Chirwere osteomyelitis: zvinokonzera, zviratidzo, nechirwere, kurapwa

Osteomyelitis chinhu anogumbura chirwere pfupa uye yakapoteredza akapfava munyama, kunoitika somugumisiro kukundwa kwavo pyogenic utachiona. Funga mamwe mashoko pamusoro chirwere. Cherechedzai achapiwa chimiro ichi chirwere, sezvo chirwere osteomyelitis. Tinodzidza pamusoro zvinokonzera ayo, nzira nechirwere uye kurapwa.

Osteomyelitis: chirwere kupatsanura

Pahwaro-siyana zvikonzero, pane classifications vanoverengeka chirwere. Zvichienderana nemamiriro ezvinhu ose panowanikwa chirwere, kunogona:

• chikuru (hematogenous);
• yechipiri (post-yaizoitika);
• odontogenic.

Hematogenous osteomyelitis kunoitika pamusana okusuma utachiona kubudikidza neropa kupinda pfupa rinenge pamwe purulent maronda, abscesses, kana anogumbura ganda maronda kuti nhengo dzomukati. Kazhinji, izvi Chirwere kunokanganisa vana. Hematogenous osteomyelitis kunotanga nokukurumidza uye mumazuva mashomanana okutanga achiteverwa zviratidzo kudhaka: nefivhiri, kuda kurutsa, kurutsa, mukuru muutera, nomusoro. Kwapera nguva (kusvika mazuva maviri) pane kuzvimba njodzi muzvidimbu icho pamwe kurwadziwa.

Posttraumatic osteomyelitis zvingaitika pashure pokuvhiyiwa achiitiswa mapfupa, rakavhurika kutsemuka kana vapfurwa ronda. Izvi zvinoitika pamberi zvinokonzera dzakadai Somuenzaniso, Kusavapo kana zvisiri vakabata kuvhiya kurapwa, kuvapo guru hematomas kana miviri dzavatorwa. vose vanobatsira kuti kukura mabhakitiriya, sezvo ivo kudzivisa chakaipa apore.

Kusiyanisa boka Vanowanzodanwa odontogenic osteomyelitis. Ndiye ane kushoma munyika maxillofacial nharaunda. Odontogenic osteomyelitis kunokanganisa periodontal zvinyama uye zino, saka chirwere hunonyatsobatana uye dentistry. Izvi Chirwere achiperekedzwa nemusoro, nefivhiri uye mukuru novutera muviri. At kwayo kunoita vanogona kunetseka kumedza, chimiro halitosis, mucosal edema, Dombo parurimi.

Zvinotevera marudzi osteomyelitis, izvo isu funga, zvichienderana hunhu waro kosi:

• chenjera;
• refu.

Kazhinji, kurapwa iri rakatanga ari Danho rokutanga chirwere. Asi pasina zvakakwana kurapa kuti rikwanise osteomyelitis anova chisingaperi.

Ishoma hurwere mhando yakadai:

• Ollier urwere;
• Brodie kuti pute;
• chirwere Garre vake.

Saka, patakaroorana vakajairana Vhuṱanzi pamusoro osteomyelitis. Ndiyo nguva yokuti funga yaro chisingaperi chimiro zvizere.

Zvinokonzera chirwere

Kuti tiwane zvinokonzera chirwere osteomyelitis, havafaniri kuitisa kusecherwa. Above zvakanga kutaurwa kuti hosha kunoitika somugumisiro kukodzera kurapwa rawo rikwanise chimiro.

The causative mumiririri echirwere osteomyelitis kakawanda ndiye anonzi Staphylococcus aureus. Kunyange pane mamiriro ezvinhu apo pakuonekwa chirwere kungakonzera Pseudomonas aeruginosa, chakuvhe, Proteus, E. coli.

Saka, zvinhu zvinonyanya kukonzera chisingaperi osteomyelitis:

• Late kuonekwa chirwere utachiona hwakakura;
• kururama Mabatirwo chakasimba siyana chirwere;
• kukundikana kuziva kunobva chirwere.

zviratidzo

Sei kukudziridza chisingaperi osteomyelitis panzvimbo yokutanga napo nzira zvakasikwa, nzvimbo uye kupararira kushoma. Kazhinji, utachiona zvakunoita avo munyama kuti vari pedyo vakashamiswa.

Chirwere osteomyelitis kunoratidzwa:

• ganda blanching;
• kurasikirwa havi;
• hope zvirwere;
• kuti chidzoke nevanhu vasingakendengi uye lethargy.

Uyezve, munguva kukura chirwere dzichitaridzika purulent fistulas. Kana kukanganisa kwavo pamusoro yakapoteredza zvinyama zvinokwanisika paumbwe abscesses, abscesses.

Kana chisingaperi osteomyelitis pamusoro mandible chikarohwa, pangava kuzvimba node nodes.

Kunze kwaizvozvo zvose, chirwere achabatsirwa vakawanda Kushatiswa utano, zviratidzo kudhaka uye soreness munzvimbo ukama nhengo dzomuviri: papfudzi kana femurs, vertebrae, uye zvichingodaro.

chirwere chirwere

Kuziva chirwere osteomyelitis ungatsauka kunotevera, kuvhiyiwa, orthopedics. Chirwere kuchasanganisira zvakawanda mabasa.

Murwere anogona kupiwa:

• The Ongororo, kuongorora, palpation.
• Radiography. An X-ray anogona kuratidza STRUCTURAL kuchinja pfupa pashure pavhiki chete pashure pakatanga chirwere.
• Nemakemikari uye CBC kuti kusarudza erythrocyte sedimentation mwero uye kuvapo kana pasina pathogenic pomutumwa.
• Cytological uye bacteriological kuongorora zvinoerera kubva ronda, fistula uye mwongo.
• Ultrassom of hunenge nzvimbo. Zvakakosha kuziva mvura mvura buildup.
• Angiography. Voitakura kunze kuziva nzvimbo kunyimwa ropa rive.
• Magnetic resonance kuri uye computed tomography. Zvinonzi inoitwa kuwana ruzivo pamusoro saizi, nzvimbo, kuparadzirwa uye unhu Kumwe kuchinja kunotanga.
• ongororo Radionuclide anodiwa kuti nenguva kuonekwa ari chirwere, ukuru ayo nekuomarara uye zvakaita anogumbura kwendangariro.

Zvinokurudzirwa kuti kwete chete zvakaitika kuona rokuongorora uye kuita X-ray, asi kuwana nguva yokuti vaifanira kubva nechirwere, kubva chete muchiitiko ichi zvichiita kusarudza zvakakodzera zvikuru kurapwa kuita.

differential kuongorora chirwere

Chirwere osteomyelitis zviratidzo zvayo anogona kufanana nevamwe zvirwere. Saka zvikuru ndiyo Implementation kuti differential nechirwere. Zvichakubatsira kusimbisa yakarurama zvikuru zvokuongorora uye inobudirira kurapwa.

Nokuti osteomyelitis angava zvakafanana:

• pakuonekwa anomera munzvimbo pfupa;
• tiibhii of mapfupa;
• osteochondropathy;
• fibrotic osteodysplasia.

mishonga

Vabatwe kusachengeteka kukuru chimiro chirwere hunosanganisira kushandiswa kukamura uchishandisa kugadzirira: sorbents, Anti-anogumbura mafuta okuzora, proteolytic makemikari uye mishonga inorwisa mabhakitiriya.

In yaizoitika maronda uye generalized mhando osteomyelitis zvakakodzera kuita marudzi akawanda yokurapa:

• detoxification ane aizomupa sesaline, "reopoligljukin" uye zvimwe zvinhu;
• antibacterial vachishandisa pfupa-tropic chiito inorwisa mabhakitiriya kana kugadzirira unokosha zvakaitika mhando mumiririri;
• pakatanga chaiyo masoja Sera staphylococcal toxoid autovaccine.

kuvhiya kurapwa

Kudiwa kuvhiyiwa chinovapo kana pane zvinoonekwa vakawanda pfari kuti murege kugadzirisa pamwe nguva. Izvi zvinogona kunzi vakuvadzwe fistula inotungamirwa kana murwere ane chakakomba cheitsvo.

Kana hosha chisingaperi osteomyelitis kuvhiya kurapwa kunosanganisira fanira maitirwo ezvinhu akawanda:

• dzichibvisa devitalized tishu;
• muchikuvadza kurapwa antiseptics uye mishonga inorwisa mabhakitiriya;
• chikweshe nyoro uye mapfupa munyama;
• abudise of ronda;
• anobudisa mushonga zvishoma nezvishoma kuva tsinga riri pedyo maronda. Izvi kudiwa humwe yaitonga inorwisa mabhakitiriya therethrough.

physiotherapy

osteomyelitis chirwere kunoda kurapwa uye mumuviri zvinhu. chinangwa chavo chikuru ndiko kubvisa kuzvimba, simba rokuzvivandudza rakaita kuti irambe urongwa, kuwedzera paumbwe nezvipusha, achidzikisa aikanganiswa utachiona, kweiyi masoja emuviri.

murwere kungadiwa kuderedza anogumbura basa:

• ane michini Laser;
• UHF-kurapa;
• erythematous dose pamusoro EUV mwaranzi;
• Microwave mushonga.

The pamusoro miitiro kuitwa chete Rakabatanidzwa mushonga uye pamberi water drainage chomunda fistula (pus).

To mhanyisa zvinyama kupora pezvakaitwa akashandiswa:

• Ultrasound kurapa;
• electrophoresis zvinoreva izvo kuvandudza muviri mavhitamini uye zvinhu;
• peloidotherapy;
• soro-kakawanda rinobva kurapa;
• kushandiswa Paraffin uye ozokerite.

Panguva chisingaperi osteomyelitis mu kuregererwa ari electrophoresis karusiyamu chloride. Kuwedzera midziyo Munzvimbo anogona kushandisa vasodilators electrophoresis.

Kuitira kuvandudza metabolic pezvakaitwa ari connective zvinyama zvinodiwa:

• Ultrasound kurapa;
• percutaneous magetsi dzishande;
• radon uye rehydrogen sulfide mabhati;

Kuregererwa chisingaperi osteomyelitis kushandisa peloidotherapy uye vakaderera Frequency kurapa kuderedza basa ropa coagulation hurongwa.

Kuti Activate dziviriro yezvirwere mumuviri murwere vanotumirwa:

• heliotherapy;
• Electrophoresis zvinodhaka kukanganisa immunomodulation;
• soro-kakawanda remagineti ari thymus;
• suberythermal dose pamusoro EUV mwaranzi;
• Laser irradiation ropa.

Kubvisa tsvina kubva murwere unofanira kuva katatu pazuva kunwa yavaibvisa chloride bicarbonate chicherwa mvura ( "Essentuki nhamba 4", "Borjomi" uye zvichingodaro).

Kuti uvandudze nerubatsiro okisijeni kuti munyama sei, oksigenobaroterapiya kana ozone dzokugezera anogona kushandiswa.

Contraindications nokuti physiotherapy

Pasinei chokwadi kuti mishonga muviri zvinhu kunounza yakawanda makomborero, pane mamiriro ezvinhu akawanda umo zvachose wairambidza. Izvi zvinosanganisira zviitiko pamberi murwere:

• nefivha yakasimba;
• septicopyemia;
• zvakakomba kudhaka;
• abscesses pasina pus water drainage nzira.

Zvakazokonzerwa chirwere chimiro chirwere

Chirwere osteomyelitis anokwanisa kukonzera vanoverengeka chakakomba uye upenyu-vachityisidzira nemigumisiro. Chirwere chinogona kukonzera fibrous dysplasia, izvo zvinozoita anokwanisa Nokumukira nechitarisiko anomera. Bone zvino anova vanga, uye pus kutanga kupararira mhiri nayo. Panguva iyi, zvimwe ropa chepfu, izvo kurufu.

Late kurapwa chirwere anogona kutsamwisa hematogenous osteomyelitis. It kunoratidzwa ne kwaita guru pfari uye yakakura purulent rikurumidze. Zvose izvi pamwe metastasis mu zvomukati.

Kuwedzera ichi zvinokosha kuziva kuti osteomyelitis inobata kwete chete mapfupa, asiwo nedzimwe nhengo: chiropa, neitsvo, kwemakemikari anobudiswa hurongwa. Kushaya nenguva kurapwa kunogona itsvo kutadza uye rufu murwere.

Matanho nokuti kudzivirira chisingaperi osteomyelitis

Takadzidza nezvechirwere ichi, sezvo osteomyelitis. Kupatsanura, zviratidzo uye zvichiita kurapwa zvadzidzwa munyaya. Zvazvinosarira kuyeuka pamusoro mumwe nyaya inokosha. Pane nzira inogona kubatsira kudzivirira zvirwere?

Kudzivirira echirwere osteomyelitis chinhu nenguva mabatiro ayo rikwanise chimiro. Nechekare panguva chiratidzo zvichibvira chirwere kutanga kutsvaka rubatsiro vakakodzera. Sezvo chikazozikamwa, zviri nyore kudzivisa panowanikwa dambudziko pane vamwe hwake kuzorwa naro.