Monga tonse tikudziwa, chida chotaya thoracentesis ndicho chida chachikulu cha thoracentesis.Kodi tiyenera kudziwa chiyani za thoracentesis?
Zizindikiro zaMatenda a thoracocentesis
1. Kutupa kwa matenda pachifuwa omwe akuganiziridwa kuti ndi hemopneumothorax, yomwe ikufunika kumveketsa bwino;Mkhalidwe wa pleural effusion sunadziwike, ndipo pleural effusion iyenera kubayidwa kuti iunikenso ma laboratory.
2. Pamene kuchuluka kwa pleural effusion (kapena hematocele) ndi punctured achire, amene amakhudza kupuma ndi kuzungulira kwa ntchito, ndipo sanayenerere thoracic ngalande, kapena pneumothorax zimakhudza kupuma ntchito.
Thoracocentesis njira
1. Wodwala amakhala pampando mobwerera m'mbuyo, mkono wathanzi kumbuyo kwa mpando, mutu pa mkono, ndi nsonga yakumtunda yomwe yakhudzidwa ikukwera pamwamba pamutu;Kapena tengani theka lakugona, mbali yomwe yakhudzidwa m'mwamba ndipo mkono wokhudzidwawo ukukwera pamwamba pamutu, kotero kuti intercosts ndi yotseguka.
2. Kuwombera ndi kukhetsa madzi kumayenera kuchitidwa pamtunda wolimba wa phokoso, kawirikawiri mu 7th mpaka 8th intercostal space of subscapular angle, kapena mu 5th mpaka 6th intercostal space of the midaxillary line.Malo opumira a ecapsulated effusion ayenera kupezeka molingana ndi X-ray fluoroscopy kapena akupanga kafukufuku.
3. Pneumothorax aspirates, kawirikawiri mu semi recumbent position, ndipo mphete yoboola mphete ili pamzere wa midclavicular pakati pa 2nd ndi 3 intercostals, kapena kutsogolo kwa armpit pakati pa 4th ndi 5th intercostals.
4. Wogwira ntchitoyo ayenera kuchita opaleshoni ya aseptic mosamalitsa, kuvala chigoba, kapu ndi magolovesi a aseptic, nthawi zonse mankhwala ophera tizilombo pakhungu ndi tincture wa ayodini ndi mowa, ndikuyala thaulo la opaleshoni.Local anesthesia iyenera kulowa mu pleura.
5. Singano iyenera kulowetsedwa pang'onopang'ono m'mphepete mwa nthiti yotsatira, ndipo chubu cha latex cholumikizidwa ndi singano chiyenera kumangidwa ndi hemostatic forceps poyamba.Pamene kudutsa parietal pleura ndi kulowa thoracic patsekeke, inu mukhoza kumva "lingaliro la kugwa" kuti singano nsonga amakana kuzimiririka mwadzidzidzi, ndiye kulumikiza syringe, kumasula hemostatic forceps pa latex chubu, ndiyeno mukhoza kupopa madzimadzi. kapena mpweya (pamene mukupopera mpweya, mungathenso kugwirizanitsa chipangizo chopangira pneumothorax pamene chitsimikiziridwa kuti pneumothorax imaponyedwa kunja, ndikuchita kupopera kosalekeza).
6. Pambuyo pochotsa madzimadzi, tulutsani singano yoboola, dinani 1 ~ 3nin ndi yopyapyala yopyapyala pabowo la singano, ndikuyikonza ndi tepi yomatira.Funsani wodwalayo kuti akhale pabedi.
7. Odwala kwambiri akabayidwa, nthawi zambiri amatenga malo athyathyathya, ndipo sayenera kusuntha thupi lawo kwambiri kuti lipume.
Njira Zopewera za Thoracocentesis
1. Kuchuluka kwa madzimadzi omwe amakokedwa ndi puncture kuti adziwe matenda nthawi zambiri amakhala 50-100ml;Pofuna kuchepetsa, sayenera kupitirira 600ml kwa nthawi yoyamba ndi 1000ml nthawi iliyonse pambuyo pake.Pa zoopsa hemothorax puncture, izo m`pofunika kumasula anasonkhanitsa magazi nthawi yomweyo, kulabadira kuthamanga kwa magazi nthawi iliyonse, ndi kufulumizitsa kuikidwa magazi ndi kulowetsedwa kupewa mwadzidzidzi kupuma ndi kuzungulira kwa kukanika kapena mantha pa m`zigawo za madzimadzi.
2. Panthawi yopuma, wodwalayo ayenera kupewa kutsokomola ndi kuzungulira kwa thupi.Ngati ndi kotheka, codeine ikhoza kutengedwa poyamba.Pakakhala chifuwa chosalekeza kapena chifuwa cholimba, chizungulire, thukuta lozizira ndi zizindikiro zina za kukomoka panthawi ya opaleshoni, kuchotsa madzimadzi kuyenera kuyimitsidwa nthawi yomweyo, ndipo adrenaline ayenera kubayidwa pansi pa khungu ngati kuli kofunikira.
3. Pambuyo pa pleural puncture ya madzimadzi ndi pneumothorax, kuwonetsetsa kwachipatala kuyenera kupitilizidwa.The pleural fluid ndi mpweya ukhoza kuwonjezekanso maola angapo kapena tsiku limodzi kapena awiri pambuyo pake, ndipo puncture ikhoza kubwerezedwa ngati kuli kofunikira.
Nthawi yotumiza: Oct-25-2022
