I-edema ye-pulmonary isifo esingumzimba esibangelwa ukungena kwamanzi angenalo ukuvuvukala kusuka kwamapilisili we-pulmonary kuya e-interstitium nase-alveoli. Ngenxa yalokhu, kukhona ukuhlukumeza okubukhali kokushintshaniswa kwegesi, i-oksijeni indlala iqala, izicubu ezithwalayo nezitho.
Izinhlobo ze-edema ye-pulmonary
I-OL yisimo lapho usizo okufanele lunikezwe ngokushesha. Kungaba khona ngenxa yokuzikhandla komzimba, futhi ebusuku - ngokuphumula. Ngezinye izikhathi i-edema ye-pulmonary iba yinkimbinkimbi, ehlaselwa ngemuva kokuphulwa kokusakazwa kohlobo olusetshenziselwa isitho. Izindiza azikwazi ukubhekana nokugqithisa kwegazi okuhlungiwe kusuka kuma-capillaries, futhi uketshezi ngaphansi kokucindezela okukhulu kudlulela e-alveoli. Ngenxa yalokhu, amaphaphu ayeke ngokufanele ukwenza imisebenzi yawo eyisisekelo.
Ukuthuthukiswa kwe-OL kwenzeka ngezigaba ezimbili. Okokuqala igazi lifaka phakathi kwe-interstitium. Lesi simo sibizwa ngokuthi i-interstitial pulmonary edema. Ngalo, i-parenchyma ihlanganiswa ngokuphelele ne-liquid, kodwa isibani se-alveoli asifaki i-transudate. Kusukela esikhaleni sangaphakathi, uma ingcindezi inganciphisi, igazi legazi lingena emagcekeni alveoli. Kulesi simo, i-edema ye-alveolar pulmonary iyatholakala.
I-edema ye-Lung ingahle ibekwe eceleni ngesikhathi sokuthuthukiswa:
- Kwenzeka kahle emahoreni angu-2-4.
- Kuthatha amahora ambalwa ukuthuthukisa okwesikhashana. Ikwazi ukuhlala usuku noma ngaphezulu.
- Ukukhanya okusheshayo kuyingozi kakhulu. Iqala ngokuzumayo, futhi imizuzu embalwa nje emva kokuqala kokufa kwenzeka.
I-edema ye-cardiogenic pulmonary
Izifo ezihlukahlukene zingabangela inkinga ye-AL. I-edema ye-cardia ye-cardiac isethwe lapho inhliziyo ibandakanyeka enkambweni yokugula. Izifo ezibangelwa ukuphazamiseka emisebenzini ye-systolic ne-diastolic ye-ventricle kwesokunxele. Hlola kule nkinga ikakhulukazi abantu abanesifo senhliziyo ischemic. Ngaphezu kwalokho, i-edema ye-pulmonary ne-infyoction ye-myocardial, isifo somfutho wegazi, isifo senhliziyo senzeka. Ukuze uqiniseke ukuthi i-OL ingumzimba we-cardiogenic ngempela, udinga ukuhlola ukucindezela kwe-capillary ye-pulmonary. Kufanele ibe ngaphezu kuka-30 mm Hg. Art.
I-edema ye-pulmary noncardiogenic
Lolu hlobo lwe-OL lungabangelwa yizifo ezihlukahlukene, okuholela enkingeni eyodwa - ukwephulwa komfutho we-alveolar. Izifo ezibangela i-edema engeyona i-cardiogenic:
- i-pneumonia (kokubili amabhaktheriya kanye negciwane);
- Isifo se-DIC;
- uhlobo oluthile lwe-pancreatitis emangalisa;
- ukuhlukunyezwa kwamaphaphu.
Inkinga enkulu ukuthi i-edema ye-cardiac ye-cardiac non-cardiac kunzima ukuhlukanisa phakathi komunye nomunye. Ukuze uhlukanise kahle le nkinga, ochwepheshe kufanele acabangele umlando wezokwelapha, ahlole i-myocardial ischemia, futhi ahlole i-hemodynamics ephakathi. Ekuhloleni, ukuhlolwa okuqondile kuyasetshenziswa-ukulinganisa kwengcindezi yejamu. Uma lezi zibalo zingaphezulu kwe-18 mm Hg. Art. Ingabe i-edema ye-cardiogenic. Ngenkinga yemvelaphi engeyona inhliziyo, ingcindezi ihlala ingavamile.
I-edema yamapayipi enobuthi
Umbuso ufika ngenxa yokuthi:
- ukwandisa ukufaneleka kwe-capillary;
- ukwephula ubuqotho babo;
- ukwephulwa kwezinqubo eziyinhloko ezenzeka ku-arc neurovegetative;
- i-oksijini yindlala.
I-edema enobuhlungu inezici ezithile. Unenkathi ehlukile yokucabanga. Ngaphezu kwalokho, izimpawu ezijwayelekile ze-OL zihlangene nezimpawu zokushisa kwamakhemikhali namaphuzu okuphefumula. Imithi ihlukanisa izikhathi ezine eziyinhloko zokuthuthukiswa kwenkinga:
- Okokuqala, ukubonakaliswa kwezifo ezibucayi kuyisici: ukukhwehlela, i-dyspnea eqinile, i-lachrymation engapheli. Ezimweni ezinzima kunazo zonke, ukuma kwe-reflex yenhliziyo nokuphefumula kungase kwenzeke.
- Ngesikhathi esifushane, izimo zomsindo zancipha. Ihlala emahoreni ambalwa kuya ezinsukwini ezimbalwa (kodwa njengomthetho, akusekho amahora angu-4 kuya ku-6). Nakuba inhlalakahle jikelele yesiguli isesimeme, izinyathelo zokuxilonga zinganquma izimpawu zokuthi i-edema esondelayo: ukuphefumula kuyaba njalo, ukushaywa umoya kuyahla.
- Isigaba sesithathu sibonisa ukuvuvukala. Ukulala cishe ngosuku. Phakathi nalesi sikhathi, izinga lokushisa likhuphuka, i-leukocytosis ye-neutrophilic iqala.
- Ekuphetheni, kunezibonakaliso zezinkinga, ezingaba izifo ezinjalo, njenge-pneumonia noma i-pneumosclerosis.
Yini ebangela i-edema ye-pulmonary?
Izizathu zokuthi kungani amaphaphu ekhula, okuningi. Phakathi kokuyinhloko kubo kukhona:
- i-sepsis (ezimweni eziningi ezivela ngemuva kokungena kwe-toxin egazini);
- ukudlula izidakamizwa;
- i-pneumonia ;
- ukudlula ngokweqile imithi ethile (eyingozi kunazo zonke izidakamizwa eziphikisayo nezidakamizwa ze-cytotoxic);
- ukulimala kwemisebe emaphashini;
- ubuthi nge-poison;
- i-stasis ekujikelezeni kokuqala (okubhekene nesifo sokuphefumula kwesifo sofuba, i- emphysema nezinye izifo zamaphaphu);
- ukunciphisa okungapheli noma okungazelelwe ezingeni lamaphrotheni egazini (njengokuthi i-cirrhosis, nephrotic syndrome nezinye izinkinga zezinso);
- i-enteropathy;
- uhlobo oluthile lwe-pancreatitis emangalisa;
- uketshezi ngegesi ;
- isifiso sesisu;
- i-pneumothorax ;
- hlala endaweni ephakeme;
- isingeniso esingalawulwa ngokungenalutho sogesi oluphakathi kwamanzi.
I-edema yepulmonary enehluleka kwenhliziyo
Lesi sifo siyisigaba sokugcina somfutho wegazi ophakeme ojikelezayo we-pulmonary. I-edema ye-pulmonary in isifo senhliziyo ivela ezinhlobonhlobo ezinzima zokuhluleka kwenhliziyo nokuphazamiseka kwesistimu yonke. I-edema ye-cardiogenic iboniswa ukukhwehlela ngokukhishwa kombala we-sputum colorish. Ezimweni ezinzima kakhulu, isiguli sibhekene nokuntuleka okunamandla oksijini futhi silahlekelwa yimiqondo. Ukuphefumula kweziguli kuba okungenasisekelo futhi akusizi ngalutho, ngakho-ke, ukuphuza umoya kwamapayipi kuyadingeka.
I-edema ye-pulmonary ukuphakama
Ukunqotshwa kwezingqimba kuyimidlalo eyingozi hhayi kuphela ngenxa yengozi yokuguqulwa kwama-avalanche. Ukuvuvukala kwamapayipi ezintabeni kuvamile. Futhi kungavela ngisho nakwabagibeli abanolwazi nabagibeli. Uma uphakeme ukhuphuka ezintabeni, umzimba wakho omncane uthola umoya ophansi. Ekuphakameni, ingcindezi yehla, futhi igazi elidlula emaphashini alitholi inani elifanele legesi ewusizo. Ngenxa yalokho, uketshezi luhlanganisa emaphashini. Futhi uma ungasizi ngokuvuvukala kwamaphaphu, umuntu angase afe.
I-edema ye-pulmonary in iziguli ezilala phansi
Umzimba womuntu awuhambisani nesikhundla esinqunyiwe isikhathi eside. Ngakho-ke, ezinye iziguli ezithandayo ziqala izinkinga ngendlela ye-OL. Izimpawu zenkinga ziyafana nezimo ezibangelwa izifo ezinzima, kodwa kulula ukuphatha i-edema yamaphalini enjalo, ngoba iyaziwa kusengaphambili ukuthi kungani yabonakala.
Futhi ezigulini ezilele, i-edema ye-pulmonary ibangela izizathu ezilandelayo: endaweni ye-supine kakhulu emoyeni ifakwe. Ngenxa yalokhu, ukugeleza kwegazi emaphashini kunciphisa, futhi izenzakalo eziqhubekayo zikhula. I-sputum, equkethe izingxenye zokuvuvukala, iqoqa, futhi iwukhipha ngokucacile kunzima. Ngenxa yalokho, izinqubo eziqhubekayo zithuthuka, ukukhukhuma kuyaqhubeka.
I-edema ye-edema - izimpawu, izimpawu
Ukubonakaliswa kwe-OL esheshayo nesikhashana kuhlukile. Lezi zinsuku ziqala kancane. I-"swallow swallow" yokuqala, isixwayiso mayelana nenkinga, iba ukuphefumula. Ekuqaleni kuvela ngesikhathi sokuzikhandla ngokomzimba, kodwa ngokuhamba kwesikhathi, ukuphefumula kuyoba nzima ngisho nasesimweni sokuphumula ngokuphelele. Ezigulini eziningi, ngokufana nokuphefumula, izimpawu ze-edema ze-pulmon zibonakaliswa, isibonelo, ukuphefumula okusheshayo, isizungu, ukulala, ubuthakathaka jikelele. Ukukhombisa ukuthi ingozi ingase kube yindlela yokulalela amaphaphu - ukungaqondakali, ukugubha kanye nemisindo enomsindo kuzwakala ku-stethoscope.
I-edema ye-pulmonary evamile ayinzima ukubona. Ngokuvamile kubonakala ebusuku, ngesikhathi sokulala. Indoda ivukela ekuhlaselweni okukhulu kwe-suffocation. Ihlanganisa ukwethuka, ngenxa yokuthi ukuhlaselwa kukhula kuphela. Ngemva kwesikhashana, ukukhwehlela, i-pallor, kubika i-cyanosis, ukujuluka okubandayo, ukuthuthumela, ukucindezela ubuhlungu endaweni yesifuba kunezelwa izimpawu ezikhona kakade. Inqubo yokwandisa i-edema, ukudideka kungase kwenzeke, ukucindezeleka kwegazi kungase kuwe, noma kunciphise - noma kungabanjwanga nhlobo - yi-pulse.
I-edema ye-pulmonary - ukwelashwa
Ukwelashwa kwe-AL kufanele kuhloswe ukunciphisa ukuze kuphele ngokuphelele zonke izimbangela ezibangela ukuthi kwenzeke.
Nansi indlela yokuphatha i-edema ye-pulmonary:
- Okokuqala, zonke izinyathelo ezidingekayo kufanele zithathwe ukunciphisa ukugeleza kwegazi emaphashini. Ukwenza lokhu kuzosiza ama-vasodilators, izidakamizwa, inqubo yokufaka igazi noma ukusebenzisa i-tourniquet.
- Uma lokhu kungenzeka, kubalulekile ukuhlinzekela izimo zokuphuma kwegazi - ngokusheshisa ukuvinjelwa kwenhliziyo nokunciphisa ukumelana kwamagciwane.
- Ukwelashwa kwe-oksijeni kusiza ukuqeda izimpawu ze-edema ye-pulmonary.
- Kubaluleke kakhulu ukunikeza isiguli ngokuthula nokumvikela ezimweni ezicindezelayo.
- Ezimweni ezinzima kunazo zonke, ingxube ka-5 ml ye-96% utshwala no-15 ml we-solution ye-glucose ka-5 ku-trachea noma nge-intravenously ivunyelwe.
I-edema ye-pulmonary - usizo oluphuthumayo, i-algorithm
Ngokushesha lapho ukuboniswa kokuqala kwe-AL kuqaphela, umuntu kufanele asizwe ngaphambi kwesikhathi sokubhedlela. Uma kungenjalo, ukuhlasela kungabangela ukufa.
Ukunakekelwa okuphuthumayo kwe-edema ye-pulmona kwenziwa ngokulandela i-algorithm elandelayo:
- Isisulu kumele sibekwe endaweni ehleliwe.
- Hlanza umthamo wokuphefumula ophezulu ovela ku-foam nge-oxygen inhalation.
- Ubuhlungu obunzima bokuma ngama-antipsychotics.
- Buyisela izinga lenhliziyo.
- Gcwalisa i-electrolyte ne-acid-base balance.
- Ngosizo lwe-analgesics, buyisela ukucindezela kwe-hydrostatic kumbuthano omncane.
- Nciphisa ithoni yemikhumbi kanye nevolumu ye-plasma ye-intrathoracic.
- Usizo lokuqala lwe-edema ye-pulmona luhilela ukwethulwa kwe-glycosides yenhliziyo.
I-edema ye-edema - therapy
Ukwelashwa okunzima kuyaqhubeka esibhedlela. Ukuze silwe nenkinga enjalo njengemithi ye-edema ye-pulmona kuzodinga lokhu okulandelayo:
- Morphine;
- Fentanyl;
- I-Furosemide ;
- I-Korglikon;
- Strofantin;
- Eufillin ;
- Aminophylline;
- ama-antibiotics (esimweni sezinkinga zebhaktheriya).
Imiphumela ye-pulmonary edema - imiphumela
I-OL ingaba nemiphumela ehlukile. Uma ukunakekelwa okuphuthumayo kunikeziwe ngesikhathi futhi ngokunembile futhi ukwelashwa okulandelayo kwenziwa ngabachwepheshe abaqeqeshiwe, ngisho ne-edema ye-pulmatic acacile izokhohlwa ngokuphepha. I-hypoxia ende ingabangela izinqubo ezingenakuguqulwa ohlelweni oluyisisekelo senzwa nobuchopho. Kodwa ezimweni ezimbi kunazo zonke, ukuqala okungazelelwe kwe-edema ephuthumayo kuholela emphumela wokubulala.
I-edemary edema - ukubikezela
Kubalulekile ukuqonda ukuthi i-AL yinkinga lapho isibikezelo esivame ukungahambi kahle. Ngokwezibalo, cishe iziguli ezingu-50% ziphila. Kodwa uma kungenzeka ukuba uhlolisise i-edema yamapulmoni yokuqala, amathuba okukhula okulula. I-puffiness, ekhula ngokumelene nesizinda se-infarction ye-myocardial, iholela ekufeni ngamacala angu-90%. Ukubuyiselwa emuva kokuhlaselwa kweziguli ezinyangeni ezimbalwa kumele kugcinwe nodokotela.