Kubva kuchipatara chemaonero, zvinonzi pamusoro-hura kana pane kona yepamusoro 30 ° pakati peericle uye musoro wepamusoro kana kana kureba kubva musoro kusvikira kumucheto wekunze we nzeve kunopfuura 2 cm. Mukati yenyaya inoti "Vana chirwere chepurasitiki, vanocheka," muchawana mashoko akawanda anofadza uye anobatsira iwe pachako.
Zvinetso zvepfungwa
Nzeve dziri kukwezva kunyatsoteerera, uye kuvapo kwemazuva ano kunogona kupa munhu pfungwa dzisina kunaka. Pfungwa yemuviri wake inoumbwa mumwana kusvika makore mashanu kusvika ku7 - ndicho chikonzero nei panguva ino vana vanowanzotanga kuseka. Kufungidzira kwepfungwa, kugamuchirwa muhuduku, kazhinji kunobata uye pakukura. Kune varwere vane makore akawanda vakarota kururamisa kukanganisa kwavo pachavo. Kuvhiyiwa kwepurasitiki kunogona kugadzirisa kukanganisa uku uye kuvandudza hupenyu hwomwana uye munhu mukuru. Nzeve yekunze inowanikwa nechetiraginousous base yakavharwa neganda rinopa maitiro aro. Lop-nzeve dzinogona kukonzerwa nechimwe chezvikonzero zvinotevera (kana kusanganiswa kwayo):
• kushayikwa kana kusarura kwe antiflora. Anti-malignancy inogona kuumbwa chirwere. Nzira yekuvhiya inoshandiswa pane dzose dzakadaro inofanirwa nekuenzanisa nekamberi kwepamusoro penzvimbo yekatekete, kunyange zvazvo dzimwe nzira dzokururamisa
• kudzika zvakadzika. Muchiitiko ichi, nzeve inotarisa zvakanyanya kuputika. Kugadziriswa kwebasa nekunyanyisa kwechikamu chekatekete kunogona kugadzirisa kukanganisa uku;
• kutenderera kweanterolateral yeanricle muchitungamiri kubva kumusoro. Kurega kutsva kunogona kushandiswa kushandiswa kwemisasa inoshandiswa kumusana kwepamusoro we nzeve uye zvinyoro-nyoro zvinyorwa zvakananga mushure mezeve (BTE fascia).
Apo kugadziriswa kwekuvhiya kunofanirwa kufungisisa zvimwe zviitiko zvekuremara mune mumwe murwere. Kushandisa nzira dzakashandiswa dzekushandisa, hazvibviri kukwanisa kugadzirisa zvinoda kuvhenekera. Pamberi pekutanga kwebasa, nzvimbo dzezvisarudzo zvakasarudzwa paganda uye mapepa emapuranga ezvinyorwa zvinoratidzwa nechiratidzo chekuvhima chinotyisa. Mukati pakati peganda uye cartilage, nzvimbo inowanikwa munharaunda uye adrenaline inoshandiswa kuderedza kubuda ropa panguva yekuvhiyiwa, kuderedza marwadzo munguva yekushanda, uye nyore nyore kutema ganda. Mushure mokucherechedza nzvimbo yenzvimbo inofungidzirwa kuti inzvimbo ye-anti-curvature uye nzvimbo yekodtilage yakasarudzwa nemushandi wekuvhiya, zvinokosha kutamisa mitsara iyi zvakananga kumusana wekateti nekubatsirwa kwekutema mifananidzo. Izvi zvakakosha kuitira kuti zviratidzo zvionekwe mushure mekuparadzanisa kweganda kubva pamusana. Kuvhara kwenguva refu kwekatekete neine nhongwe kunoitwa pamigero yeganda. Kuvhiya kunotanga 2-3 maminitsi mushure mekutsva kwemaitiro anesthetic uye epinephrine, apo mishonga inotanga kuita. Pamusoro peganda rekunze, sarure sutures inoshandiswa (inonzi suture-holders, iyo iyo inogona kudzora nzvimbo yeanricle panguva yekuvhiyiwa).
Iyo inotungidzirwa inotungamirirwa mberi kuenda padama, uye dumbbell iri panze yeganda yakanyanyisa pamwe chete nehutachiona hwemafuta pasi. Izvi zvinopa ruzivo rwechirwere chekunyengedza kwakakodzera. Sezvo kutemwa kwaitwa pamusana wekunze, shure kwekuporesa, ruvara ruchave rwusingaoneki. Chikoroti chemukati, chinoparadzaniswa neganda, chinoparadzaniswa kuti chiwane rusununguko rwemukati maro. Kuumbwa kwekambani kunogadzirwa pamusoro pepamberi pegoroti. Asi pakukwanisa kusvika pamucheto wechipupuriro, kuburikidza nekucheka kwehutakiti kunowanikwa kure nemamita 3 mm kubva pamucheto, pamwe nechepamusoro pechikamu chenzeve. Ganda riri mberi kwepamusoro penzvimbo yacho rinoparadzanisa kubva kumusana wepamusoro kumucheto wekunzwa nzeve. Mushure mokuputira ganda, katetilage yearicle inoratidzika uye inotanga kuumba mamiriro matsva ehutu. I-sutures panguva ino yekushanda inobata ganda rakaparadzana kunze kwebasa rekushanda. Nhengo imwe neimwe yekateti yemapuranga ane zvimwe zvinetso, izvo zvinowanikwa nepamusoro penzvimbo yemasero ekudzivirira uye perichondrium (tsvina yakawanda yezvibatanidza zvinogunzva maronda). Nokuita izvo zvinongororwa neecalpel mberi kwepamusoro pekatekete, zvinokwanisika kuvhara mhirizhonga uye kuparadzanisa hutachiona hwepashure, zvakangofanana nekunyora kwepamusoro pepaji yepamusoro inotemwa kunamatira kadhibhodhi yakagadzirwa. Mushure mokuputira ganda, katetilage yearicle inoratidzika uye inotanga kuumba mamiriro matsva ehutu.
I-sutures panguva ino yekushanda inobata ganda rakaparadzana kunze kwebasa rekushanda. Munguva iyi nzira, kusanganisa kunoitwa pamusana pekumusoro kwebasa iri mukuderera kunoburuka uye kunakisa kwechidiki chekateti yakasvibiswa. Kuvhara chiremera chedutikiti yemapuranga, maruva anoshandiswa achishandiswa uchishandisa zvinyorwa zvinogadziriswa. Iko kunoderedzawo ukuru hwearicle uye chiyero chekuvhara-nzeve. Kana uchisimbisa zvikwata izvi, mhepo inotendeuka inotendeuka uye inotora nzvimbo iri pedo nepamusoro pehenya. Chikamu chekupedzisira chetiketeti chinodzorwa mushure mekushaya simba kune vane suture-holders. Pakupera kwebasa racho, unofanirwa kuve nechokwadi kuti kubuda ropa kunomiswa zvachose. Kana zvisina kudaro, pasi peganda zvinogona kuumba hematoma (blood clots), kuvhiringidza maitiro ehutu. Chiremera chokuvhiya uye ruvara runofanira kunge rwakanyatsovanzwa mushure mezeve. Izvi zvichavanza chokwadi chekugadzirisa basa. Kushandiswa kwekupfekedza chikamu chakakosha chebasa rekubvisa kuvhara-yered. Iyo bhanji inobatsira kusimba uye kusimbisa nzvimbo itsva yeveve, kusvikira yapera. Iyo jira, iyo yakanyoroveswa muhutachiona, yakafukidzirwa nechokudzivirira chejize. Zvadaro, denderedzwa rakasungirirwa rinoshandiswa kumusoro, iro rakagadziriswa neladhi kuitira kuti rirege kubvisa musoro kana kubuda. Mumazuva ekushanda, zvakakosha kuti uite anesthesia yakakwana. Iko kunowanzogadzirirwa manheru emusi iwoyo kana zuva rinotevera. Mushure mokuvhiya, zvakakosha kupfeka bhanhire remazuva kwemazuva gumi, wozobvisa. Mushure meizvi, murwere anofanirwa kushandisa bhanhire kuenda kune imwe yepamusoro pausiku wemwedzi unotevera. Edema nekupwanya kunowanzoitika mukati pemwedzi miviri. Varwere havawanzodi kudzokorora kushanda, kunyange dzimwe nguva kungave nekukanganiswa kuduku kweericle kubva panzvimbo yakatemerwa.