Dzidziso yezvekurapa, Kuiswa kweEndotracheal intubation, Kuiswa kweMhino, wakadzidza here?

Kupinza mhino muchubhu kunowanzo shandiswa kuvarwere vane dambudziko rekuvhura muromo kana kuti laryngoscope haigone kuiswa, uye kune varwere vari kuvhiyiwa nemuromo, saka kupinza mhino muchubhu kunowanzo shandiswa. Kupinza mhino muchubhu kunofanira kuchengetedza murwere achifema oga, kushandisa kufema kuti anzwe ruzha rwecatheter, uye kufambisa musoro wemurwere kugadzirisa divi recatheter kuitira kuti ikwanise kuiswa mutrachea. Mushure mekunzwa kurwadziwa, 1%****** solution yakadonhedzwa kubva mumhino kuti iite kuti mitsipa yeropa yemucosal ivhare. Nekuti nzvimbo yakakombama yetracheal tube yaive kuruboshwe, zvaive nyore kuwana glottis nekuisa mhino mumhino yekuruboshwe. Mukurapa, mhino yekurudyi inoshandiswa chete kana kupinza mhino yekuruboshwe kuchikanganisa kuvhiyiwa. Munguva yekupinza tsinga, kudzidziswa kwekumutsa mweya kwemwoyo nemapapu kwakatangwa kekutanga, uye ipapo catheter yemafuta yakapinzwa mumhino, yakatarisana nemutsara wemhino wenguva refu, uye yakabuda mumhino kuburikidza nenyama yemhino yakajairika iri pasi pemhino. Ruzha rukuru rwekufema rwaigona kunzwika kubva mumuromo wecatheter. Kazhinji, ruoko rweruboshwe rwakashandiswa kugadzirisa nzvimbo yemusoro, ruoko rwerudyi rwakashandiswa kupinza tsinga, uye ipapo nzvimbo yemusoro yakafambiswa. Kupinza kwacho kwakabudirira zvakanyanya apo ruzha rwemhepo yecatheter rwaive rwakanyanya kuoneka mumuenzaniso we electronic tracheal intubation. Kana kufambira mberi kwecatheter kwakavharwa uye ruzha rwekufema rwakakanganiswa, zvinogona kunge kuti catheter yakanyura mu piriform fossa kune rumwe rutivi. Kana zviratidzo zvekushaya mweya zvikaitika panguva imwe chete, musoro unogona kunge wakanyanya kumashure, wakapinzwa mu epiglottis ne tongue base junction, zvichikonzera epiglottis pressure glottis, senge resistance yakanyangarika, uye kufema kwakakanganiswa, kunyanya nekuda kwekutenderera kwemusoro zvakanyanya, catheter mu esophagus kwakakonzerwa. Kana mamiriro ezvinhu ari pamusoro apa akaitika, catheter inofanira kubviswa kwechinguva, uye nzvimbo yemusoro inofanira kugadziriswa mushure mekunge ruzha rwekufema rwaonekwa. Kana kudzokororwa kwekufema kwebofu kwakaoma, maglottis anogona kuratidzwa nemuromo nelaryngoscope. Catheter yakasimudzirwa neruoko rwerudyi ndokuiswa mutrachea pasi pekuona kwakajeka. Neimwe nzira, muromo wecatheter unogona kusungwa neforceps kuti catheter ipinde muglottis, uye catheter inogona kusimudzirwa 3 kusvika 5cm. Zvakanakira zve nasotracheal intubation ndeizvi: (1) Nasotracheal tube haifanirwe kunge yakakura zvakanyanya, nekuti kana yakakura zvakanyanya, mikana yekukuvadzwa kwelarynx nenzvimbo iri pasi peglottic yakanyanya, saka kushandiswa kwedhayamita yakakura kwazvo yechubhu hakuwanzoitiki; ② Kuita kwemucosa yemhino kune intubation kunogona kuonekwa, kana paine kukurudzira; ③ Nasal cannula yakagadziriswa zviri nani, uye kutsvedza kushoma kwakawanikwa panguva yekuyamwisa nekufema kwekugadzira; ④ Kukombama kwemuchina wemhino kwakakura (hapana Angle yakakombama), izvo zvinogona kuderedza kumanikidzwa kwechikamu chekumashure chegurokuro nekatsi; ⑤ varwere vakamuka vainzwa vakasununguka nekupinza mhino, kumedza kwaive kwakanaka, uye varwere vaisagona kuruma kupinza mhino; ⑥ kune avo vane dambudziko rekuvhura muromo, kupinza mhino kunogona kushandiswa. Zvakashata ndeizvi: (1) Utachiona hunogona kuiswa muchikamu chepasi chekufema nekuisa mhino; ② Lumen yekupinza mhino yakareba uye dhayamita yemukati idiki, saka nzvimbo yakafa yakakura, uye lumen iri nyore kuvharwa nekubuda, izvo zvinowedzera kuramba kwenzira yekufema; ③ Kuvhiyiwa panguva yekukurumidzira kunotora nguva uye hakusi nyore kubudirira; ④ Zvakaoma kupinza mhino nepaburi remhino kana trachea yakamanikana.