Wake wazizwa ubuhlungu obungavamile, ukusinda, noma ukungakhululeki phakathi kwesifuba sakho, lapho inhliziyo yakho ikhona khona? Ungase ucabange ukuthi akuyona into embi kangako. Kodwa-ke, ngezinye izikhathi lezi zimpawu zingaba uphawu lwesimo sempilo esibi kakhulu. Yingakho namuhla sizokhuluma ngesimo esibizwa ngokuthi `(Mediastinitis)` esingase sivele esifubeni, kodwa abantu abaningi abangazi ngaso. Nakuba leli gama liyinkimbinkimbi kancane, masiliqonde kalula.

Kuyini lokhu `(Mediastinitis)`?

Kalula nje, `(Mediastinitis)` ukuvuvukala noma ukutheleleka okwenzeka endaweni ebizwa ngokuthi `(mediastinum)` phakathi kwesifuba sethu. Manje ungase uzibuze ukuthi iyini `(mediastinum)`. Cabanga nje, isifuba sethu siwumgodi omkhulu, esiwubiza ngokuthi `(umgodi wesifuba)` . Kuzo zombili izinhlangothi zalo `(umgodi wesifuba)` kukhona `(imigodi ye-pleural)` lapho amaphaphu ethu etholakala khona. Isikhala esibalulekile phakathi kwesifuba, phakathi kwamaphaphu amabili, sibizwa ngokuthi `(mediastinum).`

Le ngxenye ye-`(mediastinum)` yilapho kutholakala khona izitho eziningi ezibalulekile nezakhiwo, njengenhliziyo yethu , ingxenye yombhobho wokudla (`(umphimbo)`) , kanye nemithambo yegazi eyinhloko exhumanisa nenhliziyo. Ngakho ungaqonda ukuthi kungaba yingozi kangakanani uma kwenzeka ukuvuvukala noma ukutheleleka endaweni ebaluleke kangaka. Yingakho isimo `(Mediastinitis)` singaba yingozi empilweni.

Lesi simo (i-Mediastinitis) singaba sibi kakhulu (sivele ngokuzumayo) noma sibe singapheli (sikhula kancane kancane ngokuhamba kwesikhathi) .

Kwenzekani emzimbeni uma uba nesifo '(Mediastinitis)'?

I-Mediastinitis iyisimo esisongela impilo. Lokhu kuvuvukala kungaphazamisa ukusebenza okuvamile kwezitho zethu ezibalulekile kanye nemithambo yegazi esifubeni. Lokhu kungaholela ezinkingeni ezinkulu. Ngakho-ke, ukuthola ukwelashwa ngokushesha okukhulu kwandisa amathuba okululama nokusindisa impilo yakho.

Ezinye zezinkinga ezingase zenzeke ngenxa ye-mediastinitis yilezi:

• Ukuvaleka komoya okubangela ubunzima bokuphefumula.
• I-Constrictive pericarditis (ukuqina kolwelwesi oluzungeze inhliziyo).
• I-pneumonia ephindaphindayo.
• Ukwehluleka kwenhliziyo ohlangothini lwesokudla .
• Ushevu wegazi, okungukuthi `(Sepsis)` .
• Ukopha okukhulu.
• I-Superior vena cava syndrome (ukucindezeleka ku-superior vena cava, umthambo omkhulu othwala igazi uye enhliziyweni).

Cabanga nje, uma kwenzeka isimo esinjengalesi, sithinta wonke umzimba wethu. Yingakho kungakuhle ukuthatha lokhu kalula.

Sivame kangakanani lesi simo?

Ngokusho kodokotela, i-"Mediastinitis" iyisimo esingavamile . Kodwa-ke, izinga okwenzeka ngalo kubantu ('ukusabalala') nokuthi kubathinta kakhulu bahlukahluka kuye ngohlobo lwesifo ('esibukhali' noma 'esingapheli').

I-mediastinitis ebukhali ivame ukubonwa njengenkinga yokuhlinzwa kwesifuba, ikakhulukazi inqubo ebizwa ngokuthi i-median sternotomy . I-median sternotomy inqubo yokuhlinzwa lapho udokotela ohlinzayo esika khona ithambo lakho lesifuba (sternum) libe yizingxenye ezimbili ukuze afinyelele inhliziyo noma imithambo yegazi yakho. Phakathi kuka-0.25% no-5% wabantu abenza lolu hlobo lokuhlinzwa bathola i-mediastinitis ebukhali. Leli zinga lingahluka kuye ngesibhedlela kanye nesifunda.

I-mediastinitis engapheli ayivamile. Ivame ukutholakala ezindaweni lapho uhlobo lwesikhunta olubizwa ngokuthi i-Histoplasma capsulatum luvame khona (luvamile). Kodwa-ke, akuwona wonke umuntu ovezwe yilesi sikhunta othola lesi sifo. Abacwaningi balinganisela ukuthi ngaphansi kuka-1% walabo abavezwe bathola ukutheleleka kwesikhunta (i-histoplasmosis). Kulabo, inani elincane kakhulu lithola i-mediastinitis engapheli. Izifundo zisikisela ukuthi kusenamakhulu eziguli e-United States ezine-fibrosing mediastinitis (uhlobo lwe-mediastinitis engapheli).

Uyini umehluko phakathi kwe-'Acute Mediastinitis' kanye ne-'Chronic Mediastinitis'?

Kunezinhlobo ezimbili ze-`(Mediastinitis)`. Eyodwa yi -`Acute Mediastinitis` . Enye yi -`Chronic Mediastinitis` . Kunomehluko omkhulu phakathi kwalezi ezimbili.

I-mediastinitis ebukhali yisimo esenzeka ngokuzumayo, esinezimpawu ezinzima . Isibonelo, uma kukhona ukubhoboka komphimbo, i-mediastinitis ebukhali ingakhula zingakapheli amahora ambalwa. Ingavela futhi uma kukhona ukutheleleka emphinjeni noma emlonyeni. Njengenkinga yokuhlinzwa kwesifuba, ivame ukwenzeka zingakapheli inyanga yokuqala. Akuvamile, kungenzeka kamuva, ngisho naphakathi konyaka wokuqala. I-mediastinitis ebukhali iyisimo esiphuthumayo sezokwelapha. Ukwelashwa kumele kuqalwe ngokushesha ukuze kusindiswe impilo yakho.

I-mediastinitis engapheli nayo iyisimo esibi kakhulu, kodwa ikhula kancane kancane ezinyangeni, ngezinye izikhathi iminyaka . Lokhu kungabangela ukwakheka kwezicubu zesilonda ku-mediastinum yakho. Lesi simo sibizwa ngokuthi i-fibrosing mediastinitis noma i-mediastinal fibrosis . Imbangela eyinhloko ye-mediastinitis engapheli ivame ukuba ukutheleleka kwesikhunta.

Umuntu one-mediastinitis engapheli angase angabi nazimpawu isikhathi eside, noma angase angabi nazimpawu nhlobo. Uma enezimpawu, njengokuphelelwa umoya, angase aqale kancane futhi abe mabi kakhulu ngokuhamba kwesikhathi. Izimpawu zenzeka ngoba izicubu zesilonda ziyanqwabelana esifubeni sakho, zicindezela umphimbo wakho (i-trachea) noma i-vena cava ephezulu, umthambo omkhulu othwala igazi uye enhliziyweni yakho. Ukwelashwa kuhloswe kakhulu ekunciphiseni izimpawu nokuthuthukisa ikhwalithi yokuphila.

Ziyini izimpawu ze-`(Mediastinitis)`?

Izimpawu ziyahlukahluka kuye ngokuthi isimo `sibi` noma `sihlala isikhathi eside`.

Izimpawu ze-'Acute Mediastinitis':

• Ubuhlungu besifuba obungazelelwe, obukhulu.
• Ukugodola.
• Uma uhlinzwe nge-sternotomy ephakathi nendawo, uketshezi olufana nobovu lungase luphume enxebeni.
• Imfiva.
• Ukuphelelwa umoya.

Izimpawu ze-'Mediastinitis Engapheli':

I-mediastinitis engapheli ingase ingabingeli zimpawu. Kodwa-ke, abantu abane-fibrosing mediastinitis bangase babe nezimpawu ezifana nalezi:

• Ubuhlungu besifuba.
• Ukukhwehlela, mhlawumbe ngisho nokukhwehlela igazi.
• Ubunzima bokuphefumula.
• Izimpawu ezengeziwe ezihlobene ne-"Superior vena cava syndrome" (isib. ukuvuvukala kobuso, intamo, izandla).

Yiziphi izimbangela ze-`(Mediastinitis)`?

Izizathu zalesi simo ziyahlukahluka kuye ngohlobo lwaso.

Izimbangela ze-'Acute Mediastinitis':

I-mediastinitis ebukhali yenzeka lapho izicubu ezingaphakathi kwesifuba sakho zitheleleka ngokuzumayo. Lokhu kutheleleka kungabangelwa yi:

• Izinkinga ze-sternotomy ephakathi nendawo: Ukutheleleka okuningi ngemva kwalolu hlobo lokuhlinzwa kubangelwa yibhaktheriya ebizwa ngokuthi i-Staphylococcus aureus . Izicubu zakho zesifuba noma inxeba lokuhlinzwa lingatheleleka ngesikhathi sokuhlinzwa noma ngokushesha ngemva kwalokho. Isibonelo, uma inxeba lingapholi kahle noma uma amagciwane engena ngenxeba.
• Ukubhoboka komlomo wesibeletho: Lokhu kungenzeka ngezizathu ezahlukahlukene. Isibonelo, izinkinga ngesikhathi sezinqubo ze-endoscopic (ukuhlolwa kusetshenziswa ikhamera ukubheka ngaphakathi komlomo wesibeletho) noma ukuhlanza ngokweqile, okunamandla ( i-Boerhaave syndrome) kungabangela ukuthi umlomo wesibeletho udabuke.
• Ukutheleleka okusabalala kusuka ekhanda noma entanyeni: Odokotela bakubiza ngokuthi "i-decdending necrotizing mediastinitis." Lokhu kusho ukuthi ukutheleleka okuqale endaweni engenhla yesifuba kusakazekela phansi esifubeni, kulimaze izicubu lapho. Ukutheleleka emlonyeni wakho (njengezinyo eliphuphuke) kanye nokutheleleka komphimbo kungasakazeka ngale ndlela.

Izimbangela ze-Mediastinitis Engapheli:

I-mediastinitis engapheli ibangelwa nawukutheleleka. Kodwa-ke, kulokhu, ukuvuvukala kwezicubu zakho akwenzeki ngokushesha ngemva kokuchayeka kumagciwane, kodwa kwenzeka kancane kancane. I-mediastinitis engapheli ingabangelwa yi:

• Ukutheleleka ngefungus (lokhu kuyimbangela evame kakhulu).
• Isifo sofuba.
• Ukwelashwa ngemisebe.
• I-Silicosis (isifo samaphaphu esibangelwa ukuhogela izinhlayiya ze-silica).
• I-Sarcoidosis (ukwakheka kwamaqoqo amancane amangqamuzana okuvuvukala ezithweni ezahlukahlukene zomzimba).

Ngezinye izikhathi, asikho isizathu esicacile esingatholakala se-mediastinitis engapheli. Lokhu kubizwa ngokuthi i-idiopathic .

Ukutheleleka kwesikhunta okuvame kakhulu okubangela i-mediastinitis engapheli yi- Histoplasma capsulatum . E-United States, lesi sikhunta sivame kakhulu e-Ohio River Valley nase-Mississippi River Valley. Kwezinye izingxenye zomhlaba, sitholakala e-Afrika, e-Asia, e-Australia, eMelika Ephakathi, nasezingxenyeni zaseNingizimu Melika.

Le fungus ihlala enhlabathini. Ayilimazi ngaphandle kokuthi ingene emoyeni bese uyiphefumula. Akuwona wonke umuntu ochayeke kuyo ozogula. Eqinisweni, abantu abaningi abachayeke kuyo ngeke bagule nhlobo, noma bazoba nokutheleleka okuncane okungenazo izimpawu. Kodwa-ke, kunethuba elincane kakhulu lokuthi amasosha omzimba wakho azosabela ngokweqile kule fungus ngemva kokuchayeke kuyo (ngokuvamile eminyakeni eminingi kamuva). Lokhu kungabangela ukuvuvukala kwezicubu eziku-"mediastinum" yakho, okungaholela ezinkingeni.

Yiziphi izici eziyingozi zokuthuthukisa i-`(Mediastinitis)`?

Manje ake sibheke ukuthi ubani ongase abe nalokhu. Uma uhlinzwa okudinga `(i-median sternotomy)`, njengokuhlinzwa kwenhliziyo evulekile, ungase ukhathazeke ngezinkinga. Khuluma nodokotela wakho ngengozi yakho. Ngokuvamile, kungenzeka kakhulu ukuthi ube `i-mediastinitis ebukhali` ngemva `(i-median sternotomy)` uma unezinye zezimo ezilandelayo:

• Uma unesifo esithinta amasosha omzimba wakho .
• Isifo samaphaphu esingamahlalakhona (i-COPD) .
• Isifo sikashukela.
• Ukwehluleka kwezinso.
• Ukukhuluphala ngokweqile.
• Isifo semithambo yegazi engaphandle (i-PAD) (ukuncipha kwemithambo yegazi ezingalweni nasemilenzeni).

Ukubhema nokusebenzisa ugwayi nakho kwandisa ingozi yezinkinga ngemva kokuhlinzwa.

Izici ezithile ezihlobene nokuhlinzwa ngokwako nazo zandisa ingozi ye-mediastinitis. Lezi zifaka:

• Ukuhlinzwa kwathatha isikhathi eside kakhulu noma isiguli sasisebenzisa i-cardiopulmonary bypass isikhathi eside kakhulu.
• Ukuhlinzwa kabusha (uma usuvele uhlinzwe isifuba).

Ungu- `(Histoplasma capsulatum)`Uma uhlala endaweni lapho isikhunta sitholakala khona, usengozini enkulu yokuthola i-mediastinitis engapheli.

Itholakala kanjani i-`(Mediastinitis)`?

Odokotela bavame ukuxilonga i-mediastinitis ngokuhlolwa ngokomzimba kanye nokuhlolwa okwengeziwe.

Ngesikhathi sokuhlolwa kwakho ngokomzimba, udokotela uzokubuza ngalokhu okulandelayo:

• Izimpawu zakho.
• Umlando wakho wezokwelapha (izifo zangaphambilini, imithi, njll.).
• Mayelana nanoma yikuphi ukuhlinzwa kwakamuva noma izinqubo zezokwelapha oye wazenza .
• Mayelana nezindawo oye wazihamba (ikakhulukazi izindawo lapho `(i-Histoplasma capsulatum)` ivame khona).

Udokotela wakho angase futhi acele ukuhlolwa okwengeziwe ukuqinisekisa ukuxilongwa.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga `(Mediastinitis)`?

I-computed tomography (CT) scan ene-contrast iyindinganiso yegolide yokuxilonga i-mediastinitis. Ngaphezu kwalokho, udokotela wakho angase akucele ukuthi uhlolwe i-X-ray yesifuba noma i-biopsy yenaliti .

Iphathwa kanjani i-Mediastinitis?

Nokho, ingabe ikhona indlela yokwelapha lokhu? Yebo, ikhona. Kodwa kuyahlukahluka kuye ngohlobo lwesifo (kungakhathaliseki ukuthi `sibi` noma `singelapheki`) kanye nembangela.

I-mediastinitis ebukhali ngemva kokuhlinzwa kwe-sternotomy ephakathi ingadinga ukwelashwa okulandelayo:

• Ama-antibiotic , avame ukunikezwa ngemithambo yegazi (IV) ngesisombululo sikasawoti.
• Ukuhlinzwa kokususa izicubu ezifile nokukhipha uketshezi oluqongelelekile.

I-mediastinitis ebukhali ebangelwa ukudabuka komphimbo ingadinga ukwelashwa okulandelayo:

• Ama-antibiotic.
• Ukuhlinzwa ukulungisa imbobo, ukususa izicubu ezifile, kanye/noma ukukhipha noma yiluphi uketshezi oluqongelelekile.

Uma une-mediastinitis ebukhali, ithimba lakho lezokwelapha lizokungenisa egunjini lokunakekelwa okujulile (ICU) . Lapho, ithimba lezokwelapha lizoqapha izimpawu zakho kanye nokululama kwakho.

Ukwelashwa kwe -mediastinitis engapheli kungafaka ukuhlinzwa ukuze kuncishiswe izimpawu. Udokotela wakho angase ancome izinqubo ezivula indlela yakho yokuphefumula noma ezithuthukisa ukugeleza kwegazi emithanjeni yegazi esifubeni sakho. Abacwaningi basafuna izindlela zokwelapha abantu abane-mediastinitis engapheli.

Khuluma nodokotela wakho mayelana nezinketho zakho zokwelashwa nokuthi yini ongayilindela.

Ingabe i-Mediastinitis ingavinjelwa?

Kungcono ukuvimbela into efana nale ukuthi ingenzeki ngaphambi kokuba yenzeke. I-Mediastinitis iyinkinga evamile yezinqubo zezokwelapha. Uma uhlinzwa isifuba noma inqubo ye-endoscopic, khuluma nodokotela wakho ngezindlela zokunciphisa ingozi yezinkinga. Buza ukuthi yiziphi izinyathelo ithimba lakho lezokwelapha elizothatha ukunciphisa ingozi yakho yokutheleleka. Futhi, qiniseka ukuthi ubuza ukuthi ungalinakekela kanjani inxeba lakho ekhaya ngemva kokuhlinzwa.

Ukuvimbela ukutheleleka nokukwelapha ngokushesha nje lapho kuvela kungasiza ekunciphiseni ingozi ye-mediastinitis ebukhali. Ukutheleleka emlonyeni wakho nasemphinjeni kungasakazekela esifubeni sakho futhi kubangele izinkinga ezinkulu. Nazi ezinye izinto ongayenza ukusiza ukuvimbela lezi zinhlobo zokutheleleka:

• Nakekela kahle amazinyo nezinsini zakho (`(ukuhlanzeka komlomo)`) ukuze uvimbele izifo zamazinyo.
• Bona udokotela wamazinyo njalo ezinyangeni eziyisithupha ukuze uhlanzwe amazinyo akho , noma ulandele imiyalelo kadokotela wamazinyo.
• Bona udokotela kanye ngonyaka ukuze akuhlole ukuze uhlole impilo yakho iyonke.
• Uma unezimpawu zokutheleleka, bona udokotela ngokushesha , bese uthatha noma yimuphi umuthi owunikezwe ukwelapha ukutheleleka njengoba nje uyalelwe.

Ingabe i-Mediastinitis ingaba yingozi?

Lokhu kuyindaba engathi sína. Yebo, lesi simo singasongela impilo, okusho ukuthi singabulala. Ukuxilongwa kusenesikhathi kanye nokwelashwa kuyizindlela ezinhle kakhulu zokusindisa izimpilo. Ake sibheke lokho abacwaningi abakwaziyo ngesilinganiso sokufa kwe-mediastinitis:

• Izinga lokufa kwabantu abathola i-mediastinitis ebukhali ngemva kokuhlinzwa kwe-sternotomy ephakathi nendawo liphakathi kuka-1% no-14% . Lokhu kungcono kunangaphambili (12% kuya ku-50%). Lokhu kungenxa yentuthuko ekuphathweni kokuhlinzwa. Ungase uzibuze ukuthi kungani la mazinga ebanzi kangaka. Lokhu kungenxa yokuthi izifundo ezahlukene zocwaningo zisebenzisa amaqembu ahlukene abantu ukutadisha amazinga okufa. Ngakho-ke, umphumela wakho uzoncika ezintweni eziningi, njengokuthi uzohlinzwa kuphi, iminyaka yakho, kanye nempilo yakho iyonke.
• Izinga lokufa kwabantu abathola i-mediastinitis ebukhali ngenxa yokudabuka komphimbo liyahlukahluka kakhulu. Kuye ngokuthi uthola ukwelashwa ngokushesha kangakanani. Abantu abangaphansi kuka-10% abathola ukwelashwa zingakapheli amahora angu-24 beshonile. Lelo nani likhuphuka lifinyelele ku-30% kuya ku-40% phakathi kwalabo abathola ukwelashwa ngemva kwamahora angu-24. Ukuguga kwandisa nengozi yomphumela omubi kakhulu.
• Abantu abathola i-"Descending necrotizing mediastinitis" bangasheshe bathole i-"Sepsis" (ubuthi egazini) kanye nokwehluleka kwezitho zomzimba. Ngakho-ke, izinga lokufa liphakathi kuka-11% no-40% .

Nakuba lezi zibalo zingase zibonakale ziyesabisa kancane, kunezizathu zethemba.Ukuqaphela izimbangela nezimpawu ze-`(Mediastinitis)` kuzokusiza wazi ukuthi kufanele ufune nini usizo lwezokwelapha uma kudingeka. Futhi, ngokuthuthuka emkhakheni wezokwelapha, ukuhlinzwa kuya ngokuya kuphephile futhi nezinkinga ziyalashwa.

Kufanele ubonane nini nodokotela?

I-'Acute mediastinitis' yisimo esivele ngokuzumayo. Uma uba nezimpawu ezinjengalezi (isib. ubuhlungu besifuba obungazelelwe, obukhulu, umkhuhlane, ubunzima bokuphefumula), shayela u-911 ngokushesha noma inombolo yakho yezimo eziphuthumayo yendawo, noma uye esibhedlela esiseduze. Uma uthola ukwelashwa ngokushesha, umphumela wakho wokululama uba ngcono.

Futhi, kufanele ukhulume nodokotela ezimweni ezilandelayo:

• Uma usuzohlinzwa inhliziyo evulekile noma enye inqubo yezokwelapha eyandisa ingozi yakho ye-mediastinitis, buza ukuthi unganciphisa kanjani ingozi yakho.
• Uma unezimpawu ze-mediastinitis engapheli noma ukhathazekile ngengozi yakho.

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Cishe usuyaqonda manje ukuthi `(Mediastinitis)` yisimo esibi kakhulu, ngezinye izikhathi esisongela ukuphila. Kodwa ungesabi. Into ebalulekile ukuqaphela lokhu.

Khumbula:

* Ngemva kokuhlinzwa kwesifuba, ikakhulukazi ukuhlinzwa kwenhliziyo, nakekela inxeba. Landela imiyalelo kadokotela wakho kahle.

* Ungakushayi indiva ukutheleleka komlomo nomphimbo. Kungasakazeka futhi kubangele izifo ezingathi sína.

* Uma uzwa ubuhlungu obukhulu esifubeni, umkhuhlane, noma ubunzima bokuphefumula , funa usizo lwezokwelapha ngokushesha.

* Uma usezindaweni lapho isikhunta esifana ne-`(Histoplasma capsulatum)` sivame khona, qaphela nalokho.

* Uma lesi sifo sisheshe sitholakale futhi selashwe, amathuba okululama ayanda. Ngokuthuthuka kwesayensi yezokwelapha, manje sekungenzeka ukubhekana ngempumelelo nezimo ezinjalo.

Uma othandekayo wakho ene-mediastinitis, ungase uzizwe ukhathazekile futhi ungenalusizo. Ukufunda ngalesi sifo kungakusiza uzizwe unamandla okulawula. Lolu lwazi luzokusiza ukuthi ukhulume nethimba lezokwelapha lothandekayo wakho ngalokho okwenzekayo. Babuze ukuthi ungabasiza kanjani njengoba belulama.

i- mediastinitis, ubuhlungu besifuba, ukutheleleka kwesifuba, izinkinga zokuhlinzwa kwenhliziyo, ukubhoboka komphimbo, ukutheleleka kwesikhunta, i-mediastinum