Endoscopic maxillary sinusotomy - ndichiyani? Inde ntchito ndi zotsatira za

Mu magawo oyambirira a sinusitis mankhwala ogwira bongo. Ngati pa akuthamanga, pamene kumaliseche kwa m'mphuno si slimy ndi purulent athawe nkusani puncture. Kenako, ndi osambitsidwa ku zili. Pamafunika opaleshoni yaitali kutupa sinuses lapansi. Zizindikiro, chithandizo chimene anachita kwa nthawi yaitali ndipo ndi inefficient, amafuna njira yaikulu kwambiri vuto. Apa opaleshoni chofunika, ndi mawonekedwe njira opaleshoni ndi endoscopic maxillary sinusotomy.

Maxillary sinusotomy - ndichiyani?

Wotchedwa maxillary nkusani M'mimbamo magawo a nsagwada chapamwamba mbali zonse za izo. Chifukwa cha malo yosayenerera, iwo nthawi zambiri nkhani kutupa, amene amakhala ndi njira aakulu opaleshoni. Mu magawo oyambirira pali kuthekera azisamalila kudwala njira nkusani mankhwala. Popeza efficacy kapena pafupipafupi musabise ayenera kuonedwa kuti n'zotheka yeniyeni wodwalayo maxillary sinusotomy. Ndi bwino amanena odwala njira endoscopic za phukusi kumene kukhoza kukhala kosavuta olanda ndi zothandiza kwambiri. Purulent sinusitis - zimasonyeza mwachindunji kuchipatalako, chifukwa mphindi iliyonse ndi zinadzala ndi mapangidwe zosokonezeka.

Mafunso chimene chili maxillary sinusotomy icho chiri, odwala ambiri amapatsidwa. Pa ntchito kutsegula imagwiridwa sinuses maxillary ndi kuchotsa nkhani zonse madzi. Pamene mavuto aakulu opaleshoni mankhwala - njira yokhayo yotulukira. Zimatanthauza wodwala, yotupa foci imene n'zosatheka kuchotsa mankhwala. Choncho pamafunika alibe ang'ambe thupilo kapena puncture. Kumvetsa kuti ndi sinusotomy maxillary chimene icho chiri, wodwalayo osiyanasiyana.

Zikuonetsa kuti Khwelero

Autopsy nkusani m'pofunika aliyense wodwala ndi kutupa. Iwo anatumizidwa:

1) pamene chotupa mu nsagwada chapamwamba;

2) aakulu Inde polypoid sinusitis;

3) odontogenic maxillary sinusitis;

4) salabadira pambuyo mankhwala yaitali ndi puncture;

5) pafupipafupi recurrences sinusitis;

6) anakumana ndi matupi yachilendo nkusani;

7) kawirikawiri kapena kobwereza ululu kutengeka pa nkhope, infraorbital dera;

8) The nthawi yatsoka cha kuchulukana mu mphuno, popanda chifukwa akuoneka (matupi awo sagwirizana anachita, chimfine);

9) fungo kwa mphuno, amene maganizo wodwala kapena anthu ozungulira amatchuka;

10) nthawi kapena mosalekeza osiyanasiyana mwamphamvu Timatha ululu mano chapamwamba;

11) kuona Ndime ya mpweya kapena utuluke madzi mwa malo dzino poyamba zichotsedwa;

12) maonekedwe a kusindikiza nkhani kupitirira malire a dzino kuchitiridwa, sanaonerere mu chithunzi pamene radiograph ya;

13) Zikuoneka pa tizilombo ting'onoting'ono kompyuta tomogram kapena matupi yachilendo;

14) wanyamula sinuslifting zinalephereka;

15) kulephera kuchita Nyamulani ndi nkusani chifukwa kudziwa kudwala mu nkusani maxillary.

16) matenda "purulent sinusitis".

Komanso endoscopic alowererepo njira alipo ndi maxillary sinusotomy tingachipeze powerenga ntchito. The ambiri ankakonda - woyamba. Ndi zochepa kwambiri ndipo mu ndondomeko ndi kuchepetsedwa ndi nthawi kuchira.

contraindications

Pamaso pa zizindikiro ndi zofooka atengedwa mu nkhani opaleshoni. Opaleshoni Endoscopic maxillary sinusotomy osati ikuchitika zinthu zotsatirazi:

1) The exacerbation wa kudwala aakulu ziwalo mkati.

2) MAWONEKEDWE zizindikiro sinusitis, koma ambiri milandu opaleshoni chifukwa chimenechi sangathe kulephereka.

3) Matenda mu matupi aakulu mwamphamvu kuti zingawonjezere zilili.

4) Kulakwila dongosolo magazi coagulation.

Ambiri a boma la thupi limabweretsa wachibale. Pali zifukwa zingapo, atakambirana ndi dokotala ntchito si kutengedwera kwinako ndi liwu lina. Mpaka nthawi imeneyo, mankhwala anachita kuchotsa m'njira za m'mphuno chofuna. Zizindikiro, mankhwala amene ali ovuta kwambiri mankhwala kuchipatala mankhwala m'kamwa, cropped mankhwala kutumikiridwa intramuscularly lisanadze tsiku la ndikupeleka akufuna.

Kudzifufuza pamaso sinusotomy maxillary

Pambuyo matenda ndi kudziwa kufunika opaleshoni, odwala anali kutumikiridwa kafukufuku kutero. Chifukwa chaichi, zasayansi ndi njira malangizo. The wodwala anatumiza mayesero ambiri magazi, mkodzo mayesero, kuphunzira amuzolengedwa, kuganizira za clotting magazi. Chida chofunika kwa mafano ntchito ndi CT radiography ndi sinuses paranasal kuwunika chikhalidwe chawo.

Endoscopic njira sinusotomy maxillary

Poyerekeza ndi luso chakale cha endoscopic opaleshoni maxillary sinusotomy angapo ubwino:

• palibe mabala m'malo mwa ndondomeko, amene si limodzi ndi maonekedwe a minofu yovulazidwa;
• kupatulapo zodzikongoletsera chilema;
• kuchepetsa nthawi ya ntchito ndi nthawi kuchira;
• bwino analekerera ndondomeko anachita pansi mankhwala oletsa ululu pamalopo;
• yochepa utsalire (masiku 3-4);
• pafupifupi imperceptible kutupa pa zida jekeseni ndipo mofulumira ake mofulumira;
• pakalibe pafupifupi zosokonezeka pambuyo opaleshoni.

ubwino n'zotheka kuti ntchito njira zamakono kuchiza matenda nkusani mwamsanga ndipo popanda kumva ululu uliwonse.

Kukonzekera opaleshoni

Pa tsiku la ndondomeko, musadye kwa maola 6-7 patsogolo. ayamikira ayenera kutsata pokonzekera mankhwala oletsa ululu pamalopo. Ngati mukufuna kupereka mankhwala oletsa ululu ambiri, china kuwonjezera pa pamwamba ndikoletsedwa kumwa zakumwa kulikonse kwa maola 2 asanachite opareshoni.

Accesses pa sinusotomy maxillary endoscopically

Pamene nkusani ndi chiyambi odontogenic, njira zotheka ntchito mosiyana m'maboma ena. Endoscopic maxillary sinusotomy ikuchitika pa zochitika zonse, ndi mwayi osiyanasiyana malingana ndi zizindikiro kwa opaleshoni. Njirazi ndi monga:

• wanyamula chida kupyolera sing'anga kapena m'munsi njira za m'mphuno;
• oyamba a endoscope kukhoma zapambuyo wa nkusani maxillary;
• mwa alveolus pambuyo m'zigawo (ndi odontogenic maxillary sinusitis);
• mwa protuberance mu nsagwada chapamwamba.

Pamene ntchito endoscopic opaleshoni njira akhoza kupewa mavuto, ndi kusankha malo kwambiri kulumikiza timatha kuchepetsa iwo ndi mfundo osachepera.

Development wochita

opaleshoni imagwiridwa pansi mankhwala oletsa ululu pamalopo. Pakuti makonzedwe zokonda zapatsidwa kwa yankho la singano ndi awiri a osapitirira 0.2 mm. Pamene muyenera kuchita ochititsa dzanzi ambiri. Solutions ndi sinusotomy maxillary ndi kawopsedwe otsika ndi mpumulo waukulu ululu kwa nyengo. Kutalika kwake - zosaposa mphindi 30. The awiri a endoscope anakhazikitsa kudzera njira - osapitirira 5 mm. Choncho, puncture analengedwa mu dera la nkusani maxillary ndi kochepa. Pambuyo waikidwa ndi endoscope chubu kuchotsedwa minofu pathologically asintha ndi madzimadzi. Dongosolo lonse opaleshoni imagwiridwa m'manja mwa kujambula kanema ndi kunditumiza ku polojekiti lapansi. Izi ndi zofunika kuti mayiko kumupima m'kamwa ndi konzanso ake. Pambuyo kutsuka ndi kuyeretsedwa ntchito nkusani njira antiseptic ( "Furatsilinom", potaziyamu permanganate).

Nthawi kuchira pambuyo opaleshoni

The bwino ndondomeko zimadalira kuchira wodwalayo pambuyo. Pambuyo kumaliseche kwa dokotala kuchipatala amapereka malangizo kwa ENT kuti anapatsidwa polojekiti. Kupezeka zosowa zake osachepera mwezi, ndi nthawi akhoza adzakhala ngati n'koyenera. Doctor n'kukulemberani njira ya mankhwala ndi njira kwa kutsuka m'mphuno. Imodzi akuwonjezeka dera mankhwala a antihistamine, ndi mankhwala kulimbitsa mpanda mtima pamene anaonetsa.

Pambuyo sinusotomy maxillary mkati yochepa awasungira kutupa pang'ono. A ubwino chikutanthauza ali "Cinnabsin". Izo kumawonjezera chitetezo thupi lanu ndi kuchepetsa kutupa m'njira za m'mphuno paranasal. Chifukwa izi mofulumira wodwala kuchira pambuyo ntchito.

Pa mwezi, ayenera anasiya dziwe losambira, musadye zokometsera, kutentha ndi kuzizira chakudya. Pewani hypothermia ndi kuchititsa zodzitetezera kupewa chimfine kapena SARS. Patapita miyezi 1-2 m'pofunika kukaona chipatala chaching'ono kapena Inde mchere m'mapanga kwa masiku 10. Kasamalidwe wofunikila kulamulira chithandizo opaleshoni ikuchitika pambuyo pa miyezi 6 ndi 1 chaka maxillary sinusotomy.

Zotsatira za endoscopic maxillary sinusotomy

Mofanana ndi opaleshoni iliyonse, endoscopic maxillary sinusotomy kungavute zinthu mosiyanasiyana mwamphamvu. Mosiyana ndi njira chakale zochepetsera opareshoni ngati ndi zotsatira zochepa zosasangalatsa. Iwo amaoneka mu nthawi kuchira oyambirira kapena mtsogolo. Ena mwa mavuto ndi monga:

1) magazi kuchokera pa webusaiti ya zida jekeseni kapena gawo umene wapita.

2) nseru kapena kusanza, amene amagwirizana ndi ingestion magazi, kapena wodwala Poyankha munthuyo utsogoleli mankhwala ochititsa.

3) kupweteka kwambiri mphuno.

4) yaitali machiritso a zilonda postoperative.

5) Nthambi ya trigeminal mitsempha kuwonongeka chifukwa mu ululu kapena dzanzi innervated m'deralo.

6) Mapangidwe timapepala nkusani pa malo ang'ambe thupilo kapena zipangizo.

7) neuralgia kugwirizana ndi choipa pa ntchito.

8) bala matenda ndi zamafinya zinangoti ake.

Kuchuluka kwa mavuto ndi zochepa kwambiri kusiyana ndi zotsatira akuwuka pa maziko kulibe mankhwala opaleshoni. Zikatero, opaleshoni phukusi - njira yokhayo yotulukira. Endoscopic maxillary sinusotomy - njira zamakono kuti amalola kuti asiye nkusani kale ndipo onse.

Malangizo kwa yokonza odwala kwa ndondomeko

Pambuyo matenda ndi zochita pa pokwaniritsa endoscopic maxillary njira sinusotomy n'kofunika auzeni adokotala za tsankho la mankhwala. Nkofunika kuwerengera zochita munthu mankhwala enieni ndi kusankha njira yabwino wodwalayo kuchepetsa chiopsezo zotsatira zotheka.

takambirana

Endoscopic maxillary sinusotomy maganizo ndi HIV nthawi zambiri. Odwala lipoti kusintha mofulumira khalidwe la moyo, ndipo ambiri alibe mavuto. Chinthu chokha - ndi kukhalapo kwa chotupa yaing'ono mphuno, zikhale zovuta mpweya. A chizindikiro cha masiku ochepa popanda sanachite.