Ilekọta tracheostomy na kpụ ọkụ n'ọnụ na-elekọta

Care onye ọrịa na a tracheostomy a rụrụ n'ime ọgwụ mgbe translation of ICU ndidi. Ọtụtụ mgbe, a tracheostomy na-amanye onwe ya ịgbaso na conductive ụzọ nke ikuku ma ọ bụrụ na ọ dị mkpa ventilashion.

Egosi maka usoro

Ịrụ tracheostomy na kacha adabara anyịnya ọnọdụ na-agụnye ezigbo nhọrọ usoro na-akpachara anya dissection nke oghere eji ekunye ume homeostasis. Ọtụtụ mgbe na-eji maka ịwa ahụ ma ọ bụ endotracheal ná Nkụnwụ topically etinyere novocaine ngwọta.

The mkpa maka ọrụ na airway tracheostomy ebilite:

• na ikpe nke ruo ogologo oge n'ibu ventilashion;
• na ọnụnọ nke bulbar ọrịa;
• enweghị ekwe omume n'ihi na free ikuku permeability nke conductive ụzọ na ụzọ ọzọ;
• ala arụmọrụ airway mposi;

Usoro nke tracheostomy

Ọrụ nke tracheostomy airway achọ ọtụtụ ụdị scalpels - lesion elu n'ígwé nke anụ ahụ na tracheal mbepụ. Ọzọkwa, n'oge usoro ga-eme: eji nko, spreaders nke anụ ahụ na akwara, mkpachị, akpali mmasị swabs na ekpochapụ.

Onye ọrịa na-enịm ke supine ọnọdụ na isi ẹsịn azụ. The akpụkpọ n'elu nke oghere eji ekunye ume na-disinfected na mmanya, antiseptics, a ngwọta nke ayodiin ma jiri nlezianya na kpochapụrụ na a akpali mmasị ákwà.

N'oge usoro etinyere vetikal ịkpụ si thyroid cartilage na elu onu nke sternum. Ọzọkwa, kwụ direction na-ebipụ fascia, na mgbe ahụ iji hotara na mbụ kit MEDINSTRUMENT emee razdvizheniya muscle na ntọhapụ nke ndị oghere eji ekunye ume. Mkpa mee mgbapu oghere eji ekunye ume na-dissected na mwepụ nke a obere flaapu nke anụ ahụ, zuru ezu ịnabata airway tube.

Free tracheal n'ọnụ n'ebe bee-apụ flaapu sutured ka akpụkpọ, nke na-eme ka na-agbanwe agbanwe tracheostomy akpa. N'agbanyeghị a kama mgbagwoju anya na Usoro ị na-eme a tracheotomy, a usoro ukwuu facilitated site tupu ndidi intubation.

Oke nke akpa

Pụrụ ịtụkwasị obi, ịkpachara anya na-elekọta nke a tracheostomy na kpụ ọkụ n'ọnụ na-elekọta mkpa na nhọrọ nke a kwesịrị ekwesị tube, oke nke nke na-adabere na ọnọdụ. Ugbu n'ọtụtụ ebe zụrụ metal abụọ tube na a cuff. Ọ dịkwa ike iji plastic ọkpọkọ, nrụgide na nke a na-Nọsi'ike site pụrụ iche cylinders.

Proper nhọrọ nke elu-edu tube enye mfe elekọta a tracheostomy na kpụ ọkụ n'ọnụ na-elekọta unit enweghị na-eme na-enweghị isi mgbaka na ndidi. Na nhọrọ nke ihe ekwesighi tube nsogbu mgbe biliterenụ ka a mkpọchi nke lumen oké mịrị amị imi. Ya mere, ya nhọrọ ga-ekpe ka ọkachamara.

Service tracheotomy akpa

Na ikpe nke metal cannula achọ mmanụ nke dị n'ime tube dịkarịa ala otu ugboro n'ụbọchị maka ihicha na antiseptik ọgwụgwọ preparations. Otú ọ dị, ná mpụta akụkụ cannula mgbanwe dị nnọọ obere, ọ bụghị ihe karịrị otu izu.

Cuff cannula maka tracheotomy ghara ebi ebu ala. N'oge ruo n'oge wepụrụ na ya ngafe ikuku ma na-ehi ụra banyere 10 nkeji, mgbe ahụ, laghachi ohere. Tupu ha amalite preventative mgbake cuff ga-ọma wepu extraneous Skopje ọdịnaya nke oropharynx.

Karịsịa ostomy elekọta

Oge na-elekọta nke a tracheostomy a rụrụ iji akpali mmasị dị fere fere na owu swabs. Gburugburu anụ ahụ kpochara ọkara okirikiri mmegharị outwards. Ọzọkwa anụ ahụ enyocha maka nsogbu na-efe efe ọnya.

Care nke tracheostomy achọ nnọchi akpọchi na ihe omume nke oké mmiri ma ọ bụ unyi ìgwè njọ. Mepụta nnọchi usoro kwesịrị ọ bụrụ na e ọ bụla enyemaka. Otu onye esetịpụ tube na a ufọk ufene ọnọdụ, na-enyere ya aka na-anọchi tube ejiri.

N'oge ndị mbụ mgbe ọrụ ya na-achọsi ike na-elekọta tracheostomy na peristomalnoy ebe na etiti oge nke 6-8 awa. N'otu oge ahụ, i nwere ike mgbe niile-eji dochie fere fere dressings dị ka mkpa na-ebilite. , Tools na preparations maka na-elekọta mgbe niile kwesịrị ịbụ na aka.

Care nke tracheostomy: algọridim

N'ihi na oge mbụ nnọchi tube emepụta mgbe a ụbọchị ole na ole mgbe ndị ọrụ. Ọzọkwa, usoro a ga-rụrụ ọkà, ebe a bụ ezughị na-etolite a oké stoma.

The algọridim nke usoro:

• onye ọrịa na-etinye na ya azụ na-achụpụ ya n'isi-ya;
• rụrụ a zuru ọcha nke tracheobronchial oghere;
• wepụ phlegm a ndidi coughs mere artificially;
• Ọ na ẹkenam n'ime tube oghere mgbanwe catheter, mgbe ahụ, amịpụtara tracheostomy cannula;
• Nnọchi akpa mere wepụrụ na-eduzi;
• A ọhụrụ anwụrụ A kpọgidere na ofu na a ufọk ufene ọnọdụ;

Ijikọ ọrịa na a tracheostomy maka ventilator

Ọtụtụ mgbe ilekọta ọrịa na a tracheostomy achọ a njikọ ahụ airway ventilator. Ejikọrọ ngwaọrụ site na cannula mbụ ike na ọnụnọ nke inyeaka ogige.

N'ihi nzube nke anụ njikọ nke onye ọrịa na ventilator ọkọlọtọ cannula nwere ike dochie anya a pụrụ iche endotracheal tube ma ọ bụ ot imewe na ihe inflatable cuff. Kpọmkwem ka unit onwe ya maka ventilashion tube bụ mmasị na ọgwụgwụ nke ọkọlọtọ tọrọ ala ngwaọrụ.

kwere omume nsogbu

Care nke tracheostomy akpatakarị obibi ụfọdụ nsogbu ahụ pụrụ iyi ka anya dị ka ọrụ zuru ezu, na ọtụtụ ihe mgbe e mesịrị, ọbụna na otu ebe ala nke onye ọrịa.

The kasị sikwuoro bụ omume nke agba ọbara, karịsịa ma ọ bụrụ na tracheostomy a rụrụ iji dị ngwaọrụ na a okwu nke ịdị ngwa, na àkwà. Kwụsị oké ọbara ọgbụgba nwere ike pulsatile mkpakọ site akwara cuff. Otú ọ dị, iji zere oké ọnwụ nke ọbara ka onye ọrịa kwesịrị mberede elekọta ọkachamara.

Usoro elekọta tracheostomy achọ oge nyochaa ihe ndidi iji chọpụta a kama oké nsogbu ndị dị otú ahụ dị ka subcutaneous emphysema. Kpatara nke ikpeazụ nwere ike ịbụ na-ekwesịghị ịdị nwụnye nke tracheal tube.

Ọzọ pụtara nkịtị sikwuoro - airway mgbochi nwere ike ime spontaneously n'oge ọ bụla na ọrịa ghara ịgbanwe. Ọtụtụ mgbe ihe na-akpata okpo mgbaàmà mmụta na-aghọ a na ok okwuchi, guzobere oké imi. Ọ bụrụ na tracheotomy e rụrụ iji n'ime cannula, nsogbu nwere ike tutu amama site ya ọcha. Belata ọrịa mgbochi na-enye ohere egbu agụụ ọchịchọ ụzọ.