Chu yeu bao g o m c a u true x u o n g cot s ong d o a n thdt l ung- c u n g , tren do co n h u n g m a c h ma u ldn sau p h uc mac: c h 6 p h an c h i a c u a d o n g m a c h va tinh m a c h chu. G i u a n h u n g t h a n h ciia b un g , ngu di ta k h o n g the lien he giai phdu c h i n h xa c vi c a c c o q u a n t r ong 6 b u n g di d o n g t ro n g k h o a n g b u n g ldn, m a k h o a n g na y d tra ng thai sinh ly la k h o a n g ao. Hai khai n i e m giai p h a u cdn n h o t rong noi soi la:
- N h u n g m a c h m a u ldn gan t h a n h b u n g h on ma t b a n g phdu thuat.
- Vi tri ciia ron doi vdi m o m n h o va c h o p ha n n h a n h ciia d o n g m a c h va tinh m a c h c h u tha y d6i tuy th eo k h o a n g c a c h g i ua r o n - x u o n g ve v a goc ga p trirdc ciia x u o n g c hau .
a. d a y treo b a n g q u a n g b. giai han tren c u a v om
ba ng q u a n g
c. d o n g m a c h t h u o n g vi
Ilinli 9: Mot so vi tri giai phai lien quan den noi soi
f ) a c tinh a o c u a k h o a n g bung:
Giai thich r i n g n a n g t ha nh b un g trudc k h o n g c h o p he p d u p h o n g n h u n g t6n t h u o n g d u o n g tieu hod. Boi vi c ac c a q u a n t r on g b u n g se di the o t h a n h b u n g khi ta n a n g . N g u g c lai, a n h u n g b e nh n h an gay, b e nh n h a n m a t h a n h b u n g n h e o thi phai n a n g t ha nh b u n g g iup d ua xa dau c u a mui ki m. t ra n h c h o c vao m a c h m a u Ion sau p hu c ma c sau.
Ill- THANH BUNG BEN
Pha u t hua t noi soi t h u o n g lien q u a n nhat den voi trung, b u o n g t r u n g , t h a n h c h a u h o n g va n h u n g t h a n h p h a n tao nen t h a n h bu ng .
• M a c h m a u c h a u : n h u n g m a c h m a u c h a u giai ha n boi m o t p h a n ho b u o n g tr un g. 0 n gu oi chira de, circ ngoa i voi t r u n g - b u o n g t r u n g n d m a
l c m du oi n h u n g m a c h m a u c h a u ngoa i. K h o a n g c a c h n a y t a n g len a n g u a i da de.
• Nieu qu a n: lien q ua n true tiep vai buo ng trurng ma mat ben thi lien quan: - 0 ng u oi chira de: ho b u o n g trurng d u g c giai han bai m a c h c h a u t r o n g va
nieu q u a n phfa sau. D i e m b a m c u a day c h i n g rong a phfa trucrc, m a c h m a u c h a u n go ai a phfa tren, di tfch d o n g m a c h ron va d o n g m a c h tu c u n g a du a i.
- (3 n g u a i c o n da: ho b u o n g t ru n g d u g c giai han bai nieu q u a n va d o n g m a c h tu c u n g a phfa t r ua c , b a c u a x u a n g c u n g a phfa sau va b a t ren c u a ho q u a le a phfa d ua i .
• P h u c m a c h t h a n h c u a ho b u o n g trirng: h oa c n h u n g v un g lan can t h u o n g la n g u o n goc c u a mo t so be nh ly n h u lac noi m a c tu c u n g hoa c dinh. N h u n g bat t h u o n g nay lam th ay doi p h uc m a c (no tro nen m g h a n ) , doi khi lam th ay doi giai phdu c a c c a q u a n sau p h u c ma c . Nhurng t hao tac thuc hien phai luon luon than trong, tfnh de n d u o n g di c u a nieu q u a n va m a c h m a u c h a u h o n g (doi khi k h o d a n h gia). Kh i phdu thuat vien su d u n g d ao dien de c a m m a u , thich h g p la d a o hai c u c boi vi sir k h u y e n tan nhiet d u g c giai han h a n . Vi e c g a d inh la k h o k h a n a ma t be n c u a b u o n g t r ung va p hu c m a c . co the lam a n h huo'iig d e n vo b u o n g t r ung hoac ph uc m a c thanh. Khi v u n g pha n n h a n h d o n g m a c h c h a u bi boc lo ra thi phai d u n g n g a y tha o tac. Ki nh n g h i e m c u a c a c n h a phdu t hua t g o dfnh noi soi chi ra r ang ton t h u o n g da y c h a n g that l ung b u o n g t r u n g la tai bien ft ga p n h u n g k h o n g n goai le. Cac n ha phdu thuat l uon l uon phai n h o giai phdu t r on g dau. Doi khi k h o d a n h gia c hf nh x a c c a c c a q u a n lan c an t r on g suot thoi gian g o dfnh, d ac biet phfa ben trai.