Momwe Mungasankhire Impulanti Yoyenera ya M'chiuno

Prosthesis ya m'chiuno ndi chipangizo chachipatala chokhazikitsidwa chomwe chimakhala ndi magawo atatu: tsinde lachikazi, mutu wa chikazi ndi chikho cha acetabular. Zigawo zitatuzi zimalowa m'malo mwa chiuno chowonongeka, kubwezeretsa kuyenda ndi kuchepetsa ululu kwa wodwalayo.

01.Kodi zigawo za a prosthesis ya m'chiuno?

Prosthesis ya m'chiuno imakhala ndi zigawo zitatu zazikulu:

Tsinde lachikazi

mutachotsa mutu wachikazi wa wodwalayo, ngalande yachikazi ya wodwalayo imasinthidwanso ndipo tsinde lachikazi limalowetsedwa. Tsinde lachikazi likhoza kupangidwanso simenti kapena kusamangika (njira yoyenera yosindikizira) kutengera zaka za wodwalayo, mawonekedwe ake, kusokonezeka kwa fupa komanso zizolowezi za dokotala.

Femoral Head

Mutu wozungulira wopangidwa ndi zitsulo, polima kapena ceramic imayikidwa pamwamba pa tsinde lachikazi kuti lilowe m'malo mwa mutu wakale wowonongeka wa chikazi womwe wachotsedwa.

Prosthesis ya Acetabular (kapena chikhomo)

chiwombankhanga chowonongeka kuchokera pamwamba pa acetabulum, kumene mutu wakale wa chikazi unali, amachotsedwa. M'malo mwake ndi tapered acetabular prosthesis. Zitsulo kapena simenti zitha kugwiritsidwa ntchito kuti zikhazikike. Mkati mwa kapu iyi muli pulasitiki, ceramic kapena zitsulo zoyikapo zitsulo zomwe zimalumikizana ndi mutu wa prosthetic femoral.

02. Kodi zida zazikulu zomwe zimagwiritsidwa ntchito popanga ma prostheses m'chiuno ndi chiyani?

Ma prostheses a m'chiuno amatha kusiyanitsa malinga ndi zida zomwe zimagwiritsidwa ntchito popanga. Pakadali pano, zida izi zitha kugawidwa m'magulu atatu:

Zitsulo

Zitsulo zina, monga chitsulo chosapanga dzimbiri, cobalt-chromium alloy kapena titaniyamu zimagwiritsidwa ntchito kupanga zimayambira zachikazi.

Ma polima

polyethylene, pulasitiki yolimba kwambiri komanso zinthu zomwe zimagwiritsidwa ntchito kwambiri padziko lapansi. Ndi chinthu chosagwira ntchito komanso chogwirizana kwambiri ndi biocompatible chomwe chinayambika mu orthopedics mu 1960s monga chigawo cha simenti prostheses acetabular. Masiku ano, nkhaniyi ikugwiritsidwabe ntchito kwa odwala ena, koma chokhumudwitsa ndi chakuti pakapita nthawi, pali chiopsezo kuti prosthesis idzachoka mu pulasitiki, choncho moyo wa prosthesis udzafupikitsidwa. Komabe, chiwopsezochi chikhoza kuchepetsedwabe chifukwa odwala ena amatha kusunga pulojekitiyi kwa zaka 30 ndipo ena kwa zaka zochepa chabe.

▲Chithunzi: PROCOTYL® L Acetabular Cup (Zowonjezera Zochepa Za Mifupa: Zimagwirizana ndi Delta Ceramic Liners ndi A-Class Highly Cross-Linked Polyethylene Liners)

Dera loyenda pakati pa mutu wa chikazi ndi chikho cha chikazi chimapanga zomwe timazitcha nthawi yotsutsana. Ndilo gawo lofooka kwambiri la prosthesis, makamaka ponena za kuvala ndi kung'ambika. Pali magulu anayi otheka:

- Ceramic-polyethylene

- Ceramic-ceramic

-Metal-polyethylene

-Chitsulo-chitsulo

Gulu lirilonse la kumenyana lili ndi ubwino ndi zovuta zake, ndipo dokotala wa opaleshoni wa mafupa adzasankha kusakaniza koyenera koyenera kutengera zifukwa zingapo, kuphatikizapo msinkhu wa wodwalayo, zochitika zolimbitsa thupi, ndi fupa lapadera.

Ndikofunika kuzindikira kuti ma prostheses achitsulo nthawi zambiri savomerezedwa. Makampani ena omwe amapanga ma implants otere adaganiza zosiya kuwagulitsa mu 2010-2011, ndipo kuti apindule ndi odwala, adaganiza zokumbukira ma implants omwe sanagwiritsidwe ntchito. Vutoli limachokera ku kukangana kwa zinthu zosiyanasiyana za implant, ndipo kukangana kumeneku kumatha kutulutsa tinthu ting'onoting'ono tachitsulo tomwe timalowa m'magazi. Mu mgwirizano wa m'chiuno, tinthu tating'onoting'ono timeneti timayambitsa kusagwirizana, zomwe zimayambitsa kupweteka kwapadera ndi zotupa.

03 . Kodi njira zazikulu zopangira ma prostheses m'chiuno ndi ziti?

Ma prostheses amatha kukhazikitsidwa ku femur kapena acetabulum pogwiritsa ntchito simenti ya opaleshoni kapena kubwezeretsanso mafupa achiwiri (njira zosagwiritsidwa ntchito kapena kuponderezana). Kawirikawiri, tsinde lachikazi lolimba limagwirizanitsidwa ndi kapu yachikazi yosasunthika. Makhalidwe a njira iyi akufotokozedwa pansipa:

Njira yopangira simenti ya mafupa imagwiritsidwa ntchito

fupa simenti ntchito ndi acrylic polima . Imaumitsa mkati mwa mphindi 15 panthawi ya ndondomekoyi ndikuyika mwamsanga mutatha kukonza.

Njira zosakanizidwa kapena zosakanizidwa zimagwiritsidwa ntchito

Ma prostheses osakhazikika (ndodo zopangira kapena makapu) amakhazikika pakadutsa masabata asanu ndi limodzi mpaka khumi ndi awiri chifukwa cha zochitika za kusinthika kwa mafupa. Pofuna kulimbikitsa kusinthika kwa fupa, pamwamba pa prosthesis nthawi zambiri amakutidwa ndi hydroxyapatite, yomwe ili ndi mchere wa fupa. Pafupi fupa amazindikira hydroxyapatite monga mmodzi wa zigawo zake ndiyeno mofulumira limakula kuchokera fupa wosanjikiza wa prosthesis. Hydroxyapatite ikhoza kupangidwa ndi mankhwala.

04. Kodi prosthesis ya m'chiuno imakhala nthawi yayitali bwanji?

Moyo wautumiki wa prostheses wakula m'zaka zaposachedwa: mwa odwala osakwana zaka 50, chiwerengero cha odwala omwe ma prostheses awo akugwirabe ntchito patatha zaka khumi akugwiritsa ntchito pafupifupi 99%.

Ziwerengero zofanana zikhoza kuwonedwa mwa okalamba choncho odwala omwe amangokhala. Choncho, opaleshoni ya m'chiuno ikhoza kuchitidwa kwa odwala azaka zonse.

Moyo wautumiki wa prosthesis umadalira makamaka pazifukwa izi:

-m`badwo wa wodwalayo, thupi misa index ndi ntchito mlingo

-Kuzama kwa mutu wopindika

-mtundu wa mphindi yakukangana

Pamapeto pake, ndikofunikira kuzindikira kuti kutalika kwa prosthesis kumadalira kwambiri pakupanga kwa prosthesis. Pamene mutu wa chikazi ndi chikho cha prosthetic zimapangidwa ndi chitsulo kapena ceramic, ubwino waukulu ndi wochepa kwambiri wa kuvala ndi kuthekera kogwiritsa ntchito mutu waukulu wa chikazi, kuchepetsa chiopsezo cha kusokonezeka. Ndikofunika kuzindikira kuti pali chiopsezo cha kubalalitsidwa kwa zinyalala mu minofu yozungulira prosthesis pamene ma prostheses a zitsulo-to-zitsulo ndi ceramic-to-ceramic aphatikizidwa. Ngakhale ma prostheses a ceramic-ceramic amathyoka pang'ono poyerekezera ndi zitsulo zopangira zitsulo ndipo amalimbana ndi kukokoloka kosunthika kuposa mapeyala azitsulo, ayenera kugwiritsidwa ntchito mosamala.

05. Kodi ndi zoopsa zotani zomwe zimagwirizanitsidwa ndi ma prostheses a chiuno?

Kuphatikiza pa zoopsa zomwe zimachitika pakuchita opaleshoni iliyonse (zowopsa za anesthesia, matenda obwera kuchipatala), zovuta zimatha kuchitika:

Chiwopsezo cha kusuntha

ichi ndi vuto lalikulu kwa odwala ndipo chiopsezo chimasiyanasiyana pakapita nthawi. Ndipamwamba kwambiri m'miyezi yoyamba pambuyo pa opaleshoni ndipo imachepa pambuyo pa chaka choyamba. Kenako imawonjezeka pang'onopang'ono pakapita nthawi. Pali zifukwa zingapo zomwe zingayambitse kusokonezeka, zomwe zingakhale zokhudzana ndi wodwalayo, opaleshoni ndi implants, kapena kutsata pambuyo. Kuopsa kwa kubwereza kumawonjezeka kwambiri pambuyo pa gawo loyamba la kusokonezeka.

Kuopsa kwa matenda

opaleshoni iliyonse imakhala ndi chiopsezo chotenga matenda, ndipo pamene prosthesis imayikidwa, chiopsezochi chimawonjezeka pamene thupi lachilendo limalowa m'thupi. Mwanjira imeneyi, chitetezo cha mthupi chimapatutsidwa ndipo malo omwe amakhalapo a immunodeficiency amapangidwa. Mabakiteriya omwe nthawi zambiri alibe mwayi wokhala ndi moyo amatha kumera pathupi lachilendoli. Chiwopsezo chotenga matendachi chikhoza kukhala chotheka kwa okalamba chifukwa ali ndi chitetezo chochepa cha chitetezo cha mthupi. Zinthu zina, monga kunenepa kwambiri, zomwe zimasokoneza njira zothandizira, kapena matenda a shuga, omwe amachepetsa chitetezo cha mthupi, ndi kusuta, akhoza kuonjezera chiopsezo cha matenda.

Kuopsa kwa thupi lawo siligwirizana

zinthu zina zomwe zimagwiritsidwa ntchito popanga zida zimatha kuyambitsa kuyabwa.

Kuopsa kwa opaleshoni yokonzanso

Kulephera, kuwonongeka ndi kung'ambika, kapena kuphulika kwa prosthesis kungafunike opaleshoni yokonzanso.