Nhengo huru dzemumumuviri dzinodzivirirwa nechigadziro chemuviri chinosanganisira 2 mapairi uye nzvimbo isina chinhu pakati pavo. Kushingaira muhomwe yekunze kwemapapu kunofanira kunge iri pasi pemhepo. Kana mhepo inopinda munharaunda yakawanda, inowedzera, uye pneumothorax inotanga. Makomba haafaniri kutarisa uye orega kubatanidzwa mukufema.
Pneumothorax - classification
Pane zvakawanda zvingasarudzwa zvekuisa hutano pasi pekufungisisa: kusuruvara, nzvimbo yepamusoro, kutaurirana nemamiriro ekunze, ivhu rekugumburwa nedzimwe nzira. Kurongwa maererano nezvikonzero zvechirwere kunoonekwa zvakajeka sezvinobvira. Inosanganisira zvinotevera zvepneumothorax:
- dambudziko;
- spontaneous;
- chikonzero.
Traumatic pneumothorax
Ichi chimiro chechirwere chinowanzotungamira njodzi, njodzi dzemugwagwa uye kurwisa zvombo. Kutambudza pneumothorax ndiko kuunganidza mhepo pakati pemurefu lobes nemhaka yekupinda (bhomba, banga) kana kukuvadzwa kwakashata kwechifuva (matambudziko, kurohwa). Dzimwe nguva kukanganisa kubako rekudzivirira kunotarisana nekunze kwekurapa kwechiremba. Mumamiriro ezvinhu akadaro, iatrogenic pneumothorax yemapapu inogadziriswa. Zvinogona kuitika mushure mokunge:
- puncture;
- biopsy;
- ventilation yokugadzirira;
- kuiswa kweccterter subclavia.
Pneumothorax yomufambiro wepakati
Rudzi rwakarondedzerwa rwechirwere rwakarongeka zvakananga kuva idiopathic uye chiratidzo chechiratidzo. Iko fomu yekutanga inowanikwa mune zvakakwana noutano uye vechidiki, zvikonzero chaiyo zvechiitiko ichi hazvisi pachena. Kuongorora zvinhu ndezvekuti:
- hutano uye congenital genetic kusagadzikana;
- murume wepabonde;
- ane makore makumi maviri kusvika makumi mana;
- kunyadzisa fodya;
- high growth;
- mabasa anokonzera kupikisa kusiyana (kufamba mu ndege, kubhururuka, kukwira makomo nezvimwe zvakadaro);
- kuita basa rakawandisa.
Chiratidzo chechipiri kana chechipiri pneumothorax chepapu chinowanikwa mune vanhu vane zvirwere zvinokonzera mabasa epumusoro. Inokurudzira kuunganidzwa kwemhepo mune mumiririri wemvura zvinogona kuve zvirwere zvinotevera:
- cystic fibrosis ;
- kuwedzera kwechirwere chinoputika;
- pneumonia;
- sarcoidosis;
- fibrosing alveolitis;
- chronic obstructive chirwere chemapemmoni;
- tuberculosis;
- histiocytosis X;
- systemic scleroderma;
- rheumatoid arthritis;
- chikamu chemapapu;
- kenza;
- lymphangioleiomyomatosis;
- dermatomyositis nevamwe.
Mune mamiriro akaoma, mhepo yakanyanyisa pakati pemurefu lobes inokonzera kwete kungowedzera kuwedzera muhombho yemapapu, asiwo kukanganiswa kwakanyanya kweoksijeni, kuderera nokukurumidza kweropa mukati mumatrichi. Ichi chinonzi chinonzi pneumothorax chakanyanya uye chinoonekwa sechimwe chezvinhu zvakanyanya kuipa zvechirwere chechirwere chacho. Pasina kunetseka kurapwa, inogona kukanganisa matambudziko makuru anotyisidzira upenyu hwehupenyu.
Artificial pneumothorax
Izvo zvinenge zvataurwa zvinoshandiswa kurapwa kwekurapa. Pamberi pekugadzirwa kwemazuva ano emakemikari ekugadzirira, zvishoma nezvishoma nzira dzisina kupindira dzokupindira nekuvhiya uye kuverenga tomography, pneumothorax yepamusoro muhutuputi (collapsotherapy) ndiyo nzira yakanakisisa yekurapa uye kuongororwa. Kukanganiswa kwechinguva chiduku chemapapu ane chirwere chinokonzera kukonzera kukanganisa kwechipiki chezvinyama necrosis, resorption ye granulations uye fibrosis.
Progressive pulmonologist haigoni kushandisa mweya wekugadzira mumiririri wechipu. Kune izvi kugadzirisa pane zviratidzo zvakasimba:
- mukati mekubuda ropa (kana zvichizivikanwa, kubva kupi mapapu inowanikwa);
- tuberculosis inoparadza nemafuta matsva;
- kusakwanisa kwemazuva ano chemotherapy.
Pneumothorax - zvikonzero zve
Dzimwe nguva hutano huri pasi pekufungidzika hunobuda kamwechete, kunyanya kune varume vaduku, hwakagara huripo nekuda kwezera, hutano, mararamiro kana chido. Zvinonyanya kukonzera pneumothorax:
- kukuvadzwa;
- kuporesa zvirwere;
- kupindira mune zvokurapa.
Vhura pneumothorax
Ichi chimiro chechirwere chinoitika nekukuvadza kwakanyanya kubhokisi. Pneumothorax yakazaruka ndeyekuunganidza mhepo pakati pemurefu lobes, ine nzvimbo yekunze kunze. Pakufema mukati, iyo gasi inozadza ganda, uye pamhepo inodzoka zvakare. Kushingaira muhombho kunononoka kuenzana nekukosha kwemukati, saka mapapu haagoni kugadzirisa. Nemhaka yeizvi, inogumira kubatanidzwa mukupemha nekugadzirisa ropa neropa.
Ivhavha yakasununguka iyi pneumothorax lung. Ichi chiitiko chinoratidzwa nekuparadzaniswa kwemashuga echikuvadzwa, bruchi, kana musimba. Somugumisiro, mhepo inozadza chifukidzo chemukati chekudzivirira, asi hachidziri zvachose. Izvo zvinokonzerwa nehuwandu hwegesi pakati pemagetsi ari kuramba achiwedzera, izvo zvinotungamirira kumhanyiro emwoyo nemidziyo mikuru uye kuvhara mapapu. Pane kukanganisa kwakasimba kweropa, kufema uye okisijeni kuchinja.
Yakavharwa pneumothorax
Vatsoropodzi vorudzi urwu rwehutachiona vanogona kuva zvigunun'una zvishoma uye kukuvadzwa kwepamusoro. Saizvozvowo, inowanikwa apo pane pneumothorax pakarepo, zvikonzero zvayo zvisati zvasimbiswa. Kuunganidzwa kwemhepo pakati pemakumbo emapapu emapapu kunoumbwa nokuti chirema chiduku chinowanikwa muzwi. Kukuvadza kumagetsi hakune kunze kwekunze, uye ivhu regesi mairi haritauri. Zvishoma nezvishoma mhepo inoputika kunyange pasina rubatsiro rwechiremba, uye chiremera chakavharwa.
Pneumothorax - zviratidzo
Chirwere chemakiriniki chinoenderana nemamiriro uye kukwirira kwechiitiko chacho, iyo mhepo yemhepo inounganidza munzvimbo inoderera. Dzimwe nguva zviratidzo zvepneumothorax zvinenge zvisipo. Izvo zvinonyanya kuitika pamatambudziko ekudzivirira matambudziko. Mune dzimwe nguva, pneumothorax yemapapu inogona kuva nezviratidzo zvinotevera:
- marwadzo mubhokisi, achipa papfudzi kubva kune zvakakanganiswa;
- akadzikama;
- kupfupika kwemhepo;
- kakawanda moyo;
- Kutya kutya kwekufa;
- kusunungurwa kwe swetous festu swe swe;
- kusimba mumuviri;
- ruvara rwepepuru netsvuku yebhuruu;
- kuridza mhere panguva yekufema (ine open lung pneumothorax);
- kuvhara matanho pakati pembabvu;
- chimiro chakakurumbira chekudzivirira;
- kuvhara pasi peganda (emphysema), kana iwe ukanyora pane yaunonzwa kuoma, kufanana nechando;
- kuderedza ropa;
- faint.
Pneumothorax - kuongororwa
Kutanga, mupulistologist inoita kuongorora kwemuviri murwere achishandisa maitiro ekukwikwidza (finger tapping) uye auscultation (phonendoscope kuteerera). Nzira huru yekuziva kuti pneumothorax ndeye X-rays. Inobatsira kuona mhepo isina rusununguko muchikamu chemuviri, kuongorora kuwanda kwemapapu ekuora, kushanduka kwezvikamu zvemukati. Kana iyo X-ray kuongororwa isingadzidzisi zvakakwana, nzira dzekubatsira rubatsiro dzinobatsira dzinoshandiswa:
- computed tomography ;
- thoracoscopy;
- Kuchengetedzwa kwekwenyuka kubva kune pleural zone (kupisa kunoitwa ne pneumothorax);
- kudzidza nezvekugadzirwa kweropa kweropa;
- electrocardiography.
Pneumothorax - kurapwa
Zvirwere zvakajeka zvekuvharwa kwehutano hwehutachiona hazvirevi kutirapa yakakosha. Mukusina kwezviratidzo zvakakomba pane chikamu chekupemha uye yemwoyo mamiriro ezvinhu, kungocherechedza kwemamiriro emapapu nerubatsiro rwemafirimu inofanirwa. Mune mamwe mamiriro ezvinhu, chisarudzo chekurapa pneumothorax chinotorwa nechiremba chiremba. Kusati kwasvika munhu akaurayiwa muchipatara, zvinokosha kudzivirira kukura kwezvinetso, nokuda kweizvi unoda kuita mabasa mashomanana mashoma.
Pneumothorax - rubatsiro rwekukurumidza
Chinhu chokutanga chaunofanira kuita kana iwe uchifungidzira kuti mamiriro ezvinhu ari mubvunzo ndekushevedza boka rezvechiremba uye kugadzirisa munhu. Valve uye yakavharwa pneumothorax inoda kuvharwa kwechimbichimbi pakarepo. Izvi zvichange zvichipa mweya unobatanidza kunze uye kubatsira kuderedza kusangana pakati pemakumbo echikwata chekudzivirira chemuviri wekupumha.
Kana murwere ane chirwere chakazaruka chechirwere, pneumothorax yemapapu akarasika anonzwika, sekumhanya nemhepo nekufuridzirwa uye kubuda kubva pakuvadzwa. Munhu akabatwa anokosha kudzikama uye kumupa rusununguko rusununguko rwemogijeni, izvi zvichadzorera kushandiswa kwekufema zvishoma. Rubatsiro rwekutanga mumhepo yakasununguka pneumothorax kushandiswa kwekusungirirwa kwemazuva ose . Iyo inodzivirira kutenderera kwemweya mukati mumiririro wechipu.
Kuronga kwepneumothorax
Izvo zvinodikanwa kuti kushandiswa kunoitwa kunoitwa neyanyanzvi anoziva. Kushandiswa kwechiremba kunopisa nepneumothorax kunobatsira kuderera nokukurumidza mukumanikidzwa muhombodo yemapapu uye kumira kwekufema. Kana chirwere ichi chichikurumidza kuwedzera, unogona kutakura mvura inonwisa mvura . Kuti uite izvi, urove rusvingo rwechifukidzo kune rutivi rwakakanganiswa neine disinfected mashizha ane tsvina, tsvina yakaipisisa ine mugumo wakapinza kana chimwe chinhu chakafanana.
MuDhipatimendi rekuvhiya, kuputira mweya wakawandisa kubva kune mutsindo unoremekedzwa kunoitwa nemichina yakakosha, somuenzaniso, zvigadzirwa zvaBobrov. Pasi peanesthesia yemunharaunda, chiremba anoita kuputika kwemhino ne troka yakashata. Muhombodo yakasungirirwa mvura yakasvibiswa neyakabudiswa mugirazi yegirazi yemumwe mubhuku (bhoti raBobrov). Kana mhepo ichiri kunonoka, inoitwa nekushingaira kuriputira nemubhedha aspirator (kutsva).
Occlusion bandage ne pneumothorax
Nzira huru yekurapa kwekukurumidzira kwemafunguro akazaruka ekurwara ndeyekumisa mhepo kusvika kune ronda. Bhanji yepneumothorax inogona kuitwa kubva kuhupamhi hwehuta hwekotoni yakaputirwa nebhanhire risina kuchena, kana zvigadziriswa - zvipfeko, tirasi nezvimwe zvinhu. Inofanirwa kuvhara zvachose kukanganisa nekudzivirira kupinda mukati kwegesi muhomwe. Nokuda kwemafuro akawanda, bhanji rine pneumothorax yakazaruka yakafukidzwa nefirimu yeplastiki kana bheki cellophane.
Muchipatara, munhu anenge apona achapiwa rubatsiro rwakakodzera, runosanganisira:
- oxygen therapy;
- anesthesia;
- kubvongodza kwemavanga akazaruka, mapapu anoputika nemakumbo ayo;
- kusvetwa kwemafuro ezvinyorwa nemagadzirira chaiwo (pleurodesis).
Pneumothorax - zvinetso
Inenge hafu yevarwere vakatsanangura chiitiko chinokonzera mungozi. Iyo yakaipisisa ndiyo valve pneumothorax, kuvhiyiwa nemapfupa ekuvhura, kuvata mumhepo uye kusunungura maronda hakusi nguva dzose inoshanda. Mune zvimwe zviitiko, zvinopera nekuguma kwekufa. Zvimwe zvinetso zvakajairika zvehutano:
- kuputika kwechirwere che pleura (pyopneumothorax);
- emcutaneous emphysema ;
- kudzvinyirira kwemidziyo mikuru nemwoyo;
- kubuda ropa mukati mechipupuriro cavity;
- acute kuporesa kusakundikana;
- kuoma (kurasikirwa kwebasa) yemapapu.
Migumisiro yepneumothorax
Mugumisiro wekuunganidzwa kwemhepo mumutsara unoremekedzwa unobva pane chimiro chechirwere chacho, kusuruvara kwawo, kukonzera kukanganisa kubhokisi. Valve pneumothorax ine mhedziso isingagamuchirwi, kunyanya nemaronda akakomba mumapapu. Dzimwe mhando dzehutano dzinopindura zvakanaka kurapwa, asi dzinogona kukanganisa migumisiro ine ngozi uye dzinowanzoita zvekare. Mune mapapiro asina kuoma pneumothorax, huporofita hunofadza.