Timagwiritsa ntchito singano zosawilitsidwa kubaya khungu, minofu ya intercostal ndi pleura ya parietal mu pleural cavity, yomwe imatchedwa.kupweteka pachifuwa.
N'chifukwa chiyani mukufuna puncture pachifuwa?Choyamba, tiyenera kudziwa udindo wa thoracic puncture mu matenda ndi kuchiza matenda a thoracic.Thoracocentesis ndi njira yodziwika bwino, yosavuta komanso yosavuta yodziwira matenda ndi chithandizo pachipatala cha dipatimenti ya pulmonary.Mwachitsanzo, pofufuza, tinapeza kuti wodwalayo anali ndi pleural effusion.Tikhoza kukoka madzimadzi kudzera pleural puncture ndi kuchita mayeso osiyanasiyana kupeza chomwe chimayambitsa matenda.Ngati pali madzimadzi ambiri patsekeke, amene compresses m'mapapo kapena amaunjikira madzimadzi kwa nthawi yaitali, fibrin mmenemo n'zosavuta bungwe ndi chifukwa zigawo ziwiri za pleural adhesion, amene amakhudza kupuma ntchito m'mapapo.Panthawi imeneyi, tiyeneranso puncture kuchotsa madzimadzi.Ngati ndi kotheka, mankhwala amathanso kubayidwa kuti akwaniritse cholinga cha chithandizo.Ngati pleural effusion imayambitsidwa ndi khansa, timabaya mankhwala oletsa khansa kuti agwire ntchito yolimbana ndi khansa.Ngati pachifuwa pali mpweya wochuluka, ndipo pleural cavity yasintha kuchoka ku kupanikizika koipa kupita ku mphamvu yabwino, ndiye kuti opaleshoniyi ingagwiritsidwenso ntchito kuchepetsa kupanikizika ndikuchotsa mpweya.Ngati bronchus wodwala chikugwirizana ndi pleural patsekeke, tikhoza kubaya mankhwala buluu (otchedwa methylene buluu, amene alibe vuto lililonse kwa thupi la munthu) mu chifuwa kudzera puncture singano.Ndiye wodwalayo akhoza kutsokomola madzi a buluu (kuphatikizapo sputum) pamene akutsokomola, ndiyeno tikhoza kutsimikizira kuti wodwalayo ali ndi fistula ya bronchopleural.Bronchopleural fistula ndi njira ya pathological yomwe idakhazikitsidwa chifukwa chokhudzidwa ndi zotupa zam'mapapo mu bronchi, alveoli ndi pleura.Ndi njira yochokera pakamwa kupita ku trachea kupita ku bronchi pamilingo yonse kupita ku alveoli kupita ku visceral pleura kupita ku pleural cavity.
Kodi muyenera kuyang'ana chiyani mu puncture ya thoracic?
Pankhani ya puncture ya thoracic, odwala ambiri amakhala ndi mantha nthawi zonse.Sizophweka kuvomereza ngati singano ikugunda matako, koma imaboola pachifuwa.M’chifuwa muli mitima ndi mapapo, zimene sizingathandize koma kuchita mantha.Kodi tiyenera kuchita chiyani ngati singano yabowoledwa, kodi idzakhala yowopsa, ndipo kodi madokotala ayenera kulabadira chiyani?Tiyenera kudziwa zomwe odwala ayenera kulabadira komanso momwe angagwirire ntchito bwino.Malinga ndi njira zogwirira ntchito, pali pafupifupi palibe ngozi.Choncho, timakhulupirira kuti thoracocentesis ndi yotetezeka popanda mantha.
Kodi woyendetsa ayenera kulabadira chiyani?Aliyense wa madokotala athu ayenera kumvetsetsa bwino zizindikiro ndi zofunikira za opaleshoni ya thoracic puncture.Tikumbukenso kuti singano ayenera anaikapo m'mphepete kumtunda kwa nthiti, ndipo osati pa m'mphepete m'munsi mwa nthiti, apo ayi mitsempha ya magazi ndi mitsempha m'mphepete m'munsi mwa nthiti adzavulala molakwa.Kupha tizilombo toyambitsa matenda kumayenera kuchitidwa mosamala.Opaleshoniyo iyenera kukhala yosabala.Ntchito ya wodwalayo iyenera kuchitidwa bwino kuti asade nkhawa komanso amanjenje.Kugwirizana kwapafupi ndi dokotala kuyenera kupezeka.Pamene kulandira opareshoni, kusintha kwa wodwalayo ayenera kuonedwa nthawi iliyonse, monga chifuwa, wotumbululuka nkhope, thukuta, palpitations, syncope, etc. Ngati ndi kotheka, kusiya ntchito ndipo nthawi yomweyo kugona pabedi kupulumutsidwa.
Kodi odwala ayenera kulabadira chiyani?Choyamba, odwala ayenera kukhala okonzeka kugwira ntchito limodzi ndi madokotala kuti athetse mantha, nkhawa ndi kupsinjika maganizo.Chachiwiri, odwala sayenera kutsokomola.Azikhala pabedi pasadakhale.Ngati sakumva bwino, afotokozere dokotala kuti adziwe zoyenera kuchita kapena kuyimitsa opaleshoniyo.Chachitatu, muyenera kugona kwa maola awiri pambuyo pa thoracentesis.
Pochiza pneumothorax zomwe zatchulidwa mu gawo ladzidzidzi la dipatimenti ya m'mapapo, ngati tikumana ndi wodwala pneumothorax, kupanikizika kwa mapapo sikovuta kwambiri ndipo kupuma sikovuta pambuyo poyang'anitsitsa.Pambuyo poyang'ana, mapapo sapitiriza kukakamizidwa, ndiko kuti, mpweya wa m'chifuwa suwonjezeka.Odwala otere sangalandire chithandizo ndi puncture, intubation ndi drainage.Malingana ngati singano yokhuthala pang'ono imagwiritsidwa ntchito poboola, kuchotsa mpweya, ndipo nthawi zina mobwerezabwereza kangapo, mapapo amakulanso, zomwe zidzakwaniritsanso cholinga cha chithandizo.
Pomaliza, ndikufuna kunena za kubowola m'mapapo.M'malo mwake, kupuma kwa mapapo ndiko kulowa kwa thoracic puncture.Singano imabowoleredwa m'mapapo kudzera pa pleural cavity ndi kudzera mu visceral pleura.Palinso zolinga ziwiri.Iwo makamaka kuchititsa biopsy wa m'mapapo parenchyma, kupendanso madzimadzi mu patsekeke ya aspiration patsekeke kapena bronchial chubu kuti adziwe bwinobwino matenda, ndiyeno kuchiza matenda ena kudzera m'mapapo puncture, monga aspirating mafinya ena cavities. opanda ngalande, ndi kubaya mankhwala pakufunika kukwaniritsa cholinga cha mankhwala.Komabe, zofunika pakubowola mapapu ndizokwera.Opaleshoniyo iyenera kukhala yosamala, yosamala komanso yachangu.Nthawiyo ifupikitsidwe momwe ndingathere.Wodwalayo ayenera kugwirizana kwambiri.Kupuma kuyenera kukhala kokhazikika, ndipo musalole kutsokomola.Asanayambe puncture, wodwalayo ayenera kuyesedwa mwatsatanetsatane, kuti adokotala azitha kupeza bwino ndikuwongolera bwino kwa puncture.
Choncho, malinga ngati madokotala akutsatira ndondomeko ya opaleshoniyo ndi kuchita opaleshoni mosamala, odwalawo amathetsa mantha awo ndi kugwirizana kwambiri ndi madokotala.Kuphulika kwa thoracic ndikotetezeka kwambiri, ndipo palibe chifukwa choopa.
Nthawi yotumiza: Oct-18-2022
