Usulelo yenye yezona ngxaki zibaluleke kakhulu emva kokutshintshwa kwe-artifickent, engazisiyo nje kuphela ukubetha kwezigulana, kodwa itya imithombo yezonyango. Kule minyaka ilishumi idlulileyo, iqondo losuleleko emva kokutshintshwa kwe-Ardatificketion iye yehlile kakhulu, kodwa inqanaba lokukhula kwangoku lezigulana ezihlangeneyo zigqithile kwiqondo lokuncipha, ke ingxaki yosulelo lwendawo ayifanele ityeshelwe.
I. Izizathu ZokuSebenzisa
Usulelo oludibeneyo lwe-Post-Ardatiction oluqwalaselweyo kufuneka luthathelwe njengosulelo olufunyenwe esibhedlele ngezixhobo zokunganyangeki ngamachiza. Eyona nto ixhaphakileyo yi-staphylocococcus, i-accounting ngama-70% ukuya kwi-80%, iBacilli engalunganga, i-Aaerobes kunye ne-Anaerobes kunye ne-Streptococci yeQela ixhaphakile.
II Patogenesis
Usulelo lwahlulahlulwe lwangamacandelo amabini: Isifo esinye sisifo sakhe kwaye esinye sisifo sikade usuleleka kade okanye sibizwa ngokuba yisulelo kade-Onset. Usulelo kwangoko lubangelwa kukungena ngokuthe ngqo kwebhaktiriya kwi-raint ngexesha lotyando kwaye kuqhelekile i-sthphylococcocs pidermidis. Usulelo lwasemva kwexesha lubangelwa kukutshintshwa kwegazi kwaye uninzi lwe-staphylococcus al. Amalungu asetyenzisiweyo asebenza ngakumbi kunokwenzeka ukuba wosulelekile. Umzekelo, kukho i-10% le-10% yosulelo kwiimeko zokuhlaziywa emva kokutshintshwa kwe-artifickent, kwaye izinga losulelo liphezulu kubantu abaye baphinda bathathe indawo yokudibana kweRheumaid Arthritis.
Uninzi losulelo lwenzeka kwiinyanga ezimbalwa emva kotyando, okokuqala ukuvela kwiiveki ezimbini zokuqala emva kokuhanjiswa, kodwa kufike i-fever, iimpawu zomkhosi kufuneka zihlukane nePneumonia, i-Proct Serictions.
Kwimeko yosulelo lokuqala, iqondo lobushushu lomzimba alifumani nje le nto nje engaphili, kodwa iphakama kwiintsuku ezintathu emva kotyando. Intlungu edibeneyo ayiphumi ngokuthe ngcembe, kodwa ngokuthe ngcembe yaphazamisa, kwaye kukho iintlungu zokuphumla. Kukho i-ooching engaqhelekanga okanye imfihlakalo evela kwi-action. Oku kufanele ukuba kuhlolwe ngononophelo, kwaye umkhuhlane akufuneki ukuba ubonakale ngokulula kusulelo lwendawo ekunye kwamanye amalungu omzimba anjengemiphunga okanye umchamo. Kukwabalulekile ukuba ungayivumeli nje i-ooozing ye-ooozing njenge-oozi eqhelekileyo enjengotywala obuqhelekileyo. Kubalulekile ukuba uchonge ukuba usulelo lubekwe kwizicubu eziphezulu okanye zingene ezijikeleze i-Prostheis.
Kwizigulana ezinesifo esiphezulu, uninzi lwabo olushiye isibhedlele, ukudumba ngokudibeneyo, iintlungu, kwaye umkhuhlane awunakuba nzima. Isiqingatha sabaguli sinokungabikho fever. I-staphylococcus epidermidis inokubangela usulelo olungenabuhlungu nge-lell yegazi elimhlophe legazi kwi-10 yeepesenti zabaguli. I-sediment yegazi ephakanyisiweyo ixhaphakile kodwa ayicacanga. Intlungu ngamanye amaxesha ichithwe kakubi njengenkunkuma, le ibuhlungu ehambelana nentshukumo ekufuneka ikhulelwe, kunye nentlungu yokuvuvukala engaphelelwanga. Nangona kunjalo, kucetyisiwe ukuba eyona nto iphambili yokuKhululwa kweProsphesis ilibaziseka usulelo olungapheliyo.
III. Isifo
1. Uviwo lwe-haematological:
Ububanzi bequka ukubala kwe-mhlophe yegazi yegazi kunye nokuhlelwa kwe-interleukin 6 (il-6), iproteyini esebenzayo ye-C. Izibonelelo zoviwo lwe-haematological zilula kwaye zilula ukwenza, kwaye iziphumo zinokufumaneka ngokukhawuleza; I-ESR kunye ne-crp inobukrelekrele obuphantsi; I-Il-6 ixabiseke kakhulu ekumiseleni usulelo lwe-peripprosthetic ngexesha lokuqala.
UVIWO LOLWAZI:
Ifilimu ye-X-ray: Akukho buthathaka okanye inxenye yokufumanisa usulelo.
Ifilimu ye-X-ray yosulelo lokutshintshwa kwedolo
I-Arthrographic: Intsebenzo eyintloko ekufumanekeni kosulelo kukuphuma kwe-synovial fluid kunye nethumba.
I-CT: Ukuboniswa kokuhlonela i-effsion edibeneyo, amaphecana e-sinus, amathumbu ethambileyo, i-tiscesces, i-bone erosion, i-peripprosthetic ye-bone yokwandisa.
I-MRI: inobuthathaka kakhulu ekufumanekeni kwasekuqaleni kwe-flued floid kunye namathumba, asetyenziswanga ngokubanzi ekufumaneni isifo sosulelo lwe-peripprosthetic.
I-Ultrasound: Ukuqokelelwa kwe-sluid.
3.Unyango lwe-3.nucleard
I-Technetium-99 iskena iskena ineemvakalelo ezingama-33% kunye ne-86% ye-scansesic yosulelo emva kosulelo lwe-peripproptihetic, kunye nemvakalelo ye-lekocyte ibaluleke kakhulu kwi-77% ne-86% ye-86%. Xa izikhafu ezibini zisetyenziswa kunye kuvavanyo losulelo oluqhelekileyo Olu vavanyo lusengumgangatho wegolide kumayeza enyukliya wokuchongwa kwesifo sosulelo lwe-peripprosthetic. I-Fluorodeoxicose-Popitron Ensungur (FDG-Pet). Ifumana iiseli zokuqaqamba okunyukayo kwi-glucose ye-glucose kwindawo eyosulelekileyo.
4. Iindlela zebhayiloji zemolekyuli
I-pcr: imvakalelo ephezulu, i-postritives ephosakeleyo
Itekhnoloji ye-Gene Chip: Inqanaba lophando.
5. I-Arthrocenten:
Uvavanyo lwe-sytological lwe-floid fluid, inkcubeko ye-bacteria kunye novavanyo lobuntununtunu.
Le ndlela ilula, ikhawuleza kwaye ichanekile
Kwisisulelo se-hip, udibaniso lweLeucocyte Leucoccyte> 3,000 / ml ngokudibeneyo nge-ESR kunye ne-CRP yeyona nto iphambili kubukho bosulelo lwe-peipprosthectitic.
I-6. I-Intraoperapeetive Proped Chrid Cheane ye-hertopatrology
ICandelo le-Intraopeed elikhuthazayo le-Intraoperation ye-Perpicrosthetic ye-PerpicTitic yeyona ndlela isetyenziswayo isetyenziswa ngendlela esetyenziswayo ye-hertopatical. I-feldman ye-feldman ye-feldman ye-feldman, okt, enkulu kune okanye ilingane ne-5 neutropils kwi-goring ephezulu (i-400x) ubuncinci amasimi ahlukeneyo emicroscopic, zihlala zisetyenziswa kumacandelo aqanduse. Ibonisiwe ukuba ubuntununtunu kukungabikho kwale ndlela iya kudlula kwi-80% kunye ne-90%, ngokulandelelana. Le ndlela okwangoku iGold imigangatho ye-inraoperasis.
I-7. Inkcubeko yentsholongwane ye-pathological tishu
I-Bacterial Suries Tises inobuqili obukhulu ekufumaneni usulelo kwaye ithathelwe ingqalelo njengomgangatho wegolide wokuchonga usulelo lwe-peripprosthetic, kwaye inokusetyenziselwa uvavanyo lobuntu ngamachiza.
Iv. I-Diagonosial Dialosis
Usulelo olunobuchule obungenabuhlungu olungenabungozi olubangelwe yi-staphylococcus epidermidis kunzima ngakumbi ukwahlulahlula ukukhululeka. Kufuneka iqinisekiswe zii-X-rays kunye nolunye uvavanyo.
V. Unyango
I-1. I-Antibioting elula
I-Tsakaysma kunye ne-Se, Gawa Cwangcisiweyo ye-Arthroplasts, chwetheza i-AsyMMMMMMOTIC Uhlobo, isigulana kuphela kwinkcubeko yesixhobo esihlaziyiweyo esifunyanisiweyo, kwaye ubuncinci sine-bacteria esilinganayo; Chwetheza usulelo lokuqala, okwenzekayo kwinyanga enye yotyando; chwetheza il kukulibaziseka kosulelo olungapheliyo; kwaye chwetheza iv sisifo se-haematogenous haematogenous. Umgaqo-siseko wonyango lwe-antibiotic inobuthathaka, ixesha elaneleyo nexesha. Kunye nokuthintelwa kwe-cavity ye-cavity kunye nenkcubeko ye-intraoperation ye-intraoperation yeyokubaluleka okukhethekileyo ekukhetheni ngokuchanekileyo kwamayeza okubulala iintsholongwane. Ukuba inkcubeko yentsholongwane iyodwa ukuba i-Usulelo ndisulelekile, ukusetyenziswa ngokulula kwee-antibiotics ezibuthathaka kwiiveki ezi-6 kunokufezekisa iziphumo ezilungileyo.
I-2. Ukugcinwa kwe-prosthesis, ukubophaphula kunye nokuntywila, utyando lokunkcenkceshela ityhubhu
Indawo yokwamkela indawo yokugcina i-rauma egcina unyango lwe-Prosthesi kukuba i-Prosthes sisizinzo esizinzileyo nesikhathazayo. I-Insosultusmolmolkomty icacile, i-vintal yentsholongwane iphantsi kwaye i-antibiotics ifumaneka, kwaye i-liner okanye i-liner okanye i-spacer inokutshintshwa ngexesha lokuthathwa kwempahla. Ukunyanga i-6% kuphela ene-antibiotics kuphela kwaye i-27% ene-antibiotics kunye ne-antibiotics kunye nolondolozo lwe-antibiotics kunye nolondolozo lwe-PROSTECEIR luxeliwe kuncwadi.
Ilungele ukosuleleka kwinqanaba lokuqala okanye ukusula okukhulu kwe-haematogenous kunye nokulungiswa okuhle; Kucacile ukuba usulelo sisifo esincinci sentsholongwane esijongene nonyango kwi-antimictronial purapy. Indlela equka ukubola ngokucokisekileyo, ukugungxulwa kwe-antimicrocial kunye nokuntywila (ixesha leeveki ezi-6), kunye nenkqubo yendawo yokuhlasela i-intimicroohials (ixesha leeveki ezi-6 ukuya kwiinyanga ezi-6). Izinto ezingalunganga: Inqanaba eliphezulu lokungaphumeleli (ukuya kuthi ga kwi-45%), ixesha elide lonyango lonyango.
I-3. Inqanaba lokuhlaziya inqanaba
Inezibonelelo zokuhlala ngaphantsi koxinzelelo, ukuhlala isibhedlele esifutshane, iindleko eziphantsi zonyango, inxeba elincinci kunye nokukhula okuqinileyo, okufanelekileyo ekubuyiseleni umsebenzi odibeneyo emva kotyando. Le ndlela ilungele ukuphathwa kosulelo lokuqala kunye nosulelo olune-haematogenous.
Ukutshintshwa kwinqanaba elinye, okt, indlela yenqanaba elinye, inomda kusulelo olunobuthathaka olunobuqili, ukubopha ithambo elifanelekileyo, i-antibiotic yethambo, kunye nokufumaneka kwe-antibiotics. Ngokusekwe kwiziphumo zecandelo le-intraoperation tismen, ukuba zingaphantsi kwe-5 lekocytes / intsimi enkulu yokuqalisa. Ikhutshisa usulelo olunotywala olusezantsi. Emva kwetyala elicokisekileyo i-arrthroplatse yenqanaba yenziwa kwaye kwakungekho kuphindaphindwa kosulelo.
Emva kwetyala elicokisekileyo, i-Prosphesis itshintshwa kwangoko ngaphandle kwesidingo senkqubo evulekileyo. Inezibonelelo zentshutshiso encinci, ixesha elifutshane lonyango kunye neendleko eziphantsi, kodwa inqanaba lokuphinda kosuleleka liphezulu, elimalunga ne-23% ~ 73% ngokweenkcukacha-manani. Ukutshintshwa kwenqanaba le-Prosthesis enye ikakhulu kubaguli abalupheleyo, ngaphandle kokudibanisa nayiphi na kwezi zinto zilandelayo: (1) Imbali yotyando oluninzi kumjikelo wokudityaniswa kokutshintshwa; (2) Ukwenziwa kweTrecebo leTonis; . . (5) i-X-ray ibonisa i-osteomselitis; (6) Isiphene sethambo elifuna ukubhala kwethambo; (7) Usulelo oluxubeneyo okanye intsholongwane yentsholongwane kangaka (8) Ukuphulukana nethambo elifuna ukumiswa kwethambo; (9) Ukulahleka kwethambo olufuna ukumiswa kwethambo; kunye (10) nethambo le-bone elifuna ukumiswa kwethambo. I-Strittococcus D, I-GACTEA-ENGCEIA ENYE, ngakumbi i-pseudududududonas, njl njl. (8) Inkcubeko yentsholongwane ayicaci.
4. Uhlaziyo lweNqanaba lesiBini seNqanaba
Ibalwe ngoogqirha kule minyaka ingama-20 idlulileyo ngenxa yoluhlu lwayo lwezinto ezibonisa ukuba (ubunzima bethambo olwaneleyo, izicubu ezityebileyo) kunye nenqanaba eliphezulu lokupheliswa kosulelo.
Izithuba, abaphethe ii-antibiotic, ii-antibiotics
Nokuba isetyenzisiwe njani indlela yendlela ye-spacer, ukulungiswa kwamazwi ngamandla ngamayeza okubulala iintsholongwane kuyimfuneko ukwandisa uxinzelelo lwe-antibiotics kwi-antibiotics kwi-antibaitics kwi-osultion kwaye wanyusa inani losulelo losulelo. Kusetyenziswa i-antibiotics i-tobramitics i-tobramycin, i-theimamicin kunye ne-nivacolacycin.
Uluntu lwamathambo lwamathambo lwangaphandle luye lwazibona olona nyango lusebenzayo losulelo olunzulu emva kwe-arthroplasty. Inkqubo iqulathe ubugqwirha obucokisekileyo, ukususwa kwe-Prosthesis kunye nomzimba welinye ilizwe, ukubekwa kwendawo ehlanganisiweyo, ukuqhubeka nokusebenzisa usulelo lweeveki ezi-6 ubuncinci, kwaye emva koko, ukuphinda ulawule.
Izibonelelo:
Ixesha elaneleyo lokuchonga iintlobo zeentsholongwane kunye neearhente ezibuthathaka ze-antimicrobial, ezinokusetyenziswa ngokufezekileyo ngaphambi kotyando.
Umdibaniso wenye inkqubo yenkqubo yosulelo inokunyangwa ngexesha elifanelekileyo.
Kukho amathuba amabini okubulala impahla yokususa izicubu ze-necrotic kunye nemizimba yangaphandle, enciphisa kakhulu inqanaba lokuphinda kosulelo lwendawo.
Izinto ezingalunganga:
I-Anesthesia kunye notyando lunyusa umngcipheko.
Ixesha lokunyanga ixesha elide kunye neendleko eziphezulu zonyango.
I-Poposiperapetives esebenzayo ihlwempuzekile kwaye icotha.
I-arthroplasty: ilungele ukosuleleka okungapheliyo okungaphenduli kunyango, okanye kwiziphene ezinkulu zethambo; Imeko yesigulana imida kwakhona kwakhona kunye nokungaphumeleli kwakhona. Intsalela yendawo entsokothileyo, imfuneko yokusetyenziswa kwexesha elide kwe-braces ukuncedisa ukushukumiseka, uzinzo oluhle kakhulu, i-lib lifinyezwe, ifuthe lokusebenza, ifuthe lesicelo lilinganiselwe.
I-ArthroPardy: impatho yendabuko yesifo sendawo yokugcina izilwanyana, kunye nozinzo oluhle noncedo lwepeyinti kunye nokukhululeka kwentlungu. Izinto ezingalunganga ziquka ukunqunyulwa kwelungu lelungu, ukuphazamiseka kwe-gait kunye nokuphulukana nokuhamba okudibeneyo.
Ukunqunyulwa: Yindawo yokugqibela yokufumana unyango losulelo olunzulu. Ilungele: (1) Ilahleko yethambo engalunganga, iziphene ezithambileyo; . (3) unembali yokusilela okuninzi konyango olululo lwezigulana ezingapheliyo.
VI. Ukuthintela
I-1. Izinto zokuthintela:
Yenza iMeko efanelekileyo yokuqhubela phambili kwesigulana kwaye lonke usulelo olukhoyo kufuneka lunyangeke ngokwenkonzo. Olona nyango luqhelekileyo lwegazi oluqhelekileyo lwegazi lezo ukusuka kulusu, iTeknoloji yokuchama, kunye nephecana lokuphefumla. Kwi-hip okanye idolo yedolo, ulusu lweziphelo ezisezantsi kufuneka luhlale lungabikho. I-AyMMMMMMMMMIATIC I-BACTERIAURIA, exhaphakile kwizigulana ezindala, akufuneki ukuba iphathwe ngokufanelekileyo; Nje ukuba iimpawu zenzeka kufuneka ziphathwe ngokukhawuleza. Izigulana ezinetonititis, usulelo oluphezulu lokuphefumla, kwaye i-tinea ifanele ukuba ichaphazele i-chali yosulelo. Ukusebenza kwamazinyo amakhulu kukho umthombo onokubakho wegazi, kwaye nangona ithintelwe, ukuba imisebenzi yamazinyo iyimfuneko, kuyacetyiswa ukuba iinkqubo ezinjalo zenziwe ngaphambi kwe-artirplasty. Izigulana ezineemeko ezimbi ezingalunganga ezinje nge-asnemia, i-Hypoprotenisemia, isifo seswekile esidibeneyo kunye nosulelo lolwaphulo-mthetho olungapheliyo kufuneka liphathwe ngogonyamelo nangoko isifo siphambili sokuphucula imeko yenkqubo.
2. Ulawulo lwentsusa:
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(3) Indawo yokuqhubela phambili kufuneka ilungiselelwe ngokufanelekileyo ukulungiselela ulusu.
. Ukunxiba iigloves ezimbini kunokunciphisa umngcipheko wokudibana kwesandla phakathi kogqirha ophakathi kunye nomonde kwaye kunokucetyiswa.
.
. Ukupheliswa kwexesha lokunyathela kunokunciphisa ixesha lokuvezwa komoya, nto leyo inokunciphisa ixesha lokusetyenziswa kwe-tortaet. Kulumkele ukusebenza ngokungagungqiyo ngexesha lotyando, inxeba linokuphinda inkcenkceshelwe (i-utsale umpu onkcenkceshelayo), kwaye i-iodine-vine-vapor ingathathwa njengeminyhadala.
I-3. Izinto zeposi:
. Ke ngoko, i-Kicalapeoperation ye-Glucose yeGaziyo yeGlucose ibaluleke kakhulu.
. Isifundo sokulawulwa kwetyala sifumanise ukuba ukusetyenziswa kweposi ye-hemparin yemolekyuli ephantsi ukuthintela i-vein veris vem verissis kuluncedo ekunciphiseni ukubakho kosulelo.
. Iziphumo zokuqala zibonisa ukuba abahlohli be-Intra abasebenzisileyo njengolawulo lwendawo ye-Analgesics basenokuchaphazeleka kusulelo olunenxeba.
4. I-antibiotic prophylaxis:
Okwangoku, ukusetyenziswa kweklinikhi ye-prophylactic ye-antibiotic ye-antibiotics elawulwa ngokulandelelana kwangaphambili emva kokuba utyando inciphisa umngcipheko wokosuleleka. I-CEBSHALOPRIISs isetyenziswa ikakhulu eklinikithi ye-antibiotic yokhetho, kwaye kukho ubudlelwane bejikajika i-curve phakathi kwexesha lokusetyenziswa kwentsholongwane kunye nenqanaba losulelo lwendawo, kunye nexesha elifanelekileyo lokusetyenziswa kwentsholongwane. Isifundo esikhulu sakutsha nje sifumanise ukuba ii-antibiotics ezisetyenziswa ngaphakathi kwe-30 ukuya kwi-60 min Min ngaphambi kokuba i-appile inesilinganiselo esisezantsi. Ngokwahlukileyo koko, olunye ufundisiso oluphambili lwe-hip iyonke ibonise inani eliphantsi losulelo kunye ne-antibiotics ezilawulwa ngaphakathi kwe-30 yemizuzu yokuqala. Ke ngoko ixesha lolawulo lithathelwa ingqalelo ngokubanzi njenge-30 min ngaphambi kotyando, kunye neziphumo ezilungileyo ngexesha lokungeniswa kwe-anesthesia. Enye idosi yeprophylactic ye-antibiotics inikwa emva kotyando. EYurophu naseMelika, i-antibiotics idla ngokusetyenziswa kude kube yindawo yesithathu yeposi, kodwa eTshayina, kuxelwa ukuba zihlala zisetyenziswa rhoqo kwiiveki ezi-2 ukuya kwezi-2. Nangona kunjalo, imvumelwano jikelele kukuba ukusetyenziswa kwexesha elide kwe-antibiotics eninzi kufuneka kuthintelwe ngaphandle kokuba kukho iimeko ezizodwa, kwaye ukuba ukusetyenziswa ixesha elide, kwaye kuyacetyiswa ukusebenzisa iziyobisi ze-antifoitics kwi-antibiotics ukuze kuthintelwe usulelo lwe-antifiotics. I-vancolacoycin ibonisiwe ukuba isebenze kakuhle kwizigulana ezisemngciphekweni ophethe i-meticicicin-panyaniswa staphylococcus. Iidosi eziphezulu ze-antibiotics kufuneka zisetyenziselwe utyando ixesha elide, kubandakanya utyando ngombane, ingakumbi xa ubomi obunee-antibiotic bumfutshane.
5. Ukusetyenziswa kwe-antibiotics ngokudibeneyo ne-one yethambo:
I-cemed-hanceds enamachaphaza ahlukumeziweyo yaqala ukusetyenziswa e-Arthroplasty eNorway, apho kwakuqala i-Norway Arthristy Retistry iv kunye ne-cesthes ye-antibiotic) incitshiswa i-americiotion incitshiswe ngempumelelo kunendlela yedwa. Ukufunyanwa kuqinisekiswe kuthotho lwezifundo ezinkulu kule minyaka ili-16 izayo. Isifundo seFinland kunye noMbutho wase-Australia oorokiah ngo-2009 kufikelelwa kwisigqibo esifanayo malunga nendima ye-cemed ye-antibiomatic ngexesha lokuqala kunye ne-arthroplast. 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. Nangona kunjalo, ayizizo zonke iintsholongwane zinokongezwa kwi-ithambo. Iintsholongwane ezinokongezwa kwi-Clone yeXesha kufuneka zinezi meko zilandelayo: Uzinzo lwe-therm, i-hypoalgejinicicity, i-sloubialgenicilic, i-anticrobial spectrum, kunye nezinto ezihlazo. Okwangoku, i-vancoycin kunye ne-themamicin iqhelekile isetyenziselwa ukuziqhelanisa neklinikhi. Kwakucingelwa ukuba inaliti ye-antibiotic yesamente ibe yesamente yayiya konyusa umngcipheko wokusabela okhethekileyo, ukuvela koxinzelelo olunganyangekiyo, kunye nokuzikhulula kwe-Prostaptic, kodwa ukuza kuthi ga ngoku akukho bungqina bokuxhasa ezi zinto zixhalabisayo.
VII. Isishwankathelo
Ukwenza uxilongo oluchanekileyo noluchanekileyo ngembali, uvavanyo lomzimba kunye neemvavanyo ezisebenzayo yimfuneko yokufumana unyango olusebenzayo losulelo oludibeneyo. Ukupheliswa kosulelo kunye nokubuyiselwa kwendlela yokuhlangana engenabuhlungu, ukusebenza kakuhle ngumgaqo osisiseko kunyango losulelo oludibeneyo. Nangona unyango lwe-antibiotic losulelo oludibeneyo lulula kwaye alubizi, ukupheliswa kosulelo oludibeneyo kufuna ikakhulu iindlela ngeendlela zonqulo. Eyona nto iphambili ekukhetheni unyango lonyango kukujonga ingxaki yokususwa kwe-prosthesis, eyona nto iphambili yokujongana nosulelo oludibeneyo. Okwangoku, ukusetyenziswa kwe-antibiotics, ukubulala impahla kunye ne-arthroplatty kuye kwaba lunyango olubanzi losulelo oluhle kakhulu losulelo. Nangona kunjalo, kusafuneka kuphuculwe kwaye igqibelele.
IXESHA LOKUQALA: I-MAD-06-2024
