Chilonda: zizindikiro zimayambitsa, chithandizo

Ndikofunika kusamalira thanzi la kupuma kuchokera kwa achinyamata. Thupi la munthu limayesedwa mosalekeza ndi mabakiteriya osiyanasiyana, mavairasi, tizilombo toyambitsa matenda. Makamaka chiopsezo cha matenda chikuwonjezeka nthawi ya chisanu ndi chimfine, zomwe zasintha masiku otentha otentha.

Kutulutsa mpweya, kusuta fodya kumachepetsa chikhalidwe ndi kulola kuti matenda adzike mozama kwambiri m'mitsinje yozizira. Matendawa amakhudza ziwalo zakumapuma. Kufooka kwawo kuphatikizapo kulephera kwa chitetezo choteteza chitetezo cha tizilombo toyambitsa matenda kumabweretsa chitukuko chachikulu m'magulu apansi. Chimodzi mwa izo ndi chifuwa cha mapapo.

Kodi matenda ndi chiyani? Kodi zizindikiro za matendawa ndi ziti? Kodi mungatani kuti musagonjetse vutoli? Pafupifupi chirichonse mu dongosolo.

Zizindikiro za matendawa

Kodi ndi mapapu angati? Ndi matenda omwe chiwonongeko cha m'mapapo chimapezeka - necrosis. Mchitidwewu uli ndi khalidwe labwino. Minofu yamtundu wosungunuka imangosungunuka osati pa siteti imodzi. Njira yokhala ndi matendawa ingathe kufalikira mofulumira, kuika malo atsopano. Matendawa amatha kugwira ma lobes angapo, nthawi zina amafalikira kumapapo onse.

Mitundu yomwe imakhudzidwa ndi yofiirira. M'kati, fetid pus ndi malo amodzi. Necrosis alibe ndondomeko yolimba, ndipo, monga tanenera pamwambapa, ali ndi chizoloŵezi chofalikira.

Matendawa amagawidwa mu mitundu iwiri:

1. Kawirikawiri: kudziwika kwa matendawa kumawonedwa kuti akugawidwa.
2. Zochepa: malo amodzi akupezeka. Kawirikawiri njira zoterezi zimakhala ngati abscess ndi chigololo.

Matendawa amayamba chifukwa cha tizilombo toyambitsa matenda. Mapulotechete ndi mapuloteni, makamaka, ndi magawo amodzi. Komabe, nthenda yoyamba imadziwika kuti ndi yoperewera kwambiri m'thupi. Madokotala opanga opaleshoni ndi opaleshoni yamatenda amatanthauzira njira zoopsa zowonongeka.

Kawirikawiri, matendawa amapezeka mwa amuna akuluakulu.

Matenda ammapapo ndi matenda owopsa kwambiri. Nthawi zambiri kumabweretsa mavuto aakulu:

• Chiwonongeko choyera cha pleura;
• Kuwononga magazi;
• Kutsitsimula kwa khoma la chifuwa;
• Sepsis;
• Zambiri zagulu lazale.

Pafupifupi odwala 60 peresenti omwe ali ndi zotsatira zotere amwalira.

Zifukwa za matendawa

N'chifukwa chiyani chiphuphu chimayamba? Zomwe zimayambitsa matenda zimabisika chimodzimodzi - matenda a ziphuphu. Nthawi zambiri tizilombo toyambitsa matenda timayambitsa mabakiteriya anaerobic.

Matenda angakhale matenda odziimira okha kapena zotsatira za kuledzeretsa kwa thupi. Choncho, pali njira zingapo zothandizira matenda ovuta monga chifuwa cha mapapo.

Malingaliro amtundu wa matendawa ndi awa:

1. Amayambitsa tizilombo toyambitsa matenda m'mapapu ndipo bronchi imayambitsa matenda a chingamu, mano, nasopharynx. Zikatero, tizilombo toyambitsa matenda tizilombo toyambitsa matenda timatha kufalitsa tsamba lopuma.
2. Nthawi zina mumalowa mkati mwa ziwalo za kupuma zomwe zimakhala zochepa kwambiri m'mimba kapena m'mimba zomwe zimasiyana ndi reflux, dysphagia, panthawi yosanza. Chochitika chotsatirachi nthawi zambiri chimakwiyitsidwa ndi vuto lopweteka kwambiri kapena kumwa mowa mopitirira muyeso. Kulowa mkati mwa mankhwala oopsa a bronchi m'mimba kumayambitsa ndondomeko ya purulent-necrotic mu matenda.
3. Matendawa amatha chifukwa cha mpweya wokwanira wa mapapo. Matenda oterewa amapezeka nthawi zambiri pamene bronchi imakanizidwa ndi thupi lachilendo kapena chotupa. Pa tsamba lino, majeremusi amawonekera, ndipo phokoso lopanda kanthu limayamba kupanga.
4. Chifukwa cha kukula kwa matenda angakhale matenda opatsirana a bronchopulmonary system. Izi ndi matenda awa: bronchiectasis, chibayo, abscess yamapapu.
5. Palinso njira yoopsya yopititsa patsogolo ziphuphu. Matendawa mu chifuwa angayambidwe ndi mabala oyenda.
6. Tizilombo toyambitsa matenda tizilombo toyambitsa matenda timatha kufalikira m'mapapo kudzera m'thupi la mitsempha ndi mitsempha ya magazi. Izi zimawonedwa ndi osteomyelitis, sepsis, parotitis, angina ndi zina zambiri matenda.

Chofunika kwambiri pakukula kwa matenda ndi kuchepa kwa chitetezo. Pachifukwa ichi, thupi silingathe kulimbana ndi tizilombo toyambitsa matenda, choncho silingalepheretse kupezeka kwa chilonda.

Perekani zifukwa zotsatirazi:

• Kusuta;
• Kumwa mowa;
• Kugwiritsa ntchito mankhwala osokoneza bongo;
• HIV;
• Ukalamba;
• Kugwiritsa ntchito mahomoni a glucocorticoid;
• Matenda a shuga.

Chizindikiro cha matendawa

Mphuno ya m'mapapo imasiyana mofulumira kwambiri. Zizindikiro ndizovuta. Matendawa akufalikira mofulumira ndipo mkhalidwe wa wodwalayo ukuchepa kwambiri. Talingalirani zachipatala zomwe zimasonyeza kuti chimfine chimakhala chachikulu.

Zizindikiro zomwe zimaonetsa matendawa zikuwoneka ngati izi:

1. Ululu wowawa mu sternum. Zimakhala zovuta kwambiri pamene mukutsokomola.
2. Mkhalidwe wovuta wa wodwala: kutentha kwakukulu, kuzizira, kudzinenera kuledzera thupi.
3. Pali kusowa kwa kudya, kulemera, kuphatikizapo anorexia, tachycardia, dyspnea.
4. Chifuwa chokwanira pamodzi ndi frothy sputum ndi pus. Kutuluka kwathupi kumakhala ndi fungo lokoma. Zili ndi nsalu zofiira ndi zofiira. Pokhala ndi ziphuphu zamapapu mumatope, tinthu tating'ono tafa, magazi amapezeka.
5. Wodwala amayamba kukhumudwa.
6. Kutupa ndi kwakukulu.
7. Kupanda mpweya kumapangitsa hypoxia, yomwe imawonetseredwa ndi zala zachitsulo, khungu ndi milomo.
8. Wodwala atopa kwambiri.
9. Nthawi zina pamakhala kusokonezeka kwa chidziwitso.
10. Wodwala amapatsidwa mpweya waukulu. Kupuma bwino sikungabweretse mavuto.

Njira ya matendawa

Taganizirani momwe chifuwa cha mapapo chimayambira. Pathogenesis ya matendawa ndi ofanana kwambiri ndi mapulosi a mapapo. Pachipatala, chiphuphu chimatha kusiyanitsa ndi fungo lokoma komanso chizoloŵezi chokhala ndi nthawi yaitali.

Matendawa amadziwonetsera motere:

1. Poyamba, kutentha kwa wodwala kumatuluka. The thermometer amalemba kwambiri ntchito. Komabe, izi ndizo za odwala omwe alibe umoyo wabwino. Kwa munthuyo umoyo waumoyo ukufalikira. Amakumana ndi zofooka zoopsa, kunyoza, kuthamanga. Kawirikawiri amabwera kusanza. Pali ululu mu sternum. Kuyesera kutenga mpweya waukulu kumabweretsa mavuto aakulu. Ngati mumakanikizana pakati pa nthiti, kudera lomwe lakhudzidwayo, munthuyo ali ndi ululu.
2. Kukwiya, monga lamulo, kumachitika mwamsanga. Poyamba ndi youma. Ndiye imakhala yonyowa. Chifuwa chimayamba kukodza, chomwe chimakhala ndi fungo losasangalatsa kwambiri. Ngati zowonongeka zoterezi zatsala mu thanki kwa kanthawi, zidzagawidwa mu zigawo zitatu. Kumtunda - adzawonedwa thovu ndi ntchentche. Chingwe chapakati chili ndi madzi ozizira. Mafinya adzagwa.
3. Chizindikiro chikufulumira kwambiri. Wodwala amakhala ndi mpweya wochepa, tachycardia imawoneka, kufooka kotchulidwa. Kudziwa kwa wodwala kumaponderezedwa. Nthaŵi zina, chiphuphu chimayamba. Kutentha kumatha. Nthawi zina zimagwa pansi pa 38 C. Matendawa ndi ovuta kwambiri, chifukwa kuchuluka kwa kachilombo ka HIV kumalowa m'magazi.
4. Ngati wodwalayo apulumuka nthawiyi, ndiye kuti amodzi kapena angapo apangidwe. Zingwe zoterezi zomwe zimakhala ndi pus zimadutsa mu bronchi. Chodabwitsa ichi chimasonyeza nthawi yotsatira ya matendawa.
5. Wodwala amakula kapena amachulukitsa chifuwa, komwe amatha kutulutsa mimba. Ngati mphulupulu imatulutsa mwala waukulu, ndiye kuti nthawi yomweyo amatulutsa pus, nthawi zina ndi magazi. Matendawa amakula bwino. Koma nthawi zambiri, kutaya sikuchitika mwachindunji, koma kupyolera mu bronchi yaing'ono. Izi zimapititsa patsogolo kutulutsidwa kwa abscess ku pus, kotero mkhalidwe wa wodwalayo ukupitirira kukhala wovuta. Mphungu ndi nthendayi yamapapu imakhala ndi fungo lonunkhira. Nthawi zina zimakhala ndi zidutswa zochepa za mapapo a mapafu - sequesters.

Kuzindikira matendawa

Chofunika kwambiri pakuzindikiritsa kuti matendawa amachitidwa poyesedwa. Wodwala atha kuyendayenda kupuma gawo lomwe lakhudzidwa la chifuwacho, amachepetsa phokoso lomveka. Panthawi yachisokonezo, kupuma kumafooketsa phokoso, miyambo yowuma imapezeka.

Kuonjezera apo, matenda omwe amapezeka m'mapapu amachititsa kuti azifufuza:

1. Mayeso a magazi. Zimasonyeza kuwonjezeka kwa chiwerengero cha leukocyte, kuchepa kwa maselo ofiira a magazi, kuwonjezeka kwa ESR. Pali kuchepa kwa puloteni wathunthu wa magazi.
2. X-ray ya sternum. Matenda am'mapapu ndi necrosis amaoneka pachithunzichi ndikuwombera minofu. Kawirikawiri pali mitsempha ya kuwonongeka ndi m'mphepete mwayi. Kuda mdima kumachititsa kuti kufalikira mofulumira komanso kupitirira masiku angapo kumakhudza mbali, ndipo nthawi zina mapapo onse. X-ray ikuwonetsa kuoneka kwa kuwonongedwa mu pempho lopempha.
3. Mapulogalamu a kompyuta. Izi ndi njira zamakono zamakono. Amaphunzitsa makamaka za matendawa. Mbalameyi imathandiza kuti zitha kuwona zovunda zonse zomwe zimagwirizana ndi kusungunuka kwa mapapo.
4. Fibrobronchoscopy. Endoscopic njira yochidziwitsira imayambitsa purulent endobronchitis, kutsekedwa. Phunziroli limapereka mpata wowonera mphamvu zowonongeka.
5. Kusanthula mfuti. Pambuyo pa bronchoscopy, zomwe zimapezeka ndi mateti zimatumizidwa kukayezetsa ma laboratory. Mayeso odziwa za matendawa amavumbulutsa matenda omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.

Zingakhale zovuta

Kudandaula kwa nthaŵi yake kwa madokotala kungalepheretse matenda ngati matendawa. Mavuto amabwera, monga lamulo, ngati ulendo wa madokotala wachedwa.

Pachifukwa ichi, zotsatira zake zingakhale zoopsa:

1. Zouma, exudative pleurisy.
2. Kupitilira muchisomo cha chipolopolo chophwanya kumabweretsa pyopneumotorax. Wodwala ali ndi ululu wowawa kumbali, dyspnea ikuwonekera, pali kusuntha kwa mtima. Mkhalidwe wa wodwalayo umachepa kwambiri. Pali zodabwitsa za kugwa.
3. Amayambitsa magazi.
4. Septicopyemia. Matenda a chifuwa amachitika motsatira maziko a chiwonongeko m'mapapu a chotengera chachikulu.
5. Amyloidosis wa impso. Amakula pa matenda aakulu.

Kuonjezera apo, ndi ziphuphu zamapapu, chiopsezo cha imfa ndi chachikulu kwambiri.

Chithandizo chodziletsa

Mankhwala amaperekedwa kuchipatala.

Chithandizo cha chimfine cha m'mapapo chili ndi izi:

1. Kuchotsa thupi kwambiri. Pachifukwa chimenechi, wodwalayo amapatsidwa intravenous plasma-kusintha njira zochepa: Gemodez, Reopoliglyukin, Neokompensan. Perekani plasma, mavitanidwe a madzi a electrolyte, albumin. Lowani njira zokhudzana ndi shuga (5%, 10%) ndi insulini, komanso inhibitors ya proteolysis "Trasilol", "Contrikal."
2. Thandizo la antibacterial. Ichi ndicho mgwirizano wofunika kwambiri, popanda chithandizo cha chifuwa cha m'mapapo sichingatheke. Poyamba, ma antibiotic amalimbikitsidwa omwe amadziwika ndi zotsatira zosiyanasiyana. Monga lamulo, awa ndiwo mankhwala awa: Fortum, Cefepim, Meropenem, Tienam. Kawirikawiri wodwalayo amauzidwa mwamsanga ma antibayotiki 2. Pambuyo pozindikira tizilombo toyambitsa tizilombo, chithandizo choyenera kwambiri cha mankhwala chimasankhidwa. Kugwiritsira ntchito mankhwalawa "Ampicillin" ndi kukonzekera "Tseporin", "Gentamicin", "Kefzol", "Tetraolean".
3. Kusokoneza thupi. Wodwala akuuzidwa mankhwala Suprastin, Dimedrol, Pipolphen.
4. Vitamini complexes "Retinol acetate", "Riboflavin", "Cyanocobalamin", "Thiamine", "Pyridoxine", "Acid ascorbic acid" akulimbikitsidwa.
5. Ngati pali coagulability yamagazi, wodwalayo amamwa jekeseni mkati mwake ndi mankhwala "Heparin".
6. Kuonetsetsa kuti kupuma mokwanira, nthawi ndi nthawi kapena kupuma nthawi zonse ndi mpweya wabwino.
7. Ngati ndi kotheka, amatha kupweteka ndi matumbo a m'mimba, mchere wamtengo wapatali.
8. Lembani mowa wa phlegm. Mankhwalawa amathandizidwa ndi intravenously ndipo amagwiritsidwa ntchito pofufuzira. Wodwalayo akhoza kulandira mankhwala "Ambroxol", "Lazolvan", "Ambrobene", "Khaliksol", "ACTS Inject."

Pathandizira, mkhalidwe wa wodwalawo umayendetsedwa bwino. Kugwiritsidwa ntchito kwa mtima, chiwindi, impso zikuwonetsedwa. Ziwalo zomalizira zimapatsidwa chisamaliro chapadera, chifukwa zimapereka zotsatira za kachilombo ka HIV ndi mankhwala.

Chithandizo cha feteleza ndi chimfine cha mapapo chimaphatikizapo kukhetsa madzi. Zochita zoterezi zimapangidwa ngati abscess ili kumalo omwe ali pafupi ndi malo omwe akuphimba.

Chithandizo cha opaleshoni

Ngati ndondomekoyi sitingathe kukhazikika ndi mankhwala osamalitsa, ndiye kuti zonse zowonjezera zowonjezera zimayambira. Pachifukwachi, kusokonezeka kwa mankhwala ndi kusokoneza thupi kumakonzedwa, mkhalidwe wa wodwalawo umayesedwa (akhoza kuchitidwa opaleshoni).

Njira yothandizira opaleshoni imachotsa kuchotsa ziphuphu zakupha:

• Lobectomy;
• Bilobectomy;
• Pulmonectomy.

Kusamalira wodwala

Matendawa ndi ovuta kwa odwala okha, komanso kwa anthu omwe amawasamalira. Ndikolemetsa kwambiri nthawi zonse.

Kupereka chisamaliro chofunikira kwa wodwalayo, nkofunikira kupereka:

1. Kugwiritsira ntchito mankhwala opanga ma deodorizing. Pa ntchitoyi, creosote ikhoza kuchita.
2. Pafupi ndi bedi la wodwala nthawi zonse ayenera kukhala wodula. Kuti muchepetse kununkhira kosasangalatsa, ndibwino kuti muzitsanulira mu njira yothetsera madzi pang'ono. Kuwonjezera pamenepo, nthawi zonse iyenera kutsekedwa ndi chivindikiro.
3. Wodwala, yemwe amapezeka kuti ali ndi ziphuphu zamapapu, amatha kutuluka thukuta. Choncho, wodwalayo nthawi zambiri amafunika kusintha bedi ndi zovala.
4. Nthawi zina matenda a munthu amakula kwambiri moti sangathe kudya yekha. Choncho, iwo omwe amasamalira wodwala wotero, ndikofunika kudyetsa wodwalayo ndi supuni.
5. Ndikofunika kuti muzitha kupuma kwathunthu ndi m'maganizo.
6. Pamene hemoptysis wodwalayo ayenera kukhala pamalo omwe akukhala.
7. Wodwalayo saloledwa kulankhula, kumwa mowa kapena chakudya.

Chiwonetsero cha moyo

Kodi oyembekezera omwe ali ndi ziphuphu zam'tsogolo akuyembekezera chiyani? Zomwe zikuchitika zimakhumudwitsa kokha ngati palibe chithandizo cham'tsogolo. Ndipotu, matendawa amakula mofulumira kwambiri, ndipo amakhala ndi malo abwino. Ngati mankhwala osamalitsa sakuthandiza, ndipo chithandizo chopanda opaleshoni sichinachitike, wodwalayo amafa.

Pogwiritsa ntchito madokotala nthawi yeniyeni, chithunzi chosiyana kwambiri chimawonedwa. Ziwerengero zimati mu 70-80% mwa milandu yonse, odwala perebaryvayut amatha kubwezeretsa. Njira yoperekera ndi yokwanira imabweretsanso munthu kumoyo wathunthu.

Kusamala kwambiri kumafunikira mavuto monga sepsis, mpweya wamagazi, ziwalo zambiri zolephera. Ndi matendawa wodwalayo amafunikira thandizo lachangu. Ngati pazifukwa zilizonse siziperekedwa, ndiye kuti chiopsezo cha chitukuko chosasinthika m'thupi ndi chokwanira.

Choncho m'pofunika kutsindika kamodzinso zotsatirazi: kuti kupirira kudwala imeneyi, ayenera yomweyo dokotala ndi kukhazikitsa bwinobwino malangizo a madotolo.