Arthroscopy inobata chirwere chisingaoneki chinoshandiswa chinobvumira kuona mazamu emabvi akabatanidzwa. Mukuwedzera kumabasa ekuongororwa, mamwe maitiro ekurapa angaitwa munguva yeArthroscopy.
Kuvandudza nzira yacho
Nzira yeArthroscopy yakatanga kurondedzerwa muna 1918 muJapan. Mumakore akazotevera, nzira yacho yakashandiswa chete nevanodzidza mumwe munhu, uye muna 1957 yakaiswa kune avo vanoongorora majoka pasi pose. Kubudirira kwehutano hweutano kwakatungamirira kushandiswa kwakakura kwemaitiro arthroscopic ekuongorora mabvi, chiuno, hip, mapepa uye mazamu emaoko.
Kubatsirwa kweArthroscopy
Chinhu chikuru chekuvhiya kweArthroscopic ndechokuti mushure mekunge kusina kupotsa kwakasara. Izvi zvinokubvumira iwe kunyanya kuderedza nguva yekudzorera. Mukuwedzera, hapana chikonzero chekurapwa kwechirwere mushure mekuita, saka kupindira uku kunogona kuitwa muchipatara chezuva. Inenge 90% yevarwere vane zvirwere zvemabvi vanogona kuongororwa pamusana peamnesis uye kliniki yekuongorora.
Magnetic resonance imaging
Mune zvimwe zviitiko, varwere vane arthroscopy vanogona kugoverwa kuvarwere magnetic resonance imaging (MRI) kana kuongororwa arthroscopy. Kubatsirwa kweMRI hakusi kusakunda uye kusuruvara. Zvisinei, iyi nzira haibvumiri kuita panguva imwe chete yezvechiremba manipulations.
Arthroscopy
Munguva yeArthroscopy, kuongororwa kwemiromo uye cartilage yemabvi akabatanidzwa kunoitwa. Uyewo, mamiriro evanhu vekunze nekunze meniscus inofungidzirwa - maduku maduku emakumbo pakati pevakadzi nevakadzi.
Arthroscopy inogona kusanganiswa nekushandiswa kwenzira dzinoverengeka:
- kurapwa kwe meniscus ruptures (duku discontinuities inowanzobviswa nekubatsirwa kwezvinhu zvakasarudzwa zvinowanikwa mubato rakabatanidzwa);
- zvinogona zvakare kubvisa meniscus misodzi yakawanda (nguva pfupi mushure mekukuvara);
- kurapwa kwechirwere chinokonzera martilage kuburikidza nekuchera nzvimbo dzisina kufanana nekubatsirwa kwezvinhu zvakakosha.
Miss Johnson, ane makore 25 anodhakwa mutambi, akakuvara pamabvi panguva yekushanda.
Kutambudzika kwakanyanya mumabvi
Apo kurwadziwa mumabvi kunenge kusingagumiki, mukadzi anogona kutsvaga rubatsiro rwechiremba. Chiremba achateerera kunyunyuta kwomurwere uye oongorora mabvi akabatanidzwa. Mushure mekuongorora kwekutanga, ichaendeswa kune chiremba wemapfupa emakiriniki ari pedyo nekubvunzurudza uye kumwe kuongorora.
Nyanzvi yekuongorora
Chiremba wemapfupa akaongorora gumbo rakakuvadzwa, achicherechedza kukanganisa kwemafambiro - murwere aisagona kukotamisa zvizere uye kugadzirisa gumbo rake. Mukuwedzera, akanyunyuta pamusoro pokusagona kwekubatana (gumbo mumabvi sekunge "rakasungwa"). Nzvimbo yechipindiro yakanga ichibhururuka uye inorwadza pamarpation. Izvi zvakaratidza kuti zvinogona kukanganisa ku meniscus - chimwe chezvinhu zviviri zviduku zvinokonzerwa nekodhilaginous iri mumakumbo emabvi akabatanidzwa. Chiremba anofungidzirwa kupera kwemukati (mukati) meniscus, zvichida pamwe chete ne anterior cruciate ligament rupture. Inonzi meniscus inowanzosvibiswa nekushanduka kwakakosha kwe shank, apo gumbo rakanamatira pamabvi akabatanidzwa.
Nhungamiro yeArthroscopy
Arthroscopy yemabvi inotsanangurwa tsanangudzo inorongedzerwa nemasitori. Kujekesa kuongororwa uye kutanga utano hwehutachiona hwakakanganiswa, chiremba wemapfupa akanyora arthroscopy. Murwere wacho akabvumidzwa kune rimwe zuva chipatara chekuvhiya pasi pehurumende yakawanda anesthesia. Chinangwa chekupindira kwekuvhiya kwaiva kudzorerwa kwakakwana kwebasa rebvi rakabatanidzwa. Mushure mokunge anesthesia yatanga kuita uye masumbu akakomberedzwa nemabvi akazununguka zvachose, chiremba zvakare akaongorora chikamu chakakuvara. Kuongororwa kunowanzoitwa pasi peanesthesia kazhinji kunowanzoonesa huwandu hwekushaya simba kwemigumisiro. Chirwere chepineumatic hemostatic tourniquet chinoshandiswa kune chikamu chinoshandiswa, icho chinoita kuti kuvharidzira kwemidziyo kunokonzererwa.
Zvichienderana nemiganhu yenguva, iyi nzira yakachengeteka. Inonyanya kuita nyore kushandiswa kwekupindira. Kuderedza kudengenyeka kweropa kunopa kujekesa kwakajeka kwebato rekubatana. Kuchengetedza munda unoshanda, mabvi akabatanidzwa anonyatsogadziriswa neine antiseptic (iodine solution). Nharaunda yekupindira kwekuvhiya inoputirwa neshetera napkins. Chiremba anopinda arthroscope mubatanidzwa pamwe chete, akabatana nevhidhiyo kamera. Iyo yakareba ye optical tube iri 4.5 mm. Chimbo chacho chinowanikwa kubva kunze kwemaviro akabatanidzwa, pasi pebhapecap. Kushandisa iyo yakagadzirwa muvhidhiyo kamera, chimiro chemukati majoka masangano anotamirwa kubva kuArthroscope kusvika pakona screen. Nokudaro, chiremba anovhiya anokwanisa kuongorora mhando yepamusoro uye kuratidza hutachiona hwehutakiti, ligaments uye menisci. Mifananidzo inoguma inogona kuponeswa kuti inoshandiswe gare gare.
Mufananidzo weArthroscopic wechipfuti chakabatanidzwa wakabvumira kunyatsoongorora. Pachivako, kuputsika kwemashure kwekati meniscus kwaiva pachena. Nokudaro, munguva ye arthroscopy yekutanga kurapwa kwechipatara kwakasimbiswa. Pachikamu chemukati chekubatana, kechipiri chekudzivirira (anenge 5 mm) inoshandiswa kuisa zvishandiso zvakakosha mumakona ayo. Iyo yakakanganiswa fragment yekateti inobviswa nekubatsirwa kwezvinhu zvakakosha zvishandiso zvinobvumira zvishoma nezvishoma, zvisikwa necheka, kuti "vhudzire" zvikamu zviduku zvayo. Mushure mokubvisa chikamu chakakanganiswa chemazino, menyasi yakabatana yakanyatsogutswa nemvura yekudiridza. Usati wagumisa vanga, iwe unofanirwa kuve nechokwadi kuti hapana mavara echetilage akaora mukati. Chimwe nechimwe chezviitiko zviviri izvi zvinosungirirwa nechisungo chimwechete uye chisimbiswa nechiremba chechiremba.
Mushure mekuvhiyiwa kweArthroscopic, kupora kunenge kusisipo. Ichi ndicho chimwe chezvinhu zvinobatsira zvikuru zveyi nzira. Nzvimbo dzekufungidzirwa dzakasarudzwa nechinangwa chemunharaunda yeanesthetic, iyo inowanirwawo mujoka. Izvi zvinokubvumira kuderedza marwadzo mushure mekuguma kweanesthesia. Asati abvisa pneumatic tourniquet, bhanhire rakasungirirwa rinoshandiswa pamabvi, richiedza kunyorovesa nzvimbo inoshandiswa. Mushure mokubviswa kwekupindira kwekuvhiya murwere akaendeswa kuwadi kunoshandiswa kwepasoperative. Basa racho harina kupera kwenguva refu. Akanzwa akanetseka zvishoma mumabvi, asi haana kunzwa kurwadziwa.
• Kuongorora kwemashure
Mushure menguva yakati murwere akaongororwa nechiremba wemasopa uyo akataura kuti panguva yebasa rekupindira kwekutanga kusarudzwa kwe meniscus rupture kwakasimbiswa. Asati asunungurwa, mushure mekugadzirwa kwemashure kwakasunungurwa, uye chibatanidzwa chakanga chagadziriswa nebhanhire rakaputika (selastic "stocking").
• Chiito chemuviri
Kushaya kwekuita muviri kunogona kutungamirira kukurumidza kukurumidza kushungurudzika, saka murwere anodikanwa kuti aite nguva dzakawanda dzedzidzo yekuchengetedza mutsara.
• Mazano ekure kure
Murwere akanyeverwa kuti arege kunyatsoshanda mumuviri kwevhiki dzinenge mushure mokushanda. Sezvo misungo yehudyu ichisimbiswa nekurovedza muviri, zvipingamupinyi mubasa rekuita zvinogona kunge zvakanyatsobviswa zvachose. Kubviswa kwechikamu chiduku chemadzinisini hachiwanzo kutungamirira kumatambudziko munguva yemberi. Vakawanda vanorwara vanopora zvachose mukati memavhiki matanhatu mushure mekuvhiyiwa.