Ubuhlungu Obuhlungu Okujulile: Izimpawu, Izimbangela Nokuthola Ukuxilongwa

Ukuqonda iPleuritic Chest Pain (Pleurisy)

Uma uzwa ubuhlungu ngokuphefumula, kungakhathaliseki ukuphefumula okuvamile noma uma uphefumulela kakhulu, cishe uzwa ukhathazekile. Odokotela bachaza uhlobo lobuhlungu olwenzeka ngokuthatha umoya ojulile ngokuthi "ubuhlungu besifuba se-pleuritic" noma "pleurisy." Leli gama livela kwesinye sezimbangela ezivamile zalolu buhlungu: ukucasuka kwe-pleura, izibungu ezihlanganisa amaphaphu.

Kodwa empeleni kukhona izimbangela eziningi zalolu hlobo lobuhlungu. Yiziphi ezinye zezimbangela, izimpawu zakho zingabe ziphuthumayo, futhi yiziphi izivivinyo ezingase zithole ukuthi udokotela wakho atusa ukuba ahlolisise izimpawu zakho?

Ubuhlungu Ngokuphuza Okujulile: Pleuritic Chest Pain

Njengoba kuphawuliwe ngenhla, odokotela basebenzisa inkulumo ethi "ubuhlungu besifuba se-pleuritic" ukuchaza ubuhlungu esifundeni sesifuba esenzeka ngokuphefumula. Ubuhlungu bungenzeka kuphela ngokuphefumula noma kungaba khona ngaso sonke isikhathi futhi kukhulume kakhulu uma uthatha umoya ojulile. Ubuhlungu besifuba se-Pleuritic ngokuvamile buzwa bukhali, kunokuba bukhulu noma bunzima, kodwa kukhona okuhlukile kule mithetho jikelele.

Lapho Ubuhlungu Bokuphulukisa Isimo Esiphuthumayo?

Ngaphambi kokuxoxa ngezimbangela ezibuhlungu zokuphefumula, kubalulekile ukuqaphela uma kufanele ubize u-911. Uma unesinye sezibonakaliso ezilandelayo kanye nokuphefumula okubuhlungu, ungafundi futhi ungabize ukunakekelwa kwezempilo okuphuthumayo:

• Ubuhlungu obukhulu noma obuze ngokuzumayo
• Ubunzima bokubamba umoya wakho noma ukuphefumula okukhulu
• Ubuhlungu, ukuvuvukala, noma ukubomvu kunoma yimuphi wemilenze yakho (okungaba yi-clot yegazi) kanye nobuhlungu ngokuphefumula
• Lightheadedness noma ukuphelelwa amandla
• Ukuhlanza igazi , ngisho noma imali encane (ngisho ne-isipuni ibhekwa njengesimo esiphuthumayo sezokwelapha)

• Umzwelo wesikhathi esizayo: Uma ungeke ukwazi ukuchaza ukuthi usho ukuthini kodwa uzizwe sengathi uhlangabezana nabezimo eziphuthumayo, zithembele esimeni sakho bese ushayele ucingo 911

Esinye sezimbangela ezivame kakhulu zobuhlungu besifuba se-pleuritic yi-pulmonary embolus, i-clot yegazi ephuka emilenzeni futhi ihambela emaphashini. Lokhu kuyingozi esongela ukuphila futhi kungaholela ngokushesha ekufeni uma kungalashwa. Esifundweni sika-2017 kwaphawulwa ukuthi amaphesenti angu-5 kuya ku-21 abantu abaya ekamelweni eliphuthumayo ngebuhlungu besifuba se-pleuritic bathola ukuthi bane-pulmonary embolus.

Izindlela zePleuritic Chest Pain (Ubuhlungu obuphefumulayo)

Ngaphambi kokungena ezimbangela ezibuhlungu zokuphefumula, kuyasiza ukukhuluma ngezinqubo ezingabangela lolu hlobo lobuhlungu. Ubuhlungu nokuphefumula kungenzeka ngezimiso ezithinta cishe noma yiziphi izakhiwo ezikhona esifubeni. Lokhu kufaka:

• Izimbambo
• Imithwalo, imisipha, nezinye izicubu ezithambile zesifuba
• Umgogodla we-thoracic
• Amapayipi kanye nendawo yamaphaphu
• Inhliziyo kanye nokwengamela kwenhliziyo (i-pericardium)
• Umswakama
• Isifuba

Lalela Funda Kudivayisi kuphela Kwengeziwe Buka Kufakiwe Painful Breathing vs Pleuritic Chest Pain vs Pleurisy

Uma ufunde ngokuphefumula okubuhlungu noma ukuphefumulela okubuhlungu, ungathola lesi sihloko sidideka.

Lokhu kungenxa yokuthi ukuphefumula okubuhlungu kungabizwa ngokuthi izinto eziningi ezahlukene. Igama elithi "ubuhlungu besifuba somlomo" ngokuvamile lisetshenziselwa ukuchaza noma yibuphi ubuhlungu obwenzeka ngokuphefumula. Ngokuphambene, igama pleuriy lingasetshenziswa ngezindlela ezimbalwa ezahlukene. Ngezinye izikhathi i-Pleurisy isetshenziselwa ukuchaza noma yikuphi ubuhlungu obunzima obwenzeka ngomoya ojulile, kodwa ezinye izikhathi zisetshenziselwa ukuchaza ukuvuvukala kwe -pleura , izibilini ezimbili ezigciniwe futhi zivikele amaphaphu ngesikhathi sokuphefumula. Kukhona ukudlula ekusebenziseni la magama. Isibonelo, ezinye izimo ezinjenge-pneumonia zingabangela isimo esithile se-pleurisy (ukucasuka nokuvuvukala kwe-pleura), kodwa kungabangela ubuhlungu ngokuphefumula ngenxa yezinye izindlela ezifana nezimbambo ezisilimaza noma eziphukile kanye nezinsiza zomzimba ezisuka ekukhwehleleni.

Izizathu Ezingenzeka Zobunzima Eziphefumulayo

Kunezimbangela eziningi ezibangelwa ubuhlungu ngokuphefumula okuvela ekumane nje kube yinkimbinkimbi emvelweni omkhulu kakhulu. Ezinye zezimbangela ezivame kakhulu zidiliziwe phansi ngezindlela zomzimba.

Izizathu Ezihlobene Namafutha Okuphuza Okubuhlungu

Ngesikhathi amaphaphu engenawo ama-receptor ebuhlungu, izimo zezokwelapha ezibandakanya amaphaphu zingabangela ubuhlungu ngezindlela eziningana, kuhlanganise nalabo abangela ukucasuka kwe-pleura. Ezinye zazo zihlanganisa:

• I-Pleurisy: Njengoba kuphawuliwe ngenhla, ukuvuvukala kwe-pleura, okubizwa ngokuthi "pleurisy," kuyimbangela evamile yobuhlungu ngokuphefumula. I-Pleurisy ingenzeka yedwa noma ihlotshaniswe nesinye isimo njengalezo ezibalulwe ngezansi. Kungenzeka futhi emva kokutheleleka okuphezulu kokuphefumula, futhi kubonakala sengathi kuhlala kuze kube phakade.
• Ukutheleleka nge-viral: Amagciwane ajwayelekile kakhulu angabangela ubuhlungu besifuba se-pleuritic afaka igciwane le-Coxsackie, igciwane lesifo sokuphefumula (RSV), umkhuhlane, i-parainfluenza, izimpumputhe, i-adenovirus, i-cytomegalovirus (CMV), ne-Epstein Barr virus (ebangele i-mononucleosis).
• I-pneumonia : Izifo emaphashini, ikakhulukazi lezo ezingaphandle ezingaphazameni eduze kwe-pleural lining, zingabangela ubuhlungu ngokuphefumula.
• Umdlavuza we-Lung : Kucatshangwa ukuthi cishe isigamu sabantu abathintekayo abanomdlavuza wamaphaphu babe nobuhlungu endaweni ethile esifundeni esifubeni ngesikhathi sokuxilongwa. Akuvamile ukuthi lobu buhlungu buguqulwe ngokuphefumula, ikakhulukazi uma isisu sisendaweni yangaphandle yamapayipi eduze kwe-pleura. Njengamanje, uhlobo oluvame kakhulu lomdlavuza wamaphaphu, i- lung adenocarcinoma , livame ukukhula emaphethelweni emaphaphu eduze kwe-pleura. Lona uhlobo lomdlavuza wamaphaphu ovame kakhulu kubantu abangakaze babhemise, besifazane nabasemusha abanomdlavuza wamaphaphu.
• Isifo sofuba (i-TB): I-TB yimbangela engavamile kakhulu yobuhlungu ngokuphefumula e-United States, kodwa iyimbangela evamile kakhulu emhlabeni jikelele.
• Ama-pleural effusions: Amaqoqo e-Fluid emkhatsini wezingxenye ze-pleura, okubhekwa njengama-pleural effusions, iyimbangela evamile yobuhlungu ngokuphefumula. Kodwa-ke, njengoba nje ubuhlungu bokuphefumula kuyisimpawu esingavamile, izimpikiswano zomsindo zingahlobene nanoma yiliphi inani lezifo, kusukela ezifweni zamaphaphu kanye nesifo senhliziyo ezibhekene nezimo ezizimele njenge-arthritis ye-rheumatoid, nomdlavuza. Ukusetshenziswa kwamabizo angalungile kuyimithombo yamangqamuzana equkethe amangqamuzana omdlavuza. Lezi zingase zenzeke kubantu abanomdlavuza wamaphaphu, umdlavuza webele, kanye nezinye izinhlobo zomdlavuza ezasakazeka emaphashini.
• I-Pneumothorax : I-pneumothorax ukuwa kweyingxenye noma yonke yamaphaphu. Ukuwa kungase kube mncane kakhulu futhi kungabonakali, noma kungase kube mkhulu futhi kungabangeli ubuhlungu obukhulu ngokuphefumula kodwa nokuphefumula okunzima kakhulu ngisho nokuphefumula okuncane komzimba, isimo lapho isikhumba sesifuba sinomuzwa wokuthi ukugoqa ukubhoboza ngenxa yokuphunyuka umoya kusuka emaphashini. I-pneumothorax ingase ibe yinkimbinkimbi ye-emphysema, ezinye izifo zamaphaphu, noma ukuhlukunyezwa, noma kungenzeka ngokuzenzakalelayo kubantu abadala abadala abanempilo.
• I-pulmonary embolus : Isimo esingasongela ukuphila, imithi ye-pulmonary emboli yenzeke lapho ama-clots ephuka emithanjeni yemilenze (i- vein thrombosis ejulile ) futhi ehamba emapapheni. Njenge-pneumothorax, izimpawu zingabuka ukusuka ekungenani kuya kwesibindi, futhi lesi simo yisimo esiphuthumayo sezokwelapha. Izingozi ze-pulboary emboli zihlanganisa ukuhlinzeka kwamuva, izifo eziningi ezingapheli, ukukhulelwa, nokuhamba ibanga elide ngemoto noma indiza. Njengoba kuphawuliwe ngenhla, i-pulmonary embolus iyatholakala ngokuvamile kubantu abaya ekamelweni eliphuthumayo ngezinhlungu zesifuba se-pleuritic.
• I-Mesothelioma : I-Mesothelioma ingumdlavuza ovela ku-pleura futhi ivame kakhulu kubantu abaye babhekana ne-asbestos emsebenzini.

Izizathu Ezihlobene Nenhliziyo Yokuphuza Okubuhlungu

Njengoba inhliziyo iseduze namapapu (kanye nokukhala) futhi ihamba ngokuphefumula, izimo zenhliziyo zingabangela ubuhlungu ngokuphefumula. Ezinye izimo ezihlobene nenhliziyo ezibangelwa ubuhlungu besifuba se-pleuritic zifaka:

• I-Pericarditis : I-Pericarditis ibhekisela ukuvuvukala kwezingqimba ezihlanganisa inhliziyo (i-pericardidium) efana nalabo abakha amaphaphu. I-Pericarditis inezimbangela eziningi ezihlanganisa izifo, umdlavuza (umdlavuza ovame kakhulu umaphaphu nomdlavuza wesifuba), izimo ezizenzakalelayo ezifana ne-lupus, nesifo sezinso. Abantu abangamaphesenti angu-15 abanesifo senhliziyo bahlakulela i-pericarditis.
• Ukuhlaselwa kwenhliziyo: Ngokuvamile, ubuhlungu obuhambisana nokuhlaselwa kwenhliziyo akuhlobene nokuphefumula, kodwa ukwanda kwezinhlungu ngokuphefumula okungase kwenzeke, ikakhulukazi uma ukuhlasela kwenhliziyo kuhambisana ne-pericarditis njengoba kuphawuliwe ngenhla.
• Ukuhlukaniswa kwe-aortic: Ukusabalalisa kwe-aortic yisimo lapho ukwehlisa amandla e-aorta kuvumela igazi ukuba lichithele emgodini "lihlukanise" i-lining yangaphakathi ye-aorta, futhi kuyinto ephuthumayo yezokwelapha. Ngokuvamile kubangela uhlobo olunzima, oluqhaqhayo lobuhlungu olungase lubonakale esifubeni nasemhlane. Ngokuvamile kwenzeka kubantu abaneMarfan syndrome, amadoda avame ukude kakhulu futhi asele.
• Umfutho wegazi ophezulu we-pulmonary : I-pulmonary hypertension yisimo esibucayi lapho umshini wegazi emthonjeni we-pulmonary uphakanyisiwe. (Ihluke kunomfutho wegazi ophakeme abantu abaningi abajwayele futhi uthola ukuthi une-echocardiogram kune-cuff pressure yegazi.) Umthambo we-pulmonary unesibopho sokuthwala igazi kusuka enhliziyweni emaphashini ukuyokhipha umoya-mpilo. I-pulperary hypertension ingase ibangelwe izimo eziningana ezihlanganisa isifo senhliziyo, isifo samaphaphu, ukuphazamiseka kwezicubu, kanye nemithi ethile.

Izizathu Ze-Musculoskeletal of Breining Breathing

Izimo ezibandakanya noma yiziphi izibhamu noma izisindo ezithambile esifubeni zingabangela ubuhlungu obwenzeka noma bubi nakakhulu ngokuphefumula. Ezinye zazo zihlanganisa:

• I-Rib fractures: Ukuqhuma kombambo njengesibangela sobuhlungu ngokuphefumula kuvame ukusobala, kodwa ngezinye izikhathi lezi zintambo zingase zenzeke ngokukhwehlela noma ngokucindezeleka okuncane kubantu abane-osteoporosis. Ukuphazamiseka komdlandla , ukulimala ngokweqile, noma kunjalo, kungenzeka ukuthi akusobala. Ubuhlungu bokucindezeleka kokucindezeleka kokuvuthwa kaningi buya kancane kancane futhi bubi kakhulu ngokuphefumula okukhulu nangokukhwehlela.
• I-Costochondritis ne-Tietze syndrome : I-Costochondritis ne-Tietze syndrome yizimo ezibandakanya ukuvuvukala kwesifunda lapho izimbambo zihlangana khona kanye / noma lapho izimbambo zihlangana ne-sternum (isifuba). Nge-costochondritis, kungenzeka kube nokuvuvukala kwalesi sifunda, kanti nge-Tietze syndrome ayikho. Ubuhlungu besifuba obuhambisana nalezi zimo kaningi bephutha ngokuhlaselwa yinhliziyo. Kusukela izimbambo, ngakho-ke izimbambo zomhlanga zihamba nomoya ngamunye, ubuhlungu buvame ukuhlobene nokuphefumula, ikakhulukazi ukuthatha umoya ojulile.

Ezinye Izizathu Ezingenzeka Zokuphefumula Okubuhlungu

• Ama-shingles : Uma igciwane le-inkukhu "livuselela" ekusatshalaliswa kwezinzwa ezihlinzeka esifubeni, kungaholela ebuhlungu besifuba futhi-kuye ngokuthi indawo-ubuhlungu bungashintsha ngokuphefumula. Nakuba izibungu ngokuvamile zihilela ukuqhuma, ubuhlungu ngokuvamile buyandulela ukuqhuma ngezinsuku ezimbalwa, okwenza ukuthi ukuxilongwa kungaqiniseki ekuqaleni.
• I-reflux ye-acid : Ubuhlungu obwenzeka ngenxa yesifo se-reflux ye-gastroesophageal (GERD) akuvame ukuhlotshaniswa nokuphefumula, kodwa kungase kube nzima ngokuphefumula okujulile.

Izimpawu Ezihlanganisiwe

Kunezimbonakaliso eziningana ezingase zenzeke kanye nokuphefumula okubuhlungu okungakusiza wena nodokotela wakho ukucacisa imbangela yobuhlungu bakho. Ezinye zazo zihlanganisa:

• Ukukhwehlela, kungaba ukukhwehlela okukhulu noma ukukhwehlela okuqhubekayo
• Ezinye izinhlobo zobuhlungu obuvela ebuhlungu besifuba, ukuhlunga ubuhlungu, ukuthwala ubuhlungu bezinhlungu , nokubuhlungu emuva
• Ukuphelelwa umoya
• Ukushaya igazi
• Ukuthuthumela
• Ukushisa
• Ukulahlekelwa kwesisindo okungenalutho

Imibuzo UDokotela Wakho Ungakubuza

Ngaphandle kokubuza mayelana nezindlela ezikhona ezingenhla, udokotela wakho cishe uzokubuza:

• Ingabe wena, noma uke wabhekana na?
• Uke waba nokulimala noma ukulimala, kuhlanganise ngisho nokuhlukunyezwa okuncane?
• Uke waba nesifo sokuphefumula njengomkhuhlane noma umkhuhlane?
• Izimpawu zaqala nini, futhi zenzeke isikhathi esingakanani?
• Uke wabhekana nezimpawu ezifanayo esikhathini esidlule?
• Yiziphi ezinye izinkinga zempilo onayo?
• Iziphi izimo zezokwelapha ezigijima emndenini wakho?
• Usuqale uhlelo olusha lokuzivocavoca, noma wenza noma yikuphi umsebenzi ongokwenyama ongase ubeke ubunzima emisipha nezinye izakhiwo esifubeni sakho?
• Ingabe lezi zimpawu zenzeka ngaso sonke isikhathi, noma ngezikhathi ezithile, njengokungena ngaphandle uma kubanda?

Uvivinya Udokotela Wakho May Order

Kuye ngezibonakaliso zakho, kunezivivinyo eziningi ezihlukahlukene udokotela wakho angancoma. Lokhu kufaka:

• I-x-ray yesifuba: Gcina engqondweni ukuthi i-x-ray yesifuba ingasiza ekutholeni isimo, kodwa asikwazi ukukhipha isimo. Isibonelo, i-pulmonary embolus noma umdlavuza wamaphaphu ingaba khona naphezu kwesifo esijwayelekile se-x-ray. Eqinisweni, amancane amaphasitiki amaphaphu avame ukuphulwa kwi-x-ray futhi engatholakali aze afinyelele esiteji uma engasaphuluki. I-pulmonary embolus engabanjwanga nayo ingathí sina, futhi ingaba yingozi uma ingatholakali ngokushesha.
• I-Rib x-ray.
• Ukuskena kwe-Ventilation-perfusion: Lokhu kuvivinywa okwenziwe ukufuna ubufakazi bokubumbana kwe-pulmonary.
• I-Chest CT scan: I-CT scan ingasetshenziswa ukuhlola izimo eziningana ezihambisana nesifuba. Kungenziwa futhi, ukuze uthole umbono onembile wezintambo nezakhiwo zebony esifubeni.
• I-CT engiography.
• I-Electrocardiogram (EKG)
• I-Echocardiogram: I-echocardiogram (ukuvivinya kwe-ultrasound yenhliziyo yakho) ingenziwa ukuze ubukeke ukuvuvukala noma uketshezi emagqumeni afaka inhliziyo (i-pericarditis noma i-pericardial effusion).
• I-Oximetry: I-oximetry wuhlolo olusetshenziselwa ukukala izinga le-oxygen egazini lakho. Ngezinye izikhathi kunganika izikhombisi ezimweni zephaphu noma zenhliziyo ezingaphansi.
• Ukuhlolwa kokusebenza kwamapulmonary.
• Ukuhlolwa kwe-D-dimer.

Ukwelashwa Kokuphuza Okubuhlungu

Izinketho zokwelashwa zokuphefumula okubuhlungu zizoxhomeka esibangweni esithile. Kubalulekile ukulalela umzimba wakho uma uzwa ubuhlungu besifuba se-pleuritic, futhi "ungafihli" izimpawu zakho ngokusebenzisa imithi yobuhlungu uze uhlole ngokucophelela.

Ngezansi Ngezinhlungu Nge-Breathing

Njengoba kuphawuliwe ngenhla, kunezimbangela eziningi ezingabangela ukuphefumula noma ubuhlungu obunzima ngokuphefumula okujulile okuvela kulabo okuyizinto eziyinkimbinkimbi kulabo abasongela impilo. Kubalulekile ukukhumbula ukuthi ubuhlungu buyisignali emzimbeni wethu ositshela ukuthi kukhona okungalungile. Kungaba ukukhathazeka uma ungatholi ukuxilongwa ngokushesha, njengoba kwenzeka kaningi ngobuhlungu obufana nalokhu, kodwa uqhubeke ukhuluma nodokotela wakho uze uphendule. Cela ukuhanjiswa kumchwepheshe noma uthole umbono wesibili uma ungenayo incazelo ecacile yokungazi kahle kwakho. Okuyiqiniso ngokuphefumula okubuhlungu kuyinto yanoma yisiphi isimo sezokwelapha-kubalulekile ukuba ngummeli wakho ekunakekelweni kwezempilo ukuze uhlale uphilile.

> Imithombo:

> Berchuck, J., noS S. Patel. I-Etiology Engajwayele Ukunqotshwa Kwe-Pleuritic Chest Pain. I-Journal of General Medicine Internal . 2016. 31 (1): 138.

> Jany, B. Pulmonary Izimbangela zezinhlungu zesifuba. I-Internist . 2017. 58 (1): 22-28.

> Reamy, B., Williams, P., noMnu Odom. I-Pleuritic Chest Pain: Ukuhlunga Nge-Diagnosis Ehlukile. I-American Family Physician . 2017. 96 (5): 306-312.

> Yan, G., Littlewood, A., noM M. Latimer. Imbangela engavamile yePleuritic Chest Pain Ingane. Imibiko ye-BMJ Case . 2016. pii: bcr2016217307.