Fistula pamazima muvanhu vakuru

A fistula pamazino muvakuru kana vana ishamwari yepurulent yekuzvimba maitiro munzvimbo yezviuru makumi mashanu nemazana mashanu pazino rine chirwere. Ichi chiito chekudzivirira chemuviri, chiratidzo chinoda kutarisirwa uye kurapwa nokukurumidza, kana zvisina kudaro migumisiro yakakomba iyo inotyisidzira hutano uye kunyange hupenyu hauzove kwenguva refu mukuuya.

Chii chinonzi fistula

Iyi inzira yakakomberedzwa ne epithelium, uye inobatanidza kutarisa kwekuzvimba kwakaumbwa pamudzi wezino uye mumuromo wemuromo pachayo. Basa rayo ndere kuona kubuda kwepus kubva pakutarisa kwekuzvimba. Kubudirira kwefistula kunoitika zvishoma nezvishoma uye nguva dzose.

Kana pfungwa ye purulent kuzvimba yakaumbwa, saka nekufamba kwenguva huwandu hwayo hunowedzera, saka, kumanikidza kune matishu akavakidzana, kusanganisira pfupa, kunowedzera. Pus iri kutsvaga nzira yekubuda nayo uye inofamba ichienda kune kushoma kuramba, ichigadzira nzira yayo. Kubva pahupamhi hweshaya, pus inorwisa pasi peperiosteum, uye iyi ndiyo nzira iyo diki inoumbwa nayo. Varwere vanogona kuona bundu pagamu rine mucheno wepamusoro.

Zvimwe zviitiko zvinogona kuenda zvichienderana nemamiriro maviri.

Kana nokuda kwechimwe chikonzero, pus haigoni kuzviwanira nzira yekubuda nayo uye kuputsa periosteum uye mucous membrane, ipapo periostitis inokura, inozivikanwa se "flux". Zviratidzo zvakakodzera zvinoonekwa: kurwadziwa kwakanyanya, kunonzi edema, iyo inopesana nekuenzanisa kwechiso, hutano huzhinji hunogona kuwedzera, uye kutonhora kunogona kukwira.

Kana pus ikawana nzira yekubuda nayo, varwere vanocherechedza fistula. Paunenge uchimanikidza panzvimbo iyi, pus inobuda - uye panguva ino zviratidzo zvose zvinopera. Nokufamba kwenguva, apo kuputika kwepurulent kunopera, fistula inogona kunonoka, zvisinei, kana chikonzero chikuru chekuumbwa kwayo chisati charapwa, zvino chinogona kuumba zvakare panguva yekuwedzera.

Zvikonzero zvefistula pamazima muvanhu vakuru

Chikonzero chikuru uye chinowanzozivikanwa ndeye purulent kuzvimba kwakagadzira pamusoro pemazino, kureva, apical periodontitis. Uyezve, periodontitis idambudziko re caries, iyo isina kurapwa nenguva. Zvakadaro, pane zvimwe zvikonzero zvinoverengeka zvinogona kutungamira mukuumbwa kwepurulent kuzvimba:

• hurombo husina kunaka hwemidzi yekurapa nezve pulpit, pavakanga vasina kunyatsovharwa, vasina kunyatsogadziriswa uye hutachiona hwakaramba huri mavari, kana imwe yenzira yakarasika, saka kunyange kurapwa kwekare hakurevi kuumbwa kwekuputika mune ramangwana.
• kushungurudzika kwakakomba munguva yakapfuura, semuenzaniso, kutsemuka kwemidzi kana kuputika, sechinhu chakaoma chekuzadza midzi - kukuvara kwakadaro kunovhura nzira yehutachiona uye inofanotaura kuumbwa kwechirwere chetachiona.

Zviratidzo zvefistula pamazima muvanhu vakuru

Zviratidzo zvefistula pamakumbo kune vanhu vakuru zvakaderedzwa kusvika pakuumbwa kwe "tubercle", "pimple" sezvinonzi nevarwere, kunhuhwirira kusingafadzi uye kuravira mumuromo kune unhu. Marwadzo anogona kunge asipo, sezvo pus yawana nzira yekubuda nayo uye haina kumanikidza dense network yetsinga tsinga. Nekudaro, vamwe varwere vanocherekedza chitarisiko chekurwadziwa zvishoma kana vachiruma.

Zvinonyanya kukosha kutaura pamusoro pezviratidzo zvinotangira fistula pamazamu kune vanhu vakuru. Tichifunga kuti kazhinji kazhinji, chinokonzera apical periodontitis, zviratidzo zvinotevera zvinoonekwa:

• zino rakanyanyisa, iro rinowedzerwa nekurumwa;
• kuwedzera uye kurwadziwa kwe submandibular lymph nodes;
• kuzvimba uye kurwadziwa mukufungidzira kwemudzi wezino rinokonzera;
• kuonekwa kwekuravira kusingafadzi uye kunhuwa kubva mumuromo.

Zviratidzo zvakadaro zvinogona kuonekwa kunyange kana zino rakamborapwa, kune kuzadza kwakawanda kana kunyange korona. Asi kana fistula yangotanga, mufananidzo wekliniki unobviswa: marwadzo anonyangarika, kurwadziwa kwakadzikama chete kunopfuurira kana kuruma, uye kwete nguva dzose.

Kurapa kwefistula pamazamu muvanhu vakuru

Paunenge uchigadzira maitiro ekurapa, akawanda nuances anotariswa: ingave zino raimborapwa, chii chiri mamiriro emidzi migero, kukuvadzwa sei zino, nezvimwe zvakawanda, pamwe nezvikonzero zvekuumbwa kwefistula. pamazamu muvakuru.

Periodontal kurapwa. Chinangwa chikuru chekurapa ndechekumisa kutariswa kwekuzvimba kuseri kwemudzi we apex, kubvisa hutachiona hwehutachiona mumudziyo wegetsi, disinfected uye yemhando yepamusoro kuzadza canal, uye, chokwadi, kudzoreredza chimiro cheanatomical uye kutendeseka kwezino. Kurapa kwakadaro kunogona kutora zuva rinopfuura rimwe, uye kunyange mwedzi.

Kana iwe wakambove ne endodontic kurapwa. Matambudziko panguva yekuzadza midzi, zvinosuruvarisa, hazvisi zvisingawanzoitiki: dzimwe nguva zvinhu zvekuzadza hazvigoni kuunzwa kumudzi wepamusoro nekuda kwechimiro chakaoma chemigero, kuvharwa kwavo kwechikamu, nezvimwewo. Izvi ndizvo chaizvo zvinokonzera matambudziko - kukura kwehutachiona. .

Hazvisi zvisizvo kuti chiremba atadze kuona imwe yenzira kana matavi ayo panguva yekurapa endodontic, kana kuti kusabvisa utachiona zvachose nekuda kwekuoma kwavo patency.

Muchiitiko ichi, kurapwa kunosanganisira kuzarura migero, kushandiswa kwavo kunotevera uye kuzadza kwepamusoro-soro, kutanga nechinguva chiduku, uyezve nezvinhu zvechigarire. Nzira yakadaro yakaoma, yakareba uye inotevera kurapwa inononoka kwemwedzi.

Kana zino rinoputika panguva yekurapa. Kuboora igomba rakagadzirwa nachiremba wemazino panguva yekurapwa. Makomba akadaro, kana matanho akakodzera asina kutorwa, chimwe chezvikonzero zvekuvandudzwa kwepurulent kuzvimba. Perforation inogona kuitika panguva yekurapa midzi, kana kana pini inoiswa kana isingakodzeri chimiro chegeji. Radiography ichabvumira kuziva kuzvimba, asi kazhinji dambudziko iri rinoratidzwa nekuonekwa kwezviratidzo zvinoenderana.

Kurapa munyaya iyi kwakaoma zvikuru, asi zvose zvinoenderana nenguva yekurapa. Kana iyo perforation ichionekwa panguva yakakodzera, zvino zvinhu zvekuzadza zvinogona kuvhara kupera pasina matambudziko, asi mamiriro ezvinhu aya anoda kugara achiongororwa nachiremba.

Diagnostics

Zviratidzo zvefistula pamazamu muvanhu vakuru zvakananga, asi matanho ose ekuongorora ane chinangwa chekuziva chikonzero chikuru chekuumbwa kwayo. Izvi zvichabatsira zvinoonekwa uye zvekushandisa nzira dzekuongorora.

Zvose zvinotanga neongororo uye kujekeswa kwezvichemo. Maererano nemamwe maitiro ekurwadziwa, chiremba wemazino anogona kuita chirwere chekutanga, asi dzimwe nzira dzekuongorora dzinodiwa kuti dzisimbise.

Mushure maizvozvi, chiremba wemazino anoenderera mberi kune nzira dzekuongorora: zino rimwe nerimwe rinoongororwa, percussion (tapping), miedzo yekushisa inoitwawo.

Mamiriro emazamu anofanirwa kutariswa zvakanyanya. Iyo data yakawanikwa inoita kuti zvikwanise kuita mutsauko wekuongororwa, ndiko kuti, kusiyanisa chirwere chimwe kubva kune chimwe kana zviratidzo zvavo zvakafanana.

Zvinokwanisika kuita kuongororwa kwekupedzisira uye kuisimbisa chete mushure meX-ray kana CT scan. Idzi nzira dzekutsvagisa dzinoona mufananidzo wakavanzwa kubva pameso, dzinokutendera kuti utarise ukuru hwechironda chekuzvimba uye kuona iyo fistulous turakiti kana radiopaque zvinhu zvinounzwa mukati mayo pamberi pechifananidzo (semuenzaniso, gutta-percha).

Kuziva chikonzero chekuumbwa kwefistula, mamwe maitiro emunhu uye chirongwa chekurapa chinogadzirwa.

Mishonga yemazuva ano

Dentistry ibazi rinokura remishonga; midziyo yemazuva ano uye zvinhu zvekupedzisira zvekuzadza zvinogara zvichiiswa mukuita, izvo zvinobvumira kuponesa mazino kunyange mumamiriro ezvinhu akaoma.

Kubudirira kwekurapa kwefistula pamakumbo muvanhu vakuru kunoenderana nehutano uye nekururama kwekuongororwa. Kubatsira kwakakosha mune izvi kunopihwa neCT, radiography, uye visiography. Nzira dzekuongorora idzi dzinopa mufananidzo wakakwana wezviri kuitika.

Kushandiswa kwemaikorosikopu yemazino kunoderedzawo mukana wezvinetso panguva yekurapa endodontic, kusanganisira perforation.

Kudzivirirwa kwefistula pamazino muvakuru kumba

Kudzivirirwa kunouya pakukwesha mazino nguva nenguva: mangwanani mushure mekudya kwemangwanani uye tisati tarara uchishandisa zvakajairwa uye zvekuwedzera zvehutsanana zvigadzirwa uye zvinhu, zvinoti mabhurashi, pastes, flosses uye madiridziro.

Zvinosuruvarisa, hapana bhurashi rimwe chete uye paste rinopa 100% kubviswa kweplaque, saka, kanenge kaviri pagore, bvunzo dzekudzivirira muchigaro chechiremba wemazino uye inyanzvi yehutsanana hwemuromo inodiwa. Chinangwa chayo chikuru ndechokubvisa tartar uye plaque, nokuti izvi ndizvo zvinonyanya kukonzera caries, pamwe chete nekuputika kwegum chirwere.

Kurapa kwenguva yakakodzera kwecaries, kana isati yashanduka kuva matambudziko, ndiyo inonyanya kudzivirira fistula pamazamu. Mukuwedzera, zvinodikanwa kusarudza chiremba wemazino ane ruzivo uyo achapa endodontic kurapwa kwepamusoro.

Mibvunzo nemhinduro dzakakurumbira

Fistula pamazino muvanhu vakuru, zvinosuruvarisa, haisi kunyunyuta kusingawanzoitiki, uye pasinei nokuti ichi chinongova chiratidzo, migumisiro inogona kuva yakakomba zvikuru. Kuti urege kukurumidza kutanga kwavo, unofanirwa kutevera mimwe mitemo. Paanongotaura nezvazvo chiremba wemazino, implantologist uye orthopedist, mukwikwidzi wesainzi yezvokurapa, anoshamwaridzana purofesa weDhipatimendi reDentistry yeCentral State Medical Academy Dina Solodkaya.