Ngaba wakha wambona umntu onetyhubhu enamathele esifubeni sakhe? Mhlawumbi kumabonwakude, kwimuvi, okanye nakwisibhedlele sokwenyani. Kungaba yinto eyoyikisayo nengathandekiyo ukuyibona. "Kutheni besenza oku? Oku kumele ukuba kubuhlungu kakhulu, akunjalo?" Usenokucinga. Kodwa ubusazi na ukuba ukufaka ityhubhu esifubeni sakho yinkqubo yezonyango ebaluleke kakhulu eyenziwa rhoqo ukusindisa ubomi bomntu. Namhlanje, siza kuthetha ngale nkqubo, ebizwa ngokuba yi-thoracostomy kunyango, ngendlela elula kakhulu onokuyiqonda.
Ngamafutshane, yintoni iThoracostomy?
I-thoracostomy yinkqubo apho ugqirha otyandayo enza umngxuma omncinci ecaleni lesifuba sakho aze afake ityhubhu esifubeni sakho. Le tyhubhu idla ngokubizwa ngokuba yityhubhu yesifuba . Isizathu esiphambili sokwenza oku kukukhupha nawuphi na umoya ogqithisileyo, ulwelo, igazi, okanye ubomvu obuqokelelene kwindawo ejikeleze imiphunga yakho (esiyibiza ngokuba yi-pleural space ngokwezonyango).
Cinga ngemiphunga yethu njengeebhaluni ezimbini. Ezi bhaluni zimbini zingaphakathi kwesifuba. Kukho indawo encinci kakhulu phakathi kwemiphunga nodonga lwangaphakathi lwesifuba. Ngokwesiqhelo, akukho nto kule ndawo. Kodwa ngenxa yezifo ezithile okanye xa kukho ingozi, le ndawo izaliswa zizinto ezifana nomoya namanzi. Emva koko imiphunga iyacinezelwa kwaye ayikwazi ukufutha ngokufanelekileyo. Kuba nzima ukuphefumla, kwaye kukho iintlungu zesifuba. Kulapho oogqirha bafaka khona umbhobho wesifuba ukususa ezi zinto ziqokelelweyo.
Kwezinye iimeko ezingxamisekileyo, ingakumbi i-tension pneumothorax, kwenziwa i-needle thoracostomy ukuze kuthomalaliswe umoya ovalelekileyo kwaye kuncitshiswe uxinzelelo ngaphambi kokuba kufakwe ityhubhu yesifuba. Oku kwenziwa kwimeko engxamisekileyo, njengakwiSebe leeNgxamiseko (ETU), ukuze kusindiswe ubomi besigulana.
Zeziphi iimeko olu nyango lusetyenziselwa zona?
Zininzi izizathu zokuba kwenziwe i-thoracostomy. Isetyenziswa kakhulu kwiimeko apho kukho ukuqokelelana kwezinto ezingafunekiyo ezijikeleze imiphunga. Makhe sijonge ezinye zezi meko.
| Imeko | Kalula nje... |
|---|---|
| I-Pneumothorax (umphunga owileyo) | Imeko apho umoya uqokelelana ujikeleze imiphunga uze uyityhale yahlukane. Ifana nebhaluni eqhumayo ize ikhuphe umoya. Oku kunokubangelwa yingozi okanye zizifo ezithile. |
| Ukuphuma kwamanzi emzimbeni (ulwelo olujikeleze imiphunga) | Ulwelo (amanzi) luyaqokelelana kwindawo ejikeleze imiphunga. Oku kunokubangelwa zizinto ezifana nesifo sentliziyo, isifo sezintso, kunye nomhlaza. |
| I-Empyema (ubomvu obuzalisa imiphunga) | Ingqokelela yobofu obujikeleze imiphunga ngenxa yosulelo lwemiphunga, ingakumbi imeko efana ne-pneumonia. |
| I-Hemothorax (igazi elizalisa isifuba) | Igazi liqokelelana emiphungeni ngenxa yokwenzakala esifubeni (njengengozi, inxeba lokuhlatywa). |
| I-Chylothorax (ukuqokelelana kolwelo esifubeni) | Ngenxa yomonakalo kwinkqubo ye-lymphatic yomzimba wethu, ulwelo lwe-lymph luqokelelana lujikeleze imiphunga. |
| Usulelo lwemiphunga | Le ndlela ikwasetyenziselwa ukususa ulwelo oluqokelelana kwezinye izifo ezinzulu zemiphunga. |
Ufanele ulungiselele njani oku?
Lo ngumbuzo obaluleke kakhulu. Kodwa impendulo iyinkimbinkimbi kancinci. Kuba uninzi lwexesha, le nkqubo ebizwa ngokuba yiThoracostomy yenziwa ngexesha likaxakeka. Khawuthelekelele ukuba umntu ube sengozini yemoto endleleni waza waphuthunyiswa kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele. Ukuba imiphunga yakhe yonakele kwaye uvuvukile, oogqirha kufuneka bafake ityhubhu yesifuba ngokukhawuleza ukuze basindise ubomi bakhe. Kwimeko enjalo, akukho xesha lokulungiselela.
Kodwa ngamanye amaxesha, ngenxa yemeko yempilo esele ikho (umzekelo, umntu onolwelo oluhlala luhleli olujikeleze imiphunga), oku kunokucwangciswa kwangaphambili. Kwiimeko ezinjalo, ugqirha wakho uya kukunika imiyalelo yendlela yokulungiselela. Le miyalelo ingabandakanya:
- Ukususela kwiintsuku ezimbalwa ngaphambi konyangoUsenokucelwa ukuba uyeke ukusebenzisa amayeza athile (ingakumbi amayeza okunciphisa igazi).
- Usenokucelwa ukuba utshintshe ixesha lokusebenzisa amayeza akho.
- Uza kucelwa ukuba uyeke ukutya okanye ukusela kangangeeyure ezimbalwa ngaphambi konyango.
- Usenokucelwa ukuba unxibe impahla ekhululekileyo nekhululekileyo.
Eyona nto ibalulekileyo kukuba uthethe ngokukhululekileyo nangokunyaniseka nogqirha wakho. Ngokuqinisekileyo kufuneka uxelele ugqirha wakho ngayo yonke imithi oyithathayo (kwaneevithamini kunye nezongezo), naziphi na ii-allergies onazo, kwaye ukuba ukhulelwe okanye ukrokrela ukuba ukhulelwe.
Kwenzeka ntoni ngokwenene ngexesha lonyango?
Kulungile, ngoku makhe sibone indlela yokwenza oku. Musa ukoyika ukukufunda oku. Oku kwenziwa ngaphandle kwentlungu nangokukhuselekileyo kangangoko kunokwenzeka.
Okokuqala, ugqirha uza kwenza i-X-ray yesifuba okanye olunye uvavanyo ukuze afumane indawo echanekileyo apho ityhubhu kufuneka ifakwe khona. Emva koko unyango luya kuqala.
1. Indawo oza kubekwa kuyo: Uza kucelwa ukuba ulale ebhedini, intloko yakho iphakanyisiwe kancinci, kwaye ingalo ecaleni apho kuza kufakwa khona ityhubhu iza kubekwa ngaphezulu kwentloko yakho. Oku kuza kuvula isithuba esiphakathi kweembambo zakho, kwenze kube lula ukufaka ityhubhu.
2. Ukucoca: Okulandelayo, indawo yesifuba ekhethiweyo kwityhubhu icocwe kakuhle ngesisombululo se-antiseptic. Oku kwenziwa ukuthintela naziphi na iintsholongwane ukuba zingangeni emzimbeni.
3. Ukuba ndindisholo: Ngoku yeyona nto ibalulekileyo. Ukuze ungaziva ntlungu, kufakwa i-anesthetic yendawo , efana neLidocaine , kuloo ndawo. Usenokuziva unomsindo omncinci xa unikwa inaliti, kodwa kwimizuzu embalwa yonke indawo iya kuba ndindisholo ngokupheleleyo. Ngoko awuyi kuva nto emva koko.
4. Ukwenza i-incision: Ngoku ekubeni uphelelwe ngamandla, ugqirha uza kwenza i-incision encinci kakhulu phakathi kweembambo zakho ezimbini. Olu ayilo qhushumbo likhulu, lukwanele nje ukufaka ityhubhu.
5. Ukufakwa kwetyhubhu: Okulandelayo, ityhubhu yesifuba ifakwa ngononophelo nge-incision kwindawo ejikeleze imiphunga. Elinye icala lale tyhubhu liqhagamshelwe kwinto efana nebhotile yamanzi (isitya sokuhambisa amanzi). Umoya namanzi esifubeni aya kudlula kule tyhubhu aze aqokelele kuloo bhotile.
6. Ukhuseleko: Okokugqibela, ibhandeji elingenazintsholongwane libekwa lijikeleze indawo yokufaka ize ligqunywe. Ngamanye amaxesha, kunokufakwa umthungo omncinci eluswini ukuze kuqiniswe umbhobho eluswini ukuze ungahambi.
Le nkqubo yonke idla ngokuthatha malunga nemizuzu engama-30 .
Kwenzeka ntoni emva konyango?
Emva kokuba ityhubhu ifakiwe, uza kufumana enye i-X-ray yesifuba ukuqinisekisa ukuba ikwindawo yayo kwaye imiphunga yakho ivuvukele kakuhle. Emva koko ugqirha kunye nabahlengikazi baza kukunika imiyalelo yendlela yokunyamekela ityhubhu.
- Indawo yokusikwa kufuneka igcinwe icocekile kwaye yomile .
- Inika imiyalelo yendlela yokunyamekela ityhubhu kunye nebhotile eqhagamshelwe kuyo (isitya sokuhambisa amanzi). Eyona nto ibalulekileyo kukungavumeli ityhubhu igobe okanye inamathele naphi na . Kwakhona, ibhotile kufuneka ihlale igcinwe ngaphantsi komgangatho wesifuba . Ngale ndlela, umxholo wesifuba uya kugeleza lula ebhotileni ngokomxhuzulane.
- Ufanele uthabathe amayeza amiselweyo ngexesha elifanelekileyo .
Zithini iingenelo zolu nyango?
Nangona oku kusenokubonakala kusoyikisa kancinci, kuneengenelo ezininzi.
- Olu asilotyando olukhulu (olungena kakhulu): Ekubeni lwenziwa ngomsikelo omncinci, endaweni yomsikelo omkhulu, akukho monakalo mkhulu emzimbeni kwaye inkqubo yokuphiliswa ikhawuleza.
- Ingasindisa ubomi kwiimeko ezingxamisekileyo: Oku kungasindisa ubomi ngokukhawuleza xa kwenzeka ingozi okanye ukuwohloka kwemiphunga. Inganceda nakwiimeko ezihlala ixesha elide.
- Akukho mfuneko yokulalisa isigulane ngokupheleleyo: Oku kudla ngokwenziwa phantsi kwe-anesthesia, ngoko ke akukho mngcipheko we-anesthesia enkulu.
- Ukukhululeka ngokukhawuleza xa uphefumla nzima: Umntu onengxaki yokuphefumla ngenxa yolwelo oluzalisa imiphunga yakhe uya kuziva ekhululekile emva kokwenza oku.
Ngaba kukho naziphi na iziphumo ebezingalindelekanga okanye iingozi?
Njengakwezinye iindlela zonyango, kukho iingozi ezincinci kakhulu ezibandakanyekayo, kodwa oogqirha bathatha onke amanyathelo anokwenzeka ukunciphisa ezi ngozi.
- Ityhubhu ifakwe kwindawo engafanelekanga okanye isuka kwindawo yayo yokuqala.
- Usulelo kwindawo yokusikwa.
- I-subcutaneous emphysema (ukuqokelelana komoya phantsi kolusu).
- Ukwanda kwakhona kwe-pulmonary edema (ukuzaliswa kolwelo olujikeleze umphunga ophumileyo emva kokuba ukhule ngequbuliso kwakhona).
- Ukopha.
- Umonakalo omncinci kwimithambo-luvo okanye kwizicwili ezingqongileyo.
Amathuba okuba ezi zinto zenzeke mancinci kakhulu. Kodwa kulungile ukuzazi izinto ezinje. Ukuba unemibuzo, buza ugqirha wakho.
Ityhubhu kufuneka ishiywe ixesha elingakanani? Kuthatha ixesha elingakanani ukuphola?
Ubude bexesha apho ityhubhu yesifuba ibekwe khona buxhomekeke kwisizathu sokubekwa kwayo.
- Ukuba igazi elincinci okanye umoya ususiwe emva kwengozi, umbhobho ungasuswa kwiintsuku ezimbalwa emva kokuba uphume ngokupheleleyo.
- Nangona kunjalo, ukuba ulwelo luqhubeka luzalisa ngenxa yemeko yexesha elide, kunokufuneka ukuba ityhubhu ihlale apho kangangeeveki ezininzi . Ugqirha wakho uza kukuchazela oku.
Emva kokuba ityhubhu isusiwe, kungathatha iiveki ezintathu ukuya kwezine ukuba inxeba liphole ngokupheleleyo. Ngeli xesha, ugqirha wakho uza kukunika iingcebiso malunga nendlela yokunyamekela inxeba kunye nokuba kufuneka uziphephe na imisebenzi enzima.
Ukuba ubona into efana nale, xelela ugqirha wakho ngoko nangoko.
Ukuba unetyhubhu yesifuba, lumka ezi mpawu zilandelayo. Ukuba unayo nayiphi na kwezi, xelela ugqirha wakho ngoko nangoko .
| Uphawu lokunika ingqalelo | Inkcazo |
|---|---|
| Iimpawu zosulelo | Umkhuhlane, ukudumba kwindawo yokufaka ityhubhu, ukwanda kwentlungu okungalindelekanga, ukutshintsha kombala wolusu (ukuba bomvu), kunye nobomvu. |
| Iingxaki zepayipi | Umbhobho uqhekekile okanye uvalekile, umbhobho ukhululekile, ubungakanani bolwelo oluphuma kumbhobho buyancipha okanye buyeke ngequbuliso. |
| Ubunzima bokuphefumla | Ukuphinda okanye ukuba mandundu kokuphelelwa ngumphefumlo, iintlungu zesifuba. |
| Eminye imibuzo | Ukuba unemibuzo okanye iinkxalabo malunga nendlela yokunyamekela inxeba okanye ityhubhu. |
Yintoni umahluko phakathi kweThoracostomy, Thoracentesis, kunye neThoracotomy?
La magama mathathu avakala efana, kodwa ziindlela ezintathu ezahlukeneyo zonyango. Abantu abaninzi bayabhideka phakathi kwawo. Makhe sibone ukuba yintoni umahluko.
| Indlela yonyango | Yintoni omawuyenze ngokulula | Injongo ephambili |
|---|---|---|
| I-Thoracostomy | Ukufaka ityhubhu yesifuba ngesithuba esincinci. | Ukukhupha umoya, amanzi, negazi rhoqo kangangeentsuku okanye iiveki eziliqela. |
| I-Thoracentesis | Ukukhupha ulwelo oluncinci esifubeni usebenzisa inaliti kunye nesirinji. | Ukuze kufunyanwe isifo (ukuthatha isampuli yolwelo) okanye ukususa ulwelo oluncinci uze unike uncedo olukhawulezileyo. |
| I-Thoracotomy | Ukuvula umngxuma wesifuba ngokwenza umngxuma omkhulu phakathi kweembambo. Olu lutyando olukhulu. | Ukwenza utyando emiphungeni, entliziyweni, okanye kwezinye izitho zomzimba (umz., ukususa ithumba elinomhlaza). |
Ngamafutshane, i-thoracotomy lutyando olukhulu. Emva kolo tyando, i-thoracostomy (ityhubhu yesifuba) inokufakwa ukuze kususwe ulwelo oluqokelelana esifubeni.
Umyalezo Wokuya Ekhaya
- I-Thoracostomy (ukubekwa kwetyhubhu yesifuba) yinkqubo esindisa ubomi esusa umoya ongafunekiyo, ulwelo, igazi, okanye ubovu obuqokelelana emiphungeni.
- Nangona oku kusenokubonakala kusoyikisa, kwenziwa ngaphandle kwentlungu ingako. Olu asilotyando olukhulu.
- Olu nyango lungenziwa ngexesha likaxakeka okanye ngendlela ecwangcisiweyo kwangaphambili.
- Emva kokuba ityhubhu ifakiwe, kubaluleke kakhulu ukuze umntu alulame ngokukhawuleza ukulandela imiyalelo enikwe ngugqirha kunye nabongikazi ngokuchanekileyo.
- Ukuba unemibuzo, uloyiko, okanye amathandabuzo malunga noku, ungaze woyike ukuxoxa ngayo nogqirha wakho.
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