Cov txheej txheem kev nyab xeeb rau thoracentesis

(1) Ua ntej puncture: nkag siab tus neeg mob' lub xeev puas siab puas ntsws, piav qhia lub hom phiaj ntawm kev sib tsoo rau tus neeg mob, qhia txog kev ua haujlwm, piav qhia kev ceev faj, thiab tshem tawm tus neeg mob' kev xav thiab kev txhawj xeeb. Rau cov neeg mob uas muaj kev ntxhov siab, los ntawm kev yaum, ua qauv qhia, induction, thiab lwm yam, muab kev nplij siab ntawm lub hlwb, tshem tawm kev ntxhov siab thiab kev ntshai, tham nrog cov neeg mob ua siab zoo, txhawb cov neeg mob ua pa tob tob, thiab cia cov neeg mob kawm so; pab cov neeg mob kom xis nyob zaum los yog pw ntawm lawv sab. Tiv thaiv tus neeg mob los ntawm kev pom cov cuab yeej phais thiab cov kua pleural thiab hloov nws txoj kev xav [1].

(2) Thaum lub sij hawm puncture: hnoos thaum lub sij hawm thoracic puncture tau yooj yim ua rau lub ntsws inflation, thiab puncture koob tau yooj yim ua rau lub ntsws cov ntaub so ntswg. Qhia cov neeg mob tsis txhob hnoos, ua pa tob tob lossis hais lus thaum sib tsoo. Yog tias tsim nyog, qhia tus kws phais mob los ntawm tes teeb liab, thiab haus dej thaum tus neeg mob xav hnoos. Cov dej txias txias tuaj yeem txo qhov hnoos. Ua ntej hnoos, tshem rab koob hauv qab ntawm daim tawv nqaij. Yog tias koj hnoos heev, koj yuav tsum tshem lub koob thiab nres qhov kev ua haujlwm. Thaum lub sij hawm thoracentesis, tus neeg mob' lub plawv dhia, ua pa, ntshav siab thiab lwm yam cim tseem ceeb yuav tsum tau ua tib zoo saib xyuas kom tus neeg mob tsis txhob ntxhov siab, poob siab, ua tsis taus pa thiab lwm yam tsos mob; Ua tib zoo saib seb tus neeg mob puas muaj kiv taub hau, palpitations, hauv siab nruj, tawv nqaij daj ntseg, tawm hws, thiab khaus tawv nqaij hnoos qhuav, txawm tias fainting thiab lwm yam pleural tshua. Yog tias tus neeg mob muaj cov tsos mob saum toj no, tam sim ntawd tso tseg qhov kev cia siab, rub tawm lub koob txhaj tshuaj, nias qhov chaw puncture nrog cov ntaub qhwv tsis muaj menyuam, thiab pab tus neeg mob pw tsaug zog, muab cov pa nqus pa qis ntawm 2-5L / min, thiab muab Kev saib xyuas ECG yog tias tsim nyog. Cov neeg mob hypotension thiab poob siab yuav tsum tau txhaj tshuaj subcutaneous ntawm 0.1% epinephrine 0.5 mg raws li kws kho mob' s xaj, thiab lawv yuav tsum tau kho nrog cov tshuaj hormones thiab kua dej. Kev tswj qhov ceev ntawm cov kua dej thiab huab cua tuaj yeem zam qhov tshwm sim ntawm kev nrhiav neeg ua haujlwm pulmonary edema thiab hypotension. Tsis txhob ntau tshaj 800-1000ml rau thawj lub twj tso kua mis thiab twj tso kua mis (tshwj tsis yog cov tsheb khiav thiab nro pneumothorax), thiab lub sij hawm siv yuav tsum tau tswj tsis pub dhau 1 teev. Rau cov neeg mob uas muaj lub plawv tsis ua haujlwm, thawj lub twj tso kua mis thiab cov kua dej ntim yuav tsum me dua, thiab nws muaj kev nyab xeeb dua li ntawm 600ml. Yog tias tus neeg mob hnoos qhuav los yog hnoos hnoos thaum lub sij hawm decompression, uas qhia tau hais tias thaum ntxov ntawm kev nrhiav neeg ua haujlwm pulmonary edema, decompression yuav tsum tau nres tam sim ntawd. Feem ntau, kev nrhiav neeg ua haujlwm pulmonary edema thiab hypotension yuav tsis tshwm sim. Thaum pulmonary edema tshwm sim, kev ua haujlwm yuav tsum raug tso tseg tam sim ntawd thiab npaj rau kev cawm siav. Cov neeg mob pulmonary edema yuav tsum tau haus dej cawv moisturizing oxygen, thiab txhaj tshuaj aminophylline, cardiotonic thiab furosemide raws li kws kho mob tau sau tseg. Kho pulmonary edema nyob rau lub sijhawm kom tsis txhob ua rau tus kab mob hnyav dua thiab ua rau muaj xwm txheej. Yog tias koj xav tias muaj cov kua thiab roj ntau dua, cov kua dej kaw hauv lub thoracic yuav tsum tau ua kom ntau li ntau tau kom txo tau qhov tshwm sim ntawm cov teeb meem. Thaum lub koob txhaj tshuaj yog rub tawm ntawm lub pleural kab noj hniav, tam sim ntawd thaiv lub qhov nqaij ntuag nrog ib tus ntiv tes xoo thiab nias rau 15 feeb los pab txo qhov tshwm sim ntawm pneumothorax.

(3) Tom qab kev txhaj tshuaj: Tom qab qhov kev txhaj tshuaj tiav lawm, pab tus neeg mob kom pw tsaug zog ntawm lub txaj, hais kom nws so hauv txaj li ob teev, ua tib zoo saib tus neeg mob cov cim tseem ceeb thiab cov cim hauv siab, tshwj xeeb tshaj yog cov kev hloov hauv lub cev kub thiab ua pa, mloog tus neeg mob cov lus tsis txaus siab tseem ceeb, thiab nrhiav kom paub txog yam teeb meem thaum ntxov. Ua tib zoo saib xyuas qhov puncture point rau cov ntshav thiab kua dej. Yog tias tus neeg mob xis nyob thiab ua pa, ces coj nws tawm ntawm txaj. Rau cov neeg uas muaj syncope tom qab kev ua haujlwm, pab tus neeg mob kom so hauv txaj thiab txuas ntxiv soj ntsuam rau 30 feeb; rau cov neeg mob hypotension thaum lub sij hawm thoracic puncture, oxygen thiab kua rehydration kho yuav tsum tau txuas ntxiv tom qab ua haujlwm. Cov neeg mob pneumothorax, hemorrhage thiab daim siab raug mob thaum lub sij hawm thoracentesis yuav tsum tau txais kev kho mob thiab kev saib xyuas tom qab kev phais, thiab ua tib zoo saib xyuas cov kev hloov hauv tus neeg mob' tus mob. Qhia cov neeg mob txog qhov tshwm sim ntawm lub sijhawm, ua tib zoo mloog lawv cov kev xav thiab lub siab lub ntsws, ua tib zoo saib xyuas lawv, txhawb kom lawv ntsib kev muaj tiag, ua kom lub neej zoo, tshem tawm cov teeb meem puas siab ntsws, kho cov kab mob nrog tus cwj pwm zoo, thiab siv zog rau ceev rov qab.

Yog tias koj muaj lus nug, thov hu rau peb. Peb lub tuam txhab tuaj yeem tsim ntau yam koob txhaj tshuaj, koob tshuaj kho mob, koob txhaj tshuaj, koob tshuaj hypodermic, koob txhaj tshuaj, koob tshuaj tiv thaiv kab mob, koob txhaj tshuaj, koob txhaj tshuaj, koob tshuaj tua tsiaj, koob xaum koob, koob ovum khaws koob, koob txhaj tshuaj, thiab lwm yam Yog tias koj xav tau kev kho. koob cov khoom, thov hu rau peb. Peb tos ntsoov rau koj qhov kev nug! Qhov zoo ntawm cov khoom tsim nyob rau hauv peb lub Hoobkas yuav txaus siab rau koj!

Thov hu rau peb yog tias koj xav tau: zhang@sz-manners.com