Izimpawu nokwelashwa konyawo lukaCharcot kushukela

Isifo sikashukela mellitus siletha nezinkinga ezithinta amasistimu amaningi omzimba.

Unyawo lukaCharcot noma i-diabetesic osteoarthropathy (OAP) ngumphumela omubi wesifo sikashukela i-mellitus (DM), lapho isifo se-hormonal sabangela ukubhujiswa kwengxenye yesistimu ye-musculoskeletal of the limb.

Kuchazwa ngokuthi "ushintsho lwe-pathological olungatheleleki ekuhlanganyeleni nasemathanjeni okubangelwa yi-neuropathy yesifo sikashukela." Ukuwohloka kobuhlungu kwesakhiwo sezinyawo kuchazwe nguZh. UCharcot, usosayensi waseFrance kwezengqondo nezengqondo.

Izimbangela zesifo

Ezigulini ezine-OAP, ukuncipha kanye nokulahleka kwamandla amathambo (i-osteoporosis), ukuqina noma, kunalokho, ukubhujiswa kwezicubu zamathambo (hyperostosis and osteolysis) kuyabonakala.

Lezi zinqubo ziholela ekwaphukeni kwamathambo onyawo, i-fusion iqhubeka ngokungalungile, okuholela ekuguqukeni. Amathambo e-pathologies abangela ukonakala kanye nokulimala kwezicubu. Izilonda ziyavela.

Kuqala, izimbangela ze-neurotraumatic bekukholelwa ukuthi zibangela izinkinga. Ukuphazamiseka kwesistimu ye-peripheral yezinzwa kuholela ekusabalazweni okungalungile komthwalo emathanjeni onyawo, okuholela ekuwohlokeni nasekuqhekekeni kwamathambo ngamanye.

Ucwaningo lwakamuva lubonise ukwanda okukhulu kokuhlinzekelwa kwegazi ezicutshini zemilenze. Umphumela waba isiphetho - izinhlobo ezithile kuphela ze-neuropathy ezibangela ukulimala onyaweni lukaCharcot ngokunqotshwa kohlobo olulodwa lwama-nerve fibers abizwa ngokuthi i-myelin. Yizinguquko zabo eziholela ekwephuleni ithoni ye-vascular futhi kusheshise ukuhamba kwegazi.

Ukwephulwa kwe-calcium metabolism, ukukhiqizwa kwe-collagen kujoyina ama-pathologies we-vascular ku-mellitus yesifo sikashukela. Ushintsho lwethambo emathanjeni cishe alunabuhlungu.

Ngaphezu kwalokho, ngokuba nezicucu, isiguli siyaqhubeka nokunyakaza, okwandisa ukubhujiswa kwamathambo omlenze ophansi. Ukuvuvukala kwezicubu kubangela ukwanda kokugeleza kwegazi nokukhula ngokushesha kwe-osteoarthropathy. Ku-OAP, kuthinteka amathambo, amalunga, izicubu ezithambile, izinzwa zangaphakathi nemithambo yegazi.

Ukuvuselelwa kwezicubu zamathambo kuthonywa kakhulu yi-insulin, ukukhiqizwa kwayo kuyaphazamiseka kushukela. Amademoni demineralization, lapho inani le-calcium lehliswa kakhulu, kuholela ekukhuleni kwawo kokuqina.

Isifo sikashukela sikashukela sibhekwa njengengxaki yesifo sikashukela engaphansi kwe-1%. Eminye imithombo yezokwelapha ibiza inkomba ehlukile - ifinyelela kuma-55%. Lokhu kubonisa ubunzima bokuxilongwa kanye nezindlela zokungalingani ekuxilongeni.

Singasho ukuthi le nkinga yenzeka ezigulini ezinesifo sikashukela iminyaka engaphezu kwengu-15 futhi zihlobene nesifo sazo ngaphandle kokuthola ukunakwa okufanele.

Izimpawu nokuboniswa kwe-osteoarthropathy

Izigaba zokuqala zokuphazamiseka kwesiguli azibonakali. Iziphetho zezinzwa eziphazamisekile azinikezi isibonakaliso sezinhlungu mayelana nokukhubazeka nokukhubazeka kwamathambo.

Izimpawu zonyawo lukaCharcot ziyabonakala (bheka isithombe) lapho kwenzeka izinguquko ezinkulu ezonakalisayo ekucushweni konyawo nokuhlangana futhi kwavela izibonakaliso zesikhumba.

Ezigabeni zakamuva, izilonda zomzimba ziyabonakala, okuthi, uma utheleleke, zingaphetha ngokuba ne-gangrene.

Izimpawu ze-OAP ezikhulayo yile:

• ukuvuvukala nokubomvu komlenze ophansi, umehluko obonakalayo ekubukekeni kwawo nosayizi wawo komunye nomunye;
• ukugoba emisipha yamathole;
• ubunzima bokuhamba
• ukukhubazeka
• ukwanda kwezinga lokushisa kwezinyawo, ekuthinteni zishisa kakhulu kunenye ingxenye yomlenze.

Lezi zimpawu kungenzeka zingabi zimpawu ze-OAP, njengoba isifo sikashukela sihambisana nezinkinga eziningi. I-neuropathy yesifo sikashukela, hhayi eyinkimbinkimbi ngonyawo lukaCharcot, iholela ekwenzekeni okufanayo emilenzeni.

Kaningi, lezi yizinkinga zomlenze abantu abaningi abanazo. Ama-callus angavela, i-toena ye-ingrown, "ithambo" liyakhula. Izifo ze-fungus zezipikili zivame ukukhula.

Kuxakaniseka noshukela wegazi ophakeme, awudluleli isikhathi eside. Lezi zinkinga zivame ukuholela eqinisweni lokuthi isigaba sokuqala sesi sifo sihamba singanakwa.

Izigaba zesifo

Lesi sifo sinezindlela ezimbili - sibi futhi singamahlalakhona. Esigabeni esibi, kunokukhuphuka okukhulu kokushisa komzimba kanye ne-hyperthermia yomlenze ophansi, izinhlungu lapho uhamba, ukuvuvukala okukhulu.

Ngefomu elingamahlalakhona, ukubonakaliswa okunamandla kuyahamba, kuvela ukuvela okubonakalayo, unyawo luphendukela kwesokunene noma kwesobunxele, amathambo aphambana nesikhumba sezimbali, izilonda kanye nefomu lesikhumba lesikhumba.

Lesi sifo sinezigaba ezi-4, ezinqunywa ngezinga lokulimala kwesilonda:

1. Esokuqala - i-x-ray yonyawo kaningi alukhombisi izinguquko. I-Osteoporosis yezicubu zamathambo iyaqala, kukhona ama-microcracks. Kukhona ukuvuvukala okuncane, i-hyperemia kanye nokwanda okuncane kwezinga lokushisa. Lesi yisimo esibuhlungu salesi sifo.
2. Eyesibili inkambo engaphansi. Ukuvuvukala ne-hyperthermia kuyancishiswa. I-X-ray ikhombisa ukuqhekeka, ukwahlukaniswa kwamathambo ngamanye esakhiweni esijwayelekile samathambo. Kukhona ushintsho (ukuthopha) lwedwa.
3. Eyesithathu iboniswa yi-deformation ephelele. Ukubhujiswa kwamathambo onyawo kuyinto yomhlaba wonke. Kungabizwa ngokuthi "isikhwama samathambo." Isakhiwo samathambo siphukile, kuthiwa isithambo samathambo.
4. Okwesine kuyindlela eyinkimbinkimbi yalesi sifo. Ukulimala kwamathambo kuholela ekubonakalisweni kwesikhumba ngendlela yamanxeba nezilonda zodwa kanye nangaphezulu. Ukutheleleka okunamathiselwe kubangela i-phlegmon, ama-abscesses, esimweni esinzima kuholela ebulilini.

Izinqubo ze-Pathological zithinta ukuhlangana. I-capsule iseluliwe, imishini yokusebenza kwe-ligamentous iyaphazamiseka, ukuthambekiswa kuyakhula. Isiguli sikaguli siyashintsha. Izinguquko ezibangelwa yisifo sikashukela sikashukela sibizwa ngokuthi amajoyina kaCharcot.

Ukuxilongwa nokwelashwa

Ukuxilongwa kwalesi sifo kwenziwa ezikhungweni ezikhethekile "unyawo sikashukela". Odokotela ababheka iziguli ezinesifo sikashukela i-mellitus kuyaqabukela zihlangabezana nalokhu kuhlanganiswa kwalesi sifo futhi abanakhono lokusixilonga futhi baselaphe.

Ngisho nesigaba sokugcina kwesinye isikhathi kwesinye isikhathi sinephutha nge-phlegmon, osteomyelitis, noma ezinye izilonda zesikhumba namathambo. Okuqukethwe okuphansi kwemininingwane yama-x-ray ezigabeni zokuqala kuholela ekulahlekelweni yisikhathi kanye namathuba aphezulu wokukhubazeka.

Lapho uthola i-OAP, kubalulekile ukungabandakanyi izifo ezithathelwanayo zamathambo - i-osteomyelitis nezifo ezinezimpawu ezifanayo zomonakalo - i-rheumatism nabanye.

Kuthunyelwe:

• ukuhlolwa kwegazi kwe-biochemistry, coagulation kanye nokujwayelekile;
• ukuhlaziywa komchamo ojwayelekile kanye nomsebenzi wezinso;
• i-radiography;
• I-MRI
• isiqu.

I-Magnetic resonance imaging kanye ne-scintigraphy yenza kube nokwenzeka ukukhomba ama-microcracks, ukuhamba kwegazi okwandayo kanye nokuba khona kwenqubo yokuvuvukala emaphethelweni aphansi. Lezi izifundo ezembula kakhulu. I-Leukocytosis isiza ukukhipha i-osteomyelitis, ngoba ayigcinwa nge-OAP.

I-Skeleton bone scintigraphy

Imiphumela yokuhlolwa kwesinye isikhathi ayikuvumeli ukukhonjwa okunembile kwe-OAP, ngoba inqubo ye-pathological ingenzeka kunoma iyiphi ingxenye yezicubu zethambo.

Ngakho-ke, nge-asymmetry yamaphethelo aphansi kanye ne-hyperthermia yesinye sawo, i-neuropathy esobala, ukwelashwa kuvame ukunqunywa ngokushesha ngaphandle kokuxilongwa okunembile.

Lokhu kukuvumela ukuthi uyeke ukubhujiswa kwezicubu zamathambo ngesikhathi.

Indlela yokuthola ulwazi yokuthola ulwazi nge-scintigraphy enamaseli egazi amhlophe abhalwe ukuthi. I-biopsy yamathambo isiza ekuboneni ngokunembile i-OAP.

Izindlela zokulayisha

Ingxenye edingekayo yokwelashwa ukususwa komthwalo onyaweni, okucasulayo ukubhujiswa kwamathambo omlenze ophansi.

Ukuphumula okugcwele kuyadingeka ngokunyusa umlenze.

Ubufakazi bokuthuthuka buzoba:

• ukuncishiswa kwepuffness;
• ukwehlisa izinga lokushisa komzimba kanye nomlenze ogulayo;
• ukuncishiswa kokuvuvukala.

Ukwesekwa Ankle

Ukuswela umthwalo kuzosiza amathambo ukuthi awele endaweni yawo. Uma isiguli singashukumi singaguquki, ukuguquguquka kuzoqhubeka. Esigabeni sokuqala sesi sifo, ukuphumula kubaluleke kakhulu kunokwelashwa ngezidakamizwa.

Lapho isimo somlenze sithuthuka, kufanele kusetshenziswe i-orthosis ekhethekile yokwenziwa komuntu uma uhamba.

Ngemuva kwalokho, kuzokwanela ukugqoka izicathulo zamathambo, ezizohamba kahle umthwalo ezinyaweni.

Izingubo ezisetshenziswayo kwamanye amazwe azinconywa odokotela bethu. Zingadala ukucasuka kanye nomonakalo kulunga esele likhona eligulile.

Imithi

Amaqembu wezidakamizwa asebenzayo:

1. Ukwenza ngcono izinqubo ze-metabolic kwezicubu. Ama-bisphosphonates ne-calcitonin asiza ukumisa ukuqalwa kabusha kwamathambo. Ama-bisphosphonates avimbela amathambo omhluzi, ngokuba yizifanekiselo zezakhi zamathambo. ICalcitonin yehlisa ijubane ukuqunjelwa kwamathambo futhi igcine i-calcium kuyo.
2. Amavithamini e-B ne-alpha lipoic acid. Ukulungiselela i-Vitamin kubambezela ukuwohloka kwamathambo, ukulwa ne-osteoporosis.
3. IVitamin D3 nama-anabolic steroid akhuthaza ukukhula kwamathambo.
4. Ukulungiswa kwe-calcium.
5. Ama-diuretics nezidakamizwa ezingezona ze-steroidal anti-inflammatory asetshenziselwa ukunciphisa ukuvuvukala nokuvuvukala.

Izindlela Zokuhlinzwa

Ukuhlinzwa okwelashwa akuvamile ukusetshenziswa. Ezibangeni zokuqala zokuhlinzwa akwenziwanga. Kunengozi yokudala ukubhujiswa okwandayo kwezicubu zamathambo ngokungeza ingxenye ehlukumezanayo.

Ukwelashwa kokuhlinzwa kungenzeka ngemuva kokufakwa kwenqubo yokuvuvukala. Ukusebenza kwenziwa ukususa nokulungisa amathambo avelayo. Imvamisa kukhonjiswa uma, ngenxa yezimpawu zedisco, izicathulo zamathambo azikwazi ukusetshenziswa.

Amathambo asuswa ukuvimba ukwakheka kwamanxeba kukodwa, okuvela ngenxa yemiphumela ebuhlungu. Ngemuva kokuhlinzwa, ukungasebenzi ngokuphelele (okungenani izinyanga ezi-3) nesikhathi eside sokuvuselelwa kuyadingeka.

Ividiyo mayelana nokwelashwa ngonyawo lwesifo sikashukela:

Ukuvimbela

Izindlela zokuvimbela ukuthuthukiswa konyawo lukaCharcot zifaka ukubheka isimo sesiguli esine-mellitus yesifo sikashukela ngazo zonke izindlela. Kuyadingeka ukugcina amazinga kashukela ezingeni "elingelona isifo sikashukela".

Ukwanda okuncane kwezinkinga kwenza kungaphumeleli ukumbozwa kwazo zonke iziguli ezisengozini ngokulawulwa kwe-prophylactic kwezidakamizwa. Isifo sikashukela sinezinkinga eziningi ezinezimpawu ezifanayo.

Iziguli ezinesifo sikashukela zidinga ukuqapha isimo sezingalo. Ukwehla kokuzwela kobuhlungu emilenzeni kwandisa ingozi yokuqaphela ukuqala kwesifo. Awukwazi ukuhamba nokusebenza ngokweqile.

Kuyadingeka ukugqoka izicathulo ezintofontofo ezingadali ingcindezi eyengeziwe emathanjeni. Bheka ukudla.