The chubhu iri pahuro mushure pakuvhiya (ona mufananidzo). Sei vemabhuku chubhu pahuro yake?

Mune zvimwe zviitiko, huro surgically akaita buri. Izvi zvakakodzera nokuti zvimwe pakukuvara kana zvirwere chokuita havachanyatsogoni kufema. The chubhu iri huro zvinodiwa kuti adzorere mashandiro.

zvinogoneka zvakasiyana

Zvikuru zvinoitwa surgically okutanga ari huro yainzi tracheostomy. Nguva dzose kana chubhu anogona kuiswa zvichienderana chiratidzo. Asi chero zvakadaro chiri muviri wokumwe, rine kunovhiringidza zvainoita muviri.

Kana kurongwa kuti huro chubhu achava kupfuura mwedzi, zvakakodzera kusona kumicheto ganda kuti mucous Kamudzira yacho trachea. Muchiitiko chino, yakagadzikana tracheostomy. Asi, kana zvakakodzera, kuti ape mhepo aibuda nenzira iyi kwenguva pfupi, vanoita zvakasiyana. The cut chinoitirwa rinokosha cannula akaiswa uye micheto inoumbwa ronda haina sutured. Hazvina mudziyo uyu kunodzivisa pakazovharwa mugomba zvakasikwa. Kana yabviswa, pakakoromoka achapiwa kuvharwa kwemazuva 2-3 pachavo.

Use cannula kwenguva haina yakarumbidza nokuda mukana pathological maitiro ari kunharaunda paratracheal munyama.

Zvairatidza kuti tracheostomy

Pane zvikonzero zvinoverengeka nokuda risingagoni kuita pasina incision yacho trachea. oparesheni ichi chinodiwa rikwanise laryngeal stenosis.

Ivo zvinogona kukonzerwa zvinhu zvinotevera:

• ingress miviri vatorwa;
• hudiki (thermal kana mushonga);
• croup venhema;
• diphtheria;
• bundu;
• mativi kuoma pahuro zvinokonzera.

Rimwe boka zvikonzero kuti anosanganisira tracheostomy, kutyora tracheobronchial muti abudise. Izvi zvinoitika kana:

• zvakakomba Kukuvara randakambosangana naro pfungwa;
• cerebrovascular insufficiency (kusanganisira mushure kurohwa);
• pfungwa anomera;
• chaanoziva, achiperekedzwa havachanyatsogoni chikosoro uye pakuparadza hunenge;
• Kwenguva refu mamiriro asthmaticus;
• kutyora chipfuva chitunha kuvimbika.

Uyewo, kana kusaita zvinhu nomazvo zviri neuromuscular ezvinhu kunoda chubhu pahuro yake. Photos rinojekesa kuti hapana vanotyisa. Asi vanhu vazhinji vari kuedza kuvhara mudziyo mukuru uketani kana mutsipa Scarves. Nezvinetso neuromuscular mamiriro inomuka nokuda:

• bulbar poliomyelitis chimiro;
• maronda munzvimbo remuromo munzvimbo musana;
• polyradiculoneuritis;
• kwazvo miostenii;
• neuroinfec- maronda (zvanga zvine utachiona uhu, tetenasi, chimbwamupengo).

Tracheostomy uye intubation of dokeriro

Mune zvimwe zviitiko, hapana kuvhiya kupindira hunokosha. Tracheostomy anoitwa mune avo ezvinhu kana uchida kuva nguva refu kuti ave nechokwadi mukana kufema. Kazhinji zvinoitwa kuti kukwanisa kwenguva refu kushandisa ventilator.

Kana murwere anoda kudzorera chakaipa kufema, kupa zvakakwana gasi mukutsinhana mumapapu pakuvhiya, zvinonzi akaita tracheal intubation. Panyaya iyi, iyo chubhu kutaurwa kubudikidza mhino kana mumuromo huro. Zvisinei, nzira iyi inogona kushandiswa chete kana mamwe kufefetedza kunodiwa kuti maawa kana mazuva mashoma. Zvisinei, intubation kunogona kukonzera kukuvara parusvingo trachea yomukati. Izvi achaita marwadzo ayo.

Kana tichishandisa mhepo chubhu inopfuura pamusoro tracheostoma zvinoderedza anatomically akafa chikamu kufema turakiti. Muchiitiko chino, zvinokwanisika kudzora kwenguva yakareba mweya.

dzavanaChiremba

Mune zvimwe zviitiko, kushanda pakuraramisa yakakwana gasi mukutsinhana mumapapu uye principales. Vakawanda havanzwisisi nei kumicheto pahuro yake, muchiitiko ichi. Tracheal intubation kuita kuitira yemweya patency. Uyu ndomumwe chakavimbika kupfuura nzira, iyo inokupai kuti muchayamwa kubva principales uye trachea chokuumba chakavanzika kuburikidza chinokosha catheters.

Ita intubation mashoma zviitiko. Izvi zvinokosha kana pane njodzi chido - kupinda nemapapu gastric mukati. Uyewo, nzira iyi kunoratidzwa kutyora abudise kushanda trachea uye principales.

Asi pakurapa kenza dokeriro runodiwa tracheostomy. Implementation Its ndeimwe nzendo mishonga. The chubhu iri pahuro mushure kuvhiyiwa kuti abvise dokeriro pamberi malignancy ndiyo fanira.

The nzira inopa mukana webetsero kana kudzora kufema. Murwere, zvisinei nzvimbo mumuviri, akapa zvakajairika yemweya. Uyezve, anobvisa mukana kubitirwa kubudikidza chido namarutsi, madzihwa, ropa kana kubva spasm pakati nemarunda, iyo ingress kwemiviri yokumwe.

Mhando remapazi

Direct kwetsinga of trachea kupa mhepo entrapment uye kubviswa kana zvakakodzera kuti mitumbi vatorwa, inonzi tracheotomy. A tracheostomy - zviri nokuisa pamusoro kwokunze Huro trachea. Zvichitevera kupindira ichi pane chinokosha chubhu pahuro yake kufema.

Zvichienderana incision kusiyanisa rokumusoro, pakati uchingodzikira tracheostomy. Uyewo unogona kuva longitudinal, transverse uye U-zvakaumbwa.

At pamusoro tracheostomy incision akaita pamusoro nekamukwavarara yacho thyroid shwanu. oparesheni iri kuonekwa kupfuura nyore uye rinoitwa kakawanda.

Kana vendu unoitwa mhiri nekamukwavarara, kuti kukanganiswa kwakadaro anonzi Zvichakadaro tracheostomy. Ichi chimwe chezvinhu ngozi uye zvakaoma cheka nokuti kuti pane mukana kukuvara thyroid. It wakaita kuvhiyiwa yakadaro chete muzviitiko apo pasina mukana kuita zvinopesana, dzakadai nekenza yacho thyroid shwanu.

Zvinogonekawo kuti tiite rezasi tracheostomy. Zvinonzi kuitwa chinhu nekamukwavarara. Kuvhiya Izvi zvinoratidzwa vana pasi makore 15 nokuda hunhu maumbirwo kwemiviri. Vakawanda vanoshamisika kuti sei kumicheto pahuro vana. iye kazhinji rinowanikwa vana vachitambura kubva vachiberekwa yemweya abnormalities.

Tracheostomy nokuti ventilator

Kana murwere kunoda zvokuimba kufefetedza, mubvunzo kufunga kana kuti kuitisa kuvhiyiwa uye akacheka huro yake. Tracheostomy sepombi hunogona kuunza kutsiga ari ventilator, nokudaro hapazovi nengozi dokeriro uye subglottic kumiganhu kukuvara. Kazhinji kumubvunzo kupindira kwakadaro parinobuda pashure intubation murwere mazuva 7-10. Zvaive munguva iyi, zviri pachena kuti kufefetedza hunozodiwa pamusoro kwenguva yakareba.

Zvadaro pane zvose zviri pachena nei kumicheto iri akaiswa mukati huro. Anosiyiwa dzinoitwa chete vacheche uye varwere vaduku nokuti kuti vane tracheostomy kunowanzokonzera matambudziko. The oparesheni rinoitwa pasi vakawanda yokutindivadza pamwe intubation murwere.

Zvairatidza kuti tracheostomy muvana

Mune zvimwe zviitiko, kunyange varwere duku vanoda kumicheto pahuro yake. Imhandoi chirwere chinokurwadzai kudiwa zvakadaro? Mudziyo akaiswa vachiberekwa kana akawana mhingaidzo, namamota, zvinotyisa maronda, umbishi ari kufema turakiti.

Munguva ichangopfuura, pamusoro apa ezvinhu anogona kuonekwa ari muchimiro tracheomalacia uye laringomalyatsii. Zvinonzi yakataurawo inspiratory stridor, yokururamisa pamusoro intercostal tsandanyama, nasal flaring. Ichi angamuka nokuda vachiberekwa pahuro zvinokonzera muviri, kukuvara tsinga kana phrenic laryngeal tsinga. By chokuziva zvairatidza zvinosanganisirawo Agnese trachea.

Asi pane vakawanda vawana pathologies iyo hunozodiwa ari chubhu pahuro yake. Pashure pokuvhiyiwa, varwere vaduku vari kushandiswa nomuviri yokumwe, uye kuramba kurarama sezvinongoita. Kazhinji chubhu kunodiwa pashure refu akavhiyiwa kuti zvokuimba kufefetedza. Uyewo, tinofanira nokuti kutarisirwa usiku kufema, neuromuscular matambudziko, chisingaperi utachiona, uye chido.

Zvinoumba uchishandisa vana

Pasinei kwakaita kuti aifanira kuita tracheostomy mwana, pane dzakananga nuances kuna nzira nokuda varwere gotwe. Izvi nokuda peculiarities ari mamiriro miviri yavo. Saka, vose vana thyroid shwanu zvakakwirira zvakakwana, saka vanopedza yakaderera tracheostomy.

Varwere Young kumbobvira dissected shwashwa achiumbwa kubva pamberi tracheal rusvingo, sezvo izvi zvinogona kukonzera kusagadzikana pamusoro trachea pacharo uye ave kukonzera zvinetso decannulation. uyewo hakukodzeri nezvechisarudzo transection. Pakadaro, munhu tracheal rin'i deformation nokuda kufurirwa chubhu.

mota inotungamirwa

Vakuru nevana kungada munhu tracheostomy pamwe chimiro teratomas kana sarcomas. Asi muvarwere vaduku vanogona dzvinya trachea uye idzodzo zvakadai hemangioma kana lymphangioma.

Kana diagnosing nekenza dokeriro matanho vanachiremba inofanira kuendeswa kwete kubviswa bundu uye kudzivirira zvimwe zvayo kukura, asiwo kuti vadzorere unodzivirira, izwi uye kufema mabasa. Naizvozvo, chubhu pahuro yangu mushure kuvhiyiwa kuti laryngeal kenza mutemo unoti mune zviitiko apo murwere rinoitwa laryngectomy - kuvhiyiwa kubvisa yose dokeriro.

Izvi zvingadziviswa chete kana kenza kunokwanisa kuonekwa Panguva 1, sezvamakaropafadzwa paavhareji akarova kuchangoita dokeriro. Mumamiriro ezvinhu akadaro mumwe namabote Vocal kubviswa. Dzimwe nguva resection pamusoro dokeriro umo akabvisa chikamu muviri, asi mabasa ayo ose zvinochengetedzeka.

Kana uchida kupedza extirpation pamusoro dokeriro, zvakakodzera kugadzirira chokwadi kuti hazvibviri kushandisa zvatinosiita nzira izwi bhokisi. Chinofanira kudzorerwa.

Care of tracheostomy

Pasinei zvikonzero kuti waitoda chubhu iri huro, unofanira kurangarira kuti iye wakanga akatevera. Care riri zuva Washing uye disinfecting midziyo. Mukuwedzera, stoma nzvimbo inofanira kugara girisi ganda kuitira kubvisa mukana bundu. The chubhu anogona neoinimendi kuti zviite zvishoma nezvishoma mumatope.

Uyezve, vanachiremba vanoti kusiya stoma pasina cannulas kwechinguva (inenge awa). Asi zviri pakutanga inokosha kunyatsotevera kuongorora Clearance. Nokufamba kwenguva, akati nguva inogona yakawedzera kusvikira mugomba haisati yanyatsosvika kuumbwa. Pashure kwokupfeka ari cannula kunova basa. Panguva iyoyowo yekudyidzana kuvandudza murwere ezvinhu. Pashure tracheostomy cannula kana chubhu zvinoshatirisa tracheal rusvingo.

Features mararamiro

Wakabata pamwechete mubvunzo kuti nei chubhu iri huro zvakakodzera, vakawanda vari kufara nokuti ivo vane uremu muganhu. With akati mudziyo hazvibviri kugeza, kushambira, kushambira ari mumadziva, zvimbudzi. Pamusoro pazvo, hwakazara mukana kudzipwa. Asi, zvisinei, musika angawana lining chaiyo kunodzivisa mukana mvura kupinda stoma.

Usakanganwa kuti chaiye upenyu gassy huruva nharaunda kusashanda chaivo kudzivirirwa nasopharynx. Uye vanhu vane chubhu iri huro, hazvisi. Naizvozvo zviri nani kuti tisaita kushanyira nzvimbo dzakadaro. Varwere All aine tracheostomy zvikuru kubatwa kuzvimba uye zvimwe zvirwere bronchopulmonary. Vanofanira kwazvo okunze, kufukidza stoma bhandeji, akanyatisa nemvura. Uye kutonhora mwaka, inodziya mhepo iri kutsvakwa.

mhando tracheostomy

Kazhinji pane chubhu pahuro yake pakuvhiya. Naizvozvo, kana kuvhiyiwa isina kuitwa nyaya yokukurumidzira, murwere anogona kubvunza chiremba kuti pave wakadii tracheostomy.

Zvino pane zvakawanda mano izvi, asi vakawanda vavo vari wakaitwa thermoplastic zvinhu chaiyo. peculiarity yavo iri yokuti pane imwe tembiricha anenge 35-38 ° C ari chubhu iri huro kunova kwakavharwa nenyama. Izvi zvinobvumira kuti aponese yose mucous Kamudzira pamusoro trachea nezvimwe pedyo munyama. Chokunze pamucheto chubhu terminates mamiriro akafanana chimiro shavishavi. It anokwanisa nechokwadi yokudzivirirwa kwokunze zvinyama yakapoteredza huro ravakwa lumen.