Ankilozan\u00a0 spondilit (AS) s\u0131rt, boyun, kal\u00e7a eklemlerinde a\u011fr\u0131 yapan kronik iltihabi bir hastal\u0131kt\u0131r. Omurga, omur (vertebra) ad\u0131 verilen \u00e7ok say\u0131da kemikten olu\u015fur. Ankiloz birbirine ba\u011flanma demektir ve bu durum omurlar\u0131n birle\u015fme yerlerindeki esnekli\u011fi engeller. Ankilozan spondilit hastal\u0131\u011f\u0131ndaki\u00a0 temel problem de budur.<\/p>\n
BEL\u0130RT\u0130LER<\/p>\n
Ankilozan spondilit hastal\u0131\u011f\u0131n\u0131n en yayg\u0131n belirtileri s\u0131rt, bel ve kal\u00e7a a\u011fr\u0131s\u0131d\u0131r. Bunun yan\u0131 s\u0131ra di\u011fer eklemlerde de a\u011fr\u0131, tutukluk ve hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 g\u00f6r\u00fclebilir.\u00a0 Bel ve s\u0131rt a\u011fr\u0131lar\u0131\u00a0 ilk \u00f6nce ortaya \u00e7\u0131kan en yayg\u0131n bulgulard\u0131r.<\/p>\n
\u00a0Bu hastal\u0131kta g\u00f6r\u00fclen bel a\u011fr\u0131s\u0131n\u0131n baz\u0131 \u00f6zellikleri vard\u0131r.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 20-30 ya\u015flar\u0131nda ba\u015flar<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yava\u015f yava\u015f ba\u015flar.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00dc\u00e7 aydan daha uzun s\u00fcrelidir.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dinlenme ile \u015fikayetler k\u00f6t\u00fcle\u015fir.\u00a0 Bu nedenle sabahlar\u0131 kendinizi daha k\u00f6t\u00fc hissedersiniz<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G\u00fcn i\u00e7inde hareketle \u015fikayetlerde azalma olur.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Gece\u00a0 yar\u0131s\u0131 a\u011fr\u0131lar nedeniyle uyanabilirsiniz<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yar\u0131m Saatten uzun s\u00fcren tutukluk (sabah sertli\u011fi ) g\u00f6r\u00fcl\u00fcr. Bu yak\u0131nmalar hareketle azal\u0131r.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kal\u00e7a a\u011fr\u0131s\u0131 sa\u011f ve sol b\u00f6lgelerde yer de\u011fi\u015ftirebilir.<\/p>\n
Omurga hareketleri azalm\u0131\u015ft\u0131r. \u00d6ne e\u011filme yetene\u011fi s\u0131n\u0131rland\u0131\u011f\u0131 i\u00e7in \u00e7orap ve ayakkab\u0131 giymeniz zorla\u015fabilir. Kal\u00e7a ekleminin iltihab\u0131 s\u0131k g\u00f6r\u00fcl\u00fcr. Kal\u00e7a a\u011fr\u0131s\u0131 nedeni ile y\u00fcr\u00fcmede zorluk ya\u015fanabilir. Omuz ekleminin ve ba\u011flar\u0131n\u0131n iltihab\u0131 nedeniyle omuz hareketleri k\u0131s\u0131tlanabilir. K\u0131yafetlerinizi giyip \u00e7\u0131kar\u0131rken, sa\u00e7\u0131n\u0131z\u0131 tararken\u00a0 zorlanabilirsiniz. V\u00fccudun diz, dirsek, el bile\u011fi gibi di\u011fer eklemleri de\u00a0 tululabilir.<\/p>\n
Entezit: Entezis, kaslar\u0131n hareketini ileten tendon dedi\u011fimiz ipler ve ba\u011flar\u0131n kemiklere yap\u0131\u015fma yeridir Bu b\u00f6lge iltihaplanmas\u0131na entezit denir. Bu durum Ankilozan spondilit hastal\u0131\u011f\u0131nda s\u0131k g\u00f6r\u00fcl\u00fcr. Topuk, dirsek ve kaburgalarda da entezit olabilir. Kaburga b\u00f6lgesindeki entezitler g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131na neden olabilir. Bu a\u011fr\u0131, \u00f6ks\u00fcrmekle, haps\u0131rmakla, derin nefes almakla artar.<\/p>\n
Ankilozan spondilit hastas\u0131 iseniz kendinizi yorgun ve k\u00f6t\u00fc hissedebilirsiniz . Geceleri bel, s\u0131rt\u00a0 ve di\u011fer eklem a\u011fr\u0131lar\u0131 nedeniyle\u00a0 uyuyamayabilir ve bu\u00a0 nedenle halsiz olabilirsiniz. Bazen hafif bir ate\u015f ve zay\u0131flama da g\u00f6r\u00fclebilir.<\/p>\n
Ankilozan spondilit hastal\u0131\u011f\u0131 erkeklerde \u00fc\u00e7 kat daha s\u0131kt\u0131r. Gen\u00e7lerde \u00f6zellikle 20-30 ya\u015flar\u0131 aras\u0131nda en s\u0131k g\u00f6r\u00fcl\u00fcr. Ailenizde ve birinci derece akrabalar\u0131n\u0131zda bu hastal\u0131k varsa sizde g\u00f6r\u00fclme riski 5-16 kat artar. HLAB27 ad\u0131ndaki geni ta\u015f\u0131yanlarda bu hastal\u0131\u011f\u0131n g\u00f6r\u00fclme riski artar.<\/p>\n
TANI<\/p>\n
Hastal\u0131\u011f\u0131n tan\u0131s\u0131 ki\u015finin \u015fikayetleri ile muayene ve\u00a0 laboratuar bulgular\u0131n\u0131n birlikte de\u011ferlendirilmesi sonucu konulur. Ekleminizdeki \u015fi\u015flik, hassasiyet, hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 muayene edilir. \u00d6ne ve yana e\u011filirken zorlan\u0131p zorlanmad\u0131\u011f\u0131n\u0131za bak\u0131l\u0131r. Boyun ve omuz hareketlerindeki k\u0131s\u0131tl\u0131l\u0131\u011fa\u00a0 bak\u0131l\u0131r. R\u00f6ntgende kal\u00e7a ve bel omurlar\u0131ndaki baz\u0131 de\u011fi\u015fiklikler g\u00f6r\u00fcl\u00fcr. E\u011fer hastal\u0131\u011f\u0131n\u0131z yeni ba\u015flam\u0131\u015f ve bu de\u011fi\u015fikliklerin olu\u015fmas\u0131 i\u00e7in yeteri kadar s\u00fcre ge\u00e7memi\u015f ise r\u00f6ntgende bu bulgulara rastlanmayabilir. Bu durumda bilgisayarl\u0131 tomografi ve manyetik rezonans y\u00f6ntemleri ile bu de\u011fi\u015fiklikler ara\u015ft\u0131r\u0131l\u0131r. Klinik hikaye, muayene ve g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleri ile tan\u0131 konulamad\u0131\u011f\u0131 durumlarda di\u011fer yard\u0131mc\u0131 laboratuar testlerine ba\u015fvurulur. Bu konuda hastan\u0131n HLAB27 gen pozitifli\u011fine ve hastal\u0131\u011f\u0131n \u015fiddetli oldu\u011fu d\u00f6nemlerde kanda y\u00fckselen sedimantasyon h\u0131z\u0131 ve CRP ad\u0131ndaki\u00a0 labaratuar tahlillerine\u00a0 bak\u0131l\u0131r.<\/p>\n
KOMPL\u0130KASYONLARI<\/p>\n
Hastal\u0131\u011f\u0131n seyrinde g\u00f6r\u00fclebilecek ikincil Sa\u011fl\u0131k problemleri a\u015fa\u011f\u0131daki gibi s\u0131ralanabilir.<\/p>\n
Anterior \u00fcveit: G\u00f6z\u00fcn \u00fcvea ad\u0131ndaki tabakas\u0131n\u0131n iltihab\u0131d\u0131r. Bu durum ba\u015fka hastal\u0131klarda g\u00f6r\u00fclebilmesine ra\u011fmen en s\u0131k kar\u015f\u0131la\u015f\u0131ld\u0131\u011f\u0131 durum Ankilozan spondilit hastal\u0131\u011f\u0131d\u0131r. Nadiren bu hastal\u0131\u011f\u0131n bulgular\u0131 ba\u015flamadan \u00fcveit\u00a0 g\u00f6r\u00fclebilir. G\u00f6zde ani ba\u015flayan a\u011fr\u0131, bulan\u0131k g\u00f6rme \u0131\u015f\u0131\u011fa duyarl\u0131l\u0131k gibi\u00a0 \u015fikayetleriniz oldu\u011fu takdirde doktora ba\u015fvurun. Erken tan\u0131 ile bu sa\u011fl\u0131k problemi 2-3 ayda tedavi edilir.\u00a0<\/p>\n
N\u00f6rolojik problemler: Omurga sinir sistemini ve sinirleri korur. Ankilozan spondilit hastal\u0131\u011f\u0131’nda omurgan\u0131n esnekli\u011fi bozuldu\u011fu i\u00e7in, kazalarda k\u0131r\u0131k olu\u015fma olas\u0131l\u0131\u011f\u0131 ve b\u00f6ylece sinirlerin hasarlanma riski artar. Bu kazalar sonras\u0131nda duyu kayb\u0131 ve fel\u00e7 geli\u015febilir.<\/p>\n
Omurga k\u0131r\u0131klar\u0131: Ankilozan spondilit hastal\u0131\u011f\u0131kemiklerde Mineral azalmas\u0131 sonucu kemik kay\u0131plar\u0131na yol a\u00e7ar. Kemik erimesi (osteoporoz) denen bu durum kemik k\u0131r\u0131lma riskini artt\u0131r\u0131r. En s\u0131k boyun omurlar\u0131nda g\u00f6r\u00fcl\u00fcr. Herhangi bir kaza kaza sonras\u0131 boyun a\u011fr\u0131n\u0131zda art\u0131\u015f olursa hemen doktora ba\u015fvurmal\u0131s\u0131n\u0131z.<\/p>\n
Omurga kaymas\u0131 (Vertebra subl\u00fcksasyonu); Bazen omurlar birbiri \u00fczerinde kayabilir. E\u011fer bir sinire bas\u0131 yapm\u0131yorsa m\u00fcdahale edilmez . Kauda equina sendromu uzun s\u00fcren ve ciddi hastal\u0131\u011f\u0131 olanlarda g\u00f6r\u00fclen nadir bir durumdur. Belin alt k\u0131sm\u0131ndaki sinirlerin hasarlanmas\u0131 sonucunda d\u0131\u015fk\u0131lama ve idrar ka\u00e7\u0131rma problemleri, erkeklerde iktidars\u0131zl\u0131k g\u00f6r\u00fclebilir.<\/p>\n
Kalp ve damar bozukluklar\u0131: En yayg\u0131n g\u00f6r\u00fclen kardiyak bulgu Aort kapa\u011f\u0131 ad\u0131ndaki kalp kapa\u011f\u0131n\u0131n yetersizli\u011fidir. Kalp grafisi \u00e7ekildi\u011finde bunu d\u00fc\u015f\u00fcnd\u00fcrecek bir tak\u0131m bulgular izlenebilir.<\/p>\n
Akci\u011fer hastal\u0131klar\u0131; Kaburga ve omurlar aras\u0131ndaki esneklik kayb\u0131 nedeni ile nefes alman\u0131z s\u0131ras\u0131nda g\u00f6\u011f\u00fcs kafesiniz yeterince geni\u015fleyemez. Akci\u011ferde baz\u0131 de\u011fi\u015fiklikler olabilir.<\/p>\n
B\u00f6brek hastal\u0131klar\u0131: \u0130ltihapl\u0131 hastal\u0131klarda artan bir Protein olan amiloid, b\u00f6bre\u011fe \u00e7\u00f6kerek, b\u00f6brek yetmezli\u011fine yol a\u00e7abilir. Hastal\u0131\u011f\u0131n\u0131z uzun s\u00fcreden beri aktif ise bu durum g\u00f6zlenebilir.\u00a0 Ayr\u0131ca bu durumdan farkl\u0131 olarak, al\u0131nan a\u011fr\u0131 kesici ila\u00e7lar da, ilerleyen y\u0131llarda b\u00f6brek fonksiyon bozukluklar\u0131n\u0131n olu\u015fmas\u0131na neden olabilir. Ankilozan spondilit hastalar\u0131, nedenini bilemedi\u011fimiz bir \u015fekilde b\u00f6brek ta\u015f\u0131 d\u00fc\u015f\u00fcrmeye daha yatk\u0131nd\u0131rlar.<\/p>\n
Barsak \u00fclserleri: Ankilozan spondilit hastalar\u0131nda, bazen barsak i\u00e7inde belirti vermeyen \u00fclserlere rastalanabilir. Ayr\u0131ca bu hastalarda, iltihabi barsak hastal\u0131\u011f\u0131 olarak tarif edilen Crohn ve \u00dclseratif kolit hastal\u0131\u011f\u0131 riski artm\u0131\u015ft\u0131r. Ankilozan spondilite ek olarak s\u0131k ishal oluyor ya da kar\u0131n a\u011fr\u0131lar\u0131 \u00e7ekiyorsan\u0131z doktorunuza ba\u015fvurunuz.<\/p>\n
TEDAV\u0130<\/p>\n
Hastal\u0131\u011f\u0131n\u0131z\u0131n \u015fiddetine ve \u00f6zelliklerine g\u00f6re tedaviniz size \u00f6zel olarak d\u00fczenlenir.<\/p>\n
Egzersiz: Tedavinizin \u00f6nemli bir par\u00e7as\u0131d\u0131r. Ev egzersizleri\u00a0 ya da bir fizik tedavi uzman\u0131\u00a0 ile birlikte grup egzersizleri \u015feklinde olabilir.\u00a0 Egzersizler sizin v\u00fccudunuzun duru\u015funu d\u00fczeltmeli, derin nefes alman\u0131z\u0131 kolayla\u015ft\u0131rmal\u0131,\u00a0 s\u0131rt\u0131n\u0131z\u0131n dik duru\u015funu\u00a0 sa\u011flamal\u0131.\u00a0 Sizi zorlayan,\u00a0 sakatl\u0131\u011fa yol a\u00e7abilecek hareketlerden ka\u00e7\u0131nmal\u0131s\u0131n\u0131z. Bu nedenle, mutlaka ne t\u00fcr egsersizler yapabilece\u011finiz konusunda fizyoterapistinize dan\u0131\u015fmal\u0131s\u0131n\u0131z.<\/p>\n
Burnunuzda \u015fekil bozuklu\u011funu \u00f6nlemek i\u00e7in\u00a0 kal\u0131n yast\u0131kla yatmal\u0131s\u0131n\u0131z. D\u00fc\u015fme sonucu k\u0131r\u0131k riskini engellemek i\u00e7in banyoda\u00a0 k\u00fcvette\u00a0 tutunarak banyo yap\u0131n. Gece \u0131\u015f\u0131k a\u00e7\u0131k kals\u0131n.\u00a0 Yerlerdeki aya\u011f\u0131n\u0131za tak\u0131lacak \u015feyleri kald\u0131r\u0131n. Otomobil seyahati s\u0131ras\u0131nda mutlaka emniyet kemerinizi tak\u0131n.<\/p>\n
\u0130la\u00e7lar:<\/p>\n
A\u011fr\u0131 kesiciler:\u00a0 A\u011fr\u0131 ve tutuklu\u011fu gidermek i\u00e7in Aspirin, ibuprofen gibi a\u011fr\u0131 kesiciler kullan\u0131l\u0131r.\u00a0 En az iki hafta d\u00fczenli al\u0131nd\u0131\u011f\u0131nda etkileri ortaya \u00e7\u0131kar. \u0130ki hafta d\u00fczenli ald\u0131\u011f\u0131n\u0131z halde \u015fikayetleriniz azalmad\u0131ysa farkl\u0131 bir a\u011fr\u0131 kesiciyi deneyin. Bu ila\u00e7lar\u0131n en s\u0131k g\u00f6r\u00fclen yan etkisi mide ve barsak \u00fclserleridir.\u00a0 \u00d6nceden bilinen \u00fclseriniz varsa\u00a0 dikkatli kullanmal\u0131s\u0131n\u0131z. \u00c7\u00fcnk\u00fc kanamalar olabilir.\u00a0 Beraberinde mutlaka mide koruyucu ila\u00e7lar almal\u0131s\u0131n\u0131z.\u00a0 Kan suland\u0131r\u0131c\u0131 bir ila\u00e7 al\u0131yorsan\u0131z\u00a0 daha dikkatli olmal\u0131s\u0131n\u0131z.<\/p>\n
DMARD (Hastal\u0131\u011f\u0131n ilerlemesini durduran ila\u00e7lar):<\/p>\n
S\u00fclfasalazin: Kal\u00e7a ekleminiz tutulmu\u015f ve a\u011fr\u0131 kesici ila\u00e7larla \u015fikayetleriniz azalm\u0131yorsa\u00a0 s\u00fclfsalazin ba\u015flanabilir. 6 Ay bu ilac\u0131 ald\u0131\u011f\u0131n\u0131z halde yarar\u0131 olmad\u0131ysa ilac\u0131 de\u011fi\u015ftirmek i\u00e7in doktorunuza ba\u015fvurmal\u0131s\u0131n\u0131z. D\u00f6k\u00fcnt\u00fc, ba\u015fa\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi,\u00a0 karaci\u011fer enzimlerinde y\u00fckselme , kan say\u0131m\u0131nda d\u00fc\u015fme\u00a0 g\u00f6r\u00fclebilir. Bu ilac\u0131 al\u0131rken d\u00fczenli olarak doktorunuza ba\u015fvurmal\u0131 ve tahlillerinizi yapt\u0131rmal\u0131s\u0131n\u0131z.<\/p>\n
Metotreksat:\u00a0 Haftada bir a\u011f\u0131zdan tablet \u015feklinde al\u0131nabilir ya da kullan\u0131ma haz\u0131r enjekt\u00f6rlerle cilt alt\u0131na uygulanabilir. Karaci\u011fer enzimlerini y\u00fckseltebilir, kan say\u0131m\u0131n\u0131 d\u00fc\u015f\u00fcrebilir.\u00a0 Bu nedenle d\u00fczenli arakl\u0131klarla kan tahlili yapt\u0131rmal\u0131s\u0131n\u0131z.<\/p>\n
Biyolojik ajanlar: Anti t\u00fcm\u00f6r Nekroz fakt\u00f6r ajanlar diye bilinen bu ila\u00e7lardan\u00a0 infliximab hastanede serum i\u00e7inde verilir.\u00a0 Etanarsept ve\u00a0 adalimumab\u00a0 kullan\u0131ma haz\u0131r enjekt\u00f6rlerle cilt alt\u0131na yap\u0131l\u0131r. Bu ila\u00e7lar Romatoloji uzman\u0131 taraf\u0131ndan ba\u015flan\u0131r. Birinden yarar g\u00f6rmezseniz ya da yan etkisi olursa di\u011feri verilebilir. Her hastan\u0131n bu ila\u00e7lara ihtiyac\u0131 olmaz.\u00a0 Di\u011fer DMARD’lara cevap al\u0131nam\u0131yorsa ba\u015flanabilir.<\/p>\n
Steroidler (kortizon): Bazen eklemlere steroid yap\u0131lmas\u0131 sizi rahatlatabilir.\u00a0 Steroidler uzun d\u00f6nemde kullan\u0131ld\u0131klar\u0131nda kemik erimesini artt\u0131rd\u0131klar\u0131 i\u00e7in\u00a0 az kullan\u0131l\u0131rlar.<\/p>\n
Kalsiyum ve D vitamini:\u00a0 Kalsiyumdan zengin s\u00fct, peynir, yo\u011furt gibi \u00fcr\u00fcnleri bol t\u00fcketin, g\u00fcne\u015flenin.<\/p>\n
\u00d6NER\u0130LER<\/p>\n
sigara i\u00e7meyi b\u0131rak\u0131n. Sigara akci\u011ferin elastikiyetini azalt\u0131r.<\/p>\n
HAZIRLAYAN; Dr. Nesibe KARAHAN YE\u015e\u0130L, Prof. Dr. Ya\u015far KARAASLAN<\/p>\n","protected":false},"excerpt":{"rendered":"
Ankilozan\u00a0 spondilit (AS) s\u0131rt, boyun, kal\u00e7a eklemlerinde a\u011fr\u0131 yapan kronik iltihabi bir hastal\u0131kt\u0131r. Omurga, omur (vertebra) ad\u0131 verilen \u00e7ok say\u0131da kemikten olu\u015fur. Ankiloz birbirine ba\u011flanma demektir ve bu durum omurlar\u0131n birle\u015fme yerlerindeki esnekli\u011fi engeller. Ankilozan spondilit hastal\u0131\u011f\u0131ndaki\u00a0 temel problem de budur. BEL\u0130RT\u0130LER Ankilozan spondilit hastal\u0131\u011f\u0131n\u0131n en yayg\u0131n belirtileri s\u0131rt, bel ve kal\u00e7a a\u011fr\u0131s\u0131d\u0131r. Bunun yan\u0131 s\u0131ra di\u011fer eklemlerde de a\u011fr\u0131,[Devam\u0131n\u0131 Oku…]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22524],"tags":[23207,23208,23209,23210],"_links":{"self":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13245"}],"collection":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/comments?post=13245"}],"version-history":[{"count":0,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13245\/revisions"}],"wp:attachment":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/media?parent=13245"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/categories?post=13245"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/tags?post=13245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}