Arthrocentesis inogona kubatsira kutsvaga kupisa uye kusina kuvhiringidza arthritis
Arthrocentesis, iyo inonziwo sekubatanidzwa, ndiyo nzira iyo mvura inoshandiswa ichibva kune imwe sangano uchishandisa nete nesirinhe. Mvura inotumirwa inotumirwa ku laboratori yekubatanidza kushandiswa kwemvura .
Zviratidzo
Arthrocentesis inonyanya kushandiswa kugadzirisa chikonzero chekubatana kwekubatana . Kubvisa mashizha emvura kune zvinangwa zviviri, kurapa uyewo chinangwa chokuongororwa.
Kubviswa kwejoka remvura kunogonawo kugadzirisa marwadzo uye kumanikidzirwa pamubatanidzwa. Sezvo rutivi rwebatsiro rwemaitiro acho, mushure mekunge masanganisi emvura ari kubviswa, corticosteroid inogona kuiswa mujoinzana uchishandisa nzvimbo imwe yejojo ​​yakashandiswa kuita arthrocentesis. Inoshanda uye inowanzo "inouraya shiri mbiri nedombo rimwe."
Kuedzwa
Mu laboratori, kubatana kwemvura kunongororwa nokuda kwe:
- Kuonekwa: Mvura inotaridzika inoonekwa nemeso evanhu nokuda kwemavara uye kujekesa. Chirongwa chemazuva ose chinosvibisa (chinokonzera) uye chinoratidzika chakajeka kuti chichena. Kutonhora kusanganiswa kwemvura kunenge kusina kuchena uye kunofadza kwekuputika kana utachiona. Dambudziko rekubatana kwemvura rinowanzosakisa uye rinogona kukonzerwa nekushungurudzika kune chekubatana.
- Kubvunzurudza kwakanyanya: Inonzi fluid iri kuongororwa pasi microscope yekuvapo kwemasero eropa, makristst, uye mabhakitiriya. Kazhinji masangano emvura ari asina kana masero mashoma eropa. Nhamba huru dzemasero matsvuku eropa zvinoratidza kubuda ropa mubatanidzwa. Nhamba huru dzemasero machena anogona kuitika nehutachiona, kuputika arthritis , gout, kana pseudogout. Kana masero matsvuku eropa kana masero eropa eropa achicherechedzwa, nhamba yesero inogona kuitwa. Mvere dzisina kukwana mujoka mvura. Uric acid makristasi anoratidza gout; CPPD makristasi anoitika nepseudogout. Mabhakitiriya ari pamwe chete mumvura yakasanganiswawo uyewo asina kuratidza uye anoratidza zvirwere.
- Kuongorora kemikirini: Inonzi fluid fluid inoedzwa glucose, protein, uye lactic dehydrogenase (LDH). Abnormal joint fluid zvibereko zvinogona kuratidza kuvhiringidza kana utachiona ndezvekuti: Glucose - pasi pe 40 mg / dl; Protein - yakakura kudarika kana yakaenzana ne 3 g / dl; LDH - mukuru kune 333 IU / L.
- Zvimwe zvinoongorora: Joint fluid inowanikwa mumutambo wekuedza pashure peawa imwe yekugadzirwa kwe fibrin clot (fibrin inonzi protein inowanikwa panguva yakatarwa ropa rinoputika). Chero chipfeko chinoratidza kuti pane dambudziko ne synovial membrane. Chimwe chiedzo chinonzi mucin clot test (acetic acid inowanikwa ku synovial fluid ) inofungidzira kugadzirwa kwe hyaluronate (chikamu cheduti ).
Mamiriro ezvinhu
Arthrocentesis inoratidza chikonzero chekubatana pamwe chete uye kupfugama uye zvichienderana nemigumisiro yekuongororwa kwemasanganisi emvura, zvinotevera zvinogona kufungidzirwa:
- septic arthritis , kunyanya kwete gonococcal bacterial arthritis
- zvimwe zvirwere zvinokonzerwa nehutachiona zvakadai segonococcal infections, tuberculosis, fungal zvirwere, chirwere cheLyme
- kristal arthropathies, gout, uye pseudogout
- rheumatic disorders
- osteoarthritis
- dambudziko
- hemarthrosis (kubuda mujoka nzvimbo)
Osteoarthritis
Muchidimbu chekutsvaga kwemvura, sero count uye kusiyanisa kuverenga vanosiyanisa pakati pekusavhiringidza uye kuvhiringidza. Kutadza kusina kuvhiringidzika kunofananidzira hutachiona hwehutano kana hutsinye. Kuvhiringidza kunogonawo kuva septic arthritis kana chirwere chinonzi crystal-induced arthritis.
Chibatanidza chemajeri chema cell count uye kusiyana kwechiverengero icho chinoratidzira osteoarthritis chinoratidzika seizvi:
- Kuonekwa: Kuchenesa mvura yakasviba, yakanyanya kutaridzika, uye mucin wakanaka
- Mhristal: Basic calcium phosphate (BCP) makristasi, Apatite makristasi
- White Blood Cell Count (WBC): Haisi-kupisa mvura: 200-2000 WBC / mm3; Nhamba yeWBC kazhinji inopfuura masero mazana mashanu (kunyanya mononuclear, imwe rudzi rwechichena chemukati ropa)
Sezvo mabheji ari pamwe chete ndiyo synovial cavity yakakura (pamwe chete nzvimbo) mumuviri, inzvimbo inogona kunge yakakosha yakawanda uye nzvimbo yakawanda yeArthrocentesis.
Kubva pamubatanidzwa wechipfuva wakaderedzwa uye kuongororwa, ruzivo rwakakosha ruzivo runogona kuunganidzwa.
Sources:
Arthrocentesis of the Knee. Thomsen TW et al. The New England Journal of Medicine. May 11, 2006.
Synovial Fluid Analysis. p. 40-143. Primer paRheumatic Diseases. Mharidzo 12. Arthritis Foundation.