Nkuko twese tubizi, igikoresho cya thoracentez ni igikoresho cyingenzi cya thoracentezi.Ni iki twakagombye kumenya kuri thoracentezi?
Ibyerekana kuriThoracocentesis
1. Gupima indwara yo guhahamuka mu gatuza ukekwaho hemopneumothorax, ikeneye ibisobanuro birambuye;Imiterere ya pleural effusion ntiramenyekana, kandi effusion effusion igomba gucumita kugirango isuzumwe muri laboratoire.
2. Iyo umubare munini wa effusion effusion (cyangwa hematocele) wacumiswe mubuvuzi, bigira ingaruka kumikorere yubuhumekero no gutembera, kandi bikaba bitarujuje ibyangombwa byo kuvoma thoracic, cyangwa pneumothorax bigira ingaruka kumikorere yubuhumekero.
Uburyo bwa Thoracocentesis
1. Umurwayi yicaye ku ntebe yerekeza mu cyerekezo, hamwe n'ukuboko kwiza inyuma y'intebe, umutwe ku kuboko, hamwe n'ingingo yo hejuru yanduye yaguye hejuru y'umutwe;Cyangwa ufate igice cyigice cyo kuryama, hamwe uruhande rwafashwe hejuru hejuru hamwe nububoko bwuruhande rwafashwe hejuru hejuru yumutwe, kugirango intercost zifunguye.
2. Gutobora no gutemba bigomba gukorwa ku majwi akomeye ya percussion, muri rusange mu mwanya wa 7 kugeza ku wa 8 intera ihuza intera ya subcapular, cyangwa mu mwanya wa 5 kugeza ku wa 6 uhuza umurongo wa midaxillary.Ikibanza cyo gutobekamo effusion gikwiye kuba gihe ukurikije X-ray fluoroscopy cyangwa ibizamini bya ultrasonic.
3. Pneumothorax yifuza, muri rusange mu gice cya kabiri cyo kwisubiraho, kandi aho gutobora impeta biri ku murongo wa midclavicular hagati ya intercostale ya 2 n'iya 3, cyangwa imbere y'ukuboko hagati ya 4 na 5.
4. Umukoresha agomba gukora cyane ibikorwa bya aseptike, akambara mask, cap na gants ya aseptic, guhora yanduza uruhu ahacumita hamwe na tincure ya iyode n'inzoga, hanyuma agashyiraho igitambaro cyo kubaga.Anesthesi yaho igomba gucengera pleura.
5. Urushinge rugomba kwinjizwa buhoro buhoro kuruhande rwo hejuru rwurubavu rukurikira, hanyuma umuyoboro wa latex uhujwe nurushinge ugomba kubanza gufatanwa imbaraga za hemostatike.Iyo unyuze muri parietal pleura ukinjira mu cyuho cya thoracic, urashobora kumva "kumva ko kugwa" ko inshinge y'urushinge irwanya kubura gutunguranye, hanyuma ugahuza syringe, ukarekura imbaraga za hemostatike kumuyoboro wa latex, hanyuma urashobora kuvoma amazi cyangwa umwuka (mugihe cyo kuvoma umwuka, urashobora kandi guhuza igikoresho cya pneumothorax artificiel mugihe byemejwe ko pneumothorax yasohotse, kandi igakora pompe ikomeza).
6. Nyuma yo gukuramo amazi, kura urushinge rwacumita, kanda 1 ~ 3nin hamwe na gaze ya sterile kuri mwobo w'urushinge, hanyuma ubikosore hamwe na kaseti.Saba umurwayi kuguma mu buriri.
7. Iyo abarwayi barembye cyane bacumiswe, muri rusange bafata umwanya uhamye, kandi ntibagomba kwimura umubiri wabo cyane kugirango batobore.
Kwirinda Thoracocentesis
1. Ingano y'amazi yashushanijwe no gutobora kugirango isuzume muri rusange ni 50-100ml;Kugirango hagamijwe decompression, ntigomba kurenza 600ml kunshuro yambere na 1000ml kuri buri mwanya nyuma.Mugihe c'ihungabana rya hemothorax, ni byiza kurekura icyarimwe amaraso yegeranijwe icyarimwe, kwitondera umuvuduko wamaraso umwanya uwariwo wose, no kwihutisha guterwa amaraso no guterwa kugirango wirinde guhumeka gutunguranye no gutembera gutunguranye cyangwa guhungabana mugihe cyo gukuramo amazi.
2. Mugihe cyo gutobora, umurwayi agomba kwirinda gukorora no guhinduranya umubiri.Bibaye ngombwa, codeine irashobora gufatwa mbere.Mugihe habaye inkorora ikomeje cyangwa gukomera mu gatuza, kuzunguruka, ibyuya bikonje nibindi bimenyetso byo kugwa mugihe cyo kubaga, gukuramo amazi bigomba guhita bihagarikwa, kandi adrenaline igomba guterwa mu buryo bwihuse nibiba ngombwa.
3. Nyuma yo gutobora neza kwamazi na pneumothorax, gukomeza kwivuza bigomba gukomeza.Amazi meza na gaze birashobora kongera kwiyongera amasaha menshi cyangwa umunsi umwe cyangwa ibiri nyuma, kandi gucumita birashobora gusubirwamo nibiba ngombwa.
Igihe cyo kohereza: Ukwakira-25-2022
