Indlela yokusebenza
(I) i-anesthesia
IBrachial Plexus Block isetshenziselwa izitho ezingenhla, ibhulokhi ye-epidural noma i-subarachnoid block isetshenziselwa imilenze ephansi, kanye ne-anesthesia ejwayelekile noma i-anesthesia yendawo nayo ingasetshenziswa njengokufanele.
(Ii) isikhundla
Izitho eziphezulu: Supine, i-Elbow Flexion, Frearm phambi kwesifuba.
Izinyawo eziphansi: Supine, i-HIP Flexion, Ukuthunjwa, Ukuguquguquka Kwamadolo kanye ne-Ankle Joint in 90 degree degree steption isikhundla.
(Iii) ukulandelana kokusebenza
Ukulandelana okuqondile kokusebenza kweFixitator yangaphandle kungukushintshana kokusetha kabusha, ukuhlanganisa nokulungisa.
[Inqubo]
Okungukuthi, ukwaphuka kuqala kubuyiswe kabusha (ukulungisa ukushintshana nokuwohloka ngokweqile), bese kugwazwa ngama-Pins adangele umugqa womugqa we-fracture futhi ekugcineni kugwazwe ngokwanele komugqa we-fracture, futhi ekugcineni kugwazwe ekwanelisekeni kokuphuka kwayo bese kulungiswa ngokuphelele. Kwamanye amacala akhethekile, ukuqhekeka kungalungiswa ngokukhonkotha okuqondile, futhi lapho isimo sivuma, ukuqhekeka kungaphindwa, kulungiswe futhi kulungiswe kabusha.
[Ukuncishiswa kwe-Fracture]
Ukuncishiswa kwe-Fracture kuyingxenye ebalulekile yokwelashwa kwe-Fracture. Ukuthi ukuqhekeka kuncishisiwe ngokwenele kunomthelela oqondile kwikhwalithi yokuphulukiswa kwe-fracture. Ukuqhekeka kungavalwa noma ngaphansi kombono oqondile ngokuya ngesimo esithile. Ingashintshwa futhi ngokuya ngefilimu ye-X-ray ngemuva kokumaka komzimba. Izindlela ezithile zinjengokulandelayo.
1. Ngaphansi kombono oqondile: Ukuze uthole ama-fractures avulekile ngemikhawulo yokuqhekeka okuveziwe, ukuqhekeka kungasetha kabusha ngaphansi kombono oqondile ngemuva kokudonswa kahle. Uma ukuhlukaniswa okuvaliwe kwehluleka ukukhohlisa, ukuqhekeka kungancishiswa, kuhlatshwe futhi kugazwe ngaphansi kombono oqondile ngemuva kokuvela okuncane kwe-3 ~ 5cm.
2. Indlela yokuncipha evaliwe: Okokuqala yenza ukuqhekeka kucishe kusebenze kabusha bese kusebenza ngokuya ngokulandelana, futhi usebenzise indlela yokuphakamisa futhi usebenzise indlela yokuphakamisa nokususa ukusetha kabusha kuze kwenelisekile bese kulungiswa. Kungenzeka futhi ukuthi wenze izinguquko ezifanele zokufuduka okuncane noma uMthethosisekelo ngokusho kwe-X-ray ngemuva kokuncishiswa nokulungiswa okusekelwe endaweni yomzimba noma ukumakwa kwe-bony. Izidingo zokuncishiswa kwe-fracture, ngokwesimiso, ukuncishiswa kwe-anatomical, kepha ukuqhekeka okungathi sína okuthe xaxa, imvamisa akulula ukubuyisela ifomu lokuqala le-anatomical, ngalesi sikhathi ukwaphuka kwe-Fracture kufanele kube ukuxhumana kangcono phakathi kwe-Fracture block, futhi ulondoloze izidingo ezinhle zomugqa.
[I-pinning]
I-Pinning yindlela eyinhloko yokusebenza kwamathambo wangaphandle, kanye nenqubo enhle noma embi yokuphina kungakuthinta kuphela ukuqina kokulungiswa kokuqhekeka, kepha futhi kuhlobene nezehlakalo eziphakeme noma eziphansi zokukhuphuka. Ngakho-ke, amasu alandelayo wokusebenza kufanele alandelwe ngokuqinile lapho ethinta inaliti.
1. Gwema ukulimala okubumbene: Qonda ngokugcwele i-anatomy yesayithi lokubhoboza futhi uvikele ukulimaza imithambo yegazi enkulu.
2. Ngokuqinile inqubo yokusebenza kwe-axetic, inaliti kufanele ibe ngu-2 ~ 3cm ngaphandle kwendawo yesilonda esinegciwane.
3. Amasu angenasisekelo angahlaseli: Uma ugqoke inaliti eligcwele kanye nenaliti eligcwele eligcwele, indawo yokungena kanye nokuphuma kwenaliti yensimbi ngommese obukhali ukwenza i-0.5 ~ 1cm incision yesikhumba; Lapho ugqoke inaliti, sebenzisa ama-forceps we-haemostatic ukuhlukanisa umsipha bese ubeka i-cannula bese ushayela izimbobo. Musa ukusebenzisa ukumba kwamandla okusheshayo lapho udonsa noma uqonde ngqo ngenalithi. Ngemuva kokufaka inaliti, amalunga kufanele ashukumiseleke ahlole ukuthi ngabe kukhona yini ukungezwani esikhumbeni enalithi, futhi uma kukhona ukungezwani, isikhumba kufanele sinqunywe futhi sinqunywe.
4. Khetha indawo ne-angle yenaliti: Inaliti akufanele idlule emsipha kancane ngangokunokwenzeka, noma inaliti ifakwe endizeni eyodwa, ibanga phakathi kwezinaliti engxenyeni engu-6; Lapho inaliti ifakwe ezindizeni eziningi, ibanga phakathi kwezinaliti engxenyeni yokuqhekeka kufanele ibe inkulu ngangokunokwenzeka. Ibanga phakathi kwezikhonkwane kanye nomugqa we-fracture noma indawo ye-articular akufanele kube ngaphansi kwe-2cm.I-angle yokuwela izikhonkwane ku-25 ° ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80 ~ 80
5. Khetha uhlobo uluhlobo nobubanzi benaliti yensimbi.
6. Songa umgodi wenaliti ngokuphelele nge-alcohol gauze ne-gauze oyinyumba.
Isikhundla senaliti engenayo evuthayo evuthayo maqondana ne-Vascular nerve Buck yengalo ephezulu (umkhakha okhonjiswe emfanekisweni yindawo yezokuphepha yokwenza inaliti.)
[Ukukhwela nokulungiswa]
Esikhathini iningi ukuncishiswa kwe-fracture, ukukhonkotha kanye nokulungiswa kwenziwa ngokuhlukile, futhi ukulungisa kuqediwe njengoba kudingeka lapho kuhlatshwe izikhonkwane zensimbi ezinqunyelwe ngaphambili. Ama-flactires ezinzile ahlelwe ngokucindezela (kepha amandla okucindezela akufanele abe mkhulu kakhulu, uma kungenjalo isimo se-angular sizokwenzeka), ama-fractures ahlanganisiwe ahlelwe endaweni yokungathathi hlangothi, futhi amaphutha amathambo alungiswa esimweni sokuphazamiseka, futhi amanembe amathambo ahlelwe endaweni yokuphazamiseka.
Imfashini yokulungiswa okuphelele kufanele inake izindaba ezilandelayo: 1.
1. Hlola ukuqina kokulungiswa: Indlela ukuqondisa umdwebo ohlanganyelwe, umdwebo omude noma u-lateral ucindezela ukuphela kwe-fracture; Isiphelo sokuqhekeka esiqinile sokungaguquki akufanele sibe nomsebenzi noma inani elincane lomsebenzi wokunwebeka. Uma ukuqina kunganele, kungathathwa izinyathelo ezifanele ukukhulisa ukuqina.
2. Ibanga kusuka ku-Finator yangaphandle yamathambo esikhunjeni: 2 ~ 3cm ngelembu eliphezulu, 3 ~ 5cm ngemlenzeni engezansi, ukuze i-Trauma ishiywe ngemuva kokuvuvukala kwezentengiso futhi usizi luyalungiswa.
I-3. Lapho ihambisana nokulimala kwezicubu ezithambile ezithambile, ezinye izingxenye zingangezwa ukwenza umlenze olimele umiswe noma ngaphezulu kokwenza lula ukuvuvukala kwelembu futhi kuvikele ukulimala kwengcindezi.
I-4. I-fixilator yangaphandle yamathambo ye-cadre yamathambo akufanele ithinte ukuzivocavoca okusebenzayo kwamalunga, umlenze ophansi kufanele kube lula ukuhamba ngaphansi komthwalo, futhi umlenze ongaphezulu kufanele ube lula emisebenzini yansuku zonke nokuzinakekela.
5 Ukuphela kwenaliti ngophawu lweplastiki cap noma i-tepi egoqwe, ukuze ungabhobozi isikhumba noma ukusika isikhumba.
[Izinyathelo okufanele zithathwe emacaleni akhethekile]
Ezigulini ezinokulimala okuningi, ngenxa yokulimala okungathi sína noma ukulimala okusongela impilo ngesikhathi sokuvuselelwa kokuvuselelwa, kanye nasezimweni eziphuthumayo njengokulimala kokuqala emkhakheni noma ekulimaleni kokuqala, bese kutholwa futhi kulungiswe futhi kulungiswe futhi kulungiswe ngesikhathi esifanele.
[Izinkinga ezivamile]
1. Ukutheleleka kwePinhole; na-
2. I-necrosis yokucindezela kwesikhumba; na-
3. Ukulimala kwe-Neurovascular
I-4.
5. Izikhonkwane eziphukile
6. I-Pin Fract Fracture
7. Ukuphazamiseka okuhlanganyelwe
(Iv) ukwelashwa ngemuva kokusebenza
Ukwelashwa okufanele kwe-postoperative kuthinta ngokuqondile ukusebenza kahle kokwelashwa, uma kungenjalo izinkinga ezinjengokutheleleka kwePinhole kanye nokungazinzi kwe-Fracture kungenzeka. Ngakho-ke, kufanele kukhokhwe.
[Ukwelashwa okujwayelekile]
Ngemuva kokuhlinzwa, umlenze olimele kufanele aphakanyiswe, futhi ukusakazwa kwegazi nokuvuvukala komlenze olimele kufanele kubhekwe; Lapho isikhumba sicindezelwa yizingxenye zokulungiswa kwangaphandle kwamathambo ngenxa yesikhundla noma ukuvuvukala kwemthonjeni, kufanele kusingathwe ngesikhathi. Izikulufo ezikhululekile kufanele ziqiniswe ngesikhathi.
[Ukuvimbela nokwelapha izifo]
Ngokulungiswa kwamathambo wangaphandle uqobo, ama-antibiotic akudingekile ukuvikela ukutheleleka kwePinhole. Kodwa-ke, ukuqhekeka kanye nesilonda uqobo kufanele kuphathwe ngama-antibiotics afanele. Ukuze uthole ukuqhekeka okuvulekile, noma ngabe isilonda sikhanyisiwe ngokuphelele, ama-antibiotics kufanele asetshenziswe izinsuku ezintathu kuya kwezingu-7, futhi ama-fractures athelelekile kufanele anikezwe ama-antibiotics isikhathi eside.
[Ukunakekelwa kwePinhole]
Umsebenzi owengeziwe ngemuva kokulungiswa kwamathambo wangaphandle kuyadingeka ukunakekela ama-mainholes njalo. Ukunakekelwa okungafanele kwe-pinhole kuzoholela ekuthelelekeni kwePinhole.
1. Ngokuvamile ukugqoka kushintshiwe kanye ngosuku lwesithathu ngemuva kokuhlinzwa, futhi ukugqoka kudinga ukushintshwa nsuku zonke lapho kukhona okuvela ku-pinhole.
2. Izinsuku eziyi-10 noma ngaphezulu, isikhumba sePinhole sisongelwe, ngenkathi sigcina isikhumba sihlanzekile futhi somile, zonke izinsuku ezi-1 esikhawini sesikhumba se-pinhole noma i-iodine fluoride solution.
3. Lapho kunokungezwani esikhunjeni ePinhole, uhlangothi lwengxabano kufanele lunqunywe ngesikhathi ukunciphisa ukungezwani.
4. Naka ukusebenza kwe-aseptic lapho ulungisa i-Finator yangaphandle yamathambo noma ushintshe ukucushwa, bese ukhipha amagciwane esikhunjeni esizungeze iPinhole ne-Steel Inaliti.
5. Gwema ukutheleleka - ukutheleleka ngesikhathi sokunakekelwa kwePinhole.
I-6. Lapho ukutheleleka kwePinhole kwenzeka, kufanele kwenziwe ukwelashwa okuhlile kahle ngesikhathi, futhi umlenze olimele kufanele aphakanyiselwe ukuphumula kanye nama-antimicrobials afanele kufanele asetshenziswe.
[Umsebenzi osebenzayo]
Ukuzivocavoca okusebenzayo okufika ngesikhathi futhi okulungile akusikho kuphela ukululama komsebenzi ohlanganyelwe, kepha futhi nokwakhiwa kabusha kweHaemodynamics kanye nokukhuthaza ukucindezela ukukhuthaza inqubo yokuphulukiswa kokuphulukisa. Ngokuvamile, ukukopela kwemisipha kanye nemisebenzi ehlanganisiwe ingenziwa embhedeni kungakapheli izinsuku eziyi-7 ngemuva kokuhlinzwa. Izingalo ezingenhla zingathwala ukuncipha nokubamba izandla nokunyakaza okuzimele kwesihlakala kanye namalunga akwa-Elbow, nokuzivocavoca okushintshaniswa kungaqalwa ngeviki eli-1 kamuva; Imilenze ephansi ingashiya ingxenye ethile embhedeni ngosizo lwemvundulo ngemuva kweviki eli-1 noma ngemuva kokuthi isilonda seluphule, bese kancane kancane kancane liqala ukuhamba ngamaviki amathathu angenamfanelo kamuva. Isikhathi nemodi yokuzivocavoca okusebenzayo kuyahlukahluka kuye kumuntu, ikakhulukazi ngokuya ngezimo zasekhaya nezohlelo. Esezinhlelweni zokuzivocavoca, uma i-pinhole ibonakala ibomvu, ivuvukala, kubuhlungu futhi okunye ukuvezwa kokuvuvukala kufanele kuvikele umsebenzi, ukuphakalise umlenze othintekile embhedeni wokuphumula.
[Ukususwa kocingo lwangaphandle lwamathambo]
I-brace yangaphandle yokulungiswa kwangaphandle kufanele isuswe lapho ukwaphuka kufinyelele emithonjeni yezempilo yokuphulukiswa kokuphulukisa. Lapho ususa ubakaki wokulungisa amathambo bangaphandle, amandla okuphulukisa okuphulukisa kufanele anqunywe ngokunembile, futhi ukulungiswa kwamathambo kwangaphandle akufanele kususwe ngaphambi kokunquma amandla okuthola ithambo langaphandle, ikakhulukazi lapho ukwelapha okufana nokuphumelelwa okudala, ukuphazamiseka kwethambo kanye nethambo.
Isikhathi sePosi: Aug-29-2024
