Kutulutsa kwa Pleural

Kutulutsa kophatikizika ndikumadzaza kwamadzimadzi pakati pa minofu yomwe imayendetsa mapapo ndi chifuwa.

Thupi limatulutsa madzi amadzimadzi pang'ono kuti muchepetse mawonekedwe a pleura. Imeneyi ndi minofu yopyapyala yomwe imayendetsa chifuwa ndikumazungulira mapapo. Kutulutsa kwa Pleural ndikosazolowereka, kopanda madzi.

Pali mitundu iwiri yachinyengo:

• Kutulutsa kwa transudative pleural kumayambitsidwa ndi madzimadzi omwe amatuluka m'malo opembedzera. Izi zimachokera kukakakamizidwa kowonjezera m'mitsempha yamagazi kapena kuchuluka kwama protein ochepa. Kulephera kwa mtima ndiko chifukwa chofala kwambiri.
• Kutulutsa mopitilira muyeso kumayambitsidwa ndi mitsempha yotsekedwa yamagazi kapena mitsempha yamagulu, kutupa, matenda, kuvulala kwamapapu, ndi zotupa.

Zowopsa zakuwonongeka kwamaphatikizidwe atha kukhala:

• Kusuta ndi kumwa mowa, chifukwa izi zimatha kuyambitsa matenda amtima, mapapo ndi chiwindi, zomwe zimatha kubweretsa kuyimbira
• Mbiri yakukhudzana kulikonse ndi asibesitosi

Zizindikiro zimatha kuphatikizira izi:

• Kupweteka pachifuwa, nthawi zambiri kupweteka kopweteka komwe kumakulirakulira ndi chifuwa kapena kupuma kwambiri
• Tsokomola
• Malungo ndi kuzizira
• Zovuta
• Kupuma mofulumira
• Kupuma pang'ono

Nthawi zina sipakhala zizindikiro.

Wothandizira zaumoyo wanu adzakufunsani ndikufunsani za zomwe mukudwala. Woperekayo amamveranso m'mapapu anu ndi stethoscope ndikudina (kukumenyani) pachifuwa ndi kumtunda.

Kujambula pachifuwa kwa CT kapena chifuwa cha x-ray kungakhale kokwanira kuti wothandizira anu asankhe pa zamankhwala.

Wothandizira anu angafune kuyesa pamadzi. Ngati ndi choncho, madzi ena amachotsedwa ndi singano yolowetsedwa pakati pa nthiti. Kuyesa kwamadzimadzi kudzachitika kuti mufufuze:

• Matenda
• Maselo a khansa
• Mapuloteni
• Kuwerengera kwama cell
• Acidity yamadzi (nthawi zina)

Kuyezetsa magazi komwe kungachitike ndi monga:

• Kuwerengera magazi kwathunthu (CBC), kuti muwone ngati muli ndi matenda kapena kuchepa kwa magazi
• Impso ndi chiwindi zimagwira ntchito kuyesa magazi

Ngati zingafunike, mayeso enawa atha kuchitika:

• Ultrasound yamtima (echocardiogram) kuyang'ana kulephera kwa mtima
• Ultrasound pamimba ndi chiwindi
• Kuyezetsa mkodzo
• Mapapu akuyang'ana khansa
• Kudutsa chubu kupyola pa mphepo kuti muwone momwe mpweya ulili pamavuto kapena khansa (bronchoscopy)

Cholinga cha chithandizo ndi:

• Chotsani madzi
• Pewani madzi kuti asamangidwenso
• Dziwani ndi kuchiza chifukwa cha kuchuluka kwa madzimadzi

Kuchotsa madzimadzi (thoracentesis) kumatha kuchitika ngati pali madzi ambiri ndipo akuyambitsa chifuwa, kupuma pang'ono, kapena mpweya wochepa. Kuchotsa madzimadzi kumalola kuti mapapo akule, ndikupangitsa kupuma mosavuta.

Zomwe zimapangidwira madzi amadzimadzi ziyeneranso kuthandizidwa:

• Ngati zili choncho chifukwa cha kulephera kwa mtima, mutha kulandira ma diuretics (mapiritsi amadzi) ndi mankhwala ena ochizira kulephera kwa mtima.
• Ngati ndi chifukwa cha matenda, maantibayotiki adzaperekedwa.
• Ngati zimachokera ku khansa, matenda a chiwindi, kapena matenda a impso, chithandizo chikuyenera kupita kuzinthu izi.
  

Kwa anthu omwe ali ndi khansa kapena matenda, kutayika kumachiritsidwa nthawi zambiri pogwiritsa ntchito chubu pachifuwa kuti athetse madziwo ndikuchiza chifukwa chake.

Nthawi zina, mankhwala aliwonsewa amachitika:

• Chemotherapy
• Kuyika mankhwala pachifuwa komwe kumalepheretsa madzimadzi kuti abwererenso atatsanulidwa
• Thandizo la radiation
• Opaleshoni

Zotsatira zake zimatengera matenda omwe amabwera.

Zovuta zamankhwala ophatikizika atha kuphatikiza:

• Kuwonongeka kwa mapapo
• Matenda omwe amasanduka abscess, otchedwa empyema
• Mpweya m'chifuwa (pneumothorax) pambuyo pokhetsa madzi
• Pleural thickening (kupweteka kwa mapapo)

Itanani omwe akukuthandizani kapena pitani kuchipinda chadzidzidzi ngati muli:

• Zizindikiro za kuponderezedwa
• Kupuma pang'ono kapena kupuma movutikira pambuyo pa thoracentesis

Madzimadzi pachifuwa; Zamadzimadzi m'mapapu; Pleural madzimadzi

• Mapapo
• Dongosolo kupuma
• Chimbudzi cha Pleural

Malo BK. Thoracentesis. Mu: Roberts JR, Custalow CB, Thomsen TW, olemba., Eds. Ndondomeko Zachipatala za Roberts ndi Hedges mu Emergency Medicine ndi Acute Care. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: chaputala 9.

Broaddus VC, Kuwala RW. Kutulutsa kwa Pleural. 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 79.

Malangizo: McCool FD. Matenda otsekeka, khoma pachifuwa, pleura ndi mediastinum. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 92.