Transtracheal Oxygen Therapy ndi COPD

Njira zochepa zomwe zimagwiritsidwa ntchito kawirikawiri zimapindulitsa

Anthu omwe ali ndi matenda osokoneza bongo omwe amatha kudwala matendawa (COPD) nthawi zambiri amafuna mpweya wothandizira panthawi ina. Kaŵirikaŵiri osati, izo zidzaperekedwa kupyolera mu chubu, chomwe chimatchedwa ndodo yamagazi , yomwe imakhala pa nkhope mwachindunji pansi pa mphuno.

Nthawi zina, khola silikhala lokwanira, ndipo munthu adzafuna njira yowonjezera yobweretsera.

Kuti izi zitheke, adokotala angasankhe kugwiritsa ntchito mankhwala otchedwa transtracheal oxyrapy therapy (TTOT) omwe timapanga ting'onoting'ono tomwe timatchedwa catheter, timaphatikizidwa kupyola khosi kuti tipeze mpweya wabwino m'mapapo.

Zochita ndi Zosowa za TTOT

TTOT inagwiritsiridwa ntchito koyamba mu 1982 koma kuyambira nthawi zambiri yanyalanyazidwa ndi iwo omwe amawona kuti n'zosatheka kupatulapo ngati nthawi zambiri zimakhala zosafunika kwenikweni ( oxyxia ).

Mwachiwonekere, njirayi ili ndi malire ake. Kuika kathete mkati mwa khosi kungakhale kovuta komanso / kapena kusamvetsetsa kwa ena (ngakhale kuti sikumveka bwino). Komanso, chubuyo imatha kutseka ndipo nthawi zina zimafuna kusintha kwakukulu.

Komabe, m'zaka zaposachedwa, madokotala ambiri adavomereza ntchito yake mwa anthu omwe amakhulupirira kuti angapindule kwambiri ndi njirayi.

Izi zikuphatikizapo anthu omwe akupeza zotsatira zocheperapo-bwino ndi chingwe, nthawi zambiri chifukwa sakuzigwiritsa ntchito mokwanira komanso / kapena bwino.

Chodziwikiratu n'chakuti kugwiritsa ntchito chingwe chotsitsa kwa nthawi yayitali kungayambitse kupsa mtima kwambiri pamphuno ndi makutu ndi chitukuko cha contact dermatitis, chondritis , ndi zilonda za khungu. Izi zokha zimatha kulepheretsa kugwiritsa ntchito, zomwe zimapangitsa kuti thupi liwonongeke komanso kulekerera .

Mosiyana ndi zimenezi, TTOT ikhoza kusintha moyo wa munthu m'malo mochepetsa.

TTOT imafuna mpweya wotsika kwambiri kusiyana ndi cannula, kutanthauza kuti okosijeni yotenga mtima ingakhale yaing'ono, yowala, komanso yaitali, kuti munthu akhale kunja kwa nthawi yaitali.

TTOT imasowa mpweya wokwana 55 peresenti panthawi ya mpumulo ndi 35 peresenti panthawi ya masewero olimbitsa thupi poyerekeza ndi kadula. Ziwerengerozi zingathe kumasulira kuti zamoyo zikhale bwino komanso kuwonjezereka kwa zolimbitsa thupi . Ngakhale kuti izi sizingagonjetseni zopinga za TTOT, zimalimbikitsa kuti ntchito zawo zisagwiritsidwe ntchito ndi anthu omwe sakuyenera kutero.

Ngati mukuganiza za TTOT, pali njira ziwiri zomwe zimagwiritsidwa ntchito ndi opaleshoni:

Kusinthidwa kwa Seldinger Technique

Njira yosinthidwa yotchedwa Seldinger ndiyo njira yabwino kwambiri yotchuka ya TTOT, ngakhale kuti kutchuka kwake kwatsika chifukwa makampani ambiri a inshuwalansi sangayisunge. Ndondomeko yokhayo imachitidwa poyerekeza ndi matenda opatsirana pogonana ndipo ikuphatikizapo ndondomeko zotsatirazi:

1. Katsitsa kakang'ono kamapangidwa mu khosi kumene singano imayikidwa.
2. Wotsogolera waya amapitsidwira pa singano, ndipo singano imachotsedwa.
3. Pulogalamu yabwino yomwe imatchedwa dilator imadutsa pa waya ndikuyamba kuyendetsa minofu.

1. Pamene kutsegula kwakukulu kokwanira, dilator imachotsedwa ndipo mbola imadutsa pa waya kumayambiriro. Izi zimapangitsa kuti incision isatseke.
2. Pambuyo pachitsogolereni waya, stent imasunthira m'malo.
3. Patadutsa sabata, ulendo wobwereza uyenera kuchotsedwa. Catheter idzaikidwa mu trachea kukwaniritsa njirayi.

The Fast Tract Technique

Njira yatsopano, yotchedwa Fast Tract technique, inakonzedwa kuti iwononge njira ya TTOT. Ndondomekoyi imachitika mu chipinda chogwiritsira ntchito pansi pa malo osungirako kuwala ndipo kawirikawiri kumaphatikizapo usiku wonse.

Pofuna kutseguka, dokotalayu amapanga khungu kakang'ono pamphuno , ndikuwonetsa mkati mwa trachea.

Zilonda za khungu zikanatha kumangiriridwa ku minofu yapansi mkati mwa khosi, ndikupanga njira yamuyaya.

Pokhala ndi ndondomeko ya Fast Fast, TTOT ikhoza kuyamba tsiku lotsatira osati patatha sabata.

> Chitsime:

> Christopher, K. ndi Schwartz, M. "Transtracheal Oxygen Therapy." Buku la Chifuwa. 2011; 139 (2): 435-40. DOI: 10.1378 / chifuwa 10-1373.