Ukuchithwa kwe-Pleural

I-pleural effusion is a buildup of fluid phakathi kwezingqimba zezicubu ezigcwala amaphaphu nesifuba.

Umzimba ukhiqiza uketshezi lwe-pleural ngamanani amancane ukugcoba izindawo ze-pleura. Lesi isicubu esincane esizungeza isifuba futhi sizungeze amaphaphu. I-Pleural effusion iqoqo elingajwayelekile, eleqile loketshezi.

Kunezinhlobo ezimbili ze-pleural effusion:

• Ukuchithwa kwe-pleudative pleural kubangelwa uketshezi oluvuza esikhaleni sobuningi. Lokhu kusuka ekucindezelweni okwandayo emithanjeni yegazi noma isibalo samaprotheni aphansi egazi. Ukwehluleka kwenhliziyo kuyimbangela evame kakhulu.
• Ukuchithwa kwe-exudative kubangelwa yimithambo yegazi evinjiwe noma imithambo ye-lymph, ukuvuvukala, ukutheleleka, ukulimala kwamaphaphu, nezicubu.

Izici zobungozi bokuchithwa kwe-pleural zingafaka:

• Ukubhema nokuphuza utshwala, njengoba lokhu kungadala isifo senhliziyo, samaphaphu nesesibindi, okungaholela ekuchithweni kwemizwa
• Umlando wokuxhumana no-asbestos

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ubuhlungu besifuba, imvamisa ubuhlungu obubukhali obubi kakhulu ngokukhwehlela noma ukuphefumula okujulile
• Khwehlela
• Umkhuhlane namakhaza
• Izikhubekiso
• Ukuphefumula ngokushesha
• Ukuphelelwa umoya

Kwesinye isikhathi azikho izimpawu.

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola abuze ngezimpawu zakho. Umhlinzeki uzophinde alalele amaphaphu akho nge-stethoscope bese uthepha (ushaya) isifuba sakho nomhlane ongaphezulu.

Iskena se-CT esifubeni noma i-x-ray yesifuba kunganele ukuthi umhlinzeki wakho anqume ngokwelashwa.

Umhlinzeki wakho angafuna ukwenza izivivinyo kuketshezi. Uma kunjalo, isampula loketshezi liyasuswa ngenaliti efakwe phakathi kwezimbambo. Ukuhlolwa koketshezi kuzokwenziwa ukubheka:

• Ukutheleleka
• Amaseli womdlavuza
• Amaphrotheni amazinga
• Ukubalwa kweseli
• I-acid ye-fluid (kwesinye isikhathi)

Ukuhlolwa kwegazi okungenziwa kufaka phakathi:

• Qedela ukubalwa kwegazi (CBC), ukuhlola izimpawu zokutheleleka noma i-anemia
• Ukuhlolwa kwegazi kwezinso nesibindi

Uma kudingeka, lezi ezinye izivivinyo zingenziwa:

• I-Ultrasound yenhliziyo (i-echocardiogram) ukubheka ukwehluleka kwenhliziyo
• I-Ultrasound yesisu nesibindi
• Ukuhlolwa kwamaprotheni womchamo
• I-Lung biopsy yokubheka umdlavuza
• Ukudlulisa ithubhu enqenqemeni lokubheka umoya womoya ukuthola izinkinga noma umdlavuza (i-bronchoscopy)

Inhloso yokwelashwa uku:

• Susa uketshezi
• Vimbela uketshezi ekwakheni futhi
• Thola futhi uphathe imbangela yokwakhiwa koketshezi

Ukususa uketshezi (thoracentesis) kungenziwa uma kukhona uketshezi oluningi futhi kubangela ukucindezela kwesifuba, ukuphefumula okuncane, noma izinga eliphansi le-oxygen. Ukususa uketshezi kuvumela amaphaphu ukuthi ande, okwenza ukuphefumula kube lula.

Imbangela yokwakhiwa koketshezi nayo kufanele ilashwe:

• Uma kungenxa yokwehluleka kwenhliziyo, ungathola isisu (amaphilisi amanzi) neminye imithi yokwelapha ukwehluleka kwenhliziyo.
• Uma kungenxa yokutheleleka, kuzonikezwa ama-antibiotic.
• Uma kuvela kumdlavuza, isifo sesibindi, noma isifo sezinso, ukwelashwa kufanele kuqondiswe kulezi zimo.
  

Kubantu abanomdlavuza noma ukutheleleka, i-effusion ivame ukwelashwa ngokusebenzisa ishubhu lesifuba ukukhipha uketshezi nokwelapha imbangela yalo.

Kwezinye izimo, noma yikuphi ukwelashwa okulandelayo kuyenziwa:

• Ukwelashwa ngamakhemikhali
• Ukufaka umuthi esifubeni okuvimbela uketshezi ukuthi lungakhi futhi ngemuva kokukhishwa
• Ukwelashwa ngemisebe
• Ukuhlinzwa

Umphumela uncike kwisifo esiyimbangela.

Izinkinga ze-pleural effusion zingafaka:

• Ukulimala kwamaphaphu
• Ukutheleleka okuphenduka ithumba, okubizwa ngokuthi i-empyema
• Umoya esifubeni (pneumothorax) ngemuva kokudonswa kwamanzi
• Ukuqothula kwe-Pleural (ukukhwabanisa kwendwangu yamaphaphu)

Shayela umhlinzeki wakho noma uye egumbini labezimo eziphuthumayo uma:

• Izimpawu ze-pleural effusion
• Ukuphefumula okuncane noma ukuphefumula kanzima ngemuva nje kwe-thoracentesis

Uketshezi esifubeni; Uketshezi emaphashini; Uketshezi lwe-Pleural

• Amaphaphu
• Uhlelo lokuphefumula
• Umgodi wePleural

Ibhulokhi BK. Thoracentesis. Ku: Roberts JR, Custalow CB, Thomsen TW, ama-eds. Izinqubo Zomtholampilo zikaRoberts noHedges ku-Emergency Medicine kanye ne-Acute Care. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 9.

I-Broaddus VC, i-Light RW. Ukuchithwa kwe-Pleural. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 79.

UMcCool FD. Izifo ze-diaphragm, udonga lwesifuba, i-pleura ne-mediastinum. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 92.