Vaingoerekana pneumothorax: yayo zvinokonzera, kurapwa zvinhu uye kurapwa

Pneumothorax - chirwere pathological umo mhepo anopinda pleural mhango, kuparadza yakawedzera kuomesa mairi.

In chirwere ichi pane zvinotevera akasiyana:

• vaingoerekana pneumothorax. Zvikonzero chimiro ichi chirwere kazhinji anoramba kujeka (muzviitiko apo zvinoitika anonyanya). Secondary vaingoerekana pneumothorax kukura sezvo kuomesa zvirwere zvakasiyana siyana bapu;

• zvinorwadza. Maronda anokonzerwa bhokisi, umo mhepo anopinda pleural mhango;

• iatrogenic. Chinonzi kuomesa panguva isiri kurapwa uye zvemapapu zvokurwara zvinogona kuitika kana munhu chirwere kupindira (semuenzaniso, pashure ponji pamusoro pleural masaga pashure thoracentesis kana pleural biopsies uyewo nokuda nechepakati venous catheterization).

Funga zvinhu kukura uye nzira vaingoerekana pneumothorax.

chimiro ichi Chirwere nesekondari. Primary vaingoerekana pneumothorax zvinowanzooneka chirwere pamatunhu uye dzakaonda vechiduku. Zvinokosha kucherechedza kuti kusvuta kunowedzera ngozi kukura kuparadzwa ndiko kusvika ka20. On pakanyorwa ichi mhando pneumothorax haana kuratidza pachena pulmonary zvokurwara, asi uchiwedzera kuferefeta kwazvo kazhinji zvinoratidza subpleural bullae, humboo zvivako zvinogona kuonekwa varwere vasinganamati kuputa (anenge 81% nyaya). Zvisinei, zvinokosha kuyeuka kuti nzombe achiri aumba somugumisiro pamusoro kudzikisirana chiedza kwakavharwa nenyama jira kuti kana kunyanya activation pakati neutrophils uye macrophages, iyo anova pamusoro pakanyorwa kusvuta.

Secondary pneumothorax nguva dzose kunotangira pamusoro pakanyorwa hunotovapo zvemapapu chirwere. Ichi chimiro chirwere chakaoma, sezvo iri chokuita chinokosha vanotaura pamusoro kumwoyo.

Pakati kukonzera yechipiri vaingoerekana pneumothorax vanofanira govera chisingaperi obstructive pulmonary, asthmatic chinzvimbo, pulmonary tibhii, mabayo, pulmonary fibrosis uye connective zvinyama zvirwere (semuenzaniso, dzinonzi rheumatoid arthritis, kana spondylitis). Chaiwo etiological basa rinogona kuva kenza yemapapu uye sarcoma.

Vaingoerekana pneumothorax kunotungamirira kune vasanyanye kunokosha chinzvimbo, zvichiguma hypoxemia - rutapudzo of okisijeni wevasungwa muropa. Ndinofanira kutaura kuti gasi mukutsinhana mumapapu panguva shoma nokushushikana iyoyo, saka regai kuva hypercapnia (wakawedzera carbon dioxide inobvisa wevasungwa mumuviri).

Kazhinji vaingoerekana pneumothorax hwapedyo pa zororo uye kunoratidzwa kurwadziwa muchipfuva uye dyspnea. Zvadaro, kurwadziwa ave mikukutu kana dzava. Chest karwendo kubva pakuparadzwa ishoma. Clinical Kuratidza pneumothorax vakazvimiririra inonyangarika mukati zuva rimwe kunyange pasina kurapwa.

Kana pneumothorax vasingakoshi pathological zviratidzo kazhinji, vasipo. Dzimwe nguva varwere chokunyunyuta pamusoro tachycardia. With kukura Makakatanwa pneumothorax kakawanda heartbeats zvinogona anorova kusvika 135 paminiti, achiperekedzwa hypotension uye cyanosis uye rikwanise kufema alkalosis.

Chirwere ichi ezvinhu pazvikanganiso anamnestic data, uye yakananga zvachinja X-ray mutsetse anova kuoneka visceral pleura. Dzimwe nguva chirwere zviduku kadikidiki pneumothorax kushandiswa maekisirei kana maekisirei munguva nedzinovengwa.

Vaingoerekana pneumothorax: kurapwa

Therapies kutaurirwa zvirwere evacuating mhepo kubva pleural mabhegi, uyewo ndambosvuta dziviriro. Nzira Zvakanyanya Kunaka Panguva Yepamuviri iyi - thoracostomy uye kuvhiyiwa nokuda thoracotomy kana kuburikidza thoracoscopic kuwana.