Tracheostomy chirongwa chekuvhiya chetrachea kuti uvandudze kufefetedza kwemhepo uchishandisa mhepo inofefetera. Kupindira uku kunogona kuitwa mune imwe nhamba yemamiriro ezvinhu uye kunyanya mukutarisira kwakanyanya. 

Tracheostomy inosanganisira kugadzira kaburi kadiki mudokoriro uye kuisa kanula kadiki mukati maro, iyo inovandudza kufefetera (kupinda nekubuda kwemhepo mumapapu), ine kana isina muchina. Ichi chiito chinopfuura chepamusoro chekufema turakiti (mhino nemuromo). Mhepo haichadi kupfuura nemumhino kana mumuromo kuti isvike kumapapu. Iyo tracheostomy inogona kuva yekusingaperi kana yenguva pfupi.

Kugadzirira tracheostomy

Kana iyo tracheostomy isingaitwe mumamiriro ekukurumidzira, inotungamirwa nekubvunza anesthesia. 

Ko tracheostomy inoitwa sei?

A tracheostomy inogona kuitwa kuvhiyiwa pasi peanesthesia yakawanda kana percutaneously pasi peanesthesia yemunharaunda.

Kune tracheostomy yekuvhiya, incision inoitwa pamwero wetrachea pakati pe2nd uye 4th cartilage zvindori. Tracheostomy cannula inozopinzwa mutrachea kuburikidza neino orifice.

A percutaneous tracheostomy inoitwa pasi peanesthesia yemunharaunda, dzimwe nguva nekuwedzera sedation, pamubhedha wemurwere mukutarisira kwakanyanya uye kwete muchikwata chekuvhiya. Muchiitiko ichi, hapana ganda rekucheka. The trachea inobaiwa netsono. Iri tsono rinoshandiswa kupfuudza gwara rakaomarara iro rinounzwa hombe uye hombe dilator kusvika dzasvika padhayamita yecannula. 

Mukukurumidzira kwakanyanya, tracheostomy inogonawo kuitwa pasi peanesthesia yemunharaunda kunze kwekamuri yekuvhiya.

Provisional tracheostomy inoratidzwa mukukurumidzira kwakanyanya mumamiriro ekumusoro kwekuvhara kwemhepo (asphyxia) apo tracheal intubation isingakwanisi kana kupesana.

Tracheostomy yenguva pfupi inogonawo kuitwa kugadzirira kuvhiyiwa kwelaryngeal kana pharyngeal, kukurira intubation yakaoma panguva yeanesthesia, kubvumira kufefetera kwenguva refu mumunhu ari mukutarisira kwakanyanya. 

A definitive tracheostomy inogona kuitwa muvanhu vane advanced chronic breathing failure, in case of central or peripheral anomaly of the oropharyngeal junction (mouth-pharynx) nedambudziko rokumedza kana pakaitika zvirwere neuromuscular (senge myopathy) umo kupera simba tsandanyama dzekufema kana kukanganisa mukudzora kwavo kunoderedza kugona kwekufema uye kunoda rubatsiro rwekufema. 

Migumisiro yekupindira uku haiwanzoonekwa sekurwadziwa. Analgesics inopihwa mushure mekuvhiyiwa inobvisa chero marwadzo. Mumazuva mashoma ekutanga, cannula inogona kutsamwisa kana kukonzera reflex kukosora. Zvinotora mazuva akati wandei kuti ujaire tracheostomy chubhu uye mavhiki akati wandei kuti usanzwe zvachose. Tracheostomy haidzivisi kutaura kana kudya pamwe nekugadzirisa. 

Kurarama netracheostomy

Kana iyo tracheostomy ichinyatsojeka (muchiitiko chepamusoro chisingagumi kufema kukundikana kana kana chiitiko chechirwere cheuromuscular, somuenzaniso), tracheotomy inosangana senhanho yakaoma. kutendeseka kwake kwomuviri, tarisiro yokurarama nezvinetso zvakawanda. Zvisinei, kunounza zvikomborero. Kufema kunonyanya kugadzikana neiyi invasive ventilation pane isina-invasive ventilation. 

Vanamazvikokota vezvehutano vanodzidzisa varwere vetracheostomy neavo vakavapoteredza kuti chii chinodiwa kutarisirwa: kuchinja cannula, kutarisira gonhi retrachea, endotracheal aspirations… Vanogona kudzidzisa avo vakavapoteredza kuita izvi. 

Kuziva : Kana tracheostomy iri kwenguva pfupi, kubviswa kwecannula kunobvumira kuvhura kwe pharynx kuvhara mukati memazuva.