I-edema yepulmonary yisimo sezokwelapha esibangelwa uketshezi okweqile emasakeni emoyeni wamaphaphu (i- alveoli ). Ngenxa yokuthi i-alveoli egcwele amanzi ayikwazi ukusebenza ngendlela evamile, i-edema ye-pulmonary ngokuvamile iveza ubunzima obunzima bokuphefumula, futhi ingase ibe yinkinga esongela ukuphila.
Okwenza i-Edema yePulmonary iyinkinga
I-alveoli yilapho umsebenzi wangempela wemaphaphu kwenzeka khona.
Emagodini e-alveolar air, umoya omusha esiwuphefumulayo usondela eduze kwamapillari aphethe igazi le-oksijeni-elibi emathanjeni omzimba. (Leli gesi elimpofu e-oksijeni selivele lishaywe kusuka ngakwesokunene senhliziyo kuya emaphashini, nge-arteriary artery. Nansi okwengeziwe ngokuthi inhliziyo isebenza kanjani .)
Ngezindonga ezincane ze-alveoli, ukuhwebelana kwegesi okubucayi kwenzeka phakathi kwomoya ngaphakathi kwesikhwama se-alveolar kanye negazi "elichitha" ngaphakathi kwama-capillaries. I-oksijeni evela e-alveoli ithathwa yigazi le-capillary, futhi i-carbon dioxide egazini ihluke ibe yi-alveoli. Igazi, manje elicebile okhijeni, libuye lithathwe ngakwesobunxele senhliziyo, eliyiphakamisela izicubu. I-"allyolar" esetshenziswa "emoyeni" idluliselwa emkhathini, njengoba siphefumula.
Ukuphila ngokwabo kuxhomeke ekushintsheni okuphumelelayo kwegazi ngaphakathi kwe-alveoli.
Nge-edema ye-pulmonary, amanye amasaka e-alveolar agcwala uketshezi.
Ukushintshaniswa okubucayi kwe-air inhaled negazi le-capillary angeke kwenzeke ku-alveoli egcwele amanzi. Uma izinamba ezanele ze-alveoli zithinteka, izimpawu zenzeka. Futhi uma i-edema ye-pulmonary iba nkulu, ukufa kungacabangela.
Izimpawu zePulmonary Edema
I-edema yepulmonary ingase ivele kahle, lapho kwenzeka khona ngokuvamile kubangelwa i- dyspnea enamandla (ukuphefumula okuncane), kanye nokukhwehlela (okuyinto evame ukuveza i-pink, sputum), futhi iqhume.
I-edema ye-pulmonary engazelelwe ingase ihambisane nokukhathazeka ngokweqile, kanye ne-palpitations. I-edema ye-pulmona eqala ngokungazelelwe ijwayele ukubizwa ngokuthi "i-flash pulmonary edema," futhi ngokuvamile ibonisa ukuqhuma okungazelelwe kwenkinga yangaphakathi yenhliziyo. Isibonelo, i-coronary syndrome enamandla ingenza i-edema ye-flash pulmonary, njengoba nayo ingabangela ukucindezeleka okukhulu kokucindezeleka .
I-edema ye-pulmonary evamile ihlale ephuthumayo kwezokwelapha, futhi ingaba yingozi.
I-edema ye-pulmonary engapheli, evame ukubonakala ngokuhluleka kwenhliziyo , ivame ukudala izimpawu zokwehla nokuxuba ngokuhamba kwesikhashana, njengoba kuphazamiseka kakhulu noma ngaphezulu kwe-alveoli. Izimpawu ezijwayelekile ziyi-dyspnea ngokuzikhandla, i- orthopnea (ukuphefumula ukuphefumula ngenkathi ilele phansi), i- paroxysmal nocturnal dyspnea (ukuvuka ebusuku ukuphefumula), ukukhathala, i-edema yomlenze (ukuvuvukala), nokuzuza kwesisindo (ngenxa yokubuthelwa kwamanzi).
Yini Ebangelwa I-Edema YamaPulmonary?
Odokotela bavame ukuhlukanisa i-edema yamapulmomu ibe yinye yezinhlobo ezimbili: i-edema yamapayipi yenhliziyo, ne-edema engeyona ye-cardiac pulmonary.
I-Cardiac Pulmonary Edema
Isifo senhliziyo yisisusa esivame kakhulu se-edema ye-pulmona. I-edema ye-cardia ye-cardiac kwenzeka ngoba inkinga yenhliziyo engaphansi idala izingcindezi ngakwesokunxele senhliziyo ukuba iphakanyiswe. Le ngcindezi ephakeme idluliselwa emuva emuva, ngokusebenzisa imithanguzo ye-pulmonary, kuma-capillary alveolar.
Ngenxa yomshoshaphansi we-capillary we-pulmonary, uketshezi kuphuma kuma-capillary ukuya endaweni yomoya emoyeni, futhi i-edema yamapulmoni ivela.
Cishe noma yiluphi uhlobo lwesifo senhliziyo lungagcina luholele ekucindezelweni kwenhliziyo ephakeme kwesokunxele, futhi ngaleyo ndlela, ku-edema ye-pulmonary. Izinhlobo ezivame kakhulu zesifo senhliziyo ezibangela i-edema ye-pulmonary yizona:
- i-coronary artery disease (i-CAD)
- ukuhluleka kwenhliziyo kunoma yisiphi isizathu
- izifo ze-valve yenhliziyo, ikakhulukazi i- mitral stenosis , i- mitral regurgitation , i- aortic stenosis , noma i- aortic yokuphindaphinda
- ukucindezeleka okukhulu
Njengoba i-edema ye-pulmary cardiac engapheli, izingcindezi eziphakeme ngaphakathi kwamapillazi angagcina zenze izinguquko zenzeke emithanjeni yepulmonary.
Ngenxa yalokho, umthamo we-pulmonary high ingase ivele, isimo esibizwa nge- pulmonary hypertension . Uma ohlangothini olungakwesokudla senhliziyo kufanele uphepule igazi ngokumelene nalokhu okucindezela komthamo we-pulmonary ephakeme, ukwehluleka kwenhliziyo kwesokudla kungagcina kuthuthuke.
I-Non-Cardiac Pulmonary Edema
Ku-edema engeyona-cardiac pulmonary, uketsheziza kugcwalisa i-alveoli ngezizathu ezingahambisani nokucindezela kwenhliziyo ephakeme. Lokhu kungenzeka uma ama-capillari emaphashini abhidlizwa kwesinye isifo esingenayo inhliziyo. Ngenxa yalokho, ama-capillaries abe "aphukile," futhi aqala ukuvuza amanzi e-alveoli.
Isizathu esivame kakhulu se-edema ye-pulmary non-cardiaac is a acute respiratory syndrome (ARDS) , okubangelwa ukuvuvukala okungafani emaphashini. Lokhu kuvutha kulimaza izindonga ze-alveolar, futhi kuvumela uketshezi ukuthi kuqoqwe. I-ARD ijwayele ukubonwa kweziguli ezigula kakhulu, futhi ingabangelwa ukutheleleka, ukushaqeka, ukuhlukunyezwa, neminye imibandela eminingi.
Ngaphezu kwe-ARDS, i-edema engeyona ye-cardiac yamapayipi ingabuye ikhiqizwe ngu:
- Ukubumbana kwamapulmonary
- Ukugula okuphakeme kakhulu
- Izidakamizwa (ikakhulukazi i-heroin ne-cocaine)
- Ukutheleleka ngegciwane
- Amakhomikhali (isibonelo, ukuvuselela i-chlorine noma i-ammonia)
- Izinkinga ze-neurologic (ezifana nokuhlukunyezwa kwengqondo noma ukucwiliswa kwe-subarachnoid )
- Smoke inhalation
- Eduze ukugwinya
Ukubona i-Pulmonary Edema
Ukwenza ngokushesha ukuxilongwa kwe-edema ye-pulmona kubalulekile; futhi okubaluleke nakakhulu ukuxilonga kahle isizathu esiyimbangela.
Ukubona i-edema yamaphayiphu ivame ukufezwa ngokushesha ngokukwenza ukuhlolwa ngokomzimba, ukulinganisa amazinga e-oksijeni wegazi, nokwenza i-x-ray yesifuba.
Uma i-edema yamapulmeni isitholiwe, izinyathelo kufanele zithathwe ngokushesha ukuze zibone imbangela eyimbangela. Umlando wezokwelapha ubaluleke kakhulu kulo mzamo, ikakhulukazi uma kunomlando wezinhliziyo zenhliziyo (noma ukwanda kwengozi yomzimba), ukusetshenziswa kwezidakamizwa, ukuvezwa kwezidakamizwa noma ukutheleleka, noma izimbangela zokubeka ingozi ye-pulmonary embolus.
I- electrocardiogram kanye ne- echocardiogram ngokuvamile bayasiza kakhulu ekutholeni isifo senhliziyo esingaphansi. Uma isifo senhliziyo sisolwa kodwa asikwazi ukuboniswa ngokuhlolwa okungenasidingo, kungase kudingeke ukuthi i- catheterization yomzimba ingadingekile. Okunye okunye ukuhlola kungadingeka uma imbangela engeyona ye-cardiac isolwa.
I-edema ye-pulmary non-cardiac iyatholakala uma i-edema yamaphamitha ikhona lapho kungekho khona ukucindezeleka kwenhliziyo kwesokunxele.
Ukwelashwa kwe-Edmonary Edema
Imigomo esheshayo ekwelapheni i-edema ye-pulmona yukunciphisa ukwakhiwa kwamanzi emaphashini nokubuyisela amazinga e-oksijeni egazi ngokujwayelekile. Ukwelapha i-oksijeni cishe njalo kunikelwa ngokushesha. Uma izibonakaliso zehluleka kwenhliziyo zikhona, ama-diuretics anikezwa kahle. Imithi ehlanza igazi izitsha, njenge- nitrate , ivame ukusetshenziselwa ukunciphisa izingcindezi ngaphakathi kwenhliziyo.
Uma amazinga e-oksijeni egazi ehlala ephansi ngokweqile naphezu kwezinyathelo ezinjalo, kungenziwa isidingo sokuphuza umoya. I-ventilation yemishini ingasetshenziselwa ukwandisa ingcindezi ngaphakathi kwe-alveoli, futhi idlulisele enye ye-fluid eqoqwe emuva kuma-capillaries.
Kodwa-ke, Ukwelashwa okuphezulu kwe-edema ye-pulmonary - kungakhathaliseki ukuthi kungenxa yesifo senhliziyo noma imbangela engeyona inhliziyo - kudinga ukukhomba nokwelapha inkinga yezokwelapha engaphansi.
Imithombo:
Ware LB, Matthay MA. Umkhuba wokwelapha. I-edema ye-pulmonary evamile. N Engl J Med 2005; 353: 2788.
I-Weintraub NL, i-Collins SP, i-Pang PS, ne-al. I-syndromes ye-heart failure eyiphutha: isethulo seminyango esiphuthumayo, ukwelashwa, nesimo sengqondo: izindlela zamanje nezinhloso ezizayo: isitatimende sesayensi se-American Heart Association. Ukujikeleza ngo-2010; 122: 1975.