Posterior aphakeme alveolar ezinzwa block amazinyo: izinto, izidakamizwa

Posterior aphakeme alveolar ezinzwa block iyona ayingozi kakhulu ngokuya izinkinga ngemva kokuhlinzwa, umjovo imiklamo. Okwamanje, inqubo efanayo isetshenziswa njalo. Zilandelwa ngu ekuphathweni extraoral futhi buccal izidakamizwa. Anesthesia isetshenziswa analgesia esifundeni molars engenhla, ikakhulukazi alveolar emsipheni ukuvinjelwa.

Izici nezinqubo

Inxanxathela yokwakheka izindawo izici imithi ekuphathweni kwandisa ingozi yezinkinga ukunciphisa ukusebenza ngokusungula indlela yokubulala izinzwa. Ake sihlole amanye amaphuzu.

Ngo temporomandibular pterygium isikhala ngenhla engenhla emhlathini plexus emithambo yegazi elise. It ithatha indawo ye umqhewu infraorbital ukuze umhlathi ongezansi. wokubhoboza Khona Ngengozi odongeni vein kubangela ekwakhekeni hematoma ezinkulu, okuyinto okunzima ngempela ukuvimbela.

Faka inaliti ezingeni enganele kuholela yokuthi isixazululo umjovo yenziwa phakathi ongama okunamafutha izicubu. Kulokhu, posterior aphakeme alveolar ezinzwa block ngokuvamile hhayi ngempumelelo. ka Ukufakwa yenaliti ukujula okweqile kuholela nemiphumela elandelayo:

1. Ukwethulwa izinzwa elungiselelweni zone optic kubangela Elaine wavaleka amehlo okwesikhashana.
2. Umjovo zomuthi e nezicubu esemkhathini esibangela strabismus yesikhashana.
3. Imininingwane nge ikhambi imisipha iphiko kubangela ubuhlungu obukhulu ngemva umphumela izinzwa phezu.

Ungavumeli ichopho slide yaseNtabeni phakathi naleyo nqubo, njengoba kungenzeka perforation of izinzwa nezitsha ezincane igazi.

izinzwa zone

Tuberalnaya izinzwa amazinyo ikuvumela Numb ezindaweni ezilandelayo:

• esifundeni molars engenhla;
• nesifulelo periosteum wathi mucosa ithambo alveolar ;
• mucosa we itheku maxillary futhi thambo odongeni posteroexternal.

Isifunda ekupheleni izinzwa, wedlula ngemuva, owenziwa njalo. Front ke ongafinyelela phakathi bicuspid kuqala futhi ngokufanele mucosa, etholakala endaweni gingiva.

posterior Intraoral aphakeme alveolar ezinzwa block Yegorov

Inkambo inqubo:

1. umlomo lesiguli inxenye yavulwa. Isihlathi inamathela spatula.
2. Ngokuyala inaliti ngase ithambo Imi, udokotela kwenza wokubhoboza phezu molars yesibili ithambo.
3. Inalidi kufanele kubekwe i-engela ⁴⁵ ° ukuze ithambo alveolar.
4. Inalidi ihamba futhi emuva phakathi, kanye nesidingo ukulawula contact yayo njalo ithambo. Ngokuhamba esincane izinzwa ikhishwe.
5. Needle sifakwe 2-2.5 cm. Ukudansela isiginci sakhe piston emuva uhlole wokubhoboza bomkhumbi.
6. Uma kungekho igazi wethulwa 2 ml isixazululo. I isipetu iyasuswa.
7. Isiguli ngazo a izinzwa endaweni ukuze ugweme nokulimala.
8. umphumela Okugcwele zomuthi kwamaminithi 10.

Uma usebenzisa izinzwa esifushane esebenza, inqubo zizosebenza imizuzu 45 uma eside - kufika ku 2.5 amahora. posterior Intraoral aphakeme alveolar ezinzwa block wenziwa ngoba sinenkonzo yokunakekela iziguli emakhaya imisebenzi, futhi ngenkathi ukungenela molars eziningana.

indlela Extraoral ka

Kungakhathaliseki ukuthi iyiphi ohlangothini posterior aphakeme alveolar ezinzwa block kuyadingeka, ka imishini kudinga ukuphambuka zekhanda lesiguli kolunye uhlangothi. Eme phambi kwaleso udokotela izinzwa inquma ukujula lapho kuhlangana khona inaliti kuyadingeka ukuze ungene. Lokhu ibanga phakathi ephansi engela yangaphandle kwezisekelo iso kanye phambi ekhoneni engezansi ithambo zygomatic.

Udokotela wamazinyo itholakala ku ilungelo lesiguli. Inalidi sifakwe endaweni anteroinferior engela wethambo zygomatic. Kumele ^i-engela 45 mayelana indiza lesemkhatsini sagittal futhi ngezinye engeli kwesokudla emgqeni-orbit Trag. Ngemva ukufakwa inaliti kuya ukujula oyifunayo injected imithi ebulala izinzwa. Anesthesia eba phezu imizuzu emi-5.

amalungiselelo

Posterior aphakeme alveolar ezinzwa block kusetshenziswa ukubulala izinzwa engxenyeni ethile:

1. Lidocaine - lama-derivatives lokuqala amides ezazinemithetho kwemiqondo "Bupivacaine", "Articaine" "Mezokain 'futhi ngezinye izindlela. Isetshenziselwa ngesimo 1-2% isixazululo. Lidocaine kungokwalabo izidakamizwa ongaphakeme intengo isigaba. Is contraindicated in iziguli izilonda organic kwesibindi.
2. Trimekain isuselwe amides. Ngu nekusebenta, isivinini kanye nesikhathi isinyathelo luphakeme procaine izikhathi eziningana. It ikhiqizwa ngesimo izixazululo of lokuhlala ehlukene. Njengoba i- side effect kokuphathwa agent kungenzeka isikhumba pallor, isicanucanu, ikhanda.
3. Umuthi 'Ultrakain ", intengo okuyinto ephakeme izikhathi 1.5-2 kunobukaJohane nabanye abameleli ukubulala izinzwa engxenyeni ethile (ruble isitsha ngasinye 50), has a inzuzo enkulu ukusebenzisa. High okusheshayo umthamo kanye nesikhathi esihle isinyathelo enze kube nokwenzeka ukuba ukuyisebenzisa hhayi kuphela ukuhlinzwa kodwa futhi amazinyo zokufakelwa. Yeka ukuthi kuyinto "Ultrakain"? Intengo zomuthi (i izinzwa lokhu ithuluzi nemitholampilo kwamazinyo in Russia kuyodingeka bakhokhe ruble 250 kuya ku-300) kungenxa ivelaphi angaphandle. Analogs - "Articaine", "Alfakain", "Ubistezin".

Zonke izimali zisetshenziswa lihambisana vasoconstrictor (epinephrine). Lapho ekhetha Uchwepheshe izidakamizwa inquma ukubekezelelana ngabanye kanye umthamo esiphezulu, acabangele engu-isiguli, kanye nokukhulelwa kanye comorbidities.

yezinkinga inqubo

Posterior aphakeme alveolar ezinzwa block, okuyinto Izibuyekezo axutshwa (weziguli wabika umphumela omuhle analgesic, kodwa abanye bakhononda ngokuthi Numb isikhathi eside aluphumeleli, kungafika kumahora angu-5, plus sekushiwo side effects akuzona kuya esilindele kwabaningi), kumele kwenziwe nge onguchwepheshe abaqeqeshiwe, bakwazi inake wonke umehluko wemisindo nemiqondo yamagama umcimbi. Abanye ngenxa yezinkinga kungenzeka kakade kubhekwe. Kufanele kukhokhelwe udaba kwesikhathi ukuyivimba leyo nkinga.

izitsha Balimaze nemfundo emkhakheni hematoma izinzwa ingavinjelwa. Kuze kube yimanje, ngesikhathi inaliti izinzwa abakwazi ulahlekelwe ukuxhumana izicubu amathambo ukwethula ke ngokungenzi ezingaphezu kuka 2,5. Ngemva ekususweni INGENA ISINYENYELA inaliti kwakhiwa injected izinzwa massaged phezulu ngemuva tuberosity maxillary. Posterior aphakeme alveolar ezinzwa block inikwe amandla kuphela ukungabi khona izinqubo ukuvuvukala endaweni ka umjovo.

Kuba kuyingozi isiguli kokuthola isisombululo emgudwini wegazi. ubuthi yayo luyanda izikhathi 10, futhi ubungozi vasoconstrictor - e 40. nesineke kungaba ukushaqeka, nciphisa, yokufikelwa. Ukuvimbela lezi zinkinga, ngaphambi umjovo we izinzwa isipetu plunger edonswa emuva. Lokhu kuqinisekisa ukuthi inalidi akusho hit ibhodlela. Uma kwakuba khona igazi isipetu, udinga ukushintsha isiqondiso yenaliti bese ujova le izidakamizwa.

Ukwephula imithetho asepsis phakathi naleyo nqubo kungaholela ukutheleleka. Ifaka inalithi umlomo wakho, kudingeka uqinisekise ukuthi akazange uthinte izinyo. Hit qwembe kuzoholela ekuthuthukiseni cellulitis.

isiphetho

Ngenxa yenani elikhulu ngenxa yezinkinga yinkimbinkimbi ubuchwepheshe tuberalnoe izinzwa luqhutshwa akuvamile. Kukhethwa izinzwa kufanele esiphathiswe onguchwepheshe.