Tiyeni tiphunzire za chubu chomwe chimayikidwa munthu akavutika kupuma? (Intubation)

Mwina munamvapo mawu akuti "kuika chubu" kapena "kuika chubu" munthu akadwala kwambiri , kapena asanachite opaleshoni yayikulu. Kodi izi zikutanthauza chiyani kwenikweni? Ngakhale zingamveke zoopsa pang'ono, ndi chinthu chofunikira kwambiri chomwe nthawi zambiri chingapulumutse moyo. Tiyeni tikambirane za izi, chabwino?

Kodi intubation ndi chiyani?

Mwachidule, kulowetsa mpweya m'thupi ndi pamene dokotala kapena katswiri wazachipatala wodziwa bwino ntchito yake amalowetsa chubu chopyapyala kudzera pakamwa panu (kapena nthawi zina mphuno yanu) mu payipi yanu ya mpweya (njira yaikulu yolowera mpweya). Izi zimatchedwanso kulowetsa mpweya m'thupi kapena kulowetsa mpweya m'thupi . Chubu ichi chikayikidwa, payipi ya mpweya imakhala yotseguka, zomwe zimapangitsa kuti kupuma kukhale kosavuta. Chubuchi chimatha kulumikizidwa ku makina (nthawi zambiri chopumira mpweya ) chomwe chingakupumulireni. Kenako makinawo amapereka mpweya ndi mpweya kuti zikuthandizeni kupuma.

N’chifukwa chiyani munthu ayenera kuikidwa m’chubu chonchi?

Chubu chimafunika pokhapokha ngati munthu sangathe kupuma bwino yekha, kapena ngati mpweya wake watsekedwa kapena wawonongeka. Taganizirani izi, mpweya ndi wofunikira m'thupi lathu. Choncho ngati sitiupeza bwino, mavuto ambiri angabuke.

Izi ndi zochitika zomwe nthawi zambiri chubu chimayikidwamo:

• Kutsekeka kwa njira yopumira : Tangoganizirani ngati china chake chatsekeka mu njira yanu yopumira, monga chakudya, ndipo simungathe kupuma, ndi momwe zilili.
• Kulephera kwa mtima: Ngati mtima wasiya kugwira ntchito mwadzidzidzi , mpweya sufika ku ubongo ndi ziwalo zina. Njira imeneyi imagwiritsidwa ntchito popuma mofulumira panthawiyo.
• Kuvulala kwambiri pakhosi, pachifuwa, kapena pamimba: Kuvulala kumeneku kungakhudze njira yopumira mpweya ndikupangitsa kuti kupuma kukhale kovuta.
• Kutaya chidziwitso kapena kuchepa kwa chidziwitso: Munthu akataya chidziwitso, sangathe kulamulira kupuma kwake. Izi zikutanthauza kuti lilime likhoza kugwa ndi kutsamwitsidwa.
• Pa opaleshoni yaikulu: Pa opaleshoni ina yaikulu, mudzakhala pansi pa mankhwala oletsa ululu ndipo simudzatha kupuma nokha. Panthawiyo, chubu ichi chidzagwiritsidwa ntchito kukuthandizani kupuma mpaka opaleshoniyo itatha.
• Kulephera kupuma kapena kupuma kwakanthawi (Apnea):Pankhani ya matenda oopsa a m'mapapo monga chibayo kapena kufalikira kwa mphumu, mapapo sangathe kugwira ntchito bwino. Ngakhale zili choncho, thandizo likufunika mwanjira imeneyi.
• Kuopsa kwa zinthu monga chakudya, kusanza, kapena magazi kulowa mu mpweya wopuma kupuma : Ngati munthu ali ndi chikumbumtima, zinthu zimatha kulowa m'mapapo akamasanza. Zimenezi n'zoopsa kwambiri. Chubu ichi chimathandiza kupewa zimenezo.

Kodi kuyika chubu ndikuchilumikiza ku chopumira mpweya ndi chinthu chomwecho?

Izi ziwiri ndi zogwirizana, koma sizofanana kwenikweni.

Kulowetsa m'chubu, monga tafotokozera kale, kumatanthauza njira yolowetsa chubu (Endotracheal chubu - ETT) mu trachea.

Kenako, kudzera mu chubu ichi, mumalumikizidwa ku chipangizo chopumira. Nthawi zina ichi chingakhale chikwama chomwe dokotala amachifinya ndikuchiuzira mpweya (mwina mudachiwona m'mafilimu). Kapena, mumalumikizidwa ku makina otchedwa `Ventilator` . Makina awa ndi omwe amatumiza mpweya ndi mpweya m'mapapo mwanjira yowongoka.

Komabe, nthawi zina chopumira mpweya chimapumira kudzera mu chigoba chomwe chimaphimba pakamwa ndi mphuno. Kenako chubu sichimayikidwa. Ndi chinthu chosiyana.

Ndani amene sangaike chubu motere? (Zotsutsana)

Ngakhale izi zitha kuchitika mosamala nthawi zambiri, nthawi zina madokotala amasankha kuti sikotetezeka kuyika chubu motere. Mwachitsanzo:

• Ngati njira yopumira yawonongeka kwambiri.
• Ngati pali chotchinga chachikulu mu trachea chomwe chimalepheretsa chubu kuti chisalowe.

Tangoganizirani, ngati ngozi yaikulu yachitika m'khosi ndipo trachea yadulidwa, kuyesa kulowetsa chubu kungayambitse kuwonongeka kwakukulu, sichoncho?

Zikatero, madokotala amagwiritsa ntchito njira ina. Izi zikutanthauza kuti, amabowola kabowo kakang'ono m'munsi mwa khosi, molunjika mu mkodzo, ndikupuma kudzera mmenemo. Izi zimatchedwa `tracheostomy` . `tracheostomy` iyi ndi yofunikanso pamene chubu chikufunika kusiyidwa pamalo ake kwa masiku opitilira angapo, nthawi zina ngakhale milungu ingapo. Izi zili choncho chifukwa kuyika chubu kudzera pakamwa kapena mphuno kwa nthawi yayitali kungayambitse mavuto ena.

Kodi njira yoyika chubu iyi imagwira ntchito bwanji?

Izi nthawi zambiri zimachitika kuchipatala. Pakagwa ngozi, izi zitha kuchitika ambulansi isanakutengereni kuchipatala. Komabe, izi zimachitika ndi madokotala ophunzitsidwa bwino komanso ogwira ntchito zachipatala.

Izi ndi zomwe zimachitika nthawi zambiri:

1. Kukonzekera: Choyamba, singano yaying'ono (monga singano ya `IV`) imalowetsedwa mu mtsempha womwe uli m'dzanja lanu ndipo mankhwala ofunikira amaperekedwa kudzera mu mtsemphawo. Umu ndi momwe mankhwala oletsa ululu amaperekedwera kuti akupangitseni kugona komanso kuti musamve kupweteka kulikonse.

2. Kupereka mpweya wowonjezera:Kenako, chigoba cha okosijeni chimayikidwa pakamwa ndi mphuno kuti thupi lanu lipereke mpweya wochepa wowonjezera. Izi zimachitika kuti mpweya usathe nthawi yayitali yomwe chubucho chili pamalo ake.

3. Kuika chipangizocho: Kenako chigoba cha okosijeni chimachotsedwa, mutu wanu umatembenuzidwira kumbuyo pang'ono, ndipo chipangizo chapadera chotchedwa laryngoscope chimayikidwa mkamwa mwanu (nthawi zina kudzera mu mphuno). Chili ndi kuwala pang'ono komanso gawo lofanana ndi galasi. Izi zimathandiza dokotala kuwona bwino payipi ya mpweya ndikuyika chubu.

4. Kupangitsa kuti trachea ionekere: Chipangizochi chimasunthidwa pang'onopang'ono kuchokera mkati mwa pakamwa kupita kumbuyo, ndipo popanda kukhudza mano, gawo la pakhosi lotchedwa epiglottis (ili ngati chivindikiro chaching'ono chomwe chimatseka trachea tikameza chakudya) limakwezedwa, zomwe zimapangitsa kuti pakamwa pa trachea pawonekere bwino.

5. Kuika chubu: Kenako, nsonga ya laryngoscope imadutsa pakamwa pa trachea kupita mu trachea, ndipo chubu chopumira (endotracheal chubu) chimayikidwa pambali pake.

6. Kukhazikitsa chubu: Chubucho chikayikidwa, gawo laling'ono longa baluni lozungulira limafufuma kuti likhale lalikulu. Mwanjira imeneyi, chubucho chimakhalabe mu trachea osasuntha, ndipo mpweya wonse womwe mumapuma umapita m'mapapo ndipo sutuluka.

7. Kuchotsa ndi kulumikiza chipangizocho: Kenako laryngoscope imachotsedwa ndipo chubucho chimamangiriridwa kumbali ya pakamwa ndi pulasitala kapena lamba wa mutu kuti chisasunthe.

8. Kuyang'ana malo oyenera: Pomaliza, chubucho chimafufuzidwa kuti chione ngati chili mu trachea kapena chapita kwina. Izi zitha kuchitika ndi X-ray ya pachifuwa, kapena polumikiza thumba ku chubucho ndikuchidzaza ndi mpweya, ndikumvetsera pachifuwacho ndi stethoscope kuti muwone ngati pali phokoso lililonse lopuma.

Zonsezi zimatenga mphindi zochepa chabe, koma ziyenera kuchitidwa mosamala kwambiri komanso mwachangu.

Kodi mungalankhule ndi kudya muli ndi chubu m'malo mwake?

Ili ndi vuto kwa anthu ambiri.

• Simungathe kulankhula: Chifukwa chubu chimapita pakati pa zingwe zanu zoyankhulira (gawo lomwe limanjenjemera mukamalankhula), simungathe kulankhula muli ndi chubu m'malo mwake.
• Simungathe kudya kapena kumwa: Komanso, simungathe kumeza muli ndi chubu. Choncho simungathe kudya kapena kumwa.

Mungadabwe kuti, "Ndiye mupereka bwanji chakudya?"

Kawirikawiri, kutengera nthawi yomwe mudzakhala pa chubu ichi, madokotala adzakupatsani zakudya zomwe mukufuna kudzera mu saline (`IV fluids`) kapena ngati zakumwa kudzera mu chubu chopyapyala china chomwe chimayikidwa kudzera pakamwa panu kapena mphuno m'mimba mwanu.

Kodi mumachotsa bwanji chubu? (Extubation)

Madokotala akasankha kuti mutha kupuma bwino nokha ndipo simukufunikiranso chubu ichi, amachichotsa. Izi zimatchedwa ``Extubation .'' Iyi ndi njira yosavuta kwambiri.

Umu ndi momwe mungachitire:

1. Choyamba, chotsani pulasitala kapena tepi yomwe imagwirizira chubucho.

2. Kenako, mamina osafunikira ndi zinthu zina zomwe zili m'njira yopumira zimachotsedwa ndi chubu chofewa (chokometsera).

3. Baluni yaying'ono yomwe inadzazidwa kuti chubucho chisamamatire mkati mwa trachea yatuluka madzi.

4. Kenako, dokotala adzakuuzani kuti mupume mpweya wozama , kukhosomola mokweza, ndikusunga mpweya wanu. Pamenepo, adzatulutsa pang'onopang'ono chubucho.

Pambuyo pochotsa chubu, pakhosi panu pakhoza kukhala kupweteka kwa masiku angapo. Mungamvenso kusamasuka pang'ono mukamalankhula. Koma zimenezo zidzatha pakatha masiku ochepa.

Kodi pali zoopsa zilizonse pa izi? (Zoopsa za Kulowa M'mimba)

Kuika chubu ndi njira yodziwika bwino, yotetezeka kwambiri, komanso yopulumutsa moyo. Anthu ambiri amachira pakatha maola kapena masiku ochepa. Komabe, pali mavuto ena omwe samachitika kawirikawiri:

• Kupuma mpweya: Pamene chubu chaikidwa kapena chasiyidwa pamalo pake, nthawi zina zinthu monga kusanza ndi magazi zimatha kulowa m'mapapo.
• Chitoliro chikuyenda pamalo olakwika:
• Kulowetsa mpweya m'mapapo m'mapapo: Nthawi zina chubuchi chimangopita mu imodzi mwa njira ziwiri zazikulu zopumira zomwe zimachoka mu trachea kupita m'mapapo (zomwe zimatchedwanso mainstem intubation). Kenako mapapu amodzi okha ndi omwe amapuma.
• Kulowetsa m'chubu cha m'mero: Ngati chubucho chilowa mu chitoliro chodyera, m'mero, m'malo mwa chitoliro cha mphepo , chingayambitse kuwonongeka kwa ubongo komanso imfa ngati sichizindikirika mwachangu. Koma madokotala amasamala kwambiri pa izi.
• Kulephera kutseka njira yolowera mpweya: Nthawi zina kuyesa kuyika chubu sikungapambane, zomwe zimapangitsa kuti zikhale zovuta kuchiza wodwalayo.
• Matenda: Anthu omwe ali ndi machubu nthawi zina amatha kukhala ndi matenda monga matenda a sinus.
• Kuvulala: Mukalowetsa chubu, pakhoza kukhala kuvulala pang'ono pakamwa, mano, lilime, mawu, kapena njira yopumira. Izi zingayambitse kutuluka magazi ndi kutupa.
• Mavuto okhudza mankhwala oletsa ululu: Ngakhale kuti anthu ambiri amachira bwino atalandira mankhwala oletsa ululu, ena angachedwe kuchira kapena zinthu zina zadzidzidzi.
• Kupsinjika kwa mpweya (tension pneumothorax): Mkhalidwe umene mpweya umatsekeredwa mkati mwa chifuwa, zomwe zimapangitsa kuti mapapo agwe.

Ngakhale kuti zoopsazi zilipo, ndizochepa kwambiri poyerekeza ndi ubwino woyika chubu, makamaka ngati munthu wavulala kwambiri.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Ndikukhulupirira kuti tsopano mwamvetsa bwino za Endotracheal intubation , kapena endotracheal intubation. Iyi ndi njira yofunika kwambiri yachipatala yomwe imachitika kuti ipulumutse moyo wa munthu akalephera kupuma yekha.

Chubu ichi chimasunga payipi yolowera mpweya yotseguka ndipo chimalola mpweya kulowa m'mapapo.

Izi nthawi zambiri zimachitika kuchipatala, pakagwa ngozi, kapena musanachite opaleshoni yayikulu. Ngakhale zingawoneke zoopsa pang'ono, zimachitika kuti zikuthandizeni kuchira. Khulupirirani kuti dokotala wanu nthawi zonse adzachita zomwe zingakukomereni. Ngati muli ndi mafunso kapena nkhawa, musaope kufunsa dokotala wanu kapena namwino.

Kulowetsa m'chubu , trachea, kuyika chubu, mpweya wopumira, kupuma, opaleshoni, chithandizo chadzidzidzi