Kodi mapapu anu amamva ngati odzazidwa ndi madzi? Tiyeni tikambirane za pleural effusion!

Kodi munayamba mwamvapo kulemera pang'ono pachifuwa panu, kumva zachilendo mukamapuma? Kapena munayamba mwamvapo wina akunena kuti, "Mapapu ali odzaza ndi madzi"? Ndicho chimene tikambirane lero. Izi zimadziwika kuti pleural effusion.

Mwachidule, kodi pleural effusion ndi chiyani?

Chabwino, tsopano tiyeni tiwone mwachidule. Mapapu anu ali mkati mwa chifuwa chanu. Kuzungulira mapapo awa, komanso mkati mwa chifuwa chanu, pali ma nembanemba awiri owonda kwambiri. Timatcha ma nembanemba awa kuti pleura . Zili ngati kuti aphimbidwa mbali zonse ziwiri.

Kawirikawiri, pamakhala madzi ochepa kwambiri pakati pa nembanemba ziwirizi za pleural. Taganizirani ngati mafuta omwe amapaka mafuta mbali ziwiri za makina. Madzi awa ndi omwe amalola mapapu anu kusuntha, kufutukuka, ndi kufupika mosavuta mukamapuma.

Komabe, mu mkhalidwe uwu wotchedwa pleural effusion , kuchuluka kwa madzi pakati pa nembanemba ziwiri za pleural kumakhala kwakukulu kwambiri kuposa kwachizolowezi . Izi zikutanthauza kuti thupi lanu likupanga madzi ambiri, kapena madzi omwe amapangidwa sakubwezeretsedwanso bwino m'thupi. Pamenepo ndi pamene timati "mapapo ali odzaza ndi madzi."

Kodi pali mitundu ya pleural effusion?

Inde, madokotala amagawa pleural effusion m'mitundu iwiri ikuluikulu, kutengera mtundu wa madzi omwe amasonkhana mozungulira mapapo.

1. Madzi otuluka m'thupi (transudative) kapena opanda mapuloteni: Madzi amtunduwu nthawi zambiri amapezeka pamene kuthamanga kwa madzi m'thupi kukukwera. Mwachitsanzo, munthu amene ali ndi matenda a chiwindi ( cirrhosis ) kapena kulephera kwa mtima akhoza kukhala ndi madzi amtunduwu. Izi zimachitika pamene madzi akutuluka m'mitsempha yamagazi.

2. Madzi otuluka m'thupi kapena okhala ndi mapuloteni ambiri: Zomwe zimayambitsa madzi amtunduwu ndi khansa (monga khansa ya m'mapapo, khansa ya m'mawere) kapena matenda enaake. Pankhaniyi, madzi ochulukirapo amatuluka kudzera m'mitsempha yaying'ono yamagazi kapena madziwo sachotsedwa bwino ndi dongosolo la lymphatic.

Njira zochiritsira zimasankhidwa kutengera mtundu uwu. Chifukwa chake ndikofunikira kwambiri kuti dokotala adziwe mtundu wa madzi awa.

Kodi vutoli ndi lofala bwanji?

Ndipotu, kutuluka kwa pleural effusion ndi vuto lofala kwambiri kuposa momwe mungaganizire . Mwachitsanzo, zanenedwa kuti anthu pafupifupi 1.5 miliyoni ku United States kokha amadwala vutoli chaka chilichonse. Vutoli limapezekanso m'dziko lathu.

Kodi zizindikiro za pleural effusion ndi ziti?

Mungakhale ndi zizindikiro zina kutengera vuto lomwe linayambitsa kutuluka kwa pleural effusion. Komabe, pali zizindikiro zingapo zomwe zimakhudzana ndi kutuluka kwa pleural effusion.

• Kupweteka pachifuwa: Kupweteka kumeneku kungakule kwambiri, makamaka mukapuma mpweya wozama kapena mukutsokomola. Kungamveke ngati chinachake chikukubayani kuchokera mkati.
• Kuvuta kupuma (Dyspnea): Kupuma kungakhale kovuta komanso kovutitsa. Izi zitha kukhala zovuta kwambiri mukamachita khama.
• Orthopnea: Ichi ndi chizindikiro china chake. Zimatanthauza kuti mumavutika kupuma m'malo ena kupatula kukhala pansi kapena kuyimirira molunjika (monga kugona pansi). Anthu ena amagona ndi mapilo awiri kapena atatu kuti adzichirikize chifukwa amamva kuti akulephera kupuma akagona pansi.

Komabe, anthu ena amatha kukhala ndi pleural effusion popanda zizindikiro zilizonse . Amadziwa izi pokhapokha akapatsidwa X-ray pachifuwa pazifukwa zina.

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Pali zifukwa zambiri zomwe zimayambitsa kutuluka kwa magazi m'thupi. Nthawi zina pangakhale zifukwa zingapo. Monga tafotokozera kale, madokotala amayesa kudziwa chomwe chimayambitsa matendawa podziwa ngati madzi omwe amasonkhana ndi a transudative ( amadzi) kapena exudative (olemera mapuloteni). Nthawi zina, vuto lotchedwa pulmonary embolism (PE) lingakhale la mitundu yonse iwiri.

Zifukwa zazikulu zomwe zimapangitsa kuti madzi a transudative adziunjikire ndi izi:

• Kulephera kwa Mtima: Ichi ndi chifukwa chofala kwambiri. Mtima ukalephera kugwira ntchito bwino, kayendedwe ka madzi m'thupi kamasokonekera.
• Matenda a chiwindi: Matenda oopsa omwe amapezeka m'chiwindi.
• Matenda a Nephrotic: Ili ndi vuto la impso. Vutoli limatha kuchitika impso zikatulutsa mapuloteni ambiri.

Zifukwa zazikulu zomwe zimapangitsa kuti madzi otuluka m'thupi azisonkhana ndi izi:

• Chibayo: Matenda a m'mapapo.
• Khansa: Makamaka khansa ya m'mapapo , khansa ya m'mawere , kapena lymphoma .
• Matenda a Impso
• Matenda Otupa: Matenda osiyanasiyana otupa omwe amapezeka m'thupi.
• Pambuyo pa opaleshoni yotsegula mtima

Palinso zifukwa zochepa zomwe zimachitika kawirikawiri:

• Chifuwa chachikulu
• Matenda Odziteteza Kuthupi: Izi zikutanthauza kuti chitetezo cha mthupi chimaukira maselo ake.
• Kutuluka magazi chifukwa cha kuvulala pachifuwa.
• Chylothorax: Izi zimachitika pamene madzi otchedwa 'chyle' ochokera m'thupi la lymphatic system asonkhana m'chifuwa. Nthawi zambiri amayamba chifukwa cha kuvulala.
• Matenda osowa kwambiri pachifuwa ndi m'mimba.
• Kukhudzidwa ndi asbestos.
• Kuphulika kwa M'mero
• Pancreatitis
• Matenda a Meig: Amayambitsidwa ndi chotupa chosaopsa chomwe chimakula m'chiberekero.
• Matenda a Ovarian Hyperstimulation
• Mankhwala ena
• Opaleshoni ya m'mimba.
• Chithandizo cha X-ray

Nthawi zina, madziwo amatha kukhala ndi maselo oopsa , kapena amatha kudziunjikira ngati zotsatira za chemotherapy .

Ndani ali pachiwopsezo chachikulu chotenga izi?

Pali zinthu zingapo zomwe zingayambitse kufalikira kwa pleural effusion.

• Kukhala ndi matenda omwe amayambitsa izi: Mwachitsanzo, ngati muli ndi matenda a mtima, chiwindi, impso, kapena khansa, muli pachiwopsezo chachikulu chotenga pleural effusion.
• Kugwiritsa ntchito fodya: Anthu omwe amasuta fodya amakhala ndi vuto la mapapo.
• Kukhudzana ndi asbestos: Ichi ndi chinthu chomangira chomwe chimagwiritsidwa ntchito kwambiri. Kukhudzana nacho kwa nthawi yayitali kungayambitse kuwonongeka kwa mapapo.

Kodi izi zingayambitse mavuto otani?

Ngati pleural effusion sichitha kuchiritsidwa bwino, mavuto ena angachitike.

• Matenda amatha kusanduka thumba: Madzi omwe amasonkhana amatha kufalikira ndi majeremusi, zomwe zimapangitsa kuti likhale thumba.
• Zilonda m'mapapo: Minofu ya zilonda imatha kupangika pamalo pomwe madzi anali, zomwe zingasokoneze kugwira ntchito kwa mapapo.
• Kuwonongeka kwa mapapo anu.

Kodi mumapeza bwanji vutoli?

Mukapita kukaonana ndi dokotala, iye adzakufunsani kaye za mbiri yanu ya matenda . Ndi matenda ena ati omwe muli nawo ndipo zizindikirozi zinayamba liti? Kenako adzakuyesani thupi . Adzamvetsera mapapu anu pamene mukupuma (ndi stethoscope). Pokhapokha adzalamula mayeso ofunikira.

Ndi mayeso ati omwe akuchitidwa pa izi?

Madokotala amagwiritsa ntchito mayeso awa kuti azindikire ndikumvetsetsa mtundu wa pleural effusion:

• X-ray ya pachifuwa: Izi zingathandize kudziwa ngati madzi asonkhana komanso kuchuluka kwake.
• Kujambula pachifuwa kwa CT (Computed Tomography - CT scan): Kungathe kupanga zithunzi zomveka bwino komanso zatsatanetsatane kuposa X-ray. Kungathenso kuyang'ana momwe mapapo alili pansi pa madzi ndi zinthu zina monga zotupa.
• Ultrasound pachifuwa:Izi zimathandizanso kupeza komwe kuli madzi ndi kuchuluka kwake, komanso malo enieni oti muyike singano yaying'ono kuti muchotse madziwo.
• Kuyeza magazi m'thupi (Thoracentesis) kapena Kuyeza magazi m'thupi (Biopsy): Izi zimaphatikizapo kulowetsa singano yopyapyala kwambiri pachifuwa chanu pakati pa nthiti ziwiri kuti mutenge chitsanzo cha madzi omwe apezeka. Nthawi zina kachidutswa kakang'ono ka pleural membrane (biopsy) kamathanso kutengedwa.
• Kusanthula Madzi a Pleural: Chitsanzo cha madzi chimatumizidwa ku labu kuti akayesedwe. Izi zitha kudziwa kuchuluka kwa mapuloteni, mitundu ya maselo, ngati pali majeremusi, kapena maselo a khansa. Ichi ndi chomwe chingakuuzeni ngati madziwo ndi transudative kapena exudative.

Ngati mayeso osavuta awa sakupeza chomwe chikuyambitsa, mungafunike kuchita opaleshoni yotchedwa thoracoscopy . Izi zimatchedwanso opaleshoni ya thoracic yothandizidwa ndi kanema (VATS) . Izi zimachitika mukakhala pansi pa anesthesia. Izi zimaphatikizapo kuyika kamera kakang'ono ndi zida pachifuwa chanu kuti muwone bwino pleura ndi madera ozungulira. Chithandizo nthawi zambiri chimachitika nthawi yomweyo ndi opaleshoni iyi.

Kodi izi zimachiritsidwa bwanji?

Pali zolinga ziwiri zazikulu pochiza pleural effusion: Choyamba ndi kuchotsa madzi ochulukirapo . Chinanso ndi kuletsa madziwo kuti asadzabwerenso . Madokotala amasankha chithandizo kutengera chomwe chimayambitsa komanso kuchuluka kwa kuvutika kwanu kupuma chifukwa cha madziwo.

Mankhwala

• Ngati muli ndi madzi ochulukirapo chifukwa cha vuto monga kulephera kwa mtima , madokotala adzakupatsani mankhwala ochepetsa mphamvu ya madzi m'thupi (omwe amadziwikanso kuti "mapiritsi amadzi" chifukwa amathandiza thupi kuchotsa madzi ochulukirapo kudzera mu mkodzo) ndi mankhwala ena a kulephera kwa mtima.
• Ngati ndi chifukwa cha matenda, muyenera kumwa maantibayotiki .
• Ngati vutoli layamba chifukwa cha khansa (malignant effusion), mungalandire chemotherapy , radiation therapy , kapena kulowetsedwa mankhwala amadzimadzi m'chifuwa.

Njira Zochiritsira (Njira)

• Ngati mukuvutika kupuma, dokotala wanu angakupatseni thoracentesis yochiritsira (izi zikufanana ndi kutenga chitsanzo cha madzi, koma madzi ambiri momwe angathere amachotsedwa). Kapena angaike chubu cha pachifuwa . Izi zikuphatikizapo kulowetsa chubu chaching'ono pachifuwa chanu ndikulola madzi kutuluka mu botolo.
• Nthawi zina, makamaka pamene madzi akuchulukana chifukwa cha khansa, madziwo amatha kubwereranso ngakhale atachotsedwa. Pazochitika zovuta ngati zimenezi, dokotala angagwiritse ntchito chubu cha pachifuwa kuti atulutse madziwo.Mtundu wa mankhwala otchedwa sclerosing agent amabayidwa mu pleural cavity. Mankhwalawa mwadala amayambitsa chilonda (fibrosis) pakati pa pleural nembanemba ziwiri. Izi zimatchedwanso pleural sclerosis kapena pleurodesis . Chilondachi chikapangidwa, pleural nembanemba ziwiri zimamatirana, zomwe zimaletsa madzi kuti asasonkhanitsenso. Njirayi ndi yothandiza pafupifupi 50% yokha poletsa madzi kuti asasonkhanitsenso.

Opaleshoni

Ngati kutuluka kwa madzi m'thupi kapena pleural sclerosis sikukwanira kulamulira vuto lanu, mungafunike opaleshoni. Dokotala wanu adzakuyang'anirani mosamala ndikukambirana nanu za ubwino ndi kuipa kwa opaleshoniyo.

Pali mitundu iwiri ikuluikulu ya opaleshoni:

1. Opaleshoni Yothandizidwa ndi Video-Assisted Thoracoscopic (VATS): Izi zimaphatikizapo kupanga mabala ang'onoang'ono kamodzi kapena katatu (pafupifupi theka la inchi) pachifuwa ndikuyika kamera ndi zida zochitira opaleshoni kudzera mwa iwo kuti achite opaleshoniyo. Njirayi imagwiritsidwa ntchito pa ma pleural effusions omwe ndi ovuta kuwalamulira kapena omwe amabwereranso chifukwa cha khansa. Pa opaleshoni, chinthu monga talc kapena maantibayotiki amayikidwa mu pleural cavity kuti ayesere kuletsa madzi kuti asasonkhanitsidwenso.

2. Kuchotsa chifuwa (opaleshoni yachikhalidwe, "yotseguka"): Mu njira iyi, dokotalayo amaduladula chifuwa cha mainchesi 6-8. Iyi ndi njira yofala kwambiri yomwe imagwiritsidwa ntchito ngati muli ndi matenda. Kuchotsa chifuwa kumachotsa minofu yonse ya ulusi ndipo kumathandiza kuyeretsa bwino matenda omwe ali m'mimba mwa pleural. Mungafunike kuyika chubu cha pachifuwa kuti mutulutse madzi kwa masiku awiri mpaka milungu iwiri mutachita opaleshoni.

Kodi pali zotsatirapo zilizonse zomwe zingachitike chifukwa cha chithandizochi?

Inde, monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, mankhwala ochizira pleural effusion angayambitse zotsatirapo zina.

• Kutupa kwa m'mapapo: Izi zitha kuchitika, makamaka ngati madzi ambiri achotsedwa nthawi yomweyo.
• Magazi Oundana
• Miyimbo Yachilendo ya Mtima
• Pneumothorax: Uku ndi kugwa kwa mapapo chifukwa cha mpweya wodzaza mapapo. Nthawi zina izi zingachitike pamene singano yomwe imagwiritsidwa ntchito kuchotsa madzi yagundidwa.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire?

Izi zimasiyana malinga ndi chithandizo chomwe chachitidwa.

• Ngati munali ndi thoracentesis , muyenera kusamala pang'ono kwa masiku awiri.
• Ngati munachitidwa opaleshoni ya VATS , mungafunike kukhala m'chipatala kwa masiku angapo pambuyo pake.
• Ngati munachitidwa opaleshoni ya thoracotomy (opaleshoni yotseguka), muyenera kukhala m'chipatala kwa pafupifupi sabata imodzi.

Kodi tingatani kuti tichepetse chiopsezochi?

N'zovuta kupewa zinthu zambiri zomwe zimayambitsa kutuluka kwa pleural effusion. Komabe, mutha kuchepetsa chiopsezo chanu pang'ono mwa:

• Pewani kugwiritsa ntchito zinthu zopangidwa ndi fodya.
• Pewani kukhudzana ndi asbestos.
• Ngati dokotala wanu wakulangizani, sankhani zakudya zopanda mchere wambiri.
• Imwani mankhwala anu ochepetsa ululu (mapiritsi a madzi) pa nthawi yake.
• Ngati dokotala wanu akukuuzani kuti muchepetse kumwa madzi.

Kodi tiyenera kuyembekezera chiyani ndi vutoli?

Mukalandira chithandizo, muyenera kuyesedwanso ndi X-ray . Dokotala adzafuna kudziwa ngati chithandizocho chayenda bwino. Muyeneranso kupitiriza kulandira chithandizo cha vuto lomwe linayambitsa kutuluka kwa pleural effusion.

Kuopsa kwa vuto lanu kumadalira zinthu izi:

• Kodi chifukwa chachikulu cha pleural effusion ndi chiyani?
• Kodi zimakhudza kupuma kwanu?
• Nkhani yake ndi yakuti ngati imayankha bwino ikalandira chithandizo.

Kodi chiyembekezo cha vutoli n'chiyani?

Mawonekedwe, kapena kuti nthawi yodziwira matenda , amasiyana kwambiri kutengera chomwe chinayambitsa pleural effusion yanu ndi matenda ena omwe muli nawo. Kwa anthu ena, chithandizo cha pleural effusion chimayenda bwino. Komabe, pleural effusion ikhoza kubwereranso .

Chiyembekezo cha kufalikira kwa pleural effusion komwe kumachitika chifukwa cha khansa sichabwino kwenikweni. Ndipo ngati simuchiza bwino kufalikira kwa pleural effusion, sichabwinonso.

Kodi mumadzisamalira bwanji?

Matenda ena omwe amayambitsa pleural effusion amafunika chithandizo cha nthawi yayitali . Lankhulani ndi dokotala wanu za chithandizo chabwino kwambiri cha nthawi yayitali cha vuto lanu. Kenako, tsatirani ndondomeko yanu ya chithandizo molondola . Imwani mankhwala anu panthawi yake ndikusintha moyo wanu monga momwe dokotala wanu akulangizira.

Kodi ndi liti pamene kuli bwino kupita kwa dokotala?

Pitani ku ma aderesi onse otsatira omwe dokotala wanu walamula kuti akuthandizeni kuthana ndi vuto lanu losatha. Ngati mukuvutika kupuma , funani thandizo lachipatala nthawi yomweyo . Musazengereze.

Kodi ndi mafunso otani ofunika kufunsa dokotala wanu?

Mungathe kufunsa dokotala mafunso monga:

• N’chifukwa chiyani ndinayamba kuvutika ndi pleural effusion?
• Kodi ndimafunika kubwera kudzakuonani kangati (nthawi yokumana ndi dokotala)?
• Kodi pali mwayi wotani woti ndiyambenso kudwala matenda a pleural effusion?
• Kodi zotsatira za nthawi yayitali za pleural effusion yanga ndi ziti?

Kotero, muli ndi pleural effusion, mwina simunakhale ndi zizindikiro zilizonse. Chofunika kwambiri ndikupeza chomwe chikuyambitsa.Dokotala akadziwa chomwe chikuyambitsa vutoli, adzachitapo kanthu kuti achire. Kuyankha mafunso a dokotala molondola kungathandize kuchotsa zina mwa zomwe zimayambitsa vutoli. Ndizachibadwa kuchita mantha mukakhala ndi vuto lopuma, choncho musaope kufunsa mafunso okhudza chilichonse chomwe mukufuna kumvetsetsa.

Ndiye, ndi zinthu ziti zomwe tiyenera kukumbukira kuchokera pa zonsezi?

Kutuluka kwa madzi m'mapapo ndi kusonkhana kwa madzi pakati pa pleura, nembanemba zomwe zimazungulira mapapo. Anthu ena amatchanso izi kuti "madzi m'mapapo."

• Pakhoza kukhala zifukwa zingapo zomwe zimayambitsa izi. Zinthu monga matenda a mtima, chibayo, ndi khansa ndizomwe zimayambitsa izi.
• Zizindikiro zake zingakhale kupweteka pachifuwa komanso kuvutika kupuma . Anthu ena sangakhale ndi zizindikiro zilizonse.
• Dokotala amatha kuzindikira izi kudzera mu X-ray, CT scans, ndi fluid sampling (thoracentesis) .
• Chithandizo chimayang'ana kwambiri chomwe chimayambitsa vutoli komanso kuchotsa madzi . Mankhwala, njira zochotsera madzi, komanso nthawi zina opaleshoni ingafunike.
• Chofunika kwambiri ndikuonana ndi dokotala mwamsanga ngati mukuvutika kupuma kapena mukumva chotupa pachifuwa chanu. Kuzindikira msanga kumathandiza kuti chithandizo chikhale chosavuta komanso kumachepetsa chiopsezo cha zovuta.

Ngati muli ndi mafunso ena okhudza izi, musazengereze kulankhula ndi dokotala wanu. Khalani ndi thanzi labwino!

Kutuluka kwa madzi m'mapapo, mapapo, madzi pachifuwa, kupuma movutikira, kupweteka pachifuwa, matenda a mapapo, chithandizo chamankhwala