Lefu la tsoekere le tsamaisoa le keketseho ea tsoekere ea mali. Glucose e na le tšenyo e mpe marakong a methapo ea mali le methapo ea methapo.
Ka lebaka la phepelo e sa lekanang ea mali le bolulo bo sa tsitsang libakeng tse tlase, neuropathy e fetoha karolo ea lefu la tsoekere.
Tšobotsi e nang le tšobotsi ea neuropathy ke nts'etsopele ea liso tsa ho folisa hantle. Maemong a oele ka ho itšireletsa mafung, khaello ea phepo e nepahetseng ea lisele, tšoaetso e a kenella. Maemong a tsoetseng pele, e namela ho tishu ea masapo le osteomyelitis e etsahala.
Lisosa tsa Osteomyelitis
Litla-morao tsa leoto le ka tlase le leoto la lefu la tsoekere ke bothata bo tloaelehileng ba lefu la tsoekere. Hangata e etsahala kamora lilemo tse 5-7 ho tloha ho qala ha lefu la lefu la tsoekere mofuteng oa pele oa lefu la tsoekere. Mofuta oa bobeli oa lefu la tsoekere o ea butle mme mathata a ka hlaha hamorao.
Lebaka le ka sehloohong la nts'etsopele ea mathata a lefu la tsoekere ke puseletso e tlase ea tsoekere. Sena se ka hlaha ka mofuta o matla oa lefu lena kapa ho se tsotelle likhothaletso tsa endocrinologist. Ho na le tsoekere e ngata maling, 'me liphetoho tsa eona tse bohale li senya lebota la vascular le ho senya methapo ea methapo.
Ka ho fokotseha ha phepelo ea mali le ts'usumetso ea methapo, lisele li lahleheloa ke kutlo ea tsona le bokhoni ba ho hlaphoheloa likotsi. Tšenyo efe kapa efe e mpe ea letlalo e ka lebisang ho liso tsa lefu la tsoekere. Ba fola butle haholo, hangata ba tsoaetsoa.
Lefu la tsoekere le iponahatsa ka mefuta e 'maloa:
- Ho senyeha ha methapo ea methapo ka likepeng tse nyane le tse kholo (angiopathy)
- Tšenyo ea lesapo le masapo.
- Ho fokotsa ho itšireletsa mafung.
- Ts'oaetso ea lera.
Ho latela ts'oaetso ea mathata a methapo ea methapo kapa ea methapo, sebopeho sa neuropathic kapa ischemic sa leoto la lefu la tsoekere sea khetholoha. Empa karohano ena e hanyetsana haholo, hobane hangata lintlha tsena tse peli li sebetsa ka nako e le 'ngoe.
Ka hona, foromo e tloaelehileng ka ho fetisisa e tsoakiloeng.
Matšoao le tlhahlobo ea osteomyelitis
Leoto la lefu la tsoekere le ka bonahatsoa ke tlolo ea bohloko kapa maikutlo a mocheso lipakaneng tse tlase, letlalo le omeletseng, makhopho, ho ruruha, deformation e tloaelehileng ea leoto. Har'a likotsi tsena, ho na le liso tsa letlalo.
Li-ulc tse nang le tšoaetso e matla ka ho senya metso ea mesifa e bonolo ho ea lesapong li rarahane ka ho ruruha ha lisele tsa masapo, periosteum le mongobo oa masapo. Maemong ana, ho fokola ha osteomyelitis ho thata ho e phekola ka meriana mme hangata ho lebisa tlhokahalong ea ho felisoa hoa lipheo tse tlase.
Osteomyelitis e ka ba motsoako oa li-ulc tsa nako e telele tse telele kapa tse kholo. Nts'etsopele ea osteomyelitis e bontšoa ke matšoao a joalo:
- Ulcer ha e fole ka likhoeli tse peli tsa kalafo ea lithethefatsi.
- Leqeba le tebile mme lesapo le bonahala tlase, kapa le ka tseba ka projeke.
- Leoto le amehileng le ruruhile hape le khubelu.
- Maling, boemo ba leukocytes bo eketsehile, ESR e feta 70 mm / hora.
- Ha ho etsoa tlhahlobo ea x-ray kapa MRI, tšenyo ea masapo tlasa ulcer e ile ea fumanoa.
Pontšo e ka sehloohong ea ho lemoha hore na motho ke ea mofuta ofe ke tlhahlobo ea "biopsy".
Ho lefu la tsoekere mellitus, tšenyo ea masapo e baka lefu la tsoekere leoto la maoto (leoto la Charcot). Boemo bona bo fetoha ho ruruha ha lefu la tsoekere. Ts'ebetso ea ho ruruha e etsahala ntle le ts'oaetso. Boemong bo matla haholo, edema ea leoto la maoto e ea hlaha. Letlalo le khubelu, le thata ebile le chesa, le libaka tsa ho ruruha.
Nako ea ho ruruha haholo e ka kena molemong o sa feleng oa bophelo. Li-dislocation, li-fractures li ka hlaha manonyeletsong, masapo a holofetse. Ha nako e ntse e ea, lefu lena le ka thatafatsoa ke osteomyelitis.
Nako ea lefu la tsoekere ea lefu la tsoekere e ea methating e mengata:
- Boemo bo bobebe: edema ea leoto, redness le feberu. Litšoantšong - osteoporosis (tiske tsa masapo tse sa tloaelehang).
- Sethala sa subacute: ha ho na ho ruruha, leoto le senyehile, lesapo le senyeha litšoantšong.
- Boemo bo sa foleng: leoto le senyehile, le ts'oanang le "pampiri", li-dislocation le fractures ea masapo.
- Mothati o nang le mathata: chroniculimous ulcers, osteomyelitis.
Kalafo ea Osteomyelitis
Mokhahlelong o matla oa "osteoarthropathy" o phekoloa ka ho laolla leoto ka botlalo. Bakeng sa sena, lisebelisoa tsa orthopedic li sebelisoa: li-orthose, tutors, lieta tsa orthopedic.
Haeba sena se sa lekana 'me ulcer e sa fole, joale ho kgothaletswa thibelo e felletseng ea motsamao - phomolo e thata ea bethe. Bakeng sa phekolo ea lithethefatsi, ho sebelisoa lihlopha tse latelang tsa lithethefatsi:
- Ho thibela tšenyeho ea masapo - Alendronate, Pamidronate.
- Bakeng sa ho thehoa ha lisele tse ncha tsa masapo - li-hormone tsa anabolic steroid (Methandrostenolone, Retabolil), litokisetso tsa calcium le v3.
- Li-Painkiller - Analgin, Ketanov, Nalbufin.
- Lithethefatsi tse seng khahlanong le ho ruruha - Nimesulide, Diclofenac, Revmoxicam.
- Diuretics - Furosemide, Hypothiazide.
Ho na le maemo a ntlafatso ka mor'a kalafo ea x-ray.
Boemong bo sa foleng, ho lokisoa livithamini le calcium tse ngata. Karolo e senyehileng ea lesapo ho sa hlokahale hore ho ruruhe e ka tlosoa ka mokhoa o hlakileng. Ho roaloa lieta tsa orthopedic.
Ka nts'etsopele ea osteomyelitis, mosebetsi o ka sehloohong ke khetho ea kalafo e eketsehileng - meriana kapa ho buuoa.
Ka kalafo ea ts'ebetso ea opereishene, ho khaoloa monoana kapa karolo ea leoto le ts'usumetso ea pholiso ea maqeba ho bonts'oa. Haeba ts'oaetso ha e hlahe kamora ho buuoa, ho na le monyetla oa ho hlaphoheloa le ho khutlela bophelong bo mafolofolo. Phekolo ea kalafo ha se tiiso e khahlano le nts'etsopele ea liso tse ncha le pholiso e felletseng ea maqeba. Maemong a mang, ho khaoloa khafetsa hoa etsoa.
Haeba ho etsoa qeto mabapi le kalafo e hlokofatsang, joale ka mor'a libeke tse tšeletseng ho fanoa ka tekanyetso e phahameng ea lithibela-mafu: Cefazolin, Clindamycin, Meronem, Tienam, Ciprofloxacin. Hangata, lithibela-mafu lia kenngoa, empa ka kalafo ea nako e telele hoa khoneha ho chencha mefuta ea lipilisi.
P
ba sebelisa kalafo e kopaneng le lithethefatsi tse 'maloa - Levofloxacin + Clindamycin, lithibela-mafu tsa beta-lactam - Amoxiclav, Augmentin, Trifamox le tsona lia sebelisoa. Ho feta moo, lithibela-mafu li ka tsamaisoa ka ho khetheha, ka ho toba leqebeng ho sebelisoa lieta tse khethehileng tsa acrylate.
Phekolo ea antibiotic e fana ka liphetho tse ntle ho bakuli ba bangata, empa ho lefu la tsoekere hangata ho na le mathata a amanang le lefu la sebete, a tlatselletsang khaellong ea khafetsa ea litlamorao tsa kalafo e joalo.
Ntho ea mantlha ea kalafo e ka sebelisang kalafo ea mafu afe kapa afe khahlanong le lefu la tsoekere ke puseletso ea tsoekere e phahameng ea mali ka tšebeliso ea lithethefatsi ho e fokotsa - insulin kapa matlapa.
Ka kalafo ea ho buoa kapa hyperglycemia e matla, bakuli ba ka fetisoa ho tloha litafoleng ho ea ho insulin tlasa taolo ea tsoekere ea mali. Insulin e na le matla a ho matlafatsa lisele tsa masapo.
Nts'etsopele ea osteomyelitis ho lefu la tsoekere e ka thibeloa haeba u latela lijo tse nang le carb e tlase ho pholletsa le lefu lena, ho sebelisa meriana ka tekanyetso e khethiloeng. Bakeng sa ho fokotsa kotsi ea mathata a lefu la tsoekere, ho hlokahala hore ho boloke boemo ba tsoekere maling maling ka methating e joalo: ka mpeng e se nang letho ho fihlela ho 6.4 mmol / l, kamora ho ja kamora lihora tse peli, 8,9 mmol / l, ka nako ea ho robala, 6.95 mmol / l.
Bophahamo ba glucose bo lekanyetsoa letsatsi le letsatsi ka profil ea glycemic. Ntle le moo, hang ka mor'a likhoeli tse ling le tse ling tse tharo, bakuli bohle ba nang le lefu la tsoekere ba bontšoa ho khetholla boemo ba hemoglobin ea glycated.
Letšoao lena le bontša sekhahla sa tsoekere ea mali likhoeling tse tharo tse fetileng mme se fana ka tlhaiso-leseling ho fumana tekanyo ea matšeliso bakeng sa lefu la tsoekere. Boemo ba eona bo nepahetseng bo fihla ho 7.5%.
Metabolism ea mafura e lokela ho ba kahare ho (tekanyo ho mmol / l) - cholesterol - 4.8;
LDL e tlase ho 3, HDL e phahame ho feta 1.2. Ka li-pathologies tsa vascular, ho bohlokoa ho thibela ho kenella ha lik'habohaedreite tse bonolo feela ka lijo, empa hape le ho fokotsa mafura a liphoofolo lijong.
Ho bohlokoa hape ho hlahloba le ho phekola liso tsa letlalo ho thibela ho etsoa ha lisele tsa trophic ho lefu la tsoekere. Haeba u belaella sebopeho sa leoto la lefu la tsoekere, ho beha leihlo khafetsa ke endocrinologist, neuropathologist, ho hlokahala. Video e sehloohong sena e tsoela pele ho bua ka mathata a leqeba la lefu la tsoekere.
