Phazi la Charcot mu shuga: chithunzi ndi chithandizo

Phazi la Charcot mu mankhwala limatchulidwanso kuti diabetesic osteoarthropathy. Uku ndikovuta kwa matenda ashuga, omwe amadziwika ndi kusintha kwamafupa osiyanasiyana:

Hyperostosis Cortical wosanjikiza fupa limakula.
Matendawa Zokhudza kufooka ndi kufupika kwa mafupa.
Osteliosis. Mafupa am'mimba amatengeka kwathunthu.

Monga mukuwonera, mapazi a Charcot omwe ali ndi matenda ashuga ali ndi zovuta zoyipa. Mwanjira yamasiku onse, moyo wotere umatha kubweretsa mafupa pafupipafupi, komanso kusakanikirana kwawo kosayenera. Mfundo yomalizirayi nthawi zina imapangitsa kupunduka kwa phazi.

Yembekezerani kuti zochitika zofananira ndizomwe zidzachitike kwa iwo omwe amapezeka ndi matenda osokoneza bongo. Kuphatikiza apo, izi ndizowona kwa odwala omwe amadalira insulin komanso omwe samalowa m'gululi. Pakapita kanthawi, odwala oterewa nthawi zambiri amakhala ndi vuto la neuropathic, lomwe limayambitsa kuponderezedwa kumapazi, komanso pafupipafupi.

Vuto lomwe tafotokozazi limatha kutsagana ndi zotupa za pakhungu, zomwe zimapangitsa zovuta kale. Mfundo yofunika kuikumbukira ndi yoti zilonda zam'mimba zikagwera kumapazi ndi mitsempha, zimayambitsa magazi, magazi akufupika m'mafupa. Mwachilengedwe, pambuyo poti izi zitheke, mafupa amachepa mphamvu ndipo amatha kuthyoka katundu wolemera.

Ndikofunikira kudziwa kuti phazi la Charcot limawonekera makamaka mwa odwala omwe akhala akulimbana ndi matendawa kwa zaka zoposa 10.

Mitundu ya matenda

Pali matenda angapo am'mbuyo omwe amayambitsa mawonekedwe a phazi la matenda ashuga. Poganizira izi, mitundu ingapo yamatendawa imatha kusiyanitsidwa:

Neuroischemic. Kukula kwake kumachitika motsutsana ndi maziko a matenda ashuga a shuga, omwe amafotokozedwa mwa kuwonongeka kwa kayendedwe ka magazi m'magawo otsika. Munthawi imeneyi, phazi silisintha mawonekedwe ake ndikumverera kwake kosungika. Potere, kutupa kumachitika, khungu limayamba kuzizira, ndipo zimachitika kuti kufooka kumakhala kofooka.
Mapazi a Charcot ndi mawonekedwe a neuropathic. Pankhaniyi, matendawa amakula motsutsana ndi maziko a matenda ashuga a polyneuropathy ndipo amatsogolera kuwonongeka kwa mitsempha kumapeto kwa mitsempha. Zizindikiro za mkhalidwewu zimachepetsedwa kuchepa kwakukulu pakumverera kwa phazi, pomwe palibe ululu. Chifukwa chakuti malo osungirako malo osokoneza bongo asokonezeka, wodwalayo amagawa molakwika katundu pazolumikizira miyendo, zomwe zimayambitsa chiopsezo cha kupunduka kwamapazi.
Zosakanizidwa. Pankhaniyi, zizindikiritso za mitundu iyi pamwambazi zimawonetsedwa nthawi imodzi.

Phazi la Charcot mu shuga: magawo a chitukuko

Ngati tilingalira za kuyesedwa kwa matendawa ndi Dr. Wagner, ndizotheka kusiyanitsa magawo asanu omwe wodwalayo amapezeka ndi matenda a diabetes. Nazi zifukwa zazifupi za iwo:

Gawo loyamba. Zilonda zamtundu wapamwamba, momwe zimangokhala zigawo za khungu zomwe zimakhudzidwa. Monga chithandizo, njira yochotsa chimanga imagwiritsidwa ntchito. Ngati ndi kotheka, maantibayotiki amagwiritsidwa ntchito.
Wachiwiri. Ichi ndi chilonda chozama chomwe sichikhudza fupa. Nthawi yomweyo, mphamvu ya matenda itha kutsimikizika ndi zizindikiro zotsatirazi: kutentha kwambiri, mafinya ndi redness pakhungu lozungulira mbali yakumapazi. Zenizeni ndi mankhwala othandizira komanso opaleshoni kuti muchotse minofu yakufa.
Chachitatu. Pakadali pano, zimakhala ndi zilonda zamkati ndikuwonongeka kwa mafupa kumachitika (osteomyelitis imayamba). Njira zowonongeka zimakhudzanso minofu yofewa m'dera la phazi.Vutoli nthawi zambiri limakhala limodzi ndi kupembedzera. Chithandizo chimapangidwa chimodzimodzi monga gawo lachiwiri. Ndi matenda oopsa omwe ali ndi matendawa, kudula matendawa ndizotheka, koma milandu ngati imeneyi ndi yochepa - momwe odwala angapangidwire ndi mankhwala.

Chachinayi. Phazi la Charcot pamlingo uwu limadziwika ndi gangrene, lomwe limakhudza dera linalake, monga chala. Ndi matenda awa, kuduladula kwamunthu wakufa kumachitika ndipo makamaka muzoopsa, miyendo pansi pa bondo.
Gawo Lachisanu. Pakadali pano, zotupa ndizambiri: phazi lalikulu la phazi limakula, zomwe zimatha kubweretsa zotsatira zakupha. Njira yokhayo yodulira ndikudula, ndipo nthawi yomweyo.

Kumvetsetsa zomwe zimapangitsa kuti phazi la Charcot likhale, ndikofunikira kunena gawo la zero, zomwe zimayambira zonse zafotokozedwa pamwambapa. M'malo mwake, tikulankhula za anthu omwe ali pachiwopsezo. Muzochitika izi, zilibe zilonda pano, koma kuwonongeka kwa phazi kumaonekera, chimanga kapena chimanga chimawonekera, ndipo hyperkeratosis imadzipatsanso yokha.

Zizindikiro

Phazi la Charcot ndi matenda ashuga, chithunzi chake chomwe chimatsimikizira kuti matendawa ndi oopsa, amafunika chithandizo chanthawi yake, mwinanso mavuto ena amakula.

Chifukwa chake, kuzindikiridwa pazizindikiro zoyambirira za matendawa kuyenera kuchitika ndi kutenga nawo mbali akatswiri oyenerera. Pakukayikira koyamba kwa matenda a shuga a shuga, muyenera kuyendera endocrinologist. Ngati kuli kotheka, ndibwino kupita kuchipatala chapadera.

Kuti mupange kuzindikira koyenera, kuwunika mosamalitsa kwa chithunzi cha chipatala ndi zizindikiro za radiology, zomwe zikuwonetsa gawo linalake, zofunikira. Kuvuta kwa njira yodziwitsira matendawa kumatupa kuti chidziwitso chikhale chofanana ndi mawonekedwe a phazi la phlegmon, thrombophlebitis, lymphostasis ndi matenda ena.

Chovuta kwambiri ndikuzindikira kusiyanitsa matenda pomwe phazi la Charcot (matenda ashuga) lili pachimake. Pankhaniyi, kulandira chithandizo mwadzidzidzi kumatha kudzetsa wodwala miyendo.

Kodi matenda osiyanasiyana amawapanga bwanji?

Wodwala akakhala ndi vuto lotere, madokotala amayesetsa kupeza yankho la mafunso awiri ofunika:

Ngati pali ma radiographic zizindikiro zakuwonongeka kwa mafupa, ali ndi mtundu wanji - wopatsirana (osteomyelitis) kapena osachiritsika (OAP)?
Kodi ndizotheka kuzindikira kusintha kwa kutupa chifukwa cha kuwonongeka kwa mafupa kapenanso kuti ndi chizindikiro cha matenda ena (kuwonongeka kwanyengo, kuponderezana kwamatenda, chifuwa cha m'miyendo, matenda am'mimba, gouty nyamakazi, etc.)?

Kuti mupeze yankho la funso lachiwiri, zida zowonjezera zidzafunikira, chifukwa popanda icho ndizovuta kunena kuti wodwalayo wangokhala ndi phazi la Charcot. X-ray pamakonzedwe a kupimidwa koteroko ndiye yoyenera kwambiri.

Kuphatikiza pa radiology, muyenera kugwiritsa ntchito kulingalira kwa maginito. Chithunzi cha mafupa a phazi sichikhala chopanda tanthauzo. Njira zonse zodziwikirazi zikuthandizira kuzindikira kusintha kwa kutupa, kuchuluka kwa magazi m'dera lomwe lakhudzidwa ndi ma fractures ang'onoang'ono.

Ngati ndi kotheka, zolembedwa zam'mafupa zimatha kuwunika. Zolemba za kukonzanso minofu zitha kuganiziridwanso, chifukwa zimawonetsa ntchito ya fupa isoenzyme.

Ponena za funso loyamba, ndizofunikira pazizindikiro zowoneka zam'mapazi am'mapazi. Izi zitha kugwiranso ntchito panthawi yopuma pambuyo pakucheka, kapena opaleshoni yokhudzana ndi phazi. Kuti mudziwe mtundu wa kuwonongeka kwa mafupa, kuyezetsa magazi kumatengedwa ngati osteomyelitis.

Phazi la Charcot: chithandizo

Choyamba, muyenera kumvetsetsa kuti chithandizo cha mankhwalawa chidzapereka zotsatira zabwino kwambiri ngati wodwalayo angafunse dokotala. Koma kuti izi zichitike, anthu omwe ali ndi matenda monga matenda ashuga ayenera kudziwunika pawokha ngati mapazi awo ali.

Kufufuza koyenera kukhoza kuphunziridwa ndipo kuyenera kuphunziridwa, kufunsira kwa madokotala oyenerera kungakuthandizeni mu izi. Zotsatira zake, wodwalayo ayenera kukulitsa chizolowezi chowunikira miyendo nthawi zonse, makamaka mapazi. Malingana ndi kusintha kulikonse kapangidwe kake kajambulidwa, ngakhale kakang'ono, muyenera kukonzekera kupita kukaonana ndi adotolo.

Ndikofunikanso kuganizira mfundo yotsatirayi yomwe imayendera matenda a Charcot-Marie: kupweteka kwa phazi pamkhalidwewu kumachepetsedwa chifukwa cha atrophy of the nerves endings, ndipo zitha kuwoneka ngati wodwala kuti kuvulala komwe adalandira kuli kochepa, pomwe kuwonongeka kwakeko kuli kwakukulu.

Ngati zilonda zimawoneka pamapazi, ndiye kuti ziyenera kuyesedwa ndi kukhazikitsidwa kwa kuya. Koma zachifundo, ndi zilonda zina, kuchira ndi ma insoles am'mimba ndizotheka, chifukwa zimachepetsa kwambiri kuthamanga mukamayenda. Ngati izi sizili zokwanira, ndiye kuti kugwiritsidwa ntchito mosafunikira kumagwiritsidwa ntchito, komwe kumalepheretsa khungu kulimba.

Chithandizo cha opaleshoni chimalembedwa pamene zilonda zimafalikira mpaka pamsempha. Ngati matenda alembedwa, adotolo amafufuza maantibayotiki.

Nthawi zina zilonda zam'minda zimatha kufalikira mpaka m'mafupa. Poterepa, pakufunika opaleshoni yochotsa yotsirizirayi. Chitsanzo ndi fupa la metatarsal, lomwe limatha kuchotsedwa ndi zilonda zomwe zili pamphumi pake.

Zomwe zimayambitsa matenda a shuga

Kudzimva kosawawa kwa matenda am'mimba kumawonetsa kupezeka kwa matenda a shuga. Mawonekedwe a matendawa amatha kuwonetsedwa monga kuwonekera kwa phazi, kupsinjika, kuchuluka kwambiri, kukhalapo kwa matenda, kusankha kolakwika kwa nsapato kapena kutsika magazi.

Khungu lofiiridwanso lingasonyeze matenda. Makamaka, izi zimawonekera ngati redness idapangidwa pafupi ndi mabala. Kuphatikiza apo, khungu lokwera limatha kulumikizidwa ndi nsapato zosasangalatsa.

Kutupa kwazomwe zimatha kukhala chizindikiro cha kukhalapo kwa kutupa. Ngakhale umboni wotupa wa matenda, kulephera kwa mtima, kapena nsapato zosankhidwa bwino.

Kutentha kwakhungu kwa khungu kumatha kuwonetseranso kupezeka kwa kutupa kosafunikira. Popeza thupi laumunthu limafooka ndi matenda omwe alipo (shuga mellitus), sangathe kuthana ndi matenda ena akulu.

Zowonongeka zomwe zimayambitsidwa ndi matenda ashuga komanso mabala owononga pakhungu zimatha kuyambitsa matenda. Kuphatikiza apo, kukula kwa matendawa kumapangitsa kuti phazi likwere kwambiri, komanso kupangika kwa chimanga chifukwa chovala nsapato zosasangalatsa.

Kuyenda kovutirapo, kuwonda - kumayambitsa kuwonongeka kwakukulu kapena kuyambitsa matenda. Matenda a fungus, misomali yokhazikika - amawonetsa kukhalapo kwa matenda.

Zofunika! Zilonda zam'munsi zophatikizana ndi malungo ndi kuzizira kumawonetsa matenda akulu, omwe ngati sanalandiridwe, angadulidwe kapena kufa.

Kuphatikiza apo, zizindikiro zotchulidwa phazi zimawonetsedwa kwambiri ndi kupweteka kwambiri miyendo ndi dzanzi miyendo (matenda ashuga a m'mimba).

Zizindikiro za Osteoarthropathy

Zizindikiro za phazi zimakhala zowonekera kwambiri pamavuto omwe amakhala nawo pamunsi:

epidermophytosis ya phazi,
kupindika kwa mbale ya msomali,
bursitis wa zithupsa
kupukusa (kusintha kwa zala),
njerwa pamiyendo,
Khungu louma ndi lodzaza
bowa pamisomali.

Monga lamulo, chimanga chimawoneka m'malo omwe amapukutidwa ndi nsapato, chifukwa chomwe phazi limapereka kukakamiza kolimba.Mutha kuchotsa mawonekedwe awa mothandizidwa ndi pumice. Koma madokotala amalimbikitsa kuti tichotse chimanga chokha ndi katswiri, chifukwa ndikuchotsa kusaphunzira, chilondacho chimatha kukhala chilonda.

Ponena ndi matuza a matenda ashuga, amawonekera chifukwa chovala nsapato zolimba ndi katundu wolemera. Ngati mawonekedwe amadzaza amadzimadzi amachitika, wodwala matenda ashuga ayenera kufunsa dokotala nthawi yomweyo. Wodwalayo akanyalanyaza izi, ndiye kuti m'malo mwa chithuza chitha kuoneka khansa yotupa, ndikusintha kukhala chilonda.

Misomali imakula chifukwa chovala nthawi yayitali nsapato zolimba. Pofuna kupewa njirayi, sangathe kudulidwa mumakona. Ndikofunikira kuti muchepetse m'mbali mwa misomali mosamala pogwiritsa ntchito fayilo yodzikongoletsa. Ngati njira yodulira ndi kupukutira misomali yachitika mosasamala, ndiye chifukwa cha kupezeka kwa mabala, matenda amatha kufalikira, kukula komwe kumatha kudula dzanja.

Bursitis ndi bulge yomwe imapangika pachala. Popita nthawi, mapangidwewo amadzazidwa ndi madzi amfupa, zomwe zimapangitsa kupatuka kwa chala. Tiyenera kudziwa kuti vutoli limatha kukhala ndi chibadwa chatsopano.

Chiwopsezo chotenga bursitis chimawonjezeka chifukwa chovala nsapato zazitali, komanso nsapato zokhala ndi chala chakanthawi. Komanso kulemala uku kumayendera limodzi ndi kupweteka kwambiri. Mutha kuthana ndi vutoli pokhapokha mothandizidwa ndi ma opaleshoni othandizira.

Khungu la khungu ndikupanga ming'alu kumapazi. Potere, mtundu wa womwe umatha kusintha, ndipo nthambi yake ndiyosangalatsa. Kuwoneka kwa vutoli kumachitika chifukwa cha kuchuluka kwa zinthu zosiyanasiyana.

Zifukwa zazikulu zowonekera ming'alu kumapazi ndizophatikiza:

shuga wamagazi ambiri
magazi osakwanira m'miyendo,
kuwonongeka kwa mitsempha mathero.

Kuti mupewe vutoli, muyenera kumakonza thupi khungu lanu nthawi zonse, kuti lisasunthike.

Warts paokha ndi thupi kukula zomwe zimayambitsidwa ndi papillomavirus yaumunthu. Nthawi zina mawonekedwe awa samadzetsa zovuta kwa munthu pakuyenda, koma ngakhale pakalibe zovuta, ma warts amafunikabe kutayidwa. Njira yochotsera imachitika ndi njira ya laser ku cosmetologist.

Kuwonetsedwa kwa matendawa

Pamaso pa matenda a shuga, njira zomwe zimakhudza mitsempha zimadutsa m'thupi la wodwalayo. Zotsatira zake, zomverera zimasokonekera, zomwe zimatsogolera ku motor innervation. Chifukwa chake, mulingo wa zomverera umachepetsedwa kwambiri, ndipo mwayi wovulala umakulitsidwa.

Matenda a shuga amathandizanso kuchepa kwa minofu ya mafupa, chifukwa cha momwe matenda a shuga amayamba. Chifukwa chake, kuvulala kulikonse kumafupa.

Nthawi zambiri ndi matenda a shuga, pamakhala kusamvetseka kwathunthu kwamavuto am'mafupa. Kuzindikira pang'ono m'miyendo kumapangitsa kusintha kwa gait.

Chifukwa chake, mitolo imagawidwanso kumagawo, ndikuiwononga mtsogolo. Kuti muthane ndi vutoli, pamafunika chithandizo chachikulu.

Kutupa kwa m'munsi

Mu shuga, chiwonetsero cha kuvulala chimayendetsedwa ndi kutupa kosiyanasiyana ndi edema. Zolumikizira zazikulu zimafooka, kutambasula, kenako ndikuphwanya. Zapezeka kuti opunduka, kuphatikiza ziwalo zathanzi pantchitoyi.

Tcherani khutu! Kuvulala kocheperako kumayambitsa kupangika kwa arthropathy ya Charcot.

Chifukwa chotseguka kwa ma venous ndi ochepa shunts zomwe zimathandizira kutsika kwa magazi mu minofu ya mafupa ndi michere ya leach, fupa limatha kufooka kwambiri. Muyenera kukhala ndi lingaliro la zoyenera kuchita ngati miyendo yanu itatupa ndi matenda ashuga.

Zofunika! Odwala onse omwe ali ndi matenda ashuga polyneuropathy pambuyo pake amadwala ndi phazi la Charcot.Ndi okhawo omwe amadwala matenda ashuga omwe ali ndi vuto m'magazi kupita ku miyendo ndikuwonjezera kuchuluka kwa magazi m'magazi sangathe kudwala matenda a osteoarthropathy.

Gawo lachitatu

Pakadali pano, kuwonongeka kwa mafupa kumatchulidwa kwambiri. Ndipo kupezeka kwa matendawa kungathe kukhazikitsidwa ngakhale kowoneka. Kutha kwadzidzidzi ndi kutalikirana kumatha kuchitika.

Ponena za zala, amaimitsa mawonekedwe awo ngati mulomo, ndipo ntchito zachilengedwe za phazi zakhumudwa. Mukamayendetsa x-ray, mutha kuwona zosokoneza zambiri. Ndikovuta kuchiritsa chilema chotere, koma ndizotheka.

Kuzindikira ndi kuchiza matenda a Charcot phazi

Ndikofunikira kwambiri kuti anthu odwala matenda ashuga azindikire koyenera munthawi yochepa kwambiri kotero kuti mankhwalawa ndi othandiza kwambiri. Chifukwa chake mutha kupewa kusintha kwakukuru komanso kosasinthika phazi. Koma mwatsoka, ndizosatheka kukhazikitsa matenda atangoyamba matendawa.

Pa magawo oyamba a osteoarthropathy, ndikofunikira kukhazikitsa mtundu wamatendawa, i.e. ziyenera kutsimikiziridwa ngati ndizopatsirana kapena ayi. Njira yayikulu yomwe ingatithandizire kuzindikira matenda ndi kuwongolera njira yothandizira ndi kutsitsa kwa kulingalira kwa maginidwe, komanso ulemu wa mafupa.

Tcherani khutu! Ngati wodwala matenda ashuga apanga edema ya phazi, ndiye kuti ndikofunikira kupatula momwe angayambire matenda am'maso a Charcot.

Njira ndi njira zochizira phazi zimasiyana kwambiri kutengera ndi matendawo. Chofunikira pano ndikutsimikizira kukula kwa matendawa, kuwonongeka kwa mafupa, mapangidwe azilonda ndi chilengedwe.

Pochiza gawo loyambirira, adokotala amatenga chisamaliro chachikulu. Kupatula apo, sayenera kupatula kukhalapo kwa dislocations zotheka komanso ma microscopic fractures. Pankhani imeneyi, sizingatheke kupereka chithandizo chamankhwala popanda kuzindikira bwinobwino.

Zambiri pazamankhwala othandizira komanso opaleshoni

Ndikotheka kumenya nkhondo ndi matenda ashuga opatsirana pogwiritsa ntchito njira zakale.

Chithandizo cha Conservative chimayang'ana pa zochitika zomwe zitha kugawidwa m'mitundu iwiri:

Chithandizo choyambira. Pakadali pano, chidwi chimaperekedwa polipira matenda a shuga, kuwongolera kuthamanga kwa magazi, komanso kusintha shuga m'magazi. Odwala amaphunzitsidwa chidziwitso chofunikira ndi luso. Ngati ndi kotheka, adokotala angakufunseni kuti musiye kusuta, chifukwa kumakhala kovuta m'mitsempha yamagazi.

Zowonjezera zochizira. Ngati phazi la Charcot likupezeka ndi matenda a shuga, mankhwalawa atha kuphatikizira othandizira antimicrobial Kuchepetsa ululu wammbuyo, ma pinkiller monga Ibuprofen, Analgin, ndi ena amagwiritsidwa ntchito. Osatinso kukhudzana ndi mankhwala a antiseptic.

Ponena za kuchitapo kanthu kwa opaleshoni, imagwiritsidwa ntchito pakafunika kuchotsa zilonda ndi zilonda zam'mimba. Chithandizo cha opaleshoni chingakhale chofunikira mwachangu kusintha magazi. Ngati wodwalayo adavomerezedwa kupita kuchipatala pamapeto omaliza a matendawo, ndiye kuti mwayi woduladula mapazi ndi miyendo yochepa umakulanso.

Kubwezeretsa mafupa kumapazi

Pamene phazi la odwala matenda ashuga a Charcot limawonekera, chithandizo chimangoyang'ana kuchotsedwa kwa zilonda ndi zilonda zam'mimba, koma opaleshoni ingagwiritsidwenso ntchito ngati njira yobwezeretsa. Ndi za kukonza kuphwanya kwamiyendo.

M'malo mwake, kuyikanso kwa mafupa ndi arthrodesis sikutembenuka, komwe kumayambitsa kukakamiza pamtunda wa cellar, komwe kumapangitsa kuti pakhale chilonda chosachiritsa. Kuti mugwiritse ntchito njira ngati izi, ndikofunikira kuti mutsimikize kuti vesi limatupa, komanso kwathunthu, ndipo palibe opaleshoni ya mafupa.Ngati izi sizikwaniritsidwa, ndiye kuti pali chiopsezo kuti kulowererapo kwa opereshoni kungayambitse kuwoneka kwatsopano kwa chiwonongeko.

Ndikofunikanso kulimbitsa mafupa ndikukonzekera koyenera musanachite opareshoni.

Kusintha kwa opaleshoni phazi lomwe tafotokozazi ndikofunikira ndikusintha kwamphamvu kwa phazi, zomwe zimapangitsa kugwiritsa ntchito nsapato zapadera za orthopedic.

Njira zopewera

Chinyengo ndikofunikira kudziwa zambiri zamomwe mungapewere vuto ngati phazi la Charcot. Chithunzi cha odwala chimapangitsa kumvetsetsa kuti njira zowonongera izi ndizowopsa bwanji. Ndipo ngakhale atadzipangitsa kumva kuti chithandizo chikuchitika, izi sizitanthauza kuti zilonda sizidzawonekeranso.

Chifukwa chake, ndizotheka kupewetsa ndikuletsa kuphatikizanso kwa phazi la Charcot potsatira mfundo zotsimikiziridwa mu kapangidwe ka kupewa. Choyamba, muyenera kumayeserera pawokha miyendo ndipo, pazizindikiro zoyambirira za kuwonongeka kwa khungu kapena kupindika, pitani kuchipatala kwa endocrinologist kukayesedwa.

Muyenera kusiyanso zikhadabo za msomali ndikugwiritsa ntchito fayilo ya msomali. Nsapato zazifupi siziyenera kusiyanso m'mbuyomu, chifukwa ndizosavuta kupukuta mapazi anu ndikutenga chimanga. Kuphatikiza apo, ndikofunikira kuteteza mapazi kuti asamatenthedwe ndi kutentha kwambiri komanso kotentha.

Ngati bala lidapezeka, liyenera kuthandizidwa ndi yankho la 3% ya hydrogen peroxide, Chlorhexidine ndi Miramistin, lotsatiridwa ndi kavalidwe koyipa. Panthawi imeneyi, mankhwalawa omwe ali ndi vuto lofufuza khungu amawonongeka. Izi zimaphatikizapo ayodini, zelenka ndi potaziyamu permanganate. Ndikofunika kusamalira kuti khungu lisakhale louma. Ma Moisturizer (Callusan, Balzamed, etc.) athandizira ndi izi.

Matendawa odwala matenda ashuga ndi matenda omwe amatha kukubweretserani mavuto ena mukayamba. Chifukwa chake, mukazindikira matenda a shuga, muyenera kuphunzitsidwa koyenera ndikuwunika bwino miyendo yanu.

Matenda a diabetes a osteoarthropathy: zimayambitsa, zizindikiro, mfundo zamankhwala

Mapazi a Charcot (diabetesic osteoarthropathy) ali ndi zifukwa zotsatirazi:

kuwonongeka kwa mitsempha yamapeto, yomwe imayambitsa zazing'ono, zowonongeka zosadziwika, ma chimanga, chimanga,
kulumikizana kwa njira ya matenda opatsirana,
kuphwanya koyenera magazi chifukwa cha kusintha kwamitsempha ya m'miyendo,
bursitis ya zala,
msomali
matenda oyamba ndi mafangasi
khungu lowonda, lopyapyala,
kukula kwa kutupa.

Matenda a shuga amatha kuyambitsa zovuta zingapo.

Chimodzi mwazinthu zowopsa komanso zowopsa za vuto la endocrine ili ndi phazi la odwala matenda ashuga a Charcot (diabetesic osteoarthropathy, cholowa nawo kwa Charcot).

Tikambirananso chifukwa chomwe zimachitikira, momwe angachitire, komanso koposa zonse, momwe mungapewere kuchitika.

Mmodzi yekha mwa anthu 100 odwala matenda ashuga ali ndi matenda monga a Charcot a matenda ashuga. Asayansi akugwirabe ntchito kuti adziwe zomwe zimayambitsa izi.

Masiku ano, zifukwa zingapo zazikulu zatsimikiziridwa mwasayansi:

mawonekedwe osokoneza bongo a shuga ndi neuropathy yomwe ikupanga motsutsana ndi kumbuyo kwake. Panthawi imeneyi, chidwi chamiyendo cha miyendo imasokonezeka, ndiye kuti, ngati mutakanikiza kumapazi, kudina, kapena kugunda, munthuyo sangamve chilichonse. Wodwalayo sangathe kuyika phazi la wodwalayo pomwe akuyenda, dzanja loterolo "silimva" kuuma kwa nsapato ndi zina zosavomerezeka zakunja - izi zimabweretsa kupunduka kwakukulu,
kusuta ndi kumwa mowa. Ngakhale mwa munthu wathanzi, zizolowezi zoyipa zimayambitsa kuchepa kwa lumen ya mitsempha yamagazi, kuchepa kwa magazi, kufa kwa ma capillaries komanso zotsatira zina zosasangalatsa.Mwa odwala matenda ashuga, njirayi imathamanga kwambiri, motero phazi limakhala ndi vuto la kuperewera kwa zakudya ndi mpweya,
nsapato zolakwika
zotumphukira zamitsempha yamagazi, yomwe imadziwika kwambiri ndi matenda a atherosulinosis,
kuphwanya komwe kumachitika mu kayendedwe ka magazi m'thupi. Kuperewera kwa okosijeni m'ziwalo zina kumayambitsa kusowa kwa zakudya, kudziunjikira kwa zinthu zowola, minofu necrosis (imfa).

Munthu yemwe akudwala neuropathy sangazindikire kuti nsapato zikutupa, kuti mwala walowa mu nsapato, kuti chimanga chamagazi chikupanga, etc. Izi zimabweretsa matenda ndikuwoneka ngati kovuta kuchiritsa mabala.

Zizindikiro zowopsa

Chifukwa chake, timalemba zazikuluzo:

kuyenda movutikira, lamya,
kufalikira kwamphamvu m'munsi,
kuvulala kwapamapazi pafupipafupi: kusunthika, kuwonongeka, ma sprains,
calluses okhazikika, ming'alu, khungu lowuma,
red of the mapazi,
hyperthermia imatha kudera lomwe lakhudzidwa,
kupindika kwa chala
kuvulaza
kupweteka kwambiri m'mapazi,
Zilonda zazitali zosachiritsa, mabala. Nthawi zambiri amasintha kukhala mabala amatsukidwe ochita kubisala,
kutuluka kwa dothi,
kuwonongeka kwa msomali ndi bowa,
ingrown toenail.

Pali mtundu wopweteka wa matenda a shuga: ngati wodwala sangadziwe payekha matenda ake. Muzochitika zotere, zambiri zimatengera anthu oyandikira odwala - mwatsoka.

Khungu lofiiridwanso lingasonyeze matenda. Makamaka, izi zimawonekera ngati redness idapangidwa pafupi ndi mabala. Kuphatikiza apo, khungu lokwera limatha kulumikizidwa ndi nsapato zosasangalatsa.

Kutupa kwazomwe zimatha kukhala chizindikiro cha kukhalapo kwa kutupa. Ngakhale umboni wotupa wa matenda, kulephera kwa mtima, kapena nsapato zosankhidwa bwino.

Kutentha kwakhungu kwa khungu kumatha kuwonetseranso kupezeka kwa kutupa kosafunikira. Popeza thupi laumunthu limafooka ndi matenda omwe alipo (shuga mellitus), sangathe kuthana ndi matenda ena akulu.

Kuyenda kovutirapo, kuwonda - kumayambitsa kuwonongeka kwakukulu kapena kuyambitsa matenda. Matenda a fungus, misomali yokhazikika - amawonetsa kukhalapo kwa matenda.

Kuphatikiza apo, zizindikiro zotchulidwa phazi zimawonetsedwa kwambiri ndi kupweteka kwambiri miyendo ndi dzanzi miyendo (matenda ashuga a m'mimba).

Zolinga zakukula kwa matenda amisala

Charcot's syndrome ndi chotupa cha minyewa yonse yamiyendo. Izi zimachitika motsutsana ndi kukula kwa shuga kwa nthawi yayitali m'magazi a magazi (hyperglycemia). Nawonso, hyperglycemia imatha kubweretsa kusintha kotere.

Minofu yamitsempha imakhudzidwa

Odwala omwe ali ndi matenda ashuga akhala akuwulamulira kwanthaŵi yayitali, ali pachiwopsezo cha zovuta zam'munsi zam'munsi. Ndi minyewa yowonongeka yamiyendo, wodwalayo sangamve miyendo yawo. Munthu sangathe kudziwa malo omwe ali m'munsi ndi zala zakumaso pa nthawi yoyenda.

Wodwala matenda a shuga sangathe kumva kuvulala kwamapazi pang'ono - kudula, zipsera, matuza. Komanso, zizindikiro za kuvala kwamwano phazi - chimanga, chimanga.

Mitsempha ya miyendo imakhudzidwa, kotero magazi amayenda.

Kulephera kusamalira matenda a shuga nthawi zambiri kumabweretsa zovuta m'mitsempha, matenda a atherosulinosis.

Kuvulala kumiyendo kumatha kuchulukitsa chiopsezo chovuta kwambiri kuphazi. Vuto limodzi ndi chilonda chosachiritsa. Amatha kuputa mawonekedwe:

kuvulala kwachiwiri, kupanikizika kumtunda,
kubaya kapena kuvulaza mwendo,
chinthu chakunja chomwe chinagwidwa mu nsapato chomwe chitha kuwononga khungu la phazi.

Matendawa akuwonekera.

Kuwonongeka pakhungu la miyendo kapena misomali yokhala ndi kachilombo ka fungus kungayambitse matenda owonjezereka. Ayenera kuwunika nthawi yomweyo. Ngati msomali wakula, uyenera kuthandizidwa nthawi yomweyo kuchipatala.

Matenda a shuga ndi matenda omwe amachititsa kuti chiwalo chilichonse cha munthu chisasalidwe popanda vuto. Pali mitundu yambiri yazizindikiro ndi ma syndromes omwe akusonyeza zovuta za matendawa. Chimodzi mwa izi ndi phazi la Charcot.

Matenda a shuga amayambitsa zovuta zazikulu za kagayidwe, kusachita bwino kwamanjenje ndi machitidwe ena ambiri. Zotsatira zake, zovuta za matendawa zimatha kukhazikika, zomwe zimaphatikizapo phazi la Charcot - njira yomwe imabweretsa chiwopsezo ku thanzi komanso moyo.

Matendawa monga phazi la Charcot, akatswiri amawona ngati vuto lalikulu la matenda ashuga.

M'mabuku azachipatala, mutha kupeza mayina ena a matenda - a diabetesic osteoarthropathy, phazi la matenda ashuga, OAP.

Ngakhale pali kusiyana kwamalingaliro, mawuwo ndi ofanana - mafupa a chidacho ndi phazi awonongedwa, machiritso a minofu yofewa amasokonekera.

Kuvuta kwamatendawa kumachitika chifukwa chakuti pali kusintha kovuta mu kufupika kwa mafupa kotchedwa osteoporosis, resorption of pfupa minofu (osteeliosis) ndi hyperostosis, momwe mafupa amakula.

Nthawi zambiri zinthu zimapanikizika chifukwa cha mawonekedwe a zilonda zam'mimba pazinthu zofewa.

Phazi limakhala lodziwika ndi ma fupa ambiri am'mapazi ndi phazi

Gulu lomwe likuika pachiwopsezo cha matenda amenewa ndi anthu omwe amapezeka ndi matenda osokoneza bongo. Ubalewu umachitika chifukwa cha kupindika kwapang'onopang'ono kwa neuropathy, komwe kuvulala kulikonse kwa khungu la miyendo kumayambitsa kuthamanga kwa magazi m malo omwe akukhudzidwa ndikuwonetsa kwambiri mafupa a calcium, omwe akuphatikizira kusokonekera kwawo.

Ngati mwapezeka kuti muli ndi matenda osokoneza bongo a mellitus ndi zotumphukira neuropathy, mumakhala pachiwopsezo chopanga phazi la Charcot. Neuropathy ndichimodzi mwazinthu zazikulu zomwe zimayambitsa matendawa, chifukwa zimachepetsa mwayi wodwalayo kuti azimva kupweteka, kutentha kapena kuvulala.

Chifukwa cha kuchepa kwa chidwi, wodwalayo nthawi zambiri samazindikira kuti ali ndi vuto, mwachitsanzo, kuwonongeka. Odwala a Neopopathic omwe ali ndi tendon yopapatiza Achilles amathanso kukulitsa phazi la Charcot.

Anthu odwala matenda ashuga ayenera kudziwa zomwe zimayambitsa matendawa komanso kukula kwa matendawo. Cholinga chachikulu ndi shuga wamagazi. Zotsatira zamphamvu za hyperglycemia:

kuwonongeka kwa minyewa yamitsempha kumayamba: wodwalayo amasiya kumva miyendo, samazindikira kuvulala kwazing'ono, amanyalanyaza mawonekedwe a chimanga ndi chimanga,
kutaya kwa magazi kumakulirakulira chifukwa chamatumbo am'munsi,
mwayi wowonjezereka waivulala mwendo
chotupa chodwala chikukula.

Kuwonongeka kulikonse kwa miyendo kwa odwala matenda ashuga kumafunika kuyang'anitsitsa.

mawonekedwe osokoneza bongo a shuga ndi neuropathy yomwe ikupanga motsutsana ndi kumbuyo kwake. Panthawi imeneyi, chidwi chamiyendo cha miyendo imasokonezeka, ndiye kuti, ngati mutakanikiza kumapazi, kudina, kapena kugunda, munthuyo sangamve chilichonse. Wodwalayo sangathe kuyika phazi la wodwalayo pomwe akuyenda, dzanja loterolo "silimva" kuuma kwa nsapato ndi zina zosavomerezeka zakunja - izi zimabweretsa kupunduka kwakukulu,
kusuta ndi kumwa mowa. Ngakhale mwa munthu wathanzi, zizolowezi zoyipa zimayambitsa kuchepa kwa lumen ya mitsempha yamagazi, kuchepa kwa magazi, kufa kwa ma capillaries komanso zotsatira zina zosasangalatsa. Mwa odwala matenda ashuga, njirayi imathamanga kwambiri, motero phazi limakhala ndi vuto la kuperewera kwa zakudya ndi mpweya,
nsapato zolakwika
zotumphukira zamitsempha yamagazi, yomwe imadziwika kwambiri ndi matenda a atherosulinosis,
kuphwanya komwe kumachitika mu kayendedwe ka magazi m'thupi. Kuperewera kwa okosijeni m'ziwalo zina kumayambitsa kusowa kwa zakudya, kudziunjikira kwa zinthu zowola, minofu necrosis (imfa).

Phazi la Charcot mu matenda a shuga: zizindikiro, Zizindikiro, chithandizo

Ngati wodwala yemwe ali ndi matenda ashuga satenga njira zoyenera zopewera matenda, ndiye kuti mavuto sangapewe. Chimodzi mwazomwe zili zovuta kwambiri ndi phazi la Charcot mu shuga.

Popeza mwaona kusintha kwa phazi, mabala, chimanga, zilonda, muyenera kufunsa madokotala. Samalani maonekedwe a zovuta izi:

msomali
maonekedwe a njere zam'munda,
kukula kwa khungu
chala bursitis
kusintha kwa chala.
mawonekedwe a khungu lowuma ndi losalala,
fungal matenda amiyendo ndi misomali.

Ndi ma pathologies awa, kukula kwa matendawa kumakulanso. Anthu odwala matenda ashuga ayenera kulabadira kuti DOAP (diabetesic osteoarthropathy) imawoneka pamene mapazi adakweza, atatambalala, kapena opunduka. Kusankha nsapato kolakwika, kuvutikira kumalo ena miyendo kumathandizanso kukulitsa mavuto.

Zizindikiro za matenda osowa awa ndi monga:

redness of the khungu, lomwe limakhala pafupi ndi mabala,
kutupa kwamapazi, kutupa,
limbypertmia,
Maonekedwe a mabala oyera
chitukuko cha lameness.

Anthu odwala matenda ashuga ayenera kudziwa zizindikiro zonse kuti ayambe kulandira chithandizo munthawi yake.

Zizindikiro za phazi zimakhala zowonekera kwambiri pamavuto omwe amakhala nawo pamunsi:

epidermophytosis ya phazi,
kupindika kwa mbale ya msomali,
bursitis wa zithupsa
kupukusa (kusintha kwa zala),
njerwa pamiyendo,
Khungu louma ndi lodzaza
bowa pamisomali.

Monga lamulo, chimanga chimawoneka m'malo omwe amapukutidwa ndi nsapato, chifukwa chomwe phazi limapereka kukakamiza kolimba. Mutha kuchotsa mawonekedwe awa mothandizidwa ndi pumice. Koma madokotala amalimbikitsa kuti tichotse chimanga chokha ndi katswiri, chifukwa ndikuchotsa kusaphunzira, chilondacho chimatha kukhala chilonda.

Chiwopsezo chotenga bursitis chimawonjezeka chifukwa chovala nsapato zazitali, komanso nsapato zokhala ndi chala chakanthawi. Komanso kulemala uku kumayendera limodzi ndi kupweteka kwambiri. Mutha kuthana ndi vutoli pokhapokha mothandizidwa ndi ma opaleshoni othandizira.

Zifukwa zazikulu zowonekera ming'alu kumapazi ndizophatikiza:

shuga wamagazi ambiri
magazi osakwanira m'miyendo,
kuwonongeka kwa mitsempha mathero.

Kuti mupewe vutoli, muyenera kumakonza thupi khungu lanu nthawi zonse, kuti lisasunthike.

Warts okhawo ndi kukula kwa thupi komwe kumayambitsidwa ndi papillomavirus yaumunthu. Nthawi zina mawonekedwe awa samadzetsa zovuta kwa munthu pakuyenda, koma ngakhale pakalibe zovuta, ma warts amafunikabe kutayidwa. Njira yochotsera imachitika ndi njira ya laser ku cosmetologist.

Zizindikiro zamatenda a phazi la Charcot, zomwe zimapezeka pachikhalidwe cha matenda ashuga:

kupweteka kwakanthawi phazi,
Hyperemia (redness of the khungu),
kuchuluka kutentha kwanuko
Kupangidwa kwa zilonda zam'mimba zomwe sizichiritsa.
pafupipafupi,
kutupa, kutupa,
masinthidwe
ming'alu pa chidendene ndi kumapazi.

Zizindikiro zoyambirira za phazi la Charcot zimaphatikizira dzanzi, kugona m'miyendo, kumva kupsinjika, kupsinjika m'mbali mwa dzanja.

Gawo lachinayi

Pakadali pano, zilonda zosachiritsa zimakhala pakhungu la miyendo. Mabala oterewa amatsogolera pamavuto opatsirana ndikupanga ma phlegmon ndi gangrene. Kuchepetsa ndi chithandizo cha gawo lomaliza la matenda am'mimba ndiwopseza kwambiri;

Mapazi a Charcot amapezeka pang'onopang'ono, amapita patsogolo mwachangu, ndi matenda ashuga, zovuta zingapo zimayambitsa kulumala kwathunthu kwa munthu, kumabweretsa kulumala.

Gulu lachipatala lapadziko lonse lapansi limaphatikizapo magawo anayi a matendawa:

Pa gawo loyamba, matenda am'mimba ndi osatheka kuzindikira. Wodwala sapereka madandaulo owopsa. Chithunzi cha x-ray sichinasinthe. Pa magawo oyamba, njira zama pathological zomwe zimalumikizana zimachitika pamaselo a maselo. Matendawa amatha kukayikiridwa pamaso pa matenda oyamba ndi mafangasi a misomali, bursitis ya chala chakumapeto, toxil toenail, chimanga.
Gawo lachiwiri limadziwika ndi kusyasyalika kwamiyala ndikusintha kwamiyendo. Phazi lakhudzidwa limakhala lalikulu. Pa x-ray, kusintha kwa ma pathological kumalongosoledwa momveka bwino. Wodwalayo amadandaula za kuchepa kwa chidwi m'madera am'munsi, kumva kuwawa, kupweteka poyenda. Kuzindikira koyenera komanso chithandizo cha matenda a siteji 1, 2 amalepheretsa kupitilira kwa zizindikiro.
Gawo lachitatu limadutsa ndikuwonetsedwa. Symbomatology yam'mbuyomu imadziwika, yomwe imathandizidwa ndi ma fractures, dislocations popanda chochititsa. Zala zimapinda, munthu samatha kuyenda bwinobwino. Kuchiritsa kwathunthu matendawa sikugwira ntchito. Odwala amawonetsedwa ngati othandizira komanso othandizira.
Pa gawo lotsiriza, maonekedwe a zilonda amadziwika - mabala amachiritsidwa. Kachilombo ka bakiteriya kamajowina. Phlegmon, gangrene amawoneka pakhungu la malekezero apansi. Palibe opaleshoni yofunika kuchitidwa opaleshoni. Munthu amakhala wolumala.

Ngati matenda ashuga a psychoarthropathy sanachiritsidwe, matenda a matenda a khansa amapangidwa. Mafupa osweka amapopera molakwika ndikupanga kuphwanya kwa phazi.

Mafupa a chipilalacho atagwa, phazi lathyathyathya limapangidwa. Zimakwiyitsa kukula kwa zolakwika zolonda. Munthawi imeneyi, ndizosatheka kubwezeretsanso ntchito zam'mbuyomu.

Matenda a matenda ashuga amakula pang'onopang'ono, akudutsa motsatizana:

Gawo loyamba limadziwika ndi kuwonongedwa kwa minyewa ya sequular, cartilage. Dislocations, sprains ndi zoopsa zina zovulala ndizotheka. Pakadali pano, zizindikiro monga kutupa kwa phazi, kufiira kwa khungu kumapazi ndi chidendene, komanso kuwonjezeka kwa kutentha kwanthawi kumawonedwa.Palibe ululu wammbuyo.
Gawo lachiwiri limadziwika ndi kusinthika bwino kwa mafupa, kapangidwe kazomangamanga. Kuzindikira matenda am'mimba ndikotheka ndikuwunika kwa x-ray. Kusintha kwa minofu yamafupa kumadziwika nthawi yomweyo.
Mu gawo lachitatu, kuwonekera kwa mafupa a ankolo kumawonedwa. Odwala amadandaula za kupweteka, kugwada kwa zala, kuphwanya zinthu zoyambira za phazi, mavuto akuyenda komanso kugwirizanitsa. Nthawi imeneyi imadziwika ndi patacrafic fractures ndi dislocations.
Gawo lachinayi limadziwika ndi mawonekedwe a zilonda zam'mimba, zilonda, zotupa pakhungu la phazi la wodwala wodwala matenda ashuga. Ngati sanachiritsidwe, matendawa amatenga matenda opha ziwalo, phlegmon, sepsis, komanso poyizoni wa magazi. M'malo oterowo, njira zochitira opaleshoni sizingagawidwe.

Akatswiri amasiyanitsa magawo anayi a matenda. Poyamba, odwala amagwera mafupa, amawoneka owoneka ngati mafupa, mafupa amaphatikizika amatambasuka. Zonsezi movutikira zimatsogolera ku mawonekedwe a dislocations. Khungu limakhala lofiira, kutupira kumawonekera, matenda oopsa am'deralo amawonedwa.

Mu gawo loyamba, odwala alibe ululu. Pathology siziwonekanso ndi kuwunika kwa x-ray. Mafupa a minofu amatulutsidwa, ndipo ma fractures ndi ma microscopic.
Gawo lachiwiri limadziwika ndi kuyamba kwa kugawanika kwa mafupa. Zipilalazo zidakutidwa, mapazi ake amayamba kupunduka. Pakadali pano, mutha kutenga x-ray: zosintha ziwoneka.
Mu gawo lachitatu, kuwunika kungachitike pamaziko a kuyesa kwakunja: pali kuwonekera koonekera. Zodzipatula zokha ndi ma fractures ziwoneka. Zala zakumaso ngati mbedza, katundu pamapazi amagawikanso. Pa x-ray, kusintha mwamphamvu kudzawonekera.
Kuzindikira pa magawo anayi siovuta. Zilonda zopanda machiritso zilonda. Zotsatira zake, kachilomboka kamafika mabala, phlegmon ndi gangrene amapangidwa.

Ngati mukukana chithandizo, muyenera kudula mwendo nthawi yayitali.

Pali magawo anayi a chitukuko cha matenda ashuga.

Gawo 1 - mafupa akuwonongeka (lakuthwa, lambiri mafupa owundana, kuwonongeka kwa mafupa, ma dislocations). Pakadali pano, phazi limatupa, khungu limafupika, kutentha kumakwera. Wodwala pakadali pano samva ululu uliwonse.

Gawo 2 - phazi limakhala lopindika, ndipo zipilala zimakhala zonenepa.

Gawo 3 - Kusintha kwa mafupa ndikuwonekera kwambiri. Masinthidwe akuwonekera bwino. Zosokoneza, zobwera mozungulira ndizotheka. Zala zikugwada. Ntchito ya kumapazi imasokonekera.

Gawo 4 - mapangidwe a mabala. Zimayambitsa matenda.

Phazi la Charcot (kapena diabetesic osteoarthropathy) ndi matenda opita patsogolo omwe amabwera mkati mwa masabata kapena miyezi ingapo. Kutupa kosasunthika kumabweretsa kuwonongeka kwa phazi ndi chifuwa cholumikizira komanso zofooka zazikulu.

redness
kutupa (chizindikiro chachikulu),
kupweteka
ofunda mwendo
wolimba phazi,
kutayika kwa mwendo,
kutulutsa
kuwonongeka kwamitsempha
Kusintha kwa phazi.

Pali magawo 4 a phazi la odwala matenda ashuga a Charcot. Zonse zimayamba ndikuwonongeka kwa mafupa, mafupa owuma kwambiri amakula, makapisozi otambasuka amatambasulidwa. Vutoli limakhala chifukwa chakuwoneka ngati dislocations. Kenako khungu limayamba kufooka, kutupa ndipo matendawo amaoneka.

Gawo loyamba limadziwika ndi kusapezeka kwa ululu. Pathology sidzazindikira ngakhale pa x-ray. Mafupa am'mimba adzatulutsa, ndipo mawonekedwewo adzakhala ochepa.
Mu gawo lachiwiri, njira yodulira mafupa imayamba. Pankhaniyi, khwalala lathyathyathya, phazi lake ndi lopunduka. Pakalipano, kuyesa kwa X-ray kudzakhala kothandiza.
Gawo lachitatu limalola adokotala kuti adziwe matendawa mukamayesedwa kunja: kusinthika kudzadziwika.Mafupa obisika pang'onopang'ono amayamba kuwoneka. Zala zawo zimayamba kugwada, katundu pamapazi amapatsidwanso. Pakuwunika kwa x-ray, kusintha kwakukulu kumaonekera.
Pozindikira gawo 4 palibe zovuta. Zilonda zopanda machiritso a trophic, omwe pambuyo pake amatenga kachilomboka. Phlegmon imapangidwa ndipo, monga chotulukapo chake, pakhoza kukhala zachiwerewere. Ngati thandizo siliperekedwa munthawi yake, kudula kumatsata.

Ndi Charcot phazi, kusintha koteroko mu minofu ya mafupa kumatha kupita patsogolo:

mafupa - mafupa amakhala ochepa thupi, mphamvu zawo zimachepa,
Kuthana ndi mafupa - minofu yamafupa imatilira kwathunthu,
hyperostosis - kotakasa mafupa amakula.

Mafupa amathyoledwa mobwerezabwereza ndipo sanasankhidwa molakwika. Zotsatira zake, phazi ndilopunduka. Popita nthawi, zinthu zikuipiraipira - zovuta za neuropathic zimawonekera. Pamodzi ndi kupunduka ndi miyendo, zilonda zam'mimba zimayamba.

Phazi la Charcot sindiwo chiwonetsero chokha cha phazi la matenda ashuga.

Poyerekeza ndi matenda a shuga a shuga, njira ya neuroischemic imayamba. Imadziwoneka ngati yowonongeka m'magazi: kumvetsetsa ndi mawonekedwe a phazi limasungidwa. Koma pali chotupa, khungu limayamba kuzizira, zimachitika.

Kuwoneka kwa mawonekedwe osakanikirana kuwonongeka ndikothekanso: nthawi yomweyo, zizindikiro za phazi la Charcot ndi neuroischemic pathology zimayamba.

Kutengera ndi zomwe zimayambitsa, zopweteka zomwe zidayambitsa kupangika kwa phazi la matenda ashuga, madokotala amatha kusiyanitsa mitundu ingapo yayikulu ya matendawa.

Neuropathic

Ili ndiye mtundu wofala kwambiri wamapazi matenda. Amayamba kutsutsana ndi maziko a neuropathy - kuwonongeka kwa minyewa yamitsempha. Amadziwika ndi kuwotcha, kuwawa, kupweteka, kumverera kwa tsekwe zopendekera pamapazi. Popita nthawi, kusintha kwamatenda mu minofu yonse pamiyendo kumachitika, komwe kumatsogolera pang'onopang'ono ndikuwonongeka kwa ntchito zofunika.

Ndi mawonekedwe a neuropathic, zilonda zimadziwika kumtunda, zala, komanso pakati pawo, popeza pakadali pano zimakhala zovuta kwambiri. Matendawa nthawi zambiri amayenda limodzi ndi kusintha kwamankhwala olumikizana ndi mafupa.

Ischemic

Mtundu uwu wa phazi la Charcot umalumikizidwa ndi matenda monga matenda ashuga angiopathy - kulowetsedwa kwamitsempha yamagazi komanso kuperewera kwama magazi bwino. Wodwala motsutsana ndi zomwe zimayambitsa matenda ena a shuga ali ndi zizindikiro zake:

kutsekeka ndi khungu
kumva kuzizira m'miyendo
mawonekedwe a zilonda zidendene ndi zala,
zolimba zopanda paliponse m'dera phazi.

Mtundu wosakanizika wa phazi la Charcot, kuphatikiza mawonetsedwe amitundu ischemic ndi neuropathic, samajambulidwa machitidwe azachipatala. Malinga ndi ziwerengero, pafupifupi 15% ya anthu odwala matenda a shuga amadwala matendawa. Kwa mawonekedwe osakanikirana, mawonekedwe azachipatala omwe afotokozedwa pamwambapa ndi achilengedwe.

Kutengera chifukwa chomwe matenda ammiyendo adayambira, mitundu yotereyi imagawidwa.

Phazi la matenda ashuga: njira zochizira

Chimodzi mwazovuta za matenda a shuga ndi phazi la matenda ashuga. Chithandizo cha matendawa chimakhala chikukonzedwa nthawi zonse komanso njira zamakono zokhudzana ndi mankhwala komanso zovuta zamagetsi. Izi zikuwonetsa matenda osatha a carbohydrate metabolism amadziwika kuti amachedwa kapena amachedwa ndipo amawonedwa ngati owopsa komanso osayenera kulosera zam'tsogolo.

Matenda a shuga a matenda ashuga ndiwonetsero wa gangrene - njira yodukiza ya mbali yakumunsi. Potengera izi, wodwalayo amatha kulephera kuchita zinthu zina zodzichitira pawokha kapena kuderera ngati munthu.

Chofunika cha matenda

Necrosis yamatenda am'munsi malekezero a shuga imakhala yovuta kwambiri. Matenda a zilonda zimagwirizanitsidwa ndi kubwezera kosakwanira kwa matenda a shuga malinga ndi kuchuluka kwa mphamvu zofunika m'thupi.

Nthawi zambiri, shuga mellitus amasankha bedi yaying'ono yokhala ndi ma cellvas, ziwiya zazikulu-zotulutsa komanso ma neural conduction kuti apange zovuta. Matendawa odwala matenda ashuga amakula ndi kufalikira kwa matenda mu ziwalozi.

Vutoli ndi kuphatikiza njira zingapo:

kusintha kwamatenda a minofu yofewa,
kutsika kwamatenda oyenera m'mitsempha yayikulu,
kuchepa kwa conduction wamanjenje ndi kuzindikira.

Nthawi zambiri odwala matenda ashuga amapezeka mwa odwala omwe ali ndi vuto lachiwiri. Matenda a shuga achichepere sakhala wamba, koma kupewa matendawo kumatenga nthawi yambiri komanso kufunika kwake.

Zilonda zam'mimba zokhala ndi zilonda zapakhosi zimayamba kudwala mwa khumi aliyense wodwala matenda a shuga. Ngati chiphuphu chosakwanira chamafuta am'magazi chikuchitika, shuga owonjezera amakhudza kwambiri chilengedwe komanso kapangidwe ka ma cell.

Hemoglobin wa tinthu tachilengedwe tambiri timadzi tomwe timalumikizidwa.

Gawo la khumi la odwala matenda ashuga amakhala ndi vuto lofooka ndipo amakakamizidwa kulandira chithandizo chifukwa chodulidwa chiwalo. Nthawi zina machitidwe oterowo samapulumutsa miyoyo ya odwala: ambiri opulumuka pakadwala samadwalanso zaka ziwiri.

Izi zimatsimikizika ndi mfundo yoti:

Miyendo yakumapazi, makamaka mapazi ndi miyendo yakutsikira, amachotsedwa kwambiri pamtima, ndipo magazi amayenda mkati mwake amachepa pang'ono.
Chifukwa cha izi, chiwopsezo cha glucose chimawonjezeka, ndipo ma cell omwe amapanga ndi minofu yeniyeni amavutika kwambiri.
Kutsika kwa chidwi cha kupweteka poyang'ana kumbuyo kwa neuropathy komwe kumayamba kumayambitsa kuvulala kosafunikira ndi ma microdamages omwe amachiritsa kwa nthawi yayitali komanso languidly.
Katundu wambiri pamunsi yam'munsi ya munthu wamakono amakulitsa njira ya pathological.

Zolemba zamankhwala

Matenda a shuga am'magazi amawagawa m'mitundu:

Njira ya ischemic ya pathology imakhala ndi zotupa zoyambirira zamagazi. Zolimba zamiyendo, zakuya komanso zapamwamba, kwenikweni sizivuta.
Minofu yamitsempha makamaka imakhala ndi mawonekedwe a neuropathic mawonekedwe a zilonda zam'mimba zotupa ndi miyendo yotsika.
Matenda osakanikirana samatipatsa mwayi kuti tidziwe njira zomwe zimayambira matenda a shuga komanso zovuta zake.

Chithandizo cha matenda ashuga chimatsimikiziridwa makamaka ndi mawonekedwe ake azachipatala. Kudziwitsa za matenda a shuga kumayeneranso kukupangitsani chidwi kwambiri ndi thanzi lanu ndikuwona kusintha kwakang'ono pa khungu ndi kumverera kwanu kwamkati.

Ndikofunikira kwambiri kuzindikira kusintha kulikonse kumapazi ngati sikunafike pamlingo waukulu ndipo sikunafalikire kumiyendo yayikulu.

Zizindikiro za phazi la matenda ashuga sizitha kunyalanyazidwa, kuti musawamasulire mu zovuta:

Msomali wovomerezeka umachitika ndikudula kwaukhondo kwa misomali. Mbale ya msomali mu shuga mellitus imafooka, ndipo m'mphepete mwake amatha kuthana ndi minofu yofewa ndikuthandizira. Kuchita opaleshoni mwadzidzidzi kumatha kuyimitsa njira yotupa, mawonetsedwe oyamba omwe amatha kutembenukira munthawi.
Vuto la zilonda zapazi limatha kuyamba ndi khungu la msomali wamkati pansi. Nthawi zambiri chizindikiro ichi chimagwirizanitsidwa ndi kuvala nsapato zolimba, zomwe sizovomerezeka muzovuta zamankhwala.
Mu shuga mellitus, kachilombo koyambitsa matenda a misomali sikuloledwa, komwe kumakukulitsa, kusintha mtundu, kumapangitsa mawonekedwe a mapazi kukhala osasangalatsa komanso okonzedwa. Misomali yothina imafinya zala ndi phazi lenileni, zomwe zimayambitsanso kukha magazi kwakuthengo ndikusinthira kwachuma zosiyanasiyana komanso kulimba.
Ndi nsapato zosavutikira, chimanga ndi chimanga chosapangidwa chimapangidwanso. Ndikofunika kuti muwachotse moyenera pogwiritsa ntchito pumice osasenda miyendo, komanso kupewa kuti mapangidwe awo azigwiritsa ntchito insoles ya orthopedic.

Matenda a shuga m'mawonekedwe ake ndi matenda a polysymptomatic, ndipo nthawi zambiri amachepetsa kumva kupweteka kumayendera limodzi ndi kunenepa kwambiri komanso kupepuka kwamaso, zomwe zimapangitsa njira yodziyimira pawokha yaukhondo imakhala yoopsa. Chocheka chilichonse kapena chovulala chaching'ono chimayenera kupakidwa mankhwala, ndipo chovala chovalachi chiyenera kuyikidwa ngati kuli koyenera.
Khungu louma limaphatikizanso odwala omwe ali ndi matenda osokoneza bongo ndipo nthawi zambiri amakhala ngati amodzi othandiza kuzindikira matenda. Ming'alu m'dera la zidendene motsutsana ndi chouma imatha kuthandizidwa momveka bwino ndi zilonda zam'mimba.

Zizindikiro za phazi la matenda ashuga, omwe ndi ofunikira kudziwa njira zamankhwala atipangire:

poganiza kuti watha ntchito
goosebumps
nthawi ndi nthawi kumalimira m'miyendo ndi kumapazi.

Kuwonetsera kulikonse komwe kwapezekanso pamagawo obwereza kumafunikira thandizo lazithandizo.

Kuchiritsa kwa mankhwalawa kwa phazi la matenda ashuga chifukwa chipatala chambiri chimakhala ndi mayendedwe ambiri. Komabe, chithandizo chachikulu chofunikira ndicholinga chokwanira kulipira moyenerera matenda a shuga.

Komanso, momwe matenda amayambira m'magawo oyamba komanso pamene akukula amafuna njira zosavuta zodzitetezera:

Ndikofunikira kuteteza matenda a kuthamanga kwa magazi. Matenda oopsa ophatikizidwa ndi microangiopathy amathandizira kukulitsa phazi la matenda ashuga mwachangu komanso mosasunthika.
Mlingo wokwanira wa cholesterol m'mwazi ndizofunikiranso kupewa matenda chifukwa kuchotsedwa kwa venous stasis m'munsi malekezero.
Njira zodzitetezera ndizofunikira kwambiri pakusamalira mapazi oyera. Amawonetsera matenda a kudzilimbitsa, othandizira olimbitsa thupi.

Malangizo ambiri azachipatala akukhudzana ndi kusankha kwa nsapato ndi wodwala yemwe ali pachiwopsezo chachikulu chokhala ndi matenda ammagazi a matenda ashuga:

Nsapato zotonthoza zimachepetsa chiopsezo cha zovuta izi pafupifupi katatu.
Anthu odwala matenda ashuga ayenera kupatsa chidwi nsapato zosasoka kwambiri zomwe sizimafinya phazi komanso zokulirapo kuposa phazi mulifupi.
Ndibwino ngati nsapatozo zili ndi malamba kapena Velcro ngati miyendo yanu itatupa pambuyo pogwira ntchito tsiku.
Nsapato yokha iyenera kukhala yolimba ndikubwereza zingwe za anatomical phazi, apo ayi - payenera kukhala malo oti akhazikitse insole ya orthopedic. Zinthu izi zitha kuthandizidwa ngati wodwalayo ali ndi zofooka zina pamapeto otsika.

Poyamba, chithandizo cha zovuta zamatenda a shuga mu mawonekedwe a zotupa za m'mimba zam'minyewa zam'munsi zoyipa zinali ntchito ya endocrinologists. Popita nthawi, njira zoyeserera zochizira matendawa zakhala zothandiza kwambiri mpaka nthawi zina amatha kupewa opareshoni.

Ili ndiye gawo lalikulu kwambiri la kulinganiza chisamaliro cha odwala omwe ali ndi matenda amwazi ndi mitundu yambiri ya kagayidwe. Ena otsika ndi endocrinologists a nthawi zonse omwe amaperekanso chithandizo chokwanira chamankhwala.

Chithandizo chimafunikira kale chifooko chaching'ono pamwamba pa phazi kapena mwendo wapansi, ngati wodwala matenda a shuga akupezeka pamapu odwala. Mankhwala awo amadzuka kuti asachotse matenda ndi kuchiritsa koyambirira kwa microtrauma ndimankhwala osachepera osaneneka.

Zinthu zonse zokhala ndi zakumwa zoledzeretsa ndizotsutsana, komanso kavalidwe kabwino ka gauze ndi bandeji. Monga njira ina, iwo adavala zovala zamakono zothandizira band zomwe zimakhazikika pakhungu ndikuziteteza.

Ngati vuto la mwendo likuwoneka ndipo ladziwonetsa kale mwachipatala, ndikofunikira kuti muchepetse katundu pamapazi.

Zida zingapo zamtundu wa momwe zingathandizire ndi:

kutsitsa ma bandeji,
nsapato,
nsapato.

Mwachilengedwe, chisamaliro chamankhwala othandizira odwala matenda a shuga chimachitika pokhapokha ngati matendawo atapezeka, zomwe sizotheka.

Kuchiza kwanuko sikothandiza ngakhale chifukwa chomwe zilonda zam'matumbo zimagwirira ntchito m'magazi akulu, zimafunikira opaleshoni yodutsa kapena ena angioplasty.

Mankhwalawa odwala matenda ashuga amagwiritsidwa ntchito:

Matendawa odwala matenda ashuga amatanthauza kugwiritsa ntchito maantibayotiki pamankhwala ake. Wodwalayo amalandiranso chidziwitso chotere ngati bala la kachilomboka litapezeka, pomwe mabakiteriya achulukana ndikuwoneka ngati chipatala choyenera. Mankhwala othandizira antibiotic nthawi zambiri amachokera kwa othandizira omwe ali ndi zochita zambiri, koma kafukufuku wamankhwala am'masiku ano amatilola kukhazikitsa kuthekera kwazinthu zazing'ono kwambiri kwa ma antibacterial ena, omwe amatsimikiza kupambana kwa mankhwalawa. Kuti tichite izi, ndikokwanira kufesa mabakiteriya pazinthu zomwe zakhudzidwa ndikuchita kafukufuku wa bakiteriya.
Kudzicheka ngati njira yayikulu yothandizira matenda a purulent-necrotic of the m'munsi malembedwe a shuga mellitus akadali ambiri masiku ano. Imachitika pofuna kuti kufalikira kwa magazi kufalikire m'magazi, komwe kumayendetsedwa ndi kuledzera komanso sepsis ya chamoyo chonse. Mchitidwewo, womwe pambuyo pake umafuna kudula, nthawi zambiri umayamba ndi zilonda zam'mimba, zomwe sizilandira mankhwala oyambitsa matenda ndipo zimakhudza zigawo zonse za khungu. Ma sumu okhala ndi bacteria omwe amachokera ku gwero ili amalowa m'magazi ndikuwumitsa ziwalo ndi thupi lonse.
Kuchepetsa thupi kungafunikenso ngati sipangakhale chidakwa chonse cha thupi, koma kufalikira kwa purulent-necrotic mu minofu. Pansi pa mafupa amatha kugwira nawo ntchito yotupa, yomwe imatchedwa osteomyelitis. Njira ya pathological iyi ndiowopsa osati kokha mwa kupatsirana kwachilengedwe, komanso mwa kupangidwa kwa foci ya thrombosis.
Amakhulupilira kuti mawonetsedwe akunja a phazi la matenda ashuga ayenera kuthandizidwa ndimafuta kapena mafuta. Komabe, lingaliro ili ndilolakwika chifukwa chakuti mitundu iyi ya mankhwala ndi njira yabwino kwambiri yoperekera mabakiteriya palonda lovulala. Zochita zawo zidayenda bwino popanda njira zamakono zamankhwala, ndipo pakadali pano, zinthu zamafuta zimangowonjezera zochita. Kupukutira kwa antibiotic komanso ma siponji okongoletsa omwe amachokera ku collagen omwe amagwira ntchito yotsutsa antimicrobial ndi othandiza pakudziwitsani ming'alu ndi microtraumas.

Pa njira iliyonse ya pathological, mankhwala achikhalidwe amapereka mankhwala ambiri ndi njira zomwe amagwiritsa ntchito. Chithandizo cha sayansi sichithetsa njirazi ngati kugwiritsa ntchito mankhwalawa kumagwirizana ndi adotolo, ndipo adawonetsetsa kuti izi sizingavulaze wodwalayo. Matenda a shuga pakati pamankhwala amchikhalidwe amaloleza kugwiritsa ntchito decoction ya blueberries, mafuta a clove, uchi wa linden, yogati, masamba ndi mizu ya burdock. Iliyonse ya njirazi imachitika ngati njira yodulira m'mimba simunafotokozedwe bwino, ndipo thandizo loyenera limafunikira kuti mubwezeretse chitetezo cha mthupi lanu ndikuyambitsa njira zobwerezera.

Zizindikiro ndi chithandizo cha phazi la Charcot mu shuga

Matenda a shuga amakhalanso ndi zovuta zina zomwe zimakhudza masisitimu ambiri amthupi.

Phazi la Charcot kapena diabetesic osteoarthropathy (OAP) ndi vuto lalikulu la matenda osokoneza bongo (MM), momwe matenda am'magazi adayambitsa kuwonongeka kwa gawo la minofu ya mafupa.

Amawonetsedwa kuti "kusintha kosagwirizana ndi matenda mu mafupa ndi mafupa oyambitsidwa ndi matenda am'mimba." Kusintha kowawa kwa kapangidwe ka phazi kufotokozedwa ndi Zh. Charcot, wasayansi waku France wakuchita zamisala komanso mitsempha.

Odwala omwe ali ndi OAP, kuchepa ndi kuchepa kwa mphamvu ya mafupa (mafupa), kuchuluka kapena, m'malo mwake, kuwonongeka kwa minofu yam'mafupa (hyperostosis ndi osteolysis) kumaonedwa.

Njira izi zimatsogolera ku fupa la mafupa a phazi, kuphatikizika kumachitika molakwika, komwe kumabweretsa kuwonongeka. Mafupa a pathologies amayambitsa kuwonongeka ndi kuwonongeka kwa minofu. Zilonda zimawonekera.

Poyamba, zotupa za neurotraumatic zimakhulupirira kuti zimayambitsa zovuta. Kusokonezeka kwamitsempha yamafupipafupi kumayambitsa kufalitsa molakwika kwa mafupa a phazi, zomwe zimapangitsa kuwonongeka ndi mafupa amtundu umodzi.

Kafukufuku waposachedwa awonetsa kuwonjezeka kwakukulu pakupezeka kwa magazi kuzinthu zamiyendo. Zotsatira zake zinali chomaliza - mitundu yokhayo ya neuropathy imapangitsa kuwonongeka kwa phazi la Charcot ndikugonjetsedwa kwamtundu umodzi wamitse mitsempha yotchedwa myelin. Ndizosintha zawo zomwe zimayambitsa kuphwanya kwa mtima wamatenda ndikuthamanga kuyenda kwa magazi.

Kuphwanya kashiamu kagayidwe, kollagen kupanga nawo mu zotupa za mtima mu shuga mellitus. Kusintha kwathambo m'mafupa sikungakhale kopweteka.

Komanso, atagwa, wodwalayo akupitilizabe kuyenda, akumakulitsa chiwonongeko cha mafupa a m'munsi. Kutupa kwa minofu kumapangitsa kuti magazi azithamanga komanso kuthamanga kwa msana wa osteoarthropathy. Mu OAP, mafupa, mafupa, minofu yofewa, mitsempha yodutsa ndi mitsempha yamagazi imakhudzidwa.

Kukonzanso kwa minofu ya mafupa kumayendetsedwa kwambiri ndi insulin, kupanga kwake komwe kumalepheretsa shuga. Bone demineralization, momwe kuchuluka kwa calcium kumachepetsedwa kwambiri, kumabweretsa kukula kwawoko.

Matenda a shuga a diabetes amakhala ngati vuto la shuga, lochepera 1%. Olemba ena azachipatala amatcha chizindikiro chosiyana - mpaka 55%. Izi zikuwonetsa zovuta za kuzindikirazo komanso njira zosayenerera pakuzindikira.

Titha kunena kuti kuvutikira kumeneku kumachitika mwa odwala omwe ali ndi matenda osokoneza bongo kwa zaka zopitilira 15 ndipo amagwirizana ndi matenda awo popanda chidwi.

Zofunikira: ndizosatheka kuneneratu kukula kwa phazi la Charcot. Ngakhale ndi neuropathy yayikulu, vuto silikhala nthawi zonse.

Magawo oyamba a zovuta kwa wodwala sawoneka. Mapeto amitsempha osokonezeka samapereka chisonyezo cha kupweteka kwapafupipafupi ndi kufooka kwa mafupa.

Zizindikiro za phazi la a Charcot zimadziwika (onani chithunzi) pomwe kusintha kwakukulu pakuwongolera phazi ndi kulumikizana kwachitika ndikuwonekera kwa khungu.

Pambuyo pake, zilonda zam'mimba zimayang'aniridwa, zomwe, zikagwidwa, zimatha kutha ndi gangrene.

Zizindikiro za OAP zomwe zikupanga izi ndi:

kutupa ndi kufupika kwa gawo lakumanzere, kusiyana kwawo kwakukulu ndi kukula kwake wina ndi mnzake,
kukokana mu minofu ya ng'ombe
zovuta kuyenda
dzanzi
kuwonjezeka kwa kutentha kwa miyendo, kukhudza iwo kumatentha kwambiri kuposa gawo lina la nthambi.

Zizindikiro izi sizingakhale zizindikilo za OAP, chifukwa matenda a shuga amayenda ndi zovuta zambiri. Matenda a shuga a shuga, osavutidwa ndi phazi la a Charcot, amatsogolera zochitika zofananira m'miyendo.

Nthawi zambiri, awa ndi mavuto am'miyendo omwe anthu ambiri amakhala nawo. Mafupa amatha kuwoneka, msomali wokhazikika, "fupa" limakula. Matenda a fungal a misomali nthawi zambiri amakula.

Kuphatikizidwa ndi shuga wambiri, sizitha kwa nthawi yayitali. Mavutowa nthawi zambiri amatsogolera kuti gawo loyambirira la matendawa silikuwoneka.

Matendawa ali ndi mitundu iwiri - yovuta komanso yopweteka. Mu gawo la pachimake, pali kuwonjezeka kwakukulu kwa kutentha kwa thupi ndi hyperthermia ya m'munsi mwendo, kupweteka poyenda, kutupa kwambiri.

Mawonekedwe osapweteka, mawonekedwe owoneka amachoka, phazi likuwonekera, phazi limatembenukira kumanja kapena kumanzere, mafupa amadzaza khungu lakunyumba, zilonda zam'mimba ndi khungu.

Matendawa ali ndi magawo anayi, omwe amatsimikiza ndi kuchuluka kwa zotupa zake:

Choyamba - x-ray ya phazi nthawi zambiri siziwonetsa kusintha. Matenda a mafupa amayamba, pali ma microcracks. Pali kutupira pang'ono, hyperemia ndi kuwonjezeka pang'ono kwa kutentha. Izi ndi zovuta pachimake matenda.
Lachiwiri ndi maphunziro apamwamba. Kutupa ndi hyperthermia kumachepa. X-ray ikuwonetsa kugawanika, kudzipatula kwa mafupa amtundu uliwonse kuchokera kumafupa. Pali zosintha (zozengereza) zokhazokha.
Chachitatu chimadziwika ndi kusinthika kwathunthu. Kuwonongeka kwa mafupa a phazi ndikwadziko lonse lapansi. Itha kutchedwa "chikwama cha mafupa." Kapangidwe ka mafupa kanawonongeka, akuti mafupa.
Wachinayi ndi mtundu wovuta wa matendawa. Kuchepa kwa mafupa kumabweretsa chiwonetsero cha khungu pakhungu ndi zilonda zam'mimba zokha komanso pamwamba. Matenda ophatikizidwa amayambitsa phlegmon, ma abscesses, ovulala kwambiri.

Njira zamatsenga zimakhudza olowa. Pali kutalika kwa kapisozi, kuphwanya zida zaumisili, kufalikira kumayamba. Mphamvu ya wodwalayo imasintha. Zosintha zomwe zimayambitsidwa ndi matenda a shuga a shuga zimatchedwa malo a Charcot.

Kuzindikiritsa matendawa kumachitika m'malo apadera "matenda a shuga." Madotolo omwe amawona odwala omwe ali ndi matenda osokoneza bongo samakonda kukumana ndi zovuta za matendawa ndipo alibe luso lozindikira komanso kuchiza.

Ngakhale gawo lotsiriza nthawi zina limalakwitsa chifukwa cha phlegmon, osteomyelitis, kapena zotupa zina pakhungu ndi mafupa. Zambiri zotsika za ma x-ray m'magawo oyamba zimayambitsa kutayika kwa nthawi komanso mwayi waukulu wolumala.

Pozindikira OAP, ndikofunikira kupatula matenda opepuka a mafupa - osteomyelitis ndi matenda okhala ndi zofanana ndi zowonongeka - rheumatism ndi ena.

kuyezetsa magazi kwa biochemistry, coagulation ndi zina zonse,
kusanthula kwamkodzo ndi ntchito ya impso,
radiology
MRI
scintigraphy.

Magnetic resonance imaging ndi scintigraphy zimapangitsa kuti azindikire macrophane, kuchuluka kwa magazi ndi kupezeka kwa njira yotupa m'magawo otsika. Izi ndiye maphunziro owulula kwambiri. Leukocytosis imathandizira kuzindikira osteomyelitis, chifukwa siinawonedwe ndi OAP.

Chigoba cha mafupa

Zotsatira za zoyesazi nthawi zambiri sizimalola kuti chizindikiritso cha OAP chizindikirike, chifukwa njira ya pathological imatha kuchitika mu gawo lililonse la minofu yamafupa.

Chifukwa chake, ndi asymmetry ya malekezero am'munsi ndi hyperthermia m'modzi wa iwo, neuropathy yodziwikiratu, chithandizo nthawi zambiri chimadziwika popanda chidziwitso cholondola.

Izi zimakuthandizani kuti muchepetse kuwonongeka kwa minofu yapanthawi.

Njira yodziwitsa matenda ake ndi yoperewera yokhala ndi maselo oyera oyera. Kufufuza mafupa kumathandizira kuzindikira OAP molondola kwambiri.

Gawo lofunika la chithandizo ndikuchotsa katundu kumapazi, komwe kumayambitsa kuwonongeka kwa mafupa a pansi.

Kupuma kwathunthu kumafunikira pakukweza mwendo.

Umboni wa kukonzanso udzakhala:

kuchepa kwa puffuffuff,
kutsitsa kutentha kwa thupi ndi miyendo,
kuchepetsa kutupa.

Kuchepetsa katundu kumathandizira mafupa kulowa m'malo. Wodwala akapitilira osasunthika, kusinthaku kukupitirirabe. Pa gawo loyamba la matendawa, kupumula ndikofunikira kuposa chithandizo chamankhwala.

Mkholo ukakula, mankhwala amtundu wapadera amayenera kugwiritsidwa ntchito poyenda.

Pambuyo pake, zidzakhala zokwanira kuvala nsapato za orthopedic, zomwe zidzagawa bwino katunduyo pamapazi.

Zovala zakukonzekera zomwe zikugwiritsidwa ntchito m'maiko ena sizivomerezeka ndi madokotala athu. Amatha kuyambitsa kukwiya komanso kuwonongeka kwa dzanja.

Magulu ogwiritsira ntchito mankhwala:

Kusintha kagayidwe kachakudya minofu. Bisphosphonates ndi calcitonin amathandizira kuti ayimitse mafupa.Bisphosphonates amalepheretsa kusokonekera kwa mafupa, kukhala fanizo la zinthu za m'mafupa. Calcitonin amachepetsa kuyambiranso mafupa ndikusunga calcium mkati mwake.
Mavitamini a B ndi alpha lipoic acid. Kukonzekera kwa Vitamini kumachepetsa kuchepa kwa mafupa, kulimbana ndi mafupa.
Vitamini D3 ndi anabolic steroids amalimbikitsa kukula kwa mafupa.
Kukonzekera kwa calcium.
Ma diuretics ndi mankhwala osagwiritsa ntchito mankhwala othandizira kutupa omwe amagwiritsidwa ntchito pochepetsa kutupa ndi kutupa.

Opaleshoni yamankhwala sagwiritsidwa ntchito kwenikweni. M'magawo oyamba opareshoni sikuchitika. Pali chiopsezo chowonjezera kuwonongeka kwa minofu yamafupa powonjezera chinthu chowawa.

Chithandizo cha opaleshoni nchotheka pambuyo pakupeza njira yotupa. Ntchito zimayendetsedwa ndikuchotsa mafupa otulutsa. Nthawi zambiri zimawonetsedwa ngati, chifukwa cha zodabwitsa zakusintha, nsapato zamatumbo sizingagwiritsidwe ntchito.

Mafupa amachotsedwa kuti ateteze kupanga mabala okha, omwe amatuluka chifukwa chazovuta. Pambuyo pakuchita opaleshoni, kusasinthika kwathunthu (osachepera miyezi itatu) ndi nthawi yayitali yokonzanso.

Kanema wokhudza matenda amishuga odwala matenda ashuga:

Njira zoletsa kukula kwa phazi la Charcot zimaphatikizapo kuyang'anira wodwala yemwe ali ndi matenda a shuga mellitus m'njira zonse. Ndikofunikira kusungitsa shuga pamlingo "wopanda shuga".

Kuchuluka kwa zovuta kumapangitsa kuti kuphwanya kwa odwala onse omwe ali pachiwopsezo ndi prophylactic makonzedwe a mankhwala. Matenda a shuga amakhalanso ndi zovuta zofananira.

Odwala omwe ali ndi matenda ashuga ayenera kuyang'anitsitsa momwe miyendo ili. Kutsika kwa chidwi cha kupweteka m'miyendo kumawonjezera chiopsezo cha kuzindikira kuyambika kwa matendawa. Simungayende ndi kugwira ntchito kwambiri.

Ndikofunikira kuvala nsapato zapamwamba zomwe sizimapangitsa kupsinjika kowonjezereka pamafupa. Onani zakudya.

Zomwe, zifukwa ndi khodi ya ICD 10 mapazi a Charcot

Kuphatikiza kwa matenda oyamba kudafotokozedwa koyamba ndi dotolo Wachingelezi Mitchell. Sharko neurologist mwatsatanetsatane adafotokoza zomwe zimayambitsa (etiology) ndi makina otukula (pathogenesis) a matendawa omwe ali ndi matenda ashuga.

Diabetesic osteoarthropathy (code E10.5 malinga ndi ICD-10) imawonetsedwa ndi zotupa za m'mafupa. Pathogenesis yamatendawa imayenderana ndi matenda a shuga. Mu shuga mellitus, katundu wonyansa amawoneka pamagulu ena a mafupa akamayenda. Popita nthawi, zosintha zowonongeka zamakedzana zimachitika.

Zoyambitsa zazikulu za matendawa ndi monga:

kuwonongeka kwa mitsempha kumayambitsa kulowerera kwa mitsempha. Wodwala wodwala matenda ashuga, kumva kupsinjika pamiyendo kumachepa. Wodwala samva kupanikizika ndi nsapato, samatha kuwona mapangidwe a ming'alu, zilonda, mabala,
hyperglycemia imabweretsa kusintha kwamitsempha yamagazi. Ma capillaries amawonongeka pang'onopang'ono. Pali chiopsezo chachikulu chotengera atherosclerosis. Zolemba za atherosulinotic zimasokoneza kayendedwe ka magazi m'mitsempha yam'munsi. Popita nthawi, mabala, zilonda,
kuchepa kwa chidwi kumayambitsa kuvulala kosatha. Kuthira magazi kwakanthawi m'miyendo kumayendera limodzi ndi kuchiritsa kwa bala,
kuphwanya umphumphu wa khungu kumawopseza ndi kuwonjezera kwachiwiri kwa kachilombo kakang'ono,
chimanga, zilonda zam'mimba m'mtsogolo zimatha kuphatikizira kwa Charcot,
chida chofowoka champhamvu chobweretsa zovuta.
osakhazikika, nsapato zolimba zimayambitsa chitukuko cha matendawa,
chifuwa chachikulu, syringomyelia imatha kupanikizika ndi matenda olowa nawo.

Zizindikiro ndi magawo a DOAP

Mapazi a Charcot amapezeka pang'onopang'ono, amapita patsogolo mwachangu, ndi matenda ashuga, zovuta zingapo zimayambitsa kulumala kwathunthu kwa munthu, kumabweretsa kulumala.

Gulu lachipatala lapadziko lonse lapansi limaphatikizapo magawo anayi a matendawa:

Pa gawo loyamba, matenda am'mimba ndi osatheka kuzindikira. Wodwala sapereka madandaulo owopsa. Chithunzi cha x-ray sichinasinthe. Pa magawo oyamba, njira zama pathological zomwe zimalumikizana zimachitika pamaselo a maselo. Matendawa amatha kukayikiridwa pamaso pa matenda oyamba ndi mafangasi a misomali, bursitis ya chala chakumapeto, toxil toenail, chimanga.
Gawo lachiwiri limadziwika ndi kusyasyalika kwamiyala ndikusintha kwamiyendo. Phazi lakhudzidwa limakhala lalikulu. Pa x-ray, kusintha kwa ma pathological kumalongosoledwa momveka bwino. Wodwalayo amadandaula za kuchepa kwa chidwi m'madera am'munsi, kumva kuwawa, kupweteka poyenda. Kuzindikira koyenera komanso chithandizo cha matenda a siteji 1, 2 amalepheretsa kupitilira kwa zizindikiro.
Gawo lachitatu limadutsa ndikuwonetsedwa. Symbomatology yam'mbuyomu imadziwika, yomwe imathandizidwa ndi ma fractures, dislocations popanda chochititsa. Zala zimapinda, munthu samatha kuyenda bwinobwino. Kuchiritsa kwathunthu matendawa sikugwira ntchito. Odwala amawonetsedwa ngati othandizira komanso othandizira.
Pa gawo lotsiriza, maonekedwe a zilonda amadziwika - mabala amachiritsidwa. Kachilombo ka bakiteriya kamajowina. Phlegmon, gangrene amawoneka pakhungu la malekezero apansi. Palibe opaleshoni yofunika kuchitidwa opaleshoni. Munthu amakhala wolumala.

Magulu ena amasiyanitsa magawo awiri a matendawa: pachimake komanso chovuta. Choyamba chimadziwika ndi kukhazikika kwa kupweteka kwapweteka, komwe wodwala sakudziwa. Phazi limakhala lopindika, lotentha kukhudza. Wodwalayo akupitilizabe kupondaponda mwendo wake. Kuwonongeka kwatsopano ndi kuwonongeka kumachitika. Njira yovomerezeka pa nthawi yake pachimake imalepheretsa kusintha kosasintha.

Ngati matenda ashuga a psychoarthropathy sanachiritsidwe, matenda a matenda a khansa amapangidwa. Mafupa osweka amapopera molakwika ndikupanga kuphwanya kwa phazi.

Zochizira matenda a shuga a osteoarthropathy

Njira zochizira wodwala matenda a shuga zimaphatikizira izi:

Chithandizo cha pathological olowa amayamba ndi matenda a glycemia. Mavuto onse a shuga amayamba chifukwa cha shuga wambiri. Aliyense endocrinologist amatha kusankha njira zoyenera za wodwala. Mutha kulimbikitsa mphamvu ya mankhwala omwe amapezeka ndi wowerengeka azitsamba (kumwa zitsamba zomwe zimachepetsa shuga).
Zakudya zoyenera zimathandiza kukwaniritsa kuchuluka kwamagulu a shuga. Anthu odwala matenda ashuga sayenera kudya zipatso, zakumwa za shuga, zakudya zamafuta. Masamba, zipatso, chimanga - chakudya chachikulu cha odwala matenda a shuga.
Kukana zizolowezi zoyipa, kukhala ndi moyo wathanzi, kuyenda, maphunziro olimbitsa thupi kumachepetsa chiopsezo cha kupukuta, kugunda kwamtima, chikomokere, mitsempha ndi mitsempha.
Kuteteza magazi kulowa m'munsi, "Agapurin", "Pentoxifylline" ndi mankhwala. Mankhwala onse awiriwa amasintha magazi ake.
Zilonda zam'mimba, microtrauma, ma microcracks amayenera kuthandizidwa ndi antiseptics kuti apewe matenda a bakiteriya, omwe amathandizidwa ndi mankhwala a antibacterial am'deralo komanso a dongosolo.
Ululu wammbuyo umatsitsimuka ndimankhwala osapweteka a antiidal (Celecoxib, Ibuprofen, Movalis).

Gawo 1, 2 la matendawa limachokera ku chithandizo chamankhwala chokhazikika. Gawo 3-4 limachitidwa opaleshoni. Opaleshoniyo cholinga chake ndi kuthetseratu vuto la mafupa. Kuphatikiza apo, kuchotsedwa kwa abscesses, necrosis, zolakwika zam'mimbamo. Vutoli likayamba, yesetsani kuduladula.

Charcot akuchira

Pambuyo pakuchita opaleshoni, wodwala amafunika kukonzanso. Njirayi imapangidwa pakubwezeretsa pang'ono kapena kokwanira kwa ntchito ya phazi (zimatengera kunyalanyaza kwa njirayo).

Njira zakukonzanso zikuphatikiza:

mu malo oyamba ayenera kukhala kupumula kwa phazi. Ndizosatheka pambuyo pa opaleshoni kuti muperekenso katundu kumiyendo. Kuyenda kochepa kumaloledwa, koma munthu sangayende ndi mwendo womwe umayendetsedwa. Ndodo, njinga ya olumala, yothetsa vutoli,
nsapato zamatsenga zimalepheretsa kubwereza mobwerezabwereza, siyani kupunduka kwa phazi,
pa gawo lokonzanso, antibacterial mankhwala amatha kutumikiridwa. Mankhwala amateteza matenda opatsirana,
wodwala mankhwala mankhwala a calcium, calcitonin, calciferol, bisphosphonates. Mankhwalawa ali ndi mphamvu yothandizira. Amathandizira kuti mafupa awonongeke,
kuwunikira pafupipafupi shuga komanso kuthamanga kwa magazi kungathandize kupewa zovuta zina zamatenda.
wodwala ayenera kumwa insulin mankhwala ndi zakudya.

Zovuta zotheka

Kuchepetsa mphamvu ya miyendo kumayambitsa kupunduka kwakumaso, kusunthika, kutengeka kwa cholowa.
Osteoporosis ndikuwonongeka kwa minofu ya mafupa yomwe imachitika chifukwa chophwanya magazi m'magawo olowa, osalephera kupasuka.
Ma purulent formations (abscesses, phlegmon, osteomyelitis) amawoneka ngati matenda am'm zilonda zapakhungu apezeka.
Ngati matenda a osteoarthropathy samathandizidwa, gangrene amapangidwa. Ndi matenda awa, opareshoni imachitidwa - kudula dzanja. Wodwalayo amakhala wolumala.

Kukula kwa matendawo kumatengera kunyalanyaza. Kuzindikira koyambira komanso chithandizo choyambirira cha matenda ashuga, kupewa zovuta kumathandizira kuyimitsa kupitilira kwa matenda. Matenda a shuga a gawo 3, 4 ali ndi vuto losatsimikiza. Wodwala amapatsidwa chilema.

Kupewa matenda

Odwala omwe ali ndi matenda ashuga poyamba amakhala ndi china chodetsa nkhawa, koma aliyense ayenera kuchita chilichonse kuti ateteze mawonekedwe a phazi la Charcot.

Nawa maupangiri othandizira kupewa matenda anu:

Yang'anani shuga yanu yamagazi kuti muchepetse kupita patsogolo kwa kuwonongeka kwa mitsempha.
Pitani kwa azachipatala anu othandizira azachipatala nthawi zonse.
Onani miyendo yonse iwiri tsiku ndi tsiku kuti muwone ngati pali phazi la Charcot kapena mavuto ena okhudzana nawo.
Pewani kuvulala mwendo ndikuvala nsapato zapadera za odwala matenda ashuga.

Phazi la Charcot ndilovuta chachikulu cha matenda ashuga. Matendawa amawoneka kuti ali ndi vuto ndipo amatha kufalikira msanga, mpaka kuwonongeka kwambiri kuphazi komanso phazi, komwe kumayambitsa zilonda komanso kudula.