Matenda a matenda ashuga

Umoyo wa anthu odwala matenda ashuga nthawi zambiri umakhala pachiwopsezo. Kuphatikiza pa kuwonongeka kwaubongo, impso, mawonedwe ophatikizira ndi mitsempha, gawo lofunikira limaperekedwa kwa odwala matenda am'mimba a matenda ashuga (SDS). Zowonetsa zazikulu za matenda a zam'mimba ndizomwe zimachitika ndi zilonda zam'mimba, ischemia yovuta ndi matenda am'mafupa ndi mafupa amchikhalidwe chosakhala yopatsirana. Zilonda zam'mimba zimawerengedwa kuti ndizoopsa kwambiri, chifukwa kudziphatika kwa matenda achitetezo kumakhudza kukula kwa vuto lachiberekero ndi kuwonongeka kwa miyendo.

Matenda a shuga - chikhalidwe chomwe endocrinologists amachitapo. M'mayiko akunja, kupembedza milungu ikuphunzira nkhaniyi, komabe, mdziko lathu sayansi iyi imawonedwa kuti ndi yaying'ono, akatswiri ena ochepa kwambiri sanakhalepo.

Mfundo zazikulu

Miyendo yam'munsi imayang'aniridwa ndi kupsinjika kwakukulu pamoyo wonse. Kulemera konse kwa thupi kumapititsidwa kuzinthu zamiyendo. Ichi ndichifukwa chake kuwonongeka kwa mitsempha yamagazi, mafupa am'mitsempha ndi zida zamanjenje motsutsana ndi matenda osokoneza bongo zimakwiyitsa kukula kwa kuwonongeka ndi kuwonongeka kwa phazi.

Matenda a shuga a matenda am'mimba amayesedwa ngati njira yodziyimira yokha yomwe imachitika motsutsana ndi maziko a matenda ena a retinopathy, nephropathy, angiopathy, neuropathy. Mwendo wotsika umadutsa kusintha kwa anatomical ndi zokhudza thupi, zomwe zimawonetsedwa ndi purulent-necrotic.

Njira yopititsira patsogolo

Mu shuga mellitus, pali mtheradi (1 mtundu wa matenda) kapena wachibale (2 mtundu wa matenda) insulin pancreatic kuperewera kwa hormone. Njira zotere zimayambitsa kuchuluka kwa shuga m'magazi ndikusokonekera kwa njira zonse za metabolic. Matendawa odwala matenda ashuga ndi omwe amabwera chifukwa cha zovuta zina zomwe zimayambitsa matenda: neuropathy, angiopathy, osteoarthropathy.

Matenda a shuga

Vutoli limayambitsa kuwoneka kwa zilonda zam'mimba mu diabetes iliyonse. Makhalidwe apamwamba a glucose omwe amawonongeka amachititsa kuti mitsempha ipangidwe (maselo, ulusi, zolandilira), zomwe, zimadziwika ndi kufalikira kwa zovuta. Kuphatikiza apo, kuwonongeka kwa mitsempha kumayambikanso chifukwa cha angiopathies omwe amapezeka pafupifupi odwala matenda ashuga onse ndipo amatsogolera kuti njala ya okosijeni ya zinthu zamitsempha ikhale.

Kuwonongeka kwa mitsempha yodwala matenda a shuga ndi chimodzi mwazomwe zimayambitsa kukula kwa matenda a shuga

Kuphwanya kwachilengedwe kumapangitsa chiwonetsero cha minofu ya phazi. Kusintha kumayamba, komwe kumatsatana ndi mawonetsero otsatirawa:

• keratinization a khungu m'malo opanikizika;
• hematomas;
• mawonekedwe a chimanga;
• mapangidwe a necrosis a khungu;
• kupezeka kwa zilonda.

Matenda a shuga a Osteoarthropathy

Zotsatira zina zomwe phazi la matenda ashuga limayamba. Matendawa ndi osowa (1% yokha ya odwala matenda ashuga) ndipo amadziwika ndi matenda a mafupa. Dzina lachiwiri la osteoarthropathy ndi "phazi la Charcot."

Mfundo zazikuluzikulu zomwe zimatsagana ndi zochitika za osteoarthropathy:

• kuyang'aniridwa kwa innervation;
• michere ya michere ya cellcirculatory ndi kuchuluka kwa magazi oyambira;
• kuchepa kwa chiwerengero cha maselo achinyamata omwe amachititsa kuti masanjidwewo apangidwe;
• Kusintha kwa mafupa amunthu;
• dislocations, subluxations ndi ma fractures amawoneka.

Osteoarthopathy ndi matenda omwe amatsatana ndi kuwonongeka kwa mafupa a phazi

Zofunika! Mchitidwewo nthawi zambiri umakhudza mafupa a zala, tarsi, pochepera pachiwuno.

Matenda a shuga

Ichi ndi chotupa cha ma calibres osiyanasiyana, chomwe matenda ammimba ammimba amayamba. Mawonekedwe owoneka bwino ndi atherosclerosis ndi ma occlusion, makamaka amapezeka pansi pa bondo. Njira zofananazo zimawerengedwa kuti ndizofunikira mu purulent-necrotic njira, zowonetsedwa motsutsana ndi maziko a phazi la matenda ashuga a mtundu wa ischemic.

Zinthu Zoyambitsa

Pali zovulala zingapo zomwe zimawoneka ngati zovuta zazing'ono, koma motsutsana ndi maziko a matenda osokoneza bongo a shuga angayambitse pathologies zazikulu ndikuyamba kukhala zopangitsa kukulitsa phazi la matenda ashuga.

Gululi limaphatikizapo misomali yolowera, kusungunuka kwa misomali chifukwa cha nsapato zolimba zosasankhidwa bwino, zotupa kapena zotupa. Mapangidwe a chimanga ndi chimanga. Izi zimaphatikizanso kuwonongeka kwa makina mosasunthika pakukhulupirika kwa khungu, zidendene zophwanyika, kupunduka chifukwa cha mafupa okulitsidwa.

Masanjidwe

Kupatukana kumatengedwa ngati yunifolomu ndipo nthawi zambiri amavomerezedwa. Pali mitundu itatu yayikulu yamatendawa:

Matenda a shuga ndi matenda ake

• Wophatikizidwa phazi la mtundu wa neuropathic (60-65% ya milandu) - limachitika motsutsana ndi maziko a matenda a shuga a nthawi yayitali, ophatikizika ndi zovuta zina. Khungu silisinthidwa, kupukusira kwa mitsempha kumasungidwa, mitundu yonse yamtunduwu imasokonezedwa kwambiri, palibe ululu.
• Gangrenous phazi la mtundu wa ischemic (10-15% ya milandu) - odwala amadandaula za kupweteka kwambiri, khungu kumiyendo limakhala ndi kuwala kwamtambo, kuzizira mpaka kukhudza. Chingwe chimachepetsedwa kwambiri, koma chidwi chimakwanira. Kwenikweni, odwala nthawi yomweyo amadwala kuthamanga kwa magazi, amakhala ndi cholesterol yambiri m'magazi.
• Mtundu Wosakanikirana (20-25% ya milandu).

Ngati wodwala ali ndi ischemic matenda, chizindikirocho chimagwiritsa ntchito gulu la magonedwe am'munsi mwendo:

• 1 - kusowa kwa zizindikiro (mu 70% ya milandu).
• 2a - kupweteka poyenda kupitilira 200 m;
• 2b - kupweteka poyenda osakwana 200 m;
• 3 - kupweteka pakupuma kwathunthu;
• 4a - trophic matenda osakanikirana ndi kupweteka;
• 4b - matenda opweteka a trophic.

Kulumikizana kwamkati - chizindikiro cha kuwonongeka kumalekezero am'munsi, kuwonetsedwa pakupweteka

Kugawika kwa zilonda zam'mimba zoperewera m'matumbo a shuga:

• 0 digiri - umphumphu wa pakhungu suthyoka;
• 1 digiri - trophic zilonda zapamwamba;
• 2 digiri - trophic chilonda chokhudza zigawo zakuya za khungu;
• Giredi 3 - kutukusira kwa mafungo a mafupa kapangidwe kake kapena kapangidwe ka chotupa;
• 4th degree - gangrene, yomwe ili ndi kufotokozera koyenera;
• 5 digiri - wamba phula, pomwe kudulidwa mwadzidzidzi kumachitika.

Gawoli m'magulu a matenda opatsirana omwe amadwala matenda a shuga:

• Palibe njira yopatsirana - chilonda kapena zilonda zam'mimba sizimakhala ndi zotuluka ndipo sipangakhale chizindikiro chotupa.
• Matenda ofatsa - zizindikiro zingapo za kutupa zimawoneka (edema, redness, ululu, hyperthermia yakwanuko). Hyperemia imagwira chiwembu chosaposa 2 cm mbali zonse kuchokera pamphepete mwa bala kapena zilonda.
• Matenda oyamba - limodzi ndi lymphangitis, mapangidwe a abscess, gangren. Njirayi imaphatikizira pazinthu zozama.
• Matenda a digiri yotchulidwa - pali zizindikiro za kuledzera kwambiri kwa thupi, kuchepa kwa magazi, kuthamanga kwa mtima, kuthamanga kwa magazi, azotemia.

Zizindikiro zamatsenga

Mtundu uliwonse wamavuto ukhoza kutsagana ndi zotupa za necotic. Zizindikiro za phazi la matenda ashuga zimayambira ngati matendawa amaphatikizidwa ndi matenda oopsa opaleshoni, momwe amafunikira chithandizo chamankhwala mwachangu kapena ayi. Palibe, mtundu wa phazi la matenda ashuga ungasiyanitsidwe potengera madandaulo a odwala.

Zizindikiro zoyambirira za mtundu wa neuropathic zimawonetsedwa ndi kupweteka kwapweteka komwe kumachitika kumapazi, miyendo, m'chiuno. Zizindikiro zopweteka zimachepa pambuyo poyenda, kusintha kwa mbali ya m'munsi. Odwala amadandaula za kuchepa kwa chidwi, kumva kugwedezeka, kusasangalala, kuwotcha, kumva ngati ma goosebumps. Kuwonetsera pafupipafupi kumawonjezera kutupa, kufooka kwa minofu.

Kuwonetsedwa kowoneka bwino ndi chizindikiro cha phazi la matenda ashuga a chikhalidwe cha neuropathic

Zizindikiro za ischemic mtundu wa phazi zimawoneka motere:

• kupweteka kwambiri m'miyendo poyenda;
• odwala amakakamizidwa kuti ayime kuti kupweteka kwamankhwala kumachepa;
• kupweteka komwe kumachitika wodwalayo akakhala pamalo opingika ndikuzimiririka wodwalayo atakhala pansi;
• kukokana, makamaka usiku;
• kumverera kuzizira kumala.

Kuyang'ana kwa odwala

Tebulo likuwonetsa mfundo zazikuluzikulu zomwe zimaloleza kusiyanitsa mitundu ya phazi la matenda ashuga.

Zofunika! Zithunzi ndi zithunzi zowonetsera zamatsenga zimatha kupezeka patsamba la webusayiti kapena patsamba la mabuku apadera.

Zizindikiro

Kutsimikiza kwakanthawi kwa matendawa kumachepetsa kukula kwa vutolo, kusankha chithandizo choyenera, komanso kupewa kufunika kokaduladula miyendo. Choyamba, katswiri amatenga deta pazomwe zimayambitsa matenda ndikulongosola kupezeka kwa madandaulo. Kenako, kupenda malekezero apansi: kola ndi dorsum, malo pakati pa zala.

Katswiriyu amafotokozera khungu, kutentha kwake, kupezeka kwa tsitsi. Amawerengera turgor ndi khungu elasticity, pulsation ya mitsempha, kukhalapo kwa puffness ndi trophic zolakwika. Ngati dokotala sangathe kumvera zomwe zimachitika pamitsempha yamagazi, Dopplerography imachitika ndi chipangizo chonyamula.

Dopplerograph yonyamula - kachipangizo kamene kamakupatsani mwayi kuti mumvere kupezeka kwa kugunda kwamitsempha yamagazi

Mothandizidwa ndi wamisala, mkhalidwe wamalingaliro umayesedwa:

• tactile - monofilament;
• kupweteka - ndi nyundo ndi singano kumapeto;
• kugwedeza - kuwomba foloko;
• kutentha - kuzizira ndi zinthu zotentha.

Radiography imakuthandizani kuti mumveke bwino momwe zinthu zamkati zimagwirira ntchito ndi zida za m'mimba. Kuti muwone bwino, kuwombera kawiri konse kumagwiritsidwa ntchito.

Zitsanzo

Njira zapadera zodziwira kupezeka kwa matenda:

1. Chitsanzo Alekseev. Imawunika kusintha kwa kutentha kwa m'munsi m'munsi mwayenda. Odwala omwe ali ndi matenda otaya magazi, Zizindikiro zimachepetsedwa ndi 1-2 ° C pambuyo pa 400 m.
2. Chitsanzo Marburg. Poyerekeza pang'onopang'ono pamiyala yakumapazi, mawanga amtambo amawoneka bwino.
3. Hallmark Ratshaw. Wodwalayo wagona pansi molimba, akweza miyendo yonse ndikuwoloka. Patangopita mphindi zochepa, mapazi amawoneka.
4. Chitsanzo Cazascu. Kutsogolo kutsogolo kwa mwendo wonse kumachitika ndi chinthu chosamveka. Kuphwanya magazi kumatsimikizira kufupika kwa khungu la khungu.

Kuyeserera kwa odwala

Potsimikizira matenda a diabetes wodwala, wodwalayo amagonekedwa kuchipatala cha endocrinological kuti akonze vutoli. Njira zoyesera zakufunikira pano:

• kuyesa ndi kupindika kwa miyendo, kumveketsa kwamvekedwe;
• Pamaso pa trophic zilonda - bakiteriya inoculation a zamkati ndi mankhwala opha tizilombo;
• kukonzanso kwamitsempha yamagazi - ma ultrasound, omwe amalola kumveketsa bwino momwe mitsempha yamagazi imayendera ndi magazi kudzera mwa iwo;
• arteriography yam'munsi yotsika - njira ya radiopaque, yomwe imachitika pobweretsa sing'anga ina ndikuyendetsa ma x-ray ena;
• oximetry - kufotokozera za kukhalapo kwa ischemia, digiri yake;
• X-ray, CT, MRI - kuwunika kwa mawonekedwe amkati mwa phazi;
• mayeso a labotale (mayeso wamba, magazi a shuga, biochemistry, coagulogram);
• kuyesedwa ndi katswiri wamitsempha, nephrologist, Optometrist.

Kuyesedwa kwa shuga m'magazi ndi njira yovomerezera matenda yomwe imakupatsani mwayi wodziwa kuchuluka kwa chiphuphu cha matenda ashuga

Zochizira

Vuto lochizira zovuta za matenda ashuga silinathetsedwe kwathunthu. Monga kale, theka la odwala onse omwe amadulidwa kumadera otsika ndi odwala matenda ashuga. Amayamba kuchiza matenda ndi chifukwa chake - hyperglycemia. Ndikofunikira kwambiri kulipirira shuga kuti ukhalebe glucose mpaka 6 mmol / l, ndi hemoglobin wa glycated mpaka 6.5%.

Pulogalamuyi ya mankhwalawa imaphatikizanso kutsitsa dzanja lanu lomwe limadwala, lomwe limatengedwa kuti ndi lofunika mtundu uliwonse wamavuto, makamaka atachitidwa opaleshoni. Njira zoterezi zimapangidwa kuti muchepetse kutupa, kutupa, kupewetsa zilonda zam'mimba zokha. Kuchiritsa mwachangu kumachitika. Zilonda zam'mimba zomwe sizinachiritse kwa miyezi ingapo kapenanso zaka zimatulutsidwa m'milungu isanu ndi umodzi.

Kupuma pabedi ndi ndodo sikothandiza pankhaniyi. Njira ina ndi nsapato zochiritsa, zomwe zimatha kupangidwa kuchokera kuzipangizo zamankhwala kapena kunyumba (mwachitsanzo, kuchokera ku zazitali zakale). Chodabwitsa cha nsapato zotere ndikuti nsonga za zala kapena chidendene zimakhalabe zotseguka.

Mankhwala omwe amagwiritsidwa ntchito pochiza matenda:

• magazi magazi;
• magazi cholesterol kutsitsa wothandizira;
• mankhwala omwe amakhudza mkhalidwe wa mtima khoma kamvekedwe.

Chithandizo cha zilonda zam'mimba

Choyamba, chimanga chomwe chimapangidwa m'mphepete mwa chilondacho chimachotsedwa. Imayatsidwa ndi scalpel ndi lumo. Ngati ndi kotheka, tsembani zotupa, yeretsani malo a necrotic momwe mungathere.

Chithandizo chakumaloko chimatsatira lamulo: "Zolakwika za Wet zimafunikira zovala zofewa, ndipo zouma zimafunikira zowuma." Pakatikati pa zilondazo zokhala ndi exudate amathandizidwa ndi Dioxidine, hypertonic solution, Miramistin, Chlorhexidine. Pafupipafupi chithandizo chimasankhidwa payekhapayekha (nthawi zambiri kawiri pa tsiku). Amaloleza kulakwitsa kothira mafuta ndi iodine yokhala ndi ayodini wa Povidone-iodine, kuchokera kunja - mafuta oletsa kutupa ndi mafuta (Ibuprofen, Hydrocortisone).

Kukonzekera zochizira "zonyowa" zolakwika

Zofunika! 5% yankho la ayodini, wobiriwira wonyezimira, potaziyamu potaziyamu sagwiritsidwa ntchito pochotsa zolakwika.

Zilonda za trophic ndi necrosis wokhala ndi zizindikiro zamatenda amathandizidwa ndi antibacterial mankhwala. Kusankhidwa kwa ndalama kumachitika pambuyo pa kubzala kwa mabakiteriya komanso kumveketsa chidwi cha tizilombo toyambitsa matenda.

Werengani zambiri za mankhwalawa matenda a diabetes mu nkhaniyi.

Mankhwala othandizira

Kuchita opaleshoni kwa odwala matenda amishuga ali ndi izi:

• njira yopatsirana yomwe imawopseza moyo wa wodwala;
• kutupa kwa zinthu zam'mafupa, nyamakazi;
• chilonda chachikulu cham'mimba;
• zolakwika zazikulu pambuyo pa ntchito zam'mbuyomu;
• ischemia yovuta, ngati palibe contraindication.

Zikatero, kudula kumafunika. Kutalika kwake kumatsimikiziridwa ndi dokotala wothandizira kutengera mtundu wa minofu yothandiza, kuvutikira kwa vutolo.Kuwongolera kwa kuchepa kwa zinthu kumachitika pogwiritsa ntchito njira zina:

Kupita patsogolo kwamankhwala

Madokotala aku Cuba afunsira njira yatsopano yochizira yomwe imathandizira kupewa kupitilira kwa matenda, kuchepetsa chiopsezo cha gangore, kufulumizitsa minofu komanso kuchiritsa zolakwika. Kukonzekera kwa Cuban Eberprot-P kumayimiriridwa ndi kufotokozeredwa kwa khungu la anthu zomwe zimachitika m'maselo athanzi. Ndondomeko ya chithandizo imasankhidwa payekha munthawi iliyonse yamankhwala. Tsoka ilo, kugula chida ichi pagulu la anthu pakadali pano ndizovuta.

Eberprot-P - mankhwala a jekeseni omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo

Zithandizo za anthu

Kugwiritsa ntchito mankhwala achilengedwe ndi imodzi mwanjira zothandiza pochizira matendawa. Kuchita bwino kwawonetsa kugwiritsa ntchito masamba a zipatso ndi zipatso. Ndikofunikira kuyambitsa zipatso muzakudya za tsiku ndi tsiku (mpaka mpaka magalasi atatu patsiku), ndipo tiyi wowoneka bwino wopukutidwa amapangidwa kuchokera masamba.

Njira ina yodziwira masamba a masamba. Ma compress amapangidwa kuchokera kwa iwo, atachiritsa kale phazi ndi Furacilin njira ndikuthiriridwa ndi uchi wochepa. Masamba a mbewu amakhazikika pamwamba. Bwerezani izi m'mawa ndi madzulo.

Kutsuka kwa zolakwika za khungu kumachitika ndi decoction ya zipatso zouma zouma. Supuni ya zopangira zimatsanuliridwa mu kapu ya madzi otentha, ndikubweretsa kwa chithupsa ndikuwusefa kwa mphindi 15 kutentha kotsika ndikusefa. Yankho lakonzeka kugwiritsa ntchito.

Zambiri pankhani yokhudza matenda a matenda ashuga kunyumba zitha kupezeka m'nkhaniyi.

Kusamalira matenda ashuga

Chofunika ndikutsuka tsiku ndi tsiku ndikutsuka mapazi anu ndi sopo ndi madzi ofunda. Kenako ndikofunikira kupukuta khungu, koma osawapaka. Kusamalira mapazi kumaphatikizapo kudzipenda nokha kuti muwone khungu lowuma, zowonongeka, mabala, zipsera, chimanga, misomali yakunyumba.

Khungu limayang'aniridwa kuti lifike pakhungu, zilonda m'malo ena, komanso kuwonjezereka kwa kutentha kwanuko. Ngati chilonda kapena callus wapezeka, kudzitsegulira nokha ndi koletsedwa. Sindikiza malowo ndi gulu-lothandizira, sinthani nsapato ndikuwuza dotolo.

Kusankha nsapato yoyenera ndi njira yolepheretsa pakakhala zovuta.

Malamulo otsatirawa adzachepetsa chiopsezo cha zovuta:

• muyenera kudula misomali yanu mukasamba (amakhala ofewa);
• osadula ngodya za mbale ya msomali;
• kuyenda kuyenera kuchitika mwa nsapato zosakhazikika ndi kukula koyenera kuti isapondereze ndipo osakola ma callus);
• osapita opanda nsapato;
• kukana nsapato ndi zidendene;
• masokosi ayenera kupangidwa ndi nsalu zachilengedwe;
• ngati kuli kotheka, gwiritsani ntchito nsapato zamatumbo;
• mukasamba, yang'anani kutentha kwa madzi ndi manja anu osati ndi mapazi anu (kumva kuchepa kumatha kuchepetsedwa);
• Osadutsa miyendo yanu.

Kutsatira malangizo a akatswiri, kuthandizira glycemia woyenera komanso kusamalira miyendo tsiku ndi tsiku ndi zinthu zomwe zimachepetsa chiopsezo chokhala ndi phazi la matenda ashuga, ndipo ngati zingachitike, siyani kuchepa.