Ukunakekela tracheostomy egunjini labagula kakhulu

Ukunakekela isiguli nge tracheostomy wenziwa esibhedlela ngemuva ukuhunyushwa ICU nesineke. Ngokuvamile, i-tracheostomy ibekwa sisendleleni conductive lomoya uma kunesidingo ukupholisa.

Izinkomba inqubo

Buciko tracheostomy e izimo umile ezifanele kakhulu kuhilela elilungile Ukukhetha indlela futhi asike izidumbu zabantu ngokucophelela homeostasis kuqhoqhoqho. Ngokuvamile esetshenziselwa ukuhlinzwa noma endotracheal izinzwa ihlelwe ngokulandelana kwezihloko isicelo isixazululo novocaine.

Isidingo eyohlinzwa ukuze umgudu tracheostomy kuphakama:

• endabeni isikhathi eside ukupholisa ngemishini;
• ebukhoneni bulbar iziyaluyalu;
• ngaphandle kungenzeka mahhala emoyeni permeability bawuphithanisile umkhondo wezindlela conductive ngenye indlela;
• kahle ongaphakeme umgudu yangasese;

Su tracheostomy

Ukusebenza tracheostomy umgudu kudinga eziningana izinhlobo scalpels - lesion engxenyeni engaphandle kwesikhumba futhi tracheal imbobo. Futhi ngesikhathi inqubo iyosebenza: izingwegwe beya, spreaders kwesikhumba nemisipha, omfisha, swabs luhlanzekile futhi usula.

Isiguli ibekwa isikhundla lisalele elekhanda aphonswe emuva. Isikhumba phezu uqhoqhoqho is disinfected ngotshwala, antiseptics, isixazululo of iodine wesula ngokucophelela ngendwangu oyinyumba.

Ngesikhathi inqubo isicelo cut mpo kusukela yegilo uqwanga emaphethelweni engenhla sternum. Ngaphezu kwalokho, isiqondiso ovundlile inqanyulwa fascia, bese usebenzisa i-kit eziphawulwe ngenhla okunzima MEDINSTRUMENT kwenzeka razdvizheniya muscle ukukhululwa kwe-kuqhoqhoqho. Nommese wokubhoboza kuqhoqhoqho is dissected kanye ukususwa ichopho elincane izicubu, eyanele ukuze ihlanganise tube umgudu.

Mahhala imiphetho tracheal ezindaweni ichopho usike-off sutured isikhumba, okuyinto enomthelela ekushintsheni tracheostomy amashubhu. Naphezu inqubo kunalokho kuyinkimbinkimbi isethwe tracheotomy, inqubo lula kakhulu nge intubation pre-nesineke.

Kukhethwa amashubhu

, Ukunakekelwa Esinokwethenjelwa ngokucophelela a tracheostomy ku labagula ayekudinga ukukhethwa ngamapayipi efanelekayo, ekukhethweni zazo ixhomeke ezimweni. Okwamanje kabanzi uthenge metal ishubhu double nge cuff. Kungenzeka futhi ukusebenzisa amapayipi epulasitiki, umfutho okuyinto uhlaliseke esebenzisa amasilinda ekhethekile.

Ukukhetha Ofanele eliphezulu tube inikeza ukunakekelwa lula we tracheostomy e labagula ngaphandle okubangela ukukhathazeka ngokungadingekile nesineke. Lapho ukhetha i yezinkinga tube lungafanelekile ngokuvamile kuphakama njengoba ukuvaleka inesikhala isikhwehlela obukhulu omisiwe. Ngakho-ke, ukukhetha kwakhe kufanele kwesokunxele ochwepheshe.

Izikhungo tracheotomy amashubhu

Endabeni cannula metal kudinga isizinda tube kwangaphakathi okungenani kanye ngosuku yokuhlanza kanye isinqandakuvunda ukwelashwa amalungiselelo. Nokho, lezi zingxenye elingaphandle cannula ushintsho ezingavamile kakhulu, hhayi izikhathi ezingaphezu kwesisodwa ngesonto.

Cuff cannula ngoba tracheotomy akufanele ahlale isimo eqolo. Ngezikhathi isuswe therefrom emoyeni ngokweqile futhi igcinwe elele cishe imizuzu engu-10, wabe esebuyela isikhala. Ngaphambi kokuba bathathe yokuvimbela yokutakula cuff kufanele ususe ngokucophelela Skopje okuqukethwe nezingahlobene nendaba we oropharynx.

Ikakhulukazi ukunakekelwa ostomy

ukunakekelwa Periodic we tracheostomy wenziwa usebenzisa oyinyumba gauze ukotini swabs. nezicubu eziseduze bahlanza ukunyakaza semi isiyingi phandle. izicubu Eminye ezihlolelwe yezinkinga izilonda zaso.

Ukunakekela tracheostomy kudinga esikhundleni sivala kwenzeka umswakama ngokweqile noma ukungcola ekuqongeleleni sina. Feza inqubo esikhundleni kufanele kube uma kukhona usizo. Umuntu oyedwa ophethe tube esimweni esitebeleni, futhi umsizi wakhe ingena esikhundleni abanikazi tube.

Phakathi ngemuva kokuhlinzwa ngezinsuku zokuqala kuyinto efiselekayo anakekele tracheostomy futhi peristomalnoy endaweni ngezikhawu amahora 6-8. Ngesikhathi esifanayo, ungakwazi ukushintsha njalo gauze kusaladi uma kuba nesidingo. , Amathuluzi kanye Amalungiselelo ukunakekelwa ngaso sonke isikhathi kumele ususondele.

Ukunakekela tracheostomy: algorithm

Ngokokuqala ngqá esikhundleni tube ekhiqizwa emva kwezinsuku ezimbalwa emva kokuhlinzwa. Ngaphezu kwalokho, le nqubo kumele kwenziwe onekhono, kusukela kulesi sikhathi akwanele ukwakha stoma obukhulu.

I-algorithm inqubo:

• isiguli ibekwe emhlane wakhe aliphonse ikhanda lakhe;
• kwenziwe zokuhlanzwa ephelele izimbobo tracheobronchial;
• ukususa phlegm a ekhwehlela nesineke okubangelwa eyayenziwe;
• It is busuka tube ingaphakathi ipayipi nezimo ke ekhishwe tracheostomy cannula;
• Yomiselela amashubhu okwenziwe isuswe umqhubi;
• A ipayipi entsha abethela futhi fixed esimweni esitebeleni;

Ixhuma iziguli nge tracheostomy for mpilo

Ngokuvamile ekunakekeleni iziguli nge tracheostomy kudinga ukuxhumana mpilo umgudu. idivayisi exhunyiwe ngokusebenzisa cannula ngaphambilini osungulwe ebukhoneni compounds asizayo.

Ngenjongo uxhumano nzile isiguli mpilo cannula ejwayelekile kungenzeka indawo eziklanyelwe endotracheal tube noma umklamo ezivamile nge cuff inflatable. Ngqo iyunithi ngokwayo ngoba ukupholisa tube unamathele ekupheleni ejwayelekile ezabekwa amadivaysi.

yezinkinga kungenzeka

Ukunakekela tracheostomy ngokuvamile kuholela ukubhekana nezinkinga ezithile ezingase zivele njengoba nje ukusebenza kuqedile, nokunye kamuva, ngisho nesimo sokuhlala isiguli.

I inkinga obujwayelekile okuvela ukopha, ikakhulukazi uma tracheostomy wenziwa usebenzisa amathuluzi etholakala erhabekileko, ngesikhathi eliseceleni kombhede. Ukuphungula ukopha kakhulu kungaba pulsatile kokucindezelwa ngu Umthambo cuff. Nokho, ukugwema ukulahleka ngokweqile wegazi isiguli kufanele banikezwe usizo oluphuthumayo onguchwepheshe.

Imigomo ekunakekeleni tracheostomy zidinga luhlolo gqwa isiguli ukuze ukuthola yezinkinga esikhundleni ezinzima ezifana ne-emphysema ongama. Imbangela yale yokugcina kungenzeka ukufakwa ayilungile tube tracheal.

Okunye lalivamile inkinga - umgudu isimiso singenzeka angesabi nganoma isiphi isikhathi phakathi nokuvuselelwa lesiguli. Ngokuvamile imbangela yezimpawu zesifo obstructive imfundo iba kukakhokho obukhulu, kumiswa isikhwehlela obukhulu. Uma tracheotomy wawenziwa usebenzisa cannula kwangaphakathi, inkinga luqedwe esebenzisa uhlanzekile yayo. Ekudambiseni isimiso nesineke futhi likuvumela ukubulawa cleaner nenshisekelo izindlela.