Ukutheleleka kungenye yezinkinga ezimbi kakhulu ngemuva kokubuyiselwa okuhlangene okuhlangene, okungagcini ngokuletha kuphela ukushaywa okuningana ezigulini, kodwa futhi kudinga izinsizakusebenza ezinkulu zezokwelapha. Eminyakeni eyi-10 eyedlule, izinga lokutheleleka ngemuva kokufakwa esikhundleni sokudla okuhlangene sehle kakhulu, kepha izinga lokukhula kwamanje leziguli elisezingeni eliphakeme elihlanganisiwe lidlula kude izinga lokuncipha kwezinga lokutheleleka, ngakho-ke inkinga ukutheleleka kwe-postoperative akufanele kunganakwa.
I. Izimbangela zokuziphatha okuhle
Ukuthengwa kwezifo ezihlanganisiwe ngemuva kokufakelwa kufanele kubhekwe njengezifo ezitholakele esibhedlela ezinezinto eziphilayo ezingazweli emithini. Okuvame kakhulu yi-staphylococcus, accounting for 70% kuya ku-80%, i-bacilli engenzi kahle ye-gram, i-anaerobes neqembu neqembu le-streptococci nalo livamile.
II pathogeneis
Ukutheleleka kwehlukaniswe izigaba ezimbili: Ukutheleleka kusenesikhathi kanti okunye ukutheleleka sekwedlule isikhathi noma okubizwa ngokuthi ukutheleleka okwenzeka sekwephuzile. Ukutheleleka kusenesikhathi kubangelwa ukungena okuqondile kwamagciwane phakathi kokuhlinzekwa ngesikhathi sokuhlinzwa futhi kuvame ukugcwala uStaphylococcus Epidermidis. Ukutheleleka okufika sekwephuzile kubangelwa ukudluliswa kwegazi okubangelwa yigazi futhi kuvame kakhulu i-staphylococcus aureus. Amalunga asebenze kuwo maningi amathuba okutheleleka. Isibonelo, kunezinga lokutheleleka nge-10% kumacala okubuyekezwa ngemuva kokubuyiselwa okuhlangene okuhlangene, futhi izinga lokutheleleka liphakeme kakhulu kubantu abaye baba nokubuyiselwa okuhlangene kweRheamatoid Arthritis.
Iningi lokutheleleka livela ezinyangeni ezimbalwa ngemuva kokuhlinzwa, okokuqala kungavela emavikini amabili okuqala ngemuva kokuhlinzwa, kepha futhi sekwedlule isikhathi eminyakeni embalwa ngaphambi kokuvela kobunzima bokuhlangana, okufana nokutheleleka kwe-pneumonia, izifo ze-urinary tract nokunye.
Endabeni yokutheleleka kusenesikhathi, izinga lokushisa lomzimba alikalulami kuphela, kepha liphuma ezinsukwini ezintathu ngemuva kokuhlinzwa. Ubuhlungu obuhlangene ababuyinciphise kancane kancane, kepha kancane kancane bakhuphuke, futhi kunobuhlungu obumnandi bokuphumula. Kukhona i-oozing engajwayelekile noma imfihlo kusuka ku-incision. Lokhu kufanele kuhlolwe ngokucophelela, futhi umkhuhlane akufanele ukuthi ubhalwe kalula ekuthelelekeni kwezifo ezingemthetho kwezinye izingxenye zomzimba njengamaphaphu noma ipheshana lomchamo. Kubalulekile futhi ukuthi ungakwazi ukumane ukhiphe i-Oozioning evamile njenge-oozing ejwayelekile enjenge-liquefaction enamafutha. Kubalulekile futhi ukubona ukuthi ukutheleleka kutholakala ezicubu ezingejwayelekile noma ekujuleni kwe-prosthesis.
Ezigulini ezinezifo ezithuthukile, iningi labo elishiye isibhedlela, ukuqubuka okuhlangene, izinhlungu kanye nomkhuhlane kungenzeka kungabi nzima. Ingxenye yeziguli kungenzeka ingabi nomkhuhlane. I-Staphylococcus Epidermidis ingadala ukutheleleka okungenazinhlungu ngokubala okumhlophe kwegazi okumhlophe ku-10% yeziguli kuphela. Ukuqothuka kwegazi okuphakeme kuvame kakhulu kepha futhi akucaci. Ubuhlungu kwesinye isikhathi buhleleka njengokukhulula ukukhulula ukukhulula, okwenzeka ngobuhlungu obuhambisana nokunyakaza okufanele kukhululeke ngokuphumula, kanye nobuhlungu bokuvuvukala obungakhululiwe. Kodwa-ke, kuphakanyisiwe ukuthi imbangela eyinhloko ye-ProSthesis youngeling ibambezeleka ukutheleleka okungamahlalakhona.
III. Ukuxilonga
1. Ukuhlolwa kwe-Haematological:
Ngokuyinhloko ifaka ukubala kwamaseli amhlophe okumhlophe kanye nokuhlukaniswa, i-Impeluukin 6 (IL-6), i-C-Reactive Protein (CRP) kanye ne-Erythrocyte Sedimentation Rate (ESR). Izinzuzo zokuhlolwa kwe-haematological zilula futhi kulula ukufeza, futhi imiphumela ingatholwa ngokushesha; I-ESR ne-CRP ibe nokucaciswa okuphansi; I-IL-6 yenani elikhulu ekunqumeni ukutheleleka kwe-periprosthetic esikhathini sokuqala se-postoperative.
2. Ukuhlolwa kokuhlolwa:
Ifilimu ye-X-ray: Ayinangqondo noma icaciswe ukuthola isifo.
Ifilimu ye-X-ray yokutheleleka esikhundleni se-Knee
I-Arthrography: Ukusebenza okumele okuyisisekelo ekutholeni ukutheleleka kungukuphuma koketshezi lwe-synovial fluid kanye ne-abscess.
I-CT: Ukubona ngeso lengqondo kokuhlanzeka okuhlangene, amapheshana we-sinus, amathumba athambile wezicubu, ukuguguleka kwamathambo, ukuhlangana kwamathambo e-periprosthetic.
I-MRI: Izwela kakhulu ukutholwa kokuqala koketshezi kanye namathumba, kungasetshenziswa kabanzi ekuhlolweni kwezifo ze-periprosthetic.
I-Ultrasound: Ukuqongelelwa kwamanzi.
I-3.Cuclear Medicine
I-ExyTetium-99 Bone Scan inokuzwela kwama-33% kanye nokucaciswa kwama-86% okuxilongwa kwezifo ze-periprosthetic ngemuva kokuthola isifo se-periprosthetic, kanye nokuzwela kwama-87% kanye nokucaciswa kwama-86% kanye nokucaciswa kwama-86%. Lapho izikena ezimbili zisetshenziswa ndawonye ukuze kuhlolwe izifo ze-periprosthetic ngemuva kwe-arthroplasty, ukuzwela okuphezulu, ukucaciswa nokunemba kungatholwa. Lokhu kuhlolwa kuseyindinganiso yegolide emithini yenuzi yokuxilongwa kwezifo ze-periprosthetic. I-fluorodeoxylloxylucose-positron ukuphuma kwe-tomography (FDG-PET). Ithola amaseli wokuvuvukala ngokuthathwa kwe-glucose okukhuphukayo endaweni enegciwane.
4. Amasu we-Molecular Biology
I-PCR: Ukuzwela okuphezulu, ama-positive angamanga
IGene Chip Technology: Isigaba Sokucwaninga.
5. I-Arthrocentesis:
Ukuhlolwa kwe-cytological koketshezi oluhlanganyelwe, isiko lamagciwane kanye nokuhlolwa kokuzwela kwezidakamizwa.
Le ndlela ilula, iyashesha futhi inembile
Ezithelelekeni ze-HIP, ukubalwa kwe-leucocyte ehlanganisiwe> 3,000 / ml ngokuhlanganiswa ne-eSR eyandisiwe ne-CRP kuyindlela enhle kakhulu yokutheleleka kwe-periprosthetic.
I-6
Isigaba esiphezulu esibangelwa yi-Intraoperial Froupetic Disposotic yezicubu ze-periprosthetic yindlela esetshenziswa kakhulu ye-intraperative indlela yokuhlolwa kwe-histopathological. Izindlela zokuxilonga zikaFeldman, ie, ezinkulu kune noma zilingana nama-neutrophils angu-5 ngokukhulisa okuphezulu (400x) okungenani ama-microscopic amancane ama-microscopic, zivame ukusetshenziswa ezingxenyeni ezihlanganisiwe. Kukhonjisiwe ukuthi ukuzwela nokucaciswa kwale ndlela kuzodlula ama-80% nama-90%, ngokulandelana. Le ndlela njengamanje iyindinganiso yegolide yokuxilongwa kwe-intraperative.
7. Isiko lamagciwane izicubu ze-pathological
Isiko lamagciwane lezicubu ze-periprosthetic linokucaciswa okuphezulu kokuthola ukutheleleka futhi libhekwe njengezinga legolide lokuthola izifo ze-periprosthetic, futhi futhi lingasetshenziselwa ukuhlolwa kokuzwela kwezidakamizwa.
IV. Ukuxilonga okuhlukiles
Ukutheleleka okuhlangene okungenabuhlungu okubangelwa ama-staphylococcus ama-epidermidis kunzima ukwehlukanisa ukukhululwa komoya. Kumele kuqinisekiswe ama-X-ray kanye nezinye izivivinyo.
V. Ukwelashwa
1. Ukwelashwa okulula kwe-antibiotic
I-Tsakaysma ne-SE, i-GAWA ehlukaniswe nge-arthroplasty ukutheleleka ezinhlotsheni ezine, thayipha uhlobo lwe-asymptomatic, isiguli kuphela esisesimweni sokuhlaziya izicubu esitholakele esitholakale ukuba nokukhula kwamagciwane, futhi okungenani ama-splemens amabili aqinisekiswe ngama-bacteria afanayo; Uhlobo lwe-II luyigciwane lokuqala, elenzeka kungakapheli inyanga eyodwa yokuhlinzwa; Uhlobo lwe-IIL luyinto ebambezelekile ukutheleleka okungamahlalakhona; Futhi uhlobo i-IV ukufunwa yi-haematogenous. Umgomo wokwelashwa okulwa namagciwane uyazwela, inani elanele nesikhathi. Kanye ne-punsetivative ehlanganisiwe yokubhoboza i-cavity kanye namasiko wezicubu ezisebenzisanayo afanelekile abaluleke kakhulu ekukhetheni okulungile kwama-antibiotics. Uma isiko lamagciwane lihle ngohlobo lokutheleleka ngegciwane, ukusetshenziswa okulula kwama-antibiotics abucayi amasonto ayi-6 kungathola imiphumela emihle.
2
Isisekelo sokwamukela isisekelo sokugcina usizi lwe-protuumas ukuthi i-prosthesis iqinile futhi inegciwane elibi. Isitho esishanayo siyacaca, i-virulence enegciwane itholakala nama-antibiotics aphansi futhi anozwela, futhi i-liner noma i-spacer ingathathelwa indawo ngesikhathi sokudonswa kwemali. Ukulapha amanani angama-6% kuphela ngama-antibiotic kuphela anama-antibiotic kanye nama-antibiotics kanye nokulondolozwa kwe-prosbresis kanye nokulondolozwa kwe-prosthesis kukhulunywa ngezincwadi.
Ilungele ukutheleleka kwesigaba sokuqala noma ukutheleleka okunamandla kwe-haematogenous nge-prosthesis enhle; Futhi, kuyacaca ukuthi ukutheleleka kuyinto yokutheleleka ngegciwane eliphansi elizwela ukwelashwa kwe-antimicrobial. Indlela iqukethe ukudonswa okuphelele, ukugcwala okuthe xaxa kanye nokudonsa (ubude besikhathi amasonto ayisithupha), kanye nama-systemic system system antimicrobials (isikhathi amasonto ayisithupha kuya kwezinyanga eziyisithupha). Okubi: Izinga eliphakeme lokuhluleka (lifinyelela ku-45%), isikhathi eside sokwelashwa.
3. Ukuhlinzwa okukodwa kwesikhashana
Inezinzuzo zokuhlukumezeka okuncane, ukuhlala okufushane kwesibhedlela, izindleko zezokwelapha eziphansi, izindleko eziphansi zesilonda kanye nokuqina okuhlanganayo, okulungele ukululama komsebenzi ohlanganyelwe ngemuva kokuhlinzwa. Le ndlela ilungele ukwelashwa kokutheleleka kusenesikhathi kanye nokutheleleka okukhulu kwe-haematogenous.
Ukubuyiselwa kwesigaba esisodwa, okungukuthi, indlela yesinyathelo esisodwa, kukhawulelwe ekuthelelekeni kobuthi obuphansi, ukudonswa ngokuphelele, ukufunwa kwamathambo amathambo kanye nokutholakala kwama-antibiotics azwela. Ngokusekelwe kwimiphumela ye-Intraperative Tassus Frozen Ifriza ingxenye, uma kungaphansi kwama-leukocytes angaphansi kwama-5 / inkambu yokukhulisa ephezulu. Kuyabonakala ukutheleleka okunobuthi obuphansi. Ngemuva kokudonswa okuphelele kwe-arthroplasty eyodwa ye-arthroplasty yenziwa futhi kwakungekho nto ephindaphindayo yokutheleleka.
Ngemuva kokudonswa okuphelele, i-prosthesis isungulwa ngokushesha ngaphandle kwesidingo senqubo evulekile. Inezinzuzo zobuhlungu obuncane, isikhathi esifushane sokwelashwa kanye nezindleko eziphansi, kepha izinga lokuphindaphinda lokutheleleka kwe-postoperative liphezulu, elingaba ngu-23% ~ 73% ngokuya ngezibalo. Ukushintshwa kwe-prosthessig ye-One-Stage kulungele iziguli ezikhulile, ngaphandle kokuhlanganisa noma yikuphi okulandelayo: (1) Umlando wokuhlinzwa okuningi kokuhlinzwa okuningiliziwe okuhlanganisiwe; (2) Ukwakheka kwamapheshana we-sinus; (3) ukutheleleka okunzima (isib. I-septic), i-Ischemia kanye nokushayisana kwezicubu ezizungezile; . (5) I-X-ray eveza i-osteomyelitis; (6) Ukulimala kwamathambo kudinga ukuxhunyelelwa kwamathambo; . (8) ukulahleka kwamathambo kudinga ukuxhunyelelwa kwamathambo; (9) ukulahleka kwamathambo kudinga ukuxhunyelelwa kwamathambo; kanye (10) namathambo amathambo adinga ukuxhunyelelwa kwamathambo. I-Streptococcus D, amagciwane angenama-gram-amabi, ikakhulukazi ama-pseudomonas, njll.), Noma ukutheleleka fungal, ukutheleleka nge-mycobaterial; (8) Isiko lamagciwane alicaci.
4. Ukuhlinzwa kwesikhashana kwesibili
Kuvunyelwa odokotela abahlinzayo kule minyaka engama-20 edlule ngenxa yezinkomba zawo ezahlukahlukene (amathambo anele amathambo, izicubu ezithambile ze-periarticular) kanye nezinga eliphakeme lokuqedwa kokutheleleka.
Ama-Spacers, abathwali be-antibiotic, ama-antibiotic
Kungakhathalekile ukuthi i-Spacer Technique esetshenzisiwe, ukulungiswa kokhonkolo okunama-antibiotic kuyadingeka ukwandisa ukufinyeleleka kwama-antibiotic ku-Joint futhi kwandise izinga lokulahla ukutheleleka. I-antibiotic evame ukusetshenziswa yi-tobramycin, i-gelamicin ne-vancomycin.
Umphakathi wama-Orthopedic waphesheya ubone ukwelashwa okusebenzayo kakhulu kokutheleleka okujulile ngemuva kwe-arthroplasty. Le ndlela iqukethe ukudonswa okuphelele, ukususwa kwenhlangano ye-prosthesis kanye nokubekwa kwe-spacer okuhlangene, ukusetshenziswa okuqhubekayo kwama-antimicrosobials abucayi abucayi okungenani amasonto ayisithupha, futhi ekugcineni, ngemuva kokulawula okusebenzayo kokutheleleka, ukuletha kabusha kwe-prostheresis.
Izinzuzo:
Isikhathi esanele sokuthola izinhlobo zegciwane kanye nama-antimicrobial anvents azwela, angasetshenziswa ngempumelelo ngaphambi kokuhlinzwa kabusha.
Ukuhlanganiswa kwezinye izifo ezihlelekile zokutheleleka kungalashwa ngendlela esifike ngesikhathi.
Kunamathuba amabili okudonswa kofuywayo ukususa izicubu ze-necrotic kanye nezinhlaka zakwamanye amazwe ngokuphelele, okunciphisa kakhulu isilinganiso sokuphindaphindeka kwezifo zeposi.
Okubi:
I-Re-Anesthesia nokuhlinzwa kwandisa ingozi.
Isikhathi sokuthatha isikhathi eside kanye nezindleko eziphakeme zezokwelapha.
Ukubuyiselwa okusebenzayo kwe-postoperative akonakele futhi kuhamba kancane.
I-ArthroPlasty: Ilungele ukutheleleka okuphikelelayo okungaphenduli ekwelashweni, noma iziphene ezinkulu zamathambo; isimo sesiguli sikhawulela ukuguqulwa kabusha nokwakhiwa kabusha. Ubuhlungu be-postoperative asele, isidingo sokusetshenziswa kwesikhathi eside kwama-brace ukusiza ukuhamba, ukuqina okuhlangene, ukunciphisa umkhawulo, umthelela osebenzayo, ubukhulu besicelo bunqunyelwe.
I-ArthroPlasty: Ukwelashwa kwendabuko kwezifo ze-postoperative, ngokuqina okuhle kwe-postoperative kanye nokukhululeka kobuhlungu. Okubi kubandakanya ukunciphisa umlenze, ukuphazamiseka kwe-gait kanye nokulahleka kokuhamba ngokuhlanganyela.
Ukunqunywa: Kuyindlela yokugcina yokwelashwa kokutheleleka okujulile kweposi. Ilungele: (1) Ukungaguquki okungekho emthethweni ukulahleka kwamathambo, izicubu ezithambile; . (3) Unomlando wokuhlulela okuningi kokuhlinzwa kwesibuyekezo kweziguli ezingapheli.
VI. Ukuvimbela
1. Izici zokusebenzisana nazo:
Lungiselela isimo sokubambisana kwesiguli kanye nazo zonke izifo ezikhona kufanele zelaphe i-Preakoictively. Izifo ezivame kakhulu zegazi ezithwalwa yilezo ezivela esikhunjeni, ipheshana lomchamo, kanye nepheshana lokuphefumula. Ku-hip noma e-knee arthroplasty, isikhumba semikhawulo engezansi kufanele ihlale ingahlukaniswa. I-asymptomatic bacteriuuria evamile, evame ezigulini ezikhulile, akudingeki iphathwe ngokulingana; Lapho kwenzeka izimpawu kumele ziphathwe ngokushesha. Iziguli ezine-tonsillitis, izifo eziphakeme zokuphefumula eziphezulu, kanye ne-tinea pedis kufanele ibe nokugcwala kwasendaweni ukutheleleka. Imisebenzi emikhulu yamazinyo ingumthombo ongaba khona wokutheleleka kwegazi, futhi yize kuvinjelwe, uma kudingeka imisebenzi yamazinyo, kunconywa ukuthi lezo zinqubo zenziwe ngaphambi kwe-arthroplasty. Iziguli ezinezimo ezijwayelekile ezifana ne-anemia, i-hypyproteemia, isifo sikashukela esihlangene nokutheleleka okungapheli komchamo komchamo kufanele kuphathwe ngolaka futhi kusenesikhathi sesifo esiyinhloko sokuthuthukisa isimo se-system.
2. Ukuphathwa kwe-Intrapeaperative:
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(3) Indawo yokubambisana kufanele ilungiselelwe kahle ukulungiswa kwesikhumba.
. Ukugqoka amagilavu aphindwe kabili kunganciphisa ubungozi bokuxhumana ngesandla phakathi kodokotela ohlinzayo nesiguli futhi kunganconywa.
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(6) Ukwenza ngcono inqubo yokuhlinzwa ye-opharetha futhi unciphise isikhathi sokusebenza (<2.5 h uma kungenzeka). Ukufushama kwezikhathi zokuhlinza kunganciphisa isikhathi sokuvezwa komoya, okuzonciphisa isikhathi sokusetshenziswa kwe-tourniquet. Gwema ukusebenza kanzima ngesikhathi sokuhlinzwa, isilonda singaphiliswa kaninginingi (isibhamu esinencela ukushelela singcono kakhulu), futhi ukucwiliswa kwe-iodine-vapor kungathathwa ngenxa yokuvela kokusolwa ukuthi kungcoliswe.
3. Izici Zokuphambanisa:
. Ngakho-ke, ukuqapha ukubonwa kwe-glucose yegazi kwegazi le-Clinical Platerative kubalulekile ngokulinganayo.
. Ucwaningo lokulawula amacala luthole ukuthi ukusetshenziswa kwe-postoperative kwe-repin ephansi yamangqamuzana ukuvikela i-thrombosis ejulile ye-thrombosis yayinenzuzo ekunciphiseni amathuba okutheleleka.
. Imiphumela yokuqala iphakamisa ukuthi amakhethini we-Intra-articur articur asetshenziswe njengoba ukuphathwa kwe-analgesics nakho kungathambekele ekuthelelekeni kwesilonda.
4. I-Antibiotic prophylaxis:
Njengamanje, ukusetshenziswa komtholampilo okujwayelekile kwemithamo ye-prophylactic yama-antibiotics kulawulwa ngokuhlelwa ngaphakathi ngaphambi nangemva kokuhlinzwa kunciphisa ubungozi bokutheleleka kweposi. Ama-Cephalosporins asetshenziswa kakhulu ngokomtholampilo njenge-antibiotic yokuzikhethela, futhi kukhona ubudlelwano bejika elibunjiwe phakathi kokutheleleka kwama-antibiotic kanye nezinga lokutheleleka kwesayithi lokuhlinzwa kanye nangemva kwesikhathi esifanelekile sokusebenzisa ama-antibiotic. Ucwaningo olukhulu lwakamuva lwathola ukuthi ama-antibiotics asetshenziswa kungakapheli ama-30 kuye kwangama-60 min ngaphambi kokuvela kwasekudla okuphansi kakhulu kokutheleleka. Ngokuphambene nalokho, okunye ukutadisha okukhulu kwengqikithi ye-hip arthroplasty kubonise izinga eliphansi kakhulu lokutheleleka ngama-antibiotic alawulwa ngaphakathi kwemizuzu engama-30 yokuqala ye-incision yokuqala. Ngakho-ke isikhathi sokuphatha ngokuvamile sithathwa njengemizuzu engama-30 ngaphambi kokuhlinzwa, ngemiphumela emihle ngesikhathi sokungeniswa kwe-anesthesia. Omunye umthamo we-prophylactic wama-antibiotics unikezwa ngemuva kokuhlinzwa. EYurophu nase-United States, ama-antibiotic avame ukusetshenziswa kuze kube usuku lwesithathu postoperative, kodwa eChina, kubikwa ukuthi ngokuvamile asetshenziswa ngokuqhubekayo amasonto ayi-1 kuye kwayi-2. Kodwa-ke, ukuvumelana okujwayelekile ukuthi ukusetshenziswa kwesikhathi eside kwama-antibiotics abanzi abubanzi UVancomycin ukhonjiswe ukuthi uphumelele ezigulini ezinobungozi obukhulu ephethe i-staphylococcus engavunyelwe yi-staphylococcus. Imithamo ephakeme yemithi elwa namagciwane kufanele isetshenziselwe ukuhlinzwa isikhathi eside, kufaka phakathi ukuhlinzwa kwezwe, ikakhulukazi lapho impilo ye-antibiotic ifushane.
I-5. Ukusetshenziswa kwama-antibiotic ngokuhlanganiswa ne-Bone Cement:
Usimende ofakwe ama-antibiotic waphinde wasetshenziswa okokuqala e-Arthroplasty eNorway, lapho ekuqaleni isifundo seRhthroplasty Registry Registry kukhombisa ukuthi ukusetshenziswa kwenhlanganisela ye-antibiotic IV kanye nesimende (okuhlangene okulwa namagciwane) kuncishiswe isilinganiso sokutheleleka okujulile kunanoma iyiphi indlela eyedwa. Lokhu kuthola kwaqinisekiswa ochungechungeni lwezifundo ezinkulu eminyakeni eyi-16 eyalandela. Isifundo saseFinland kanye ne-Australia Asthedicic Association 2009 yafinyelela iziphetho ezifanayo ngeqhaza le-antibiotic-infleased cement ngesikhathi sokuqala kanye nokubuyekezwa kwe-knee arthroplasty. It has also been shown that the biomechanical properties of bone cement are not affected when antibiotic powder is added in doses not exceeding 2 g per 40 g of bone cement. Kodwa-ke, akuwona wonke ama-antibiotic angangezwa ku-Bone Cement. Ama-antibiotic angangezwa ku-Bone Cement kufanele abe nezimo ezilandelayo: ukuphepha, ukuqina okushisayo, i-hypoallergergenicicity, i-solubility enhle ye-aqued, i-antimicrobial spectrum ebanzi, kanye ne-popimicrobial spectrum, nezinto ezibanzi. Njengamanje, iVancomycin neGentamicin bavame ukusetshenziswa kakhulu ekusebenzeni kwemitholampilo. Kwakucatshangwa ukuthi umjovo we-antibiotic ku-CEAND kuzokhulisa ubungozi bokungezwani komzimba, ukuvela kwezinkinga ezivinjezelwe, kanye nokukhululwa kwe-asuptic kwe-prosthesis, kepha kuze kube bufakazi bokusekela lokhu kukhathazeka.
VII. Ukubeka kafushane
Ukwenza Ukuxilongwa Okusheshayo Nokunembile ngomlando, ukuhlolwa ngokomzimba kanye nokuhlolwa okushukunyiswayo kuyimfuneko yokwelashwa okuphumelelayo kokutheleleka ngokuhlanganyela. Ukuqedwa kokutheleleka kanye nokubuyiselwa kokuhlanganiswa kobuhlungu, okusebenzayo kahle kokufakelwa kungumgomo oyisisekelo ekwelapheni izifo ezihlangene. Yize ukwelashwa okulwa nama-antibiotic kokutheleleka okuhlangene kulula futhi akubizi, ukuqedwa kokutheleleka ngokuhlanganyela kudinga inhlanganisela yezindlela zokuhlinzwa. Isihluthulelo sokukhetha ukwelashwa okuhlinza ukubheka inkinga yokususwa kwe-prosthesis, okuyinto ebaluleke kakhulu yokubhekana nezifo ezihlangene. Njengamanje, ukusetshenziswa okuhlanganisiwe kwama-antibiotics, ukufuya kanye ne-arthroplasty sekube ukwelashwa okuphelele kwezifo ezihlanganyelwe ezihlanganyelwe. Kodwa-ke, kusadinga ukwenziwa ngcono futhi kubekwenziwe ngokuphelele.
Isikhathi sePosi: Meyi-06-2024
