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He aha ka subcutaneous emphysema?
Hoʻoikaika maʻi kūpale - ʻo ia ka hōʻiliʻili ʻana o nā ʻea a i ʻole nā ea i loko o nā ʻiʻo, e hoʻokumu ai i kahi cushion ea. Ma ke ʻano maoli, hiki ke unuhi ʻia ka huaʻōlelo emphysema e like me ka piʻi ʻana o ka ea. ʻO ke kumu o kēia maʻi e hiki ke hōʻeha i ka umauma, ma muli o ka ʻeha nui o nā ʻōpū hanu, a me ka pōʻino o ka esophagus. ʻO ia ke kumu e hoʻokomo ai ka ea i ka mediastinum i nā ʻaʻa nui a me nā moku, e alakaʻi ana i ka asphyxia, ka hemahema o ka cardiovascular a, ma muli o ka make.
ʻO ke kumu o ka subcutaneous emphysema hiki ke lilo i ʻeha hohonu waho, kahi i pōʻino ai nā ʻōpū hanu.
I ka lāʻau lapaʻau, he mea maʻamau ka hoʻokaʻawale ʻana ma waena o nā kumu nui o ka ea e komo ana i nā ʻiʻo, ʻo ia hoʻi, ʻekolu wale nō:
he ʻeha o ka umauma, nona ka waiwai e hoʻokuʻu wale i ka ea i loko o nā ʻiʻo, akā ʻaʻole e hāʻawi i ka manawa e hoʻi ai;
i ka wā e pōʻino ai ka bronchi, trachea a i ʻole esophagus, i ka wā i hōʻino ʻia ai ka pleura mediastinal, no laila e komo manuahi ka ea mai ka mediastinum i ka lua pleural;
i ka manawa like o ka pono o ka pleura parietal a me ka māmā, he ʻano like ka ʻeha.
Ke komo ka ea i loko o nā ʻiʻo, hiki iā ia ke neʻe manuahi ma lalo o ka ʻili mai ka ʻāpana areola a i ka ʻāpana maka. ʻO ka subcutaneous emphysema pinepine ʻaʻole ia e hoʻopilikia i nā mea maʻi. ʻO ia iho, ʻaʻole pilikia kēia maʻi inā ʻike ʻia ke kumu o kona hanana ʻana i ka manawa. No kaʻikeʻana i ke kumu, he mea nui e hahai i ka dynamics o ka uluʻana o kēia kaʻina hana.
Hoʻokaʻawale nā kauka i nā maʻi āpau i ʻelua mau makahiki: ʻōpio a me nā mea ma mua o 40 mau makahiki. ʻO ka maʻi i loko o ia mau kānaka ke hele mau i nāʻano likeʻole. I ka poʻe ʻōpio, ma kahi o 20-30 mau makahiki, loaʻa ka emphysema ma kahi ʻano maʻalahi a ʻaʻohe hopena. I nā poʻe ʻelemakule, ʻoi aku ma mua o 40 mau makahiki, ʻoi aku ka ʻino o ka maʻi a lōʻihi iki ka hoʻōla ʻana mai ka maʻi.
Nā kumu o ka subcutaneous emphysema
Hoʻokaʻawale nā kauka i nā kumu aʻe, ma muli o ke ʻano o ka emphysema subcutaneous:
ʻO ka maʻi maʻi bronchitis, ka puhi paka. I ka 90% o nā hihia, ʻo ka puhi paka ka mea e ulu ai ka emphysema. He nui nā poʻe maʻi i kuhihewa i ka manaʻoʻiʻo ʻo ka bronchitis o ka mea puhi paka he maʻi ʻino loa. Loaʻa i ka uahi paka ka nui o nā mea ʻino e hoʻopau ai i ka ʻōpū hanu i loko o ke kino o ka mea puhi. Ke alakaʻi nei kēia i nā loli koʻikoʻi;
Hoʻololi i ke ʻano maʻamau o ka umauma ma muli o nā hopena o waho, trauma;
ʻO nā ʻeha koʻikoʻi (ka haʻi paʻa o ka iwi ʻaoʻao, kahi ʻāpana i hou ʻia i ka ʻāmāmā) a i ʻole ka ʻoki umauma, laparoscopy;
ʻO ka anomaly i ka hoʻomohala ʻana o nā ʻāpana o ka ʻōnaehana hanu, ʻo ka hapa pinepine kēia mau malformations congenital;
ʻO ka inhalation o nā meaʻawaʻawa i loaʻa ka hopena pōʻino i ka ʻōnaehana hanu (nā hana ʻoihana, ka polluted environment, hana me nā mea ʻawaʻawa a i ʻole ka hana ʻino, nā mea kūkulu hale, etc.
ʻEha pū, ʻaneʻane hakahaka. Ma muli o ka hopena o nā kinoea pauka ma ka ʻili a puni ka ʻeha, hiki mai ka emphysema non-extensive;
ma'i anaerobic;
Pahi, ʻeha ʻeha;
ʻO nā ulia kaʻa kahi i paʻi ai ka poʻe i hōʻeha i ko lākou umauma i ka huila a i ʻole nā noho me ka ikaika nui;
ʻO ka pōʻino o ka māmā ma muli o ke kaomi kūloko ikaika loa, ka mea i kapa ʻia he barotrauma (lele i loko o ka wai, kahi luʻu ʻoi i ka hohonu);
Me ka haki o nā iwi maka;
Neoplasms ma ka ʻāʻī a ma ka trachea;
ʻO Angina Ludwig;
ʻAha o ka esophagus. ʻO kēia kumu ka mea kakaʻikahi;
I kekahi manawa, hiki mai ka emphysema i ka wā o ka ʻoki niho, ma muli o ke ʻano o ka mea kani;
ʻO kaʻeha i kahi hui nui (knee joint);
Me ka ventila artificial o ka mama. Hoʻohana i kahi paipu tracheal.
Nā hōʻailona o ka emphysema subcutaneous
ʻO ka manawa pinepine nā hōʻailona o ka emphysema subcutaneous:
ka pehu ma ka ʻāʻī;
ʻeha o ka umauma i ka hanu ʻana;
ʻeha ʻāʻī, pilikia ka ʻai ʻana;
hanu hana;
ka pehu o ka ʻili i ka ʻike ʻole ʻia o nā ʻāpana o kāna hana inflammatory.
Hiki iā ʻoe ke ʻike i ka emphysema subcutaneous me ka hoʻohana ʻana i kahi X-ray i nā pae hope o ka maʻi. A me ka palpation maʻalahi i ka wahi i manaʻo ʻia o ka hōʻiliʻili ʻana o ka ea. Ma lalo o nā manamana lima, e ʻike maikaʻi ʻia ka hele ʻana o nā ea ma lalo o ka ʻili.
I ka palpted, ʻaʻole e ʻeha ka mea maʻi a i ʻole ka ʻeha. Ke kaomi nei ʻoe ma kahi o ka hoʻoulu ʻana o nā kinoea, lohe ʻia kahi kani ʻano, kahi mea e hoʻomanaʻo nui ai i ka crunch o ka hau. Me ka hōʻiliʻili nui o ka ea ma lalo o ka ʻili, ʻo nā ʻiʻo e pili ana i kēia wahi e pehu nui a ʻike ʻia e ka maka.
Inā hoʻokumu ʻia ka emphysema subcutaneous ma ka ʻāʻī, hiki i ka mea maʻi ke hoʻololi i kona leo a paʻakikī ke hanu.
Hiki ke hōʻiliʻili ka ea ma lalo o ka ʻili ma nā wahi like ʻole o ke kino, ma nā wāwae a me nā lima, a me ka ʻōpū.
ʻO ka mālama ʻana i ka emphysema subcutaneous
Hiki ke ʻike ʻia ka Emphysema me ka X-ray a i ʻole CT scan o ka umauma. Ke ʻike koke ʻia nā ʻōhū ea i loko o nā ʻiʻo o ke kino, hoʻomaka koke ka mālama ʻana. I ka hoʻomaka mua o ka maʻi, lawe ʻia ka conservative therapy, ʻo ia hoʻi, ua kuhikuhi ʻia nā sprays kūikawā a me nā aerosol. Eia naʻe, ʻaʻole hiki iā lākou ke hoʻōki i ka ulu ʻana o ka maʻi.
ʻO ke ala o ka maʻi e nānā pono ʻia e nā kauka me kahi alapine, a ʻike ʻia nā exacerbations o ka maʻi 2 a i ʻole 3 mau manawa i ka makahiki. I loko o ia mau exacerbations, ulu ka hanu nui. Ma ke kolu a me ka ha o ka ma'i emphysema, 'a'ohe hopena o ka lā'au lapa'au i ka ma'i a pono e 'ae ka mea ma'i i ke ka'ina hana.
ʻOiai ʻo ka ʻoiaʻiʻo, ʻo ka subcutaneous emphysema ʻaʻole pono ka mālama ʻana. ʻO ia iho, ʻaʻole pilikia kēia maʻi i ke kino o ke kanaka, ʻo ia wale nō ka hopena o ka ʻeha waho a i ʻole kekahi ʻano o loko. A ma hope iho ua wehe ʻia. Paʻa ka ea ma lalo o ka ʻili. Nalo mālie ka maʻi me ka ʻole o ka lāʻau lapaʻau kūikawā.
ʻO ka maikaʻi o ka hoʻopau ʻia ʻana o ke kumu o ka emphysema ʻo ka resorption o ka ea. No ka wikiwiki o ka ho'ōla ʻana, ʻōlelo ʻia nā hana hanu i ka ea ʻāina hou. I kēia hihia, hoʻopiha ʻia ke koko me ka oxygen, e kōkua ana i ka leaching o ka nitrogen mai ke kino.
Ma muli o ka nui o ka emphysema, ua hana ʻia kekahi hana ʻokiʻoki, kahi i manaʻo ʻia e hoʻonui i ka hoʻopau ʻana i ka hōʻiliʻili ea.
Hiki ke pilikia wale ka Emphysema inā i hana ʻia i loko o ka ʻāpana o ka umauma a pālahalaha koke i ka ʻāʻī, ma lalo o ka ʻili, a laila komo i loko o nā ʻiʻo o ka ʻāʻī a me ka mediastinum, e hoʻopiʻi pono ai i nā kino koʻikoʻi o loko. I kēia hihia, pono kahi hana koʻikoʻi, e kōkua i ka ʻike ʻana i ke kumu o ka hoʻoheheʻe ʻana i ka ea, a me ka hoʻopau ʻana me ka ʻole o nā hopena koʻikoʻi no ka mea maʻi.