Ingabe izinzipho zakho sezikhulile futhi izinzipho zakho sezishintshile? Ake sifunde ngale Hypertrophic Osteoarthropathy!

Wake waphawula ukuthi iminwe yakho noma izinzwane zakho zikhulu ngendlela engavamile, kanti izinzipho zakho zigobile noma zinesimo esingajwayelekile? Ngezinye izikhathi asizinaki kakhulu lezi. Kodwa-ke, uma ubona lezi zimpawu, kungaba uphawu lwesimo esibizwa ngokuthi 'i-Hypertrophic Osteoarthropathy' . Lokhu kubizwa nangokuthi i-HOA ngamafuphi. Lesi simo ngokwaso asiyona ingozi kangako, kodwa ezinye izimo eziyisisekelo ezibangela ukuthi singadinga ukwelashwa. Ngakho-ke, ake sixoxe ngale HOA ngokuningiliziwe futhi sifunde kabanzi.

Kuyini i-hypertrophic osteoarthropathy (HOA)?

Kalula nje, i-hypertrophic osteoarthropathy (HOA) yisimo esibangela ukuthi iziphetho zeminwe noma izinzwane zakho zivuvuke futhi zibe yindilinga (zibambe ama-clubbing) kanye noshintsho ezinzipho zakho. Umuntu one-HOA angase:

• Izihloko zeminwe noma izinzwane ziyakhula futhi zivuvuke .
• Izinzipho zigobile phansi futhi zibukeka zigobile, njengokungathi zidonswe phezulu.

I-HOA ngezinye izikhathi ingaqala ebuntwaneni noma ebusheni. Kwabanye abantu, ingakhula futhi kamuva ekuphileni. Nakuba i-HOA ngokwayo ingeyona ingozi, uma kukhona isimo esiyisisekelo esiyibangelayo, kubalulekile ukuyiphatha.

Yiziphi izinhlobo eziyinhloko zalokhu?

Kunezinhlobo ezimbili eziyinhloko zama-HOA:

1. I-Primary Hypertrophic Osteoarthropathy (PHO): Lolu hlobo luyizakhi zofuzo, okusho ukuthi lungazuzwa kubazali kubantwana.

2. I-Secondary Hypertrophic Osteoarthropathy (SHO): Lolu hlobo lubangelwa yizimo ezingamahlalakhona njengesifo senhliziyo nesifo samaphaphu. Lezi zimo zivame ukubangela amazinga aphansi omoya-mpilo egazini lakho.

Ubani onamathuba amaningi okuthola lesi simo?

Eqinisweni, noma ubani, kungakhathaliseki ubulili noma ubuzwe, angaba nalesi simo esibizwa ngokuthi i-hypertrophic osteoarthropathy.

Kodwa-ke, i-HOA eyinhloko (i-PHO) ivame ukuvela phakathi nonyaka wokuqala wokuphila noma ngesikhathi sobusha. Isimo se-PHO:

• Kuvamile kakhulu kubantu abamnyama.
• Kwenzeka kakhulu emadodeni.

I-HOA yesibili (i-SHO) yisimo esivame ukubonakala kakhulu kubantu abaneminyaka ephakathi kuka-55 no-75.

Sivame kangakanani lesi simo?

Abacwaningi abakwazi ukusho ngqo ukuthi bangaki abantu abane-HOA. Kodwa kuyaziwa ukuthi phakathi kuka-95% no-97% wabantu abane-HOA bane-secondary type (SHO) . Lokhu kusho ukuthi abantu abaningi bashintsha iminwe yabo ngenxa yesinye isimo.

Kungani kwakhiwa le HOA? Yiziphi izizathu?

Ake sibone ukuthi yini ebangela lokhu.

Izizathu ze-HOA Eyinhloko (i-PHO)

Lokhu kubangelwa ukuguquka kwezakhi zofuzo okukhona lapho kuzalwa . Ingane ingase izuze lokhu kuguquka kwezakhi zofuzo kumama, kuyise, noma kokubili.

Izizathu ze-HOA yesibili (SHO)

Imbangela eyinhloko ye-HOA yesibili (i-SHO) yisifo samaphaphu . Uma lesi simo sibangelwa yisifo samaphaphu, sibizwa ngokuthi i-Hypertrophic Pulmonary Osteoarthropathy (i-HPOA) .

Isifo esiyinhloko samaphaphu esingadala i-HPOA umdlavuza wamaphaphu , ikakhulukazi umdlavuza wamaphaphu ongewona amangqamuzana amancane . Ngaphezu kwalokho, ezinye izifo zamaphaphu ezingadala i-HPOA zifaka:

• Izimila ezithambile ze-pleura
• Ukutheleleka kwamaphaphu okungapheli
• I-Cystic Fibrosis (isifo sofuzo esithinta uhlelo lokuphefumula)
• I-Mesothelioma (umdlavuza wolwelwesi lwamaphaphu)
• Umdlavuza osakazeke kwezinye izindawo futhi othinta amaphaphu (isifo samaphaphu esishintshashintshayo)
• Ukukhubazeka kwemithambo yegazi emaphashini (ukungasebenzi kahle kwemithambo yegazi emaphashini)
• Isifo Sofuba Sephaphu
• I-Sarcoidosis (ukuqhekeka kwamaseli ezingxenyeni ezahlukene zomzimba)

Kunezinye izici ezingathinta i-HOA yesibili (SHO):

• Izifo zesibindi, i-bile, kanye ne-gallbladder (izimo ze-hepatobiliary):
• I-Biliary Atresia (Ukuvinjelwa Kwemisele Yenyongo Ezinganeni Ezincane)
• Umdlavuza
• I-cirrhosis yesibindi
• I-Cholangitis Eyinhloko Ye-Biliary
• Isifo sikaWilson (ukuqongelela kwethusi emzimbeni)
• Izifo zenhliziyo:
• I-Atrial myxoma (isimila esingeyona umdlavuza esakheka enhliziyweni)
• Isifo Senhliziyo Esibangelwa Yi-Cyanotic (isifo senhliziyo lapho kunokuncipha komoya-mpilo egazini)
• Ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo (i-Infective Endocarditis)
• Izimo zesisu:
• Ukusetshenziswa kabi kwemithi yokuhlanza isisu
• I-Achalasia (inkinga ngokusebenza kwe-sphincter yomphimbo)
• Umdlavuza
• I-Familial Adenomatous Polyposis (ukukhula okuncane emathunjini amakhulu)
• Isifo Sokuvuvukala Kwamathumbu

Ngaphezu kwalokhu, ezinye izimo eziningana zingabangela i-SHO:

• Isifo se-Celiac (ukungezwani komzimba ne-gluten)
• Izifo zamathumbu ezifana ne-dysentery
• Isifo samaGraves (hyperthyroidism)
• I-Hyperthyroidism
• I-Myelofibrosis (isifo somnkantsha wamathambo)
• Isifo se-POEMS
• I-Thymoma (isimila se-thymus gland)

Cabanga nje, umuntu omaziyo ubelokhu ekhwehlela isikhashana futhi iminwe yakhe ishintshe kanje, futhi ngemva kokubona udokotela kuphela lapho athola khona ukuthi kuyinkinga yamaphaphu. Ngakho-ke kubalulekile ukunaka lezi zimpawu.

Ziyini izimpawu ze-HOA?

Uphawu oluyinhloko lwe-HOA ukugoba noma ukuvuvukala kweminwe noma izinzwane. Lokhu kuvame ukuthinta izinhlangothi zombili zomzimba ngokulinganayo. Ungase uqaphele izinto ezifana nalezi:

• Izihloko zeminwe noma izinzwane zivuvukele futhi ziyindilinga .
• Imibimbi emalungeni eduze kweminwe iyanyamalala.
• Izinzipho zigobile phansi futhi zibonakala sengathi ziyantanta.
• Isikhumba esisezansi kozipho siyacwebezela futhi sibe sincane .
• Izinzipho ziyathamba .
• Izihloko zeminwe noma izinzwane zibomvu futhi zizwakala zifudumele .

Ezinye izici ze-HOA ongase uzibone zifaka:

• Ukwanda kwe-glandular hypertrophy. Lokhu kungabangela izimo ezifana ne-acne, ukujuluka ngokweqile (hyperhidrosis), ukugoba kwamehlo aphezulu (i-ptosis yamehlo aphezulu), kanye ne-seborrheic dermatitis.
• I-Periostitis ukuvuvukala kolwelwesi olumboza amathambo. Lokhu kungabangela ubuhlungu emaqakaleni, ezihlakaleni, noma emadolweni.
• Ukuvuvukala kwezicubu ezithambile zemilenze (ukuvuvukala okungenamigoqo).
• Ukuqina kwamathambo emaqakaleni nasezihlakaleni.
• Ukuqina kwesikhumba (i-Pachydermia). Isikhumba ebusweni nasekhanda singase sibe lukhuni futhi sibe nemigqa ejulile.

Yiziphi izici ezikhethekile ze-HOA yesibili (SHO)?

Ngaphezu kwezimpawu ezivamile ze-HOA okukhulunywe ngazo ngaphambili, abantu abane-HOA yesibili (SHO) bangase babe nokukhishwa kwamalunga . Lokhu kwenzeka lapho uketshezi olwengeziwe luqongelela ezicutshini ezisemalungeni nasezindaweni ezizungezile. Ukukhishwa kwamalunga kungabangela:

• Ubuhlungu
• Ububomvu
• Ukuqina
• Ukuvuvukala

Ukuvuvukala kwamalunga okuhambisana ne-SHO kuvame ukubonakala emadolweni nasezihlakaleni .

Ukuthola kanjani lokhu? Yiziphi izivivinyo ezenziwa odokotela?

Uma uya kudokotela, into yokuqala abazoyenza ukuhlola ukuthi akukho yini ukushaywa yizinzwane noma ama-clabs ezandleni zakho. Ngaphezu kwalokho, bazobheka nalokhu okulandelayo ngesikhathi sokuhlolwa komzimba:

• Ingabe izici zobuso seziqinile?
• Ingabe imilenze yakho ivuvukele?
• Ingabe kukhona ubuhlungu uma ucindezela amaqakala, amadolo, noma izihlakala?
• Ingabe amathambo asemaqakaleni nasezihlakaleni ayaqina?

Uma udokotela esola isimo esibizwa ngokuthi i-HOA, angenza izivivinyo eziningana, njengokuthi:

• Uphawu lwephrofayela kaLovibond:Uma ubheka umunwe wakho ohlangothini, ngokuvamile uzobona i-engeli ebanzi "efana no-V" lapho ipuleti lezipikili lihlangana khona nokugoba kwesikhumba phansi kwe-nail (ukugoba kwezipikili okuseduze). Uma une-HOA, uzipho lwakho lugobile phansi, okwandisa le engeli. Ku-nail evamile, le engeli ingu-160 degrees noma ngaphansi. Ku-nail ene-clubbed, ingu-180 degrees noma ngaphezulu.
• Isilinganiso sokujula kwe-Phalangeal: Unamathambo amathathu (ama-phalange) emunweni ngamunye. Ithambo elibamba uzipho (i-phalange ekude) livame ukuba lifushane kunethambo eliseduze nalo (i-phalange ephakathi). Uma une-HOA, i-phalange yakho ephakathi imfushane kune-phalange yakho ekude.
• Uphawu lukaSchamroth: Beka izinzipho zeminwe yakho yokukhomba ndawonye. Bheka isikhala esinjengedayimane (ifasitela) phakathi kwesisekelo sesiphandla kanye ne-cuticle. Uma kungekho sikhala, kungenzeka ukuthi une-HOA.

Ukuhlolwa okwengeziwe ukuthola i-HOA yesibili (SHO)

Uma udokotela esola ukuthi esinye isimo sezokwelapha esiyisisekelo sibangela i-HOA, angaphakamisa ezinye izivivinyo eziningana:

• I-Angiography (ukuhlolwa kwemithambo yegazi)
• Ukuhlolwa kwegesi yegazi le-arterial
• Ukuhlolwa kwegazi
• Ukuskena kwamathambo
• I-X-ray yesifuba
• I-CT scan (i-Computed Tomography scan) noma i-ultrasound scan (i-Ultrasound)
• I-Echocardiogram noma i-Electrocardiogram (EKG)
• Iskeni se-MRI (I-MRI - Ukufanekisa i-Magnetic Resonance)
• Ukuhlolwa kokusebenza kwamaphaphu

Lezi zivivinyo zingasiza udokotela wakho ukuthola imbangela ye-HOA yakho. Uma iskeni ibonisa ukukhula okungavamile (njengesimila), udokotela wakho angase futhi asikisele i-biopsy (ukuthatha isampula yamaseli nokuwahlola). Lokhu kungasiza ekutholeni imbangela eqondile yokukhula.

Kuphathwa kanjani lokhu?

Izindlela zokwelapha ziyahlukahluka kuye ngohlobo lwe-HOA.

Ukwelashwa kwe-HOA eyinhloko (i-PHO)

Uma ungenabo ubuhlungu noma izimpawu zakho zingezimbi kakhulu, ungase ungadingi ukwelashwa okukhethekile kwe-HOA eyinhloko (i-PHO). Kodwa-ke, uma unezimpawu, ungase ukwazi ukusebenzisa imithi efana nalokhu:

• Imithi engeyona i-steroidal elwa nokuvuvukala (ama-NSAID)
• Izithibi ze-COX-2
• Ama-bisphosphonates
• I-Octreotide

Ukwelashwa kwe-HOA yesibili (SHO)

Lapho welapha i-HOA yesibili (i-SHO), into eyinhloko ukwelapha imbangela eyinhloko . Ukwelashwa kungafaka:

• Ukwelashwa ngama-antimicrobial ekwelapheni isifo sofuba
• Ukwelashwa ngamakhemikhali ukwelapha umdlavuza wamaphaphu
• Ukufakelwa kwesibindi noma ukufakelwa kwesibindi kwesifo sesibindi
• Ukuhlinzwa kokufakelwa amaphaphu kwe-cystic fibrosis
• Ukususwa kwe-Radiofrequency yamathumba emaphashini (kusetshenziswa ukushisa ukubhubhisa amathumba)
• Ukuhlinzwa kwesifo senhliziyo noma umdlavuza wamaphaphu

Uma isimo esiyisisekelo esibangela i-SHO singelashwa, udokotela angase asikisele imithi yokulawula izimpawu.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?

Lokhu kuncike kakhulu ohlotsheni lwe-HOA onayo, ubukhali besimo, kanye nokwelashwa okutholayo. Uma isimo esiyisisekelo seselashwe, ukubhula nge-club kungaphela ngokushesha.

Ingabe kukhona esingakwenza ukunciphisa ukwenzeka kwalokhu?

Ingozi eyinhloko ye-HOA (PHO)

Njengoba i-PHO iwufuzo, akukho esingakwenza ukunciphisa ukwakheka kwayo.

Ingozi yesibili ye-HOA (SHO)

Ukuze unciphise ingozi yokuthola i-SHO, kubaluleke kakhulu ukulandela indlela yokuphila enempilo . Lokhu kubaluleke kakhulu uma usengozini yesifo senhliziyo noma isifo samaphaphu. Nazi ezinye izinto ongazenza:

• Ukugcina isisindo esinempilo.
• Ukudla ukudla okunempilo okunempilo kwenhliziyo.
• Ukuzivocavoca njalo.
• Ukunciphisa ukusetshenziswa kotshwala nezidakamizwa.
• Ukuyeka ukubhema. Lokhu kubaluleke kakhulu, ngoba ukubhema kuyimbangela enkulu yezifo eziningi zamaphaphu.
• Ukunciphisa ukucindezeleka.

Ikusasa lizomphathelani umuntu one-HOA?

Kumuntu one-HOA eyinhloko (PHO)

I-PHO ingase iyeke ukuba yimbi ngokwayo. Ngezinye izikhathi, ikakhulukazi ngemva kokuthomba, ingase ibe ngcono ngokuphelele.

Kumuntu one-HOA yesibili (SHO)

Uma imbangela eyisisekelo yelashwa ngempumelelo, lesi simo singalapheka ngokuphelele. Kodwa-ke, uma imbangela eyisisekelo ingelapheka ngempumelelo (isibonelo, umdlavuza ongathi sína), lesi simo singase siqhubeke.

Kwenzekani uma isimo se-HOA sihlala isikhathi eside?

Uma isimo se-HOA sesiqhubeke isikhathi eside, ungase ubhekane nezinto ezifana nalezi:

• Ukulahlekelwa uhla lokunyakaza emalungeni
• I-Osteoarthritis (ubuhlungu bamalunga)
• Ubuhlungu

Kodwa-ke, khumbula ukuthi eziningi zalezi zimpawu zingalawulwa ngokwelashwa okufanele .

Uma kukhona i-HOA, uzinakekela kanjani?

Uma une-HOA, into engcono kakhulu ongayenza ukuqhubeka nokuphuza ukwelashwa okunikezwayo ukulawula izimpawu zakho. Kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho.

Kufanele ubonane nini nodokotela?

Kufanele uqaphele ngalezi zinto:

• Ngemva kokwelashwaUma izimpawu zokushaywa yi-club ziphinde zibuye, bona udokotela. Lokhu kungase kubonise ukuphinda kwesimo esiyisisekelo.
• Uma ukhathazekile ngemiphumela emibi evela ekwelashweni .
• Uma kungekho ntuthuko ebonakala naphezu kokwelashwa isikhathi esithile.

Ezimweni ezinjalo, udokotela wakho angase asikisele ezinye izindlela zokwelapha ezifanele wena.

Isifinyezo: Izinto Okufanele Uzikhumbule (Umyalezo Ofanele Uwuthathe Uhambe Nawo Ekhaya)

Kulungile, ake sikhumbule kafushane lokho esikukhulumile.

I-Hypertrophic osteoarthropathy (HOA) yisimo lapho iziqongo zeminwe zivuvukala khona futhi izinzipho zigugile. Kungaba okuyinhloko (okwezakhi zofuzo) noma okwesibili (okubangelwa esinye isifo). Izimbangela eziyinhloko ze-HOA yesibili yisifo samaphaphu nesenhliziyo.

• Izimpawu: Ukuvuvukala kweminwe, izinzipho zezinyawo ezikhule ngaphakathi, ubuhlungu bamalunga, kanye nokuqina kwesikhumba.
• Ukuxilongwa: Ukuhlolwa kwezokwelapha, ukuhlolwa okukhethekile (iLovibond, amaphuzu eShamroth), kanye nokuskena ukuze kubhekwe imbangela eyisisekelo.
• Ukwelashwa: Ku-PHO, imithi inikezwa ngokwezimpawu. Ku-SHO, into eyinhloko ukwelapha isifo esiyisisekelo.
• Okubaluleke kakhulu: Uma ubona noma yiziphi izinguquko eminweni yakho, ungazinaki futhi ufune iseluleko sezokwelapha. Ngoba, nakuba i-HOA ingeyona ingozi, isifo esiyimbangela singaba yingozi.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

I- Hypertrophic Osteoarthropathy, ukuvuvukala kweminwe, izinguquko zezinzipho, i-PHO, i-SHO, isifo samaphaphu, isifo senhliziyo, ubuhlungu bamalunga, ukuxhuzula