Isu tinoshandisa sterilized tsono kubaya ganda, intercostal tishu uye parietal pleura mu pleural cavity, iyo inonzi.kuputika kwechipfuva.
Sei uchida kubaya chipfuva?Chokutanga pane zvose, tinofanira kuziva basa rekuputira thoracic mukuongororwa uye kurapwa kwezvirwere zve thoracic.Thoracocentesis inzira yakajairika, iri nyore uye iri nyore yekuongororwa uye kurapwa mune yekiriniki yedhipatimendi repulmonary.Semuenzaniso, kuburikidza nekuongororwa, takaona kuti murwere aive nepleural effusion.Tinogona kutora mvura kuburikidza nepleural puncture uye kuitisa bvunzo dzakasiyana siyana kuti tiwane chikonzero chechirwere.Kana paine mvura yakawanda mugomba, iyo inomanikidza mapapu kana kuunganidza mvura kwenguva yakareba, iyo fibrin mairi iri nyore kuronga uye inokonzera maviri akaturikidzana epleural adhesion, iyo inokanganisa basa rekufema remapapu.Panguva ino, tinofanirawo kuboora kubvisa mvura.Kana zvichidikanwa, mishonga inogonawo kubaiwa kuti ibudirire chinangwa chekurapa.Kana iyo pleural effusion ichikonzerwa negomarara, tinobaya majekiseni ekurwisa cancer kuita basa rekurwisa cancer.Kana pane gasi rakawandisa mubhokisi rechipfuva, uye pleural cavity yakashanduka kubva pakumanikidzwa kusina kunaka kusvika kune yakanaka, ipapo kushanda uku kunogona kushandiswawo kuderedza kudzvinyirira uye kubvisa gasi.Kana bronchus yemurwere yakabatana ne pleural cavity, tinogona kubaya mushonga webhuruu (unonzi methylene bhuruu, usingakuvadzi kumuviri wemunhu) muchipfuva kuburikidza netsono yekubaya.Ipapo murwere anogona kukosora mvura yebhuruu (kusanganisira sputum) paanenge achikosora, uye ipapo tinogona kusimbisa kuti murwere ane bronchopleural fistula.Bronchopleural fistula inzira yehutano yakasimbiswa nekuda kwekubatanidzwa kwemapapu emapapu mubronchi, alveoli uye pleura.Inzira kubva pamuromo kuenda kutrachea kuenda kubronchi pamatanho ese kusvika kualveoli kuenda kuvisceral pleura kuenda kupleural cavity.
Chii chinofanira kutariswa mune thoracic puncture?
Kana zvasvika pakubaya thoracic, varwere vazhinji vanogara vachitya.Haisi nyore kubvuma setsono inorova magaro, asi inobaya chipfuva.Kune mwoyo nemapapu muchipfuva, izvo zvisingagoni kubatsira asi kutya.Chii chatinofanira kuita kana tsono ikabaiwa, ichava nengozi here, uye chii chinofanira kungwarirwa navanachiremba?Tinofanira kuziva izvo varwere vanofanira kuteerera uye nzira yekushandira pamwe zvakanaka.Maererano nemaitiro ekushanda, pane inenge isina ngozi.Nokudaro, tinotenda kuti thoracocentesis yakachengeteka pasina kutya.
Chii chinofanira kutariswa nemushandisi?Mumwe nemumwe wevanachiremba vedu anofanirwa kuve nekunzwisisa kwakanaka kwezviratidzo uye zvekushandisa zvakakosha zve thoracic puncture.Zvinofanira kucherechedzwa kuti tsono inofanira kupinzwa kumucheto wepamusoro pembabvu, uye usambofa iri pazasi pembabvu, zvikasadaro tsinga netsinga dziri kumucheto kwezasi kwembabvu dzinokuvara nekukanganisa.Disinfection inofanira kuitwa nemazvo.Kuvhiya kwacho kunofanira kunge kusina utachiona zvachose.Basa remurwere rinofanira kuitwa zvakanaka kudzivirira kufunganya uye kutya kwepfungwa.Kubatana kwepedyo nachiremba kunofanira kuwanikwa.Paunenge uchigamuchira kuvhiyiwa, kuchinja kwemurwere kunofanira kuonekwa chero nguva, zvakadai sechikosoro, chiso chakacheneruka, kudikitira, palpitations, syncope, etc. Kana zvichidiwa, mira kushanda uye pakarepo uvate pamubhedha kuti ununurwe.
Chii chinofanira kutariswa nevarwere?Chokutanga pane zvose, varwere vanofanira kugadzirira kushanda pamwe chete navanachiremba kuti vabvise kutya, kushushikana uye kushushikana.Chechipiri, varwere havafaniri kukosora.Vanofanira kugara pamubhedha pachine nguva.Kana vasinganzwe zvakanaka, vanofanira kutsanangurira chiremba kuitira kuti chiremba afunge zvokuteerera kana kuti kumbomira kuvhiyiwa.Chechitatu, unofanira kurara pasi kwemaawa maviri mushure me thoracentesis.
Mukurapwa kwepneumothorax inotaurwa muchikamu chekukurumidzira chedhipatimendi remapapu, kana tikasangana nemurwere ane pneumothorax, kudzvanywa kwemapapu hakusi kwakakomba uye kufema hakuna kuoma mushure mekuongorora.Mushure mekucherechedza, mapapu haarambe achimanikidzirwa, kureva kuti, gasi muchipfuva harisi kuwedzera kuwedzera.Varwere vakadaro vanogona kunge vasina kurapwa nepuncture, intubation uye drainage.Chero bedzi tsono yakakora ichishandiswa kubaya, kubvisa gasi, uye dzimwe nguva kakawanda kakati wandei, mapapu anowedzera kuwedzera, izvo zvinozoitawo chinangwa chekurapa.
Pakupedzisira, ndinoda kutaura nezvekubaya kwemapapu.Muchokwadi, kubaya kwemapapu ndiko kupinda kweiyo thoracic puncture.Tsono inobairwa mumapapu kuburikidza ne pleural cavity uye kuburikidza ne visceral pleura.Panewo zvinangwa zviviri.Ivo vanonyanya kuitisa biopsy yemapapu parenchyma, uyezve kuongorora mvura iri mugomba reaspiration cavity kana bronchial chubhu kuti ijekeswe, uyezve kurapa zvimwe zvirwere kuburikidza nekuputika kwemapapu, sekushuvira pus mune mamwe makomba. ine mvura isina kusimba, uye kubaya zvinodhaka pazvinenge zvakakodzera kuti uwane chinangwa chekurapa.Nekudaro, zvinodikanwa zvekubaya mapapu zvakakwirira.Kuvhiya kunofanirwa kuve nekuchenjerera, kungwarira uye nekukurumidza.Nguva yacho inofanira kupfupiswa sezvinobvira.Murwere anofanira kushandira pamwe.Kufema kunofanira kugadzikana, uye hapana kukosora kunofanira kubvumidzwa.Pamberi pekuputira, murwere anofanirwa kuwana kuongororwa kwakadzama, kuitira kuti chiremba akwanise kuwana nekuvandudza chiyero chekubudirira kweiyo puncture.
Naizvozvo, chero bedzi vanachiremba vachitevera matanho okuvhiya uye kushanda zvakanaka, varwere vanobvisa kutya kwavo uye vanobatira pamwe navanachiremba.Thoracic puncture yakachengeteka zvakanyanya, uye hapana chikonzero chekutya.
Nguva yekutumira: Oct-18-2022
