Mhlawumbi ukhe weva ngomntu omdala olele esibhedlele ngenxa “yolwelo olusezimpumlweni.” Mhlawumbi kwenzeke komnye umntu kusapho lwakho. Lithetha ukuthini kanye kanye eli “lwelo olusezimpumlweni”? Ngaba le yinto yokoyika? Namhlanje, masithethe ngale meko, ebizwa ngokuba yi-“Pleural Effusion” ngokwezonyango, ngendlela elula kakhulu onokuyiqonda.
Kuthetha ukuthini kanye kanye ukuzalisa imiphunga yakho ngamanzi?
Khawuthelekelele ukuba imiphunga yethu ikwigumbi elikhuselayo ngaphakathi esifubeni. Ezi ziphaphu zijikeleze ezi ziphaphu, kunye nangaphakathi esifubeni, kukho ii-membrane ezimbini ezibhityileyo. Zifana nebhaluni ngaphakathi ebhaluni. Ezi ziphaphu zimbini sizibiza ngokuba yi-pleura.
Ngokwesiqhelo, kumntu ophilileyo, kukho ulwelo oluncinci kakhulu phakathi kwezi membrane zimbini. Lufana negrisi encinci kumatshini. Ngenxa yolu lwelo, xa siphefumla, xa imiphunga yethu ifinyela kwaye ikhula, loo nkqubo yenzeka ngaphandle kobunzima okanye ukungqubana. Leyo yindlela yendalo.
Kodwa kwimeko ebizwa ngokuba yi-"Pleural effusion" ( ukuphuma kolwelo olungaphezulu kunolufunekayo) luqokelelana kwindawo engenanto phakathi kwezi membrane zimbini. Oku kuqhele ukubizwa ngokuba "lulwelo olukwimiphunga." Ngokuchanekileyo, olu lwelo aluzalisi imiphunga ngokwalo, kodwa luzalisa phakathi kwemembrane ezimbini ze-pleural ezijikeleze imiphunga.
Kunokubakho izizathu ezibini eziphambili zokuqokelelana kolwelo ngale ndlela:
1. Umzimba usenokuba uvelisa olu lwelo luninzi kakhulu .
2. Ngaphandle koko, umzimba usenokungakwazi ukufunxa ngokufanelekileyo ulwelo oluveliswayo.
Nokuba yeyiphi na indlela, isiphumo kukuba ulwelo luyaqokelelana lujikeleze imiphunga, luyicinezele, kwaye ubunzima bokuphefumla buqala ukwenzeka.
Kukho iintlobo ezimbini zolwelo ezidibanayo.
Oogqirha bahlula i-pleural effusion ibe ziintlobo ezimbini eziphambili ngokusekelwe kuhlobo lolwelo oluqokelelanayo. Kuba izinto ezikwilwelo zinokunika umbono olungileyo wokuba yintoni unobangela.
| Uhlobo lolwelo | Inkcazo kunye nezizathu eziphambili |
|---|---|
| I-Transudative (Iphezulu kulwelo, iphantsi kwiproteni) | Ngamafutshane, olu lulwelo olufana "namanzi". Luneproteni encinci. Oku kubangelwa kukwanda koxinzelelo kwimithambo yegazi yomzimba okanye ukwehla kwenqanaba leproteni egazini. Iindawo zolwelo ziyavuza kwimithambo yegazi. Izizathu eziphambili: Ukusilela kwentliziyo, i-Cirrhosis yesibindi, i-Nephrotic Syndrome. |
| I-Exudative (Uxinano oluphezulu, iiproteni eziphezulu) | Olu lwelo luneproteni egqithisileyo, iiseli, nezinye izinto. Oku kubangelwa lusulelo, ukudumba, okanye umhlaza ngaphakathi okanye ngeenxa zonke kwipleura. Oku kwenzeka xa ulwelo luphuma kwimithambo yegazi okanye inkqubo ye-lymphatic ingakwazi ukususa ulwelo. Izizathu eziphambili: Isifo semiphunga, umhlaza (ingakumbi imiphunga, umhlaza webele), isifo sephepha, isifo sezintso, emva kotyando lwentliziyo. |
Xa unyanga, kubalulekile ukufumanisa ukuba loluphi uhlobo kwezi zimbini onalo kwaye yintoni ebangela oko.
Ziziphi iimpawu onokuzifumana?
Abanye abantu bane-pleural effusion kodwa ababonisi zimpawu. Ifunyanwa ngengozi ngexesha le-X-ray yesifuba ngesinye isizathu. Nangona kunjalo, abantu abaninzi baba neempawu, ingakumbi xa ulwelo luqokelelana.
- Ubunzima bokuphefumla: Olu lolona phawu luphambili noluqhelekileyo. Xa ulwelo luzalisa imiphunga, akukho ndawo yaneleyo yokuba imiphunga ivuvuke ngokufanelekileyo. Oku kwenza kube nzima ukuphefumla kwaye kukwenze uzive ufuthanisekile.
- Intlungu yesifuba: Intlungu ebukhali eviwayo ingakumbi xa uphefumla nzulu okanye ukhohlela. Oku kwenzeka xa ii-membranes ezimbini ze-pleural zixubana.
- Ukukhwehlela okomileyo: Abanye abantu banokuba nokukhwehlela okomileyo okungapheliyo.
- I-Orthopnea: Olu luphawu olwahlukileyo. Ukuphefumla kuba nzima ngakumbi xa ulele phantsi, kodwa ukuphefumla kuba lula xa uhleli okanye umile.
- Umkhuhlane: Ukuba unobangela oyintloko lusulelo (olufana ne-pneumonia), iimpawu ezinje ngomkhuhlane kunye neentlungu zomzimba nazo zinokuvela.
Into ebalulekileyo kukuba ezi mpawu azikho kwi-pleural effusion kuphela. Zinokubonwa nakwezinye izifo ezifana nesifo sentliziyo kunye ne-asthma. Ngoko ke, ukuba unale mpawu, kubaluleke kakhulu ukubona ugqirha ngokukhawuleza ukuze ufumane unobangela.
Ungayibona njani le meko?
Xa usiya kugqirha, uza kuqala akubuze ngeempawu zakho kunye nazo naziphi na ezinye iimeko zempilo onokuba nazo (ezifana nesifo sentliziyo okanye isifo seswekile). Emva koko baza kubeka i-stethoscope esifubeni sakho baze bamamele. Ukuba kukho ulwelo olujikeleze imiphunga yakho, izandi ozivayo xa uphefumla zinokutshintsha.
Emva koko, kuya kufuneka kwenziwe uvavanyo oluninzi ukuqinisekisa isifo kunye nokufumana unobangela.
- I-X-reyi yesifuba: Olu lolona vavanyo lulula nolulula. I-X-reyi inokubona ngokucacileyo ukuba kukho ulwelo olujikeleze imiphunga kunye nokuba lungakanani.
- I-CT scan: Oku kunokuvelisa umfanekiso ocacileyo, onemilinganiselo emithathu (3D) wemiphunga kunye nendawo ye-pleural. Oku kunokuba luncedo kakhulu ekufumaneni unobangela wokuqokelelwa kolwelo (njengethumba).
- I-ultrasound scan: Oku kunokunceda ekufumaneni indawo yolwelo kunye nokulinganisa ubungakanani bolwelo. Isetyenziselwa ukunceda ukukhokela inaliti kwindawo leyo, ingakumbi xa kusenziwa inkqubo ebandakanya ukususa ulwelo.
- I-Thoracentesis: Olu lolunye lovavanyo olubaluleke kakhulu. Lubandakanya ukwenza umngxuma omncinci esifubeni, ukufaka inaliti encinci phakathi kweembambo ezimbini, kunye nokuthatha isampuli yolwelo olujikeleze imiphunga. Olu vavanyo lolwelo luthunyelwa kwilabhoratri ukuze luvavanywe.
Yintoni oyikhangelayo xa uvavanya isampuli yolwelo?
Ilebhu ivavanya ulwelo ukuze ibone iiproteni, iswekile, iintlobo zeeseli (ngaba zikhona iiseli zomhlaza?), kunye neentsholongwane ezincinci ezifana neebhaktheriya. Olu lwazi lunceda ugqirha ukuba agqibe ukuba ngaba ``yi-Transudative'' okanye ``i-Exudative'', kwaye nokuba ingaba imbangela lusulelo, umhlaza, okanye enye into.
Kwezinye iimeko, ukuba ezi mvavanyo azikwazi ukubona unobangela, inkqubo ebizwa ngokuba yi-thoracoscopy okanye i-VATS inokwenziwa. Oku kuquka ukufaka ikhamera ngokusebenzisa umngxuma omnye okanye ngaphezulu esifubeni ukuze kujongwe ngqo kwi-pleura kunye nemiphunga. Isampuli yezicubu ingathathwa ukuze kuthathwe i-biopsy.
Zithini iindlela zonyango?
Kukho iinjongo ezimbini eziphambili ekunyangeni i-pleural effusion:
1. Ukususa ulwelo olugqithisileyo kunye nokunciphisa ubunzima bokuphefumla.
2. Ukunyanga unobangela oyintloko wokwanda kolwelo kunye nokuthintela ukwanda kolwelo.
Khumbula, ukususa nje ulwelo olujikeleze imiphunga akwanelanga. Ukuba imeko engaphantsi ayinyangwa, ulwelo lusenokuzalisa kwakhona.
1. Ukunyanga unobangela oyintloko
- Ukuba ulwelo luqokelelana ngenxa yokungasebenzi kakuhle kwentliziyo , amayeza aphucula ukusebenza kwentliziyo kunye ne-diuretics (iipilisi zamanzi) ezisusa amanzi agqithisileyo emzimbeni ayanikwa.
- Isizathu: I-PneumoniaUkuba lusulelo lwebhaktiriya, kunikwa amayeza okubulala iintsholongwane.
- Ukuba unobangela ngumhlaza , kuya kufuneka wenze i-chemotherapy kunye nonyango lwe-radiation.
2. Iindlela zokususa ulwelo oluqokelelweyo
- I-Thoracentesis yoNyango: Olu luvavanyo olufanayo esiluxubushe ngaphambili, kodwa endaweni yokuthatha isampuli, ulwelo oluninzi kangangoko kunokwenzeka lususwa ngenaliti. Oku kunika isiqabu ngokukhawuleza kwisigulana.
- Umbhobho Wesifuba: Ukuba ubungakanani bolwelo buninzi kakhulu okanye ulwelo lutyebile (njengobovu), umbhobho omncinci obizwa ngokuba yi-"chest tube" unokufakwa esifubeni kangangeentsuku ezimbalwa. Ulwelo luthululwa kancinci kancinci kwibhotile ngale mbhobho.
- I-Pleural Sclerosis: Le nkqubo isetyenziswa ukuba ulwelo luyaqhubeka nokuqokelelana ngenxa yesizathu esifana nomhlaza. Kule nkqubo, amayeza akhethekileyo (afana ne-talc) afakwa ngetyhubhu yesifuba phakathi kwe-pleural membranes ezimbini. Eli yeza libangela ukudumba phakathi kwe-pleural membranes ezimbini, okubangela ukuba zinamathele kunye. Oku ke kususa indawo apho ulwelo lunokuphinda luqokelelane khona.
- Utyando: Ukuba ezinye iindlela aziphumelelanga okanye ukuba kukho umaleko omkhulu ojikeleze i-pleura ngenxa yosulelo, utyando lunokufuneka.
- I-VATS (utyando lwe-thoracoscopic oluncediswa yividiyo): Utyando olwenziwe kusetyenziswa ikhamera efakwe ngemigqomo emincinci.
- I-Thoracotomy: Utyando lwendabuko olubandakanya ukuvula isifuba. Oku kunokususa ngokupheleleyo izicubu ezineentsholongwane.
Iingxaki ezinokuvela kule meko
Ukuba ayinyangwanga kakuhle, i-pleural effusion inokubangela iingxaki ezahlukeneyo.
- Usulelo: Iintsholongwane zinokungena kulwelo olujikeleze imiphunga zize zenze ithumba.
- Amanxeba ajikeleze imiphunga: Ukugcinwa kolwelo ixesha elide kunokubangela ukuba i-pleural membrane ibe nkulu, nto leyo ethintela imiphunga ukuba ivuvuke kakuhle.
- I-Pneumothorax ephukileyo: Ngamanye amaxesha imiphunga inokonakala ngexesha lenkqubo yokususa ulwelo.
Kungoko ke, kubaluleke kakhulu ukufuna iingcebiso zonyango ngokukhawuleza ukuba uneempawu.
Ngaba le meko ingaphetshwa?
Ekubeni i-pleural effusion ibangelwa sisifo esithile, into ekufuneka siyenze kukuzama ukuthintela ukuphuhliswa kweso sifo sisisiseko.
- Kuphephe ukutshaya: Ukutshaya yimbangela enkulu yomhlaza wemiphunga nesifo sentliziyo.
- Kuphephe ukudibana ne-asbestos: Oku kunokubangela izifo zemiphunga.
- Indlela yokuphila enempilo: Izinto ezinje ngokutya okunesondlo, ukuzilolonga, kunye nokunciphisa ukutya ityuwa eninzi kunokunceda ukulawula iimeko ezifana nesifo sentliziyo kunye nesifo sezintso.
- Ukuba sele unesifo sentliziyo okanye sezintso, thatha amayeza njengoko ugqirha wakho ekuyalele kwaye uye kwiikliniki ngexesha.
Umyalezo Wokuya Ekhaya
- " I-Pleural effusion " kukuqokelelana okungaqhelekanga kolwelo phakathi kwee-membrane ezimbini ezijikeleze imiphunga.
- Ubunzima bokuphefumla, iintlungu zesifuba xa uphefumla nzulu, kunye nokukhwehlela okomileyo zezona mpawu ziphambili.
- Le meko ayisosifo, kodwa luphawu lwesinye isifo. Ingabangelwa zizizathu ezahlukeneyo, ezifana nesifo sentliziyo, inyumoniya, kunye nomhlaza.
- Eyona nto ibalulekileyo kunyango kukuphatha ngokufanelekileyo unobangela oyintloko, ukongeza ekususeni ulwelo.
- Ukuba wena okanye umntu omaziyo unale mpawu, musa ukoyika okanye ukulibazisa , kodwa bonana nogqirha ngokukhawuleza. Ukuxilongwa kwangoko kunye nonyango kunokuthintela iingxaki.
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