Ọrịa shuga phosphate n'ime ụmụaka: ihe kpatara ya na mgbaàmà ya

Ọrịa shuga Phosphate - a mkpụrụ ndụ ihe nketa mere mebiri nke ịnweta metabolism, nke absorption na assimilation nke site na ahu na-ata ahụhụ, nke na-eduga ná pathology nke ọkpụkpụ usoro. Dika ihe omuma ohuru si puta, o bu otutu ndi oria a kporo aru. E gosipụtara ya site na hypotension muscle, rickets nke ọkpụkpụ ahụ (nrụrụ dịgasị iche iche nke ọkpụkpụ nke ala ala, rickets na ndị ọzọ), mgbada azụ. Diagnosis nke ọrịa shuga phosphate sitere na nsonaazụ nyocha nke ọbara na mmamịrị (ọkwa nke alkaline phosphatase, caldị calcium, ụdị vitamin D) na - arụ ọrụ na nyocha mkpụrụ ndụ. A na-eme ọgwụgwọ nke ọrịa a site na ịdepụta oke vitamin nke vitamin D, phosphorus na calcium, orthopedic ma ọ bụ ịwa ahụ nke nrụrụ ọkpụkpụ.

Ozi izugbe

Ọrịa shuga phosphate (vitamin D na-eguzogide) bụ mkpokọta aha maka ọtụtụ tubulopathies nwere mkpụrụ ndụ ihe (nsogbu nke ibute ihe na nsị akụrụ), ebe nkwanye ugwu nke phosphate ion na-enwe na mmepe nke erughi ha n’ahụ. A kọwara otu ụdị ọrịa a na - ebutekarị, nke usoro kachasị ike nke ejikọtara na Xromosome, bụ nke a kọwara na 1937. N'afọ ndị sochirinụ, ndị na-amụ banyere mkpụrụ ndụ ihe nketa kpughere ọtụtụ ụdị ọrịa shuga phosphate nke nwere etiologies dị iche iche, nnyefe ihe nketa na foto ahụike. Agbanyeghị, ha niile nwere njiri mara - ha na-akpata site na mmịpụta nke phosphorus na akụrụ, bụ ihe mgbaàmà mara ya, na -echikwa anya etu esi eme ọgwụ vitamin nke oge a, achọpụtara mgbasa nke metụtara phosphate ọrịa shuga, mgbasa nke metụtara njikọ chromosome X. ma na-achịkwa ma recessive), autosomal dominant na autosomal recessive. Ihe kariri ụdị ụdị a bụ 1:20 000 (ụdị jikọtara X), ụdị ndị ọzọ adịkarịghị njọ.

Ihe kpatara na nhazi nke oria fosifeti

Na agbanyeghị na mkpụrụ ndụ ihe nketa akpọrọ nke ọrịa shuga phosphate, ihe na - ebute ọrịa hypophosphatemia n'ụdị ọrịa dị iche iche bụ otu ihe - mmebi nke nnabata nnagide (reabsorption) nke phosphates na nsị nke akụrụ. Nke a ga - enyere gị aka ịkọpụta ọnọdụ a na tubulopathies ma ọ bụ ọrịa nke usoro urinary, otu o sila dị, mgbe ọ mere, anụ ahụ niile na ọkachasị akwara gbasara ahụ. Na mgbakwunye, ụdị ụfọdụ nke ọrịa shuga phosphate na-esonyere site na mwepu ike nke calcium na eriri afọ na akụrụ, mmepe nke urolithiasis, ọrụ ezighi ezi nke glands parathyroid. Enwere nkwekọ doro anya n'etiti ụdị mkpụrụ ndụ ihe nketa na nke ọrịa, nke na-enye anyị ohere ịmepụta nhazi ọkwa doro anya, nke na-anabatakarị nke nwere ụdị 5 nke ọrịa.

A na - ejikọ ọrịa shuga phosphate njikọ X - bụ ụdị dị iche iche na - ahụkarị usoro ọmụmụ a, n'ihi mmụkọ sitere na mkpụrụ ndụ PHEX. Ọ na - etinye enzyme nke a na - akpọ endopeptidase, nke na - eduzi ọrụ nke ụzọ ion nke akụrụ na obere eriri afọ. N'ihi ntụpọ sitere na mkpụrụ ndụ ihe nketa, enzyme ahụ enwetara enweghị ike ịrụ ọrụ ya, yabụ, nnyefe ike nke phosphate ion site na sel ahụ na akụkụ ahụ dị n’elu na-eji nwayọ nwayọ. Nke a na-ebute mmụba na ọnwụ nke phosphate ion na mmamịrị na ihe isi ike nke nnabata ha na eriri afọ, n'ihi nke hypophosphatemia na-etolite n'ọbara, mgbanwe mgbanwe rickets na-apụta na anụ ahụ n'ihi ụkọ nke ihe ndị dị na mineral.

A na-ejikọ nri shuga phosphate X na-akpata - n'adịghị ka nsụgharị nke gara aga, ọ na-emetụta naanị ụmụ nwoke, ebe ụmụ nwanyị nwere ike rụọ ọrụ dị ka ndị na - ebu usoro pathology. Ihe kpatara ụdị ọrịa a bụ mmụba sitere na mkpụrụ ndụ CLCN5, nke na-etinye usoro usoro protein chlorine. N'ihi ntụpọ sitere na mkpụrụ ndụ ihe nketa, ntụgharị nke ion niile (gụnyere phosphates) site na membranes nke mkpụrụ ndụ nephron epithelial na-ewe iwe, n'ihi nke ọrịa shuga phosphate na-amalite.

Autosomal Dominant Phosphate Ọrịa Shuga - ụdị ọrịa nke nje mkpụrụ ndụ FGF23 mepụtara bụ chromosome 12th. Ngwaahịa nke ngosipụta ya bụ protein nke akpọrọ ihe na - eme ka ihe a na - akpọ fibroblast-23, ọ bụ ezie na osteoblasts na - enyocha ya ma na - eme ka mkpụrụ ndụ phosphate ion dị na mmamịrị na - ebute ya. Ọrịa shuga Phosphate na-etolite na mmụba FGF23, n'ihi nke protein ya na-emepụta na-eguzogide ihe nke nchebe ọbara, n'ihi nke ọ na-agbakọta na, n'ihi ya, mmetụta ahụ na-abawanye na mmepe nke hypophosphatemia. A na-ele ụdị ọrịa a ụdị shuga dị n'ọrịa shuga phosphate.

Autosomal recessive phosphate ọrịa shuga Bụ ụdị ọrịa na - adịghị ahụkebe na - akpata site na mmụba na mkpụrụ ndụ DMP1 nke dị na kromosome nke anọ. Ihe ọmụmụ ahụ na-etinye ihe acidic matrix dentine phosphoprotein, nke etoliteworo na dentin na anụ ahụ, ebe ọ na-achịkwa mmepe ha. Emebeghị ịmụ banyere ọrịa shuga phosphate na mkpụrụ ndụ ihe nketa a n'ụzọ zuru ezu.

Autosomal recessive phosphate ọrịa shuga na hypercalciuria - bukwanye ụdị ụdị ọrịa a na - esite na mmetụ nke ihe omimi nke SLC34A3 nke dị na kromosome nke itoolu. Ọ na - edobe usoro nke sodium dabere na ụrọ phosphate na akụrụ na, nwere ntụpọ n'ihe owuwu ahụ, ọ na - eduga n'ịba ụba nke calcium na site na mmamịrị na-enwe ntakịrị mgbakwunye na plasma.

E nwekwara ụdị ọrịa shuga phosphate, tinyere hyperparathyroidism, urolithiasis na nsogbu ndị ọzọ. Varietiesfọdụ ụdị oria a jikọtara ya na ọrịa mkpụrụ ndụ dịka ENPP1, SLC34A1 na ụfọdụ ndị ọzọ. Ọmụmụ banyere ihe ọ bụla nwere ike ibute ọrịa shuga phosphate ka na-aga n'ihu.

Ọrịa shuga nke Phosphate

Ihe ngosiputa nke oria phosphate n’ihi ihe banyere mkpụrụ ndụ ihe nketa nke ọrịa a bụ njiri mara oke - iji obere usoro asymptomatic pụta n’ọrịa doro anya. Enwere ike igosipụta ụfọdụ nsogbu gbasara ọrịa (dịka ọmụmaatụ, n'ihi mmụba na mkpụrụ ndụ FGF23) naanị site na hypophosphatemia na mmụba nke ọkwa phosphorus na mmamịrị, ebe enweghị mgbaàmà ọria. Agbanyeghị, ọtụtụ mgbe, ọrịa shuga phosphate na-eduga na foto nke rickets na-ahụkarị ma na-etolite na nwata - 1-2 afọ, n'oge na-adịghị anya nwa ahụ malitere ije ije.

Hypotension muscle dị ka nwa ọhụrụ nwere ike ịbụ otu n'ime ihe ngosipụta mbụ nke ọrịa shuga phosphate, mana a naghị ahụ ya n'ọnọdụ niile. Ọtụtụ mgbe, mmepe nke ọrịa na-amalite site na nrụrụ n'ụdị O, nke nwere ike ibute ụzọ isi. Site na ịba n'ihu nke ọrịa shuga phosphate, ihe ịrịba ama ndị ọzọ nke ọrịa rickets nwere ike ime - nzụlite uto na mmepe anụ ahụ, isi mkpịsị eze mejupụtara (ọkachasị ụdị ọrịa ọrịa autosomal), alopecia. Mmebi akwara, ọdịdị nke ọgịrịga “rosary”, nkụchi nke ọkpụkpụ aka n’ụkwụ bụ ihe e ji mara ha. Ọzọkwa, na ọrịa shuga phosphate, a na-ahụ ọnya na azụ (ọ na-abụkarị ọdịdị akwara ozi) na ọkpụkpụ, n'ọnọdụ ndị a na-adịghị ahụkebe, n'ihi mgbu ụkwụ, a napụrụ nwatakịrị ahụ ohere ịga ije. Ọdịghị ọgụgụ isi nke ọgụgụ isi nke ọrịa a ka egosighi.

Nchọpụta ọrịa shuga phosphate

Otu n'ime ụzọ izizi maka ịchọpụta ọrịa shuga phosphate bụ nyocha izugbe nke nwatakịrị na-arịa ọrịa na ọmụmụ banyere mmeghachi omume nke ọrịa ahụ na ojiji nke vitamin nke mbụ. D. Dị ka a na-achị, ya na usoro a na-enwe ihe osise banyere rickets na iguzogide iji ọgwụ ọdịnala nke vitamin a (mmanụ azụ, ngwọta mmanụ) . Maka mkpebi ziri ezi nke ọrịa shuga phosphate site na iji usoro ọmụmụ biochemical nke ọbara na mmamịrị, ọmụmụ x-ray, nyocha mkpụrụ ndụ. Ngosiputa mgbe nile oria a bu hypophosphatemia ma obu mbelata ogo nke phosphate ion n’ime plasma obara, nke ekpebiri n’otu akụkụ nke nyocha ihe banyere ndu. N'otu oge ahụ, ọkwa nke kalsel nwere ike ịbụ nke nkịtị ma ọ bụ nwee ụba, ka ọ dị, ụdị ụfọdụ nke ọrịa shuga phosphate (n'ihi mmụba na usoro nke SLC34A3) bụkwa omume ihu abụọ. Ọzọkwa, na ọrịa shuga phosphate, mmụba nke ọkwa alkaline phosphatase na oge ụfọdụ mmụba nke ọkwa homonụ parathyroid nwere ike ime. Nnwale mmamịrị sitere na kemịkalụ na-ekpughe oke elu nke phosphorus (hyperphosphaturia) na, n'ọnọdụ ụfọdụ, hypercalciuria.

Ihe omumu ihe omimi nke oria phosphate choputara ihe omuma ama nke rickets - mmebi nke okpukpu ukwu nke ukwu, ikpere na hips, ọnụnọ osteoporosis (n'ọnọdụ ụfọdụ, osteosclerosis mpaghara nwere ike ime) na osteomalacia. Ọkpụkpụ ọkpụkpụ gbanwere - cortical oyi akwa na-abawanye, usoro ọnya ahụ na-abawanye, diaphysis na-abawanye. Ọtụtụ mgbe, afọ x-ray na arịa ọrịa shuga phosphate na-adịkarị n’azụ, nke na-egosi igbu oge n’ọkpụkpụkpụkpụkpụkpụkpụkpụ mmadụ. Mkpụrụ ndụ ihe nketa ọhụụ na-enye gị ohere ịchọpụta ihe niile ụdị ọrịa a, dịka iwu, a na-eji usoro usoro usoro mkpụrụ ndụ ihe omimi metụtara ọrịa. N'ọnọdụ ụfọdụ, akụkọ banyere mkpụrụ ndụ ihe nketa nke onye ọrịa nwere ike igosipụta ụdị mkpụrụ ndụ ihe nketa nke ọrịa shuga phosphate.

Ọgwụ shuga Phosphate

A na-agwọ ọrịa shuga phosphate site na njikọta ọgwụ vitamin, orthopedic na usoro ịwa ahụ. Na agbanyeghi aha ozo maka ogwu a (vitamin D na - eguzogide rickets), a na - eji vitamin a eme ihe n’ilebara onodu a anya, ma a gha abawanye otutu ogwu a. Na mgbakwunye, ndị ọrịa nwere ọrịa shuga phosphate ka edepụtara nkwadebe calcium na phosphorus, vitamin A, E na otu B. Ọ dị mkpa na a ga-ebu ọgwụgwọ ahụ na vitamin nke nwere abụba (ọkachasị D na A) naanị n'okpuru nlekọta nke dibịa yana iji nlezianya debe ọgwụ iji gbochie mmeghachi omume na-achọghị. nsogbu. Iji nyochaa ịdị irè nke ọgwụgwọ na izi ezi nke ọgwụ ọgwụ a nyere, a na-eme nha maka ọkwa phosphate na calcium na mmamịrị mgbe niile. N'ime ụdị ọrịa shuga phosphate siri ike, enwere ike igosipụta ojiji nke vitamin D maka ndụ.

Na nchoputa mbu oria a, ogha ya n’enweghi mgbochi nke nkwuputa akwara site na usoro orthopedic na mbu - yikwasi bandeeji n’iru. Site na ịchọpụta ọrịa shuga phosphate nke nwere nsogbu nrụrụ ọkpụkpụ na -akpata, enwere ike igosipụta mgbazi. Asdị asymptomatic nke ọrịa a, gosipụtara naanị hypophosphatemia na hyperphosphaturia, dị ka ọtụtụ ndị ọkachamara si kwuo, ọ dịghị mkpa ọgwụgwọ siri ike. Agbanyeghị, achọrọ nlezianya banyere ọnọdụ ọkpụkpụ, usoro akwara, na akụrụ (mgbochi urolithiasis), nke a na-eme site na nyocha ahụike mgbe niile site n’aka onye ọkà mmụta endocrinologist.

Amụma na igbochi ọrịa shuga phosphate

Prognosis nke ọrịa shuga phosphate nwere ike ịdị iche ma dabere n'ọtụtụ ihe - ụdị ọrịa, ogo mgbaàmà, afọ nke ịchọpụta ọrịa na mbido ọgwụgwọ ọfụma. Ọtụtụ mgbe, prognosis ahụ dị mma, mana ịchọrọ ndụ ogologo oge niile nke iji vitamin D, calcium na phosphorus nwere ike ịdịgide. Ọkpụkpụ akwara na-esite n’ịchọpụta ọrịa ma ọ bụ ọgwụgwọ na-adịghị mma nke ọrịa shuga phosphate nwere ike imebi ndụ onye ọrịa. Mgbochi ọrịa a ketara eketa ga-ekwe omume nanị n'ụdị ndụmọdụ mkpụrụ ndụ ihe nketa maka ndị nne na nna tupu ịtụrụ nwa, n'ihi na a zụlitela usoro ụfọdụ nke nchọpụta nke afọ ime.

Ihe na - akpata ọrịa shuga dị iche iche

Nkọwa mbụ nke ọrịa pụtara na narị afọ nke 20. Edebara onye ọrịa ahụ na ụdị dịgasị iche iche nke hypophosphatemic rickets yana ọrụ nke ketara eketa gosipụtara ya. Mgbe emesiri, achoputara oria ndi ozo nke bu oria phosphate, nke nwere njiri mara ha na ihe ha na-akpata, udiri ihe nketa na ihe ndi ozo. N'okpuru ebe anyị bi na isi ihe.

Ejiri rickets hypophosphatemic jikọrọ X. Nke a bụ otu n'ime ọrịa ndị a na-ahụkarị n'ọrịa rickets, ọnụọgụ ya bụ 1: 20,000 nke ọnụ ọgụgụ ụmụaka. A na-eleba ihe kpatara ọrịa a anya dị ka mmụba na mkpụrụ ndụ PHEX nke na-eme ka ọrụ enzyme endopeptidase na-arụ ọrụ na mmebi nke homonụ peptide dị iche iche. N'okwu a, ụkọ nke protein na - eme, na - ebuga ngwakọta phosphorus na tubules nke nephron (akụkụ nhazi nke akụrụ) na eriri afọ, nke na - eduga na ọnwụ nke ụsọ phosphorus na mmamịrị na ịmịchasị ihe na mgbaze. Yabụ, metabolism nke-calcium na-agbaghasị n’ahụ, yana ihe mgbaàmà iche iche metụtara ya na-eme. Ọrịa a na-eme ka metabolism ụbụrụ na - akpata ọrịa na mkpụrụ ọgwụ akwara (pensụl mkpụrụ ndụ) na mmiri ọgwụ gabigara ókè na-eme ka ọrịa ahụ ka njọ.
Autosomal na-achịkwa hypophosphatemic rickets. Udiri oria a bu nke akari karia nke mbu ma n’enwecha nsogbu. E jikọtara ya na mmụba nke usoro FGF-23, karyotyped na chromosome 12. Onyinye a bụ ihe na - emegharị site na osteocytes (sel sel) iji gbochie realsorption renal (iweghachi ume na mmamịrị) nke phosphates. Site na mmụba n'ọrụ ya na ọbara, a na-ahụ hypophosphatemia.
Autosomal recessive hypophosphatemic rickets. Ọrịa shuga dị iche iche nke phosphate a bụ n'ihi mmụba na mkpụrụ ndụ DMP1, nke na-ahụ maka njikọta protin ọkpụkpụ a kapịrị ọnụ nke na-etinye aka na nhazi nke ịba ụba nke osteoblasts (mkpụrụ ndụ ọkpụkpụ akabeghị aka). Ọ na - eme ka mwepụ phosphorus na mmamịrị na mkpo ya na mkpokoro parathyroid na calcitriol.
Ọrịa hypophosphatemic rickets na hypercalciuria. Nke a bụ oria a na-adịghị ahụkebe n'ihi mmerụaka nke mkpụrụ ndụ nke SLC34A3, nke na-egbochi ọrụ sodium phosphate cotransporters, nke na-ebugharị ebugharị ihe dị iche iche na tubules na phosphate homeostasis. Ihe e ji mara ya bụ phosphorus na kalsia na mmamịrị ya, mmụba nke ọrụ calcitriol na mmepe nke rickets.

Ọmụmụ ịrịa ọrịa shuga phosphate bụ polymorphic. Ọrịa ahụ na-eme ka ọmarịcha ya na nwata, mana ọ nwere ike igosipụta onwe ya ma emesịa - na afọ 7-9. Ọzọkwa, ogo nke mgbaàmà ọrịa nwekwara ike ịdị iche. N'ọnọdụ ụfọdụ, ọrịa ahụ nwere usoro asymptomatic ma gosipụta ya site na mgbanwe dị nro na metabolism phosphorus-calcium. Agbanyeghị, ụdị hypophosphatemic rickets na-enwekarị ihe osise a na-ahụkarị:

mmezu nke mmepe ahu na uto ya,
Ọkpụkpụ ọkpụkpụ na-adị (nrụrụ ọkpụkpụ) nke akụkụ aka ekpe, ndọkụrịta nke ọkpụkpụ aka aka, nrụrụ nke okpokoro isi).
mgbanwe na uru nwa ahụ (yiri duck)
imebi nguzobe ezé,
ọrịa ọnya
ihe mgbu, wdg.

Akwara hypotension, njiri mara ezi rickets, anaghị adịkarị n'ọrịa shuga phosphate.

Mmepe ọgụgụ isi nke ọrịa a anaghị ata ahụhụ.

Diagnostics

Nchọpụta ọrịa shuga phosphate dị na ụmụaka sitere na onyonyo a na-ahụkarị, data sitere na nyocha anụ ahụ na nyocha. Achọpụtara nchọpụta ahụ site na nsonaazụ ụlọ nyocha na ngwa ọrụ:

mgbanwe na nnwale ọbara (hypophosphatemia, alkaline phosphatase mụbara, ọkwa nkịtị ma ọ bụ elu nke homonụ parathyroid na calcitonin) yana mmamịrị (hyperphosphaturia, wedata phosphate mbelata na mkpịsị akụrụ, ịmụba calcium naanị na hypophosphatemic rickets with calcuria),
X-ray data (ihe ịrịba ama nke osteoporosis system, nrụrụ ọkpụkpụ, mgbanwe nke ọkpụkpụ), osteomalacia).

Mgbe ụfọdụ ọrịa ahụ na-amalite, a na-achọpụta ndị ọrịa dị otú ahụ na rickets ma na-enye ọgwụ ọgwụ na vitamin D, ọgwụgwọ dị otú ahụ anaghị arụpụta ma na-enye ihe mere ha ga-eji chee na ọ nwere ọrịa shuga phosphate. Ọ bụrụ na ọ dị mkpa, n'ọnọdụ ndị dị otú a, enwere ike ikenye ọmụmụ mkpụrụ ndụ ihe nketa iji mata mmebi mkpụrụ ndụ ihe nketa.

A na - ahụta njikọta nke hypophosphatemia na rickets nke aka n'ụfọdụ ọnọdụ ọrịa ndị ọzọ ga - eme nchọpụta ọdịiche:

Ọria akụrụ (akụrụ akwara tubular acidosis, ọrịa akụrụ na-adịghị ala ala) na imeju (cirrhosis),
pathology endocrine (hyperfunction nke glands parathyroid),
ịba n'ahụ akwara, ọrịa celiac enteropathy,
alimentary (nri) ụkọ nke vitamin D na site,
ị certainụ ọgwụ ụfọdụ.

Ọgwụ zuru oke nke hypophosphatemic rickets kwesịrị ịmalite na mmalite nke ọrịa ahụ. Nke mbu, ebum n’uche ya banyere mmezi nke nsogbu nke ihe omimi na mgbochi nke mmebi ọkpụkpụ. Mgbe edepụtara ya, a na-atụle ọrụ nke usoro yana ntinye nke ọgwụ n’onwe ya.

Ndabere nke ọgwụgwọ ọgwụgwọ bụ ọgwụ ogologo oge na oke ọnụọgụ vitamin D. A na-enye ya iwu:

jiri rickets na-arụ ọrụ n'ime anụ ahụ,
ụfụ nke ọgwụ na mmamịrị,
mụbara alkaline phosphatase n’ime ọbara,
na nkwadebe maka ịwa ahụ iji dozie nrụrụ ọkpụkpụ.

Nri mbụ nke vitamin D bụ 10,000-20000 IU kwa ụbọchị. A na-emewanye mmụba ha n'okpuru nchịkwa ndị na-egosi metabolism nke-calcium metabolism n’ime ọbara. Oke onunu ogwu nke ubochi nwere ike idi elu ma gha ufodu ruru 250,000-300,000 IU.

Na ọnụnọ nke ekweghị mmadụ nọrọ na vitamin D, yana nnukwu ịba ụba, a na-ele ịhọpụta ụdị ọgwụgwọ ahụ adịghị mma.

Na mgbakwunye na vitamin D, a na-atụ aro ka ndị ọrịa dị otú a:

phosphorus na nhazi nke calcium,
ngwakọta nke citrate (n'ime ọnwa isii iji meziwanye nnabata ndị a na - achọpụta).
homonụ na-eto.

N'ime oge dị ukwuu nke usoro ahụ, a na-adụ ndị ọrịa ọdụ ka ha hie ụra, mgbe ha nwesịrị mgbaghara - ọgwụgwọ ịhịa aka n'ahụ, mmega ahụ a na-eme na spa spa.

Ihe nlebara anya maka odi nma na nti ajuju bu:

ọdịmma,
osooso nke uto,
normalisation nke phosphorus metabolism na ahụ,
ezigbo rediological radio (weghachite usoro ọkpụkpụ).

Ọnụnọ nrụrụ ọkpụkpụ na –emebi ndabere nke mgbatị ahụike na ụlọ nyocha, ana-agbazi ịwa ahụ ha. Enwere ike iji usoro ndị a maka nke a:

osteotomi (dissection) nke ogologo ọkpụkpụ toubu na ndọtị nke eriri aka ya,
mgbochi nke Ilizarov ndọpụ uche na ngwa mkpakọ.

Ekwesịrị ịrụ ụdị ọrụ ahụ naanị mgbe ọgwụgwọ ogologo oge na nyocha nke ogologo oge gasịrị.

Kedu dọkịta ịkpọtụrụ

Ọ bụrụ na a na-enyo enyo ọrịa shuga phosphate, ọ dị mkpa ịkpọtụrụ dọkịta na-ahụ maka ụmụaka, mgbe nyocha nke mbụ, ga-edunye nwa ahụ ka ya na onye ọkachamara na-ahụ maka ọrịa endocrinologist, orthopedist, na nephrologist. Ọgwụgwọ a gụnyere masseur, physiotherapist, ọkachamara na usoro mmega ahụ na usoro ọgwụgwọ. Ọ bụrụ na ọ dị mkpa, dọkịta na-awa ahụ ga-awa ahụ.