Zamkatimu
Mawu akuti "pneumosclerosis" akhala akugwiritsidwa ntchito ndi mankhwala kuyambira 1819, woyamba kuigwiritsa ntchito anali Laennec, yemwe anachita izi kufotokoza mkhalidwe wa wodwala amene khoma la bronchus linawonongeka, gawo lina linakulitsidwa. Lingaliroli linaphatikiza mawu awiri achi Greek - kuwala ndi kuphatikizika.
Kodi pulmonary fibrosis ndi chiyani?
Pneumosclerosis ya m'mapapo ndi kuwonjezeka kwachilendo kwa kukula kwa minofu yolumikizana yomwe imatha kuchitika m'mapapo a munthu chifukwa cha kutupa, njira ya dystrophic. Madera omwe amakhudzidwa ndi minofu yotere amataya mphamvu, kusintha kwapathological mu kapangidwe ka bronchi kumawonedwa. Minofu ya m'mapapo imachepa ndikukhuthala, chiwalocho chimakhala cholimba, chopanda mpweya, ndipo kupanikizana kumachitika. Nthawi zambiri, matendawa amakumana ndi amuna (komanso akazi samatetezedwa), gulu lazaka silichita nawo gawo.
Zifukwa za pneumosclerosis
Pali matenda, kusowa kwanthawi yake komanso chithandizo chokwanira chomwe chingayambitse chitukuko cha pneumosclerosis mwa wodwala:
sarcoidosis m'mapapo;
chifuwa chachikulu (pleura, mapapo), mycosis;
bronchitis mu mawonekedwe aakulu;
chibayo (chopatsirana, aspiratory, virus);
mpweya wamakampani;
chithandizo cha radiation (polimbana ndi khansa);
alveolitis (fibrosing, matupi awo sagwirizana);
kuwonongeka kwa makoma a mitsempha (granulomatosis);
reflux ya gastroesophageal;
kuwonongeka kwa sternum, kuvulala kwa mapapu parenchyma;
chibadwa (matenda a m'mapapo);
exudative pleurisy (mawonekedwe ovuta, nthawi yayitali);
chinthu chachilendo mu bronchi.
Matendawa amathanso kuyambitsa ndi kumwa mankhwala angapo (apressin, cordarone). Kuphatikiza apo, zizolowezi zoyipa (kusuta), zachilengedwe zosauka (kukhala m'malo owopsa) zimawonedwa ngati zowopsa.
Pali akatswiri omwe eni ake ali pachiwopsezo chowonjezereka. Kupanga kovulaza, migodi ndi malo omwe mpweya wowopsa ndi fumbi zimakula. Zowopsa zimawopseza odula magalasi, omanga, opukutira ndi zina zotero.
Chizindikiro cha pneumosclerosis
Zizindikiro zazikulu za pulmonary pneumosclerosis ndi mawonetseredwe a matendawa, zotsatira zake zomwe zinakhala.
Mukhozanso kukumana ndi zizindikiro zotsatirazi, zomwe zikusonyeza kuti muyenera kukaonana ndi dokotala mwamsanga:
kupuma movutikira, kupeza khalidwe lokhazikika, kukhalabe ngakhale mu mkhalidwe wosagwira ntchito;
chifuwa chachikulu, limodzi ndi secretions mu mawonekedwe a mucopurulent sputum;
kutopa kosatha, kufooka, kugunda kwa chizungulire;
kupweteka pachifuwa;
cyanosis ya khungu;
kuonda;
chifuwa chopunduka;
kwambiri pulmonary insufficiency;
phalanges zala zofanana ndi ng'oma (zala za Hippocrates);
mikangano pa auscultation (yowuma, kuwira bwino).
Kuopsa kwa zizindikiro za matenda mwachindunji zimadalira kuchuluka kwa pathological connective minofu. Mawonetseredwe ang'onoang'ono ndi makamaka khalidwe la limited pneumosclerosis.
Mitundu ya pneumosclerosis
Malinga ndi mphamvu ya kugawa mu pulmonary parenchyma wa connective minofu, ndi mwambo kusiyanitsa zotsatirazi pneumosclerosis:
Matenda a Fibrosis. Amadziwika ndi kusinthana kwa minofu yolumikizana ndi mapapo mwa wodwala.
Matenda a Sclerosis. Pali m'malo m'mapapo parenchyma ndi connective minofu, mapindikidwe ake dongosolo.
Cirrhosis. Kuphatikizika kwa pleura, m'malo mwa mitsempha yamagazi, bronchi ndi alveoli ndi kolajeni, kulephera kwa ntchito zosinthira gasi. Gawoli limatengedwa kuti ndilowopsa kwambiri.
Malinga ndi malo a chotupacho, mitundu iyi ya matendawa imasiyanitsidwa:
interstitial;
peribronchial;
alveolar;
perilobular;
perivascular.
Ngati wodwala ali ndi interstitial pneumosclerosis, chibayo cha interstitial ndi gwero lake. Cholinga chachikulu cha minofu yolumikizana ndi malo omwe ali pafupi ndi bronchi, mitsempha ya magazi, ndi interalveolar septa amavutikanso.
Maonekedwe a Peribronchial nthawi zambiri amakhala chifukwa cha chifuwa chachikulu. Kwa mawonekedwe awa, kugwidwa kwa dera lozungulira bronchi la wodwalayo ndikofanana, kupangidwa kwa minofu yolumikizira kumachitika m'malo mwa minyewa yam'mapapo. Matendawa nthawi zambiri lipoti yekha ndi chifuwa, patapita kanthawi sputum kumaliseche akhoza kuwonjezeredwa.
Perivascular pneumosclerosis imatanthawuza kuwonongeka kwa malo ozungulira mitsempha ya magazi. Perilobular imatsogolera ku kutanthauzira kwa chotupacho pamodzi ndi milatho ya interlobular.
Komanso, pneumosclerosis imagawidwa m'mitundu kutengera matenda omwe amatsimikizira kufalikira kwake.
Magulu otsatirawa akusiyanitsidwa:
sclerosis ya m'mapapo minofu;
postnecrotic;
discirculatory.
Kuphatikiza apo, kuchuluka kwa matendawa kumaganiziridwa - kuchepa, kufalikira kwa pneumosclerosis.
Mawonekedwe ochepa, nawonso, amagawidwa m'malo am'deralo ndi okhazikika:
Pneumosclerosis yam'deralo imatha kupezeka m'thupi la munthu kwa nthawi yayitali osapereka zizindikiro zilizonse. Zingadziŵike pokha pokha powerama ndi kupuma movutikira pomvetsera. X-ray imathandizanso kudziwa matenda, chithunzicho chiwonetsa gawo la minofu ya m'mapapo yophatikizika. Mtundu uwu sungakhale chifukwa cha pulmonary insufficiency.
Magwero amtundu wamtunduwu ndi chiphuphu cha m'mapapo, chomwe chimawononga mapapu a parenchyma. Komanso, chifukwa akhoza kugona m'mapanga (TB). Mwina kuwonjezeka kwa minofu yolumikizana, kuwonongeka kwa foci yomwe ilipo komanso yochiritsidwa kale.
Kufalitsa pneumosclerosis ya m'mapapo
Cholinga cha matenda a pneumosclerosis sichingakhale mapapu amodzi okha (kumanzere kapena kumanja), koma onse awiri. Pankhaniyi, kupezeka kwa cysts m'mapapu ndizotheka, ndipo kusintha kwa pathological komwe kumachitika ndi ziwiya kumathekanso. Ubwino wa zakudya zam'mapapo zam'mapapo ndi okosijeni umachepa, njira zopumira zimasokonekera. Kufalikira kwa mawonekedwe kungayambitse kupanga "cor pulmonale". Matendawa amadziwika ndi kukula kofulumira kwa mtima wabwino, chifukwa cha kuthamanga kwa magazi.
Kapangidwe ka mapapu mu diffuse pneumosclerosis imachitika motere:
Collagenization ya m'mapapo - mmalo mwa kuwonongeka kwa ulusi wotanuka, madera akuluakulu a collagen fibers amawonekera.
Kuchuluka kwa mapapu kumachepetsedwa, kapangidwe kake kamakhala kopunduka.
Mabowo (cysts) okhala ndi bronchoalveolar epithelium amawonekera.
Zifukwa zazikulu za chitukuko cha matendawa ndi njira yotupa yomwe imachitika pachifuwa. Gwero lawo likhoza kukhala losiyana - chifuwa chachikulu, chibayo chosatha, matenda a radiation, kukhudzana ndi mankhwala, chindoko, kuwonongeka kwa chifuwa.
Kutali nthawi zonse kufalikira pneumosclerosis imadzichenjeza yokha ndi zizindikiro zenizeni. Wodwalayo akhoza kukhala ndi kupuma pang'ono, poyamba kuchitika kokha ndi kutopa, kugwira ntchito mwakhama, maphunziro a masewera. Ndiye pakubwera siteji pamene kupuma pang'ono kumawoneka ngakhale mumtendere, panthawi yopuma. Chizindikiro ichi sichokha, ndizothekanso kutsokomola (kuuma, pafupipafupi), kupweteka kosalekeza m'dera la chifuwa.
Komanso, mawonetseredwe monga kupuma movutikira, cyanosis ya khungu, yoperekedwa ndi kusowa kwa mpweya, ndizothekanso. Wodwala akhoza kuonda mwadzidzidzi, kumva kufooka nthawi zonse.
Peripheral pneumosclerosis
Chofala kwambiri cha hilar pneumosclerosis ndi bronchitis, yomwe imakhala ndi mawonekedwe osatha. “Olakwa” a matendawa angakhalenso poizoni wa zinthu zovulaza, chibayo, ndi chifuwa chachikulu. Kukula kwa matendawa, monga lamulo, kumachitika motsutsana ndi maziko a kutupa, dystrophy. Zizindikiro za chikhalidwe ndi kutayika kwa elasticity m'dera lomwe lakhudzidwa, kuwonjezeka kwa kukula kwa minofu yolumikizana yomwe imapezeka m'madera oyambira m'mapapo. Komanso anawonjezera kuphwanya gasi kuwombola.
Basal pneumosclerosis
Ngati minofu ya m'mapapo yasinthidwa ndi minofu yolumikizana makamaka m'magawo oyambira, matendawa amatchedwa basal pneumosclerosis. Mmodzi wa magwero aakulu a matenda amaona kuti m`munsi lobe chibayo, mwina wodwalayo kamodzi anali kulimbana ndi matenda. X-ray idzawonetsa kumveka kowonjezereka kwa minofu ya zigawo za basal, kuwonjezeka kwa chitsanzo.
Chithandizo cha pulmonary pneumosclerosis
Ngati muli ndi zizindikiro za pneumosclerosis, muyenera kulembetsa kukaonana ndi dokotala wamkulu kapena pulmonologist. Njira zothandizira zimatsimikiziridwa ndi siteji yomwe matendawa ali. Koyamba, wofatsa mawonekedwe, osati limodzi ndi zizindikiro kwambiri, safuna yogwira mankhwala. Popeza pneumosclerosis nthawi zambiri amakhala ngati matenda concomitant, m`pofunika kuchiza gwero lake.
Maselo a tsinde
Njira yatsopano yothanirana ndi pneumosclerosis ndi chithandizo cha ma cell. Ma cell a stem ndi omwe amatsogolera ma cell onse m'thupi la munthu. "Maluso" awo apadera ali mu mphamvu yosintha kukhala maselo ena aliwonse. Khalidweli limagwiritsidwa ntchito mwachangu mu cell therapy motsutsana ndi pulmonary pneumosclerosis.
Akabayidwa kudzera m'mitsempha, maselo atsinde amadutsa m'magazi kupita ku chiwalo chomwe chakhudzidwa. Kenako, amalowetsa minofu yomwe yawonongeka ndi matendawa. Mofananamo, chitetezo cha mthupi chimayatsidwa, njira za metabolic zimayamba. Minofu ya m'mapapo yachibadwa imabadwanso.
Kuchita bwino kwa chithandizo cha ma cell kumatsimikiziridwa ndi tsiku lomwe lidayambika. Ndikoyenera kuyamba chithandizo mapapu onse asanayambe kugwidwa ndi ndondomeko ya fibrosis. Kupambana kumadaliranso kukhalapo kwa nsanja ya minofu yathanzi, yomwe ndi yofunika kuti maselo azitha kugwirizanitsa ndikuyambanso njira zomanganso.
Chithandizo cha tsinde cell chimasinthiratu kagayidwe kachakudya kamene kamachitika m'thupi la wodwala pneumosclerosis. Ntchito za endocrine, chitetezo cha mthupi ndi manjenje zimabwezeretsedwa. Maselo amatulutsanso mphamvu ya antitumor. Chifukwa cha chithandizo, chiwalo chokhudzidwa chimayambanso kugwira ntchito ndipo chimakhala chathanzi.
Zotsatira za chithandizo cha "ma cell" ndikubwezeretsanso mapangidwe a mapapu, kutha kwa kupuma movutikira ndi chifuwa chowuma, zomwe zinali zifukwa zazikulu za kuzunzidwa kwamuyaya kwa wodwalayo. Chitetezo ndi mphamvu ya chithandizo chatsimikiziridwa ndi maphunziro angapo.
Thandizo la oxygen
Kuchiza kwa okosijeni ndi njira yochiritsira yamakono yotengera mpweya wosakaniza ndi mpweya wa okosijeni ndi wodwalayo. Njirayi imakulolani kuti muthe kulipira kusowa kwa okosijeni komwe kwapangidwa m'thupi. Chimodzi mwa zizindikiro zazikulu za kukhazikitsa kwake ndi pneumosclerosis ya m'mapapo.
Mpweya, womwe ndi chida chothandizira mpweya, umadzaza ndi okosijeni mu voliyumu yomweyi yomwe imakhazikika mumlengalenga. Kupereka kwa gasi kumachitika nthawi zambiri pogwiritsa ntchito ma catheters a nasal (intranasal), amathanso kukhala:
masks (pakamwa ndi mphuno);
mahema okosijeni;
machubu (tracheostomy, intubation);
hyperbaric oxygenation.
Chifukwa cha kupezeka kwa okosijeni, kubwezeretsedwa kwa ma cell metabolism kumachitika.
Chithandizo cha Mankhwala
Ngati njira ya pneumosclerosis ikutsatiridwa ndi kuwonjezereka kotupa (chibayo, bronchitis), wodwalayo amapatsidwa mankhwala:
antibacterial;
odana ndi yotupa;
expectorant;
mucolytic;
mankhwala a bronchodilator.
Ngati pneumosclerosis ndi yoopsa, pali kuwonjezereka kwa matendawa, madokotala amagwirizanitsa glucocorticosteroids. Thandizo la maphunziro, lomwe limaphatikizapo kugwiritsa ntchito mankhwala a m'thupi pang'onopang'ono, amachitidwa kuti athetse kutupa, kupondereza kukula kwa minofu yolumikizana. Nthawi zambiri mankhwalawa amaphatikizidwa ndi immunosuppressive agents. Kukonzekera kwa anabolic ndi vitamini kungapangidwenso.
Kuti chithandizo chamankhwala chikhale chothandiza momwe zingathere, bronchoscopy yochizira imagwiritsidwa ntchito. Kusokoneza uku kumakupatsani mwayi wopereka mankhwala mwachindunji ku minofu ya bronchial, chotsani zomwe zili ndi zotupa za bronchopulmonary system.
Physiotherapy
Ngati wodwalayo ali ndi pneumosclerosis, akhoza kupatsidwa physiotherapy. Ntchito ya physiotherapeutic njira mu nkhani iyi ndi kuthetsa syndrome mu osagwira gawo, kukhazikika ndondomeko mu gawo yogwira.
Popeza kulephera kwa m'mapapo mwanga, iontophoresis ndi calcium kolorayidi, novocaine imasonyezedwa. Ultrasound yokhala ndi novocaine imatha kuperekedwanso. Ngati matendawa ali pa chipukuta siteji, izo m`pofunika kuchita inductometry ndi diathermy mu chifuwa m`dera. Ndi kupatukana kosauka kwa sputum, Vermel system (electrophoresis ndi ayodini) imagwiritsidwa ntchito, ndi kusowa kwa zakudya m'thupi - kuwala kwa ultraviolet. Njira ina yocheperako ndiyo kuyatsa ndi nyali ya solux.
Ngati n'kotheka, physiotherapy tikulimbikitsidwa kuti pamodzi ndi nyengo mankhwala. Odwala ndi pneumosclerosis amawonetsedwa kuti akupumula m'mphepete mwa Nyanja Yakufa. Nyengo yam'deralo idzakhala ndi machiritso pa zamoyo zomwe zakhudzidwa.
Kuchita masewera olimbitsa thupi
Ntchito yayikulu, kupindula komwe kumayendetsedwa ndi masewera olimbitsa thupi ochiritsira, ndikulimbitsa minofu yopuma. Maphunzirowa amachitidwa moyang'aniridwa ndi aphunzitsi aluso, zomwe amachita amateur zitha kuvulaza.
Kulipiridwa pneumosclerosis ndi chisonyezo cha ma gymnastics opuma. Ntchito iliyonse iyenera kuchitidwa popanda zovuta, kumamatira pang'onopang'ono kapena pang'onopang'ono, ndikuwonjezera katunduyo. Malo abwino ochitira masewerawa ndi msewu, mpweya wabwino umawonjezera mphamvu ya masewera olimbitsa thupi. Zochita za physiotherapy zimakhala ndi zotsutsana - kutentha thupi kwambiri, mawonekedwe aakulu a matendawa, mobwerezabwereza hemoptysis.
Polipira njira ya pathological, odwala amatha kulumikiza masewera ena. Ndi pneumosclerosis, kupalasa, skating ndi skiing ndizothandiza. Madokotala nthawi zambiri amalangiza kutikita minofu pachifuwa komanso. Mothandizidwa ndi njira, kusokonezeka komwe kumapanga m'mapapo kumachotsedwa. Kutikita minofu bwino mkhalidwe wa mtima, bronchi, mapapo, ndipo linalake ndipo tikulephera kukula kwa m`mapapo mwanga fibrosis.
Kupititsa patsogolo ntchito
Akuluakulu alowererepo kungakhale koyenera ngati wodwalayo ali m`deralo mawonekedwe a matenda, chiwonongeko cha m`mapapo minofu, suppuration wa m`mapapo parenchyma, fibrosis ndi matenda enaake a m`mapapo. Chofunika kwambiri cha mankhwalawa ndikuchotsa malo omwe akhudzidwa ndi minyewa yam'mapapo.
njira zopewera
Nthawi zonse zimakhala zosavuta kupewa pneumosclerosis kusiyana ndi kuchichotsa. Chofunika kwambiri pa izi ndi chithandizo chanthawi yake cha chibayo, chifuwa chachikulu, bronchitis, ndi chimfine. Izi zithandizanso:
kusiya kusuta;
kusintha kwa ntchito ndi kuyanjana pafupipafupi ndi zoopsa za ntchito;
kuchepetsa kumwa mowa;
ndondomeko zolimbitsa thupi;
masewera olimbitsa thupi nthawi zonse, masewera olimbitsa thupi;
zakudya zopatsa thanzi, kudya ma vitamini complexes;
kuyenda pafupipafupi mumlengalenga;
radioography pachaka.
Kusiya kusuta ndiye chinthu chofunikira kwambiri pamndandandawu. Ndudu kwambiri kuipiraipira mkhalidwe wa m`mapapo, kumathandiza kuti chitukuko cha matenda a kupuma ziwalo.
Ngati pneumosclerosis wapezeka mu nthawi yake, pansi pa mankhwala olondola, wodwalayo mosamalitsa kutsatira malangizo onse a dokotala ndi kukhala ndi moyo wathanzi, matenda adzagonjetsedwa.