Bututun zama na thoracic - rufaffiyar magudanar thoracic
1 Alamu
1. Babban adadin pneumothorax, bude pneumothorax, tashin hankali pneumothorax, pneumothorax yana zalunci numfashi (yawanci lokacin da ƙwayar huhu na pneumothorax unilateral ya fi 50%).
2. Thoracocentesis a cikin maganin ƙananan pneumothorax
3. Pneumothorax da hemopneumothorax suna buƙatar iskar inji ko na wucin gadi
4. Maimaituwar pneumothorax ko hemopneumothorax bayan cire bututun magudanar ruwa na thoracic.
5. Traumatic hemopneumothorax yana shafar ayyukan numfashi da na jini.
2 Shiri
1. Matsayi
Zama ko matsakaicin matsayi
Mai haƙuri yana cikin rabin kwance (idan alamun mahimmanci ba su da kwanciyar hankali, mai haƙuri yana cikin kwancen kwance).
2. Zaɓi wurin
1) Zaɓin sararin intercostal na biyu na layin clavicular na tsakiya don magudanar ruwa na pneumothorax.
2) An zaɓi zubar da jini tsakanin tsakiyar layin axillary da layin axillary na baya, kuma tsakanin 6th da 7th intercostals.
3. Disinfection
Maganin fata na yau da kullun, diamita 15, 3 aidin 3 barasa
4. maganin sa barcin cikin gida
Intramuscularly allura na phenobarbital sodium 0 lg.
Kutsawa cikin gida na Layer na shirye-shiryen bangon kirji a cikin yankin incision na maganin sa barci zuwa pleura;Yanke fata 2cm tare da layin intercostal, ƙara ƙarfin jijiyoyi tare da gefen babba na haƙarƙari, kuma raba sassan tsoka na intercostal zuwa kirji;Za a sanya bututun magudanar ruwa nan da nan lokacin da ruwa ya fito.Zurfin magudanar ruwa a cikin ramin ƙirjin kada ya wuce 4 ~ 5cm.Ya kamata a suture fatar jikin bangon ƙirji da zaren siliki mai matsakaicin girman, a haɗa bututun magudanar ruwa kuma a gyara shi, kuma a rufe shi da gauze mara kyau;A wajen gauze, kunsa dogon tef a kusa da bututun magudanar ruwa sannan a liƙa a bangon ƙirji.An haɗa ƙarshen bututun magudanar ruwa zuwa bututun roba na disinfection zuwa kwalban da aka haɗe da ruwa, kuma bututun roba da aka haɗa da kwalban da aka rufe da ruwa yana daidaitawa akan saman gadon tare da tef ɗin m.Ana sanya kwalbar magudanar ruwa a ƙarƙashin gadon asibiti inda ba shi da sauƙi a durƙusa ƙasa.
3 Intubation
1. Ciwon fata
.
3. Ramin gefen bututun magudanar ruwa ya kamata ya zama 2-3cm mai zurfi a cikin rami na kirji
4 Hattara
1. Idan akwai babban hematocele (ko effusion), ya kamata a kula da hawan jini a hankali yayin zubar da ruwa na farko don hana majiyyaci daga firgita kwatsam ko rushewa.Idan ya cancanta, yakamata a ci gaba da sakin hawan jini don guje wa haɗari kwatsam.
2. Kula da kiyaye bututun magudanar ruwa ba tare da matsi ko murdiya ba.
3. Taimakawa majiyyaci don canza matsayi da kyau a kowace rana, ko ƙarfafa majiyyaci ya yi zurfin numfashi don samun cikakkiyar magudanar ruwa.
4. Yi rikodin ƙarar magudanar ruwa na yau da kullun (ƙarar magudanar ruwa a cikin sa'a ɗaya a farkon matakin bayan rauni) da canje-canjen kaddarorinsa, kuma gudanar da gwajin fluoroscopy na X-ray ko duban fim kamar yadda ya dace.
5. Lokacin maye gurbin kwalban da aka rufe bakararre, za a toshe bututun magudanar ruwa na ɗan lokaci kaɗan, sa'an nan kuma za a sake sakin bututun magudanar ruwa bayan maye gurbin don hana iska daga tsotsewa ta hanyar mummunan matsi na ƙirji.
6. Domin kawar da kamuwa da cuta na biyu, ana iya yin al'adar ƙwayoyin cuta da gwajin jiyya na magudanar ruwa idan an canza kaddarorin ruwan magudanar ruwa.
7. Lokacin fitar da bututun magudanar ruwa, yakamata a fara goge fatar da ke kusa da abin da aka yanka, a cire tsayayyen sut ɗin, a matse bututun magudanar ruwa kusa da bangon ƙirji da ƙarfin jijiyoyin jini, sannan a rufe magudanar buɗaɗɗen da 12 ~ Yadudduka 16 na gauze da 2 yadudduka na gauze na Vaseline (ciki har da ɗan ƙaramin vaseline an fi so).Mai aiki ya kamata ya riƙe gauze da hannu ɗaya, ya riƙe bututun magudanar ruwa da ɗayan hannun, sannan a cire shi da sauri.An rufe gauze a buɗe magudanar ruwa gaba ɗaya akan bangon ƙirji tare da babban tef ɗin mannewa wanda yanki ya wuce gauze, kuma ana iya canza suturar bayan sa'o'i 48 ~ 72.
5 Jinyar bayan tiyata
Bayan an yi aiki, bututun magudanar ruwa yakan cika cikawa don kiyaye lumen ba tare da toshewa ba.Ana yin rikodin kwararar magudanar ruwa kowace awa ko awa 24.Bayan magudanar ruwa, huhu yana fadada da kyau, kuma babu iskar gas ko ruwa.Ana iya cire bututun magudanar ruwa lokacin da majiyyaci ya numfasa sosai, kuma ana iya rufe raunin da gauze na vaseline da tef ɗin m.
Lokacin aikawa: Juni-10-2022
