Iyo microdebrider yaive yepamutemo muna 1969 kuitira kushandiswa kwekubvisa zvipembenene zvakapoteredza mutsara. Kubvira panguva iyo, kushandiswa kwemakemikari yakagadzirwa semushandi wekuvhiya unoshandiswa mumakumbo emapfupa uye zvekuvhiya kwechivi uye chekupedzisira mumakore ekuma 1990. Ichi chiridzwa ndechimwe chezvinhu zvakakosha zvikuru zvakaiswa mumunda we rhinology.
Iyo microdibrider isimbi yakagadzika ine tambo yakadzika ine chikamu chemukati uye chekunze. Pamugumo we tube, zvose zviri mukati uye kunze zvemukati zvine tube iyo inoderedza tissue sezvinonzi mapeji anofamba mberi uye mberi. Iyo catheter inoramba ichinyanya kushandiswa kune chigadzirwa kuitira kuti kutema mishonga inotorwa uye kubviswa kubva panzvimbo yekuvhiya. Iyo inokurumidza mashizha anotamisa zviduku zviduku, asi zvishoma nezvishoma mashizha akaiswa, iyo huru zvikamu. Unhu hwekucheka hwakakosha kuti hushandiswe nehutano kana kenza kana imwe sarudzo-tsanangudzo yekutsvaga inoda kuitwa.
Nzira Dzakasiyana
Pamberi pemashandisirwo emagetsi, chirwere chechivi kazhinji chinosanganisira kushandiswa kwechirongwa chechireta uye simba. Iyi yakanga iri nzira yekubatsira kubvisa pfupa nematehwe kubva kumapapiro emasasa uye masasa. Power drills isiriwo rimwe simba rekushandisa iro rinogona kushandiswa mukugadzirwa kwekuvhiya.
Tichaongorora kubatsirwa kwokuti kushandisa microdebrider kwaunza kunyika yekuvhiya. Zvisinei, muchiito, vanachiremba vanovhiya vanowanzoshandisa kusanganiswa kwepurettes, microdebriders, uye forceps.
Kubatsirwa
Microdebriders vane zvakawanda zvinobatsira. Yokutanga inosanganisira zvakasiyana-siyana zvezano rinogona kushandiswa. Zvichienderana nemhando yehutano huri kuitwa, zvimwe zvinowanikwa zviripo zvinogona kuuya nemapurogiramu anotangira, izvo zvinobvumira kuwana nyore nyore kune nzvimbo dzakaoma dzokuvhiya (sezvinoitwa sinanas paranasal).
Mamwe mazano anobvumirawo 360-degree rotation (kufanana ne Straightshot M4 iri mumufananidzo uri pamusoro apa), iyo inobvumira nzira dzakarurama dzematunhu anoda kubviswa.
Mabhesi anogonawo kugadziriswa ne microdibrider. Yakananga-yakakomberedzwa mapepa yakajeka uye inogona kunge isingatambudziki kupfuura mamwe mavara. Nepo mashizha akaomeswa anopa kubata kwakanaka kune chiremba. Aya mazai anogona kuva nekukurumidza kuchinjwa kuti abvumira kushanda kwakasimba kwekucheka pamwe nekucheka mapfupa. Nzira dzakajairika dzingashandisa izvi kumapfupa dzinosanganisira:
- Septoplasty inosanganiswa ne septum yakatsauka
- Septal spur resection
- Dacryocystorhinostomy inobatanidza ne nasolacrimal duct kudzivirira
Nepo kushandiswa kwemakemikarikoni hakuzogadziri dambudziko rekubuda ropa, kupfuurira kunobvumira vashandi vako vanoona chiitiko chekuvhiya kuti vakwanise kugara kwenguva yakareba kwenguva yakareba. Izvi zvinogona kuderedza nguva yakawanda yekuvhiya inodiwa kuita chirwere chako kuburikidza nekuderedza nhamba yenguva iyo chiremba anovhiya anoda kuchinja zviridzwa. Mimwe michina yakawanda yakagadzirisa michina yakawedzera kukwanisa kwekugadzirisa muchigadzirwa chimwechete icho chinowedzera kubvumira kurasikirwa kweropa kudarika uye kushandiswa kuduku kwezviridzwa.
Kukanganisika
Chimwe chinhu chiduku chiduku chinosanganisira kushandiswa kwe microdebrider muchigadzirwa chokugadzira ndiro mari inosanganiswa neyese unit uye iyo inogadziriswa mashizha kana ichienzanisa nezvimwe zvishandiso zvetsika.
Zvisinei, mumutambo chaiyo, izvi hazvisi zvido zvishoma kwauri semurwere. Simba rekushandisa rinobvumira zvishoma zvishoma kushungurudzika kune chiremba anovhiya achivhiya. Izvi zvinoita kuti zvive nyore kutsvaga zvimwe zvikamu zvezvivara zviduku zvakapoteredza chikamu che sinus. Izvi zvinova zvishoma zvekufunganya apo kubudisa bone ne microdebrider.
Matambudziko anoshandiswa nekushandisa microdebrider haawanzoitiki; zvisinei, zvakakosha kuti iwe unzwisise chero dambudziko raunganganisa nekuvhiyiwa kwako. Pamusana pekushandiswa kwepamusoro-soro, kunomumwe mitsara yekukuvadza kwakaitika.
Pakave nezviitiko zviviri zvakataurwa nezvekukuvara kwemaziso kunofanirwa kuenzanirana nesimba rekutsvaira pa microdebrider pamwe chete nekodha imwe ye subarachnoid hemorrhage (kuchenesa nzvimbo yakakomberedza uropi). Aya marudzi emishumo haawanzoitiki uye michina yakawanda inoshandiswa munyika yose zuva rega rega. Muchidimbu microdebriders zvipfeko zvakachengetedzwa zvinoshandiswa pakuvhiyiwa kwechivi.
Kunobva:
Bruggers, S. & Sindwani, R. (2009). Otolaryngologic Makliniki eNorth America. 42 (5), 781-787