A tube a cikin makogwaro bayan tiyata (ga photo). Me saka a tube a makogwaro?

A wasu lokuta, makogwaro surgically sanya rami. Wannan wajibi ne ga wasu sun ji rauni ko cututtuka hade tare da mai illa numfashi. A tube a cikin makogwaro wajibi ne a mayar da aikin.

zai yiwu bambancin

Musamman sanya ta surgically bude a cikin makogwaro kira wani tracheostomy. A lokacin da akai ko tube za a iya kafa dangane da nuni. Amma a wani hali da shi ne a kasashen waje jiki, wanda yana da wani irritating sakamako a jiki.

Idan an shirya cewa a cikin makogwaro tube zai zama fiye da wata daya, ya zama dole a dinka da gefuna da fata zuwa mucous membrane na trachea. A wannan yanayin, a barga tracheostomy. Amma, idan ya cancanta, don samar da iska ya kwarara a cikin wannan hanya na wani dan gajeren lokaci, aiki daban. A yanke sanya ta musamman cannula an saka da gefuna kafa ta ciwo ba sutured. Yana da wannan na'urar hana rufe daga cikin rami halitta. Idan aka cire, da rata za a rufe for kwanaki 2-3 a kan nasu.

Amfani cannula for Extended lokaci ba da shawarar saboda da yiwuwar wani pathological dauki a cikin kusanci da paratracheal kyallen takarda.

Alamomi ga tracheostomy

Akwai dalilai da dama ga wanda ba zai iya yi ba tare da incision na trachea. Wannan aiki da ake bukata a cikin m laryngeal stenosis.

Su za a iya lalacewa ta hanyar da wadannan dalilai:

• ingress na waje jikinsu.
• konewa (thermal ko sunadarai).
• ƙarya croup.
• diphtheria.
• ƙaruwa.
• gefe inna daga cikin vocal igiyoyinsu.

Wani rukuni na dalilan da cewa sun hada da wani tracheostomy, a take hakkin da tracheobronchial itace magudanun ruwa. Wannan na faruwa a lokacin da:

• m traumatic kwakwalwa rauni.
• cerebrovascular insufficiency (ciki har da bayan shanyewar jiki).
• kwakwalwa marurai.
• coma, tare da illa tari da hadiya da numfashinsa.
• dogon lokaci matsayi asthmaticus.
• take hakkin da kirji gawa mutunci.

Har ila yau, a lokacin da gazawarsa na neuromuscular tsarin na bukatar a tube a makogwaro. Hotuna da shi a fili cewa babu wani abu mai tsanani. Amma mutane da yawa suna kokarin rufe sama da na'urar high ƙuƙumma ko wuyansa Scarves. Matsaloli tare da neuromuscular tsarin tashi saboda:

• bulbar poliomyelitis form.
• raunuka a cikin mahaifa yankin na laka.
• polyradiculoneuritis.
• m miostenii.
• neuroinfec- raunuka (botulism, tetanus, ciwon hauka).

Tracheostomy da intubation na maƙogwaro

A wasu lokuta, babu m baki ne ba makawa. Tracheostomy yi a cikin wadanda yanayi a lokacin da kana bukatar wani dogon lokaci don tabbatar da yiwuwar numfashi. Sau da yawa shi ne yake aikata domin ya sami damar na dogon lokaci don amfani mai ventilator.

Idan wani haƙuri yana bukatar maido da numfashi, don samar da cikakken gas musayar a cikin huhu a lokacin tiyata, shi aka yi tracheal intubation. A wannan yanayin, da tube aka gabatar ta hanci ko bakin cikin makogwaro. Duk da haka, wannan hanya za a iya amfani kawai idan ƙarin samun iska ake bukata domin 'yan sa'o'i ko kwanaki. Duk da haka, intubation iya haifar da lalacewar da ciki bango na trachea. Wannan zai sa ta ƙanƙancewa.

Lokacin amfani da iska tube wuce sama tracheostoma rage-rage anatomically matattu ɓangare na numfashi fili. A wannan yanayin, yana yiwuwa don sarrafa na dogon lokaci na numfashi.

tiyata

A wasu lokuta, da yadda ake gudanar zama dole don samar da cikakken gas musayar a cikin huhu da kuma bronchi. Mutane da yawa ba su fahimci dalilin da ya sa a tube a makogwaronsa, a cikin wannan harka. Tracheal intubation ake yi, don tabbatar airway patency. Wannan shi ne daya daga cikin mafi m hanyoyin, wadda kuma ba ka damar tsotse daga bronchi da trachea samar da wata sirrin ta musamman catheters.

Make intubation a cikin 'yan lokuta. Wannan shi ne zama dole idan akwai wani hadarin tsammãni - shigar da huhu da na ciki da abinda ke ciki. Har ila yau, wannan hanya da aka nuna a take hakkin da magudanun aiki na trachea da bronchi.

Amma a lura da ciwon daji na maƙogwaro ake bukata tracheostomy. Its aiwatar shi ne daya daga cikin matakai na far. A tube a cikin makogwaro bayan tiyata don cire maƙogwaro a gaban malignancy ne m.

A hanya samar da yiwuwar wani karin ko sarrafawa numfashi. A haƙuri, ko da kuwa matsayin na jiki, bayar da al'ada airway. Bugu da kari, shi da gusar da yiwuwar shaƙuwa da muradinta na aman, gamsai, jini ko daga spasm da jijiyoyin, ingress waje jikinsu.

-daban na yadda ake gudanar da

Direct dissection na trachea don samar da iska entrapment da kuma kau idan ya cancanta na kasashen waje jikinsu, da ake kira tracheotomy. A tracheostomy - shi ne tsawwala a waje bude na trachea. Bayan wannan shiga tsakani akwai wani musamman tube a makogwaro numfashi.

Dangane da incision rarrabe babba, tsakiya da kuma ƙananan tracheostomy. Har ila yau yana iya zama a tsaye, mai gangara da kuma U-dimbin yawa.

A saman tracheostomy incision sanya a saman Isthmus na thyroid gland shine yake. Wannan aiki yana dauke su mafi sauki da kuma aka yi sau da yawa.

Idan yanke aka sanya a fadin Isthmus, cewa irin wannan tsangwama da aka kira da nufin tracheostomy. Wannan shi ne daya daga cikin mafi hatsari da kuma wahala cuts saboda gaskiyar cewa akwai hadarin na thyroid lalacewa. An yi irin wannan aiki ne kawai a lokuta inda babu damar yi in ba haka ba, kamar cancers na thyroid gland shine yake.

Shi ne kuma zai yiwu a gudanar da ƙananan tracheostomy. Yana da aka yi da wani Isthmus. Wannan tiyata da aka nuna ga yara yan kasa da shekaru 15 da shekaru saboda da yanayin da tsarin jikinsu. Mutane da yawa mamaki me ya sa a tube a cikin makogwaro a yara. ta sau da yawa bayyana a cikin yara fama da nakasar airway munanan.

Tracheostomy for ventilator

Idan haƙuri bukatar inji iska, da tambaya da la'akari da ko da za su gudanar da tiyata da kuma yanka masa makogwaro. Tracheostomy shambura iya tabbatar da zaman lafiyar na da ventilator, haka nan zai zama wani hadarin da maƙogwaro da subglottic yankin na lalacewa. Sau da yawa tambaya na wannan shiga tsakani yakan bayan intubation na haƙuri ga 7-10 kwanaki. A lokacin da wannan lokaci, a fili yake cewa samun iska za a bukata a kan wani dogon lokaci.

To, akwai duk ya bayyana dalilin da ya sa a tube an saka a cikin makogwaro. Ware ake yi kawai domin jarirai da kuma matasa marasa lafiya saboda gaskiyar cewa suna da wani tracheostomy sau da yawa yana sa rikitarwa. The aiki aka yi a karkashin janar maganin sa barci da intubation na haƙuri.

Alamomi ga tracheostomy a yara

A wasu lokuta, har ma da karami marasa lafiya bukatar a tube a makogwaro. Wace irin cuta tsokani irin wannan bukatar? Na'ura an saka a cikin nakasar ko samu toshewa, marurai, traumatic raunuka, rashin ci gaba na numfashi fili.

Kwanan nan, cikin sama yanayin za a iya gano a cikin hanyar tracheomalacia da laringomalyatsii. Haka kuma an lura inspiratory stridor, karyata na intercostal tsokoki, da hanci flaring. Wannan yanayin na iya bayyana saboda nakasar vocal igiyoyinsu inna, lalacewar da juyayi tsarin ko phrenic laryngeal jijiya. By m alamomi kuma sun hada da Agnese trachea.

Amma akwai da dama na samu pathologies a cikin abin da za a bukata da tube a makogwaro. Bayan tiyata, matasa marasa lafiya suna yin amfani da su a kasashen waje jiki, da kuma ci gaba da kai a rayuwa. Sau da yawa tube ake bukata bayan dogon ayyukan for inji iska. Har ila yau, da bukatar shi taso a dare apnea, neuromuscular matsaloli, na kullum cututtuka, da tsammãni.

Features na aiki yara

Ko da kuwa abin da ya kai ga bukatar a yi wani tracheostomy yaro, akwai takamaiman nuances na hanya ga ƙarami marasa lafiya. Wannan shi ne saboda da peculiarities na tsarin jikinsu. Saboda haka, duk yara thyroid gland shine yake shi ne high isa, saboda haka abin da suka ciyar ƙananan tracheostomy.

Sun marasa lafiya ba dissected guringuntsi aka kafa daga gaban tracheal bango, kamar yadda wannan zai iya kai wa ga rashin zaman lafiya na trachea da kanta da kuma zama wani dalili na matsaloli a decannulation. shi ma ba ya shige wani zaɓi transection. A irin wannan yanayi, wani tracheal zobe nakasawa saboda da matsa lamba tube.

ƙari samuwar

Manya da yara na iya bukatar wani tracheostomy tare da bayyanar teratomas ko sarcomas. Amma a cikin matasa marasa lafiya na iya damfara da trachea da kuma irin wannan tsarin a matsayin hemangioma ko lymphangioma.

Lokacin da diagnosing ciwon daji na maƙogwaro taku likitoci ya kamata a directed ba kawai don kau da ƙari kuma hana ta kara girma, amma kuma ya mayar da m, murya da numfashi ayyuka. Saboda haka, da tube a makogwaro bayan tiyata na laryngeal ciwon daji ne m, a lokuta inda haƙuri aka yi laryngectomy - tiyata don cire duka maƙogwaro.

Wannan za a iya kauce masa kawai idan ciwon daji aka kamu a mataki 1, cikinsa da talakawan bugi so kawai maƙogwaro. A irin wannan halin da ake ciki daya vocal igiyoyinsu cire. Wani lokaci a resection na maƙogwaro a wadda cire sashi na jiki, amma duk da ayyuka aka kiyaye.

Idan kana bukatar ka kammala extirpation na maƙogwaro, shi wajibi ne da za a shirya domin gaskiyar cewa ba shi yiwuwa a yi amfani da saba hanya murya akwatin. Yana dole ne a mayar da.

Kula da tracheostomy

Ko da kuwa daga cikin dalilan da ake bukata da tube a cikin makogwaro, kana bukatar ka tuna da yadda ta da ake bi. Kula ne kullum wanka da disinfecting na'ura. Bugu da kari, da stoma yanki dole ne kullum sa mai fata domin kawar da yiwuwar hangula. A tube iya bi da tare da man ƙanshi ga sauƙaƙe zamiya.

Bugu da kari, likitoci bayar da shawarar barin stoma ba tare da cannulas don wani lokaci (game da sa'a). Amma a farko shi ne muhimmanci a hankali saka idanu da yarda. A tsawon lokaci, ya ce lokaci za a iya ƙara har da rami da aka ba tukuna kafa cikakken. Bayan da cewa saka da cannula zama dole ba. A lokaci guda muhimmanci inganta haƙuri da yanayin. Bayan tracheostomy cannula ko tube irritates da tracheal bango.

Features salon

Bayan aikatã game da tambayar me ya sa a tube a cikin makogwaro wajibi ne, mutane da yawa sun damu saboda suna da wani nauyi da iyaka. Tare ce na'urar ba shi yiwuwa a dauki wani shawa, iyo, iyo a cikin kududdufai, dakunan wanka. Bayan duk, shi ne fraught tare da hadarin choking. Amma, duk da haka, kasuwar iya samun musamman rufi da cewa ya hana yiwuwar ruwa shigar da stoma.

Kada ka manta da cewa a cikin al'ada rayuwa a gassy da m yankunan kunna halitta kariya na nasopharynx. Kuma mutanen da suke da wani bututu a makogwaronsa, shi ne ba. Saboda haka shi ne mafi alhẽri a kauce wa ziyartar irin wannan wurare. Dukan marasa lafiya da tracheostomy mafi saukin kamuwa zuwa kumburi da kuma sauran bronchopulmonary cututtuka. Dole ne su a cikin zafi weather, rufe da stoma bandeji, ya yi sharkaf da ruwa. Kuma a cikin sanyi kakar, dumi iska ne ake so.

iri tracheostomy

Sau da yawa akwai tube a makogwaro lokacin tiyata. Saboda haka, idan tiyata da aka ba su aikata a cikin wani al'amari na gaggawa, da mãsu haƙuri iya tuntubar da wani likita ya tabbatar da abin da irin tracheostomy.

Yanzu akwai fadi da kewayon wadannan na'urori, amma mafi yawansu suna sanya na musamman thermoplastic abu. Su peculiarity ta'allaka ne da cewa a zazzabi na game 35-38 ° C da tube a cikin makogwaro zama na roba. Wannan ba ka damar ceton dukkan mucous membrane na trachea da kuma sauran m kyallen takarda. A m baki na tube terminates tsarin kamã da siffar malam. Shi ne iya tabbatar da kariya na waje nama kewaye da makogwaro sanya a cikin lumen.