Isifo sikashukela i-mellitus yisifo esithinta izitho zomuntu eziningi. Ukugula kunama-syndromes amaningi nezimpawu ezikhombisa ukuba khona kwezinkinga. Enye yezimpawu ezivezwa unyawo lukaCharcot.
Esikhathini sikashukela, amasosha omzimba awalawuli amasosha omzimba olimele nezitho zomzimba. Iziguli zivame ukubika ukukhula okusheshayo kwezinkinga zomlenze.
Unyawo lwesifo sikashukela yisifo esidala ukuholela ezinkingeni ezinkulu. Uma kutholakala isifo sikashukela, kuyadingeka ukuqapha ngokucophelela isimo semilenze nezinguquko ezenzekayo.
Luyini unyawo lukaCharcot
Isifo sikashukela sikashukela sonyawo sivezwa ngokwephula ukwakheka kwamaphethelo aphansi avela ngokwanda koshukela wegazi. Ngokulawulwa kweshukela okunganele, ukuzwela kwezinzwa kuyancipha futhi ukopha emithanjeni yemilenze kuyehla.
Ngakho-ke, kukhona ingozi yokuhlukumezeka emilenzeni kanye nokubonakala kwezifo.
Isifo sikashukela, uhlelo lwezinzwa luvame ukuthinteka, futhi umuntu akazizwa eqinile emilenzeni. Inqubo yokuqunjelwa kwe-sebum, kanye nokujuluka, iyaphazamiseka. Lesi simo sinomthelela ekuqaleni:
- amathambo
- isikhumba
- amalunga onyawo.
Ingcindezi ivela ngesikhathi sokuhamba kwamalunga, okuholela ekulimaleni kwesikhumba. Isilonda kanye neCharcot's syndrome ingavela. Lokhu kuvezwa ngokubonakala kwamanxeba emilenzeni, kulimale amathambo namajoyinti.
Ngaso leso sikhathi, ukwelashwa kwenzeka kancane, amagciwane asakazeka kaningi. Ngecala eligijimayo, kuqhamuke isifo sikashukela ku-mellitus yesifo sikashukela, esigcotshwe ukunqunywa kwesitho. Ukutheleleka kusongela impilo ngoba kungangena egazini.
Isifo sikaCharcot sibizwa njengokunqotshwa kwazo zonke izicubu zamaphethelo aphansi.
Lokhu kungenxa yokwanda okungapheli kwamazinga kashukela wegazi.
Izici zokuqala kwesifo
Abantu abanesifo sikashukela nokulawulwa okunganele kwalesi sifo basengozini yokulimala emlenzeni. Uma izinzwa zemilenze zilimele, isiguli singase singazizwa izinyawo.
Kulokhu, umuntu akakwazi ukubona ukuthi iminwe nezinyawo zakhe zikuphi lapho zihamba. Uma izinzwa ziphilile, lapho ngesikhathi sokunyakaza umuntu uzizwa sengathi izinyawo zisesimweni esishubile.
Ku-mellitus yesifo sikashukela, isiguli asinakuzwa ukulimala ezinyaweni, ngokwesibonelo, amabhulashi, ukusikeka nokushayeka. Ngokuthwala okwenziwe ngonyawo, izimbila nezommbila zivame ukuvela.
Ukulawulwa okungafanele kwalesi sifo kuholela ezimweni eziba zimbi kakhulu ze-arterial and atherosulinosis.
Ukulimala emilenzeni kwandisa ingozi yezinguquko ezibalulekile onyaweni. Isilonda esingacwasi kubhekwa njengenye yezinkinga ezivamile. Ukubonakala kwakhe kungacunula:
- ingcindezi engapheli emilenzeni
- ukulimala kwesibili
- ukulimala noma ukubotshwa
- into yakwamanye amazwe engena ezicathulweni,
- ukubukeka kokutheleleka.
Ukulimala esikhunjeni sezipikili noma izinyawo ezinegciwane lokukhunta kungadala ukusabalala okukhulu kokutheleleka. Kufanele uthintane nodokotela ngokushesha bese uqala ukwelashwa.
Izinhlobo zesifo
Ngokuya ngembangela yesifo sikashukela sikashukela, kungahle kube nezindlela eziningana zesifo.
Indlela ye-neuropathic yiyona evame kakhulu. Izicubu zomgogodla zithinta kakhulu izinto ezahlukahlukene ezilimazayo. Ngakho-ke, kusengcupheni yokugula. Kukhona ukwephulwa kokufakwa ngaphakathi kwezicubu zemilenze, khona-ke ukwakheka kwazo nemisebenzi kuyonakala.
Imvamisa kuba nezilonda phakathi kweminwe nezinsalo zezinyawo. Kulezi zindawo, unyawo lubhekene nengcindezi enkulu kunazo zonke. Kukhona futhi ukwephulwa kwemishini yethambo-ligamentous.
Isifo i-neuropathy yesifo sikashukela singaba:
- izinhlungu
- akubuhlungu.
Inkambo yesifo saleli fomu ayiboniswa izimpawu ezibuhlungu. Umuntu akezwa ukuvela kwezilonda, ukungakhululeki kanye nomonakalo. Imvamisa umuntu onesifo sikashukela ukhononda ngokuxineka emilenzeni. Ifomu lobuhlungu libonakaliswa ukubonakaliswa okunjalo:
- ukuduma kwemikhawulo engezansi,
- umkhuhlane emilenzeni
- ama-goosebumps
- Ubuhlungu busesimweni esizolile
- ukuba khona kwe-ishayela emilenzeni ngokubonakala kwe-neuropathy.
Ukuthuthukiswa kwalolu hlobo lwesifo kwenzeka ngezilonda ze-atherosulinotic zemithambo yemilenze. Kuvela izimpawu ezilandelayo:
- isikhumba esibandayo emilenzeni, esivame ukupenda kanye ne-cyanotic,
- umbala wesikhumba opinki uvela ngokunwebeka okusebenzayo kwama capillaries,
- ukubukeka kwezilimi emunweni,
- izinhlungu zesithende
- ukungakwazi ukuzizwa ushayela ezinyaweni,
- ukudalulwa uma kunobuhlungu obukhulu emlenzeni lapho uhamba.
Ifomu elihlanganisiwe liqukethe amafomu we-neuropathic nama-ischemic. Lesi sifo sithinta ngokwesilinganiso kufinyelela ku-15% wabantu abanesifo sikashukela.
Ukubonakaliswa kwalesi sifo
Isifo sikashukela sikashukela sigcwala ukukhubazeka okungapheli, ukulimala kanye nokuwohloka kwesimo esijwayelekile semilenze. Unyawo lukaCharcot lubonakala ngokulahleka ngokuphelele kwemisebenzi yalo.
Ngalesi sifo, kungaba nezimpawu ezinjalo:
- Ubuhlungu ngenxa yokwelula nokucwila kwezinyawo,
- ukuthuthukiswa kokutheleleka
- ubomvu besikhumba, okuqinisekisa ukuba khona kwaleli gciwane,
- imilenze evuvukele
- ukukhuphuka kokushisa kwesikhumba ngenxa yokutheleleka,
- umthwalo wezinyawo, amabele uma ugqoke izicathulo ezingakhululeki,
- okuqukethwe kwe-purulent okugeleza kusuka emanxebeni,
- ukulila, ubunzima bokuhamba,
- ukugcotshwa kwepuleti lezipikili,
- ukuba khona kwesikhunta
- ukubanda komkhuhlane ngenxa yokutheleleka,
- Ubuhlungu obukhulu emilenzeni kanye nokuqina kwabo.
Njengomthetho, emilenzeni kuyavela:
- amabhulukwe kanye calluses
- ukungena kwezipikili esikhunjeni,
- ukuphuma kwethambo kuphela ngonyawo,
- bursitis kuzithupha
- ukutheleleka ngefungal
- isikhumba esiqhekekile
- ukudonsa isikhumba
- ukugoba kweminwe.
Kunezigaba ezine ekwakhiweni kwesifo sikashukela:
- esigabeni sokuqala, amalunga ayabhujiswa. Ukulimala okuhlanganayo, ukuwohloka kwamathambo amancane nokusakazeka kwenzeka. Lesi sigaba sibonisa ngokugcwala konyawo, ubomvu kwesikhumba, ukukhuphuka kwezinga lokushisa. Umuntu akezwa zinhlungu njengamanje,
- esigabeni sesibili, imigoqo icindezelwe, unyawo lonakele,
- esigabeni sesithathu, ukuguquguquka kuyabonakala. Kungahle kube nokuphahlazeka okuzenzakalelayo nokusabalalisa. Izinzwane ziqala ukugoba futhi nemisebenzi yonyawo iyaphazamiseka,
- esigabeni sesithathu, kuvela amanxeba, okuholela ekuthelelekeni.
Ukuhlanganiswa kukaSharko yi-arthropathy eqhubekayo ebonakala ngokuthikamezeka kobuhlungu bezinzwa ngenxa yezifo ezahlukahlukene, imellitus yesifo sikashukela esivame kakhulu. Imiphumela yile:
- ukumisa ngokuhlanganyela
- ukucaciswa okucacile,
- deformation
- ukungazinzi.
Ukuxilonga
Uma kusolakala ukuthi isifo sikashukela sikashukela sikashukela, kubalulekile ukubonana nodokotela ngesikhathi. Uma kungenzeka, kungcono ukuvakashela isikhungo sezokwelapha esikhethekile.
Ukwenza ukuxilongwa okuyiqiniso, kuyadingeka ukuthi utadishe ngokucophelela isithombe somtholampilo kanye nokuhlolwa kwe-x-ray, okuzobonisa isigaba esithile sokukhula kwalesi sifo. Ubunkimbinkimbi bokunquma ukugula bunamathela iqiniso lokuthi i-Symbomatology ingahle ifane:
- phlegmon lonyawo,
- thrombophlebitis
- lymphostasis nezinye izifo.
Okunzima kakhulu wukuxilongwa okuhlukile uma kwenzeka unyawo lukaCharcot lusesigabeni esibi. Esimweni esinjalo, ukwelashwa okubambezelekile kungabiza umuntu alahlekelwe yikhanda.
Ungalapha unyawo lwesifo sikashukela ngokuhlinzwa noma usebenzisa izindlela zakudala. Ukwelashwa kokuqapha kubandakanya, okokuqala, ukwelashwa okuyisisekelo. Kulesi sigaba udinga:
- khokhela ushukela
- lawula ingcindezi
- yenza amazinga e-glucose abe ngokwejwayelekile.
Uma udokotela esetholile ukuthi kukhona unyawo lukaCharcot kushukela, khona-ke ukwelashwa kufanele kufaka phakathi ukwelashwa okubulala amagciwane ngamakhambi okubulala amagciwane. Ukumisa i-pain syndrome, izidakamizwa ezifana ne-Analgin noma i-Ibuprofen nazo ziyasetshenziswa.
Ngaphezu kwalokho, isiguli sidinga ukubhekana nezindlela zokwelapha ezihlose ukubuyisela umuzwa wezinzwa futhi sithuthukise ukuhamba kwegazi endaweni yezinyawo. Futhi, udokotela angabeka izidakamizwa ze-antiseptic.
Ngaphezu i-radiography, i-imagic resonance imaging nayo iyasetshenziswa. Kwezinye izimo, i-scintigraphy yamathambo onyawo iyaboniswa.
Zonke lezi zindlela zokuxilonga zisiza ekuboneni izinga lezinguquko zokuvuvukala, ukuba khona kwama-micro-fractures kanye nezinga lokuphuma kwegazi ezindaweni ezithintekile. Uma kunesidingo, kuyahlolwa izimpawu zamakhemikhali ezinamandla okubola kwamathambo.
Amamaki wokuvuselelwa kwezicubu nawo ayabhekwa, ngoba akhombisa umsebenzi wethambo. Lolu lwazi lungahle lube usizo esikhathini sokusebenza esilandela ngemuva kokukhishwa okuphelele.
Ukuze unqume imbangela yokubhujiswa kwamathambo, udinga ukuthatha ukuhlolwa kwegazi kwe-osteomyelitis.
Ukwelashwa
Okokuqala, kubalulekile ukuqonda ukuthi ukwelashwa kuzohlinzeka ngemiphumela ephezulu uma umuntu edlulisa udokotela ngesikhathi. Abantu abanokuxilongwa kwesifo sikashukela kufanele bahlaziye izinyawo zabo njalo.
Noma ngubani angafunda ukuhlolwa okufanele uma ecela usizo kudokotela ofanelekayo. Ngenxa yalokho, umuntu kufanele enze umkhuba wokuhlola njalo izitho zakhe eziphansi, ikakhulukazi, izinyawo.
Ngokushesha lapho noma yiziphi, noma ezincane, izinguquko kwisakhiwo zikhonjwa, kufanele uthintane nodokotela ngokushesha. Ngaphezu kwalokho, kubalulekile ukucubungula okuvame ukuhambisana nesifo sikaCharcot-Marie, okuwukuthi ubuhlungu onyaweni ngenxa ye-atrophy of nerve endings. Kungabonakala kumuntu ukuthi lokhu kulimala kuncane, noma kunjalo, ukulimala kuyinto enkulu.
Uma izilonda zivele onyaweni, lapho-ke zidinga ukuthi zixilongwe ngokusungulwa kokujula. Kwezilonda ezithile, ukululama ngama-insoles we-orthopedic kukhonjisiwe. Lama-insoles anciphisa kakhulu izinga lokucindezela lapho uhamba. Uma ngabe le ndlela ayanele, khona-ke ukusetshenziswa kwe-immobilization, okuvimbela umphumela onamandla esikhunjeni.
Ukuhlinzwa kungabekwa uma isilonda sesisakazekele ezingeni lesikhumba. Lapho elungisa iqiniso lokutheleleka, udokotela unquma ukusetshenziswa kwamagciwane. Kwezinye izimo, izilonda ezinotshani zande zize zivele emabeleni. Kulokhu, kunesidingo sokuhlinzwa okususa lezi zilonda.
Isibonelo ithambo le-metatarsal, elingasuswa nesilonda esisendaweni yangaphambili.
Ukubuyiselwa kwamathambo onyawo
Lapho kuvela unyawo lwesifo sikashukela, ukwelashwa kugxila ekuqothulweni kwezilonda namathumba. Ukungenelela kokuhlinzwa kungabekwa njengenyathelo lokubuyisela emuva uma kudingeka ukulungiswa kokudalwa konyawo.
Ukuhlelwa kabusha kwe-arthrodesis kanye nokwakheka kwamathambo akunathathi hlangothi, okubangela ukwanda kwengcindezi ebusweni bethala. Ngakho-ke, kuvela isilonda esingelapheki.
Ukuze usebenzise amasu anjalo, kuyadingeka ukufezekisa ukumiswa kwenqubo yokuvuvukala nokungabikho kwe-osteolysis. Uma lezi zimo zingagadliwe, kungenzeka ukuthi ukusebenza kuzodala ukucekelwa phansi okusha.
Ngaphambi kokuhlinzwa, udinga ukuqinisa amathambo usebenzisa izindlela ezithile. Ukubuyisela unyawo kuyadingeka lapho kukhubazeke kakhulu, okwenza ukusetshenziswa kwezicucu zamathambo kungasebenzi.
Ukuvimbela
Okokuqala, udinga ukuhlola njalo izinyawo zodwa. Ekubonakalisweni kokuqala kokulimala kwesikhumba noma ukuvela kwayo, kufanele uthintane nodokotela we-endocrinologist.
Kuyadingeka ukulahla isikhafu esisika izipikili. Kungcono ukusebenzisa ifayela lezipikili. Izicucwana ezingcolile kufanele zilahlwe njengoba zihudula ngezinyawo nangefomu lokushaya.
Kubalulekile ukuvikela izinyawo emiphumeleni yokushisa okuhlukahlukene. Uma kutholakala isilonda, kufanele siphathwe nge-3% hydrogen peroxide solution noma i-chlorhexidine nge-bandage. Kulesi simo, awukwazi ukusebenzisa imikhiqizo enomphumela wokubumba. Lezi zimali zifaka:
- oluhlaza
- iodine
- potanganum permanganate.
Kuyadingeka ukuqinisekisa ukuthi isikhumba sihlala somile. Ungasebenzisa okhilimu, isibonelo, iBalzamed noma i-Callusan. Ividiyo ekulesi sihloko ikhuluma ngezindlela zonyawo lwesifo sikashukela.
