今天要跟大家分享的內容,其實也是治療師自己經歷過的事情
面對嚴重的身體損傷(如:韌帶撕裂、盂唇破裂、椎間盤突出、關節磨損….等),除了影響到日常生活的功能之外,大家其實更煩惱的是到底需不需要開刀這件事。畢竟,有些人害怕開刀而產生的些副作用,有些人則是認為會影響到工作上的安排(開刀很有可能導致需要缺勤一陣子),再來則是像是經濟上的考量….等等。但是開不開刀與否,實際上要怎麼做決定,我們會從以下幾個面向去探討。
在講到開不開刀的參照指標,我們有兩個重要的決定因素
1. 需求
其實這是我認為最基礎且首要考量的事項,對於之後的身體活動,你有怎樣的規劃與需求。如果一位十字韌帶中度撕裂的運動員,面臨到的是日後更長遠完整的職業生涯,那他的需求就擺在那,因為完整健康的韌帶才有辦法陪他度過每一個高強度的賽季。又或者一位家庭主婦,後十字韌帶中度撕裂,在往後的人生裡,她不會再面臨到任何高強度的運動需求時,則可以選擇不開刀的方式,慢慢使組織在復健中逐步自癒。所以一樣的狀況,開與不開刀與你的角色又或者說與你的需求是最直接相關的.

2. 結構損傷的程度
組織在受傷後,都有不同等級的損傷。以韌帶為例,
其撕裂傷總共分為三個等級:
- 輕度
- 中度
- 完全斷裂
如果今天,損傷程度是最嚴重的完全斷裂,基本上要維持基礎日常生活就會有一定的難度,而此時不論是醫師或是治療師,可能都會高度建議你開刀來修復,因為這是一個『無法自癒』的狀況!其次,要考慮長遠後的影響。有些組織在受傷後,雖然不會在現階段導致任何嚴重的不適感,但卻是引發退化性疾病的元兇,因為組織的改變,導致身體的使用方式改變,進而加速了退化的進程,這些狀況也會是建議開刀的其中一項原因。最後,能夠自癒的組織,我們會以保守治療的方式(不開刀,且做物理治療),來讓身體重拾功能。畢竟,能少挨一刀是一刀,對吧?
那麼最後,我們要如何尋求專業建議,並在知曉身體狀況的情形下,作出決定呢?
- 受傷後的檢查(X光、超音波、核磁共振MRI)
- 醫師會診告知受傷狀況
- 術前物理治療諮詢(暸解有無不開刀的可能性)
- 統整建議後,綜合評估自身社經狀態,決定是否接受手術
如果確定不做手術了,那麼接下來就是要好好與物理治療師訂定治療目標,以期持之以恆地對身體進行復健與訓練。
倘若決定要開刀了,術前的這段時間,也不能怠慢,必須積極的進行術前訓練來減低術後的不適,以及減少復原所需耗費的時間。而在術後,當然必須開始積極復健,以恢復身體原本的功能,並逐步返回原本訂定的術後目標。
如果您有開刀的困擾,也歡迎來達心諮詢狀況,達心結合了:
- 術前諮詢
- 術前訓練
- 術後復健
- 專業規劃完整術後訓練場地
讓專業給您釐清方向,有了方向之後,才可以更有信心地去面對一切的病痛喔!
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