Charcot phazi shuga: chithunzi ndi mankhwala

Shuga amadziwika kuti ambiri monga matenda zovuta ndi imene tikukhalamoyi. Koma nthawi zina sikuti vuto ndi zovuta njira zina zowononga. Chitsanzo chimodzi chidwi ndi Charcot phazi. matenda Izi ndi lalikulu ndi loopsa.

maonekedwe a matenda

Charcot phazi mankhwala komanso chimatanthauza ashuga osteoarthropathia. Tikuyankhula zokhudza vuto lalikulu matenda a shuga amene ali ndi makhalidwe osiyanasiyana kusintha fupa:

• Hyperostosis. Kukula yokhudza kotekisi fupa.
• Kufooka kwa mafupa. Tikuyankhula zokhudza kufooka ndi kupatulira mafupa.
• Ostelioz. Bone minofu kwathunthu odzipereka.

Monga mukuonera, Charcot phazi shuga ndi zinadzala ndi mavuto aakulu negative. Mu chimango cha kudacita a moyo ndi matenda amenewa kungachititse kuti kawirikawiri fractures fupa, komanso asamadye coalescing awo. Mfundo yamasika amayambitsa mapindikidwe phazi.

Amafuna zikuchitika chonchi amene ali ndi mphumu matenda mawonekedwe a shuga. Ndipo ndikofunika odwala insulin-yozungulira, ndi anthu omwe safuna kugwera mu gulu ili. Patapita nthawi zina nthawi odwala amenewa kawirikawiri amodzi mavuto neuropathic amene amayambitsa fractures pa mwendo, ndipo kawirikawiri.

Vuto pamwamba akhoza limodzi ndi zilonda za pakhungu, akudziwitsa kumva zinthu kale kovuta. Mfundo yofunika kuti pamene pa neuropathy ndi kuonekera chilonda pa phazi, iwo amayambitsa kwambiri magazi, amatuluka kunja kashiamu kwa mafupa. Mwachibadwa, pambuyo ndondomeko oterowo mafupa kutaya mphamvu ndipo akhoza kuswa pansi katundu zolimbitsa.

Dziwani chakuti Charcot phazi kuonekera makamaka odwala amene akuvutika ndi matenda kwa zaka zoposa 10.

mitundu ya matenda

Pali matenda ena maziko chopatsa maonekedwe a phazi matenda ashuga. Popeza mfundo imeneyi, pali njira zingapo za matenda:

• Neuroischemic. chitukuko chikuchitika ndi maziko a ashuga angiopathy, amene anasonyeza ndi kuwonongeka mu m'munsi malekezero magazi. Mmenemonso, phazi sasintha kake, ndi tcheru ake anakhalabe. Choncho pali kutupa, khungu amakhala ozizira, ndi zimachitika ofooka.
• Charcot phazi - neuropathic mawonekedwe. Pankhaniyi, matenda akufotokozera mu maziko a ashuga polyneuropathy ndipo kumayambitsa kugonjetsedwa kwa molekezera mitsempha mapazi. Zizindikiro za chikhalidwe ichi ndi kuchepetsedwa kuti kuchepetsa kwambiri tilinazo phazi, pali ululu chomwecho. Chifukwa chakuti innervation akawinduka, wodwalayo molakwa kugawira katundu pa malo mwendo, umene ndi chifukwa chake pali chiopsezo mapindikidwe mapazi.
• Osokonezeka. Pankhaniyi, pa nthawi yomweyo, zizindikiro za mitundu onse a pamwamba.

Charcot phazi shuga: siteji ya chitukuko

Ngati ife kuganizira zochita za matenda ndi Dr. Wagner, kudzakhala kotheka kuonetsetsa 5 magawo kuti apatsira mtima ndi matenda a "ashuga phazi". Apa ikulongosola mwachidule:

• Gawo loyamba. Chilonda pamwamba mtundu, amene anakhudzidwa ndi lokha zigawo kumtunda kwa khungu. Monga mankhwala ntchito Technology kuchotsa calluses. Ngati ndi kotheka, mankhwala ntchito.
• Chachiwiri. Ndichidziwitso chilonda kwambiri, musati mugunda fupa. Motero angathe kudziwa zotsatira za matenda ndi mbali zotsatirazi: mkulu kutentha, mafinya ndi redness mozungulira mbali akhudzidwa ndi phazi. Ndi apakhungu mankhwala ndi opaleshoni kuti achotse minofu wosabereka.
• Chachitatu. Pa nthawi imeneyi, iwo anapanga chilonda kwambiri, fupa imfa zimachitika (osauka osteomyelitis). njira zowononga bwanji komanso minofu zofewa mu phazi. A chikhalidwe zofanana nthawi zambiri limodzi ndi suppuration. Chithandizo anatumizidwa chimodzimodzi monga choncho ndi gawo lachiwiri. Mu matenda makamaka aakulu akhoza amputation, koma Zikatero n'zochepa - chikhalidwe cha odwala zambiri n'zotheka kusintha mankhwala mopyola.

• Chachinayi. Charcot phazi pa mlingo amakhala ndi chilonda, ndipo izi zimakhudza malo enaake, monga chala. Ngati matenda imeneyi ikuchitika amadulidwa chiwalo mbali yosabala ndi Zikavuta - miyendo bondo.
• Mbali wachisanu. Pa nthawi imeneyi, chiwonongeko pazipita: kukhala ndi chilonda kwambiri phazi, tingayambe kuti ziyende amapha. Yekha muyeso ogwira ndi amputation, ndipo mwamsanga.

Kusanthula kuti kuletsa ndi Charcot tiyenera kutchula siteji ziro, lomwe lili m'mbuyo onse tafotokozazi. Ndipotu, tikulankhula za anthu amene ali pa chiopsezo. Pamene boma alibe ulceration, koma amakhala noticeable chilema phazi, pali calluses kapena chimanga, koma Ikuonetsanso lokha anamva hyperkeratosis.

diagnostics

Charcot phazi shuga, kumene zithunzi kutsimikizira kuopsa kwa matenda, pamafunika chithandizo yake, mwinamwake inu mukhoza kukhala mavuto aakulu.

Choncho, matenda a zizindikiro woyamba wa matenda muyenera kucheza ndi thandizo la akatswiri oyenerera. Pa kukayikitsa woyamba wa matenda a shuga osteoarthropathia ayenera kulipira ulendo kwa dokotala-m'thupi yemwenso. Ngati n'kotheka, ndi bwino kupita ku malo apadera zachipatala.

Kuti apange matenda zolondola, muyenera mosamala zizindikiro za matenda ndi radiological zimene zimaloza ku siteji ena. Kuvuta kwa ndondomeko kudziŵa matenda zithupsa pansi chakuti zizindikiro amakhala ngati chiwonetsero cha cellulitis phazi, thrombophlebitis, lymphostasis ndi matenda ena.

Ovuta kwambiri ndi masiyanidwe matenda ngati kumene Charcot phazi (ashuga) ndi pa siteji pachimake. Mu nkhani iyi, akuchedwa mankhwala ndalama wodwala nthambi imfa.

Kodi masiyanidwe matenda mu gawo pachimake?

Pamene wodwala mu chikhalidwe choterocho, madokotala akuyesetsa yankho mafunso awiri ofunika:

• Ngati muli yoyenera zizindikiro radiographic chiwonongeko fupa, mtundu wa chikhalidwe iwo ali - matenda opatsirana (osteomyelitis) kapena noninfectious (kapu)?
• N'zotheka kudziwa kusintha yotupa chifukwa cha kuwonongedwa kwa nyumba fupa kapena zizindikiro zosiyanasiyana za matenda (enaake ophwanya matenda limodzi pachimake thrombophlebitis, phlegmon phazi, gouty nyamakazi, etc.).?

Kuti tipeze yankho ku funso lachiwiri, muyenera zida zina, chifukwa popanda kudzakhala kovuta amanena kuti wodwalayo Charcot phazi. X-ray monga gawo la kafukufuku ameneyu ndi zofunika kwambiri.

Kuwonjezera X-ray, m'pofunika kugwiritsa ntchito chapamwamba kwambiri. Kukhala nthano ndi phazi chigoba scintigraphy. Onse zonsezi matenda chingatithandize kudziwa kusintha yotupa, kuchuluka magazi m'malo akhudzidwa ndi microfractures.

Mu nkhani ya chitha kukhala imawunikidwa zolembera amuzolengedwa cha kuwonongedwa fupa. Zolembera ya kukhazikitsanso minofu Angagwiritsidwenso n'komwe chifukwa amatsanzira ntchito za isoenzyme fupa.

Ponena za funso loyamba, ndi zogwirizana kwambiri pa zizindikiro zoonekeratu zilonda trophic phazi. mfundo zimenezi zingakhale zogwirizana ndi m'nthawi postoperative zotsatirazi amputation kapena opaleshoni zokhudza phazi. Kudziwa chikhalidwe cha fupa chiwonongeko, atayezetsa kwa osteomyelitis.

Charcot phazi: chithandizo

Choyamba tiyenera kuzindikira kuti lipole idzapereka zotsatira kwambiri ngati wodwalayo kuchipatala m'nthawi yake. Koma zimenezi zichitike, anthu ndi matenda monga matenda a shuga ayenera kutha paokha ngoziyo boma la kumapazi awo.

Woyenera anayendera ndipo ayenera kuphunzira, likuthandizani oyenerera kuchipatala. Motero, wodwalayo ayenera kukhala ndi chizolowezi nthawi zonse kuyendera mapazi, ndipo makamaka phazi. Kamodzi wolembedwa kusintha kulikonse mu dongosolo, ngakhale ang'ono, muyenera kukonzekera ulendo kwa dokotala.

M'pofunikanso kuganizira mfundo zotsatirazi, amene anatsagana ndi matenda Lou Gehrig - Marie: ululu phazi ndi chikhalidwe ichi yafupika chifukwa manja a molekezera mitsempha, ndi mtima zingaoneke kuti kuwonongeka chifukwa laling'ono, pamene kuwonongeka kwenikweni kwambiri.

Ngati zilonda phazi kuoneka, m'pofunika kufufuza ndi kolowera kuya. Pankhani zotsatira achire, pansi zilonda zina ungakonzedwe mothandizidwa ndi insoles mafupa, monga iwo kuchepetsa kuthamanga pa kuyenda. Ngati muyeso izi singakwane, ntchito immobilization, kuteteza anakhudzidwa kwambiri khungu.

Opaleshoni chithandizocho anasankha pamene chilonda chimafikira kwa mlingo wa dermis lapansi. Ngati panali mfundo amodzi matenda, dokotala mankhwala mankhwala.

Nthawi zina zilonda plantar imafika ngakhale kwa prominences Bony. Pankhaniyi, pali kufunika kuchotsa opaleshoni ya inawo. Mwachitsanzo, munthu metatarsal fupa, kuchotsa amene angathe chilonda, isanafalikire mu forefoot lapansi.

Kuti mudziwe zambiri pa mankhwala ndi opaleshoni

Kulimbana ndi matenda ashuga miyendo ndipo kungakhale kugwira ntchito mwa njira zachikhalidwe.

chithandizo ndiwofatsa lolunjika pa zinthu zimene angathe kugawidwa mitundu iwiri:

• chithandizo Basic. Pa mlingo chidwi matenda a shuga malipilo, ulamuliro kuthamanga ndi normalization wa shuga. Odwala amaphunzitsidwa kudziwa zofunika ndi luso. Ngati ndi kotheka, dokotala angafunse kusiya kusuta chifukwa zoyipa pa Mitsempha.

• Zina achire miyeso. Ngati matenda Charcot phazi shuga, mankhwala akhoza monga mankhwala antimicrobial ntchito mankhwala. Kupweteka kasamalidwe ntchito mankhwala opha monga "Ibuprofen", "Analgin" neri Al. Komanso, wodwalayo amaloŵamo mndandanda wa miyeso chithandizo kubwezeretsa mitsempha conduction ndi kusintha otaya magazi mapazi. Kodi kuchita wopanda Impact m'deralo ntchito antiseptics.

Koma opaleshoni, amagwiritsidwanso ntchito ngati pamene pali kufunika kuchotsa abscesses ndi zilonda. Opaleshoni mankhwala akhoza kukhala zogwirizana muyeso kusintha magazi. Ngati wodwalayo ndi anavomereza kuti kuchipatala mu magawo lotsiriza la nthenda, iyo kumachititsa wa amputation mapazi ndi miyendo m'munsi.

Ayambe mafupa phazi

Pamene ashuga phazi chithandizo Charcot makamaka lolunjika pa kuchotsa zilonda ndi abscesses, koma opaleshoni akhoza kugwiritsidwa ntchito ngati kanthu kuchepetsa. Tikuyankhula zokhudza kukonzedwa kwa chilema phazi.

Kwenikweni anachita n'chongoletsa resection nyumba fupa ndi arthrodesis amene amayambitsa kuwonjezeka kuthamanga padziko plantar, imbaenda kuna mapangidwe zilonda sanali kuchiritsa. Pofuna kutsatira njira zimenezi, choyamba pofuna kuti vesili ndi yotupa ndondomeko, ndi kwathunthu, ndipo panalibe osteolysis. Ngati zinthu izi ndisanakumane, pali chiopsezo kuti opaleshoni zidzayambitsa zikamera malo atsopano chiwonongeko.

Komanso, pamaso opaleshoni wokha kulimbitsa mafupa ndi mankhwala oyenerera.

Pamwambapa anafotokoza kukonza opaleshoni phazi n'kofunika pamene amphamvu mapindikidwe, kugwiritsa ntchito inefficient wa nsapato zapadera mafupa.

zodzitetezera

Koonekeratu kufunika mudziwe mmene tingapewere vuto, Charcot phazi. odwala chithunzi Zimatithandiza kumvetsa mmene n'kotani ndi ndondomeko zowononga. Ndipo ngakhale kwawakhudza ndi mankhwala zinachitikadi, izi sizitanthauza kuti chilonda siziwoneka kachiwiri.

Choncho, kupewa ndi kuteteza kukonzanso yatsoka a Charcot phazi kutsatira mfundo chotsimikiziridwa mu chimango cha kupewa. Choyamba muyenera nthawi zonse kuyendera mapazi awo, ndi zizindikiro woyamba kuvulazidwa khungu kapena kupsyinjika kupita yomweyo kuyezedwa ndi m'thupi yemwenso ndi.

Komanso kusiya lumo msomali clippers ndi msomali file ntchito. nsapato yopapatiza, nayenso, ayenera kukhala m'mbuyomu, chifukwa n'zosavuta opaka mapazi ake kenako chimanga. Komanso, Nkofunika kuteteza phazi kuchokera kutentha ndi otsika.

Ngati chilonda anali wapezeka, m'pofunika pokonza 3% njira ya hydrogen peroxide, "Chlorhexidine" ndi "miramistinom" kenako ntchito Mavalidwe wosabala. Imeneyi, iwo ali kauntala mankhwala amene ali ndi khungu zotsatira. Zikuphatikizapo ayodini, anzeru wobiriwira, ndipo permanganate potaziyamu. Nkofunika kusamalira chakuti khungu sakhala zauve. Izi zidzathandiza moisturizers ( "Kallyuzan", "Balzamed" neri Al.).

zotsatira

Ashuga phazi - matenda zimene zingachititse mavuto aakulu ngati kuthamanga. Choncho, matenda a shuga ayenera aphunzitsidwe ndi mosamala kuyan'ana mkhalidwe wa mapazi awo.