Ukufakwa kwe-intubation ekhaleni kuvame ukusetshenziswa ezigulini ezinobunzima bokuvula umlomo noma i-laryngoscope ayikwazi ukufakwa, kanye nasezigulini ezihlinzwa ngomlomo, ngakho-ke ukufakwa kwe-intubation okungaboni kuvame ukusetshenziswa. Ukufakwa kwe-intubation okungaboni kumele kugcine isiguli siphefumula ngokuzenzekelayo, kusetshenziswe ukugeleza komoya ukulalela umsindo we-catheter, futhi kushukumise ikhanda lesiguli ukuze kulungiswe indlela i-catheter eqondiswa ngayo ukuze ifakwe ku-trachea. Ngemva kokuhlinzwa, isisombululo esingu-1%****** sakhishwa ekhaleni ukuze kubangele ukufinyela kwemithambo yegazi ye-mucosal. Ngenxa yokuthi indawo ethambekele ye-tracheal tube yayingakwesobunxele, kwakulula ukufinyelela i-glottis ngokufaka i-intubation ekhaleni lesobunxele. Emtholampilo, ikhala lesokudla lisetshenziswa kuphela lapho ukufakwa kwe-intubation ekhaleni lesobunxele kuphazamisa ukuhlinzwa. Ngesikhathi sokufakwa kwepayipi, ukulingisa ukuqeqeshwa kokuvuselelwa kwenhliziyo nokuphefumula kokuphefumula kwe-alar yomuntu ekhaleni kwenziwa kuqala, kwabe sekufakwa i-catheter yokugcoba ekhaleni, iqonde emgqeni we-nasal longitudinal, futhi iphume ekhaleni nge-nasal meatus evamile phansi ekhaleni. Umsindo wokuphefumula omkhulu wawuzwakala usuka emlonyeni we-catheter. Ngokuvamile, isandla sobunxele sasisetshenziselwa ukulungisa isikhundla sekhanda, isandla sokudla sasisetshenziselwa ukufakwa kwepayipi, bese kususwa isikhundla sekhanda. Ukufakwa kwaphumelela kakhulu lapho umsindo wokuhamba komoya we-catheter wawusobala kakhulu kumodeli ye-electronic tracheal intubation. Uma inqubekela phambili ye-catheter ivinjiwe futhi umsindo wokuphefumula uphazamisekile, kungenzeka ukuthi i-catheter ishelele ku-piriform fossa ohlangothini olulodwa. Uma izimpawu ze-asphyxia zenzeka ngesikhathi esifanayo, ikhanda lingase libe lihlehla kakhulu, lifakwe ku-epiglottis kanye ne-tongue base junction, okuholela ekutheni i-epiglottis pressure glottis, njengokumelana kunyamalale, kanye nokuphazamiseka komsindo wokuphefumula, ikakhulukazi ngenxa yokugoba kwekhanda ngokweqile, i-catheter ingene emhubheni. Uma kwenzeka lezi zimo ezingenhla, i-catheter kufanele ihoxiswe isikhashana, futhi isikhundla sekhanda kufanele silungiswe ngemva kokuvela kwemisindo yokuphefumula. Uma ukufakwa kwe-blind okuphindaphindiwe kwakunzima, ama-glottis angavezwa ngomlomo nge-laryngoscope. I-catheter yathuthukiswa ngesandla sokunene yafakwa ku-trachea ngaphansi kokubona okucacile. Ngaphandle kwalokho, isihloko se-catheter singaboshwa nge-forceps ukuthumela i-catheter ku-glottis, bese i-catheter ingathuthukiswa ngo-3 kuya ku-5cm. Izinzuzo zokufakwa kwe-nasotracheal yilezi ezilandelayo: (1) I-nasotracheal tube akufanele ibe nkulu kakhulu, ngoba uma inkulu kakhulu, amathuba okulimala kwe-larynx kanye nendawo engaphansi kwe-glottic aphezulu kakhulu, ngakho-ke ukusetshenziswa kobubanzi obukhulu kakhulu be-tube akuvamile; ② Ukusabela kwe-nasal mucosa ekufakweni kwe-intubation kungabonakala, kungakhathaliseki ukuthi kukhona ukukhuthazwa; ③ I-nasal cannula yalungiswa kangcono, futhi kwatholakala ukushelela okuncane ngesikhathi sokuncelisa nokuphefumula okwenziwe; ④ Ukugoba kwe-cannula yamakhala kukhulu (akukho Angle ebukhali), okunganciphisa ingcindezi engxenyeni engemuva ye-larynx kanye ne-cartilage yesakhiwo; ⑤ iziguli eziphapheme zazizizwa zikhululekile ngokufaka i-nasal intubation, isenzo sokugwinya sasisihle, futhi iziguli azikwazanga ukuluma i-intubation; ⑥ kulabo abanobunzima bokuvula umlomo, kungasetshenziswa ukufaka i-nasal intubation. Okubi yile: (1) Ukutheleleka kungangeniswa emgudwini wokuphefumula ophansi ngokufaka i-nasal intubation; ② I-lumen ye-nasal intubation inde futhi ububanzi bangaphakathi buncane, ngakho isikhala esifile sikhulu, futhi i-lumen kulula ukuyivimba ngokukhipha, okwandisa ukumelana kwendlela yokuphefumula; ③ Ukuhlinzwa esimweni esiphuthumayo kuthatha isikhathi futhi akulula ukuphumelela; ④ Kunzima ukufaka i-nasal intubation lapho i-trachea incane.
Isikhathi sokuthunyelwe: Jan-04-2025