Momwe mungachiritsire matenda ashuga

Matenda a shuga a matenda ashuga (SDS) ndi njira ya m'mapazi, yomwe imachitika motsutsana ndi zotupa za zotupa za zotumphukira zamawiya osiyanasiyana, mafupa am'mitsempha, zida za pakhungu ndi zida zam'mafupa. Kupanikizika kumawoneka mwa kupangika kwa zolakwika za trophic ndi njira pur puric-necrotic.

Matendawa amatchulidwa motere:

• matenda ashuga a chikhalidwe cha ischemic;
• matenda ashuga a neuropathic chikhalidwe;
• mawonekedwe osakanikirana momwe mawonetseredwe a mtima ndi minyewa amaphatikizidwa.

Zizindikiro ndi chithandizo cha phazi la matenda ashuga takambirana m'nkhaniyi.

Kusiyanitsa mitundu

Chithandizo cha phazi la matenda ashuga chimatengera mtundu wake ndi makina otukuka. Mawonekedwe a mawonekedwe a neuropathic ndi awa:

• Khungu la miyendo ndi lofiira;
• Kusintha kwamiyendo kwakukulu (zala zimayamba kuluka, mitu ya mafupa imatuluka, "phazi la Charcot" limawonekera);
• kutupa kwapawiri kumachitika, komwe kumatha kukhala chisonyezo cha matenda a mtima ndi impso;
• kapangidwe ndi khungu la msomali wake limasintha, makamaka ndi matenda oyamba ndi fungus;
• m'malo opanikizika kwambiri, ma hyperkeratoses (khungu limakula, lomwe limakonda kusenda);
• Zilonda zimakhazikitsidwa kumbali yakumaso;
• kukoka kwaposachedwa kwasungidwa;
• Khungu lakhala louma komanso lopota.

Neuropathy ndi angiopathy ndizinthu ziwiri zazikulu pakukula kwa matenda a shuga

Njira ya ischemic ya pathology imadziwika ndi mawonetsero otsatirawa:

• khungu limatulutsa khungu;
• palibe kuwonongeka kwa miyendo;
• kunyansidwa ndikosafunikira, kumawoneka ngati kachilombo kamodzi kakuchitika;
• kapangidwe ndi khungu la masanjidwe a misomali;
• kutchulidwa kukula mozungulira zilonda zam'malo m'malo oponderezedwa kwambiri;
• kukhalapo kwa zigawo za necrosis;
• ochepa kupindika kumachepetsedwa kwambiri, ndipo pamalo ovuta kulibe;
• mapazi ali ozizira kukhudza.

Njira zoyendetsera odwala

Akatswiri angapo omwe akhudzidwa ndi mankhwalawa amathandizira odwala matenda ashuga: othandizira, endocrinologist, angiosurgeon, podologist. Wochiritsira (kapena dokotala wabanja) akuchita ntchito yayikulu yodwala matenda ashuga, kudziwa njira zoyendetsera wodwala, ndikupereka upangiri kwa akatswiri otalikira. The endocrinologist ili ndi ntchito zofanana. Kuphatikiza apo, adotolo amalimbana ndi matenda oyamba.

Angiosurgeon amagwira mtima pamitsempha yamagazi, imagwiritsa ntchito njira zobwezeretsanso magazi, ndipo pamavuto ena pamadulidwa. Dokotala wa podologist ndi dokotala yemwe ntchito yake imaphatikizapo kusamalira phazi, kuchiza phazi la matenda ashuga, kuchiza misomali yakunyumba, ndi zina zambiri.

Chithandizo cha phazi la matenda ashuga chimakhazikika pa mfundo zinayi:

• Kukwaniritsa chindapusa cha shuga.
• Kusamalira bwino miyendo kuti mupewe zovuta.
• Mankhwala.
• Njira zopanda mankhwala.

Malipiro a matenda oyambitsidwa ndi matenda

Hyperglycemia ndiye amene amayambitsa kukula kwa zovuta zonse zodziwika bwino za matenda ashuga. Kusungabe kuchuluka kwa shuga m'magazi ovomerezeka kumalepheretsa kuwonongeka kwa mitsempha ndi mitsempha, komwe kukhazikitsidwa kwa phazi la matenda ashuga kumakhazikitsidwa.

Kutengera ndi zotsatira za njira zakufufuzira matenda, endocrinologist imazindikira kuyenera kwa mankhwala a insulin kapena makonzedwe a mankhwala ochepetsa shuga (zimatengera mtundu wamatenda oyamba). Ngati ndi kotheka, kuwongolera kumachitika, njira imodzi imasinthidwa ndi ina kapena mankhwala ena amawonjezeredwa.

Kudziyang'anira nokha shuga ndi njira yofunikira kwambiri yopewera matenda ashuga

Zofunika! Ndikofunikira kukwaniritsa kuchuluka kwa shuga m'magazi osaposa 6 mmol / l, ndi glycosylated hemoglobin (HbA1c) - osapitirira 6.5%.

Kusamalira miyendo

Onse omwe ali ndi matenda ashuga ayenera kutsatira malamulo osamalira mapazi kuti aletse zovuta kapena kuchepetsa kufalikira. Kuopsa kwa kukhazikikako kumatengera momwe zakhudzira chidwi cha wodwalayo. Mwachitsanzo, wodwala yemwe ali ndi vuto lomva bwino amatha kudula zala zawo ndi lumo, ndipo ndi wosweka, amatha kungoyala.

Upangiri wa akatswiri osamalira mapazi ndi monga:

Chifukwa chiyani miyendo imapweteka ndi matenda ashuga

1. Kusankha nsapato zoyenera. Mitundu yamatsenga kapena yomwe imapangidwa molingana ndi magawo a wodwala angagwiritsidwe ntchito. Mwina kugwiritsidwa ntchito kwa owongolera zala za coracoid, bursoprotectors kuteteza malo amtundu wina, orsopedic insoles.
2. Kuchotsa kwa chimanga panthawi yake. Sitikulimbikitsidwa kuti mutsegule matumba nokha, ndikofunika kuperekera kwa dotolo ndondomeko iyi.
3. Kuthetsa makulidwe a misomali. Ngati vutoli limayambitsidwa ndi bowa, ndikofunika kuchita mankhwala a antimycotic. Zina zoyambitsa zimafunikira kuduladula nsonga ya msomali.
4. Kuchotsa khungu lowuma ndi ming'alu. Kirimu wa emollient kapena antifungal chithandizo umagwiritsidwa ntchito (kutengera chinthu cha etiological).

Mankhwala

Miyezo yogwiritsiridwa ntchito kwa mankhwalawa pochiza matenda amtundu wa matenda ashuga imakhala ndi malangizo awiri omwe angagwiritsidwe ntchito palimodzi. Izi zimaphatikizapo ndalama zothandizira kukonza kagayidwe kachakudya mu minyewa yamanjenje ndi kugwiritsa ntchito mankhwala kuti athetse zizindikiritso mu mawonekedwe a ululu ndi zovuta zamavuto.

Mankhwala Olimbana ndi Matenda a metabolism

Magulu omwe amagwiritsidwa ntchito moyenera amachokera ku alpha-lipoic acid ndi mavitamini a B-mfululizo. Mankhwala ena adagwiritsidwapo ntchito kale, koma palibe omwe adakwaniritsidwa. Othandizira "Metabolic" amatha kuchepetsa kukula kwa mitsempha ya neuropathic ya pathology ndikuchepetsa kuwunika kwa zizindikiro.

Alpha-lipoic acid (Berlition, Thiogamm, Espa-Lipon) ali ndi izi:

• kumanga ndikuchotsa ma radicals aulere;
• Amasintha magazi kudzera m'mitsempha ya epineural (yomwe imathandizira mitsempha);
• kubwezeretsanso kuchepa kwa puloteni ya cell;
• imathandizira kuthamanga kwa kufalikira kwa chisangalalo motsatira ulusi wamanjenje.

Thiogamma - zotumphukira za alpha-lipoic (thioctic) acid, zomwe zimathetsa chipatala cha matenda ammimba a matenda ashuga

Kuchuluka kwa mavitamini a B angapo m'magazi omwe ali ndi matenda ashuga kumachepetsedwa kwambiri. Ichi ndi chifukwa cha kuyamwa kwambiri mkodzo. Zachulukidwe zomwe zimapangidwa ndi Vitamini ndizophatikiza ndi madzi komanso sizingalowe bwino mu zotchinga za magazi. Kuti athane ndi nkhaniyi, Neuromultivit, Milgamm, Benfotiamine adapangidwa.

Chithandizo cha Zizindikiro

Mankhwalawa sagwiritsidwa ntchito kwa odwala onse, chifukwa kuwawa kwa gawo loyambalo pambuyo pake kumasinthidwa ndikusowa kwathunthu kwa ululu ndi kuchepa kwakukali kwamitundu yonse yamva.

Odwala omwe akuwonetseratu mawonetseredwe am'matumbo amathandizidwa ndi ma antidepressants (amitriptyline, imipramine) ndi anticonvulsants (carbamazepine, tegretol, phenytoin). Magulu onse awiriwa sagwiritsidwa ntchito ngati wodwala ali ndi glaucoma, chifukwa amatha kuthana ndi kukoka kwa mitsempha.

Pakadali pano, amagwiritsidwa ntchito kwambiri:

• Gabapentin ndi mankhwala oletsa kupweteka omwe amachepetsa kupweteka kwa mitsempha. Zotsatira zoyipa zimakhala pafupifupi zopanda pake. Chizungulire, mseru wofatsa, komanso kugona.
• Pregabalin - nawonso ali m'gulu la anticonvulsants, ali ndi kachitidwe kofanana ndi Gabapentin.
• Duloxetine ndi mankhwala ochepetsa nkhawa omwe ali ndi vuto lapakati. Chenjezo liyenera kuperekedwa kwa omwe ali ndi matenda ashuga omwe ali ndi glaucoma ndi malingaliro ofuna kudzipha motsutsana ndi maziko a matenda amanjenje.

Kubweretsa

Chatsopano pochiza matenda am'mimba a shuga, Eberprot-P ndi mankhwala a ku Cuba omwe amachititsanso khungu kukula. Mankhwala apaderawa adapangidwa kuti apangidwe mobwerezabwereza kwambiri maselo a zilonda zam'mimba, atabayidwa molunjika m'mphepete mwa bala, ndikusintha singano mutangomaliza kuponya.

Eberprot-P - chida chothandizira jakisoni wam'deralo, yemwe amathandizidwa kuti azilakwitsa

Madokotala aku Cuba akuti mankhwalawa amachepetsa chiwerengero chofunikira chokwanira, amachepetsa chiopsezo chodulidwa, komanso amathandizira kuchiritsa zilonda zam'mimba. Ku Cuba, Eberprot-P amapita kwa odwala kwaulere. M'mayiko ena, mtengo wake umakwera mpaka madola masauzande angapo.

Kubwezeretsa magazi

Zimaphatikizapo kuwongolera kosalekeza kwa kulemera kwa thupi, kuchepa kwake ndi kuchuluka, kukana zizolowezi zoyipa, kuthandizira kuthamanga kwa magazi. Pochiza matenda oopsa, ACE inhibitors (Lisinopril, Captopril), calcium antagonists (Verapamil, Nifedipine) amagwiritsidwa ntchito chifukwa cha kusowa kwawo pakusokoneza momwe amapangira kagayidwe kachakudya. Kugwiritsa ntchito thiazide diuretics (hydrochlorothiazide) kunawonetseranso zabwino.

Gawo lotsatira ndi kusintha kwa mawonekedwe a lipid. Monga momwe kafukufuku wasonyezera, zakudya zomwe zili mwa mtundu wake sizingakhudze cholesterol yamagazi m'mayendedwe ashuga m'njira yofunikira. Mankhwala amatchulidwa pamodzi ndi zakudya. Chifukwa chaichi, ma statins amagwiritsidwa ntchito (Simvastatin, Lovastatin).

Ma antiplatelet

Mlingo wocheperapo wa acetylsalicylic acid ungachepetse chiopsezo cha odwala matenda a shuga. Ngati pali zotsutsana ndi phwando lake, sankhani Clopidogrel, Zilt.

Kubwezeretsanso magazi m'magazi - gawo la mankhwalawa odwala matenda ashuga

Milandu yomwe imabweretsa chiopsezo cha mtima ndi ma pathologies a mtima komanso pambuyo pa kulowerera kwam'magazi, kugwiritsa ntchito mankhwala oopsa a antithrombotic (Aspirin + Clopidogrel).

Mankhwala osokoneza bongo

Gulu la mankhwalawa limatha kusintha kuchuluka kwa magazi m'malo a ischemia chifukwa cha mphamvu yake yamagazi ndi magazi. Izi zikuphatikiza:

• Pentoxifylline (Wasonite, Trental);
• Sulodexide;
• Ginkgo biloba Tingafinye.

Kuchita bwino kwa ndalamazo kumatsimikiziridwa ndi kuthekera kochulukitsa kuyenda kwa wodwala wodwala mosadukiza claudication syndrome kangapo. Komabe, kugwiritsa ntchito kwawo ndikofunikira mu magawo awiri oyamba a matenda. Ndi ischemia yoopsa kwambiri, ma prostaglandins amapatsidwa mankhwala (Vazaprostan, Alprostan).

Opaleshoni

Poyerekeza ndi matenda am'mimba a shuga, opaleshoni ya opaleshoni imatha kukhala ndi zolinga zingapo: kubwezeretsa magazi kumalo ena, kuchotsedwa kwadzidzidzi kwa dzanja lanu lakumanzere ndi zofunikira za puritis-necrotic njira, komanso kukonza kwa mafupa.

Njira zikuluzikulu zakonzanso ntchito:

• Opaleshoni ya Bypass (aortic-femoral, iliac-femal, femal-femal-popliteal) ndi njira yomwe imagwiritsidwa ntchito kwambiri yomwe imakupatsani mwayi wopanga magazi.
• Balloon angioplasty - "kutupa" kwamakina kwa dera lomwe lakhudzidwa ndi mtsempha wamagazi komwe kumabwezeretsa magazi. Itha kuchitika ngati ntchito yokhayo kapena kuphatikiza ndi kuyika stent (chipangizo chomwe chimasunga malo obwezerezedwawo kuti chisaphatikizidwe mobwerezabwereza).
• Sympatectomy ndi kulowererapo komwe ma lumbar ganglia ambiri omwe amayang'anira kukhazikitsidwa kwa mtima wamankhwala amachotsedwa.

Balloon angioplasty - njira yowonjezera chilolezo cha mtsempha womwe wakhudzidwa

Kucheka - kuchotsa minofu yosagwira pamodzi ndi mafupa am'mimba. Kutalika kwa kulowererako kumatsimikiziridwa ndi angiosurgeon. Kuwongolera kwa mafupa kumayimiriridwa ndi ankolo ogwirizana arthrodesis, Achilles tendon pulasitiki.

Chithandizo cha zilonda zam'mimba ndi purulent-necrotic

Zochita zakomweko zimaphatikizira kuchotsa necrosis, kusinthanitsa ndi zilonda zam'mimba, kuyika chimanga m'mbali, kutsuka mabala ndi kuvala. Zovuta "zakufa" zimafuna kuchotsedwa, chifukwa zimawerengedwa kuti ndi mulingo woyenera kwambiri wowonjezera matenda. Mchitidwewo ungathe kugwiritsidwa ntchito pogwiritsa ntchito scalpel, lumo, supuni ya Volkman, mavalidwe okhala ndi ma enzymes kapena ma hydrogels. Onetsetsani kuti mwayang'ana mabala anu pogwiritsa ntchito batani, chifukwa ngakhale chilema chaching'ono chimatha kukhala fistula.

Kusangalala kwa chimanga m'mphepete mwa chilema - gawo la zilonda zam'mimba mu phazi la matenda ashuga

Kusamba bala kumachepetsa kuchuluka kwa microflora ya pathogenic pamtunda. Kuchita bwino kunawonetsedwa ndi kutsina ndi syringe ndi singano. Amadziwika kuti wobiriwira wobiriwira, ayodini, potaziyamu permanganate yankho ndi rivanol amatsutsana pochiza zolakwika zam'mimba. Hydrogen peroxide ikhoza kugwiritsidwa ntchito pokhapokha pakuyeretsa, pomwe zinthu zamkati zamatumbo ndi magazi zikupezeka.

Zilonda zotsuka zitha kuchitidwa:

• mchere njira;
• Miramistin;
• Chlorhexidine;
• Dioxidine.

Pambuyo pa njirayi, chilondacho chiyenera kuphimbidwa ndi kuvala. Ngati chida chikugwiritsidwa ntchito pazinthu izi, ziyenera kukhazikitsidwa ndi mafuta kuti zisaume kaye. Ndizotheka kupereka antimicrobials (Betadine, Argosulfan), maantibayotiki (mafuta a Levomekol), othandizira kuchira (Becaplermin gel), ma proteinolytic (Chymotrypsin, mafuta a Iruxol).

Kwezani katundu

Ziribe kanthu momwe kukonzekera kwamakono kumagwira ntchito, pomwe wodwala akayamba kulondera, munthu sangayembekezere kuchiritsidwa kwake. Ngati zilonda zapezeka kumtunda wakumbuyo kapena kumbuyo, palibe chifukwa choti mutumizire zida zina. Ikakhala pamalo othandizira, bandeji yapadera yopangidwa ndi zida za polymeric kapena nsapato ya theka imagwiritsidwa ntchito. Monga lamulo, zala zimasiyidwa zotseguka.

Zofunika! Kuchiritsa kwapakati kwa zilonda zomwe zidakhalapo kwa zaka zambiri poyerekeza ndi momwe njira yotsitsira imakhalira masiku 90.

Boot ndi njira imodzi yotulutsira mwendo

Kuyang'anira matenda

Zisonyezero zosankhidwa maantibayotiki:

• chilonda chokhala ndi matenda;
• ischemic necrosis;
• chilema chomwe chinakhalapo kwa nthawi yayitali cha kukula kwakukulu ndi chiopsezo chachikulu cha matenda.

Kusankhidwa kwa mankhwalawa kumadalira zotsatira za kubzala mbewu ndikutsimikiza kwa chidwi cha tizilombo. Penicillins (Amoxiclav), cephalosporins (Ceftriaxone, Cefepim), fluoroquinolones (Ofloxacin, Ciprofloxacin), aminoglycosides (Amikacin, Gentamicin) amawakonda.

Maantibayotiki amatengedwa pakamwa ndikuyang'aniridwa kholo. Kutalika kwa chithandizo kumatengera mkhalidwe wa wodwalayo. Mitundu yopepuka imafuna kusankha kwa mankhwalawa kwa masiku 10-14, ovuta - kwa mwezi kapena kupitirira.

Njira zopanda mankhwala

Njirazi siziyankha funso la momwe mungakhalire ndi phazi la matenda ashuga, koma lithandizira kuchepetsa kuwala kwa chithunzithunzi. Izi zimaphatikizapo kutikita minofu, zochizira, physiotherapy.

Kusisita

Musanayambe kutikita minofu, manja a akatswiri amathandizidwa ndi ufa wa talcum, ufa wa mwana kapena zonona zonona. Njirayi iteteza miyendo ya wodwalayo kuti isawonongeke komanso kuti ayambe kutsetsereka. Munjira, wodwalayo amakhala m'malo omwe amam'patsa vuto losakhalitsa (akugona kumbuyo kwake, kumbali yake, atakhala).

Kukula kwa malekezero am'munsi kumayambira ndi gawo lamiyendo yotsika ndi chopondera, kenako ndikutukuka kuchokera pabondo mpaka gawo la inguinal. Kutikita minofu palokha kumachitika komaliza. Mtundu uliwonse wa phalanx, malo ophatikizika pakati, chomera komanso kumbuyo, chidendene chimaphunziridwa.

Kutikita minofu - njira yochizira komanso prophylactic yodwala matenda ashuga

Zofunika! Kumapeto kwa njirayi, khungu limanyowa ndi kirimu wamafuta.

Zochita zolimbitsa thupi

Cholinga ndikupititsa kukhathamiritsa kwa magazi m'magawo a ischemia, koma zochitika zazikulu zolimbitsa thupi sizikuwonetsedwa, chifukwa zimatha kubweretsa zowawa zambiri komanso zovuta. Mutha kuchita masewera olimbitsa thupi:

• kusinthasintha ndi kukulira kwa zala;
• ukukhala kuchokera ku chidendene mpaka kumapeto, ndikupuma phazi lake pansi;
• miyendo yozungulira yozungulira ikukhala pansi;
• kusinthasintha ndi kukulitsa mwendo m'chiuno cholumikizira;
• kusuntha kozungulira pachifuwa cholumikizira.

Physiotherapy

Gwiritsani ntchito mankhwala a electrophoresis. Zink, mkuwa, potaziyamu, yomwe thupi la odwala limafunikira, imalowetsedwa kudzera pakhungu pogwiritsa ntchito zanthawi yomweyo. Kukonzekera kwa Zinc kumakhala ndi zotsatira zabwino pa boma la kapamba, mkuwa umathandizira pakupanga metabolic, kumachepetsa shuga. Zowawa za ululu zimakuthandizani kuti muime novocaine-iodine electrophoresis, kukhazikitsidwa kwa njira ya 5% ya sodium thiosulfate.

Njira ina yothandiza ndi magnetotherapy. Munda womwe umapangidwa nthawi ya njirayi umakhala ndi zoteteza, analgesic, immunomodulating.

Hyperbaric oxygenation imagwiritsidwanso ntchito pochiza matenda ammimba. Njira imeneyi imagwiritsidwa ntchito pochotsa hypoxia ya zovuta zosiyanasiyana. Gawoli limatha kupitilira ola limodzi. Njira zotere zimafunikira 10 mpaka 14.

Njira za anthu

Sizingatheke kuchiritsa matenda azitsamba, koma ndizotheka kuti magazi azikhala pamilingo yovomerezeka komanso kuti achepetse kupita patsogolo kwa matendawa.

Chinsinsi 1. Supuni ya zipatso zouma zothira 0,5 malita a madzi otentha. Ikani madzi osamba ndikusamba mphindi 20. Mutatha kusefa msuzi chifukwa chake, mutha kukonza zolakwika ndi zilonda.

Ziphuphu za chitumbuwa cha mbalame - nyumba yosungiramo ma tannins yomwe imathandizira kuchiritsa

Chinsinsi 2. 2 tbsp sungunulani uchi linden mu lita imodzi ya madzi ofunda. Sambani ma bafa osamba ndi yankho (mphindi 15 tsiku lililonse).

Chinsinsi chachitatu. Konzani chisakanizo cha maluwa owuma a chamomile, masamba a rosemary ndi nthangala za mpiru mu chiyerekezo cha 2: 1: 2. Thirani malita 0,5 a madzi ofunda usiku. Ndi kulowetsedwa komwe kumachitika, pangani ma compress m'malo omwe ali ndi vuto lolcerative.

Werengani zambiri za kuchiza matenda ashuga pakhomo lino.

Tsoka ilo, ndizosatheka kuchiritsa matenda amishuga odwala matenda ashuga, komabe, ndizotheka kusintha mtundu waumoyo wa wodwalayo. Izi zimafunikira kuzindikira kwakanthawi, kutsatira malingaliro a madokotala, kusamalira mapazi mosalekeza.