Ukuqonda iPleuritic Chest Pain (Pleurisy)
Ukuba unentlungu ngokuphefumula, nokuba ukuphefumula okuqhelekileyo okanye xa uhamba nomoya ophefumlelweyo, usenokuba ukhathazekile. Oogqirha bachaza uhlobo lweentlungu ezenzekayo ngokuthatha umoya ojulile ngokuthi "intlungu yesifuba" okanye "pleurisy." Igama livela kwesinye sezizathu eziqhelekileyo zolu buhlungu: ukucaphuka kwendlebe, iimbumba zifaka imiphunga.
Kodwa kukho ngokwenene ininzi yezizathu zolu hlobo lwentlungu. Ziziphi ezinye zezizathu, nini iimpawu zakho ziza kuba yimeko engxamisekileyo, kwaye zeziphi iimvavanyo ukuba ugqirha wakho uncome ukuba uhlolisise iimpawu zakho?
Ubunzima Bokuphefumula Okukhulu: I-Pleuritic Chest Pain
Njengoko kuphawuliwe ngasentla, oogqirha basebenzisa ibinzana elithi "intlungu yesifuba se-pleuritic" ukuchaza intlungu kwisipfuba esifubeni esenzeka ngokuphefumla. Intlungu inokuvela kuphela ngokuphefumla okanye inokuthi ikhona ngexesha lonke ize ikhulume ngakumbi xa ithatha umoya ophefumlelweyo. Iintlungu zesifuba sePleuritic zidla ngokukhawuleza, kunokuba ziphosakele okanye zinzima, kodwa kukho ukungafani kulo mgaqo jikelele.
Xa Ubunzima Bokuphelelwa Ngxamiseko?
Ngaphambi kokuba uxoxe ngezizathu ezinokubangela iintlungu ngokuphefumla, kubalulekile ukuba uqaphele xa kufuneka ubize i-911. Ukuba unayo impawu elandelayo kunye nokuphefumla okubuhlungu, ungafundi ngokuqhubekayo uze ucele unonophelo lwengonyango oluphuthumayo:
- Ubuhlungu obunzima okanye obuza ngokukhawuleza
- Ubunzima bokubamba umoya wakho okanye ukuphefumula okukhulu
- Ubuhlungu, ukuvuvukala, okanye ubomvu kuyo nayiphi na imilenze yakho (leyo ingaba yindoda yegazi) kunye nentlungu ngokuphefumla
- Lightheadedness okanye ukuphelelwa amandla
- Ukuhlamba igazi , nangona ixabiso elincinci (nokuba i-teaspoon ithathwa njengongxamiseko lwezonyango)
- Uvakalelwa yintsikelelo ezayo: Ukuba awukwazi ukuchaza oko uthethayo kodwa uzive ngathi uhlangabezana nexakeka kwimeko engxamisekileyo, kholosa isiza sakho uze ubize 911
Esinye sezizathu eziqhelekileyo zentlungu yesifuba se-pleuritic yi-pulmonary embolus, i-clot yegazi ephuka emilenzeni ize ihambe kwimiphophu. Oku kuyingozi yokongela ubomi kwaye iyakwazi ukukhokelela ngokukhawuleza ekufeni ukuba ingaphathwa kakubi. Ngophando lwango-2017 kwaphawulwa ukuba abantu aba-5 ukuya kuma-21 ekhulwini labantu abaya kwindlu egxininiso kunye neentlungu zesifuba se-pleuritic bafunyenwe babe ne-pulmonary embolus.
Iinkqubo zePleuritic Chest Pain (Ubuhlungu obuphefumulayo)
Ngaphambi kokungena kwizinto ezinokubangela iintlungu ngokuphefumla, kunceda ukuthetha malunga neendlela ezinokubangela olu hlobo lobuhlungu. Ubunzima bokuphefumla buya kwenzeka ngeemeko ezithinta phantse naziphi na izakhiwo ezikhoyo esifubeni. Ezi ziquka:
- Iimbambo
- Iigaments, izihlunu kunye nezinye iifomthi ezithambileyo zesifuba
- Umlenze womzimba
- Imiphunga kunye nendawo yamapapu
- Intliziyo kunye nendawo yentliziyo (i-pericardium)
- Isisu
- Isifuba
I-Painful Breathing vs Pleuritic Chest Pain vs Pleurisy
Ukuba ufunde ngokuphefumla okubuhlungu okanye ukuphefumula okubuhlungu, unokufumana le ngongoma ididekile.
Oku kungenxa yokuba ukuphefumula okubuhlungu kunokubizwa ngokuba yizinto ezininzi ezahlukeneyo. Ixesha elithi "intlungu yesifuba se-pleuritic" isetyenziselwa ukuchaza nayiphi na intlungu eyenzeka ngokuphefumula. Ngokwahlukileyo, igama elithi pleurisy lingasetyenziswa ngeendlela ezimbalwa ezahlukeneyo. Ngezinye izihlandlo iPleurisy isetyenziselwa ukuchaza nayiphi na intlungu ebuhlungu eyenzeka ngokuphefumula, kodwa ezinye izihlandlo zisetyenziswe ngokucacileyo ukuchaza ukuvuvukala kwe -pleura , iimbumba zombini ezikhuselweyo kunye nokukhusela imiphunga ngexesha lokuphefumula. Kukho ukuxhaphaka ngokusebenzisa le migaqo. Ngokomzekelo, ezinye iimeko ezifana ne-pneumonia zingabangela imeko ethile ye-pleurisy (ukucaphuka kunye nokuvuvukala kwe-pleura), kodwa kunokubangela intlungu ngokuphefumula ngenxa yezinye iindlela ezifana nezimbambo eziphazamisekileyo okanye ezidibeneyo kunye neentsundu ze-muscle ekukhwehleleni.
Iingxaki Zokuba Zibuhlungu Ngokuphefumula
Kukho ezininzi ezinokubangela iintlungu ngokuphefumla okuvela ekubeni yinto engathintekiyo kwimvelo. Ezinye zezona zizathu eziqhelekileyo zidilizwe phantsi ngaphantsi komzimba.
Izizathu ezinxulumene nomlenze we-Breasting Breathing
Nangona imiphunga ayinayo i-receptor, iimeko zonyango ezibandakanya imiphunga zingabangela iintlungu ngeendlela ezininzi, kubandakanywa nezinto ezinokubangela ukucaphuka kwe-pleura. Ezinye zezi ziquka:
- I-Pleurisy: Njengoko kuphawuliwe ngasentla, ukuvuvukala kwe-pleura, ebizwa ngokuthi "pleurisy," yimbangela eqhelekileyo yentlungu ngokuphefumla. I-Pleurisy ingenzeka yodwa okanye idibene nomnye umqathango onjengezo zikhankanywe ngezantsi. Kungenzeka kwakhona emva kwentsholongwane ephezulu yokuphefumula, kwaye kubonakala ngathi ihlala ngonaphakade.
- Usulelo lwe-Virus: Iintsholongwane eziqhelekileyo ezinokubangela ubuhlungu besifuba se-pleuritic ziquka intsholongwane yeCoxsackie, intsholongwane yokuphefumula (RSV), umkhuhlane, i-parainfluenza, i-mumps, i-adenovirus, i-cytomegalovirus (i-CMV) kunye ne-Epstein Barr virus (ebangela i-mononucleosis ephathekayo).
- I-Pneumonia : Izifo kwimiphunga, ngokukodwa ezo kwimimandla engaphandle yemiphunga ecaleni kwendwangu yesigxina, ingabangela intlungu ngokuphefumla.
- Umdlavuza womlenze : Kucingelwa ukuba malunga nesiqingatha sabantu abafumene umdlavuza wamaphaphu babandezeleka kwindawo ethile esifubeni sabo ngexesha lokuxilongwa. Akuqhelekanga ukuba le ntlungu iguqulwe ngokuphefumula, ingakumbi ukuba i-tumor ikhona kwimimandla engaphandle yemiphunga ecaleni kwendlebe. Okwangoku, uhlobo oluqhelekileyo lomdlavuza wamaphaphu, umphunga we-lungen adarocarcinoma , ukhula ukhula kwipheripha yompompo kufuphi ne-pleura. Olu hlobo lomhlaza womphunga oqhelekileyo kubantu abangazange bavume, abafazi nabaselula abanomdlavuza wemiphunga.
- Isifo sofuba (i-TB): I-TB yimbangela eqhelekileyo yentlungu ngokuphefumula e-United States, kodwa yinto ebangela kakhulu emhlabeni jikelele.
- Ukusetyenziswa kwezinto ezibonakalayo: Ukuqokelela kwamanzi phakathi kweengqimba ze-pleura, ezibizwa ngokuba yimpembelelo yomsindo, yinto ebangela intlungu ngokuphefumula. Nangona kunjalo, njengokuba intlungu ngokuphefumula kungumqondiso ongeyodwa, iziphumo zentsholongwane zinokuthi zihambelane naluphi na inani lezifo, ezivela kwisifo samaphaphu kunye nesifo senhliziyo ukuya kwiimeko ezizimeleyo ezifana ne-rheumatoid arthritis kunye nomhlaza. Ukusetyenziswa kwamangqumbo angalungile kukunyanzeliswa kwesigxina esineengqamuzana zomhlaza. Ezi zenzeke kubantu abanomdlavuza wamaphaphu, umdlavuza webele, kunye nezinye i-cancer ezingasasazeka kwimiphunga.
- I-Pneumothorax : I-pneumothorax kukuwa kwe nxalenye okanye yonke imiphunga. Ukuwa kweyona nto ingancinci kwaye ingabonakali, okanye inokuba yinto enkulu kwaye ingabangeli nje intlungu ngokuphefumla kodwa iphefumle kakhulu kwaye i-emphysema yangaphantsi, imeko apho isikhumba sesifuba sinomuzwa wokubhukuda ngenxa yokusinda umoya ovela kumaphaphu. I-pneumothorax inokuvela njengengxaki ye-emphysema, ezinye izifo zamaphaphu, okanye i-trauma, okanye inokwenzeka ngokukhawuleza kubantu abadala abadala.
- I-Pulmonary embolus : Isimo esisongela ubomi, i-pulmonary emboli yenzeke xa amaqhekeza ephuka emilanjeni yemilenze ( intlungu ye-vein thrombosis ) kunye nokuya emiphakeni. Njengoko i-pneumothorax, iimpawu zingaphuma ukusuka ekuncinci ukuya kwinqanaba, kwaye le meko yimeko engxamisekileyo yonyango. Imiba yengozi ye-pulmonary emboli ibandakanya ukuhlinzwa kwangoku, izifo ezininzi ezingapheliyo, ukukhulelwa, kunye nokuhamba umgama omde ngemoto okanye kwindiza. Njengoko kuphawuliwe ngasentla, i-pulmonary embolus ifumaneka ngokuqhelekileyo kubantu abaya kwigumbi elingxamisekileyo kunye neentlungu zesifuba.
- I-Mesothelioma : I-Mesothelioma ngumhlaza ovela kwi-pleura kwaye ixhaphake kubantu abaye bafumana i- asbestos emsebenzini.
Izizathu ezinxulumene neentliziyo zokuphefumula okubuhlungu
Ekubeni intliziyo ihlala kufuphi nemiphunga (kunye ne-pleura) kwaye ihamba ngokuphefumula, iimeko zeentliziyo zingabangela intlungu ngokuphefumula. Ezinye iimeko ezinxulumene nentliziyo ezenza iintlungu zesifuba se-pleuritic ziquka:
- I-Pericarditis : I-Pericarditis ibhekisela ekuvukeleni kweembumba ezifake intliziyo (i-pericardium) efana nalezo zifaka imiphunga. I-Pericarditis inezimbangela ezininzi ezibandakanya izifo, umdlavuza (umdlavuza wesifo somdlavuza kunye nomhlaza wesifuba), izimo ezizimeleyo njenge-lupus, nesifo sezintso. Phantse iipesenti ezili-15 zabantu abanesifo senhliziyo bahlakulela i-pericarditis ngokunjalo.
- Ukuhlaselwa yintliziyo: Ngokuqhelekileyo, intlungu enxulumene nokuhlaselwa kwentliziyo ayihambelani nokuphefumula, kodwa ukwanda kweentlungu kunye nokuphefumula okukhulu kunokwenzeka, ngokukodwa ukuba ukuhlasela kwentliziyo kuhambelana ne-pericarditis njengoko kuchazwe ngasentla.
- I-disorction ye-Aortic: I-dissection ye-aorism yimeko apho ukuphazamiseka kwi-aorta kuvumela igazi ukuba lichithe kwi-lining "idibanise" i-lining yangaphakathi ye-aorta, kwaye yimeko engxamisekileyo yonyango. Ngokuqhelekileyo kubangela uhlobo olunzima, oluqhawulayo intlungu enokuthi ibonakale kwisifuba nasemva. Ngokuqhelekileyo kubakho kubantu abane-Marfan syndrome, ngokuqhelekileyo amadoda aphakamileyo kwaye ancike.
- I-pulmonary hypertension : I-pulmonary hypertension yimeko enzima apho uxinzelelo lwegazi kwi-pulmonary artery liphakanyisiwe. (Ukwahlukileyo kunomdla wokuxinzelela kwegazi abantu abaninzi bayaziqhelanisa kwaye bafumaneka nge-echocardiogram kunokuba i-blood pressure coff.) Umthambo we-pulmonary uxanduva lokuthwala igazi ukusuka entliziyweni kwimiphunga ukuze ufune i-oxygen. I-pulmonary hypertension inokubangelwa yimiba yeemeko eziquka isifo senhliziyo, isifo seemiphunga, ukuphazamiseka kwezicubu kunye nezinye iyeza.
Izizathu zeMisculoskelet of Breining Breathing
Iimeko ezibandakanya nayiphi na i-bony okanye izithambo ezincinci ezifubeni zingabangela intlungu eyenzeka okanye iya kuba nzima ngokuphefumla. Ezinye zezi ziquka:
- Ukuqhaqha kweRib: Ukuqhaqha umbhobho njengobangela wentlungu ngokuphefumla kubonakala ngokucacileyo, kodwa ngamanye amaxesha ezi zintluko zingenzeka ngokukhwehlela okanye ngokubandezeleka kakhulu kubantu abane-osteoporosis. Ukuphazamiseka kwengcinezelo , umonakalo owenziwe ngokweqile, nangona kunjalo, akunakwenzeka. Iintlungu zengcinezelo yokuxinwa kwembambo zivame ukuza ngokuhamba kancane kwaye zibi kakhulu ngokuphefumula kunye nokukhwehlela.
- I-Costochondritis ne-Tietze syndrome : I-Costochondritis neTyetze syndrome ziimeko ezibandakanya ukuvuvukala kommandla apho iimbambo zidibanisa kunye / okanye apho iimbambo zidibanisa ne-sternum (isifuba). Nge-costochondritis, kunokudumala kwesi sifunda, kanti nge-Tietze syndrome ayikho. Intlungu yesifuba ehambelana nale miqathango iphandwe iphosakele ngenxa yokuhlaselwa kwentliziyo. Ekubeni izibambo, kwaye ngoko ke izibambo zeembambo zihamba ngokuphefumula ngamnye, intlungu idla ngokubhekiselele ekuphefumuleni, ingakumbi ithatha umoya ophefumlelweyo.
Ezinye izizathu ezenzekayo zokuphefumula okubuhlungu
- Iingqungquthela : Xa isifo se-inkukhu siphinda "senza kwakhona" ekusasazeni kwentsholongwane esinika isifuba, kunokukhokelela intlungu yesifuba-kuxhomekeke kwindawo-intlungu ingatshintsha ngokuphefumula. Nangona iindwangu zidla ngokubandakanya ukukhawuleza, intlungu ihlala ihamba ngaphambi kweentsuku ezimbalwa, okwenza ukuba ukuxilongwa kungaqinisekanga ekuqaleni.
- I-acid reflux : Ubunzima obwenzeka ngenxa yesifo se-reflux yesifo se-gastroesophageal (GERD) asiqhelekanga kudibaniswa nokuphefumla, kodwa kungadlwengulwa ngokuphefumula.
Iimpawu eziManyeneyo
Kukho impawu ezinokuthi zenzeke kunye nokuphefumla okubuhlungu okunokukunceda wena kunye nogqirha wakho ukucacisa isizathu seentlungu zakho. Ezinye zezi ziquka:
- Ukukhwehlela, nokuba ukukhwehlela okukhulu okanye ukukhwehlela okuqhubekayo
- Ezinye iintlobo zesifo esivela kwintlungu yesifuba, ukuxhamla intlungu, ukunyamezela intlungu , ukuya kwintlungu
- Ukuqhawukelwa ngumphefumlo
- Ukuhlamba igazi
- Ukuthuka
- Ukugubha
- Ukulahlekelwa kwesisindo esingenziyo
Imibuzo Ugqirha Wakho Unokubuza
Ukongeza kokubuza malunga neempawu ezichaphazelekayo ngasentla, ugqirha wakho uya kukubuza:
- Ngaba wena okanye uke wapha?
- Ngaba unayo nayiphi na inzakalo okanye ingozi, kubandakanywa nentshontsho?
- Ngaba unesifo sokuphefumula njengomkhuhlane okanye umkhuhlane?
- Ziqale nini iimpawu, kwaye zide zide kangakanani?
- Ngaba uye wafumana iimpawu ezifanayo kwixesha elidlulileyo?
- Ziziphi ezinye iingxaki zonyango onayo?
- Ziziphi iimeko zonyango ezihamba kwintsapho yakho?
- Ngaba uqalise inkqubo entsha yokuzilolonga, okanye wenza nantoni na into eyenziwa ngumzimba ongayifaka imisipha kunye nezinye izakhiwo kwisifuba sakho?
- Ngaba iimpawu ziya kwenzeka ngexesha lonke, okanye ngamaxesha athile, njengokungena ngaphandle xa kubanda?
Uvavanya uDokotela wakho ngoMeyi
Ngokuxhomekeke kwiimpawu zakho, kukho iimvavanyo ezahlukeneyo ugqirha wakho angancoma. Ezi ziquka:
- I-x-ray yesifuba: Gcina ukhumbule ukuba i-x-ray isifuba sinokukunceda ukuxilonga imeko, kodwa ayikwazi ukukhuphela imeko. Ngokomzekelo, i-pulmonary embolus okanye umdlavuza wamaphaphu unokuba khona nangona i-x-ray yesifuba esifanayo. Enyanisweni, amancinci amancinci emaphaphu aqhelekiweyo kwi-x-ray kwaye afunyanwanga ade afinyelele kwisigaba xa engasaphili. I-pulmonary embolus ephosakeleyo nayo inzulu, kwaye inokuba yingozi xa ingafumaneki ngokukhawuleza.
- I-Rib x-ray.
- Ukutsalwa kwe-ventilation-perfusion: Olu luvavanyo olwenziwe ukukhangela ubungqina be-pulmonary embolism.
- I-CT scan: I-CT scan ingasetyenziselwa ukuvavanya iimeko ezinxulumene nesifuba. Kungenziwa, ngokunjalo, ukufumana umbono ochanekileyo weembambo kunye nezakhiwo zebony kwisifuba.
- CT engiography.
- I-Electrocardiogram (EKG)
- I-Echocardiogram: I-echocardiogram (ukuhlolwa kwe-ultrasound yentliziyo yakho) inokwenziwa ukukhangela ukuvuvukala okanye ukuchithwa kwamanzi kwiimbumba ezinobumba entliziyweni (i-pericarditis okanye i-pericardial effusion).
- I-Oximetry: I-oximetry ngumvavanyo osetyenziswa ukulinganisa izinga le-oksijini egazini lakho. Ngamanye amaxesha kunokunika iingqinisiso kwiimeko eziphantsi kwamaphaphu okanye entliziyweni.
- ImiSebenzi yovavanyo.
- Uvavanyo lweD-dimer.
Unyango lwe-Breathing Painful
Izinyathelo zokonyanga ukuphefumula buhlungu ziya kuxhomekeka kwisizathu esithile. Kubalulekile ukuphulaphula umzimba wakho ukuba unentlungu yesifuba se-pleuritic, kwaye "ungabonakalisi" iimpawu zakho ngokusebenzisa imithi yeentlungu uze ufumane uvavanyo olunzulu.
Ngaphantsi kobuhlungu obuphefumulayo
Njengoko kuphawuliwe ngasentla, kukho ezininzi ezinokubangela ukuphefumla okubuhlungu okanye intlungu ngokuphefumula okunzulu okuvela kwizinto ezinokubangela inkathazo kulabo abasongela ubomi. Kubalulekile ukukhumbula ukuba intlungu ibonakaliso esivela emzimbeni wethu isitsho ukuba into ephosakeleyo. Kuyakhathazeka ukuba awufumani ukuxilongwa ngokukhawuleza, njengoko kudla ngokubakho intlungu enjengale, kodwa qhubeka uxoxa nodokotela wakho de ube nempendulo. Cela ukuthunyelwa kwingcali okanye ufumane umbono wesibini ukuba awunayo inkcazelo efanelekileyo yokungahambi kwakho. Okuyinyani ngokuphefumla okubuhlungu kukunyani naziphi na izifo zonyango-kubalulekile ukuba ube ngummeli wakho kwiinkathalo zempilo ukuze uhlale uphilile.
> Imithombo:
> Berchuck, J., no S. Patel. I-Etiology ye-Ploritic Chest Pain. I-Journal yeGrimeli yangaphakathi . 2016. 31 (1): 138.
> I-Jany, B. I-Pulmonary Izizathu zeentlungu zesifuba. Wangaphakathi . 2017. 58 (1): 22-28.
> Reamy, B., Williams, P., kunye noMnu Odom. I-Pleuritic Chest Pain: Ukuhlenga nge-Diagnosis. WaseMerika ugqirha . 2017. 96 (5): 306-312.
> Yan, G., Littlewood, A., noM M. Latimer. Isizathu esingaqhelekanga sePleuritic Chest Pain eMntwaneni. Imibiko yee-BMJ Case . 2016. pii: bcr2016217307.