Nyob hauv pob txha yog pob txha. Thaum nws ua mob, osteomyelitis pib tsim. Tus kab mob kis mus rau spongy thiab compact khoom, thiab maj mam mus rau lub periosteum. Kev mob ntawm cov pob txha pob txha yog ib qho kab mob txaus ntshai thiab nyuaj uas tsis yooj yim rau kev kuaj pom hauv thawj theem, uas yog vim li cas muaj ntau yam teeb meem tshwm sim. Cov xwm txheej zoo li no ua rau muaj kev phom sij rau lub neej thiab yuav tsum tau saib xyuas sai thiab kho mus ntev.
Tus yam ntxwv ntawm tus kab mob
Mob pob txha yog ib yam kab mob sib kis uas nyuaj kho thiab ua rau muaj ntau yam tsis zoo. Pathogenic microorganisms nkag mus rau hauv cov pob txha cov ntaub so ntswg los ntawm cov hlab ntsha los yog los ntawm cov kab mob nyob ze. Tus kab mob no tuaj yeem tshwm sim hauv pob txha thaum nws raug puas tsuaj vim yog pob txha lossis phom phom.
Nyob rau hauv cov neeg mob menyuam yausTus kab mob no cuam tshuam feem ntau ntawm cov pob txha ntev ntawm cov ceg. Hauv cov neeg laus, qhov tshwm sim ntawm cov txheej txheem pathological nce ntxiv. Yog ib tug neeg raug mob ntshav qab zib, ces tus kab mob tuaj yeem cuam tshuam cov pob txha ntawm ko taw.
Thaum cov kab mob tsis muaj zog thiab kev tiv thaiv kab mob siab, cov pob txha pob txha tuaj yeem ua mob ntev yam tsis muaj suppuration thiab hloov pauv ntawm cov pob txha. Nrog rau cov txheej txheem ntawm osteomyelitis, cov ntaub so ntswg tuag yog tsim, uas yog tsis lees paub tom qab ib pliag. Vessel thrombosis maj mam tsim nyob ib ncig ntawm nws, cov txheej txheem ntawm cov ntshav ncig thiab pob txha noj zaub mov cuam tshuam.
Ntxiv rau, cov hlwb ntawm lub cev tiv thaiv kab mob maj mam sib sau ua ke, tsim ib hom granulation ncej. Nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm ib tug thickening ntawm lub periosteum thiab hu ua periostitis. Xws li ib tug ncej kom meej meej distinguishes ntawm cov ntaub so ntswg tuag thiab noj qab nyob zoo qhov chaw. Periostitis yog hais txog ib qho ntawm cov cim qhia ntawm osteomyelitis.
Kev faib tawm tseem ceeb
Nyob ntawm qhov ua rau mob ntawm cov pob txha pob txha, ntau hom kab mob sib txawv, qhov txawv ntawm qhov kev kawm, nrog rau txoj kev kuaj mob thiab kev kho mob. Ntawm qhov tseem ceeb ntawm kev puas tsuaj, nws yog ib qho tsim nyog yuav tsum tau hais txog:
- tuberculous;
- actinomycotic;
- brucellosis;
- gonorrheal;
- syphilitic.
Tuberculosis hom kab mob no feem ntau pom nyob rau hauv cov menyuam yaus, cov hluas.
Actinomycotic hom pathology yog nrog los ntawm kev puas tsuaj loj rau periosteum nrog kev tsim tom ntejfistulas thiab kev sib cais ntawm cov ntsiab lus purulent.
Brucellosis yog tshwm sim los ntawm qhov txhab ntawm tus txha caj qaum hauv thaj tsam lumbar thiab cuam tshuam rau cov kabmob thiab cov hlab ntsha nyob ze.
Hom kab mob syphilitic tshwm sim nyob rau hauv daim ntawv tertiary thiab nyob rau hauv cheeb tsam tsev menyuam. Nws muaj kev kawm ntev thiab nrog kev tsim ntawm abscesses.
Hom kab mob gonorrheal tshwm sim tawm tsam keeb kwm ntawm kev sib deev uas twb muaj lawm, yog nyob hauv thaj tsam lumbar thiab, hauv nws cov cim, zoo li cov kab mob sciatica. Tsis tas li ntawd, cov kws kho mob paub qhov txawv ntawm qhov mob ntawm cov pob txha pob txha ntawm tus txha nraub qaum, uas yog:
- psoriatic;
- ankylosing;
- aseptic;
- reactive;
- hematogenous.
Ankylosing hom pathology belongs rau pab pawg ntawm cov kab mob rheumatic, feem ntau tshwm sim tawm tsam keeb kwm ntawm rheumatoid mob caj dab, ua rau lub cev tsis muaj zog thiab maj mam nce ntxiv.
Reactive yog tsim thaum muaj ntau yam tsis ua haujlwm ntawm lub cev tiv thaiv kab mob tom qab kis kab mob hauv plab lossis kev sib deev. Qhov no cuam tshuam rau lumbar qaum.
Psoriatic hom kab mob tshwm sim tawm tsam keeb kwm ntawm psoriasis hnyav.
Hematogenous osteomyelitis yog tsim thaum tus kab mob staphylococcal nkag mus rau hauv lub cev.
Aseptic o ntawm cov pob txha pob txha tsis cuam tshuam nrog cov txheej txheem sib kis, tab sis txhim kho nrog kev raug mob nraub qaum, uas provokes necrosis.
Muab cov tsos mob uas twb muaj lawm,faib cov hom osteomyelitis xws li:
- ntsim;
- piv txwv tsis pub;
- chronic;
- atypical.
Yeej, cov kab mob pib mob hnyav heev thiab, nrog nws cov kev kawm tsis zoo tshaj plaws, dhau mus rau hauv daim ntawv mob ntev. Lub sijhawm mob hnyav yuav kav ntev li ob peb hnub. Kev puas tsuaj ntev tuaj yeem kav ntev li ob peb xyoos.
Kev tshwm sim
Kev mob ntawm cov pob txha ntawm tus txha nqaj qaum thiab cov pob qij txha yog provoked los ntawm ntau yam kab mob. Cov kab mob pathogenic tuaj yeem nkag mus rau hauv cov hlab ntsha. Qhov no yog txoj kev hematogenous ntawm kev sib kis thiab feem ntau tshwm sim hauv cov menyuam yaus thiab cov tub ntxhais hluas.
Kev sib cuag yog tsim nyob rau hauv rooj plaub ntawm kev kis kab mob ntawm cov pob txha thaum mob ntawm cov nqaij mos. Cov kab mob aseptic tau pom thaum lub sijhawm ua haujlwm thiab kaw cov pob txha. Feem ntau, cov kab mob tshwm sim los ntawm Staphylococcus aureus, Pseudomonas aeruginosa lossis E. coli, thiab qee zaum streptococcus.
Ntawm qhov ua rau osteomyelitis yuav tsum tau qhia:
- -fractures, mob rau, mob;
- muaj foci ntawm tus kab mob;
- txo qis kev tiv thaiv;
- xav ua xua;
- lub cev qaug zog;
- tsis muaj kev tswj hwm ntawm cov tshuaj psychotropic thiab steroids;
- mob ntshav qab zib;
- lub plawv thiab lub raum tsis ua haujlwm.
Tseem muaj lwm yam laj thawj, xws li kev siv cov koob txhaj tshuaj tsis kho, kho catheters.
Yuav ua li cas yog cov paib
Ntawm cov tsos mob tseem ceeb ntawm kev mob ntawm cov pob txha pob txha ntawm tus txha nraub qaum, nws yog ib qho tsim nyog yuav tsum tau ua kom pom tseeb xws linyiam:
- pob txha;
- ua daus no thiab ua npaws;
- o ntawm thaj chaw cuam tshuam;
- kev ua haujlwm tsis zoo ntawm tus ceg ceg;
- fistula tsim;
Qee zaum, tus kab mob no yuav luag asymptomatic. Nrhiav kev kho mob yog tias koj mob pob txha thiab kub taub hau. Daim ntawv mob osteomyelitis ib txwm tshwm sim tom qab tus txheej txheem mob. Lub pathological kab noj hniav yog tsim nyob rau hauv cov pob txha. Nws muaj cov khoom ntawm cov ntaub so ntswg tuag thiab cov kua dej purulent, uas tau tso tawm ib ntus los ntawm fistulas ntawm daim tawv nqaij.
Cov kab mob no yog undulating, maj mam kaw lub fistulas yog hloov los ntawm lub sij hawm tshiab ntawm exacerbation thiab kua paug tawm. Thaum lub sij hawm mob hnyav zuj zus, ib tug neeg txoj kev noj qab haus huv sai sai. Qhov kub poob qis, thiab qhov mob maj mam ploj mus. Tib lub sijhawm, cov ntshav suav tau nce mus txog qhov qub. Thaum lub sij hawm no, cov sequesters tshiab pib maj mam sau rau hauv cov pob txha tshuaj, uas nws thiaj li pib tsis lees paub thiab provoke ib tug exacerbation. Lub sijhawm ntawm kev zam txim tuaj yeem mus txog ntau xyoo.
Cov tsos mob ntawm kev rov qab los ntawm ntau txoj hauv kev zoo ib yam li kev mob osteomyelitis. Hauv qhov no, mob hnyav thiab mob tshwm sim, phlegmon tsim.
Thaum cov pob txha pob txha ntawm lub femur ua rau mob, ib qho kab noj hniav ib ncig ntawm cov pob txha. Lub abscess muaj cov kua paug. Tus kab mob yog sluggish, thiab tsis muaj cov cim tshwj xeeb ntawm cov txheej txheem inflammatory. Nrog ib tug exacerbationmuaj mob hnyav rau ntawm txhais ceg, tshwj xeeb tshaj yog thaum hmo ntuj. Hauv qhov no, fistulas tsis tsim.
Sclerosing osteomyelitis yog nrog los ntawm kev nce hauv pob txha ceev, nrog rau txheej txheej ntawm periosteum. Cov pob txha thickens thiab ua zoo li ib tug spindle. Daim ntawv no ntawm pathology yog qhov nyuaj rau kho.
Nyob rau hauv mob pob txha mob, cov tsos mob tau hais heev. Ib qho teeb meem zoo sib xws feem ntau pom hauv cov tub. Hauv qhov no, phlegmonous o yog tsim.
Daim ntawv tshuaj lom ntawm tus kab mob pib yuav luag ntawm xob laim thiab tuaj yeem ua rau tus neeg mob tuag. Tus kab mob pib tam sim ntawd. Nyob rau hauv cov ntaub ntawv no, muaj ib tug muaj zog bursting thiab ib tug ntse mob nyob rau hauv lub caj dab, feem ntau nyob ze ntawm lub xub pwg nyom, lub hauv caug los yog lub luj tshib. Mob thiab tsis xis nyob yog hnyav heev los ntawm kev txav mus los. Qhov kub nce me ntsis.
Paleness ntawm daim tawv nqaij, lethargy, ua pa ceev thiab mem tes, tsaug zog tau sau tseg. Nyob rau ntawm qhov chaw mob yog o thiab liab ntawm daim tawv nqaij. X-ray hloov pauv tau pom tsuas yog 2 lub lis piam tom qab pib tus kab mob.
Diagnostics
Yog tias muaj cov tsos mob ntawm qhov mob ntawm pob txha pob txha ntawm pob txha pob txha los yog txha nraub qaum, koj yuav tsum sab laj nrog kws kho mob uas yuav ua qhov kev ntsuam xyuas dav dav thiab tshuaj kho. Thaum pib, tus kws kho mob tshuaj xyuas qhov chaw nyob ze ntawm cov pob txha raug mob los txiav txim seb muaj qhov o, mob, thiab liab ntawm cov ntaub so ntswg. Kev sojntsuam tsis tseeb yog siv los tshuaj xyuas fistulas.
Ntawm cov cim qhia txog kev xauo tuaj yeem ua tau thaum kuaj hauv chav kuaj, cov txiaj ntsig ntawm qhov yuav pom qhov nce hauv ESR thiab cov leukocytes. Ntshav thiab tso tawm los ntawm fistulas yuav raug kuaj xyuas microbiological kom paub meej txog hom kab mob thiab xaiv cov tshuaj tua kab mob.
X-ray yog siv los txheeb xyuas qhov chaw necrotic ntawm pob txha. Fistulography implies qhov kev taw qhia ntawm ib yam khoom tshwj xeeb rau hauv fistulous nqe lus, thiab tom qab ntawd kev tshawb fawb ntawm sab hauv ntawm lub fistula yog nqa tawm. Nws yuav tsum tau muab sau tseg tias nyob rau hauv thawj theem ntawm tus kab mob, kev kuaj X-ray yog tsis paub txaus.
Tomography suav nrog kev ua x-rays los ntawm ntau txoj haujlwm. Thaum ua lawv txoj kev tsom xam, ib daim duab peb sab ntawm cov pob txha cuam tshuam yog tsim. Qhov no yog txoj kev nyab xeeb ntawm kev tshawb fawb, uas tso cai rau koj rov tsim cov duab ntawm ib puag ncig cov ntaub so ntswg kom ntau li ntau tau.
Ib pob txha biopsy raug txiav txim kom paub meej qhov kev kuaj mob. Nws tau ua thaum lub sijhawm ua haujlwm nyob rau hauv cov tshuaj loog. Hauv qhov no, tus kws phais mob ua tib zoo txiav cov ntaub so ntswg thiab siv ib daim ntawm cov khoom kuaj. Qhov no tso cai rau koj los txiav txim seb hom kab mob. Qee qhov xwm txheej, kev kuaj ntshav biopsy yog ua nrog nyias, ntev koob nyob rau hauv cov tshuaj loog hauv zos. Tag nrho cov txheej txheem yog tswj los ntawm radiography.
Txoj kev kho mob
Thaum mob mob ntawm pob txha pob txha ntawm femur lossis txha nraub qaum, yuav tsum tau pw hauv tsev kho mob. Kev kho mobua nrog kev pab ntawm kev phais thiab kev siv tshuaj. Kev ua haujlwm suav nrog kev ua lub qhov hauv cov pob txha, ntxuav thiab tom qab tso dej ntawm cov kab noj hniav. Nrog rau cov chav kawm tshwj xeeb ntawm cov kab mob pathology, cov chaw purulent uas twb muaj lawm hauv cov leeg tau qhib, thiab cov pob txha trepanation tau ua.
Tom qab cov kab noj hniav tau ntxuav tag nrho cov kua paug, cov tshuaj tua kab mob tau nkag rau hauv nws los ntawm catheters. Kev kho mob ntawm pob txha pob txha ntawm tus txha nraub qaum suav nrog:
- koob tshuaj tua kab mob siab;
- detoxification;
- txhawb kev kho cov ntaub so ntswg;
- Y tiv thaiv kab mob thiab cov vitamins.
Yog tias tus kab mob no tau tshwm sim los ntawm staphylococcus, ces siv cov txheej txheem immunotherapy tshwj xeeb. Qhov yuav tsum tau ua ua ntej yog immobilization ntawm limb nrog ib tug splint. Tom qab qhov mob hnyav zuj zus lawm, physiotherapy raug muab tshuaj, tshwj xeeb, xws li cov hlau nplaum, UHF thiab ntau lwm tus.
Nyob rau hauv cov txheej txheem ntawm cov kab mob ntev, kev kho mob ntawm cov pob txha pob txha txhais tau hais tias kev ua haujlwm. Tib lub sijhawm, fistulas raug tshem tawm thiab cov pob txha kab noj hniav raug ntxuav.
Drug therapy
Vim qhov mob ntawm pob txha pob txha ntawm lub hauv caug pob qij txha thiab txha nraub qaum yog provoked los ntawm cov kab mob, kev kho tshuaj tua kab mob tau pom zoo. Txawm li cas los xij, nws tsim nyog nco ntsoov tias tsis yog txhua hom kab mob kis tau zoo rau hom kev kho mob no. Cov tshuaj raug xaiv los ntawm kev tshawb fawb hauv chav kuaj. Hauv qhov no, nws yog ib qho tsim nyog los txiav txim siab qhov txiaj ntsig ntawm cov tshuaj tua kab mob tshwj xeebcov kab mob yog cov raug mob tshaj plaws. Cov tshuaj yog txhaj ncaj qha rau hauv cov pob txha kab noj hniav.
Nyob rau hauv cov ntaub ntawv ntawm intoxication ntawm lub cev hnyav, kev siv cov droppers nrog saline yog qhia. Qhov no tso cai rau koj tshem tawm cov tshuaj lom ntau ntau ntawm lub cev. Cov txheej txheem no tseem ceeb tshwj xeeb yog tias muaj kab mob sepsis. Tsis tas li ntawd, saline pab lub cev tiv thaiv kab mob.
Ntxiv rau, cov tshuaj immunostimulants thiab probiotics raug sau tseg, vim tias siv cov tshuaj tua kab mob ntev ntev, cov hnyuv microflora raug rhuav tshem, uas ua rau txo qis hauv lub cev tiv thaiv. Xav tias thaum lub sij hawm xws li ib tug pathology, cov ntaub so ntswg mos kuj raug cuam tshuam, cov tshuaj hauv zos yog muab rau ib tug neeg, tshwj xeeb tshaj yog cov gels thiab tshuaj pleev. Kev kho mob ntawm daim tawv nqaij yog ua txhua hnub.
Kev ua haujlwm
Thaum mob pob txha liab, kev ua haujlwm tau qhia, vim tias qhov xwm txheej no tuaj yeem ua rau muaj kev phom sij heev. Tsis tas li ntawd, muaj lwm yam qhia txog kev cuam tshuam, xws li:
- cov txheej txheem purulent inflammatory;
- fistula;
- kab mob chronic.
Kev cuam tshuam kev phais yuav qhib lub periosteum, vim qhov no yuav tso cai rau koj mus rau qhov chaw ntawm purulent o. Thaum xub thawj, qhov chaw cuam tshuam yog kho nrog tshuaj tua kab mob, ua kom cov nqaij mos incision. Ib feem ntawm periosteum raug tshem tawm, qhib sab hauv kwj dej yog ntxuav nrogtshuaj tua kab mob.
Muaj Teeb Meem
Nws yog ib qho tseem ceeb heev kom paub txog kev phom sij ntawm cov pob txha pob txha thiab yuav ua li cas tiv thaiv cov teeb meem. Qhov tshwm sim tuaj yeem yog hauv zos thiab dav. Cov teeb meem hauv zos yuav tsum muaj xws li:
- phlegmon thiab abscess;
- spontaneous fractures;
- mob caj dab purulent;
- poob kev sib koom ua ke.
Cov teeb meem dav dav suav nrog ntshav qab zib theem nrab, sepsis thiab kab mob autoimmune.
Kev tiv thaiv kev tiv thaiv
kev tiv thaiv osteomyelitis tseem ceeb heev, uas txhais tau tias:
- zoo pw thiab so;
- noj qab nyob zoo;
- no stress;
- khoom noj muaj txiaj ntsig;
- kev tiv thaiv kab mob;
- kho mob raws sijhawm.
Yog tias koj hnov qhov kev puas tsuaj me ntsis, nws raug nquahu kom mus ntsib kws kho mob tam sim, vim qhov no yuav tiv thaiv qhov tshwm sim ntawm qhov mob thiab teeb meem ntawm cov kab mob no.
