Sawubona futhi wamukelekile kubhulogi yolwazi lwezempilo yokugaya ukudla. Sekuyisikhathi sokuqala ngqo ngesihloko esibalulekile empilweni yanamuhla esheshayo: ukulimala kwesisu kungabangela ukulimala okukhulu nezinkinga, ngakho-ke kubalulekile ukuqonda izimbangela zako, izimpawu, kanye nezinketho zokwelapha.
Lesi sihloko sizokunikeza ulwazi ngakho konke okudingeka ukwazi ngezimbangela ezivamile zokulimala kwesisu, njengezingozi zezimoto, ukuwa, kanye nokushaywa ngobudlova. kanye nangezimpawu "kubhalwe ngabantu, ngenxa yabantu" kanye nobukhulu balokhu kulimala.
Sizoxoxa futhi ngokubaluleka kokuxilonga kusenesikhathi kanye nezinketho zokwelashwa ezifanele, kanye Kanjani Ibanjiwe (Isofthiwe Yokuphatha Nokubalwa Kwezimali Engcono Kakhulu) ingenza ukuphathwa kwezinqubo kusebenze kahle kakhulu ukukhokhisa lolu hlobo lokulimala.
Sekuyisikhathi sokuhlala phansi uzizwe ukhululekile futhi khuthaza ngokujulilebamba umoya wakho imizuzwana emi-4 bese khipha umoya kancaneUkuphinda lo msebenzi izikhathi ezine kusiza ukufaka umoya-mpilo ezingqimbeni ezijulile zobuchopho, kufinyelele ekugxiliseni okungcono kanye nokugxila kolwazi olusha ku-neuronal.
Lokhu okuthunyelwe okufundisayo kuyindlela enhle kakhulu yokufundisa ukuthuthukiswa komuntu siquokuzonquma isimo sengqondo sokuthatha isinyathelo futhi kufune usizo ngokushesha uma kuyisimo sengqondo umphenduli wokuqala ingculaza yokuqala lapho ebhekene nokulimala kwesisu.
Kungakhathaliseki ukuthi ufuna ukuthola ulwazi olubalulekile mayelana nokulimala kwesisu noma ukwenza kube lula ukulimala kwakho kanye nezinqubo zokukhokhisa zezokwelapha, lesi sihloko sizokusiza.
Qhubeka ufunda ukuze ufunde konke okudingeka ukwazi mayelana nokulimala kwesisu!
Ukulimala kwesisu.
Ukulimala kwesisu kuyisimo sezokwelapha esingabangelwa ukulimala okungabonakali nokuvulekile futhi kuthinte izitho ezibalulekile kule ndawo yomzimba. Ukuqaphela izimpawu nokufuna usizo lwezokwelapha ngokushesha kubalulekile, njengoba ukungenelela ngesikhathi kungaba yinto ebalulekile ukuze ululame.
Ukuqonda izindlela zokulimala kanye nezinyathelo zokunakekelwa kokuqala kungasiza ochwepheshe bezempilo kanye nomphakathi jikelele ukuba balungele kangcono ukubhekana nezimo eziphuthumayo. Imfundo nokuvimbela kubalulekile ukunciphisa izingozi ezihlobene nalolu hlobo lokulimala.
Ukulimala kwesisu okungabonakali:
Ukulimala kwesisu kuyisimo esibucayi nesivame kakhulu esivame ukwenzeka ngenxa yomthelela okhipha amandla e-kinetic ezingeni lesisu, okuyinto Kubangela ububanzi obubanzi ngokulimala okuningana okungenzeka ezithweni zangaphakathi.
Kubalulekile ukuqonda uhlobo lokulimala kwesisu, okuhlanganisa izimpawu zako, izimbangela, kanye nezinketho zokwelapha ezitholakalayo. Isifunda sesisu sigcina izitho ezibalulekile njenge- isisu, isibindi, ubende namathumbuNgakho-ke, noma yiluphi uhlobo lokuhlukumezeka kule ndawo lungaba usongo olukhulu empilweni nasenhlalakahleni yomuntu.
Ezimweni eziphuthumayo, ikakhulukazi lezo ezihilela ukulimala okukhulu, ukwelashwa kokulimala kwesisu kungaba nzima kakhulu kochwepheshe bezempilo, njengoba kudinga ulwazi olujulile ngalesi simo kanye nokungenelela okusheshayo nokuphumelelayo.
Ngokuphathelene nezimbangela zokulimala kwesisu, kunemithombo eminingana engaba khona, yonke enamandla okulimaza kakhulu izakhiwo zangaphakathi zesisu.
I-Los izingozi zezimoto ezihamba ngesivinini esikhuluUkushayisana okukhulu kanye nokudluliselwa kwamandla amakhulu kubantu abagibele emotweni kungenye yezimbangela eziyinhloko zokulimala kwesisu.
Amandla amakhulu kanye nobudlova bezingozi ezinjalo kungabangela isisu ukuba sihlaselwe yilesi sifo. umthelela ongazelelwe, ongathi sína futhi olimazayo, okuvame ukubangela ukulimala okuningana kwesisu okubuhlungu ngaphakathi.
Ukuwa, ikakhulukazi kusukela phezulu noma phansi kwezitebhisi, kanye nezinye izinhlobo zokulimala okunamandla okubuthuntu, njengokuthi ukuhlaselwa ngokomzimba noma ukushaya izintoZingabangela nokulimala kwesisu, okubangela umonakalo ezithweni zangaphakathi kanye nezakhiwo.
Kubalulekile ukuqaphela ukuthi ubukhulu bokushaqeka abuhlobene ngempela namandla abonakalayo omthelela, ngoba ngisho izehlakalo ngokusobala ukulimala okuncane kungabangela umonakalo omkhulu wangaphakathi.
Ikakhulukazi ezingozini zomgwaqo, ukwehla okusheshayo kanye nomthelela wamandla obuthuntu ohambisana ukushayisana kwezimoto nezinye izinhlobo zokulimala kwezimoto Zingacindezela kakhulu isisu, okubangela ukulimala okuhlukahlukene kwezitho zangaphakathi.
Kuyathakazelisa ukufunda ngokuguquguquka komzimba kokushayisana, okuhlanganisa nendlela ukusebenzisana komzimba nezinto ezahlukahlukene zemoto noma indawo ezungezile okungaholela ngayo... amaphethini okuhlukumezeka ayinkimbinkimbiLokhu kwenza ukuhlolwa okunembile kanye nokuxilongwa kokulimala kwesisu kube yisici esibalulekile sempendulo yezokwelapha ezigamekweni ezinjalo.
Uma kukhulunywa ngokuwa, izindlela zokulimala zingabandakanya amandla ahlukile, njengokuthi umthelela womzimba emhlabathini noma kwezinye izindawokanye nokusatshalaliswa kwamandla esiswini sonke, konke okungabangela ukwenzeka kokulimala okukhulu kwesisu kanye izinkinga zesifuba noma imisipha yamathambo ehlobene (izingxenye ezingaphandle).
Kubalulekile ukuqaphela nokuqonda izimpawu ezahlukene zesifo ukulimala kwesisu okuvaliwe, njengoba zivame ukuba uphawu lokulimala okukhulu kwangaphakathi, naphezu kokungabikho kwezimpawu zangaphandle zokulimala.
Izimpawu ezivamile zifaka phakathi ubuhlungu obuphakathi, ukuzwela okukhulu, kanye nokuvuvukala kwesisuokungase kuhambisane nokushintsha kombala wesikhumba, okubonisa ukuthi kukhona ukopha kwangaphakathi.
Ukulimala kwesisu okuvulekile noma okungenayo:
Ezimweni zokulimala okujulile, njengokudutshulwa noma ukugwazwa, amanxeba okungena noma okuphuma angase abonakale, kodwa umonakalo wangaphakathi awenzayo ungaba mkhulu futhi ungase ubulale.
Kubalulekile ukuqaphela amathuba okopha ngaphakathi kanye nokukhula kokushaqeka, okungabonakala njengezimpawu zokuzizwa unesizungu, ubuthakathaka, kanye nokushaya kwenhliziyo okusheshayo nokubuthakathaka.
Ngaphezu kwalokho, ukuba khona kwe izinqwaba ezizwakalayo noma ukuvela kwezitho zomzimba Ubuhlungu besisu, kanye nemisindo engavamile yamathumbu, nakho kungaba izinkomba ezibalulekile zokulimala okukhulu kwesisu.
Uma kuhlolwa ubukhali kanye nomthelela ongaba khona wokulimala kwesisu, kubalulekile ukuhlukanisa phakathi kokulimala okubuthuntu nokungena ngaphakathi, njengoba izindlela eziyisisekelo kanye namaphethini omonakalo wangaphakathi kungahluka kakhulu phakathi kwalezi zigaba ezimbili.
I-Los ukulimala kwesisu okuvaliweNgokuvamile kuhlotshaniswa namandla angabonakali, lokhu kulimala kungabangela umonakalo onjengokopha kwangaphakathi, ukulimala kwezitho zomzimba, noma ukuthuthukiswa kwe-a isifo se-abdominal compartmentkonke lokhu kungaba nemiphumela emibi empilweni yesiguli futhi kudinga ukungenelela okusheshayo nokuphumelelayo.
Ngakolunye uhlangothi, ukulimala okuhlabayo, okuhlanganisa ukulimala okubangelwe ngu- ukungena kwezinto zakwamanye amazwe noma izakhi Esiswini, ziletha izinselele nezingozi ezihlukile, futhi zivame ukudinga izindlela ezikhethekile zokuhlola nokwelapha ukubhekana nohlobo oluthile kanye nobukhulu bokulimala kwangaphakathi.
Ukuhlolwa nokwelashwa kokulimala kwesisu
Uma kukhulunywa ngokuxilongwa nokwelashwa kokulimala kwesisu, kubalulekile ukuba nolwazi oludingayo ngendlela ehlelekile nephelele ukuqinisekisa ukuthi kutholakala futhi kwelashwa ukulimala okungenzeka ngesikhathi.
Ukuhlolwa kwesiguli esinokulimala kwesisu okusolwayo kuvame ukuqala nge- umlando wezokwelapha ophelele kodwa omfushane kanye nokuhlolwa ngokomzimba, okuhloswe ngakho ukuhlonza izindlela zokulimala ezingaba khona, kanye nokuba khona kwezimpawu ezithile ezingase zibonise ukuthi kukhona ukulimala okukhulu kwangaphakathi.
Benza lokhu ngesifinyezo: IBANZIKonke okudingeka ukwazi ngakho:
- A: ukungezwani komzimba: ama-antibiotic, ama-analgesic, ama-anesthetic.
- M: imithi oyithatha ngomuthi kadokotela kanye nemithi ongayithenga ngaphandle kwemithi kadokotela.
- P: izifo abhekene nazo njengamanje, futhi uma engowesifazane, susa ukukhulelwa.
- Lapho: ukudla noma ukudla kokugcina.
- A: indawo (amabhayisikobho) kanye nemicimbi ehlobene.
Ukuhlola kokuqala:
Lokhu kuhlola kokuqala kubalulekile ekuqondiseni izinyathelo zokuxilonga ezilandelayo, ezingafaka phakathi ukusetshenziswa kwezifundo zezithombe ezifana ne-ultrasound, i-computed tomography (CT), kanye, kwezinye izimo, ukuhlolwa kwe-diagnostic peritoneal lavage (DPL) noma ukuhlolwa kwe-ultrasound ye-focused abdominal trauma (FAST).
Ezimweni lapho kusolwa ukuthi kukhona ukulimala kwesisu, ikakhulukazi uma kukhulunywa ngendlela yokulimala okukhulu noma ukuba khona kwezinkomba ezithile zemitholampilo, kungase kuboniswe i-diagnostic peritoneal lavage (DPL) ukuze kuhlolwe ukopha kwangaphakathi noma umonakalo wesitho.
Le nqubo ihilela ukufaka i-catheter emgodini we-peritoneal ukuthola nokuhlaziya amasampula oketshezi ukuze ukuthola ukuba khona kwegazi noma ezinye izimpawu ezibalulekile zokulimala kwangaphakathi kwesisu, futhi kungadlala indima ebalulekile ekutholakaleni nasekuchazweni kwasekuqaleni kokulimala okunjalo esimweni sokulimala.
Ngaphezu kwe-PLD, ukusetshenziswa kwezindlela zokuthwebula izithombe ezithuthukisiwe, njenge-computed tomography (CT), kumelela itshe eliyisisekelo lenqubo yokuxilonga ukulimala kwesisu, njengoba kuvumela ukubona ngeso lengqondo kanye nokuchaza ukulimala kwangaphakathi, okuhlanganisa ukuba khona kwama-hematomas, ukulimala kwemithambo yegazi, kanye nokunye okutholakele okubalulekile okungadinga ukungenelela okusheshayo.
Uma ukuhlolwa okuphelele sekuqediwe futhi uhlobo oluthile kanye nobukhulu bokulimala kwesisu sekucacisiwe, amasu okuphatha nokwelapha afanele angasetshenziswa ukubhekana nezidingo zomuntu ngamunye zesiguli.
Ezimweni zeziguli ezizinzile ezinezimpawu zokulimala kwesisu okuncane noma okuphakathi, indlela yokulondoloza, ehlanganisa ukuqapha okuseduze, ukuphathwa kobuhlungu, kanye nezinyathelo zokusekela, ingafaneleka ukuze kube lula ukuphulukiswa kwemvelo kanye nokuxazulula ukulimala okutholiwe.
Kodwa-ke, uma kukhona izinto ezithile eziyingozi, ukopha okuqhubekayo, noma ukuhlonza umonakalo omkhulu wesitho, ukungenelela kokuhlinzwa kungadingeka, njengokuthi i-laparotomy yokuhlolaukubona ngeso lengqondo, ukuhlola nokwelapha ngqo ukulimala okutholiwe, nokuvimbela ukuthuthukiswa kwezinkinga ezengeziwe ezingabeka engcupheni ukululama kwesiguli kanye nenhlalakahle yesikhathi eside.
I-laparotomy yokuhlola, inqubo yokuhlinzwa ehilela ukuhlola nokuhlola umgodi wesisu, iyindlela ebalulekile yokwelapha ukulimala okukhulu kwesisu, njengoba ivumela ukubona ngeso lengqondo kanye nokuhlola izitho zangaphakathi nezakhiwokanye nokwenza ukulungiswa kokuhlinzwa okudingekayo ukuze kulungiswe ukulimala okutholiwe.
Uma kukhulunywa ngokuhlukumezeka okujulile, njengokudutshulwa noma ukugwazwa, i-laparotomy yokuhlola ivame ukukhonjiswa ukuze kutholakale futhi kwelashwe izinga eliphelele lokulimala. ukulimala kwangaphakathi.
Lokhu kuhlanganisa ukulungisa imithambo yegazi eyonakele, ukususa izinto zangaphandle, nokulawula imithombo engaba khona yokopha.konke lokhu kubalulekile ukuze kuthuthukiswe imiphumela yesiguli futhi kuncishiswe ingozi yezinkinga zesikhathi eside.
Isinqumo sokwenza ukuhlinzwa, okuhlanganisa ne-laparotomy yokuhlola, sinqunywa ngokucophelela futhi silungiselelwe izimo ezithile zesiguli ngasinye, kucatshangelwa ubukhulu bokulimala, ukuba khona kwezimo zezokwelapha ezihambisanayo kanye nezinzuzo kanye nezingozi ezingaba khona zezinyathelo zokuhlinzwa ezihlongozwayo.
Kuzo zonke izimo zokulimala kwesisu, ukwelashwa nokunakekelwa okuqhubekayo kwesiguli kufanele kufake indlela ehlukahlukene, ehilela ukubambisana okuseduze phakathi kwezokwelapha ezahlukahlukene, njengokuthi imithi ephuthumayo, ukuhlinzwa kokulimala, ukunakekelwa okujulile, kanye nezithombe zokuxilonga, ukuqinisekisa ukuhlinzekwa kokunakekelwa okuphelele nokuphumelelayo.
Ngaphezu kwalokho, isigaba sokunakekelwa ngemva kokulimala kufanele sihlanganise ukulandelwa ngokucophelela, ukuvuselelwa, futhi, uma kuboniswe, ukuhlinzekwa kokusekelwa kwengqondo ukubhekana nezidingo zesiguli eziphelele kanye nokwenza kube lula ukululama kwazo okuhle kanye nokuqala kabusha imisebenzi yazo yansuku zonke.
Ngokusebenzisa indlela ehlelekile negxile esigulini yokwelapha ukulimala kwesisu, ochwepheshe bezempilo bangalwela ukuthuthukisa imiphumela kanye nekhwalithi yokuphila kwabantu abathintekile yilokhu kulimala okungaba kubi kakhulu, futhi banciphise umthelela wesikhathi eside wokulimala empilweni yabo yonke kanye nesimo sabo sokusebenza.
Isiphetho
Isikhathi sezinto ezibalulekile—ukwazi konke okudingeka ukwazi ngezimbangela, izimpawu, kanye nezinketho zokwelapha ukulimala kwesisu—sibalulekile ekuphatheni lezi zinhlobo zokulimala. Ngezixazululo zokukhokha nokuphatha ezisebenza kahle zikaHolded, amabhizinisi angonga isikhathi futhi aqinisekise izinqubo zokukhokha ezinembile.
Ukuqaphela izimpawu eziyisixwayiso nokufuna usizo lwezokwelapha ngokushesha kungaba nomthelela omkhulu emiphumeleni yalesi simo esingasongela ukuphila. Kuze kube yilapho okuthunyelwe okulandelayo okufundisayo!
UDkt. Jorge Delgado, Udokotela Ohlinzayo. Ukulimala Kwesisu.