I-Pneumomediastinum

-Delile

• Izimbangela nezici zobungozi
• Izimpawu
• Ukuxilongwa
• Ukwelashwa nokuphathwa kwezinketho
• I-Pneumomediastinum ezinganeni ezisanda kuzalwa
• Umbono

Ukubuka konke

I-Pneumomediastinum ingumoya maphakathi nesifuba (i-mediastinum).

I-mediastinum ihlala phakathi kwamaphaphu. Iqukethe inhliziyo, i-thymus gland, nengxenye yomphimbo kanye ne-trachea. Umoya ungabanjwa kule ndawo.

Umoya ungangena kwi-mediastinum kusukela ekulimaleni, noma ekuvuza emaphashini, ku-trachea, noma ku-esophagus. I-pneumomediastinum ezenzekelayo (i-SPM) iyindlela yesimo esingenayo imbangela esobala.

Izimbangela nezici zobungozi

I-Pneumomediastinum ingenzeka lapho ingcindezi ikhuphuka emaphashini futhi ibangela ukuthi amasaka omoya (alveoli) aqhume. Enye imbangela engaba khona ukulimala kwamaphaphu noma kwezinye izakhiwo eziseduze ezivumela umoya ukuba ungene phakathi kwesifuba.

Izimbangela ze-pneumomediastinum zifaka:

• ukulimala esifubeni
• ukuhlinzwa entanyeni, esifubeni, noma esiswini esingaphezulu
• ukudabula umphimbo noma amaphaphu ngenxa yokulimala noma inqubo yokuhlinzwa
• imisebenzi ebeka ingcindezi emaphashini, njengokuzivocavoca okukhulu noma ukubeletha
• ushintsho olusheshayo kwingcindezi yomoya (i-barotrauma), njengokuvuka ngokushesha okukhulu ngenkathi utshuza nge-scuba
• izimo ezidala ukukhwehlela okukhulu, njenge-asthma noma ukutheleleka kwamaphaphu
• ukusetshenziswa komshini wokuphefumula
• ukusetshenziswa kwezidakamizwa ezihogelwayo, njenge-cocaine noma insangu
• izifo zesifuba njengesifo sofuba
• izifo ezibangela ukushaqeka kwamaphaphu (isifo samaphaphu esiphakathi)
• ukuhlanza
• i-Valsalva maneuver (ukushaya ngamandla ngenkathi uqhubeka phansi, inqubo esetshenziselwa ukuvula izindlebe zakho)

Lesi simo asivamile kakhulu. Ithinta phakathi kuka-1 kwabangu-7,000 no-1 kwabangu-45,000 babantu abangeniswa esibhedlela. izalwa nayo.

maningi amathuba okuthi athole i-pneumomediastinum kunabantu abadala. Lokhu kungenxa yokuthi izicubu ezifubeni zazo ziyakhululeka futhi zingavumela umoya ukuba uvuza.

Ezinye izinto ezinobungozi zifaka:

• Ubulili. Abesilisa bakha amacala amaningi (), ikakhulukazi amadoda aneminyaka engama-20 kuya kwengama-40.
• Isifo samaphaphu. I-pneumomediastinum ivame kakhulu kubantu abane-asthma nezinye izifo zamaphaphu.

Izimpawu

Uphawu oluyinhloko lwe-pneumomediastinum ubuhlungu besifuba. Lokhu kungenzeka ngokuzumayo futhi kungaba nzima. Ezinye izimpawu zifaka:

• ukuphelelwa umoya
• ukuphefumula kanzima noma okungajulile
• ukukhwehlela
• ubuhlungu bentamo
• ukuhlanza
• inkinga yokugwinya
• izwi elicinene noma elihoshozelayo
• umoya ngaphansi kwesikhumba sesifuba (i-emphysema engaphansi)

Udokotela wakho angase ezwe umsindo okhalayo ngesikhathi ngokushaya kwenhliziyo yakho lapho ulalele isifuba sakho nge-stethoscope. Lokhu kubizwa ngokuthi uphawu lukaHamman.

Ukuxilongwa

Kusetshenziswa izivivinyo ezimbili zokuthwebula izithombe ukuthola lesi simo:

• I-computed tomography (i-CT). Lokhu kuhlolwa kusebenzisa i-X-ray ukudala izithombe eziningiliziwe zamaphaphu akho. Ingakhombisa ukuthi umoya uku-mediastinum.
• I-X-ray. Lokhu kuhlolwa kwe-imaging kusebenzisa imithamo emincane yemisebe ukwenza izithombe zamaphaphu akho. Kungasiza ukuthola imbangela yokuvuza komoya.

Lezi zivivinyo zingabheka izinyembezi emgodini noma emaphashini akho:

• I-Esophagogram iyi-X-ray yesimila esithathwa ngemuva kokugwinya i-barium.
• I-Esophagoscopy idlulisa ithubhu phansi komlomo noma ekhaleni lakho ukubuka umphimbo wakho.
• I-Bronchoscopy ifaka ithubhu elincane, elikhanyisiwe elibizwa nge-bronchoscope emakhaleni noma emlonyeni wakho ukuhlola umoya wakho.

Ukwelashwa nokuphathwa kwezinketho

I-Pneumomediastinum ayibi kakhulu. Umoya uzogcina uphinde ungene emzimbeni wakho. Inhloso enkulu yokuyelapha ukuphatha izimpawu zakho.

uzohlala ubusuku bonke esibhedlela ukuze aqashwe. Ngemuva kwalokho, ukwelashwa kuqukethe:

• ukuphumula kombhede
• ukudambisa izinhlungu
• izidakamizwa ezilwa nokukhathazeka
• umuthi wokukhwehlela
• ama-antibiotic, uma kunesifo esihilelekile

Abanye abantu bangadinga umoya-mpilo ozobasiza baphefumule. I-oksijeni nayo ingasheshisa ukubuyiselwa kabusha komoya ku-mediastinum.

Noma yisiphi isimo esingahle sidale ukwakheka komoya, njenge-asthma noma ukutheleleka kwamaphaphu, kuzodinga ukwelashwa.

I-Pneumomediastinum kwesinye isikhathi yenzeka kanye ne-pneumothorax. I-pneumothorax yiphaphu eliwohlokile elidalwa ukwakheka komoya phakathi kwamaphaphu nodonga lwesifuba. Abantu abane-pneumothorax bangadinga ishubhu lesifuba ukusiza ukukhipha umoya.

I-Pneumomediastinum ezinganeni ezisanda kuzalwa

Lesi simo asijwayelekile ezinganeni, sithinta kuphela u-0.1% wazo zonke izingane ezisanda kuzalwa. Odokotela bakholelwa ukuthi kubangelwa umehluko ocindezelweni phakathi kwezikhwama zomoya (i-alveoli) nezicubu ezibazungezile. Ukuvuza komoya kusuka ku-alveoli bese kungena ku-mediastinum.

I-Pneumomediastinum ivame kakhulu ezinganeni ezi:

• zisemshinini wokuphefumula ozisizayo ukuba ziphefumule
• phefumula (aspirate) ukunyakaza kwabo kokuqala kwamathumbu (meconium)
• une-pneumonia noma esinye isifo samaphaphu

Ezinye izingane ezinalesi sifo azinazo izimpawu. Abanye banezimpawu zokuphefumula, kufaka phakathi:

• ukuphefumula okusheshayo ngokungavamile
• ukububula
• ukuqhuma kwamakhala

Izingane ezinezimpawu zizothola i-oxygen yokubasiza baphefumule. Uma ukutheleleka kubangele isimo, kuzolashwa ngama-antibiotic. Izingane ziqashwa ngokucophelela ngemuva kwalokho ukuqinisekisa ukuthi umoya uyanyamalala.

Umbono

Yize izimpawu ezinjengobuhlungu besifuba nokuphefumula okuncane kungasabisa, i-pneumomediastinum imvamisa ayibi yimbi. I-pneumomediastinum ezenzakalelayo ivame ukuzithuthukisa yodwa.

Uma isimo sesihambile, asibuyi. Kodwa-ke, ingahlala isikhathi eside noma ibuye uma ibangelwa ukuziphatha okuphindaphindiwe (njengokusebenzisa izidakamizwa) noma ukugula (njengesifuba somoya). Kulezi zimo, umbono ubheka imbangela.