Uburyo bwo gukoresha
(I) Anesthesia
Uburyo bwo gufunga amaguru n'amaboko bukoreshwa ku ngingo zo hejuru, uburyo bwo gufunga amaguru n'amaboko bukoreshwa ku ngingo zo hasi, naho uburyo bwo gufunga amaguru n'amaboko bukoreshwa mu buryo busanzwe cyangwa uburyo bwo gufunga amaguru n'amaboko bushobora gukoreshwa uko bikwiye.
(II) Umwanya
Amaguru yo hejuru: gusinzira, guhindukira kw'inkokora, ukuboko imbere y'igituza.
Amaguru yo hasi: gusinzira, gusinzira ikibuno, gushinyagurirwa, gusinzira ivi n'ingingo y'akaguru mu mwanya wo kwagura umugongo wa dogere 90.
(III)Urutonde rw'imikorere
Urukurikirane rwihariye rw'imikorere ya fixator yo hanze ni uguhinduranya gusubiramo, gushyiramo imigozi no kuyishyiraho.
[Inzira]
Ni ukuvuga ko imvune ibanza guhindurwa (gukosora ubumuga buzenguruka n’ubufatanye), hanyuma igatoborwa n’udupira turi kure y’umurongo w’imvune hanyuma igatangira gukosorwa, hanyuma igashyirwa mu mwanya wayo no gutoborwa n’udupira turi hafi y’umurongo w’imvune, hanyuma igashyirwa mu mwanya wayo kugeza igihe imvune inyutse ikwiriye hanyuma igakosorwa yose uko yakabaye. Mu bihe bimwe na bimwe byihariye, imvune ishobora kandi gukosorwa hakoreshejwe uburyo bwo kuyishyira mu mwanya wayo, kandi iyo ibintu bibaye ngombwa, imvune ishobora gukosorwa, kuyikosora no kuyisubiza mu mwanya wayo.
[Kugabanya kuvunika kw'amagufwa]
Kugabanya imvune ni igice cy'ingenzi mu kuvura imvune. Kuba imvune yagabanutse neza bigira ingaruka ku buryo imvune ikira neza. Iyo mvune ishobora gufungwa cyangwa ikareba neza bitewe n'imimerere runaka. Ishobora kandi guhindurwa hakurikijwe filime ya X-ray nyuma yo gushushanya ubuso bw'umubiri. Uburyo bwihariye ni ubu bukurikira.
1. Kureba neza: Ku mvune zifunguye zifite impera zavunitse, imvune ishobora kongera gusubizwa inyuma nyuma yo gusukurwa neza. Iyo imvune ifunze idashoboye gukoreshwa, imvune ishobora kugabanuka, gutoborwa no gukosorwa nyuma yo gukata gato ka cm 3-5.
2. Uburyo bwo kugabanya imvune bufunze: banza ushyireho imvune mu buryo burambuye hanyuma ukoreshe uko bikurikirana, ushobora gukoresha agapira k'icyuma hafi y'umurongo w'imvune, hanyuma ugakoresha uburyo bwo guterura no gukurura kugira ngo imvune ikomeze gusubizwamo kugeza igihe irangiye hanyuma igakosorwa. Birashoboka kandi gukora impinduka zikwiye ku kwimuka guto cyangwa guhindagurika hakurikijwe X-ray nyuma yo kugabanya no guhagarara hashingiwe ku buso bw'umubiri cyangwa ibimenyetso by'amagufwa. Ibisabwa kugira ngo imvune igabanuke, muri rusange, ni ukugabanya imiterere y'umubiri, ariko imvune ikomeye yacitse, akenshi ntibyoroshye kugarura imiterere y'umubiri w'umwimerere, muri iki gihe imvune igomba kuba ihuye neza n'igice cy'imvune, kandi kugira ngo ikomeze kuba ifite ingufu nyinshi.
[Gushyiramo agapira]
Gufata amagufwa ni bwo buryo bw'ingenzi bwo kubaga amagufwa yo hanze, kandi uburyo bwiza cyangwa bubi bwo gufata amagufwa ntibugira ingaruka gusa ku kudahagarara kw'amagufwa, ahubwo bunagira ingaruka ku ndwara nyinshi cyangwa nkeya ziterwa n'amagufwa. Kubwibyo, uburyo bukurikira bwo kubaga bugomba gukurikizwa neza mu gihe cyo gupfunyika urushinge.
1. Irinde kwangirika kw'ingingo: Sobanukirwa neza imiterere y'aho umuntu acukuye kandi wirinde gukomeretsa imiyoboro y'amaraso n'imitsi.
2. Uburyo bwo kubaga budafite aside, urushinge rugomba kuba ruri kuri cm 2 ~ 3 hanze y'aho igisebe cyanduye kiri.
3. Uburyo bworoshye bwo kudakoresha icyuma: iyo ufashe urushinge rw'igice cy'urushinge kandi rufite umurambararo munini, shyiramo icyuma gityaye n'aho rusohokera urushinge ukoresheje icyuma gityaye kugira ngo ukore uruhu rufite uburebure bwa 0.5 ~ 1cm; iyo ufashe urushinge rw'igice cy'urushinge, koresha forceps zo gutandukanya imitsi hanyuma ushyireho cannula hanyuma utobore imyobo. Ntugakoreshe ingufu zihuta cyane iyo utoboye cyangwa utoboye urushinge mu buryo butaziguye. Nyuma yo gutoboza urushinge, ingingo zigomba kwimurwa kugira ngo harebwe niba hari imbaraga zihari ku ruhu ku rushinge, kandi niba hari imbaraga zihari, uruhu rugomba gucibwa no gushongeshwa.
4. Hitamo neza aho urushinge ruherereye n'inguni yarwo: urushinge ntirugomba kunyura mu mitsi gato gashoboka, cyangwa urushinge rugomba gushyirwa mu mwanya w'imitsi: iyo urushinge rushyizwe mu murongo umwe, intera iri hagati y'inshinge mu gice cyavunitse ntigomba kuba munsi ya cm 6; iyo urushinge rushyizwe mu mirongo myinshi, intera iri hagati y'inshinge mu gice cyavunitse igomba kuba nini gashoboka. Intera iri hagati y'inshinge n'umurongo w'aho imvune cyangwa ubuso bufatanye ntigomba kuba munsi ya cm 2. Inguni yo kwambukiranya inshinge mu gice cya multiplanar igomba kuba 25° ~ 80° ku nshinge zuzuye na 60° ~ 80° ku nshinge zuzuye.
5. Hitamo neza ubwoko n'umurambararo w'urushinge rw'icyuma.
6. Zingira umwobo w'urushinge neza ukoresheje agatambaro ka alukolo n'agatambaro katanduye.
Aho urushinge rw'inyuma rw'umugongo ruherereye ugereranije n'umutsi wo hejuru w'ukuboko (Urugero rugaragara ku ishusho ni ahantu hatekanye ho gushyira urushinge mu ruziga.)
[Gushyiraho no gushyiraho]
Mu bihe byinshi, kugabanya imvune, gufunga no gufunga bikorerwa mu buryo butandukanye, kandi gufunga bikorwa uko bikenewe iyo imigozi y'icyuma yagenwe yatobowe. Imvune zihamye zishyirwaho hakoreshejwe gukanda (ariko imbaraga zo gukanda ntizigomba kuba nyinshi cyane, bitabaye ibyo hazavuka ubumuga bw'inguni), imvune zacitse zishyirwa mu mwanya utari wo hasi, naho ubumuga bw'amagufwa bugashyirwa mu mwanya utari wo hasi.
Imiterere y'uburyo bwo gukurura ibintu muri rusange igomba kwitabwaho n'ibi bikurikira: 1.
1. Gerageza uburyo ingingo ihagaze neza: uburyo ni ugukoresha ingingo, uburebure bw'ingingo cyangwa gusunika impande z'ingingo icitse; impera y'ingingo ihamye idahinduka ntigomba kugira igikorwa cyangwa ngo ibe ifite urwego ruto rwo gukurura. Niba ubushobozi budahagije, ingamba zikwiye zishobora gufatwa kugira ngo hongerwe uburyo bwose buhamye.
2. Intera iri hagati y’igufwa rifata inyuma ugana ku ruhu: 2 ~ 3cm ku gice cyo hejuru, 3 ~ 5cm ku gice cyo hasi, kugira ngo hirindwe ko uruhu rukandagira kandi byorohereze ubuvuzi bw’ihungabana, iyo kubyimba gukomeye cyangwa ihungabana ari rinini, intera ishobora gusigara ari nini mu ntangiriro, kandi intera ishobora kugabanuka nyuma y’uko kubyimba kugabanutse kandi ihungabana rikosowe.
3. Iyo habayeho imvune ikomeye ku mubiri, hari ibice bishobora kongerwamo kugira ngo urwego rwakomeretse rube ruhagaze cyangwa rurerure hejuru, kugira ngo byorohereze kubyimba kw'urugingo no gukumira imvune.
4. Agakoresho ko gushyira amagufwa inyuma y’ingingo ntigakwiye kugira ingaruka ku myitozo ngororamubiri y’ingingo, igice cyo hasi kigomba kuba cyoroshye kugendamo igihe umuntu aremerewe, naho igice cyo hejuru kigomba kuba cyoroshye mu mirimo ya buri munsi no mu kwiyitaho.
5. Impera y'urushinge rw'icyuma ishobora gushyirwa ku gice cyo gufata urushinge cy'icyuma kingana na cm 1, kandi umurizo muremure cyane w'urushinge ugomba gucibwa. Impera y'urushinge ipfundikiwe umupfundikizo wa pulasitiki cyangwa kaseti, kugira ngo idatobora uruhu cyangwa ngo iruce.
[Intambwe zigomba gufatwa mu manza zidasanzwe]
Ku barwayi bafite ibikomere byinshi, bitewe n'ibikomere bikomeye cyangwa imvune zishobora gushyira ubuzima bwabo mu gihe cyo kubyutsa umubiri, ndetse no mu bihe byihutirwa nko gutanga ubufasha bw'ibanze mu murima cyangwa imvune nyinshi, urushinge rushobora kubanza gushyirwaho imigozi no gufungwa, hanyuma rukosorwa, rukosorwa, kandi rugafatwa mu gihe gikwiye.
[Ingorane zisanzwe]
1. Kwandura udukoko two mu muhogo; na
2. Kugabanya uruhu mu mitsi; na
3. Gukomereka kw'imitsi n'amaraso
4. Gutinda gukira cyangwa kudakira kw'imvune.
5. Udupira twamenetse
6. Gucika kw'inzira y'agapira
7. Kutagenda neza kw'ingingo
(IV) Ubuvuzi nyuma yo kubagwa
Kuvurwa neza nyuma yo kubagwa bigira ingaruka zitaziguye ku buryo ubuvuzi bugenda neza, bitabaye ibyo hashobora kubaho ingorane nko kwandura mu mwobo no kudahuza kw'ivunika. Kubwibyo, hakwiye kwitabwaho bihagije.
[Ubuvuzi rusange]
Nyuma yo kubagwa, urwego rw'umubiri rwakomeretse rugomba kuzamurwa hejuru, kandi amaraso atembera neza no kubyimba kw'urugingo rwakomeretse; iyo uruhu rukandamijwe n'ibice by'icyuma gifata amagufwa bitewe n'aho urwego rw'umubiri ruhagaze cyangwa rubyimbye, rugomba gufatwa neza ku gihe. Ibikoresho birekuye bigomba gukazwa ku gihe.
[Gukumira no kuvura indwara zandura]
Ku bijyanye no gufata amagufwa yo hanze, imiti yica udukoko si ngombwa kugira ngo hirindwe kwandura umwobo w'inyuma. Ariko, aho imvune n'igikomere ubwabyo bigomba kuvurwa na miti yica udukoko uko bikwiye. Ku mvune zifunguye, nubwo igikomere cyaba cyarasukuwe neza, imiti yica udukoko igomba gukoreshwa iminsi 3 kugeza kuri 7, kandi imvune zanduye zigomba guhabwa imiti yica udukoko igihe kirekire uko bikwiye.
[Kwita ku mwobo w'impini]
Hakenewe akazi kenshi nyuma yo gufata amagufwa yo hanze kugira ngo umuntu yita ku mwobo w'inyuma buri gihe. Kwita ku mwobo w'inyuma bidakwiye bizatera kwandura mu mwobo w'inyuma.
1. Muri rusange ipfundikizo rihindurwa rimwe ku munsi wa 3 nyuma yo kubagwa, kandi ipfundikizo rigomba guhindurwa buri munsi iyo hari amazi ava mu mwobo w'inyuma.
2. Mu minsi 10 cyangwa irenga, uruhu rw'agace k'umugozi rupfunyitse mu buryo bw'imigozi, mu gihe uruhu rukomeza gusukura kandi rwumye, buri munsi 1-2 mu gace k'umugozi ibitonyanga bya 75% by'umuti wa alcool cyangwa iodine fluoride bishobora kuba.
3. Iyo hari umuvuduko mu ruhu ku mwobo w'inyuma, uruhande rw'umuvuduko rugomba gucibwa ku gihe kugira ngo ugabanye umuvuduko.
4. Witondere uburyo bwo gukora ibintu bidatera isesereza mu gihe uhindura icyuma gifata amagufwa cyangwa uhindura imiterere yacyo, kandi ushyire imiti ku ruhu rukikije umwobo w'icyuma n'urushinge rw'icyuma buri gihe.
5. Irinde kwandura indwara zitandukanye mu gihe cyo kwita ku mwobo w'inyuma.
6. Iyo habayeho kwandura ku mwobo w'inyuma, hagomba gukorwa ubuvuzi bukwiye ku gihe, kandi urugingo rwakomeretse rugomba kuzamurwa kugira ngo ruruhuke kandi hagashyirwaho imiti irwanya udukoko ikwiye.
[Imyitozo ngororamubiri]
Imyitozo ngororamubiri ikorwa ku gihe kandi neza ntabwo ifasha gusa mu gusubiza imikorere y'ingingo, ahubwo inafasha mu kongera kubaka uburyo bwo kuvura indwara no gukangura imitsi kugira ngo habeho gukira kw'imvune. Muri rusange, gufunga imitsi no gukora imirimo y'ingingo bishobora gukorwa mu buriri mu minsi 7 nyuma yo kubagwa. Amaboko yo hejuru ashobora gukora akazi ko gukanda no gufata amaboko no gukora ingendo z'ukuboko n'inkokora, kandi imyitozo yo kuzunguruka ishobora gutangira nyuma y'icyumweru kimwe; amaguru yo hasi ashobora kuva mu buriri igice cy'igice hifashishijwe inkoni nyuma y'icyumweru kimwe cyangwa nyuma yuko igikomere kimaze gukira, hanyuma agatangira kugenda buhoro buhoro yikoreye ibiro byose nyuma y'ibyumweru 3. Igihe n'uburyo bw'imyitozo ngororamubiri bihinduka bitewe n'umuntu ku giti cye, ahanini bitewe n'imiterere y'aho umuntu atuye n'imiterere y'umubiri we. Mu gihe cyo gukora imyitozo ngororamubiri, niba umwobo w'inyuma usa n'umutuku, wabyimbye, ubabaza n'ibindi bimenyetso by'ububyimba bigomba guhagarika igikorwa, kuzamura amaguru yafashwe n'ingingo ukajya mu buriri.
[Gukuraho agakoresho ko gufata amagufwa yo hanze]
Igikoresho cyo gufunga inyuma kigomba gukurwaho iyo imvune igeze ku bipimo byo gukira kw'imvune. Mu gukuraho agakoresho ko gufunga inyuma k'amagufwa, imbaraga zo gukira kw'imvune zigomba kumenyekana neza, kandi imbaraga zo gufunga inyuma y'amagufwa ntizigomba gukurwaho mbere y'igihe hatabayeho kumenya neza imbaraga zo gukira kw'amagufwa n'ingorane zigaragara zo gufunga inyuma y'amagufwa, cyane cyane mu kuvura indwara nko kuvunika kwa kera, kuvunika kwangiritse, no kudahuza kw'amagufwa.
Igihe cyo kohereza: Kanama-29-2024
