I-arthroscopy yindlela yokuhlinza encane engavamile evumela ukubuka umcibisholo wamadolo. Ngaphandle kwemisebenzi yokuxilonga, ezinye izindlela zokwelashwa zingenziwa ngenkathi i-arthroscopy.
Ukuthuthukiswa kwendlela
Inqubo ye-arthroscopy yaqala ukuchazwa ngo-1918 eJapane. Eminyakeni eyalandela, le ndlela yayisetshenziswa kuphela ngabachwepheshe ngabanye, futhi ngo-1957 kwaziswa odokotela bamazinyo emhlabeni wonke. Ukuthuthukiswa kobuchwepheshe bezokwelapha kuye kwaholela ekusetshenzisweni okubanzi kwezinqubo ze-arthroscopic zokuhlola amadolo, ama-ankle, ama-hip, amahlombe nesandla samakhanda.
Izinzuzo ze-arthroscopy
Inzuzo ebalulekile yokuhlinzwa kwe-arthroscopic yukuthi emva kwalo cishe akukho okushiya kwesokunxele. Lokhu kukuvumela ukuba unciphise kakhulu isikhathi sokutakula. Ngaphezu kwalokho, asikho isidingo sokuguliswa esibhedlela ngemuva kwesimiso, ngakho-ke lokhu kungenelela kungenziwa esibhedlela sosuku. Cishe iziguli ezingu-90% ezinezifo zamadolo zingatholakala ngesisekelo se-anamnesis nokuhlolwa komtholampilo.
I-imaging resonance ye-magnetic
Kwezinye izimo, iziguli ezine-arthroscopy zingabelwa iziguli ezitholakala emaginini ama-resonance imaging (MRI) noma i-arthroscopy yokuxilonga. Izinzuzo ze-MRI akuzona ukuphazamiseka nokubuhlungu. Kodwa-ke, le ndlela ayivumeli ukuqhutshwa okwenziwa ngesikhathi esisodwa kokwelapha kwezokwelapha.
I-Arthroscopy
Phakathi ne-arthroscopy, ukuhlolwa kwemigudu kanye ne-cartilage yamadolo ehlangene kwenziwa. Futhi, isimo se-meniscus yangaphandle nesingaphakathi kulinganiselwa - amaphakheji amancane aphakathi kwe-femal kanye ne-tibia.
I-arthroscopy ingahlanganiswa nokuqaliswa kwenani lezinqubo:
- ukwelashwa kwe-meniscus rupture (ama-discontinuities amancane avame ukuqedwa ngosizo lwezinsimbi ezikhethekile ezifakwe emgodleni ohlangene);
- Kungenzeka futhi ukuqeda izinyembezi ezinkulu zamadoda (ngokushesha ngemva kokulimala);
- ukwelashwa komonakalo we-articular cartilage ngokushelela izindawo ezingafani ngokusiza amadivaysi akhethekile.
U-Miss Johnson, udansa womqeqeshi oneminyaka engu-25 ubudala, wamlimaza edolweni ngesikhathi sokusebenza.
Ubuhlungu obukhulu emadolweni
Uma ubuhlungu emadolweni buba nzima, owesifazane angacela usizo lwezokwelapha. Udokotela uzolalela izikhalazo zesiguli bese ehlola idolo elihlangene. Ngemuva kokuhlolwa kokuqala, kuzothunyelwa kudokotela ohlinzayo wamazinyo emtholampilo oseduzane ukubonisana nokuhlolwa okungeziwe.
Ukuhlolwa kochwepheshe
Udokotela wezinambuzane uhlolisise idolo elimele, ebona ukulinganiselwa komthamo wokunyakaza - isiguli asikwazanga ukugoba ngokugcwele futhi siqondise umlenze wakhe. Ngaphezu kwalokho, wakhononda ngokungahlali kahle komlenze (umlenze emadolweni njengokungathi "uboshwe"). Indawo yokujoyina yayivuvukile futhi ibuhlungu ku-palpation. Lokhu kuboniswe ukulimala okungenzeka kumadoda - enye yezinkampani ezimbili ezincane ezinama-cartilaginous ezitholakala emgodini ohlangothini lwamadolo. Udokotela ubhekene nokuhlukana kwe-meniscus yangaphakathi (okungaphakathi), mhlawumbe kuhlangene nokuhlukunyezwa kwangaphakathi kwe-ligament. I-meniscus yangaphakathi ivame ukulimazwa ngokuphenduka okubukhali kwe-shank, lapho umlenze ugobile emadolweni.
Isiqondiso se-arthroscopy
I-arthroscopy yemininingwane yedolo ehlangene ibhalwe ngumuthi wamazinyo. Ukuze kucaciswe ukuxilongwa futhi uqale ukwelashwa kwe-articular cartilage eyonakalisiwe, udokotela wamazinyo wabikeza i-arthroscopy. Isiguli sasivunyelwa esibhedlela sosuku sokuhlinzwa ngaphansi kwe-anesthesia jikelele. Umgomo wokungenelela kokuhlinzekwa kwaba ukubuyiswa okuphelele komsebenzi wamadolo. Ngemuva kokuthi i-anesthesia iqale ukusebenza futhi izidumbu ezizungezile ngamadolo zazikhululekile ngokuphelele, udokotela waphinde wahlola isilonda esilimele. Ukuhlolwa okuphindaphindiwe ngaphansi kwe-anesthesia jikelele kuvame ukuveza izinga elikhulu lokuncipha kwemigqa. I-tourniquet ye-hemostatic ye-pneumatic isetshenziswa emlenzeni oqhutshwayo, okuqinisekisa ukuthi ukugoqa izitsha ngenxa yokucindezela.
Ngaphansi kwemingcele yesikhathi, le nqubo iphephile. Kulula kakhulu inqubo yokungenelela kokuhlinzwa. Ukunciphisa ukugeleza kwegazi kunikeza ukubonakala okucacile komgudu ohlangene. Ukuze uphathe insimu yokusebenza, indawo eguqa ngamadolo ihlungwa ngokucophelela nge-antiseptic (ikhambi le-iodine). Umkhakha wokungenelela okuhlinzekwa okuhlinzekwa ngugqoke ama-napkins oyinyumba. Udokotela ufaka i-arthroscope emgodini ohlangene, oxhumeke ekhamera yevidiyo. Ububanzi be-tube optical ngu-4.5 mm. Insimbi ifakwa kusuka ngaphandle kwehlangothini lamadolo, ngezansi kwe-kneecap. Ukusebenzisa ikhamera yevidiyo eyakhelwe ngaphakathi, isithombe sezakhiwo zangaphakathi ezihlangene sidluliselwa ku-arthroscope kuya kusikrini sokuqapha. Ngakho-ke, udokotela ohlinzayo angakwazi ukuhlola isigxobo somlomo futhi abonise ukuthi i-pathology ye-cartilage, i-ligaments kanye ne-menisci. Isithombe esiwumphumela singasindiswa ukusetshenziswa kamuva.
Isithombe se-arthroscopic yesigxobo esihlangene savumela ukuxilongwa okunembile. Esikrinini, ukuhlukana ngemuva kwe-meniscus yangaphakathi kubonakala ngokucacile. Ngakho-ke, phakathi ne-arthroscopy isifo sokutholwa kwengqondo esandulele saqinisekiswa. Ehlangothini elingaphakathi lohlangene, ukuhlunga okuncane okwesibini (cishe ngo-5 mm) kwenziwa ukufaka amathuluzi akhethekile emgodleni wayo. Ingxenyana ewonakele ye-cartilage isuswe ngosizo lwamathuluzi akhethekile okuvumela kancane kancane, ungqimba ngendlala, "ukuphuca" izingxenye ezincane kunawo wonke. Emva kokukhipha ingxenye eyonakele ye-meniscus, umgudu ohlangene uhlanjululwe ngokuphelele ngesisombululo sokunisela. Ngaphambi kokuvala isilonda, kudingeka uqiniseke ukuthi ayikho izinhlayiya ze-cartilage ewonakele ngaphakathi. Ngenye yalezi zimboni ezimbili zibhekwa nge-stitch eyodwa futhi zivalwe nge-plaster yezokwelapha.
Ngemuva kokuhlinzwa kwe-arthroscopic, ukukhwabanisa cishe cishe akukhona. Lokhu kungenye yezinzuzo eziyinhloko zale ndlela. Izindawo zokucubungula ziqoshiwe ngesisombululo se-anesthetic yangakini, esajojelwa kuhlangene. Lokhu kukuvumela ukuba unciphise ubuhlungu ngemva kokuphela kwe-anesthesia. Ngaphambi kokukhipha i-tourniquet ye-pneumatic, i-bandage ehlanganisiwe isetshenziswa emadolweni, ibeke ukucindezela komnene endaweni eqhutshwayo. Ngemuva kokuphela kokungenelela kokuhlinzwa isiguli sathunyelwa esigcemeni sokuthola i-postoperative. Ukusebenza akuzange kudlule isikhathi eside. Wazizwa engathandeki emadolweni, kepha akazange azizwe kabi.
• Ukuhlolwa kwangemva kokusebenza
Ngemva kwesikhashana isiguli sasihlolwa ngudokotela wamazinyo owabika ukuthi ngesikhathi sokungenelela kokusebenzisana ukuqinisekiswa kokuqala kokuhlukumeza kwe-meniscus kwaqinisekiswa. Ngaphambi kokukhipha, i-bandage e-postoperative ehlanganiswa yasuswa, futhi ukuhlanganiswa kwakunesibambo se-tubular esingaxhunyiwe (ukusondeza "ukubeka impahla").
• Umsebenzi womzimba
Ukuntuleka komzimba kungaholela ekutheni i-musrox atrophy isheshe, ngakho isiguli sidinga ukwenza njalo uchungechunge lwezivivinyo ukuze silondoloze ithoni ye-muscle.
• Isibikezelo esikude
Isiguli sasixwayiswe ukuba sigweme ukuzama ukuqinisa ngokomzimba okungenani amasonto amane ngemuva kokusebenza. Njengoba imisipha ye-hip iqiniswa ukuzivocavoca, imikhawulo emisebenzini yomzimba ingasuswa ngokuphelele. Ukususwa kwengxenye encane ye-meniscus akuvamile ukuholela ezinkingeni esikhathini esizayo. Iziguli eziningi zilulame ngokuphelele kungakapheli amasonto ayisithupha emva kokuhlinzwa.