Kuwombera thupi kwa anthu omwe ali ndi chiwopsezo ndio pangozi yayikulu ya kuphulika kwa magazi ndi kufooketsa mafupa
Matenda a mitsempha pambuyo pa kuika ziwalo ndizovuta kwambiri kuika anthu odwala kuposa momwe odwala ambiri amazindikira. Komabe, ndi chinthu chomwe chiyenera kumveka, makamaka musanayambe kugwiritsira ntchito ziwalo zothandizira thupi, kuti zitha kuchitidwa. Pang'ono kwambiri, matenda a mafupa m'mabvuto otere angayambitse kupweteka kwa pfupa, koma panthawi zovuta kwambiri zingayambitse mafupa.
Mwachiwonekere, izi zidzakhudza kwambiri moyo wa wodwala, ndipo zikhoza kuonjezera ngozi ya imfa.
Kodi Ndi Zinthu Ziti Zomwe Zimapangidwira Kuopsa Kwambiri kwa Matenda a Matenda?
Ngakhale kuti impso 'zimagwiritsidwa ntchito m'mafupa, si odwala omwe ali ndi impso kulephera (omwe amalandira impso) omwe ali pangozi yaikulu ya matenda a mafupa ndi fractures. Ambiri opatsirana opaleshoni (kuphatikizapo opatsirana a impso, mtima, mapapo, chiwindi, ndi mafupa a mafupa) akhoza kukhala ndi mavuto monga kuphwanya, kupweteka kwa mafupa, kufooketsa mafupa, ndi zina zotero. Komabe, zoopsa zingakhale zosiyana malinga ndi limba lomwe likukhudzidwa. Mwachitsanzo, kuchuluka kwa zophulika m'magazi opatsirana impso kungakhale paliponse kuyambira 6 peresenti mpaka 45 peresenti, posiyana ndi 22 mpaka 42 peresenti kwa ovomerezeka a kusintha mtima, mapapo, kapena chiwindi.
Kodi Kuopsa Kwambiri kwa Matenda a Matenda Kumatha Kutani?
Monga tafotokozera pamwambapa, chiwerengerocho chidzakhala chosiyana ndi limbalo.
Phunziro lapamtima la odwala 86 omwe analandira impso zokhudzana ndi impso, anapeza kuti odwalawo anawonjezeka katatu pangozi ya fractures m'zaka 10 zoyambirira atalandira impso, mosiyana ndi munthu wamba. Ngakhale patatha zaka khumi zotsatila, chiopsezocho chinali chikhalirebe. Izi zikusonyeza kuti chiopsezo chowonjezereka chikupitirirabe nthawi yayitali pambuyo pakupatsirana kwa impso.
Komabe, fractures ndi chitsanzo chimodzi chokha cha matenda a mafupa atatha kuika thupi. Osteoporosis ndizofala. Timawona izi pa mitundu yosiyanasiyana ya ziwalo zogonana ndi impso zosiyanasiyana (88 peresenti), mtima (20 peresenti), chiwindi (37 peresenti), mapapo (73 peresenti), ndi fupa (29 peresenti ya obwezeretsa).
Kodi Zimatenga Nthawi Yotani Kuti Pakhale Matenda a Pambuyo Pambuyo?
Chinthu chodabwitsa kwambiri pokhudzana ndi kutulutsa mafupa ndi momwe odwala amachitira pang'onopang'ono mafupa awo. Kuwongolera, impso, mtima, ndi chiwindikiro cha chiwindi amatha kuperewera kwa 4 mpaka 10 peresenti ya mitsempha yawo ya mafupa (BMD) mkati mwa miyezi 6 kapena 12 yoyamba kutuluka thupi. Kuti mumvetse bwino izi, yerekezerani nambalayi ndi kuchuluka kwa fupa la mnofu m'modzi mwa amayi omwe amatha kutuluka m'mimba mwa osteoporotic, omwe amangokhala 1 mpaka 2 peresenti pachaka!
Nchiyani Chimachititsa Kuwonongeka kwa Thupi ndi Mafupa mwa Anthu Amene Amalandira Zopangira Zamagulu?
Poyang'ana pazifukwa zosavuta kumva, kuperewera kwa mafupa kwa anthu omwe amalandira ziwalo zimachokera ku zinthu zomwe zimakhalapo kusanayambe kuikidwa , komanso kuperewera kwa mafupa kumene kumachitika pambuyo poika thupi .
Zowonjezera zomwe zimapangitsa kuti mafupa awonongeke omwe amagwiritsidwa ntchito kwa munthu wokongola, mwachiwonekere ndi ofunikira apa.
Izi zikuphatikizapo:
- Kulephera kwa Vitamini D
- Kusuta
- Matenda a shuga
- Ukalamba
Koma, tiyeni tione zina mwazidzidzidzi zomwe zimayambitsa ziwalo zogonjera ziwalo zomwe zikuphatikizapo:
Chotsani-konzekera Zowopsa
Zinthu zoopsa kwa odwala omwe ali ndi matenda a impso ndi awa:
- Kulephera kwa Vitamini D
- Kugwiritsidwa ntchito mobwerezabwereza kwa steroids ( zomwe zimayambitsa mafupa ), monga chithandizo cha matenda osiyanasiyana a impso
- Mankhwala a asidi akulu m'magazi, otchedwa acidosis acidosis
- Maseŵera apamwamba a hormone yonyansa m'magazi (yotchedwa secondary hyperparathyroidism ), yomwe imayambitsa kuphulika kwa kashiamu kumathambo
Zowopsa kwa odwala omwe ali ndi matenda a chiwindi ndi awa:
- Kuperewera kwa zakudya m'thupi, kawirikawiri kumawoneka odwala matenda a chiwindi
- Cholestasis
- Matenda a testosterone otsika kapena hypogonadism
Zowopsa kwa odwala omwe ali ndi matenda a mapapo ndi awa:
- Kugwiritsidwa ntchito mobwerezabwereza kwa steroid, kuchiza matenda a m'mapapo, monga COPD kapena mphumu
- Kusuta, chiopsezo chachikulu cha matenda a mitsempha ndi mafupa
- Mankhwala a asidi apamwamba, chifukwa cha carbon dioxide kusungira magazi
Zowopsa kwa odwala omwe ali ndi matenda a mtima ndi awa:
- Kugwiritsidwa ntchito mobwerezabwereza kwa mapiritsi a madzi, kapena diuretics, zomwe zingachititse kuti calcium iwonongeke. Zitsanzo monga mankhwala monga furosemide ndi torsemide.
- Ntchito yochepetsetsa yochepetsedwa, yomwe imakhala yofala kwa odwala ali ndi matenda a mtima
Zomwe zimachitika posachedwa
Zomwe zimayambitsa matenda omwe amachititsa kuti mnofu usaphonye nthawi zambiri amatha kupitirira mpaka atapangidwanso. Komabe, zifukwa zatsopano zowonjezera zimayambira pamene wodwalayo ali ndi ziwalo zothandizira amalandira thupi latsopano. Zinthu izi zikuphatikizapo:
- Kugwiritsira ntchito Steroid : Odwala atalandira kulumikizidwa kwa thupi, amafunika mankhwala kuti ateteze chitetezo chawo cha mthupi kuchokera ku "kukana" chiwalo chatsopanocho. Steroids imakhala imodzi mwa mankhwalawa. Tsoka ilo, ma steroid amachepetsa mafupa atsopano opanga mapuloteni mwa kuletsa mtundu wina wa mafupa otchedwa "osteoblast." Amathandizanso kuwonongeka kwa mafupa pogwiritsa ntchito mtundu wina wa selo lotchedwa "osteoclast." Mwa kuyankhula kwina, pamene muli pa steroid, mukuyatsa kandulo pamapeto onse awiri. Palinso njira zina zomwe ma steroid amakhudzidwa, omwe sali pambali pa nkhaniyi (chinachake chomwe chimatchulidwa kuti chinawonjezeredwa-malamulo a Receptor Activator ya Nuclear Factor kappa-B) yomwe imayambitsa mafupa.
- Calcineurin inhibitor amagwiritsa ntchito : Monga steroids, izi ndizozigawo zina zomwe zimagwiritsidwa ntchito popewera kukana thupi. Mankhwalawa ndi monga cyclosporine, tacrolimus, ndi zina zotero. Zingayambitse kupweteka kwa mafupa, koma kawirikawiri imathandizanso kuti impso zikhoze kutembenuza mavitamini D kuti azigwiritsa ntchito (zomwe ndi zofunika kuti mafupa apangidwe), chinachake chimatchedwa activation.
Kodi Mukudziwa Bwanji Matenda a Matenda a Matenda M'magulu Amene Amalandira Chomera Chomera?
Kuyeza kwa "golide" kuyesa kupezeka kwa matenda a mafupa kumalo omwe amapatsidwa ndi pfupa, zomwe zimaphatikizapo kumangiriza singano m'fupa, ndikuyang'ana pansi pa microscope kuti adziwe. Popeza odwala ambiri sali mafani akuluakulu omwe amamangiriza zingwe zazikulu m'mafupa awo, mayesero osagwiritsidwa ntchito amagwiritsidwa ntchito poyesa koyambirira. Ngakhale kuti DEXA yodziŵika bwino (yomwe imagwiritsidwa ntchito kufufuza mitsempha ya mafupa) ndiyeso yowonongeka kuti ayang'ane thanzi la mafupa ambiri, amatha kufotokozera kuti chiwopsezo cha fractures m'kugwiritsidwa ntchito kwa thupi sikunatsimikizidwe. Kuchokera pamwambo weniweni, mayeserowa adakalipo ndipo akulimbikitsidwa ndi bungwe lalikulu monga American Society of Transplantation ndi KDIGO.
Mayesero ena othandizira kapena othandizira amaphatikizapo mayesero opangira mafupa monga fupa la osteocalcin ndi mafupa a phosphate. Monga digiri ya DEXA, palibe mwa izi zomwe zaphunziridwa mwakukhoza kwawo kulongosola chiopsezo cha kupweteka pakupatsirana odwala.
Kuchiza Matenda a Matenda M'mitenda Yokonzekera Bungwe
Miyezo yambiri imagwiritsidwa ntchito kwa anthu ambiri, mofanana ndi momwe amachitira munthu wolandira. Izi zimaphatikizapo masewera olimbitsa thupi, kusuta fodya, kulangizira zakudya ndi calcium ndi vitamini D supplementation.
Miyeso yeniyeni yowunikira pazifukwa zowonjezera zowonjezera kulandira ziwalo ndi kuphatikizapo:
- Kupewa steroids, ngati n'kotheka, ngati gawo la zakudya zolimbitsa thupi zomwe zimagwiritsidwa ntchito popewera kukana thupi. Komabe, izi ziyenera kuyeza kuwonjezera pa chiopsezo chowonjezeka cha kukanidwa kwa thupi.
- Gawo lofala la mankhwala omwe nthawi zambiri amalimbikitsidwa pa vuto ili ndi chinachake chotchedwa " bisphosphonates ," zomwe zimagwiritsidwa ntchito popewera ndi kuchiza kuperewera kwa mafupa a steroid pakati pa anthu ambiri. Ngakhale kuti kafukufuku wina wasonyeza mankhwalawa kukhala othandiza popewera ndi kuchiza pang'onopang'ono kubzala mafupa, palibe deta yomwe yatsimikizira kuti bisphosphonates ikhoza kuchepetsa chiopsezo cha ziphuphu zenizeni.
> Zosowa
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