I-Arthroscopy yinkqubo yokucubungela encinane engavumelekanga evumela ukubonwa kwesigxina sexolo. Ukongeza kwimisebenzi yokuxilonga, ezinye iindlela zokunyanga zonyango zingenziwa ngexesha le-arthroscopy.
Ukuphuhliswa kwendlela
Inkqubo ye-arthroscopy yaqale ichazwa ngo-1918 eJapan. Kwiminyaka elandelayo, le ndlela yayisetyenziswe kuphela ngabachwephesha ngabanye, kwaye ngo-1957 kwaziswa kwii-orthopedic surgeons kuwo wonke umhlaba. Ukuphuhliswa kobuchwepheshe bezobugcisa kuye kwaholela ekusebenziseni ngokubanzi iindlela ze-arthroscopic zokuhlolisana ngamadolo, i-ankle, i-hip, ihlombe kunye neengalo zesandla.
Iinzuzo ze-arthroscopy
Inzuzo ebalulekileyo ye-arthroscopic surgery kukuba emva kwayo akukho phantse ekhohlo. Oku kukuvumela ukuba unciphise kakhulu ixesha lokubuyisela. Ukongezelela, akukho mfuneko yokubhedlelelwa isigulane emva kokuya kwenkqubo, ngoko ke uncedo lungenziwa kwisibhedlele sosuku. Phantse i-90% yezigulane ezinezifo zedolo zingatholakala kwi-anamnesis kunye noviwo lweklinikhi.
Ukucatshulwa kwemifanekiso yamagnetic
Kwezinye iimeko, izigulane ezine-arthroscopy zingabelwa kwizigulane zengqondo zokumangalisa magnetic (MRI) okanye i-arthroscopy yokuxilonga. Inzuzo ye-MRI ayiyiyo ingeniso kwaye ayibuhlungu. Nangona kunjalo, le ndlela ayivumeli ukuqhutyelwa kwamanye amayeza.
Arthroscopy
Ngexesha le-arthroscopy, ukuhlolwa kwemizila kunye ne-cartilage yexolo elihlangeneyo lenziwa. Kwakhona, imeko ye-meniscus yangaphandle neyangaphakathi iqikelelwa - iincinci ezincinci phakathi kwe-femoral ne-tibia.
I-arthroscopy ingadibaniswa nokuphunyezwa kwenani leenkqubo:
- unyango lwe-meniscus rupture (i-discontinuities encinci idla ngokuphela ngoncedo lwezixhobo ezizodwa ezifakwe kwisigxina esivumeleneyo);
- Kwakhona kunokwenzeka ukuphelisa iinyembezi ezinkulu zamadoda (kungekudala emva kokulimala);
- ukonakalisa umonakalo we-articular cartilage ngokushenxisa indawo ezingafaniyo ngoncedo lwezixhobo ezikhethekileyo.
U-Miss Johnson, umdanisi oneminyaka engama-25 ubudala, walimala emadolweni ngexesha lokusebenza.
Intlungu enzima emadolweni
Xa intlungu emadolweni ingenakubekezeleka, umfazi unokufuna uncedo lwezokwelapha. Ugqirha uya kuphulaphula izikhalazo zesigulane aze ahlole idolo. Emva kokuhlolwa kokuqala, kuya kuthunyelwa kwiphrotheji yamazinyo yeklinikhi ekufutshane ngokubonisana kunye noviwo olongezelelweyo.
Uviwo lweengcali
Ugqirha wama-orthopedic uhlolisise idolo elimazi, ebona ukunciphisa umthamo wokunyakaza-isigulane asikwazi ukuguqa ngokuzeleyo nokulungisa umlenze wakhe. Ukongezelela, wakhankqalaza ngokungazinzi kokubambisana (umlenze emadolweni njengokungathi "uhluthiwe"). Indawo yokudibanisa yayivuvukile kwaye ibuhlungu ekunxineni. Oku kubonakalise umonakalo kumntu we-meniscus - enye yeediski ezimbini ezincinci zengqungquthela ezisemgodini wexolo. Ugqirha ugxeka ukuphulwa komntu (wangaphakathi) we-meniscus, mhlawumbi ngokudibanisa nokuphuka kwangaphambili kwesigidi. I-meniscus yangaphakathi ihlala iwonakaliswe ngokuguquka okubukhali kwe-shank, xa umlenze ugobile emadolweni.
Isikhokelo se-arthroscopy
I-arthroscopy yegama elidityanisiweyo legama elimiselweyo limiselwe ngumzimba wamazinyo. Ukucacisa ukuxilongwa nokuqala unyango lwe-articular cartilage eyonakalisiweyo, ugqirha wamathambo wachaza i-arthroscopy. Isigulane sasivunyelwa kwisibhedlele sosuku sokusebenza phantsi kwe-anesthesia jikelele. Injongo yongenelelo lophulo-mthetho lugqityiwe olupheleleyo lomsebenzi wexolo. Emva kokuba i-anesthesia yaqala ukusebenza kwaye izihlunu ezijikeleze idolo zazixolise ngokupheleleyo, ugqirha waphinda wahlola inyathelo elimele. Uvavanyo oluphindaphindiweyo phantsi kwe-anesthesia jikelele luvame ukutyhila iqondo elincinci lokunciphisa imizila. I-pneumatic hemostatic tourniquet isetyenziswe kwisigxina esisebenzayo, esiqinisekisa ukubetha kweempahla ngenxa yokunyanzeliswa.
Ngokuxhomekeke kwimingcele yexesha, le nkqubo ikhuselekile. Ilula kakhulu inkqubo yokungenelela ngophengululo. Ukunciphisa ukugeleza kwegazi kunika ukubonakala okucacileyo kwendawo yokudibanisa. Ukunyanga intsimi yokusebenza, indawo edibeneyo emadolweni ichithwe ngokucokisekileyo kunye ne-antiseptic (isisombululo se-iodine). Ummandla wongenelelo ngoncedo lukhunjulwe ngamaphulebhu angenayo. Ugqirha ungena kwi-arthroscope kwisigxina esihlangeneyo, esixhunywe kwikhamera yevidiyo. Ubungakanani bhubhe ye-optical ngu-4.5 mm. Isixhobo sifakwa ukusuka ngaphandle kwexolo elihlangeneyo, ngaphantsi kwe-kneecap. Ukusebenzisa ikhamera yevidiyo ekwakhiweyo, umfanekiso wezakhiwo ezidibeneyo zangaphakathi udluliselwa kwi-arthroscope ukuya kwisikrini esisezantsi. Ngaloo ndlela, ugqirha unokwazi ukuhlolisisa isigxina se-articular kwaye sibonakalise ukukhubazeka kwe-cartilage, iigaments kunye ne-menisci. Umfanekiso obangelwayo ungagcinwa ukusetyenziswa kamva.
Umfanekiso we-arthroscopic wesigxina esihlangeneyo savumela ukuxilongwa ngokuchanekileyo. Kwisikrini, ukuphuka komva kwe-meniscus yangaphakathi kubonakala ngokucacileyo. Ngaloo ndlela, ngexesha le-arthroscopy ukuxilongwa kwangaphambili kweklinikhi kwaqinisekiswa. Kwinqanaba elingaphakathi lomxube, isicatshulwa esincinane sesibini (malunga ne-5 mm) senziwa ukufaka izixhobo ezikhethekileyo kwisigxina sawo. Iqhekeza elonakalisiweyo le-cartilage lisuswe ngoncedo lwezixhobo ezikhethekileyo ezivumela ngokuthe ngcembe, ungqimba ngoluhlu, "uhlambe" kwiindawo ezincinci. Emva kokususa inxalenye ewonakalisiweyo ye-meniscus, umgudu odibeneyo uhlanjululwe ngokupheleleyo ngesisombululo sokunkcenkceshela. Ngaphambi kokuba uvale isilonda, kufuneka uqiniseke ukuba akukho ziqulatho ze-cartilage ezilimele ngaphakathi. Ngalunye lwezinto ezimbini ezibonwayo zixutywa ngesigxina esisodwa kwaye zitywinwe kunye ne-plaster.
Emva kokuhlinzwa kwe-arthroscopic, ukukhawulwa kwamatye kungabikho. Le ngenye yeenzuzo eziphambili zale ndlela. Iindawo zokubambisana zihlanjwe ngesisombululo se-anesthetics yasekhaya, esajojowe kwi-joint. Oku kukuvumela ukuba unciphise intlungu emva kokuphela kwe-anesthesia. Ngaphambi kokususa i-tourniquet ye-pneumatic, i-bandage elastic isetyenziswe emadolweni, iqhuba uxinzelelo oluncinane kwindawo eqhutywayo. Emva kokupheliswa kwongenelelo lophulo-mthetho isigulane sagqithiselwa kwiwadi ngenxa yokuphucula emva kokusebenza. Umsebenzi awuzange uhlale ixesha elide. Waziva ehle kakhulu emadolweni, kodwa akazange azive intlungu.
• Uvavanyo lokuvavanya
Emva kwesikhashana isigulane sasihlolisiswa ngugqirha wamazinyo owakubonisa ukuba ngexesha lokungenelela kokusebenza ukuxilongwa kwangaphambili kwe-meniscus rupture kwaqinisekiswa. Ngaphambi kokukhutshwa, i-bandage elastication e-post-operative yasuswa, kwaye idibeneyo yayigxininiswe ne-bandage ebulalayo (i-stock "e-stock").
• Umsebenzi wezobugcisa
Ukungabikho komsebenzi kungabangela ukuba i-atrophy ixakeke ngokukhawuleza, ngoko isigulane sidinga ukuba senze rhoqo uchungechunge lokuzilolonga ukugcina ithoni ye-muscle.
• Isibikezelo esikude
Isigulane saxwayiswa ukuba sigweme ukunyanzelisa umzimba ngokukodwa ngeveki ezine emva kokusebenza. Njengoko izihlunu zomlenze ziqiniswa ngumsebenzi, izithintelo kwimisebenzi yomzimba zingasuswa ngokupheleleyo. Ukususwa kwecandelo elincinci le-meniscus lingaqhelanga ukuba kukho iingxaki kwixesha elizayo. Uninzi lwezigulane luya kupheliswa ngokupheleleyo emva kweeveki ezintandathu emva kokuhlinzwa.