{"id":634,"date":"2018-12-29T23:15:39","date_gmt":"2018-12-29T20:15:39","guid":{"rendered":"http:\/\/www.damartedavileri.com\/?p=634"},"modified":"2020-01-11T00:10:08","modified_gmt":"2020-01-10T21:10:08","slug":"avaskuler-nekroz","status":"publish","type":"post","link":"https:\/\/www.damartedavileri.com\/en\/2018\/12\/avaskuler-nekroz\/","title":{"rendered":"Avask\u00fcler Nekroz"},"content":{"rendered":"
\"Avask\u00fcler

Avask\u00fcler Nekroz Tedavisi<\/p><\/div>\n

Avask\u00fcler nekroz, toplardamarlar\u0131n k\u0131lcal damarlara kan ak\u0131\u015f\u0131n\u0131 sa\u011flayamamas\u0131 sonucu kanlanamayan uyluk b\u00f6lgesinin yuvarlak k\u0131sm\u0131ndaki dokunun zamanla \u00f6lmesidir. B\u00f6lgedeki kan kayna\u011f\u0131n\u0131n kesilmesi nedeniyle kemik dokusunun \u00f6l\u00fcm\u00fc de denebilir. Avask\u00fcler nekroz, osteonekroz veya kemik enfarkt\u00fcs\u00fc olarak da adland\u0131r\u0131l\u0131r. Kan kayna\u011f\u0131 yeterince azald\u0131\u011f\u0131nda, kemik dokusu \u00f6lmeye ba\u015flar.<\/p>\n

Avask\u00fcler Nekroz baca\u011f\u0131n \u00fcst k\u0131sm\u0131n\u0131 etkileyen bir durumdur. \u00d6zellikle femur ba\u015f\u0131 daha az kan ak\u0131m\u0131 al\u0131r ve kan kayna\u011f\u0131 yeterince azald\u0131\u011f\u0131nda kemik dokusu \u00f6l\u00fcr.\u00a0Kemik \u00f6ld\u00fc\u011f\u00fcnde, femur ba\u015f\u0131 \u00e7\u00f6ker, hatta yeterince \u015fiddetli olursa, kal\u00e7a eklemi kendisi \u00e7\u00f6ker.<\/p>\n

Femur ba\u015f\u0131 bozulmas\u0131 kal\u00e7a kemi\u011finde \u00e7\u00f6kme, erime ve kire\u00e7lenmeler g\u00f6r\u00fcl\u00fcr devam\u0131nda ise femur ba\u015f\u0131ndaki yuvarlak k\u0131s\u0131m bozulup k\u00f6\u015feli bir hale gelir kal\u00e7an\u0131n d\u00f6nme hareketleri yap\u0131s\u0131ndaki bozulmadan dolay\u0131 yap\u0131lamaz ve femur ba\u015f\u0131 kal\u00e7a eklemine s\u00fcrt\u00fcnerek a\u011fr\u0131, ac\u0131 ve hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131na sebep olur. Do\u011fal olarak kal\u00e7a da eski i\u015flevlerini yerine getiremez.<\/p>\n

Avask\u00fcler nekroz genellikle 30 ila 50 ya\u015f aras\u0131ndaki insanlar\u0131 etkiler.<\/p>\n

Belirtiler <\/strong><\/p>\n

Avask\u00fcler nekroz en s\u0131k olarak femur (diz ekleminden kal\u00e7a eklemine uzanan kemik) gibi uzun kemiklerde tutulum yapar. En \u00e7ok etkilenen kemi\u011fin femur kemi\u011fi olmas\u0131yla birlikte di\u011fer yayg\u0131n olan yerler aras\u0131nda \u00fcst kol kemi\u011fi, diz, omuz ve ayak bile\u011fi bulunur. \u00c7o\u011fu durumda eklemde a\u011fr\u0131 ve rahats\u0131zl\u0131k vard\u0131r. Avask\u00fcler nekroz, \u00f6ncelikle\u00a0omuz diz ve kal\u00e7a eklemlerini etkiler. \u00c7o\u011fu durumda hastal\u0131k ba\u015flang\u0131\u00e7ta belirti vermeyebilir. Eklem a\u011fr\u0131s\u0131 yava\u015f\u00e7a geli\u015febilir, bu da hareket etme kabiliyetini s\u0131n\u0131rlar. Ge\u00e7 kal\u0131nm\u0131\u015f tedavilerde kemik veya eklem y\u00fczeyinde \u00e7\u00f6kmeler olu\u015fabilir.<\/p>\n

Avask\u00fcler nekroz (AVN) \u00f6nce kas\u0131kta hafif bir a\u011fr\u0131 ile kendini g\u00f6sterir. \u00d6zellikle \u00e7ok y\u00fcr\u00fcmek ve \u00e7ok ayakta kalmakla artan a\u011fr\u0131lar\u0131 hareket k\u0131s\u0131tlamalar\u0131 izler. Deformite artt\u0131k\u00e7a a\u011fr\u0131 da artar ve kal\u00e7ada g\u00fc\u00e7 kayb\u0131 olu\u015fur. Zamanla merdiven \u00e7\u0131kmak gibi g\u00fcnl\u00fck ihtiya\u00e7lar bile giderilemez hale gelir.<\/p>\n

Hastal\u0131k belirti verdikten sonra ihmal edilip tedavi edilmezse zamanla ilerler, kemik \u00e7\u00f6ker, eklem y\u00fczeyi k\u0131r\u0131larak a\u011fr\u0131 ve artrite yol a\u00e7ar.<\/p>\n

\"Avask\u00fcler

Avask\u00fcler Nekroz<\/p><\/div>\n

Nedenleri:<\/strong><\/p>\n

Temelinde dola\u015f\u0131m kaynakl\u0131 kanlanmama gibi \u00f6nemli bir problemden ortaya \u00e7\u0131kan avask\u00fcler nekrozu tetikleyen belirgin nedenler:<\/p>\n

– Trafik kazas\u0131 gibi travmalar,<\/p>\n

– Kemik k\u0131r\u0131klar\u0131, eklem \u00e7\u0131k\u0131klar\u0131,<\/p>\n

– Kal\u00e7a femur ba\u015f\u0131na uygulanan baz\u0131 ameliyatlar,<\/p>\n

– A\u015f\u0131r\u0131 alkol t\u00fcketimi,<\/p>\n

– \u015eeker hastal\u0131\u011f\u0131,<\/p>\n

– Obezite,<\/p>\n

– A\u015f\u0131r\u0131 kortizon kullan\u0131m\u0131,<\/p>\n

– Anemi,<\/p>\n

– Gut hastal\u0131\u011f\u0131<\/p>\n

– Romatoid artrit olarak s\u0131ralanabilir.<\/p>\n

Hastal\u0131\u011f\u0131n Tan\u0131s\u0131:<\/strong><\/p>\n

Bu hastal\u0131kta da erken tan\u0131 \u00e7ok \u00f6nemlidir. R\u00f6ntgen ancak hastal\u0131k ilerledi\u011finde bulgu verdi\u011finden erken evre durumlarda kemik sintigrafisi ve mr tercih edilen tan\u0131 y\u00f6ntemleridir.<\/p>\n

Hastal\u0131k \u00e7ok sinsi seyretti\u011fi i\u00e7in genelde hastalar a\u011fr\u0131 \u015fiddetlendi\u011fi ve hareket k\u0131s\u0131tlanmas\u0131 ba\u015flad\u0131\u011f\u0131nda doktora ba\u015fvururlar ve olduk\u00e7a ge\u00e7 kalm\u0131\u015f olurlar.<\/p>\n

A<\/strong>vask\u00fcler nekrozda uygulanan tedavi y\u00f6ntemleri nelerdir?\u00a0<\/strong><\/p>\n

Avask\u00fcler nekrozda en \u00f6nemli ve en basit yakla\u015f\u0131m femurun ba\u015f\u0131ndan ge\u00e7en y\u00fck\u00fcn\u00a0azalt\u0131lmas\u0131d\u0131r. Hastan\u0131n uzun s\u00fcre ayakta kalmamas\u0131 ve kendisini yormamas\u0131 gerekir. \u00d6zellikle koltuk de\u011fnekleri kullanmalar\u0131 \u00f6nerilir. \u0130la\u00e7 tedavileri \u00f6zellikle hastal\u0131\u011f\u0131n erken d\u00f6neminde etkilidir. Kullan\u0131lan ila\u00e7lar a\u011fr\u0131y\u0131 bir miktar azaltsa da tek ba\u015f\u0131na ila\u00e7la tedavi m\u00fcmk\u00fcn de\u011fildir.<\/p>\n

Tedavilerde ana ama\u00e7 femur ba\u015f\u0131n\u0131n dokusunun kanlanmas\u0131n\u0131 art\u0131rmak, \u00e7evre dokuya kan vererek reperfizyon ve d\u00fcfizyon mant\u0131\u011f\u0131n\u0131 \u00e7al\u0131\u015ft\u0131r\u0131p femur ba\u015f\u0131nda kemik dokusunun kanlanmas\u0131n\u0131 sa\u011flamakt\u0131r. Kan yard\u0131m\u0131 ile gelen oksijen b\u00f6lgedeki hasarlar\u0131 onararak hastalar\u0131n \u015fik\u00e2yetlerini b\u00fcy\u00fck \u00f6l\u00e7\u00fcde azalt\u0131r.<\/p>\n

\u00d6zellikle kal\u00e7a b\u00f6lgesinde etkilenen dokular\u0131 beslemek ve avask\u00fcler nekrozu y\u00f6netmek i\u00e7in g\u00fcn\u00fcm\u00fczde uygulanabilecek \u00e7ok say\u0131da farkl\u0131 tedavinin ba\u015f\u0131nda d\u00fc\u015f\u00fck enerjili lazer tedavisi <\/strong>gelir.<\/p>\n

\"Avask\u00fcler

Avask\u00fcler Nekroz<\/p><\/div>\n

D\u00fc\u015f\u00fck Enerjili Lazer Tedavisi Uygulan\u0131\u015f\u0131 <\/strong><\/p>\n

Damar yolundan ince bir katater yard\u0131m\u0131yla uygulanan lazer tedavisi hastalar\u0131n \u015fik\u00e2yetleri, mr ve damarsal bulgular\u0131 de\u011ferlendirilerek, \u00f6dem, bas\u0131n\u00e7, kemikteki kans\u0131zl\u0131\u011f\u0131n derecesine g\u00f6re de\u011fi\u015fik dalga boy ve g\u00fc\u00e7lerinde verilecek lazer \u0131\u015f\u0131n\u0131 se\u00e7ildikten sonra g\u00fcnde 1 saatlik seanslar \u015feklinde toplamda 6 veya 8 seans olarak uygulan\u0131r.<\/p>\n

Hastanede yat\u0131\u015f ve ameliyat sonras\u0131 belli bir istirahat s\u00fcrecinin ya\u015fanmad\u0131\u011f\u0131 d\u00fc\u015f\u00fck enerjili lazer tedavisi g\u00fcnl\u00fck hayatla birlikte ilerleyen bir tedavi \u015feklidir. Tedaviden hemen sonra b\u00fcy\u00fck \u00f6l\u00e7\u00fcde \u015fikayetlerinin azal\u0131p, hareketlerinin rahatlad\u0131\u011f\u0131 g\u00f6r\u00fcl\u00fcr . Avask\u00fcler nekroz genelde geriye d\u00f6n\u00fc\u015f\u00fcms\u00fcz bir hastal\u0131k olmas\u0131na ra\u011fmen d\u00fc\u015f\u00fck enerjili lazer tedavisi ile eklem k\u0131k\u0131rdaklar\u0131 ve alttaki kemik dokuda kanlanma ve beslenmenin artmas\u0131 h\u00fccre \u00e7o\u011falmas\u0131n\u0131 h\u0131zland\u0131r\u0131r. B\u00f6ylece ba\u015flang\u0131\u00e7 ve orta evredeki hastal\u0131k tamamen iyile\u015firken ileri evre vakalarda ise genel durumda %60-80 rahatlama sa\u011flan\u0131r.<\/p>\n

\u00d6zellikle avask\u00fcler kal\u00e7a nekrozunda \u00e7ok ileri vakalarda eklem protezi yap\u0131lmas\u0131 gereklidir. Ama genelde bu vakalar\u0131n ya\u015f\u0131n\u0131n protez operasyonu i\u00e7in gen\u00e7 olmas\u0131 olduk\u00e7a \u00f6nemli bir problemdir. Erken yap\u0131lan protezin ilerleyen y\u0131llarda gev\u015femesi ve eskimesi nedeni ile ikinci bir protez operasyonunu gerektirebilir. Fakat her yenilenen protezde ba\u015far\u0131 oran\u0131 d\u00fc\u015ft\u00fc\u011f\u00fcnden ve ilk protezdeki rand\u0131man sa\u011flanamad\u0131\u011f\u0131ndan d\u00fc\u015f\u00fck enerjili lazer tedavisi sayesinde protez operasyonunun y\u0131llarca ileriye b\u0131rak\u0131lmas\u0131 sa\u011flan\u0131r. Bu da g\u00fcn\u00fcm\u00fcz ko\u015fullar\u0131nda hastalar\u0131n ya\u015fam standard\u0131 a\u00e7\u0131s\u0131ndan bak\u0131ld\u0131\u011f\u0131nda olduk\u00e7a ciddi bir kolayl\u0131kt\u0131r.<\/p>\n

D\u00fc\u015f\u00fck Enerjili Lazer Tedavisinin iyile\u015ftirici Etkisi Mekanizmas\u0131<\/strong><\/p>\n

Kan h\u00fccreleri lazer enerjisine maruz kald\u0131klar\u0131nda, h\u00fccrenin i\u00e7sel dengesinde de\u011fi\u015fiklik meydana getirir. Solunum zincirinin harekete ge\u00e7mesiyle ATP(enerji) sentezi ba\u015flar. Lazer etkisi ayn\u0131 zamanda h\u00fccredeki hidrojen iyon seviyelerini etkiler. Bunun ATP(enerji) sentezi artmas\u0131 kombinasyonuyla, h\u00fccreden sodyum, potasyum, kalsiyum ge\u00e7irgenli\u011fi artar. De\u011fi\u015fik renklerde dalga boylar\u0131nda ve de\u011fi\u015fik frekanslarda kullan\u0131lan lazer \u0131\u015f\u0131nlar\u0131 mevcuttur.<\/p>\n

Avask\u00fcler nekroz hastalar\u0131nda en \u00f6nemli \u0131\u015f\u0131k ye\u015fil \u0131\u015f\u0131kt\u0131r. Tedavi s\u0131ras\u0131nda \u0131\u015f\u0131nlar hemoglobine ba\u011flan\u0131r.<\/p>\n

K\u0131rm\u0131z\u0131 kan h\u00fccrelerinin fonksiyonlar\u0131n\u0131 davran\u0131\u015flar\u0131n\u0131 ve h\u00fccre elastikiyetlerini iyile\u015ftirir.<\/p>\n

Oksijen ula\u015f\u0131m\u0131n\u0131 art\u0131rarak iyile\u015fmeyi sa\u011flar.<\/p>\n

Kan\u0131n viskositesini azalt\u0131r, kan ak\u0131m\u0131n\u0131 h\u0131zland\u0131r\u0131r..<\/p>\n

Dengeleyici ve onar\u0131c\u0131 patikalar\u0131 aktive eder.<\/p>\n

Do\u011fal plaket reaktivitesini sa\u011flar yava\u015f yava\u015f kaybolmas\u0131yla plaketlerin aktive olmas\u0131n\u0131 ve aktivasyon unsurlar\u0131na tepki verir.<\/p>\n

Na K pompas\u0131 \u00fczerinde pozitif etkisi vard\u0131r. H\u00fccre i\u00e7i,h\u00fccre d\u0131\u015f\u0131 cation homoestasislerin d\u00fczenlenmesine yard\u0131m eder.<\/p>\n","protected":false},"excerpt":{"rendered":"

Avask\u00fcler nekroz, toplardamarlar\u0131n k\u0131lcal damarlara kan ak\u0131\u015f\u0131n\u0131 sa\u011flayamamas\u0131 sonucu kanlanamayan uyluk b\u00f6lgesinin yuvarlak k\u0131sm\u0131ndaki dokunun zamanla \u00f6lmesidir. B\u00f6lgedeki kan kayna\u011f\u0131n\u0131n kesilmesi nedeniyle kemik dokusunun \u00f6l\u00fcm\u00fc de denebilir. Avask\u00fcler nekroz, osteonekroz veya kemik enfarkt\u00fcs\u00fc olarak da adland\u0131r\u0131l\u0131r. Kan kayna\u011f\u0131 yeterince azald\u0131\u011f\u0131nda, kemik dokusu \u00f6lmeye ba\u015flar. Avask\u00fcler Nekroz baca\u011f\u0131n \u00fcst k\u0131sm\u0131n\u0131 etkileyen bir durumdur. \u00d6zellikle femur ba\u015f\u0131 […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-634","post","type-post","status-publish","format-standard","hentry","category-general"],"translation":{"provider":"WPGlobus","version":"3.0.0","language":"en","enabled_languages":["tr","en"],"languages":{"tr":{"title":true,"content":true,"excerpt":false},"en":{"title":false,"content":false,"excerpt":false}}},"yoast_head":"\nAvask\u00fcler Nekroz - Damar Tedavileri<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/www.damartedavileri.com\/2018\/12\/avaskuler-nekroz\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Avask\u00fcler Nekroz - 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