Pneumomediastinum

Zamkati

• Zomwe zimayambitsa komanso zoopsa
• Zizindikiro
• Matendawa
• Chithandizo ndi kasamalidwe
• Pneumomediastinum m'mwana wakhanda
• Chiwonetsero

Chidule

Pneumomediastinum ndi mpweya pakati pa chifuwa (mediastinum).

Mediastinum imakhala pakati pa mapapo. Lili ndi mtima, thymus gland, ndi gawo lina la kholingo ndi trachea. Mpweya ukhoza kutsekerezedwa mderali.

Mpweya umatha kulowa mu mediastinum kuchokera kuvulala, kapena kutuluka m'mapapu, trachea, kapena kummero. Pneumomediastinum yodzidzimutsa (SPM) ndi mawonekedwe amikhalidwe yomwe ilibe chifukwa chodziwikiratu.

Zomwe zimayambitsa komanso zoopsa

Pneumomediastinum imatha kuchitika kukakamizidwa kukwera m'mapapu ndikupangitsa matumba amlengalenga (alveoli) kuphulika. Chifukwa china chomwe chingakhale chifukwa cha kuwonongeka kwa mapapo kapena zinthu zina zapafupi zomwe zimalola mpweya kulowa pakati pa chifuwa.

Zomwe zimayambitsa pneumomediastinum ndi izi:

• kuvulala pachifuwa
• Kuchita opaleshoni mpaka m'khosi, pachifuwa, kapena kumtunda
• misozi m'mimba kapena m'mapapo chifukwa chovulala kapena opaleshoni
• ntchito zomwe zimapangitsa kupanikizika m'mapapu, monga kuchita masewera olimbitsa thupi kwambiri kapena kubereka
• kusintha kwakanthawi kwa kuthamanga kwamlengalenga (barotrauma), monga kukwera msanga kwambiri mukasambira pamadzi
• mikhalidwe yomwe imayambitsa kutsokomola, monga mphumu kapena matenda am'mapapo
• kugwiritsa ntchito makina opumira
• kugwiritsa ntchito mankhwala osokoneza bongo, monga cocaine kapena chamba
• matenda pachifuwa monga chifuwa chachikulu
• Matenda omwe amayambitsa zilonda zam'mapapo (matenda am'mapapo amkati)
• kusanza
• kuyendetsa kwa Valsalva (kuwomba mwamphamvu uku mukugwetsa, njira yomwe imagwiritsidwa ntchito kutulutsa makutu anu)

Matendawa ndi osowa kwambiri. Zimakhudza pakati pa 1 mwa 7,000 ndi 1 mwa anthu 45,000 omwe adalandiridwa kuchipatala. amabadwa nawo.

ali ndi chiopsezo chotenga pneumomediastinum kuposa achikulire. Izi ndichifukwa choti ziphuphu zomwe zili pachifuwa chawo zimamasuka ndipo zimatha kulola mpweya kutuluka.

Zina mwaziwopsezo ndizo:

• Jenda. Amuna amapanga milandu yambiri (), makamaka amuna azaka zapakati pa 20 mpaka 40.
• Matenda am'mapapo. Pneumomediastinum imafala kwambiri mwa anthu omwe ali ndi mphumu ndi matenda ena am'mapapo.

Zizindikiro

Chizindikiro chachikulu cha pneumomediastinum ndi kupweteka pachifuwa. Izi zitha kuchitika modzidzimutsa ndipo zitha kukhala zovuta. Zizindikiro zina ndizo:

• kupuma movutikira
• kupuma kovuta kapena kosazama
• kukhosomola
• kupweteka kwa khosi
• kusanza
• vuto kumeza
• mawu amphuno kapena okweza
• mpweya pansi pa khungu la chifuwa (subcutaneous emphysema)

Dokotala wanu amatha kumva phokoso lofuula nthawi ndi kugunda kwa mtima wanu mukamamvera pachifuwa ndi stethoscope. Ichi chimatchedwa chizindikiro cha Hamman.

Matendawa

Mayeso awiri ojambula amagwiritsidwa ntchito kuti azindikire izi:

• Ma kompyuta tomography (CT). Kuyesaku kumagwiritsa ntchito ma X-ray kuti apange zithunzi zambiri zamapapu anu. Ikhoza kuwonetsa ngati mpweya uli mu mediastinum.
• X-ray. Kuyesa kulingalira uku kumagwiritsa ntchito kuchepa kwa radiation kupanga zithunzi zamapapu anu. Itha kuthandizira kupeza chomwe chimayambitsa kutuluka kwa mpweya.

Mayeserowa amatha kuyang'ana m'miso kapena m'mapapu:

• Esophagogram ndi X-ray ya kholingo yomwe imatengedwa mukatha kumeza barium.
• Esophagoscopy imadutsa chubu pakamwa panu kapena m'mphuno kuti muwone khosi lanu.
• Bronchoscopy imayika chubu chowonda, chowala chotchedwa bronchoscope m'mphuno kapena mkamwa mwanu kuti muwone momwe mukuyendera.

Chithandizo ndi kasamalidwe

Pneumomediastinum siyabwino. Mpweyawo pamapeto pake umakonzanso thupi lanu. Cholinga chachikulu pakuchiza ndikuwongolera zizindikiritso zanu.

adzagona mchipatala usiku kuti awunikidwe. Pambuyo pake, mankhwalawa amakhala ndi:

• kupumula kama
• amachepetsa ululu
• mankhwala odana ndi nkhawa
• mankhwala a chifuwa
• maantibayotiki, ngati matenda akukhudzidwa

Anthu ena angafunike mpweya kuti uwathandize kupuma. Oxygen amathanso kufulumizitsa kubwezeretsanso kwa mpweya mu mediastinum.

Chikhalidwe chilichonse chomwe chingayambitse mpweya, monga mphumu kapena matenda am'mapapo, chiyenera kuthandizidwa.

Pneumomediastinum nthawi zina imachitika limodzi ndi pneumothorax. Pneumothorax ndi mapapo omwe agwa chifukwa cha kuchuluka kwa mpweya pakati pa mapapo ndi khoma la chifuwa. Anthu omwe ali ndi pneumothorax angafunike chubu pachifuwa kuti athandize kukhetsa mpweya.

Pneumomediastinum m'mwana wakhanda

Matendawa sapezeka kawirikawiri mwa ana, omwe amakhudza 0,1% yokha mwa ana onse obadwa kumene. Madokotala amakhulupirira kuti zimayambitsidwa chifukwa cha kusiyana kwa kukakamiza pakati pamatumba amlengalenga (alveoli) ndi minyewa yowazungulira. Kutuluka kwa mpweya kuchokera ku alveoli ndikulowa mu mediastinum.

Pneumomediastinum imafala kwambiri mwa makanda omwe:

• ali ndi makina opumira omwe amawathandiza kupuma
• pumani mu (aspirate) matumbo awo oyamba (meconium)
• kukhala ndi chibayo kapena matenda ena am'mapapo

Ana ena omwe ali ndi vutoli alibe zisonyezo. Ena ali ndi zizindikiro zakupuma, kuphatikizapo:

• kupuma mofulumira kwambiri
• kunyinyirika
• kuwuluka kwa mphuno

Ana omwe ali ndi zizindikilo amalandira mpweya wowathandiza kupuma. Ngati matenda adayambitsa vutoli, adzalandira mankhwala opha tizilombo. Makanda amayang'aniridwa pambuyo pake kuti awonetsetse kuti mpweyawo uthe.

Chiwonetsero

Ngakhale zizindikiro monga kupweteka pachifuwa komanso kupuma movutikira kumatha kukhala kowopsa, pneumomediastinum nthawi zambiri siyowopsa. Pneumomediastinum yokhazikika imayamba bwino yokha.

Vutoli likangopita, silibwerera. Komabe, imatha kukhala nthawi yayitali kapena kubwerera ngati imayambitsidwa ndimakhalidwe obwereza (monga kugwiritsa ntchito mankhwala osokoneza bongo) kapena matenda (monga mphumu). Pakadali pano, mawonekedwe amatengera choyambitsa.