Igama elithi "ukuhlukunyezwa kokubeletha" ezinqenqemeni kuvame ukusetshenziselwa ukubeka noma yimuphi umonakalo ezithombeni nasezintweni zomntwana kanye nomama. Kunezinhlobo eziningi zezifo ezinjalo, kanti ngamunye wabo ubele ingozi ethile.
Izinhlobo zokuhlukunyezwa kokuzalwa
Konke ukulimala, uma kukhululwa, kungenziwa ukwahlukaniswa:
- ukuhlukunyezwa kwengane esanda kuzalwa;
- ukuhlukunyezwa kowesifazane ekubelethweni.
Ngokuvamile umonakalo ngesikhathi sokudlula emgodini wokubeletha uthola izithelo. Phakathi kokulimala okuvamile komntwana:
- Ukulimala kwezicubu ezithambile - ama-abrasions, ukukhwabanisa, ukulimala kwezicubu ezingaphansi, imisipha, umsele wokuzalwa, i-cephalothorem.
- Ukulimala kokubeletha kwesistimu ye-musculoskeletal: ukuphahlazeka nokuhlukumeza kwe-clavicle, izinsikazi, ihlombe, ukuxoshwa kwamalungu, ukulimala kwamathambo e-skull.
- Ukulimala kwezitho zangaphakathi: ukubola kwesibindi, ama-adrenals, i-pleen.
- Ukulimala kwesistimu yenzwa yomphakathi: ukuhlukunyezwa kokubeletha kokubeletha, ukulimala komgogodla.
- Ukulimala kwesimiso sezinzwa zomzimba: umonakalo ku-plexus ye-brachial - i-Duchene-Erba paresis / ukukhubazeka noma i-Dejerine-Clumpke ukukhubazeka, ukukhubazeka ngokuphelele, i-diaphragm paresis, ukulimala kweso lesibindi.
Phakathi kwemonakalo etholwa owesifazane ohlelweni lokubeletha, kubalulekile ukuhlukanisa:
- ukwelula nokuqothula isisu;
- ukuphuka kwe-perineum;
- ukwephula ubuqotho besisu, umlomo wesibeletho.
Ukulimala kokubeletha kwezinsana
Ukuhlukunyezwa kwe-Neonatal kuvame ukubangelwa ukwephulwa kwenqubo yokulethwa, amaqhinga wokubeletha. Ngenxa yalokhu, umonakalo wesikhumba, amafutha angaphansi kwesikhumba ukubonakaliswa kaningi kokuhlukunyezwa kokubeletha. Phakathi kwabo kukhona:
- isikhalazo;
- abrasions;
- i-petechiae;
- i-ecchymosis.
Ukulimala okunjalo kutholakala ngokuhlola okubukwayo osanda kuzalwa. Izitho zangaphakathi nezinhlelo zingozi kakhulu. Isici sabo kungabikho izimpawu zezinsuku ezimbalwa namasonto. Ukuzibona, izindlela zokucwaninga ezengeziwe ziyadingeka. Umphumela uncike esikhathini sokuphathwa kanye nokutholakala kokuhlukunyezwa kokubeletha.
Ukuhlukunyezwa kokubeletha kumama
Ukuhlukunyezwa kokubeletha kumama kuphakama ngenxa yokungaziphathi kahle, kanye nobukhulu obukhulu besisu. I-Vulvar ihlukana kakhulu kaningi esifundeni se-labi minora, i-clitoris futhi imelela ukuqhuma okuncane noma izinyembezi. Ukulimala kwesifazane ngaphakathi kwesithathu esingaphansi kwaso ngokuvamile kuvumelana nokuqedwa kwe-perineum, futhi uma ingxenye engenhla ikalé, igundane lesisu nelinye lomlomo lilimala. Ingxenye yesithathu yomzimba wesifazane, ngenxa yokuthi ikhono layo eliphakeme lokwelula, alivami ukulimala. Ukuphuka kwe-perineum kwenzeka ikakhulukazi esigabeni sesibili somsebenzi.
Ukuhlukunyezwa kokubeletha - izimbangela
Ukuhlaziywa kwezimbangela ezibangelwa ukwelashwa kwenza kube lula ukukhomba amaqembu amathathu amakhulu okubangela ukuphulwa:
- ehambisana nesimo somama;
- esimiswe yi-state of the fetus;
- ehlobene nendlela yokuzalwa, okuthiwa "ukuhlukunyezwa kwe-obstetric."
Ngakho-ke, phakathi kwezimo "zokubeletha" ezithathelwanayo, izithiyo zezidakamizwa zivame ukubizwa ngokuthi:
- ekuqaleni noma, ngokuphambene, iminyaka yokubeletha ekupheleni;
- i-gestosis;
- i-pelvis encane kakhulu;
- i-uterine hypoplasia ;
- izifo ezikhulelwe: izifo zenhliziyo, i-endocrine, izifo zemizimba;
- ukukhulelwa ngaphambi kwesikhathi;
- izimo zokusebenza eziyingozi.
Iqembu elikhulu lezimbangela ezibangela ukuhlukunyezwa ezinganeni yizo ezihlobene ngqo nomntwana. Ngakho-ke, ukuphulwa kuvame ukushiwo:
- isethulo sangasese;
- ukungabi namanzi ;
- ukubeka okungalungile kwekhanda ku-pelvis encane;
- ukuguqulwa kokuqala;
- usayizi omkhulu we-fetus;
- i-intrauterine hypoxia ;
- ukungavamile kokuthuthukiswa kwe-intrauterine;
- ukuphefumula.
Phakathi kokuhlukunyezwa komsebenzi, ngenxa yokuthi kukhona, phakathi kwezinye izinto, ukuhlukunyezwa kokuzalwa komgogodla wesibeletho, kubalulekile ukuhlukanisa:
- ngokusheshisa noma, ngokuphambene, umsebenzi omude;
- ukuqhutshwa kwesigqi sokuvuthwa ngokungabikho komsebenzi wezabasebenzi;
- umsebenzi ongajwayelekile owenziwe;
- ukusetshenziswa okungenangqondo kwezinsizakalo ze-obstetric (vula umlenze, ukufakwa kwe-obstetric forceps, ukusetshenziswa kwe-extractor).
Ama-fractures ekubelethweni
Lolu hlobo lokuhlukumezeka ekubelethweni kwengane lubangelwa ezimweni eziningi nge-manual engavumelekile yombhalo. Ngokuvamile, kunomonakalo ku-clavicle, amathambo wezandla noma izinyawo (kuye ngokuthi uhlobo lunikezelo). I-subperiosteal fractures ye-clavicle ithola odokotela ngosuku 2-3 emva kokubeletha. Ngalesi sikhathi ukuvuvukala okukhulu, i-callus yakhiwa endaweni yesilonda. Ngenxa yokufuduka kwethambo, ingane encane ayikwazi ukwenza ukunyakaza okusebenzayo ngezibambiso, kodwa lapho ezama ukuzama, uqala ukukhala.
Ukuphuka kwehlombe noma isicupho kuhambisane nokuntuleka kokuhamba kwemilenze, kukhona ukuvuvukala, ukuguquka, isilonda esonakalisiwe sincishisiwe. Uma kwenzeka ukuhlukumezeka kwalolu hlobo, ibhandlela ye-gypsum isetshenziselwa ukuphindaphinda kokuqala kwesilungu esilimele. Uma kwenzeka i-collarbone iphukile, ingane ifakwa kwi-bandage yakwaDezo, ngaphezu komama, kunconywa ukuba kwenziwe ukugqama okuqinile kwengane esanda kuzalwa.
Ukulimala kokubeletha emgodleni
Ukulimala kokuzalwa komgogodla ezinsaneni kubonakala kungapheli. Kulesi sifo singabandakanya izinhlobo ezahlukene zokuphulwa:
- ukuphuma kwegazi emgodleni womgogodla;
- ukucindezela komgogodla, ukuphuka.
Ukulimala kokubeletha kwentambo yomgogodla kungase kungabonakali ngokubonakalayo, kodwa kuhambisane nesithombe somtholampilo esicacile. Kukhona izimpawu zokuphazamiseka komgogodla:
- ukuzethemba nokuzizwa komzimba;
- ukungabi khona kwengqondo;
- ukukhala okunamandla okwesikhashana;
- ukuphefumula okuphefumulayo.
Ukuthuthukiswa kwalesi sifo kuhambisana nenengozi enkulu yokufa kwengane ekusukeni kokuphefumula. Ukuhlukunyezwa okubeletha okunjalo, i-asphyxia lapho kungenakugwema khona, kungaholela ekufeni kwengane. Ngentuthuko enhle yezenzakalo kukhona ukulawulwa kancane kancane kokushaqeka komgogodla. Ngakho-ke, esikhundleni sokususwa kwe-hypotension kufika ubuhlungu obukhulu, kunezimpendulo ze-vasomotor, ukujuluka, i-trophic yezincubu ze-nervous and muscular ziyathuthuka. Ukulimala okukhazimulayo kuhambisana nokubonakala kwezimpawu ze-neurological: Izinguquko kumsindo we-muscle, reflexes nokuhamba kwezimoto.
Ukuhlukunyezwa kokubeletha kwezinsana
Ukuhlukunyezwa kokubeletha okubangelwa ukubeletha kungumphumela wokucindezelwa kwekhanda yi-canal yokuzalwa. Ukuhlukumeza kwenzeka uma ubukhulu be-fetus abuhambisani ne-pelvis encane noma uma umsebenzi wezisebenzi uphazamiseka (umsebenzi ode isikhathi eside). Ukulimala okungahambi ngaso sonke isikhathi kuhambisane nokushaya kwesisu, okuyinto, kuye ngokuthi isayithi lendawo, kungaba:
- i-cephalohematemata yangaphakathi ye-epidural - iphakathi kwe-mater ehlala njalo namathambo e-skull;
- i-subdural - i-hemorrhage yendawo phakathi kwe-medulla eqinile ne-arachnoid;
- I-Subarachnoid - etholakala esikhaleni se-subarachnoid;
- Ngokwemvelo - ifinyelela emgodini wezingxenyana ze-lateral;
- i-parenchymatous - i-hemorrhage ibe yizinto eziphathelene nobuchopho, obunomlingiswa we-hematoma;
- exubile - ama-hemorrhages amaningi ezinhlokweni zobuchopho, ama-ventricles, izinto eziphathelene nobuchopho.
Ukulimala kokubeletha kwesimiso sezinzwa
Ngesikhathi sokubeletha, ukulimala kokubili kwesistimu yezinzwa eziphakathi nendawo. Ngokuvamile, inqubo yokwelapha ihilela izimpande, i-plexus, i-peripheral kanye ne-cranial neerve. Phakathi kwezilonda ezijwayelekile zesimiso sezinzwa zomzimba, kutholakala njalo:
- i-paresis ye-plexus ye-brachial;
- I-Duchenne-Erba paresis - ehlotshaniswa nomonakalo ku-plexus ne-rootlets;
- i-paresis ye-obstetric ephansi kaDejerine-Klumpke - i-plexus noma izimpande ziyathinteka, okuholela ekuphazanyeni komsebenzi wezingalo ezikude.
Ukulimala kokubeletha kwesimiso sezinzwa esiyinhloko kutholakala esiteji sokuqala ngokuba khona kwezibonakaliso zezici:
- ukunciphisa ithoni ye-muscle;
- ukuvinjelwa kokuhamba kwezandla nezinyawo;
- i-muscle atrophy;
- ukubonakala kwe-dyspnea;
- i-cyanosis;
- ukwehluleka ukuphefumula.
Ukuhlukunyezwa kokuzalwa - izimpawu
Izimpawu zokuhlukunyezwa kokubeletha ziningi kangangokuthi odokotela bayazihlanganisa ezinhlangothini ezinkulu eziningana - kuye ngokuthi yiziphi izitho ezilimazekile. Ukuhlukunyezwa kokubeletha kwekhanda, isibonelo, kuhambisana nalezi zenzakalo ezilandelayo:
- ukukhathazeka;
- ukuphazamiseka kokulala;
- ukuqina (ithoni elidlulele) emisipha yentamo;
- ukuvuselelwa;
- ukuhlanza;
- i-nystagmus (ukunyakaza okungavamile okusheshayo kokunyakaza kwama-eyeballs);
- i-strabismus;
- i-pallor;
- ukuthuthumela (ukuthuthumela) kwemisipha ehlukahlukene, ukuphazamiseka.
Izimpawu ezisemqoka zokulimala kwezicubu ezithambile yizi:
- ama-abrasions, ama-scratches;
- ukubola kwesisu.
Mayelana nokuhlukunyezwa kwesistimu yethambo uthi:
- ukuvinjelwa kokunyakaza okusebenzayo;
- ukuphendula okubuhlungu (ukulila) ngezinyathelo zokuhamba ezinhlangothini zesilonda;
- ukuguqulwa nokunciphisa ithambo elonakalisiwe.
Ukuhlukunyezwa kokubeletha - ukuxilongwa
Ukuhlukunyezwa kokubeletha kwesifunda somlomo wesibeletho akubangeli ubunzima ekutholeni - ikhanda lomntwana liphendukele ekuqondeni komonakalo, kukhona ukwanda kwethambo le-muscle kusuka ohlangothini oluphambene. Noma kunjalo, ukulimala kwezitho zangaphakathi kudinga ukuziphatha kwezindlela zokucwaninga ze-hardware. Phakathi kwezindlela ezisetshenziselwa ukunquma:
- ukuhlolisisa nokunakwa kwezitho, ikhanda;
- I-Ultrasound yendawo ehlongozwayo yomonakalo;
- i-radiography;
- izivivinyo zokusebenza.
Ukwelashwa kokulimala kokuzalwa
Uma kutholakala ukuhlukunyezwa kokubeletha, ukunakekelwa kwezingane kubandakanya ukuqapha okugcwele nokuvimbela izinkinga. Umama uthola izincomo ezithile ezivela odokotela okufanele bahlonishwe ngokugcwele. Ngokuvamile, ukwelashwa kokuhlukunyezwa kokubeletha kuncishisiwe kuye:
- ukuvimbela ukutheleleka kwezicubu ezithambile ezonakele;
- okwenziwa ukusikhipha, ukuvocavoca kwezokwelapha ukwenyuka kwezwi lomuthi;
- ukuchithwa kwemilenze eyonakalisiwe;
- ukulungiswa kokuhlinzwa (uma kwenzeka ukuphuma kwangaphakathi, i-torticollis, isibonelo);
- imithi yokwelapha yokonakalisa isimiso sezinzwa.
Imiphumela yengozi yokuzalwa
Ukuze kuqinisekiswe ukuthi abantwana abanakho ukulimala ngokomzimba nangokwengqondo ngemva kokulimala, omama kumele bafeze konke ukuqashwa abakutholayo. Noma kunjalo, ukuhlukunyezwa kokuzalwa akusiyo njalo i-traceless. Izinsana eziningi ezithinteka ekuguleni kwamanzi ezigulini eziyingozi ziphinde zihlakulele ukungasebenzi kahle okungavamile. Ukulimala kwisistimu ye-central neyonqubo yomshoshaphansi kuyingozi kakhulu, ukubikezela kanye nemiphumela kuxhomeke ekucindezeleni kwezinkinga zezinzwa.