SON SUYAGI SINISHLARINI ANIQLASH, DAVOLASH VA QAYTA JAROHATLANISHNING OLDINI OLISHDA ZAMONAVIY YONDASHUVLAR
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Son suyagi sinishi, tashxis, jarrohlik davolash, reabilitatsiya, tromboemboliyani oldini olish, bifosfonatlar, yiqilishning oldini olish##article.abstract##
Kirish. Son suyagining sinishi ortopedik travmatologiyada jiddiy muammo bo‘lib, ayniqsa, yoshi katta bemorlar orasida yuqori kasallanish va o‘lim darajasi bilan ajralib turadi. Ayollar bu jarohatning taxminan 80% ini tashkil etadi, va o‘rtacha bemor yoshi 80 yoshga teng. Asosiy xavf omillari orasida yiqilish, suyak mineral zichligining pasayishi, jismoniy faollikning kamayishi va uzoq muddatli dori vositalarini qo‘llash kiradi.
Usullar. Son suyagi sinishining klinik tekshiruvi odatda chanoq sohasida og‘riq va shikastlangan oyoqqa tayanishning imkoni yo‘qligi bilan namoyon bo‘ladi. Siljigan sinishlarda tashqi rotatsiya, abduksiya va oyoqning qisqarishi kuzatiladi. Diagnostikaning asosiy usuli rentgenografiya bo‘lib, chanoqning old-orqa (AP) va son suyagining lateral proektsiyadagi tasvirlari olinadi. Agar rentgenografik natijalar normal bo‘lsa, ammo yashirin sinishdan shubha qilinsa, magnit-rezonans tomografiya (MRT) tavsiya etiladi.
Natijalar. Ko‘pgina son suyak sinishlari jarrohlik yo‘li bilan davolanadi, operatsiya usuli esa ortoped jarroh tomonidan tanlanadi. Eng keng tarqalgan jarrohlik yondashuvlari osteosintez va son bo‘g‘imini protezlashdir. Infeksion asoratlarning oldini olish maqsadida operatsiyadan oldin Staphylococcus aureus ga qarshi antibiotiklar qo‘llaniladi. Shu bilan birga, venoz tromboemboliyaning oldini olish uchun, ayniqsa, past molekulyar og‘irlikdagi geparinlardan foydalanish tavsiya etiladi.
Xulosa. Son suyak sinishlari sog‘liq uchun jiddiy muammo bo‘lib, tezkor tashxis va kompleks davolash yondashuvini talab qiladi. Jarrohlik davolash, profilaktik choralar, tizimli reabilitatsiya va yiqilishlarning oldini olish bo‘yicha chora-tadbirlarni o‘z ichiga olgan kompleks yondashuv bemorlarning hayot sifatini yaxshilash va o‘lim darajasini pasaytirishda muhim ahamiyat kasb etadi.
Библиографические ссылки
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Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
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Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Kammerlander C, Gosch M, Blauth M, et al. The effects of comorbidities on outcomes in patients with hip fractures. Eur J Trauma Emerg Surg. 2017;43(3):349-357.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
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Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
