Wakamboona here kuti kana mwana wako achinzwa dzihwa kana fivha, ganda riri pakati pembabvu dzechipfuva rinopinda mukati paanofema? Kana kuti zvinoita sekunge chipfuva chake chiri kurova here? Zvakajairika kuti chero amai kana baba vatye zvishoma pavanoona izvi. Izvi ndizvo zvatinodaidza kuti Intercostal Retractions mukurapa. Ichi chiratidzo chakakosha chekuoma kwekufema. Saka ngatitaurei nezvazvo nenzira iri nyore uye yakajeka nhasi.
Zvichitaurwa zviri nyore, chii chinonzi Intercostal Retractions?
Kudhonza kwemukati membabvu zvinoreva apo tsandanyama neganda zviri pakati pembabvu dzako zvinodhonza mukati paunofema. 'Intercostal' zvinoreva nzvimbo iri pakati pembabvu mbiri. Kudhonza kwechipfuva uku kunoreva kuti pane kuzvimba kana kuvharika mumapapu, zvichiita kuti zviome kufema.
Funga nezvazvo nenzira iyi. Patinofema zvakanaka, tsandanyama iri pakati pechipfuva nedumbu, inonzi diaphragm, inodonha pasi. Izvi zvinogadzira kumanikidzwa kusina kunaka mukati mechipfuva, uye mweya unodhonzwa mumapapu. Izvi zvakafanana nekukwevera mushonga musirinji. Asi chii chinoitika kana nzira yekufema, iyo nzira inopfuura nayo mweya, ikavharirwa kana kuderedzwa netsvina kana chimwe chinhu? Kunyangwe diaphragm ichidonha pasi, mweya hauna kukwana unogona kupinda mumapapu.
Zvakaita sekuti uri kuvhara mugumo wetsvina wobva wasveta kune rimwe divi. Kunyangwe uchidhonza zvakasimba sei, hapana chinoburuka mutsvina, panzvimbo pezvo mativi etsvina anonyura mukati. Ndizvo zvinoitika mukati mechipfuva. Nekuti mhepo haisi kupinda, tsandanyama neganda rechipfuva zvinotanga kudhonza mukati.
Izvi zvinogona kunge zvakajairika mushure mekumhanya nekutamba, asi kana chiratidzo ichi chikaitika munhu akazorora, asina kushandisa simba, chiratidzo chekunetseka kukuru kwekufema.
Ndezvipi zvimwe zviratidzo zvekushaya mweya?
Kudhonzwa kwemukati membabvu kunoratidzika semakomba ari pakati pembabvu. Zvinoita sekunge mbabvu dziri kudhonzwa mukati. Izvi zvinonyanya kuonekwa muvacheche nevana vadiki nekuti vane mafuta mashoma mumuviri. Vanachiremba vanogona kunge vakakuudza dzimwe nguva kuti utarise kuoma kwechipfuva kana mwana wako achinetseka kufema. Kuwedzera kune chiratidzo ichi, kune zvimwe zviratidzo zvakawanda zvinogona kuonekwa kana mwana wako achinetseka kufema.
| Chiratidzo | Tsananguro |
|---|---|
| Kuputika kwemhino | Mhino dzinokura uye dzinotetepa pakufema kwega kwega. |
| Kufema nekukurumidza (`Tachypnea`) | Huwandu hwekufema paminiti hunowedzera zvakanyanya nekukura. |
| Manzwi asina kujairika | Kufema kana ruzha rwakaoma (stridor) muchipfuva kana pahuro paunenge uchifema. |
| Kushaya mweya | Kunzwa kana kuratidzika semunhu apererwa nemhepo, kunyangwe pakutaura. |
| Kutora nguva yakareba kufema | Zvinotora nguva yakareba kufema pane kufema. |
Kana ukaona chimwe chezviratidzo izvi, kunyanya kana mwana akadhonzwa nedumbu rake, idambudziko rehutano. Enda nemwana kana munhu wacho kuchipatara chiri pedyo (ETU) nekukasika.
Kune mhando dzakasiyana dzekudzokorora here?
Ehe, izvi zvinogona kukamurwa kuita mhando dzakasiyana zvichienderana nekuti ganda riri pachipfuva nemutsipa rinodhonzwa kupi. Zvichibva panzvimbo iyoyo, chiremba anogona kunzwisisa kuti nzira yekufema yakavharika kupi.
| Rudzi rwekudzosera shure | Nzvimbo yaunodhonza | Kazhinji zvinoratidzwa |
|---|---|---|
| Intercostal | Pakati pembabvu | Kuvharika kwenzira yekufema yakaderera. |
| Subcostal | Pasi pembabvu, nzvimbo yedumbu | Kuvharika kwenzira yekufema yakaderera. |
| Pasi pevhu | Pasi pepfupa rechipfuva | Kuvharika kwenzira yekufema yakaderera. |
| Suprasternal (`Tracheal tug`) | Pakati pemutsipa, pamusoro pepakati pepfupa rechipfuva | Kuvharika kwenzira yekufema pamusoro. |
| Muviri weSupraclavicular | Pamusoro pebhonzo remusana | Kuvharika kwenzira yekufema pamusoro. |
Ndezvipi zvikonzero zvikuru zvemamiriro ezvinhu aya?
Kudhonzwa kwemukati medumbu kunokonzerwa nekuvharika kana kutetepa kwenzira yekufema. Izvi zvinogona kunge zvine zvikonzero zvakasiyana-siyana.
- Kuwedzera kwezvirwere zvakaita seasthma kana COPD: Mumamiriro ezvinhu aya, nzira dzekufema dzinoita shoma, zvichiita kuti zviome kufema.
- Zvirwere zvekufema: Kunyanya muzvirwere zvakaita se `RSV` virus, `COVID-19`, izvo zvinowanzoitika kuvana.
- Kuzvimba kwenzira yekufema: Zvirwere zvakaita se'Bronchiolitis' (kuzvimba kwenzira diki dzekufema), 'Croup' (kuzvimba kwegurokuro), uye 'Pneumonia' (pneumonia).
- Kuvharika: Kuvharika kwenzira yekufema nekuda kwechimwe chinhu chakanamira pahuro (semuenzaniso, chidimbu chechikafu, chitoyi), madzihwa akakora, kana bundu.
- Kurwara Kwakanyanya (Anaphylaxis): Kurwara kwakanyanya kana munhu arumwa nechikafu, mishonga, kana zvipembenene kunogona kukonzera kuti nzira dzekufema dzizvimbe uye dzivharike.
- Zvimwe zvinokonzera: Kuoma kwetsinga dzenzwi, chirwere cheshuga chinonzi ketoacidosis, uye zvirwere zvisingawanzoitiki zvakaita seReye's syndrome.
Vanachiremba vanopa kurapwa kupi padambudziko iri?
Kana munhu ane dambudziko rekudhonza dumbu rake akaunzwa kuchipatara, chinangwa chekutanga chevanachiremba ndechekuderedza matambudziko ekufema uye kupa muviri mweya unodiwa. Zvichienderana nechikonzero chacho, nzira dzakasiyana-siyana dzekurapa dzinoshandiswa.
- Kurapa neokisijeni: Okisijeni inopihwa kuburikidza nechubhu yemhino kana mask yekumeso.
- Kurapa nebulizer: Kufema mushonga wekufema, wakadai semabronchodilators anovhura nzira dzekufema kana kuti corticosteroids inoderedza kuzvimba.
- Kubvisa chinovhara: Kubvisa chimwe chinhu chakanamira mumhepo.
- Kufema zvakanaka nemhepo ine simba: Kana kufema wega kwakaoma, muchina unoburitsa mweya kana okisijeni pakumanikidzwa kwakanyanya. Izvi zvinogona kuitwa kuburikidza nemasiki ekumeso akadai se `CPAP` kana `BiPAP` kana, muzviitiko zvakakomba, nekubatanidza nemuchina wekufema wekugadzira (`mechanical ventilation`).
Munguva yekurapwa uku, chiremba anogona kuita bvunzo dzinoverengeka kuti awane chikonzero chechirwere ichi.
- Kuongororwa kweX-ray yechipfuva kana CT scan.
- Kutora mushonga wekukwesha mhino kuti uone hutachiona.
- Kuongororwa kweropa.
Ndezvipi njodzi dziripo kana dzikasarapwa?
Kana chirwere chiri kukonzera kudhonzwa kwedumbu remukati medumbu chikasarapwa, chirwere chacho chinogona kuipa. Muzviitiko zvakakomba, kuoma kufema,
- Kuderera kweokisijeni mumuviri (hypoxia).
- Kuwedzera kwehuwandu hwekabhoni dhayiokisaidhi muropa (hypercapnia).
- Matambudziko anotyisidzira hupenyu akadai sekutadza kufema zvachose anogona kuitika.
Mharidzo Yekuenda Nayo Kumba
- Kudhonza ganda pakati pembabvu kana uchifema. Ichi chiratidzo chakakosha chekuoma kwekufema .
- Hunhu uhwu hunogona kuonekwa zvakajeka pakati pevana vadiki nevacheche.
- Kana ukaona chiratidzo ichi wakangomira, usina kushandisa simba, idambudziko. Enda kuchipatara chiri pedyo neEmergency Department (ETU) nekukasika.
- Dambudziko iri rinogona kuitika nekuda kwezvikonzero zvakasiyana-siyana, zvakaita seasthma, pneumonia, kana chimwe chinhu chinovhara nzira yekufema.
- Kurapwa kunovhura nzira dzekufema uye kunopa muviri mweya waunoda. Zvakakosha kuti usatye kana ukaona chirwere ichi uye kuti utsvage rubatsiro rwakakodzera rwechiremba nekukurumidza.
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