Ukuncintisana - yimuphi uhlobo lendlela? Ukucubungula nokulinganisa

Ukwelashwa kwanoma yisiphi isifo kuqala ngokuhlolwa okujwayelekile okusemtholampilo okudingekayo ukuze uthole umqondo jikelele wesiguli, isimo sempilo yakhe kanye nokwenza uxhumano phakathi kwezitho ezithintekayo ngabanye ngamalungu ezitho zomzimba. Izindlela eziyinhloko zokuhlolwa ziyi: ukuqoqwa kwe-anamnesis, ukuhlolwa kwesiguli, ukuqhuma, ukuxubana nokushaya. Lezi zindlela zokuhlola zifundisa, zilula, zifinyeleleka futhi azilimazi neze isiguli.

I-Percussion iyindlela evumela ukuthi kutholakale okungavamile kokusayizi nokucushwa kwezitho zangaphakathi, ukucacisa indawo yabo. Kuphazamisa emzimbeni futhi kuhlolwe imisindo ephakama kuyilapho izicubu ezinempilo nezithintekile zizwakala ngokuhlukile. Ukuhlotshaniswa eduze ne-palpation - indlela yesimo esivumelana nesineke.

Imigomo yokugubha kanye nokulinganisa

Ukuqhuba ingxabano kunemigomo emibili eyinhloko:

- funda ngezinguquko ezithombeni, okuqukethwe kwemoya kuzo kanye nokuba khona noma ukungabi khona kwezinto ezincane;

- sinquma imingcele, ukuma nokulinganisa kwezitho.

Ukuzwa kusiza:

- sinqume ukuzwela kwezitho kanye nezicubu kanye nesimo sezolimo;

- hlola izinga lokushisa kwesikhumba, ukuthuthwa kwezikebhe, ukukhishwa kwamathumbu emathunjini;

- ukuhlola i-broncho-pulmonary pathologies;

- ukuveza umumo kanye nemvelo ye-deformation, neoplasms.

Izinhlobo zokungqubuzana, i-palpation: izindlela zokuqhuba

Kunezinhlobo ezimbili eziyinhloko zokucubungula:

- Ukunciphisa okuqondile kuhilela ukubamba iminwe eyodwa noma ngaphezulu emzimbeni wesiguli.

- Umcibisholo ohlangene owenziwa ngosizo lwento enamathiselwe emzimbeni, lapho kusetshenzwa khona ukushaya.

Kunezindlela eziningana zokuxhumana okuqondile:

- Indlela Yanovsky FG, ehlanganisa ukusebenzisa inyama yesikhala sokuphela komunwe wenkomba noma umunwe ophakathi kwesandla sokunene;

- indlela ye-Obraztsov VP, lapho umunwe wenkomba, oshaya, amaslayidi avela ngemuva komunwe wesithathu;

- Inqubo ye-Auenbrugger, efaka ukufaka ngeminwe eboshiwe kanye nengxenye esifubeni (okungavamile ukusetshenziswa namuhla);

- ukushayisana kwe-sliding kuyindlela yokuqhuba ucwaningo ngokusebenzisa inyama yeminwe eminingana, evumela ngokuqondile ukucacisa imingcele yezitho.

I-percussion ehlangene nayo ingenziwa futhi ngezindlela eziningana:

- umunwe on the funer;

- isando ku-pleometer;

- indlela yomunwe-umunwe.

I-percussion ehlangene iyindlela ephumelela kunazo zonke yokuhlola, ngoba ngosizo lwe-plemetrix umsindo ophumela ngokuya uba ngaphezulu futhi uhlukile.

Kuye ngokucwiliswa okujulile kweminwe noma yezandla , izicubu zihlukanisa:

- Palpation engaphezulu. Lena indlela yokuqondisa, ukuhlolwa kokuqala. Isetshenziselwa ukucacisa ukushisa, umswakama, ukuzwela kanye nesisindo somzimba. Imivimbo ye-Symmetrical ingasiza ekunqumeni isimo semvelo, yembula noma yikuphi ukubunjwa noma izigxobo esikhumbeni, izicubu ezingaphansi, ukuthola ukuhlukumeza kwamasipha emlenzeni, emuva, esiswini. I-palpation ye-surface ingenziwa ngezintambo ezimbili noma ezimbili. Iminwe iselulekile, ingcindezi ebusweni bokuthinta akufanele ibe.

- I-palpation ejulile, esetshenziselwa ukuhlola isimo sezitho nezicubu ezisezingeni eliphansi emzimbeni.

Izinhlobo ezahlukene zolimi olujulile zisetshenziselwa ukuzwa imisipha ehlukene, amalunga nezinye izindawo:

• Ukuze uhlole imisipha, amathambo ngaphansi kocingo lwe-muscle, i-articular gap, i-palpation isetshenziselwa ukucwiliswa okujulile kwephuzu linye noma iminwe eminingi.
• Izitho zesigxobo esiswini sezihlolwe ngosizo lwe-palpation ejulile yokulalisa.
• Kucwaningo lwesibindi, isisu somzimba wesisu kanye nase-ascites kusetshenziswa i-balling noma i-palpation enamandla.
• Ukubona uketshezi oluthelwe emadolweni, udokotela angasebenzisa ukucindezelwa okucindezelwe ngeminwe eminingana.
• Cwaninga isibeletho, ama-ovari, izicubu ezincane zesikhumba, isibindi, amadolo kanye nezinhlanganisela zomugqa zizosiza ukunakekelwa kwe-bimanual, kwenziwe ngezandla zombili.

Ubuningi bokungqubuzana: umcibisholo

Amandla we-stroke ephikisanayo ayathinta ukusatshalaliswa kwezinyathelo ezizungezile ngaphakathi nokujula, ubukhulu bezwi kanye nenani lomoya elilethwa ukunyakaza okuzungezile. Ukunikezwa konke lokhu kuhlobana kuhlukaniswe ngokuthi:

- ejulile (eqinile noma ephakeme);

- ngaphandle (obuthakathaka noma ethule).

Ukuqubuzana okujulile (okunamandla) kunikeza ukuguqulwa kwezicubu ebusweni kuze kufike ku-5 cm, ngokujula - kufika ku-6 cm. Ingxabano ye-acoustic (ebuthakathaka) iyingxenye yesine eqinile. Ngokuya ngobukhulu besendaweni ethintekile, ukujula kwendawo kanye nenhloso yohlolo, udokotela angasebenzisa ukucubungula okungaphezulu noma okuncane.

Imisindo yezingcingo: izinhlobo

1. Umsindo ocacile, we-pulmonary uzwakala ngenkathi ubamba isifuba ngqo ngaphezu kwamaphaphu.
2. Umsindo wezinsikazi, noma ongeyena owenzekayo uma kwenzeka ushaya izingxube nezinsimbi ezingenomoya ezingenalutho.
3. Umsindo owenziwe ngomsindo uvezwe ngesikhathi kuqhutshwa izingxenyana ezisemoyeni, isibonelo, i-larynx, i-trachea noma intathu.

Ukusebenza komtholampilo we-percussion

Ngokuklama, kunezinhlobo ezimbili zokungqubuzana:

- Ukuqhathanisa, okubandakanya ukusebenzisa izikhali eziningana ezilinganayo ezingxenyeni ezilinganayo zendawo yokufunda. Kuvame ukusetshenziselwa ukuhlolwa kwemaphaphu.

- I-Topographic, echaza imingcele nobukhulu bezitho kanye nokukhipha lezi zimingcele ebusweni bomzimba. I-percussion ye-Topographical idinga ukuhlukumezeka okungenangqondo nokusetshenziswa kwesifo esifushane.

Ukucubungula kwenhliziyo kukuvumela ukuthi unqume ubukhulu, ukuma nokuma kwesitho nesikhwama se-vascular ngokwayo. Inhliziyo iyisisindo esingenangqondo, esingenanjongo, egazini eligcwele igazi, ngakho-ke uma uthepha indawo yokuziphulukisa ngokuphelele, umsindo ukhululekile. Ngakwesobunxele nangakwesokudla kuhlanganiswe nokukhanya - isilwane esinomoya, ngakho-ke umsindo kule ndawo uzobe uphambene. Ukuvuthwa okuvamile kwenhliziyo kwenziwa endaweni yokuma noma ehlezi ngezandla phansi, ukuphefumula kufanele kube nokuthula ngesikhathi esifanayo.

I-percussion yesibindi, njengegesi elinyene, linikeza umsindo othobekile uma uthepha. Ukuguqulwa kulandela kusukela phezulu, lapho umsindo uzocaca khona, futhi ulandele phansi kuze kube khona umsindo ongeyonto. Izinguquko zomsindo zibangelwa ukuthi isibindi siphelelwe ingxenye ngamaphaphu. Ukuxubha kwesibindi kumele kwenziwe ngokuqondile. Imikhombandlela yocwaningo lwakhiwe yizimbambo kanye nemigqa emibala yomlomo yesifuba. Ngemuva kokungqubuzana, kufanele kulandelwe i-palpation, noma i-palpation yelungu, elivumela ukucacisa izinguquko ekuhambeni, ifomu kanye nesibindi sesibindi, izindawo ezibuhlungu, kuvumela ukuhlukanisa imingcele ephansi yesigungu.

Ukunquma isimo samapayipi esifubeni futhi maqondana nezinye izitho kuzosiza ukuqhutshwa kwemiphahla emaphashini. Umvuthwandaba womsindo we-percussion phezu kwezicubu ze-pulmonary umsindo ocacile. Kule ndawo ukuthi umsindo lapho uthayipha uqondile kuwo wonke umzimba. Ukuhlanganiswa kwesifuba kukuvumela ukuba ubone ukuthi ukhona kanjani, izindawo ezibuhlungu, ukumelana nokuthuthumela kwezwi. Ukuzwa kwenziwa ngezandla zombili ngesikhathi esisodwa. Indawo ebuhlungu eveziwe izwa ngokucophelela. Uma isifuba sencazelo yokumelana imisiwe kalula, lokhu kuwubufakazi bokuthi uyakwazi ukuqina nokuqina, okubhekwa njengokujwayelekile. Ungacindezela kokubili ngaphambili nangemuva, ukubeka ngokulinganayo izandla zakho, naseceleni, lapho isifuba siphenduka khona.

Izici zezingxabano zezingane

Ukucubungula ezinganeni, ikakhulukazi ngonyaka wokuqala wokuphila, kudinga udokotela ukuba aqaphele, ngoba izitho zalezi ziguli zincane, izindonga zesifuba zincane, futhi isikhumba sinomthelela kakhulu.

Uma uhlola amaphaphu, kufanele uqaphele ngokukhethekile isikhundla somntanakho, lapho isikhonkwane sitholakala khona ngokulinganisa. I-percussion ehlangene isetshenziselwa ukuhlolwa kwezingane ezindala, izingane ezisetshenziselwa ukuzisebenzisa ngqo. Ingemuva ibamba ngokuma noma ehlezi lapho imilenze iwela, izingxenyeni eziseceleni zesifuba - endaweni ehlezi, ngezandla ezelulelwe phambili noma ngemuva kwekhanda, nesifuba - esimweni sokuhlala.

I-Percussion ingathula kuphela: umunwe-umunwe noma oqondile. Umsindo ophezulu futhi ocacile womsindo wezingane ezincane uthathwa njengokujwayelekile. Ngesikhathi sokukhala, ingashintsha ibe yi-tympanic.

Ukuphambana: imithetho ejwayelekile

1. Ikamelo kufanele lifudumele futhi libe nokuthula.
2. Isikhundla sikadokotela siyinto elula.
3. Isimo sesiguli sincike eminyakeni yobudala nobukhulu besimo. Umuntu omdala angakwazi ukuma noma ahlale ehlala endaweni ekhululekile kakhulu. Ukuncelisa i-breastfeed endaweni efanele kufanele kugcinwe, ukucindezela yona, umama.
4. Umzimba we-naked uxoxwa.
5. Izandla zomdokotela zifudumele, zomile futhi zihlanzekile.
6. Iphutha le-percussion kufanele libe lukukhanya, elilinganayo, elifushane, elithintekayo.
7. Isipikili emunwe, eqhuba izingxabano, kufanele kube mfushane.

Ukulinganisa kanye nokucubungula yizo izindlela zokwelapha zokuhlola izitho zangaphakathi, okuvumela ukuba uhlole ngokulinganayo isimo sabo kanye nesimo, okudinga ukuba udokotela aqaphele futhi aqaphele.