Kutsegula

Tracheostomy ndi njira yochitira opareshoni yopanga kutsegula kupyola khosi kulowa mu trachea (mphepo yamkuntho). Nthawi zambiri chubu chimayikidwa kudzera pachitseko ichi kuti chizitha kuyendetsa ndege ndikuchotsa zotuluka m'mapapu. Chubu ichi chimatchedwa chubu cha tracheostomy kapena chubu cha trach.

Anesthesia wamba imagwiritsidwa ntchito, pokhapokha ngati zinthu zili zovuta. Izi zikachitika, mankhwala amanjenje amayikidwa mderalo kuti akuthandizeni kumva kupweteka pang'ono panthawiyi. Mankhwala ena amaperekedwanso kuti akupumulitseni bata (ngati pali nthawi).

Khosi limatsukidwa ndikutidwa. Mabala opangira opaleshoni amapangidwa kuti awulule mphete zolimba za cartilage zomwe zimapanga khoma lakunja la trachea. Dokotalayo amatsegula potseguka ndikulowetsa chubu cha tracheostomy.

Tracheostomy itha kuchitika ngati muli:

• Chinthu chachikulu chotsekereza msewu
• Kulephera kupuma nokha
• Chizoloŵezi chobadwa nacho cha kholingo kapena trachea
• Anapumira zinthu zovulaza monga utsi, nthunzi, kapena mpweya wina wa poizoni womwe umafufuma ndikulepheretsa mayendedwe ake
• Khansa yapakhosi, yomwe imatha kukhudza kupuma mwa kukanikiza njira yapaulendo
• Kufooka kwa minofu yomwe imakhudza kumeza
• Kuvulala kwambiri kwa khosi kapena pakamwa
• Kuchita opaleshoni mozungulira bokosi lamawu (kholingo) lomwe limalepheretsa kupuma bwino ndikumeza

Zowopsa za anesthesia iliyonse ndi izi:

• Mavuto kupuma
• Zomwe zimachitika ndi mankhwala, kuphatikizapo matenda a mtima ndi kupwetekedwa mtima, kapena kusokonezeka (kuthamanga, kutupa, kupuma movutikira)

Zowopsa za opaleshoni iliyonse ndi izi:

• Magazi
• Matenda
• Kuvulala kwamitsempha, kuphatikizapo ziwalo
• Zosokoneza

Zowopsa zina ndi izi:

• Kulumikizana kwachilendo pakati pa trachea ndi mitsempha yayikulu yamagazi
• Kuwonongeka kwa chithokomiro
• Kukokoloka kwa trachea (kawirikawiri)
• Kuboola m'mapapo ndi m'mapapo kumagwa
• Minofu yotupa mu trachea yomwe imayambitsa kupweteka kapena kupuma movutikira

Munthu atha kukhala wamantha ndikumverera kuti sangathe kupuma ndikuyankhula akamadzuka koyamba pambuyo pa tracheostomy ndikuyika chubu cha tracheostomy. Kumva uku kumachepa pakapita nthawi. Mankhwala atha kuperekedwa kuti athandize kuchepetsa nkhawa za wodwalayo.

Ngati tracheostomy ndi yakanthawi, chubu chimachotsedwa. Kuchira kumachitika mwachangu, ndikusiya chilonda chaching'ono. Nthawi zina, pamafunika kuchitidwa opaleshoni kuti atseke tsambalo (stoma).

Nthawi zina kukhwimitsa kwa trachea kumatha kukula, komwe kumakhudza kupuma.

Ngati chubu cha tracheostomy ndichokhazikika, dzenje limakhala lotseguka.

Anthu ambiri amafunika masiku 1 kapena 3 kuti azolowere kupuma kudzera mu chubu la tracheostomy. Zimatenga nthawi kuti muphunzire kuyankhulana ndi ena. Poyamba, zimakhala zosatheka kuti munthuyo azilankhula kapena kupanga phokoso.

Pambuyo pophunzitsidwa ndikuchita, anthu ambiri amatha kuphunzira kulankhula ndi chubu cha tracheostomy. Anthu kapena abale amaphunzira momwe angasamalire tracheostomy nthawi yachipatala. Ntchito yosamalira kunyumba imatha kupezeka.

Muyenera kubwerera kumachitidwe anu amoyo. Mukakhala panja, mutha kuvala chofunda (mpango kapena chitetezo china) pamwamba pa tracheostomy stoma (una). Gwiritsani ntchito zodzitetezera mukamakumana ndi madzi, ma aerosols, ufa, kapena tinthu tating'onoting'ono ta chakudya.

• Tracheostomy - mndandanda

Greenwood JC, Winters INE. Chisamaliro cha Tracheostomy. Mu: Roberts JR, Custalow CB, Thomsen TW, olemba., Eds. Ndondomeko Zachipatala za Roberts ndi Hedges mu Emergency Medicine ndi Acute Care. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: mutu 7.

Kelly AM Zovuta zapuma. Mu: Cameron P, Jelinek G, Kelly AM, Brown A, Little M, olemba. Buku Lophunzitsira la Mankhwala Achikulire Achikulire. Wolemba 4. Philadelphia, PA: Elsevier Churchill Livingstone; 2015: mutu 6.