Tracheotomy - Iyini? Technique tracheotomy

Ngo kokuhlinzwa, kukhona imiqondo ezimbili - tracheotomy futhi tracheostomy.

Tracheotomy - intuba tracheal kanye nokwethulwa tube kuwo sokufinyelela umoya ongena yomoya ephansi ngesikhathi asphyxia. Lo msebenzi eziphuthumayo wenziwa.

Tracheostomy - nayo kokuvula kuqhoqhoqho, kodwa suturing emaphethelweni Imi umphumela ijwabu ecashile kanye kumiswa imigodi ukuphefumula.

Umlando omncane

Le ndlela eziphuthumayo kwakuvele kwaziwa eGibhithe lasendulo nalapho India, kunobufakazi obubhalwe ukuthi bathokozela ngisho Aleksandr Veliky ukuze kusindiswe amabutho akhe. Mayelana nale nqubo, thina wabhala uHippocrates futhi Gallen, kodwa ngenxa ukuhlukumezeka kwakhe nengozi ekuphileni ngokuvamile Kunconywa ukuba silusebenzise umkhuba.

Ukusebenza lokuqala yimpumelelo owenziwa udokotela Italian Anthony Brasavola ngo-1546. Lobu wubufakazi bokuqala zabhala emva inqubo isiguli usaphila. Kusukela 1718 lolo hlobo lokuhlinza isiba ezejwayelekile futhi odokotela abaye basisebenzisa ngayo kabanzi. Nokho abaningi namanje ukulisebenzisa. Ngokwesibonelo, udokotela siqu uGeorge Washington wakhetha ukuba nesineke bangaphezu banquma ukwenza zokukhwabanisa okuyingozi.

Ukuvela imithetho ka aseptic kanye isinqandakuvunda kancane kwanciphisa ingozi yezinkinga nokufa, kodwa namanje akazange ukukholisa abezokwelapha ukuthi le ndlela iphephile ukuze isiguli. Okwamanje, tracheotomy - indlela ekhethekile ukusiza, esetshenziselwa kuphela uma zonke ezinye izindlela (reception Geymliha, intubation) ayizwakali noma awunaso isikhathi.

I izinkomba ukuhlinzwa

Kungakhathaliseki kungase kubonakale tracheotomy elula, izinkomba ngoba zibukhali ngokwanele, njengoba ingozi ukuze ukuphila komuntu ngalesi zokukhwabanisa mkhulu izinzuzo ezingaba khona. Ziyakwazi:

1. emizimbeni Foreign amanga ngaphezu kuqhoqhoqho, okuyinto ayikwazi ukususwa ngezinye izindlela.
2. Contusions ukuvala inesikhala we amalaka.
3. Acute laryngeal stenosis at diphtheritic croup, pertussis, isimungumungwana, typhus futhi t. D.
4. Abaphila inesikhala we kuqhoqhoqho noma umphimbo lwesimila.
5. Kokucindezela elingenhla ipheshana zokuphefumula kusuka ngaphandle.
6. chemical ukusha
7. stenosis nomzimba.

Izinhlobo umgudu ukuvimbela

• Olunamandla, noma fulminant, - eba indaba ngemizuzwana. Lokhu kungaba njengoba ukuvaleka imizimba angaphandle, efana edema nomzimba.
• Acute - kuzibonakalisa kwamaminithi ambalwa, ngokuvamile exhumene idiphtheria noma imigwamanda angaphandle.
• Subacute - ukuvala mafutha anciphisa isikhala esingaphakathi umgudu okungatheni kungase kuhlale amashumi imizuzu noma amahora. Lesi simo esivamile croup zamanga, umphimbo obuhlungu, amakhemikhali ukusha.
• Okungalapheki - angakhula iminyaka engu enjalo izinqubo sokugembula ezifana nomdlavuza amalaka, perichondrium, cicatricial contracture kuqhoqhoqho.

ngezigaba

Kunezinhlobo eziningana tracheotomy, kuye ngokuthi ubuchwepheshe kokusebenza yayo.

Izinga asike izidumbu zabantu:

• Phezulu: ezingeni uqwanga cricoid.
• Isilinganiso: ezingeni uqwanga yegilo.
• Lower noma konikotomiya.

Ngu ubunjalo Imi isehlane:

• Longitudinal.
• Lateral.
• U-okwenyanga.

amathuluzi

Ungakhohlwa ukuthi kuwo wonke nokuphuthuma kwawo kanye ngokurhaba, le ndlela ibekwe njengoba ukusebenza. Tracheotomy kumele kwenziwe othile lamathuluzi, uma ikhona ayatholakala. Evamile, zingase ngamaqembu amabili amakhulu: nokuhlinzwa jikelele futhi amathuluzi ezikhethekile.

Isigaba sokuqala sihlanganisa esebenzisa, scalpels, izibopho bokumisa igazi, sikelo kuhlinzwa, ingwegwe kwezicubu zizalela, ipayipi, isipetu kanye nenaliti. Isigaba sesibili sihlanganisa a tracheal cannula, luer, ehlanganisa amashubhu ababili babe sebehlela eyodwa ngaphakathi nezinye; Shassinyaka ngixhumane ngokubamba uqhoqhoqho ngaphandle traumatizing ke; traheorasshiritel nehhuku ukuhambisa eceleni kulesi siqephu sezwe we indlala yegilo.

Technique tracheotomy

Ngaphambi yimuphi operation Kwenziwa ngevolumu okuhambisanayo ukuqeqeshwa esiza udokotela wakho ngokushesha ngangokunokwenzeka futhi ngaphandle kobuhlungu isiguli ukuba sifeze kokungenela kunesidingo. Kulokhu-ke kubalulekile ukuba ogulayo emhlane wakhe kanye esiphezulu aphonse emuva ikhanda lakhe emuva uqwanga we kuqhoqhoqho babe kuyabonakala. Ukuze wenze lokhu, ngezinye izikhathi ukusebenzisa ibhulashi. Ngemva nenkanuko edlulele, umuntu uthola izinto zokubulala izinzwa. Kungaba imuncwe njengendlela jikelele kanye lendawo. Konke kuncike kule mibandela ukusebenza uqhutshwa ngaphansi kwazo, ikhono ubudala, wezokwelapha kanye esibhedlela lesiguli. Uma kuphakama isimo esiphuthumayo, udokotela uqhuba zokukhwabanisa ngaphandle izinzwa. Phela amalungiselelo uzoqala ngokushesha tracheotomy.

Nqubo wakubo isikhumba Sectional, amafutha ongama, fascia kanye webs fibrous phansi kusukela uqwanga yegilo. Khona-ke imisipha wadalula okuyinto buhlanjululwe i obtuse ngendlela izinhlangothi. Ngaphansi kuba uqwanga futhi lesi siqephu we indlala yegilo. Iron ahlukaniswa kuqhoqhoqho kanye lizokhuphuka, enqamula omunye fascia. Hook futhi silungise amalaka, nokukhawulela nommese blade umunwe ngebhandeshi noma kakhonkolo, wenze imbobo encane. Umgomo abayifunayo. Air emuva emaphashini. Okokuqala stop ukuphefumula kungenzeka, kodwa isiguli sesiqala futhi ngincipha pink. Kuphela emva udokotela yayiqiniseka ukuthi le ndoda yaqala ukushaya futhi sakwazi ukuphefumula futhi, isilonda ufakwa cannula futhi kuvikelwe sutures wakhe noma ingcina. Isilonda sutured kangangokuba uvalwe labetibambile tube.

Konikotomiya

Lesi yisinyathelo encane ngaphambi tracheotomy, uma kungekho thuba futhi ukuze siqinisekise ukuthi ngokuvamile afeze tracheotomy. Running ke, ungakwenzi ukusikeka ekhuphukayo. Omunye ezinyakazayo enqamula entanyeni kwehle kuze uqwanga cricoid nemisipha schitoperstnevidnoy. Isigaba ngocingo sifakwe, ke buhlanjululwe emihlathini futhi uzilungise kulesi sikhundla. Uma isiguli waqala ukuba sikwazi ukuphefumula, waphenduka pink, ayenakho ukukhwehlela ke inqubo kuphumelele. Njengoba nje ingozi isidlulile, lingase lihunyushwe ngazo endaweni konikotomiyu tracheostomy ukunikeza njalo komoya esigulini.

amaphutha kungenzeka ngesikhathi zokukhwabanisa

Noma yimuphi operation has nemiphumela yako, yayiphumula futhi tracheotomy. Nezinkinga ezingase bavele kukho, kungenziwa zihlukaniswe amaqembu amathathu.

1. Ngo izinyathelo inqubo:

• Engalungile cutting line kungabangela ukopha emithambo yegazi, emoyeni embolism, futhi ngezinye izikhathi transection we ezivamile carotid Umthambo ;
• igazi angangena yomoya ephansi, okubangela asphyxia okuphindaphindiwe;
• kwesigaba kufanele alingane ububanzi we cannula, kungenjalo kuyodingeka thunga futhi eminye ona nezicubu;
• cut ezijulile kungabangela ukulimala ngomphimbo, ngakho ikhaba nommese kufanele igcine 1 cm.

2. Ngokushesha ngemva kokuhlinzwa:

• hypoxia;
• ukwa tracheal izindandatho noma umshini wokubhoboza;
• emphysema ongama;
• pneumothorax.

3. umthelela imisiwe:

• tracheobronchitis;
• tracheal stenosis bese uphinda asphyxia;
• ukushintsha (hoarseness) amavoti ngoba yansukuzonke ezinzwa transection;
• ukukhubazeka yezimonyo.

Bonke odokotela ngisho ekolishi khumbula tracheotomy kanjani yingozi. Lokhu akulona uhlobo ukusebenza ukuthi kungaba kwenziwe njalo. Kuphela eziphuthumayo, ikakhulukazi uma isiguli on the esengozini yokufa nokuphila, ngoba ngokushesha, ungakwazi ukulimaza isiguli. Futhi uma lokhu zokukhwabanisa akuyona kwenziwe esibhedlela, kodwa endaweni ethile emgwaqweni noma ekhaya, kufanele ucabange kayikhulu ngaphambili kokuthi unqume. Simple Uma unganakile, inqubo kumele sisekelwe nesipiliyoni of nodokotela ohlinzayo. Tracheotomy ekhaya akuyona nje kungenzeki, kuyingozi. Uma ungenayo imfundo yezokwelapha namakhono afanele, ungazami phinde it.

Kuphethe i tracheotomy kuwusizo kuphela ukuze asindise ukuphila lomuntu! Ingozi yokufa noma sina yezinkinga siphakeme ngokwanele ukwenza udokotela cabanga izindlela. Ngisho unikezwa yokuthi lo msebenzi yaziwa kusukela kudala, abezokwelapha ongakabi esiphethweni ukuthi angalenza kanjani uphephile ngokwanele.

Tracheotomy - kuba ithuba ukusindisa ukuphila kothile, kodwa ithuba okulingana efanayo ukuze bawususe.