Cov pob txha orthopedic yog ib yam khoom siv kho mob uas siv dav hauv kev phais pob txha. Nws feem ntau yog siv los kho cov pob qij txha cuav, sau cov pob txha tsis zoo, thiab muab kev txhawb nqa thiab kev kho mob pob txha tawg. Nws sau qhov sib txawv ntawm cov pob qij txha cuav thiab cov pob txha, txo qhov hnav thiab tshem tawm kev ntxhov siab, thiab ua kom muaj txiaj ntsig zoo ntawm kev phais hloov pob qij txha.
Cov kev siv tseem ceeb ntawm cov ntsia hlau cement pob txha yog:
1. Kho cov pob txha tawg: Cov pob txha cement siv tau los sau thiab kho cov qhov chaw tawg.
2. Kev phais pob txha: Hauv kev phais pob txha, cov pob txha siv los kho thiab rov tsim cov pob qij txha.
3. Kho cov pob txha tsis zoo: Cov pob txha cement tuaj yeem sau cov pob txha tsis zoo thiab txhawb kev rov ua dua tshiab ntawm cov pob txha.
Qhov zoo tshaj plaws, cov pob txha cement yuav tsum muaj cov yam ntxwv hauv qab no: (1) kev txhaj tshuaj txaus, cov khoom programmable, cohesion, thiab radiopacity rau cov khoom tuav zoo tshaj plaws; (2) lub zog txaus rau kev txhawb nqa tam sim ntawd; (3) porosity txaus kom tso cai rau cov kua dej ncig, kev tsiv teb tsaws chaw ntawm tes, thiab kev loj hlob ntawm pob txha tshiab; (4) osteoconductivity zoo thiab osteoinductivity los txhawb kev tsim pob txha tshiab; (5) biodegradability nruab nrab kom phim qhov resorption ntawm cov khoom siv pob txha cement nrog kev tsim pob txha tshiab; thiab (6) muaj peev xwm xa tshuaj zoo.
Xyoo 1970, cov pob txha cement tau siv raupob qij txhaKev kho cov hniav cuav, thiab nws kuj siv tau ua cov khoom siv los sau thiab kho cov ntaub so ntswg hauv kev kho pob txha thiab kev kho hniav. Tam sim no, cov pob txha cement uas siv dav tshaj plaws thiab tshawb fawb suav nrog polymethyl methacrylate (PMMA) pob txha cement, calcium phosphate pob txha cement thiab calcium sulfate pob txha cement. Tam sim no, cov pob txha cement uas siv ntau tshaj plaws suav nrog polymethyl methacrylate (PMMA) pob txha cement, calcium phosphate pob txha cement thiab calcium sulfate pob txha cement, ntawm cov PMMA pob txha cement thiab calcium phosphate pob txha cement yog cov siv ntau tshaj plaws. Txawm li cas los xij, calcium sulfate pob txha cement muaj kev ua haujlwm tsis zoo thiab tsis tuaj yeem tsim cov tshuaj sib txuas ntawm calcium sulfate grafts thiab cov pob txha nqaij, thiab yuav lwj sai. Calcium sulfate pob txha cement tuaj yeem nqus tau tag nrho hauv rau lub lis piam tom qab cog rau hauv lub cev. Qhov kev lwj sai no tsis phim cov txheej txheem tsim pob txha. Yog li ntawd, piv nrog calcium phosphate pob txha cement, kev tsim kho thiab kev siv tshuaj ntawm calcium sulfate pob txha cement yog qhov tsawg heev. PMMA pob txha cement yog cov polymer acrylic tsim los ntawm kev sib xyaw ob yam khoom: kua methyl methacrylate monomer thiab dynamic methyl methacrylate-styrene copolymer. Nws muaj cov monomer residue tsawg, tsis tshua muaj kev qaug zog thiab kev ntxhov siab tawg, thiab tuaj yeem ua rau muaj pob txha tshiab thiab txo qhov tshwm sim ntawm cov kev tsis zoo los ntawm kev tawg nrog lub zog tensile siab heev thiab plasticity. Cov khoom tseem ceeb ntawm nws cov hmoov yog polymethyl methacrylate lossis methyl methacrylate-styrene copolymer, thiab cov khoom tseem ceeb ntawm cov kua yog methyl methacrylate monomer.
Cov pob txha PMMA muaj lub zog tensile siab thiab plasticity, thiab khov sai, yog li cov neeg mob tuaj yeem sawv ntawm txaj thiab ua cov haujlwm kho dua tshiab thaum ntxov tom qab phais. Nws muaj cov duab zoo heev, thiab tus neeg teb xov tooj tuaj yeem ua txhua yam plasticity ua ntej cov pob txha khov. Cov khoom siv muaj kev nyab xeeb zoo, thiab nws tsis raug rhuav tshem lossis nqus los ntawm lub cev tib neeg tom qab tsim hauv lub cev. Cov qauv tshuaj lom neeg ruaj khov, thiab cov khoom siv kho tshuab tau lees paub.
Txawm li cas los xij, nws tseem muaj qee qhov tsis zoo, xws li qee zaum ua rau muaj kev siab siab hauv cov pob txha thaum lub sijhawm sau, ua rau cov roj poob rau hauv cov hlab ntsha thiab ua rau embolism. Tsis zoo li cov pob txha tib neeg, cov pob qij txha cuav tseem yuav xoob dhau sijhawm. PMMA monomers tso tawm cua sov thaum lub sijhawm polymerization, uas yuav ua rau puas tsuaj rau cov ntaub so ntswg lossis cov hlwb nyob ib puag ncig. Cov ntaub ntawv uas ua rau cov pob txha cement muaj qee yam cytotoxicity, thiab lwm yam.
Cov khoom xyaw hauv cov pob txha cement yuav ua rau muaj kev tsis haum tshuaj, xws li pob khaus, urticaria, ua tsis taus pa thiab lwm yam tsos mob, thiab thaum muaj mob hnyav, yuav muaj kev poob siab anaphylactic. Yuav tsum tau kuaj kev tsis haum tshuaj ua ntej siv kom tsis txhob muaj kev tsis haum tshuaj. Cov kev tsis haum tshuaj rau cov pob txha cement suav nrog kev tsis haum tshuaj rau cov pob txha cement, pob txha cement xau, pob txha cement xoob thiab dislocation. Cov pob txha cement xau yuav ua rau cov nqaij mob o thiab cov tshuaj lom, thiab tej zaum yuav ua rau cov hlab ntsha thiab cov hlab ntsha puas tsuaj, ua rau muaj teeb meem. Kev kho pob txha cement yog qhov txhim khu kev qha thiab tuaj yeem kav ntev tshaj kaum xyoo, lossis ntau tshaj nees nkaum xyoo.
Kev phais pob txha cement yog ib qho kev phais mob uas tsis tas yuav phais ntau, thiab nws lub npe scientific yog vertebroplasty. Pob txha cement yog ib yam khoom polymer uas muaj dej zoo ua ntej khov. Nws tuaj yeem nkag mus rau hauv cov pob txha caj qaum tau yooj yim los ntawm rab koob puncture, thiab tom qab ntawd kis mus rau cov kab tawg sab hauv ntawm cov pob txha caj qaum; pob txha cement khov li ntawm 10 feeb, lo rau cov kab tawg hauv cov pob txha, thiab cov pob txha cement tawv tuaj yeem ua lub luag haujlwm txhawb nqa hauv cov pob txha, ua rau cov pob txha caj qaum muaj zog dua. Tag nrho cov txheej txheem kho mob tsuas yog siv sijhawm 20-30 feeb xwb.
Yuav kom tsis txhob muaj kev sib kis tom qab txhaj tshuaj pob txha, ib hom khoom siv phais tshiab tau tsim tawm, uas yog lub cuab yeej phais pob txha. Nws ua ib qho kev phais me me rau ntawm tus neeg mob nraub qaum thiab siv ib rab koob tshwj xeeb los txhaj lub cev pob txha hla daim tawv nqaij hauv qab kev saib xyuas X-ray kom tsim ib txoj kab ua haujlwm. Tom qab ntawd muab lub npas tso rau hauv kom ua rau lub cev pob txha tawg, thiab tom qab ntawd txhaj tshuaj pob txha rau hauv lub cev pob txha kom rov qab zoo li lub cev pob txha tawg. Cov pob txha cancellous hauv lub cev pob txha raug nias los ntawm lub npas nthuav dav los ua ib qho thaiv kom tiv thaiv kev xau pob txha, thaum txo qhov siab thaum txhaj tshuaj pob txha, yog li ntawd txo cov pob txha xau. Nws tuaj yeem txo qhov tshwm sim ntawm cov teeb meem ntsig txog kev tawg pob txha, xws li mob ntsws, mob siab, kab mob hauv txoj hnyuv, thiab lwm yam, thiab zam kev puas tsuaj ntawm pob txha tawg los ntawm kev poob pob txha vim kev pw tsaug zog ntev.
Yog tias phais PKP, tus neeg mob feem ntau yuav tsum tau so hauv txaj tsis pub dhau 2 teev tom qab phais, thiab tuaj yeem tig rov qab rau ntawm lub axis. Thaum lub sijhawm no, yog tias muaj kev xav tsis zoo lossis qhov mob txuas ntxiv zuj zus, yuav tsum qhia rau tus kws kho mob raws sijhawm.
Lus Cim:
① Tsis txhob tig lub duav thiab khoov ntau yam haujlwm;
② Tsis txhob zaum lossis sawv ntev ntev;
③ Tsis txhob nqa qhov hnyav lossis khoov mus khaws cov khoom hauv av;
④ Tsis txhob zaum saum lub rooj zaum qis;
⑤ Tiv thaiv kom tsis txhob ntog thiab rov qab muaj pob txha tawg.
Lub sijhawm tshaj tawm: Kaum Ib Hlis-25-2024
