He aha maoli ka pleural effusion? E ʻike kākou i ke ʻano o ia mea.

Ua lohe paha ʻoe i kahi ʻelemakule e hoʻokomo ʻia ana i ka haukapila me ka "wai i loko o nā māmā." Malia paha ua hiki i kekahi o kou ʻohana ponoʻī. He aha ke ʻano o kēia "wai i loko o nā māmā"? He mea anei kēia e makaʻu ai? I kēia lā, e kamaʻilio kākou e pili ana i kēia maʻi, i kapa ʻia ʻo "Pleural Effusion" ma nā ʻōlelo lapaʻau, ma ke ʻano maʻalahi loa e hiki ai iā ʻoe ke hoʻomaopopo.

He aha ke ʻano o ka hoʻopiha ʻana i kou mau māmā me ka wai?

E noʻonoʻo e noho ana ko kākou mau māmā i loko o kahi keʻena pale i loko o ka umauma. A puni kēia mau māmā, a ma loko hoʻi o ka umauma, aia ʻelua mau membrane lahilahi. Ua like ia me kahi pōpō i loko o kahi pōpō. Kāhea mākou i kēia mau membrane ʻelua ʻo pleura.

ʻO ka maʻamau, i loko o ke kanaka olakino, he liʻiliʻi loa ka wai ma waena o kēia mau membrane ʻelua. Ua like ia me kahi ʻaila liʻiliʻi i loko o kahi mīkini. Ma muli o kēia nui o ka wai, i ka wā e hanu ai kākou, i ka wā e ʻūlū ai a hoʻonui ai ko kākou mau māmā, hana ʻia kēlā kaʻina hana me ka ʻole o ka pilikia a i ʻole ka friction. ʻO ia ke ala kūlohelohe.

Akā i loko o ke kūlana i kapa ʻia ʻo "Pleural effusion", ʻoi aku ka nui o ka wai ma mua o ka mea e pono ai e hōʻiliʻili ma kahi hakahaka ma waena o kēia mau membrane ʻelua. ʻO kēia ka mea a mākou e kapa pinepine ai he "wai i loko o nā māmā." I ka pololei, ʻaʻole hoʻopiha kēia wai i nā māmā ponoʻī, akā ma waena o nā membrane pleural ʻelua e hoʻopuni ana i nā māmā.

Hiki i ʻelua mau kumu nui no ka hōʻiliʻili ʻana o ka wai ma kēia ʻano:

1. Ke hana nui nei paha ke kino i kēia wai.

2. A i ʻole, ʻaʻole paha e hiki i ke kino ke omo hou i ka nui maʻamau o ka wai i hana ʻia.

ʻO kēlā me kēia ʻano, ʻo ka hopena, hōʻiliʻili ka wai a puni nā māmā, e kau ana i ke kaomi ma luna o lākou, a hoʻomaka nā pilikia hanu.

ʻElua ʻano wai e hui pū ana.

Ua hoʻokaʻawale nā ​​kauka i ka pleural effusion i ʻelua mau ʻano nui e pili ana i ke ʻano o ka wai e hōʻiliʻili ana. No ka mea, hiki i nā ʻāpana o ka wai ke hāʻawi i kahi manaʻo maikaʻi o ke kumu.

I ka wā e mālama ai, he mea nui e ʻike pono i ka mea o kēia mau ʻano ʻelua āu e loaʻa ai a me ke kumu.

He aha nā hōʻailona āu e ʻike ai?

Loaʻa i kekahi poʻe ka pleural effusion akā ʻaʻole hōʻike i kekahi mau hōʻailona. ʻIke ʻia ia ma ka hanana i ka wā o ka X-ray umauma no kekahi kumu ʻē aʻe. Eia nō naʻe, nui ka poʻe e loaʻa nā hōʻailona, ​​​​ʻoiai ke hōʻiliʻili ka wai.

• Paʻakikī ka hanu ʻana: ʻO kēia ka hōʻailona nui a maʻamau. Ke piha ka wai a puni nā māmā, ʻaʻohe wahi lawa no nā māmā e pehu pono ai. Hoʻopaʻakikī kēia i ka hanu ʻana a hoʻopāʻiwa iā ʻoe.
• ʻEha umauma: He ʻeha ʻoi e ʻike ʻia ana i ka wā e hanu hohonu ai a i ʻole e ʻū ana. Hana ʻia kēia i ka wā e hamo ai nā membrane pleural ʻelua.
• ʻŪhū maloʻo: Hiki i kekahi poʻe ke loaʻa i ka ʻūhū maloʻo mau.
• Orthopnea: He hōʻailona kū hoʻokahi kēia. E lilo ana ka hanu ʻana i mea paʻakikī ke moe i lalo, akā e maʻalahi ka hanu ʻana i ka wā e noho ana a kū ana paha.
• Kuni: Inā he maʻi (e like me ka niumonia) ke kumu nui, hiki nō hoʻi ke ʻike ʻia nā hōʻailona e like me ke kuni a me ka ʻeha o ke kino.

Pehea e ʻike ai i kēia maʻi?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a me nā kūlana olakino ʻē aʻe āu e loaʻa ai (e like me ka maʻi puʻuwai a i ʻole ka maʻi diabetes). A laila e kau lākou i kahi stethoscope ma kou umauma a hoʻolohe. Inā he wai a puni kou mau māmā, e loli paha nā leo āu e lohe ai i kou hanu ʻana.

Ma hope o kēlā, e kauoha ʻia kekahi mau hoʻokolohua e hōʻoia i ka maʻi a ʻike i ke kumu.

• X-ray umauma: ʻO kēia ka hoʻāʻo maʻalahi loa a maʻalahi hoʻi. Hiki i ka X-ray ke ʻike maopopo inā he wai a puni nā māmā a me ka nui o ia mea.
• CT scan: Hiki i kēia ke hana i kahi kiʻi ʻekolu-dimensional (3D) maopopo o nā māmā a me ka pleural space. Hiki i kēia ke kōkua nui i ka loaʻa ʻana o ke kumu o ka hōʻiliʻili ʻana o ka wai (e like me ka puʻupuʻu).
• ʻO ke kiʻi ʻana o ka ultrasound: Hiki i kēia ke kōkua i ke kuhikuhi ʻana i kahi o ka wai a me ke ana ʻana i ka nui o ka wai. Hoʻohana ʻia ia e kōkua i ke alakaʻi ʻana i ka nila i loko o ka wahi, ʻoiai ke hana nei i kahi kaʻina hana e pili ana i ka wehe ʻana i ka wai.
• Thoracentesis: ʻO kēia kekahi o nā hoʻokolohua koʻikoʻi loa. Pili ia i ka hana ʻana i kahi ʻoki liʻiliʻi ma ka umauma, ke hoʻokomo ʻana i kahi nila liʻiliʻi ma waena o nā iwi ʻaoʻao ʻelua, a me ka lawe ʻana i kahi laʻana o ka wai a puni nā māmā. A laila hoʻouna ʻia kēia laʻana wai i kahi keʻena hoʻokolohua no ka hoʻāʻo ʻana.

He aha kāu e nānā ai i ka wā e hoʻāʻo ai i kahi hāpana wai?

Hoʻāʻo ka lab i ka wai no ka protein, ke kō, nā ʻano cell (aia nā cell cancer?), a me nā microorganism e like me ka bacteria. Kōkua kēia ʻike i ke kauka e hoʻoholo inā he "Transudative" a i ʻole "Exudative", a inā he maʻi, kanesa, a i ʻole kekahi mea ʻē aʻe ke kumu.

I kekahi mau hihia, inā ʻaʻole hiki i kēia mau hoʻokolohua ke kuhikuhi i ke kumu, hiki ke hana ʻia kahi kaʻina hana i kapa ʻia he thoracoscopy a i ʻole VATS. Pili kēia i ke komo ʻana i kahi kāmela ma o hoʻokahi a ʻoi aku paha mau ʻoki liʻiliʻi ma ka umauma e nānā pololei i ka pleura a me nā māmā. Hiki ke lawe ʻia kahi laʻana o ka ʻiʻo no ka biopsy.

He aha nā lāʻau lapaʻau?

ʻElua mau pahuhopu nui i ka mālama ʻana i ka pleural effusion:

1. Ke wehe ʻana i ke kahe nui a me ka hōʻoluʻolu ʻana i nā pilikia hanu.

2. Ke mālama ʻana i ke kumu nui o kēia hōʻiliʻili ʻana o ka wai a me ka pale ʻana i ka hōʻiliʻili hou ʻana o ka wai.

1. Ke mālama ʻana i ke kumu kumu

• Inā hōʻiliʻili ka wai ma muli o ka hāʻule ʻana o ka puʻuwai , hāʻawi ʻia nā lāʻau lapaʻau e hoʻomaikaʻi i ka hana o ka puʻuwai a me nā diuretics (nā pila wai) e wehe i ka wai keu mai ke kino.
• Kumu: PneumoniaInā he maʻi bacteria, hāʻawi ʻia nā antibiotics.
• Inā he maʻi kanesa ke kumu, pono ʻoe e hana i ka chemotherapy a me ka radiation therapy.

2. Nā ʻano hana no ka wehe ʻana i ka wai i hōʻiliʻili ʻia

• ʻO ka Thoracentesis Therapeutic: ʻO kēia ka hoʻāʻo like a mākou i kūkākūkā ai ma mua, akā ma kahi o ka lawe ʻana i kahi hāpana, ua wehe ʻia ka nui o ka wai e like me ka hiki me kahi nila. Hāʻawi kēia i ka hōʻoluʻolu koke i ka mea maʻi.
• ʻŌmole umauma: Inā nui loa ka nui o ka wai a mānoanoa paha ka wai (e like me ka pus), hiki ke waiho ʻia kahi ʻōmole liʻiliʻi i kapa ʻia he "ʻōmole umauma" i loko o ka umauma no kekahi mau lā. Hoʻokahe mālie ʻia ka wai i loko o kahi ʻōmole ma o kēia ʻōmole.
• Pleural Sclerosis: Hoʻohana ʻia kēia kaʻina hana inā hoʻomau ka hōʻiliʻili ʻana o ka wai ma muli o kahi kumu e like me ke kanesa. Ma kēia kaʻina hana, hoʻokomo ʻia kahi lāʻau lapaʻau kūikawā (e like me ka talc) ma o kahi ʻōmole umauma ma waena o nā membrane pleural ʻelua. Hoʻoulu kēia lāʻau lapaʻau i ka mumū ma waena o nā membrane ʻelua, e hoʻopili ai iā lākou. A laila hoʻopau kēia i kahi e hiki ai i ka wai ke hōʻiliʻili hou.
• ʻOki kino: Inā ʻaʻole holomua nā ʻano hana ʻē aʻe a inā ua hana ʻia kahi papa mānoanoa a puni ka pleura ma muli o ka maʻi, pono paha ke ʻoki kino.
• VATS (ʻoki thoracoscopic kōkua wikiō): He ʻoki kino i hana ʻia me ka hoʻohana ʻana i kahi kāmela i hoʻokomo ʻia ma o nā ʻoki liʻiliʻi.
• Thoracotomy: He hana kuʻuna e pili ana i ka wehe ʻana i ka umauma. Hiki i kēia ke wehe loa i nā ʻiʻo i loaʻa i ka maʻi.

Nā pilikia e kū mai ana mai kēia ʻano

Inā ʻaʻole i mālama pono ʻia, hiki i ka pleural effusion ke hana i nā pilikia like ʻole.

• Maʻi: Hiki i nā germs ke komo i loko o ke wai a puni nā māmā a hana i kahi abscess.
• ʻO ka ʻōpala a puni nā māmā: ʻO ka paʻa ʻana o ka wai lōʻihi e hiki ai ke hoʻonui i ka membrane pleural, e pale ai i nā māmā mai ka hoʻoulu pono ʻana.
• Pūmāmā hiolo/Pneumothorax: I kekahi manawa hiki ke hōʻino ʻia nā māmā i ka wā o ke kaʻina hana wehe wai.

No laila, he mea nui loa e ʻimi koke i ke kōkua lapaʻau inā loaʻa nā hōʻailona.

Hiki ke pale ʻia kēia kūlana?

ʻOiai ʻo ka pleural effusion ka hopena o kahi maʻi ʻē aʻe, ʻo ka mea a mākou e hana ai, ʻo ia ke hoʻāʻo e pale i ka ulu ʻana o kēlā maʻi kumu.

• E pale i ka puhipaka: ʻO ka puhipaka kekahi kumu nui o ka maʻi kanesa o ka māmā a me nā maʻi puʻuwai.
• E pale i ka pili ʻana i ka asbestos: Hiki i kēia ke hana i nā maʻi māmā.
• He nohona olakino: ʻO nā mea e like me ka ʻai kaulike, ka hoʻoikaika kino, a me ka hōʻemi ʻana i ka nui o ka paʻakai e hiki ke kōkua i ka kaohi ʻana i nā maʻi e like me ka maʻi puʻuwai a me nā maʻi puʻupaʻa.
• Inā loaʻa iā ʻoe ka maʻi puʻuwai a i ʻole ka maʻi puʻupaʻa, e lawe i ka lāʻau lapaʻau e like me ke kauoha a kāu kauka a hele i nā keʻena lapaʻau i ka manawa kūpono.