Interstitial zvirwere zvemapapu: tsananguro, zvinokonzera, zviratidzo, chirwere, kupatsanura uye kurapwa

Chii interstitial zvirwere zvemapapu vari? Treatment zvirwere izvi, avo zviratidzo uye kupatsanura zvichabviswa kurondedzerwa pashure.

pfupiso

Interstitial zvirwere zvemapapu - iri kunzwisisa chirwere zvirwere zvemapapu rinenge kuti kuratidza kuzvimba uye rirambe richibvira endothelial kutyora chivako perivazalnyh alveolar masvingo uye perilymphatic munyama. A maitiro kuchiitwa pathological ezvinhu akadaro dyspnea. chiratidzo ichi chinoratidza pulmonary insufficiency.

Interstitial zvirwere zvemapapu kunotungamirira fibrosis. Mazuva okurapa, ichi izwi harishandiswi ndi ILD, asi dzimwe nguva richiri kushandiswa mupfungwa iyi.

kupatsanura

Chii kusiyanisa interstitial bapu chirwere? The kupatsanura zvirwere izvi kunoitika pazuva etiological nenheyo:

• Zvakaitwa nezvinodhaka, kana kuti, kuti nemishonga, mishonga antiarrhythmic uye zvinodhaka kuti mishonga.
• Inhalation mamwe zvinhu kubva dzakapoteredza svikiro (inorganic uye Organic zvinhu, silicosis, berylliosis, asbestosis, sema alveolitis exogenous kana Hypersensitivity pneumonitis).
• Systemic connective zvinyama zvirwere (dzinonzi rheumatoid arthritis, scleroderma, chinonzi systemic lupus erythematosus, dermatomyositis).
• Idiopathic (histiocytosis X, sarcoidosis, alveolar proteinosis, idiopathic pulmonary fibrosis, idiopathic interstitial alveolitis, kusanganisira chakasimba interstitial alveolitis).
• Chirwere (Pneumocystis nemabayo, SARS, tiibhii).
• Associated interstitial zvemapapu chirwere (nezvirwere chiropa: chikuru biliary cirrhosis, vanoshingaira chisingaperi chiropa, pamwe pulmonary vasculitis: lymphomatoid granulomatosis, granulomatosis Wegener vake, Hypersensitivity vasculitis, necrotizing vasculitis, systemic; munhu "batanidza maringe hondo" kuita).
• Nyanyisa mapundu (carcinomatosis limfangitny).

Ndezvipi ILD?

Sezvataurwa pamusoro apa, mashoko interstitial zvemapapu chirwere Generic boka rimwe zita Airways chirwere. Vane zvakafanana ndechokuti vose kukanganisa interstices, kuti chikamu mumapapu.

Interstitial connective zvinyama inonzi pulmonary tishu. Inopa kutsigira nemaziso mhepo SACS uye Formação de pakati mumapapu.

tsinga nomunyika interstitium ushande gasi mukutsinhana mashandiro pakati mhepo iri kufema turakiti uye neropa. Interstitial zvinyama zviri zvitete zvokuti hazvisi kuonekwa pamusoro X-ray kana panguva CT. Asi, pasinei ichi, zvichiri chirwere chinogona kuonekwa mukufamba kuferefeta izvi.

Chero zvirwere zvemapapu rinenge kukonzera thickening kwayo. munhu pathological ezvinhu akadaro kungakonzerwa chokutsva, kuzvimba kana scarring. Dzimwe mhando lesion interstitial zvinyama nokukurumidza kupfuura, nepo vamwe vari chisingarapiki kana chirwere.

Zvinokonzera chirwere

Ndokusaka ndiri kuva interstitial zvemapapu chirwere (kurapwa vanorumbidza nyanzvi zvichakurukurwa pazasi)? Pane zvakawanda siyana zvinokonzera zvemapapu tishu maronda. Somuenzaniso, interstitial mabayo zvinokonzerwa nemavhairasi, mabhakitiriya kana chakuvhe. Kukura zvimwe zvirwere zvinogona chokuita dzose inhalation kuti irritants akadai asbestos, talc, silica guruva, simbi guruva, marasha kana zviyo. Very kashoma zvirwere zvemapapu boka iri vari kuumbwa nokuda zvinokonzerwa marwadzo zvinoriumba.

A chinoratidza ILD ndiko kuti zvose izvi zvinoita pave kukura womumwe chirwere. Kazhinji zvinokonzera asingazivikanwi.

chirwere zviratidzo

Diffuse interstitial zvemapapu chirwere hwokuratidza kuzvimba zvemapapu rinenge wayo unozotevera kukuvara. Kwakadaro pathological inoti aine kupfupika mweya. Ndiro huru chiratidzo ILD. Pakutanga, kupfupika mweya hauna kunyanya kuoneka, asi zvinokosha murwere kuita muviri kana kukwira masitepisi, iye pakarepo anoita pacharo akanzwa.

Tinofanirawo kuziva kuti nokuti ILD kunoratidzwa yakaoma chikosoro. Uyewo, varwere uremu yekudyidzana. Vane vagari uye tsandanyama marwadzo, kurukutika. In yepamusoro kacho, munhu zvisinganzwisisiki rakawedzerwa zvipikiri, miromo uye ganda dzokai rwebhuruu. Akadaro pathological chakajairika chokuita yakaderera kwevari okisijeni muropa.

Chirwere zvirwere interstitial bapu

Sei kuziva chirwere pasi kukurukurwa? Kazhinji, vanhu vane ILD pulmonologist vachinyunyuta pamusoro chikosoro uye kupfupika mweya. Kuti zvakarurama nechirwere, chiremba kazhinji anoshandisa zvinotevera chiedza nzira:

• Computed tomography. Kuburikidza nzira iyi, unogona kuumba mufananidzo rakazara mumapapu, uyewo zvose pedyo hurongwa. ILD nokururamisira nyore chirwere ne CT.
• X-ray. kudzidza pechipfuva kwakadaro raiwanzoitwa kuongorora mukuru ezvinhu pulmonary hurongwa. Kwakaitwa interstitial kuoneka mune mifananidzo muchimiro zvomucheka mitsetse.

• High chisarudzo CT. Rairira scanner Kurongwa, uyewo nyanzvi ruzivo yekudyidzana kuwedzera chirwere efficacy pamusoro ILD.
• Lung biopsy uye kudzidza mimwe nemaikorosikopu. Kazhinji ndizvo chete nzira yokuziva mhando kukuvadza zvemapapu tishu. mimwe yayo anogona kutorwa vachishandisa Videoassisted thoracoscopic kuvhiyiwa, bronchoscopy kana toraktomii.

Zvinofanira kucherechedzwa kuti nokuda kunyatsoongorora kuti kufema basa , dzimwe nyanzvi kuitisa chaiwo miedzo, kusanganisira spirometry, muviri plethysmography, uye vamwe.

Treatment uye zvekuchipatara nhungamiro

Interstitial zvirwere zvemapapu - iri chaizvo chakakomba chirwere rinoda kurapwa pakarepo. Zano kurapa zvirwere zvakadai zvinofanira kusarudzwa chete pulmonologist, zvichienderana mhaka kukura uye mhando kukuvara tishu.

Kazhinji, kurapwa rinoitwa nevanhu ILD inorwisa mabhakitiriya. nevasori kwakadaro kunobatsira kuti marudzi akawanda interstitial nemabayo kwemabhakitiriya mavambo.

Kana nemavhairasi nemabayo, sezvinoita mutemo, handicho tisingatungamirirwi. Bata pamwe nemishonga kunodiwa. Zvinofanira kucherechedzwa kuti ichi chirwere isingawanzowanikwi, vose fungal mabayo, panobviswa chete kuburikidza dzakananga antifungal nevamiririri.

Rumwe rudzi mishonga rinoshandiswa nekuda pakurapa ILD muri corticosteroids. gadziriro yakadaro achabvisa kuzvimba, kwete chete mumapapu, asiwo dzimwe nhengo dzomuviri. Panzira, dzimwe vamiririri kushandiswa pakurapa chirwere muna mubvunzo unogona chete kunetesa kukuvara mumapapu, uyewo Kuipa basa ravo. Uyewo, kakawanda vasaziva rokuzvidzivirira kuderedza kuzvimba, zvinoita kuti zvimwe zvinetso zvoutano.

Vanhu vane yakaderera okisijeni tigutsikane muropa mugadziriro, nyanzvi angarayira kufema okisijeni kuburikidza chaiwo namano. Matanho aya kuchabatsira kuvandudza zvinonyatsorehwa ezvinhu omurwere, uyewo kuzadza haro pomwoyo iri O _2.

Tinofanirawo kuziva kuti vanachiremba vanokurudzira varwere vavo kuitika dzimwe nguva, munhu zvemapapu nokuisazve. Izvi kazhinji nzira inonyatsobudirira yokubatana nayo chirwere, kunyanya zvakakomba uye kukura zviitiko.

mataridzikiro

Vamwe varwere pamusoro pakanyorwa ILD nezvechinhu mwoyo kukundikana, uye pane BP iri zvemapapu midziyo. Mikana murwere apore kana kosi kuwedzera chirwere kuvimba zvikonzero zvavo kukura, nekuomarara uye kuongorora chirwere nguva. Zvinofanira kucherechedzwa kuti idiopathic pulmonary fibrosis iri zvakanaka murombo fungidziro.