Empyema

Umxholo

• Oonobangela
• Iimeko ezikubeka emngciphekweni
• Iimpawu
• Impyema elula
• Ubunzima be-empyema
• Iingxaki
• Ukuchonga impyema
• Unyango
• Imbonakalo

Yintoni empyema?

I-Empyema ibizwa ngokuba yi-pyothorax okanye i-purulent pleuritis. Yimeko apho ubofu buhlangana kwindawo ephakathi kwemiphunga kunye nomphezulu wangaphakathi wodonga lwesifuba. Lo mmandla waziwa njengendawo yokubongoza. I-Pus lulwelo oluzaliswe ngamaseli omzimba, iiseli ezifileyo, kunye neebhaktiriya. I-Pus kwindawo ye-pleural ayinakukhohlela. Endaweni yoko, kufuneka ichithwe ngenaliti okanye ngoqhaqho.

I-Empyema ihlala ikhula emva kwenyumoniya, nosulelo lwesifo semiphunga.

Oonobangela

I-Empyema inokukhula emva kokuba unenyumoniya. Iindidi ezininzi zebacteria zinokubangela inyumoniya, kodwa ezona zimbini zixhaphakileyo zezi IStreptococcusinyumoniya kwaye IStaphylococcus aureus. Ngamaxesha athile, i-empyema inokwenzeka emva kokuba utyandiwe esifubeni. Izixhobo zonyango zinokudlulisa ibhaktiriya kwindawo yakho yokubongoza.

Indawo yokuncoma ngokwendalo inamanzi athile, kodwa usulelo lunokubangela ukuba ulwelo lwakhe ngokukhawuleza kunokuba lunokufunxwa. Ulwelo emva koko losuleleka yintsholongwane ebangele inyumoniya okanye usulelo. Ulwelo olosulelekileyo luyajiya. Inokubangela ukuba ulwelo lwemiphunga yakho kunye nesifuba sincamathele kunye kunye nokwenza iipokotho. Oku kubizwa ngokuba yimpyema. Imiphunga yakho ayinakukwazi ukufutha ngokupheleleyo, enokubangela ubunzima bokuphefumla.

Iimeko ezikubeka emngciphekweni

Umngcipheko omkhulu we-empyema kukuba nenyumoniya. I-Empyema yenzeka rhoqo kubantwana nakubantu abadala abadala. Nangona kunjalo, akuqhelekanga ngokufanelekileyo. Kwisifundo esinye, kwenzeke ngaphantsi kwepesenti enye yabantwana abane-pneumonia.

Ukuba nezi meko zilandelayo kunokunyusa namathuba akho empyema emva kwenyumoniya:

• bronchiectasis
• isifo esinganyangekiyo semiphunga (COPD)
• irheumatoid Arthritis
• utywala
• isifo seswekile
• amajoni omzimba abuthathaka
• utyando okanye umothuko osandula ukwenzeka
• ithumba lemiphunga

Iimpawu

I-Empyema inokuba lula okanye inzima.

Impyema elula

I-empyema elula ivela kumanqanaba okuqala okugula. Umntu unolu hlobo ukuba ubofu buhamba ngokukhululekileyo. Iimpawu ze-empyema elula zibandakanya:

• ukuqhawukelwa ngumphefumlo
• ukukhohlela owomileyo
• ifiva
• ukubila
• Intlungu yesifuba xa uphefumla okunokuthi kuchazwe njengokuhlaba
• intloko ebuhlungu
• ukudideka
• Ukuphelelwa ngumdla wokutya

Ubunzima be-empyema

Ubunzima be-empyema buya kwenzeka kwinqanaba lokugula. Kwi-empyema eyinkimbinkimbi, ukuvuvukala kunzima kakhulu. Izicubu ezibomvu zingenza kwaye zahlule isifuba kwisikhala esincinci. Oku kubizwa ngokuba yindawo, kwaye kunzima ukunyanga.

Ukuba usulelo luyaqhubeka luba mandundu, lungakhokelela ekwakhiweni kwe-peel eshinyeneyo ngaphezulu kwe-pleura, ebizwa ngokuba yipeleyali. Eli cwecwe lithintela umphunga ekubeni wandise. Utyando luyafuneka ukuyilungisa.

Ezinye iimpawu kwi-empyema enzima zibandakanya:

• ubunzima bokuphefumla
• ukuncipha kwezandi zokuphefumla
• ukuhla ukusinda
• iintlungu zesifuba

Iingxaki

Kwiimeko ezinqabileyo, imeko ye-empyema enzima inokukhokelela kwiingxaki ezinzima. Oku kubandakanya i-sepsis kunye nomphunga owileyo, okwabizwa ngokuba yi-pneumothorax. Iimpawu ze-sepsis zibandakanya:

• umkhuhlane ophezulu
• Ukugodola
• ukuphefumla ngokukhawuleza
• ukukhawuleza kwentliziyo
• uxinzelelo lwegazi oluphantsi

Umphunga owileyo unokubangela iintlungu ngesiquphe, ezibukhali esifubeni kunye nokuphefumla kancinci okuba mandundu xa ukhohlela okanye uphefumla.

Ezi meko zinokubulala. Ukuba unale mpawu, kuya kufuneka ubize i-911 okanye umntu akuqhubele kwigumbi lexakeka.

Ukuchonga impyema

Ugqirha unokurhanela i-empyema ukuba unenyumoniya engaphenduliyo kunyango. Ugqirha wakho uya kuthatha imbali epheleleyo yonyango kunye novavanyo lomzimba. Banokusebenzisa i-stethoscope ukumamela nasiphi na isandi esingaqhelekanga kwimiphunga yakho. Ugqirha wakho uhlala esenza iimvavanyo ezithile okanye iinkqubo zokuqinisekisa isifo:

• I-X-ray yesifuba kunye ne-CT scans ziya kubonisa ukuba akukho okanye akukho fluid kwindawo yokubhenela.
• I-ultrasound yesifuba iya kubonisa ubungakanani bolwelo kunye nendawo echanekileyo.
• Uvavanyo lwegazi lunokunceda ukujonga ubalo lweeseli ezimhlophe, ujonge iprotein esebenzayo yeC, kwaye uchonge ibhaktheriya ebangela usulelo. Inani leeseli ezimhlophe linokuphakanyiswa xa unesifo.
• Ngexesha le-thoracentesis, inaliti ifakwe ngasemva kwembambo yakho kwisithuba sokuthabatha isampulu yolwelo. Amanzi ke ayahlalutywa phantsi kwemicroscope ukukhangela iibhaktiriya, iiprotein kunye nezinye iiseli.

Unyango

Unyango lujolise ekususeni ubofu kunye nolwelo kwi-pleura kunye nokunyanga usulelo. Amayeza okubulala iintsholongwane asetyenziselwa ukunyanga usulelo olusisiseko. Uhlobo oluthile lwe-antibiotiki luxhomekeke kuhlobo luni lweebhaktheriya ezibangela usulelo.

Indlela esetyenziselwa ukukhupha ubofu ixhomekeke kwinqanaba le-empyema.

Kwiimeko ezilula, inaliti inokufakwa kwisithuba sokucoca ulwelo. Oku kubizwa ngokuba yi-thoracentesis.

Kumanqanaba okugqibela, okanye i-empyema entsonkothileyo, ityhubhu yokuhambisa amanzi kufuneka isetyenziselwe ukukhupha ubofu. Le nkqubo ihlala isenziwa phantsi kwe-anesthesia kwigumbi lokusebenza. Kukho iintlobo ezahlukeneyo zotyando koku:

ThoracostomyKule nkqubo, ugqirha wakho uya kufaka ityhubhu yeplastiki esifubeni sakho phakathi kweembambo ezimbini. Emva koko baya kudibanisa ityhubhu kwisixhobo sokutsala kunye nokususa ulwelo. Banokujova amayeza ukunceda ukukhupha ulwelo.

Ividiyo-incedwa ngophando lwe-thoracic: Ugqirha wakho uya kususa izicwili ezichaphazelekayo ezingqonge umphunga wakho emva koko ufake ityhubhu yokuhambisa amanzi okanye usebenzise amayeza ukususa ulwelo. Baza kwenza ukubonwa okuncinci okuncinci kwaye basebenzise ikhamera encinci ebizwa ngokuba yi-thoracoscope yale nkqubo.

Ukucaciswa okuvulekileyo: Kolu tyando, ugqirha wakho wotyando uya kuyikhupha i-pleural peel.

Imbonakalo

Umbono we-empyema ngonyango olukhawulezileyo ulungile. Ukulimala kwexesha elide kwimiphunga kunqabile. Kuya kufuneka ugqibe ii-antibiotics zakho ezimiselweyo kwaye uye kulandelwa isifuba X-ray. Ugqirha wakho unokuqinisekisa ukuba i-pleura yakho iphiliswe ngokufanelekileyo.

Nangona kunjalo, kubantu abanezinye iimeko ezichaphazela amajoni omzimba, i-empyema inokuba nezinga lokufa elinokufikelela kuma-40 eepesenti.

Ukuba ayinyangwa, i-empyema inokukhokelela kwiingxaki ezinokubangela ubomi ezinje nge-sepsis.