Opaleshoni Troyanova-Trendelenburg - ndichiyani?

M'zaka zaposachedwapa, varicose mitsempha amamuonera chizolowezi rejuvenation. Mkazi aliyense chachitatu matenda adakali ntchito. Pakati pa anthu, imodzi akuvutika khumi. Thrombosis kapena thrombophlebitis - vuto yoopsa matenda venous. Pankhaniyi m'pofunika ntchito crossectomy (Troyanova-Trendelenburg ntchito).

Features ya mitsempha varicose

Varicose mitsempha amatchedwa matenda kugwirizana ndi kusintha okhazikika khoma mtima, kuwonjezeka ndi kutambasuka ziwiya ndi mapangidwe protrusions, mfundo, ndi zina magazi.

M'munsi nthambi venous maukonde ukufanizidwa zachiphamaso ndiponso ziwiya kulankhulana wina ndi mzake. Kachitidwe padziko imakhala yaikulu ndi yaing'ono mitsempha saphenous. kumayamba kwambiri m'dera groin ndi ili mu kumtunda kwa ntchafu, kugwera kwambiri femoral mtsempha.

Varices limodzi ndi kusintha kuthamanga intravascular, liwiro magazi, njira patsogolo. Ziwiya ndi dilated, wodzazidwa ndi magazi. Dongosolo valavu wa mitsempha salinso kupirira ntchito zonse unilateral m'magazi, ndi prerequisites mapangidwe Reflux magazi (m'mbuyo kuponya). Nthawi zambiri panthaŵi ya chithunzi matenda a matenda ndi mu kugwedezeka zonse zomwe zimabweretsa wodwala kukaonana ndi dokotala mtima.

Nthawi zambiri kusankha akatswiri amakhala ntchito Troyanova-Trendelenburg. Chimene icho chiri, momwe anachita komanso zotsatira za phukusi, tiyeni tione zina.

Cholinga crossectomy

The katswiri ayenera ntchito yaikulu - kuti tichotse Reflux ndi kuthetsa njira patsogolo mu mitsempha varicose anasintha. Ndiye kodi kuletsa magazi ndi thandizo la mankhwala si zotheka, njira yokha kukhala mphambano odwala mtima ndi makhwawa awo.

Crossectomy (pa Troyanov-Trendelenburg opareshoni) imatengedwa kuti ndi kwakukulu alowererepo. Iwo anachita mu nkhani ya varices mavuto (mwachitsanzo, thrombosis kapena phlebitis) kapena ulalo mankhwala zovuta.

Mosiyana crossectomy ndi phlebectomy

Posachedwapa phlebectomy (venectomy) ankaona kuti njira yabwino zochizira mitsempha varicose. Iwo anachita pansi ochititsa dzanzi msana m'chipatala. Opaleshoni ankasiyana kwambiri zoopsa ndi chitukuko cha mavuto postoperative. Posachedwapa zotsatira flebektomii anayamba kusonyeza kuti m'pofunika kupeza njira kwakukulu kwambiri kuchepetsa kuthekera zisadzachitikenso matenda.

Venectomy limodzi ndi ankawoloka kwambiri saphenous mtsempha mu ntchafu chapamwamba, koma osati pafupi anastomosis, ndikumutsogolera ndi resumption a inflows Reflux safeny za fistula. Kuyambiranso amapezeka yense wopirira lachitatu.

Wamakono crossectomy izo zochokera chakuti odulidwa ndi mphambano akutsatiridwa mwachindunji pa confluence mwakuya femoral mtsempha, ndi chifukwa kuti palibe Reflux magazi mu dongosolo kwambiri.

Zikuonetsa kuti alowererepo

Opaleshoni Troyanova-Trendelenburg unachitikira mwamsanga masiku oyambirira mapangidwe thrombosis, kusintha kuletsa ndondomeko pathological ndi dongosolo zachiphamaso venous kwa kwambiri.

Zikuonetsa kuti alowererepo ndi mayiko otsatirawa:

• thrombophlebitis mlingo wa bondo ndi pamwamba;
• thrombophlebitis, zosokonezeka njira purulent;
• thrombosis kobwereza kapena amene alibe kongoletsani lokha njira zina chithandizo;
• thrombosis la mlingo wa bondo ndi pamwamba.

contraindications

Nkofunika kuzindikira kuti Troyanova-Trendelenburg ntchito amene umboni ali pangozi, osaganizira pamaso pa contraindications. Pankhaniyi tikulankhula za moyo wa wodwalayo.

Pamene akukonzekera ndi phukusi la akatswiri kuzindikiridwa zinthu zingapo pamene opaleshoni si zofunika:

1. matenda Somatic - thupi wodwala kwambiri wofooka, ndipo ntchito iliyonse kumafuna khama kubwezeretsa. Zikatero m'pofunika kugwiritsa ntchito njira zochepa kwambiri mankhwala.
2. Atherosclerosis a m'munsi malekezero kwambiri.
3. Pa mimba kapena mkaka wa m'mawere.
4. Pamaso pa matenda kapena purulent totupa pa malo alowererepo anakonza.
5. Zinthu zimene n'zosatheka amathera psinjika wabwino wa miyendo pambuyo opaleshoni (kunenepa aakulu).
6. Thrombophlebitis kapena thrombosis kwambiri m'mitsempha.

Opaleshoni Troyanova-Trendelenburg amafuna kutsegula mofulumira wodwala pambuyo alowererepo, kotero matenda amene wodwala kudzuka pa tsiku lachiwiri, ankaona payekha.

Kukonzekera opaleshoni

Popeza nthawi zambiri wodwala ifika ndi phukusi mwadzidzidzi, pa kafukufuku ndi kudali pa mokakamizidwa osachepera:

• wamba magazi ndi mkodzo mayesero;
• magazi sayansi;
• coagulation;
• kafukufuku chindoko, matenda a chiwindi;
• kuphimba kwa HIV.

ndikuphunzitsidwa ndi kufunsa kuti akatsimikizire pamaso matenda somatic, amene akhala contraindication. Anagwiritsanso mitsempha ultrasound kudziwa kutanthauzira kwa anastomoses, malo Mitsempha odwala, ndi zochitika za ndondomeko pathological.

Atafotokoza miyezo zofunika, dokotala mtima akufotokoza mmene masitonkeni psinjika kapena zotanuka bandeji ayenera kugula kuti agwire psinjika a ziwalo yomweyo pambuyo opaleshoni.

Inde ya opaleshoni

Opaleshoni Troyanova-Trendelenburg, zochokera njira zomwe zimafunika luso mkulu wa opaleshoni ya, anachita ntchito wamba kapena ambiri ochititsa dzanzi. Kusankha mankhwala ochititsa dzanzi zimapangitsa dzanzi, Kutsata mfundo zonse mwachindunji ndi wodwalayo.

Opaleshoni Troyanova-Trendelenburg ndipo anafotokoza m'nkhani ndizo njira zotsatirazi:

1. Opaleshoni malo mankhwala ndi njira antiseptic, ntchito mapepala wosabala, sikulola munthu mwayi.
2. The groin dokotala probes adzionere wa mtsempha wamagazi femoral, pansi wakupambana medially ndi pang'ono subcutaneous Vienna.
3. Anatomical makhalidwe odwala onse zosiyanasiyana, motero malo mitsempha osiyana. ang'ambe thupilo The imagwiridwa, malingana ndi malo aakulu saphenous mtsempha anastomosis.
4. Pambuyo odulidwa dokotalayo umalandira venous mtengo, nsalu ndi amadula ilo.
5. Iwo anatsindika kwambiri saphenous Vienna m'dera pamene amalowa dongosolo kwambiri, ligated namdula. Pa nthawi imeneyi, ndi magazi kuundana apite.
6. Kenako, momwemo ali okhaokha namdula makhwawa mtsempha osachepera asanu mulitali (a ochepa mabala zina monga zofunikira). Iwo wochititsidwa pofuna kupewa n'zosiyana magazi deta ndi zisadzachitikenso matenda.
7. amacheka onse sutured, anaika bere.
8. Pa kumalekezero m'munsi kuvala psinjika chovala kapena zotanuka bandeji.

Opaleshoni Troyanova-Trendelenburg kugwirizana ndi kutupa ndi mapangidwe magazi kuundana, choncho akatswiri mwadzidzidzi musayese kuchotsa mochuluka za mitsempha, ndi pazipita cropped Malo ndondomeko pathological.

Nthawi postoperative

Tsiku loyamba wodwala amathera mu bedi. Ichi ndi chifukwa zotsatira zotheka mbali kwa mankhwala ochititsa dzanzi pa. Pa tsiku lachiwiri zikusonyeza kutsegula wodwalayo kuti bwino kutetezera zingagwiritsidwenso ntchito ya thrombosis. Soreness ndi zolimbitsa, koma dokotala n'kukulemberani ndi relievers ululu kapena nonsteroidal odana ndi yotupa mankhwala, ngati n'koyenera.

Chofunika ndi psinjika okwanira wa malekezero a m'munsi, imene akadali pa mwezi kuchokera alowererepo pa.

Ankamvera ayenera ntchito umalimbana popewa njira patsogolo mu dongosolo m'mitsempha (kuyenda thupi mankhwala).

zosokonezeka kutheka pambuyo opaleshoni

Opaleshoni Troyanova-Trendelenburg, zosokonezeka amene n'zochepa kwambiri, amatanthauza njira kwakukulu mankhwala. Ndi chifukwa kawirikawiri mavuto pa minofu zoopsa alowererepo (amene sakhoza kupewedwa), ndi kuphwanya ndikupeleka luso. Wodwala akhoza kukhala ndi pathologies zotsatirazi:

• magazi;
• hematoma m'dera la alowererepo;
• matenda a bala opaleshoni;
• matenda a dongosolo lymphatic ndi mapangidwe conglomerates enaake;
• paresthesia (chisokonezo tilinazo khungu pamene mukuwoloka molekezera mitsempha);
• lymphorrhea (outflow wa lymph ku mphambano za ziwiya lymphatic).

Ena mavuto ali paokha, pamene ena amafuna mankhwala owonjezera. Hematoma mu Zikavuta, gonjerani zina puncture ndi mankhwala opha tizilombo. Infection mabala imafunanso ntchito wothandizila antibacterial (penicillin, macrolides, cephalosporins). Mkhutu tilinazo abwezeretsedwa paokha, sikutanthauza ena amene.

Pomaliza

Wina njira kwakukulu mankhwala zovuta kwa mitsempha varicose ndi mavuto ake ndi ntchito Troyanova-Trendelenburg. Inde ntchito zikusonyeza mmene Sinthani dongosolo kuthetsa Reflux ndi kupewa zisadzachitikenso matendawa. Compliance ndi malangizo opaleshoni katswiri kupewa kufunika kukonzanso chithandizo.