I-Sengstaken-Blakemore Tube

Umxholo

• Xa ityhubhu ye-Sengstaken-Blakemore iyimfuneko?
• Ifakwa njani ityhubhu ye-Sengstaken-Blakemore?
• Ngaba zinokubakho iingxaki ekusebenziseni esi sixhobo?
• Imbonakalo yale nkqubo

Yintoni ityhubhu ye-Sengstaken-Blakemore?

I-Sengstaken-Blakemore (SB) ityhubhu yityhubhu ebomvu esetyenziselwa ukumisa okanye ukucothisa ukuphuma kwegazi kwisisu kunye nesisu. Ukuphuma kwegazi kubangelwa sisisu esiswini okanye esophageal varices, eziyimithambo edumbileyo ngenxa yokungahambi kakuhle kwegazi. Ukwahluka kwetyhubhu ye-SB, ebizwa ngokuba yityhubhu iMinnesota, inokusetyenziselwa ukudodobalisa okanye ukukhupha isisu ukunqanda ukufakwa kwetyhubhu yesibini ebizwa ngokuba yityhubhu ye-nasogastric.

Umbhobho we-SB unamazibuko amathathu kwelinye icala, ngalinye linomsebenzi owahlukileyo:

• I-balloon port esophageal port, efaka ibhaluni encinci kwindawo yomqala
• izibuko lesisu esiswini, esisusa ulwelo kunye nomoya ngaphandle kwesisu
• ibhaluni yesisu esiswini, efaka ibhaluni esiswini

Kwelinye icala ityhubhu ye-SB kukho iibhaluni ezimbini. Xa ufumene, ezi iibhaluni zibeka uxinzelelo kwiindawo ezophayo ukunqanda ukuhamba kwegazi. Umbhobho ufakwa ngomlomo, kodwa unokufakwa ngempumlo ukufikelela esiswini. Oogqirha baya kuyisusa xa ukopha kuyekile.

Xa ityhubhu ye-Sengstaken-Blakemore iyimfuneko?

Ishubhu ye-SB isetyenziswa njengendlela engxamisekileyo yokulawula ukopha kwimithambo edumbileyo yokuqunjelwa. I-Esophageal kunye ne-gastric veins zihlala zidumba ukusuka kwi-portal hypertension okanye ukuxinana kwe-vascular. Okukhona imithambo idumba, kokukhona imithambo iya kuphuka, ibangele ukopha kakhulu okanye ukothuka ekuphulukaneni negazi elininzi. Ukuba ukushiywa kungakhange kunyangwe okanye kunyangwe emva kwexesha, ukulahleka kwegazi okugqithisileyo kunokubangela ukufa.

Ngaphambi kokukhetha ukusebenzisa ityhubhu ye-SB, oogqirha baya kuzikhupha zonke ezinye iindlela zokucothisa okanye zokuyeka ukopha. Obu buchule bunokubandakanya i-endoscopic variceal banding kunye nenaliti yeglue. Ukuba ugqirha ukhetha ukusebenzisa ityhubhu ye-SB, iza kusebenza okwethutyana.

Kwezi meko zilandelayo, oogqirha bacebisa ngokuchasene nokusebenzisa ityhubhu ye-SB:

• Ukopha kwe-Variceal kuyayeka okanye kuyacothisa.
• Isigulana kutsha nje besenziwe utyando olubandakanya umqala okanye izihlunu zesisu.
• Isigulana sinomqala ovaliweyo okanye oncitshisiweyo.

Ifakwa njani ityhubhu ye-Sengstaken-Blakemore?

Ugqirha unokufaka ityhubhu ye-SB ngeempumlo, kodwa kunokwenzeka ukuba ifakwe ngomlomo. Ngaphambi kokufaka ityhubhu, uhlala u-intubated kwaye uhambisa umoya ngendlela efanelekileyo ukulawula ukuphefumla kwakho. Unikwa ulwelo lwe-IV ukugcina ukujikeleza kwegazi kunye nevolumu.

Ugqirha emva koko ujonga ukuvuza komoya kwiibhaloni zesisu kunye nesisu esiswini esifunyenwe ekupheleni kwetyhubhu. Ukwenza oku, bafaka iibhaluni kwaye bazibeke emanzini. Ukuba akukho kuvuza komoya, iibhaluni ziya kuncitshiswa.

Ugqirha kufuneka afake ityhubhu yes Salem kule nkqubo yokukhupha isisu.

Ugqirha ulinganisa le mibhobho mibini ukuqinisekisa ukubekwa ngokuchanekileyo esiswini. Okokuqala, ityhubhu ye-SB kufuneka ibekwe ngokufanelekileyo esiswini. Emva koko balinganisa ityhubhu yesump yaseSalem ngokubhekisele kwityhubhu ye-SB kwaye bayimakisha kwindawo oyifunayo.

Emva kokulinganisa, ityhubhu ye-SB kufuneka ithambise ukuthambisa inkqubo yokufaka. Umbhobho ufakwa de uphawu olwenziwe ngugqirha lube kwiintsini zakho okanye ekuvuleni umlomo.

Ukuqinisekisa ukuba ityhubhu ifikelela esiswini sakho, ugqirha uyifaka ibhaluni yesisu ngesuntswana lomoya. Baye basebenzise iX-ray ukuqinisekisa ukubekwa ngokufanelekileyo. Ukuba ibhaluni enomoya ibekwe ngokuchanekileyo esiswini, bayifaka ngomoya owongezelelweyo ukufikelela kuxinzelelo olufunwayo.

Nje ukuba bafake ityhubhu ye-SB, ugqirha uyidibanisa kubunzima bokutsalwa. Ukuchasana okongeziweyo kunokubangela ukuba ityhubhu yolule. Kule meko, kufuneka baphawule inqaku elitsha apho ityhubhu ishiya umlomo wakho. Ugqirha kuya kufuneka ayitsale ityhubhu ngobunono ade azive exhathisa. Oku kubonisa ukuba ibhaluni ifakwe ngokufanelekileyo kwaye ifaka uxinzelelo ekuphumeni kwegazi.

Emva kokuziva uxhathise kwaye ulinganisa ityhubhu ye-SB, ugqirha ufaka ityhubhu yesampuli yeSalem. Zombini ityhubhu ye-SB kunye ne-Salem sump tube zikhuselekile emva kokubekwa ukuthintela intshukumo.

Ugqirha usebenzisa ukutsala kwizibuko le-SB aspiration kunye ne-Salem sump ukususa naliphi na ihlwili legazi. Ukuba ukuphuma kwegazi kuyaqhubeka, banokunyusa uxinzelelo lwamaxabiso. Kubalulekile ukuba ungagqithisi ibhaluni yokuvuthwa ukuze ungaphumi.

Xa ukopha kuyekile, ugqirha wenza la manyathelo okususa ityhubhu ye-SB:

1. Cazulula ibhaluni yokuxhalaba.
2. Susa ibambelele kwityhubhu ye-SB.
3. Cazulula ibhaluni yesisu.
4. Susa ityhubhu ye-SB.

Ngaba zinokubakho iingxaki ekusebenziseni esi sixhobo?

Kukho iingozi ezimbalwa ezinxulunyaniswa nokusebenzisa ityhubhu ye-SB. Unokulindela ukungakhululeki kwinkqubo, ngakumbi umqala obuhlungu ukuba ityhubhu ifakwe ngomlomo. Ukuba ibekwe ngokungachanekanga, ityhubhu ye-SB inokuchaphazela amandla akho okuphefumla.

Ezinye iingxaki ezivela ekubekeni ngokungalunganga le tyhubhu okanye iibhaluni ezaphukileyo zibandakanya:

• hiccups
• intlungu
• ukopha okuphindaphindiweyo
• i-aspiration pneumonia, usulelo olwenzeka emva kokuphefumla ukutya, ukugabha, okanye amathe emiphungeni
• Izilonda zomqala, xa kukho izilonda ezibuhlungu kwinxalenye esezantsi yomqala
• izilonda zangaphakathi, okanye izilonda ezakha inwebu yangaphakathi
• isithintelo esibuhlungu se-laryngeal, okanye ukuvalwa kwindlela yakho yomoya ethintela ukutya kweoksijini

Imbonakalo yale nkqubo

Ityhubhu ye-SB sisixhobo esisetyenziselwa ukunqanda ukopha kwisisu sakho nakwisisu. Ihlala isetyenziswa kwiimeko zongxamiseko kwaye kuphela ixesha elifutshane. Oku kunye neenkqubo ezifanayo ze-endoscopic zinezinga eliphezulu lokuphumelela.

Ukuba unemibuzo malunga nale nkqubo okanye unamava obunzima, thetha ngezinto ezikuxhalabisayo kugqirha.