Poka o te pokohiwi tahi: technique Lead

Poka o te tahi pokohiwi ko te tukanga hāparapara, i roto i nei kōkuhunga te tākuta te ngira ki te capsule tahi. Kei te whakamana te tikanga rite mō ngā take tātaritanga mo te huru hauora ngā ranei. Ko te whakaaro o te tukanga taua - te hekenga i roto i te maha o te inu synovial tahi.

E rua ngā momo o te poka

poka wehea tākuta ki e rua momo:

• Healing.
• Tātaritanga.

anatomy tahi

I roto i te poka o te tahi pokohiwi he tika ki te tango ki roto ki pūkete nga āhuatanga āhuatanga o tona anatomy. Ko te synovium - he casing i runga i tona hanganga, me te take mai rerekē i kiriuhi serous (pērā i te kiriuhi o te kiripūkahu, peritoneum, pericardium). takoto te rerekētanga matua i roto i te meka e tona taha marae e anga ana te mata i roto i te kōhao, e kore e roto i epithelium me ararewa endothelial. rerekē te matotoru membrane. I tua atu, kua reira he nui haere te tūtohutanga ki waiariki, ngaukino, hopuhopu, me matū resistance.

Na roto i te hypersensitivity synovium ki mate kanorau titau pipiki tino ki ngā iroiti mua ki te tukanga poka, a i mua i te whakatuwheratanga i te kōhao articular. I tua atu titau te reira taatiraa whakahauanga. Kei roto i te kōhao tahi he nui iti o te wai synovial, āhua wha milliliters. Ko te inu synovial horomata, kua he tae kakau kōwhai me te he reira tino mārama. Kei te āhuatanga i te reira na roto i te pokey tiketike, kei reira ngā pūtau phagocytic me ma ngā pūtau toto, engari he iti rawa ona āhuatanga antibacterial. Nā ki te meka i kukū mucopolysaccharides inu synovial o taimaha motuhake tiketike, piki te reira i roto i te tahi, me te kore e haaparare i roto o tona kōhao.

ka Technique o te poka o te tahi pokohiwi e kōrero i raro nei.

Mō te inu tahi

Haere i te inu tahi me e kore e meinga te mea tino uaua te tukanga mate no te mea o tona nui iti o te pēhanga kino, me te pokey tiketike. hononga Healthy Ko te pēhanga tōraro:

• Pona: 270-210 mm te wai tīwae.
• Tineia: 75-90 mitamano o tīwae wai.

Ko te aroaro o te pēhanga tōraro ai te rerewai inu o paraharaha subchondral me synovial, te wahi puta wheua ngohe tahi kai.

He onge poka o te tahi pokohiwi i roto i te tangata hauora.

Ko te mahi o te inu synovial

Ko te mahi matua whakamana e te inu synovial, kia ngā:

• mahi toitoi. inu Synovial i roto i te taupiri ki wheua ngohe articular whakarato kaupapa noa o te papa wheua tuhia.
• mahi pūkoro. whai wāhi inu Synovial te i roto i ngā tukanga pūkoro tupu i waenganui i moenga iaia me te articular inu.
• mahi arataukai. Avascular inu synovial e whangainga ana te paparanga wheua ngohe.

Ki te kahore he he tukanga inflammatory i roto i te hononga, te piki inu synovial i roto i te ihirangi pūmua. he tika ki te nui haere uruhanga iaia tenei. riro i takatakahia te wai, faarahi te reira i te ihirangi o neutrophils hua i roto i te synovitis pāmamae whakapeka.

Poka o te tahi pokohiwi: he tauākī

• Whakatau i o nga tirotiro o te hanganga (i roto i te aroaro o te pirau, exudate toto ranei). Ki te roto i te hononga pakaru toto, kia meinga ai adhesions synovitis, wheua ngohe kino āhua degenerative, kōtuitui-articular. I roto i te take o te haemarthrosis pakeke me te mumura piripiri pūāhua pāmamae te wheua a te nuinga pakaru wheua ngohe matotoru, a kihai extravasated pānga toto. Mahi whakaora i o ngohe puta ki huringa i roto i te wāhanga proliferative o kiko tūhonohono. I roto i te take o te kino ki te anga puta coagulation feunga tere me clots ka i hanga, e taea arahi ki te tini nui o kiriuhi kiko. Ka rite ki te hua, haamata te reira ki obliteration o te kōhao tahi.
• Te whakatū kino tīhaetia i roto i te tahi turi whakamahi pnevmoartrografii Radiography ranei.
• Te Haamauraa i te aroaro i roto i te kōhao tahi "sino raihi" ranei "kiore tahi."

Ki tenei mutunga whakaritea poka tātaritanga o te tahi pokohiwi.

Tuhinga mō ngā tukanga hauora pērā i poka

• Tangohanga o toto i te whanaketanga hemarthrosis.
• Tangohanga o exudate, pirau i te kōhao articular, te whakataki o rongoā paturopi.
• Kupu Whakataki otinga novocaine i whakaiti o raruraru.
• Kupu Whakataki o corticosteroids i roto i ngā ki Lydasum te aroaro o deformans arthrosis.
• Kupu Whakataki o te hāora rangi ranei mo ngā tukanga ngawari te whati i hanga i roto i te take o adhesions kaiota adhesions articular. Ko taea hoki Introduction o te hāora ki te whakahoki nekeneke mahi ranei rohe redressatsii.

Ki tenei mutunga, ka taea te kawea te poka pokohiwi, me te turi hononga.

te tikanga

Nā ki te tūtohutanga tino o te inu synovial ki mate, i roto i te poka tahi me te whai inexorably nga ture katoa o te asepsis me antisepsis.

I mua i te whakatinana a koutou i te poka, kia ata decontaminated te pae poka. He mea tika ki te whakamahi i semidesyatiprotsentnogo waipiro. Kia kua te kiri i te pae poka kua hinu rima ōrau otinga konutawa, kia nekehia atu e rua horoia ki te waipiro ona toenga. hiahiatia Tangohanga o iodine wäriu, rawa ki nui whakahinuhinu te tika ki te meka e taea iodine tahi ki te ngira tomo ki te kōhao tahi, me tenei ai ritenga me te kino wera tauhohenga synovial. I tua atu, ka taea e iodine e haru X-hihi, e taea pā te tika o te pikitia - taea te whakaatu i te reira atu atarangi ketia te whakapakoko.

Whakamahia rehunga kookuhutanga rohe.

Me pēhea te ki te hanga i te poka?

Ko te roa o te ngira poka mo te 5-6 henimita. Ki te kawea te whakataki o te hāora i roto i, na kia whakamahia te ngira he kikokore, ki runga ki te tetahi mirimita te whānui. Kore, ka taea e te hau tomo ki te kiko ngohengohe e karapoti ana i te tahi. E, i roto i te tahuri, tīmata i te subcutaneous, uaua periarticular emphysema ranei.

Me e whakangaueuetia kiri poka i te tahi pokohiwi ki te taha. Tenei taea ki te whakapiko i te hongere marutanga mahue e te ngira, me te kiri i muri i te tukanga e hoki ki te wāhi. mawehe taua tikanga te kătahi o mate i te mata tinana ki te kōhao tahi.

kia e whakakorikoria te ngira rawa āta, e ngana ana ki te whakatau, ka ina e tū te mutunga o taua mea i roto i te capsule tahi. Ki te he te toto te kōhao glenoid, i reira ka kia novocaine otinga poke i roto i te pūwero, ki te pirau ranei - riro kapua te otinga.

Mō te hohonu i nei te poka, i reira e kia whakatinana rerekē whakaaro. Ētahi tuhinga e ai ta e kia tomo te ngira ake ki tetahi henemita, me te tahi atu - i 2-3 cm.

Me ngotea poka wai te pūwero ki te rōrahi o te 10 ki te 20 karamu. Ki te hiahiatia - whakahaere taero. I muri i te tango i te ngira tukua kiri rītaha te, reira piko te hongere marutanga, kei te ka tukinotia te pae poka ki te waipiro, me te takai horomata tono.

Technology poka, te tahi pokohiwi

kia kawea atu poka o te tahi i te taha, ki mua muri ranei. Ki te kawea te tikanga i roto i roto i mua, ka kia kia hoatu te manawanui i runga i te hoki. I muri iho, me kitea te tākuta te tukanga coracoid o nga matatahi pokohiwi, i te mea e toru henimita raro atu i te mutunga distal o te āhei. kia te ngira kia whakahaerea i raro i a ia, ka arahi i waenganui i nga wheua pokohiwi o te matenga, me tona peka i roto i te ahunga i mua ki te hoki. whakaurua te ngira te ki te hohonu o te 4 cm.

Ki te whakamana i te poka e te tākuta o te taha tahi pokohiwi, kia te manawanui kia hoatu ki te taha ki te ritenga atu, ia whakanohoia tona ringa i rite haere te kātua. Ko paku raro i te tuberosity nui o te upoko peke ko tona matenga te whanui o te maihao. rakau ngira Ko te wahi i raro i te tukanga acromion, i te mea te nuinga kohuki, a ka kōkiri i te reira i roto i te ua pakihiwi i roto i te manureva frontal.

I roto i te whakahaere i te muri o te ngā tukanga poka manawanui hiahiatia ki te takoto i runga i tona kopu. I muri iho, mana'o te tākuta mo te ua pakihiwi me tona mata raro. I tenei wāhi, i reira te mea he poka, kei paku raro atu i te mata muri o te tukanga acromion. I roto i tenei wahi ko reira e tika ana ki te wero i te ngira, ka hoatu ai ki te hohonu o te 5 cm i te aronga o te coracoid scapula.