Wakamboshanyira mumwe munhu ari muchikamu chevarwere vanorwara zvakanyanya (ICU) here? Kana kuti wakambowana chiremba achikutsanangurira nezvemafambiro ekufema paunenge uchigadzirira kuvhiyiwa here? Chimwe chezvinhu zvaunonzwa panguva dzakadaro ndechekuti vari kuisa "chubhu yekufema." Saka, kungofanana nekuisa chubhu iyi, kuibvisa inzira yakakosha uye yakarongwa. Mukurapa, kubvisa chubhu iyoyo ndiko kwatinodaidza kuti "extubation." Nhasi, ngatitaurei nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.
Kutanga, ngationei kuti chii chinonzi intubation?
Tisati tataura nezvekuburitsa mvura mumuviri, ngationgororei muchidimbu kuburitsa mvura mumuviri. Zvichitaurwa zviri nyore, ichi chinhu chinoitwa nechikwata chekurapa kuti chiponese hupenyu hwako kana uchinetseka kufema wega nekuda kwechimwe chikonzero. Vanoisa chubhu yepurasitiki inochinjika, inonzi chubhu ye endotracheal (ETT) , kuburikidza nemuromo wako ichipinda mupaipi yemhepo (nzira huru yekufema).
Funga nezvazvo nenzira iyi: mapapu edu akafanana neinjini yemotokari. Anoda mweya unogara uchishandiswa (oxygen) kuti ashande. Kungofanana nemota isingafambi kana paine kuzara kwemotokari, kana nzira yekufema yako yakavharwa kana kufema kwako kusina simba, okisijeni haisviki kumapapu ako. Panguva iyoyo, chubhu iyi inoiswa, uye muchina, ventilator, wakabatana nayo, uye unopiwa huwandu hweokisijeni hwaunoda. Izvi zvinonzi intubation.
Iye zvino pamwe wava kunzwisisa kuti chii chinonzi extubation . Kureva kuti, maitiro ekubvisa chubhu yainge iripo nokungwarira mushure mekunge chikwata chevanachiremba chave nechivimbo chekuti unogona kufema zvakanaka wega zvakare, pasina rubatsiro.
Muzviitiko zvipi zvinoitwa extubation?
Izvi hazviitiki kune wese munhu panguva imwe chete kana nenzira imwe chete. Zvinoenderana nechikonzero chawakaiswa muchubhu uye kuti hutano hwako hwakagadzikana zvakadii.
Mushure mekuvhiyiwa
Kana wavhiyiwa zvikuru, unorara zvachose. Tinoti mushonga weanesthesia unoshanda kwenguva pfupi. Mishonga iyi inomisa tsandanyama dzinodzora kufema kwako. Panguva iyoyo, vanachiremba vanoisa chubhu iyi yekufema kuti vave nechokwadi chekuti unowana okisijeni yakakwana panguva yese yekuvhiyiwa.
Mushure mekunge kuvhiyiwa kwapera zvakanaka, timu yezvekurapa ichabvisa chubhu iyi kana migumisiro yeanesthetic yapera uye wava kukwanisa kufema wega zvakare. Kazhinji, chubhu iyi inenge yabviswa panguva yaunozoziva zvakare. Saka ungasatomboiyeuka. Muchiitiko ichi, chubhu iyi inogona kunge yagara kwenguva pfupi seawa imwe chete kana maviri.
Nekuda kwechirwere kana tsaona
Kana munhu akabatwa nechubhu yekufema nekuti haakwanise kufema nekuda kwetsaona, hutachiona hwakanyanya (senge pneumonia), kana chimwe chirwere chakakomba, nzira yekubvisa chubhu yacho yakasiyana zvishoma. Munhu uyu anowanzova mukamuri revarwere vanorwara zvakanyanya (ICU).
Vasati vabvisa chubhu, vanachiremba vanofanira kuva nechokwadi chekuti unogona kufema wega. Vachaita bvunzo yakakosha yeizvi. Inonzi Spontaneous Breathing Test (SBT) .
Zvichitaurwa zviri nyore, izvi zvakafanana nekudzidzira zvishoma. Chiremba achaderedza zvishoma nezvishoma rutsigiro rwemuchina wekufema uye achakuyedza kwemaminitsi mashoma kuti aone kuti unogona kufema zvakanaka sei wega. Mwero weokisijeni yako, kurova kwemoyo, uye kufema kwako zvichatariswa zvakanyanya munguva iyi. Kana ukapasa bvunzo iyi chete ndipo chiremba achasarudza kubvisa chubhu.
Dzimwe nguva ungasapasa bvunzo iyi kekutanga. Izvi zvinonzi "kurumura mwana." Izvi zvakajairika. Kana izvi zvikaitika, chiremba anomirira kusvika wava nani zvishoma uye ozoita bvunzo iyi zvakare mushure mezuva rimwe kana maviri.
Ndezvipi zvikonzero zvikuru zvekuiswa kwechubhu?
Kuti uite extubation, intubation inofanira kutanga yaitwa. Heano mamwe ezvikonzero zvinowanzoitwa. Ngatiise izvi patafura yakaita seiyi kuti tizvinzwisise zvakajeka.
| Chikonzero cheIntubation | Nemashoko akareruka... |
|---|---|
| Kuvharirwa kweNzira Dzemhepo | Kuvharika kwenzira yekufema zvachose nekuda kwechikonzero chakadai sekunge chikafu chinonamira mumuromo kana kuti chirwere chakakomba cheallergy. |
| Kusungwa Kwemwoyo | Nekuti kana mwoyo ukangoerekana wamira, zvakakosha kupa okisijeni kuuropi nemuviri. |
| Kukuvara Kwakanyanya | Kukuvadzwa kwenzira yekufema kana kutadza kufema nekuda kwekukuvara kwakanyanya kwemutsipa, chipfuva, kana dumbu. |
| Kurasikirwa Nekuziva | Muzviitiko zvakakomba zvekusaziva, rurimi runofanira kudzoserwa kumashure kudzivirira kuvharika kwemhepo uye kudzora kufema. |
| Kuvhiya | Kudzora zvakakwana kufema paunenge uchinwa mushonga weanesthesia. |
| Kutadza Kufema | Nekuda kwechirwere chakakomba chakadai sepneumonia, mapapu haakwanise kuwana huwandu hweokisijeni hunodiwa nemuviri ega. |
| Njodzi yeKufema | Kudzivirira zvinhu zviri mudumbu (chikafu, kurutsa, ropa) zvemunhu asina chaanoziva kuti zvisapinde mumapapu. |
Matanho api anobatanidzwa mukuita extubation?
Zvakanaka, ngationei kuti chiremba kana mukoti akadzidziswa angabvisa sei chubhu iyi. Ichi hachisi chinhu chinogona kuburitswa zvese panguva imwe chete. Pane matanho mashoma ekuchibvisa.
1. Kugadzirira murwere: Kutanga, musoro wemubhedha uchasimudzwa mudenga. Uchaiswa panzvimbo yekugara. Izvi zvichabatsira mhepo kuyerera ichipinda mumapapu uye kuderedza njodzi yezvinhu zvakaita semate kupinda mumapapu mushure mekunge chubhu yabviswa.
2. Kusveta: Tevere, mudziyo wakakosha (mudziyo wekusveta) unoshandiswa kubvisa madzihwa ese, mate, nezvimwe zvinhu zvisingadiwe kubva mumuromo mako, pahuro, nemuchubhu yekufema. Izvi zvakakosha zvikuru, nekuti kana zvisina kudaro, zvinhu izvi zvinogona kupinda mumapapu ako kana chubhu yacho yabviswa.
3. Kusunungura chubhu: Tambo kana tepi inobatidza chubhu kumeso kwako inobviswa nokungwarira.
4. Kuparadzaniswa nemuchina wekufema: Chubhu yacho yakabviswa pamuchina wekufema wainobatanidzwa nawo.
5. Kubvisa chubhu: Iye zvino ndicho chinhu chinonyanya kukosha. Chiremba anokuudza kuti "fema zvakadzama wokosora."Paunenge uchikosora kana kubudisa mweya, vanoburitsa chubhu nekukurumidza uye zvakatsetseka. Vanoita izvi kana uchikosora, izvo zvinovhura tambo dzenzwi rako, zvichiita kuti chubhu ibude zviri nyore. Uye kukosora kunoburitsawo chero chinhu chiri muhuro mako.
Une pfungwa here kana chubhu yabviswa?
Uyu mubvunzo une vanhu vazhinji. Mhinduro yacho, dzimwe nguva hongu, dzimwe nguva kwete.
- Mushure mekuvhiyiwa: Chubhu inowanzo bviswa usati wawanazve ruzivo, paunenge uchiri pasi peanesthesia. Saka inobviswa paunomuka.
- Kana uri mukamuri revarwere vanorwara zvakanyanya (ICU): Chubhu yacho ichabviswa uchiri munhu akangwara, sezvo zvichikosha kuti uve munhu akangwara uye uteerere zvaunoudzwa (semuenzaniso, kukosora kana uchiudzwa kuti "kosora").
Chii chinoitika mushure mekubviswa kwemasero emuviri?
Kubvisa chubhu hazvirevi kuti basa rapera. Maawa mashoma anotevera akakosha zvikuru. Chikwata chevanachiremba chichakutarisa zvakanyanya.
- Okisijeni: Kazhinji, mushure mekunge chubhu yabviswa, unopihwa okisijeni shoma kuburikidza ne cannula yemhino kana mask yeokisijeni kuti muviri wako ugone kugadzikana nemamiriro ezvinhu matsva.
- Kuongororwa: Mwero weokisijeni muropa rako (uchishandisa pulse oximeter), kurova kwemoyo, uye BP zvinoongororwa nguva dzose.
- Kukosora: Madzihwa anogona kuungana muhuro nekuda kwechubhu. Saka, uchakurudzirwa kukosora nguva nenguva kuti ubvise. Kana zvichidikanwa, ungangodawo kusveta zvakare kuti ubvise pahuro.
Pane matambudziko anogona kuitika panguva yekuvhiyiwa kwechibereko here?
Sezvinoitwa chero nzira ipi zvayo yekurapa, kune dzimwe njodzi diki dzinobatanidzwa mukubvisa dumbu. Asi yeuka, timu yezvekurapa yakagadzirira zvese izvi.
| Dambudziko | Chii chinoitika neizvi? |
|---|---|
| Kukundikana kweExtubation | Kana chubhu yabviswa, murwere haachakwanisi kufema ega sezvaitarisirwa. Kana izvi zvikaitika, chubhu inofanira kuiswazve kuitira kuchengetedzeka kwemurwere (re-intubation).Zvinoitika. Izvi zvinogona kuitika mu10%-15% yevanhu. Njodzi yacho yakakwira zvishoma kune vanhu vane makore anopfuura 65 uye avo vane chirwere chemwoyo kana chekufema. |
| Kufema zvine ruzha (Stridor) | Chubhu iyi inogona kukonzera kuzvimba kudiki mumhepo yepamusoro, kunyanya kutenderedza tambo dzenzwi. Izvi zvinogona kukonzera ruzha rwakakora uye rwakakwirira paunofema mushure mekunge chubhu yabviswa. Izvi zvinogona kudzorwa nemishonga. |
| Kukuvadzwa kwetambo dzenzwi | Kashoma, kukuvara kudiki kwetsinga dzenzwi kunogona kuitika panguva yekuisa kana kubvisa chubhu. Izvi zvinogona kukonzera shanduko muzwi (kutsvedza) kwenguva pfupi. |
| Kukosora kwakanyanya uye kuvharika kwemhepo inofambisa mweya (laryngospasm) | Vamwe vanhu vanogona kunzwa kusimba kwetsinga dzenzwi zvichikonzerwa nekunzwa pahuro kana chubhu yabviswa. Izvi zvinodzokera pazvakajairika mukati memasekonzi mashoma. |
Ndezvipi zvakanakira extubation?
Ichi chinhu chakanaka kwazvo. Kubvisa mweya wemunhu zvinoreva kuti adarika danho rakakosha murwendo rwake rwekupora.
- Chiratidzo chekupora: Kubatsira kukuru ndekwekuti unogona kufema wega zvakare. Izvi zvinoreva kuti mapapu ako nemuviri wako zviri kudzokera pakare.
- Kugona kutaura: Haugone kutaura chubhu iripo. Kana yabviswa, unokwanisa kutaura zvakare munguva pfupi. Kunyange zvazvo pahuro pako pangave panorwadza pakutanga uye inzwi rako richichinja zvishoma, izvi zvichapera mumazuva mashoma. (Zvichapera mumazuva mashoma).
- Kugona kudya nekunwa: Saizvozvowo, haugone kudya kana kunwa nemuromo chubhu iripo. Kana chubhu yabviswa uye kugona kwako kumedza (gag reflex) kwasimbiswa, unogona kutanga kudya zvakare.
- Kudzivirira njodzi dzinotora nguva refu: Kune dzimwe njodzi dzinoenderana nekuva nechubhu yekufema kwenguva yakareba (semuenzaniso, kusashanda zvakanaka kwenzwi, pneumonia, tracheomalacia ). Extubation zvinoreva kuti hauna njodzi idzodzo.
Kana iwe kana mumwe munhu wemumhuri mako achifanira kuita izvi, usatya kana kuzeza. Bvunza chiremba wako chero mibvunzo kana zvinokunetsa. Vachakutsanangurira zvese.
Mharidzo Yekuenda Nayo Kumba
- Kubvisa dumbu (extubation) inzira yekubvisa chubhu ye endotracheal (ETT) inoiswa mu trachea yako mushure mekunge wakwanisa kufema zvakanaka wega.
- Izvi hazvisi zvinhu zvinoitwa panguva imwe chete. Chinhu chichaitwa nechikwata chevanachiremba mushure mekunyatsoongorora mamiriro ako ezvinhu uye kuronga kwako.
- Zvakajairika kuva nekurwadziwa pahuro uye kurira kwezwi kwemazuva mashoma mushure mekunge chubhu yabviswa.
- Kunyange zvazvo dzimwe nguva matambudziko angamuka (akadai sekukundikana kwekubvisa matubhu), timu yezvekurapa inogara yakagadzirira kugadzirisa matambudziko acho.
- Kubvisa muviri zvinoreva kuti watora danho guru uye rinokosha parwendo rwako rwekupora. Izvozvo zvinhu zvinofadza!
- Kana uine zvinokunetsa nezvekurapa kwako kana kwemumwe wako, gara uchikurukura nezvazvo nachiremba wako.
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