Ziwalo zazikuluzikulu zotetezera zimatetezedwa ndi chingwe chokhala ndi phokoso chokhala ndi mapiri awiri ndi malo opanda kanthu pakati pawo. Kupsyinjika mu chipolopolo chapakati cha mapapo kumayenera kukhala pansi pa mlengalenga. Ngati mpweya umalowa m'kati mwake, imakula, ndipo pneumothorax imayamba. Maungulo musawongole ndikusiya kutenga mpweya.
Pneumothorax - mtundu
Pali njira zambiri zomwe mungasankhire zovuta zomwe mukuziganizira: kuuma, kumidzi, kulankhulana ndi malo akunja, kuvomereza ndi zofunikira zina. Makhalidwe malinga ndi zomwe zimayambitsa matendawa amawoneka momveka bwino. Zimaphatikizapo mitundu yotsatira ya pneumothorax:
- chisokonezo;
- mosakhalitsa;
- kupanga.
Matenda a pneumothorax
Mtundu uwu wa matendawa nthawi zambiri umayenda ndi ngozi, ngozi za pamsewu ndi zida zankhondo. Kuopsa kwa pneumothorax ndiko kusungunula mpweya pakati pa loants pleative chifukwa cholowa (bullet, mpeni) kapena kuvulala koopsa mu chifuwa (mikwingwirima, kukwapula). Nthaŵi zina kuwonongeka kwa chipolopolo chotetezera kumapangidwanso ndi vuto lachipatala. Zikatero, iatrogenic pneumothorax ya mapapo imatsimikiziridwa. Zitha kuchitika pambuyo:
- chiwonongeko;
- biopsy;
- mpweya wokwanira;
- kukhazikitsa catheter ya subclavia.
Pneumothorax ya mawonekedwe odzidzimutsa
Mtundu wofotokozedwa wa matendawa umakhala wosiyana mwapadera kukhala gawo lodziwika bwino komanso lachidziwitso. Fomu yoyamba imapezeka mwamtheradi ndi achinyamata, zomwe zimayambitsa zochitikazi sizili bwino. Zowonongeka ndi izi:
- zolepheretsa kubadwa kwa thupi komanso matenda obadwa mwadzidzidzi;
- mwamuna;
- zaka kuyambira zaka 20 mpaka 40;
- kusuta fodya;
- kukwera kwakukulu;
- ntchito zomwe zimagonjetsa kupanikizana kusiyana (kuyenda mu ndege, kuthawa, kukwera mapiri ndi zina zotere);
- kuchita masewera olimbitsa thupi.
Matenda a chiwindi kapena achiwiri a pneumothorax amapezeka mwa anthu omwe ali ndi matenda omwe amachititsa ntchito za kupuma. Kulimbikitsanso kuti mlengalenga pakhale mlengalenga, matendawa ndi awa:
- cystic fibrosis ;
- kuwonjezereka kwa mphumu yakufa;
- chibayo;
- sarcoidosis;
- ululu wa alveolitis;
- matenda osokoneza bongo;
- chifuwa chachikulu;
- chithunzi;
- systemic scleroderma;
- nyamakazi ya nyamakazi;
- kupuma kwa mapapo;
- khansara;
- lymphangioleiomyomatosis;
- dermatomyositis ndi ena.
Pakakhala zovuta kwambiri, mpweya wochulukirapo pakati pa pleural lobes umawongolera kuwonjezeka kwa chifuwa cha mapapo, komanso kuwonongeka kwa mpweya wa oxygen, kuchepa mofulumira kwa magazi mu mitsempha. Matendawa amatchedwa kwambiri pneumothorax ndipo amachitidwa kuti ndi imodzi mwa zinthu zoopsa kwambiri pa matendawa. Popanda chithandizo chamwadzidzidzi, chingayambitse mavuto aakulu omwe amawopsyeza moyo wa munthu.
Pentiumothorax yobisika
Chikhalidwe chofotokozedwa ndi chithandizo chapadera cha zamankhwala. Asanayambe kupanga zakonzedwe zamakono zamakono, njira zochepetsetsa zochepa zopangira opaleshoni ndi computed tomography, pneumothorax yopanga mankhwala mu chifuwa chachikulu (collapsotherapy) ndiyo njira yabwino kwambiri yothandizira ndi matenda. Kuwonongeka kwapang'onopang'ono kwa mapapo omwe amakhudzidwa kumathandiza kuti matupi a necrosis, a resorption of granulations ndi fibrosis asakhalensopo.
Mafupipafupi omwe amapita patsogolo samagwiritsa ntchito mpweya wokhala ndi chitsimikizo. Kuwonongeka uku kuli zizindikiro zolimba:
- magazi amkati (ngati amadziwika, omwe amachokera m'mapapo);
- chifuwa chachikulu chakupha ndi maphala atsopano;
- zovuta zamakono zamakono.
Pneumothorax - zimayambitsa
Nthawi zina matenda omwe amalingalira amayamba mwachindunji, makamaka kwa anyamata, omwe amagwiritsidwa ntchito chifukwa cha msinkhu, umoyo wawo, moyo wawo kapena zokondweretsa. Zomwe zimayambitsa pneumothorax:
- kuvulala;
- matenda opatsirana;
- thandizo lachipatala.
Tsegulani pneumothorax
Mtundu uwu wa matendawa umapezeka ndi kuwonongeka kwa chifuwa. Pneumothorax yotseguka ndikutenga mpweya pakati pa lobes pleural, yomwe imakhala nayo kunja. Mukamapuma, mpweya umadzaza mthunzi, ndipo kutulutsa mpweya kumabwera. Kupanikizika kwa chipolopolocho ndi pang'onopang'ono kufanana ndi mtengo wa mlengalenga, kotero mapapu sangathe kuwongola. Chifukwa cha izi, amasiya kugwira nawo ntchito yopuma komanso amapereka magazi ndi mpweya.
Valavu yotsegula ndi mapapo a pneumothorax. Matendawa amadziwika ndi kuchoka kwa ziwalo za chilonda, bronchi, kapena minofu. Chotsatira chake, mpweya umadzaza mchere wofufuzira, koma sumazima. Kupsyinjika ndi kutaya kwa mpweya pakati pa pang'onopang'ono kumawonjezeka, zomwe zimayambitsa kusuntha kwa mtima ndi ziwiya zazikulu ndi kuperewera kwa mapapo. Pali kuphwanya kwakukulu kwa magazi, kupuma ndi kusintha kwa mpweya.
Pneumothorax yotsekedwa
Otsutsa a mtundu uwu wa matenda akhoza kukhala zovulaza zazing'ono ndi kuvulala kwakukulu. Mofananamo, zimaonedwa ngati pali pneumothorax, zomwe zimayambitsa zomwe sizinakhazikitsidwe. Kupeza mpweya pakati pa ziwalo za m'mapapo kumapangidwira chifukwa chilema chaching'ono chimawonekera phokosolo. Kuwonongeka kwa mpanda kulibe kanthu kwa kunja, ndipo mpweya wa mpweya umene uli mmenemo sukuwonjezeka. Pang'onopang'ono mlengalenga imadzipweteka ngakhale popanda thandizo la mankhwala, ndipo chilema chatsekedwa.
Pneumothorax - zizindikiro
Chithunzi cha kuchipatala chimadalira momwe mawonekedwewo alili, komanso mphamvu ya mpweya yomwe imasonkhana m'malo opempherera. Nthawi zina zizindikiro za pneumothorax sizipezeka. Izi ndizowona makamaka pa zochitika zapadera zomwe zimayambitsa matenda. Nthawi zina, pneumothorax ya mapapo akhoza kukhala ndi zizindikiro zotsatirazi:
- kupweteka m'chifuwa, kupereka kumapewa ku mbali yowonongeka;
- chifuwa chouma;
- mpweya wochepa;
- zowawa za mtima zambiri;
- kuopa mantha a imfa;
- kutulutsa thukuta la viscous yozizira;
- kufooka mu thupi;
- chikopa cha buluu ndi buluu;
- kulira phokoso panthawi yopuma (ndi mapulogalamu otsegula pneumothorax);
- kusokoneza mipata pakati pa nthiti;
- chidziwitso chapachifuwa;
- Kutupa pansi pa khungu (emphysema), pamene iwe ubwereza pa zomwe iwe umamva kuphulika, monga chipale chofewa;
- kuchepetsa kuthamanga kwa magazi;
- akufooka.
Pneumothorax - matenda
Choyamba, katswiri wamapiritsi amamuyesa wodwala pogwiritsa ntchito njira zogwiritsira ntchito (kupopera kwala) ndi kusangalala (phonendoscope kumvetsera). Njira yaikulu yodziwira kuti pneumothorax ndi X-rays. Zimathandizira kuona mpweya waulere mu membrane yowonjezera, kuyesa kuchuluka kwa mapaipi owonongeka, kusamuka kwa ziwalo za pakati. Ngati kuyesera kwa X-ray sikuphunzitsa bwino, njira zothandizira zothandizira zimagwiritsidwa ntchito:
- chiwerengero ;
- thoracoscopy;
- Kufufuza kwa exudate kuchokera ku pleural zone (kuponyedwa kumachitika ndi pneumothorax);
- kuphunzira zazigawo za magazi;
- makina opangira magetsi.
Pneumothorax - mankhwala
Matenda osavuta a matenda otsekedwa sakufuna mankhwala apadera. Ngati palibe zizindikiro zoopsa za thupi la kupuma ndi mtima, kokha kukuwona kwa mkhalidwe wa mapapo ndi chithandizo cha radiography akuyenera. Nthawi zina, chisankho cha momwe mungachiritse pneumothorax chimatengedwa ndi opaleshoni ya thoracic. Asanafike kuchipatala, ndikofunika kuteteza chitukuko cha mavuto, chifukwa ichi muyenera kuchita zinthu zosavuta.
Pneumothorax - thandizo ladzidzidzi
Chinthu choyamba choti muchite pamene mukukayikira kuti pali vuto lomwe mukufunsidwa ndikuitana gulu lachipatala ndikukhazika mtima pansi munthu. Valve ndi yotsekedwa yotsekemera pneumothorax imasowa madzi omwe amathamanga. Kukonzekera kumeneku kumapereka mpweya wochuluka kunja ndikuthandizira kuchepetsa kupanikizika pakati pa ziweto za chitetezo cha ziwalo za kupuma.
Ngati wodwala ali ndi mawonekedwe otseguka, pneumothorax wa mapaipi oonongeka amveka, ngati kulira mluzi ndi kudzoza ndi kutuluka kunja kwa bala. Wopwetekedwayo ndi wofunika kuti azikhazika mtima pansi ndikumupatsa mpata wopeza mpweya wabwino, izi zidzabwezeretsa kupuma pang'ono. Thandizo loyambalo pamphuno pneumothorax ndilo kugwiritsa ntchito chovala chophimba chodziwika. Zimalepheretsa kutuluka kwa mlengalenga kumalo ozizira.
Kusamba kwa pneumothorax
Ndikofunika kuti kugwiritsidwa ntchito kwa katswiri wodziwa bwino. Pulogalamu yachipatala yopopedwa ndi pneumothorax imathandizira kuti pang'onopang'ono kuchepa kwa chipolopolo cha mapapo ndi kuimitsa kupuma. Ngati mkhalidwe wa wodwalayo uwonongeka mofulumira, ukhoza kuyendetsa madzi akudzidzidzi. Pochita izi, kuboola khoma la chifuwa pambali yowonongeka ndi singano yowonongeka ya disinfected, kapu yaing'ono yokhala ndi mapeto othamanga kapena chinthu chomwecho.
Mu dipatimenti yopanga opaleshoni, kutulutsa mpweya wochulukirapo kuchokera pamtanda wodandaula kumapangidwa ndi zipangizo zamakono, mwachitsanzo, zipangizo za Bobrov. Pansi pa anesthesia wamba, dokotala amapanga katemera wa thorax ndi troter wosabala. Mu dzenje laikidwa ngalande yomwe imatuluka mu kapu ya galasi yavotolo (Bobby's bank). Ngati mpweya uli pang'onopang'ono kwambiri, umaphatikizapo kupopera ndi aspirator (aspiration).
Kumanga bandage ndi pneumothorax
Njira yaikulu yothandizira mwachangu njira yotseguka ya matenda ndiyo kulepheretsa mpweya kupita kuchilonda. Banjage ya pneumothorax ikhoza kupangidwa kuchokera ku thonje lakuda la thonje lamkati lokulumikizidwa ndi bandeji wosabala, kapena zipangizo zopangidwa bwino - zovala, tilu ndi zina. Izi ziyenera kuphimba kuwonongeka kwake ndikuletsa kutsekemera kwa mpweya mu dzenje. Kuti ukhale wolimba kwambiri, bandage ndi yotsegula pneumothorax ili ndi filimu ya pulasitiki kapena thumba la cellophane.
Mu chipatala, wozunzidwa adzapatsidwa thandizo loyenerera, lomwe limaphatikizapo:
- mpweya wabwino;
- chithunzi;
- kugulira opaleshoni ya mabala otseguka, mapapo a mapapo ndi ziwalo zake;
- Kuwombera mchere wodandaula ndikukonzekera mwapadera (pleurodesis).
Pneumothorax - mavuto
Pafupifupi theka la odwala adanena kuti vutoli limayambitsa zotsatira zoopsa. Chowopsa kwambiri ndi valve pneumothorax, opaleshoni ndi chifuwa choyamba, kutsegula kwa mpweya ndi mabala oyipa sizothandiza nthawi zonse. Nthaŵi zina, zimathera ndi zotsatira zowononga. Zovuta zina zofala za matenda:
- kutukumula kwa phokoso (pyopneumothorax);
- emphatic ;
- kupanikizika kwa ziwiya zazikulu ndi mtima;
- kutuluka mkati mwa cavity;
- zovuta kupuma;
- kuuma kwa ntchito (mapaintchito) a mapapo.
Zotsatira za pneumothorax
Zotsatira za kusungunuka kwa mpweya mu membrane yodandaula zimadalira mtundu wa matendawa, kuuma kwake, kuwononga kwa chifuwa. Valve pneumothorax ali ndi vuto loipa kwambiri, makamaka ndi mabala aakulu m'mapapu. Mitundu ina ya matenda imayankha bwino kuchipatala, koma ikhoza kuyambitsa zotsatira zoopsa ndipo imatha kubwereranso. Mu mapapo osavuta kwambiri a pneumothorax, maulosi ndi abwino.