Hoʻonui effa

ʻO kahi pleural effusion kahi kūkulu o ka wai ma waena o nā papa o nā kiko i kū i nā māmā a me ka lua o ka pahu.

Hoʻopuka ke kino i ka wai pleura i nā mea liʻiliʻi e lubricate i nā ʻili o ka pleura. ʻO kēia nā mea lahilahi e hoʻopili ana i ka lua o ka umauma a hoʻopuni i nā akemāmā. ʻO Pleural effusion kahi ʻano maʻamau, hōʻiliʻili nui o kēia wai.

ʻElua ʻano o ka pleura effusion:

• Hoʻokumu ʻia ka transudative pleural effusion e ka kahe ʻana o ka wai i ka lewa pleural. ʻO kēia mai ka hoʻonui ʻia o ke kaomi i loko o nā kīʻaha koko a i ʻole ka helu protein haʻahaʻa o ke koko. ʻO ke kū ʻole o ka puʻuwai ke kumu maʻamau.
• Hoʻokumu ʻia ka effudative effusion e nā kīʻaha koko i hoʻopaʻa ʻia a i ʻole nā ​​kīʻaha lymph, ka pehu ʻana, ka maʻi, ka ʻeha māmā, a me nā tumors.

Nā kumuhana kūpilikiʻi o ka pleural effusion e komo pū:

• ʻO ka puhihu ʻana a me ka inu ʻana i ka ʻalekohola, no ka mea, he kumu ia na ka puʻuwai, naʻau a me nā akepaʻa, i hiki ai i ka effusion pleural
• Mōʻaukala o ka launa pū ʻana me asbestos

Hiki i nā ʻōuli ke hoʻokomo i kekahi o kēia mau mea:

• ʻO ka ʻeha o ka umauma, maʻamau ka ʻeha ʻoi aku ʻoi aku ka maikaʻi me ka hanu a me nā hanu hohonu
• Cough
• Fiva a me nā anuanu
• Hiccups
• Hanu wikiwiki
• Pokole o ka hanu

I kekahi manawa ʻaʻohe hōʻailona.

E nānā ana kāu mea mālama ola iā ʻoe a nīnau e pili ana i kāu mau hōʻailona. E hoʻolohe ka mea hāʻawi i kāu mau māmā me kahi stethoscope a kāomi (percuss) i kou umauma a me luna ma hope.

Ua lawa paha ka loiloi CT chest a i ʻole ka x-ray umauma no kāu mea hāʻawi e hoʻoholo ai i ka lāʻau.

Makemake paha kāu mea e hana i nā hoʻokolohua ma ka wai. Inā pēlā, hemo kahi laʻana o ka wai me kahi nila i hoʻokomo ʻia ma waena o nā iwi ʻaoʻao. E hana ʻia nā hoʻāʻo ʻana ma ka wai e nānā no:

• Maʻi kīnā
• Nā hunaola maʻi ʻaʻai
• Nā pae protein
• Heluhelu ʻia ke kelki
• Acidity o ka loli (i kekahi manawa)

Hiki ke hana ʻia nā hoʻokolohua koko e:

• Helu piha ke koko (CBC), e nānā i nā hōʻailona o ka maʻi a i ʻole anemia
• ʻO nā hoʻokolohua koko a me nā ake hana

Inā pono, hana ʻia kēia mau hoʻokolohua ʻē aʻe:

• Ultrasound o ka puʻuwai (echocardiogram) e nānā no ka maikaʻi ʻole o ka naʻau
• Ultrasound o ka'ōpū a me ke ake
• Ke hoʻāʻo ʻana i ka protein mimi
• ʻO ka biopsy lung e ʻimi ai i ka maʻi ʻaʻai
• Ke hele nei i kahi paipu ma ka puka makani e nānā i nā alaloa no nā pilikia a i ʻole ke kanesa (bronchoscopy)

ʻO ka pahuhopu o ka mālama ʻana i:

• Wehe i ka wai
• Kāohi i ka wai mai ke kūkulu hou ʻana
• Hoʻoholo a mālama i ke kumu o ke kūkulu ʻana o ka wai

Ke hoʻopau nei i ka wai (thoracentesis) hiki ke hana inā nui ka wai a ke kumu ia e kaomi ana i ka umauma, ka liʻiliʻi o ka hanu, a me kahi pae oxygen liʻiliʻi. ʻO ka hemo ʻana i ka wai e hoʻonui ka māmā, e maʻalahi ai ka hanu ʻana.

Pono e mālama ʻia ke kumu o ke kūkulu wai.

• Inā pili ia i ka maikaʻi ʻole o ka puʻuwai, hiki iā ʻoe ke loaʻa i nā diuretics (nā pila wai) a me nā lāʻau ʻē aʻe e mālama ai i ka puʻuwai ʻole.
• Inā pili ia i kahi maʻi, e hāʻawi ʻia nā antibiotic.
• Inā mai ka maʻi ʻaʻai, maʻi maʻi akepaʻa, a i ʻole nā ​​maʻi pākī, e kuhikuhi ʻia ka mālama ʻana i kēia mau ʻano.
  

I ka poʻe me ka maʻi ʻaʻai a maʻi paha, mālama pinepine ʻia ka effusion e ka hoʻohana ʻana i ka pahu umauma e hoʻokahe i ka wai a mālama i kāna kumu.

I kekahi mau hihia, hana ʻia kekahi o kēia mau ʻano mālama ʻana:

• ʻO Chemotherapy
• Ke waiho nei i ka lāʻau i loko o ka umauma e pale ai i ka wai mai ke kūkulu hou ʻana ma hope o ka hoʻokahe ʻia ʻana
• Lapaʻau hoʻomākala
• ʻOki kino

Pili ka hopena i ka maʻi maʻi.

Komo paha nā pilikia o ka effusion pleural:

• Poino o ka puʻu
• ʻO ka maʻi e lilo i abscess, i kapa ʻia he empyema
• ʻO ka lewa i ka umauma umauma (pneumothorax) ma hope o ke kahe o ka effusion
• Ka mānoanoa o Pleural (scarring o ka uhi o ka māmā)

Kāhea i kāu mea lawelawe a hele i ka lumi pilikia inā loaʻa iā ʻoe:

• Nā ʻōuli o ka effusion pleural
• Ka hanu ʻana o ka hanu a paʻakikī paha i ka hanu ʻana ma hope pono o ka thoracentesis

Loli i ka umauma; Loli ma ka akemāmā; Pleural wai

• Lungs
• ʻŌnaehana hanu
• ʻO ka lua Pleural

ʻO Blok BK. Thoracentesis. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 9.

Broaddus VC, RW māmā. Hoʻonui effa. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 79.

ʻO McCool FD. Nā maʻi o ka diaphragm, ka paia o ka umauma, ka pleura a me ka mediastinum. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 92.