Nthawi zina dzanja lanu limapweteka, eti? Zili ngati kuvulala. Anthu ambiri amaganiza kuti ndi kuvulala pang'ono komwe kumatha pakatha masiku ochepa. Koma nthawi zina pamakhala chifukwa chachikulu chomwe chimayambitsa ululuwu. Matenda a Kienböck ndi vuto losowa koma lofunika kudziwa. Dzinali likhoza kukhala latsopano kwa inu, koma ndikofunikira kudziwa za ilo.
Mwachidule, kodi matenda a Kienböck ndi chiyani?
Chabwino, tiyeni tifotokoze izi mosavuta. Dzanja lanu limapangidwa ndi mafupa ang'onoang'ono, kutanthauza mafupa 8 ogwirizana. Timatcha awa `(mafupa a Carpal)` . Pakati pa mafupa asanu ndi atatu awa, pali fupa laling'ono lomwe limaoneka ngati mwezi wozungulira, pakati. Umu ndi momwe madokotala amatcha fupa la `(Lunate)` . Fupa la `(Lunate)` ili limathandiza kwambiri kupinda ndi kuzungulira dzanja lathu bwino.
Matenda a Kienböck ndi matenda omwe magazi amalowa m'mafupa a lunate pang'onopang'ono ndipo pamapeto pake amasiya. Monga momwe mtengo umafera popanda madzi, fupali limafa pang'onopang'ono popanda magazi. Mu zamankhwala, izi zimatchedwa osteonecrosis . Izi sizichitika mwadzidzidzi, koma pang'onopang'ono zimakula pang'onopang'ono pakapita nthawi. Nthawi zina, izi zimatha kubweretsa matenda monga nyamakazi m'dzanja.
Ndani amene ali ndi mwayi waukulu wopeza izi? Kodi zimayambitsa chiyani?
Ngakhale kuti matendawa amatha kuchitika pa msinkhu uliwonse, nthawi zambiri amapezeka mwa amuna azaka zapakati pa 20 ndi 40. Komabe, izi sizikutanthauza kuti akazi sangathe kudwala matendawa.
Sizikudziwika bwino 100% chomwe chimayambitsa kuchepa kwa magazi kupita ku lunate. Komabe, pali zinthu zingapo zomwe zikuganiziridwa kuti zimayambitsa izi:
- Mavuto a mitsempha yamagazi yomwe imapereka magazi ku mafupa: Anthu ena amabadwa ndi vuto la momwe mitsempha yamagazi yomwe imapereka magazi ku fupa la ``Lunate`` imakhalira. Pazochitika zotere, pali mwayi waukulu woti magazi achepe. Akatswiri amakhulupirira kuti ichi ndiye chifukwa chachikulu.
- Kuvulala pachikhatho: Mwina mwagwa, mwachita ngozi ya galimoto, kapena mwavulala kwambiri pachikhatho chanu mukuchita masewera. Izi zitha kuchitika pamene fupa la lunate lawonongeka ndipo magazi atsekedwa, zomwe zimayambitsa vutoli.
- Kusiyana kwa kutalika kwa mafupa m'dzanja: Pali mafupa awiri akuluakulu m'munsi mwa dzanja lathu, radius ndi ulna . Mwa anthu ena, mafupa awiriwa sali ofanana kutalika. Limodzi ndi lalifupi pang'ono kuposa linalo. Izi zikachitika, kupanikizika kosazolowereka kumayikidwa pa fupa la lunate pamene dzanja likuyenda. Pakapita nthawi, kupanikizika kumeneku kumatha kuwononga fupa ndikusokoneza kuyenda kwa magazi.
- Matenda ena:Anthu omwe ali ndi matenda okhudzana ndi magazi monga ``Sickle cell anemia'' ndi ``Lupus'', komanso omwe ali ndi matenda ena amitsempha monga ``Cerebral palsy'' ali pachiwopsezo chotenga matenda a Kienböck.
Kodi zizindikiro za matendawa ndi ziti?
Nthawi zambiri, palibe zizindikiro zazikulu kumayambiriro kwa matendawa. Anthu ena sangakhale ndi zizindikiro zilizonse. Koma pali zizindikiro zina zomwe zimaonekera. Tiyeni tiwone zomwe zili.
| Chizindikiro | Kodi zimenezo zimamveka bwanji? |
|---|---|
| Kupweteka kwa dzanja | Zili ngati ululu wa dzanja lopindika. Ukhoza kukhala ululu wochepa womwe umabwera ndi kutha nthawi zina, kapena ukhoza kukhala ululu wokhazikika komanso wakuthwa. |
| Kutupa ndi kuuma | Dzanja langa likuwoneka lotupa. Ndikadzuka m'mawa, limamva lolimba komanso lovuta kupindika. |
| Kuvuta kugwira (kugwira kofooka) | Manja anga amafooka ndikachita zinthu monga kutsegula chivundikiro cha botolo la madzi kapena kutembenuza chogwirira chitseko. Manja anga amapweteka ndikanyamula chinthu cholemera. |
| Kuletsa kuyenda | Simungathe kupinda dzanja lanu mmwamba ndi pansi kapena mozungulira mosavuta monga momwe munkachitira kale. |
| Kukonza | Mukasuntha dzanja lanu, limapanga phokoso la 'kusweka', ngati kuti mafupa akupera kuchokera mkati. |
| Ululu pamalo enaake | Ndimamva kupweteka ndikakanikiza chala changa pamwamba pa dzanja langa, pakati pomwe (pamene pali fupa la lunate). |
Chofunika kwambiri n’chakuti, mukakumana ndi ululu wotere, musaunyalanyaze, mukumaganiza kuti, “Ndi kuvulala chabe.” Makamaka ngati ululuwo sunathe patatha sabata imodzi kapena ziwiri, muyenera kuonana ndi dokotala.
Kodi dokotala amazindikira bwanji matendawa?
Mukapita kwa dokotala, adzakufunsani za ululu umene ulipo, nthawi yomwe wakhalapo, komanso nthawi yomwe ukukulirakulira. Kenako adzafufuza dzanja lanu. Adzafunika kuchita mayeso angapo kuti atsimikizire kuti muli ndi matendawa.
- Kuyezetsa X-ray: Choyamba kuchita ndi X-ray. Komabe, kumayambiriro kwa matendawa, X-ray singasonyeze kusiyana kwakukulu.
- Kujambula kwa MRI: Iyi ndiyo njira yabwino kwambiri yodziwira matendawa. Kujambula kwa MRI kumatha kuzindikira msanga ngati fupa la ``Lunate`` likutuluka magazi kapena ayi, komanso ngati fupalo layamba kufa.
- Kujambula kwa CT: Kujambula kwa CT kungathandize kuona bwino ngati fupa lasweka kapena lasweka.
- Kujambula Mafupa: Izi zitha kuwona momwe mafupa amagwirira ntchito m'thupi.
Magawo anayi a matenda a Kienböck
Pambuyo pa mayeso awa, dokotala adzakuuzani gawo lomwe matenda anu ali. Pali magawo anayi akuluakulu.
| Gawo | Kodi chimachitika ndi chiyani pa siteji iyi? |
|---|---|
| Gawo 1 | Iyi ndi nthawi yoyamba. Ululu umamveka ngati dzanja lopindika. Palibe kusiyana kwa X-ray. Koma ngati muyang'ana ndi MRI, mutha kuwona kuti magazi opita ku fupa la `(Lunate)` achepa. |
| Gawo 2 | Chifukwa cha kusowa kwa magazi, fupa limayamba kuuma ngati mwala. Izi zimatchedwa "sclerosis" . Pa X-ray, fupa limaoneka loyera kuposa ena onse. Ululu umawonjezeka pang'ono. |
| Gawo 3 | Fupa lolimba tsopano likusweka ndipo likuyamba kusweka m'zidutswa. Izi zingapangitse mafupa ena omwe ali pachikhatho kusuntha pang'ono kuchokera pomwe anali kale. Ululu umawonjezeka, mphamvu m'dzanja imachepa, ndipo zimakhala zovuta kupindika chikhatho. |
| Gawo 4 | Imeneyi ndi nkhani yoipa kwambiri. Fupa la lunate latsala pang'ono kusweka ndi kusweka. Sikuti zokhazo, komanso mafupa ena ozungulira limayambanso kutha. Cholumikizira cha dzanja chimawonongeka, ndipo nyamakazi imayamba. |
Anthu ena angatenge miyezi ingapo kuti ayambe gawo loyamba mpaka lachinayi. Kwa ena, zingatenge zaka zambiri.
Kodi mankhwala ochizira izi ndi otani?
Ngakhale kuti palibe mankhwala amodzi okha a matendawa, mankhwala omwe alipo panopa angathandize kuchepetsa ululu, kukonza magwiridwe antchito a dzanja, ndikuletsa matendawa kuti asakule kwambiri. Chithandizocho chimadalira zinthu zambiri, kuphatikizapo gawo la matenda anu, zaka zanu, ndi ntchito yanu.
Mankhwala opanda opaleshoni
Izi nthawi zambiri zimachitika msanga matendawa akangoyamba.
- Kuletsa dzanja kuyenda: Dzanja limakhala losayenda bwino mu pulasitala kwa miyezi ingapo. Kupuma kumeneku nthawi zina kungathandize kuti fupa libwererenso magazi.
- Mankhwala Ochepetsa Ululu: Dokotala wanu angakulangizeni mankhwala ochepetsa kutupa monga ibuprofen kuti muchepetse ululu ndi kutupa. Koma kumbukirani kuti mankhwalawa si oyenera anthu omwe ali ndi mphumu, zilonda zam'mimba, kuthamanga kwa magazi, matenda a impso kapena mtima. Choncho , musamwe mankhwalawa popanda kufunsa dokotala.
- Chithandizo cha ntchito: Katswiri wa zamaganizo adzakuphunzitsani momwe mungachitire ntchito za tsiku ndi tsiku m'njira yochepetsera ululu wa m'chiwuno.
Chithandizo kudzera mu opaleshoni
Ngati matendawa ndi aakulu, kapena ngati njira zina zothandizira sizithandiza, dokotala angakulangizeni opaleshoni. Mtundu wa opaleshoni yochitidwa umasiyana malinga ndi gawo la matendawa.
| Dzina la opaleshoni | Mwachidule, izi ndi zomwe zimachitika... |
|---|---|
| Kulinganiza Ma Joint | Ngati kutalika kwa mafupa awiri omwe ali pa mkono, ``Radius'' ndi ``Ulna'', kuli kosiyana, opaleshoni imachitidwa kuti ifanane kutalika kwawo. Kachidutswa kakang'ono ka fupa kamalumikizidwa pa fupa lalifupi kuti kalitambasule, kapena kachidutswa kakang'ono kamadulidwa kuchokera ku fupa lalitali kuti kalifupikitse. Izi zimachepetsa kupanikizika kwa fupa la ``Lunate''. |
| Kubwezeretsa magazi m'thupi | Izi zimaphatikizapo kubwezeretsa magazi ku fupa la lunate. Chidutswa chaching'ono cha fupa chokhala ndi mtsempha wa magazi chimatengedwa kuchokera ku mbali ina ya thupi (monga ntchafu) ndikuchiyika mu fupa la lunate lomwe likumwalira. Izi zitha kuchitika kokha m'magawo awiri oyamba a matendawa. |
| Kusakanikirana | Matendawa akakula kwambiri, mafupa angapo m'dzanja amayikidwa pamodzi kuti achepetse ululu. Nthawi zina, ngati mafupa a dzanja lonse ayikidwa pamodzi, dzanja silingathe kupindika, koma dzanja limatha kuzunguliridwa. |
| Kuchotsa Minofu ya Proximal Row Carpectomy (PRC) | Ngati fupa la lunate lasweka kwathunthu, fupa ndi mafupa angapo apafupi amachotsedwa. Izi zimachepetsa ululu, koma zimachepetsa kuyenda kwa dzanja. |
| Kukhazikitsa Arthroplasty | Mu izi, fupa la ``Lunate`` lowonongeka limachotsedwa ndikusinthidwa ndi fupa lochita kupanga (``prosthetic``). |
Kodi muyenera kupita kwa dokotala liti?
Matendawa akapezeka msanga, chithandizo ndi zotsatira zake zimakhala zabwino. Choncho, musayembekezere mpaka mutawona zizindikiro zomwe zili pansipa ndikuonana ndi dokotala.
- Ngati mukuvutika kusuntha dzanja lanu, dzanja lanu, kapena zala zanu.
- Ngati pali kufiira kosazolowereka kuzungulira dzanja.
- Ngati kutupa kukukulirakulira.
- Ngati pali ululu wosapiririka .
Dokotala wanu adzakutumizani kwa katswiri pankhaniyi, yemwe ndi dokotala wa mafupa .
Uthenga Wopita Nawo Kunyumba
- Matenda a Kienböck ndi matenda osowa kwambiri pomwe magazi opita ku fupa laling'ono lomwe lili m'dzanja lanu lotchedwa lunate amatsekedwa, zomwe zimapangitsa kuti pang'onopang'ono life.
- Chizindikiro choyamba chingakhale kupweteka komwe kumamveka ngati dzanja lopindika. Choncho ngati muli ndi ululu wosatha ngati uwu, musanyalanyaze.
- Matendawa amakula pang'onopang'ono pakapita nthawi. Ngati sachiritsidwa, ululu ukhoza kuwonjezeka ndipo dzanja limatha kulephera kuyenda.
- Zotsatira zanu zidzadalira kwambiri momwe mumapezera matendawa mwachangu ndikuyamba kulandira chithandizo.
- Lankhulani ndi dokotala wanu kuti mudziwe njira yabwino kwambiri yothandizira.
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