Rutsoka Charcot mune cheshuga: pikicha uye kurapwa

Chirwere cheshuga mellitus anozivikanwa vakawanda sezvo chirwere pamwe yatiri kurarama yakaoma. Asi mune zvimwe zviitiko kungoratidza chokwadi dambudziko rakaoma pezvakaitwa mberi dzinoparadza. Mumwe muenzaniso unoshamisa ndiye Charcot rutsoka. chirwere ichi chinhu chakakomba uye ngozi.

zviri chirwere

Charcot rutsoka mu mushonga uyewo kunorondedzerwa se shuga osteoarthropathia. Tiri kutaura zvakakomba kuomesa kwakaita cheshuga, iro dzinoratidzwa siyana pfupa kuchinja:

• Hyperostosis. Kukura cortical pfupa.
• Osteoporosis. Tiri kutaura kwakaderera uye rive dete mapfupa.
• Ostelioz. Bone rinenge wefodya chose.

Sezvaunogona kuona, rutsoka Charcot mu cheshuga hwakazara chakakomba migumisiro yakaipa. Mugadziriro yechinangwa zvatinosiita mararamiro chirwere chakadai kungaita kuti kakawanda pfupa mitswe, uyewo zvavo kushandisa coalescing. Ekupedzisira chokwadi dzimwe nguva anoita deformation norutsoka.

Kutarisira zviitiko zvakadaro zvakakodzera vaya vane asima chirwere muchimiro cheshuga. Uye zvinokosha kuti varwere jekiseni-zvaanoda, uye vaya vasina kuwira muboka iri. Pashure imwe nguva varwere dzakadaro kazhinji yatarwa neuropathic yematambudziko iyo kukonzera mitswe rutsoka, uye kakawanda.

Dambudziko pamusoro rinogonawo achiperekedzwa nemaronda ganda, achiita rakaoma zvinhu kare akaoma. Chinonyanya kukosha ndechokuti kana pane imwe neuropathy kuoneka urikanwi pamusoro netsoka, vanovakonzera ropa aibuda chinokosha, flushes kunze karusiyamu kubva mapfupa. Sezvingatarisirwa, pashure yakadaro muitiro mapfupa vanorasikirwa simba uye anogona kutyora pasi zvine mwero zvinorema.

Zvinokosha kucherechedza kuti Charcot rutsoka kuonekwa zvikurukuru varwere vari kutambura pamwe chirwere kwemakore anopfuura 10.

marudzi chirwere

Pane zvimwe zvirwere kumashure kuti tipedzisire pakuonekwa rutsoka shuga. Wapiwa chokwadi ichi, pane zvakawanda siyana chirwere:

• Neuroischemic. kukura kwayo inoitika tikafunga chirwere cheshuga angiopathy, izvo kunoratidzwa munhu kudzikira mune dzakaderera migumo ropa riyerere. In mamiriro ichi, kuti rutsoka haachinji chimiro yayo, aikanganiswa anodzokororwa. Saka ari kuzvimba ipapo, ganda inova kuchitonhora, uye simba kufamba kweropa.
• rutsoka Charcot - neuropathic chimiro. Panyaya iyi, hosha ikabuda pakanyorwa chirwere cheshuga polyneuropathy uye inotungamirira pokukundwa etsinga harinzwi pamakumbo. Zviratidzo izvi ezvinhu vari kuderedzwa kuti zvinokosha rutapudzo iri aikanganiswa norutsoka, pane dzimwe chete marwadzo. Nokuti chokuti innervation akashatirwa, murwere zvisiri anoparadzira mutoro pamusoro gumbo mapfundo, ndokusaka pane njodzi deformation makumbo.
• Hwakakanyiwa. Panyaya iyi, panguva imwe chete, zviratidzo kwose pamusoro.

Charcot rutsoka mu cheshuga: padariro pakukura

Kana isu kufungawo tinyatsonzwisisa chirwere naDr Wagner, zvichiita kuti govera 5 nzendo inopfuura murwere ane chirwere che "rutsoka shuga". Heino imwe tsananguro pfupi:

• Danho rokutanga. Urikanwi pamusoro mhando, apo sei vari okumusoro akaturikidzana ganda chete. Sezvo kurapwa uchishandisa Technology bvisa calluses. Kana zvakakodzera, nemishonga inorwisa mabhakitiriya anoshandiswa.
• Second. Zviri pamusoro rakadzika urikanwi, regai yakarova pfupa. Saka munhu anogona kuona zvakakonzerwa utachiona anotevera zvinhu: refu tembiricha, pus uye akatsvuka kumativi njodzi chikamu rutsoka. Hazvina kukamura uchishandisa mishonga uye kuvhiyiwa kubvisa tishu isingabereki.
• Third. Panguva iyi, yava akaumba rakadzika urikanwi, mapfupa kurasikirwa rikauya (dzichiri osteomyelitis). Rokuparadza pezvakaitwa sei uyewo nyoro zvinyama rutsoka. A yakafanana ezvinhu kunowanzoguma suppuration. Treatment basa zvakafanana sokune wechipiri pachikuva. In chirwere kunyanya kuoma inogona kudimurwa, asi nyaya dzakadaro hadziwanzowaniki - nezvevakafa varwere kazhinji zvichiita kuvandudza mishonga kuburikidza.

• Chechina. Charcot rutsoka panguva ino pamwero kunoratidzwa neronda rinonyenga, hunobata chimwe chikamu, munwe kwakadaro. Kana chirwere ichi rinoitwa amputations isingabereki zvikamu uye Muzviitiko zvakaipisisa - makumbo pazasi pebvi.
• Danho wechishanu. Panguva iyi, kuparadzwa maximum: dzichiri chaizvo neronda rinonyenga norutsoka, izvo zvingaita kuti munhu zvinouraya mugumisiro. The chete chiyero inobudirira kuti kudimurwa, uye pakarepo.

Kuongorora kuti rurege ndiye Charcot aikosheswa kudoma razero pachikuva, iyo inotanga zvose zvataurwa pamusoro apa. Kutaura zvazviri, tiri kutaura pamusoro vanhu vari pangozi. Kana mamiriro ichi haana ulceration, asi anova kuoneka wakarebesa norutsoka, pane calluses kana corns, asi kunoitawo pacharo akanzwawo hyperkeratosis.

Diagnostics

Charcot rutsoka muna cheshuga, apo mapikicha vanosimbisa kukomba kwechirwere chacho, kunoda yakakodzera kurapwa, zvimwe unogona kuva zvakakomba matambudziko.

Naizvozvo, chirwere ari zviratidzo chirwere wokutanga kupedza pamwe rubatsiro vanokwanisa nenyanzvi. Panguva nokufungirana ine chirwere cheshuga osteoarthropathia wokutanga kunofanira kubhadhara kushanya kune chiremba-endocrinologist. Kana zvichiita, zviri nani kuti uende unyanzvi zvipatara.

Kuitira kuti kuongororwa zvakarurama, tinoda kunyatsodzidza kurapwa uye radiological zviratidzo zvichaita kunongedzera mumwe Danho. Kunzwisisa kwakaita muitiro Pakusarudza chirwere mamota pasi chokwadi kuti zvingaratidza akafanana kuratidzwa cellulitis norutsoka, thrombophlebitis, lymphostasis nezvimwe zvirwere.

Chinonetsa ndiyo differential zvokuongorora panyaya apo Charcot rutsoka (chirwere cheshuga) riri kusachengeteka kukuru rwakazara. Panyaya iyi, kunonoka kurapwa hungada murwere gumbo kurasikirwa.

Ko differential zvokuongorora iri rikwanise chokutambudzika?

Kana murwere mumugariro, vanachiremba vari kuedza kuwana mhinduro dzemibvunzo miviri inokosha:

• Kana uine yakakodzera radiographic zviratidzo pfupa kuparadzwa, chii zvakasikwa mhando zvavari - zvirwere (osteomyelitis) kana noninfectious (chivharo)?
• Tinokwanisa here kuziva anogumbura kuchinja pamusana pokuparadzwa pfupa zvivako kana ivo zviratidzo zvakasiyana chirwere (rheumatic vadyi zvinetso, rikwanise thrombophlebitis, phlegmon rutsoka, gouty chearthritis, etc.).?

Kuti tiwane mhinduro yemubvunzo wechipiri, unofanira mimwe midziyo, nekuti pasina zvaizova zvakaoma nharo kuti murwere ari Charcot rutsoka. Maekisirei sorutivi muongororo iyi ndiyo inonyanya kukosha.

Kuwedzera X-ray, zvakakodzera kushandisa simba rinonzi magnetic resonance kuri. Asina chakaipa uye tsoka skeletal scintigraphy. Vose chirwere matanho aya kuchabatsira kuziva anogumbura kuchinja, vakawedzera ropa riyerere munzira njodzi munzvimbo uye kuduku.

Kana vanoshaya zvinogona kuongororwa nokukanganisika zvezvinangwa pfupa kwokuparara. Sezviratidzo pakati zvinyama rokuvakazve zvinogona kucherechedzwa nokuti vanoratidza basa mapfupa isoenzyme.

Ichitaura mubvunzo wokutanga, chinonyanya akakodzera pane zviratidzo pachena trophic nemaronda norutsoka. mashoko Izvi zvingava akakodzera, uye panguva postoperative nguva inotevera kudimurwa kana kuvhiyiwa chokuita tsoka. Kuti tizive hunhu pfupa kuparadzwa, muedzo kuti osteomyelitis ropa.

Charcot rutsoka: kurapwa

Chokutanga tinofanira kunzwisisa kuti apore ichabereka mukuru mugumisiro kana murwere kuona chiremba nenguva nenzira. Asi kuti izvi zviitike, vanhu vakadaro chirwere sezvo cheshuga, vanofanira kukwanisa vakazvimiririra kuongorora mamiriro tsoka dzavo.

Nomazvo Kuongorora anogona uye vanofanira kudzidza, izvi zvichakubatsira zvokurapa zano vakakodzera. Somugumisiro, murwere vanofanira kuva netsika nguva dzose kuzoongorora tsoka, uye chidimbu rutsoka. , Imi kamwe chete chakanyorwa chero kuchinja mamiriro, kunyange zviduku vanofanira kuronga kushanyira chiremba.

Zvinokoshawo kuti funga zvinotevera chokwadi, izvo achiperekedzwa Lou Gehrig nehosha - Marie: kurwadziwa rutsoka pamwe ichi ipfupi nokuda atrophy yacho etsinga harinzwi uye murwere sokuti kunoguma kukuvadzwa kuri zviduku, apo zvaparadzwa chaizvoizvo chakakomba.

Kana rutsoka nemaronda kuoneka, zvinokosha kuti tiongorore navo kudzama marongero. Panyaya kuchirapa chaizvoizvo, pasi zvimwe nemaronda inogona kudzorerwa uchibatsirwa vachibatsira insoles, sezvo ivo kuderedza kumanikidzwa panguva achifamba. Kana ichi chiyero hazvivakwani, kushandisa immobilization, zvomutadzisa zvakasimba zvainoita ganda.

Kuvhiya kurapwa akasarudzwa kana urikanwi kunosvika kune ufanane dermis. Kana paiva yakamisirwa chokwadi chirwere, chiremba vanonyorera inorwisa mabhakitiriya.

Dzimwe nguva plantar nemaronda anogona kuwedzera kunyange mhou prominences. Muchiitiko chino, pane kudiwa kuvhiya kubviswa yokupedzisira. Somuenzaniso, imwe metatarsal mapfupa, kubvisa rinogona urikanwi, vemunyika vari forefoot.

Kuti uwane mamwe mashoko pamusoro zvokurapa uye zvomusejari kurapwa

Kurwa norutsoka chirwere cheshuga uye zvinogona kushanda pachishandiswa dzenhoroondo nzira.

Kuchinja mabatiro rinonyatsotarira zvinhu zvinogona rakakamurwa mhando mbiri:

• Basic kurapwa. Panguva iyi Hazvizivikanwi nzeve cheshuga muripo, kumanikidza kuzvidzora uye normalization ropa shuga yomuropa. Varwere vari kubatira zvakakodzera uye unyanzvi. Kana zvakakodzera, chiremba wako angakumbira kurega kusvuta nokuti ine kunambwa midziyo ropa.

• Mamwe kuchirapa matanho. Kana chirwere Charcot rutsoka mu cheshuga, kurapwa zvingasanganisira inorwisa utachiona kurapa vachishandisa mishonga inorwisa mabhakitiriya. Nokuti marwadzo Kutarisira akashandisa dzokutindivadza akadai "Ibuprofen", "Analgin" and said. Uyewo, murwere kaviri nhevedzano kurapwa matanho kudzorera tsinga conduction uye kuvandudza ropa riyerere pamakumbo. Musaita pasina yomunharaunda kwechirwere kushandisa antiseptics.

Kana vavhiyiwa, rinoshandiswa panyaya kunodiwa vaparidzi kubvisa abscesses uye maronda. Kuvhiya kurapwa angava akakodzera chipimo kuvandudza ropa riyerere. Kana murwere vakabvuma kuti utano jeri iri okupedzisira nzendo chirwere, izvozvo kunowedzera mukana wokuti kugura tsoka uye maoko nemakumbo ezasi.

Kuzoita rutsoka marangwanda

Kana shuga rutsoka Charcot kurapwa zvikurukuru nezvezvandaifanira dzichibvisa maronda uye abscesses, asi kuvhiya kungashandiswa senzira yokuderedza chiito. Tiri kutaura nokururamiswa netsoka wakarebesa.

Chaizvoizvo akaita neutralize resection remafupa zvivako uye arthrodesis, anokonzera kuwedzera kumanikidza pamusoro plantar pamusoro, zvinoita kuti paumbwe dzisiri achiporesa maronda. Kuti kushandisa mitoo yakadai, zviri kutanga zvakakodzera kuitira kuti ndima iri kushoma, uye zvakazara, uye pakanga pasina osteolysis. Kana izvi zvinhu zvisina asangana, pane mukana kuti kuvhiyiwa kuchatungamirira kwaita itsva nzvimbo kuparadzwa.

Uyewo, asati oparesheni iri aida kusimbisa pfupa achishandisa zvinodhaka zvakakodzera.

The pamusoro-chinorondedzerwa kuvhiya yokugadzirisa tsoka kunokosha kana simba deformation, kuita va neudhadha kushandisa chaiwo vachibatsira shangu.

matanho

Pachena ndiko kukosha mashoko sei kudzivisa dambudziko rakadaro, Charcot rutsoka. Photo varwere Inotibatsira kunzwisisa sei zvakakomba iri rinoparadza muitiro. Uye kunyange kana hwakava uye kurapwa akanga akatakurwa achiburitswa kunze, izvi hazvirevi kuti urikanwi haangavi kuonekwa zvakare.

Saka, kudzivisa uye kudzivisa apiwa panowanikwa Charcot rutsoka nokutevera Itariro nenheyo gadziriro muzvidzivirire. Chekutanga unofanira nguva dzose kuti aongorore tsoka dzavo, uye nezviratidzo ganda kukuvara kana kugozha kutanga kuenda pakarepo kuti ndiongororwe ane endocrinologist.

Uyewo kurega chigero ezvipikiri clippers uye chipikiri faira kushandisa. Narrow shangu, zvakare, tinofanira kuramba kare, nokuti nyore chokuzora tsoka dzake uye kuwana zviyo. Uyezve, zvinokosha kuti achengetedze rutsoka kubva kumusoro uye yakaderera tembiricha.

Kana ronda yakanga dzakaonekwa, zvinokosha kuti ironge 3% mhinduro kuti hydrogen peroxide, "Chlorhexidine" uye "miramistinom" kunoteverwa kushanda chena dressings. Pakadaro, ivo pakaunda mishonga kuti vane kusukuta matehwe kushanda. Izvi zvinosanganisira ayodhini, kupenya mutema, uye potassium permanganate. Zvakakosha kuti kutarisira ndechokuti ganda asingadi kuwana tsvina. Izvi zvichabatsira moisturizers ( "Kallyuzan", "Balzamed" and said.).

zvabuda

rutsoka chirwere cheshuga - chirwere chinogona kukonzera dzakakomba yematambudziko kana kumhanya. Naizvozvo, nechirwere nechirwere cheshuga vanofanira kudzidziswa uye kunyatsotevera kuongorora mamiriro tsoka dzavo.