Mediastinitis

Mediastinitis ndikutupa ndi kukwiya (kutupa) kwa chifuwa pakati pa mapapo (mediastinum). Dera ili lili ndi mtima, mitsempha yayikulu yamagazi, chopumira (trachea), chubu cha chakudya (esophagus), thymus gland, ma lymph node, ndi minofu yolumikizana.

Mediastinitis nthawi zambiri amachokera ku matenda. Zitha kuchitika modzidzimutsa (pachimake), kapena zimatha kukula pang'onopang'ono ndikuwonjezeka pakapita nthawi. Nthawi zambiri zimachitika ndimunthu yemwe posachedwapa adachitidwa opaleshoni yaposachedwa kapena yapachifuwa.

Munthu amatha kukhala ndi misozi m'mimba mwawo yomwe imayambitsa mediastinitis. Zomwe zimayambitsa misozi ndizo:

• Njira monga endoscopy
• Kusanza mwamphamvu kapena kosalekeza
• Zowopsa

Zina mwa zifukwa za mediastinitis ndizo:

• Matenda a fungal otchedwa histoplasmosis
• Mafunde
• Kutupa kwa ma lymph node, mapapo, chiwindi, maso, khungu, kapena ziwalo zina (sarcoidosis)
• Matenda a chifuwa chachikulu
• Kupuma mu anthrax
• Khansa

Zowopsa ndi izi:

• Matenda am'mimba
• Matenda a shuga
• Mavuto kumtunda kwa m'mimba
• Opaleshoni yaposachedwa pachifuwa kapena endoscopy
• Kufooka kwa chitetezo cha mthupi

Zizindikiro zimaphatikizapo:

• Kupweteka pachifuwa
• Kuzizira
• Malungo
• Zovuta zonse
• Kupuma pang'ono

Zizindikiro za mediastinitis mwa anthu omwe achita opaleshoni yaposachedwa ndi awa:

• Chikondi cha pachifuwa
• Ngalande ngalande
• Khoma lachifuwa losakhazikika

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zidziwitso ndi mbiri yazachipatala.

Mayeso atha kuphatikiza:

• Chest CT scan kapena MRI scan
• X-ray pachifuwa
• Ultrasound

Wothandizirayo akhoza kuyika singano m'dera la kutupa. Izi ndikuti mupeze choyimira choti mutumizire banga la gramu ndi chikhalidwe kuti mudziwe mtundu wa matendawa, ngati alipo.

Mutha kulandira maantibayotiki ngati muli ndi matenda.

Mungafunike kuchitidwa opaleshoni kuti muchotse malo otupa ngati mitsempha yamagazi, mphepo yamkuntho, kapena kholingo yatsekedwa.

Momwe munthu amachitira bwino zimadalira chifukwa komanso kuopsa kwa mediastinitis.

Mediastinitis pambuyo pochita opaleshoni pachifuwa ndiwovuta kwambiri. Pali chiopsezo chofa chifukwa cha vutoli.

Zovuta zimaphatikizapo izi:

• Kufalikira kwa kachiromboka m'magazi, mitsempha, mafupa, mtima, kapena mapapo
• Zosokoneza

Kukhwimitsa kumatha kukhala koopsa, makamaka ngati kuyambitsidwa ndi matenda a mediastinitis. Kukhazikika kumatha kusokoneza ntchito yamtima kapena yamapapo.

Lumikizanani ndi omwe amakupatsani ngati mwachitidwa opareshoni pachifuwa ndikupanga:

• Kupweteka pachifuwa
• Kuzizira
• Kutuluka kwa bala
• Malungo
• Kupuma pang'ono

Ngati muli ndi matenda am'mapapo kapena sarcoidosis ndipo mukukumana ndi izi, onani omwe akukuthandizani nthawi yomweyo.

Pochepetsa chiopsezo chokhala ndi mediastinitis yokhudzana ndi opareshoni pachifuwa, zilonda zamankhwala ziyenera kukhala zoyera komanso zowuma mukatha opaleshoni.

Kuchiza chifuwa chachikulu, sarcoidosis, kapena zovuta zina zomwe zimakhudzana ndi mediastinitis zitha kupewa izi.

Matenda pachifuwa

• Dongosolo kupuma
• Mediastinum

Cheng GS, Varghese TK, Park DR. Pneumomediastinum ndi mediastinitis. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 84.

Van Schooneveld TC, Rupp INE. Mediastinitis. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 85.