Unyawo Charcot ku seswekile: ifoto kunye nonyango

Diabetes sinwenwa yaziwa ngabaninzi njenge isifo letiya esiphila kuyo. Kodwa kwezinye iimeko isibakala nje le ngxaki intsonkothile neenkqubo zokunceda yingozi. Omnye umzekelo okuphawuleka unyawo Charcot. Le uphethwe i enkulu yingozi.

iimpawu zesifo

unyawo Charcot in amayeza achazwa kwakunye osteoarthropathia seswekile. Sithetha ingxaki enkulu seswekile, nto leyo iphawulwa ezahlukeneyo utshintsho bone:

• Hyperostosis. Growing ithambo cortical.
• Kwamathambo. Sithetha malunga Akuhlangani kunye ukuxozwa emathanjeni.
• Ostelioz. Bone inyama ako ngokupheleleyo.

Njengoko ubona, unyawo Charcot e seswekile naxa ingumbandela ozaliswe ziziphumo kakhulu ezimbi. Phakathi sikhokelo yesiqhelo indlela yobomi sisifo enjalo kunokukhokelela kwamathambo rhoqo, kwakunye coalescing yazo kabi. Into yokugqibela ngamanye amaxesha ebangela deformation senyawo.

Lindela izinto ezinjalo kuyimfuneko abo sombefu kwafunyaniswa ukuba uhlobo seswekile. Kwaye kubalulekile ukuba izigulane insulin-abaxhomekeke, nabo abo kuwa kweli qela. Emva kwexesha elithile izigulane basoloko iingxaki fixed neuropathic ezibangela ukwaphula unyawo, kwaye rhoqo.

Le ngxaki ingentla kwakhona zihambe nezilonda ulusu, benze nzima imeko sele kunzima. Eyona nto ibalulekileyo kukuba xa kwindawo neuropathy kuvela isilonda kwi unyawo, bevakalise ukuhamba kwegazi ebalulekileyo, egungxula ngaphandle calcium evela amathambo. Ngokuqhelekileyo, emva kwenkqubo enjalo amathambo uphelelwe amandla kwaye nawaphula phantsi imithwalo ngomlinganiselo.

Kubalulekile ukuphawula ukuba Charcot unyawo zivela kakhulu izigulane abakufumana kunzima nesi sifo iminyaka engaphezu kwama-10.

Isifo

Kukho ezinye izifo imvelaphi ezikhokelela inkangeleko yonyawo seswekile. Xa sijonge le nyaniso, kukho iintlobo ezininzi sifo:

• Neuroischemic. uphuhliso yawo uthatha indawo ngokuchasene nentsukaphi angiopathy seswekile, nto leyo kubonakaliswa ukwehla ezisezantsi eziphelweni ukuhamba kwegazi. Kule meko, unyawo ayitshintshi ukwakheka kwalo, novakalelo layo igcinwa. Ngenxa yoko kukho ukudumba, isikhumba kuba kuyabanda, yaye sazi buthathaka.
• unyawo Charcot - fomu neuropathic. Kulo mzekelo, esi sifo senzeka imvelaphi polyneuropathy seswekile kwaye ikhokelela ngokoyiswa iziphelo-luvo ezinyaweni. Iimpawu zesi sifo bancipha unciphiso ebalulekileyo uvakalelo yonyawo, kukho kwi intlungu efanayo. Ngenxa yokuba le innervation aphazanyiswa, isigulana isasaze ngokungachanekanga umthwalo emalungwini emlenzeni, nto leyo esisizathu sokuba kukho umngcipheko deformation iinyawo.
• Mixed. Kulo mzekelo, ngaxeshanye, iimpawu zazo zombini iintlobo ngasentla.

Charcot unyawo seswekile: kwinqanaba lophuhliso

Ukuba uthathe ingqalelo yokuba uvavanyo sifo nguGqirha Wagner, kuya kuba lula ukwabela izigaba 5 eyipasile isigulana unesifo 'unyawo seswekile ". Nantsi inkcazelo emfutshane:

• Isigaba sokuqala. Isilonda uhlobo ngaphezulu, apho abachaphazelekayo kuphela umphantsi nomphezulu kwesikhumba. Njengoko unyango usebenzisa Technology ukususa calluses. Ukuba kuyimfuneko, amachiza asetyenziswa.
• Yesibini. Ibe malunga isilonda nzulu, musa wabetha ithambo. Ngaloo ndlela umntu ukubona isiphumo wokosuleleka ezi mpawu zilandelayo: lobushushu eliphezulu, ububomvu kunye bomvu emhlabeni inxalenye uchaphazelekayo yonyawo. Kuyinto antibiotics mlonyeni kunye notyando ukususa inyama balala emqokozweni.
• Okwesithathu. Kweli nqanaba, kuye kwasekwa isilonda nzulu, kwamathambo kwenzeka (asakhasayo osteomyelitis). iinkqubo etshabalalisayo zichaphazela kwakhona kwizihlunu ezithambileyo unyawo. Yimeko efanayo Idla yi suppuration. Treatment isabelo efanayo njengoko kunjalo sesibini isigaba. Xa isifo ngakumbi kakhulu kunokuba umlenze, kodwa iimeko ezinjalo zinqabile - imeko izigulana amaxesha kuyenzeka ukuba ukuphucula amayeza nge.

• Okwesine. unyawo Charcot kweli nqanaba luphawulwa ekuboleni, nto leyo ichaphazela inxalenye ethile, umnwe ezinjalo. imilenze ezantsi kwedolo - Ukuba le uphethwe abanqanyulwe izahlulo balala emqokozweni kwiimeko kakhulu kwenziwa.
• Isigaba sesihlanu. Kweli nqanaba, intshabalalo lininzi: ekuphuhliseni njengesilonda ngokubanzi unyawo, nto leyo enokukhokelela ekubeni ibe esibulalayo. Lo mqathango okhankanywe ngempumelelo kuphela ukuba umlenze, yaye ngoko nangoko.

Ukuhlaziya in ukuba stop sikhankanye iqonga Charcot kaThixo zero, olungaphambi zonke ezichazwe ngasentla. Enyanisweni, sithetha abantu abasemngciphekweni. Xa oku Urhulumente akukho zizilonda, kodwa uba ukukhubazeka olubonakalayo lwe yonyawo, kukho calluses okanye corns, kodwa wenza ngokwayo waziva hyperkeratosis.

ekuxilongweni

unyawo Charcot e seswekile, apho iifoto kuqinisekisa ubunzulu esi sifo, kufuna unyango ngexesha, kungenjalo uya ukuphuhlisa iingxaki ezinzulu.

Ngoko ke, lokufunyaniswa Iimpawu zokuqala zesi sifo kufuneka achithe ngoncedo yeengcali abafanelekayo. Xa ukusola yokuqala osteoarthropathia seswekile kufuneka ahlawule utyelelo kugqirha-endocrinologist. Ukuba kunokwenzeka, kungcono uye kwiziko lonyango ezizodwa.

Ukuze wenze ukuxilongwa, kufuneka ukufunda ngenyameko imiqondiso zeklinikhi zeradiyoloji ukuba uza kubakhombisa kwinqanaba elithile. Ukuntsonkotha inkqubo yokufumanisa isifo mbambano yokuba iimpawu ukuze zifane sisibonakaliso cellulitis kwenyawo, thrombophlebitis, lymphostasis kunye nezinye izifo.

Eyona nto inzima kukuba uxilongo umahluko kwimeko apho Charcot unyawo (seswekile) lukwisigaba yayiyazi. Kulo mzekelo, ulibaziseko unyango zinokubiza ilahleko lomzimba nomonde.

Njani na uxilongo mahluko kwisigaba oyingozi?

Xa isigulana zikwimeko, oogqirha Uzama ukufumana impendulo kwimibuzo ebalulekileyo emibini:

• Ukuba unayo iimpawu ezifanelekileyo radiographic wentshabalalo ithambo, hlobo luni nendalo na - izifo ezosulelayo (osteomyelitis) okanye noninfectious (Cap)?
• Unako ukujonga utshintsho kwiintetho ezikralayo, ngenxa yokwaphuka izakhiwo yethambo okanye ukuba iimpawu ezahlukeneyo sifo (ukuphazamiseka samathambo joint, thrombophlebitis etsolo, unyawo phlegmon, samathambo gouty, njalo njalo).?

Ukuze ufumane impendulo kulo mbuzo wesibini, kuya kufuneka izixhobo ezongezelelweyo, kuba ngaphandle bekuya kuba nzima ukuba uphikise ukuba isigulana Charcot ngonyawo. -X-reyi njengenxenye yale saveyi yeyona ibalulekileyo.

Ukongezelela X-ray, kuyimfuneko ukusebenzisa ngemagnethi ekuvakaleni kwelizwi umfanekiso. Kungabi okungahambi unyawo scintigraphy skeletal. Zonke ezi manyathelo diagnostic kuya kunceda ukuphawula utshintsho ukudumba, ukwanda igazi flow ezindaweni kunye microfractures abachaphazelekayo.

Kwimeko intswelo emaziqatshelwe markers kwemichiza yokwaphuka ithambo. Amagosa angabevi esiqwini yokwakha kwakhona zithathelwe ingqalelo kuba zibonisa umsebenzi lo isoenzyme ithambo.

Ngokuphathelele umbuzo wokuqala, kubalulekile kakhulu elichaphazelekayo iimpawu ezicacileyo zizilonda trophic senyawo. Le nkcukacha zibe efanelekileyo, kwaye ngeli xesha postoperative ilandelayo umlenze okanye uqhaqho emalunga unyawo. Ukuze ubone uhlobo wentshabalalo ithambo, uvavanyo igazi osteomyelitis.

unyawo Charcot: unyango

Okokuqala simele siqonde ukuba inkqubo impiliso uvelise isiphumo kakhulu ukuba isigulane bonana nogqirha ngendlela ngexesha. Kodwa ukuba oku kwenzeke, abantu unesifo ezifana neswekile, kufuneka ukwazi ukuhlola ngokuzimeleyo imeko kweenyawo zabo.

uhlolo abanolwazi nga kwaye kufuneka bafunde, oku kuya kunceda iingcebiso zobugqirha abafanelekayo. Ngenxa yoko, isigulane kufuneka hlakulela umkhuba rhoqo ukuhlola iinyawo, kwaye ingakumbi unyawo. Xa naluphi na utshintsho kubume, abhalwe nokuba incinane, kufuneka ukuba isicwangciso utyelelo kugqirha.

Kubalulekile ukuqwalasela into elandelayo, nto leyo sikhatshwa sisifo Lou Gehrig esithi - Marie: intlungu unyawo nale meko zincitshisiwe ngenxa yoma ke kwalapho, kwaye isigulane kusenokubonakala ngathi umonakalo eliphuma minor, lo gama umonakalo omkhulu enyanisweni.

Ukuba nezilonda unyawo kuvela, kuyimfuneko ukuhlola nabo ubunzulu sentlalo. Ngokumalunga isiphumo enyangayo, phantsi nezilonda ezithile kubuyiselwa ngoncedo insoles wamathambo, njengoko nciphisa ngokubaluleka ingcinezelo ngexesha ukuhamba. Ukuba lo mqathango akwanelanga, sebenzisa immobilization, ukuthintela nempembelelo enamandla apha esikhumbeni.

unyango Surgical ubekiwe xa isilonda kudlulela kwinqanaba dermis. Ukuba kwakukho into abasimiselweyo zosulelo, ugqirha uyakukumisela antibiotics.

Ngamanye amaxesha izilonda plantar nga ukwandisa kude kuse prominences nokudleka. Kulo mzekelo, kukho imfuneko kokususa le yokugqibela. Ngokomzekelo, ithambo amadeo, ukususa leyo isilonda, yenzelwe ukuba i forefoot.

Ukuze ufumane inkcazelo engakumbi malunga unyango konyango,

Yilwa ngonyawo seswekile kwaye ukusebenza ngeendlela ngeendlela yamandulo.

unyango Conservative swi izinto ezinokuthi zohlulwa ngokwendidi ezimbini:

• unyango Basic. Kweli nqanaba ingqalelo kwimbuyekezo isifo seswekile, ulawulo xi kuqheleke amaqondo eswekile yegazi. Izigulane bafundiswa ngolwazi nezakhono eziyimfuneko. Ukuba kuyimfuneko, ugqirha wakho ukucela ukuba ukuyeka ukutshaya kuba iba nefuthe elibi imithambo yegazi.

• amanyathelo ezongezelelweyo elapha. Ukuba une Charcot unyawo e seswekile, unyango ziquka unyango elwa usebenzisa antibiotics. Kuba ulawulo ubuhlungu kusetyenziswa iintlungu ezifana "ibuprofen", "Analgin" et al. Kwakhona, isigulana ivavanywa uthotho lwamanyathelo unyango ukubuyisela luvo Uhanjiso nokuphucula kwegazi ezinyaweni. Musa ukwenza ngaphandle impembelelo yasekuhlaleni ngokusebenzisa ebulala.

Yona utyando, lisetyenziswa kwimeko apho kukho imfuneko ukususa amathumba kunye nezilonda. unyango Surgical inokuba umlinganiselo efanelekileyo ukuze kuphuculwe ukuhamba kwegazi. Ukuba isigulane amkelwe kwiziko lezempilo kwi zigaba yokugqibela sifo, kwenyusa amathuba okwalandelwa iinyawo kunye asezantsi omzimba.

Ukufunyanwa kwe asemzimbeni yonyawo

Xa unyango Charcot unyawo seswekile ikakhulu kugxininisa ekususeni izilonda kunye namathumba, kodwa utyando ukuze zingasetyenziswa njenge amanyathelo okunciphisa. Sithetha ulungiso ukukhubazeka yonyawo.

Eneneni eyenziwa Nokwethisa resection izakhiwo ngethambo kunye arthrodesis, obe ubaqhiphukisa ukwanda koxinzelelo phezu plantar, nto leyo ekhokelela ukuba ukuyilwa izilonda non-zempiliso. Ukuze isicelo ubuchule ezinjalo, oko kuqala kuyimfuneko ukuqinisekisa ukuba le vesi kuyinkqubo kwiintetho ezikralayo, kwaye ngokupheleleyo, yaye kungekho osteolysis. Ukuba ezi zinto zombini azenzeki, kukho i-risk yokuba utyando iya kukhokelela ukuvela kwamaziko amatsha bekhaliswa kukwaphulwa.

Kwakhona, ngaphambi kokuba umsebenzi ayinqwenelayo ukomeleza ithambo kusetyenziswa amayeza afanelekileyo.

Le ukulungiswa echazwe-ngentla zoqhaqho unyawo kuyimfuneko xa strong deformation, ukwenza ukusetyenziswa okungafanelekanga izihlangu ezizodwa wamathambo.

amanyathelo othintelo

Obonakalayo ukubaluleka kolwazi malunga nokuba ungayinqanda njani le ngxaki, Charcot ngonyawo. iziguli photo Kuthi kusenza siqonde kunzulu kangakanani na yinkqubo etshabalalisayo oku. Yaye ukuba uye waba negalelo kwaye unyango lwaqhutywa, oku akuthethi ukuba isilonda alizukuvela kwakhona.

Ngoko ke, ukuze uphephe nokuthintela, kunokwenzeka ukuba unyawo Charcot ngokulandela imigaqo esiqinisekisiweyo kwisikhokelo yothintelo. Okokuqala kufuneka rhoqo ukuba ahlole iinyawo zabo, yaye ke imiqondiso yokuqala yokwenzakala ulusu okanye zizame ukuya ngoko nangoko makancinwe i endocrinologist.

Kwakhona kufuneka ukunikezela izikere Iziqhano isikhonkwane kunye ifayile iinzipho ukuyisebenzisa. izihlangu emxinwa, kakhulu, kufuneka sihlale kwixa elidluleyo, kuba kulula pakani iinyawo zakhe uze ufumane ingqolowa. Ngaphezu koko, kubalulekile ukuba ukukhusela unyawo ukusuka amaqondo aphezulu nezisezantsi.

Ukuba inxeba ibhaqwe, kuyimfuneko ukuba ukuqhubekekisa isisombululo hydrogen peroxide, "Chlorhexidine" yaye "miramistinom" ilandelwa yi isicelo of zokubopha ludlolo-3%. Kule meko, ukuba zemithi ukuba babe kunokutshiswa. Ezi ziquka iodine, eluhlaza brilliant, kunye potassium permanganate. Kubalulekile ukuba anyamekele ukuba ulusu ayikho mdaka. Oku kuya kunceda moisturizers ( "Kallyuzan", "Balzamed" et al.).

iziphumo

unyawo abaneswekile - isifo enokukhokelela iingxaki ezinkulu xa ibalekiswa. Ngoko ke, lokufunyaniswa seswekile kufuneka baqeqeshwe kwaye ngokusondeleyo esweni imeko kweenyawo zabo.