Ngaba imiphunga yakho ivakala ngathi izaliswe ngamanzi? Masithethe nge-pleural effusion!

Ngaba wakha waziva ubunzima obuncinci esifubeni sakho, uvakalelo olungaqhelekanga xa uphefumla? Okanye wakha weva umntu esithi, "Imiphunga igcwele amanzi"? Yiloo nto siza kuthetha ngayo namhlanje. Oku kwaziwa ngokwezonyango njenge-pleural effusion.

Ngamafutshane, yintoni i-pleural effusion?

Kulungile, masibone ukuba yintoni le ngolu hlobo. Imiphunga yakho ingaphakathi kwesifuba sakho. Ejikeleze la maphaphu, nangaphakathi kwesifuba sakho, kukho ii-membrane ezimbini ezincinci kakhulu. Ezi membrane sizibiza ngokuba yi-pleura . Kufana nokuba zigqunywe macala omabini.

Ngokwesiqhelo, kukho ulwelo oluncinci kakhulu phakathi kwezi membrane zimbini ze-pleural. Cinga ngalo njengeoyile ethambisa iindawo ezimbini zomatshini. Olu lwelo luvumela imiphunga yakho ukuba ishukume, ikhule, kwaye inciphe ngokulula xa uphefumla.

Nangona kunjalo, kule meko ibizwa ngokuba yi-pleural effusion , ubungakanani bolwelo phakathi kwee-pleural membranes ezimbini buphezulu kakhulu kunesiqhelo . Oku kuthetha ukuba umzimba wakho uvelisa olu lwelo luninzi kakhulu, okanye ulwelo oluveliswayo aluphindi lufunxwe ngokufanelekileyo emzimbeni. Kulapho sithi "imiphunga igcwele amanzi."

Ngaba kukho iintlobo ze-pleural effusion?

Ewe, oogqirha bahlula i-pleural effusion ibe ziintlobo ezimbini eziphambili, kuxhomekeke kuhlobo lolwelo oluqokelelana emiphungeni.

1. Ulwelo olungenamanzi okanye olungenaproteni: Olu hlobo lolwelo ludla ngokuvela xa uxinzelelo lolwelo emzimbeni lusanda. Umzekelo, umntu onesifo sesibindi (isifo sesibindi) okanye ukungasebenzi kakuhle kwentliziyo unokuba nolu hlobo lolwelo. Oku kwenzeka xa ulwelo luphuma kwimithambo yegazi.

2. Ulwelo oluphumayo okanye oluneproteni eninzi: Izizathu eziphambili zolu hlobo lolwelo ngumhlaza (umzekelo, umhlaza wemiphunga, umhlaza webele) okanye uhlobo oluthile losulelo . Kule meko, ulwelo oluninzi luvuza ngemithambo yegazi emincinci okanye ulwelo alususwa ngokufanelekileyo yinkqubo ye-lymphatic.

Iindlela zonyango zimiselwa ngokusekelwe kolu hlobo. Ngoko ke kubaluleke kakhulu ukuba ugqirha ayazi uhlobo lolu lwelo.

Ixhaphake kangakanani le meko?

Enyanisweni, i-pleural effusion yimeko eqhelekileyo kunokuba unokucinga . Umzekelo, kuxelwe ukuba malunga ne-1.5 yezigidi zabantu e-United States kuphela bahlakulela le meko minyaka le. Le meko ikwabonakala kwilizwe lethu.

Zithini iimpawu ze-pleural effusion?

Usenokuba nezinye iimpawu ngokuxhomekeke kwimeko ebangela i-pleural effusion. Nangona kunjalo, kukho iimpawu ezininzi ezikhethekileyo kwi-pleural effusion.

• Intlungu yesifuba: Le ntlungu inokuba mandundu, ingakumbi xa uphefumla nzulu okanye ukhohlela. Isenokuvakala ngathi kukho into ekuhlabayo ngaphakathi.
• Ubunzima bokuphefumla (Ukuphelelwa ngamandla): Ukuphefumla kunokuvakala kunzima kwaye kukufuthanisele. Oku kunokuba kubi ngakumbi xa uzibhokoxa.
• I-Orthopnea: Olu luphawu oluthile. Kuthetha ukuba unobunzima bokuphefumla kwiindawo ezingezizo ezokuhlala okanye zokuma ngokuthe nkqo (umzekelo, ukulala phantsi). Abanye abantu balala benemiqamelo emibini okanye emithathu ukuze bazixhase kuba baziva befuthanisekile xa belele phantsi.

Nangona kunjalo, abanye abantu banokuba ne-pleural effusion ngaphandle kweempawu . Bafumanisa ngayo kuphela xa bethatha i -X-ray yesifuba ngesinye isizathu.

Kutheni oku kusenzeka? Zithini izizathu zoku?

Zininzi izizathu zokuphuma kwegazi emzimbeni. Ngamanye amaxesha zininzi izizathu ezinokubandakanyeka. Njengoko besitshilo ngaphambili, oogqirha bazama ukufumanisa unobangela ngokufumanisa ukuba ulwelo oluqokelelayo luyi-transudative ( olunamanzi) okanye luyi -exudative (olutyebileyo kwiproteni). Ngamanye amaxesha, imeko ebizwa ngokuba yi -pulmonary embolism (PE) inokuba zizo zombini ezi ntlobo.

Ezona zinto ziphambili ezibangela ukuqokelelwa kolwelo lwe-transudative zezi:

• Ukungasebenzi kakuhle kwentliziyo: Le yeyona nto ibangela ukuba intliziyo ingasebenzi kakuhle, ukulawulwa kolwelo emzimbeni kuyaphazamiseka.
• I-Cirrhosis: Yimeko embi kakhulu eyenzeka esibindini.
• Isifo seNephrotic: Le yingxaki yezintso. Le meko inokwenzeka xa izintso zikhupha iiproteni ezininzi kakhulu.

Izizathu eziphambili zokuqokelelwa kolwelo oluphuma emzimbeni zezi:

• I-Pneumonia: Usulelo lwemiphunga.
• Umhlaza: Ingakumbi umhlaza wemiphunga , umhlaza webele , okanye i-lymphoma .
• Isifo sezintso
• Isifo Sokudumba: Iimeko ezahlukeneyo zokudumba ezenzeka emzimbeni.
• Emva kotyando lwentliziyo evulekileyo

Kukwakho nezizathu ezingaqhelekanga:

• Isifo sephepha
• Isifo Sokuzikhusela Ngokwasemzimbeni: Oku kuthetha ukuba inkqubo yomzimba yokuzikhusela ihlasela iiseli zayo.
• Ukopha ngenxa yokwenzakala esifubeni.
• I-Chylothorax: Oku kwenzeka xa ulwelo olubizwa ngokuba yi-'chyle' oluvela kwinkqubo ye-lymphatic luqokelelana esifubeni. Ludla ngokubangelwa kukwenzakala.
• Usulelo olungaqhelekanga esifubeni nasesiswini.
• Ukuvezwa kwi-asbestos.
• Ukuqhuma komlomo
• I-Pancreatitis
• Isifo sikaMeig: Sibangelwa sisimila esingenobungozi esikhula kwi-ovary.
• Isifo se-Ovarian Hyperstimulation
• Amanye amayeza
• Utyando lwesisu.
• Unyango lweMisebe

Kwezinye iimeko, ulwelo ngokwalo lunokuba neeseli ezinobungozi , okanye lunokuqokelelwa njengesiphumo esingesihle se -chemotherapy .

Ngubani osengozini enkulu yokuphuhlisa oku?

Kukho izinto ezininzi ezinokubangela umngcipheko obangelwa kukuphuma kwegazi emzimbeni.

• Ukuba neemeko zempilo ezibangela oku: Umzekelo, ukuba unesifo sentliziyo, isifo sesibindi, isifo sezintso, okanye umhlaza, usemngciphekweni omkhulu wokufumana i-pleural effusion.
• Ukusetyenziswa kweemveliso zecuba: Abantu abatshayayo banokuba neengxaki zemiphunga.
• Ukuvezwa kwi-asbestos: Le yinto eqhelekileyo yokwakha. Ukuvezwa kuyo ixesha elide kunokubangela umonakalo emaphaphu.

Zeziphi iingxaki ezinokubangela oku?

Ukuba i-pleural effusion ayinyangwanga kakuhle, ezinye iingxaki zinokubakho.

• Usulelo oluguquka lube lithumba: Ulwelo oluqokelelweyo lunokosulelwa ziintsholongwane, nto leyo ebangela ukuba luguquke lube lithumba.
• Amanxeba ajikeleze imiphunga: Izicubu zamanxeba zinokwenzeka apho ulwelo belukhona, nto leyo ephazamisana nokusebenza kwemiphunga.
• Ukonakala kwemiphunga yakho.

Uyifumana njani le meko kanye kanye?

Xa usiya kugqirha, uza kuqala akubuze ngembali yakho yezonyango . Zeziphi ezinye izifo onazo kwaye ezi mpawu ziqale nini? Emva koko baza kwenza uvavanyo lomzimba . Baza kumamela imiphunga yakho njengoko uphefumla (nge-stethoscope). Kuphela emva koko baya kuyalela uvavanyo olufunekayo.

Zeziphi iimvavanyo ezenziwayo koku?

Oogqirha basebenzisa olu vavanyo ukuxilonga nokuqonda uhlobo lwe-pleural effusion:

• I-X-reyi yesifuba: Oku kunokunceda ekuqinisekiseni ukuba ulwelo luqokelelene na kwaye lungakanani.
• I-CT scan yesifuba (i-Computed Tomography - i-CT scan): Ingavelisa imifanekiso ecacileyo neneenkcukacha ezingaphezulu kune-X-rays. Ingajonga nemeko yemiphunga phantsi kolwelo kunye nezinye izinto ezifana neethumba.
• I-ultrasound yesifuba:Oku kukwanceda ekufumaneni indawo kunye nobungakanani bolwelo, kunye nendawo echanekileyo apho kufuneka ufake khona inaliti encinci yokususa ulwelo.
• I-Thoracentesis okanye i-Biopsy: Oku kuquka ukufaka inaliti encinci kakhulu esifubeni sakho phakathi kweembambo zakho ezimbini ukuze uthathe isampuli yolwelo oluqokelelweyo. Ngamanye amaxesha iqhekeza elincinci le-pleural membrane (i-biopsy) linokuthathwa.
• Uhlalutyo lwePleural Fluid: Isampuli yolwelo ithunyelwa kwilebhu ukuze ivavanywe. Oku kunokumisela ubungakanani beproteni, iintlobo zeeseli, nokuba kukho iintsholongwane, okanye iiseli zomhlaza. Oku kukuxelela ngqo ukuba ulwelo luyi-transudative okanye yi-exudative.

Ukuba ezi mvavanyo zilula azifumani unobangela, kunokufuneka wenze inkqubo ebizwa ngokuba yi-thoracoscopy . Oku kukwabizwa ngokuba yi-video-assisted thoracic surgery (VATS) . Oku kwenziwa ngelixa uphantsi kwe-anesthesia jikelele. Oku kubandakanya ukufaka ikhamera encinci kunye nezixhobo esifubeni sakho ukuze ubone ngcono i-pleura kunye neendawo ezikufutshane. Unyango ludla ngokwenziwa ngexesha elinye nale nkqubo.

Iphathwa njani le nto?

Kukho iinjongo ezimbini eziphambili xa kunyangwa i-pleural effusion: Enye kukususa ulwelo olugqithisileyo . Enye kukuthintela ulwelo ukuba lungaphinde luqokelelane . Oogqirha bakhetha unyango ngokusekwe kwisizathu esiyintloko kunye nokuba ubunzima bokuphefumla bungakanani ngenxa yolwelo.

Amayeza

• Ukuba ugcina ulwelo ngenxa yemeko efana nokusilela kwentliziyo okuxineneyo , oogqirha baya kukunika amayeza okukhupha ulwelo (akwaziwa ngokuba "ziipilisi zamanzi" kuba zinceda umzimba ukhuphe ulwelo olugqithisileyo ngomchamo) kunye namanye amayeza okusilela kwentliziyo.
• Ukuba kungenxa yosulelo, kuya kufuneka uthathe amayeza okubulala iintsholongwane .
• Ukuba le meko ibangelwa ngumhlaza (i-malignant effusion), ungafumana i-chemotherapy , unyango lwe-radiation , okanye ukufakelwa iyeza lolwelo esifubeni.

Iindlela zonyango (Iinkqubo)

• Ukuba unengxaki yokuphefumla, ugqirha wakho angenza i-thoracentesis yonyango (oku kufana nokuthatha isampuli yolwelo, kodwa ulwelo oluninzi kangangoko lunokukhutshelwa). Okanye banokufaka ityhubhu yesifuba . Oku kuquka ukufaka ityhubhu encinci esifubeni sakho nokuvumela ulwelo ukuba luphume ebhotileni.
• Ngamanye amaxesha, ingakumbi xa ulwelo luqokelelana ngenxa yomhlaza, ulwelo lunokuphinda luqokelelane nasemva kokuba lususiwe. Kwiimeko ezinjalo ezinzima ukuzilawula, ugqirha angasebenzisa umbhobho wesifuba ukukhupha ulwelo.Uhlobo lonyango olubizwa ngokuba yi-sclerosing agent lufakwa kwi-pleural cavity. Olu nyango ngabom lubangela isilonda (i-fibrosis) phakathi kwee-pleural membranes ezimbini. Oku kukwabizwa ngokuba yi-pleural sclerosis okanye i-pleurodesis . Xa esi silonda senziwe, ii-pleural membranes ezimbini ziyanamathelana, zithintela ulwelo ukuba luphinde luqokelelane. Le ndlela isebenza malunga ne-50% kuphela ekumiseni ulwelo ukuba luphinde luqokelelane.

Utyando

Ukuba ukuphuma kwamanzi emzimbeni okanye i-pleural sclerosis akwanelanga ukulawula imeko yakho, unokufuna utyando. Ugqirha wakho uza kukuxilonga ngononophelo aze axoxe nawe ngezinto ezilungileyo nezingalunganga ngotyando.

Kukho iintlobo ezimbini eziphambili zotyando:

1. Utyando lweThoracoscopic oluncediswa yiVidiyo (i-VATS): Oku kuquka ukwenza imingxunya emincinci ukuya kwemithathu esifubeni kunye nokufaka ikhamera kunye nezixhobo zotyando ngazo ukuze kwenziwe utyando. Le ndlela isetyenziselwa ukuphuma kwe-pleural okunzima ukuyilawula okanye okuphindaphindekayo ngenxa yomhlaza. Ngexesha lotyando, into efana ne -talc okanye i-antibiotic ifakwa kwi-pleural cavity ukuzama ukuthintela ulwelo ukuba lungaqokeleli kwakhona.

2. I-Thoracotomy (utyando lwesiqhelo, "oluvulekileyo" lwesifuba): Kule nkqubo, ugqirha wenza utyando oluyi-intshi ezi-6-8 esifubeni. Le yeyona nkqubo ixhaphakileyo esetyenziswayo ukuba unosulelo. I-thoracotomy isusa zonke izicwili ezineentambo kwaye inceda ekucoceni ngokupheleleyo usulelo olukwi-pleural cavity. Kusenokufuneka ufake ityhubhu yesifuba ukuze ukhuphe ulwelo kangangeentsuku ezimbini ukuya kwiiveki ezimbini emva kotyando.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga ezinokubakho ngenxa yonyango?

Ewe, njengakwezinye iindlela zonyango, unyango lwe-pleural effusion lunokubangela ezinye iziphumo ebezingalindelekanga.

• Ukudumba kweMiphunga: Oku kunokwenzeka, ingakumbi ukuba kususwe ulwelo oluninzi ngaxeshanye.
• Amahlwili egazi
• Izingqisho Zentliziyo Ezingaqhelekanga
• I-Pneumothorax: Oku kukuwa kwemiphunga ngenxa yomoya ozalisa imiphunga. Ngamanye amaxesha oku kunokwenzeka xa inaliti esetyenziselwa ukususa ulwelo ibethekile.

Kuthatha ixesha elingakanani ukuchacha?

Oku kuyahluka ngokuxhomekeke kunyango olwenziweyo.

• Ukuba ubune -thoracentesis , kuya kufuneka ulumke kancinci kangangeentsuku ezimbini.
• Ukuba wenze utyando lwe -VATS , kunokufuneka uhlale esibhedlele iintsuku ezimbalwa emva koko.
• Ukuba wenze utyando lwe-thoracotomy (utyando oluvulekileyo), kuya kufuneka uhlale esibhedlele kangangeveki.

Singenza ntoni ukunciphisa lo mngcipheko?

Kunzima ukuthintela izinto ezininzi ezibangela i-pleural effusion. Nangona kunjalo, ungawunciphisa umngcipheko wakho ngokuthi:

• Ziphephe iimveliso zecuba.
• Kuphephe ukuvezwa kwi-asbestos.
• Ukuba ugqirha wakho ukucebisile, dla ukutya ukutya okungenatyuwa ingako.
• Sela amayeza akho okukhupha isisu (iipilisi zamanzi) ngexesha elifanelekileyo.
• Ukuba ugqirha wakho ukuxelela ukuba wenze njalo, nciphisa umlinganiselo wokutya ulwelo.

Yintoni esifanele siyilindele ngale meko?

Emva kokuba ufumene unyango, kuya kufuneka uphinde wenze i-X-ray . Ugqirha uya kufuna ukwazi ukuba unyango luphumelele na. Kuya kufuneka uqhubeke ufumana unyango lwemeko ebangele ukuphuma kwegazi emzimbeni.

Ubunzima bemeko yakho buxhomekeke kwezi zinto zilandelayo:

• Yintoni eyona nto ibangela ukusasazeka kwe-pleural effusion?
• Ingaba iyayichaphazela indlela ophefumla ngayo?
• Imalunga nokuba iyasabela kakuhle na kunyango.

Iyintoni ikamva lale meko?

Imbono, okanye i-prognosis , iyahluka kakhulu kuxhomekeke kwinto ebangele i-pleural effusion yakho kunye nezinye iimeko zonyango onazo. Kwabanye abantu, unyango lwe-pleural effusion luphumelele. Nangona kunjalo, i-pleural effusion inokubuya .

Ithemba lokuba i-pleural effusion ebangelwa ngumhlaza alikho lihle kangako. Kwaye ukuba awuyinyangi kakuhle i-pleural effusion, nayo ayilunganga.

Uzinyamekela njani?

Ezinye iimeko ezibangela i-pleural effusion zifuna unyango lwexesha elide . Thetha nogqirha wakho malunga nonyango olungcono lwexesha elide lwemeko yakho. Emva koko, landela isicwangciso sakho sonyango ngokuchanekileyo . Sela amayeza akho ngexesha kwaye ugcine utshintsho lwendlela yokuphila olucetyiswa ngugqirha wakho.

Kunini apho kungcono ukubona ugqirha?

Yiya kuzo zonke iintlanganiso zokulandelela ugqirha wakho aziyalele ukuba zilawule imeko yakho engapheliyo. Ukuba ufumana ubunzima bokuphefumla , funa uncedo lwezonyango ngoko nangoko . Musa ukulibazisa.

Yeyiphi imibuzo ebalulekileyo omele uyibuze ugqirha wakho?

Ungabuza ugqirha imibuzo efana nale:

• Kutheni le nto ndiphuhlise le pleural effusion?
• Kufuneka ndize kukubona kangaphi (iintlanganiso zokulandelela)?
• Zithini amathuba okuba ndiphinde ndibe ne-pleural effusion?
• Zithini iziphumo zexesha elide ze-pleural effusion yam?

Ngoko ke, une-pleural effusion, mhlawumbi ubungenazo iimpawu. Eyona nto ibalulekileyo kukufumana unobangela.. Nje ukuba ugqirha ayazi imbangela, uza kuthatha amanyathelo okunyanga. Ukuphendula imibuzo kagqirha ngokuchanekileyo kunokunceda ekususeni ezinye zezizathu. Kuqhelekile ukuba uzive usoyika xa unengxaki yokuphefumla, ngoko ungoyiki ukubuza imibuzo ngayo nantoni na ofuna ukuyiqonda.

Ngoko ke, zeziphi izinto ekufuneka sizikhumbule kuzo zonke ezi zinto?

I-Pleural effusion kukuqokelelana kolwelo phakathi kwe-pleura, ii-membranes ezijikeleze imiphunga. Abanye abantu bakwabiza oku ngokuthi "ngamanzi emiphungeni."

• Zininzi izizathu ezibangela oku. Izinto ezifana nesifo sentliziyo, inyumoniya, kunye nomhlaza zezona ziphambili.
• Iimpawu zingabandakanya iintlungu esifubeni kunye nobunzima bokuphefumla . Abanye abantu basenokungabi nazo kwaphela iimpawu.
• Ugqirha angakufumanisa oku nge -X-ray, i-CT scans, kunye ne-fluid sampling (thoracentesis) .
• Unyango lujoliswe kwisizathu esiyintloko kunye nokususwa kolwelo . Amayeza, iindlela zokususa ulwelo, kwaye ngamanye amaxesha notyando lunokufuneka.
• Eyona nto ibalulekileyo kukubona ugqirha ngokukhawuleza ukuba unengxaki yokuphefumla okanye uziva iqhuma esifubeni sakho. Ukufunyaniswa kwangoko kwenza unyango lube lula kwaye kunciphisa umngcipheko weengxaki.

Ukuba unemibuzo engaphezulu malunga noku, ungathandabuzi ukuthetha nogqirha wakho. Hlala usempilweni!

Ukuphuma kwegazi esiswini , imiphunga, amanzi esifubeni, ubunzima bokuphefumla, iintlungu esifubeni, isifo semiphunga, unyango lwezonyango