Koj cov pob qij txha ntiv tes puas loj zuj zus thiab koj cov rau tes puas hloov lawm? Cia peb kawm txog Hypertrophic Osteoarthropathy no!

Koj puas tau pom tias koj cov ntiv tes lossis cov ntiv taw loj heev, thiab koj cov rau tes khoov lossis muaj cov duab txawv txawv? Qee zaum peb tsis tau ua tib zoo saib xyuas cov no. Txawm li cas los xij, yog tias koj pom cov tsos mob no, nws yuav yog ib qho cim ntawm tus mob hu ua 'Hypertrophic Osteoarthropathy' . Qhov no kuj hu ua HOA luv luv. Tus mob nws tus kheej tsis txaus ntshai heev, tab sis lwm yam mob uas ua rau nws yuav xav tau kev kho mob. Yog li, cia peb tham txog HOA no kom meej thiab kawm ntxiv.

Hypertrophic osteoarthropathy (HOA) yog dab tsi?

Hais yooj yim xwb, hypertrophic osteoarthropathy (HOA) yog ib yam mob uas ua rau cov ntiv tes lossis cov ntiv taw o thiab puag ncig (clubbing) thiab hloov pauv hauv koj cov rau tes. Ib tug neeg uas muaj HOA yuav:

• Cov ntiv tes lossis cov ntiv taw yuav loj hlob thiab o .
• Cov rau tes raug khoov thiab zoo li nkhaus, zoo li lawv raug rub rau saum.

Qee zaum HOA tuaj yeem pib thaum yau lossis thaum hluas. Rau qee tus neeg, nws kuj tuaj yeem tshwm sim tom qab hauv lub neej. Txawm hais tias HOA nws tus kheej tsis ua rau muaj kev phom sij, yog tias muaj ib qho mob hauv qab ua rau nws, nws yog ib qho tseem ceeb uas yuav tsum kho nws.

Cov hom tseem ceeb ntawm qhov no yog dab tsi?

Muaj ob hom HOA tseem ceeb:

1. Mob Pob Txha Osteoarthropathy (PHO): Hom mob no yog los ntawm noob caj ces, uas txhais tau tias nws tuaj yeem tau txais los ntawm niam txiv mus rau menyuam yaus.

2. Kab mob pob qij txha caj qaum loj thib ob (SHO): Hom kab mob no yog tshwm sim los ntawm cov mob ntev xws li kab mob plawv thiab kab mob ntsws. Cov mob no feem ntau ua rau cov pa oxygen tsawg hauv koj cov ntshav.

Leej twg yuav muaj tus mob no ntau dua?

Qhov tseeb, txhua tus neeg, tsis hais poj niam txiv neej lossis haiv neeg, tuaj yeem muaj tus mob no hu ua hypertrophic osteoarthropathy.

Txawm li cas los xij, thawj HOA (PHO) feem ntau tshwm sim hauv thawj xyoo ntawm lub neej lossis thaum lub hnub nyoog hluas. PHO:

• Nws yog ntau dua ntawm cov neeg dub.
• Nws tshwm sim ntau dua rau cov txiv neej.

HOA theem ob (SHO) yog ib qho mob uas feem ntau pom ntau zaus rau cov neeg hnub nyoog ntawm 55 thiab 75 xyoo.

Qhov teeb meem no feem ntau tshwm sim li cas?

Cov kws tshawb nrhiav tsis tuaj yeem hais meej tias muaj pes tsawg tus neeg muaj HOA. Tab sis nws paub tias ntawm 95% thiab 97% ntawm cov neeg uas muaj HOA muaj hom thib ob (SHO) . Qhov no txhais tau tias feem ntau cov neeg muaj cov kev hloov pauv ntiv tes no vim yog lwm yam mob.

Vim li cas ho tsim HOA no? Yog vim li cas?

Cia peb saib seb dab tsi ua rau qhov no.

Vim li cas rau HOA Thawj Zaug (PHO)

Qhov no yog tshwm sim los ntawm kev hloov pauv caj ces uas muaj thaum yug los . Tus menyuam yuav tau txais qhov kev hloov pauv caj ces no los ntawm niam, txiv, lossis ob leeg.

Vim li cas hoa thib ob (SHO)

Qhov ua rau muaj HOA theem ob (SHO) yog kab mob ntsws . Thaum qhov mob no yog los ntawm kab mob ntsws, nws hu ua Hypertrophic Pulmonary Osteoarthropathy (HPOA) .

Kab mob ntsws tseem ceeb uas ua rau HPOA yog mob qog nqaij hlav ntsws , tshwj xeeb yog mob qog nqaij hlav ntsws uas tsis yog mob me . Tsis tas li ntawd, lwm yam kab mob ntsws uas ua rau HPOA muaj xws li:

• Cov qog nqaij hlav benign ntawm pleura
• Kab mob ntsws ntev
• Cystic Fibrosis (ib yam kab mob caj ces uas cuam tshuam rau lub cev ua pa)
• Mesothelioma (mob qog nqaij hlav ntawm daim ntaub ntawm lub ntsws)
• Mob qog nqaij hlav uas tau kis los ntawm lwm qhov chaw thiab cuam tshuam rau lub ntsws (Kab mob ntsws kis mus rau lwm qhov)
• Kev puas tsuaj ntawm cov hlab ntsha hauv lub ntsws (pulmonary arteriovenous malformation)
• Kab mob ntsws
• Sarcoidosis (cov hlwb sib sau ua ke hauv ntau qhov ntawm lub cev)

Muaj lwm yam uas tuaj yeem cuam tshuam rau HOA theem ob (SHO):

• Cov kab mob ntawm daim siab, cov kua tsib, thiab cov qog ntshav hauv lub zais zis (mob hepatobiliary):
• Biliary Atresia (Kev Txhaws Cov Kav Dej Hauv Cov Menyuam Yaus)
• Mob qog noj ntshav
• Kab mob siab cirrhosis
• Kab mob Biliary Cholangitis thawj zaug
• Kab mob Wilson (muaj tooj liab ntau hauv lub cev)
• Cov kab mob plawv:
• Atrial myxoma (ib qho mob qog nqaij hlav uas tsis yog mob qog nqaij hlav uas tsim nyob rau hauv lub plawv)
• Kab Mob Plawv Cyanotic (kab mob plawv uas muaj cov pa oxygen hauv cov ntshav tsawg dua)
• Kev kis kab mob ntawm sab hauv ntawm lub plawv (Infective Endocarditis)
• Cov mob plab hnyuv:
• Kev siv tshuaj laxative tsis raug
• Achalasia (teeb meem nrog kev ua haujlwm ntawm esophageal sphincter)
• Mob qog noj ntshav
• Familial Adenomatous Polyposis (kev loj hlob me me hauv txoj hnyuv loj)
• Kab Mob Plab Hnyuv

Ntxiv rau qhov no, ntau lwm yam mob tuaj yeem ua rau SHO:

• Kab mob Celiac (kev ua xua rau gluten)
• Cov kab mob hauv plab xws li dysentery
• Kab mob Graves (hyperthyroidism)
• Kev mob hyperthyroidism
• Myelofibrosis (ib yam kab mob ntawm cov pob txha pob txha)
• POEMS syndrome
• Thymoma (ib qho qog ntawm cov qog thymus)

Xav txog seb, ib tug neeg uas koj paub tau hnoos ib ntus thiab lawv cov ntiv tes tau hloov pauv li no, thiab tsuas yog tom qab mus ntsib kws kho mob lawv thiaj li pom tias nws yog teeb meem ntawm lub ntsws. Yog li nws yog ib qho tseem ceeb uas yuav tsum tau ua tib zoo saib xyuas cov tsos mob no.

Cov tsos mob ntawm HOA yog dab tsi?

Cov tsos mob tseem ceeb ntawm HOA yog clubbing lossis o ntawm cov ntiv tes lossis cov ntiv taw. Qhov no feem ntau cuam tshuam rau ob sab ntawm lub cev sib npaug. Koj yuav pom tej yam zoo li:

• Cov ntiv tes los yog cov ntiv taw o thiab puag ncig .
• Cov kab nrib pleb ntawm cov pob qij txha ze ntawm cov ntiv tes ploj mus lawm.
• Cov rau tes nkhaus mus rau hauv qab thiab zoo li ntab.
• Daim tawv nqaij ntawm lub hauv paus ntawm tus ntsia hlau yuav ci ntsa iab thiab nyias .
• Cov rau tes ua mos .
• Cov ntiv tes lossis cov ntiv taw liab thiab sov so .

Lwm yam ntxwv ntawm HOA uas koj yuav pom muaj xws li:

• Kev loj hlob ntawm cov qog ntshav hauv lub qhov muag. Qhov no tuaj yeem ua rau muaj mob xws li pob txuv, tawm hws ntau dhau (hyperhidrosis), qhov muag sab saud poob qis (upper eyelid ptosis), thiab seborrheic dermatitis.
• Kab mob Periostitis yog o ntawm cov ntaub so ntswg uas npog cov pob txha. Qhov no tuaj yeem ua rau mob pob luj taws, dab teg, lossis hauv caug.
• O ntawm cov nqaij mos ntawm ob txhais ceg (o uas tsis yog qhov pitting).
• Pob txha tuab hauv pob luj taws thiab dab teg.
• Tawv nqaij tuab (Pachydermia). Tawv nqaij ntawm lub ntsej muag thiab taub hau yuav ntxhib thiab muaj cov kab tob.

Cov yam ntxwv tshwj xeeb ntawm HOA theem ob (SHO) yog dab tsi?

Ntxiv rau cov tsos mob ntawm HOA uas tau hais ua ntej lawm, cov neeg uas muaj HOA theem ob (SHO) kuj tseem yuav muaj cov kua dej hauv cov pob qij txha . Qhov no yog thaum cov kua dej ntxiv tsim nyob rau hauv cov nqaij hauv thiab ib puag ncig cov pob qij txha. Cov kua dej hauv cov pob qij txha tuaj yeem ua rau:

• Mob
• Liab
• Kev tawv
• Kev o

Qhov o ntawm cov pob qij txha uas cuam tshuam nrog SHO feem ntau pom muaj nyob rau hauv lub hauv caug thiab dab teg .

Koj nrhiav tau qhov no li cas? Cov kws kho mob ua dab tsi kuaj?

Thaum koj mus ntsib kws kho mob, thawj qhov uas lawv yuav ua yog xyuas seb puas muaj qhov mob ntawm koj cov ntiv tes lossis cov ntiv taw. Tsis tas li ntawd, lawv kuj yuav saib cov hauv qab no thaum kuaj lub cev:

• Cov yam ntxwv ntawm lub ntsej muag puas tau ntxhib lawm?
• Koj ob txhais ceg puas o?
• Puas muaj mob thaum koj nias rau ntawm pob luj taws, hauv caug, lossis dab teg?
• Cov pob txha hauv pob luj taws thiab dab teg puas tuab zuj zus?

Yog tias tus kws kho mob xav tias muaj mob hu ua HOA, nws yuav ua ntau yam kev kuaj mob, xws li:

• Lovibond tus cim qhia txog tus kheej:Thaum koj saib koj tus ntiv tes los ntawm sab, feem ntau koj yuav pom lub kaum sab xis dav "V" uas lub phaj rau tes ntsib daim tawv nqaij ntawm lub hauv paus ntawm tus ntsia hlau (proximal nail fold). Yog tias koj muaj HOA, koj tus ntsia hlau yuav khoov rau hauv qab, ua rau lub kaum sab xis no nce ntxiv. Hauv tus ntsia hlau ib txwm, lub kaum sab xis no yog 160 degrees lossis tsawg dua. Hauv tus ntsia hlau clubbed, nws yog 180 degrees lossis ntau dua.
• Qhov sib piv ntawm qhov tob ntawm cov pob txha ntiv tes: Koj muaj peb lub pob txha (phalanges) hauv txhua tus ntiv tes. Cov pob txha uas tuav cov ntsia hlau (distal phalange) feem ntau luv dua li cov pob txha nyob ib sab ntawm nws (phalange nruab nrab). Yog tias koj muaj HOA, koj cov phalange nruab nrab luv dua li koj cov phalange distal.
• Cov tsos mob Schamroth: Muab cov rau tes ntawm koj cov ntiv tes taw tso ua ke. Nrhiav qhov sib txawv zoo li pob zeb diamond (qhov rai) ntawm lub hauv paus ntawm tus rau tes thiab cov cuticles. Yog tias tsis muaj qhov sib txawv, tej zaum koj muaj HOA.

Cov kev ntsuam xyuas ntxiv kom pom cov HOA theem ob (SHO)

Yog tias tus kws kho mob xav tias lwm yam mob nkeeg ua rau HOA, nws yuav qhia ntau yam kev kuaj ntxiv:

• Angiography (kev kuaj xyuas cov hlab ntsha)
• Kev kuaj roj ntshav hauv cov hlab ntsha
• Kev kuaj ntshav
• Kev kuaj pob txha
• Kev X-ray hauv siab
• Kev luam theej duab CT (Computed Tomography scan) lossis kev luam theej duab ultrasound (Ultrasound)
• Kev kuaj mob plawv los yog ECG (Echocardiogram)
• Kev Ntsuas MRI (MRI - Kev Siv Duab Sib Nqus Sib Nqus)
• Kev kuaj xyuas kev ua haujlwm ntawm lub ntsws

Cov kev kuaj no tuaj yeem pab koj tus kws kho mob nrhiav qhov ua rau koj tus mob HOA. Yog tias daim duab scan qhia txog kev loj hlob tsis zoo (xws li qog nqaij hlav), koj tus kws kho mob kuj tseem yuav qhia kom kuaj ib qho biopsy (siv cov qauv ntawm cov hlwb thiab kuaj lawv). Qhov no tuaj yeem pab txiav txim siab qhov ua rau muaj kev loj hlob.

Qhov no kho li cas?

Cov txheej txheem kho mob sib txawv nyob ntawm hom HOA.

Kev kho mob ntawm thawj HOA (PHO)

Yog tias koj tsis mob lossis koj cov tsos mob tsis hnyav, tej zaum koj yuav tsis xav tau kev kho mob tshwj xeeb rau tus kab mob HOA thawj zaug (PHO). Txawm li cas los xij, yog tias koj muaj cov tsos mob, koj yuav siv tau cov tshuaj xws li:

• Cov tshuaj tiv thaiv kev mob uas tsis yog steroidal (NSAIDs)
• Cov tshuaj COX-2 inhibitors
• Cov tshuaj Bisphosphonates
• Octreotide

Kev kho mob ntawm HOA theem ob (SHO)

Thaum kho tus mob HOA theem ob (SHO), qhov tseem ceeb tshaj plaws yog kho qhov ua rau mob . Kev kho mob yuav suav nrog:

• Kev kho mob antimicrobial rau kev kho mob tuberculosis
• Kev kho mob qog noj ntshav los kho mob qog noj ntshav hauv lub ntsws
• Kev hloov siab lossis kev hloov siab rau kab mob siab
• Kev phais hloov ntsws rau cystic fibrosis
• Kev siv hluav taws xob los tua cov qog nqaij hlav hauv lub ntsws (radiofrequency ablation)
• Kev phais rau kab mob plawv lossis mob qog nqaij hlav ntsws

Yog tias tsis kho tau qhov mob tseem ceeb uas ua rau muaj SHO, tus kws kho mob yuav muab tshuaj los tswj cov tsos mob.

Yuav siv sijhawm ntev npaum li cas los kho kom rov zoo los ntawm kev kho mob?

Qhov no yeej nyob ntawm seb koj muaj hom HOA twg, qhov mob hnyav npaum li cas, thiab kev kho mob uas koj tau txais. Thaum kho qhov mob hauv qab no lawm, kev sib deev hauv clubbing yuav ploj mus sai sai.

Puas muaj dab tsi peb ua tau los txo qhov tshwm sim ntawm qhov no?

Kev pheej hmoo HOA thawj zaug (PHO)

Vim tias PHO yog caj ces, peb tsis muaj dab tsi ua tau los txo nws txoj kev tsim.

Kev pheej hmoo thib ob ntawm HOA (SHO)

Yuav kom txo tau qhov kev pheej hmoo ntawm kev mob SHO, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li kev noj qab haus huv . Qhov no tseem ceeb heev yog tias koj muaj feem yuav mob plawv lossis mob ntsws. Nov yog qee yam uas koj tuaj yeem ua tau:

• Tswj kom muaj qhov hnyav noj qab nyob zoo.
• Noj zaub mov zoo rau lub plawv.
• Ua si nawv tsis tu ncua.
• Txwv kev siv cawv thiab tshuaj yeeb.
• Tso kev haus luam yeeb. Qhov no tseem ceeb heev, vim kev haus luam yeeb yog ib qho ua rau muaj ntau yam kab mob ntsws.
• Txo kev ntxhov siab.

Yav tom ntej yuav zoo li cas rau ib tus neeg uas muaj HOA?

Rau ib tus neeg uas muaj HOA thawj (PHO)

Tej zaum PHO yuav tsis mob ntxiv lawm. Qee zaum, tshwj xeeb tshaj yog tom qab nws tseem hluas, nws yuav zoo dua tag nrho.

Rau ib tus neeg uas muaj HOA theem ob (SHO)

Yog tias kho tau qhov ua rau mob no zoo lawm, ces tus mob no yuav kho tau tag nrho. Txawm li cas los xij, yog tias tus mob no kho tsis tau zoo (piv txwv li, mob qog nqaij hlav loj), tus mob no yuav nyob mus li.

Yuav ua li cas yog tias qhov xwm txheej HOA kav ntev?

Yog tias qhov xwm txheej HOA tau tshwm sim ntev heev, koj yuav ntsib tej yam zoo li no:

• Kev poob ntawm ntau yam kev txav mus los hauv cov pob qij txha
• Mob pob qij txha (mob pob qij txha)
• Mob

Txawm li cas los xij, nco ntsoov tias ntau yam ntawm cov tsos mob no tuaj yeem tswj tau nrog kev kho mob kom zoo .

Yog tias muaj HOA, koj yuav saib xyuas koj tus kheej li cas?

Yog koj muaj tus mob HOA, qhov zoo tshaj plaws uas koj ua tau yog txuas ntxiv noj tshuaj uas koj tau txais los tswj koj cov tsos mob. Nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia.

Thaum twg koj yuav tsum mus ntsib kws kho mob?

Koj yuav tsum ceev faj txog cov no:

• Tom qab kev kho mobYog tias cov tsos mob ntawm kev mob clubbing rov tshwm sim dua, mus ntsib kws kho mob. Qhov no yuav qhia tau tias muaj kev rov tshwm sim ntawm qhov mob tseem ceeb.
• Yog tias koj muaj kev txhawj xeeb txog cov kev mob tshwm sim los ntawm kev kho mob .
• Yog tias tsis pom kev zoo dua txawm tias kho tau ib ntus.

Thaum muaj li no, koj tus kws kho mob tuaj yeem qhia lwm yam kev kho mob uas haum rau koj.

Cov Lus Qhia Luv: Tej Yam Yuav Tsum Nco Ntsoov (Cov Lus Coj Mus Tsev)

Zoo, cia peb rov qab xav txog qhov peb tau tham txog.

Kab mob Hypertrophic osteoarthropathy (HOA) yog ib yam mob uas cov ntiv tes o thiab cov rau tes puas. Nws tuaj yeem yog thawj (genetic) lossis thib ob (ua los ntawm lwm yam kab mob). Cov ua rau muaj HOA thib ob yog kab mob ntsws thiab kab mob plawv.

• Cov tsos mob: O ntawm cov ntiv tes, cov rau tes taw uas loj hlob tuaj, mob pob qij txha, thiab daim tawv nqaij tuab.
• Kev kuaj mob: Kev kuaj mob, kev ntsuam xyuas tshwj xeeb (Lovibond, Shamroth cov qhab nia), thiab kev luam theej duab los nrhiav qhov ua rau mob.
• Kev Kho Mob: Rau PHO, cov tshuaj raug muab raws li cov tsos mob. Rau SHO, qhov tseem ceeb tshaj plaws yog kho tus kab mob tseem ceeb.
• Qhov tseem ceeb tshaj plaws: Yog tias koj pom muaj kev hloov pauv hauv koj cov ntiv tes, tsis txhob tsis quav ntsej lawv thiab nrhiav kev pab kho mob. Vim tias, thaum HOA tsis txaus ntshai, tus kab mob hauv qab uas ua rau nws tuaj yeem txaus ntshai.

Vam tias koj pom cov ntaub ntawv no muaj txiaj ntsig. Nyob kom noj qab nyob zoo!

` Kab mob pob txha caj qaum hypertrophic, o ntiv tes, hloov rau tes, PHO, SHO, kab mob ntsws, kab mob plawv, mob pob qij txha, mob pob qij txha