M'chiuno olowa: m'chiuno m'malo, ndi kusintha zina

Zimfundo okhumudwitsa ndi kupanda sayenda ali choletsa pochita zinthu tsiku ndi tsiku, zikhale zosatheka kuti munthu wabwinobwino. Kwambiri pamene chidwi ndi ntchafu olowa. arthroplasty amathandiza kuti kubwezeretsa zotayika ntchito ndi manja, monga zambiri njira yokhayo wodwalayo. Zikuonetsa ntchito iyi anthu oposa 300 zikwi chaka.

Woyamba ndi waukulu chizindikiro cha matenda olowa ululu. Poyamba, ululu ndi wotsika kwambiri, koma m'tsogolo, ndi kupitirira kwa matenda, ululu wagundika, kukhala mabwenzi nthawi zonse wa munthu.

Kenako pakubwera kwa kukanika ya nthambi akhudzidwa. Matendawa ali ndi vuto patsogolo, kutsogolera zina kumaliza immobilization. odwala amenewa ndiwofatsa mankhwala si kuthandiza kupulumutsa m'chiuno anakhudzidwa.

Ncafu arthroplasty panopa ndi imodzi mwa njira zamakono kwambiri chisamaliro opaleshoni odwala ndi zotupa za malo. Pa ntchito ngati minofu matenda kuwonekera mu ntchafu pawiri unasintha kupeza mano otere yokumba.

Kapangidwe ndi ntchito mfundo m'chiuno

M'chiuno olowa ndi imodzi mwa fupa waukulu mu mfundo mu thupi la munthu. Mayeso kutsegula iwo kwambiri mu ndondomeko ya moyo wa munthu, ngati ali kulumikiza nthambi m'munsi ndi mafupa a chiuno.

ncafu ya Kaonekedwe:

• femoral mutu - mapeto chapamwamba femur ndi mawonekedwe ozungulira;
• acetabulum - ndi nyuzi woboola pakati recess a mafupa a chiuno, chimene chili femoral mutu;
• olowa chichereŵechereŵe - minofu kuti ali ndi zakudya ngati lubricant kuti facilitates kayendedwe wa articular mbali olowa;
• synovial (kwapakati) madzi - kulemera wapadera wa kugwirizana gelatinous, zomwe chakudya chichereŵechereŵe ndipo kumathandiza kuchepetsa mikangano ya kali articular;
• olowa kapisozi ndi Mitsemphayi - connective minofu kuti akutumikira monga posungira wa pamalo articular ndi kuonetsetsa mtendere wa olowa.

Minofu ndi tendons Ufumuyo m'dera m'chiuno, contractions ake kulola gulu mmenemo. Boma wathanzi a m'chiuno olowa ndi mafoni kwambiri, kukhala amasamukira mu ndege iliyonse ndi malangizo. Iye uzigwirizana ndi ntchito pulogalamu ya kuyenda ndi kuthandizidwa.

N'chifukwa chiyani tiyenera olowa m'malo?

dokotala kuika mtima pamaso pa funso la m'malo ntchafu yake prosthesis ayenera zifukwa zabwino. Opaleshoni Amasankhidwa, ngati nthenda umalandira mphambano wafika moti munthu nthawi zonse amamva ululu kwambiri, kapena nthambi akhudzidwa sangathe kuchita ngakhale kayendedwe kwambiri. Mu zinthu izi, pamene chidwi ndi ntchafu limodzi m'chiuno m'malo akhoza kukhala njira.

Ena mwa matenda amene angathe kuyambitsa matenda olowa zofuna opaleshoni ndi:

• nyamakazi deformans kusintha mu nkhani 2 ndi 3, kukula kwa matenda;
• nyamakazi deformans madigiri 3 pa mapindikidwe mmodzi wa malo;
• ncafu olowa ankylosis kunachitika nyamakazi, ndi chifukwa ankylosing spondylitis;
• aseptic necrosis mutu femoral chifukwa cha kuvulala ndi matenda magazi;
• kuvulala kwa mutu ndi khosi femur mu mawonekedwe a wovulala okalamba;
• kutupa m'dera kumwendo thandizo la mankhwala opaleshoni.

Ncafu m'malo n'koyenera okha nkhani ya kutayiratu kuthekera zolimbitsa thupi ndi kuyenda. Chigamulo chomaliza akutengedwa pa opaleshoni, amaganizira zinthu zonse.

Contraindications opaleshoni

Pali milandu pamene ngakhale anthu amene ali ndi zosowa pachimake pa ntchafu m'malo, simungathe kupita kwa opaleshoni chifukwa cha contraindications.

Malamulo ambiri monga:

• zochitika zina pamene wodwala sadzakhala amatha kuyenda palokha, ngakhale pa nkhani ya opaleshoni ya;
• matenda aakulu mu dekompensatsionnoy sitepe (matenda a mtima, matenda cerebrovascular, kwa chiwindi kulephera) mavuto pamene opareshoni angathe vutoli alipo;
• aakulu m'mapapo matenda kuchititsa kulephera kupuma ndipo mpweya (ndiko kumayambitsa chifuwa cha mphumu);
• Various kutupa fupa, khungu kapena minofu zofewa m'dera la m'chiuno olowa;
• kufooka kwa mafupa, zikubweretsa osakwanira mphamvu ya fupa ndi chiopsezo postoperative kuthyoka pa kuyenda wabwinobwino;
• pathologies imene palibe femur medullary ngalande.

gulu la amadzala

Mu prosthesis kuti m'malo akhudzidwa m'chiuno limodzi ayenera kokwanira mphamvu, ziyenera adzatsekeredwa atathana ndi ndi inertia kwa zimakhala wodwala. amadzala Current, anapanga ma polima, ziwiya zadothi ndi kasakaniza wazitsulo zitsulo akwaniritsa zonse zofunika. Kunja, ndi prosthesis akufanana ndi anthu m'chiuno olowa.

mfundo zake:

• Cup endoprosthesis. gawo ili m'malo mwa acetabulum wa olowa m'chiuno. Mfundo opanga ndi ceramic. Komabe, pali makapu anapanga ma polima.
• Mutu wa prosthesis lapansi. Zitsulo gawo ozungulira mawonekedwe ndi ❖ kuyanika polymeric. Izi zipangitsa kutsetsereka softness, pamene mutu ndi zimayenda mu chikho endoprosthesis pa magulu osiyanasiyana a nthambi.
• Mwendo prosthesis. Kulandira katundu kwambiri, nthawi zonse wa zitsulo. Ndi m'malo a khosi ndi chapamwamba wachitatu wa femur lapansi.

Komanso amadzala anawagawa umodzi-mtengo ndi iwiri mtengo. The umodzi-mtengo mtima ziwalo kusunga acetabular awo proteziruya mutu femoral ndi khosi. Ili ndi buku chakale cha prosthesis, chimene chimagwiritsidwa ntchito. Kugwiritsa yodziwika ndi pafupipafupi mkulu wa wovulala acetabulum, ndipo anaimitsa ntchito zawo kuchita ano mafupa.

Maganizo endoprosthesis ndi dzina chiweruzo. Iwo amapanga okwana m'chiuno arthroplasty. Apa pali onse atatu zigawo zikuluzikulu pamwamba pa prosthesis lapansi.

ncafu nthawi endoprosthesis utumiki anatsimikiza ndi khalidwe zipangizo kuti atumikira kuti iwo. Amphamvu zitsulo amadzala lolimba kwa zaka 20. Komabe, zotsatira mulingo woyenera mitundu moyo utumiki wa ntchito galimoto ndi osakaniza chipereka zitsulo-polima-ceramic.

preliminaries

odwala onse amene muyenera yopanga, maphunziro iyenera kuchitikira kudziwa boma la m'chiuno olowa (ultrasound, Kujambula, X-ray) kuti achotse contraindications onse angathe.

No yapadera yophunzitsa ntchito sikutanthauza. Popeza contraindications kumachitika ntchito opareshoni kusankha. M'mawa wa opaleshoni kuti amete khungu m'dera m'chiuno. Kudya ndi kumwa akuletsedwa.

ndondomeko sitepe

Wodwala aikidwa pa tebulo ya opareshoni, pamene iye anachita ochititsa dzanzi. njira zogwirizana wa mankhwala oletsa ululu dzanzi ndi mtima. Kutalika kwa ntchito angafikire ku milandu yovuta maola 5. Choncho njira yabwino kapena msana ochititsa dzanzi kapena mankhwala ochititsa dzanzi zonse. Yoyamba njira ya mankhwala ochititsa dzanzi kumabweretsa kuwonongeka zochepa, choncho ndi bwino kuti aike okalamba.

Akamaliza wa mankhwala oletsa ululu dokotala ntchito odulidwa bungwe kupeza m'chiuno olowa. Chofunika odulidwa - za 20 cm Pali kung'ambika ya kapisozi olowa ndi kuchotsedwa mutu wa femur, amene umamvera resection ..

mawerengeredwe fupa akubwera mu maonekedwe a endoprosthesis lapansi. prosthesis fixation limapezeka nthawi zambiri kudzera mwa simenti. Lotsatira, pamwamba pa za acetabulum kubowola kuchotsedwa articular chichereŵechereŵe, limene anapereka chikho endoprosthesis.

zosokonezeka Nkosatheka

Ncafu ya opaleshoni m'malo imatengedwa kuti ndi opaleshoni zovuta.

Zimenezi zingachititse mavuto:

• magazi;
• magazi kuundana mu mitsempha ya m'makona m'munsi;
• suppuration wa prosthesis ndi mabala pa opaleshoni;
• hematoma;
• kukana endoprosthesis;
• mavuto a dongosolo mtima.

Mosamala kukonzekera ntchito minimizes chiopsezo zosokonezeka.

Zotsatira za ntchito

Malinga ndi kafukufuku, ntchafu m'malo mtima umboni kwa kwambiri gawo labwino. Odwala amene ali ndi wokhutira ndi ntchito. Mu opareshoni anthu wachinyamata wopanda matenda concomitant wa ntchito m'chiuno olowa amabwezeretsedwa zonse. Munthu akhoza kuyenda ngakhalenso kuchita masewera olimbitsa thupi, popanda overloading ndi prosthesis. Zamasewera zochitika contraindicated.

Pali zotsatira osauka pambuyo opaleshoni m'chiuno m'malo. Nthawi zambiri zidzachitika mu ukalamba, ngati muli comorbidities. 20% odwala likufa m'chiuno m'malo, odwala kusonyeza ndemanga kukhumudwitsa zotsatira za ntchito.

Kuchira pambuyo opaleshoni

Konzanso odwala ayenera kuyamba mwamsanga pambuyo opaleshoni. Ntchitoyi pambuyo opaleshoni m'chiuno m'malo, ndi kupuma kokoka. N'zoona kuti prosthesis kakusintha iyenela ndekha, koma ayesetse kukumana osachepera minofu chidule pambuyo m'chiuno m'malo mwachita. Konzanso ayenera kukhala wolamulidwa chachikulu - muyenera zonse kuwonjezera katundu.

Tsiku loyamba pambuyo opaleshoni

odwala ambiri ndi kucheza nawo odwala mwakayakaya. Pali bwino kuwayang'anira zizindikiro yofunika, pomwepo poyankha kusintha onse negative. Patapita maola angapo pambuyo opaleshoni, munthu amatha kukhala ndi nthawi yocheza ndi mwayi atakhala, akuponya pansi atavalanso zoteteza.

M'chiuno opareshoni zoletsedwa kukhotetsa kuposa 90 °. Izi zikhoza kusokoneza matabwa ake ndi fixation mu fupa. Kutenga malo atakhala bwino ankalamulira zachipatala chipatala kapena banja antchito. Adzakuthandizani kulimbikitsa nthambi akhudzidwa ndi adzapereka thandizo, ngati pali chizungulire.

Kudzuka

A masiku angapo kutuluka pabedi zawo pambuyo opaleshoni sayenera. Dalirani nthambi wathanzi, popanda kugwiritsa ntchito zipangizo wothandiza, izo ndikoletsedwa kwa masabata angapo. zipangizo Assistive atha kutumikira ngati ndodo kapena ndodo. Pamene chikhalidwe zogwira mtima wa wodwalayo pambuyo opareshoni monga ntchafu m'malo, konzanso amalola ntchito thandizo kudzuka tsiku lotsatira Komabe, odwala ambiri Sali okonzeka kutero.

kuyenda

Lolani mtima kuyenda pa tsiku lachitatu pambuyo pa opaleshoni. Pa nthawi yomweyo ayenera kumvera malamulo onse kusintha kuimirira. Onetsetsani kulimbikitsa opareshoni kumalekezero manja kapena mwendo zabwino sveshivaniya bedi. Mukhoza pa ndodo ndi mwendo wathanzi. kuyesa kudalira mwendo wovulala ndikoletsedwa Patangopita mwezi opaleshoni, kotero izo ziyenera kukhala mu Limbo. Ntchito ndodo poyenda, ndi bwino kuti miyezi itatu.

Pa otaya otetezeka nyengo konzanso mukhoza kupita pa ndodo thandizo. Dalirani pa mwendo wovulala akhoza kukhala mwezi umodzi, koma osati kusuntha thupi lake lonse la thupi. Kuyambira zolimbitsa thupi pambuyo opaleshoni m'chiuno m'malo m'pofunika kuutsiriza miyendo ku mbali ndi kubwerera kwa iye kubwerera ndi kuukitsidwa ndi kutsitsa mu kuimirira. Kutsegula ndi opareshoni mwendo miyezi iwiri katundu, osati choposa hafu ya wodwala thupi. Yambani kuyenda popanda kwathunthu improvised kutheka pambuyo miyezi 4-6 ntchito. Katunduyu ayenera ziwonjezeke pang'onopang'ono ndipo pang'onopang'ono.

chakudya

The chigawo chachikulu cha ayambe wodwalayo zakudya zoyenerera. The zakudya ziyenera kukhala mwa mapuloteni, mchere ndi mavitameni. Sikuti kutsatira kwambiri mkulu-kalori chakudya, chifukwa odwala sanayende mwachangu. Unspent mphamvu Pankhaniyi kungachititse kuti kunenepa, zimene sachedwa kuchira. Sitingachisonyeze kupangidwa ndi kuphika, yokazinga ndi mafuta zakudya zakudya kusuta. Analola nsomba, nyama Taphunzira, masamba ndi zipatso, dzinthu, mazira. Palibe sangathe kumwa mowa, khofi ndi tiyi.

Mankhwalawa ndi konzanso

Chithandizo kuchipatala kumatenga masabata 2-3. Choncho chilonda machiritso ndondomeko ndi kuyang'aniridwa. Childs, sutures amachotsedwa pambuyo pa masiku 12. The ena kukhala mu malo dokotala wodwalayo komanso abale ake aphunzire yosavuta konzanso wa mwendo ntchito. miyezi 3 pambuyo opaleshoni, ndi radiography a m'chiuno olowa. Izi zimathandiza kuunikira bwino ntchito ndi fixation wa analili lapansi.

Kamodzi mtima wa akatulutsidwa bungwe la mankhwala, thandizo lalikulu mu konzanso zina mukhoza kukhala kukambirana ndi dokotala-rehabilitator amene angakuthandizeni zinazake payekha konzanso. Izi kungathandize otetezeka ndi zochepa yaitali kuchira nthawi. odwala ambiri kubwerera ku moyo wokangalika chikuchitika Patangotha miyezi isanu ntchito. Ndi bwino kuchepetsa katundu kuti chomaliza nthambi konzanso kuti anakumana yopanga. M'chiuno limodzi lomwe olowa m'malo inayenda bwino, amatha nthawi yaitali kutumikira mbuye wake.

kumene opareshoni

Best ntchito zonsezi akutsatiridwa kunja. Takhala zipatala otchuka kwambiri a Israel ndi Germany, amene amakhazikika mu kukhazikitsa njira zimenezi. Komabe, mtengo wa m'chiuno m'malo m'zipatala amenewa ndi mkulu. A zina wololera, ngati pa chifukwa chilichonse opareshoni kunja sizingatheke ntchafu m'malo mwa Moscow. madokotala Russian utakwaniritsa zaka zaposachedwapa kwambiri patsogolo m'munda wa m'malo molumikizana mafupa, kupanga kwa chaka osachepera 20 zikwi nthawi m'chiuno m'malo. Mtengo wa opaleshoni mu dziko lathu zochepa kwambiri kusiyana mu zipatala achilendo, ndipo 38,000 rubles.