Iyo Sengstaken-Blakemore Tube

Zvemukati

• Sengstaken-Blakemore tube inodiwa riini?
• Inoiswa sei Sengstaken-Blakemore chubhu?
• Pane zvingangonetsa pakushandisa chishandiso ichi?
• Maonero eiyi maitiro

Chii chinonzi Sengstaken-Blakemore tube?

Iyo Sengstaken-Blakemore (SB) chubhu tsvuku chubhu inoshandiswa kumisa kana kunonoka kubuda ropa kubva mudumbu uye mudumbu. Kubuda ropa kunowanzo kukonzerwa negastric kana esophageal varices, ayo ari tsinga dzakazvimba kubva pakuvhiringidzwa kweropa kuyerera. Misiyano yeSB chubhu, inonzi iyo Minnesota chubhu, inogona zvakare kushandiswa kudzikamisa kana kudurura dumbu kudzivirira kuisirwa yechipiri chubhu inonzi nasogastric tube.

Iyo SB chubhu ine matatu madoko kune mumwe mugumo, imwe neimwe iine rakasiyana basa:

• esophageal balloon port, iyo inokwidza kabhaluni diki mune yegurokuro
• gastric aspiration port, inobvisa mvura uye mweya kubva mudumbu
• gastric balloon chiteshi, iyo inosimudzira bharuni mudumbu

Kune rumwe rutivi rweSB tube kune mabhaluni maviri. Kana yafemerwa, aya mabhaluni anoisa kumanikidza kunzvimbo dziri kubuda ropa kumisa kuyerera kweropa. Iyo chubhu inowanzo kuiswa kuburikidza nemuromo, asi inogona zvakare kuiswa kuburikidza nemhino kusvika mudumbu. Vanachiremba vanozoibvisa kana ropa ramira.

Sengstaken-Blakemore tube inodiwa riini?

Iyo SB chubhu inoshandiswa senzira yechimbichimbi yekudzivirira kubuda kweropa kubva kuzvimba tsinga dzesophageal. Esophageal uye gastric mutsinga zvinowanzozvimba kubva kune portal hypertension kana kushushikana kwevascular. Kana tsinga dzikanyanya kuzvimba, ndipo panonyanya kutsemuka mutsinga, zvichikonzera kubuda ropa zvakanyanya kana kuvhunduka kubva pakurasikirwa neropa rakawandisa. Kana ikasiiwa isina kurapwa kana kurapwa zvakanyanya, kurasikirwa kweropa kwakanyanya kunogona kukonzera kufa.

Vasati vasarudza kushandisa iyo SB chubhu, vanachiremba vanopedza dzimwe nzira dzese kunonoka kana kumira kubuda ropa. Aya matekiniki anogona kusanganisira endoscopic variceal banding uye glue majekiseni. Kana chiremba akasarudza kushandisa iyo SB chubhu, inoshanda chete kwenguva pfupi.

Muzviitiko zvinotevera, vanachiremba vanopa zano pamusoro pekushandisa iyo SB chubhu:

• Variceal kubuda ropa kunomira kana kunonoka.
• Murwere nguva pfupi yadarika akavhiyiwa ane esophagus kana mhasuru dzemudumbu.
• Murwere ane dumbu rakavharika kana kutetepa.

Inoiswa sei Sengstaken-Blakemore chubhu?

Chiremba anogona kuisa SB chubhu kuburikidza nemhino, asi zvinonyanya kuiswa mukati memuromo. Usati waisa iyo chubhu, iwe unowanzo kuve wakakomberedzwa uye neanogadzirwa nemhepo kudzora kufema kwako. Iwe unopihwawo IV mvura kuti uchengetedze kutenderera kweropa uye huwandu.

Chiremba anobva atarisa kubuda kwemhepo mune esophageal uye gastric balloons anowanikwa panoperera chubhu. Kuti vaite izvi, ivo vanofutisa mabharuni uye voaisa mumvura. Kana pasina mweya unodonha, mabhaluni anozobviswa mweya.

Chiremba anodawo kuisa Salem sump tube yeiyi nzira yekudonha dumbu.

Chiremba anoyera aya maviri machubhu kuti ave nechokwadi chekuiswa chaiko mudumbu. Kutanga, iyo SB chubhu inofanirwa kuve yakanyatsoiswa mudumbu. Ivo vanotevera kuyera iyo Salem sump chubhu yakanangana neSB chubhu uye voimaka panzvimbo yaunoda.

Mushure mekuyera, iyo SB chubhu inofanirwa kuvezwa kuti isapindire maitiro. Iyo chubhu inoiswa kusvikira mucherechedzo wakaitwa nachiremba uri pamatadza ako kana kushama kwemuromo wako.

Kuti uone kuti chubhu inosvika mudumbu mako, chiremba anofuridza chibharumu chegastric nemhepo shoma. Ivo vanobva vashandisa X-ray kusimbisa kuiswa kwakakodzera. Kana chibharumu chakazara mweya chakamiswa mushe mudumbu, vanochiputira nemweya wekuwedzera kuti usvike padanho raunoda.

Kana vangoisa iyo SB chubhu, chiremba anoibatanidza kune huremu hwekutambisa. Kuwedzera kuramba kunogona kukonzera kuti chubhu itambanuke. Mune ino kesi, ivo vanofanirwa kutara iyo points nyowani apo chubhu inosiya muromo wako. Chiremba anodawo kudhonza chubhu zvinyoro nyoro kusvikira vanzwa kuramba. Izvi zvinoratidza kuti chibharumu chakanyatsofutirwa uye nekumanikidza kubuda kweropa.

Mushure mekunzwa kuramba uye kuyera iyo SB chubhu, chiremba anoisa iyo Salem sump chubhu. Zvese zviri zviviri SB chubhu neSalem sump chubhu inochengetedzwa mushure mekuiswa kudzivirira kufamba.

Chiremba anoshandisa kukweva kuchiteshi cheSB chinoshuvira uye Salem sump kubvisa chero ropa rakagwamba. Kana kubuda ropa kuchienderera, vanogona kuwedzera kukwira kwemitengo. Izvo zvakakosha kuti usanyanya kuwedzeredza iro bharumu esophageal kuti rirege kubuda.

Kana iko kubuda kweropa kwamira, chiremba anoita nhanho idzi kubvisa iyo SB chubhu:

1. Deredza bhaluni yesophageal.
2. Bvisa traction kubva kuSB tube.
3. Deredza bhaluni yegastric.
4. Bvisa iyo SB chubhu.

Pane zvingangonetsa pakushandisa chishandiso ichi?

Pane njodzi shoma dzinosanganisirwa nekushandisa iyo SB chubhu. Iwe unogona kutarisira kumwe kusagadzikana kubva munzira, kunyanya huro huro kana iyo tube yakaiswa kuburikidza nemuromo. Kana ikaiswa zvisizvo, iyo SB chubhu inogona kukanganisa kugona kwako kufema.

Zvimwe zvinonetsa kubva pakuisa zvisizvo iyi chubhu kana mabharuni akaputika anosanganisira:

• hiccups
• kurwadziwa
• kubuda ropa
• aspiration pneumonia, chirwere chinoitika mushure mekufema chikafu, kurutsa, kana mate mumapapu
• esophageal ulceration, apo maronda anorwadza anoumba muchikamu chezasi chegurokuro
• mucosal ulceration, kana maronda anoumba pane mucous membranes
• kuvharira kwakanyanya, kana kuvharika munzira dzako dzepamhepo dzinotadzisa oxygen kudya

Maonero eiyi maitiro

SB chubhu mudziyo unoshandiswa kumisa kubuda kweropa mudumbu rako uye mudumbu. Iyo inowanzo shandiswa mune emergency mamiriro uye chete kwenguva pfupi yenguva. Iyi uye yakafanana endoscopic maitiro ane yakanyanya kubudirira mwero.

Kana iwe uine mibvunzo nezve iyi maitiro kana wakasangana nematambudziko, kurukura zvaunonetseka nachiremba.