Yini okufanele uyenze ukuze kuqhume umhlanga?
I-Rib fractures ingaba buhlungu kakhulu futhi ikhungathekise ngoba ayikho ukwelashwa okuqondile kubo ngaphandle kwemithi yobuhlungu kanye nesikhathi sokuphulukisa. Njengoba kuqhuma umvuthwandaba, ubuhlungu bezintambo bungadlwengulwa ukunyakaza okuncane kakhulu: ukuphefumula, ukukhwehlela nokuhamba komzimba ophezulu.
Esigungwini sesibhedlela, izimbambo zezintambo ziwuhlobo oluvame kakhulu lokulimala okubangelwa yi-traum trauma.
Ngaphezu kwalokho, izimbambo zezintambo zithinta kakhulu impilo yonke kanye nobungozi bokufa. Ngamanye amazwi, umuntu ogcina ukulimala kanzima futhi unezimbambo eziningana eziphukile asemngciphekweni omkhulu wokufa.
Sonke sinezintambo ezingu-12 zezimbambo. Izimbambo zokuqala ezintathu zinzima ukuphula futhi ngokuvamile ziphukile ngemuva kokuthungathwa kwamandla amakhulu (isib. Ukushayeka kwemoto). Ezinye izimbambo eziyisishiyagalolunye kulula ukuphuka futhi zilandele ukuhlukana okuningi, nezimbambo eziphakathi ngokuvamile ziphukile. Ezinye izimbangela ezivame kakhulu zokuqhuma izimbambo ziyawa, ukulimala okuhlobene nemidlalo (isib., Ibhola lezinyawo noma ukugijima), izingozi zemoto, ukushaya nokukhwehlela okukhulu (kwasebekhulile).
Kuze kube yingxenye yazo zonke izimbambo zomcibisholo zenzeke zibheke phambili (i-anterior) nohlangothi (lateral) umhlanga wezintambo futhi azibonakali kwi-X-ray. Ngaphezu kwalokho, kunzima ukubona izinguquko ze-X-ray ukuze kuqhume ukuhlukana kwezinsuku ezimbalwa zokuqala ngemuva kokulimala. Okokugcina, umonakalo we-cartilage kungenzeka ukuthi awukwazi ukubona kwi-X-ray.
I-Ultrasound ivela njengethuluzi lokuxilonga elingase likwazi ukubona ukubhekwa kwezimbambo, kufaka phakathi ama-fractures ku-cartilage
Ngaphakathi kwayo, ukuqubuka kombambo kuyabuhlungu kepha akusikho okusongela ukuphila. Kodwa-ke, izimbambo zezintambo ngokuvamile zihlobene kakhulu nezinye izinhlobo zokulimala okungathí sina. Ngezimbambo zomzimba, odokotela basolisa okulandelayo:
- I-air negazi emgodini wamaphaphu (okungukuthi, i-hemopneumothorax)
- Ukulimala kwe-Vascular (izitsha ezinkulu ze-thoracic kuhlanganise umthambo we-subclavian kanye nemithanjeni, umshini ongenawo wonke umvuthwandaba kanye nemithanjeni, kanye nomshini ovamile ovamile we-carotid)
- Ukulimala kwesisu
- Ukungcoliswa kwamapulmonary
- Ukulimala emoyeni (izinyembezi ze-bronchial)
Uma udokotela elindela i-pneumothorax, amafilimu alungile noma okuphefumula ayobe eyala, okuyizinhlobo ezithile ze-X ray. Ngaphezu kwalokho, uma kwenzeka ukuhlukumezeka okukhulu noma uma izimbambo zichithekile, udokotela angase alandele izithombe ezifakiwe zesifuba.
Ubuhlungu bokuhlukana kwembambo kwenza kube nzima ukuphefumula futhi kungasiza ekwenzeni i- atelectasis . I-Atelectasis ichazwa njengokuwa okuyingxenye noma ephelele yamaphaphu. Ngokuqondile, lapho isiguli sibhekene nobunzima obomvu, uphefumula kalula ngaleyo ndlela u-hypoventilating amaphaphu; le hypoventilation imiphumela in atelactasis. I-Rib fractures yenza kube nzima nakakhulu ukugcoba othile ekusekeleni kwe-ventilatory.
Iziguli ezibhedlela ezibuhlungu obukhulu obangelwa yizintambo zokufiphaza zingathola ibhuloho yesibindi nge-anesthetic ende ende efana ne-bupivacaine. Lokhu kusebenza kwama-anesthetic okwesikhathi eside kuthatha amahora angu-12. Ngezinye izikhathi, i-epidural inganikezwa ukuyeka ubuhlungu, ikakhulukazi uma kunesifo esibuhlungu esifubeni.
Iningi lembambo ephuka, kodwa, ayiphathwa ngokusebenza okuqondile kwe-anesthetics.
Ukwengeza, izimbambo zezintambo aziphathwanga ngokungenakulinganiswa kwendonga yesifuba kanye nokubopha (okungaholela ekutheni i-pneumonia noma i-atelectasis). Esikhundleni salokho, izimbambo zezintambo ziphathwa ngokuhlanganiswa kwe-benzodiazepines, i-opioids, nama-NSAID (izidakamizwa ezifana ne-Advil). Ngokuphawulekayo, i-benzodiazepines ne-opioids inamandla okuhlukunyezwa, futhi ukusetshenziswa kwabo kufanele kusetshenziswe njengoba kunqunywe isikhathi esingaphezu kwesikhathi sokugula noma ukulimala.
Uma wena noma othandekayo ehlushwa ukulimala okubangela ukuthi imbambo iphele ngaphandle kwesilungiselelo esibhedlela, kunethuba elihle udokotela wakho angeke akwazi ukuxilonga ukuphulwa kwe-X-ray.
Esikhundleni salokho, ubuhlungu phezu kwezimbambo ezithintekayo kungenzeka kube uphawu olulodwa lokulimala.
Ukuphulukiswa okuphulukisiwe komkhuhlane wokuqubuzana ngokuvamile kubandakanya ukusetshenziswa kwamaphakethe eqhwa nemithi yokugulisa ubuhlungu kanye nokuzivocavoca. Kubalulekile ukuthi uhlale usebenza ngesikhathi uthola ukuhlukumezeka kwembambo. Ukubuyisela kungathatha amasonto ayisithupha.
Ngisho noma kungekho ukwelashwa okuqondile kokuqhekeka kombambo, uma usola ukuthi ubekezelele, kuwumqondo omuhle ukubona udokotela. Udokotela angakusiza ubuhlungu futhi akuhlole ezinye izinhlekelele noma ukulimala. Ngaphezu kwalokho, udokotela angakunikeza imithi yokwelapha yokulimala kwakho. Sicela ukhumbule ukuthi uma imithi enqunyiwe, sicela uthathe njengoba nje kunqunyiwe. Imithi ethile enqunyiwe yenzalo yokuphulwa-i-opioids kanye ne-benzodiazepines-inekhono lokuhlukunyezwa uma ithathwe ngokungalungile noma ngokweqile.
Imithombo:
UBrunett PH, i-Yarris LM, i-Cevik A. Isahluko 258. I-Traumatic Trauma. Ku: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Umuthi Ophuthumayo We-Tintinalli: Umhlahlandlela Wokufunda Ophelele, 7e . ENew York, NY: McGraw-Hill; 2011.