Ukusebenza Troyanova-Trendelenburg - kuyini?

Eminyakeni yamuva, varicose emithanjeni usezuze ukuthambekela rejuvenation. Wonke umuntu wesifazane sesithathu namanje isifo abaseminyakeni yokusebenza. Phakathi kwabantu, oyedwa ehlupheka eziyishumi. Thrombosis noma thrombophlebitis - kwetintfo esiyingozi yesifo emithambo yegazi. Kulokhu-ke kubalulekile ukusebenzisa crossectomy (operation Troyanova-Trendelenburg).

Izici varicose emithanjeni

Varicose emithanjeni ibizwa ngokuthi isifo ahlobene nezinguquko unomphela odongeni semithambo, ukwandiswa kanye ukwandiswa izitsha lapho kumiswa ziboya ifindo, futhi eminye kwegazi.

Lower esitho emithambo yegazi inethiwekhi umelwe olukha phezulu futhi ngokujulile izitsha ukuxhumana nomunye. Uhlelo ebusweni siqukethe emithanjeni ezinkulu nezincane saphenous. siqala Iningi labantu endaweni imbilapho kanye itholakala engxenyeni engenhla senyonga ukuwela vein ezijulile femoral.

Varices ephelezelwa izinguquko ingcindezi intravascular, okwehlisa ukugeleza kwegazi, izinqubo amile. Imikhumbi kuthiwa osuke usuvulekile, agcwele igazi. Uhlelo umphini emithanjeni ayisekho lapho zibhekene nomsebenzi alawule egazini sohlangothi olulodwa, i-izimfanelo for kumiswa igazi Reflux (nokujikijela emuva). Ngokuvamile kuba kulezi zikhathi isithombe emitholampilo ye isifo ngawo ugcwaliseka ngokugcwele, elibangela isiguli lapho ebonisana udokotela ohlinza imithambo yegazi.

Ngokuvamile kukhethwa ochwepheshe kuba operation Troyanova-Trendelenburg. Yini-ke, indlela ukuthi kwenziwe yini umphumela we kokungenela, ukuwucabangela ngokwengeziwe.

I crossectomy injongo

Lo chwepheshe kufanele umsebenzi oyinhloko - balahle Reflux futhi ukuqeda izinqubo amile e emithanjeni varicose washintsha. Ngakho indlela ayeke ukugeleza kwegazi ngosizo imithi akunakwenzeka, indlela kuphela babe empambana iziguli semithambo nemingenela yabo.

Crossectomy (ku Troyanov-Trendelenburg operation) ubhekwa ukungenela olukhulu. It wenziwa uma varices yezinkinga (isib thrombosis noma phlebitis) noma njengoba isixhumanisi ekwelapheni eziyinkimbinkimbi.

Ngokungafani crossectomy ngu phlebectomy

Muva nje phlebectomy (venectomy) kwakubhekwa njengesenzo kukho kakhulu ekwelapheni varicose emithanjeni. It wenziwa ngaphansi izinzwa emgogodleni esibhedlela. Ukusebenza kwahluka kakhulu kuhlasimulise kanye nokuthuthukiswa yezinkinga nasezinkingeni ezilandela ngemva kokuhlinzwa. Ngokushesha Imiphumela flebektomii waqala ukubonisa ukuthi kubalulekile ukuthola indlela olukhulu ngokwengeziwe ukuze kuncishiswe amathuba okuba nesifo sokuphinda.

Venectomy ephelezelwa ukweqa vein omkhulu saphenous ethangeni engenhla, kodwa hhayi eduze anastomosis, okuholela ekungeneni kakhulu resumption of ziyamaniswa nokungangeni Reflux safeny mayelana fistula. Lapho inkinga iphinde ibuya kuzo zonke nesineke wesithathu.

Yesimanje crossectomy ke esekelwe yokuthi Imi futhi empambana abazenzi ngqo ngesikhathi confluence vein ezijulile femoral, futhi umphumela waba ukuthi akukho Reflux igazi ohlelweni ezijulile.

Izinkomba lokungenela

Ukusebenza Troyanova-Trendelenburg labetibambile ngokushesha ezinsukwini zokuqala ngemva kokwakhiwa thrombosis, inguquko sokunqanda inqubo sokugembula nge olukha phezulu uhlelo emithambo yegazi otweni.

Izinkomba lokungenela kukhona uthi ezilandelayo:

• thrombophlebitis ezingeni kwedolo nangaphezulu;
• thrombophlebitis, yezinkinga ubovu izinqubo;
• thrombosis yansukuzonke noma lowo ongenakho, utsheleke ngokwalo kwamanye izinqubo ukwelashwa;
• thrombosis ka ezingeni kwedolo nangaphezulu.

Izimo

Kubalulekile ukuqonda ukuthi ukusebenza Troyanova-Trendelenburg whose fakazi is esiphuthumayo, ungacabangi khona Izimo. Kulokhu sikhuluma ngempilo isiguli.

Lapho sihlela kokungenela wezazi lakhomba inani izici lapho ukuhlinzwa akuyona efiselekayo:

1. isifo ukuphathwa kwabathintwayo - umzimba lesiguli buthaka kakhulu, futhi iyiphi ukusebenza lidinga wazama ukubuyisela. Esimweni esinjalo kubalulekile ukusebenzisa izindlela kancane ezinqala yokwelashwa.
2. Isifo sokuqina kwemithambo yegazi wemikhawulo aphansi ezinzima.
3. Ngesikhathi ekhulelwe noma lactation.
4. Ukuba khona kwezifo ezithathelwanayo noma ubovu ukuqubuka endaweni ukungenelela kuhlelwe.
5. Izimo lapho akunakwenzeka ukuchitha kokucindezelwa ezinhle imilenze emva kokuhlinzwa (ukukhuluphala ezinzima).
6. Thrombophlebitis noma deep vein thrombosis.

Ukusebenza Troyanova-Trendelenburg kudinga kusebenze okusheshayo isiguli emva kokungenela, ukuze isifo lapho isiguli singenakukwazi ukuvuka ngosuku lwesibili, kubhekwe ngamunye.

Ukulungiselela ukuhlinzwa

Njengoba ezikhathini eziningi isiguli ifika i kokungenela eziphuthumayo, inhlolovo udlule esiphansi ayimpoqo:

• ukuhlolwa evamile egazi noma omchamo;
• igazi oyisazi samakhemikhali ezinto eziphilayo;
• coagulation;
• ucwaningo ku ugcunsula, isifo sokusha kwesibindi kohlobo;
• ukuhlolwa i-HIV.

Udokotela kuboniswane wokuthi yadalwa khona izifo ukuphathwa kwabathintwayo, okuyinto babé contraindication. Futhi kwenziwe emithanjeni ultrasound ukucacisa kwasendaweni anastomoses, indawo yegazi iziguli, tigameko inqubo sokugembula.

Ngemuva kokwenza i-izilinganiso kunesidingo, udokotela ohlinza imithambo yegazi uchaza indlela kokucindezelwa amasokisi noma ngebhandeshi nokunwebeka kumele ithengwe ukuze afeze kokucindezelwa nemilenze ngokushesha ngemva kokuhlinzwa.

Inkambo ukusebenza

Ukusebenza Troyanova-Trendelenburg, amasu based edinga ikhono eliphezulu udokotela ohlinzayo, kusetshenziswa izinzwa wendawo noma jikelele. Kukhethwa izinzwa kwenza obulala izinzwa, wokuxhumanisa yonke imininingwane ngqo isiguli.

Ukusebenza Troyanova-Trendelenburg futhi echazwe esihlokweni siqukethe izinyathelo ezilandelayo:

1. indawo Steel ziphathwe izixazululo isinqandakuvunda, isicelo amashidi oyinyumba, alikushiyi ukufinyelela.
2. Udokotela ohlinzayo imbilapho Uyaphenya ishayela we Umthambo femoral, ngaphansi oludlula medially futhi kancane Vienna ongama.
3. izici yokwakheka yazo zonke iziguli zihlukene, futhi ngaleyo ndlela indawo ngemithambo ezahlukene. I imbobo wenziwa, kuye ngokuthi indawo enkulu saphenous vein anastomosis.
4. Ngemva Imi udokotela ohlinzayo ufinyelela emithambo yegazi ugongolo, amabhandishi futhi enquma ke.
5. Saqokomisa elikhulu eVienna saphenous endaweni lapho agelezela uhlelo ezijulile, ligated nginqume. Kuleli qophelo, ne amahlule ihambe.
6. Ngokulandelayo, ngendlela efanayo awavikelekile waquma umthambo nemingenela okungenani ezinhlanu kanye ubude bayo (ukusikeka ezengeziwe ambalwa wenza njengoba kudingekile). It is olwenziwa yokuvimbela reverse igazi Iqoqo isifo Ukuphinda.
7. Zonke sebeziqhumbuza sutured, ibekwe endle.
8. On emkhawulweni aphansi kungezi phezu kwakho ingubo kokucindezelwa noma ngebhandeshi nokunwebeka.

Ukusebenza Troyanova-Trendelenburg ezihambisana yisihlungu kanye kumiswa amahlule, ngakho uma ochwepheshe eziphuthumayo ungazami ukususa okuningi imithambo kanye esiphezulu endaweni inqubo sokugembula ukunqampunwa.

Isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa

Ngosuku lokuqala isiguli uchitha embhedeni. Lokhu kungenxa imiphumela engemihle evela izinzwa. Ngosuku lwesibili ikhombisa ukusebenza isiguli ukuze engcono uyivikele kusukela ekusetshenzisweni of thrombosis. Soreness kuyinto ngokulinganisela, kodwa udokotela utjho relievers ubuhlungu noma izidakamizwa nonsteroidal eqeda ukuvuvukala, uma kunesidingo.

Imfuneko kokucindezelwa ezanele wemikhawulo aphansi, esiqhutshwa namanje isikhathi esingaphezu kwenyanga ngemva kokungenela.

Kufanele kucatshangelwe ukuthi imisebenzi ukuze kuvinjelwe izinqubo amile ohlelweni umthambo (ukuhamba, umsebenzi yokwelapha).

yezinkinga Okungenzeka emva kokuhlinzwa

Ukusebenza Troyanova-Trendelenburg, yezinkinga okuyizinto ezingavamile kakhulu, libhekisela izindlela ezinkulu ukwelashwa. Kuyinto imbangela njalo izinkinga phakathi kwezicubu ukuhlukumezeka kokungenela (okuyinto kungagwenywa cha), kanye ukwephulwa kuthengiselana art. Isiguli okungenzeka ukuthuthukisa pathologies ezilandelayo:

• ukopha;
• hematoma endaweni yokungenela;
• isifo isilonda kuhlinzwa;
• iziyaluyalu uhlelo lymph kumiswa conglomerates fibrosis;
• paresthesia (ukuphazamiseka ukuzwela kwesikhumba lapho eqa kwalapho kuhlangana khona imizwa);
• lymphorrhea (outflow ka-lymph kusukela empambana we lymph).

Ezinye yezinkinga ayazimela, kuyilapho ezinye zidinga ukwelashwa okwengeziwe. Hematoma ezimweni ezimbi kakhulu, kube kokujeziswa okuqhubekayo lubhoboze elashwe ngemithi elwa namagciwane. Ukutheleleka amanxeba futhi kudinga ukusetshenziswa ejenti elwa namagciwane (penicillins, macrolides, cephalosporins). ukuzwela Ukuphazamiseka kubuyiselwa ngokuzimela, akudingi letengetiwe.

isiphetho

Omunye izindlela ezinkulu ukwelashwa eyinkimbinkimbi varicose emithanjeni kanye nezinkinga salo ukusebenza Troyanova-Trendelenburg. Inkambo ukusebenza kubonisa indlela yokuthuthukisa uhlelo ukuqeda Reflux nokuvinjelwa Ukuphinda lesi sifo. Ukuhambisana iseluleko yokusebenza Uchwepheshe ukugwema isidingo re-ukwelashwa.