Zotsatira zoyipa zazitali za kuchuluka kwa glycemia pamitsempha yamagazi mthupi zitha kuwonongeka. Ntchito yofunikira ya munthu wodwala matenda ashuga ndikusunga shuga mumagulu 6.7-8.0 mmol / l. Chiyembekezo chokwanira kwa odwala endocrinological ndichakuti kudulidwa mwendo pang'ono mu shuga sikumakhudza chiyembekezo cha moyo mwanjira iliyonse. Zomwe zimayambitsa ndikupewa zovuta zomwe zimachedwa?
Chinsinsi cha kuthana ndi mavuto a shuga
Miyendo ya munthu wodwala matenda ashuga atha kusintha mitundu iwiri. Mapazi amakhudzidwa, mavuto awo amathandizidwa ndi podiatrist. Mkhalidwe wazombo zam'munsi zatsika ndi gawo la angiologist. Mankhwala omwe satulutsa zotsatira zenizeni angafunike opaleshoni. Kudula nthambi miyendo nthawi zina kumakhala ntchito yofunikira, mwinanso kupha magazi kumachitika ndipo wodwalayo angamwalire.
Momwe zovuta zomwe zimatchedwa kuti zovuta za endocrinological zikupangidwira zimadalira mwachangu:
- mtundu wa matenda ashuga (1, 2nd);
- kudziwa matendawo;
- zaka wodwala;
- kukana kwa thupi.
About ischemia ndi gangore
Maziko othandizira opaleshoni yayikulu ndikubwera kwa matenda opita patsogolo omwe wadutsa chotchingira chitetezo cha mthupi. Dera lamalire loterolo limatchedwa kuti ischemia yovuta. Ndi iyo, minofu necrosis mitundu, foci - trophic zilonda.
Zifukwa zingapo zimayambitsa gangore:
- aakulu osachiritsa microtrauma (abrasion, zikande, kudula);
- kutentha ndi chisanu;
- ingrown toenail kapena corpus callosum;
- matenda a fungal.
Chimanga ndi madera opindika ndi owopsa chifukwa chilonda chokutidwa ndi khungu chimatha kubisala pansi pawo. Nthawi zambiri izi zimachitika kumbali ya mwendo momwe mumakhala kusokonekera pafupipafupi kapena kulemera kwenikweni kwa thupi kwa wodwalayo kumagwa. Akapangidwa, chilonda cha trophic chimakhudza minofu yakuya, mpaka mafupa ndi minyewa.
Pankhaniyi, odwala matenda ashuga amakumana ndi vuto lowonda, lomwe limakulirakulira. Ischemia yokha siyingadutse. Amakhulupirira kuti ngati palibe kusintha komwe kumachitika mchaka chimodzi, ndiye kuti kudula mwendo pang'ono kapena pang'ono.
Magawo a ischemia amakula chifukwa cha kuchuluka kwa nthawi yayitali matenda ashuga. Zizindikiro zimawonedwa payokha komanso kuphatikiza:
- kutaya mtima;
- dzanzi (nthawi zina mwadzidzidzi komanso mwamphamvu, makamaka usiku);
- kumva kuzizira, kuyaka m'miyendo.
Mitsempha ya m'miyendo yoluka, mabala ndi zikanga pakhungu sizichiritsa. Ndikofunikira kudziwa kuti ngakhale mutawalimbitsa, mawonekedwe amdima osafota amakhalabe. Pamene mafinya (maselo oyera oyera) afa, fungo la fetid limamveka.
Kuchepetsa pang'ono mabala ndi zilonda zam'mimba kukuwonetsa kuchepa kwa kusinthanso kwa mphamvu ya maselo
Kulemera pokonzekera opareshoni
Mawonekedwe pamapazi amtundu uliwonse ayenera kuyang'aniridwa mosamala. Pewani kukwawa, mwachitsanzo, kulumidwa ndi tizilombo. Microtrauma yaying'ono kwambiri ikuwopseza kuti isinthe.
Trophic circulatory matenda ndi minofu matenda amabweretsa zotsatirazi:
Zizindikiro za gangrene mu shuga- necrosis (kufa kwa cell);
- Kusintha kwa khungu m'miyendo (kuchokera pachimvekere chowawa, mpaka utoto);
- mawonekedwe a puffuff pa phazi.
Akatswiri amakambirana za mwayi wothandizidwa ndi vuto la kuchepa kwa mtima chifukwa cha vuto la mtima, sepsis - kutenga matenda, mawonekedwe a subcutaneous hematomas).
Gulu la madokotala munthawi ya opareshoni amawunika:
- kuchuluka kwa miyendo;
- zinthu zofunikira pakuchita opaleshoni;
- kuthekera kwa ma prosthetics.
Pali mitundu ingapo yamavuto owopsa: yonyowa, kapena yonyowa, yowuma. Ndi mtundu wotsiriza, opareshoni amakonzedwa m'njira yoyenera, ina iliyonse - mwachangu (mwadzidzidzi). Matendawa amagwiritsa ntchito magazi kuchokera pansi pamtima, impso komanso chiwindi.
Mavuto osokoneza bongo a shuga amatsogolera ku angiopathy (kuwonongeka kwa mitsempha ndi capillaries)
Magawo olimbitsa ndi kukakamiza zolimbitsa thupi
Kuchita opareshoni kumachitidwa pansi pa opaleshoni yotupa (anesthesia). M'masiku ambiri opaleshoni, ndikofunikira kuti muwone kapangidwe kake ka chitsa kuti muonjezere zina za mwendo. Pambuyo pake, kuchipatala komanso kunyumba, chilonda cha tsiku ndi tsiku ndikuwongolera komanso nkhondo yolimbana ndi kutupa imachitika.
Pali magawo akuchotsa ziwalo zam'munsi:
- kudulidwa kwa lobes phazi (zala, metatarsus);
- kudula mwendo pamwamba, ndikofunikira kupatula mafupa a mwendo wotsika;
- cholumikizira bondo ndi ntchafu ndizosungika kwathunthu;
- resection wa gawo lowonongeka la ntchafu pamwamba pa bondo;
- cholowa m'chiuno;
- m'chiuno kwathunthu, zidutswa za mafupa amchifuwa.
Kuyambira sabata yachiwiri ya nthawi yogwira ntchito, adokotala amafotokoza momwe angachitire zinthu zolimbitsa thupi, kutikita minofu kuti abwezeretse magazi mozungulira komanso kuchepa kwa magazi. Kusunthika kwa massage (kumenya, kupukusa kuwala) koyamba kuchitidwa pamwamba pa chitsa chomwe chikutuluka, kenako chokha.
Ndi njira yochitira masewera olimbitsa thupi (zovuta zolimbitsa thupi) mawonekedwe ayenera kukhala olimba, wodwalayo ayenera kugona pamimba pake. Kuti muchepetse kutupa m'miyendo, gawo lathanzi la mwendo limakwezedwa ndikukhazikika pabedi la wodwalayo. Chiwalo chathanzi chimachitanso masewera olimbitsa thupi komanso kutikita minofu. Mu sabata lachitatu, wodwalayo amaloledwa kudzuka ndikuyimirira pafupi ndi kama. Pogwira chinthu chokhazikika, amatha kuchita masewera olimbitsa thupi kumbuyo.
Yang'anani! Mavuto amendo amatha kupezekanso m'mitundu yosiyanasiyana ya matenda ashuga, 1 ndi 2
Mu postoperative nthawi yochira, vuto lofunika kwambiri ndi chakudya chapadera komanso kukonza mosamala kwa othandizira a hypoglycemic. Mungafunike kuletsa insulin yayitali. Mulingo wa tsiku ndi tsiku wa mahomoni amagawidwa pawiri.
Mavuto a postoperative, ma prosthetics
Muzochita zamankhwala, zimatsimikiziridwa kuti nthawi zambiri patatha masiku 3-4 atachitidwa opaleshoni, wodwalayo amatulutsa chibayo (chibayo). Anthu odwala matenda ashuga amatha kuzunzidwa ndi zowawa za phantom. Asayansi akupitiliza kufufuza zomwe zimayambitsa chizindikirochi m'malo opezeka mthupi ndi njira zowathetsera. Phantom kusautsika amalembedwa ngakhale mwa anthu omwe amagwiritsidwa ntchito pochotsa phalanx ya chala.
Odwala amathandizidwa, limodzi ndi maantibayotiki, opanikiza, amatenga ma psychotropic, osokoneza bongo. Kudulidwa ndi vuto lalikulu m'thupi komanso m'maganizo. Ndikofunikira kuti anthu apafupi akhale pafupi ndi wodwalayo ndikupereka chithandizo chonse.
Mavuto atadulidwa angathenso kulumikizidwa ndi izi:
- chotupa cha chitsa;
- kuchedwetsa machiritso;
- mapangidwe a yotupa woyendera nthambi.
Pofuna kuthana ndi izi, kuvala zothinana kumagwiritsidwa ntchito, komwe kumachepera pang'onopang'ono kulowera chitsa kupita kuzinthu zabwino, komanso kukhetsa mafinya.
Pali kudalira mwachindunji kwa ma prosthetics pa nthawi yomwe wodwalayo angagwire ntchito. Ngati munthu ayima pa prosthesis ndikuzolowera, ndiye kuti zonse zowunikira zimayenda bwino katatu. Imfa yayikulu (50%) imawonedwa patatha chaka chimodzi atadulidwa kwathunthu mwendo mwa odwala okhudzana ndi zaka.
Pa gawo la shin resection, mwayi wazotsatira zabwino za anthu odwala matenda ashuga ndi 80%, mapazi - 93%. Kudulidwa kobwereza ndikosayenera. Nthawi zambiri, kudula ma phalanges a zala sikutanthauza ma prosthetics. Chingwe: Chala chala ndi chala chachiwiri chimawonedwa ngati chofunikira pakugwirira ntchito kwamafupa am'munsi, kuyenda koyenera.
Kuzindikira kwakanthawi mozizira
Amadziwika kuti pakati pa ziwonetsero zoyambirira za angiopathy, pamakhala kumverera kupweteka m'miyendo mukamayenda. Wodwala matenda ashuga amakhala ndi mwayi wapadera wotchedwa interlaumentla claudication. Atrophy ya minofu ya pang'onopang'ono imatha kudziwikira pawokha poyesa kuchuluka kwa miyendo ndi m'chiuno ndi sentimita yofewa.
Pakadali pano, sizothekabe kuthana kwathunthu ndi mawonekedwe a angiopathy
Matenda oopsa a arterial (kuthamanga kwa magazi) ndi kusuta zimayipa gawo lalikulu pakukula kwa zizindikiro za angiopathy. Kuwonongeka kwa ziwiya zazing'onoting'ono komanso zazing'ono kumatengera kuphwanya ntchito ndi kapangidwe kazinthu:
- minofu ya mtima
- mchere umayikidwa;
- spikes imakula;
- kuyenda kwa zala, mawondo ndi ochepa;
- kupweteka kuwoneka.
Zotheka za angiopathy zamitundu yosiyanasiyana ya shuga ndizosiyana. Njira zazikulu zothandizira kulipira shuga wambiri ndi insulin ndi zakudya. Ngati wodwala yemwe ali ndi mankhwala a insulin samathandiza kuthana ndi hyperglycemia, ndiye kuti pamakhala vuto lalikulu. Wodwala yemwe amagwiritsa ntchito mankhwala ochepetsa shuga pogwiritsa ntchito mapiritsi amakhalabe ndi chiyembekezo chodzapatsirana mahomoni.
Pali nthawi zina pamene odwala akuwopa kuti asinthane ndi insulin m'malo mwamankhwala ndikudikirira zovuta zina mwanjira ya gangrene. Ngati kuli kotheka kubwezera koyenera, pambuyo pa zaka 1-2 pali kusinthika kumadera otsika, kumverera kuzizira kumatha.
Mosavuta kuteteza ngozi!
Podzilimbitsa pamiyendo, ndikofunikira kuti wodwalayo azigwiritsa ntchito kalilole kuwona gawo lawo lotsika. Pambuyo pakusamba, ndikofunikira kupukuta mosamala danga la khungu pakati pa zala kuti chinyontho chisakhale, ndikupanga malo oti chitukuko cha chotupa chikhale. Ndikulimbikitsidwa kuwonjezera mafuta a talcum kapena ufa wa ana.
Pofuna kupewa zovuta za anthu odwala matenda ashuga ndi m'munsi kwambiri ndizoletsedwa:
- mapazi okwera;
- Valani nsapato zolimba ndi zidendene zapamwamba (pamtunda wa 3-4 masentimita) kapena masokosi okhala ndi zingwe zolimba;
- kudula chimanga, magawo a khungu;
- kudula misomali posachedwa, pamsonkhano.
Malo owuma ayenera kuti azisakaniza ndi zonona za ana
Aliyense wodwala matenda ashuga ayenera kudziwa zomwe zingamuwopseze ngati samvera thupi lake. Yankho la funso loti ndindalama yambiri imadulidwa mwendo ndikosiyana - zimatengera wodwalayo, pakumvera kwake ndi malingaliro a akatswiri. Malinga ndi kuchuluka kwa kugonjetsedwa, komitiyi imavomereza gulu lolemala.
Munthu ali ndi ufulu kulandira thandizo kuchokera kuboma m'njira yolipirira ndalama, kupereka mankhwala kwaulere, phindu laumoyo. Zitsanzo zambiri zimadziwika pamene odwala atachitidwa opaleshoni miyendo, amayenda mwamasewera ndipo nthawi zambiri amakhala otakataka.
