Ukulimala kwezemidlalo
1K 0 01.04.2019 (kugcine ukubuyekezwa: 01.07.2019)
Ukwephuka kwamathambo we-pelvic kuyingozi eyingozi emathanjeni, kuhambisana nokwephula ubuqotho bamathambo okhalo.
Ikhodi ye-ICD-10
Ngokusho kwe-ICD-10, ukuphuka kwamathambo okhalo kungokwesigaba se-S32. Le khodi ifaka nokulimala komgogodla we-lumbosacral.
Izizathu
Ukuphuka kwamathambo okhalo kwenzeka ngaphansi kwethonya le-ejenti elibuhlungu. Izimo ezisebenzele ukuyithola ingahle ibe:
- ukuwa entabeni;
- ukukhama lapho ushaya isithuthuthu noma isondo lemoto;
- ukuwa kwezakhiwo nezakhiwo ngesikhathi esiphuthumayo;
- imithelela eseceleni ezingozini zomgwaqo;
- izingozi zezimboni.
Ukwahlukanisa
Kunamaqembu amaningana aphambili okwephuka okhalweni:
- Isitebele. Ukuqhubeka kwendandatho ye-pelvic akuphuli. Lokhu kufaka phakathi ukuphuka okungekuhle futhi okuhlukanisiwe;
- Ayizinzi. Ukuphulwa kobuqotho kukhona. Ukulimala kuhlukaniswa ngendlela yesenzeko ku:
- ukuzinza okujikelezayo;
- ngokungazinzile.
- Ukwehlukaniswa kwamathambo okhalo.
- Ukuqhekeka kwangaphansi noma imiphetho ye-acetabulum.
Izimpawu
Izimpawu zomtholampilo zokwephuka zingahlukaniswa cishe zibe ezasendaweni jikelele. Izimpawu zendawo zincike lapho kutholakala khona umonakalo endandeni ye-pelvic.
Ukubonakaliswa kwasendaweni:
- ubuhlungu obukhulu endaweni eyonakele;
- ukuvuvukala;
- ukunciphisa umlenze ongezansi;
- hematoma;
- ukusonteka kwamathambo okhalo;
- ukunyakaza okulinganiselwe kwemilenze;
- ukwephulwa kokusebenza kokuhlanganiswa kwe-hip;
- crunching kanye ne-crepitus, engazwakala ngesikhathi sokushaywa kwendawo elimele.
Izimpawu ezivamile
Iziguli eziningi zisengozini yokwethuka ngenxa yobuhlungu obukhulu nokuphuma kakhulu kwegazi. Ngaphansi kwethonya laso, isiguli sikhombisa lezi zimpawu ezilandelayo:
- ukucwenga kwesikhumba;
- ukujuluka;
- i-tachycardia;
- ukwehla okukhulu kwengcindezi yegazi;
- ukulahlekelwa ukwazi.
Ngokuhlukumezeka kwesinye, kwenzeka i-hematuria nobunzima bokuchama. Uma i-urethra ithintekile, kungahle kube nokulimazeka ku-perineum, ukugcinwa komchamo, ukuphuma kwegazi ku-urethra.
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Insiza yezimo eziphuthumayo
Uma usola ukulimala okhalweni, isisulu kufanele siyiswe egumbini labezimo eziphuthumayo ngokushesha. Izinto zokuhamba kufanele zenziwe yithimba lama-ambulensi. Ngaphambi kokufika kodokotela, umuntu kufanele anikezwe usizo olufanele losizo lokuqala:
- ukukhululeka kobuhlungu ukuvimbela ukushaqeka okuthusayo ngezinhlungu ezithomalalisayo;
- ngokuphuka okuvulekile, kuyadingeka ukumisa ukopha ngokusebenzisa i-tourniquet engezansi kokulimala, futhi wenze ukwelashwa ngama-antibacterial agents.
Lapho uhambisa isiguli esikhungweni sezokwelapha, sibeke endaweni eqinile endaweni ephakeme. Iroli eqinile noma umcamelo ubekwa ngaphansi kwamadolo esiguli, usinikeze ukuma kwe "frog". Kuyadingeka ukulungisa umuntu ngentambo.
Ukufika ngesikhathi kanye nekhwalithi yokunakekelwa kwezempilo okunikeziwe kunquma isikhathi sokululama kwesisulu ngemuva kokulimala kanye nengozi yezinkinga.
Ukuxilongwa
Ukuqashelwa kwezifo kwenziwa ngesisekelo se:
- ukutadisha umlando wesiguli nezikhalazo zaso;
- ukuhlolwa komzimba;
- imiphumela yezinsimbi (i-X-ray, i-laparoscopy, i-laparocentesis, i-laparotomy, i-ultrasound, i-urethrography) nezindlela zokuxilonga elebhu (i-CBC, izifundo ze-bacteriostatic kanye ne-bacteriological).
Ukwelashwa
Ukwelashwa kokuqhekeka kwezitho zangasese kuqukethe izigaba eziningana. Inani lezinqubo zokwelashwa lincike ebucayi bokulimala. Okokuqala ukwelashwa anti-ukushaqeka. Isimo sizinzile nge-anesthesia eyanele. Ngale njongo, inqubo ye-intrapelvic anesthesia isetshenziswa.
Esigabeni sesibili sokwelashwa, ukwelashwa kokumnika kwenziwa. Ngosizo lwayo, ukulahleka kwevolumu yegazi kuyagcwaliswa. Ukwelashwa kuhlolwe ukulinganisa ukucindezelwa kwegazi, ukushaya kwenhliziyo, ukuhlolwa kwegazi nomchamo.
Isigaba sesithathu ukukhubaza ukukhubazeka kwethambo le-pelvic. Uma kwenzeka ukulimala okuncane, isisulu sivunyelwe ukuhamba ngemuva kwesonto. Amanye amaqhinga okwelashwa ancike esinqumweni sikadokotela wokuvuselela.
Iziguli ezinokuphuka okukhulu zithola ukwelashwa kwamathambo.
Ukuvuselelwa
Ukuphasa inkambo yokuhlumelelisa isinyathelo esidingekayo ukuze kubuyiselwe isiguli endleleni yokuphila ejwayelekile nokuvikela ukukhubazeka. Ukululama kwesiguli kwenziwa ngaphansi kweso lochwepheshe onolwazi. Isiguli ngasinye siyalungiswa ngokuya ngohlelo ngalunye, izinto ezisemqoka kuzo okuyilezi:
- Ukwelapha umzimba;
- ukwelashwa okuhlose ukuqinisa amathambo;
- ukusetshenziswa kwemikhiqizo yangaphandle;
- ukubhucungwa umzimba;
- izinqubo ze-physiotherapy;
- i-cryomassage;
- ukudonsa amathambo.
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Bangaki abasesibhedlela abanokuphuka okhalo
Isikhathi sokulaliswa esibhedlela singafika ezinyangeni ezimbili. Ubude bokuhlala esikhungweni sezokwelapha esinokulimala okuyinkimbinkimbi kuncike esinqumweni sikadokotela oya khona.
Izinkinga
Isimo senkinga sincike ebucayi bokulimala kanye nesimo somzimba sokuzivikela sesisulu.
Ngokuphuka kwesikhumba, izinqubo ezilandelayo ze-pathological zingakhula emzimbeni:
- ukutheleleka (i-pelvioperitonitis, ukusabalalisa i-peritonitis);
- ukulimala ku-OMT;
- ukopha.
Imiphumela
Umphumela we-pathology uvame ukungathandeki. Endabeni yokulimala okucezile noma okuncane, isiguli silulama kalula.
Ngokulimala kwendandatho ye-pelvic, ukuvuselelwa kwesiguli kudinga imizamo emikhulu.
Ukwephuka okunzima ukulahleka kwegazi okunamandla nokulimala ezithweni zangaphakathi kuvame ukubulala. Impilo yesiguli incike ekunakekelweni ngokwanele kwezokwelapha.
