Kukuvara zvakanyanya pachipfuva here? Ngatitaurei kuti chipfuva chinonzi flail chipfuva chii uye kuti chinogona sei kuisa hupenyu panjodzi!

Ungafungidzira here kuti mamiriro ezvinhu akaipisisa angave akaita sei kana mbabvu dzako dzakawanda dzikatyoka, kwete panzvimbo imwe chete, asi munzvimbo mbiri kana nhatu? Ndiyo mamiriro ehutano akakomba, anorwadza zvikuru, uye emergency atichataura nezvawo nhasi (Flail Chest) . Ichi chinhu chinogona kuisa hupenyu panjodzi huru. Saka, zvakakosha kuti uzive izvi.

Chii chaizvo chinonzi Flail Chest? Chii chinoitika kuchipfuva?

Zvichitaurwa zviri nyore, chipfuva chine flail chirwere apo mbabvu nhatu kana kupfuura dziri pedyo muchipfuva chako dzinotyoka, kana kuti mbabvu imwe chete inotyoka munzvimbo mbiri. Fungidzira kuti kana izvozvo zvikaitika, nzvimbo yemadziro echipfuva apo mbabvu dzakatyoka inova "yakasununguka," zvichireva kuti inorasikirwa nekugadzikana kwayo. Zvakafanana nechikamu chemadziro chinodonha kubva pachivako. Izvi ndizvo zvinoita kuti zviome kufema kamwe kamwe.

Chinhu chisingawanzoitika panyaya iyi ndechekuti kana mbabvu yatyoka seizvi, chikamu ichocho chechipfuva chinofamba kana uchifema nenzira yakasiyana neyakasara yechipfuva chako chine hutano. Kureva kuti, paunofema (inhale), chikamu chakatyoka, chakasununguka chinopinda. Asi paunofema (exhale), chikamu ichocho chinobuda. Zvinoita sekunge chiri kushanda neimwe nzira! Vanachiremba vanoti kufamba uku kusina kujairika "paradoxical movement" . Izvi zvinodzivirira mapapu kufema zvakanaka uye kufema mweya, zvichikanganisa maitiro ese ekufema.

Ndiani anonyanya kubatwa nechirwere ichi (Flail Chest)?

Dambudziko iri rine njodzi rinonzi Flail Chest rinowanzoitika nekuda kwekukuvara kukuru . Ngationei kuti ndiani ari panjodzi huru:

• Kune avo vari kuita tsaona dzakakomba dzemotokari . Kutaura zvazviri, ichi ndicho chikonzero chikuru che (Flail Chest).
• Kudonha kubva pakakwirira chinhu chine njodzi, kunyanya kune vakwegura. Kana uine osteoporosis , chirwere chinoita kuti mapfupa ako asashande zvakanaka sezvaunokura, kunyangwe kudonha kudiki kunogona kutyoka mbabvu dzako.
• Vamwe vana vari panjodziwo. Semuenzaniso, vana vane zvirwere zvinokonzera kushaya simba kwemapfupa, zvakaita seOsteogenesis Imperfecta (chirwere chemajini chinoita kuti mapfupa aputsike nyore nyore), kana vana vane zvimwe zvirwere zvemuviri zvevana, vanogonawo kuva nechirwere ichi.
• Dzimwe ongororo dzakawana kuti varume vane mukana wekuva nechirwere ichi (Flail Chest).

Ndezvipi zviratidzo zveFlail Chest?

Ngationei kuti zviratidzo zvipi zvingaratidzwa nemunhu ane chirwere chechipfuva chakakombama. Zvakakosha kuziva izvi:

• Kurwadziwa kwakanyanya muchipfuva, zvichikonzera kufema zvishoma nezvishoma. Zvakaoma kufema zvakadzama nekuti chipfuva chinorwadza zvakanyanya.
• Kushaikwa kweoxygen yakakwana munyama dzemuviri. Izvi zvinonzi "hypoxia" mune zvehutano. Ichi chirwere chine njodzi.
• Miromo yebhuruu kana kuti minwe (cyanosis). Izvi zvinoitika kana muviri usingawani okisijeni yakakwana. Ichi chiratidzo chedambudziko.

Vanachiremba vanoongorora sei Flail Chest?

Ngationei kuti chiremba anoongorora sei chirwere ichi chakakomba chinonzi Flail Chest nemazvo.

Vanachiremba vanofungidzira izvi zvakanyanya nekutarisa kufema kwako . "Kufamba kusinganzwisisike" kwandatsanangura kare, kunova kufamba kwechikamu chechipfuva chakatyoka kuenda kune rimwe divi paunofema, chinhu chinogona kuonekwa nachiremba kunze. Paunofema, chikamu ichocho chakatyoka chinobuda mberi, uye paunofema, chikamu ichocho chinopinda mukati.

Maitiro aya ekufema asina kujairika ndiwo anonyanya kukosha pakuziva Flail Chest.

Uye zvakare, bvunzo dzakadai dzinogona kuitwa:

• X-ray yechipfuva: Izvi zvinogona kuratidza pachena kuti mbabvu dzakatyoka kupi uye sei. Zvisinei, hazvigone kuratidza kukuvara kwekatsi iri pakati pembabvu. Uyewo, mavanga emapapu ako dzimwe nguva anogona kuonekwa paX-ray.
• Dzimwe nguva, kana chiremba achibata chipfuva chako zvinyoro nyoro , anogona kunzwa mbabvu dzakatyoka uye kusagadzikana munzvimbo iyoyo.

Chifuva cheFlail chinorapwa sei?

Chifuva cheFlail chirwere chinouraya chinoda kurapwa nekukurumidza. Mushure mekupinda muchipatara, kurapwa kunotevera kunowanzoitwa:

Kurapa kwekutanga uye kudzora marwadzo

• Chinhu chekutanga chauchaita ndechekukupa okisijeni kuti ikubatsire kufema. Kurova kwemoyo wako, BP, uye mwero weokisijeni zvichatariswawo .
• Tevere, kudzora marwadzo kwakakosha zvikuru. Nekuti kana usingakwanise kufema zvakanaka nekuda kwekurwadziwa kwakanyanya, mamiriro acho anogona kuipa. Unogona kuita zvinhu zvakaita seizvi kuderedza marwadzo:
• Mishonga inopinzwa netsinga (IV).
• Jekiseni rakakosha rinopihwa kumusana (epidural anesthesia).
• Majekiseni anouraya marwadzo anovhara tsinga dziri pakati pembabvu (`intercostal pain blocks`).
• Dzimwe nguva nzira dzinopfuura imwe chete idzi dzinoshandiswa pamwe chete.

Kuchengetedza mapapu akachena: (Kuchengetedza Hutsanana hweMapupa)

Izvi zvakakosha zvikuru. Chimwe chezvinetso zvikuru zvinogona kuitika kana munhu aine chirwere cheFlail Chest ndiko kukura kwepneumonia . Kuti izvi zvisaitike, zvakakosha kumisa kuungana kwezvinobuda zvakaita semanyoka mumapapu. Zvinhu zvinoitwa pakuita izvi zvinonzi `(Pulmonary hygiene)`Inonzi (nzira yekuchengetedza hurongwa hwekufema hwakachena). Inonziwo `(chimbuzi chepamupa)` kana `(kurapa chipfuva)`. Inosanganisira zvinotevera:

• Kusveta: Chubhu yakatetepa inopinzwa mumhepo uye madzihwa akaungana anoburitswa.
• Kushandisa mudziyo wakakosha kubatsira kuvandudza kufema (`Incentive spirometry`): Izvi zvinodzidzisa murwere kufema zvakadzama uye kukura mapapu zvakanaka.
• Kurapa nebronchodilator: Iyi mishonga inogona kupihwa semishonga inofemerwa. Inopa nzira dzekufema dzakakura uye inoita kuti kufema kuve nyore.
• Kuongororwa kwemvura: Kuti mapapu ashande zvakanaka, huwandu hwemvura mumuviri, kunyanya muropa, hunofanira kunge huri padanho rakakodzera.
• Kuisa murwere panzvimbo yakakodzera: Izvi zvinoita kuti kufema kuve nyore uye zvinogona kuderedza marwadzo.

Rubatsiro rwekufema nekuvhiyiwa

• Vamwe varwere vanogona kupihwa muchina unonzi ``CPAP - Continuous Positive Airway Pressure'' kuti uvabatsire kufema. Kana kuti vanogona kupihwa oxygen yekuwedzera.
• Ungangoda kubatanidzwa nemuchina wakakosha ('mechanical ventilator') kuti ukubatsire kufema , zvichida kwemazuva akati wandei kana mavhiki, kusvika maronda ako apora.
• Mune zvimwe zviitiko zvakakomba, kuvhiyiwa kunogona kudiwa kudzivirira matambudziko akadai sepneumonia, kuderedza kugara muchipatara, uye pamwe kudzivirira rufu. Maitiro aya anonzi surgical rib fixation . Izvi zvinosanganisira kuisa michina, senge maplate nema screws, akagadzirwa nesimbi senge titanium, muchipfuva kuti mbabvu dzakatyoka dzigadzikane.

Nguva yekupora inomira sei?

Zvinogona kutora mwedzi yakati wandei kuti unyatsopora kubva pachirwere ichi chakakomba chinonzi Flail Chest. Nekuti izvi zvinokonzerwa netsaona yakakomba, kutyoka kwembabvu uku kunofanira kupora pamwe chete nemamwe mavanga anokonzerwa netsaona iyoyo.

Ungangoda kugara muchipatara, pamwe muIntensive Care Unit (ICU) kwemazuva mashoma kana kupfuura. Kana uine mbabvu dzakagadzirwa sezvandambotaura, zvimwe zvidzidzo zvakaratidza kuti nguva yaunogara muchipatara nenguva yaunogara muICU inogona kuderedzwa.

Kunyangwe mushure mekunge wadzoka kumba kubva kuchipatara, unogona kunge uine matambudziko ekufema kwenguva yakati. Saka , unofanira kuramba uchiita maekisesaizi ekufema ayo vanachiremba vako nevanorapa muviri vanokudzidzisa, uye woaita nemazvo.

Semuyenzaniso:

• Kufema zvishoma nezvishoma nemiromo yakasungwa (kufema nemiromo yakasungwa).
• Kufema zvakadzika kubva mudumbu (`kufema kwedumbu`).
• Unofanirawo kudzidzira nzira dzekukosora dzakadzora kuti uderedze kuungana kwematehwe mumapapu.

Njodzi yekubatwa nechipfuva chinoputika inogona kuderedzwa here?

Ehe, kusvika pamwero wakati. Flail Chest inokonzerwa nekukuvadzwa kwakanyanya, saka kuderedza njodzi yekukuvara kwakadaro kunogona kuderedza njodzi yechirwere ichi.

• Gara uchityaira zvakachengeteka. Usatyaira nekukurumidza zvisina kufanira, uye gara wakasunga bhandi rako rekuchengetedza.
• Kana wakwegura kana kuti uri panjodzi yekudonha, chenjera kunyangwe uri kumba. Chengeta pasi pako pasina zvinhu zvinotsvedza nezvipingamupinyi. Iva nechokwadi chekuti pane chiedza chakakwana. Kana uchida chinhu chekufambisa, senge chinofamba kana tsvimbo, chishandise pasina kuzeza.

Chifuva chechipfuva nepneumothorax zvakafanana here?

Kwete. Flail Chest nePneumothorax (mapapu akadonha) zvinhu zviviri zvakasiyana.

Pneumothorax inguva apo mhepo inoungana munzvimbo yepleural iri pakati pemadziro echipfuva nemapapu panzvimbo pekupinda mumapapu. Zvisinei, dambudziko guru rechipfuva cheflail ipneumothorax, iyo inogona kuitika kana chidimbu chembabvu dzakatyoka chikaiswa mumapapu.

Flail Chest yakakomba zvakadini?

Ichi chinhu chaunofanira kuyeuka: Flail Chest chirwere chakakomba zvikuru, chinouraya vanhu. Hachifanirwe kurapwa kumba. Chinofanira kurapwa nekukasika kuchipatara.

Sezvo izvi zvichikonzerwa netsaona yakakura, kana uine chirwere chinonzi Flail Chest, zvinotora nguva yakareba kuti upore. Uchafanira kugara muchipatara kwenguva yakareba. Ungatove uri pamuchina wekufema kwemazuva akati wandei. Kunyangwe watanga kupora, uchafanira kuramba uchiita maekisesaizi ekufema uye physiotherapy sezvakarairwa nachiremba wako.

Chekupedzisira, zvinhu zvaunofanira kurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, saka, ndinofunga kuti wanzwisisa zvimwe zvinhu zvakakosha kubva pane zvatataura nezvazvo (Flail Chest). Chekupedzisira, hezvino zvandinofanira kutaura:

• Chifuva cheFlail hachisi chinhu chekurerutsa. Idambudziko guru, rinoisa hupenyu panjodzi.
• Chikonzero chikuru cheizvi itsaona dzakakomba, kunyanya tsaona dzemotokari uye kudonha kubva pakakwirira.
• Chinhu chikuru uye chinonyanya kusiyanisa izvi kufamba kwechikamu chechipfuva kuenda kune rimwe divi paunenge uchifema (`paradoxical movement`) . Pamwe chete neizvi, kurwadziwa kwakanyanya uye kuoma kufema kunoitika.
• Kana uine zviratidzo zvakaita seizvi, kana kuti wakamboita tsaona yakakura, zvakakosha kutsvaga rubatsiro rwechiremba nekukasika.Usapedza nguva.
• Zvinotora nguva kuti unyatsopora, uye kunyangwe wabuda muchipatara, unofanira kuramba uchitevera mazano echiremba uye kuita maekisesaizi ekufema.
• Edza kuzvidzivirira kubva mutsaona zvakanyanya sezvinobvira uye kuderedza njodzi yekuti zvinhu zvakadaro zviitike .

Kana iwe kana mumwe munhu waunoziva aine zviratidzo izvi, kana kuti uchifunga kuti wakaita tsaona yakakura, chinhu chakanakisa chaungaita ndechekuenda kuchipatara chiri pedyo nekukurumidza wotsvaga mazano echiremba. Izvi zvinogona kutoponesa hupenyu!

Chifuva Chinotsemuka , Kutyoka Mbabvu, Kusagadzikana kweMadziro eChifuva, Kufema Kunorema, Njodzi, Kukuvara kweChifuva, Kutambudzika kweKufema