Ukuhlinzwa kancane koda: nezikhungo

ubuchwepheshe Medical akuyona emi namanje; ukuthuthukiswa yabo kakhulu yandisa amathuba - kokubili isinyathelo zokuxilonga nokwelapha.

Ikakhulukazi, ngenxa ukuthuthukiswa esebenzayo of amasu endoscopic is ziyasatshalalaiswa ukuhlinzwa kancane koda. Cabanga ukuthi kuyini, kulesi sihloko.

Kungani ngidinga ukuhlinzwa kancane koda

Zonke ubuqili yaleli su okuhloswe ngaso ukunciphisa imiphumela ebuhlungu emzimbeni wesiguli, okuyinto azinakugwenywa e kokungenela kuhlinzwa.

Izibonelo amasu kungenzeka Endoscopy nokuhlinzwa laparoscopic.

Inhlanganisela laparoscopy nge izindlela ukufinyelela izitho zangaphakathi kungabuye chasiselwe ukuhlinzwa kancane koda.

ngenxa yokuthandwa kwayo, kulula ukuchaza.

Le nqubo ihlangabezana kokubili izithakazelo isiguli (imithelela le misebenzi sakugcina), futhi izithakazelo izimo zenhlalo yomphakathi nezomnotho (ngokusebenzisa ukuhlinzwa kancane koda, kungenzeka ukuba kakhulu ukunciphisa isikhathi ukuhlala lesiguli esibhedlela.

Laparoscopy iye kabanzi ezisetshenziswayo ekuhlinzeni ezingane besisu: izingane iningi imisebenzi ezithweni besisu kwenziwa laparotomy. ukuhlinzwa Laparoscopic kungenzeka izingane zabo bonke ubudala. Futhi for the iziguli kancane bobudala obungefani inikeza ithuluzi kits laparoscopy, kokuba diameters ezahlukene.

Kwabesifazane abakhulelwe, kungenzeka ukuhlinzwa laparoscopic sincane kakhulu.

izinzuzo

• Ukulimala umzimba lesiguli phakathi nokuhlinzwa, kwenziwe ngokuhambisana namasu ukuhlinzwa kancane koda, kakhulu ngaphansana lesizinda evamile tekusebenta.
• I yesikhathi eside embhedeni ukuphumula ngemva kokuhlinzwa kancane koda akudingekile. manipulations ezinjalo eyenziwa emitholampilo ezikhethekile ukuhlinzwa kancane koda (okuthiwa imitholampilo wosuku olulodwa).
• Nizkotravmaticheskie ukuhlinzwa is kahle ikubekezelele iziguli.
• Level kwezicubu esicindezelayo lezi manipulations kuyinto aphansi ngenxa ukunciphisa isikhathi kokungenela; futhi ezingeni eliphansi ukuhlukumezeka kungandisa imiphumela zokwelapha kanye yezimonyo.

Izibonelo kusukela emlandweni konke kwaqala kanjani

Ukusebenza laparokopicheskaya lokuqala kakhulu kwenziwa eFrance in the 80s yekhulu lama-20. Eminyakeni embalwa kamuva, le ndlela seyenziwe kwisicelo mass.

Ngemva ekuqaleni ukusetshenziswa ehlelekile yaleli su lithole ukuthuthukiswa ngokushesha futhi ngesikhathi esifushane sekuthandwa kakhulu.

Nebubi ukungenelela kancane koda

• Ukuhlinza kusetshenziswa amasu endoscopic, ungavumeli palpation ijwabu.
• Isidingo ukufaka imishini zobuchwepheshe esibhedlela noma ukudalwa izikhungo olukhethekile ukuhlinzwa kancane koda; izindleko aphezulu imishini enjalo.
• Isidingo ukuthola izisebenzi zezokwelapha amakhono ukusebenza imishini zobuchwepheshe.

laparoscopy

Lolu hlobo lokuhlinzwa kancane koda singasetshenziswa ezimweni ezilandelayo:

• ukungazali Female.
• Ukwelashwa nokuvikelwa endometriosis.
• izinhlumba wesibeletho.
• lesizalo fibroids.
• ukhulela ethunjini.
• Ukususwa we gallbladder.
• Ukususwa izimila elincane izitho zangaphakathi.
• Ukususwa kwezimiso zamanzi.
• Ukwelapha pathologies ezithile semithambo.

kokungenela Steel iqala neqiniso ukuthi anterior udonga besisu, wenze ezintathu noma ezine wokubhoboza. Ngemva kwalokho therethrough emzimbeni injected carbon dioxide edingekayo ukuze wandise ivolumu ye umgodi futhi ekwakhekeni nendawo eyanele msebenzi. Ngokulandelayo, nge omunye punctures owethulwa ikhamera, elibonisa ku qapha yokusebenza ensimini, izitho zangaphakathi namathuluzi zokukhwabanisa okokufaka ngokusebenzisa punctures asele.

Mini-laparotomy (mini-ukufinyelela)

Eqinisweni, kulesi simo, ukusebenza ezivamile kuhlinzwa, kodwa ngokusebenzisa imbobo ezincane kakhulu ukuthi yenziwe yaba khona ukusetshenziswa isethi okhethekile amathuluzi. Ngale ndlela, izinqubo eziningi kuhlinzwa ezithweni besisu engenziwa.

Endoscopy

Le nqubo ibizwa esetshenziswa ukuhlola izitho zangaphakathi kokuba isakhiwo eziyize, futhi kwenziwe ngosizo amathuluzi akhethekile - endoscopes.

Endoscopic ukuhlinzwa kancane koda, ngokungafani laparoscopy isebenzisa punctures noma ukusikeka; amathuluzi yezokwelapha afakwa izitho eziyize ngokusebenzisa orifices zemvelo. Ngakho, sokuthola zokukhwabanisa enjalo kwenzeka kakhulu kulula.

Ngakho, emitholampilo kanye nokuhlinzwa endoscopic futhi kancane koda endoscopic neminyango esibhedlela izakhiwo wahlola elandelayo izitho:

• emphinjeni;
• esiswini;
• amathumbu;
• amalaka;
• kuqhoqhoqho;
• bronchi;
• esinyeni.

Ngaphezu luhlolo, Endoscopy futhi inikeza amathuba izinqubo zokwelapha, efana esiswini ukopha izitobhi, kokukhipha usayizi encane isisu izimila emathunjini. manipulations anjalo enziwa ezibhedlela ezejwayelekile kanye emitholampilo ezikhethekile (isib, umtholampilo Coloproctology futhi kancane Okuhlaselayo Ukuhlinzwa).

isikhathi nokuvuselelwa

Ngenxa ezingeni eliphansi traumatization kwezicubu futhi izitho imisebenzi eyenziwa ngokuhambisana nezimiso lokuhlinzwa kancane koda, isikhathi nokuvuselelwa emva kokuhlinzwa okunjalo isikhathi esincane futhi ibekezelelwe kahle iziguli.

Ukuqokwa nokunwetshiwe embhedeni ukuphumula usebenzisa izindlela ukuhlinzwa malotravmaticheskih akudingekile.

Ubuhlungu syndrome kakhulu kancane evelele at imisebenzi ezincane, leli qiniso kwenza kungabi kungenzeka ukugwema ukusetshenziswa kwezidakamizwa, okuqondene iqembu analgesics, futhi kungakho emibi yawo.

Lapho ukuhlinzwa kancane koda asifanele

Naphezu zonke izinzuzo amasu ukuhlinzwa kancane koda singasetshenziswa kuzo zonke izimo. Ezinye ukuhlinza nokuhumushela olimini isigaba nizkotravmatichnyh ehluleka.

1. Ukuba khona ukuvuvukala kule komgodi ongaphakathi kwamathumbu. Leli qiniso kuyinto isithiyo ingxenye imisebenzi enjalo. Ikakhulukazi eziyinkinga amacala lapho isiguli inomlando ukungenelela amaningi kuhlinzwa, okuholela kwetinhlavu ukuvuvukala. Nokho, kwezinye izimo, lapho isiguli uyenqaba laparoscopic ukuhlinzwa kule komgodi ongaphakathi kwamathumbu ngenxa yokubakhona ukuvuvukala, ukuhlinzwa awufezi okubizwa ngokuthi mini-ukufinyelela. Akukho algorithm olulodwa awukho; It isinqumo uma ngayinye.
2. Izifo uhlelo senhliziyo nemithambo yegazi kanye namaphaphu e esiteji decompensation. Lokhu kungenxa yokuthi i-laparoscopy kudinga yethula ngaphakathi komgodi ongaphakathi kwamathumbu-carbon dioxide; futhi lokhu, esikhundleni salokho, kuholele ukwanda ingcindezi naphakathi-besisu nokudala ingcindezi eyengeziwe ku diaphragm, futhi ngenxa yalokho, kwi zeNhlangano ingaphakathi esifubeni. Iziguli cardio-yamaphaphu esingamahlalakhona ukuchayeka esinjalo siholela ukuwohloka.
3. I ukwanda okukhulu kwezincwadi isisindo lesiguli. Ukukhuluphala lwesithathu futhi degree wesine nakho kungase kube contraindication ukuhlinzwa laparoscopic ngenxa yokuthi ukufinyelela ku kwezitho zangaphakathi kulezi zimo kungase kunganeli obuphelele amathuluzi. Ngaphezu kwalokho, ngenxa mass eziphakeme anterior udonga besisu iziguli enjalo ezimweni eziningi awukwazi ukwakha pneumoperitoneum.
4. nomfutho wegazi ophezulu Ocular, e-glaucoma ethile. Pneumoperitoneum kungabangela ukwanda ingcindezi intraocular, eziya ziba zimbi lesi sifo kanye nezinkinga (isib lamabutho ngwengwzi).
5. Izinga eliphezulu myopia - kuze kufinyelele diopters eziyisithupha (ngenxa yesizathu esifanayo - ukuvimbela lamabutho ngwengwzi). Nokho, kwezinye izimo kungase kube okuhlukile, isibonelo uma ukuchayeka zesikhashana noma laparoscopy malogazovoy lapho ingcindezi besisu liphume kancane.
6. Izifo kohlelo igazi, libhekene kahle ikhono layo ihlule. uthi okunjalo zigcwele ukopha kakhulu, okuyinto akwamukeleki.

Lapho esegugile ngokuvamile eqoshiwe lahlukene izimo, kuyinto contraindication ukuhlinzwa laparoscopic. Ezimweni ezinjalo, iziguli Ngahlinzwa ngoba mini-ukufinyelela amasu kokuba kakhulu kungekho Izimo ezivamile.