Utshintsho lwengcinezelo
Kukho umxinzelelo omncinci omncinci kwintlambo yesikhalazo ekuphumleni. Lo ngumkhosi ogcina umphunga eludongeni lwesifuba. Ukuba uxinzelelo luba luhle, ukudonsa umphunga wepomphu uyayisusa kude nodonga lwesifuba, kwaye indawo ekhutshiwe izaliswe ngomoya (pneumothorax) okanye utywala. I-Pneumothorax ihlukaniswe ngokukhawuleza kwaye ibuhlungu. Ngokuqhelekileyo imeko ibangelwa ukuphuka kwe-pulvey alveoli kunye ne-visceral pleura. Ingaba yintloko, okokuthi, engahambelani nanoma yiphina i-pulmonary pathology, okanye yesibini, xa isithuba siba sisiphumo sesifo - umzekelo, i-emphysema, isifo esingenasifo se-pulmonary disease okanye isifo sofuba. Utshintsho lwengcinezelo lwangaphandle olubangela ukwandiswa kwesifuba, umzekelo ngethuba le-flight high-voltage, lusetyenziswa phambili ekuphuhlisweni kwe-pneumothorax. Kwenzeka ukuba i-flap ye-flap yenziwe kwisiza sokuphuka, isebenza njenge-valve. Ngethuba lokuphefumlelwa, "i-valve" ivuleka kwaye umoya uyanconywa kwisigxina, xa ikhutshwa, ivala, ivimbela umoya kwindawo yesigxina. Ngaloo ndlela, nganye inhalation, umthamo womoya kwisithuba sokunyuka kwenyuka. Umphunga kunye ne-mediastinum (isikhala se-anatomiki esiphakathi kwe-thorax) sithunyulwe kwinqanaba elincinane ukusuka kwisihlunu, siphazamisa umphunga oqhelekileyo. Ukubuyela kwintliziyo kunobungozi kwaye i-heartdiac output is reduced. Le meko yaziwa ngokuba yi-pneumothorax enkulu.
Iimpawu
Isigulane nge-pneumothorax ngokukhawuleza sivakalelwa ngokukhawuleza kokuphefumula okufutshane, sihamba kunye nentlungu yokubetha esifuba. Ukuhamba kwindonga yesifuba kuncinci kwicala elichaphazelekayo. Ingxolo yokuphefumula ngexesha lokuhlaselwa (ukuphulaphula isifuba, ngokuqhelekileyo nge-stethoscope) inqabile kuneqhelekileyo, kwaye xa uyiphonononga, unokuva isandi somthunzi onjenge-drum. Nge-pneumothorax enamandla, kukho ukwanda kwe-dyspnea kunye nokufuduka kwe-mediastinum, enokufunyanwa ngokumisela indawo ye-trachea ngaphezu kokusika kwe-sternum.
Uphando
Ukuxilongwa kuqinisekiswa ngu-radiography yesifuba, eyenziwa ngokuphefumlelwa ngokupheleleyo. Ngamanye amaxesha i-pneumothorax encinci ayifumanekanga, kodwa ayinayo intsingiselo yekliniki. Kwiimeko ezibucayi, kungabikho xesha loviwo, kwaye ugqirha kufuneka enze ukuxilongwa okusekelwe kwiimpawu. Kwimeko ye-pneumothorax, xa kungekho unyango olufike ngexesha, ukufa kungenzeka. Ukugcina ubomi besigulane kukugqithiswa kwesigxina - injoyi ye-tube okanye inaliti kwisigxina sokukhupha umoya. Oogqirha babhekisela kwi-pneumothorax enzulu kwiimeko ezixakeka. Xa kungabikho uncedo, lusongela ubomi besigulane. Uxinzelelo kwisigxina soxinzelelo kufuneka sincitshiswe ngokufaka i-cannula ye-intercostal okanye i-needle enkulu engenalathisi.
Diagnostics
Ukuba imeko yesigulane ihlahloka ngokukhawuleza, umntu kufuneka acinge ukuba khona kwe-pneumothorax enzima kwaye athathe amanyathelo afanelekileyo ngokusekelwe kwidatha yeclini kuphela, ngaphandle kokusebenzisa i-radiography. Inaliti efakwe eludongeni lwe-thorac ukuya kwisigxina esiya kubangela ukuhla kweengcinezelo kwaye iya kuthintela ukwakheka kweempawu. I-Pneumothorax yomthamo omncinci unokuphiliswa ngokukhawuleza. Ukuba kuphela iimpawu ezincinci zikhoyo, umthamo weemiphunga awuyi kudluli kwi-20% yombhalo wayo, kwaye isigulane sikhokelela ekuphumeni komzimba, kunengqiqo ukunciphisa ukubonwa kwesigulane kunye nefomoroscopy esifubeni ngokuphindaphindiweyo kwipneumothorax. Kwiimeko ezininzi, i-pneumothorax isombululo kwisonto elithandathu. Ukuba iimpawu ziqhubeka, i-pneumothorax kufuneka isombululelwe, mhlawumbi ngokufuna i-air ngenaliti engekho, okanye ngokusebenzisa imithombo yamanzi. I-cannula ye-intercostal ifakwe kwisigxina se-pleural ngokusebenzisa indawo yesine okanye yesihlanu ye-intercostal kwinqanaba elisezantsi, kwaye emva koko lugqitywe nge-suture. I-cannula ixhunywe yintambo yesikhephe kwisitya esixhotywe nge-valve yokuphuma kwaye igcwele ngamanzi. Xa ibhubhu ingaphantsi kwinqanaba lamanzi, inkqubo iya kwenza i-valve yokukhangela kunye nomoya ngokukhawuleza igxothwe kwisigxina. Ngamanye amaxesha inqweno iyadingeka ukususa umoya ongaphezulu. Ukuphefumula ngokusebenzisa inaliti yenziwa ngokufaka inaliti kwisigxina sokuxhamla kunye nomoya osondayo usebenzisa i-valve enendlela ezintathu. Le nkqubo ayibuhlungu kakhulu isigulane kwaye inceda ukunciphisa ixesha elichithwe esibhedlele. Nangona kunjalo, kusebenza kuphela kwi-pneumothorax encinci. Ukuba ususa ngokukhawuleza umlinganiselo omkhulu womoya ukusuka kwisigxina somfutho, umkhuhlane esifubeni unako ukuqokelela, okuya kubangela ukuvuvukala komphunga owandisiweyo. Kwenzeka ukuba i-pneumothorax ayivumelekanga, kuba ukuvula kokuqala kwi-pleura ye-visceral ivulekile. Le meko yaziwa ngokuba yi-bronchopleural fistula. Kule meko, unako ukuvala isiphako nge-thoracotomy (ukuvula ukuvuthwa kwesigxina se-thoracic) okanye i-thoracoscopy (indlela yokungabonakaliyo encinci apho izixhobo ze-endoscopic zisetyenziselwa ukujonga nokubuyisela isigxina). I-25% ye-pneumothoraxes iphinda iphinde iphinde ifune ukulungiswa kokugqibela kokupasa. Nge-pneumothorax enkulu yamanzi, umsele wamanzi ungeke usebenze. Oku kwenzeka ukuba isigulane sele sine-pneumothorax esisodwa kwixesha elidlulileyo okanye lilungu leqela elinobuchule elinomngcipheko omkhulu wokuphindaphinda (umzekelo, indiza). Kwiimeko ezinjalo, i-pleurodesis okanye i-pleurectomy ingenziwa. Injongo ye-pleurodesis kukufakela i-visceral kunye ne-parietal pleura ngeekhemikhali ezinjenge-talc oyinyumba okanye i-nitrate yesilivere, okanye ukucoca. Injongo ye-pleurectomy kukususa zonke iingubo zamaphepha, kodwa zikhokelela ekubhenkeleni okukhulu.