Sisebenzisa iinaliti ezihlambulukileyo ukugqobhoza ulusu, izicubu ze-intercostal kunye ne-parietal pleura kwi-pleural cavity, ebizwa ngokuba yi-pleural cavity.ukugqabhuka kwesifuba.
Kutheni ufuna ukuhlatywa esifubeni?Okokuqala, kufuneka siyazi indima ye-thoracic puncture kwi-diagnostic kunye nokunyangwa kwezifo ze-thoracic.I-Thoracocentesis yindlela eqhelekileyo, elula kwaye elula yokuxilongwa kunye nonyango kumsebenzi wekliniki wesebe le-pulmonary.Umzekelo, ngokuxilonga, sifumanise ukuba isigulana sine-pleural effusion.Sinokutsala ulwelo ngokugqabhuka kwe-pleural kwaye siqhube iimviwo ezahlukeneyo ukufumana unobangela wesi sifo.Ukuba kukho ulwelo oluninzi kwi-cavity, ecinezela imiphunga okanye iqokelele ulwelo ixesha elide, i-fibrin kuyo kulula ukuyiququzelela kwaye ibangele iileya ezimbini ze-pleural adhesion, echaphazela umsebenzi wokuphefumla wemiphunga.Ngeli xesha, kufuneka kwakhona sigqobhoze ukususa ulwelo.Ukuba kuyimfuneko, iziyobisi zinokuthi zitofwe ukufezekisa injongo yonyango.Ukuba i-pleural effusion ibangelwa ngumhlaza, sitofa amayeza achasene nomhlaza ukuze adlale indima echasene nomhlaza.Ukuba kukho igesi eninzi kwisigxina sesifuba, kwaye i-pleural cavity itshintshile ukusuka kuxinzelelo olubi ukuya kuxinzelelo olulungileyo, ke lo msebenzi ungasetyenziselwa ukunciphisa uxinzelelo kunye nokukhupha igesi.Ukuba i-bronchus yesigulana idityaniswe ne-pleural cavity, sinokutofa iyeza elizuba (elibizwa ngokuba yi-methylene blue, engenabungozi emzimbeni womntu) esifubeni ngenaliti yokuhlatywa.Emva koko isigulane sinokukhohlela ulwelo oluluhlaza (kuquka isikhohlela) xa sikhohlela, kwaye ke sinokuqinisekisa ukuba isigulana sine-bronchopleural fistula.I-bronchopleural fistula yi-pathological passage esekwe ngenxa yokubandakanyeka kwezilonda zemiphunga kwi-bronchi, alveoli kunye ne-pleura.Yindlela esuka kumqolo womlomo ukuya kwi-trachea ukuya kwi-bronchi kuwo onke amanqanaba ukuya kwi-alveoli ukuya kwi-visceral pleura ukuya kwi-pleural cavity.
Yintoni ekufuneka ihlawulwe kwi-thoracic puncture?
Xa kuziwa kwi-thoracic puncture, izigulane ezininzi zihlala zisoyika.Akulula ukuyamkela njengenaliti ebetha iimpundu, kodwa igqobhoza isifuba.Kukho iintliziyo kunye nemiphunga esifubeni, ezingenakunceda kodwa ukwesaba.Yintoni esifanele siyenze ukuba inaliti igqojozwe, ngaba iya kuba yingozi, yaye yintoni abafanele bayinikele ingqalelo oogqirha?Sifanele sazi ukuba izigulane kufuneka zinikele ingqalelo kuzo kunye nendlela yokusebenzisana kakuhle.Ngokweenkqubo zokusebenza, akukho phantse ingozi.Ngoko ke, sikholelwa ukuba i-thoracocentesis ikhuselekile ngaphandle kokwesaba.
Yintoni ekufuneka umqhubi anikele ingqalelo kuyo?Ugqirha ngamnye wethu kufuneka abe nokuqonda kakuhle kwezalathisi kunye nezinto eziyimfuneko ekusebenzeni kwe-thoracic puncture.Kufuneka kuqatshelwe ukuba inaliti kufuneka ifakwe kumda ongaphezulu wembambo, kwaye ungaze ube kwincam engezantsi yembambo, kungenjalo imithambo yegazi kunye nemithambo-luvo ecaleni komphetho ongezantsi wembambo iya kwenzakala ngempazamo.Ukubulala iintsholongwane kufuneka kwenziwe ngononophelo.Utyando kufuneka lungabi ntsholongwane ngokupheleleyo.Umsebenzi wesigulana kufuneka wenziwe kakuhle ukuphepha ukuxhalaba kunye nesimo sengqondo.Intsebenziswano esondeleyo kunye nogqirha kufuneka ifunyanwe.Xa ufumana utyando, utshintsho lwesigulane kufuneka lujongwe nangaliphi na ixesha, njengokukhohlela, ubuso obukhanyayo, ukubila, ukubethelwa kwentliziyo, i-syncope, njl. Ukuba kuyimfuneko, ukuyeka ukusebenza kwaye ngokukhawuleza ulale ebhedini ukuze uhlangulwe.
Yintoni abamele banikele ingqalelo kuyo abaguli?Okokuqala, izigulana kufuneka zilungele ukusebenza ngokusondeleyo noogqirha ukuphelisa uloyiko, ukuxhalaba kunye noxinzelelo.Okwesibini, izigulane akufanele zikhohlele.Kufuneka bahlale ebhedini kwangethuba.Ukuba baziva bengaphilanga, bafanele bamcacisele ugqirha ukuze ugqirha abone ukuba yintoni amakayihoye okanye anqumamise utyando.Okwesithathu, kufuneka ulale phantsi malunga neeyure ezimbini emva kwe-thoracentesis.
Kunyango lwe-pneumothorax ekhankanywe kwicandelo likaxakeka kwisebe le-pulmonary, ukuba sidibana nesigulane esine-pneumothorax, ukunyanzeliswa kwemiphunga akunzima kwaye ukuphefumla akunzima emva kokuhlolwa.Emva kokuqwalaselwa, umphunga awuqhubeki ukunyanzeliswa, oko kukuthi, igesi esifubeni ayiqhubeki ngokunyuka.Izigulana ezinjalo azinakunyangwa ngokuhlatywa, intubation kunye ne-drainage.Logama nje inaliti engqindilili kancinane isetyenziselwa ukugqobhoza, ukususa igesi, kwaye ngamanye amaxesha ngokuphindaphindiweyo kangangezihlandlo ezininzi, imiphunga iya kwandiswa kwakhona, nayo eya kuphumeza injongo yonyango.
Okokugqibela, ndingathanda ukukhankanya ukuhlatywa kwemiphunga.Enyanisweni, ukuhlatywa kwemiphunga kukungena kwe-thoracic puncture.Inaliti ihlatywa kwimiphunga ngokusebenzisa i-pleural cavity kunye ne-visceral pleura.Kukho neenjongo ezimbini.Ubukhulu becala bakwenza i-biopsy ye-lung parenchyma, bajonge ngakumbi ulwelo olukumngxunya we-aspiration cavity okanye ityhubhu yebronchial ukwenza uxilongo olucacileyo, emva koko banyange ezinye izifo ngokugqabhuka kwemiphunga, njengokunqwenela ububovu kweminye imingxuma. kunye ne-drainage engekho mgangathweni, kunye nokutofa iziyobisi xa kuyimfuneko ukufezekisa injongo yonyango.Nangona kunjalo, iimfuno zokuhlatywa kwemiphunga ziphezulu.Umsebenzi kufuneka ulumke ngakumbi, uqaphele kwaye ukhawuleze.Ixesha kufuneka licuthwe kangangoko.Umguli kufuneka asebenzisane ngokusondeleyo.Ukuphefumla kufuneka kuzinzile, kwaye kungabikho ukukhohlela kufuneka kuvunyelwe.Ngaphambi kokugqobhoza, isigulane kufuneka sifumane uviwo olucacileyo, ukwenzela ukuba ugqirha akwazi ukufumana indawo ngokuchanekileyo kwaye aphucule izinga lokuphumelela kwe-puncture.
Ngoko ke, logama oogqirha belandela amanyathelo otyando yaye besebenza ngononophelo, abaguli baya kuluphelisa uloyiko lwabo baze basebenzisane ngokusondeleyo noogqirha.I-Thoracic puncture ikhuselekile kakhulu, kwaye akukho mfuneko yokoyika.
Ixesha lokuposa: Oct-18-2022
