Tracheostomy ndi kutsegula kwa trachea kuti mpweya wabwino ukhale wabwino pogwiritsa ntchito mpweya wabwino. Izi zitha kuchitika pakanthawi kochepa komanso makamaka mu chisamaliro chachikulu. 

Tracheostomy imapangidwa ndikupanga kabowo kakang'ono mu kholingo ndikuyikamo ka cannula kakang'ono, komwe kumathandizira mpweya wabwino (kulowa ndi kutuluka kwa mpweya m'mapapo), ndi makina kapena opanda makina. Kuchita uku kumadutsa njira yopumira yakumtunda (mphuno ndi pakamwa). Mpweya sufunikanso kudutsa m’mphuno kapena m’kamwa kuti ukafike m’mapapo. Tracheostomy ikhoza kukhala yokhazikika kapena yochepa.

Kukonzekera tracheostomy

Pamene tracheostomy sichichitika mwadzidzidzi, imatsogoleredwa ndi anesthesia. 

Kodi tracheostomy imachitidwa bwanji?

Tracheostomy ikhoza kuchitidwa opaleshoni pansi pa anesthesia wamba kapena percutaneously pansi pa anesthesia wamba.

Pa tracheostomy ya opaleshoni, kudulidwa kumapangidwa pamtunda wa trachea pakati pa mphete za 2 ndi 4 za cartilage. Thupi la tracheostomy cannula limalowetsedwa mu trachea kudzera m'njira iyi.

A percutaneous tracheostomy ikuchitika pansi pa anesthesia wamba, nthawi zina ndi sedation yowonjezera, pambali pa bedi la wodwalayo mu chisamaliro chapadera osati mu opaleshoni. Pamenepa, palibe kudulidwa khungu. Khomo la trachea limakhomeredwa ndi singano. Singano iyi imagwiritsidwa ntchito podutsa kalozera wokhazikika pomwe amalowetsedwamo zokulirapo zazikulu ndi zazikulu mpaka zifike m'mimba mwake mwa cannula. 

Pazidzidzi zadzidzidzi, tracheostomy imathanso kuchitidwa pansi pa anesthesia wamba kunja kwa chipinda chopangira opaleshoni.

Tracheostomy yapang'onopang'ono imasonyezedwa mwachangu kwambiri pakadutsa kumtunda kwa mpweya (asphyxia) pamene tracheal intubation sizingatheke kapena contraindicated.

Tracheostomy yosakhalitsa ingathenso kuchitidwa pokonzekera opaleshoni ya laryngeal kapena pharyngeal, kuti athetse vuto la intubation panthawi ya anesthesia, kulola mpweya wabwino wa makina kwa munthu yemwe ali ndi chisamaliro chachikulu. 

Tracheostomy yotsimikizika imatha kuchitika mwa anthu omwe ali ndi vuto lopumira kwambiri, ngati ali ndi vuto lapakati kapena lotumphukira la oropharyngeal junction (pakamwa-pharynx) omwe ali ndi vuto lakumeza kapena matenda a neuromuscular (monga myopathy) momwe kufowoka kwa minyewa. minyewa yopumira kapena chilema pakuwongolera kwawo kumachepetsa kupuma bwino ndipo kumafuna thandizo la mpweya wabwino. 

Zotsatira za kuchitapo kanthu kumeneku nthawi zambiri sizimawonedwa ngati zopweteka. Analgesics kutumikiridwa pambuyo opaleshoni kuthetsa ululu uliwonse. M'masiku ochepa oyamba, cannula ikhoza kukhala yokhumudwitsa kapena kuyambitsa chifuwa cha reflex. Zimatenga masiku angapo kuti muzolowere chubu cha tracheostomy komanso milungu ingapo kuti musamve nkomwe. Tracheostomy saletsa kulankhula kapena kudya ndi kusintha kwina. 

Kukhala ndi tracheostomy

Pamene tracheostomy ndi yotsimikizika (pakakhala kulephera kupuma kwapang'onopang'ono kapena ngati matenda a neuromuscular, mwachitsanzo), tracheotomy imadziwika ngati gawo lovuta. kukhulupirika kwake kwakuthupi, chiyembekezo chokhala ndi zopinga zambiri. Komabe, kumabweretsa mapindu. Kupuma kumakhala komasuka ndi mpweya wosokonezawu kusiyana ndi mpweya wosasokoneza. 

Ogwira ntchito zachipatala amaphunzitsa odwala tracheostomy ndi omwe ali nawo pafupi chithandizo chomwe chikufunika: kusintha kwa cannula, chisamaliro cha orifice ya trachea, endotracheal aspirations… Akhoza kuphunzitsa omwe ali nawo pafupi kuchita izi. 

Kudziwa: Pamene tracheostomy ili yochepa, kuchotsedwa kwa cannula kumalola kutsegula kwa pharynx kutseka m'masiku ochepa.