Tracheotomy - he aha te mea tenei? tracheotomy technique

I roto i te pokanga, i reira e rua ariā - he tracheotomy me tracheostomy.

Tracheotomy - he tuwhera tracheal me te whakataki o te ngongo ki reira mo te whai wāhi o te rangi ki nga Airways raro i roto i asphyxia. kawea ana tēnei mahi ohotata i roto.

Tracheostomy - Kei te whakatuwhera hoki te pukorokoro, engari suturing nga taha o te tarai hua ki te kiko whāriki me te hanganga o rua mō te manawa.

He hītori iti

I mohiotia kua tenei tikanga o whawhati tata i roto i Ihipa tahito me Inia, i reira he taunakitanga ā-tuhi e fiefia ratou ara Aleksandr Veliky mo te whakaoranga o te tangata i roto i tona ope. Mō tenei tukanga, i tuhituhi matou Hipokeletisí ko Gallen, engari no te mea o tona ngaukino me te ati ki te ora te maha tūtohu kore ki te whakamahi i te reira i roto i te mahi.

kawea te mahi angitu tuatahi i roto i te tākuta Itari Anthony Brasavola i 1546. Ko te taunakitanga tuhia tuatahi tenei e muri i te tukanga e ora ana ano te manawanui. Mai 1718 Kei te hoko tenei momo o te pokanga i te mau me te kua tono tākuta atu whānui. Otiia he tokomaha e tonu wehi ki te whakamahi i te reira. Hei tauira, te rata whaiaro o George Washington whiriwhiria ki te kia manawanui mate atu i whakaritea e ki te hanga i te whawhe meá.

Ko te putanga o nga ture o ngā iroiti, me te rongoā horoi ahua iti te mōrea o pōauautanga me te tahuti nei, engari tonu kihai i riria te hapori hauora e he haumaru hoki te manawanui tenei tikanga. I tēnei wā, tracheotomy - he ara motuhake ki te āwhina, te whakamahia nei anake ina e whai hua ana ētahi atu tikanga katoa (fariiraa Geymliha, intubation) ranei e kore e whai wa.

Ko te tohu mo te pokanga

Ko nga mea katoa kia mea tracheotomy ohie, he pākaha tohu mo reira nui, pera i te mōrea ki te ora te tangata i roto i tenei whawhe he nui ake te painga pea. Ko ratou:

1. tinana Foreign takoto i runga i te pukorokoro, e kore e taea te nekehia atu e te tahi atu tikanga.
2. Contusions, whāiti te lumen o te paeoro.
3. stenosis laryngeal koi i diphtheritic croup, pertussis, karawaka, te fiva rahi, me te t. D.
4. Īnaki te lumen o te pukorokoro paeoro ranei puku.
5. Kōpeketanga o te wahi romahā o runga i waho.
6. weranga matū
7. stenosis pāwera.

Momo o te airway tukuna ai

• Whakapeka, fulminant ranei, - whakawhanake i roto i te mea o hēkona. kia tenei rite blockage i tinana ke, rite edema pāwera.
• Whakapeka - faaite ake i roto i te meneti torutoru, te tikanga hono ki diphtheria tinana ke ranei.
• Subacute - kati te lumen airway kia muri hoki tekau o meneti noa haora ranei. He angamaheni o mua teka, nui korokoro, ngiha matū tenei huru.
• Mau tonu - Ka taea e tupu mo tau i taua tukanga pathological pērā i te mate pukupuku o te paeoro, perichondrium, pukorokoro contracture cicatricial.

whakarōpū

He maha ngā momo o tracheotomy, i runga i te hangarau o tona whakatinanatanga rānei.

Ko te taumata o te tuakitanga:

• Top: i te taumata o te wheua ngohe cricoid.
• Toharite: i te taumata o te wheua ngohe thyroid.
• Raro konikotomiya ranei.

Na roto i te āhua o te tarai taratahi te:

• Roa.
• Lateral.
• U-āhua.

mea

Kaua e wareware ki e mo tona ru katoa ka improvised, tūnga tenei tikanga te rite te mahi. Me Tracheotomy mahi he tetahi huinga o taputapu, ki te he e wātea ana tetahi. Conventionally, e taea te wehea ratou ki ngā rōpū matua e rua: ko te pokanga whānui me mea motuhake.

Ko te rōpū tuatahi ngā Kuku, scalpels, hononga hoki mutu toto, kutikuti hāparapara, matau mo te hua te kopa, he pū tōngāmimi, pūwero me te ngira. Ko te rōpū tuarua ngā te tracheal pūkawe, luer, ngā rua korere whakaritea tetahi i roto i te tahi atu; Shassinyaka matau hoki pupuri i te pukorokoro kahore traumatizing reira; traheorasshiritel me matau ki te neke peka te Tāmaki o te repe thyroid.

tracheotomy technique

I mua kawea tetahi mahi i roto i runga i te rōrahi hāngai o te whakangungu e tauturu to koutou tākuta rite wawe tonu, me te mamae mo ki te manawanui kawe i te wawaotanga tika. I roto i tenei take he tika reira ki te hoatu i te manawanui i runga i tona hoki, me te mōrahi maka hoki tona matenga hoki ki te ngohe o te pukorokoro i mārama kitea. Ki te mahi i tenei, i ētahi wā te whakamahi i te takai. I muri i warea, e tango te tangata rehunga. Ka taea te hau te reira rite te whānui, me te rohe. Te reira i katoa tei runga i te tikanga i raro i i whakahaere te mahi te, kaha tau, hauora, me te hōhipera o te manawanui. Ki te he āhuatanga ohotata, tataki te tākuta whawhe kahore rehunga. I muri i nga mau faaineineraa katoa e timata tonu tracheotomy.

Technique Ko raro papanga kiri motu, ngako subcutaneous, fascia me te pungawerewere kaiota i te wheua ngohe thyroid. Katahi te uaua kitea diluted nei i roto i te pūpū taha tikanga. I raro i reira ko te wheua ngohe me te Tāmaki o te repe thyroid. wehea te rino no i te pukorokoro me pana ake, tuaki tetahi fascia. Matau a whakatika i te paeoro, whāiti scalpel mata maihao takai te raima ranei, meinga he kokoti iti. tutuki ana te whāinga te. Air hoki ki te pūkahukahu. kia puta manawa mutu Tuatahi, engari te manawanui ka tīmata te maremare me te māwhero. Anake i muri i whakaaro e timata te tangata ki te manawa ano te tākuta, kua whakaurua te patunga ki te pūkawe me noaa ona sutures piripiri ranei. sutured te patunga e kia e te piri reira puritia ngongo.

Konikotomiya

Ko te taahiraa iti i mua ki te tracheotomy tenei, ki te mea kahore he faingamālie me te wa ki te whakarite kia te tikanga kawe i te tracheotomy. Rere reira, e kore e mahi i motu āpitihanga. Kotahi nekehanga tuaki te kaki ki raro ki te wheua ngohe cricoid me schitoperstnevidnoy tuhonohono. Kei te whakaurua te wāhanga rawhi, kua diluted reira kauae, ka whakatika ratou i roto i tenei tūranga. Ki te timata te manawanui ki te manawa, ka tahuri ia māwhero, i ia he mare, na he angitu te tukanga. Ka rite ki haere te ati kua, e taea te iritihia i roto i te konikotomiyu tracheostomy ki te whakarato i te rere o te hau tamau ki te manawanui.

hapa pea i roto i te whawhe

He Tetahi mahi ona mau hopearaa, ko kahore okotahi me tracheotomy. Ko te pōauautanga e ara ake i reira, e taea te wehea ki ngā rōpū e toru.

1. I roto i te tukanga takahanga o:

• Ka taea e aho whakairo hē meinga toto venous, rangi Embolism, a ētahi wā transection o te iatuku kakī noa ;
• Ka taea e te tiki toto ki nga Airways raro, meinga asphyxia toutou;
• Me kia rite ki te diameter o te pūkawe wāhanga, te kore e whai i te reira ki te tuitui me te kino anō te kiko;
• Ka taea e tapahia hohonu meinga whara esophageal, kia kia kia iti te mata scalpel ki 1 cm.

2. tonu i muri i te pokanga:

• hypoxia;
• whati mowhiti tracheal poka ranei;
• emphysema subcutaneous;
• pneumothorax.

3. pānga whakaroa:

• tracheobronchitis;
• tracheal stenosis me anō asphyxia;
• huri (whango) pōti mō te transection io recurrent;
• hē Paku.

tākuta katoa noa i kāreti mahara tracheotomy pehea kino. e kore ko te ahua o te mahi e taea te kawea i roto i tonu tenei. Anake i roto i te ohorere, tautautefito ki he taimi ko te manawanui i runga i te mimiha o te ora me te mate, no te mea i roto i te hohoro, koutou e taea e kino i te manawanui. A, ki te kahore te tenei whawhe kawea atu i roto i te fare ma'i, engari vahi i runga i te huarahi ranei i te kāinga, kia whakaaro koutou rau nga wa i mua i te whakatau koe. Simple i mawhiti tuatahi, me tautoko te tikanga i rawaka wheako o te tākuta. e kore e taea noa Tracheotomy i te kāinga, ko reira kino. Ki te kore koe e whai mātauranga hauora me ngā pūkenga e tika ana, e kore e tamata i te faahiti i te reira.

A amo i te tracheotomy pai anake ki te whakaora ora o te tangata! Ko te mōrea o te mate nui ranei pōauautanga he tiketike nui ki te hanga i te tākuta whakaaro e pā ana ki ētahi. Ahakoa homai te meka i e kua mohiotia tenei mahi mai te wa tukuiho, e kore kua te hapori hauora ano ngā atu pehea ki te hanga i haumaru te reira nui.

Tracheotomy - Ko reira he whai wāhi ki te whakaora i te ora o te tangata, engari ko te reira i te rave'a ōrite taua ki te tango i te reira atu.