Kodi ngati madzimadzi mu M'mimbamo pleural: Amachititsa ndi Chithandizo

Ngati m'dera pleural ayamba kudziunjikira madzimadzi (effusion), ndiye chikhalidwe chotere kwambiri pathological zingasonyeze kuti thupi akufotokozera ena matenda ndi woopsa kwambiri. Matenda kudwala m'njira zosiyanasiyana, kenako dokotala n'kukulemberani mankhwala oyenera.

Nthawi zina, kudzikundikira madzi ngati lingachititse decompensation kupuma kulephera, zimayambitsa imfa. Komanso, matenda limodzi ndi mavuto aakulu kwambiri. Choncho, chithandizo cha matenda ayenera anayamba posachedwapa.

zambiri

mapapo anthu amacheza ndi nembanemba awiri, wotchedwa pleura. Akunja akulowa chifuwa khoma ndipo mkati - kwa mapapo ndi zimakhala ena. kusiyana A aumbike pakati pawo, chotchedwa pleural M'mimbamo kapena maganizo.

Free madzimadzi mu machitidwe pleural patsekeke chigawo chimodzi lubricating pamalo pleural, kulola zigawo pa kupuma momasuka Wopanda wina ndi mnzake. Izi zimachitika mavuto padziko, zimene zimathandiza kusunga padziko phapo pamodzi ndi khoma la pachifuwa. Kuchuluka kwa madzimadzi mu M'mimbamo pleural ayenera kukhala masupuni a tiyi 4. Ngati chifukwa cha matenda ayamba kudziunjikira, buku ake angafikire malita 5-6.

Madzimadzi atasunga M'mimbamo pleural akhoza zosiyanasiyana:

• magazi, pleural ngati ziwiya kuonongeka;
• sanali yotupa chikhalidwe cha madzimadzi (transudate);
• mafinya kapena madzimadzi nawo mu kutupa pleural (exudate).

Kudzikundikira magazi zambiri kumachitika chifukwa cha kuwonongeka kwa mitsempha, lomwe limapezeka mu ngozi. Lymph akulowa pleural M'mimbamo pamene kuvulala kwa ritsa thoracic, ndilo lalikulu lymph chotengera.

Transudate akhoza kudziunjikira mu M'mimbamo aliyense ngati thupi mwadongosolo poyera kuti ndondomeko iliyonse dongosolo. Mwachitsanzo, angakhale kuchepetsa kuthamanga kwa magazi chifukwa kutaya magazi chachikulu, kapena amayaka. Komanso, pamaso pa transudate mu M'mimbamo pleural zimawonedwa ngati mu zotengera kumawonjezera kuthamanga hydrostatic chimene chili cholephera mtima.

Madzimadzi mu M'mimbamo pleural, makamaka exudate amasonkhana yotupa ndondomeko. Izi zikhoza kukhala chibayo, khansa, pleurisy.

zifukwa

The madzi atasunga M'mimbamo pleural, - matenda kuti ndi sekondale. Izi zikutanthauza kuti chitukuko cha matenda kumachitika pa maziko a loyenda mu thupi la matenda ena.

Ndi chiyani icho? Kodi tchimo, ngati madzimadzi atasunga M'mimbamo pleural? zifukwa motere:

• Pachifuwa zoopsa, chifukwa mu zotengera wosweka magazi, oyenerera pakati pa nthiti. Lusoli kuchitika thoracic ritsa chophukacho.
• M'mimba matenda, yotupa chikhalidwe cha Azidziwa. Exudate ayamba kudziunjikira poyankha abscess chiwindi, kapamba, subdiaphragmatic abscess, peritonitis.
• matenda Oncological bwanji pleura, osati monga cholinga chachikulu, koma mu mapangidwe metastases. zotupa chachikulu uka kwa maselo a mesothelium ndi kukumana anthu ntchito ku makampani asibesitosi. Kulosera tsogolo la matenda akumane choncho. Ngati chotupa ndi mtima wabwino kuti madokotala ananena zawo zambiri N'zolimbikitsa.
• Mtima kulephera, zomwe zimathandiza kuti magazi.
• Chibayo. The ndondomeko yotupa akhoza kutenga malo onse mu kuya kwa m'mapapo parenchyma ndi pleura pafupi ndithu kuti amakwiya yotupa madzimadzi kudzikundikira.
• Opatsirana ndi matupi awo sagwirizana matenda.
• TB.
• Myxedema (mucosal edema) cimabwela kupanda chithokomiro ntchito.
• M'mapapo mwanga embolism syndrome mitsempha pamene pali mapangidwe infarction m'mapapo mwanga ndi kudzikundikira wotsatira wa transudate.
• Uremia, kunachitika kulephera aimpso. Chotero boma ndi khalidwe la angapo kulephera limba, glomerulonephritis, sepsis, haemolysis yaikulu ya maselo ofiira, cheza matenda.
• Zokhudza zonse connective matenda minofu: periarteritis nodosa, zokhudza zonse lupus erythematosus, lomwe ndi chifukwa kudzikundikira exudate.

zizindikiro

Kaya chifukwa panali kudzikundikira madzimadzi mu M'mimbamo pleural, kupuma kulephera angagwe. Umaonekanso motere:

• ululu kumanzere kapena kumanja;
• dyspnea, kufupika kwa mpweya;
• youma chifuwa, kumene kumachitika chifukwa psinjika wa bronchi buku lalikulu la madzi;
• miyendo bluish chifukwa chosowa mpweya;
• kuonjezera kutentha thupi chifukwa ndondomeko yotupa.

Tiyeni tione mwatsatanetsatane zizindikiro onena kudzikundikira madzimadzi mu M'mimbamo pleural ku matenda ena.

kuvulazidwa

Pachifuwa zoopsa kapena m'mapapo kumabweretsa chitukuko mofulumira insufficiency kupuma. Motero hemoptysis, pakamwa foamy sputum limapezeka chofiira. Wakhala kuphwanya kutsitsimuka, khungu amakhala bluish kulocha, munthu ukhoza kugwera mu chikomokere.

Pa chophukacho wa magazi thoracic msempha umayamba kuyenda mu M'mimbamo pleural, zikubweretsa imfa magazi ndi hemorrhagic mantha. Sungani munthu kovuta.

matenda Oncological

Mu chochitika cha kukhalapo Mesothelioma madzimadzi mu M'mimbamo pleural ndi chomaliza mu chitukuko cha zotupa. Tikhoza kunena motsimikiza kwambiri kuti imfa adzafika miyezi 7-10. Madzimadzi a matenda amenewa yodziwika ndi kuchepa lakuthwa mu mlingo wa shuga mu izo, kukhuthala asidi hyaluronic, ndipo ambiri zambiri wamagazi.

chibayo

Zizindikiro zotsatirazi chibayo zisonyeza kuti ndondomeko pathological chikuchitika mu m'mapapo parenchyma:

• malungo;
• yonyowa chifuwa;
• ululu kobwereza mu mbali yake;
• kufupika kwa mpweya;
• crackles;
• aakulu kuledzera.

kulephera mtima

The anapeza madzimadzi mu M'mimbamo pleural zoopsa mtima kumaonekera motere:

• kufooka;
• kutopa;
• mtima akuyamba ntchito intermittently;
• wosafuna ntchito thupi;
• chifuwa ululu.

diagnostics

Kwambiri nkhani matenda njira imatengedwa pachifuwa radiography, zimathandiza kutsimikizira pamaso pa kudwala monga syndrome madzimadzi mu M'mimbamo pleural, kapena sanamwe. Izi kwakukulukulu facilitates ntchito dokotala poika mankhwalawa. Radiographs molondola amapereka mlingo wa madzi ndi pafupifupi buku lake, kukhalapo ndi kusapezeka kwa mpweya.

M'pofunikanso kudziwa chikhalidwe cha effusion, ndi zitheke, ndi puncture imagwiridwa. Chifukwa chaichi, okhutira madzi otengedwa M'mimbamo pleural kuti kuzindikira chiŵerengero cha kuchuluka kwa mapuloteni, kulemera yeniyeni, ntchito ya dehydrogenase lactate. Kugwira mbewu pa bowa, mabakiteriya asidi-kudya tizilombo. madzimadzi akhoza kukhala magazi, mafinya serosa. Kudzikundikira madzimadzi mu magazi zimawonedwa mu nsautso, m'mnyewa wamtima odwala khansa ya m'mapapo ndi okhudzidwa pleural. Purulent exudate amasonkhana kulephera mtima, ndipo serous - pambuyo matenda opatsirana.

Ndi njira yabwino udzakhalire mapapo ndi chifuwa CT jambulani imatengedwa. limathandiza kwagona kuti ndondomeko amalola kuti molondola kudziwa kuchuluka kwa madzi anamasulidwa ndi operewera. Pulmonologists analimbikitsa amathera CT aone miyezi sikisi iliyonse. Ichi chizathandiza chizindikiritso cha kudzikundikira madzimadzi mu pleural syndrome patsekeke.

chithandizo

Ndi kudzikundikira pang'ono madzimadzi kuchitiridwa yekha zakuya matenda. A ambiri effusion, makamaka ngati amakwiya wheezing amene amafuna ngalande kuthetsa matenda. Kawirikawiri madzi linanena bungwe kudzera puncture, pamene pleural M'mimbamo catheter kapena singano yaing'ono. Kawirikawiri, needling ikuchitika zolinga matenda, koma pa ndondomeko n'zotheka kutulutsa mpaka 1.5 malita effusion. More Chotsani ali osavomerezeka, monga chiopsezo edema m'mapapo mwanga zimachitika.

Kuchotsa atasunga wambirimbiri madzimadzi pamtima khoma mwa chubu wake umayamba. Ndondomeko ikuchitika motere: dokotala ochititsa dzanzi amachita ndi ang'ambe thupilo ndipo amaika chubu pulasitiki pakati pa mbali ziwiri za chifuwa. Pambuyo pake, zikugwirizana kuti dongosolo ngalande, amene salola mpweya kulowa M'mimbamo pleural. Kugwiritsa X-ray ulamuliro Katswiri n'chakuti zolondola unsembe chubu, kuyambira ngalande si payekha.

Ngati madzimadzi mu M'mimbamo pleural anapeza chifukwa TB kapena coccidioidomycosis, mu nkhani iyi, pamafunika yaitali chithandizo ndi mankhwala. Ngalande kugwira zovuta pansi mafinya kwambiri viscous, kapena pamene ali fibrous "m'thumba", choncho zinthu zimene tiyenera tikonze yekha ndi kuchotsa mbali ina ya nthiti kwa oyamba lalikulu ngalande catheter. Kawirikawiri ntchito chofunika kuchotsa wosanjikiza kunja kwa pleura lapansi.

Chotupa Pleural tidzapeze chakuti madzi ayamba kudziunjikira mu M'mimbamo pleural. Chithandizo mu nkhani iyi ndi yaitali ndithu, monga zingakhale zovuta kuthetsa exudate chifukwa kudzikundikira ake mofulumira. Adza kwa ngalande chithandizo ndi kulandira mankhwala anticancer. Komabe, ngati njira zimenezi si ntchito, ndi madzi akupitiriza kudziunjikira, pawekha ikuchitika pleural patsekeke. Buku lonse la exudate amachotsedwa mwa chubu, kenako mu pleural M'mimbamo therethrough kutumikiridwa irritant, monga talc kapena doxycycline njira. Ndi amenewa nzothandiza amapezeka jointing zigawo ziwiri pleural, ndipo palibe malo ufulu kudzikundikira madzi.

Ngati M'mimbamo pleural ladzala ndi mwazi, mpaka magazi anayima, ikuchitika mwa chubu ngalande amene amagwiranso ntchito kwa utsogoleli wa mankhwala kuphwanya magazi kuundana. Sikumatha magazi kapena kulephera kuchotsa madzimadzi kudzera catheter wa - zikuonetsa kuti alowererepo pa opaleshoni.

zosokonezeka

Atasunga M'mimbamo pleural wa madzimadzi, makamaka zambiri, kungachititse kuti khamu matendawo. Iwo akhoza kukhala pachimake m'mapapo mwanga insufficiency, kutupa ndi matenda a chiyambi m'mapapo, mavuto ndi ntchito chiwindi, mtima ndi ziwalo zina za m'kati.

Popeza madzi ndi mafinya ndi Mwina mkulu wa kufalitsa mwa zonse m'mimba, tiyenera kuyembekezera kwa matenda thirakiti m'mimba. Mtundu wa exudate anasonkhanitsa m'dera pleural chinthu, zimayambitsa imfa kapena kulumala kulandira munthu. Izi zikugwirizana ndi kufunika resection a kapamba kapena ndulu.

mavuto amenewa angayambe amuna ndi akazi a misinkhu yonse, kotero chithandizo ayenera anayamba mwamsanga ndi kugwiritsa ntchito njira zodzitetezera.

kupewa

Kupewa pakutchulidwa matenda zomwe zingachititse kudzikundikira madzimadzi mu M'mimbamo pleural, iwo ayenera mwamsanga ankachitira. Ngati mankhwala mankhwala kapena opaleshoni inayenda bwino, kusuntha kuti zochita zina. Izi zikhoza kukhala kusiyiratu makhalidwe oipa, wathanzi moyo, kutenga maofesi vitamini ndi wolemera zigawo zothandiza mankhwala.

zodzitetezera kuyenera kuphatikizapo ulemu zolimbitsa thupi ndi kudya zakudya zapadera. Kodi kudyedwa tsiku ndi tsiku ngati kuli kotheka, zipatso ndi ndiwo zamasamba, mapuloteni zachilengedwe, chakudya, mafuta, nyama. Madokotala amalangiza kuchita Zochita tsiku lililonse, kuzimitsidwa ndi kuyenda kwambiri wapansi. Njira imeneyi ndi kupewa matenda 100% ogwira.

Pomaliza

Chotero kodi ngati madzi ndi wapezeka mu M'mimbamo pleural? Chifukwa chikhalidwe chotere pathological ndi chitukuko cha matenda, nthawi zambiri zoopsa ndithu. Nthawi zina, matenda anatuluka kungachititse kuti imfa. Onetsetsani kuti kukaonana ndi katswiri, amene pambuyo miyeso matenda adzamuika yoyenera ndi woyenera chithandizo. Pofuna kupewa chitukuko cha kupewa matenda ayenera kutsatiridwa.