Wake wazizwa unesisindo esincane esifubeni sakho, umuzwa ongajwayelekile lapho uphefumula? Noma wake wezwa othile ethi, "Amaphaphu agcwele amanzi"? Yilokho esizokhuluma ngakho namuhla. Lokhu kwaziwa ngokwezokwelapha ngokuthi i-pleural effusion.

Kalula nje, kuyini i-pleural effusion?

Kulungile, manje ake sibone ukuthi lokhu kuyini ngamagama alula. Amaphaphu akho angaphakathi kwesifuba sakho. Eduze kwala maphaphu, nangaphakathi kwesifuba sakho, kunezimbobo ezimbili ezincane kakhulu. Sibiza lezi zimbobo ngokuthi i-pleura . Kufana nokuthi zimbozwe nhlangothi zombili.

Ngokuvamile, kunoketshezi oluncane kakhulu phakathi kwalezi zingxenyana ezimbili ze-pleural. Cabanga ngakho njengamafutha agcoba izingxenye ezimbili zomshini. Lolu ketshezi yilona oluvumela amaphaphu akho ukuba anyakaze, akhule, futhi anciphe kalula uma uphefumula.

Kodwa-ke, kulesi simo esibizwa ngokuthi i-pleural effusion , inani loketshezi phakathi kwezingqimba ezimbili ze-pleural liphakeme kakhulu kunokuvamile . Lokhu kusho ukuthi umzimba wakho ukhiqiza kakhulu lolu ketshezi, noma uketshezi olukhiqizwayo aluphinde lumuncwe kahle emzimbeni. Yilapho sithi khona "amaphaphu agcwele amanzi."

Ingabe kukhona izinhlobo zokuphuma kwegazi emithanjeni yegazi?

Yebo, odokotela bahlukanisa i-pleural effusion ibe izinhlobo ezimbili eziyinhloko, kuye ngohlobo loketshezi oluqoqana emaphashini.

1. Uketshezi olungenawo amaprotheni amaningi, olunamanzi: Lolu hlobo loketshezi luvame ukwenzeka lapho ingcindezi yoketshezi emzimbeni ikhuphuka. Isibonelo, umuntu onesifo sokuqina kwesibindi (isifo sesibindi) noma ukwehluleka kwenhliziyo angase abe nalolu hlobo loketshezi. Lokhu kwenzeka lapho uketshezi luphuma emithanjeni yegazi.

2. Uketshezi oluphumayo noma olucebile ngamaprotheni: Izimbangela eziyinhloko zalolu hlobo loketshezi umdlavuza (isibonelo, umdlavuza wamaphaphu, umdlavuza webele) noma uhlobo oluthile lokutheleleka . Kulokhu, uketshezi oluningi kakhulu luvuza ngemithambo yegazi emincane kakhulu noma uketshezi alususwa kahle uhlelo lwe-lymphatic.

Izindlela zokwelapha zinqunywa ngokusekelwe kulolu hlobo. Ngakho-ke kubaluleke kakhulu ukuthi udokotela azi uhlobo lwalolu ketshezi.

Sivame kangakanani lesi simo?

Eqinisweni, i-pleural effusion yisimo esivame kakhulu kunalokho ongakucabanga . Isibonelo, kubikwa ukuthi cishe abantu abayizigidi ezingu-1.5 e-United States kuphela bahlushwa yilesi simo minyaka yonke. Lesi simo siyabonakala nasezweni lethu.

Ziyini izimpawu zokuphuma kwegazi emithanjeni yegazi?

Ungase ube nezinye izimpawu kuye ngesimo esiyisisekelo esibangele ukugeleza kwe-pleural. Kodwa-ke, kunezimpawu eziningana eziqondene ngqo nokugeleza kwe-pleural.

• Ubuhlungu besifuba: Lobuhlungu bungase bube bubi nakakhulu, ikakhulukazi uma uphefumula kakhulu noma ukhwehlela. Kungase kuzwakale sengathi kukhona okukuhlabayo ngaphakathi.
• Ubunzima bokuphefumula (Ukuphelelwa umoya): Ukuphefumula kungase kuzwakale kunzima futhi kucinane. Lokhu kungaba kubi kakhulu ngokuzikhandla.
• I-Orthopnea: Lokhu kuyimpawu ethile. Kusho ukuthi unenkinga yokuphefumula kwezinye izindawo ngaphandle kokuhlala noma ukuma uqonde (isibonelo, ukulala phansi). Abanye abantu balala nemicamelo emibili noma emithathu ukuze bazisekele ngoba bazizwa becindezekile lapho belele phansi.

Kodwa-ke, abanye abantu bangase babe ne-pleural effusion ngaphandle kwezimpawu . Bathola ngakho kuphela uma bethathwa i -X-ray yesifuba ngesinye isizathu.

Kungani lokhu kwenzeka? Yiziphi izizathu zalokhu?

Kunezimbangela eziningi zokuphuma kwegazi emzimbeni. Ngezinye izikhathi kungahileleka izizathu ezingaphezu kweyodwa. Njengoba sixoxile ngaphambili, odokotela bazama ukuthola imbangela ngokunquma ukuthi uketshezi oluqoqayo luyi-transudative ( olunamanzi) noma i -exudative (olucebile ngamaprotheni). Ngezinye izikhathi, isimo esibizwa ngokuthi i-pulmonary embolism (PE) singaba yizo zombili izinhlobo.

Izimbangela eziyinhloko zokuqongelela uketshezi lwe-transudative yilezi:

• Ukwehluleka Kwenhliziyo: Lena yimbangela evame kakhulu. Uma inhliziyo ingasebenzi kahle, ukulawulwa koketshezi emzimbeni kuyaphazamiseka.
• I-Cirrhosis: Isimo esibi kakhulu esenzeka esibindini.
• I-Nephrotic Syndrome: Lena inkinga yezinso. Lesi simo singavela uma izinso zikhipha amaprotheni amaningi kakhulu.

Izizathu eziyinhloko zokuqongelela koketshezi oluphuma emzimbeni yilezi:

• I-pneumonia: Ukutheleleka kwamaphaphu.
• Umdlavuza: Ikakhulukazi umdlavuza wamaphaphu , umdlavuza webele , noma i-lymphoma .
• Isifo Sezinso
• Isifo Sokuvuvukala: Izimo ezahlukahlukene zokuvuvukala ezenzeka emzimbeni.
• Ngemva kokuhlinzwa kwenhliziyo evulekile

Kukhona nezizathu ezingavamile kakhulu:

• Isifo sofuba
• Isifo Sokuzivikela Emzimbeni: Lokhu kusho ukuthi amasosha omzimba ahlasela amangqamuzana awo.
• Ukopha ngenxa yokulimala esifubeni.
• I-Chylothorax: Lokhu kwenzeka lapho uketshezi olubizwa ngokuthi 'chyle' oluvela ohlelweni lwe-lymphatic luqoqana esifubeni. Ngokuvamile lubangelwa ukulimala.
• Izifo ezingavamile zesifuba nesisu.
• Ukuchayeka ku-asbestos.
• Ukuqhuma Komqala
• I-Pancreatitis
• I-Meig's Syndrome: Ibangelwa isimila esingenabungozi esikhula esibelethweni.
• I-Ovarian Hyperstimulation Syndrome
• Eminye imithi
• Ukuhlinzwa kwesisu.
• Ukwelashwa Ngemisebe

Kwezinye izimo, uketshezi ngokwalo lungase lube namaseli anobungozi , noma lunganqwabelana njengomphumela we -chemotherapy .

Ubani osengozini enkulu yokuthuthukisa lokhu?

Kunezici eziningana eziyingozi ezingaba nomthelela ekuthuthukisweni kwe-pleural effusion.

• Ukuba nezimo zezokwelapha ezibangela lokhu: Isibonelo, uma unesifo senhliziyo, isifo sesibindi, isifo sezinso, noma umdlavuza, usengozini enkulu yokuthola i-pleural effusion.
• Ukusetshenziswa kwemikhiqizo kagwayi: Abantu ababhemayo banamathuba amaningi okuba nezinkinga zamaphaphu.
• Ukuchayeka ku-asbestos: Lokhu kuyinto yokwakha evamile. Ukuchayeka kukho isikhathi eside kungabangela umonakalo emaphashini.

Yiziphi izinkinga ezingabangelwa yilokhu?

Uma i-pleural effusion ingelashwa kahle, kungase kube nezinkinga ezithile.

• Ukutheleleka okuphenduka ithumba: Uketshezi oluqongelelekile lungatheleleka ngamagciwane, okubangela ukuthi luphenduke ithumba.
• Izibazi emaphashini: Izicubu zezibazi zingakheka lapho uketshezi lwalukhona, ziphazamise ukusebenza kwamaphaphu.
• Ukulimala kwamaphaphu akho.

Uyithola kanjani ngempela le simo?

Uma uya kudokotela, uzoqala ngokukubuza ngomlando wakho wezokwelapha . Yiziphi ezinye izifo onazo futhi lezi zimpawu zaqala nini? Bese bezokwenza ukuhlolwa ngokomzimba . Bazolalela amaphaphu akho njengoba uphefumula (nge-stethoscope). Kulapho-ke kuphela lapho bezoyala khona ukuhlolwa okudingekayo.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Odokotela basebenzisa lezi zivivinyo ukuze baxilonge futhi baqonde uhlobo lwe-pleural effusion:

• I-X-ray yesifuba: Lokhu kungasiza ekunqumeni ukuthi uketshezi luqongelelene yini nokuthi lungakanani.
• I-CT scan yesifuba (i-Computed Tomography - i-CT scan): Ingaveza izithombe ezicacile nezinemininingwane eminingi kune-X-ray. Ingahlola nesimo samaphaphu ngaphansi koketshezi kanye nezinye izinto ezifana nezimila.
• I-ultrasound yesifuba:Lokhu kusiza futhi ukuthola indawo kanye nenani loketshezi, kanye nendawo eqondile lapho kufanele kufakwe khona inalithi encane yokususa uketshezi.
• I-Thoracentesis noma i-Biopsy: Lokhu kuhilela ukufaka inalithi encane kakhulu esifubeni sakho phakathi kwezimbambo zakho ezimbili ukuze kuthathwe isampula yoketshezi oluqoqiwe. Ngezinye izikhathi ucezu oluncane lwe-pleural membrane (i-biopsy) lungathathwa futhi.
• Ukuhlaziywa Koketshezi Lwe-Pleural: Isampula yoketshezi ithunyelwa elabhorethri ukuze ihlolwe. Lokhu kunganquma inani lamaprotheni, izinhlobo zamaseli, ukuthi kukhona yini amagciwane, noma amaseli omdlavuza. Yilokhu okungakutshela ngqo ukuthi uketshezi luyi-transudative noma i-exudative.

Uma lezi zivivinyo ezilula zingayitholi imbangela, kungadingeka ukuthi wenze inqubo ebizwa ngokuthi i-thoracoscopy . Lokhu kubizwa nangokuthi ukuhlinzwa kwe-thoracic okusizwa ngevidiyo (VATS) . Lokhu kwenziwa ngenkathi ungaphansi kwe-anesthesia ejwayelekile. Lokhu kuhilela ukufaka ikhamera encane namathuluzi esifubeni sakho ukuze ubone kangcono i-pleura nezindawo ezizungezile. Ukwelashwa kuvame ukwenziwa ngesikhathi esifanayo nale nqubo.

Kuphathwa kanjani lokhu?

Kunemigomo emibili eyinhloko lapho welapha i-pleural effusion: Eyokuqala ukukhipha uketshezi oluningi . Enye ukuvimba uketshezi ukuthi lungaphinde luqongelelane . Odokotela bakhetha ukwelashwa ngokusekelwe embangela eyinhloko nokuthi uphefumula kanzima kangakanani ngenxa yoketshezi.

Imithi

• Uma ugcina uketshezi ngenxa yesimo esifana nokwehluleka kwenhliziyo okubangelwa ukuminyana , odokotela bazokunikeza imithi yokukhipha uketshezi emzimbeni (eyaziwa nangokuthi "amaphilisi amanzi" ngoba asiza umzimba ukukhipha uketshezi oluningi ngomchamo) kanye neminye imithi yokwehluleka kwenhliziyo.
• Uma kungenxa yokutheleleka, kuzodingeka uthathe ama-antibiotic .
• Uma lesi simo sibangelwa umdlavuza (i-malignant effusion), ungathola i-chemotherapy , ukwelashwa ngemisebe , noma ukumnika umuthi owuketshezi esifubeni.

Izindlela zokwelapha (Izinqubo)

• Uma unenkinga yokuphefumula, udokotela wakho angase akwenzele i-thoracentesis yokwelapha (lokhu kufana nokuthatha isampula yoketshezi, kodwa uketshezi oluningi ngangokunokwenzeka luyasuswa). Noma bangase bafake ipayipi lesifuba . Lokhu kuhilela ukufaka ipayipi elincane esifubeni sakho bese uvumela uketshezi ukuthi luphume ebhodleleni.
• Ngezinye izikhathi, ikakhulukazi uma uketshezi lunqwabelana ngenxa yomdlavuza, uketshezi lungaphinda lunqwabelane ngisho nangemva kokuba lususiwe. Ezimweni ezinjalo okunzima ukuzilawula, udokotela angasebenzisa ipayipi lesifuba ukukhipha uketshezi.Uhlobo lomuthi olubizwa ngokuthi i-sclerosing agent lufakwa emgodini we-pleural. Lo muthi ubangela ngamabomu isibazi (i-fibrosis) phakathi kwezingqimba ezimbili ze-pleural. Lokhu kubizwa nangokuthi i-pleural sclerosis noma i-pleurodesis . Uma lesi sibazi sakheka, izingqimba ezimbili ze-pleural ziyanamathelana, zivimbele uketshezi ukuthi luphinde luqongelelane. Le ndlela isebenza cishe ngo-50% ekuvimbeleni uketshezi ukuthi luphinde luqongelelane.

Ukuhlinzwa

Uma ukuphuma kwamanzi noma i-pleural sclerosis kunganele ukulawula isimo sakho, ungase udinge ukuhlinzwa. Udokotela wakho ohlinzayo uzokuhlola ngokucophelela futhi axoxe nawe ngezinzuzo kanye nokungalungi kokuhlinzwa.

Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa:

1. Ukuhlinzwa Kwe-Thoracoscopic Okusizwa Yividiyo (i-VAT): Lokhu kuhilela ukwenza ukusikwa okuncane kakhulu okukodwa kuya kokuthathu (cishe ingxenye yesentimitha) esifubeni bese kufakwa ikhamera namathuluzi okuhlinza ngawo ukuze kwenziwe ukuhlinzwa. Le ndlela isetshenziselwa ukuphuma kwe-pleural okunzima ukuyilawula noma okuphindaphindayo ngenxa yomdlavuza. Ngesikhathi sokuhlinzwa, into efana ne -talc noma i-antibiotic ifakwa emgodini we-pleural ukuzama ukuvimba uketshezi ukuthi lungaqongelelani futhi.

2. Ukuhlinzwa kwesifuba (ukuhlinzwa kwendabuko, "okuvulekile"): Kule nqubo, udokotela ohlinzayo wenza ukusika kwesifuba okungamasentimitha angu-6-8. Lena inqubo evame ukusetshenziswa uma unesifo. Ukuhlinzwa kwesifuba kususa zonke izicubu ezinemicu futhi kusiza ekuhlanzeni ngokuphelele isifo esiku-pleural cavity. Kungase kudingeke ukuthi ufake ipayipi lesifuba ukuze kukhishwe uketshezi izinsuku ezimbili kuya kwamasonto amabili ngemva kokuhlinzwa.

Ingabe ikhona imiphumela emibi engaba khona ngenxa yokwelashwa?

Yebo, njenganoma yikuphi ukwelashwa kwezokwelapha, ukwelashwa kwe-pleural effusion kungabangela imiphumela emibi ethile.

• Ukuvuvukala Kwemiphunga: Lokhu kungenzeka, ikakhulukazi uma inani elikhulu loketshezi lisuswa ngesikhathi esisodwa.
• Amahlule egazi
• I-Anormal Heart Rhythms
• I-Pneumothorax: Lokhu kuwukuwohloka kwamaphaphu ngenxa yomoya ogcwalisa amaphaphu. Ngezinye izikhathi lokhu kungenzeka uma inaliti esetshenziswa ukususa uketshezi ishaywa.

Kuthatha isikhathi esingakanani ukululama?

Lokhu kuyahlukahluka kuye ngokwelashwa okwenziwe.

• Uma uke waba ne -thoracentesis , kuzodingeka uqaphele kancane cishe izinsuku ezimbili.
• Uma uhlinzwe i-VATS , kungadingeka uhlale esibhedlela izinsuku ezimbalwa ngemva kwalokho.
• Uma uhlinzwe nge-thoracotomy (ukuhlinzwa okuvulekile), kuzodingeka uhlale esibhedlela cishe isonto lonke.

Yini esingayenza ukuze sinciphise le ngozi?

Kunzima ukuvimbela izinto eziningi ezibangela i-pleural effusion. Kodwa-ke, unganciphisa ingozi yakho ngokuthi:

• Gwema imikhiqizo kagwayi.
• Gwema ukuchayeka ku-asbestos.
• Uma udokotela wakho ekutshelile, dla ukudla okunosawoti omncane.
• Thatha imithi yakho yokukhipha isisu enqunyiwe (amaphilisi amanzi) ngesikhathi.
• Uma udokotela wakho ekutshela ukuthi wenze kanjalo, nciphisa ukudla kwakho okuketshezi.

Yini okufanele siyilindele ngalesi simo?

Ngemva kokuthola ukwelashwa, kuzodingeka uphinde wenze i-X-ray . Udokotela uzofuna ukwazi ukuthi ukwelashwa kuphumelele yini. Kuzodingeka futhi uqhubeke nokuthola ukwelashwa kwesimo esibangele ukuphuma kwe-pleural.

Ubukhulu besimo sakho buxhomeke kulezi zici:

• Iyini imbangela eyinhloko yokuqhuma kwe-pleural?
• Ingabe kuyathinta ukuphefumula kwakho?
• Kumayelana nokuthi iyasabela kahle yini ekwelashweni.

Iyini ikusasa lalesi simo?

Umbono, noma isibikezelo , siyahlukahluka kakhulu kuye ngokuthi yini ebangele i-pleural effusion yakho kanye nezinye izimo zezokwelapha onazo. Kwabanye abantu, ukwelashwa kwe-pleural effusion kuyaphumelela. Kodwa-ke, i-pleural effusion ingabuya .

Umbono wokuphuma kwegazi elibangelwa umdlavuza awumuhle neze. Futhi uma ungalaphi kahle ukuphuma kwegazi elibangelwa umdlavuza, nakho akukuhle.

Uzinakekela kanjani?

Ezinye izimo ezibangela ukuphuma kwegazi emzimbeni zidinga ukwelashwa kwesikhathi eside . Khuluma nodokotela wakho mayelana nokwelashwa kwesikhathi eside okungcono kakhulu kwesimo sakho. Bese ulandela uhlelo lwakho lokwelashwa ngqo . Thatha imithi yakho ngesikhathi futhi ulondoloze izinguquko zendlela yokuphila ezinconywa udokotela wakho.

Kunini lapho kungcono ukubona udokotela?

Yiya kuzo zonke izikhathi zokulandelela udokotela wakho akuyalele ukuthi zilawule isimo sakho esingamahlalakhona. Uma ubhekene nobunzima bokuphefumula , funa usizo lwezokwelapha ngokushesha . Ungalibali.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela wakho?

Ungabuza udokotela imibuzo efana nale:

• Kungani ngithole lokhu kukhishwa kwe-pleural effusion?
• Kukangaki ngidinga ukuza kuwe (ama-aphoyintimenti okulandelela)?
• Angakanani amathuba okuba ngiphinde ngibe ne-pleural effusion?
• Iyini imiphumela yesikhathi eside yokukhishwa kwe-pleural yami?

Ngakho-ke, une-pleural effusion, mhlawumbe ubungenazo izimpawu. Isihluthulelo ukuthola imbangela.Uma udokotela eseyazi imbangela, uzothatha izinyathelo zokuyelapha. Ukuphendula imibuzo kadokotela ngendlela efanele kungasiza ekususeni ezinye zezimbangela. Kuvamile ukuzizwa wesaba uma unenkinga yokuphefumula, ngakho ungesabi ukubuza imibuzo nganoma yini ofuna ukuyiqonda.

Ngakho-ke, yiziphi izinto okudingeka sizikhumbule kukho konke lokhu?

I-Pleural effusion ukuqongelela koketshezi phakathi kwe-pleura, ulwelwesi oluzungeze amaphaphu. Abanye abantu bakubiza nangokuthi "amanzi emaphashini."

• Kungaba nezizathu eziningana zalokhu. Izinto ezifana nesifo senhliziyo, i-pneumonia, kanye nomdlavuza yizona eziyinhloko.
• Izimpawu zingase zihlanganise ubuhlungu besifuba kanye nobunzima bokuphefumula . Abanye abantu bangase bangabi nazo nhlobo izimpawu.
• Udokotela angakuxilonga lokhu nge -X-ray, i-CT scans, kanye nokuthatha amasampula oketshezi (thoracentesis) .
• Ukwelashwa kuhloswe imbangela eyinhloko kanye nokususwa koketshezi . Imithi, amasu okususa uketshezi, futhi ngezinye izikhathi ngisho nokuhlinzwa kungadingeka.
• Into ebaluleke kakhulu ukubonana nodokotela ngokushesha okukhulu uma unenkinga yokuphefumula noma uzwa iqhubu esifubeni sakho. Ukutholwa kusenesikhathi kwenza ukwelashwa kube lula futhi kunciphisa ingozi yezinkinga.

Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukukhuluma nodokotela wakho. Hlala uphilile!

Ukuphuma kwegazi esiswini , amaphaphu, amanzi esifubeni, ubunzima bokuphefumula, ubuhlungu besifuba, isifo samaphaphu, ukwelashwa kwezokwelapha