Nzira shoma inoshandiswa inowanzoshandiswa inobatsira
Vanhu vane chirwere chisingaperi chisingagadziriswa cheplm (COPD) vanowanzodikanwa kuwedzerwa okisijeni mune zvishoma zvishoma zvechirwere chacho. Kazhinji pane zvisiri izvo, zvichaburitswa kuburikidza ne tube, inonzi " nasal cannula" , iyo inogara pachiso chaipo pasi pemhino.
Mune zvimwe zviitiko, cannula haizove yakakwana, uye munhu achada nzira yakananga yekuendesa.
Nokuda kweizvi, chiremba angasarudza kushandisa transtracheal oksijeni therapy (TTOT) iyo iyo tube shoma, inonzi catheter, inosungirwa kuburikidza nehomwe mumutsipa kuti ipe oxygen zvakananga pamapapu.
Pros uye Cons yeTTOT
TTOT yakatanga kushandiswa muna 1982 asi kubvira panguva iyo yakanyanya kubviswa nevaya vanofunga kuti haina kukwana kunze kweizvi mumamiriro ekunyanya kukanganiswa kwemhepo ( hypoxia ).
Zviri pachena, nzira yacho ine zvisingakwanisi. Kuiswa kwecatheter mumutsipa kunogona kutambudza uye / kana kutarisa kune vamwe (kunyange zvazvo kazhinji isingafungi kuti haisi kufara). Uyezve, iyo tube inowanzovhara uye dzimwe nguva inoda kuchinjwa.
Zvisinei, mumakore achangobva kupfuura, vanachiremba vanoverengeka vakabvumidza kushandiswa kwaro kune vanhu avo vanotenda kuti vanogona kubatsirwe zvikuru kubva pakurongwa.
Izvi zvinosanganisira vanhu vari kuwana zvishoma-kupfuura-zvakakosha nemigumisiro ne cannula, kazhinji nokuti havasi kushandisa zvakakwana uye / kana zvakanaka.
Ichokwadi chiripo ndechokuti kushandiswa kwenguva refu kwe cannula kunogona kutungamirira kutsamwa kusingaperi kumativi emhino uye nzeve uye kukura kwekutumira dermatitis, chondritis , uye zvipembenene zveganda. Izvi chete zvinogona kuvhiringidza kushandiswa, zvichiita kuti kuora kwekuita muviri uye kushingaira kushivirira .
Kusiyana neizvi, TTOT inogona kuvandudza mararamiro ehupenyu hwevanhu pane kuzvideredza.
TTOT inoda oksijeni yakanyanya kudarika ye cannula, zvinoreva kuti inotakura oksijeni concentrator inogona kuva duku, kujekesa, nekureba kwenguva refu, zvichibvumira munhu kuti ave kunze uye anenge kwenguva yakareba kwenguva.
TTOT inodawo 55 muzana mashoma oksijeni panguva yekuzorora uye 35 muzana panguva yezvokuvhiya kana zvichienzaniswa nekwenyula. Nhamba idzi dzinogona kushandura kune hutano hwakanaka huri nani uye kuwedzerwa kwekurovedza muviri . Kunyange zvazvo zvinyorwa izvi zvisingakundi zvachose zvipingamupinyi zveTTOT, ivo vanotsigira kushandiswa kwayo mukati mevanhu havasi kupindura kuongororwa kweyerojeni therapy pamwe chete.
Kana uchitarisa TTOT, pane maitiro maviri akajairika anoshandiswa nevarapiki:
Modified Seldinger Technique
Shanduro yeSaldinger yakashandurwa ndiyo inonyanya kuzivikanwa TTOT nzira, kunyange zvazvo kudarika kwayo kwave kwanyura sezvo vazhinji vekambani dzishuwarenzi havazoifukidzi. Nzira yacho pachayo inoitwa pasi peanesthesia pane kunze kwepakati uye inosanganisira matanho anotevera:
- Chinhu chiduku chinoshandiswa chakaitwa mumutsipa umo mune tsono.
- Nhungamiro yematare inobva yapfuura pamusoro penheyo, uye tsono inobviswa.
- Bhuku rinotonhora rinonzi dilator rinobva rapfuura pamusoro pese uye rinotanga nzira yekunyora zvinyoronyoro mutsipa.
- Kana imwe nguva mukova ukakura, iyo dilator inobviswa uye stent inodarika pamusoro pechipinda mumugumo. Izvi zvichachengetedza kusanganisa kubva pakuvhara.
- Mushure mokunge mutungamiri wechenedzwa abviswa, stent inogadziriswa munzvimbo.
- Mushure mevhiki, kudzokera kunodzoka kwaizogadzirirwa kubvisa stent. Iyo catheter yaizoiswa zvakare mu trachea kuti ipedze nzira yacho.
The Fast Tract Technique
Nzira itsva, inonzi Fast Tract nzira, yakagadziridzwa kugadzirisa nzira yeTTOT. Nzira yacho inowanikwa muimba yekushandira pasi pechiedza chechiedza uye kazhinji inosanganisira kugara kweusiku.
Kuti aumbe ruvheko rwechirwere, chirwere ichi chichigadzira ganda duku rinoputika pamutsipa, richiisa mukati me trachea.
Ganda rinoputika raizotakurwa kusvika kumutsipa wechiri mukati memutsipa, zvichigadzira nzira yekusingaperi.
NeTest Tract nzira, TTOT inogona kutanga zuva rinotevera panzvimbo yevhiki imwe chete.
> Kwakabva:
> Christopher, K. uye Schwartz, M. "Transtracheal Oxygen Therapy." Journal Journal. 2011; 139 (2): 435-40. DOI: 10.1378 / chest.10-1373.