Ƙarshen humerus na kusa yana ɗaya daga cikin raunin da ya fi dacewa a cikin raunin raunin da ya faru, kuma mafi yawan raunin humerus na kusa shine raunin osteoporotic maras ƙarfi a cikin tsofaffi.
Ko da yake ana iya bi da mafi yawan raunin humerus na kusa da ra'ayin mazan jiya, 10-15% na karaya har yanzu suna buƙatar magani na tiyata, wanda ya haɗa da gyaran farantin raguwa na incisional, raguwar raguwar ƙusa na ciki na ciki, da maye gurbin haɗin gwiwa.
Shawarar jiyya yana buƙatar dogara ne akan yanayin jiki na majiyyaci, tsinkayensa ko nata, tsammanin tunani, da nau'in karaya.
Sake saitin da gyaran karayar gaggawa
【Shawarwari】 Don kusanci humeral mafi girma tuberosity (NEER nau'in 2 partial fracture) karaya hade tare da kafada dislocation, preoperative CT jarrabawa, sai dai karaya a yankin wuyan tiyata, repositioning da braking tare da traumatic kafada takalmin gyaran kafa a karkashin gaggawa maganin sa barci (masanin shawarwari rate: 100%).
2. Preoperative m zafi kula
【Shawarwari】 Marasa lafiya tare da raunin humerus proximal suna da fifiko ga analgesia na farko tare da acetaminophen na baka ko NSAIDs, kuma ana iya ƙara opioids na baka idan tasirin ba shi da kyau (yawan shawarwarin masana: 100%, ƙimar shawarwari mai ƙarfi: 73.8%).
3. Ilimin mishan kafin a fara aiki
[Shawarwari] Ya kamata a gudanar da ilimin gaba da gaba ta hanyoyi daban-daban. (Ƙimar shawarwarin ƙwararru: 100%; ƙaƙƙarfan ƙimar shawarwari: 83.8%)
4. Ƙimar abinci mai gina jiki da magani mai tallafi kafin yin aiki
【Shawarwari】 Don kammala gwajin sinadirai na marasa lafiya a cikin sa'o'i 24 na shiga da kuma samar da ayyukan abinci mai gina jiki ga marasa lafiya masu haɗarin abinci mai gina jiki. (Ƙimar shawarwarin ƙwararru: 98.5%; ƙaƙƙarfan ƙimar shawarwari: 55.9%)
5. Ƙididdigar glucose na lokaci-lokaci da ƙa'ida a cikin masu ciwon sukari
Shawarwari】 Maƙasudin sarrafa glycemic shawarar da aka ba da shawarar ga yawancin masu ciwon sukari waɗanda ke jure wa tiyatar zaɓi shine 7.8 zuwa 10.0 mmol/L.
6. Gudanar da kumburin nama mai laushi a cikin lokacin aiki
【Shawarwari】 Ga majinyatan da ake zaɓen tiyata don karyewar humerus na kusa, ana ba da hanyoyi da yawa na jiki don rage kumburi yayin lokacin aiki. (Ƙimar shawarwarin ƙwararru: 98.5%; ƙaƙƙarfan ƙimar shawarwari: 80.9%)
7. Gudanar da abinci kafin yin aiki
【Shawarwari】 Marasa lafiya da zaɓaɓɓen tiyata za su iya cin abin sha mai tsafta 2 sa'o'i kafin tiyata da abinci mai sitaci ko kayan kiwo 6 hours kafin tiyata. (Ƙimar shawarwarin ƙwararru: 100%; ƙaƙƙarfan ƙimar shawarwari: 76.5%)
8. Gudanar da catheter na fitsari na lokaci-lokaci
【Shawarwari】 Ba a ba da shawarar ɓangarorin fitsari na yau da kullun don aikin tiyatar humerus na kusa ba (Matsayin ƙwararru: 100%; Adadin shawarwari mai ƙarfi: 78.6%)
9. Prophylactic aikace-aikace na perioperative antimicrobial kwayoyi
【Shawarwari】 Ga marasa lafiya da proximal humerus karaya bukatar endoprosthesis ko hadin gwiwa maye, da prophylactic amfani da farko da na biyu-ƙarni cephalosporins bada shawarar ga kamuwa da cuta rigakafin a cikin perioperative zamani. (Kudin shawarwarin ƙwararru: 97.1%; ƙaƙƙarfan ƙimar shawarwari: 73.5%)
10. Zaɓin maganin sa barci
【Shawarwari】 Anesthesia bada shawarar zuwa dauko hanyar yankin block fili janar maganin sa barci, zaži kwayoyi don kauce wa aggravating da tsarin gabobin jiki tabarbarewar tsofaffi marasa lafiya, da kuma kula da karfafa monitoring (gwani shawarwarin kudi: 100%; karfi shawarwari kudi: 71.4%).
11. Intraoperative hawan jini contro
[Shawarwari] Ya kamata a ba da hankali ga rage yawan karfin jini don rage asarar jini na ciki don raunin raunin da ya faru, amma tsofaffi marasa lafiya tare da cututtuka masu yawa ya kamata su kula da kiyaye kwanciyar hankali na hemodynamic don kauce wa rashin isasshen ƙwayar kyallen takarda da gabobin (gwajin shawarwarin kwararru: 100%; Ƙarfin shawarwarin: 61.9%).
12. Intraoperative girma management
[Shawarwari] Aiwatar da dabarun sarrafa ruwa mai manufa, kuma ana iya ba da magungunan vasoactive ta hanyar kariya yayin maganin sa barci na gabaɗaya don hana wuce gona da iri (yawan shawarar kwararru: 100%; ƙimar shawarwari mai ƙarfi: 69.1%).
13. Gudanar da jini a ciki
[Shawarwari] Ba a ba da shawarar hauhawar jini mai sarrafawa ta ciki don raunin humeral na kusa, musamman a cikin tsofaffi marasa lafiya, kuma ana iya amfani da ƙarin jini na ciki da tranexamic acid. Binciken intraoperative na HGB <80g/L yana ba da shawarar zubar da jini na allogeneic (yawan shawarar ƙwararru: 100%; ƙimar shawarwari mai ƙarfi: 73.8%).
14. Rigakafin ciwon ciki na ciki
[Shawarwari] Marasa lafiya tare da karaya mai kusanci ya kamata su ƙarfafa sa ido kan zafin jiki na ciki kuma su ɗauki matakai daban-daban don kiyaye ainihin zafin jiki sama da 36 ° C ( ƙimar shawarwarin masana: 100%; ƙimar shawarwari mai ƙarfi: 76.2%).
15. Zaɓin hanyar tiyata
(1) Karaya matakin na proximal humerus
[Shawarwari] Ana ba da shawarar matakan Neer don matakan karaya na kusa da humerus (yawan shawarar kwararru: 100%; ƙimar shawarwari mai ƙarfi: 83.3%).
(2) Hanyar tiyata
Ya kamata a zaɓi tsarin aikin tiyata bisa ga ɓangarorin ƙwayoyin cuta, ingancin kashi, yanayin yanayin haƙuri da yanayin tunanin mutum da sauran abubuwan da suka dace.
[Shawarwari] Za'a iya zaɓar kayan gyara na ciki bisa ga nau'in karaya da girman kashi, kamar faranti ko ƙusa intramedullary; ga tsofaffi marasa lafiya tare da osteoporosis waɗanda ke da wuyar sake saitawa ko gyarawa, 4-ɓangarorin ɓangarorin (da raguwar raguwa), ɓangarorin 3 tare da osteoporosis mai tsanani, tsagawar tsaga da ƙwayar wuyansa na jiki, an zaɓi maye gurbin haɗin gwiwar kafada na wucin gadi, kuma an ba da shawarar maye gurbin haɗin gwiwar kafada idan an haɗa shi tare da rotator cuff rauni (masanin shawarwarin kudi: 100.4%).
![Karayar humerus na kusa]()
Hoto 1 Mace mai shekaru 65 tare da karaya-ɓangarorin kashi 4 na shigar da ƙararrakin humeral na kusa da allograft fibular implant farantin gyare-gyare tare da ƙaddamarwa da sakewa.
16. Sanya bututun magudanar rauni
[Shawarwari] Alamu don rashin sanya bututun magudanar ruwa: ① Ƙwararren ƙwararrun dabarun aiki (MIPPO da nailing intramedullary); ② Rashin zubar jini. Alamu don sanya bututun magudanar ruwa: ① ta hanyar tsarin pectoral deltoid, gyare-gyaren farantin kulle ko maye gurbin haɗin gwiwa na kafada; ② gagarumin zub da jini daga saman rauni (ƙididdigar shawarwarin masana: 100%; ƙimar shawarwari mai ƙarfi: 71.4%).
17. Rufe rauni
【Shawarwari】 An rufe katsewar tiyata ta hanyar sauƙi mai katsewa, sutures-by-Layer sutures ( ƙimar shawarwarin masana: 100%; ƙimar shawarwari mai ƙarfi: 76.2%).
18. Abincin dawowa bayan tiyata
【Shawarwari】 Marasa lafiya za su iya shan abin sha ba tare da shan barasa ba ta baki da zarar sun farka bayan tiyata, kuma su ci gaba da cin abinci na yau da kullun bayan sa'o'i 1-2 idan ba a sami wani sakamako mai kyau ba.
19. Zaɓin matsayi na gaba da aiki da wuri
【Shawarwari】 Marasa lafiya ba sa buƙatar kwanta a kan matashin kai bayan tiyata, za su iya ɗaukar matsayi na ɗan lokaci kuma suna iya motsawa a ƙasa bayan farkawa. Ya kamata a birki takalmin kafada mai rauni.
20. Matakan analgesic bayan aiki
【Shawarwari】 Analgesia bayan tiyata a cikin marasa lafiya tare da karaya mai kusanci ana ba da shawarar yin amfani da toshewar yanki a haɗe tare da na yau da kullun na '' bayan gida '' na NSAIDs, kuma idan ya cancanta, famfo mai sarrafa kansa na jini ko na gefe jijiyoyi toshe kai mai sarrafa analgesia0% shawarar: ƙimar ƙarfi 0% 78.6%).
21. Rigakafin tashin zuciya da amai bayan aiki
[Shawarwari] Duk majiyyata yakamata a ba su maganin rigakafin hana kumburin rigakafin 30 min kafin ƙarshen tiyata. (Kudirin shawarwarin gwani: 97%; ƙaƙƙarfan ƙimar shawarwari: 47.8%)
22. Gyaran aiki
【Shawarwari】 Marasa lafiya da ƙayyadaddun ƙayyadaddun raunin humerus ya kamata su fara motsa jiki da wuri-wuri bayan tiyata. Ayyukan gyaran gyare-gyare suna taimakawa wajen mayar da aikin na sama da kyau (Matsalar shawarwarin Kwararru: 100%; Ƙarfin shawarwarin shawara: 92.9%).
23. Sharuɗɗan fitarwa da bin diddigi
【Shawarwari】Ya kamata a kafa ma'auni na fitarwa, kuma a rika bin marasa lafiya akai-akai na akalla watanni 6 (yawan shawarar kwararru: 100%; Adadin shawarwari mai karfi: 83.3%).
Yadda Ake Siyan Kayan Gyaran Orthopedic da Instruments?
Domin CZMEDITECH , muna da cikakken samfurin layi na kayan aikin tiyata na orthopedic da kayan aiki masu dacewa, samfurori ciki har da kashin baya implants, intramedullary kusoshi, farantin rauni, farantin kulle, cranial-maxillofacial, prosthesis, kayan aikin wuta, masu gyara waje, arthroscopy, kula da dabbobi da saitin kayan aikinsu.
Bugu da kari, mun himmatu wajen ci gaba da bunkasa sabbin kayayyaki da fadada layin samfur, ta yadda za a iya biyan bukatun tiyata na karin likitoci da marasa lafiya, da kuma sa kamfaninmu ya kara yin gasa a cikin dukkan masana'antar sarrafa kasusuwa ta duniya da masana'antar kayan aiki.
Muna fitarwa a duk duniya, don haka za ku iya Tuntuɓe mu a adireshin imel song@orthopedic-china.com don faɗakarwa kyauta, ko aika sako ta WhatsApp don amsa cikin gaggawa +86- 18112515727 .
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