Ukwelashwa yisisusa esijwayelekile salolu hlobo lwephunga lokuwa
I-Atelectasis yigama lezokwelapha elisetshenziselwa ukuchaza ukuwa okuphelele noma okuyingxenye yamaphaphu. Ngezinye izikhathi ibizwa ngokuthi "iphaphu eliphukile," nakuba leli gama lingasetshenziswa nesimo esibizwa nge- pneumothorax .
Lapho kwenzeka i-atelectasis, umoya omusha awukwazi ukufinyelela izakhiwo ezincane zamapayipi, okuthiwa yi- alveoli , lapho kushintshaniswa oksijini ne-carbon dioxide.
Lokhu kubangela amazinga we-oksijeni eyancipha ehanjiswa ezithombeni nasezicukeni zomzimba ( hypoxia ).
I-Atelectasis ingaba yinkimbinkimbi, ivele ngokuzumayo phezu kwendaba yemizuzu, noma engapheliyo, ithuthuke isikhathi esithile sezinsuku kuya kwamasonto.
Izimbangela ze-Atelectasis
Kunezimbangela ezine eziyinhloko ze-atelectasis: i-hypoventilation, ukuvinjelwa kwamanqamu, ukucindezela umoya, nokunamathela.
- I-Hypoventilation (ukuphefumula ngesilinganiso esingajwayelekile) kuvamile ngesikhathi sokuhlinzwa, ikakhulukazi nge-anesthesia ejwayelekile, noma lapho umuntu efakwa endaweni yokuphefumula. Yona kanye isenzo sokuphefumula okungavimba ukuvimbela umoya ukuba ungene e-alveoli, okubangela ukuthi amasaka omhlaba aphikise futhi awele. I-Hypoventilation yiyona imbangela evame kakhulu ye-atelectasis, ikakhulukazi ngemva kokuhlinzwa kwesifuba.
- Ukuvinjelwa kwe-Airway kungabangelwa uma kukhona okuvimbela ingxenye ngaphakathi kwamaphaphu (njenge-mucus noma into yangaphandle) noma ngaphandle kwamaphaphu (njengendlala ecindezelayo emoyeni futhi ibangele ukuvimbela). I-carronoma ye-Bronchioloalveolar uhlobo olulodwa lomdlavuza owaziwa ukuthi lubangele izicubu ema-alveoli namavesi ally.
- Ukucindezela kwe-Airway kuvame ukubangelwa ukwakhiwa kwezikhukhula endaweni ejikeleze amaphaphu ( pleural effusion ). Kungase futhi kube umphumela wenhliziyo ekhulisiwe, i-aneurysm, i-tumor, i-lymph nodes ekhulisiwe, noma ukuqoqwa kwamanzi emzimbeni wesisu ( ascites ).
- Ukuncoma kuyimvelo engavamile lapho izicubu ziqala ukunamathela ndawonye. Ngokuvamile, izicubu zangaphakathi nezitho zinezakhiwo ezisheshayo, ngakho-ke zingashintsha kalula njengoba umzimba uhamba. I-lubricating substance ibizwa ngokuthi i-surfactant. Uma i-surfactant ingekho, amaphaphu alahlekelwa ukucindezeleka komhlaba futhi angawa.
Ezinye izinto ezibangela ukudla ngokweqile zihlanganisa ukukhuluphala, ukubhema, ukulala okude isikhathi eside / ukungahambi kahle, ukuqhuma ukuqhuma (okungaholela ekuphefumuleni okungapheli), izidakamizwa noma izidakamizwa (ezinganciphisa ukuphefumula), kanye nesifo sokuphefumula (RDS) ezinsana ezisanda kuzalwa.
Izimpawu ze-Atelectasis
I-Atelectasis ivame ukuba nezimpawu ezimbalwa uma ikhula kancane noma ifaka ingxenye encane yamaphaphu. Ngakolunye uhlangothi, uma isimo siphuthuma ngokushesha noma sithinta ingxenye enkulu, izimpawu zingase zivelele futhi ziholele ukwethuka. I-Atelectasis ivame ukuvela phakathi kwamanye amazwe, okusho ukuthi yiliphi iphaphu noma elinye.
Izimpawu ezivamile zihlanganisa:
- Ukuphefumula ( dyspnea )
- Ukukhwehlela okungenakukhiqiza
- Ubuhlungu obuhlungu obuhlungu besifuba obuhlungu kakhulu ngokuphefumula okujulile ( ubuhlungu besifuba se-pleuritic )
- I-bluish tinge izindebe, izinzwane, noma iminwe ebangelwa ukungabi khona kwe-oxygen (i- cyanosis )
Ukuxilongwa kwe-Atelectasis
Uma udokotela wakho esolwa ukuthi une-atelectasis, uzokwenza ukuhlola ngokomzimba ngokuthepha (ukushaya i-percussing) esifubeni sokulalela imisindo yokukhuluma. Uma kukhona ukuphazamiseka kwamaphaphu okuyingxenye noma okuphelele, imisindo yokuphefumula izothula noma iyabonakala ingekho.
Ngemva kwalokhu, udokotela uzolalisa uphenyo olungafaka:
- I-X-ray ye-Chest , engase iveze ukuthi i-trachea nenhliziyo ishintshe isikhundla
- I-computed tomography (CT scan) ukufuna ubufakazi obonakalayo bokuvimbela
- I-imagery ye-resonance magnetic (MRI), isebenzisa amagagasi amakhulu ukukhiqiza izithombe
- I-bronchoscopy , i-flexible scope efakwe ku-windpipe ukubuka amaphaphu
- Amagesi wegazi (oximetry) ukuhlola izinga lokunciphisa oksijini
- I-Positron-emission tomography (i-PET scan), engabona ukuxilongwa kwe-cell metabolism okungenzeka ukuthi ingenzeka ngomdlavuza
Izinketho zokwelapha ze-Atelectasis
Ukwelashwa kwe-atelectasis kuncike ekubambeni okuyinhloko, ngenhloso yokukhulisa kabusha amaphaphu kuya esayizi yayo evamile. Izindlela zingahluka. Uma isisu sinesizathu sokuwa, ukuhlinzwa kungase kubandakanyeke.
Ukuze kusetshenziswe umfutho wezinyembezi, kungase kudingeke ukuba kusetshenziswe umsele wamanzi. Ukuvimbela kwangaphakathi, i-bronchoscopy ingasetshenziselwa ukususa into yangaphandle, kanti imishanguzo ye- bronchodilation ingasiza ngokuvulwa kwezingxenye zomoya. Ezimweni eziningi, kuzodingeka inhlanganisela yezindlela zokwelapha.
Uma izimpawu zisho, ingcindezi yokuphela-yokuphefumula (PEEP) ingasetshenziswa. Lona ukwelashwa lapho inhlanganisela yomoya-mpilo ihlinzeka ngamaski ngaphansi kwengcindezi, ukuvimbela amaphaphu ukuthi awe phansi ngokuphelele ngesikhathi sokuphuma kwamanzi. Uma izimpawu zinzima, intubation kanye ne-ventilation kungadingeka kuze kube yilapho isimo esibucayi sisebenza ngokugcwele.
Uma i-atelectasis ingapheli, kungase kube nzima ukuthola amaphaphu ukuthi aphinde awandise. Ukususwa kwengxenye eyonakele yamaphaphu (nge- lobectomy noma ukuthengiswa kwesigaba ) kungaboniswa.
Izinkinga zingase zenzeke uma amabhaktheriya eboshwe endaweni yokuwa. Lokhu kungaholela ekuthuthukiseni ukutheleleka, kuhlanganise ne-pneumonia kanye ne-sepsis. I-Bronchiectasis , ukuphakama okungavamile kwemikhumbi yomoya okuholela ekuhlanganiseni kwamanzi amaphaphu, kungase kuvele ngezinye izikhathi. Uma ingxenye enkulu yemaphaphu ithinteka yizinto, ukuhluleka kokuphefumula kungaholela.
Ukuvimbela i-Atelectasis Ngemva kokuhlinzwa
Ukuhlinza ngesifuba kubangelwa imbangela enkulu ye-atelectasis. Ukukuvimbela ukuba ingenzeki emva kwenqubo yokuhlinzeka, odokotela bazokweluleka ngokujwayelekile ukuba uyeke ukubhema kuqala nokuphambili.
Emva kokuhlinzwa, kunezinto ezintathu okufanele uqinisekise ukuqinisekisa ukuthi amaphaphu akho ahlale egcwele:
- Yenza ukuzivocavoca okujulile, ugxile ezintweni ezinamapulangwe amade nama-exhales alawulwayo. Imithi yokwelapha ingase ishiwo futhi uma ukuphefumula kungakhululekile.
- Yenza umzamo wokukhwehlela ukhiphe noma yikuphi umcubu noma isikhuphuka emaphashini.
- Shintsha isikhundla sakho, uhlezi phezulu noma uhambele cishe njengoba udokotela wakho evumela.
> Imithombo:
> Ferrando, C., Romero, C., Tusman, G. et al. "Ukunemba Kwe-Test-Air-Test-Non-Invasive-Test-Air for Testing Atelectasis Ezilwelweni Eziphephile Ngemva Kokuhlinzwa: Isifundo Sezindiza Esihlosekayo, Ukuhlola." BMJ Open . 2017 '7 (5): e015560.
> Restrepo, R., noBraverman, J. "Izinselele Zanje ZokuQaphela, Ukuvimbela Nokunakekelwa Kwe-Atelectasis YePulmonary Pulmonary." Ukubuyekezwa kobuchwepheshe bemithi yokuphefumula . 2015; 9 (1): 97-102.