Neck vagosympathetic blockade musi Vishnevsky

Drug blockade of remuromo vertebrae ari tsitsi hunde pamwe vagus etsinga anonzi "blockade vagosympathetic". Iye akarayira Aleksandr Aleksandrovich Vishnevsky vachida kukanganisa tsinga nomunhu panguva plevropulmonalnogo kuvhunduka nokuda yaizoitika zvirwere uye kukuvara muchipfuva nharaunda.

Zvinopa mudanga yakanaka kwakaguma zvirwere anogumbura hunhu uye zvakasiyana-siyana kuti tsandanyama matauriro.

Shane novocaine blockade ruzivo S. G. Zograbyan nechinangwa kubvuma gipotenzionny chirwere zvinorwadza mavambo. The zvaanorumbidza pamusoro experimental kukuvara uropi umo blockade muromo wechibereko urege tsitsi ganglia kwemhuka nemashoko chepfungwa hypotension kungaita kuti rakawedzera intracranial kumanikidzwa kwenguva pfupi nguva. Zvinoderedza nomusoro muna 80% nyaya pashure nzira. Asi mugumisiro dzakapfuura chete kuchitsauko maawa. Izvi imhaka yokuti blockade panguva chepfungwa vascular spasm anobatsira, somugumisiro nani ropa wedzerai muuropi.

Zvichienderana chii nzira?

Blockade vagosympathetic - nzira tsika-pathogenetic kurapwa pachishandiswa:

• Muchidimbu kumira peripheral huta patency.
• In zvakaitwa mbishi novocaine mhinduro kuti zvichikurukura mashandiro ari nechepakati tsinga (CNS).

Benefits blockade

Under urongwa uhwu Vishnevsky kuuya dzimwe mhedziso:

• Nezvikonzero zvakasiyana-siyana, chokutsva muitiro pakutanga kukura kwayo ndiko pasi mitemo chete.
• The kukura Chiito kuzvimba anogona umbomiswa kusvikira riri padariro serous infiltration kuti munyama.
• Zvakakomba kuzvimba chimiro nokukurumidza zvishoma, abscesses uye akabvumira zvishoma kupfuura - kunoratidzwa.
• Infiltrative, unsharp uye mamwe chisingaperi mhando kuzvimba akataurwa trophic panofamba, dzimwe nguva bystrorazreshimymi.
• The zvirwere chokuita Kumwe kuchinja kunotanga vari nhengo. Zvishomanana akashatirwa kuti tsinga, iyo anoita remuromo vagosympathetic blockade nhengo atakatora kubva dzakachinjwa mamiriro. In blockade iyi pezvakaitwa akadaro sei multi-basa: rinobvumira spasm, anodzosa paresis.
• Pezvakaitwa pathological hunhu, izvo zvinokonzerwa Kuchinja uchishandisa mundima uye capillaries, novocaine nechigumbuso anorayira kugadzirisa vasiri nzvimbo vascular rusvingo.

Ndezvipi blockades zviripo?

Funga mubvunzo uyu zvizere. The Mhando chikuru kuvharwa:

• Blockade pakati pakakuvara mapfupa refu.
• Futlyarnoy papfudzi nechigumbuso.
• Futlyarnoy blockade Shin.
• Blockade kwomuchinjikwa chikamu.
• The blockade of femoral etsinga.
• Sciatic tsinga.
• Tibial tsinga.
• Peroneal tsinga.
• Intercostal conduction blockade.
• Paravertebral blockade.
• Uye chokwadi, mutsipa vagosympathetic.

Vagosympathetic blockade: uchapupu

Zvairatidza remuromo vagosympathetic blockade vari zvakare:

• Plevropulmonalnoe kuvhunduka.
• Multiple rumbabvu mitswe.
• Open, akadzivira uye vharafu masumbu.
• Burns ari kufema turakiti.
• Postoperative nemabayo.
• Syndromes zvinorwadza kubitirwa.
• Syndromes kuti mafuta blockages (pulmonary fomu).

Kakawanda izvozvo ndepana pathologies izvi kuita muitiro.

To blockade akanga kuitwa vagosympathetic Vishnevsky nzira, unofanira kuziva zveufende-anatomical kubatana zviri tsitsi hunde uye vagus tsinga. neoplasms ava pamusoro hyoid mapfupa muna imwe kletchatochnyh nharaunda rinopa tsanangudzo ine synchronous ichivharira mukana kana kuzviita pano novocaine. Below vakakamurwa parietal rukoko yacho fascia wechina.

murwere gadziriro

Pamberi pakutanga blockade ari chiremba anoongorora IAA chinu kana ampoule rufimbi. Murwere anofanira kuva muna supine nzvimbo nokuda kuitwa yokutindivadza hakurevi haabatanidzi nechitarisiko yematambudziko siyana. Vasati vavhiyiwa nguva dzose zvakaipa ganda ane akambozvishandisa kuuraya utachiona mhinduro. The blockade unodiwawo. Processing zvinokosha kuitisa fanira hwaro, sezvo hazvibviri kudzivirira kuonana utachiona vari ponji nzvimbo.

Pashure paizvozvo, nzvimbo yacho ganda zvinokosha kumanikidza chena yomucheka.

Chii chinoitika chinotevera?

Murwere anoiswa pamusoro wake shure pasi chipande panguva imwe chete unoisa pamutsago. The musoro zvayaitenderera paguyo mune vakomana akananga kupi blockade. Ruoko murwere nokuda rokuputsa pasi blockade. By rwemberi kumucheto kurudyi sternocleidomastoid tsandanyama, pamusoro payo kusvika 1-1.5 masendimita jekiseni pasi ganda 1-2 Rine mamiririta 0.25-5% mhinduro yacho rufimbi zvichachipedza. Kana chimiro Yarema tsinga chisingaoneki, ipapo kupinza nzvimbo tsono akafanosarudza chechetere kuwana yokumusoro pamucheto epiglottis thyroid.

ari vagosympathetic blockade sei chaizvo anoita?

Chidobi akasiyana, voitakura kunze unyanzvi zvikuru vanokwanisa chete. vakasununguka ruoko tsandanyama uye nhumbi indekisi munwe zvakachinja muna uye overtures kutanga pose vertebrae ari remuromo nomuzongoza. Uyezve panguva munwe kuguma akatanga tsono guru uye tofambira poura akananga kutanga vertebral pamusoro. Panguva kupinza of tsono ine vhoriyamu duku, pa 2-3 Rine mamiririta, mushonga akanga anowedzera jekiseni rufimbi kuti kurwadziwa pakuvhiya. Pakangotanga tsono muromo akabata vertebrae kuita aspirate (kuitwa kuitira kudzivisa intravascular kwokubatsira ari rufimbi). Pashure pokusimbisa kuti ropa harina asvika ari sirinji zvishoma nezvishoma akawedzera 30-60 ml 0.25% mhinduro kubva rufimbi. The tsono ari ipapo vakabva rikazvisundira pamusoro jekiseni nzvimbo mbereko gauze kwemaminitsi 1-2.

Kana mukanyatsochengeta murayiro uye zvinoenderana nemitemo vagosympathetic blockade rufimbi mhinduro awane vagus etsinga uye dzimwe tsinga kuti Uchabva remuromo tsitsi hunde nodes.

Zviratidzo pashure nzira

Chinobudirira hwaiitwa blockade vagosympathetic murwere kunokonzera zvinotevera zviratidzo:

• Ptosis (vachirembedza rokumusoro fungiro).
• Miosis (marwadzo ari mudzidzi).
• Enophthalmos (confluence eyeballs nechomukati Horner kuti vanamwari vainamatwa vari vatatu).
• Akatsvuka kumeso uye mucous membranes nameso.
• Perikornealnaya vascular jekiseni.
• Kwakaderedza vangadikitira kuitwa blockade.

Neck vagosympathetic blockade musi Vishnevsky anovanza marwadzo, chikosoro dzepanguva, Machiridza kweropa maitiro uye anowedzera BP.

Blockade haagoni kuitwa kumativi ose kamwechete. The nguva penguva pakati kurapwa zvinofanira kuva kwemaminitsi 30-40. Uyewo panguva nzira haigoni kuwedzerwa kuna adrenaline rufimbi mhinduro.

Chii chinokonzera mitemo yakadaro? Chokwadi ndechokuti unogona netsaona kuwana kufema rutivi rwomuviri nokuda blockade.

yematambudziko

Mushure anokwanisika kuitikawo yematambudziko:

• Kutyora carotid tsinga panguva kuboora.
• Kutyora womukati jugular tsinga.
• Kutyora yegurokuro.

The ndingangokuvara atonia uye intestinal paresis (matambudziko akadaro regai zvinoda vavashandire).

izvi zvose zvinogona kukonzera remuromo vagosympathetic blockade musi Vishnevsky. Zvairatidza kwairi isu akaongororwa.

mapindukiro

Chimwe Kupindira pamutsipa kunoda kuwana, kureva, akagura neimwe paiva ganda. Kuvhura pamutsipa utsanana anofanira kuchengetedzwa, sezvazvakanyorwa amuudza muviri chikamu. Nokuda kwaizvozvi, pamutsipa uchishandisa transverse kuwana Kocher, vachifamba transverse ganda matanga. Sutures avhiyiwa hazvisi kazhinji asingaoneki. Kana tichiita mabasa pamusoro zvikamu Mutsipa longitudinal vanowanzoshandisa chikamu longitudinal achitevedza kumberi kana shure mucheto sternocleidomastoid tsandanyama. Kunyanya kuoneka vazvo pashure evaMedhia longitudinal chikamu. Vagosympathetic blockade (unyanzvi iwayo akakurumbira) kuchabatsira kudzivisa oparesheni ichi.

With svom vakagwinya havadi majee, vanofanira kuchengeta njodzi uye tirambe takamuka. Ipapo tsaona hachifadzi siyana zvinogona kudziviswa.