Chubu mu mmero pambuyo opaleshoni (onani chithunzi). Chifukwa amaika chubu mu mmero wake?

Nthawi zina, pakhosi opaleshoni anapanga dzenje. Izi ndi zofunika chifukwa kuvulala ena kapena matenda kugwirizana ndi mkhutu kupuma. Chubu mu mmero m'pofunika kuti abwezeretse kugwira ntchito.

Kusiyana zotheka

Mwapadera ndi opaleshoni kutsegula mu mmero wotchedwa tracheostomy. Nthawi zonse kapena chubu akhoza anapereka malinga ndi umboni. Koma Mulimonsemo ndi thupi yachilendo, amene ali zimakhudzanso akutivutitsa pa thupi.

Ngati zakonzedwa kuti chubu pakhosi adzakhala kuposa mwezi umodzi, m'pofunika kusoka m'mbali mwa khungu nembanemba mucous ya trachea ndi. Pankhaniyi, khola tracheostomy. Koma, ngati n'koyenera kupereka otaya mpweya njira imeneyi kwa nthawi yochepa, kuchita mosiyana. Odulidwa anapanga ndi cannula apadera anaikapo ndi m'mbali popangidwa ndi bala si sutured. Ndi chipangizo izi kumathandiza kutsekera kwa dzenje analengedwa. Ngati chikutha lisaoneke zidzatsekedwa kwa masiku 2-3 paokha.

Ntchito cannula kwa nthawi yaitali ali osavomerezeka chifukwa cha n'zotheka pathological angachitire pafupi ndi zimakhala paratracheal.

Zikuonetsa kuti tracheostomy

Pali zifukwa zingapo zomwe simungakhoze kuchita popanda ang'ambe thupilo wa trachea a. Opaleshoni imeneyi chofunika pachimake laryngeal stenosis.

Iwo akhoza zimayamba ndi zinthu zotsatirazi:

• ingress wa matupi yachilendo;
• amayaka (matenthedwe kapena mankhwala);
• croup wabodza;
• diphtheria;
• kutupa;
• amaganiza ziwalo za zingwe amapilira.

gulu lina la zifukwa omwe ndi tracheostomy, kuphwanya ngalande tracheobronchial mtengo. Izi zimachitika pamene:

• aakulu choipa zoopsa ubongo;
• cerebrovascular insufficiency (kuphatikizapo pambuyo zikwapu);
• ubongo zotupa;
• chikomokere, limodzi ndi mkhutu chifuwa ndi Pomeza bongo;
• yaitali udindo asthmaticus;
• kuphwanya umphumphu pachifuwa nyama.

Komanso, pamene kulephera a dongosolo neuromuscular amafuna chubu mu mmero wake. Photos momveka bwino kuti palibe choopsa. Koma anthu ambiri akuyesa kubisa chipangizo makolala mkulu kapena mipango khosi. Mavuto ndi dongosolo neuromuscular uka chifukwa:

• bulbar poliomyelitis mawonekedwe;
• zotupa mu dera khomo lachiberekero wa chingwe msana;
• polyradiculoneuritis;
• miostenii chaukali;
• zotupa neuroinfec- (botulism, kafumbata, matenda a chiwewe).

Tracheostomy ndi intubation ya m'phuno ndi

Nthawi zina, palibe alowererepo opaleshoni ndi chofunika kwambiri. Tracheostomy anachita mu zochitika pamene mukufuna nthawi yaitali kuonetsetsa kuti n'zotheka kupuma. Nthawi zambiri zachitika kuti athe kwa nthawi yaitali ntchito othandizira.

Ngati wodwala ayenera kuti abwezeretse kupuma bwinobwino, kupereka wathunthu mpweya kuwombola mu mapapo pa opaleshoni, iwo anachita tracheal intubation. Pankhaniyi, chubu umayamba mwa mphuno ndi mkamwa kapena mu mmero. Komabe, njira imeneyi angagwiritsidwe ntchito kokha pamene mpweya zina zofunika kwa maola angapo kapena masiku. Komabe, intubation kungawononge khoma mkati mwa trachea ndi. Uyu adzachititsa chidule chake.

Pamene ntchito mpweya chubu akudutsa pamwamba tracheostoma amachepetsa gawo anatomically akufa pa mundawo kupuma. Pankhaniyi, n'zotheka kulamulira kwa nthawi yaitali mpweya.

maopaleshoni

Nthawi zina, ntchito koyenera kupereka wathunthu mpweya kuwombola mu mapapo ndi bronchi. Ambiri samazindikira chifukwa chake chubu mu mmero wake, mu nkhani iyi. Tracheal intubation akuchita kuonetsetsa airway patency. Ichi ndi chimodzi mwa njira yodalirika, amene amalola kuti aziyamwa pa bronchi ndi trachea kupanga chinsinsi kudzera catheters wapadera.

Pangani intubation mu zina. Zimenezi n'zofunika ngati pali chiopsezo cha chiyembekezo - kulowa mapapo zili muzituluka. Komanso, njirayi zikusonyezedwa kuphwanya ngalande ntchito ya trachea ndi bronchi.

Koma mankhwalawa khansa ya m'phuno ndi chofunika tracheostomy. kukhazikitsa ndi limodzi mwa magawo wa mankhwala. Chubu mu mmero pambuyo opaleshoni kuti achotse m'phuno pamaso pa chotupa chija ndi kuvomerezedwa.

Ndondomeko amatipatsa kuthekera ndi kupuma wothandiza kapena ankalamulira. Wodwala, kaya udindo wa thupi, anapereka airway yachibadwa. Komanso, kumatha kuthekera asphyxiation ndi chiyembekezo masanzi, ntchofu, mwazi, kapena ndi kuphipha wa Mitsemphayi, ndi ingress wa matupi yachilendo.

mitundu ya ntchito

Direct kung'ambika wa trachea kupereka mpweya entrapment ndi kuchotsa ngati kofunika matupi yachilendo, wotchedwa tracheotomy. tracheostomy A - izo chimamangidwa pa kutsegula kunja trachea a. Zotsatirazi phukusi pali chubu wapadera pakhosi kupuma.

Malinga ang'ambe thupilo la kusiyanitsa chapamwamba, pakati ndi kutsikira tracheostomy. Komanso akhoza kukhala kotenga, yopingasa ndi U-zooneka.

Pa pamwamba pa tracheostomy ang'ambe thupilo anapanga pamwamba pa Korinto a chithokomiro England. Opaleshoni imeneyi kuti zinali zophweka kwambiri ndipo anachita zambiri.

Ngati odulidwa wapangidwa kudutsa Korinto, kuti kusokonezedwa amenewa amatchedwa tracheostomy zikutanthauza. Ichi ndi chimodzi mwa mabala zoopsa kwambiri ndi zovuta chifukwa chakuti pali chiopsezo cha kuwonongeka chithokomiro. Iyo yachita opareshoni umenewu pa nthawi imene palibe mwayi kuchitira mwina, monga khansa ya chithokomiro England.

Ndi zotheka kuti agwire tracheostomy m'munsi. Iwo imagwiridwa ndi Korinto ndi. opaleshoni Tikutero chifukwa ana osaposa zaka 15 chifukwa chikhalidwe cha matupi dongosolo. Ambiri amadabwa chifukwa chubu mu mmero ana. iye umatchulidwatchulidwa ana akuvutika kuvutika kobadwa nako airway.

Tracheostomy kwa othandizira

Ngati wodwalayo amafuna mpweya makina, funso moganizira ngati kuchita opaleshoni ndi kudula khosi lake. Tracheostomy machubu ungathe kubweretsa mtendere wa othandizira pa, kotero kudzakhala palibe chiopsezo ya m'phuno ndi subglottic dera kuwonongeka. Nthawi zambiri funso aziloŵerera limatuluka pambuyo intubation wodwalayo kwa masiku 7-10. Inali nthawi imeneyi, zikuonekeratu kuti mpweya zidzafunika pa nthawi yaitali.

Ndiye pali onse zimaonekeratu chifukwa chubu ndi anaikapo mu mmero. Kuchotserapo anapangidwa yekha makanda ndi achinyamata amene akudwala chifukwa chakuti ali ndi tracheostomy zimayambitsa matendawo. opaleshoni imagwiridwa pogonekedwa ndi mankhwala ambiri ndi intubation wodwala.

Zikuonetsa kuti tracheostomy ana

Nthawi zina, ngakhale odwala zing'onozing'ono muyenera chubu mu mmero wake. Kodi mtundu wa matenda amakwiya ngati pakufunika? Chipangizo ndi anaikapo mu kobadwa nako kapena kugula kutsekeka, zotupa, zotupa zoopsa, chosakhwima pa mundawo kupuma.

Posachedwapa, chikhalidwe pamwamba angathe kuonedwa mu mawonekedwe tracheomalacia ndi laringomalyatsii. Iwo ananenanso inspiratory stridor, Anabweza a minofu intercostal, amphuno flaring. chikhalidwe ichi zingachitike chifukwa kobadwa nako amapilira zingwe ziwalo, kuwonongeka kwa wamanjenje dongosolo kapena phrenic laryngeal mitsempha. Ndi zizindikiro titadziwa mulinso Agnese trachea.

Koma pali zingapo pathologies anapeza imene zidzafunika chubu mu mmero wake. Pambuyo pa opaleshoni, odwala achinyamata ndikuzolowera thupi achilendo, ndipo akupitirizabe kukhala ndi moyo wabwinobwino. Nthawi zambiri chubu chofunika pambuyo ntchito yaitali mpweya makina. Komanso, kufunika kwake tingafunse pa usiku apnea, mavuto neuromuscular, matenda aakulu, ndi kukhumba.

Features ana opaleshoni

Mosasamala zomwe zinachititsa kuti kufunika kochita ndi tracheostomy mwana, pali mfundo zina zabwino yeniyeni ndondomeko kwa odwala wamng'ono. Izi ndi chifukwa peculiarities wa kapangidwe ka matupi awo. Motero, ana a chithokomiro England ndi mkulu mokwanira, kotero iwo amathera tracheostomy m'munsi.

odwala Young konse kuligaŵa chichereŵechereŵe aumbike kuchokera kutsogolo khoma tracheal, monga ingathandize kuti Kusakhazikika kwa trachea yokha ndi kukhala chifukwa cha mavuto decannulation. komanso si woyenera njira transection. Zikatero, ndi tracheal mphete mapindikidwe chifukwa chubu kuthamanga.

chotupa mapangidwe

Akulu ndi ana angafunike tracheostomy ndi maonekedwe a teratomas kapena sarcomas. Koma odwala achinyamata compress ya trachea ndi dongosolo monga hemangioma kapena lymphangioma.

Pamene Kupeza Vuto khansa ya m'phuno njira madokotala ayenera kupita osati kuti kuchotsa chotupa ndi kuteteza kukula zina, komanso kubwezeretsa zodzitetezera mawu ndi ntchito kupuma. Choncho, chubu mu mmero wanga pambuyo opaleshoni khansa laryngeal ndi kuvomerezedwa pa nthawi imene wodwala imagwiridwa laryngectomy - opaleshoni kuti achotse m'phuno lonse.

Zimenezi zikhoza kupewedwa pokhapokha ngati khansa amawapeza pa siteji 1, mmene pafupifupi anakantha kokha m'phuno. Zikatere munthu timinofu kuchotsedwa. Nthawi zina resection ya m'phuno imene anachotsa mbali ya thupi, koma ntchito zake zonse zimasungika.

Ngati mukufuna kumaliza extirpation wa m'mphako ya m'pofunika kukhala okonzekera chakuti n'zosatheka ntchito alipidwa njira mawu bokosi. Liyenera kubwezeretsedwa.

Care la tracheostomy ndi

Kaya zifukwa zomwe zimafunikira chubu mu mmero, muyenera kukumbukira mmene iye anali kuutsatira. Care ndi tsiku kuchapa ndi zida masaka. Komanso, dera stoma ayenera nthawi zonse mafuta khungu kuti kuthetsa kuthekera mkwiyo. chubu akhoza ankachitira ndi mafuta wonunkhila bwino kuti magawowa kutsetsereka.

Komanso, madokotala amalangiza kusiya stoma popanda cannulas kwa nthawi yaitali (pafupi ora). Koma poyamba ndikofunika kuwunika mosamala chilolezo. M'kupita kwa nthawi, anati nthawi akhoza ziwonjezeke mpaka dzenje sanayambebe athanzi. Pambuyo pake kuvala cannula amakhala zosafunika. Pa nthawi yomweyo kwambiri kuwongolera alili. Pambuyo tracheostomy cannula kapena chubu umasokoneza tracheal khoma.

Features moyo

Popeza anachitira funso la chifukwa chubu mu mmero n'kofunika ambiri wakhumudwa chifukwa ali ndi kulemera malire. Ndi anati chipangizo sikutheka madzi osamba, kusambira, kusambira m'madamu, ndi mabafa. Ndipotu, ndi zinadzala ndi ngozi ya kutsamwa. Koma Komabe, msika mungapeze akalowa wapadera zoletsa kuti n'zotheka madzi kulowa stoma.

Musaiwale kuti moyo wabwino m'madera gassy ndi yafumbi adamulowetsa chitetezo chilengedwe cha nasopharynx lapansi. Ndipo anthu amene ali ndi chubu mu mmero, si. Choncho ndi bwino kupewa kuyendera malo amenewa. odwala onse ndi tracheostomy kuti atengeke kutupa ndi matenda ena bronchopulmonary. Iwo ayenera m'nyengo yotentha, kuphimba stoma bandeji, titanyowa ndi madzi. Ndipo pa nyengo yozizira, mphepo yofunda wokha.

mitundu tracheostomy

Nthawi zambiri pali chubu mu mmero wake pa opaleshoni. Choncho, ngati opaleshoni si zichitike mwamsanga, wodwala kukaonana ndi dokotala kukhazikitsa mtundu wa tracheostomy.

Tsopano pali osiyanasiyana zipangizozi, koma ambiri a iwo anapanga mfundo zapadera thermoplastic. peculiarity awo kwagona kuti pa kutentha pafupifupi 35-38 ° C chubu mu mmero amakhala zotanuka. Zimenezi zimathandiza kuti apulumutse lonse mucous nembanemba wa trachea ndi zimakhala ena pafupi. M'mphepete kunja kwa chubu kumathera dongosolo chokhala mawonekedwe a Gulugufe. Iwo akhoza kuonetsetsa chitetezo cha minofu kunja ozungulira kukhosi anapanga lumen wa.