Kodi Broncopleural Fistula ndi chithandizo chotani?

Zamkati

• Zomwe zimayambitsa bronchopleural fistula
• Momwe mungadziwire
• Momwe mankhwalawa amachitikira

Bronchopleural fistula imafanana ndi kulumikizana kwachilendo pakati pa bronchi ndi pleura, yomwe ndi nembanemba iwiri yomwe imayendetsa mapapu, zomwe zimapangitsa kuti mpweya usayende bwino komanso umakhala wochulukirapo pambuyo pa opaleshoni yamapapo. Bronchopleural fistula nthawi zambiri imadziwika ndi zizindikilo ndi zizindikilo zomwe zimaperekedwa ndi mayiyo komanso kuyerekezera kwa kujambula, monga chifuwa cha radiology ndi bronchoscopy.

Izi ndizosowa komanso zowopsa, makamaka zikachitika mwa ana, ndipo ziyenera kuthetsedwa mwachangu kuti asaike moyo wa munthu pachiwopsezo. Chifukwa chake, ndikofunikira kuti atachita opareshoni yam'mapapo kapena ngati munthuyo ali ndi vuto lililonse la kupuma, amayesedwa kuti awone ngati pali kusintha kulikonse ndipo ngati kuli kofunikira, ayambe kulandira chithandizo.

Zomwe zimayambitsa bronchopleural fistula

Bronchopleural fistula imakhudzana kwambiri ndi opaleshoni yamapapu, makamaka lobectomy, momwe mapapo amachotsedwa, ndi pneumonectomy, pomwe mbali imodzi yamapapo imachotsedwa. Kuphatikiza apo, ndizofala kuti bronchopleural fistula ichitike chifukwa cha matenda opatsirana, omwe, chifukwa chakupezeka kwa tizilombo toyambitsa matenda, kufa kwa minofu kumachitika. Zina mwazomwe zimayambitsa bronchopleural fistula ndi:

• Chibayo, chifuwa chomwe chimawerengedwa kuti ndi vuto la matendawa, makamaka chifukwa cha bowa kapena mabakiteriya amtunduwu Mzere;
• Khansa ya m'mapapo;
• Pambuyo pa chemotherapy kapena radiation radiation;
• Kuphatikizana kwa mapapu;
• Kusuta fodya;
• Matenda osokoneza bongo;
• Mawotchi mpweya.

Ndikofunikira kuti chifukwa cha bronchopleural fistula chizindikiridwe kotero kuti mankhwala oyenera ayambike ndipo zovuta zimapewa, monga kuvuta kwa kupuma, kufalikira kosakwanira kwa mapapu, zovuta kusunga mpweya mu pulmonary alveoli ndi imfa.

Momwe mungadziwire

Matenda a bronchopleural fistula amapangidwa ndi dokotala kapena pulmonologist pogwiritsa ntchito mayeso oyerekeza, monga chifuwa cha radiology, momwe atelectasis imatha kuwonekera, zomwe sizomwe zimadutsa mpweya kupita kudera lina lamapapo, kugwa, kapena gulu la m'mapapo mwanga. Kuphatikiza pa ma radiography, adotolo amayenera kupanga bronchoscopy, momwe chubu chaching'ono chimayikidwa kudzera m'mphuno kuti mawonekedwe am'mapapo aziwoneka, komanso komwe fistula ndi kukula kwake zitha kudziwika bwino.

Kuphatikiza apo, adotolo amayenera kuwunika zizindikilo za munthuyo, monga kukhosomola magazi kapena ntchofu, kupuma movutikira ndi malungo, kukhala wamba kuzindikirika pambuyo pochita maopareshoni am'mapapo, omwe zizindikilo zawo zimawoneka patadutsa milungu iwiri kutengera ..

Chifukwa chake, ndikofunikira kuti atachita opaleshoni yopuma, munthu amayang'aniridwa pafupipafupi ndi dokotala kuti apewe mapangidwe a fistula ndi zovuta zawo.

Momwe mankhwalawa amachitikira

Chithandizo cha bronchopleural fistula chimasiyanasiyana malinga ndi chomwe chimayambitsa, mbiri yachipatala yamunthuyo ndi zizindikilo ndi zizindikilo zomwe zimaperekedwa. Nthawi zambiri, chithandizochi chimakhala chikuchita opaleshoni kuti athetse fistula, komabe ndizotheka kuti patapita kanthawi fistula ipezekanso. Kuchita opaleshoni nthawi zambiri kumalimbikitsidwa ngati chithandizo chamankhwala sichikhala chofunikira, pakakhala zikwangwani zosonyeza sepsis kapena pakatuluka mpweya.

Chithandizo chodziletsa chimakhala ndi ngalande yamadzi am'madzi, mpweya wabwino, chithandizo chamagulu ndi kugwiritsa ntchito maantibayotiki, ndipo njira yothandizirayi imafala kwambiri ngati bronchopleural fistula imachitika chifukwa cha matenda. Komabe, ngalande yamadzi amtunduwu imathandizanso kupangika kwa fistula watsopano. Chifukwa chake, chithandizo cha vutoli chimawerengedwa kuti ndi chovuta pamankhwala ndipo mosasamala kanthu za chithandizo chovomerezeka, ndikofunikira kuti munthuyo ayang'anitsidwe pafupipafupi kuti athe kuwunika momwe achire akuchitira komanso kufunikira kwachitetezo chatsopano.

Njira yatsopano yochiritsira yomwe yaphunziridwa ndikuyika masenchymal stem cell mu bronchopleural fistula, omwe ndi maselo omwe amatha kupanganso minofu ndipo, chifukwa chake, amatha kuvomereza fistula. Komabe, sizikudziwika momwe maselowa amagwirira ntchito pokonza fistula ndipo sangakhale ndi zotsatirapo zofanana kwa anthu onse. Chifukwa chake, maphunziro owonjezera amafunikira kuti atsimikizire momwe mankhwala amtunduwu amathandizira pa fistula ya bronchopleural.