Esibhibhayo: izimpawu, izimbangela, ukwelashwa

On umgudu wokuphefumula impilo kudinga ukunakekelwa kusukela zisencane. Umzimba womuntu njalo iyahlaselwa-bacterium ahlukahlukene, amagciwane, amagciwane. Ikakhulukazi ingozi yesifo inyuka lapho kubanda futhi kubanda, washintsha, izinsuku zabo efudumele libalele.

ukungcoliswa komoya, ukubhema, babhebhethekise isimo bese uvumele ukutheleleka ukungena ijule ngokungaphezulu ku iziteshi zokuphefumula. Izifo kuthinta elingenhla umgudu wokuphefumula. ubuthaka babo, kuhlangene ukungakwazi izivikeli mzimba ukuze amelane nokuhlaselwa kwamagciwane kuholela ukuthuthukiswa pathologies sína izigaba aphansi. Omunye wabo kuyinto esibhibhayo kwamaphaphu.

Kuyini isifo? Ziyini izimpawu sici sifo? Indlela yokubhekana naso futhi ukuthi ungakwazi ukuwunqoba lo zokugula ezimbi? Izinto eziza kuqala.

Izimpawu isifo

Uyini esibhibhayo kwamaphaphu? Lokhu zokugula, lapho kuwa wamaphaphu izicubu - necrosis. inqubo enjalo has a uhlamvu Putrid. Ubovu Fusion lendwangu akugcini libe linye. Inqubo sokugembula uyakwazi zanda ngokushesha, esehlanganise izindawo ezintsha. Ukugula kungathinta iyizingxenye eziningana, ngezinye izikhathi nangabo lonke wamaphaphu.

izicubu athintekayo libhekene ensundu. Ngaphakathi yenziwe yaba yasendaweni ubomvu fetid. Necrosis ayinakho ukuma okuqinile, futhi njengoba kushiwo ngenhla, enokuthambekela lalanda.

Pathology ihlukaniswe 2 izinhlobo:

1. Distribution: kwasendaweni isifo lobar uyalandelwa.
2. Izivimbelo: indawo segmental kutholakala. Ngokuvamile le nqubo ichazwa njengehamba ithumba, egqoke uhlamvu gangrenous.

Lesi sifo sibangelwa nezilwanyana ezincane pathogenic. Ithumba nezilonda ezingapholi, ngokuyisisekelo iyafana inqubo izinyathelo. Nokho, esihluke wangaphambili kungagcini ubovu inqubo isifo ezicutshini. odokotela abahlinzayo thoracic futhi pulmonologists ubheke lezi pathologies amafomu nzima kakhulu futhi kuyingozi yembubhiso.

Ngokuvamile, isifo sitholakale amadoda phakathi-abaneminyaka.

Esibhibhayo kwamaphaphu - isifo esiyingozi kakhulu. Kuvame ukubangela yezinkinga ebulalayo:

• ubovu kubhujiswa lesi pleura;
• ukopha yamaphaphu;
• suppuration esifubeni udonga;
• sepsis;
• kwezitho zomzimba eziningi.

Babalelwa ku-60% eziguli ebhekene imiphumela enjalo afe.

Izimbangela zesifo

Kungani kukhona esibhibhayo? Izimbangela zesifo kufihlwe kwelinye into eyodwa - ukutheleleka lesion izicubu. Ngokuvamile nezilwanyana ezincane ukuthi kumkhathaze zezifo amagciwane anaerobic.

Izifo kungaba zokugula ezimele noma umphumela lokudakwa. Ngakho, kukhona izinto eziningi ezisebenza ngokubambisana ezinjalo izifo ezibuhlungu njengesilonda esibhibhayo.

Etiology lesi sifo simiswe ngalendlela lelandzelako:

1. Avuse ingress microbial emaphashini futhi bronchi ikani isifo sezinsini, izinyo nasopharynx. Ngaphansi kwezimo ezinjalo okwazi microflora pathogenic asakaze phansi umgudu.
2. Ngezinye izikhathi kukhona Ukungena ohlelweni zokuphefumula isamba iminonjana osenyameni evela ekhaleni nomphimbo noma isisu okuqukethwe lapho Reflux, dysphagia, ngesikhathi ukuhlanza. Lo mkhuba yokugcina ngokuvamile esibangelwa ukulimala ekhanda noma ukudakwa. Bagamanxela bronchi okuqukethwe isisu nolaka kubangela inqubo necrotic ezicutshini.
3. I zokugula bungase bubangelwe ukupholisa ingafaneleki. isimo esinjalo sivame kwenzeka uma isibambo bronchus nomzimba angaphandle noma isimila. Kuleli sayithi zikhona amagciwane, futhi uqala ukwakha abscesses nezilonda ezingapholi.
4. Imbangela yesifo bangaba izifo ubovu ka umgudu wokuphefumula. Lezi zifo ezilandelayo: bronchiectasis, inyumoniya, wamaphaphu ithumba.
5. Izimali nazo kuhlasimulise indlela ukuthuthukiswa esibhibhayo. Ukuthola ngegciwane esifubeni kungase kubangelwe eyenza umuntu acabange eseZwini amanxeba.
6. nezilwanyana ezincane Pathogenic bakwazi ukusakaza emaphashini nguhlelo negazi kwemigudu ye-lymph. Lokhu kungabonakala osteomyelitis, sepsis, mumps, umkhuhlane nezinye pathologies eziningi.

Indima ebalulekile ekuthuthukiseni lesi sifo udlala lube buthaka amasosha omzimba. Kulokhu, umzimba akakwazi ukubhekana ezincane, futhi ngaleyo ndlela ngeke ukuvimbela okuvela kuyo esibhibhayo.

Lezi zinto ezilandelayo ingozi ivelele:

• ukubhema;
• ukuluthwa utshwala;
• yizidakamizwa;
• Ukutheleleka nge-HIV;
• sokuguga;
• ukusebenzisa glucocorticoids;
• sikashukela.

symptomatology lesi sifo

Ngiphephile ukuthuthukiswa ngokushesha libhekene esibhibhayo. Izimpawu zinzima. Ukugula ngokushesha futhi isimo lesiguli liwohloka sina. Ake sicabangele lokho izimpawu zokwelapha ukubonwa esibhibhayo.

Izimpawu agcwele isifo zimi kanje:

1. ukungakhululeki ubuhlungu sternum. Yena kuxhomeke kakhulu lapho ukhwehlela.
2. Isimo Esibucayi nesineke: imfiva, Ukugodola, ukudakwa kubi.
3. Kukhona ukuntuleka ukudla, ukuncipha emzibeni, kuze sokuzincisha ukudla, tachycardia, iphika.
4. ukukhwehlela Olukhulu ephelezelwa isikhwehlela frothy futhi ubomvu. Ukwaba ezahlukene iphunga fetid. Bona abonise Tint ensundu ukunikeza ungqimba amagwebu. Lapho wamaphaphu isikhwehlela esibhibhayo singenzeka efile izicubu izinhlayiya, igazi.
5. Isiguli iqala ukuba kuminyanise.
6. Kukhona ngabe ujuluka kakhulu.
7. I yokushodelwa umoya kuholela hypoxia, okuyinto uveta integument iminwe bluish, isikhumba sezindebe.
8. Isiguli uyakhathala ngokushesha.
9. Ngezinye izikhathi kukhona isiyezi.
10. Isiguli sinikezwa umoya kakhulu ubuhlungu. Calm ukuphefumula ukungakhululeki kubangela.

Inkambo sifo

Cabanga indlela ukuthuthukisa esibhibhayo. I pathogenesis lesi sifo kakhulu efana ukugeleza wamaphaphu ithumba. esibhibhayo emtholampilo kungaba ukuhlukanisa malodor alandisa propensity eliphezulu enqubweni hronifitsirovaniyu.

Izifo sinezimfanelo njengoba kulandela:

1. Ekuqaleni, isiguli enomkhuhlane. Thermometer nerejista ukusebenza eqinile. Nokho, kuyinto eyinqaba kulabo iziguli abangenayo ukuntula mzimba. Umuntu kabi nakakhulu. Uzizwa imakwe ubuthakathaka, isicanucanu, ukucobeka. Ngokuvamile kuza ukuhlanza. Ubuhlungu sternum livela. Ukuzama ukuthatha ezijulile umoya imbangela ukungakhululeki ezinzima. Uma ucindezela phakathi izimbambo, ubuhlungu livela phezu endaweni ethintekile, kubantu.
2. Khwehlela ngokuvamile kwenzeka ngokushesha. Ekuqaleni sesomile. Khona-ke buba manzi. Buqala ukukhwehlela isikhwehlela, elithatha iphunga ezingemnandi kakhulu. Uma ocucuzayo ezinjalo isikhathi esithile kwesokunxele ethangini, kuyothiwa ihlukaniswe 3 izingqimba. Ngo elingenhla - Foam slime sizoba. Isendlalelo phakathi iqukethe ketshezi. Inzika ngeke baphume ubomvu.
3. Symptomatology ngokushesha ethuthuka. Isiguli ikhula dyspnea, tachycardia avele, ubuthakathaka evelele. ukwazi lesiguli ucindezelwe. Kwezinye izimo, ikhoma eba. Amazinga zingancishiswa. Ngezinye izikhathi lehla ngezansi 38 C. Lesi simo kubalulekile ngempela, ngoba igazi idwetshwa inani elikhulu lokuqukethwe itheleleke.
4. Uma isiguli uyasinda lesi sikhathi, walibumba eyodwa noma ngaphezulu abscesses. izimbotshana okunjalo equkethe ubomvu, ukuthambekela ukugqekeza bronchus. Lesi simo esiyingqayizivele sibangelwa kuwuphawu kwesikhathi esilandelayo sokuthuthuka lesi sifo.
5. Iziguli zinamathuba ukukhwehlela nakakhulu, lapho semali phlegm. Uma abscesses kuthiwa likhanyelwe ngokusebenzisa bronchi ezinkulu, isiguli ngokushesha labelwe eziningi ubomvu, kwezinye izimo ngegazi. Isimo liyathuthuka ngokushesha ngokwanele. Kodwa iningi bethulula akuyona indlela eqondile, kodwa ngokusebenzisa bronchi encane. Lokhu kakhulu kubambezela ukukhululwa kwe ubomvu kusuka ithumba, ngakho isimo lesiguli uyaqhubeka ukuthatha izinto ngokungathí sina. Isikhwehlela nge esibhibhayo wamaphaphu possesses iphunga eyanele malodorous. Ngezinye izikhathi liqukethe izingcezu ezincane wamaphaphu izicubu - sequesters.

sitholakele isifo

A indima ebalulekile ekunqumeni zokugula udlala behlolwa. Isiguli emuva ku inqubo emishinini yokuphefumula wengxenye ethintekile kwesifuba, mfushane eshaywayo umsindo. Phakathi auscultation ukubona umsindo zokuphefumula buthaka, kwesifuba ezomile.

Ngaphezu kwalokho, ukuxilongwa wamaphaphu esibhibhayo kuhlanganisa izindlela wezinsimbi futhi laboratory:

1. Igazi test. Ibonisa ukwanda isibalo leukocyte, erythrocyte ezingeni esincishisiwe, okwandisa ESR. A ukwehla Imininingwane igazi amaprotheni.
2. X-ray of the sternum. Esibhibhayo futhi necrosis of wamaphaphu izicubu ziboniswe Ukufiphala isithombe. Ngokuvamile zatholakala nokwahlukana temlomo jagged noma scalloped emaphethelweni. Ukufiphala enokuthambekela a ukusakazwa ngokushesha futhi ukuhlala izinsukwana kungathinta Lobe eduze, futhi ngezinye izikhathi yonke wamaphaphu. X-ray abonise okuvela exudate e ngalo ingaphakathi pleural.
3. computed tomography. Le ndlela yesimanje yama-X-ray. Kuyinto ikakhulukazi ulwazi kulesi egunjini lokuhlolwa kwezifo. Tomogram kungathola zonke kwachitheka izimbotshana ezihambisana esishintshashintshayo ukuncibilika emaphashini.
4. Bronchoscopy. Endoscopic indlela zokuxilonga inquma ubovu endobronchitis, obturation. Lolu cwaningo kunikeza ithuba lokubheka Dynamics inqubo sokugembula.
5. Uhlaziyo isikhwehlela. Ngemva okuqukethwe bronchoscopy kanye isikhwehlela etholwe zithunyelwa ezikhungweni zocwaningo. Ukuhlonzwa kwesifo ukuthola zokugula lwegciwane asivumele ukunquma nozwela nezilwanyana ezincane nemithi.

yezinkinga kungenzeka

Kuphela ukwelashwa esifike ngesikhathi kudokotela ongamisa lo zokugula, njengesilonda esibhibhayo. kuphakama izinkinga, njengoba umthetho, uma evakashele odokotela imisiwe.

Kulesi simo, kungase kube nemiphumela emibi kakhulu:

1. Dry, effusion pleural.
2. A impumelelo kule ingaphakathi pleural kuholela pneumoempyema gangrenous. Isiguli sinelungelo i-acute flank ubuhlungu, iphika, inhliziyo ukufuduka kwenzeka. isimo wesiguli liwohloka. Lo mkhuba wokugoqa.
3. ukopha kakhulu.
4. Pyosepticemia. I zokugula kwenzeka ngokumelene ingemuva nolokubhujiswa emaphashini wesikebhe ezinkulu.
5. amyloidosis kwezinso. Kutfutfukisa esimweni ifomu njalo lesi sifo.

Ngaphezu kwalokho, lapho ukukhanya esibhibhayo ingozi eliphezulu kakhulu sokufa.

ukwelashwa ngoludala

Ukwelashwa uqhutshwa ngendlela imvelo esibhedlela.

Ukwelashwa nokuvikelwa wamaphaphu esibhibhayo siqukethe izinyathelo ezilandelayo:

1. kobuthi egazini nezibi. Ngenxa yalezi zinjongo, isiguli iqondiswa ngemithambo yegazi plasma-abambele izixazululo ziphansi isisindo yamangqamuzana "Hemodez", "Reopoligljukin", "Neokompensan". Yabela plasma vodnoelektrolitnye ingxube-albumin. isixazululo Iphathwe glucose (5%, 10%) kanye insulin, kanye inhibitor ka proteolysis "Trasylol", "Contrycal".
2. Ukwelapha umuntu ngemithi elwa namagciwane. Lona Abantu yibona ababaluleke kakhulu, ngaphandle kwalokho ekwelapheni wamaphaphu esibhibhayo akunakwenzeka. Ekuqaleni ukuncoma antibiotic, ebangeni zawo ezibanzi yemiphumela. Njengomthetho, kuba izidakamizwa ezilandelayo: "Fortum", "Cefepime", "Meropenem", "Tienam". Ngokuvamile, iziguli iqondiswa i-antibiotic ngokushesha 2. Ngemva kokuchaza lwegciwane kuyakhethwa eqondile more yokwelapha lwemithi. inhlanganisela izidakamizwa "Ampicillin" nezidakamizwa "Tseporin", "Gentamycin", "Kefzol", "tetraolean" siyasebenza ngempela.
3. Ebulala umzimba. Isiguli ezinqunyiwe imithi "Suprastin", "Diphenhydramine", "pipolfen".
4. Kunconywe Vitamin izakhiwo "retinol acetate" "riboflavin" "cyanocobalamin" "Thiamin" "pyridoxine" "ascorbic acid".
5. Uma kukhona i-high blood ekunqandeni, isiguli ngemithambo yegazi injected izidakamizwa "Heparin".
6. Ukuqinisekisa ukuphefumula ezanele ngezikhathi ezithile noma njalo kwenziwe humidified-mpilo ephefumula.
7. Uma kudingeka, thatha nilwe paresis kwamathumbu, kabusha isihlahla tracheobronchial.
8. Yabela phlegm izidakamizwa. Laba basizi iphathwa ngemithambo yegazi futhi isetshenziselwa ephefumula. Isiguli kungenzeka Kunconywa imithi "Ambroxol", "Lasolvan", "Ambrobene", "Haliksol", "ACC injective."

Esikhathini ngezimo zesiguli ngokuqinile ziqashwe ngesikhathi yokwelapha. Kukhona umsebenzi zenhliziyo uhlelo, isibindi kanye nezinso. Iziphathimandla yokugcina ukukhokhela ukunakekelwa okukhethekile, ngoba zinika ekhishwa impahla elinegciwane nemithi.

Ukwelashwa nokuvikelwa ithumba futhi wamaphaphu esibhibhayo kuhilela amanzi ingaphakathi. Lezo esithathwayo uma ithumba itholakala eduze kwamanzi imbozwe pleura.

ukwelashwa op

Uma inqubo ehluleka ekulinganiseni yokwelapha ngoludala, lapho-ke zonke izinkomba lokungenela olukhulu. Ngenxa yalesi hemodynamic olungisiwe, iziyaluyalu umzimba, ahlolwe isimo lesiguli (ukuthi kungenzeka ukuba afeze ukuhlinzwa).

Ukuhlinzwa kuhilela ukususwa gangrenous wamaphaphu izicubu:

• lobectomy;
• bilobektomiyu;
• pneumonectomy.

ukunakekelwa

Lesi sifo ngempela kunzima kokubili iziguli kanye ntu azinakekele. Kakhulu ukala njalo ukwethula nephunga Putrid.

Ukunikeza ukunakekelwa okufanele ukuze isiguli, kufanele kube:

1. Ukusetshenziswa deodorizing ejenti. Endimeni esinjalo singamelana isinyathelo creosote.
2. Eduze embhedeni isiguli kumele igcinwe spittoon. Ukuze wehlise nephunga ezingemnandi, kutuswa ukuba uthele isixazululo kancane deodorizing. Ngaphezu kwalokho, kufanele qiniseka uvale lid.
3. Iziguli uxilongwe esibhibhayo, uthambekela ukujuluka ngokweqile. Ngakho-ke, isiguli kuzodinga izinguquko njalo embhedeni izingubo.
4. Ngezinye izikhathi isimo umuntu ngakho yawohloka, ukuthi akakwazi ngisho ukwenza ukudla kwazo. Ngakho-ke, labo abanakekela iziguli esinjalo, isiguli kumele bondliwe ngesipuni.
5. Kubalulekile ukuqinisekisa lokuphumula okuphelele ngokomzimba nangokwengqondo.
6. Lapho hemoptysis isiguli kufanele babe sesimweni semi ehlezi.
7. Isiguli kungavunyelwe ukukhuluma, aphuze isiphuzo esishisayo noma ukudla.

ukuphila Ukubikezela

Yini elindele labo iziguli ukuthi nginesifo wamaphaphu esibhibhayo? Esidumazayo umhlahlo kuphela icala uma kungekho ukwelashwa esifike ngesikhathi. Ngemva ukugula ngokushesha okukhulu andisa, esehlanganise izindawo enempilo. Uma yokwelapha olandelanayo ehluleka, futhi ukuhlinzwa akuyona kwenziwe, isiguli uyafa.

Nge ukwelashwa esifike ngesikhathi odokotela waphawula isithombe ehluke ngokuphelele. Izibalo sithi 70-80% azo zonke iziguli perebaryvat esibhibhayo bese alulame. Yiqiniso okugcwele ezanele ukwelashwa umuntu ibuyisela ekuphileni okuvamile.

I ukunakekela okukhethekile kudingeka yezinkinga ezifana sepsis, ukopha yamaphaphu, lezo zitho zomzimba eziningi. Ngaphansi kwalezi izifo isiguli abadinga usizo oluphuthumayo. Uma nganoma isiphi isizathu ke singanikezwanga, ingozi eliphezulu imiphumela engelapheki emzimbeni.

Ngakho-ke kubalulekile ukugcizelela waphinda okulandelayo: ukuze babhekane nalesi zokugula, kufanele ngokushesha ubone udokotela futhi ukufaka loluhlelo ngokuphelele izincomo odokotela bebhekile.