Osteomyelitis na ƙafa a cikin ciwon sukari mellitus: lura da yatsunsu da ƙashi

Ciwon sukari mellitus yana tare da haɓakar glucose na jini. Glucose yana da sakamako mai lahani ga bangon jijiyoyin jini da jijiyoyin jijiya.

Sakamakon karancin jini da rashin ingantaccen ciki a cikin ƙananan ƙarshen, neuropathy yana haɓaka azaman rikicewar ciwon sukari.

Halin halayyar neuropathy shine haɓakar cututtukan warkarwa mara kyau. A cikin yanayin faduwa cikin rigakafi, rashin abinci mai gina jiki na kyallen takarda, kamuwa da cuta ya shiga. A cikin manyan maganganu, yana yadawa zuwa kasusuwa na kasusuwa kuma osteomyelitis yana faruwa.

Sanadin Osteomyelitis

Neuroarancin ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta tare da ƙirƙirar ƙafafun ciwon sukari cuta ce mai gama gari da ke yawan ciwon sukari. Yawancin lokaci yakan faru ne bayan shekaru 5-7 daga farkon cutar a farkon nau'in ciwon sukari. Nau'in na biyu na ciwon sukari yayi hankali kuma rikitarwa zai iya bunkasa sosai daga baya.

Babban dalilin ci gaban rikicewar cutar sankara shine rashin biyan bashin glucose. Wannan na iya faruwa tare da mummunan nau'in cutar ko watsi da shawarwarin likitancin endocrinologist. Babban taro na glucose a cikin jini, da sauye-sauyensa na katsewa suna tarwatse bangon jijiyoyin jiki da lalata muryoyin jijiya.

Tare da raguwa cikin wadatar jini da motsa jiki, tsokoki sun rasa hankalinsu da ikon murmurewa daga raunin da suka ji. Duk wani ƙaramin lalacewa ko fashewar fata zai iya haifar da haifar da cututtukan cututtukan cututtukan zuciya. Suna warkar da su a hankali, galibi suna kamuwa da cuta.

Kafar ciwon sukari ta bayyana kanta a cikin abubuwan da yawa:

• Rashin lafiyar jijiyoyin jiki a cikin ƙananan jirgi da ƙananan jijiya (angiopathy)
• Lalacewar kashi da osteoporosis.
• Rage rigakafi.
• Ciwon mara.

Ya danganta da yawan cututtukan jijiyoyin jiki ko na jijiyoyin jiki, ana rarrabe wani nau'in ƙwaƙwalwar ƙwaƙwalwa ko ischemic na ƙafafun sukari. Amma wannan rarrabuwa akwai sabani sosai, tunda yawanci wadannan abubuwan biyu suna aiki lokaci daya.

Sabili da haka, nau'ikan haɗuwa da aka fi sani.

Bayyanar cututtuka da bayyanar cututtuka na osteomyelitis

Za a iya bayyanar da cutar sankarar ta hanyar cin zarafi ko zafin zazzabi na ƙananan ƙarshen, ƙarar bushewar fata, fasa, kumburi, nakasar ƙafa. A cikin wadannan raunin da ya faru, cutar fata.

Cutar cutar kututture da lalata kyallen takarda zuwa kasusuwa suna da rikitarwa ta hanyar kumburi ƙasusuwa, periosteum da bargo na kashi. A wannan yanayin, osteomyelitis da ke fitowa yana da wuyar magance tare da magani kuma sau da yawa yakan haifar da buƙatar datse ƙananan ƙarshen.

Osteomyelitis na iya zama rikitarwa ga kowane irin rauni mai zurfi ko babba. Irin wannan alamun yana nuna alamun ci gaban osteomyelitis:

1. Ciwon mara baya warkarwa a cikin watanni biyu na magani.
2. Raunin yana da zurfi kuma kasusuwa ana iya gani a kasan, ko kuma za a iya tantance shi ta hanyar bincike.
3. Gashinan da abin ya shafa sun kumbura kuma ja.
4. A cikin jini, an kara matakin leukocytes, ESR ya fi 70 mm / awa.
5. Lokacin gudanar da gwajin x-ray ko MRI, an gano lalata kashi a ƙarƙashin rauni.

Babban alamar ganewar asali biopsy ne (binciken nama) na kasusuwa.

A cikin ciwon sukari mellitus, lalata kashi yana haifar da cututtukan ciwon sukari (ƙafar Charcot). Wannan yanayin yana tasowa cikin matsanancin ciwon suga. Tsarin kumburi yana faruwa ba tare da kamuwa da cuta ba. A cikin mawuyacin hali, kafafu kafaɗun kafa na kafa ya na tasowa. Fata yana da ja, mai wuya da zafi, tare da wuraren kumburi.

Tsawon lokacin kumburi zai iya shiga yanayin rayuwa na yau da kullun. Rushewa, karaya na iya faruwa a cikin gidajen abinci, kasusuwa sun lalace. A tsawon lokaci, cutar na iya rikitarwa ta hanyar osteomyelitis.

Hanyar kamuwa da cututtukan cututtukan cututtukan cututtukan daji ta cikin matakai da yawa:

• Mataki m: edema na ƙafa, jan ciki da zazzabi. A cikin hotuna - osteoporosis (nama mai saukin ganewa kashi).
• Mataki na Subacute: babu kumburi, ƙafafun ya lalace, an lalace ƙasusuwa a cikin hotunan.
• Matsayi na yau da kullun: ƙafafun ya lalace, mai kama da "takarda takarda", dislocations da karaya ƙasusuwa.
• Matsayi tare da rikitarwa: rauni na koda, osteomyelitis.

Osteomyelitis magani

Matsayi na osteoarthropathy ana bi da shi tare da cikakken saukar da kafa. Don wannan, ana amfani da kayan aikin orthopedic: orthoses, tutors, takalma orthopedic.

Idan wannan bai isa ba kuma cutar ba ta warkewa ba, to, ana bada shawarar cikakken ƙuntata motsi - hutun gado mai ƙarfi. Don maganin ƙwayar cuta, ana amfani da rukuni na gaba na ƙwayoyi:

1. Don hana lalata kashi - Alendronate, Pamidronate.
2. Don ƙirƙirar sabon ƙwayar tsoka - kwayoyin anabolic steroid (Methandrostenolone, Retabolil), shirye-shiryen alli da Vitamin D3.
3. Maƙasudin Zane - Analgin, Ketanov, Nalbufin.
4. Magungunan rigakafin ƙwayar cuta marasa lalacewa - Nimesulide, Diclofenac, Revmoxicam.
5. Diuretics - Furosemide, Hypothiazide.

Akwai maganganun ci gaba bayan maganin x-ray.

A cikin yanayin na yau da kullun, an wajabta shirye-shiryen bitamin da alli. Wani kashi da ya lalace daga kashi ba tare da kumburi ba za'a iya cire shi ta hanyar magani. Ana nuna takalmin orthopedic.

Tare da haɓakar osteomyelitis, babban aiki shine zaɓi na ƙarin magani - magani ko tiyata.

Ta hanyar yin jiyya, an rage yatsa ko wani ɓangare na ƙafa da ƙarfafa warkarwa mai rauni. Idan kamuwa da cuta bai inganta ba bayan tiyata, to akwai damar murmurewa da komawa zuwa rayuwa mai aiki. Jiyya na tiyata ba shi da garantin ci gaban sabbin raunuka da kuma cikakkiyar warkarwa da raunuka. A wasu halaye, ana maimaita yankan kwaskwarima.

Idan an yanke shawara game da magani na mazan jiya, to a cikin makonni shida ana amfani da allurar rigakafi masu yawa: Cefazolin, Clindamycin, Meronem, Tienam, Ciprofloxacin. Yawancin lokaci, rigakafin ƙwayoyin rigakafi ana allurar rigakafi, amma tare da tsawan magani yana yiwuwa a canza zuwa siffofin kwamfutar hannu.

Psuna amfani da haɗin kai tare da magunguna da yawa - Levofloxacin + Clindamycin, maganin beta-lactam - Amoxiclav, Augmentin, Trifamox suma ana amfani dasu. Bugu da ƙari, ana iya gudanar da maganin rigakafi ta hanyar kai tsaye, kai tsaye cikin rauni ta amfani da beads na acrylate na musamman.

Magungunan rigakafin ƙwayar cuta suna ba da sakamako mai kyau a cikin yawancin marasa lafiya, amma a cikin ciwon sukari mellitus yawanci akwai raguwar cututtukan hanta, wanda ke ba da gudummawa ga ci gaba da tasirin sakamako na irin wannan magani.

Babban abinda yake haifar da warkewar cutar don magance kowace cuta game da ciwon sukari shine ramawar sukari mai hawan jini tare da amfani da kwayoyi don rage shi - insulin ko allunan.

Tare da magani na tiyata ko hyperglycemia mai tsanani, ana iya canja wurin marasa lafiya daga allunan zuwa insulin a ƙarƙashin ikon sukari na jini. Insulin yana da ikon ƙarfafa ƙwayar ƙashi.

Haɓakar osteomyelitis a cikin ciwon sukari na mellitus za a iya hana shi idan kun bi abinci mai ƙarancin carb a ko'ina cikin cutar, ɗauki magunguna a cikin zaɓin da aka zaɓa. Don rage haɗarin rikice-rikice na ciwon sukari mellitus, ya wajaba don kula da matakin glucose a cikin jini a cikin irin wannan jeri: a kan komai a ciki har zuwa 6.4 mmol / l, bayan cin abinci bayan sa'o'i biyu, 8.9 mmol / l, a lokacin barci, 6.95 mmol / l.

Ana auna matakan glucose kowace rana tare da bayanin martaba na glycemic. Bugu da ƙari, sau ɗaya a kowane watanni uku, duk marasa lafiya da ke dauke da cutar sankara suna nuna ƙayyadaddun matakan gemoclobin.

Wannan alamar yana nuna matsakaicin matakin sukari na jini a cikin watanni uku da suka gabata kuma yana da ƙarin bayani don ƙayyade matsayin diyya ga masu ciwon sukari. Matsakaicin aikinsa ya kai 7.5%.

Fat metabolism ya kamata ya kasance cikin (auna a cikin mmol / l) - cholesterol - 4.8;

LDL yana ƙasa da 3, HDL ya fi 1.2 girma. Tare da cututtukan jijiyoyin bugun gini, yana da mahimmanci don hana ciwar ba kawai carbohydrates mai sauƙi tare da abinci ba, har ma don rage kitsen dabbobi a cikin abincin.

Hakanan yana da mahimmanci a bincika da kuma magance cututtukan fata don hana samuwar cututtukan cututtukan trophic a cikin ciwon sukari. Idan kuna tsammanin samuwar ƙafar mai ciwon sukari, kula da kullun ta hanyar endocrinologist, neuropathologist, podologist ya zama dole. Bidiyo a cikin wannan labarin ya ci gaba da magana game da matsalolin rauni na ciwon sukari.