Cishe uke wezwa ngomuntu osekhulile olaliswe esibhedlela “enoketshezi emaphashini.” Mhlawumbe sekwenzekile komunye umuntu emndenini wakho. Kusho ukuthini ngempela lokhu “ketshezi emaphashini”? Ingabe lokhu kuyinto okufanele uyesabe? Namuhla, ake sixoxe ngalesi simo, esibizwa ngokuthi “i-Pleural Effusion” ngokwezokwelapha, ngendlela elula kakhulu ongayiqonda.
Kusho ukuthini ngempela ukugcwalisa amaphaphu akho ngamanzi?
Ake sithi amaphaphu ethu asegumbini elivikelayo ngaphakathi kwesifuba. Kuzungeze la maphaphu, kanye nangaphakathi kwesifuba, kunezimbotshana ezimbili ezincane. Kufana nebhaluni ngaphakathi kwebhaluni. Sibiza la maphaphu amabili ngokuthi i-pleura.
Ngokuvamile, kumuntu ophilile, kuba khona inani elincane kakhulu loketshezi phakathi kwalezi zindwangu ezimbili. Kufana noketshezi oluncane emshinini. Ngenxa yaleli nani loketshezi, lapho siphefumula, lapho amaphaphu ethu efinyela futhi ekhula, leyo nqubo yenzeka ngaphandle kobunzima noma ukungqubuzana. Leyo yindlela yemvelo.
Kodwa esimweni esibizwa ngokuthi "i-Pleural effusion", uketshezi oluningi kunalokho okudingekayo luqoqana endaweni engenalutho phakathi kwalezi zindwangu ezimbili. Yilokhu esivame ukukubiza ngokuthi "uketshezi emaphashini." Ukuze kube sobala, lolu ketshezi alugcwalisi amaphaphu ngokwawo, kodwa lugcwalisa phakathi kwezindwangu ezimbili ze-pleural ezizungeze amaphaphu.
Kungaba nezizathu ezimbili eziyinhloko zokuqongelela uketshezi ngale ndlela:
1. Umzimba ungase ukhiqize kakhulu lolu ketshezi.
2. Ngaphandle kwalokho, umzimba ungase ungakwazi ukumunca kahle inani elijwayelekile loketshezi olukhiqizwayo.
Noma ngabe yikuphi, umphumela uba ukuthi uketshezi luyanqwabelana emaphashini, luwacindezele, bese kuba nobunzima bokuphefumula.
Kunezinhlobo ezimbili zoketshezi ezihlangana ndawonye.
Odokotela bahlukanisa i-pleural effusion ibe izinhlobo ezimbili eziyinhloko ngokusekelwe kuhlobo loketshezi oluqongelelayo. Ngoba izingxenye zoketshezi zinganikeza umbono omuhle wokuthi iyini imbangela.
| Uhlobo Loketshezi | Incazelo nezizathu eziyinhloko |
|---|---|
| I-Transudative (Kunoketshezi oluningi, kuncane ngamaprotheni) | Kalula nje, lokhu kuwuketshezi olufana "namanzi". Luneprotheyini encane. Lokhu kubangelwa ukwanda kwengcindezi emithanjeni yegazi yomzimba noma ukwehla kwezinga leprotheyini egazini. Izingxenye zoketshezi ziyavuza emithanjeni yegazi. Izimbangela Eziyinhloko: Ukwehluleka Kwenhliziyo, I-Cirrhosis Yesibindi, I-Nephrotic Syndrome. |
| I-Exudative (Ukuminyana okuphezulu, amaprotheni aphezulu) | Lolu ketshezi luqukethe amaprotheni amaningi, amaseli, nezinye izinto. Lokhu kubangelwa ukutheleleka, ukuvuvukala, noma umdlavuza ngaphakathi noma eduze kwe-pleura. Lokhu kwenzeka lapho uketshezi luphuma emithanjeni yegazi noma uhlelo lwe-lymphatic lungakwazi ukususa uketshezi. Izimbangela eziyinhloko: I-pneumonia, umdlavuza (ikakhulukazi amaphaphu, umdlavuza webele), isifo sofuba, isifo sezinso, ngemva kokuhlinzwa kwenhliziyo. |
Uma welapha, kubalulekile ukuthola ukuthi yiluphi uhlobo lwalezi zinhlobo ezimbili onalo nokuthi lubangelwa yini.
Yiziphi izimpawu ongase uzibone?
Abanye abantu banenkinga yokukhipha igazi emlonyeni kodwa ababonisi zimpawu. Kutholakala ngengozi ngesikhathi se-X-ray yesifuba ngesinye isizathu. Kodwa-ke, abantu abaningi baba nezimpawu, ikakhulukazi lapho uketshezi luqoqana.
- Ubunzima bokuphefumula: Lolu uphawu oluyinhloko noluvame kakhulu. Uma uketshezi lugcwala emaphashini, awekho indawo eyanele yamaphaphu yokufutha kahle. Lokhu kwenza kube nzima ukuphefumula futhi kukwenze uzizwe ucindezekile.
- Ubuhlungu besifuba: Ubuhlungu obubukhali obuzwakalayo ikakhulukazi uma uphefumula kakhulu noma ukhwehlela. Lokhu kwenzeka lapho izicubu ezimbili ze-pleural zihlangana.
- Ukukhwehlela okomile: Abanye abantu bangase babe nokukhwehlela okomile okuqhubekayo.
- I-Orthopnea: Lokhu kuyimpawu ehlukile kancane. Ukuphefumula kuba nzima kakhulu uma ulele phansi, kodwa ukuphefumula kuba lula uma uhleli noma umile.
- Umkhuhlane: Uma imbangela eyinhloko iwukutheleleka (njenge-pneumonia), izimpawu ezifana nomkhuhlane kanye nobuhlungu bomzimba nazo zingase zivele.
Into ebalulekile ukuthi lezi zimpawu azigcini nje ngokuphuma kwegazi emzimbeni. Zingabonakala nakwezinye izifo ezifana nesifo senhliziyo kanye ne-asthma. Ngakho-ke, uma unalezi zimpawu, kubaluleke kakhulu ukubona udokotela ngokushesha ukuze uthole imbangela.
Ungasibona kanjani lesi simo?
Uma uya kudokotela, uzoqala ngokukubuza ngezimpawu zakho kanye nanoma yiziphi ezinye izimo zezokwelapha ongase ube nazo (njengesifo senhliziyo noma isifo sikashukela). Bese bebeka i-stethoscope esifubeni sakho bese belalela. Uma kukhona uketshezi oluzungeze amaphaphu akho, imisindo oyizwayo lapho uphefumula ingashintsha.
Ngemva kwalokho, kuzokwenziwa izivivinyo eziningana ukuqinisekisa lesi sifo nokuthola imbangela.
- I-X-ray yesifuba: Lesi isivivinyo esilula kakhulu nesilula kakhulu. I-X-ray ingabona ngokucacile ukuthi kukhona uketshezi oluzungeze amaphaphu nokuthi lungakanani.
- I-CT scan: Lokhu kungaveza isithombe esicacile, esinezinhlangothi ezintathu (3D) samaphaphu kanye nesikhala se-pleural. Lokhu kungaba usizo kakhulu ekutholeni imbangela yokunqwabelana koketshezi (njengesimila).
- Ukuskena nge-ultrasound: Lokhu kungasiza ekutholeni indawo yoketshezi kanye nokukala inani loketshezi. Kusetshenziswa ukusiza ekuqondiseni inaliti endaweni, ikakhulukazi lapho kwenziwa inqubo ehilela ukususa uketshezi.
- I-Thoracentesis: Lokhu kungenye yezivivinyo ezibaluleke kakhulu. Kuhilela ukwenza ukusika okuncane esifubeni, ukufaka inalithi encane phakathi kwezimbambo ezimbili, bese kuthathwa isampula yoketshezi oluzungeze amaphaphu. Le sampula yoketshezi ithunyelwa elabhorethri ukuze ihlolwe.
Yini oyibhekayo lapho uhlola isampula yoketshezi?
Ilebhu ihlola uketshezi ukuze ithole amaprotheni, ushukela, izinhlobo zamaseli (ingabe akhona amangqamuzana omdlavuza?), kanye nama-microorganisms afana namagciwane. Lolu lwazi lusiza udokotela ukuthi anqume ukuthi ngabe ``i-Transudative'' noma ``i-Exudative'', nokuthi ngabe imbangela iyisifo, umdlavuza, noma okunye.
Kwezinye izimo, uma lezi zivivinyo zingakwazi ukukhomba imbangela, inqubo ebizwa ngokuthi i-thoracoscopy noma i-VATS ingenziwa. Lokhu kuhilela ukufaka ikhamera ngokusebenzisa ukusikwa okuncane okukodwa noma ngaphezulu esifubeni ukuze kubhekwe ngqo i-pleura namaphaphu. Isampula yezicubu nayo ingathathwa ukuze kuhlolwe.
Yiziphi izindlela zokwelapha?
Kunezinhloso ezimbili eziyinhloko ekwelapheni i-pleural effusion:
1. Ukususa uketshezi oluningi nokunciphisa ubunzima bokuphefumula.
2. Ukwelapha imbangela eyinhloko yalokhu kwakheka koketshezi nokuvimbela ukwakheka koketshezi okwengeziwe.
Khumbula, ukususa nje uketshezi oluzungeze amaphaphu akwanele. Uma isimo esiyisisekelo singelashwa, uketshezi lungaphinde lugcwale.
1. Ukwelapha imbangela eyisisekelo
- Uma uketshezi luqongelela ngenxa yokwehluleka kwenhliziyo , kunikezwa imithi ethuthukisa ukusebenza kwenhliziyo kanye nemithi yokukhipha amanzi emzimbeni (amaphilisi amanzi) asusa amanzi angaphezulu emzimbeni.
- Imbangela: I-pneumoniaUma kuyisifo esibangelwa amagciwane, kunikezwa ama-antibiotic.
- Uma imbangela kungumdlavuza , kuzodingeka wenze i-chemotherapy kanye nokwelashwa ngemisebe.
2. Izindlela zokususa uketshezi oluqongelelekile
- I-Thoracentesis Yokwelapha: Lolu uhlobo lokuhlolwa esixoxe ngalo ngaphambili, kodwa esikhundleni sokuthatha isampula, uketshezi oluningi ngangokunokwenzeka lususwa ngenaliti. Lokhu kunikeza isiguli impumuzo esheshayo.
- Ipayipi Lesifuba: Uma inani loketshezi liningi kakhulu noma uketshezi lujiyile (njengobomvu), ipayipi elincane elibizwa ngokuthi "ipayipi lesifuba" lingafakwa esifubeni izinsuku ezimbalwa. Uketshezi lukhishwa kancane kancane ebhodleleni ngaleli payipi.
- I-Pleural Sclerosis: Le nqubo isetshenziswa uma uketshezi luqhubeka nokuqongelela ngenxa yesizathu esinjengomdlavuza. Kule nqubo, umuthi okhethekile (njenge-talc) ufakwa ngethubhu yesifuba phakathi kwezicubu ezimbili ze-pleural. Lo muthi ubangela ukuvuvukala phakathi kwezicubu ezimbili, okubangela ukuba zinamathele ndawonye. Lokhu-ke kususa isikhala lapho uketshezi lungaqongelela khona futhi.
- Ukuhlinzwa: Uma ezinye izindlela zingaphumeleli noma uma ungqimba olukhulu seluvele luzungeze i-pleura ngenxa yokutheleleka, kungase kudingeke ukuhlinzwa.
- I-VATS (ukuhlinzwa kwe-thoracoscopic okusizwa yividiyo): Ukuhlinzwa okwenziwa kusetshenziswa ikhamera efakwe ngokusikwa okuncane.
- I-Thoracotomy: Ukuhlinzwa kwendabuko okuhilela ukuvula isifuba. Lokhu kungasusa ngokuphelele izicubu ezinegciwane.
Izinkinga ezingase zivele ngenxa yalesi simo
Uma kungelashwa kahle, ukuphuma kwegazi emithanjeni yegazi kungadala izinkinga ezahlukahlukene.
- Ukutheleleka: Amagciwane angangena oketshezini oluzungeze amaphaphu akhe ithumba.
- Izibazi ezizungeze amaphaphu: Ukugcinwa koketshezi isikhathi eside kungabangela ukuthi ulwelwesi lwe-pleural lujiye, kuvimbele amaphaphu ukuthi akhukhumale kahle.
- Amaphaphu/i-Pneumothorax ephukile: Ngezinye izikhathi amaphaphu angonakala ngesikhathi senqubo yokukhipha uketshezi.
Ngakho-ke, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma unezimpawu.
Ingabe lesi simo singagwenywa?
Njengoba ukuphuma kwegazi emzimbeni kuyimbangela yesinye isifo, okumele sikwenze ukuzama ukuvimbela ukukhula kwaleso sifo esiyisisekelo.
- Gwema ukubhema: Ukubhema kuyimbangela enkulu yomdlavuza wamaphaphu nesifo senhliziyo.
- Gwema ukuchayeka ku-asbestos: Lokhu kungabangela izifo zamaphaphu.
- Indlela yokuphila enempilo: Izinto ezifana nokudla okulinganiselayo, ukuvivinya umzimba, nokunciphisa ukudla usawoti omningi kungasiza ekulawuleni izimo ezifana nesifo senhliziyo nesifo sezinso.
- Uma usuvele unesifo senhliziyo noma sezinso, thatha imithi njengoba nje udokotela wakho ekuyalele futhi uye emitholampilo ngesikhathi.
Umlayezo Wokuya Nawe Ekhaya
- " I-Pleural effusion " ukunqwabelana okungavamile koketshezi phakathi kwezingqimba ezimbili ezizungeze amaphaphu.
- Ubunzima bokuphefumula, ubuhlungu besifuba lapho uphefumula kakhulu, kanye nokukhwehlela okomile yizimpawu eziyinhloko .
- Lesi simo akusona isifo, kodwa uphawu lwesinye isifo. Singabangelwa yizizathu ezahlukahlukene, njengesifo senhliziyo, i-pneumonia, kanye nomdlavuza.
- Into ebaluleke kakhulu ekwelapheni ukwelapha imbangela eyinhloko ngendlela efanele, ngaphezu kokususa uketshezi.
- Uma wena noma othile omaziyo enalezi zimpawu, ungesabi noma ulibale , kodwa bonana nodokotela ngokushesha. Ukuxilongwa kusenesikhathi kanye nokwelashwa kungavimbela izinkinga.
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