Ke Tube i loko o ka'ā'ī ma hope oʻoki kino (e nānā Hawaii photo). No ke aha la hookomo i kekahi Tube i loko o kona puu?

Ma kekahi mau hihia, puʻu, surgically i puka. He mea pono no kekahi mau nā palapū a mai pili me kaʻole hanu. Ke Tube ma ka puu, he pono ke kuleana pili i ka hoihoi.

hiki likeʻole

Pela i ma surgically weheʻana i loko o ka puu i kapaia he tracheostomy. I ka manawa a eia paha ka Tube hiki ke kau ke kaumaha ma muli o ka PAaIEN. Akā, ma kekahi hihia ia mea he haole kino, i ka mea i keʻano ukiuki o ia ma luna o ke kino.

Inā ka mea, ua? Oaony ia i loko o ka puu şarkı e e oi ma mua o ka malama, ka mea i pono, e humuhumu i nā kihi o ka ili i ka mucousʻili lahilahi o ka trachea. Ma keia hihia, he hale lio tracheostomy. Akā, inā he pono, e i ea pele i loko o keia alanui no ka pōkole wā o ka manawa, hana okoa. Ke oki i ma kekahi kūikawā cannula ua hookomoia, a me nā kihi i hanaʻia e kaʻeha ua ole sutured. He kēia mea ua ālai 'i ka panina o ka lua hana. Inā ka mea, ua weheʻia, ka nahā i e e paa no 2-3 lā ma luna o lākou iho.

E ho ohana i cannula no, ua kīkoʻo akula manawa ua ole e waiho no ka mea, o ka manawa kūpono o ka pathological naoh i loko o ka wahi o ka paratracheal nā'aʻaʻa.

Nāʻikepili no ka tracheostomy

Aia nō kekahi mau kumu no ka i hiki ole ke hana me incision o ka trachea. Keia hana ua koi 'ia ma ka huʻi laryngeal stenosis.

Ka mea hiki ke kena ae la ia e na kēia kumumea:

• ingress o na kino;
• 'ā (thermal ole Nine Inch);
• wahahee croup;
• diphtheria;
• haanou ana;
• kapakahi lōlō o na kaula vocal.

Kekahi pūʻulu o nā kumu e like me ka tracheostomy, he 'aʻe' ana o ka tracheobronchial laau nōkahea. Keia ia lŘlŘ ka wā:

• loa traumatic lolo eha;
• cerebrovascular insufficiency (me ma hope o hahau ana);
• lolo hikoko;
• coma, pu e hoʻopōʻino cough a me ka moni 'ia reflexes;
• lōʻihi-ʻia you asthmaticus;
• 'aʻe' ana o ka pahu kupapau ano hoopono.

Nō hoʻi, i ka wa a ka incompetence o ka neuromuscular'ōnaehana koi ka Tube i loko o kona puu. Photosʻo ia ka mea akaka ia, aohe mea i weliweli. Akā, he nui na kanaka e ho'āʻo ana e uhi i ka mea kiʻekiʻe me nā momi pepeiao, a me ka'ā'ī scarves. Pilikia a me ka neuromuscular'ōnaehana kū i aie i ka:

• bulbar poliomyelitis palapala;
• lesions ma ka cervical māhele o ka spinal ke kaula;
• polyradiculoneuritis;
• loa miostenii;
• neuroinfec- lesions (botulism, tetanus, rabies).

Tracheostomy a me intubation o ka larynx

Ma kekahi mau hihia, iʻoki lāʻau lapaʻau 'uao mea paʻa mau. Tracheostomy hula i loko o ia mau wahi, i hiki ia oe e pono ai i ka lōʻihi wā e hoʻopaʻa i ka manawa kūpono o ka hanu. Pinepine ka mea, ua hanaia ma ka mea e e hiki ia no ka lōʻihi manawa e hoʻohana i ka ventilator.

Inā pono i ke ahonui, e hoihoi maʻamau hanu, e hoolako i ka piha kinoea, e loaa hou i loko o nā maʻiʻaʻai iʻoki kino, ka mea, ua hana tracheal intubation. Ma keia hihia, ke Tube ua hoʻolauna ma ka ihu a me ka waha i loko o ka puu. Naʻe, i kēia iaoia hiki ke hoʻohana wale ka wā hou hoʻokomo ea ua pono no kekahi mau hola paha lā. Eia naʻe, intubation hiki i poino i ka pā paia o ka trachea. Kēia e i kona contraction.

I ka hoʻohana 'ana i ka lewa şarkı hele ma luna tracheostoma emi anatomically make hapa o ka naehana'āpana. Ma keia hihia, e mea hiki ke kū i ka wā lōʻihi o ka hanu.

Surgeries

Ma kekahi mau hihia, o ka hana pono e hoolako i ka piha kinoea, e loaa hou i loko o nā maʻiʻaʻai a me bronchi. He nui e ike i ke kumu o ka Tube i loko o kona puu, ma keia hihia. Tracheal intubation e hana e hōʻoia 'airway patency. 'O kēia kekahi o ka loa ike loea ki ina hana like, a i leie aku oe i ka waiu, mai ka bronchi a me ka trachea e lilo i ka malu ma kūikawā catheters.

E intubation i loko o kekahi mau hihia. He mea pono ina he mea kekahi pilikia o ka wehena - komo i ka ia maʻiʻaʻai o gastric Contents. Nō hoʻi, i kēia hana ua hoike mai ma ka 'aʻe o ka nōkahea hana o ka trachea a me ka bronchi.

Akā, ma ka iapaau ana o ka maʻi 'aʻai o ka larynx ua koi tracheostomy. Kona manaʻo,ʻo ia kekahi o nā kuʻina o ka Inc. Ke Tube i loko o ka'ā'ī ma hope oʻoki kino, e wehe i ka larynx ma ke alo o ka malignancy mea OAXA.

Ke kaʻina hana eaaaony i ka manawa kūpono o ka hanu kākoʻo paha lāʻau. Ke hoomanawanui, nānā 'ole o ke kulana o ke kino, nae ka maʻamau airway. Eia hou kekahi, ia eliminates ka manawa kūpono o ka asphyxiation ma ka wehena o ka luaʻi, mucus, koko paha mai ka spasm o na ligaments, ka ingress o na kino.

'ano o nā hana

Direct dissection o ka trachea e i ea entrapment a me ka wehe 'ana ina pono o na kino, i kapaia tracheotomy. A tracheostomy - ka mea, ua kau ma luna o ka mea mawaho e komo ai o ka trachea. Ma hope o keia 'uao, he mea he kūikawā Tube i loko o kona puu i ka hanu.

Ke kaumaha ma muli o ka incision hoomaopopo luna, waena, a ma lalo tracheostomy. Nō hoʻi ka mea hiki e lonikū, transverse a me ka U-hoʻokino.

Ma ka luna o ka tracheostomy incision i ma luna o ka isthmus o ka thyroid gland. Keia hana ua manaoia e ia i ka loa a me ka poe noonoo ole ua hana hou pinepine ana.

Inā ke oki ua i nā kāʻei i ka isthmus, ua kapaʻia i ke 'ākeʻakeʻa i ke kaulana tracheostomy. 'O kēia kekahi o ka noho pilikia loa a me ka pilikiaʻoki aie i ka mea i loaʻa o ka pilikia o ka thyroid ka pōʻino. Ua Ua hana ia ka hana wale nō i loko o hihia ma kahi o ka manawa, e hana i ole ia, e like me Ka maʻi 'aʻai o ka thyroid gland.

Ua mea no hoi e hiki ke lawe mai i ka lalo tracheostomy. Ua ua hana ia e kekahi isthmus. Uaʻoki kino ua hōʻike no nā keiki ma lalo o ka makahiki o ka 15 makahiki ma muli o ke 'ano o ka' ole kino. He nui kahaha no ke kumu o ka Tube i loko o ka puu o na keiki. ia pinepine i ke keiki e loaa ana mai ka congenital airway abnormalities.

Tracheostomy no ka ventilator

Inā ka hoʻomanawanui koi ma paʻi hoʻokomo ea, i ka ninau o ka noonoo ina paha e hoʻomakaʻoki kino, a oki i kona puu. Tracheostomy paipu hiki ke kaulike i ke kumupaʻa o ka ventilator, pela aole e e ole pilikia o ka larynx a me subglottic māhele o ke poho. Pinepine i ka ninau ana o ka 'uao e pii ai ma hope o intubation o ke ahonui i 7-10 lā. Ka mea, iloko oia kau, ka mea, ua ike e hoʻokomo ea e e pono ai no ka lōʻihi wā.

A laila, he mea a pau e lilo ike ke kumu i ka Tube ua hookomoia i loko o ka puu. Hewa i i na kamalii uuku, a opiopio nā mea maʻi wale no ka aie i ka mea i ka mea, i ka tracheostomy pinepine ke kumu no complications. Ke hana ua hana ma lalo o mau anesthesia me intubation o ka hoʻomanawanui.

Nāʻikepili no ka tracheostomy i keiki

Ma kekahi mau hihia, o ka mea liilii loa nā mea maʻi e pono ai i ka Tube i loko o kona puu. He aha ke ano o ka maʻi hoʻonāukiukiʻana mai o ia i ka mea e pono ai? Kekahi mea i ua hookomo ia ma congenital a loaa iaʻi, hikoko, traumatic lesions, immaturity o ka naehana'āpana.

Nei, ka mea ma luna o ke ano hiki ke 'akomi i loko o ka palapala tracheomalacia a me ka laringomalyatsii. Ua Ua pū kaulana inspiratory stridor, retraction o ka intercostal nāʻiʻo, nasal flaring. Keia ano hiki ke ala mai ma muli o ka congenital vocal kaula lōlō, pōʻino i ka'emi'ōnaehana a phrenic laryngeal nā aʻalolo. Ma innate nāʻikepili i nā Agnese trachea.

Akā, loaʻa nō i ka helu o ka loaʻa pathologies ma i e e pono ai ka Tube i loko o kona puu. Ma hope oʻoki kino, opiopio nā mea maʻi e noho hoʻohana i ka haole kino, a me ka hoʻomau i alakai i ka maʻamau ola. Pinepine i ka Tube ua pono ai ma hope o hana loa no me mechanical hoʻokomo ea. Nō hoʻi, i ka pono no ka mea, kupu ana ma ka po apnea, neuromuscular pilikia, maʻi nā mea palahēhē, a me ka wehena.

Hiʻona o ka pae'ōnaehana keiki

Nānā 'ole o ka mea alakaʻi i ka pono, e hana i kekahi tracheostomy keiki, eia kekahi nuances o ke kaʻina hana no ka muli loa nā mea maʻi. Keia mea aie a hiki i ke 'o ka' ole o ko lākou mau kino. Penei, a pau nā mamo thyroid gland mea kiʻekiʻe lawa, no laila, e pana aku au i ka lalo tracheostomy.

Young nā mea maʻi ole dissected cartilage ua hana mai ke alo mai o ka tracheal pa, e like me keia e alakai i ka instability o ka trachea ia iho, a lilo i kumu o ka pilikia i loko o decannulation. ka mea no hoi aole e pono koho transection. Ma ia he hihia, he tracheal apo deformation aie i ka'aloʻahiʻa Tube.

ʻeho ho okumu

Mākua a me nā keiki e koi i ka tracheostomy me keʻano o nā teratomas a sarcomas. Akā, ma ka opiopio nā mea maʻi e oOeEIAOO i ka trachea a me ka na me ka ho okumu i hemangioma paha lymphangioma.

I ka diagnosing Ka maʻi 'aʻai o ka larynx u kauka e ke kauoha ole wale i ka wehe' ana i kaʻeho, a pale ai kona ulu hou, akā, no hoi, e hoihoi i ka aiiay, leo a me ka ÷ naehana hanu i hana '. No laila, i ka Tube i loko o koʻu puu ma hope oʻoki kino o laryngeal Ka maʻi 'aʻai mea OAXA ma ka hihia ma ka hoʻomanawanui ua hoʻokō laryngectomy -ʻoki kino, e wehe i ka larynx holoʻokoʻa.

Ua hiki ke käpae 'wale ina i ka maʻi' aʻai ua diagnosed i kahua 1, ai ka awelika hahau aku e wale larynx. Ma ia wahi, i hiki vocal kaula kekahi wehe. I kekahi manawa, i ka i wehe 'ia i ka resection o ka larynx hapa o ke kino, akā, ua malamaia ua mau mea a pau i hana' kona.

Inā 'oe pono e hoʻokō' extirpation o ka larynx, ia mea e pono ia e hoomakaukau ai no ka oiaio i ka mea mea hiki ole e hoʻohana i ka mau alanui leo pahu. Ua pono e hoihoi hou ia.

Malama o ka tracheostomy

Nānā 'ole o na kumu i koi' ia ka Tube i loko o ka puu, e pono e hoomanao pehea la ia e hahai. Mālama i kela la i keiaʻauʻau a me disinfecting i hoʻomākaukauʻia. Eia hou, i ka stoma āpana pono mau lubricate i ka ili, i mea e hoʻopau i ka manawa kūpono o ka mea ukiuki loa. Ke Tube hiki e hana i ka mea poni, e kōkua ai ka hāʻuleʻana.

Eia hou kekahi, kauka waiho aku e waiho ana i ka stoma ole cannulas no kekahi manawa (ma kahi o ka hola). Akā, ma mua ia mea nui e pono kanaka hoʻoponopono i kaʻae. Over manawa, i aku la hiki e mahuahua manawa a hiki i ka puka ua ole i maopopo hana. Hope i ke komo ana o ka cannula i AND. I ka Ia manawa me ka nui loa ka hoʻomaikaʻi i ka hoʻomanawanui ka kulana. Ma hope o tracheostomy cannula a Tube nāuki mai ka tracheal pa.

hiʻona Aloha Hawaii

Ua hana mai i ka ninau o ke kumu i ka Tube i loko o ka puu mea pono, he nui nā naʻau, no ka mea, i ke kaumaha kali. Me la mea he mea hiki ole ke lawe i ka ua auanei, au, au i loko o ka loko, make up. Ma hope o nā mea a pau, ia mea fraught me ka pilikia o ka hakui o. Akā, nae, ke kuai hiki ke 'imi i ka kūikawā naʻau e ālai' ia 'o ka manawa kūpono o ka wai e komo i ka stoma.

Mai poina i ka maʻamau ola i loko o gassy a dusty wahi ho'ā 'maoli palekana o ka nasopharynx. A me kanaka, ka poe i ka Tube i loko o ka puu, ia mea ole. No ia mea, ia mea maikaʻi, e loaʻa 'ana ia mau wahi. All nā mea maʻi me ka tracheostomy hou susceptible i ka li nui, a me ka bronchopulmonary maʻi. Ka mea pono ma ka wela, uhi ka stoma lole wili,ʻona nō me ka wai. A i loko o ke anu wa pono, mehana ua makemake.

ano tracheostomy

Pinepine ka mea, he Tube i loko o kona puu iʻoki kino. Nolaila, ina ua ole ke hana i kaʻoki kino i loko o kekahi mea o ka urgency, ka hoʻomanawanui ke kukakuka pu me ke kauka, e hookupaa aku i ke ano o ka tracheostomy.

Ano, aia no he ākea huahelu o kēia mau mea, akā, ka hapanui o ia i hana no ka kūikawā thermoplastic mea. Lākou peculiarity waiho i loko o ka mea ana i ka wela o ka ma kahi o 35-38 ° C ka Tube i loko o ka puu i laholio. Ua apono 'oe, e hoola i ka holoʻokoʻa mucousʻili lahilahi o ka trachea a me ka' ē aʻe e pili nā'aʻaʻa. Ke kae o ka Tube terminates 'ole ua like no me ke kinona o ka hahai. He hiki ke hōʻoia i ka palekana o ka mea mawaho'aʻaʻa a puni i ke kania-i ma ka lumen.