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Hydrothorax

Hydrothorax (pleural effusion) are often complicates the course of disseminated tumor. Frequently the cause of fire: kantseromatoz pleura, lymph violation snaslidok metastatic mediastinal lymph nodes, supporting cardiogenic pathology.

Hydrothorax greatly enhances the patient's condition, manifesting painful dyspnea and respiratory insufficiency. On physical examination bugged weakened sharply against the backdrop of breath shortening percussion. Radiographically determined eclipse corresponding part of the chest, which merges with the shadow of the diaphragm. If the pleural cavity is defined horizontal level, it is about hidropnevmotoraks.

Conservative therapy for hydrothorax conducted on the same principles as in ascites. However, the only effective way to eliminate it is pleural puncture with evacuation of fluid. This manipulation should be performed by a medical expert in a hospital or clinic, equipped with X-ray equipment. In extreme cases, for special reasons (non-transportable condition of the patient), pleural puncture can be performed at home. The doctor performing such manipulation should be aware of the risk of complications related to pleural puncture (pneumothorax, bleeding) and be ready to eliminate them in nelikarnyanyh conditions. Mandatory rules is to monitor patients for 1.5-2 hours after puncture for early diagnosis of pneumothorax. When suspected his development to X-Ray.

Permanent thoracostomy is used quite often in the case of pnevmohidrotoraksu or if unsuccessful conservative treatment of pleurisy. Patients with pleural drainage may, if necessary, be located at home. Caring for them includes prevention of infection and ensure hermetyzmu (drainage by Byulau), under the constant supervision of the surgeon.

Fistula

Fistulas (fistula) - abnormal connection between hollow organs (esophageal-tracheal, gastrointestinal, rectal, vaginal, rectal-mihurna etc.) between hollow organs and skin (biliary, intestinal, urinary) between pathological cavity and hollow organ or skin (pus, ligature fistulas, etc.). Voles are also different stoma (Tracheostomy, Gastrostomy, Colostomy, etc.). Voles can be artificial (iatrogenic) or develop as a result of pathological processes. There are also hubovydni fistulas - are lined with mucous such fistula itself is not closed. The main problems that arise in the presence of fistulas associated with indigestion and abnormal secretions. Palliative care for patients with fistulas includes the following highlights: permanent collection secretions, skin care and its protection, anti-odor, keeping calm conditions around the patient.

Esophageal-tracheal fistula accompanied by the entry of food into the airways and, therefore, the development of mammary pneumonia, which quickly leads to a forthcoming tragedy patient. The only real method of providing temporary help such patients - Formation of gastro-enterostomy or.

Gastro-intestinal fistula leads to persistent diarrhea and clinically eructation of fecal odor, nausea, sometimes vomiting feces. Eliminate the gastro-intestinal fistulas can only surgically. If surgery is not possible, the required appointment antidiarrhoeal and antiemetic drugs, ensuring hygienic conditions. Using deodorant air, constant ventilation, delicate treatment of the patient from attending and relatives - helps provide care without developing serious inconvenience.

Mizhkyshkovi thin-tovstokyshkovi fistulas occur more often diarrhea, flatulence and other digestive disorders. Their konservatyne treatment involves the use of individual diet and destination antidiarrhoeal drugs.

Considerable inconvenience cause gastro-vaginal, intestinal-sechomihurni and, especially gastro-vaginal fistula-sechomihurni. Isolation of feces and gases through the urinary ways almost impossible to control and it significantly affects the quality of life of patients. Surgical treatment of such complications remains very difficult problem, and, in most cases, reduces the formation of unloading kolostom care, which is much simpler. Conservative therapy in such cases is to ensure adequate care and protection of the skin around the fistula and their crotch using protective creams and ointments.

With small fistulas with different separating basic care tasks - separating and removing the protection skin. For this purpose, use different ubyrayuchi headbands kalopryyomnyky, protective ointment. Should regularly consult a surgeon for the question of the application of special treatments.

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