Pneumothorax Pneumothorax

Treatment of diseases: closed pneumothorax Indication Spontaneous pneumothorax, traumatic pneumothorax. Preoperative preparation Artificial air chest, sterile gas brooch and 2ml syringe, clean the plate. Surgical procedure 1. Check whether the water level in the pressure chest and the pumping level in the pneumothorax has reached the required position. Whether the rotating path switch is unobstructed, whether there is any impediment or air leakage. Attach the latex tube to the suction port. 2, the patient supine position, arms hold the head, according to the X-ray chest to choose the best needle position, usually in the second front rib cage midline outside the line, or in the front 4-5 intercostal space. 3, according to routine disinfection of skin and lidocaine local anesthesia. Assistant put on the gas brooch, check whether the gas brooch is unobstructed, and then turn the access switch to the pressure measurement position. 4, the operator's left hand fixed the puncture site skin, the right hand holding the gas brooch, slowly enter the needle along the upper edge of the lower rib, when entering the chest cavity, it is also "falling feeling", and it can be seen that the liquid level in the pressure tube moves up and down with the breath, record pumping Pre-thoracic chest pressure. Turn the vent switch to the "pumping" position, and pull out the gas in the chest as the level in the pumping cylinder drops. When the level drops to the 0 position, turn the vent switch again to another pumping position to continue pumping. Record the amount of pumping. During the pumping process, the ventilator switch is rotated to the pressure measurement position from time to time to observe the pressure change in the chest cavity. When the chest pressure drops to about 0 to -20 Pa (0 to -2 mmH2O), the pumping should be stopped. Observe for 2-3min, if there is no change in chest pressure, stop pumping. Observe for 2-3min, such as no change in chest pressure, suggesting "closed" pneumothorax; if the pressure rises rapidly, it is "tensional" pneumothorax; if the chest pressure fluctuates around 0 before pumping, there is no obvious after pumping Decline, there is no obvious increase in the middle of the "traffic" pneumothorax; the latter two types of pneumothorax, should be replaced with intercostal cannula for thoracic closed drainage. 5, after pumping, pull out the gas brooch, cover the gauze, press 1min tape to fix. 6. Arrange the equipment and turn the switch on the pressure measuring tube and the pumping water on both sides to the closed position. The course of the disease should record in detail the pumping process, the amount of pumping, the chest pressure before and after pumping, and the patient's symptoms. Continue to observe the changes in the condition, the next day to take a chest X-ray review.