Uphando luyinto ebangela ukuba le hlobo lomphunga liwele
I-Atelectasis ligama lonyango elisetyenziselwa ukuchaza ukugqitywa okupheleleyo okanye okukhethiweyo kwemiphunga. Ngamanye amaxesha kuthiwa "umphunga owayo," nangona eli gama lingasetyenziswa kwimeko ebizwa ngokuba yi- pneumothorax .
Xa i-atelectasis ivela, umoya omtsha awukwazi ukufikelela kwiindawo ezincinci zemiphunga, ebizwa ngokuthi i- alveoli , apho i-oksijeni kunye ne-carbon dioxide zatshintshaniswa.
Oku kubangela ukuba izinga lokunciphisa i-oksijini linikezelwe kwizitho kunye nezicubu zomzimba (i- hypoxia ).
I-Atelectasis inokuba nzima, ivele ngokukhawuleza malunga nomba wemizuzu, okanye ingapheliyo, ikhula kwithuba leentsuku ukuya kwiiveki.
Izizathu zeAtelectasis
Kukho ezine ezinezizathu eziphambili ze-atelectasis: i-hypoventilation, ukuvinjelwa kwamanzi, ukunyanzelwa kwamanzi kunye nokuthobela.
- I-Hypoventilation (ukuphefumula ngesantya esingaqhelekanga) iqhelekileyo ngexesha lotyando, ngakumbi nge-anesthesia jikelele, okanye xa umntu efakwe kwisiphene. Isenzo sokuphefumula okungapheliyo kuvimbela umoya ukuba ungene e-alveoli, kubangela ukuba iipakthi zomoya zidibanise kwaye zidibane. I-Hypoventilation yimbangela eqhelekileyo ye-atelectasis, ingakumbi emva kokuhlinzwa kwesifuba.
- Ukukhutshwa kwe-Airway kunokubangelwa xa into ethile ibimbela ingqungquthela engaphakathi kwimpompo (njenge-mucus okanye into yangaphandle) okanye ngaphandle kwemipopho (njenge-tumor ephoxayo kwindlela yokuhamba umoya kwaye ibangele ukukhutshwa). I-Bronchioloalveolar carcinoma yinto enye yomhlaza eyaziwayo ukuba ibangele izicubu kwi-alveoli kunye neendidi ezihlangeneyo.
- Ukunyanzeliswa kwe-Airway kubangelwa yinto yokwenza umbane kwiindawo ezijikeleze imiphunga ( ukukhulelwa komsindo ). Kungaba ngumphumo wentliziyo ekhulisiweyo, i-aneurysm, i-tumor, i-lymph nodes eyandisiweyo, okanye ukuqokelela kwamanzi kwisisu esiswini ( ascites ).
- Ukuxhaswa yimeko engavumelekanga apho izicubu ziqala ukunamathela. Ngokuqhelekileyo, izicubu zangaphakathi kunye nezitho zinezakhiwo ezipholileyo, ngoko zikwazi ukuhamba kalula njengoko umzimba uhamba. Into ecocekileyo ibizwa ngokuba yi-surfactant. Xa i-surfactant isweleka, imiphunga ilahlekelwa ngumbane kwaye ingawa.
Ezinye izinto ezifaka isandla kwi-atelectasis ziquka ukukhuluphala, ukutshaya, ukulala okulala ixesha elide / ukungahambi kakuhle, imfucuza yomzimba (okungabangela ukuphefumula okungapheliyo), izidakamizwa okanye izidakamizwa (ezinokuphefumula) kunye ne-RDS) kwiintsana ezisanda kuzalwa.
Iimpawu zeAtelectasis
I-Atelectasis kaninzi impawu ezincinane xa ikhula ngokukhawuleza okanye iquka inxalenye encinane yomphunga. Ngapha koko, ukuba imeko ikhula ngokukhawuleza okanye inokuchaphazela inxalenye enkulu, iimpawu zinokumangalisa kwaye zidibanise. I-Atelectasis ivela ngokubini ngokubanzi, okubhekisela kumnye umphunga okanye kwenye.
Izimpawu eziqhelekileyo ziquka:
- Ukuphefumula ( dyspnea )
- Ukukhwabanisa, ukukhwehlela okungenakuvelisa
- Intlungu ebuhlungu yesifuba esibuhlungu ngokuphefumula ( intlungu yesifuba se-pleuritic )
- I-bluish tinge emilonyeni, iminwe, okanye iminwe ebangelwa ukungabikho kwe-oxygen (i- cyanosis )
Ukuxilongwa kweAtelectasis
Ukuba ugqirha wakho ugxeka ukuba unayo i-atelectasis, uza kwenza uvavanyo olusemzimbeni ngokuthinta (ukukhangela i-percussing) kwisifuba sokuphulaphula izandi. Ukuba kukho ukuphela kwemiphunga ekhethekileyo okanye epheleleyo, izandi zokuphefumula ziya kuthula okanye zingabonakali.
Ukulandela oku, ugqirha uya kulawula uphando oluninzi olubandakanya:
- I-X-ray yesifuba , engayibonisa ukuba i-trachea nentliziyo zitshintshe isikhundla
- I-tomography ye-Computed (CT scan) ukukhangela ubungqina obubonakalayo bokubandezeleka
- Umfanekiso we-magnontic resonance (MRI), usebenzisa amaza ombane ukuvelisa imifanekiso
- I-bronchoscopy , i-flexible scope efakwe kwi-windpipe ukujonga imiphunga
- Iigesi zegazi (i-oximetry) ukuvavanya izinga lokunyuswa kwe-oksijini
- I-Positron-emission tomography (i-PET scan), ekwazi ukubona i-cell metabolism engaxhamliyo njengoko inokuvela ngomhlaza
Izinketho zokwelapha kwi-Atelectasis
Utyando lwe-atelectasis luxhomekeke kwisizathu esisiseko, ngenjongo yokwandisa kwakhona imiphunga ukuya kubukhulu bayo obuqhelekileyo. Iinkqubo ziyahluka. Ukuba isisu siyimbangela yokuwa, ukuhlinzwa kungabandakanyeka.
Ukuze kuqhutywe imfesane yomsindo, kufuneke kufuneke umjelo wesigxina. Ukuvinjelwa kwangaphakathi, i-bronchoscopy ingasetyenziselwa ukususa into yangaphandle, xa unyango lwe- bronchodilation lunokunceda ekuvulekeni kweendinyana zomoya. Kwiimeko ezininzi, ukudibanisa iindlela zokwelapha kuya kufuneka.
Xa izibonakaliso zikhankanywe, ukunyanzelwa kokuphela kokuphefumula (PEEP) kunokusetyenziswa. Le yonyango apho umxube we-oksijini unikezwa ngumaski phantsi kwengxinzelelo, ukuthintela imiphunga ukuba idibanise ngokupheleleyo ngexesha lokuphumayo. Ukuba iimpawu zinzima, i-intubation kunye nokuphuphuma umoya kungadingeka de kube imeko ephantsi ilawulwa ngokupheleleyo.
Xa i-atelectasis ingapheliyo, kunokuba nzima ukufumana imiphunga ukuba yandisa. Ukususwa kwenxalenye eyonakalisiweyo yempompo (ngokusebenzisa i- lobectomy okanye i- resectional resection ) ingaboniswa.
Iingxaki zingabangela ukuba iibhaktheriya ziboshwe kwindawo yokuwa. Oku kunokukhokelela ekuphuhliseni intsholongwane, kubandakanywa ne-pneumonia kunye ne-sepsis. I-Bronchiectasis , ukunyuka okungaqhelekanga kwee-airways okubangela ukuhlengahlengiswa kwemipuphu, ngamanye amaxesha kunokwenzeka kwakhona. Xa inxalenye enkulu yemiphunga ichaphazeleka yizinto, ukungaphumeleli kokuphefumula kungabangela.
Ukukhusela i-Atelectasis Emva kokuPiliswa
Utyando lwebhokisi luhlala luyimbangela ebalulekileyo ye-atelectasis. Ukukuthintela ukuba kwenzeke emva kwenkqubo yokuhlinzwa, oogqirha baya kukucebisa ukuba uyeke ukutshaya kuqala.
Emva kokuhlinzwa, kukho izinto ezintathu omele uyenze ukuqinisekisa ukuba iimiphunga zakho zihlala zigcwele ngokupheleleyo:
- Ukwenza ukuphefumla okuchukumisayo, ugxininise kwiimbhobho ezinde kunye nokuxilongwa okulawulwayo. Iyeza zonyango zinokumiselwa ukuba ngaba ukuphefumula kungakhululeki.
- Yenza umgudu wokukhwehlela ukucoca nayiphi na i-mucus okanye i-sputum ukusuka kumaphaphu.
- Sitshintsha isikhundla sakho, uhleli phezulu okanye uhamba ngokubanzi njengoko ugqirha wakho evumela.
> Imithombo:
> Ferrando, C., Romero, C., Tusman, G. et al. "Ukuchaneka kwe-Postoperative, Non-Invasive Air-Test to Diagnose Atelectasis kwizigulane eziPheleleyo emva kokuPiliswa: IsiFundo soPhando seProjekti, i- BMJ Open . 2017 '7 (5): e015560.
> Restrepo, R., kunye noBraverman, J. "Iingxaki ezikhoyo kwiNgcaciso, ukuKhusela nokuPhathwa kwePlmonary Pulmonary Atelectasis." Ukuphononongwa kobuNtsholongwane kaGawulayo . 2015; 9 (1): 97-102.