Neronda rinonyenga: zviratidzo, zvinokonzera, kurapwa

On the kufema hurongwa utano zvinoda kutarisirwa kubva pazera. Muviri womunhu achigara pasi kurwisa siyana utachiona, utachiona, utachiona husingaurayiwi nemishonga. Kunyanya ngozi chirwere inowedzera panguva ekunze kuchitonhora uye mamiriro okunze chando, akachinja, mazuva jeka dzavo inodziya.

kusvibisa mhepo, fodya, sembura mamiriro uye kubvumira chirwere dawo zvikuru zvakadzama kupinda kufema makwara. Chirwere inokanganisa yokumusoro kufema hurongwa. utera hwavo, pamwe nekusagona kuti zvirwere kurwisa kurwisa utachiona kunotungamirira kukudziri- zvakakomba pathologies panzvimbo dzapasi mapoka. Mumwe wavo ari neronda rinonyenga pakati mumapapu.

Chii chinonzi chirwere? Ndezvipi zviratidzo yo chirwere? Zvokuita nayo uye kana unogona kurova ichi bhowa zvokurwara? zvinhu zvokutanga pakutanga.

Zvinoitwa zvirwere

Chii neronda rinonyenga pakati mumapapu? zvokurwara ichi, panguva iyo pokuwa zvemapapu rinenge - necrosis. mumwe mutoo kwakadaro ane chinonyangadza hunhu. Purulent Fusion of Mucheka hakungogumiri mumwe mugove. The pathological muitiro anokwanisa nokukurumidza kupararira, kufukidza nzvimbo itsva. Chirwere chinogona kukanganisa lobes akawanda, dzimwe nguva asiwo yose zvemapapu.

Kwakaitwa zvinyama inozivikanwa shava. Inside vemunyika fetid pus. Necrosis haina kunyatsoteerera chimiro, uye sezvo ambotaurwa, ane tsika anokudza.

Zvokurwara rakakamurwa 2 mhando:

1. Distribution: localization lobar chirwere kuchengetwa.
2. Kurambidzwa: segmental nzvimbo inowanikwa. Kazhinji izvi chinorondedzerwa se ane pute, akapfeka gangrenous hunhu.

The chirwere kunokonzerwa pathogenic tusingaoneki. Pute uye neronda rinonyenga, vanotova zvakafanana muitiro matanho. Zvisinei, aimbova chakasiyana zvishoma purulent chirwere kwacho munyama. Thoracal vanachiremba uye pulmonologists anotaura pathologies izvi chinonetsa uye ngozi siyana kuparadzwa.

Kakawanda, maperembudzi chirwere mu repakati varume.

Neronda rinonyenga of mapapu - nechirwere ngozi chaizvo. Kazhinji kunotungamirira kune zvinouraya yematambudziko:

• purulent kuparadzwa pleura;
• pulmonary ropa;
• suppuration bhokisi rusvingo;
• sepsis;
• vakawanda nhego kukundikana.

About 60% wevarwere kutarisana migumisiro yakadaro kufa.

Zvinokonzera chirwere

Sei pane neronda rinonyenga? Zvinokonzera hosha yakavigwa chimwe chete - kubva lesion tishu utachiona. Kazhinji tusingaoneki vanotsamwisa chirwere vari anaerobic utachiona.

Chirwere chinogona kuva chega zvokurwara kana mugumisiro kudhaka. Saka, pane vakawanda zvigadziriswe zvakadaro anorwadza zvirwere seronda rinonyenga.

The etiology chirwere riri sezvinotevera:

1. Kutsamwisa microbial ingress mumapapu uye principales kunogona zvirwere, zino nasopharynx. Mumamiriro ezvinhu akadaro anokwanisa pathogenic microflora kuparadzira pasi yemweya.
2. Dzimwe nguva pane ari kupinda munzvimbo kufema hurongwa zvikasawanirwa uwandu pakuyerera kubva mhuno uye pahuro kana dumbu mukati apo reflux, dysphagia, panguva kurutsa. Zvapedzisira chiri kazhinji kunokonzerwa akuvara mumusoro kana kudhaka. Rakapinda kupinda principales hasha dumbu mukati kunokonzera necrotic kwacho munyama.
3. The zvokurwara kungakonzerwa shoma kufefetedza. ezvinhu akadaro rinowanzoberekera kana kusvinwa bronchus wokumwe muviri kana bundu. On nzvimbo iyi pane utachiona, uye anotanga kuumbika abscesses uye neronda rinonyenga.
4. Chikonzero chirwere chinogona kuva zvirwere purulent kuti kufema hurongwa. Ndivo anotevera zvirwere: bronchiectasis, mabayo, zvemapapu pute.
5. Mari tiri dzechimwe mashandiro neronda rinonyenga kukura. Kuwana chirwere ari mubhokisi anogona kukonzerwa rakapinza maronda.
6. Pathogenic tusingaoneki akakwanisa kuparadzira kusvika mumapapu kubudikidza nhengo dzinobudisa maitiro uye ropa midziyo. Izvi zvinogona kuonekwa osteomyelitis, sepsis, mumps, dzihwa uye nezvimwe pathologies zhinji.

Basa rinokosha kukura chirwere chinoita kwakaderera dziviriro yezvirwere mumuviri. Panyaya iyi, muviri hausi kukwanisa kukurira tupukanana tusingaoneki, uye naizvozvo haangagoni kudzivisa panowanikwa neronda rinonyenga.

Zvinotevera zvinokonzera njodzi aunonyanya:

• kusvuta;
• kudhakwa;
• kupindwa muropa;
• HIV chirwere;
• kukwegura;
• Kushandisa glucocorticoids;
• cheshuga.

symptomatology chirwere

Kumbonyanya nokukurumidza budiriro hwokuratidza neronda rinonyenga. Zviratidzo zviri zvakakomba. The chirwere mberi nokukurumidza uye murwere nemamiriro zvakakomba kuipa. Ngatikurukurei kumwe zviratidzo kuona neronda rinonyenga.

Zviratidzo izvo zvaizobatsira chirwere ndeinotevera:

1. Rwadza kusanzwa ari sternum. Ari pakudzidza kana iwe kukosora.
2. Dambudziko murwere: nefivha, chills, raidudzwa kudhaka.
3. Pane kusava kudya, uremu, kusvikira neanorexia, tachycardia, kupfupika mweya.
4. Zvikuru vangakosora achiperekedzwa frothy sputum uye pus. Allocating akasiyana fetid kwakanaka. Ivo vanoratidza black tint uye anopa furo rukoko. Kana zvemapapu sputum neronda rinonyenga anogona kuitika akafa zvinyama nezvimedu, ropa.
5. Murwere rinotanga kumudzipa.
6. Pane kunonyengedza vangadikitira.
7. Kushaya okisijeni kunotungamirira hypoxia, iyo kuratidza rinokwanisa kucheneruka minwe, ganda integument kwemiromo.
8. Murwere anoneta nokukurumidza.
9. Dzimwe nguva pane dzungu.
10. Murwere anopiwa befu chinorwadza. Zvinyoronyoro kufema kusagadzikana kunokonzera.

Weboka chirwere

Funga sei kukudziridza neronda rinonyenga. The pathogenesis chirwere zvakafanana zvikuru aibuda zvemapapu pute. Akaora neronda rinonyenga anogona kusiyanisa mashoko maitiro malodor uye yakakwirira propensity kuti hronifitsirovaniyu rikurumidze.

Chirwere anoratidza sezvinotevera:

1. Pakutanga, murwere ane fivha. Thermometer kunonyora simba unongotaura. Zvisinei, zviri yaingowanikwa varwere vaya vasina Immune Deficiency. Munhu anzwe zvakaipisisa. Anonzwa anozivikanwa muutera, kuda kurutsa, lethargy. Kazhinji anouya kurutsa. The marwadzo sternum rinowanika. Kuedza ndatura befu chikonzero zvikuru kusanzwa. Kana tichiita pakati mbabvu, marwadzo rinowanika pamusoro Munzvimbo iyi, muvanhu.
2. Chikosoro Kazhinji kunoitika pakarepo. Pakutanga zviri pakaoma. Zvadaro anova akanyorova. Rinotanga kukosora sputum, rine zvikuru hachifadzi kwakanaka. Kana akadaro kuerera kwenguva yakati akasiyiwa tangi, zvicharangarirwa kukamurwa 3 akaturikidzana. In rokumusoro - furo pamwe nebhitumini chichachengetwa. The pakati rukoko ine mvura yakachena. Emadhaka achadonha kubuda urwa.
3. Symptomatology iri kukurumidza kufambira mberi. Murwere rinokura dyspnea, tachycardia kuoneka, raidudzwa utera. murwere kuziva wakamanikidzwa. Mune zvimwe zviitiko, pakoma hwapedyo. The tembiricha inogona kuderedzwa. Dzimwe nguva anosiya pazasi 38 C. Uyu ezvinhu rakanyatsojeka kutsoropodza, nekuti ropa vakavhomora vazhinji kutapukirwa mukati.
4. Kana murwere unopona iyi, iye akaumba mumwe kana kupfuura abscesses. in kwakadaro chine pus, vane tsika kumedura kuva bronchus. Fani iyi kunoratidza chinotevera nguva pakukura chirwere.
5. Varwere vane chikosoro kwakaipa, umo yakawanda phlegm. Kana abscesses vari vakapedzwa kuburikidza hombe principales, murwere pakarepo dzinounzwa zvakawanda pus, mune zvimwe zviitiko ropa. Mamiriro ezvinhu mukuvandudza nokukurumidza zvakakwana. Asi akawanda Kuburitswa mu haisi zvakananga nzira, asi kuburikidza principales diki. Izvi zvinooneka rinononotsa kusunungurwa pus kubva pute, saka murwere nemamiriro chichiri zvakakomba. Sputum pamwe neronda rinonyenga yemapapu ane zvakakwana malodorous kwakanaka. Dzimwe rine zvidimbu zviduku zvemapapu rinenge - sequesters.

chirwere chirwere

Chinhu chinokosha pakuita Pakusarudza zvokurwara chinoita kuongorora chaiko. Murwere lagging mumashure nedanho afemeruke pakati njodzi chikamu mubhokisi, wakaatapudza percussion inzwi. Panguva auscultation wanikidza kufema ruzha simba, yakaoma wheezing.

Mukuwedzera, zvokuongorora kuti zvemapapu neronda rinonyenga zvinosanganisira richishanda uye rabhoritari nzira:

1. Blood bvunzo. Zvinoratidza nokuwedzera kwenhamba leukocytes, erythrocytes akaderedza pamwero, kuwedzera ESR. A kuderera zvachose ropa mapuroteni.
2. Maekisirei yacho sternum. Neronda rinonyenga uye necrosis kuti zvemapapu rinenge vari pamufananidzo dimming. Kazhinji zvakawanikwa nomumukanwa disintegration kuenzana kana scalloped kumicheto. Dimming iine katsika akurumidze kuparadzirwa uye kuti mazuva akawanda anogona kukanganisa pedyo akafukidza, uye dzimwe nguva yose zvemapapu. Maekisirei dzinoratidza panowanikwa exudate mu ari pleural mhango.
3. Computed tomography. Nzira iyi ano X-ray. Hazvina kunyanya idzidzise zvokurwara ichi. Tomogram anogona kuona zvose pokuwa in kuti dzinoenderana utsotso munyika dzine ose mumapapu.
4. Bronchoscopy. Endoscopic chirwere nzira anosarudza purulent endobronchitis, obturation. Kudzidza chinopa mukana kuchengeta simba pamusoro pathological muitiro.
5. The kuongorora sputum. Mushure bronchoscopy uye sputum akawana mukati yakatumwa murabhoritari nemiedzo. Chirwere miedzo wanikidza nayo utachiona zvokurwara uye kubvumira tinosarudza aikanganiswa zvigare nemishonga.

zvinogoneka yematambudziko

vachinyatsoziva kurapwa kuti chiremba chete anogona kumisa zvokurwara ichi, seronda rinonyenga. Matambudziko simuka, ari kutonga, kana kushanyira vanachiremba kunonoka.

Pakadaro, pangava migumisiro:

1. Dry, pleural effusion.
2. A budiriro iri pleural mhango zvinotisvitsa gangrenous pneumoempyema. Murwere ane rikwanise parutivi marwadzo, kupfupika mweya, mwoyo misha kunoitika. Murwere Mamiriro kuipa. Chiitiko kuchidonha.
3. Kunonyengedza kubuda ropa.
4. Pyosepticemia. The zvokurwara kunoitika pamusoro mamiriro kuparadzwa mumapapu munhu mudziyo guru.
5. renal amyloidosis. Zvinoita zvakaitika chirwere chimiro chirwere.

Uyezve, kana chiedza neronda rinonyenga mukuru chaizvo mukana rufu.

kuchinja mabatiro

ARV ichiitwa muchipatara ezvinhu.

Mabatirwo zvemapapu neronda rinonyenga ine zvinotevera zviyero:

1. Ndichibvunza detoxification. Zvinangwa izvi, murwere chinotarisirwa nomutsinga Plasma-dzinomiririra mhinduro vakaderera samolecular uremu "Hemodez", "Reopoligljukin", "Neokompensan". Ipa yeplasma vodnoelektrolitnye masanganiswa sealbumin. Raitongwa shuga mhinduro (5%, 10%) chete jekiseni, uyewo FIs kuti proteolysis "Trasylol", "Contrycal".
2. Inorwisa mabhakitiriya kurapa. Ndicho Chinhu chinonyanya kukosha, pasina iyo kurapa zvemapapu neronda rinonyenga hazvitomboiti. Pakutanga vanokurudzira mishonga, yayo zvakawanda zvinokonzerwa. Kazhinji, ndiro zvinodhaka zvinotevera: "Fortum", "Cefepime", "Meropenem", "Tienam". Kazhinji, varwere vari dzakabatwa mushonga unorwisa pakarepo 2. Ataura kuti utachiona hwakakura anosarudzwa kunyatsoenderana kurapwa zvaiitwa. Kubatana zvinodhaka "Ampicillin" zvinodhaka "Tseporin", "Gentamycin", "Kefzol", "tetraolean" rakanyatsojeka inobudirira.
3. Desensitization of muviri. The murwere ushandiswe mishonga "Suprastin", "Diphenhydramine", "pipolfen".
4. Akakurudzira vhitamini zvivako "Retinol Acetate" "riboflavin" "cyanocobalamin" "Thiamin" "pyridoxine" "Ascorbic asidhi".
5. Kana paine mukuru kweropa, murwere nomutsinga jekiseni zvinodhaka "Heparin".
6. Kuti pave nechokwadi yakakwana kufema nguva nenguva kana akaramba akaita humidified okisijeni inhalation.
7. Kana zvakakodzera, tora kurwa pamwe paresis ari paura, nokubatanidzwazve ari tracheobronchial muti.
8. Ipa phlegm zvinodhaka. nevasori aya achiita nomutsinga uye rinoshandiswa kuti inhalation. Murwere anogona varumbidzwa mishonga "Ambroxol", "Lasolvan", "Ambrobene", "Haliksol", "ACC injective."

In ezvinhu murwere zvachose kuongororwa panguva mushonga. Pane Zvaiitwa kumwoyo, chiropa uye neitsvo. Ekupedzisira Zviremera kubhadhara vainyatsotarisirwa, nekuti zvavanokupai goho riri utachiona zvokunyama uye mishonga.

Treatment ane pute uye zvemapapu neronda rinonyenga kunosanganisira abudise mhango. chiito chakadaro rakundwa, kana mota iri mupasi pedyo pemvura nokufukidzwa pleura.

kushanda kurapa

Kana muitiro anokundikana kudzikamisa kuchinja kurapa, ipapo pane zvose zvairatidza kuti yakakura kupindira. Nokuti ichi akagadziridzwa hemodynamic, metabolic zvirwere, vakafunga murwere nemamiriro (kana zvichibvira aite oparesheni).

Kuvhiya kunosanganisira Kubviswa gangrenous bapu tishu:

• lobectomy;
• bilobektomiyu;
• pneumonectomy.

ukoti nokutarisirwa

The chirwere zvakaoma zvose varwere uye vanhu vari kuvachengeta. Very anoidza kuramba kupa chinonyangadza kunhuwa.

Kupa rubatsiro rwakakwana kuti murwere, panofanira kuva:

1. Kushandiswa deodorizing nevamiririri. In basa akadaro anogona kuita creosote.
2. Pedyo murwere mubhedha inofanira kuchengetwa ari chairside. Kuderedza chisingafadzi munhuhwi, Zvinokurudzirwa kudira zvishoma deodorizing mhinduro. Uyezve, tinofanira kuva nechokwadi kuti kuvhara muvharo.
3. Varwere vari panoonekwa neronda rinonyenga, asingatani kwazvo vangadikitira. Naizvozvo, murwere zvinoda kakawanda kuchinja pamubhedha nguo.
4. Dzimwe nguva mamiriro ezvinhu munhu saka pazvairamba, kuti haangagoni kunyange kuita zvokudya zvavo pachavo. Saka, vaya vanotarisira varwere zvakadaro, murwere anofanira kudya chipunu.
5. Zvakakosha kuti tive nechokwadi kwakakwana mumuviri uye mupfungwa zororo.
6. Kana hemoptysis murwere inofanira kuva mune Semi-agere chinzvimbo.
7. Murwere hakubvumidzwi kutaura, kunwa inopisa kunwa kana zvokudya.

upenyu Kufembera

Chii chakamirira varwere ivavo nechirwere bapu neronda rinonyenga? Kugumbura kushurudzira chete nyaya kana pasina nenguva kurapwa. Pashure chirwere nokukurumidza anowedzera, kufukidza nzvimbo utano. Kana kuchinja kurapa zvinopera, uye kuvhiya haina kuitwa, murwere anofa.

With nenguva kurapwa vanachiremba vakachengeta mufananidzo yakasiyana zvachose. Statistics anoti muna 70-80% wevarwere zvose perebaryvat neronda rinonyenga uye achapora. dzizere uye zvakakwana yawapiwa munhu anodzokera dzose upenyu.

The vainyatsotarisirwa inoda yematambudziko akadai sepsis, pulmonary ropa, vakawanda nhengo kukundikana. Under izvi zvirwere murwere vachida zvashata rubatsiro. Kana chipi chikonzero hazvina inopiwa, mupristi mukana kusingarapiki migumisiro pamuviri.

Naizvozvo zvakakodzera kuti kusimbisa kamwe zvakare zvinotevera: kuti atsungirire zvokurwara ichi, inofanira kukurumidza kuona chiremba uye kushandisa zvakazara kunenge pavadzidzisi.