Uzizwa sengathi amaphaphu akho agcwele uketshezi? Ake sixoxe nge-Pleural Effusion ne-Nirogi Lanka!

Wake wazizwa unesisindo esincane esifubeni sakho noma waphawula into engavamile uma uphefumula? Mhlawumbe wake wezwa othile ekhuluma ngokuthi, “kukhona uketshezi emaphashini.” Kwa-Nirogi Lanka, sifuna ukukusiza uqonde lesi simo, esibizwa nge-Pleural Effusion ngokwezokwelapha.

Kuyini ngempela i-Pleural Effusion?

Ake sikuchaze kalula lokhu. Amaphaphu akho ahlala ngaphakathi kwesifuba sakho. Kuzungeze iphaphu ngalinye futhi kugcwale ingaphakathi lodonga lwesifuba sakho kunezingqimba ezimbili ezithambile zezicubu ezaziwa ngokuthi i- pleura . Cabanga ngalezi njengesembozo esivikelayo esinezingqimba ezimbili samaphaphu akho.

Ngaphansi kwezimo ezivamile, kunoketshezi oluncane phakathi kwalezi zingqimba ezimbili ze-pleural. Lusebenza njenge-lubricant emshinini, luvumela amaphaphu akho ukuba ashelele, akhule, futhi anciphe kalula ngenkathi uphefumula.

Ukuphuma kwegazi emzimbeni kwenzeka uma kukhona ukunqwabelana okungavamile, okweqile kwalolu ketshezi phakathi kwalezo zingqimba ze-pleural. Lokhu kuvame ukwenzeka ngoba umzimba wakho ukhiqiza uketshezi oluningi kakhulu noma ngoba awukhiphi uketshezi ngendlela efanele. Kalula nje, lokhu kuvame ukuchazwa ngokuthi “amanzi emaphashini.”

Ingabe kunezinhlobo ezahlukene zokuphuma kwegazi emithanjeni yegazi?

Yebo, odokotela bahlukanisa ama-pleural effusions abe izinhlobo ezimbili eziyinhloko ngokusekelwe ekwakhekeni koketshezi oluqoqwe emaphashini.

1. I-Transudative (uketshezi olungenamaprotheni amaningi, olunamanzi): Lolu hlobo luvame ukubangelwa ukucindezela okukhulu emithanjeni yegazi yomzimba. Isibonelo, kungenzeka kubantu abaphila ne- cirrhosis (isifo sesibindi) noma ukwehluleka kwenhliziyo . Empeleni, uketshezi luphuma emithanjeni yegazi ngenxa yokungalingani kwengcindezi.

2. I-Exudative (uketshezi olucebile ngamaprotheni): Lolu hlobo luvame ukubangelwa ukuvuvukala, ukutheleleka , noma umdlavuza (njengomdlavuza wamaphaphu noma webele). Kulesi simo, uketshezi luyavuza ngoba imithambo yegazi “ivuza” ngenxa yesifo, noma uhlelo lomzimba lwe-lymphatic alukwazi ukuhlanza uketshezi kahle.

Kubalulekile ukunquma ukuthi hlobo luni lwesifo onaso, njengoba kuqondisa indlela yakho yokwelashwa lapha eNirogi Lanka.

Sivame kangakanani lesi simo?

Ukuphuma kwegazi emithanjeni kuvame kakhulu kunalokho ongase ucabange . Isibonelo, e-United States kuphela, kulinganiselwa ukuthi cishe amacala ayizigidi ezingu-1.5 atholakala minyaka yonke. Sibona lesi simo njalo emitholampilo yethu lapha.

Ziyini izimpawu zokuphuma kwegazi emithanjeni yegazi?

Ungase ube nezimpawu ezihlobene nesimo sempilo esiyisisekelo esibangele ukuchitheka kwegazi. Kodwa-ke, kunezibonakaliso ezimbalwa ezibonisa ngqo ukuchitheka kwegazi kwegazi ngokwalo:

• Ubuhlungu Besifuba: Lokhu kuvame ukuba kubi kakhulu uma uphefumula kakhulu noma ukhwehlela. Kungazwakala sengathi umuzwa obukhali, ohlabayo.
• Ukuphelelwa Umoya (Dyspnea): Ungase uzizwe sengathi awukwazi ukubamba umoya wakho, umuzwa ovame ukuqina ngokuzikhandla ngokomzimba.
• I-Orthopnea: Lesi yisibonakaliso esithile lapho ukuphefumula kuba nzima ngaphandle kokuthi uhleli noma ume uqonde. Iziguli eziningi zikuthola kunzima ukulala phansi futhi kungadingeka zilale zisekelwe emicamelweni eminingana ukuze ziphefumule kahle.

Sicela uqaphele ukuthi abanye abantu bangase babe ne-pleural effusion ngaphandle kwezimpawu ezibonakalayo nhlobo. Kulezi zimo, kuvame ukutholakala ngengozi ngesikhathi se -X-ray yesifuba ngesinye isizathu.

Kungani lokhu kwenzeka? Ziyini izimbangela?

Kunezimbangela eziningi ezingaba khona zokuphuma kwegazi emithanjeni yegazi, futhi ngezinye izikhathi kungase kuhileleke izinto ezingaphezu kwesisodwa. Njengoba kushiwo, odokotela banquma imbangela ngokuhlaziya ukuthi uketshezi luyi -transudative noma i-exudative . Izimo ezithile, njenge- pulmonary embolism (PE) — i-blood clot emaphashini—ngezinye izikhathi ingabangela noma yiluphi uhlobo.

Izimbangela ezivamile zoketshezi lwe-Transudative:

• Ukwehluleka Kwenhliziyo: Lesi ngesinye sezimbangela ezivame kakhulu, lapho ukungakwazi kwenhliziyo ukupompa kahle kuholela ekugcinweni koketshezi emzimbeni wonke.
• I-Cirrhosis: Isimo esibi esithinta ukusebenza kwesibindi.
• I-Nephrotic Syndrome: Isifo sezinso esibangela ukulahlekelwa kakhulu kwamaprotheni emchameni wakho, okuholela ekushintsheni koketshezi.

Izimbangela ezivamile zoketshezi oluphumayo:

• I-pneumonia: Ukutheleleka kwebhaktheriya noma igciwane kwezicubu zamaphaphu.
• Umdlavuza: Ikakhulukazi umdlavuza wamaphaphu , umdlavuza webele , noma i-lymphoma .
• Isifo Sezinso.
• Izifo Zokuvuvukala: Izimo ezahlukahlukene zomzimba ezibangela ukuvuvukala kwangaphakathi.
• Ngemva kokuhlinzwa kwenhliziyo evulekile.

Izimbangela ezingavamile:

• Isifo sofuba: Ukutheleleka okungaholela ekuqongeleleni koketshezi esifubeni.
• Isifo Sokuzivikela Emzimbeni: Izimo lapho amasosha omzimba wakho ehlasela khona ngephutha amangqamuzana omzimba wakho, okuholela ekuvuvukeni.
• Ukopha okungene esifubeni ngenxa yokulimala noma ukulimala kwesifuba.
• I-Chylothorax: Isimo esenzeka lapho 'i-chyle,' uketshezi oluvela ohlelweni lwe-lymphatic, luqoqana esifubeni, okuvame ukubangelwa ukulimala.
• Ukutheleleka okungajwayelekile kwesifuba nesisu.
• Ukuchayeka ku- Asbestos .
• Ukuqhuma Komqala
• I-Pancreatitis
• I-Meig's Syndrome: Ibangelwa umdlavuza wesibeletho ongemuhle.
• I-Ovarian Hyperstimulation Syndrome
• Imithi ethile.
• Izinkinga ngemva kokuhlinzwa kwesisu.
• Ukwelashwa Ngemisebe

Kwezinye izimo, uketshezi oluqongelelekile lungase lube namangqamuzana abulalayo (umdlavuza), noma uketshezi lungaqongelelana njengomphumela ongemuhle wokwelashwa ngamakhemikhali .

Ubani osengozini enkulu yokuthuthukisa lokhu?

Izici eziningana eziyingozi zinegalelo ekuthuthukisweni kwe-pleural effusion:

• Izimo zezokwelapha eziyisisekelo: Uma unesifo senhliziyo, isifo sesibindi, isifo sezinso, noma umdlavuza, ingozi yakho yokuthola i-pleural effusion iphakeme.
• Ukusetshenziswa kukagwayi: Ukubhema kwandisa kakhulu ingozi yakho yokuthola izinkinga ezihlobene namaphaphu.
• Ukuchayeka ku-asbestos: Ukuchayeka isikhathi eside kule nto, eyake yaba yinto evamile ezintweni zokwakha, kungaholela ekulimaleni okukhulu kwamaphaphu.

Yiziphi izinkinga ezingaba khona?

Uma kungelashwa, ukuphuma kwegazi emithanjeni yegazi kungadala izinkinga eziningana:

• Ukutheleleka noma ithumba: Uketshezi lungatheleleka, okungase kuholele ekwakhekeni kwesikhwama esigcwele ubomvu.
• Izibazi: Izicubu ezinemicu zingakheka endaweni lapho uketshezi lukhona khona, okungase kuphazamise ukusebenza kwamaphaphu akho.
• Ukulimala kwamaphaphu ngqo.

Lesi simo sitholakala kanjani?

Uma uvakashela udokotela, bazoqala ngokuxoxa ngomlando wakho wezokwelapha —kufaka phakathi izimo ezikhona kanye nesikhathi sezimpawu zakho. Okulandelayo, kuzokwenziwa ukuhlolwa ngokomzimba , lapho udokotela wakho ezosebenzisa khona i-stethoscope ukulalela imisindo yokuphefumula kwakho. Kulapho-ke kuphela lapho bezoyala khona ukuhlolwa kokuxilonga okudingekayo.

Yiziphi izivivinyo ezihilelekile?

Odokotela basebenzisa izivivinyo ezilandelayo ukuqinisekisa ukuthi kukhona i-pleural effusion futhi baqonde uhlobo lwayo:

• I-X-ray yesifuba: Isetshenziselwa ukuthola ubukhona kanye nomthamo woketshezi.
• I-CT scan (i-Computed Tomography): Inikeza izithombe ezinemininingwane eminingi nezicacile uma kuqhathaniswa ne-X-ray, okusivumela ukuthi sibone amaphaphu ngaphansi koketshezi futhi sibone izinqwaba ezingaba khona.
• I-Chest Ultrasound: Isiza ekutholeni uketshezi futhi inqume indawo ephephile nenembile kakhulu yokukhipha amanzi.
• I-Thoracentesis noma i-Biopsy: Kufakwa inalithi encane phakathi kwezimbambo zakho ukuze kuthathwe uketshezi oluqongelelwe. Kwezinye izimo, ucezu oluncane lwe-pleural lining lungathathwa ukuze kwenziwe i-biopsy.
• Ukuhlaziywa Koketshezi Lwe-Pleural: Uketshezi oluqoqiwe luhlaziywa elebhu ukuze kutholakale okuqukethwe yiphrotheni, izinhlobo zamaseli, ukutheleleka, noma amaseli omdlavuza. Lokhu kuhlolwa kubalulekile ukuze kutholakale ukuthi uketshezi 'luyi-transudative' noma 'luyi-exudative'.

Uma imbangela ingacaci ngemva kwalezi zivivinyo, ungadinga i- thoracoscopy , eyaziwa nangokuthi i-Video-Assisted Thoracic Surgery (VATS) . Le nqubo yenziwa ngaphansi kwe-anesthesia ejwayelekile. Sisebenzisa ikhamera encane namathuluzi afakwe esifubeni sakho ukuze sibone i-pleura nezindawo ezizungezile. Ngokuvamile, ukwelashwa kungenziwa phakathi nale nqubo efanayo.

Kuphathwa kanjani lokhu?

Ukwelashwa kwe-pleural effusion kunemigomo emibili eyinhloko: ukukhipha uketshezi oluningi nokuvimbela ukuthi lungabuyi . Udokotela wakho waseNirogi Lanka uzokwenza ukwelashwa kwakho kube ngokwembangela eyinhloko kanye nobunzima bobunzima bakho bokuphefumula.

Imithi

• Uma isimo sakho sibangelwa ukwehluleka kwenhliziyo okubangelwa yi -Congestive Heart Failure , singase sikunikeze imithi yokukhipha uketshezi emzimbeni (evame ukubizwa ngokuthi “amaphilisi amanzi” ukusiza umzimba wakho ukhiphe uketshezi oluningi ngomchamo) kanye neminye imithi yenhliziyo.
• Uma kukhona ukutheleleka, kuzodingeka ama-antibiotic .
• Uma kubangelwa umdlavuza (i-malignant effusion), ungase uthole i-chemotherapy , ukwelashwa ngemisebe , noma ukufakelwa imithi ngqo esifubeni.

Izinqubo

• Uma ubhekene nobunzima bokuphefumula, udokotela wakho angenza i-Therapeutic Thoracentesis (efana nokuthatha isampula yoketshezi, kodwa lapha umgomo uwukukhipha uketshezi oluningi ngangokunokwenzeka). Ngaphandle kwalokho, kungafakwa i- Chest Tube . I-tube encane ifakwa esifubeni sakho, okuvumela uketshezi ukuthi luphume kancane kancane luye esitsheni sangaphandle sokuqoqa.
• Kwezinye izimo, ikakhulukazi lapho uketshezi luqongelela ngenxa yomdlavuza, lungaphinde lubuye ngisho nangemva kokukhipha amanzi. Kulezi zimo ezinzima ukuzilawula, udokotela angase afake i- Sclerosing Agent esikhaleni se-pleural ngepayipi lesifuba. Lo muthi usetshenziselwa ukudala ngamabomu izibazi (fibrosis) phakathi kwezingqimba ezimbili ze-pleura. Le nqubo yaziwa ngokuthi i-Pleural Sclerosis noma i-Pleurodesis . Uma lokhu kuqubuka kwezibazi, izingqimba ezimbili ze-pleural zinamathelana, zisuse isikhala lapho uketshezi lungaqongelela khona. Le ndlela iphumelela cishe ngo-50% ekuvimbeleni ukuqongelela koketshezi esikhathini esizayo.

Ukuhlinzwa

Uma isimo sakho singakwazi ukuphathwa kahle nge-drainage noma i-pleural sclerosis, ungase udinge ukuhlinzwa. Udokotela wakho ohlinzayo uzokwenza ukuhlolwa okuphelele futhi axoxe nawe ngezinzuzo nezingozi ezingaba khona zenqubo.

Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa:

1. Ukuhlinzwa Kwe-Thoracoscopic Okusizwa Yividiyo (i-VAT): Phakathi nale nqubo, kwenziwa ukusikwa okukodwa noma okuthathu okuncane kakhulu (cishe ingxenye yesentimitha ngayinye) esifubeni sakho, lapho kufakwa khona ikhamera kanye nezinsimbi zokuhlinza. Le ndlela isetshenziselwa izimo eziqinile noma ukuphuma kwe-pleural okuphindaphindiwe okubangelwa yizimila. Ngesikhathi sokuhlinzwa, izinto ezifana ne -Talc noma ama-antibiotic zingasetshenziswa esikhaleni se-pleural ukuvimbela uketshezi ukuthi lubuye.

2. Ukuhlinzwa kwesifuba (ukuhlinzwa kwendabuko, "okuvulekile"): Kule ndlela, udokotela wakho ohlinzayo wenza ukusika okungamasentimitha angu-6-8 esifubeni sakho ukuze enze ukuhlinzwa. Lokhu kuvame ukusetshenziswa uma unesifo. Ukuhlinzwa kwesifuba kuvumela udokotela ohlinzayo ukuthi asuse zonke izicubu ezinemicu futhi ahlanze kahle isifo esikhaleni se-pleural. Ngemva kokuhlinzwa, kuzodingeka ipayipi lesifuba ukuze likhiphe uketshezi noma kuphi kusukela ezinsukwini ezimbili kuya emavikini amabili.

Ingabe ikhona imiphumela emibi engaba khona evela kulezi zindlela zokwelapha?

Yebo, njenganoma yikuphi ukungenelela kwezokwelapha, kunemiphumela emibi engaba khona ehlotshaniswa nokwelashwa kwe-pleural effusion.

• I-Pulmonary Edema: Lokhu kungenzeka, ikakhulukazi uma umthamo omkhulu woketshezi ususwa ngokushesha kakhulu.
• Amahlule egazi
• I-Anormal Heart Rhythms
• I-Pneumothorax: Lokhu kubhekisela ephashini eliwile ngenxa yomoya ongena esifubeni. Lokhu kungenzeka ngezinye izikhathi uma inalithi yokukhipha amanzi ibhoboza iphashini ngengozi.

Kuthatha isikhathi esingakanani ukululama?

Isikhathi sokululama sincike ekwelashweni okutholile.

• Uma uke waba ne- Thoracentesis , kungase kudingeke ukuthi uphumule cishe izinsuku ezimbili.
• Uma uhlinzwe nge- VATS , kungadingeka uhlale esibhedlela izinsuku ezimbalwa ngemva kwalokho.
• Uma wenze i- Thoracotomy (ukuhlinzwa okuvulekile), kufanele ulindele ukuhlala esibhedlela cishe isonto elilodwa.

Yini esingayenza ukuze sinciphise ingozi?

Nakuba izimbangela eziningi eziyisisekelo zokuphuma kwe-pleural kunzima ukuzivimbela, ungasiza ekunciphiseni ingozi yakho ngokuthatha izinyathelo ezilandelayo:

• Gwema yonke imikhiqizo kagwayi.
• Vimbela ukuchayeka ku-Asbestos.
• Landela ukudla okune-sodium ephansi uma udokotela wakho ekuncomile.
• Phuza ama-Diuretics akho anqunyiwe (amaphilisi amanzi) njengoba nje kuqondiswe.
• Nciphisa umthamo wakho woketshezi uma welulekwa yithimba lakho lezokwelapha.

Yini okufanele uyilindele ngokuqhubekela phambili?

Ngemva kokwelashwa kwakho, cishe uzodinga ama-X-ray alandelayo . Udokotela wakho uzosebenzisa lokhu ukuhlola impumelelo yenqubo. Ngaphezu kwalokho, uzoqhubeka nokwelashwa kwesimo sempilo esiyisisekelo esibangele ukuphuma kwe-pleural.

Ubunzima besimo sakho buxhomeke ezintweni eziningana:

• Imbangela eyinhloko yokwanda kwe-pleural effusion.
• Indlela okukuthinta ngayo ukuphefumula kwakho.
• Indlela umzimba wakho osabela kahle ngayo ekwelashweni.

Uyini umbono wesikhathi eside?

Umbono wesikhathi eside, noma isibikezelo , uyahlukahluka kakhulu kuye ngokuthi imbangela eyinhloko yokuvuvukala kwe-pleural yakho kanye nezinye izimo zakho zempilo. Ezigulini eziningi, ukwelashwa kokuvuvukala kwe-pleural kuyaphumelela, yize kungenzeka ukuthi lesi simo siphinde sibuye.

Uma ukuphuma kwegazi kubangelwa umdlavuza, isibikezelo ngokuvamile sivikelwe kakhulu. Ngaphezu kwalokho, ukunganaki ukwelashwa kokuphuma kwegazi egazini kungaholela ezinkingeni ezinkulu zempilo.

Ungazinakekela kanjani?

Ezinye izimo eziholela ekuqhekekeni kwe-pleural zidinga ukunakekelwa kwesikhathi eside . Xoxani ngesu lokwelapha elingcono kakhulu lesimo sakho esingamahlalakhona nomhlinzeki wakho wezempilo waseNirogi Lanka. Kubalulekile ukunamathela ngokuqinile ohlelweni lwakho lokwelashwa.: thatha yonke imithi ngesikhathi futhi ulandele izincomo zikadokotela wakho mayelana nokushintsha kwendlela yokuphila.

Kufanele ubonane nini nodokotela?

Kubalulekile ukuya kuzo zonke izikhathi zokulandelela udokotela wakho azihlelile ukuze aphathe isimo sakho esingamahlalakhona. Uma ubhekene nobunzima bokuphefumula noma ukuphelelwa umoya, sicela ufune usizo lwezokwelapha oluphuthumayo ngokushesha ngokushayela u-911 noma uvakashele igumbi lezimo eziphuthumayo eliseduze nawe. Ungalibali.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Ukuze uqonde kangcono impilo yakho, cabanga ngokubuza udokotela wakho imibuzo elandelayo:

• Iyini imbangela eyisisekelo yokuqhuma kwe-pleural yami?
• Kufanele ngibuye kangaki ukuze ngithole ama-aphoyintimenti okulandelela?
• Amathuba okuba lesi simo siphinde sivele angakanani?
• Yimiphi imiphumela engaba khona yesikhathi eside yalokhu kugeleza kwe-pleural empilweni yami?

Ukuphila ne-pleural effusion kungaba yinto ekhathazayo, noma ngabe awubonisi izimpawu okwamanje. Ukuthola imbangela eyinhloko yisinyathelo esibaluleke kakhulu. Uma udokotela wakho esethole imbangela, uzokwakha uhlelo lokwelashwa oluqondiwe. Ukucaca nokunembile lapho uphendula imibuzo kadokotela wakho kusiza ukunciphisa ukuxilongwa. Kujwayelekile ngokuphelele ukuzizwa ukhathazekile lapho ukuphefumula kuba nzima, ngakho-ke sicela ungangabazi ukubuza noma yimiphi imibuzo onayo. KwaNirogi Lanka, ukucaca kwakho nenduduzo yakho yizinto eziza kuqala kithi.

Izinto ezibalulekile okufanele uzicabangele

I-Pleural effusion yigama lezokwelapha elisho ukunqwabelana koketshezi oluningi esikhaleni esiphakathi kwezingqimba ze-pleura, ulwelwesi oluncane oluzungeze amaphaphu akho. Lokhu kuvame ukubizwa ngokuthi "uketshezi oluzungeze amaphaphu."

• Kunezimbangela eziningi ezingaba khona, okuhlanganisa ukwehluleka kwenhliziyo, i-pneumonia, kanye nomdlavuza ongaphansi.
• Izimpawu ezivamile zifaka phakathi ubuhlungu besifuba kanye nokuphelelwa umoya, yize abanye abantu bengase bangabi nazimpawu.
• Odokotela baxilonga lesi simo besebenzisa amathuluzi anjenge -X-ray yesifuba, ama-CT scan, kanye ne-diagnostic thoracentesis (ukuhlaziywa koketshezi).
• Ukwelashwa kugxile ekubhekaneni nembangela eyinhloko kanye nokususa uketshezi ngemithi, izinqubo zokukhipha amanzi, noma, uma kudingeka, ukuhlinzwa.
• Okubaluleke kakhulu: uma uzwa ubuhlungu besifuba obungazelelwe noma ubunzima bokuphefumula, funa usizo lwezokwelapha ngokushesha. Ukutholwa kusenesikhathi kwenza ukwelashwa kuphumelele kakhudlwana futhi kunciphisa ingozi yezinkinga.

Uma uneminye imibuzo, sicela uxhumane nodokotela wakho. Hlala uphilile!

Amathegi: Ukuphuma kwe-Pleural, Amaphaphu, Uketshezi oluzungeze amaphaphu, Ukuphelelwa umoya, Ubuhlungu besifuba, Isifo samaphaphu, Ukwelashwa kwezokwelapha