Pho mabala (chachikulu chithandizo opaleshoni): a Zida zogwiritsira ntchito mankhwala

Bala - minofu imeneyi kuwonongeka kudzera makina pamaso pa kuyan'anila umphumphu wa khungu. Pamaso pa bala, osati yotupa kapena hematoma tingaone ndi makhalidwe monga zowawa, dehiscence, magazi, kusokonezeka ndi kukhulupirika. Pho bala umachitika choyamba mawola 72 choipa, ngati palibe contraindications.

zosiyanasiyana mabala

Aliyense bala ali M'mimbamo, malinga ndi pansi. Malinga ndi kuvulala ndi kuvulala onse anawagawa akanadulidwa, sliced, akanadulidwa, anatunduzidwa, analumidwa ndi poizoni. Pa mabala PECVD m'pofunika kuganizira. Ndipotu, chikhalidwe cha kuvulala kwa zosiyanasiyana zimaonetsa loyamba chithandizo.

• Puncture mabala nthawi zonse ntchito sharps, monga singano. Chinthu chapadera ndi kuya chachikulu kuwonongeka, koma kuwonongeka kwa mapepala ang'onoang'ono. Poona zimenezi, onetsetsani palibe kuwonongeka kwa magazi zotengera, ziwalo kapena misempha. Puncture mabala ndi oopsa chifukwa zizindikiro ofooka. Kotero ngati pali bala mmimba pali kuthekera kwa kuwonongeka chiwindi. Si kophweka kanthu pa PECVD.
• Incised bala ntchito ndi chinthu lakuthwa, minofu wamng'ono chiwonongeko. Pa nthawi yomweyo, gaping M'mimbamo n'zosavuta kuyendera ndi kuchita PECVD. mabala oterowo ankachita bwino, ndi machiritso ndi kusala kudya, popanda matendawo.
• Akanadulidwa Zilonda chifukwa mavuto pachimake, koma ndi chinthu cholemera, monga nkhwangwa. Choncho kuwononga pansi osiyana, yodziwika ndi hiatus lonse ndi minofu pafupi choipa. Chifukwa cha luso limeneli kungachepetse buluzi.
• Contused mabala zimachitika pamene ntchito chinthu yosamveka. zotupa awa amakhala ndi ndi kuchuluka kwa minofu kuonongeka, mwamphamvu impregnated ndi magazi. Pogwira PECVD mabala ayenera kudziwa kuti pali kuthekera kwa zosayembekezereka wa suppuration.
• Kuluma mabala ndi oopsa malowedwe ndi matenda malovu a nyama, ndipo nthawizina anthu. Pali matenda pachimake ndi maonekedwe a matendawa HIV.
• Poizoni mabala zambiri uka pamaso pa njoka kuluma kapena kangaude.
• mabala Gunshot amadziŵika ndi mtundu wa zida ntchito, mbali ya kuwonongeka ndi malowedwe njira. Mwayi matenda.

Pogwira PECVD mabala yofunika ankaimba ndi kukhalapo kwa zamafinya zinangoti. kuvulala oterowo zamafinya zinangoti, svezheinfitsirovannymi ndi aseptic.

Cholinga cha PSD

Pulayimale chithandizo opaleshoni m'pofunika kuchotsa tizilombo zoipa zimene analowa chilonda. Kuti tichite zimenezi, kudula aliyense kuonongeka necrotic minofu ndi magazi kuundana. Pambuyo atsekedwa ndi stitches ndi ngalande imagwiridwa, ngati n'koyenera.

Ndondomeko chofunika pamaso pa kuwonongeka minofu m'mbali losongoka. Pamafunika yemweyo kwambiri ndi zauve mabala. Kuwonongeka kwa mitsempha yaikulu magazi, ndipo nthawizina mafupa ndi mitsempha imafunanso ntchito opaleshoni. PSD imachitika imodzi ndi comprehensively. dokotala amafunika thandizo kwa wodwala kwa maola 72 pambuyo anavulala. CVD oyambirira ikuchitika kwa usiku woyamba, kupitiriza tsiku lachiwiri - ndi kuchedwa alowererepo pa opaleshoni.

Zida PECVD

Kuti akwanitse zofunika ndondomeko bala chithandizo amafuna osachepera mabuku awiri a Anatipatsa. kusintha awo pa ntchito, ndipo pambuyo siteji zauve - akonzanso:

• Clip "forceps" mzere, amene amangomvera munda opaleshoni;
• zisonga scalpel, bryushisty;
• nsalu khasu ntchito atagwira Mavalidwe ndi zipangizo zina;
• Kocher achepetsa, Billroth ndi "udzudzu" ntchito kuti magazi asiye kutuluka pamene PECVD mabala awo ntchito zambiri ndi zazikulu;
• lumo, ali molunjika ndi yokhota kumapeto m'mphepete pa ndege kapena makope angapo;
• Probes Kocher, yosema ndiponso bellied;
• ya singano;
• chofukizira singano;
• tweezers;
• ngowe (angapo awiriawiri).

A zida opaleshoni kuti njirayi mulinso suture masingano kwa syringes jekeseni, nsalu, mipira gauze, magolovesi, machubu ndi zimakhala zosiyanasiyana. zinthu zonse zofunika CVD - msoko ndi zida opaleshoni kuvala, zipangizo ndi mankhwala anafuna kuti chithandizo cha zilonda - anayikidwa pa tebulo opaleshoni.

mankhwala ofunika

debridement chachikulu chokwanira popanda mankhwala apadera. The zofala kwambiri ntchito ndi:

• 70% mowa;
• 3% njira ya hydrogen peroxide;
• Yodopiron 1 njira% kapena 0.5% chlorhexidine bigluconate;
• 10% njira ya NaCl;
• 0,25% - 0.5% novocaine njira.

masiteji PECVD

Pulayimale chithandizo opaleshoni ikuchitika mu magawo angapo:

1. Kupenda bala ndi mankhwala ake atawapulumutsa antiseptic.
2. Kuchotsa minofu kuonongeka, matupi yachilendo, zidutswa fupa. Anachita kung'ambika kwa chilonda akamavutika.
3. Magazi asiye kutuluka.
4. Ngalande.
5. Stitching.

Kodi PECVD

Kuti akachite opaleshoni mtima aikidwa pa tebulo. malo umadalira pa dislocation la pabalapo. Dokotalayo ayenera kukhala omasuka. Ananyamula chimbudzi mabala ankachitira munda opaleshoni, amene delimits ndi wosabala disposable zovala zamkati. Komanso, maganizo yaikulu imagwiridwa, umalimbana kuchiritsa mabala kupezeka ndi mankhwala ochititsa dzanzi chikuyendetsedwera. Nthawi zambiri, madokotala amagwiritsa ntchito njira Wisniewski - kutumikiridwa 0.5% novocaine yankho pa mtunda wa masentimita awiri kuchokera konsekonse odulidwa. The njira yomweyi jekeseni mbali inayo. Ndi yankho lolondola wodwala pa khungu mozungulira chilondacho pali "ndimu peel". Gunshot mabala zambiri amafuna utsogoleli wa mankhwala oletsa ululu ambiri kwa wodwala.

M'mbali kuwonongeka kutsatira 1 masentimita Kohhera achepetsa namdula ngati amodzi. Pamene ndondomeko ndi truncated nezhiznedeyatelnosposobnaya minofu pa nkhope kapena zala, kenako woyikidwa msoko zolimba. M'malo a magolovesi ndi zida ntchito.

chilonda ndi osambitsidwa ndi chlorhexidine ndi ikuchitika anayendera ake. Puncture mabala, yaing'ono koma kwambiri odulidwa, dissect. Ngati minofu zowonongeka, iwo achotsedwa m'mbali. Womwewo mwachita ndi makombo a mafupa. Kenaka hemostasis. The gawo lamkati la chilonda woyesedwa woyamba ndi yankho ndi kukonzekera ndiye antiseptic.

Achitira bala ndi zizindikiro za sepsis sewn mwamphamvu chachikulu Buku suture wokutidwa ndi bandeji aseptic. Sutures kugwira ntchito uniformly wogonjetsa zigawo zonse m'lifupi ndi kuya. M'pofunika kuti akukhudza mzake, koma osati kudwala. Pogwira ntchito zofunika kupeza msoko zodzikongoletsera pambuyo pa kuchiritsidwa.

Mu zina, matabwa chachikulu musati alipo. Incised bala mwina ndi kuvulala kwambiri kuposa zikuoneka pa koyamba. Ngati mukukayika, dokotalayo amagwiritsa anachedwa suture chachikulu. Njira ntchito ngati chilonda linali litadzala. Kutsekedwa ikuchitika pamaso pa adipose minofu ndi mafupa si omangika. A masiku angapo pambuyo poona chilonda ndi sutured mapeto.

Mabala pidalumwa

Pho mabala, alumidwa kapena poizoni, ali kusiyana kwake. Pamene kuluma si nyama chiri n'kutheka kuti matenda a chiwewe. Pa siteji oyambirira nthendayo kuletsedwa matenda a chiwewe seramu. mabala amenewa nthawi zambiri amakhala purulent, kotero yesetsani sachedwa PECVD. Pamene ndondomeko umagwiritsidwa ntchito yaikulu anachedwa suture ndi kugwiritsa ntchito mankhwala antiseptic.

Bala yochokera kulumidwa ndi njoka, liyenela imposition wa tourniquet zothina kapena bandeji. Komanso, chilonda atapanga ntchito novocaine kapena ntchito ozizira. Kuti n'chongoletsa ululu jekeseni protivozmeinaya seramu. Kangaude kulumidwa oletsedwa permanganate potaziyamu. Isanafike poizoni izi cholizira, ndi chilonda ankachitira ndi antiseptic.

zosokonezeka

Wa osasamalira mankhwala kumabweretsa chilonda antiseptic bala suppuration. Kusagwiritsa njira analgesia, komanso kuchititsa kuvulala zina amayambitsa nkhawa mtima chifukwa kukhalapo ululu.

Wamwano mtima kuti zimakhala ndi, chosadziwa thunthu umawononga kwa ziwiya lalikulu magazi, ziwalo ndi mapeto mitsempha. Osakwanira amachititsa hemostasis njira yotupa.

Nkofunika kuti debridement chachikulu zinachitikadi monga mwa malamulo katswiri.