Tej zaum koj twb tau hnov txog ib tug neeg laus uas raug mob hauv tsev kho mob vim "kua dej hauv lub ntsws." Tej zaum nws tau tshwm sim rau ib tug neeg hauv koj tsev neeg. Qhov "kua dej hauv lub ntsws" no txhais li cas? Qhov no puas yog ib yam dab tsi uas yuav tsum ntshai? Hnub no, cia peb tham txog qhov mob no, uas hu ua "Pleural Effusion" hauv cov lus kho mob, hauv txoj kev yooj yim uas koj tuaj yeem nkag siab.
Txhais li cas tiag tiag kom koj lub ntsws puv nrog dej?
Xav txog tias peb lub ntsws nyob hauv ib lub chamber tiv thaiv sab hauv lub hauv siab. Nyob ib puag ncig cov ntsws no, thiab sab hauv ntawm lub hauv siab, muaj ob lub membrane nyias nyias. Nws zoo li lub npas nyob hauv lub npas. Peb hu ob lub membrane no ua pleura.
Feem ntau, rau ib tug neeg noj qab nyob zoo, muaj ib qho me me ntawm cov kua dej ntawm ob lub membrane no. Nws zoo li cov roj me me hauv lub tshuab. Vim yog qhov ntau ntawm cov kua dej no, thaum peb ua pa, thaum peb lub ntsws cog thiab nthuav dav, cov txheej txheem ntawd tshwm sim yam tsis muaj teeb meem lossis kev sib txhuam. Qhov ntawd yog txoj kev ntuj.
Tiam sis nyob rau hauv ib qho mob hu ua "Pleural effusion", ntau cov kua ntau dua li qhov tsim nyog yuav sib sau ua ke hauv qhov chaw khoob ntawm ob lub membranes no. Qhov no yog qhov peb feem ntau hu ua "kua hauv lub ntsws." Yog hais kom meej, cov kua no tsis puv lub ntsws nws tus kheej, tab sis nyob nruab nrab ntawm ob lub pleural membranes uas nyob ib puag ncig lub ntsws.
Muaj ob qho laj thawj tseem ceeb rau kev sib sau ua ke ntawm cov kua dej hauv txoj kev no:
1. Lub cev tej zaum yuav tsim cov kua dej no ntau dhau .
2. Yog tsis ua li ntawd, lub cev yuav tsis nqus tau cov kua dej uas tsim tawm li qub.
Txawm li cas los xij, qhov tshwm sim yog tias cov kua dej sib sau ua ke nyob ib puag ncig lub ntsws, muab kev nyuaj rau lawv, thiab ua pa nyuaj pib tshwm sim.
Muaj ob hom kua uas los ua ke.
Cov kws kho mob faib cov kua dej hauv lub ntsws ua ob hom loj raws li qhov xwm txheej ntawm cov kua dej uas sib sau ua ke. Vim tias cov khoom ntawm cov kua dej tuaj yeem muab lub tswv yim zoo txog qhov ua rau yog dab tsi.
| Hom kua | Kev piav qhia thiab cov laj thawj tseem ceeb |
|---|---|
| Transudative (Muaj kua ntau, muaj protein tsawg) | Hais yooj yim xwb, qhov no yog ib yam kua uas zoo li "dej". Nws muaj protein tsawg dua. Qhov no yog vim muaj kev nce siab hauv cov hlab ntsha ntawm lub cev lossis txo qis ntawm cov protein hauv cov ntshav. Cov kua ntawd tawm hauv cov hlab ntsha. Cov ua rau tseem ceeb: Lub plawv tsis ua haujlwm, Kab mob siab cirrhosis, Kab mob nephrotic. |
| Cov kua qaub tawm (Qhov ceev dua, cov protein ntau dua) | Cov kua no muaj cov protein, cov cell, thiab lwm yam ntau dhau. Qhov no yog tshwm sim los ntawm kev kis kab mob, kev o, lossis mob qog noj ntshav hauv lossis ib puag ncig lub pleura. Qhov no yog thaum cov kua ntws tawm ntawm cov hlab ntsha lossis lub cev lymphatic tsis tuaj yeem tshem tawm cov kua. Cov ua rau mob tseem ceeb: Mob ntsws, mob qog noj ntshav (tshwj xeeb yog mob ntsws, mob qog noj ntshav hauv lub mis), mob ntsws ntsws, mob raum, tom qab phais plawv. |
Thaum kho mob, nws yog ib qho tseem ceeb kom paub meej tias koj muaj hom twg ntawm ob hom no thiab dab tsi ua rau nws.
Tej zaum koj yuav muaj cov tsos mob dab tsi?
Muaj ib txhia neeg muaj cov kua dej hauv lub ntsws tab sis tsis muaj tsos mob dab tsi. Nws raug pom thaum lub sijhawm thaij duab X-ray hauv siab vim lwm qhov laj thawj. Txawm li cas los xij, ntau tus neeg muaj cov tsos mob, tshwj xeeb tshaj yog thaum cov kua dej sib sau ua ke.
- Ua pa nyuaj: Qhov no yog qhov tsos mob tseem ceeb thiab feem ntau tshwm sim. Thaum cov kua dej puv nkaus lub ntsws, tsis muaj chaw txaus rau lub ntsws kom nqus tau zoo. Qhov no ua rau nws nyuaj rau ua pa thiab ua rau koj xav tias tsis muaj pa txaus.
- Mob hauv siab: Mob heev uas hnov tshwj xeeb tshaj yog thaum ua pa tob lossis hnoos. Qhov no tshwm sim thaum ob lub pleural membranes sib txhuam ua ke.
- Hnoos Qhuav: Qee tus neeg yuav hnoos qhuav tas li.
- Orthopnea: Qhov no yog ib qho tsos mob tshwj xeeb. Ua pa nyuaj dua thaum pw, tab sis ua pa yooj yim dua thaum zaum lossis sawv ntsug.
- Kub taub hau: Yog tias qhov ua rau mob yog kev kis kab mob (xws li mob ntsws), cov tsos mob xws li kub taub hau thiab mob lub cev kuj tseem yuav tshwm sim.
Qhov tseem ceeb yog tias cov tsos mob no tsis yog tsuas yog muaj rau cov kua dej hauv lub pleural xwb. Lawv kuj tuaj yeem pom hauv lwm yam kab mob xws li kab mob plawv thiab mob hawb pob. Yog li ntawd, yog tias koj muaj cov tsos mob no, nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib kws kho mob tam sim ntawd kom paub qhov ua rau.
Yuav paub qhov mob no li cas?
Thaum koj mus ntsib kws kho mob, nws yuav xub nug koj txog koj cov tsos mob thiab lwm yam mob uas koj muaj (xws li kab mob plawv lossis ntshav qab zib). Tom qab ntawd lawv yuav muab lub stethoscope tso rau ntawm koj lub hauv siab thiab mloog. Yog tias muaj kua dej nyob ib puag ncig koj lub ntsws, lub suab uas koj hnov thaum koj ua pa yuav hloov pauv.
Tom qab ntawd, yuav muaj ntau qhov kev kuaj mob kom paub meej tias muaj tus kab mob thiab nrhiav qhov ua rau muaj tus kab mob.
- X-ray hauv siab: Qhov no yog qhov kev kuaj yooj yim tshaj plaws. X-ray tuaj yeem pom tseeb tias puas muaj kua dej nyob ib puag ncig lub ntsws thiab muaj pes tsawg.
- Kev thaij duab CT: Qhov no tuaj yeem tsim tau daim duab peb-seem (3D) ntawm lub ntsws thiab qhov chaw pleural kom meej dua. Qhov no tuaj yeem pab tau zoo heev rau kev nrhiav qhov ua rau cov kua dej sib sau ua ke (xws li qog).
- Kev ntsuas ultrasound: Qhov no tuaj yeem pab txheeb xyuas qhov chaw ntawm cov kua dej thiab ntsuas qhov ntau ntawm cov kua dej. Nws yog siv los pab coj rab koob mus rau hauv thaj chaw, tshwj xeeb tshaj yog thaum ua cov txheej txheem uas cuam tshuam nrog kev tshem tawm cov kua dej.
- Kev kuaj lub hauv siab: Qhov no yog ib qho ntawm cov kev kuaj tseem ceeb tshaj plaws. Nws suav nrog kev txiav me me hauv lub hauv siab, ntxig ib rab koob me me ntawm ob sab tav, thiab coj cov kua dej ncig lub ntsws. Cov kua dej no ces xa mus rau chav kuaj mob kom kuaj.
Thaum koj sim cov kua dej, koj yuav tsum saib dab tsi?
Lub chaw kuaj mob yuav kuaj cov kua dej kom paub txog cov protein, qab zib, hom cell (puas muaj cov cell mob qog noj ntshav?), thiab cov kab mob me me xws li cov kab mob bacteria. Cov ntaub ntawv no pab tus kws kho mob txiav txim siab seb nws puas yog "Transudative" lossis "Exudative", thiab seb qhov ua rau yog kev kis kab mob, mob qog noj ntshav, lossis lwm yam.
Muaj tej lub sij hawm, yog tias cov kev kuaj no tsis tuaj yeem qhia tau qhov ua rau mob, yuav muaj ib txoj kev kuaj hu ua thoracoscopy lossis VATS. Qhov no suav nrog kev ntxig lub koob yees duab los ntawm ib lossis ntau qhov kev txiav me me hauv lub hauv siab kom saib ncaj qha rau ntawm pleura thiab lub ntsws. Kuj tseem yuav muab ib qho qauv ntawm cov ntaub so ntswg coj mus kuaj mob.
Cov kev kho mob yog dab tsi?
Muaj ob lub hom phiaj tseem ceeb hauv kev kho mob pleural effusion:
1. Tshem tawm cov kua dej ntau dhau thiab txo qhov teeb meem ua pa.
2. Kho qhov ua rau muaj cov kua dej ntau dhau thiab tiv thaiv kom tsis txhob muaj cov kua dej ntau ntxiv.
Nco ntsoov tias, tsuas yog tshem cov kua dej ncig lub ntsws xwb tsis txaus. Yog tias qhov mob tseem ceeb tsis kho, cov kua dej ntawd yuav rov puv dua.
1. Kho qhov ua rau mob
- Yog tias cov kua dej sib sau ua ke vim yog lub plawv tsis ua haujlwm , cov tshuaj uas txhim kho kev ua haujlwm ntawm lub plawv thiab cov tshuaj diuretics (tshuaj ntsiav dej) uas tshem tawm cov dej ntau dhau ntawm lub cev yuav muab rau.
- Ua rau: Mob ntswsYog tias nws yog kab mob bacterial, cov tshuaj tua kab mob yuav muab rau.
- Yog tias qhov ua rau yog mob qog noj ntshav , koj yuav tsum tau siv tshuaj chemotherapy thiab tshuaj tua kab mob.
2. Cov txheej txheem rau kev tshem tawm cov kua dej uas tau sib sau ua ke
- Kev Siv Tshuaj Kho Mob Hauv Lub Plab: Qhov no yog tib qho kev kuaj uas peb tau tham ua ntej, tab sis es tsis txhob coj mus kuaj, yuav muab cov kua dej ntau li ntau tau los ntawm koob. Qhov no ua rau tus neeg mob zoo sai sai.
- Lub Raj Mis Hauv Siab: Yog tias cov kua dej ntau dhau los yog cov kua dej tuab (zoo li kua qaub), ib lub raj me me hu ua "lub raj mis hauv siab" yuav raug muab tso rau hauv lub hauv siab rau ob peb hnub. Cov kua dej maj mam ntws mus rau hauv lub raj mis los ntawm lub raj mis no.
- Kab mob Pleural Sclerosis: Cov txheej txheem no yog siv yog tias cov kua dej tseem sib sau ua ke vim yog ib qho ua rau xws li mob qog noj ntshav. Hauv cov txheej txheem no, ib yam tshuaj tshwj xeeb (xws li talc) raug ntxig rau hauv lub raj hauv siab ntawm ob lub pleural membranes. Cov tshuaj no ua rau o ntawm ob lub pleural membranes, ua rau lawv lo ua ke. Qhov no ces tshem tawm qhov chaw uas cov kua dej tuaj yeem sib sau ua ke dua.
- Kev Phais Mob: Yog tias lwm txoj kev tsis ua tiav lossis yog tias muaj txheej tuab nyob ib puag ncig lub pleura vim muaj kev kis kab mob, kev phais mob yuav tsim nyog.
- VATS (Kev phais mob thoracoscopic uas muaj video pab): Ib qho kev phais mob uas siv lub koob yees duab ntxig rau hauv cov qhov me me.
- Thoracotomy: Ib qho kev phais mob ib txwm muaj uas yuav tsum qhib lub hauv siab. Qhov no tuaj yeem tshem tawm cov nqaij mob tag nrho.
Cov teeb meem uas yuav tshwm sim los ntawm tus mob no
Yog tias tsis kho kom zoo, pleural effusion tuaj yeem ua rau muaj ntau yam teeb meem.
- Kev kis kab mob: Cov kab mob tuaj yeem nkag mus rau hauv cov kua dej nyob ib puag ncig lub ntsws thiab ua rau muaj o.
- Kev caws pliav nyob ib puag ncig lub ntsws: Kev khaws cov kua dej ntev ntev tuaj yeem ua rau daim nyias nyias pleural tuab, tiv thaiv cov ntsws kom tsis txhob nthuav dav.
- Lub ntsws tawg/Pneumothorax: Qee zaum lub ntsws tuaj yeem raug puas tsuaj thaum lub sijhawm tshem tawm cov kua dej.
Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev pab kho mob tam sim ntawd yog tias koj muaj cov tsos mob.
Puas zam tau qhov xwm txheej no?
Vim tias pleural effusion yog qhov tshwm sim ntawm lwm yam kab mob, qhov peb yuav tsum ua yog sim tiv thaiv kev loj hlob ntawm tus kab mob hauv qab no.
- Tsis txhob haus luam yeeb: Kev haus luam yeeb yog ib qho ua rau mob qog nqaij hlav ntsws thiab mob plawv.
- Tsis txhob raug cov asbestos: Qhov no tuaj yeem ua rau muaj kab mob ntsws.
- Kev ua neej noj qab nyob zoo: Tej yam xws li kev noj zaub mov kom sib npaug, kev tawm dag zog, thiab kev txo kev noj ntsev ntau dhau tuaj yeem pab tswj cov mob xws li kab mob plawv thiab kab mob raum.
- Yog tias koj twb muaj kab mob plawv lossis mob raum lawm, noj cov tshuaj raws nraim li koj tus kws kho mob tau hais thiab mus rau cov chaw kho mob raws sijhawm.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- " Pleural effusion " yog qhov tsis zoo li qub ntawm cov kua dej ntawm ob lub membranes uas nyob ib puag ncig lub ntsws.
- Ua pa nyuaj, mob hauv siab thaum ua pa tob tob, thiab hnoos qhuav yog cov tsos mob tseem ceeb.
- Tus mob no tsis yog ib yam kab mob, tab sis yog ib qho tsos mob ntawm lwm yam kab mob. Nws tuaj yeem tshwm sim los ntawm ntau yam, xws li kab mob plawv, mob ntsws, thiab mob qog noj ntshav.
- Qhov tseem ceeb tshaj plaws hauv kev kho mob yog kho qhov ua rau mob, ntxiv rau kev tshem tawm cov kua dej.
- Yog koj lossis ib tug neeg koj paub muaj cov tsos mob no, tsis txhob ntshai lossis ncua sijhawm , tab sis mus ntsib kws kho mob tam sim ntawd. Kev kuaj mob thaum ntxov thiab kev kho mob tuaj yeem tiv thaiv cov teeb meem.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus