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Neurosurgery: Chii Chinonzi Burr Hole?Imba inobhururuka ndiyo gomba rinoputirwa mucheka, iro rinozivikanwa sekrikan. Bhuni dzinogadziriswa kuti dzifambise kuvhiyiwazve, kana kuti ingangodaro ichinyangadza muhenya, zvichienderana nemamiriro ezvinhu. Hazvisi nyore, burr hove igomba duku rakagadzirwa mudhehenya rine chirwere chokuvhiya.
Nzvimbo inoputika inogona kuitwa nokuda kwezvikonzero zvakasiyana-siyana, zvakadai sokuita ganiotomy yakakura, kudarika catheters yemvura inobvumira kuti cerebrospinal fluid drainage kana kuti kubuda ropa risingaperi .
Nzvimbo inoputika, kana kuti kazhinji masango, chikamu chakakosha chezhinji hwekuvhiya kweuropi. Sei? Dhehenya racho rakaoma kwazvo, zvichiita kuti chidimbu chechikafu chisakwanise. A saw rinogona kushandiswa kudurudza mufupa, asi kudzvora bhehenya kunoshandisa unyanzvi hwepamusoro uye nzira dzekudzivirira kukuvara kwouropi. Bhero rinoita kuti zvikwanise kugadziriswa mucheka pasina kuisa njodzi inopinza mukati mehutachi hwakaoma hutachiona.
Funga nezvenzvimbo inonzi burr sokutanga kwekudzidzira kuita chirwere cheuropi, panzvimbo yekuvhiyiwa pachako. Nzvimbo inoburitsa inoita kuti zvikwanisike "kubatanidza mavara" saka vanachiremba vanogona kuisa mabheji akawanda, saka shandisa chidimbu chakasiyana chekubatanidza masango iwayo uye kusimudza chikamu chetsanga. Izvi zvinosiya firiji kuti chiremba aite basa.
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Nei Chirongo cheBurr Chishandiswa?Nzvimbo inoshandiswa inoshandiswa kana pane dambudziko neuropi iyo inofanirwa kurapwa chirwere. Kuti uwane ruzivo rweuropi, crani (kana kuti nhehenya) inofanira kuvhurwa kuti ibvumira kupinda muuropi. Muzvizhinji zvekuvhiya, kuisa gomba mubhehenya ndiyo nzira yakanakisisa yekurapa kukuvara kana kurwara.
Pane zvikonzero zvakawanda nei chiremba aifanira kuvhiya uropi hunotanga ne burr hole. Zvikonzero izvi zvinogona kusanganisira:
- Kuti abvise kudzvinyirira kuuropi
- Kutanga kuvhara kukuru, kwakadai sekrianiotomy
- Kuisa ganda rinotaridzirwa mukati mehenya
- Kuti abvise ropa ravha
- Kubvisa tumarara
- Kuchengetedza kukanganisa
- Kubvisa chimwe chinhu kunze
- Kuisa chirongwa chechiremba, chakadai se shunt kana chemotherapy wafers
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Ngozi dzeBurr Hole ProcessBurr hole inogadziriswa ine ngozi huru, kuwedzera kune njodzi dzinobatanidza nekuvhiya kwose uye anesthesia zvinetso . Sezvakaitwa nekuvhiya chero kupi zvako, njodzi dzenzira yacho dzinofanira kuyerwa pamusoro pezvinobatsira. Mune zvimwe zviitiko, njodzi yekukuvara nekusingaperi kana kunyange rufu inogona kunge yakasiyana nekuvhiyiwa, saka iyo inofanirwa kuonekwa kana ichisarudza kuvhiyiwa.
Mune zvimwe zviitiko - kazhinji mushure mekurwadziwa kana kukuvadzwa kuuropi - kuvhiyiwa kunogona kuitwa sechisarudzo chokupedzisira. Mune zviitiko izvi, njodzi dzenzira yacho dzakakwirira zvikuru, asi kusaita chirwere kunogona kukonzera rufu, saka chisarudzo kazhinji chinonetsa kwazvo.
Ngozi dzekuvhiya kuti uise bundu rinosanganisira:
- Seizure
- Bleeding
- Stroke
- Kurwara kwekudzikwa kana uropi
- Kupera kweuropi
- Kuora kwehupombwe, kusanganisira kuchinja mukati memanzwi, zvinetso zvepfungwa, kusangana kwekutarisana uye kutadza kutaura
- Kuzvimba kweuropi
- Coma
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Nzira yeBurr HoleBurr chirwere chinokonzerwa chinoshandiswa neurosurgeon, chiremba anovhiya akadzidziswa zvakananga muuropi uye chirwere chepfungwa, anozivikanwa sechiitiro chekuvhiya.
Kuti uite burr hole nzira, nzvimbo yepachipi iyo inofanira kuiswa inofanira kuvezwa yakachena bvudzi. Ipapo ganda richagadzirirwa nechinangwa chakakonzerwa kugadzirisa zvirwere pamusana peganda. Apo musoro unogona kuveurwa mushure mekuvhiyiwa, ganda rinogadzirwa richaitwa munzvimbo yekushanda. Izvi zvinogona kuitwa kana pakarepo kana mushure mokunge anesthesia inopiwa, uye zvinodiwa kuderedza dambudziko rehutachiona.
Mushure mokunge anesthesia muperekedzi ave achitarisira kugara, murwere achaputirwa uye achaiswa muvharidziro , kana vasati vava kugamuchira rubatsiro nekufema kwavo. Izvo zvinoitwa kuchengetedza mhepo uye kuendesa okisijeni panguva yekuvhiyiwa.
Munguva pfupi, anesthesia inotanga kushanda, uye murwere achange akamira panzvimbo yokuvhiya. Izvi zvinowanzoitwa mune imwe yenzira mbiri: Kana iyo musoro inotsigirwa pamapiro kana tirasi, kana kuti misoro yemusoro inogona kushandiswa, iyo inofadza inobata musoro ichiri panzvimbo yakakodzererwa nekuvhiyiwa. Rimwe catheter ye foley rinowanzoiswa panguva ino, kana risati rasvika pane imwe nzvimbo isati yasvika.
Kana imwe nguva yakanyatsogadziriswa, kusanganisa kwokutanga kunogadzirwa mucheka, kuitira kuti ganda rinogona kubviswa kubva panzvimbo yekuvhiya. Mhepo inoshandiswa inonyanya kushandiswa inoshandiswa kupinda muhenya. Kunyange zvazvo kudonha kunogona kuonekwa sechinhu chinoshandiswa, inogadzirirwa kumira kudonha kamwechete kana bhehenya riri kupinda mukati, kudzivirira kukuvara kuuropi.
Mamwe mapuropi europi, akadai se ventriculostomy, anongoda chirongo chimwe chete chekuvhiya. Mune dzimwe mamiriro ezvinhu, imwe bhuvhu (s) inogona kuiswa, ipapo mabhuti anowirirana achishandiswa pfupa rinokosha rakaona. Izvi zvinobvumira chikamu chedehenya kuti chibviswe, iyo nzira inozivikanwa sekrianiotomy, iyo inopa chiremba chiremba nzvimbo yakawanda yekushanda pauropi.
Kana imwe nguva pfuti inopera yakapedzwa, kuwedzerwa kwekuwedzera kunofanira kuitwa muchigarire. Chigarire ndicho chifukidzo chakaoma pamusoro peuropi. Kunyange zvazvo ichiita seine firimu yakaonda, inenge yakasimba chaizvo uye inofanira kushandiswa kure.
Zvose zvinotevera zvinoshandiswa kuburikidza ne burr hole kana kuti craniotomy. Kana imwe nguva yapera, dura rinogona kugadziridzwa pamwe chete kana kubviswa kwakasara kuzaruka. Ganda racho richadzoserwa munzvimbo yayo chaiyo uye tsvimbo kana zvigadzirwa zvinoshandiswa kupfigira kuvhara.
Zvichienderana nehutano hwekuvhiyiwa, musoro unogona kuputirwa nemabhandeji kana kuti nzvimbo yacho inogona kunge isina kuvharwa nekugadzirisa zvishoma.
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Kudzorerwa Pashure peBurr Hole SurgeryIkoko hakuna kuzorodza kwemashure mushure mekuiswa kwebharr hole, sezvo zvikonzero zvekuita izvi zvakasiyana-siyana. Muzviitiko zvakakomba, murwere angave asina chaanoziva uye achirapwa muI ICU kwemazuva kana masvondo mushure mekugadzirisa, asi vamwe varwere vangave vakasvinura uye vachiita kazhinji nguva pfupi mushure mekubuda kune anesthesia.
Muzviitiko zvizhinji, murwere achadzoka muI ICU, yakadai sekuvhiya ICU kana neuro ICU, kwaanogona kunyatsoongororwa nevashandi. Izvi zvinobvumira murwere kuti arambe achicherechedza kubva kune vanamukoti uye chero zviratidzo zvezvinetso zvinofanira kuziviswa nokukurumidza.
Kuoma kwekukuvadzwa kana kurwara kucharaira kuti nokukurumidza murwere anodzokera sei kurarama, uye kana vakadzokera kune zvakajairika. Kune vamwe, kudzokera kumabasa avo chaiwo uye unhu hunoita zvishoma nezvishoma; kune vamwe, pangave pane uchapupu hushomanana hwekuti vaive nekuvhiyiwa kwakakosha mazuva mashoma kare.
Kuchengetedza kuvhara kuchave kwakakosha zvikuru, sezvo utachiona muhutachiwana hunogona kusvika nyore nyore maviri europi. Muzviitiko zvakawanda, ma antibiotics achapiwa kuti kudzivirira utachiona hurege kuitika, kunyange kana pasina hutachiona huripo iye zvino.
Irourosurgeon inoita chirwere ichi chichava yako yakanakisisa inopa ruzivo pamusoro pemhando yorudzii inofanira kutarisirwa. Vachazokwanisa kufunga nezvehutano hwehutano hwomurwere, kukosha kwekukuvadza kunokonzera burr hunodikanwa, pamwe nezera, nezvimwe zvinhu zvinobatsira pakukwanisa kugadzirisa zvakakwana.
Shoko Rinobva:
Iyo nguva dzose yakakomba kana munhu achida bundu rakaiswa, ingave kuongorora kana kuti kubvumira chirwere chakaoma zvikuru. Iwe unogona kutarisira nguva dzose kuchengetedza kwakasimba kugara uchiita nguva dzose kutarisa kunogona, uye kugona kunogona kunge kwakaoma. Pasinei nokuti chikonzero chekuvhiyiwa, chirwere chepfungwa chinoda kuti nguva yakakura yekurapa yemurwere ichienzaniswa nemamwe mavhiya chaiwo.
Sources:
Burr hole: Subdural Hematoma. Neurosurgery PA. Yakasvika muna March 2011. http://www.neurosurgerypa.com/procedures/Burrhole.html
Ngozi Yokuvhiya Njodzi. University of Maryland Medical Center. Yakasvika muna March 2011. http://www.umm.edu/ency/article/003018ris.htm