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MIKROJARROHi

charrohiMIKROJARROHi, yak bakhshi ilmi jarrohist, ki dar mavridi on dar barobari korbasti usulhoi mamuli jarrohi, hamchunin az usuli jarrohi tavassuti asbobhoi makhsusi daqiq, mikroskop va suzanhoi nafis istifoda mekunand. M. ba manoi mahdud – jarrohii unsurhoi nozuktarin, ragho, asabho va ba manoi vase – saviyai balandi tekhnikai jarrohi ast.
Tekhnikai makhsusi jarrohi ba mikrojarroh imkon medihad, ki boftahoro nihoyat boehtiyot burida, tashkilahoi anatomii maydatarinro judo kunad. M. – ro dar jarrohii chashm va gushi miyona farovon istifoda mebarand. Dar dahsolahoi okhir M. hangomi ba joyashon dukhtani angushtho, panjai dastu poy, dast yo poe, ki dar natijai sadama kanda shudaast, ba panjai dast kuchonda shinondani angushtoni poy (dar surate, ki angushti dast nobud shuda boshad), ozod kuchonda shinondani porahoi murakkabi bandu bugum (pust bo charbi zeri pust va mushaki on) bo maqsadi pinhon kardani nuqsi boftahoi narm, varamhoi limfavii dastu poyho, kuchonda shinondani mushak yo ustukhon, ivaz kardani asabhoi kanorii osebdida, jarrohii tajdidii majroi mani va naychahoi bachadon va g. kor farmuda meshavad. M. hangomi az tasiri oseb kanda shudani angushton, panjai dast yo poy ahamiyati bagoyat kalon dorad, zero ba joyashon dukhtani uzvhoi kandashuda va barqaror namudani faoliyati onho biduni istifoda az usulhoi M. imkonnopazir ast.
Malumot dar borai muhlati zinda mondani qismhoi kandashudai badan dar jadval aks yoftaast. CHunonki mebinem, baroi zinda nigoh doshtani uzvi kandashudai badan va to ba markazi makhsusi M. burda rasondani bemor fursat vujud dorad. Ammo samarai chunin jarrohi ba chorahoi avvaline, ki dar joi hodisa andeshida meshavand, sakht vobasta ast. Pesh az hama joi zakhmro ba bandinai fishorovar basta, khunraviro qat mekunand (vaqti toftabandiro qayd kardan zarur ast), yorii tajiliro davat menamoyand yo chorai harchi zudtar ba muassisai tabobatii nazdiktarin rasondani jabrdidaro meandeshand. Qismi kandashudai dast yo poyro shustan yo doru kardan hargiz mumkin nest. Agar bandinai pok yoft nashavad, uzvi kandashudaro ba yagon lattai toza mepechonand. Bad du khaltai sellofaniro shusta toza mekunand. Ba khaltai khurdtar uzvi kandashudaro andokhta dahonashro mahkam mebandand. Ba khaltai digar yakh yo barf andokhta, bad ba daruni on khaltai avvalro joy mekunand va dahoni onro ham mebandand.
Muhlati mahfuz mondani qobiliyati zindagii uzvhoi
kandashuda vobasta ba harorati muhit (ba hisobi soat)
Uzvi kandashuda Muhlati qobiliyati zindagii uzv
dar haror. to + 40 dar haror. ziyoda az + 40
Angushton 16 soat 8 soat
Panjai dast 12 soat 6 soat
Soid 6 soat 4 soat
Bozu 6 soat 4 soat
Panjai poy 6 soat 4 soat
Soq 6 soat 4 soat
Ron 6 soat 4 soat

Mutakhassisoni markazhoi jarrohii raghoi khungard dar zeri mikroskop uzvi qatshudaro barqaror mesozand, sharayon, varid, asab, ustukhonhoro ba yakdigar mepayvandand. Agar boftaho bezarar va muhlati ba bemorkhona ovardani osebdida rioya shuda boshad, qarib 80 foizi angushtu panjahoi dast dubora mechaspand.
Agar angushtoni dast naboshand, baroi barqaror namudani vazifai panja yak, du va hatto se angushti poyro burida ba dast mechasponand. Tajriba nishon medihad, ki baroi barqaror gashtani faoliyati chunin angushton mashgul shudan ba varzishi shifoi, fizioterapiya va g. ahamiyati kalon dorad.
Bo maqsadi rafi nuqsi kalon az yak joi badan ba joi digar kuchondani boftahoi narm va barqaror kardani khungardishi onho fasli muhimi M. ba hisob meravad.
Tekhnikai M. dar mavridi jarrohii raghoi limfa (hangomi varamidani dastu poyho) farovon istifoda meshavad. Dar natijai jarrohi varam khele kam shuda, harakati poy behtar megardad. Dar surati oseb didani tanai asabhoi kanori asabro bo usuli M. dukhtan, vale agar oseb kalon boshad, yake az asabhoi zeri pustro az soq yo soid girifta ba sifati transplantat istifoda burdan mumkin ast. Dar vaqti noguzaronishi naychahoi Fallopiy va yo majroi mani, ki boisi bezuryoti megardad, bo yorii M. qobiliyati guzaronishi onhoro barqaror kardan mumkin ast.
M. dar Tojikiston az s.-hoi 80 – umi a. 20 mansha megirad. S. 1987 dar BKSH №5 ba nomi akad. K. T. Tojiev zeri rohbarii professoron N. U. Usmonov va K. P. Ortiqov avvalin shubai M. tashkil karda shud, ki 10 kat dosht. Dar yak muddati kutoh chand nafar mutakhassisoni sohai M. tayyor karda shudand (K. P. Ortiqov, U. A. Qurbonov, G. M. Hojamurodov), olotu tajhizoti zaruri dastras gasht (mikroskopi jarrohii Karl-Seyss, asbobu afzori mikrojarrohi, rishtahoi makhsus va g.).
M.-i avvalin dar jumhuri s. 1985 anjom doda shudaast. To s. 1990 kormandoni shuba ziyoda az 1000 mikrojarrohiro ba anjom rasondand. Bahri dar amal vorid sokhtani M. se nafar mutakhassisoni varzida – K. P. Ortiqov, U. A. Qurbonov va G. M. Hojamurodov sazovori Mukofoti komsomoli Tojikiston gashtand.
Soli 1991 shubai M. ba shubai jarrohii plastiki va tajdidi tabdil doda shud. Felan on dar sokhtori Markazi ilmii jumhuriyavii jarrohii dilu ragho va qafasi sina faoliyat dorad. Kormandoni shuba to in dam 150 usuli navi M.-ro dar amal tatbiq namudaand, mas., replantatsiyai bandhoi qatshuda, autotransplantatsiyai boftaho, rekonstruksiyai bandchai ragu asabho, insidodi naychai bachadon, benaslii sidodi (obturiatsiya)-i mardho, varikotsele, gipospadiya, limfostazi andomho, hamchunin bemorii jogar, ziqi nafas, amrozi gadudi boloi gurda, talkhadon, osebi raghoi andomho, tarmimi mahbal hangomi atreziya, rekonstruksiyai sutunmuhra va g.
M. dar robita bo dig. usulhoi jarrohi rivoj meyobad.
Ad.: Belousov A. E., Tkachenko S. S., Mikrokhirurgiya v travmatologii, L., 1988; Belousov A. E., Plasticheskaya, rekonstruktivnaya i esteticheskaya khirurgiya, M., 1998; Kurbanov U. A., Davlatov A. A., Osnovi mikrokhirurgii (uchebno-metodicheskoe posobie), D., 2008.

U. A. Qurbonov.

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