Hemothorax

Hemothorax muunganidzwa weropa munzvimbo iri pakati pechidziro chechipfuva nemapapu (iyo pleural mhango).

Chikonzero chakajairika chehemothorax chipfuva chinoshungurudza. Hemothorax inogona zvakare kuitika kune vanhu vane:

• Ropa rinovhara ropa
• Chifuva (thoracic) kana kuvhiya moyo
• Kufa kwemapapu emapapu (pulmonary infarction)
• Lung kana kenza yekuteterera - yekutanga kana yechipiri (metastatic, kana kubva kune imwe saiti)
• Kubvarura mumudziyo weropa kana uchiisa chepakati venous catheter kana kana ichibatanidzwa neakanyanya BP
• Tiibhii

Zviratidzo zvinosanganisira:

• Kufema kwekufema
• Inokurumidza, isina kudzika kufema
• Kurwadziwa pachifuva
• Kuderera kweropa (kuvhunduka)
• Pale, inotonhorera uye inonamira ganda
• Kukurumidza kurova kwemoyo
• Kusadzikama
• Kufunganya

Wako wekuchengeta hutano anogona kucherechedza kuderera kana kusavapo kwekufema kurira padivi rakakanganiswa. Zviratidzo kana zvakawanikwa zvehemothorax zvinogona kuoneka pane zvinotevera bvunzo:

• Chest x-ray
• CT scan
• Thoracentesis (drainage ye pleural fluid kuburikidza netsono kana catheter)
• Thoracostomy (drainage ye pleural fluid kuburikidza nechipfuva chubhu)

Chinangwa chekurapa ndechekuita kuti munhu agadzikane, kumisa kubuda kweropa, uye kubvisa ropa nemhepo munzvimbo yekukumbira.

• Chubhu yechipfuva inoiswa kuburikidza nechidziro chechipfuva pakati pemumbabvu kudurura ropa nemhepo.
• Iyo inosara munzvimbo uye yakasungirirwa mukuyamwa kwemazuva akati wandei kuti iwedzere kuwedzera mapapu.

Kana chipfuva chechipfuva choga chisingadzore kubuda kweropa, kuvhiya (thoracotomy) kunogona kudikanwa kumisa kubuda kweropa.

Chikonzero chehemothorax chichagadziriswawo. Mapapu ari pasi anogona kunge akadonha. Izvi zvinogona kutungamira mukufema kunetseka. Mune vanhu vakakuvara, chipfuva chubhu dhizaini inogona kunge iri izvo zvese zvinodiwa. Kuvhiya kunogona kusakosha.

ZVAUNOFANIRA KUTARIRA KUDhipatimendi Rekurumidzira

Iye mupi achayera nekutarisa zviratidzo zvakakosha zvemunhu, zvinosanganisira kugarisa kweoksijeni, kupomba, kufema, uye kuwedzerwa kweropa. Zviratidzo zvicharapwa sekudikanwa. Munhu wacho anogona kugamuchira:

• Kufema rutsigiro - Izvi zvinogona kusanganisira okisijeni, isinga-kuvhiringidza yemhepo kumanikidza rutsigiro senge BIPAP, kana endotracheal intubation (kuiswa kweanofema chubhu kuburikidza nemuromo kana mhino munzira yemhepo) uye kuiswa pane mweya (mweya wekutsigira mweya wekufema)
• Kuongororwa kweropa uye pamwe nekuwedzerwa ropa
• Chest tube (chubhu kuburikidza neganda uye mhasuru pakati pembabvu kupinda munzvimbo yakatenderedza mapapu) kana paine kuputsika kwemapapu
• CT scan
• Kuongorora kweiyo pleural fluid, Electrocardiogram (ECG)
• Mvura inopihwa kuburikidza netsinga (IV)
• Mishonga yekurapa zviratidzo
• X-ray dzechipfuva nedumbu kana zvimwe zvikamu zvemuviri kana paine zvimwe zvekukuvara

Mhedzisiro yacho inoenderana nechikonzero chehemothorax, huwandu hwekurasikirwa neropa uye nekukurumidza kurapwa kupihwa.

Muchiitiko chekushungurudzika kukuru, mhedzisiro ichawedzera kubva pakukuvara kwekukuvara uye nemwero wekubuda ropa.

Zvinetso zvinogona kusanganisira:

• Yakapunzika mapapu, kana pneumothorax, inotungamira mukufema kutadza (kutadza kufema zvakanaka)
• Fibrosis kana kupora kweiyo pleural membranes uye pasi pemapapu tishu
• Kubatwa kweiyo pleural fluid (empyema)
• Kuvhunduka uye kufa mumamiriro ezvinhu akaoma

Fonera 911 kana iyo yemuno emergency emergency kana uine:

• Chero ipi inogona kukuvadza zvakanyanya pachifuva
• Kurwadziwa pachifuva
• Yakanyanya shaya, mutsipa, bendekete kana ruoko kurwadziwa
• Kunetseka kufema kana kupfupika kwekufema

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (se911) kana uine:

• Dzungu, hurema, kupisa uye kukosora, kana kunzwa kwekuremerwa mubhokisi rako

Shandisa matanho ekuchengetedza (akadai semabhande epachigaro) kudzivirira kukuvara. Zvichienderana nechakakonzera, hemothorax inogona kunge isingadziviriki.

• Aortic rupture - chifuva x-ray
• Kufuridzira system
• Chifuva chubhu kupinza - akateedzana

Chiedza RW, Lee YCG. Pneumothorax, chylothorax, hemothorax, uye fibrothorax. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Bhuku reRefiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits 81.

Raja AS. Kunetseka kukuru. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chitsiko 38.

Semon G, McCarthy M. Chest madziro, pneumothorax, uye hemothorax. Mune: Cameron AM, Cameron JL, eds. Parizvino Kuvhiya Therapy. 13 ed. Philadelphia, PA: Elsevier; 2020: 1146-1150.