Indlela yokwenza iNgxaki kunye Nento ongayenza ukukhusela ukukhathazeka kokuPhulukisa
Utyando olutshintsho lwe-Knee luphakathi kwezinto eziqhelekileyo unyango lwe- arthritis enamandla . Ukuphulukiswa kwe-incision yokugonywa kukukhathazeka ngabantu abaninzi abakwenzayo kulo msebenzi. Kuyaziwa ukuba ukutshatyalaliswa kwegama lokuguqula idolo luyinkxalabo enzulu, kwaye ukuba ne-incision ephilisa kakuhle kukuba izigulane ezininzi zixhalabisa.
Nazi ezinye iimpawu zokuphulukana neengxaki, ukuba zinokuthintelwa njani, kwaye yintoni efuna ukuba yenziwe kunyango.
Ubunzima bokuphulukana neengxaki emva kokuguqulwa kwamadolo kuyahluka kuye kuxhomekeke kwizifundo ezahlukeneyo, kodwa phakathi kweepesenti ezi-1 kunye ne-10 ekhulwini kwiingxelo ezininzi. Oku kuthetha ukuba kunethuba elincinci leengxaki zokuphilisa, kodwa oku akuyona inkcazo engavumelekanga, kwaye enye abantu abaye baqhutyelwa ukuguqulwa kwamadolo kufuneka baqonde kwaye bayayiqonda.
Ukukhathazeka ngokukodwa kukuba ithuba lokutshatyalaliswa okutshatyalaliswa kwamadolo kubantu abangenazo iingxaki zokuphulukisa ukunyanga kungaphantsi kwama-1 kweepesenti, kodwa kubantu abafumana iingxaki zokuphilisa, ithuba lokusuleleka kwintsholongwane eminyaka yokuqala emva kokuhlinzwa kuphezu kwe-10 pesenti! Yingakho thina njengabagqirha sifuna ukuqinisekisa ukuba senza konke okusemandleni ukukunceda ukuphilisa ngokufanelekileyo, kwaye ngokukhawuleza ukulawula nayiphi na inxeba engabonakali iyaphilisa.
UkuPhiliswa kweeNgxelo
Ukuphulukiswa kwesikhumba kunye nama-tissue-tisses amanyathelo asemqoka ukukhusela ukungena kweebhaktheriya ebusweni besikhumba nangaphandle. Kuze kube loo mqobo iphilisiwe, kukho umngcipheko wokungena kwintsholongwane kunye nokusuleleka kokutshintshwa kwamadolo-ingxaki enokubakho.
Ngenxa yoko, ukuqinisekisa ukuba ukuphulukiswa ngokukhawuleza kweziganeko kubaluleke kakhulu kwimpumelelo yokuguqulwa kwamadolo.
Kukho amanyathelo amanyathelo okuphilisa ayenzeka emva kokutshintshwa kwamadolo (okanye nayiphi na ingozi yokugonywa) eyenziwa:
- Isigaba sokuqala ukuvuvukala ; kweli nqanaba eliqala ngokukhawuleza emva kokuvalwa kwesicatshulwa. Kulo nqanaba lokuqala, isilonda sivala ngokubizwa nge- clotting cascade , kwaye izibonakaliso zithunyelwa ngomzimba obangele ukuphilisa iiseli kwindawo yesicatshulwa. Isigaba esivuthayo sihlala kwiiveki ezimbalwa zokuqala emva kokuhlinzwa.
- Isigaba sesibini sisanda ; ngeli nqanaba liqala malunga neveki emva kokuhlinzwa kwaye ligqithise isigaba sokuvuvukala. Isigaba esandayo kubalulekile ukuphuhlisa iimfuneko zeesetyhula kunye nokuphulukisa izicubu ezijikelezayo.
- Isigaba sokugqibela sokuphilisa ukukhula ; ngeli nqanaba liqala emva kweeveki ezi-3 kwaye likwazi ukuphela unyaka. Ngethuba lokuhluma kwesilonda, izicubu zokuphilisa ziyaqina kwaye zinjengekhumba eliqhelekileyo. Ukuphulukiswa kwezicubu ezinobumba obuthakathaka kakhulu kumanyathelo okuqala, kwaye ekugqibeleni uphinde uphinde ufumane ama-80 ekhulwini olusisigxina esikhumbeni ngaphakathi kweenyanga ezintathu. Ubomvu abuzange buqine njengezikhumba zesikhumba.
Izizathu Zeminye ImiSebenzi Ayiphilisi
Uninzi lweemeko zonyango lunokuchaphazela kakhulu amanyathelo okuphilisa kunye namandla olwaphulo lokugqibela.
Ezinye zeemeko zinokuthintelwa okanye ubuncitshiswe ubuncinci, ngelixa abanye bangabi lula ukuguqula. Izimbalwa zeemeko eziqhelekileyo ezichaphazela ukuphulukiswa kwezilonda kunye namandla ziquka:
- Ukungondleki
- Sikashukela
- Irheumatoid arthritis
- Ukunyanya
- Ukutshaya
Ngenxa yezi zizathu, iinkqubo ezininzi zokubuyisela izalathisi ziya kubacebisa abantu abanaluphi na uhlobo loqhagamshelwano oluthile lokufakelwa ngokutsha ukuze kulungiswe le miqathango ngaphambi kokuhlinzwa. Umzekelo, ukuqinisekisa ukutya okunomsoco, ukulawula iswekile yegazi (i- hemoglobin A1C ngaphantsi kwe-8.0 ), ukulawula izidakamizwa ze-rheumatoid , ukulahleka kwesisindo, kunye nokuyeka ukucinywa komguba kuzo zonke iindlela abantu abanokuzithatha ukunciphisa umngcipheko wokuphulukiswa kwezilonda emva kokuhlinzwa ngokuguqulwa kwamadolo.
Ukongezelela, abanye oogqirha banokuthabisa malunga nokuqhutyelwa ukuguqulwa kwamadolo ngokubhekiselele kubungozi abasemngciphekweni. Nangona wonke umntu efuna ukukholelwa ukuhlinzwa kwakhe uya kuhamba kakuhle kwaye engenakho inkxalabo, kukho abantu abangabhetele kwaye baphelelwe ngokukhuselekileyo ngezilwanyana zonyango, ingakumbi ukuba basengozini enkulu yokuphulukisa iingxaki emva kokuhlinzwa ngokuguqulwa kwamadolo.
Enye into engabangela iingxaki ngokuphulukiswa kwelinxeba zibandakanyeka phambi kokugonywa ngamadolo. Oku kubaluleke kakhulu ingxaki xa i-incision yangaphambili ikhona njengokuba ingasetyenziselwa kwakhona kwaye ukufakwa okutsha kufuneka kufakwe phezu kwedolo. Isixhobo ngasinye sibangela ukuphazamiseka kwisibonelelo esisisigxina se-tissue, kwaye izigqibo ezininzi zingashiya indawo zesikhumba ngaphandle kokunikezelwa kwegazi okwaneleyo. Ukuba oko kwenzeka, ngoko i-necrosis yamathambo (indawo yesikhumba sefile) iyakwenzeka, ishiya indawo enokufuna i-skin or soft-tissue grafts.
Indlela yokwenza iNgxaki
Imiqondiso yokukhangela xa kuhlolwe isicatshulwa sokusoloko sinenkinga yokuphilisa kubandakanya:
- Ukuqhubela phambili okanye ukuqhubela phambili umjelo osuka kwi-incision
- Izikhewu okanye imingxuma kwi-incision
- Amathisisi amnyama okanye ama-dusky azungeze isixhobo
- I-sutures ephukile okanye izibonda zesikhumba eziphumayo kwindawo yecala
Iimpawu eziqhelekileyo zengxaki yokuphilisa iilonda ziqhubekayo okanye ziqhube umdaka emva kokuhlinzwa. Kuyinto eqhelekileyo ukuba inxeba yokugonywa ibe nomsele othile emva kokuhlinzwa, kodwa umjelo ongaphezu kweeyure ezingama-72 emva kokuvalwa kwesilonda akuthathwa njengesiqhelo. Nangona ukubonakala kwebhanki emva kwesi sihlandlo kungabi yimbangela yokukhathazeka, ngaphezu kwama-2 centimeters of drainage kwi-bandage bandage ayiqwalaselwa njengesiqhelo kwaye kufuneka ihlolwe ngugqirha wakho.
Udokotela wakho ugqirha uya kufuneka ukuba aqinisekise ukuba umjelo uvela kummandla wokujikeleza okanye ukusukela ngaphaya komda wokutshintshwa kwamadolo. Ukongeza, uya kufuneka ukuba aqinisekise ukuba umjelo ubonisa iimpawu zentsholongwane. Ukuba umjelo uvela kwinqanaba elincinci lesilonda okanye unokusuleleka, ngoko utyando luya kuba luyimfuneko kunyango.
Yintoni Okumele Yenze Xa Ukuxhamla Kungaboni
Ukuba unesilonda esingasiphilisi, kufuneka udibanise ugqirha wakho ngokukhawuleza. Ukuba ukugqitywa kokugqitywa kukugqitha ngaphezu kweeyure ezingama-72 emva kokuhlinzwa, abantu kufuneka bahlale esibhedlele ukuze babone okanye ukuba balandele isigulane esifanelekileyo ukuqinisekisa ukuba isilonda siyaqhubeka siphilisa. Kwiimeko apho umlambo uyancipha, kwaye akukho nanye uphawu lokusuleleka, la manxeba angaphilisa. Nangona kunjalo, bafuna ukulandelelana okufutshane njengoko utshintsho kwicala kufuneka lugqithise ukungenelela okungakumbi.
Ngokuqhelekileyo unyango lomzimba luya kuncitshiswa kwezi zi gulane, kwaye ukuguqa ngamadolo angaphezu kwama-45 degrees kungabanjwa iintsuku ezimbalwa. Ukuguqa ngamadolo kwandisa uxinzelelo kwiimfucu ezijikelezayo, kwaye kunokunciphisa i-oxygenation yalezo zicubu. Ukugcina umlenze uqondile kunokunceda uomise ukutyunjwa kwezinye iimeko. Amachiza amancinci egazini angenza negalelo kwiphilisi yokucoca, kwaye ngenxa yalesi sizathu i-antiticoagulation iza kubanjwa ixesha elithile kumntu onomdla wokugonywa ngokuqhubekayo.
Ukuba isilonda sidlula ngaphaya kweveki emva kokuhlinzwa, utyando kufuneka lwenziwe ukuqinisekisa ukuba akukho uphawu lokusuleleka kwaye lukhusele ukusuleleka ekubeni yingxaki. Akukho nxaxheba ekulawuleni unyango lwe-antibiotics ngokungabikho kwonyango olwenziwe ngolu hlobo lwengxaki.
Ukuba kukho ubungqina besikhumba se-necrosis okanye i-gap ekwakheni isicatshulwa, kunokwenzeka ukuba izicubu ezongezelelweyo ezinempilo, mhlawumbi ngoluhlobo lwe-graft yolusu okanye ukutshintshela kwezinto ezincinci, kunokufuneka ukuba unikezele ngokukhawuleza kwilonda . Kule meko, kufuneka ufune isiluleko esivela kumgqirha ogqirha weplastiki onokusebenzisana kunye nomgulane wakho wamazinyo ukuze acebise indlela efanelekileyo yokufumana ulwaphulo oluphambili.
ILizwi
Inxalenye ebalulekileyo yokuphumelela ngokuguqulwa kwamadolo yindlela yokucoca ngokufanelekileyo. Ukuba isicatshulwa asikwazi ukuphilisa ngokupheleleyo, ukusuleleka kwintsholongwane kunokuvela kwesikhumba ukuya ekugqibeleni ukuguqulwa kwamadolo, kubangele ukukhathazeka ngeengxaki ezinzulu. Ukuba kukho iinkxalabo zokuphilisa isikhumba sakho, vumela ugqirha wakho ukuba azi ngokukhawuleza. Ukunyamezela nokuphuculwa kwangoko kweengxaki zokuphulukisa ulusu kubaluleke kakhulu ekuthintela ingxaki enzulu.
> Imithombo:
> Simons MJ, Amin NH, Scuderi GR "Iingxaki ezixakekileyo zokulimala Emva kwe-Total Knee Arthroplasty: Ukuthintelwa noLawulo" J Am Acad Orthop Surgery. 2017 Aug; 25 (8): 547-55.