Zolinga Zomwe Izo Zimatumikira ndi Zimene Zingakhudze Izo
Phokosoli ndilofunikira kwambiri pambali ya kupuma yomwe cholinga chake ndi kusunga mapapu ndikuchepetsa mkangano uliwonse umene ungakhale pakati pa mapapo, nthiti, ndi chifuwa. Kodi chikhalidwe cha pleura ndi chiyani chomwe chimakhudza dera lino la mnyamata?
Makhalidwe a Pleura
Phokosolo limatanthawuza makamaka zigawo ziwiri zomwe zimaphimba mapapo.
Mlengalenga pakati pa makina awiriwa amatchedwa madzi ochulukirapo omwe amadzazidwa ndi madzi ofunda , otentha omwe amatchedwa pleural fluid . Phokosoli liri ndi zigawo ziwiri, zosiyana:
- The visceral pleura ndi nsonga yoonda, yomwe imabisa pamwamba pa mapapo ndi kumangirira m'madera omwe amalekanitsa zosiyana (zotchedwa hilum ).
- Puloetal pleura ndi nsonga ya kunja imene imayendera khoma la mkati mwa chifuwa ndi diaphragm.
Phokoso la visceral ndi parietal likulumikizana pakhomopo la mapapu onse, kumene mabakiteriya aakulu, mitsempha ya pulmonary, ndi mitsempha ya pulmona imalowa m'mapapo.
Ntchito ya Pleura
Mbali ziwiri zomwe zimapanga chitetezo zimatumikira makamaka kuchepetsa kukangana pamene mapapo amakula ndikugwirizanitsa panthawi yopuma. Madzi ochepa pakati pa zigawozi, pafupifupi 4 mpaka 5 cc wa pempho lamadzimadzi, amathandiza kukhala ngati chingwe.
Phokosolo silokhalo lokha la ziwalo zowonjezera thupi.
Pali memphane kuzungulira mtima (pericardium) ndi nembanemba yophimba pamimba (peritoneum) komanso.
Zinthu Zokhudza Pleura
Pogwiritsa ntchito madzi odzola, ziwalozi zimatha kugwirana, zimathandiza kuti mapapu azifutukula panthawi yopuma.
Ngati phokosolo likuwombera, kapena ngati madzi amadzimangirira pakati pa ma membrane, akhoza kulepheretsa kuyenda ndi kusokoneza kupuma.
Pali zinthu zingapo zomwe zingakhudze kwambiri pleura. Ngati kutupa kumaphatikizapo, kupweteka kumakhala kovuta komanso kumverera ndi mpweya uliwonse. Ululu umene umafalikira ndi mpweya wakuya ndipo nthawi zambiri umamva bwino kwambiri umatchedwa "pleuritic" kupweteka pachifuwa.
Pakati pa zochitika za pleura:
- Pleurisy ndi kutukusira kwa zidutswa zamtunduwu zomwe zimakhala zovuta komanso zovuta. Ambiri amayamba chifukwa cha matenda a tizilombo koma amayamba chifukwa cha mabakiteriya ndi matenda omwe amadzimadzimadzimadzi monga rhumumayimakazi ndi lupus . Chisokonezo chomwe chimaphatikizapo pleurisy chimakhala choipa kwambiri pakapita kunja kunja kwa nyengo yozizira.
- Pleural effusion mu kusungunuka kwa madzi owonjezera mu malo opempherera. Izi zikachitika, kupuma kungakhale kovuta. Kusokonezeka mtima kwa mtima kumayambitsa vuto lalikulu, koma pali zifukwa zambiri zomwe zingayambitse. Kuwongolera kwachinyengo kungakhale kochepa kwambiri, ndipo kumawoneka pa masomphenya ojambula monga chifuwa x-ray kapena CT scan, kapena lalikulu, yomwe ili ndi mapaundi angapo a madzi.
- Kupweteketsa mtima kwachinyengo kumatanthauza kugwidwa ndi khansa ya m'mapapu, kapena khansa zina monga khansa ya m'mawere yomwe yafalikira (yowonongeka) kumapapo kuchokera kumbali zina za thupi.
- Pleural mesothelioma ndi khansara ya pleura, imayamba chifukwa cha ntchito ya asbestos.
- Pneumothorax ndi chikhalidwe chomwe mpweya umasonkhanitsa mu chumity. Zikhoza kuyambitsidwa ndi chiwerengero cha zinthu, kuphatikizapo opaleshoni pachifuwa cha chifuwa, ndi COPD . Anthu ena amapanga "pneumothorax" ndipo nthawi zambiri akakhala aang'ono. Kuphatikiza ndi mpweya wochepa, anthu amatha kumva "crepitus" momwe zimamvekera ngati kuphulika kumalo pansi pa khungu la khosi ndi chifuwa.
- Hemothorax imatanthawuza magazi m'magazi okhutira omwe angathe kuchitika pa opaleshoni ya chifuwa kapena kupwetekedwa mtima.
Kuchiza Pleura Kusokonezeka
Kusokonezeka kwa pleura nthawi zina kungakhale chizindikiro chopanda chidziwitso ndi kuthetsa paokha.
Zina zimafuna thandizo lachipatala. Chithandizo chidzadalira makamaka chomwe chimayambitsa vutoli. Ngati kuwonjezeka kwa madzi, magazi, kapena mpweya kumakhudzidwa, chifuwa cha chifuwa chingagwiritsidwe ntchito kuthandizira kuchotsa.
Zing'onozing'ono zopempherera zikhoza kuchoka paokha; zikuluzikulu zidzafunika kuthiridwa. Njira yoyamba imachotsa madzi ndi singano yomwe imatsogoleredwa kudzera mu khungu la chifuwa ndi mchimake (thoracentesis). Kawirikawiri, malingana ndi chifukwa chake, kupweteka kwachinyengo kudzabwereranso, makamaka ngati kuli ndi khansa.
Ndilimbikitsanso mobwerezabwereza zowonjezereka pali zinthu zingapo. Choyamba, thoracentesis ikhoza kubwerezedwa. Ngati chitsimikiziro chachisembwere chidzatuluka, sitepe yotsatira idzadalira chifukwa chomwe chimayambitsa ndi chikhalidwe cha munthuyo ndi chisokonezo chachikulu. Anthu omwe ali ndi thanzi labwino, ndondomeko yotchedwa pleurodesis imachitika nthawi zambiri. Uwu ndi opaleshoni yomwe chinthu chokwiya, monga talc, chimayikidwa pakati pa magawo awiri a pleura. Talc imayambitsa kukwiya ndi kutupa, potsirizira pake zimapangitsa kuti zigawo ziwirizo zigwirizane ndi "kugwiritsidwa" palimodzi, kuti phokoso la pleural lisakhalenso liripo kuti madzi asungunuke.
Ndi khansa, kuthamangitsidwa kwachinyengo nthawi zambiri kumakhudzidwa pafupi kutha kwa moyo. Ngati zili choncho, kathete yosungiramo mankhwala ikhoza kuikidwa pamtanda kuti phokoso likhale lopitirira, kapena nthawi iliyonse yomwe ikupangitsa kuti mpweya ukhale wochepa.
Ngati anthu omwe ali ndi mesothelioma, opaleshoni yotchedwa pleurectomy ikhoza kuchitidwa kuti achotse gawo la pleura kapena pleura kuti ateteze madzi. Amathandizanso dokotalayo kuti achotse zotupa zomwe zapangidwa mkati mwa chifuwa.
> Zosowa
> Batra, H. ndi Antony, V. "Maselo a pleural mesothelial m'matenda achidziwitso ndi mapapo." Journal of Thoracic Disease . 2015; 7 (6): 964-980.
> Bertin, F. ndi a Deslauriers, J. "Anatomy ya Pleura: Zithunzi Zomwe Zimagwiritsidwa Ntchito." Zipatala Zopha Opaleshoni . 2011; 21 (2): 165-171.