Kushingaira kuchinja
Pane zvishoma zvisiri izvo zvinomanikidzwa mumunyengetero wechipfuva pazororo. Uyu ndiwo simba rinochengetedza mapapu pamadziro echifuva. Kana kudzvinyirira kuchiva kwakanaka, kukwevera kwepapu kunokonzera kure nemadziro echifuva, uye nzvimbo yakasunungurwa yakazara nemhepo (pneumothorax) kana mvura. Pneumothorax inogoverwa muzvinyorwa uye zvinotambudza. Zvinowanzokonzerwa nemamiriro ezvinhu anokonzerwa nekuputika kweplmonary alveoli uye visceral pleura. Inogona kuva yekutanga, iyo, isingabatanidzi chero mapepa ekurapa, kana yechipiri, apo gwa rinova chikonzero chechirwere - somuenzaniso, emphysema, chronic obstructive chirwere chepachimara kana chirwere chetachiona. Kuchinja kwekunze kwekunetseka kunokonzera kuwedzera kwechifuva, somuenzaniso panguva yepamusoro yekubhururuka, zvakare kunotangira kukura kwepneumothorax. Izvi zvinoitika kuti ruvara rwemavara runoumbwa panzvimbo yekubhururuka, kuita sevhavha. Munguva yekufuridzirwa, "valve" inotanga uye mhepo inomhanya mukati mechipfuva, apo inoputika, inovhara, ichivhara mhepo munzvimbo inoteterera. Nokudaro, nemhepo imwe neimwe inoputika, dutu remhepo iri munzvimbo inokurudzira inowedzera. Iyo mapapu uye mediastinum (nzvimbo inotomical iri pakati pegwenzi) inodzingwa kune imwe nzvimbo yakatarisana kubva kuchiremera, ichivhiringidza mapapu evhuzha. Izvo zvinodzoka kumwoyo zvinowedzera uye chibereko chemoyo chinoderera. Izvi zvinonzi inozivikanwa sepneumothorax yakasimba.
Zviratidzo
Mumwe murwere ane pneumothorax anozviona anononoka kufema kwekufema, kufambidzana nekurwadziwa kwepaburi mubhokisi. Kufamba kworusvingo rwechifuva kune zvishoma kune rumwe rutivi rwakavhiringidzika. Ruzariro rwemapfupa ekuputika (kunyatsoteerera chifuyo, kazhinji ne stethoscope) yakanyanyisa kupfuura yakasununguka, uye paunenge uchitema, unogona kunzwa inzwi remumvuri wakafanana nemumvuri. Ne pneumothorax yakasimba, kune kuwedzera kwe dyspnea uye kuparadzaniswa kwema mediastinum, iyo inogona kuonekwa nekusarudza nzvimbo ye trachea pamusoro pekucheka kwejeri kwe sternum.
Kutsvakurudza
Kuongororwa kunosimbiswa neyeroography yebhokisi, iyo inogadzirwa nehuwandu hwekudzima. Zvishoma zvishoma pneumothorax dzimwe nguva hazviwaniki, asi haina chirwere chechirwere. Mumamiriro ezvinhu akaoma, pangave pasina nguva yekuongororwa, uye chiremba anofanira kuongororwa zvichienderana nezviratidzo. Munyaya yepneumothorax yakasimba, kana pasina chirwere chakakodzera panguva, rufu runogona kuitika. Kuponesa hupenyu hwemuurwere ndeyekudzivirirwa kwechiremba - kujowa kwepurasitiki kana nenyuchi mumukati mutsindo kubvisa mhepo yakawandisa. Vanachiremba vanotaura nezvepneumothorax yakasimba kune mamiriro ekukurumidzira. Kana kusina rubatsiro, kunotyisidzira hupenyu hwomurwere. Izvo zvinomanikidzwa mumumvuri wechipupuriro zvinofanira kuderedzwa nekuisa mukana wekodzero kana kuti nhovo huru isina kuvhara mukati mechipupuriro cavity.
Diagnostics
Kana chirwere ichi chichikurumidza kukurumidza, munhu anofanira kutora kuvapo kwepneumothorax inotyisa uye kutora matanho akakodzera zvichienderana nematareji chete, pasina kushandisa rayography. Iyo nheyo inowanikwa kuburikidza nerusvingo rwe thoracic mukati mechipupuriro ichi inotungamirira mukuderera kwekumanikidzwa uye ichadzivirira kuvaka-zviratidzo. Pneumothorax yediki duku inogona kuporeswa pakarepo. Kana zviratidzo zvishoma zvisipo zviripo, mapapu ekudarika kwemapapu haapfuuri 20% yehuwandu hwayo, uye murwere anotungamira mararamiro ehupenyu, zvinonzwisisika kugadzirisa kutarisa kwemurwere pamwe nechifukidzo cheputioroscopy kuti resorption ye pneumothorax. Muzviitiko zvakawanda, pneumothorax resolves mukati memavhiki matanhatu. Kana zviratidzo zvinoramba zvichiripo, pneumothorax inofanira kugadziriswa, zvichida nekutsvaga mhepo kuburikidza nechidzitiro chisina kuvhara, kana kushandisa shongwe yemvura. Iyo inonzi intercostal cannula inowanikwa mumumvuri wechipfuva kuburikidza nechina kana yechishanu nzvimbo inosvika mukati mutsara wepakati, uye yakagadzirirwa ne suture. Iyo cannula inosanganiswa nekatheter kumudziyo wakagadzirwa nevhavha yekutakura uye izere nemvura. Kana bhutu iri pasi pemvura, urongwa hunoita sevhavhavha uye mhepo inodzingwa zvishoma nezvishoma kubva pachigunun'una. Dzimwe nguva aspiration inoda kubvisa mhepo yakawandisa. Kupisa nemumushoni kunoitwa nekuisa nenyuchi mumhepo inoputika uye mumhepo inoyamwa uchishandisa gavheti nhatu. Iyi nzira haina kunetseka kune murwere uye inobatsira kuderedza nguva yakashandiswa muchipatara. Zvisinei, inoshanda chete pineumothorax duku. Kana ukakurumidza kubvisa huwandu hwemhepo kubva pachigunun'una chemukati, ruzivo ruri muchipfuva runogona kuunganidza, izvo zvinotungamirira kukuputika kwemapapu akawedzerwa. Zvinowanzoitika kuti pneumothorax haibvumirwi, sezvo kuvhura kwokutanga muvheta yevisceral inoramba iripo. Ichi chiitiko chinonzi bronchopleural fistula. Muchiitiko ichi, unogona kuvhara chirema ne thoracotomy (kuvhurika kwekuvhara mutsara we thoracic) kana kuti thoracoscopy (nzira inowanzosavhiringidza iyo michina inogadziriswa inoshandiswa kufungidzira uye kudzorera mutezo wechipu). 25% yepneumothoraxes inodzoka zvakare uye inoda kururamiswa kwokupedzisira kwokugadzira. Nehuru-guru pneumothorax, mvura yakaderera inogona kunge isingabatsiri. Izvi zvinoitika kana murwere wacho atove ane pneumothorax pamwe chete munguva yakapfuura kana ari weboka rezvese rine ngozi yakawanda yekudzoka (somuenzaniso, ndege). Mumamiriro ezvinhu akadaro, pleurodesis kana pleurectomy inogona kuitwa. Chinangwa chepuroseisis ndechekufungidzira zvinonzi visceral uye parietal pleura nemakemikari zvakadai sedare rakaoma kana kuti nitrate yesirivha, kana kupora kupora. Izvo zvinangwa zve pleurectomy ndeyekubvisa zvose zvakashandurwa zvinyorwa zvemashoko, asi zvinotungamirira kukurashika kukuru.