Kusintha kwachisokonezo
Pali vuto linalake lopwetekedwa mtima panthawi yopuma. Izi ndizo mphamvu zomwe zimapangitsa mapapo ku khoma la chifuwa. Ngati vuto limakhala lolimbikitsa, kukoka kwa mapapo kumatulutsa kutali ndi khoma la chifuwa, ndipo malo omasuka amadzazidwa ndi mpweya (pneumothorax) kapena madzi. Pneumothorax imagawidwa mwadzidzidzi komanso mopweteketsa mtima. Modzidzimutsa ndizochitika chifukwa cha kupasuka kwa alveoli yamapapo ndi visceral pleura. Zingakhale zoyamba, zomwe sizikugwirizana ndi matenda enaake, kapena yachiwiri, pamene mpata umakhala chifukwa cha matenda - mwachitsanzo, emphysema, matenda osokoneza bongo kapena chifuwa chachikulu cha TB. Kusintha kwa kuthamanga kwa kunja kumene kumayambitsa kufalikira kwa chifuwa, mwachitsanzo pa nthawi ya kuthawa kwapamwamba, kumayambitsanso kukula kwa pneumothorax. Izi zimachitika kuti chiphuphu chimapangika pa malo omwe amachoka, ngati valavu. Pa kudzoza, "valavu" imatsegulidwa ndi mpweya imayamwa mu chumity, pamene imatulutsidwa, imatseka, imatseka mpweya mu dera la pleural. Choncho, ndi mavitamini onse, mpweya wa mlengalenga umawonjezeka. Mapapu ndi mediastinum (malo osungunuka omwe ali pakati pa thorax) amathamangitsidwa kumbali yosiyana ndi lachilonda, kusokoneza mapapu abwino. Nthendayi imabwerera m'mtima imayamba kuwonongeka ndipo chiwerengero cha mtima chimachepa. Matendawa amadziwika kuti pneumothorax.
Zizindikiro
Wodwala yemwe ali ndi pneumothorax amadzidzimutsa, amamva kupweteka kwapang'onopang'ono, kuphatikizapo ululu wopweteka m'chifuwa. Kuyenda kwa khoma la chifuwa kuli kochepa pa mbali yokhudzidwa. Phokoso lakupuma panthawi yachisokonezo (kumvetsera chifuwa, kawirikawiri ndi stethoscope) kumakhala kosavuta kuposa kawirikawiri, ndipo mukamapopera, mumatha kumva phokoso la mthunzi ngati mthunzi. Ndi pneumothorax kwambiri, pali kuwonjezeka kwa dyspnea ndi kuthamangitsidwa kwa mediastinum, yomwe ingakhoze kudziwika pozindikira malo a trachea pa kudula kochepa kwa sternum.
Kafukufuku
Matendawa amatsimikiziridwa ndi radiography ya chifuwa, zomwe zimachitika ndi kutuluka kwathunthu. Nthawi zina pneumothorax sichipezeka, koma ilibe tanthauzo lachipatala. Panthawi yovutayi, pangakhale nthawi yoti afufuze, ndipo adokotala ayenera kupeza matenda okhudzana ndi zizindikiro. Pankhani ya pneumothorax kwambiri, ngati palibe mankhwala oyenera, imfa ikhoza kuchitika. Kupulumutsa moyo wa wodwala ndikuthamanga kwapakati - jekeseni wa chubu kapena singano mu phokoso lopanda mphamvu kuti achotse mpweya wambiri. Madokotala amatchula kuti pneumothorax kwambiri ndi zovuta. Ngati palibe chithandizo, chimaopseza moyo wa wodwalayo. Kupanikizika mu chumity chulukitsiro kuyenera kuchepetsedwa mwa kuika chimbudzi chokhazikika kapena singano yaikulu yopanda phokoso m'malo opempherera.
Zosokoneza
Ngati mliriwo ukufalikira mofulumira, ayenera kuwona kuti pali pneumothorax yovuta komanso kutenga njira zoyenera malinga ndi dokotala yekha, popanda kugwiritsa ntchito radiography. Nthano yomwe imayikidwa kudzera mu khoma la thoracic m'kati mwachitsulo chidzapangitsa kuchepa kwachangu komanso kudziteteza kumangidwe. Pneumothorax ya voliyumu yaing'ono ingathe kuchiritsidwa pokhapokha. Ngati pangakhale zizindikiro zochepa zokha, kupuma kwa m'mapapo sikupitirira 20% ya voliyumu yake, ndipo wodwalayo amatsogolera moyo wamoyo, ndizomveka kuchepetsa momwe wodwalayo amaonera ndi chifuwa cha fluoroscopy kuti resorption ya pneumothorax. Nthaŵi zambiri, vuto la pneumothorax limatha mkati mwa milungu isanu ndi umodzi. Ngati zizindikiro zikupitirirabe, pneumothorax iyenera kuthetsedwa, mwina mwa kufunafuna mpweya kupyolera mu singano, kapena pogwiritsa ntchito ngalande yamchere. Mng'oma wothandizana nawo umalowetsedwa m'kati mwachitsulo podutsa mphindi yachinayi kapena yachisanu kuchokera pakati pa mzere wa pakati, ndipo kenako umakhala ndi suture. Dothili limagwirizanitsidwa ndi catheter ku chotengera chokhala ndi valve yotulutsa madzi ndipo chimadzaza madzi. Pamene chubu ili m'munsi mwa madzi, dongosololi limakhala ngati valavu ndi mpweya zimachotsedwa pang'onopang'ono. Nthawi zina aspiration amafunika kuchotsa mpweya wambiri. Kutentha kupyolera mu singano kumapangidwira poika singano mu mthunzi wofufuzira ndi mpweya woyamwa pogwiritsa ntchito valve njira zitatu. Njirayi siipweteka kwambiri kwa wodwalayo ndipo imathandiza kuchepetsa nthawi yomwe yakhala m'chipatala. Komabe, imagwiritsidwa ntchito pokhapothorax yaing'ono. Ngati mwamsanga mumachotsa mpweya wambiri kuchokera pamtanda, phokoso likhoza kukhalapo, zomwe zimadzetsa kutupa kwa mapapo. Izi zimachitika kuti pneumothorax sichiloledwa, popeza kutsegulira koyamba pa visceral pleura kumatseguka. Matendawa amadziwika kuti bronchopleural fistula. Pankhani imeneyi, mukhoza kutseka chilema ndi thoracotomy (kutsegulira opaleshoni ya thoracic) kapena thoracoscopy (njira yochepa yomwe imatha kugwiritsidwa ntchito kuti iganizire ndi kubwezeretsa chingwe). 25% ya pneumothoraxes amatha kubwereranso ndipo amafunikanso kuwongolera kotsiriza. Pokhala ndi pneumothorax pulogalamu yaikulu, madzi osalimba angakhale opanda ntchito. Izi zimachitika ngati wodwalayo ali kale ndi pneumothorax yapakati kapena ali wa gulu la akatswiri omwe ali ndi chiopsezo chachikulu chobwereza (mwachitsanzo, ndege). Zikatero, pleurodesis kapena pleurectomy akhoza kuchitidwa. Cholinga cha pleurodesis ndikulumikiza phokoso la visceral ndi parietal ndi mankhwala monga tinthu wosabala kapena nitrate ya siliva, kapena kupopera opaleshoni. Cholinga cha pleurectomy ndicho kuchotsa mapepala onse osinthidwa, koma kumabweretsa zovuta kwambiri.