Mwina munamva kupsinjika pang'ono kapena kusasangalala pakhosi panu mutadzuka mutachita opaleshoni. Kapena mwina munaona munthu wapafupi nanu ali mu chipinda chosamalira odwala kwambiri (ICU) ali ndi chubu mkamwa mwake. Lero tikulankhula za kuchotsa chubu chomwe chimawathandiza kupuma. Izi zimatchedwa extubation m'mawu azachipatala. Ngakhale izi zingamveke ngati mawu owopsa, kwenikweni ndi chizindikiro chabwino kwambiri paulendo wanu wochira.
Choyamba, tiyeni tiwone, kodi Intubation ndi Extubation ndi chiyani?
Izi n'zosavuta kwambiri.
- Kulowetsa mpweya m'mapapo: Tangoganizani kuti simungathe kupuma nokha chifukwa cha matenda, ngozi, kapena opaleshoni yaikulu. Panthawiyo, madokotala adzaika chubu chosinthasintha kudzera pakamwa panu mu chubu chanu cha mphepo. Chubu ichi chimatchedwa Endotracheal Tube (ETT) . Chubu ichi chimalumikizidwa ndi chopumira mpweya ndipo chimapereka mpweya m'mapapo anu. Kulowetsa mpweya m'mapapo ndi njira yolowetsa chubu ichi.
- Kutulutsa mpweya: Thanzi lanu likayamba bwino ndipo madokotala ali ndi chidaliro kuti mutha kupuma bwino nokha, popanda thandizo lililonse, adzachotsa mosamala chubu chomwe chidayikidwa kale (ETT). Iyi ndi njira yomwe timaitcha kuti extubation .
N’chifukwa chiyani munthu ayenera kuikidwa m’chubu chonchi?
Pali zifukwa zingapo zomwe munthu sangathe kupuma yekha. Izi ndi zina mwa zifukwa zazikulu zomwe kuyika machubu m'mimba kungakhale kofunikira musanatulutse machubu.
| Chifukwa | Kufotokozera kosavuta |
|---|---|
| Opaleshoni | Mankhwala oletsa kupuma, omwe amaperekedwa pa opaleshoni yayikulu, amaletsa kupuma kwathu kwakanthawi. Chifukwa chake, chubu ichi chimayikidwa kuti chitithandize kupuma panthawi ya opaleshoni. |
| Kulephera Kupuma | Matenda oopsa monga chibayo ndi kuwonongeka kwa mapapo kungalepheretse thupi kulandira mpweya womwe limafunikira. |
| Kutsekeka kwa Njira Yopumira | Izi ndizofunikira kuti njira yodutsa mpweya ikhale yotseguka ngati china chake chatsekeka pakhosi kapena njira yodutsa mpweya yatupa chifukwa cha ziwengo zazikulu. |
| Kuvulala | Kuvulala kwambiri kumutu , khosi, ndi pachifuwa kungawononge dongosolo la kupuma. |
| Kutaya Chikumbumtima | Munthu akataya chikumbumtima, sangathe kulamulira njira yopumira. Palinso chiopsezo cha zinthu monga kusanza kulowa m'mapapo (aspiration). |
Kodi extubation imachitika bwanji? Kodi njira imeneyi ndi yotani?
Izi si nkhani yongochotsa chubu ndikuchibwezeretsa. Gulu lachipatala limachita izi mwadongosolo komanso mosamala kwambiri.
Kodi madokotala amasankha bwanji nthawi yoti achotse chubucho?
Amachita mayeso apadera pa izi. Amatchedwa Spontaneous Breathing Test (SBT) . Mwachidule, izi zimayesa ngati mungathe kupuma nokha popanda thandizo lochepa kuchokera ku makina opumira mpweya. Zili ngati kutenga 'test drive' pang'ono mukamaphunzira kuyendetsa galimoto. Ngati mwapambana mayesowa, zikutanthauza kuti mapapu anu ali ndi mphamvu zokwanira kuti agwirenso ntchito.
Adzafufuzanso momwe mukuvutikira kutsokomola komanso kutsuka pakhosi panu (gag reflex). Izi ndizofunikira kuti muteteze zinthu monga chakudya ndi zakumwa kuti zisalowe m'mapapo mwanu.
Njira zochotsera chubu
Mukadutsa SBT, dokotala kapena anamwino ophunzitsidwa bwino adzatsatira izi:
1. Kukonzekera bedi: Mudzabweretsedwa pamalo oyimirira pabedi.
2. Kuyeretsa: Chipangizo chapadera choyamwitsa chimagwiritsidwa ntchito kuchotsa mamina ndi zinyalala zonse pakamwa panu, pakhosi, ndi mkati mwa chubu.
3. Kuchotsa tepi: Pulasitiki kapena tepi yomwe imagwirira chubu kumaso imachotsedwa.
4. Kupereka malangizo opumira: Dokotala akukuuzani kuti "pumirani mpweya wambiri ndikutsokomola." Pamene mukutsokomola, amachotsa chubucho mwachangu komanso mosalala.
Ntchito yonseyi imatenga masekondi angapo. Mwina simungamve.
Kodi chimachitika n'chiyani munthu akachotsa mimba? Kodi mungayembekezere chiyani?
Chinthu choyamba chomwe mudzamva mutachotsa chubucho ndi mpumulo waukulu! Komabe, mutha kumvanso kupweteka pakhosi panu komanso mawu osamveka bwino kwa masiku angapo. Izi ndi zachilendo. Zili ngati kupweteka pakhosi chifukwa cholira kwa nthawi yayitali.
Pambuyo poti chubucho chachotsedwa, gulu lachipatala lidzapitiriza kukuyang'anirani.
- Mlingo wa okosijeni m'magazi mwanu umayesedwa nthawi zonse.
- Samalani kugunda kwa mtima wanu ndi momwe mumapumira.
- Nthawi zina, poyamba, mpweya pang'ono ungaperekedwe kudzera mu kannula ya m'mphuno kapena chigoba cha mpweya.
Kodi mumadziwa bwino mukachotsa chubucho?
Izi zimadalira chifukwa chomwe mudayikidwira pa chubu.
- Pa opaleshoni: Nthawi zambiri, chubucho chimachotsedwa nthawi yomweyo opaleshoni itatha, musanadzuke kwathunthu kuchokera ku opaleshoni yoletsa kupweteka. Mukadzuka, chubucho chimatha.
- Mu Chipinda Chosamalira Anthu Odwala Kwambiri (ICU): Ngati mukulandira chithandizo cha matenda kapena ngozi, chubucho chidzachotsedwa muli maso. Koma musadandaule, gulu lachipatala lidzakufotokozerani zonse ndikukupangitsani kukhala chete.
Kodi pali zoopsa ndi zovuta za extubation?
Monga momwe zimakhalira ndi njira iliyonse yachipatala, pali zoopsa zazing'ono kwambiri. Koma izi sizichitika kawirikawiri. Madokotala amadziwa bwino izi, kotero nthawi zonse amakhala okonzeka kuthana ndi mavuto otere.
Vuto lalikulu ndi kulephera kutulutsa mpweya . Izi zikutanthauza kuti chubu chikachotsedwa, simungathe kupuma bwino ndipo muyenera kubwezeretsanso mpweya.
- Izi zimachitika kwa anthu ochepa okha, pafupifupi 10%-14%, omwe amachotsedwa machubu awo motsatira dongosolo.
- Chiwopsezochi n'chokwera pang'ono kwa anthu azaka zopitilira 65, komanso omwe ali ndi matenda amtima kapena matenda osatha a m'mapapo.
Mavuto ena ang'onoang'ono:
- Kusintha kwa mawu ndi kupweteka pakhosi: Imeneyi ndi vuto lofala lomwe anthu ambiri amakumana nalo ndipo limatha okha pakatha masiku ochepa.
- Stridor: Nthawi zina, phokoso laling'ono la mluzu limamveka popuma chifukwa cha kutupa pakhosi. Madokotala amadziwa momwe angachiritsire izi.
- Kutsokomola kwambiri: Kutsokomola komwe kumachitika pamene chubu chachotsedwa nthawi zina kungayambitse kulimba kwa minofu ya pakhosi (laryngospasm).
Chofunika ndichakuti zonsezi zimachitika kawirikawiri. Dokotala wanu ndi wokonzeka kuchita zonsezi. Choncho musadandaule kwambiri ndi izi.
Uthenga Wopita Nawo Kunyumba
- Kutulutsa thupi ndi gawo labwino kwambiri komanso labwino paulendo wanu wochira. Zimatanthauza kuti thupi lanu lili ndi mphamvu zokwanira zogwirira ntchito lokha.
- Izi zimachitika ndi madokotala ndi ogwira ntchito ophunzitsidwa bwino, atatsimikizira 100 peresenti ya chitetezo chanu.
- Ndizachilendo kukhala ndi pakhosi pang'ono komanso kusintha mawu kwa masiku angapo chubu chikachotsedwa. Musadandaule nazo.
- Mukamaliza kuyeretsa thupi, mudzakhala omasuka kulankhula, kudya, ndi kumwa kachiwiri.
- Ngati muli ndi mantha, kukayikira, kapena mafunso okhudza njira imeneyi, lankhulani ndi dokotala wanu poyera za nkhaniyi . Adzakufotokozerani zonse.
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