Kachilomboka kameneka kanali kovomerezeka m'chaka cha 1969 chifukwa chogwiritsira ntchito kuchotsa zotupa m'mimba mwachangu. Kuchokera nthawi imeneyo, kugwiritsa ntchito microdebrider kunayambitsidwa ngati chipangizo chogwiritsira ntchito m'matumbo ndiyeno opaleshoni yamphongo ndi yoposerapo m'zaka za m'ma 1990. Chida ichi ndi chimodzi mwa zinthu zofunika kwambiri zomwe zakhala zikulowetsedwa mu rhinology.
Tizilombo toyambitsa matenda ndi chida chokhala ndi chida chokhala ndi mkati ndi kunja. Kumapeto kwa chubu, mbali zonse zamkati ndi zamkati za chubu zimakhala ndi tsamba lomwe limadula minofu monga momwe tsamba limathamangira patsogolo. Catheter imagwiritsidwa ntchito mofulumira kwa chipangizo kotero kuti mdulidwe umachepetse ndikuchotsedwa kumalo opaleshoni. Zipangizo zamakono zimathamangitsa zidutswa zing'onozing'ono, pamene pang'onopang'ono masambawo amatha, zimakula kwambiri. Makhalidwe abwino ndi abwino kwambiri kuti agwiritsidwe ntchito ndi matenda ngati khansara kapena kuunika kwina kumeneku kumafunika kuchitidwa.
Njira Zina
Asanagwiritse ntchito ma microdebriders, opaleshoni ya sinus kawirikawiri imaphatikizapo kugwiritsa ntchito mwambo wamachiritso ndi forceps. Imeneyi inali njira yopangira fupa ndi minofu kuchokera kumapanga ndi minofu. Kukonza mphamvu ndigwiritsanso ntchito chipangizo china chomwe chingagwiritsidwe ntchito pochita opaleshoni.
Tidzafufuza ubwino wogwiritsira ntchito tizilombo toyambitsa matenda tawabweretsa ku chipatala. Komabe, pakuchita, madokotala ochita opaleshoni nthawi zambiri amagwiritsa ntchito magulu a curettes, microdebriders, ndi forceps.
Phindu
Ma microdebriders ali ndi ubwino wambiri. Yoyamba ikuphatikizapo malingaliro osiyanasiyana omwe angagwiritsidwe ntchito. Malinga ndi mtundu wa ndondomeko yomwe ikuchitika, zina zomwe zimapezeka zimabwera ndi zothandizira, zomwe zimapangitsa kuti mukhale ovuta kupeza malo ovuta opaleshoni (monga ziwonongeko za paranasal).
Malangizo ena amavomerezanso kutembenuka kwa digirii 360 (monga Straightshot M4 pa chithunzi pamwambapa), chomwe chimapereka njira zowonjezereka za minofu yomwe ikuyenera kuchotsedwa.
Mabomba angasinthidwenso ndi microdibrider. Mabala okwera mozungulira ali olondola kwambiri ndipo akhoza kukhala okhumudwa pang'ono kuposa masamba ena. Ngakhale mazira otentha amathandizira bwino dokotala wa opaleshoni. Madzi awa akhoza kukhala ndi liwiro losinthidwa kuti alole kuti mwamsanga kudula kudula komanso kudula mafupa. Njira zowonjezera zomwe zingagwiritsidwe ntchito pafupa ndizo:
- Septoplasty yogwirizana ndi seveni yosokonezeka
- Sewal yasokoneza resection
- Dacryocystorhinostomy yogwirizanitsidwa ndi njira yosawonongeka
Ngakhale kugwiritsidwa ntchito kwa microdibrider sikungachepetse chiopsezo chokhala ndi magazi, kupitilira kumapangitsa ochita opaleshoni kuti awonetsetse kuti malo opaleshoniwa akhale omveka kwa nthawi yaitali. Izi zingachepetse nthawi yochulukitsa yopaleshoni yomwe ikufunika kuti mupange opaleshoni yanu mwa kuchepetsa nthawi imene dokotalayo akufunikira kusintha zosintha. Ena opanga tizilombo tating'onoting'ono tomwe timapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda timapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.
Kuipa
Chinthu chimodzi chochepa chokhudzana ndi kugwiritsidwa ntchito kwa microdebrider mu malo opaleshoni ndi mtengo wogwirizanitsa ndi chipangizo chimodzi ndi malo omwe amalowetsamo poyerekeza ndi zida zambiri za chikhalidwe.
Komabe, mchitidwe weniweni, izi sizikukukhudzani ngati wodwala. Zida zamagetsi zimapangitsa kuti madokotala apite opaleshoni yanu. Izi zimapangitsa kuti zikhale zovuta kudziwa zinthu zina za minofu yofewa kuzungulira chikhomo. Izi zimakhala zosadetsa nkhaŵa pamene akuchotsa fupa ndi microdebrider.
Mavuto omwe amagwiritsidwa ntchito pogwiritsa ntchito microdibrider ndi ochepa; Komabe, nkofunika kuti mumvetse mavuto alionse omwe angagwirizane ndi opaleshoni yanu. Chifukwa cha kugwiritsidwa ntchito kwapamwamba kwambiri, palinso malipoti ena a kuwonongeka komwe kwachitika.
Pakhala pali 2 milandu yokhudza kuvulala kwa diso yomwe imayesedwa kuti ikugwirizana ndi mphamvu ya kuyamwa kwa microdibrider komanso kachilombo kamodzi kowonongeka kwa thupi (kutaya mpweya kuzungulira ubongo). Mauthenga awa ndi osowa kwambiri ndipo ma microdebriders amagwiritsidwa ntchito padziko lonse lapansi tsiku ndi tsiku. Ambiri a microdebriders ndi zipangizo zotetezedwa pogwiritsa ntchito opaleshoni ya sinus.
Chitsime:
Bruggers, S. & Sindwani, R. (2009). Makanema a Otolaryngologic a North America. 42 (5), 781-787