Kuvhiya ndicho chikonzero chinowanzoita kuti rudzi urwu rwemapapu ruwande
Atelectasis izwi rinoshandiswa kurondedzera kukanganisa kwakakwana kana kusarura kwemapapu. Iko dzimwe nguva inonzi "mapapu akawa," kunyange zvazvo izwi racho rinogona kushandiswawo kune chinonzi pneumothorax .
Apo eatlectasis inosvika, mweya mutsva haugone kusvika kumadzimai maduku emapapu, anonzi alveoli , uko oxygen uye carbon dioxide zvinopatsanurwa.
Izvi zvinoguma muhuwandu hwakadzika hwe okisijeni huchiendeswa kune nhengo uye maviri emuviri ( hypoxia ).
Atelectasis inogona kunge yakaoma, ichiitika kamwe kamwe pamusoro penyaya yemaminitsi, kana kusingaperi, kuwedzera kwemazuva kwemavhiki.
Zvinokonzera Atelectasis
Pane zvikonzero zvina zvinokonzera kudyalectasis: hypoventilation, kuvhiringidza kwemhepo, kubhururuka kwemhepo, nekubatanidzwa.
- Hypoventilation (kufema nenzira inononoka zvishoma nezvishoma) inowanzovhiringidzika panguva yekuvhiyiwa, zvikurukuru neaneshehesia yakawanda, kana kana munhu akaiswa pamubhedha. Icho chiito chekufema kwakadzikama kunodzivirira mweya kubva pakuenda kune raveuveoli, zvichiita kuti mabhesi emhepo asvibise uye aparare. Hypoventilation ndiyo inonyanya kukonzera shandisisis, kunyanya mushure mekuvhiyiwa kwechifuva.
- Kuvhara kwemhepo kunogona kukonzerwa kana chimwe chinhu chichivhara ndima kana mukati memapapu (semucheka kana chinhu chekunze) kana kunze kwemapapu (sechirwere chinomhanya mumhepo uye chinokonzera kudzivirira). Bronchioloalveolar carcinoma imwe yerudzi rwekenza inozivikanwa kuti inokonzera matumire mu alveoli uye pamwe chete ndima.
- Kushanda kwemhepo kunowanzokonzerwa nekuvakwa kwemvura mumhepo yakapoteredza mapapu ( pleural effusion ). Inogonawo kuva mugumisiro wemwoyo wakawedzerwa, aneurysm, tumorori, lymph nodes yakawedzerwa, kana kuunganidza mvura mumvura yepamu ( ascites ).
- Kukanganiswa kwechimiro chisina kujairika apo mishonga inotanga kubatana pamwe chete. Kazhinji, mukati memaviri uye nhengo dzemuviri dzine nzvimbo dzinotsvedza, saka dzinogona kufamba nyore nyore sezvo muviri unofamba. Iko rinoshandisa mafuta rinonzi "surfactant". Apo inopactant inoshaikwa, mapapu anorasikirwa nehutano hwepasi uye anogona kudonha.
Zvimwe zvikonzero zvinoita kuti atelectasis zvive nekuwedzera kurema, kusvuta, nguva refu yemubhedha kuisa / kusasviba, nhengo dzomukati dzinoputika (izvo zvinogona kuguma nekufema zvishoma), narcotics kana sedatives (iyo inogona kunonoka kufema), uye kupemha kunetseka (RDS) muzvitsva.
Zviratidzo zveAtelectasis
Atelectasis kazhinji ine zviratidzo zvishomanana kana ichikura zvishoma nezvishoma kana inosanganisira chikamu chiduku chepapu. Kusiyana neizvi, kana mamiriro acho achikura nokukurumidza kana kukanganisa chikamu chikuru, zviratidzo zvinogona kuva zvinotyisa uye zvinototyisa. Atelectasis inowanzoitika pamwe chete, zvinoreva mune rimwe mapapu kana rimwe.
Zviratidzo zvinozivikanwa zvinosanganisira:
- Kusuruvara kwemhepo ( dyspnea )
- Kuchengeta, kusagadzikana
- Chirwere chinopinza chepfu chinowedzera nekufema kwakanyanya ( pleuritic chest pain )
- Bluish tinge kune miromo, zvigunwe, kana minwe inokonzerwa nokusakwana kwe okisijeni ( cyanosis )
Kuongororwa kweAtelectasis
Kana chiremba wako achifungidzira iwe une atelectasis, iye achaita kuongororwa kwemuviri kuburikidza nekutengesa (kutengesa) chifukidzo chekuteerera nokuda kwekutaura kwemashoko. Kana pane mapapu asina kukwana kana akaperera, kurira kwemhepo kuchave kwakanyarara kana kuonekwa kusipo.
Kutevera izvi, chiremba acharaira tsvakurudzo dzinoverengeka dzinogona kusanganisira:
- Chep X-ray , iyo inogona kuratidza kuti trachea nemwoyo zvakashanduka
- Computed tomography (CT scan) kutsvaga uchapupu hunoratidzwa hwekudzivirira
- Magnetic resonance imaging (MRI), achishandiswa magnetic mafungu ekubudisa zvifananidzo
- Bronchoscopy , nzvimbo yakajeka yakaiswa mukati memhepo yekufema kuona mapapu
- Ropa gasi (oximetry) kuongorora huwandu hwekudzivirira oksijeni
- Positron-emission tomography (PET scan), iyo inogona kuona kusagadzikana kwemasero metabolism sezvainogona kuitika nekenza
Treatment Options yeAtelectasis
Kurapa kwe atelectasis kunobva pane chinokonzera chikonzero, nechinangwa chekuwedzerazve mapapu kusvika pakukura kwayo. Nzira idzi dzinogona kusiyana. Kana chirwere chiri chikonzero chekuwa, kuvhiyiwa kunogona kubatanidzwa.
Nokuda kwekunyunyuta kwechisimba, kunyura kwemvura inogona kudiwa. Nokudzivirira mukati, maronchoscopy inogona kushandiswa kubvisa chimwe chinhu chekunze, apo mishonga inokonzera mhirizhonga inogona kubatsira nekuvhura kwemafunguro egungwa. Muzviitiko zvakawanda, kusanganiswa kwemaitiro ekurapa kuchadiwa.
Kana zviratidzo zvichitaurirwa, kupedzisira kwakanaka-kupera simba kunokonzerwa (PEEP) kunogona kushandiswa. Uyu ndiwo mushonga umo musanganiswa weokisijeni unopiwa ne maski pasi pekumanikidzwa, kudzivirira mapapu kuti asagumburwe zvachose panguva yekubuda. Kana zviratidzo zvakanyanya, intubation uye ventilation inogona kudiwa kusvikira mamiriro ezvinhu ari pasi ari kunyatsogadziriswa.
Apo eatlectasis isingaperi, zvinogona kuva kazhinji zvakaoma kuwana mapapu kuti awedzerezve kuwedzera. Kubviswa kwechikamu chakakanganiswa chemapapu (kuburikidza nelobectomy kana segmental resection ) inogona kuratidzwa.
Zvinetso zvinogona kuitika kana mabhakitiriya akabatwa munzvimbo yekudonha. Izvi zvinogona kutungamirira kukura kwehutachiona, kusanganisira pneumonia uye sepsis. Bronchiectasis , kuwedzera kusinganzwisisiki kwemafunguro emhepo kunoguma nekubatana kwemvura mumapapu, zvinogonawo dzimwe nguva kuitika. Apo chikamu chikuru chemapapu chinokanganiswa nezvinhu izvi, kukanganisa kuputika kunogona kuguma.
Kudzivirira Atelectasis Mushure mekuvhiya
Kuvhiya cheputi kunoramba kuri chikonzero chikuru chedyalectasis. Kuzvidzivirira kuti zvirege kuitika mushure mekuvhiya, vanachiremba vachakukurudzira kuti urege kusvuta fodya uye kutanga.
Mushure mekuvhiyiwa, kune zvinhu zvitatu zvaunofanira kuita kuti huve nemapapu ako akaramba akazara zvakakwana:
- Ita maitiro ekufema zvakadzika, uchitarisa mazamu akareba uye akadzora zvinyorwa. Mishonga inorwadza inogonawo kurongerwa kana kufema kunonyanya kunetseka.
- Ita zvakaoma kukwezva kusunungura chero mukoko kana sputum kubva kumapapu.
- Shandura nzvimbo yako, wakagara kumusoro kana kufamba-shanduka zvakanyanya sezvakaitwa nachiremba wako.
> Sources:
> Ferrando, C., Romero, C., Tusman, G. et al. "Kunyoresa kweChipoperative, Isingasviki Air-Test for Diagnose Atelectasis muVarwere Vane Utano Pashure Kokuvhiya: Chiitiko Chinotarisirwa, Chirwere Chekuongorora Chiitiko." BMJ Open . 2017 '7 (5): e015560.
> Restrepo, R., naBraverman, J. "Matambudziko Azvino muKubvuma, Kudzivirira, uye Kuchirwa kwePerioperative Pulmonary Atelectasis." Ongororo Ongororo YezveHupemiramu Mishonga . 2015; 9 (1): 97-102.