Koj puas paub plaub txoj hauv kev kho suture rau Achilles tupture?
Achilles leeg tsis sib xws yog feem ntau tshwm sim los ntawm ib tug dheev tig nrog ko taw raws li qhov chaw, ua rau Achilles tuptify. Hom Achilles no puas ntsoog yog tshwm sim los ntawm kev kua muag, thiab qhov tsis zoo yog qhov tsis xwm yeem hauv lub ntsej muag ponytail. Lwm hom Achilles GRANCES mi txhob haus cawv yog qhov kev raug mob qhib los ntawm kev ua txhaum cai ncaj qha ntawm pob taws. Kaw cov kev raug mob qee zaum tsis pom los ntawm tus neeg mob lawv tus kheej thiab tau raug kho ua tim khawv rau ceg ceg, ua rau kev kho mob ncua. Tom qab kuaj xyuas Achilles muj siab, kev phais ua kom tiav yuav tsum tau ua.
Kev phais mob thiab suture tam sim no yog cov txheej txheem phais txha caj qaum rau kev kho ACHILLES Txawm li cas los xij, qhov xwm txheej ntawm cov teeb meem xws li kev raug mob, mob tsoo, thiab txawm tias Achilles To siab. Qhov ua raws li - nce cov txiaj ntsig ntawm percutaneous cheesture txoj kev rau kev ua phem, thiab qhov tseem ceeb tshaj plaws, qhov xwm txheej tsis tshua muaj kev cuam tshuam, nce kev kho mob.
Lub hauv paus kev kho mob ntawm seb puas yuav ua kev phais mob thiab cov suturing rau kom tiav rupture ntawm lub kaw mankilles tendon tau ib txwm muaj kev sib cav sib ceg. Qee cov kws tshawb fawb ntseeg tias kev kho cov qauv rau Achilles mi txhob siv dag yog caws tshuaj kho, thiab kev saib xyuas tau raug xaiv. Ntev npaum li cas raws li pob zeb sib koom ua ke yog nyob rau hauv kev phais mob pob zeb, lub sijhawm phais mob thaum nws thiaj li kho tau tus kab mob kev pheej hmoo; Lwm pab pawg ntawm cov kws tshawb fawb lees paub kev kho mob postoning ntawm kev phais mob ua kom muaj kev phais mob ntxiv rau tom qab kev phais mob ua rau muaj kev cuam tshuam rau kev ua haujlwm ntawm kev phais mob. Rau qhov kev rov ua kom muaj kev nplua nuj thiab kev phais mob, kev tshawb fawb tau tshaj tawm tias qhov xwm txheej tsis zoo yog 12.6% rau kev saib xyuas tau thiab tsuas yog 3.5% rau kev phais mob; Qhov tshwm sim ntawm tus hniav raug mob yog 4% rau kev phais mob thiab 0% rau kev saib xyuas kev kho mob. Tus nqi ntawm kev sib tw hauv kev sib tsoo tsawg kawg nkaus ntawm kev kho mob, uas yog kev kho mob me me, thaiv yog kev phais mob me me, uas yog kev hloov kho ntawm tus kab mob ib txwm, Suture kho txoj kev kho: (1) Cov neeg tsis sib xws tshiab, nrog qhov tsis sib xws feem ntau yog ntawm kev sib tw ntawm 3cm hauv kev tawm tsam ntawm qhov tsis sib xws ntawm qhov tsis sib xws ntawm qhov tsis sib xws ntawm qhov tsis sib xws ntawm qhov tsis sib xws ntawm qhov kev tawm tsam. Cov Achilles tupture xaus tau tuaj yeem sib cuag nrog txhua lwm yam thiab lub sutured cov kessler suture, xaus} Percutaneous cheem metion suturing kuj tseem tuaj yeem kho khov kho agilles greaton rupture.
(2) Kev raug mob sab nrauv, Achilles tsis muaj zog ntau tshaj 10 hnub, Achilles tendon kev cog lus feem ntau ncav cuag thiab necosis ntawm qhov tawg kawg. Cia siab ib sis ntawm pob taws cog qoob loo tsis tuaj yeem ua tiav {{5} {{7} {{} xaus kev sib chwv ntawm cov achilles tendon tawg kawg. Qhia Aplahas Vy suture kho.
(3) Kev raug mob qub, Achilles teepon rupture kav ntev dua 3 lub lis piam, thaum lub sij hawm twg taw tes tajliab feem ntau tshaj 6cm. Nws raug nquahu kom siv cov qauv Lindholm (Pasrotrocnius aponeurocnosis kev phais mob Yog tias nws pom thaum phais mob uas lub zog ntawm kev kho mob Achilles, siv cov kab mob luv luv, thiab cov khoom siv dag zog, thiab cov tshuaj tsw qab los ntawm kev hloov pauv ntawm cov hau kev.
(4) Kev ua kom raug mob los ntawm kev raug mob los ntawm kev ua phem feem ntau nrog cov tsis xws luag hauv cov pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha pob txha luj taws thiab tawv nqaij thiab tawv nqaij thiab tawv nqaij. Nws yog qhov nyuaj rau kev txhim kho omillesly tratonilles kev puas tsuaj los ntawm loosening hauv zos, nro txo, suturing, lossis cov tawv nqaij ua kom tawv nqaij ntsuab. Tam sim no, cov hauv qab no feem ntau siv: ① leeg transposition nrog cov leeg pedicle los kho Achilles kev puas tsuaj; ② Transposition ntawm vascularized ntaub so ntswg nrov plig plawg rau kev kho Achilles tendons; ③ Hloov pauv dawb ntawm cov ntaub so ntswg muag plawg nrog vascular anastomosis rau kev kho Achilles kev puas tsuaj.
Lub 2krackow suture kev kho mob yog tsim nyog rau mob Achilles mupture. Achilles mendon rupture yuav tsum tau ua ua ntej o tuaj yeem ua haujlwm tom qab ofinkles tshwm sim tom qab offised kab mob, tawv nqaij necrosis, thiab cov tshuaj nplaum ntawm Achilles Teg thiab tawv nqaij. [Txoj hauj lwm thiab kev ua yeeb yam] tus neeg mob yuav tsum nyob rau hauv ib qho kev ua yeeb yam tu ncua, nyob rau hauv cov tshuaj loog hauv cheeb tsam lossis kev sib tw ntawm cov tshuaj loog, nrog cov ncej puab loj los khi rau sab saud thiab nruab nrab. Cov tshuaj tua kab ntawm cov tawv nqaij ntawm cov ceg tawv uas cuam tshuam nrog cov ntaub ntawv iodine thiab ethanol, nteg daim ntaub tsis huv, thiab lo ua yeeb yam tsis huv. Tsav ntshav nrog kev sib tw. [Incision] Qhov kev phais ncua ntev yog ua rau sab hauv ntawm lub achilles tendon, muaj lub ntsiab lus los tiv thaiv kev sib txhuam ntawm cov tub rog ua haujlwm). Cov Achilles Tendon yog nthuav tawm los ntawm peb qhov kev teeb meem loj: The Erterior Midline Mus kom ze, txoj kev txuas ntxiv, thiab txoj hauv kev nruab nrab. Cov kab nruab nrab tau muab kev pom zoo dua ntawm cov achilles tendon, tab sis tom qab ntev}}}}}}} txaus luag hnav ntawm pob taws ntawm khau thiab ua rau mob. Ib qho ntxiv, lub suture qhib ntawm kev phais yog qhov kev kho siab tshaj plaws, uas cuam tshuam rau kev kho kom zoo ntawm kev phais thiab tuaj yeem ua rau Achilles Tulnos tsho; Cov kab ke txuas ntxiv tuaj yeem yooj yim ua rau cov pob taws ua kom yooj yim, ua rau tsis muaj teeb meem ntawm pob taws thiab ua rau cov hlab nqaij ntev ntawm cov tawv nqaij; Txoj kev sib tw ntev rau sab hauv ntawm cov Achilles clanton yog kev nyab xeeb, thiab txo tus nqi ntawm daim tawv nqaij cutaneous thiab txo tus nqi ntawm daim tawv nqaij ntawm daim tawv nqaij nqaij qaib thiab kev phais kab mob hauv lub posterior ncaj.
Txiav qhib daim tawv nqaij, subcutaneous ntaub so ntswg, thiab sib sib zog nqus cov nqaij mos rau cov tawv nqaij sib txawv thiab kho cov tawv nqaij kom zoo nkauj thiab kho kom zoo nkauj rau cov tawv nqaij uas tsis sib xws (daim duab 1a, b).
Daim duab 1: Krackow suture phais rau kev kho cov aighes millos tsis haum: phais.
Kev phais mob ntse yuav tsum tau ua rau qhov tob fascia (leeg leeg sab nraud sab nraud) kom tsis txhob muaj kev puas tsuaj ntawm cov khoom siv sib tw, yog li txo cov tawv nqaij necrosis, kab mob, thiab cov tshuaj nplaum ntawm qhov chaw phais; Tiv thaiv cov ntaub so ntswg peritendinous thiab tsis txhob ua kom muaj kev puas tsuaj ntawm vascular uas nkag mus rau hauv Achilles leeg los ntawm lub vias sab (daim duab 2).
Daim duab 2 qhov quav nplaim ib ncig ntawm Achilles Tendon A. Foral saib; B. Sab hauv Saib. [Suture] Siv lub suture tsis muaj . 2}}}} seeb augilles tev los yog 2-0 antosterial budis suture (daim duab 3c). Ntxiv dag zog rau lub pob caus ntawm lub pob caus thaum kawg, thiab sib quas suturing ntawm cov leeg sab nraud cov nqaij mos tuaj yeem tiv thaiv kev khaus. Tom qab kho, cov Achilles rau cov leeg thiab nruj, kom tsis txhob thaiv cov ntshav kom raug txiav tawm thiab cuam tshuam zoo; Suture cov ntaub so ntswg nyob ib ncig ntawm cov leeg thiab qhwv nws tag nrho ib ncig ntawm cov lws suav los txo cov achilles ntawm tus txiv neej (daim duab 3D); Tom qab phais tas, lub plaster tais yog tsau nyob rau hauv qhov kev hloov pauv thiab cog cog kom txo qis nro ntawm cov ntug dej nyab xeeb. Tawm ntawm qhov tsis zoo tso kua dej ntws tawm hauv qhov chaw, nrog txoj haujlwm siab thiab qhov deb kawg ntawm lub raj xa dej tso rau ntawm qhov txhab qis ntawm lub qhov txhab; Yog tias ib tug roj hmab sawb yog siv rau kev tso kua muag, qhov hluav taws xob yuav tsum nyob ntawm qhov qis tshaj plaws ntawm qhov dej ntws, rov qab mus rau qhov tsis zoo ntws tawm lub raj. Qhov tob tob tau kaw kom nruj, thiab txoj kev zoo yog los khi nws ib rab koob nyob rau hauv ib lub sij hawm "8" cov duab tsis tau knoting. Tom qab ua tiav suturing, lub tob fascia yog uniformly knotted thiab kaw, thaum lub pob caus ntawd sab laug hauv qab (daim duab 3e); Tawm ntawm suture ob lub pob zeb tob thaum subcutane nqaij suturing; Tawm ntawm suture ob lub pob zeb tob thaum subcutane nqaij suturing; Sutrure daim tawv nqaij kom ntseeg tau tias qhov kaw ntom nti ntawm kev phais.
Daim duab 3: Krackow suture thiab phais mob ntawm agute agilles leeg tupture: suturing thiab txhim kho. [Txhim kho] ceg ntev nrum lossis kev zawm hniav (daim duab thib 1} Cov xwm txheej) {{{{{{{} ecutally percutaneous cheem metonilles tupture, tab sis lub suturing yuav ua rau kev puas tsuaj rau cov hlab sural. Kev txhim kho thev naus laus zis tuaj yeem pab txo cov kev ua kom zoo no. Nyob rau xyoo 1977, Dr. Ma & Graphtith xub siv thiab tshaj tawm cov qauv no, tab sis tus nqi sib npaug Yog li qee cov kws kho mob tau tsim cov kev ntsuas cov khoom siv kev phais, thiab lwm yam los ntawm kev siv kev pheej hmoo ntawm kev raug mob ntawm kev raug mob rau cov hlab ntsha sural. Cov cuab yeej cog lus tshaj plaws ntawm lawv
Nws yog Achillon Achilles tooton stapler, uas siv ib "lub thawv" suture txoj kev. Hauv kev tshawb nrhiav hauv tsev kho mob, peb tau pom tias lub suture yog nquag los txiav cov achilles tendon, thiab muaj kev ua xyem xyav txog cov neeg kho mob muaj zog ntawm cov suture thaum ntxov; Qhov kev tshawb fawb kawg qhia tau tias nws tsis tuaj yeem muab cov tshuaj kho kom zoo, tsuas yog 1/10 ntawm krackow kev txhim kho thiab kev tiv thaiv nrog plaster lossis kev sib tw yog qhov tsim nyog; Ib qho ntxiv, kev tshawb fawb ntawm CadaGer cov txheej txheem tau pom tias qhov kev pheej hmoo ntawm kev raug mob siab heev, nrog kev raug mob siab ntawm 25.6% rau kev raug mob siab thiab kev raug mob ntawm cov hlab ntsha raug mob. Xyoo 2007, Tuam Tshoj qhia tus chillon stapler. Txawm li cas los xij, vim nws tsis txaus ntseeg suturing thiab kev puas tsuaj rau lub plab zom mov, nws tsis tau tshaj tawm dav dav thiab tau raug tso tseg rau hauv chaw kho mob. Txawm li cas los xij, qee qhov ntawm nws cov ntsiab lus tau muab cov tswv yim tshiab rau peb cov kev tshawb fawb ntawm percutaneous cheem cov thev naus laus zis rau Achilles Tulon.
1. Kev tsim kho thiab tsim cov channel tau pab cov suturing system thiaj li yuav zam rau cov kev puas tsuaj iatrogenic rau lub zog ntawm suturing, Chen Hua li al. Tsim thiab tsim cov channel pab me me loveb feem ntau leeg tuturing system (camir) raws li kev txhim kho bunnel suture txoj kev. Xyoo 2015, nws tau tso cai rau lub teb chaws tsim muaj cov ntaub ntawv Patent, thiab qee cov ntaub ntawv tau lees paub tias cov txheej txheem suturing txo qis thiab qhov txhab mob. Txoj kev no (Daim Duab 4) ua tiav percutaneous percutaneous portasive suturing ntawm Achilles tendon los ntawm tsib cov tswv yim loj, uas tuaj yeem zam kev puas tsuaj iatrogenic kev puas tsuaj rau lub suab quaj qw.
Daim duab 4: Kev tsim qauv tsim ntawm Achilles Tendon channel pab cov suturing system (camir) siv A. Prote software; B. Lub cev daim duab. 1. Tshwj xeeb tsim tsa cov tawv nqaij, los ntawm daim tawv nqaij, afcutaneous ntaub so ntswg, Achilles tendon sheath, nrog lub suab quaj nrov nyob sab nraud cov channel; 2. Center thiab eccentric phau ntawv qhia kev qhia suture stitching kom tsis txhob muaj suture kev hla kev; 3. Qhov tshwj xeeb tsim trocar muaj lub tshuab hloov pauv nrog 30℃ntawm lub chansing fascia, cia cov channel thiab storilles tendon, zoo sib xws nrog xaws nrog xaws nrog xaws nrog xaws nrog xaws nrog xaws nrog xaws.
(1) Cov txheej txheem 1 ua rau cov neeg txheeb ze txav ntawm lub stapler thiab cov nqaij mos, tab tom ua thiab ua rau muaj kev npau taws ib txwm muaj
Cov Achilles Tendon txav los ntawm cov channel no los ua tiav cov nroj tsuag cog qoob loo thiab dorsiflexion ntawm pob luj pob sib koom tes. Daim tawv nqaij ntawm cov achilles tendon muaj qee qhov kev sib cav sib ceg, yog li kom ua tiav kev swb ntawm cov stapler thiab lub achilles tendon, lub siab ntev yuav tsum tau ua rau tob fascia. Sab ntawm cov tub ntxhais tshwj xeeb ntawm cov kab ke no muaj cov hniav hloov nrog lub kaum sab xis ntawm 30℃uas tuaj yeem txiav tom qab dhau los ntawm tob fascia.
(2) Technology 2: Tsim kom tsis txhob muaj kev puas tsuaj rau kev puas tsuaj rau qhov muag ntawm cov channel, thiab cov tawv nqaij sib cais tau muab tso rau ntawm cov nqaij tawv nqaij los ntawm qhov tob fascia, tshwj xeeb tshaj yog cov hlab ntsha sural; Tom qab ntawd ntxig qhov tshwj xeeb tsim cov ntaub ntawv tshwj xeeb, nkag mus rau qhov tob tob, thiab nkag rau hauv sheath ntawm achilles tendon; Ntxig tib txoj kev mus rau hauv contralateral channel; Kho cov kev txiav ntawm cov txaj ntawm kev sib tw ntawm Achilles cov leeg mus, thawb cov stapler thiab qis, thiab txiav 1cm sib sib zog nqus mus rau hauv lub fascia; Ntxig lub tes tsho raws txoj kev tseem ceeb thiab tsim kom muaj meture channel. (3) Cov thev naus laus zis los tiv thaiv hla kev txiav ntawm cov lus qhia txog kab kab sib kab thiab ua rau muaj kev sib cais tawg.
Daim duab 5: Bunnel Stitching Txoj Kev A. Classic Stitching Txoj Kev; B. Txhim kho lub bunnel xaws txoj kev. (4) Technique 4: Lub Suture Sab Hauv Lub Tawv Ob Leeg yog rub tawm los ntawm kev phais kab mob sab caj npab rub tawm lub soob ntawm cov leeg ntawm lub nroog ntawm lub cev. (5) Kev Kho Mob 5: Kev Txhim Kho Ntawm Achilles Ntawm ayute Achilles tupture siv chanupture siv suture txoj haujlwm (camir) [txoj hauj lwm thiab kev ua yeeb yam] tus neeg mob sab nrauv / lumbar plesxus block tshuaj loog. Ib qho kev sib tw yog khi rau sab saud thiab nruab nrab ntawm cov ceg tawv yog txhuav nrog kev tourniquet siab ntawm 320mMhg (1mmHG {{} kpa).
Tom qab kev ua kom tiav kev ua kom tiav, kev txhaj tshuaj ntawm 1g cefmetazole sodium yog tswj kom tiv thaiv tus kab mob. [Suture channel kev tsim] Ua ntej, kov lub xaib ntawm Achilles leeg nruj thiab ua kom muaj kev txwv ntev ntev rau kev coj ua ntawm Achilles tendon
1.5cm transverse phais. Txiav qhib daim tawv nqaij, subcutaneous ntaub so ntswg, thiab Achilles tendon cerist fasath los ua rau repupured kawg ntawm achilles tendon. Siv kocker foldps kom clamp qhov kawg ntawm Achill Achilles Tas, rub tawm cov caj npab, ntxig rau sab caj npab, tso cov camilles caj npab, thiab clamp lub Achilles. Raws sab hauv sab caj npab taw qhia lub qhov, ua rau 5 hli ntev catalps phais ntawm daim tawv nqaij. Siv hemostatic sib thawb kom thawb qhib cov hlab ntsha uas yuav tau khiav sab hauv qhov kev txiav txim siab (Daim duab 6A). Ntxig ib qho {{{{8} ated sab sab hniav taw qhia lub tsho (Daim duab 6B), Bluntly Tas nrho cov neeg ua haujlwm sab nraud Txiav lub ntsej muag txaus siab yog 1.0-1.5cm nrog sab hniav ntawm qhov kawg ntawm lub khob hliav qab. Tig lub tes tsho mus rau sab caj npab ntawm lub stapler raws tus taw qhia los ua kom tiav lub tsev kawm ntawv channel (Daim Duab 6D).
Daim duab 6: Camir Chinesally Explasive kho mob Achilles Greaton Rupture: Cov chaw tsim khoom.
Suture: xov lub rab koob raws lub hauv paus lossis eccentric kev txhim kho bunnel lub qhov kawg ntawm kev sib luag ntawm Achillal Achilles Tendon (Daim duab 7E). Rub tawm ntawm cov camir sab hauv sab hauv los ntawm kev phais thiab tawm ntawm lub suture (tsis muaj} Siv tib txoj kev, nkag siab qhov deb ntawm lub plab zom mov, zawm lub plab zom mov, khi lub pob caus ntawd, thiab ua kom tiav cov me nyuam me me ntawm Achilles Tendon (Daim Duab 7I). Siv 3-0 nqus tau weiqiao yim koob Kaw cov interision txheej los ntawm txheej txheej, thov nias cov ntaub qhwv elastic, thiab xoob lub tourniquet. Kev Tswj Xyuas Posterative thiab kev rov kho kom rov zoo dua yog tib yam li kev phais mob thiab kev kho kom haum.
Daim duab 7 Camir Chineserally tsis tshua muaj kev kho mob ntawm Achilles greaton rupture: suturing. Lub 4ABRAHAM V - y suture txoj kev yog tsim nyog rau kev kho subacute Achilles tupture. [Txoj hauj lwm thiab loog]
Tus neeg mob tau muab tso rau hauv txoj haujlwm nquag, nrog kev sib tw nrog tus ncej puab uas tau txuas nrog tus ncej puab. Ib txoj kev phais ncaj ntawm kwv yees li 15cm yog ua rau sab hauv ntawm cov Achilles cov kab txuas mus rau hauv nruab nrab, them nyiaj rau kev tiv thaiv cov hlab ntsha sural thiab superficial peroneal.
【Kev phais】 Txiav qhib lub achilles tendon aponurosis, tshawb xyuas qhov kawg ntawm kev raug mob thaum 30℃sib koom ua ke ntawm 20℃cog flexion. Yog tias qhov tsis xws li ntev yog 3 {{-} 6cm, ua Abraham V}} y Txujc 8). Ua ib qho kev ua kom tsis pub dhau "{{- Tus kab mob ntawm lub plab zom mov, thiab qhov ntev ntawm ob qho kev phais mob yuav tsum yog tsawg kawg yog 1.5 zaug ntev dua li qhov tsis xws luag. Sutrure: txiav qhib cov leeg cov caj npab thiab txav mus rau hauv qis kom tiav thaum kawg {13 {{16} {} {kawg anastomosis. Siv tsis . 2 suture los txhim kho lub kesser schilled ntawm Achilles sucilles "Vy" {17} {17} {17} {17} {17} {17}- lub qhov txhab. Kev kho mob tom qab thiab kev rov kho dua yog tib yam li kev kho mob.
Daim duab 8 Abraham V - y suture kho rau subacute a achilles tupture. Txoj kev Lindholm yog qhov tsim nyog rau kev kho Achilles matilles tupture. [Txoj hauj lwm thiab kis tau] tus neeg tus neeg mob dag thiab ua rau lub ntsej muag zoo nkauj arc {}} Daim incision los ntawm nruab nrab ntawm plab hlaub mus rau pob txha pob txha pob txha. Kev phais tob tob yog tsim nyob rau hauv nruab nrab kev coj ua kom ua rau lub auppured a achilles. Ntxuav, kho thiab suture lub tawg kawg
Ua ntej, ntxuav lub qhov txhab, kho qhov tawg, thiab siv cov tawv ncauj tawv nqaij rau matless steel xov rau cov sutmittent suture.
Tig lub plab zom mov thiab Achilles Tendon nrov plig plawg: Txiav lub hauv paus ntawm cov achilles tendon, tig mus rau ntawm achilles tendon, thiab suture rau ntawm achilles tendon, thiab suture ib qho kev sib tw, thiab suture lawv mus rau hauv achilles tendon. Suture cov npoo ntawm tev thiab tag nrho cov npog qhov chaw tawg ntawm cov achilles tendon los ntawm suturing ob leeg tonons ua ke. Thaum lub nro yog qhov sib txawv yog qhov sib txawv, cov flastrocnemi tendon nrov plig tuaj yeem ua rau muaj kev sib cav sib ceg nrog qhov kawg nkaus, thiab qhov kawg ntawm qhov kawg tuaj yeem txhawb nqa thiab sutured. Yog tias muaj tsob ntoo cog ntoo tam sim no, cov leeg no tuaj yeem siv rau kev txhawb zog. Suture qhov tsis xws luag ntawm lub aponurosis kaw qhov sib txawv sab laug los ntawm lub downward ntawm cov leeg hlua. Suture lub tendon sheath thiab puag ncig cov ntaub so ntswg thiab tawv nqaij (Daim duab 9).
Daim duab 9 Lindholm txoj kev los kho Achilles matilles matus. Tus kab mob kis tau tom qab mob hlwb yog 7.15% vim yog qhov chaw ntiav ntawm qhov chaw mos, uas yog them los ntawm tawv nqaij thiab nyias nyias subcutane nqaij. Nws raug nquahu kom tsis txhob ua ib qho kev phais kab mob sib deev ntawm cov npoo ntawm Achilles tendon thiab ua cov ntse
Ua tib zoo saib cov ntaub so ntswg nyob ib ncig ntawm Achilles tendon thiab ua kom huv si los ntshav ua ntej kaw qhov phais. Txawm li cas los xij, qhov xwm txheej ntawm kev raug mob qub yog qhov siab dua, ncav cuag 27. Muaj keeb kwm ntawm kev kaw kev kho mob ntawm Achilles Tendon chaw ua ntej kev phais; Nws muaj feem xyuam rau cov xwm txheej xws li ntau cov nro hauv lub nroog nruj thaum kaw qhov phais. Qhov kev txiav txim siab ntev ntawm sab hauv ntawm cov Achilles ua rau cov ntshav tawm tsam ntawm cov leeg, tab sis kuj tseem ua kev sib txhuam nyob hauv thaj chaw nrog cov kev ntxhov siab tshaj plaws.
Thaum phais mob, saib xyuas yuav tsum tau them rau: (1) Thaum lub sijhawm sib koom ua ke, nws yuav tsum tau ua kom muaj zog ntxiv, nws yuav tsum tau muab tshem tawm hauv pob luj taws. Thompson xeem yuav tsum tau ua rau ob sab, qhia tias qhov nruj me ntsis yog qhov tsim nyog). (2) Lub zog ntawm Achilles Tawb leeg leeg tuaj yeem tswj hwm tus pob taws sib koom tes hauv qhov chaw nruab nrab. (3) Cov Achilles caj npab yuav tsum raug kho kom tiav, thiab qhov tob tob yuav tsum muaj kev sib haum xeeb. Qhov tob tob muaj peev xwm tiv taus qhov nro ntawm cov lws meem txav mus rau ntawm daim tawv nqaij tawv nqaij thiab tso cai rau kev tsim cov tawv nqaij thiab muaj kev sib tw ntawm cov kab mob hnyuv siab rau ntawm daim tawv nqaij. (4) Tshwj tsis yog lub cev sheath tsis yog sutured txaus siab, sim tsis txhob cog hniav los tiv thaiv cov zaj duab xis kom tsis txhob muaj kev sib zog. (5) Postoperative pob taws pob qij txha cais cog cov nroj tsuag kom tsis txhob muaj kev sib zog hauv lub hauv zos; Siv cov kessler suture txoj kev, qhov tawg tag nrho cov Achilles Tendon yog anastomosed nyias kho los kho cov ntshav ncig sab hauv thiab sab nraud. Qhov tseem ceeb yog muab tso rau ntawm cov txheej txheem phais tas rau thaum lub ntsiab cai phais, nrog rau lub hauv paus ntawm kev tiv thaiv thiab kho cov ntshav ntawm qhov kawg li ntau tau. Qee qhov kev phais mob yog raws li hauv qab no: (1) Cov ntshav ntawm cov tub rog ua yeeb yam tsuas yog los ntawm caj dab plab, thiab cov ntaub so ntswg. Thaum ua ib qho kev phais ntawm sab hauv ntawm lub achilles tendon, daim tawv nqaij, thiab lawv yuav tsum tau rub tawm ntawm ob sab kom ua rau Achilles tendon. Kev noj tshuaj me yuav tsum tau zam kom txo qis kev puas tsuaj rau cov ntshav tawm ntawm lub cev tsis muaj kev tiv thaiv thiab rov qab ntau li ntau tau. (2) Muaj ib ntu semi- Cov cheeb tsam thaj tsam hauv 10-18mm ua rau lub achilles rau hauv lub achilles rau lub achilles rau 1 / 2-2 / 3 ntawm lub achilles tev. Yog li ntawd, kev phais yuav tsum txo qis haujlwm hauv thaj chaw no ntau li ntau tau. (3) Achilles ib txwm muaj cai suturing nrog silk xov tuaj yeem yooj yim ua rau cov ntaub so ntswg thiab cov nplaum; Txawm hais tias cov hlau xaim hlau muaj lub teeb pom kev sib tw thiab lub zog siab tensile, nws yooj yim rau kev txiav caj dab thiab yuav tsum tau tshem tawm theem nrab. Qhia kesser suture nrog No.2 polyester suture, ces interon pawg nrog 3-0 polysaccharide 910 yim koob
Nws; Smascia thiab Achilles Toon Ntau li ntau tau, thiab kho qhov tob tob ncig ntawm Achilles tendon ntau li ntau tau los txo cov adhesterative adhesions.
(4) Ua kom huv si tshem tawm cov ischemic necrotic mos luam yeeb ntawm cov Achilles Tendon Stump ntawm lub stump ntawm lub stump ntawm lub stump ntawm lub stump rau cov laus raug mob. Yaug qhov kev phais mob nrog cov roj salineological ua ntej txiav cov pa roj plab ua ntej nrov plig plawg.
(5) Kev nro kev hloov kho thaum ua npuas kom zoo tshaj plaws yog qhov tseem ceeb tshaj plaws hauv Achilles kev phais mob. Lub nro thaum Achilles Tendon anastomosis yuav tsum zoo ib yam li ntawm tus meralatal Achilles txiv neej. Ntau dhau ntawm cov nro yuav ua rau muaj kev nyuaj rau dorsiflexion ntawm lub pob zeb sib koom ua ke, thaum tsis txaus ntseeg tuaj yeem ua rau muaj cov nyiaj tsis txaus ntseeg. Peb cov lus qhia yog txhawm rau kuaj cov nras ntawm kev noj qab haus huv (hauv caug, thiab ua ntej kev phais mob siab dua 30 degree
(6) Lub sijhawm kev phais mob feem ntau ntau dua 3 lub lis piam tom qab tawg, ua rau poob ntawm caj dab Muaj cov lus qhia kev tshawb fawb tias cov neeg mob uas nkag siab txog kev phais mob ntxiv, thaum cov uas tau txais kev phais mob rau ib lub lim tiam tsuas yog 74% ntawm kev noj qab haus huv. Peb qhov kev pom zoo yog tias kev kuaj mob yog qhov tseeb, yuav tsum muaj kev txhim kho ntxiv thiab phais yuav tsum ua sai li sai tau.
Siv: [1] ortopedic suture tutorial / Edited los ntawm Tang Peifu, Gao. -} yuan, Yizhu, Zhang Liai, Tang PEATURING ntawm kev kho cov nyhuv ntawm kev kho mob hnyav Cov phau ntawv xov xwm Suav ntawm kev phais kev phais, 2015, 29 (1): 35-38. [3] Yang ying, cheng Anyuan, Xu Li, Song Qi Kev Tshawb Xyuas ntawm kev ua haujlwm tsawg tsawg nrog cov chinese kaw atsilles miurning [j]. Cov Ntaub Ntawv Suav ntawm Pob Txha thiab Sib Koom Tes, 2020, 35 (6): 647-649
