Orthopedic pob txha cement yog cov khoom siv kho mob dav siv hauv kev phais orthopedic. Nws yog tsuas yog siv los kho cov pob qij txha pob txha, sau cov pob txha tsis xws luag kab noj hniav, thiab muab kev txhawb nqa thiab kho hauv kev kho pob txha. Nws puv qhov sib txawv ntawm cov pob qij txha thiab cov pob txha pob txha, txo qhov hnav thiab cuam tshuam kev ntxhov siab, thiab txhim kho cov txiaj ntsig ntawm kev sib koom tes hloov pauv.
Cov kev siv tseem ceeb ntawm cov pob txha cement rau tes yog:
1. Kho cov pob txha tawg: Cov pob txha pob txha tuaj yeem siv los sau thiab kho qhov chaw tawg.
2. Kev phais orthopedic: Hauv kev phais orthopedic, pob txha cement yog siv los kho thiab rov tsim kho cov pob qij txha.
3. Kho pob txha tsis xws luag: Pob txha pob txha tuaj yeem ua rau cov pob txha tsis xws luag thiab txhawb cov pob txha rov tsim dua tshiab.
Qhov zoo tshaj plaws, cov pob txha pob txha yuav tsum muaj cov yam ntxwv hauv qab no: (1) kev txhaj tshuaj txaus, cov khoom siv tau zoo, kev sib koom ua ke, thiab cov xov tooj cua kom pom cov khoom zoo; (2) lub zog txhua yam tsim nyog rau kev txhawb nqa tam sim; (3) txaus porosity tso cai rau cov dej ntws, cell migration, thiab tshiab pob txha ingrowth; (4) zoo osteoconductivity thiab osteoinductivity los txhawb cov pob txha tshiab; (5) nruab nrab biodegradability kom phim cov resorption ntawm cov pob txha cement khoom nrog cov pob txha tshiab; thiab (6) muaj peev xwm xa tshuaj tau zoo.
Xyoo 1970s, pob txha cement tau siv rausib koomprosthesis fixation, thiab nws kuj tseem siv tau los ua cov ntaub so ntswg txhaws thiab kho cov ntaub ntawv hauv orthopedics thiab kho hniav. Tam sim no, feem ntau siv thiab tshawb fawb pob txha pob txha muaj xws li polymethyl methacrylate (PMMA) pob txha cement, calcium phosphate pob txha cement thiab calcium sulfate pob txha cement. Tam sim no, feem ntau siv pob txha cement ntau yam xws li polymethyl methacrylate (PMMA) pob txha cement, calcium phosphate pob txha cement thiab calcium sulfate pob txha cement, ntawm PMMA pob txha cement thiab calcium phosphate pob txha cement yog feem ntau siv. Txawm li cas los xij, calcium sulfate pob txha cement muaj kev ua haujlwm tsis zoo thiab tsis tuaj yeem tsim cov tshuaj lom neeg ntawm calcium sulfate grafts thiab pob txha cov ntaub so ntswg, thiab yuav degrade 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 degradation sai sai no tsis phim cov txheej txheem tsim cov pob txha. Yog li ntawd, piv nrog calcium phosphate pob txha cement, kev txhim kho thiab kev kho mob ntawm calcium sulfate pob txha cement kuj tsis tshua muaj. PMMA pob txha cement yog acrylic polymer tsim los ntawm kev sib xyaw ob yam: kua methyl methacrylate monomer thiab dynamic methyl methacrylate-styrene copolymer. Nws muaj qhov tsis tshua muaj monomer residue, tsis tshua muaj zog tiv thaiv thiab kev ntxhov siab tawg, thiab tuaj yeem tsim cov pob txha tshiab thiab txo qhov tshwm sim ntawm qhov tsis zoo tshwm sim los ntawm kev puas tsuaj nrog lub zog tensile thiab plasticity. Lub ntsiab ntawm nws cov hmoov yog polymethyl methacrylate los yog methyl methacrylate-styrene copolymer, thiab lub ntsiab ntawm cov kua yog methyl methacrylate monomer.
PMMA pob txha cement muaj zog tensile siab thiab yas, thiab solidifies sai, yog li cov neeg mob tuaj yeem tawm ntawm txaj thiab ua haujlwm kho mob thaum ntxov tom qab phais. Nws muaj cov zoo zoo plasticity, thiab tus neeg teb xov tooj tuaj yeem ua txhua yam plasticity ua ntej cov pob txha cement solidifies. Cov khoom muaj kev ruaj ntseg zoo, thiab nws tsis degraded los yog absorbed los ntawm tib neeg lub cev tom qab tsim nyob rau hauv lub cev. Cov qauv tshuaj yog qhov 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 zaus ua rau muaj kev kub ntxhov hauv cov pob txha kab noj hniav thaum lub sij hawm txhaws, ua rau cov roj tee nkag mus rau hauv cov hlab ntsha thiab ua rau embolism. Tsis zoo li tib neeg cov pob txha, cov pob qij txha tuaj yeem tseem xoob dhau sijhawm. PMMA monomers tso cua sov thaum lub sij hawm polymerization, uas yuav ua rau puas tsuaj rau cov ntaub so ntswg los yog hlwb. Cov ntaub ntawv uas tsim cov pob txha cement muaj qee yam cytotoxicity, thiab lwm yam.
Cov khoom xyaw hauv cov pob txha cement tuaj yeem ua rau muaj kev tsis haum tshuaj, xws li pob khaus, urticaria, dyspnea thiab lwm yam tsos mob, thiab thaum mob hnyav, anaphylactic shock yuav tshwm sim. Kev kuaj tsis haum yuav tsum tau ua ua ntej siv kom tsis txhob muaj kev fab tshuaj. Kev tsis zoo rau cov pob txha cement muaj xws li pob txha cement tsis haum, pob txha cement to, pob txha cement loosening thiab dislocation. Cov pob txha cement to yuav ua rau cov nqaij o thiab cov tshuaj lom, thiab tseem tuaj yeem ua rau cov hlab ntsha thiab cov hlab ntsha puas, ua rau muaj teeb meem. Cov pob txha cement fixation yog qhov txhim khu kev qha thiab tuaj yeem kav ntev tshaj kaum xyoo, lossis ntau tshaj nees nkaum xyoo.
Kev phais pob txha pob txha yog ib qho kev phais me me, thiab nws lub npe scientific yog vertebroplasty. Pob txha cement yog cov khoom siv polymer nrog zoo fluidity ua ntej solidification. Nws tuaj yeem nkag mus rau hauv cov pob txha tau yooj yim los ntawm cov koob txhaj tshuaj, thiab tom qab ntawd diffuse raws li xoob sab hauv pob txha tawg ntawm lub vertebrae; pob txha cement solidifies nyob rau hauv li 10 feeb, nplaum cov kab nrib pleb hauv cov pob txha, thiab cov pob txha tawv cement tuaj yeem ua lub luag haujlwm txhawb nqa hauv cov pob txha, ua rau cov vertebrae muaj zog. Tag nrho cov txheej txheem kho tsuas yog siv sijhawm 20-30 feeb.
Txhawm rau kom tsis txhob muaj kev sib kis tom qab kev txhaj tshuaj ntawm pob txha pob txha, ib hom tshiab ntawm cov cuab yeej phais tau tsim, uas yog cov cuab yeej vertebroplasty. Nws ua rau muaj kev phais me me ntawm tus neeg mob rov qab thiab siv tshwj xeeb lub hnab tawg kom ua rau daim tawv nqaij pob txha caj dab los ntawm cov duab xoo hluav taws xob. Tom qab ntawd lub zais pa yog muab tso rau hauv cov duab ntawm cov pob txha pob txha pob txha, thiab tom qab ntawd cov pob txha cement yog txhaj rau hauv lub cev vertebral kom rov zoo li qub ntawm lub cev pob txha pob txha. Cov pob txha tshem tawm hauv lub cev vertebral yog compacted los ntawm balloon expansion los tsim ib tug barrier los tiv thaiv cov pob txha cement to, thaum txo lub siab thaum lub sij hawm cov pob txha cement, yog li ntawd zoo heev txo cov pob txha cement to. Nws tuaj yeem txo qhov tshwm sim ntawm cov teeb meem cuam tshuam nrog kev puas tsuaj ntawm lub txaj so, xws li mob ntsws, mob siab, kab mob urinary, thiab lwm yam, thiab zam lub voj voog tsis zoo ntawm cov pob txha los ntawm cov pob txha poob vim kev pw tsaug zog ntev.
Yog tias kev phais PKP tau ua tiav, tus neeg mob feem ntau yuav tsum tau so hauv txaj tsis pub dhau 2 teev tom qab kev phais, thiab tuaj yeem tig rau ntawm lub axis. Thaum lub sijhawm no, yog tias muaj qhov txawv txav lossis qhov mob hnyav zuj zus ntxiv, tus kws kho mob yuav tsum tau ceeb toom rau lub sijhawm.
Nco tseg:
① zam lub duav loj tig thiab khoov cov dej num;
② Tsis txhob zaum lossis sawv ntev ntev;
③ Tsis txhob nqa qhov hnyav lossis khoov kom khaws cov khoom hauv av;
④ Tsis txhob zaum ntawm qhov quav;
⑤ Tiv thaiv kev ntog thiab rov ua dua ntawm pob txha.
Post lub sij hawm: Nov-25-2024
