Necrosis Avascular bone. necrosis Avascular yentloko femoral

necrosis Avascular intloko femoral ezibangelwa igazi flow kakuhle olujikeleza kwanikwa kwisiza. izenzakalo abanjalo ngenxa ucinezelo okanye torsion kwi occlusion encinane thrombus kwemithambo okanye umothuko. Emva koko, thatha sihlolisise, yintoni na necrosis avascular yentloko femoral.

mandundu

vasospasm elide kunye nokwanda viscosity igazi, stasis lwemithambo kunye ukuphazamiseka lokuphuma imoshe kakhulu amandla yentloko ithambo lethanga. Kulo mba, ukunyuka koxinzelelo lwangaphakathi, ischemia kuphuhliswa. Oku kudale iphula iimpawu mechanical esiqwini ithambo. Ngenxa yoko, mgodini kwakheka. Ekuhambeni kwexesha, lo ithambo uqalisa ukugqabhuza le intlala articular ibhuqiwe, iya atyabukile off.

Iimpawu zokugula

Necrosis (avascular) ithambo ezifumaneka kaninzi. Advantageously, lo leengxaki banesifo kumadoda abaneminyaka eyi-20 ukuya 45 ubudala. Kwakhona unesifo necrosis avascular yentloko femoral kubantwana abaneminyaka emi-2 ukuya ku-12. Ngelo xesha linye amakhwenkwe begula kakhulu. Iimpawu eziyelelene necrosis avascular, kwezinye iimeko kakhulu kunzima umahluko. Kuthi kunzima ukwenza ukuxilongwa. Ngokukodwa, iimpawu necrosis avascular phantse yinto enzima wabonakala zenkqubo zophendlo lwezifo kwi joint hip.

isimo progression

necrosis Avascular yokuzenzela kakhulu ngokukhawuleza. Ngosuku lwesithathu isigulane iziva kunzima ukunyuka ngamandla intlungu. Xa uzama ukuba aphakame, xa ehamba kukho intlungu kwindawo ubudoda. Kwakhona uvela kwicala kunye phambi womlenze nedolo unika. Xa izigulane ezininzi, iintlungu kunokuba yindinisa rhoqo. Singafane ubusuku kusasa iiyure ukuncipha. Xa uhambisa umthwalo ezenza intlungu ezisezantsi umva okanye ezinqeni. Ukushukumiseka kwesithintelo, kukuvela ekuqhwaleleni kufuneka ngoko nangoko tufwile mntu abe isizathu udluliselwe yincutshe.

necrosis Avascular intloko femoral: Oonobangela

Ngokutsho iingcali ezininzi, uphuhliso leengxaki igalelo inani elide utywala ezininzi. Kwakhona ukuba necrosis babe corticosteroids kunyango ixesha elide ngeedosi eziphezulu. Phakathi miba athandwa kakhulu ebangela imeko, kufuneka kwakhona makuqatshelwe umenzakalo: kwizaphuko, komsipha, ukugruzuka. Necrosis (avascular) amathambo baqalise ngenxa njengesiqhelo ukudinwa, ntshikilelo, uhlobo ngokweemvakalelo. Akhawunti iimeko apho ngezifo uye savela ngenxa pancreatitis ezinganyangekiyo okanye bukhali. Njengoko wenze nokuqhelana radiation ngeedosi eziphezulu njengomba ingqondo. Pathology esenokulandelwa irhengqa cell anemia, osteomyelitis. Xa yezonyango, kukho ikho into necrosis idiopathic. Oku kusetyenziswa xa kunzima ukwazi ukuba yintoni kanye baphambana ngezifo.

ekuxilongweni

necrosis Avascular kufuneka inokuchazwa kwangethuba kangangoko kunokwenzeka. Kulo mzekelo, kusenokwenzeka ukuba wenze ngaphandle uqhaqho. Noko ke, njengoko umthetho, lo ngezifo banesifo kakhulu emva kwexesha. Oku kubangelwa yinto yokuba imbonakalo intlungu isigulane hip uthunyelwa uviwo X-ray. Xa imifanekiso kwinqanaba lokuqala sifo ukuba andibhaqwa. Ukuhlukunyezwa kuyabonakala kwi x-reyi kwiinyanga ezimbalwa kamva. Chonga necrosis (avascular) amathambo sikwinqanaba lokuqala kunokwenzeka ngokusebenzisa MRI okanye CT. Musa ukunika uhlalutyo japan oluchanileyo igazi ultrasound. Njengoko iindlela zokuxilonga ezisetyenzisiweyo ukuskena nomlinganiselo yengcinezelo yangaphakathi ithambo.

Izigaba zophuhliso izifo

Njani liphakama necrosis avascular yentloko femoral? yezifo sigaba zezi zilandelayo:

• Ukophulwa umsebenzi yegazi. Kweli nqanaba ukuthintela nokuxhuma iintsimbi ukudlulisela emi elide endaweni eyodwa run. Izigulane bacetyiswa ukuba ukuphumla nokuphumla. Unyango kweli nqanaba kufuneka lujoliswe ukubuyisela ukuhamba kwegazi entloko femoral, ngokunjalo kwezihlunu okutsha. Isigulane kuyanconywa imithambo ezizodwa okuthintela yoma kwezihlunu. Kweli nqanaba yingcali ingenza isindululo ukwamkeleka amachiza vasodilator. Mayeza aza kukunceda ukuba ekupheliseni ngxi abuyisele isakhiwo intloko ngenxa kuqheleke kwegazi asuse ziba. Effective kulo mzekelo, non-steroidal amachiza-ukudumba uchwetheze novocaine yaye kuvalwe girudoterapija, umyalezo. Kwakhona kuyasebenza decompression le trochanter omkhulu okanye lithambo intloko femoral.
• Deformation kunye ukwaphuka into eyonakeleyo. Kweli nqanaba, ukuba ukuhamba luncedo ngesantya olucothayo uqeqesho imizuzu ne30-50 kwi ibhayisekile zokubhala, kunye lokuqubha emanzini olwandle. Lwamayeza isincomo iziyobisi, igalelo ngokubuyiselwa esiqwini bone kunye vasodilators. Ngaba wamiselwa hirudotherapy, massage, decompression.
• Ukudleka welungu kasikrobana. Kweli nqanaba esi sifo kucetyiswa ukuba imithambo, umyalezo. Ukusuka amalungiselelo zamagcisa unganika hondroprotektory kunye vasodilators.

Ngomhla oya kulandela kamva yi ekuqhwaleleni uphawu kunye Ukuncitshiswa ebalulekileyo mlenze achaphazelekayo. Njengoko kubonakala ingakumbi xa isigulana ngokuxwesileyo. Ngokuchasene yangasemva ngezifo iqhubeka yoma izihlunu: izihlunu baqalisa sofinyela, zinciphise ubukhulu.

necrosis Avascular intloko femoral: unyango kunye NSAIDs

Amalungiselelo olukhethwa eli qela kufuneka ibandakanye iindlela ezifana "Diclofenac", "Indomethacin" "ketoprofen" "piroxicam" "Phenylbutazone" "meloxicam" "nimulid" "Celebrex" kunye nezakhi zawo. La amayeza ukunceda ekunciphiseni iintlungu. Kufuneka kuqatshelwe ukuba NSAIDs azisinyangi necrosis (avascular) ithambo. Noko ke, la mayeza angasindisa isigulana iinzuzo eyaneleyo ephathekayo. Wabelwa ngendlela ngexesha, amachiza ukuthintela reflex spasm kwezihlunu ebonakala njengempendulo intlungu nodandatheko. Ukunyenyiswa imicu kunceda ukubuyisela kwegazi kummandla ochaphazelekayo. Noko ke, NSAIDs kungaba yingozi umguli. Isibakala sokuba emva kokuba isicelo amayeza liyayeka umntu uzive iintlungu ukulayisha kummandla ochaphazelekayo kwakunye usempilweni. Oku, kunegalelo intshabalalo ekhawulezileyo wethambo entloko. Ngokuphathelele oku, isigulane kufuneka kukhunjulwe ukuba, nangona ukungabikho intlungu, indawo ochaphazelekayo kufuneka ukhuselwe uxinezeleko.

vasodilators

Olu didi lubandakanya iziyobisi ezifana "Trental" ( "Pentosifillin", "Agapurin") kunye "Teonikol" (ksantinola nicotinate). Abasakwazi ngempumelelo necrosis avascular. Ezi amayeza kunceda ekupheliseni ngxi phakathi kwegazi. Xa reception yabo ekhawulezayo kwakhona kwinyama ithambo entloko. Oku kwenzeka ngenxa yokuba igazi esimbaxa uzinziso ngoku ukuphelisa spasm kwemithambo yegazi. Phakathi iingenelo ezongezelelweyo iziyobisi vasodilator ukuze kuchazwe ukhuseleko lwabo phantse ngokupheleleyo. Xa ulandela iingcebiso kagqirha neziqhutywa kwi amathamo zonyango, baye phantse akukho Izimo kunye neziphumo ebezingalindelekanga. Zange ezimiselweyo iqhosha etsolo engabalulekanga kwi flow, kwakunye izigulane kutsha ubunzima stroke ukopha. Xa efumana vasodilators izigulane basoloko uzive ubushushu, bejamelene reddens. Oku Kuyinto eqhelekileyo kwiimeko ezinjalo. Ngenxa kuyo vasodilatation nje esebenzayo. Ukuthatha amayeza kolu didi ikhutshwa phandle kabini ngonyaka kwizifundo Sithatha iinyanga 2-3.

Kuthethwa ukukhuthaza ukulungisa inyama

Olu luhlu kufuneka luquke iziyobisi ezifana "Calcium D3 Forte", "Alpha D3 TEVA", "Osteomag", "Oksidevit" kunye nabanye. Ezi zixhobo ziluncedo kakhulu ngezifo. Iivithamini D ukuphucula calcium ukufunxeka. Ngenxa yoko umxholo inyuswe kakhulu. Oku, luthintela zinomgutyulo reverse calcium lamathambo egazini. Kule ezimbaxa oluhlala nezinto skeletal. Ngokukodwa, eyavela yaligqiba inwebu ithambo intloko femoral. uncedo olufunekayo zokugula ukuba calcitonin. Ezi ziquka, ingakumbi, zibandakanya izixhobo ezifana "Sibakaltsin", "Alostin", "Miakaltsik" kunye nabanye. La machiza zivuselela ukusekwa bone kwaye ukuphelisa intlungu. Ngenxa ukusebenzisa kwabo kunciphisa kakhulu kwaye enza umsebenzi osteoblast ikhalsiyam lokuphuma ( "isakhiwo" cells).

Ukuze ufumane inkcazelo engakumbi,

necrosis Avascular intloko femoral (ICD-10: M91.1) elinye igama. Nguye isifo Legg-kwamagogo-Perthes. Eyona leengxaki iqhelekileyo eNgilani. Kweli lizwe ebhalisiweyo mzekelo 1 nganye abemi 1800.