Avascular necrosis fupa. Avascular necrosis mutu femoral

Avascular necrosis mutu femoral chifukwa cha otaya mkhutu magazi mu dongosolo mtima kupereka malo. zochitika oterowo ndi chifukwa psinjika kapena torsion pa yaing'ono thrombus mtsempha wamagazi occlusion kapena kupwetekedwa mtima. Kenako, tione zimene avascular necrosis mutu femoral.

zinthu kukulitsa

Yaitali vasospasm ndi kuchuluka magazi kukhuthala, venous stasis ndi chisokonezo cha outflow kwambiri kusokoneza mphamvu ya mutu wa fupa ntchafu. Mu nkhani imeneyi, wakewe umafuna ukuwonjezeka, ischemia akufotokozera. Izi amakwiya kuphwanya mawotchi katundu minofu fupa. Chifukwa, voids anapanga. M'kupita kwa nthawi, fupa akuyamba deform, chichereŵechereŵe articular zikadzawonongedwa, ndi katungulume kutali.

kudwala Features

Necrosis (avascular) fupa anapeza zambiri. Advantageously, ndi kudwala amawapeza anthu azaka zaka 20 kuti 45. Komanso anapezeka ndi avascular necrosis mutu femoral ana zaka 2 mpaka 12. Pa nthawi yomweyo anyamata kudwala zambiri. Zizindikiro kuti ayende avascular necrosis, zina kovuta kusiyanitsa. Ndi penapake zovuta kuti apange matenda zolondola. Makamaka, zizindikiro necrosis avascular pafupifupi osiyana kuwonekera kwa ndondomeko pathological mu ntchafu olowa.

udindo kupitilira

Avascular necrosis kusiyana mofulumira kwambiri. Pa tsiku lachitatu wodwala akumva mumamva kupweteka mwamphamvu ukuwonjezeka. Pamene inu muyesera imirirani, poyenda pali ululu m'dera groin. Iye limapezekanso pa mbali ndi kutsogolo kwa ntchafu ndipo bondo amapereka. Odwala ambiri, ululu akhoza kukhala yotopetsa ndipo nthawi zonse. Izo zikhoza maola usiku ndi m'mawa kuchepa. Pamene kusuntha katundu imfayo kupweteka m'munsi kapena thako. Sayenda malire, pakutchulidwa wa kupunduka ayenera yomweyo kuchenjeza munthu ndi kukhala chifukwa mwamsanga kungapezeke kuti katswiri.

Avascular necrosis mutu femoral: Zoyambitsa

Malinga ndi akatswiri ambiri, chitukuko cha kudwala kumathandiza kuti wambiri yaitali mowa lalikulu zedi. Zimachititsanso necrosis akhale corticosteroids yaitali chithandizo mlingo waukulu. Mwa zifukwa wotchuka kuchititsa chikhalidwe, tiyenera kukumbukira kuvulala: fractures, sprains, mikwingwirima. Necrosis (avascular) mafupa amayamba chifukwa alipidwa kutopa, nkhawa, chifukwa chopwetekedwa mtima. Chifukwa nthawi imene kudwala ali kusanduka chifukwa cha kapamba aakulu kapena pachimake. Monga akhoza kuchita komanso kukhudzana ndi cheza mu mlingo waukulu ngati chinthu n'zothandiza. Kudwala chingabwere limodzi zenga magazi m'thupi selo, osteomyelitis. Mu yochizira matenda, pali chinthu monga necrosis idiopathic. Izo ntchito pamene kuli kovuta kudziwa ndendende chikwiyire ndi kudwala.

diagnostics

Avascular necrosis ayenera kuzindikiridwa mwamsanga. Pankhaniyi, ayenera kuchita popanda opaleshoni. Komabe, monga ulamuliro, ndi kudwala amawapeza mochedwa kwambiri. Ichi ndi chifukwa chakuti maonekedwe a ululu mu ntchafu wodwala anatumiza kwa X-ray bwino. M'zithunzi gawo loyamba la matenda si wapezeka. Violation zionekera pa x-ray miyezi ingapo. Kupeza necrosis (avascular) mafupa mu masiteji koyamba ndi kudzera Kujambula kapena CT. Musapereke molondola chifukwa kusanthula magazi ndi ultrasound. Monga njira yodziwira ntchito chindodo ndi muyeso wa kuthamanga mkati mwa fupa.

Magawo chitukuko matenda

Kodi m'kati avascular necrosis mutu femoral? pathological siteji ali motere:

• Kulakwila ntchito mtima. Pa nthawi imeneyi kupewa kudumpha zolemera kusamutsa ubwenzi yaitali pa malo amodzi mothamanga. Odwala anauzidwa kupuma ndi yosangalala. Chithandizo panthawi imeneyi ayenera umalimbana kubwezeretsa magazi mu mutu femoral, komanso minofu kusinthika. Wodwala tikulimbikitsidwa Zochita wapadera kupewa minofu ya manja. Pa nthawi imeneyi katswiri angakulangizeni kuvomereza mankhwala vasodilator. Mankhwala kudzakuthandizani kuthetsa stagnation ndi kubwezeretsa Kapangidwe ka mutu chifukwa cha normalization wa magazi ndi kuthetsa spasms. Kugwiritsa mu nkhani iyi, si steroidal odana ndi yotupa mankhwala lembani novocaine anatseka misewu girudoterapija, kutikita. Imakhudzanso decompression wa trochanter wamkulu kapena fupa la mutu femoral.
• Mapindikidwe ndi wovulala katunduyo zowonongeka. Pa nthawi imeneyi, ndi zothandiza kuyenda pang'onopang'ono pang'onopang'ono kwa mphindi 30-50 maphunziro pa njinga yosasuntha, ndi kusambira m'madzi nyanja. Wa mankhwala osavomerezeka mankhwala zimathandiza kuti kubwezeretsedwa kwa fupa minofu ndi vasodilators. Amaikidwa kukhala hirudotherapy, kutikitirako decompression.
• Nyamakazi a m'chiuno olowa. Apa matenda tikulimbikitsidwa kuti olimbitsa kutikita. Kuchokera Kukonzekera waluso akhoza perekani hondroprotektory ndi vasodilators.

Pa tsiku la mtsogolo ndi Amowabu kupunduka ndi kufupikitsa yofunika kwambiri nthambi akhudzidwa. Monga chimaonekera pamene wodwala angathe yopingasa. Against maziko a kudwala m'kati ndi manja minofu: zimakhala anayamba ndi kuotcha ndi kuotcha kukula.

Avascular necrosis mutu femoral: chithandizo ndi NSAIDs

Kukonzekera yochezera ndi gulu pazikhalanso njira monga "Diclofenac", "Indomethacin" "ketoprofen" "piroxicam" "Phenylbutazone" "meloxicam" "nimulid" "Celebrex" ndi ena ofanana awo. mankhwala awa amathandiza kuchepetsa ululu. Tikumbukenso kuti NSAIDs chiyani sikuchiritsa necrosis (avascular) fupa. Komabe, mankhwala awa akhoza kubweretsa mtima akukwana ubwino chogwirika. Anawapatsa yake, mankhwala kuteteza reflex minofu kuphipha limapezeka poyankha ululu mumamva. Yosangalala ulusi amathandiza kuti abwezeretse magazi mu zinkakhala m'dera. Komabe, NSAIDs amakhala woopsa wodwalayo. chakuti pambuyo ntchito mankhwala munthu amathera kumva ululu ndi kutsegula malo akhudzidwa komanso wathanzi. Zimenezi, limathandiza kuti kuwonongedwa mofulumira fupa mutu. Mogwirizana ndi izi, wodwala ayenera kukumbukira kuti, ngakhale sitili ululu, zinkakhala m'dera ayenera kutetezedwa nkhawa.

vasodilators

gulu Izi zikuphatikizapo mankhwala monga "Trental" ( "Pentosifillin", "Agapurin") ndi "Teonikol" (nicotinate ksantinola). Iwo zimathandiza kwambiri necrosis avascular. mankhwala amenewa amathandiza kuthetsa stagnation kupezeka pa. Pa phwando awo inapita ayambe zimakhala fupa la mutu. Izi imatheka chifukwa wolumikizira magazi olimba panopa ndi Kupha kuphipha ziwiya kakang'ono ka magazi. Mwa ubwino zina za mankhwala vasodilator akhoza kutchulidwa otetezedwa pafupifupi mtheradi. Pamene inu potsatira malangizo adokotala ndi kutumikiridwa pa mlingo achire, ali pafupifupi munthu contraindications ndi zotsatira zake zoyipa. Iwo sanali analamula kuti pachimake m'mnyewa wamtima infarction mu otaya, komanso monga odwala amene posachedwapa anadwala hemorrhagic sitiroko. Pamene kulandira vasodilators odwala zambiri amamva kutentha, iwo amakumana reddens. Izi zimachitika ndithu mu Zikatero. Chifukwa izo basi yogwira vasodilatation. Kumwa mankhwala mu gulu ikuchitika kawiri pa chaka mu maphunziro chosatha miyezi 2-3.

Zikutanthauza kulimbikitsa minofu kukonza

gulu pazikhalanso mankhwala monga "kashiamu D3 forte", "Alpha D3 TEVA", "Osteomag", "Oksidevit" ndi ena. Zida izi ndi zothandiza kwambiri kudwala. Mavitamini D patsogolo kashiamu mayamwidwe. Chifukwa cha zimenezi zili ndi kwambiri. Zimenezi, kumathandiza excretion n'zosiyana kashiamu fupa mu magazi. Mu pawiri izi amasonkhana zinthu chigoba. Makamaka, ndende zake zochuluka fupa minofu ya mutu femoral. thandizo yokulirapo mu kudwala kubweretsa calcitonin. Zikuphatikizapo, makamaka, monga zida monga "Sibakaltsin", "Alostin", "Miakaltsik" ndi ena. Mankhwalawa yotithandiza fupa mapangidwe ndi kuthetsa ululu. Zikomo amagwiritsa ntchito kwambiri kumachepetsa ndi limakhazikitsa kashiamu outflow osteoblast ntchito ( "nyumba" maselo).

Kuti mudziwe zambiri,

Avascular necrosis mutu femoral (ICD-10: M91.1) ali dzina lina. Ndipo Iye matenda Legg-Calve-Perthes. The kudwala ambiri mu England. Mu dziko lino mayina 1 mlandu pa okhala 1800.