Opaleshoni - yotani? Mitundu ndi magawo a popanga munthu opaleshoni

Lingaliro la "ntchito opaleshoni" - ndinazolowera Chirasha mawu a Chigiriki amene amatanthauza "kuti dzanja." Kuyambira masiku a Greece wakale, panatenga zaka zambiri, ndipo masiku ano opaleshoni - zosiyanasiyana zotsatira pa zimakhala wamoyo, amene kukonzedwa ntchito ya chamoyo wonse. Mu ndondomeko ya ntchito minofu ndi sakukhudzidwa adagwidwa ndi kulumikizana kachiwiri.

mbiri nkhani

Kutchula koyamba za opaleshoni zokhudzana ndi VI m'ma BC. e. Chiyambireni cha anthu nthawi anasiya magazi, mabala ndi wophwanyika kapena kudula akhudzidwa nthambi chilonda. Olemba mbiri ya mankhwala mukudziwa kuti kale nthawi yathu ino ndiye ochiritsa anali wokhoza craniotomy, kugwetsa mafupa othyoka ngakhalenso ... kuchotsa ndulu.

Mu zonse mabuku ndi mawu wakale wa mbiri ya mankhwala kuti ali ndi mpeni, udzu mawu mu nkhokwe dokotala. Kuyambira kalekale mpaka pano mpeni - tsopano analogs ake, kumene - mu malo oyamba. Opaleshoni - ichi ndi njira kwambiri kwakukulu mankhwala, amene amalola munthu kuchotsa matenda kwamuyaya. Yopangidwa kuposa opaleshoni ina, Hippocrates, Galen ndi Celsus.

The bwino Russian dokotala anali Nikolay Ivanovich Pirogov, amene manda achifundo kusungidwa winery lapansi. Chuma chake zakale adakali ufulu Kusamalira achibale a anthu anachiritsa ndi kupulumutsidwa ku imfa. Pamene dokotala wamkulu kuthandiza anansi awo popanda malipiro - ndi adzakumbukira kufikira tsopano. Mapayi anachotsa ndulu masekondi 40, dzanja lake Tingaone mu crypt wa - ndi yaitali, zala wochepa.

Analgesia kapena mankhwala ochititsa dzanzi

ntchito iliyonse - makamaka ululu. Pa ululu wa minofu moyo amachitira kuphipha ndi kuwonongeka kwa magazi, choncho Tengani zowawa - ntchito yaikulu pa opaleshoni. Anafika ife kudziwa mbiri imene ankagwiritsa ntchito makolo athu analgesia: decoctions a zomera munali zinthu chomwa mankhwalawa, mowa, chamba, ndipo psinjika ozizira ndi Mitsempha.

Yojambula zinachitika mu opaleshoni ku pakati pa XIX atumwi, pamene nitrous oxide linatsegulidwa, diethyl efa kenako chloroform. Iwo akhala akugwiritsidwa ntchito kuyambira nthawi imeneyo, ambiri ochititsa dzanzi. Patapita nthawi, madokotala anaona ndi bongo m'njira yakuti chinthu anaesthetises minofu kwanuko. ntchito mankhwala ozunguza bongo tinganene kuti chiyambi cha m'dera - ochititsa ndi kusalola - mankhwala ochititsa dzanzi.

Pofika cha m'ma otsiriza zikuphatikizaponso atulukira relaxants minofu kapena zinthu zina zimene kugwetsa minofu. Popeza kuti nthawi opaleshoni anaima mu osiyana mankhwala sayansi ndi ntchito, ndi inextricably zogwirizana ndi opaleshoni ya.

Modern opaleshoni - mndandanda wa njira nthambi zosiyanasiyana za mankhwala. Tikhoza kunena kuti ndi kupanga nzeru anasonkhanitsa wa mankhwala.

Opaleshoni: Mitundu ya ntchito

Kuonetsetsa gulu ndi khalidwe la ntchito alowererepo ndi magawo a kukhwima.

Ndi chikhalidwe cha ntchito kungakhale kwakukulu, symptomatic kapena palliative.

Kwakukulu opaleshoni - ndi kuwonongedwa kwathunthu ndondomeko pathological. Chitsanzo chachikulu tingachipeze powerenga - kuchotsa chofuna zakumapeto mu appendicitis pachimake.

Symptomatic - ndi kuwonongedwa kwa zizindikiro kwambiri mavuto a matenda. Mwachitsanzo, khansa thumbo palokha defecation sizingatheke ndi dokotala amatenga gawo wathanzi ya m'matumbo kwa zapambuyo khoma m'mimba. Malinga ndi boma ambiri chotupa wodwalayo achotsedwa nthawi yomweyo kapena mtsogolo. Mtundu wa abut palliative komanso kuthetsa zosiyanasiyana zosokonezeka.

The kofunika kusankidwa opaleshoni

Nthawi zina wodwala amafuna opaleshoni mwamsanga. Mitundu ntchito mwadzidzidzi ikuchitika mwamsanga, ayenera kupulumutsa miyoyo. konikotomiya ichi kapena tracheostomy kubwezeretsa airway puncture wa pleural M'mimbamo pa hemothorax moyo pachiswe ndi ena.

Emergency opaleshoni ungachedwetsedwe maola 48. Mwachitsanzo - aimpso colic, ureteral miyala. Ngati pa maziko a mankhwala ndiwofatsa wodwalayo amalephera "kubereka" kwa mwala, m'pofunika kuchotsa izo opaleshoni.

Kusankidwa opaleshoni zachitika pamene njira zina kusintha ukupeza kumeneko, ndi kuopseza mwachindunji moyo, nayenso, kulibe. Mwachitsanzo, chotero ntchito opaleshoni - kuchotsa mitsempha yaitali insufficiency aakulu venous. Komanso, chafika kuchotsa cysts ndi chosaopsa zotupa.

Mitundu ndikupeleka, magawo a opaleshoni: Opaleshoni

Kuwonjezera mitundu pamwamba ntchito akhoza kukhala wosakwatira kapena Mipikisano gawo. Mu magawo ena angaphunzitse kukhazikitsanso ziwalo pambuyo amayaka kapena kupwetekedwa, kumuika khungu kumezanitsa zokonzera chilema minofu.

ntchito iliyonse ikuchitika mu magawo 3: akuchita njira opaleshoni, njira kugwira ntchito ndi linanena bungwe. Access - ichi anapeza matenda mliri, ndi kung'ambika wa zimakhala kufikako. Chikuonetseratu - ndi kuchotsa kwenikweni kapena kusamuka kwa minofu, ndipo linanena bungwe ndi - ndi stapling zigawo zonse za minofu.

Opaleshoni pa chilichonse limba ali makhalidwe yake. Mwachitsanzo, opaleshoni ubongo amafunika ndi craniotomy, chifukwa mukufuna kutsegula mbale fupa poyamba kuti mwayi kwa thunthu ubongo.

Pa siteji ya zotuluka ntchito olumikiza Mitsempha, mitsempha ziwalo za ziwalo dzenje, minofu, fascia ndi khungu. Onse pamodzi ndi bala postoperative, amafuna yokonza mosamala machiritso.

Zochepetsera choipa thupi?

Funso kazivutitsa madokotala a nthawi zonse. Pali ntchito mofanana mu kupwetekedwa mtima kwawo ndi matenda. Mfundo kuti si thupi amatha msanga komanso kupirira kuvulala analandira pa opaleshoni. M'madera amacheka anapanga chophukacho, suppuration, wandiweyani zipsera nonabsorbable zimene zimaipitsa limba ntchito. Komanso, sutures zingasiyane kapena aphenyuke magazi kuchokera Mitsempha anavulala.

mavuto onsewa chifukwa madokotala kuchepetsa kukula kwa ang'ambe thupilo kuti osachepera zotheka.

Choncho panali wapadera gawo opaleshoni - mikroinvazivny, pamene ang'ambe thupilo ting'onoting'ono pakhungu ndi minofu limene zida endoscopic.

opaleshoni endoscopic

Izi ndi opaleshoni wapadera. Mitundu ndi magawo mu zina. Pa phukusi yomweyo n'chofunika kwambiri molondola matenda a matenda.

Dokotalayo wolowera ndi ang'ambe thupilo yaing'ono kapena puncture, yomwe ili pansi pa ziwalo ndi zimakhala wa khungu, iye amaona kudzera kamera ya kanema anaika pa endoscope lapansi. Ibid anaika paddles kapena zida towerengeka; mbano, kumadalira ndi clamps, amene amachotsa zigawo matenda minofu kapena ziwalo lonse.

Endoscopic opaleshoni anamukwiyira massively ntchito kuchokera theka lachiwiri la atumwi wotsiriza.

opaleshoni popanda magazi

Iyi ndi njira kupulumutsa magazi wodwalayo yekha pa opaleshoni. Njira imeneyi nthawi zambiri ntchito opaleshoni ya mtima. Pamene mwazi opaleshoni ya mtima wodwala yekha pamodzi ndi dera extracorporeal, amene anakhalabe magazi thupi lonse. Pambuyo opaleshoni, magazi akubwereranso ku njira zake zachilengedwe.

A ndondomeko zovuta opaleshoni chotero. Mitundu ya ntchito, magawo ake anatsimikiza mtima boma makamaka kwa chamoyo. Njira imeneyi amapewa kufunika kogwiritsa ntchito kutaya magazi ndi kuika magazi. Chotero alowererepo ndi chimatheka pamphambano ndi opaleshoni TRANSFUSIOLOGY - nzeru za magazi a mwiniwake.

magazi a winawake - si chipulumutso, komanso chitetezo anthu ena, mavairasi ndi zigawo zina yachilendo. Ngakhale kukonzekera bwino kwambiri magazi mwiniwake Sizotheka kupewa zotsatira zoipa.

opaleshoni mtima

Chigawo chimenechi cha opaleshoni zamakono zathandiza kupulumutsa miyoyo yambiri. Mfundo ndi losavuta - kubwezeretsedwa kwa magazi mu zotengera za vutolo. Mu atherosclerosis, matenda a mtima kapena kuvulala pa njira ya mavuto magazi uka. Ndi zinadzala ndi mpweya njala ndipo kenako selo imfa ndi minofu linapangidwa iwo.

Bwezerani magazi m'njira ziwiri: kukhazikitsidwa kwa stent kapena kumezanitsa.

Stent - chimango zitsulo amene amakankhira mpanda wa chidebe ndiponso kupewa kuphipha ake. stent chikuyambika pamene Mitsempha bwino anasunga. The stent nthawi anapereka odwala wachinyamata.

Ngati chotengera makoma anadabwa ndondomeko atherosclerotic kapena kutupa aakulu, ndiye kukankha iwo zosatheka. Pankhaniyi, kulenga workaround kwa magazi kapena shunt. Kuti tichite zimenezi, kutenga mbali ya m'mitsempha femoral ndi magazi pa izo, kupewa malo zosafunika.

Shunting Kukongola

Ichi ndi odziwika bwino kwambiri opaleshoni, chithunzi anthu, ilo kakusintha, inadutsa pa masamba a manyuzipepala ndi magazini. Izo ntchito zochizira kunenepa ndipo lembani shuga 2. Onse zinthu izi imakhudzana ndi kudya aakulu. Pa ntchito kwa m'mimba gawo kufupi ndi kum'mero, ndi ventricle aumbike ang'onoang'ono, mphamvu osapitirira 50 ml ya chakudya. Iye anagwirizana ndi intestine yaing'ono. Duodenum ndi kutsatira matumbo ake kupitiriza nawo chimbudzi chakudya, monga malowa amamangiriridwa pansipa.

Wodwala pambuyo ntchito ngati angathe kudya pang'ono ndipo wotaya 80% kulemera woyambawo. Pamafunika kudya zakudya zapadera, olemera ndi mapuloteni ndi mavitamini. Otero opareshoni moona zosintha moyo, koma pali odwala amene amakwanitsa kutambasula ventricle aumbike chongopeka pafupifupi miyeso poyamba.

zozizwitsa opaleshoni

umisiri wamakono kulola kuchita zozizwitsa. Nkhani tsopano ndiyeno inadutsa malipoti alowererepo zachilendo inatha bwinobwino. Mwachitsanzo, posachedwapa ndi madokotala Spanish ku Malaga anali wodwala ubongo opaleshoni, imene operable ankaimba chitoliro.

Akatswiri French ikuchitika kumuika zimakhala za nkhope kuyambira 2005. Zotsatirazi iwo madokotala maxillofacial zonse pa khungu repot zitsulo ndi minofu pa nkhope ndi ziwalo zina za thupi, kubwezeretsa anataya pambuyo kuvulala ndi ngozi maonekedwe.

Madokotala ... ngakhale m'mimba. Pali milandu pamene chipatso atachotsedwa chiberekero, kuchotsa chotupa anali anachita ndi mwana wosabadwayo anabwerera mmbuyo. Amabadwa moyo wathanzi mwana zonse yaitali - yabwino dokotala mphotho.

Science kapena luso?

N'zovuta funso limeneli unambiguously. Opaleshoni - Zisudzo a chidziwitso, zinachitikira ndi makhalidwe a dokotala wa. Limodzi ndi mantha kukwata kuopsa, ndipo winayo kuchita zonse zotheka ndi zosatheka katundu amene ali pa mphindi.

Mugawo ya Nobel Prize mu Opaleshoni kupereka mu 1912 ku France Alexis Carrel pa ntchito yake pa suture mtima ndi ya kupatsidwa zina ziwalo. Kuyambira pamenepo, zaka zoposa 100 cha zipambano opaleshoni si kupereka chidwi mu Komiti ya Nobel. Komabe, zaka 5 opaleshoni kuoneka luso, kwambiri kuwongolera zake. Choncho, kukhala mofulumira opaleshoni laser amalola kudzera amacheka ting'onoting'ono kuchotsa chophukacho intervertebral, "asanduke nthunzi" BPH "solder" chithokomiro cysts. The sterility mtheradi wa lasers ndi luso lawo ziwiya china chotulutsa kulola dokotala kuchitira zosiyanasiyana matenda.

dokotala A amatchedwa lero ndi chiwerengero cha mphoto ndi mphatso, ndipo chiwerengero cha anthu amene anapulumutsidwa ndi thanzi la odwala.