Concomitant choipa. Angapo ndipo amaphatikiza zoopsazo

kuvulala Concomitant zikuphatikizapo zosiyanasiyana diagnoses, khalidwe kwa anthu opulumuka zotsatira aakulu zoopsa ziwalo zambiri ndi malo a thupi. Apa, woyamba wa zotupa zonse olekanitsidwa imene, pamodzi ndi zovuta kuvulala kwa mutu ndi ziwalo ndi kuswa a dongosolo minofu ndi mafupa.

zifukwa zazikulu kupeza ophatikizana mabvuto

Concomitant choipa zambiri chifukwa cha ngozi zoopsa, kugwa kuchokera pamwamba kwambiri kapena chifukwa cha ziwawa. Malinga ndi ziwerengero zokhumudwitsa, zambiri za kuvulala nafe mu aakulu imagwera pa gulu ngozi pa phazi. Pa nthawi yomweyo, milandu zambiri za imfa anati kugwa kuchokera kumwamba ndi.

Ngati ife kulankhula za anthu amene amamenyedwa, ndiye zoterezi yodziwika ndi aakulu cranial ndi nkhope zoopsa, pamodzi ndi kuvulala msana, ziwalo.

chithunzi matenda

Tikaphatikiza choipa zosiyanasiyana zosiyanasiyana zizindikiro zomwe zimadalira kwenikweni pa malo zowonongeka yovuta kwambiri, pamaso pa kukha mwazi zinthu zoopsa mantha, matenda, ubongo, matenda a mtima, dongosolo kupuma.

Wonse matenda chithunzi pokonza kuvulala okhudzidwa zachokera kutsogolera choipa, pamaso amene amabisa kuopseza moyo. Komabe, pali milandu pamene pali kuposa ofanana kuwonongeka kusalekerera lalikulu.

Mitundu kuvulala okhudzidwa

Pali losavuta gulu la zovuta ophatikizana polytrauma, zomwe n'zofunika kwambiri ngati mtima yoyenera mlingo wa kuwonongeka madokotala mwadzidzidzi.

Potengera chikhalidwe cha kuwonongeka mwakayakaya kugwirizana kutsogolera wachinsinsi motere:

• lotseguka kapena chatsekedwa ubongo choipa ndi kuvulala cranial molumikizana ndi mtundu womwewo wa m'madera ena a thupi monga thoracic, dipatimenti celiac, miyendo mafupa a chiuno;
• lotseguka kapena chatsekedwa choipa pachifuwa, pamodzi ndi choipa ubongo zoopsa;
• lotseguka kapena chatsekedwa choipa celiac M'mimbamo, mutu, msana, miyendo;
• zovuta msana choipa pamodzi ndi kuvulala mbali zina: ubongo, pamimba, mafupa a chiuno, chifuwa;
• kwambiri m'chiuno choipa, pamodzi ndi ubongo, celiac, thoracic kuvulala.

Angapo ndipo amaphatikiza zoopsazo

Pamaso pa wavulala mu nkhani ya kukhalapo kwa wozunzidwayo chikumbumtima kungachititse kuti mapangidwe otchedwa kuwonongeka psevdodominantnyh. chikhalidwe choterocho zimayambitsa wodwala kuganizira kuvulala zochepa kwambiri, kukusokonezani dokotala matenda zolondola.

Kupewa zolakwa matenda pokonza angapo zoopsa mwadzidzidzi amalola Buku ndi kuchititsa X-ray mosamala mafupa lonse.

Popeza chikumbumtima kupanga angapo polytrauma Musanayambe wochititsidwa pamaso pa zotupa mu thorax, msana, pamimba, chigaza ndi mafupa a chiuno. Pa nthawi yomweyo, chifukwa kuchita X-ray matenda angakhale nthambi pamaso abrasions, edemas, hematomas, uncharacteristic boma khola nthambi motility.

chisamaliro choyamba mwadzidzidzi

Lolemera concomitant choipa amatanthauza kuwonongeka imene olimba a boma anavulala mwachuluka amadalira liwiro la mwadzidzidzi choyamba. Zoyendera wodwalayo vuto la kuvulala ophatikizana amafuna machira zovuta, potero kuchepetsa mosavuta airway chopingasa magazi, masanzi, ndi kupewa chinenero kapena Anabweza wa mandible lapansi. Mu yomweyi, m'chigawo cha nasopharynx kutsukidwa gauze kapena madzi a zachipatala suction. Aakulu ophatikizana zoopsa kungafune kutsegula wapadera wa pakamwa gag.

Komanso, ngati kulephera n'zosavuta kubala yokumba kupuma pakamwa ndi pakamwa kapena kudzera wagawo ndi KI-ZM. Pamene mwamsanga, mwamsanga, ndipo ambiri Chofunika, thandizo zolondola kudzera kukhazikitsa ntchito pamwamba, wozunzidwayo akuchira mpweya, kenako zambiri amapezeka boma sadziwa.

Pambuyo yobereka kuti anakhudzidwa chipinda kugwirizana zoopsa ziziyenda ntchito yofunika thupi amafuna kugwiritsira poliglyukina, prednisolone, hydrocortisone. Pamaso pa kuvulala kwambiri moti miyendo wolumikizira magazi yatsoka superimposed oyang'anira.

Concomitant choipa ana, kapena munthu matenda oopsa kwambiri omwe pali otsika magazi ndipo amafuna utsogoleli wa insulin kulowetsa mtsempha 40% TH pamene kudyetsa shuga poliglyukina timadzi.

Mu chochitika cha umagunda mofulumira zotumphukira ziziyenda pa mavuto 80 mamilimita Hg. Art. mu nkhani ya nthambi fractures osakaniza ali osavomerezeka nthawi yocheza mu imposition matayala. M'malo mwake, cholinga ndi anaikira kuletsa kulephera kwa ziwalo zofunika kwambiri.