Ezokwelapha, 'intubation' ibhekisela endleleni evumela ukufakwa kweshubhu endleleni yokuphefumula - ngokuqondile kuqhoqhoqho - ngezintambo zezwi zesiguli ngenhloso enkulu yokuvumela umuntu ongakwazi ukuphefumula ngokuzimela.

Indlela ejwayeleke kakhulu yokufaka intubation 'endotracheal' intubation, engenzeka

• orotracheally: ithubhu ingena ngomlomo wesiguli (indlela evame kakhulu);
• i-rhinotracheally: ithubhu lingena ngekhala lesiguli (indlela engavamile kakhulu).

Intubation: isetshenziswa nini?

Inhloso eyinhloko yazo zonke izinhlobo ze-intubation ukuvumela ukuphefumula komuntu, ngenxa yezizathu ezihlukahlukene, ongakwazi ukuphefumula ngokuzimela, okubeka impilo yesiguli engozini.

Enye inhloso ye-intubation ukuvikela indlela yokuphefumula ekuhogeleni okungenzeka kwe-gastric material.

Intubation yenziwa ezimeni eziningi zezempilo, njenge:

• ezigulini ze-coma;
• ngaphansi kwe-anesthesia jikelele;
• ku-bronchoscopy;
• ezinqubweni ze-endoscopic operative airway ezifana nokwelashwa nge-laser noma ukwethulwa kwe-stent ku-bronchi;
• ekuvuseleleni iziguli ezidinga ukwesekwa kokuphefumula (isb ezimeni zokutheleleka okukhulu kwe-Covid-19);
• emithini ephuthumayo, ikakhulukazi ngesikhathi sokuvuselelwa kwe-cardiopulmonary.

Ezinye izindlela zokusebenzisa intubation

Kukhona ezinye izindlela zokusebenzisa intubation, kodwa ngokungangabazeki zihlasela kakhulu futhi azinayo ingozi, ngokwesibonelo.

• i-tracheotomy: lena inqubo yokuhlinzwa evame ukusetshenziswa ezigulini ezidinga ukwesekwa kokuphefumula isikhathi eside; funda kabanzi: I-tracheotomy kungenzeka yokukhuluma, ubude besikhathi, imiphumela, uma yenziwa
• i-cricothyrotomy: indlela ephuthumayo esetshenziswa lapho intubation ingenakwenzeka futhi i-tracheotomy ingenakwenzeka.

Izinhlobo zamashubhu asetshenziswa ku-intubation

Kunezinhlobo ezihlukahlukene zamashubhu endotracheal for intubation yomlomo noma yamakhala; kukhona eziguquguqukayo noma eziqinile kancane, ezinokwakheka okuthile ngakho-ke ziqinile kakhulu.

Amashubhu amaningi afanayo anomkhawulo ophefumulayo wokuvala umzila womoya ophansi, ongavumeli umoya ukuba uphume noma uketshezi olushibhile.

Intubation: kungani kwenziwa ngesikhathi sokubulala izinzwa?

I-Intubation yenziwa i-anesthesiologist ngesikhathi se-anesthesia jikelele, ngoba - ukuletha i-anesthesia - isiguli sinikezwa izidakamizwa ezivimbela ukuphefumula kwakhe: isiguli asikwazi ukuphefumula ngokuzimela futhi i-endotracheal tube, exhunywe kumshini wokuphefumula othomathikhi, ivumela isihloko. ukuphefumula ngendlela efanele ngesikhathi sokuhlinzwa.

Ekusebenzeni isikhathi esifushane (kufika emaminithini angu-15) ukuphefumula kusekelwa ngemaski yobuso, ithubhu loqhoqhoqho lisetshenziswa uma ukuhlinzwa kuthatha isikhathi eside.

Ngizozwa ubuhlungu?

Intubation ihlale yenziwa ngemva kokuba isiguli silalisiwe, ngakho-ke ngeke uzwe ubuhlungu obubangelwa yikho.

Ngemva kwenqubo ngeke ukhumbule noma ukubekwa kweshubhu noma ukususwa kwalo (okungukuthi, ukuphuma) emgudwini womoya lapho inqubo isiphelile. Ukungakhululeki okuncane emphinjeni kungenzeka, futhi kaningi, ngemuva kokukhishwa.

Ubuhlungu bomphimbo ngemva kwe-intubation: ingabe kuvamile?

Njengoba kusanda kushiwo, ngemva kokuba isiguli senziwe intubation, singase sibe nezimpawu ezingemnandi, ezihlanganisa:

• Umphimbo obuhlungu
• ukuzwa komzimba wangaphandle emphinjeni;
• ubunzima bokugwinya okuqinile noketshezi;
• ukungakhululeki lapho wenza imisindo;
• ukuhosha.

Lezi zimpawu, nakuba zicasula, zivamile futhi azimbi kakhulu, futhi zivame ukunyamalala ngokushesha, ngokuvamile phakathi kwezinsuku ezimbili.

Uma ubuhlungu buqhubeka futhi bungabekezeleleki ngokungagwegwesi, funa iseluleko kudokotela wakho.

Amasu e-Intubation

I-tracheal intubation ingenziwa ngokusebenzisa amasu ahlukahlukene.

• Indlela yendabuko: iqukethe i-laryngoscopy eqondile lapho i-laryngoscope isetshenziselwa ukubona ngeso lengqondo i-glottis ngaphansi kwe-epiglottis. Ishubhu libe selifakwa elinombono oqondile. Le nqubo yenziwa ezigulini eziqulekile (eziqulekile) noma ezingaphansi kwe-anesthesia jikelele, noma lapho zithole izinzwa zendawo noma ezithile zezakhiwo zomzila womoya ophezulu (isb. ukusebenzisa isibulali-zinzwa sasendaweni njenge-lidocaine).
• Ukungeniswa kokulandelana okusheshayo (i-RSI) (ukwethulwa kokuphahlazeka) kuwukuhluka kwenqubo evamile ezigulini ezingaphansi kokuhlinzwa kwezinzwa. Kwenziwa lapho ukwelashwa komzila womoya ngokushesha futhi okuqinisekile ngokufaka intubation kuyadingeka, futhi ikakhulukazi uma kunengozi eyengeziwe yokuhogela ukukhishwa kwesisu (isifiso) okungase kuholele ku-pneumonia ab ingestis. Ku-RSI, i-sedative yesikhathi esifushane efana ne-etomidate, i-propofol, i-thiopentone noma i-midazolam ilawulwa, ilandelwa ngokushesha umuthi okhubazekile oqeda amandla njenge-succinylcholine noma i-rocuronium.
• Indlela ye-Endoscope: enye indlela yokufaka isiguli esikwaziyo (noma esithuliswe kancane) ngaphansi kwe-anesthesia yendawo ukusetshenziswa kwe-endoscope eguquguqukayo noma okufanayo (isb ukusebenzisa i-video-laryngoscope). Le nqubo ikhethwa uma kulindelwe ubunzima, njengoba ivumela isiguli ukuba siphefumule ngokuzenzakalelayo, ngaleyo ndlela siqinisekise ukungena komoya kanye ne-oxygenation ngisho noma kwenzeka i-intubation ehlulekile.

Ingabe i-intubation iveza ubungozi kanye nezinkinga?

Intubation ingadala umonakalo emazinyweni, ikakhulukazi esimweni samazinyo awonakele ngaphambilini noma ubudlelwano obunzima be-anatomical.

Ngaphezu kwezimpawu zomphimbo ezicasulayo ezivame ukubonakala ezibonwe ngenhla, ezimweni ezingavamile ukujwayela kungabangela umonakalo omkhulu ezicutshini edlula kuzo, kuze kuholele ekuphumeni kwegazi.

I-intubation ingase iveze izinkinga ezingalindelekile, ikakhulukazi ezimweni ezinzima ezingalindelekile zokuthuthumela, okuyinto engavamile kodwa engenzeka, lapho izici ze-anatomical zesiguli zenza ukuma okulungile kweshubhu endleleni yomoya kube yinkinga kakhulu.

Ngenhlanhla, kulezi zimo, udokotela unamathuluzi angawasebenzisa ukumsiza ukuba anciphise izingozi esigulini ngangokunokwenzeka, njengama-videolaryngoscopes nama-fiberscopes, akha ubunzima obungalindelekile noma obekulindelekile bokungena okuhlangatshezwane nabo.

Ngokuhleleka kakhudlwana, ubungozi bangaphambi kwesikhathi nangaphambi kwesikhathi bumi kanje:

Izingozi zangaphambi kwesikhathi

• ukulimala kwamazinyo
• ubuhlungu bomphimbo;
• ukopha;
• i-edema yezakhiwo ze-glottic;
• i-pneumomediastinum;
• ukuhosha;
• ubunzima bokukhuluma;
• ukubhoboza uqhoqhoqho;
• ukuboshwa kwe-cardiovascular from vagal stimulation.

Izingozi ezingemuva kwesikhathi

• ukulimala koqhoqhoqho
• i-decubitus ye-chordal;
• izakhiwo ze-decubitus buccal, pharynx, hypopharynx;
• inyumoniya;
• i-sinusitis.

Funda Futhi:

Ukuphila Kwezimo Eziphuthumayo Ngisho Kakhulu...Bukhoma: Landa Uhlelo Olusha Lwamahhala Lwephephandaba Lakho Olwe-IOS Ne-Android

I-UK / Igumbi Lezimo Eziphuthumayo, Intubation Yezingane: Inqubo Nengane Esesimweni Esibucayi

I-Endotracheal Intubation Ezigulini Zezingane: Amadivayisi E-Supraglottic Airways

Ukushoda Kwezidambisi Kubhebhethekisa Ubhadane EBrazil: Imithi Yokwelapha Iziguli EzineCovid-19 Ayinayo

I-sedation kanye ne-Analgesia: Izidakamizwa Zokusiza Intubation

I-Anxiolytics And Sedatives: Iqhaza, Umsebenzi Nokuphathwa Nge-Intubation kanye Nokuphefumula Kwemishini

I-New England Journal Of Medicine: I-Intubations Ephumelelayo Ngokwelashwa Kwamakhala Okugeleza Kakhulu Ezinganeni Ezisanda kuzalwa

Source:

Imithi Online