Yintoni i-Broncopleural Fistula kwaye inyangwa njani?

Umxholo

• Iimbangela ze-bronchopleural fistula
• Indlela yokuchonga
• Unyango lwenziwa njani

I-bronchopleural fistula ihambelana nonxibelelwano olungaqhelekanga phakathi kwe-bronchi kunye ne-pleura, eyimbumba ephindwe kabini ebeka imiphunga, ekhokelela ekungonelini kokuhamba komoya kwaye iphindaphindwe rhoqo emva kotyando lwemiphunga. I-bronchopleural fistula ihlala ichongwa ngeempawu kunye neempawu ezibonakaliswa ngumntu kunye novavanyo lwe-imaging, olufana nesifuba se-radiography kunye ne-bronchoscopy.

Le meko inqabile kwaye inzulu, ngakumbi xa isenzeka ebantwaneni, kwaye kufuneka isonjululwe ngokukhawuleza ukuze ingabeki ubomi bomntu emngciphekweni. Ke ngoko, kubalulekile ukuba emva kotyando lwemiphunga okanye xa umntu enalo naluphi na uhlobo lokukhubazeka kokuphefumla, iimviwo zokulandelela ziyaqhutywa ukukhangela naluphi na utshintsho kwaye, ukuba kukho imfuneko, ukuqala unyango.

Iimbangela ze-bronchopleural fistula

I-bronchopleural fistula inxulumene ngakumbi notyando lwemiphunga, ikakhulu i-lobectomy, apho kukhutshwa khona umqala wamaphaphu, kunye ne-pneumonectomy, apho icala elinye lemiphunga lisuswe khona. Ukongeza, kuqhelekile ukuba i-bronchopleural fistula yenzeke njenge-necrotizing usulelo, apho, ngenxa yobukho be-microorganism ejongene nosulelo, ukufa kwethishu kwenzeka. Ezinye izinto ezinokubangela i-bronchopleural fistula zezi:

• I-pneumonia, i-fistula ithathwa njengengxaki yesi sifo, ngakumbi xa ibangelwa ngumngundo okanye ibhaktiriya yohlobo IStreptococcus;
• Umhlaza wemiphunga;
• Emva kwekhemotherapy okanye unyango ngemitha;
• Ukuxinana kwemiphunga ye-lung;
• Ukutshaya okungapheliyo;
• Isifo esinganyangekiyo semiphunga;
• Ukungenisa umoya ngoomatshini.

Kubalulekile ukuba unobangela we-bronchopleural fistula uchongwe ukuze kuqalwe unyango olufanelekileyo kwaye kuthintelwe iingxaki, ezinje ngobunzima kwinkqubo yokuphefumla, ukwanda okungonelanga kwemiphunga, ubunzima bokugcina umoya kwi-alveoli yemiphunga kunye nokufa.

Indlela yokuchonga

Ukuxilongwa kwe-bronchopleural fistula kwenziwa ngugqirha oqhelekileyo okanye i-pulmonologist kusetyenziswa iimvavanyo zokucinga, ezinje nge-radiology yesifuba, apho i-atelectasis inokubonwa khona, yimeko apho kungekho moya womoya oya kwindawo ethile yomphunga, Ukuwa, okanye isixhobo semiphunga. Ukongeza kwirejografi, ugqirha kufuneka enze i-bronchoscopy, apho kufakwa khona ityhubhu encinci ngeempumlo ukuze kubonwe indlela yokuphefumla, kunye nendawo ye-fistula kunye nobungakanani bayo.

Ukongeza, ugqirha kufuneka avavanye iimpawu kunye neempawu ezivezwe ngumntu, njengokukhohlela igazi okanye umchamo, ukuphefumla nzima kunye nomkhuhlane, ukuba yinto eqhelekileyo ukuqaphela emva kokwenza utyando lwemiphunga, iimpawu zakhe ezibonakala ngaphezulu okanye ngaphantsi kweeveki ezi-2 emva kwenkqubo .

Ke ngoko, kubalulekile ukuba emva kotyando lokuphefumla, umntu lowo abekwe esweni rhoqo ngugqirha ukuthintela ukwakheka kwefistula kunye neengxaki zabo.

Unyango lwenziwa njani

Unyango lwe-bronchopleural fistula luyahluka ngokwonobangela, imbali yonyango lomntu kunye neempawu kunye neempawu ezichaziweyo. Uninzi lwexesha, unyango luquka ukwenza utyando ukusombulula i-fistula, nangona kunjalo kunokwenzeka ukuba emva kwethutyana i-fistula izakuvela kwakhona. Utyando luhlala lucetyiswa kwiimeko apho unyango olulondolozayo lungenasiphumo sinqwenelekayo, xa kukho imiqondiso ebonisa isifo sepsis okanye xa kukho ukuvuza komoya.

Unyango lwe-Conservative luqukethe umjelo we-pleural fluid, ukungena komoya, inkxaso yesondlo kunye nokusetyenziswa kwee-antibiotics, kwaye le ndlela yonyango ixhaphake kakhulu xa i-bronchopleural fistula isenzeka ngenxa yosulelo. Nangona kunjalo, umjelo wamanzi we-pleural fluid unokukhetha ukwenziwa kweefistula ezintsha. Ke ngoko, unyango lwale meko luthathwa njengomceli mngeni kunyango kwaye ngaphandle konyango olucetyiswayo, kubalulekile ukuba umntu abekwe esweni rhoqo ukuze avavanye impumelelo kunyango kunye nemfuno yongenelelo olutsha.

Indlela entsha yonyango ethe yafundwa kukubekwa kweeseli zeseli zemeschchal kwi-bronchopleural fistula, iiseli ezinakho ukuvuselela izicwili kwaye, ke, zinokuthanda ukuvalwa kwefistula. Nangona kunjalo, akukaziwa ukuba ezi seli zisebenza njani kwisisombululo se-fistula kwaye ngekhe zibe nefuthe elifanayo kubo bonke abantu. Ke ngoko, kufuneka kuqhubeke izifundo ukuze kuqinisekiswe isiphumo solu hlobo lonyango kwi-bronchopleural fistula.