ʻO ke hōʻino kino o ka maʻi diabetes he mea maʻamau. Pono kēlā ʻano hoʻopiʻi e koi ai i ka mālama ʻana, ʻaʻole e hoʻohee wale i ke kaʻina luku, akā e ʻae ʻia ka hoʻomaikaʻi ʻana i ke ʻano maʻamau o ka ʻōnaehana musculoskeletal.
ʻO nā kumu kumu o nā ʻōhumu o ka maʻi maʻi lohi, ʻo ia hoʻi nā ala e pili ana i ka iwi, ka pae kiʻekiʻe o ka glucose koko nui. Ma hope o nā mea āpau, ʻo ka maʻi hyperglycemia āpau i ka hopena maikaʻi i nā kino āpau a me nā papa o kahi kanaka.
Ua loaʻa ʻia kahi piʻi nui o ka glucose i ka hoʻopili ʻana i ka sorbitol i hōʻiliʻili i nā neurons a me nā cell endothelial. E kūlike i kēia kiʻi, ulu pinepine ka lolo neuropathy.
Eia kekahi, hiki ke kumu o ka hōʻeha ʻana i ka maʻi maʻi ma ka maʻi maʻi ma muli o ka hoʻololi ʻana i nā kiko o ka huakaʻi e hoʻonāukiuki i ka hoʻouluʻeha oxidative a me ka hoʻokumu ʻana o nā radical manuahi. A inā he hemahema o ka insulin, ua ʻike ʻia nā loli i ka ʻano o ka proteinglican o ka cartilage a me nā iwi.
ʻO nā maʻi hoʻohui me ka maʻi maʻi maʻi maʻi
I kahi maʻi hyperglycemia maʻi ākea, ua ʻokoʻa ʻē nā mea ʻokoʻa. I kekahi mau hihia, kumu ka maʻi ʻia e ka hewa i ka microcirculation, hoʻopōmaikaʻi ʻia o nā kiko kīnā ʻole, a i ʻole nā hoʻopiʻi neuropathic. A ua nānā pinepine ʻia nā syndromes rheumatic i nā maʻi me nā hōʻike o nā ala pili.
Nui nā hopena o ka hoʻopiʻi o ka maʻi maʻi. E pili ana kēia:
- hoʻowahāwahā idiopathic skeletal hyperostosis;
- osteoporosis;
- infarction mū ka maʻi.
Eia nō naʻe, me ka piʻi mau i ka nui o ka kō, me nā mea maʻi he nui i hōʻike i kahi hōʻailona o ke ʻano o ka hōʻemi o ka ʻili o nā kiko o nā ʻano, me nā leʻaleʻa e like me:
- Hana a Dupuytren;
- maʻiʻo chiroartropathy maʻi (cyst);
- tenosynovitis o nā uaua flexor (ka wili a ka lima);
- ʻo ka capsulitis pūlehu (periarthritis, ʻeha ma ka poʻohiwi).
ʻO kekahi hoʻopiʻi maʻamau o ka maʻi maʻamau ʻo ka neuropathy. Hoʻopili kēia i ka amyotrophy, neuropathic arthritis (osteoarthropathy, Charcot joints), sympastical reflex dystrophy, carpal valve syndrome a keu aku.
I mea e ʻole ai i kēia mau hopena, ʻaʻole pono wau a me ka mea maʻi e hoʻokomo i nā mea kanu, he mea koʻikoʻi loa ia e hoʻokō i ka mālama manawa i ka manawa. A no ka hoʻonui ʻana i nā pae glucose, pono nā lāʻau antidiabetic e like me Metformin e hana maʻamau.
E kū'ē i ke ʻano o ke ala o ka maʻi maʻamau (5-8 mau makahiki), nui nā mea maʻi e hoʻomohala i ka osteoarthropathy maʻi maʻi. ʻIke ʻia nā hōʻailona koʻikoʻi o ka maʻi e ka ultrasound osteometry.
I ka maʻamau pinepine, pili ka maʻi i ka umauma o lalo. I ka 60% o nā hihia, ua komo nā mea hili i ka tarsal-metatarsal i ke kaʻina pathological, a me nā kuʻekuʻe wāwae a me ka metatarsophalangeal e pili pū ana i kahi liʻiliʻi loa (30%).
I kekahi manawa ua eha ka ʻāʻī a me ke kuli. Ma ke ʻano he kānāwai, hoʻokahi kēia ʻaoʻao.
Nā hōʻailona hoʻohālikelike o ka osteoarthropathy he hōʻeha, ka ʻūhū a me ka hoʻonā ʻana o nā mea i hoʻopili. Ma muli o kahi paleʻole o ka palaualelo, sprain a me ka hikiʻole o ka paia o nā wāwae i ʻike ʻia, kahi pinepine e alakaʻi i kā lākou hōʻalo a me ka deform.
ʻO kahi hoʻopiʻi maʻamau pū kekahi o ka maʻi hyperglycemia maʻi o ka maʻi maʻi maʻi diabetes (SDS). ʻO kēia kahi maʻi wāwae e hāpai i ka wā e hoʻopilikia ai ka iwi, articular a me nā pāwili palupalu, a me nā moku a me nā nerves. Ma muli o kēia, ua puka nā hana necrotic purulent i ka mea maʻi a me nā ʻōpū ma nā ʻano wāwae.
Pōhoihoi, ʻike ʻia ʻo SDS i nā poʻe maʻi ma mua o ke ala o ke ala lōʻihi o ke ʻano maʻi o ka maʻi maʻi (mai 15 mau makahiki). ʻO ka mea pōʻino, ma 70% o nā hihia, ʻo ka piʻi ʻana o ka maʻi e koi ai i ka amputation a i kekahi manawa he wāwae ke kau.
ʻO nā hōʻola ʻana o nā maʻi kulekuleka e holo a me ka hyperthermia o nā wāwae. I ka hoʻomaka, ʻike ʻia ka ʻeha i ka ʻaoʻao ma lalo, e koi ana i kahi hōʻike diagnostic kahi ʻano me ke ʻeha a nā maʻi a me ka thrombophlebitis venous.
Ma ke ka hoʻomohala ʻana i ka maʻi, pili ʻia ka wāwae. I ka wā hope, ulu hou ka neuropathy, ʻaʻohe mea ʻeha.
I ka manawa pinepine, me ka piʻi mau ʻana i ka kō koko koko, ʻike ʻia kahi maʻi maʻi maʻi maʻi o ka hoʻoweliweli paʻa ʻana. ʻO ka hapa nui a i kekahi manawa me nā kuʻekuʻe nui e kahakaha ʻia.
ʻO nā hōʻailona o ka OPS ka ʻeha e kū mai i ka wā o ka neʻe ʻana. ʻO ka pinepine loa, ua hoʻopili ʻia nā pilina interphimal interphalangeal a me nā metacarpophalangeal, ʻaʻole i emi pinepine - ka lima, ka ʻūlima, nā kuʻekuʻe pulima a me nā kuʻekuʻe.
Hoʻomaʻo pinepine, ʻike ʻia ka maʻi inā hiki ʻole i ka mea maʻi ke pani paʻa i kona mau lima. ʻO ka pinepine, ʻo ka maʻi o nā "pule lima lima" e kū e kū'ē i ke kua o nā loli ʻē aʻe. Eia hou hoʻi, ke kau nei ʻo ka hopena o OPS i ka lōʻihi o ke ʻano o ka papa o ka maʻi diabetes a me kona uku.
ʻO kekahi ʻano hoʻopiʻi maʻamau o ka hyperglycemia ʻo ka maʻi wāʻohiwi poʻohiwi. Hoʻohui pinepine ʻia kēia pathology me ka OPS syndrome, a i kekahi manawa, me ka tenosynovitis o nā pālima. I mea e pale ai i ka hoʻomohala ʻana o ia mau maʻi, he mea nui ia e nānā i nā hōʻailona glucose, a no ko lākou normalization, pono nā poʻe maʻi maʻi ole-insulin e hāpai mau i ka Metformin.
Hoʻomaʻa pinepine, kahi ala lōʻihi o kahi maʻi e hōʻake ana i ka hyperglycemia i ke hoʻololi ʻana i ka hoʻoponopono ʻana o nā iwi. Me ka nele o ka insulin, pilikia kēia hanana i ka hana osteoblastic.
I nā hapalua o nā hihia, heʻokoʻa nā osteopenia a me nā osteoporosis. Eia kekahi, emi ka papa o kēia mau pathologies i ka loli kūpono o kahi pani. ʻO nā kumu e hoʻopiʻi i ka hoʻomohala ʻana o ka maʻi osteopenic:
- decompension lōʻihi o ka pākūkū o nā kalapona;
- ka hōʻike ʻana i nā maʻi o ka maʻi ma lalo o nā makahiki he 20 i ka makahiki;
- hānai ma mua o 10 mau makahiki.
ʻO ka ʻōmaʻomaʻo Rheumatoid kekahi hopena hoʻopiʻi maʻamau i ka maʻi maʻi, e like me nā poʻe maʻi maʻi. Hoʻohālikelike ʻia ka maʻi e ke ʻano o ke ʻeha ʻāʻī i kahi kihi, kahi hana hōʻoweliweli a me ke kūpaʻa o ka ʻaoʻao i pā ʻia.
Akā inā aia ka lolo, e hōʻeha ka meaʻai i nā kihi a me nā wāwae āpau, he aha ka mea e hana ai a pehea e mālama ai i kēlā mau kūlana?
Kūmaʻomaʻo Therapeutic
ʻO ke kumu nui no ka pale ʻana i ka holomua o nā maʻi hui me ka mālama ʻana i kahi index glucose kiʻekiʻe (a 10 mmol / l) i ka lā a pau o ka lā. Inā ʻaʻole, ʻaʻole maikaʻi loa ka mālama ʻana no ka wāwae deformity a me nā ʻōlelo ʻē aʻe o ka maʻi diabetes. No laila, he mea nui e lawe i nā papa antidiabetic i kēlā me kēia lā, e like me Metformin a i Siofor paha.
A me kahi hōʻino koʻikoʻi i nā hoʻopili, me ka hoʻohui ʻana o ka lāʻau, ka lāʻau anti-inflammatory a me nā lāʻau e hoʻōla i ka kiko cartilage i kuhikuhi ʻia. I nā kūlana holomua, hana ʻia nā inikua, akā inā mālama ʻia ka kahe interarticular wale nō.
Eia nō hoʻi, ke hoʻohaʻahaʻa pinepine ʻia ka mālama ʻana i nā hana hoʻopiʻi a ma kahi maʻi maʻi i ka lawe ʻana i nā derivatives pyrazolone a me nā huaora B 12. ʻO Corticosteroids ka wā i hoʻohana ʻole ʻia no ka atropathy, ʻoiai lākou e pili ana i ka hoʻoliʻiliʻi ʻana i ke kō. Akā inā pono, intra- a me ka hoʻokele periarticular o nā liʻiliʻi liʻiliʻi (a hiki i 37 ml o ka hydrocortisone) i kekahi mau manawa.
No ka pono o ka lāʻau lapaʻau e pono ai, pono ka mea maʻi e lawe i ka lāʻau lapaʻau i nā papa aʻo a lōʻihi hoʻi. Eia kekahi, pono ia e hōʻoia ʻia ma ka ʻōnaehana, ka mea e hiki ai i ke kauka ke kāohi i ka kaʻina hana.
I kahi hihia o ka wāwae wāwae, mālama ʻia nā ʻōpio trophic a kuhikuhi ʻia nā antibiotika. Pono kekahi e haʻalele i nā hana ʻino, hoʻolako i ka lawe ʻana i nā wāwae a me nā hōʻola i nā maʻi e hōʻino i ka hoʻoulu hou ʻana o nā kumu ulcerative.
Me ka ʻeha a i ʻole arthrosis i ka mellitus maʻi mellitus, hiki ʻole ke hoʻohana ʻana i nā ʻano o ka maʻi maʻamau. ʻO kekahi o nā loea kaulana loa ʻo ka hana magnetic, i ka wā o ka hoʻopalulu ʻia ʻana o nā pihi i ka hohonu o ka ʻumikūmālua ʻumikūmālua.
Loaʻa nā pono o ka hōʻike magnetic:
- ka hemo ʻana o ka mumū;
- hoopau ia o ka eha;
- ka hoʻomaikaʻi ʻana i ke kūlana maʻamau o ka ʻōnaehana musculoskeletal;
- Hiki ke hoʻokō ʻia ke kaʻina hana i kahi kokoke i kekahi makahiki.
ʻO ka papa aʻo e mālama ai e pili ana i 30 lā. Eia nō naʻe, kōkua ka hōʻikeʻike aku i ka hoʻomaka ma ka hoʻomaka ʻana o ka hoʻomohala ʻana i nā maʻi hui. Eia kekahi, ua hoʻohālikelike ʻia kēia kaʻina hana i ka pilikia o ka puʻuwai, ke kanesa, ke maʻi pākī, ke kīloʻi ʻana o ke koko a me ka wā hāpai.
Inā hoʻopilikia pū ka maʻi maʻa, ua hāʻawi pinepine ʻia ʻo ia i ka lāʻau laser. Hoʻolaha nā hanana like like i nā papa - 20 mau papa o kēlā me kēia lā. Akā ke kūpono lākou i nā mea maʻalahi wale nō o ka maʻi.
Ma kahi o ka lawe ʻana i nā lāʻau antihyperglycemic, e like me ka Metformin, nā huaora, nā mea hōʻeha a me nā lāʻau anti-inflammatory, no ka maʻi maʻi me ka pilikia pū ʻana, he mea nui ia e pili i nā lula āpau no ka mālama wāwae, e mālama pono ana i nā wāwae. He mea nui hoʻi ia e hana i nā hoʻomaʻamaʻa kūikawā inā ua hoʻopili ʻia kahi prosthesis, ʻoiai inā ua hoʻokomo ʻia ka mea implantable i kēia manawa.
Eia kekahi, me nā pilikia me nā hui pūpū, hōʻike ʻia ka massage therapeutic. No laila, inā e hoʻokō ʻoe i kahi kaʻina hana ma ka liʻiliʻi he 10 mau minuke i ka lā, hiki iā ʻoe ke hōʻemi i ka hōʻeha o ka ʻeha a hoʻonui i ka ʻike ʻana o nā kuʻuna. Eia nō naʻe, contraindicated therapy like in stabil arterial hypertension, fever, ke koko a me nā maʻi ʻili.
ʻO ka pale ʻana i ka hoʻomaka ʻana o nā hoʻopiʻi articular i ka maʻi diabetes me ka mālama pono glycemic control, me ka hiki ʻole iā ʻoe ke ʻiha wale i ka pilikia, akā, i ke pale ʻana i kona hanana ma ka wā e hiki mai ana. No kēia pahuhopu, pono ia e hahai i kahi meaʻai, hoʻomaʻemaʻe, pale aku i ke kaumaha, hana mau pinepine iā Metformin, Metglib a me nā mea lapaʻau antidiabetic.
Pehea ka pili ʻana o ka maʻi maʻi i nā kuʻina i ke wikiō i kēia ʻatikala.
