I-arthrocentesis inokukunceda ukufumanisa i-arthritis yokuvuvukala nokungavuki
I-arthrocentesis, ebizwa ngokuba yinjongo ehlanganyeneyo, yinkqubo apho umbane utyitywa kwi-joint ngokusebenzisa inaliti kunye nesirinji. I-fluid ithunyelwe kwibhubhoratri ukwenzela ukuhlalutya kwamanzi .
Iinkcazo
I-Arthrocentesis isetyenziselwa ngokusetyenzela ukuseka imbangela yokuxhatshazwa okuhlangeneyo . Ukususa umbane ohlangeneyo unenjongo ezimbini, unyango kunye nenjongo yokuxilonga.
Ukukhutshwa kwamanzi odibeneyo kunokunciphisa ubuhlungu kunye noxinzelelo kwi-joint. Njengenzuzo yecala yenkqubo, emva kokukhatyathwa kwamanzi ohlangeneyo, i- corticosteroid ingafakwa kwi-joint joint site esetyenziselwa ukwenza i-arthrocentesis. Isebenza kakuhle kwaye "ibulala iintaka ezimbini ngelitye elinye."
U vavanya
Kwilabhoratri, ukusetyenziswa kwamanzi okudibeneyo kuhlalutyo:
- Imbonakalo: I-fluid iyabonwa ngamehlo abantu ngenxa yombala nokucaca. Uhlobo oluqhelekileyo lwamanzi luyi-viscous (sticky) kwaye lubonakala lucacile kuluphuzi olukhanyayo. Ukuqhaqhaqhaqhaqhaqhaqhaqhaqheko oluqhekezayo aluqhelekanga kwaye kuyaphakamisa ukuvuvukala okanye isifo. I-fluody joint fluid ayiqhelekanga kwaye ingabangelwa yi-traumatic to joint.
- Uvavanyo lweMicroscopic: I-fluid ehlangeneyo iyahlolwa phantsi kwe-microscope ukuba khona kweeseli zegazi, i-crystals, kunye ne-bacteria. Umzimba oqhelekileyo ohlangeneyo awunayo okanye iimbalwa zegazi ezimbalwa. Inani elikhulu lamaseli obomvu libonisa ukuphuma egazini. Inani elikhulu lamaseli egazi ezimhlophe lunokubangelwa ngosulelo, isifo sesifo se-arthritis , isigulane, okanye i-pseudogout. Ukuba amangqamuzana egazi abomvu okanye amangqamuzana egazi amhlophe ayabonwa, inani leseli lingaqhutywa. Amakristal aqhelekanga kwintlambo ehlangeneyo. Iikridi ze-uric acid zibonisa i-gout; I-CPPD yamakristal iyenzeka nge-pseudogout. Iibhakteria ngokusetyenziswa kwamanzi zidibeneyo ziqhelekanga kwaye zibonakalisa ukusuleleka.
- Uhlalutyo lweMichiza: Umlambo ohlangeneyo uvavanyelwa i-glucose, iprotheni kunye ne-lactic dehydrogenase (LDH). Iziphumo ezingaqhelekanga ezihlangeneyo zomzimba ezinokubonisa ukuvuvukala okanye ukusuleleka: I-glucose - ngaphantsi kwama-40 mg / dl; Iiprotheyini - ezinkulu okanye zilingana no-3 g / dl; I-LDH - ngaphezulu kwama-333 IU / L.
- Olunye luhlalutya: I-fluid ehlangeneyo ibonwa kwiphubhu yokuvavanya emva kweyure enye yokwakhiwa kwe-fibrin clot (i-fibrin yiprotheni eyenziwe ngexesha legazi eliqhelekileyo). Naliphi na i-clot ibonisa ukuba kukho ingxaki nge membrane yelenovial (uluhlu lweetyhubhu ezihamba ngokubambisana). Olunye uvavanyo olubizwa ngokuba luvavanyo lwe-mucin clot (i-acetic acid yongezwa kwi- synovial fluid ) liqikelela ukuveliswa kwe-hyaluronate (icandelo le- cartilage ).
Iimeko
I-Arthrocentesis ibonisa isizathu sokuxubusha kunye kunye nokuvuvukala kunye neziphumo zoluhlalutyo lwamanzi oluhlangeneyo, le miqathango iyakucelwa ukuba:
- I-arthritis ye-septic , ingakumbi i-arthritis engekho ye-gonococcal
- ezinye izifo ezichaphazelekayo ezifana ne-gonococcal infections, isifo sesifo sofuba, ukusuleleka kwefungal, isifo seLyme
- i-crystal arthropathies, gout, kunye ne-pseudogout
- izifo zengxubusho
- osteoarthritis
- ngxakini
- hemarthrosis (ukuphuma egazini kwindawo)
Osteoarthritis
Kuhlalutyo lwamanzi oludibeneyo, inani leeseli kunye nokubala okuhlukanayo kwahlula phakathi kokungabikho kokuvuvukala nokuvuvukala. Ukungasebenzi okungekho ukuvuvukala kubonisa ukuba i-osteoarthritis okanye i-traum edibeneyo. Ukusetyenziswa kwamachiza okuvuthayo kungaba yintlungu ye-arthritis okanye i-arthritis eyenziwa yi-crystal.
Inani elihlangeneyo leseli kunye nokubala ngokwahlukileyo okubonakalisa i-osteoarthritis kubonakala ngathi:
- Ukubonakala: Sula umbane, i-viscosity ephezulu kunye ne-mucin enhle
- Amakristali: Amakristal ase-calcium phosphate (BCP) asezantsi, ama-apatite crystals
- I-White Blood Cell Count (i-WBC): Awuyi-inflammatory fluid: 200-2000 i-WBC / mm3; Inani le-WBC lisoloko lingaphantsi kwamaseli e-500 (ngokuyininzi i-mononuclear, uhlobo oluthile lweselungu legazi elimhlophe)
Ekubeni ixolo elidityanisiweyo lilo likhulu le-synovial cavity (indawo edibeneyo) emzimbeni, kuyindawo ebonakalayo yokuxubusha okubalulekileyo kunye nesayithi eliqhelekileyo le-arthrocentesis.
Ukususela kumlambo ohlangeneyo ogqityiwe kwaye uhlalutyiweyo, kubalulekile ukuqokelela ulwazi olubalulekileyo lokuxilonga.
Imithombo:
I-Arthrocentesis ye-Knee. Thomsen TW et al. I-New England Journal of Medicine. Meyi 11, 2006.
Synovial Fluid Analysis. p.140-143. I-Primer kwi-Rheumatic Diseases. Uhlobo 12. I-Arthritis Foundation.