Blunt ukuhlukumezeka besisu. Ukulimala kwezitho ezingaphakathi, lesisu. eziphuthumayo

Locked (blunt) besisu ukuhlukumezeka - umonakalo akuyona ephelezelwa esephule ubuqotho odongeni kwamathumbu. Lezi ukulimala zibizwa futhi ngokuthi "non-eyenza umuntu acabange eseZwini". Nokho, ukuntuleka pathologies ezibukwayo akubona ubufakazi kulondolozwe izitho zangaphakathi. Kuvaliwe ukuhlukumezeka besisu zihlanganisa ukulimala amanyikwe, ubende, isibindi, ipheshana emathunjini, isinye nezinso, esithinta impilo lesiguli kanye kungaholela ekufeni.

omsakazo

Shaya esiswini kubhekwa njengembangela eyinhloko ukulimala kwezitho ezingaphakathi. Iningi leziguli abathintekayo ngale ndlela, abangu lathambisa ngesikhathi yokulimala. Imisipha unganyakazi, ukuthi kwenza abantu bakuphathe Ukungena amabutho ushaye ezijulile ezicutshini. Le ndlela yokwenza libhekene ukulimala kulezi zimo ezilandelayo:

• izigameko zobugebengu (shot ngesibhakela noma wakhahlela esiswini);
• awe ukuphakama;
• ukushayisana kwezimoto;
• ukulimala ezemidlalo;
• okungenakudanjiswa ukukhwehlela reflex, kulandelwa ukusikwa abukhali kwemisipha besisu;
• izingozi zezimboni;
• izinhlekelele zemvelo noma impi.

Okwamanje umthelela we isici elimazayo kubangela ukulimala odongeni besisu, khona ukukhuluphala kanye Ngakolunye uhlangothi, Ukuwohloka noma ukuba buthakathaka kwezicubu apharathasi kwandisa ingozi yokulimala kwezitho zangaphakathi.

amacala zokwelapha njalo kuthiwa ezihambisana ukuhlukumezeka, yokuxhuma blunt izilonda esiswini kanye kwamathambo emikhawulweni, ukhalo, izimbambo, emgogodleni, cranio-cerebral ukuhlukumezeka. indlela enjalo kubangela ukuthuthukiswa ukopha okusezingeni eliphezulu, isisindo futhi ngezimo zesiguli ngesivinini ukubukeka ukushaqeka esibuhlungu.

Uma kukhona ukuhlukumezeka ezincane kumele uye egunjini labadinga usizo oluphuthumayo eliseduze. Abasebenza ubusuku nemini, izisebenzi kuyodingeka usizo lokuqala, kokunquma umbuzo esibhedlela kanti khona umonakalo wangaphakathi. Nakani! Endabeni ka isimo esibi ngenxa yanoma yisiphi ukudabuka isitho yangaphakathi ukunyakaza ethintekile noma okusolwa esizimele isiguli is contraindicated. Qiniseka ukubiza i-ambulensi.

ngezigaba

Blunt ukuhlukumezeka besisu ahlukaniselwe ngokuvumelana nezimiso ezilandelayo:

1. Ngaphandle umonakalo izitho we komgodi ongaphakathi kwamathumbu (nemivimbo, izinyembezi amaqembu kwemisipha futhi fascia).
2. Nge khona ukulimala kwezitho ezingaphakathi, okuyinto zitholakala esikhaleni peritoneal (isibindi iphula ubende izigaba pheshana, isinye).
3. Nge umonakalo ahlelwe retroperitoneal izitho (amanyikwe igebe, izinso).
4. Pathology ne ukopha intraperitoneal.
5. Umonakalo, ephelezelwa usongo okuvela peritonitis (ukuhlukumezeka izitho eziyize).
6. Kuhlanganiswe umonakalo ka parenchymal eziyishumi nemitshingo eziyize.

ubuhlungu syndrome

Kuvaliwe ukuhlukumezeka besisu libhekene owokuqala isikhalazo main kusuka isisulu - ukuvela ubuhlungu esiswini. Kubalulekile ukukhumbula ukuthi isigaba Erectile ukushaqeka kungenziwa ephelezelwa okusithiyayo ubuhlungu, okwenza kube nzima ukuhlonza isifo. Endabeni ukulimala ezihambisana ubuhlungu lwezimbambo eziphukile nasemilenzeni, ukhalo afake izimpawu ezibangwa blunt ukuhlukumezeka besisu, endaweni yesibili.

isigaba Torpid ukushaqeka depresses ukukhanya izimo ezibuhlungu ngenxa yokuthi isiguli neliphithene noma aquleke.

Ubunjalo ubuhlungu, ngegalelo lako futhi ngemisebe ye emizweni zincike umonakalo nogwali kwasendaweni abahilelekile. Ngokwesibonelo, blunt isibindi ukuhlukumezeka ephelezelwa ubuhlungu bezwe izinhlungu, imbuthuma ku ilungelo ibhodi lemisindo esifundeni. Ukudabuka we ubende kuboniswe imbuthuma ubuhlungu ibhodi lemisindo ngakwesokunxele. Ukuze umonakalo kwamanyikwe libhekene ubuhlungu ibhande, usabela kokubili clavicles, okhalweni, ehlombe.

Ukudabuka we ubende, ngemiphumela okuyizinto esindayo isiguli ngenxa ngokweqile ukopha, ephelezelwa ingxenye yesithathu yazo zonke ukulimala esiswini esivaliwe. kaningi umonakalo kukhona ubende kanye nezinso kwesokunxele. Ngokuvamile, odokotela kufanele uthonye isiguli futhi uma akabonanga lwasemtholampilo isithombe omunye izitho eziningana kwalimala.

Trauma engxenyeni engenhla ipheshana emathunjini, ephelezelwa ukudabuka odongeni ububonisa angababulali ubuhlungu obuhlabayo evelayo ngenxa Ukungena lokuqukethwe emathunjini phakathi komgodi peritoneal. Ukukhanya iziguli ubuhlungu ungalahlekelwa ukwazi. Ukulimala ikholoni mancane nabanolaka ukubonakaliswa, ngoba okuqukethwe akuyona acid imvelo eqinile.

Ezinye izimpawu zokwelapha

Blunt ukuhlukumezeka besisu owabonakaliswa ukuhlanza reflex. Ezimweni ukudabuka kwezindonga emathunjini amancane noma isisu ebuhlanzweni aqukethe amahlule noma ube umbala ngezizathu ikhofi. Ukungasondelani okunjalo kusukela indle abonisa ukuhlukumezeka we-colon. Ukulimala ingemuva ephelezelwa ukubukeka elikhanyayo obomvu igazi noma amahlule.

ukopha Intraabdominal kuhambisana zimpawu ezilandelayo:

• ubuthakathaka futhi ukozela;
• isiyezi;
• ukuvela "Izimpukane" phambi kwamehlo;
• isikhumba futhi lwamafinyila ulwelwesi babe tinge bluish;
• ukwehlisa umfutho wegazi;
• ababuthakathaka nokushaya kwenhliziyo okusheshayo;
• njalo ukuphefumula engajulile;
• ukubukeka izithukuthuku ebandayo.

Umonakalo izitho eziyize kubangele ukuthuthukiswa peritonitis. In esinjalo zokugula abathintekayo umzimba kuyanda wemfanelo e lokushisa komzimba (nge ukopha oluqinile - hypothermia), ukuhlanza zingalawuleki, emathunjini motility ukuboshwa. Ubunjalo ubuhlungu kushintsha njalo, nese soreness omkhulu ukunyamalala layo lesikhashana.

Urinary system ukuhlukumezeka noma sokuphazamiseka kuhambisana nokuntuleka umchamo okukhipha, hematuria cwe, ukuzwa ubuhlungu endaweni okhalweni. Kamuva kukhulisa ukuvuvukala endaweni ukuxhuma.

Ukulimala kwezitho ezingaphakathi ngaphandle ukuhlukumezeka

Alimazayo we anterior udonga besisu livela izinguquko ezibukwayo lendawo:

• ukuvuvukala;
• ngamanzi;
• ubuhlungu;
• nemivimbo imihuzuko;
• hematomas.

Ubuhlungu contusion esihambisana naleli bhokisi, iyakhula nanoma yimuphi ushintsho isikhundla umzimba, sneezing, ukukhwehlela, sokuzikhulula.

Blunt ukuhlukumezeka besisu kungase kuhambisane izinyembezi fascia. Isiguli ekhononda we ubuhlungu evelele, umuzwa ususuthi. Kukhona paresis ashukumisayo emathunjini, futhi ngokufanelekile, ubunjalo othakazelisayo ukuvimbela. Ukudabuka amaqembu kwemisipha ephelezelwa ukubonakaliswa bendawo ngesimo punctate nokopha noma hematoma ezinkulu, okungase yenziwe yaba yasendaweni hhayi kuphela endaweni lwesigemegeme esibuhlungu, kodwa kude futhi nangale.

Imiphumela yaloku kuhlola okungenhla yokugcina "obonakele anterior udonga besisu" efakwa uma isiqinisekiso yokuntuleka pathologies yangaphakathi.

izinyathelo zokuxilonga

Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa kwesimiso lesiguli iqala anamnesis futhi travmogeneza. definition obengeziwe isimo abalimele kuhlanganisa izindlela ezilandelayo luhlolo:

1. Uhlaziyo jikelele igazi neuropathy libonisa yonke izimpawu acute ukopha: ukwehla abomvu egazi ashaye futhi athwala umoya-mpilo, hematocrit, leukocytosis ebukhoneni i ukuvuvukala.
2. Urinalysis inquma hematuria okubi kakhulu, futhi uma kwamanyikwe lilimele - khona Amylase e umchamo.
3. Kusukela izindlela wezinsimbi luhlolo esinyeni esebenzayo catheterization nekungeniswa uphenyo esiswini.
4. Ultrasound luhlolo.
5. tomography ngekhompyutha nge emthanjeni Ngokuphambene impahla.
6. X ray.
7. Okunye inhlolovo uma kunesidingo (cystography, rheovasography, ERCP).

kwamangqamuzana zokugula

Ukuphenywa ngalo ingaphakathi lesisu kanye nezinhlaka elise kufanele kube leyehlukehlukene kusukela ukulimala concomitant kungase kucindezele izimpawu umonakalo, outputting kuqhame umtholampilo nezinye ukuhlukumezeka.

Trauma isikhungo, ukuhlinzeka round ukwelashwa iwashi, akakwazi ukuba nizifeze zonke lezi zokupopola, ngakho ngemva luhlolo kokuqala isisulu ithunyelwa esibhedlela umnyango kuhlinzwa.

Usizo lokuqala for ukulimala besisu

Uma usola ukuthi ukulimala kwezitho ezingaphakathi kumele zithobele imithetho elandelayo:

1. Sibekezele ibekwe endaweni eqinile, ukuhlinzeka isimo ukuphumula.
2. Ukuze indawo ukuhlukumezeka ukwenza abandayo.
3. Ningamniki amanzi isisulu nokudla.
4. Ungathathi izidakamizwa ngaphambi kokufika usizo oluphuthumayo, ikakhulukazi analgesics.
5. Uma kungenzeka, unikeze zokuya sikhungo.
6. Uma kukhona ukuhlanza, qhelisa ikhanda lesiguli ecaleni, ngakho lokho akwenzekanga ka nenshisekelo.

izimiso ukunakekelwa kwezempilo

Blunt ukuhlukumezeka besisu kudinga ngokushesha kokungenela Ochwepheshe, njengoba umphumela omuhle kungenzeka kuphela uphethwe esifike ngesikhathi futhi ukuyelapha ngokushesha. Ngemva sinjalo isimo ethintekile kanye antishock alinganise iziguli, kokungenela kuhlinzwa. ukulimala Kuvaliwe zidinga ukuhambisana nemibandela elandelayo ngesikhathi imisebenzi:

• ukubulawa kwezinzwa okuvamile nge ezanele muscle;
• medium umugcamkhatsi laparotomy, okuvumela ukufinyelela zonke izindawo esiswini;
• inqubo elula, kodwa yalokho esinokwethenjelwa umcimbi;
• ukuphazamiseka esikhathi esifushane;
• izlivshuyusya phakathi komgodi ongaphakathi kwamathumbu igazi abangathelelekile isicelo reinfusion.

Uma isibindi lilimele, isidingo ukumisa ukopha excision kwezicubu nonviable, suturing. Ukudabuka we ubende, ngemiphumela okungase kuholele ekubeni uthunyelelwe ukususwa emzimbeni, kudinga wokubuyekeza obuphelele. Endabeni ukuhlukumezeka ezincane kubonisa hemostasis suturing. Nge isitho eqinile umonakalo isicelo splenectomy.

Breaks ipheshana ephelezelwa ukususwa izicubu devitalized, ukopha, isibukezo zonke izihibe labetibambile wamathumbu resection uma kunesidingo.

ukulimala kwezinso abadinga isitho-ukungenelela, kodwa ukuchotshozwa eqinile noma ukuhlala ngokwahlukana imithambo yokudla umzimba kwenziwe nephrectomy.

isiphetho

ukuhlukumezeka Isibikezelo esiswini incike velocity we usizo, lo mshini yokulimala, we lesifanele umehluko ukuxilongwa, abasebenzi lochwepheshe bezokwelapha ezikhungweni zezempilo, ukusiza izisulu.