noi xong 1 dong mach thi mdi tim ra tinh mach dl dang vi chay ra mau den.
Lam sach va cat ngan dot xtfdng d phan chi bi cut. 5.2. Doi 1
Chuyen benh nhan vao tham kham lam sang, X quang d chi bi thtfdng ton, chup ngtfc, lam dien tam do, sinh hoa mau, xet nghiem mau ntfdc tieu, nhom m£u, thti cheo va xac dinh thromboplastine dtfdc hoat hoa 1 phan. Bat diu truyen dich vao tlnh mach cho khang sinh tinh mach, ngtia uon van, dat thong dai vi mo lau.
Da so ghep noi deu dtfdc vo cam vdi Bupivacain (Marcaine) phong be nach, day la thuoc te cd tac dung keo dai. Tre dtfdi 10 tuoi thi gay me.
Nhd phong be giao cam vdi gay te vung va giti cho cd the am ma giup cho ttidi mau ngoai vi.
Dat garo va dung kinh phong dai cat loc vet thtfdng va danh dau cac than kinh mach mau cung ttfdng ttf nhtf d phan chi bi cut. d ngon tay, thtfdng tim tinh mach la kho khan, can kien nhln, kinh nghiem va ky thuat boc tach vi noi lai chi cd ket qua phu thuoc vao trinh do kheo leo khi noi 1 so tinh mach.
Thtfdng tim 1 tinh mach tot d dtfdi da, roi lay no lam moc, lat vat da, tim cac tinh mach khac d dtfdi da. Mot cach khac la boc tach tinh mach len cao, tim theo cho noi vdi cac tinh mach khac.
6. KY THUAT MO NOI
Ky thufit mo noi thay doi it theo mtic cat cut (d ngon, d b in tay, d co ta y ...) v& theo loai thtfdng ton (cat gon, dap nat, gi&ng x6...). Noi l^u d ng6n v i d b in tay pho bien hdn la noi lai d cao hdn.
Thti ta mo d ngon tay, ban tay la:
- Tim, danh dau mach mau, th in kinh - Cat loc
- Lam ngan va co' dinh xtfdng - Khau gan duoi
- Khau gan gap - Noi cac dong mach - Phuc hoi cac than kinh - Noi cac tinh mach - Che phu da
Can tim cac mach mau trtfdc khi c i t loc. Khi c i t loc, can kinh phong dai, vet thtfdng sach roi mdi lo ttfdi mau. Can ttfdi rtia co giong phun. Can cat bo to chtic hoai tti, nhat la cd hoai tti.
Ngoai cac to chtic da ke, con phuc hoi mang xtfdng, bao khdp, day chang, cac day ch&ng ben. Phuc hoi ky dau tot cho chtic nang ban tay. Can co' dinh vting de cti dong sdm. Phuc hoi sdm de hdn la de muon ve sau.
7. LAM NGAN XUONG VA CO OjNH
Can c i t bo du xtfdng de no'i mach co dtfdc noi mac binh thtfdng. No'i tinh mach, dong mach, than kinh khong bao gid dtfdc cang. Vay can c i t n g in cac dau xtfdng. Xtfdng ngan bdt cung de che phu da phia sau cho no'i tinh mach.
Mtfc do c i t xtidng phu thuoc vao loai thtfdng ton. Bi giang giat, dap nat, phai c i t bo nhieu, d ngon thtfdng c&t xtfdng 5m m-1,0cm . Cat cao tren ban tay, c i n c&t xtfdng 2-4cm. Bi gifing giat con can cfit nhieu hdn ntia.
Co ngtfdi khong cat xtfdng ma ghep tinh mach, song cat xtfdng tot hdn, vi 1 mieng no'i thi hdn la 2 m ieng no'i nhtf khi can ghep tlnh mach, do'i vdi thtfdng ton rong d than kinh va phan mem, cung can cat ngan xtfdng.
C) c i t cut ngon cai, can co' giti xtfdng toi da. Song, cd khi khong lam dtfdc.
Cd nhieu cach ket hdp xtfdng: