okuyinto sealingly evala ingxenye ezilimele odongeni esifubeni. Ngebhandeshi okuyinto ngeke adlule emoyeni, singenziwa ka polyethylene noma Cellophane futhi ungqimba obukhulu ukotini gauze.

Lapho pneumothorax umphini kudinga eliyifa ngokushesha wokubhoboza pleural, ozokusiza ukusakaza wamaphaphu, ukuqeda igesi mahhala futhi ukuvimbela displacement kwezitho mediastinal.

Izinyathelo zokunqanda zokugula

Uma kutholakale ukuthi une-pneumothorax, ukwelashwa kuhlanganisa imisebenzi elandelayo:

• needling Pleural, lapho umoya ukuncela kusuka ngaphakathi komgodi pleural.

• Steel suturing bronchial unokungaxhumani, iphaphu, ukulimala esifubeni udonga.

• Nkinga ngalo ingaphakathi pleural ne ukusungulwa ngamapayipi amanzi lapho ukususwa emoyeni kusukela ingaphakathi pleural kuzokwenzeka.

• Uma ubuhlungu liphinyiselwe pathologies ezifana pneumothorax, impatho kungafaka kunokusebenzisa imithi ebulala izinzwa.

• Oxygen (okuqhubekayo umoya-mpilo umncane izinhlelo amashubhu ekhethekile).

• Pleurodesis - Fusion inqubo pleura usebenzisa ukuhlinzwa noma umjovo ku ngalo ingaphakathi pleural imithi ekhethekile (uma ngokuphindaphindiwe njalo pneumothorax).

Izinkinga nemiphumela

Pneumothorax - usesimweni esibucayi ukuthi kungabangela:

• ukopha Intrapleural.

• Pleurisy - ukuvuvukala pleura, esibonakala by kumiswa ukuvuvukala, ingqondo thuthuva eyayembuleka ukukhanya.

• emphysema Ongama - ngumkhuba lapho umoya ngokulambisa ku namanoni ongama. Thola isimo izingxenye ukuvuvukala, ukuvuvukala izicubu ongama: uma uchofoza phezu kwabo, kukhona umsindo ehlukile, afana ziwe kweqhwa ezomile.

• Air ngokufaka izicubu mediastinal. Kulokhu, kukhona kokucindezelwa izitsha ezinkulu futhi inhliziyo.

• Ezimweni ezimbi kakhulu (nge lesion yenqwaba, izilonda kakhulu eyenza umuntu acabange eseZwini kwesifuba) is asikabi ekufeni.

zokuvimbela

Ukuvimbela pneumothorax, kumele zithobele imithetho ethile:

• Isikhathi aphathe isifo samaphaphu.

• Yeka ukubhema.

• Gwema ukulimala esifubeni.

• Uma pneumothorax kwenzeka kaningi impela, kuhle ukuba afeze inqubo pleurodesis (umphetho pleura).

isiphetho

Kulesi sihloko, saxoxa isifo esinjengo pneumothorax. Izimpawu, izimbangela kanye nezimiso ekwelapheni zokugula Kwahlolisiswa yithi. Kunoma pneumothorax kudinga esibhedlela ngokushesha isiguli ukuhlinzwa. Nge ezanele yesimanje yokwelapha Izibikezelo of pneumothorax nokuguqulwa ngokuvamile evumayo. Impumelelo ekwelapheni pneumothorax kuhlasimulise kuthinta ubunjalo umonakalo okuhambisayo kwesifuba. Zinakekele futhi uhlale unempilo!