{"id":166209,"date":"2022-02-17T08:49:40","date_gmt":"2022-02-17T07:49:40","guid":{"rendered":"https:\/\/sdk.mk\/?p=166209"},"modified":"2022-02-17T08:49:40","modified_gmt":"2022-02-17T07:49:40","slug":"ju-njoftojme-me-semundjet-e-rralla-semundja-e-buerger","status":"publish","type":"post","link":"https:\/\/sdk.mk\/index.php\/maqedonia\/ju-njoftojme-me-semundjet-e-rralla-semundja-e-buerger\/","title":{"rendered":"JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: S\u00cbMUNDJA E BUERGER"},"content":{"rendered":"<div class=\"f52428582a4b906b2d2e2a7d733c7d27\" data-index=\"7\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<!-- MSP Ads Asynchronous JS Tag - Generated with Revive Adserver v5.4.1 -->\r\n<ins data-revive-zoneid=\"167\" data-revive-id=\"060fdb01f6430ec164d3519234aa4967\"><\/ins>\r\n<script async src=\"\/\/panel.ads.com.mk\/www\/delivery\/asyncjs.php\"><\/script>\n<\/div>\n<p><em><strong>S\u00ebmundja e Buerger\/Buerger disease<\/strong><\/em><\/p>\n<p>ICD &#8211; 10: I 73.1<\/p>\n<p>Prevalenca: 1-5\/10.000<\/p>\n<p>S\u00ebmundja e Burger \u00ebsht\u00eb nj\u00eb s\u00ebmundje e rrall\u00eb e arterieve dhe venave t\u00eb krah\u00ebve dhe k\u00ebmb\u00ebve. N\u00eb s\u00ebmundjen e Burger, en\u00ebt e gjakut fryhen dhe mund t\u00eb bllokohen nga nj\u00eb mpiksje gjaku. Kjo, nga ana tjet\u00ebr, mund t\u00eb d\u00ebmtoj\u00eb ose shkat\u00ebrroj\u00eb indet e l\u00ebkur\u00ebs dhe mund t\u00eb shkaktoj\u00eb infeksion dhe gangren\u00eb. S\u00ebmundja Burger zakonisht ndodh n\u00eb duar dhe k\u00ebmb\u00eb dhe mund t\u00eb p\u00ebrhapet p\u00ebr t\u00eb prekur zona m\u00eb t\u00eb m\u00ebdha t\u00eb duarve dhe k\u00ebmb\u00ebve.<\/p>\n<p>S\u00ebmundja Burger u p\u00ebrshkrua p\u00ebr her\u00eb t\u00eb par\u00eb nga kirurgu gjerman Felix von Winivarter n\u00eb 1879. Por n\u00eb vitin 1908 s\u00ebmundja mori p\u00ebrshkrimin e saj t\u00eb par\u00eb patologjik t\u00eb sakt\u00eb nga internisti amerikan Leo Buerger n\u00eb Spitalin Mount Sinai n\u00eb Nju Jork. Burger e quajti at\u00eb &#8220;gangren\u00eb spontane&#8221; pasi studioi amputimet e 11 pacient\u00ebve. N\u00eb 1924, Dr Burger publikoi nj\u00eb monografi mbi s\u00ebmundjen bazuar n\u00eb testet e kryera n\u00eb 500 pacient\u00eb. S\u00ebmundja e Burger prek nj\u00eb pjes\u00eb t\u00eb vog\u00ebl t\u00eb pacient\u00ebve me \u00e7rregullime t\u00eb qarkullimit t\u00eb gjakut (rreth 3%), por \u00ebsht\u00eb e v\u00ebshtir\u00eb p\u00ebr mjek\u00ebt dhe kirurg\u00ebt vaskular ta diagnostikojn\u00eb dhe trajtojn\u00eb. Pacient\u00ebt jan\u00eb meshkuj t\u00eb mosh\u00ebs 25-45 vje\u00e7 t\u00eb cil\u00ebt e p\u00ebrdorin shum\u00eb duhanin, nd\u00ebrsa s\u00ebmundja \u00ebsht\u00eb shum\u00eb e rrall\u00eb te grat\u00eb. M\u00eb shpesh haset n\u00eb Indi, Koreja dhe Japoni. N\u00eb Evrop\u00ebn Per\u00ebndimore, me p\u00ebrjashtim t\u00eb Mesdheut, shihet mjaft rrall\u00eb. Pothuajse t\u00eb gjith\u00eb t\u00eb diagnostikuarit me s\u00ebmundjen Burger pin\u00eb cigare ose p\u00ebrdorin forma t\u00eb tjera t\u00eb duhanit, t\u00eb tilla si p\u00ebrtypja e duhanit. Heqja dor\u00eb nga t\u00eb gjitha format e duhanit \u00ebsht\u00eb m\u00ebnyra e vetme p\u00ebr t\u00eb ndaluar s\u00ebmundjen. P\u00ebr ata q\u00eb nuk ndalen, amputimi i gjith\u00eb ose e nj\u00eb pjese t\u00eb gjymtyr\u00ebve mund t\u00eb jet\u00eb p\u00ebrfundimisht i nevojsh\u00ebm.<\/p>\n<p><strong>Simptomet:<\/strong><\/p>\n<p>S\u00ebmundja mund t\u00eb jet\u00eb akute ose kronike. N\u00ebse s\u00ebmundja \u00ebsht\u00eb e papritur, amputimi i k\u00ebmb\u00ebve p\u00ebr nj\u00eb koh\u00eb t\u00eb shkurt\u00ebr mund t\u00eb jet\u00eb i pashmangsh\u00ebm. Rreth 20-30% e njer\u00ebzve humbin nj\u00ebr\u00ebn k\u00ebmb\u00eb n\u00eb 5 vitet e para. P\u00ebr shkak t\u00eb ndryshimeve vaskulare, shfaqen \u00e7rregullime t\u00eb qarkullimit t\u00eb gjakut, ve\u00e7an\u00ebrisht n\u00eb k\u00ebmb\u00eb dhe duar, t\u00eb cilat mund t\u00eb \u00e7ojn\u00eb n\u00eb simptomat e m\u00ebposhtme: k\u00ebmb\u00eb t\u00eb ftohta \/ duar t\u00eb ftohta; ndjesi shpimi gjilp\u00ebrash n\u00eb k\u00ebmb\u00eb; fillimisht \u2192 klaudikim intermitent (dhimbje n\u00eb k\u00ebmb\u00eb gjat\u00eb ecjes); m\u00eb von\u00eb \u2192 dhimbje n\u00eb k\u00ebmb\u00eb gjat\u00eb pushimit; mpirje (parestezi); \u00ebnjtje (edem); ndryshime karakteristike t\u00eb gjymtyr\u00ebve &#8211; gishta blu (cianoz\u00eb); ulceracion i mundsh\u00ebm (qelb); prishja e indeve.<\/p>\n<p><strong>Shkaqet:<\/strong><\/p>\n<p>Shkaku i s\u00ebmundjes \u00ebsht\u00eb i panjohur, megjith\u00ebse pirja e duhanit dihet se \u00ebsht\u00eb faktori kryesor i rrezikut. Mekanizmi mund t\u00eb p\u00ebrfshij\u00eb nj\u00eb reaksion i mbindjeshm\u00ebris\u00eb s\u00eb von\u00eb ose angit toksik. Sipas nj\u00eb teorie tjet\u00ebr, s\u00ebmundja Burger mund t\u00eb jet\u00eb nj\u00eb s\u00ebmundje autoimune e shkaktuar nga nj\u00eb reagim qelizor i mbindjeshm\u00ebris\u00eb ndaj kolagjenit t\u00eb tipit I dhe III q\u00eb gjendet n\u00eb en\u00ebt e gjakut. Studimet klinike kan\u00eb treguar se kur nj\u00eb pacient abstenon nga pirja e duhanit, s\u00ebmundja p\u00ebrmir\u00ebsohet ndjesh\u00ebm. P\u00ebrndryshe, b\u00ebhet m\u00eb keq. Disa shkenc\u00ebtar\u00eb pohojn\u00eb se mund t\u00eb jet\u00eb nj\u00eb alergji ndaj p\u00ebrb\u00ebr\u00ebsve t\u00eb tymit t\u00eb duhanit. Sa i p\u00ebrket antitrupave p\u00ebr zhvillimin e s\u00ebmundjes, nikotina \u00e7on n\u00eb ngushtimin e tep\u00ebrt t\u00eb venave. K\u00ebshtu, qarkullimi i gjakut b\u00ebhet nj\u00eb faktor i r\u00ebnd\u00ebsish\u00ebm patologjik.<\/p>\n<p><strong>Diagnoza:<\/strong><\/p>\n<p>Nuk ka asnj\u00eb test laboratorik specifik q\u00eb mund t\u00eb diagnostikoj\u00eb s\u00ebmundjen Burger. \u00cbsht\u00eb e \u00e7uditshme q\u00eb, edhe n\u00eb fazat akute, proteina C-reaktive dhe shkalla e sedimentimit t\u00eb eritrociteve jan\u00eb normale. P\u00ebr t\u00eb p\u00ebrjashtuar s\u00ebmundjet e tjera vaskulare, kryhen nj\u00eb s\u00ebr\u00eb testesh, t\u00eb tilla si testet e funksionit t\u00eb m\u00ebl\u00e7is\u00eb, testet e glukoz\u00ebs n\u00eb gjak, shkalla e sedimentimit t\u00eb eritrociteve dhe testet e antitrupave antinuklear\u00eb.<br \/>\nM\u00ebnyra e vetme e besueshme p\u00ebr t\u00eb diagnostikuar s\u00ebmundjen Burger \u00ebsht\u00eb nj\u00eb ekzaminim histologjik, dmth marrja e mostrave dhe ekzaminimi i indeve. Kur merret parasysh informacioni p\u00ebr prij\u00ebn e duhanit, gjinia, mosha dhe pasqyra klinike, dhe kur kryeni arteriografi dhe ultratinguj Doppler, diagnoza \u00ebsht\u00eb shum\u00eb e leht\u00eb dhe e thjesht\u00eb.<\/p>\n<p><strong>Faktor\u00ebt e rrezikut:<\/strong><\/p>\n<p>Pirja e duhanit rrit ndjesh\u00ebm rrezikun e zhvillimit t\u00eb s\u00ebmundjes s\u00eb Burger. Duhanpir\u00ebsit kan\u00eb m\u00eb shum\u00eb gjasa t\u00eb zhvillojn\u00eb s\u00ebmundjen e Burger, megjith\u00ebse mund t\u00eb ndodh\u00eb edhe tek njer\u00ebzit q\u00eb p\u00ebrdorin \u00e7do form\u00eb t\u00eb duhanit, p\u00ebrfshir\u00eb purot dhe duhanin p\u00ebrtyp\u00ebs.<\/p>\n<p>Ende nuk \u00ebsht\u00eb e qart\u00eb se si p\u00ebrdorimi i duhanit rrit rrezikun e s\u00ebmundjes, por pothuajse t\u00eb gjith\u00eb t\u00eb diagnostikuarit me s\u00ebmundjen Burger konsumojn\u00eb duhan. Supozohet se kimikatet n\u00eb duhan mund t\u00eb irritojn\u00eb indet e en\u00ebve t\u00eb gjakut, duke i shkaktuar ato t\u00eb fryhen.<\/p>\n<p>S\u00ebmundja \u00ebsht\u00eb m\u00eb e p\u00ebrhapur n\u00eb Lindjen e Mesme dhe t\u00eb Larg\u00ebt, ku forma m\u00eb e r\u00ebnd\u00eb e pirjes s\u00eb duhanit \u00ebsht\u00eb e zakonshme. Edhe pse pirja e duhanit pasiv nuk konsiderohet nj\u00eb faktor kryesor rreziku p\u00ebr s\u00ebmundjen, n\u00ebse jeni diagnostikuar, duhet t\u00eb shmangni zonat e pirjes s\u00eb duhanit. Pirja e duhanit pasiv mund ta p\u00ebrkeq\u00ebsoj\u00eb gjendjen tuaj.<\/p>\n<p><strong>Nd\u00ebrlikimet:<\/strong><\/p>\n<p>N\u00ebse s\u00ebmundja e Burger p\u00ebrkeq\u00ebsohet, rrjedhja e gjakut n\u00eb duar dhe k\u00ebmb\u00eb zvog\u00eblohet. Kjo \u00ebsht\u00eb p\u00ebr shkak t\u00eb bllokimit q\u00eb e b\u00ebn t\u00eb v\u00ebshtir\u00eb q\u00eb gjaku t\u00eb arrij\u00eb n\u00eb gishtat tuaj. Indet e varfra me gjak nuk marrin oksigjen dhe l\u00ebnd\u00eb ushqyese t\u00eb mjaftueshme p\u00ebr t\u00eb mbijetuar. Kjo mund t\u00eb shkaktoj\u00eb vdekjen e l\u00ebkur\u00ebs dhe indeve t\u00eb majave t\u00eb gisht\u00ebrinjve (gangren\u00eb). Shenjat dhe simptomat e gangren\u00ebs p\u00ebrfshijn\u00eb l\u00ebkur\u00ebn e zez\u00eb ose blu, humbjen e ndjesis\u00eb n\u00eb gishtat e prekur dhe er\u00ebn e pak\u00ebndshme nga zonat e prekura. Gangrena \u00ebsht\u00eb nj\u00eb s\u00ebmundje serioze q\u00eb zakonisht k\u00ebrkon amputim t\u00eb gishtit t\u00eb prekur.<\/p>\n<p><strong>Trajtimi dhe barnat:<\/strong><\/p>\n<p>L\u00ebnia e duhanit \u00ebsht\u00eb m\u00ebnyra m\u00eb efektive p\u00ebr t\u00eb ndaluar p\u00ebrparimin e s\u00ebmundjes. Edhe disa cigare n\u00eb dit\u00eb mund ta p\u00ebrkeq\u00ebsojn\u00eb s\u00ebmundjen. Gjithashtu \u00ebsht\u00eb e k\u00ebshillueshme q\u00eb t\u00eb shmangni ftohjet t\u00eb cilat kan\u00eb efekt t\u00eb ngushtimit t\u00eb en\u00ebve t\u00eb gjakut. Ila\u00e7et p\u00ebr zgjerimin e en\u00ebve t\u00eb gjakut p\u00ebrmir\u00ebsojn\u00eb qarkullimin e gjakut dhe mund t\u00eb ngadal\u00ebsojn\u00eb p\u00ebrparimin e s\u00ebmundjes. Simpatektomia \u00ebsht\u00eb nj\u00eb metod\u00eb kirurgjikale e prerjes s\u00eb nervave, e cila zvog\u00eblon dhimbjen dhe zgjeron en\u00ebt e gjakut.<\/p>\n<div class=\"yj6qo\"><\/div>\n<div class=\"adL\"><\/div>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>S\u00ebmundja e Buerger\/Buerger disease ICD &#8211; 10: I 73.1 Prevalenca: 1-5\/10.000 S\u00ebmundja e Burger \u00ebsht\u00eb nj\u00eb s\u00ebmundje e rrall\u00eb e [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":166210,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"no","inline_featured_image":false},"categories":[3087],"tags":[],"imageURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2022\/02\/17-Buerger-disease-1-650x366.png","thumbURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2022\/02\/17-Buerger-disease-1-250x141.png","categoryNames":["Maqedonia"],"feature_caption":"","subtitle":"","views":"1162","source":"\u0421\u043a\u043e\u043f\u0458\u0435, (\u0421\u0410\u041a\u0410\u041c\u0414\u0410\u041a\u0410\u0416\u0410\u041c.\u041c\u041a)","yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v15.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: S\u00cbMUNDJA E BUERGER - \u0421\u0430\u043a\u0430\u043c \u0414\u0430 \u041a\u0430\u0436\u0430\u043c<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sdk.mk\/index.php\/maqedonia\/ju-njoftojme-me-semundjet-e-rralla-semundja-e-buerger\/\" \/>\n<meta property=\"og:locale\" content=\"mk_MK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: S\u00cbMUNDJA E BUERGER - \u0421\u0430\u043a\u0430\u043c \u0414\u0430 \u041a\u0430\u0436\u0430\u043c\" \/>\n<meta property=\"og:description\" content=\"S\u00ebmundja e Buerger\/Buerger disease ICD &#8211; 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