Kodi munayamba mwawonapo munthu ali ndi chubu chomwe chaikidwa pachifuwa pake? Mwina pa TV, mu kanema, kapena ngakhale kuchipatala chenicheni. Zingakhale zoopsa komanso zosasangalatsa kuziona. "Chifukwa chiyani akuchita izi? Izi ziyenera kuti zimapweteka kwambiri, eti?" Mungaganize. Koma kodi mumadziwa kuti kuyika chubu pachifuwa chanu ndi njira yofunika kwambiri yachipatala yomwe nthawi zambiri imachitidwa kuti ipulumutse moyo wa munthu. Lero, tikambirana za njira iyi, yomwe imatchedwa thoracostomy mu zamankhwala, m'njira yosavuta kwambiri yomwe mungamvetse.

Mwachidule, kodi Thoracostomy ndi chiyani?

Kuchotsa thoracostomy ndi njira yomwe dokotala wa opaleshoni amadula pang'ono mbali ya chifuwa chanu ndikuyika chubu pachifuwa chanu. Chubu ichi nthawi zambiri chimatchedwa chubu cha pachifuwa . Chifukwa chachikulu chochitira izi ndikutulutsa mpweya, madzi, magazi, kapena mafinya omwe asonkhana m'malo ozungulira mapapo anu (omwe madokotala amati pleural space).

Taganizirani mapapu athu ngati mabaluni awiri. Mabaluni awiriwa ali mkati mwa chifuwa. Pali malo ochepa kwambiri pakati pa mapapu ndi khoma lamkati la chifuwa. Nthawi zambiri, palibe chilichonse m'malo awa. Koma chifukwa cha matenda ena kapena pakagwa ngozi, malowa amadzaza ndi zinthu monga mpweya ndi madzi. Kenako mapapu amapanikizika ndipo sangathe kudzaza bwino. Zimakhala zovuta kupuma, ndipo pamakhala kupweteka pachifuwa. Pamenepo madokotala amaika chubu cha pachifuwa kuti achotse zinthu zomwe zasonkhanitsidwazi.

Pazidzidzidzi zina, makamaka tension pneumothorax, singano ya thoracostomy imachitidwa kuti ichepetse mpweya wotsekeredwa ndikuchepetsa kuthamanga kwa mpweya musanayike chubu cha pachifuwa. Izi zimachitika pazidzidzidzi, monga ku Dipatimenti Yoona za Zadzidzidzi (ETU), kuti apulumutse moyo wa wodwalayo.

Kodi mankhwalawa amagwiritsidwa ntchito pa matenda otani?

Pali zifukwa zambiri zomwe opaleshoni ya thoracostomy ingachitikire. Imagwiritsidwa ntchito makamaka ngati pali zinthu zosafunikira zomwe zasonkhanitsidwa kuzungulira mapapo. Tiyeni tiwone zina mwa izi.

Kodi muyenera kukonzekera bwanji izi?

Funso ili ndi lofunika kwambiri. Koma yankho lake ndi lovuta pang'ono. Chifukwa nthawi zambiri, njira iyi yotchedwa Thoracostomy imachitika mwadzidzidzi. Tangoganizani kuti wina wachita ngozi yagalimoto pamsewu ndipo akuthamangitsidwa ku Emergency Treatment Unit (ETU) ya chipatala. Ngati mapapu ake awonongeka ndipo wadzazidwa ndi mpweya, madokotala ayenera kuyika chubu cha pachifuwa mwachangu kuti apulumutse moyo wake. Pazochitika zotere, palibe nthawi yokonzekera.

Koma nthawi zina, chifukwa cha matenda omwe analipo kale (monga munthu amene ali ndi madzi ochulukirapo m'mapapo), izi zitha kukonzedwa pasadakhale. Pazochitika zotere, dokotala wanu adzakupatsani malangizo amomwe mungakonzekerere. Malangizo awa angaphatikizepo:

• Kuyambira masiku angapo chithandizo chisanachitikeMungapemphedwe kuti musiye kumwa mankhwala ena (makamaka mankhwala ochepetsa magazi).
• Mungapemphedwe kusintha nthawi ya mankhwala anu.
• Mudzapemphedwa kuti musadye kapena kumwa kwa maola angapo musanalandire chithandizo.
• Mungapemphedwe kuvala zovala zomasuka komanso zomasuka.

Kodi chimachitika ndi chiyani kwenikweni panthawi ya chithandizo?

Chabwino, tsopano tiyeni tiwone momwe tingachitire izi. Musaope kuwerenga izi. Izi zimachitika popanda kupweteka komanso mosamala momwe zingathere.

Choyamba, dokotala adzajambula X-ray pachifuwa kapena kusanthula kwina kuti apeze malo enieni omwe chubucho chiyenera kuyikidwa. Kenako chithandizo chidzayamba.

1. Malo Oyikira: Mudzapemphedwa kugona pabedi, mutu wanu utakwezedwa pang'ono, ndipo mkono womwe uli kumbali yomwe chubucho chidzalowetsedwa udzaikidwa pamwamba pa mutu wanu. Izi zidzatsegula mpata pakati pa nthiti zanu, zomwe zidzapangitsa kuti chubucho chikhale chosavuta kulowetsa.

2. Kuyeretsa: Kenako, malo a pachifuwa omwe asankhidwa kuti agwiritsidwe ntchito pa chubucho amatsukidwa bwino ndi mankhwala opha tizilombo toyambitsa matenda. Izi zimachitika kuti tizilombo toyambitsa matenda tisalowe m'thupi.

3. Kusamva Chisoni: Tsopano ndi gawo lofunika kwambiri. Pofuna kuti musamve ululu uliwonse, mankhwala oletsa ululu am'deralo , monga Lidocaine , amaikidwa m'derali. Mungamve kupweteka pang'ono mukalandira jakisoni, koma pasanathe mphindi zochepa dera lonselo lidzakhala lopanda chisoni. Choncho simudzamva chilichonse pambuyo pake.

4. Kupanga chotupa: Tsopano popeza mwachita dzanzi, dokotala adzapanga chotupa chaching'ono kwambiri pakati pa nthiti zanu ziwiri. Ichi si chotupa chachikulu, koma chokwanira kulowetsa chubu.

5. Kuika chubu: Kenako, chubu cha pachifuwa chimayikidwa mosamala kudzera mu choboola m'malo ozungulira mapapo. Mbali ina ya chubuchi imalumikizidwa ndi chinthu chonga botolo la madzi (chidebe chotulutsira madzi). Mpweya ndi madzi omwe ali pachifuwa adzayenda kudzera mu chubuchi ndikusonkhana mu botololo.

6. Chitetezo: Pomaliza, chopondera chopanda banga chimayikidwa mozungulira malo olowetsera ndipo chimaphimbidwa. Nthawi zina, chosokera chaching'ono chingaikidwe pakhungu kuti chigwirizane ndi chubucho kuti chisayendeyende.

Njira yonseyi nthawi zambiri imatenga pafupifupi mphindi 30 .

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Mukayika chubucho, mudzapatsidwa X-ray ina pachifuwa kuti muwonetsetse kuti chili pamalo pake komanso kuti mapapu anu adzaza mpweya bwino. Kenako dokotala ndi anamwino adzakupatsani malangizo a momwe mungasamalire chubucho.

• Malo odulira ayenera kukhala oyera komanso ouma .
• Limapereka malangizo a momwe mungasamalire chubu ndi botolo lolumikizidwa nalo (chidebe chotulutsira madzi). Chofunika kwambiri ndichakuti chubucho chisapindike kapena kumatirira kulikonse . Komanso, botolo liyenera kusungidwa pansi pa mulingo wa pachifuwa . Mwanjira imeneyi, zomwe zili m'chifuwa zidzayenda mosavuta mu botolo malinga ndi mphamvu yokoka.
• Muyenera kumwa mankhwala omwe mwapatsidwa panthawi yake .

Kodi ubwino wa chithandizochi ndi wotani?

Ngakhale izi zingawoneke zoopsa pang'ono, zili ndi zabwino zambiri.

• Iyi si opaleshoni yaikulu (Yosavulaza kwambiri): Popeza imachitika kudzera mu kudula pang'ono, m'malo moduladula kwakukulu, thupi siliwonongeka kwambiri ndipo njira yochiritsira imafulumira.
• Zingapulumutse miyoyo pa nthawi yadzidzidzi: Izi zingapulumutse moyo mwachangu ngati ngozi kapena mapapo agwa. Zingathandizenso kuchira ku matenda a nthawi yayitali.
• Palibe chifukwa chogonetsa wodwalayo tulo tofa nato: Izi nthawi zambiri zimachitika pansi pa mankhwala oletsa ululu, kotero palibe chiopsezo cha mankhwala oletsa ululu aakulu.
• Mpumulo wachangu wa kupuma movutikira: Munthu amene akuvutika kupuma chifukwa cha madzi odzaza m'mapapo mwake adzamva bwino kwambiri akangochita izi.

Kodi pali zotsatirapo kapena zoopsa zilizonse?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa zazing'ono kwambiri, koma madokotala amachita chilichonse chotheka kuti achepetse zoopsazi.

• Chubucho chimayikidwa pamalo olakwika kapena chimasuntha kuchokera pamalo ake oyambirira.
• Matenda pamalo odulira.
• Subcutaneous emphysema (mpweya wochuluka pansi pa khungu).
• Kutupa kwa mapapo komwe kumakulanso (madzimadzi odzaza mozungulira mapapo omwe atuluka madzi atayambanso kukula mwadzidzidzi).
• Kutuluka magazi.
• Kuwonongeka pang'ono kwa mitsempha kapena minofu yozungulira.

Mwayi woti zinthuzi zichitike ndi wochepa kwambiri. Koma ndi bwino kudziwa zinthu ngati izi. Ngati muli ndi mafunso, funsani dokotala wanu.

Kodi chubucho chiyenera kukhala nthawi yayitali bwanji? Zimatenga nthawi yayitali bwanji kuti chichiritsidwe?

Kutalika kwa nthawi yomwe chubu cha pachifuwa chili m'malo mwake kumadalira chifukwa chomwe chayikidwa.

• Ngati magazi kapena mpweya pang'ono unachotsedwa pambuyo pa ngozi, chubucho chingachotsedwe patatha masiku ochepa chitatha kutuluka madzi onse.
• Komabe, ngati madziwo akupitiriza kudzaza chifukwa cha vuto la nthawi yayitali, mungafunike kukhala ndi chubucho kwa milungu ingapo . Dokotala wanu adzakufotokozerani izi.

Pambuyo poti chubucho chachotsedwa, zingatenge milungu itatu kapena inayi kuti chovulalacho chichiritse bwino. Panthawi imeneyo, dokotala wanu adzakupatsani malangizo a momwe mungasamalire bala komanso ngati muyenera kupewa kuchita zinthu zolemetsa.

Ngati muwona chilichonse chonga ichi, uzani dokotala wanu nthawi yomweyo.

Ngati muli ndi chubu cha pachifuwa, samalani ndi zizindikiro zotsatirazi. Ngati muli ndi chimodzi mwa izi, uzani dokotala wanu nthawi yomweyo .

Kodi pali kusiyana kotani pakati pa Thoracostomy, Thoracentesis, ndi Thoracotomy?

Mawu atatuwa amamveka ofanana, koma ndi njira zitatu zosiyana zochiritsira. Anthu ambiri amasokonezeka pakati pawo. Tiyeni tiwone kusiyana kwake.

Mwachidule, opaleshoni ya thoracotomy ndi opaleshoni yaikulu. Pambuyo pa opaleshoniyo, thoracostomy (chubu cha pachifuwa) ikhoza kuyikidwa kuti ichotse madzi omwe amasonkhana pachifuwa.