Yini i-Broncopleural Fistula nokuthi ilashwa kanjani

-Delile

• Izimbangela ze-bronchopleural fistula
• Ungayibona kanjani
• Yelashwa kanjani

I-bronchopleural fistula ihambelana nokuxhumana okungavamile phakathi kwe-bronchi ne-pleura, okuyi-membrane ephindwe kabili ebeka amaphaphu, okuholela ekungeneni komoya okwanele futhi kuvame kakhulu ngemuva kokuhlinzwa kwamaphaphu. I-bronchopleural fistula ivame ukukhonjwa ngezibonakaliso nezimpawu ezethulwe ngumuntu kanye nokuhlolwa kwe-imaging, njenge-radiography yesifuba kanye ne-bronchoscopy.

Lesi simo siyivelakancane futhi sibucayi, ikakhulukazi uma sivela ezinganeni, futhi kufanele sixazululwe ngokushesha ukuze singabeki impilo yomuntu engcupheni. Ngakho-ke, kubalulekile ukuthi ngemuva kokuhlinzwa kwamaphaphu noma lapho umuntu enanoma yiluphi uhlobo lokukhubazeka kokuphefumula, kwenziwa izivivinyo zokulandelela ukubheka noma yiziphi izinguquko futhi, uma kunesidingo, ukuqala ukwelashwa.

Izimbangela ze-bronchopleural fistula

I-bronchopleural fistula ihlobene kakhulu nokuhlinzwa kwamaphaphu, ikakhulukazi i-lobectomy, lapho kukhishwa khona i-lobe lung, ne-pneumonectomy, lapho kususwa khona uhlangothi olulodwa lwephaphu. Ngaphezu kwalokho, kuvamile ukuba i-bronchopleural fistula yenzeke ngenxa yokutheleleka nge-necrotizing, lapho, ngenxa yobukhona begciwane elincane elibhekene nokutheleleka, kwenzeka izicubu zokufa. Ezinye izimbangela ze-bronchopleural fistula yilezi:

• I-pneumonia, i-fistula ethathwa njengenkinga yesifo, ikakhulukazi uma ibangelwa isikhunta noma amabhaktheriya ohlobo I-Streptococcus;
• Umdlavuza wamaphaphu;
• Ngemuva kwamakhemikhali noma ukwelashwa ngemisebe;
• Ukuphazamiseka kwe-biopsy yamaphaphu;
• Ukubhema okungapheli;
• Isifo samaphaphu esingapheliyo;
• Ukungenisa umoya ngomshini.

Kubalulekile ukuthi kubonakale imbangela ye-bronchopleural fistula ukuze kuqalwe ukwelashwa okufanele futhi kugwenywe izinkinga, njengobunzima bokuphefumula, ukunwetshwa okunganele kwamaphaphu, ubunzima bokugcina umoya omncane ku-alveoli yamaphaphu nokufa.

Ungayibona kanjani

Ukuxilongwa kwe-bronchopleural fistula kwenziwa ngudokotela ojwayelekile noma i-pulmonologist ngokusebenzisa ukuhlolwa kwe-imaging, njenge-radiography yesifuba, lapho i-atelectasis ingabonakala khona, okuyisimo lapho kungekho khona umoya oya esifundeni esithile samaphaphu, ukuwa, noma iqembu lamaphaphu. Ngaphezu kwe-radiography, udokotela kufanele enze i-bronchoscopy, lapho kufakwa khona ithubhu elincane ngekhala ukuze izinhlaka zesistimu yokuphefumula zibonakale, nendawo ye-fistula nobukhulu bayo kungabonakala kahle.

Ngaphezu kwalokho, udokotela kufanele ahlole izimpawu nezimpawu ezethulwe ngumuntu, njengokukhwehlela igazi noma amafinyila, ukuphefumula kanzima nokuba nomkhuhlane, okujwayeleke kakhulu ukubonwa ngemuva kokwenza ukuhlinzwa kwamaphaphu, okuvela izimpawu zalo cishe emasontweni ama-2 ngemuva kwenqubo .

Ngakho-ke, kubalulekile ukuthi ngemuva kokuhlinzwa kokuphefumula, lo muntu ubhekwa njalo ngudokotela ukuze agweme ukwakheka kwama-fistula nezinkinga zawo.

Yelashwa kanjani

Ukwelashwa kwe-bronchopleural fistula kuyahluka ngokuya ngesizathu, umlando wezokwelapha womuntu kanye nezimpawu nezimpawu eziveziwe. Isikhathi esiningi, ukwelashwa kuqukethe ukwenza ukuhlinzeka ukuxazulula i-fistula, kepha kungenzeka ukuthi ngemuva kwesikhashana i-fistula iphinde ivele. Ukuhlinzwa kuvame ukunconywa ezimweni lapho ukwelashwa okulondolozayo kungenawo umphumela owufunayo, lapho kunezibonakaliso ezibonisa i-sepsis noma lapho kuvuza khona umoya.

Ukwelashwa okulondolozayo kune-drainage ye-pleural fluid, ukupholisa imishini, ukwesekwa kokudla okunomsoco nokusetshenziswa kwama-antibiotic, futhi le ndlela yokwelapha ivame kakhulu lapho i-bronchopleural fistula ivela njengomphumela wezifo. Kodwa-ke, ukugeleza kolwelwesi lwe-pleural nakho kungavumela ukwakheka kwamafistula amasha. Ngakho-ke, ukwelashwa kwalesi simo kubhekwa njengenselelo yezokwelapha futhi noma ngabe kunjani ukwelashwa okunconywayo, kuyadingeka ukuthi lowo muntu abhekwe njalo ukuze ahlole impumelelo yezokwelapha kanye nesidingo sokungenelela okusha.

Indlela entsha yokwelapha eye yafundwa ukubekwa kwamaseli we-mesenchymal stem ku-bronchopleural fistula, okungamaseli akwazi ukuvuselela izicubu futhi, ngakho-ke, angavumela ukuvalwa kwe-fistula. Kodwa-ke, akukaziwa ukuthi lawa maseli asebenza kanjani ekuxazululeni i-fistula futhi futhi ngeke abe nomphumela ofanayo kubo bonke abantu. Ngakho-ke, kudingeka izifundo ezengeziwe ukufakazela umphumela walolu hlobo lwezokwelapha kuma-bronchopleural fistula.