Ngaphambili kunye umva tamponade impumlo: ezibonisa kunye nenkcazelo inkqubo

tamponade ngeempumlo isetyenziswa Unxunguphalo ENT ukunqanda ukopha ngeempumlo of etiologies ezahlukeneyo. Ke ukuba tamponade ngaphambili - inkqubo eqhelekileyo kakhulu, ngasemva kuphela "abanyuliweyo." Abo igazi akafuni ayeke ngenxa yaso nasiphi na isizathu, okanye abo umonakalo emibi kakhulu kunokuba kubonakala xa efika kuqala.

epistaxis

ngeempumlo ebizwa ukopha evela lweHo- ngeempumlo, apho ulwelo aqukuqela yempumlo phezu kobuso okanye choanae kumva womqala. Kukho iindidi ezimbini ukopha: ngaphambili nangesemva. Kwezinye iimeko, igazi ungena bile nasolacrimal (ngenxa isiphumo sokufunxa), kwaye aphuma ngokusebenzisa kwisokethi iliso. Oku kulahlekisa amangqina le nto amagqirha nokunika uncedo lokuqala.

igazi kunye negazi egazi Fresh ukuze bawe phakathi kuvuleke iminxunya kungena esiswini, ebangela yimvakalelo isicaphucaphu okanye ukugabha nokuba. kunqabile kakhulu nokopha lunokubulala. Le ncwadi ithetha inkokheli Attila, ngubani belivile phezu igazi lakhe ephupheni ngobusuku ngomtshato wabo.

tamponade ngeempumlo iyafuneka ukuze ayeke ukopha ngeempumlo. Mhlawumbi ukulahleka ulwelo ngaxeshanye kunye encinane, kodwa ubukho iingxaki le meko yongxamiseko.

izizathu

inkqubo yokukhetha (cipande okanye ngomva ngeempumlo tamponade ifuna isigulane) kuxhomekeke apho kwizikhephe yonakele. Le isibaluli kuphela. Kodwa apha izinto kungabangela nokopha kakhulu lukhulu. Zahlula-hlulwe zasekuhlaleni zenkqubo.

Local ziquka:

• ukulimala empumlo;
• namaqumrhu angaphandle;
• nokudumba ekweneni inwebu kwiinwebu ezi zicatshulwa ngeempumlo.

Ezi zinto zintathu ixhaphakileyo ezibangela nokopha. Kukho bumane:

• deformation yokwakheka;
• iziyobisi inhalation;
• iinkqubo cancer em- ngeempumlo;
• umoya obandayo and owomileyo;
• kakubi ngamathontsi abanomkhuhlane oqhelekileyo;
• barotrauma kwegazi.

izinto systemic ziquka allergies, ukwanda abasisigxina uxinzelelo lwegazi, ubukho njengomkhuhlane. Ngaphezu koko, ukopha ukusuka impumlo leswikulu iziyobisi nonsteroidal anti-ukudumba, utywala, kukho iingxaki kunye nenkqubo coagulation, iivithamini C kunye K imibala, izifo systemic sokuhlasela.

pathophysiology

Ukuvula ukopha, kufuneka ukonakalisa udonga inqanawa. Le inwebu kwiinwebu impumlo kakuhle kakhulu vascularized, ngoko nkqu isicelo encinane amandla elaneleyo igazi kuphalala.

Kaninzi nokopha kwenzeka kubantwana abangaphantsi kweminyaka elishumi ubudala kwaye ebantwini phezu zaba ngamashumi omathandathu, ngokuqhelekileyo abantu.

Ngokuchasene imvelaphi ukopha koxinzelelo oluphezulu kwenzeka ngokuqhutywa ngumdla kwaye inokuba kakhulu elide, ukuba ixesha na ukuthatha inyathelo. Xa ebudaleni i uxakaxa kangangokuba ezingcakacileyo ukuba nkqu ngeenkqubo ezisisiseko umzimba kungabangela komsipha benqanawa.

Ngowe-95% yomthombo ukopha ekudibaneni ngeempumlo anteroinferior ngokwahlukana. Kukho ebizwa ngokuba yi-Kisselbahovo plexus. Kukhona "umqondiso" ukopha. Bona luphawulwa spontaneity, kwaye intaphane ixesha elifutshane. Kwezi ziganeko ukuze ngenxa yomonakalo izitya enkulu phezu kobuso, komsipha kwemithambo okanye kobungxowa ithumba.

Phambi ekhaleni tamponade

Impumlo tamponade ngaphambili ukuba ukopha osetyenziswa rhoqo. "Uthando" inkqubo zonyango elabangela kukuba kwiimeko ezininzi, zonakaliswe izitya phambi lweHo- ngeempumlo, kunye nemfuneko kwezinye iindlela musa.

Njengomgaqo, abanjalo ukopha hayi izifo ezizimeleyo. Bathi - iimpawu kuphela utshintsho umzimba wonke ngayo. Ngoko ke, ukopha rhoqo nezolo kufuneka ucinge ngoko ezinye eziye zenzeka xa impilo yakho kwaye ingaba kukho isizathu ukukhangela kwagqirha.

umyalezo weimeyile

Yaba oonobangela ebuhlungu ukopha. Ziquka konzakale nasiphi na imvelaphi, kuquka utyando. Kananjalo kukho izizathu ibonisa ukuba sizibandakanya abonakalisa kwezifo systemic kunye yokwakheka ingqibelelo ngeempumlo.

Abafazi ephawulwe konkomentiruyuschie (okt ezibhalwa ngaxeshanye kunye sexesheni) kunye ngokuzibona (oko kukuthi, ngokubuyisela umsebenzi sexesheni) ukopha. Indlela yokuba nokudaleka kodwa ayikaqondwa.

Kunjalo, yintoni unobangela igazi iivesi ngeempumlo, qiniseka ukuba ukuyeka isikhathi saso.

Iindlela ukunqanda ukopha esuka empumlweni

Namhlanje, zininzi iindlela ukunqanda ukopha. Ukukhetha ixhomekeke massiveness ikwabangela yale meko. Akunjalo njenge ndlela iphambili iza kusetyenziswa impumlo tamponade. isiqabu of algorithm elophayo iqulathe la manyathelo alandelayo:

1. Funa ukopha.
2. Ukumisela unobangela.
3. Chonga isitya yonakele.
4. Stop ezophayo ngendlela lula yaye ngokukhawuleza.
5. Hlola ubume umguli.

Lungisa naziphi na nokopha okuncinci ngezi ndlela zilandelayo:

1. tamponade impumlo. Le nqubo ilula: le mithambo turbinate kuhlatywa okanye yomqhaphu igozi buzane-3% hydrogen peroxide.

2. yokunyakamisa a turunda yomqhaphu vasoconstrictor ilahla khona, uze ungene kwi sicatshulwa ngeempumlo, igazi avela kuyo.

3. Cela isigulane ukuba ukuthatha ukuphefumla nzulu impumlo, nokukhupha umlomo wakho ngaxeshanye ukuba umkhenkce phezu ibhulorho empumlweni kunye nentamo.

Ekwenzeni naziphi na iinkqubo isigulane kufuneka ahlale okanye uthathe isiqingatha indawo tye esehlisa intloko yakhe phambili. Oku kwenzelwa ukuqinisekisa ukuba igazi akuthethi numb ngasemva womqala ukuya isisu.

Izixhobo phambi tamponade

Ukuba zonke iindlela ngasentla olungasebenziyo, uqhuba i impumlo tamponade ngaphambili. Izixhobo ngayo ilula ukuqalisa. Ubukhulu becala Ugqirha kufuneka wenze zomzimba basekuhlaleni lidocaine nakumarhanana okanye novocaine (ngaphambili kuqhutywa allergoproby course). Ke ugqirha ufaka ibe ukopha stroke igozi engenazintsholongwane zifakwe iziyobisi hemostatic okanye Vaseline, linamafutha aqholiweyo. ubude igozi ibe malunga asixhenxe iisentimitha, kodwa ububanzi - isiqingatha kuphela. Turunda afakwe emilise ikhodiyani ukwenzela ukugcwalisa ngokupheleleyo lweHo- ngeempumlo.

Loo tampon Okuseleyo phantse ezintathu iintsuku, wazisusa ekupheleni kweli xesha. Xa ukopha ngakumbi kakhulu, igozi kungashiywa iintsuku ezisixhenxe, kodwa kule meko kufuneka ogalelwe ioli nesisombululo elwa aminocaproic acid.

Izinto ezibangela tamponade emva

Impumlo tamponade wangaphambili unganikeli iziphumo ezilindelekileyo. Okanye umthombo ukopha kunokuba ibe ngaphezulu kunoko bekulindelwe kuqala. Kwiimeko ezinjalo babhenele nangaphezulu ixesha elide, kodwa indlela ephumelelayo.

Ngasemva tamponade impumlo yenzelwa ukunqanda ukopha ngeempumlo, ukuba:

1. Le isigulane igalelo ngqo empumlweni okanye ngeempumlo sicatshulwa ezikhuphile umzimba amazwe.
2. Ukuba ukopha kubangelwa nokuthimliswa elide ukugeleza okanye sinusitis.
3. Kwiimeko apho uxinzelelo lwegazi oluphezulu systemic akuthethi bawa phantsi iindonga isitya kwaye uthintele ukuyilwa ihlwili legazi.
4. Unobangela ukopha - ithumba, uhageleyo.
5. Isigulana unesifo igazi.

Technique ngeempumlo tamponade

Qhuba le entamo iyakwazi nje umntu oqeqeshelwe, musa ukuzama self-medicate ekhaya. Ukongeza kugqirha kwesi senzo kwakubandakanya abantu ababini okanye abathathu. Omnye wabo efunekayo ukuze zigcine indawo echanekileyo zentloko yesigulane. Elesibini kuthatha ilaphu kwaye kubanceda ukuba ukulungisa, kwaye eyesithathu kulungiselela ilaphu ezintsha ludlolo, xa kukho imfuneko.

Phambi kokuba uqale inkqubo, isigulana ilawulwa na, sine lokuphumla yena ukunciphisa reflex gag. Emva koko, le kwisisu ngomlomo ngokusebenzisa catheter ethambileyo ifakiwe impumlo, ogalelwe ioli ube mnye ioli vaseline wawuqalekisa. Ekupheleni kwale ityhubhu iyavalwa igozi ngobukhulu ezifanelekileyo. Ngomhla kwasala has imisonto emithathu: ezimbini wayifaka catheter, yaye omnye uhlala emlonyeni, uze emva koko eqhotyoshelwe kule isiziba emhlathini. Inyathelo elilandelayo - ekususeni catheter nge empumlweni. Kulo mzekelo, i swab licinezelwe ku UJoan livale ngokupheleleyo le nasopharynx. Emva koko, yenza tamponade ngaphambili kwaye lenzeka ngaphambili i imigca emibini. Susa kwasala kunye emveni kweentsuku ezimbini okanye ezintathu.

ukungaphili

Tamponade le lweHo- ngeempumlo, kwakunye naziphi na ezinye nokuqhathwa kungabangela iingxaki. Phakathi kwezi into ezifana necrosis le isifo ngeempumlo. Oku kwenzeka ngenxa yokuba ucinezelo elide kwimikhumbi kunye luvo ngexesha sesichengeni turundy. Ingxaki yesibini inokuba exacerbation ubovu okanye uphuhliso zezifo sinuses (sinusitis maxillary, sinusitis), ekubeni igazi kunye igozi amele i medium elungileyo lokukhula amagciwane.

Kwiimeko ezimbaxa, lo tamponade ngasemva kunokubangela deformation impumlo kunye zekhala ngeempumlo. Ukongeza, uthomalaliso kungabangela ukuyilwa kwento hematoma okanye ekudibaneni yokubolisa ngenxa ukunyibilika abazibandakanya usulelo yesibini.