Phazi la odwala matenda ashuga: ICD-10 code, gulu, zomwe zimayambitsa ndi njira zamankhwala

Chimodzi mwazinthu zovuta kwambiri za matenda a shuga ndi matenda ashuga oyamba.

Wodwala amene satsatira zakudya zomwe wapatsidwa, samayang'anira bwino shuga yemwe ali pamlingo woyipa (nthawi zambiri patadutsa zaka 15 mpaka 20 atazindikira kuti matendawa ndi omwe ali ndi matendawa), kupsinjika koteroko kumawonekera m'njira zosiyanasiyana.

ICD 10 diabetesic phazi ndimavuto owopsa, nthawi zambiri amatsogolera ku gangrene (minofu necrosis).

Mavuto a shuga

Nthawi zambiri, zovuta za matenda ashuga zimachitika chifukwa cha vuto la wodwala. Ngati anyalanyaza mankhwalawo, anyalanyaza malangizo azachipatala, samayang'anira kudya kwake, samapereka insulin panthawi yake, mosasamala mtundu wa matendawa.

Nthawi zambiri zotsatira zake zimakhala zazikulu, ndipo nthawi zambiri zotsatira zakupha siziphatikizidwa. Mavuto amatha chifukwa cha matenda amodzi, kuvulala, Mlingo wolakwika wa insulin, kapena kugwiritsa ntchito mankhwala omwe atha kale (kapena osazindikira).

Chimodzi mwazovuta zazikulu za matenda ashuga ndi:

1. lactic acidosis - kuphwanya chilengedwe acidic m'thupi chifukwa cha kuchuluka kwa ma asidi a lactic;
2. ketoacidosis - kuchuluka kwa matupi a ketone m'magazi chifukwa chosakwanira insulin;
3. hypoglycemic chikomokere - zotsatira zakugwa kwakukulu m'magazi a glucose;
4. hyperosmolar coma - chotsatira cha kuchuluka kwakuchulukirapo kwamas shuga;
5. odwala matenda ashuga phazi - chifukwa mtima pathologies m'munsi malekezero;
6. retinopathy - chotsatira chophwanya misozi;
7. encephalopathy - kuwonongeka kwa minyewa yaubongo chifukwa cha kusokonezeka kwamitsempha yamagazi;
8. mitsempha - ntchito kuwonongeka kwa zotumphukira mitsempha chifukwa cha kusowa minofu mpweya machulukitsidwe;
9. zotupa zamkati - mawonetseredwe pafupipafupi amachitika chifukwa cha kusokonezeka kwa metabolic m'maselo a khungu.

Kodi matenda ammimba a shuga ndi otani?

Matenda amtunduwu amakhudza minofu ya kumapazi. Njira zotupa mwa iwo zimayendetsedwa ndi kusefukira kwamphamvu, zomwe zimapangitsa kuti pakhale vuto lonyansa.

Zomwe zimayambitsa mawonetseredwe oterewa zimatha kukhala matenda a shuga, matenda osokonezeka m'matumbo am'munsi, omwe amakulitsidwa ndi matenda a bakiteriya.

Msonkhano woyamba wa International Symposium, womwe unachitika mchaka cha 1991 ndipo unadzipereka ku matenda a matenda ashuga, unapanga gulu lotengera momwe mitundu ya matendawa idayamba kusiyanitsidwa ndi zomwe zimayambitsa.

Mitundu yotsatirayi ndiosiyanitsidwa:

• mawonekedwe a neuropathic - imadziwoneka yokha ngati zilonda zam'mimba, kutupa, kuwonongeka kwa minyewa yamitsempha, yomwe ndi zotsatira za zosokoneza pakugwira ntchito kwamanjenje. Izi zimachitika chifukwa chakuchepa kwa kayendetsedwe ka mitsempha m'malo am'malo am'munsi;
• mawonekedwe a ischemic - ndi chotsatira cha mawonetseredwe a atherosulinotic, motsutsana ndi kumbuyo komwe kufalikira kwa magazi kumasokonezeka m'munsi malekezero;
• neuroischemic (kapena wosakanikirana) mawonekedwe - amatenga zizindikilo za mitundu yonse iwiriyi.

Nthawi zambiri, odwala matenda a shuga amawonetsa mawonekedwe a neuropathic mawonekedwe. Wotsatira pafupipafupi ndiye mawonekedwe osakanizika. Mtundu wa ischemic phazi la matenda ashuga limawonekera kawirikawiri. Kuchiza kumakhazikika pofufuza mwakuzindikira mitundu (mitundu) ya matenda.

Zomwe zimapangitsa kuti pakhale zovuta

Matenda a shuga m'magawo achibwibwi amadziwika ndi kusintha kwakukuru mu kuchuluka kwa shuga m'magazi, kapena poti gawo lake lalikulu m'magazi limakhalapo kwanthawi yayitali. Izi zimakhudza mitsempha ndi mitsempha yamagazi.

Ma capillaries a microvasculature amayamba kufa, ndipo pang'onopang'ono matendawa amatenga ziwiya zazikulu.

Kusagwiritsidwa ntchito mosavomerezeka ndi magazi kumapangitsa kuti trophism isakwanitse. Chifukwa chake yotupa njira limodzi ndi minofu necrosis. Vutoli limakhudzidwa ndikuti phazi, lomwe limakhala gawo limodzi lolimbitsa thupi, limakhala lotseguka nkhawa, ndipo, kawirikawiri, kuvulala pang'ono.

Munthu, chifukwa chakuchepa kwa kulowetsedwa (chidwi cha manjenjenje), sangasamalire zowonongeka zazing'ono (mikwingwirima, mabala, zikanda, mabala, mafinya), zomwe zimabweretsa kuchuluka kwa zotupa, chifukwa pakakhala magazi osakwanira m'matumbo ang'onoang'ono oteteza ntchito ya thupi m'malo awa sikugwira ntchito.

Zotsatira zake, izi zimatsogolera kuti mabala ang'ono samachiritsa kwa nthawi yayitali, ndipo ngati atatenga kachilomboka, amakula ndi zilonda zochulukirapo, zomwe zimatha kuchiritsidwa popanda zotsatira zoyipa pokhapokha atapezeka kuti ali koyambirira.

A syndrome monga phazi la matenda ashuga sakhala amachotsedwa konse ndipo nthawi zambiri amakhala m'gulu la matenda opatsirana.

Chifukwa chake, wodwalayo akulangizidwa kuti adziyang'anire mosamala, azitsatira mosamalitsa zakudya zomwe wapatsidwa komanso malangizo ena azachipatala, ndipo ngati zikuoneka kuti zilizonse zokayikitsa, pitani kuchipatala msanga.

Zizindikiro

Iliyonse mwa mafomuwo imadziwika ndi zake zokha. Makamaka:

• mawonekedwe a neuropathic kutsitsa kwamphamvu kwa phazi, kusinthika kwawo kuli ndi mawonekedwe, mawonekedwe a chimanga, cholingalira cha hyperkeratosis chimawonedwa. Pakapita nthawi, zilonda zimawonekera pamasamba, ndizovala mozungulira;
• mawonekedwe a ischemic kumachitika popanda maonekedwe a chimanga ndi kupunduka, chidwi cha khungu sichimachepa, koma nthawi yomweyo kusintha kwa malo a mapazi kumakhala kofooka ndipo sikumveka kwenikweni. Khungu limasandulika, kuyamba kuzizira. Zilonda zopweteka zimatuluka. Mitundu yawo ilibe tsatanetsatane womveka, m'mphepete mwawo nthawi zambiri safanana;
• mawonekedwe osakanikirana Zonsezi ndi mawonekedwe ena ali mawonekedwe.

Akatswiri amasiyanitsa magawo asanu ndi imodzi a matendawa:

1. kuwonongeka kwa phazi. Palibe zilonda pano;
2. mawonekedwe a zilonda zoyambirira zapamwamba;
3. kukulitsa zilonda zam'mimba, zomwe minyewa ndi minyewa ya tendon imakhudzidwa;
4. Zilonda zimakoka kwambiri mpaka zimakhudza minofu ya mafupa;
5. chiyambi cha zofooka zochepa;
6. gangore ikukula.

Njira Zodziwitsira

Kuzindikira kumachitika chifukwa cha mbiri yakale yakuchipatala, kuyezetsa wodwalayo ndi zotsatira za kuyesedwa, zomwe zimaphatikizapo maphunziro ndi njira monga:

• kuyezetsa magazi konse;
• kuwunika kwamitsempha;
• Ultrasound yamitsempha yamagazi yofunika kuyesa kuchuluka kwa kayendedwe ka magazi (Doppler ultrasound);
• chikhalidwe cha magazi pa mabakiteriya;
• angiography (kusiyanitsa x-ray, yoyang'ana kwambiri kuphunzira kwamitsempha yamagazi);
• General x-mapazi;
• biopsy ndi kuwunika zamkati zam'mimba zilonda.

Mukamayesedwa, kutentha kwa thupi, kukakamizidwa, kupuma, komanso zimachitika. Pambuyo pake, kupenda kwamilondayo mozama kumachitika ndi kutsimikiza kwa kuchuluka kwa mphamvu zawo komanso zisonyezo zingapo. Kuti adziwe kukula kwa kuwonongeka kwa minofu, dokotalayo amatha kuyesa kufufuza ndi kuchitira opereshoni mabala.

Chithandizo

Mankhwalawa amayamba ndikulipira matenda a shuga komanso kusintha kuchuluka kwa shuga m'magazi, popeza shuga wambiri amakhala ndi zotsatirapo zonse zoyipa.

Mwambiri, mankhwala othandizira a ischemic ndi neuropathic mitundu ndi ofanana ndipo amagwirizana polimbitsa magazi mu miyendo ndi achire kapena njira zopangira opaleshoni. Pankhani ya achire, mankhwala a antibacterial amadziwika, komanso mankhwala omwe amapangidwa kuti athandize magazi kutuluka komanso kuchepetsa kutupa.

Ndi akatswiri opaleshoni, amatha kutembenukira ku percutaneous Transluminal angioplasty, mothandizidwa ndi momwe zingathekere kubwezeretsa kayendedwe ka magazi m'mitsempha popanda zotupa pakhungu ndi puntery punction, komanso thrombarterctomy kapena distal bypass surge.

Zowopsa zomwe zimakhudzidwa ndi matenda zimapangidwa ndi regimen yofatsa; chithandizo cham'mimba chimachitika ndi antiseptic agents. Pankhani ya mawonekedwe a neuropathic, akatswiri amapereka chidwi chapadera pakubwezeretsa kwa malo okhala mkati mwendo, momwe mankhwala omwe amafunikira kusintha kagayidwe amatha kugwiritsidwa ntchito.

Chimodzi mwazinthu zazikulu zamankhwala ndicho kusiya kusuta kwathunthu. Nikotine imakhudza kwambiri kama wam'kati mwa michere, chifukwa chomwe njira zochiritsira zobwezeretsanso magazi zimatha kukhala zopanda ntchito kapena zitha kukhala zazifupi.

ICD Code 10

Kufufuza kotereku kumachitika ku ICD-10 (International Classization of Diseases 10 revision), yomwe idayambitsidwa ku Russia kuyambira chaka cha 1999. Ili mu kalasi ya E10 - E14 "Diabetes mellitus" ndipo yaikidwa mu E10.5 kapena E11.5, kutengera mtundu ndi matendawo.

Njira zopewera

Anthu omwe akudwala matenda a shuga amalangizidwa kuti azisamala kuchuluka kwa shuga omwe ali m'magazi awo ndikugwiritsa ntchito insulin yapamwamba kwambiri yopangidwa ndi makampani otchuka azamankhwala.

Komanso, nsapato zabwino zili ndi chikoka chachikulu. Iwo omwe adapezeka kuti ali ndi matenda a shuga pafupi zaka 10 kapena kupitila zapitazo ayenera kusamala kuti azigula nsapato zapamwamba zokha, zopandaulemu zomwe khungu la kumapazi silisunthika, ndikupanga ma microcracks ndi ma fractures.

Nsapato ziyenera kukhala zazifupi, zopumira, makamaka zopangidwa ndi zinthu zachilengedwe.. Palibe chifukwa chomwe kuyitanitsa kuyimbira ndi kubwereketsa. Payokha, ndikofunikira kutchulapo ukhondo wamapazi. Muyenera kuigwiritsa ntchito mozama, kutsuka mapazi anu ndi sopo ochapira nthawi zonse, kupewa matenda oyamba ndi fungus ndi kuvulala pang'ono, abrasions.

Wodwala matenda ashuga omwe amayang'anitsitsa zonse zofunikira pamwambazi sangakhudzidwe ndi matenda.

Makanema okhudzana nawo

Momwe mungachiritsire mabala ndi zilonda zam'mimba? Upangiri wa Dokotala mu kanema: