Simenti ya mafupa a mafupa ndi mankhwala omwe amagwiritsidwa ntchito kwambiri pa opaleshoni ya mafupa. Amagwiritsidwa ntchito makamaka kukonza ma prostheses ophatikizira opangira, kudzaza mafupa opunduka mafupa, ndikupereka chithandizo ndi kukonza chithandizo cha fracture. Amadzaza kusiyana pakati pa mafupa opangira mafupa ndi minofu ya mafupa, amachepetsa kuvala ndi kusokoneza maganizo, komanso amawonjezera mphamvu ya opaleshoni yolowa m'malo.
Ntchito zazikulu za misomali ya simenti ya mafupa ndi:
1. Kukonza fractures: Simenti ya mafupa ingagwiritsidwe ntchito kudzaza ndi kukonza malo ophwanyika.
2. Opaleshoni ya mafupa: Pa opaleshoni ya mafupa, simenti ya mafupa imagwiritsidwa ntchito kukonzanso ndi kumanganso malo olowa.
3. Kukonza zolakwika za mafupa: Simenti ya mafupa imatha kudzaza zofooka za mafupa ndikulimbikitsa kusinthika kwa mafupa.
Momwemo, simenti ya fupa iyenera kukhala ndi zizindikiro zotsatirazi: (1) jekeseni wokwanira, katundu wokonzedweratu, mgwirizano, ndi radiopacity kuti agwire bwino; (2) mphamvu zamakina zokwanira zolimbitsa nthawi yomweyo; (3) porosity yokwanira kulola kuyenda kwamadzimadzi, kusuntha kwa maselo, ndi kulowetsedwa kwa mafupa atsopano; (4) osteoconductivity wabwino ndi osteoinductivity kulimbikitsa mapangidwe mafupa atsopano; (5) biodegradability yapakati kuti ifanane ndi fupa la simenti ya fupa ndi mapangidwe atsopano a mafupa; ndi (6) kuthekera kopereka mankhwala moyenera.
M'zaka za m'ma 1970, simenti ya mafupa idagwiritsidwa ntchitopamodziprosthesis fixation, ndipo itha kugwiritsidwanso ntchito ngati kudzaza minofu ndi kukonza zida za mafupa ndi mano. Pakali pano, simenti ya mafupa yomwe imagwiritsidwa ntchito kwambiri komanso yofufuzidwa ndi polymethyl methacrylate (PMMA) bone simenti, calcium phosphate bone simenti ndi calcium sulfate bone simenti. Pakali pano, mitundu ya simenti ya mafupa yomwe imagwiritsidwa ntchito kwambiri ndi polymethyl methacrylate (PMMA) bone simenti, calcium phosphate bone simenti ndi calcium sulfate bone simenti, zomwe zimagwiritsidwa ntchito kwambiri ndi PMMA bone simenti ndi calcium phosphate bone simenti. Komabe, simenti ya mafupa a calcium sulphate imakhala ndi ntchito yolakwika yachilengedwe ndipo sangathe kupanga mgwirizano wamankhwala pakati pa calcium sulfate grafts ndi minofu ya mafupa, ndipo idzawonongeka mofulumira. Calcium sulphate mafupa simenti amatha kuyamwa kwathunthu mkati mwa masabata asanu ndi limodzi mutayikidwa m'thupi. Kuwonongeka kofulumira kumeneku sikukugwirizana ndi mapangidwe a mafupa. Choncho, poyerekezera ndi simenti ya mafupa a calcium phosphate, kakulidwe ndi kagwiritsidwe ntchito ka simenti ya mafupa a calcium sulphate ndi yochepa. PMMA bone simenti ndi acrylic polima wopangidwa ndi kusakaniza zigawo ziwiri: madzi methyl methacrylate monoma ndi dynamic methyl methacrylate-styrene copolymer. Zili ndi zotsalira zochepa za monomer, kukana kutopa pang'ono ndi kupsinjika maganizo, ndipo zimatha kuyambitsa mapangidwe atsopano a mafupa ndi kuchepetsa zochitika zowopsa zomwe zimachitika chifukwa cha kusweka kwamphamvu kwambiri komanso pulasitiki. Chigawo chachikulu cha ufa wake ndi polymethyl methacrylate kapena methyl methacrylate-styrene copolymer, ndipo chigawo chachikulu cha madzi ndi methyl methacrylate monoma.
Simenti ya mafupa ya PMMA imakhala ndi mphamvu zolimba kwambiri komanso pulasitiki, ndipo imalimba mofulumira, kotero odwala amatha kudzuka pabedi ndikuchita ntchito zokonzanso mwamsanga pambuyo pa opaleshoni. Ili ndi mawonekedwe abwino kwambiri apulasitiki, ndipo wogwiritsa ntchito amatha kupanga pulasitiki iliyonse simenti ya fupa isanalimba. Zinthuzi zimakhala ndi chitetezo chabwino, ndipo siziwonongeka kapena kutengeka ndi thupi la munthu pambuyo popanga thupi. Kapangidwe kakemidwe kamakhala kokhazikika, ndipo zida zamakina zimadziwika.
Komabe, imakhalabe ndi zovuta zina, monga nthawi zina kuchititsa kuthamanga kwambiri m'mafupa a m'mafupa panthawi yodzaza, zomwe zimapangitsa kuti madontho a mafuta alowe m'mitsempha yamagazi ndikuyambitsa embolism. Mosiyana ndi mafupa a anthu, mafupa ochita kupanga amatha kukhala omasuka pakapita nthawi. Ma monomers a PMMA amatulutsa kutentha panthawi ya polymerization, zomwe zingayambitse kuwonongeka kwa minofu kapena maselo ozungulira. Zida zomwe zimapanga simenti ya mafupa zimakhala ndi cytotoxicity, ndi zina zotero.
Zomwe zili mu simenti ya mafupa zimatha kuyambitsa kuyabwa, monga zidzolo, urticaria, dyspnea ndi zizindikiro zina, ndipo zikavuta kwambiri, kugwedezeka kwa anaphylactic kumatha kuchitika. Kuyezetsa ziwengo kuyenera kuchitidwa musanagwiritse ntchito kuti mupewe ziwengo. Zoyipa za simenti ya mafupa ndi monga fupa la simenti yosagwirizana ndi fupa, kutuluka kwa simenti ya mafupa, kumasula simenti ya mafupa ndi kusuntha. Kutayikira kwa simenti ya mafupa kumatha kuyambitsa kutupa kwa minofu ndi zochita zapoizoni, komanso kuwononga mitsempha ndi mitsempha yamagazi, zomwe zimayambitsa zovuta. Kukhazikika kwa simenti ya mafupa ndikodalirika ndipo kumatha kupitilira zaka khumi, kapena kupitilira zaka makumi awiri.
Opaleshoni ya simenti ya mafupa ndi opaleshoni yocheperako pang'ono, ndipo dzina lake lasayansi ndi vertebroplasty. Simenti ya mafupa ndi zinthu za polima zomwe zimakhala ndi madzi abwino zisanakhazikike. Iwo mosavuta kulowa vertebrae kudzera puncture singano, ndiyeno diffus pamodzi lotayirira mkati ming'alu ming'alu ya vertebrae; simenti ya fupa imalimba pafupifupi mphindi 10, kumamatira ming'alu ya mafupa, ndipo simenti yolimba ya fupa imatha kugwira ntchito yothandizira mkati mwa mafupa, kupanga vertebrae kukhala yolimba. Njira yonse yamankhwala imangotenga mphindi 20-30.
Pofuna kupewa kufalikira pambuyo pa jekeseni wa simenti ya mafupa, mtundu watsopano wa opaleshoni wapangidwa, womwe ndi chipangizo cha vertebroplasty. Amapanga kabowo kakang'ono pamsana wa wodwalayo ndipo amagwiritsa ntchito singano yapadera yoboola fupa la vertebral pakhungu pansi pa X-ray kuyang'anira kukhazikitsa njira yogwirira ntchito. Kenako baluni imayikidwa kuti ipange thupi lophwanyidwa losweka, ndiyeno simenti ya fupa imalowetsedwa mu vertebral thupi kuti libwezeretse mawonekedwe a vertebral yosweka. The cancellous fupa mu vertebral thupi ndi akaumbike ndi baluni kukulitsa kupanga chotchinga kuti fupa simenti kutayikira, pamene kuchepetsa kupanikizika pa fupa simenti jakisoni, potero kuchepetsa kwambiri fupa simenti kutayikira. Zingathe kuchepetsa mavuto okhudzana ndi kupumula kwa bedi, monga chibayo, zilonda zopanikizika, matenda a mkodzo, ndi zina zotero, ndikupewa matenda oopsa a osteoporosis chifukwa cha kuwonongeka kwa mafupa chifukwa cha kupuma kwa nthawi yaitali.
Ngati opaleshoni ya PKP yachitidwa, wodwalayo nthawi zambiri ayenera kupuma pabedi mkati mwa maola a 2 pambuyo pa opaleshoniyo, ndipo akhoza kutembenukira pa oxis. Panthawi imeneyi, ngati pali kumverera kwachilendo kapena ululu ukupitirirabe, dokotala ayenera kudziwitsidwa nthawi yake.
Zindikirani:
① Pewani kuzungulira kwakukulu m'chiuno ndi kupindika;
② Pewani kukhala kapena kuyimirira kwa nthawi yayitali;
③ Pewani kunyamula zolemera kapena kugwada kuti mutenge zinthu pansi;
④ Pewani kukhala pampando wotsika;
⑤ Pewani kugwa ndi kubwereza kwa fractures.
Nthawi yotumiza: Nov-25-2024
