Arthrocentesis ingathandize kuthandizira kutupa nyamakazi komanso kosakanikirana ndi nyamakazi
Arthrocentesis, yomwe imatchedwanso kuti aspiratory aspirations, ndiyo njira yomwe madzi amachotsedwa ku mgwirizano pogwiritsa ntchito singano ndi syringe. Madzi amadzimadzi amatumizidwa ku labotale kuti ayambe kufufuza .
Zisonyezo
Arthrocentesis amagwiritsidwa ntchito makamaka pofuna kukhazikitsa chifukwa cha kusokonezeka . Kutulutsa madzi olowa pamodzi ali ndi zolinga ziwiri, chithandizo komanso cholinga cha matenda.
Kutulutsidwa kwa madzi olowa pamodzi kungathandizenso kuchepetsa ndi kupanikizika pamodzi. Ngati phindu la njirayi, mutangotulutsa madzi olowa pamodzi, corticosteroid ikhoza kuikidwa muzowonongeka pogwiritsira ntchito malo omwe amagwiritsidwa ntchito popanga arthrocentesis. Ndizovuta komanso "zimapha mbalame ziwiri ndi mwala umodzi."
Kuyesedwa
Mu labotale, madzimadzi ophatikizana amadziwunikira:
- Kuwonekera: Madzi amadziwoneka ndi diso la munthu kuti apeze mtundu ndi kufotokoza. Mawonekedwe ophatikizana amadzimadzi amakhala okonzeka (okonzeka) ndipo amawonekeratu kuti akuwoneka achikasu. Mvula yamadzimadzi yowonongeka ndi yachilendo komanso yowononga kutupa kapena matenda. Madzi ophatikizana amagazi amakhalanso achilendo ndipo angayambidwe chifukwa cha kupweteka kwa mgwirizano.
- Kuyeza kwa microscopic: Madzi oundana amafufuzidwa pang'onopang'ono pogwiritsa ntchito microscope kukhalapo kwa maselo, mitsempha, ndi mabakiteriya. Madzi osakanikirana amodzi ali ndi maselo ochepa kapena ochepa. Maselo ofiira ambiri amagazi amasonyeza magazi m'magulu. Maselo oyera amagazi amatha kupezeka ndi matenda, nyamakazi yotupa , gout, kapena pseudogout. Ngati maselo ofiira kapena maselo oyera a m'magazi amawonedwa, chiwerengero cha maselo chikhoza kuchitidwa. Ng'ombe sizinali zachilendo mumadzimadzi. Uric acid amakristasi amasonyeza gout; Makandulo a CPPD amapezeka ndi pseudogout. Mabakiteriya mumadzimadzi ophatikizana amakhalanso osalongosoka komanso amasonyeza matenda.
- Kusanthula kwa mankhwala: Mankhwalawa amayesedwa ndi shuga, mapuloteni, ndi lactic dehydrogenase (LDH). Zotsatira zosakanikirana zamadzimadzi zomwe zingasonyeze kutupa kapena matenda ndi: Shuga - osakwana 40 mg / dl; Mapuloteni - aakulu kapena ofanana ndi 3 g / dl; LDH - oposa 333 IU / L.
- Zina zimafufuza: Madzi amadzimadzi amadziwika mkati mwa ola limodzi pambuyo pa ora limodzi kuti apangidwe ndi fibrin clot (fibrin ndi mapuloteni omwe amapangidwa nthawi zonse. Chovala chirichonse chimasonyeza kuti pali vuto ndi synovial membrane (mzere wa minofu yomwe imayika mgwirizano). Chiyeso china chotchedwa mucin clot test (acetic asidi akuwonjezeredwa ndi synovial madzi ) amalinganiza kupanga hyaluronate (gawo la kanyumba ).
Zinthu
Arthrocentesis amadziwitsanso chifukwa cha kugwiritsidwa ntchito pamodzi ndi kutukumula komanso chifukwa cha zotsatira zowonongeka kwa madzi, zifukwa zotsatirazi zikhoza kuyembekezera:
- Matenda a nyamakazi , makamaka a nyamakazi omwe si a gonococcal
- Matenda ena odwala matenda a gonococcal, chifuwa chachikulu, matenda opatsirana, matenda a Lyme
- khungu la kristalo, gout, ndi pseudogout
- vuto la rheumatic disorders
- osteoarthritis
- kusokonezeka
- hemarthrosis (kutuluka m'mphindi)
Osteoarthritis
Pogwiritsa ntchito madzi ophatikizana, kuchepetsa maselo ndi kusiyana kumasiyanitsa pakati pa zosautsa ndi zotupa. Zovuta zopanda kutupa zimapangitsa kuti thupi la osteoarthritis liwonongeke. Zomwe zimapweteketsa mtima zimatha kukhala nyamakazi yamtenda kapena nyamakazi.
Chiwerengero cha maselo ophatikizirana omwe amadziwika ndi osiyana ndi omwe amasonyeza osteoarthritis amawoneka ngati awa:
- Kuwonekera: Chotsani zamadzimadzi, mkulu wa viscosity, ndi mucin wabwino
- Makhiristo: Makristal a Basic calcium phosphate (BCP), makristati a Apatite
- Nkhumba Yachizungu ya Magazi (WBC): Osati yotupa madzi: 200-2000 WBC / mm3; Kuwerengera kwa WBC kaŵirikaŵiri maselo osakwana 500 (makamaka mononuclear, mtundu wina wa selo loyera la magazi)
Popeza bondo limodzi ndilo lalikulu kwambiri la synovial (malo ophatikizira) m'thupi, ndilo malo omwe amawoneka kuti ndi ofunika kwambiri komanso malo omwe anthu ambiri amagwiritsa ntchito.
Kuchokera kumadzimadzi ophatikizana omwe atsekedwa ndi kufufuza, mauthenga ofunikira ofunikira akhoza kusonkhanitsidwa.
Zotsatira:
Arthrocentesis ya Knee. Thomsen TW et al. The New England Journal of Medicine. May 11, 2006.
Synovial Fluid Analysis. p.140-143. Choyamba pa Rheumatic Diseases. Sukulu 12. Arthritis Foundation.