Operation Troyanova-Trendelenburg - yintoni na?

Kwiminyaka yakutshanje, varicose yegazi iye Ndizuze utyekelo lobomi. Wonke umfazi wesithathu uba kusekho isifo yokusebenza ubudala. Phakathi kwabantu, omnye ehlupheka ezilishumi. Thrombosis okanye thrombophlebitis - kwingxaki eyingozi sifo lwemithambo. Kule meko kuyimfuneko ukusebenzisa crossectomy (Troyanova-Trendelenburg operation).

Iimpawu emithanjeni varicose

Varicose emithanjeni kuthiwa isifo ezinxulumene notshintsho abasisigxina eludongeni semithambo, ukwanda kunye ukwandiswa iimpahla kunye ukuyilwa lunamaqoqo, amaqhina, kunye nokuhamba kwegazi.

omzimba Lower network lwemithambo bubonakaliswe and zinzulu neempahla ukunxibelelana nabanye. Inkqubo kumphezulu iquka imithambo ezinkulu nezincinci saphenous. iqala ezininzi kule ndawo nasemiphakathweni kwaye ibekwe nakumphezulu womlenze, oluwe ndlela enzulu femoral.

Varices sikhatshwe utshintsho koxinzelelo intravascular, sehlise ukuhamba kwegazi, iinkqubo amile. Kwizikhephe inimba, zigcwele igazi. Inkqubo esingajikiyo ngemithambo akusekho ukumelana umsebenzi yokulawula egazini ngomoya omnye, ezona zinto zifuneka kuqala ukuze kwakhiwe reflux igazi (Ukuphosa umva). Amaninzi ke kula maxesha okuba singazi umfanekiso kwezonyango sifo ngokupheleleyo, nto leyo ebangela ukuba isigulane ukuba adibane yingcibi nemithambo.

Ngokufuthi ukhetho leengcali iba operation Troyanova-Trendelenburg. Ntoni na, njani na ukuba kwenziwe kwaye yintoni umphumo kongenelelo, cinga ngakumbi.

Injongo crossectomy

Yingcali ukuba umsebenzi omkhulu - ukuba bahlukane reflux kunye nokuphelisa iinkqubo amile emithanjeni varicose yatshintsha. Ngoko ukuba angenza ntoni ukuhamba kwegazi ngoncedo iyeza akwenzeki, ekuphela kwendlela abe ekudibaneni kwe izigulane nemithambo kunye nemingenela yawo.

Crossectomy (on Troyanov-Trendelenburg operation) uthathwa ukuba ungenelelo olukhulu. Oku kwenziwa kwimeko varices iingxaki (umz, thrombosis okanye phlebitis) okanye ikhonkco kwi unyango entsonkothileyo.

Ngokungafaniyo crossectomy ngu phlebectomy

Kutshanje phlebectomy (venectomy) yayigqalwa ukhetho elisemagqabini unyango ngemithambo varicose. It lwenziwa phantsi zomzimba spinal esibhedlele. Umsebenzi wayehluke kwakubuhlungu kakhulu kunye nophuhliso iingxaki postoperative. Kungekudala iziphumo flebektomii baqalisa ukubonisa ukuba kuyimfuneko kukufumana indlela olukhulu ngakumbi ukunciphisa amathuba ukuphinda sifo.

Venectomy ephelekwa ukunqumla Kusenjalo saphenous enkulu ethangeni ephezulu, kodwa hayi kufutshane anastomosis, ekhokelela kusiwe kwesixa reflux safeny malunga fistula. Iphinde ibuya kuyo isigulane zonke wesithathu.

Maxesha crossectomy isekelwe kwinto yokuba osikiweyo kunye kuhlangana zenziwa ngqo kwi ekudibaneni Kwangale enzonzobila femoral, ngenxa yokuba akukho gazi reflux kwinkqubo enzulwini.

Ubungqina obubonakalayo buxela ukuba angenelele

Operation Troyanova-Trendelenburg eyayibanjelwe ngokungxamisekileyo kwiintsuku zokuqala emva kokumiselwa thrombosis, inguqu, ukuba kumiswe inkqubo zophendlo lwezifo kunye nenkqubo phezulu lwemithambo enzonzobila.

Ubungqina obubonakalayo buxela ukuba ungenelo lithi zilandelayo:

• inqanaba thrombophlebitis kwe kwedolo ngasentla;
• thrombophlebitis, iingxaki iinkqubo ubovu;
• thrombosis nezolo okanye lowo Ongayinikeliyo ngokwayo kwezinye iinkqubo zonyango;
• thrombosis ye inqanaba kwedolo ngasentla.

Izimo

Kubalulekile ukuqonda ukuba ukusebenza Troyanova-Trendelenburg ubungqina bakhe lunxunguphalo, musa cinga ubukho Izimo. Kule meko sithetha ngobomi umguli.

Xa becwangcisa ukungenelela yeengcali ezichongiweyo eziliqela ahlinzwe akunqwenelekile:

1. isifo Somatic - emzimbeni wakhe buthathaka kakhulu, yaye nayiphi na msebenzi ufuna kakhulu umgudu ukubuyisela. Kwimeko enjalo kuyimfuneko ukusebenzisa iindlela ngaphantsi kakhulu unyango.
2. Yamafutha kweqondo asezantsi kakhulu.
3. Ngexesha ekhulelwe okanye zisanyisa.
4. Ubukho kwezifo ezosulelayo okanye ubovu irhashalala kwindawo kongenelelo olucwangcisiweyo.
5. Iimeko ezenza kube nzima ku tirhisa ucinezelo kakuhle imilenze emva kotyando (ukutyeba kakhulu).
6. Thrombophlebitis okanye deep vein thrombosis.

Operation Troyanova-Trendelenburg ifuna ukusebenza ngokukhawuleza isigulane emva kokuba ungenelelo, ukuze isifo apho umguli alunako ukuphuma ebhedini ngosuku lwesibini, ingqalelo ngamnye.

Ukulungiselela utyando

Ekubeni kwiimeko ezininzi isigulane ifika ukuba kukho ungenelelo likaxakeka, isaveyi yaye angaludlulisa ubuncinane esisinyanzelo;

• iimvavanyo zegazi kunye nomchamo eqhelekileyo;
• eziphilayo igazi;
• coagulation;
• uphando negcushuwa, hepatitis;
• baxilonga HIV.

Le therapist na owayethandabuza ukuba akukho ngqiqweni phambi kwezifo somatic, ebe a contraindication. Kwakhona wayisa imithambo ultrasound ukufumanisa kwasendaweni of anastomoses, indawo kwemithambo yegazi yezigulane, izehlo inkqubo yezifo.

Emva kokwenza imilinganiselo kuyimfuneko, ugqirha nemithambo uchaza indlela iikawusi ucinezelo okanye umhlabelo elastic kufuneka ithengwe ukuze baphumeze ucinezelo kwamalungu ngoko nangoko emva kotyando.

indlela yokusebenza

Operation Troyanova-Trendelenburg, ubuchule esekelwe efuna sisakhono ephakamileyo ugqirha, ngokusebenzisa zomzimba okanye ngokubanzi. Ukhetho zomzimba kwenza anesthesiologist, ngokulungelelanisa zonke iinkcukacha ngqo kunye isigulane.

Operation Troyanova-Trendelenburg nechazwe kwinqaku iqulathe la manyathelo alandelayo:

1. indawo Surgical iphathwa kunye magciwane, isicelo amaphepha engenazintsholongwane, licacile ukufikelela.
2. Ugqirha ubudoda Uphanda ubume kwemithambo femoral, phantsi bekuza medially kunye ongama eVienna omncinane.
3. iimpawu yokwakheka zonke izigulane zahlukene, yaye ngaloo ndlela indawo yegazi ezahlukeneyo. Le liqatywe lwenziwa, ngokuxhomekeke indawo enkulu saphenous vein anastomosis.
4. Emva kokuba Imi ugqirha lufika umqadi lwemithambo, amabhandeji kunye usika kuyo.
5. It kandziyise saphenous Vienna omkhulu ukuya kwindawo apho ayajika kwinkqubo anzongonzongo, ligated yaye kunqunyulwa. Kweli nqanaba, kunye egazi igazi ihambe.
6. Okulandelayo, ngendlela efanayo zisekhusini, ndinqumle nemingenela ubuncinane ezintlanu umthambo ecaleni ubude bayo (ezimbalwa ezongezelelweyo ezicentile njengokuba kuyimfuneko). Luqhutywa lokuthintela yokuqokelela igazi umva kunye ukuphinda izifo.
7. Zonke ukusikwa sutured, wabeka yamanzi amdaka.
8. Kwi esiphelweni ephantsi ungambathi ingubo ucinezelo okanye bandage ilastiki.

Operation Troyanova-Trendelenburg enxulumene nangokurhala, ukuyilwa egazi igazi, ngoko kwimeko iingcali likaxakeka musa ukuzama ukususa kangangoko imithambo, kwaye ubuninzi lwathatha indawo yenkqubo yezifo.

Ithuba postoperative

Ngosuku lokuqala isigulane ichitha ebhedini. Oku kungenxa yeziphumo ebezingalindelekanga unako zomzimba. Ngosuku lwesibini ibonisa ukusebenza yomguli ukuze akhusele kakhulu kuyo kwakhona thrombosis. Bomzimba kuba ngokulinganisela, kodwa ugqirha ubeka okuphelisa iintlungu okanye iziyobisi nonsteroidal anti-ukudumba, xa kukho imfuneko.

Imfuneko ucinezelo olwaneleyo kweqondo asezantsi, ibanjwa nangoku ngaphezu kwenyanga emva kolo ngenelelo.

Ingqalelo kufuneka inikwe kwimisebenzi ezijolise ekuthinteleni iinkqubo amile kwinkqubo Kwangale (ukuhamba, umthambo therapy).

iingxaki emva kotyando

Operation Troyanova-Trendelenburg, iingxaki ezo zinqabile kakhulu, libhekisela iindlela olukhulu unyango. Oku ngunobangela rhoqo neengxaki ngethuba longenelelo inyama lokuthuthuzela amaxhoba (leyo ukuthintelwa), kunye nobugcisa ukuhlukunyezwa intengiselwano. Isiguli ukuphuhlisa ezimbi zilandelayo:

• ukopha;
• hematoma kwindawo ngoncedo;
• usulelo inxeba steel;
• ukuphazamiseka kwenkqubo emithanjeni kunye nokusekwa conglomerates esinganyangekiyo;
• paresthesia (ukuphazamiseka uvakalelo ulusu xa ewela kwalapho);
• lymphorrhea (outflow of nkovu ukusukela kwisiphambuka iimpahla emithanjeni).

Ezinye iingxaki ngokwabo, ngoxa abanye abafuna unyango olongezelelweyo. Hematoma kwiimeko kakhulu, kuba kuxhomekeka kwenzakalani phambili kunye nonyango isibulala-zintsholongwane. Usulelo amanxeba nayo ifuna ukusetyenziswa arhente antibacterial (penicillins, macrolides, cephalosporins). ubuntununtunu ongeva ibuyiselwe ngokuzimeleyo, akunyanzelekanga ukuba imiqathango eyongezelelweyo.

isiphelo

Enye Iindlela olukhulu unyango oluntsonkothileyo emithanjeni varicose kunye neengxaki zawo ukusebenza Troyanova-Trendelenburg. Ikhosi umsebenzi ubonisa ukuba kuphuculwe indlela inkqubo ukuphelisa reflux kunye nokuthintelwa ukwenzeka sifo. Ukuthobela icebiso specialist yokusebenza ukunqanda imfuneko kwakhona unyango-.