Kuvunika kw'ikibuno hagati y'abagore ni byo bikunze kugaragara cyane mu buvuzi kandi ni kimwe mu bikomere bitatu bikunze kugaragara bifitanye isano n'indwara yo kuvunika kw'amagufwa mu bageze mu za bukuru. Ubuvuzi busanzwe busaba kuryama igihe kirekire mu buriri, bigatera ibyago byinshi byo kurwara ibisebe by'umuvuduko, kwandura indwara z'ibihaha, kuvura ibihaha, kuvura imitsi yo mu mitsi miremire, n'izindi ngorane. Ingorane zo kurera ni nyinshi, kandi igihe cyo gukira ni kirekire, bigashyira umutwaro uremereye ku muryango ndetse no ku miryango. Kubwibyo, kubagwa hakiri kare, igihe cyose bishoboka, ni ingenzi kugira ngo hagerwe ku musaruro mwiza ku bikomere byo ku kibuno.
Muri iki gihe, uburyo bwo gufata PFNA (proximal femoral nail antirotation system) bufatwa nk'icyitegererezo cyiza cyo kuvura imvune zo mu kibuno. Kugira ubufasha bwiza mu gihe cyo kugabanya imvune zo mu kibuno ni ingenzi cyane kugira ngo wemererwe gukora imyitozo ngororamubiri hakiri kare. Intraoperative fluoroscopy ikubiyemo anteroposterior (AP) na lateral views kugira ngo harebwe igabanuka ry'inyuma y ...
▲ Ishusho igaragaza uburyo imiterere y’ubufasha bwiza (a), ubw’ubufasha butagira aho bubogamiye (b), n’ubw’ubufasha bubi (c) bw’amagufwa yo mu kibuno mu ishusho y’imbere.
▲ Ishusho igaragaza uburyo imvune zo mu kibuno zigaragara ku ruhande rw'inyuma, imiterere y'ubufasha butagira aho bubogamiye (d), imiterere y'ubufasha butagira aho bubogamiye (e), n'imiterere y'ubufasha butari bwiza (f).
Iyi nkuru irimo amakuru y’abarwayi 128 bavunitse mu kibuno. Amashusho yo mu gihe cyo kubagwa imbere n’inyuma yatanzwe ku baganga babiri batandukanye (umwe ufite uburambe buke n’undi ufite uburambe bwinshi) kugira ngo bapime ubufasha bwiza cyangwa budahagije. Nyuma y’isuzuma rya mbere, hakozwe isuzuma rishya nyuma y’amezi 2. Amashusho ya CT nyuma yo kubagwa yahawe umwarimu w’inararibonye, maze amenya niba ikibazo cyari gifite ubuziranenge cyangwa budahagije, nk’ihame ryo gusuzuma ukuri kw’isuzuma ry’amashusho ryakozwe n’abaganga babiri ba mbere. Igereranya ry’ingenzi riri muri iyi nkuru ni iri rikurikira:
（1）Ese hari itandukaniro rikomeye mu mibare mu bisubizo by'isuzuma hagati y'abaganga bafite uburambe buke n'abadafite uburambe mu isuzuma rya mbere n'irya kabiri? Byongeye kandi, iyi nkuru irasuzuma uburyo amatsinda ahuza abantu bafite uburambe n'abadafite uburambe mu isuzuma rya kabiri ndetse n'uburyo amatsinda yombi ahuza abantu.
（2） Hakoreshejwe CT nk'icyitegererezo cya zahabu, iyi nkuru irasuzuma ikizewe kurushaho mu gusuzuma ireme ry'igabanuka: isuzuma rya lateral cyangwa anteroposterior.
Ibisubizo by'ubushakashatsi
1. Mu byiciro bibiri by'isuzuma, hamwe na CT nk'igipimo ngenderwaho, nta tandukaniro rikomeye ryagaragaye mu mibare mu bijyanye n'ubushobozi bw'umubiri, umwihariko, igipimo cy'ubwiyongere bw'indwara, igipimo cy'ubwiyongere bw'indwara, n'ibindi bipimo bijyanye no gusuzuma ireme ry'igabanuka ry'indwara hashingiwe ku bipimo bya X-ray hagati y'abaganga babiri bafite uburambe butandukanye.
2. Mu isuzuma ry’igabanuka ry’ubuziranenge, dufashe urugero rw’isuzuma rya mbere:
- Iyo hari ubwumvikane hagati y’isuzuma rya anteroposterior n’iry’inyuma (ryose ari ryiza cyangwa ritari ryiza), ukwizerwa mu guhanura igabanuka ry’ubwiza bwa CT ni 100%.
- Iyo hari ukutumvikana hagati y’isuzuma rya anteroposterior n’iry’inyuma, ukwizerwa kw’ibipimo by’isuzuma rya lateral mu guhanura igabanuka ry’ubwiza bwa CT kuba hejuru.
▲ Ishusho igaragaza inkunga nziza igaragara mu ishusho iri imbere mu gihe igaragara nk'aho idashimishije mu ishusho iri inyuma. Ibi bigaragaza ko hari ukudahuza mu bisubizo by'isuzuma hagati y'ishusho iri imbere n'iri ku ruhande.
▲ Uburyo bwo kongera gusuzuma CT mu buryo butatu butanga amashusho yo kwitegereza mu buryo butandukanye, bukoreshwa nk'icyitegererezo cyo gusuzuma igabanuka ry'ubwiza bw'umubiri.
Mu bipimo byabanje byo kugabanya imvune hagati y’uturemangingo, usibye inkunga nziza n’iy’ibidafatika, hariho n’igitekerezo cy’inkunga "itagira aho ibogamiye", bivuze kugabanuka kw’imiterere y’umubiri. Ariko, bitewe n’ibibazo bijyanye no gukemura ikibazo cy’izuba no kumenya amaso y’umuntu, "kugabanuka kw’imiterere y’umubiri" mu buryo bw’imitekerereze ntabwo bibaho, kandi buri gihe hari ukunyuranya guto ku kugabanuka "kwiza" cyangwa "kwiza". Itsinda riyobowe na Zhang Shimin wo mu bitaro bya Yangpu i Shanghai ryasohoye inyandiko (inyinshi yibagiranye, yakwishimira ko hari umuntu wayitanga) ivuga ko kugera ku nkunga nziza mu mvune hagati y’uturemangingo bishobora gutanga umusaruro mwiza ugereranije no kugabanuka kw’imiterere y’umubiri. Kubwibyo, dukurikije ubu bushakashatsi, hagomba gushyirwamo imbaraga mu gihe cyo kubaga kugira ngo haboneke inkunga nziza mu mvune hagati y’uturemangingo, haba mu buryo bwo kureba imbere no ku ruhande.
Igihe cyo kohereza: Mutarama-19-2024
