Ntchito

Zamkati

• Zoyambitsa
• Zinthu zomwe zimayika pachiwopsezo
• Zizindikiro
• Zambiri empyema
• Zovuta zovuta
• Zovuta
• Kuzindikira matenda
• Chithandizo
• Chiwonetsero

Kodi empyema ndi chiyani?

Empyema amatchedwanso pyothorax kapena purulent pleuritis. Ndi mkhalidwe womwe mafinya amasonkhana m'dera pakati pa mapapo ndi mkatikati mwa khoma lachifuwa. Malowa amadziwika kuti malo opembedzera. Mafinya ndi madzimadzi omwe amadzaza ndi maselo amthupi, ma cell akufa, ndi mabakiteriya. Mafinya m'malo opembedzera sangathe kutsokomola. M'malo mwake, imayenera kukhetsedwa ndi singano kapena opaleshoni.

Empyema nthawi zambiri imayamba pambuyo pa chibayo, chomwe ndi matenda am'mapapo.

Zoyambitsa

Empyema imatha kukhala ndi chibayo. Mitundu yambiri ya mabakiteriya imatha kubweretsa chibayo, koma mitundu iwiri yofala kwambiri ndi iyi Mzerechibayo ndipo Staphylococcus aureus. Nthawi zina, empyema imatha kuchitika mutatha kuchitidwa opaleshoni pachifuwa. Zida zamankhwala zimatha kusamutsa mabakiteriya m'kati mwanu.

Malo opembedzera mwachilengedwe amakhala ndimadzimadzi, koma matenda amatha kupangitsa kuti madzi amange mwachangu kuposa momwe angatengere. Madzi amadzimadzi amatenga kachilombo ka bakiteriya kamene kamayambitsa chibayo kapena matenda. Tizilombo toyambitsa matenda timayamba kukula. Zimatha kupangitsa kuti mapapo anu ndi chifuwa chanu zigwirizane ndikupanga matumba. Izi zimatchedwa empyema. Mapapu anu sangathe kukwanira kwathunthu, zomwe zingayambitse kupuma kovuta.

Zinthu zomwe zimayika pachiwopsezo

Choopsa chachikulu chomwe chimayambitsa matendawa ndi chibayo. Empyema imachitika kawirikawiri mwa ana ndi akulu akulu. Komabe, sizachilendo. Mu kafukufuku wina, zidachitika ochepera 1 peresenti ya ana omwe ali ndi chibayo.

Kukhala ndi zinthu zotsatirazi kungakulitsenso mwayi wakudya chifuwa chachikulu:

• bronchiectasis
• Matenda osokoneza bongo (COPD)
• nyamakazi
• uchidakwa
• matenda ashuga
• chitetezo chofooka
• opaleshoni kapena zoopsa zaposachedwa
• chotupa m'mapapo

Zizindikiro

Empyema ikhoza kukhala yophweka kapena yovuta.

Zambiri empyema

Empyema yosavuta imachitika koyambirira kwa matenda. Munthu ali ndi mtundu uwu ngati mafinya akuyenda mwaulere. Zizindikiro za empyema zosavuta ndizo:

• kupuma movutikira
• chifuwa chowuma
• malungo
• thukuta
• kupweteka pachifuwa popuma komwe kumatha kufotokozedwa ngati kubaya
• mutu
• chisokonezo
• kusowa chilakolako

Zovuta zovuta

Mavuto ovuta kumachitika kumapeto kwa matendawa. M'magulu ovuta, kutupa kumakhala kovuta kwambiri. Minofu yotupa imatha kupangika ndikugawana pachifuwa m'ming'alu yaying'ono. Izi zimatchedwa loculation, ndipo ndizovuta kwambiri kuchiza.

Ngati nthendayi ikupitilira kukulirakulira, imatha kubweretsa khungu lolimba pamwamba pa pleura, yotchedwa pleural peel. Tsamba limeneli limalepheretsa mapapo kukula. Opaleshoni imafunika kuti ikonzeke.

Zizindikiro zina zovuta kuzimvetsa ndizo:

• kuvuta kupuma
• kuchepa kwa mawu
• kuonda
• kupweteka pachifuwa

Zovuta

Nthawi zambiri, vuto la empyema yovuta limatha kubweretsa zovuta zovuta kwambiri. Izi zikuphatikizapo sepsis ndi mapapo omwe agwa, otchedwanso pneumothorax. Zizindikiro za sepsis ndi monga:

• malungo akulu
• kuzizira
• kupuma mofulumira
• kuthamanga kwa mtima
• kuthamanga kwa magazi

Mapapu omwe agwa amatha kuyambitsa kupweteka kwadzidzidzi, kwakuthwa pachifuwa komanso kupuma movutikira komwe kumangokulira mukakhosomola kapena kupuma.

Izi zitha kupha. Ngati muli ndi zizindikirozi, muyenera kuyimbira 911 kapena wina azikupititsani kuchipinda chadzidzidzi.

Kuzindikira matenda

Dokotala akhoza kukayikira empyema ngati muli ndi chibayo chomwe sichikulabadira chithandizo. Dokotala wanu atenga mbiri yonse yazachipatala ndikuwunika. Atha kugwiritsa ntchito stethoscope kuti amvetsere phokoso lililonse m'mapapu anu. Dokotala wanu nthawi zambiri amayesa mayesero kapena njira zina kuti atsimikizire matenda ake:

• Ma X-ray pachifuwa ndi ma CT scan adzawonetsa ngati pali madzi mumalo opembedzera.
• Ultrasound pachifuwa chiwonetsa kuchuluka kwa madzimadzi ndi malo ake enieni.
• Kuyezetsa magazi kumatha kuthandizira kuwona kuchuluka kwama cell oyera, kuyang'ana protein yolumikizidwa ndi C, ndikuzindikira mabakiteriya omwe amayambitsa matendawa. Kuwerengera kwa maselo oyera kumatha kukwera mukakhala ndi matenda.
• Pakati pa thoracentesis, singano imayikidwa kumbuyo kwa nthiti yanu kumalo opempha kuti mutenge madzi. Timadzimadzi timayang'aniridwa ndi microscope kuti tione mabakiteriya, mapuloteni, ndi maselo ena.

Chithandizo

Chithandizochi chimathandiza kuchotsa mafinya ndi madzimadzi kuchokera ku pleura ndikuchiza matendawa. Maantibayotiki amagwiritsidwa ntchito pochiza matendawa. Mtundu wa maantibayotiki umadalira mtundu wa mabakiteriya omwe akuyambitsa matendawa.

Njira yomwe amagwiritsira ntchito kukhetsa mafinya imadalira gawo la empyema.

Nthawi zosavuta, singano imatha kulowetsedwa m'malo opumira kukhetsa madzi. Izi zimatchedwa percutaneous thoracentesis.

M'magawo amtsogolo, kapena empyema yovuta, chubu chazinyalala chiyenera kugwiritsidwa ntchito kukhetsa mafinya. Njirayi imachitika nthawi zambiri pochita dzanzi m'chipinda chopangira opaleshoni. Pali mitundu yosiyanasiyana ya opaleshoni ya izi:

Thoracostomy: Pochita izi, dokotala wanu adzaika chubu cha pulasitiki m'chifuwa chanu pakati pa nthiti ziwiri. Kenako amalumikiza chubu ndi chida chokoka ndikuchotsa madzi. Amathanso kubaya mankhwala kuti athandize kukhetsa madziwo.

Opaleshoni ya thoracic yothandizidwa ndi makanema: Dokotala wanu amachotsa minofu yomwe yakhudzidwa ndi mapapo anu ndikuyika chubu kapena kugwiritsa ntchito mankhwala kuti athetse madzimadzi. Adzapanga zochepera zitatu ndikugwiritsa ntchito kamera yaying'ono yotchedwa thoracoscope pochita izi.

Tsegulani zotsegula: Pochita opaleshoniyi, dokotalayo amachotsa khungu lanu.

Chiwonetsero

Chiyembekezo chodwala mwachangu ndichabwino. Kuwonongeka kwakanthawi m'mapapu ndikosowa. Muyenera kumaliza maantibayotiki anu ndikupatsani X-ray yotsatira. Dokotala wanu akhoza kutsimikiza kuti pleura wanu wachira bwino.

Komabe, mwa anthu omwe ali ndi zovuta zina zomwe zimasokoneza chitetezo cha mthupi, empyema amatha kufa ngati 40%.

Ngati sichithandizidwa, empyema imatha kubweretsa zovuta zowopsa monga sepsis.