I-Transtracheal Therapy Oxygen ne-COPD

Inqubo encane engasetshenziswa ngokuvamile inezinzuzo zayo

Abantu abanesifo esingavamile (pulmonary pulmonary disease) (COPD) bavame ukudinga uketshezi oluthe xaxa ezigabeni ezilandelayo zesifo. Ngokuvamile kunalokho, kuzonikezwa nge-tube, okuthiwa i- cannula yamanzi , ehlala ebusweni ngqo ngaphansi kwempumu.

Kwezinye izimo, i-cannula ngeke ibe ngokwanele, futhi umuntu uzodinga indlela eqondile yokulethwa.

Ukuze kube sekugcineni, udokotela angakhetha ukusebenzisa i-transtracheal therapy okwelapha (TTOT) lapho ithoni encane, ebizwa ngokuthi i-catheter, ifakwa emgodini entanyeni ukunikeza oksijini ngqo emaphashini.

Imikhiqizo ne-Cons of TTOT

I-TTOT isetshenziswe okokuqala ngo-1982 kodwa kusukela ngaleso sikhathi kuye yaxoshwa kakhulu yibo abayibheka ukuthi ayinakwenzeka ngaphandle kwamacala okunciphisa oksijini okweqile ( hypoxia ).

Ngokusobala, inqubo inezilinganiso zayo. Ukufakwa komgodla entanyeni kungabangela ukucindezeleka kanye / noma kungaboni kahle kwabanye (nakuba ngokuvamile kungabhekwa njengokungakhululekile). Ngaphezu kwalokho, i-tube ithambekele ekugubheni futhi ngezinye izikhathi idinga ukulungiswa okungenakulinganiswa.

Kodwa-ke, eminyakeni yamuva, odokotela abaningi baye bakuvumela ukusetshenziswa kwabo kubantu abakholelwa ukuthi bangazuza kakhulu enkambisweni.

Lokhu kufaka phakathi abantu abaphumelela imiphumela engaphansi-engcono kakhulu nge-cannula, ngokuvamile ngoba bengayisebenzisi ngokwanele futhi / noma ngokufanele.

Iqiniso liwukuthi ukusetshenziswa kwesikhathi eside kwe-cannula kungaholela ekucaseni okungapheli emakhaleni nasezindlebeni nasekuthuthukisweni kokuxhumana nodokotela, i- chondritis , nezilonda zesikhumba. Lokhu kuphela kunganciphisa ukusetshenziswa, okuholele ekutheni umonakalo wokuzivocavoca umzimba nokubekezelela ukuvivinya umzimba .

Ngokuphambene, i-TTOT ingakuthuthukisa izinga lomuntu lomuntu kunokuba linciphise.

I-TTOT idinga i-oksijini engaphansi kakhulu kune-cannula, okusho ukuthi i- oksijeni ye-oksijithali ephathekayo ingaba encane, ilula futhi ihlale ihlala isikhathi eside, ivumela umuntu ukuba aphume futhi ahambe isikhathi eside.

I-TTOT idinga okwamanje amaphesenti angu-55 oksijini ngesikhathi sokuphumula kanye namaphesenti angu-35 phakathi nokuvivinya umzimba uma kuqhathaniswa ne-cannula. Lezi zinombolo zingakwazi ukuhumusha ekuthuthukiseni ukusebenza komzimba kanye nokunyuka kokubekezela kokuzivocavoca . Nakuba la maqiniso enganqobe ngokuphelele izithiyo eziya ku-TTOT, zikhuthaza ukuthi ukusetshenziswa kwazo kubantu aziphenduli ku-standard standard ye-oxygen kanye nokuthi kufanele.

Uma ucabangela i-TTOT, kunezinqubo ezimbili ezivamile ezisetshenziswa abahlinzayo:

I-Modified Techding Technique

Inqubo eguquliwe yeSeldinger iyindlela eyaziwa kakhulu ye-TTOT, nakuba ukuthandwa kwayo kunqatshiwe kusukela izinkampani eziningi zomshuwalense ngeke zimboze. Inqubo ngokwayo yenziwa ngaphansi kwe-anesthesia ngesisekelo sokugula futhi ifaka izinyathelo ezilandelayo:

1. Ukuchotshozwa okuncane kwenziwa entanyeni lapho inaliti ifakwa khona.
2. Umhlahlandlela wenethiwekhi udluliselwa phezu kwenaliti, futhi inaliti ikhishwa.
3. Ibhuloho elibushelelezi elibizwa ngokuthi i-dilator lidluliselwa phezu kwentambo bese liqala inqubo yokwehlisa ngobumnene izicubu zentamo.

1. Uma sekuvulekile ngokwanele, i-dilator isusiwe futhi i-stent idluliselwa phezu kwecingo kufaka. Lokhu kuzogcina ukuchotshozwa ekuvaleni.
2. Ngemuva kokuthi umhlahlandlela wenethiwekhi ususwe, i-stent i-sutured endaweni.
3. Ngemuva kwesonto, ukuvakashelwa kokuvakasha kwakuzohlelwa ukukhipha i-stent. I-catheter ingabe ifakwe emthonjeni ukuze iqedele inqubo.

I-Tech Tract Fast

Indlela entsha, ebizwa ngokuthi i-Fast Tract, yenzelwe ukuhlunga inqubo ye-TTOT. Le nqubo yenziwa ekamelweni lokusebenza ngaphansi kokudalwa okukhanya futhi ngokuvamile kuhilela ukuhlala ubusuku bonke.

Ukwakha ukuvula okuyi-transtracheal, udokotela ohlinzayo uzodala izikhumba ezincane zesikhumba entanyeni, eveze ngaphakathi kwe-trachea.

I-flaps isikhumba izobe isetshenziselwa imisipha engaphakathi ngaphakathi entanyeni, idale indlela engapheliyo.

Ngenkambiso ye-Fast Tract, i-TTOT ingaqala ngosuku olulandelayo esikhundleni seviki kamuva.

> Umthombo:

> UChristopher, K. noSchwartz, M. "Ukwelashwa Kwama-Oxygen Transtracheal." Journal Chest. 2011; 139 (2): 435-40. I-DOI: 10.1378 / i-chest.10-1373.