I-Thoracic indwelling tube - i-drainage ye-thoracic evaliwe
1 Izinkomba
1. Inani elikhulu le-pneumothorax, i-pneumothorax evulekile, i-tension pneumothorax, i-pneumothorax icindezela ukuphefumula (ngokuvamile lapho ukucindezelwa kwamaphaphu e-unilateral pneumothorax kungaphezu kuka-50%).
2. I-Thoracocentesis ekwelapheni i-pneumothorax ephansi
3. I-Pneumothorax kanye ne-hemopneumothorax edinga umoya omncane noma owokwenziwa
4. I-pneumothorax ephindaphindiwe noma i-hemopneumothorax ngemva kokususwa kwe-thoracic drainage tube
5. I-hemopneumothorax ebuhlungu ethinta imisebenzi yokuphefumula nokujikeleza kwegazi.
2 Ukulungiselela
1. Izimo
Indawo yokuhlala noma yokulala kancane
Isiguli sisendaweni elele uhhafu (uma izimpawu ezibalulekile zingazinzile, isiguli sisendaweni elele phansi).
2. Khetha indawo
1) Ukukhethwa kwesikhala sesibili se-intercostal somugqa we-clavicular omaphakathi we-pneumothorax drainage
I-2) I-Pleural effusion ikhethiwe phakathi kwe-axillary midline kanye ne-posterior axillary line, naphakathi kwe-6th kanye ne-7th intercostals.
3. Ukubulala amagciwane
Ukukhishwa kwesikhumba okujwayelekile, ububanzi 15, 3 iodine 3 utshwala
4. I-anesthesia yendawo yokungena
Umjovo we-intramuscular of phenobarbital sodium 0 lg.
Ukungena kwendawo kwesendlalelo sokulungiswa kwezindonga zesifuba endaweni ye-anesthesia incision kuya ku-pleura;Sika isikhumba ngo-2cm eduze komugqa we-intercostal, welule i-vascular forceps eceleni konqenqema olungaphezulu lwezimbambo, futhi uhlukanise izingqimba ze-intercostal muscle esifubeni;Ishubhu lokudonsa amanzi kufanele libekwe ngokushesha lapho uketshezi luphuma.Ukujula kweshubhu lokudonsa amanzi emgodini wesifuba akufanele kudlule u-4 ~ 5cm.Isikhumba sodonga lwesifuba kufanele siboshwe ngentambo kasilika ephakathi nendawo, ishubhu lokudonsa amanzi kufanele liboshwe futhi lilungiswe, futhi limbozwe nge-gauze oyinyumba;Ngaphandle kwe-gauze, bopha itheyiphu ende ezungeze ishubhu lokudonsa amanzi bese ulinamathisela odongeni lwesifuba.Ukuphela kweshubhu lokudonsa amanzi kuxhunywe ku-disinfection yeshubhu yenjoloba ende ebhodleleni elivalwe ngamanzi, futhi ishubhu lerabha elixhunywe ebhodleleni elivalwe ngamanzi limiswa phezu kombhede nge-adhesive tape.Ibhodlela lokudonsa amanzi lifakwa ngaphansi kombhede wasesibhedlela lapho okungelula khona ukuwisa.
3 Intubation
1. Ukusikwa kwesikhumba
2. Ukwehlukaniswa okubuthuntu kongqimba lwemisipha nokubekwa kweshubhu lokudonsa ithoracic elinembobo eseceleni onqenqemeni olungaphezulu lombambo.
3. Imbobo eseceleni yeshubhu lokudonsa amanzi kufanele ibe ngu-2-3cm ukushona emgodini wesifuba
4 Izinyathelo zokuqapha
1. Uma kwenzeka i-hematocele enkulu (noma i-effusion), umfutho wegazi kufanele uqashwe ngokucophelela phakathi nokukhipha amanzi okuqala ukuze kuvinjelwe isiguli ekushaqekeni okungazelelwe noma ukuwa.Uma kunesidingo, umfutho wegazi kufanele udedelwe ngokuqhubekayo ukuze kugwenywe ingozi engazelelwe.
2. Naka ukugcina ishubhu lokudonsa amanzi livuliwe ngaphandle kwengcindezi noma ukuhlanekezela.
3. Siza isiguli ukuthi sishintshe isikhundla ngendlela efanele nsuku zonke, noma ukhuthaze isiguli ukuthi sithathe umoya ojulile ukuze sifinyelele amanzi agcwele.
4. Rekhoda umthamo wansuku zonke wokudonsa amanzi (ivolumu yokukhipha amanzi ngehora esigabeni sokuqala ngemuva kokulimala) kanye nezinguquko zezakhiwo zakhona, futhi wenze i-X-ray fluoroscopy noma ukuhlolwa kwefilimu ngokufanele.
5. Uma kushintsha ibhodlela lamanzi angenalutho elivalekile, ishubhu lokudonsa amanzi kufanele livalwe okwesikhashana kuqala, bese kuthi ishubhu lokudonsa amanzi likhishwe futhi ngemva kokushintshwa ukuze kuvinjwe umoya ukuthi ungamuncwa ukucindezela okungalungile kwesifuba.
6. Ukuze kuqedwe ukutheleleka kwesibili, ukuhlolwa kwesiko lebhaktheriya kanye nokuhlolwa kokuzwela kwezidakamizwa koketshezi lwe-drainage kungenziwa uma izakhiwo ze-drainage zishintshwa.
7. Lapho ukhipha ishubhu lokudonsa amanzi, isikhumba esizungeze indawo kufanele sibulawe amagciwane kuqala, kukhishwe umsele ongashintshi, ishubhu lokudonsa amanzi eduze nodonga lwesifuba kufanele liboshwe ngama-vascular forceps, futhi ukuvuleka komsele kufanele kuvalwe nge-12 ~ Izingqimba eziyi-16 ze-gauze kanye nezingqimba ezi-2 ze-vaseline gauze (kuhlanganise ne-vaseline encane kakhulu kuyakhethwa).Umsebenzisi kufanele abambe i-gauze ngesandla esisodwa, abambe ishubhu lokukhipha amanzi ngesinye isandla, futhi alikhiphe ngokushesha.I-gauze ekuvuleni kwe-drainage yayivalwe ngokuphelele odongeni lwesifuba ngesiqephu esikhulu se-tape yokunamathisela indawo yayo idlula i-gauze, futhi ukugqoka kungashintshwa ngemva kwamahora angu-48 ~ 72.
5 Ubuhlengikazi bangemva kokuhlinzwa
Ngemuva kokuhlinzwa, ishubhu lokudonsa amanzi livame ukugcwala ngokweqile ukuze kugcinwe i-lumen ingavimbeli.Ukugeleza kwamanzi kuqoshwa njalo ngehora noma amahora angama-24.Ngemuva kokukhipha amanzi, amaphaphu akhula kahle, futhi akukho gesi noma ukuphuma kwamanzi.Ishubhu lokukhipha amanzi lingasuswa lapho isiguli siphefumula ngokujulile, futhi isilonda singavalwa nge-vaseline gauze kanye ne-adhesive tape.
Isikhathi sokuthumela: Jun-10-2022
