Operation Troyanova-Trendelenburg - chii?

Mumakore achangopfuura, varicose mutsinga awana tsika rejuvenation. mukadzi wese wechitatu ane achiri chirwere zera kushanda. Pakati pavanhu, mumwe mugumi. Thrombosis kana thrombophlebitis - pakava pamusoro venous chirwere ngozi. Muchiitiko ichi zvakakosha kushandisa crossectomy (Troyanova-Trendelenburg oparesheni).

Zvinoumba varicose mutsinga

Varicose mutsinga chinonzi chirwere chokuita zvachose kuchinja vascular parusvingo, kukura uye kuwedzera midziyo nokuumbwa miganhu, nokusunungura mapfundo, uye zvakare kufamba kweropa.

Lower muzvidimbu venous Network anomiririrwa zvachero uye zvakadzama midziyo kukurukurirana mumwe nomumwe. The pose hurongwa ine zvikuru nezviduku saphenous mutsinga. kunotangira Most ari muhudyu nzvimbo uye riri mu rokumusoro chikamu yehudyu vasawira yakadzika femoral tsinga.

Varices achiperekedzwa nokuchinja intravascular kumanikidzwa, tava kuderera aibuda ropa, mira kwendangariro. Nemidziyo dilated, akazara neropa. The vharafu Tsika mutsinga vasisiri kutsungirira basa waidzora yaitsigira divi muropa, kuti prerequisites kuti paumbwe reflux ropa (shure uzvirasire). Kazhinji iri nguva ava kunotoda mufananidzo hosha iri chipatapata, iro rinoita kuti murwere kubvunza munhu vascular chiremba.

Kazhinji pakusarudza nyanzvi zvava kushanda Troyanova-Trendelenburg. Chii, kuti akaita uye chii mugumisiro kupindira, funga zvakare.

Chinangwa crossectomy

Mazvikokota anofanira huru basa - ndeyokubvisa reflux uye kubvisa mira pezvakaitwa mu varicose mutsinga zvakachinja. Saka sei kumisa ropa kubuda tichibatsirwa mishonga hazvibviri, nzira bedzi yokuva mharadzano wevarwere vascular vavo vabati vechibharo.

Crossectomy (musi Troyanov-Trendelenburg oparesheni) riri kuonekwa yakakura kupindira. It rinoitwa pakuparwa varices zviome (semuenzaniso, thrombosis kana phlebitis) kana link zvakaoma kurapwa.

Kusiyana crossectomy ne phlebectomy

More ichangopfuura phlebectomy (venectomy) kwainzi chaizvo chingaitwa mishonga varicose mutsinga. It rinoitwa pasi musana yokutindivadza muchipatara. Operation zvakasiyana zvikuru zvinorwadza uye kukura postoperative yematambudziko. Nokukurumidza flebektomii zvabuda akatanga kuratidza kuti zvakakosha kuwana nzira okunyanyisa kuderedza mukana chirwere dzokororo.

Venectomy achiperekedzwa pokuyambuka guru tsinga saphenous mune muchiuno, asi kwete pedyo anastomosis, zvoita kuti resumption pamusoro inflows reflux safeny pamusoro fistula. Kuitazve rinowanikwa mune ose murwere rechitatu.

Mazuvaano crossectomy nayo inobva pakuti akagerwa uye mharadzano yaitwa zvakananga panguva confluence rakadzika femoral tsinga, zvokuti hapana ropa reflux kwakadzikadzika hurongwa.

Zvairatidza kuti kupindira

Operation Troyanova-Trendelenburg wakaitwa nokukurumidza mumazuva okutanga pashure paumbwe thrombosis, sanduko kumisa pathological muitiro pamwe zvachero venous gadziriro pakadzika.

Zvairatidza kuti kupindira ndedzinotevera inoti:

• thrombophlebitis pamwero ibvi uye pamusoro;
• thrombophlebitis, matambudziko ose purulent pezvakaitwa;
• idzokororo thrombosis kana munhu asingarevi mhindu pacharo kuti nemamwe maitiro kurapwa;
• thrombosis pakati ufanane ibvi uye pamusoro.

Contraindications

Zvakakosha kunzwisisa kuti Troyanova-Trendelenburg oparesheni ane uchapupu chiri chimbichimbi, havarangariri kuvapo contraindications. Muchiitiko ichi tiri kutaura pamusoro poupenyu murwere.

Kana kuronga chinhu kupindira nyanzvi akataura zvinhu zvinoverengeka kana Kuvhiya hakungodiwi:

1. Somatic chirwere - muviri murwere simba zvikuru, uye chero oparesheni kunoda kuedza kudzorera. Pakadaro zvakafanira kushandisa zvishoma zvikuru nzira kurapwa.
2. Atherosclerosis repasi wamativi chakakomba.
3. Panguva pamuviri kana lactation.
4. Kuvapo zvinotapuriranwa kana purulent mapundu pa nzvimbo vakaronga kupindira.
5. Conditions umo hazvibviri kupedza compression zvakanaka makumbo mushure pakuvhiya (zvikuru kufutisa).
6. Thrombophlebitis kana yakadzika tsinga thrombosis.

Operation Troyanova-Trendelenburg kunoda nokukurumidza activation murwere mushure kupindira, saka hosha iyo murwere havagoni kumuka pazuva rechipiri, vaiona nomumwe.

Preparation kunorapwa

Sezvo kakawanda murwere anosvika kuti pakaita kupindira, asi ongororo uye kupfuudza rokumanikidzirwa minimum:

• zvakafanana ropa uye weti miedzo;
• ropa nemakemikari omuviri;
• coagulation;
• tsvakurudzo pamusoro njovhera, hepatitis;
• achivhara nokuti neHIV.

Chiremba kubvunzwa kutonga kubva kuvapo kwakaita somatic zvirwere, iyo yava contraindication. Also vakatapwa Ultrasound mutsinga kuziva localization pakati anastomoses, nzvimbo ropa nhumbi varwere, kuitika pamusoro pathological muitiro.

Pashure pokutaura kuyerwa zvakafanira, munhu vascular chiremba anotsanangura sei compression masokisi kana kwakavharwa nenyama bhandiji zvinofanira kutengwa kuti vaite compression nhengo dzake pakarepo pashure kuvhiyiwa.

weboka oparesheni

Operation Troyanova-Trendelenburg, inobva unyanzvi kunoda refu unyanzvi chiremba, akaita kushandisa yomunharaunda kana mukuru yokutindivadza. Pakusarudza yokutindivadza zvinoita anesthesiologist, ekufambisa zvose zvakananga murwere.

Operation Troyanova-Trendelenburg uye anorondedzerwa munyaya chinosanganisira zvinotevera matanho:

1. Kuvhiya nzvimbo iri kubatwa akambozvishandisa kuuraya utachiona zvinogadzirisa, vakashandisa chena machira, inosiya pasina nzvimbo kuwana.
2. The groin chiremba Yatanga Kuongorora kurova kwemwoyo ari femoral tsinga, pasi izvo zvinopfuura medially uye zvishoma subcutaneous Vienna.
3. Anatomical zvechadenga varwere vose kusiyane uye nokudaro nzvimbo dzakasiyana mutsinga. The incision rinoitwa, zvichienderana nzvimbo huru saphenous tsinga anastomosis.
4. Mushure vendu chiremba zvasvika venous danda, mabhandeji achizviitira nayo.
5. It pachena mukuru saphenous Vienna kusvika nzvimbo inoyerera munzvimbo yakadzika maitiro, ligated uye akagura. Panguva iyi, neropa clots vanogona kuenda.
6. Next, saizvozvo vari voga uye akagura tsinga rechibharo kanenge kashanu pamwe kureba kwayo (mashoma dzokuwedzera maronda akaita se zvakakodzera). Zvinonzi inoitwa yokudzivisa neizvi ropa muunganidzwa uye chirwere dzokororo.
7. cheka All sutured, akaisa drains the.
8. On rezasi kumugumo kupfeka compression nguvo kana kwakavharwa nenyama bhandiji.

Operation Troyanova-Trendelenburg chokuita kuzvimba uye paumbwe ropa clots, saka kana yedambudziko nyanzvi usaedza kubvisa sezvo zhinji mutsinga, uye kufadza yakasvikawo nzvimbo pathological muitiro.

The postoperative kumwedzi

zuva rokutanga murwere inopedzwa pamubhedha. Izvi imhaka zvingakonzerwa nemishonga kubva yokutindivadza. Pazuva rechipiri chinoratidza activation murwere kuitira kudzivirira zvakanaka kubva shandisazve pakati thrombosis. Soreness riri mwero, asi chiremba prescribes kurwadziwa relievers kana nonsteroidal Anti-anogumbura zvinodhaka, kana zvichidikanwa.

Chinodiwa raiita compression repasi wamativi, rinoitwa vachiri pamusoro mwedzi pashure kupindira.

Nehanya inofanira kupiwa mabasa zvainanga kudzivisa mira pezvakaitwa ari tsinga ino (muchifamba, kurovedza muviri marapirwo).

Possible yematambudziko pashure pokuvhiyiwa

Operation Troyanova-Trendelenburg, nemamwe matambudziko zvacho chaizvo zvisingawanzoitiki, rinoreva okunyanyisa nzira kurapwa. Zviri chikonzero kakawanda yematambudziko panguva zvinyama kunotevera kupindira (risingagoni kudziviswa), uye kutyora mutengapwe unyanzvi. Murwere zvingamuka zvinotevera pathologies:

• ropa;
• hematoma munzvimbo kupindira;
• hweHIV of kuvhiya ronda;
• zvirwere zviri nhengo dzinobudisa ino nokuumbwa cystic conglomerates;
• paresthesia (chainetsa aikanganiswa ganda kana kuyambuka tsinga harinzwi);
• lymphorrhea (water drainage pakati node kubva mharadzano ari nhengo dzinobudisa midziyo).

Vamwe matambudziko vari pachavo, apo vamwe zvinoda okuwedzera kurapa. Hematoma muna Muzviitiko zvakaipisisa, muzviise pasi zvakare kuponjesa pamwe asingaurayiwi kurapa. HweHIV mavanga kunodawo kushandiswa antibacterial vamiririri (penicillins, macrolides, cephalosporins). Havachanyatsogoni utetsa anodzorerwa vakazvimiririra, haatarisiri okuwedzera matanho.

mhedziso

Mumwe okunyanyisa nzira kunzwisisa Mabatirwo varicose mutsinga wayo yematambudziko ndiyo oparesheni Troyanova-Trendelenburg. Course hwokushanda anoratidza sei kuti ndiwedzere negadziriro kubvisa reflux uye kudzivirira dzokororo chirwere chacho. Zvaidiwa uchishandisa nyanzvi zano kudzivisa kudiwa apiwa kurapwa.