Koyarwar likitanci, shigar da bututun ciki na Endotracheal, shigar da hanci, shin ka koya?

Sau da yawa ana amfani da hanyar shigar hanci ga marasa lafiya da ke da wahalar buɗe baki ko kuma ba za a iya saka laryngoscope ba, kuma ga marasa lafiya da ake yi wa tiyatar baki, don haka ana amfani da hanyar shigar hanci ta makaho. Dole ne hanyar shigar hanci ta makaho ta sa majiyyaci ya yi numfashi ba zato ba tsammani, ya yi amfani da hanyar fitar numfashi don sauraron sautin catheter, sannan ya motsa kan majiyyaci don daidaita alkiblar catheter ɗin don a saka shi cikin trachea. Bayan maganin sa barci, an sauke maganin 1%****** daga hanci don haifar da matsewar jijiyoyin jini na mucosa. Saboda layin bututun tracheal da ke karkata yana hagu, ya fi sauƙi a sami damar shiga glottis ta hanyar shigar hanci a cikin hancin hagu. A aikin asibiti, ana amfani da hanyar shigar hanci ta dama ne kawai lokacin da hanyar shigar hanci ta hagu ta tsoma baki a aikin. A lokacin da ake yin amfani da intubation, an fara yin kwaikwayon horar da farfaɗo da huhu na ɗan adam na alar eversion, sannan aka saka catheter mai shafawa a cikin hanci, wanda ke tsaye a layin dogon hanci, sannan daga hancin ta hanyar hancin da aka saba amfani da shi a ƙasan hanci. Ana iya jin ƙarar numfashi mai ƙarfi daga bakin catheter. Gabaɗaya, an yi amfani da hannun hagu don daidaita matsayin kai, an yi amfani da hannun dama don yin intubation, sannan aka motsa matsayin kai. Shigar da shi ya yi nasara sosai lokacin da hayaniyar iskar catheter ta fi bayyana a cikin samfurin intubation na lantarki na tracheal. Idan an toshe ci gaban catheter kuma an katse sautin numfashi, yana iya zama cewa catheter ya zame cikin piriform fossa a gefe ɗaya. Idan alamun asphyxia suka faru a lokaci guda, kai na iya zama baya da yawa, an saka shi cikin epiglottis da mahaɗin tushe na harshe, wanda ke haifar da matsin lamba na epiglottis, kamar juriya ya ɓace, kuma katsewar sauti na numfashi, galibi saboda yawan lanƙwasa kai, catheter cikin esophagus ya haifar. Idan yanayin da ke sama ya faru, ya kamata a cire catheter na ɗan lokaci, sannan a daidaita matsayin kai bayan sautin numfashi ya bayyana. Idan sake shigar da catheter ta makance ya yi wahala, za a iya fallasa glottis ta baki da laryngoscope. An haɓaka catheter ɗin da hannun dama sannan a saka shi cikin trachea a ƙarƙashin gani mai kyau. A madadin haka, ana iya ɗaure ƙarshen catheter ɗin da forceps don aika catheter ɗin zuwa cikin glottis, sannan a iya ƙara catheter ɗin daga 3 zuwa 5cm. Fa'idodin shigar da nasotracheal sune kamar haka: (1) Bai kamata bututun nasotracheal ya yi girma ba, domin idan ya yi girma sosai, damar lalacewa ga maƙogwaro da yankin subglottic yana da yawa, don haka amfani da diamita mai girma na bututun ba kasafai ake gani ba; ② Ana iya lura da martanin mucosa na hanci ga shigar da catheter, ko akwai motsawa; ③ An gyara cannula na hanci da kyau, kuma an sami ƙarancin zamewa yayin shayarwa da numfashi na wucin gadi; ④ Lanƙwasawar hancin yana da girma (babu kusurwa mai tsanani), wanda zai iya rage matsin lamba a ɓangaren baya na makogwaro da guringuntsi; ⑤ Marasa lafiya da suka farka sun ji daɗin shigar hancin hanci, hadiya tana da kyau, kuma marasa lafiya ba za su iya cizon shigar hancin ba; ⑥ ga waɗanda ke da wahalar buɗe baki, ana iya amfani da shigar hancin hancin. Rashin amfani da su sune kamar haka: (1) Ana iya shigar da kamuwa da cuta a cikin ƙananan hanyoyin numfashi ta hanyar shigar hancin hancin; ② Lumen na shigar hancin hanci yana da tsayi kuma diamita na ciki ƙarami ne, don haka wurin da ya mutu yana da girma, kuma fitar ruwa yana da sauƙin toshewa, wanda ke ƙara juriyar hanyar numfashin; ③ Tiyatar a lokacin gaggawa tana ɗaukar lokaci kuma ba abu ne mai sauƙi a yi nasara ba; ④ Yana da wuya a shigar da bututun hancin ta cikin ramin hanci lokacin da bututun hancin ya yi ƙunci.