I tube emphinjeni emva kokuhlinzwa (bheka isithombe). Kungani ukufaka epayipini yakhe?

Kwezinye izimo, umphimbo surgically wenza umgodi. Lokhu kuyadingeka ngenxa yokulimala ezithile noma yizifo ezihlobene nokungabikho ukuphefumula kahle. I tube emphinjeni okudingekayo ukuze ababuyisele ekupheleleni umsebenzi.

ukuhluka kunokwenzeka

Ngokukhethekile eyenziwe surgically kokuvula emphinjeni ngokuthi i tracheostomy. I njalo isikhathi noma tube lingasethwa kuncike inkomba. Kodwa noma kunjalo kuba nomzimba angaphandle, okuyinto ine umphumela kuyacasula emzimbeni.

Uma kuhlelwe ukuthi tube emphinjeni kuyoba ngaphezu kwenyanga, kubalulekile ukuba thunga emaphethelweni kwesikhumba ukuze ulwelwesi lwamafinyila we kuqhoqhoqho. Kulokhu, a tracheostomy esitebeleni. Kodwa, uma kunesidingo, ukuhlinzeka komoya ngale ndlela isikhathi esifushane, isinyathelo ehlukile. Imi ezenziwa cannula ekhethekile ifakwe futhi emaphethelweni ezakhiwe Isilonda hhayi sutured. Kuyinto kule divayisi kuvimbela sokuvalwa imbobo wadala. Uma isuswe, igebe izovalwa izinsuku 2-3 bebodwa.

Sebenzisa cannula isikhathi eside is hhayi Kunconywa ngoba kungenzeka ukusabela sokugembula eduze kwezicubu paratracheal.

Izimpawu ze-tracheostomy

Kunezizathu eziningana okuyiwona ngeke akwenze ngaphandle imbobo we kuqhoqhoqho. Lo msebenzi iyadingeka acute laryngeal stenosis.

Abakwazi kubangelwe lezi zinto ezilandelayo:

• ingress imizimba angaphandle;
• ukusha (ezishisayo noma amakhemikhali);
• croup zamanga;
• idiphtheria;
• ukuvuvukala;
• emaceleni ukukhubazeka we yezwi.

Elinye iqembu izizathu okunesivivinyo tracheostomy, ukunikezwa kwe-amanzi tracheobronchial esihlahleni. Lokhu kwenzeka uma:

• kabi engqondweni kuhlasimulise ukulimala;
• esingamahlalakhona cerebrovascular (kufaka ngemuva unhlangothi);
• izimila ebuchosheni;
• ikhoma, ephelezelwa ukukhwehlela kahle futhi elisheshayo nokugwinya;
• yesikhathi eside isimo asthmaticus;
• kokunikezwa kwe-ubuqotho esifubeni isidumbu.

Futhi, lapho ukuhluleka kohlelo kwamanyuroni kudinga epayipini yakhe. Izithombe likwenza kucace ukuthi akukho esabekayo. Kodwa abantu abaningi uzama ukufihla idivayisi ezinjengenyanga okusezingeni eliphezulu noma scarves entanyeni. Izinkinga ohlelweni kwamanyuroni kuphakama ngenxa:

• ifomu poliomyelitis bulbar;
• izilonda esifundeni wesibeletho ka emgogodleni;
• polyradiculoneuritis;
• miostenii ezinzima;
• izilonda neuroinfec- (botulism, ngqi, ngamarabi).

Tracheostomy futhi intubation we umphimbo

Kwezinye izimo, akukho kokungenela kuhlinzwa lubaluleke. Tracheostomy lwenziwa labo izimo lapho udinga isikhathi eside ukuqinisekisa ukuthi kungenzeka ukuphefumula. Ngokuvamile kwenziwa ukuze nikwazi isikhathi eside ukusebenzisa womoya-mpilo.

Uma kudingeka ukuba isiguli sibe ukubuyisela uphefumula ngokuvamile, ukunikeza negesi lokushintshisana ephelele emaphashini phakathi nokuhlinzwa, wenziwa tracheal intubation. Kulokhu, tube yethulwa ngokusebenzisa ikhala noma umlomo ku emphinjeni. Nokho, le ndlela ingasetshenziswa kuphela lapho ukupholisa ludingeka amahora ambalwa noma izinsukwana. Nokho, intubation kungabangela umonakalo odongeni engaphakathi kuqhoqhoqho. Lokhu kuzokwenza ukusikwa yayo.

Uma usebenzisa tube emoyeni sihamba ngenhla tracheostoma incipha ingxenye anatomically efile yaleli pheshana zokuphefumula. Kulokhu, kungenzeka ukulawula isikhathi eside umoya.

ukuhlinza

Kwezinye izimo, imisebenzi edingekayo ukuze ahlinzeke negesi lokushintshisana ephelele emaphashini futhi bronchi. Abaningi abazi ukuthi kungani epayipini yakhe, kulesi simo. Tracheal intubation abakwenzayo ukuqinisekisa umgudu patency. Lena ngenye yezindlela othembeke kunabo bonke, okuyinto futhi likuvumela ukuthi ncela kusukela bronchi kanye kuqhoqhoqho ukwakha imfihlo ngokusebenzisa catheters ekhethekile.

Yenza intubation ezimweni ezimbalwa. Lokhu kuyadingeka uma kukhona ingozi nenshisekelo - lingene emaphashini lokuqukethwe esiswini. Futhi, le nqubo kuboniswa ephula amanzi umsebenzi uqhoqhoqho futhi bronchi.

Kodwa ekwelapheni umdlavuza amalaka liyadingeka tracheostomy. nokuqaliswa kwalo ingenye izigaba yokwelapha. I tube emphinjeni emva kokuhlinzwa ukususa amalaka ebukhoneni umdlavuza Kuphoqelekile.

Inqubo inikeza ukuthi kungenzeka ukuphefumula asizayo noma elawulwa. Isiguli, kungakhathaliseki isikhundla umzimba, inqobo nje uma kungena umoya evamile. Ngaphezu kwalokho, aqede kungenzeka ukuklinya ngu nenshisekelo ubuhlanzo, isikhwehlela, igazi noma spasm we nemisipha, le ingress imizimba angaphandle.

izinhlobo imisebenzi

asike izidumbu zabantu eqondile kuqhoqhoqho ukunikeza emoyeni ukubhajwa nokususwa uma kunesidingo zemizimba angaphandle, ngokuthi tracheotomy. A tracheostomy - it is lingabekela kuvulwa sangaphandle uqhoqhoqho. Ukulandela lesi kokungenela kukhona tube ekhethekile semphinjeni engathandi ukuphefumula.

Kuye imbobo ukuhlukanisa engenhla, maphakathi kanye tracheostomy aphansi. Futhi kungaba longitudinal, transverse kanye ezimise U-.

Ngesikhathi phezulu imbobo tracheostomy senziwa phezulu mdweshu we indlala yegilo. Lo msebenzi ubhekwa elula kakhulu futhi wenziwa kaningi.

Uma Imi kwenziwa ukunqamula kulesi siqephu sezwe, ukuthi nokugxambukela ubizwa ngokuthi tracheostomy kusho. Lena enye yezinhlobo ezingu ukusikeka yingozi kakhulu futhi kunzima ngenxa yokuthi kukhona ingozi yokonakalisa yegilo. Kuye kwenziwa ukuhlinzwa okunjalo kuphela ezimweni lapho kungekho thuba ukwenza ngenye indlela, ezifana umdlavuza indlala yegilo.

Kungenzeka futhi ukuba bafeze tracheostomy aphansi. It wenziwa sezwe. Lokhu kuhlinza kuboniswa izingane ezingaphansi kweminyaka eyi-15 ngenxa yesimo yemizimba isakhiwo. Abaningi bayazibuza ukuthi kungani ngamapayipi emphinjeni ezinganeni. wayevame livela izingane abaphethwe azalwa naso umgudu kwezinso.

Tracheostomy for mpilo

Uma isiguli sidinga ukupholisa mechanical, umbuzo ucabangela ukuthi okanye ukuqhuba ukuhlinzwa wanquma emphinjeni wakhe. Tracheostomy amashubhu okwaziyo ukugcina ukuzinza le mpilo, ngaleyo ndlela ngeke kube khona ingozi amalaka nesifunda subglottic umonakalo. Ngokuvamile umbuzo sokungenela liphuma ngemva intubation isiguli izinsuku 7-10. Kwakuphakathi nalesi sikhathi, kusobala ukuthi umoya omncane kudingeke isikhathi eside ngeke.

Khona-ke kukhona zonke kuyacaca ukuthi kungani ngamapayipi ufakwa emphinjeni. Ukuxolela zenziwa kuphela izinsana seziguli ezisencane ngenxa yokuthi ukuthi babe tracheostomy ngokuvamile kubangela izinkinga. Ukusebenza wenziwa ngaphansi izinzwa jikelele nge intubation isiguli.

Izimpawu I-tracheostomy ezinganeni

Kwezinye izimo, ngisho iziguli kulencane badinga epayipini yakhe. Hlobo luni isifo kuphakamisa nesidingo esingaka? Kudivayisi sifakwe isimiso azalwa naso noma bathenga, izimila, izilonda esibuhlungu, yokungavuthwa yaleli pheshana zokuphefumula.

Muva nje, isimo ngenhla kungatholakala e-tracheomalacia ifomu laringomalyatsii. Kuyaqapheleka futhi stridor inspiratory, sokuhoxisa kwemisipha intercostal, flaring acinene. Lesi simo singaba kuphakama ngenxa azalwa naso yephimbo ukukhubazeka, ukulimala isimiso sezinzwa noma phrenic laryngeal emsipheni. Ngu izinkomba isegazini futhi zihlanganisa kuqhoqhoqho Agnese.

Kodwa zikhona eziningi pathologies aluthola lapho kuyodingeka le epayipini yakhe. Ngemva kokuhlinzwa, iziguli asemasha ukujwayelana nomzimba angaphandle, futhi uqhubeke ukuphila okuvamile. Ngokuvamile tube kuyadingeka emva umsebenzi ngesikhathi eside ngoba ukupholisa lokukhanda. Futhi, isidingo ke kuphakama at ebusuku zokuphelelwa umoya, izinkinga kwamanyuroni, izifo ezingelapheki, futhi nokufuna kugunyazwe ugqozi.

Izici yokusebenza nezingane

Kungakhathaliseki ukuthi yini ebangele ukuba isidingo ukwenza ingane tracheostomy, kukhona umehluko wemisindo nemiqondo yamagama eqondile inqubo iziguli omncane. Lokhu kungenxa izici of isakhiwo imizimba yabo. Ngakho, bonke indlala izingane yegilo siphakeme ngokwanele, ngakho ukuchitha tracheostomy aphansi.

kwakhiwa uqwanga seziguli ezisencane neze dissected is kusukela phambi kodonga tracheal, njengoba lokhu kungaholela ukuntengantenga we kuqhoqhoqho uqobo futhi ibe imbangela nobunzima e decannulation. futhi kungahlali inketho transection. Esimweni esinjalo, i tracheal indandatho ukusonteka ngenxa tube ingcindezi.

isimila ukwakheka

Abantu abadala kanye nezingane kungadinga tracheostomy nge ukubukeka teratomas noma sarcomas. Kodwa ngo seziguli ezisencane zingase cindezela kuqhoqhoqho kanye okwakheke ezifana hemangioma noma lymphangioma.

Lapho kuhlolwa umdlavuza amalaka izinyathelo odokotela kufanele iqondiswe hhayi kuphela ukukhishwa kwe-isimila futhi kuvimbele ekukhuleni kwayo eminye, kodwa futhi ukubuyisela zokuzivikela, izwi kanye nemisebenzi zokuphefumula. Ngakho-ke, i-epayipini yami emva kokuhlinzwa yomdlavuza laryngeal Kuphoqelekile ezimweni lapho isiguli wenziwa Ukukhishwa kwamalaka akumshiyanga nje - ukuhlinzwa ukhishwe wonke amalaka.

Lokhu kungagwenywa kuphela uma umdlavuza sitholakale ngesikhathi esiteji 1, lapho isilinganiso wamshaya Kuphela amalaka. Esimweni esinjalo eyodwa yephimbo isusiwe. Ngezinye izikhathi resection we umphimbo lapho kususwe ingxenye yomzimba, kodwa yonke imisebenzi yayo kuyagcinwa.

Uma udinga ukuqedela extirpation we umphimbo, kubalulekile ukuba alungiselele yokuthi ukholelwa ngokuqinile ukuthi akunakwenzeka ukuba usebenzise evamile ibhokisi indlela izwi. It kumelwe ibuyiselwe.

Ukunakekela tracheostomy

Kungakhathaliseki izizathu ukuthi kudingeka tube emphinjeni, udinga ukukhumbula ukuthi ethola khona ilandelwe. Care ukuwasha nsuku zonke futhi apharathasi magciwane. Ngaphezu kwalokho, endaweni stoma kumele njalo kuthambisa isikhumba ukuze kuqedwe kungenzeka yokucasuka. I tube bangase baphathwe wamafutha okugcoba ukuba lula beya.

Ngaphezu kwalokho, odokotela batusa kokushiya stoma ngaphandle cannulas isikhashana (cishe ihora). Kodwa ekuqaleni kubalulekile eduze nokuqapha imvume. Ngokuhamba kwesikhathi, wathi isikhathi zingandiswa kuze umgodi ayakhekanga ngokugcwele okwamanje. Ngemva kwalokho okokugqoka we cannula iba ezingadingekile. Ngesikhathi esifanayo kakhulu ekuthuthukiseni isimo lesiguli. Ngemva tracheostomy cannula noma tube ecasula odongeni tracheal.

Izici yokuphila

Njengoba asebenzelana ngayo umbuzo othi kungani ngamapayipi emphinjeni kuyadingeka, abaningi awuphathekile kahle ngenxa banayo umkhawulo isisindo. Nge wathi kudivayisi akunakwenzeka ushawa, ukubhukuda, ukubhukuda kweziziba, izindlu zokugezela. Phela, igcwele ingozi yokubindeka. Nokho, Kodwa, emakethe ungathola khona inhlansi yethemba ekhethekile oluvimbela kungenzeka amanzi angena stoma.

Ungakhohlwa ukuthi ukuphila okuvamile ezindaweni gassy qu isebenze Ukuvikelwa kwemvelo nasopharynx. Futhi abantu abanombono tube emphinjeni, akusiyo. Ngakho-ke kungcono sokugwema ukuvakashela izindawo ezinjalo. Zonke iziguli ezine-a tracheostomy usengozini yokuthola ukuvuvukala kanye nezinye izifo bronchopulmonary. Kufanele kushisa, ukumboza ibhandishi stoma, ugcwala emanzini. Futhi ngenkathi ezibandayo, izikhatha zomoya oshisayo okunxanelekayo.

izinhlobo tracheostomy

Ngokuvamile kukhona epayipini yakhe phakathi nokuhlinzwa. Ngakho-ke, uma ukuhlinzwa is akwenziwanga erhabekileko, isiguli ubonane nodokotela ukusungula onjani tracheostomy.

Manje kukhona uhlu olubanzi lezi amadivaysi, kodwa iningi labo zenziwa elinama ekhethekile Thermoplastic. engavamile wabo itholakala lokuthi ukuthi ezingeni lokushisa mayelana 35-38 ° C tube emphinjeni iba nokunwebeka. Lokhu kukuvumela ukuba ugcine yonke ulwelwesi lwamafinyila we kuqhoqhoqho nezinye ezicutshini ezincikene nawo. Emaphethelweni elingaphandle tube evala isakhiwo efana ukuma uvemvane. Kuyinto okwazi ukuqinisekisa ukuvikelwa ijwabu zangaphandle ezizungezile emphinjeni eyenziwe mafutha anciphisa isikhala esingaphakathi.