Kuthekani ukuba kulwelo em- pleural: Ubangela and Treatment

Ukuba indawo pleural iqala ukuba nomzi ulwelo (effusion), koko imeko embi kangaka zophendlo lwezifo kusenokubonisa ukuba umzimba iphuhlisa isifo ethile, kwaye anobungozi. Sifo leengxaki ngeendlela ezahlukeneyo, kwaye ke ugqirha imisela unyango olufanelekileyo.

Kwezinye iimeko, ukuqokelelana iziselo ezinjalo zingabangela decompensation ukusilela yokuphefumla, ngokufuthi ngokungasingisi kufeni. Ukongeza, le sifo lukhatshwa iingxaki ezinkulu kakhulu. Ngoko ke, unyango lwesi sifo kufuneka ziqale ngokukhawuleza kangangoko kunokwenzeka.

ulwazi jikelele

imiphunga Human singqongwe imifinya ababini, ngokuba pleura. Engaphandle izibandakanya udonga esifubeni kwaye elingaphakathi - emiphungeni kunye nezinye kwizihlunu. A umsantsa wenziwe phakathi kwabo, ebizwa kwisisu pleural okanye uxinezeleko.

fluid ezamahala kwi izenzo kwisisu pleural njenge yokuqaba icandelo imiphezulu pleural, sivumele zomaleko ngexesha uphefumla ngokukhululekileyo sehla nxamnye omnye komnye. Oku kunegalelo imeko ngaphezulu, nto leyo evumela ukugcina kumphezulu kwemiphunga kunye eludongeni esifubeni. Isixa ulwelo em- pleural kufuneka iitispuni 4. Ukuba isiphumo ndandingenampilo liqala ukuba nomzi, umthamo wayo ukufikelela iilitha 5-6.

Kulwelo amaninzi kwisisu pleural nga zinokohluka:

• igazi, pleural ukuba iimpahla ezonakeleyo;
• uhlobo non-yokukrala kulwelo (transudate);
• ubomvu okanye fluid adibane nazo apha ukudumba pleural (exudate).

Ukuqokelelela igazi ngokuqhelekileyo kwenzeka ngenxa yomonakalo imithambo yegazi, olwenzeka xa iingozi. Nkovu ungena kwisisu pleural xa konzakale ye bile thoracic, nto leyo isitya nkovu enkulu.

Transudate bangaqokelela na kwisisu ukuba umzimba ngendlela baboniswa nayiphi na inkqubo inkqubo. Umzekelo, oku kube ukwehliswa uxinzelelo lwegazi ngenxa omkhulu ilahleko kwegazi, okanye nokutsha. Kwakhona, ubukho transudate em- pleural liyasetyenziswa kwimeko nasezimpahleni kwandisa uxinzelelo hydrostatic na ukusilela entliziyweni.

Kulwelo kwisisu pleural, ingakumbi exudate oluhlala kwinkqubo arhabaxa. Oku kunokuba inyumoniya, umhlaza, unepleurisy.

izizathu

Ulwelo amaninzi kwisisu pleural, - isifo leyo yesibini. Oku kuthetha ukuba uphuhliso sifo lwenzeka kwi imvelaphi aqukuqela lomzimba lomnye sifo.

Yintoni na? Yintoni isono, ukuba ulwelo amaninzi kwisisu pleural? Kusenokwenzeka kuba ngolu hlobo lulandelayo:

• Chest esibuhlungu, nto leyo imithambo yegazi ezaphukileyo, elahliweyo phakathi ezimbanjeni. Kusenokwenzeka kwakhona kwenzeka thoracic duct komsipha.
• isifo besisu, uhlobo yokukrala lokuzala. Exudate uqala ukuba yande njengempendulo esibindini ithumba, pancreatitis, ithumba subdiaphragmatic, peritonitis.
• izifo Oncological ichaphazela pleura, kungekuphela nje kugxila kwinjongo ephambili, kodwa kukwenziwa metastases. kwiiseli ze mesothelium kuvela nangezilonda Primary ahlangane nabantu abasebenza iinkampani asbestos. Abantu abane case esibi. Ukuba Ithumba nabungozi, i-ALS ngokuqhelekileyo siyakhuthaza.
• ukusilela Heart, into leyo eyenza igalelo uxinzelelo lwegazi.
• Inyumoniya. Le nkqubo yokukrala ingaqhuba zombini kwi ubunzulu parenchyma wemiphunga pleura ikufutshane ngokwaneleyo ukuba afune beqokelela arhabaxa fluid.
• Izifo ezosulelayo kunye negazi.
• Tuberculosis.
• Myxedema (nokudumba mucosal) olubangelwa kukungabi umsebenzi lengqula.
• imithambo syndrome Embolism pulmonary xa kukho ukuyilwa iqhosha yemiphunga kunye nokwanda kweziveliso ze-transudate.
• Uremia, ivela ukusilela kwezintso. Loo urhulumente uphawu ukusilela ezininzi umbutho, glomerulonephritis, nokudumba, haemolysis omkhulu iiseli ezibomvu, ukugula radiation.
• ZeNkqubo izifo nokuqina zomzimba: periarteritis nodosa, systemic lupus zomzimba, ezo unobangela ukuqokelelana exudate.

iimpawu

Enoba kutheni kukho zemali ulwelo em- pleural, ukusilela sokuphefumla esinokubakho. Oku kuboniswa ngolu hlobo lulandelayo:

• iintlungu kwicala lasekhohlo okanye lasekunene;
• dyspnea, uphelelwa umoya;
• ukhohlokhohlo owomileyo, leyo kwenzeka ngenxa ucinezelo le umthamo omkhulu lolwelo bronchi;
• imilenze esiluhlaza ngenxa yokunqongophala kwe-oksijini;
• ukwanda lobushushu emzimbeni ngenxa yenkqubo arhabaxa.

Makhe sihlolisise ngokweenkcukacha iimpawu ezichaza nokwanda kolwelo em- pleural kwi izifo ezithile.

ukulimala

trauma esifubeni okanye semiphunga kukhokelela ekukhuleni ngokukhawuleza insufficiency sokuphefumla. Ngenxa yoko kukho hemoptysis, umlomo foamy isikhohlela kubonakala obubomvu. Uye kuye kophulwa osezingqondweni, isikhumba uba ithinti oluhlaza, umntu awele isiqaqa.

Xa uqhekeko yegazi aorta thoracic uqala ukugeleza kungena kwisisu pleural, okukhokelela kwilahleko lwegazi kunye ukopha kukothuka. Gcina umntu kunzima.

izifo Oncological

Kwimeko apho kukho mesothelioma fluid em- pleural linqanam lokugqibela kuphuhliso yamathumba. Singatsho ngokuqinisekileyo enkulu ukuba ukufa kuza iinyanga 7-10. Zizizwe isifo esinjalo ephawuleka ukuhla elibukhali kwi kwinqanaba glucose kuso, viscosity ka hyaluronic acid, kwaye amaxesha amaninzi wamagazi.

pneumonia

Ezi mpawu zilandelayo yinyumoniya iya kubonisa ukuba inkqubo zophendlo lwezifo ithatha indawo kwi parenchyma lung:

• umkhuhlane;
• ukukhohlela manzi;
• ubuhlungu nezolo ecaleni layo;
• ukuphelelwa umoya;
• crackles;
• ukunxila kakhulu.

senhliziyo

Kulwelo amaninzi kwisisu pleural kwi ukusilela entliziyweni kubonakala ngolu hlobo lulandelayo:

• yobuthathaka;
• nokudinwa;
• intliziyo iqala ukusebenza nqapha;
• ukungabi namdla, ngenxa yomzimba;
• iintlungu esifubeni.

ekuxilongweni

Eyona ndlela kakhulu ulwazi diagnostic kuthathwa esifubeni ray, inceda ukuqinisekisa ubukho ngezifo ezifana syndrome fluid em- pleural, okanye ukungabikho kwalo. Oku kubangelwa lula umsebenzi ugqirha ekuqeshweni unyango olufanelekileyo. Radiographs icwangcisa ngokuchanileyo inqanaba ulwelo kunye nomthamo cishe, ubukho nokungabikho umoya.

Kwakhona kuyimfuneko ukumisela uhlobo effusion, kwaye ukuza kuthi ga ngoku, kukho okuhlatywa olwenziweyo. Ukulungiselela le njongo, isiqulatho ulwelo athathwe kwisisu pleural ukuze kuchongwe umlinganiselo isixa protein, ubunzima ezithile, umsebenzi dehydrogenase zincancise. Ukwenza yesityalo nomngundo, iintsholongwane, iintsholongwane acid-fast. Kulwelo abe ligazi, ubomvu, serosa. Ukuqhubeka kolwelo egazini uyaqapheleka trauma, engabalulekanga izigulane umhlaza wemiphunga kunye nokubandakanyeka pleural. exudate ubovu oluhlala kuzo ukusilela intliziyo, yaye serous - emva izifo ezosulelayo.

Kwakhona yindlela elungileyo nomfanekiso imiphunga kunye nesifuba CT scan uthathwa. inzuzo yayo usendleleni yokuba inkqubo ikuvumela ukugqiba ngokuchanileyo umlinganiselo wokubanzi akhululwe kwaye unobangela wale meko. Pulmonologists Siyaleza tirhisa CT scan qho emva kweenyanga ezintandathu. Oku kuvumela ukuphawulwa zokwanda fluid kwi pleural kwisisu syndrome.

unyango

Nge ukuqokelelana okuncinane kolwelo uphathwa ingxaki izifo kuphela. Inani elikhulu effusion, ingakumbi ukuba afune ukutswina ezifuna semibhobho ukuphelisa esi sifo. Amaxesha amaninzi ilulwelo imveliso nge okuhlatywa, xa lweHo- catheter pleural okanye inaliti encinane. Ngokuqhelekileyo, needling lwenziwa ngeenjongo diagnostic, kodwa ebudeni kunokwenzeka enjalo ukumpompa ukuya ku 1.5 iilitha effusion. Okunye Cima akunconywa, njengoko umngcipheko nokudumba yemiphunga nezengekho zenzeka.

Ukususa efunde kwi isixa esikhulu ulwelo eludongeni esifubeni ngokusebenzisa ityhubhu layo lokuQala. Le nkqubo yenziwa ngolu hlobo lulandelayo: emva kokuba ugqirha zomzimba yenza imbobo yaye ufaka ityhubhu yeplastiki phakathi emancamini omabini esifubeni. Emva koko, koko lebhokisi ukuba inkqubo yokukhupha amanzi, nto leyo akavumeli umoya ukungena kwisisu pleural. Ukusebenzisa ingcali ulawulo X-ray ikhankanya ufakelo tube echanekileyo, ekubeni semibhobho akwenzeki ngenye indlela.

Ukuba fluid em- pleural emfono ngenxa sisifo sephepha okanye coccidioidomycosis, kulo mzekelo, kufuna unyango lwexesha elide kunye antibiotics. Esidi enze ezintsonkothileyo phantsi ububomvu viscous kakhulu, okanye xa kuthe "pocket" ezinezikhondo, ngoko ke meko mayilungiswe kuphela ngokususa yinxalenye ubambo ukuba ukusungulwa catheter omkhulu. Ayifane umsebenzi kufuneka ukususa umaleko olungaphandle pleura.

Ithumba Pleural kukhokelela ekubeni ulwelo iqala ukuba yande em- pleural. Unyango kule meko kakhulu elide, njengoko kunokuba nzima ukuphelisa exudate ngenxa beqokelela yayo ekhawulezileyo. Liza kutsalwe uncedo nokufumana iziyobisi anticancer. Noko ke, ukuba iindlela ezinjalo ayikasebenzi, kwaye ulwelo liyaqhubeka ukuba nomzi, bodwa yenziwa kwisisu pleural. yonke umthamo exudate isusiwe ngenxa ityhubhu, uze kungena lweHo- therethrough pleural ezilawulwa esahlala, ezifana talc okanye isisombululo doxycycline. Ne enjalo isivuseleli kwenzeka jointing iileya ezimbini pleural, yaye akukho ndawo simahla sokuzuza ulwelo.

Ukuba kwisisu pleural lizele ligazi, kwada ukopha wayeka, lwenziwa nge ityhubhu sesixokelelwano nesetyenziswa malunga nolawulo iziyobisi ndoyidiliza egazi. ukopha eqhubekayo okanye bokungakwazi ukususa fluid ngokusebenzisa catheter - kubonakala ukuba ungenelelo yotyando.

ukungaphili

Ebibekiwe em- pleural kolwelo, ingakumbi izixa ezikhulu, kungakhokelela ekubeni ezininzi iingxaki. Kunokuba yayiyazi pulmonary insufficiency, nangokurhala, usulelo imvelaphi, iingxaki umsebenzi kwesibindi, intliziyo namanye amalungu zangaphakathi lung.

Ekubeni ulwelo kunye ubofu babe namathuba eziphezulu nokusasazwa ngaphakathi kwisisu, kufuneka kulindeleke yeengxaki ukusuka phecana zesisu. Olu hlobo exudate amaninzi kwindawo pleural ngumba, ngokufuthi ekhokelela ekufeni okanye ukukhubazeka ukufumana umntu. Oku kusebenza kuzo imfuneko resection zepancreas okanye udakada.

iingxaki ezinjalo kwenzeka amadoda kunye namabhinqa ayo yonke iminyaka, ngoko unyango kufuneka uqale kwangethuba kangangoko kunokwenzeka kunye nokusebenzisa amanyathelo othintelo.

ukuvimbela

Ukuze kuphetshwe izifo ezinokubangela ukuqokelelana kolwelo em- pleural, kufuneka ngokukhawuleza ngayo. Ukuba unyango zintsholongwane okanye uqhaqho kuphumelele, bafudukele izenzo ezongezelelweyo. Oku kunokuba alahle imikhwa emibi, indlela yokuphila esempilweni, ukuthatha izakhiwo vitamin kunye namacandelo abazizityebi luncedo iziyobisi.

amanyathelo azizithintelo kufuneka iquke intlonipho umsebenzi ngokwasemzimbeni ukutya okhethekileyo. Ukuba buselwe yonke imihla kangangoko kunokwenzeka, iziqhamo ngamaxesha kunye nemifuno, iiprotheni zendalo, isitatshi, amafutha, inyama. Oogqirha Siyaleza ukwenza imithambo yonke imihla, ungacimi kwaye ahambe umgama omde ngeenyawo. Le ndlela ekuthinteleni esi sifo-100% ngempumelelo.

isiphelo

Ngoko ke yintoni ukuba ulwelo kubonakele em- pleural? Isizathu sokuba imeko zophendlo lwezifo ezifana kukuveliswa sifo, ngokufuthi unzulu. Kwezinye iimeko, esi sifo kwavela kunokukhokelela ekufeni. Qiniseka ukuba adibane oyingcaphephe, owathi emva kokuba amanyathelo diagnostic liya kumisela unyango olufanelekileyo kunye nobuchule. Ukuze kuthintelwe uphuhliso zokuthintela izifo kufuneka ilandelwe.