Sisebenzisa izinaliti ezifakwe inzalo ukubhoboza isikhumba, izicubu ze-intercostal kanye ne-parietal pleura emgodini we-pleural, obizwa ngokuthi.ukubhoboza isifuba.
Kungani ufuna ukubhoboza isifuba?Okokuqala, kufanele sazi indima ye-thoracic puncture ekuxilongweni nasekwelapheni izifo ze-thoracic.I-Thoracocentesis iyindlela evamile, elula futhi elula yokuxilongwa nokwelashwa emsebenzini womtholampilo womnyango wamaphaphu.Isibonelo, ngokuhlola, sithole ukuthi isiguli sasinomphumela we-pleural effusion.Singakwazi ukudonsa uketshezi ngokusebenzisa i-pleural puncture futhi sihlole izivivinyo ezihlukahlukene ukuze sithole imbangela yalesi sifo.Uma kunoketshezi oluningi emgodini, ocindezela amaphaphu noma aqongelela uketshezi isikhathi eside, i-fibrin kuyo kulula ukuyihlela futhi ibangele izingqimba ezimbili zokunamathela kwe-pleural, okuthinta umsebenzi wokuphefumula wamaphaphu.Ngalesi sikhathi, sidinga futhi ukubhoboza ukuze sikhiphe uketshezi.Uma kunesidingo, izidakamizwa nazo zingajovwa ukuze kufezwe injongo yokwelashwa.Uma i-pleural effusion ibangelwa umdlavuza, sijova imithi elwa nomdlavuza ukuze idlale indima yokulwa nomdlavuza.Uma kukhona igesi eningi emgodini wesifuba, futhi i-pleural cavity ishintshile kusukela ekucindezelweni okungalungile kuya ekucindezelweni okuhle, khona-ke lokhu kusebenza kungasetshenziswa futhi ukunciphisa ukucindezela nokukhipha igesi.Uma i-bronchus yesiguli ixhunywe ne-pleural cavity, singajova umuthi oluhlaza okwesibhakabhaka (okuthiwa i-methylene blue, engenabungozi emzimbeni womuntu) esifubeni ngenaliti yokubhoboza.Khona-ke isiguli singakhwehlela uketshezi oluluhlaza okwesibhakabhaka (kuhlanganise nesikhwehlela) lapho sikhwehlela, bese singaqinisekisa ukuthi isiguli sine-bronchopleural fistula.I-bronchopleural fistula iyindlela ye-pathological eyasungulwa ngenxa yokubandakanyeka kwezilonda zamaphaphu ku-bronchi, alveoli kanye ne-pleura.Kuwumzila osuka emgodini womlomo uye kuqhoqhoqho kuye ku-bronchi kuwo wonke amazinga ukuya ku-alveoli kuya ku-visceral pleura kuya ku-pleural cavity.
Yini okufanele inakwe ku-puncture ye-thoracic?
Uma kuziwa ekubhobozeni i-thoracic, iziguli eziningi zihlala zesaba.Akulula ukwamukela njengenaliti eshaya ezinqeni, kodwa ibhoboza isifuba.Kunezinhliziyo namaphaphu esifubeni, angeke akwazi ukwesaba.Yini okufanele siyenze uma inaliti ibhobozwa, ingabe izoba yingozi, futhi yini odokotela okufanele bayinake?Kufanele sazi ukuthi iziguli kufanele zikunake kanjani nokuthi zibambisane kanjani kahle.Ngokwezinqubo zokusebenza, cishe akukho ngozi.Ngakho-ke, sikholelwa ukuthi i-thoracocentesis iphephile ngaphandle kokwesaba.
Yini okufanele inake umqhubi?Udokotela wethu ngamunye kufanele aziqonde kahle izinkomba kanye nezinto ezibalulekile zokusebenza zokubhoboza i-thoracic.Kumele kuqashelwe ukuthi inaliti kufanele ifakwe onqenqemeni olungenhla lombambo, futhi ungalokothi ube semaphethelweni aphansi ombambo, ngaphandle kwalokho imithambo yegazi nezinzwa eduze konqenqema olungezansi lombambo kuzolimala ngephutha.Ukubulala amagciwane kufanele kwenziwe ngokucophelela.Ukuhlinzwa kufanele kube yinyumba ngokuphelele.Umsebenzi wesiguli kufanele wenziwe kahle ukuze kugwenywe ukukhathazeka kanye nesimo sengqondo sokwethuka.Ukubambisana okuseduze nodokotela kufanele kutholakale.Lapho uthola ukuhlinzwa, izinguquko zesiguli kufanele zibhekwe nganoma yisiphi isikhathi, njengokukhwehlela, ubuso obuphaphathekile, ukujuluka, ukushaya kwenhliziyo, i-syncope, njll. Uma kunesidingo, yeka ukusebenza futhi ngokushesha ulale embhedeni ukuze utakulwe.
Yini okufanele iziguli zinake?Okokuqala nje, iziguli kufanele zikulungele ukusebenzisana eduze nodokotela ukuze kuqedwe ukwesaba, ukukhathazeka kanye nokungezwani.Okwesibili, iziguli akufanele zikhwehlele.Kufanele bahlale embhedeni kusenesikhathi.Uma bengazizwa kahle kufanele bachazele udokotela ukuze udokotela acabangele ukuthi yini okufanele ayinake noma ayimise okwesikhashana ukuhlinzwa.Okwesithathu, kufanele ulale cishe amahora amabili ngemuva kwe-thoracentesis.
Ekwelapheni i-pneumothorax okukhulunywe ngayo esigabeni esiphuthumayo somnyango wamaphaphu, uma sihlangana nesiguli esine-pneumothorax, ukucindezelwa kwamaphaphu akubi kakhulu futhi ukuphefumula akunzima ngemva kokuhlolwa.Ngemva kokubona, iphaphu aliqhubeki licindezelwa, okungukuthi, igesi esifubeni aliqhubeki nokukhula.Iziguli ezinjalo angeke zelashwe ngokubhoboza, ngokufaka intubation kanye nokukhipha amanzi.Uma nje inaliti ewugqinsi kancane isetshenziselwa ukubhoboza, ukususa igesi, futhi ngezinye izikhathi ngokuphindaphindiwe izikhathi ezimbalwa, iphaphu lizophinde likhule, elizophinde lifinyelele inhloso yokwelashwa.
Ekugcineni, ngingathanda ukusho ukubhoboza kwamaphaphu.Eqinisweni, ukubhoboza kwamaphaphu kuwukungena kokubhoboza isifuba.Inaliti ibhotshozwa ephashini ngokusebenzisa i-pleural cavity kanye ne-visceral pleura.Kukhona nezinhloso ezimbili.Ikakhulukazi ukwenza i-biopsy ye-parenchyma yamaphaphu, iphinde ihlole uketshezi olusemgodini we-aspiration noma ishubhu le-bronchial ukuze kutholakale ukuxilongwa okucacile, bese belapha izifo ezithile ngokubhoboza amaphaphu, njengokufisa ubomvu kweminye imigodi. ne-drainage engekho kahle, kanye nokujova izidakamizwa uma kunesidingo ukuze kuzuzwe inhloso yokwelashwa.Nokho, izidingo zokubhoboza amaphaphu ziphezulu.Umsebenzi kufanele ucophelele, ucophelele futhi usheshe.Isikhathi kufanele sifinyezwe ngangokunokwenzeka.Isiguli kufanele sibambisane eduze.Ukuphefumula kufanele kuzinzile, futhi akukho ukukhwehlela okufanele kuvunyelwe.Ngaphambi kokubhoboza, isiguli kufanele sithole ukuhlolwa okuningiliziwe, ukuze udokotela akwazi ukuthola kahle futhi athuthukise izinga lokuphumelela lokubhoboza.
Ngakho-ke, uma nje odokotela belandela izinyathelo zokuhlinzwa futhi behlinza ngokucophelela, iziguli zizoqeda ukwesaba kwazo futhi zibambisane eduze nodokotela.Ukubhoboza isifuba kuphephe kakhulu, futhi asikho isidingo sokwesaba.
Isikhathi sokuthumela: Oct-18-2022
