Amalungu amakhulu okuphefumula akhuselwe yintambo yesigxina esinezikhalazo ezi-2 kunye nendawo engenanto phakathi kwabo. Uxinzelelo kwigobolondo yangaphandle yemiphunga kufuneka ibe ngaphantsi kwemoya. Ukuba umoya ungena kwisigxina, ukhula, kwaye i-pneumothorax iqala. Imipu ayilungisi kwaye iyeke ukuthatha inxaxheba kwinkqubo yokuphefumula.
Pneumothorax - udidi
Kukho iindlela ezininzi zokuthayibha i-pathology phantsi kwengqwalasela: ukukhawuleza, ukuhlala kwendawo, ukunxibelelana nommandla wangaphandle, umthamo wokuwa kunye nezinye iimpawu. Ukwahlula ngokubangela izizathu zesifo kubonwa ngokucacileyo kunokwenzeka. Iquka iintlobo ezilandelayo ze-pneumothorax:
- buhlungu;
- ngokukhawuleza;
- yokwenza izinto.
I-pneumothorax eyingozi
Le ndlela yesifo isoloko ihamba neengozi, izingozi zendlela kunye nokuhlaselwa ngokuxhoba. I-pneumothorax ephazamisayo kukuqokelela umoya phakathi kwe-lobes yesininzi ngenxa yokungena (ibhokhwe, umlenze) okanye ukulimala okubi kwesifuba (ukuvuthwa, ukubetha). Ngamanye amaxesha umonakalo kwiqokobhe elikhuselekileyo likhula ngokubhekiselele kwindlela yokwelapha. Kwiimeko ezinjalo, i-pneumothorax iatrogenic yomphunga ichongiwe. Kungenzeka emva kokuba:
- ukugqitywa;
- biopsy;
- ventilation;
- ukufakwa kwecatheter subclavia.
I-Pneumothorax yefomathi yangaphandle
Uhlobo oluchazweyo lwesifo luhlukaniswe ngokwahlukileyo kwi-subdipe idiopathiki kunye nesifo. Ifom yokuqala ifumaneka ngokusemgangathweni nakubantu abancinci, izizathu ezibalulekileyo zezi bakala azicaci. Izinto zokudalwa zilandelayo:
- ukuzalwa kunye nokuzalwa okungavumelekanga kokuzalwa komzimba;
- ngokwesini;
- abaneminyaka engama-20 ukuya kuma-40 ubudala;
- umlutha wecuba;
- ukukhula okuphezulu;
- imisebenzi ebonisa ukuba ulwahlulo lwengcinezelo (ukuhamba ngeenqwelo, ukudilika, ukunyuka kweentaba kunye nezinye);
- umsebenzi owenziwe ngokweqile.
I-Symptomatic okanye yesibili ipneumothorax yempompo ifunyanwe kubantu abaneentsholongwane ezichaphazela imisebenzi yenkqubo yokuphefumula. Ukuvuselela ukuqokelela umoya kwintlambo yesiganeko kunokuthi kwezi zifo zilandelayo:
- cystic fibrosis ;
- ukunyanzeliswa kwe-asthma ye-bronchial;
- pneumonia;
- sarcoidosis;
- i-fibrosing alveolitis;
- isifo esingenasifo sokuphefumula;
- isifo sofuba;
- i-histiocytosis X;
- scleroderma;
- i-rheumatoid arthritis;
- ukungabikho komphunga;
- nomhlaza;
- lymphangioleiomyomatosis;
- dermatomyositis nabanye.
Kwiimeko ezinzima, umoya ogqithisileyo phakathi kwe-lobes ye-pleural ingabangeli nje ukwanda kwenycinezelo kwimiguphu, kodwa kunye nokusilela kwe-oksijeni, ukunciphisa ngokukhawuleza kwixinzelelo lwegazi kwimibhobho. Le meko ibizwa ngokuba yi-pneumothorax enkulu kwaye ithathwa njengenye yezinto eziyingozi kakhulu kwizikolo zesifo. Ngaphandle kolwaphulo olungxamisekileyo, lunokukhupha iingxaki ezinzulu ezisongela ubomi bomntu.
I-pneumothorax yokufakelwa
Isimo esinikeziweyo sisilungiso esikhethekileyo sezokwelapha. Ngaphambi kokuveliswa kwamalungiselelo amakhemikhali anamhlanje, iindlela ezincinci zokungenelela ngoncedo kunye nophando lwe-tomography, i-pneumothorax yokufakelwa kwisifo sofuba (i-collapsotherapy) yindlela efanelekileyo kakhulu yokonyango kunye nokuxilongwa. Ukuphoqeleka okwexeshana kwiphemphu echaphazelekayo kubangela ukunyamalala kwe-necrosis yezicubu, ukuhlaziywa kwe-granulations kunye ne-fibrosis.
Iiplumologologists eziqhubela phambili zingavumelekanga ukuba zisebenzise umoya owenzela umoya. Kule mpazamo kukho izibonakaliso eziqinileyo:
- Ukuphuma kwangaphakathi (ukuba kuyaziwa, ukusuka kuyo imiphunga);
- isifo sofuba esitshabalalisa kunye neendawo zokuvumba;
- ukungakwazi ukwenza i-chemotherapy yanamhlanje.
I-Pneumothorax - izizathu
Ngamanye amaxesha i-pathology ephantsi kwengqwalasela ivela ngokukhawuleza, ngokukodwa kumadoda amancinci, athathwe kuyo ngenxa yobudala, ububele, indlela yokuphila okanye umdlalo. Izizathu ezibalulekileyo ze-pneumothorax:
- nzakala;
- izifo zokuphefumula;
- ngoncedo lwezonyango.
Vule pneumothorax
Le fomu yesifo iqhutyelwa ngumonakalo omkhulu kwisifuba. I-pneumothorax evulekile ukuqokelela umoya phakathi kwe-lobes yesigxina, esinokuphuma ngaphandle. Xa uphefumula, igesi igcwalisa umtya, kwaye ekuphumeni kwemoya kuya kubuya. Uxinzelelo kwi-shell ihamba ngokulinganayo kwixabiso lemoya, ngoko umphunga awukwazi ukulungisa. Kungenxa yoko, uyeka ukuthatha inxaxheba kwiinkqubo zokuphefumula kwaye unikezelo ngegazi nge-oxygen.
I-valve evulekile ngumphunga we-pneumothorax. Le meko ibonakaliswe ngokufuduka kweetyhuse zelungu elilinzakeleyo, i-bronchi, okanye imisipha. Ngenxa yoko, umoya uzalise umgca wecala lokungcolisa, kodwa awuqali ngokupheleleyo. Uxinzelelo kunye nomthamo wegesi phakathi kweepalali zikhula rhoqo, ezikhokelela ekuhambeni kweentliziyo kunye neempahla ezinkulu kunye nokutshitshisa imiphunga. Kukho ulwaphulo olunamandla lokujikeleza kwegazi, ukuphefumla kunye ne-oxygen exchange.
Pneumothorax
Abacebisi bolu hlobo lwezilwanyana ezinokubethwa kwintsholongwane bangaba nemisipha emincinci kunye nokulimala okungekho nto. Ngokufanayo, kuphawulwa xa kukho i-pneumothorax, iimeko ezingekasekwa. Ukuqokelela umoya phakathi kweepalali zommangalo wamaphaphu kubunjwa ngenxa yokuba i-defect encinane ibonakala kwi-pleura. Umonakalo kwisigodlo asinakho ukuphuma ngaphandle, kwaye umthamo wegesi kuwo awunyuli. Kancinci umoya uyazikhupha ngaphandle kokungenelela kwezonyango, kwaye isiphako sivaliwe.
I-Pneumothorax - iimpawu
Umfanekiso weklinikhi uxhomekeke ekubunjweni kunye nokubandezeleka kwimeko, umthamo womoya oqokelela kwindawo yesigxina. Ngamanye amaxesha iimpawu ze-pneumothorax zisekho. Oku kuyinyani ngokukodwa kwi-pathology yangundoqo. Kwezinye iimeko, i-pneumothorax yomphunga ingaba neempawu ezilandelayo:
- intlungu kwisifuba, ukunika ihlombe ukusuka kwicala elonakalisiweyo;
- ukukhwehlela;
- ukuphefumula okufutshane;
- izibilini ezininzi;
- ukwesaba ukufa;
- ukukhululwa kwe-swecous sweat;
- ubuthathaka emzimbeni;
- isikhumba esiluhlaza okomvu okwesibhakabhaka;
- ukubethela umlozo ngexesha lokuphefumula (nge-pulne pneumothorax evulekile);
- izikhala phakathi kwezimbambo;
- isiqhwenga esibalulekileyo;
- Ukuvuvukala phantsi kwesikhumba (emphysema), xa ucofa apho uva khona ukukhahlela, kufana nekhephu;
- ukunciphisa uxinzelelo lwegazi;
- utyhafile.
I-Pneumothorax - ukuxilongwa
Okokuqala, i-pulmonologist iqhuba uvavanyo lomzimba lwesigulane usebenzisa iindlela zokuxubusha (ukubetha ngomunwe) kunye nokukhangela (ukulalela i-phonendoscope). Indlela ephambili yokufumanisa i-pneumothorax yi-X ray. Kunceda ukubona umoya okhululekileyo kumlenze womlomo, ukuvavanya izinga lokubola kwemiphunga, ukufuduka kwamalungu omzimba. Ukuba uvavanyo lwe-X-ray alukwaziswa ngokwaneleyo, iindlela zokuxilongwa kwabancedi zisetyenziswa:
- tomography ;
- thoracoscopy;
- Uhlalutyo lwe-Exudate ukusuka kummandla wesigxina (ukugqithwa kwenziwa nge-pneumothorax);
- ukufunda ngokubunjwa kwegazi;
- electrocardiography.
I-Pneumothorax - unyango
Iimeko ezilula zohlobo oluvaliweyo lwezilwanyana aludingi unyango olukhethekileyo. Ukungabikho kweempawu ezinzima kwi-system yokuphefumula kunye ne-cardiovascular system, kuphela ukuqwalaselwa kwimeko yomphunga ngosizo lwe-radiography. Kwezinye iimeko, isigqibo malunga nendlela yokuphatha i-pneumothorax sithathwa ngumgqirha we-thoracic. Ngaphambi kokufika kwexhoba esibhedlele, kubalulekile ukukhusela ukuphuhliswa kweengxaki, oku kufuneka wenze imisebenzi embalwa elula.
I-Pneumothorax - uncedo olungxamisekileyo
Into yokuqala yokwenza xa usolitshitshisa imeko ekhutshwe kuyo kukubiza iqela lezokwelapha kwaye uhlalise umntu. I-Valve ne-heavy pneumothorax evaliweyo idinga umjelo osondeleyo wesigxina. Olu hlobo luya kunika umoya wokuqokelela ngaphandle kwaye kuncedise ukunciphisa uxinzelelo phakathi kweepalali zegobolondo elikhuselekileyo lezitho zokuphefumula.
Ukuba isigulane sinomzimba ovulekileyo we-pathology, i-pneumothorax yomphunga owonakele iyazwakala, njengokumemeza ngokuphefumlelwa kunye nokuphuma kwilonda. Ixhoba kubalulekile ukuzola kunye nokumnika ukufikelela kokukhululeka kwomoya-mpilo, oku kuya kubuyisela inkqubo yokuphefumula. Uncedo lokuqala kwi-pneumothorax evulekile lusetyenzisweni lokugqoka okutywinwe . Ithintela ukugeleza komoya kwintlambo yesigxina.
Utywala lwe pneumothorax
Kuyinto enqwenelekayo ukuba oku kuqhutyelwa ngumbutho oqeqeshiwe. Ukugqitywa kwesigxina se-pneumothorax kunomdla wokunciphisa ngokukhawuleza kwingcinezelo yemiphunga kunye nokuqheleka kokuphefumula. Ukuba imeko yesigulane ihlahloka ngokukhawuleza, unokuqhuba umjelo wongxamiseko. Ukwenza oku, ugubungela udonga lwesifuba kwicala elilinakaliswe ngedaliti enesisiphene esingaxhatshazwayo, ityhumbini elincinci eliphelileyo okanye into efanayo.
Kwisebe eligqirhayo, ukupompa umoya ogqithiseleyo ukusuka kwisigxina esilungelelweyo senziwa ngamacandelo akhethekileyo, umzekelo, izinto zokusebenza zikaBobrov. Ngaphantsi kwe-anesthesia yendawo, ugqirha wenza i-thorax nge-trocar eyinyumba. Kwimingxuma ifakwe umjelo kunye nesiphumo kwisitya seglasi yesibalo esithile (ibhanki kaBobrov). Ukuba umoya uhlala uphelile, uqhutyelwa ukuwupompa ngokucoca nge-vacuum aspirator (ukunyuka).
Ibhanji yokuqeshwa kunye ne-pneumothorax
Indlela ephambili yokhatyathwa ngokukhawuleza kwindlela evulekile yokukhubazeka kukuyeka ukufikelela komoya kwilonda. Ibhanji ye-pneumothorax inokwenziwa kwinqanaba elincinci loboya bekotton ehlanganiswe ngebhanki engumzimba, okanye izinto ezilungelelanisiweyo - iimpahla, ithubhu kunye nezinye izinto. Kumele ikhuphe ngokupheleleyo umonakalo kwaye inqande ukungena kwegesi kwindawo. Ngenxa yokuqina okukhulu, i-bandage ene-pneumothorax evulekile ifakwe ifilimu yeplastiki okanye isikhwama se-cellophane.
Esibhedlele, ixhoba liya kunikwa ngoncedo olufanelekileyo, olubandakanya:
- yonyango lonyango;
- anesthesia;
- Ukutyunjwa kwamanxeba avulekileyo, ukuphunga imiphunga kunye neembumba zayo;
- Ukugxilwa kweepalal pleal kunye namalungiselelo akhethekileyo (pleurodesis).
I-Pneumothorax - iingxaki
Phantse isiqingatha sezigulane ezichaze ukuba imeko ibangela iziphumo eziyingozi. Iyona nto inzima kakhulu i-valve pneumothorax, ukuhlinzwa ngokuvulwa kwesibindi, ukunyusa umoya kunye nokunyunjwa kwamanxeba ayisoloko isebenza kakuhle. Kwezinye iimeko, iphelela ngomphumo obulalayo. Ezinye iingxaki eziqhelekileyo zokugula:
- ukuvuvukala kwe-pleura (pyopneumothorax);
- emphysema engaphantsi ;
- uxinzelelo lweempahla ezinkulu kunye nentliziyo;
- ukuphuma egazini ngaphakathi;
- ukuhluleka kokuphefumula;
- ubunzima (ukulahleka komsebenzi) wemphunga.
Iziphumo ze-pneumothorax
Isiphumo sokuqokelela umoya kumlenze wesigxina kuxhomekeke kwimeko yesifo, ubunzima bayo, umonakalo ohambelana nesifuba esifubeni. I-valve pneumothorax ineyona nto ingavumelekiyo, ikakhulukazi ngamanxeba amaninzi emiphakeni. Ezinye iintlobo zentsholongwane ziphendula kakuhle unyango, kodwa ziyakhupha iziphumo ezinobungozi kwaye zilungele ukuphinda zibuyele. Kwiimiphunga eziphambene ne-pneumothorax, iziprofeto ziyamkeleka.