Kana iwe wakamboudzwa iwe une empyema, zvinorevei? Ndezvipi zvinokonzera chiitiko ichi uye ndiani ari pangozi? Ndezvipi zvirongwa zvokurapa zviripo uye chii chaunofunga?
Tsanangudzo
An empyema inounganidza pus pakati pezvikamu zviviri zvezviviri ( pleura ) iyo inongedza mapapupa. An empyema kazhinji inowanzoita sechinhu chinokonzera pneumonia, kusaputika kwemapapu, kana chifuva chemafupa.
Anatomy
Nzvimbo yepuresi kana nzvimbo yakagadzikana inzvimbo iri muchifuva chiri pakati pe "visceral pleura" (membrane iri kunze kwemapapu) uye parietal pleura (iyo membrane iri kuvhara mukati memadziro echifuva) Kazhinji, nzvimbo ino ine Pane mashupuni mashoma ekuderera kwemvura . Nzvimbo yepyema, nzvimbo iyi inogona kunge ine pint kana kuti yakawanda yechirwere chechirwere chechirwere.
Empyema Fluid
Mvura inenge iri mune empyema inonzi inonzi pus uye inosanganiswa mabhakitiriya, masero akafa, uye masero machena eropa. Bhakitiriya yakawanda kwazvo inokonzera empyema ndeye Streptococcus pneumoniae ("pneumonia" mabhakitiriya) uye Staphylococcus aureus .
Kana muenzaniso wekuchema mutsva ukasvibiswa, mazhenje uye maitiro akaoma epa empyema kazhinji anonyatsojeka mukusiyana kwaanoita nenzira yakasiyana-siyana yemvura yakawanda iyo inopenya uye inopera.
Zviratidzo nezviratidzo
Zviratidzo zvakabatana ne empyema zvinogona kukonzerwa nekuvapo kwehutachiona uye nekudzvinyirira pamapapu nepfupa kubva pakuwedzera kwemvura mukati mekunyengeterera nzvimbo. Zviratidzo nezviratidzo zvinowanzobatanidza:
- Fever uye chills
- Usiku hwekukutura: Izvi zvinogona kuva zvakakosha nekudonhedzera kutuka usiku hunoda kuchinja kweusiku mbatya
- Kuchepa kwepfupa, kazhinji kwakapinza uye kunowedzera nekufuridzirwa
- Kuratidzira kufema: Kuoma kufema kunogona kuuya zvishoma nezvishoma kana nokukurumidza zvichienderana nehukuru hwekuvhiringidza uye kuoma kwemamiriro ezvinhu epasi
- Kufuridza kwakakomba: Kukwezera kunogonawo kubereka nekuda kwekubatana kwepneumonia
- Hiccups: Kushungurudzika kwemafupa nemishu munharaunda ino nekuda kwekuvakwa kwemvura kunogona kukonzera huccups
- Kurasikirwa kweuviri
- Kuneta
- Muitiro mukuru wekusapora
Zvinokonzera
Kune huwandu hwemamiriro ezvinhu akasiyana-siyana angaita kuti uwane empyema. Zvimwe zvezvi zvinosanganisira:
- Pneumonia (Ichi ndicho chikonzero chinowanzoitika chepyema.)
- Chest trauma.
- Kuvhiyiwa kwechifuva, zvakadai seyayo yemukenza wemapapu.
- Iro thoracentesis: Dzimwe nguva utachiona hunogona kukonzerwa zvisingazivikanwi kana thoracentesis (tsono "pombi" ye pleural space) yakaitwa kuti iongorore zvirwere kana kana chikwata chechipfuva chiiswa panzvimbo yekudhonza (sezvinonzi pneumothorax) kana mvura (semu pleural effusion.)
- Inga fistula yegonchoplela: A fonchotula inonzi bronchopleural inonzi fistula kana mukanini inogona kukura pakati pezvinyorwa nzvimbo uye bronchi panguva yekuvhiyiwa kwemapapu, zvichibvumira mabhakitiriya kuti adzoke kubva kubronchi kusvika kune nzvimbo inoderera.)
- Kuwedzerwa kwehutachiona: Utachiona mudumbu (peritonitis) kana nzvimbo pakati pemapapu (mediastinitis) inogona kupararira munzvimbo inoderera.
- Chifukidzo chemapapu chinogona kuputika munzvimbo inenge iripo.
Risk Factors
An empyema inowanzoitika kune mumwe munhu ane:
- Chirwere cheshuga
- Nhoroondo yekudhakwa
- Kurwisa zvirwere zvakadai se rheumatoid arthritis
- Muviri wechirwere chekudzivirira muviri, zvakadai sekemotherapy
- Zvirwere zvakakomba zvakadai seCOPD uye chisingarapiki chinonzi bronchitis
- Gastroesophageal reflux chirwere
Kuziva
Kuti uongororwe neyempyema, vanachiremba vatanga kutora nhoroondo yakanyatsogadzirira uye vanoita kuongorora mumuviri. Nhoroondo inogona kubatsira kuziva kana kune chero njodzi dzinokonzera njodzi, uye kuongorora mumuviri kungaratidza kufema kunopera kunzwika. Kutevera izvi, chikwata x-ray kana chifu CT scan inoitwa kuti ienderere mberi nekuongorora mapapu.
Pane imwe nguva uye ultrasound inogonawo kuitwa. Kuti uzive kana mabhakitiriya aripo, uye kuti aone kuti ma antibiotics aya mabhakitiriya anorevei, thoracentesis inoitwa kutora muenzaniso we empyema (iyo inonaya inogona kucheneswawo zvakare.) Mvura inotumirwa kubhi kuti kuti aite chikonzero chekutsvaga kwemvura, kuongorora kwezviri mukati memvura. Kuyera ropa kunogona kuitwawo kuti utsvake uchapupu hwehutachiona.
Treatment Options
Kurapa kwempyema kunogona kuputsika kusvika mumatanho maviri; danho rokutanga ndokubvisa mvura yakasviba, mushure mokunge utachiona hunofanirwa kubatwa.
Muchengetedzwa kwemhepo: Fluid inobviswa kuburikidza ne thoracentesis. Dzimwe nguva izvi zvakajeka, kunyanya kana empyema isati yavapo kwenguva refu. Bhuku rebhokisi rinokwanisa kuiswa kuitira kuti rambe richibudisa mvura.
Apo chinangwa chakange chiripo kwenguva yakati, chinogona kuwanikwa. Izvi zvinoitika kana zvisikwa zvemavara uye zvinoparadzanisa mvura yakasviba muzvikamu zvakasiyana-siyana. Izvi zvinokonzera mvura yakanyanya kuoma, uye dzimwe nguva miitiro yakawanda ye thoracentesis inodiwa kubvisa fluid.
Kurapa chirwere chacho: Vanachiremba vanotanga mishonga inorwisa mabhakitiriya pakarepo apo samuenzaniso inotorwa. Vamwe vanhu vanoshamisika kuti sei kwete panguva iyoyo, asi kutanga kwemishonga inorwisa mabhakitiriya kazhinji kunononoka kuti ipe mabhii mukana wekanakisisa wekuziva chaizvo mabhakitiriya ari kukonzera utachiona. (Kana mishonga inorwisa mabhakitiriya inotanga kusati yasvika kune thoracentesis, zvingava zvakaoma kuziva kuti mabhakitiriya ndeapi ane hutachiona hwehutachiona.) Mushure mekunge watanga ma antibiotic, lab ichaitazve mamwe maedzo kuti aongorore ma antibiotic mabhakitiriya anonyanya kufunga-uye mishonga inouraya yaunopiwa inogona kuchinjwa mushure memazuva mashoma.
Matambudziko / Kuvhiya
Neine empyema, kunyanya iyo yakave iripo kwechinguva, zvisikwa zvinoputika zvinogona kuvaka. Zvinogona kuve zvakadikanwa kuti chiremba chiremba abvise zvimwe zvezvisikwa zvitsvuku uye zvikamu zvehuturo kuitira kuti agadzirise utachiona. Izvi zvinogona kuitwa kana kuburikidza ne thoracotomy (chirwere chekuvhara mapapu) kana chirwere chinonzi thoracoscopic (chirwere chinoputika chinoputika mumapapu,) nekambani-yakabatsiridzwa kutaridzika kwechirasi inove yakagadzirisa uye isingasviki mukana wevanhu vakawanda. Mukuwedzera, zvidzidzo zvitsvakurudzo zvakawana kuti nzira dzisiri dzekuvhiya dzinowanzobudirira senzira dzokuvhiya dzekurapa empyema. Zvimwe zvinetso zvinogona kusanganisira sepsis-hutachiona hunotyisa mumuviri wose, uye kuora uye kuwedzerwa kwezvinyorwa zvinorema.
Prognosis
Kufanirwa kwepyema kunowanzoenderana nechinokonzera chinokonzera.
Pasi Pasi
An empyema izwi rinoshandiswa kurondedzera kuvapo kwehutachiwana hwechirwere ichi chakakomberedza mapapu. Chikonzero chinonyanya kukanganisa chiropa, asi mamwe mamiriro ezvinhu, pamwe nekuvhiyiwa uye kushungurudzika, zvinogona kuva nemhosva. Kurapa kunosanganisira kutora sampuli yemvura inotumirwa kubasa uye kubvisa zvinodhaka zvakanyanya zvinogona kukonzera kupfupika kwemhepo uye zvimwe zviratidzo. Mishonga inorwisa mabhakitiriya inopiwa ipapo kurapa utachiona.
Kutumidzwa: em-pie-ee-ma
Inonziwo : pylothorax, chiremera chine utachiona, purulent pleuritis, empyema thoracis
Mienzaniso: Jerry akagadzira empyema mushure mekuvhiyiwa kwekenza yemapapu, uye chiremba wake akaita chirongwa chokubvisa mvura yakakonzerwa.
> Sources:
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> National Library of Medicine. MedlinePlus. Empyema. Yapindurwa 02/15/15. https://medlineplus.gov/ency/article/000123.htm
> Redden, M., Chin, T., uye M. van Driel. Kugadziriswa Kusingasviki Nekuvhiya Kutarisira kwePleural Empyema. Cochrane Database yekuongorora kwakarongeka . 2017. 3: CD010651.
> Zanotti, G., naJ. Mitchell. Bronchopleural Fistula uye Empyema Pashure peAnatomic Pung Resung Resection. Tichiracic Surgery Makliniki . 2015. 25 (4): 421-7.