Pneumothorax iyo pneumomediastinum: badbaadinta bukaanka qaba barotrauma sambabada
Aynu ka hadalno pneumothorax iyo pneumomediastinum: barotrauma waa dhaawac unug oo uu keeno isbeddel la xidhiidha cadaadiska gaaska ee qaybaha jidhka
Sababaha kordhiya khatarta barotrauma sambabada waxaa ka mid ah dabeecadaha qaarkood (tusaale kor u kaca degdega ah, neefta oo la qabsado, hawo ciriiri ah oo neefsashada) iyo cilladaha sambabada (tusaale ahaan cudurrada sambabada xanniba ee joogtada ah).
Barotrauma sambabada: pneumothorax iyo pneumomediastinum waa astaamo caadi ah
Bukaannada u baahan baaritaanka neerfaha iyo sawirka laabta.
Pneumothorax waa la daaweeyaa.
Ka-hortagga waxa ay ka kooban tahay hoos u dhigidda dabeecadaha khatarta ah iyo la-talinta khataraha khatarta sare leh.
Kala fogaansho xad dhaaf ah iyo dilaac alveolar ah ayaa laga yaabaa inay dhacaan marka qofka neefta la hayo (badanaa marka la neefsanayo hawo ciriiri ah) marka la fuulayo, gaar ahaan marka kor loo qaado dusha sare.
Natiijadu waxay noqon kartaa pneumothorax (oo keenta dyspnea, laab xanuun iyo dhawaaqa neefta oo yaraada ee sambabada ipsilateral) ama pneumomediastinum (oo keenaysa cidhiidhi laabta, qoorta xanuunka, xanuunka pleuritic oo ka soo bixi kara garbaha, dyspnea, qufac, xabeeb iyo dysphagia).
Pneumomediastinum waxa laga yaabaa inay ku keento crepitus luqunta, iyadoo ay ugu wacan tahay emphysema-ka hoostiisa oo isku xidha, iyo naadir crepitus-ka hore inta lagu jiro systole (calaamadaha Hamman).
Hawadu waxay marmarka qaarkood xidhi kartaa dareeraha daloolka xuubka xuubka (si been abuur ah oo soo jeedinaya dillaaca mindhicirka iyo baahida laparotomy), laakiin badanaa ma keenaan calaamadaha xuubka xuubka.
Pneumothorax hypertensive, in kasta oo ay naadir ku tahay barotrauma, waxay keeni kartaa hypotension, turgor xididdada qoorta, hyperresonance on garaaca iyo, sida natiijada kama dambaysta ah, leexashada tracheal.
Dildilaaca alveolar waxa laga yaabaa inay u ogolaato hawadu inay gasho wareegga xididada sambabada taas oo keenta embolism gaaska halbowlaha ah.
Inta lagu jiro apnea qotodheer, cadaadiska sambabada inta lagu jiro soo-dejintu marar dhif ah ayey keeni kartaa hoos u dhaca mugga sambabada ee ka hooseeya mugga haraaga, taasoo keenta bararka xuubka xuubka, ciriiriga xididada iyo dhiig-baxa, kaas oo ka muuqda bukaan-socod iyo dhiig-baxa inta lagu jiro kor u kaca.
Ogaanshaha barotrauma sambabada
- Qiimaynta caafimaadka
- Sawirka laabta
Bukaan-socodka waxay u baahan yihiin baaritaan neerfaha si ay u baaraan calaamadaha cillad maskaxeed ee labaad ee ka soo baxa halbowlayaasha.
Raajada laabta ayaa la sameeyaa si loo ogaado calaamadaha pneumothorax ama pneumomediastinum (xarunta shucaaca ee u dhaxaysa warqadaha xuubka xuubka wadnaha).
Haddii raajada laabta ay tahay mid taban balse uu jiro tuhun caafimaad oo xooggan, markaas sawirka CT-ga ee xabadka ayaa laga yaabaa inuu ka xasaasisan yahay rajada caadiga ah, sidaas darteedna lagu ogaanayo.
Ultrasonography waxa kale oo laga yaabaa inay faa'iido u leedahay ogaanshaha sariirta degdega ah ee pneumothorax.
Pneumoperitoneum oo aan dillaacin viscera waa in laga shakiyaa marka pneumoperitoneum uu jiro iyada oo aan lahayn calaamadaha peritoneal.
Daaweynta barotrauma sambabada
- 100% oxygen
- Mararka qaarkood thoracostomy
Pneumothorax hypertensive oo looga shakisan yahay ayaa lagu daweeyaa daloolin ay ku xigto thoracostomy.
Haddii pneumothorax yar uu jiro (tusaale, 10 ilaa 20%) oo aanay jirin calaamado dhiig-baxa ama degenaansho la'aanta neefsiga, waxaa lagu xalin karaa iyadoo la maamulayo qulqulka sare ee 100% ogsijiinta 24-48 saacadood.
Haddii daawayntani ay noqoto mid aan waxtar lahayn ama haddii pneumothorax ka sii muhiimsani jiro, dheecaanka xuubka ayaa la sameeyaa (iyadoo la isticmaalayo tuubada pigtail ama tuubo yar oo laabta ah).
Looma baahna daaweyn gaar ah oo loogu talagalay pneumomediastinum; astaamuhu waxay caadi ahaan si kedis ah u xalliyaan saacado ama maalmo gudahood.
Dhawr saacadood oo indho-indhayn ah ka dib, bukaannada intooda badan waxaa lagu daweyn karaa si ku salaysan bukaan-socod; socodka sare ee 100% ogsijiinta ayaa lagula talinayaa bukaanadan si loo dardargeliyo dib u soo celinta gaasaska dusha sambabada.
Marar dhif ah, mediastinotomy ayaa looga baahan yahay si loo xalliyo pneumomediastinum hypertensive.
Barotrauma sambabada: ka hortagga
Ka-hortagga ayaa ah daaweynta ugu fiican ee barotrauma sambabada.
Waqtiga saxda ah iyo farsamooyinka ayaa lagama maarmaan ah.
Bukaannada khatarta sare ugu jira pneumothorax inta lagu jiro quusitaanka waxaa ka mid ah kuwa qaba bullae sambabada, Marfan syndrome, cudurrada sambabada xannibaadda ee joogtada ah ama taariikhda pneumothorax iskiis ah.
Shakhsiyaadka noocaas ah waa in aanay quusin oo aanay ka shaqayn meelaha ay cadaadiska hawadu ku badan tahay.
Bukaanka qaba neefta ayaa laga yaabaa inay halis ugu jiraan barotrauma sambabada, inkastoo qaar badan ay si badbaado leh u quusi karaan ka dib qiimeyn habboon iyo daaweyn.
Bukaanka qaba pneumomediastinum quusitaanka ka dib waa in loo gudbiyo khabiir ku takhasusay daawada biyaha hoostooda si loo qiimeeyo khatarta mustaqbalka ee quusitaanka.
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