Ngosipụta nke mgbapu thoracic
Iji dokwuo anya ọdịdị nke nfụkasị ahụ, a ga-eme nyocha nke pleural puncture na nyocha agụụ iji nyere aka nyocha;Mgbe enwere oke mmiri ma ọ bụ mkpokọta gas na-akpata mgbaàmà mkpakọ nku ume, na ndị ọrịa pyothorax kwesịrị ịgbanye mmiri mmiri maka ọgwụgwọ;A ghaghị ịgbanye ọgwụ n'ime oghere obi.
Contraindications nkethoracic mgbapu
(1) Ebe mgbapu nwere mbufụt, etuto na trauma.
(2) A na-enwekarị ọbara ọgbụgba siri ike, pneumothorax na-akpaghị aka, nnukwu mkpụkọ ọbara, ụkwara nta nke akpa ume siri ike, emphysema, wdg.
Akpachara anya maka mgbamgba akwara
(1) Ndị ọrịa nwere nkwarụ coagulation, ọrịa na-agba ọbara na ndị na-aṅụ ọgwụ mgbochi ọrịa kwesịrị ka a gwọọ ha nke ọma tupu ịwa ahụ.
(2) Ekwesịrị ịgbanye mgbamgba n'ọkpụkpụ n'ọnụ iji gbochie ujo pleural.
(3) Ekwesịrị ịgbanye mgbamgba ahụ nso na nsọtụ elu nke ọgịrịga ka ọ ghara imerụ arịa ọbara intercostal na irighiri akwara.A ga-edobe agịga, tube latex ma ọ bụ mgba ọkụ ụzọ atọ, cylinder agịga, wdg iji gbochie ikuku ịbanye n'ime obi ma mee ka pneumothorax.
(4) Ọkpụkpụ kwesịrị ịkpachara anya, usoro ahụ kwesịrị ịbụ nka, yana ịgbasa ọrịa ahụ kwesịrị ịkpachara anya iji zere ibute ọrịa ọhụrụ, pneumothorax, hemothorax ma ọ bụ mmerụ ahụ na mberede na arịa ọbara, obi, imeju na splin.
(5) E kwesịrị izere ụkwara n'oge a na-agbapụta ya.Lelee mgbanwe onye ọrịa n'oge ọ bụla.N'ihe banyere ihu charọt, ọsụsọ, isi ọwụwa, obi mgbawa na obi adịghị ike, a ga-akwụsị nsị ozugbo.Kwe ka onye ọrịa dinara ala, kukuo oxygen mgbe ọ dị mkpa, ma gbanye adrenaline ma ọ bụ sodium benzoate na caffeine subcutaneously.Na mgbakwunye, a ga-eme ọgwụgwọ kwekọrọ na ọnọdụ ahụ.
(6) A ghaghị ịgbanye mmiri ahụ nwayọ.Ọ bụrụ na a ga-agbanye nnukwu mmiri mmiri n'ihi ọgwụgwọ, a ga-ejikọta mgbanaka ụzọ atọ n'azụ agịga nkwụsị.Mmiri ahụ ekwesịghị ịfesa nke ukwuu maka ọgwụgwọ.Ọ bụrụ na ọ dị mkpa, enwere ike ịgbanye ya ọtụtụ ugboro.Ọnụ ego mmiri a na-agbapụta maka oge mbụ agaghị agafe 600ml, na ọnụ ọgụgụ mmiri a na-agbapụta maka oge ọ bụla ga-abụ ihe dịka 1000ml.
(7) Ọ bụrụ na amịpụtara mmiri na-agba ọbara, kwụsị ịbịaru ozugbo.
(8) Mgbe ọ dị mkpa ịgbanye ọgwụ n'ime oghere obi, jikọta sirinji a kwadebere nke nwere mmiri mmiri ọgwụ ahụ mgbe ọ gbasasịrị, gwakọta ntakịrị mmiri mmiri ahụ na mmiri ọgwụ ahụ, gbanye ọzọ iji hụ na agbaba ya n'ime igbe. oghere
Kedu ka esi ahọrọ ebe nkwụsị nke thoracic?
(1) Ọkpụkpụ thoracic na drainage: nzọụkwụ mbụ bụ ịme ụda n'ime obi, wee họrọ akụkụ ahụ nwere ụda siri ike doro anya maka nkwụsịtụ, nke enwere ike ịchọta ya na X-ray na B-ultrasound.Enwere ike iji akara ntu ntu na akpụkpọ ahụ na violet ntu, a na-ahọrọkarị ya dị ka ndị a: 7 ~ 9 ahịrị intercostal nke akụkụ subscapular;7-8 intercostals nke eriri axillary azụ;6 ~ 7 intercostals nke ahịrị midaxillary;N'ihu axillary bụ 5-6 ribs.
(2) Encapsulated pleural effusion: puncture nwere ike rụrụ na Nchikota X-ray na ultrasonic localization.
(3) Pneumothorax decompression: oghere intercostal nke abụọ na ahịrị midclavicular ma ọ bụ oghere intercostal 4-5 na ahịrị midaxillary nke akụkụ ahụ emetụtara na-ahọrọkarị.N'ihi na irighiri akwara intercostal na akwara na veins na-aga n'akụkụ ala nke ọgịrịga ahụ, a ga-ekenye ha site na nsọtụ elu nke ọgịrịga ahụ ka ọ ghara imebi irighiri akwara na arịa ọbara.
Usoro dum nke nkwụsị thoracic
1. Gwa onye ọrịa ka o were oche chere ihu n'azụ oche, tinye aka abụọ n'azụ oche, ma dabere n'egedege ihu n'ihu.Ndị na-enweghị ike ibili nwere ike na-a ọkara ọdụ ọnọdụ, na-emetụta forearm na-ebuli na ohiri isi.
2. A ga-ahọrọ ebe mgbaba n'akụkụ kacha pụta ìhè nke ụda ụda obi.Mgbe enwere mmiri mmiri dị ukwuu, a na-ejikarị eriri scapular ma ọ bụ 7th ~ 8th intercostal oghere nke azụ axillary akara;Mgbe ụfọdụ, a na-ahọrọ oghere intercostal nke isii ruo nke asaa nke ahịrị midaxillary ma ọ bụ 5th intercostal oghere nke ahịrị axillary n'ihu dị ka ebe ntụpọ.Enwere ike ikpebi mmịpụta mkpuchi mkpuchi site na nyocha X-ray ma ọ bụ ultrasonic.A na-eji owu swab tinye n'ime methyl violet (gentian violet) akara ebe ntụpọ ahụ na akpụkpọ ahụ.
3. Na-asachapụ akpụkpọ ahụ mgbe niile, yiri uwe aka na-adịghị mma, ma kpuchie akwa nhicha ahụ.
4. Jiri 2% lidocaine rụọ ọrụ mgbakasị infiltration mpaghara site na akpụkpọ ahụ ruo na mgbidi pleural na ebe ntụpọ dị na nsọtụ elu nke ọgịrịga ala.
5. Onye na-arụ ọrụ na-eji mkpịsị aka aka ekpe na mkpịsị aka etiti na-edozi akpụkpọ anụ nke ebe nkwụsị ahụ, na-atụgharị ọkpụkpụ ụzọ atọ nke agịga ahụ n'ebe a na-eji aka nri mechie igbe ahụ, wee jiri nwayọọ nwayọọ na-atụgharị. na-adụpu agịga ahụ n'ime ebe mgbanwụ ahụ.Mgbe nguzogide nke n'ọnụ agịga na-apụ na mberede, tụgharịa nkuku ụzọ atọ iji mee ka ọ jikọọ na igbe maka mmịpụta mmiri.Onye nnyemaaka na-eji ike hemostatic iji nyere aka dozie agịga mgbapu iji gbochie anụ ahụ ngụgụ mebie site na ịbanye nke ukwuu.Mgbe sirinji zuru ezu, tụgharịa valvụ ụzọ atọ iji jikọọ ya na ụwa dị n'èzí wee wepụ mmiri mmiri ahụ.
6. Na njedebe nke mmịpụta mmiri, wepụ agịga ntụpọ ahụ, kpuchie ya na gauze na-adịghị mma, pịa ya na obere ike maka oge, dozie ya na teepu ntanye ma rịọ onye ọrịa ka ọ dinara ala.
Oge nzipu: Ọktoba 20-2022
