Okondedwa takambirana kale zomwe zimachitika ndi
Zikuwoneka kuti ndi chiyani chomwe chili chovuta kwambiri pa izi?
Koma! Mpaka pano, odwala amabwera kudzawonana ndi kunena kuti - "Koma kuchipatala china adokotala adati..." Amanena kuti mano ovuta kwambiri oterewa sangachotsedwe kunja kwa chipatala, m'dipatimenti ya opaleshoni ya maxillofacial, komanso popanda opaleshoni. Monga, wodzala ndi zotsatira.
Sikuti mawu oti "chipatala" ndi "opaleshoni ya maxillofacial" amadzutsa mantha pafupi ndi mantha mwa odwala ambiri, koma pambuyo pa mawu otero zimakhala zovuta kwambiri kuwatsimikizira mosiyana.
Pambuyo pa mantha oterowo, ndipo sindingathe kutchula china chirichonse, ambiri amapita kuchipatala, kukatenga mayesero, kuvomereza intubation anesthesia ndikugona m'mawodi kwa masiku angapo, kusangalala ndi anthu ammudzi, kumvetsera mwachidwi kwa anamwino ndi anamwino. matenda a nosocomial.
Nthawi yomweyo, ku funso "Kodi munalungamitsa bwanji kufunikira kochotsa dzino mu dipatimenti ya opaleshoni ya maxillofacial?" Sindinalandirepo yankho lomveka bwino.
Chinthu chokhacho chomwe amangonena nthawi zambiri ndi: "Chabwino, adandiuza kuti dzinolo ndi lovuta ... ndi lakuya ... pali mitsempha pafupi ndi izo ...". Inde, ndikutha kuganiza kuti zonsezi ndi zoona, ndipo pali minyewa pamenepo, ndipo socket ndi yakuya, koma ...
Mayeso?
Chabwino, CT scan (chithunzi cha volumetric cha 3D) chikhoza kuchitika kulikonse.
Zachiyani?
Ndipo chifukwa orthopantomography (OPTG, kafukufuku kapena panoramic fano la mano) ndi planar, kutanthauza kuti tsatanetsatane wa fano ndi pamwamba wosanjikiza wosanjikiza wina ndi mzake. Chifukwa chake, ndizosatheka kuyang'ana chinthu chophunzirira, makamaka, dera la dzino lanzeru lomwe lili pafupi ndi mitsempha ya mandibular, mu ndege zonse, kuchokera kumbali ina kapena kuyerekezera kosiyana. CBCT (Cone Beam Computed Tomography), m'malo mwake, imatipatsa mwayi umenewu.
Mwina ma maxillofacial units anuwa amalemba madotolo ophunzitsidwa mwapadera omwe ali ndi njira yochotsa dzino osalumikizana? Ndi ziti, popanda kudulidwa kulikonse kapena kuyesetsa kulikonse, zomwe zingakakamize 8 kusungunuka ndi mphamvu chabe yamalingaliro?
Chabwino, ayinso!
Ndipo ndimafunsabe kuti: "Zikuoneka kuti dzinolo linachotsedwa mwamsanga ndipo palibe chimene chikukuvutitsani?" Zopusa! Sindinafike ngakhale pano.
Nthawi yapakati yochotsa mano anzeru (omwe ali pansi pa chingamu) m'malo oterowo, malinga ndi odwala, ndi maola 2,5. Ndinamva kangapo, tangoganizani, za 4 (!) maola. Kodi simukuganiza kuti izi ndi zochuluka? Panthawiyi, mutha kukweza sinus mbali zonse ziwiri, kukhazikitsa ma implants 8, kudzipangira nokha chakudya chamasana, komanso kukhala ndi nthawi yoti mugone. Kwa mawu anga monga "m'chipatala chathu, kuchotsa dzino monga izi kumatenga pafupifupi mphindi 25-30, kuchokera ku anesthesia kupita ku suture," anthu ambiri, kunena mofatsa, amayang'ana modabwa.
Ndikuganiza kuti inu, pokhala maola 4 pampando wa mano, ndipo ngakhale pulofesa wina, atapachikidwa ndi regalia, sangakhulupirire kuti zonsezi zikanatheka "pang'ono" mofulumira. Ndipo m'malo ochezeka, odekha komanso omasuka. Popanda zoopsa ndi nkhawa zosafunikira.
Ndiye nchifukwa chiyani anthu amatumizidwa ku chipatala cha maxillofacial kuti akachotse mano awo anzeru? Ndani amachita izi?
Nawa ndani:
- mwina adotolo sakudziwa momwe/amawopa kuchotsa mano oterowo ndipo akufuna kuchita bwino pokutumizani kwa katswiri wina (zomwe ndizotheka)
- kapena akufuna kukuwonongerani ndalama.
Mfundo yoyamba ndi yomveka bwino. Ngati simukudziwa, perekani kwa wina. Izi ndi zolondola.
Koma kodi ndalama zimagwirizana ndi chiyani ndipo n'chifukwa chiyani "amasudzulana"? Chifukwa mukulipira ntchito zomwe, monga tapeza, sizofunika:
- mtengo watsiku womwe umakhala m'chipatala ndi pafupifupi ma ruble 4. Kutengera ngati mudzakhala ndi chipinda chimodzi, kapena kwa mausiku angapo mudzamva kulira kwa anthu ena makumi awiri omwe ali ndi "mwayi" omwe ali ndi mano anzeru.
Koma sizokhazi.
Ngati anesthesia wamba ndi wofunikira, onjezerani ku ndalama zomwe zagwiritsidwa ntchito m'chipindamo kukambirana ndi wogonetsa-resuscitator (pafupifupi ma ruble 1,5), kuyezetsa koyenera kwa labotale (pafupifupi ma ruble 3), komanso njira yamankhwala ogonetsa. Osachepera maola awiri, koma nthawi zina ochulukirapo. Ndipo izi zitha kukuwonongerani ma ruble 8 mpaka 30.
Koma opaleshoni yokhayo ndiyofunika, sichoncho? Monga lamulo, kuchotsa dzino lokhudzidwa kumawononga ma ruble 14 mpaka 23. Titha kuganiza kuti m'chipatala chabwino mtengo wochotsa udzakhala wofanana (osawerengera ward, anesthesia, mayesero, zokambirana ndi anesthesia).
Kodi mukumva kusiyana kwake? Chabwino, si chisudzulo? Amakuopsezani, kenako amakulandani ndalama. Ndalama zambiri ndithu.
Nβchifukwa chiyani ndinalemba zonsezi?
Ine ndikufuna kukuuzani inu, abwenzi okondedwa, izo mochitachita Palibe mano anzeru omwe sangachotsedwe kunja kwa chipatala, pa nthawi yokumana ndi odwala kunja. Mutakhala mphindi makumi anayi pakukambirana, kufufuza ndi ntchito yokha, mutha kuthetsa vutoli kamodzi. Munthawi yaifupi kwambiri, muyambiranso, mudzatha kuchita bizinesi yanu, osapatuka ku moyo wanu wamba. Palibe chifukwa chotenga tchuthi chodwala ndikulemba ntchito namwino. Khalani ndi moyo wabwinobwino, koma ndi malingaliro ena atatha opareshoni, kusankhidwa ndi mayeso.
Zikomo chifukwa chakumvetsera. Ndidzakhala wokondwa kuyankha mafunso anu mu ndemanga!
Moona mtima, Andrey Dashkov
Ndi chiyani chinanso chomwe mungawerenge ponena za mano anzeru ndi kuchotsedwa kwawo?
Source: www.habr.com