Ngaba unalo olu hlobo lwentlungu esifubeni? (Mediastinitis) Masifunde ngayo.

Ngaba wakha waziva iintlungu ezingaqhelekanga, ubunzima, okanye ukungakhululeki phakathi kwesifuba sakho, apho intliziyo yakho ikhoyo? Usenokucinga ukuba akukho nto imbi kangako. Nangona kunjalo, ngamanye amaxesha ezi mpawu zinokuba luphawu lwemeko yempilo enzulu ngakumbi. Yiyo loo nto namhlanje siza kuthetha ngemeko ebizwa ngokuba yi -`(Mediastinitis)` enokwenzeka esifubeni, kodwa abantu abaninzi abangazi ngayo. Nangona eli gama liyinkimbinkimbi kancinci, masiliqonde ngokulula.

Yintoni le `(Mediastinitis)`?

Ngamafutshane, `(Mediastinitis)` kukudumba okanye usulelo oluvela kwindawo ebizwa ngokuba yi`(mediastinum)` embindini wesifuba sethu. Ngoku usenokuba uzibuza ukuba yintoni `(mediastinum)`. Khawuthelekelele, isifuba sethu singumngxuma omkhulu, esiwubiza ngokuba yi`(thoracic cavity)` . Kumacala omabini ale `(thoracic cavity)` kukho `(pleural cavities)` apho imiphunga yethu ikhoyo. Indawo ebalulekileyo embindini wesifuba, phakathi kwemiphunga emibini, ibizwa ngokuba yi`(mediastinum).`

Eli candelo le-`(mediastinum)` kulapho amalungu amaninzi abalulekileyo kunye nezakhiwo, njengentliziyo yethu , inxalenye yombhobho wokutya (`(esophagus)`) , kunye nemithambo yegazi ephambili edibana nentliziyo, zifumaneka khona. Ngoko ke ungaqonda ukuba kunokuba nzima kangakanani ukuba ukudumba okanye usulelo lwenzeka kwindawo ebaluleke kangaka. Yiyo loo nto imeko `(Mediastinitis)` inokuba yingozi ebomini.

Le meko (i-Mediastinitis) inokuba yingxaki ebukhali (eyenzeka ngequbuliso) okanye engapheliyo (ikhula kancinci ngokuhamba kwexesha) .

Kwenzeka ntoni emzimbeni ukuba unesifo se-`(Mediastinitis)`?

I-Mediastinitis yimeko esongela ubomi. Oku kuvutha kunokuphazamisa ukusebenza okuqhelekileyo kwamalungu ethu abalulekileyo kunye nemithambo yegazi esifubeni. Oku kunokukhokelela kwiingxaki ezinkulu. Ke ngoko, ukufumana unyango ngokukhawuleza kwandisa amathuba okuchacha nokusindisa ubomi bakho.

Ezinye zeengxaki ezinokubakho ngenxa ye-mediastinitis zezi:

• Ukuvaleka kwendlela yomoya okubangela ubunzima bokuphefumla.
• I-Constrictive pericarditis (ukuqina kwe-membrane ejikeleze intliziyo).
• I-pneumonia ephindaphindayo.
• Ukusilela kwentliziyo kwicala lasekunene .
• Ukutyhefwa kwegazi, oko kukuthi `(Sepsis)` .
• Ukopha kakhulu.
• I-Superior vena cava syndrome (uxinzelelo kwi-superior vena cava, umthambo omkhulu othwala igazi uye entliziyweni).

Khawucinge nje, ukuba imeko efana nale iyenzeka, ichaphazela yonke inkqubo yomzimba wethu. Yiyo loo nto kungakuhle ukuyithatha lula le nto.

Ixhaphake kangakanani le meko?

Ngokutsho koogqirha, "i-Mediastinitis" yimeko engaqhelekanga . Nangona kunjalo, umlinganiselo eyenzeka ngawo ebantwini ('ukuxhaphaka') kunye nabantu abachaphazeleka kakhulu uyahluka ngokuxhomekeke kuhlobo lwesifo ('esibukhali' okanye 'esingapheliyo').

I-mediastinitis ebukhali idla ngokubonwa njengengxaki yotyando lwesifuba, ingakumbi inkqubo ebizwa ngokuba yi-median sternotomy . I-median sternotomy yinkqubo yotyando apho ugqirha ohlinzayo enqumla isifuba sakho (sternum) kubini ukuze afikelele entliziyweni okanye kwimithambo yegazi. Phakathi kwe-0.25% kunye ne-5% yabantu abenza olu hlobo lotyando bafumana i-mediastinitis ebukhali. Eli zinga linokwahluka ukusuka esibhedlele ukuya kwesinye nakwingingqi ukuya kwesinye.

I-mediastinitis engapheliyo inqabile nangakumbi. Ihlala ifunyaniswa kwiindawo apho uhlobo lwefungus olubizwa ngokuba yiHistoplasma capsulatum luxhaphakileyo (luqhelekile). Nangona kunjalo, ayinguye wonke umntu ochaphazeleka yile fungus ofumana esi sifo. Abaphandi baqikelela ukuba ngaphantsi kwe-1% yabo bachaphazeleka banesifo sefungus (i-histoplasmosis). Kubo, linani elincinci kakhulu elifumana i-mediastinitis engapheliyo. Izifundo zibonisa ukuba kusekho amakhulu ezigulana eMelika ezine-fibrosing mediastinitis (uhlobo lwe-mediastinitis engapheliyo).

Yintoni umahluko phakathi kwe-'Acute Mediastinitis' kunye ne-'Chronic Mediastinitis'?

Kukho iintlobo ezimbini ze-`(Mediastinitis)`. Enye yi -`Acute Mediastinitis` . Enye yi -`Chronic Mediastinitis` . Kukho umahluko omkhulu phakathi kwezi zimbini.

I-mediastinitis ebukhali yimeko eyenzeka ngequbuliso, eneempawu eziqatha . Umzekelo, ukuba kukho ukugqobhoka kwi-esophagus, i-mediastinitis ebukhali inokukhula kwiiyure ezimbalwa. Inokwenzeka naxa kukho usulelo emqaleni okanye emlonyeni. Njengengxaki yotyando lwesifuba, idla ngokuvela kwinyanga yokuqala. Ayifane yenzeke kamva, kwanakwiminyaka yokuqala. I-mediastinitis ebukhali yingxamiseko yezonyango. Unyango kufuneka luqalwe ngoko nangoko ukuze kusindiswe ubomi bakho.

I-Mediastinitis engapheliyo nayo yimeko enzima, kodwa ikhula kancinci kancinci kangangeenyanga, ngamanye amaxesha iminyaka . Oku kunokubangela ukuba izicubu ezibomvu ziqokelele kwi-mediastinum yakho. Le meko ibizwa ngokuba yi-fibrosing mediastinitis okanye i-mediastinal fibrosis . Eyona nto ibangela i-mediastinitis engapheliyo idla ngokuba lusulelo lwefungus.

Umntu one-mediastinitis engapheliyo usenokungabi nazimpawu ixesha elide, okanye usenokungabi nazo kwaphela iimpawu. Ukuba uneempawu, ezinje ngokuphefumla kancinci, zisenokuqala kancinci kwaye zibe mandundu ngokuhamba kwexesha. Iimpawu zenzeka kuba izicubu ezirhabaxa ziyaqokelelana esifubeni sakho, zicinezele umqala wakho (i-trachea) okanye i-vena cava ephezulu, umthambo omkhulu othwala igazi uye entliziyweni yakho. Unyango lujolise kakhulu ekunciphiseni iimpawu kunye nokuphucula umgangatho wobomi.

Zithini iimpawu ze-`(Mediastinitis)`?

Iimpawu ziyahluka ngokuxhomekeke ekubeni imeko `ibukhali` okanye `ingapheliyo`.

Iimpawu ze-'Acute Mediastinitis':

• Intlungu yesifuba eqatha ngequbuliso.
• Ukugodola.
• Ukuba uhlinzwe i-sternotomy ephakathi, ulwelo olufana nobovu lunokuphuma enxebeni.
• Ifiva.
• Ukuqhawukelwa ngumphefumlo.

Iimpawu ze-'Chronic Mediastinitis':

I-mediastinitis engapheliyo isenokungabangeli zimpawu. Nangona kunjalo, abantu abane-fibrosing mediastinitis banokufumana iimpawu ezifana nezi:

• Iintlungu zesifuba.
• Ukukhohlela, mhlawumbi nokukhohlela igazi.
• Ubunzima bokuphefumla.
• Iimpawu ezongezelelweyo ezinxulumene ne-"Superior vena cava syndrome" (umz., ukudumba kobuso, intamo, izandla).

Zithini izizathu ze-`(Mediastinitis)`?

Izizathu zale meko ziyahluka ngokuxhomekeke kuhlobo lwayo.

Izizathu ze-'Acute Mediastinitis':

I-mediastinitis ebukhali yenzeka xa izicubu ezingaphakathi esifubeni sakho zisuleleka ngequbuliso. Ezi zifo zinokubangelwa zezi:

• Iingxaki ze-median sternotomy: Uninzi lwezifo emva kolu hlobo lotyando zibangelwa yintsholongwane ebizwa ngokuba yiStaphylococcus aureus . Izicubu zakho zesifuba okanye inxeba lotyando linokosuleleka nokuba ngexesha lotyando okanye kungekudala emva koko. Umzekelo, ukuba inxeba alipholi kakuhle okanye ukuba iintsholongwane zingena ngenxeba.
• Ukugqobhoka komlomo wesibeleko: Oku kunokwenzeka ngezizathu ezahlukeneyo. Umzekelo, iingxaki ngexesha leenkqubo ze-endoscopic (uvavanyo olusebenzisa ikhamera ukujonga ngaphakathi komlomo wesibeleko) okanye ukuhlanza okugqithisileyo nokunamandla ( i-Boerhaave syndrome) kunokubangela ukuba umlomo wesibeleko ukrazuke.
• Usulelo olusasazeka entloko okanye entanyeni: Oogqirha babiza oku ngokuthi "yi-descending necrotizing mediastinitis." Oku kuthetha ukuba usulelo oluqale kwindawo ephezulu yesifuba lusasazeka luye esifubeni, lonakalise izicubu apho. Usulelo emlonyeni wakho (njengezinyo eliphumileyo) kunye nosulelo lomphimbo lunokusasazeka ngale ndlela.

Izizathu zeMediastinitis engapheliyo:

I-Mediastinitis engapheliyo ikwabangelwa lusulelo. Nangona kunjalo, kule meko, ukudumba kwizicubu zakho akwenzeki kwangoko emva kokudibana nebhaktheriya, kodwa kwenzeka kancinci kancinci. I-Mediastinitis engapheliyo inokubangelwa zezi zinto zilandelayo:

• Usulelo lwefungus (le yeyona nto ixhaphakileyo).
• Isifo sephepha.
• Unyango ngemitha.
• I-Silicosis (isifo semiphunga esibangelwa kukuphefumla amasuntswana esilica).
• I-Sarcoidosis (ukwakheka kwamaqela amancinci eeseli ezivuthayo kwizitho ezahlukeneyo zomzimba).

Ngamanye amaxesha, akukho sizathu sicacileyo esifumanekayo se-mediastinitis engapheliyo. Oku kubizwa ngokuba yi-idiopathic .

Usulelo oluqhelekileyo lwefungus olubangela i-mediastinitis engapheliyo yiHistoplasma capsulatum . E-United States, le fungus ixhaphake kakhulu kwi-Ohio River Valley nakwi-Mississippi River Valley. Kwezinye iindawo zehlabathi, ifumaneka e-Afrika, e-Asia, e-Australia, kuMbindi Melika, nakwiindawo ezithile zaseMzantsi Melika.

Le fungus ihlala emhlabeni. Ayinabungozi ngaphandle kokuba ingena emoyeni uze uyiphefumle. Ayinguye wonke umntu ochaphazelekileyo oya kugula. Enyanisweni, uninzi lwabantu abachaphazelekileyo yile fungus abayi kugula konke konke, okanye baya kuba nosulelo oluncinci olungenazo iimpawu. Nangona kunjalo, kukho ithuba elincinci kakhulu lokuba inkqubo yakho yomzimba yokuzikhusela iya kusabela kakhulu kule fungus emva kokuba ichaphazelekile (ngokufuthi emva kweminyaka). Oku kunokubangela ukudumba kwezicubu ezikwi "mediastinum" yakho, nto leyo enokubangela iingxaki.

Ziziphi izinto ezibangela umngcipheko wokukhula kwesifo se-`(Mediastinitis)`?

Ngoku makhe sijonge ukuba ngubani onokuthi abe nale meko. Ukuba wenza utyando olufuna i-`(median sternotomy)`, njengotyando lwentliziyo evulekileyo, usenokuba nexhala malunga neengxaki. Thetha nogqirha wakho malunga nomngcipheko wakho. Ngokubanzi, usenokuba ne-`acute mediastinitis` emva kwe-`(median sternotomy)` ukuba unenye yezi meko zilandelayo:

• Ukuba unesifo esibangela ukuba amajoni akho omzimba abe buthathaka .
• Isifo semiphunga esingapheliyo (i-COPD) .
• Isifo seswekile.
• Ukungasebenzi kakuhle kwezintso.
• Ukutyeba kakhulu.
• Isifo semithambo yegazi ejikeleze umzimba (i-PAD) (ukuncitshiswa kwemithambo yegazi ezingalweni nasemilenzeni).

Ukutshaya nokusebenzisa icuba kwandisa umngcipheko weengxaki emva kotyando.

Izinto ezithile ezinxulumene notyando ngokwalo nazo ziyandisa umngcipheko we-mediastinitis. Ezi ziquka:

• Utyando luthathe ixesha elide kakhulu okanye isigulane besikwi-cardiopulmonary bypass ixesha elide kakhulu.
• Utyando kwakhona (ukuba sele utyando lwesifuba).

Ungu `(Histoplasma capsulatum)`Ukuba uhlala kwindawo apho ifungus ixhaphake khona, usemngciphekweni omkhulu wokufumana i-mediastinitis engapheliyo.

Ifunyaniswa njani i-`(Mediastinitis)`?

Oogqirha badla ngokuxilonga i-mediastinitis ngokuhlolwa ngokwasemzimbeni nangovavanyo olongezelelweyo.

Ngexesha lovavanyo lwakho lomzimba, ugqirha uza kukubuza malunga noku:

• Iimpawu zakho.
• Imbali yakho yezonyango (izifo zangaphambili, amayeza, njl.njl.).
• Malunga notyando lwakutshanje okanye iinkqubo zonyango oye wazenza .
• Malunga neendawo oye wazihamba (ingakumbi iindawo apho `(iHistoplasma capsulatum)` ixhaphake khona).

Ugqirha wakho unokuyalela iimvavanyo ezongezelelweyo ukuqinisekisa ukuba unesifo.

Zeziphi iimvavanyo ezisetyenziselwa ukuxilonga `(Mediastinitis)`?

I-computed tomography (CT) scan ene-contrast yeyona ndlela ibalaseleyo yokuxilonga i-mediastinitis. Ukongeza, ugqirha wakho unokuyalela ukuba kwenziwe i-X-ray yesifuba okanye i-biopsy yenaliti .

Inyangwa njani iMediastinitis?

Ewe, ngaba lukhona unyango lwale nto? Ewe, lukhona. Kodwa luyahluka ngokuxhomekeke kuhlobo lwesifo (nokuba `siyingozi` okanye `singapheliyo`) kunye nesizathu.

I-mediastinitis ebukhali emva kwe-sternotomy ephakathi ingadinga unyango olulandelayo:

• Ii-antibiotics , ezidla ngokunikezelwa ngemithambo yegazi (IV) ngesisombululo se-saline.
• Utyando lokususa izicwili ezifileyo kunye nokukhupha ulwelo oluqokelelweyo.

I-mediastinitis ebukhali ebangelwa kukukrazuka kwe-esophageal ingadinga unyango olulandelayo:

• Amayeza okubulala iintsholongwane.
• Utyando lokulungisa umngxuma, ukususa izicwili ezifileyo, kunye/okanye ukukhupha naluphi na ulwelo oluqokelelweyo.

Ukuba une-mediastinitis ebukhali, iqela lakho lezonyango liza kukungenisa kwigumbi lonyango oluphezulu (ICU) . Apho, iqela lezonyango liza kujonga ngokusondeleyo iimpawu zakho kunye nokuchacha kwakho.

Unyango lwe -mediastinitis engapheliyo lungabandakanya utyando lokunciphisa iimpawu. Ugqirha wakho unokucebisa iinkqubo ezivula indlela yakho yomoya okanye eziphucula ukuhamba kwegazi kwimithambo yegazi esifubeni sakho. Abaphandi basakhangela iindlela zonyango zabantu abane-mediastinitis engapheliyo.

Thetha nogqirha wakho malunga neendlela onokukhetha kuzo unyango kunye noko unokukulindela.

Ngaba i-Mediastinitis ingathintelwa?

Kungcono ukuthintela into efana nale ukuba ingenzeki ngaphambi kokuba yenzeke. I-Mediastinitis yingxaki eqhelekileyo yeenkqubo zonyango. Ukuba wenza utyando lwesifuba okanye inkqubo ye-endoscopic, thetha nogqirha wakho malunga neendlela zokunciphisa umngcipheko weengxaki. Buza ukuba zeziphi amanyathelo aza kuthathwa liqela lakho lezonyango ukunciphisa umngcipheko wosulelo. Kwakhona, qiniseka ukuba ubuza malunga nendlela yokunyamekela inxeba lakho ekhaya emva kotyando.

Ukuthintela usulelo nokulunyanga kwangoko xa lusenzeka kunokunceda ukunciphisa umngcipheko we-mediastinitis ebukhali. Usulelo emlonyeni nasemqaleni wakho lunokusasazeka esifubeni sakho luze lubangele iingxaki ezinkulu. Nazi ezinye izinto onokuzenza ukunceda ukuthintela olu hlobo losulelo:

• Lumka kakuhle amazinyo neentsini zakho (`(ucoceko lomlomo)`) ukuze uthintele ukosuleleka kwamazinyo.
• Bona ugqirha wamazinyo rhoqo emva kweenyanga ezintandathu ukuze ucoce amazinyo akho , okanye ulandele imiyalelo kagqirha wamazinyo.
• Bona ugqirha kanye ngonyaka ukuze akuhlole ukuze ujonge impilo yakho iyonke.
• Ukuba uneempawu zosulelo, bonana nogqirha ngoko nangoko , kwaye uthathe naliphi na iyeza elinikiweyo lokunyanga usulelo njengoko kuchazwe.

Ngaba iMediastinitis ingabulala?

Le yingxaki enzulu. Ewe, le meko inokuba yingozi ebomini, nto leyo ethetha ukuba inokubulala. Ukuxilongwa kwangoko kunye nonyango zezona ndlela zilungileyo zokusindisa ubomi. Makhe sijonge oko abaphandi bakwaziyo malunga nezinga lokufa kwe-mediastinitis:

• Izinga lokufa kwabantu abafumana i-mediastinitis ebukhali emva kotyando oluphakathi kwe-sternotomy liphakathi kwe-1% ne-14% . Oku kungcono kunangaphambili (12% ukuya kwi-50%). Oku kungenxa yophuculo kulawulo lotyando. Usenokuzibuza ukuba kutheni la manqanaba ebanzi kangaka. Oku kungenxa yokuba izifundo ezahlukeneyo zophando zisebenzisa amaqela ahlukeneyo abantu ukufunda amazinga okufa. Ngoko ke, iziphumo zakho ziya kuxhomekeka kwizinto ezininzi, njengokuthi utyando lwakho luza kuqhubeka phi, ubudala bakho, kunye nempilo yakho iyonke.
• Izinga lokufa kwabantu abafumana i-mediastinitis ebukhali ngenxa yokukrazula komphimbo liyahluka kakhulu. Kuxhomekeke ekubeni ufumana unyango ngokukhawuleza kangakanani. Ngaphantsi kwe-10% yabantu abanyangwa kwiiyure ezingama-24 emva kokuba beswelekile. Elo nani linyuka liye kuma-30% ukuya kuma-40% phakathi kwabo banyangwa emva kweeyure ezingama-24. Ukwaluphala kwandisa umngcipheko wesiphumo esibi.
• Abantu abafumana i-"Descending necrotizing mediastinitis" banokukhawuleza bafumane i-"Sepsis" (ityhefu egazini) kunye nokungasebenzi kakuhle kwamalungu omzimba. Ke ngoko, izinga lokufa liphakathi kwe-11% kunye ne-40% .

Nangona ezi zibalo zisenokubonakala zisoyikisa kancinci, zikho izizathu zokuba nethemba.Ukwazi izizathu kunye neempawu ze-`(Mediastinitis)` kuya kukunceda wazi ukuba kufuneka ufune nini uncedo lwezonyango ukuba kuyimfuneko. Kwakhona, ngokuhambela phambili kwicandelo lezonyango, utyando luya lukhuseleka kwaye neengxaki ziyanyangwa.

Ufanele uye nini kugqirha?

I-'Acute mediastinitis' yimeko efika ngequbuliso. Ukuba ubonakalisa iimpawu ezinje (umz., iintlungu zesifuba eziqatha ngequbuliso, umkhuhlane, ubunzima bokuphefumla), fowunela u-911 ngoko nangoko okanye inombolo yakho yongxamiseko yasekuhlaleni, okanye uye esibhedlele esikufutshane. Okukhona ufumana unyango ngokukhawuleza, kokukhona iziphumo zakho zokuchacha zingcono.

Kwakhona, kufuneka uthethe nogqirha kwiimeko ezilandelayo:

• Ukuba uza kwenza utyando lwentliziyo evulekileyo okanye olunye unyango oluya kwandisa umngcipheko wakho we-mediastinitis, buza ukuba ungawunciphisa njani umngcipheko wakho.
• Ukuba uneempawu ze-mediastinitis engapheliyo okanye ukhathazekile ngengozi yakho.

Okokugqibela, umyalezo oya ekhaya

Mhlawumbi ngoku uyaqonda ukuba `(Mediastinitis)` yimeko embi kakhulu, ngamanye amaxesha esongela ubomi. Kodwa ungoyiki. Into ebalulekileyo kukukwazi oku.

Khumbula:

* Emva kotyando lwesifuba, ingakumbi utyando lwentliziyo, nyamekela inxeba. Landela imiyalelo kagqirha wakho ngokuchanekileyo.

* Musa ukungazinaki izifo zomlomo nomqala. Zinokusasazeka kwaye zibangele izifo ezinzulu.

* Ukuba ufumana iintlungu eziqatha esifubeni ngequbuliso, umkhuhlane, okanye ubunzima bokuphefumla , funa uncedo lwezonyango ngokukhawuleza.

* Ukuba ukwiindawo apho iifungi ezifana ne-`(Histoplasma capsulatum)` zixhaphake khona, yazi loo nto.

* Okukhona isifo sifunyanwa ngokukhawuleza size sinyangwe, kokukhona amathuba okuchacha aphezulu. Ngokuhambela phambili kwesayensi yezonyango, ngoku kunokwenzeka ukujongana ngempumelelo nezi meko.

Ukuba umntu omthandayo une-mediastinitis, ungaziva uxhalabile kwaye ungenakunceda. Ukufunda ngesi sifo kunokukunceda uzive unamandla okulawula imeko. Olu lwazi luza kukunceda uthethe neqela lezonyango lomntu omthandayo malunga nokwenzekayo. Babuze ukuba ungamnceda njani njengoko echacha.

i- mediastinitis, iintlungu zesifuba, usulelo lwesifuba, iingxaki zotyando lwentliziyo, ukugqobhoka komphimbo, usulelo lwefungus, i-mediastinum