Hlokomela tracheostomy ka tlhokomelo e matla

Tlhokomelo ea mokuli le tracheostomy ka e etsoa ka sepetlele ka mor'a ho fetolela ICU mamello. Hangata ka ho fetisisa, e leng tracheostomy e behilweng ka tsela conductive tsa moea ha ho hlokahala ventilation.

Ho bonahala ho buuoa

Ho phetha tracheostomy ka maemo a loketse ho fetisisa ema akarelletsa homolog khetha mokhoa le dissection hloko ea trachea homeostasis. Sebelisoa hangata bakeng sa ho buuoa kapa endotracheal thethebatso lihlooho sebelisoa novocaine tharollo.

Ho hlokahala bakeng sa tshebetso ho airway tracheostomy hlaha:

• tabeng ea nako e telele ho phetha molao feela ventilation;
• ka ho ba teng ha lefu bulbar;
• ntle ho monyetla bakeng sa mahala moea e lumellang metsi ho kena ea litsela conductive ka tsela e 'ngoe;
• tlaase bokgoni airway ntloana;

Mokhoa oa tracheostomy

Tšebetso ea tracheostomy airway hloka 'maloa mefuta scalpels - lethopa ka ntle le dikarolo tsa letlalo le tracheal incision. Hape nakong ea ho buuoa hoo ho tla sebetsa: Sliding lihakisi, spreaders tsa letlalo le mesifa, dikotwana tse, swabs nyopa le hlakola.

Mokuli e kenngoa ka boemo supine le hlooho lahleloa khutla. Letlalo holim 'a trachea e disinfected le joala, antiseptics, tharollo ea a iodine litareng e' me ka hloko felisoa ka lesela nyopa.

Nakong ea Tsamaiso ea sebelisoa sehiloeng paatsepama tloha thyroid lefufuru ho bohale e ka holimo ea sternum ena. Ho ekelletsa moo, ka tataiso tshekaletseng e khaola fascia, ebe sebedisa Kit boletsoeng ka holimo MEDINSTRUMENT le hlaha razdvizheniya mesifa le ho lokolloa ha trachea ena. Scalpel puncture trachea e dissected le tlosa e le uputsa senyenyane sa dinama tse nyenyane tse, e lekaneng ea ho amohela e airway tube,.

Free tracheal metshetshe libakeng khaola-theoha uputsa sutured ho letlalo, e leng thusa hore ho ho fetola methapo tracheostomy. Ho sa tsotellehe mokhoa ena e rarahaneng o etsa tracheotomy, tsamaiso haholo go tlhofofadiwa ke intubation pele ho ba le mamello.

Le ho khetha methapo

E ka tšeptjoang, hloko tlhokomelo ya le tracheostomy ka tlhokomelo e matla e hlokahalang e le tlhopho ya e tube, loketse, le ho khetha tseo ho itšetlehile ka maemo. Hona joale ho pharaletseng a reka tšepe habeli tube, le cuff ka. Hape, hoa khoneha ho sebelisa lipeipi polasetiki, khatello ea ka e tsitsa ka meqomo e khethehileng.

E loketseng kgetho ya tube, boleng bo phahameng e fana ka tlhokomelo ea bonolo a tracheostomy ka matla unit trust tlhokomelo ntle baka tšitiso ho sa hlokahale ho ba le mamello. Ka tlhopho ya e mathata tse sa lokang tube, hangata e hlaha ka blockage ea lumen teteaneng mucus omisitsoeng. Ka hona, khetha lokela ho letšehali ho ea ho barutehi.

methapo tšebeletso tracheotomy

Tabeng ea tšepe cannula hloka tse qotsitsoeng ea tube, ka hare bonyane hang ka letsatsi bakeng sa ho hloekisa le lokisetsa sebolaya dikokwana-hloko kalafo. Leha ho le joalo, ka likarolo tse ling ka ntle la phetoho cannula e sa tloaelehang ka ho fetisisa, e seng ho feta hang ka beke.

Cuff cannula bakeng tracheotomy ha aa lokela ho lula ka boemo moya na. Nako le nako tlosoa therefrom moea feteletseng me ba 'na robetse ka 10 metsotso e, ka nako eo o ile a khutlela sebaka. Pele embarking ka thibelo hlaphoheloa cuff lokela ho ka hloko tlosa extraneous dikahare tsa oropharynx e Skopje.

Haholo-holo hlokomela ostomy

tlhokomelo ea nako le nako ba tracheostomy ka o etsoa ho sebelisoa nyopa gauze le k'hothone swabs. Sebaka se potolohileng dinama tse nyenyane tse hloekisa mekhatlo seka-chitja supa ka ntle. dinama tse nyenyane tse ka ho eketsehileng lekanyetswa go ya ka ho mathata le diso tšoaetsanoang.

Tlhokomelo ea tracheostomy ho hloka Phetolo liloko ka ketsahalo ea mongobo ka tsela e feteletseng kapa mobu bokella tebileng. Etsa ea ka mokhoa o Phetolo e lokela ho ba ha ho na thuso efe kapa efe. motho a le mong o nka tube ba maemong a tsitsitseng, 'me mothusi oa hae nka sebaka lipane tube,.

Nakong ea matsatsi a pele ka mor'a opereishene e lakatsehang ho hlokomela tracheostomy le peristomalnoy sebakeng ka dikgao ya dihora tse 6-8. Ka nako e tšoanang, o ka kamehla nka sebaka gauze dressings ka ho hlokahala. , Tools le litokisetso bakeng sa tlhokomelo ya lokela ho lula ba le haufi.

Tlhokomelo ea tracheostomy ho:-tharabololo

Ka lekhetlo la pele Phetolo tube, hlahiswa ka mor'a matsatsi a seng makae ka mor'a hore ke buuoe. Ho feta moo, mokhoa o sa lokela ho phethwa ka ba nang le tsebo, kaha nako ena ke ha ho a lekana ho etsa stoma teteaneng.

The-tharabololo ya Tsamaiso ya:

• mokuli e behoa ka morao ea hae le ho leleka hlooho ea hae;
• a etsa ho itlhoekisa ka ho feletseng mekoting tracheobronchial;
• ho tlosa tlala likhohlela sa khohlela mamello bakileng artificially;
• Ho e hlahiswa ka tube cavity tenyetsehang catheter, joale ntšitsoeng tracheostomy cannula;
• Phetolo methapo etsa tlosoa mokhanni;
• A phala e ncha e tlamelletsoeng le tsitsitseng ba maemong a tsitsitseng;

Tlohang bakuli le tracheostomy bakeng sa mochine o hokeletsoeng

Hangata e hlokomela bakuli ba tracheostomy e hloka e le mabapi le airway mochine. Amana sesebediswa ka cannula e neng e thehilweng ka ho ba teng ha metsoako ea thusang.

Ka morero oa ho mabapi tsitsitseng oa mamello ho mochine o hokeletsoeng tekanyetso cannula e ka nkeloa sebaka ke e khethehileng etselitsoeng endotracheal tube, kapa moralo tloaelehileng ka cuff inflatable banana. Ka ho toba ho ea unit trust ka boeona e bakeng sa tube, ventilation o khomaretse qetellong ea melao-motheo ea behiloeng disebedisweng tse ding.

mathata khoneha

Tlhokomelo ea tracheostomy hangata isang ho sebetsana le mathata a itseng a ka 'nang hlaha hang feela ha ke buuoe li feletseng,' me e ngata hamorao, esita le ka boemo tsitsitseng oa mokuli.

The complication atileng ka ho fetisisa ke ketsahalo e sa tsoa mali, haholo-holo haeba tracheostomy e phethile sebedisa lisebelisoa fumaneha ka taba ea metsotso e jele babeli, ka haufi le bethe ea. Felisa mali ka tsela e feteletseng ka pulsatile compression ke mothapo cuff. Leha ho le joalo, ho qoba ho lahleheloa ke tsela e feteletseng ea mali ho ba le mamello lokela ho fuoa tlhokomelo tshohanyetso setsebi.

Terms of hlokomela tracheostomy hloka nako le nako hlahloba mokuli e le hore ba khona ho utloa ka mathata a ho ena e matla e kang subcutaneous emphysema. Sesosa sa ho qetellang ka 'na ba fosahetse tlhomamiso ya tracheal tube,.

Tse ling ka toka ho tloaelehile hore batho complication - airway obstruction ka etsahala ka boithatelo ka nako efe kapa efe nakong ya tsosoloso oa mokuli. Hangata ka ho fetisisa sesosa sa thuto matšoao a obstructive fetoha diporopo le letšo-letšo, thehoa ea mucus teteaneng. Ha tracheotomy ile a etsa sebedisa cannula hare, bothata ba ka e felisoe ka tlhoekiso lona. Fokotsa obstruction mamello hape o dumella ho phetha lephaka aspiration litseleng.