I-edema yepulmonary yimeko yezokwelapha ebangelwa ukwanda kwamanzi emiphakeni yomoya yemiphunga (i- alveoli ). Ngenxa yokuba i-alveoli ene-fluid ayikwazi ukusebenza ngokuqhelekileyo, i-edema ye-pulmonary ivelisa ubunzima obunzima bokuphefumla, kwaye inokuthi ibe yinkinga yokubeka ubomi.
Kutheni i-Edema yePulmonary iyingxaki
I-alveoli yilapho umsebenzi wangempela wemiphunga uqhubeka khona.
Kwizikhwama zomoya zomoya, umoya ophefumlelweyo ophefumulayo uya kufutshane nama-capillary ethwele igazi elingenayo i-oksijeni-ehlwempuzekileyo kwiisisu zomzimba. (Igazi le-oksijeni elihlwempuzekileyo liye laphunyiswa ukusuka kwicala lasekunene lentliziyo emiphakeni, nge-pulmonary artery. Nantsi enye indlela intliziyo isebenza ngayo .)
Ngeendonga ezincinci ze-alveoli, ukutshintshiselwa kwegesi ebalulekileyo phakathi kwomoya ngaphakathi kwesikhwama se-alveolar kunye negazi "elichithwe" ngaphakathi kwiplasillari. I-oksijeni evela kwi-alveoli ithathwa yigazi le-capillary, kunye ne-carbon dioxide egazini ihluke kwi-alveoli. Igazi, ngoku i-oxygen-rich wealth once again, iqhutyelwa kwicala lasekhohlo lentliziyo, eliyipompozela kwiifom. I-"usetyenziso" yomoya ogqithiseleyo uphuma emoyeni, njengoko siphefumula.
Ubomi ngokwawo buxhomekeke ekutshintshiseni ngokuchanekileyo kwee-alveoli.
Nge-edema ye-pulmonary, ezinye iisabha ze-alveolar zizaliswe ngogesi.
Utshintshiselwano olubalulekileyo lwe-air inhaled kunye negazi le-capillary alinakwenzeka kwi-alveoli egcwele amanzi. Ukuba inani elaneleyo le-alveoli lichaphazelekayo, iimpawu ziyavela. Kwaye ukuba i-edema ye-pulmona iyaba yanzila, ukufa kungaqulunqwa.
Iimpawu ze-Edema yePulmonary
I-edema yepulmonary inokuthi ibe yinto enzima, apho imeko idala i- dyspnea enamandla (ukuphefumula okufutshane), kunye nokukhwehlela (okuvame ukuvelisa i-pink, frothy sputum), kunye ne-wheyzing.
I-edema ye-pulmatic ephawuleza nayo inokuthi ihambisane nokuxhalaba okukhulu, kunye neepilpitations. Ngokugqithisileyo i-edema ye-pulmatic iqala ukubizwa ngokuthi "i-edema ye-pulmary edem," kwaye idla ngokubonisa ngokugqithiseleyo inkathazo yengqondo. Ngokomzekelo, i -coronary syndrome enamandla iyakwazi ukuvelisa i-edema ye-pulmonary flash.
I-edema ye-pulmatic Acute ihlala yimeko engxamisekileyo yonyango, kwaye ingaba yingozi.
I-edema yengqolowa engapheliyo, edlalwa ngokuphelelwa yintliziyo , ibangela ukuba izibonakaliso ze-wax zixhomekeke kwixesha, njengoko kuninzi okanye i-alveoli encinci ichaphazelekayo. Iimpawu eziqhelekileyo ziyi-dyspnea kunye nokusebenza, i- orthopnea (ubunzima bokuphefumula ngoxa ulala phantsi), i-dyspnea yomsindo ebusuku (ukuvuka ebusuku ukuphefumula), ukukhathala, i-edema yomlenze (ukuvuvukala), kunye nokufumana ubunzima (ngenxa yokuqokelela kwamanzi).
Yintoni eyenza i-Edema yePulmonary?
Oogqirha bavame ukuhlula i-edema yepommoni kwenye yeentlobo ezimbini: i-edema ye-pulmonary cardia, kunye ne-horma ye-pulmary pulmary.
I-Cardiac Pulmonary Edema
Isifo senhliziyo sisona sizathu esiqhelekileyo se-edema ye-pulmonary. I-edema yepalmary cardia ivela ngenxa yokuba ingxaki yentliziyo yintliziyo ibangela uxinzelelo kwicala lasekhohlo lentliziyo ukuba liphakanyiswe. Olu xinzelelo oluphezulu ludluliselwa ngasemva, ngeemvini zepmonom, kwi-capillary alveolar.
Ngenxa yoxinzelelo oluphezulu lwe-pulmonary capillary, i-fluid iphuma kuma-capillaries kwisiza somoya, kwaye i-edema yamapulmoni ivela.
Phantse naluphi na uhlobo lwesifo senhliziyo ekugqibeleni lunokukhokelela ekunyanzelekeni kwimizi yesifo esisekhohlo, kwaye ngaloo ndlela, kwi-edema ye-pulmonary. Iintlobo eziqhelekileyo zezifo zentliziyo ezibangela i-edema ye-pulmonary zi:
- isifo se-coronary disease (CAD)
- ukuhluleka kwentliziyo kunoma yiphina isizathu
- isifo senhliziyo, i- mitral stenosis , i- mitral regurgitation , i- aortic stenosis , okanye i- aortic kwakhona
- ngxinzelelo ophezulu
Ngenxa ye-edema ye-pulmary cardiac engapheliyo, iingcinezelo eziphakamileyo ngaphakathi kwipilillari zingagcina zenze utshintsho luvele kwimithambo ye-pulmonary.
Ngenxa yoko, ukunyanzeliswa komthamo ophezulu wepommonary kungenzeka, imeko ebizwa ngokuba yingozi yomshukela we-pulmonary . Ukuba ihlangothi elifanelekileyo lentliziyo kufuneka lipompoze igazi kule nxinxu ephakamileyo yompompo, ukusilela kwintliziyo yesinqe kungapheli.
I-Edema ye-Cardiac Pulmonary Edema
Kwi-edema ye-pulmary non-cardiac, i-fluide igcwalisa i-alveoli ngezizathu ezingahambelani nokunyanzeliswa kwengqondo. Oku kuya kwenzeka xa ama-capillari emiphakeni awonakaliswe kwisifo esithile esingenalo isifo. Ngenxa yoko, i-capillaries "ihlaziyekile," kwaye iqala ukukhupha umlambo kwi-alveoli.
Isizathu esiqhelekileyo se-edema ye-pulmary pulmary is a severe respiratory syndrome syndrome (ARDS) , ebangelwa ukuvuvukala komzimba kwimiphunga. Oku kutshabalalisa kwonakalisa izindonga ze-alveolar, kwaye kuvumela ukuba amanzi aqokelele. I-ARDS ibonakala ngokugqithisekileyo kwizigulane ezigulayo, kwaye ingabangela ukusuleleka, ukutshitshiswa, ukukhathazeka, kunye nezinye iimeko.
Ukongeza kwi-ARDS, i-edema engeyi-cardiac pulmonary iyakhutshwa kwakhona yi:
- Ukugqithiswa kwepulmonary
- Ukugula okuphezulu
- Iziyobisi (ikakhulukazi i-heroin ne-cocaine)
- Izifo zintsholongwane
- Iibhoksi (ngokomzekelo, ukuvula i-chlorine okanye i-ammonia)
- Iingxaki ze-neurologic (ezifana noxinzelelo lweengqondo okanye i- subarachnoid hemorrhage )
- Ukuthungula umsi
- Ephantse idilika
Ukuchonga i-Edema yePulmonary
Ukukhawuleza ukuxilongwa kwe-edema yamapulmari kubaluleke kakhulu; kwaye ingakumbi ngokubalulekayo ngokuchanekileyo ukuxilonga isizathu esisiseko.
Ukuchonga i-edema yempompo ngokuqhelekileyo kufezwa ngokukhawuleza ngokuqhuba uvavanyo olwenyama, ukulinganisa iqondo le-oksijeni yegazi, nokwenza i-x-ray esifubeni.
Emva kokuba kufunyenwe i-edema ye-pulmma, amanyathelo kufuneka athathwe ngokukhawuleza ukuze abone isizathu esiyintloko. Imbali yonyango ibaluleke kakhulu kule migudu, ingakumbi ukuba kukho imbali yesifo senhliziyo (okanye yandisa ingozi ye-cardiovascular risk), ukusebenzisa iziyobisi, ukuchithwa kwezidakamizwa okanye izifo, okanye izinto ezinobungozi be-pulmonary embolus.
I- electrocardiogram kunye ne- echocardiogram bahlala benceda ekufumaneni izifo zesifo senhliziyo. Ukuba isifo senhliziyo sikhankanywe kodwa asikwazi ukubonakaliswa ngolu vavanyo olungapheliyo, ukunyanzelwa komzimba kungadingeka . Uluhlu lweminye imvavanyo lunokufuneka ukuba umntu ongeyena osisigxina.
I-edema ye-pulmary non-cardiac ifunyaniswa xa i-edema yamaphammoni ikhona ngokungabikho kweemeko zentliziyo ephakamileyo ekhohlo.
Unyango lwe-Edema yePulmonary
Iinjongo ezikhawulezayo ekuphatheni i-edema yamapulmoni kukunciphisa i-buildup yamanzi kwimiphunga kunye nokubuyisela izinga le-oksijeni yegazi kwiimeko eziqhelekileyo. Ulwaphulo lwe-oksijeni luhlala lunikezwa ngokukhawuleza. Ukuba iimpawu zesifo senhliziyo zikhoyo, i-diuretics nayo inikwe ngokucacileyo. Amachiza aphucula igazi iinqanawa, ezifana ne- nitrate , zihlala zisetyenziselwa ukunciphisa iingcinezelo entliziyweni.
Ukuba igazi lezinga le-oksijeni lihlala liphantsi kancinci nangona kunjalo, i-air ventical mayingadingeka. Ukunyusa umoya wokusetyenziswa kwamanzi kungasetyenziselwa ukwandisa uxinzelelo ngaphakathi kwe-alveoli, kwaye uqhube uphinde ulandelelanise umbane wamanzi kwi-capillaries.
Nangona kunjalo, Ulona unyango oluphezulu lwe-pulema ye-pulema - nokuba lubangelwa sisifo senhliziyo okanye kungengobomi bentliziyo - kufuna ukuchonga nokunyangwa kwengxaki yonyango.
Imithombo:
I-LB, uMaty MA. Ukusebenza kwezonyango. I-edema yempompo. N Engl J Med 2005; 353: 2788.
Weintraub NL, Collins SP, Pang PS, et al. I-heart failure ye-syndromes: Inkcazo yeSebe eliphuthumayo, unyango kunye nesimo: iindlela ezikhoyo kunye neenjongo ezizayo: isitatimenti sesayensi esivela kwi-American Heart Association. Ukuhamba ngo-2010; 122: 1975.