Zifukwa za Chifuwa Kukula ndi Kulimbana Pamene Mukukhala Nawo
Chikwama cha chifuwa ndi chubu la pulasitiki loponyera lomwe limaphatikizidwa mu chifuwa kuti amve kapena madzi. Magazi m'chifuwa angakhale magazi (monga opaleshoni kapena opweteka), kapena pus (kuchokera ku matenda monga chibayo).
Kodi Zimagwiritsidwa Ntchito Piti?
Chikwama cha chifuwa chingapangidwe chifukwa cha zifukwa zingapo:
- Kuwonjezera mapapu pamene mapapu akugwa ( pneumothorax ). Ndi pneumothorax, chubuyi imalowetsedwa m'kati mwake , malo pakati pa membranes ( pleura ) yomwe imayendera mapapu.
- Pambuyo pa opaleshoni ya kansa ya m'mapapo kukhetsa madzi omwe amakhala mumlengalenga atapangidwa pambuyo pake. Ndi njira zoperewera zosawonongeka, monga opaleshoni yamagetsi yothandizira mavidiyo (VATS) kuti apange lumpectomy kapena njira zina, chifuwa cha chifuwa sichifunika. Pamene chifuwa cha chifuwa chimagwiritsidwa ntchito pambuyo pa VATS, chikhoza kuchotsedwa mwamsanga (mwachitsanzo, nthawi zambiri maola 48) kusiyana ndi omwe ali ndi thoracotomy ya khansa ya m'mapapo.
- Chifukwa chachisembwere chachisoni - zonse zowonongeka komanso zopweteka (onani pansipa).
- Kuchita opaleshoni ya mtima.
- Ngati pali magazi m'matumbo ( hemothorax ), mwachitsanzo, kuchokera ku zoopsa.
- Kuchetsa pusiti kuchokera ku matenda kapena abscess ( empyema .)
Kuyika
Ngati chifuwa cha chifuwa chimaikidwa kuti chifuwa chitheke, malo ochepa omwe ali pachifuwa amatha kugwiritsidwa ntchito pogwiritsira ntchito mankhwala opweteka. Pambuyo pake chubu imayikidwa, ndipo imagwirizanitsidwa ndi makina omwe amagwiritsira ntchito kuyamwa kuti achotse mpweya, motero mapuloteni amathera.
Thumba imagwedezeka m'malo kotero sizingatuluke ndi kuyenda.
Pamene chifuwa cha chifuwa chimaikidwa pambuyo pochita opaleshoni, chimayikidwa pansi pa anesthesia mu chipinda chogwiritsira ntchito. Pambuyo pake chubu imagwirizanitsidwa ndi chidebe chochepa kuposa chifuwa, pogwiritsa ntchito mphamvu yokoka kuti madzi owonjezera atseke.
Kodi Iwo Anasiya Kutali Kwambiri Motani?
Nthawi imene chifuwa chopangira chifuwacho chidzakhalabe m'malo chingasinthe malinga ndi chifukwa chimene chimayikidwira, ndipo mpweya umatha nthawi yaitali bwanji.
Ndi pneumothorax, madokotala adzayang'ana x-ray kuti atsimikizire kuti mpweya wonse wachotsedwa, ndipo mapapo afalikira kwathunthu. Pambuyo pa opaleshoni ya khansa ya m'mapapo, chubu imasiyidwa m'malo mpaka madzi ochepa okha atsala, nthawi zambiri masiku atatu kapena anai.
Kuchotsa
Kuchotsa chifuwa cha chifuwa kawirikawiri kumakhala kosavuta komanso kungatheke bwino pabedi lanu lachipatala popanda kunyowa. Ma sutures amalekanitsidwa ndipo chubu imamveka. Dokotala wanu adzakufunsani inu kuti mutenge mpweya ndikuugwira, ndipo chubu imachotsedwa. Suture ndiye amangirizidwa kuti atseke chilonda ndi kuvala kumagwiritsidwa ntchito. Ngati chubu iikidwa pamapapo otayika, x-ray idzachitidwa kuti muzitsimikizira kuti mapapu akupitirizabe kufalikira atachotsedwa.
Mavuto
Zovuta za chifuwa chopangira chifuwa ndizofanana ndi zomwe zimapezeka ndi machitidwe ena opaleshoni ndipo zingaphatikizepo:
- Kusuta.
- Kutenga.
- Ululu - Ngakhale kuti malo opangira chifuwa cha chifuwa amadziwika bwino, zimakhala zovuta kudutsa m'dera limene chimagwiritsira ntchito chida. Kuonjezera apo, mankhwala osokoneza bongo am'deralo sadzachotsa lingaliro lokoka ngati chubu chimayikidwa.
- Kugwiritsa ntchito phokoso lopanda phokoso (ena mwachangu) amatanthauza "malo," mwa kuyankhula kwina, ali ndi magulu angapo ang'onoang'ono a madzi, pus, kapena magazi omwe amagawidwa ndi minofu. malo omwe chifuwa cha chifuwa chimayikidwa.
- Pneumothorax - Thumba la chifuwa nthawi zambiri limaikidwa kuti limasulire mpweya kuchokera ku mapapo otayika, koma ikhozanso kutsegula mapapo chifukwa cha pneumothorax. Mapapu omwe agwidwa akhoza kugwa kachiwiri pamene chubu imachotsedwa.
- Zida zina pafupi ndi chifuwa cha chifuwa zingadwale, monga mimba, m'mimba, mapapo, kapena chithunzithunzi.
Pleural Effusions kwa Anthu Amene Ali ndi Khansa
Zovuta zowonongeka ndizofala kwambiri kwa anthu omwe ali ndi khansara yamapapo ndipo amapezeka ndi khansa ya m'mawere. Pakati penipeni, madzi amadzimangirira mumalo osungira madzi, malo omwe ali pakati pa ziwalo ziwiri zomwe zimayendera mapapu. Malowa amakhala ndi tiyi ya tiyi kapena inayi yokha ya madzi, koma ndi khansara yamapapu, malita angapo a madzi amatha kukhalapo, kapena kubwereranso, mofulumira.
Pamene maselo a khansa alipo pamtendere, amatchulidwa kuti ndiwopweteka kwambiri . Ngati kupweteka kwachinyengo kulipo, kumaphatikizapo khansara yamapapo monga siteji 4.
Anthu ambiri omwe ali ndi khansara yamapapo amatha kukhala ndi chithandizo chobwerezabwereza-ndipo ngakhale kuti nthawi zambiri izi zimakhala zosautsa, kupanikizika m'mapapu kuchokera ku madzi owonjezera kumapweteka ndi kupuma pang'ono. T
Pali njira zambiri zothandizira kuchitapo kanthu mobwerezabwereza, kaya kuwonongeka kuli koopsa kwambiri. Nthaŵi zina shunt imayikidwa kuchokera ku malo osungira mimba mpaka mimba kuti madzi amatha kutuluka mosalekeza. Njirayi ikhoza kukhala yabwino kuposa kukhala ndi thoracentesis (nthawi yomwe singano imayikidwa mu malo awa) kukhetsa madzi. Shunt ikhoza kuyikidwa kunja kwa thupi lanu. Izi zimathandiza anthu kukhetsa madzi awo nthawi ndi nthawi kunyumba popanda kubwerera kuchipatala nthawi iliyonse madzi amatha. Nthawi zambiri madzimadzi amatsanulidwa chifukwa cha zizindikiro zomwe zimakhala zoopsa (nthawi zambiri zimatonthozedwa kuti mutonthoze osati chifukwa ndizofunikira kuti muchotse madzi onse).
Njira ina yowonjezereka yowonjezereka ndi kupweteka danga pakati pa ziwalo ziwiri zofufuzira. Njirayi imatchedwa pleurodesis ndipo imagwiritsidwa ntchito mu chipinda chogwiritsira ntchito pansi pazirombo zambiri. Pamene zigawo za pleura zimawombera palimodzi, zimathetseratu malo osungira madzi kuti pasapezeke malo omwe madzi amatha kusonkhanitsa.
Kulimbana ndi Chifuwa Tube
Kukhala ndi chikwama cha chifuwa pamalo pomwe ziri zovuta kwambiri. Pa chifukwa chilichonse mlengalenga kapena madzimadzi apeza phokoso lachisankho, nthawi yomwe akudikira kuti athetse ndi kusadziwa ndi yovuta kwa odwala komanso okondedwa awo. Lankhulani ndi dokotala wanu za malingaliro anu, ndipo funsani kulingalira nthawi yomwe idzasiyidwe m'malo. Khalani wochonderera nokha ndikufunsa mafunso . Mankhwala akusintha ndipo odwala ndi madokotala akugwira ntchito limodzi mofanana kuposa kale pofika pakupanga zisankho zokhudzana ndi chithandizo chamankhwala.
Chitsime:
Deng, B., Qian, K., Zhou, J., Tan, Q., ndi R. Wang. Kukonzekera kwa Thandizo la Chifuwa Kuchipatala Kukonzekera kwa Odwala Matenda a Khansa Pambuyo pa Opaleshoni ya Opaleshoni Yophatikizapo Mavidiyo: A Meta-Analysis and Review Review. World Journal of Surgery . 2017 Mar 13. (Epub patsogolo pa kusindikiza).
National Institute of Health. Medline Plus. Chifuwa chofufuzira chubu. Kusinthidwa 04/13/15. https://medlineplus.gov/ency/article/002947.htm