Ukuhlinzwa: tympanoplasty. Izibuyekezo emva kokuhlinzwa

izinkinga Ukuzwa singenzeka ngenxa yezizathu ezihlukahlukene, futhi kwezinye izimo ezikhungathekisayo zalesi sifo kuthiwa kuyehla kube ukuwohloka phakathi indlebe umsebenzi. Ukuze uyibuyisele, zisebenzisa tympanoplasty - ukusebenza, ngesikhathi lapho kabusha uqobo ngqo kontwentwesi. Leli fomu yokwelashwa uye wabonisa kaningi ukuba siphumelele.

Ingqikithi inkinga

Uma kuziwa lolu hlobo lokuhlinza, tympanoplasty like (operation maphakathi nendlebe) Kushiwoni indlela eqondile ekwelapheni ezingamahlalakhona suppurative abezindaba otitis ku eardrum. Kumele kuqashelwe ukuthi le nomthelela liyinkimbinkimbi futhi nomthelela obonakalayo okuzivuselela, ukuvumela ukuvuselelwa maphakathi nendlebe.

Kunengqondo ukuba banake yokuthi otitis ezingamahlalakhona uxilongwe kaningi. It kuholela ekwakhekeni emigodini eardrum, okuthiwa perforation. Ngenxa yalesi sizathu, kuba nokwenzeka Ukungena namagciwane abangela izifo kule ingaphakathi tympanic, okuyinto ke kuholela ukukhululwa ubomvu ukuthi kungaphazamisa ngaphezu konyaka owodwa.

Tympanoplasty - ukusebenza, ngaphandle kuyo ukuba banqobe abezindaba suppurative otitis kuyoba nzima kakhulu. Ngaphezu kwalokho, lolu hlobo sifo eziphambili kungaholela okuvela ithumba futhi thrombosis palsy, futhi kwezinye izimo - futhi meningitis.

Izinkomba esinyathelweni

Kunezindlela eziningi izimo kokungenela kuhlinzwa kuyadingeka okukhulunywa ngaphansi okuyinto ngenhla. Iphuzu liwukuthi izinkinga zezempilo ezilandelayo:

- kumiswa emphethweni noma perforation emaphakathi we ulwelwesi tympanic, elibangela lesi displacement we ossicular;

- polyp ukuthi ukuthuthukisa maphakathi nendlebe;

- timpanoskleroz;

- perforation we eardrum, akuyona ephelezelwa ukuvuvukala;

- cystic of maphakathi nendlebe.

Kusobala ukuthi ziningi izizathu ezizwakalayo ukuthi kungani ukuhlinzwa tisetjentiswe.

Izimo

Kubalulekile ukuqonda ukuthi kuba khona ukuhlinzwa endlebeni (tympanoplasty) ayikwazi ukunikeza ithonya oyifunayo. Lapha iSifo okuyiwona sebenzisa amasu afanayo is hhayi Kunconywa:

- exacerbation izifo ezingamahlalakhona;

- ingcina otitis abezindaba;

- ubuthulu kuphelele;

- isimo esibi jikelele esigulini;

- sepsis kanye nezinkinga ukonakala.

Dehumidifying operation maphakathi nendlebe nge tympanoplasty contraindicated esimweni lapho egxilile sokwephulwa kwe ephikelelayo patency tube sokuzwa. Lokhu sigaba zingafaka kombungu esizalweni, kanye izibazi kanye ukuvuvukala, okubangelwa ukushisa.

Contra, kokuba uhlamvu isihlobo

Kulokhu sikhuluma lezo zifo engibukhulumile ngaso ukusebenza engathandeki, kodwa kungenzeka. Kulokhu, isinqumo sokugcina kuzothatha udokotela, osekelwe kokuhlangenwe nakho kwakhe futhi isimo isiguli. Ngakho do Izimo:

- ukuvuvukala acute maphakathi nendlebe;

- iguliswa-hlobo izifo esigabeni acute;

- nezinkinga engenhla ipheshana zokuphefumula;

- inqubo epidermizatsii.

ukuthatha kuphela ikhumbule zonke Izimo ezifana nalezi ezichazwe ngezansi inganikelwa lolu hlobo ukwelashwa tympanoplasty. Izibuyekezo emva kokuhlinzwa kuyinto uphawu ebalulekile izinga lokwelashwa, Ngakho-ke, thina zihlale nesithakazelo kule ukubukwa iziguli mayelana umtholampilo ethile. Lokhu kungasiza izinkundla.

Kubalulekile nokukhumbula ukuthi udokotela ubophekile ukuba ukuqhuba ucwaningo kwezinye indlebe futhi wenze izibikezelo mayelana ingozi ukubhujiswa kwalo. Ngemva kwalokho isinqumo zizokwenziwa mayelana nokusebenza esikhathini eardrum yesibili.

Kufanele kwenziwe ukuhlolisisa egcwele olujwayelekile: koaguloramma, ukuhlaziywa kwamakhemikhali kanye jikelele egazi noma omchamo, kanye ukuhlolwa igazi for ugcunsula,-HIV, i-hepatitis B no-C Uhlelo inhlolovo ihlanganisa electrocardiogram.

Inqubo belungiselela ukuhlinzwa

Ngaphambi kokuba kokungenela ngokushesha, ukukhiqiza ukwelashwa ngoludala, okuhloswe ngalo ukulungisa indlebe tympanoplasty. Engxenyeni phakathi komgodi lapho eardrum is esifakiwe izindlela ezihlukahlukene ezihloselwe ukusebenzisa i anti-inflammatory, vasoconstrictor nomphumela anti-virus. Bonke babe anhlobonhlobo izenzo.

Izinqubo ezinjalo zibalulekile kakhulu ngoba enze kube nokwenzeka ukuba uhlanze endaweni eziqhutshwa ezifweni. Kuyinto sibonga le nqubo, kuba nokwenzeka uvikelekile tympanoplasty. Izibuyekezo ngemva kokuhlinzwa, ngokulandelana, uyophinde abe okungcono omuhle, njengoba kulungiswa (yokuhlanza) ekuqaleni Ukuvinjwa umphumela ku phakathi indlebe ukutheleleka, futhi kamuva ikhuthaza ukuphulukiswa okusheshayo amanxeba kuhlinzwa.

Ngaphezu kwalokho, lesi sinyathelo kuholela patency ngcono tube sokuzwa, okuyinto kunomthelela oqonde ngqo kwi izinga umphumela kuhlinzwa.

Uma isiguli ukwethula ukugula okungalapheki, kufanele uxhumane iphrofayela udokotela. izinsuku ezingu-7 ngaphambi kokuba ukusebenza kuyokwenzeka, kumelwe senqabe ukwamukela izimali ezisetshenziselwa ehlambulula igazi. Kuyinto umbuzo-non-steroidal izidakamizwa eqeda ukuvuvukala ( "paracetamol", "aspirin") futhi "Warfarin".

imithelela

Kukhona amasu ahlukahlukene ukuthi uvumele ukuthola ekwenteni ncono isimo maphakathi nendlebe ngemva kokuhlinzwa. Tympanoplasty ngenxa yalesi sizathu kungabuye kwenziwe ngezindlela ezahlukene. Kunengqondo ukuhlukanisa izindawo ezintathu ezibalulekile:

- yokutakula usebenzisa ossikuloplastiki. Iqiniso yalezo ziguli ngenxa ezinzima ukuvuvukala ossicles sokuzwa zilimele, kanye nokuvuselelwa yabo kungenzeka kuphela ngosizo emkhakheni wezitho zokwenziwa. Kulokhu, ngokusebenzisa amamathiriyelii njenge-titanium, usimende kanye plastic.

- Ingqikithi uhlobo lokuvala yesibili kuyehla kube ngu ezicutshini eardrum uqobo of maphakathi nendlebe. Okuvame kakhulu kanti okungenani kuyinkimbinkimbi nje tympanoplasty ezinjalo. Izibuyekezo emva kokuhlinzwa zaloluhlobo zinzima ezimweni eziningi ezinhle.

- myringoplasty ngaphandle emkhakheni wezitho zokwenziwa. Yasetshenziswa ekwelapheni iziguli kanye obonakele ossicles sokuzwa, kodwa amazinyo okufakelwa azisetshenziswa. Ukubuyisela ithambo ngokwanele bomdabu.

Ngezinye izikhathi odokotela ebhekene nenkinga enjalo, njengoba Fusion we ezimbili evele of maphakathi nendlebe, okuyinto ngenxa inkinga abezindaba otitis. Kulokhu, ukubuyisela tympanum esetshenziswa njengoba grafts futhi kontwentwesi ngokwayo, ngokuqondile kakhulu, izinsalela zayo.

isikhathi nokuvuselelwa

Ukuze ukusetshenziswa indlela enjalo ukwelashwa njengoba tympanoplasty, izimpendulo yaba mihle emva kokuhlinzwa, kubalulekile ukuhlela izinga nesineke yokutakula.

Okokuqala, ihlala izinsuku 1-3 esibhedlela. Ukuvuselelwa kuhilela ukusetshenziswa kwemithi elwa namagciwane phakathi nesonto lokuqala nasezinkingeni ezilandela ngemva kokuhlinzwa. Kanye lezi zinyathelo, ukuvuselelwa, ophuthumayo ukuziphatha kwansuku zonke igazi. Loku kuchaza ukuthi uhlelo isingeniso phakathi sokuzwa tube pharyngeal umlomo vasoconstrictors.

Njengoba ukukhululwa kwe-canal sokuzwa of tampons ayishe-, ekuqaleni, isiguli kufanele kube njalo unomphela Luhlolo ezizayo.

Ngakho ukuthi ngemva ebuyile ukusebenza emuva ngokushesha ngangokunokwenzeka, udinga kancane thimula, nishaye impumulo yakho uphinde uvikele endlebeni kusukela amanzi Ukungena. Mayelana izindlela eziphumelelayo isivikelo umswakama ngenkathi ethatha eshaweni kakhulu bonana nodokotela wakho kuqala. Kusukela nokuphakamisa izinto ezisindayo futhi kufanele uyekwe. Empeleni, kudingeka ukuqeda noma yimuphi umthwalo kungabangela ukungezwani okukhulu endaweni maphakathi nendlebe.

yezinkinga kungenzeka

Uma sicabangela zonke izici ukuhlinzwa, kuyafaneleka ukuthi kunobungozi ezithile phakathi nenqubo ethile yokuthola ezifana tympanoplasty. Izinkinga kusuka ukuhlinzwa kungaba ehluke ngokuphelele: umonakalo uxhaxha, ngalo ingaphakathi tympanic, emsipheni ebusweni ngisho meninges kanzima. Kugcine, ngasendleleni, ngezinye izikhathi kuba imbangela opha vein jugular noma otolikvorei.

Futhi banake ingozi ukuvuvukala aseptic of endlebeni kwesikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa. Lesi simo ngokuvamile uhambisana ocucuzayo, ukuvuvukala futhi ubuhlungu.

Ngezinye izikhathi kungase kubonakale emva kokuhlinzwa tympanoplasty gnoetichenie indlebe. Izibuyekezo ukusekela yokuthi le nkinga kuyenzeka. Ngenxa yalesi sizathu, futhi imodi ezibalulekile umile ngesikhathi sokulanda, njengoba odokotela bayokwazi ukunikeza uchwepheshe futhi usizo ngesikhathi abasuke beludinga uma yezinkinga kungenzeka.

Izinkinga olujwayelekile Ungahlanganisa ikhanda isikhathi eside (imiphumela fistula we uxhaxha), ibhalansi kahle nesiyezi.

Indlela kunjalo ukufakelwa

Labo asebephumelele ukusebenza nokusetshenziswa sokwenziwa kubalulekile ncamashi ulandele izincomo odokotela, njengoba kwaba njalo endabeni ka-ukuvuvukala maphakathi nendlebe usungaqala inqubo ukungamukeleki.

ukuvuvukala Eqinisweni ngeke kuthinte ijubane yokutakula. Ngemuva kokusebenzisa tympanoplasty nge sokwenziwa kukhona ingozi displacement we yokugcina, kanye necrosis noma yoma. Ngakho, uma ayenayo indawo ayehlala wokufakelwa ngokwalo kufanele ivikeleke kahle.

ukulahlekelwa kukuzwa

Libhekisela ukubonakaliswa iqembu yezinkinga ku eziqhutshwa indlebe ubuthulu, ongafinyelela ezingeni yokungezwa egcwele. Le nkinga yenza ngokwayo wazizwa emva tympanoplasty eziyinkimbinkimbi noma okungezona olukhulu. Ukwephula bezibona umsindo ngezinye izikhathi umphumela labyrinthitis esisheshayo, okuyinto angaya ngaphandle ukwelashwa. Uma lokhu kungenzeki, khona-ke lokhu kwelashwa abanekhono ngaphansi kweso lwezokwelapha kuzosiza iwukudambisa inkinga.

Ngakho, kumelwe siqonde ukuthi ukuzwa ukungakhuli, imbangela owawungumnyaka uxhaxha, ubunjalo yesikhashana futhi esilaphekayo.

Kodwa izindaba ezinhle ziwukuthi lezi yezinkinga kuyagcinwa kuphela 3% eziguli bani Wahlinzwa. Izibuyekezo tympanoplasty has a omuhle ogxile, ngakho akufanele esabe yaleli su.

ukukhubazeka esifushane

Lena enye inkinga engase ivele emva kokuhlinzwa ku maphakathi nendlebe. Izindaba ezinhle ukuthi ubunjalo yalesi nkinga eyesikhashana. Kubangele ukukhubazeka short-term kuyinto ukuvuvukala nasezinkingeni ezilandela ngemva kokuhlinzwa we emsipheni ebusweni.

Kwezinye izimo, emsipheni kungalimala ngenxa Ukunqamula intraoperative. Njengoba izinyathelo zokulungisa esetshenziswa plastic. Sikhuluma abathungela ezinzwa saphenous entanyeni. Ngo i samuntu okunye, emsipheni ebusweni ligated nge sublingual. Nge yemigwaqo ezinjalo phakathi nokuhlinzwa, ngisho nangemva kokuba plastic ingozi ukulondolozwa lobuthakathaka asalile we imisipha yobuso.

Izibuyekezo

Uma ulihlola okwashiwo abantu abanquma ku kabusha maphakathi nendlebe, kungashiwo ngokuthi indlela yokwelashwa siyasebenza kakhulu.

Iningi UMkhandlu unquma ku izinyathelo ezinjalo kwabezindaba ezingamahlalakhona otitis, ngoba uma lwabo inkinga yaxazululeka kuphela ngemuva kokuhlinzwa "tympanoplasty". Uma ukululama ephelele, asikwazi ngokuqinisekile ngenxa yezinkinga kungenzeka nezici umzimba ngayinye nesineke ngabanye.

Kodwa uma sikhuluma ezomhlaba, ke indlebe, kuza emuva evamile ngemva kwenyanga eyodwa kusukela ngosuku ukusebenza.

Imiphumela

abezindaba Okungalapheki otitis - ke isifo esiyingozi, futhi uma ugijima ke, ukulimala maphakathi nendlebe kungaba ephawulekayo. Tympanoplasty yena, ikuvumela iwukudambisa ngokuphelele le nkinga futhi abuyisele eardrum. Ngaphezu kwalokho, ukusebenza uqobo kuthatha cishe ihora. Ngakho, asikho isizathu ukuziba impatho enjalo.