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Chii chinonzi subcutaneous emphysema?
Subcutaneous emphysema - uku ndiko kuunganidzwa kwegasi kana mabhubhu emhepo mumatishu, zvichikonzera kuumbwa kwecushion yemhepo. Chaizvoizvo, izwi rekuti emphysema rinogona kushandurwa sekuwedzera kwemhepo. Chikonzero chechirwere ichi chinogona kuva kukuvara kwechipfuva, semugumisiro wekuti nhengo dzekufema dzakakuvadzwa zvakanyanya, pamwe nekukuvadzwa kweguro. Ndicho chikonzero mhepo inopinda mu mediastinum inomanikidza tsinga huru nemidziyo, iyo inotungamirira kuasphyxia, kushaya simba kwemwoyo uye, sechikonzero, rufu.
Chikonzero che subcutaneous emphysema chinogonawo kuva chironda chekunze chakadzika, panguva iyo nhengo dzekufema dzakakuvadzwa.
Mumushonga, itsika kusiyanisa pakati akati wandei matsime emhepo anopinda munyama, anoti matatu chete:
ronda rechipfuva, iro rine pfuma yekungobvumira mhepo kupinda mumatumbu, asi kwete kuipa mukana wekudzoka shure;
kana kukanganisa kubronchi, trachea kana esophagus, apo mediastinal pleura yakakuvadzwa, saka mhepo inobva mu mediastinum inopinda zvakasununguka mu pleural cavity;
panguva imwechete kukanganisa kwekuvimbika kweparietal pleura nemapapu, ronda rine chitarisiko chevharuvhu.
Kana mhepo ichipinda mumatishu, inogona kufamba zvakasununguka pasi peganda kubva munzvimbo yeareolar kuenda kunzvimbo yechiso. Subcutaneous emphysema kazhinji haikonzeri kukanganisa kunoonekwa nevarwere. Iyo pachayo, chirwere ichi hachina ngozi kana chikonzero chekuitika kwayo chinozivikanwa munguva. Kuti uwane chikonzero, zvakakosha kutevera maitiro ekugadzirwa kwechiitiko ichi.
Vanachiremba vanokamura varwere vese mumapoka maviri ezera: vadiki uye avo vatopfuura makore makumi mana. Chirwere muvanhu vakadaro nguva dzose chinopfuurira nenzira dzakasiyana. Muvanhu vechidiki, vane makore anenge 40-20, emphysema inoitika muchimiro chakapfava uye pasina mhedzisiro. Muvanhu vakwegura, vanopfuura makore makumi mana, chirwere chacho chakanyanya kuoma uye kupora kubva kuchirwere kunotora nguva shoma.
Zvikonzero zve subcutaneous emphysema
Vanachiremba vanosiyanisa zvikonzero zvinotevera, semugumisiro weiyo subcutaneous emphysema inooneka:
Chronic bronchitis, kusvuta. Mu90% yezviitiko, kusvuta kunokonzera kukura kwe emphysema. Varwere vazhinji vari kukanganisa mukutenda kuti bronchitis yemuputi chirwere chisingakuvadzi zvachose. Utsi hwefodya hune huwandu hukuru hwezvinhu zvinokuvadza zvinokonzera kuparadzwa kwechirwere chekufema mumuviri wemuputi. Izvi zvinotungamirira kuchinja kukuru;
Shanduko muchimiro chechimiro chechipfuva semugumisiro wekunze kwemaitiro, kushungurudza;
Kukuvara kwakakomba (kutyoka kwakavharwa kwembabvu, chidimbu chayo chakabaya mapapu) kana kuvhiyiwa kwechipfuva, laparoscopy;
Anomaly mukukura kwenhengo dzemuviri wekufema, kazhinji kazhinji idzi dzinonzi congenital malformations;
Kufema zvinhu zvine muchetura izvo zvinokanganisa maitiro ekufema (zviitwa zvehunyanzvi, nharaunda yakasvibiswa, kushanda nezvinhu zvine chepfu kana mukugadzirwa kune njodzi, vavaki, nezvimwewo, vanhu vanofema mweya une tsvina yakawanda inokuvadza);
Ronda repfuti, rakaita kunge risina chinhu. Pamusana pekuita kwemagasi eupfu paganda rakapoteredza vanga, kwete-yakawanda emphysema inoitika;
anaerobic utachiona;
Banga, maronda akagomara;
Kurovera kwemotokari umo vawirwa nenjodzi vanorova zvipfuva zvavo pachidhiraivho kana zvigaro nesimba guru;
Kukuvadza kumapapu kunokonzerwa nechisimba chakasimba chemukati, iyo inonzi barotrauma (kusvetuka mumvura, kunyura kunopinza kusvika pakadzika);
Nekutyoka kwemapfupa echiso;
Neoplasms pamutsipa uye mu trachea;
Angina Ludwig;
Kubuda kwegurokuro. Ichi chikonzero ndicho chisingawanzoitiki;
Dzimwe nguva emphysema inoitika panguva yekuvhiyiwa kwemazino, nekuda kwekusiyana kwechiridzwa;
Kukuvadza kujojo huru (mabvi akabatanidzwa);
Nekugadzirwa kwemhepo yemapapu. Kushandisa tracheal tube.
Zviratidzo zve subcutaneous emphysema
Kazhinji zviratidzo zve subcutaneous emphysema ndezvi:
kuzvimba mumutsipa;
kurwadziwa kwechipfuva pakufema;
kurwadziwa kwehuro, kunetseka kumedza;
kufema kunoshanda;
kuputika kweganda mukushayikwa kwezviratidzo zvakajeka zvekugadzirisa kwayo.
Iwe unogona kuona subcutaneous emphysema uchishandisa X-ray mumatanho ekupedzisira echirwere. Zvakare palpation yakapfava munzvimbo yakarongwa yekuunganidza mweya. Pasi peminwe, kuvapo kwemhepo inoputika pasi peganda ichave yakanyatsonzwa.
Kana ikabatwa, murwere haazonzwi kurwadziwa kana kusagadzikana. Paunenge uchidzvanya panzvimbo yekuunganidza magasi, ruzha rwehunhu runonzwika, rwunoyeuchidza zvakanyanya kunyungudika kwechando. Nekuunganidzwa kukuru kwemhepo pasi peganda, matishu ari pedyo nenzvimbo iyi anozvimba zvekuti anozoonekwa nemeso.
Kana subcutaneous emphysema yakaumbwa mumutsipa, murwere anogona kuchinja inzwi rake uye zvichava zvakaoma kufema.
Mhepo inogona kuungana pasi peganda munzvimbo dzakasiyana-siyana dzemuviri, kunyange pamakumbo nemaoko, uye mudumbu.
Kurapa kwe subcutaneous emphysema
Emphysema inogona kuonekwa ne X-ray kana CT scan yechipfuva. Pakangoonekwa mabhuru emhepo mumatishu emuviri, kurapwa kunotanga nekukurumidza. Muchikamu chekutanga chechirwere, kurapa kwekuchengetedza kunoitwa, kureva kuti, sprays yakakosha uye aerosols inorayirwa. Zvisinei, ivo havakwanisi kumisa kukura kwechirwere.
Nzira yechirwere ichi inonyatsoongororwa navanachiremba vane imwe nguva yakawanda, uye kuwedzera kwechirwere kunoonekwa 2 kana katatu pagore. Panguva yekuwedzera kwakadaro, kutadza kufema kwakanyanya. Muchikamu chechitatu nechina che emphysema, kurapwa kwekurapa hakuna simba pachirwere uye murwere anofanira kubvumirana nekupindira kwekuvhiya.
Kunyange zvakadaro, subcutaneous emphysema kazhinji haidi kurapwa. Nayo pachayo, chirwere ichi hachiiti chero njodzi kumuviri wemunhu, inongova mugumisiro wekukuvadza kwekunze kana imwe nhengo yemukati. Uye shure kwaizvozvo inobviswa. Jekiseni remhepo pasi peganda rinomira. Chirwere chacho chinopera zvishoma nezvishoma pasina unyanzvi hwokurapa.
Zvinobudirira zvakadii chisakiso cheemphysema chakabviswa ndiko kudzoreredzwa kwemhepo. Kuti ikurumidze kupora, maitiro ekufema mumhepo itsva yenyika anokurudzirwa. Muchiitiko ichi, ropa rakazara neokisijeni, iyo inobatsira pakudonha kwenitrogen kubva mumuviri.
Zvichienderana nehukuru hwe emphysema, kumwe kupindira kwekuvhiya kunoitwa, iyo inotarisirwa kuwedzera kubviswa kwekuunganidza kwemhepo.
Emphysema inogona kuva nengozi chete kana yakaumbwa munzvimbo yechipfuva uye inokurumidza kupararira kumutsipa, pakutanga pasi peganda, uye inopinda mukati memitsipa yemutsipa uye mediastinum, iyo inogona kukonzera kudzvinyirira kwenhengo dzinokosha dzomukati. Muchiitiko ichi, kuvhiyiwa kwekukurumidzira kunokosha, izvo zvichabatsira kuziva chinokonzera jekiseni remhepo, pamwe nekuibvisa pasina migumisiro yakakomba kumurwere.