Uburyo bwo gukora
(I) anesthesia
Brachial Block yakoreshejwe kumajana yo hejuru, epide uhagarika cyangwa guhagarika subwachnoid ikoreshwa kumaguru, kandi anesthesia rusange cyangwa anesthesia yaho birashobora kandi gukoreshwa nkuko bikwiye.
(Ii) umwanya
Amaguru yo hejuru: Supine, Elbow Flexion, ukuboko imbere yigituza.
Amaguru yo hepfo: Supine, HIP Flexion, gushimuta, guhindagurika ku mavi hamwe no kumenyo hamwe mumwanya wo kwagura impamyabumenyi 90.
(Iii) Igikorwa gikurikirana
Urukurikirane rwihariye rwibikorwa bya fineri yo hanze ni uguhindura gusubiramo, gushyiraho imitwe no gukosorwa.
[Inzira]
Ni ukuvuga, kuvunika kwabanje gusubirwamo (gukosora ubumuga bwo kunyeganyega no kurengana), hanyuma ugatobora amapine kumurongo wo kuvunika, hanyuma ushyireho amapine, hanyuma ushyireho amapine, hanyuma ushyireho amapine yumurongo uvuza, hanyuma ushyireho amapine, hanyuma ushyireho amapine, hanyuma ushyireho amapine, hanyuma ushyireho amapine yo kuvunika, hanyuma ushyireho amapine, hanyuma ushyireho amapine yo kuvunika, hanyuma ushyireho amapine, hanyuma ushyireho amapine yo kuvunika, hanyuma ushyirweho kandi ushyireho amapine, hanyuma ushyireho amapine, hanyuma utombere kandi ushyireho amapine yo kuvunika, hanyuma ukatongana kandi ukinjizamo kunyurwa no kunanirwa rwose. Mubibazo byihariye, kuvunika birashobora kandi gukosorwa no kwibohora muburyo butaziguye, kandi iyo ibintu bishoboke, kuvunika birashobora gusubirwamo, byahinduwe no kongera gukosorwa.
Kugabanuka]
Kugabanya kuvunika nigice cyingenzi cyo kuvura. Niba kuvunika bigabanuka bishimishije bifite ingaruka zitaziguye ku bwiza bwo gukiza. Kuvunika birashobora gufungwa cyangwa mubyerekezo bitaziguye ukurikije uko ibintu byihariye. Irashobora kandi guhindurwa ukurikije firime ya X-ray nyuma yumubiri. Uburyo bwihariye ni bukurikira.
1. Mubyerekezo bitaziguye: kubice bifunguye hamwe no kuvunika kugaragara birangira, kuvunika birashobora gusubirwamo hakurikijwe iyerekwa ritaziguye nyuma yo guhanura neza. Niba kuvunika gufunga binaniza gukoreshwa, kuvunika birashobora no kugabanuka, gutobora no gukosorwa munsi yereye iyerekwa ritaziguye nyuma yo gutegurwa gato nyuma ya 3 ~ 5cm.
2. Uburyo bufunze: Banza uvugishe hafi hanyuma ukorere ukurikije urukurikirane, urashobora gukoresha progaramu yo gutemba, hanyuma ukoreshe uburyo bwo guterura no kunyurwa no kunyurwa no gukosorwa. Birashoboka kandi guhindura ingirakamaro muguhindura ibintu bito cyangwa kumbaza ukurikije x-ray nyuma yo kugabanya no gukosora ukurikije umubiri cyangwa ibiranga amagufwa. Ibisabwa kugabanuka, muburyo bwo kugabanya anatolicake, ariko birakomeye byo kuvunika, akenshi ntibyari byoroshye kugarura imiterere ya anatomique, muriki gihe kuvunika bigomba kuba byiza hagati yo kuvunika, no gukomeza ibisabwa byose.
[Pinning]
Gutwika ni tekinike yingenzi yo gukosora amagufwa yo hanze, kandi tekinike nziza cyangwa mibi yo kwiyerekana ntabwo igira ingaruka gusa yo gukosorwa, ariko nanone bifitanye isano nubunini cyangwa buke cyane. Kubwibyo, tekinoroji zikurikira zigomba gukurikizwa cyane mugihe urushinge.
1. Irinde kwangirika kwingwate: Sobanukirwa neza na anatomy y'urubuga rutobora kandi wirinde gukomeretsa imiyoboro nyamukuru y'amaraso.
2. Tekinike yo gukora cyane, inshinge igomba kuba 2 ~ 3cm hanze yakarere ka wanduye.
3. Tekiniki zidatera imbere: iyo wambaye igice cyumushinyagu hamwe nigishishwa cyuzuye, urushinge rwamabuye nicyuma gityaye kugirango uruhuke uruhu 0.5 ~ 1cm; Mugihe wambaye igice-urushinge, koresha ibyangombwa bya Haeoswatike kugirango utandukanye imitsi hanyuma ushyire urusaku hanyuma ugacukura umwobo. Ntukoreshe imbaraga zihuta zo gushimisha mugihe ucukura cyangwa uhanganye nurushinge. Nyuma yo gutsinda urushinge, ingingo zigomba kwimurwa kugirango urebe niba hari amakimbirane mu ruhu ku rushinge, kandi niba hari impagarara, uruhu rugomba gutemwa kandi rukatirwa.
4. Hitamo neza aho hantu ningugu yumushingwe: Urushinge ntirukwiye kunyuramo bike gishoboka, cyangwa urushinge rugomba kwinjizwa mu ndege imwe, intera irinjizwa mu indege imwe, intera iri hagati y'inshinge mu gice cyo kuvunika ntagomba kuba munsi ya cm 6; Iyo urushinge rwinjijwe mu ndege nyinshi, intera iri hagati yinshinge mugice cyo kuvunika bugomba kuba kinini gishoboka. Intera iri hagati yimirongo hamwe numurongo uvunika cyangwa hejuru yubuhanzi ntigomba kuba munsi ya 2cm. Inguni zambuka ryibipimo byipimisha byinshi na 60 ° ~ 80 °
5. Hitamo neza ubwoko na diameter y'urushinge rw'ibyuma.
6. Uzenguruke umwobo ushimishije hamwe na alcoze na gaze ya gaze na sterile.
Umwanya wurungano rwibanze rwinshi mubijyanye na bundle ya vascular bundle yukuboko hejuru (umurenge werekanye murugero ni ahantu h'umutekano wo guhangana nurushinge.)
[Gushiraho no gukosora]
Mubihe byinshi byo kugabanya, kwikubita no gukosora bikozwe muburyo bundi, kandi gukosora birarangiye mugihe bisabwa mugihe ibiciro byateganijwe mbere byateganijwe. Kuvunika bihamye bikosowe hamwe no kwikuramo (ariko imbaraga zo kwikuramo ntizigomba kuba nini cyane, bitabaye ibyo kubungabunga inguni bizaba bigerwaho) mumwanya utabogamye, kandi ishyano ryamagufa rishyizwe mubikorwa birangaza.
Imyambarire ya rusange igomba kwitondera ibibazo bikurikira: 1.
1. Gerageza umutekano wo gukosora: Uburyo ni ugukoresha hamwe, gushushanya kirekire cyangwa kuruhande rusunika kurangirira; Itara rihamye rihamye ntirishobora kugira ibikorwa cyangwa umubare muto gusa mubikorwa bya elastike. Niba hashyizweho ingamba zidahagije, zikwiye zishobora gufatwa kugirango wongere uburemere rusange.
2. Intera kuva mumagufwa yo hanze kuruhu: 2 ~ 3cm kumagambo yo hejuru, 3 ~ 5cm kumagambo yo hepfo, mugihe kubyimba byose, kandi intera irashobora kugabanuka nyuma yo kubyimba igabanywa nihungabana rirasanwa.
3. Iyo aherekejwe nigikomere gikomeye cyoroheje, ibice bimwe birashobora kongerwaho kugirango umuntu wakomeretse yahagaritswe cyangwa hejuru, kugirango yoroshya kubyimba igihimba kandi aribuza gukomeretsa.
4.
5. Iherezo ryurushinge rwicyuma rirashobora guhura nudushingo clip clip kuri 1cm, hamwe numurizo muremure cyane wumushi urushinge bigomba gucibwa. Iherezo ry'urushinge hamwe na kashe ya plastike cyangwa kaseti ipfunyitse, kugirango udacumize uruhu cyangwa ngo ugabanye uruhu.
[Intambwe zigomba gufatwa mu manza zidasanzwe]
Ku barwayi bafite ibikomere byinshi, kubera ibikomere bikomeye cyangwa ibikomere byangiza ubuzima mugihe cyo kuzura, ndetse no mubihe byihutirwa nko kubanza gusozwa, hanyuma byongera gukosorwa, kandi byongeye gukosorwa, no gukosorwa, kandi bikemurwa mugihe gikwiye.
[Ibibazo bisanzwe]
1. Indwara ya Pinhole; na
2. Gukemura Uruhu NECROSIS; na
3. Imvune ya NeurovasCular
4. Gutinda gukira cyangwa kudakiza kuvuka.
5. Amapine yamenetse
6. Pin Tract
7. Ihuriro rihuriweho
(Iv) kuvura nyuma yo kuvura
Kuvura neza gutabara neza bigira ingaruka kubikorwa byo kuvura, bitabaye ibyo kubibazo nkibi byanduye bya pishole no mubusaruro bishobora kubaho. Kubwibyo, kwitabwaho bihagije bigomba kwishyurwa.
[Ubuvuzi rusange]
Nyuma yo kubagwa, igihome cyakomeretse kigomba kuzamurwa, kandi gukwirakwiza amaraso no kubyimba igihome cyakomeretse bigomba kubahirizwa; Iyo uruhu rugizwe nibigize amagufwa yo hanze yububiko kubera umwanya cyangwa kubyimba igihimba, bigomba gukemurwa mugihe. Imigozi irekuye igomba gukomera mugihe.
[Gukumira no kuvura indwara]
Kubicuruzwa byamagufwa yo hanze ubwabyo, antibiyotike ntabwo ari ngombwa kugirango wirinde kwandura Pinhole. Ariko, kuvunika kandi igikomere ubwacyo ntigomba gufatwa na antibiyotike nkuko bikwiye. Kubijyanye no gukingura, nubwo igikomere cyuzuyemo ibintu byangiritse cyane, kigomba gukurikizwa muminsi 3 kugeza 7, no kuvunika kwanduye bigomba guhabwa antibiyotike mugihe kirekire nkuko bikwiye.
[KONHOLE KUBONA]
Ibikorwa byinshi nyuma yo gukosora amagufwa asabwa kwita kuri Pinholes buri gihe. Ubwitonzi budakwiye buzavamo kwandura pinhole.
1. Muri rusange imyambarire yahinduwe rimwe kumunsi wa 3 nyuma yo kubagwa, kandi imyambarire igomba guhinduka buri munsi mugihe hari oozing kuva kuri Pinhole.
2. Iminsi 10 cyangwa irenga, uruhu rwa Pinhole ni fibrous zipfunyitse, mugihe ugumye uruhu rusukuye kandi rwumye, buri munsi wiminsi 1 ~ 2 mumato ya pinhole cyangwa iyode ya fluoride irashobora.
3. Iyo hari amakimbirane mu ruhu kuri Pinhole, uruhande rwo guhagarika rugomba gucibwa mugihe cyo kugabanya impagarara.
4. Witondere ibikorwa byingeptike mugihe uhinduye amagufwa yo hanze cyangwa guhindura iboneza, no kwanduza uruhu ruzengurutse Pinhole hamwe nurushinge rwibyuma basanzwe.
5. Irinde kwandura-mugihe cya Pinhole.
6. Indwara ya pinhole ibaho, ivurukwa neza rigomba gukorwa mugihe, kandi igihome gikomeye cyakomeretse kigomba kuzamurwa muburuhukiro kandi kidakwiye kigomba gukoreshwa.
Imyitozo ikora]
Imyitozo yigihe gito kandi ikwiye ntabwo ifasha gusa kugarura imikorere ihuriweho, ariko no kongera kubaka Haemodynamike no Gutesha umutwe Guteza imbere inzira yo gukiza. Muri rusange, kugabanuka kwimitsi nibikorwa bihuriweho birashobora gukorwa muburiri mugihe cyiminsi 7 nyuma yo kubagwa. Amaguru yo hejuru arashobora gukora gukubita no gufata amaboko no kugenda kwigenga wintoki n'inkokora ingingo, hamwe nimyitozo yo kuzunguruka irashobora gutangira nyuma yicyumweru 1; Amaguru yo hepfo arashobora kuva mu buriri afashijwe na inkoni nyuma yicyumweru 1 cyangwa nyuma igikomere gimaze kugenda, hanyuma ugatangira kugendana nuburemere bugenda bwitwaje ibiro byuzuye. Igihe nuburyo bwimyitozo yimikorere iratandukanye kubantu, cyane cyane bitewe nibihe byaho nuburyo bwa sisitemu. Muburyo bwimyitozo, niba Pinhole igaragara itukura, yabyimbye, irababaza kandi izindi myigaragambyo igomba guhagarika ibikorwa, kuzamura ingingo yibasiwe kuryama.
[Gukuraho Amagufwa yo hanze]
Urwenya rwo hanze rugomba kuvaho mugihe kuvunika kwageze ku bipimo bya kavukire byo gukiza. Mugihe ukuraho amagufwa yo hanze, imbaraga zo gukiza kumeneka zigomba kwiyemeza neza, kandi iyo ikosora igusora amagufwa yo gukosora imbema, cyane cyane mugihe cyo kuvura amagufwa ashaje, cyane cyane kuvunika, n'amagufwa antion.
Igihe cya nyuma: Aug-29-2024
