Subcutaneous emphysema

Subcutaneous emphysema imachitika pamene mpweya umalowa m'minyewa pansi pa khungu. Izi zimachitika pakhungu ndikuphimba pachifuwa kapena m'khosi, komanso zimatha kuchitika mbali zina za thupi.

Subcutaneous emphysema nthawi zambiri imawoneka ngati khungu losalala. Wothandizira zaumoyo akamva (palpates) khungu, limatulutsa chidwi chosazolowereka (gasi) pamene mpweya umakankhidwa kudzera mu minofu.

Izi ndizosowa. Zikachitika, zomwe zingayambitse zimaphatikizapo:

• Mapapo omwe agwa (pneumothorax), omwe nthawi zambiri amapezeka ndi nthiti yophulika
• Kuthyoka mafupa nkhope
• Kung'ambika kapena kung'amba panjira
• Kung'ambika kapena kung'amba m'mimba kapena m'mimba

Izi zitha kuchitika chifukwa cha:

• Kupwetekedwa kopanda pake.
• Kuvulala kwaphulika.
• Kupuma kokeni.
• Zowononga kapena kuwotcha kwamankhwala kwam'mero ​​kapena njira yapaulendo.
• Kuvulala pamadzi.
• Kusanza kwamphamvu (Boerhaave syndrome).
• Zowawa zopitilira muyeso, monga kuwomberedwa ndi mfuti kapena mabala obaya.
• Pertussis (chifuwa chachikulu).
• Njira zina zamankhwala zomwe zimayika chubu mthupi. Izi zimaphatikizapo endoscopy (chubu cholowa m'mimba ndi m'mimba kudzera pakamwa), mzere wapakati (venous catheter mumtsinje pafupi ndi mtima), endotracheal intubation (chubu mummero ndi trachea kudzera mkamwa kapena mphuno), ndi bronchoscopy (chubu mumachubu za bronchial kudzera pakamwa).

Mpweya ukhozanso kupezeka pakati pa zigawo za khungu pamanja ndi miyendo kapena torso pambuyo pa matenda ena, kuphatikiza mpweya wambiri, kapena pambuyo pa kusambira pamadzi. (Anthu osuta masewera olimbitsa thupi omwe ali ndi mphumu amatha kukhala ndi vuto ili kuposa ena osambira.)

Zambiri mwazomwe zimayambitsa matenda am'mimba otchedwa emphysema ndizovuta, ndipo mwina mukukuthandizani kale. Nthawi zina kumakhala kuchipatala kumafunikira. Izi ndizotheka ngati vuto limabwera chifukwa cha matenda.

Ngati mukumva mpweya wocheperako poyerekeza ndi zina mwazomwe tafotokozazi, makamaka pambuyo povulala, imbani foni ku 911 kapena nambala yantchito zadzidzidzi nthawi yomweyo.

Osapereka madzi aliwonse. Musamusunthire munthu pokhapokha ngati pakufunika kuti muwachotse m'malo owopsa. Tetezani khosi ndi msana kuti musavulazidwe pochita izi.

Woperekayo ayesa ndikuwunika zofunikira za munthuyo, kuphatikiza:

• Kukhuta kwa oxygen
• Kutentha
• Kugunda
• Kupuma
• Kuthamanga kwa magazi

Zizindikiro zidzathandizidwa pakufunika. Munthuyo akhoza kulandira:

• Ndege komanso / kapena kupuma - kuphatikiza mpweya kudzera pa chida chobwerekera kunja kapena endotracheal intubation (kuyika kwa chubu lopumira mkamwa kapena mphuno kulowa mlengalenga) ndikuyikapo makina opumira (makina opumira moyo)
• Kuyesa magazi
• Chubu pachifuwa kudzera pakhungu ndi minofu pakati pa nthitiyo kulowa m'malo opembedzera (danga pakati pa khoma la chifuwa ndi mapapo) ngati mapapo agwa
• Kujambula kwa CAT / CT (kompyuta axial tomography kapena kulingalira bwino) pachifuwa ndi pamimba kapena malo okhala ndi mpweya wochepa
• ECG (electrocardiogram kapena kutsata mtima)
• Zamadzimadzi kudzera mumtsempha (IV)
• Mankhwala ochizira matenda
• X-ray ya pachifuwa ndi pamimba ndi ziwalo zina za thupi zomwe mwina zavulala

Kulosera kumatengera chifukwa cha emphysema wocheperako. Ngati zikugwirizana ndi zoopsa zazikulu, njira kapena matenda, kuopsa kwa mikhalidweyo kumatsimikizira zotsatira zake.

Ma emphysema amtundu wa subcutaneous ogwirizana ndi kusambira pansi pamadzi nthawi zambiri amakhala ocheperako.

Crepitus; Subcutaneous mpweya; Minofu emphysema; Opyma ya opaleshoni

Wolemba Byyny RL, Shockley LW. Kusambira pamadzi ndi dysbarism. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 135.

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.

[Adasankhidwa] Kosowsky JM, Kimberly HH. Matenda a Pleural. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chap 67.

Raja AS. Zoopsa Thoracic. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 38.