Ukuhlinzwa - Yini leyo? Izinhlobo futhi izigaba izinqubo kuhlinzwa

Umqondo "operation kuhlinzwa" - ingashintshwa ukuze isiRashiya inkulumo lesiGreki ngokwezwi nezwi elisho "ukwenza ngesandla." Kusukela ezinsukwini ngezikhwepha yaseGrisi yasendulo, kwathatha iminyaka eminingi, futhi namuhla le ukuhlinzwa - ezihlukahlukene nemiphumela eziphilayo, lapho umsebenzi yokulungiswa wonke umzimba. Ngo inqubo izicubu imisebenzi inqanyuliwe, wabashukumisa futhi axhunyiwe futhi.

icala umlando

Lapho kukhulunywa ngaye okokuqala ukuhlinzwa ezihlobene VI ekhulwini BC. e. Kusukela ekuqaleni kwesikhathi abantu bayeka ukopha, ukunakekela amanxeba nechobozekile noma anqunywe ethintekile esitho esibhibhayo. Izazi-mlando kwezokwelapha ukwazi ukuthi kudala ngaphambi kwenkathi yethu le ke abelaphi bakwazi ukwenza craniotomy, le mishini yenze amathambo aphukile ngisho ... ukususa gallbladder.

Kuzo zonke izincwadi kufanele isitatimende wasendulo wokukhulekela izindawo emlandweni wezokwelapha ukuthi Unommese, futhi izwi utshani arsenal kadokotela. Kusukela ezikhathini zasendulo kuze kube namuhla ummese - manje analogs yayo, yebo - kwasekuqaleni. Ukusebenza - lena indlela olukhulu kakhulu sokwelashwa, okuvumela umuntu ukuqeda lesi sifo kuze kube phakade. Sikhanyisiwe ngaphezu kwanoma yimuphi omunye ukuhlinzwa, UHippocrates, uGalen no KaCelsus.

The best udokotela ohlinzayo isiRashiya kwakuwulimi Nikolay Ivanovich Pirogov, ogama ethuneni ninobubele igcinwe Winery. Ngoba imfuyo yakhe yangaphambili namanje khulula izihlobo Ukunakekela walabo waphulukisa futhi basindiswe ekufeni. Uma udokotela ohlinzayo omkhulu ekusizeni omakhelwane babo ngaphandle kwenkokhelo - kanti ngeke uyikhumbule kuze kube manje. Pies wasusa gallbladder ngemizuzwana 40, isandla sakhe kungabonwa ku Crypt - nge ezinde, neminwe emide emincane.

Analgesia noma izinzwa

Noma yimuphi operation - Ngokuyinhloko ubuhlungu. On ubuhlungu lokuphila izicubu iyaphendula spasm kanye Ukuwohloka kwegazi, ngakho yaba namandla okususa ubuhlungu - umsebenzi oyinhloko phakathi nokuhlinzwa. Kufikwe imininingwane engokomlando ukuthi lokuphila elalisetshenziswa okhokho lwethu analgesia: Iziphungo izitshalo aqukethe izinto kwezidakamizwa, utshwala, insangu, kokucindezelwa abandayo futhi imithambo yegazi.

Breakthrough iphutha ekuhlinzeni phakathi kwekhulu XIX, lapho i-nitrous oxide lapho kwavulwa, diethyl ether bese chloroform. It ibilokhu isetshenziswa kusukela ngaleso sikhathi, ukubulawa kwezinzwa okuvamile. Ngemva nje kancane kwalokho, odokotela abahlinzayo waphawula-cocaine ngomqondo wokuthi ketshezi anaesthetises izicubu endaweni. ukusetshenziswa Cocaine angabhekwa ekuqaleni wendawo - babashayeli kanye kokuziphatha - izinzwa.

Maphakathi nekhulu leminyaka eledlule zihlanganisa kokutholakala imisipha relaxants noma izinto ezingase kubathene imisipha. Kusukela ngaleso sikhathi, isayensi yokubulala izinzwa elavelela isayensi ahlukene yezokwelapha nasezinkolelweni, kuhlangene ngokungenakuhlukaniswa zokuhlinzwa.

ukuhlinzwa Modern - iqoqo amasu ezivela emagatsheni ahlukahlukene wezokwelapha. Singasho ukuthi kuyinto zamagama wolwazi zanqwabelana wezokwelapha.

Ukuhlinzwa: Izinhlobo zemisebenzi

Ukwabela kusigaba ubunjalo kokungenela imisebenzi kanye izigaba ukuvuthwa.

Ngu uhlobo ukusebenza kungaba olukhulu, lingaze noma okuthuthukisa.

ukuhlinzwa Radical - iyona ukuqedwa oluphelele inqubo sokugembula. Isibonelo zakudala - kokukhipha isithasiselo avuvukele e appendicitis oyingozi.

Okunezimpawu - iyona ukuqedwa izimpawu zokucindezeleka kakhulu lesi sifo. Ngokwesibonelo, e umdlavuza rectal sokuzikhulula ezimele akunakwenzeka, futhi udokotela ohlinzayo ithatha ingxenye enempilo kapopopo kuya anterior udonga besisu. Kuye isimo jikelele isimila lesiguli ziyasuswa ngesikhathi esifanayo noma kamuva. Ukuze lolu hlobo Abut okuthuthukisa futhi uqede ezihlukahlukene izinkinga.

I ukuhlinzwa esiphuthumayo futhi yokuqokwa

Ngezinye izikhathi isiguli sidinga ukuhlinzwa esiphuthumayo. Izinhlobo imisebenzi ephuthumayo kwenziwe ngokushesha ngangokunokwenzeka, badinga ukuze kusindiswe ukuphila. Lokhu konikotomiya noma tracheostomy ukubuyisela umgudu wokubhoboza we pleural umgodi phakathi hemothorax ezisongela ukuphila nabanye.

ukuhlinzwa eziphuthumayo kungenziwa ilibele kuze 48 amahora. Isibonelo - colic kwezinso, ureteral amatshe. Uma on isizinda ukwelashwa ngoludala isiguli ehluleka "abelethe" itshe, kubalulekile ukuze uyisuse surgically.

ukuhlinzwa ezokuziKhethela kwenziwa lapho nezinye izindlela zokuthuthukisa isimo sempilo lapho, futhi usongo ngqo ukuphila, futhi, ayikho. Ngokwesibonelo, operation ezifana kuhlinzwa - ukususwa ngemithambo enwetshiwe nge nesifo esingamahlalakhona emithambo yegazi. Futhi, kuhlelwe ukuba asuse izinhlumba kanye izimila ingozi.

izinhlobo kuthengiselana, izigaba ukuhlinzwa: Surgery

Ngaphandle izinhlobo ngenhla wokusebenza kungaba single- noma multi-esiteji. Kwezinye izigaba izophela kabusha izinhlaka ngemva ukusha noma ukuhlukumezeka, ukufakelwa kwesikhumba xhumelela zokulungisa izicubu isici.

Noma yimuphi operation eyenziwa ngezigaba 3: kokwenza indlela kuhlinzwa, amasu op futhi okukhiphayo. Finyelela - lokhu okutholakele isifo kokugqashuka, le asike izidumbu zabantu kwezicubu ukuzifinyelela. Ukwamukelwa - ukususwa langempela noma ukufuduka kwezicubu, futhi okukhipha - a stapling zonke zamatshe izicubu.

Umsebenzi isitho ngasinye has izici zayo siqu. Ngokwesibonelo, ukuhlinzwa kobuchopho ngokuvamile kudinga craniotomy, ngoba ufuna ukuvula plate ithambo ekuqaleni sokufinyelela ketshezi ebuchosheni.

Ngesikhathi sigaba Imiphumela tekusebenta uxhumeke ku imithambo yegazi, imizwa, izingxenye izitho eziyize, imisipha, fascia nesikhumba. Zonke ndawonye kuyinto isilonda nasezinkingeni ezilandela ngemva kokuhlinzwa, kudinga yesondlo ngokucophelela singcono.

Indlela ukunciphisa ukulimala kwezitho zomzimba?

Lo mbuzo ekukhathaza odokotela abahlinzayo sonke isikhathi. Kukhona imisebenzi ukuthi kukhona emadanisekako nokuhlukumezeka kwabo nalesi sifo. Iqiniso ukuthi akuwona wonke umzimba uyakwazi ngokushesha futhi kahle ukuze abhekane nokuhlukaniswa ukulimala wathola phakathi nokuhlinzwa. Ezindaweni lapho ukusikeka akhiwa umbhunu, suppuration, uzigcinele izibazi nonabsorbable ezephula isitho umsebenzi. Ngaphezu kwalokho, sutures kungahluka noma angavulwa opha imithambo yegazi abalimala.

Zonke lezi yezinkinga kubangele bahlinze ukunciphisa ubukhulu imbobo esiphansi ngangokunokwenzeka.

Ngakho kwaba khona ukuhlinzwa ekhethekile kwesigaba - mikroinvazivny, lapho imbobo encane esikhumbeni nemisipha kulo imishini endoscopic.

ukuhlinzwa endoscopic

Lena ukuhlinzwa ekhethekile. Izinhlobo kanye izigaba kwezinye wakhe. Ngesikhathi kokungenela esifanayo uphethwe kubaluleke kakhulu olunembile lesi sifo.

Udokotela ohlinzayo ingena ngokusebenzisa imbobo encane noma umshini wokubhoboza, etholakala ngaphansi kwezitho nezicubu kwesikhumba, ebona ngokusebenzisa ikhamera yevidiyo ubekwe endoscope. Ibid ibekwe amaphini noma amathuluzi amancane: nezizenze, izinkintsho futhi izibopho, nge okususa izicubu izigaba onesifo noma izitho lonke.

ukuhlinzwa endoscopic phathelana bakamalalahlengezela lisetshenziswa kusukela isigamu kwekhulu elidlule yesibili.

ukuhlinza ngaphandle kwegazi

Lena yindlela ukulondoloza umthamo wegazi lesiguli siqu phakathi nokuhlinzwa. Le ndlela uvame ezisetshenziswayo ekuhlinzeni ngaphandle inhliziyo. Lapho igazi inhliziyo ukuhlinzwa lesiguli siqu eqoqwe phezu kwengungu extracorporeal, ngawo zigcinwe ukugeleza kwegazi wonke umzimba. Ngemva kokuhlinzwa, igazi ubuyela ekugelezeni kwawo kwemvelo.

A inqubo eyinkimbinkimbi kakhulu ukuhlinzwa okunjalo. Izinhlobo zemisebenzi, ezigabeni kunqunywa esimweni esithile umzimba. Le ndlela ugwema isidingo ukusebenzisa ukopha futhi ukumpontshelwa igazi. i sokungenela yenziwe yaba khona at kwalapho nge ukuhlinzwa TRANSFUSIOLOGY - isayensi ukumpontshelwa igazi.

igazi yomunye - akuyona insindiso kuphela, kodwa futhi amasosha omzimba zabanye abantu, amagciwane kanye nezinye izingxenye angaphandle. Ngisho ukulungiselelwa ngokucophelela kakhulu igazi akuyona njalo ingagwenywa imiphumela engemihle.

ukuhlinzwa semithambo

Le ngxenye ukuhlinzwa zanamuhla ubani oye zasiza ekulondolozeni ukuphila kwabantu abaningi. Umgomo ilula - ukubuyiselwa ukugeleza kwegazi izitsha inkinga. Ngo isifo sokuqina kwemithambo yegazi, isifo senhliziyo noma ukulimala endleleni igazi ligeleze izithiyo kuphakama. Igcwele umoya-mpilo yendlala ekugcineni ukufa kwamangqamuzana nezicubu sakhiwa kubo.

Buyisela ukugeleza kwegazi ngezindlela ezimbili: ukusungulwa kwesiGungu stent noma milisa.

Stent - luhlaka metal okuyinto odlulela ezindongeni esitsheni iphinde ivimbele spasm yayo. I stent isethwe lapho Imithambo yegazi ezigcinwe kahle. I stent ijwayele ukusethwa iziguli ngokulinganiswa ayemncane.

Uma izindonga isitsha emangazwe inqubo atherosclerotic noma ukuvuvukala ezingamahlalakhona ke baphoqelele nabo engenakwenzeka. Kulokhu, ukudala workaround ngoba igazi noma shunt. Ukuze wenze lokhu, thatha yingxenye vein femoral futhi opha kuso, ukugwema indawo engafanele.

Shunting Nobuhle

Lona eyohlinzwa kunazo owaziwa, isithombe abantu, kube ethole, kubaneka emakhasini amaphephandaba nomagazini. Isetshenziselwa ukwelapha ukukhuluphala nesikashukela soHlobo 2. Zombili lezi zimo elihlobene ne ukudla ezingamahlalakhona. Phakathi nomsebenzi we-ingxenye esiswini akhelene emphinjeni, kwakheka ventricle encane, namandla hhayi ngaphezu kuka-50 ml ukudla. Ukanye emathunjini amancane. Duodenum nokulandela amathumbu akhe phambili nokudlala indima ukugaya ukudla, njengoba le ndawo unamathele ngezansi.

Sibekezele ngemva kokuhlinzwa enjalo ungadla kancane futhi ilahlekelwa ku-80% isisindo ayengaphansi. Kudinga olukhethekile lokudla, ahlanganiswe amaprotheni namavithamini. kwakhiwa Ezinye eyohlinzwa enjalo ezishintsha ukuphila kwayo ngempela, kodwa kuneziguli abaphethe yokwelula ventricle is eyayenziwe cishe ukuze Ubukhulu yayo yangaphambili.

izimangaliso kuhlinzwa

ubuchwepheshe besimanje ukuvumela amandla okwenza izimangaliso. Ezindabeni manje bese kuvela imibiko kokungenela engavamile yaphela ngempumelelo. Ngokwesibonelo, muva nje nodokotela abahlinzayo zeSpanishi Malaga waba nokuhlinzwa ubuchopho nesineke, phakathi kwesikhathi lapho operable abadlale saxophone.

ochwepheshe French kwenziwe ukufakelwa izicubu ubuso kusukela ngo-2005. Ukuwalandela odokotela abahlinzayo maxillofacial wonke repot steel isikhumba futhi imisipha ebusweni nezinye izingxenye zomzimba, Ukubuyisela elahlekile ngemva ukulimala nezingozi ukubukeka.

Ukuhlinza ... ngisho esibelethweni. Kukhona amacala lapho isithelo esuswa kwesibeletho, ukukhishwa kwe-isimila wawenziwa futhi ingane wabuya emuva. Njengoba ayezalelwe ukuphila okugcwele eside ingane enempilo - okungcono udokotela ohlinzayo umvuzo.

Isayensi noma ubuciko?

Kunzima ukuphendula lo mbuzo nangokunembile. Ukuhlinzwa - Fusion nolwazi, okuhlangenwe nakho kanye nobuntu nodokotela ohlinzayo. Omunye uyesaba sizifake engozini, kanye nezinye yenzani konke okusemandleni futhi zingenakwenzeka wemithwalo ukuthi has okwamanje.

Isikhathi sokugcina uMklomelo KaNobel Zokuhlinza emahlangothini 1912 engumFulentshi Alexis Carrel ngomsebenzi wakhe ku suture semithambo kanye le ukufakelwa kwezitho. Kusukela ngaleso sikhathi, sekudlule iminyaka engaphezu kuka-100 kuyo yonke imisebenzi kuhlinzwa kungukuthi ukhishwa isithakazelo eKomidini kaNobel. Nokho, njalo ngemva kweminyaka 5 ukuhlinzwa avele ubuchwepheshe, kakhulu ekuthuthukiseni ngemiphumela yako. Ngakho, ithuthuka ngokushesha ukuhlinzwa laser ivumela ngokusebenzisa sebeziqhumbuza ezincane ukususa hernia intervertebral, "shabalala" BPH "solder" yegilo izinhlumba. I inzalo eliphelele lasers kanye ikhono lazo izitsha weld ukuvumela udokotela ohlinzayo ukwelapha ezihlukahlukene izifo.

Udokotela ohlinzayo ibizwa ngokuthi namuhla akuyona inani imiklomelo kanye nemiklomelo, futhi nenombolo yezimpilo ngazisile ngisindisile futhi impilo iziguli.