Kuchenesa mudumbu, kana gastric lavage, chiitiko chinokurumidzira chinoitwa kana paitika kudhakwa kwakanyanya mushure mekumwa nemaune kana netsaona kwechinhu chine chepfu (chinodhaka, chigadzirwa chemumba). Kazhinji inosanganisirwa mukubatana kwekufungidzira pamwe nekuedza kuzviuraya kwezvinodhaka, gastric lavage iri isinganyanyo shandiswa nhasi.

Kuchenesa dumbu, kana gastric lavage (LG), chiito chekukurumidzira chinoitwa nehupfu hwakanyanya. Chinangwa chayo ndechokubvisa zvinhu zvine chepfu zviripo mukati medumbu zvisati zvagadziriswa uye zvichikonzera maronda kana kushandura rimwe remabasa emuviri.

Kuchenesa dumbu ndeimwe yedzinonzi nzira dzekuchenesa dumbu, padivi pe:

• kurutsa kurutsa;
• adsorption yezvinhu zvine chepfu pane activated kabhoni;
• kumhanyisa kwematumbo ekufambisa.

Gastric lavage inoitwa muchipatara, kazhinji mukamuri yekukurumidzira. Iko kusati kwaiswa kwe "chengetedzo" yeparutivi venous nzira inokurudzirwa zvine simba, uye kuvepo kweyekumutsazve ngoro kunomanikidzwa. Vanamukoti vane mvumo yekuita maitiro asi kuvepo kwechiremba kunokosha panguva yekuita. Gastric lavage inogona kuitwa pamunhu anoziva kana ane hurema hwekuziva. Mune ino kesi, iye anozobva apindirwa.

Gastric lavage yakavakirwa pachisungo chekutaurirana ngarava, kana "siphoning", mune iyi nyaya pakati pezviri mukati medumbu uye nekupihwa kwekunze kwemvura.

Probe, inonzi Faucher tube, inosvitswa mumuromo, ndokuzopinda mudumbu kusvikira yasvika mudumbu. Iyo probe inosungirirwa pamuromo netepi, kozoti tulip (chirongo) chakanamirwa kuchirongwa. Mvura yemunyu inodziya inozodururwa muchirongwa, zvidiki zvishoma, uye mvura yekuwachisa inozotorwa nekusvina, pamwe neepigastric massage. Iko kuvhiya kunodzokororwa kudzamara mvura yachena. Mvura yakakura inogona kudiwa (10 kusvika 20 litita).

Kuchengetwa kwemuromo kunoitwa panopera gastric lavage. Kuwedzera gastric lavage, inoshanda marasha inogona kupihwa mushure mekubviswa kwecatheter.

Pese pakuitwa, mamiriro emurwere ekuziva, moyo uye mweya wekufema zvinonyatso kutariswa.

Kuongororwa

Mushure mekugezesa gastric, murwere anotariswa zvakanyanya. Anoiswa panzvimbo akarara nedivi, kuti asarutse. X-ray yechipfuva, ionogram yeropa, ECG uye tembiricha zvinotorwa.

Kugaya basa kuchatangazve zvakasarudzika mushure mekubvisa gastric. 

Njodzi 

Kune njodzi dzakasiyana dzekusuka mudumbu:

• bronchial inhalation ndiyo yakanyanya kuomarara dambudziko, iyo inogona kutyisidzira hupenyu;
• neBP, tachycardia;
• bradycardia yemadzimai mavambo panguva yekuunzwa kwechubhu;
• mazino kana maronda emuromo.

Kuchenesa dumbu kunogona kuitwa:

• mune chiitiko chekuzvidira kudhakwa, ndiko kuti kuedza kuzviuraya zvinodhaka (kana "kudhakwa kwezvinodhaka"), kana netsaona, kazhinji muvana;
• mune zvimwe zviitiko zvekubuda ropa mudumbu, kuongorora kubuda kweropa uye kugadzirisa chirwere chekuongorora endoscopy.

Kana iyo gastric lavage yaive kwenguva yakareba ichionekwa senzira yereferensi yekubvisa zvigadzirwa zvine muchetura, ishoma nhasi. Musangano wekubvumirana muna 1992, wakasimbiswa nekurudziro yeAmerican Academy Clinicat Toxicology uye European Association of Poison Centers uye Clinicat toxicologists, kutaura chokwadi yakaisa zviratidzo zvakasimba zvekugezwa kwegastric nekuda kwenjodzi dzayo, kuderera kwayo kubatsira / njodzi chiyero asiwo yayo. mutengo (iyo nzira inounganidza vashandi uye inotora nguva). Izvi zviratidzo zvinotarisa mamiriro ekuziva kwemurwere, nguva yakapfuura kubva pakumedza uye zvinogona kuitika muchetura wezvigadzirwa zvakamwiwa. Nhasi, gastric lavage inoitwa mune izvi zvisingawanzo zviratidzo:

• muvarwere vanoziva, mune chiitiko chekumwa kwezvinhu zvine huturu hwakanyanya hwekukuvara (Paraquat, Colchicine, iyo yakashandiswa marasha asina simba) kana mune chiitiko chekudhakwa kukuru ne tricyclic antidepressants, chloroquine, digitalis kana theophylline;
• mune varwere vane akachinja kuziva, intubated, mukutarisira kwakanyanya, kana chiitiko chekumwa kwezvinhu zvine huturu hwakanyanya kugona;
• mune varwere vane akachinja kuziva, kwete intubated, mushure mekuyedzwa neFlumazenil (kuona benzodiazepine kudhakwa), mune chiitiko chekumwa kwezvinhu zvine huturu hwakanyanya kugona.

Izvi zvinoratidza kuti hazvisi zvepamutemo. Uye zvakare, ikozvino zvave kugamuchirwa kuti gastric lavage iri, musimboti, haibatsire anopfuura awa imwe mushure mekumwa kwezvinhu zvine chepfu, nekuda kwekushanda kwayo kwakaderera mushure menguva ino yenguva. Muchokwadi, marasha akaomeswa anowanzo sarudzwa pane gastric lavage.

Gastric lavage inopesana mune inotevera kesi:

• chepfu ne caustics (bleach semuenzaniso), mahydrocarbons (white spirit, stain remover, dhiziri), zvinhu zvinopupuma (mvura yekusuka ndiro, hupfu hwekuwachisa, nezvimwewo);
• muchetura neopiates, benzodiazepines;
• yakachinja mamiriro ekuziva, kunze kwekunge murwere akafukidzwa neakafemerwa balloon catheter;
• nhoroondo yekuvhiyiwa gastric (kuvapo kwemavanga emudumbu), gastric ulcer kana esophageal varices;
• kana iri njodzi yekufema, kugwinha, kurasikirwa kwekudzivirira kwekufema kwemhepo;
• vanhu vakura vanovimba;
• mucheche ari pasi pemwedzi mitanhatu;
• njodzi mamiriro hemodynamic mamiriro.