Njengoba sonke sazi, idivayisi ye-thoracentesis elahlayo iyithuluzi eliyinhloko le-thoracentesis.Yini okufanele siyazi nge-thoracentesis?
Izinkomba zeI-Thoracocentesis
1. Ukubhobozwa kokuxilonga kokuhlukumezeka kwesifuba okusolwa nge-hemopneumothorax, okudinga ukucaciswa okwengeziwe;Imvelo yokuphuma kwe-pleural ayinqunywanga, futhi ukuphuphuma kwe-pleural kudinga ukubhobozwa ukuze kuhlolwe ilabhorethri.
2. Uma inani elikhulu le-pleural effusion (noma i-hematocele) ibhobozwa ngokwelashwa, okuthinta imisebenzi yokuphefumula nokujikeleza kwegazi, futhi ingakafaneleki ukukhishwa kwe-thoracic, noma i-pneumothorax ithinta umsebenzi wokuphefumula.
Indlela ye-Thoracocentesis
1. Isiguli sihlala esihlalweni sibheke emuva, ingalo enempilo isemuva kwesihlalo, ikhanda engalweni, nomlenze ongaphezulu othintekile welulelwe ngaphezu kwekhanda;Noma thatha uhhafu wokulala ohlangothini, uhlangothi oluthintekile lubheke phezulu futhi ingalo eseceleni ethintekile iphakanyiswe ngaphezu kwekhanda, ukuze ama-intercost avuleke ngokuqhathaniswa.
2. Ukubhoboza nokukhipha amanzi kufanele kwenziwe endaweni yomsindo oqinile wokushaywa, ngokuvamile endaweni yesi-7 kuya kweyesi-8 ye-engeli ye-subscapular, noma endaweni yesi-5 kuya ku-6 ye-intercostal yomugqa we-midaxillary.Indawo yokubhoboza ye-encapsulated effusion kufanele ibekwe ngokuya nge-X-ray fluoroscopy noma ukuhlolwa kwe-ultrasonic.
3. Ama-aspirates e-Pneumothorax, ngokuvamile asesimweni se-semi recumbent, futhi indawo yokubhoboza iringi ikumugqa we-midclavicular phakathi kwe-intercostals yesi-2 neyesi-3, noma ngaphambili kwekhwapha phakathi kwe-intercostals yesi-4 neyesi-5.
4. Umsebenzisi kufanele enze ukuhlinzwa kwe-aseptic ngokuqinile, agqoke imaski, ikepisi namagilavu e-aseptic, ajwayele ukubulala amagciwane esikhumbeni endaweni yokubhoboza nge-iodine tincture notshwala, futhi abeke ithawula lokuhlinza.I-anesthesia yendawo kufanele ingene ku-pleura.
5. Inaliti kufanele ifakwe kancane onqenqemeni olungenhla lombambo olandelayo, futhi ishubhu le-latex elixhunywe enalitini kufanele liboshwe ngama-forceps e-hemostatic kuqala.Lapho udlula ku-pleura ye-parietal futhi ungena emgodini wesifuba, ungase uzwe "umuzwa wokuwa" ukuthi ithiphu yenaliti imelana nokunyamalala okungazelelwe, bese uxhuma isipetu, ukhulule i-hemostatic forceps ku-tube latex, bese ungakwazi ukupompa uketshezi. noma umoya (uma udonsa umoya, ungakwazi futhi ukuxhuma idivayisi yokwenziwa ye-pneumothorax uma kuqinisekiswa ukuthi i-pneumothorax ikhishwa, futhi yenza ukupompa okuqhubekayo).
6. Ngemva kokukhipha uketshezi, khipha inaliti yokubhoboza, cindezela u-1~3nin nge-gauze oyinyumba embotsheni yenaliti, bese uyilungisa nge-adhesive tape.Cela isiguli ukuthi sihlale embhedeni.
7. Lapho iziguli ezigula kakhulu zibhobozwa, ngokuvamile zithatha indawo eyisicaba, futhi akufanele zinyakazise umzimba wazo kakhulu ukuze zibhoboze.
Izinyathelo zokuphepha ze-Thoracocentesis
1. Inani loketshezi oludonswa ngokubhoboza ukuze kuxilongwe ngokuvamile luyi-50-100ml;Ngenhloso yokuwohloka kwengcindezi, akufanele idlule ku-600ml okokuqala bese kuthi u-1000ml ngesikhathi ngasinye ngemuva kwalokho.Ngesikhathi sokubhoboza i-hemothorax ebuhlungu, kuyatuseka ukukhulula igazi elinqwabelene ngesikhathi esifanayo, unake umfutho wegazi nganoma yisiphi isikhathi, futhi usheshise ukumpontshelwa igazi nokumnika ukuze kuvinjelwe ukungasebenzi kahle kokuphefumula nokujikeleza kwegazi noma ukushaqeka phakathi nokukhipha uketshezi.
2. Ngesikhathi sokubhoboza, isiguli kufanele sigweme ukukhwehlela nokushintshashintsha kwesimo somzimba.Uma kunesidingo, i-codeine ingathathwa kuqala.Esimeni sokukhwehlela okuqhubekayo noma ukucinana kwesifuba, isiyezi, umjuluko obandayo nezinye izimpawu zokuwa ngesikhathi sokuhlinzwa, ukukhipha uketshezi kufanele kumiswe ngokushesha, futhi i-adrenaline kufanele ijovwe ngaphansi kwesikhumba uma kunesidingo.
3. Ngemva kokubhoboza i-pleural yoketshezi kanye ne-pneumothorax, ukubhekwa komtholampilo kufanele kuqhutshekwe.Uketshezi lwe-pleural kanye negesi kungase kukhuphuke futhi ngemva kwamahora ambalwa noma usuku olulodwa noma ezimbili kamuva, futhi ukubhoboza kungaphinda uma kunesidingo.
Isikhathi sokuthumela: Oct-25-2022
