Zamkatimu
Ankylosing spondylitis ndi matenda aakulu omwe amatsagana ndi kutupa kwa msana. Amatchedwanso matenda a Bechterew ndi spondyloarthritis.
Pathology ikupita patsogolo nthawi zonse, ndipo zomwe zimayambitsa matendawa sizikudziwikabe mpaka pano. Matendawa ndi a gulu la spondyloarthritis ndipo amachititsa maphatikizidwe a intervertebral mfundo ndi kuletsa zina za kuyenda kwa msana.
Kodi ankylosing spondylitis ndi chiyani?
Ankylosing spondylitis ndi matenda a systemic omwe amadziwika ndi kutupa kwa minofu yolumikizana ndi kuwonongeka kwa mafupa ndi mitsempha ya msana. Kuphatikiza pa zinthu zomwe zalembedwa, ziwalo zamkati ndi zotumphukira zimatha kuvutika. Pathology imakhala ndi nthawi yayitali ndipo imapita patsogolo nthawi zonse. Chotsatira cha matenda ndi kuletsa kuyenda kwa msana ndi mapindikidwe ake. Zotsatira zake, munthuyo amakhala wolumala.
Woyamba kufotokoza matendawa anali VM Bekhterev. Izi zinachitika mu 1892. M’zaka zimenezo, ankylosing spondylitis ankatchedwa “kuuma kwa msana ndi kupindika.”
Zizindikiro za ankylosing spondylitis
Zizindikiro za matenda mwachindunji zimadalira siteji ya chitukuko cha matenda. Ankylosing spondylitis imadziwika ndi nthawi yayitali, kotero kusintha kwa mafupa ndi minofu kumachitika nthawi zonse.
Magawo a chitukuko cha ankylosing spondylitis:
Gawo loyamba. Panthawi imeneyi, zizindikiro zoyamba za pathology zimawonekera.
siteji yowonjezera. Zizindikiro za matendawa zimatchulidwa.
siteji mochedwa. M'magulu pali kusintha kwakukulu.
Zizindikiro zoyambirira
Pafupifupi 10-20% ya anthu, matendawa ali ndi njira yobisika ndipo samadziwonetsera mwa njira iliyonse kumayambiriro kwa chitukuko.
Nthawi zina, matendawa amakhala ndi zizindikiro zotsatirazi:
Ululu m'chigawo cha sacrum. Ndi zowawa zowawa zamtunduwu zomwe zimakhala chizindikiro choyamba cha matenda omwe akukula. Nthawi zambiri, ululu umakhazikika kumbali imodzi ya sacrum, koma ukhoza kutulutsa ntchafu ndi kumbuyo.
Kuuma kwa msana. Zimawonekera makamaka m'mawa, mutagona, kapena mutatha nthawi yayitali pamalo amodzi. Masana, kuuma kumatha, ndipo ndizothekanso kuchotsa chifukwa cha kutentha. Chikhalidwe chosiyana cha ululu ndi kuuma komwe kumachitika ndi ankylosing spondylitis ndikuti zomverera zimawonjezeka pakupuma, ndipo zimatha pambuyo pochita masewera olimbitsa thupi.
Kupweteka pachifuwa. Izi zimachitika chifukwa chakuti nthiti za nthiti-vertebral zimakhudzidwa. Ululu umakula poyesa kupuma kwambiri, komanso panthawi ya chifuwa. Nthawi zina anthu amasokoneza zowawa zotere ndi ululu wamtima komanso intercostal neuralgia. Madokotala amalangiza kuti odwala musadule kuya kwa kudzoza, musasinthe kupuma mozama.
Kuwonongeka kwa malingaliro. Sikuti odwala onse omwe ali ndi matenda a Bechterew amavutika ndi kusweka komanso kukhumudwa. Mphwayi imayamba mwa odwala ena okha.
Kumva kukanikiza pachifuwa. Zikuwoneka chifukwa cha kuwonongeka kwa kayendedwe ka nthiti. Anthu omwe ali ndi ankylosing spondylitis amasintha kupuma kwa m'mimba.
Kugwa mutu. Chizindikiro ichi chimachitika chifukwa chakuti mafupa amavutika, ndipo msana wa msanawo umapunduka.
Kuletsa kuyenda.
Zizindikiro mochedwa siteji
Kumapeto kwa chitukuko cha matendawa, munthu amakhala ndi zizindikiro zotsatirazi:
Zizindikiro za radiculitis. Iwo yodziwika ndi ululu kwambiri msana, dzanzi minofu, kumva kulasalasa. M'dera lomwe lakhudzidwa, kukhudzidwa kwa tactile kumachepetsa, minofu imataya kamvekedwe kake, imakhala yofooka ndi atrophy. Zochita zilizonse zolimbitsa thupi zimabweretsa ululu wochuluka.
Kuphwanya kwa magazi ku ubongo. Munthu amamva kupweteka kwa mutu, amakhala osasunthika, akugunda, nthawi zambiri amakhala m'dera la occipital. Wodwalayo ali ndi chizungulire ndi tinnitus, kusokonezeka kwa maso kungachitike. Kuwonongeka kwa zakudya zaubongo kumatha kuwonetsedwa ndi kugunda kwa mtima, kutentha thupi, kutuluka thukuta, kukwiya, kufooka komanso kutopa.
Kulephera kupuma. Zowukira zimachitika chifukwa cha kusuntha kwa chifuwa kumakulirakulira, kuthamanga kwa mapapo kumawonjezeka, mitsempha yamagazi imakanikizidwa.
Kuchulukitsa kwa magazi. Chizindikiro ichi chimayamba chifukwa chakuti magazi amapita ku ubongo amavutika, katundu paziwiya ndi mtima ukuwonjezeka.
Kuwonongeka kwa msana. Malumikizidwe ake amakhala ossify, zomwe zimabweretsa kuwonongeka kwa kuyenda kwawo. Chigawo cha khomo pachibelekeropo mwamphamvu arches patsogolo, ndi thoracic dera kumbuyo.
Zizindikiro za kuwonongeka kwa ziwalo zina
Malingana ndi mawonekedwe a matendawa, zizindikiro za ankylosing spondylitis zidzasiyana.
Mu mawonekedwe a rhizomelic, mafupa a m'chiuno amavutika, kotero kuti zizindikiro za matenda zikhoza kusiyanitsa motere:
Ossification ya msana wa msana.
Kuwonjezeka kwapang'onopang'ono kwa zizindikiro za pathological.
Ululu m`chigawo cha m`chiuno olowa. Kumbali ina, iwo adzapweteka kwambiri.
Kuwala kwa ululu mu ntchafu, groin, mawondo.
Mu mawonekedwe ozungulira a matendawa, mawondo ndi mapazi amakhudzidwa.
Zizindikiro zazikulu za kuphwanya:
Kwa nthawi yayitali, zizindikiro zokhazo zomwe zimakhudza msana wa msana zimavutitsa munthu.
Makamaka achinyamata amavutika ndi zotumphukira mawonekedwe a matendawa. Pambuyo pake matendawa amayamba mwa munthu, m'munsimu ziwopsezo za kuwonongeka kwa mafupa zimachepa.
Ululu umakhazikika m'mawondo ndi m'magulu amagulu.
Malumikizidwewo ndi opunduka, amasiya kugwira ntchito yawo moyenera.
Mtundu wa Scandinavia wa matendawa umawonetsedwa ndi zizindikiro monga:
Kuwonongeka kwa timagulu tating'ono ta mapazi ndi manja.
M'kupita kwa nthawi, mafupa amapunduka, kuyenda kwawo kumakula.
Chipatala cha Scandinavia mawonekedwe a matendawa amafanana ndi nyamakazi.
Zifukwa za ankylosing spondylitis
Ngakhale kuti mankhwala amakono apita patsogolo, zifukwa zenizeni za matenda a Bechterew sizikudziwikabe.
Madokotala amangoganizira zomwe zimayambitsa matenda chifukwa cha:
Cholowa chotengera chitukuko cha matenda. Monga momwe kuwonera kukuwonetsa, matenda a Bechterew amapatsirana kuchokera kwa abambo kupita kwa mwana mu 89% ya milandu.
Anasamutsa urogenital matenda. Kuthekera kwa matenda a Bechterew kumawonjezeka ngati matenda a urogenital ali ndi njira yokhazikika, ndipo munthuyo salandira chithandizo chokwanira.
Kuchepetsa chitetezo chokwanira. Zifukwa za kufooka kwa chitetezo cha thupi zingakhale zosiyana kwambiri. Chitetezo cha mthupi chikamachepa, m'pamenenso pali mwayi wa ankylosing spondylitis.
Choyamba, ndi matenda a Bechterew, sacrum ndi dera iliac amakhudzidwa, ndiyeno matenda amafalikira ku ziwalo zina.
Diagnostics
Kuti apeze matenda olondola, wodwalayo ayenera kuchita maphunziro angapo. Popanda matenda athunthu, sizingatheke kudziwa matenda a Bechterew.
Ndi dokotala uti woti mukumane naye?
Ngati munthu ali ndi zizindikiro zomwe zingasonyeze ankylosing spondylitis, ayenera kulankhula ndi akatswiri monga:
Wothandizira. Dokotala akhoza kukayikira matendawa kuti apange matenda oyamba. Kuti mufotokozere, kuyezetsa kwina ndi kupita kwa madokotala aukadaulo wocheperako kumafunika.
Vertebrologist. Dokotala uyu amakhazikika pa matenda a msana.
Rheumatologist. Dokotala uyu amachitira rheumatism ndi ma pathologies ena olowa.
Dokotala wamafupa. Dokotala wa zapaderazi ndi chinkhoswe chizindikiritso ndi kuchiza matenda a minofu ndi mafupa dongosolo.
Kuyeza kwa zida ndi labotale
Poyamba, dokotala amaphunzira mbiri ya wodwalayo, amamuyesa, amagwedeza msana ndi mfundo zina, ndikuwunika kayendetsedwe kake.
Kufufuza komwe kumayenera kuchitidwa kuti amvetsetse matenda:
Radiography ya msana.
MRI ya msana.
Kupereka magazi kuti muwunikenso. Wodwala adzakhala ndi mlingo wokwera wa ESR ndi zotsatira zabwino za DPA, zomwe zimasonyeza kutupa m'thupi. Pankhaniyi, rheumatoid factor idzakhala palibe.
Mayeso a magazi a HLA-B27 antigen. Kafukufukuyu amachitika pazochitika zotsutsana.
Njira zodziwitsa kwambiri zowunikira ndi MRI ndi radiography.
Chithandizo cha ankylosing spondylitis
Sizingatheke kuchiza matenda a Bechterew. Komabe, ngati chithandizocho chinayambika pa nthawi yake, ndiye kuti zimakhala zotheka kuyimitsa kupitirira kwake, kuteteza chitukuko cha mavuto ndi immobilization ya wodwalayo. Wodwalayo amapatsidwa chithandizo cha moyo wonse, chomwe sichiyenera kusokonezedwa. Dokotala adzafunika kuyendera dongosolo. Apo ayi, pathology idzakula.
Chithandizo chosagwiritsa ntchito mankhwala
Payokha, mankhwala osagwiritsa ntchito mankhwala osokoneza bongo sangalole kuti akwaniritse zotsatira zabwino, koma kuphatikiza ndi kuwongolera mankhwala ndi kinesitherapy, zotsatira zake sizikhala nthawi yayitali.
Njira zomwe zingagwiritsidwe ntchito mu matenda a Bechterew:
Physiotherapeutic zotsatira pa thupi. Odwala angasonyezedwe magnetotherapy, ultrasound mankhwala, balneotherapy, kutenga bischofite, sodium kolorayidi ndi wa hydrogen sulfide osambira.
X-ray mankhwala. Kuchiza koteroko kumaphatikizapo kuwonekera kwa ma X-ray kudera lomwe lakhudzidwa.
Kuchiza. Zimasonyezedwa pambuyo pofikira chikhululukiro chokhazikika. Ndikofunika kukhudza msana molondola, katswiri yekha ndi amene amaloledwa kuchita njirayi. Apo ayi, mukhoza kuvulaza munthu.
Thandizo lolimbitsa thupi. Wodwalayo ayenera kuchita masewera olimbitsa thupi. Chovutacho chimapangidwa payekha payekha. Kuchita masewera olimbitsa thupi tsiku ndi tsiku kudzalepheretsa kuphulika kwa minofu ndikusunga ntchito ya msana.
Kinesitherapy Ndi chithandizo ndi njira zopumira komanso kuyenda.
Kuchita masewera olimbitsa thupi mu dziwe. Musanayambe kusambira, muyenera kufunsa dokotala.
Kuchita masewera olimbitsa thupi pamayimidwe apadera.
Video: mbiri ya moyo weniweni: