I-arthrocentesis ingasiza ekuxilongeni i-arthritis evuthayo futhi engekho ukuvuvukala
I-arthrocentesis, ebizwa nangokuthi i-aspiration joint, yinkqubo lapho uketshezi olukhipha khona kuhlanganiswe usebenzisa inaliti nesirinji. I-fluid ithunyelwa ebhokisithri ukuze kuhlaziywe okuhlangenwe nakho okunesisindo .
Izinkomba
I-arthrocentesis isetshenziselwa ngokuyinhloko ukusungula imbangela ye- effusion ehlangene . Ukukhipha uketshezi ohlangene kunezinhloso ezimbili, ukwelashwa kanye nenjongo yokuxilonga.
Ukukhishwa kwamanzi ahlangene nakho kunganciphisa ubuhlungu nokucindezela ekuhlanganyeleni. Njengenzuzo ehlangothini yenqubo, ngemuva kokukhishwa kwamakhemikhali ehlangene, i- corticosteroid ingafakwa inhlanganisela besebenzisa isayithi efanayo yomjovo esetshenziselwa ukwenza i-arthrocentesis. Isebenza kahle futhi "ibulala izinyoni ezimbili ngetshe elilodwa."
Ukuhlola
Esikhatsini selabhorethri, uketshezi oluhlangene kuhlungwa ngalokhu:
- Ukubukeka: I-fluid iyabonwa ngeso lomuntu ngombala nokucaca. I-fluid ejwayelekile evamile iyisivunguvungu (inamathele) futhi ibonakala icace ngokukhanya okuphuzi. Ukushisa okuketshezi okungajwayelekile akuvamile futhi kusikisela ukuvuvukala noma ukutheleleka. Uketshezi oluhlangene lwamanzi nakho okungavamile futhi kungabangelwa ukuhlukumezeka kokujoyina.
- Ukuhlolwa kwe-Microscopic: I-fluid ehlangene ihlolwe ngaphansi kwe-microscope ukuba khona kwamangqamuzana egazi, amakristalu, nama-bacterium. Uketshezi olujwayelekile oluhlangene alunayo noma ambalwa amangqamuzana egazi. Izinombolo ezinkulu zamangqamuzana egazi obomvu zibonisa ukuphuma kwegazi kuhlangene. Izinombolo ezinkulu zamangqamuzana egazi ezimhlophe zingenzeka ngokutheleleka, i- arthritis yokuvuvukala , i-gout, noma i-pseudogout. Uma amangqamuzana egazi abomvu noma amangqamuzana amhlophe egazini egcinwa, inani le-cell lingenziwa. Ama-crystals ajwayelekile kuvumelwaneni ohlangene. Ama-crystals e-uric acid abonisa i-gout; Amakristalu e-CPPD akhona nge-pseudogout. Ama-bacteria ayenamanzi ahlangene abuye ajwayelekile futhi akhombise ukutheleleka.
- Ukuhlaziywa kwamakhemikhali: I-fluid ehlangene ihlolwe i-glucose, amaprotheni, ne-lactic dehydrogenase (LDH). Imiphumela engavamile yoketshezi emzimbeni engase ikhombise ukuvuvukala noma ukutheleleka yilezi: I-glucose - engaphansi kuka-40 mg / dl; Amaprotheni - angaphezu kuka-3 g / dl; I-LDH - ngaphezu kuka-333 IU / L.
- Okunye kuhlaziya: I-fluid ehlangene iyabonakala emgodini wokuhlola ngemuva kwehora elilodwa ukubunjwa kwe-fibrin clot (i-fibrin yiprotheni eyakhiwe ngesikhathi segazi elijwayelekile). Noma iyiphi i-clot ibonisa ukuthi kunenkinga nge-membrane yesi-synovial (uhlaka lwesisindo oluqondisa ukujoyina). Olunye uvivinyo olubizwa ngokuthi i-mucin clot test (i-acetic acid eyongezwa ku- synovial fluid ) lilinganisa ukukhiqizwa kwe-hyaluronate (ingxenye ye- cartilage ).
Izimo
I-Arthrocentesis iveza imbangela yokuxuba okuhlangene nokuvuvukala futhi isekelwe emiphumeleni yokuhlaziywa kwamanzi ahlangene, lezi zimiso ezilandelayo zingase zikhonjulwe:
- i-arthritis ye-septic , ikakhulukazi engekho-gonococcal bacterial arthritis
- ezinye izifo ezithathelwanayo zamathambo ezifana nokutheleleka kwe-gonococcal, isifo sofuba, ukutheleleka kwefungal, isifo se-Lyme
- i-crystal arthropathies, i-gout, ne-pseudogout
- ukuphazamiseka kwe-rheumatic
- i-osteoarthritis
- ukuhlukunyezwa
- i-hemarthrosis (ukuphuma egazini elihlangene)
I-osteoarthritis
Kuhlaziywa okumanzi okuhlangene, ukubalwa kwamaseli nokwahlukana kokuhlukanisa ukuhlukanisa phakathi kokusebenza okungenalo ukuvuvukala nokuvuvukala. Izenzo ezingekho ukuvuvukala ziphakamisa i-osteoarthritis noma ukuhlukumezeka kokujoyina. Amagciwane okuvuvukala angase abe ne-septic arthritis noma i-arthritis eyenziwa yi-crystal.
Ukubalwa kwamaseli ehlangene okulinganayo nokubala okuhlukanisa okubonisa ukuthi i-osteoarthritis ibonakala kanje:
- Ukubukeka: Sula uketshezi, i-viscosity ephezulu, ne-mucin enhle
- Amakristali: Amakhadi ase-Basic calcium phosphate (BCP), ama-apatite amakristali
- I-White Blood Cell Count (WBC): Amanzi angenalo ukuvuvukala: 200-2000 WBC / mm3; I-WBC count ngokuvamile ingaphansi kwamangqamuzana angu-500 (ikakhulukazi i-mononuclear, uhlobo oluthile lweseli elimhlophe legazi)
Njengoba idolo elihlangene liyi-synovial cavity enkulu (isikhala esihlangene) emzimbeni, kuyindawo engenzeka kakhulu ye-effusion ehlangene kanye nesayithi elivamile le-arthrocentesis.
Kusukela kumfutho ohlangene odonswe futhi wahlaziywa, ulwazi olubalulekile lokuxilonga lungabuthwa.
Imithombo:
I-Arthrocentesis ye-Knee. Thomsen TW et al. I-New England Journal of Medicine. Ngo-Meyi 11, 2006.
Synovial Fluid Analysis. p.140-143. I-Primer kuma-Rheumatic Diseases. Edition 12. Arthritis Foundation.