Umuyoboro wa Thoracic utuye - ufunze amazi ya thoracic
1 Ibyerekana
1. Umubare munini wa pneumothorax, pneumothorax ifunguye, pneumothorax ya tension, pneumothorax ikandamiza guhumeka (muri rusange iyo kwikuramo ibihaha bya pneumothorax birenze 50%).
2. Thoracocentezi mu kuvura pneumothorax yo hepfo
3. Pneumothorax na hemopneumothorax bisaba guhumeka cyangwa gukora artificiel
4. Indwara ya pneumothorax cyangwa hemopneumothorax nyuma yo gukuraho umuyoboro wamazi wa thoracic
5. Ihahamuka hemopneumothorax igira ingaruka kumikorere yubuhumekero no gutembera.
2 Kwitegura
1. Imyifatire
Umwanya wicaye cyangwa igice
Umurwayi ari muri kimwe cya kabiri kibeshya (niba ibimenyetso byingenzi bidahagaze neza, umurwayi aba ari muburyo bubeshya).
2. Tora urubuga
1) Guhitamo umwanya wa kabiri intercostal yumurongo wo hagati wa clavicular kumurongo wa pneumothorax
2) Pleural effusion yatoranijwe hagati yumurongo wa axillary hagati yumurongo winyuma, no hagati ya 6 na 7 intercostal
3. Kwanduza
Kurandura uruhu rwiza, diameter 15, 3 iyode 3 inzoga
4. Anesthesia yaho yinjira
Gutera inshinge za sodium ya fenobarbital 0 lg。
Kwinjira kwaho murwego rwo gutegura urukuta rwigitereko murwego rwo gutera anesteziya kuri pleura;Kata uruhu 2cm kumurongo wa intercostal, wongere imbaraga zamaraso kumpera yo hejuru yimbavu, hanyuma utandukanye imitsi yimitsi ihuza igituza;Umuyoboro wamazi ugomba guhita ushyirwa mugihe amazi asohotse.Ubujyakuzimu bw'amazi ava mu cyuho cy'igituza ntibugomba kurenza 4 ~ 5cm.Uruhu rwo mu gatuza uruhu rwuruhu rugomba gushushanyirizwa hamwe nududodo duto duto duto duto, umuyoboro wamazi ugomba guhuzwa kandi ugashyirwaho, kandi ugatwikirwa na gaze ya sterile;Hanze ya gaze, uzenguruke kaseti ndende uzengurutswe n'amazi hanyuma uyashyire kurukuta rw'igituza.Impera yumuyoboro wamazi uhujwe numuyoboro muremure wa disinfection hamwe nuducupa twafunze amazi, kandi umuyoboro wa reberi uhujwe n’icupa rifunze amazi ashyirwa hejuru yigitanda hamwe na kaseti ifata.Icupa ryamazi rishyirwa munsi yigitanda cyibitaro aho bitoroshye kugwa hasi.
3 Intubation
1. Gutemagura uruhu
2. Gutandukanya byimazeyo imitsi no gushyira umuyoboro wamazi wa thoracic ufite umwobo wuruhande unyuze kumpera yo hejuru yimbavu
3. Umwobo wo kuruhande wumuyoboro wamazi ugomba kuba ufite cm 2-3cm zinjira mumyanya yigituza
4 Kwirinda
1. Mugihe habaye Hematocele nini (cyangwa effusion), umuvuduko wamaraso ugomba gukurikiranirwa hafi mugihe cyamazi yambere kugirango wirinde umurwayi gutungurwa cyangwa kugwa gitunguranye.Bibaye ngombwa, umuvuduko wamaraso ugomba guhora urekurwa kugirango wirinde akaga.
2. Witondere kugirango umuyoboro wamazi udafungwa nta gahato cyangwa kugoreka.
3. Fasha umurwayi guhindura imyanya neza buri munsi, cyangwa ushishikarize umurwayi guhumeka neza kugirango agere kumazi yuzuye.
4. Andika ingano ya buri munsi (ingano yamazi kumasaha mugihe cyambere nyuma yimvune) nimpinduka zumutungo wacyo, hanyuma ukore X-ray fluoroscopi cyangwa isuzuma rya firime nkuko bikwiye.
5. Iyo usimbuye icupa ryamazi adafunze, umuyoboro wamazi ugomba kubanza gufungwa byigihe gito, hanyuma umuyoboro wamazi ukongera kurekurwa nyuma yo gusimburwa kugirango wirinde umwuka kwinjizwa numuvuduko mubi wigituza.
6. Mu rwego rwo gukuraho ubwandu bwa kabiri, umuco wa bagiteri hamwe n’ibizamini byo gukangurira ibiyobyabwenge amazi y’amazi birashobora gukorwa niba imiterere y’amazi yahinduwe.
7. Mugihe ukuramo umuyoboro wamazi, uruhu ruzengurutse rugomba kubanza kwanduzwa, suture ihamye igomba gukurwaho, umuyoboro wamazi hafi yurukuta rwigituza ugomba gufatishwa imbaraga zamaraso, kandi gufungura amazi bigomba gutwikirwa 12 ~ Ibice 16 bya gaze na 2 bya Vaseline ya gaze (harimo na vaseline nkeya irahitamo).Umukoresha agomba gufata gaze ukoresheje ukuboko kumwe, gufata umuyoboro wamazi ukoresheje ukundi kuboko, hanyuma ukabikuramo vuba.Gase yafunguye amazi yafunzwe burundu kurukuta rwigituza hamwe nigice kinini cya kaseti ifata agace karenze gaze, kandi imyambarire irashobora guhinduka nyuma yamasaha 48 ~ 72.
5 Ubuforomo nyuma yo kubagwa
Nyuma yo gukora, umuyoboro wamazi ukunze kuba mwinshi kugirango lumen idakumirwa.Amazi atemba yandikwa buri saha cyangwa amasaha 24.Nyuma yo kuvoma, ibihaha byaguka neza, kandi nta gaze cyangwa amazi asohoka.Umuyoboro wamazi urashobora gukurwaho mugihe umurwayi ahumeka cyane, kandi igikomere gishobora gufungwa na gaze ya vaseline hamwe na kaseti.
Igihe cyo kohereza: Jun-10-2022
