Ukudibanisa iipulmonary

I-pulmonary embolus kukuvaleka komthambo emiphungeni. Esona sizathu siqhelekileyo sokuvaleka sisithintelo segazi.

I-pulmonary embolus ihlala ibangelwa ligazi legazi elivela kumthambo ngaphandle kwemiphunga. Elona gazi liqhelekileyo lelinye likumthambo onzulu wethanga okanye kwi-pelvis (indawo yenyonga). Olu hlobo lwe-clot lubizwa ngokuba yi-vein thrombosis (DVT). Igazi liyophuka lize liye emiphungeni apho lihlala khona.

Izizathu ezimbalwa eziqhelekileyo zibandakanya amaqamza omoya, amathontsi amanqatha, i-amniotic fluid, okanye ii-clumps ze-parasites okanye iiseli zesisu.

Usengozini yokufumana le meko ukuba wena okanye usapho lwakho unembali yamahlwili egazi okanye ukuphazamiseka okuthile kokuqina. I-pulmonary embolus inokwenzeka:

• Emva kokubeleka
• Emva kokuhlaselwa yintliziyo, ukuhlinzwa kwentliziyo, okanye ukubetha
• Emva kokulimala kakhulu, ukutsha, okanye ukwaphuka kwesinqe okanye ithambo lethanga
• Emva kotyando, ubukhulu becala ithambo, ukudibana, okanye utyando lobuchopho
• Ngexesha okanye emva kwendiza ende okanye ukukhwela imoto
• Ukuba unomdlavuza
• Ukuba uthatha iipilisi zokulawula ukuzalwa okanye unyango lwe-estrogen
• Ukuphumla kwebhedi yexesha elide okanye ukuhlala kwindawo enye ixesha elide

Ukuphazamiseka okunokukhokelela kumahlwili egazi kubandakanya:

• Izifo zamasosha omzimba ezenza kube nzima ukuba igazi lijiye.
• Ukuphazamiseka okwenzeka kwilifa elenza ukuba igazi likwazi ukubambeka. Esinye sezo ngxaki kukusilela kwe-antithrombin III.

Iimpawu eziphambili ze-pulmonary embolism zibandakanya iintlungu zesifuba ezinokuba zezi zilandelayo:

• Ngaphantsi kwesifuba okanye kwicala elinye
• Ubukhali okanye uhlabe
• Ukutsha, ukuba buhlungu, okanye buthuntu, ubunzima obunzima
• Rhoqo iba mandundu ngokuphefumla okunzulu
• Unokugoba okanye ubambe isifuba sakho ukuphendula kwintlungu

Ezinye iimpawu zingabandakanya:

• Ukuba nesiyezi, ukuba nentloko elula, okanye ukuphelelwa ngamandla
• Inqanaba leoksijini eliphantsi egazini (hypoxemia)
• Ukuphefumla ngokukhawuleza okanye ukuvutha
• Ukukhawuleza kwentliziyo
• Ndiziva ndixhalabile
• Intlungu yomlenze, ubomvu, okanye ukudumba
• Uxinzelelo lwegazi oluphantsi
• Ukukhwehlela ngesiquphe, kunokwenzeka ukukhohlela igazi okanye umchamo wegazi
• Ukuphefumla okufutshane okuqala ngesiquphe xa ulele okanye usebenza
• Umkhuhlane ophantsi
• Ulusu oluhlaza okwesibhakabhaka (i-cyanosis) -ixhaphakile

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho kunye nembali yezonyango.

Olu vavanyo lweelebhu lulandelayo lunokwenziwa ukuze ubone indlela esebenza kakuhle ngayo imiphunga yakho:

• Iigesi zegazi
• I-oximetry yentliziyo

Olu vavanyo lulandelayo lokucinga lunokunceda ekumiseleni apho igazi ligazi khona:

• I-x-ray yesifuba
• I-CT angiogram yesifuba
• Ukungenisa umoya kwempumlo / ukuskena nge-perfusion, ekwabizwa ngokuba kukuskena kwe-V / Q
• I-CT pulmonary angiogram

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Isifuba se-CT scan
• Uvavanyo lwegazi lwe-D-dimer
• Uvavanyo lwe-Doppler ultrasound emilenzeni
• Echocardiogram
• ECG

Uvavanyo lwegazi lunokwenziwa ukukhangela ukuba unethuba elongezelelekileyo lokujiya kwegazi, kubandakanya:

• Iintsholongwane ze-Antiphospholipid
• Ukuvavanywa kwemfuza ukukhangela utshintsho olwenza ukuba ubenamathuba okuphuhlisa amahlwili egazi
• ILupus anticoagulant
• Amanqanaba eProtheni C kunye neeprotein S

I-pulmonary embolus ifuna unyango kwangoko. Kuya kufuneka uhlale esibhedlele:

• Uya kufumana amayeza okucoca igazi kwaye wenze ukuba kungabikho galelo lokuba igazi lakho lenze amahlwili ngakumbi.
• Kwiimeko ezinzima, ezisongela ubomi be-pulmonary embolism, unyango lunokubandakanya ukuchithwa kwe-clot. Oku kubizwa ngokuba yonyango lwe-thrombolytic. Uya kufumana amayeza okunyibilikisa ihlwili.

Nokuba ufuna ukuhlala esibhedlele okanye hayi, kuyakufuneka uthathe amayeza ekhaya ukunciphisa igazi:

• Unokunikwa iipilisi oza kuzithatha okanye unokufuna ukuba uzitofa.
• Kwamanye amayeza, uya kudinga iimvavanyo zegazi ukujonga idosi yakho.
• Kude kube nini ufuna ukuthatha la mayeza kuxhomekeka ikakhulu kwisizathu kunye nobungakanani begazi lakho.
• Umboneleli wakho uyakuthetha nawe ngomngcipheko weengxaki zokopha xa usela la mayeza.

Ukuba awukwazi ukuthatha abacoci gazi, umboneleli wakho unokucebisa ukuba utyando lubeke isixhobo ekuthiwa inferior vena cava filter (IVC filter). Esi sixhobo sibekwe kwimithambo ephambili esiswini sakho. Igcina amahlwili amakhulu angangeni kwimithambo yegazi yemiphunga. Ngamanye amaxesha, icebo lokucoca okwethutyana linokubekwa kwaye lisuswe kamva.

Ukuphiliswa kakuhle komntu kwimfumba ye-pulmonary kunokuba nzima ukuqikelela. Ihlala ixhomekeke:

• Yintoni ebangele ingxaki kwindawo yokuqala (umzekelo, umhlaza, utyando olukhulu, okanye ukwenzakala)
• Ubungakanani begazi elixineneyo emiphungeni
• Ukuba ihlwili legazi liyanyibilika ngokuhamba kwexesha

Abanye abantu banokuphuhlisa iingxaki zeentliziyo nemiphunga zexesha elide.

Ukufa kunokwenzeka kubantu abane-pulmonary embolism.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911), ukuba unempawu ze-pulmonary embolus.

Abacoci begazi banokumiselwa ukuba bancede ukuthintela i-DVT kubantu abasemngciphekweni omkhulu, okanye abo bafumana utyando olunobungozi.

Ukuba unayo i-DVT, umboneleli wakho uya kukuyalela uxinzelelo lwesokisi. Banxibe njengoko kuyalelwe. Baza kuphucula ukuhamba kwegazi emilenzeni yakho kwaye banciphise umngcipheko wamahlwili egazi.

Ukuhambisa imilenze yakho rhoqo ngexesha lokuhamba ngenqwelomoya, ukuhamba ngenqwelo-mafutha, kunye nezinye iimeko ohleli kuzo okanye ulele ixesha elide nazo zinokunceda ukuthintela i-DVT. Abantu abasemngciphekweni omkhulu wokugubungela igazi banokufuna ukudubula kwegazi elibizwa ngokuba yiherparin xa bethatha inqwelo moya ehlala ixesha elide kuneeyure ezi-4.

Musa ukutshaya. Ukuba uyatshaya, yeka. Abasetyhini abathatha i-estrogen kufuneka bayeke ukutshaya. Ukutshaya kwandisa umngcipheko wokuba namahlwili egazi.

I-venous thromboembolism; Umqala wegazi; Ihlwili legazi - umphunga; Ubumbano; Ukudumba embolus; I-Embolism - pulmonary; I-DVT - ukumbumba kwemiphunga; Thrombosis - embolism yemiphunga; Thromboembolism pulmonary; PE

• I-vein thrombosis enzulu - ukukhutshwa
• Ukuthatha i-warfarin (Coumadin, Jantoven) -ukubuza ugqirha wakho
• Ukuthatha warfarin (Coumadin)

• Amaphaphu
• Inkqubo yokuphefumla
• Ukudibanisa iipulmonary

IGoldhaber SZ. Ukudibanisa iipulmonary. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2019: isahl. 84.

UKline JA. I-pulmonary embolism kunye ne-vein thrombosis enzulu. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: Iikhonsepthi kunye nokuziqhelanisa neKlinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; 2018: isahluko 78.

UMorris TA, uFedullo PF. I-pulomboary thromboembolism. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; Ngo-2016: isahluko 57.