Osteonecrosis

Osteonecrosis ndi mafupa omwe amayamba chifukwa chosowa magazi. Amakonda kwambiri mchiuno ndi paphewa, koma amatha kukhudza ziwalo zina zazikulu monga bondo, chigongono, dzanja ndi bondo.

Osteonecrosis imachitika pamene gawo la fupa silimalowa magazi ndikufa. Pakapita kanthawi, fupa limatha kugwa. Ngati osteonecrosis sichithandizidwa, olowa nawo amafooka, ndikupangitsa kuti nyamakazi iwonongeke.

Osteonecrosis imatha kuyambitsidwa ndi matenda kapena zoopsa zazikulu, monga kusweka kapena kusokonezeka, komwe kumakhudza magazi kufupa. Osteonecrosis amathanso kuchitika popanda kuvulala kapena matenda. Izi zimatchedwa idiopathic - kutanthauza kuti zimachitika popanda chifukwa chodziwika.

Izi ndi zina mwazomwe zingayambitse:

• Kugwiritsa ntchito ma oral kapena intravenous steroids
• Kumwa mowa kwambiri
• Matenda a khungu
• Kuthamangitsidwa kapena kupasuka mozungulira cholumikizira
• Zovuta zotseka
• HIV kapena kumwa mankhwala a HIV
• Thandizo la radiation kapena chemotherapy
• Matenda a Gaucher (matenda omwe zinthu zoipa zimakhazikika m'ziwalo zina ndi mafupa)
• Systemic lupus erythematosus (matenda omwe amangodziyimitsa okha omwe chitetezo chamthupi chimalakwitsa molakwika minofu yathanzi monga fupa)
• Matenda a Legg-Calve-Perthes (matenda aubwana momwe fupa la ntchafu silimapeza magazi okwanira, ndikupangitsa kuti fupa lifa)
• Matenda osokoneza bongo ochokera kumadzi akuya kwambiri

Matenda a osteonecrosis akamachitika paphewa, nthawi zambiri amakhala chifukwa chothandizidwa kwa nthawi yayitali ndi ma steroids, mbiri yovulala pamapewa, kapena munthuyo ali ndi matenda a zenga.

Palibe zisonyezo kumayambiriro. Pamene kuwonongeka kwa mafupa kukukulirakulira, mutha kukhala ndi zizindikiro zotsatirazi:

• Kupweteka kwa olowa komwe kumatha kuchuluka pakapita nthawi ndikukhala koopsa ngati fupa ligwa
• Ululu womwe umachitika ngakhale atapuma
• Kuyenda kocheperako
• Kupweteka kwa m'mimba, ngati chiuno cha m'chiuno chikukhudzidwa
• Kukhazikika, ngati vutoli limachitika mwendo
• Zovuta ndi mayendedwe apamwamba, ngati cholumikizira phewa chikukhudzidwa

Wothandizira zaumoyo wanu adzakuyesani kuti muwone ngati muli ndi matenda kapena zovuta zomwe zingakhudze mafupa anu. Mudzafunsidwa za zomwe mukudziwa komanso mbiri yazachipatala.

Onetsetsani kuti wothandizira wanu adziwe za mankhwala aliwonse kapena mavitamini omwe mukuwatenga, ngakhale mankhwala owonjezera.

Pambuyo pa mayeso, omwe akukuthandizani adzaitanitsa mayeso amodzi kapena angapo otsatirawa:

• X-ray
• MRI
• Kujambula mafupa
• Kujambula kwa CT

Ngati wothandizira wanu akudziwa chifukwa cha matenda a osteonecrosis, gawo lina la mankhwalawa lithandizira pazomwe zimayambitsa matendawa. Mwachitsanzo, ngati vuto lakutseka magazi ndilomwe limayambitsa, chithandizo chimakhala, mwa zina, mankhwala osungunula magazi.

Matendawa akagwidwa msanga, mumalandira mankhwala ochepetsa ululu ndikuchepetsa kugwiritsa ntchito dera lomwe lakhudzidwa. Izi zingaphatikizepo kugwiritsa ntchito ndodo ngati mchiuno mwanu, bondo, kapena bondo lakhudzidwa. Mungafunike kuchita masewera olimbitsa thupi osiyanasiyana. Chithandizo chosagwira ntchito nthawi zambiri chimachedwetsa kufalikira kwa matenda a osteonecrosis, koma anthu ambiri amafunika kuchitidwa opaleshoni.

Zosankha za opaleshoni ndizo:

• Kuboola fupa
• Kuboola mafupa pamodzi ndi magazi ake (vascularized bone graft)
• Kuchotsa gawo lamkati mwa fupa (kupsinjika kwapakati) kuti muchepetse kupanikizika ndikulola mitsempha yatsopano kuti ipangidwe
• Kudula fupa ndikusintha mayikidwe ake kuti muchepetse kupsinjika kwamafupa kapena olowa (osteotomy)
• Kulowa m'malo limodzi

Mutha kupeza zambiri ndi zothandizira zothandizira ku bungwe lotsatirali:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases - www.niams.nih.gov/health-topics/osteonecrosis
• Arthritis Maziko - www.arthritis.org

Mumachita bwino bwanji zimadalira izi:

• Zomwe zimayambitsa osteonecrosis
• Matendawa ndi owopsa akapezeka
• Kuchuluka kwa mafupa omwe akukhudzidwa
• Msinkhu wanu komanso thanzi lanu lonse

Zotsatira zimatha kusiyanasiyana ndi kuchira kwathunthu mpaka kuwonongeka kwamuyaya mufupa lomwe lakhudzidwa.

Matenda a osteonecrosis otsogola amatha kuyambitsa matenda a nyamakazi komanso kuchepa kwanthawi zonse. Milandu yayikulu ingafune kulowetsa m'malo limodzi.

Itanani omwe akukuthandizani ngati muli ndi zizindikiro.

Matenda ambiri a osteonecrosis alibe chifukwa chodziwikiratu, motero kupewa sikungatheke. Nthawi zina, mutha kuchepetsa ngozi yanu pochita izi:

• Pewani kumwa mowa mopitirira muyeso.
• Ngati n'kotheka, pewani kumwa kwambiri komanso kugwiritsa ntchito corticosteroids kwa nthawi yayitali.
• Tsatirani njira zachitetezo mukamayenda kuti mupewe matenda osokoneza bongo.

Matenda a necrosis; Matenda a mafupa; Ischemic mafupa necrosis; AVN; Aseptic necrosis

• Aseptic necrosis

[Adasankhidwa] McAlindon T, Ward RJ. Osteonecrosis. Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, olemba. Zamatsenga. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: chap 206.

MP wa ku Whyte. Osteonecrosis, osteosclerosis / hyperostosis, ndi zovuta zina za mafupa. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 248.