Sanibonani ngemfudumalo futhi namukelekile, msebenzisi we-inthanethi, kubhulogi enolwazi, lapho siqala khona ukuhlaziywa okuphelele kokuhlukumezeka kwesifuba okuvaliwe, ukulimala okubi kakhulu nokuvamile okuvame ukubangelwa yizimbangela ezahlukahlukene, njengezingozi zezimoto, ukuwa, noma ubudlova obungokomzimba.
Lolu hlobo lokuhlukumezeka lungabangela izimpawu ezifana nobuhlungu besifuba, ukuphelelwa umoya, kanye nokuqina kwemisipha yezimbambo. Kunconywa usizo lwezokwelapha ngokushesha. "kubhalwe ngabantu, ngenxa yabantu" ukwelashwa okufanele nokufika ngesikhathi ngokusebenzisa izibhedlela noma imitholampilo yezempilo ye inethiwekhi yezempilo yomphakathi noma yangasese futhi ngokuya ngendawo yakho yomhlaba wonke.
Lesi sihloko sizoxoxa ngezimbangela, izimpawu, kanye nezinketho zokwelapha ukulimala kwesifuba okubuthuntu. Sizophinde sibhekane nemibuzo evame ukubuzwa kanye nokubaluleka kokucabangela ukuhlukahluka kwemikhuba yezokwelapha ukuze kuthuthukiswe ukunakekelwa kweziguli.
Ukulimala kwesifuba okubuthuntu.
Kuyingozi evame kakhulu emadolobheni anenani elikhulu labantu kanye nezimoto eziningi; izingozi zezimoto, izingozi zasekhaya, izingozi zezimboni, kanye nemidlalo enomthelela omkhulu ngezinye zezimbangela ezimbalwa zokulimala esifubeni.
Lokhu kulimala kungabangelwa ukulimala okunamandla okugobhoza ngaphambili, ohlangothini noma ngemuva kwekhanda, futhi ezimweni eziningi, isisulu sihlanganyela ukulimala okuningi, isibonelo, ekhanda, esiswini noma emathanjeni omzimba, ngaleyo ndlela sibe yisisulu se-polytrauma futhi sibe nesibikezelo esiqaphile.
Ngaphandle kokuchitha isikhathi, ake singene endabeni yokulimala kwesifuba!
Izimbangela:
Ukulimala esifubeni okubuhlungu kungabangelwa yizigameko ezahlukahlukene, ezivame kakhulu izingozi zezimotoUmthelela kanye namandla engozi yemoto kungabangela ukulimala okukhulu esifubeni.
Ngaphezu kwalokho, iwela kusukela phezuluIzinto eziwayo, njengeladi noma isakhiwo, nazo zingabangela ukulimala okukhulu esifubeni. ubudlova obungokomzimbaLokhu kuhlanganisa ukuhlaselwa kanye nemidlalo yokuthintana, okuyimbangela engaba khona yokulimala kwesifuba okubuhlungu.
Lezi zenzo zobudlova ezivame ukwanda zingabangela isifuba ukuba sishayelwe ngokuqondile noma sicindezelwe ngamandla, okubangela amazinga ahlukahlukene ubukhali bokulimala kwesifuba.
I-Los izingozi zomsebenziUkulimala okufana nokulimala okuchotshozwayo noma ukushaywa yinto esindayo nakho kuyizimbangela ezaziwayo zokulimala esifubeni okubuhlungu futhi ngezinye izikhathi kuhambisana nokulimala kwesisu noma kwemilenze.
Ngakolunye uhlangothi, okuqinisekile ezemidlalo ezinomthelela omkhulu, njengebhola lombhoxo kanye neragbiLe misebenzi ingabangela abantu ukuba bahlukunyezwe esifubeni. Ukuhlanganiswa komthelela wejubane elikhulu kanye nokushayisana komzimba kule midlalo kungabangela ukuba kusetshenziswe amandla amakhulu esifubeni, okwandisa ingozi yokulimala esifubeni.
Futhi, imisebenzi efana ukugibela amahhashi kanye nemidlalo eyingozi, njengokukhuphuka noma ukugxuma esibhakabhakeniFuthi banengozi engaba khona yokulimala esifubeni okubuhlungu, ikakhulukazi ezimweni zokuthi ukuwa noma umthelela.
Ukuqonda ukuhlukahluka kwezimbangela ezingaba khona zokulimala kwesifuba okubuhlungu kubalulekile ekuqaliseni izinyathelo zokuvimbela nokuqinisekisa ukunakekelwa kwezokwelapha okusheshayo, okufanele, kanye nesikhathi esifanele ukuze kusindiswe impilo uma kwenzeka ukulimala kwesifuba okubi kakhulu.
Izimpawu
Uma kukhulunywa ngokulimala kwesifuba okubuhlungu, izimpawu zingahluka kakhulu kuye ngohlobo kanye nobukhali bokulimala. Iziguli zingase zibe nezimpawu ezahlukahlukene, kusukela kwezincane kuya kwezinzima.
Phakathi kwezimpawu ezivame kakhulu ukuba khona ubuhlungu besifubaUbuhlungu bungase bube bubi nakakhulu uma uphefumula noma ukhwehlela. Ngaphezu kwalokho, kungase kube nokuthamba noma ukuba khona kwemivimbo noma imihuzuko esifubeni, okubonisa indawo yokulimala.
Izimpawu zokuphefumula, njenge ukuphefumula okufushane, ukuphefumula okusheshayo noma okungajulile futhi i ukuba khona kokuphefumula Ukwehla kwemisindo yokuphefumula noma ukwehla kwemisindo yokuphefumula nakho kungaba uphawu lokulimala kwesifuba okubuhlungu. amacala abucayi kakhuluIsiguli singase sibonakale sinokukhubazeka okubonakalayo noma amanxeba avulekile esifubeni, okubonisa ukulimala okukhulu okungaphansi.
Ezimweni zokulimala kwesifuba okubuthuntu, iziguli zingase zibe nezimpawu zokulimala kwangaphakathi, njengokuba khona kwe-subcutaneous emphysema, lapho umoya uvaleleke khona ngaphansi kwesikhumba, noma izinga lokuqonda elishintshile.
Kubalulekile futhi ukuqaphela izimpawu ezingase zibambezeleke, njengokukhula kwezinkinga ezifana ne-pneumonia noma i-pleural effusion ngemuva kokulimala kokuqala. Ukuqaphela nokuqonda izimpawu ezahlukahlukene ezihambisana nokulimala kwesifuba okubuhlungu kubalulekile ukuqinisekisa ukuxilongwa nokungenelela ngesikhathi esifanele, okungathinta kakhulu imiphumela yesiguli kanye nokululama.
Ubuhlungu besifuba
Ubuhlungu besifuba buwuphawu olujwayelekile lokulimala kwesifuba okubuhlungu futhi bungabonakala ngezindlela ezahlukene, njengobuhlungu obuhlabayo noma umuzwa obuhlungu nongacacile. Ubuhlungu bungase bube sendawo lapho ukulimala kwenzeke khona noma busakazeke kwezinye izindawo zesifuba noma emhlane.
Ezimweni zokulimala okubuhlungu, ubuhlungu bungase bube bubi kakhulu ngokunyakaza, ukuphefumula, noma ukubhoboza indawo ethintekile. Kubalulekile ukuqaphela ukuthi, nakuba ubuhlungu besifuba buwuphawu oluvamile nolulindelekile lokulimala kwesifuba okubuhlungu, izici kanye nephethini yobuhlungu kunganikeza ulwazi olubalulekile mayelana nohlobo kanye nobunzima bokulimala okuyisisekelo.
Ngakho-ke, ukuhlolwa okuphelele kobuhlungu besifuba, okuhlanganisa ukuqala kwabo, ubude besikhathi, kanye nezinto ezikhulisa noma eziqeda ubuhlungu, kubalulekile ekuhlolweni nasekwelapheni ukulimala kwesifuba okubuhlungu.
Ngaphezu kwalokho, uma kwenzeka ukulimala esifubeni okubuhlungu, kubalulekile ukucabangela amathuba okulimala okuhambisana nalokho, njengalokho okuthinta uhlelo lwemisipha noma izitho zangaphakathi.
Ukuba khona kwezimpawu ezihambisanayo, njengokuthi ubuhlungu besisu noma imiphumela engavamile yezinzwaKufanele futhi ihlolwe ngokucophelela futhi ingase idinge uphenyo olwengeziwe ukuqinisekisa ukwelashwa okuphelele nokuphumelelayo kokulimala kwesifuba okubuhlungu kanye nanoma yiziphi izimo ezihlobene.
Ukuphelelwa umoya
Iziguli ezinesifo sokulimala esifubeni zingase zibe namazinga ahlukahlukene okucindezeleka kokuphefumula, kusukela ekuphazamisekeni kokuphefumula okuncane kuya kokubi kakhulu. Ukuphazamiseka kwendlela evamile yokuphefumula ngenxa yokulimala esifubeni kungabangela umuzwa wokuphelelwa umoya noma ubunzima bokuphefumula.
Kwezinye izimo, isiguli singase sibonise izinga lokuphefumula elikhuphukile ngomzamo wokulungisa ukusebenza kabi kwesifuba esilimele. Ukulimala okubi kakhulu, njenge- i-pneumothorax yokucindezeleka noma i-hemothorax enkuluZingabangela i-hypoxia enkulu kanye nokwehluleka kokuphefumula, okwakha izimo eziphuthumayo ezisongela ukuphila ezidinga ukungenelela okusheshayo endaweni yengozi.
Ekuhlolweni kwesiguli esinokulimala kwesifuba okubuhlungu kanye nezimpawu zokuphefumula ezihambisana nakho, kubalulekile ukwenza ukuhlolwa okujulile kwendlela yokuphefumula, ukuphefumula, kanye nokujikeleza kwegazi ukuze kutholakale ngokushesha futhi kuxazululwe noma yiziphi izinkinga ezibalulekile ezithinta isimo sokuphefumula sesiguli.
Lokhu kuhlanganisa izinyathelo zokuqinisekisa ukuthi umoya uyasebenza, umoya owanele, kanye nokuhlinzekwa komoya-mpilo kanye nokusekelwa komoya-mpilo njengoba kudingeka.
Ngaphezu kwalokho, ukuhlonza nokwelashwa kokulimala okuhambisana nakho, njengokuthi isifuba esimise okwemicibisholo (isifuba se-funnel ngenxa yokucwila kwe-sternum esifubeni sesisulu) noma ukuminyana kwamaphaphuZibalulekile ekunciphiseni umthelela wokulimala kwesifuba okubuhlungu ekusebenzeni kokuphefumula kanye nesimo somtholampilo sesiguli sonke.
Ukwelapha
Ukwelashwa kokulimala kwesifuba okubuhlungu kuhlanganisa indlela eyahlukene yemikhakha ehlukene okuhloswe ngakho ukubhekana nemiphumela ehlukahlukene engaba khona kanye nezinkinga ezivela ekushaqekeni kokuqala.
Izinhloso eziyinhloko zokwelashwa yilezi: Ukuqinisekisa ukuzinza nokusebenza kwezakhiwo zesifuba, kanye nokwenza ngcono ukusebenza kokuphefumula kanye nokusebenza kwenhliziyo. futhi kuvimbele ukuthuthukiswa kwezinkinga zesibili. Ukuhlolwa kokuqala kanye nokwelashwa kwesiguli esinokulimala kwesifuba okubuhlungu kubalulekile ekunqumeni inkambo yokwelashwa elandelayo kanye nomphumela ophelele.
Uma ubona isiguli esinokulimala kwesifuba okubuhlungu, into ebaluleke kakhulu ukwenza ukuhlolwa okuphelele kwesimo sesiguli, unaka kakhulu izindlela zokuphefumula, ukuphefumula, kanye nokujikeleza kwegaziLokhu kuhlanganisa izinyathelo zokuvikela indlela yokuphefumula, ukuhlinzeka ngomoya-mpilo owanele kanye nokuphefumula, kanye nokuhlola izimpawu zokucindezeleka kokuphefumula noma ukukhubazeka kwenhliziyo nemithambo yegazi.
Ukuqashelwa kusenesikhathi kanye nokungenelela okusheshayo ezimweni ezisongela ukuphila njenge-tension pneumothorax, i-open pneumothorax, noma i-massive hemothorax kubalulekile ekuqiniseni nasekuphatheni isiguli esinokulimala kwesifuba okubuhlungu.
Ngakolunye uhlangothi, ukwelashwa kokulimala kwesifuba okubuhlungu kungase kuhilele ukuphathwa kwemithi yokunciphisa ubuhlungu besifuba nokunciphisa umsebenzi wokuphefumula, kuyilapho futhi kududuza isisulu.
Uma kwenzeka ukuphuka kwezimbambo noma ukulimala kwemisipha, ukusetshenziswa kwamasu okuphatha ubuhlungu afanele, okuhlanganisa i-anesthesia yesifunda noma i-systemic analgesia, kungathuthukisa kakhulu induduzo yesiguli futhi kube lula ukusebenza kokuphefumula.
Ngakolunye uhlangothi, Ukusetshenziswa kwamasu okuthuthukisa inhlanzeko yamaphaphu nokuvimbela izinkinga, njenge- ukushukunyiswa kwasekuqaleni kanye nokwelashwa kokuphefumula, kubalulekile ekunakekelweni nasekuphathweni okuphelele kweziguli ezithintekile esifubeni.
Ukuhlolwa kwesiguli kanye nokuzinza
Uma kubhekene nokulimala kwesifuba okubuhlungu, ukuhlolwa kokuqala kanye nokuzinza kwesiguli kubaluleke kakhulu ekunqumeni inkambo yokwelashwa kanye nomphumela ophelele.
Uma isiguli sibhekene nokulimala kwesifuba okusolwayo, ukugxila okuyinhloko kuwukuhlola isimo saso ngokushesha nangokuhlelekile, kugxilwe kakhulu endleleni yokuphefumula, ukuphefumula, kanye nokujikeleza kwegazi. Lokhu kuhlanganisa izinyathelo zokuqinisekisa ukuthi umoya uyasebenza, ukunikeza umoya ohlanzekile kanye nokufaka umoya-mpilo okwanele, kanye nokuhlola izimpawu zokucindezeleka kokuphefumula noma ukushaqeka kwe-hypovolemic.
Ukuqashelwa kusenesikhathi kanye nokwelashwa okusheshayo kwezimo ezisongela ukuphila, njenge-tension pneumothorax noma i-massive hemothorax, kubalulekile ekuqiniseni isiguli ekuqaleni kanye nokunciphisa ukulimala okungenzeka okulandelayo.
Uma kwenzeka ukulimala kwesifuba okubuhlungu, ukuzinzisa isiguli kuhilela nokusebenzisa izinyathelo zokunciphisa ingozi yezinkinga nokuthuthukisa ukusebenza kwezakhiwo zesifuba.
Lokhu kuhlanganisa ukuvimbela kahle ukuqhekeka okusolwayo, ukulawula ukopha kwangaphandle, kanye nokugcinwa kokuqina kwe-hemodynamic. Ngaphezu kwalokho, ukuphathwa kwemithi yokunciphisa ubuhlungu kusenesikhathi nangokucophelela, ngokuya ngamazinga obuhlungu besiguli kanye nesimo somtholampilo, kuyisici esibalulekile sokuqinisekisa induduzo kanye nenhlalakahle yesiguli ngesikhathi sokuqala kokwelashwa.
Ukuhlolwa okuphelele nokuhlelekile kwesiguli, kanye ukuqaliswa ngesikhathi kokungenelela okufanele kokwelapha, yakha isisekelo sokwelashwa okuphumelelayo, okugxile esigulini kokulimala kwesifuba okubuhlungu.
Ukuvinjelwa kokwaphuka kwezimbambo
Uma kuqhathaniswa nokulimala kwesifuba okubuhlungu, ukuba khona kokuphuka kwezimbambo kuyinto evamile futhi ebalulekile, okungenzeka ukuthi kuphazamise ukusebenza kokuphefumula futhi kubangele ubuhlungu obukhulu kanye nokungakhululeki esigulini.
Ukuvimbela ukuphuka kwezimbambo ngokusebenzisa amadivayisi okusekela, njengebhande lezimbambo noma ibhande lesifuba, kudlala indima ebalulekile ekwelapheni lokhu kulimala.
Ngokunikeza ukwesekwa kwangaphandle kanye nokunciphisa ukunyakaza kodonga lwesifuba olulimele, ukuvimbela ukuphuka kwezimbambo kunganciphisa ubuhlungu ngempumelelo, kuvimbele ukufuduka okwengeziwe kwezingcezu eziphukile, futhi kube lula inqubo yokuphulukiswa.
Ngaphezu kwalokho, ezimweni ze- ukuphuka kwezimbambo okuyinkimbinkimbi noma okunzima kakhuluUkusetshenziswa kwamasu anjengokuhlinza noma ukufakwa kwezimila ezizinzayo kungase kube yinto efanele ukuqinisekisa ukuthi izimbambo ezilimele zihambisana kahle futhi zizinzile.
Lokhu kungenelela, okwenziwa ngokubambisana nochwepheshe bokuhlinzwa kwamathambo noma kwesifuba, kunganciphisa kakhulu ukugula okuhambisana nakho futhi kusheshise ukululama kwesiguli.
Ngaphezu kokuzinzisa okwenziwa ngomshini, ukwelashwa okuphumelelayo kokuphuka kwezimbambo kuhlanganisa nokulawula ubuhlungu okwanele kanye nokusetshenziswa kwamasu okwenza ngcono ukusebenza kokuphefumula, njengokunyakaza kwasekuqaleni kanye nokwelashwa kokuphefumula.
Indlela ebanzi neyinkimbinkimbi yokuvimbela ukunyakaza kanye nokwelashwa kokuphuka kwezimbambo ibalulekile ukunciphisa umthelela walokhu kulimala enhlalakahleni yesiguli nokusheshisa ukululama kwaso kanye nokuvuselelwa kwaso.
Ukugeleza komoya noma igazi eliqongeleleke esifubeni
Ekwelapheni ukulimala kwesifuba okubuhlungu, ukukhipha umoya noma igazi ngokushesha nangokuphumelelayo okuqongelelwe emgodini wesifuba kuyisici esibalulekile nesifike ngesikhathi sokwelashwa okuphuthumayo okudingekayo esimweni esinjalo.
Izimo ezifana ne-pneumothorax, i-hemothorax, noma ukuba khona kwesilonda esivulekile esifubeni kungabangela ukunqwabelana komoya noma igazi ngaphakathi kwesikhala se-pleural, okubeka ingcindezi ezakhiweni eziseduze futhi kuphazamise ukusebenza kokuphefumula kanye nokusebenza kwenhliziyo.
Ukufakwa kwepayipi lesifuba ngesikhathi esifanele nangokufanele, ngaphansi kwezimo ezihlanzekile kanye nokusebenzisa isiqondiso sesithombe uma kudingeka, kwenza kube lula ukukhipha umoya noma igazi esikhaleni se-pleural, okuholela ekukhuleni kabusha kwamaphaphu athintekile kanye nokubuyiselwa kwamandla ajwayelekile esifubeni.
Ngaphezu kwalokho, uma kwenzeka i-pneumothorax yokucindezelekaUkungenelela okusheshayo, njengokuncishiswa kwenaliti njengokwelashwa kokuqala (isikhala sesibili se-intercostal, umugqa we-midclavicular), kubalulekile ekunciphiseni ngokushesha ingcindezi ngaphakathi kwesikhala se-pleural nokuvimbela ukuwohloka okuqhubekayo kwesimo sesiguli.
Ukuqapha nokuphathwa okuqhubekayo kwepayipi lesifuba, okuhlanganisa nokuhlolwa kwendlela yokukhipha amanzi kanye nokusebenza kwe-x-ray yesifuba ukuqinisekisa ukwanda kwamaphaphu, kubalulekile ukuqinisekisa ukusebenza kahle kokungenelela kanye nokuxazululwa kwesifo esiyisisekelo.
Ngokubhekana ngokushesha nokuqongelela komoya noma igazi esifubeni, ochwepheshe bezempilo banganciphisa ingozi yokuphazamiseka kokuphefumula, bavimbele ukuthuthukiswa kwezinkinga zesibili, futhi bakhuthaze ukululama okuphelele kanye nenhlalakahle yeziguli ezihlukunyezwe esifubeni.
Ukuphathwa nokuqapha ubuhlungu
Ngemva kwesigaba sokwelashwa esiphuthumayo, ukuhlolwa okuqhubekayo kanye nokuphathwa kobuhlungu ezigulini ezihlukunyezwe esifubeni kubalulekile ukuze kuthuthukiswe induduzo yazo, ukuhamba kwazo, kanye nokululama kwazo konke.
Ukusetshenziswa kwamasu okuphatha ubuhlungu aklanyelwe wena, kucatshangelwa uhlobo nobukhulu bobuhlungu, kanye nezintandokazi zomuntu ngamunye kanye nomlando wezokwelapha, kubalulekile kakhulu ukubhekana nomthelela ongokomzimba nongokwengqondo yokulimala okubuhlungu ezingeni lesifuba.
Lokhu kungase kuhilele ukusetshenziswa kwemithi yobuhlungu yomlomo, amasu okubulala izinzwa esifundeni, noma ezinye izindlela ezingezona ezemithi zokulawula nokuqeda ubuhlungu besiguli ngempumelelo, ngaleyo ndlela kuvunyelwe ukuphefumula kangcono.
Ngaphezu kwalokho, ukuhlinzekwa kwemfundo efanele kanye nokusekelwa mayelana nendlela elindelekile yokululama, ukuqashelwa kwezinkinga ezingaba khona, kanye nokukhuthazwa kwe izinyathelo zokuzinakekela kanye nokuvuselela Ziyizingxenye ezibalulekile zokulandelela isikhathi eside kanye nokwelashwa kweziguli ezilimele esifubeni esibuhlungu.
Ngokuqinisekisa ukuthi iziguli zinolwazi kanye nezinsiza ezidingekayo ukuze zihlanganyele ngenkuthalo ekululameni kwazo, ochwepheshe bezempilo bangafaka isandla empumelelweni iyonke futhi bathuthukise indlela yesiguli ngemva kokulimala.
Ngaphezu kwalokho, ukuhlanganiswa kokunakekelwa kokulandelela okuhlukahlukene, okubandakanya ochwepheshe abavela emikhakheni efana ne i-orthopedics, i-pulmonology, kanye ne-physiotherapy, kunegalelo elikhulu nakakhulu ku ukwelashwa okuphelele nokuphelele kweziguli ezinokulimala kwesifuba okubuhlungu, ngenhloso yokugcina yokwandisa ukululama kwazo kokusebenza kanye nekhwalithi yokuphila.
Isiphetho
Ukuphetha ngamaphuzu abaluleke kakhulu, Ukulimala kwesifuba okubuthuntu kuwukulimala okukhulu okungabangelwa yizici ezahlukene.njengezingozi zomgwaqo, ukuwa, noma ubudlova obungokomzimba. Kubonakaliswa yizimpawu ezingaba zimbi kakhulu, njengobuhlungu besifuba kanye nobunzima bokuphefumula.
Ukuhlolwa okusheshayo kanye nokwelashwa kubalulekile ukuze kube nomphumela ophumelelayo. Izindlela zokwelapha zingafaka phakathi ukunakekelwa kwenxeba, ukugoma, kanye nama-antibiotic, kuye ngokuthi ukulimala kungakanani.
Kubalulekile ukuqapha isiguli eduze futhi sibhekane nanoma yikuphi ukushintshashintsha kwendlela yokwelapha ukuze kuthuthukiswe ukunakekelwa kwesiguli sonke. Ukwelashwa kusenesikhathi nangokufanele kungavimbela ezinye izinkinga futhi kukhuthaze ukululama okusheshayo. Kuze kube yisibuyekezo sezindaba esilandelayo!
UDkt. Jorge Delgado, Udokotela Ohlinzayo. Ukulimala Kwesifuba.