Khosi vagosympathetic anatseka misewu pa Vishnevsky

Mankhwala anatseka misewu ya vertebrae khomo lachiberekero wa thunthu wachifundo pamodzi ndi mitsempha vagus amatchedwa "anatseka misewu vagosympathetic". Iye analamula dzina lake Aleksandr Aleksandrovich Vishnevsky ndi cholinga pakamwa zikhumbo mitsempha pa mantha plevropulmonalnogo chifukwa matenda zoopsa ndi malo kuvulala pachifuwa.

Kamakupatsani khola zabwino matenda a kutupa chikhalidwe ndi matenda osiyanasiyana minofu kamvekedwe.

Shane novocaine anatseka misewu anakumana S. G. Zograbyan ndi cholinga kuti azindikire gipotenzionny syndrome zoopsa chiyambi. Anaona kuvulazidwa experimental ubongo imene anatseka misewu ya khomo lachiberekero wachifundo ganglia nyama ndi hypotension oziziritsa kungayambitse kuthamanga intracranial kwa nthawi yochepa. Amachepetsa mutu 80% milandu pambuyo ndondomeko. Koma zotsatira zinatha kokha maola angapo. Ichi ndi chifukwa chakuti anatseka misewu pa nthawi ya oziziritsa mtima kuphipha relieves, chifukwa cha bwino kotunga magazi ku ubongo.

Kuchokera pa ndondomeko zimene?

Anatseka misewu vagosympathetic - njira mankhwala mwambo-pathogenetic zochokera:

• Mwachidule kusiya patency zotumphukira mantha.
• Mu zimene yaiwisi novocaine njira yothetsera kusonyeza ntchito za dongosolo chapakati mantha (CNS).

ubwino anatseka misewu

Mu zinthu zimenezi Vishnevsky kubwera kwa zinthu zina:

• Pazifukwa zosiyanasiyana, kutupa ndondomeko pa chiyambi cha kukula umamumvera malamulo ofanana.
• Kukula ndondomeko kutupa akhoza inaimitsidwa mpaka pa siteji ya serous kusalola zimakhala.
• Aakulu kutupa mawonekedwe mofulumira kwambiri okha, abscesses ndi analola m'kupita pang'ono - awululidwa.
• Infiltrative, unsharp ndi njira zina aakulu kutupa ali anasonyeza mosinthana trophic, nthawi zina bystrorazreshimymi.
• matenda kugwirizana ndi kusintha pathological mu ziwalo. Pang'ono kuyabwa ya ubongo, zomwe amachita khomo lachiberekero akupanga vagosympathetic anatseka misewu limba ndi boma kusinthidwa. Mu anatseka misewu izi mu njira ngati zimenezi Mipikisano ntchito: akulola kuphipha, amazibwezera paresis.
• Njira pathological chilengedwe zomwe zimapangidwa ndi kusintha mu ndime opaleshoni ndipo capillaries, novocaine chipika potsogolera kukonza thupi udindo wa pakhoma mtima.

Kodi mitundu ya blockades kulibe?

Taganizirani funso ili mwatsatanetsatane. The mitundu ikuluikulu ya kutsekedwa:

• Anatseka misewu ya wovulala mafupa yaitali.
• Futlyarnoy phewa chipika.
• Futlyarnoy anatseka misewu atavalanso zoteteza.
• Anatseka misewu a chigawo mtanda.
• The anatseka misewu ya mitsempha femoral.
• Sciatic mitsempha.
• Tibial mitsempha.
• Peroneal mitsempha.
• Intercostal conduction anatseka misewu.
• Paravertebral anatseka misewu.
• Ndipo ndithudi, khosi vagosympathetic.

Vagosympathetic anatseka misewu: umboni

Zikuonetsa khomo lachiberekero vagosympathetic anatseka misewu nawonso:

• Plevropulmonalnoe mantha.
• Angapo nthiti fractures.
• Open, anatseka ndipo masango valavu.
• Burns pa mundawo kupuma.
• Postoperative chibayo.
• Syndromes zoopsa asphyxiation.
• Syndromes wa blockages mafuta (mawonekedwe m'mapapo mwanga).

Nthawi zambiri kumachitika pa pathologies izi kuchita ndondomeko.

Kuti anatseka misewu zinachitikadi ndi vagosympathetic Vishnevsky njira, muyenera kudziwa zosamveka-anatomical kugwirizana thunthu wachifundo ndi mitsempha vagus. neoplasms Awa pamwamba pa fupa hyoid m'dera lina kletchatochnyh kuti apereke malongosoledwe a synchronous Letsani Mwina pamene kutumikiridwa pano novocaine. Pansipa zidzasankhidwa parietal wosanjikiza wa fascia chachinayi.

kukonzekera mtima

Pamaso pa chiyambi cha anatseka misewu ya Adokotala mawu akuti pa mbale kapena ampoule mankhwala ochititsa. Wodwala ayenera kukhala mu malo supine chifukwa cha zochita za mankhwala oletsa ululu si kukusalani maonekedwe a mavuto osiyanasiyana. Asanachite opareshoni nthawi zonse ankakonda khungu ndi njira antiseptic. anatseka misewu ndi kunatanthauzanso. Processing n'kofunika kuchita maziko kuvomerezedwa, chifukwa n'zosatheka kupewa kukhudzana ndi tizilombo toyambitsa matenda mu puncture malo.

Pambuyo pake, dera khungu m'pofunika kuti asanene nsalu chowuma.

Chimachitika n'chiyani?

Wodwala aikidwa pa nsana wake pansi tsamba nthawi yomweyo umachititsa khushoni. mutu zimayenda zosiyana kumene anatseka misewu ya. Mkono wa wodwalayo ndi kukoka pansi anatseka misewu. Ndi kumbuyo m'mphepete bwino minofu sternocleidomastoid, pamwamba likulu lake pafupifupi 1-1.5 masentimita jekeseni pansi pakhungu la 1-2 ml ya 0.25-5% njira ya njira mankhwala ochititsa. Ngati mawonekedwe Yarema mtsempha ndi zosaoneka, ndiye mayikidwe malo singano anakonzeratu mlingo kupeza m'mphepete kumtunda kwa epiglottis chithokomiro.

Kodi ndendende ndi anatseka misewu vagosympathetic?

Ndi njira yapadera, izo ikuchitika yekha akatswiri kwambiri oyenerera. ufulu dzanja minofu ndi zipangizo za index chala ali ankatembenukira ndi kum'sangalatsa koyamba padziko vertebrae a msana khomo lachiberekero. Komanso kumapeto chala umayamba singano lalikulu ndi kusuntha inwards kwa koyamba vertebral pamwamba. Pa mayikidwe a singano ndi buku laling'ono, pa 2-3 ml, yankho anali Komanso jekeseni mankhwala ochititsa kuti ndondomeko mpumulo ululu. Pamene singano nsonga nakhudza vertebrae kuchita aspirate (ikuchitika pofuna kupewa makonzedwe intravascular wa mankhwala ochititsa a). Pambuyo pa kutsimikizira kuti magazi si anafikira mu syringe ndi pang'onopang'ono anawonjezera 30-60 ml ya 0,25% njira ya mankhwala ochititsa. The singano Kenako ananyamuka unkagunda jekeseni malo yolera yotseketsa gauze kwa mphindi 1-2.

Mukasungadi ndi kutsatira malamulo a vagosympathetic anatseka misewu mankhwala ochititsa njira secures mitsempha vagus ndi misempha ena kuti kuyambira khomo lachiberekero wachifundo mfundo thunthu.

Zizindikiro pambuyo ndondomeko

Khalidwe ogwira mtima a anatseka misewu vagosympathetic mtima amachititsa zizindikiro zotsatirazi:

• Ptosis (kuŵeramitsa wa chikope chapamwamba).
• Miosis (chidule cha mwana wa).
• Enophthalmos (confluence eyeballs mkati wa ku Horner a).
• Redness a nkhope ndi nembanemba mucous wa maso.
• Perikornealnaya mtima jekeseni.
• Yafupika thukuta chochitidwa ndi anatseka misewu ya.

Khosi vagosympathetic anatseka misewu pa Vishnevsky limaleka ululu, chifuwa reflex, malankhulidwe ndi mitsempha ya magazi ndi kumawonjezera magazi.

Anatseka misewu sizingakhoze kuchitidwa mbali zonse mwakamodzi. Nthawi imeneyi pakati mankhwala ayenera kukhala mphindi zosachepera 30-40. Komanso pa ndondomeko sangathe zidzawonjezedwa kwa njira zikuwonjezereka masiku ano popha ululu.

Kodi chimayambitsa malamulo otere? mfundo ndi yakuti mukhoza mwangozi kutenga ziwalo kupuma chifukwa anatseka misewu ya.

zosokonezeka

Pambuyo komanso angayambe mavuto:

• Kulakwila mtsempha wamagazi ndi carotid pa kuboola.
• Kuphwanya mkati jugular mtsempha.
• Kulakwila kholingo.

Mwina atonia ndi matumbo paresis (mavuto amenewa popanda chithandizo chapadera).

Zonsezi zingachititse khomo lachiberekero vagosympathetic anatseka misewu pa Vishnevsky. Zikuonetsa kuti ife tayang'ananso.

zina

alowererepo wina pa khosi amafuna mwayi, ndiye kudula aliyense wosanjikiza khungu. Kulumikiza aukhondo khosi ayenera anakhalabe, monga kuwuluridwa gawo thupi. Chifukwa cha ichi, pa khosi ntchito mwayi yopingasa Kocher, akuyenda khungu yopingasa makutu. Sutures pambuyo ntchito mu nkhani iyi ndi zambiri wosaoneka. Pamene tikugwira ntchito mbali ya khosi ndi kotenga nthawi zambiri ntchito gawo kotenga pamodzi kutsogolo kapena kumbuyo m'mphepete sternocleidomastoid minofu. Makamaka noticeable seams patapita apakatikati gawo kotenga. Vagosympathetic anatseka misewu (ndi njira zachilendo) kudzakuthandizani kupewa opaleshoni.

Ndi thanzi svom safuna nthabwala, ayenera kusunga tipewe ngozi ndipo tikhalebe maso. Ndiye ngozi zosiyanasiyana zosasangalatsa zikhoza kupewedwa.