Ngezinyawo sikaCharcot sikashukela: isithombe kanye nokwelashwa

Ngifundise ngesifo sikashukela yaziwa abaningi njengoba isifo eziyinkimbinkimbi nge esiphila kuzo. Kodwa kwezinye izimo iqiniso nje inkinga nzima izinqubo okwengeziwe elimazayo. Esinye isibonelo okuphawuleka unyawo sikaCharcot. Lokhu uphethwe esingathí sina kodwa futhi kuyingozi.

izici isifo

SikaCharcot unyawo kwezokwelapha kanye kuchazwa njenganoma osteoarthropathia sikashukela. Sikhuluma isimo esibucayi sikashukela, okuyinto libhekene ezihlukahlukene ithambo izinguquko:

• Hyperostosis. Growing ithambo cortical.
• Lokhu kwakubangelwa ukukhumuzeka kwamathambo. Sikhuluma buthakathaka futhi thinning amathambo.
• Ostelioz. Bone izicubu is egxile ngokuphelele.

Njengoba ubona, unyawo sikaCharcot sikashukela igcwele nemiphumela ongemuhle. Ngaphansi kohlaka indlela evamile yokuphila kuyinto leso sifo kungaholela njalo ithambo waphuka, kanye ukungasetshenziswa kahle kwazo coalescing. ngezinye izikhathi Iqiniso yokugcina kubangela ukusonteka senyawo.

Lindela intuthuko enjalo kudingeka labo somoya kutholakala ukuthi uphethwe ngendlela sikashukela. Futhi kubalulekile ukuba iziguli insulini-engaphansi, labo ningaweli kuleli qembu. Ngemva kwenkathi ethile yesikhathi iziguli anjalo ngokuvamile esinqunyiwe yezinkinga neuropathic ezibangela waphuka onyaweni, futhi njalo.

Inkinga ngenhla kungabuye ephelezelwa izilonda zesikhumba, ayenze lukhuni nzima isimo esinzima kakade. Iphuzu eliyinhloko liwukuthi lapho ngesikhathi peripheral avele isilonda onyaweni, babangela abalulekile ukugeleza kwegazi, Ukufikelwa ukushisa ngaphandle calcium kusukela amathambo. Ngokwemvelo, emva komsebenzi onjalo amathambo uphelelwe amandla bese ungakwazi ukugqashula ngaphansi imithwalo ngokulinganisela.

Kuyaphawuleka yokuthi sikaCharcot unyawo avele ikakhulukazi ezigulini uhlushwa isifo iminyaka engaphezu kwengu-10.

izinhlobo isifo

Kukhona izifo ngesizinda eziholela ukubonakala unyawo sikashukela. Ngokuya ngaleli qiniso, kukhona izinhlobo eziningana sifo:

• Neuroischemic. Ukuthuthukiswa Its yenzeka isizinda angiopathy sikashukela, okuyinto esashiwo Oqala ukungezwa aze agcine ephansi emikhawulweni ukugeleza kwegazi. Kuleli zinga, unyawo ayishintshi ezakheke, kanye nokuzwela yayo inakekelwa. Ngakho kukhona ukuvuvukala, isikhumba kuba ezibandayo nenhliziyo ishayela ababuthakathaka.
• ngezinyawo sikaCharcot - ifomu neuropathic. Kulokhu, lesi sifo eba isizinda polyneuropathy sikashukela kanye kuholela kokunqotshwa kwe eziyimpumelelo ezinzwa izinyawo. Izimpawu zalesi simo ziyancipha ukuncipha eziphawulekayo nozwela ngezinyawo, kukhona ngesikhathi ubuhlungu obufanayo. Ngenxa yokuthi i-innervation kuyaphazamiseka, isiguli ngokungalungile ihambisa umthwalo emalungeni umlenze, yingakho kukhona ingozi ukusonteka zezinyawo.
• Mixed. Kulokhu, ngesikhathi esifanayo, izimpawu zombili lezi zinhlobo okungenhla.

SikaCharcot unyawo sikashukela: esigabeni yentuthuko

Uma thina acabangele ukuhlola lesi sifo nguDkt Wagner, sizokwazi ukwaba 5 izigaba ludlulele isiguli kwathiwa unesifo "unyawo sikashukela". Nansi incazelo emfushane:

• Isigaba sokuqala. Isilonda ebusweni uhlobo, lapho kuthinteka kuphela izingqimba engenhla isikhumba. Ngenxa yokwelashwa usebenzisa Technology ukususa calluses. Uma kudingekile, imithi elwa namagciwane asetshenziswa.
• Okwesibili. Kumayelana isilonda esijulile, musa hit ithambo. Kanjalo umuntu angakwazi ukuba sithole umphumela yokungenwa yizifo ngokucindezela izici ezilandelayo: a okusezingeni eliphezulu lokushisa, ubomvu kanye ububomvu emhlabeni ingxenye ethintekile unyawo. Kuyinto imithi elwa namagciwane oluhlelwe ngezihloko futhi ukuhlinzwa ukuze kusikwe izicubu engatheli.
• Okwesithathu. Kulesi sigaba, kube kwakhiwa isilonda esijulile, kwamathambo kwenzeka (ekuthuthukiseni osteomyelitis). izinqubo Okulimazayo kuthinte futhi izicubu zomzimba ezithambile onyaweni. Isimo esifana uvame ukuhambisana suppuration. Ukwelashwa wabele efanayo endabeni ne esigabeni sesibili. Ngo isifo zibe nzima ngokukhethekile kungaba umlenze, kodwa Ezimweni ezinjalo ezingajwayelekile - isimo iziguli ngokuvamile kungenzeka ngcono imithi ngokusebenzisa.

• Okwesine. SikaCharcot unyawo kulelizinga libhekene esibhibhayo, esithinta endaweni ethile, umunwe ezinjalo. Uma ngabe le uphethwe Kwenziwa amputations izingxenye abakhiqizi futhi ezimweni ezimbi kakhulu - imilenze ngezansi kwedolo.
• Isigaba sesihlanu. Kulesi sigaba, ukubhujiswa esiphezulu: kokuthandana esibhibhayo olubanzi unyawo, okungaba nomphumela ebulalayo. Okuwukuphela ngesilinganiso ngempumelelo iwukuba umlenze, futhi ngokushesha.

Ukuhlaziya ngalolo stop Kuhle kokusho iqanda esiteji sikaCharcot, obulandela zonke ezichazwe ngenhla. Eqinisweni, sikhuluma nabantu abasengozini. Uma lokhu isimo ayinakho ulceration, kodwa iba deformity lubonakale senyawo, kukhona calluses noma corns, kodwa ibuye izenze wazizwa hyperkeratosis.

ukuhlola

SikaCharcot unyawo sikashukela, lapho izithombe ukuqinisekisa kahle ukungathí sina kwaleso sifo, zidinga ukwelashwa ngesikhathi esifanele, kungenjalo ungase ukuthuthukisa eziyingozi.

Ngakho-ke, sitholakele izimpawu zokuqala zesifo kudingeka bachithe ngosizo ochwepheshe abafanelekayo. Ngesikhathi izinsolo lokuqala osteoarthropathia sikashukela kufanele ukhokhe uma uya kudokotela-endocrinology. Uma kungenzeka, kungcono ukuya isikhungo sezokwelapha ezikhethekile.

Ukuze wenze i-ukusazi ngokunembile isifo esikuphethe, kudingeka Ukutadisha ngokucophelela izibonakaliso emitholampilo radiology ezokwenza ukhombe isigaba ethile. Ukuba yinkimbinkimbi kwayo inqubo sokunquma isifo yangempela yokuthi izimpawu zingase zifane ukubonakaliswa cellulitis senyawo, thrombophlebitis, lymphostasis kanye nezinye izifo.

Okunzima kakhulu yikona umehluko esimweni lapho sikaCharcot unyawo (sikashukela) kuyinto ngesikhathi liqala oyingozi. Kulokhu, ukubambezeleka ekwelashweni kungadla isiguli isitho somzimba ukulahlekelwa.

Kushiwo ngamuphi umqondo ukuthi uphethwe umehluko e isigaba neso elibukhali kangaka?

Lapho isiguli ekuleso simo, odokotela ozama uthole impendulo emibuzweni emibili ebalulekile:

• Uma une izimpawu ezifanele radiographic ithambo ekubhujisweni, onjani imvelo zingabantu - izifo ezithathelwanayo (osteomyelitis) noma noninfectious (CAP)?
• Singakwazi yini ukuthola izinguquko ukuvuvukala ngenxa yokucekelwa ithambo izakhiwo noma loko kuyizimpawu zokuthi ezahlukene zesifo (iziyaluyalu rheumatism ngokuhlanganyela, thrombophlebitis acute, phlegmon unyawo, isifo samathambo gouty, njll).?

Ukuze uthole impendulo yombuzo othi yesibili, uzodinga imishini eyengeziwe, ngoba ngaphandle kwalo kungaba nzima baphikisa ngokuthi isiguli sikaCharcot ngezinyawo. X-ray njengengxenye lolucwaningo iyona ebaluleke kakhulu.

Ngaphezu-X-ray, kubalulekile ukusebenzisa magnetic resonance imaging. Kungabi okungahambi kahle wabe unyawo scintigraphy lwamathambo. Konke lokhu izinyathelo zokuxilonga kuzosiza ukukhomba izinguquko ukuvuvukala, kukhuphuke ukugeleza kwegazi ezindaweni ethintekile kanye okuncane.

Uma kwenzeka isidingo kungahlolwa nakomaka kwamakhemikhali ithambo ukuphuka. Abamakayo ka ukuba kwakhiwe kabusha izicubu ingaphinda kucatshangelwe ngoba babonakalisa umsebenzi wethambo isoenzyme.

Ngokuphathelene umbuzo wokuqala, lubalulekile kakhulu izimpawu ezisobala izilonda trophic senyawo. Lolu lwazi lungase lube efanele, futhi ngesikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa elandelayo ukunqunywa noma ukuhlinzwa eziphathelene unyawo. Ukuze ubone ukuthi uhlobo ithambo ekubhujisweni, ukuhlolwa igazi for osteomyelitis.

ngezinyawo sikaCharcot: ukwelashwa

Okokuqala kumelwe siqonde ukuthi le nqubo zokuphulukisa liyakuthela umphumela omkhulu kunayo yonke uma isiguli kumele ubonane nodokotela ngendlela esifike ngesikhathi. Kodwa ukuze lokhu kwenzeke, abantu unesifo njengesifo sikashukela, kufanele ukwazi ngokuzimela ukuhlola isimo izinyawo zabo.

wokuhlola abanekhono bangakhuluma futhi kufanele bafunde, lokhu kuzosiza iseluleko ofanelekayo wezokwelapha. Ngenxa yalokho, isiguli kufanele ahlakulele umkhuba njalo ahlole izinyawo, futhi ngokukhethekile unyawo. Uma eqoshiwe noma yiziphi izinguquko kule isakhiwo, ngisho encane, udinga ukuhlela Ukuvakashela udokotela.

Kubalulekile futhi ukuba sicabangele iqiniso elandelayo, okuyinto kuhambisana isifo sikaLou Gehrig - UMarie: ubuhlungu unyawo nale nkinga kuyehla ngenxa yoma we eziyimpumelelo kwenzwa nokungenwa isiguli kungase kubonakale ukuthi okudalwa akulutho, kuyilapho umonakalo empeleni sina.

Uma avele ngezinyawo nezilonda, kubalulekile ukuze awahlole ngokulungiselelwa ukujula. Ngokuphathelene nomphumela oqabulayo, ngaphansi izilonda ezithile ingabuyiswa ngosizo insoles wamathambo, njengoba kakhulu ukunciphisa umfutho wegazi phakathi ukuhamba. Uma ngabe le ngesilinganiso alanele, sebenzisa immobilization, okuvimbela ukusebenza eqinile esikhumbeni.

ukwelashwa Steel lumiswa lapho isilonda kudlulela ezingeni dermis. Uma kwakuba khona Eqinisweni esinqunyiwe ukutheleleka, udokotela ngeke antibiotic.

Ngezinye izikhathi izilonda plantar ongalinikeza ngisho kuya prominences bony. Kulokhu, kukhona isidingo ukususwa kuhlinzwa lakamuva. Njengoba isibonelo, ithambo metatarsal, ukususa ezingasetshenziswa isilonda, zendawo forefoot.

Ukuze uthole ukwaziswa okwengeziwe ngokusebenzisa imithi futhi kuhlinzwa

Fight ngonyawo sikashukela kanye kungaba op esebenzisa izindlela zakudala.

ukwelashwa okulondoloza igxile nemisetjenzana okungabuzwa lahlukaniswa izinhlobo:

• ukwelashwa Eyisisekelo. Kulelizinga ukunakekela sikashukela isinxephezelo, ukulawula ingcindezi futhi ukuzinza of amazinga kashukela egazini. Iziguli ayebonakalisa ukuqonda nemakhono ladzingekile. Uma kudingeka, udokotela wakho angase abuze ukuyeka ukubhema ngoba nomphumela omubi imithambo yegazi.

• izinyathelo engeziwe zokwelapha. Uma sisheshe sikaCharcot unyawo sikashukela, ukwelashwa ingase ihlanganise yokwelapha elwa namagciwane usebenzisa imithi elwa namagciwane. Ukuze ubuhlungu ukuphathwa esetshenziswa imithi yokubulala izinzwa ezifana "ibuprofen", "Analgin" et al. Futhi, isiguli asitholayo uchungechunge ukwelashwa izinyathelo ukubuyisela ezinzwa conduction futhi sithuthukise ukugeleza kwegazi ezinyaweni. Musa ukwenza ngaphandle umthelela wendawo kokusebenzisa antiseptics.

Njengoba ukuhlinzwa, isetshenziswa esimweni lapho kunesidingo ukususa abscesses kanye nezilonda. ukwelashwa Steel kungenzeka ngesilinganiso esifanele ukuthuthukisa ukugeleza kwegazi. Uma isiguli ungeniswe sezempilo emabangeni lokugcina isifo, kwandisa amathuba ukunqunywa ezinyawo nasemilenzeni aphansi.

Nokuvulwa skeleton unyawo

Lapho ukwelashwa unyawo sikashukela sikaCharcot ngokuyinhloko igxile ekususeni izilonda kanye abscesses, kodwa ukuhlinzwa lingasetshenziswa njengoba isinyathelo ukunciphisa. Sikhuluma yokulungiswa deformity unyawo.

Empeleni wenziwa iwukudambisa resection ithambo izakhiwo kanye arthrodesis, okuyinto abangela ukwanda ingcindezi phezu plantar, okuyinto kuholela ekwakhekeni izilonda ze-non-ephulukisa. Ukuze ukusebenzisa amasu anjalo, kuba okokuqala kudingekile ukuqinisekisa ukuthi leli vesi kuyinto ukuvuvukala, futhi ngokugcwele, futhi kwakungekho osteolysis. Uma lezi zimo hhayi wahlangana, kunobungozi ukuthi ukuhlinzwa kuzoholela ukuvela izikhungo ezintsha yembubhiso.

Futhi, ngaphambi msebenzi oyifunayo ukuze uqinise ithambo esebenzisa izidakamizwa ezifanele.

Okungenhla-echazwe ukulungisa kuhlinzwa senyawo kuyadingeka uma eqinile ukusonteka, sizisebenzise kahle izicathulo ezikhethekile wamathambo.

izinyathelo

Esobala iwukuthi ukubaluleka ngolwazi lokuthi ungahlala kanjani umraro onje, sikaCharcot unyawo. iziguli isithombe Sisenza sikwazi ukuqonda le siyingozi kangakanani inqubo elimazayo. Futhi ngisho noma iye yathinta kanye nokwelashwa kwenziwa, lokhu akusho ukuthi isilonda ngeke sivele futhi.

Ngakho, ukugwema futhi kuvimbele kabusha okwenziwe sikaCharcot unyawo ngokulandela izimiso efakazelwe kohlaka zokuvimbela. Okokuqala udinga njalo ukuzohlola izinyawo zabo, futhi ngezinye izimpawu zokuqala isikhumba ukulimala noma uhlobo ukuya ngokushesha ukuhlolwa i endocrinology.

Futhi kumelwe siyiyeke sikelo nail izinzipho kanye ifayela nail ukuyisebenzisa. izicathulo Esincane, futhi, kumelwe sihlale esikhathini esidlule, ngoba kulula ukuba uwuhlikihle izinyawo zakhe bese uthole corn. Ngaphezu kwalokho, kubalulekile ukuvikela ngezinyawo, bephuma kuyo amazinga aphakeme okushisa aphansi.

Uma isilonda itholiwe, kubalulekile ukucubungula isixazululo 3% we-hydrogen peroxide, "Chlorhexidine" futhi "miramistinom" kulandelwe isicelo kusaladi oyinyumba. Kulesi simo, zingabantu esiphikisayo imithi ukuthi ibe nomphumela ukushuka. Lezi zihlanganisa i-iodine, oluhlaza abakhaliphile kanye potassium permanganate. Kubalulekile ukunakekela iqiniso lokuthi isikhumba engakutholi ezingcolile. Lokhu kuzosiza moisturizers ( "Kallyuzan", "Balzamed" et al.).

Imiphumela

ngezinyawo Diabetic - isifo engaholela eziyingozi uma ugijima. Ngakho-ke, sitholakele isifo sikashukela kudingeka aqeqeshwe futhi eduze nokuqapha isimo ezinyawo zazo.