Muaj cov xwm txheej thaum nws yooj yim tsis tuaj yeem tiv nrog qhov teeb meem yam tsis muaj kev phais. Hauv tsab xov xwm no, kuv xav tham txog kev ntsuas kev kho mob tom qab txiav tus neeg mob ceg.
Cov ntsiab lus tseem ceeb
Thaum pib, koj yuav tsum nkag siab cov ntsiab lus uas yuav siv zog rau hauv kab lus.
- Yog li, kev txiav ceg ceg yog kev phais tshem tawm ntawm tus mob ceg. Lub hom phiaj ntawm qhov kev ua no yog txhawm rau cawm tib neeg txoj sia. Nws tsim nyog hais tias qhov kev txiav txim siab ntawm kev cuam tshuam kev phais yog ua los ntawm cov kws kho mob nkaus xwb.
- theem amputation yog hais txog qhov chaw uas tus ceg raug txiav.
- Kev kho kom rov zoo yog txheej txheem los ntawm cov kws tshaj lij ntawm ntau yam profile (cov kws kho mob, kws kho hlwb, kws kho hniav, kws kho hniav) qhia tus neeg kom hloov mus rau txhua yam nyob ib puag ncig nws yam tsis muaj ceg tawv.
Muaj ntau qhov qhia txog kev txiav ntawm lub ceg qis. Ib qho laj thawj yog ntshav qab zib. Los ntawm nws tus kheej, tus kab mob yuav tsis ua rau qhov teeb meem no. Txawm li cas los xij, qee qhov xwm txheej (kev tsis saib xyuas tus kab mob, nws txoj kev hloov mus rau ib daim ntawv decompensated), kev kho mob tuaj yeem ua tau.mus rau amputation (qhov no tshwm sim nyob rau hauv li 8-10% ntawm cov neeg mob). Dab tsi tshwm sim tuaj yeem txiav txiav ceg rau ntshav qab zib?
- Neuropathy cuam tshuam tshwj xeeb nrog cov hlab ntsha puas.
- Micro- thiab macroangiopathy (cov no yog kev ua txhaum ntawm cov qauv thiab kev ua haujlwm ntawm ob lub nkoj loj thiab me).
- Necrotic hloov pauv tshwm sim nyob rau hauv qis extremities.
Raws li nws tau dhau los ua qhov tseeb, thawj zaug thiab lub ntsiab lus qhia rau kev txiav tawm yog kev ua txhaum ntawm kev ua haujlwm ntawm cov hlab ntsha ntawm ceg. Qhov no tshwm sim vim kev ua tsis tiav ntawm metabolic thiab kev txhim kho ntawm cov txheej txheem xws li autoimmunization. Stagnation tshwm nyob rau hauv cov hlab ntsha, oxygen starvation tshwm sim, uas ua rau ob txhais ceg yooj yim mus rau ntau yam kab mob. Thiab txawm tias qhov bruise me ntsis tuaj yeem ua rau txoj kev loj hlob ntawm cov txheej txheem purulent txaus ntshai tshaj plaws. Kom tsis txhob tuag, nyob rau hauv cov xwm txheej zoo li no, cov kws kho mob txiav txim siab radical. Ntawd yog, tus neeg mob xav tau kev txiav tawm ntawm ceg (hauv ntshav qab zib, cov xwm txheej zoo li no tsis raug cais tawm). Feem ntau qhov no tsuas yog txoj hauv kev los cawm tus neeg mob txoj sia.
Yuav ua li cas
Raws li nws tau pom meej lawm, kev txiav ceg ceg yog qhov cuam tshuam loj hauv lub neej thiab kev noj qab haus huv ntawm tus neeg mob. Tias yog vim li cas tom qab kev ua haujlwm ib tus neeg xav tau lub sijhawm ntev ntawm kev kho kom rov zoo. Nws yog ib qho tsim nyog hais tias kev ua tiav ntawm kev kho kom rov zoo yog nyob ntawm ntau yam:
- Nyob zoo (qhov tseem ceeb yog qhov ua haujlwm zoo ntawm nws tus kheej).
- Tsim nyog prosthesis (kev ua haujlwm zoo ntawm tus kws kho hniav yog qhov tseem ceeb).
- Rehabilitation program.
Yog tias yam tsawg kawg ib qho ntawm cov ntsiab lus no tsis ua tiav zoo, cov txheej txheem kho dua tshiab yuav ncua qeeb heev.
Post-operative period
Txawm hais tias tus ntiv taw lossis ib feem loj ntawm tus ceg ceg tau txiav, kev rov ua haujlwm tom qab ntxov tseem tseem ceeb heev. Qhov tseem ceeb ntawm qhov no:
- Yuav tsum tau tiv thaiv ntau yam teeb meem, xws li kab mob ntawm cov pob txha.
- Nws tseem ceeb heev uas yuav tsum tau saib xyuas cov ntshav thiab cov qog ntshav hauv cov leeg.
- Yuav tsum tiv thaiv kev sib koom ua ke thiab cov leeg nqaij nkim. Hauv qhov no, koj yuav xav tau kev zaws thiab kho mob.
- Nws tseem yuav tsum tswj qhov mob, zam nws kom zoo tshaj plaws.
- Thiab, tau kawg, tus neeg mob yuav xav tau kev txhawb nqa kev xav. Tom qab tag nrho, rau yuav luag txhua tus neeg, kev poob ntawm ceg ceg yog qhov tawg loj heev.
Rehabilitation theem 1. Kev npaj pob tw
Yog tias tus neeg mob tau txiav tawm ceg, ntau theem ntawm kev kho mob yuav tsum ua kom tiav thaum thawj xyoo tom qab kev phais. Yog li, raws li tau hais los saum toj no, qhov zoo ntawm cov stump yog qhov tseem ceeb heev. Nws nyob ntawm ntau yam:
- Nqaj lengths.
- Amputation level.
- Postoperative caws pliav (nws yuav tsum nyob deb ntawm qhov chaw siab tshaj plaws axial load).
- Cov pob txha zoo li (nws nyob ntawm cov txheej txheem los ntawm kev cuam tshuam kev phais).
- Contractures, i.e.txwv kev txav mus los. Qhov no yog qhov tseem ceeb heev, vim tias qhov zoo ntawm tus neeg taug kev mus ntxiv yog nyob ntawm qhov xwm txheej no.
Dab tsi tseem ceeb uas yuav tsum paub txog kev tu tsob ntoo
Tom qab kev txiav ntawm txhais ceg, nws yog ib qho tseem ceeb heev uas yuav tsum tau saib xyuas cov kab mob tom qab phais kom zoo. Thaum ntxov, tus kws kho mob thiab tus kws saib xyuas neeg mob tuaj saib xyuas nws. Ntawm no nws yog ib qho tsim nyog los qhia meej tias cov neeg mob uas muaj vascular pathology thiab ntshav qab zib mellitus tsim nyog tau txais kev saib xyuas tshwj xeeb, vim tias cov kab mob no ua rau muaj kev pheej hmoo ntawm kev kis kab mob ntawm cov pob txha. Qhov tseem ceeb:
- Txoj kev tu cev yog qhov tseem ceeb heev. Ib qho kev sib piv da dej txhua hnub yog qhov xav tau. Koj tuaj yeem ntxuav koj txhais taw nrog xab npum me nyuam, tom qab so nws qhuav nrog phuam.
- Lub pob zeb yuav tsum tau tshuaj xyuas txhua hnub rau kev hloov ntawm daim tawv nqaij. Qhov no yog ib qho tseem ceeb heev, thiab nrog kev hloov me ntsis, koj yuav tsum tau nrhiav kev qhia los ntawm kws kho mob.
- Tom qab ua haujlwm, daim tawv nqaij ntawm cov pob txha ua rau rhiab heev. Koj tuaj yeem daws qhov no nrog kev pab ntawm massage. Koj tuaj yeem ua nws ob qho tib si nrog koj txhais tes thiab nrog lub pob roj hmab me me, ua rau lub voj voog ncig. Nyob rau tib lub sijhawm, lub stump yuav tsum rubbed nrog phuam. Cov txheej txheem no yuav tsum tau ua kom ntau li ntau tau, nyiam dua ob peb zaug hauv ib hnub.
- Nws yuav tsum nco ntsoov tias qhov caws pliav tom qab yuav tsum tau moisturized. Qhov no tseem ceeb tshwj xeeb tshaj yog nyob rau thawj ob peb lub lis piam tom qab txiav ceg ceg.
Lub sijhawm ntawm kev hloov pauv tom qab hloov pauv hauv cov neeg mob ntshav qab zib feem ntau yog ntev dua.
Edema
Teb ntawm yuav ua li cas ceg tau txiavNrog ntshav qab zib mellitus lossis lwm yam kab mob, tus neeg mob feem ntau tsim edema. Qhov no tsis yog txaus ntshai, vim hais tias nws yog ib qho kev tshwm sim ntawm tib neeg lub cev rau kev phais. Txawm li cas los xij, qhov xwm txheej yuav tsum tsis txhob cia rau lub caij nyoog. Yuav tsum tau ua:
- Thawj zaug tom qab ua haujlwm, lub qhov txhab yuav tsum tsis txhob raug thawb. Yog li ntawd, cov ntaub qhwv ntawm lub pob zeb tsis nruj.
- Yuav kom tiv thaiv qhov o, koj tuaj yeem siv cov cuab yeej hauv qab no: compression stockings, elastic bandage, silicone cover.
- Yog tias qhov kev txiav txim siab ntawm ceg tau ua tiav, tus neeg mob tau pom zoo kom pw ntawm nws lub plab ob zaug hauv ib hnub (rau ib nrab teev), tig nws lub taub hau mus rau qhov chaw xis nyob. Qhov no yog qhov tsim nyog txhawm rau txhawm rau cov leeg ntawm cov pob txha kom ncab thiab yog li cob qhia thiab so.
kev sib cog lus
Ib qho teeb meem uas tuaj yeem tshwm sim tom qab txiav ceg yog kev cog lus sib koom. piv txwv li kev txwv tsis pub txav mus los hauv kev sib koom ua ke, uas tuaj yeem tshwm sim los ntawm deformity ntawm cov leeg, leeg, tawv nqaij, thiab lwm yam. Kev tiv thaiv kev ntsuas:
- Qhov tseem ceeb tshaj plaws yog kom paub meej qhov tseeb ntawm lub caj dab rau tus neeg mob. Lub stump yuav tsum ncaj, nws yuav tsum tsis txhob cia nyob rau hauv ib tug khoov txoj hauj lwm ntev.
- Kev tshem tawm qhov o thiab mob raws sijhawm yog qhov tseem ceeb. Txhawm rau tiv thaiv kev deformation ntawm tus txha nraub qaum, nws yog ib qho tsim nyog yuav tsum tau siv lub rooj zaum nrog ib lub pob zeb tshwj xeeb rau lub pob zeb thawj zaug tom qab ua haujlwm.
- Tus neeg mob tseem yuav xav tau ob qho tib si kev ua haujlwm thiab kev ua haujlwm kho mob. Txawm li cas los xij, koj yuav tsum nco ntsoov zam cov ntawdkev tawm dag zog uas ua rau mob.
ntsiab lus tseem ceeb: sai li sai tau tom qab ua haujlwm, tus neeg mob yuav tsum tshwm sim rau tus kws kho hniav. Tom qab tag nrho, qhov sai sai tus neeg tau txais ntawm prosthesis, qhov tsawg nws yuav poob qhov kev txawj ntse tseem ceeb tshaj plaws, thiab qhov yooj yim dua thiab sai dua cov txheej txheem kho dua tshiab yuav ua tiav.
Paj siab mob
Txawm hais tias txhais ceg tau txiav saum lub hauv caug lossis hauv qab, tus neeg mob yuav raug tsim txom los ntawm kev mob phantom. Cov no yog qhov mob rhiab heev uas tus neeg mob hnov hauv ib ceg ceg uas raug txiav tawm. Txhawm rau zam qhov no, cov ntsiab lus hauv qab no tseem ceeb:
- Tus neeg mob yuav tsum tau qhib kom sai li sai tau, piv txwv li hloov mus rau qhov chaw zaum.
- Yuav tsum tau zaws thiab cov kua dej ntawm cov pob txha.
- Lub siab hauv cov pob zeb yuav tsum tsis sib xws. Yog li ntawd, txoj phuam qhwv caj dab yog qhov tseem ceeb heev.
- Mob ntshav qab zib tuaj yeem zam tau yog tias tus neeg pib tawm dag zog kom sai li sai tau. Physiotherapy kuj tseem ceeb.
- Thiab, tau kawg, qhov ntxov tshaj plaws prosthetics yog qhov tseem ceeb tshaj plaws.
Yog tias mob phantom tshwm sim nyob rau lub sijhawm lig (tsis yog tom qab kev ua haujlwm), qhov no txhais tau hais tias kev saib xyuas cov pob zeb tau ua tsis raug lossis tsis txaus. Txawm li cas los xij, hauv cov xwm txheej zoo li no, koj tuaj yeem daws qhov teeb meem. Nov yog qhov uas daim iav kho tuaj yeem pab tau.
Rehabilitation theem 2. Prosthetics
Tom qab kev txiav tawm ntawm txhais ceg tau ua tiav, kev kho dua tshiab pib nrog kev npaj cov pob zeb rau cov pob qij txha thiab cov pob qij txha nws tus kheej. Lub tswvyim no txhais li cas? Yog li, prosthetics yog ib hom kev pab tshwj xeeb rau cov neeg mob uas tau poob ib feem ntawm lub cev xav tau. Qhov ntawd yog, nrog kev pab los ntawm ib tug prosthesis, koj tuaj yeem kho qhov qub lossis ze rau kev ua haujlwm ntawm lub cev uas ploj lawm.
About prosthetics nws tus kheej
Cov kws kho mob niaj hnub hais tias tom qab txiav ib ceg, nws yog ib qho tseem ceeb rau cov ceg tawv kom sai li sai tau. Yog li, thawj prosthetics yuav tsum tau ua nyob rau hauv 14th-21st hnub tom qab kev phais. Rov ua dua prosthetics raug tshuaj raws li thiab thaum hnav cov khoom tseem ceeb tshwm sim.
theem ntawm prosthetics
txheej txheem Prosthetics muaj ntau cov kauj ruam:
- Xaiv tus tsim ntawm cov khoom, piv txwv li prosthesis.
- ntsuas los ntawm tus ncej.
- Npaj plaster zoo thiab tsis zoo.
- Sib dhos cov khoom kom haum.
- Kawg kawg, suav nrog txhua lub sijhawm thiab xav tau.
- Yeeb yam ntawm prosthesis.
- Kev qhia siv.
Feem ntau hais lus, kev ua tiav ntawm tus neeg mob txoj kev kho kom rov zoo yuav luag tag nrho yog nyob ntawm qhov zoo ntawm cov khoom siv tes ua. Nws qhov hnyav, qhov ntev, tswj txoj kev, tsim, zoo nkauj thiab tshuaj pleev ib ce yog qhov tseem ceeb. Koj kuj yuav tsum tau ua kom haum cov khoom rau ib tus neeg mob. Thiab, tau kawg, theem kawg ntawm kev kho kom rov zoo yog tus cwj pwm ntawm tus neeg mob thiab nws lub siab xav rov qab mus rau lub neej zoo li sai tau. Yog hais tias ib tug neeg tau muaj tus ntiv taw hlais, yuav tsis xav tau ib qho prosthesis hauv qhov no. Yam khoomKev kho kom rov zoo tuaj yeem zam tau.
About hniav hniav
Nws tsim nyog hais tias cov prostheses lawv tus kheej muaj ob hom: thawj thiab theem nrab.
- Primary prostheses tseem hu ua kev cob qhia prostheses. Lawv yog cov tsim nyog thiaj li tsim tau cov stump kom zoo, nrog rau qhia tus neeg mob txog qhov tseem ceeb ntawm lawv txoj kev siv. Nws yog ib qho tsim nyog hais tias qhov ua tau ntxov tshaj plaws ua ntej prosthetics ua rau nws muaj peev xwm tiv thaiv qhov tshwm sim ntawm kev txwv kev txav hauv cov pob qij txha loj. Nws tseem yog ib qho tseem ceeb kom paub meej tias cov khoom siv no tau ua hauv tsev kho mob, vim tias nws yuav tsum tau koom nrog ntau tus kws tshaj lij.
- Tom qab thawj theem prosthetic, tus neeg mob tau muab cov prosthesis mus tas li (qhov nruab nrab rau ob xyoos).
Type of prostheses
Prostheses yog tsim los ntawm ntau yam technologies. Lawv yog cov modular thiab tsis-modular (txawm li cas los xij, modular prostheses feem ntau siv). Lawv suav nrog cov hauv qab no:
- Tau lub tes tsho, uas yog ua raws li qhov xav tau ntawm tus neeg mob lub pob.
- Kho thiab txuas cov khoom siv.
- Tus neeg nqa khoom module. Nws txawv nyob ntawm seb qhov ntev npaum li cas ntawm tus prosthesis.
- ko taw module.
- Prosthesis attachments.
Nws tseem tsim nyog hais tias ib qho khoom siv mus tas li, tsis zoo li kev cob qhia prosthesis, kuj tseem muaj cov txheej txheem kom zoo nkauj, uas muaj cov khoom tshwj xeeb tso rau. Qhov no yog qhov tsim nyog kom cov prosthesis zoo ib yam li cov ceg tiag tiag.
Disability
Nws tsim nyog hais tias tus neeg muaj cai muaj kev xiam oob khab thaum ib ceg txiav. Yog li, feem ntau yuav, thaum xub thawj nws yuav tsum tau lees paub ib xyoos ib zaug. Txawm li cas los xij, tom qab qee lub sijhawm (tsis pub dhau plaub xyoos), koj tuaj yeem thov rau qhov hu ua kev xiam oob qhab tsis tas li. Yog tias muaj kev txhim kho ntawm cov pob qij txha, los ntawm kev txiav txim siab ntawm pawg thawj coj, nws muaj peev xwm txo tau cov pab pawg neeg tsis taus.
