thoracotomy

The thoracotomy is due to the presence of lesions inside the thoracic cavity and requires a thoracotomy for targeted surgery. Because the chest drainage tube, urinary tube, stomach tube and other pipelines may cause pain or discomfort, it should be properly fixed. When the patient sits up or turns over, pay attention to keep the pipeline in sync with the body, prevent the pipeline from pulling, twisting, stimulating the wound and aggravating the pain. Change position, cough and other activities: postoperative semi-recumbent position, not only facilitate drainage, but also reduce the knife edge tension and reduce pain. Basic Information Specialist Category: Inspection Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to normal eating habits and pay attention to personal hygiene. Normal value The body is healthy and healthy. There is no disease. Clinical significance Because the chest drainage tube, urinary tube, stomach tube and other pipelines may cause pain or discomfort, it should be properly fixed. When the patient sits up or turns over, pay attention to keep the pipeline in sync with the body, prevent the pipeline from pulling, twisting, stimulating the wound and aggravating the pain. Change position, cough and other activities after the operation of the semi-recumbent position, not only facilitate drainage, but also reduce the knife edge tension, reduce pain. Help the patient to move gently when changing position, plan the number of times, and avoid repeated stimulation. When coughing, you can hold the knife edge by hand to prevent wound pain caused by pulling the suture or abdominal pressure too high; prevent the infection incision from changing regularly, aseptic operation, and give antibiotics and nutritional support after doctor's advice. Abnormal results Pain after thoracotomy can lead to changes in breathing, circulatory function, endocrine function, immune function, and even complications such as atelectasis, hypoxemia, hypercapnia, and thus affect the surgical outcome and recovery of the condition. . The people in need of examination have suspected intrathoracic hemorrhage, lung cancer, lung abscess, tuberculosis, benign lung tumor, tuberculoma, bronchiectasis, pulmonary bullae, pulmonary cyst, esophageal cancer, empyema, parenchymal pleurisy, mediastinal tumor and other symptoms. Precautions Forbidden before examination: Pay attention to normal eating habits and pay attention to personal hygiene. Requirements for inspection: Actively cooperate with the doctor. Because the chest drainage tube, urinary tube, stomach tube and other pipelines may cause pain or discomfort, it should be properly fixed. When the patient sits up or turns over, pay attention to keep the pipeline in sync with the body, prevent the pipeline from pulling, twisting, stimulating the wound and aggravating the pain. Change position, cough and other activities: postoperative semi-recumbent position, not only facilitate drainage, but also reduce the knife edge tension and reduce pain. Help the patient to move gently when changing position, plan the number of times, and avoid repeated stimulation. When coughing, you can hold the knife edge by hand to prevent wound pain caused by pulling the suture or abdominal pressure too high; prevent infection: regular infusion of the incision, aseptic operation, antibiotics and nutritional support after doctor's advice. Inspection process Surgical methods: After opening the skin and muscles, the intercostal muscles were cut into the chest along the avascular zone of the upper edge of the ribs. The posterior margin reached the ankle ligament and the anterior margin was about 2 cm away from the rib arch. Extend the chest incision with both hands, gently pull the incision in reverse, make the incision preliminarily expand, and understand the flexibility of the rib and the tension of the incision. If the rib is flexible, the ribs are not cut, and the chest expander is placed, 5 cm each time. The gradual enlargement of the incision can be extended to 14 to 18 cm (note that it cannot be in place at one time). If the ribs have poor flexibility and the incision tension is large, the lower ribs are cut at the corners of the rear ribs. Care should be taken to avoid the intercostal nerves and blood vessels in the lower edge of the upper rib and then open the incision. At the end of the operation, 1% bupivacaine 5 mL + Corning Ketong 1 + VitB. 100 mg was used as the intercostal nerve and the upper and lower rib nerves. When closing the chest, use a 2-needle 10 thread to cut the upper and lower intercostals and close the chest. Note that when suturing the intercostal space, the periosteum is cut along the lower rib margin by an electric knife about 0.3 cm, separated along the periosteum, and the intercostal nerve and blood vessels of the lower rib groove are pushed open, where the needle is inserted and the upper intercostal space is closed. The upper edge of the rib avoids suturing the intercostal nerves and blood vessels, and finally sutures the layers of the incision. Not suitable for the crowd Inappropriate crowd: No. Adverse reactions and risks Causes atelectasis, hypoxemia, hypercapnia and other complications.