Ukushintsha kwengcindezi
Kunomcindezelo omncane omncane emgodini wesikhala ekuphumuleni. Lona amandla okugcina iphaphu emdongeni wesifuba. Uma ingcindezi iba yinto enhle, ukudonsa okwephuka kwamaphaphu kuyayidonsela kude nodonga lwesifuba, futhi isikhala esikhululwe sigcwele umoya (pneumothorax) noma uketshezi. I-Pneumothorax ihlukaniswe yaba yinto evamile futhi ehlukumezayo. Ngokuvamile yisimo esibangelwa ukuphuka kwe-alveoli yamapulisi kanye ne-plecer visceral. Kungaba yinto eyisisekelo, okungukuthi, engahlotshaniswa nanoma yikuphi ukukhubazeka kwamapayipi, noma eyesibili, lapho igebe iba yisifo sesifo - isibonelo, isifo se-emphysema, isifo esingenasifo se-pulmonary chronic or tuberculosis. Ukuguquka kwengcindezi yangaphandle eyenza ukukhuliswa kwesifuba, isibonelo ngesikhathi sezindiza eziphakeme kakhulu, kubuye kwenzeke ekuthuthukiseni i-pneumothorax. Kwenzeka ukuthi i-flap ye-tissue isakhiwe kusayithi lokuphuka, okwenza njenge-valve. Ngesikhathi sokuphefumulelwa, "i-valve" ivuleka futhi umoya uyangena emgodini wesikhala, lapho ukhululwa, uvala, uvimbela umoya endaweni yesikhalazo. Ngakho-ke, nge-inhalation ngayinye, ivolumu yomoya emoyeni wesikhala iyanda. Amaphaphu kanye ne-mediastinum (isikhala samathambo esivela phakathi kwe-thorax) basuke behlala endaweni engafani ne-lesion, bephazamisa amaphaphu avamile. Ukubuyela emuva enhliziyweni kuyadala futhi ukuphuma kwenhliziyo kwehla. Lesi simo siyaziwa njenge-pneumothorax enkulu.
Izimpawu
Isiguli esine-pneumothorax ngokuzenzekelayo sizwa ngokungazelelwe kokuphefumula okuphefumula, kuhambisane nobuhlungu bokugwaza esifubeni. Ukuhamba kwendonga yesifuba kunqunyelwe ohlangothini oluthintekile. Umsindo wokuphefumula ngesikhathi sokuhlaselwa (ukulalela isifuba, ngokuvamile nge-stethoscope) kulukhuni kunokujwayelekile, futhi uma uwuthatha, ungazwa umsindo womthunzi onjenge-drum. Nge-pneumothorax enamandla, kunyuke ku-dyspnea nokufuduka kwe-mediastinum, okungatholakala ngokunquma isikhundla se-trachea ngaphezu kokusika kwe-sternum.
Ucwaningo
Ukuxilongwa kuqinisekiswa yi-radiography yesifuba, esenziwa nge-exhalation ephelele. Ngezinye izikhathi i-pneumothorax encane ayitholakali, kodwa ayikho isidingo somtholampilo. Esimweni esibucayi, kungase kungabi nesikhathi sokuhlolwa, kanti udokotela kufanele enze ukuxilongwa ngokusekelwe ezimpawu. Endabeni ye-pneumothorax enamandla, uma kungekho ukwelashwa okufika ngesikhathi, ukufa kungenzeka. Ukulondoloza impilo yesiguli kuyisigxobo esiyindilinga - umjovo we-tube noma inaliti emgodini wezinyembezi ukususa umoya owandayo. Odokotela babhekisela ku-pneumothorax ejulile ezimweni eziphuthumayo. Uma kungekho usizo, kusongela impilo yesiguli. Ukucindezela emgodini we-pleural kufanele kunciphise ngokufaka i-cannula ye-intercostal noma isidingo esikhulu esingenalutho emgodini wesikhala.
Ukuhlonza
Uma isimo sesiguli siphumelela ngokushesha, umuntu kufanele abhekane nokuba khona kwe-pneumothorax eqinile futhi athathe izinyathelo ezifanele ngokusekelwe kwedatha kuphela yemitholampilo, ngaphandle kokusebenzisa i-radiography. Inaliti efakwe ngodonga lwama-thoracic emgodini wesikhala uyoholela ekunciphiseni kwengcindezi futhi izovimbela ukwakheka kwezimpawu. I-pneumothorax yevolumu encane ingelashwa ngokuzenzekelayo. Uma ngabe izimpawu ezincane zikhona, ukukhishwa kwemali kwamapayipi akudluli u-20% wevolumu yayo, futhi isiguli sihola indlela yokuphila, kodwa kunengqondo ukunciphisa ukubhekwa kwesiguli ngesifo esifubeni se-feoroscopy ukuphindaphinda kwe-pneumothorax. Ezimweni eziningi, izixazululo ze-pneumothorax zingakapheli amasonto ayisithupha. Uma izimpawu ziqhubeka, i-pneumothorax kufanele ixazululwe, mhlawumbe ngokufisa umoya ngokusebenzisa isidingo esingenalutho, noma ngokusebenzisa umsele wamanzi. I-cancola ye-intercostal ifakwa emgodini we-pleural ngokusebenzisa isikhala sesine noma sesihlanu se-intercostal emgqeni we-axillary ophakathi, bese uhlelwe nge-suture. I-cannula ixhunywe ngendwangu emkhunjini ogcwele i-valve yokuphuma futhi igcwele amanzi. Lapho i-tube ingaphansi kwezinga lamanzi, uhlelo lusebenza njenge-valve yokuhlola kanye nomoya kancane kancane kukhishwa emgodini wesikhala. Ngezinye izikhathi ukulangazela kuyadingeka ukususa umoya owedlula. Ukuphefumula ngokusebenzisa inaliti kwenziwa ngokufaka inaliti emgodini wesikhala kanye nomoya ophuzayo usebenzisa i-valve enendlela ezintathu. Le nqubo ayidabukisayo kakhulu isiguli futhi isisiza ukunciphisa isikhathi esichitha esibhedlela. Nokho, kusebenza kuphela nge-pneumothorax encane. Uma ususa masinyane umoya omkhulu kusuka emgodini we-pleural, uketshezi esifubeni kungagcina, okuzoholela ekuvupheni kwephaphu elandisiwe. Kwenzeka ukuthi i-pneumothorax ayivunyelwe, ngoba ukuvula kokuqala ku-plecer visceral kuvulekile. Lesi simo siyaziwa ngokuthi i-fostula ye-bronchopleural. Kulolu cala, ungagcina isici nge-thoracotomy (ukuvulwa kokuhlinzwa kwe-thoracic cavity) noma i-thoracoscopy (inqubo encane engavumelani lapho kusetshenziselwa khona izinto ezisetshenziswayo ukuze zibonise futhi zibuyiselwe isikhala). I-25% ye-pneumothoraxes iphinda iphinde iphinde ifune ukulungiswa kokugcina kokuhlinzwa. Nge-pneumothorax enkulu yevolumu, amanzi emvula angase asebenze kahle. Lokhu kwenzeka uma isiguli sesivele sine-pneumothorax esisodwa esikhathini esedlule noma singeqembu lezisebenzi elinengozi enkulu yokuphindaphinda (isibonelo, indiza). Ezimweni ezinjalo, i-pleurodesis noma i-pleurectomy ingenziwa. Inhloso ye-pleurodesis ukufakela i-visceral kanye ne-parietal pleura ngamakhemikhali njengethalente oyinyumba noma i-nitrate yesiliva, noma ukukhwabanisa ukuhlinzwa. Umgomo we-pleurectomy ukukhipha wonke amashidi ama-pleural, kodwa kuholela ekusweleni okukhulu.