Te ngongo noho i roto i te kopu - katia te whakaheke wai
1 Tohutohu
1. Ko te nui o te pneumothorax, pneumothorax tuwhera, tension pneumothorax, pneumothorax ka pehia te manawa (i te nuinga o te waa ka neke ake i te 50%) te paheketanga o te huhu o te pneumothorax unilateral.
2. Thoracocentesis i roto i te maimoatanga o te pneumothorax raro
3. Pneumothorax me te hemopneumothorax e hiahia ana ki te whakamahana miihini, ki te hau hangai ranei
4. Pneumothorax auau, hemopneumothorax ranei i muri i te tangohanga o te ngongo wairere thoracic
5. Ko te hemopneumothorax mamae e pa ana ki nga mahi rewharewha me te rere toto.
2 Te faaineineraa
1. Turanga
Te noho, te noho takahanga ranei
Ko te tūroro kei te haurua te noho takoto (mehemea karekau nga tohu ora i tau, kei te noho takoto te manawanui).
2. Tikina te pae
1) Te kowhiringa o te rua o nga waahi intercostal o te raina clavicular waenga mo te wai rere pneumothorax
2) I whiriwhiria te pupuhi o te pleural i waenga i te raina waenga axillary me te raina axillary o muri, a i waenganui i te 6th me te 7th intercostals
3. Whakakorenga mate
Ko te whakakino kiri, te diameter 15, 3 iodine 3 te waipiro
4. Aromatawai whakaurunga rohe
Ko te werohanga o te konutai phenobarbital 0 lg.
Ko te whakaurunga a-rohe o te paparanga whakareri pakitara pouaka i roto i te waahi werohanga rewharewha ki te pleura;Tapahia te kiri kia 2cm te taha o te raina i waenga i te taha, whakaroahia nga maru ngongo ki te taha o runga o nga riu, ka wehea nga papaa uaua intercostal ki te uma;Me tuu tonu te ngongo wai ka puta te wai.Ko te hohonu o te ngongo whakaheke ki roto i te kohao pouaka kaua e neke ake i te 4 ~ 5cm.Me tuituia te kiri o te pakitara o te pouaka ki te miro hiraka reo-rahi, ka herea te ngongo whakaheke wai, ka whakakikoruatia, ka hipoki ki te karaehe horomata;I waho o te kakano, takai he rīpene roa huri noa i te ngongo whakaheke wai ka whakapiri ki te pakitara o te uma.Ko te pito o te ngongo wai e hono ana ki te ngongo rapa roa whakakino ki te pounamu hiri wai, a ko te ngongo rapa e hono ana ki te pounamu hiri wai ka mau ki runga i te mata o te moenga me te riipene piri.Ka whakatakotoria te pounamu waikeri ki raro i te moenga o te hōhipera e kore e ngawari ki te turaki.
3 Whakanuia
1. Te tapahi kiri
2. Ko te wehenga puhoi o te paparanga uaua me te tuunga o te ngongo whakaheke toto me te kohao taha ki te taha o runga o te rara.
3. Me 2-3cm te hohonu o te kohao taha o te ngongo wairere ki roto i te kohao pouaka
4 Whakatupato
1. Mena he nui te hematocele (he whakaheke ranei), me ata tirotirohia te pehanga toto i te wa e rere ana te wai tuatahi kia kore ai te manawanui e oho ohorere, ka hinga ranei.Mena e tika ana, me tuku tonu te pehanga toto kia kore ai e raru ohorere.
2. Kia tupato ki te pupuri i te ngongo wairere kia kore e araia kia kore he pehanga, he korikori ranei.
3. Awhina i te manawanui ki te whakarereke tika i te tuunga ia ra, ki te akiaki ranei i te manawanui ki te tango i te manawa hohonu kia pai ai te rere o te wai.
4. Tuhia te rōrahi wairere o ia rā (te rōrahi wairere ia hāora i te wā tōmua i muri i te wharanga) me ngā panonitanga o ōna āhuatanga, me te whakahaere X-ray fluoroscopy, kiriata anō rānei ina tika.
5. I te wa e whakakapihia ana te pounamu kua hirihia te wai, me kati te ngongo whakaheke i te tuatahi, katahi ka tukuna ano te ngongo wai i muri i te whakakapinga kia kore ai te hau e ngotea e te pehanga kino o te pouaka.
6. Hei whakakore i te mate tuarua, ka taea te whakahaere i te ahurea kitakita me te whakamohiotanga o nga raau taero o te wai whakaheke mena ka whakarereketia nga ahuatanga o te wai.
7. I te wa e toia ana te ngongo wai, me whakakorehia te kiri huri noa i te wehenga tuatahi, me tango te hiku kua whakaritea, me awhi te ngongo wai e tata ana ki te pakitara o te pouaka ki te maru vascular, me hipoki te whakatuwheratanga o te wai ki te 12 ~ 16 nga papa o te whariki me te 2 nga paparanga o te Vaseline kawa (tae atu ki te whaanui ka pai ake).Me pupuri te kaikawe ki tetahi ringa, ka mau ki tetahi atu ringa te ngongo wai, ka tere toia ki waho.Ko te whariki i te whakatuwheratanga wai i hiri katoatia ki te pakitara o te pouaka me te riipene whakapiri nui atu te rohe ki te karaehe, a ka taea te whakarereke i te kakahu i muri i te 48 ~ 72 haora.
5 Te mahi tapuhi
I muri i te mahi, he maha nga wa ka whakakiia te ngongo whakaheke kia kore ai e arai te lumen.Ka rekotia te rere wairere ia haora, 24 haora ranei.Whai muri i te whakaheke wai, ka kaha te tipu o te huhu, karekau he hau, he wai ranei.Ka taea te tango i te ngongo whakaheke wai i te wa e hoha hohonu ana te manawanui, ka taea te kati i te patunga ki te kaini vaseline me te riipene whakapiri.
Wā tuku: Hune-10-2022
