Odma płucna – zagrażająca życiu konsekwencja urazu klatki piersiowej
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Odma płucna – zagrażająca życiu konsekwencja urazu klatki piersiowej

Natalia Janus1 803 komentarze
Ten tekst przeczytasz w 2 min.

Przyczyną wystąpienia odmy opłucnej jest m.in. nieszczelny miąższ płucny oraz przedziurawiona klatka piersiowa. Wówczas dochodzi do przedostania się powietrza do jamy klatki piersiowej, które to uciska płuco i powoduje jego zapadnięcie.

Oprócz urazów klatki piersiowej do najczęstszych przyczyn odmy płucnej zalicza się pęknięcie gruźliczej jamy, jak również pęknięcie pęcherzy rozedmowych, do których może dojść podczas silnego kaszlu.

Odma płucna zazwyczaj objawia się silnym bólem okolicy mostka, spłyceniem oddechu oraz przyspieszeniem akcji serca. Ponadto może również dojść do zasinienia górnych partii ciała (twarzy i szyi) i zauważalnego poszerzenia żył szyjnych. Odma opłucna może również powodować takie powikłania, jak zrosty, gromadzenie się płynu, ropniaki opłucnej, krwawienie do opłucnej bądź zespół Hornera.

Częściej narażeni na jej wystąpienie są mężczyźni. Z uwagi na duże ryzyko wystąpienia nawrotu, pacjenci, u których doszło wcześniej do wystąpienia odmy, powinni zostać objęci stałą opieką lekarską. Niedotlenienie, które występuje przy odmie płucnej może prowadzić do omdlenia, dlatego tak ważne jest niezwłoczne wezwanie pomocy.

Jakie badania wykażą odmę płucną?

W celu zlokalizowania miejsca odmy i ilości nagromadzonego w jamie opłucnej powietrza wykonuje się badanie RTG klatki piersiowej bądź tomografię komputerową (u pacjentów po urazie). W tzw. nagłych przypadkach stosuje się badanie USG, a to z uwagi na szybkość otrzymania wyniku.

Ponadto w diagnostyce odmy płucnej wykonuje się również gazometrię i pulsoksymetrię (oceniają krew pod kątem pH i stopnia nasycenia gazami), oraz EKG serca.

Jak leczyć odmę płucną?

Jeżeli odma płucna wystąpiła jednorazowo i nie jest rozległa zalecany jest odpoczynek oraz leki przeciwbólowe. Ponadto dobroczynny wpływ będzie miała również tlenoterapia i ćwiczenia oddechowe. Natomiast u pacjentów z odmą otwartą niezbędnym będzie założenie opatrunku uszczelniającego.

U pacjentów, u których odma wystąpiła po raz pierwszy można również wykonać nakłucia umożliwiające odessanie powietrza. Niekiedy konieczne będzie wykonanie drenażu jamy opłucnowej, podczas którego do jamy wprowadza się dren, który to ma za zadanie wyregulować panujące tam ciśnienie.

U pacjentów z odmą płucną stosuje się również torakotomię, która polega na chirurgicznym usunięciu takich zmian, jak nieszczelny miąższ czy opłucna ścienna wraz ze zrostami. Jest to najbardziej inwazyjna metoda leczenia tego schorzenia, która pozwala jednak na zminimalizowanie ryzyka nawrotu odmy.

Źródło: abczdrowie.pl

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