Chii chaunofanira kuita kuti nhavu iputsike?
Kubhuta kuputika kunogona kurwadzisa zvinorwadza uye kunokanganisa nokuti hapana maitiro chaiwo kune avo kunze kwekurwadziwa kwemishonga nenguva yekuporesa. Nechibvu chinoputsika, kurwadziwa kwechibvu kunogona kuwedzererwa nekushambadza kuduku: kufema, kukwezva, uye kufamba kwemuviri wepamusoro.
Munzvimbo yezvipatara, nhavu inoputika ndiyo inowanzovhiringidzika inokonzerwa nechifuva chepfu.
Uyezve, nhavu dzakaputika dzakanyatsobatanidzwa nehutano hutano uye njodzi yekufa. Mune mamwe mazwi, munhu anotsigira kukuvara kwakanyanya uye ane nhamba dzakawanda dzakaputsika ari pangozi yakakura yekufa.
Isu tose tine makero gumi nemaviri embabvu. Nhamba dzitatu dzokutanga dzakaoma kuputsa uye zvinowanzoputsika mushure mokunge dambudziko guru remhepo (semuenzaniso, kuparara kwemotokari). Mamwe mapfumbamwe mapfumbamwe ari nyore kuputsa uye kubhadhara kwezviputi zvakanyanya, uye nhengo dzomukati dzinowanzoputswa. Zvimwe zvinowanzoita zvinokonzera nhavu zvinoputsika zvinowira, kukuvara kwemitambo (semuenzaniso, mutambo webhola kana kuputika), ngozi dzemotokari, kurwisana nekukanganiswa kukuru (kune vakwegura).
Kusvikira hafu yezvese zvinokonzera rib zvinoitika kumberi (anterior) uye kurutivi (lateral) rib cage uye hazvionekwi pa X-ray. Uyezve, zvakanyanya kuoma kuona ruzivo rwe X-ray rwechipiri kune nhavu kuputsika kwemazuva mashomanana mushure mekukuvara. Pakupedzisira, kukanganisa katetilasi kunogona kunge kusingaoneki pa X-ray.
Ultrasound iri kubuda sechinhu chinogona kugadziriswa chigadzirwa kuti chionekwe nenyuchi fractures, kusanganisira fractures mu cartilage
Mukati uye pachedu, chibvu chinoputsika chinorwadza asi kwete upenyu hunotyisidzira. Zvisinei, chibvu chinoputika kazhinji chinowanzobatanidzwa kune dzimwe mhando dzekukuvara zvakanyanya. Nechibhakera chinoputika, vanachiremba vanonyanya kushungurudza pane zvinotevera:
- Mhepo uye ropa mumapapu emapapu (kureva, hemopneumothorax)
- Kuvhiringidzika kweVavendi (iyo midziyo yakawanda yemagetsi inosanganisira subclavia arteri uye mitsipa, arteri isina simba uye mitsipa, uye yakasiyiwa yerari inonzi carotid)
- Kukuvara kwepamuviri
- Kuputsika kwepulmonary
- Kukuvara kumhepo (bronchial tears)
Kana chiremba achimirira pneumothorax, mafirimu akarurama kana anovhima angangove akarayirwa, ayo ari mamwe mavara eX-rays. Uyezve, kana paine dambudziko rakaoma kana kuti mbabvu dzichibva kune imwe nzvimbo, chiremba anogona kuronga mifananidzo yeputi.
Kutambudzika kwebvuri kuputsika kunoita kuti zvive zvakaoma kufema uye zvinogona kuita kuti atelectasis . Atelectasis inotsanangurwa sekuparara kusina kukwana kana kwakakwana kwemapapu. Kunyanya kunyanya, apo murwere ane ruzivo rwechibvu anofema zvishoma zvishoma achipikisa mapapu; iyi hypoventilation inoguma muna atelactasis. Rib fractures inoita kuti zvive zvakaoma kukumbura mumwe munhu kubva pakutsigira ventilatory.
Vachipatara vane chirwere chakakomba chinokonzerwa nemitambo inoputika inogona kugadziriswa nehutachiona nemakore akawanda anesthetic sebupivacaine. Iyi yakareba-kuita anesthetic inotora maawa gumi nemaviri. Dzimwe nguva, dambudziko rinogona kupiwa kuti rimise marwadzo, kunyanya panyaya yekushushikana kwechifuva chemafuro.
Nhamba dzakawanda dzinoputika, zvisinei, hazvirevi nekushandiswa zvakananga kweanesthetics.
Uyezve, nhavu dzakaputika hazvirevi nekudzivirira kwechifukidzo chechifuva uye kusungwa (izvo zvinogona kuita kuti pneumonia kana atelectasis). Panzvimbo pacho, nhavu inoputika inobatwa pamwe nekubatanidzwa kwe benzodiazepines, opioids, uye NSAIDs (zvinodhaka seAppil). Zvinonzwisisika, benzodiazepines uye opioids vane simba rekushandisa zvisina kunaka, uye kushandiswa kwavo kunofanira kushandiswa sezvinorayirwa kusina nguva kudarika chirwere kana kukuvara.
Kana iwe kana munhu waunoda ane chirwere chinokonzera nhavu kuputsika kunze kwechipatara, kune chiitiko chakanakidza chiremba wako asingakwanisi kuongororeka kuputika pa X-ray.
Pane kudaro, kurwadziwa pamusoro pemabvu anokanganisa kunogona kuva chiratidzo chekukuvara.
Kunze kwekurapwa kwechibvumirano kuputika kunowanzosanganisira kushandiswa kwemagetsi evhaji uye mishonga yemishonga inorwadza pamwe nekufema maitiro. Zvakakosha kuti urambe uchishingaira paunopora kubva kumbabvu kuputsika. Kudzorera kunogona kutora vhiki dzitanhatu.
Kunyange zvazvo pasina chirongwa chaiyo chekuputika kwembambo, kana iwe uchifungidzira kuti iwe wakatsigira imwe, iri pfungwa yakanaka kuona chiremba. Chiremba anogona kubatsira nemarwadzo nekukuongorora iwe zvimwe zvekukuvara kana kukuvara. Uyezve, chiremba anogona kukupa mishonga yekurwadziwa kwekukuvara kwako. Ndapota yeuka kuti kana wakarongerwa mishonga, tapota tora sezvakanyorwa. Mimwe mishonga inorayirirwa nenyuchi kuputsika-opioid uye benzodiazepines-inogona kushandiswa zvisina kunaka apo inotorwa zvisina kururama kana kupfuura.
Sources:
Brunett PH, Yarris LM, Cevik A. Chitsauko 258. Pulmonary Trauma. Muna: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e . New York, NY: McGraw-Hill; 2011.