GANGRENE MU SHUGA: ZIMAYAMBITSA KOMANSO ZOTSATIRA ZAKE

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Gangrene ndi necrosis ya m'deralo (necrosis) ya zomanga thupi.

Pathology ndi owopsa ndikutulutsa zakumwa za cadaveric m'magazi: izi zimapangitsa kuti pakhale zovuta zochokera ku ziwalo zofunika za mtima, chiwindi, impso ndi mapapu. Gangrene ndi njira yodziwika bwino ya matenda ashuga: nthawi zambiri pamavuto, izi zimawonekera mu mawonekedwe a phazi la matenda ashuga - minofu necrosis ya m'munsi malekezero.

Gangrene mu shuga - zambiri

Matenda a shuga amatanthauza zomwe zimayambitsa matenda osiyanasiyana komanso matenda opatsirana. Ziwerengero zakuchipatala zomwe zidakhumudwitsa zikuwonetsa kuti wodwala aliyense wachiwiri yemwe amapita kukaonana ndi endocrinologist wa matenda ashuga kale ali ndi mbiri yovuta yamatenda ambiri.

Matenda a shuga monga njira ya kagayidwe kachakudya kamakhudza ziwalo zonse ndi minyewa: kawirikawiri madokotala amayenera kugwiritsa ntchito njira zochizira kuti awonjezere kapena kupulumutsa moyo wa wodwalayo.

Chimodzi mwamavuto akulu kwambiri ashuga omwe ali nawo ndi matenda opatsirana a m'matumbo: matenda a minofu necrosis chifukwa kuwonongeka kwa kotulutsa magazi.

Mu matenda a shuga, mitsempha ya m'magazi imayamba kugwira ntchito, imakhala yochepa, imakhala yochepa, ndipo imaleka kukwaniritsa ntchito yopereka minofu ndi mpweya ndi michere. Matendawa amatchedwa atherosulinosis.

Choyamba, mitsempha yaying'ono yam'magazi - ma capillaries amasinthidwa amisala, kenako mitsempha yayikulu imakumananso ndi zomwezi. Mafupa, mafupa amakhudzidwa, mawonekedwe a zilonda zam'mimba zimachitika (makamaka kumapeto pang'ono). Ngati pakadali pano njira zoyenera zochizira sizinatenge, vuto la minyewa yotupa limayamba.

Ngati sanalandiridwe, chifukwa cha zovuta zamkati, khungu limabweretsa. Koma nthawi zina ngakhale kukafika kwa dokotala sikothandiza kupulumutsa minofu yakufa. Odwala, pali njira imodzi yokha yochizira matenda osokoneza bongo - kudula manja. Zabwino kwambiri ndi zochitika zachipatala pomwe, odwala matenda ashuga, madokotala ochita opaleshoni amayenera kudula chala chala: nthawi zina mwendo womwe umakhudzidwa mpaka bondo kapena kumtunda umadulidwa.

Zimayambitsa gangore mu shuga

Zomwe zimagwirizanitsidwa ndimatenda a gangren mu matenda a shuga zingakhale motere:

Kuphulika kwa mtima chifukwa cha atherosulinosis ndi ischemia;
Kusintha pang'onopang'ono kwa odwala omwe ali ndi matenda ashuga, omwe ngakhale mabala ang'onoang'ono amatenga kachilomboka, zomwe zimathandiza kukulitsa matenda opatsirana;
Polyneuropathy, ikukula chifukwa cha kuphwanya kwachilengedwe kagayidwe kazakudya (iwo amataya magwiridwe antchito a micheresels a mitsempha ya mitsempha, chifukwa chomwe maselo amakhudzidwa ndi kukalamba msanga ndi necrosis);
Kuphwanya njira ya mapangidwe a mafupa (izi zimabweretsa mafupa am'mimba komanso aseptic necrosis);
Kuchepetsa chitetezo cha mthupi;
Kukhalapo kwa kunenepa kwambiri;
Tsekani nsapato zosasangalatsa;
Kusuta.

Nthawi zambiri, kukula kwa gangrene sichinthu chimodzi, koma zovuta zonse.

Ziwerengero zachipatala zikuwonetsa kuti 80% ya anthu omwe amwalira ndi matenda ashuga chifukwa cha gangore.

Mitundu ya Diabetesic Gangrene

Pali mitundu inayi ya gangore komwe adachokera:

Neuropathic, chifukwa cha kuwonongeka kwa minyewa yamanjenje;
Angiopathic, chifukwa cha kuwonongeka kwamitsempha yamagazi;
Osteopathic, akukula chifukwa cha kuwonongeka kwa mafupa;
Zosakanizidwa.

Mwa chikhalidwe chake ndi mawonekedwe ake otaya, mitundu iwiri ya gangrene imayamba:youma komanso yonyowa.

Youma gangrene ndi matenda ashuga, amapanga ngati pakhale kuwonongeka pang'onopang'ono patency ya capillaries ndi mitsempha yayikulu yamagazi. Nthawi zambiri njirayi imatha kwa zaka zingapo. Munthawi imeneyi, thupi la odwala matenda ashuga amatha kusintha pang'ono matendawa ndikuyamba kukhala ngati njira zoteteza. Nthawi zambiri khungu lowuma limakhudza zala, pomwe minofu yakufayo sili ndi kachilomboka.

Zizindikiro zoyambirira za khungu lowuma ndizopweteka kwambiri kumapazi.

Palibe chizindikiro cha kuledzera. Kuopsa kwa moyo wa wodwala wodwala matenda owuma kumakhala kodetsa nkhawa: kumasula zakumwa zoopsa m'magazi ndizosachedwa kapena kupezeka paliponse. Kudula kungathe kulembedwera pazifukwa zodzikongoletsa kapena ngati prophylaxis, popeza nthawi zina khungu louma limasanduka lonyowa.

Zowonda kwambiri owopsa kwambiri. Chilonda chimakhala chofalikira pafupipafupi ndi ma virus a anaerobic omwe amachulukana mwachangu, zomwe zimapangitsa kuti chiwopsezo chikhale chambiri m'dera la minofu yowonongeka. Kunja, gangrene akuwoneka ngati chigamba cha minofu yakuda kapena yakuda: pomwe matendawa amapita patsogolo, ndikokulirapo gawo la minyewa yosintha. Nthawi zina, phazi lonse, mwendo wotsika, ndi ntchafu kapena dzanja zimakhudzidwa ndi njirayo (ngati gangrene akukulira kumtunda).

Zizindikiro za gangrene mu shuga

Odwala a shuga a mitundu yonse 1 ndi mtundu 2 ali pachiwopsezo cha zovuta.

Monga lamulo, odwala matenda ashuga ali ndi malo ochepetsera ululu, ndipo mwina sangawone mawonekedwe a zilonda ndi mabala m'thupi, ming'alu, chimanga. Pakadali pano, njira za pathological zimachitika m'dera lomwe lakhudzidwa - kachilombo ka tizilombo toyambitsa matenda ndi bowa, matenda, kulanda gawo lalikulu la minofu yamoyo.

Kuwonongeka kwachilengedwe kumachitika chifukwa cha kuchuluka kwambiri kwa shuga, komwe kumayambitsa poizoni m'thupi ndi kufa kwa mitsempha yotsiriza yomwe imapereka ma sign a ululu ndikuwongolera chidwi.

Mitsempha yomwe imayambitsa kutulutsa thukuta imafanso, zomwe zimapangitsa kuti khungu lizikhala louma, mawonekedwe a ming'alu ndikulimbikitsa kubereka kwachangu kwa microflora ya pathogenic. Dziwani kuti kugwiritsa ntchito maantibayotiki pakhungu lotupa kumathandizira magawo oyamba, mtsogolomo, mabakiteriya ndi ma tizilombo tina amatulutsa kukana (mankhwala) awa.

Ndi gangrene, miyendo yakumunsi imakhudzidwa kwambiri, nthawi zambiri mbali zina za thupi - mikono kapena thunthu.

Chosiyana kwambiri ndi vutoli ndi geninant gangore, momwe msempha wamtsempha wamagazi umachitika mwachangu.

Mphezi zamagetsi zimayamba kupangika. Mwachizolowezi, necrosis imayendetsedwa ndi nthawi yayitali yokhala ndi zizindikiro zapang'onopang'ono zomwe zimagwirizanitsidwa ndi kuchepa kwa chidwi cha minofu.

Nthawi zina, gangrene amakula pang'onopang'ono ndipo amayenda ndi izi:

Redness, pallor ndi cyanosis a khungu ku lesion malo;
Kuwonongeka kwa zala kumiyendo ndi manja;
Lakuthwa, kuboola ululu m'chiuno;
Kutenthedwa kwamiyendo mwendo pamene mukuyenda, dzanzi komanso kumva kuthedwa nzeru.
Edema wa miyendo yomwe yakhudzidwa;
Kuchepetsa kutentha m'miyendo;
Kuchepa kwa phazi;
Kuwonongeka kwa mbale ya msomali, kusinthanitsa, mawonekedwe a msomali;
Pafupipafupi matenda a fungus ku malo a lesion.

Kukula kwa zilonda zapagulu pa siteji yowonjezera minofu necrosis kumayendera limodzi ndi kupweteka kwambiri, komwe sikumayima ndi ochiritsira wamba. Kupereka magazi m'dera lomwe lakhudzidwalo kulibe.

Ngati chonyansa cham'mimba chikamera, kachilomboka nthawi zonse kamajowina, komwe kumayambitsa kutulutsa kwatsopano. Kukula kwa gangrenous necrosis kumabweretsa kuledzera kwa thupi ndipo kumayendetsedwa ndi kuzizira, kutentha thupi, nseru, ndi kusanza.

Chithandizo cha Matendawa

The achire zotsatira za gangrene amachitika m'njira ziwiri - okhazikika komanso opaleshoni.

Njira zozizira zimapangidwira kuti zipereke zotsatirazi:

Kulipira shuga;
Kuchepetsa katundu pazinthu zomwe zakhudzidwa ndi miyendo
Kuchepetsa dera la matenda ndi maantibayotiki, odana ndi kutupa;
Zizindikiro mankhwala a kuledzera;
Kupititsa patsogolo chitetezo chathupi komanso kuwonjezeka kukana mothandizidwa ndi vitamini.

Njira zodzitchinjiriza zimatsogolera kuzinthu zabwino mosasintha ayi. Njira yayikulu yonyowa gangrene ndi njira yochitira opaleshoni - njira yokhayo yopewera kufa.

Pakupanga opaleshoni, minofu yomwe yakhudzidwa imachotsedwa ndipo madera omwe amakhala pafupi ndi malo omwe ali ndi matendawa amayeretsedwa. Kuphatikiza pa kuchitapo kanthu kwa opaleshoni, njira zothandizirazi zitha kutumikiridwa - kuchotsa thupi ndi kulowetsedwa, kupatsidwa magazi.

Mitsempha yamagazi yochokera ku ziwiya zomwe zakhudzidwa ndi ischemia ndi atherosulinosis amathanso kuchotsedwa. Muzipatala zamakono, opaleshoni ya microsuction bypass, stinging ndi kuyeretsa kwamitsempha pogwiritsa ntchito kafukufuku yemwe adalowetsedwa m'mitsempha ndipo athetse kwathunthu thrombus amagwiritsidwa ntchito.

Mu theka la zovuta zomwe zimachitika pakhungu lonyowa, madokotala ochita opaleshoni amayenera kudula miyendo yomwe idakhudzidwa, zomwe zimapangitsa kuti asamagwire ntchito komanso kulumala.

Kupewa

Mutha kupewa kukula kwa matenda osokoneza bongo omwe ali ndi matenda ashuga mothandizidwa ndi njira zoyambira zodzitetezera.

Anthu odwala matenda ashuga ayenera kuyang'anitsitsa momwe mapazi awo aliri,
gwiritsani mabala munthawi yake
Valani masokosi opangidwa ndi nsalu zachilengedwe ndi nsapato zotayirira, zomasuka,
mafuta mafuta pakhungu.

Kusapezeka kwa zizolowezi zoipa kumachepetsa mwayi wamavuto. Mukasamba, odwala matenda ashuga amayenera kuyang'anira kutentha kwa madzi: sayenera kukhala apamwamba kuposa madigiri 35-36.

Sankhani dokotala ndipo pezani nthawi:

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