ʻO Empyema

Anter

• Nā Kumu
• Nā kūlana e hoʻoweliweli ai iā ʻoe
• Nā ʻōuli
• Empyema maʻalahi
• Empyema paʻakikī
• Nā pilikia
• Kuhi diagnost empyema
• Lapaʻau
• Outlook

He aha ka empyema?

Kāhea ʻia ʻo Empyema pyothorax a i ʻole purulent pleuritis. He kūlana ia e ʻākoakoa ai ka pā i kahi ma waena o nā akemāmā a me ka ʻaoʻao i loko o ka paia umauma. ʻIke ʻia kēia wahi ma ke ʻano pleura. ʻO ka pus kahi wai i hoʻopiha ʻia me nā hunaola pale, nā hunaola make, a me nā bacteria. ʻAʻole hiki ke ʻānai ʻia ka pus ma kahi ākea. Akā, pono e ninini ʻia e kahi nila a i ʻole kahi ʻoki.

Hoʻoulu mau ʻo Empyema ma hope o ka pulumonia, ʻo ia kahi maʻi o ke aʻa māmā.

Nā Kumu

Hiki i ka Empyema ke ulu ma hope o kou loaʻa ʻana i ka maʻi ponia. Hiki i nā ʻano bacteria he nui ke kumu i ka niumonia, akā ʻo nā mea maʻamau ʻelua ʻO Streptococcuspulumoniae a Staphylococcus aureus. I kekahi manawa, hiki i ka empyema ke hana ma hope o kāu kaukala ʻana ma kou umauma. Hiki i nā mea lāʻau lapaʻau ke hoʻolilo i nā bacteria i loko o kāu lua pleura.

Loaʻa i ka lewa pleural kekahi wai, akā hiki i ka maʻi ke hoʻokumu i ka wai e wikiwiki aʻe ma mua o ka hiki ke komo. A laila hele a maʻi ka wai i nā maʻi bacteria nāna i hoʻokumu i ka pulumona a i ʻole ka maʻi. Mānoanoa ka wai laha. Hiki iā ia ke hoʻopili i ka uhi o kou mau māmā a me ka lua o ka umauma e pili pū a hana i nā ʻeke. Kapa ʻia kēia he empyema. ʻAʻole hiki i kou mau māmā ke ulu nui i loko, a hiki i nā pilikia o ka hanu ʻana.

Nā kūlana e hoʻoweliweli ai iā ʻoe

ʻO ka mea nui weliweli no ka empyema ka loaʻa ʻana o ka maʻi pneumonia. Hana pinepine ʻo Empyema i nā keiki a me nā mākua makua. Eia naʻe, mea maʻamau ʻole. I hoʻokahi noi, ua hana ia ma lalo o 1 pākēneka o nā keiki me ka maʻi puʻupuʻu.

ʻO ka loaʻa ʻana o nā kūlana aʻe hiki ke hoʻonui i kou manawa o ka empyema ma hope o ka maʻi pīpī.

• bronchiectasis
• maʻi pulmonary pulupulu paʻa (COPD)
• rumatika
• ʻalekohola
• diabetes
• ʻōnaehana pale nawaliwali
• ʻoki kino a i ʻole trauma ʻino
• maloʻo ʻaʻā

Nā ʻōuli

Hiki ke maʻalahi a paʻakikī paha ʻo Empyema.

Empyema maʻalahi

Hana ʻia ka empyema maʻalahi i nā wā mua o ka maʻi. Loaʻa i kekahi i kēia ʻano inā kū kahe ka manu. ʻO nā ʻōuli o ka empyema maʻalahi ʻo:

• pokole o ka hanu
• ʻūhū maloʻo
• fiva
• ka houʻu ʻana
• ʻeha ka umauma ke hanu ʻia e wehewehe ʻia ma ke ʻano he hou ʻana
• ʻeha poʻo
• huikau
• nalo ʻai ʻole

Empyema paʻakikī

Hana ʻia ka empyema paʻakikī i ka hope o ka maʻi. I ka empyema paʻakikī, ʻoi aku ka nui o ka mumū. Hiki ke hana a hoʻokaʻawale i kaʻiʻo scar i nā lua o ka liʻiliʻi. Kapa ʻia kēia wahi he wahi noho, a ʻoi aku ka paʻakikī o ka mālama ʻana.

Inā hoʻomau ka maʻi o ka maʻi, hiki iā ia ke alakaʻi i ka hoʻokumu ʻana o kahi peel mānoanoa ma luna o ka pleura, i kapa ʻia he peʻe pleura. Pale kēia peel i ka hāhā mai ka hoʻonui. Pono ke ʻoki e hoʻoponopono iā ia.

ʻO nā ʻōuli ʻē aʻe i ka empyema paʻakikī me:

• paʻakikī i ka hanu ʻana
• kani ka hanu hoʻēmi
• Kaumaha emi
• ʻeha ka umauma

Nā pilikia

I nā hanana maʻamau, hiki i kahi hihia o ka empyema paʻakikī ke alakaʻi i nā pilikia koʻikoʻi. Pākuʻi ʻia kēia i ka sepsis a me ke akahai hāneʻe, i kapa ʻia hoʻi he pneumothorax. ʻO nā ʻōuli o sepsis ka:

• wela wela
• haʻalulu
• hanu wikiwiki
• wikiwiki o ka puʻuwai
• haʻahaʻa haʻahaʻa haʻahaʻa

Hiki i kahi māmā i hāʻule ke kumu i ka ʻeha o ka umauma ʻoi loa a me ka hanu o ka hanu e ʻoi aku ka maikaʻi ke ʻoka a hanu paha.

Hiki ke make i kēia mau kūlana. Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​pono ʻoe e kāhea iā 911 a i ʻole e hoʻokele kekahi iā ʻoe i kahi keʻena pilikia.

Kuhi diagnost empyema

Manaʻo paha ke kauka he empyema inā loaʻa ʻoe i ka maʻi ʻaʻohe e pane ana i ka lāʻau. E lawe kāu kauka i ka mōʻaukala piha a me ka hoʻokolokolo kino. Hiki iā lākou ke hoʻohana i kahi stethoscope e hoʻolohe ai i nā kani kūlohelohe ʻole i kou mau māmā. Hana pinepine kāu kauka i kekahi mau hoʻokolohua a i ʻole nā ​​kaʻina hana e hōʻoia i kahi kuhi:

• E hōʻike nā X-ray a me ka CT scans inā aia a loaʻa ʻole ka wai i ka pleural space.
• E hōʻike kahi ultrasound o ka umauma i ka nui o ka wai a me kona wahi kikoʻī.
• Hiki i nā hoʻokolohua koko ke kōkua i ka helu ʻana i kāu helu keʻokeʻo koko keʻokeʻo, e nānā no ka protein C-reactive, a ʻike i nā bacteria e hōʻeha ana i ka maʻi. Hiki ke hāpai ʻia ka helu keʻokeʻo keʻokeʻo ke loaʻa ʻoe i kahi maʻi.
• I ka wā o ka thoracentesis, ua hoʻokomo ʻia kahi nila i loko o ka hope o kāu ribcage i kahi ākea e lawe i kahi laʻana o ka wai. A laila kālailai ʻia ka wai ma lalo o kahi microscope e nānā ai no nā koʻohune, protein, a me nā hunaola ʻē aʻe.

Lapaʻau

Hoʻopaʻa ʻia ka mālama ʻana i ka wehe ʻana i ka pā a me ka wai mai ka pleura a me ka mālama ʻana i ka maʻi. Hoʻohana ʻia nā lāʻau antibiotic e mālama i ka maʻi maʻi. ʻO ke ʻano kikoʻī o antibiotic kaukaʻi ʻia i ke ʻano o nā koʻohune ke kumu nei i ka maʻi.

ʻO ke ʻano i hoʻohana ʻia e hoʻokahe i ka pā i ka pae o ka empyema.

I nā hihia maʻalahi, hiki ke hoʻokomo i kahi nila i loko o ka pleural space e hoʻokahe i ka wai. Kapa ʻia kēia ʻo perkutanent thoracentesis.

I nā wā ma hope, a i ʻole empyema paʻakikī, pono e hoʻohana i kahi paipu hoʻoheheʻe e hoʻokahe i ka pā. Hana pinepine ʻia kēia hana ma lalo o ka anesthesia i loko o kahi lumi hana. Aia kekahi mau ʻano ʻoki o kēia.

Thoracostomy: I kēia kaʻina hana, e hoʻokomo kāu kauka i kahi pahu ea i loko o kou umauma ma waena o nā iwi ʻelua. A laila e hoʻopili lākou i ka paipu i kahi mea hū a hemo i ka wai. Hoʻokomo pū paha lākou i ka lāʻau e kōkua i ka hoʻopau i ka wai.

ʻOki kino wikiō i kōkua ʻia: E hoʻoneʻe aku kāu kauka lāʻau i nā mea i hoʻopā ʻia a puni kou māmā a laila e hoʻokomo i kahi paipu hoʻoheheʻe a hoʻohana i ka lāʻau e lawe i ka wai. E hana lākou i ʻekolu mau ʻoki liʻiliʻi a hoʻohana i kahi kāmela liʻiliʻi i kapa ʻia he thoracoscope no kēia kaʻina.

Wehe decortication: I kēia ʻoki ʻana, e ʻili ana kāu mea kauka i ka peel pleura.

Outlook

ʻO ka nānā no ka empyema me ka hoʻomaʻamaʻa koke he maikaʻi. Laha iki ka hōʻino lōʻihi Pono ʻoe e hoʻopau i kāu mau lāʻau i kauoha ʻia a hele i loko no kahi X-ray umauma ukali. Hiki i kāu kauka ke hōʻoia i ke ola pono o kāu pleura.

Eia nō naʻe, i ka poʻe me nā kūlana ʻē aʻe e hoʻopili i ka ʻōnaehana paleʻea, hiki i ka empyema ke loaʻa i ka helu make ma kahi o 40 pākēneka.

Inā mālama ʻole ʻia ia, hiki i ka empyema ke alakaʻi i nā pilikia weliweli e like me sepsis.