Ibimenyetso byo gutobora thoracic
Kugirango dusobanure neza imiterere ya effusion effusion, hagomba gukorwa ibizamini byo kwinezeza no kwifuza kugirango bifashe gusuzuma;Iyo hari amazi menshi cyangwa kwirundanya kwa gaze bikavamo ibimenyetso byo guhagarika ibihaha, kandi abarwayi ba pyothorax bakeneye kuvoma amazi kugirango bavurwe;Ibiyobyabwenge bigomba guterwa mu cyuho.
KurwanyaThoracic
(1) Ikibanza cyo gutobora gifite umuriro, ikibyimba nihahamuka.
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Kwirinda Thoracic Gutobora
(1) Abarwayi bafite inenge ya coagulation, indwara ziva amaraso hamwe nabafata imiti igabanya ubukana bagomba kuvurwa uko bikwiye mbere yo kubagwa.
(2) Gutobora Thoracic bigomba gutera aneste byuzuye kugirango birinde guhungabana.
.Urushinge, umuyoboro wa latex cyangwa inzira eshatu, silinderi y'urushinge, nibindi bigomba guhagarikwa kugirango umwuka winjire mu gituza kandi uteze pneumothorax.
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(5) Inkorora igomba kwirindwa mugihe cyo gutobora.Itegereze impinduka z'umurwayi igihe icyo aricyo cyose.Iyo mu maso hahindutse, kubira ibyuya, kuzunguruka, guhinda umushyitsi no guhungabana, gucumita bigomba guhita bihagarikwa.Reka umurwayi aryame neza, ahumeka ogisijeni mugihe bibaye ngombwa, hanyuma atere adrenaline cyangwa sodium benzoate na cafine munsi.Byongeye kandi, ubuvuzi bujyanye nabwo bugomba gukorwa hakurikijwe imiterere.
(6) Amazi agomba kuvoma buhoro.Niba amazi menshi agomba kuvomwa kubera kuvurwa, inzira-nzira eshatu igomba guhuzwa inyuma y'urushinge rwacumita.Amazi ntagomba gutwarwa cyane kugirango avurwe.Bibaye ngombwa, irashobora kuvomwa inshuro nyinshi.Umubare w'amazi yavomwe bwa mbere ntushobora kurenga 600ml, kandi umubare w'amazi yavomwe kuri buri mwanya nyuma yaho uzaba hafi 1000ml.
(7) Niba havuyemo amazi ava, hagarika gushushanya ako kanya.
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Nigute ushobora guhitamo thoracic puncture umwanya uhagaze?
.Ingingo yo gutobora irashobora gushyirwaho ikimenyetso kuruhu hamwe na violet yimisumari, kandi akenshi itoranywa kuburyo bukurikira: 7 ~ 9 imirongo ihuza imirongo ya subcapular;7-8 intercostal yumurongo winyuma;6 ~ 7 intercostal yumurongo wa midaxillary;Imbere ya axillary ni imbavu 5-6.
(2) Encapsulated pleural effusion: puncture irashobora gukorwa ifatanije na X-ray na ultrasonic localisation.
.Kubera ko imitsi ya intercostal na arterière na veine bigenda bikikije inkombe yo hepfo yurubavu, bigomba gutoborwa mu gice cyo hejuru cyurubavu kugirango birinde kwangiza imitsi nimiyoboro yamaraso.
Inzira yose yo gutobora thoracic
1. Tegeka umurwayi gufata intebe ireba inyuma yintebe, shyira amaboko yombi inyuma yintebe, hanyuma ushingire agahanga ku kuboko.Abadashobora guhaguruka barashobora gufata kimwe cya kabiri cyo kwicara, kandi ukuboko kwanduye kuzamuye umusego.
2. Ingingo yo gutobora igomba gutoranywa mugice kigaragara cyijwi ryigituza.Iyo hari amazi menshi yishimye, umurongo wa scapular cyangwa umwanya wa 7 ~ 8 wa intercostal yumurongo winyuma winyuma ufatwa;Rimwe na rimwe, umwanya wa 6 kugeza ku wa 7 intercostal yumurongo wa midaxillary cyangwa umwanya wa 5 intercostal yumurongo wimbere wimbere nawo watoranijwe nkibice byacumita.Encapsulated effusion irashobora kugenwa na X-ray cyangwa ibizamini bya ultrasonic.Ingingo ya puncture irangwa kuruhu hamwe na pamba yometse muri methyl violet (gentian violet).
3. Burigihe kwanduza uruhu, kwambara uturindantoki twa sterile, no gupfuka igitambaro cyo kwanduza.
4. Koresha lidocaine 2% kugirango ukore anesthesi ya infiltration yaho kuva kuruhu kugeza kurukuta rwiza kuri point de puncture kuruhande rwo hejuru rwurubavu rwo hepfo.
5. Umukoresha atunganya uruhu rwurubuga rwacumita akoresheje urutoki rwerekana ikiganza cyibumoso nintoki yo hagati, ahindura inkoko yinzira eshatu zurushinge rwacumita aho igituza gifunze ukuboko kwiburyo, hanyuma buhoro buhoro atobora urushinge rwacumita ahantu anesteziya.Iyo kurwanya urushinge rw'urushinge bibuze gitunguranye, hindura isake yinzira eshatu kugirango ihuze nigituza kugirango ikuremo amazi.Umufasha akoresha imbaraga za hemostatike kugirango afashe gutunganya urushinge rwacumita kugirango wirinde ko ibihaha byangirika byinjira cyane.Siringe imaze kuzura, hinduranya inzira-eshatu kugirango uyihuze nisi yo hanze hanyuma usohore amazi.
6. Kurangiza gukuramo amazi, kura urushinge rwacumise, kurupfukirana na sterile sterile, kanda n'imbaraga nkeya mumwanya muto, ubikosore hamwe na kaseti ifata hanyuma usabe umurwayi kuryama acecetse.
Igihe cyo kohereza: Ukwakira-20-2022
