Pleural puncture

Ukugqunywa kwesikhumba ukugqama kwendonga yesifuba kanye nekhanda elimboza amaphaphu (pleura), okukhiqizwa ngezinjongo zokuxilonga noma zokwelapha. Lokhu kungenelela okulula esifubeni, okuyinto kwezinye izimo kuvumela ukulondoloza impilo yesiguli.

Izinkomba zokuvala isikhala somlomo

Isibonakaliso esiyinhloko sokuqhaqhazela isisindo ukusola kokukhona emgodini wesikhala noma umoya (igazi, exudate, transudate). Lokhu kukhwabanisa kungadingeka kulezi zimo nezifo:

Okuqukethwe kwesigxobo se-pleural esitholakalayo ngokusetshenziselwa ukugcoba sisetshenziselwa ukuxilongwa ngezinqubo zokuhlola izifo ze-bacteriological, cytological and physico-chemical.

Ngezinhloso zokwelapha, usebenzisa ukukhishwa kwesibindi, okuqukethwe kwesigxobo se-pleural sifuna futhi sageza. Futhi emgodini wesikhala ungase uphathwe imithi ehlukahlukene: ama-antibiotics, ama-antiseptics, ama-enzyme e-proteolytic, ama-hormone, ama-antinoplastic agents, njll.

Ukulungiselela ukukhishwa kwesibindi

Ngosuku lokuhlukumeza, ezinye izinyathelo zezokwelapha nezokuxilonga zikhanseliwe, kanye nokuthatha imithi (ngaphandle kwalezo ezibalulekile). Futhi imithwalo yemvelo neuropsychic kufanele ikhishwe, ukubhema kuvinjelwe. Ngaphambi kokugqotshwa, isisu nesisu kufanele kukhishwe.

I-Technique ye-puncture puncture

Ngokwezwi elidabukisayo ukugcoba inaliti ene-cut-cut, isetshenziselwa ukuxhuma nge-adapter ye-raber nge-system yokukhipha amanzi.

  1. Ukuxhaphazwa kwenziwa endaweni yesiguli esihlezi esihlalweni esibheke emuva. Inhloko kanye ne-trunk kufanele zikhonjiswe phambili, futhi isandla sithathwe phezu kwekhanda (ukwandisa izikhala ze-intercostal) noma ucike ngemuva kwesitulo. Isayithi lokuqothulwa libhekwa ngesisombululo se-alcohol kanye ne-iodine. Bese wenza i-anesthesia yendawo - ngokuvamile isisombululo se-novocaine.
  2. Indawo yokuqhafaza incike enjongweni yayo. Uma kunesidingo sokususa umoya (isikhala se-pleural sigcwele i-pneumothorax), ukukhishwa kwesikhumba kwenziwa kwesikhala sesithathu kuya kwesine ngaphakathi kwe-intercostal emgqeni wangaphakathi noma ophakathi kwe-axillary. Uma kwenzeka ukukhishwa kwamanzi (ukukhishwa kwesigxobo se-pleural ne-hydrothorax), ukukhishwa kwesikhala kwenzeka okwesithupha ukuya kwesikhala se-intercostal esiyisikhombisa phakathi komugqa ophakathi noma we-posterior axillary. Inaliti ixhunywe kwisirinji ngehubhu yerabha. Ukuthungwa kokuqukethwe kwesigxobo se-pleural kwenziwa kancane ukuze kungabikho ukufuduka kwe-mediastinum.
  3. Indawo yokuguqulwa iphathwa nge-iodonate nokuphuza utshwala, emva kwalokho isethente esinyumba isetshenziselwa futhi ihlanganiswe ne-adhesive plaster. Okulandelayo, i-bandage eqinile yeshidi lesifuba senziwa. Izinto ezitholakalayo ekuthunjweni kufanele zihanjiswe ebhokisatri ukuze zihlolwe ngaphandle kwehora.
  4. Isiguli sinikezwa esigcemeni ku-gurney endaweni yokulala. Phakathi nosuku uqinisekiswa ukuphumula kombhede futhi uhlolwe isimo esivamile.

Izinkinga zokukhishwa kwesibindi

Uma wenza umsebenzi wezwi, izinkinga ezilandelayo zingenzeka:

Uma kunoma yiziphi izinkinga, kudingeka ukuba ususe ngokushesha inaliti kusuka emgodini we-pleural, wabeka isiguli ngemuva futhi ubize udokotela ohlinzayo. Ngomoya ohlangene nezitsha ze-cerebral, i-neuropathologist kanye ne-resuscitator badinga usizo.