Thoracentesis
3. Disinfection
1) Routine ganda disinfection, 3 ayodhini 3 doro, dhayamita 15cm
2) Pfeka magirovhosi asingabereki,
3) Gomba kuisa tauro
4. Layer by layer local infiltration anesthesia
1) Varwere vanogona kupiwa 0.011mg / kg atropine intravenously kudzivirira vasovagal reflex panguva yekubudisa mvura.Anesthetics kana sedative haidi kushandiswa.
2) Panguva yekuputika, murwere anofanira kudzivisa kukosora uye kutenderera kwemuviri, uye kutora codeine kutanga kana zvichidiwa.
3) 2ml lidocaine yakabaiwa kumucheto kwepamusoro pembabvu inotevera kuti iite colliculus.
4) Pinda layer ne layer kudzivirira jekiseni mutsinga dzeropa, uye usapinde mu pleural cavity zvakanyanya.
5. Kubaya
Ganda panzvimbo yepuncture inogadziriswa neruoko rworuboshwe, uye tsono inopinzwa neruoko rworudyi
Kumucheto kwepamusoro pembabvu inotevera, panzvimbo yeanesthesia yemunharaunda, jekiseni tsono kusvikira kupikisa kwapera, uye kumisa jekiseni.
Fixed puncture tsono kudzivirira kuboora nhengo dzomukati
Dzivirira mhepo kuti isapinda mu pleural cavity.Ngwarira paunenge uchishandisa silinda yetsono uye chinja-nzira nhatu.Mhepo haibvumidzwe kupinda mugomba rechipfuva.Usambofa wakapomba pleural fluid zvine simba kudzivirira tsono kana catheter ichipinda mupleura ichikuvadza mapapu.
6. Kudhonza tsono
1) Mushure mekubvisa tsono yepuncture, ivhare ne sterile gauze uye gadzirisa pasi pekumanikidzwa
2) Rara wakanyarara mushure mekuvhiyiwa kudzivirira kucheneswa kwenzvimbo
7. Kuchengetedza panguva uye mushure mekushanda
1. Kana paine anaphylactic shock, mira kuvhiya nekukurumidza uye jekiseni 0.1% --------------0.3ml-0.5ml adrenaline pasi pecutaneously.
Murwere anogona kunzwa kurwadziwa muchipfuva kana mapapu akatambanudzwa zvakare kumadziro echipfuva.Muchiitiko chekurwadziwa kwakanyanya kwechipfuva, dyspnea, tachycardia, kupera simba kana zvimwe zviratidzo zvakakomba, zvinokurudzirwa kuti murwere ane pleural allergy, uye mvura inofanira kumiswa, kunyange kana pachine kuwanda kwepleural effusion mubhokisi.
2. Imwe nguva yekupomba kwemvura haifaniri kunge yakawandisa, kwete kupfuura 700 kwekutanga, uye kwete kupfuura 1000 mune ramangwana.Kune varwere vane huwandu hukuru hwepleural fluid, isingasviki 1500ml yemvura inofanirwa kudirwa nguva yega yega kudzivirira kusagadzikana kwehemodynamic uye / kana pulmonary edema mushure mekutora mapapu.
Muchiitiko chekushungurudzika kwehemothorax puncture, zvinokurudzirwa kubvisa ropa rakaungana panguva imwe chete, teerera kuropa reropa chero nguva, uye kukurumidza kuwedzerwa ropa uye kuisirwa kudzivirira kungoerekana kufema uye kutenderera kweropa kusashanda kana kuvhunduka panguva yekubvisa mvura.
3. Diagnostic fluid kutorwa 50-100
4. Kana iri empyema, edza kuisveta yakachena nguva dzose
5. Cytological ongororo inofanira kunge iri 100 uye inofanira kuendeswa nekukurumidza kudzivirira cell autolysis
6. Dzivisa puncture pazasi yepfumbamwe intercostal nzvimbo kudzivirira kukuvara kune abdominal nhengo
7. Mushure me thoracocentesis, kuongororwa kwekliniki kunofanira kuenderera mberi.Inogona kuva maawa akawanda kana rimwe kana mazuva maviri gare gare, thoracocentesis inogona kudzokororwa kana zvichidiwa.
Nguva yekutumira: Jun-08-2022
