Matenda a shuga a Osteoarthropathy

Matenda a diabetes a arthropathy ndi njira yamafupa komanso mafupa ndi zotupa zawo, zomwe zimakhala zovuta kwambiri kwa matenda ashuga. Ndi matendawa, njira zopewera pafupipafupi zimachitika, mafupa amapindika komanso kuwonongeka. Onse okalamba ndi achinyamata amatha kudwala.

Arthropathy imakula pafupifupi zaka 6 pambuyo pozindikira matenda a shuga. Makamaka ngati chithandizo chokwanira mwatsatanetsatane sichinachitike kapena mankhwalawo anali osakwanira. Zotsatira zazitali za matenda ashuga ndizosiyana kwambiri komanso zosachepera shuga. Mwachitsanzo, kuwonjezera pa arthropathy, polyneuropathy, angiopathy, encephalopathy, matenda ashuga a retinopathy, a nephropathy, ndi matenda ashuga nthawi zambiri.

Njira zomwe zimayambira matenda a shuga a arthropathy nthawi zambiri zimakhala zothandizirana, koma mafupa onse nthawi zina amakhudzidwa.

Zizindikiro ndi Zomwe Zimayambitsa

Zizindikiro zimawonetsedwa ndi kupweteka komanso kusasangalala m'malumikizidwe, makamaka bondo ndi phewa. Zimakhala zovuta kuti wodwalayo azungulire, kuuma molumikizana.

Matendawa nthawi zambiri amakhala ovuta. Matenda a 2 a shuga amayambitsa zizindikilo zotere. Ngakhale adakali aang'ono, pamaso pa matenda oopsa a shuga, munthu amatha kulemala, atalephera kugwira ntchito.

Zomwe zimayambitsa matenda a diabetes a arthropathy ndi matenda ashuga acidosis komanso kuchepa kwa mchere wamchere, polyneuropathy.

Majoyano otsatirawa amakhudzidwa koyamba:

• metatarsophalangeal
• bondo
• bondo
• pakapita nthawi - m'chiuno

Gawoli likuwonetsedwanso ndi kusintha kwakukuru kwa mahomoni m'thupi, chifukwa chake, sikuti ndi dokotala wa mafupa okha, komanso endocrinologist amatenganso mbali yofunika pa mankhwalawo.

Popeza kuti ndi maondo, maondo ndi ma metatarsophalangeal joints omwe amakhudzidwa malo oyamba kumalumikizidwa ndi katundu wawukulu kwambiri, mwachitsanzo, poyenda.

Zizindikiro za matendawa zitha kukhala motere:

• kuuma
• kutsika kwa matalikidwe oyenda,
• kutupa, kutupa, makamaka madzulo,
• kupweteka palpation,
• kuwonjezeka pang'ono kwa kutentha kwanuko.

Nthawi ya radiology, ma osteophytes am'mphepete komanso subchondral osteossteosis atha kupezeka mwa odwala.

Pali magawo anayi a matenda a shuga a arthropathy, aliwonse amadziwika ndi zomwe zikugwirizana.

• Gawo 1 - Pachimake. Pali kutupira kapena kutupira pang'ono kwa mapazi, nthawi zina khungu limafupika. Ululu pa palpation ndi pa kayendedwe palibe. Mukamawerengera pogwiritsa ntchito njira za x-ray, ndizotheka kudziwa zizindikiro zoyambirira za mafupa.
• Gawo 2 - Subacute. Kutupa ndi kutupa kuwonjezeka, ndikuyenda nthawi yayitali, ululu ulipo kale. Crunch nthawi zina imamveka kumaloko. Mu phunziroli - kuwoneka kwa kusintha pakusintha kwa phazi komanso mapangidwe oyamba a mafupa.
• Gawo lachitatu - Kusintha kwatsoka kwa mafupa kumachitika. Kusunthika kwa komwe kwakhudzidwa kwatayika. Zowawa zimatha kukhazikika, osangoyenda, komanso kupuma.
• Gawo 4 - Yovuta. Kuyenda pawokha sikosatheka. Pali zowawa zakuthwa pang'ono poyesera kuti mudzuke kapena kukhala pansi. Maonekedwe pafupipafupi a phazi la matenda ashuga. Pa kafukufukuyu, kuwonongeka kwa minofu yafupa kumadziwika.

Pamodzi ndi zizindikiro zazikulu, palinso zizindikiritso za urogenital: kupweteka kwam'mimba, khomo lachiberekero, kutuluka kwa magazi mkati mwa mankhwalawa ndikotheka mwa mkazi, ndipo mwaimuna mumakhala mawonekedwe amtundu wa prostatitis, kuyimitsidwa kukodza ntchito.

Mavuto

Zitha kukhala zosiyana. Chifukwa chake, chifukwa chakuti kuchuluka kochepetsera kayendedwe ndi kumva, kuvulala kosiyanasiyana ndikotheka. Nthawi zambiri izi ndizophatikiza ndi ma dislocation, micronaddies of ligaments, kuvulala kwa minofu ululu.

Matenda a mafupa amtunduwu amatsogolera ku chochitika chakuti mafupa amachitika pafupipafupi osati fupa. Kukakamizidwa kukakhala pampando kapena pakama kumapangitsa magazi kulowa m'magazi, komwe kumabweretsa zovuta zina: kulumpha mu kuthamanga kwa magazi, kupweteka kwa mtima, kupweteka mutu, kuchuluka kwa magazi, kutsekeka kwa dongosolo la kupuma, komanso kukula kwa polyneuropathy.

Zizindikiro

Kuzindikira kumakhazikitsidwa pa kuwunika kokwanira kwa chithunzi chonse cha matenda. Dokotala amatenga mbiri yonse ya wodwalayo, amamuyeza mayeso, amasankha akatswiri odziwa ntchito zingapo kuti adziwe momwe ubongo ungagwiritsire ntchito mphamvu za mtima, endocrine, mantha amthupi ndi mafupa.

Ma labotale ndi njira zodziwitsira matenda zimachitika, monga:

1. Ma X-ray amalo omwe anakhudzidwa m'magawo angapo (kuchuluka kwa minyewa yam'mafupa komanso kuchuluka kwa mineralization kumawululidwanso).
2. CT ndi MRI yamalumikizidwe (gawo lakuwonongeka kwa minofu ya mafupa, kusintha kosiyanasiyana mu minofu yofewa kumatsimikiziridwa).
3. Njira yapadera yomwe imakulolani kuti muzindikire molondola mawonekedwe a minofu yam'mafupa - Scintigraphy.
4. Kuyesedwa kwa magazi pafupipafupi (kudziwa mulingo wa leukocytes ndi ESR).
5. Kuyesa kwa magazi a biochemical (kudziwa zizindikiro za kutupa).
6. USDG yamitsempha yamagazi (posankha).
7. Kusintha kopanga.
8. Kuyesedwa kwa magazi kwa shuga.

Pakakhala zovuta, kuphatikiza mafupa nthawi zina kumachitika. Njira yodziwikirayi ndiyofunikanso kuti mutsimikizire za matendawa.

Chithandizo cha matenda ashuga Arthropathy

Popeza matenda ashuga a m'matumbo amtundu wamatenda a 2 shuga, chithandizo chachikulu chikuyenera kukonza matenda omwe amayambitsa matendawa. Pachifukwa ichi, adotolo amakupangira mankhwala apadera kuti achulukitse shuga. Nthawi zina, pamavuto akulu, chithandizo cha insulin ndi chofunikira.

Ndikulimbikitsidwanso chithandizo:

1. Kuphatikizika kwa mavitamini ndi michere (mavitamini a B ndizofunikira kwambiri, zomwe zimakhudzidwa ndikubwezeretsa komanso kufalitsa matenda a minyewa yamitsempha).
2. Mankhwala a Neurotrophic.
3. Cholinesterase Inhibitors
4. Kuvomerezeka kwa lipoic acid.
5. Kugwiritsa ntchito mankhwala a chondroprotective (mkati mwanjira ya makapisozi komanso mwanjira ya mafuta / ma gels).
6. Biophosphonates.
7. Mankhwala osapatsirana othana ndi zotupa (mu mawonekedwe a mapiritsi kapena jakisoni muzovuta).
8. Anabolic steroids (bwezeretsani mafupa).
9. Chithandizo cha physiotherapeutic (mwachitsanzo, magnetotherapy kapena electrophoresis ndi mankhwala apadera).
10. Zochita zolimbitsa thupi (m'magawo oyamba a matendawa).

Ndi kukula kwa njira zopatsirana, antibacterial wothandizira amalembedwa.

Mu gawo lotsatira la matenda ashuga arthropathy, chithandizo cha opaleshoni chimasonyezedwa.

Zithandizo za anthu

Amagwiritsidwa ntchito ngati zowonjezera ku chithandizo chachikulu komanso atakambirana ndi adokotala.

Tiyi yofunda ndi masamba a lilac, mabulosi abulu, currant, marigold ndi maluwa a chamomile, ma infusions ochokera dandelion posachedwa ndi othandiza.

Mutha kupanga ma compress otsatirawa: mutenge momwemo masamba a linden, lunguzi ndi calendula. Pogaya kapena kuwaza finely, sakanizani, onjezani 1 tsp. mafuta a maolivi ndi mafuta ochulukirapo am'nyanja. The osakaniza umagwiritsidwa ntchito olumala mafupa kwa theka la ora 2 pa tsiku. Chifukwa chake, kutupa kumatha, kupweteka kumachepetsa, ming'alu ndi mabala pakhungu limachiritsidwa.

Kuchiza moyenera nthawi yomweyo kumabweretsa zotsatira zabwino ndikuchotsa zovuta. Njira zapamwamba za matenda ashuga arthropathy zimayambitsa kulumala.

Kodi tsambalo linali lothandiza? Gawani patsamba lanu lochezera!

Kodi izi ndizowopsa bwanji?

Monga tanena kale, matenda ashuga a shuga ndi matenda oopsa, zomwe zikutanthauza kuti ndi owopsa. Matendawa amatha kutha kuwonongeratu mafupa omwe akhudzidwa kapena cholumikizira, komanso chifukwa chodwala kwamatenda am'mimba, zilonda zam'mimba ndi kutupa, ndikupanga matenda oyima pawokha:

• Osteomyelitis - kuwonongeka kwa mafupa.
• Mangochika - kwambiri purulent matenda kutupa kwa khungu ndi mucous nembanemba.
• Phlegmon - purulent kutupa kwa adipose minofu, kufalitsa thupi lonse.
• Gangrene - necrosis.

Mavuto aliwonse omwe atchulidwa pamwambapa sangathe kungotaya dzanja kapena cholumikizira, komanso ndiwakufa ndikusiya zovuta zazikulu kumbuyo.

Zizindikiro

Zizindikiro za matenda a shuga a osteoarthropathy zimadalira gawo lachitukuko cha matendawa:

Gawo lachinayi ndilosasinthika ndipo limatsogolera kulumala chifukwa chakulephera kuyendetsa pawokha.

Kupewa

Popewa kukula kwa matenda a diabetesic osteoarthropathy, odwala matenda ashuga ayenera kusamala kuwunika shuga ndipo potero amachedwetsa polyneuropathy motalika momwe mungathere kapena kuchitira poyambira, osadikirira zovuta zazikulu.

Kuyeserera kwakanthawi kochepa mu podolog, kumwa mankhwala olimbitsa chigoba ndikupewa masewera olimbitsa thupi omwe amaika pangozi, makamaka kusweka.

Zotsatira ndi zovuta

Ndi kuzindikira koyambirira, kuchira kwathunthu ndikotheka popanda zotsatirapo zoyipa, komabe, ndi zaka, nthawi yobwezeretsa imafunikira zowonjezereka, popeza minofu yam'mafupa imabwezeranso.

Mu gawo lomaliza, odwala matenda ashuga samalidwa. Poterepa, chinthu chokhacho chomwe chingapangidwe ndikuletsa kuwonongedwa kwa mafupa ndi minofu yowazungulira.

Zotsatira zomvetsa chisoni kwambiri, matenda am'mimba amatha kuchepa mbali kapena dzanja, komanso kufooka kwamfupa kumatha kupangitsa matenda amodzi omwe amayamba chifukwa chofalikira kumankhwala ofewa komanso m'mafupa, kenako nkufa kwawo.

Kufalikira kwa zotupa

Mwambiri, OAP imakhudza mafupa ndi mafupa a mapazi. Mu 1991, gulu la OAP lidaganiziridwa kutengera momwe ntchitoyi idayendera. Mu 20-25% ya odwala, OAI imakhudza mapazi onse awiri, koma nthawi zambiri osati imodzi. Pali milandu ya OAP yomwe imawonongeka ndi mafupa ena: bondo ngakhale kolowole.

Chithunzi 1

Etiology, pathogenesis ndi njira yachilengedwe ya OAP

Osteoarthropathy makamaka kuwonongeka kwa mafupa, mosiyana ndi mitundu ya mafupa, omwe amangokhala mderalo. Zomwe zimapangitsa kuti zotupa izi zitheke ndiku kuphwanya kwa malo okhala m'munsi chifukwa cha matenda ashuga a m'mimba.

Kwa nthawi yayitali, kukula kwa OAP kumaganiziridwa makamaka kuchokera kumbali ya neurotraumatic ndi neurovascular. Malinga ndi yoyamba, mota ndi ma sensores (kudzera mu kutayika kwa proprioccious reflexes) mitundu ya neuropathy imayambitsa kuphwanya kwa biomechanics ya phazi. Zotsatira zake ndi katundu wachilendo pamafupa a phazi mukamayenda, kuwongolera patapita kanthawi kuti awonongeke. Lingaliro lina lidzakhazikitsidwa ndi kupezeka kwa magazi a magazi am'magazi a OAP, chifukwa chake lingaliro linatsogolera pakuyenda bwino kwa magazi mosagwirizana mu minofu ya mafupa. Mu 1989, asayansi adanenanso kuti kuvulala kwamapazi kawiri kawiri komanso kuchuluka kwamagazi m'mitsempha yamafupa kumathandizira kuti OAI ipangidwe. Chifukwa chake, njira zonsezi zimasonyezedwera chiphunzitso "chopanga".

Amadziwika kuti OAP simakula mwa odwala omwe ali ndi vuto la magazi kupita kumadera akumunsi. Ichi ndichifukwa ndi mitundu ya ischemic ndi neuroischemic mitundu ya matenda ashuga phazi, kuwonjezereka kwamphamvu kwa kayendedwe ka magazi m'matumbo a mafupa ndikosatheka.

Ngakhale kuti chitukuko cha OAP kokha m'magazi a matenda ashuga chimadziwika bwino, ndizosatheka kulosera chitukuko cha OAP, popeza izi sizimachitika mwa odwala onse, ngakhale ndi neuropathy yayikulu. Pankhaniyi, adanenanso kuti OAP siyambitsa mawonekedwe aliwonse, koma "subspecies" ena a neuropathy okha. Mu 1992, ofufuza aku Britain adayikira malingaliro (pambuyo pake adatsimikizira ntchito zingapo) kuti mawonekedwe apadera a matenda am'mimba a chiwindi ndi kuwonongeka koyambirira kwa mafupa am'mitsempha ya myelin komanso chitetezo chocheperako cha bezmyelinovy ​​kumabweretsa ku OAA, komwe kumayambitsa kuphwanya kwamtundu wamagalasi, komwe kumayambitsa kuchuluka kwamagazi m'mafupa.

Njira zamtunduwu zimagwira ngati chofunikira, mtundu wa mbiri yakuwonetseredwa kwa OAP - mafupa am'malo am'mphepete mwa m'munsi, omwe amachepetsa kukana kwa mafupa pamavuto owonongeka. Panthawi imeneyi, zomwe zimapangitsa kuti mafupa ayambe kuwonongekeratu chifukwa cha kuwonongeka kwa mafupa kapena mafupa m'miyendo.

Pambuyo kuwonekera kwa OAP, njirayi imadutsa magawo anayi.

Chithunzi 2

Gawo loyamba (pachimake) limadziwika ndi edema ya phazi, hyperemia yofatsa komanso hyperthermia yam'deralo. Ululu ndi kutentha thupi sizingawonongeke. Ma radiyo sangathe kuwonetsa masinthidwe owononga (pakadali pano akuyimiridwa ndi ma micro-fractures) okha, mafupa am'mapazi amapezeka.

Chithunzi 3

Chachiwiri (subacute): kugawanika kwa mafupa ndi chiyambi cha kusintha kwa phazi. Nthawi zambiri, kutsetsereka kwa chipilala kuphazi lakhudzidwa kumachitika. Edema ndi kutupa pagawo lino amachepetsa. Radiologically yotsimikiza kugawanika kwa mafupa.

Chachitatu (chaching'ono): kuvundikira kwambiri phazi, kupezeka kwa kwaphulika ndikugawika. Mtundu wa mapindikidwe umatengera pomwe panali lesion. Nthawi zambiri, katundu pamiyendo poyenda kumabweretsa chisokonezo cha mtundu wa "pepala lolemetsa" kapena "kugwedeza pansi". Izi zimaphatikizidwa ndi kupunduka kwa valgus kwa m'mphepete mwa phazi m'chigawo chakunyumba, kufooka kwa zala. Radiological - kugawanika kwa mafupa, kufooka mwamphamvu kwachifuwa, kuwonongeka kwa mafupa ndi paraossal. Ntchito ya mafupa a phazi ndi yopunduka kwathunthu; muzovuta, phazi limatha kufaniziridwa mophiphiritsa ndi "thumba la mafupa."

Chithunzi 5b.

Chachinayi (gawo la zovuta): kuchuluka kwambiri kwa gawo la phazi lopunduka kumayambitsa kupangika kwa zolakwika zam'mimba, ndi matenda awo, kukulitsa kwa phlegmon, osteomyelitis, gangrene.

Chithandizo cha OAP

Mu gawo la pachimake, cholinga chamankhwala ndikuyimitsa machitidwe a osteolysis, kuti mupewe kuwonongeka kwa ma cell kapena kuwaphatikiza.

Choyipa chofala kwambiri ndikuwongolera kwa mankhwala osokoneza bongo. Mankhwalawa samawonetsedwa amitundu yonse ya matenda am'mimba a shuga (kokha kwa ischemic ndi neuroischemic), koma ngati OAP atha kuwonjezera magazi ochulukirapo mu minofu yamafupa.

Maziko a mankhwalawa amayamba kupweteka kwambiri ndikutulutsa miyendo yonse mpaka chizindikiro cha kutupa (edema, hyperthermia yam'deralo) chikazimiririka. Kutulutsa kokwanira kumathandizira kuphatikiza zidutswa za mafupa ndipo ndikofunikira kuposa chithandizo chamankhwala. Ngati kutsitsa sikunachitike, kusunthidwa kwa mafupawo ndi kukulitsa mapindikidwe amtsogolo a phazi, akuwonetsedwa ku mkuyu. 2-5. M'masiku oyamba ndi masabata matendawa, kupumula pogona kumasonyezedwa. Mtsogolomo, kuyenda kumatha kuchitika, koma pokhapokha amapangika gawo lomwe limasunthira gawo lalikulu la katundu kuchokera kumapazi kupita kumapazi. Kutsitsa kwakanthawi popanga orthosis kumatha kuchitika pogwiritsa ntchito malamba, omwe amasiyana ndi orthosis mu mawonekedwe ake (ogulitsidwa atapangidwa kale) komanso osakhazikika mwamphamvu ndi dzanja.

Pambuyo pakuwongolera kwa edema (nthawi zambiri pambuyo pa miyezi 4), orthosis imasiyidwa pang'onopang'ono, ndipo wodwalayo amaloledwa kuyenda mu nsapato zopangidwa ndi amisala

Njira yofanizira kutsitsa miyendo nthawi ya OAP m'maiko ambiri, makamaka mayiko olankhula Chingerezi (USA, Great Britain, Australia, ndi zina), ndikugwiritsa ntchito zokutira kovala zopangidwa ndi zida za polymeric zofanana mu katundu kupita ku gypsum (Total Control Cast). Koma ngakhale ndi ochita bwino kwambiri omwe akuchita njirayi, njirayi imakhala yokhazikika ndi zotupa za khungu (bedores) pamavalidwe osavomerezeka mu 10% ya milandu.

Mu gawo lowopsa la OAP, mankhwala amagwiritsidwa ntchito omwe amakhudza kagayidwe ka mafupa.

Bisphosphonates ndi calcitonin amalepheretsa mapangidwe a mafupa.

Bisphosphonate wakunyumba wam'badwo woyamba xidiphon (etidronate) ndiwodziwika pamtengo wokwera mtengo. 15-25 ml yankho lakonzedwa lopangidwira limayikidwa pamimba yopanda kanthu m'maphunziro apakati (mwachitsanzo, masiku 10 oyambirira a mwezi uliwonse), chifukwa kudya kwake kosalekeza kumabweretsa chiopsezo cha osteomalacia. Bisphosphonates amakono - fosamax (alendronate) ndi ena - amagwiritsidwa ntchito mopitilira ndipo amathandiza kwambiri. Mlingo wa fosamax ndi 10,0 mg (piritsi limodzi) pamimba yopanda kanthu tsiku lililonse. Pali lipoti la bonephos bisphosphonates (clodronate) mwa odwala omwe ali ndi OA.

Calcitonin (myakalcic) amagwiritsidwa ntchito mobisa kapena mu mnofu pa 100 IU kamodzi pa tsiku (nthawi zambiri masabata 1-2), kenako mawonekedwe a a pua a 200 IU tsiku lililonse.

Fupa minofu kukondoweza ndi yogwira vitamini D metabolites₃ (alpha D₃-Teva et al.) Ndi anabolic steroids.

Alpha D₃-Teva imagwiritsidwa ntchito pa 0,5-1 mcg / tsiku (makapisozi a 2-4) mukatha kudya. Alpha D₃-Teva amathandizira kukonza kuyamwa kwa calcium m'matumbo ndi kutseguka kwa njira zokukonzanso mafupa, amatha kupondereza kuchuluka kwa mahomoni a parathyroid, amalimbikitsa kukomoka kwa minyewa, kuchepetsa maonekedwe a myopathy. Chithandizo cha nthawi yayitali Alpha D₃- Teva amathandizira kuchepetsa ululu, kuwonjezera mphamvu ya minofu, kugwirizanitsa kayendedwe, kuchepetsa ngozi ya kugwa ndi mafupa. Pafupipafupi pazovuta zomwe zimachitika pakapita nthawi yayitali Alpha D₃-Ali otsika.

Anabolic steroids (retabolil, nerobol) amayikidwa ngati jakisoni kamodzi pa sabata kwa masabata 3-4.

Kukonzekera kwa calcium kumapangitsa kuti magazi asamayende bwino, popeza kuphatikiza calcium kumapangidwa ndi minofu ya mafupa kumayendetsedwa ndi mahomoni ofanana. Mankhwalawa amagwiritsidwa ntchito ngati othandizira kutsimikizira kudya calcium kokwanira pa matenda a minofu ya minofu (yomwe imayenera kukhala 1000-1500 mg / tsiku, poganizira zakudya zonse). Kuphatikiza kwakukulu kwambiri kwa bioavailability kumakhala ndi lactate ndi calcium carbonate. Ali m'gulu la calcium-Sandoz forte, vitrum-calcium ndi calcium-D₃-Nalumidwa, yomwe imatha kutumizidwa piritsi limodzi patsiku (pafupifupi 500 mg ya calcium yoyambira). Otsiriza a mankhwalawa alinso ndi vitamini D₃, koma mu Mlingo wa kupewa, chida ichi chiyenera kuganiziridwa makamaka ngati gwero la calcium. Kukonzekera kwa kashiamu kumatengedwa masana, popeza ndi nthawi imeneyi kuti kunyinyirika kwawo kumachitika. Calcium gluconate (mapiritsi a 100 mg) ndi okwera mtengo, koma amasiyana mu otsika a bioavailability, ndichifukwa chake mlingo wofunikira tsiku lililonse wa mankhwalawa ndi mapiritsi 10.

Calcitonin ndi bisphosphonates angayambitse hypocalcemia, vitamini D₃ ndi kukonzekera kwa calcium - kuonjezera kuchuluka kwa calcium m'magazi. Chifukwa chake, ndikofunikira kudziwa mulingo wa calcium wokhala ndi ionized musanalandire chithandizo komanso mwezi uliwonse motsutsana ndi maziko ake (mu ma laboratories amakono, chizindikiro ichi chimatsimikiziridwa mu magazi a capillary). Nthawi zambiri kuphatikiza kwa imodzi mwa resorption inhibitors, vitamini D, mumagwiritsidwa ntchito.₃ ndi kukonzekera calcium. Kutengera ndi kuchuluka kwa calcium ionized, Mlingo wa mankhwala ena umakulanso kapena kuchepa. Kutalika kwa chithandizo ndi miyezi 4-6.

Othandizira othandizira (NSAIDs, bandeging bandeti ya miyendo, nthawi zina okodzetsa) amagwiritsidwa ntchito kuti athetse edema.

Chithandizo cha X-ray cha mafupa omwe akhudzidwa chimakupatsani mwayi wopewetsa kutupa. Komabe, malinga ndi kafukufuku wambiri wowongoleredwa ndi placebo, zoona zake zowongolera kupitilira kwa maphunziro a OAP pambuyo poyipa wa x-ray sizidatsimikizidwe. Chifukwa chake, chithandizo cha x-ray chikuyenera kugwiritsidwa ntchito pokhapokha ndikutsegula miyendo mwendo.

Zotsatira zoyenera zamankhwala zomwe zimayambitsidwa pachimake ndikuletsa ma fractures kapena kuphatikiza zidutswa. Zotsatira zamankhwala zimatilola kuweruza kusintha kwa chithunzi cha chipatala ndikuwongolera radiography patatha miyezi 4-6 kuchokera pakuwonekera kwa matendawa.

Pambuyo pakuchulukitsidwa kwa phenomena yotupa, chiopsezo chowonjezereka cha OAP chimatsalira (chimodzimodzi kapena madera ena). Kuphatikiza pa njira zodzitetezera (onani pansipa), ndikofunika kuvala nsapato zamadzimadzi zomwe zimachepetsa katundu pazolowera phazi (makamaka tarsus) mukamayenda.

Ngati njirayi ili pa gawo lachiwiri kapena lachitatu, cholinga chachikulu cha chithandizo ndikupewa mavuto a OAP. Pamaso pa kupunduka kwa phazi, nsapato zovuta zamatsenga zokhala ndi mpumulo wamkati wobwereza mawonekedwe osafunikira a phazi ndizofunikira. Khola lokhazikika lokhala ndi gawo lotchedwa roll - lomwe limakwezedwa kutsogolo - limalepheretsa kufalikira kwina kwa zidutswa za mafupa mukamayenda. Kuvala kosalekeza nsapato zapamwamba kwambiri kumalepheretsa kukula kwa zilonda zam'mapazi m'malo opanikizika kwambiri. Kuyesa kukonza zamankhwala mu OAI (thandizo la arch, zina ndi zina) ndizopanda pake komanso zopsya mtima ndi kukula kwa zilonda zam'mimba.

Njira zakukonzera opaleshoni kwa mafupa a phazi ndi OAP

Njira zingapo zoperekera opaleshoni zakhala zikufunsidwa kuti zikonzedwe kuwongolera phazi panthawi ya OAA (arthrodesis, resection of fupa la zinthu zomwe zimapanga kupanikizika kowonjezereka pamtunda wa plantar ndikupangitsa kuti pakhale chilonda chosachiritsa), koma ku Russia sakhala ndi chidziwitso chochepa ndi kugwiritsa ntchito kwawo. Mkhalidwe wosakayikira wogwiritsa ntchito njirazi ndi kutsimikizika kwathunthu kwa njira yotupa ndi osteolysis (popeza mwanjira ina opaleshoni ingapangitse kuwonekera kwatsopano kwa chiwonongeko chatsopano). Mwinanso, kuthandizidwa ndimankhwala omwe amalimbitsa minofu yam'mafupa kumapangitsa kuti pakhale ntchito yabwino. Komabe, vuto lazomwe limapereka chithandizo chamankhwala othandizira opaleshoni komanso chitetezo chake kwa odwala omwe ali ndi OA akadatsutsidwa. Nthawi zambiri, chisonyezo cha mankhwalawa ndi kuvulala kwamapazi kwambiri, kupangitsa kuti kusakhale kotheka kupanga nsapato zamatumbo oyenera. Mulimonsemo, atachitidwa opaleshoni, ndikofunikira kuti mutsimikizire kutuluka kwathunthu kwa miyezi 3 ya ziwalo zomwe zakhudzidwa (kupumula kwa kama, pompano - Total Contact Cast kapena kufanana kwake).

Limagwirira chitukuko ndi zoyambitsa matenda

Osteoarthropathy (OAP) ndi chiwonongeko cha mafupa ndi mafupa achikhalidwe chosachiritsika motsutsana ndi phazi la matenda ashuga. Pathology nthawi zambiri imakumana ndi akatswiri odziwa ntchito: akatswiri azachipatala, madokotala ochita opaleshoni, a endocrinologists. Ndizovuta kupatula wodwala ku chiwerengero chachikulu cha odwala matenda ashuga omwe ali pachiwopsezo, chifukwa chake matendawa sapezeka kawirikawiri munthawi yake.

Chifukwa chachikulu chomwe chimatithandizira kukula kwamatendawa ndi matenda a shuga.

Uku ndikugonjetsedwa kwamapeto amitsempha yophatikizira pamodzi ndi kuphwanya kwa microcirculation. Mkulu kuchuluka kwa shuga kumakhudza minyewa yamitsempha ndikuwononga khoma lamitsempha, zomwe zimayambitsa kuphwanya kapangidwe, mphamvu ndi ntchito ya minofu ya mafupa. Ndi kuchepa kwa kagayidwe kazinthu komanso kumva, ntchito yowononga aseptic m'mafupa imayamba.

Kuphulika kwa banal, kusunthidwa pang'ono komanso ngakhale kukhathamiritsa kwa ankolo kumatha kuyambitsa matendawa. Chikwangwani chaching'ono kapena kusweka pakhungu chimasanduka chilonda chovuta kuchiritsa. Matendawa amatengedwa kufalikira kufupi ndi minofu yofewa, ndiye kuti mafupawo amakhudzidwa ndi njirayo.

Zizindikiro zake za osteoarthropathy

Phazi la Charcot limakonda kukhala ndi anthu odwala matenda ashuga omwe akhala akudwala kwa zaka zoposa 10. Awa ndi odwala omwe ali ndi mtundu wa matenda a mitundu yonse yoyamba ndi yachiwiri. Popita nthawi, odwala oterewa amakumana ndi mavuto a neuropathic. Amayambitsa mafinya a mafupa a phazi, kuwonjezereka, ngakhale katundu pang'ono. Kutuluka kwa magazi kumachotsa calcium m'mafupa, kukulitsa vutoli. Maonekedwe a zilonda zimaphatikizidwanso ndi neuropathy.

Njira ya pathological nthawi zambiri imakhudza mafupa a tarsus ndi phalanx a zala ziwiri zoyambirira. Zala zina, makamaka chala chaching'ono, komanso chidendene, zimatha kukhudzidwa. Osteoarthropathy amadziwika ndi zotupa zamtundu wa mafupa:

• kuchuluka kwa cortical wosanjikiza - hyperostosis,
• Mafupa a mafupa - kuchuluka kwa mafupa,
• kufupa kwathunthu - osteolysis.

Mawonekedwe a neuroischemic a osteoarthropathy amakula kuchokera kuzovuta zam'magazi kumapeto kwenikweni, koma zomverera zimasungidwa, ndipo phazi silolakwika. Khungu limazizira kukhudza, kugunda kofooka, kutupa kumawonekera.

Mtundu wina ndiwotheka, womwe, chifukwa cha kuchepa kwa chidwi, wodwalayo samva kupweteka akamayenda. Katundu pazolumikizana sikumagawidwa molondola, zomwe zimawopseza ndikusintha kwotsatira.

Magawo a Osteoarthropathy

Mchitidwewo umayamba pang'onopang'ono ndikupangitsa wodwalayo kusintha kosasintha m'mafupa. Njira yamatendawa imagawidwa m'magulu anayi.

1. Kutambasuka kwa kapisozi yolumikizira, kutsitsa, microfracture. Gawo limachitika ndendende, khungu la phazi limasanduka lofiira ndikutupa, kutentha kwanyumbako kumawuka. Zilonda zimapangidwa zomwe zimakhudza gawo lokha la khungu. Amathandizidwa pogwiritsa ntchito njira yochotsa callus.
2. Kutupa kumawonjezeka, pomwe redness ndi kutentha kwa khungu kumachepa. Kuyenda nthawi yayitali, wodwalayo amamva bwino, komanso amamva kuwawa. Kusunthika kwamalumikizidwe kumachepetsedwa, crunch imamveka, phazi limayamba kupunduka. Zilonda zomwe zilipo zimakuya popanda kuwonongeka kwa mafupa ndikutulutsa mafinya.
3. Mu nyengo yayitali, kukonzanso kumakhala koonekera, kumverera kothandizira pa mwendo kumatha. Mawonekedwe amkati mwa phazi amakhala ngati pepala lanyumba, ndipo zala zake amazilumikiza. Dislocation yachilendo komanso kufinya kumachitika, zowawa zimawoneka ngakhale pakupuma. Zilonda zakuya zimakhudza fupa.
4. Gawoli limadziwika ndi zovuta zomwe zimakhudzana ndi kuwonongeka kwa mafupa. Ndiosasinthika ndipo imayambitsa kulumala. Odwala sangathe kuyima payokha.

Mwachikhalidwe, pali gawo la zero. Munthawi imeneyi, zilonda sizinapangike, koma kufooka kwa phazi kuli kale. Chimanga, chimanga, keratinization wopaka khungu amatha kuonekera.

Chithandizo cha matenda a shuga a osteoarthropathy

Chithandizo cha OAP chimaphatikizapo kuwongolera glycemia. Odwala ayenera kuyeza shuga m'mawa wopanda kanthu komanso maola awiri atatha kudya.

Munthawi yamatumbo a osteoarthropathy, kumasula chiwalo chodwala ndikofunikira. M'masiku oyambilira, kupuma pabedi kumafunikira kupewa kutayidwa kwa mafupawo. Mukachotsa edema ndi hyperemia, amaloledwa kusuntha pang'ono. Kuchepetsa kupanikizika pamapazi, njira zapadera zimagwiritsidwa ntchito polimbitsa phazi. Izi ndizovala zosiyanasiyana, ma bandeji, ma orth, nsapato za amiseche.

Kuchiza kumachitika ndi mankhwala a magulu osiyanasiyana. Ma biophosphonates amathandizira kuchepetsa njira yowonongera mafupa - awa ndi Xidiphon, Fosamax. Kuwongolera metabolism ya calcium-phosphorous, calcitonin wa chithokomiro ndi mankhwala. Mankhwala osagwirizana ndi antisteroidal omwe amalimbana ndi kutupa kwa arthralgia (kupweteka kwaphatikizidwe). Kubwezeretsa minofu ya mafupa, mankhwala a anabolic steroid amafunikira. Ngati mavuto abwera ndi matenda opatsirana, wodwalayo amafunikira chithandizo chamankhwala othandizira.

Pali njira zingapo zakukonza kupunduka kwamapazi.

Chimodzi mwa izo ndi kuchotsedwa kwa mafupa kuti muchepetse kuthamanga pakokha. Opaleshoni imachitidwa pambuyo poti kutupa kumatha. Chizindikiro chakuduladula ndikusokonezeka kwakukulu, momwe sizingatheke kupangira nsapato za orthopedic. Kuchita opareshoni kumachitika ndi kuwonongeka kosasinthika kumapeto kwa matenda ashuga OAP. Amachotsa phalanges ya chala, mafupa a phazi kapena gawo la mwendo, koma opaleshoniyo samachotsa mawonekedwe a zilonda zatsopano ndi zilonda.

Kuneneratu komanso kupewa matenda ashuga a shuga

Zotsatira za matendawa zimatengera gawo la osteoarthropathy. Kuzindikira koyenera komanso kulandira chithandizo mwachangu zitha kuyimitsa njira zowonongeka. Kupanda kutero, zovuta za mtima zimabweretsa kuwonongeka kwa kayendedwe ka kayendedwe komanso kulumala. Mu osteomyelitis wodwala, kusinthanso kwachilendo ndikofunikira.

Kupewa kumatengera chithandizo choyenera cha matenda ashuga.

Odwala ayenera kuwongolera momwe aliri. Ndikofunikira kusungitsa kuchuluka kwa shuga m'magazi pazofunikira zovomerezeka. Matenda a shuga a 2 amafunika kusinthana ndi insulin panthawi yake. Odwala ayenera kupita ku endocrinologist kawiri pachaka ndikusintha mankhwala kuti achepetse shuga.

Ndikofunikira kwambiri kupewa mikwingwirima, ma distlocation, ma fractures. Madokotala amalimbikitsa kuti odwala matenda ashuga azivala nsapato zamatumbo, komanso kuyang'anitsitsa miyendo yawo ndikuwona kuwonongeka kwa khungu kuteteza zilonda zam'mimba. Ngati mukukayikira kuti phazi lisokonekere, muyenera kupita ku orthopedist.