{"id":39,"date":"2024-02-15T11:16:30","date_gmt":"2024-02-15T08:16:30","guid":{"rendered":"https:\/\/www.halukcabuk.com\/al\/?p=39"},"modified":"2024-09-23T12:57:19","modified_gmt":"2024-09-23T09:57:19","slug":"nekroza-avaskulare-e-te-pasmes","status":"publish","type":"post","link":"https:\/\/www.halukcabuk.com\/al\/nekroza-avaskulare-e-te-pasmes\/","title":{"rendered":"Nekroza Avaskulare E T\u00eb Pasm\u00ebs"},"content":{"rendered":"<h2>\u00c7far\u00eb \u00ebsht\u00eb Nekroza Avaskulare e Hips?<\/h2>\n<p><a href=\"https:\/\/www.halukcabuk.com\/al\/nekroza-avaskulare-e-te-pasmes\/\"><strong>Nekroza avaskulare<\/strong><\/a> \u00ebsht\u00eb nj\u00eb gjendje e shkaktuar nga bllokimet mikroskopike n\u00eb en\u00ebt e gjakut q\u00eb furnizojn\u00eb kock\u00ebn e hips n\u00eb pacient\u00ebt e rritur, duke \u00e7uar n\u00eb d\u00ebshtim t\u00eb furnizimit me gjak dhe krijimin e frakturave t\u00eb kolapsit. K\u00ebto fraktura kolapsi mund t\u00eb ndryshojn\u00eb form\u00ebn e nyj\u00ebs s\u00eb hips dhe t\u00eb rezultojn\u00eb n\u00eb humbje t\u00eb l\u00ebvizjes. Rreth 10% e t\u00eb rriturve q\u00eb n\u00ebnshkruajn\u00eb z\u00ebvend\u00ebsim total t\u00eb hips kan\u00eb nekroz\u00eb avaskulare si shkak t\u00eb themelore.<\/p>\n<h3>\u00c7far\u00eb jan\u00eb faktor\u00ebt e rrezikut p\u00ebr nekroz\u00ebn avaskulare?<\/h3>\n<p>Nd\u00ebrsa kjo gjendje shkakton kryesisht deformitete n\u00eb kock\u00eb, problemi themelor \u00ebsht\u00eb n\u00eb en\u00ebt e gjakut. \u00c7do gjendje q\u00eb mund t\u00eb shkaktoj\u00eb bllokim vaskular \u00ebsht\u00eb nj\u00eb faktor rreziku p\u00ebr nekroz\u00ebn avaskulare t\u00eb hips. K\u00ebto p\u00ebrfshijn\u00eb nj\u00eb diet\u00eb me yndyra t\u00eb larta, pirjen e duhanit, \u00e7rregullime t\u00eb gjakderdhjes dhe mpiksjes, si dhe s\u00ebmundje t\u00eb tilla si anemia e qelizave n\u00eb form\u00eb sickle. Disa pacient\u00eb mund t\u00eb zhvillojn\u00eb k\u00ebt\u00eb gjendje si rezultat i trajtimeve p\u00ebr shkak t\u00eb shkakut tjet\u00ebr, shpesh n\u00eb pacient\u00eb q\u00eb marrin terapis\u00eb me steroid (kortizon) p\u00ebr shkak t\u00eb s\u00ebmundjeve reumatizmale, leucemis\u00eb ose COVID-19. Kortizoni luan nj\u00eb rol t\u00eb r\u00ebnd\u00ebsish\u00ebm n\u00eb shkaktimin e mpiksjeve, q\u00eb mund t\u00eb bllokojn\u00eb en\u00ebt q\u00eb \u00e7ojn\u00eb n\u00eb hips.<\/p>\n<h3>Cilat jan\u00eb simptomat e nekroz\u00ebs avaskulare t\u00eb hips?<\/h3>\n<p>Pacient\u00ebt me nekroz\u00eb avaskulare t\u00eb hips zakonisht paraqiten me ankesat e dhimbjeve n\u00eb hips dhe inguinale q\u00eb rriten ngadal\u00eb. Me kalimin e dit\u00ebve, dhimbja n\u00eb hips rritet dhe shfaqen v\u00ebshtir\u00ebsi n\u00eb ecje dhe \u00e7alje. Nd\u00ebrsa stadiumi i s\u00ebmundjes p\u00ebrparon, ankesat rriten dhe l\u00ebvizshm\u00ebria e hips zvog\u00eblohet. Shum\u00eb pacient\u00eb fillimisht mund t\u00eb ken\u00eb nj\u00eb fillim nj\u00ebansh, por s\u00ebmundja prek mbi 90% t\u00eb dy hipsave. <iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/hPt6eB0YdVI?si=J2iHq7s140dTcI3Z\" width=\"100%\" height=\"550\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h3>Si konfirmohet diagnoza?<\/h3>\n<p>Diagnoza e nekroz\u00ebs avaskulare t\u00eb hips b\u00ebhet fillimisht me nj\u00eb rentgen t\u00eb hipsit n\u00eb pacient\u00ebt q\u00eb dyshohet se kan\u00eb k\u00ebt\u00eb s\u00ebmundje. Duke qen\u00eb se \u00ebsht\u00eb shum\u00eb e v\u00ebshtir\u00eb t\u00eb kapen s\u00ebmundjet n\u00eb faza shum\u00eb t\u00eb hershme, n\u00ebse dyshohet p\u00ebr s\u00ebmundjen, \u00ebsht\u00eb e nevojshme t\u00eb b\u00ebhet nj\u00eb skanim MR t\u00eb hipsit p\u00ebr t\u00eb konfirmuar diagnoz\u00ebn. Disa raste mund t\u00eb k\u00ebrkojn\u00eb teste t\u00eb tjera si tomografi dhe sintigrafi. Po ashtu, disa teste t\u00eb gjakut mund t\u00eb k\u00ebrkohen p\u00ebr t\u00eb vler\u00ebsuar faktor\u00ebt e rrezikut.<br \/>\nSakt\u00ebsia e MR n\u00eb diagnoz\u00eb \u00ebsht\u00eb shum\u00eb e lart\u00eb dhe pas MR-s\u00eb, trajtimi i pacient\u00ebve fillon n\u00eb p\u00ebrputhje me faz\u00ebn e s\u00ebmundjes.<\/p>\n<h3>Cila \u00ebsht\u00eb trajtimi?<\/h3>\n<p>Trajtimi i s\u00ebmundjes varet nga faza e saj. N\u00eb p\u00ebrgjith\u00ebsi, s\u00ebmundja ndahet n\u00eb 4 faza. Faza m\u00eb e r\u00ebnd\u00ebsishme jan\u00eb faza 1 dhe 2a, q\u00eb jan\u00eb periudha para shfaqjes s\u00eb frakturave t\u00eb kolapsit n\u00eb hips. N\u00eb k\u00ebt\u00eb periudh\u00eb, \u00ebsht\u00eb e nevojshme t\u00eb hiqet sa m\u00eb shpejt\u00eb pesha nga pacienti. Pra, pacienti duhet t\u00eb fitoj\u00eb nj\u00eb pal\u00eb shkopinj t\u00eb ndihm\u00ebs p\u00ebr t\u00eb reduktuar ngarkes\u00ebn mbi kockat e hipsit dhe p\u00ebr t\u00eb parandaluar fraktur\u00ebn e kolapsit.<br \/>\nN\u00eb k\u00ebto faza, mund t\u00eb kryhen nd\u00ebrhyrje p\u00ebr t\u00eb parandaluar fraktur\u00ebn e kolapsit dhe p\u00ebr t\u00eb rivendosur furnizimin me gjak n\u00eb kock\u00eb. Nj\u00eb nga procedurat m\u00eb themelore \u00ebsht\u00eb kompresioni i kore e hipsit, i cili p\u00ebrfshin hapjen e kanaleve n\u00eb brend\u00ebsi t\u00eb kock\u00ebs me ndihm\u00ebn e veglave speciale. Kjo ndihmon p\u00ebr t\u00eb reduktuar presionin brenda kock\u00ebs dhe p\u00ebr t\u00eb ndihmuar n\u00eb rikthimin e furnizimit me gjak, duke mund\u00ebsuar sh\u00ebrimin pa kolaps. P\u00ebrve\u00e7 k\u00ebsaj, aplikimi i qelizave staminale t\u00eb marr\u00eb nga palca e kock\u00ebs ose yndyra mund t\u00eb rris\u00eb k\u00ebt\u00eb sh\u00ebrim. Trajtimi me oksigjen hiperbarik \u00ebsht\u00eb gjithashtu nj\u00eb metod\u00eb e provuar.<\/p>\n<p>Kur s\u00ebmundja p\u00ebrparon dhe shfaqen fraktura, mund t\u00eb nevojiten nd\u00ebrhyrje m\u00eb t\u00eb m\u00ebdha. Metodat kirurgjikale q\u00eb p\u00ebrfshijn\u00eb vendosjen e en\u00ebve nga kocka e jashtme t\u00eb ky\u00e7it (fibula) ose pa en\u00eb n\u00eb brend\u00ebsi t\u00eb kock\u00ebs s\u00eb hipsit jan\u00eb trajtime q\u00eb mund t\u00eb aplikohen p\u00ebr pacient\u00ebt n\u00eb fazat e hershme t\u00eb kolapsit. N\u00eb pacient\u00ebt me faza shum\u00eb t\u00eb avancuara, ve\u00e7an\u00ebrisht n\u00eb rastet kur deformimi i nyj\u00ebs s\u00eb hipsit \u00ebsht\u00eb b\u00ebr\u00eb i qart\u00eb, shum\u00eb pacient\u00eb mund t\u00eb k\u00ebrkojn\u00eb z\u00ebvend\u00ebsimin total t\u00eb hipsit.<\/p>\n<p>P\u00ebrve\u00e7 trajtimeve kirurgjikale, mund t\u00eb p\u00ebrdoren ila\u00e7e q\u00eb parandalojn\u00eb shkat\u00ebrrimin e kockave, ila\u00e7e p\u00ebr uljen e kolesterolit p\u00ebr pacient\u00ebt me profilin e yndyr\u00ebs t\u00eb \u00e7rregullt, dhe disa ila\u00e7e antikoagulante p\u00ebr t\u00eb ndihmuar n\u00eb rritjen e furnizimit me gjak dhe n\u00eb parandalimin e kolapsit.<\/p>\n<h3>Si \u00ebsht\u00eb procesi i s\u00ebmundjes?<\/h3>\n<p>Edhe n\u00ebse s\u00ebmundja kapet n\u00eb nj\u00eb faz\u00eb shum\u00eb t\u00eb hershme, \u00ebsht\u00eb e v\u00ebshtir\u00eb t\u00eb parashikohet se si do t\u00eb zhvillohet. Megjith\u00ebse ka nj\u00eb metod\u00eb llogaritjeje nga imazhet MR, disa pacient\u00eb mund t\u00eb p\u00ebrgjigjen mir\u00eb ndaj trajtimeve, nd\u00ebrsa disa t\u00eb tjer\u00eb mund t\u00eb mos p\u00ebrgjigjen nj\u00eblloj. Sidomos, p\u00ebrgjigjja ndaj trajtimit \u00ebsht\u00eb shum\u00eb m\u00eb e ul\u00ebt n\u00eb pacient\u00ebt me nekroz\u00eb avaskulare t\u00eb shkaktuar nga p\u00ebrdorimi i steroid\u00ebve (kortizon).<br \/>\nN\u00eb procesin natyral t\u00eb s\u00ebmundjes, \u00ebsht\u00eb e r\u00ebnd\u00ebsishme t\u00eb ruhet integriteti i nyj\u00ebs s\u00eb hipsit. Pas imazheve fillestare MR, trajtimi fillon dhe pacient\u00ebt kontrollohen \u00e7do muaj me rentgen dhe, n\u00eb raste t\u00eb nevojshme, me MR p\u00ebr t\u00eb ndjekur zgjidhjen e edem\u00ebs kockore dhe rikthimin e furnizimit me gjak, q\u00eb mund t\u00eb zgjas\u00eb 3-6 muaj. N\u00eb rastet kur s\u00ebmundja p\u00ebrparon, vet\u00eb kufizimi i s\u00ebmundjes mund t\u00eb zgjas\u00eb m\u00eb shum\u00eb se nj\u00eb vit.<\/p>\n<h3>Rezultatet<\/h3>\n<p>Pacient\u00ebt e diagnostikuar me nekroz\u00eb avaskulare t\u00eb hipsit n\u00eb fazat e hershme, n\u00ebse trajtohen me metoda t\u00eb p\u00ebrshtatshme, mund t\u00eb sh\u00ebrohen pa fraktura t\u00eb kolapsit t\u00eb nyj\u00ebs. Nd\u00ebrsa p\u00ebr pacient\u00ebt me fraktura t\u00eb kolapsit, procesi varet nga deformimi q\u00eb \u00ebsht\u00eb krijuar. N\u00ebse deformimi \u00ebsht\u00eb i kufizuar dhe nuk kufizon l\u00ebvizjen e hipsit ose shkakton \u00e7alje, pacient\u00ebt ndjekin monitorim t\u00eb gjat\u00eb. N\u00ebse deformimi p\u00ebrparon shum\u00eb dhe shkakton kufizim t\u00eb l\u00ebvizjes s\u00eb nyj\u00ebs s\u00eb hipsit, pacient\u00ebt mund t\u00eb ken\u00eb nevoj\u00eb p\u00ebr operacion t\u00eb z\u00ebvend\u00ebsimit total t\u00eb hipsit.<\/p>\n<h2 class=\"subheader no-margin-top\">Pyetje dhe P\u00ebrgjigje<\/h2>\n<h3>Kam marr\u00eb trajtim me kortizon p\u00ebr s\u00ebmundjen reumatizmale. \u00c7far\u00eb duhet t\u00eb b\u00ebj p\u00ebr t\u00eb parandaluar nekroz\u00ebn avaskulare t\u00eb hipsit?<\/h3>\n<p>Nuk \u00ebsht\u00eb e sakt\u00eb t\u00eb flitet p\u00ebr nj\u00eb trajtim real mbrojt\u00ebs. Megjithat\u00eb, pacient\u00ebt e till\u00eb rekomandohet t\u00eb jen\u00eb n\u00ebn mbik\u00ebqyrje t\u00eb af\u00ebrt dhe t\u00eb marrin suplemente t\u00eb kalciumit dhe vitamin\u00ebs D q\u00eb mb\u00ebshtesin formimin e kockave.<\/p>\n<h3>Kam nekroz\u00eb avaskulare n\u00eb t\u00eb dy hipsat. Si duhet t\u00eb mobilizohem?<\/h3>\n<p>Kjo ndodh n\u00eb rreth 90% t\u00eb rasteve t\u00eb nekroz\u00ebs avaskulare t\u00eb hipsit. Pacient\u00ebt duhet t\u00eb p\u00ebrdorin dy shkopinj ndihm\u00ebs p\u00ebr t\u00eb reduktuar sa m\u00eb shum\u00eb ngarkes\u00ebn mbi hips dhe p\u00ebr t\u00eb minimizuar aktivitetet e p\u00ebrditshme.<\/p>\n<h3>Kam marr\u00eb diagnoz\u00ebn e nekroz\u00ebs avaskulare t\u00eb hipsit. A ka suplemente ushqimore q\u00eb mund t\u00eb ndihmojn\u00eb n\u00eb p\u00ebrmir\u00ebsimin e sh\u00ebrimit?<\/h3>\n<p>Ky \u00ebsht\u00eb nj\u00eb \u00e7\u00ebshtje shum\u00eb e diskutueshme. Kalciumi dhe vitaminat C dhe D zakonisht rekomandohen p\u00ebr shkak se luajn\u00eb nj\u00eb rol t\u00eb drejtp\u00ebrdrejt\u00eb n\u00eb formimin dhe shkat\u00ebrrimin e kockave. Megjithat\u00eb, nj\u00eb substanc\u00eb me t\u00eb dh\u00ebna shkencore si suplement \u00ebsht\u00eb Resveratroli, i cili gjendet n\u00eb farat e rrushit t\u00eb kuq. Edhe pse doza e sakt\u00eb nuk \u00ebsht\u00eb e njohur, rekomandohet t\u00eb konsumohet rreth 1 lug\u00eb \u00e7aji far\u00eb rrushi t\u00eb kuq n\u00eb dit\u00eb.<br \/>\nP\u00ebr informacion m\u00eb t\u00eb detajuar, mund t\u00eb vizitoni kanalin tim n\u00eb YouTube: <a href=\"https:\/\/www.youtube.com\/@profdrhalukcabuk\" target=\"_blank\" rel=\"noopener\"><strong>@profdrhalukcabuk<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00c7far\u00eb \u00ebsht\u00eb Nekroza Avaskulare e Hips? Nekroza avaskulare \u00ebsht\u00eb nj\u00eb gjendje e shkaktuar nga bllokimet mikroskopike n\u00eb en\u00ebt e gjakut q\u00eb furnizojn\u00eb kock\u00ebn e hips n\u00eb pacient\u00ebt e rritur, duke \u00e7uar n\u00eb d\u00ebshtim t\u00eb furnizimit me gjak dhe krijimin e frakturave t\u00eb kolapsit. K\u00ebto fraktura kolapsi mund t\u00eb ndryshojn\u00eb form\u00ebn e nyj\u00ebs s\u00eb hips dhe [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":302,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-39","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-specializimet"],"_links":{"self":[{"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/posts\/39","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/comments?post=39"}],"version-history":[{"count":8,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/posts\/39\/revisions"}],"predecessor-version":[{"id":350,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/posts\/39\/revisions\/350"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/media\/302"}],"wp:attachment":[{"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/media?parent=39"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/categories?post=39"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.halukcabuk.com\/al\/wp-json\/wp\/v2\/tags?post=39"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}