Kei te pēhia ō pukahukahu e te wai? Me kōrero tātou mō te Pleural Effusion ki Nirogi Lanka!

Kua rongo koe i te taumaha ngawari i roto i tō uma, kua kite rānei koe i tētahi mea rerekē i a koe e manawa ana? Kua rongo pea koe i tētahi e kī ana, "he wai kei roto i ngā pukahukahu." I Nirogi Lanka, e hiahia ana mātou ki te āwhina i a koe ki te mārama ki tēnei āhuatanga, e kiia nei i roto i te rongoā ko te Pleural Effusion.

He aha tonu te Pleural Effusion?

Me wehewehe noa iho tēnei. Kei roto i te kōhao o tō uma ōu pūkahukahu. Kei te karapoti i ia pūkahukahu, ā, kei te whakarārangi i te taha o roto o tō uma, e rua ngā paparanga kiko angiangi e mōhiotia ana ko te pleura . Whakaarohia ēnei hei anga tiaki paparua mō ō pūkahukahu.

I raro i ngā āhuatanga noa, he iti noa te wai kei waenganui i ēnei paparanga pleural e rua. He rite tonu tana mahi ki te hinu whakahinuhinu i roto i te mīhini, e āhei ai ōu pukahukahu ki te nekeneke, ki te whānui, me te whakawhāiti ngāwari i a koe e manawa ana.

Ka puta te totohu i roto i te pleural ina he nui rawa te wai e puta mai ana i waenganui i aua paparanga pleural. I te nuinga o te wā ka puta tēnei nā te mea he nui rawa te wai e whakaputaina ana e tō tinana, nā te mea rānei kāore e tino pai te tango i te wai. I roto i ngā kupu ngāwari, ka kiia tēnei he "wai ki runga i ngā pukahukahu."

He rerekē ngā momo rerenga wai i roto i te pleural?

Ae, e rua ngā momo matua o ngā rerenga wai i roto i te puku e whakarōpūhia ana e ngā tākuta, i runga i te hanganga o te wai e kohia ana i te taha o ngā pukahukahu.

1. Transudative (He wai kore-pūmua, he wai): Ko te nuinga o te wā ka puta tēnei momo i te pikinga o te pēhanga i roto i ngā oko toto o te tinana. Hei tauira, ka pā pea ki te hunga e ora ana me te cirrhosis (he mate ate) me te ngoikore o te ngakau . Ko te tikanga, ka turuturu te wai i roto i ngā oko toto nā te kore taurite o te pēhanga.

2. Pupuhi (Wai whai pūmua): Ko te tikanga ka puta mai tēnei momo i te mumura, i te mate pāwera , i te mate pukupuku rānei (pēnei i te mate pukupuku o te pūkahukahu, o te ū rānei). I tēnei wā, ka turuturu te wai nā te mea kua "turuki" ngā oko toto nā te mate, kāore rānei e taea e te pūnaha lymphatic o te tinana te whakakore tika i te wai.

He mea nui te whakatau ko tēhea momo kei a koe, hei ārahi i tō huarahi maimoatanga i Nirogi Lanka.

He pēhea te noa o tēnei āhuatanga?

He nui ake te kitea o te toto e puta mai ana i te pleural effusion i tō whakaaro . Hei tauira, i te United States anake, e kiia ana he tata ki te 1.5 miriona ngā keehi ka kitea i ia tau. He maha tonu ngā kitenga o tēnei mate i roto i ā mātou mahi haumanu i konei.

He aha ngā tohu o te rerenga wai i roto i te pleural?

Tērā pea ka pāngia koe e ngā tohu e pā ana ki te mate hauora i puta ai te rerenga toto. Heoi, he iti noa ngā tohu e pā ana ki te rerenga toto i roto i te pleural:

• Mamae o te uma: Ka kino ake tēnei ina manawa hōhonu koe, ina maremare rānei. Ka rite ki te kare koi, ki te wero.
• Te Poto o te Manawa (Dyspnea): Tērā pea ka rite koe ki te kore e taea e koe te hopu i tō manawa, he kare e kaha ake ana i te kaha o te mahi tinana.
• Orthopnea: He tohu motuhake tēnei e uaua ai te manawa mēnā kāore koe e noho tika ana, e tū tika ana rānei. He maha ngā tūroro e uaua ana ki te takoto papatahi, ā, me moe pea rātou me te tautoko i runga i ētahi urunga kia pai ai te manawa.

Kia mōhio mai, tera pea ētahi tāngata ka pāngia e te toto totoka , engari kāore he tohu e kitea ana . I ēnei wā, ka kitea noa iho i te wā e tangohia ana he hihi-X o te uma mō tētahi atu take.

He aha tēnei ka tupu ai? He aha ngā take?

He maha ngā take pea mō te rerenga toto i roto i te pleural, ā, i ētahi wā ka nui atu i te kotahi ngā āhuatanga e pā ana. E ai ki te kōrero, ka whakatauhia e ngā tākuta te take mā te tātari mēnā he transudative , he exudative rānei te wai. Ko ētahi āhuatanga, pērā i te pulmonary embolism (PE) — he toto totoka i roto i te pukahukahu — ka puta pea i ētahi momo e rua.

Ngā take noa mō te wai whakawhiti:

• Te ngoikore o te ngākau: Koinei tētahi o ngā tino take, ka kore e taea e te ngākau te papu tika ka pupuri wai puta noa i te tinana.
• Ātete ate: He mate kino e pā ana ki te mahi a te ate.
• Te Mate Pūkahukahu: He mate tākihi e ngaro nui ai te pūmua i roto i tō mimi, ka huri ai te wai.

Ngā take noa mō te putanga mai o te wai:

• Pneumonia: He mate huakita, he mate huaketo rānei o te kiko o te pukahukahu.
• Matepukupuku: Ina koa ko te matepukupuku pūkahukahu , te matepukupuku ū , te lymphoma rānei.
• Mate whatukuhu.
• Ngā Mate Mumura: Ngā momo āhuatanga pūnaha e puta ai te mumura o roto.
• I muri i te pokanga tuwhera o te ngākau.

Ngā take kāore i te tino kitea:

• Te mate kohi: He mate ka hua ake he wai i roto i te uma.
• Mate Pūnaha Ārai Mate: Ngā āhuatanga ka whakaekea hētia e tō pūnaha ārai mate ō ake pūtau tinana, ka puta ai te mumura.
• Te toto e rere ana ki roto i te uma nā te whara, te whara rānei o te uma.
• Chylothorax: He āhuatanga e puta ana ina kohia te 'chyle,' he wai mai i te pūnaha lymphatic, ki roto i te uma, he maha ngā wā ka puta mai i te whara.
• Ngā mate urutā o te uma me te puku.
• Te pānga ki te Asbestos .
• Pakaru o te korokoro
• Te mate pāwera
• Te Mate Meig: I puta mai i tētahi pukupuku whatukuhu pai.
• Te Mate Whakaohooho Ovarian
• Ko ētahi rongoā .
• Ngā raruraru i muri i te pokanga puku.
• Te Whakaora Irahiko

I ētahi wā, tera pea kei roto i te wai kua kohia ngā pūtau kino (matepukupuku), tera rānei ka kohia te wai hei pānga taha o ngā maimoatanga chemotherapy .

Ko wai kei te nui ake te mōrearea ki te whakawhanake i tēnei?

He maha ngā āhuatanga mōrearea e whai wāhi ana ki te whanaketanga o te rerenga toto pleural:

• Ngā āhuatanga hauora matua: Mena kei te pāngia koe e te ngoikore o te ngākau, te mate ate, te mate tākihi, te mate pukupuku rānei, ka nui ake tō tūponotanga ki te whakawhanake i te pleural effusion.
• Te whakamahi tupeka: Mā te momi hikareti ka nui ake te tūponotanga o te whakawhanake i ngā raruraru e pā ana ki te pukahukahu.
• Te pānga ki te asbestos: Ko te pānga roa ki tēnei rauemi, i kitea noa i roto i ngā rauemi hanga whare, ka arahi pea ki te kino nui o te pukahukahu.

He aha ngā raruraru pea ka pā mai?

Ki te kore e rongoatia, ka arahi pea te pleural effusion ki ētahi raruraru:

• Mate Pukupuku, Pukupuku rānei: Ka pangia pea te wai, ka arahi pea ki te hanganga o te pute kī tonu i te pupuhi.
• Te whara: Ka puta he kiko muka ki te wāhi o te wai, ka whakararu pea i te mahi a ō pukahukahu.
• Te kino tika o te pukahukahu.

Me pēhea te tautuhi i tēnei mate?

Ina toro atu koe ki tētahi tākuta, ka matapakihia tuatahitia e rātou tō hītori hauora — tae atu ki ngā āhuatanga o nāianei me te wā i puta ai ō tohumate. Muri iho, ka whakahaerehia he whakamātautau tinana , ā, i taua wā ka whakamahia e tō tākuta he stethoscope hei whakarongo ki ngā oro o tō manawa. Kātahi anō ka whakaritea e rātou ngā whakamātautau tātaritanga e tika ana.

He aha ngā whakamātautau e whai wāhi ana?

Ka whakamahia e ngā tākuta ngā whakamātautau e whai ake nei hei whakaū i te aroaro o te pleural effusion me te mārama ki tōna āhua:

• X-ray o te uma: Whakamahia hei kimi i te aroaro me te rahinga o te wai.
• Matawai CT (Tomography Rorohiko): Ka whakarato i ngā whakaahua taipitopito ake, mārama ake i te hihi-X, e āhei ai tātou ki te kite i ngā pukahukahu i raro i te wai me te tautuhi i ngā puranga pea.
• Te Whakamātautau Uira o te Uma: Āwhina ki te kimi i te wai me te whakatau i te wāhi tino haumaru me te tino tika mō te tango wai.
• Te Tirotiro i te Tora, te Koiora rānei: Ka werohia he ngira angiangi ki waenganui i ō rara hei whakamātautau i te wai kua kohia. I ētahi wā, ka tangohia pea he wāhanga iti o te arai pleural mō te koiora.
• Tātaritanga Wai o te Pleural: Ka tātarihia te wai i kohia i roto i te taiwhanga mō te ihirangi pūmua, ngā momo pūtau, te mate, ngā pūtau matepukupuku rānei. He mea nui tēnei whakamātautau hei whakatau mēnā he 'transudative', he 'exudative' rānei te wai.

Mena kāore anō kia mārama te take i muri i ēnei whakamātautau, me whai thoracoscopy pea koe, e mōhiotia ana ko te Ataata-Āwhina Pokanga Uma (VATS) . Ka mahia tēnei tikanga i raro i te mate whakamoe whānui. Ka whakamahia e mātou he kāmera iti me ngā taputapu kua whakaurua ki roto i tō uma hei tiro i te pleura me ngā wāhi e karapoti ana. He maha ngā wā, ka taea te mahi maimoatanga i roto i tēnei tikanga anō.

Me pēhea te rongoā mō tēnei?

E rua ngā whāinga matua o te maimoatanga mō te rerenga toto pleural: te tango i te wai nui me te aukati i tōna hokinga mai . Ka whakaritea tō maimoatanga e tō tākuta Nirogi Lanka i runga i te take me te kaha o ō uauatanga manawa.

Ngā rongoā

• Mena ko te Congestive Heart failure te take o tō mate, ka tohua pea e mātou ngā rongoā diuretics (e kiia ana ko ngā "pire wai" hei āwhina i tō tinana ki te tango i te wai nui mā te mimi) me ētahi atu rongoā mō te ngakau.
• Mena he mate pāwera kei roto, ka hiahiatia he rongoā paturopi .
• Mena nā te mate pukupuku (malignant effusion) i puta mai ai, ka taea te whiwhi i te chemotherapy , te radiation therapy , te werohanga rānei i te rongoā ki roto i te uma.

Ngā Tukanga

• Mena kei te uaua koe ki te manawa, ka mahi pea tō tākuta i te Therapeutic Thoracentesis (he rite ki te tango tauira wai, engari ko te whāinga i konei ko te tango i te nui o te wai e taea ana). Tērā atu huarahi, ka whakaurua pea he Ngongo Uma . Ka whakanohoia he ngongo iti ki roto i te kōhao o tō uma, kia taea ai te mimiti haere o te wai ki roto i tētahi ipu kohi o waho.
• I ētahi wā, inā koa ka kohia te wai nā te mate pukupuku, ka hoki anō pea ahakoa kua ringihia te wai. I roto i ēnei āhuatanga uaua ki te whakahaere, ka werohia pea e te tākuta he Ākena Whakatō ki roto i te wāhi pleural mā te ngongo uma. Ka whakamahia tēnei rongoā hei hanga i te kiriuhi (fibrosis) i waenganui i ngā paparanga e rua o te pleura. E mōhiotia ana tēnei tikanga ko te Pleural Sclerosis, ko te Pleurodesis rānei. Kia puta mai tēnei kiriuhi, ka piri ngā paparanga pleural e rua tetahi ki tetahi, ka whakakorea te wāhi ka kohia ai te wai. E 50% te angitu o tēnei tikanga ki te aukati i te kohi wai a meake nei.

Pokanga

Mena kāore e taea te whakahaere tika i tō āhuatanga mā te waikeri, te sclerosis pleural rānei, me mahi pokanga pea koe. Ka tirotirohia e tō taote pokanga he tirotiro hōhonu, ā, ka kōrero tahi me koe mō ngā painga me ngā mōrearea pea o te mahi.

E rua ngā momo pokanga matua:

1. Pokanga Ataata Āwhina-Tākuta (VATS): I roto i tēnei tikanga, ka mahia tētahi, kia toru rānei ngā tapahi iti rawa (tata ki te hawhe inihi te roa o ia tapahi) ki roto i tō uma, ā, mā roto ka whakauruhia he kāmera me ngā taputapu pokanga. Ka whakamahia tēnei tikanga mō ngā take uaua, ngā rerenga toto hoki e puta mai ana i te puku. I te wā o te pokanga, ka taea te tāpiri i ngā matū pēnei i te Talc , i ngā paturopi rānei ki te wāhi puku hei ārai i te hokinga mai o te wai.

2. Te pokanga uma (te pokanga tuku iho, "tuwhera"): I tēnei huarahi, ka tapahia e tō taote pokanga he 6-8 inihi te roa ki roto i tō uma hei mahi i te pokanga. He tikanga tēnei mēnā he mate pāwera tōu. Mā te pokanga uma ka taea e te taote pokanga te tango i ngā kiko muka katoa me te horoi pai i te mate mai i te wāhi pleural. Whai muri i te pokanga, me whakamahi he ngongo uma hei tango i te wai mō ngā rā e rua ki te rua wiki.

He pānga taha pea kei te puta mai i ēnei maimoatanga?

Ae, pērā i ngā wawaotanga hauora katoa, tera pea ētahi pānga taha e pā ana ki ngā maimoatanga mō te pleural effusion.

• Te Pupuhi Pūkahukahu: Ka puta pea tēnei, inā koa mēnā ka tere rawa te tangohia o te nui o te wai.
• Ngā Putunga Toto
• Ngā Auahatanga o te Ngākau Rerekē
• Pneumothorax: E pā ana tēnei ki te hinganga o te pukahukahu nā te hau e tomo ana ki te uma. Ka puta pea tēnei i ētahi wā mēnā ka pokaia te pukahukahu e te ngira tango wai.

Kia pēhea te roa o te whakaoranga?

Ko te roa o te whakaoranga e whakawhirinaki ana ki te maimoatanga i whakawhiwhia ki a koe.

• Mena i mahia he Thoracentesis ki a koe, me ata noho koe mō ngā rā e rua.
• Mena i mahia he pokanga VATS ki a koe, me noho pea koe ki te hōhipera mō ētahi rā i muri mai.
• Mena i mahia he pokanga tuwhera ( thoracotomy ) ki a koe, me noho koe ki te hōhipera mō te wiki pea.

He aha tā tātou e taea ai te whakaiti i te mōrearea?

Ahakoa he uaua ki te ārai i te nuinga o ngā tino take o te rerenga toto i roto i te kiriuhi pleural, ka taea e koe te āwhina ki te whakaiti i tō tupono mā te mahi i ēnei mahi:

• Āta karohia ngā hua tupeka katoa.
• Ārai i te pānga ki te Asbestos.
• Whāia he kai iti-konutai mēnā kua tūtohutia e tō tākuta.
• Tangohia ngā pire wai ( Diuretics ) kua tohua kia rite ki ngā tohutohu.
• Whakawhāitihia te inu wai e inuhia ana e koe mēnā kua tohua e tō tīma hauora.

He aha tāu e tumanako ai mō te haere whakamua?

I muri i tō maimoatanga, tera pea ka hiahiatia he hihi-X whai muri . Ka whakamahia ēnei e tō tākuta hei aromatawai i te angitu o te tikanga. Hei tāpiri, ka haere tonu te maimoatanga mō te mate hauora taketake i puta ai te pleural effusion.

Ko te kaha o tō āhua e whakawhirinaki ana ki ētahi āhuatanga:

• Ko te tino take o te putanga mai o te wai i roto i te pleural.
• Te nui o tōna pānga ki tō manawa.
• Te pai o te urupare a tō tinana ki te maimoatanga.

He aha te tirohanga mō te wā roa?

He rerekē te tirohanga mō te wā roa, te matapae rānei, i runga i te pūtake o tō rerenga wai i roto i te pleural me ō mate hauora kē atu. Mō te nuinga o ngā tūroro, he angitu te maimoatanga mō te rerenga wai i roto i te pleural, ahakoa tera pea ka hoki anō te mate.

Mena nā te mate pukupuku te rerenga wai i puta mai ai, he pai ake te āhua o te mate. Hei tāpiri, ki te kore e rongoatia te rerenga wai i roto i te pleural, ka pā mai pea he raruraru hauora nui.

Me pēhea koe e tiaki ai i a koe anō?

Ko ētahi āhuatanga e arahi ana ki te rerenga wai i roto i te pleural e hiahiatia ana he tiaki roa . Kōrerohia te rautaki maimoatanga pai rawa atu mō tō mate mau tonu me tō kaiwhakarato hauora o Nirogi Lanka. He mea nui kia piri tonu ki tō mahere maimoatanga.tangohia ngā rongoā katoa i te wā tika, ā, whai i ngā tohutohu a tō tākuta mō ngā huringa āhua noho.

Āhea koe me toro atu ki te tākuta?

He mea nui kia tae atu koe ki ia wā tirotiro kua whakaritea e tō tākuta hei whakahaere i tō mate pūmau. Mena ka pāngia koe e te uaua ki te manawa, ki te poto rānei te manawa, me rapu awhina hauora tonu mā te waea atu ki te 911, ki te toro atu rānei ki tō rūma ohorere tata. Kaua e whakaroa.

Ngā pātai matua hei pātai atu ki tō tākuta

Hei mārama ake ki tō hauora, whakaarohia te pātai atu ki tō tākuta i ēnei pātai e whai ake nei:

• He aha te tino take o te putanga mai o taku wai i roto i te pleural effusion?
• Kia pēhea te auau o taku hokinga atu mō ngā wā whakarite whai muri?
• He aha te tūponotanga ka hoki anō tēnei āhuatanga?
• He aha ngā pānga roa pea o tēnei rerenga wai i runga i te kiri e pā ana ki tōku hauora?

Ahakoa kāore koe e whakaatu ana i ngā tohumate, ka āwangawanga pea te noho me te totohu i roto i te pleural, ahakoa kāore koe e whakaatu ana i ngā tohumate i tēnei wā. Ko te tautuhi i te pūtake o te mate te taahiraa tino nui. Kia whakatauhia e tō tākuta te take, ka whakawhanakehia e rātou he mahere maimoatanga kua whakaritea. Mā te mārama me te tika o te whakautu i ngā pātai a tō tākuta ka āwhina i te whakawhāiti i te tautuhi mate. He mea noa te manukanuka ina uaua te manawa, nō reira kaua e mangere ki te pātai mai i ō pātai. I Nirogi Lanka, ko tō mārama me tō whakamarie te mea nui ki a mātou.

Ngā mea matua hei whakaaroaro

Ko te pleural effusion te kupu hauora mō te kohikohinga o te wai nui i roto i te āputa i waenganui i ngā paparanga o te pleura, te kiriuhi angiangi e karapoti ana i ō pukahukahu. E kiia ana tēnei ko te "wai e karapoti ana i ngā pukahukahu".

• He maha ngā take pea, tae atu ki te ngoikore o te ngakau, te niumōnia, me ngā mate pukupuku kei raro.
• Ko ngā tohu noa ko te mamae o te uma me te poto o te manawa, ahakoa kāore pea ētahi tāngata e tohu i ngā tohu.
• Ka tātaritatia tēnei mate e ngā tākuta mā te whakamahi i ngā taputapu pēnei i te hihi-X o te uma, te matawai CT, me te tātaritanga thoracentesis (tātari wai).
• Ko te arotahi o te maimoatanga he aro ki te kimi i te pūtake o te wai me te tango i te wai mā te rongoā, ngā tikanga tango wai, te pokanga rānei mēnā e tika ana.
• Ko te mea nui: ki te pāngia koe e te mamae ohorere o te uma, e te uaua rānei ki te manawa, rapua tonutia he awhina hauora. Mā te kitenga wawe ka whai hua ake te maimoatanga, ā, ka whakaitihia te tūponotanga o ngā raruraru.

Mēnā he pātai anō āu, tēnā whakapā atu ki tō tākuta. Kia ora tonu koe!

Ngā Tohu: Te rerenga wai i roto i te puku, Ngā Pūkahukahu, Te wai huri noa i ngā pūkahukahu, Te poto o te manawa, Te mamae o te uma, Te mate pūkahukahu, Te maimoatanga hauora