Kudulira zala matenda ashuga

3.3. Zochita za opaleshoni zamatenda a matenda ashuga

Pakadali pano, matenda ashuga a m'mimba sikuti akuphwanya njira zomwe zidakonzedweratu, kuphatikizapo zamatsenga. M'malo mwake, zovuta zambiri zomwe zimayambitsa kuphwanya kwa mphamvu yodwala yamapazi zimathandizira kuti mawonekedwe azachuma azitha kuthinana komanso zimapangitsa kuti zilonda zam'mimba zizipweteka. Pali kuwonongeka kwa phazi, komwe kumabweretsa kupweteka kosalekeza, kuvulala kwamphamvu, kulephera kuvala nsapato zokhazikika. Chifukwa chake, limodzi ndi othandizira opaleshoni omwe amachitidwa opaleshoni yayikulu yamapazi, pali maopareshoni omwe amagwiritsidwa ntchito mwanjira yomwe anakonza ndikuwongolera ntchito zosiyanasiyana kuti apititse patsogolo moyo wa odwala omwe ali ndi matenda osokoneza bongo.

Kugawidwa kwa njira zopangira opaleshoni ya matenda amishuga a matenda a shuga D. G. Armstrong, R. G. Frykberg (2003)

Opaleshoni yopanga phazi Laphunziro la Class 1 Amachitika mwa odwala omwe ali ndi vuto lopunduka phazi pakalibe zizindikiro zakumverera kwazovuta.

Opaleshoni ya Phazi 2 Prophylactic phazi. Kuchitapo kanthu kumachitika kwa odwala omwe ali ndi vuto la phazi pamaso pa zizindikiro za kuphwanya mphamvu, okhala ndi zilonda zam'mimba kapena ndikuwopseza chitukuko chakumapeto.

Njira Zolowera Mapazi a Class 3 Kuthandizira kuchiritsa bala lotseguka

(anakonza, anakhazikika necenessomy, mapangidwe a bala, kutseka kwa pulasitiki pachilonda)

Njira Zopangira Opaleshoni Phazi Laphunziro 4

ndi / kapena ndondomeko ya necrotic.

Pakatikati pake, makalasi awiri oyamba opanga maopaleshoni adakonzedwa kuti akonzedwe ndikuwongolera mafupa, ndipo kuwunika kwawo sikungathe kufalikira kwa bukuli. Olembawo amafanananso ndi kulowererapo

syat, arthrodesis ya ankolo olowa, Achilles tendon pulasitiki yofanana ndi kupindika kwa tsinde la phazi, etc.

Ndikofunikira kukhazikika mwatsatanetsatane pa opaleshoni ya phazi mwadzidzidzi (giredi 4), komanso pazokongoletsedwa zolimbitsa thupi ndi kutsekeka kwapulasitiki kwa bala (kalasi lachitatu).

Opaleshoni yodzidzimutsa ya zotupa za purcin necrotic

ndi matenda ashuga apamtima

Ntchito yofunsa mwachangu kapena mwachangu (onani "Terms of preoperative maandalizi") kulowererapo kwa opaleshoni kumakhala, choyamba, kuchotsa purulent ndi / kapena necrotic kuyang'ana kumapazi, ndipo chachiwiri, popewa kufalikira kwa kutukusira kwa purulent ndipo, chachitatu, pakukulitsa kukhalabe ndi dzanja lothandizira.

Pachitetezo cha opaleshoni ya zotupa za purulent-necrotic motsutsana ndi maziko a matenda am'mimba a shuga, kudulidwa kumakhala pamalo apadera. Kuduladula - kuchotsa kwathunthu kapena pang'ono kwina kwa gawo la miyendo ndi njira yowopsa, kapena kudzera pakuchita opaleshoni. Zizindikiro

D. G. Armstrong ndi R. G. Fraykberg (2002) amatengedwa kuti ndi akulu ndi ang'ono. Malire omwe agawika magawo awiriwa ndi ntchito ya Expressulatio tarsometatarsea (gawo la Lisfranco). Ichi ndi cholumikizira chovuta pakati pamafupa apansi achitsulo ndi mzere wamafupa wamatumbo. Chifukwa chake, kudulidwa pang'ono kumaphatikizanso kudula kwam'mbali mwa phazi, kudulidwa kwa transmetatarsal (malinga ndi Sharpe), ndikudulidwamo kwa Lisfrank. Kuchepetsa kwakukulu ndi ntchito za Chopart, Syme, ndipo pansi pa bondo (Pansi pa Knee) ndi pamwamba pa bondo (Pamwambapa Knee).

Zisonyezero za kumadulidwa kwamiyendo ndi puritis necrotic zotupa za phazi odwala omwe ali ndi matenda osokoneza bongo

(ngati kukonzanso kwa mtima sikungatheke)

Zisonyezero zam'munsi zodwala mutu wa matenda ashuga ayenera kugawidwa mtheradi ndi wachibale.

Zizindikiro zenizeni zakumaduladula miyendo

1. Mchiuno:

- kuphatikizika kwa mitsempha yayikulu yam'munsi ya miyendo ndi kuwonongeka kwa kayendedwe ka magazi ndi mgwirizano wapafupipafupi wa phazi (kuposa malo 2 a phazi)

- wamba chonyowa gangdom kulikonse

- ponsepo pouma phazi

- kukhalapo kwa anaerobic opaleshoni yam'mimba pamunsi yotsika (clostridial kapena non-clostridial)

Pa mulingo wa tibia:

wamba youma gangore wa proximal mbali phazi 3. Level - 1 gawo lamanja proximal kwa ovuta

stenosis ya chotupa chachikulu cha mwendo kapena ntchafu:

arterial stenosis (malinga ndi Doppler ultrasonography) amaposa 75%, LPI 0.5 yokhala ndi puroses necrotic pamiyendo, komanso kukhalapo kwa "zomwe zikukulitsa" zochitika:

- kuwongolera kwa magazi othandizira

- kufalikira kwa ndondomeko ya purulent-necrotic yakumapazi kumapazi opitilira mbali ziwiri za thupi,

- zakumwa zoledzeretsa zam'tsogolo 2-3 tbsp. (Gostishchev, 1992)., Sepsis,

- kulimbikira, kosasinthika kwa shuga.

- ischemia yovuta kwambiri, yosasinthika pakukonzedwa kwachipatala kwa milungu yopitilira 2.

Mabuku apanyumba othandizira odwala matenda ashuga phokoso komanso zomwe amachepetsa kwa odwala omwe ali ndi matenda osokoneza bongo ndi ochepa. Kutengera izi, mawonekedwe a njira zopangira opaleshoni yodwala matenda ashuga, omwe amayenera kuchitidwa nthawi zambiri ndi dokotala wa opaleshoni, adzaonedwa pansipa.

masewera othandizira opaleshoni m'magulu azachipatala, komanso madipatimenti apadera "odwala matenda ashuga" m'zipatala zosiyanasiyana.

Kudulidwa pang'ono

Kuchepetsa mkono wam'munsi m'chiuno mwa odwala matenda ashuga kumatha kuchitika kumtunda, pakati, kapena kutsika kwachitatu. Nthawi zina, ndi mawonekedwe a ischemic a VDS okhala ndi ma protocol a femor artery kapena ma occlusions pamwamba pa inguinal ligament, kudula kumene kapena kuwuluka kapena kuwuluka kwambiri. Monga momwe dzinalo likunenera, mzere wolumikizana wa femur mu zochitika izi umadutsa nthawi yomweyo pansi pa trochanter wocheperako, kapena pakati pa ochepera ndi okulirapo.

Kufalikira kwa mchiuno m'chiuno molumikizana pano kumawonedwa kukhala koyipa pokhudzana ndi kuchiritsidwa kwa bala la postoperative, lomwe pansi pake pali acetabulum. Kununkhira kwa ntchafu kuyenera kukondedwa chifukwa cha subtrochanteric kapena transcutaneous. Kuchita matumbo akulu pamwambapa kapena pansi pa bondo mwa odwala matenda a shuga, ambiri opanga maopaleshoni amakana kugwiritsa ntchito alendo. Ulendo, kuchokera pamalingaliro athu, ndiwosatheka chifukwa cha kuvutika kwakukuru kwa chitsa chamtsogolo, komanso chifukwa cha ischemia yofewa yowonjezera. Kudutsa koyambirira ndi kulumikizana kwa mitsempha yayikulu mu mitsempha ya mitsempha kumapangitsa kuti magazi asatayike.

Mwachitsanzo - kumadula m'chiuno pakati lachitatu ndi mtundu wofalikira kwambiri. Kutsogolo ndi kumbuyo komwe kumakhala kovunda kumadulidwa. Khungu ndi minofu yapansipansi zimatayidwa. Msempha waukulu wa saphenous umapezeka, umatulutsidwa, ndipo umatambasulidwa; Kukutira kwa khungu (zonse pakumaso ndi kwapambuyo) kwa 2 - 2,5 masentimita oyandikira mpaka pakhungu limatsitsidwa mopusa kuchokera ku minofu kupita m'mwamba. Chotupa cham'mimba cha ntchafu (chotupa cha akazi, pakati pake ndi mtsempha wachikazi, pambuyo pake - mitsempha yachikazi) pakati pake lachitatu nthawi yomweyo chimakhala pansi pa minofu yolimbitsa. Minyewa yopusa, zala zagwidwa, zikuwonekera

woposa 10-12 masentimita ndi ma intersects. Hemostasis pakupanga. Gawo loyandikira la minofu limakulungidwa ndi asanu ndi atatu (makamaka ndi kambuku), ulusi umatengedwera kukachotsedwa - wogwirizira, amakwezedwa. Nthawi yomweyo, mbale yolumikizana yotayirira yomwe imaphimba mitsempha ya mitsempha imayamba kuwonekera. Yotsirizira imasankhidwa mosamala ndi lumo mmwamba ndi pansi. Msempha, mtsempha ndi mitsempha zimawonekera. Mtsempha umadutsidwa ndi scalpel lakuthwa 3 cm pamwamba pazombo. Pambuyo pakuwoloka mitsempha yachikazi, mtolo wonse wamanjenje mopusa umayimilira masentimita 4-5. Nthawi yomweyo, nthambi za mitsempha yachikazi ndi mitsempha imadutsana ndikumanga. Tizikumbukira kuti kuthamanga kwakuya kwazinthu zachikazi kumachoka pachimake chachikazi pamwamba pa malo athu antchito ndipo magazi omwe amapezeka mpaka minofu ya chitsa sichingakhudzidwe. Kenako magawo azinthu zofananira komanso zotumphukira za zotupa zamkati mwaakazi ndi mitsempha imasemphana ndi bandeji.

Mu gawo lotsika lachitatu la ntchafu, komanso pamalire apakati ndi otsika lachitatu, zombo zachikazi zimasokera molimba komanso pambuyo pake, kusiya Gunther Canal, kuti alowe mu popliteal fossa. Chifukwa chake, kuti mupeze mtolo wamanjenje pano, ndikofunikira kuti musangodutsa minofu yowongolera, komanso tsamba lokwera pakati pa m. m. magnus medialis et adductor magnus.

Pambuyo poyambitsira ziwiya zazimayi, kuduladula m'chiuno kumachitika malinga ndi njira yanthawi zonse. Minofu ya magulu akunja, amisili ndi am'mbuyo, komanso mitsempha yotsatsira pambuyo pazowunikira motsatizana kwa mitsempha ikupatsirana, ndipo pamapeto pake ukaziwo ndiwopakidwa. Minofu yolimbana nayo imakokedwa chifukwa cha kupindika kwa fupa. Kudulidwa kwa tibia kumachitika chimodzimodzi, kudutsa minofu ndi kumanganso bandeti m'mbuyomu

3 mitolo yamanjenje.

Za kukhetsa kwa chitsa. Sitiyikirira "omaliza" pachilonda cha postoperative, kuwakhulupirira kuti ali gwero la matenda komanso kuthekera

chifukwa supplement mabala. Pakudula kwamchiwuno, ngalande ziwiri za ngalande za chloride zopangira mafuta (ma machubu akuchotsa magazi) zimadutsa pamabowo olowera kumbuyo kwa chitsa ndikusiyidwa pamphuno. Chimodzi mwa mabowo mu chubu chiyenera

onetsetsani kuti mwakhala pakati pa khungu ndi fascia. Zingwe zolumikizidwa zimalumikizana ndi imodzi mwazomwe zimagwira ntchito yogwira zofuna (accordion, vacuum, etc.). Zilonda zimachotsedwa pakatha masiku awiri ndi atatu. Sterile accordion ikusintha tsiku ndi tsiku.

Shin kudulidwa

Mwa kudulidwa "pansi pa bondo", kuduladula mwendo wapansi kumtunda kwake kwachitatu kumachitika nthawi zambiri - kudula matumbo.

Kudzicheka mwendo wachitatu kumtunda kwa mwendo

Mwendo ukadulidwa, kudula kwamphongo kumakondedwa m'chigawo chachitatu, chifukwa ndikudula kwamtunduwu, magazi amafikira ku chitsa cha mwendo umasungidwa, kutuluka kwa minofu yamitsempha kumalimbitsidwa, mphamvu ya chitsa chake imakhala bwino, ndipo mwayi wowonjezeranso ma prosthetics umakonzedwa.

Njira ya opaleshoni iyi ili ndi zochitika zina. Kuwonekera kumapangidwa pakhungu, minofu yapamtunda, chifuwa cha m'munsi. Chojambulacho chakumbuyo chimadulidwa 2 3 kutalika kuposa kutsogolo. Mukamadula zingwe zakutsogolo, ndikofunikira nthawi yomweyo kudutsa periosteum ya tibia ndi minofu yolowerera. Kenako, osasinthanitsa ndikukutira, gwiritsani ntchito raspator kuti musiyanitse ndi tibia. Njira imeneyi imakupatsani mwayi wokhala ndi vutoli lokwaniritsira la khungu lakunja-fascial-periosteal. Minofu ya ng'ombe imalekanitsidwa momasuka kuchokera ku soleus ndikudutsana pokhudzana ndi khungu lomwe lakhudzidwa. Minofu yokhayo imachotsedwa mosavuta kuchokera ku chitsa cha minofu ya ng'ombe yomwe idawolokedwa kale yomwe imakhala yopanda mwendo, komanso kuchokera ku minofu yakuya kwa kumbuyo kwa mwendo wakumbuyo (mkuyu. 19). Kenako, m. yekha mopusa, ndi kanjedza kumaimirira kumalo ophatikizika kumutu wa fayilo. Apa, kutalika kwa minofu sikupitirira masentimita 2. Mutha kudula osati fupa lokha, koma 2-3 cm kutali. Pankhaniyi, palibe kutulutsa magazi konse. Nthawi yomweyo pansi pa kutali m. soleus ndiye chachikulu (cha 3 cha kumtunda kwachitatu kwa mwendo) mitolo ya mitsempha (a. et vv. tibialis posteriores), yomwe tsopano ndiyosavuta kwambiri, motsogozedwa ndi diso, kudula ndi kumanga (mkuyu. 18).

Mkuyu. 18. Yabwino pabedi ndi m'munsi miyendo yam'mimba m'chigawo chachitatu chapamwamba

1. Pabedi lakutsogolo.

2. Pabedi lam'mbali. 3, 4. Mabedi am'mbuyo.

5. Mtsempha wamtundu wa tibial.

6. Mtsempha wakumbuyo wam'mbuyo.

8. Mitsempha yam'maso.

9. tibia.

10. Fibula

Tibia imakulungidwa 2 cm pamwamba pamlingo wa minofu yowolokera. Komanso, fibular - 1 cm pafupifupi kwa tibial. Mukawona mafupa omwewo pamtunda womwe uli ndi minofu yopingasa, zovuta zimakhalapo ndikuwunika kwawo kwapambuyo pa utuchi. Ndikofunikira kuti muthetsenso tumpulu ya tuberositas tibiae ndi hacksaw kapena chisel (kuwonjezera "osalala" m'mphepete ndi rasp) osachepera 3 cm kuti muthetse kufalikira kwamkati mwa mafupa apansi pa khungu lakunja. Pankhaniyi, pamapangidwa mawonekedwe osunthira, pomwe, pomwe bala limaluka, chimadzala.

Ngati izi sizichotsedwa, khungu limakhala ndi khungu pakapita nthawi yocheperako lingakhale m'malo opsinjika mopitirira muyeso. Kuphatikiza apo, pambuyo pake, pa prosthetics pazifukwa zomwezo, zilonda zimatha kupanga chifuwa chachikulu. Zinyumba zamisempha yotsutsa zimakola msana wake pamtengo wapamwamba wa tibia.

Minofu yolimbana ndi kukokana iyenera kusokonekera, chifukwa minofu yoluka bwino, ngati khungu layamba kusokonekera, lidzateteza pakulimbana ndi chitsa cha tibial. Kuchotsa m. pekee ndi othandiza pofotokozera mosavuta mapangidwe

ntchito, oyenera ma prosthetics a m'munsi chitsa. Nthawi zambiri ndikofunikira kuwona kupindika kwa chitsa ngati "chibonga chokhala ngati" chibonga pakatikati kapena kumtunda kwa miyendo yakumunsi ndikusunga misa yayikulu. Pakapita nthawi, mwachidziwikire, chitsacho chimapeza mawonekedwe ofanana chifukwa cha minofu atrophy. Koma izi zimachitika zaka 1-2. Kuphatikiza apo, ndikukhalabe ndi minofu yayikulu kumbuyo kwa chitsa chakumapeto, pali zovuta pakudula kwachiwiri ndi kupindika kosachedwa kukhosi: kutalikirana kwakutali patatha masiku 5, kufupikitsako kumapangitsa kuti bala lizisungunuka ndi zovuta, zomwe zimapangitsanso khungu necrosis, koma kwambiri mawu achidule.

Mkuyu. 19. Mtanda wodula wa tibia pamalire a kumtunda ndi pakati kwachitatu. Minofu Yofalikira

Komanso, monga nkhani yakudula kwa m'chiuno, ngalande ziwiri za 2 za chinyl chloride zimayikidwa kudzera m'makontena awiri awiri kumbuyo kwa chitsa. Amabweretsedwa ku utuchi wa tibia. Zingwe zolumikizidwa zimalumikizidwa ndi chidwi chachikulu. Pulasitala woponyera pachitsa ndikofunika poletsa kupindika kwa dzanja.

Kutulutsidwa kwapamwamba kwa Shin

Pakadali pano, chifukwa cha kupambana kwa ma prosthetics a m'munsi, madokotala ambiri a mayiko ena abwereranso kumalo ena omwe amadziwika kuti ali ndi matenda osokoneza bongo. Amaperekedwa ngati njira ina yapamwamba yodulira ma diaphyseal. Mitundu iwiri ya mabulidwe a supradermal amadziwika kwambiri - malinga ndi Pirogov ndi Syme (Syme).

Zidulidwa malinga ndi Pirogov

Ubwino waukulu pakusinthaku ndi kuthandizira kwa chitsa cha m'munsi pa chimbudzi cham'madzi ndi pakhungu lanyama, chomwe chimasinthidwa katundu wambiri chifukwa kukhalapo kwa zingwe za khungu zosapanga bwino zomwe zimagawanitsa mafuta osunthika kukhala lobules.

Pogwiritsa ntchito opaleshoni iyi, magazi amafikira ku chitsa kuchokera ku chotupa cha posterior tibial.

Kupendekeka kofewa kumapangidwa kumafupa: kuchokera ku chidendene chakunja, kupyola pakati, kufikira chidendene chamkati, kuzunguliza ngati mawonekedwe. Chojambula chowoneka ngati arc, kumbuyo kwa phazi, chokhala ndi chopondera chikuyang'anizana ndi zala, chikugwirizana ndi malekezero oyambira (mkuyu. 20, A). Amatsegula cholumikizira, kudutsa zigawo zam'maso, kapisozi yolumikizana kuzungulira mbali yonse ndikupanga phokoso lakuthwa kwamapazi, ndikugudubuza mawonekedwe a talus. Ndinawona calcaneus kumbuyo kwa talus ndikuchotsa phazi (mkuyu.20, B). Gawani minofu yofewa kuchokera ku tibia ndi masentimita 2-3. Yang'anani pamalo owoneka bwino a mafupa amiyendo yam'munsi (mkuyu. 20, D). Ulusiwo umadulidwa mosazungulira ndikuzungulira ndi rasp. Chovala chachikopa, kuphatikiza chotsalira cha calcaneus, chimakola khungu lakumunsi. Calcaneus imakhazikitsidwa ndi utuku wa mafupa amiyendo am'munsi okhala ndi mafinya awiri kapena atatu otengedwa kudzera mwa calcaneus ndi tibia (mkuyu. 20, B). Chilondacho chimasinthidwa (mkuyu. 20, D). Ikani pulasitala wammbuyo kwa masabata atatu.

Kutulutsa Kwa Saimaa

Kucheka kwa Saimaa ndi ntchito yakusankha pomwe calcaneus singagwiritsidwe ntchito kuthandizira, mwachitsanzo, ndi osteomyelitis yake. Mabala ndi ofanana ndikudula malingana ndi Piro

Govu. Njira ya opareshoni imabwerezanso komaliza, kupatula pamenepa - mutadutsa chifuwa cha chidacho, phazi lonse, limodzi ndi calcaneus, limachotsedwa. Kenako, khungu la chidendene limakwiriridwa pakhungu la mwendo wapansi pamwamba pa utuchi wa tibia.

Chifukwa chodulidwa miyendo kwa odwala matenda ashuga

Mchitidwe wamanjenje umakhudzidwa kwambiri ndi kugwira ntchito kwa mitsempha ndi mitsempha yamagazi m'magazi oyenda, zonsezi zimawonongedwa pakapita nthawi. Zotsatira zonsezi zimabweretsa zotsatira zowopsa komanso zosasangalatsa zotulukapo zaumoyo.

Ngati munthu akudwala nthendayi, ndiye kuti mabala ake amachiritsa bwino, motero nthawi zambiri gangrene imayamba. Ngati zoterezi zapezeka mwa munthu, ndiye kuti mwendo wakewo umatha kuduladwanso.

Nkhope zamilandu izi sizimafa nthawi yomweyo, koma pang'onopang'ono, chifukwa cha njira yodziyeretsa iyamba. Kucheka mwendo ndi matenda a shuga nthawi zambiri kumabweretsa zotsatirapo zoyipa kwambiri, koma zimadalira nthawi yodziwika ndi kupezeka kwake.

Njira zochizira zosagwiritsa ntchito zimawonetsa kuwongolera kwakutali kwambiri kuposa nthawi iliyonse. Ngati othandizira achire otere sagwira ntchito, ndiye pokhapokha ngati mbali zina zolumikizidwa.

Ngati izi sizichitika mu nthawi, ndiye kuti zoyipa ziyamba - kutukusira kwa kutupa. Kudulidwa kwa chala chilichonse m'masititala ya shuga ndikovuta, koma kumatha kuvomerezedwa moyenera.

Zomwe zimadulidwa

Kuphulika kwa kagayidwe kachakudya kumabweretsa kusintha kwamatumbo mu mtima. Kudzikundikira kwa zinthu za ballast m'magazi, kusintha kwa autoimmune kumapangitsa kuti maselo awonongeke chifukwa chodziteteza. Pazifukwa izi, kuchuluka kwa zombo zabwinoko kumachepetsedwa, ndikupereka njira yoyambira kufotokoza bwino, kenako ischemia yodziwikiratu.

Kudula mwendo chifukwa cha matenda ashuga sikungapeweke ngati:

1. Magazi a m'miyendo akupita patsogolo,
2. Kuperewera kwa oksijeni kumapangitsa khungu kutengeka mosavuta ndi matenda,
3. Kutha kukonzanso chitseko kumachepetsedwa,
4. Ndi chithunzi chachipatalachi, kuwonongeka kulikonse kwamakina kumakwiyitsa mapangidwe a zotupa, phlegmon ndi zina zotupa za purulent zomwe ndizovuta kuchiza,
5. Kuwonongeka kwathunthu kwa minofu yamafupa kumakwiyitsa maonekedwe a osteomyelitis - chiwonongeko champhamvu cha minofu yamafupa.

Matenda a shuga chifukwa cha shuga wamagazi amavuta chifukwa cha matenda amitsempha yamagazi komanso minyewa yamanjenje. Chifukwa cha njira zomwe zayamba, matenda ashuga a mtima ndi minyewa amayamba, zomwe zimapangitsa kuti pakhale ming'alu pakhungu, mabala ndi zilonda zam'mimba.

Vutoli ndilowopsa chifukwa cha kuchepa kwa chidwi cha khungu, chifukwa pomwe wodwalayo saona nthawi yomweyo zovuta. Chiyambireni cha gangrene chingakhale kuvulala kulikonse, mwachitsanzo, chikwangwani, msomali wopingidwa, wosadulidwa mosapambana panthawi ya pedicle pedicure.

Kuchiritsidwa kwa zilonda zam'mimba ndikazitali, mwayi wokhala ndi zilonda zam'mimba ndizambiri. Ndi chotupa chopanda matenda, gangrene amakula.

Ngati mankhwala osokoneza bongo sakugwira, dzanja limadulidwa.

Wodwala ali ndi izi:

• kupweteka m'miyendo, makamaka kumapazi ndi zala, kukulirakulira panthawi yonyamula katundu,
• kuchepa kwa khungu, kutsekeka kwa miyendo,
• mapangidwe a ming'alu, mabala am'mimba oyera ndi zilonda zam'mimba, makamaka phazi,
• Kusintha kwa khungu
• mapangidwe gangore popanda mankhwala.

Kuwonetsedwa kwa gangrene kumadalira mtundu wake:

• Youma gangrene. Imakhala ndi chitukuko chachitali, mpaka zaka zingapo ndipo sichiwopseza moyo. Khungu lomwe limakhudzidwa limasinthidwa kukhala lamtambo kapena lofiira, limasuluka kwambiri. Kusungunuka kwa malo omwe akhudzidwa kumachitika, pambuyo pake minofu yakufa imakanidwa.
• Zowonda kwambiri. Zilonda zomwe zilipo sizichiritsa, zomwe zimabweretsa zotsatira zoyipa. Khungu lomwe lidakhudzidwa limatembenuka kukhala lamtambo kapena labiliwira, pamakhala fungo la zowola ndi zotupa pakhungu. Matendawa amakhudza mitundu yonse ya minyewa yomwe imavunda. Zotsatira zake, mwendo kapena chala chimadulidwa.

Kudulidwa mwendo mu matenda ashuga sikuti ndi chinthu chofunikira. Ngati wodwalayo amakhala ndi moyo wathanzi, ndiye kuti izi zitha kupewedwa. Ndikofunika kuti munthuyo azichita nawo masewera olimbitsa thupi. Nthawi yomweyo, sikofunikira kukhazikitsa zolemba za Olimpiki, ndikokwanira kuchita masewera olimbitsa thupi osavuta kangapo sabata. Kuchuluka kwa odwala matendawa kumachepetsa zoterezi:

• Mtsempha umawonongeka kotero kuti umakhala wosagawika,
• Kuphwanya kwamphamvu kwamapangidwe amitsempha yamagazi. Kuphatikiza apo, izi zimagwira ntchito pazombo zazikulu komanso zazing'ono kwambiri, zowoneka ngati zazing'ono,
• Njira zachikhalidwe zomwe zimachitika chifukwa chosagwiritsidwa ntchito molakwika.

Zokha, izi sizidzabweretsa kuchotsedwa kwa mwendo kapena gawo lina. Pofuna kuyambitsa kupha, matenda amayenera kulowa mthupi, ndipo chitetezo cha mthupi chimayenera kulephera.

Zimangotengera wodwala kuti chitetezo chake chikhala champhamvu bwanji. Ndi moyo wabwino komanso kusamalira thanzi nthawi zonse, thupi lidzatha kuthana ndi kutupa.

Pankhaniyi, simudzadulidwa mwendo pamwamba pa bondo kapena kuchotsa chala mu shuga. Koma ngati njira yotupa imalephereka, ndiye kuti kuchotsa kwa dzanja ndi dzanja ndiyo njira yokhayo yomwe ingapulumutse moyo wa wodwalayo.

Mitundu Yosintha

Pali magawo atatu a kudulidwa miyendo mu matenda ashuga:

1. Guillotine (mwadzidzidzi).
2. Poyamba
3. Sekondale

Kuduladula kwa Guillotine kumachitika chifukwa cha mawonekedwe ofunikira pamene sikuthekanso kukoka, ndipo sizingatheke kudziwa bwinobwino malire a minofu yakufa. Zikatero, gawo la mwendo limadulidwa pang'ono pamwamba pa zotupa zowoneka ndi maso.

Dokotala amapanga lingaliro pakucheka kwapakati pomwe sikungatheke kubwezeretsa magazi onse mu mwendo womwe wakhudzidwa. Popita nthawi, kusintha pang'onopang'ono kumachitika.

Kudulanso kwachiwiri ndikofunikira muyezo wa matenda ashuga ndipo amadziwikanso pambuyo pomanganso ziwiya zonse.

Imachitika makamaka chifukwa cha kulephera kubwezeretsa kwa minyewa yam'manja. Kodi njira zopewera ndi ziti?

Pali mitundu ingapo ya kuduladula miyendo mu matenda ashuga. Aliyense wa iwo ali ndi mawonekedwe ake. Chifukwa chake, mitundu ya kudula miyendo mu matenda ashuga:

• Matenda a mwadzidzidzi ndi mtundu wam'manja womwe umagwiritsidwa ntchito mukafuna kuthana ndi matenda mwachangu. Pankhaniyi, ndizosatheka kudziwa molondola malire a chotupa, kotero gawo lina la mwendo limachotsedwa, ndikupanga mawonekedwe okwera pang'ono kuposa zotupa za khungu.
• Poyamba - yomwe imakhudzana ndi zovuta zamagazi. Mwakutero, ndizosatheka kubwezeretsa ntchito yamitsempha yamagazi, koma atachitidwa opaleshoni, minofu imatha kusinthika,
• Chachiwiri - kudula, komwe kumachitika pokhapokha ngati kuli koyenera, minofuyo ikachira ndikubwerera mwakale. Nthawi zambiri njirayi imagwiritsidwa ntchito pambuyo poti iyambe kugwira ntchito.

Kodi chifukwa chani kuti kudulidwako ndikofunika? Ndikungoti nthawi zina gawo ili lokhalo limakhala lopanda tanthauzo, chifukwa nthawi zambiri zimachitika kuti kuchotsedwa miyendo kumachitika mwachangu, ndipo njira yachiwiri imachitika pokhapokha ngati ikufunika mwachangu ndikadutsa mayeso oyenera.

Mitundu ya ma opaleshoni othandizira opaleshoni imagawidwa m'mitundu ingapo:

• guillotine kapena mwadzidzidzi
• choyambirira
• sekondale.

Mtundu woyamba umapangidwa pamene vuto la wodwala lili pachiwopsezo ndipo palibenso mwayi wochedwa kudula. Nthawi yomweyo, ndizosatheka kudziwa komwe kuli minofu yakufa, choncho amachitidwa opaleshoni yomwe imachotsa gawo lalikulu kwambiri la chiwalo.

Kudula koyambirira kumachitika ngati dokotala wothandizidwa ndi mankhwalawa sangabwezeretse ntchito yoyenda magazi.

Kudulanso kwachiwiri ndikofunikira pambuyo pobwezeretsa magwiridwe amwazi. Zimachitika ndi njira yosagwiritsa bwino ntchito yobwezeretsa mitsempha m'miyendo ya wodwala.

Mano amapangidwa pogwiritsa ntchito mitundu ingapo. Ndizowunikira komanso zosasinthika (komabe, ma prostate ma modular nthawi zambiri amagwiritsidwa ntchito). Amakhala ndi magawo awa:

1. Chingwe cholandirira, chomwe chimapangidwa potengera chitsa cha wodwalayo.
2. Kusintha ndi kulumikiza zida.
3. Module yonyamula. Amasamba kutengera kutalika kwakudikirira kwa prosthesis.
4. Module ya phazi.
5. Zambiri za chikhodzodzo.

M'pofunikanso kutchulapo kuti, phula losatha, mosiyana ndi kuphunzitsira, limaphatikizanso ndi zingwe zodzikongoletsera, pomwe zimayikidwa masheya apadera. Izi ndizofunikira kuti ma prosthesis afanane momwe angathere ndi mwendo weniweni.

Ntchito ikuyenda bwanji?

Odwala ena amakumana ndi zovuta zina atadula miyendo. Amatha kuwonetsedwa, mwachitsanzo, pakuchulukitsidwa kwazitali kwa sutures, mapangidwe a malo okhala ndi chofukizira ndi kutupa kwa chitsa.

Pofuna kupatula zovuta zoterezi, ndikulimbikitsidwa kugwiritsa ntchito kuvala kwapadera. Chowonadi ndi chakuti amathandizira kukhazikika kwa kayendedwe ka magazi komanso kayendedwe ka mitsempha m'dera la ziwiya zowonongeka atachotsa.

Pambuyo pochotsa mbali ya mwendo kapena chala, pali zovuta zingapo - kuchokera pazomwe sizichiritsa kwa nthawi yayitali kuti kutupa ndi kutupa. Pofuna kupewa zotsatira zosafunikira, ndikofunikira kuvala bandeji yokhazikika yomwe imakhazikika pakuyenda kwa magazi ndi kutuluka kwa magazi. Ayenera kukhala olimba, ovulala kwambiri m'munsi mwa chitsa, mavutowo amachepa kumka kumtunda.

Kutikita pafupipafupi kwa chitsa ndi minofu yoyandikana - kugwada, kupukusa, kuwomba - ndikofunikira, chifukwa zimakupatsani kubwezeretsa minofu ya atrophied.

Ndikofunikira kudziwa kuti:

1. Odwala onse amadwala ululu wamphantom. Pankhaniyi, katswiri wama psychologist ndi analgesics athandizira kuyanjananso ndi kutayika.
2. Chithandizo cha mankhwalawa chimagwiritsidwa ntchito onse mwamankhwala (pachimake) komanso physiotherapeutic.
3. Mphamvu zowoneka bwino zimawonedwa ndi masewera olimbitsa thupi komanso mitundu yonse ya kutikita minofu, kuphatikizapo kudzithandiza. Mukachiritsa, mutha kusamba osamba.

Ndi chisamaliro chosauka, kubwezeretsanso minofu necrosis ndi matenda a bala ndikotheka. Kuchita mobwerezabwereza, pakufunika ntchito yayikulu.

Ngati munthu wadulidwa, ndiye kuti zotsatirazi zitha kudziwika:

• poizoni wama minofu yathanzi samaloledwa, chifukwa palibe chomwe chimalepheretsa zotsatira zabwino za microflora yakunja, popeza chotupa chidapangidwa,
• Nthawi zambiri miyendo imadulidwa, chifukwa amafunika magazi ambiri,
• Makoma a mitsempha ya magazi amachepera msanga, pamene munthu ayamba kudwala matenda ashuga.

Osatengera kuti chala kapena chiwalo chonse chidadulidwa, gawo loyambirira lachiwonetsero chothandizira pakukonzanso limakhalabe lofunikira kwambiri. Zofunika pankhaniyi:

1. Kupewa mavuto osiyanasiyana, mwachitsanzo, kufalikira kwa chitsa, ndikofunikira.
2. Ndikofunikira kwambiri kuwunika kayendedwe ka magazi ndi magazi m'miyendo.
3. Kupewa kuuma molumikizana mafupa ndi minofu hypotrophy ndikofunikira. Poterepa, mufunika olimbitsa thupi komanso achire.
4. Ndikofunikanso kuwongolera zowawa, kuzipewa momwe mungathere.
5. Zachidziwikire, mungafunike thandizo la psycho-maikutlo la wodwalayo. Zowonadi, kwa pafupifupi anthu onse, kutayika kwa miyendo ndikumenyedwa kwakukulu.

Kodi kudula zala kumawonetsedwa liti?

Njirayi ndiyosinthika, amangoigwiritsa ntchito pokhapokha ngati akufunikira kupulumutsa wodwalayo. Pokhudzana ndi kufalikira kwathunthu kwa mitsempha yamagazi, kutuluka kwa magazi kumayimitsidwa ndipo zimakhala zolimba m'miyendo yamunthu zimaperekedwa ndi iyo, zomwe zingalole kuti zife.

Zinthu zapoizoni, tizilombo toyambitsa matenda komanso michere imachuluka m'thupi, poyizoni wamagazi, sepsis imachitika, chifukwa choti wodwalayo angafe.

Kudzicheka kwa chala kumatha kuletsa imfa ya wodwalayo, chifukwa amachotsa minofu ya necrotic. Zizindikiro zakuduladula zitha kukhala motere:

• neoplasms yoyipa,
• kachilombo ka anaerobic,
• Phazi kapena miyendo
• Kuyimitsidwa kwathunthu kwa kuzungulira.

Ndikofunikira kuyang'anira thanzi lanu ndikuwona matendawa munthawi yake, chifukwa chake ngati munthu yemwe wayimirira kwakanthawi amamva kuti wakomoka, kusapeza bwino komanso ululu wolumikizana ayenera kupita kuchipatala mwachangu.

Zotsatira zake

Kudulidwa miyendo ndi njira yovuta kwambiri. Kuchita kotereku sikungatheke popanda thandizo la mankhwala owonjezera.

Komanso, pochita njira zochizira pambuyo pakuchita opaleshoni, sizingatheke popanda kupweteketsa ululu mothandizidwa ndi mankhwala ochititsa dzanzi ndi ma analgesics. Ululu wammbuyo umatha pambuyo pochira bala.

Pofuna kuthetseratu kupweteka kwakanthawi kochepa pantchito, makonzedwe a mankhwala omwe si a mahomoni omwe amachepetsa kutupa amayikidwa.

Pambuyo pochotsa chala mu matenda a shuga, matendawa ndi abwino, koma ngati opareshoniyo idachitika munthawi yake, ndipo atatsata njira yoyenera yokonzanso. Kupanda kutero, zovuta monga yachiwiri kufalikira kwa zimakhala.

Ngati wodwala yemwe ali ndi vuto la matenda ashuga sathamangira kwa dokotala, koma akuyesetsa kuthandizidwa payekha, zotsatirapo zake zimakhala zachisoni kwambiri. Ndikumauma pang'onopang'ono, chala pakapita kanthawi chimangodzicheka, komanso ndi chonyowa, matenda amatalikirana mwachangu, kenako ndikuduladula phazi lonse ndikofunikira kupulumutsa moyo.

Mulimonsemo, pambuyo pa opaleshoni, wodwalayo ayenera kulabadira momwe akumvera, ndipo pakakhala zizindikiro zotsatirazi, funsani dokotala posachedwa:

• Ngati malo ozungulira chilondacho ayamba kutupa, asandulika ofiira ndi zowawa - ichi ndi chizindikiro cha kutupa kwachiwiri,
• Ngati bala lake silikuchira kwa nthawi yayitali, magazi amawonekera kuchokera pamenepo, muyenera kufunsa dokotala,
• Ngati redness, dzanzi, dontho lakuda lomwe likuwoneka ngati chilonda likawoneka m'dera la chitsa kapena pa mwendo wina kapena chala chotsatira, muyenera kulumikizana ndi dokotala nthawi yomweyo, ndiye kuti omwe akhudzidwa akhoza kupulumutsidwa.
• Ngati mukuda nkhawa ndi ululu wowawa womwe suchoka ngakhale mutatha analgesics.

Sikovuta kupewa zovuta pambuyo pakuchita opaleshoni, ndikokwanira kutsatira malingaliro onse a dokotala ndikuchiza bala la postoperative. Ndikofunikanso kuyang'anira thanzi lanu, kupewa kutalikirana, kuti musabwezeretsenso necrosis ya minofu ya kumapazi.

Ngati opaleshoni yochotsa mankhwalawo kuti muchotse chala chakecho idapangidwa munthawi yake komanso molondola, ndiye kuti matchulidwe ake amakhala ambiri. Ngati munthu akuzengereza kupita kuchipatala, ndiye kuti ndi matenda owuma, kudzidulira chala. Pakanyowa, zimakhala zoyandikana nazo zimayambitsa matenda, ndikuchotsa phazi ndi miyendo yonse.

Werengani zambiri za gangrene zam'munsi - werengani apa.

Pambuyo pakuchita opaleshoni, ndikofunikira kutsatira malingaliro onse a akatswiri omwe amapezekapo, chiritsani chilondacho, onetsetsani kuti sichikutuluka ndipo sichifuna kudulanso kwachiwiri.

Pali nthawi zina pamene sikutheka kupirira vuto popanda kuchitidwa opareshoni. Munkhaniyi ndikufuna kulankhula za njira zodzikonzera nditadula miyendo ya wodwala.

Mawu Ofunika

Poyambirira, muyenera kuthana ndi mawu omwe agwiritsidwa ntchito mwachangu mu nkhaniyi.

1. Chifukwa chake, kuduladula mwendo ndikuchotsa dzanja lamatenda. Cholinga cha ntchitoyi ndikupulumutsa moyo wa munthu. Ndikofunika kunena kuti madotolo amapanga chisankho pakuthandizira opaleshoni pokhapokha ngati pali chovuta kwambiri.
2. Mulingo wotseka ndi malo pomwe mwendo udulidwapo.
3. Kukonzanso ndi njira yomwe akatswiri akatswiri osiyanasiyana (madotolo, akatswiri azamisala, orthopedists, mahule) amaphunzitsira munthu kuti azolowere chilichonse kuzungulira iye popanda dzanja lotayika.

Zizindikiro zoduladula mbali ya m'munsi zimatha kukhala zambiri. Chifukwa chimodzi ndi matenda ashuga. Matendawa pawokha sangayambitse vutoli. Komabe, nthawi zina (kunyalanyaza matendawa, kusinthika kwake kukhala mawonekedwe obwezeretseka), zisonyezo zamankhwala zodulidwa zimatheka (izi zimachitika pafupifupi 8-10% ya odwala). Kodi kudula miyendo kumatha kufotokozedwa liti mu shuga?

1. Neuropathy yokhudzana ndi kuwonongeka kwa mitsempha.
2. Micro ndi macroangiopathy (izi ndi kuphwanya kapangidwe kake ndi kayendedwe kabwino kazombo zazikulu ndi zazing'ono).
3. Kusintha kwa ma nikirotic komwe kumachitika kumapeto pang'ono.

Monga zadziwika kale, chizindikiritso choyambirira komanso chachikulu chakudula ndikuphwanya kugwira ntchito kwa ziwiya zamiyendo. Izi zimachitika chifukwa cha kusokonezeka kwa kagayidwe ndi kagwiridwe kazinthu monga autoimmunization.

Kusunthika kumawonekera m'matumbo, kufa ndi mpweya wa oxygen, zomwe zimapangitsa miyendo kukhala pachiwopsezo cha matenda osiyanasiyana. Ndipo ngakhale kuphulika kocheperako kumatha kupangitsa kuti pakhale njira zoyipa zowoneka bwino.

Popewa kufa, pazinthu zotere, madokotala amapanga chisankho champhamvu. i.e. wodwala amafunanso kudula mwendo (ndi matenda ashuga, zotere sizimadziwika).

Nthawi zambiri, mwa njira imeneyi ndi pomwe wodwala angapulumutse moyo wake.

Monga tamva kale, kudula mwendo ndikusokoneza kwambiri moyo ndi thanzi la wodwalayo. Ichi ndichifukwa chake pambuyo pa opareshoni munthu amayembekeza nthawi yayitali kukonzanso. Ndizoyenera kunena kuti kupambana pakukonzanso chithandizo kumatengera zinthu zingapo:

1. Chitsa chabwino (mtundu wa momwe ntchito ikufunira).
2. Fomu lolingana (lofunikira ndi ntchito yabwino ya prosthetist).
3. Kukonzanso dongosolo.

Ngati chimodzi mwazomwezichitidwa mosachita bwino, njira yokonzanso ikhoza kuchedwa kwambiri.

Gawo lokonzanso 1. Kukonzekera chitsa

Ngati wodwalayo adachitidwa opaleshoni "mwendo", magawo angapo abwinobwino azofunikira chaka chatha atachitidwa opaleshoni. Chifukwa chake, monga tafotokozera pamwambapa, chitsa cha chofunikira ndichofunikira kwambiri. Zimatengera zinthu zambiri:

1. Kutalika kwa chitsa.
2. Chiwopsezo chodulira.
3. Postoperative scar (iyenera kukhala kutali ndi malo okhala ndi axial katundu wambiri).
4. Mitundu ya chitsa (zimatengera njira yomwe opaleshoniyo idachitikira).
5. Kulera, i.e., malire amsewu. Izi ndizofunikira kwambiri, chifukwa mtundu waomwe munthu akuyenda kupitiliza zimatengera chinthuchi.

Zomwe zili zofunikira kudziwa za chisamaliro chitsa

Pambuyo podulidwa mwendo kuti ichitike, ndikofunikira kwambiri kusamalira bwino mawonekedwe a postoperative suture. M'masiku oyamba, adokotala ndi namwino amamuwona. Apa ndikofunikira kufotokoza kuti odwala omwe ali ndi mtima wam'mimba komanso matenda osokoneza bongo amafunika chisamaliro chapadera, chifukwa ndi matenda omwe amawonjezera chiopsezo cha matenda a chitsa. Chofunika:

1. Ukhondo wa chitsa ndikofunika kwambiri. Kusamba kosiyanitsa tsiku lililonse ndikofunikira. Mutha kusamba phazi lanu ndi sopo wa ana, mutapukuta ndi thaulo.
2. Chitsa chimayenera kuyang'aniridwa tsiku ndi tsiku kuti mtundu wa khungu usinthe. Izi ndizofunikira kwambiri, ndipo ndikusintha pang'ono muyenera kufunsa dokotala.
3. Pambuyo pakuchita opaleshoni, khungu la chitsa limayamba kumva kwambiri. Mutha kuthana ndi izi mothandizidwa ndi kutikita minofu. Mutha kuzichita ndi manja onse ndi mpira yaying'ono wa mphira, ndikupanga mozungulira. Nthawi ndi nthawi, chitsa chake chimayenera kupukutidwa ndi thaulo. Muyenera kuchita izi pafupipafupi, ndi bwino kangapo patsiku.
4. Tiyenera kukumbukira kuti postoperative bala iyenera kukhala yothira. Izi ndizofunikira makamaka mu masabata angapo atadulidwa miyendo.

Nthawi ya kusintha kwa masanjidwe othandizira odwala omwe ali ndi matenda osokoneza bongo nthawi zambiri amakhala yayitali.

Matenda am'munsi mwam'mimba ndi necrosis ya zimakhala zake, chifukwa cha zifukwa zingapo zamkati kapena zakunja. Akuluakulu, kukula kwa mwendo gangrene kumakwiyitsa zotupa zam'mimba, kusintha kwa mitsempha yamagazi m'miyendo ndi kumapazi, ischemia yovuta kwambiri ngati pali embolism kapena ochepa.

Zomwe zimayambitsa kunja kwa gangore zimaphatikizapo kuchuluka kwa frostbite kapena kuvulala koopsa.

Minyewa imatha kukhala youma komanso yonyowa, yomwe imatsimikiziridwa ndi kukhalapo kwa malire omveka pakati pa minofu yamoyo ndi yakufa. Dry gangrene ndiyabwino kwambiri, chifukwa chifukwa cha kutsekeka kwa njira ya necrotic, zinthu zowola sizilowa m'magazi, zomwe zimayambitsa kuledzera.

Ndi chonyowa chonyansa, njira yosasinthika yochokera ku minofu yathanzi sikuchepera. Uwu ndi mtundu wovuta kwambiri, womwe ukukula patsogolo pang'onopang'ono, womwe umachitika ndi kuledzera komanso kutentha thupi.

Mpaka pano, kuduladula ndiyo njira yokhayo yochizira matenda amimbayo, kukhazikitsa komwe kumapulumutsa wodwala.

Kupewa mukamadzicheka

Kuti mupewe kukula kwa gangrene, muyenera:

• Pewani kuchuluka kwakukulu kwamagazi,
• miyezi itatu iliyonse imayesa mayeso a hemoglobin wa glycosylated,
• muziyang'ana miyendo yanu tsiku ndi tsiku chifukwa cha ming'alu ndi zilonda zam'mimba, ndikuwathandiza ngati atapezeka
• Valani nsapato zabwino
• sewera masewera kapena kuchita masewera olimbitsa thupi,
• kutikita minofu.

Mosakayikira, atadulidwa, wodwala amafunika kutsatira mosamalitsa njira zopewera. Ndi njira izi zomwe zingathandize kubwezeretsa ziwalo zamthupi mwachangu momwe zingathekere.

Zofunika! Ndi matenda a shuga, simungayende opanda nsapato! Masokisi amayenera kupangidwa kokha ndi ulusi wachilengedwe, ma synthetics amaletsedwa! Masokisi ndi nsapato ziyenera kukhala zaulere kuti kusunthika sikuletsa.

Ndi matenda a shuga, wodwalayo amakulimbikitsidwa kuti azichulukitsa miyendo ndi miyendo, koma njirayi imakhala ndi zotsutsana.

Kukonzanso mwendo ndikadula mwendo pamwamba pa bondo kumaphatikizanso njira zodzitetezera kuti zisachulukitse matenda opatsirana. Mulinso:

• Zaukhondo
• Kugwiritsa ntchito mwala wa pumice kuti kuthetsere khungu la keratinized. Lumo siliyenera izi,
• Kusintha khungu,
• Chithandizo chamiyendo cham'miyendo,
• Sinthani zovala nthawi zonse kuti muyere,
• Kusisita
• Kuyenda
• Kutsatira ndi malingaliro a madokotala ena.

Kodi njira izi zikuyenera kutsatiridwa mpaka liti? Moyo wanu wonse ngati mukufuna kukhala athanzi. Osadandaula ngati vuto lakukhudzani. Anthu amakhala ndi mahule ambiri, ndipo ena amakhala akatswiri othamanga.

Kutchepetsa kudalira

Anthu odwala matenda ashuga atadulidwa kokwanira mbali yaumayi amatha mkati mwa miyezi 12 mwa milandu 50%. Zizindikiro zomwe zatsimikizidwa zikutsimikiziridwa kuti opaleshoniyo idachitidwa mwa munthu wachikulire wokhala ndi zikhalidwe zokhudzana ndi matenda. Mwa odwala omwe atha kupitirirapo, kufa kumachepetsedwa katatu.

Pambuyo ndikudula mwendo wapansi popanda kukhala ndi nthawi yokwanira yokonzanso, odwala oposa 20% amafa. Pafupifupi 20% ya iwo pambuyo pake adzafunanso kubwezeretsanso gawo la akazi.

Mwa anthu odwala matenda ashuga omwe adakwanitsa kuyendayenda pamiyendo, ziwengo sizingadutse 7% pakadutsa miyezi 12 kuchokera ku matenda aliwonse omwe adakumana nawo. Odwala, atatha kudula pang'ono (zala zazing'ono) ndi mawonekedwe a phazi, adzakhala ndi moyo wokhala ndi moyo wofanana ndi m'badwo wawo.

Chifukwa chake, pankhani ya matenda ashuga, mwayi wokhala ndi zovuta zingapo, kuphatikiza omwe amagwirizana ndi madera akumunsi, ndiwokwera kwambiri. Pofuna kutalikitsa moyo wa wodwalayo, akatswiri amalimbikira kudula mwendo kapena gawo lililonse la iwo.

Kupanda kutero, kukula kwa gangrene, sepsis ndi kufa kwa matenda ashuga mwina. Komabe, ngakhale atadulidwa, ndikofunikira kutsata mosamalitsa malingaliro onse a dokotalayo kuti akhalebe 100% yazofunikira.

Ngati mwendo wadulidwa m'chiuno, theka la odwala matenda ashuga okha ndi omwe amapulumuka chaka chatha atachitidwa opereshoni. Ziwerengero zofananira zimawonedwa mu ukalamba, pamene shuga imayendera limodzi ndi zovuta zina. Mwa odwala omwe anakwanitsa kuphunzira ma prostheses, kupulumuka kumakhala katatu kwambiri.

Ndikudula mwendo wapansi, ngati palibe kukonzanso zokwanira, 20% ya ozunzidwayo amafa. Enanso 20 peresenti ya opulumuka amafunikanso kudula miyendo - tsopano. Mwa odwala omwe adadwala kale, kufa kwa chaka sikupitirira 7% (pamaso pa matenda achilendo).

Ndi njira yaying'ono yochita opaleshoni (kusanjikanso phazi, kuchotsa chala), chiyembekezo cha moyo chimakhalabe pamlingo wazaka zake.

Ndi matenda opatsirana a shuga, zovuta za zovuta ndizambiri. Kudula mwendo mu matenda ashuga ndi chifukwa chachikulu chomwe madokotala ochita opaleshoni amakakamizidwa kuti ateteze matenda osokoneza bongo kapena sepsis ndikupulumutsa moyo wa wodwalayo.

Kuti mubwezeretse ndikukhalanso wogwira ntchito kwa dzanja lomwe lakhudzidwa panthawi yakusinthika, ndikofunikira kutsatira zonse zomwe dokotala wakulemberani.

Njira zamakono zodziwitsira zala za matenda ashuga - muvidiyoyi

Anthu ambiri sadziwa momwe angakhalire atatha kuchita opaleshoni yovuta ngati iyi ndikuyamba kuvutika mtima kwambiri. Koma moyo ukatha, ndipo ntchito yayikulu ya abale a wodwalayo ndikuwathandiza wodwala ndikuwathandiza.

Kwakukulukulu, opaleshoni ikatha, odwala amatha kukhala ndi matenda a "shuga" kwazaka zambiri, koma nthawi yomweyo, kudula gawo la thupi kuyenera kuchitidwa moyenera, ndipo wodwalayo ayenera kutsatira malingaliro onse a dokotala.

Ngati munthu samvera zomwe dokotalayo amamuuza, matendawo amakhumudwitsa, popeza ndizotheka kukwaniritsa chotupa ndi miyendo yachiwiri, yomwe iyenera kudulidwanso.

Ngati munthu ali ndi matenda ashuga, ndiye kuti njira yodulira nthawi zambiri imachitika ndipo izi zimathandiza munthu kupulumutsa moyo. Zikatero, ndikofunikira kutsatira malingaliro azachipatala, ndiye kuti mwayi ndi wolepheretsa kukula kwa njira zomwe zimathandizira kupititsa patsogolo shuga.

Zikatero, ndikofunikira kuti musayambitse ntchitoyi, chifukwa kudula kumatha kukhudza mbali zazikulu zamiyendo. Ndizowopsa kuti izi zimayambitsa theka laimfa mwa odwala matenda ashuga. Ndikofunikira mu zochitika zotere kudzuka nthawi pambuyo pa opareshoni, ndiye kuti mwayi wokonzanso umachulukitsa katatu.

Kuchita bwino kumalola munthu kuti azikhala nthawi zonse pagulu, amabwezeretsedwa kuntchito yake yakale ndikuyankhulana ndi abwenzi. Zikatero, ndikofunikira kusankha ma prosthesis oyenera, ndiye kuti palibe chomwe chingasokoneze moyo wabwino.

Musaganize kuti njira yodulira dzanja ndi mathero amoyo. Osatengera izi, kwa anthu ambiri, izi nthawi zambiri zimasintha moyo pomwe mungapeze anzanu komanso malingaliro atsopano.

Mitundu yogwirapo

Kudulidwa kumakupatsani mwayi:

• kuteteza kuledzera kwamasamba oyenera kapena ziwalo chifukwa cha mphamvu ya michere ya pathogenic
• khalani okwanira m'dera la musculoskeletal bwino kuti muchite ma prosthetics ena.

Madera akumunsi nthawi zambiri amadulidwa chifukwa:

• amayenda mosalekeza, amafunikira magazi athunthu,
• sikuti aliyense amapatsidwa chisamaliro chokwanira,
• mwachangu amachepetsa makoma amitsempha yamagazi yolimbana ndi matenda a shuga.

1. Zadzidzidzi. Opaleshoni yotere imachitidwa ngati kuli kofunika kuti muchotse matendawa mwachangu, pamene chiopsezo cha imfa chiwonjezereka. Ndizosatheka kudziwa malire enieni a chotupa, chifukwa kudulidwa kumachitika pang'ono pamwamba pa mawonekedwe a chotupa. Opereshoni imachitika m'magawo angapo. Choyamba, nthambi yomwe idakhudzidwayo imachotsedwa pamwamba pamalire a malo ake, kenako chitsa chimapangidwanso kuti ziwonjezeke.
2. Poyamba. Amachitika ngati magazi m'dera lomwe lakhudzidwalo sangathe kubwezeretsedwanso pogwiritsa ntchito njira zolumikizira thupi.
3. Sekondale. Kudulidwira kwamtunduwu kumachitika pambuyo poyesera kuti ayambirenso kutaya magazi m'chiwalo. Kuchita opareshoni kumachitika motsika, kukhudza madera am'munsi mwendo, phalanx ya zala ndi phazi.

Mukadulidwa, dzanja lonse kapena gawo lina la nthambi limachotsedwa:

1. Zala. Kuchita opareshoni kumachitika chifukwa cha necrosis, yomwe imapangika mbali iyi ya nthambi chifukwa cha kusayenda bwino kwa magazi kapena kupangika kowoneka bwino. Kucheka kumachitika pokhapokha ngati magazi abwinobwino amapita kumapazi. Pa opaleshoni, zala zakufa zimadulidwa.
2. Imani. Kuyambiranso m'mbali mwendowu kumaphatikizanso nthawi yayitali yochira. Ndi zotsatira zopambana za opaleshoni, ntchito yothandizira dzanja imakhalabe. Pambuyo ndikudula, ndikulimbikitsidwa kuvala nsapato zapadera kuti muchepetse kupanga kwa arthrosis.
3. Drumstick. Mankhwala opangira opaleshoni amachitika molingana ndi njira ya Pirogov. Zimakhazikitsidwa ndikuchotsa mwendo wotsika ndikutsatira kwina kwa mwendo. Njira iyi yochotsera imagwiritsidwa ntchito ndi mitundu yapamwamba yamapazi am'mapazi. Kuchita opaleshoni yopambana kumakupatsani mwayi wosunthira momasuka pogwiritsa ntchito prosthesis komanso popanda ndodo yothandizira kale miyezi ingapo.
4. Thu. Kudulira kwamtunduwu kumagwiritsidwa ntchito pomwe sizingatheke kuchotsa mwendo umodzi wokha.

Kanema pazomwe muyenera kuyang'ana mukadula:

Kukonzanso komanso ma prosthetics

Kulowererapo kulikonse kumafunikira njira zowonjezera zochira. Kudulidwa kwa dzanja pakati pa zovuta za shuga kumadziwika kuti kumachitika pafupipafupi. Kuchotsa miyendo, ndipo nthawi zina zonse, kumakulolani kupulumutsa moyo wa munthu, koma kumabweretsa kufunika koti muphunzire kukhalapo popanda miyendo.

Nthawi yokonzanso ikufuna kupondereza njira yotupa, kupewa kupezeka kwa matenda, komanso monga chithandizo cha zilonda zamasiku onse. Kuphatikiza apo, wodwalayo amapatsidwa njira zingapo zochitira masewera olimbitsa thupi komanso masewera ena olimbitsa thupi omwe ali m'gulu la masewera achire.

Kukonzanso kumafuna wodwala:

• kutsatira zakudya
• tumikirani minofu, zolimbitsa thupi kuti muchepetse ululu wa minyewa,
• gonani pamimba panu kwa milungu iwiri ndi itatu,
• pamalo apamwamba, sungani mwendo wovulala papulogalamu yokweza kuti musatupe,
• mosamala mabala kuti mupewe matenda ndi kutupa.

Zovuta zomwe zingachitike mutadula:

• kutenga matenda, kuphatikiza sepsis yayikulu,
• necrosis ya minofu, yomwe imadziwika kwambiri ndi odwala matenda a shuga,
• mawonekedwe a preinfarction
• kugwiritsa ntchito molakwika antiseptics ndi antibacterial,
• magazi akhungu m'mitsempha,
• thromboembolism
• chibayo chomwe chinachitika mkati mwa masiku atatu kuyambira tsiku la opaleshoni,
• subcutaneous hematoma, yopangidwa kuzungulira maziko a kuyimitsidwa kolakwika kwa magazi,
• matenda am'mimba dongosolo
• phantom ululu.

Zomwe zimayambitsa kupweteka kwa phantom kuchokera ku mbali ya etiological sizinaphunziridwe molondola, kotero palibe njira zochiritsira zothandiza kuti zithetsere.

Vutoli limadziwika ndi kupezeka kwa zosasangalatsa zam'munsi mwa miyendo yolumikizidwa (kukhomoka kwa bondo, kupweteka kuphazi, kuyabwa m'dera la zidendene). Vutoli limakulitsa nthawi yokonzanso. Amachotsedwa mothandizidwa ndi mankhwala, physiotherapy, malingaliro amisala, antidepressants.

Phantom Pain Video:

Udindo wofunikira umachitika ndikumakonzekeretsa kwa wodwala kuti akhale ndi moyo. Odwala ambiri amakhala ndi nkhawa, amaganiza zodzipha chifukwa cha kupsinjika kwambiri chifukwa cha kulumala kwakuthupi. Kukwaniritsa kukhazikika m'maganizo, wodwala, monga lamulo, amathandiza banja ndikuyang'ana cholinga.

Ngati gawo lokonzanso ladutsa mosavuta, ndipo palibe zovuta, pitani ku prosthetics. Choyamba, wodwalayo amaphunzitsidwa njira yoyambira. Pochotsa dzanja lonse, munthu amayenera kuphunzira kuyendanso.

Maphunzirowa atangoyamba kumene, minofu yabwino ikhala. Ma prostate okhazikika amapangidwira payekhapayekha kwa aliyense malinga ndi magawo ake. Zofooka zomwe zadziwika kuti zimatha.

Njirayi imachitika kumapeto kwachiwiri - chiyambi cha sabata lachitatu kuyambira nthawi ya opareshoni. Kukonzanso kumachitika pambuyo pa kuvala kwazomwe zidapangidwa kale. Ngati wodwalayo adadulidwa zala, ndiye kuti safunika kuchita ma prosthesis.

1. Kusankha kapangidwe.
2. Kutenga miyezo kuchokera pa chitsa.
3. Kupanga zinthu.
4. Msonkhano wachipembedzo.
5. Kutsiliza malonda malinga ndi zofuna za wodwala.
6. Kutulutsa kwamayendedwe.
7. Maphunziro a ntchito.

Kupambana kwa nthawi yokonzanso kumadalira mtundu wa prosthesis, kukula kwake, njira yolamulira, kapangidwe, ndi zokongoletsa. Maganizo a wodwalayo amakhudzanso kuchuluka kwa kubwereranso mwakale.

Moyo pambuyo ndi kuneneratu

Kuchepetsa nthawi zambiri kumachitika mu shuga. Chifukwa cha njirayi, wodwalayo amapulumutsidwa. Kutsatira malangizo ena azachipatala omwe amawaganizira kuti azikhala ndi vuto la shuga kumapereka mpata wopewera kubwerezanso matenda, komanso kupitiriza kwa matenda ashuga.

Mitundu yomwe idakhazikitsidwa imayambitsa kudula gawo lalikulu la chiwalo, chomwe chimayambitsa kufa mu 50% ya milandu pachaka. Odwala omwe anatha kuyimirira ndi miyendo atachitapo opaleshoni yotereyi amachepetsa chiopsezo cha kufa pafupifupi katatu.

Kudulidwa kopambana kumalola anthu ambiri kukwanitsa kukhazikika kwachikhalidwe, kuchira kwathunthu pantchito zawo zam'mbuyomu kapena kuyamba kudziyang'ana okha. Kusankha prosthesis yoyenera kumapangitsa wodwala kutsogolera moyo womwewo ngati kale. Kwa anthu ambiri, kudula mwendo kumasandutsanso malingaliro, motero kumakulimbikitsani kusewera masewera kapena kuyenda mwachangu.

Anthu omwe amadulidwa ndikulandila ndalama kulandira thandizo kuchokera ku boma, akhoza kudalira gawo la zilema, komanso kulipiritsa zabwino.