Phais: tympanoplasty. Xyuas tom qab phais

Hnov teeb meem yuav tshwm sim tau rau ntau yam yog vim li cas, thiab nyob rau hauv tej rooj plaub ntawm tus kab mob yog txo mus rau ib tug deterioration ntawm nruab nrab pob ntseg nuj nqi. Yuav kom restore nws, siv tympanoplasty - lag luam, thaum lub sij hawm uas reconstructed nws tus kheej ncaj qha nruas ntsej. Qhov no daim ntawv ntawm kev kho mob tau muaj pov thawj ntau zaus yuav zoo.

Lub essence ntawm qhov teeb meem

Thaum nws los txog rau daim ntawv no ntawm kev phais, tympanoplasty li (lub lag luam nyob rau hauv nruab nrab lub pob ntseg) yog meant ib lub qauv ntawm cov kev kho mob ntawm tus kab mob suppurative otitis xov xwm nyob rau hauv lub nruas ntsej. Nws yuav tsum tau muab sau tseg hais tias qhov no tej yam yog complex thiab muaj ib tug tseem ceeb regenerative nyhuv, tas cov reconstruction ntawm nruab nrab pob ntseg.

Nws ua rau kev txiav txim zoo them sai sai rau lub fact tias mob otitis tshuaj mob ntau heev. Nws ua rau yus mus rau tsim ntawm qhov nyob rau hauv lub nruas ntsej, uas yog hu ua perforation. Vim li no, nws yuav tau nkag mus ntawm pathogenic cov kab mob nyob rau hauv lub tympanic kab noj hniav, uas nyob rau hauv lem ua rau qhov kev tso tawm ntawm kua paug uas yuav cuam tshuam ntau tshaj li ib xyoo.

Tympanoplasty - lag luam, tsis muaj uas nws yog los mus kov yeej suppurative otitis xov xwm yuav tsis tshua muaj neeg yooj yim. Ntxiv mus, qhov no hom ntawm advanced kab mob no yuav ua nyob rau hauv qhov tshwm sim ntawm rwj thiab cerebral thrombosis, thiab nyob rau hauv tej rooj plaub - thiab meningitis.

Indications rau Kauj ruam

Muaj ib tug xov tooj ntawm tej yam kev mob nyob rau hauv uas phais pab yog tsim nyog hais saum toj no. Kab hauv qab no raws li nram no noj qab haus huv tej teeb meem:

- tsim ntug los yog central perforation ntawm lub tympanic membrane, uas ua rau lub xaav ntawm lub ossicular;

- polyps uas tsim nyob rau hauv nruab nrab pob ntseg;

- timpanoskleroz;

- perforation ntawm lub nruas ntsej, yog tsis nrog mob;

- fibrosis ntawm nruab nrab pob ntseg.

Nws yog pom tseeb tias muaj ntau ntau yam yog vim li cas vim li cas kev phais yuav yuav yam.

Contraindications

Nws yog ib qho tseem ceeb kom nkag siab txog hais tias muaj neeg mob qhov twg phais nyob rau hauv lub pob ntseg (tympanoplasty) tsis tau muab cov kev kawm cawv. Ntawm no mob rau cov uas siv ib tug zoo xws li cov txheej txheem yog tsis pom zoo:

- exacerbation ntawm tus kab mob cov kab mob;

- nplaum otitis xov xwm;

- tiav lag ntseg;

- mob loj heev kev mob ntawm tus neeg mob;

- sepsis thiab lub taub dej khawb teeb meem.

Dehumidifying lag luam nyob rau hauv nruab nrab pob ntseg nrog tympanoplasty txhob nyob rau hauv lub rooj plaub uas lub tsau pheej cuam tshuam ntawm patency ntawm lub hnov raj. Pawg no tej zaum yuav muaj xws li congenital malformations, raws li zoo raws li nti thiab adhesions, uas ua los ntawm o.

Contra, muaj ib tug txheeb ze ua cim

Nyob rau hauv cov ntaub ntawv no peb yuav sib tham txog cov neeg cov kab mob tiv thaiv uas lub lag luam yog undesirable, tab sis ua tau. Nyob rau hauv cov ntaub ntawv no, qhov kawg kev txiav txim siab yuav siv sij hawm tus kws kho mob, raws li nyob rau hauv nws kev kawm txawj thiab hauv lub xeev ntawm tus neeg mob. Yog li ntawd ua contraindications:

- mob o nyob rau hauv nruab nrab pob ntseg;

- tsis haum-hom kab mob nyob rau hauv lub mob nyob ntev;

- teeb meem nrog rau cov Upper pa ib ntsuj av tau;

- epidermizatsii txheej txheem.

Tsuas yog kev noj mus rau hauv tus account tag nrho cov contraindications piav saum toj no yuav muab qhov no zoo ntawm kev kho mob raws li tympanoplasty. Xyuas tom qab phais yog ib qho tseem ceeb kos npe rau ntawm qhov zoo tshaj ntawm kev kho mob, yog li ntawd, peb yeej ib txwm xav nyob rau hauv lub views ntawm cov neeg mob txog ib qho kev kuaj mob. Qhov no yuav pab forums.

Nws yog ib nqi nco ntsoov tias tus kws kho mob yog yuam ua hauj lwm kom muaj cai ib daim ntawv ntsuam xyuas ntawm lwm yam pob ntseg thiab twv txog qhov uas yuav muaj ntawm nws cov kev puas tsuaj. Tom qab qhov kev txiav txim yuav tsum tau ua hais txog lub lag luam nyob rau hauv lub thib ob nruas ntsej.

Nws yuav tsum tau yuav tsum tau nqa tawm ib daim ntawv qhia txog kev soj ntsuam ntawm ib tug general xwm: koaguloramma, biochemical thiab tsom xam ntawm cov ntshav thiab zis, raws li zoo raws li ib tug soj ntsuam ntshav seb syphilis, HIV, kab mob siab B thiab C. Qhov kev tshawb fawb kev pab cuam muaj xws li ib tug electrocardiogram.

Tus txheej txheem ntawm kev npaj rau kev phais

Ua ntej ib tug txhob cuam tshuam, tsim conservative kev kho mob, uas yog npaj los npaj pob ntseg tympanoplasty. Nyob rau hauv nruab nrab ib feem ntawm cov kab noj hniav qhov twg lub nruas ntsej yog inputted ntau yam txhais tau tias tsim los thov ib tug anti-inflammatory, vasoconstrictor thiab anti-bacterial nyhuv. Lawv tag nrho cov muaj ntau yam ntawm kev ua.

Tej txheej txheem tseem ceeb heev vim hais tias lawv ua tau los ntxuav lub ua cheeb tsam los ntawm kab mob. Nws yog ua tsaug rau txoj kev ua no, nws yuav tau mus ua tympanoplasty. Xyuas tom qab lub lag luam, ntsig txog, kuj yuav dua zoo, raws li Readjustment (tu) chiv thaiv cov hlab cov nyhuv rau hauv nruab nrab lub pob ntseg mob, thiab tom qab txhawb sai kho ntawm kev phais qhov nqaij.

Ntxiv mus, qhov no kev ntsuas ua rau zoo tuaj patency ntawm lub hnov raj, uas muaj ib tug ncaj qha feem rau qhov zoo ntawm cov kev tshwm sim ntawm kev phais.

Yog hais tias tus neeg mob muaj mob, koj yuav tsum tham ib tug kws kho mob profile. 7 hnub ua ntej lub lag luam yuav muab qhov chaw, peb yuav tsum tsis kam txais yuav cov nyiaj siv rau thinning cov ntshav. Nws yog ib lo lus nug uas tsis yog-tshuaj anti-inflammatory siv tshuaj ( "Paracetamol", "Tshuaj aspirin") thiab "warfarin".

impacts

Muaj ntau ntau yam tswv yim uas cia kom tau ib tug tseem ceeb kev txhim kho nyob rau hauv lub zwj ceeb ntawm nruab nrab pob ntseg tom qab phais. Tympanoplasty rau no yog vim li cas muaj peev xwm kuj yuav nqa tawm nyob rau hauv ntau txoj kev. Nws ua rau kev txiav txim zoo kom paub qhov txawv peb tseem ceeb no:

- Rov qab siv ossikuloplastiki. Yeej muaj tseeb rau cov neeg cov neeg mob uas vim rau muaj mob loj inflammatory txheej txheem hnov ossicles puas, thiab lawv kev ncaj ncees yog tau tsuas yog nrog kev pab los ntawm cov khoom cuav. Nyob rau hauv cov ntaub ntawv no, uas siv cov ntaub ntawv xws li titanium, MAAs thiab yas.

- Lub essence ntawm lub thib ob hom kaw yog txo los ntawm cov nruas ntsej tus kheej ntaub so ntswg ntawm nruab nrab pob ntseg. Feem ntau thiab tsawg nyuab yog cia li xws li ib tug tympanoplasty. Xyuas tom qab phais ntawm no hom yog nyob rau hauv feem ntau tus neeg mob zoo.

- myringoplasty tsis muaj cov khoom cuav. Siv los kho cov neeg mob uas puas hnov ossicles, tab sis cov hniav yas yog tsis siv. Yuav kom restore txaus haiv neeg cov pob txha.

Tej zaum cov kws kho mob kev nyuaj siab nrog xws li ib tug teeb meem, raws li cov fusion ntawm ob chaw ntawm nruab nrab pob ntseg, uas yog vim mob otitis media. Nyob rau hauv cov ntaub ntawv no, mus rau restore lub tympanum siv raws li grafts thiab nruas ntsej nws tus kheej, precisely ntau, nws residues.

kev ncaj ncees lub sij hawm

Yuav kom siv cov qauv ntawm cov kev kho mob raws li tympanoplasty, cov lus teb zoo tom qab kev phais, nws yog tsim nyog los npaj zoo tus neeg mob rov qab.

Ua ntej ntawm tag nrho cov, nws nyob qis qis rau 1-3 hnub nyob rau hauv lub tsev kho mob. Rehabilitation yuav siv cov tshuaj tua kab mob thaum lub sij hawm thawj postoperative lub lim tiam. Nrog rau cov kev ntsuas, kev ncaj ncees, ceev yog lub sij cwjpwm ntawm anemia. Qhov no txhais tau tias cov kev taw qhia mus rau hauv lub hnov raj pharyngeal lub qhov ncauj vasoconstrictors.

Txij li thaum qhov kev tso tawm ntawm lub hnov kwj dej ntawm tampons yog gradual, thaum xub thawj, tus neeg mob yuav tsum nyob rau ib tug mus tas lub hauv paus nyob rau hauv lub tuaj lub xeem.

Yog li ntawd hais tias tom qab lub lag luam bounce rov qab sai li sai tau, koj yuav tsum tsawg txham, tshuab koj lub qhov ntswg thiab tiv thaiv lub pob ntseg los ntawm dej allergic. Hais txog zoo txoj kev tiv thaiv tawm tsam dej thaum noj ib da dej yog zoo tshaj plaws mus tham nrog koj tus kws kho mob. Los ntawm lifting hnyav khoom kuj yuav tsum tau tso tseg. Nyob rau hauv qhov tseeb, koj yuav tsum mus tshem tawm tej load uas yuav ua rau zoo kawg nro nyob rau hauv lub cheeb tsam ntawm nruab nrab pob ntseg.

tau teeb meem

Yog hais tias peb xav txog tag nrho cov kev seevcev ntawm qhov phais, yog tsim nyog sau cia hais tias muaj tej yam txaus ntshai thaum lub sij hawm ib tug txheej txheem xws li tympanoplasty. Teeb meem los ntawm kev phais yuav ua tau txawv kiag li: kev puas tsuaj rau lub labyrinth, lub tympanic kab noj hniav, lub ntsej muag paj thiab txawm nyuaj meninges. Lub Xeem, Lub los ntawm txoj kev, tej zaum nws yuav ua kom muaj kev los ntshav los ntawm lub jugular hlab ntsha los yog otolikvorei.

Tsis tas li ntawd xyuam xim rau txoj kev pheej hmoo ntawm aseptic o ntawm lub pob ntseg nyob rau hauv lub postoperative lub sij hawm. Qhov no mob yog feem ntau nrog paug, o thiab mob.

Tej zaum nws yuav tshwm sim tom qab lub lag luam tympanoplasty gnoetichenie pob ntseg. Xyuas txhawb qhov tseeb hais tias qhov teeb meem no yog noj qhov chaw. Vim li no, thiab tseem ceeb nyob ruaj ruaj hom thaum lub sij hawm rov qab, raws li cov kws kho mob yuav tsum tau muab cov kws muaj txuj thiab raws sij hawm kev pab nyob rau hauv cov ntaub ntawv uas tau teeb meem.

Teeb meem ntawm ib tug general xwm tej zaum kuj muaj xws li heev mob taub hau (rau txim ntawm fistula ntawm lub labyrinth), impaired tshuav nyiaj li cas thiab kiv taub hau.

Yuav ua li cas yog lub hloov cov ntaub ntawv

Cov neeg uas tau dhau mus lawm lub lag luam nrog rau kev siv ntawm prosthesis, nws yog tsim nyog los raws nraim qab lub tswv yim pom zoo ntawm cov kws kho mob, raws li nyob rau hauv cov ntaub ntawv ntawm o ntawm nruab nrab pob ntseg yuav pib cov txheej txheem ntawm rejection.

o fact yuav tseem yuav muaj rau cov kev ceev ntawm rov qab. Tom qab siv tympanoplasty nrog prosthesis muaj ib tug uas yuav ntawm xaav ntawm lub yav tas, li zoo li necrosis los yog Atrophy. Yog li ntawd, yog tias koj muaj ib tug prosthetic qhov chaw nws tus kheej yuav tsum tau muaj kev tiv thaiv kom huv si.

tsis hnov lus

Nws yog hais txog cov pab pawg neeg manifestation ntawm cov teeb meem nyob rau hauv lub ua pob ntseg tsis hnov lus, uas yuav ncav cuag cov theem ntawm tag nrho cov lag ntseg. Qhov teeb meem no ua rau nws tus kheej muaj tom qab ib tug tham los yog uas tsis yog-radical tympanoplasty. Kev ua txhaum ntawm lub xaav ntawm lub suab yog tej zaum qhov tshwm sim ntawm reactive labyrinthitis, uas muaj peev xwm mus tsis kho mob. Yog hais tias qhov no tsis tshwm sim, ces lub peev xwm txoj kev kho nyob rau hauv kev kho mob saib xyuas yuav pab tau kom neutralize cov teeb meem.

Yog li, peb yuav tsum to taub hais tias lub rooj sib hais kev tsis taus, qhov ua rau ntawm uas yog tus labyrinth, qhov xwm ntawm ib tug ib ntus thiab kho tau.

Tab sis qhov xwm zoo yog hais tias cov teeb meem muaj cai xwb nyob rau hauv 3% ntawm cov neeg mob uas underwent phais. tympanoplasty xyuas muaj ib tug feem ntau zoo, thiaj li yuav tsum tsis txhob ntshai ntawm cov txheej txheem no.

Luv-lub sij hawm tuag tes tuag taw

Qhov no yog lwm yam tab kaum uas yuav tshwm sim tom qab phais rau hauv nruab nrab lub pob ntseg. Qhov xwm zoo yog hais tias qhov xwm ntawm qhov teeb meem no yog ib ntus xwb. Ua short-term tuag tes tuag taw yog postoperative o ntawm lub ntsej muag paj.

Nyob rau hauv tej rooj plaub, lub paj yuav puas vim intraoperative hla kev. Raws li daws cov teeb meem kev ntsuas siv cov yas. Peb yuav tau tham txog xaws saphenous paj ntawm lub caj dab. Nyob rau hauv ib qho lwm txoj kev embodiment, lub ntsej muag paj yog koom nrog lub sublingual. Nrog xws li ib kev tshuam thaum phais, txawm tom qab lub yas yog ib tug uas yuav ntawm preservation ntawm residual tsis muaj zog ntawm lub ntsej muag nqaij.

Xyuas

Yog hais tias koj nyeem cov lus ntawm cov neeg uas txiav txim siab nyob rau hauv lub reconstruction ntawm nruab nrab pob ntseg, nws yuav tau muab xaus lus hais tias qhov no txoj kev kho mob yog zoo heev.

Feem ntau ntawm cov Council yuav txiav txim siab rau tej kev ntsuas nyob rau hauv mob otitis media, vim hais tias nyob rau hauv lawv cov ntaub ntawv qhov teeb meem twb daws tsuas yog tom qab lub lag luam "tympanoplasty". Thaum nws yog ua tiav rov qab, peb yuav tsis hais tseeb vim hais tias ntawm tau teeb meem thiab cov yam ntxwv ntawm tus kab mob ntawm txhua tus neeg mob.

Tab sis yog hais tias peb tham txog Salaries, ces lub pob ntseg, los rov qab mus rau qub tom qab ib lub hlis ntawm hnub tim uas lub lag luam.

tau

Mob otitis xov xwm - nws yog ib tug kab mob loj, thiab yog hais tias koj khiav nws, cov kev puas tsuaj mus rau nruab nrab lub pob ntseg yuav ua tau teeb meem loj. Tympanoplasty, nyob rau hauv lem, tso cai rau koj mus kiag li neutralize qhov teeb meem thiab restore lub nruas ntsej. Ntxiv mus, lub lag luam nws tus kheej yuav siv sij hawm txog ib teev. Yog li, muaj yog tsis muaj yog vim li cas yuav las mees xws kev kho mob.