Wake wambona umuntu onepayipi elinamathele esifubeni sakhe? Mhlawumbe ku-TV, ku-movie, noma ngisho nasesibhedlela sangempela. Kungaba yinto eyesabekayo nengakhululekile ukuyibona. "Kungani benza lokhu? Lokhu kumele ukuthi kubuhlungu kakhulu, akunjalo?" Ungase ucabange. Kodwa bewazi ukuthi ukufaka ipayipi esifubeni sakho kuyindlela yezokwelapha ebaluleke kakhulu evame ukwenziwa ukusindisa impilo yomuntu? Namuhla, sizokhuluma ngale nqubo, ebizwa ngokuthi i-thoracostomy kwezokwelapha, ngendlela elula kakhulu ongayiqonda.
Kalula nje, kuyini i-Thoracostomy?
I-thoracostomy inqubo lapho udokotela ohlinzayo enza khona ukusika okuncane ohlangothini lwesifuba sakho bese efaka ipayipi esifubeni sakho. Leli payipi livame ukubizwa ngokuthi ipayipi lesifuba . Isizathu esiyinhloko sokwenza lokhu ukukhipha noma yimuphi umoya ongaphezulu, uketshezi, igazi, noma ubomvu obuqongeleleke esikhaleni esizungeze amaphaphu akho (esikubiza ngokuthi isikhala se-pleural ngokwezokwelapha).
Cabanga ngamaphaphu ethu njengamabhaluni amabili. Lawa mabhaluni amabili angaphakathi kwesifuba. Kunesikhala esincane kakhulu phakathi kwamaphaphu nodonga lwangaphakathi lwesifuba. Ngokuvamile, akukho lutho kulesi sikhala. Kodwa ngenxa yezifo ezithile noma uma kwenzeka ingozi, lesi sikhala sigcwele izinto ezifana nomoya namanzi. Khona-ke amaphaphu ayacindezelwa futhi awakwazi ukufutha kahle. Kuba nzima ukuphefumula, futhi kuba nobuhlungu besifuba. Yilapho odokotela befaka khona ithubhu yesifuba ukuze basuse lezi zinto eziqongelelekile.
Kwezinye izimo eziphuthumayo, ikakhulukazi i-tension pneumothorax, kwenziwa i-nail thoracostomy ukuze kuncishiswe ingcindezi ngokukhulula umoya ovalelekile ngaphambi kokuba kufakwe ipayipi lesifuba. Lokhu kwenziwa esimweni esiphuthumayo, njengaseMnyango Wezimo Eziphuthumayo (ETU), ukuze kusindiswe impilo yesiguli.
Yiziphi izimo ezisetshenziswayo lokhu kwelashwa?
Kunezizathu eziningi zokuthi kungani kungenziwa i-thoracostomy. Isetshenziswa kakhulu ezimweni lapho kukhona ukunqwabelana kwezinto ezingafuneki emaphashini. Ake sibheke ezinye zalezi zimo.
| Isimo | Kalula nje... |
|---|---|
| I-Pneumothorax (iphaphu eliwile) | Isimo lapho umoya uqoqana khona uzungeze amaphaphu bese uwahlukanisa. Kufana nebhaluni eliqhumayo bese likhipha umoya. Lokhu kungabangelwa ingozi noma izifo ezithile. |
| Ukuphuma kwegazi emaphashini (uketshezi oluzungeze amaphaphu) | Uketshezi (amanzi) luqoqana esikhaleni esizungeze amaphaphu. Lokhu kungabangelwa izinto ezifana nesifo senhliziyo, isifo sezinso, kanye nomdlavuza. |
| I-Empyema (ubomvu obugcwalisa amaphaphu) | Iqoqo lobomvu obuzungeze amaphaphu ngenxa yokutheleleka kwamaphaphu, ikakhulukazi isimo esifana ne-pneumonia. |
| I-Hemothorax (igazi eligcwalisa isifuba) | Igazi liqoqana emaphashini ngenxa yokulimala esifubeni (njengengozi, inxeba lokugwazwa). |
| I-Chylothorax (ukuqongelela koketshezi esifubeni) | Ngenxa yomonakalo ohlelweni lwe-lymphatic lomzimba wethu, uketshezi lwe-lymph luqoqana emaphashini. |
| Ukutheleleka kwamaphaphu | Le ndlela isetshenziswa futhi ukususa uketshezi oluqongelela kwezinye izifo ezinzima zamaphaphu. |
Kufanele uzilungiselele kanjani lokhu?
Lona umbuzo obaluleke kakhulu. Kodwa impendulo iyinkimbinkimbi kancane. Ngoba isikhathi esiningi, le nqubo ebizwa ngokuthi i-Thoracostomy yenziwa esimweni esiphuthumayo. Cabanga ukuthi othile ube sengozini yemoto emgwaqweni futhi uphuthunyiswa e-Emergency Treatment Unit (ETU) yesibhedlela. Uma amaphaphu akhe onakele futhi evuvukele, odokotela kufanele bafake ipayipi lesifuba ngokushesha ukuze basindise impilo yakhe. Esimweni esinjalo, asikho isikhathi sokulungiselela.
Kodwa ngezinye izikhathi, ngenxa yesimo sezokwelapha esivele sikhona (isibonelo, umuntu onoketshezi oluqhubekayo emaphashini), lokhu kungahlelwa kusenesikhathi. Ezimweni ezinjalo, udokotela wakho uzokunikeza imiyalelo yokuthi ungalungiselela kanjani. Le miyalelo ingafaka:
- Kusukela ezinsukwini ezimbalwa ngaphambi kokwelashwaUngase ucelwe ukuthi uyeke ukuthatha imithi ethile (ikakhulukazi imithi yokunciphisa igazi).
- Ungase ucelwe ukuthi ushintshe isikhathi somuthi wakho.
- Uzocelwa ukuthi ungadli noma uphuze amahora ambalwa ngaphambi kokwelashwa.
- Ungase ucelwe ukuthi ugqoke izingubo ezikhululekile nezikhululekile.
Into ebaluleke kakhulu ukuvuleleka nokwethembeka kudokotela wakho. Kufanele nakanjani utshele udokotela wakho ngayo yonke imithi oyiphuzayo (ngisho namavithamini kanye nezithasiselo), noma yikuphi ukungezwani komzimba onakho, futhi uma ukhulelwe noma usola ukuthi ukhulelwe.
Kwenzekani ngempela ngesikhathi sokwelashwa?
Kulungile, manje ake sibone ukuthi singakwenza kanjani lokhu. Ungesabi ukufunda lokhu. Lokhu kwenziwa ngaphandle kobuhlungu nangokuphepha ngangokunokwenzeka.
Okokuqala, udokotela uzokwenza i-X-ray yesifuba noma olunye uhlolo ukuze athole indawo eqondile lapho kufanele kufakwe khona ipayipi. Ngemuva kwalokho ukwelashwa kuzoqala.
1. Indawo: Uzocelwa ukuba ulale embhedeni, ikhanda lakho liphakeme kancane, kanti ingalo ohlangothini lapho kuzofakwa khona ipayipi izobekwa ngaphezu kwekhanda lakho. Lokhu kuzovula isikhala phakathi kwezimbambo zakho, okwenza kube lula ukufaka ipayipi.
2. Ukuhlanza: Okulandelayo, indawo yesifuba ekhethelwe ipayipi ihlanzwa kahle ngesisombululo se-antiseptic. Lokhu kwenziwa ukuvimbela noma yimaphi amagciwane ukuthi angangeni emzimbeni.
3. Ukuba ndikindiki: Manje yingxenye ebaluleke kakhulu. Ukuze uvimbele ukuthi ungezwa ubuhlungu, kufakwa umuthi wokubulala izinzwa wendawo , njenge- Lidocaine , endaweni. Ungase uzizwe umuzwa omncane wokuhlaba lapho unikezwa umjovo, kodwa kungakapheli imizuzu embalwa yonke indawo izobe indikindiki ngokuphelele. Ngakho ngeke uzwe lutho ngemva kwalokho.
4. Ukwenza i-incision: Manje njengoba usuphelelwe amandla, udokotela uzokwenza i-incision encane kakhulu phakathi kwezimbambo zakho ezimbili. Lokhu akuyona i-incision enkulu, kwanele nje ukufaka ipayipi.
5. Ukufakwa kwepayipi: Okulandelayo, ipayipi lesifuba lifakwa ngokucophelela ngokusebenzisa i-incision esikhaleni esizungeze amaphaphu. Esinye isiphetho saleli payipi sixhunywe kokuthile okufana nebhodlela lamanzi (isitsha sokukhipha amanzi). Umoya namanzi esifubeni kuzogeleza ngaleli payipi bese kuqongelela kulelo bhodlela.
6. Isivikelo: Ekugcineni, kufakwa ibhandeji elingenamagciwane endaweni yokufaka bese limbozwa. Ngezinye izikhathi, kungafakwa umthungo omncane esikhumbeni ukuze kuboshwe ipayipi esikhumbeni ukuze lingakwazi ukuhambahamba.
Le nqubo yonke ivame ukuthatha imizuzu engama-30 .
Kwenzekani ngemva kokwelashwa?
Ngemva kokufakwa kwepayipi, uzobe usunikwa enye i-X-ray yesifuba ukuqinisekisa ukuthi isendaweni yayo nokuthi amaphaphu akho agcwele umoya kahle. Ngemuva kwalokho udokotela nabahlengikazi bazokunikeza imiyalelo yokuthi ungayinakekela kanjani ipayipi.
- Indawo yokusikwa kufanele igcinwe ihlanzekile futhi yomile .
- Inikeza imiyalelo yokuthi ungayinakekela kanjani ithubhu kanye nebhodlela elixhunywe kulo (isitsha sokukhipha amanzi). Into ebaluleke kakhulu ukungavumeli ithubhu ligobe noma linamathele noma kuphi . Futhi, ibhodlela kufanele lihlale lingaphansi kwesifuba . Ngaleyo ndlela, okuqukethwe yisifuba kuzogeleza kalula ebhodleleni ngokuya ngamandla adonsela phansi.
- Udinga ukuthatha imithi oyinikezwe udokotela ngesikhathi esifanele .
Ziyini izinzuzo zalokhu kwelashwa?
Nakuba lokhu kungase kubonakale kusabisa kancane, kunezinzuzo eziningi.
- Lokhu akusiwo ukuhlinzwa okukhulu (Okungangeni kakhulu): Njengoba kwenziwa ngokusikwa okuncane, kunokuba kube ukusikwa okukhulu, kunomonakalo omncane emzimbeni futhi inqubo yokuphulukiswa ishesha.
- Kungasindisa izimpilo ezimweni eziphuthumayo: Lokhu kungasindisa impilo ngokushesha uma kwenzeka ingozi noma ukuwohloka kwamaphaphu. Kungaphinde kunikeze impumuzo ezimweni zesikhathi eside.
- Asikho isidingo sokulalisa isiguli ngokuphelele: Lokhu kuvame ukwenziwa ngaphansi kwe-anesthesia, ngakho-ke akukho bungozi bokulalisa isiguli kakhulu.
- Ukuphumula okusheshayo kokuphelelwa umoya: Umuntu onenkinga yokuphefumula ngenxa yoketshezi olugcwalisa amaphaphu akhe uzozizwa ekhululekile ngokushesha ngemva kokwenza lokhu.
Ingabe ikhona imiphumela emibi noma izingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezincane kakhulu ezihilelekile, kodwa odokotela bathatha zonke izinyathelo ezingenzeka ukuze banciphise lezi zingozi.
- Ipayipi lifakwa endaweni engafanele noma lisuka endaweni yalo yokuqala.
- Ukutheleleka endaweni yokusikwa.
- I-subcutaneous emphysema (ukuqongelela komoya ngaphansi kwesikhumba).
- Ukwanda kabusha kwe-pulmonary edema (uketshezi olugcwala nxazonke kwephaphu eliphumile ngemva kokuba liphinde landa ngokuzumayo).
- Ukopha.
- Umonakalo omncane ezinzwa noma ezicutshini ezizungezile.
Amathuba okuba lezi zinto zenzeke mancane kakhulu. Kodwa kuhle ukuqaphela izinto ezinjengalezi. Uma unemibuzo, buza udokotela wakho.
Kufanele kushiywe isikhathi esingakanani ipayipi? Kuthatha isikhathi esingakanani ukuphola?
Ubude besikhathi ipayipi lesifuba likhona ngaso buxhomeke esizathwini sokubekwa kwalo.
- Uma igazi elincane noma umoya ususiwe ngemva kwengozi, ipayipi lingasuswa ezinsukwini ezimbalwa ngemva kokuba selikhiphe amanzi ngokuphelele.
- Kodwa-ke, uma uketshezi luqhubeka nokugcwala ngenxa yesimo sesikhathi eside, kungadingeka ukuthi ube nepayipi endaweni yalo amasonto ambalwa . Udokotela wakho uzokuchazela lokhu.
Ngemva kokususwa kwepayipi, kungathatha amasonto amathathu kuya kwamane ukuthi inxeba liphole ngokuphelele. Phakathi naleso sikhathi, udokotela wakho uzokweluleka ngokuthi ungalinakekela kanjani inxeba nokuthi kufanele yini ugweme imisebenzi enzima.
Uma ubona into efana nale, tshela udokotela wakho ngokushesha.
Uma unepayipi lesifuba, qaphela lezi zimpawu ezilandelayo. Uma unanoma yikuphi kwalokhu, tshela udokotela wakho ngokushesha .
| Uphawu okufanele ulunake | Incazelo |
|---|---|
| Izimpawu zokutheleleka | Umkhuhlane, ukuvuvukala endaweni yokufakwa kwepayipi, ukwanda okungalindelekile kobuhlungu, ukushintsha kombala wesikhumba (ukubomvu), kanye nobomvu. |
| Izinkinga zamapayipi | Ipayipi liyagoba noma linamathele, ipayipi liyaxega, inani loketshezi oluphuma epayipini liyancipha noma lima ngokuzumayo. |
| Ubunzima bokuphefumula | Ukuphindaphinda noma ukuba kubi kokuphelelwa umoya, ubuhlungu besifuba. |
| Eminye imibuzo | Uma unemibuzo noma ukukhathazeka mayelana nendlela yokunakekela inxeba noma ipayipi. |
Uyini umehluko phakathi kwe-Thoracostomy, i-Thoracentesis, ne-Thoracotomy?
La magama amathathu azwakala efana, kodwa ayizindlela ezintathu ezahlukene zokwelapha. Abantu abaningi bayadideka phakathi kwawo. Ake sibone ukuthi umehluko uyini.
| Indlela yokwelapha | Okufanele ukwenze nje | Inhloso eyinhloko |
|---|---|---|
| I-Thoracostomy | Ukufaka ipayipi lesifuba ngembobo encane. | Ukuxoshwa okuqhubekayo komoya, amanzi, negazi izinsuku eziningana noma amasonto. |
| I-Thoracentesis | Ukukhipha inani elincane loketshezi esifubeni usebenzisa inalithi nesipetu. | Ukuze kutholakale ukuthi unesifo (ukuthatha isampula yoketshezi) noma ukukhipha inani elincane loketshezi bese kunikezwa usizo ngokushesha. |
| Ukususwa kwesifuba | Ukuvula umgodi wesifuba ngokwenza ukusika okukhulu phakathi kwezimbambo. Lokhu ukuhlinzwa okukhulu. | Ukwenza ukuhlinzwa emaphashini, enhliziyweni, noma kwezinye izitho zomzimba (isib., ukususa isimila esinomdlavuza). |
Kalula nje, i-thoracotomy iwukuhlinzwa okukhulu. Ngemva kwalokho kuhlinzwa, i-thoracostomy (ithubhu lesifuba) ingafakwa ukuze kususwe uketshezi oluqongelela esifubeni.
Umlayezo Wokuya Nawe Ekhaya
- I-Thoracostomy (ukufakwa kwepayipi lesifuba) inqubo esindisa impilo esusa umoya ongafuneki, uketshezi, igazi, noma ubomvu obuqoqana emaphashini.
- Nakuba lokhu kungase kubonakale kusabisa, kwenziwa ngobuhlungu obuncane. Lokhu akulona ukuhlinzwa okukhulu.
- Lokhu kwelashwa kungenziwa esimweni esiphuthumayo noma ngendlela ehleliwe kusengaphambili.
- Ngemva kokufakwa kwepayipi, kubaluleke kakhulu ukuze umuntu alulame ngokushesha ukulandela imiyalelo enikezwe udokotela nabahlengikazi ngqo.
- Uma unemibuzo, ukwesaba, noma ukungabaza ngalokhu, ungesabi ukuxoxa ngakho nodokotela wakho.
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