I-Anatomy neSebenzi ye-Pleural Fluid nokungajwayelekile
Uma udokotela wakho ekushilo ukuthi une-build-up ye-pleural fluid noma ukutheleleka okubandakanya isikhala sakho somlomo, kusho ukuthini lokho?
Iyini i-Pleural Fluid?
I-Pleural fluid yilezi zitshalo ezitholakala phakathi kwezingxenye ze- pleura , izibilini zazo ezihlanganisa umgudu futhi zizungeze amaphaphu. Isikhala esine-fluid sibhekwa njengesikhala somlomo noma isikhala somlomo.
I-pleural fluid ejwayelekile iqukethe inani elincane lomswakama omncane (serous) osebenza njenge-lubricant ngesikhathi sokuphefumula.
Izinguquko kumthamo we-pleural fluid zingabangelwa ukutheleleka, ukuhlukunyezwa, noma ezinye izimbangela futhi zingaholela ezinkingeni zokuphefumula nezinye izimo ezimbi. Ukukhishwa kwe-fluural fluid kusivumela ukuba sihlolisise izimbangela zalezi zinguquko noma ukuphenya ngezinpawu zokutheleleka noma izifo. Lapho inani elikhulu lomsindo wesikhalazo
Umsebenzi we-Pleural Fluid
I-Pleural fluid iyinhlangano yamanzi amancane amancane agcwalisa umgudu phakathi kwezingxenye zangaphakathi (outer) kanye ne-visceral (ngaphakathi) izikhala ezizungezile amaphaphu. Umthamo wetshezi uyingcosana, cishe ama-ccs angu-20 noma amathisipuni amane.
Imisebenzi ye-flule ye-pleural ngokugcoba isikhala phakathi kwe-pleura, okuvumela ukuba i-pleura ihambe kahle ngokuphuza nokuphumula. Ngale ndlela, ithokoza izicubu ezinomphunga zamaphaphu ngokumelene nokungezwani kwezimbambo kanye nodonga lwesikhumba ngokwayo.
Izimo ezibandakanya i-Pleural Cavity
Kunezimo eziningana ezingaba nomthelela emgodini we-pleural futhi, ngokuzenzakalelayo, i-pleural fluid. Phakathi kwazo:
- Ukususwa kwe-Pleural yisimo lapho uketshezi oludlulayo luhlanganisa khona isikhala esiphezulu. Kunezimbangela eziningi zokwenza izinyathelo zomzwelo, kuhlanganise nokuhluleka kwenhliziyo, ukungena kwe-pulmonary, izimo zezinso, umdlavuza, nezifo ezizimele njenge-lupus kanye ne-rheumatoid arthritis. Abantu abangaphezu kuka-200 000 base-US bathinteka ngokunyakaza kwamacala ngonyaka ngamunye.
- Ngesikhathi umuthi wetshezi uqukethe amangqamuzana omdlavuza, kubizwa ngokuthi i- effusion ebulalayo yesikhala . Nakuba lokhu kwenzeka kaningi ngesikhathi somdlavuza wamaphaphu wesigaba 4, kungase kwenzeke nezinye izifo zomdlavuza eziye zasakazeka (ezifakwe emzimbeni) ezivela kwezinye izingxenye zomzimba, kuhlanganise nesifuba nama-ovari.
Izimpawu nokuxilongwa kwezifo eziphuthumayo
Uma uketshezi kuphakama endaweni yesikhala, kunganciphisa amaphaphu angaphansi. Lokhu nakho kungabangela ukuphefumula, ubuhlungu besifuba, nezinye izimpawu zokucindezeleka ukuphefumula.
Ukuphenya, udokotela uzokhipha i-pleural fluid ngokusebenzisa inqubo ejwayelekile:
- I-Thoracentesis (ebizwa nangokuthi i-aspiration aspiration) ihlunga u-pleural fluid ngokufaka inaliti ngaphakathi kwesikhala esiphezulu, isampula sayo singabuye sihlaziywe ebhodini.
Phezu kokukhipha kwamanzi, amasampula angahlolwa ukuze aqinise izimbangela zanoma yiziphi izinguquko noma ukuqinisekisa ukuthi kukhona ukutheleleka noma isifo. Izindlela ezimbili eziyinhloko zokuhlaziya zihlanganisa:
- Ukuhlaziywa kwamanzi amancane kuyinkqubo lapho umthamo otholakala khona nge-thoracentesis uhlolwa kokubili ukuhambisana nokunye okufana namaprotheni. Kunezinhlobo ezimbili eziyinhloko zoketshezi olunamanzi ezitholakalayo emithonjeni ye-pleural. Enye ingu-transudate, okuyisimiso esincane esicacile, esivamile esivame ukubonwa ngokuhluleka kwenhliziyo. Enye i-exudate, i-thicker, i-pus-like fluid etholakala njalo ngesikhathi sokutheleleka.
- I- cytology ye- pleural iyinqubo ehlose ukubona ukuthi kukhona amaseli amhlophe egazi amhlophe (okukhona kwabo okungabonisa ukutheleleka), amabhaktheriya (ukusebenzisa i- gram stain ), nezinye izinto ezingafanele zibe khona. Uma ukutheleleka kusolwa, lo mfula uzobe uhlonywe ukuze uhlonze i-agent ephathekayo.
Ukwelashwa kwezifo ezibuhlungu ze-Pleural Fluid
Uma uketshezi oluningi lwe-pleural luhlanganisa isikhala esiphezulu, kungabangela ukwanda okuphefumulayo, ubuhlungu besifuba (ngokuvamile ukuwohloka ngokuphefumula okujulile,) futhi ekugcineni kungacindezela inhliziyo eholela ekuhlulekeni kwenhliziyo.
Ukuze ususe umkhuhlane, ithobhu yesifuba ivame ukufakwa.
Ukubekwa kwe-tube ye-Chest kuhilela ukufaka ithubhu eguquguqukayo ibe isikhala esiphezulu. Ithebhu ingase ishiywe endaweni ukukhipha uketshezi okwedlulele, igazi, noma umoya oqoqiwe. Kungagcinwa endaweni yokuhlukahluka kwesikhathi kuye ngokuthi isimo noma imbangela.
Ngezinye izikhathi, uketshezi oluqhubekayo luqhubeka lubuthelela, okwenze kube nzima ukususa ithubhu yesifuba. Kunezinqubo ezimbalwa ezingenziwa uma lokhu kwenzeka. Ku- pleurodesis , izingxube ezimbili ze-pleura ziyaphoqeleka ukuba zihambisane komunye nomunye ngokufaka injini yamakhemikhali (njenge-talc) endaweni yesikhalazo. Lokhu kudala ukuvuvukala futhi ekugcineni kukhishwe okuhlanganisa ukufaka izingxenye zombili we-pleura ndawonye, ukuqeda isikhala sokukhala.
Enye indlela ukubeka i-stent engxenyeni yesikhala esixhunywe ngaphandle komzimba. I-fluid ingahoxiswa ngezikhathi ezithile, ngisho nasenduduzo yendlu yakho. Lokhu kwenziwa njalo kaningi ukuze kusetshenziswe umfutho wekhanda elihambelana nomdlavuza ophakeme.
Okokugcina, i- pleurectomy ingenziwa. Kule nqubo izinambuzane ezinamanzi ziyasuswa, zisuse ngokuphumelelayo isikhala sokukhala.
> Imithombo
- > Society of American of Clinical Oncology. "Umkhuhlane Emagqumeni Emvelo noma Ukulimala Okubi Okumangalisayo." I-Alexandria, eVirginia; Agasti 2016.
- > Dixon, G .; de Fonseka, D .; no-N. Maskell. "Izimpikiswano ze-Pleural: > image-guided > biopsy vs. thoracoscopy for non-sensural effusions?" Journal of Thoracic Disease . 2015; 7 (6): 1041-51.
- > I-Library Kazwelonke Kazwelonke Yezokwelapha. "Ukuhlaziywa kwe-Pleural Fluid." I- MedlinePlus. > Bethesda >, Maryland; Kubuyekezwe ngo-11/19/15.