Alamun huda thoracic
Domin a fayyace yanayin zub da jini, yakamata a yi gwajin huda huhu da buri don taimakawa wajen gano cutar;Lokacin da adadin ruwa mai yawa ko tarin iskar gas ya haifar da bayyanar cututtuka na huhu, kuma marasa lafiya na pyothorax suna buƙatar zubar da ruwa don magani;Dole ne a yi allurar magunguna a cikin kogon kirji.
Contraindications nahuda thoracic
(1) Wurin huda yana da kumburi, ƙari da rauni.
(2) Akwai yanayin zub da jini mai tsanani, pneumothorax na kwatsam, daskarewar jini mai yawa, tarin fuka mai tsanani, emphysema, da sauransu.
Kariya don Huɗar Ƙajiya
(1) Marasa lafiya da ke da lahani, cututtukan jini da masu shan magungunan kashe qwari kafin a yi musu aikin.
(2) Yakamata a yi huda huda gabaɗaya don hana tashin hankali.
(3) Dole ne a yi huda kusa da gefen haƙarƙari na sama don guje wa rauni ga tasoshin jini da jijiyoyi.Dole ne a kiyaye allurar, bututun latex ko sauyawa ta hanyoyi uku, silinda allura, da sauransu don hana iska daga shiga cikin kirji da haifar da pneumothorax.
(4) Huda ya kamata a yi taka tsantsan, dabarar ta zama kwararre, sannan a tsattsage maganin kashe kwayoyin cuta don gujewa haifar da sabon kamuwa da cuta, pneumothorax, hemothorax ko rauni na bazata ga magudanar jini, zuciya, hanta da mafari.
(5) A guji tari yayin huda.Kula da canje-canjen majiyyaci a kowane lokaci.Idan fuskar ta baci, gumi, amai, bugun zuciya da raunin bugun jini, za a dakatar da huda nan take.Bari majiyyaci ya kwanta, ya sha iskar oxygen lokacin da ya cancanta, kuma a yi masa allurar adrenaline ko sodium benzoate da maganin kafeyin subcutaneously.Bugu da ƙari, za a yi maganin da ya dace bisa ga yanayin.
(6) Dole ne a rika zubar da ruwan a hankali.Idan dole ne a zubar da ruwa mai yawa saboda jiyya, ya kamata a haɗa maɓallin hanyar uku a bayan allurar huda.Kada a zubar da ruwan da yawa don magani.Idan ya cancanta, ana iya yin famfo a cikin sau da yawa.Adadin ruwan da aka busa a karon farko ba zai wuce 600ml ba, kuma adadin ruwan da aka zuga a kowane lokaci bayan haka zai zama kusan 1000ml.
(7) Idan ruwan jini ya fito, a daina yin zane nan da nan.
(8) Idan ya zama dole a zuba magani a cikin ramin kirji, sai a hada sirinji da aka shirya mai dauke da ruwan maganin bayan an zuba ruwa, sai a hada kadan daga cikin ruwan kirjin da ruwan maganin, sannan a sake yin allurar a cikin kirjin. rami
Yadda za a zabi wurin sanya huda thoracic?
(1) Huda huda da magudanar ruwa: mataki na farko shi ne yin bugun ƙirji, sannan zaɓi ɓangaren da ke da tsayayyen sauti mai ƙarfi don huda, wanda za a iya kasancewa tare da X-ray da B-ultrasound.Ana iya sanya alamar huda a kan fata tare da ƙusa violet, kuma sau da yawa ana zaba kamar haka: 7 ~ 9 intercostal Lines na kusurwar subscapular;7-8 intercostals na layin axillary na baya;6 ~ 7 intercostals na layin midaxillary;Gaban axillary shine 5-6 hakarkarinsa.
(2) Encapsulated pleural effusion: huda za a iya yi a hade tare da X-ray da ultrasonic localization.
(3) Pneumothorax decompression: sararin intercostal na biyu a cikin layi na tsakiya ko 4-5 intercostal sarari a cikin layi na midaxillary na gefen da ya shafa an zaba gaba ɗaya.Domin jijiyoyi masu tsaka-tsaki da arteries da veins suna gudana tare da ƙananan gefen haƙarƙarin, ya kamata a huda su ta gefen haƙarƙarin na sama don guje wa lalata jijiyoyi da tasoshin jini.
Dukan tsari na huda thoracic
1. Umurci majiyyaci ya hau kujerar da ke fuskantar bayan kujera, sannan ya dora hannayen gaba biyu a bayan kujera, sannan ya jingina goshinsa a goshinsa.Wadanda ba za su iya tashi ba za su iya ɗaukar matsayi na rabin zama, kuma an tayar da goshin da ya shafa akan matashin kai.
2. Za a zaɓi wurin huda a mafi ƙaran ɓangaren sautin bugun ƙirji.Lokacin da akwai ruwa mai yawa, layin scapular ko 7th ~ 8th intercostal sarari na layin axillary na baya yawanci ana ɗauka;Wani lokaci sararin intercostal na 6 zuwa na 7 na layin midaxillary ko 5th intercostal sarari na layin axillary na gaba kuma ana zaɓin wuraren huda.Za'a iya ƙayyade zubar da jini ta hanyar X-ray ko jarrabawar ultrasonic.An sanya alamar huda a fata tare da swab auduga da aka tsoma a cikin methyl violet (genian violet).
3. Kashe fata akai-akai, sanya safar hannu mara kyau, sannan a rufe tawul ɗin ramin rigakafin.
4. Yi amfani da lidocaine 2% don yin maganin sa barci na gida daga fata zuwa bangon ɗigon ruwa a wurin huda a saman gefen haƙarƙarin ƙasa.
5. Mai aiki yana gyara fatar wurin huda da yatsan hannun hagu da yatsa na tsakiya, yana juya zakarin allurar huda mai fuska uku zuwa wurin da aka rufe kirji da hannun dama, sannan a hankali. huda allurar huda cikin wurin maganin sa barci.Lokacin da juriya na titin allura ya ɓace ba zato ba tsammani, juya zakara ta hanyoyi uku don haɗa shi da ƙirji don cirewar ruwa.Mataimakin yana amfani da karfin jini na jini don taimakawa gyara allurar huda don hana ƙwayar huhu lalacewa ta hanyar shiga sosai.Bayan sirinji ya cika, kunna bawul ɗin hanya uku don haɗa shi da duniyar waje sannan a fitar da ruwan.
6. A ƙarshen hakar ruwa, fitar da allurar huda, rufe shi da gauze mara kyau, danna shi da ɗan ƙaramin ƙarfi na ɗan lokaci, gyara shi tare da tef ɗin m kuma tambayi mara lafiya ya kwanta har yanzu.
Lokacin aikawa: Oktoba-20-2022
