Wokubhoboza ehlombe ngokuhlanganyela: amasu Ukuhola

Wokubhoboza we ngokuhlanganyela ehlombe kuyinto phakathi nenqubo yokuhlinzwa, phakathi kwesikhathi lapho udokotela okokufaka inaliti ku egobolondweni lelunga. Inqubo efanayo wenziwa ngezinhloso zokuxilonga noma isimo yezokwelapha ekhona. Injongo ukwenza inqubo enjalo - ukwehla kwenani uketshezi ngokuhlanganyela lwamalunga.

Izinhlobo ezimbili wokubhoboza

Odokotela Abahlinzayo wokubhoboza lahlukaniswa izinhlobo:

• Ukuphulukisa.
• Yokucwaninga.

anatomy ngokuhlanganyela

Phakathi wokubhoboza we ngokuhlanganyela ehlombe kuyadingeka ukuba acabangele izici isici umkhathi. I synovium - a bezinhlamvu okuyinto ku isimo sawo futhi imvelaphi sihluke ulwelwesi serous (ezifana ulwelwesi we pleura, peritoneum, pericardium). Umehluko omkhulu itholakala lokuthi hlangothi zayo zangaphakathi ebhekene ebusweni ngalo ingaphakathi, ayiqukethe epithelium kanye ulwelwesi endothelial. I ukujiya ulwelwesi kuyahlukahluka. Ngaphezu kwalokho, it has ezwela anda ukuze ukumelana ezishisayo, kuyashaqisa, ezithathelwanayo, futhi amakhemikhali.

Ngu hypersensitivity synovium yizifo ezihlukahlukene kudinga ukunamathela ngokuqinile aseptic ngaphambi inqubo wokubhoboza, futhi ngaphambi kokuvula ngalo ingaphakathi articular. Ngaphezu kwalokho ke kudinga ukubekwa uphawu saziso. I ingaphakathi ngokuhlanganyela iqukethe esincane uketshezi lwamalunga, cishe namamililitha ezine. Uketshezi lwamalunga luhlanzekile, has a yellow utshani umbala kuba ngokuphelele esicacile. It libhekene viscosity ephakeme, iqukethe amaseli phagocytic kanye amangqamuzana amhlophe egazi, kodwa izakhiwo zalo elwa namagciwane mancane kakhulu. Ngenxa yokuthi elihlale mucopolysaccharides uketshezi lwamalunga ephezulu isisindo othize, aqoqana ngokuhlanganyela hhayi ekubhebhetselisa aphume umgodi yayo.

Technique we wokubhoboza we ngokuhlanganyela ehlombe kuzoxoxwa ngezansi.

Mayelana uketshezi ngokuhlanganyela

Thola uketshezi ngokuhlanganyela futhi akabubangeli inqubo isifo kunzima kakhulu ngenxa senani elincane ingcindezi engemihle futhi viscosity okusezingeni eliphezulu. amalunga omzimba abe nempilo kukhona ingcindezi ezimbi:

• Iqakala: amanzi 270-210 mm ikholomu.
• Singabongi: 75-90 amamilimitha angu yamanzi ikholomu.

Ukuba khona ingcindezi negative kubangela Osmosis uketshezi izingqimba subchondral futhi lwamalunga, lapho uqwanga ngokuhlanganyela kwenzeka ukudla.

Wokubhoboza we ngokuhlanganyela ehlombe in abantu enempilo akuvamile.

Imisebenzi uketshezi lwamalunga

Imisebenzi esemqoka eyenziwa uketshezi lwamalunga, kungabandakanya:

• Locomotor umsebenzi. uketshezi lwamalunga esihambisana uqwanga articular inikeza ukunyakaza khulula we okushiwo ithambo evele.
• umsebenzi umzimba. uketshezi lwamalunga ehilelekile izinqubo umzimba okwenzeka phakathi imibhede semithambo kanye articular uketshezi.
• umsebenzi trophic. Avascular uketshezi lwamalunga uyasondla izingqimba uqwanga.

Uma kukhona ukuvuvukala kwamalunga, le lwamalunga inyuka uketshezi ngoba aqukethe amaprotheni amaningi. Lokhu kungenxa anda permeability semithambo. Lolu ketshezi lube turbid, it kwandisa okuqukethwe neutrophil okuholela acute synovitis esibuhlungu.

Wokubhoboza we ngokuhlanganyela ehlombe: isitatimende

• Ukunqunywa okuqukethwe Ukwakheka (e khona ubomvu, exudate noma igazi). Uma emalungeni ezilimele equkethwe igazi, kungase kubangele synovitis, umonakalo uqwanga imvelo esiwohlozayo, naphakathi-articular ukuvuvukala. Endabeni kuhlasimulise haemarthrosis ukuqina kanye ukuvuvukala ingcina Uhlamvu ezabangela kakhulu ezilimele uqwanga ukujiya hhayi extravasated igazi umphumela. MIN_WAIT_HOURShishwa uqwanga kwenzeka nezinguquko kule ingxenye proliferative zezicubu zezinzwa. Uma kwenzeka lomonakalo igobolondo kwenzeka coagulation ngokwanele okusheshayo futhi amahlule ke kwakhiwa, okuyinto kungaholela ekwandeni okuphawulekayo kwezicubu ulwelwesi. Ngenxa yalokho, uqala nokwaphakade we umgodi ngokuhlanganyela.
• Ukusungula umonakalo meniscus emalungeni amadolo usebenzisa pnevmoartrografii noma-X ray.
• Ukusungula khona kule ingaphakathi ngokuhlanganyela "Izidumbu irayisi" noma "amagundane ngokuhlanganyela."

Kuze kube yimanje esimisiwe wokubhoboza lekutfola joint ehlombe.

Izinkomba obudingekayo ukwelapha labo ezifana wokubhoboza

• Ukususwa kwegazi ukuthuthukiswa hemarthrosis.
• Ukususwa kwezimiso exudate, ubomvu kusuka ngaphakathi komgodi articular, ukwethulwa izixazululo antibiotic.
• Isingeniso isixazululo novocaine at nokwehlisa dislocation.
• Ukwethulwa corticosteroids lihambisana Lydasum khona arthrosis deformans.
• Isingeniso umoya-mpilo noma emoyeni ekusetshenzwa mnene ukwa kwakheka uma ukuvuvukala fibrous ukuvuvukala articular. Isingeniso umoya-mpilo futhi kungenzeka ukubuyisela motor umsebenzi noma eyingqopha redressatsii.

Kuze kube yimanje, i-wokubhoboza theka ehlombe kwamajoyinti.

inqubo

Ngenxa ukuzwela kakhulu uketshezi lwamalunga izifo, phakathi wokubhoboza ngokuhlanganyela kumele sisondela ngokungenakuvinjelwa ulandele yonke imithetho asepsis futhi antisepsis.

Ngaphambi nokuqalisa wokubhoboza, isayithi wokubhoboza kufanele kahle decontaminated. Kungcono ukusebenzisa semidesyatiprotsentnogo utshwala. Uma isikhumba kusayithi wokubhoboza iye owagcoba amaphesenti amahlanu isixazululo iodine, izinsalela zayo kufanele isuswe ngu ukusula ngotshwala kabili. Ukususwa iodine asalile, ikakhulukazi nge Lubrication luningi iyadingeka ngenxa yokuthi i-iodine kanye inalidi ikwazi ukungena ngaphakathi komgodi ngokuhlanganyela, futhi lokhu kubangela ukucasuka futhi ezinzima lwamalunga ukuphendula ezishile. Ngaphezu kwalokho, i-iodine ukubamba X-ray, okungase kuthinte ukunemba isithombe - ke ungabonisa izithunzi ezengeziwe phendulela isithombe.

Sebenzisa wendawo kokuziphatha izinzwa.

Indlela yokwenza wokubhoboza?

Ubude inaliti wokubhoboza for 5-6 amasentimitha. Uma ukwethulwa mpilo kwenziwe, inaliti ke kumele kusetshenziswe nomzimba omncane, elilodwa milimitha ububanzi. Kungenjalo, igesi ungakwazi ukungena izicubu zomzimba ezithambile ezungeze ngokuhlanganyela. Lokho kubanika, ukuqala ongama, imisipha periarticular noma ne-emphysema.

Skin wokubhoboza ngesikhathi ngokuhlanganyela ehlombe kumele iyiswe ohlangothini. Lokhu kuvumela ukuze agobe isiteshi isilonda kwesokunxele inaliti, futhi esikhumbeni ngemva inqubo ebuyiselwa isikhala. Le ndlela ugwema Ukungena ukutheleleka ebusweni umzimba phakathi komgodi ngokuhlanganyela.

Inalidi kufanele ashukumiseleke kancane kakhulu, ezama ukunquma lapho ukuphela kwayo izobanjelwa egobolondweni lelunga. Uma umgodi glenoid has igazi, kuzoba novocaine isixazululo staining ku emjovweni noma uma ubomvu - ikhambi iba esinamafu.

Mayelana ukujula lapho wokubhoboza, kunemibono ehlukene lufanele lwenteke kulamazinga lalandzelako. Ezinye izincwadi uthi inaliti kufanele ukungena elilodwa isentimitha, kanye nezinye - at 2-3 cm.

wokubhoboza Liquid kumelwe ncela isipetu ephethe umthamo we-10 kuya 20 amagremu. Uma kudingeka - iqondiswa izidakamizwa. Ngemva kokususa inaliti isikhumba olubandlululayo ikhishwe, kanjalo eguqa isiteshi isilonda, isayithi wokubhoboza ke ziphathwe i utshwala ngebhandeshi oyinyumba isicelo.

Ubuchwepheshe lubhoboze ngokuhlanganyela ehlombe

Wokubhoboza we ngokuhlanganyela kumele kwenziwe kusukela ohlangothini, phambi noma labaqaphi elingemuva. Uma inqubo yenziwa phambi, isiguli kufanele agqoke emuva. Ngemva kwalokho, udokotela ohlinzayo wangitshela kumele uthole inqubo coracoid we izindwani ehlombe, okuyinto ngamasentimitha amathathu ngaphansana ukuphela distal we clavicle. Inalidi lekufanele yentiwe ngaphansi kwakhe phila phakathi amathambo ihlombe ikhanda futhi uyihlumela yayo ohlangothini kusukela phambili kuya emuva. Inalidi sifakwe ku-4 cm ukujula.

Uma wokubhoboza wenziwa udokotela ohlinzayo ehlombe ohlangothini ngokuhlanganyela, isiguli kufanele abulawe uhlangothi, ngenkathi, isandla sakhe sasishaywe ibekwe ncamashi kanye isiqu. Ububanzi umunwe kancane kusukela tuberosity enkulu ekhanda humerus uyinhloko yakhe. induku Needle ingxenye ngaphansi inqubo acromion, okuyinto kakhulu ophumile, bese kuthuthukiswe ngokusebenzisa imisipha deltoid indiza engaphelele.

Lapho efeza ezingemuva izinqubo wokubhoboza nesineke edingekayo ukuze walala ngesisu sakhe. Ngemva kwalokho, udokotela ohlinzayo wangitshela uzwelana imisipha deltoid futhi usiko aphansi. Kuleli qophelo, kukhona umgodi, elise kancane kuka onqenqemeni ezingemuva inqubo acromion. Kule ndawo kubalulekile ukujova inaliti wakufaka ku-5 cm ukujula ku isiqondiso coracoid scapula.