YPleural Effusion vs Pulmonary Edema
Pleural effusion thiab pulmonary edema yog ob yam mob ntsws. Ob qho no qhia qee yam ntawm pathophysiology thiab plawv tsis ua haujlwm, kua dej ntau dhau, lub siab tsis ua haujlwm, thiab lub raum tsis ua haujlwm tuaj yeem ua rau ob qho xwm txheej no.
Pleural Effusion
Peb muaj ob lub ntsws nyob rau hauv lub thoracic kab noj hniav. Lub ntsws yog npog nrog ob txheej txheej nyias nyias hu ua pleura. Cov txheej sab hauv yog adhered rau sab nrauv ntawm lub ntsws thiab yog visceral pleura. Cov txheej txheej ntawm lub thoracic kab noj hniav yog parietal pleura. Qhov chaw muaj peev xwm nruab nrab ntawm ob txheej ntawm pleura yog qhov chaw nruab nrab ntawm lub pleural. Kev sau cov kua dej hauv qhov chaw muaj peev xwm no hu ua pleural effusion.
Muaj ob hom pleural effusions; Lawv yog cov transudative effusions thiab exudative effusions. Pleural effusions tuaj yeem tshwm sim vim yog vim li cas hauv qab no.
- siab hydrostatic siab ntawm pulmonary leeg (lub plawv tsis ua hauj lwm, constrictive pericarditis, pericardial effusion thiab dej ntau dhau),
- Cov proteins qis qis (mob mob siab, protein poob enteropathy, nephrotic syndrome, dav ntawm daim tawv nqaij, hypothyroidism thiab kub hnyiab),
- Kab mob (pneumonia, ntsws abscess, tuberculosis),
- Kab mob (systemic lupus erythematosus, connective tissue disorders and rheumatoid arthritis),
- Malignancy (mob qog nqaij hlav hauv lub ntsws thiab cov qog metastatic)
Ua kom siab hydrostatic siab thiab cov kua roj ntsha qis ua rau muaj kev hloov pauv hloov pauv thaum muaj kab mob, o thiab mob qog noj ntshav ua rau muaj qhov tshwm sim ntawm exudative effusions. Cov neeg mob uas muaj pleural effusions tam sim no nrog ua tsis taus pa luv, txo kev ua haujlwm siab, thiab pleuritic yam mob hauv siab. ceg o, kiv taub hau, mob hauv siab ischemic, orthopnea, paroxysmal nocturnal dyspnea, parotid o o, gynecomastia, plab plab, haus dej cawv ntev, mob raws plab, frothy tso zis, daim tawv nqaij ua pob liab vog, malar ua pob liab vog, yuag poob ntawm cov appetite, thiab ua rau poob phaus. qhov tseem ceeb ntawm effusion.
Ntawm kev ntsuam xyuas, yuav ua pa sai, txo qis hauv siab nthuav dav, daim ntawv ceeb toom npub, ua tsis taus pa qis dua ntawm thaj chaw cuam tshuam, thiab ua pa bronchial saum cheeb tsam. Chest X-ray, ECG, tag nrho cov ntshav suav, ESR, ntshav urea, electrolytes, spirometry, hnoos qeev microscopy, kab lis kev cai thiab arterial blood gas analysis yog cov niaj hnub tshawb nrhiav.
Kho qhov hauv paus ntsiab lus yuav txo qhov effusion. Yog tias muaj cov tsos mob, effusion tuaj yeem tso tawm. Cov kua pleural tuaj yeem xa mus rau cov protein, qabzib, pH, LDH, ANA, ntxiv, rheumatoid factor thiab cytology). Hauv kev rov ua dua pleural effusions, pleurodesis nrog tetracycline, bleomycin, lossis talc yog ib qho kev xaiv.
Pulmonary Edema
Pulmonary edema yog vim qhov siab ntawm hydrostatic siab ntawm cov hlab ntsws pulmonary leeg. Kev ua haujlwm tsis zoo ntawm sab laug ventricular yog qhov ua rau ntau tshaj. Sab laug ventricular tsis ua haujlwm tuaj yeem ua rau lub plawv nres, arrhythmias, myocarditis, endocarditis, dej ntau dhau, lub raum tsis ua haujlwm, kub siab, thiab ventricular outflow ib puag ncig. Pulmonary edema yog ib qho tshwm sim ntawm kev ua haujlwm tsis zoo ntawm lub ventricular thiab ib qho ua rau muaj xwm txheej ceev.
Pulmonary edema nthuav tawm raws li cov hnoos qeev liab, hnoos, thiab ua tsis taus pa, uas nce ntxiv thaum pw. Qhov no yog kev kho mob xwm txheej ceev. Ntawm kev ntsuam xyuas, yuav muaj ob sab basal crepitations, ntshav siab thiab lub plawv dhia ceev. Tus neeg mob yuav tsum tau muab lub txaj. Diuretics kom tshem tawm cov ntsws, txo cov ntshav siab, thiab kho qhov ua rau lub plawv tsis ua hauj lwm yog cov hauv paus ntsiab lus ntawm kev tswj.
YPulmonary Edema vs Pleural Effusion
• Pleural effusion yog cov kua dej tawm sab nraud lub ntsws thaum pulmonary edema yog cov kua dej hauv lub ntsws.
• Pleural kua sau nyob rau hauv lub pleural qhov chaw thaum edema kua sau nyob rau hauv alveoli.
• Pleural effusion muab pleuritic yam mob hauv siab thaum pulmonary edema tsis.
• Pleural effusion txo lub hauv siab nthuav dav, npub rau percuss thaum pulmonary edema tsis yog.
• Basal creps yog qhov tseem ceeb hauv pulmonary edema thaum bronchial ua pa thiab aegophony (egophony) pom hauv pleural effusion.
• Pleural effusion txo qis cov ces kaum costophrenic thiab pom tau tias yog ib lub crescent zoo nyob rau hauv qis ntsws teb nyob rau hauv lub hauv siab X-ray. Nyob rau hauv pulmonary edema, alveolar edema, Kurly B kab, cardiomegaly, dilatation ntawm lub qaum lobe arterioles, thiab effusion yuav pom nyob rau hauv lub hauv siab X-ray.
