Nrog qee cov kab mob ntawm cov kab mob genitourinary ntawm ntau yam etiologies, tib neeg tsis tuaj yeem mus rau chav dej me me ntawm lawv tus kheej. Ib txoj hauv kev zoo tshaj plaws ntawm kev tso zis yog trocar epicystostomy. Thaum lub sijhawm ua haujlwm phais, ib qho kev phais yog ua nyob rau hauv qis ntawm lub plab kab noj hniav thiab ib tug tshwj xeeb catheter yog ntsia, uas yog txuas nrog rau lub tso zis. Qhov kev ntsuas no tuaj yeem ua raws li kev daws teeb meem ib ntus thiab mus tas li. Cia wb mus saib seb qhov txheej txheem niaj hnub no yog dab tsi, nws ua li cas thiab siv lub hom phiaj twg.
Thaum twg tso zis tso zis?
Qhov laj thawj tseem ceeb yog urinary retention (ICD code 10 - Z93.5). Qhov teeb meem no tuaj yeem tshwm sim hauv tib neeg los ntawm ntau yam, tab sis ntawm cov kws kho mob tseem ceeb yog cov hauv qab no:
- mechanical urethral thaiv;
- zais zis tsis ua haujlwm;
- nyob twj ywm hauv cov xwm txheej ntxhov siab;
- kev puas siab puas ntsws;
- qhov txhab mob ntawm lub plab pelvic;
- qaum lossis hlwb raug mob;
- kab mob sib kis thiab kab mob sib kis.
Txawm hais tias yog vim li cas, qhov kev kho mob nkaus xwb yog tso lub tso zis tso zis, txij li kev kho mob rau paradoxical ischuria tsis muaj zog.
Indications rau kev phais
Cia peb saib kom ze rau qhov no. Trocar epicystostomy yog ib txoj hauv kev kho mob feem ntau siv nyob rau hauv niaj hnub urological xyaum. Qhov no yog vim qhov tseeb tias nws tso cai rau koj los daws cov teeb meem loj heev. Ntawm cov lus qhia tseem ceeb rau kev teem caij, cov hauv qab no tuaj yeem paub qhov txawv:
- mob ischuria, uas tso zis hauv txoj hauv kev tsis yooj yim;
- tso zis tso zis tshwm sim los ntawm kev xav tsis thoob;
- tsim cov ntshav txhaws lossis purulent plugs;
- kev puas tsuaj rau lub zais zis;
- benign prostatic hyperplasia;
- cancer;
- Yurethritis;
- ntau lub zais zis pathologies;
- xav tau tshuaj;
- dej ntws ceev;
- kev kho qee yam kab mob gynecological hauv cov poj niam;
- kuaj mob perinatal ntawm anomalies.
Rau ib qho ntawm cov teeb meem saum toj no, tso zis tso zis tso cai rau koj tsimtshem tawm cov zis ntau ntxiv thiab txhim kho tus neeg mob txoj kev noj qab haus huv.
Contraindications rau catheter insertion
Qhov no yuav tsum tau muab qhov tseem ceeb tshwj xeeb. Txawm hais tias nws cov txiaj ntsig zoo, epicystostomy yuav tsis ua rau txhua kis. Ntawm no nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus account cov duab kho mob thiab kev kuaj mob ntawm txhua tus neeg mob. Ntawm cov contraindications tseem ceeb, cov kws tshaj lij tsim nyog paub qhov txawv hauv qab no:
- qis zais zis;
- cystitis thiab paracystitis, tshwm sim hauv daim ntawv mob hnyav;
- thaiv cov hlab ntsha los ntawm cov ntshav txhaws;
- zais zis cancer;
- kev cog lus sphincter;
- nti loj;
- puab tsaig hernia;
- tsis muaj urea;
- mob urethritis;
- kev rog dhau.
Yog tus neeg mob muaj ib yam ntawm cov teeb meem no, tus kws kho mob xaiv lwm txoj kev kho mob raws li daim duab kho mob thiab kuaj pom.
Yuav ua li cas rau kev phais?
Kev kho mob no tsis pub dawb. Nws yog qhov nyuaj rau npe rau tus nqi tshwj xeeb uas cov haujlwm yuav raug nqi. Nws tag nrho yog nyob ntawm seb cov tshuaj twg thiab cov txheej txheem uas tus neeg mob yuav xav tau rau lub sijhawm kho mob. Rau kev phais mob, koj yuav tsum tau yuav ib lub teeb rau trocar epicystostomy. Xws li:
- cystostomy catheter;
- koob nrog mandrel;
- retainer;
- syringe;
- pov tsegscalpel;
- clip.
Ntxiv rau cov txheej txheem tseem ceeb, yuav tsum tau kho cov ntaub qhwv ntsej muag, uas yog siv rau tus neeg mob tom qab kev teeb tsa lub catheter thiab tso zis.
lub zais zis epicystostomy ua li cas?
Cia peb saib kom ze rau qhov no. Kev phais mob rau kev mob urinary retention tsis yog txhawm rau txhim kho kev noj qab haus huv ntawm tib neeg, tab sis cawm nws txoj sia. Tom qab tag nrho, yog hais tias lub zais zis tshwm sim, nws yuav ua rau mob heev tuag. Cov kws kho mob tau mus rau epicystostomy nyob rau hauv cov xwm txheej uas nws tsis tuaj yeem txhim kho lub tso zis rau ib qho laj thawj ntawm tus qauv.
Raws li tau hais los saum toj no, tus neeg mob tau txiav txim siab ntawm lub plab thiab ib qho tshwj xeeb trocar catheter raug teeb tsa. Nws tsis yog tsuas yog lub luag haujlwm rau tshem tawm cov dej khib nyiab ntawm lub cev, tab sis kuj tso cai rau koj nkag mus rau cov tshuaj hauv kev kho mob ntawm ntau yam kab mob.
Kev cuam tshuam kev phais yog ua nyob rau theem. Txawm li cas los xij, ua ntej ua nws, tus kws kho mob yuav tsum paub nws tus kheej nrog keeb kwm kev kho mob, nrog rau tau txais cov txiaj ntsig ntawm qee qhov kev sim ntxiv. Qhov no yog qhov tsim nyog txhawm rau txhawm rau xaiv qhov kev kho mob uas tsim nyog tshaj plaws thiab txo qis qhov tshwm sim ntawm qhov teeb meem. Cov txheej txheem ntawm trocar epicystostomy yog raws li nram no:
- Tus kws phais ua qhov me me hauv qab ntawm lub plab.
- Ib lub tso zis tso zis ntawm cov leeg nqaij thiab tso rau hauv lub zais zis.
- Ib lub raj xa dej nkag los ntawm qhov ntawdtso zis.
- Tus neeg mob tau sutured thiab hnav khaub ncaws tsis muaj menyuam.
Kev ua haujlwm yog ua los ntawm kev siv lub cystoscope, ua tsaug uas txhua qhov kev ua tau ua tiav nrog qhov raug siab.
Qhov tsis zoo ntawm cov txheej txheem
Nyob rau hauv mob urinary retention (ICD code 10 - Z93.5), epicystostomy yog nyob deb ntawm kev kho mob zoo tshaj plaws. Txawm li cas los xij, txoj kev no tsis zoo tagnrho. Nws kuj muaj qee qhov tsis zoo. Raws li cov kws tshaj lij uas tsim nyog, qhov tseem ceeb yog qhov nce rhiab heev ntawm daim tawv nqaij nyob ib ncig ntawm lub catheter. Tab sis ntawm no cov neeg mob lawv tus kheej feem ntau raug liam, uas tsis ua raws li cov qauv kev nyiam huv. Yog tias koj saib xyuas koj tus kheej zoo, ces tus mob no ploj mus ntawm nws tus kheej tom qab ib ntus. Nws kuj tshwm sim tias qee qhov chaw ntawm qhov chaw phais plam qhov kev xav, tab sis nws rov qab los tom qab lub catheter raug tshem tawm. Tsis tas li, qee qhov teeb meem thaum lub sijhawm ua haujlwm tshwm sim thaum tus neeg mob muaj teeb meem nrog kev rog. Nws yog ib qho nyuaj heev rau ntxig ib lub raj los ntawm ib txheej loj ntawm cov ntaub so ntswg adipose.
Qhov tshwm sim ntawm kev ua haujlwm
Hauv kev kho mob, muaj cov xwm txheej thaum, tom qab trocar epicystostomy, cov zis tseem tsis zoo los ntawm lub zais zis. Yog tias koj tsis ua dab tsi thiab tsis mus ntsib kws kho mob ntev, ces qhov no yog fraught nrog cov teeb meem hauv qab no:
- kev txhim kho kab mob sib kis;
- mob pyelonephritis;
- raum mob raum.
Qhov laj thawj tshwj xeeb rau kev txhawj xeeb thiab muaj laj thawj zoo mus ntsib kws kho mobtej zaum yuav khaus thiab hais tau cov tsos mob. Ntawm qhov kev ntxhov siab tshaj plaws yog cov hauv qab no:
- lub cev kub;
- mob plab;
- huab tso zis nrog cov ntxhiab tsw qab;
- reddening ntawm daim tawv nqaij ib ncig ntawm lub catheter;
Nws kuj tsim nyog sab laj nrog tus kws kho mob tshwj xeeb yog tias tso zis tsis nkag mus rau hauv qhov zis ntev. Qhov no yog tshwj xeeb tshaj yog muaj tseeb nyob rau hauv lub zais zis catheterization nyob rau hauv cov poj niam uas muaj menyuam. Congestion thiab o tuaj yeem cuam tshuam rau kev xeeb tub thiab ua rau muaj kev pheej hmoo.
Cov neeg mob ua yuam kev ntau
Tom qab trocar epicystostomy, cov neeg mob yuav tsum ua raws li qee cov cai kom lub sijhawm kho kom rov zoo dua sai sai thiab tsis muaj teeb meem tsim nyog. Qhov loj tshaj plaws yog ntxuav lub catheter. Raws li kws kho mob, rau qhov no, tib neeg siv ntau yam tshuaj tua kab mob, uas yog nruj me ntsis txwv tsis pub, vim qhov no ua rau muaj kev pheej hmoo kis mob. Yog tias urosepsis pib, nrog rau qhov mob ntawm lub zais zis, qhov no tuaj yeem ua rau tuag taus txawm tias koj mus rau tsev kho mob raws sijhawm.
Rules of care
Ib qho tseem ceeb tshaj plaws ntawm kev cuam tshuam kev phais yog kev kho kom rov zoo. Tab sis nws tsis yog nyob ntawm ntau yam kev txawj ntawm tus kws tshaj lij, tab sis ntawm tus neeg mob nws tus kheej thiab nws ua raws li tag nrho cov tshuaj. Rau kev rov qab los ua qhov chawib txwm, kev saib xyuas tshwj xeeb xav tau tom qab trocar epicystostomy.
Cov kua dej thiab catheter yog ua los ntawm cov khoom tshwj xeeb inert, txawm li cas los xij, lawv tseem pom los ntawm lub cev raws li lub cev txawv teb chaws, yog li muaj qhov tshwm sim ntau ntawm kev tsis lees paub lossis kev tsis haum tshuaj, uas, dhau los, tuaj yeem ua rau anaphylactic. poob siab. Txhawm rau zam qhov no, koj yuav tsum ua raws li cov cai hauv qab no:
- Ntxuav koj txhais tes kom huv si nrog xab npum thiab dej ua ntej thiab tom qab tuav koj lub catheter.
- Saib xyuas qib ntawm cov zis hauv qhov tso zis thiab khoob nws raws sijhawm.
- Kho cov zis ntawm lub cev thiab tsis txhob tso rau ntawm qhov chaw qias neeg.
- Disinfect ntws cov ntsiab lus nrog cov tshuaj tua kab mob tshwj xeeb.
- Ntxhis koj cov hniav thaum sawv ntxov thiab yav tsaus ntuj.
Raws li kev da dej lossis da dej, cov txheej txheem dej tsis txwv hauv txoj cai. Tab sis cov kws kho mob qhia kom tsis txhob tawm ntawm lawv mus rau tag nrho lub sijhawm kho mob. Raws li kev xyaum qhia, nws yog vim da dej uas ua xua feem ntau tshwm sim.
Lub neej tom qab kev phais
Bladder puncture deals hnyav rau lub hlwb thiab kev ntseeg tus kheej. Thiab muaj cov laj thawj rau qhov no, vim tias qhov tsis muaj peev xwm mus rau chav dej ntawm koj tus kheej yog kev txaj muag rau txhua tus txiv neej thiab poj niam. Tsis tas li ntawd, qhov muaj qhov tso zis qhia txog qee qhov tsis yooj yim rau tib neeg lub neej txhua hnub. Cov kauj ruam yooj yooj yim hauv qab no yuav pab koj siv nws sai dua thiab nkag mus rau lub suab zoo li qub.tswv yim:
- Koj yuav tsum tau saib xyuas qhov dej tshuav. Kev haus dej kom ntau yuav txo tau qhov tshwm sim ntawm kev tsim cov txheej txheem nyob ruaj khov.
- Koj yuav tsum tso tshuaj yej dub thiab kas fes, dej qab zib thiab cawv ib ntus. Cov dej qab zib no muaj qhov ua rau khaus khaus thiab rov qab qeeb.
- Cov ntawv qhia zaub mov txhua hnub yuav tsum tau hloov kho. Nws yog ib qho tsim nyog kom tsis suav cov khoom qab ntsev, ntsim thiab qaub los ntawm nws. Nws tuaj yeem ua rau cem quav thiab ntau yam teeb meem loj.
Yog tias koj ua raws li kev noj zaub mov zoo thiab ua raws li cov cai ntawm kev nyiam huv ntawm tus kheej, ces yuav tsis muaj teeb meem. Tab sis yog tias koj pom ib qho ntawm cov tsos mob tau piav qhia saum toj no, koj yuav tsum nrhiav kev pab kho mob tam sim.
Hloov lub catheter tom tsev
Nws yog qhov txaus ntshai heev ua qhov no ntawm koj tus kheej, vim tias tsis muaj kev paub thiab kev paub, koj tuaj yeem ua rau lub cev raug mob. Tab sis yog tias qhov kev xav tau tshwm sim, ces hloov raws li cov hauv qab no algorithm:
- Npua lub hnab.
- Puag koj nraub qaum, khoov koj lub hauv caug thiab sib nrug.
- Kho lub raj nrog tshuaj tua kab mob.
- Npua cov ntsiab lus ntawm lub zais pa catheter nrog 10 ml syringe.
- Ua tib zoo tshem lub raj ntawm lub urethra thiab ntxig ib qho tshiab.
Cov lus qhia no siv tau rau txhua tus poj niam txiv neej. Tab sis koj yuav tsum mus rau qhov kev hloov pauv ywj pheej tsuas yog qhov chaw kawg nkaus xwb, thaum tsis muaj lwm txoj hauv kev tawm. Yog tias ua tau, cov txheej txheem yuav tsum tau uaprofiled specialist.
Zoo kawg
Kev tso zis tso zis yog ib qho teeb meem loj uas ua rau muaj kev hem thawj rau tib neeg lub neej. Tab sis ua tsaug rau epicystostomy, cov kws kho mob tuaj yeem kho cov zis tso zis. Coob leej neeg ntshai ntawm qhov kev ua haujlwm no thiab tsis xav mus rau nws, vim lawv tsis paub yuav ua li cas lawv yuav qhia rau tib neeg. Tab sis tsis muaj dab tsi tsis ncaj ncees lawm. Tom qab siv lub tso zis, koj tuaj yeem rov qab mus rau koj lub neej li qub thiab txuas ntxiv ua tej yam qub.
