Tracheotomy - chii ichi? chidobi tracheotomy

In vavhiyiwa, pane pfungwa mbiri - a tracheotomy uye tracheostomy.

Tracheotomy - a tracheal buri kuuyisa pamusoro chubhu mariri nokuda kuwana mhepo munzvimbo dzapasi Airways munguva asphyxia. Izvi chimbichimbi oparesheni rinoitwa.

Tracheostomy - riri kuzarura trachea, asi suturing kumicheto kunoguma chekawo kuti runotikurudzira zvinyama uye paumbwe makomba kufema.

A Nhoroondo shoma

nzira iyi zvashata rakanga nechakare muIjipiti yekare uye India, pane inonzi hwokuti vainakidzwa kunyange Aleksandr Veliky ruponeso kuvanhu muhondo yake. About nzira iyi, isu akanyora Hippocrates uye Gallen, asi nekuda kwake mupfungwa uye ngozi kuupenyu inowanzonzi varumbidzwa kwete kurishandisa uchidzidzira.

Yokutanga kubudirira kushanda akanga kuitwa chiremba Italian Anthony Brasavola muna 1546. Ichi ndicho chokutanga rakanyorwawo uchapupu kuti pashure nzira murwere achiri mupenyu. Sezvo 1718 ichi mhando wokuvhiya ava munhuwo uye vanachiremba vakashandisa yainyanya. Asi vazhinji vachiri kurishandisa. Somuenzaniso, pachako nachiremba George Washington akasarudza kuva anoshivirira akafa pane akasarudza kuita ngozi evanhu.

The kwaita mitemo ine aseptic uye akambozvishandisa kuuraya utachiona yakati akaderedza ngozi yematambudziko uye vanofa asi haana vabvume zvokurapa kuti nzira iri wakachengeteka nokuda murwere. Pari, tracheotomy - nzira chaiyo kubatsira, iro rinoshandiswa chete kana dzimwe nzira dzose (mabiko Geymliha, intubation) hadzibatsiri kana havana nguva.

The zvairatidza kuti kuvhiyiwa

Chero zvingaita nyore tracheotomy, zviratidzo nokuti vari kuomesa zvakakwana, sezvo pakaoma kuti upenyu hwevanhu panguva evanhu uyu mukuru uchabatsirwa. Ivo:

1. Foreign miviri nhema pamusoro trachea, risingagoni kubviswa nedzimwe nzira.
2. Contusions, kuderedza lumen yacho dokeriro.
3. Chenjera laryngeal stenosis panguva diphtheritic croup, pertussis, gwirikwiti, typhus uye t. D.
4. Bindepinde pakati lumen pamusoro trachea kana dokeriro bundu.
5. Compression rokumusoro kufema turakiti kubva kunze.
6. mushonga hudiki
7. Sema stenosis.

Mhando yemweya mhingaidzo

• Chenjera, kana fulminant, - anova panyaya mumasekonzi. Izvi zvinogona kuva blockage kubudikidza miviri vatorwa, kufanana sema edema.
• Chenjera - kunooneka pacharo mashoma maminitsi, kazhinji kwakabatana diphtheria kana miviri dzavatorwa.
• Subacute - nokuvhara yemweya lumen agare makumi kwemaminitsi kana kunyange maawa. Ichi chirwere Ndiwo croup kwenhema, kwazvo huro, makemikari kutsva.
• Chirwere - anogona kukura kwemakore pathological zvakadai pezvakaitwa akadai nekenza dokeriro, perichondrium, cicatricial contracture trachea.

kupatsanura

Kune mhando dzakawanda tracheotomy, zvichienderana mabikirwo kwayo Implementation.

Padanho kwetsinga:

• Top: panguva ufanane cricoid shwashwa.
• Avhareji: panguva ufanane thyroid shwashwa.
• Lower kana konikotomiya.

By yezvakaita chekawo iri dzoga:

• Longitudinal.
• Lateral.
• U-zvakaumbwa.

zviridzwa

Usakanganwa kuti zvose zvayo yokukurumidzira uye kugadzirwa, nzira iri papi sezvo oparesheni. Tracheotomy zvinofanira kuitwa imwe yakatarwa maturusi, kana paine zvinowanikwa. Conventionally, vanogona kuva mapoka mapoka makuru maviri: mukuru oparesheni uye unyanzvi zviridzwa.

Boka rokutanga rinosanganisira forceps, scalpels, okusungisa kuti kumisa ropa, kuvhiya chigero, zvikorekedzo ruminant munyama, anobudisa mushonga zvishoma nezvishoma, sirinji uye tsono. Boka rechipiri kunosanganisira tracheal cannula, luer kuitika sepombi maviri akaronga imwe mukati mumwe; Shassinyaka zvepabonde nokuti wakabata trachea pasina traumatizing nayo; traheorasshiritel uye haka kufamba padivi rokuPacific yacho thyroid shwanu.

chidobi tracheotomy

chero oparesheni ari pamberi kuitwa pamusoro runoenzanirana vhoriyamu kurovedza anobatsira chiremba wako nekukurumidza uye nyarara kuti murwere aite zvakakodzera kupindira. Muchiitiko ichi zvakakodzera kuisa murwere ari shure kwake uye vaifanira kukanda musana musoro wake shure shwashwa yacho trachea zvaive kuonekwa. Kuti aite izvi, dzimwe nguva vanoshandisa chinotenderera. Mushure Kuda kutamba, munhu anogamuchira yokutindivadza. Inogona inhaled sezvo wemauto uye nemakanzuru. Zvose zvinoenderana mamiriro ezvinhu ayo pokuvhiyiwa iri kuitwa, murwere zera, zvokurapa uye chipatara vanokwanisa. Kana pakaita dambudziko, chiremba inoitisa bata pasina yokutindivadza. Mushure zvose kugadzirira ichatanga pakarepo tracheotomy.

Chidobi iri stratified sectional ganda, subcutaneous mafuta, fascia uye fibrous Matandira downwards kubva thyroid shwashwa. Ipapo pachena tsandanyama iyo rakasanganiswa nenzira obtuse nenzira rwemberi. Pasi ndiro shwashwa uye rokuPacific yacho thyroid shwanu. Iron anosiiwa ari trachea uye kuzvisimudza, dissect mumwe fascia. Hook uye kugadzira dokeriro, vakaomerwa scalpel chipande munwe bhandiji kana plaster, kuita diki incision. Vavariro kunokwanisika. Air shure mumapapu. First vanorega kufema zvingaitika, asi murwere zvino anotanga vangakosora uye pingi. Chete pashure chiremba ainyatsotenda kuti murume akatanga kufema zvakare, kuti ronda akaiswa mugomba cannula uye yakasimbiswa sutures yake kana namira. The ronda sutured kuitira kuti zvakasimba inoitwa chubhu.

Konikotomiya

Iri danho duku asati ari tracheotomy, kana pasina mukana uye nguva kuitira kuti kazhinji basa iri tracheotomy. Kumhanya izvozvo, regai kuita incremental maronda. Imwe inofamba dissect mutsipa pasi cricoid shwashwa nemarunda schitoperstnevidnoy. The kiramba chikamu akaiswa kuti rakasanganiswa shaya uye dzibve munzvimbo iyi. Kana murwere akatanga kufema, akatendeukira Pink, aiva chikosoro, saka nzira iri kubudirira. Panongotanga nengozi kwapfuura, rinogona kushandurwa mune tracheostomy konikotomiyu kupa kugara mhepo aibuda kumurwere.

Possible zvikanganiso panguva kuchinja

Chero oparesheni ine migumisiro yacho, akanga asingasiyi uye tracheotomy. The matambudziko dzinomuka pauri, inogona kupatsanurwa muzvikwata zvitatu.

1. Mukuita nhanho:

• Sizvo nokuveza mutsetse kunogona kukonzera venous ropa, mhepo embolism, uye dzimwe nguva transection zvinowanzoitwa carotid tsinga ;
• ropa anogona kupinda dzakaderera Airways, zvichikonzera akadzokorora asphyxia;
• chikamu anofanira akaenzana dhayamita ari cannula, zvimwe zvichaita kuti kusona uye zvakare kukuvadza pasi tishu;
• zvakadzama vendu anogona kukonzera esophageal kukuvara, saka scalpel chipande anofanira chete 1 cm.

2. Pakarepo pashure kuvhiyiwa:

• hypoxia;
• kutsemuka tracheal zvindori kana ponji;
• subcutaneous emphysema;
• pneumothorax.

3. kunonoka Impact:

• tracheobronchitis;
• tracheal stenosis uye kuzodzosera asphyxia;
• changed (hoarseness) mavhoti kuti idzokororo tsinga transection;
• zvizorwa kuremara.

vanachiremba All kunyange kubva kukoreji rangarirai tracheotomy sei nengozi. Izvi hazvina mhando kushanda kuti anogona kuitwa dzose. Chete yedambudziko, kunyanya kana murwere ari vava kuda upenyu norufu, nekuti kukurumidza, unogona kukuvadza murwere. Uye kana kumonyanisa ichi haina kuitwa muchipatara, asi kumwe mumugwagwa kana kumba, unofanira kufunga nguva zana usati wasarudza. Simple Pakutanga, magadzirirwo inofanira anotsigirwa zvakakwana ruzivo chiremba. Tracheotomy mumba kwete hazviiti, kune ngozi. Kana usina wezvokurapa dzidzo uye unyanzvi zvakakodzera, usaedza kudzokorora.

Akatakura panze tracheotomy chete dzematongerwe kuponesa upenyu hwemunhu! Ngozi rufu kana zvakakomba yematambudziko zvakakwirira zvakakwana kuti chiremba afunge nezvazvo zvinotsiva. Kunyange ukapiwa kuti oparesheni ichi rave richizivikanwa kubvira panguva yakare, zvokurapa hakusati afunga sei kuti ngozi zvakakwana.

Tracheotomy - ndiwo mukana kuponesa upenyu mumwe munhu, asi ndiko chete nerokuti mukana kuti vauuraye.