Sengstaken-Blakemore Tube

Zamkati

• Kodi chubu la Sengstaken-Blakemore ndilofunika liti?
• Kodi chubu la Sengstaken-Blakemore limalowetsedwa bwanji?
• Kodi pali zovuta zina pakugwiritsa ntchito chipangizochi?
• Maonekedwe a njirayi

Kodi Sengstaken-Blakemore tube ndi chiyani?

Sengstaken-Blakemore (SB) chubu ndi chubu chofiira chomwe chimagwiritsidwa ntchito kuyimitsa kapena kuchepetsa magazi kutuluka m'mimba ndi m'mimba. Kutaya magazi kumayambitsidwa ndimatumbo am'mimba kapena esophageal, omwe ndi mitsempha yomwe yatupa chifukwa chakulephera magazi. Kusiyanasiyana kwa chubu la SB, lotchedwa chubu la Minnesota, litha kugwiritsidwanso ntchito kupondereza kapena kukhetsa m'mimba kuti mupewe kuyika chubu yachiwiri yotchedwa nasogastric chubu.

SB chubu ili ndi madoko atatu kumapeto kwake, iliyonse imagwira ntchito yosiyana:

• esophageal balloon port, yomwe imadzaza buluni yaying'ono pamphako
• gastric aspiration port, yomwe imachotsa madzi ndi mpweya m'mimba
• chapamimba baluni doko, lomwe limapatsa buluni m'mimba

Pamapeto ena a chubu la SB pali mabuloni awiri. Akakhudzidwa, mabaluni amenewa amayika madera omwe akutuluka magazi kuti magazi asatuluke. Chubu chimalowetsedwa kudzera mkamwa, koma amathanso kulowetsedwa kudzera mphuno kuti akafike m'mimba. Madokotala amazichotsa magazi akasiya.

Kodi chubu la Sengstaken-Blakemore ndilofunika liti?

Thubhu ya SB imagwiritsidwa ntchito ngati njira yadzidzidzi yochepetsera kutuluka kwamitsempha yotupa yotupa. Mitsempha ya Esophageal ndi chapamimba nthawi zambiri imafufuma chifukwa chazotupitsa magazi kapena kusokonekera kwamitsempha. Mitsempha ikamakula, mitsempha imayamba kuphulika, ndikupangitsa magazi kutuluka kwambiri kapena kudandaula chifukwa chotaya magazi ambiri. Ngati sanalandire chithandizo kapena mochedwa kwambiri, kutaya magazi kwambiri kumatha kubweretsa imfa.

Asanasankhe kugwiritsa ntchito chubu cha SB, madotolo amathetsa njira zina zonse kuti achepetse kapena kusiya magazi. Izi zitha kuphatikizira endoscopic variceal banding ndi jakisoni wa guluu. Ngati dokotala asankha kugwiritsa ntchito chubu cha SB, chimagwira ntchito kwakanthawi.

Milandu yotsatira, madokotala amalangiza kuti musagwiritse ntchito chubu la SB:

• Kutuluka magazi m'matumbo kumasiya kapena kumachedwetsa.
• Wodwalayo posachedwapa anachitidwa opaleshoni yokhudzana ndi kholingo kapena minofu ya m'mimba.
• Wodwalayo ali ndi chotupa choletsa kapena chocheperako.

Kodi chubu la Sengstaken-Blakemore limalowetsedwa bwanji?

Dokotala amatha kulowetsa chubu cha SB kudzera pamphuno, koma ndizotheka kulowetsedwa kudzera mkamwa. Musanalembe chubu, nthawi zambiri mumakhala ndi makina opumira mpweya kuti muzitha kupuma bwino. Mumapatsidwanso madzi amtundu wa IV kuti magazi aziyenda bwino komanso voliyumu.

Kenako dokotalayo amayang'ana ngati pali kutuluka kwa mpweya m'mabuluni otupa m'mimba ndi m'mimba omwe amapezeka kumapeto kwa chubu. Kuti achite izi, amalowetsa mabaluni ndikuwayika m'madzi. Ngati kulibe kutuluka kwa mpweya, mabuloni amasweka.

Adokotala amafunikanso kuyika chubu cha Salem sump kuti izi zitheke m'mimba.

Dokotala amayesa machubu awiriwa kuti awonetsetse kuti m'mimba mwayikidwa bwino. Choyamba, chubu cha SB chimayenera kukhazikika bwino m'mimba. Kenako amayesa chubu cha Salem motsutsana ndi chubu la SB ndikulemba pamtengo womwe akufuna.

Mukayeza, chubu la SB liyenera kupakidwa mafuta kuti muchepetse mayikidwe. Chubu chimalowetsedwa mpaka chizindikiro chomwe dotolo wapanga chili m'kamwa mwanu kapena pakamwa panu.

Kuonetsetsa kuti chubu ikufika m'mimba mwanu, adokotala amalowetsa buluni yam'mimba ndi mpweya wochepa. Amagwiritsa ntchito X-ray kutsimikizira kuyikika koyenera. Ngati buluni wokhala ndi mpweya wokhazikika bwino m'mimba, amawukitsa ndi mpweya wowonjezera kuti afike pamavuto omwe angafune.

Akangoyika chubu la SB, adokotala amalilumikiza ndi cholemera kuti chikoke. Kukaniza kowonjezerako kumatha kuchititsa chubu kutambasula. Poterepa, ayenera kulemba mfundo yatsopano pomwe chubu chimachoka pakamwa pako. Adokotala amafunikanso kukoka chubu mofatsa mpaka atayamba kukana. Izi zikusonyeza kuti buluniyo ili ndi mpweya wokwanira komanso kupondereza magazi.

Atamva kukana ndikuyesa chubu cha SB, adokotala amalowetsa chubu cha Salem sump. Thubhu yonse ya SB ndi chubu cha Salem sump ndizotetezedwa pambuyo poyikapo kuti zisawonongeke kuyenda.

Dokotala amagwiritsira ntchito kuyamwa ku doko la SB aspiration ndi Salem sump kuti achotse magazi aliwonse. Ngati magazi akupitilizabe, atha kukulitsa kukwera kwamitengo. Ndikofunika kuti musapitirire kuchuluka kwa buluni kuti isapuluke.

Kutuluka magazi kutatha, adotolo amachita izi kuti achotse chubu cha SB:

1. Chotsani buluni.
2. Chotsani samatha mu chubu SB.
3. Chotsani buluni yam'mimba.
4. Chotsani chubu cha SB.

Kodi pali zovuta zina pakugwiritsa ntchito chipangizochi?

Pali zoopsa zingapo zomwe zimagwiritsidwa ntchito pogwiritsa ntchito chubu la SB. Mutha kuyembekezera kusapeza bwino pamachitidwe, makamaka zilonda zapakhosi ngati chubu chidalowetsedwa pakamwa. Ngati atayikidwa molakwika, chubu la SB lingakhudze kupuma kwanu.

Zovuta zina pakukhazikitsa kolakwika chubu kapena mabuluni ophulika ndi awa:

• ming'alu
• ululu
• kutuluka magazi mobwerezabwereza
• aspiration chibayo, matenda omwe amapezeka mukapuma chakudya, kusanza, kapena malovu m'mapapu
• zilonda zam'mimba, zilonda zopweteka zikamachitika m'munsi mwake
• Zilonda zam'mimba, kapena zilonda zam'mimba zomwe zimapanga nembanemba
• Kutsekeka kwapakhosi kovuta, kapena kutsekeka kwamawayu anu omwe amalepheretsa kudya kwa oxygen

Maonekedwe a njirayi

Thubhu ya SB ndichida chomwe chimagwiritsidwa ntchito poletsa kutuluka magazi m'mimba ndi m'mimba. Amagwiritsidwa ntchito nthawi zadzidzidzi komanso kwa nthawi yochepa. Izi ndi zina zoterezi za endoscopic zimakhala bwino kwambiri.

Ngati muli ndi mafunso okhudza njirayi kapena mwakumana ndi zovuta, kambiranani nkhawa zanu ndi dokotala.