Timalimbana ndi matenda wamba pa chimfine.
Momwe momwe miliri ikukhalira, zipatala zambiri zimasinthidwa kukhala zipatala zothandizira odwala omwe ali ndi COVID-19. Mabungwe okonzanso azachipatala ayimitsa maulendo oyendera odwala komanso opareshoni, pomwe kuchuluka kwa matenda mwa anthu sikunachepe. Kuphatikizirapo mavuto omwe amayenera kuperekedwa kwa otorhinolaryngologist. Makamaka kwa owerenga Wday.ru, otorhinolaryngologist, mkulu wa otorhinolaryngology chipatala cha European Medical Center, Yulia Selskaya, analankhula za ambiri ENT matenda, zomwe zimayambitsa ndi njira mankhwala.
K.m. N., Otorhinolaryngologist, wamkulu wa chipatala cha otorhinolaryngology ku European Medical Center
Kuvuta kupuma kwa m'mphuno ndi chizindikiro chodziwika bwino kuti ndi nthawi yoti muwone otorhinolaryngologist. Zomwe zimayambitsa chizindikirochi zimatha kukhala zovuta zosiyanasiyana, zomwe nthawi zambiri zimakhala kupindika kwa mphuno yamphuno, sinusitis (sinusitis), matenda obanika kutulo komanso matenda obanika kutulo.
Zifukwa za ENT pathologies
Nthawi zambiri, zomwe zimayambitsa matenda a ENT zimasiyanasiyana malinga ndi mtundu wa chilema.
Kupindika kwa nasal septum, mwachitsanzo, amapezeka mwa ana ndi akuluakulu. Komabe, monga lamulo, ana ambiri amakhala ndi septum yamphongo yamphongo kuyambira kubadwa. Pakukula ndi mapangidwe a mafupa a nkhope, zolakwika zimachitika nthawi zambiri, kuvulala kumachitika, chifukwa chomwe septum imatha kupindika. Komanso, vuto la kupuma limatha kukulirakulira panthawi yochita masewera olimbitsa thupi kapena pambuyo pake, pamene munthu akufunika kubwezeretsanso nkhokwe za okosijeni, koma sangathe kutero.
Zomwe zimayambitsa kukokomeza koopsa kwambiri ndizo apnea, ndiko kuti, obstructive sleep apnea syndrome (OSAS) ikhoza kukhala malocclusion komanso kusokonezeka kwa mphuno, nasopharynx, laryngopharynx. Mutha kukuthandizani kudziwa komwe kumachokera kukopera kwanu mayeso athunthu - kuwunika kwa mtima ndi polysomnography. Maphunzirowa amatithandiza kuzindikira mavuto amene munthu amakumana nawo akagona.
Zomwe zimayambitsa kukokomeza koopsa kwambiri ndizo apnea, ndiko kuti, obstructive sleep apnea syndrome (OSAS), ikhoza kukhala malocclusion komanso kusokonezeka kwa mphuno, nasopharynx, laryngopharynx. Mutha kukuthandizani kudziwa komwe kumachokera kukopera kwanu mayeso athunthu - kuwunika kwa mtima ndi polysomnography. Maphunzirowa amatithandiza kuzindikira mavuto amene munthu amakumana nawo akagona.
Kutupa kwa tonsils kwa nthawi yayitali (zilonda zapakhosi) zimathandizira ku matenda komanso kutengera kwa makolo. Zilonda zam'thupi, chitetezo chamthupi chosakhazikika komanso ngakhale caries zingayambitsenso matendawa. Kufika pa tonsil ya matenda, matendawa amakhala mu lacunae, ndiko kuti, muzopopera zomwe zimalowa mu makulidwe a tonsils. Zakudya zinyalala ndi mabakiteriya kulowa lacunae opunduka.
Chimodzi mwa matenda aakulu a mucous nembanemba wa paranasal sinuses ndi sinusitis... The zimayambitsa kutupa kungakhale onse kobadwa nako ndipo anapeza pathologies wa m`mphuno patsekeke. Bakiteriya kapena tizilombo matenda, matupi awo sagwirizana rhinitis komanso tifulumizane isanayambike sinusitis. Ngati muwona kutayika kwa fungo ndi kukoma, kupweteka mutu, kufooka, ndipo chofunika kwambiri, kutuluka kwa ntchentche yachikasu kapena yobiriwira kuchokera kumphuno, mwinamwake njira yotupa imakhalapo.
Njira zowongolera ndi kuchiza ma pathologies
1. Kuwongolera kupindika kwa septum ya m'mphuno zotheka ndi chithandizo cha opaleshoni - septoplasty... Opaleshoni akulimbikitsidwa odwala 18-20 zaka, kuyambira m`badwo uno wa nkhope mafupa amaonedwa mokwanira anapanga. Komabe, ana amathanso kuchitidwa septoplasty ngati ali ndi kupindika kwakukulu kwa septum ya m'mphuno, zomwe zimawononga thanzi la mwanayo. Panthawi ya opaleshoni, zidutswa zokhotakhota za septum ya m'mphuno zimachotsedwa kapena kusuntha. Zosintha zonse zimachitika mkati mwa mphuno, kotero palibe zizindikiro pakhungu. Panthawi ya septoplasty, ndizotheka kukonza mavuto omwe akubwera, chifukwa chake kuwunika kwa endoscopic kwa mphuno yamphuno ndi computed tomography ya sinuses paranasal ndikofunikira musanachite opaleshoni. Zomwe zafufuzidwa zimatilola kuzindikira mavuto kuphatikiza kupindika kwa septum ya m'mphuno ndikupatsa madokotala mwayi wowawongolera panthawi ya septoplasty.
2. Chithandizo cha opaleshoni ya matenda obanika kutulo chimasonyezedwa pakupuma kosavutikira komanso kupuma movutikira kwambiri. Kwambiri mitundu ya ma pathologies awa kutsutsana kuti alowererepo opaleshoni. Pali magawo atatu a chithandizo cha opaleshoni ya kugona ndi kukodzera.
Choyamba ndi kukonza mkamwa wofewa.
Chachiwiri ndikuchotsa mwachangu ma pathologies amphuno. Izi zikuphatikizapo kukonzedwa kwa nasal septum, turbinates, sinuses.
Chachitatu ndi kuphatikiza kwa njira izi.
3. Matenda a tonsillitis amapezeka panthawi yokambirana ndi kuyang'anitsitsa (katswiri amawona zomatira za tonsils ndi arches), komanso malinga ndi zotsatira za mayesero a labotale (dokotala amayang'ana zizindikiro za matenda a streptococcal).
Atazindikira pachimake tonsillitis zopatsidwa mankhwala a antiotic.
RџS•Rё mawonekedwe osachiritsika matenda, tikulimbikitsidwa kuchotsa zomwe zili mu lacunae ya tonsils pogwiritsa ntchito:
Kutsuka и njira ya mankhwala.
Anapatsidwanso physiotherapy - kuwala kwa ultraviolet ndi ultrasound m'chigawo cha submandibular.
Ngati njira zoterezi zilibe zotsatira zomwe mukufuna, tikulimbikitsidwa kuchitapo opaleshoni - kuchotsa tonsils.
Mmodzi wa zotheka opaleshoni njira zochizira matenda tonsillitis ndi radio wave fulguration ya tonsils… Amakhala kugwiritsa ntchito mkulu-pafupipafupi magetsi kuti cauterize minofu popanda kukhudzana mwachindunji ndi elekitirodi ndi minofu.
Njira yamakono yamakono ingagwiritsidwenso ntchito - robotic yothandizira tonsillectomy… Kuchotsedwa kwa matani motere kukuchitika molunjika bwino chifukwa cha makina amakono a robotic ndi zida zamakanema a endoscopic.
3. The tingachipeze powerenga mankhwala sinusitis ndi mankhwala.zolembedwa ndi dokotala. Komabe, mwatsoka, njirayi nthawi zambiri imatsimikizira kusagwira ntchito kwake, popeza zizindikirozo zimangopita kwa kanthawi, ndipo matendawa amapita kumalo aakulu.
Njira yatsopano komanso yothandiza yochizira sinusitis pakali pano ntchito endoscopic sinus opaleshoni… Izi malangizo a mankhwala kumafuna baluni sinusoplasty. The ndondomeko minimizes kuopsa kwa kutaya magazi, zoopsa, postoperative mavuto ndi kuphwanya masoka anatomy wa nkusani. Panthawi ya baluni sinusoplasty, popanda kuwononga mucous nembanemba, akatswiri amatsegula zilonda zotupa, kuyika katheta ya baluni pamenepo, ndikuifufumitsa ndikugwiritsa ntchito njira zapadera zotsuka mafinya ndi mafinya. Mukatsuka, chidacho chimachotsedwa pabowo.
Nthawi yokonzanso
1. Monga ulamuliro, postoperative nthawi pambuyo septoplasty m'chipatala nthawi zonse masiku 1-2… Wodwalayo atha kupita kwawo. Kupuma kwachizolowezi kumabwezeretsedwa mkati mwa masiku 7-10. Panthawi yokonzanso, tikulimbikitsidwa kuti tipewe kusuta, kumwa mowa, kupsinjika kwa thupi komanso kutentha, kuti musawombe mphuno kwambiri, komanso kuti musachotse ma tamponi mkati mwa maola XNUMX mutatha opaleshoni. Izi zidzachepetsa chiopsezo chotaya magazi.
2. Opaleshoni ya Apnea Amachitidwa pansi pa anesthesia. Nthawi yokonzanso ndi pafupifupi masabata xnumx... Kuwonjezera opaleshoni zikunena zochizira snoring, n`zotheka ntchito matenda a intraoral or Chithandizo cha CPAP… Mankhwalawa tichipeza kulenga zabwino anzawo, amene amathandiza kubwezeretsa airway patency. Akagona, wodwalayo amavala chigoba cholumikizidwa ndi chipangizo chomwe chimapangitsa kuti munthu azipanikizika.
3. Ma tonsils amachotsedwa pogwiritsa ntchito mankhwala amakono. Izi sikuti zimathandiza kuti omasuka opaleshoni wodwalayo, komanso amapereka mwamsanga kuchira nthawi.
4. Nthawi yokonzanso pambuyo pake baluni sinusoplasty pafupifupi ndi tsiku linapambuyo pake opaleshoni yapamwamba wodwala amafunika kuchira kuyambira masiku atatu mpaka asanu.