I-endoscopic sinasotomy maxillary - yintoni na? Inkqubo yokusebenza kunye nemiphumo

Kwizigaba zokuqala ze-sinusitis, unyango lweziyobisi lusebenza kakuhle. Xa kuqhutywe ukuhamba, xa ukukhutshwa kwintlambo engasese kungabonakali, kodwa kungenakwenzeka, kuya kwenzeka ukuba ubaleke ngokubamba izipho. Emva koko bahlamba kwizinto ezikuyo. Kudinga ukungenelela ngoncedo olwenziwe ukunyuka kwexesha elide lezono ezinkulu. Iimpawu, unyango olude kwaye alusebenzi, ludinga isisombululo esinzulu ngakumbi kwingxaki. Nanku kufuneka umsebenzi, kwaye enye yeendlela zokugonywa yi-endoscopic sinus anatomy.

Yintoni na?

Izono ezinama-maxillary zibizwa ngokuba ngamagumbi kwimimandla yomhlathi ophezulu kumacala omabini awo. Ngenxa yendawo engabonakaliyo, bahlala bevezwe kwiinkqubo ezivuthayo ezivame ukuphela kwisifundo esingapheliyo kwaye kufuna ukungenelela okutyathwayo. Kwimigangatho yokuqala, kusenokwenzeka ukunyanga i-pathology yeasillas maxillary ngeendlela zokwelapha. Ukungabikho kokusebenza okanye ukuphindaphindiwe kwakhona, ithuba lokusebenzisa i-sinusotomy maxillary yesigulane esithile kufuneka kuthathelwe ingqalelo. Kungcono ukuqondisa isigulane kwi-intervention endoscopic eya kuba yincinci encinci kwaye isebenza ngokusisigxina. I-sinusitis yama-maxillary enobugqwetha yinkcazo ngqo yonyango, kuba yonke iminithi iqulethwe ukubunjwa kweengxaki.

Imibuzo malunga nento eyenziwa yi-genyantotomy, ukuba yintoni, ibuzwa izigulane ezininzi. Ngethuba lokusebenza, iimpazamo ezinkulu zivuliwe kwaye zonke izinto eziphathekayo zikhutshwa. Ngeengxaki ezinzulu, unyango olunyango luphela yindlela yokuphuma kwimeko. Izigulana zithunyelwa kuyo, ukugxilwa okuvuthayo apho akunakwenzeka ukucoca ngamachiza. Ngako oko, ukufikelela kwi-incision okanye ukupakishwa kuyadingeka. Ukufumanisa xa i-sinus maxillary eyenziwa, yintoni, isigulane asilula.

Izimpawu zokusebenza

Ukuvulwa kwama-maxillary sinuses ayilungelelanisi sonke isigulane esinokuvuvukala. Inikwe:

1) nge-cyst kumhlathi ophezulu;

2) inkqubo engapheliyo ye-maxillary sinusitis;

3) sinusitis yama-maxontogenic maxillary;

4) ukungabikho kweziphumo emva kokunyanga kwexesha elide kunye nokugqitywa kweziyobisi;

5) ukuphindaphinda rhoqo kwe-maxillary sinusitis;

6) iinqununu zamazwe angaphandle angene kwiisono;

7) ukuvakalelwa ngokukhawuleza okanye ngokukhawuleza kwimeko, kummandla we-infraorbital;

8) isiqhelo senkqubela ye-nasal ngaphandle kwesizathu esibangelwayo (ukusabela, ukubandayo);

9) ukubonakala kwiphunga elimnandi elivela ekhaleni, elivezwa ngumguli ngokwakhe okanye elichazwe ngabantu abazungezile;

10) ngezihlandlo okanye rhoqo kwiintlungu zokuguqulwa kwamandla kwimeko yamazinyo aphezulu;

11) Ukuvakalelwa kwendiza yomoya okanye ukuhamba kwamanzi kuqhutyelwa kwindawo apho isinyo sasuswa ngaphambili;

12) ukubonakala kwezinto ezizaliswe ngaphaya komda wezinyo ekuphathweni, eziza kubonwa kwifoto xa i-radiograph ithathwa;

13) ukubonakala kwikhompyutri yekhompyutri ye-polyps okanye yamanye amazwe;

14) ukuphakama kwesono esingaphumeleli;

15) ukwenqaba ukuphakamisa i-sinus ngenxa yokufumanisa i-pathology kwi-sinus maxillary.

16) ukuxilongwa kwe "sinusitis purulent."

Ukongezelela kwindlela yokungenelela endoscopic, kukho nesebenzi yeklasiy sinusitis. Eyona nto ikhethwayo yiyokuqala. Kubuhlungu kakhulu, kwaye ubude benkqubo kunye nokubuyiswa kufutshane kulo lonke inkqubo.

Ukungqinelana

Ekubeni kukho izibonakaliso, imida yokungenelela kokungenwa kwezicwangco ikwaqwalaselwa kwakhona. Ukuhlinzwa okwenziwe nge- endoscopic maxillary akukwenziwanga kwezi zilandelayo:

1) Ukunyaniseka kwesifo esingapheliyo sesitho sangaphakathi.

2) Ukubonakaliswa kweempawu ze-sinusitis, kodwa kwiimeko ezininzi, ukuhlinzwa ngenxa yesi sizathu akunako ukuhlehliswa.

3) Izifo ezinobungozi obunzima, ezinokunyusa iimeko zeemeko.

4) Ukuchithwa kwe-system coagulation system.

Amaninzi amaninzi emzimbeni acingwa njengesiqhelo. Ngenxa yezizathu ezininzi, emva kwesivumelwano kunye nodokotela ogqirha, umsebenzi awuhlehliselwe elinye ixesha. Kuze kube ngeli xesha, unyango lweziyobisi lwenziwa ukuze kukhutshwe ukuvuvukala kwesono se-maxillary. Iimpawu, unyango olunzima kumachiza omlomo ngomlomo, lugqitywa ngamachiza alawulwa nge-intramuscularly kuze kube ngumhla wokucetywa komsebenzi.

Uviwo phambi kwe-genyanthomia

Emva kokumisela ukuxilongwa kunye nokuqulunqa isidingo sokungenelela, ugulane unikezelwa izifundo eziyimfuneko. Kule ndlela, iirabhoratri kunye nezindlela ezisetyenziswayo ziyasetyenziswa. Isigulane sithunyelwa kwiimvavanyo zegazi jikelele, iimvavanyo zomchamo, iimvavanyo ze-biochemical, ukuhlolwa kwegazi lokusebenza kwegazi. Ukususela kwi-instrumental, imifanekiso ene-CT kunye ne-X-ray yezidalwa ze-paranasal ziyadingeka ukuba zisebenze ukuhlola imeko yazo.

Indlela ye-endoscopic yokuqhuba i-sinillasi yama-maxillary

Xa kuthelekiswa nobuchwepheshe beklasikhi, ukusebenza kwe-endoscopic maxusry sinusotomy inezinzuzo ezininzi:

• Ukungabikho kwezibhengezo kwisiza senkqubo, engakhange ihambisane nokubonakala kwesikhumba sesibisi;
• Ukukhutshwa kwesiphene sokuzilungisa;
• Ukunciphisa ngexesha lokusebenza kunye nexesha lokubuyisela;
• Ukunyamezela kakuhle kwenkqubo eyenziwa phantsi kwe-anesthesia yendawo;
• Mfutshane ukuhlala esibhedlele (ukuya kwiintsuku eziyi-3-4);
• Ukuqhawula okungaqhelekanga kwisiza sokusungulwa kwesixhobo kunye nokunyamalala kwayo ngokukhawuleza;
• Phantse ukungabikho ngokupheleleyo kweengxaki emva kokuhlinzwa.

Ezi nzuzo zivumela ukuba sisebenzise iindlela zanamhlanje zokunyanga i-pathology ye-maxillary sinuses ngokukhawuleza kwaye ingenabuhlungu.

Ukulungiselela umsebenzi

Ngomhla wenkqubo akufanele uchithe iiyure ezingama-6 ukuya ku-7 phambi kwayo. Ezi ndululo kufuneka zibonwe xa zilungiselela i-anesthesia yendawo. Ukuba u-anesthesia jikelele ucebisiwe, ngoko ke ukongezelela koku ngasentla akuvumelekile ukusela nasiphi na isiselo seyure ezimbini ngaphambi kokuba usebenze.

Ukufikeleleka ekugqibeleni kwe-endometri

I-genyantritis inemvelaphi ye-odontogenic, indlela yokuphela kuphela ekhoyo isetyenziswa ngokungafani nezinye iimeko. I-sinosotomy yama-maxosari ye-Endoscopic yenziwa kuzo zonke ezinye iimeko ngezinye iifowuni, kuxhomekeke kwiimpawu zokusebenza. Ziquka:

• Isixhobo sokusetyenziswa phakathi kweepalini eziphakathi okanye eziphantsi;
• Ukuqaliswa kwe-endoscope kwindonga yangaphambili yesinus maxillary;
• Ngokusebenzisa i-alveolus emva kokuphuma kwezinyo (nge-odontogenic sinusitis);
• Nge-hillock kwisangqa esiphezulu.

Xa usebenzisa i-endoscopic inqubo yokuhlinzwa, iingxaki zingagwenywa, kwaye ukhetha indawo ethile yokufikelela ivumela ukuba iyancitshiswe kumaxabiso amancinci.

Inkqubo

Umsebenzi uwenziwa phantsi kwe-anesthesia yendawo. Ukuzisa isisombululo, inzuzo inikwe ama-agile ane-diameter engaphantsi kwama-0.2 mm. Ukuba kuyimfuneko, i- anesthesia jikelele isenziwa . Iisombululo nge-gaymorotomii zinobuthi obuphantsi kunye nexesha elide le-anesthesia. Ubude balo abukho ngaphezu kwemizuzu engama-30. Ububanzi be-endoscope efakwe kwi-stroke ayikho ngaphezu kwe-5 mm. Ngako oko, i-puncture eyenziwa kwindawo ye-sinus maxillary encinci. Ngaloo ndlela, i-tube yoposcope ifakwe kwaye izicubu kunye noswelo olususwe ngokutsha. Yonke inkqubo yokusebenza iqhutyelwa phantsi kolawulo lwe-video ebhalisiwe kwi-monitor. Oku kuyimfuneko ukuba uhlolisise ngokulula umgca kunye nokucoceka kwayo. Emva kokuhlambulula, hlamba i sinus ngezisombululo zokuxhatshazwa ("Furacilin", i-permanganate ye potassium).

Ixesha lokubuyisela emva kokuhlinzwa

Impumelelo yenkqubo ixhomekeke ekubuyiseni kwesigulane emva kwayo. Emva kokukhutshwa esibhedlele, ugqirha unikezela ukudluliselwa kugqirha we-ENT ukujonga imeko. Udinga ukuyivakashela ubuncinane inyanga, kwaye, njengoko kuyimfuneko, eli gama linokunyulwa. Ugqirha ubeka ikhosi ye-antibiotics kunye nezisombululo zokuhlamba i-nasal cavity. Ngexesha elifanayo, i-antihistamines kunye namalungiselelo ayongezwa kwisikimu sokuqinisa udonga lwama-vascular phambi kweziboniso.

Emva kwe-gammorotomy ngexesha elifutshane, i-edema encinci ihleli. "I-Cinnabsin" inefuthe elihle kulo mba. Iyakwandisa izikhuselo zomzimba kwaye inciphisa ukuvuvukala kwezono zepanasanaal. Ngenxa yoko, ukubuyiswa kwesigulane emva kokuhlinzwa kukhawuleza.

Ngenyanga kufuneka enqabile ukutyelela ipulazi, ungadli ukutya okomnandi, okubandayo nokutshisa. Kufuneka ukuba ugweme i-hypothermia kwaye uthathe amanyathelo okukhusela ukuze ugweme ukufumana umkhuhlane okanye i-ARVI. Emva kweenyanga ezi-1-2 kuyacetyiswa ukutyelela i-sanatorium okanye ikhondo leetyuwa iintsuku ezili-10. Ukuhlolwa okuyimfuneko ekulawuleni unyango ogqityiweyo kwenziwa emva kweenyanga ezi-6 emva kwe-sinusitis maxillary kunye no-1 unyaka.

Iziphumo ze-endoscopic sinus

Njengawo nongenelelo olungagqirha, i-endoscopic maxillary sinusotomy ingaba nzima ngeemeko zokuhluka kanzima. Ngokwahlukileyo kwindlela yokwenza unyango, le nto ayikho imiphumo emibi. Zizibonakalisa ngokwabo kwithuba lokuqala lokuphucula okanye emva kwexesha. Iingxaki ziquka:

1) Ukukhenkcela kwisiza sokungena kweso sixhobo okanye indawo evezwe kuyo.

2) Ukuxubha okanye ukuhlanza, okubangelwa ingress yegazi kwisisu okanye impendulo yomntu ngamnye kwisigxina sokulawulwa kwe-anesthetic.

3) Intlungu ebuhlungu kwimpumlo.

4) Ukuphulukiswa ixesha elide lelinxeba emva kokusebenza.

5) Ukulimala kwisebe le-nerve ye-trigeminal, ekhokelela kwintsikelelo enzima yendawo engenakuhlala kuyo okanye i-numbness.

6) Ukuqulunqwa kweendinyana ze-fistulous kwinqanaba lokusungula ukusetyenziswa kwezixhobo okanye ukuchithwa.

7) I-Neuralgia inxulumene noxinzelelo ngexesha lotyando.

8) Ukunyanga kwesilonda kunye nokuxhaswa kwayo.

Isiganeko senkxalabo sincinci kuneemiphumo ezibangelwa ukungabikho konyango. Kwiimeko ezinjalo, utyando luphela yindlela yokuphuma. I-endoscopic sinrosotomy sinusotomy yindlela ekhoyo namhlanje evumela umntu ukuba akhohlwe ngesimo sinusitis kanye kunye.

Imemo yokulungiselela izigulane ngenkqubo

Emva kokumisela ukuxilongwa kunye nokusombulula umcimbi we-endometrial gammorotomy, kubalulekile ukuxelela ugqirha malunga nokunyamezela kwamayeza. Kubalulekile ukuqwalasela impendulo nganye kwisichengiselwano esithile kunye nokukhetha ikhambi elihle kwisigulane ukwenzela ukunciphisa ingozi yemiphumo engenzeka.

Ukuphonononga malunga nenkqubo

Iingxelo ze-Endoscopic genyanthytomy zihlala zihle. Izigulane zibika ukuphucula ngokukhawuleza kumgangatho wobomi, kwaye abaninzi abanakho iingxaki. Into ewukuphela kokuvuvukala encinane kwimpumlo, eyenza ukuphefumula kube nzima. Isibonakaliso kwiintsuku ezimbalwa iintsuku ngaphandle komkhondo.