Njengoko sonke siyazi, isixhobo se-thoracentesis esilahlwayo sisixhobo esiphambili se-thoracentesis.Yintoni esifanele siyazi malunga ne-thoracentesis?
Iimpawu zeI-Thoracocentesis
1. I-diagnostic puncture ye-chest trauma ekrokrelwa nge-hemopneumothorax, efuna ukucaciswa ngakumbi;Ubume bepleural effusion abuchazwanga, kwaye ipleural effusion ifuna ukuhlatywa kuvavanyo lwaselabhoratri.
2. Xa ubuninzi be-pleural effusion (okanye i-hematocele) ihlatywa ngonyango, echaphazela imisebenzi yokuphefumula kunye ne-circulatory, kwaye ayikabikho ukufaneleka kwi-thoracic drainage, okanye i-pneumothorax ichaphazela umsebenzi wokuphefumula.
Indlela yeThoracocentesis
1. Isigulane sihlala esihlalweni kwicala elingasemva, kunye nengalo ephilileyo emva kwesihlalo, intloko engalweni, kunye nomlenze ophezulu ochaphazelekayo wolulelwe ngaphezu kwentloko;Okanye thatha isiqingatha secala lokulala, kunye necala elichaphazelekayo liphezulu kwaye ingalo yecala echaphazelekayo iphakanyiswe ngaphezu kwentloko, ukwenzela ukuba i-intercosts ivuleke.
2. I-puncture kunye ne-drainage kufuneka yenziwe kwindawo yomsindo oqinileyo we-percussion, ngokuqhelekileyo kwi-7th ukuya kwi-8th intercostal space ye-angle ye-subscapular, okanye kwi-5 ukuya kwe-6 ye-intercostal indawo yomgca we-midaxillary.Indawo yokuhlatywa kwe-encapsulated effusion kufuneka ibekwe ngokwe-X-ray fluoroscopy okanye uvavanyo lwe-ultrasonic.
3. I-Pneumothorax aspirates, ngokubanzi kwi-semi-recumbent position, kunye ne-ring piercing point kumgca we-midclavicular phakathi kwe-2nd kunye ne-3 intercostals, okanye phambi kwe-armpit phakathi kwe-4th kunye ne-5 intercostals.
4. Umsebenzisi kufuneka enze ngokungqongqo utyando lwe-aseptic, anxibe imaski, ikepusi kunye neeglavu ze-aseptic, rhoqo abulale iintsholongwane eluswini kwindawo yokugqobhoza nge-iodine tincture kunye notywala, kwaye abeke itawuli yotyando.I-anesthesia yendawo kufuneka ingene kwi-pleura.
5. Inaliti kufuneka ifakwe ngokucothayo ecaleni komphetho ophezulu wembambo elandelayo, kwaye ityhubhu yelatex eqhagamshelwe kwinaliti kufuneka icinezelwe nge-hemostatic forceps kuqala.Xa udlula kwi-pleura ye-parietal kwaye ungena kwi-thoracic cavity, unokuziva "uluvo lokuwa" ukuba incam yenaliti iyamelana nokunyamalala ngokukhawuleza, emva koko udibanise isirinji, ukhulule i-hemostatic forceps kwi-tube ye-latex, kwaye emva koko unokumpompa ulwelo. okanye umoya (xa upompa umoya, unokuphinda udibanise isixhobo sepneumothorax eyenziweyo xa uqinisekiswa ukuba i-pneumothorax ikhutshwe, kwaye yenza ukupompa okuqhubekayo).
6. Emva kokutsalwa kwamanzi, khupha inaliti yokuhlatywa, cinezela i-1 ~ 3nin nge-gauze eyinyumba kumngxuma yenaliti, kwaye uyilungise ngeteyiphu yokunamathela.Cela isigulana sihlale ebhedini.
7. Xa izigulana ezigula kakhulu zihlatywa, ngokuqhelekileyo zithatha indawo ecaba, kwaye akufanele zishukumise umzimba wazo kakhulu ukuze zihlatywe.
Izilumkiso zeThoracocentesis
1. Ubungakanani bolwelo olutsalwa ngokugqobhoza ukuxilongwa luyi-50-100ml;Ngenjongo yokunciphisa, akufanele idlule i-600ml okokuqala kunye ne-1000ml ngexesha ngalinye emva koko.Ngexesha lokuhlatywa kwe-hemothorax ebuhlungu, kuyacetyiswa ukuba kukhululwe igazi eliqokelelweyo ngaxeshanye, ubeke ingqalelo kuxinzelelo lwegazi nangaliphi na ixesha, kwaye ukhawuleze utofelo-gazi kunye nokutofelwa ukuthintela ukungasebenzi kakuhle kokuphefumla kunye nokujikeleza kwegazi okanye ukothuka ngexesha lokutsalwa kwamanzi.
2. Ngethuba lokuhlatywa, isigulane kufuneka sigweme ukukhwehlela kunye nokujikeleza komzimba.Ukuba kuyimfuneko, i-codeine ingathathwa kuqala.Kwimeko yokhohlokhohlo oluqhubekayo okanye ukuqina kwesifuba, isiyezi, ukubila okubandayo kunye nezinye iimpawu zokuwa ngexesha lotyando, ukutsalwa kolwelo kufuneka kuyekwe ngoko nangoko, kwaye iadrenaline kufuneka itofwe ngaphantsi kwesikhumba ukuba kuyimfuneko.
3. Emva kwe-pleural puncture ye-fluid kunye ne-pneumothorax, ukuqwalaselwa kweklinikhi kufuneka kuqhutyelwe.I-pleural fluid kunye negesi inokunyuka kwakhona kwiiyure ezininzi okanye enye okanye iintsuku ezimbini emva koko, kwaye ukugqobhoza kunokuphindwa ukuba kuyimfuneko.
Ixesha lokuposa: Oct-25-2022
