Intubation - ukwethulwa ngamapayipi kuqhoqhoqho

Impilo - ukubaluleka kunazo zonke ezingenziwa umuntu. Kwezinye izimo, isidingo imisebenzi yezempilo. Uma usebenzisa izinzwa zidinga intubation - iyisingeniso kuqhoqhoqho of ngamapayipi ekhethekile. Naphezu lula, kubuye kube uhlobo ukusebenza lihlotshaniswa ingozi futhi izinselele ezinzima zobuchwepheshe.

Injongo intubation

intubation asetshenzisiwe (kusho ukuthi le zokukhwabanisa uzobe echazwe esihlokweni) can futhi prehospital ekuhlinzekeni usizo oluphuthumayo.

Intubation uyakwazi:

• ubambe ukuphefumula lesiguli, ngokukhethekile, ukuphatha, kanye nokwesekwa;
• patency evamile umgudu kungakhathaliseki isikhundla esigulini;
• ukungabikho ingozi ukufuthelana ngenxa umthelela ubuhlanzo, isikhwehlela, igazi, imizimba angaphandle kanye nemisipha spasm;
• ikhono ukususa imizimba bezinye izizwe abavela emaqenjini bronchi kanye kuqhoqhoqho;
• kungenzeka eyayembuleka izindawo ukukhanya;
• ngcono izimo zokuqeda edema yamaphaphu.

Intubation eyenziwa (lokhu ukwethulwa tube kuqhoqhoqho) nge ecinene ngenxa edema yamaphaphu, ubuthi okukhulu, nokuvaleka kwemigudu yokuphefumula, kodwa phambi ugebhezi, ukuvuvukala nezinye ukulimala kabuhlungu emgogodleni wesibeletho amathambo wesibeletho awukwazi bafeze lo inqubo Ukuhlukumeza isakhiwo.

Amathuluzi intubation

Kukhona iqoqo elithile amathuluzi ezisetshenziswa intubation (lokhu kusebenza lula ukuphefumula) kwenziwa. Lokhu kudinga:

• amashubhu endotracheal ezahlukene yangaphandle usayizi ububanzi, ubude, kufakwe noma ingafakiwe cuff, nokuba khona eyodwa noma ezimbili lumens (bezmanzhetnye amashubhu asetshenziselwa izingane);
• laryngoscope nge izindwani iqonde futhi lwalugobile: kuheleza ingxenye, okuyinto ufakwa ibhethri, futhi ukudla nge isibani (izindwani kungashintshwa ngokushesha uma kunesidingo);
• anasteziologicheskie nezizenze (abe ukuma egwegwile);
• umqhubi - ngenduku yensimbi mncane, okwathi nakuba bawo nezinto ezasetshenziswa, uthambile (ezimweni ezinzima kudinga intubation);
• ukubulala izinzwa engxenyeni ethile ukusetshenziswa sprayer (akuvamile ukusetshenziswa ngoba iningi intubation - yinqubo kufakwe ishubhu kuqhoqhoqho, it is eyenziwa uma eziphuthumayo lapho isiguli ngaphansi izinzwa jikelele, noma lutho).

izinhlobo intubation

Kuye injongo yale yokumelapha, intubation emaphashini (okungukuthi, ngenhla) kuyinto zezinhlobo ezimbili:

• orotracheal - ngamapayipi kuqhoqhoqho ngomlomo;
• nasotracheal - ukwethulwa tube endotracheal ngokusebenzisa ekhaleni (kulesi simo ubukhulu amashubhu kumele kube kancane kancane).

Eceleni kubalulekile ukwaba tracheostomy, kodwa lo msebenzi kuphela ngalokwanele okusikhumbuza intubation, njengoba eyenziwa izinzwa ubuchwepheshe ezahlukene ngokuphelele, kodwa umgomo ziyefana - umgudu.

Sobuchwepheshe wamaphaphu intubation

Intubation - ukwethulwa ngamapayipi kuqhoqhoqho. Isilawuli Samandla kwenziwa ngezindlela ezimbili, kuncike ekutheni isiguli bayazi noma cha. Esimweni sokuqala, umuntu izinzwa wendawo. Isiguli kumelwe uphefumule ngokujulile, donsa lapho tube uqhubekile ngokusebenzisa glottis. Udokotela ngesikhathi esifanayo kuqinisekisa ukuthi kwihendisethi uye ngiyitholile kuqhoqhoqho esikhundleni emphinjeni.

Lapho ngokungazi isimo lesiguli usebenzisa indlela laryngoscopy oqondile. Kulokhu, ikhanda kufanele kwenzeke ukuba qondanisa, kungcono wasibeka ngaphansi roller. Udokotela avule umlomo esigulini kuphela, kunesithembiso ikhaba laryngoscope ngemuva olimi, ngaleyo ndlela kuyisunduzele ngakwesobunxele, bese ukhuthaza laryngoscope kuqhoqhoqho. Ngemva kwalokho, tube sifakwe umoya.

wamathumbu intubation

Kukhona into efana intubation emathunjini, noma intraoperative decompression emathunjini. Lokhu zokukhwabanisa wenziwa ukususa okuqukethwe emathunjini. Kukhona izinhlobo ezintathu wamathumbu intubation:

• nasogastric;
• retrograde ngokusebenzisa ingemuva;
• retrograde ngokusebenzisa fistula emathunjini.

Futhi wenziwa intubation emathunjini amancane ngokusebenzisa appendikostomu le ngokuvinjelwa noma ngokwelashwa post-op iziguli uhlangothi.

Isetshenziselwa lokhu iphenya ekhethekile ukuthi kungaba olulodwa-siteshi, ezimbili-wesiteshi multi-channel, kodwa owokuqala ezimbili ezisetshenziswa kakhulu.

Njenganoma iyiphi enye ukuhlinzwa, intubation (a zokukhwabanisa ukuze lula ukuphefumula) ungaba ukuxakeka. Ivame ukutholakala kokuziklinya, umonakalo emazinyweni nolwelwesi lwamafinyila, izinhlungu zibe. Nokho, uma lonke inqubo yenziwa ngokuvumelana nemithetho, ngeke kube izinkinga ngemva kokuhlinzwa, futhi ukuphila lesiguli uyakusindiswa.