Ishubhu Sengstaken-Blakemore

-Delile

• Ngabe kudingeka ithubhu le-Sengstaken-Blakemore?
• Ifakwa kanjani ithubhu leSengstaken-Blakemore?
• Ingabe zikhona izinkinga ezingaba khona ekusebenziseni le divayisi?
• Umbono wale nqubo

Yini ishubhu le-Sengstaken-Blakemore?

Ishubhu le-Sengstaken-Blakemore (SB) liyishubhu elibomvu elisetshenziselwa ukumisa noma ukwehlisa ukopha okuphuma emphinjeni nasesiswini. Ukopha kuvame ukubangelwa isisu noma isisophageal varices, okuyimithambo evuvukele ngenxa yokuphazamiseka kokugeleza kwegazi. Ukuhluka kweshubhu le-SB, elibizwa ngokuthi yi-Minnesota tube, kungasetshenziselwa ukunciphisa noma ukukhipha isisu ukugwema ukufakwa kweshubhu yesibili ebizwa ngokuthi i-nasogastric tube.

Ishubhu le-SB linamachweba amathathu ngapha nangapha, ngalinye linomsebenzi ohlukile:

• esophageal balloon port, efaka ibhaluni elincane endaweni
• imbobo yokuphefumula esiswini, esusa uketshezi nomoya ngaphandle kwesisu
• i-gastric balloon port, efaka ibhaluni esiswini

Ngakolunye uhlangothi lweshubhu le-SB kunamabhaluni amabili. Lapho enomoya, la mabhaluni afaka ingcindezi ezindaweni eziphuma igazi ukuze kumiswe ukuhamba kwegazi. Ishubhu lifakwa ngomlomo, kepha lingafakwa nangamakhala ukuze lifinyelele esiswini. Odokotela bazoyisusa uma ukopha sekuyekile.

Ngabe kudingeka ithubhu le-Sengstaken-Blakemore?

Ishubhu le-SB lisetshenziswa njengenqubo ephuthumayo yokulawula ukopha emithanjeni yokuvuvukala yokuvuvukala. Imithambo ye-esophageal neyesisu ivame ukuvuvukala kusuka ku-portal hypertension noma isiminyaminya semithambo. Lapho imithambo ikhukhumala, kulapho kungenzeka khona ukuthi imithambo iqhume, kubangele ukopha ngokweqile noma ukushaqeka ekulahlekelweni yigazi eliningi. Uma ishiywe ingalashwa noma yelashwa sekwephuze kakhulu, ukopha ngokweqile kungadala ukufa.

Ngaphambi kokukhetha ukusebenzisa ishubhu le-SB, odokotela bazokhipha zonke ezinye izindlela ukwehlisa noma ukumisa ukopha. Lezi zindlela zingafaka i-endoscopic variceal banding kanye nemijovo yeglue. Uma udokotela ekhetha ukusebenzisa ithubhu ye-SB, izosebenza okwesikhashana kuphela.

Ezimweni ezilandelayo, odokotela bayeluleka ngokusebenzisa i-SB tube:

• Ukopha kwe-Variceal kuyama noma kwehlisa ijubane.
• Muva nje isiguli sihlinzwe sifaka phakathi isisu noma imisipha yesisu.
• Isiguli sinesifo esivinjelwe noma esincishisiwe.

Ifakwa kanjani ithubhu leSengstaken-Blakemore?

Udokotela angafaka ishubhu le-SB ngamakhala, kodwa maningi amathuba okuthi ifakwe ngomlomo. Ngaphambi kokufaka ishubhu, uvamise ukufakwa intubated futhi usebenzise imishini ukuze ukwazi ukuphefumula. Unikezwa futhi uketshezi lwe-IV ukugcina ukujikeleza kwegazi nevolumu.

Udokotela ube esehlola ukuvuza komoya kumabhaluni esophageal kanye nasesiswini atholakala ekugcineni kweshubhu. Ukuze benze lokhu, bafaka amabhaluni bese bewafaka emanzini. Uma kungekho ukuvuza komoya, amabhaluni azoncishiswa.

Udokotela futhi udinga ukufaka ishubhu le-Salem sump kule nqubo yokukhipha isisu.

Udokotela ulinganisa la mashubhu amabili ukuqinisekisa ukubekwa okunembile esiswini. Okokuqala, ishubhu le-SB kufanele libekwe kahle esiswini. Ngokulandelayo balinganisa ishubhu le-Salem sump ngokuqhathanisa neshubhu le-SB bese belimaka endaweni abayifunayo.

Ngemuva kokulinganisa, ishubhu le-SB kumele ligcotshwe ukwenza lula inqubo yokufaka. Ishubhu lifakwa kuze kube yilapho uphawu olwenziwe udokotela lusezinsinini zakho noma ekuvuleni umlomo wakho.

Ukuqinisekisa ukuthi ithubhu lifinyelela esiswini sakho, udokotela ufaka ibhaluni esiswini ngesilinganiso esincane somoya. Bese basebenzisa i-X-ray ukuqinisekisa ukubekwa okufanele. Uma ibhaluni eligcwele umoya libekwe kahle esiswini, balifaka ngomoya owengeziwe ukuze bafinyelele kwingcindezi abayifunayo.

Lapho nje sebeyifakile ishubhu le-SB, udokotela uyixhuma kusisindo sokudonsa. Ukumelana okungeziwe kungadala ukuthi ithubhu iluleke. Kulokhu, badinga ukumaka iphuzu elisha lapho ishubhu lishiya khona umlomo wakho. Udokotela futhi udinga ukudonsa ishubhu kancane baze bezwe ukumelana nako. Lokhu kukhombisa ukuthi ibhaluni ligcwele kahle futhi lifaka ingcindezi ekopheni.

Ngemuva kokuzwa ukumelana nokukala ishubhu le-SB, udokotela ufaka ishubhu le-Salem sump. Kokubili ishubhu le-SB kanye ne-Salem sump tube kuvikelekile ngemuva kokubekwa ukuvimbela ukunyakaza.

Udokotela usebenzisa ukuncela ethekwini le-SB aspiration kanye naseSalem sump ukuze asuse noma yimaphi amahlule egazi. Uma ukuphuma kwegazi kuqhubeka, bangakhuphula ingcindezi yokwehla kwamandla emali. Kubalulekile ukuthi ungaleli ngokweqile ibhaluni lokuqopha ukuze lingaphumi.

Lapho ukopha sekuyekile, udokotela wenza lezi zinyathelo ukususa ishubhu le-SB:

1. Susa ibhaluni lokuqopha.
2. Susa ibambelele kushubhu ye-SB.
3. Khipha ibhaluni esiswini.
4. Susa ishubhu le-SB.

Ingabe zikhona izinkinga ezingaba khona ekusebenziseni le divayisi?

Kunezingozi ezimbalwa ezihambisana nokusebenzisa ithubhu ye-SB. Ungalindela ukungakhululeki kusuka kule nqubo, ikakhulukazi umphimbo obuhlungu uma ishubhu lifakwe ngomlomo. Uma ibekwe ngokungalungile, ishubhu le-SB lingathinta ikhono lakho lokuphefumula.

Ezinye izinkinga ezivela ekubekeni ngokungafanele le tube noma amabhaluni aqhekekile afaka:

• izinqa
• ubuhlungu
• ukopha okuphindelela
• i-aspiration pneumonia, ukutheleleka okwenzeka ngemuva kokuphefumula ukudla, ukuhlanza, noma amathe emaphashini
• ulceration esophageal, lapho izilonda ezibuhlungu zakha engxenyeni engezansi yomhosha
• i-mucosal ulceration, noma izilonda ezakha kulwelwesi lwamafinyila
• ukuvinjelwa okukhulu kwe-laryngeal, noma ukuvinjelwa ezindleleni zakho zomoya okuvimbela ukungena kwe-oxygen

Umbono wale nqubo

Ishubhu le-SB iyithuluzi elisetshenziselwa ukunqanda ukuphuma kwegazi esiswini sakho nasesiswini. Ngokuvamile isetshenziswa ezimweni eziphuthumayo futhi kuphela isikhathi esifushane. Lokhu nezinqubo ezifanayo ze-endoscopic zinezinga eliphezulu lokuphumelela.

Uma unemibuzo mayelana nale nqubo noma uhlangabezane nezinkinga, xoxa ngezinkinga zakho nodokotela.