Inkcazo pneumothorax: iintlobo zezifo, ebangela, isifo kwaye afumane unyango

Xa abaninzi uthotho malunga noogqirha kunye abecuphi, kuvamile ukubona amagama, intsingiselo apho kuthetha okubi okanye musa ukuqonda konke konke. Ngokomzekelo, pneumothorax. Yintoni na kwesi sifo ndinaso? Iimpawu, iimpawu apho abasebenzi kaxakeka ukuze amisele ngokuchanekileyo phambi kwayo, isixa uncedo, kunye nezinye izinto ezininzi ngasemva emfihlekweni. Kweli nqaku uza kufumana iimpendulo eziya kunceda Orient kwimeko kakhulu.

definition

Pneumothorax - ke sibe umoya okanye igesi kungena kwisisu thoracic. Kaninzi kwenzeka emva kokwenzakala ngenxa an open ukwaphuka le iimbambo okanye ukwenzakala lung eliqela ithambo, kwakunye ngenxa komsipha kwamathumba lung, evula iinkunzi okanye ukunyibilika ezindongeni yobubi bronchus. pneumothorax Secondary i phambili sisifo elide miphungeni.

ezibonisa kwezonyango iimpawu kuxhomekeke ikakhulu kwindlela ngokukhawuleza agcwalise umoya kwisisu pleural. Kwiimeko ezininzi, uphethwe kunokwenzeka emva kokuba kugqitywe uviwo lwe isigulana kule ndawo. Ngamanye amaxesha, iindlela ezongezelelweyo iimviwo, ezifana-X-reyi.

Unyango idla yotyando. Oku kuthetha ukuba ukususwa umoya ukusuka lweHo- esifubeni semibhobho okanye okuhlatywa, abuyisele umsebenzi amalungu mediastinum zize zizibuyisele ezihlalweni zabo.

Unxibelelwano yemeko ezisingqongileyo

Xa uhlobo kukho iinguqulelo ezininzi pneumothorax. Iintlobo sifo zixhomekeke kuyo icala umngxuma eyakhiwe (ngaphandle okanye ngaphakathi emzimbeni), kwakunye ubukhulu kunye nezinga ekungeneni igesi.

• pneumothorax ezivaliweyo sifo kwiimeko xa kwisisu pleural uwa isixa minor yerhasi emngxunyeni omncinane, hayi ukunxibelelana yemeko ezisingqongileyo. Uxinzelelo em- esifubeni inyuswe kancinane, isiphako uvaliwe ngokwawo, ngaphandle olunye uncedo. amaqamza kancinci ukunyibilika phakathi amaphepha pleura, emiphungeni, kwaye zithatha imo yawo eqhelekileyo.
• pneumothorax Vula phambili ngaphandle angena amanxeba zodonga esifubeni, okanye komsipha of a bronchus enkulu. Soloko enxibelelana bume lwangaphandle. Ngenxa kule uxinzelelo ezigxekayo kwisisu lwangaphakathi enxulumaniswe ephilayo emoyeni apho ukukhanya siyabutyaka, yaye umoya akuthethi ayongena kuyo.

• Udidekile okanye pneumothorax vana ivela kuphela xa enxulumene nokwenzakala (nxeba esifubeni eludongeni pleura kunye umonakalo komsipha le bronchi ezinkulu), yaye ungachazwa ukuba umoya ongena lweHo- umzimba kwi inhalation, kodwa engashiyi siphefumla yakhe. Uxinzelelo em- pleural luthelekiswa kuqala kunye uwabonisa kwaye lisaqhubeka nokukhula. Ngenxa yokuba amalungu mediastinal abantu bengenamakhaya yaye zixinaniswe.

Pathogenesis

Ukwenzela ukunceda kakuhle, kuyimfuneko ukwazi indlela pneumothorax ibunjiwe, iintlobo yayo. Physiology yale nkqubo iza kuxhomekeka kukuba em- oluqhelekileyo pleural ngaphakathi xi ezimbi. Oku kunceda ugcine imiphunga ngokwaseburhulumenteni eyandisiweyo, kwakunye ikhawulezisa ukutshintshiselana yeegesi kwi-alveoli. Xa yobunzima esifubeni ibuhlungu kwaye umoya uqalisa ukuba bazalise kwisisu pleural, imiphunga ukwehla umthamo.

Uphazamisane umoya yesiqhelo, yaye ngenxa yoko umntu uqala ukuba yayiminxa. Ukongeza, umoya Oluma kwaye lenkosikazi amalungu mediastinal: intliziyo, aorta, kuvuleke iminxunya, eyenza kube nzima ukwenza imisebenzi yawo ngqo.

umyalezo weimeyile

Ukusuka arhente okubuhlungu ngayo kuxhomekeke iza kuba yintoni a pneumothorax. Umyalezo weimeyile, iintlobo, Pathogenesis, ibonwa zonyango kunye unyango i ikhonkco inextricable ubhalo ulwazi unako ukusindisa ubomi, nokuba awunalo yokwenza kwezonyango.

1. pneumothorax okuzenzekelayo umsantsa bronchus enkulu okanye parenchyma lung sinxulumana zokonzakala mechanical kwesifuba. Yahlulahlulwe yaba ngamaqela amabini amakhulu:

• Primary, okanye idiopathic, akukho kwesizathu. Ivame kakhulu kumadoda asematsha abade ngaphezu kwabasetyhini abaneminyaka efanayo, akhe. Oku kunokucaciswa ezi mpawu zilandelayo: utshintsho zophendlo lwezifo kwi kwemiphunga ngenxa siphene yemfuza kwi synthesizing enzyme alpha-1-antitrypsin, nto leyo efunekayo eqhelekileyo yokusebenza alveoli; pleura zibhityile kakhulu, nto leyo lowanyathela kwindawo xi okungenamsebenzi, ezifana ukhohlela okanye uthimla; yokwehla ngokukhawuleza xa kokonyuka intaba (isifo intaba) okanye antywiliselwe ngaphantsi kwamanzi (isifo caisson).
• pneumothorax Secondary ukhandwa kwisiqalo yesifo semiphunga sele ezikhoyo ezifana COPD (chronic obstructive isifo pulmonary), abanesigulo esinganyangekiyo kunye sombefu.

2. I-common kakhulu amatyala pneumothorax esibuhlungu. Iintlobo zokwenzakala kuwa zibe ziindidi ezimbini: angena ukwenzakala lweHo- kwesifuba (zakhutshwa, amanxeba zinqunqwe, Ukophuka evulekileyo iimbambo); blunt isifuba kwentlungu (avtotravmy, atsho phakathi izinto zokubhala imenyu).

3. Ngexesha iinkqubo zonyango kwakhona musa ngaphandle imbonakalo pneumothorax. Kwiimeko ezinjalo, oko kuthiwa iatrogenic. Iingozi ziquka pleura okanye biopsy lung, amathumba isiqulatho okuhlatywa diagnostic kunye cysts, zokusingatha catheter subclavian kunye barotrauma evela ALV (ngumntu lung umoya).

ikliniki

Emva kokuba yenze uphando kunye noviwo lomguli ugqirha uhlawula ingqalelo iintlungu esifubeni ngequbuliso, ukuphelelwa umoya, ukuphefumla ngokukhawuleza kunye nezinga intliziyo, ukhohlokhohlo owomileyo. uvalo Acute nabo kuba sisiphumo pneumothorax. Iintlobo zokwenzakala kunye nohlobo yokwenzakala, maxa wambi abangaboni ubonwe, kuya kunceda kuzigqibezela Uxilongo kwaye sithumele isigulane unyango. Oku kunokuba isebe esibhedlele okanye likaxakeka utyando okanye unyango. Yonke into ixhomekeke yengxinano nengcinezelo imeko kunye umonakalo ethile.

ekuxilongweni

Njengoko kukhankanyiwe ngasentla, esazi indlela, nto leyo eye ngokuba pneumothorax, iintlobo kunye umehluko. uphethwe ayikho nzima. Akwanelanga ukubamba uviwo lwangaphandle esifubeni kunye nemiphunga auscultation amacandelo macala (luthelekiswe kwinxalenye okunempilo yesigulana). Ukuba ufuna ukubona umonakalo awukwazi, ngoko ukuze uqiniseke ngokupheleleyo ukuba ufuna ukuthumela isigulana to-X-reyi okanye CT. Umoya ayibonisi yemisebe radioactive, yaye ke ngoko kuya kuba ibonakale ngokucacileyo emfanekisweni.

Njengoko indlela eyongezelelweyo ungasebenzisa kwenkcazelo berhasi igazi (ukuze ukufumanisa ukuba kukho utshintsho oluphawulekayo bejonge hypercapnia), electrocardiography (ukuthintela iingxaki ezifana ukusilela intliziyo), kwakunye ukubhenela thethwano ngotyando (oku kudla kwenziwa kwinqanaba le yoviwo wesigulane yonxunguphalo mnyango).

likaxakeka

Nakuba iintlobo ezahlukeneyo pneumothorax, uncedo lokuqala lifinyele ukuba ubize inqwelo yezigulana. Ekubeni umntu abangaqeqeshelwanga ukujongana yokulimala ngaphakathi, akunakwenzeka, kuya kudingeka amava kunye trauma ugqirha. Ekuphela kwento kungenziwa kwimeko uhlobo evulekileyo isifo - ukuba ukunyanzelisa umhlabelo elingqingqwa etywiniweyo kwi inxeba. Uyakwazi ukusebenzisa oilcloth, izisongeli zeplastiki okanye Yangamafu yomqhaphu-igozi. Ezi zazo ziya kunceda kuba pneumothorax elivaliweyo.

Species engxamisekileyo uncedo pre-zonyango kunye isifo eziziziqalelo esi sifo kufuneka zifakwe ngaphakathi komthetho ulwazi nawuphi na umntu, abafundi kunyaka ophelileyo (wokhuselo civil). Uya kwandula ke ukwazi ukuhlola ngokwaneleyo imeko uze wenze isigqibo esifanelekileyo.

unyango

Into yokuqala ukwazi kakuhle oko uhlobo pneumothorax kwi umguli. Ukuba isixa komoya phakathi sheets pleural kancinci, uncedo zisenokuba kufuneka. Kancane ukuxazulula. Kwimeko apho isixa-igesi ngesiqhelo kuthintela lula ukuvula, kufuneka aspirated ngesirinji ngokuthi puncturing kwisisu pleural. Oku kuya kunceda ngokukhawuleza ukuphelisa pneumothorax. Types (yononophelo olungxamisekileyo exhomekeke kule) izifo kubalulekile, kuba ifuna indlela eyahlukileyo. A yonge umonakalo zifuna ukufakelwa macala yamanzi Byulau.

Ukongeza, xa ukonzakala omkhulu efuna ungenelelo utyando ukuze kokuphela parenchyma emiphungeni, pleura kunye iziphene inyumoniya, kwakunye ukuvalwa angena amanxeba esifubeni.

Njengoko therapy lingaze isincomo iintlungu neoksijini inhalation. Ukuba neziqephu pneumothorax-phindwa amaxesha amaninzi ngokwaneleyo, isiguli mabacetyiswe ukuba ukuvelisa pleurodesis - pleura ngelotha kunye.

Iingxaki abantu abane

Njengoko ngokunjalo emva nasiphi na isifo, kusoloko kukho iziphumo yokuhlaselwa pneumothorax. Forms of ngayo kule meko lidlale indima minor. Kwindawo yokuqala phakathi iingxaki ezixabisa ukopha okanye hemothorax. Emva kwakhe sahlala unepleurisy (ukudumba kwizicwili kwaye ukuyilwa azikhuli phakathi pleura) kunye emphysema ongama (umoya ngokungenisa esikule ngaphantsi kwesikhumba). isigulane afele kwindawo ebalulekileyo yokwenzakala kunye noncedo libaziseko.

ukuvimbela

Ukuze kuthintelwe uphuhliso pneumothorax, kwanele ukuba uyigcine imithetho embalwa elula:

• Kwangethuba kwaye uphathe ngokupheleleyo inkqubo yokuphefumla nokunqanda iingxaki zawo, ekhokelela ukuyilwa amanqaku uswele amandla wemiphunga pleura.
• Nika imikhuba emibi, ngokukodwa - ngokutshaya.
• Zama ukunqanda uhlukunyezwe esifubeni.
• Thabatha amanyathelo ukuthintela ukuphinda-pneumothorax.