Puncture o ka'ūhā mua ami: alakaʻi 'ana i kūpono

Puncture o ka'ūhā mua ami mea heʻoki lāʻau lapaʻau kaʻina hana, oiai i ka kauka nā manaʻo i ke kui kele ma loko o ka ami mea hōʻikeʻikeʻuʻuku. A like ke kaʻina hana no ua hana no PalekanaEND_LINK hana ai no ke kanawai 'inikua kulana. I ka manao o ia ke kaʻina hana - he emi ma ka helu o nā hui synovial loli.

Elua ano o ka puncture

Surgeons puncture maheleia i mau hoailona ia mea:

• Healing.
• PalekanaEND_LINK.

ami'anatomia

Iloko o ka puncture o ka'ūhā mua mau mea e pono ke lawe i ka mooolelo o ka ano hiʻona o kona'anatomia. Ka synovium - i ka pōkā pū a ma luna o kona 'ole a me ka molekumu oʻokoʻa mai serous membranes (e like me kaʻili lahilahi o ka pleura, peritoneum, pericardium). I ka papa kuhikuhiE like ke moe i loko o ka mea i kona pahaleʻaoʻao huli i ka ili i loko o ka lua, 'aʻole e apo ia epithelium a me ka endothelial naʻau. I kaʻili lahilahi mānoanoa loli aʻe. Eia hou, ka mea, i ka mahuahua pā lonoaʻili i ka thermal, traumatic, infectious, a me Nine Inch e kū'ē'ē mai.

By hypersensitivity synovium i nā nā mea palahēhē pono kānana adherence e aseptic mamua i ka puncture kaʻina hana, a me ma mua wehe i ka articular lua. Ma waho aʻeo ka mea pono OAXA hoailona iho la i. Ke ami lua he he uuku nui o synovial loli, ka hola eha ka pono. Ke synovial loli Ua sterile, ua he lenalena ka mauu maloo waihoʻoluʻu a me ia mea loa kālaʻe. Ua Ua wehewehe aku ma kiʻekiʻe (viscosity), inā loaʻa phagocytic keena, a keʻokeʻo koko keena, akā, kona antibacterial waiwai, ua uuku loa. Aie i ka mea i paʻa kūhohonu loa mucopolysaccharides synovial loli o ke kiʻekiʻe kekahi ke kaupaonaʻana, ka mea accumulates i loko o ka hui a meʻaʻole eiei mai o kona lua.

'Ana i kūpono no ka puncture o ka'ūhā mua ami e e kūkā mai ma lalo nei.

About ka ami loli

E kiʻi i ka hui loli, a aole i i ka maʻi kaʻina ka loa paʻakikī no ka mea, o ka uuku nui o ka io ka puʻuwai a me ka kiʻekiʻe (viscosity). Healthy ami i ka hopena maikaʻi puʻe:

• Na puupuu wawae: 270-210 mm o ka wai kia ao.
• Ka ululāʻau,: 75-90 millimeters o ka wai kia ao.

Ke alo aku o ka io puʻe kumu loli osmosis o subchondral a me ka synovial papa, kahi ami cartilage ia lŘlŘʻai.

Puncture o ka'ūhā mua ke ami hoi i ola kānaka mea pohihihi keia.

I ka mana o ka synovial loli

I ka papa kuhikuhiE oihana hana 'ia e ka synovial loli, e komo:

• Locomotor kuleana pili i. Synovial loli ma ka tandem me articular cartilage hoʻolako noa ana o ka mea kiko'ī a iwi surfaces.
• Metabolic kuleana pili i. Synovial loli ua komo i loko o metabolic keʻano o ka hanaʻana 'ia ma waena o vascular na moe a me articular loli.
• Trophic kuleana pili i. Avascular synovial loli nourishes ka cartilage papa.

Inā he mea i hoʻoʻino kaʻina i loko o na ami, ka synovial loli kēia piʻina ma ka kumuʻiʻo maʻiʻo. O ke kumu ho i ka māhuahua vascular permeability. Ka wai i turbid, ka mea maoli i ka maʻiʻo o neutrophils kūpono i ka huʻi traumatic synovitis.

Puncture o ka poʻohiwi ami: he olelo

• Hoʻoholo 'ana i kahi o ka haku mele' ana (i loko o ke alo o ka pus, exudate a me ke koko). Inā ka poino ami i kakauiaʻi maluna koko, ka mea hiki i synovitis, cartilage pōʻino degenerative ano, ke kūʻai '-articular adhesions. Ma ka hihia o traumatic haemarthrosis oolea a me ka li nui lina ano ua lawe mai pili kēia poino cartilage mānoanoa, aʻaʻole extravasated koko kanawai. E noho ana o cartilage ia lŘlŘ me ka loli ma ka proliferative ke keʻena o connective'aʻaʻa. I Ina o ke poho a hiki i ka iwi ia lŘlŘ lawa kokololio coagulation, a laila i hanaʻia clots, a hiki e alakai ai i ka nui ka hoʻonuiʻana o ka'aʻaʻa membranes. E like me ka hopena, e hoʻomaka e obliteration o na ami lua.
• E kukulu meniscus pōʻino i loko o ke kuli ami hoʻohana pnevmoartrografii a radiography.
• E kukulu i ke alo i loko o ka ami lua "laiki kino" a me "ke ami hoiʻiole."

No keia hopena e waeia PalekanaEND_LINK puncture o ka'ūhā mua ami.

Nāʻikepili no ka 'inikua ke kaʻina hana e like me puncture

• Removal o ke koko ma hemarthrosis ulu.
• Removal o exudate, pus, mai ka articular lua, i ka hoike o antibiotic pāʻoihana.
• Introduction novocaine pāʻoihana ma ka ho'ēmiʻana o ka dislocation.
• Introduction o corticosteroids ma ka pu ana me Lydasum i ke alo o ka arthrosis deformans.
• Introduction o ka o oxygen a lewa no ka akahai hana fracture hana i loko o ka hihia o fibrous adhesions articular adhesions. Introduction o ka o oxygen mea no hoi e hiki Hawaii hana ole redressatsii hiʻona'āina, e hoʻihoʻi aku.

No keia hopena, he puncture hiki ke lawe poʻohiwi, a kukuli ami.

i ke kaʻina hana

Aie i ka lōʻihi pā lonoaʻili o ka synovial loli i nā mea palahēhē, iloko o na ami puncture pono inexorably hahai i na rula o ka asepsis a me ka antisepsis.

Mua oe hoʻokō i ka puncture, ka puncture paena e e ho'ōla loa decontaminated. He kupono e hoʻohana semidesyatiprotsentnogo ka waiʻona. Once o kaʻili i ka puncture paena i ua momona o ka iʻa elima pakeneka iodine pāʻoihana, kona koena e e wehe 'ia ma ka holoi ana me ka waiʻona i nā manawaʻelua. Removal o koena iodine, o ka oi aku me ka nui lubrication ua koi 'ia ma muli o ia ka mea i iodine pu me ke kui kele ma ke komo i loko o ka hui lua, a me keia ke kumu ae hookaawale a me ka loa synovial naoh kuni i ka mea. Eia hou kekahi, iodine hiki ka hoʻokemu X-kukuna, i mea e loli i ka pololei o ke kiʻi - ka mea, ke hōʻike 'ana i nā manaʻo kuhi hewa paha ka nānaina i ke kiʻi.

E hoʻohana i nā infiltration anesthesia.

Pehea e hana i ka puncture?

Ka lōʻihi o ke kui kele ma puncture no 5-6 kenimika. Inā i ka hoike o ke o oxygen ua lawe mai, alaila, i ke kui kele ma e e hoʻohana i ka lahilahi, i hiki i kekahi millimeter ma anawaena. I ole ia, i ke kinoea ke komo i loko o ka pahee'aʻaʻa puni i ke ami. Mea, ma ka huli, kāhea he subcutaneous, periarticular Muscle paha emphysema.

pono e hoʻoneʻe Skin puncture ma ka'ūhā ke ami hoi i kaʻaoʻao. Ua apono 'e lena i kaʻeha Kanal haʻalele ma ke kuikele, a ua hoi aku la a hiki i ka wa o kaʻili ma hope o ka hana. Oia iaoia hookaaokoa ae mai o ka anal o ka maʻiʻaʻai mai ke kino 'ilikai i loko o ka ami lua.

Ke kui kele ma E e neʻe loa lohi, ho'āʻo ana e hooholo ia ai ka hopena o ka mea e e paa ia ma ka ami mea hōʻikeʻikeʻuʻuku. Inā ka glenoid lua i ke koko, ma laila e e novokainovoj i hookohu aku i kākoʻo pāʻoihana i loko o ka 'ohe, a ina pus - ka pāʻoihana i turbid.

About ka hohonu ma i ka puncture, ua nui na ano manaʻo e e hoʻokō. Kekahi moʻokalaleo mai nei i ke kui kele ma e komo iloko mai i kekahi kenimika, a me ka mea 'ē aʻe - ma 2-3 knm.

Wai puncture pono waiu i ka 'ohe me ka buke o ka 10 a hiki i 20 nā huna. Inā koi 'ia - lawelawe ai'. Ma hope o ka wehe 'ana i ke kui kele ma biased ili ua hookuu, hiki anuenue i ka eha Kanal, ka puncture paena ua laila ia me ka waiʻona, a me ka lole wili sterile noi.

Technology puncture i ka'ūhā mua ami

Puncture o ke ami e halihaliia oia iwaho, mai kaʻaoʻao, alo a me ka hope. Inā i ke kaʻina hana e lawe mai ma ka mua, a laila, i ka hoʻomanawanui e e kau ma luna o ke kua. Mahope, i ka surgeon pono loaʻa i ka coracoid kaʻina hana o ka poohiwi kōmi 'ana, i mea ekolu mau kenimika haʻahaʻa ma mua o ka distal hope o ka clavicle. Ke kui kele ma E e lawelawe ma lalo iho ona, a alakai ma waena o ka poohiwi iwi o ke poo a me kona offshoot ma ke ala e hiki aku, mai ke alo i ka hope. Ke kui kele ma ua hookomoia i ka hohonu o ka 4 knm.

Inā ka puncture ua hana ma ka surgeon o ka poohiwi huiʻaoʻao, ka hoʻomanawanui e e waiho ia ma kaʻaoʻao e ku pono ana, i ka wa o kona lima, i kau like ma ke kumu. Ka laula o ka manamana lima mea iki emi mai ka nui tuberosity o ka humerus poʻo o kona poʻo. Needle koʻokoʻo o ka hapa ma lalo o acromion kaʻina hana, i mea ka loa nei iluna, a laila mua ia ma ka deltoid Muscle i loko o ka frontal pelane.

I lawe mai i ka hope o ka hoʻomanawanui puncture kaʻina hana i koi 'ia e waiho ana ma kona'ōpū. Mahope, i ka surgeon Kahalaopuna deltoid Muscle a me kona lalo palena. Ma keia wahi, he mea i ka lua, Aia iki haʻahaʻa ma mua o ka mea hope loa o ka acromion kaʻina. Ma keia wahi ia mea e pono ke inject i ke kui kele, a kau aku la ia i ka hohonu o ka 5 knm ma ke ala e hiki aku o ka scapula coracoid.