Indlela Yokuhlola Inkinga Nalokho Ongakwenza Ukuze Uvimbele Ukukhathazeka Ukuphulukisa
Ukuhlinzeka ngokuhlinzwa okunye okunye okunye kuwukuthi kunezinye izifo ezivame ukwelashwa kwamathambo amaningi . Ukuphulukiswa kokuhlanganiswa okuhlinzekwayo ukukhathazeka kwabantu abaningi abenza lokhu kuhlinzwa. Kuyaziwa ukuthi ukutheleleka kokuguqula amadolo kuyinkimbinkimbi enkulu, futhi ukuqubuka okuphilisa kahle ukukhathazeka iziguli eziningi ziyesaba.
Nazi ezinye zezibonakaliso zezinkinga zokuphulukisa, ukuthi zingavikelwa kanjani, nokuthi yini engadinga ukuthi yenziwe ukwelashwa.
Izinkinga zokuphulukiswa kwezinkinga ngemuva kokuguqulwa kwamadolo ziyahlukahluka kuye ngezifundo ezihlukene, kodwa liphakathi kwamaphesenti angu-1 namaphesenti angu-10 kumbiko amaningi. Lokhu kusho ukuthi kukhona ithuba elincane lenkinga yokuphulukisa, kodwa lokhu akuyona into engavamile, futhi okunye okudingeka ukuthi abantu abaqhutshwa ukuguqulwa kwamadolo baqonde futhi baqaphele.
Okukhathazeka ngokuyinhloko ukuthi ithuba lokutheleleka kwegciwane elingathí sina kubantu abangenazo izinkinga zokuphulukisa ukugcoba kungaphansi kwamaphesenti angu-1, kodwa kubantu abanenkinga yokuphulukisa, ithuba lokutheleleka okungathí sina emnyakeni wokuqala wokuhlinzwa emva kuka-10 amaphesenti! Yingakho thina njengabahlinzayo bafuna ukuqinisekisa ukuthi senza konke okusemandleni ukukusiza ukuphulukisa kahle, futhi ngokushesha uphathe noma yisiphi isilonda esingabonakali ukuphulukisa.
Ukuphulukiswa Kwezingxoxo
Ukuphulukisa isikhumba kanye nezicubu ezithambile yizinyathelo ezibalulekile zokuvimbela ukungena kwamabhaktheriya emkhatsini wesikhumba nangaphandle kwemvelo. Kuze kube yilapho lesi sithinte siphulukiswa, kukhona ingozi engaba khona yokungena kwebhaktheriya nokutheleleka kokufaka esikhundleni sokuguqula amadolo-into engaba yingozi.
Ngenxa yalesi sizathu, ukuqinisekisa ukuthi ukuphulukiswa okusheshayo kokubheka kubalulekile ekuphumeleleni kokuhlinzwa kwamadolo esikhundleni.
Kunezinyathelo eziningana zokuphulukiswa ezenzeka ngemuva kokuguqulwa kwamadolo (noma noma yikuphi ukufakwa kokugqoka) kwenziwa:
- Isigaba sokuqala ukuvuvukala ; lesi sigaba esiqala ngokushesha emva kokuvalwa kwesicingo. Kulesi sigaba sokuqala, isilonda sigqabhuka ngegama elibizwa nge- clotting cascade , futhi izimpawu zithunyelwa emzimbeni odonsela amangqamuzana okuphulukisa endaweni yesicingo. Isigaba sokuvuvukala sithatha amasonto ambalwa okuqala ngemva kokuhlinzwa.
- Isigaba sesibili ukukhula ; lesi sigaba siqala cishe ngesonto ngemuva kokuhlinzwa futhi sidlulela isigaba sokuvuvukala sokuphulukisa. Isigaba esiyinkimbinkimbi kubalulekile ekuthuthukiseni ukuhlinzekwa kwezidakamizwa ezidingekayo kanye nokuphulukisa izicubu ezungeze ukufakwa.
- Isigaba sokugcina sokuphulukisa ukuvuthwa ; lesi sigaba siqala ngemuva kwamasonto amathathu futhi singaphelela unyaka. Ngesikhathi sokuvuthwa kwesilonda, izicubu zokuphulukisa ziqina futhi zifana nesikhumba evamile. Ukuphulukisa izicubu ezibomvu buthakathaka kakhulu ezinkathini zokuqala, futhi ekugcineni kufinyelela cishe amaphesenti angama-80 wamandla esikhumba evamile ezinyangeni ezintathu. Isibhamu asikaze siqine njengezicubu zesikhumba evamile.
Izizathu Zeminye Imihlahlandlela Awuphulukisi
Izimo eziningi zezokwelapha zingathinta kakhulu izigaba zokuphulukisa kanye namandla okulwa nokugcina.
Ezinye zalezi zimo zingavinjelwa noma okungenani zinciphise, kanti ezinye zingase zingabi lula ukuzenza. Izimbalwa zezimo ezivamile ezithinta ukuphulukisa ukulimala kanye namandla zihlanganisa:
- Ukungondleki
- Isifo sikashukela
- I-rheumatoid arthritis
- Ukukhuluphala
- Ukubhema
Ngenxa yalezi zizathu, izinhlelo eziningi zokubambisana zizokweluleka abantu abanoma yiluphi uhlobo lokuhlinzwa okuhlanganyelwe ukujoyina lezi zimo ngaphambi kokuhlinzwa. Isibonelo, ukuqinisekisa ukudla okunomsoco, ukulawula ishukela egazini (i- hemoglobin A1C engaphansi kuka 8.0 ), ukulawula izidakamizwa zesifo sofuba , ukulahlekelwa kwesisindo, nokuqeda ugwayi yizo zonke izinyathelo abantu abangazithatha ukuze banciphise ingozi yokulimala kwalimala ngemuva kokuhlinzwa kwesigodlo.
Ngaphezu kwalokho, abanye odokotela abangathakathaka bangase batusa ngokungahambisani nokuguqulwa kwamadolo ikakhulukazi kubantu abathinteka kakhulu. Nakuba wonke umuntu efuna ukukholelwa ukuthi ukuhlinzwa kwakhe kuzohamba kahle futhi ngaphandle kokuzibandakanya, kukhona abantu abangase babe ngcono futhi baphelelwe ngokuphepha ngemithi engahambi kahle, ikakhulukazi uma besengozini enkulu yokucindezeleka ngemuva kokuhlinzwa kwesigodlo.
Esinye isici esingabangela izinkinga ngokuphulukiswa kwesilonda kunemibandela yokuhlinzwa ngaphambi kokuhlangana kwegolo. Lokhu ikakhulukazi inkinga uma ukuhlaselwa kwangaphambili kutholakala kangangokuthi akukwazi ukusetshenziselwa kabusha futhi ukucubungula okusha kudinga ukufakwa phezu kwedolo elihlangene. Ukuqubuka komunye nomunye kubangele ukuphazanyiswa kwezinto eziqhelekileko zokuhlinzeka ngamathambo esikhunjeni, begodu ukucabangela okuningi kungashiya indawo yesikhumba ngaphandle kokwanele kwegazi. Uma lokho kwenzeka, khona-ke i- necrosis yezicubu (indawo yezicubu zesikhumba efile) ingenzeka, ishiya indawo engadinga isikhumba sesikhumba noma esithambile.
Indlela Yokuveza Inkinga
Izibonakaliso okufanele zibheke lapho uhlola ukugxeka okusolakala ukuthi unenkinga yokuphulukisa zihlanganisa:
- Ukugeleza okuqhubekayo noma okuqhubekayo kusuka ekufakweni
- Amaphakheji noma izimbobo ku-incision
- Amathisisi amnyama noma ama-dusky azungeze ukuqubuka
- Ama-sutures aphukile noma izikhumba zesikhumba eziye zavela endaweni yesikhumba
Izimpawu ezivame kakhulu zenkinga yokuphulukisa isilonda kukhona ukuphikelela okuqhubekayo noma okuqhubekayo emva kokuhlinzwa. Kuyinto evamile ukuba isilonda sokuhlinzwa sibe nomsele owodwa ngemva kokuhlinzwa, kodwa amanzi angaphezu kwamahora angu-72 emva kokuvalwa kwesilonda akubhekwa njengesijwayelekile. Ngesikhathi abanye bebheka ebhandini ngemuva kwalesi sikhathi kungase kungabi imbangela yokukhathazeka, ngaphezu kwamamitha angu-2 wamanzi emgodini we-gauze akubhekwa njengokwejwayelekile futhi kufanele ihlolwe udokotela wakho ohlinzayo.
Udokotela wakho ohlinzayo uzodinga ukucacisa ukuthi ngabe umsele uvela ku-incision nxazonke noma kusuka ekujuleni kokuzungeza kwamadolo esikhundleni. Ngaphezu kwalokho, uzodinga ukunquma ukuthi imilayezo ibonisa yini izimpawu zokutheleleka. Uma lo mgwaqo uvela engxenyeni ejulile yelonda noma engase isakazeke, khona-ke ukuhlinzeka cishe kuyodingeka ukwelashwa.
Okufanele Ukwenze Uma Ukulimaza Kuphulukisi
Uma unesilonda esingelapheki, udinga ukubandakanya udokotela wakho ohlinzayo ngokushesha ngangokunokwenzeka. Uma ukukhishwa okuhlinzekwayo kudla amahora angaba ngu-72 ngemuva kokuhlinzwa, abantu kufanele bahlale esibhedlela ukuze babone noma bebe nesiguli esilandelayo ukuqinisekisa ukuthi isilonda siqhubeka siphulukisa. Ezimweni lapho amanzi ehla khona, futhi ayikho enye isibonakaliso sokutheleleka, lezi zilonda zinganciphisa kancane kancane. Kodwa-ke, zidinga ukulandelwa okusheshayo njengoba ushintsho esiqondeni kufanele lubonise ukungenelela okunonya.
Ngokuvamile ukwelashwa ngokomzimba kuzokwenyuka kulezi ziguli, futhi ukuguqa ngamadolo angaphezu kuka-45 degrees kungabanjwa izinsuku ezimbalwa. Ukuguqa ngamadolo kukhulisa ukucindezela kwamathishu ahamba nobunzima, futhi kunganciphisa ukuphefumula kwalezi zicubu. Ukugcina umlenze uqondile kungasiza ukomise ukuqhuma kwezinye izimo. Imithi yokwehlisa igazi ingabangela nesilonda sokukhipha, futhi ngenxa yalesi sizathu i-anticoagulation isikhathi esithile iyoqhutshwa isikhathi esithile kumuntu onokuqhubeka nokukhipha ukugqoka okuhlinzayo.
Uma isilonda sigxuma ngaphezu kweviki elilodwa ngemuva kokuhlinzwa, kufanele kwenziwe ukuhlinzekwa ukuqinisekisa ukuthi ayikho uphawu lokutheleleka okujulile nokuvimbela ukutheleleka ekubeni yinkinga. Ayikho indima yokuphatha ukwelashwa kwama-antibiotic ngokungabikho ukwelashwa okuhlinzekwa lolu hlobo lwenkinga.
Uma kukhona ubufakazi besifo se-necrosis noma i-gap ekwenzeni ukucubungula, kungenzeka ukuthi izicubu ezengeziwe ezinempilo, mhlawumbe ngesimo sokuhlanganiswa kwesikhumba noma ukudluliselwa okunamandla okunamathenda, kungadingeka ukuhlinzekela ngokwanele kwilonda . Kulezi zimo, kufanele futhi ufune iseluleko kumuntu ohlinzayo ohlinzeka nge-plastic orghete ukuze aluleke indlela engcono yokuthola ukonakala okuphethwe kahle, okuphulukisa ukuhlinzwa.
Izwi elivela
Ingxenye ebalulekile yokuhlinzwa ngokuphumelelayo kwamadolo ukuhlinzwa okuphulukisiwe kahle. Uma ukungcola kungaphilisi ngokugcwele, ukutheleleka kungathola kusuka esikhumbeni kuze kube sekufakeni ukuguqulwa kwamadolo, kubangele ukukhathazeka ngezinkinga ezinkulu. Uma kunokukhathazeka ngokuphulukiswa kwesikhumba sakho, vumela udokotela wakho ohlinzayo wazi ngokushesha. Ukwelashwa okudabukisayo nokuqala kwezinkinga zokuphulukisa isikhumba kubalulekile ekuvimbeleni ukucindezeleka okungathí sina.
> Imithombo:
> Simons MJ, Amin NH, Scuderi GR "Izinkinga Eziphuthumayo Eziyingozi Ngemuva Konke Ingqimba Ye-Arthroplasty: Ukuvimbela Nokuphathwa" J Am Acad Orthop Surg. 2017 Aug; 25 (8): 547-55.