Zokuhlatywa le igxalaba joint: indlela Lead

Zokuhlatywa kwegxalaba yinkqubo yotyando, apho ugqirha kungeniswe inaliti kungena philisi ehlangeneyo. Kwenziwa inkqubo efanayo lwenziwa ngeenjongo zokuxilonga okanye ukuba imeko yezonyango okhoyo. Injongo yale nkqubo - kukho ukuhla kwamanani ulwelo synovia.

iintlobo ezimbini zokuhlatywa

Botyando okuhlatywa zohlulwa ngokwendidi ezimbini:

• Impiliso.
• Sokuhlola.

komzimba joint

Ngexesha okuhlatywa kwegxalaba kuyimfuneko ukuze bakuthathele ingqalelo iimpawu uphawu komzimba wakhe. Le synovium - a istili leyo kwi isakhiwo sayo kunye nemvelaphi eyahlukileyo inwebu serous (ezifana inwebu le pleura, peritoneum, pericardium). Umahluko ephambili kuxhomekeke kwinto yokuba icala layo ngaphakathi elijongene phezu em-, aliqulathanga epithelium kunye akhande endothelial. Ebubanzini ndizayo lohlukile. Ukongeza, ine- uvakalelo landile ukuya nokumelana thermal, kubuhlungu, ezosulelayo, kunye imichiza.

Ngu hypersensitivity synovium ukuba izifo ezahlukeneyo kufuna ukubambelela ngokungqongqo aseptic phambi kokuba inkqubo okuhlatywa, kwaye phambi kokuba uvule lweHo- articular. Ukongeza ifuna uphawu enyanzelekileyo. Komgodi joint iqulathe imali encinci ulwelo lwamalunga, malunga mililitha ezine. Le fluid synovia ludlolo, abe iindiza umbala omthubi kwaye kuyacaca ngokupheleleyo. Lubonakala yi viscosity aphezulu, iqulethe iiseli phagocytic kunye iiseli ezimhlophe zegazi, kodwa iimpawu zayo antibacterial mancinci kakhulu. Ngenxa yokuba ayegcwele mucopolysaccharides fluid lwamalunga ubunzima ophezulu ethile, oko oluhlala kwi ngokudibeneyo kwaye kuyenye ngaphandle kwisisu yayo.

Technique le okuhlatywa kwegxalaba iza kuxoxwa ngezantsi.

Malunga kulwelo joint

Fumana kulwelo ngokudibeneyo kwaye obangela inkqubo sifo kunzima kakhulu ngenxa yokuba imali yayo encinane xi ezingakhiyo viscosity eliphezulu. amalungu sisempilweni uxinzelelo negative:

• Iqatha: column amanzi 270-210 mm.
• Ewenzayo: 75-90 omise lomxholo amanzi.

Ubukho xi ezimbi ebangela kucocwa fluid lezitya subchondral kunye lwamalunga, apho intlala ngokudibeneyo lwenzeka izidlo.

Zokuhlatywa kwegxalaba ebantwini abaphile kunqabile.

Imisebenzi kulwelo synovia

Imisebenzi ephambili eyenziwa yi kulwelo lwamalunga, ukuze ziquka:

• umsebenzi weentshukumo. fluid synovia ngokubambisana kunye intlala articular inika intshukumo ekhululekileyo imiphezulu ithambo ekhankanyiweyo.
• umsebenzi metabolic. ulwelo synovia libandakanyeka kwiinkqubo pathways ezenzeka phakathi iibhedi nemithambo kunye articular fluid.
• umsebenzi Trophic. fluid Avascular synovia ondla oomaleko intlala.

Ukuba kukho inkqubo yokukrala kwamalunga, nokwanda lwamalunga ulwelo kwi protein. Oku kungenxa yokwanda permeability nemithambo. Ulwelo luba turbid, kwenyusa umxholo neutrophils neziphumo synovitis oyingozi esibuhlungu.

Zokuhlatywa kwegxalaba: inkcazo

• Ukumiselwa ngokuqulethwe ubume (xa kukho ubomvu, exudate okanye igazi). Ukuba amalungu ezonakeleyo eziqulathwe igazi, inokuba azikhuli synovitis, umonakalo intlala indalo sisiba mandundu, ase-articular. Kwimeko ka-traumatic haemarthrosis ukuqina kunye nokudumba ngcina umlinganiswa kubangelwa ubukhulu becala ezonakeleyo intlala ubukhulu kwaye extravasated ukusebenza igazi. Nokuhlaziya ngokutsa intlala lwenzeka kunye utshintsho kwicandelo proliferative kwithishyu nokuqina. Kwimeko umonakalo iqokobhe kwenzeka coagulation ngokwaneleyo okukhawulezayo kunye egazi koko kwasekwa, nto leyo enokukhokelela ekubeni ukwanda elibalulekileyo ingaphandle zeethishu. Ngenxa yoko, uqala obliteration le kwisisu ehlangeneyo.
• Ukuseka umonakalo meniscus kwi joint emadolweni usebenzisa pnevmoartrografii okanye ray.
• Ukumiselwa phambi em- joint "imizimba irayisi" okanye "neempuku ezimanyeneyo."

Ukuze le njongo elimisiweyo okuhlatywa diagnostic kwegxalaba.

Ubungqina obubonakalayo buxela ukuba iinkqubo zonyango ezifana zokuhlatywa

• Ukususwa ngegazi kuphuhliso hemarthrosis.
• Ukususwa exudate, ubomvu lweHo- articular, intshayelelo kwezisombululo isibulala-zintsholongwane.
• Intshayelelo novocaine isisombululo xa ekunciphiseni dislocation.
• Ukuqaliswa corticosteroids xa zidityaniswe ne Lydasum ubukho deformans arthrosis.
• Intshayelelo oksijini okanye nomoya ukuba iinkqubo mnene ngokwaphulwa kwasekwa kwimeko azikhuli ezinezikhondo azikhuli articular. Ukuqaliswa oxygen nako ukubuyisela umsebenzi motor okanye umaki redressatsii.

Ukuza kuthi ga ngoku, kukho okuhlatywa ingaqhuba egxalabeni nedolo amalungu.

inkqubo

Ngenxa uvakalelo egqithiseleyo kulwelo lwamalunga ukuba ungenwe lula zizifo, ngexesha okuhlatywa joint kufuneka ngokukhawuleza ehlabathini balandele yonke imithetho asepsis kunye antisepsis.

Phambi kokuba usebenzise i okuhlatywa, isiza okuhlatywa kufuneka ngocoselelo decontaminated. Uyacetyiswa ukuba usebenzise semidesyatiprotsentnogo utywala. Xa kuthe kwakho eluswini kwindawo okuhlatywa iye uyithambise amahlanu ekhulwini ayodini, ngeempahla zayo kufuneka zisuswe babulale notywala kabini. Ukususwa iodine eyintsalela, ingakumbi ukuthambisa ajikeleze intabalala iyafuneka ngenxa yokuba ayodini kunye inaliti kusichukumisa kungena kwisisu joint, yaye oku kubangela ukuphazamiseka kwaye yababuhlungu lwamalunga asabela komtshiso oko. Ukongeza, iodine ukubamba-X-reyi, nto leyo enokuchaphazela ukuchaneka umfanekiso - oko ukubonisa izithunzi ezongezelelweyo bayasigqwetha umfanekiso.

Sebenzisa zomzimba nokungena yasekuhlaleni.

Indlela yokwenza okuhlatywa?

Ubude inaliti okuhlatywa kwezi cm 5-6. Ukuba ukuqaliswa ioksijini kuliwa, ngoko inaliti kufuneka kusetyenziswe zingcakacile, ukuba millimitha enye ububanzi. Kungenjalo, irhasi ukugqobhoza kulo inyama ithambile ezingqonge entlanganweni. Loo nto, zivuse, isihlunu ongama periarticular okanye emphysema.

Ulusu okuhlatywa kwi kwegxalaba kufuneka waya ngaphesheya. Oku kukuvumela ukuba agobe ijelo inxeba kushiywe inaliti, kwaye eluswini emveni kokuba nkqubo abuyiselwe kwisithuba. indlela enjalo uyayiphepha kwii-usulelo ukusuka kumphezulu umzimba kwisisu ehlangeneyo.

Inaliti ushukunyiswayo ngokucothayo kakhulu, ukuzama ukufumanisa xa ukuphela kwayo kuya kuqhutyelwa philisi ngokuhlangeneyo. Ukuba kwisisu glenoid unalo igazi, apho kuya kubakho isicombululo bala novocaine kwi isirinji, okanye xa ubomvu - isisombululo kuba lisibekele.

Malunga kubunzulu apho okuhlatywa, kukho izimvo ezahlukeneyo kufuneka kuphunyezwe. Abanye ncwadi ithi inaliti kufuneka ukugqobhoza ukuya sentimitha mnye, kunye nezinye - ngo 2-3 cm.

zokuhlatywa Ulwelo kufuneka besanya isirinji kunye umthamo grams-10 ukuya kuma-20. Ukuba kufuneka - alawulwa iziyobisi. Emva kokususa inaliti ulusu nomkhethe kwiwebhsayithi, ngokwenjenjalo ayeguqa umjelo ngenxeba, isiza okuhlatywa ke iphathwa kunye notywala kunye umhlabelo, nokuphepha isicelo.

Technology kwenzakalani kwegxalaba

Zokuhlatywa welungu kufuneka wenziwe evela ecaleni, ngaphambili okanye ngasemva. Ukuba le nkqubo yenziwe ngaphambili, ngoko isigulane kufuneka ufakwe kwi ngasemva. Emva koko, ugqirha kufuneka ukufumana inkqubo coracoid ye yabe zamagxa, nto leyo cm abathathu ngaphantsi ekupheleni distal le clavicle. Inaliti kufuneka ilawulwe phantsi kwakhe kwaye ikhokelele phakathi amathambo zamagxa ze intloko som yayo kwicala ukusuka phambili ukuya emva. Inaliti kufakwa ukuya kubunzulu-4 cm.

Ukuba okuhlatywa lwenziwa yi ugqirha we nomlenze kwicala edibeneyo, isigulane kufuneka abulawe icala, ngelixa isandla sakhe yabekwa kanye apha esiqwini. Ububanzi ngomnwe usezantsi kancinane tuberosity esikhulu intloko ihumerus na intloko yakhe. intonga inaliti indawo phantsi koqhubekeko acromion, nto leyo kakhulu, elibukhali, uze phambili ngapha esihlunwini deltoid kwi-moya ngokungqalileyo.

Ekwenzeni Ezomva iinkqubo isigulane okuhlatywa efunekayo kukubeka isisu sakhe. Emva koko, lo gqirha unovelwano esihlunwini deltoid udini awo. Kweli nqanaba, kukho umhadi, ibekwe kancinci koko ngohlangothi ngasemva inkqubo acromion. Kule ndawo kuyimfuneko ukuba bafake inaliti uze uyibeke ukuya kubunzulu-5 cm kwicala coracoid scapula.