Ukulimala kakhulu esifubeni? Makhe sithethe ngokuba siyintoni isifuba esithambileyo kwaye singaba yingozi njani ebomini!

Ungayicinga imeko embi ukuba iimbambo zakho ezininzi beziphulwe, kungekhona kwindawo enye, kodwa kwiindawo ezimbini okanye ezintathu? Leyo yimeko yezonyango enzulu, ebuhlungu kakhulu, nengxamisekileyo esiza kuthetha ngayo namhlanje (Flail Chest) . Le yinto enokuba yingozi kakhulu kubomi bakho. Ke ngoko, kubaluleke kakhulu ukuba uqaphele oku.

Yintoni kanye kanye iFlail Chest? Kwenzeka ntoni esifubeni?

Ngamafutshane, isifuba esithambileyo yimeko apho iimbambo ezintathu okanye ngaphezulu ezikufutshane esifubeni sakho zaphukile, okanye ubuncinci imbambo enye yaphukile kwiindawo ezimbini. Khawuthelekelele ukuba xa oko kusenzeka, indawo yodonga lwesifuba apho iimbambo zaphukileyo iba "yikhululekileyo," oko kuthetha ukuba ilahlekelwa kukuzinza kwayo. Kufana nenxalenye yodonga ewa kwisakhiwo. Yile nto eyenza kube nzima kakhulu ukuphefumla ngequbuliso.

Eyona nto ingaqhelekanga ngale nto kukuba xa ubambo luphukile ngolu hlobo, loo nxalenye yesifuba iyashukuma xa uphefumla ngendlela eyahlukileyo kunezinye isifuba sakho esisempilweni. Oko kukuthi, xa uphefumla (uphefumla), inxalenye ephukileyo nekhululekileyo iyangena. Kodwa xa uphefumla (ukhupha umoya), loo nxalenye iyaphuma. Kufana nokuba isebenza ngenye indlela! Oogqirha bathi le ntshukumo engaqhelekanga "yintshukumo engaqhelekanga" . Oku kuthintela imiphunga ekuphefumleni nasekukhupheni umoya ngokufanelekileyo, okuphazamisa yonke inkqubo yokuphefumla.

Ngubani ochaphazeleka kakhulu yile meko (Flail Chest)?

Le meko iyingozi ebizwa ngokuba yiFlail Chest yenzeka ngenxa yokwenzakala okukhulu . Makhe sibone ukuba ngubani osengozini enkulu:

• Kwabo babandakanyeka kwiingozi ezinkulu zezithuthi . Enyanisweni, le yeyona nto iphambili ebangela (iFlail Chest).
• Ukuwa ukusuka kwindawo ephakamileyo kuyingozi, ingakumbi kubantu abadala. Ukuba une -osteoporosis , isifo esenza amathambo akho abe buthathaka njengoko ukhula, nokuba ukuwa okuncinci kunokukuphula iimbambo.
• Abanye abantwana nabo basengozini. Umzekelo, abantwana abanezifo ezibangela ubuthathaka bamathambo, njenge -Osteogenesis Imperfecta (isifo semfuza esibangela ukuba amathambo aphuke lula), okanye abantwana abanezifo ezithile ze-metabolic ebuntwaneni, nabo banokuba nale meko.
• Ezinye izifundo zifumanise ukuba amadoda anokuba namathuba amancinci okufumana esi sifo (Flail Chest).

Zithini iimpawu zeFlail Chest?

Ngoku makhe sibone ukuba zeziphi iimpawu umntu one-flail esifubeni anokubonisa. Kubaluleke kakhulu ukuzazi ezi:

• Intlungu ebuhlungu kakhulu esifubeni, ebangela ukuphefumla kancinci nangokunganzulu. Kunzima kakhulu ukuphefumla nzulu kuba isifuba sibuhlungu kakhulu.
• Ukungabikho kweoksijini eyaneleyo kwizicubu zomzimba. Oku kubizwa ngokuba yi- "hypoxia" ngokwezonyango. Le yimeko eyingozi.
• Imilebe eluhlaza okwesibhakabhaka okanye iminwe (i-cyanosis). Oku kwenzeka xa umzimba ungafumani ioksijini eyaneleyo. Olu luphawu lwengxakeko.

Oogqirha bayixilonga njani iFlail Chest?

Makhe sibone ukuba ugqirha uxilonga njani ngokuchanekileyo esi sifo sibi esibizwa ngokuba yiFlail Chest.

Oogqirha bakrokrela oku ngokuyintloko ngokuqwalasela indlela ophefumla ngayo . "Intshukumo engaqhelekanga" endiyichazile ngaphambili, eyindlela yokushukuma kwenxalenye yesifuba ephukileyo ukuya kwelinye icala xa uphefumla, yinto ugqirha anokuyibona ngaphandle. Xa uphefumla, loo nxalenye iphukileyo iphuma phambili, kwaye xa uphefumla, loo nxalenye ingena ngaphakathi.

Le ndlela yokuphefumla engaqhelekanga yeyona nto iphambili ekuchongeni iFlail Chest.

Ukongeza, iimvavanyo ezinje zinokwenziwa:

• I-X-reyi yesifuba: Oku kungabonisa ngokucacileyo ukuba iimbambo zaphukile phi kwaye njani. Nangona kunjalo, akunakubonisa umonakalo kwi-cartilage ephakathi kwembambo. Kwakhona, imivumbo emiphungeni yakho ngamanye amaxesha inokubonwa kwi-X-reyi.
• Kwezinye iimeko, xa ugqirha ekuchukumisa kancinci esifubeni sakho, usenokuziva iimbambo eziphukileyo kunye nokungazinzi kuloo ndawo.

Iphathwa njani iFlail Chest?

Isifuba esibizwa ngokuba yiFlail Chest sisifo esisongela ubomi esifuna unyango olungxamisekileyo. Emva kokungeniswa esibhedlele, unyango olulandelayo ludla ngokunikezelwa:

Unyango olusisiseko kunye nolawulo lweentlungu

• Into yokuqala oza kuyenza kukunika ioksijini ukuze ikuncede uphefumle. Isantya sentliziyo yakho, uxinzelelo lwegazi, kunye namanqanaba eoksijini nazo ziya kuhlolwa.
• Okulandelayo, ukulawula iintlungu kubaluleke kakhulu. Kuba ukuba awukwazi ukuphefumla kakuhle ngenxa yentlungu enzima, imeko inokuba mandundu. Ungenza izinto ezinje ukunciphisa iintlungu:
• Amayeza okusebenzisa imibhobho (IV).
• Inaliti ekhethekileyo enikwa indawo yomqolo (i-epidural anesthesia).
• Iinaliti ezibulala iintlungu ezithintela imithambo-luvo ephakathi kweembambo (`iibhloko zeentlungu ze-intercostal`).
• Ngamanye amaxesha kusetyenziswa iindlela ezingaphezu kwenye kwezi xa zidibene.

Ukugcina imiphunga icocekile: (Ucoceko lweMiphunga)

Oku kubaluleke kakhulu. Enye yeengxaki eziphambili ezinokubakho kwimeko ye (Flail Chest) kukukhula kwe-pneumonia . Ukuthintela oku, kuyimfuneko ukuyeka ukuqokelelwa kwencindi efana ne-mucus emiphungeni. Izinto ezenziwayo ngenxa yoku zibizwa ngokuba yi `(Pulmonary hygiene)`Ibizwa ngokuba (yindlela yokugcina inkqubo yokuphefumla icocekile). Ikwabizwa ngokuba yi-`(indlu yangasese yamaphaphu)` okanye `(i-physiotherapy yesifuba)`. Iquka oku kulandelayo:

• Ukufunxa: Kufakwa umbhobho omncinci kwindlela yomoya kwaye i-mucus eqokelelweyo iyatsalwa.
• Ukusebenzisa isixhobo esikhethekileyo ukunceda ukuphucula ukuphefumla (`Incentive spirometry`): Oku kuqeqesha isigulana ukuba siphefumle nzulu kwaye siphuhlise imiphunga kakuhle.
• Unyango lwe-Bronchodilator: Ezi zinokunikwa njengamayeza aphefumlwayo. Ziyandisa iindlela zomoya (i-bronchi) kwaye zenze kube lula ukuphefumla.
• Ukubeka esweni ulwelo: Ukuze imiphunga isebenze kakuhle, ubungakanani bolwelo emzimbeni, ingakumbi egazini, kufuneka bube kwinqanaba elifanelekileyo.
• Indawo efanelekileyo yomguli: Oku kwenza ukuphefumla kube lula kwaye kunokunciphisa iintlungu.

Uncedo lokuphefumla kunye notyando

• Ezinye izigulana zinokunikwa umatshini obizwa ngokuba yi- "CPAP - Continuous Positive Airway Pressure" ukuze zincede ziphefumle. Okanye zinokunikwa ioksijini eyongezelelweyo.
• Kusenokufuneka uqhagamshelwe kumatshini okhethekileyo ('i-mechanical ventilator') ukukunceda uphefumle , mhlawumbi kangangeentsuku okanye iiveki ezimbalwa, de amanxeba akho aphole.
• Kwezinye iimeko ezinzima, utyando lunokufuneka ukuze kuthintelwe iingxaki ezifana ne-pneumonia, kuncitshiswe ukuhlala esibhedlele, kwaye mhlawumbi kuthintelwe nokufa. Le nkqubo ibizwa ngokuba yi -surgical rib fixation . Oku kubandakanya ukufaka izixhobo, ezifana neepleyiti kunye nezikrufu, ezenziwe ngesinyithi ezifana ne-titanium, esifubeni ukuze kuzinziswe iimbambo ezaphukileyo.

Linjani ixesha lokuchacha?

Kungathatha iinyanga ezininzi ukuba umntu aphile ngokupheleleyo kule meko inzima ebizwa ngokuba yiFlail Chest. Ngenxa yokuba oku kubangelwa yingozi enkulu, la maqhekeza eembambo kufuneka aphole kunye nezinye iingozi ezivela kuloo ngozi.

Kusenokufuneka uhlale esibhedlele, mhlawumbi kwiYunithi yoKhathalelo oluPhezulu (ICU) kangangeentsuku ezimbalwa okanye ngaphezulu. Ukuba unembambo yotyando endikhankanyileyo ngaphambili, ezinye izifundo zibonise ukuba ubude bexesha olihlala esibhedlele kunye nobude bexesha olihlala e-ICU bunokuncipha.

Nokuba sele ubuyile ekhaya uvela esibhedlele, usenokuba nobunzima bokuphefumla okwethutyana. Ngoko ke , kufuneka uqhubeke nokwenza umthambo wokuphefumla ofundiswa ngoogqirha bakho kunye neengcali zonyango, kwaye uwenze ngokuchanekileyo.

Umzekelo:

• Ukuphefumla kancinci ngemilebe exineneyo (ukuphefumla ngemilebe exineneyo).
• Ukuphefumla nzulu esiswini (`ukuphefumla kwe-diaphragmatic (isisu)`).
• Kwakhona kufuneka uziqhelise iindlela zokukhohlela ezilawulwayo ukuze unciphise ukuqokelelwa kwe-mucus emiphungeni.

Ngaba umngcipheko wesifuba esithambileyo ungancitshiswa?

Ewe, ngandlela ithile. Isifuba esithambileyo sibangelwa kukwenzakala okukhulu, ngoko ke ukunciphisa umngcipheko wokwenzakala okunjalo kunokunciphisa umngcipheko wale meko.

• Qhuba ngokukhuselekileyo rhoqo. Musa ukuqhuba ngesantya esingeyomfuneko, kwaye soloko unxibe ibhanti lakho lesihlalo.
• Ukuba umdala okanye usemngciphekweni wokuwa, lumka nokuba usekhaya. Gcina umgangatho wakho ungenazinto zityibilikayo nezithintelo. Qinisekisa ukuba kukho ukukhanya okwaneleyo. Ukuba ufuna isixhobo sokuncedisa ukuhamba, njengesibambi okanye intonga, sisebenzise ngaphandle kokuthandabuza.

Ingaba isifuba esithambileyo kunye ne-pneumothorax ziyafana?

Hayi. Isifuba esithambileyo kunye nePneumothorax (umphunga owileyo) zizinto ezimbini ezahlukeneyo.

I-Pneumothorax kuxa umoya uqokelelana kwindawo ye-pleural phakathi kodonga lwesifuba nomphunga endaweni yokungena emphungeni. Nangona kunjalo, ingxaki enkulu yesifuba esithambileyo yi-pneumothorax, enokwenzeka ukuba iqhekeza lembambo ephukileyo lihlala emphungeni.

Inzulu kangakanani iFlail Chest?

Nantsi into ekufuneka uyikhumbule: Isifuba seFlail sisifo esingxamisekileyo esisongela ubomi. Akufuneki sinyangwe ekhaya. Sinyangwe ngoko nangoko esibhedlele.

Ekubeni oku kungenxa yengozi enkulu, ukuba unesifo esibizwa ngokuba yiFlail Chest, kuya kuthatha ixesha elide ukuba uphile. Kuya kufuneka uhlale esibhedlele ixesha elide. Usenokuba usebenzisa isixhobo somoya kangangeentsuku ezininzi. Kwanasemva kokuba uqalile ukuphola, kuya kufuneka uqhubeke nokwenza umthambo wokuphefumla kunye nonyango lomzimba njengoko ugqirha wakho ekuyalele.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke, ndicinga ukuba uziqondile iingongoma ezibalulekileyo koko sithethe ngako (Flail Chest). Okokugqibela, nantsi into endifuna ukuyithetha:

• Isifuba esithambileyo asinto ithathwa lula. Yimeko engxamisekileyo enzulu nesongela ubomi.
• Isizathu esiphambili soku ziingozi ezinkulu, ingakumbi iingozi zezithuthi kunye nokuwa ukusuka phezulu.
• Uphawu oluphambili nolwahlukileyo koku kukuhamba kwenxalenye yesifuba ukuya kwelinye icala xa uphefumla (`intshukumo engaqhelekanga`) . Kunye noku, kukho iintlungu eziqatha kunye nobunzima bokuphefumla.
• Ukuba uneempawu ezinje, okanye ukuba ukhe waba sengozini enkulu, kubalulekile ukuba ufune unyango ngokukhawuleza.Musa ukuchitha ixesha.
• Kuthatha ixesha ukuba uphile ngokupheleleyo, kwaye nokuba uphumile esibhedlele, kufuneka uqhubeke nokulandela iingcebiso zonyango kwaye wenze umthambo wokuphefumla.
• Zama ukuzikhusela kwiingozi kangangoko unako kwaye unciphise umngcipheko wokuba iimeko ezinjalo zenzeke .

Ukuba wena okanye umntu omaziyo unale mpawu, okanye ukuba ucinga ukuba ube sengozini enkulu, eyona nto ingcono onokuyenza kukuya esibhedlele esikufutshane ngokukhawuleza kwaye ufumane ingcebiso yezonyango. Oku kungasindisa nobomi!

---

Isifuba Esiqhekekileyo , Ukuqhekeka Kweembambo, Ukungazinzi Kodonga Lwesifuba, Ukuphefumla Okukhubazekileyo, Iingozi, Ukulimala Kwesifuba, Uxinzelelo Lokuphefumla