Tracheal it is the place that breath must want to pass, but as a result of the environment pollute gradually, can cause tracheal disease. Appear tracheal disease wants seasonable cure, remedial time is longer, taking medicine cannot be solved completely, must want undergo surgery. In pathological changes tracheal place has cut, make tracheal and complete extend, the recuperation of repass major, the illness can improve gradually. But in finish operation
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1. posture: Take commonly lie on one’s back, humeral underlay one small pillow, head hind is admired, make tracheal and adjacent the skin, expose apparent, sit at head side at operation; assistant with benefit, in order to secure the head, maintain in the middle of. Groovy disinfection, spread asepsis towel.
2. bureau hemp: Edge neck Qianzhengzhong, go up from thyroid lower edge, the nest goes up to breastbone below, with lidocaine soak anaesthesia, heavy to insensible, danger or choking patient, if already did not have consciousness, also can not grant anaesthetic.
3. cut: Adopt straight cut more (complete hemp patient can use transversely mouth) , come from thyroid lower edge approach point of the check on breastbone, along the neck line incision skin mixes Qianzhengzhong subcutaneous tissue.
Organize before 4. is detached and tracheal: With depart of central line of hemal clamp edge sternal and hyoid flesh reachs flesh of sternal armour shape, expose thyroid isthmus, if isthmus is too wide, can depart slightly in its lower edge, with crotchet general isthmus up drawing, also can hold isthmus clip when necessary cut off seam plunge into, so that expose tracheal. In separate course, two pull a hook to answer forcibly even, make operation
Shanghai night net Eye shot maintains from beginning to end in central line, often probe cricoid cartilage to reach with finger tracheal whether to maintain in in the middle of the position.
5. incision is tracheal: Affirmatory and tracheal hind, general at the 2nd ～ 4 tracheal annulus are in
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, the razor blade that use a needle falls oneself up arc dissections the wall before 2 tracheal annulus forms 1 ～ tracheal before mural valve (incision 4 ～ 5 annulus person for low a tracheotomy) , after waiting for intubate, secure hypodermic (art hind is tracheal bushing emergence person, be helpful for tracheal bushing inserting) , point of a knife has not been inserted deep, lest stab,tracheal rear wall causes tracheal esophagus fistula with the wall before esophagus.
6. inserts tracheal bushing: Support tracheal cut in order to bend clamp or tracheal cut dilator, insert size to suit, the tracheal bushing that contains tubal core, after the canal outside inserting, take out tubal core instantly, put inner tube, suck clean secretion, check have without haemorrhage.
7. cut handles: The belt on will tracheal bushing is fastened at cervical, hit into fast knot with firm and fixed. Cut one
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