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肩关节手术后的日常生活

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实用、单手操作的方法,帮助你在手术手臂佩戴悬吊带休息期间,完成洗漱、穿衣、睡眠以及日常活动。

一个人用吊带固定一只手臂,单手扣衬衫纽扣。
在术后手臂用吊带固定的情况下,管理日常生活——穿前开式衣物和使用单手技巧会让事情变得更容易。 Kieran Hirpara 4.0

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

肩关节手术后的最初几周,您的手臂需要佩戴吊带。 您的手仍然可以活动(可以抓握、写字和使用手机),但手臂本身需要保持支撑和休息。我们所进行的修复需要时间在不受干扰的情况下愈合,这意味着在您获得许可之前,手臂不得主动抬举、伸展或承重。好消息是,通过一些小技巧和少量规划,日常生活中的几乎所有事情都可以单手完成。本页面是我们单独提供的吊带佩戴指南的实用配套内容(该指南涵盖如何佩戴吊带以及佩戴时长);本页面则侧重于如何度过日常。

先坦诚说明:大多数人发现最初几周最为艰难,许多人在初期需要他人协助进行洗漱、穿衣和一些家务。这完全正常且是暂时的,随着时间推移会逐渐缓解。提前安排一些帮助会带来显著改善。

清洗与淋浴

关于清洗的好消息是:您的敷料是防水的,因此您可以淋浴,让水直接淋在敷料上:正常淋浴即可。原则是轻拍冲洗,不要搓洗或浸泡:不要用毛巾或海绵摩擦敷料,并避免泡澡、游泳或将患侧肩膀浸入水中,因为这些动作可能导致敷料边缘翘起,使水渗入伤口下方。让水自然流过敷料,之后用轻拍(不要摩擦)的方式将区域拍干。如果敷料边缘翘起或松动,请保持原状并告知我们。许多人在最初几周会使用淋浴凳(这能降低因单手且身体失衡时滑倒的风险)。

通常您可以取下吊带进行清洗,但原则是保持手臂静止并得到支撑,而不是使用它。让手臂靠在身体侧面或放在腿上。如果您的外科医生允许,您可以轻轻向前倾斜身体,让手臂从肩膀自然下垂,利用重力而非肌肉力量,使手臂保持完全放松。切勿主动抬起或伸展手臂进行清洗。

患侧的腋窝是最难清洁的部位,因为您无法抬起手臂去清洗。技巧是将上半身向远离患侧的方向倾斜,让手臂放松并依靠自身重量轻轻向外漂移;这样可以充分打开腋窝,以便用毛巾或湿巾清洁和擦干,并涂抹除臭剂。让重力发挥作用,不要耸肩来腾出空间。

头发和背部确实很难单手完成。使用长柄海绵有助于清洁背部。对于头发,弯腰在水盆上方清洗或在最初一两周内请求他人帮助是简便的方法;不值得为了清洗而做出扭曲身体的动作,以免牵拉肩膀。如果您愿意稍后再洗头,可以使用干洗发水过渡几天。

穿衣

在挑选未来一周的衣物时,请考虑佩戴吊带的影响:

  • 宽松且前开襟。 纽扣式或拉链式前开襟衬衫、开衫和大袖口背心远比紧身衣物容易穿脱。在单手操作期间,避免使用繁琐的小纽扣和挂钩。
  • 避免套头衣物。 必须套头穿着的紧身T恤和套头衫会使肩部产生我们正试图避免的动作。
  • 先穿患侧手臂,后脱患侧手臂。 穿脱时,先将健侧手臂轻轻伸入袖中,再穿患侧手臂;脱衣时,先脱健侧手臂。这样可以避免患侧肩部过度伸展以追赶进度。
  • 易穿脱的鞋子。 系带鞋几乎无法单手操作;套脚鞋或魔术贴鞋可省去许多挫败感。松紧鞋带是改造现有鞋子的廉价方案。

睡眠

在术后早期数周,睡眠往往是最困难的部分,也是最常见的困扰之一,但随着肩部症状逐渐缓解,睡眠情况会稳步改善。平躺时手臂会向后滑动并对肩部产生牵拉,因此大多数人采用半卧位睡眠效果更佳:可使用躺椅,或在床上用多个枕头或背部楔形垫垫高上半身。

以下几点能带来显著改善:

  • 支撑整条手臂。 在肘部和前臂下方垫入枕头,防止手臂下垂牵拉肩部;同时在身体侧方放置枕头,避免睡眠中翻身压到手术侧肩部。
  • 先控制疼痛。 许多人会在睡前约半小时服用止痛药,以便在躺下时药物已起效。
  • 注意吊带摩擦。 在吊带内穿一件薄款背心或T恤,可防止吊带整夜摩擦或擦伤颈部皮肤。

睡眠时是否需持续佩戴吊带,以及需佩戴多长时间,详见我们关于佩戴吊带的单独指南。

进食、烹饪及家务

几乎所有这些活动都可以用您的健侧手配合患侧手的抓握功能来完成;关键在于滑动和固定,而非抬起

  • 滑动沉重的锅具、盘子和水壶,而不是搬运它们。水壶只装到所需的量,使其更轻。
  • 在碗或砧板下放置防滑垫,可以让一只手完成双手的工作。简单的一手辅助器具(如开罐器、护盘器、摇柄刀叉)价格低廉且确实有用。
  • 提前准备。在手术前批量烹饪并储备一些简单的餐食,并将日常用品(杯子、麦片、药物)移至无需伸展即可触及的台面高度,可以消除大量日常麻烦。
  • 在繁重和不便的工作上寻求帮助:如装满衣物的洗衣篮、购物、更换床单、任何需要双手操作且需抬起的物品。在这些事情上逞强并无必要;让肩部愈合。

保持手臂其余部分活动

悬吊带仅让肩部休息,而非整个手臂。除非 您被告知例外,否则请轻柔且定期活动允许活动的部位:

  • 手和腕: 每小时数次张开并闭合手指,并绕腕转动, 以保持其柔韧并帮助消除肿胀。
  • 肘部: 如果您的外科医生表示允许,每天数次将手臂从 悬吊带中取出,并轻柔地伸直和弯曲肘部(保持肩部静止),以防肘部僵硬。
  • 姿势: 手臂悬吊时,人们很容易出于保护目的而含胸驼背。请挺直坐立,不时轻柔地将肩胛骨向后收,并活动健康的肩部,以缓解悬吊带常导致的颈部和上背部紧张。

这些是通用原则;您个人的活动规则优先。 每种手术都有其特定的注意事项,因此如果我们的书面说明或您的物理治疗师关于您的肘部或肩部有不同的指示,请遵循那些指示。

何时寻求帮助

大多数恢复过程顺利,但如果您出现以下任何情况,请联系我们的医生、您的全科医生(GP)或寻求紧急护理:

  • 疼痛加剧且无法通过处方止痛药控制,或突然明显加重。
  • 伤口问题: 红肿范围扩大、发热、肿胀,或伤口有液体或脓液渗出,尤其是伴有发烧或身体不适感时。
  • 手指出现麻木、发冷、苍白或发绀,或严重肿胀: 这可能意味着吊带或敷料过紧,或影响了血液循环。请松开吊带并尽快寻求建议。
  • 小腿疼痛、肿胀或发红,或突发呼吸困难或胸痛: 这些可能是血栓的信号,需要紧急医疗关注。若出现突发呼吸困难或胸痛,请拨打 000 求助。

如有疑虑,始终建议咨询。我们宁愿您尽早联系,也不愿您等待并担忧。


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