Empyema

-Delile

• Izimbangela
• Izimo ezikubeka engcupheni
• Izimpawu
• Impyema elula
• Impyema eyinkimbinkimbi
• Izinkinga
• Ukuhlonza impyema
• Ukwelashwa
• Umbono

Yini empyema?

I-Empyema ibizwa nangokuthi i-pyothorax noma i-purulent pleuritis. Kuyisimo lapho ubuthi buhlangana khona phakathi kwamaphaphu nengaphakathi langaphakathi lodonga lwesifuba. Le ndawo yaziwa njengesikhala se-pleural. I-Pus uketshezi olugcwele amaseli omzimba, amaseli afile, nama-bacteria. I-Pus esikhaleni sokuncenga ayikwazi ukukhwehlela. Esikhundleni salokho, idinga ukukhishwa ngenaliti noma ngokuhlinzwa.

I-Empyema ivame ukukhula ngemuva kwe-pneumonia, okuwukutheleleka kwezicubu zamaphaphu.

Izimbangela

I-Empyema ingakhula ngemuva kokuba une-pneumonia. Izinhlobo eziningi ezahlukene zebhaktheriya zingadala i-pneumonia, kepha ezimbili ezivame kakhulu I-Streptococcuspneumoniae futhi I-Staphylococcus aureus. Ngesinye isikhathi, i-empyema kungenzeka ngemuva kokuhlinzwa esifubeni sakho. Izinsimbi zezokwelapha zingadlulisela amabhaktheriya emgodini wakho wokuncenga.

Isikhala sobuningi ngokwemvelo sinoketshezi oluthile, kepha ukutheleleka kungadala ukuthi uketshezi lwakhiwe ngokushesha kunokuba lungangena. Uketshezi lube selutheleleka ngamagciwane abangele inyumoniya noma ukutheleleka. Uketshezi olunaleli gciwane luyaqina. Kungadala ukuthi ulwelwesi lwamaphaphu akho nesifuba sakho kunamathele ndawonye futhi kwakheke amaphakethe. Lokhu kubizwa nge- empyema. Amaphaphu akho kungenzeka angakwazi ukufutha ngokuphelele, okungaholela ezinkingeni zokuphefumula.

Izimo ezikubeka engcupheni

Isici esikhulu sengozi ye-empyema ukuba nenyumoniya. I-Empyema yenzeka kakhulu ezinganeni nakubantu abadala asebekhulile. Kodwa-ke, akuvamile. Kwesinye isifundo, kwenzeke ezingaphansi kwephesenti elilodwa lezingane ezine-pneumonia.

Ukuba nale mibandela elandelayo kungakhuphula namathuba akho okuba ne-empyema ngemuva kwe-pneumonia:

• bronchiectasis
• isifo esingapheliyo sokuvimbela kwamaphaphu (COPD)
• isifo samathambo
• ukuphuza ngokweqile
• isifo sikashukela
• amasosha omzimba abuthakathaka
• ukuhlinzwa noma ukuhlukumezeka kwakamuva
• ithumba lamaphaphu

Izimpawu

I-Empyema ingaba lula noma ibe yinkimbinkimbi.

Impyema elula

I-empyema elula ivela ezigabeni zokuqala zokugula. Umuntu unalolu hlobo uma ubomvu lugeleza ngokukhululeka. Izimpawu ze-empyema elula zifaka:

• ukuphelelwa umoya
• ukukhwehlela okomile
• imfiva
• ukujuluka
• ubuhlungu besifuba lapho uphefumula okungachazwa njengokugwaza
• ikhanda
• ukudideka
• ukulahlekelwa isifiso sokudla

Impyema eyinkimbinkimbi

I-empyema eyinkimbinkimbi yenzeka esigabeni sakamuva sokugula. E-empyema eyinkimbinkimbi, ukuvuvukala kunzima kakhulu. Izicubu ezibomvu zingakha futhi zihlukanise isifuba sibe yizimbotshana ezincane. Lokhu kubizwa ngokuthi yi-loculation, futhi kunzima kakhulu ukuselapha.

Uma ukutheleleka kuqhubeka nokuba kubi kakhulu, kungaholela ekwakhekeni kwesikhumba esijiyile phezu kwe-pleura, ebizwa ngokuthi ikhasi lesicelo. Leli cwecwe livimbela amaphaphu ukuthi ande. Ukuhlinzwa kuyadingeka ukukulungisa.

Ezinye izimpawu ku-empyema eyinkimbinkimbi zifaka:

• ukuphefumula kanzima
• ukuncipha kwemisindo yokuphefumula
• ukuncipha komzimba
• ubuhlungu besifuba

Izinkinga

Ezimweni ezingavamile, icala le-empyema eliyinkimbinkimbi lingaholela ezinkingeni ezinzima kakhulu. Lokhu kufaka phakathi i-sepsis nephaphu eliwile, elibizwa nangokuthi i-pneumothorax. Izimpawu ze-sepsis zifaka:

• umkhuhlane omkhulu
• Ukugodola
• ukuphefumula okusheshayo
• ukushaya kwenhliziyo okusheshayo
• umfutho wegazi ophansi

Iphaphu eliwohlokile lingadala izinhlungu zesifuba, ezibukhali nesifuba nokuphefumula okuya kuba kubi kakhulu uma ukhwehlela noma uphefumula.

Lezi zimo zingabulala. Uma unalezi zimpawu, kufanele ushayele ku-911 noma othile akushayele egumbini lezimo eziphuthumayo.

Ukuhlonza impyema

Udokotela angase asole impyema uma une-pneumonia engaphenduli ekwelashweni. Udokotela wakho uzothatha umlando ophelele wezokwelapha nokuhlolwa komzimba. Bangasebenzisa i-stethoscope ukulalela noma imiphi imisindo engajwayelekile emaphashini akho. Udokotela wakho uvame ukwenza izivivinyo noma izinqubo ezithile ukuqinisekisa ukuxilongwa:

• Ama-X-ray esifuba nama-CT scan azokhombisa ukuthi ngabe kukhona yini uketshezi esikhaleni sobuningi.
• I-ultrasound yesifuba izokhombisa inani loketshezi nendawo yalo ngqo.
• Ukuhlolwa kwegazi kungasiza ukuhlola ukubalwa kwamaseli wakho amhlophe egazi, ukubheka amaprotheni asebenza ngo-C, nokukhomba amagciwane abangela ukutheleleka. Ukubalwa kwamaseli amhlophe kungakhuphuka uma unesifo.
• Ngesikhathi se-thoracentesis, inaliti ifakwa ngemuva kwembambo yakho esikhaleni sokucela ukuthatha isampula loketshezi. Uketshezi bese luhlaziywa ngaphansi kwesibonakhulu ukubheka amabhaktheriya, amaprotheni namanye amaseli.

Ukwelashwa

Ukwelashwa kuhlose ukususa ubomvu noketshezi oluvela ku-pleura nokwelapha ukutheleleka. Ama-antibiotic asetshenziselwa ukwelapha ukutheleleka okuyisisekelo. Uhlobo oluthile lwama-antibiotic luncike ekutheni hlobo luni lwama-bacteria olubangela ukutheleleka.

Indlela esetshenziselwa ukukhipha ubomvu incike esigabeni se-empyema.

Ezimweni ezilula, inaliti ingafakwa esikhaleni sokuncenga ukukhipha uketshezi. Lokhu kubizwa ngokuthi i-percutaneous thoracentesis.

Ezigabeni zakamuva, noma empyema eyinkimbinkimbi, kufanele kusetshenziswe ithubhu lokuhambisa amanzi ukukhipha ubomvu. Le nqubo ivame ukwenziwa ngaphansi kwe-anesthesia egumbini lokuhlinza. Kunezinhlobo ezahlukahlukene zokuhlinzwa kwalokhu:

I-Thoracostomy: Kule nqubo, udokotela wakho uzofaka ishubhu lepulasitiki esifubeni sakho phakathi kwezimbambo ezimbili. Bese bezoxhuma ishubhu kudivayisi yokudonsa bese besusa uketshezi. Bangaphinde bafake umuthi wokusiza ukukhipha uketshezi.

Ukuhlinzwa kwe-thoracic okusizwa ngevidiyo: Udokotela wakho ohlinzayo uzosusa izicubu ezithintekile ezungeze iphaphu lakho bese efaka ishubhu lokuhambisa amanzi noma asebenzise umuthi ukususa uketshezi. Bazokwakha ukusikeka okuncane okuthathu futhi basebenzise ikhamera encane ebizwa nge-thoracoscope kule nqubo.

Vula ukwehlukanisa: Kulokhu kuhlinzwa, udokotela wakho ohlinzayo uzosusa ikhasi le-pleural.

Umbono

Umbono we-empyema ngokwelashwa ngokushesha muhle. Ukulimala kwesikhathi eside emaphashini akuvamile. Kufanele uqedele ama-antibiotics onqunyelwe bese uya ku-X-ray yesifuba sokulandelela. Udokotela wakho angaqiniseka ukuthi i-pleura yakho iselapheke kahle.

Kodwa-ke, kubantu abanezinye izimo ezibeka engcupheni amasosha omzimba, i-empyema ingaba nezinga lokufa eliphakeme ngamaphesenti angama-40.

Uma ingalashwa, i-empyema ingaholela ezinkingeni ezingasongela impilo ezifana ne-sepsis.