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Matenda a Edzi: Kodi Mng'oma wa Burr Ndi Chiyani?Gombe la burr ndi dzenje limene limaikidwa m'magazi, lomwe limatchedwanso kuti crane. Mabowo a Burr amaikidwa kuti apangitse opaleshoni yowonjezera, kapena ingakhale yokhayo yomwe imasokonezeka mugaza, malingana ndi momwe zinthu zilili. Chokhachokha, dzenje lakung'onong'ono ndi dzenje laling'ono lomwe limapangidwa mudekha ndi kupaleshoni.
Dothi la burr likhoza kupangidwa pa zifukwa zosiyanasiyana, monga kupanga craniotomy yochulukirapo, kudutsa catheters ya madzi yomwe imalola kuti madzi osakanizika amadzipiritsike kapena kuchotsedwa kwa magazi aakulu .
Mng'oma, kapena nthawi zambiri mabowo, ndi mbali yofunikira kwambiri ya opaleshoni ya ubongo. Chifukwa chiyani? Tsaga ndi lovuta kwambiri, kupangitsa kuti chitsulo chisamatheke. A saw akhoza kugwiritsidwa ntchito kudula fupa, koma kudula chigaza kumapanga luso lapadera ndi njira zothandizira kupewa ubongo ku ubongo. Malo obisala amachititsa kuti azidula mudenga popanda kuika pangozi zovuta kwambiri ku matenda osakanikirana a ubongo.
Ganizirani za chitseko chachikulu ngati chiyambi cha incision kuchita opaleshoni ya ubongo, osati opaleshoni yokha. Malo obisala amachititsa kuti "athe kugwiritsira ntchito madontho" kotero opaleshoni amatha kuyika mabowo angapo, kenaka agwiritse ntchito chida china chogwirizanitsa mabowo ndikukweza gawo la chigaza. Izi zimasiya zenera kuti dokotalayo azigwira ntchito.
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N'chifukwa Chiyani Phokoso la Burr Likugwiritsidwa Ntchito?Phokoso la burr ntchito limagwiritsidwa ntchito ngati pali vuto la ubongo lomwe liyenera kuchitidwa opaleshoni. Kuti athe kupeza minofu ya ubongo, crane (kapena fupa) liyenera kutsegulidwa kuti lilowetse ubongo. Pa opaleshoni yambiri, kuyika dzenje mugaza ndiyo njira yabwino yothetsera kuvulala kapena matenda.
Pali zifukwa zambiri zomwe dokotala amafunikira kuchita opaleshoni ya ubongo yomwe imayamba ndi dzenje. Zifukwa zimenezi zingakhalepo:
- Kuthetsa kupanikizika pa ubongo
- Kuyamba kuyambira kwakukulu, monga craniotomy
- Kuyika makanema omwe amawerenga kupsyinjika mkati mwa chigaza
- Kuchotsa magazi
- Kuchotsa chotupa
- Pofuna kupweteka
- Kuchotsa chinthu chachilendo
- Kuika chipangizo chamankhwala, monga shuff kapena chemotherapy wafers
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Kuopsa kwa Njira ya Burr HoleKupaka malo oopsa kumakhala ndi zoopsa zazikulu, kuphatikizapo zoopsa zomwe zimagwiridwa ndi opaleshoni yonse ndi mavuto a anesthesia . Monga momwe opaleshoni iliyonse imachitira, ngozi za ndondomekozi ziyenera kuyeneredwa ndi zomwe zingathandize. Nthawi zina, chiopsezo chovulazidwa mpaka kalekale kapenanso kufa chingakhale chosiyana ndi opaleshoni, kotero kuti chiyenera kuganiziridwa posankha opaleshoni.
Nthawi zina - kawirikawiri pambuyo pangozi kapena kuvulala kwa ubongo - opaleshoni ikhoza kuchitidwa ngati njira yomaliza. Pazochitikazi, kuopsa kwa ndondomekoyi ndipamwamba kwambiri, koma kusachita opaleshoni kungapangitsenso imfa, motero chisankho nthawi zambiri chimakhala chovuta kwambiri.
Kuopsa kwa opaleshoni yopangira bwalo la burr ndilo:
- Kusaka
- Kusuta
- Sitiroko
- Kutengera kwa incision kapena ubongo
- Kusuntha kwa ubongo
- Kuwonongeka kwa ubongo, kuphatikizapo kusintha kwa maganizo, mavuto a kukumbukira, mavuto oyanjanitsa ndi kulephera kwa kulankhula
- Kutupa kwa ubongo
- Coma
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Njira ya Burr HoleKuchita opaleshoni yachitsulo kumachitidwa ndi katswiri wa opaleshoni, dokotala wochita opaleshoni wophunzitsidwa makamaka mu ubongo ndi opaleshoni ya msana, wotchedwa kuti kafukufuku wamagetsi .
Pofuna kubisala, malo a scalp omwe adzayikidwa ayenera kuvekedwa tsitsi. Ndiye khungu lidzakonzedwa ndi njira yapadera yokonzedwa kuti athetse majeremusi pamwamba pa khungu. Pamene mutu umatha kuvekedwa musanachitike opaleshoni, chithunzithunzi cha khungu chidzachitidwa mu chipinda chogwiritsira ntchito. Izi zikhoza kuchitidwa mwamsanga musanayambe kapena pambuyo poti anesthesia yaperekedwa, ndipo nkofunika kuchepetsa chiopsezo cha matenda.
Pambuyo pa opereka mankhwala a anesthésia apereka malo okhala, wodwalayo amatha kuvulala ndi kuikidwa pa mpweya wabwino , ngati sakulandira thandizo ndi mpweya wawo. Izi zimachitidwa pofuna kuteteza mlengalenga ndi kutulutsa oksijeni pa opaleshoni.
Posakhalitsa, anesthesia idzayamba kugwira ntchito, ndipo wodwala adzaikidwa opaleshoni. Izi zimachitidwa chimodzi mwa njira ziwiri: Mutuwo umathandizidwa pa mapilo kapena talasi, kapena piritsi zingagwiritsidwe ntchito, zomwe zimagwiritsira ntchito mutu womwe uli woyenera kwambiri opaleshoni. Catheter ya foley imayikidwa panthawiyi, ngati ilibe kale panthawiyi.
Kamodzi kogwiritsidwa ntchito bwino, kapangidwe koyamba kamapangidwa pamutu, kuti khungu lichotsedwe kuchoka ku malo opaleshoni. Kuwombera kwapadera kumagwiritsidwa ntchito kuti alowe mudekha. Ngakhale kubowola kungawoneke ngati kubowola, kalinganizidwa kuti asiye kubowola kamodzi kagawa kakalowa, kupewa kuvulala kwa ubongo.
Opaleshoni ina ya ubongo, monga ventriculostomy, imangofuna malo amodzi okha kuti achite opaleshoni. Nthawi zina, malo ena amatha kuikidwa, kenako mabowo amagwiritsidwa ntchito pogwiritsa ntchito fupa lapadera la fupa. Izi zimathandiza gawo la chigaza kuchotsedwa, njira yomwe imatchedwa craniotomy, yomwe imapatsa dokotalayo mwayi wambiri woti agwire ubongo.
Pambuyo pake, phokosolo liyenera kupangidwa mu dura. Zomerazi ndizovala zolimba pa ubongo. Ngakhale kuti ikuoneka ngati filimu yopyapyala, imakhala yamphamvu kwambiri ndipo imayenera kusunthira pambali.
Zotsatira zonsezi zimachitika kudzera mu dzenje la burr kapena craniotomy. Mukamaliza, sitimayo imatha kudulidwa pamodzi kapena kutsekedwa kumatseguka. Khungu lidzabwezeretsedwanso mmalo ake omwe amadziwika ndi malo omwe amagwiritsidwa ntchito kutseketsa incision.
Malingana ndi momwe opaleshoniyo imachitira, mutuwo ukhoza kukulumikizidwa ndi mabanki kapena malowo akhoza kukhala ovala zochepa.
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Kubwezeretsa Pambuyo pa Kuchita Opaleshoni YoyendaPalibenso njira zowonongeka pambuyo poika malo a burr, popeza zifukwa zomwe zimayendera zimasiyana kwambiri. Pazifukwa zovuta, wodwalayo angakhale wopanda chidziwitso ndipo akuchiritsidwa ku ICU kwa masiku kapena masabata mutatha njirayi, pamene odwala ena akhoza kukhala ogalamuka ndikukhala mwachizolowezi posachedwa atachoka ku anesthesia.
Nthaŵi zambiri, wodwalayo adzabwezeretsedwa ku ICU, monga ICU yopanga opaleshoni kapena neuro ICU, kumene angayang'anire mosamala ndi antchito. Izi zimapangitsa wodwalayo kuti asamalire nthawi zonse kuchokera kwa anamwino komanso kuti zizindikiritso za mavuto zichitike mwamsanga.
Kuopsa kwa chovulala kapena matenda kudzalimbikitsa momwe wodwalayo akubwerera mwamsanga, ndipo ngati abwerera ku chizoloŵezi. Kwa ena, kubwerera kuzochita zawo ndi makhalidwe awo kungakhale pang'onopang'ono; kwa ena, pangakhale umboni wochepa wakuti iwo anali ndi opaleshoni yotereyi masiku angapo m'mbuyomo.
Kusamalira mankhwalawa kudzakhala kofunika kwambiri, popeza matendawa amatha kufikira m'magulu a ubongo. Kawirikawiri, mankhwala opha tizilombo adzapatsidwa kuti tipewe matendawa, ngakhale palibe matenda omwe alipo tsopano.
Nthenda yotchedwa neurosurgeon yomwe ikuchitidwa opaleshoni idzakhala njira yanu yabwino yowunikira zokhudzana ndi mtundu wanji wa kuchira komwe muyenera kuyembekezera. Adzatha kuganizira thanzi la wodwalayo, kuopsa kwake kwa kuvulaza kofunikira, komanso msinkhu, ndi zina zomwe zimathandiza kuti athe kuchira.
Mawu Ochokera:
Nthawi zonse zimakhala zovuta pamene munthu akusowa chingwe choikapo, kaya ndi kufufuza kapena kulola opaleshoni yovuta kwambiri. Mukhoza nthawizonse kuyembekezera kuti chithandizo cholimba chikhalebe chowunika nthawi zonse, ndipo kuchira kungakhale kovuta. Mosakayikira chifukwa cha opaleshoni, opaleshoni ya ubongo idzafuna nthawi yochulukirapo ya wodwala poyerekeza ndi opaleshoni yowonjezereka.
Zotsatira:
Phokoso lamoto: Hematoma yodziwika. Neurosurgery PA. Inapezeka mu March 2011. http://www.neurosurgerypa.com/procedures/Burrhole.html
Ngozi Zopangira Ubongo. Chipatala cha Medical University ku Maryland. Inapezeka mu March 2011. http://www.umm.edu/ency/article/003018ris.htm