Bangane abathandekayo, sesixoxile kwenzakalani futhi
Kubukeka sengathi yini enzima kangaka ngalokhu?
Kodwa! Kuze kube manje, iziguli ziyafika zizobonisana futhi zithi - “Kodwa komunye umtholampilo udokotela uthe...” Zithi amazinyo anjalo ayinkimbinkimbi ngendlela exakile awakwazi ukukhishwa ngaphandle kwesibhedlela, emnyangweni wokuhlinza i-maxillofacial, ngisho nangaphandle kokubulala izinzwa okuvamile. . Njengokuthi, kugcwele imiphumela.
Akukhona nje ukuthi amagama athi "isibhedlela" kanye "nokuhlinzwa kwe-maxillofacial" avusa umuzwa wokwesaba onqenqemeni lokuhlasela kweziguli eziningi, kodwa ngemva kwezitatimende ezinjalo kunzima kakhulu ukuzikholisa ngenye indlela.
Ngemuva kokusatshiswa okunjalo, futhi angikwazi ukukubiza ngokuthi yini enye, abaningi baya esibhedlela, baqoqe izivivinyo, bavume ukufakwa kwe-intubation anesthesia futhi balale emawadini izinsuku ezimbalwa, bejabulela umphakathi wendawo, isimo sengqondo sokunaka sabahlengikazi kanye ne ukutheleleka kwe-nosocomial.
Ngasikhathi sinye, embuzweni othi "Usichazele kanjani isidingo sokukhishwa kwezinyo kuphela emnyangweni wokuhlinzwa we-maxillofacial?" Angikaze ngithole impendulo ecacile.
Okuwukuphela kwento abavame ukuyisho ukuthi: "Awu, bangitshele ukuthi izinyo liyinkimbinkimbi ... lijulile ... kukhona inzwa eduze kwalo ...". Yebo, ngingacabanga kahle ukuthi konke lokhu kuyiqiniso, futhi kukhona i-nerve lapho, futhi isokhethi nayo ijulile, kodwa ... uyini umehluko oyisisekelo endleleni yokukhishwa kwesiguli kanye nesiguli?
Ukuhlola?
Hhayi-ke, ukuskena kwe-CT (isithombe sevolumu ye-3D) singenziwa-noma yikuphi.
Yini?
Futhi ngenxa yokuthi i-orthopantomography (i-OPTG, inhlolovo noma isithombe se-panoramic samazinyo) i-planar, okusho ukuthi umniningwane ngamunye wesithombe ugqizwe ungqimba ngongqimba komunye nomunye. Ngakho-ke, akunakwenzeka ukuhlola into efundwayo, ikakhulukazi, indawo yezinyo lokuhlakanipha eliseduze ne-mandibular nerve, kuzo zonke izindiza, ukusuka kwelinye i-engeli noma ekuqageleni okuhlukile. I-CBCT (Cone Beam Computed Tomography), ngokuphambene nalokho, isinika leli thuba.
Mhlawumbe lawa mayunithi akho e-maxillofacial aqasha odokotela abaqeqeshwe ngokukhethekile abanesu lokukhipha izinyo okungaxhunywana naye? Yikuphi, ngaphandle kokusikwa noma yimuphi umzamo, okuzophoqa isi-8 ukuba sihlakazeke ngamandla okucabanga nje?
Hhayi-ke, cha!
Futhi ngilokhu ngibuza: “Kusobala ukuthi izinyo likhishwe ngokushesha futhi akukho okukukhathazayo?” Crap! Angizange ngifike lapha.
Isikhathi esimaphakathi sokususwa kwamazinyo okuhlakanipha athinteke kancane (lawo angaphansi kwezinsini ngokuphelele) ezikhungweni ezinjalo, ngokusho kweziguli, amahora angu-2,5. Ngezwa izikhathi ezimbalwa, cabanga nje ngakho, cishe amahora angu-4(!). Awucabangi ukuthi lokhu kuwukudlula ngokweqile? Ngalesi sikhathi, ungenza i-sinus lift nhlangothi zombili, ufake izimila eziyi-8, uzihlelele ukudla kwasemini, futhi ube nesikhathi sokuthatha isihlwathi. Esitatimendeni sami njengokuthi "emtholampilo wethu, ukususa izinyo elifana naleli kuthatha isilinganiso semizuzu engu-25-30, kusukela ekubulaweni kwezinzwa kuya kumthungo," abantu abaningi, ukuyibeka kancane, babuke ngokumangala.
Ngicabanga ukuthi, njengoba uchithe amahora angu-4 esihlalweni sikadokotela wamazinyo, ngisho noprofesa othile, elenga nge-regalia, ngeke akholelwe ukuthi konke lokhu kwakungenziwa "kancane" ngokushesha. Futhi endaweni enobungane, ezolile futhi enethezekile. Ngaphandle kwezingozi nokukhathazeka okungadingekile.
Pho kungani abantu bethunyelwa esibhedlela i-maxillofacial ukuze bakhishwe amazinyo obuhlakani? Ubani owenza lokhu?
Nakhu ukuthi ubani:
- kungenzeka ukuthi udokotela akazi ukuthi/ uyesaba kanjani ukukhipha amazinyo anjalo futhi ufuna ukuwenza aphephile ngokukuthumela komunye uchwepheshe (okungenzeka kakhulu)
- noma bafuna ukukuqola ngemali.
Iphuzu lokuqala licacile. Uma ungazi ukuthi kanjani, nikeza omunye umuntu. Lokhu kulungile.
Kodwa imali ihlangene ngani nayo futhi kungani “idivosa”? Ngoba ukhokhela izinsizakalo, njengoba sisanda kuthola, ezingadingeki:
- izindleko zosuku oluchithwa esibhedlela zingama-ruble ayizinkulungwane ezingu-4. Kuye ngokuthi uzoba nekamelo elilodwa, noma ubusuku obuningana uzozwa ukuhona kwabanye abantu abangamashumi amabili "abanenhlanhla" abafanayo abanamazinyo okuhlakanipha.
Kepha akupheleli lapho.
Uma i-anesthesia ejwayelekile idingeka, engeza emalini esetshenziswe ewadini ukubonisana nodokotela obulala izinzwa-okuvuselela kabusha (cishe ama-ruble ayizinkulungwane ezingu-1,5), ukuhlolwa kwelabhorethri okudingekayo (ngokwesilinganiso sama-ruble ayizinkulungwane ezingu-3), kanye nenqubo yokubulala izinzwa ngokwayo. Okungenani amahora amabili, kodwa ngezinye izikhathi ngaphezulu. Futhi lokhu kungakubiza kusuka kuma-ruble ayi-8 kuye kwangama-30 ayizinkulungwane.
Kodwa ukuhlinzwa ngokwayo kuwufanele okuthile, akunjalo? Njengomthetho, ukususa izinyo elithintekile kubiza kusuka kuma-ruble ayi-14 kuye kwangama-23 ayizinkulungwane. Singacabanga ukuthi esibhedlela esihle izindleko zokususwa zizoqhathaniswa (ngaphandle kwewadi, i-anesthesia, ukuhlolwa, ukubonisana kanye ne-anesthesia).
Uyawuzwa umehluko? Hhayi-ke, akusona yini isehlukaniso? Bayakwethusa, bese bayakuqola imali. Imali eningi impela.
Kungani ngisho ukubhala konke lokhu?
Ngifuna ukunitshela, bangane abathandekayo, lokho ngokweqiniso Awekho amazinyo obuhlakani angakwazi ukususwa ngaphandle kwesibhedlela, ngesikhathi esimisiwe esijwayelekile sesiguli esingaphandle. Ngemva kokuchitha okungenani imizuzu engamashumi amane ekubonisaneni, ukuhlolwa kanye nokusebenza ngokwakho, uzoxazulula inkinga unomphela. Esikhathini esifushane ngangokunokwenzeka, uzobuyela emsebenzini, uzokwazi ukuqhubeka nebhizinisi lakho, cishe ngaphandle kokuphambuka endleleni yakho yokuphila evamile. Asikho isidingo sokuthatha ilivu yokugula futhi uqashe umhlengikazi. Phila impilo yakho evamile, kodwa ngezincomo ezithile zangemuva kokuhlinzwa, ama-aphoyintimenti nokuhlolwa.
Ngiyabonga ukulalela kwenu. Ngizojabula ukuphendula imibuzo yakho kumazwana!
Ozithobayo, u-Andrey Dashkov
Yini enye ongayifunda ngamazinyo okuhlakanipha nokususwa kwawo?
Source: www.habr.com