Kujambula kwa nyenyezi za bondo - zonse zomwe mumafuna kudziwa potsata ndondomeko ndi kupuma

Kujambula kwa nyenyezi za mawondo ndi mawonekedwe omwe ndi otchuka kwambiri. Zimakuthandizani kudziwa nthawi yomwe mukudwala matendawa ndikugonjetsa matendawa mwamsanga. M'mbuyomu, opaleshoni zopweteka zinagwiritsidwa ntchito kuthetsa mavuto a mawondo. Komabe, ndi chitukuko cha matekinoloje, njira yothandizira odwala matendawa amatha kusintha kwambiri.

Kodi kugwiritsira ntchito nyenyezi kumaphatikizapo chiyani?

Ndondomekoyi ndi njira yoperekera opaleshoni yochepa. Zimagwiritsidwa ntchito pogwiritsa ntchito chipangizo chapadera - arthroscope. Chipangizochi chili ndi singano yopyapyala ndi kamera ya fiber optic. Chithunzi chonse chikuwonetsedwa. Kuti mumvetse zomwe nyamakazi imatulutsa, dokotala amuthandiza, ndani angamuuze wodwala zonse zomwe zimachitika muzogwiritsidwa ntchito. Pali njira zingapo izi:

• chithandizo;
• kuchiza.

Mpaka pano, njirayi imatengedwa ngati "golide" mulimbana ndi matenda a minofu. Njirayi ilibe mafananidwe. Zili ndi ubwino wambiri:

• Zomwe zimawonongeka - ndondomekoyi imachitidwa pang'onopang'ono m'kati mwa thumba lachikwama;
• Zonsezi zimachitidwa molondola kwambiri;
• chithunzithunzi chosagwirizana ndi malo opanda kunja omwe sali wosabala;
• Panthawiyi, ngalande yamadzi ikhoza kuchitidwa panthawi imodzi;
• chifukwa opaleshoniyo imakhala yopanda malire, nthawi ya khalidwe lake yafupika kufika ola limodzi, ndipo kenako amakhala m'chipatala - mpaka masiku 2-3;
• palibe chifukwa chokhazikitsira phazi kwa nthawi yaitali.

Pali zosokoneza mwa njira iyi:

• Njirayi ndi yamtengo wapatali, chifukwa imagwiritsidwa ntchito pa zipangizo zamtengo wapatali;
• dokotala akuchita opaleshoniyi ayenera kukhala katswiri wapamwamba, popeza kusokonezeka kwa dokotala wopanda nzeru kungachititse kuti pakhale mavuto.

Kujambula kwa nyenyezi za mawondo a mabondo - zizindikiro

Kutumiza kwa njirayi kumaperekedwa ndi katswiri wamatenda, rheumatologist kapena orthopedist. Kugwiritsira ntchito nyamakazi ya bondo ikulimbikitsidwa pazochitika izi:

• ndi dislocation ;
• pamene bwalo la bondo liri lofunikira ngati pakupezeka mitundu yambiri;
• ngati kuli kotheka, biopsy;
• Ngati malo owonongeka akugwiritsidwa ntchito;
• ndi nyamakazi ya nyamakazi ;
• pamene umphumphu wa meniscus uli wosweka;
• pamaso pa thupi lachilendo pamphepete mwa mawondo a mawondo;
• chifukwa cha hyperplasia ya thupi la mafuta.

Kupenda nyenyezi pamagulu

Ndondomekoyi imaonedwa kuti ndi yophunzitsa. Chifukwa cha iye, chikhalidwe cha mawondo amafufuzidwa kuchokera mkati. Zonsezi zikuwonetsedwa pazong'onong'ono mu nthawi yeniyeni. Nthano yamakono imathandiza kupeza mfundo zotere:

• onetsetsani malo omwe amadziwika kuti ali ndi matenda;
• kulosera mlingo wa kufalikira kwake;
• kumvetsa bwino.

Mankhwala ojambula nyamakazi

Njira imeneyi imalimbikitsidwa pamene mankhwala osokoneza bongo amadziwika bwino. Mwachitsanzo, kugwiritsira ntchito nyamakazi yokhudzana ndi mawondo kumatchulidwa, kugwiritsidwa ntchito kwa meniscus pankhaniyi kumachitika ndi zovuta zochepa. Ndondomeko yotereyi imaonedwa kuti ndi yopweteketsa kwambiri: pambuyo pake pamakhala msoko waung'ono. Kuwonjezera apo, kukonzanso sikuchedwa kwa nthawi yaitali. Monga momwe chiwonetsero chimasonyezera, odwala mwamsanga akubwerera ku moyo wawo.

Kutulukira kwa nyenyezi - zosiyana

Ngakhale kuti njirayi ili ndi ubwino wambiri, nthawi zina iyenera kusiya. Chigamulo chomaliza ndicho ngati kachipangizo kakang'ono ka bondo kamapangidwa ndi dokotala atatha kufufuza bwinobwino wodwalayo. Zonsezi zotsutsana ndi kukhazikitsidwa kwa ndondomekoyi zingakhale zogawidwa m'magulu awiri: zenizeni ndi zachibale. Yoyamba ikuphatikizapo zotsatirazi:

• kutupa kumaphatikizapo mapangidwe a pus;
• fibrous kapena fupa ankylosis;
• matenda aakulu a wodwalayo.

Zotsutsana zotsutsana zikuphatikizapo:

• maphwando a condyles;
• Kuphwanya kukhulupirika kwa ziphuphu, zomwe zili pafupi ndi thumba lachikwama;
• hemarthrosis .

Kodi mawonekedwe a bondo amachitika bwanji?

Asanayambe kuchita izi, wodwalayo ayenera kukonzekera. Katswiri wochita masewera olimbitsa thupi amakhulupirira kuti njira zotsatirazi zidzachitika pasadakhale:

• ECG inachitika;
• kukakamizidwa kwa magazi kunayesedwa;
• chotseketsa chinali chitatsimikiziridwa;
• X-ray ya chifuwa;
• MRI ya mgwirizano wa mawondo anachitidwa;
• mayesero a magazi ndi mkodzo atumizidwa.

Madzulo madzulo a tsiku limene nyamakazi ya knee yokhala ndi meniscus ikuchitika, wodwalayo akuyeretsedwa ndi maema. Asanagone, amamupatsa mapiritsi ogona. Komanso madzulo simungathe kudya kapena kumwa chirichonse. M'mawa mmawa musanayambe opaleshoni tsitsi lanu lidzameta tsitsi. Ndondomeko yokha siimatenga nthawi yoposa ola limodzi.

Chidutswa cha nyenyezi cha mawondo a knee chikuchitidwa motere:

1. Wodwala akugona pa tebulo logwira ntchito (kumbuyo). Bondo limene ntchitoyo lidzachitidwe liyenera kukhala loyendetsedwa pamtunda wa 90 ° ndipo limakhala ndi zipangizo zapadera.
2. Khungu lawonongeka.
3. Pofuna kuchepetsa kuthamanga kwa magazi kupita kumbali, mawotchi amaikidwa pa ntchafu.
4. Anedhesia.
5. Dokotala wa opaleshoni amapanga 3 notch 3-6 mm long.
6. Arthroscope imayikidwa kudzera mu dzenje. Dokotala amayang'anitsitsa dera lomwelo. Ngati ndi kotheka, imapumphukira kunja, imatsuka mpandawo ndikuchita zonse zoyenera.
7. Kupyolera mu katchi, chida cholowetsedwa chimachotsedwa.
8. Pa malo ochiritsidwa, mabanki osakanizidwa akugwiritsidwa ntchito.

Kujambula kwa nyenyezi za mawondo a bondo - anesthesia

Malingana ndi zotsatira za mayesero omwe asanatuluke opaleshoniyo ndikuganizira momwe nthawi ikuyendera, wogonana ndi anesthetist akuganiza kuti ndi njira yanji yowonongeka yomwe angapereke. Anesthesia ndi nyamakazi ya bondo ingakhale motere:

1. Mderalo - amapereka mankhwala osokoneza bongo (Lidocaine, Novocaine kapena Ultrakain) pafupi ndi zomwe zikuchitika m'tsogolomu. Zovuta za njirayi ndizofupikitsa. Anesthesia ya m'deralo imapangidwa ngati kugwiritsira ntchito nyamakazi ya bondo kumatulukira.
2. Mimba yam'mimba (imatchedwanso epidural) - mankhwalawa amayidwa kudzera mu catheter kumalo a msana wam'mimba. Njira yayikulu ya njira imeneyi yothandizira anthu ndi kuti nthawi ya opaleshoni dokotala amapitirizabe kuyankhulana ndi wodwalayo. Ngati pali chosowa chowonjezera kwa anesthesia, izi zimachitika kudzera mu catheter ya zachipatala.
3. Kawirikawiri - imagwiritsidwa ntchito pokhapokha pochiza matenda aakulu kwambiri.

Katswiri wojambula nyenyezi wamphongo

Zochitika zitatu za opaleshoni zimapangidwa pa opaleshoni. Zochitazi zikuyimiridwa ndi nyamakazi - njirayi ndi iyi:

1. Choyamba - kupyolera mu dzenje limeneli, kamera yowonjezera imayikidwa. Chida ichi chikugwirizanitsidwa ndi chowunika kumene chithunzi chikutumizidwa.
2. Kachilombo ka kachiwiri kamene kamayambitsa mankhwala m'thupi (mwachitsanzo, Adrenaline, sodium chloride). Mankhwalawa amagwiritsidwa ntchito kuchepetsa chiopsezo cha magazi pamene opaleshoni ndi kupititsa kafukufuku.
3. Kutengeka kwachitatu - kupyolera mu chipindachi kumayambitsidwa ntchito yaikulu.

Kujambula nyenyezi pamagolo - pambuyo pa opaleshoni

Pamapeto pa ndondomekoyi, adokotala amapereka malingaliro a wodwalayo momwe angakhalire nthawi yobwezeretsa. Tsatirani zosowa zawo kuti mukhale osamala. Malangizidwewa ndi ofunikira kwambiri monga kukonzekera kugwiritsidwa ntchito bwino, kukonzekera opaleshoni. Nthaŵi zambiri, amamasulidwa tsiku lotsatira opaleshoniyo. Nthawi zambiri wodwalayo amasiyidwa ndi dokotala kwa masiku angapo.

Kujambula kwa nyenyezi - zovuta

Ngakhale kuti opaleshoni yotereyi imatengedwa kuti ndi yotetezeka, pali ngozi kuti pangakhale zotsatira zoipa pambuyo pake. Kaŵirikaŵiri taonani mavuto ngati amenewa:

• Bondo pambuyo poti arthroscopy ikukula;
• kutentha kwa thupi kumatuluka;
• Pali vuto mu chifuwa (wodwalayo ndi wovuta kupuma);
• Chifukwa cha matenda opweteka, nyamakazi imayamba;
• mavuto m'mathambo amatchulidwa;
• kusuntha kwa mgwirizano kuli kovuta;
• pali kuwongolera pamene mukuyendetsa;
• bondo ndi lopweteka kwambiri;
• pali mankhwala a khungu;
• kawirikawiri hemarthrosis.

Zowawa pambuyo poti arthroscopy ya bondo limodzi

Chisokonezo choterechi pambuyo pa opaleshoni ndi chachilendo. Nthaŵi zambiri, amaimitsidwa ndi mankhwala osokoneza bongo. Pa chifukwa chimenechi, wodwala sayenera kudandaula ndi kudandaula kuti chinachake chalakwika. Ngati, pambuyo pa kugwiritsira ntchito nyamakazi ya meniscus, bondo limapweteka kwambiri, ndipo opweteka omwe adalangizidwa ndi dokotala samuthandiza, thandizo lachipatala liyenera kufunidwa mwamsanga. Mwinamwake, zotsatirapo zazikulu zinayambika. Nthawi zambiri ululu wosasunthika umakhala ndi zotsatirazi:

• Kutseka mitsempha ya magazi ndi magazi (kumapezeka odwala olemera kwambiri);
• nyamakazi ;
• kutchulidwa kwa madzi ophatikizana, okwiya ndi katundu wolemera kwambiri pa bondo;
• hemarthrosis;
• matenda a algodystrophic;
• kutupa kwa ziphuphu za rumen.

Kuwoneka pa bondo pambuyo poti nyamakazi imatuluka

Kusokonezeka pa nthawi ya postoperative kumatengedwa ngati chikhalidwe cha thupi. Zifukwa zake ndi izi:

• Mu mpweya wa mpweya umene umatuluka;
• wodwalayo ali ndi madzi ochepa;
• panali zowonjezereka za ziwalo zomveka.

Ngati bondo likuphwanyidwa pambuyo pa miyezi 4-5, izi zikuwonetsa chitukuko cha arthrosis. Ndili ndi matendawa, chotupa chokongoletseracho chimachepetsedwa ndipo kuyambitsidwa kwa kayendetsedwe kake kumasokonezeka. Bondo limatha, ndipo zotsatira zake zimawonjezeka kutentha. Khungu laderali limakhala lotentha ndipo limapeza mtundu wobiriwira. Zonsezi zikuphatikizapo ululu waukulu.

Bondo silingamangidwe pambuyo poti nyamakazi imatuluka

M'masiku oyambirira operekera ntchito mu zochitika izi palibe chowopsya. Komabe, ngati bondo loponyera bondo silikugwada patadutsa sabata, ili ndi chizindikiro chenjezo. Zifukwa za kuyenda kochepa zingakhale:

• hemarthrosis;
• kutukusira kwa katemera wa postoperative;
• kufotokoza kwa madzi ophatikizana;
• matenda a algodystrophic.

Kukonzekera pambuyo poti arthroscopy ya mawondo a bondo

Njira yobwezeretsa imayamba m'maola oyambirira pambuyo pa opaleshoni. Zitha kukhala masabata 3 mpaka 8. Ndiye wodwalayo akubwerera ku moyo wathunthu. Kubwezeretsa pambuyo poti nyamakazi ya bondo imachepetsedwa kuzinthu zotsatirazi:

1. Pofuna kupewa kuyambira kwa kutupa, wodwala ayenera kutenga mankhwala opha tizilombo omwe adayankha.
2. Sungani mwendo wothandizira pa malo okweza. The ayezi iyenera kugwiritsidwa ntchito pa bondo. Njira zoterezi zimachepetsa kupweteka ndi kutupa.
3. Ndikofunika kuti muveke masiku awiri.
4. Kuti athetse vuto la wodwala, kumwa mankhwala opweteka ndi koyenera.
5. Ndikofunika kuchotsa katunduyo pamagulu ogwiritsidwa ntchito. Mukhoza kudzuka tsiku lachitatu mutatha opaleshoniyi. Pankhaniyi, mutha kusuntha pogwiritsa ntchito zida.
6. Mu masabata awiri otsatira pambuyo pa opaleshoni, galimoto ikuletsedwa!
7. Katswiri wochita masewera olimbitsa thupi wophimba bondo atachira pambuyo pochita opaleshoni adzafulumira kuchita mankhwala opaleshoni.
8. Masabata angapo oyambirira atatha opaleshoni, osambira otentha saloledwa. Ndilosavomerezeka ndi hypothermia.
9. Pofuna kubwezeretsa mitsempha yambiri, oyendetsa chondere ayenera kutengedwa.

LFK pambuyo poti arthroscopy ya bondo limodzi

Mankhwala opanga masewera olimbitsa thupi amathandiza kulimbitsa minofu ndikufulumizitsa njira yobwezera. Musanayambe kugunda bondo mutatha kugwiritsira ntchito nyamakazi, muyenera kufunsa katswiri. Kukonzekera kosayenera kungabweretse mavuto aakulu. Pambuyo pa kugwiritsira ntchito nyamakazi yokhudzana ndi mawondo omwe anagwidwa, kubwezeretsedwa kumalimbikitsidwa kuyamba ndi katundu wamng'ono, pang'onopang'ono kuwonjezereka. Zochita zingakhale:

• kupweteka kwa minofu ya ntchafu;
• kukweza phazi;
• kuziyika kulemera;
• kusambira;
• kuyenda ndi zina zotero.