Ukuhlaziywa kwe-Pleural fluid

Ukuhlaziywa kwe-Pleural fluid ukuhlolwa okuhlola isampula loketshezi oluqoqwe esikhaleni sobuningi. Lesi yisikhala esiphakathi kolwelwesi lwangaphandle lwamaphaphu (pleura) nodonga lwesifuba. Lapho uketshezi luqoqa esikhaleni sokucela, lesi simo sibizwa ngokuthi yi-pleural effusion.

Inqubo ebizwa nge-thoracentesis isetshenziselwa ukuthola isampula ye-pleural fluid. Umhlinzeki wezokunakekelwa kwempilo uhlola isampula okufanele alibheke:

• Amaseli anomdlavuza (amabi)
• Ezinye izinhlobo zamaseli (ngokwesibonelo amaseli egazi)
• Izinga le-glucose, amaprotheni namanye amakhemikhali
• Amagciwane, isikhunta, amagciwane, namanye amagciwane angadala izifo
• Ukuvuvukala

Akukho ukulungiselela okukhethekile okudingekayo ngaphambi kokuhlolwa. I-ultrasound, i-CT scan, noma i-x-ray yesifuba izokwenziwa ngaphambi nangemva kokuhlolwa.

UNGAKHOHLISI, phefumulela phezulu, noma unyakaze ngesikhathi sokuhlolwa ukuze ugweme ukulimala emaphashini.

Tshela umhlinzeki wakho uma uthatha imithi ukunciphisa igazi.

Nge-thoracentesis, uhlala emaphethelweni esihlalo noma embhedeni ikhanda lakho nezingalo kuhleli etafuleni. Umhlinzeki uhlanza isikhumba eduze kwendawo yokufaka. Umuthi we-numbing (i-anesthetic) ufakwa esikhunjeni.

Inaliti ibekwa esikhunjeni nasemisipha yodonga lwesifuba esikhaleni sobuningi. Njengoba uketshezi lungena ebhodleleni leqoqo, ungahle ukhwehle kancane. Lokhu kungenxa yokuthi iphaphu lakho liyanda futhi ukugcwalisa isikhala lapho bekukhona khona uketshezi. Lokhu kuzwa kuhlala amahora ambalwa ngemuva kokuhlolwa.

Ngesikhathi sokuhlolwa, tshela umhlinzeki wakho uma unobuhlungu besifuba obubukhali noma ukuphefumula okuncane.

I-Ultrasound ivame ukusetshenziselwa ukunquma ukuthi inaliti ifakwe kuphi futhi uthole umbono ongcono woketshezi olusesifubeni sakho.

Isivivinyo senziwa ukuthola imbangela ye-pleural effusion. Kuyenziwa futhi ukunciphisa ukuphefumula okufushane okungabangelwa yi-pleural effusion enkulu.

Imvamisa imbobo yenkolo iqukethe amamililitha angaphansi kwama-20 (4 amathisipuni) oketshezi olucacile, oluphuzi (serous)

Imiphumela engajwayelekile ingakhombisa izimbangela ezingaba khona ze-pleural effusion, njenge:

• Umdlavuza
• Isifo sokuqina kwesibindi
• Ukwehluleka kwenhliziyo
• Ukutheleleka
• Ukungondleki okukhulu
• Ukuhlukumezeka
• Ukuxhumana okungavamile phakathi kwesikhala sokuncenga nezinye izitho (isibonelo, i-esophagus)

Uma umhlinzeki esola ukutheleleka, kwenziwa isiko loketshezi ukubheka amabhaktheriya nezinye izidalwa.

Ukuhlolwa kungenziwa futhi nge-hemothorax. Leli iqoqo legazi ku-pleura.

Izingozi ze-thoracentesis yilezi:

• Iphaphu eliwile (pneumothorax)
• Ukwehla ngokweqile kwegazi
• Ukuqoqwa kabusha kwamanzi
• Ukutheleleka
• I-edema yamaphaphu
• Ukucindezeleka kokuphefumula
• Khwehlela okungapheli

Izinkinga ezinkulu azivamile.

Ibhulokhi BK. Thoracentesis. Ku: Roberts JR, Custalow CB, Thomsen TW, ama-eds. Izinqubo Zomtholampilo zikaRoberts & Hedges e-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.