Kuwonongeka kophatikizana kwa matenda ashuga kumachitika kawirikawiri. Kupsinjika kotereku kumafunikira chithandizo chamankhwala, chomwe sichingachedwetse chiwonongeko, komanso kulola kusintha kwamachitidwe a musculoskeletal system.
Zomwe zimayambitsa zovuta za matenda obwera chifukwa cha matenda ashuga, omwe ndi mafupa a minyewa, ndizo kuchuluka kwa shuga m'magazi. Kupatula apo, matenda oopsa a hyperglycemia amakhudzanso ziwalo zonse ndi machitidwe a munthu.
Zinapezeka kuti kuchuluka kwa glucose kumakhudza kapangidwe ka sorbitol kamene kamakhala ndi ma neurons ndi maselo a endothelial. Poona izi, matenda a shuga amachitidwa nthawi zambiri.
Kuphatikiza apo, zomwe zimayambitsa kupweteka kwapakati pa matenda ashuga zimatha kukhala chifukwa chakuti kusintha kwamankhwala olumikizana kumayambitsa kupsinjika kwa oxidative ndikupanga ma radicals omasuka. Ndipo pankhani ya kuchepa kwa insulini, kusintha kwa kapangidwe ka kapangidwe ka cartilage ndi mafupa zimadziwika.
Matenda ophatikizana ndi shuga
Mu hyperglycemia wodwala, mafupa amakhudzidwa mosiyanasiyana. Nthawi zina, matendawa amayamba chifukwa cha kusayenda bwino kwa ma cellcirculation, kuchuluka kwa minofu yolumikizana, kapena mavuto a neuropathic. Ndipo ma syndromes osakanikirana nthawi zambiri amawonedwa mwa odwala omwe ali ndi mawonekedwe a ziwalo zam'thupi.
Pali zovuta zambiri zophatikiza odwala matenda ashuga. Izi zikuphatikiza:
- kupukusa idiopathic chigoba hyperostosis;
- matenda a mafupa;
- matenda a shuga a shuga.
Komanso, ndi shuga wambiri wokhazikika, odwala ambiri amawonetsa zizindikiro za kuchepa kwa minyewa yodziwika bwino, kuphatikizapo zotupa monga:
- Dupuytren mapangidwe ake;
- matenda ashuga chiroartropathy (cyst);
- tenosynovitis ya minofu yosinthika (kuthyola chala);
- zomatira kapisozi (periarthritis, dzanzi).
Vuto linanso lofala la matenda ashuga ndi neuropathy. Izi zimaphatikizapo amyotrophy, neuropathic arthritis (osteoarthropathy, mafupa a Charcot), amamvera chisoni a Reflex dystrophy, carpal valve syndrome ndi zina zambiri.
Pofuna kuti izi zisachitike, ine ndi wodwalayo sitinayikemo zofunikira, ndikofunikira kwambiri kuchitira chithandizo chanthawi yake. Ndi kusintha magawo a shuga, mankhwala opatsirana ngati Metformin amayenera kumwedwa nthawi zonse.
Poyerekeza ndi maphunziro a shuga a nthawi yayitali (zaka 5-8), odwala ambiri amadwala matenda a shuga. Zizindikiro zoyambirira za matendawa zimadziwika ndi ultrasound osteometry.
Nthawi zambiri, matendawa amakhudza mbali yakumunsi. Mu 60% ya milandu, ma tarsal-metatarsal joints amagwira nawo ntchito ya pathological, pomwe chidendene ndi metatarsophalangeal zimakhudzidwa pang'ono nthawi zambiri (30%).
Nthawi zina m'chiuno ndi m'chiuno mumakhala mavuto. Monga lamulo, njirayi ndi mbali imodzi.
Kuwonetsedwa kwa osteoarthropathy ndikumva kupweteka, kutupa ndi kupindika kwa mafupa. Chifukwa chophwanya zamkati, kupsinjika ndi kusakhazikika kwa khwalala kwamiyendo kumawonekera, zomwe nthawi zambiri zimayambitsa kufupikitsa ndi kusinthika.
Chinanso chomwe chimapangitsa matenda osokoneza bongo a hyperglycemia ndi matenda osokoneza bongo (SDS). Ichi ndi matenda ammiyendo omwe amayamba pamene mafupa, mafupa am'mimba komanso zofewa, komanso ziwiya ndi mitsempha zimakhudzidwa. Zotsatira zake, njira za purcin necrotic zimachitika mwa wodwala komanso zilonda zam'miyendo.
Kwenikweni, SDS imawonekera mu odwala okalamba motsutsana ndi maziko a maphunziro a shuga (kuyambira zaka 15). Tsoka ilo, mu 70% ya milandu, kupititsa patsogolo matendawa kumadula kudula ndipo nthawi zina phazi liyenera kuyilidwa.
Zizindikiro zamatenda a matenda am'mimba ndizotupa ndi hyperthermia ya kumapazi. Poyamba, kupweteka kumawonekera pansi, komwe kumafunikira kafukufuku wosiyanitsa ndi nyamakazi yovuta kapena venous thrombophlebitis.
Pokonza nthendayi, kutsetsereka kwa phazi kumachitika. Pakapita nthawi, neuropathy yayikulu imayamba, ndipo palibe ululu.
Nthawi zambiri, pakumawonjezeka kwa shuga m'magazi, matenda ashuga okhala ndi vuto lochepa. Ang'ono kwambiri ndipo nthawi zina mafupa akulu amakhala olimba.
Zizindikiro za OPS ndizopweteka zomwe zimachitika panthawi yolumikizana. Nthawi zambiri, mafupa a proximal interphalangeal ndi metacarpophalangeal amakhudzidwa, nthawi zambiri - mkono, mkono, manja ndi m'chiuno.
Nthawi zambiri, matendawa amapezeka pomwe wodwalayo sangathe kugwirana manja ndi manja awo. Nthawi zambiri, vuto la "manja opemphera" limayamba chifukwa cha kusinthika kwina. Kuphatikiza apo, kupezeka kwa OPS kumadalira nthawi yayitali ya matenda ashuga komanso chimaliziro chake.
Vuto linanso lofala la hyperglycemia ndi periarthritis yamapewa. Izi matenda nthawi zambiri amaphatikizidwa ndi OPS syndrome, ndipo nthawi zina, ndi tenosynovitis ya manja. Kuti tipewe kukula kwa matenda otere, ndikofunikira kuwunika mayendedwe a glucose, ndipo kwa mawonekedwe awo, odwala osadalira insulini amayenera kutenga Metformin nthawi zonse.
Nthawi zambiri, kuphunzira kwa nthawi yayitali komwe kumayambitsa matenda a hyperglycemia kumathandizira kusintha kwa mafupa. Ndi kuchepa kwa insulin, izi zimapangitsa ntchito ya osteoblastic.
Mu theka mwazinthuzi, mafupa am'mimba komanso mafupa akusintha. Kuphatikiza apo, maphunzirowa amatithandizira kuti ziwonekere. Zifukwa zomwe zingathandizire kukulitsa osteopenic syndrome:
- kuwonongeka kwa nthawi yayitali kwa chakudya;
- chiwonetsero cha matenda ashuga odwala osakwana zaka 20;
- shuga kwa zaka zopitilira 10.
Rheumatoid nyamakazi imakhalanso vuto la shuga, makamaka kwa okalamba. Matendawa amadziwika ndi kuwoneka kwa ululu wopweteka m'kuphatikizika, kuphwanya kayendedwe kake ndikutupa kwa malo omwe akhudzidwa.
Koma ngati pali matenda ashuga, chakudyacho chimapweteka mafupa onse ndi miyendo yodontha, chochita ndi momwe mungathanirane ndi zoterezi?
Njira zochizira
Chofunikira kwambiri popewa kupitirira kwa matenda olowa ndikusunga index ya glucose (mpaka 10 mmol / l) tsiku lonse. Kupanda kutero, chithandizo cha kupunduka kwa phazi ndi zovuta zina za matenda a shuga sizingathandize. Chifukwa chake, ndikofunikira kumwa mapiritsi a antiidiabetes tsiku lililonse, monga Metformin kapena Siofor.
Ndipo ndikuwonongeka kwakukulu kwa mafupa, kuphatikizapo nyamakazi, mankhwala osokoneza bongo ndi mankhwala omwe amakonzanso minofu ya cartilage imayikidwa. Muzochitika zapamwamba, jakisoni amapangidwa, koma pokhapokha malo osokoneza bongo amasungidwa.
Komanso, mankhwala othandizira odwala omwe ali ndi vuto la matenda ashuga nthawi zambiri amatsitsidwa kuti atenge pyrazolone derivatives ndi vitamini B 12. Corticosteroids sichigwiritsidwa ntchito kawirikawiri atropathy, chifukwa zimakhudza kuchuluka kwa shuga. Koma ngati ndi kotheka, intra- ndi periarticular makonzedwe osachepera 37 mg wa hydrocortisone nthawi zina amasonyezedwa.
Kuti mankhwala azachipatala azigwira ntchito bwino, wodwalayo ayenera kumwa mankhwalawo pamaphunziro komanso kwa nthawi yayitali. Nthawi yomweyo amafunika kuyesedwa mwadongosolo, zomwe zingathandize kuti adokotala azilamulira machitidwe ake.
Ngati vuto la phazi likuwonongeka, zilonda zam'mimbazo zimaperekedwa ndipo maantibayotiki adayikidwa. Ndikofunikanso kusiya zizolowezi zoyipa, kupereka zodula miyendo ndikuchiritsa matenda omwe amalepheretsa kupangidwanso kwamapangidwe am'mimba.
Ndi nyamakazi kapena arthrosis mu shuga mellitus, njira zomwe siziri zachikhalidwe zingagwiritsidwe ntchito. Njira imodzi yodziwika bwino ndi chithandizo cha maginito, pomwe mafupa amamuwotcha pakuya masentimita khumi ndi awiri.
Ubwino wa kudziwitsana ndi maginito:
- Kuchotsa kutupa;
- kuthetsa kupweteka;
- kusintha kwa ambiri mkhalidwe wamisempha;
- njira zitha kuchitika pafupifupi zaka zilizonse.
Njira ya mankhwala kumatenga pafupifupi masiku 30. Komabe, kukhudzana ndi maginito kumathandiza pokhapokha pakukula kwa matenda olowa. Komanso, njirayi imapangidwa chifukwa cha mavuto a mtima, khansa, chifuwa, magazi osagwirizana komanso nthawi yapakati.
Ngati wodwalayo ali ndi vuto lolumikizana, amapatsidwa mankhwala a laser. Njira zofananazi zimachitika maphunziro - 20 magawo tsiku lililonse. Koma amagwira mitundu yokhayo ya matendawa.
Kuphatikiza pakutenga mankhwala a antihyperglycemic, monga Metformin, mavitamini, ma pinkiller ndi mankhwala othana ndi kutupa, kwa odwala matenda ashuga omwe ali ndi mavuto olowa, ndikofunikira kutsatira malamulo onse osamalira mapazi, kulipira chidwi makamaka pamapazi. Ndikofunikanso kuchita masewera olimbitsa thupi ngati chikhodzodzo chakhazikitsidwa, makamaka ngati chofunikira chakayikidwa posachedwa.
Kuphatikiza apo, ndi zovuta zamafupa, kutikita minofu ndikuwonetsedwa. Chifukwa chake, ngati muchita zomwezi osachepera mphindi 10 patsiku, mutha kuchepetsa kupweteka kwambiri ndikuwonjezera chidwi cha mafupa. Komabe, chithandizo choterechi chimaphatikizidwa mu matenda oopsa, kutentha thupi, magazi ndi khungu.
Kuletsa kupezeka kwa zovuta zamatendawa mu shuga kumakhala ndi kayendetsedwe ka glycemic mosamala, kuti musathe kungochotsa vutoli, komanso kupewa kupezeka kwake mtsogolo. Pachifukwa ichi, ndikofunikira kutsatira zakudya, kuchita masewera olimbitsa thupi, kupewa kupsinjika, kumwa mankhwala a Metformin, Metglib ndi mankhwala ena a antiidiabetes.
Momwe matenda a shuga amakhudzira mafupa amauza katswiri muvidiyoyi.
