I-Edema yamaphaphu

Uketshezi olusemaphashini luthinta izigidi zabantu emhlabeni wonke futhi lungabeka ukuphila kwakhe engozini ngaphandle kosizo lwezokwelapha olufanele. Le bhulogi enemininingwane ihlola izici ezibalulekile ze-pulmonary edema, kusukela ezimpawu zayo eziyisixwayiso zakuqala kuye ezindleleni zokwelashwa ezihlukahlukene. Odokotela basebenzisa amasu ahlukene okuphatha lesi simo, okuhlanganisa ukwelashwa komoyampilo, imithi, kanye nokubhekana nembangela ewumsuka. 

Iyini i-Pulmonary Edema? 

I-pulmonary edema yisimo sezempilo esibucayi esibonakala ngokunqwabelana okungavamile koketshezi emasakeni omoya wamaphaphu (alveoli). Lokhu kunqwabelana koketshezi kuphazamisa ukuphefumula okuvamile ngokuvimbela ukushintshaniswa komoya-mpilo okufanele emaphashini. 

Okulandelayo yizinhlobo ezijwayelekile ze-pulmonary edema: 

• I-Cardiogenic Pulmonary Edema: Kuvela ngenxa yezinkinga zenhliziyo ezithinta ikhono lenhliziyo lokususa igazi emaphashini ngempumelelo 
• I-Non-cardiogenic Pulmonary Oedema: Le edema iphumela ekulimaleni okuqondile kwezicubu zamaphaphu. Izici ezihlukahlukene, kuhlanganise nobuthi, imithi, noma ukuhlukumezeka esifubeni, kungabangela.

Uma uketshezi luqoqana emasakeni omoya wephaphu, lunciphisa inqubo ebalulekile yokushintshanisa igesi evame ukwenzeka ezingeni le-alveolar. Lokhu kuphazamiseka kungadlulela ekuhlulekeni kokuphefumula uma kungelashwa. Ubukhulu be-edema ye-pulmonary buyahlukahluka, kanti izimo ezibucayi zikhula ngokuzumayo futhi zidinga ukungenelela kwezokwelapha ngokushesha. 

Izimpawu ze-Edema yamaphaphu 

Izimpawu ze-edema yamaphaphu zibonakala ngokuhlukile kuye ngokuthi zikhula ngokuzumayo noma kancane kancane ngokuhamba kwesikhathi. 

• Izimpawu Ezingazelelwe (Acute): 
  • ezinzima ukuphelelwa umoya lokho kuba kubi ngomsebenzi 
  • Umuzwa wokuminza noma wokuminza, ikakhulukazi lapho ulele 
  • Ukukhwehlela ophinki, isikhwehlela esinamagwebu 
  • Ukushaya kwenhliziyo okusheshayo, okungajwayelekile 
  • Ukushisa noma ukudonsa umoya 
  • Isikhumba esibandayo, esicwebezelayo 
  • Ukukhathazeka okwedlulele noma ukungahlaliseki 
• Izimpawu zesikhathi eside (Ezingalapheki): 
  • Ukuphefumula ngesikhathi sokusebenza ngokomzimba 
  • Ukuphefumula kanzima lapho ulele phansi 
  • Ukuvuka ebusuku uzizwa uphelelwa umoya 
  • Ukukhwehlela okusha noma okubi kakhulu 
  • Ukuvuvukala kwemilenze nezinyawo 
  • Ukukhathala okungavamile 
  • Ukuzuza ngokushesha kwesisindo 

Izinkinga ze-Pulmonary Edema 

Lesi simo sivela ngezindlela ezimbili ezihlukene, ngayinye inesethi yayo yezimbangela kanye nezici zobungozi. 

• Izinkinga ze-Cardiogenic: 
  • Ukuhluleka kwenhliziyo ukulahla 
  • I-valve yenhliziyo izinkinga 
  • Isifo se-artery Coronary 
  • Umfutho wegazi ophezulu 
  • Izigqi zenhliziyo ezingajwayelekile 
  • I-Cardiomyopathy (imisipha yenhliziyo ebuthakathaka) 
• Izinkinga ze-Noncardiogenic: 
  • I-Acute Respiratory Distress Syndrome (ARDS) 
  • Izifo ezinzima noma i-sepsis 
  • Ukuchayeka kubuthi noma intuthu 
  • Ukuchayeka kokuphakama okuphezulu 
  • Izehlakalo ezicishe ziminze 
  • Ukuhlukumezeka okukhulu noma ukulimala 

I-Pulmonary Edema Risk Factors 

• Izimo Zempilo: Lokhu kuhlanganisa isifo sezinso esingamahlalakhona, izinkinga zesibindi, ukuvimbela i-apnea yokulala, kanye nezifo ezinzima. 
• Izici Zemvelo: Abantu abaya ezindaweni eziphakeme ngaphezu kwamamitha angu-8,000 bangase babe ne-high-altitude pulmonary edema, ikakhulukazi uma bekhuphuka ngokushesha kakhulu ngaphandle kokujwayela okufanele. 
• Ukuchayeka Eminye Imithi: Izidakamizwa ezingekho emthethweni noma izinto ezinobuthi zingalimaza amaphaphu futhi zibangele ukunqwabelana koketshezi. 

Izinkinga ze-Pulmonary Edema 

Njengoba isimo siqhubeka, iziguli zingase zibe nezinkinga eziningana ezibalulekile: 

• Ukwehluleka ukuphefumula okudinga ukushaywa umoya ngemishini 
• Ubuthakathaka benhliziyo kanye nokwehluleka kwenhliziyo ekugcineni 
• Ukuvuvukala emilenzeni, izinyawo, nendawo yesisu 
• Ukugcwala koketshezi emaphashini (i-pleural effusion) 
• Ukuminyana kwesibindi nokuvuvukala 
• I-Acute Respiratory Distress Syndrome (ARDS) 

Sifo 

Ukuxilongwa kwe-edema yamaphaphu ngokuvamile kuhlanganisa ukuhlolwa okuphelele komzimba nokubuyekezwa komlando wezokwelapha, ikakhulukazi ezimweni zenhliziyo nemithambo yegazi namaphaphu. 

Odokotela bavamise ukuqala ngamathuluzi okuxilonga ayisisekelo: 

• Ukuhlolwa kwegazi: 
  • Ukuhlolwa kwe-BNP ukuhlola izinkinga zenhliziyo 
  • Gcwalisa inani legazi 
  • Ukuhlolwa kokusebenza kwezinso kanye ne-thyroid 
  • Ukuhlolwa kwamazinga e-Electrolyte 
• Izifundo ze-Imaging: 
  • I-X-ray yesifuba ukuqinisekisa uketshezi emaphashini 
  • I-CT scan ukuze uthole ukuhlolwa okuningiliziwe kwamaphaphu 
  • I-Echocardiogram ukuhlola ukusebenza kwenhliziyo 
  • I-Lung ultrasound ukuthola ukunqwabelana koketshezi 
• Okunye Ukuhlola: I-Pulse oximetry kanye nokuhlolwa kwegesi ye-arterial kusiza ukunquma amazinga komoyampilo egazini. 

Ukwelashwa 

• Ukwelashwa Ngeoksijini: Lokhu kwelashwa kusebenza njengokwelashwa okuyinhloko kwe-edema yamaphaphu. Odokotela baletha umoya-mpilo ngezindlela ezihlukahlukene: 
  • Imaski yobuso noma i-cannula yamakhala ezimweni ezithambile 
  • Umfutho womoya oqhubekayo (CPAP) wezimo ezimaphakathi 
  • Ukungena komoya ngemishini ezimweni ezimbi kakhulu ezidinga usizo lokuphefumula 
• Imithi: Imithi yakha ingxenye ebalulekile yesu lokwelapha. Odokotela bangase banikeze izinhlobo eziningana zemithi yokuphatha lesi simo ngempumelelo. Lokhu kufaka phakathi ama-diuretics okukhipha uketshezi okweqile, izinciphisi ezilayishwa kuqala ukuze zehlise umfutho wenhliziyo namaphaphu, kanye nezinciphisa ukulayishwa ngemuva kokwelula imithambo yegazi. 

Uzoyibona Nini Udokotela 

Ukungenelela kwezokwelapha ngokushesha kuyadingeka uma othile ehlangabezana: 

• Ukuphefumula kungazelelwe futhi okubi kakhulu 
• Ubuhlungu besifuba noma ukungakhululeki 
• Isikhwehlela esipinki noma esinegazi uma ukhwehlela 
• Ukucwala okuluhlaza okwesibhakabhaka noma okumpunga kwezindebe noma izinzipho 
• Ukudideka noma ukozela 
• Ukushaya kwenhliziyo okusheshayo nokujuluka 
• Ukukhathazeka okukhulu noma umuzwa wokuphelelwa umoya 
• Ukuphefumula kanzima lapho ulele phansi 
• Ukukhwehlela okuqhubekayo okuhlala isikhathi esingaphezu kwamaviki angu-2-3 

Prevention 

Odokotela batusa ukuguqulwa okuqondile kwendlela yokuphila kanye nezinyathelo zokuvimbela ukwehlisa amathuba okuthuthukisa lesi simo esibucayi se-pulmonary. 

Amaqhinga Abalulekile Okuvikela: 

• Lawula umfutho wegazi ngokuqapha njalo nangokubambelela emithini yemithi 
• Gcina ukuphathwa ngendlela efanele kwezimo ezikhona zenhliziyo namaphaphu 
• Landela ukudla okulinganiselayo okunosawoti omncane (ngaphansi kuka-2,300 mg nsuku zonke) 
• Zivocavoce njalo okungenani ngemizuzu eyi-120-150 yomsebenzi omaphakathi masonto onke 
• Gcina isisindo esinempilo ngokudla okufanele 
• Gwema ukubhema kanye nokuchayeka entuthuni kagwayi 
• Thola imigomo evamile yokuvimbela izifo zokuphefumula 

Kubantu abahlela imisebenzi yendawo ephakeme, izinyathelo ezithile zokuphepha zisiza ukuvimbela i-high-altitude pulmonary edema:

• Ukunyuka kancane kancane, okwandisa ukuphakama ngamafidi angekho ngaphezu kwe-1,000 ngosuku ngaphezu kwamamitha angu-8,200, kuyasiza. 
• Ukuthatha imithi yokuvimbela efana ne-acetazolamide noma i-nifedipine 

Isiphetho 

Umbono weziguli ze-pulmonary edema uyaqhubeka nokuba ngcono njengoba ulwazi lwezokwelapha lukhula. Abantu abalandela izinhlelo zabo zokwelashwa futhi benze izinguquko ezinconyiwe zendlela yokuphila bavame ukubona ukuthuthuka okubalulekile kukhwalithi yabo yempilo. Impumelelo ekulawuleni i-edema ye-pulmonary incike kokubili ukungenelela kwezokwelapha nokuzibophezela kwesiguli ekulandeleni amasu okuvimbela. 

FAQs 

1. Uyini umehluko phakathi kwe-pulmonary edema kanye nenyumoniya?

Nakuba zombili izimo zithinta amaphaphu, zinezici ezihlukile. I-edema yamaphaphu ihlanganisa ukunqwabelana koketshezi emasakeni omoya, kuyilapho inyumoniya ukutheleleka okubangela ukuvuvukala emaphashini. Inyumoniya ngokuvamile ibangela imfiva kanye nokukhwehlela okukhiqizayo okunamafinyila aminyene, kuyilapho i-pulmonary edema ivame ukukhiqiza isikhwehlela esibomvana, esinamagwebu. 

2. Iyini imbangela ehamba phambili ye-pulmonary edema? 

Izinkinga zenhliziyo, ikakhulukazi ukwehluleka kwenhliziyo eqinile, zimelela imbangela evame kakhulu ye-edema yamaphaphu. Lesi simo siqala lapho inhliziyo ingakwazi ukumpompa igazi ngokuphumelelayo, okuholela ekwenyukeni komfutho emithanjeni yegazi yamaphaphu kanye nokuvuza koketshezi okulandelanayo kumasaka omoya. 

3. Ubona kanjani uma unoketshezi emaphashini akho? 

Odokotela bahlonza uketshezi olusemaphashini ngokusebenzisa izinkomba eziningana: 

• Imisindo eqhephukayo lapho ulalele amaphaphu 
• Ukuphefumula okusheshayo nokukhuphuka kwenhliziyo 
• Ukuvuvukala entanyeni nasesiswini 
• Isikhumba esiphaphathekile noma esiluhlaza okwesibhakabhaka 

4. Ulukhipha kanjani uketshezi emaphashini?

Odokotela basebenzisa izindlela ezahlukene ukususa uketshezi okweqile, okuhlanganisa: 

• Izidakamizwa ze-diuretic zokwandisa ukukhishwa kwamanzi 
• Ukwelashwa kwe-oxygen eyengeziwe 
• Inqubo ye-Thoracentesis ezimweni ezinzima 
• Ukwelashwa kwezimo zenhliziyo ezingaphansi 

5. Ingabe amaphaphu angakwazi ukuzikhipha oketshezini?

Amaphaphu ngokwemvelo acwenga uketshezi oluncane ngohlelo lwawo lokudonsa amanzi. Kodwa-ke, ku-edema yamaphaphu, ukunqwabelana koketshezi kudlula umthamo wemvelo wamaphaphu, okudinga ukungenelela kwezokwelapha. 

6. Ingabe umuntu angalulama e-pulmonary edema?

Abantu abaningi bangalulama edema yamaphaphu ngokwelashwa okufanele. Umugqa wesikhathi wokuthola kabusha uyahlukahluka futhi uncike kumbangela kanye nokubambelela ekwelashweni. Izimo ezimaphakathi zivame ukubonisa ukuthuthuka phakathi kwezinyanga eziyisi-6 kuya onyakeni ngokunakekelwa kwezokwelapha okufanele kanye nokuguqulwa kwendlela yokuphila. 

UDkt. Suhas P. Ithiphu

MBBS, TDD, DNB (Izifo Zokuphefumula), CTCCM (ICU Fellowship), CCEBDM
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529