I-Thoracentesis
3. Ukubulala amagciwane
1) Ukukhishwa kwesikhumba okujwayelekile, 3 iodine 3 utshwala, ububanzi 15cm
2) Gqoka amagilavu oyinyumba,
3) Ithawula lokubeka imbobo
4. Isendlalelo ngesendlalelo sokungena endaweni yokubulala izinzwa
I-1) Iziguli zinganikezwa i-0.011mg / kg i-atropine nge-intravenously ukuvimbela i-vasovagal reflex ngesikhathi sokukhishwa kwamanzi.Ama-anesthetics noma ama-sedatives awadingi ukusetshenziswa.
I-2) Ngesikhathi sokubhoboza, isiguli kufanele sigweme ukukhwehlela nokujikeleza kwesimo somzimba, futhi sithathe i-codeine kuqala uma kunesidingo.
3) I-2ml i-lidocaine yabhotshwa emaphethelweni angaphezulu ombambo olulandelayo ukuze kwakheke i-colliculus
4) Faka ungqimba ngongqimba ukuze uvimbele ukujova emithanjeni yegazi, futhi ungangeni umgodi we-pleural ujule kakhulu.
5. Ukubhoboza
Isikhumba endaweni yokubhoboza silungiswa ngesandla sobunxele, futhi inaliti ifakwe ngesandla sokudla
Onqenqemeni olungaphezulu lombambo olandelayo, endaweni ye-anesthesia yendawo, jova inaliti kuze kuphele ukumelana, futhi umise umjovo.
Inalithi yokubhoboza engaguquki ukuvimbela ukubhobozwa kwezitho zangaphakathi
Vimbela umoya ukuthi ungangeni emgodini we-pleural.Qaphela lapho usebenzisa isilinda yenaliti kanye nokushintsha kwezindlela ezintathu.Umoya awuvunyelwe ukungena emgodini wesifuba.Ungalokothi umpompe uketshezi lwe-pleural ngamandla ukuze ugweme inaliti noma i-catheter engena ku-pleura ilimaza iphaphu.
6. Ukudonsa inaliti
1) Ngemuva kokukhipha inaliti yokubhoboza, yimboze nge-gauze oyinyumba bese uyilungisa ngaphansi kwengcindezi
2) Lala unganyakazi ngemva kokuhlinzwa ukuze ugweme ukuhlanzwa kwendawo
7. Izinyathelo zokuphepha ngesikhathi nangemva kokuhlinzwa
1. Esimeni sokushaqeka kwe-anaphylactic, yeka ukuhlinzwa ngokushesha bese ujova u-0.1% -------------0.3ml-0.5ml i-adrenaline ngaphansi kwesikhumba.
Isiguli singase sizwe ubuhlungu besifuba lapho iphaphu lelulelwa kabusha odongeni lwesifuba.Esimweni sobuhlungu obukhulu besifuba, i-dyspnea, i-tachycardia, ukuquleka noma ezinye izimpawu ezimbi kakhulu, kuphakanyiswa ukuthi isiguli sinokungezwani komzimba, futhi ukugeleza kwamanzi kufanele kumiswe, ngisho noma kusekhona inani elikhulu le-pleural effusion esifubeni.
2. Isikhathi esisodwa ukupompa uketshezi akufanele kube kuningi, kungabi ngaphezu kwama-700 okokuqala, futhi kungabi ngaphezu kuka-1000 esikhathini esizayo.Ezigulini ezinoketshezi oluningi lwe-pleural, kufanele kukhishwe uketshezi olungaphansi kuka-1500ml isikhathi ngasinye ukuze kugwenywe ukuntengantenga kwe-hemodynamic kanye/noma i-pulmonary edema ngemva kokuqashwa kwamaphaphu.
Uma kwenzeka ukubhoboza i-hemothorax ebuhlungu, kuyatuseka ukukhipha igazi eliqoqiwe ngesikhathi esifanayo, unake umfutho wegazi nganoma yisiphi isikhathi, futhi usheshise ukumpontshelwa igazi nokumnika ukuze kuvinjelwe ukungasebenzi kahle kokuphefumula nokujikeleza kwegazi noma ukushaqeka ngesikhathi sokukhipha uketshezi.
3. Ukukhishwa kwe-Diagnostic fluid 50-100
4. Uma kuyi-empyema, zama ukuyimunca ihlanzekile ngaso sonke isikhathi
5. Ukuhlolwa kwe-Cytological kufanele okungenani kube yi-100 futhi kufanele kuhanjiswe ngokushesha ukuze kuvinjelwe ukuhlaziya iseli
6. Gwema ukubhoboza ngezansi kwesikhala se-intercostal sesishiyagalolunye ukuze uvimbele ukulimala ezithweni zesisu
7. Ngemuva kwe-thoracocentesis, ukubhekwa komtholampilo kufanele kuqhutshwe.Kungase kube amahora ambalwa noma usuku olulodwa noma ezimbili kamuva, i-thoracocentesis ingaphinda iphindwe uma kunesidingo.
Isikhathi sokuthumela: Jun-08-2022
