Igama elithi "intlungu yokubeleka" kwimithintelo isetyenziselwa ukukhetha nayiphi na umonakalo kwizitho kunye neenkqubo zentsana kunye nomama. Kukho iintlobo ezininzi zezilwanyana ezinjalo, kwaye nganye yazo imele ingozi ethile.
Iintlobo zengxaki yokuzalwa
Konke ukulimala, xa kuhanjiswe, kungahlulwa:
- ukuxhatshazwa kwintsana;
- intlungu yomfazi ekubelekeni.
Ngokuqhelekileyo umonakalo ngexesha lokudlula kwinqanaba lokuzala lifumana isiqhamo. Phakathi kokulimala okuqhelekileyo komntwana:
- Ukulimala kwezicubu ezithambileyo - izibambiso, ukukhawulwa, ukulimala kwimizimba engaphantsi, imisipha, isalathisi sokuzalwa, i-cephalothorem.
- Ukulimala kokuzalwa kwesistim se-musculoskeletal: ukutyhoboka kunye neziqhekeza ze-clavicle, amabhinqa, iigxala, ukuhluthwa kwamalungu, umonakalo emathanjeni enkkull.
- Ukulimala kwamalungu angaphakathi: ukubola kweesibindi, i-adrenals, ipeni.
- Ukulimala kwinkqubo yesantya esisemkhatsini: umonakalo wokubeleka, ukulimala kwentambo yomgudu.
- Ukulimala kwenkqubo ye-nervous system: umonakalo kwi-plexus ye-brachial - iDuchene-Erba paresis / ukukhubazeka okanye ukukhubazeka kukaDeerer-Clumpke, ukukhubazeka okupheleleyo, i-paresis ye-diaphragm, umonakalo kwimbilini yobuso.
Phakathi kwemonakalo efunyenwe ngumfazi kwindlela yokubeletha, kuyimfuneko ukuhlula:
- Ukwelula nokweqhawula isondo;
- ukuphuka kwe-perineum;
- ukuphulwa kobungqina besisu, umlomo wesibeleko.
Ukulimala kokuzalwa kwabantwana abatsha
Ukuxhatshazwa kwe-neonatal kudla ngokubangela ukuphulwa kwenkqubo yokunikezelwa, iindlela zokubeletha. Ngenxa yoko, umonakalo wesikhumba, i-fat-cutaneous manifestation of the birth trauma. Phakathi kwazo:
- imincinci;
- abrasions;
- petechiae;
- ecchymosis.
Umonakalo onjalo ufumanisa ngokuhlola okubonakalayo kwintsana. Izitho zangaphakathi kunye neenkqubo ziyingozi kakhulu. Into ebonakalayo kubo kungabikho kwempawu zeentsuku eziliqela kunye neveki. Ukuzichonga, iindlela zokuphanda ezongezelelweyo zifunekayo. Isiphumo sincike kwixesha lokunyanga kunye nokufumanisa intlungu yokuzalwa.
Ingozi yokuzalwa kumama
Ingxaki yokuzala xa umama evela ngenxa yokungaziphathi kakuhle, kunye nobukhulu bomntwana obukhulu. I-Vulvar i-rupture ivela ngokuphindaphindiweyo kwingingqi ye-labia minora, i-clitoris kwaye ibonisa ukutyana okanye iinyembezi ezincinci. Ukulimala kwesigxina kwisigxina esingaphantsi kwesibini kudibanisa kunye nokuqhekeka kwe-perineum, kwaye ukuba inxalenye engaphezulu yenzakele, igxobhozo lesiswini kunye nesibilini senzalo. Ingxenye yesithathu yesini, ngenxa yobuchule obuphezulu bokusula, ayinakunobungozi. Ukuphuka kwe-perineum kwenzeka ngokukodwa kwisigaba sesibini sezabasebenzi.
Ingozi yokuzalwa - ibangela
Uhlalutyo lwezizathu ezinokubangela ukukhubazeka kwenza ukuba kubekho ukuchonga amaqela angama-3 asephambili ekubangela ukuphula umthetho:
- ehambelana nemeko yomama;
- imiselwe ngumbuso womntwana;
- inxulumene nendlela yokuzalwa, oko kuthiwa "intlungu yokukhusela."
Ngoko, phakathi kwezinto ezithandwayo "zokubeleka," izigqirha zibizwa ngokuthi:
- kwangoko okanye, ngokuchaseneyo, ubudala bexesha lokuzala;
- gestosis;
- i-pelvis encinci;
- uterine hypoplasia ;
- izifo ezikhulelwe: izifo zentliziyo, i-endocrine, izifo zengqondo;
- ukukhulelwa kwangaphambili;
- iimeko eziyingozi.
Iqela elikhulu lezinto ezibangela ukuxhatshazwa kwabantwana yilezo ezihambelana ngqo nomntwana. Ngoko ke, ukuphulwa kudla okukhankanywe:
- intetho ye-pelvic;
- kunqongophala kwamanzi ;
- ukubeka indawo engalunganga kwentloko kwi-pelvis encinci;
- kokuqala;
- ubungakanani obukhulu bomntwana;
- i-hypoxia yangaphakathi ;
- ukungaqhelekanga kophuhliso lwangaphakathi;
- i-asphyxiation.
Phakathi kweempembelelo zabasebenzi, ngenxa yokuba kukho, phakathi kwezinye izinto, ukuxhwalala kokuzalwa komlomo wesibeleko, kubalulekile ukuhlula:
- ngokukhawuleza okanye, ngokuchaseneyo, umsebenzi wexesha elide;
- ukuqhutyelwa kwengqungquthela yesingqisho ngokungabikho kwemisebenzi yabasebenzi;
- umsebenzi ongaqhelekanga;
- Ukusetyenziswa okungenangqiqo kwezibonelelo ezinobuncwane (vula umlenze, ukufakwa kwezinto ezinobunzima, ukusetyenziswa kwe-extractor).
Izahlulo ekuzalweni
Olu hlobo loxinzelelo ekuzalweni komntwana lubangelwa kwiimeko ezininzi ngeencwadi ezingenakulungelelanisi. Ngokuqhelekileyo, kukho umonakalo kwi-clavicle, amathambo ezandla okanye iinyawo (kuxhomekeke kwindlela yokubonisa). I-subperiosteal fractures ye-clavicle ifunyanwa ngamagqirha ngosuku 2-3 emva kokuziswa. Ngalesi sikhathi ukukhukhula okukhulu, i-callus yenziwa kwisiza sesilonda. Ngenxa yokufuduka kwethambo, umncinci akakwazi ukwenza ukunyakaza okusebenzayo kunye nezibamba, kodwa xa ezama ukunyamekela, uqala ukukhala.
Ukuqhekeka kwegxalaba okanye i-hip kuhambelana nokungabikho kokunyakaza kwemilenze, kukho ukuvuvukala, ukuguqulwa, inxalenye eyonakalisiwe ifutshane. Xa kwenzeka unxunguphalo lwalolu hlobo, ibhanti ye-gypsum isetyenziswe ngokutsha kwakhona kwelungu elenzakele. Xa kuthe kwaqhekeka i-collarbone, umntwana ubeka kwi-bandage yakwaDozo, ngaphezu komama, kunconywa ukuba kuqhutywe i-swaddling encinci yentsana ezalwayo.
Ukulimala kokuzalwa emgodini
Ukulimala kokuzalwa komgudu kwiintsana kwenzeka ngokungaqhelekanga. Kule ntsholongwane kunokubandakanya iintlobo ezahlukeneyo zokuphulwa:
- ukuphuma kwintambo yomthambo;
- ukunyanzeliswa kwentambo yomthambo, ukuphuka.
Ukulimala kokuzalwa kwintambo yomgudu kungabonakali kubonakale, kodwa kuhamba nekliniki ecacileyo. Kukho iimpawu zokuxhamla umlenze:
- ukuxhamla kunye nokuxhatshazwa kwemisipha;
- ukungabikho kwengcamango;
- ukukhala okungapheliyo;
- ukuphefumla.
Uphuhliso lwale ntsholongwane luhambelana nomngcipheko ophezulu wokufa kwesana olusandula ukuphefumula ukuphefumula. Ingozi enjalo yokuzalwa, njenge-asphyxia apho ingenakukhuseleka, ingakhokelela ekufeni komntwana. Ngentuthuko efanelekileyo yeziganeko kukho ukunyanzeliswa kokuhamba komzimba. Ngoko, ekutshintsheni i-hypotension ihamba ngokukhawuleza, kukho izimpembelelo ze-vasomotor, ukuxuma, i-trophic ye-tissue ne-muscular iphucula. Ukulimala kokukhanya kuhamba kunye nembonakalo yeempawu zengqondo: utshintsho kwimiyalezo ye-muscle, i-reflexes kunye neempendulo.
Ukukhathazeka ngokubeleka kwabantwana abatsha
Ingozi yokuzalwa yintlungu iyiphumo lokunyanzelisa intloko ngedaka lokuzalwa. Udlwengulo luyenzeka xa ubukhulu bomntwana obuthatshayo buhambelani ne-pelvis encinci okanye ukuba umsebenzi wabasebenzi uphazamiseka (abasebenzi bexesha elide). Ukulimala ngokukhawuleza rhoqo kunokuhamba kunye nokuqhwala, oku, kuxhomekeka kwisayithi yendawo, ingaba:
- i-ecephalohematemata yangaphakathi-yangaphakathi iphakathi kwe-mater ehlalayo kunye namathambo egazi;
- i-subdural - i-hemorrhage ifumaneka phakathi kwe-medulla eqinile ne-arachnoid;
- I-Subarachnoid-esekelwe kwisithuba se-subarachnoid;
- I-intraventricular - iya kwi-ventricles;
- i-parenchymatous - i-hemorrhage kwi-substance yengqondo, ene-character of hematoma;
- ixutywe - amanxeba amaninzi kwiimbumba zengqondo, ama-ventricles, ingqondo yengqondo.
Ukulimala kokuzalwa kwenkqubo yesifo
Ngethuba lokubeletha, umonakalo kwinkqubo yesantya yesiseko kunye neyomnxeba inokwenzeka. Ngokuqhelekileyo, inkqubo yesifo esithintekayo iquka iingcambu, i-plexus, i-peripheral ne-cranial nervo. Phakathi kwezilonda eziqhelekileyo kwinkqubo yesistim yomnatha, kuyafumaneka rhoqo:
- i-paresis ye-plexus ye-brachial;
- I-Duchenne-Erba paresis-inxulumene nomonakalo kwi-plexus kunye ne-rootlets;
- i-paresis engezansi yeDejerine-Klumpke - i-plexus okanye ingcambu iyachaphazelekayo, leyo ibangela ukuphazanyiswa komsebenzi wengalo ephasayo.
Ukulimala kokuzalwa kwinkqubo yesantya ephakathi kunqunywe kwinqanaba lokuqala phambi kobuchule beempawu:
- itysile yehla yehla;
- umda wokuhamba kwezandla kunye neenyawo;
- i-atrophy;
- ukubonakala kwe-dyspnea;
- i-cyanosis;
- ukuphefumula okuphefumulayo.
Ingozi yokuzalwa - iimpawu
Imiqondiso yoxinzelelo lokuzalwa ininzi kangangokuthi oogqirha babamanyanisa kumaqela amaninzi amakhulu - kuxhomekeke kwiindawo ezonakalisiweyo. Uxinzelelo lokuzalwa kwentloko, umzekelo, luhamba kunye nezi zinto ezilandelayo:
- uxhalaba;
- ukuphazamiseka kokulala;
- ubunzima (ithoni egqithiseleyo) yentloko yentloko;
- ngokutsha;
- ukuhlanza;
- i-nystagmus (ukunyanzelisa ngokukhawuleza ukuhamba kweempawu zamehlo);
- i-strabismus;
- iphosa;
- ukuthuthumela (iintlanzi) zeentlobo ezahlukeneyo, ukuxubha.
Iimpawu eziphambili zenzakaliso zethambo ezincinci zi:
- izibheno;
- ukubola.
Ngoxinzelelo lweenkqubo zethambo uthi:
- umda wokunyakaza okusebenzayo;
- ukuphendula okubuhlungu (ukulila) kunye nokunyakaza kwesilenze esingasecaleni lesilonda;
- ukutshintsha nokunciphisa ithambo elonakalisiweyo.
Ingozi yokuzalwa - ukuxilongwa
Ingozi yokuzalwa yommandla wesibeleko ingabangela ubunzima ekuxilongweni - intloko yomntwana iphendukele kumda wonakalo, kukho ukunyuka kwetoni ye-muscle ukusuka kwelinye icala. Nangona kunjalo, umonakalo kwizitho zangaphakathi kufuna ukuziphatha kweendlela zokwenza uphando ngeekhompyutha. Phakathi kweendlela ezisetyenziselwa ukucacisa:
- uviwo kunye nokutyumla kwezitho, inhloko;
- I-Ultrasound yendawo ecetywayo yomonakalo;
- i radiography;
- iimvavanyo zokusebenza.
Unyango lokulimala kokuzalwa
Xa kuphazamiseka intlungu yokubeleka, ukunakekelwa kwabantwana kubandakanya ukubeka esweni ngokupheleleyo kunye nokukhusela iingxaki. Umama ufumana iingcebiso ezithile ezivela oogqirha kufuneka bahlonishwe ngokupheleleyo. Ngokuqhelekileyo, unyango lwentlungu yokubeleka luyancitshiswa:
- ukuthintela ukusuleleka kwezicubu ezithambileyo;
- ukuqhuba ukusikwa, ukuvuthwa kwezonyango zonyango ukwenzela ukwandiswa kwetoni yomzimba;
- ukukhutshiswa kwezitho ezonakalisiweyo;
- Ukulungiswa kokuhlinzwa (xa kwenzeka ukuphuma kwangaphakathi, i-torticollis, umzekelo);
- unyango lwe-syndromic umonakalo kwinkqubo yeentlanzi.
Iziphumo zoxinzelelo lokuzalwa
Ukuqinisekisa ukuba abantwana abanalo ukukhubazeka ngokomzimba nangokwengqondo emva kokulimala kokubeleka, oomama mabazalisekise bonke abaqeshwa abafumanayo. Nangona kunjalo, ukuxhatshazwa kokuzalwa akusoloko kulandelwa. Iintsana ezininzi ezisanda kuzalwa ezithintekayo kwiintlanzi ze-adrenal zihlakulela ukungazinzi. Ukulimala kwinkqubo yesiseko kunye neyomnxeba kuyona yingozi kakhulu, ukuxela kunye nemiphumo kuxhomekeke ekubandezelekeni kweengxaki zegazi.