Orthopedic bone simenti chinhu chekurapa chinoshandiswa zvakanyanya mukuvhiya kwemapfupa. Inonyanya kushandiswa kugadzirisa artificial joint prostheses, kuzadza bone defect cavities, uye kupa tsigiro nekugadzirisa mukurapa kwekutyoka. Inozadza mukaha pakati pemajoini ekugadzira uye mapfupa enyama, inoderedza kupfeka uye inoparadzira kushushikana, uye inosimudzira mhedzisiro yekuvhiya majoini.
Izvo zvakanyanya kushandiswa kwebhonzo simende zvipikiri ndezvi:
1. Kugadzirisa kuputsika: Bone simenti inogona kushandiswa kuzadza nekugadzirisa nzvimbo dzakaputsika.
2. Kuvhiyiwa kwemapfupa: Mukuvhiyiwa kwemapfupa, simiti yepfupa inoshandiswa kugadzirisa nekugadzirisa zvakare nzvimbo dzakabatana.
3. Bone defect kugadziriswa: Bone simenti inogona kuzadza kukanganisa kwemapfupa uye kukurudzira kuvandudzwa kwemapfupa emapfupa.
Nenzira yakanaka, simiti yepfupa inofanira kuva nemaitiro anotevera: (1) injectability yakakwana, programmable properties, kuwirirana, uye radiopacity yehutano hwakanaka hwekubata zvinhu; (2) simba rakakwana remagetsi rekusimbisa pakarepo; (3) porosity yakakwana yekubvumira kutenderera kwemvura, kutama kwesero, uye kutsva kwebhonzo; (4) yakanaka osteoconductivity uye osteoinductivity kukurudzira kuumbwa kwemapfupa matsva; (5) kuenzanisa biodegradability kuti ienderane resorption yebhonzo sement zvinhu nekugadzirwa kwemapfupa matsva; uye (6) kugona kuburitsa zvinodhaka.
Mumakore ekuma1970, simende yebhonzo yakanga yashandiswajointprosthesis fixation, uye inogona zvakare kushandiswa sekuzadza matishu uye kugadzirisa zvinhu mu orthopedics uye mazino. Parizvino, anonyanya kushandiswa uye akatsvakurudzwa masamende emapfupa anosanganisira polymethyl methacrylate (PMMA) bone simenti, calcium phosphate bone simenti uye calcium sulfate bone simende. Parizvino, iyo inowanzo shandiswa bone simende marudzi anosanganisira polymethyl methacrylate (PMMA) bone simenti, calcium phosphate bone simenti uye calcium sulfate bone simenti, pakati payo PMMA bone simende uye calcium phosphate bone simenti ndiyo inonyanya kushandiswa. Zvisinei, calcium sulfate bone simenti ine hurombo hwehupenyu uye haigoni kuumba zvisungo zvemakemikari pakati pe calcium sulfate grafts uye bone tissue, uye inoderedza nokukurumidza. Calcium sulfate bone simenti inogona kunyura mukati memavhiki matanhatu mushure mekuiswa mumuviri. Izvi zvinokurumidza kuparara hazvifananidzi maitiro ekugadzira mapfupa. Nokudaro, kana zvichienzaniswa ne calcium phosphate bone simenti, kukura uye kushandiswa kwekliniki ye calcium sulfate bone simenti ishoma. PMMA bone simende is an acrylic polymer yakaumbwa nekusanganisa zvinhu zviviri: liquid methyl methacrylate monomer uye dynamic methyl methacrylate-styrene copolymer. Iyo ine yakaderera monomer yakasara, yakaderera kuneta kuramba uye kunetseka kutsemuka, uye inogona kukonzeresa kuumbwa kwemapfupa matsva uye kuderedza chiitiko chekukanganisa kunokonzerwa nekutyoka ine yakanyanya kusimba simba uye plastiki. Chinhu chikuru chehupfu hwayo ndeye polymethyl methacrylate kana methyl methacrylate-styrene copolymer, uye chikamu chikuru chemvura ndeye methyl methacrylate monomer.
PMMA bone simenti ine simba rakanyanya kusimba uye plastiki, uye inosimbisa nekukurumidza, saka varwere vanogona kubva pamubhedha uye kuita mabasa ekugadzirisa mushure mekuvhiyiwa. Iyo ine yakanakisa chimiro chepurasitiki, uye anoshanda anogona kuita chero purasitiki isati pfupa simende yaoma. Izvo zvinhu zvine kuita kwakanaka kwekuchengetedza, uye hazvina kuderedzwa kana kutorwa nemuviri wemunhu mushure mekuumba mumuviri. Chimiro chemakemikari chakagadzikana, uye michina yemagetsi inozivikanwa.
Nekudaro, ichine zvimwe zvipingamupinyi, sekuti pane dzimwe nguva kukonzeresa kukwirisa mumapfupa emapfupa panguva yekuzadza, zvichiita kuti madonhwe emafuta apinde mutsinga dzeropa uye kukonzera embolism. Kusiyana nemapfupa evanhu, majoini ekugadzira anogona kuramba akasununguka nekufamba kwenguva. PMMA monomers inoburitsa kupisa panguva yepolymerization, izvo zvinogona kukonzera kukuvadza kune akatenderedza tishu kana masero. Izvo zvinhu zvinogadzira simende yebhonzo zvine imwe cytotoxicity, nezvimwe.
Izvo zvinoshandiswa mumapfupa simenti zvinogona kukonzera kusawirirana, zvakadai sekuputika, urticaria, dyspnea nezvimwe zviratidzo, uye mumatambudziko akaoma, anaphylactic shock inogona kuitika. Kuongororwa kweAllergy kunofanirwa kuitwa kusati kwashandiswa kudzivirira kusawirirana. Mabatiro akashata kubhonzo simende anosanganisira bone sement allergic reaction, bone simende leakage, bone simende kusunungura uye kutsemuka. Bone simende kuvuza kunogona kukonzera kuzvimba kwematishu uye kuita muchetura, uye inogona kutokuvadza tsinga netsinga, zvichitungamira kumatambudziko. Bone simenti fixation yakavimbika uye inogona kugara kweanopfuura makore gumi, kana kunyange anopfuura makore makumi maviri.
Bone simende kuvhiyiwa kunowanzo kuvhiyiwa zvishoma, uye zita rayo resainzi ndeye vertebroplasty. Bone simenti chinhu chepolymer chine mvura yakanaka isati yasimba. Inogona kupinda nyore nyore muvertebrae kuburikidza netsono yekubaya, uye yobva yapararira pamwe nekusadzika kwemukati kutsemuka kwakatsemuka kwevertebrae; pfupa simende inosimba muinenge maminitsi gumi, inonamira mitswe mumapfupa, uye simiti yakaoma yepfupa inogona kuita basa rinotsigira mukati memapfupa, zvichiita kuti vertebrae yakasimba. Iyo yose nzira yekurapa inongotora 20-30 maminitsi.
Kuti udzivise kupararira mushure mejojo yesamende yebhonzo, rudzi rutsva rwechigadzirwa chekuvhiya chakagadzirwa, icho chinonzi vertebroplasty device. Inoita diki diki kumusana wemurwere uye inoshandisa yakakosha kuboya tsono kubaya vertebral muviri kuburikidza neganda pasi peX-ray yekutarisa kumisikidza chiteshi chekushanda. Ipapo chibharumu chinopinzwa kuti chiumbe muviri wakatsikirirwa wakatyoka wevertebral, uyezve simende yebhonzo inobayiwa mumutumbi wevertebral kudzoreredza kutaridzika kwemuviri wakatyoka wevertebral. Iro pfupa rinokanzura mumuviri wevertebral rakaumbwa nekuwedzerwa kwebharumu kuita chipingamupinyi chekudzivirira bhonzo simende kubuda, uku ichideredza kudzvanywa panguva yejojo simende yebhonzo, nekudaro ichideredza zvakanyanya kudonha simende. Inogona kuderedza kuitika kwezvinetso zvine chokuita nekuzorora kwemubhedha wekuputsika, zvakadai semabayo, maronda ekumanikidzika, zvirwere zvehutachiwana, nezvimwewo, uye kudzivisa hutsinye hwehutachiona hunokonzerwa nekurasikirwa kwepfupa nekuda kwekuzorora kwenguva refu kwemubhedha.
Kana kuvhiyiwa kwePKP kuchiitwa, murwere anofanirwa kuzorora pamubhedha mukati meawa maviri mushure mekuvhiyiwa, uye anogona kutendeuka paaxis. Munguva iyi, kana pane kunzwa kusina kujairika kana kuti kurwadziwa kunoramba kuchiwedzera, chiremba anofanira kuziviswa munguva.
Cherechedza:
① Dzivisa kutenderera kwechiuno kwakakura uye zviitiko zvekukotama;
② Dzivisa kugara kana kumira kwenguva yakareba;
③ Rega kutakura uremu kana kukotama kuti unhonge zvinhu pasi;
④ Dzivisa kugara pachituru chakaderera;
⑤ Kudzivirira kudonha uye kudzokorora kwekuputsika.
Nguva yekutumira: Nov-25-2024
