Osteomyelitis nyob rau hauv cov me nyuam: ib tug piav qhia ntawm qhov ua rau, cov tsos mob thiab kev kho mob nta

Nyob rau hauv xyoo tsis ntev los, feem ntau nyob rau hauv cov me nyuam pib kuaj tau tus kab mob, xws li osteomyelitis. Qhov no necrotic txheej txheem ntawm ib tug kab xwm uas tsim nyob rau hauv cov pob txha, cov uas lwm tus nqaij mos mos, hlwb pob txha. Ua no pathology kab mob uas tsim kua paug. Yog hais tias tus kab mob no yuav ua mob, ces qhov uas yuav muaj cov pob txha deformation unformed tus me nyuam lub cev pob txha.

Osteomyelitis nyob rau hauv cov me nyuam feem ntau muaj feem xyuam rau lub sab ceg, hip, puab tsaig pob qij txha, humerus, vertebra. Yuav kom tiv thaiv tau tus me nyuam los ntawm kev phiv txim ntawm tus kab mob no yuav tsum tau tag rau cov yam tseem ceeb uas ua rau no pathology.

ua rau

Tus kab mob ntau susceptible mus rau cov tub hluas tshaj cov ntxhais. Qhov no yog vim lub fact tias lawv yog cov ntau ntau mobile. Tsis tas li ntawd, odontogenic osteomyelitis nyob rau hauv cov me nyuam kuj muaj nyob feem ntau nyob rau hauv caug, txij li thaum qhov ua rau ntawm nws kev raug mob yog skeletal lub puab tsaig uas yuav npaj nyob rau hauv sib ntaus los yog ntog.

Heev feem ntau, qhov ua rau ntawm tus kab mob nyob rau hauv cov me nyuam muaj xws li twb purulent kab mob zoo li impetigo, otitis media, pyelonephritis, boils, kub nyhiab, cov qhov txhab. Tsis tas li ntawd ua rau txoj kev loj hlob ntawm osteomyelitis paug, hniav caries, purulent tonsillitis, tonsillitis.

Thaum penetrated lub cev ntawm puas daim tawv nqaij, mucosa los yog lymphoid pharyngeal nplhaib, tus kab mob no pib mus rau propagate los ntawm cov circulatory system. Feem ntau cov feem ntau, tus neeg saib xyuas yog suav tias yog osteomyelitis Staphylococcus aureus cov kab mob, uas yog muaj nyob rau hauv 80% ntawm cov neeg. Qhov seem 20% ntawm cov neeg mob nrog pathology ntawm tus kab mob Streptococcus, E. coli, tus kab mob salmonella, Bacillus Pfeiffer. Nyob rau hauv cov me nyuam mos lub cev kab mob nkag mus rau los ntawm txoj hlab qhov txhab.

Tsis nyob rau hauv tag nrho cov mob, cov pob txha yog ib tug hotbed ntawm o. Kis tau nws kab mob tau los ntawm cov uas lwm tus kabmob los yog tej nqaij mos. Nws yog ua tau, thiab qhov rov qab qhov teeb meem no, thaum yus thawj zaug muaj hlwb pob txha koom tes, thiab xwb ces - ib ncig cov ntaub so ntswg.

cov tsos mob

Qhov no pathology yuav manifest nws tus kheej nyob rau hauv ntau txoj kev nyob ntawm tus me nyuam lub hnub nyoog, lub cev thiab pob txha ntawm lub cheeb tsam cov. Nyob rau hauv cov me nyuam mos thiab cov me nyuam ib tug me ntsis loj tshaj tus kab mob no muaj feem xyuam rau lawv tag nrho noj qab haus huv. Tus me nyuam yuav sluggish, nws muaj ib tug tshee nyob tsis tswm, tsis qab los noj mov, ua npaws kub heev, zoo nkaus li daj ntseg. Feem ntau pathological mob yog nrog los ntawm raws plab thiab ntuav.

Yog hais tias koj saib tus me nyuam, peb yuav pom tias nws pib mus saib xyuas lawv cov hoob kawm, tsis txhob kov nws los yog tsiv mus nyob nws. Cov tawv nqaij ntawm lub cov kev sib koom yog feem ntau reddened. Ob peb hnub tom qab ntawd, lossis puas liab liab thiab o pib nce. Yog hais tias koj cia li tsis txhob pib kev kho mob, yuav muaj purulent metastases thoob plaws hauv lub cev.

Mob hematogenous osteomyelitis nyob rau hauv cov me nyuam laus manifested nyob rau hauv ib tug ntau pronounced daim ntawv. inflammatory kev loj hlob yog npaum li cas qeeb qeeb, thiab liab thiab o pib tshwm tsuas ib lub lim tiam tom qab qhov pib ntawm tus kab mob. Yog hais tias lub sij hawm tsis pib kho mob, tej zaum yuav muaj intra-npag rwj, uas txhais tau hais tias yog ib tug gradual kis mob rau cov uas lwm tus nqaij mos. Nyob rau hauv cov ntaub ntawv no, phais yog inevitable. Thaum intermuscular phlegmon txoj kev txhim kho nyob rau hauv tus me nyuam tus mob yuav tsum tau cai thaum xub thawj, tab sis nws yog yuam kev lawm. Osteomyelitis nyob rau hauv cov me nyuam muaj peev xwm ua rau mob xws li suppurative mob caj dab thiab sepsis.

Cov mob hauv daim ntawv ntawm tus kab mob nyob rau hauv cov me nyuam tom qab ib tug thaum yuav mob, hla ntawm uas cov kev kho mob ua rau yus tuag. Nws yog yog li ntawd ib qho tseem ceeb rau kev tshawb nrhiav no pathology thiab pib nws kev kho mob.

Nta odontogenic osteomyelitis

Qhov no hom ntawm pathology nws muaj nws tus yam ntxwv. Pos hniav thiab canals pib paug, thiab nqaij mos o lub ntsej muag. Ntawm daim tawv nqaij thiab txheej membrane daj thiab qhuav, kub taub hau, ua daus no, thiab yog ib tug general tsis muaj zog. Nyob rau hauv cov me nyuam yaus cim tu-sauv, ntuav, kem plab. Qhov no qhia tau hais tias lub hauv paus poob siab system pib tau khaus li tsim ib tug muaj zog intoxication. Odontogenic osteomyelitis ntawm lub puab tsaig nyob rau hauv cov me nyuam yog protracted.

Tshwj xeeb tshaj yog cov mob daim ntawv

Qhov no daim ntawv ntawm tus kab mob yog thawj los sis theem nrab. Cov yav tas yog yus muaj los ntawm remissions thiab exacerbations, alternating nruab nrab ntawm lawv. Thaum lub sij hawm txoj kev zam txim tus me nyuam tsis muaj teeb meem dab tsi tsis txaus siab, tab sis thaum pib lub aggravation, lub nce nyob rau kub yog cai, muaj mob rau palpation. Tej zaum qhov qhib ntawm lub fistula nrog lub tsim ntawm kua paug. Cov sij hawm yuav kav rau xyoo, yog hais tias qhov muaj feem xyuam rau lub ob lub raum, lub siab thiab lub plawv.

Mob osteomyelitis nyob rau hauv cov me nyuam ntawm thawj hom tshwm sim tsis muaj mob theem thiab pib ntawm tus kab mob cov tsos mob yog zim zuag. Me ntsis mob tsis muaj leej localization. Feem ntau cov feem ntau, cov niam txiv coj lawv cov me nyuam mus rau lub tsev kho mob tsuas yog thaum muaj yog nce mob los yog mob loj tshwm sim.

diagnostics

Nws yog ib qho tseem ceeb kom raug kuaj tus kab mob no, vim nws yog lawv cov tsos mob ntseeg tau tsa rheumatic fever, purulent mob caj dab, Ewing lub sarcoma.

Thaum lub heev thaum pib ntawm kev loj hlob ntawm cov pob txha osteomyelitis nyob rau hauv cov me nyuam muaj cov tsos mob uas yuav ua rau ib tug kws kho mob los xav tias tsim ntawm phem kab mob. Tsuas yog tus tseeb mob tswj competent kho mob, uas saib kuas muaj kev vam meej outlook.

kev kho mob ntawm tus kab mob no

Yog hais tias muaj yog xws li ib tug pathology, raws li osteomyelitis (cov me nyuam), kev kho mob yuav tsum muab qhov chaw nrog kev koom tes ntawm cov hoomaum, radiologist, thiab lwm yam tshwj xeeb. Feem ntau cov feem ntau muab tshuaj tua kab mob rau lub hom phiaj no thiab nqa tawm lub lag luam.

Tshuaj tua kab mob yuav tsum tau siv raws li sai li sai tau. Ua ntej, ib tug loading koob tshuaj ntawm cov tshuaj cia tus me nyuam kom txhob rau mob. Feem ntau cov feem ntau cov hom phiaj muab tshuaj penicillin pab pawg neeg. Yuav tsum siv sij hawm tshuaj tua kab mob rau ib tug ntev lub sij hawm, tej zaum cov kev kho mob muaj peev xwm kav rau peb lub hlis. Cov koob tshuaj yuav tsum raug txo maj. Nyob rau tib lub sij hawm tus me nyuam yuav tsum tau muab cov tshuaj rau qhov ncauj tawm vim hais tias tshuaj tua kab mob tua tau cov microflora. Tej zaum nws yuav tsum tau phais kev cuam tshuam. Nyob rau hauv cov ntaub ntawv no autopsied rwj kua paug muab tshem tawm thiab ntxuav channel. Qhov phais yog ua sai sai siv ib lub zos ua kom loog. Tej zaum cov kws kho mob muab ib tug ntws rau tshem tawm cov kua.

Lub ntsiab kev kho mob rau osteomyelitis odontogenic - phais, uas yuav qhov kev tshem tawm ntawm tus hniav, uas yog lub hauv paus ntawm kab mob. Nyob rau hauv ua kom tsaug zog subperiosteal phais khoom ua paug. Cov kab lis kev cai yog nqa tawm los mus txiav txim qhov rhiab heev ntawm kab ntawd los tshuaj tua kab mob. Thaum lub sij hawm kev phais, lub qhov txhab yog drained, ces taw detoxication txoj kev kho, antihistamines, tshuaj tua kab mob, calcium pab, vitamins, thiab nonspecific immunomodulating agents. Tus me nyuam yuav tsum muab rau haus kom ntau li ntau dej thiab pub nws nroj tsuag thiab mis nyuj cov khoom noj.

teeb meem

Osteomyelitis nyob rau hauv cov me nyuam muaj peev xwm ua rau ntau yam teeb meem. Nws yuav ua tau:

• pob txha tsis xws luag;
• mob caj dab povtseg;
• raws li ib tug tshwm sim ntawm pinching ntawm cov leeg nrob qaum raug mob licas;
• yog hais tias tus kab mob ntaus lub duav ob leeg los yog cov me nyuam tus taw, nyob rau hauv heev zaum muaj tiav immobilization;
• muaj yog tsis khov nyob rau hauv cov pob qij txha;
• impaired cov pob txha loj hlob;
• Nws pib tsim theem nrab mob osteomyelitis, uas tom qab ua rau yus disturbance ntawm hwj tau lub cev;
• muaj yog ib tug puas dislocation;
• osteomyelitis ntawm lub puab tsaig, uas yog feem ntau kuaj nyob rau hauv cov tub hluas, ua rau cov tsim ntawm meningitis, entailing hloov nyob rau hauv lub cev.

xaus

Txawm tias muaj tseeb hais tias osteomyelitis nyob rau hauv cov me nyuam yog heev loj teeb meem, niaj hnub cov tshuaj yuav ntse kho no txaus ntshai tus kab mob, kom ntseeg tau lub feem ntau dej siab raug. Raws li statistics, cov neeg tuag los ntawm tau txais me me txhua txhua xyoo. Cov niam txiv yuav tsum tau them ntau xim rau kev kho mob ntawm lawv cov me nyuam, saib mus rau nws hais tias tsis tau txais ib tug mob nyob rau hauv kev raug mob thiab wounds, thiab kom sai nrhiav kev kho mob.