Ingozi iphinde ibe ngaphezu kuka-58 kunabantu abaningi
Inkinga iqala ngokungenasisekelo ngokungaqondakali okungacacile emlenzeni, ikakhulukazi endaweni yokulima. Kamuva, ubuhlungu buba nzima kakhulu futhi buqala ukubandakanya i-hip. Ngesikhathi esifushane, ukuhamba kuyoba nzima, futhi ubuhlungu buyokhula ngamandla kuze kube yilapho ekugcineni uzizwe ungenakubekezeleka. Kuyinto kuphela lesi sigaba ukuthi abantu abaningi bazobona udokotela.
Phakathi kwabantu abane-HIV, lezi zinhlobo zempawu zingasho noma yiziphi izinto, ezinye zazo ezihlobene nokutheleleka kanye nezinye ezingekho. Kodwa-ke, esinye sezimbangela ezivame kakhulu isifo se-bone esibulalayo se-hip esiziwa ngokuthi i-avascular necrosis, noma i-AVN.
Ukuqonda i-Necrosis ye-Avascular
I-necrosis ye-Avascular iyisifo nesifo se-vascular esibhekwa ngezimvamisa ezinkulu kubantu abanesandulela ngculaza eside. Eyaziwa nangokuthi i- osteonecrosis , i-AVN uhlobo lwethambo lensimbi lokufa elibangelwa igazi elinciphisa amathambo. Ukugeleza kwegazi kuvinjelwe ngenye yezindlela ezimbili: ngokunciphisa imithwalo yegazi noma ukuhlukumezeka ezitsheni ezisekela ithambo.
Njengoba ukugeleza kwegazi kunciphisa, amaseli aqala ukufa ngenxa yokuntuleka kokudla. Njengoba isimo siqhubeka, ithambo liba buthakathaka futhi likhukhumezeke kuze kube yilapho, ekugcineni liba lihlelekile kakhulu kangangokuthi liphuka, ngokuvamile libe izingcezu eziningana.
I-AVN yisifo esiqhubekayo esibuhlungu ngokuhamba kwesikhathi. Cishe njalo iyakuthinta u-hip kodwa futhi ingabonakala emadolweni noma emahlombe. I-AVN ithinta abantu abanesandulela ngculaza ngezikhathi ezingu-58 izinga elibonwe emphakathini jikelele futhi lihambisana, okungenani ngeyingxenye, nokuvuvukala okungapheli okuhambisana nokutheleleka kwe-HIV eside.
Izimpawu nokuxilongwa kwe-AVN
Ekuqaleni kwe-AVN, kungenzeka kube nezimpawu ezimbalwa noma ezingekho. Njengoba lesi sifo siqhubeka, kungaba khona ubuhlungu obukhulayo ku-groin kanye ne-hip. Njengoba i-AVN ingabonakali kwi-X-ray evamile, ukuxilongwa kungase kube nzima. Eqinisweni, kuvame ukuphutha ngenxa yobuhlungu obukhulu bomzimba noma i- arthritis .
Ngaphandle uma kuthathwa ukuskena kwe-imagination yama- magnetic resonance (MRI) , i-AVN ingavame ukungafundwa iminyaka eminingi. Ekugcineni, ubuhlungu bungenakubekezeleleka ukuthi ukuhamba kuvinjelwe. Ama-fractures avamile njengoba inani elithe xaxa lamathambo liqala ukufa, ikakhulukazi ezinhlanganisweni ezithwala isisindo.
Izimbangela ze-AVN kubantu abane-HIV
I-AVN iyinkinga evamile kubantu abanesandulela ngculaza futhi ngokuvamile ihlotshaniswa nokuvuvukala okuqhubekayo okubonwa nokutheleleka isikhathi eside. Ngokuhamba kwesikhathi, lokhu ukuvuvukala kubangela ukuwohloka kwamangqamuzana namathishu kuwo wonke umzimba, okuholela ekusebenzeni kofuzo olubizayo olubizwa ngokuthi i- senescence engakafiki (ukuguga ngaphambi kwesikhathi). Ngokuvamile ososayensi babhekisela ekuphenduleni okuvuthayo ngokuthi "ukuvuvukala."
Ngenxa yalolu hlelo, umuntu onesandulela ngculaza ngokuvamile uzobhekana nezimo ezihlobene nokuguga eminyakeni engu-10 kuya kweyi-15 ngaphambili kunabalingani babo abangenalo igciwane. Phakathi kwalezi zimo ezihlobene nokuguga i-bone ne-hip fractures ngokuvamile ibonakala kubantu abangu-70 nangaphezulu.
Ezinye izici ezingozini zingabangela i-AVN kubantu abane-HIV, kubandakanya:
- Ukubhema
- Ukuphuza utshwala
- I-cholesterol ephakeme ne-triglycerides
- I-pancreatitis engapheli
- I-coagulopathy (i-disorder disorder eyenziwe ukungakwazi ukumboza)
- Ukusetshenziswa kwe-Corticosteroid
Ukwelashwa kwe-AVN
Ngeshwa, akukho ukwelashwa okungaphulukisa i-AVN. Imithi yokuhlunguphazwa ngezidakamizwa nezinkinga ezingenayo i-narcotic ingasetshenziswa ukukhulula noma yikuphi ubuhlungu obuhlobene. Imithi eyancipha ukuvuvukala kwendawo ingasiza.
Kunezinqubo zokuhlinza ezingabuyisa ukugeleza kwegazi endaweni ephethwe. Kodwa-ke, ezimweni eziningi, ukushintshwa kwe-hip kuyindlela kuphela yokuphinde ibuyele ngokugcwele uma kwenzeka isidumbu esibonakalayo sokufa kwethambo.
Ngalokho kuthiwa, ukuxilongwa kokuqala kanye nokwelashwa kwe-HIV kuyaziwa ukunciphisa umthelela wokuvuvukala okungapheli, ukunciphisa ingozi yezifo eziningi zesikhathi esigcwele ngamaphesenti angu-53 .
Izwi elivela
Uma unesandulela ngculazi futhi uzwa ubuhlungu be-hip noma ubuhlungu, tshela udokotela wakho kungakhathaliseki ukuthi kunzima kangakanani. Ukuxilongwa okuqala kwe-AVN kukunikeza ukhetho oluningi lwezokwelapha, kungakhathaliseki ukuhlinzwa noma okungenalo = ukuhlinzwa, futhi kungathuthukisa umphumela wesikhathi eside ngenkathi kulondolozwa ukuhamba kwakho.
> Imithombo:
> I-INSIGHT START Study Group. "Ukuqaliswa Kwethemishana Ye-Antiretroviral In HIV Early Infection." I-New England Journal of Medicine. Julayi 20, 2015; I-DOI: 10.1056 / NEJMoa1506816.
> Wilmes, D .; I-Docquier, i-P .; UBelkhir, uL. et al. "I-necrosis ye-Avascular yekhanda lezinsikazi ezigulini ezine-virus immunodeficiency virus 1 (HIV-1)." I-Journal ye-International AIDS Society. 2012; 15 (Suppl 4): 18325.