Zamkatimu
Kodi subcutaneous emphysema ndi chiyani?
Subcutaneous emphysema - uku ndiko kudzikundikira kwa mpweya kapena mpweya mu minofu, zomwe zimapangitsa kuti pakhale phokoso la mpweya. Kwenikweni, mawu akuti emphysema angatanthauzidwe ngati kuwonjezereka kwa mpweya. Chifukwa cha matendawa chikhoza kukhala kuvulala pachifuwa, chifukwa chake ziwalo za kupuma zinavulala kwambiri, komanso kuwonongeka kwa m'mimba. Ichi ndichifukwa chake mpweya wolowa mu mediastinum umakakamiza mitsempha yayikulu ndi zotengera, zomwe zimatsogolera ku asphyxia, kulephera kwamtima komanso kufa.
Chifukwa cha subcutaneous emphysema angakhalenso kunja kwambiri bala bala, imene kupuma ziwalo zinawonongeka.
Muzachipatala, ndi chizolowezi kusiyanitsa pakati pa magwero angapo a mpweya kulowa minofu, ndicho atatu okha:
chilonda cha pachifuwa, chomwe chili ndi katundu wongolowetsa mpweya mu minofu, koma osapatsa mwayi wobwerera;
ngati kuwonongeka kwa bronchi, trachea kapena esophagus, pamene mediastinal pleura yawonongeka, kotero kuti mpweya wochokera ku mediastinum umalowa momasuka mu pleural cavity;
munthawi yomweyo kuphwanya umphumphu wa parietal pleura ndi mapapo, bala ali ndi mawonekedwe valavu.
Mpweya ukalowa m'matumbo, umatha kuyenda momasuka pansi pa khungu kuchokera kudera la areolar kupita kudera la nkhope. Subcutaneous emphysema nthawi zambiri sichimayambitsa zosokoneza zomwe odwala angazindikire. Payokha, matendawa si owopsa ngati chifukwa cha zochitika zake chimadziwika mu nthawi. Kuti tipeze chifukwa, ndikofunika kutsata zochitika za chitukuko cha ndondomekoyi.
Madokotala amagawa odwala onse m'magulu awiri azaka: achinyamata ndi omwe ali ndi zaka zoposa 40. Matenda mwa anthu oterewa nthawi zonse amapita m'njira zosiyanasiyana. Mwa achinyamata, azaka zapakati pa 20-30, emphysema imachitika mofatsa kwambiri komanso popanda zotsatirapo zake. Mwa anthu okalamba, opitirira zaka 40, matendawa ndi ovuta kwambiri ndipo kuchira ku matendawa kumatenga nthawi yayitali.
Zifukwa za subcutaneous emphysema
Madokotala amasiyanitsa zifukwa zotsatirazi, zomwe zimawonekera subcutaneous emphysema:
Matenda a bronchitis, kusuta. Mu 90% ya milandu, ndi kusuta komwe kumayambitsa emphysema. Odwala ambiri amalakwitsa pokhulupirira kuti bronchitis ya osuta ndi matenda osavulaza konse. Utsi wa fodya uli ndi zinthu zambiri zovulaza zomwe zimayambitsa kuwonongeka kwa mpweya m'thupi la wosuta. Izi zimabweretsa kusintha kwakukulu;
Kusintha mu mawonekedwe abwino a chifuwa chifukwa cha zochitika zakunja, kuvulala;
Kuvulala kwakukulu (kutsekedwa kwa nthiti, chidutswa chomwe chinapyoza m'mapapo) kapena opaleshoni ya pachifuwa, laparoscopy;
Anomaly mu chitukuko cha ziwalo za kupuma dongosolo, nthawi zambiri izi ndi kobadwa nako malformations;
Kupuma kwa zinthu zapoizoni zomwe zimawononga dongosolo la kupuma (ntchito zaukatswiri, malo oipitsidwa, kugwira ntchito ndi zinthu zapoizoni kapena kupanga zowopsa, omanga, ndi zina zambiri, anthu omwe amapuma mpweya wokhala ndi zonyansa zambiri zovulaza);
Chilonda chowomberedwa, chopangidwa mopanda kanthu. Chifukwa cha zotsatira za mpweya wa ufa pakhungu lozungulira bala, emphysema yosadziwika imapezeka;
matenda a anaerobic;
Mpeni, mabala osaoneka bwino;
Kugunda kwagalimoto komwe ovulala akugunda pachifuwa pachowongolera kapena mipando mwamphamvu kwambiri;
Kuwonongeka kwa mapapu chifukwa champhamvu kwambiri mkati, chomwe chimatchedwa barotrauma (kudumphira m'madzi, kudumphira mozama mpaka kuya);
Ndi kuthyoka kwa mafupa a nkhope;
neoplasms pakhosi ndi trachea;
Angina Ludwig;
Kuphulika kwa khosi. Chifukwa ichi ndi chosowa kwambiri;
Nthawi zina emphysema kumachitika pa opaleshoni mano, chifukwa cha peculiarity wa chida;
Kuvulala kwa mgwirizano waukulu (bondo);
Ndi yokumba mpweya mpweya wa m'mapapo. Kugwiritsa ntchito chubu la tracheal.
Zizindikiro za subcutaneous emphysema
Nthawi zambiri zizindikiro za subcutaneous emphysema ndi:
kutupa pakhosi;
kupweteka pachifuwa pamene kupuma;
zilonda zapakhosi, zovuta kumeza;
kupuma movutikira;
kutupa khungu pakalibe zoonekeratu kuda ake yotupa ndondomeko.
Mukhoza kudziwa subcutaneous emphysema ntchito X-ray mu magawo otsiriza a matenda. Komanso palpation yosavuta m'dera lomwe mukufuna kuti mutenge mpweya. Pansi pa zala, kukhalapo kwa thovu la mpweya pansi pa khungu kudzamveka bwino kwambiri.
Pamene palpated, wodwalayo samva kupweteka kapena kusapeza. Mukakanikiza pagawo la mpweya wowunjikana, phokoso lodziwika bwino limamveka, lomwe limakumbutsa kwambiri chipale chofewa. Ndi mpweya wambiri pansi pa khungu, minyewa yoyandikana ndi malowa imatupa kwambiri kotero kuti imawonekera ndi maso.
Ngati subcutaneous emphysema yapangika pakhosi, wodwalayo amatha kusintha mawu ake ndipo zimakhala zovuta kupuma.
Mpweya ukhoza kudziunjikira pansi pa khungu m'malo osiyanasiyana a thupi, ngakhale pamiyendo ndi mikono, ndi pamimba.
Chithandizo cha subcutaneous emphysema
Emphysema imatha kupezeka ndi X-ray kapena CT scan ya pachifuwa. Mwamsanga pamene thovu la mpweya likuwonekera mu minofu ya thupi, chithandizo chimayamba mwamsanga. Kumayambiriro kwa matendawa, mankhwala ochiritsira amachitidwa, ndiko kuti, mankhwala apadera opopera ndi ma aerosols amalembedwa. Komabe, sangathe kuletsa kukula kwa matendawa.
Njira ya matendawa imayang'aniridwa ndi madokotala pafupipafupi, ndipo kuwonjezereka kwa matendawa kumawonedwa 2 kapena 3 pa chaka. Pakuwonjezereka kotereku, kupuma movutikira kumayamba. Mu gawo lachitatu ndi lachinayi la emphysema, chithandizo chamankhwala sichimakhudza matendawa ndipo wodwalayo ayenera kuvomereza kuti achitepo opaleshoni.
Ngakhale kwenikweni, subcutaneous emphysema nthawi zambiri safuna chithandizo chilichonse. Payokha, matendawa sakhala oopsa kwa thupi la munthu, ndi zotsatira za kuvulala kwakunja kapena chiwalo china chamkati. Ndipo pambuyo pake amachotsedwa. Mpweya jakisoni pansi pa khungu amasiya. Matendawa pang'onopang'ono amatha popanda mankhwala apadera.
Momwe chomwe chimayambitsa emphysema chathetsedwa bwino ndikulowetsa mpweya. Kuti machiritso afulumire, kuchita masewera olimbitsa thupi mu mpweya watsopano wa dziko kumalimbikitsidwa. Pamenepa, magazi amadzaza ndi mpweya, zomwe zimathandiza kuti nayitrogeni atuluke m'thupi.
Malingana ndi kukula kwa emphysema, njira ina yopangira opaleshoni imachitidwa, yomwe cholinga chake ndi kupititsa patsogolo kuchotsedwa kwa mpweya.
Emphysema ikhoza kukhala yoopsa pokhapokha ngati yapangidwa m'dera la chifuwa ndipo imafalikira mofulumira ku khosi, poyamba pansi pa khungu, ndiyeno imalowa mu minofu ya khosi ndi mediastinum, zomwe zingayambitse kupanikizika kwa ziwalo zofunika kwambiri. Pankhaniyi, opaleshoni yofulumira ndiyofunika, yomwe ingathandize kudziwa chomwe chimayambitsa jekeseni wa mpweya, komanso kuchotsa popanda zotsatira zoopsa kwa wodwalayo.