I-Pneumosclerosis yamaphaphu

Igama elithi “pneumosclerosis” liye lasetshenziswa ezokwelapha kusukela ngo-1819, owokuqala wethula ukusetshenziswa kwakunguLaennec, owenza lokhu ukuze achaze isimo sesiguli odonga lwaso lwe-bronchus lwalulimele, ingxenye yalo yakhuliswa. Umqondo uhlanganise amagama amabili esiGreki - ukukhanya nokuhlanganisa.

Yini i-pulmonary fibrosis?

I-Pneumosclerosis yamaphaphu ukwanda okungavamile kobukhulu bezicubu ezixhumeneyo ezingase zenzeke emaphashini omuntu ngenxa yokuvuvukala, inqubo ye-dystrophic. Izindawo ezithintekile yizicubu ezinjalo zilahlekelwa ukunwebeka kwazo, izinguquko ze-pathological esakhiweni se-bronchi ziyabonakala. Izicubu zamaphaphu ziyancipha futhi ziba namandla, isitho sithola ukuvumelana okuqinile, okungenamoya, futhi ukucindezela kwenzeka. Ngokuvamile, lesi sifo sibhekene nabesilisa (kodwa nabesifazane abavikelekile), iqembu lobudala alidlali indima.

Izinkinga ze-pneumosclerosis

Kunezifo, ukuntuleka kokwelashwa okufika ngesikhathi futhi okwanele okungaholela ekwakhiweni kwe-pneumosclerosis esigulini:

• i-sarcoidosis yamaphaphu;

• isifo sofuba (i-pleura, amaphaphu), i-mycosis;

• i-bronchitis ngendlela engapheli;

• i-pneumonia (ezithathelwanayo, ezifisayo, ezibangelwa amagciwane);

• amagesi ezimboni;

• ukwelashwa ngemisebe (ekulweni nomdlavuza);

• i-alveolitis (i-fibrosing, i-allergic);

• ukulimala kwezindonga zemithambo yegazi (granulomatosis);

• i-reflux ye-gastroesophageal engapheli;

• ukulimala kwe-sternum, ukuhlukumezeka ku-parenchyma yamaphaphu;

• izakhi zofuzo (izifo zamaphaphu);

• i-pleurisy exudative (ifomu elinzima, inkambo ende);

• into yangaphandle ku-bronchi.

Lesi sifo singabuye siqale ngokuthatha imithi eminingi (i-apressin, i-cordarone). Ngaphezu kwalokho, imikhuba emibi (ukubhema), imvelo empofu (ukuhlala endaweni eyingozi) kubhekwa njengezici eziyingozi.

Kukhona amaphrofeshinali abanikazi bawo abasengozini enkulu. Ukukhiqizwa okuyingozi, izimayini izindawo lapho kuchuma khona amagesi ayingozi nothuli. Ingozi isongela abasiki bengilazi, abakhi, abagaya nokunye.

Izimpawu ze-pneumosclerosis

Izimpawu eziyinhloko ze-pulmonary pneumosclerosis yizibonakaliso zesifo, umphumela waba.

Ungase futhi ube nezimpawu ezilandelayo, okubonisa isidingo sokuvakashela udokotela ngokushesha:

• ukuphefumula, ukuzuza uhlamvu oluhlala njalo, ukuhlala ngisho sesimweni sokungasebenzi;

• ukukhwehlela okukhulu, okuhambisana nokukhishwa kwesikhwehlela se-mucopurulent;

• ukukhathala okungapheli, ubuthakathaka, ukuqubuka kwesiyezi;

• ubuhlungu esifubeni;

• i-cyanosis yesikhumba;

• ukuncipha komzimba;

• ukukhubazeka kwesifuba;

• ukungasebenzi kahle kwamaphaphu;

• i-phalanges yeminwe efana nezigubhu (iminwe kaHippocrates);

• ama-rales on auscultation (eyomile, i-finely bubbling).

Ubukhulu bezimpawu zesifo ngokuqondile buxhomeke kumthamo wezicubu ezixhumene ze-pathological. Ukubonakaliswa okuncane kuyisici esiyinhloko se-pneumosclerosis elinganiselwe.

Izinhlobo ze-pneumosclerosis

Ngokuya ngokuqina kokusatshalaliswa ku-pulmonary parenchyma yezicubu ezixhumeneyo, kuyisiko ukuhlukanisa lezi zinhlobo ezilandelayo ze-pneumosclerosis:

• I-Fibrosis. Ibonakala ngokushintshaniswa kwezicubu ezixhumeneyo nezamaphaphu esigulini.

• I-Sclerosis. Kukhona ukushintshwa kwe-parenchyma yamaphaphu ngezicubu ezixhumeneyo, ukuguqulwa kwesakhiwo sayo.

• I-Cirrhosis. Ukuhlanganiswa kwe-pleura, ukushintshwa kwemithambo yegazi, i-bronchi ne-alveoli nge-collagen, ukwehluleka kwemisebenzi yokushintshana kwegesi. Lesi sigaba sithathwa njengesiyingozi kakhulu.

Ngokuya kwendawo yesilonda, izinhlobo ezilandelayo zesifo zihlukaniswa:

• interstitial;

• i-peribronchial;

• i-alveolar;

• i-perilobular;

• i-perivascular.

Uma isiguli siba ne-interstitial pneumosclerosis, inyumoniya ye-interstitial cishe ingumthombo wayo. Okuhlosiwe okuyinhloko kwezicubu ezixhunyiwe yindawo eseduze ne-bronchi, imithambo yegazi, kanye ne-interalveolar septa nayo ihlupheka.

Ukubukeka kwe-Peribronchial ngokuvamile kuwumphumela we-bronchitis engapheli. Kuleli fomu, ukuthunjwa kwendawo ezungeze i-bronchi yesiguli kuvamile, ukwakheka kwezicubu ezixhunyiwe kwenzeka esikhundleni sezicubu zamaphaphu. Lesi sifo ezimweni eziningi sizibika ngokukhwehlela kuphela, ngemva kwesikhashana ukuphuma kwesikhwehlela kungase kwengezwe.

I-perivascular pneumosclerosis isho ukulimala endaweni ezungeze imithambo yegazi. I-Perilobular iholela endaweni yesilonda eduze kwamabhuloho ahlangene.

Futhi, i-pneumosclerosis ihlukaniswe ngezinhlobo kuye ngokuthi yisiphi isifo esiqinisekisa ukusabalala kwayo.

Amaqembu alandelayo ahlukaniswa:

• i-sclerosis yezicubu zamaphaphu;

• i-postnecrotic;

• i-discirculatory.

Ngaphezu kwalokho, izinga lokusabalala kwalesi sifo liyacatshangelwa - i-pneumosclerosis elinganiselwe, ehlakazekayo.

Ifomu elilinganiselwe, lona, ​​lihlukaniswe ngokwendawo kanye nokugxila:

• I-pneumosclerosis yendawo ingaba khona emzimbeni womuntu isikhathi eside ngaphandle kokunikeza izimpawu. Ingatholwa kuphela ngokuhemuza kahle nangokuphefumula kanzima lapho ulalele. I-x-ray nayo izosiza ekuxilongeni, isithombe sizoveza ingxenye yezicubu zamaphaphu ezihlangene. Lolu hlobo alukwazi ukuba yimbangela yokungasebenzi kahle kwamaphaphu.

• Umthombo wezinhlobo ezigxile kukho yithumba lamaphaphu, okuholela ekulimaleni kwe-parenchyma yamaphaphu. Futhi, isizathu singase silale emigedeni (isifo sofuba). Mhlawumbe ukwanda kwezicubu ezixhumeneyo, ukulimala kwe-foci ekhona futhi eselashiwe kakade.

Ukusabalalisa i-pneumosclerosis yamaphaphu

Okuhlosiwe kwe-diffuse pneumosclerosis kungase kube iphaphu elilodwa kuphela (kwesokunxele noma kwesokudla), kodwa kokubili. Kulokhu, ukuvela kwama-cysts emaphashini kungenzeka, futhi izinguquko ze-pathological ezenzeka ngemikhumbi nazo zingenzeka. Izinga lokudla okunomsoco wezicubu zamaphaphu ezinomoya-mpilo liyawohloka, izinqubo zokungenisa umoya ziyaphazamiseka. Ifomu lokusabalalisa lingabangela ukwakheka kwe-"cor pulmonale". Lesi simo sibonakala ngokukhula ngokushesha kwenhliziyo efanele, okubangelwa umfutho wegazi ophezulu.

I-anatomy yamaphaphu e-diffuse pneumosclerosis iba nezinguquko ezilandelayo:

• I-Collagenization yamaphaphu - esikhundleni sokuwohloka kwezintambo ezinwebekayo, izindawo ezinkulu ze-collagen fibers zivela.

• Umthamo wamaphaphu uyancipha, isakhiwo sikhubazekile.

• Kuvela izimbotshana (ama-cysts) ahlanganiswe ne-bronchoalveolar epithelium.

Izizathu eziyinhloko zokuthuthukiswa kwalesi sifo yizinqubo zokuvuvukala ezenzeka esifubeni. Umthombo wabo ungahluka - isifo sofuba, inyumoniya engapheli, ukugula ngemisebe, ukuchayeka kumakhemikhali, ugcunsula, ukulimala kwesifuba.

Ukude njalo i-pneumosclerosis ixwayisa ngayo ngezimpawu ezithile. Isiguli singase sibe nokuphefumula, ekuqaleni kwenzeka kuphela ngokukhathala, ukusebenza kanzima, ukuqeqeshwa kwezemidlalo. Bese kufika isiteji lapho ukuphefumula okuncane kubonakala ngisho nesimo esizolile, ngesikhathi sokuphumula. Lesi sibonakaliso akusona sodwa, kungenzeka futhi ukukhwehlela (omile, njalo), ubuhlungu obuhlala njalo endaweni yesifuba.

Futhi, ukubonakaliswa okufana nokuphefumula, i-cyanosis yesikhumba, ehlinzekwa ukuntuleka komoya-mpilo, kungenzeka. Isiguli singase silahlekelwe isisindo ngokuzumayo, sizizwe sibuthakathaka njalo.

I-peripheral pneumosclerosis

Umthombo ovame kakhulu we-hilar pneumosclerosis i-bronchitis, enefomu elingapheli. “Izigebengu” zalesi sifo nazo zingaba ushevu ngezinto eziyingozi, inyumoniya, nesifo sofuba. Ukuthuthukiswa kwalesi sifo, njengomthetho, kwenzeka ngokumelene nesizinda sezinqubo zokuvuvukala, i-dystrophy. Izimpawu zesici ukulahlekelwa ukunwebeka endaweni ethintekile, ukwanda kobukhulu bezicubu ezixhumene ezenzeka ezindaweni eziyisisekelo zamaphaphu. Okunye okwengezwe wukwephulwa kokushintshaniswa kwegesi.

I-basal pneumosclerosis

Uma izicubu zamaphaphu zithathelwa indawo yizicubu ezixhumeneyo ikakhulukazi ezigabeni eziyisisekelo, lesi simo sibizwa ngokuthi i-basal pneumosclerosis. Omunye wemithombo eyinhloko yalesi sifo ubhekwa njenge-lobe pneumonia ephansi, mhlawumbe isiguli sake sabhekana nalesi sifo. I-x-ray izobonisa ukucaca okwengeziwe kwezicubu zezigaba ze-basal, ukwanda kwephethini.

Ukwelashwa kwe-pulmonary pneumosclerosis

Uma unezimpawu ze-pneumosclerosis, kufanele nakanjani ubhalisele ukubonisana nodokotela ojwayelekile noma i-pulmonologist. Izindlela zokwelapha zinqunywa isigaba lapho lesi sifo sitholakala khona. Ifomu lokuqala, elithambile, elingahambisani nezimpawu ezinzima, alidingi ukwelashwa okusebenzayo. Njengoba kunikezwe ukuthi i-pneumosclerosis ezimweni eziningi isebenza njengesifo esihambisanayo, kuyadingeka ukuphatha umthombo wayo.

Amaseli we-stem

Indlela entsha yokulwa ne-pneumosclerosis ukwelashwa kwamaseli. Ama-stem cell angamanduleli awo wonke amaseli emzimbeni womuntu. “Amathalenta” abo ayingqayizivele asemandleni okuguqula abe yinoma yimaphi amanye amangqamuzana. Le khwalithi isetshenziswa ngenkuthalo ekwelapheni kwamaseli ngokumelene ne-pulmonary pneumosclerosis.

Njengoba ejova ngomjovo, ama-stem cells angena emgudwini wegazi aye esithweni esithintekile. Ngokulandelayo, bashintsha izicubu ezilinyazwe yilesi sifo. Ngokuhambisanayo, ukuzivikela komzimba kuyasebenza, izinqubo ze-metabolic ziyasebenza. Izicubu zamaphaphu ezivamile zizalwa kabusha.

Ukusebenza kokwelashwa kwamaseli kunqunywa usuku lokuqala kwayo. Kunconywa ukuthi uqale ukwelashwa ngaphambi kokuba wonke amaphaphu abanjwe inqubo ye-fibrosis. Impumelelo iphinde incike ekubeni khona kwenkundla yezicubu ezinempilo, okudingekayo ukuze amaseli anamathisele ngokuphephile futhi aqale izinqubo zokwakha kabusha.

Ukwelashwa kwe-stem cell kujwayelekile izinqubo ze-metabolic ezenzeka emzimbeni wesiguli esine-pneumosclerosis. Imisebenzi ye-endocrine, amasosha omzimba kanye nezinzwa iyabuyiselwa. Amaseli nawo akhiqiza umphumela osebenzayo we-antitumor. Njengomphumela wokwelashwa, isitho esithintekile siphinde sisebenze esilahlekile futhi sibe nempilo.

Umphumela wokwelashwa "kwamaselula" ukubuyiselwa kwesakhiwo samaphaphu, ukunyamalala kokuphefumula nokukhwehlela okomile, okwakuyizimbangela eziyinhloko zokuhlushwa kwaphakade kwesiguli. Ukuphepha nokusebenza ngempumelelo kokwelashwa kufakazelwe izifundo eziningi.

Ukwelashwa kwe-oxygen 

Ukwelashwa komoyampilo kuyindlela yokwelapha yesimanje esekelwe ekuhogeleni kwengxube yegesi komoyampilo yisiguli. Inqubo ikuvumela ukuba unxephezele ukuntuleka komoya-mpilo okwakheke emzimbeni. Enye yezinkomba eziyinhloko zokuqaliswa kwayo i-pneumosclerosis yamaphaphu.

Igesi, okuyithuluzi lokwelapha umoya-mpilo, igcwele umoya-mpilo kumthamo ofanayo nalowo ogxiliswe emoyeni osemkhathini. Ukunikezwa kwegesi kuvame ukwenziwa kusetshenziswa ama-catheter akhala (intranasal), futhi kungaba:

• imaski (umlomo namakhala);

• amatende oksijini;

• amashubhu (tracheostomy, intubation);

• i-hyperbaric oxygenation.

Ngenxa yokulethwa komoyampilo, ukubuyiselwa okusebenzayo kwemetabolism yamaselula kwenzeka.

Ukwelashwa Kwemithi

Uma inkambo ye-pneumosclerosis ihambisana nokukhushulwa kokuvuvukala (i-pneumonia, i-bronchitis), isiguli sinikezwa imithi:

• elwa namagciwane;

• elwa nokuvuvukala;

• i-expectorant;

• i-mucolytic;

• ama-bronchodilators.

Uma i-pneumosclerosis inzima, kukhona ukukhula okusheshayo kwesifo, odokotela baxhuma i-glucocorticosteroids. Ukwelashwa kwezifundo, okubandakanya ukusetshenziswa kwezidakamizwa ze-hormonal ngemithamo emincane, kwenziwa ukumisa inqubo yokuvuvukala, ukucindezela ukukhula kwezicubu ezixhumeneyo. Ngokuvamile lezi zidakamizwa zihlanganiswa nama-immunosuppressive agents. Amalungiselelo e-Anabolic namavithamini angase anqunywe.

Ukuze ukwelashwa kwezidakamizwa kuphumelele ngangokunokwenzeka, i-bronchoscopy yokwelapha isetshenziswa. Lokhu kukhwabanisa kukuvumela ukuthi ulethe izidakamizwa ngqo kuzicubu ze-bronchial, ususe okuqukethwe okuhlangene nokuvuvukala kwesistimu ye-bronchopulmonary.

Physiotherapy

Uma isiguli sine-pneumosclerosis, angase anqunywe i-physiotherapy. Umsebenzi wezinqubo ze-physiotherapeutic kuleli cala ukukhulula i-syndrome esigabeni esingasebenzi, ukuzinzisa inqubo esigabeni esisebenzayo.

Uma kungabikho ukungasebenzi kahle kwamaphaphu, i-iontophoresis ene-calcium chloride, i-novocaine iboniswa. I-ultrasound ene-novocaine ingase futhi ibekwe. Uma lesi sifo sisesiteji sokunxeshezelwa, kuhle ukuqhuba i-inductometry ne-diathermy endaweni yesifuba. Ngokuhlukaniswa kwe-sputum okungalungile, uhlelo lwe-Vermel (i-electrophoresis ene-iodine) isetshenziswa, ngokungondleki - i-ultraviolet irradiation. Enye indlela engasebenzi kahle i-irradiation ngesibani se-solux.

Uma kungenzeka, i-physiotherapy inconywa ukuba ihlanganiswe nokwelashwa kwesimo sezulu. Iziguli ezine-pneumosclerosis ziboniswa ukuthi ziphumule ogwini loLwandle Olufile. Isimo sezulu sendawo sizoba nomthelela ekwelapheni okuphilayo okuthintekile.

Ukuvivinya umzimba

Umsebenzi oyinhloko, ukuphumelela kwawo okwenziwa lula ngokuzivocavoca umzimba okwelapha, ukuqinisa imisipha yokuphefumula. Amakilasi aqhutshwa ngaphansi kokugadwa othisha abangochwepheshe, ukusebenza kwe-ateur kungalimaza.

I-pneumosclerosis enxeshezelwe iyinkomba ye-gymnastic yokuphefumula. Ukuzivocavoca ngakunye kufanele kwenziwe ngaphandle kokungezwani, ukunamathela ngejubane eliphansi noma eliphakathi, kancane kancane ukwandisa umthwalo. Indawo engcono kakhulu yokuzijwayeza umgwaqo, umoya omusha ukhulisa ukusebenza kahle kokuzivocavoca. Ukuzivocavoca kwe-Physiotherapy kune-contraindications - ukushisa okuphezulu, uhlobo olunzima lwesifo, i-hemoptysis ephindaphindiwe.

Lapho kunxeshezelwa inqubo ye-pathological, iziguli zingaxhuma eminye imidlalo. Nge-pneumosclerosis, ukugwedla, ukushushuluza nokushushuluza kuyasiza. Odokotela bavame ukutusa ukubhucungwa kwesifuba. Ngosizo lwezinqubo, ukuminyana okwakhiwa ezicubu zamaphaphu kuyaqedwa. I-Massage ithuthukisa isimo senhliziyo, i-bronchi, amaphaphu, futhi ivimbela ukuthuthukiswa kwe-pulmonary fibrosis.

Ukungenelela kokusebenza

Ukungenelela okukhulu kungase kube okufanelekile uma isiguli sinesimo sendawo sesifo, ukubhujiswa kwezicubu zamaphaphu, ukukhuphuka kwe-parenchyma yamaphaphu, i-fibrosis kanye ne-cirrhosis yamaphaphu. Ingqikithi yokwelashwa ukukhipha ngokuhlinzwa indawo ethintekile yezicubu zamaphaphu.

izindlela zokuthibela

Kuhlala kulula ukuvimbela i-pneumosclerosis kunokuqeda ngokuphelele. Into ebaluleke kakhulu kulokhu ukwelashwa okufika ngesikhathi kwe-pneumonia, isifo sofuba, i-bronchitis, nemikhuhlane. Okulandelayo nakho kuzosiza:

• ukuyeka ukubhema;

• ukushintsha umsebenzi ngokuxhumana njalo nezingozi zomsebenzi;

• ukunciphisa ukusetshenziswa kophuzo oludakayo;

• izinqubo zokuqina;

• ukuvivinya ukuphefumula okuvamile, ama-gymnastics;

• ukudla okunomsoco, ukudla okune-vitamin complexes;

• ukuhamba njalo emoyeni;

• i-radiography yonyaka.

Ukuyeka ukubhema kuyinto ebaluleke kakhulu kulolu hlu. Ugwayi ulimaza kakhulu isimo samaphaphu, unomthelela ekwakhiweni kwezifo zezitho zokuphefumula.

Uma i-pneumosclerosis itholakala ngesikhathi esifanele, iphathwa ngendlela efanele, isiguli sinamathela ngokuqinile kuzo zonke izincomo zikadokotela futhi sihola impilo enempilo, lesi sifo sizonqotshwa.