Endoscopic maxillary sinusotomy - chii ichocho? Nzira yekushanda pamwe nemigumisiro

Muchikamu chekutanga che sinusitis, chirwere chemishonga chinoshanda. Kana kuyerera kuri kushanda, apo kusununguka kubva kumapanga emvura kunenge kusina mucous, asi purulent, zvinokwanisika kupukunyuka ne puncturing the sinuses. Mushure mokunge vashamba kubva pane zviri mukati. Inoda kupindira kwokuvhiya kwechirwere chenguva refu yezvivi maxillary. Zviratidzo, kurapwa kwaro kwenguva yakareba uye isingabatsiri, zvinoda imwe nzira yakakomba dambudziko racho. Pano kuvhiyiwa kunodikanwa, uye imwe yemhando dzekuvhiya ndeye endoscopic sinus anatomy.

Chii ichocho?

Mafuta e-maxillary anonzi mavhesi ari munzvimbo dzejaya riri kumusoro kumativi maviri acho. Nemhaka yenzvimbo isinganzwisisiki, ivo vanowanzotarisana nekuputira zvirongwa izvo zvinowanzoguma mune zvisingagumi uye zvinoda kupindira kwekupora. Mune matanho okutanga, achiri kushandiswa kurapa hutachiona hwemaidillary maxillary nemishonga yekurapa. Mukusabatwa kwekubudirira kana kazhinji kudzoka, mukana wokuita maxillary sinusotomy kune mumwe murwere unofanirwa kufungwa. Zvakanakisisa kutungamirira murwere kusvika pakupindira kwekusingaperi izvo zvichange zvisingasviki uye zvichinyatsobudirira. Purulent maxillary sinusitis inoratidza zvakananga kurapwa, nokuti maminitsi ose anozara nekuumbwa kwematambudziko.

Mibvunzo pamusoro pokuti chinonzi genyantotomy chinangwa chei, chii ichocho, inobvunzwa nevarwere vakawanda. Munguva yekushanda, mawonesa maxillary anovhurwa uye zvose zviri mukati zviri mukati zviri kubviswa. Nezvinetso zvakakomba, kurapwa kwekuporesa ndiyo nzira chete yekubuda mumamiriro ezvinhu. Varwere vanotumirwa mairi, kunyanya kutsvaira umo zvisingakwanisi kuchenesa mishonga. Nokudaro, kupinda kuburikidza nekukanganiswa kana kuvharwa kunodiwa. Kuwana apo iyo maxillary sinus inoitwa, chii ichocho, murwere haasi nyore.

Zviratidzo zvekushanda

Kuvhurwa kwemasono maillailla hazvibvumirwi kune varwere vose vane kuputika. Inopiwa:

1) ne cyst mujaya kumusoro;

2) chisingagumi chemajasipirini macrosillary sinusitis;

3) odontogenic maxillary sinusitis;

4) kushayikwa kwemigumisiro pashure pekugara kwenguva refu kwemishonga nekurapa;

5) kakawanda kudzokorora kwemaximillary sinusitis;

6) ingress yemitumbi yekunze muzvivi;

7) kakawanda kana periodic kunzwisa kurwadza pamusoro pechiso, munharaunda ye infraorbital;

8) iyo periodic occurrence yenyuchi kusangana pasina chikonzero chaicho (allergen reaction, colds);

9) kuonekwa kwekunhuhwirira kunofadza kubva mumhino, iyo inonzwiwa nemurwere pachake kana kuti yakataurwa navanhu vakavapoteredza;

10) nguva kana nguva yekurwadziwa kwekushungurudzika kwakasiyana-siyana munzvimbo yemazino makuru;

11) manzwiro ekufamba kwemhepo kana mvura inonaya ichiyerera ichienda panzvimbo iyo zino raimbobviswa;

12) kuonekwa kwekuzadza zvinhu kunze kwemiganhu yezino richirapwa, iyo ichaonekwa mumufananidzo apo roentgenogram ichiitwa;

13) kutaridzika pamakombiyuta emhando yemapurps kana miviri yekunze;

14) sinus isingabudiriri kusimudza;

15) kuramba kurwisa sinus nekuda kwekuonekwa kwehutachiwana mumusasa we maxillary.

16) kuongororwa kwe "purulent sinusitis."

Mukuwedzera kune nzira yekupindira yekugadzirisa, panewo kushandiswa kwekare kwe maxillary sinusitis. Kunyanya kufarirwa ndeyekutanga. Icho chinotambudza zvikuru, uye nguva yenguva uye nzira yekudzorera inopfupiswa muhutano hwose.

Contraindications

Mukuvapo kwezviratidzo, kukwana kwekupindira kwekuvhiya kunobatanidzwawo. Endoscopic chirwere chemaximillary hachina kuitwa mumamiriro ezvinhu anotevera:

1) Kuwedzerwa kwezvirwere zvisingaperi zvemukati.

2) Kuonekwa kwezviratidzo zve sinusitis, asi muzviitiko zvakawanda, kuvhiyiwa nokuda kwechikonzero ichi hazvikwanisi kusarudzwa.

3) Zvirwere muzvikamu zvekuoma kwakasimba, izvo zvinogona kuwedzera mararamiro emamiriro acho ezvinhu.

4) Kusvibiswa kweropa rinogadzirisa chirongwa.

Mamiriro akawanda emuviri anonzi akafanana. Nokuda kwezvikonzero zvinoverengeka, mushure mokunge vabvumirana nachiremba, chirwere chacho hachina kusimbiswa kune imwe nguva. Kusvikira panguva ino, kurapa kwezvinodhaka kuri kuitwa kuitira kubvisa kuvhiringidza kwemasono akawanda. Zviratidzo, kurapa kwacho kwakaoma kumishonga mishonga yemuromo, kunomiswa nemishonga inoshandiswa zvakagadziriswa kusvikira zuva rekushandiswa kunoitwa.

Kuongorora pamberi pegenyanthomia

Mushure mokusimbisa kuongororwa uye kusarudza kudiwa kwekupindira, murwere anopiwa zvidzidzo zvinodiwa. Nokuda kweizvi, mabharatori uye nzira dzakashandiswa dzinoshandiswa. Murwere anotumidzwa kuzongororwa ropa, urwere, urongwa hwehupenyu, kuongorora ropa kunoitwa. Kubva pachigadzirwa, mifananidzo neC CT uye X-ray yezvivi zveparanasal zvinotarisirwa kuti basa riongorore mamiriro avo.

Endoscopic nzira yekuitisa maxillary sinusitis

Mukuenzanisa neklasiki yeklasikisi, kushandiswa kwemazuva ekupedzisira maxillary sinusotomy ine zvikomborero zvakawanda:

• Kusabatwa kwekufungidzirwa panzvimbo yeyo nzira, iyo isingafambidzwi nechitarisiko chemavara;
• Kuregererwa kwechinokonzera chinokonzera;
• Kuderedza munguva yekushanda uye nguva yekudzorera;
• Kukanganisika kwakanaka kwemaitiro akaitwa pasi peanesthesia;
• Mutsara kugara muchipatara (kusvika mazuva 3-4);
• Zvinenge zvisingabvumirwi kuzvidzora panzvimbo yekuiswa kwechiridzwa uye kuparara kwayo nokukurumidza;
• Anenge asisipo kusakwana kwematambudziko mushure mekuvhiyiwa.

Izvi zvinotibvumira kuti tishandise nzira dzemazuva ano dzekurapa hutachiona hwezvivi zve maxillary nokukurumidza uye kusuruvara.

Kugadzirira kushanda

Pazuva rekuita iwe haufaniri kudya maawa matanhatu nemaviri asati apera. Kurumbidzwa kwakadaro kunofanira kuonekwa paunenge uchigadzirira anesthesia yemunharaunda. Kana mukuru weanesthesia ari kurongwa, ipapo kuwedzera kune pamusoro apa zvinorambidzwa kunwa chero doro remaawa maviri vasati vasvika.

Kuwana nekunyanyisa kwemapetometri

Ne genyantritis ine anodontogenic yakabva, nzira chete inogoneka inoshandiswa kusiyana nemamwe mamiriro ezvinhu. Endoscopic maxillary sinusotomy inowanikwa mune mamwe mamiriro ezvinhu nezvimwe zvinowanikwa, zvichienderana nezviratidzo zvekushanda. Zvinosanganisira:

• Izvo zvinoshandiswa kuburikidza nepakati pepakati kana pasi pasi pemapapiro;
• Kutanga kwe endoscope muusvingo rwekunze hwema maxillary sinus;
• Kupfurikidza ne alveolus mushure mekuchenesa mazino (neodontogenic sinusitis);
• Kuburikidza ne hillock mujaya rekumusoro.

Paunenge uchishandisa nzira yekupedzisira yokuvhiya, zvinetso zvinogona kudziviswa, uye kusarudza imwe nzvimbo yakakodzera yekuwanika inovabvumira kuti vaderedzwe kusvika pazvinhu zvishoma.

Nzira

Kuvhiya kunoitwa pasi peanesthesia yemo. Kuti ugovhura mhinduro yacho, iyo inobatsira inopiwa kumashanga ane deta risingasviki 0.2 mm. Kana zvichidikanwa, general anesthesia inoitwa . Kugadziriswa ne gaymorotomii vane uwandu hwakanyanya uye nguva refu yeanesthesia. Nguva yaro haisi maminitsi makumi matatu. Iyo yakareba ye endoscope inowanikwa kuburikidza nesitiroko haisi ye5 mm. Nokudaro, kupisa kunoitwa munzvimbo ye maxillary sinus shoma. Nenzira iyo, endoscope tube inosungirirwa uye iyo pathologically inoshandiswa mishonga uye mvura inobviswa. Izvo zvose zvinoshandiswa pakuvhiya zvinoshandiswa pasi pekutungamirirwa kwevhidhiyo yekunyora kunoparidzirwa kune chekuona. Izvi zvinodikanwa kuti zvive nyore kuti uongorore danda uye utsanana hwayo. Mushure mekuchenesa, shambidza sinus ne antiseptic solutions ("Furacilin", potassium permanganate).

Kudzoka nguva mushure mekuvhiyiwa

Kubudirira kwehutano kunoenderana nekudzorerwa kwemurwere mushure maro. Mushure mokusunungurwa kubva kuchipatara, chiremba anovhiya anopa kutumira kune chiremba we ENT kuti aongorore mamiriro acho. Iwe unofanirwa kuishanyira kwekanguva mwedzi, uye, kana zvichidiwa, izwi rinogona kuwedzerwa. Chiremba anorayira nzira yemishonga inorwisa mabhakitiriya uye zvigadziriswa zvekushambidza mutsara. Panguva imwe chete, antihistamines uye kugadzirira zviri kuwedzerwa kune chirongwa chekusimbisa rusvingo rwevascular pamberi pezviratidzo.

Mushure mokunge gammorotomy kwenguva pfupi, edema duku inoramba iripo. I "Cinnabsin" inobatsira mune izvi. Inowedzera kudzivirirwa kwomuviri uye inoderedza kuzvimba kwezvivi zveparanasal. Nokuda kweizvi, kuporeswa kwemurwere mushure mekuvhiyiwa kunowedzera.

Mumwedzi unofanirwa kushanyira dziva racho, usadya zvokudya zvinonaka, zvinotonhora uye zvinopisa. Zvakakosha kudzivisa hypothermia uye kutora matanho ekudzivirira kudzivisa kuwana hotera kana ARVI. Pashure pemwedzi miviri zvinonzwisisika kushanyira sanatorium kana maruva emumatare kwemazuva gumi. Kuongororwa kunofanirwa kuti utungamiri hwekushanda hurambe huri kuitwa mwedzi mitanhatu mushure me maxillary sinusitis uye 1 gore.

Migumisiro ye sinos endoscopic

Kungofanana nekupindira kupi zvayo, chirwere chemaximillary sinusotomy chinogona kunge chakaoma nemamiriro ezvinhu ekusiyana kwakasimba. Kusiyana neklassical nzira yekurapa, kushanda uku hakuwanzove nemigumisiro inofadza. Vanozviratidza pachavo munguva yekutanga yekudzikinura kana nguva. Zvinetso zvinosanganisira:

1) Kubvambura kubva panzvimbo yejojo yechimbo kana nzvimbo yakaratidzwa.

2) Nausea kana kurutsa, izvo zvinokonzerwa ne ingress yeropa mukati mudumbu kana kuti murwere wega wega kupindura kwehutachiona hwehutachiona.

3) kurwadziwa kwakanyanya mumhino.

4) Kuporeswa kwenguva refu kwevanga rinotevera.

5) Kukuvadzwa kwebazi rerujovo rwetatu, izvo zvinoita kuti unyoro hwakanyanya hwemusha usina kukodzera kuwanikwa kana kuti kushaya simba.

6) Kuumbwa kwemafungiro ekunyengedza pachinangwa chekubudiswa kweiyo instrumentation kana incision.

7) Neuralgia yakabatana nekutambudzika panguva yokuvhiyiwa.

8) Kuvharirwa kwevanga uye kuregererwa kwaro.

Chiitiko chezvipingamupinyi zvakanyanya kudarika zvinokonzerwa nekusavapo kwekurapwa kwekuvhiya. Mumamiriro ezvinhu akadaro, kupindira kwekuvhiya ndiyo nzira chete yekubuda. Endoscopic maxillary sinusotomy ndiyo nzira yemazuva ano inobvumira munhu kukanganwa nezve sinusitis kamwe chete.

Memo yekugadzirira varwere zvekuita

Mushure mokusimbisa kuongororwa uye kugadzirisa nyaya ye endometrial gammorotomy, zvakakosha kuudza chiremba nezvekusagadzikana kwemishonga. Zvakakosha kufunga nezvekuita kweumwe munhu kune imwe chirwere uye kusarudza mishonga yakanakisisa kune murwere kuitira kuti kuderedza dambudziko remigumisiro inogoneka.

Ongororo pamusoro penzira

Endoscopic genyanthytoma kuongororwa mune dzakawanda zviitiko zvakanaka. Varwere vanorondedzera kukurumidza kukurumidza muhupenyu hwehupenyu, uye vazhinji havana dambudziko. Chinhu chega bedzi kuvepo kwekudzidzira kuduku mumhino, izvo zvinoita kuti kufema kuve kwakaoma. Chiratidzo mumazuva mashoma mashizha asina tsanangudzo.