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肋骨骨折的家庭急救

佚名 2023-11-16 03:59:43

一、什么是肋骨骨折

人體(ti)一共(gong)有(you)12對(dui),共(gong)24根肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu),分(fen)為(wei)左右(you)兩排(pai)。前(qian)面(mian)連接胸(xiong)(xiong)骨(gu)(gu)(gu)(gu),后面(mian)連接脊柱,圍(wei)成(cheng)胸(xiong)(xiong)腔(qiang)(qiang)(qiang)。肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)具有(you)重(zhong)(zhong)要的(de)(de)(de)生理意義,它不僅是(shi)整個(ge)胸(xiong)(xiong)腔(qiang)(qiang)(qiang)的(de)(de)(de)支架,而且是(shi)呼(hu)(hu)吸運動不可缺(que)少的(de)(de)(de)組(zu)成(cheng)部分(fen)。當人呼(hu)(hu)氣時,肋(lei)(lei)(lei)間肌拉著肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)向外(wai)展,同時膈肌下沉,胸(xiong)(xiong)腔(qiang)(qiang)(qiang)擴大,空氣就(jiu)被(bei)吸進肺里(li);當人呼(hu)(hu)氣時,肋(lei)(lei)(lei)間肌放松,胸(xiong)(xiong)腔(qiang)(qiang)(qiang)回位,肺里(li)的(de)(de)(de)空氣隨即被(bei)呼(hu)(hu)出體(ti)外(wai)。肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)下面(mian)還保(bao)護著人體(ti)的(de)(de)(de)重(zhong)(zhong)要臟器―――心臟和(he)肺臟。由于肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)有(you)一定的(de)(de)(de)彈性(xing),當胸(xiong)(xiong)腔(qiang)(qiang)(qiang)受(shou)到(dao)外(wai)力(li)打擊時,肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)的(de)(de)(de)彈性(xing)和(he)支撐作用可以(yi)保(bao)護里(li)面(mian)的(de)(de)(de)重(zhong)(zhong)要臟器不受(shou)傷害。但是(shi),如果(guo)外(wai)力(li)過大,超過了肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)的(de)(de)(de)承受(shou)能力(li),肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)就(jiu)會折(zhe)斷,這就(jiu)是(shi)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折(zhe)。

在(zai)胸部(bu)創傷中,肋骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)(zhe)最常見(jian),占胸部(bu)創傷的(de)(de)50~70%。其中,又以單肋骨(gu)(gu)(gu)折(zhe)(zhe)最為多見(jian)。第1~3肋骨(gu)(gu)(gu)短粗,且有鎖骨(gu)(gu)(gu)、肩胛骨(gu)(gu)(gu)保護,除非是(shi)特別巨大的(de)(de)暴力,否則一般(ban)不會骨(gu)(gu)(gu)折(zhe)(zhe)。第4~7肋骨(gu)(gu)(gu)長而薄,最易折(zhe)(zhe)斷(duan)。第8~10肋骨(gu)(gu)(gu)前(qian)端的(de)(de)肋軟(ruan)骨(gu)(gu)(gu)形成肋弓,與胸骨(gu)(gu)(gu)相連(lian),第10~12肋骨(gu)(gu)(gu)前(qian)端游離,它們彈性(xing)都較(jiao)大,一般(ban)也不會骨(gu)(gu)(gu)折(zhe)(zhe)。如果(guo)發(fa)生骨(gu)(gu)(gu)折(zhe)(zhe),應警惕腹部(bu)臟器和膈肌的(de)(de)損傷。相比(bi)之下,老年人骨(gu)(gu)(gu)質疏松,脆性(xing)較(jiao)大,更易發(fa)生骨(gu)(gu)(gu)折(zhe)(zhe)。

二、識別肋骨骨折

骨(gu)折處疼(teng)(teng)痛(tong)是最(zui)常(chang)見的(de)癥狀。肋(lei)(lei)骨(gu)骨(gu)折后,可刺激旁邊(bian)的(de)肋(lei)(lei)間(jian)神經(jing)產(chan)生局部疼(teng)(teng)痛(tong),隨咳(ke)嗽(sou)、深(shen)呼吸(xi)、體位變動加劇。用手(shou)擠壓胸(xiong)廓,局部胸(xiong)壁也會(hui)(hui)產(chan)生明(ming)顯壓痛(tong)。有(you)時病人(ren)還能自(zi)己聽到骨(gu)折處有(you)“咯(ge)吱(zhi)咯(ge)吱(zhi)”的(de)摩擦音。如(ru)果肋(lei)(lei)骨(gu)斷端刺破了胸(xiong)膜和(he)肺組織,就(jiu)會(hui)(hui)使空(kong)(kong)氣(qi)(qi)進入(ru)到胸(xiong)膜腔里,產(chan)生氣(qi)(qi)胸(xiong)。隨著時間(jian)的(de)延長,胸(xiong)腔里的(de)空(kong)(kong)氣(qi)(qi)越(yue)積(ji)越(yue)多(duo),壓迫(po)正常(chang)的(de)肺組織,就(jiu)會(hui)(hui)產(chan)生呼吸(xi)困難。大(da)的(de)暴力還會(hui)(hui)使多(duo)根肋(lei)(lei)骨(gu)出現(xian)(xian)(xian)多(duo)處多(duo)端骨(gu)折,胸(xiong)廓會(hui)(hui)出現(xian)(xian)(xian)明(ming)顯畸形。這時局部胸(xiong)壁因失去(qu)肋(lei)(lei)骨(gu)的(de)支撐(cheng)而(er)軟(ruan)化,出現(xian)(xian)(xian)反(fan)常(chang)呼吸(xi)現(xian)(xian)(xian)象(xiang)。即吸(xi)氣(qi)(qi)時胸(xiong)腔內壓增加,軟(ruan)化區(qu)胸(xiong)壁內陷;呼氣(qi)(qi)時則反(fan)之,軟(ruan)化區(qu)向外(wai)膨出。醫學上稱為鏈枷胸(xiong)。如(ru)果這種(zhong)現(xian)(xian)(xian)象(xiang)持續存在,就(jiu)會(hui)(hui)使病人(ren)出現(xian)(xian)(xian)呼吸(xi)衰竭,導(dao)致生命危險(xian)。

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