Opaleshoni ulusi mutu, makulidwe, kukula

Aliyense pafupifupi njira munthu wina pa moyo wawo kamodzi anakumana anavulala kwambiri kapena ntchito. Nthawi zonse, kuwononga madokotala sutured kuti imathandizira lipole. Ulusi osiyana opaleshoni kwa ambiri?

Sakundithandiza stitches

mabala ndi zilonda, opaleshoni m'mimba, kuvulala ena - anthu ambiri mulimonse anakumana ndi chakuti tili ndi kusoka nsalu zawo zabwino ndipo mofulumira machiritso. Kwa nthawi yaitali vutoli, pamodzi ndi mpumulo ogwira ululu chinali chopunthwitsa chachikulu kwa pofuna kukwaniritsa opaleshoni.

M'mbiri yonse pakhala nthawi zingapo kudza ndi kuchepa kwa chilangocho. Mwachitsanzo, mu opareshoni wakale Rome anakumana chitukuko zachitika ndi aliyense sukulu gladiator anali dokotala amene ankachitira omenyana bala pambuyo zisudzo zinalephereka. Mu Middle Ages mankhwala kale lonse silinali kusangalala, ndi nzeru zonse zakale wawaiwala, ikhalenso mu Kubadwa Kwatsopano ndi masiku ano.

Never sipafunika mu kuchiritsa mabala, chifukwa m'mbiri yonse ya anthu nthawi zonse kuchitikira nkhondo, ndi yamtendere wosabala ulusi opaleshoni chakupulumutsa miyoyo yambiri. Kodi bwanji?

nkhani

Science ali ndi chiwerengero mokwanira lalikulu zikuonetsa kuti maopaleshoni oyamba, kuphatikizapo zovuta kwambiri, ikuchitika kale kubwera kwa zipangizo wapadera ndi nzeru zakuya za thunthu la munthu.

Woyamba zalembedwa ntchito suture inkachitika zaka 2000 pamaso yathu ino. Ntchito thonje ndi masingano mu machiritso a zilonda wakhala amafotokozedwa lonena Chinese mankhwala. Masiku amenewo, khungu stitched horsehair, sinew nyama, thonje CHIKWANGWANI, mitengo ndi zomera zina. Mu 175 BC, Galen anali anatchula catgut, womwe wapangidwa ndi minofu connective ziweto. M'zaka za m'ma XX, iye anali pafupifupi yekha suture. Komabe, mu 1924, iye anatulukira zakuthupi, amene anadzatchedwa nayiloni. Iye ankaona woyamba kupanga ulusi, oyenera stitching mabala. Patapita anaonekera poliyesitala ndi nayiloni, omwe pafupifupi nthawi yomweyo anayamba kugwiritsidwa ntchito mu opaleshoni. Pakati pa zaka za m'ma zimenezi, anatulukira polypropylene 70 - kupanga ulusi absorbable.

Pa nthawi yomweyo ngati zosiyanasiyana ulusi opaleshoni ndi singano chinakwera metamorphosis. Ngati adalibe wapadera sanali amasiyana alipidwa, iwo anali reusable ndi okha maganizo minofu, kenako iwo anagula masiku yokhota kumapeto mawonekedwe, akhala zobisika kwambiri ndi yosalala. Contemporary disposable masingano atraumatic padziko microroughness awo odzazidwa silikoni.

Modern suture

Opaleshoni ya atumwi XXI ntchito mwawo ochokera m'madera ndi katundu. Iwo akhoza kukhala zachilengedwe ndi kupanga. Palinso anthu kuti patapita nthawi ntchito pa cholinga chawo, pamene kuchotsa kufunika iwo. Mothandizidwa nthawi zambiri sutured ziwalo, pamene kwa kunja chizolowezi ingagwiritsidwe ntchito, zomwe chofunika kuchotsa ina. Chigamulo chomaliza atengedwa ndi dokotala, malingana ndi zinthu zosiyanasiyana, chikhalidwe cha chilonda ndi alili. Iye amayamikira kukula kwa sutures opaleshoni, kusankha makulidwe yoyenera kuthandiza minofu, koma osati kuwakhumudwitsa kamodzinso.

zofunika

Pali katundu amene ayenera amakono ulusi opaleshoni. amafuna suture Iwowa anakonza mu 1965. Komabe, iwo akugwirabe ntchito mpaka pano:

• Easy yolera yotseketsa;
• hypoallergenic;
• mtengo wotsika;
• inertness;
• mphamvu;
• kukaniza matenda;
• resorbability;
• amagwiritsidwa ntchito mwanjira kwa minofu uliwonse;
• kutakasuka, chomasuka dzanja, palibe filament chikumbukiro;
• kusowa kwa ntchito kompyuta;
• malo kudalirika.

Modern, masoka ndi kupanga suture mwanjira kukumana kwambiri mfundo zofunika zimenezi. Nthawi zambiri ndi mankhwalawa ngakhale mabala akuluakulu angathe kuchiritsidwa. Ndipo chifukwa cha opaleshoni izi bwinobwino kukhala kwa tsiku pamene ntchito ya akutsatiridwa onse pa mlingo yaying'ono, ndi mwai zovuta ziwalo ofunika kwambiri monga mtima ndi ubongo, ndipo odwala zambiri patangotha nthawi yochepa.

makulidwe

Kumene, kwa zaka zikwi zingapo, ulusi opaleshoni lasintha kwambiri ndi mafanizo simungathe kupita ndi zimene iwo anakakamizika ntchito pamene madokotala.

Masiku ano, madokotala ndi khamu lonse la suture zinthu zosiyana oyenera zosiyanasiyana zimakhala ndi thupi lonse. Ambiri zomveka kwa layman khalidwe ndi makulidwe a sutures opaleshoni. Zingamvekere mphamvu ndi china chotulutsa zoopsa ndi moyenera, chilonda machiritso nthawi.

Pali za makumi awiri m'magawo zosiyana okha makulidwe. Momwe mfundo za zimasiyana 0.01 kuti 0,9 millimeters. Choncho, choyamba kwambiri nkhani ya m'magawo awa n'kakang'ono kuposa tsitsi la munthu ndi za 8 nthawi!

mitundu

Poyamba kuonetsetsa mitundu iwiri ya suture:

• monofilament suture ulusi;
• multifilament, amene nawonso, akhoza anapotoza kapena kuluka.

Aliyense wa mitundu obadaet ubwino yekha, zovuta ndi peculiarities. Choncho, monofilament ubwino amenewa:

1. Kusalala. Malinga ndi kapangidwe ka mtundu uwu si zoopsa, kupewa magazi kwambiri.
2. Chomasuka mpheto. Monofilament kawirikawiri amagwiritsidwa ntchito chifukwa sutures intradermal, chifukwa zilibe kutsatira zimakhala ndi mosavuta anachotsa ngati n'koyenera.
3. Popeza mmene chingwe. zodabwitsazi kwagona kuti n'zoyenera lotayirira wa ulusi wina ndi mzake anapanga pakati pa yaying'ono-voids, amene anadzazidwa ndi nkhani za chilonda, kuwonjezera kutenga matenda. Pamene palibe choopsa monofilament.
4. Inertness. Monofilament ulusi ndi zochepa akutivutitsa kwa khungu, pamene akugwiritsa ntchito zochepa mwayi kutupa choipa.

Choncho monofilametny suture zakuthupi ndiponso ali choonekera sangathe. A mphamvu ochepa. Zimafunika yarns masiku ano zimene ayenera mlingo wa mfundo - iwo limakhumudwitsa minofu ndi machiritso pang'onopang'ono. Popeza monofilament ali yosalala pamwamba, kumalimbikitsa zomangamanga zovuta si zabwino kwambiri. Pamene ntchito mtundu wa chuma ndi kuti ntchito mfundo zambiri kuti china chotulutsa bwino zinthu.

Kuonjezera katundu wa filaments ndi TACHIMATA ndi nyimbo zosiyana kuti kuchepetsa kufala kwa matenda, kuwonjezera smoothness ndi biocompatibility. Komanso ntchito mosalekeza pa ulusi latsopano ndi zipangizo, kotero kuti opaleshoni si chilili.

Catgut ndi cellulosic zipangizo

Monga tanenera kale, ulusi opaleshoni, amene anachokera ku m'matumbo mawu ng'ombe, anakhala wa woyamba. Lero, sayansi ya ulimi wake zambiri wangwiro kwambiri kuposa kale, pali suture zakuthupi ndi chrome yokutidwa, kuwonjezera mphamvu ndi resorption nthawi.

Ichi ndi mtundu wotchuka wa ulusi, ngakhale kuti ntchito zina zofanana ndi chiwalo kupatsidwa zina ndi angayambitse yoyenera ayankhe m'thupi. Komabe catgut wangwiro, ngati msoko M'pofunika yaitali, chifukwa masiku 10, iye akhoza kuyimisa theka, ndi miyezi 2 ina inawonongedwa potsatira udindo wake.

Mapadi ulusi kupanga poliniti otchedwa oktselon ndi katselon. Iwonso m'kanthawi kochepa wa mayamwidwe, zomwe zimawachititsa singasiyanitsidwe mu urology, pulasitiki opaleshoni Dokotala. Komabe, iwo ndi mwayi zofunika - sanakukane ndi thupi ngati minofu yachilendo.

Otsala a absorbable

Other ulusi opaleshoni ali yaitali kuwonongedwa, amene lipindulitsa pa ambiri, thoracic ndi Oncology. Longest polidiaksanon watsimikiza - mu mofulumira yake amatenga miyezi 6-7.

Ubwino ulusi kupanga ndi amathandiza kuti mofulumira kwambiri ndi oyera bala machiritso, kuchepetsa chiopsezo cha matenda oyamba aliyense ndi inflammations. N'chifukwa chake kuchokera phasing kuchokera catgut, kupeza analogues otetezeka.

Silika ndi nayiloni

Awiri mitundu awa - sutures opaleshoni, absorbable kuyesedwa. Zochita izi zikutanthauza kuti kuchotsa awo m'thupi amatenga zaka zingapo. Silika kale kale muyeso wa golide, obaladaya amagwiritsidwa ntchito mwanjira mu ntchito. Komabe, chifukwa chakuti ulusi ake akuchokera achilengedwe, matabwa ndi ntchito zake zambiri chofuna ndipo amafunika chisamaliro kwambiri. Koma zotanuka kwambiri, cholimba ndi zofewa, ndipo izi yapindula chikondi cha Madokotala.

Nayiloni ulusi ndi zimayambitsa munthu amene yotupa. Komabe, kawirikawiri amagwiritsidwa ntchito chifukwa suturing ndi tendon ndi pochiza matenda a maso.

nonabsorbable

Opaleshoni ulusi umene uyenera ndiye amachotsedwa ndi dzanja, amasiyana zosiyanasiyana zokwanira. Ena katundu kwambiri mpheto, koma reactogenic. Other inert ndi wowona, koma kovuta ntchito ndipo ali ndi mphamvu otsika. Komabe, pafupifupi onse a iwo ankagwiritsa ntchito onse wamba mu opaleshoni apadera.

Kusiyanitsa magulu otsatirawa:

• Polyolefins - prolene, polypropylene. Ngakhale kuti mafupa amenewa pafupifupi konse suppurate, operability ndi osauka, ndipo ali zomangira zambiri mfundo.
• Polyesters - nayiloni ndi poliyesitala. Zimagwiritsa ntchito kuthandiza zimakhala sefani ndi ntchito endoscopic.
• Fluoropolymers. Gulu langwiro kwambiri - ndi katundu wabwino mpheto ndi mphamvu zokwanira. Izo sikutanthauza ambiri mfundo.

Zitsulo ndi titaniyamu

Mwina kuwoneka zachilendo, koma zitsulo akadali ntchito opaleshoni mu mawonekedwe a ulusi-ngati waya ndi bulaketi kwa makina wapadera. A drawback lalikulu - zoipa kuti zimakhala ozungulira. Komabe, zina mwa zamafupa ndi fupa opaleshoni m'malo zitsulo sungakhoze kukhala kanthu.

Kotero pali zosiyanasiyana kwambiri sutures. Iwo amagwiritsa ntchito zolinga zosiyana, ndipo n'kofunika, kodi ulusi pamapeto pake opaleshoni amusankha. dzina, ndithudi, palibe udindo, koma dokotala nthawi zonse amaganizira zifukwa zambiri posankha zabwino wodwalayo.