Siyakwamukela ngemfudumalo kule bhulogi yezempilo enolwazi, le ndawo yesiqondiso sezokwelapha esikhethekile. ukungakhululeki ngenxa yokulimala kwesisu Ngemva kwengozi kungaba yinto edidayo; ngezinye izikhathi ubuhlungu bubonakala bungabalulekile, kodwa esiswini okwenzeka ngaphansi kwesikhumba yikho okubaluleke ngempela.
Ngaphambi kokuchaza izinhlobo zobuhlungu obuvela ngemva komthelela noma izimpawu ezidinga ukuhlolwa okusheshayo kokuhlinzwa, ngiyakumema ukuthi uphumule izandla zakho futhi uphefumule ngokuthula; ukuqapha okuqaphile Iyithuluzi lakho lokuvimbela elingcono kakhulu.
Ngaphansi kwesiqondiso sezemfundo sikaDkt. Jorge Delgado, sizohlaziya indlela yokuhlukanisa ukucasuka okudlulayo nophawu lwesixwayiso olusezingeni eliphezulu.
Ukukhathazeka okuvamile
Ingabe kuvamile ukuzizwa ungakhululekile ezinsukwini ezimbalwa ngemva kokushaywa isisu?
Kuvamile ukuzwa ubuhlungu bemisipha noma ukuklwebheka okungaphezulu. Kodwa-ke, uma ukungakhululeki okubangelwa ukulimala kwesisu kukhula ngamandla, kuba njalo, noma kuhambisana nesiyezi, kungabonisa ukulimala kwangaphakathi okukhula kancane kancane okudinga ukunakekelwa kwezokwelapha.
Ngingazi kanjani ukuthi ubuhlungu bungaphakathi noma buyimisipha nje?
Ubuhlungu bemisipha buvame ukuba bubi kakhulu ngokunyakaza noma lapho indawo ithintwa. Ubuhlungu bangaphakathi buvame ukuba bukhulu, buhlala njalo, futhi bungasakazeka emahlombe noma emhlane, ngokuvamile buhambisana nomuzwa "wesisu esiqinile" noma isicanucanu.
Yiziphi izimpawu ezibonisa isimo esiphuthumayo sangempela?
Kufanele uye ekamelweni lezimo eziphuthumayo ngokushesha uma uzwa ukuquleka, ukuphaphatheka okukhulu, ubunzima bokuphefumula, ukuhlanza igazi, noma uma isisu sakho sizizwa siqinile futhi sibuhlungu uma usithinta kancane. Lezi yizimpawu zokuthi kungenzeka ukuthi kukhona ukopha kwangaphakathi noma isitho esibhobozekile.
Yiziphi izifundo ezenziwayo ukuhlola lokhu kungakhululeki?
Ezingeni eliphezulu, uchwepheshe uzosebenzisa ukuhlolwa okuningiliziwe ngokomzimba, i-ultrasound (Eco-FAST) kanye, ezimweni ezithile, i-computed tomography (CT) scan ukuze kutholakale umonakalo ezithweni ezifana ne-spleen noma isibindi ezingabonakali ngaphandle.
Ngakho-ke, ake siqhubekele ngqo engxoxweni mayelana nokungakhululeki okubangelwa ukulimala kwesisu. Sizohlaziya izimpawu, njengoba lesi kuyisimo esibi futhi esingasongela impilo esenzeka lapho isisu sithola ukulimala kwangaphandle.
Lolu hlobo lokuhlukumezeka lungaholela ezibonakalisweni ezahlukene, njengokuthi Ubuhlungu besisufuthi kungaba nemiphumela yesikhathi eside.
Kulesi sihloko sizohlola izincazelo, izimbangela ezivame kakhulu, izimpawu, kanye nokuhlolwa kwezokwelapha. "kubhalwe ngabantu, ngenxa yabantu" kanye nezinketho zokwelapha ukulimala kwesisu.
Kubalulekile ukwelapha lesi simo ngokushesha, njengoba singaba imbangela enkulu yokukhubazeka kanye nokufa okuphezulu.
Ukuze uqhubeke nokujabulela lokhu kufunda okuqabulayo nokumnandi, kungumqondo omuhle ukufaka umoya-mpilo kuma-neurons akho ngokuthatha umoya ojulile, uwubambe imizuzwana emine, bese uphinda lo msebenzi izikhathi ezine. Lena yindlela ephumelela kakhulu yokunikeza ama-neurons akho umthombo wamandla ongcono kakhulu.
Lokhu kuvumela ulwazi oluhloselwe intuthuko yomuntu siqu ukuthi lunqume isimo sengqondo sokuthatha isinyathelo futhi lufune usizo oluphuthumayo lwezokwelapha ngenethiwekhi yezempilo yomphakathi noma yangasese ukuze kutholakale ukunakekelwa okusheshayo nokufika ngesikhathi.
Ngakho-ke, ukugwema ukuzihlola noma ukuzelapha kubambezela ukuxazulula ukungakhululeki futhi kwandisa izinkinga ezinkulu esiswini.. Ake sifinyelele kolunye ulwazi oluthakazelisayo!
Ukungakhululeki ngenxa yokulimala kwesisu
Ukungakhululeki ngenxa yokulimala esiswini kuvame kakhulu kunalokho abantu abaningi abakukholelwayo. Kulinganiselwa ukuthi Abantu abayizigidi ezingu-48 e-United States Bayalimala, kanti ukulimala kwesisu kubalelwa phakathi kuka-10% no-20% walokhu.
Ukusabalala kwayo kungaba nzima ukukukala ngokunembile, njengoba ivame ukuhlonzwa kabi noma ukunganakwa ukuze kutholakale izimpawu ezisobala kakhulu endaweni ethintekile.
Izimbangela zokungakhululeki ngenxa yokulimala kwesisu ziyahlukahluka, kodwa ngokuvamile zibangelwa ukulimala okubuhlungu, njengengozi yethrafikhi noma yomsebenzi, ukulimala kwezemidlalo, ukuwa noma ingozi yasekhaya, noma ukulwa ngokomzimba.
Izimpawu zingase zihlanganise ubuhlungu obukhulu obuba bubi kakhulu ngokunyakaza, isicanucanu, ukuhlanza, ukuvuvukala, kanye nesifo sohudo, phakathi kwezinye. Uma kungelashwa, izinkinga ezifana nokutheleleka, ukubhoboka kwezitho zomzimba, ngisho nokopha kwangaphakathi kanye ne-sepsis (ukutheleleka okuvamile) zingavela.
Ukuze kuvinjelwe lezi zinkinga ukuthi zingabi zimbi kakhulu, kubalulekile ukuthi noma ubani ozwa ubuhlungu obuhlobene nokulimala kwesisu afune usizo lochwepheshe ngokushesha okukhulu.
Incazelo yokulimala kwesisu:
Ukulimala kwesisu kubhekisela kunoma yikuphi ukulimala ngokomzimba, njengamandla abukhali, amanxeba angena ngaphakathi, noma ukuchayeka ekuqhumeni, okuthinta izakhiwo zesisu.
Lolu hlobo lokuhlukumezeka lungabangela ukulimala okuhlukahlukene, njengalokho okwenziwa odongeni lwesisu, izitho zesisu, kanye nemithambo yegazi yangaphakathi kwesisu. Kungaphinde kuholele ezinkingeni ezifana nokopha kwangaphakathi, izifo, kanye nokungasebenzi kahle kwezitho zomzimba.
Impendulo yokuqala yomzimba ekulimaleni, kanye nokukhula kwezimpawu okulandelayo kanye nemiphumela engaba khona yesikhathi eside, kuyizinto ezibalulekile okufanele uzicabangele ekwelapheni ukulimala kwesisu.
El ukulimala kwesifuba esiswini Kuyimbangela enkulu yokugula nokufa emhlabeni wonke, njengoba izingozi zomgwaqo ezihamba ngesivinini esikhulu, ukuwa, kanye nobudlova phakathi kwabantu kuyizindlela zokulimala ezivame ukuhambisana nokulimala kwesisu.
Ukuhlukahluka kwalezi zimbangela kungaholela ekulimaleni okuhlukahlukene kwesisu, okudinga ukuqonda okujulile ngemiphumela engaba khona ezakhiweni zangaphakathi zomzimba kanye nemisebenzi yawo.
Izimbangela ezivamile zokulimala kwesisu
Kunezimbangela eziningana ezivamile zokulimala kwesisu, okuhlanganisa izingozi zezimoto, ezivame ukubandakanya ukulimala okukhulu okubangelwa ukucasuka; ukulimala okuhlabayo, njengalokho okubangelwa ukudutshulwa noma ukugwazwakanye nokulimala okubukhali, okungabangelwa ukuhlaselwa, izehlakalo ezihlobene nezemidlalo, noma ukuwa ngengozi.
Kubalulekile ukuqaphela ukuthi imbangela ethile yokulimala kwesisu ingaba nomthelela omkhulu ohlotsheni kanye nobukhulu bokulimala okubangelwa yilokhu.
Isibonelo, ngenkathi ukuhlukumezeka okunamandla okungabonakali kungenzeka kakhulu ukuthi kubangele umonakalo ezithweni zangaphakathi, ukulimala okuhlabayo zihlotshaniswa nengozi ephezulu ye- ukubhoboza ngqo kwezitho zomzimba kanye nokuqhekeka kwemithambo yegazi.
Ngaphezu kokulimala kwangaphandle, imisebenzi ethile noma imisebenzi yokuzijabulisa ingandisa ingozi yokulimala esiswini.
Isibonelo, ezemidlalo ezithintana nabantu, izingozi zezimboni Futhi imisebenzi yezandla ehilela imishini noma imishini esindayo ingandisa amathuba okubhekana namandla amakhulu abukhali noma angena esiswini, okungaholela emazingeni ahlukahlukene omonakalo wangaphakathi.
Sola ukulimala kwangaphakathi kwesisu uma usebenza "njengomuntu ophendula kuqala"
Njengomuntu osabela kuqala, ukulimala kwesisu okungaba khona kungaba nzima ukukubona nokwelapha. Kubalulekile ukwazi ukuthi i-kinematics yengoziLokhu kuzoqala izimpawu zokulimala kwesisu ukuze isimo sihlolwe kahle futhi kucelwe usizo lwezokwelapha uma kudingeka.
Ukungakhululeki ngenxa yokulimala kwangaphakathi kwesisu kungaba ukuhlonzwa ngezindlela ezahlukene, njengokuhlola ngokomzimba, ukuqaphela ukuziphatha kanye nokubonakaliswa uma umuntu ekwazi ukukhuluma, noma ukucabangela izici eziyingozi, njengezigameko zakamuva ezihlobene nokuwa, izingozi zomgwaqo noma ubudlova.
Izimpawu zingase zihlanganise ukuminyana noma ukuvuvukala okubonakalayo lapho kuhlolwa, ukubhoboza isisu okubuhlungu, ukushaqeka, noma ukuqwasha okusheshayo; nokho, kungcono ukwenza iphutha uma kusolwa ukulimala kwangaphakathi, njengoba ezinye izimpawu zingase zingakabonakali okwamanje.
Uma usola ukuthi umuntu olimele ulimele ngaphakathi esiswini, umsebenzi wakho obaluleke kakhulu ukuthola usizo ngokushesha okukhulu, uthatha zonke izinyathelo zokuphepha ezidingekayo.
Izimpawu eziyinhloko zokulimala kwesisu
Ukuqaphela izimpawu zokulimala kwesisu kubalulekile ekuxilongweni nasekungeneleleni ngokushesha. Nakuba ukuvezwa kwezimpawu kungahluka kuye ngembangela ethile kanye nohlobo lokulimala, kunezinkomba eziningana ezivamile zokulimala kwesisu.
Zingase zibe nobuhlungu besisu obujwayelekile noma obujwayelekile, ukuzwela okukhulu, ukudumba, ukuvuvukala, kanye nokushintsha kombala wesikhumba.
Kwezinye izimo, abantu abalimele esiswini nabo bangase babe khona Izinkinga zokugaya ukudla, njengokucanuzela kwenhliziyo nokuhlanza, kanye nokuqulekaikakhulukazi uma ukulimala kubangele ukopha okukhulu kwangaphakathi noma umonakalo wesitho somzimba.
Kubalulekile ukuqaphela ukuthi ukubonakaliswa kwezimpawu ekuhlukunyezweni kwesisu kungaba nzima, ikakhulukazi esimweni se-polytrauma, lapho isiguli silimele khona ezicutshini eziningi zomzimba.
Isibonelo, ezimweni zokulimala kwesisu ngemuva kwengozi yemoto, ukuba khona kwe- ukulimala okuhlangene ekhanda, esifubeni noma ohlelweni lwemisipha Kungafihla noma kwenze kube nzima ukuhlola ukungakhululeki kwesisu, okungaholela ezinkingeni zokuxilonga kanye nokubambezeleka kokwelashwa.
Ukuhlolwa Kwezokwelapha Kwesisu Esihlukumezekile
Ukuhlolwa kwezokwelapha kwesiguli esinokulimala kwesisu okusolwayo kuhilela indlela ebanzi ehlanganisa umlando wezokwelapha wesiguli, ukuhlolwa ngokomzimba okuphelele, kanye nokusetshenziswa ngokuhlakanipha kwezifundo zokuxilonga ukuhlola ubukhulu kanye nohlobo lokulimala.
Kunakekelwa ngokukhethekile izimpawu ezibalulekile zesiguli, ukugxila ekuhlonzeni izimpawu zokushaqekaokungase kubonise ukulahlekelwa igazi okukhulu noma ezinye izinkinga ezisongela ukuphila.
Uma kukhulunywa ngokulimala kwesisu, ukuhlolwa ngokomzimba kwesisu kubaluleke kakhulu futhi kungase kuhilele Ukuhlolwa okuhlelekile kobuhlungu besisu, ukuqina kwaso, kanye nokuba khona kwezinqwaba ezizwakalayo noma izimpawu zokopha kwangaphakathi.
Uchwepheshe wezempilo angasebenzisa nezivivinyo zokuxilonga, njengokuthi ama-ultrasound noma ama-computed tomography scan (CT), ukubona ngeso lengqondo izakhiwo zesisu nokubona izimpawu zokulimala, njengokusikeka kwezitho zomzimba, ama-hematoma, noma ukuba khona koketshezi olukhululekile emgodini we-peritoneal.
Izinhlobo zokulimala kanye nemiphumela engaba khona
Ukulimala kwesisu kungabangela ukulimala okuhlukahlukene, okuhlanganisa ukuqhekeka kwe-spleen kanye nesibindi, ukulimala kwezinso, ukubhoboka kwamathumbu, kanye nama-hernia abuhlungu, phakathi kokunye.
Uhlobo kanye nobukhulu balokhu kulimala kungaba nemiphumela ebalulekile empilweni yesiguli esheshayo neyesikhathi eside, kanye nokwenzeka kwezinkinga ezifana nokopha kwangaphakathi, ukutheleleka, kanye nokwehluleka kwezitho zomzimba.
Kwezinye izimo, ukuba khona kokulimala kwesisu kungadinga nokuhlinzwa okuphuthumayo ukulungisa izakhiwo ezonakele nokuvimbela eminye imiphumela emibi enhlalakahleni yesisulu.
Ukuqonda izinhlobo ezahlukene zokulimala okungenzeka ngenxa yokulimala kwesisu kubalulekile ukuze kuqondiswe izindlela zokwelapha ezifanele nokunciphisa ingozi yezinkinga.
Isibonelo, ngenkathi ukulimala kwesisu okubuthuntu ngokuvamile zihlotshaniswa ne ukulimala kwezitho zomzimba eziqinile, the ukuhlukumezeka okujulile, njenge amanxeba okudutshulwa noma ommeseZingabangela ukulimala kokubili ezithweni eziqinile kanye nasezandleni ezingenalutho, okungaba yizinselele ezahlukene zokuxilonga kanye nokwelashwa.
Izifundo zokuxilonga ziyadingeka ekuhlukunyezweni kwesisu
Ukuhlolwa kokuxilonga ukulimala kwesisu kuvame ukuhilela inhlanganisela yezifundo zezithombe kanye nokuhlolwa kwelebhu, okubalulekile ukuhlonza ukuba khona kanye nobukhulu bokulimala kwangaphakathi.
Izindlela zokuthwebula izithombe zokuxilonga, njenge-ultrasound, i-CT, kanye nokuhlanzwa kwe-peritoneal lavage (DPL), zinganikeza ulwazi olubalulekile mayelana nendawo kanye nobukhulu bokulimala kwesisu, kanye nokuba khona kwezinto eziyinkimbinkimbi, njengoketshezi olukhululekile noma umoya emgodini we-peritoneal.
Izifundo zelebhu, okuhlanganisa ukubalwa kwegazi okuphelele, amaphrofayili okujiya, kanye nokuhlolwa kwezimpawu zomonakalo wezitho zomzimba, njenge-enzyme yesibindi, kubalulekile ukuhlola impendulo yomzimba yesiguli ekulimaleni kwesisu kanye nokuhlonza noma yiziphi izinkinga zomzimba ezihlobene, njenge-coagulopathies noma ukungasebenzi kahle kwezitho eziningi.
Ezimweni ezithile, imiphumela yalezi zifundo zokuxilonga ingabuye yazise inqubo yokwenza izinqumo zokwelashwa okulandelayo, njengesidingo sokuhlolwa kokuhlinzwa, izinqubo ze-radiological zokungenelela, noma ukuqapha okuqhubekayo isimo sesiguli.
Ukuhlukaniswa kwe-triage kanye nobunzima
Ukuhlolwa kokuqala kanye nokuhlukaniswa kweziguli ezihlukunyezwe yisisu kubalulekile ekubekeni phambili ukunakekelwa kanye nezinsizakusebenza ngokusekelwe ebunzimeni bokulimala kwazo. Le nqubo ihilela ukuhlolwa okuhlelekile kwesimo sesiguli sonke.
Ngakolunye uhlangothi, uhlobo lwesigameko esibuhlungu kanye nokuba khona kwemiphumela ethile yezokwelapha, ilebhu kanye nezithombe ezingase zibonise isidingo sokungenelela okuphuthumayo noma izinga eliphezulu lokunakekelwa.
Ngokukhetha nokuhlola ngokunembile iziguli ezinezimo ezibuhlungu esiswini, ochwepheshe bezempilo bangaqinisekisa ukuthi izisulu ezinezimo ezisongela ukuphila zithola ukwelashwa okusheshayo nokufanelekile, ngenkathi bethuthukisa ukwabiwa kwezinsiza zezempilo endaweni yezokwelapha eguquguqukayo, engaba yinselele, futhi enobutha.
Izinhlelo ezahlukene zokulinganisa kanye neziqondiso zemitholampilo ziye zasungulwa ukusiza ekukhetheni nasekuhlukaniseni ukulimala kwesisu, kucatshangelwa izici ezifana nendlela yokulimala, imingcele yomzimba, kanye nokucatshangelwa kokwakheka komzimba.
Lawa mathuluzi ahlinzeka ngosizo olubalulekile kubasebenzi bezempilo ekuboneni ngokushesha nangokunembile amacala abucayi kakhulu, okwenza kube lula ukuphathwa kokungenelela kwezokwelapha nokuhlinzwa okufika ngesikhathi nangokuqondile ukuze kuthuthukiswe imiphumela yesiguli.
Ukuphathwa kokuqala kanye nokwelashwa kokulimala kwesisu
Ukuhlolwa kokuqala kokulimala kwesisu kugxile ekuqinisekiseni ukuzinza kwesiguli kanye nokubhekana nanoma yikuphi inkinga esheshayo ebeka impilo yabo engozini futhi kuncishiswe ingozi yokulimala okuqhubekayo noma ukuwohloka komzimba.
Lokhu kungafaka phakathi ukungenelela okufana nokuphathwa komoya, ukwesekwa kokujikeleza kwegazi, kanye nokunikezwa kwe-analgesia kanye noketshezi lokuvuselela ukuze kugcinwe ukugeleza okwanele kwezicubu kanye nokufakwa komoya-mpilo.
Kwezinye izimo, lapho isimo sesiguli singazinzile, izinqubo zokuhlinzwa eziphuthumayo, njenge-laparotomy yokuhlola, zingadingeka ukuze kutholakale futhi kulungiswe umsuka wokulimala kwesisu.
Ngemva kokuzinza kwesiguli, ukwelashwa okuqhubekayo kokuhlukumezeka kwesisu ngokuvamile kudinga indlela ehlukahlukene ehilela ochwepheshe ekuhlinzeni ukuhlukumezeka, ukunakekelwa okujulile, i-radiology yokungenelela, kanye neminye imikhakha efanele.
El ukwelashwa okungezona ukuhlinzwaLe ndlela, ehlanganisa ukusetshenziswa kokubuka okuqhubekayo, ukuhlolwa ngokomzimba okulandelanayo, kanye, kwezinye izimo, izinqubo ze-radiological zokungenelela, ingacatshangelwa iziguli ezizinzile ngokwe-hemodynamic ezinezinhlobo ezithile zokulimala kwesisu, njengokusikeka okuncane kwezitho eziqinile noma amazinga athile okulimala kwesisu okubuthuntu noma okungenayo.
Ukungenelela okungenzeka kokuhlinzwa ekulimaleni kwesisu
Ezimweni ze ukulimala kwesisu okunzima noma okuyinkimbinkimbiUkungenelela kokuhlinzwa kungadingeka ukuze kulungiswe izitho ezonakele noma ezibhobozekile, kulawulwe ukopha okuqhubekayo, noma kuxazululwe ezinye izinkinga ezibalulekile ezingelashwa ngaphandle kokuhlinzwa.
I-Los izinqubo zokuhlinzwa Uma kwenzeka ukulimala kwesisu, izinqubo zingafaka phakathi, phakathi kokunye, i-laparotomy yokuhlola, ukulungiswa kwezimbobo zamathumbu, ukwelashwa kokulimala kwe-diaphragmatic okubuhlungu, kanye nokususwa kwezitho zesisu ezonakele kakhulu noma ezifile.
Isinqumo sokwenza ukuhlinzwa ngenxa yokulimala kwesisu sisekelwe ku- ukuhlolwa okuphelele kwesimo somtholampilo sesiguli, uhlobo kanye nobukhulu bokulimala kwabo, kanye nezinzuzo ezingaba khona kanye nezingozi zokwelashwa ngokuhlinzwa, ngokuvumelana nemikhuba emihle kanye neziqondiso zezokwelapha ezimisiwe.
Kubalulekile ukuqaphela ukuthi ukwelashwa okuphumelelayo kokulimala kwesisu, kungaba ngezindlela ezingezona ezokuhlinzwa noma ezokuhlinzwa, ngokuvamile kudinga ukubambisana okuseduze phakathi kwamalungu ahlukahlukene eqembu lezempilo, okuhlanganisa odokotela abahlinzayo abahlinzayo ngenxa yokulimala, odokotela ababulala izinzwa, abasebenzi bokunakekelwa okujulile kanye nabahlengikazi abanekhono.
Lolu hlaka oluhlanganisa imikhakha eminingi lubalulekile ekuhlinzekeni ukunakekelwa okuphelele nokuhlanganisiwe ezigulini ezihlukunyezwe yisisu, okugxile ekwenzeni ngcono ukululama kwazo kwesikhathi eside kanye nenhlalakahle yazo.
Ukulimala kwesisu kuhlanganisa izinhlobo eziningi zokulimala okubangelwa izimbangela ezahlukene, ngayinye inezinselelo zayo kanye nokucatshangelwa kwayo.
Ukwelashwa okuphumelelayo kokuhlukumezeka kwesisu kudinga ukuqonda okujulile izindlela zokulimala (i-kinematics), izinhlobo ezingaba khona zomonakalo wangaphakathi, kanye nezindlela ezingcono kakhulu zokuhlola, ukuxilongwa, kanye nokwelashwa.
Ngokuhlala uqaphile futhi unolwazi oluphelele mayelana nentuthuko yakamuva ekwelapheni ukulimala kwesisu, ochwepheshe bezempilo bangaqinisekisa ukuthi iziguli ezithintekile kulesi simo esiyinkimbinkimbi nesivame ukuba bucayi zinikezwa ukunakekelwa okuseqophelweni eliphezulu, okusekelwe ebufakazini.
Ukuhlaziywa kwenani
Ukuqapha Okusebenzayo:
Inzuzo eyisisekelo ukuvimbela. UDkt. Delgado wengeza inzuzo ngokuchaza ukuthi "isikhathi sokubuka" ekhaya sibaluleke njengokunakekelwa esibhedlela, okunikeza isiguli amandla okwazi kahle ukuthi yini okufanele siyiqaphele.
Umbono Wezemfundo:
Umehluko usekucaceni kwemfundiso. Njengoba uprofesa oqeqeshiwe wezokuhlinzwaUDkt. Delgado uchaza ukwesaba ukuhlukumezeka, akuguqule kube inqubo yezinyathelo ezinengqondo eziqinisekisa ukuphepha kwesiguli ngaphandle kokuwela ovalweni.
Isiphetho
Ukuze sicacise izinto ezibalulekile, ukulimala kwesisu Kuyisimo esibi futhi esingasongela impilo esingabangelwa ukulimala kwangaphandle noma izici zangaphakathi.
Kungaba nezimpawu ezahlukahlukene futhi kudinga ukuhlolwa okusheshayo kanye nokwelashwa. Ukuxilongwa okunembile, ukuhlolwa okufanele, kanye nokungenelela ngesikhathi kubalulekile ekwelapheni ukulimala kwesisu kanye nokunciphisa umthelela wako kumuntu.
Ngakho-ke, kubalulekile ukufunda ngezimpawu, izimbangela, kanye nezinketho zokwelapha ukulimala kwesisu ukuze uqonde futhi uqaphele ubucayi besimo somgodi wesisu.
Uma uthola lolu lwazi olusha mayelana nempilo yokugaya ukudla luthakazelisa, sekuyisikhathi sokuluhlanganyela ezinkundleni zokuxhumana ukuze abantu abaningi emhlabeni wonke bazuze! Siyabonga ngempendulo yakho eqotho ngebhulogi yezempilo yokugaya ukudla evimbela ukugaya ukudla! Kuze kube yisibuyekezo sezindaba esilandelayo!
UDkt. Jorge Delgado, Udokotela Ohlinzayo. Ukungakhululeki ngenxa yokulimala kwesisu.
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