Osteomyelitis ya phazi mu matenda a shuga: chithandizo chala ndi mafupa

Matenda a shuga amaphatikizika ndi kuwonjezeka kwa shuga m'magazi. Glucose imatha kuwononga makoma amitsempha yamagazi ndi mafupa amitsempha.

Chifukwa chosakwanira magazi komanso kusowa malo okhala m'munsi, neuropathy imayamba ngati vuto la matenda ashuga.

Chizindikiro cha neuropathy ndikutukuka kwa zilonda zam'mbuyo. Mu kugwa chitetezo chokwanira, kusowa kwa minofu, matenda amalowa. Muzochitika zapamwamba, zimafalikira ku minofu ya mafupa ndipo osteomyelitis imachitika.

Zoyambitsa za Osteomyelitis

Kutsitsa kwamitsempha ya m'miyendo ndi mapangidwe a phazi la matenda ashuga ndimavuto ambiri a shuga. Nthawi zambiri zimachitika zaka 5 - 7 kuchokera pomwe matendawa adayamba matenda ashuga. Mtundu wachiwiri wa matenda ashuga umayamba pang'onopang'ono ndipo zovuta zimatha kuyamba pambuyo pake.

Chifukwa chachikulu chomwe chitukuko cha matenda ashuga chimapangidwira chimachepetsa shuga. Izi zimatha kuchitika ndi matenda oopsa kapena kunyalanyaza malangizo a endocrinologist. Kuphatikizika kwa shuga m'magazi, ndipo kusintha kwache kosokoneza kumasokoneza khoma lamitsempha ndikuwononga ulusi wamitsempha.

Ndi kuchepa kwa magazi komanso kusangalatsa kwamanjenje, minofu imasiya kumva komanso kutha kuyambiranso kuvulala. Kuwonongeka kulikonse kapena kuwonongeka kwa khungu kumatha kubweretsa kupangika kwa zilonda za matenda ashuga. Amachira pang'onopang'ono, nthawi zambiri amatenga kachilomboka.

Matenda a shuga amawonekera pama syndromes angapo:

• Vuto la mtima m'matumbo ang'onoang'ono (angiopathy)
• Kuwonongeka kwa mafupa ndi mafupa.
• Anachepetsa chitetezo chokwanira.
• Matenda a zilonda.

Kutengera kufalikira kwa matenda amitsempha kapena minyewa, mawonekedwe a neuropathic kapena ischemic phazi la matenda ashuga amasiyanitsidwa. Koma gawoli limakhala lachiwonetsero kwambiri, chifukwa nthawi zambiri zinthu ziwiri izi zimachitika nthawi imodzi.

Chifukwa chake, mawonekedwe osakanikirana ambiri.

Zizindikiro ndi matenda a osteomyelitis

Matenda a shuga amatha kuwonetsedwa ndikuphwanya ululu kapena kutentha kwa m'munsi m'munsi, khungu lowuma, ming'alu, kutupa, kupindika kwa phazi. Pakati pa zovulala izi, zilonda zamkhungu zimayamba.

Zilonda zoyambitsidwa ndi chiwonongeko cha minofu yofewa kupita ku fupa ndizovuta chifukwa cha kufooka kwa minofu ya mafupa, mafupa am'mimba ndi mafupa. Pankhaniyi, osteomyelitis yomwe ikubwera imakhala yovuta kuthandizira ndimankhwala ndipo nthawi zambiri zimabweretsa kufunika kokadula kumapeto.

Osteomyelitis imatha kukhala chopondana ndi zilonda zamtunda zazitali kapena zazikulu. Kukula kwa osteomyelitis kumasonyezedwa ndi zizindikiro zotere:

1. Zilonda samachiritsa mu miyezi iwiri ya mankhwala.
2. Chilondacho ndi chakuya ndipo fupa limawoneka pansi, kapena lingatsimikizidwe ndi kafukufuku.
3. Chiwalo chomwe chakhudzidwa ndi chotupa komanso chofiira.
4. M'magazi, mulingo wa leukocytes ukuwonjezeka, ESR imaposa 70 mm / ola.
5. Mukamayeserera x-ray kapena MRI, kuwonongeka kwa mafupa pansi pa chilonda adapezeka.

Chizindikiro chachikulu chodziwitsa ndi kuphipha kwa minofu.

Mu matenda a shuga mellitus, kuwonongeka kwa mafupa kumayambitsa matenda a diabetesic osteoarthropathy (phazi la Charcot). Matendawa amakula kwambiri odwala matenda ashuga. Njira yotupa imachitika popanda matenda. Mu gawo la pachimake, edilatal edema ya phazi limayamba. Khungu limakhala lofiira, lolimba komanso lotentha, lokhala ndi malo a kutupa.

Nthawi yotupa kwambiri imatha kukhala yopanda zovuta. Disloclocation, ma fractures amatha kuphatikizika, mafupa amaperewera. Popita nthawi, matendawa amatha kupanikizika ndi osteomyelitis.

Njira ya odwala matenda ashuga amadutsa angapo magawo:

• Acute siteji: edema ya phazi, redness ndi fever. Zithunzizi - mafupa am'mimba (mafupa osowa).
• Gawo la subacute: palibe kutupa, phazi ndi lopindika, fupa limawonongedwa pazithunzi.
• Pafupipafupi: phazi limakhala lopindika, lofanana ndi "pepala lolemetsa", masamu komanso mafupa owonongeka.
• Gawo lomwe limakumana ndi zovuta: zilonda zam'mimba, osteomyelitis.

Chithandizo cha Osteomyelitis

The pachimake gawo la osteoarthropathy amathandizidwa ndi kutsitsa kwathunthu mwendo. Kwa izi, zida zamatsenga zimagwiritsidwa ntchito: ma orthoses, aphunzitsi, nsapato zamatumbo.

Ngati izi sizokwanira ndipo zilonda zake sizichiritsa, ndiye kuti kayendedwe kokwanira ndikulimbikitsidwa - kupumula kwa kama. Pazithandizo zamankhwala, magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito:

1. Popewa kuwonongeka kwa mafupa - Alendronate, Pamidronate.
2. Kupanga minofu yatsopano ya mafupa - mahomoni a anabolic steroid (Methandrostenolone, Retabolil), calcium ndi Vitamini D3 kukonzekera.
3. Ma Painkiller - Analgin, Ketanov, Nalbufin.
4. Mankhwala osokoneza bongo a nonsteroidal - Nimesulide, Diclofenac, Revmoxicam.
5. Diuretics - Furosemide, Hypothiazide.

Pali milandu ya kusintha pambuyo pa x-ray.

Mu gawo lalitali, mavitamini ndi calcium amakonzekera. Gawo lomwe lawonongedwa fupa pakalibe kutupa limatha kuchotsedwa mothandizidwa. Kuvala nsapato zamankhwala kumaonetsa.

Ndi chitukuko cha osteomyelitis, ntchito yayikulu ndikusankha kwa chithandizo chinanso - mankhwala kapena opareshoni.

Ndi chithandizo cha opaleshoni, kudulidwa kwa chala kapena gawo la phazi ndi kukondoweza kwa mabala amachiritsa. Ngati matenda samakula pambuyo pakuchita opaleshoni, ndiye kuti pali mwayi wakuchira komanso kubwerera ku moyo wokangalika. Chithandizo cha opaleshoni sichitsimikizo chotsutsana ndi zilonda zatsopano ndikuchiritsidwa kwathunthu kwa mabala. Nthawi zina, kudula mobwerezabwereza kumachitika.

Ngati lingaliro liperekedwa pazamankhwala osokoneza, ndiye kuti pasanathe milungu isanu ndi umodzi pamakhala Mlingo wambiri wa anti -amu wodziwika: Cefazolin, Clindamycin, Meronem, Tienam, Ciprofloxacin. Nthawi zambiri, maantibayotiki amabayidwa, koma ndimankhwala omwe amapezeka kwa nthawi yayitali amatha kusintha mawonekedwe a mapiritsi.

Pamagwiritsa ntchito mankhwala ophatikiza pamodzi ndi mankhwala angapo - Levofloxacin + Clindamycin, mankhwala a beta-lactam - Amoxiclav, Augmentin, Trifamox amagwiritsidwanso ntchito. Kuphatikiza apo, maantibayotiki amatha kuperekedwa mwachindunji, mwachindunji pachilonda pogwiritsa ntchito mikanda yapadera ya acrylate.

Mankhwala othandizira antibiotic amathandiza odwala ambiri, koma m'mankhwala am'magazi nthawi zambiri mumakhala zovuta zina, zomwe zimapangitsa kuti pakhale zotsatira zoyipa za chithandizo chotere.

Chochita chachikulu chothandizira kuchiza kwa matenda aliwonse motsutsana ndi matenda ashuga ndicho kubwezeretsa shuga yayikulu yamagazi pogwiritsa ntchito mankhwala kuti achepetse - insulin kapena mapiritsi.

Ndi chithandizo cha opaleshoni kapena hyperglycemia yayikulu, odwala amatha kusamutsidwa kuchokera pamapiritsi kupita ku insulin motsogozedwa ndi shuga. Insulin imatha kulimbitsa minofu ya mafupa.

Kukula kwa osteomyelitis mu matenda a shuga kutha kupewedwa ngati mutsata zakudya zama carb otsika matenda onse, kumwa mankhwala mosankha. Kuti muchepetse chiwopsezo cha zovuta za matenda osokoneza bongo, ndikofunikira kusungitsa shuga m'magazi m'magawo otere: pamimba yopanda kanthu mpaka 6.4 mmol / l, mutatha kudya pambuyo maola awiri, 8.9 mmol / l, pogona, 6.95 mmol / l.

Miyezo ya glucose imayezedwa tsiku lililonse ndi mbiri ya glycemic. Kuphatikiza apo, kamodzi miyezi itatu iliyonse, odwala onse omwe ali ndi matenda a shuga amawonetsedwa kuti adziwe kuchuluka kwa hemoglobin ya glycated.

Chizindikirochi chikuwonetsa kuchuluka kwa shuga m'miyezi itatu yapitayi ndipo ndikuwadziwitsanso kuti mudziwe kuchuluka komwe kulipira shuga. Mulingo wake woyenera wafika pa 7.5%.

Metabolism yamafuta iyenera kukhala mkati (muyeso wa mmol / l) - cholesterol - 4.8;

LDL ndi yotsika kuposa 3, HDL ndi yapamwamba kuposa 1.2. Ndi mtima pathologies, ndikofunikira kuti muchepetse kudya kosakhazikika kwa chakudya komanso chakudya, komanso kuchepetsa mafuta a nyama muzakudya.

Ndikofunikanso kupenda ndi kuchiza zotupa za khungu kuti mupewe kupangika kwa zilonda zam'mimba mwa matenda ashuga. Ngati mukukayikira kukhazikitsidwa kwa phazi la matenda ashuga, kuyang'anira pafupipafupi ndi endocrinologist, neuropathologist, ndikofunikira. Kanemayo munkhaniyi akupitiliza mutu wa mavuto a bala la matenda ashuga.