Atelectasis - chii ichi? Chirwere, kurapwa uye fungidziro

Atelectasis - chii ichi? Mhinduro nyaya iyi vezvokurapa chete nevaya unyanzvi. Asi nokuti kuona here havadi chiremba. Details of atelectasis, unogona kudzidza kubva zvinhu yacho.

The tsananguro

Atelectasis - chirwere pathological iyo kunoratidzwa kurasikirwa chiedza airiness zvose kana imwe nzvimbo. Viewed izwi rine Greek mavambo. Akashandurirwa Russian, zvinoreva "vakakundikana" kana "kukwana tatamuka jira."

zvinokonzera

Atelectasis - vasanyanye of zvemapapu chidimbu. Kukudziridza akadaro pathological mamiriro anogona kuguma zvinoverengeka. We nyorai zvihombe izvozvi:

• Inosimudzira pamusoro makakatanwa aona pamadziro ose Formação de. Kazhinji, zvokurwara uyu anokonzerwa pulmonary edema kana cardiogenic noncardiogenic mavambo, uyewo kushaya surfactant kana zvirwere kwendangariro.
• Compression of Airways kana zvemapapu, izvo zviri kukonzerwa siyana zvimwewo zvinoitika (semuenzaniso, mediastinal bundu, imwe anomaly kukura guru midziyo ropa, lymphadenopathy, myocardial hypertrophy , etc.).
• Zvokurwara mucosa (yomukati) rusvingo bronchus (semuenzaniso bronhomalyatsiya, deformation, kuzvimba kana edema).
• Mhingaidzo kana occlusion pamusoro lumen paiya inonzi Árbol yokumwe miviri, madzihwa, caseous guru (semuenzaniso, tiibhii), uye mucosal edema.
• Kutyorwa zvepanyama karwendo pechipfuva, izvo simuka nokuda kuoma phrenic etsinga, mukuru yokutindivadza, scoliosis kana neuromuscular zvirwere.
• Kuwedzera dzomunyika kumanikidzwa iri pleural mhango (kusanganisira hemothorax, hydrothorax, empyema, pneumothorax).

Nei achiri kuitika atelectasis? The zvinokonzera ichi kazhinji akavanda chakasimba muhombe pokuwa zvemapapu, iyo unovapo sezvo postoperative kuomesa nokuda kwenguva refu kutadza kufamba murwere, okisijeni ovhadhozi, hypothermia, kushandisa dzakakwirira mishonga ine sedatives uye opioids, uyewo vasodilating nevamiririri.

zvinokonzera njodzi

Ndiani kazhinji kuchengetwa atelectasis? chirwere ichi rinowanikwa vanhu vane kufutisa, cystic fibrosis uye asima. Uyewo zvakanga muvamwe vanosvuta.

kupatsanura

By kwakabva atelectasis kuti zvemapapu akafukidza kunogona vachiberekwa (kureva, chikuru) kana akawana (kureva, yechipiri).

Under mukuru chirwere aireva hurumende kana achangozvarwa hakuna rimire nyore. Kana akawana atelectasis, muchiitiko ichi pane spadenie zvemapapu rinenge izvo zvakanga zvamboshandiswa munyaya kufema kwacho.

Hatigoni kutaura kuti vakadaro mananara anofanira kusiyaniswa kubva pamuviri atelectasis, kureva airless mamiriro mumapapu, izvo akaona mudumbu, uye vasiri (kureva, hypoventilation kuti unowanikwa vanhu zvimwe hwakanaka uye rudzi dzichipfekeka kuchengeterwa zviri zvemapapu tishu).

Mhando zvirwere

Zvichienderana chitsama zvemapapu rinenge kuti kunosvika kubva kufema kwacho, chirwere mubvunzo rakakamurwa:

• acinar;
• segmental;
• lobular;
• muunganidzwa;
• zvakarurama.

Uyewo, zvingava bilateral kana yaitsigira divi. Sezvineiwo, wokutanga mhando zvikuru ngozi uye vanokwanisa chaizvo nyore kurufu zvomurwere.

chirwere mhando

Zvichienderana etiopathogenic zvinhu zviri zvokurwara iyi pulmonary gadziriro rakakamurwa marudzi anotevera:

• Compression atelectasis, kana kuparara yemapapu. Ichi chirwere kunokonzerwa compression pamusoro zvemapapu rinenge kubva kunze, uye kuunganidza mune pleural mhango pakati fluid mhepo, ropa kana pus.
• Obstructive atelectasis. Fani iyi chokuita zvokuimba kutyora trachea uye Árbol mhingaidzo.
• Discoid atelectasis yemapapu. kazhinji zvokurwara kwakadaro anova pashure contusion thorax kana rumbabvu mitswe.
• Marwadzo - kunokonzerwa compression pamusoro fibrous zvinyama zviri Formação de (mu subpleural mumapapu).
• Acinar - chokuita nokusava surfactant (kazhinji kunoitika muna vakuru uye vachangoberekwa pamwe kufema nenhamo chirwere).

Zvinofanira kucherechedzwa kuti chirwere unogona kunzi dzepanguva uye postoperative, uye zvishoma nezvishoma kuva chakasimba, nyore uye kwakatooma, kupfuura uye kuramba.

zviratidzo

Kuchinyanya zvemapapu atelectasis kiriniki kunobva vhoriyamu uye velocity inochera kure nonfunctioning zvemapapu tishu. Mikroatelektazy, kuroora segmental atelectasis uye srednedolevoy chirwere kazhinji asymptomatic.

Panyaya chakasimba-kutanga chirwere, ane kwazvo zviratidzo. Panyaya iyi, murwere anonzwa pakarepo kurwadziwa, paroxysmal dyspnea, cyanosis, yakaoma chikosoro, tachycardia uye hypotension. Kusiyana kuwedzera kufema kukundikana kunogona kuitika kunyange zvinouraya.

On kuzviongorora murwere akazivisa kuti backlog pakati njodzi akafukidza zvemapapu panguva kufema, uyewo nechepazasi kufema bhokisi kuwedzerazve. Mukuwedzera, pamusoro moto atelectasis vakatsunga kungopotsera percussion inzwi kana mupfupi. Panguva mweya zvikuru attenuated (hazvigoni kunzwa).

matambudziko anoitika atelectasis

With zvishoma nezvishoma shutdown yemapapu kufefetedza zvikamu nezviratidzo chirwere akataurwa kune muduku pamwero. Asi haizopereri atelektaticheskaya nemabayo ikabuda gipopnevmatoza.

Chimiro chikosoro pamwe sputum, nefivhiri, uye kuwedzera zviratidzo kudhaka hurukuro pamusoro accession kuti kuzvimba. Panyaya iyi, chirwere mubvunzo rakaoma nokuda kukura zvemapapu pute kana pute nemabayo.

Diagnostics

Chirwere pakati zvemapapu atelectasis kuitwa X-ray Kuongorora ari kufema nhengo ari lateral uye frontal fungidziro. Izvi kunoratidza homogeneous dimming yemapapu munda mediastinum zvaizopedza kurutivi kunokurumidziswa chikamu kufema kwacho. Uyewo, X-ray ndipo chepamusoro ari diaphragm mazibota uye kwakawedzera mhepo yemapapu.

Muzviitiko mubvunzo, nzira iyi kudzidza akarongwa nokuda CT. Uyewo, kuti tizive zvinhu zvinokonzera obstructive atelectasis kushandiswa bronchoscopy uye panguva kwenguva refu atelectasis zvibereko angiopulmonography uye bronhografii.

mabatiro

Kuziva miedzo zvemapapu atelectasis zvinoda chiremba (pulmonologist, neonatology, kunotevera kana thoracal chiremba) zvinoshingaira nzira. Just kuzvarwa vana vane chikuru pulmonary atelectasis kubudisa suctioning zviri kufema ezvinhu kuburikidza rabha anobudisa mushonga zvishoma nezvishoma. Kana waida, ubudise tracheal intubation uye rimire zvemapapu.

In ichi mhando zvirwere zvakadai obstructive atelectasis kuti kwakakonzerwa muviri vatorwa, dzokubudisa racho kuitwa zvokurapa chirwere bronchoscopy.

Kana zvemapapu spadenie kwakakonzerwa kuunganidza vakasindimara chakavanzika, ipapo vanopedza endoscopic nokubatanidzwazve ari Árbol muti.

Kuti kuderedza postoperative atelectasis akatakurwa tracheal aspirate, kurovedza kufema, masaja muchipfuva percussion, postural abudise, uyewo inhalation pamwe enzayemu uye bronchodilator zvinodhaka.

Hatigoni kutaura kuti pane zvose atelectasis yaigara pasi fanira Implementation pamusoro chokudzivirira Anti-anogumbura kurapa.

mataridzikiro

Kubudirira mune rakawedzerwa chiedza kunoenderana nguva kutanga kurapwa uye anoita kuti atelectasis. Kana kuchaitwa kwakakwana ekupedzisira mumazuva matatu for yokutanga aremekedzwe kufema nhengo nzvimbo kupora akanaka.

Kana Muzviitiko zvakaipisisa havagoni haabatanidzi kukura yechipiri kuchinja akarara mugove. Nokukurumidza vakashanduka uye hombe atelectasis kunogona rufu.