Zapambuyo kuposa alveolar mitsempha njerwa mu mano: zida za magetsi, mankhwala

Zapambuyo kuposa alveolar mitsempha chipika ndi zoopsa kwambiri mawu a mavuto, jekeseni njira. Pa nthawi, ndondomeko ofanana ntchito infrequently. Zagwiridwa ndi makonzedwe extraoral ndi buccal mankhwala. Mankhwala ochititsa dzanzi ntchito dera analgesia wa molars chapamwamba, makamaka alveolar mitsempha anatseka misewu.

njira Features

Zovuta anatomical makhalidwe mankhwala makonzedwe m'madera azitaya mavuto ndi kuchepetsa mphamvu ya mankhwala ochititsa dzanzi. Tiyeni tikambirane mfundo zina.

Mu temporomandibular pterygium danga pamwamba chapamwamba nsagwada plexus venous ili. Iwo ali ndi malo a kudula infraorbital kuti nsagwada m'munsi. Mwangozi puncture a linga mtsempha amachititsa mapangidwe hematoma lalikulu, lomwe ndi kovuta kupewa.

Amaika singano msinkhu osakwanira kumabweretsa mfundo yakuti jekeseni njira ikuchitika mu subcutaneous mafuta minofu. Pankhaniyi, zapambuyo kuposa alveolar mitsempha chipika Nthawi zambiri osati ogwira. Owonjezera akuya mayikidwe la singano zimabweretsa zotsatira zotsatirazi:

1. Chiyambi cha mankhwala ochititsa mu dongosolo chamawonedwe zone amachititsa khungu zosakhalitsa.
2. Jekeseni wa mankhwala mu minofu yozungulira omwe amachititsa strabismus zosakhalitsa.
3. Contact ndi yankho ku minofu phiko amachititsa ululu pambuyo zotsatira mankhwala ochititsa pa.

Musalole nsonga ya Wopanda pa phiri pa njirayi, chifukwa n'zotheka perforation ya mitsempha ndi ziwiya kakang'ono ka magazi.

zone ochititsa dzanzi

Tuberalnaya ochititsa dzanzi pa mano limakupatsani dzanzi madera awa:

• m'chigawo cha molars chapamwamba;
• ndipo periosteum chophimba anati mucosa alveolar fupa ;
• mucosa wa nkusani maxillary ndi fupa la posteroexternal khoma.

Mapeto dera la mankhwala, kudutsa kuseri, nthawi zonse. Front izo angafikire pakati pa bicuspid woyamba ndi mogwirizana mucosa, m'dera la gingiva lapansi.

Intraoral zapambuyo kuposa alveolar mitsempha chipika kwa Yegorov

Njira ya ndondomeko:

1. pakamwa wodwalayo ndi theka anatsegula. Tsaya amakhala kuti spatula lapansi.
2. Mwa kutsogolera singano kwa fupa odulidwa, dokotala akupanga puncture pa molars wachiwiri kwa fupa.
3. singano ayenera pabwino pa makona a ° ⁴⁵ fupa alveolar.
4. The singano amasuntha ndi ku pakati, ndipo kufunika kolamulira kukhudzana ake nthawi zonse ndi mafupa. M'kupita kwa pang'ono mankhwala ochititsa anamasulidwa.
5. Singano ndi anaikapo 2-2.5 cm. Imakoka pisitoni kuyang'ana kwa puncture chombocho.
6. Ngati magazi umayamba 2 ml ya yankho. The syringe atachotsedwa.
7. Wodwala amayikanikiza malo ochititsa dzanzi pofuna kupewa kufinya.
8. Full zotsatira za mankhwala ndi pa mphindi 10.

Ngati inu ntchito yochepa wotenga mankhwala ochititsa, ndondomeko udzakhala wogwira mtima kwa mphindi 45 pamene yaitali - mpaka 2.5 maola. Intraoral zapambuyo kuposa alveolar mitsempha chipika amachitidwa pa ntchito outpatient, ndipo pamene kanthu molars angapo.

Extraoral njira

Ziribe kanthu zomwe mbali ya zapambuyo kuposa alveolar chipika mitsempha n'kofunika zida amafuna kupatuka pa mutu wodwalayo zosiyana. Kutsogolo kwa dokotala ochititsa dzanzi Mzimuyo kuya kumene singano n'kofunika kulowa. Mtunda pakati pa ngodya m'munsi akunja wa zitsulo diso ndi kutsogolo m'munsi ngodya ya fupa zygomatic.

Dentist lili kudzanja lamanja la wodwalayo. The singano ndi anaikapo m'dera anteroinferior ngodya ya fupa zygomatic. Izo ziyenera kukhala makona ^a 45 ulemu kwa apakatikati sagittal Ndege pa kumathandiza kupeza ngodya zabwino ufulu mzere-kanjira Trag. Pambuyo mayikidwe a singano akuya kufunika jekeseni mankhwala ochititsa. Mankhwala ochititsa dzanzi zimatenga mphindi 5.

kukonzekera

Zapambuyo kuposa alveolar chipika mitsempha imagwiridwa ntchito mankhwala opha m'dera:

1. Lidocaine wa - ndi ena ofanana loyamba amides pa omwe apanga "Bupivacaine", "Articaine" "Mezokain 'ndi njira zina. Izo ntchito mu mawonekedwe a 1-2% njira. Lidocaine wa wa mankhwala mtengo otsika gulu. Kodi contraindicated odwala ndi zotupa organic chiwindi.
2. Trimekain lachokera amides. Ndi dzuwa liwiro, ndi nthawi ya ntchito ndi wamkulu kuposa procaine kangapo. Izo zinabala mu mawonekedwe a njira ya woipa osiyana. Monga mbali zotsatira za utsogoleli wa wothandizila ndi kumachitika khungu pallor, nseru, mutu.
3. Mankhwala "Ultrakain", mtengo umene nthawi 1.5-2 kuposa oimira ena a dzanzi m'deralo (50 rubles pa mbale), ali ndi mwayi kugwiritsa ntchito. Mkulu mayamwidwe mphamvu ndi nthawi yabwino ya kanthu n'zotheka kuti ntchito osati opaleshoni komanso mano apulasitiki. Kodi ndindalama "Ultrakain"? Mtengo wa mankhwala (kwa mankhwala ochititsa dzanzi chida mu zipatala mano mu Russia kulipira kwa rubles 250 300) nkwa magwero ake akunja. Analogs - "Articaine", "Alfakain", "Ubistezin".

ndalama zonse ntchito limodzi ndi vasoconstrictor (wa epinephrine). Posankha katswiri mankhwala ndiyo kulolerana munthu ndi mlingo pazipita, ganizirani zaka za wodwalayo, komanso mimba ndi comorbidities.

zosokonezeka wochita

Zapambuyo kuposa alveolar mitsempha chipika, amene ndemanga ali osokonezeka (odwala lipoti kwambiri analgesic zotsatira, koma ena akudandaula kuti dzanzi nthawi yaitali si pochitika, maola 5, kuphatikiza kale mavuto si kwa sanakonde ambiri), ayenera kuchitidwa ndi katswiri kwambiri oyenerera, athe kuganizira mfundo zina zabwino zonse zimene ankachitazo. Ena mwa mavuto n'zotheka kale kale. Ziperekedwe nkhani ya nthawi kuwaletsa.

ziwiya chilonda ndi maphunziro m'munda wa hematoma ochititsa dzanzi angathe kupewedwa. Kuti zimenezi zitheke, pa singano ochititsa dzanzi sitingathe kutaya kukhudzana ndi minofu fupa ndi kuti atchule kuti ndi osapitirira 2.5 cm. Pambuyo kuchotsa singano adzalowerera anapanga jekeseni mankhwala ochititsa massaged oposa kumbuyo tuberosity maxillary. Zapambuyo kuposa alveolar chipika mitsempha ndikoyambitsidwa yekha, pakalibe njira yotupa pa malo a jekeseni.

Zimakhala zowopsa wodwalayo kupeza njira mu m'magazi. kawopsedwe yake chinawonjezeka ndi nthawi 10, ndi vasoconstrictor zotsatira - mu 40. The moleza mtima mantha, kugwa, kukomoka. Pofuna kupewa mavuto amenewa, asanayambe jekeseni wa mankhwala ochititsa syringe plunger ndi nditadzipatula. Izi zipangitsa kuti singano Kodi kugunda botolo. Ngati panali magazi syringe, muyenera kusintha malangizo a singano kenako jekeseni ya mankhwala.

Kuphwanya malamulo a asepsis pa ndondomeko kungayambitse matenda. Kulowetsa singano mu pakamwa panu, muyenera kuonetsetsa kuti simunandikhudze dzino. Hit zolengeza zidzapangitsa kuti chitukuko cha cellulitis.

Pomaliza

Chifukwa cha kuchuluka kwa mavuto ndi zovuta za sayansi ya tuberalnoe ochititsa dzanzi ndi kuchita kawirikawiri. Kusankha mankhwala ochititsa ayenera akuyang'anira katswiri.