I-Orthopedic bone Cement iyimpahla yezokwelapha esetshenziswa kakhulu ekuhlinzeni amathambo. Isetshenziselwa kakhulu ukulungisa ama-prostheses ahlangene okwenziwa, ukugcwalisa imigodi ye-bone defect, nokuhlinzeka ngokusekela nokulungiswa ekwelapheni ukuphuka. Igcwalisa igebe phakathi kwamalunga okwenziwa kanye nezicubu zamathambo, inciphisa ukuguga futhi ihlakaze ukucindezeleka, futhi ithuthukise umphumela wokuhlinzwa okushintshiwe kwamalunga.
Ukusetshenziswa okuyinhloko kwezipikili zikasimende wamathambo yilezi:
1. Ukulungisa ukuphuka: Usimende wethambo ungasetshenziswa ukugcwalisa nokulungisa izindawo zokuphuka.
2. Ukuhlinzwa Kwamathambo: Ekuhlinzweni kwamathambo, usimende wamathambo usetshenziselwa ukulungisa nokwakha kabusha izindawo ezihlangene.
3. Ukulungiswa kokukhubazeka kwamathambo: I-bone Cement ingagcwalisa ukukhubazeka kwamathambo futhi ikhuthaze ukuvuselelwa kwezicubu zethambo.
Ngokufanelekile, usimende wamathambo kufanele ube nalezi zimpawu ezilandelayo: (1) ukujova okwanele, izakhiwo ezihlelekayo, ukuhlangana, kanye ne-radiopacity yezindawo zokuphatha ezifanele; (2) amandla anele emishini ukuze kuqiniswe ngokushesha; (3) i-porosity eyanele ukuvumela ukugeleza koketshezi, ukufuduka kwamangqamuzana, nokungena kwamathambo amasha; (4) i-osteoconductivity enhle kanye ne-osteoinductivity ukuze kuthuthukiswe ukwakheka kwamathambo amasha; (5) ukubola kwe-biodegradability okulinganiselwe ukufanisa ukuxutshwa kabusha kwento ye-samente yethambo nokwakheka kwamathambo amasha; kanye (6) nekhono lokuletha izidakamizwa ngempumelelo.
Ngawo-1970, usimende wamathambo wawusetshenziselweokuhlangeneukulungiswa kwe-prosthesis, futhi ingasetshenziswa njengokugcwalisa izicubu nokulungisa izinto ku-orthopedics kanye nodokotela bamazinyo. Njengamanje, osimende bamathambo abasetshenziswa kakhulu futhi abacwaningwayo bahlanganisa usimende wamathambo we-polymethyl methacrylate (PMMA), i-calcium phosphate bone usimende kanye nosimende wamathambo we-calcium sulfate. Njengamanje, izinhlobo zikasimende zethambo ezivame ukusetshenziswa zihlanganisa i-polymethyl methacrylate (PMMA) usimende wamathambo, usimende wethambo le-calcium phosphate kanye nosimende wamathambo we-calcium sulfate, phakathi kwawo usimende wethambo le-PMMA kanye nosimende wamathambo we-calcium phosphate asetshenziswa kakhulu. Kodwa-ke, usimende wamathambo we-calcium sulfate unomsebenzi ongemuhle wezinto eziphilayo futhi awukwazi ukwakha izibopho zamakhemikhali phakathi kokuxhunyelelwa kwe-calcium sulfate nezicubu zamathambo, futhi uzowohloka ngokushesha. I-Calcium sulfate bone Cement ingamuncwa ngokuphelele emasontweni ayisithupha ngemva kokufakwa emzimbeni. Lokhu konakala okusheshayo akufani nenqubo yokwakheka kwamathambo. Ngakho-ke, uma kuqhathaniswa nosimende wethambo le-calcium phosphate, ukuthuthukiswa kanye nokusetshenziswa komtholampilo kukasimende wamathambo e-calcium sulfate kulinganiselwe. I-PMMA bone Cement iyipolymer ye-acrylic eyakhiwe ngokuxuba izingxenye ezimbili: i-liquid methyl methacrylate monomer kanye ne-dynamic methyl methacrylate-styrene copolymer. Inezinsalela eziphansi ze-monomer, ukumelana nokukhathala okuphansi kanye nokuqhekeka kwengcindezi, futhi ingadala ukwakheka kwamathambo amasha futhi inciphise izehlakalo zokusabela okungekuhle okubangelwa ukuphuka okunamandla aqine kakhulu kanye nepulasitiki. Ingxenye eyinhloko yempushana yayo i-polymethyl methacrylate noma i-methyl methacrylate-styrene copolymer, futhi ingxenye eyinhloko yoketshezi i-methyl methacrylate monomer.
I-PMMA bone Cement inamandla aphezulu okuqina kanye nepulasitiki, futhi iqina ngokushesha, ukuze iziguli zikwazi ukuphuma embhedeni futhi zenze imisebenzi yokuvuselela ngaphambi kokuhlinzwa. Inokwakheka okuhle kwepulasitiki, futhi opharetha angenza noma iyiphi ipulasitiki ngaphambi kokuba usimende wethambo uqine. Impahla isebenza kahle ngokuphepha, futhi ayonakaliswa noma amuncwe umzimba womuntu ngemva kokwakheka emzimbeni. Isakhiwo samakhemikhali sizinzile, futhi izakhiwo zemishini ziyabonakala.
Kodwa-ke, isenayo eminye imibimbi, njengokubangela umfutho ophakeme ngezikhathi ezithile emgodini womnkantsha ngesikhathi sokugcwalisa, okwenza amaconsi amafutha angene emithanjeni yegazi futhi abangele i-embolism. Ngokungafani namathambo abantu, amalunga okwenziwa asengase axege ngokuhamba kwesikhathi. Ama-PMMA monomers akhulula ukushisa ngesikhathi se-polymerization, okungase kubangele ukulimala kwezicubu ezizungezile noma amaseli. Izinto ezakha usimende wamathambo zine-cytotoxicity ethile, njll.
Izithako ze-bone Cement zingase zibangele ukungezwani komzimba, njengokuqubuka, i-urticaria, i-dyspnea nezinye izimpawu, futhi ezimweni ezimbi kakhulu, ukushaqeka kwe-anaphylactic kungase kwenzeke. Ukuhlolwa kokungezwani komzimba kufanele kwenziwe ngaphambi kokusetshenziswa ukuze kugwenywe ukungezwani komzimba. Ukusabela okungekuhle kusimende wamathambo kuhlanganisa ukungezwani nethambo likasimende, ukuvuza kukasimende wethambo, ukuxega kukasimende wamathambo kanye nokugudluka. Ukuvuza kukasimende wethambo kungase kubangele ukuvuvukala kwezicubu kanye nokusabela okunobuthi, futhi kungase kulimaze izinzwa nemithambo yegazi, okuholela ezinkingeni. Ukulungiswa kukasimende wethambo kunokwethenjelwa futhi kungahlala iminyaka engaphezu kweshumi, noma ngisho nangaphezulu kweminyaka engamashumi amabili.
Ukuhlinzwa kukasimende wethambo kuwukuhlinzwa okuvamile okungavamisile, futhi igama lakhona lesayensi yi-vertebroplasty. Usimende wethambo uyinto ye-polymer enoketshezi oluhle ngaphambi kokuqina. Ingangena kalula kumathambo omgogodla ngenaliti yokubhoboza, bese isakazeka eduze kwemifantu yokuphuka yangaphakathi okuxekethile kwe-vertebrae; usimende wethambo uqina cishe emizuzwini eyi-10, unamathisele imifantu emathanjeni, futhi usimende wamathambo aqinile ungadlala indima esekelayo ngaphakathi emathanjeni, okwenza ama-vertebrae aqine. Yonke inqubo yokwelapha ithatha imizuzu engu-20-30 kuphela.
Ukuze ugweme ukusabalalisa ngemva kokujova usimende wamathambo, uhlobo olusha lwedivayisi yokuhlinza selwenziwe, okuyidivayisi ye-vertebroplasty. Kwenza ukusika okuncane emhlane wesiguli futhi kusebenzisa inaliti yokubhoboza ekhethekile ukubhoboza umzimba womgogodla ngesikhumba ngaphansi kokuqapha kwe-X-ray ukuze kusungulwe isiteshi esisebenzayo. Khona-ke ibhaluni lifakwa ukuze lilolonge umzimba we-vertebral ocindezelwe, bese usimende wethambo ujovwa emzimbeni we-vertebral ukubuyisela ukubukeka komzimba we-vertebral ophukile. Ithambo elikhanselekayo emzimbeni we-vertebral lihlanganiswe ukunwetshwa kwebhaluni ukwenza umgoqo wokuvimbela ukuvuza kukasimende wamathambo, kuyilapho kunciphisa ukucindezela ngesikhathi sokujova usimende wamathambo, ngaleyo ndlela kunciphisa kakhulu ukuvuza kukasimende wamathambo. Inganciphisa izehlakalo zezinkinga ezihlobene nokuphumula kombhede wokuphuka, njengenyumoniya, izilonda zokucindezela, izifo ze-urinary tract, njll., futhi igweme umjikelezo ononya we-osteoporosis obangelwa ukulahlekelwa kwamathambo ngenxa yokuphumula kombhede isikhathi eside.
Uma kwenziwa ukuhlinzwa kwe-PKP, isiguli ngokuvamile kufanele siphumule embhedeni phakathi namahora angu-2 ngemva kokuhlinzwa, futhi singaguqula i-eksisi. Ngalesi sikhathi, uma kukhona ukuzwa okungavamile noma ubuhlungu buqhubeka buba bubi nakakhulu, udokotela kufanele aziswe ngesikhathi.
Qaphela:
① Gwema imisebenzi emikhulu yokuzungeza okhalweni nokugoba;
② Gwema ukuhlala noma ukuma isikhathi eside;
③ Gwema ukuthwala isisindo noma ukugoba ukuze ucoshe izinto eziphansi;
④ Gwema ukuhlala esitulweni esiphansi;
⑤ Vimbela ukuwa nokuphindaphinda kokuphuka.
Isikhathi sokuthumela: Nov-25-2024
