IHemothorax

I-Hemothorax yingqokelela yegazi kwisithuba esiphakathi kodonga lwesifuba kunye nemiphunga (indawo yokubongoza).

Unobangela uqhelekileyo hemothorax - esifubeni trauma. IHemothorax inokwenzeka nakwabantu:

• Isiphene sokuvala igazi
• Isifuba (thoracic) okanye uqhaqho lwentliziyo
• Ukufa kwethishu yemiphunga (pulmonary infarction)
• Umlenze okanye umdlavuza we-pleural - oyintloko okanye wesibini (i-metastatic, okanye kwenye indawo)
• Ukuqhekeka kwisitya segazi xa ubeka i-catheter ye-venous esembindini okanye xa unxulunyaniswa noxinzelelo lwegazi
• Isifo sephepha

Iimpawu zibandakanya:

• Ukuqhawukelwa ngumphefumlo
• Ukukhawuleza, ukuphefumla nzulu
• Iintlungu zesifuba
• Uxinzelelo lwegazi oluphantsi (ukothuka)
• Isikhumba esipholileyo nesipholileyo
• Inqanaba lentliziyo elikhawulezayo
• Ukungazinzi
• Ixhala

Umboneleli wakho wezempilo unokuqaphela ukuncipha okanye ukungabikho kwemisindo yokuphefumla kwicala elichaphazelekayo. Iimpawu okanye iziphumo zehemothorax zinokubonwa kwezi mvavanyo zilandelayo:

• I-x-ray yesifuba
• Ukuskena i-CT
• I-Thoracentesis (umjelo wamanzi we-pleural fluid ngenaliti okanye nge-catheter)
• I-Thoracostomy (umjelo wamanzi we-pleural fluid kwityhubhu yesifuba)

Injongo yonyango kukwenza umntu azinze, ayeke ukopha, kwaye asuse igazi kunye nomoya kwisithuba seplato.

• Umbhobho wesifuba ufakwa kudonga lwesifuba phakathi kweembambo ukukhupha igazi nomoya.
• Ishiywe endaweni kwaye incanyathiselwe ukufunxa kangangeentsuku ezininzi ukwandisa iphaphu kwakhona.

Ukuba ityhubhu yesifuba iyodwa ayikulawuli ukopha, utyando (thoracotomy) lunokufuneka ukunqanda ukopha.

Unobangela wehemothorax uya kunyangwa. Umphunga ongaphantsi unokuwa. Oku kunokukhokelela kubunzima bokuphefumla. Kubantu abanokulimala, ityhubhu yesifuba yesifuba inokuba yiyo yonke into efunekayo. Utyando alunakuba yimfuneko.

OKO UNGAKULINDELEKA KWISEBE LEZONGXAMISEKO

Umboneleli uya kulinganisa kwaye abeke esweni iimpawu ezibalulekileyo zomntu, kubandakanya ukwanda kweoksijini, ukubetha kwentliziyo, inqanaba lokuphefumla, kunye noxinzelelo lwegazi. Iimpawu ziya kunyangwa xa kufuneka njalo. Umntu angafumana:

• Inkxaso yokuphefumla- Oku kunokubandakanya ioksijini, inkxaso engafunekiyo yoxinzelelo lomoya njengeBIPAP, okanye i-endotracheal intubation (ukubekwa kwetyhubhu yokuphefumla ngomlomo okanye impumlo kwindlela yomoya) kunye nokubekwa kumatshini wokuphefumla (ubomi bokuxhasa umatshini wokuphefumla)
• Uvavanyo lwegazi kunye notofelo gazi olunokwenzeka
• Ityhubhu yesifuba (ityhubhu ngesikhumba kunye nezihlunu eziphakathi kweembambo kwindawo ejikeleze imiphunga) ukuba kukho ukuwa kwemiphunga
• Ukuskena i-CT
• Uhlalutyo lwe-pleural fluid, i-Electrocardiogram (ECG)
• Ulwelo olunikwa ngomthambo (IV)
• Amayeza okunyanga iimpawu
• I-X-ray yesifuba kunye nesisu okanye amanye amalungu omzimba ukuba kukho ezinye izinto ezonzakeleyo

Isiphumo sixhomekeke kwisizathu se-hemothorax, inani lokulahleka kwegazi kunye nendlela unyango olukhawulezileyo olunikezelwa ngayo.

Kwimeko yokwenzakala okukhulu, isiphumo siya kuthi songeze kubungakanani bokwenzakala kunye nenqanaba lokopha.

Iingxaki zinokubandakanya:

• Umphunga owileyo, okanye i-pneumothorax, ekhokelela ekusileleni komphefumlo (ukungakwazi ukuphefumla ngokufanelekileyo)
• I-Fibrosis okanye ukunqunyulwa kweembumba kunye neethambo zemiphunga
• Usulelo lwe-pleural fluid (empyema)
• Umothuko kunye nokufa kwiimeko ezinzima

Tsalela u-911 okanye inombolo yongxamiseko yendawo ukuba unayo:

• Nakuphi na ukwenzakala okunobungozi esifubeni
• Iintlungu zesifuba
• Umhlathi omkhulu, intamo, igxalaba okanye ingalo
• Ukuphefumla nzima okanye ukuphefumla kancinci

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba unayo:

• Ukuba nesiyezi, ukuba nentloko ebukhaphukhaphu, umkhuhlane kunye nokukhohlela, okanye uvakalelo lobunzima esifubeni sakho

Sebenzisa amanyathelo okhuseleko (anje ngamabhanti esihlalo) ukunqanda ukwenzakala. Kuxhomekeka kwisizathu, ihemothorax ayinakuthinteleka.

• Ukuqhekeka kwe-aortic - i-x-ray yesifuba
• Inkqubo yokuphefumla
• Ukufakwa kwetyhubhu yesifuba-uthotho

UkuKhanya kweRW, uLee YCG. Pneumothorax, chylothorax, hemothorax, kunye ne-fibrothorax. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahl 81.

URaja AS. Umonzakalo weToracic. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: iikhonsepthi kunye nokuziqhelanisa neklinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 38.

Isemon G, McCarthy M. Udonga lwesifuba, i-pneumothorax, kunye nehemothorax. Ku: ICameron AM, uCameron JL, ii-eds. Unyango lwangoku lonyango. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2020: 1146-1150.