I-Orthopedic bone Cement yinto yonyango esetyenziswa ngokubanzi kwi-orthopedic surgery. Ikakhulu isetyenziselwa ukulungisa i-prostheses edibeneyo yokwenziwa, ukuzalisa i-bone defect cavities, kunye nokubonelela ngenkxaso kunye nokulungiswa kwonyango lokuphuka. Izalisa umsantsa phakathi kwamalungu okwenziwa kunye nezicubu zethambo, inciphisa ukunxiba kunye nokusabalalisa uxinzelelo, kwaye iphucula umphumo wotyando lokubuyisela.
Olona setyenziso luphambili lwezikhonkwane zesamente zezi:
1. Ukulungisa iifractures: I-samente yamathambo ingasetyenziselwa ukuzalisa kunye nokulungisa iindawo zokuphuka.
2. Utyando lwamathambo: Kutyando lwamathambo, isamente yamathambo isetyenziselwa ukulungisa nokwakha ngokutsha iindawo ezidibeneyo.
3. Ukulungiswa kwe-Bone defect: I-samente yamathambo inokuzalisa iziphene zethambo kunye nokukhuthaza ukuvuselelwa kwethambo.
Ngokufanelekileyo, i-samente yamathambo kufuneka ibe nezi mpawu zilandelayo: (1) injectable eyaneleyo, iipropathi ezicwangcisiweyo, ukudibanisa, kunye ne-radiopacity kwiipropati zokuphatha kakuhle; (2) amandla aneleyo omatshini ukuqiniswa kwangoku; (3) i-porosity eyaneleyo yokuvumela ukujikeleza kwamanzi, ukufuduka kweeseli, kunye nokungena kwamathambo amatsha; (4) i-osteoconductivity enhle kunye ne-osteoinductivity ukukhuthaza ukubunjwa kwamathambo amatsha; (5) i-biodegradability eyimodareyitha ukuze ihambelane ne-resorption yezinto zesamente yamathambo kunye nokwakhiwa kwamathambo amatsha; kunye (6) nesakhono esisebenzayo sokuhanjiswa kweziyobisi.
Ngeminyaka yee-1970, i-samente yethambo yayisetyenziselwengokubambisanaukulungiswa kweprosthesis, kwaye inokusetyenziswa njengokuzaliswa kwezicubu kunye nokulungisa izinto kwi-orthopedics kunye namazinyo. Okwangoku, i-samente yamathambo esetyenziswa kakhulu kunye nophando ibandakanya i-polymethyl methacrylate (PMMA) i-samente yamathambo, i-calcium phosphate bone sement kunye ne-calcium sulfate bone cement. Okwangoku, iintlobo zesamente ezisetyenziswa ngokuqhelekileyo zibandakanya i-polymethyl methacrylate (PMMA) i-samente yethambo, i-calcium phosphate bone sement kunye ne-calcium sulfate bone sement, phakathi kwayo i-PMMA bone samente kunye ne-calcium phosphate bone sement zisetyenziswa ngokuqhelekileyo. Nangona kunjalo, i-calcium sulfate bone samente inomsebenzi ombi we-biological kwaye ayikwazi ukwenza iibhondi zeekhemikhali phakathi kwe-calcium sulfate grafts kunye ne-bone tissue, kwaye iya kuncipha ngokukhawuleza. I-calcium sulfate yesamente yethambo inokufunxwa ngokupheleleyo kwiiveki ezintandathu emva kokufakelwa emzimbeni. Oku kuthotywa ngokukhawuleza akuhambelani nenkqubo yokwakhiwa kwamathambo. Ke ngoko, xa kuthelekiswa nesamente yethambo le-calcium phosphate, uphuhliso kunye nokusetyenziswa kwekliniki ye-calcium sulfate yesamente yethambo kulinganiselwe. I-PMMA bone sement yi-acrylic polymer eyenziwe ngokuxuba amacandelo amabini: i-liquid methyl methacrylate monomer kunye ne-dynamic methyl methacrylate-styrene copolymer. Inentsalela ye-monomer ephantsi, ukumelana nokudinwa okuphantsi kunye nokuqhekeka koxinzelelo, kwaye inokubangela ukwakheka kwamathambo amatsha kunye nokunciphisa izehlo zokusabela okubi okubangelwa kukuqhekeka okunamandla aphezulu kakhulu kunye neplastiki. Inxalenye ephambili yomgubo wayo i-polymethyl methacrylate okanye i-methyl methacrylate-styrene copolymer, kwaye inxalenye ephambili yolwelo yi-methyl methacrylate monomer.
I-PMMA yesamente yethambo inamandla aphezulu kunye neplastiki, kwaye iqina ngokukhawuleza, ngoko izigulane zinokuphuma ebhedini kwaye zenze imisebenzi yokubuyisela ekuqaleni emva kokuhlinzwa. Inobume beplastikhi obugqwesileyo, kwaye umqhubi unokwenza nayiphi na iplastiki phambi kokuba ithambo lesamente liqina. Izinto eziphathekayo zinokusebenza kakuhle kokhuseleko, kwaye azithotywanga okanye zifunnwe ngumzimba womntu emva kokubunjwa emzimbeni. Ulwakhiwo lweekhemikhali luzinzile, kwaye iimpawu zomatshini zibonwa.
Nangona kunjalo, isenezinto ezingalunganga, ezinje ngokubangela uxinzelelo oluphezulu kwithambo lomongo ngexesha lokuzaliswa, okubangela ukuba amaconsi amanqatha angene kwimithambo yegazi kwaye abangele i-embolism. Ngokungafaniyo namathambo abantu, amalungu angengowamvelo asenokukhululeka ngokuhamba kwexesha. I-PMMA monomers ikhupha ubushushu ngexesha le-polymerization, enokubangela umonakalo kwizicubu ezijikelezileyo okanye iiseli. Izinto ezenza i-samente yethambo zine-cytotoxicity ethile, njl.
Izithako ezikwisamente yamathambo zinokubangela ukuguquguquka, urticaria, idyspnea kunye nezinye iimpawu, kwaye kwiimeko ezinzima, ukothuka kwe-anaphylactic kungenzeka. Uvavanyo lwe-allergies kufuneka lwenziwe ngaphambi kokusetyenziswa ukunqanda ukusabela komzimba. Iimpembelelo ezimbi kwisamente yethambo ziquka ukuguquguquka kwethambo lesamente, ukuvuza kwesamente yethambo, ukukhulula isamente yethambo kunye nokuchithwa. Ukuvuza kwesamente yethambo kunokubangela ukudumba kwezicubu kunye nokuphendula okuyityhefu, kwaye kunokonakalisa imithambo-luvo kunye nemithambo yegazi, okukhokelela kwiingxaki. Ukulungiswa kwesamente yethambo kunokwethenjelwa kakhulu kwaye kunokuhlala iminyaka engaphezu kweshumi, okanye nangaphezulu kweminyaka engamashumi amabini.
Utyando lwesamente yethambo lutyando oluqhelekileyo oluncinci, kwaye igama layo lesayensi yi-vertebroplasty. I-samente yethambo yimathiriyeli yepolymer ene-fluidity elungileyo ngaphambi kokuqina. Iyakwazi ukungena lula kwi-vertebrae ngenaliti yokubhoboza, kwaye emva koko isasazeke kunye neentanda ezivulekileyo zangaphakathi ze-vertebrae; i-samente yethambo iqina malunga nemizuzu eyi-10, ibambelele kwiintanda emathanjeni, kwaye i-samente yamathambo eqinile inokudlala indima exhasayo ngaphakathi kwamathambo, okwenza i-vertebrae ibe yomelele. Yonke inkqubo yonyango ithatha kuphela imizuzu engama-20-30.
Ukuze ugweme ukusabalalisa emva kwesitofu se-samente yethambo, uhlobo olutsha lwesixhobo sotyando lwenziwe, oluyisixhobo se-vertebroplasty. Kwenza inxeba elincinane kumqolo wesigulana kwaye lisebenzisa inaliti ekhethekileyo yokugqobhoza ukugqobhoza umzimba we-vertebral ngesikhumba phantsi kwe-X-ray esweni ukuseka umjelo osebenzayo. Emva koko ibhaluni ifakwe ukubumba umzimba we-vertebral oxinyiweyo, kwaye i-samente yethambo ifakwe kumzimba we-vertebral ukubuyisela ukubonakala kwe-vertebral body fracture. Ithambo elikhansela kumzimba we-vertebral lixutywe ngokunyuka kwebhaluni ukwenza umqobo wokuthintela ukuvuza kwesamente yethambo, ngelixa kunciphisa uxinzelelo ngexesha lokutofa kwesamente yethambo, ngaloo ndlela kunciphisa kakhulu ukuvuza kwesamente yethambo. Inokunciphisa iziganeko zeengxaki ezinxulumene nokuphumla kombhede wokuphuka, njenge-pneumonia, izilonda zoxinzelelo, izifo ze-urinary tract, njl., kwaye ugweme umjikelezo okhohlakeleyo we-osteoporosis obangelwa ukulahleka kwethambo ngenxa yokuphumla kwexesha elide lokulala.
Ukuba utyando lwe-PKP lwenziwa, isigulane kufuneka siphumle ebhedini ngaphakathi kweeyure ze-2 emva kokuhlinzwa, kwaye sinokujika kwi-axis. Ngeli xesha, ukuba kukho ukuvakalelwa okungaqhelekanga okanye intlungu iyaqhubeka nokuba nzima, ugqirha kufuneka aziswe ngexesha.
Phawula:
① Kuphephe ukujikeleza esinqeni esikhulu kunye nemisebenzi yokugoba;
② Kuphephe ukuhlala okanye ukuma ixesha elide;
③ Kuphephe ukuthwala ubunzima okanye ukugoba ukuze uchole izinto eziphantsi;
④ Kuphephe ukuhlala kwisihlalo esiphantsi;
⑤ Thintela ukuwa kunye nokuphindaphinda kokwaphuka.
Ixesha lokuposa: Nov-25-2024
