Joint hip: esikhundleni hip, futhi yokutakula okwengeziwe

Amalunga ukuthi ubuhlungu kanye nokuntuleka ukuhamba kukhona isithiyo wokugcwalisa imisebenzi yansuku zonke, zikwenza ukuba uphile impilo ejwayelekile. Ikakhulukazi kanzima lapho ehlaselwa joint hip. arthroplasty kusiza ukubuyisela umsebenzi elahlekile kwamalungu omzimba, njengoba kunjalo ngokuvamile indlela kuphela ukuze isiguli. Izinkomba kulo msebenzi abantu abangaphezu kuka-300 eziyinkulungwane ngonyaka.

Uphawu lokuqala kanye eyinhloko isifo ngokuhlanganyela ubuhlungu. Ekuqaleni, ubuhlungu abe ukushuba ongaphakeme, kodwa esikhathini esizayo, ne ukuqhubeka kwesifo, ubuhlungu iyanda, waba nabangane njalo yomuntu.

Okulandelayo kuba ithuba nezinkinga esitho ethintekile. Lesi sifo enokuthambekela inchubekelembili, okuholela ngezinye izikhathi ukuqedela immobilization. Iziguli ezinjalo ukwelashwa ngoludala akakwazi ukusiza ukutakula hip abathintekayo.

arthroplasty Hip okwamanje eyodwa yezindlela zesimanje iningi ukunakekelwa kuhlinzwa in iziguli izilonda amalunga omzimba. Phakathi ukusebenza ezifana nezicubu onesifo esisesigabeni kwakwakhe hip washintsha ukuze amazinyo okufakelwa yokufakelwa.

I owakheke ngayo nosebenza ngayo emalungeni hip

Joint hip ingenye ithambo elikhulu emalungeni emzimbeni womuntu. Ukuhlolwa ukulayisha kubo eliphezulu kakhulu enqubeni wokuphila kwabantu, njengoba ukhonza ukuxhuma nasemilenzeni aphansi kanye ukhalo.

Ukwakheka hip:

• ikhanda femoral - ekupheleni engenhla kunawo wonke ukuba simise eyindilinga;
• acetabulum - ikhefu uphondo angamasongo ukhalo, okuyinto iduduzekile ikhanda femoral;
• uqwanga ngokuhlanganyela - ijwabu ukuthi unesikhathi igrisi jelly-like ukuthi kusiza ukuhamba izingxenye articular ngokuhlanganyela;
• lwamalunga (naphakathi) uketshezi - isisindo olukhethekile ukungaguquguquki gelatinous, okuyinto uyasondla uqwanga futhi kusiza ukunciphisa friction of evele articular;
• egobolondweni lelunga nemisipha - ezicutshini ukuthi ukhonza njengelungu nokugcinwa evele articular futhi ukuqinisekisa ukuzinza ngokuhlanganyela.

Imisipha nge imisipha unamathisele endaweni hip, Kufinyeta yayo ukuvumela ukuhamba kuwo. Embusweni okunempilo joint hip kuyinto mobile kakhulu, ukukwazi ukuhambisa nganoma iyiphi indiza futhi beqondiswa nguye. Alwa ngayo imisebenzi software ukuhamba nokusekelwa.

Kungani sidinga Ukushintshwa kwamajoyinti omzimba?

Udokotela ogulayo phambi umbuzo esikhundleni hip yayo sokwenziwa idinga izizathu ezinhle. Umsebenzi ezimisiwe, uma isifo ifinyelela kwalapho ifinyelele kangangokuthi umuntu njalo usuke ezwa ubuhlungu kakhulu, noma esitho ethintekile akakwazi ukwenza ngisho ukunyakaza eziyisisekelo kakhulu. Kulezi zimo, lapho ehlaselwa joint hip, hop esikhundleni bangaba indlela yokuphuma.

Ezinye zezifo ebangela izifo uyayibonisa yini ngokuhlanganyela ezidinga ukuhlinzwa yilezi:

• osteoarthritis deformans esethola uma 2 no-3, ngobucayi isifo;
• osteoarthritis deformans 3 degrees ngesikhathi ukusonteka of omunye emalungeni;
• hip ankylosis ngokuhlanganyela okwenzeka rheumatoid arthritis, futhi ngenxa ankylosing spondylitis;
• necrosis aseptic ikhanda femoral ngenxa yokulimala neziyaluyalu kwegazi;
• ukulimala ekhanda kanye entanyeni kunawo wonke ngesimo ukwa kwasebekhulile;
• ukuvuvukala endaweni iqakala abadinga imishanguzo kuhlinzwa.

esikhundleni Hip kuyafaneleka kuphela uma yokulahlekelwa ngokuphelele kungenzeka lokuzivivinya nokuhamba. Isinqumo sokugcina esithathwayo ekusebenzeni, ikhumbula zonke izinto.

Izimo ukuhlinzwa

Kukhona amacala lapho ngisho abantu banesidingo acute ukuze uthole elizongena esikhundleni hip, abakwazi ukuya ukuhlinzwa ngenxa Izimo.

Imingcele ezivamile zihlanganisa:

• izimo lapho isiguli ngeke ikwazi ukunyakaza ezimele, ngisho esimweni enza ukusebenza;
• isifo esingelapheki e dekompensatsionnoy isinyathelo (senhliziyo, isifo cerebrovascular, ukwehluleka hepatic) izinkinga lapho i operation babhebhethekisa uyakwazi ekhona;
• nesifo samaphaphu okubangela nokuvaleka kwemigudu yokuphefumula nokushaya komoya (emphysema, isifuba somoya);
• Abahlukahlukene ithambo ukuvuvukala, isikhumba noma izicubu zomzimba ezithambile endaweni joint hip;
• kwamathambo, okuholela amandla enganele esihlasela amathambo futhi ingozi ikhefu nasezinkingeni ezilandela ngemva kokuhlinzwa ithambo phakathi ukuhamba evamile;
• pathologies lapho kungekho canal kunawo wonke medullary.

Ukwahlukaniswa izimila

Esikhathini sokwenziwa ukuze esikhundleni ethintekile hip ngokuhlanganyela, kufanele kube amandla anele, kumele ngokuphephile fixed kanye unayo i inertia ezicutshini isiguli. izimila yamanje, eyenziwe polymers, izinto ezenziwe ngobumba nensimbi Alloys ukuhlangabezana nazo zonke izidingo ezidingekayo. Ngaphandle, le sokwenziwa kufana womuntu hip ngokuhlanganyela.

imininingwane yayo:

• Cup endoprosthesis. Le ngxenye ubuyisela acetabulum we ngokuhlanganyela okhalo. Material for umkhiqizo sobumba. Nokho, kukhona izindebe eyenziwe polymers.
• Inhloko sokwenziwa. Metal ingxenye ifomu eyindilinga nge enamathela polymeric. Lokhu kuqinisekisa ngokuhambisa umsungulo, lapho ikhanda liphenduka ku endoprosthesis inkomishi ngesikhathi esitho ukunyakaza ahlukahlukene.
• Umlenze sokwenziwa. Ukubona umthwalo omkhulu kunayo yonke, ngakho ngaso sonke isikhathi wenza metal. Kuyinto esikhundleni isiphundu sabo yesithathu engenhla kunawo wonke.

Futhi izimila zihlukaniswe owodwa Induku kabili ngenduku. I single-pole nesineke lokufakelwa kwezitho ukugcina Acetabular yabo proteziruya inhloko femoral nentamo. Lena inguqulo ephelelwe yisikhathi sokwenziwa okuyinto kabanzi ngaphambi. Ukusebenzisa libhekene ukuvama kwazo eliphezulu ukwaphuka we acetabulum, futhi wayeka ukusetshenziswa kwabo umkhuba yesimanje wamathambo.

endoprosthesis Bipolar kukhona igama Imininingwane. Bakha Imininingwane hip arthroplasty. Lapha kukhona bonke ezintathu yezingxenye ngenhla we sokwenziwa.

hip esigcwele endoprosthesis kunqunywa izinga izinto abaye bakhonza ukubenza. Eziqine metal izimila eside kuze kube iminyaka engu-20. Nokho, imiphumela eliphezulu inhlanganisela impilo inkonzo motor umsebenzi futhi inhlanganisela sibathelela metal-polymer-Ceramic.

preliminaries

Zonke zeziguli okudingeka emkhakheni wezitho zokwenziwa, izifundo kumele iqhutshwe, ekutholeni isimo joint hip (ultrasound, i-MRI, X-ray) ukuba ngakususi konke Izimo ezingaba khona.

Ayikho indlela ekhethekile yokusebenza ukuqeqeshwa akudingi. In the ukungabikho Izimo kwenzeka ukusebenza isabelo okukhethayo. Ekuseni ukuhlinzwa phuca isikhumba endaweni hip. Idla futhi iphuza zivinjelwe.

inqubo isinyathelo

Isiguli ibekwe etafuleni yokusebenza, lapho kwenziwa izinto zokubulala izinzwa. indlela esingaguquguquki izinzwa obulala izinzwa kanye nesineke. Isikhathi ukusebenza ongafinyelela ezimweni ezinzima amahora 5. Ngakho-ke, ukukhetha okungcono noma izinzwa emgogodleni noma izinzwa egcwele. Indlela yokuqala indlela yokubulala izinzwa kuletha umonakalo kancane, ngakho-ke kungcono lokuqoka asebekhulile.

Lapho beqeda udokotela izinzwa cut uhlela ukufinyelela joint hip. Imi edingekayo - 20 cm Kukhona asike izidumbu zabantu we egobolondweni lelunga basusa inhloko kunawo wonke, okuyinto kuncike resection ..

ithambo ukumodeliswa iza ngesimo endoprosthesis. sokwenziwa nenkanuko edlulele kwenzeka kaningi kakhulu esebenzisa usimende. Ngokulandelayo, ebusweni the acetabulum sokuprakthiza isuswe uqwanga articular, okuyinto bese usetha inkomishi endoprosthesis.

yezinkinga cishe

Hip ukuhlinzwa esikhundleni ubhekwa ukuhlinzwa eziyinkimbinkimbi.

Kungaba singaholela ezinkingeni:

• ukopha;
• amahlule lihambe ngemithambo wemikhawulo aphansi;
• suppuration zezinsimbi zokuhamba kanye amanxeba kuhlinzwa;
• hematoma;
• ukwenqaba endoprosthesis;
• yezinkinga yisimiso senhliziyo nemithambo yegazi.

ukulungiselela operation Qaphela enciphisa ubungozi ukuxakeka.

Imiphumela imisebenzi

Ngokwezibalo, hip esikhundleni kobufakazi isiguli kakhulu ingxenye ezinhle. Iziguli ukuzwa ukwaneliseka ekusebenzeni. Ngo kokuhlinzwa kulezo ayesemncane ngaphandle izifo concomitant we-hip umsebenzi ngokuhlanganyela esimweni ngokugcwele. Umuntu uyakwazi ukuhamba futhi ngisho nasekuhwebeni nokuvivinya umzimba, ngaphandle ngokweqile le sokwenziwa. imisebenzi Zemidlalo kuthiwa contraindicated.

Kunemiphumela abampofu emva kokuhlinzwa hip esikhundleni. Ngokuvamile zenzeka lapho umuntu eguga, uma une comorbidities. Ngo-20% eziguli othola hip esikhundleni, iziguli ukubonisa izibuyekezo esidumazayo imiphumela imisebenzi.

Yokutakula emva kokuhlinzwa

Ukuvuselelwa leziguli kufanele uqale ngokushesha ngemva kokuhlinzwa. Lokhu emva kokuhlinzwa hip esikhundleni, futhi ukuphefumula umzimba. Yiqiniso, kumelwe ukuthi sokwenziwa usebhekene igcinwe kuphela, kodwa kufanele bazame ukuhlangabezana ubuncane imisipha ngemuva hip esikhundleni kwenziwe. Ukuvuselelwa kumele babhekane nomthetho main - udinga andise umthwalo.

Ngosuku lokuqala emva kokuhlinzwa

Iziguli eziningi kudingeka bachithe nabo labagula. Kukhona engcono ukuqapha yokuhlola izimpawu ezisemqoka, ngokushesha ephendula zonke izinguquko ezimbi. Ngemva kwamahora ambalwa ngemuva kokuhlinzwa, umuntu kungase kudingeke ukuchitha isikhathi esimweni ehlezi, bephonsa phansi shin.

I-hip eziqhutshwa asivunyelwe ukugoba okukhulu kuka-90 °. Lokhu kungaphazamisa isimo sawo futhi nenkanuko edlulele in the bone. Thatha isikhundla ehlezi is best elawulwa umtholampilo wezokwelapha noma umndeni abasebenzi. Bazokusiza ukuhambisa esitho ethintekile futhi uyonikeza usizo lokuqala, uma kukhona isiyezi.

Ukuvuka

Ezinsukwini ezimbalwa ukuphuma embhedeni bebodwa ngemva kokuhlinzwa akufanele kube. Ncika umlenze enempilo, ngaphandle kokusebenzisa amadivaysi elisizayo, ke akuvunyelwe amasonto amaningana. amadivaysi obusizayo zingakhiqiza umhlanga noma ngezinduku. Nokho, lapho isimo eyanelisayo isiguli emuva kokuhlinzwa ezifana hip esikhundleni, ukuvuselelwa ivumela usebenzisa usizo uvuke ngosuku olulandelayo, iziguli eziningi okwamanje ukulungele ukwenza kanjalo.

ukuhamba

Vumela isiguli ukuhamba ngosuku lwesithathu emva kokuhlinzwa. Ngesikhathi esifanayo kufanele uhambisane nazo zonke izimfuneko zokuhlala kwathatha imile. Qiniseka ukuthi ukuhambisa eziqhutshwa emkhawulweni izandla noma umlenze ezinhle sveshivaniya embhedeni. Ungathola i ngezinduku umlenze enempilo. Noma yimuphi umzamo wokubuyisa ancike emlenzeni elimele akuvunyelwe ingakapheli inyanga emva kokuhlinzwa, ngakho-ke kufanele kube in limbo. Sebenzisa izinduku bezihambela, kungcono hhayi esingaphansi kwezinyanga ezintathu.

Ngezinye ukugeleza okuphephile kwesikhathi nokuvuselelwa kungaqhubeka umhlanga ukwesekwa. Ncika emlenzeni elimele kungaba inyanga, kodwa hhayi ukuguquguquka lonke ngesisindo sakhe somzimba. Ukuqala umsebenzi emva kokuhlinzwa hip esikhundleni kuyadingeka ukuze ucede imilenze ukuze ohlangothini kubuye emuva zakhe ukukhulisa ukwehlisa imile. Layisha eziqhutshwa umlenze izinyanga ezimbili umthwalo, esingeqile omunye uhhafu esisindo lesiguli. Qala ukuhamba ngaphandle ngokurhaba ngokugcwele ngangokunokwenzeka ngemva kwezinyanga 4-6 wokusebenza. Imithwalo kumele lenyuke kancane kancane.

ukudla

I isici esiyinhloko sokulawula nokuvulwa isiguli umsoco ofanele. Ukudla kufanele kube phezulu e amaprotheni, amaminerali namavithamini. Akubalulekile ukuba banamathele kakhulu ukudla okwakha, ngoba iziguli Ungahambisa ngenkuthalo. amandla engasetshenzisiwe kulokhu kungaholela kwesisindo okuyinto kuzobambezela yokutakula. Akubonisi siwumkhiqizo wokuziphendukela ukubhaka, okuthosiwe nokudla okunamafutha, ukudla ngabhema. inhlanzi kuvunyelwe, inyama ebomvu, imifino kanye nezithelo, okusanhlamvu, amaqanda. Akunakusetshenziswa abakwazi ukuphuza utshwala, yini ikhofi noma itiye.

I ngelashwa

Imithi yokukwelapha emtholampilo ihlala amasonto 2-3. nilimaza Ngakho ukuphulukiswa inqubo iyahlolwa. Ngokuvamile, sutures ziyasuswa ngemuva kwezinsuku ezingu-12. Ezinye izindaba zika-ukuhlala ngendlela isikhungo sokwelapha isiguli nezihlobo zakhe bafundiswa amakhono elula nokuvuselelwa umlenze eziqhutshwa. 3 izinyanga emva kokuhlinzwa, omunye esimweni we ngokuhlanganyela hip. Kuyasiza hlola impumelelo ukusebenza kanye nenkanuko edlulele ka nolwelwesi.

Uma isiguli akhishwe isikhungo sezokwelapha, liwusizo olukhulu nokuvuselelwa okwengeziwe ungaba ngokuxhumana udokotela-rehabilitator abazokusiza ukuphuma uhlelo ngabanye ukuvuselelwa. Lokhu kuzosiza ukwenza kube lilondeke kakhudlwana, futhi kancane isikhathi eside isikhathi ekululameni. Iziguli eziningi ubuyela ukuphila okumatasa senzeka ngemva kwezinyanga eziyisithupha ukusebenza. kunconywa ukunciphisa umthwalo kokugcina esitho nokuvuselelwa ukuthi kwavele emkhakheni wezitho zokwenziwa. Joint hip, okuyinto Ukushintshwa kwamajoyinti omzimba kwaba yimpumelelo, uyakwazi isikhathi eside ukuba inkosi yaso.

lapho siqhutshwa

Okuhle kunakho konke ukuthi le misebenzi eyenziwa phesheya. Sibé imitholampilo ethandwa kakhulu kuka-Israyeli futhi eJalimane, abangongoti ukuqaliswa yalokhu kungenelela. Nokho, izindleko hip esikhundleni emitholampilo enjalo kakhulu. A ehlukile ezinengqondo, nganoma yisiphi isizathu ukuba eyohlinzwa phesheya akunakwenzeka, engena esikhundleni hip eMoscow. odokotela Russian esesikwenzile kule minyaka yamuva eziningi intuthuko emkhakheni Ukushintshwa kwamajoyinti omzimba, ezibangela ngonyaka okungenani izikhathi eziyinkulungwane 20 esikhundleni hip. Intengo lo msebenzi ezweni lethu incane kakhulu ukwedlula emitholampilo angaphandle, futhi ruble 38.000.