U kutyanda? Iintlobo kunye namagatya okuhlinzwa

Igama elithi "ukuqhutyelwa kokusebenza" ligama lesiGrike eliguqulelwe kwisiRashiya, eguqulelwe ngokoqobo lithetha "yenza ngesandla". Ukususela kwiminyaka emininzi yeGrisi iminyaka emininzi idlulile, kwaye namhlanje ukusebenza ngophando oluthile luyimpembelelo eyahlukileyo kwiimfucu eziphilileyo, ngexesha apho umsebenzi wendalo yonke ulungiswa. Ngethuba lokusebenza, izicubu ziyahlukana, zihanjiswe ziphinde zihlangane.

Imvelaphi

Ukuqala kokukhankanywa kokungenelela kokugqithisa kubhekisela kwikhulu le-VI BC. E. Ukususela ekuqaleni kweenkulungwane, abantu bayeke ukuphuma, balisa amanxeba kwaye banqunyulwa izitho ezichithwe okanye zithinteka yi-gangrene. Iimbali-zembali zonyango ziyazi ukuba ixesha elide ngaphambi kwexesha lethu abaphilisi bebazi indlela yokwenza i-trepanation yegazi, ukukhupha amathambo aphukile kunye ... nokususa i-gallbladder.

Kuzo zonke iincwadi zezifundo kwimbali yonyango kukho inkcazo yamandulo yokuba kwi-arsenal yogqirha kukho umsi, utshani kunye negama. Ukususela kumaxesha amandulo ukuya kwiintsuku zethu, ummese-ngoku ngokufana nawo, ngokuqinisekileyo-ngowokuqala. Ukusebenza yindlela ephezulu kakhulu yokunyanga, ukuvumela umntu ukuba asuse eso sifo ngonaphakade. Uphuhliso oluphucukileyo ngaphezu kwamanye uHippocrates, uGalen noCelsus.

Oyena ogqirha waseRussia wayenguNikolai Ivanovich Pirogov, ogugu lwakhe lokungcwaba lugcinwa eVinnitsa. Ngenxa yelifa lakhe langaphambili, izalamane zalaba baphatha kunye nokuzisindisa ekufeni ziyaqhubeka zihamba ngokukhululeka. Emva kokuba ugqirha ogqithisileyo wancedisa abamelwane bakhe bengenakho ukuhlawulwa - kwaye bamkhumbula kade. I-Pirogov isusile i-gallbladder kwiminitha engama-40, iibhululo zakhe ziyabonakala ethuneni-kunye neminwe ende ende.

Anesthesia okanye i-anesthesia

Naluphina usebenzo ngowokuqala kuyo yonke intlungu. Ngeentlungu, izicubu eziphilayo zichaphazelekayo kunye nokuphazamiseka kwegazi, ngoko ukususa intlungu yinto yokuqala yokungenelela ngophulo. Sivile ulwazi lwembali malunga nezinto ookhokho bethu abasebenzisa ngayo i-aneshesia: i-decoctions yezityalo eziqukethe izinto ezidakayo, utywala, i-marijuana, ibanda kunye ne-vasoconstriction.

Ukuqhutyelwa kokuhlinzwa kwenzeka phakathi kwekhulu le-XIX, xa i-nitrous oxide, i-diethyl ether, kwaye i-chloroform yafunyanwa. Ukususela ngeli xesha, i- anesthesia jikelele yaqala ukusetyenziswa . Kamva kamva, oogqirha baqwalasela i-cocaine ngengqiqo yokuba le nkunkuma i-anesthetizes tisses locally. Ukusetyenziswa kwe-cocaine kunokuqwalaselwa njengesiqalo somqhubi wendawo kunye nokungena ngaphakathi-anesthesia.

Ngaphakathi kwekhulu leminyaka elidlulileyo kukufumanisa izihlunu ze-muscle okanye izinto ezinokuthi zingakwazi ukukhupha izihlunu. Ukususela ngeli xesha, i-anesthesiology iye yavela njengezohlukeneyo zenzululwazi yezokwelapha kunye nolwazi olukhethekileyo, oluxhomekeke ngokuchanekileyo kunye nokuhlinzwa.

Usebenziso lwangoku luyinkimbinkimbi yezakhono ezivela kwamasebe ahlukeneyo amayeza. Singaxelela ukuba oku kuhlanganiswa kolwazi oluqokelelwa ngamayeza.

Umsebenzi wokuphanda: iintlobo zemisebenzi

Ukwahlula kwemisebenzi lukwahluke ngohlobo lwongenelelo, ukuphuthuma kunye nesigaba.

Ngokwemvelo, usebenzo lunokuba lukhulu, luphawu oluthile okanye olusisigxina.

Ukuhlinzwa ngokugqithiseleyo kukupheliswa ngokupheleleyo kwenkqubo ye-pathological. Umzekelo weklasi ukukhutshwa kwesilwanyana esivuthayo esivuthayo esine-appendicitis.

I-Symptomatic kukupheliswa kweempawu ezibuhlungu kakhulu zesifo. Ngokomzekelo, ngomhlaza wesibeleko, ukuhlukunyezwa okuzimeleyo akunakwenzeka, kwaye ugqirha ubonakalisa inxalenye enempilo yengxande kwindonga yangasemva yomzimba. Ngokuxhomekeka kwimeko epheleleyo yesigulane, isisu sisuswa ngokukodwa okanye kamva. Le ntlobo ihlanganiswe ne-palliative, kwaye iyakunqumla iingxaki ezahlukeneyo.

Uphuhliso oluphuculweyo nocwangcisiweyo

Ngamanye amaxesha isigulane sidinga inkqubo yokuphucula ngokukhawuleza. Iintlobo zengqesho zongxamiseko zenziwa ngokukhawuleza, kunyanzelekile ukuba zilondoloze ubomi. Yindlela yokuthambisa i-tracheotomy okanye i-conicotomy yokubuyisela ubuchwephesha bomoya, isithintelo esinomlomo kunye nobungqina obusongela i-hemothorax nabanye.

Usebenziso olukhawulezayo lunokumiselwa kwiiyure ezingama-48. Umzekelo - colic renal, amatye kwi-ureter. Ukuba, ngokuchasene nemvelaphi yonyango olulondolozayo, isigulane asiphumelelanga "ukuzala" ilitye, ngoko kuyimfuneko ukusisusa ngendlela yokusebenza.

Umsebenzi ocwangcisiweyo wenziwa xa kungekho zikho iindlela zokuphucula umgangatho wezempilo, kwaye akukho nengozi ngqo ebomini. Ngokomzekelo, ukuhlinzwa okwenjenjalo kukususwa kwemvini ekhulisiweyo ekungenakulinganisweni okungapheliyo. Kucetywayo kwakhona ukususwa kwama-cyst kunye neengxaki ze-bladder.

Ukuphanda: iintlobo zemisebenzi, izigaba zokuhlinzwa

Ukongeza koku ngasentla, usebenzo lunokuthi lube linye-okanye amanqanaba amaninzi ngeentlobo. Kwinqanaba elincinane, ukuhlaziywa kwezitho emva kokutshisa okanye ukulimala, ukufakelwa kwesikhumba sokukhupha isicatshulwa senyama kungenziwa.

Naliphi na umsebenzi owenziwa kwizigaba ezi-3: ufikelelo lokufikelela, ukwamkelwa komsebenzi kunye nokuhoxiswa. Ukufikeleleka kukuvulwa kwengqwalasela ebuhlungu, ukuchithwa kwezicubu ngendlela. Ukwamkeleka empeleni kususwe okanye ukuhamba kweethubhu, kwaye umphumo ukugqithwa kwazo zonke izicubu ezinqamleziweyo.

Ukusebenza kwilungu ngalinye kuneempawu zalo. Ngoko, utyando olwenziwe kwingqondo kaninzi ludinga i-trepanation yekrele, kuba ukufikelela kwizinto ezinengqondo kukho okokuqala ukuba uvule ipuleti yethambo.

Kwinqanaba lemveliso yokusebenza, iinqanawa, amathambo, iinxalenye zezitho ezingenanto, imisipha, i-fascia kunye nesikhumba zixhunyiwe. Konke ndawonye kwenza isilonda emva kokuphilisa.

Indlela yokunciphisa intlungu yomzimba?

Lo mbuzo ukhuthaza abagqirha bonke ixesha. Kukho imisebenzi enokufaniswa kwimeko yabo yokukhathazeka kwisifo ngokwayo. Inyani kukuba akusiyo yonke into eyenziwa yinto yokukwazi ukukhawuleza kwaye ihlangabezane neemeko ezifunyanwe ngexesha lokungenelela ngophengululo. Kwiindawo zokuzibandakanya, i-hernias, i-suppriments, i-dense, engabonakaliyo, iphazamisa imisebenzi yelungu. Ukongezelela, izibonda zingadibanisa okanye ziphephe kwiinqanawa ezilimele zingavulwa.

Zonke ezi nkxalabo zibangela ukuba oogqirha banciphise ubukhulu bezinto ezinobuncinane.

Kwaye kwakukho icandelo elikhethekileyo lotyando - i-microinvasive, xa kuqhutyelwa ukutyhulwa okuncinci kwesikhumba kunye nezihlunu, apho kusetyenziswa khona izixhobo ze-endoscopic.

Ukugqithwa kwe-Endoscopic

Lo msebenzi ogqityiweyo wokuhlinzwa. Iintlobo kunye nezigaba kulo zihluke. Ngale ngenelelo, ukuxilongwa ngokuchanekileyo kwesi sifo kubaluleke kakhulu.

Udokotela ogqirha ungena ngokubambisa okufutshane okanye ukutshitshiswa, izitho kunye nezicubu phantsi kwesikhumba ubona ngekhamera yevidiyo efakwe kwi-endoscope. Endaweni enye kufakwa i-manipulators okanye izixhobo ezincinci: i-forceps, i-loops kunye ne-clamps, apho iindawo ezichaphazelekayo zamathambo okanye izitho ezipheleleyo zisuswe.

Imisebenzi ye-Endoscopic sele isetyenziswe ngokusesikweni ukususela kwisiqingatha sesibini sekhulu lokugqibela.

Ukuhlinzwa ngaphandle kwegazi

Le yindlela yokulondoloza igazi lomguli ngexesha lotyando. Le ndlela isetyenziselwa ukuhlinzwa kwintliziyo. Xa uqhuba umsebenzi entliziyweni, igazi legazi liqokelelwa kwisiphaluka esingekho emzimbeni, apho ukujikeleza kwegazi kulo lonke umzimba kugcinwa. Emva kokusebenza, igazi libuyela kwiklasi yemvelo.

Inkqubo enzima kakhulu yindlela yokuhlinzwa. Iintlobo zemisebenzi, izigaba zayo zichongiwe ngumbuso othile wendalo. Le ndlela inceda ukuphepha ukulahlekelwa kwegazi kunye nesidingo sokusebenzisa igazi lomnikeli. Ukungenelela okunjalo kuye kwabonakala kwinqanaba lotyando lwe-transfusiology - isayensi yokumpontshelwa igazi legazi.

Igazi labanye abantu alilona usindiso kuphela, kodwa nakwabanye amaqhinga omzimba, ii-virus kunye nezinye izixhobo ezingaphandle. Ngona ulungelelwaniso olunzulu lwegazi lomnikeli alisoloko liphepha imigudu emibi.

Ukunyangwa kwamaVascular

Eli candelo lotyando lwanamhlanje lwanceda ukugcina ubomi obuninzi. Umgaqo wayo ulula - ukubuyiswa kwegazi ngeempahla ezinzima. I-Atherosclerosis, ukuhlaselwa yintliziyo okanye ukuxhwaleka kwindlela yokuhamba kwegazi, kuvela iingxaki. Oku kubangelwa yindlala yomoya kwaye ekugqibeleni ukufa kweeseli kunye nezicubu ezibandakanya zazo.

Buyisela ukuhamba kwegazi ngeendlela ezimbini: nge-stent okanye shunt.

I-stent isakhelo sesinyithi esithatha iindonga zesitya kwaye sivimbela ukungcola kwayo. I-stent isungulwa xa iindonga zeempahla zigcinwa kakuhle. I-stent ihlala isetyenziswe izigulane ezincinane.

Ukuba iindonga zeempahla zichaphazeleka yinkqubo ye-atherosclerotic okanye ukutshabalalisa okungapheliyo, oko kusenakukwazi ukubenza bahlukane. Kule meko, i-pass-pass okanye i-shunt idalwe igazi. Ukwenza oku, thabatha inxalenye yesisu somfazi uze uvumele igazi kulo, ujikeleze isayithi esingenakunceda.

I-Bypass ubuhle

Lo ngowona msebenzi ogqityiweyo ogqityiweyo, iifoto zabantu abaye badlulela kuyo, bakhanyisa kumaphephandaba namaphephancwadi. Isetyenziselwa ukunyanyisa ukunyameka kunye nohlobo lwe-2 lweswekile. Bobabini le miqathango inxulumene nokutya okungapheliyo. Ngethuba lokusebenza, i-ventricle encinci yenziwa ukusuka kwindawo yesisu esisemngceleni we-esophagus, engenayo ngaphezu kwe-50 ml yokutya. I-intestine encinane ijoyina kuyo. I-duodenum kunye nesisu esilandelayo siyaqhubeka nokuthatha inxaxheba ekutyeni ukutya, njengoko le sayithi idibanisa ngezantsi.

Isigulane emva kwalolu msebenzi singadla encinci kwaye siphuluke kwi-80% yesisindo sangaphambili. Kudinga ukutya okukhethekileyo, kulungiswe ngeprotheni kunye namavithamini. Kwabanye, utyando olunjalo luguqula ubomi, kodwa kukho izigulana ezikwazi ukululalisa i-ventricle eyenziwe ngokukhawuleza ukuya kwisayizi efanayo.

Izibilini zokugada

Iikhompyutha zobuchwepheshe zanamuhla zenza ukuba kwenzeke imimangaliso yangempela. Kwiindaba, iingxelo zongenelelo ezingavumelekanga, ezagqitywa ngempumelelo, zagqanyiswa kunye kwaye. Ngoko, ngoku kutshanje, oogqirha baseSpain baseMalaga baqhuba ukusebenza kwengqondo, ngexesha apho umqhubi wadlala i-saxophone.

Iingcali zeFransi zenza ukutshintshwa kwezicubu zobuso ukususela ngo-2005. Ukubalandela, oogqirha bama-maxillofacial kuwo onke amazwe aqala ukutsala isikhumba kunye nezihlunu ebusweni kwezinye iindawo zomzimba, ukubuyisela ubuso obulahlekileyo emva kokulimala kunye neengozi.

Ukwenza ukungenelelo kwanokuba ... kwisibeleko. Kukho iimeko xa umntwana esususwe kwisigxina se-uterine, isisu sasuswa, kwaye isiqhamo sabuya. Umntwana ozalisekileyo wexesha elizeleyo ozalwayo nguye umvuzo wogqirha ogqwesileyo.

Isayensi okanye ubugcisa?

Kunzima ukuphendula ngokuthe ngqo umbuzo lo mbuzo. Umsebenzi ophenywayo kukuxuba ulwazi, amava kunye neempawu zobuqu zogqirha. Omnye uloyiko lokuthatha ingozi, enye inokwenza konke okusemandleni kwaye engenakwenzeka kwimithwalo ayinayo okwangoku.

Ekugqibeleni i-Nobel Prize in Surgery yanikezelwa ngo-1912 kuMFrentshi u-Alexis Carrel ukuba asebenze kwi-suture ye-vascular kunye nokufakelwa kwenyama. Ukususela ngoko, kwiminyaka engaphezu kwe-100 yokuphunyezwa kokuphumelelayo ayinakunikwa inzala yeKomidi yeNobel. Nangona kunjalo, yonke iminyaka engama-5 kwindlela yokuhlinzwa, kukho ubuchwepheshe obuphucula ngokuphawulekayo iziphumo zayo. Ngoko, ukuhlinzwa ngokutsha ngokukhawuleza kwe-laser kukuvumela ukuba ususe isithintelo se-interverterbral, "uqhube" i-adenoma yeprotrate ngokusebenzisa izinto ezincinci, kwaye "u-solder" i-cysts ye-thyroid gland. Ukunyaniseka kwe-lasers kunye nokukwazi ukugungqa iinqanawa kunika ugqirha amandla okuphatha izifo ezahlukahlukeneyo.

Ugqirha wangempela namhlanje ubizwa ngokuba yi-inani lamabhaso kunye neebhonasi, kodwa ngaba inani labomi basindisiwe kunye nezigulane eziphilileyo.