Ntenda yopuma movutikira

Matenda oopsa a kupuma (ARDS) ndimapapo oopsa omwe amapewetsa mpweya wokwanira kuti usalowe m'mapapu ndi magazi. Makanda amathanso kukhala ndi vuto la kupuma.

ARDS imatha kuyambitsidwa ndi vuto lililonse lalikulu mwachindunji kapena mwanjira ina m'mapapu. Zomwe zimayambitsa zimaphatikizapo:

• Kupuma masanzi m'mapapu (aspiration)
• Kupuma mankhwala
• Kuika mapapo
• Chibayo
• Matenda am'madzi (matenda mthupi lonse)
• Zowopsa

Kutengera kuchuluka kwa mpweya m'magazi komanso popuma, kuuma kwa ARDS kumadziwika kuti:

• Wofatsa
• Wamkati
• Kwambiri

ARDS imadzetsa kuchuluka kwamadzimadzi m'matumba amlengalenga (alveoli). Amadzimadzi amenewa amaletsa mpweya wokwanira kuti usadutse m'magazi.

Kukhathamira kwa madzi kumapangitsanso kuti mapapu akhale olemera komanso owuma. Izi zimachepetsa mphamvu yamapapu kukulira. Mulingo wa oxygen m'mwazi ukhoza kukhala wocheperako, ngakhale munthuyo atalandira mpweya kuchokera kumakina opumira (mpweya) kudzera mu chubu chopumira (endotracheal chubu).

ARDS nthawi zambiri imachitika limodzi ndi kulephera kwa ziwalo zina, monga chiwindi kapena impso. Kusuta ndudu komanso kumwa mowa mwauchidakwa zitha kukhala pachiwopsezo pakukula kwake.

Zizindikiro nthawi zambiri zimayamba mkati mwa 24 mpaka 48 maola ovulala kapena matenda. Kawirikawiri, anthu omwe ali ndi ARDS amadwala kwambiri moti sangathe kudandaula za zizindikiro. Zizindikiro zimatha kuphatikizira izi:

• Kupuma pang'ono
• Kugunda kwamtima
• Kuthamanga kwa magazi ndi kulephera kwa ziwalo
• Kupuma mofulumira

Kumvetsera pachifuwa ndi stethoscope (auscultation) kumawulula phokoso lachilendo, monga mabakiteriya, omwe atha kukhala zizindikilo zamadzimadzi m'mapapu. Nthawi zambiri, kuthamanga kwa magazi kumakhala kotsika. Cyanosis (khungu labuluu, milomo, ndi misomali yoyambitsidwa ndi kusowa kwa mpweya kumatumba) imawonekera nthawi zambiri.

Mayeso omwe amagwiritsidwa ntchito pozindikira ARDS ndi awa:

• Magazi amitsempha yamagazi
• Kuyesa magazi, kuphatikiza CBC (kuwerengera kwathunthu magazi ndi zama chemistry zamagazi
• Zikhalidwe zamagazi ndi mkodzo
• Bronchoscopy mwa anthu ena
• X-ray pachifuwa kapena CT scan
• Chikhalidwe cha sputum ndikuwunika
• Kuyesedwa kwa matenda omwe angakhalepo

Echocardiogram ingafunike kuthana ndi kulephera kwa mtima, komwe kumawoneka kofanana ndi ARDS pachifuwa cha x-ray.

ARDS nthawi zambiri amafunika kuthandizidwa kuchipatala (ICU).

Cholinga cha chithandizo ndikuthandizira kupuma ndikuchiza zomwe zimayambitsa ARDS. Izi zitha kuphatikizira mankhwala ochizira matenda, kuchepetsa kutupa, ndikuchotsa madzi m'mapapu.

Mpweya wabwino umagwiritsidwa ntchito popereka mpweya wokwanira komanso kuthamanga kwa mapapo owonongeka. Nthawi zambiri anthu amafunika kukhala okhazikika pamankhwala. Mukamalandira chithandizo, othandizira azaumoyo amayesetsa kuteteza mapapu kuti asawonongeke. Chithandizo chake chimamuthandiza mpaka mapapo amachira.

Nthawi zina, mankhwala otchedwa extracorporeal membrane oxygenation (ECMO) amachitika. Pakati pa ECMO, magazi amapopedwa kudzera mumakina kuti apereke mpweya komanso kuchotsa mpweya woipa.

Achibale ambiri a anthu omwe ali ndi ARDS ali pamavuto akulu. Nthawi zambiri amatha kuthana ndi mavutowa polowa m'magulu othandizira omwe mamembala amagawana zomwe amakumana nazo pamavuto.

Pafupifupi gawo limodzi mwa atatu mwa anthu omwe ali ndi ARDS amamwalira ndi matendawa. Anthu omwe amakhala ndi moyo nthawi zambiri amabwerera m'mapapo, koma anthu ambiri amakhala ndi vuto lamapapo (nthawi zambiri).

Anthu ambiri omwe amapulumuka ARDS amakumbukirabe kapena mavuto ena azaumoyo atachira. Izi zimachitika chifukwa cha kuwonongeka kwaubongo komwe kumachitika pomwe mapapo sanali kugwira bwino ntchito komanso ubongo sunapeze mpweya wokwanira. Anthu ena amathanso kukhala ndi nkhawa atapanikizika ndi ARDS.

Mavuto omwe angabwere chifukwa cha ARDS kapena chithandizo chake ndi awa:

• Kulephera kwa ziwalo zambiri zamagulu
• Kuwonongeka kwa mapapo, monga mapapu omwe agwa (omwe amatchedwanso pneumothorax) chifukwa chovulala kuchokera pamakina opumira amafunikira kuchiza matendawa
• Pulmonary fibrosis (kupweteka kwa m'mapapo)
• Chibayo chokhudzana ndi mpweya wabwino

ARDS nthawi zambiri imachitika panthawi ina yamatenda, yomwe munthu amakhala kale mchipatala. Nthawi zina, munthu wathanzi amakhala ndi chibayo chachikulu chomwe chimakulirakulira ndikukhala ARDS. Ngati zikukuvutani kupuma, itanani nambala yanu yadzidzidzi (monga 911) kapena pitani kuchipinda chadzidzidzi.

Noncardiogenic m'mapapo mwanga edema; Kuchuluka-permeability m'mapapo mwanga edema; ARDS; Kuvulala kwamapapo

• Chimfine ndi chimfine - zomwe mungafunse dokotala wanu - wamkulu
• Chimfine ndi chimfine - zomwe mungafunse dokotala - mwana
• Mwana wanu wakhanda akatentha thupi

• Mapapo
• Dongosolo kupuma

Lee WL, Slutsky AS. Pachimake hypoxemic kupuma kulephera ndi ARDS. 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 100.

Matthay MA, Ware LB. Pachimake kupuma kulephera. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 96.

Seigel TA. Mawotchi mpweya wabwino ndi chithandizo chosagwira mpweya. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 2.