Pneumothorax - izinsana

I-Pneumothorax iqoqo lomoya noma igesi esikhaleni esingaphakathi kwesifuba esizungeze amaphaphu. Lokhu kuholela ekuweni kwamaphaphu.

Lo mbhalo ukhuluma nge-pneumothorax ezinganeni.

I-pneumothorax yenzeka lapho amanye amasaka omoya amancane (i-alveoli) amaphaphu engane egcwala ngokweqile futhi eqhuma. Lokhu kubangela ukuthi umoya uvuza esikhaleni esiphakathi kodonga lwamaphaphu nesifuba (isikhala sokuncenga).

Isizathu esivame kakhulu se-pneumothorax yisifo sokuphefumula sokuphefumula. Lesi yisimo esivela ezinganeni ezizalwa zisencane kakhulu (ngaphambi kwesikhathi).

• Amaphaphu engane awanayo into eshelelayo (i-surfactant) eyisiza ukuthi ihlale ivulekile (igcwele umoya). Ngakho-ke, izikhwama zomoya ezincane azikwazi ukwanda kalula.
• Uma ingane idinga umshini wokuphefumula (i-mechanical ventilator), ingcindezi eyengeziwe emaphashini engane, evela emshinini kwesinye isikhathi ingaqhuma izikhwama zomoya.

I-Meconium aspiration syndrome ingenye imbangela ye-pneumothorax ezinganeni ezisanda kuzalwa.

• Ngaphambi noma ngesikhathi sokuzalwa, ingane ingaphefumula lapho kunyakaza amathumbu okokuqala, okubizwa ngokuthi i-meconium. Lokhu kungavimbela imigwaqo yomoya futhi kubangele nezinkinga zokuphefumula.

Ezinye izimbangela zibandakanya inyumoniya (ukutheleleka kwamaphaphu) noma izicubu zamaphaphu ezingathuthukile.

Ngaphansi kokujwayelekile, usana olunempilo ngenye indlela lungaqala ukuvuza komoya lapho kuthatha ukuphefumula okumbalwa kokuqala emva kokuzalwa. Lokhu kwenzeka ngenxa yengcindezi edingekayo yokwandisa amaphaphu okokuqala ngqa. Kungaba nezici zofuzo eziholela kule nkinga.

Izinsana eziningi ezine-pneumothorax azinazo izimpawu. Lapho izimpawu zenzeka, zingabandakanya:

• Umbala wesikhumba o-Bluish (cyanosis)
• Ukuphefumula ngokushesha
• Ukubhakuza kwamakhala
• Ukububula ngokuphefumula
• Ukuthukuthela
• Ukungahlaliseki
• Ukusetshenziswa kweminye imisipha yesifuba nesisu ukusiza ukuphefumula (ukuhlehlisa)

Umhlinzeki wezokunakekelwa kwempilo angaba nobunzima bokuzwa imisindo yokuphefumula lapho elalele amaphaphu wosana nge-stethoscope. Imisindo yenhliziyo noma yamaphaphu ingabonakala sengathi ivela engxenyeni ehlukile yesifuba kunokujwayelekile.

Ukuhlolwa kwe-pneumothorax kufaka:

• I-x-ray yesifuba
• Uphenyo olukhanyayo olubekwe esifubeni sengane, olwaziwa nangokuthi "i-transillumination" (amaphakethe omoya azobonakala njengezindawo ezilula)

Izingane ezingenazo izimpawu zingase zingadingi ukwelashwa. Ithimba lokunakekelwa kwezempilo lizobheka ukuphefumula kwengane yakho, ukushaya kwenhliziyo, ileveli ye-oxygen, nombala wesikhumba. I-oxygen eyengeziwe izonikezwa uma kudingeka.

Uma ingane yakho inezimpawu, umhlinzeki uzofaka inaliti noma ishubhu elincanyana elibizwa nge-catheter esifubeni sengane ukuze kususwe umoya ophumele esikhaleni sesifuba.

Njengoba ukwelashwa kuzoncika nasezindabeni zamaphaphu eziholele ku-pneumothorax, ingahlala izinsuku kuye emasontweni.

Okunye ukuvuza komoya kuzophela ezinsukwini ezimbalwa ngaphandle kokwelashwa. Izinsana ezisuswe umoya ngenaliti noma nge-catheter zivame ukwenza kahle ngemuva kokwelashwa uma zingekho ezinye izinkinga zamaphaphu.

Njengoba umoya wakheka esifubeni, ungadudula inhliziyo iye kolunye uhlangothi lwesifuba. Lokhu kubeka ingcindezi kuwo womabili amaphaphu angawanga kanye nenhliziyo. Lesi simo sibizwa ngokuthi yi-tension pneumothorax. Kuyisimo esiphuthumayo sezokwelapha. Kungathinta ukusebenza kwenhliziyo namaphaphu.

I-pneumothorax ivame ukutholwa ngemuva nje kokuzalwa. Shayela umhlinzeki wakho uma usana lwakho lunezimpawu ze-pneumothorax.

Abahlinzeki egunjini labagula kakhulu elisanda kuzalwa (i-NICU) kufanele babuke usana lwakho ngokucophelela ukuthola izimpawu zokuvuza komoya.

Ukuvuza komoya wamaphaphu; Pneumothorax - neonatal

• Pneumothorax

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Ukukhanya RW, Lee GL. I-Pneumothorax, i-chylothorax, i-hemothorax ne-fibrothorax. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 81.

UWinnie GB, Haider SK, Vemana AP, Lossef SV. Pneumothorax. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 439.