Ukuba uxelelwe ukuba unobungozi, kuthini ukuthini? Ziziphi izibangela zeli meko kwaye ngubani osengozini? Ziziphi iindlela zokonyango ezikhoyo kunye nantoni na?
Inkcazo
I-empyema iqoqo le-pus phakathi kwee-2 zeetekisi (i- pleura ) ebeka umgca wamaphaphu. I-empyema kakhulu ibonakala njengengxaki ye-pneumonia, i-abscess yamapom, okanye i-traum trauma.
Anatomy
Indawo yesigxina okanye isigxina ngummandla esifubeni esifubeni esiphakathi kwe-pleura ye-visceral (i-membrane ngaphandle kwemipopu) kunye ne-parietal pleura (i-membrane efaka ngaphakathi ngaphakathi kwindonga yesifuba.) Ngokuqhelekileyo, lo mmandla uqulethe nje Ngaphantsi kweetaypoons of pleural fluid . Ngaloo ndawo, indawo leyo inokuthi iqulethe i-pint okanye ininzi yesifo se-pleural fluid.
Empyema Fluid
Umkhuhlane oqulethwe kwi-empyema ubizwa ngokuba yi-pus kwaye uqulethe inhlanganisela yebhaktheriya, iiseli ezifile kunye neeseli ezimhlophe zegazi. Iibhaktheriya eziqhelekileyo ezibangela i-empyema yi- Streptococcus pneumoniae (i-"pneumonia" ibhakteria) kunye ne- Staphylococcus aureus .
Xa isampuli ye-pleural fluid idityanisiwe, imbonakalo ebhakabhaka kunye nenqabileyo ye-empyema ngokuqhelekileyo ibonakala ngokucacileyo kwindlela ihluke ngayo kunye nesisindo somnxeba esiqhelekileyo esinesigxina.
Izimpawu kunye neMpawu
Iimpawu ezinxulumene ne-empyema zingabangelwa bobabini ngenxa yobungqina besifo kunye noxinzelelo kwimiphunga kunye nesifuba ekunyuseni kwamanzi kwi-space pleural. Imiqondiso kunye neempawu eziqhelekileyo ziquka:
- Ifiva kunye nezipho
- Ukuzikhupha ebusuku: Ezi zinto zinokubaluleka kakhulu ngokugubungela ukukhupha ebusuku efuna ukuguqulwa kweengubo zasebusuku
- Iintlungu zesifuba, zihlala zibukhali kwaye zibuhlungu ngokuphefumlelwa
- Ukuphefumula: Ukuphefumula okunzima kunokuza ngokukhawuleza ngokukhawuleza ngokuxhomekeke kubukhulu be-effusion kunye nobukhulu beenkqubo eziphantsi
- Umkhuhlane owomileyo: Ukukhwehlela kungaphinda kuvelise ngenxa yempumoniya
- Iingqungquthela: Ukutshitshiswa kwe- diaphragm kunye neentsholongwane kule ndawo ngenxa yokwakhiwa kwe-fluid kungabangela ukuba i-hiccups
- Ukulahleka kwesisindo (ukulahlekelwa kwesisindo esingenziyo)
- Ukukhathala
- Ingqiqo jikelele yokungahlali kakuhle
Izizathu
Kukho inani leemeko ezahlukeneyo ezinokubangela ukuba i-empyema. Ezinye zezi ziquka:
- I-Pneumonia (Le yeso sizathu esivakalayo se-empyema.)
- Ixinzelelo.
- Utyando lwebhokisi, njengaleyo yomhlaza womphunga.
- I-thoracentesis: Ngamanye amaxesha usulelo luya kubangelwa ngokungazenzisiyo xa i-thoracentesis (inaliti "ipompo" yendawo yokukhalaza) yenzelwa ukuxilonga izifo okanye xa ityhubhu yesifuba ifakwe ukukhupha umoya (njengokuba i-pneumothorax) okanye i-fluid (nje ukuxhatshazwa kwesigxina.)
- I-fistula ye-bronchopleal: I-fistula e-bronchoplegy isifo se-fistula okanye i-canal engakhula phakathi kwendawo yesikhala kunye ne- bronchi ngexesha lotyando lwemiphunga, ukuvumela iibhaktheriya ukuba zidlule kwi-bronchi ukuya kwindawo yesikhalazo.)
- Ukwandiswa kosulelo: usulelo kwisisu (peritonitis) okanye ummandla phakathi kwemiphunga (mediastinitis) inokusasazeka kwisikhala somlomo.
- Ikhefu lomphunga lingahle liphumele kwisikhala esiphezulu.
Izinto zobungozi
I-empyema iyakwenzeka kakhulu kumntu onalo:
- Sikashukela
- Imbali yobunxila
- Izifo ezizimela ngokuzenzekelayo ezifana ne-rheumatoid arthritis
- I-immune system egxininisiweyo, njenge-chemotherapy
- Izifo ezinamafutha ezifana neCOPD kunye ne-bronchitis engapheliyo
- Isifo se-reflux se-Gastroesophageal
Ukuxilongwa
Ukufumanisa i-empyema, oogqirha baqala ukuthatha imbali eyiyo kwaye baqhuba uvavanyo lomzimba. Imbali ingancedisa ukuba ngaba kukho nayiphi na ingozi, kwaye ukuhlolwa komzimba kungabonisa ukuvakala komsindo. Ukulandela oku, i-x-ray esifubeni okanye isifuba CT isenziwa ukuqhubela phambili ukuhlola imiphunga.
Ngezinye izihlandlo kwaye i-ultrasound ingenziwa kwakhona. Ukuze ukwazi ukuba ngaba iibhaktheriya zikhona, kwaye ufumanisa ukuba zeziphi i-antibiotics ezi bhaktile ziyakhathalela, i-thoracentesis yenziwa ukuthatha isampuli ye-empyema (i-fluid inokucinywa kwakhona.) Umkhuhlane uthunyelwa kwibhule ukuze ukwenza uhlalutyo lwamanzi olululo, uvavanyo lwezinto eziqulethwe ngumkhuhlane. Iimvavanyo zegazi zingenziwa kwakhona ukukhangela ubungqina bentsholongwane.
Izinyango Zonyango
Unyango lwe-empyema luya kuphulwa zibe ngamanyathelo amabini; Isinyathelo sokuqala ukususa umkhuhlane, emva koko isifo kufuneka siphathwe.
Ukususwa kwe-Fluid: I- Fluid isuswe nge-thoracentesis. Ngamanye amaxesha oku kuyinto elula, ngakumbi ukuba i-empyema ayizange ibe khona ixesha elide. Itheyibhu yesifuba ingafakwa kwakhona ukwenzela ukuba iqhubeke igalela i-fluid.
Xa i-empyema ibakho ixesha elithile, ingafumaneka. Oku kwenzekayo xa iifom ezinamaqabunga ahlukeneyo kwaye ihlukanisa i-fluid ibe ngamagumbi ahlukeneyo. Oku kwenza ukuba umbane ube nzima kunzima, kwaye ngamanye amaxesha kufuneke ukuba kwenziwe amanyathelo athile kwi-thoracentesis ukususa umbane.
Ukunyanga intsholongwane: Oogqirha baya kuqalisa iintsholongwane emva kokuba isampuli ithathwe. Abanye abantu bayazibuza ukuba kutheni kungekudala, kodwa ukuqala kwezixhobo zokulwa ne-antibiotics ngokukhawuleza kulibazisekile ukwenzela ukuba ibhanti inethuba elihle lokugqiba ukuba yiyiphi ibhaktheriya ebangela ukusuleleka. (Ukuba i-antibiotics iqaliswa phambi kwe-thoracentesis, kunzima ukufumanisa ukuba yiyiphi ibhaktheriya enoxanduva lokusuleleka.) Emva kokuba uqaliswe kwii-antibiotiki ibar iya kwenza iimvavanyo ezingaphezulu ukujonga ukuba yeyiphi i-antibiotics ibhaktheriya enokukhathazeka-kwaye iintsholongwane ezinikezelwayo zingatshintshwa emva kweentsuku ezimbalwa.
Iingxaki / Utyando
Ngona-mpepha, ngokukodwa oye waba khona okwethutyana, izicubu ezinobumba zingakha. Kungenokwenzeka ukuba ugqirha ukususa ezinye iisculi ezibomvu kunye neengxenye zephalami ukwenzela ukulungisa isifo. Oku kunokwenziwa okanye nge- thoracotomy (ukuvulelwa kwiphaphu evulekile) okanye utyando lwe-thoracoscopic (ukuhlinzwa okungaphantsi kwe-lung yangaphakathi), kunye nokunyanyiswa kwe-video eyancediswa yi-video ibe yindlela efanelekileyo kunye neyona nto ingabonakaliyo kubantu abaninzi. Ukongezelela, uphando olutshanje lufumene ukuba iindlela zokungasebenzisi iindlela ezingapheliyo zihlala zisebenza ngendlela efanelekileyo njengonyango lokunyanga. Ezinye iingxaki zingabandakanya i-sepsis-intsholongwane ephazamisayo kulo lonke umzimba, kunye nobunzima kunye nokuqina kweempawu zomlomo.
Prognosis
Ukugxekwa kwe-empyema kuxhomekeka kakhulu kwizinto ezibangela.
Okukwintsusa
I-empyema iyigama elisetyenziselwa ukuchaza ubukho be-inflammatory fluid ejikeleze imiphunga. Isizathu esona siqhelo sisifo se-pneumonia, kodwa ezinye iimeko, kunye nokuhlinzwa kunye noxinzelelo, kungabangela uxanduva. Unyango lubandakanya ukuthatha isampuli yomlambo ukuthumela kwibhabhu nokususa umbane ogqithiseleyo ongabangela ukuphefumla okufutshane kunye nezinye iimpawu. Iza-antibiotics zinikezelwa ukunyanga usulelo.
Ukubiza igama: em-pie-ee-ma
Kwakhona kuthiwa : i-pylothorax, intsholongwane yomsindo, i-purulent pleuritis, i-empyema thoracis
Imizekelo: UJerry wahlakulela umtsalane emva kokuhlinzwa kwakhe umdlavuza wamaphaphu, kwaye ugqirha wakhe wenza inkqubo yokususa umkhuhlane osulelekileyo.
> Imithombo:
> McCauley, L, noN. Dean. I-pneumonia kunye ne-empyema: i-causal, engaqhelekanga okanye engaziwa. Umbhalo Wezifo Zesifo . 2015. 7 (6): 992-8.
> IThala leSizwe leMithi. MedlinePlus. Empyema. Ukuhlaziywa 02/15/15. https://medlineplus.gov/ency/article/000123.htm
> Redden, M., Chin, T., kunye noMn. Van Driel. UkuPhepha okuPhezulu kokuPhatha okungapheliyo ukuPhathwa kwePleural Empyema. I-Cochrane Database yeeNkqubo eziPhezulu . 2017. 3: CD010651.
> Zanotti, G., noJ. Mitchell. I-Bronchopleural Fistula kunye ne-Empyema Emva kokuHlulwa kwe-Anatomic Lung. Iiklinikhi zeeTraphic Surgery . 2015. 25 (4): 421-7.