I-Thoracentesis
3. Ukubulala iintsholongwane
I-1) I-disinfection yesikhumba yesiqhelo, i-3 iodine 3 utywala, ububanzi be-15cm
2) Nxiba iiglavu ezingenazintsholongwane,
3) Ithawula yokubeka umngxuma
4. I-Layer by layer infiltration anesthesia yendawo
I-1) Izigulane zinokunikwa i-0.011mg / kg i-atropine nge-intravenously ukukhusela i-vasovagal reflex ngexesha lokukhutshwa kwamanzi.I-anesthetics okanye i-sedatives ayifuni ukusetyenziswa.
I-2) Ngethuba lokuhlatywa, isigulane kufuneka sigweme ukukhwehlela kunye nokujikeleza komzimba, kwaye uthathe i-codeine kuqala ukuba kuyimfuneko.
3) I-2ml i-lidocaine yahlatywa kumphetho ophezulu wembambo elandelayo ukwenza i-colliculus
4) Faka umaleko ngokomaleko ukuthintela isitofu kwimithambo yegazi, kwaye ungangeni nzulu kakhulu kumqolo wepleural.
5. Ukugqobhoza
Ulusu kwindawo yokubhoboza lulungiswe ngesandla sasekhohlo, kwaye inaliti ifakwe ngesandla sokunene
Kumda ophezulu wembambo elandelayo, kwindawo ye-anesthesia yendawo, faka inaliti kuze kube yilapho ukuchasana kuphelile, kwaye umise inaliti.
Inaliti elungisiweyo yokugqobhoza ukuthintela ukugqobhoza kwamalungu angaphakathi
Thintela umoya ekungeneni kumgodi wepleural.Qaphela xa usebenzisa i-cylinder yenaliti kunye nokutshintsha iindlela ezintathu.Umoya awuvumelekanga ukuba ungene kwindawo yesifuba.Ungaze umpompe i-pleural fluid ngamandla ukunqanda inaliti okanye i-catheter engena kwi-pleura yenzakalise imiphunga.
6. Ukutsala inaliti
1) Emva kokususa inaliti yokubhoboza, yimboze nge-gauze oyinyumba kwaye uyilungise phantsi koxinzelelo
2) Lala uthule emva kokuhlinzwa ukuze uphephe ukucocwa kwendawo
7. Izilumkiso ngexesha nasemva kotyando
1. Kwimeko ye-anaphylactic shock, yeka ukusebenza ngokukhawuleza kwaye utofe i-0.1% -------------0.3ml-0.5ml adrenaline ngaphantsi kwe-subcutaneously.
Isigulana sinokuva intlungu yesifuba xa umphunga uphinda wolulelwe kudonga lwesifuba.Kwimeko yesifuba esibuhlungu kakhulu, i-dyspnea, i-tachycardia, isiqaqa okanye ezinye iimpawu ezinzulu, kucetyiswa ukuba isigulane sine-pleural allergies, kunye ne-drainage kufuneka imiswe, nokuba kusekho ubuninzi be-pleural effusion esifubeni.
2. Ixesha elinye ukupompa ulwelo akufanele kube kakhulu, kungabi ngaphezu kwama-700 okokuqala, kwaye kungabi ngaphezu kwe-1000 kwixesha elizayo.Kwizigulane ezinomthamo omkhulu we-pleural fluid, ngaphantsi kwe-1500ml yolwelo kufuneka ikhutshwe ngexesha ngalinye ukunqanda ukungazinzi kwe-hemodynamic kunye / okanye i-pulmonary edema emva kokufunwa kwemiphunga.
Kwimeko yokuhlatywa kwe-hemothorax ebuhlungu, kuyacetyiswa ukuba ukhuphe 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.
3. I-Diagnostic fluid extraction 50-100
4. Ukuba yi-empyema, zama ukuyifunxa icocekile ngalo lonke ixesha
5. Uviwo lwe-Cytological kufuneka lube yi-100 ubuncinane kwaye lufanele lungeniswe ngokukhawuleza ukuthintela ukuguqulwa kweseli
6. Kuphephe ukugqobhoza ngaphantsi kwesithuba sesithoba se-intercostal ukukhusela ukwenzakala kwizitho zesisu
7. Emva kwe-thoracocentesis, ukuqwalaselwa kweklinikhi kufuneka kuqhutyelwe.Kungaba iiyure eziliqela okanye enye okanye iintsuku ezimbini kamva, i-thoracocentesis inokuphinda iphindwe xa kuyimfuneko.
Ixesha lokuposa: Jun-08-2022
