Iimpawu zokuhlatywa kwe-thoracic
Ukuze kucaciswe uhlobo lwe-pleural effusion, i-pleural puncture kunye nokuhlolwa kwe-aspiration kufuneka kwenziwe ukunceda ukuxilongwa;Xa kukho ubuninzi be-fluid okanye ukuqokelela kwegesi okubangelwa iimpawu zokunyanzeliswa kwemiphunga, kwaye izigulane ze-pyothorax zifuna ukupompa ulwelo lonyango;Iziyobisi kufuneka zitofwe kwindawo yesifuba.
Contraindications ofukugqabhuka kwesifuba
(1) Indawo yokugqobhoza inokuvuvukala, ithumba kunye nokwenzakala.
(2) Kukho ukuthambekela kokuphuma kwegazi kakhulu, i-pneumothorax ezenzekelayo, i-blood clots enkulu, isifo sofuba esibi kakhulu se-pulmonary, i-emphysema, njl.
Izilumkiso ze-Thoracic Puncture
(1) Izigulana ezineziphene ze-coagulation, izifo ezophayo kunye nabo bathatha i-anticoagulant drugs kufuneka banyangwe ngokufanelekileyo phambi kotyando.
(2) Ukuhlatywa kwethoracic kufuneka kuhlatywe ii-anesthetized ngokupheleleyo ukuthintela ukothuka kwepleural.
(3) I-puncture kufuneka iqhutywe kufutshane nomphezulu wembambo ukuphepha ukwenzakala kwimithambo yegazi kunye nemithambo-luvo.Inaliti, i-latex ityhubhu okanye i-switch-way-way switch, i-cylinder yenaliti, njl.
(4) Ukugqobhoza kufuneka kulumke, ubuchule bufanele bube nobuchule, kwaye ukubulala iintsholongwane kufuneka kube ngqongqo ukuthintela ukubangela usulelo olutsha, i-pneumothorax, i-hemothorax okanye ukwenzakala ngengozi kwimithambo yegazi, intliziyo, isibindi kunye nodaka.
(5) Ukukhohlela kufuneka kuphetshwe ngexesha lokugqobhoza.Jonga utshintsho lwesigulana nangaliphi na ixesha.Kwimeko yobuso obumnyama, ukubila, isiyezi, ukubetha kwentliziyo kunye ne-pulse ebuthathaka, ukugqobhoza kuya kumiswa kwangoko.Vumela isigulane silale, siphefumlele ioksijini xa kuyimfuneko, kwaye utofe iadrenaline okanye i-sodium benzoate kunye ne-caffeine ngaphantsi kwesikhumba.Ukongezelela, unyango oluhambelanayo luya kwenziwa ngokwemeko.
(6) Ulwelo kufuneka lumpontshwe kancinane.Ukuba umthamo omkhulu wolwelo kufuneka umpontshwe ngenxa yonyango, ukutshintshwa kweendlela ezintathu kufuneka kudityaniswe emva kwenaliti yokubhoboza.Ulwelo akufuneki lutsalwe kakhulu kunyango.Ukuba kuyimfuneko, inokumpontshwa ngamaxesha amaninzi.Ubungakanani bolwelo olumponthiweyo okokuqala aluyi kuba ngaphezu kwe-600ml, kwaye ubungakanani bolwelo olumponthiweyo ngexesha ngalinye emva koko luya kuba malunga ne-1000ml.
(7) Ukuba ulwelo olophayo lukhutshiwe, yeka ngokukhawuleza ukuzoba.
8 umgodi
Indlela yokukhetha indawo yokubeka i-thoracic puncture?
(1) I-Thoracic puncture kunye ne-drainage: inyathelo lokuqala kukwenza i-percussion esifubeni, kwaye ukhethe indawo enesandi esicacileyo esicacileyo sokugqobhoza, esinokufumaneka ngokudibanisa ne-X-reyi kunye ne-B-ultrasound.I-puncture point inokumakishwa kwesikhumba nge-nail violet, kwaye ihlala ikhethwa ngolu hlobo lulandelayo: i-7 ~ 9 imigca ye-intercostal ye-angle ye-subscapular;I-7-8 intercostals yomgca we-axillary yangasemva;I-6 ~ 7 i-intercostals yomgca we-midaxillary;Umphambili we-axillary uneembambo ezi-5-6.
(2) I-encapsulated pleural effusion: i-puncture ingenziwa ngokudibanisa ne-X-ray kunye ne-ultrasonic localization.
(3) Ukuchithwa kwe-Pneumothorax: indawo yesibini ye-intercostal kumgca we-midclavicular okanye i-4-5 intercostal space kumgca we-midaxillary wecala elichaphazelekayo likhethwa ngokubanzi.Ngenxa yokuba imithambo-luvo ye-intercostal kunye nemithambo kunye nemithambo ihamba ecaleni komgca ongezantsi wembambo, kufuneka ihlatywe kumgca ongasentla wembambo ukunqanda ukonakalisa imithambo-luvo kunye nemithambo yegazi.
Yonke inkqubo yokuhlatywa kwe-thoracic
1. Yalela isigulana ukuba sithathe isihlalo esijonge ngasemva kwesitulo, sibeke iingalo zombini ngasemva kwesitulo, kwaye singqiyame ibunzi emabunzini.Abo bangenako ukuvuka banokuthatha isiqingatha sokuhlala, kwaye i-forearm echaphazelekayo iphakanyiswe emqamelweni.
2. Indawo yokugqobhoza iya kukhethwa kweyona ndawo icacileyo yesandi sokubethwa kwesifuba.Xa kukho i-pleural fluid eninzi, umgca we-scapular okanye i-7th ~ 8th intercostal space ye-posterior axillary line idla ngokuthathwa;Ngamanye amaxesha indawo ye-6 ukuya kwe-7 ye-intercostal yomgca we-midaxillary okanye indawo ye-5 ye-intercostal yomgca we-axillary yangaphambili nayo ikhethwe njengeendawo zokubhoboza.I-encapsulated effusion inokumiselwa nge-X-ray okanye uvavanyo lwe-ultrasonic.Indawo yokugqobhoza iphawulwe eluswini ngeswab yekotoni efakwe kwi-methyl violet (gentian violet).
3. Rhoqo bulala iintsholongwane eluswini, nxiba iiglavu ezingenazintsholongwane, kwaye ugqume itawuli yomngxuma wokubulala iintsholongwane.
4. Sebenzisa i-2% ye-lidocaine ukwenza i-anesthesia yokungena kwendawo ukusuka kwesikhumba ukuya kwindonga ye-pleural kwindawo yokubhoboza kwinqanaba eliphezulu leembambo ezisezantsi.
5. Umsebenzisi ulungisa ulusu lwendawo yokuhlatywa ngomnwe wesalathisi sesandla sasekhohlo kunye nomnwe ophakathi, ajike iqhude elineendlela ezintathu zenaliti yokuhlatywa kwindawo apho isifuba sivalwe ngesandla sasekunene, emva koko ngokuthe chu. igqobhoze inaliti yokuhlatywa kwindawo ye-anesthesia.Xa ukuxhathisa kwincam yenaliti ngokukhawuleza shwaka, jika umqhagi wendlela-ntathu ukuze udibanise nesifuba ukutsalwa kwamanzi.Umncedisi usebenzisa i-hemostatic forceps ukunceda ukulungisa inaliti yokuhlatywa ukukhusela izicubu zemiphunga ukuba zingonakaliswe ngokungena nzulu kakhulu.Emva kokuba i-syringe igcwele, vula i-valve yeendlela ezintathu ukuyidibanisa nehlabathi langaphandle kwaye ukhuphe ulwelo.
6. Ekupheleni kokukhutshwa kwamanzi, khupha inaliti ye-puncture, uyigubungele nge-gauze oyinyumba, yicinezele ngamandla amancinci umzuzwana, uyilungise nge-adhesive tape kwaye ucele isigulane ukuba silale.
Ixesha lokuposa: Oct-20-2022
