Wake wezwa ngomuntu ofakwe ipayipi lesifuba ngemuva kwengozi noma ngoba wayenenkinga yokuphefumula? Kungenzeka ukuthi uke wakubona ngisho nasefilimini. Igama lezokwelapha lalokhu yi-Thoracostomy. Nakuba kungase kuzwakale kuyesabisa kancane, kuyinqubo ebaluleke kakhulu yokusindisa impilo. Kulungile, ngakho ake sixoxe ngakho konke ngamagama alula namuhla.
Kuyini i-Thoracostomy?
Kalula nje, i-thoracostomy inqubo lapho udokotela enza khona ukusikwa okuncane ohlangothini lwesifuba sakho, phakathi kwezimbambo ezimbili, bese efaka ipayipi lepulasitiki ngalo. Ngokuvamile leli payipi silibiza ngokuthi 'ipayipi lesifuba'.
Manje bheka, kunezimbotshana ezimbili ezincane ezizungeze amaphaphu ethu futhi zigcwele ngaphakathi kodonga lwesifuba sethu. Isikhala esiphakathi kwalezi zimbotshana ezimbili sibizwa ngokuthi 'isikhala se-pleural'. Ngenxa yezimo ezithile zezokwelapha noma izingozi , umoya, uketshezi (njengamanzi), igazi, noma ubomvu kungaqongelela kulesi sikhala. Uma lokhu kwenzeka, amaphaphu awakwazi ukufutha noma ukufiphaza kahle, okungabangela ubunzima bokuphefumula nobuhlungu obukhulu.
Inhloso eyinhloko yokuhlinzwa kwesifuba ukususa noma yimuphi umoya noma uketshezi olungafuneki oluqongelele esifubeni ngepayipi, okuvumela amaphaphu ukuthi asebenze ngokukhululeka futhi.
Esimweni esiphuthumayo, ikakhulukazi esimweni esiyingozi njenge-'Tension Pneumothorax', lapho ungaphefumula khona kodwa ungakwazi ukuphefumula, odokotela bafaka inaliti ngokushesha bese bekhipha umoya ngaphambi kokufaka leli payipi lesifuba. Lokhu kubizwa ngokuthi i-'Needle Thoracostomy'. Lena inqubo esindisa impilo eyenziwa eMnyangweni Wezimo Eziphuthumayo (ETU).
Yiziphi izimo ezenziwa nge-thoracostomy?
Odokotela benza lokhu kwelashwa ngezizathu ezahlukene. Ake sibheke izizathu eziyinhloko.
| Isimo | Incazelo elula |
|---|---|
| I-Pneumothorax (ukuwa kwamaphaphu) | Umoya ugcwalisa isikhala esizungeze amaphaphu. |
| I-Pleural Effusion (ukuqongelela koketshezi emaphashini) | Ukunqwabelana koketshezi (njengamanzi) emaphashini. |
| I-Empyema | Ukunqwabelana kobomvu esikhaleni esizungeze amaphaphu. |
| I-Hemothorax | Ukuqongelela kwegazi ngaphakathi kwesifuba (ngokuvamile ngemva kwengozi). |
| I-Chylothorax | Uketshezi olufana nobisi (i-lymph) oluvela ohlelweni lwe-lymphatic luqoqana esifubeni. |
| Ukutheleleka Kwamaphaphu | Ukuqongelela koketshezi emaphashini ngenxa yezifo ezinzima njenge-pneumonia. |
Ingabe ngidinga ukulungiselela lokhu kwelashwa kusengaphambili?
Esikhathini esiningi, lokhu kwenziwa uma kwenzeka ingozi noma isimo esiphuthumayo, ngakho-ke asikho isikhathi sokulungiselela kusenesikhathi. Ezimweni ezinjalo, odokotela abase-Emergency Treatment Unit (ETU) benza izinqumo ngokushesha futhi bakwenze lokhu.
Kodwa-ke, ngezinye izikhathi, ngenxa yesimo esingamahlalakhona njengoketshezi oluqhubekayo esifubeni, leli payipi lingahlelwa futhi libekwe. Ezimweni ezinjalo, udokotela wakho uzokunikeza imiyalelo ethile.
- Eminye imithi (ikakhulukazi imithi yokunciphisa igazi) kungadingeka iyekwe ezinsukwini ezimbalwa ngaphambi kokwelashwa.
- Uzocelwa ukuthi ugweme ukudla noma ukuphuza amahora ambalwa ngaphambi kokwelashwa.
- Tshela udokotela wakho nganoma yimiphi eminye imithi, amavithamini, noma izithasiselo ozithathayo.
- Uma une-allergies kunoma yimuphi umuthi, qiniseka ukuthi uyakhuluma ngawo.
- Futhi yazisa udokotela wakho uma ukhulelwe noma ungase ukhulelwe .
Kwenzekani ngempela uma kwenziwa i-thoracostomy?
Le nqubo ivame ukuthatha cishe imizuzu engama-30. Usuke uphapheme phakathi nale nqubo. Ungakhathazeki, odokotela bazokwenza konke okusemandleni abo ukuqinisekisa ukuthi awuzizwa ubuhlungu.
1. Okokuqala, kwenziwa i-X-ray yesifuba ukuqinisekisa ukuthi ipayipi libekwe kahle.
2. Ngemuva kwalokho uzocelwa ukuba ulale embhedeni, uphakamise ikhanda lakho kancane, bese ubeka ingalo ohlangothini lapho ipayipi lizofakwa khona ngaphezu kwekhanda lakho.
3. Isikhumba esifubeni lapho kuzofakwa khona ipayipi sihlanzwa kahle futhi sigezwe ngesisombululo se-antiseptic.
4. Okulandelayo, into ebaluleke kakhulu. Umuthi wokubulala izinzwa (njenge-'Lidocaine') ufakwa endaweni yesikhumba. Lokhu kuzokusiza ukuthi ungazizwa ubuhlungu obukhulu ngalokho okwenzayo ngemva kwalokho.
5. Ngemva kokuba isikhumba singenasici, kwenziwa ukusika okuncane kakhulu phakathi kwezimbambo ezimbili.
6. Ngaleso simbozo, kufakwa ipayipi lepulasitiki (ipayipi lesifuba) ngokucophelela endaweni ezungeze amaphaphu.
7. Ingaphandle lepayipi lixhunywe ebhodleleni noma esikhwameni esikhethekile (isitsha sokukhipha amanzi) esiqoqa uketshezi noma umoya ophuma esifubeni.
8. Ekugcineni, kufakwa amafutha okubulala amagciwane endaweni lapho ipayipi lingena khona esikhumbeni bese limbozwa ngendwangu ehlanzekile.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Njenganoma yikuphi ukwelashwa, kunezinzuzo kanye nezingozi ezincane kakhulu.
Izinzuzo eziyinhloko
- Lena inqubo elula engadingi ukusikwa okukhulu (okungenangozi kangako).
- Kubalulekile ukusindisa izimpilo ezimweni eziphuthumayo.
- Lokhu akudingi i-anesthesia ephelele (ukulahlekelwa ukwazi).
- Lokhu kunikeza impumuzo enkulu kumuntu onenkinga yokuphefumula ngenxa yoketshezi oluqhubekayo esifubeni sakhe.
Izinkinga ezincane ezingaba khona
Odokotela benza konke okusemandleni abo ukunciphisa lezi zingozi.
- Ipayipi lilahlekile noma liyakhululeka.
- Ukutheleleka kwenxeba.
- Ukuqongelela komoya ngaphansi kwesikhumba (`Subcutaneous emphysema`).
- Ukopha.
- Akuvamile kakhulu, ukulimala kwemizwa noma izicubu ezizungezile.
- Uketshezi luyanqwabelana emaphashini ngemva kokuba esephinde avuvukaliswa (`i-Re-expansion pulmonary edema`).
Kwenzekani ngemva kokwelashwa?
Ngemva kokufakwa kwepayipi, kuzothathwa enye i-X-ray ukuqinisekisa ukuthi ikhona. Udokotela kanye nabasebenzi bobuhlengikazi bazokunikeza imiyalelo yokuthi ungayinakekela kanjani ipayipi kanye nenxeba ngenkathi usegumbini.
- Inxeba kufanele ligcinwe lihlanzekile futhi lomile .
- Ipayipi kumele ligcinwe lingagobi noma linamathele .
- Okubaluleke kakhulu: Gcina njalo isitsha sokukhipha amanzi singaphansi kwesifuba sakho . Ngaphandle kwalokho, okuqukethwe yilesi sitsha kungavuza emuva esifubeni sakho.
- Phuza imithi yokubulala izinhlungu neminye imithi oyinikezwe udokotela wakho ngesikhathi esifanele.
Kufanele kushiywe isikhathi esingakanani ipayipi lesifuba?
Lokhu kuncike esizathwini sokufakwa kwepayipi. Uma lonke uketshezi noma umoya osesifubeni usuphumile, ipayipi livame ukususwa zingakapheli izinsuku ezimbalwa. Kodwa-ke, uma uketshezi luqhubeka nokunqwabelana ngenxa yesimo esingamahlalakhona, njengomdlavuza, ipayipi kungadingeka lishiywe amasonto. Buza udokotela wakho ukuthola ulwazi olwengeziwe.
Kunini lapho udinga ukubonana nodokotela ngokushesha okukhulu?
Uma ufakwe ipayipi lesifuba, qaphela kakhulu izimpawu ezilandelayo. Uma unanoma iyiphi yalezi, tshela udokotela wakho noma umhlengikazi ngokushesha.
Funa iseluleko sezokwelapha ngokushesha:
* Uma uba nezimpawu zokutheleleka njengokuvuvukala , ukubomvu, ukwanda okungalindelekile kobuhlungu, noma umkhuhlane endaweni yenxeba.
* Uma ithubhu libonakala ligobile noma linamathele .
* Uma unenkinga yokuphefumula .
* Uma ithubhu lizwakala sengathi likhululekile .
Uma ubona into efana nale, yazisa udokotela wesibhedlela noma umhlengikazi ngokushesha. Ungesabi ukubuza ngayo.
Umlayezo Wokuya Nawe Ekhaya
- I-Thoracostomy inqubo elula nesindisa impilo esusa umoya noma uketshezi olungafuneki esifubeni ngepayipi.
- Lokhu kwelashwa kusetshenziswa ezimweni lapho amaphaphu ewile, uketshezi, igazi, noma ubomvu bugcwalisa amaphaphu.
- Lokhu kuvame ukwenziwa ngenkathi uvukile, ngomuthi oqeda izinhlungu, ukuze ungezwa ubuhlungu obukhulu.
- Ngemva kokufakwa kwepayipi, landela imiyalelo kadokotela wakho yokuthi ungayinakekela kanjani (ikakhulukazi mayelana nepayipi nebhodlela).
- Uma kuvela izinkinga, njengomkhuhlane, ukuvuvukala kwesilonda, noma ubunzima bokuphefumula, funa iseluleko sezokwelapha ngokushesha.
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