Pneumothorax na pneumomediastinum: ịzọpụta onye ọrịa na pulmonary barotrauma

By Cristiano Antonino On Jan 23, 2022

Ka anyị kwuo banyere pneumothorax na pneumomediastinum: barotrauma bụ mmebi anụ ahụ kpatara mgbanwe mgbanwe gas na akụkụ ahụ.

Ihe na-eme ka ohere nke barotrauma nke akpa ume na-abawanye gụnyere àgwà ụfọdụ (dịka mgbago ngwa ngwa, ijide ume, iku ume ikuku) na nsogbu akpa ume (dịka ọrịa na-adịghị ala ala).

Barotrauma Pulmonary: pneumothorax na pneumomediastinum bụ ngosipụta a na-ahụkarị

Ndị ọrịa chọrọ nyocha akwara ozi na onyonyo nke obi.

A na-agwọkwa pneumothorax.

Mgbochi gụnyere ibelata omume ihe egwu yana ịgakwuru ndị na-eme ihe egwu dị elu.

Ntughari na mgbawa nke alveolar nwere ike ime mgbe mmadụ na-ejide ume (na-emekarị ka ọ na-eku ume ikuku) n'oge mgbago, karịsịa n'oge ịwụ elu ngwa ngwa.

Ihe ga-esi na ya pụta nwere ike ịbụ pneumothorax (na-ebute dyspnoea, mgbu obi na mbelata ụda ume sitere na ngụgụ ipsilateral) ma ọ bụ pneumomediastinum (na-akpata njigide obi, n'olu mgbu, pleuritic mgbu nke nwere ike ịgbapụta n'ubu, dyspnea, ụkwara, oke iwe na dysphagia).

Pneumomediastinum nwere ike ịkpata crepitus n'olu, n'ihi emphysema subcutaneous concomitant, na adịkarịghị a precordial crepitus n'oge systole (akara Hamman).

Ikuku nwere ike na-ekekọta mmiri mgbe ụfọdụ n'ime oghere peritoneal (na-egosi n'ụzọ ụgha na mgbawa eriri afọ na mkpa maka laparotomy), mana ọ naghị ebute akara peritoneal.

Pneumothorax ọbara mgbali elu, ọ bụ ezie na ọ dị ụkọ na barotrauma, nwere ike ime ka hypotension, turgor veins olu, hyperresonance na percussion na, dị ka nchọpụta ikpeazụ, tracheal deviation.

Mgbawa nke alveolar nwere ike ikwe ka ikuku banye n'ime mgbasa nke venous nke akpa ume nke na-ebute ikuku gas embolism.

N'oge apnea miri emi nke ukwuu, mkpakọ nke ngụgụ n'oge mgbada nwere ike adịkarịghị eme ka mbelata olu ngụgụ n'okpuru olu fọdụrụnụ, na-akpata edema mucosal, mkpọchị vaskụla na ọbara ọgbụgba, nke na-egosipụta n'ụlọ ọgwụ dị ka dyspnea na hemoptysis n'oge mgbago.

Nchọpụta nke pulmonary barotrauma

Nyocha ụlọ ọgwụ
Onyonyo obi

Ndị ọrịa na-achọ nyocha akwara ozi iji chọpụta ihe ịrịba ama nke arụrụ ọrụ ụbụrụ nke abụọ n'ime akwara akwara.

A na-eme X-ray nke obi iji chọpụta ihe ịrịba ama nke pneumothorax ma ọ bụ pneumomediastinum (band nke redio n'etiti akwụkwọ ntanye pleural n'akụkụ akụkụ obi).

Ọ bụrụ na X-ray nke obi adịghị njọ mana enwere enyo ụlọ ọgwụ siri ike, mgbe ahụ nyocha CT nke obi nwere ike ịdị nro karịa X-ray ọkọlọtọ, ya mere nchọpụta.

Ultrasonography nwekwara ike ịba uru maka nyocha ngwa ngwa n'akụkụ akwa nke pneumothorax.

Pneumoperitoneum na-enweghị mgbawa nke viscera kwesịrị ka a na-enyo enyo mgbe pneumoperitoneum dị na-enweghị akara peritoneal.

Ọgwụgwọ nke pulmonary barotrauma

100% oxygen
Mgbe ụfọdụ, thoracostomy

A na-agwọ onye a na-enyo enyo na ọ nwere pneumothorax ọbara mgbali elu site na nhụsianya mgbaka na-esote thoracostomy.

Ọ bụrụ na obere pneumothorax dị (dịka, 10 ruo 20%) na enweghị ihe ịrịba ama nke hemodynamic ma ọ bụ enweghị ike iku ume, enwere ike dozie ya site n'ịkwanye nnukwu ikuku oxygen 100% maka awa 24-48.

Ọ bụrụ na ọgwụgwọ a egosighi na ọ naghị arụ ọrụ ma ọ bụ ọ bụrụ na pneumothorax dị ịrịba ama karị, a na-eme drainage pleural (iji pigtail catheter ma ọ bụ obere akpa igbe).

Enweghị ọgwụgwọ a kapịrị ọnụ maka pneumomediastinum achọrọ; mgbaàmà na-akwụsịkarị ozugbo n'ime awa ma ọ bụ ụbọchị.

Mgbe awa ole na ole nyochachara, ọtụtụ ndị ọrịa nwere ike ịgwọta n'ụlọ ọgwụ; A na-atụ aro ka mmiri dị elu nke 100% oxygen na ndị ọrịa a iji mee ngwangwa reabsorption nke gas na elu ngụgụ.

Ọ dị obere, a na-achọ mediastinotomy iji dozie pneumomediastinum ọbara mgbali elu.

Pulmonary barotrauma: mgbochi

Mgbochi bụ ọgwụgwọ kachasị mma maka barotrauma pulmonary.

Oge ziri ezi na usoro dị mkpa.

Ndị ọrịa nwere nnukwu ihe ize ndụ nke pneumothorax n'oge ndakpu mmiri gụnyere ndị nwere ọrịa pulmonary bullae, ọrịa Marfan, ọrịa na-adịghị ala ala na-egbochi akpa ume ma ọ bụ akụkọ ihe mere eme nke pneumothorax ozugbo.

Ndị dị otú ahụ ekwesịghị ịdaba ma ọ bụ rụọ ọrụ n'ebe ndị nwere oke ikuku.

Ndị ọrịa nwere ụkwara ume ọkụ nwere ike ịnọ n'ihe ize ndụ maka barotrauma pulmonary, ọ bụ ezie na ọtụtụ nwere ike ịdaba n'enweghị nsogbu mgbe nyocha na ọgwụgwọ kwesịrị ekwesị.

Ndị ọrịa nwere pneumomediastinum mgbe imikpu mmiri ga-ezigara onye ọkachamara n'ịgwọ ọgwụ n'okpuru mmiri maka nyocha ihe egwu n'ime mmiri mmiri n'ọdịnihu.