Zizindikiro zoyambirira ndi chithandizo cha gangrene mu shuga

Gangrene mu shuga ndi njira ya necrosis yam'thupi lathupi m'thupi, chifukwa cha momwe matenda opatsirana amawonedwera. Zinthu za cadaveric zimalowanso m'magazi, zomwe zimapangitsa kuti vutoli lithe - kugonjetsedwa kwamphamvu kwamkati mwa matenda ashuga - chiwindi, mtima, mapapu.

Kuyimbira mochedwa kwa dotolo, kulandira chithandizo chokwanira, moyo wopanda thanzi, ndikunyalanyaza vutoli kumabweretsa zotsatira chimodzi chokha - iyi ndi njira yodalirika yothandizirana yomwe imaphatikizapo kudulidwa koperewera.

Poyerekeza ndi za matenda ashuga, malekezero otsika omwe nthawi zambiri amavutika. Munthu wodwala matenda ashuga amatha kupindika phazi, phalax imodzi, imatha kukhudza zala zonse, ndikasiyidwa osachitapo kanthu, komanso kwa nthawi yayitali, imakhala yoyipa. Ngati simukuonana ndi dokotala munthawi yake, odwala matenda ashuga azikula bwino, zomwe zingapangitse kuti mwendo wake udulidwe.

Ndikofunikira kuganizira zomwe zimayambitsa matenda, kuti mudziwe zizindikiro za matenda am'mimba. Kuphatikiza apo, muyenera kudziwa ngati ndizotheka kupewa njirayi, komanso momwe mungachiritsire gangore popanda kuduladula?

Chifukwa chiyani zigawenga zimachitika?

Podziwa chomwe gangore ndi, muyenera kudziwa chifukwa chake zingachitike. Kukula kwa gangrene mu matenda ashuga kumatha kutengera zifukwa zosiyanasiyana. Komabe, m'malo ambiri, gangore imayamba chifukwa cha zifukwa zingapo nthawi imodzi.

Mtundu wa ischemic wa gangrene ndi chifukwa cha kusintha kwa ma atherosselotic m'thupi, chifukwa chomwe mitsempha yamagazi imatsekedwa, zomwe zimapangitsa kuti magazi azisokonekera. Zotsatira zake, minofu siyilandira magazi ndi mpweya wokwanira, imfa imachitika.

Phazi la matenda ashuga limadziwika ndi kukula kwa zilonda pamiyendo kapena kumapazi, ndipo ngati sachira kwa nthawi yayitali, kuphatikiza kachilomboka kamajowina, kuwoneka kwa gangrene kwachilengedwe chopatsirana kumapezeka.

Pali zifukwa zina zomwe zimayambitsa matenda osokoneza bongo:

• Zotsatira za kusokonezeka kwa glucose metabolism m'thupi ndi polyneuropathy, yomwe imayamba m'maselo a chapakati mantha. Poona izi, zotengera za maikulosikopu zimakhudzidwa, ndipo kukalamba kwa maselo kumawonedwa.
• Ndi kuphwanya kwa ziwiya zing'onozing'ono komanso kuchepa kwa kutsekeka kwa makoma a capillary, gangrene amayamba matenda a shuga.
• Pophwanya ziwiya zazikulu, motsutsana ndi kusintha kwa ma atherosselotic, ma magazi amawoneka m'thupi - izi zimachititsanso kuti pakhale gangrene.
• Tissue necrosis ndi chotsatira cha zinthu zambiri monga nsapato zosamasuka, kunenepa kwambiri, kufooka kwakukulu kwa chitetezo chathupi.

Matenda a shuga, kaya akhale mtundu wanji, ndiwowopsa kwa odwala matenda ashuga kuti apeze zovuta zingapo. Ndipo gangrene wa matenda ashuga (chithunzi), m'modzi wa iwo.

Anthu odwala matenda ashuga amatha kukhala ndi zilonda zam'miyendo pamiyendo yawo, komanso kumva pang'ono, chifukwa cholowera chakumapeto, wodwalayo samamva kusintha kulikonse m'thupi lake.

Matenda am'munsi kwambiri omwe ali ndi matenda osokoneza bongo samayamba atangoyamba kumene matenda.

Itha kuwonekera pokhapokha ngati matenda atapezeka, osachepera zaka 5 zapitazo.

Zizindikiro zake zodwala

Mafuta ochulukirapo m'magazi amawononga thupi pang'onopang'ono, chifukwa cha zomwe mathero amitsempha, omwe amachititsa kuti "kupweteka" kufa, afe, azilamulira chiwopsezo cha m'munsi.

Pamodzi ndi izi, mitsempha yam'mimbayo yomwe imayambitsa thukuta pakhungu la miyendo imafa, zomwe zimatsogolera pakhungu louma, ming'alu nthawi zambiri imawoneka. Ndipo popeza zonse ndizachilengedwe, matenda owonjezera amalumikizana ndi bala losachiritsika komanso lotseguka, lomwe limangokulitsa zinthu.

Tsoka ilo, ngati munthu ali ndi vuto loti achedwa kuchepa, kugwiritsa ntchito bwino mankhwalawa kumachepetsa. Maantibayotiki samathandiza, chifukwa sangathe kuthana ndi ntchitoyi, mabakiteriya amayamba kulimbana nawo. Ndipo pankhaniyi, kupewa kudula miyendo, sikugwira ntchito.

Chizindikiro choyambirira mwa mawonekedwe akuwonetsa kuti njira ya pathological yomwe ikupanga m'thupi sichikupezeka, chifukwa miyendo sikhala nayo chidwi chofananira. Komabe, zizindikiro zoyambirira zakutsogolo zomwe ziyenera kupangitsa kuti azikhala ndi nkhawa azitha kudziwa:

1. Kutopa kwambiri kwakumapeto kwam'munsi pamayendedwe, kumanjenjemera phazi, kusakhazikika kwa miyendo kuti igwire.
2. Kusintha kwa phazi, kupweteka m'miyendo.
3. Kusintha mtundu wam'mphepete, kapena mapazi, zala. Khungu limakhala lozizira komanso lofiyira, limatha kunenedwa pafupi ndi buluu.

Ngati mutchera khutu kwambiri kwa nthawi yomweyo, ndikuyamba kuchiritsa zilonda zam'miyendo, ndiye kuti matendawa ndi abwino. Chachikulu ndikutsatira malingaliro onse a dotolo, kutsogoza moyo wolondola (zakudya zimachita mbali yofunika).

• M'dera lomwe lakhudzidwalo pali kupweteka kwapafupipafupi, mankhwalawa samachepetsa mkhalidwe wa wodwalayo.
• Madera okhudzidwa amasandulika akuda kapena kapezi, kuwonetsa kuti necrosis ya minofu yayamba.
• Palibe magazi omwe akhudzidwa m'deralo.
• Pali zovuta: matenda. Izi zimachitika makamaka kwa milandu yanyengo.
• Anthu opulula amasulidwa ku bala, kuledzera kwa thupi kwapezeka.

Tsoka ilo, ndizovuta kusiya njira yomwe yayamba, koma ndizotheka ngati wodwalayo angafunse dokotala panthawi komanso osagwiritsa ntchito njira ina kunyumba.

Dokotala yemwe amapezekapo, mosakayikira, amayesa kuyang'anitsitsa dzanja, akuwonetsa kafukufuku wa bakiteriya, kuyezetsa shuga, magazi ndi kupenda kwa mawonekedwe, ndikuwunikanso kuyesa kwa magazi m'thupi.

Mitundu yamavuto

Mu shuga mellitus, mitundu iwiri ya gangore imayamba: gangonda youma komanso yonyowa (yonyowa).

Dry gangrene amakula mu zochitika izi pomwe mawonekedwe a mitsempha ya magazi amachepetsedwa. Izi zitha kukhala zaka 2-3. Munthawi imeneyi, munthu amatha kukhala phee osamva kusintha kwa thupi lake, ndipo thupi limasinthika ndimatenda amtunduwu, limayamba kugwira ntchito yoteteza.

Munthawi zambiri, khungu louma limawoneka zala zakumanzere, njira zopatsirana sizikugwirizana.

Mtundu wamtunduwu umadziwika ndi zizindikiro zotsatirazi: kupweteka kwambiri m'miyendo, komwe kumatsalira pakapita nthawi. Pakufufuza kwakunja, dera lomwe lakhudzidwalo limasiyana mosiyana ndi malo athanzi, palibe fungo. Chilondacho sichikhudzanso thanzi.

Monga lamulo, palibe chowopsa ndi mtundu wamtunduwu, ndipo mwendo ukhoza kudulidwa kokha ndi zodzikongoletsera zodzikongoletsera. Kapena muzochitika zomwe zimakhala ndi chiopsezo cha 100% cholowa mu malo onyowa.

Wet gangrene amadziwika ndi izi:

1. Ngati wodwala ali ndi phazi la matenda ashuga, ndiye kuti kuwonjezera kwa mabakiteriya ndi nthawi, amayamba kuchulukana mwachangu, chifukwa chomwe dera lomwe lakhudzidwalo likukula.
2. Chiwalo pang'onopang'ono chimatha kudziwika ndi mawu oti "cadaveric", matendawa amapita mwachangu, minofu yathanzi imakhudzidwa.
3. Fungo losasangalatsa limamveka kumadera omwe ali ndi kachilomboka, chilondacho chimakhala chonyowa nthawi zonse, ndipo sichitha.
4. Kupha poizoni kumachitika, popeza zinthu zambiri za cadaveric zalowa m'magazi.

Ndi chonyowa gangrene, dera lomwe limalowedwa mkati mwa matenda a minyewa limadzaza ndi hydrogen sulfide, kotero mukadina chilonda, mumatha kumva mawu.

Ndikofunika kudziwa kuti mtundu uwu wa gangore suchiritsidwa, ndiye kuti sizotheka konse kupulumutsa mwendo, ndipo njira yabwino kwambiri yothanirana ndi izi ndi kudula mwendo.

Kodi kuchitira gangore?

Chithandizo cha gangore ndi matenda a shuga chitha kuchitidwa m'njira ziwiri - uku ndi kuchitira opaleshoni ndi chithandizo chamankhwala. Komabe, chithandizo chothandiza kwambiri ndichochita opareshoni.

Mwa chithandizo chokhazikika, adotolo amayesera kuti alipire chipepeso pamatendawa, amachepetsa katundu pamiyendo (makamaka dera lomwe lakhudzidwa), agwiritseni ntchito maantibayotiki kuti achepetse kufalikira kwa njira zopatsirana, ndikuchepetsa poizoni m'thupi la wodwalayo.

Pa chithandizo chamankhwala osokoneza bongo, mavitamini a odwala matenda ashuga ndi mitundu yama mchere amathandizidwa, omwe amalimbitsa chitetezo cha mthupi cha munthu ndikuwonjezera ntchito zake zotchinga zachilengedwe.

Njira yakuchita opareshoni ndiyo chithandizo chachikulu cha chonyowa, ndipo njira yokhayo yomwe ingathandize kuti asafe. Pamodzi ndi kuchotsedwa kwa makina a minofu yakufa, zinthu zotsatirazi zimachitika:

• Antibacterial mankhwala kudzera yotakata sipekitiramu mankhwala.
• Zizindikiro zochizira zomwe zimachepetsa thupi kuledzera.
• Kuika magazi.

Odwala ambiri ali ndi chidwi ndi kuchuluka kwa momwe amakhala ndi zowawa zotere? Matenda owuma samakhudza kutalika kwa nthawi yomwe munthu amakhala, ndipo nthawi zambiri zimayambitsa kufa kwa odwala.

Komabe, wodwalayo amatha kufa ndi matenda omwe adayambitsa mkhalidwewu. Mwachitsanzo, mwa okalamba, kukula kwa gangrene kumachitika chifukwa cha atherosulinosis, yomwe ingayambitse imfa.

Nkhani yonyowa yamatenda, popanda kulandira chithandizo chokwanira, moyo wa munthu sudzatha masiku atatu, ndipo ola lililonse limawerengeka. Ndikofunika kudziwa kuti sizingatheke kuchiritsa matendawa kunyumba, palibe mafuta a gangrene omwe angathane nawo, komanso kutikita minofu ya matenda ashuga.

Njira zopewera

Kupweteka m'miyendo ndi matenda a shuga ndikovuta kwamuyaya kwa odwala, makamaka kwa anthu omwe ali ndi mitundu iwiri ya matenda. Pofuna kuteteza thanzi la munthu, kuti muchepetse kukula kwa zovuta, ndikofunikira msanga utazindikira kuti matendawa ayamba kuyamba.

Ndikofunikira kusiya zizolowezi zoyipa, zomwe zimatha kubweretsa vuto losazungulira bwino mthupi, zomwe zimapangitsa kuti pakhale kusintha kwa atherosselotic ndi phazi la matenda ashuga. Zonsezi motsatira tcheni zimatha kukhala chifukwa cha gangore.

Ngati callus ikupezeka kumapazi, zomata zomatira, ndiye kuti, zinthu zomata, sizigwiritsidwa ntchito. Mukamachotsa chigamba chomatira, pali mwayi wochotsa khungu lakumaso, zomwe zimapangitsa kuti bala lithe kutenga matenda.

Nsapato sizofunika kwenikweni. Nsapato kapena nsapato zosavomerezeka zimatha kubweretsa kukula kwa miyendo m'miyendo. Ndikofunikira kuvala nsapato zapamwamba zokha, siziyenera kukanikiza ndi kupukusa, kuphwanya, etc.

M'nyengo yotentha, muyenera kukhala eni ake a nsapato zingapo, ndipo muyenera kuvala motembenuka, ndiye kuyeretsa osalephera. Tsiku lililonse muyenera kuyang'ana miyendo yanu kuti iwonongeke komanso mabala, chisamaliro chapadera chimaperekedwa ku dera lodyera pakati.

Kupewera kumakhala ndi mfundo zambiri, ndipo kumangoyang'anira mosamalitsa kokha komwe kumakupatsani mwayi wopulumutsa thanzi lanu ndikupewa kukula kwa phazi la matenda ashuga. Kuyang'anira shuga, magazi ndi miyendo, komanso moyo wathanzi kumachepetsa chiopsezo cha zovuta. Kanemayo munkhaniyi amapereka njira yothanirana ndi gangore.

Mitundu ya Diabetesic Foot Syndrome

Pali mitundu itatu ya matenda amishuga odwala matenda ashuga:

1. Fomu la Neuropathic. Zowonongeka zam'mitsempha. Zotsatira zake, kumverera kumatsika, khungu limakhala louma, minofu atrophy. Phazi limawonongeka mwachangu, zilonda zam'mimba zimawonekera, ndipo chifukwa cha kuchepetsedwa kwa chidwi cha ululu wodwala samazindikira izi.
2. Fomu ya Ischemic. Kuwonongeka kwa mtima kumapangitsa. Ululu m'matumbo a ng'ombe amawoneka mukamayenda. Khungu la miyendo limayamba kupindika, kuzizira, tsitsi limatuluka. Mwina kukula kwa gangrene.
3. Fomu yosakanizika.

Youma gangrene

Ndikuphwanya magazi pang'onopang'ono, minofu ya phazi imamwalira, kusowa chinyezi, kupukuta, khwinya. Magazi ochokera m'matumbo amalowa m'matumbo oyandikana, amawonongeka kukhala chitsulo, ndikupangitsa khungu lakuda malo okhala. M'malire ndi minofu yathanzi, kutupa kumawonekera. Dry gangrene imayamba ndikumva ululu m'munsi mwa chotupa cha mtsempha. Chala chimakhala chakuda, chozizira, mtsogolomo - cyanotic, kenako chimachita khungu kapena kutuwa. Ngati chisamaliro chachipatala sichiperekedwa, njirayi imafalikira kwambiri mpaka kuchuluka kwa magazi. Nthawi zina kudzicheka kwa zokha kumatha kuchitika pamalire ndi minofu yathanzi - kukana kwa minofu yowonongeka. Matenda owuma amakhala ochulukirapo mwa anthu owonda.

Zowonda kwambiri

Imachitika ndikuphwanya kwambiri magazi, nthawi zambiri motsutsana ndi maziko a edema, lymphostasis, mwa anthu onenepa kwambiri.

Zowonda kwambiri

Amadziwika ndi matenda, zomwe zimayambitsa kuledzera kwambiri kwa thupi.

Zimayamba ndi kupaka khungu. Kenako mawanga ofiira ndi ma thovu amawonekera pamenepo, odzazidwa ndi zowonekera. Mwendo umatupa msanga, kupweteka, kenako kutaya kumverera. Matendawa amalowa, mkondowo umayamba. Izi zimaphatikizidwa ndi kuledzera kwa thupi: kutentha kwa thupi kumakwera kwambiri, kuzizira, kulumikizana, thukuta, kupha, kuopa. Mkhalidwewo umawopseza moyo wa wodwalayo.

Chithandizo cha gangrene a m'munsi malekezero a shuga

Ndi matenda opatsirana am'munsi, chithandizo chokha chomwe chingapulumutse moyo ndikudulanso kwa omwe akhudzidwa. Ndi chonyansa chodula, kudula kumachitika mwachangu, popeza matenda angayambitse sepsis ndi kufa kwa wodwalayo.

Ndi matenda owuma, kukonzekera kwa ntchito kumachitika ndikulimbikitsa kuthamanga kwa magazi kuposa msempha, kumapangitsa kuti magazi azikhala ndi magazi, ziwalo zofunika kwambiri, kuthana ndi matendawa, komanso kupweteka kokwanira kwa wodwala.

Kuchulukitsa voliyumu kumatengera mtundu wa gangren komanso momwe zotengera zilili komanso zimakhala. Nthawi zambiri kudula zala, kumodzi kapena zingapo, kumachepera - miyendo, ndipo kawirikawiri - "kukweza" kwambiri pamlingo wa ntchafu kapena mwendo wapansi.

Kupewa gangore, komanso kuyambiranso, kugwira ntchito zolimbitsa thupi komanso zosabwezeretsa pamitsempha yomwe imabwezeretsa magazi m'magawo owonongeka a mitsempha ndiyofunikira kwambiri. Arterial prosthetics, opaleshoni yodutsa, angioplasty, stenting amachitidwa.

Palibe chifukwa muyenera kuyesa kuchiza matenda am'miyendo ndi matenda ashuga okhala ndi wowerengeka azitsamba, kuyembekezera kuchita popanda kuduladula, kuponderezana, mafuta opaka, ofunda, ndi zina zotere. opareshoni yambiri.

Zoneneratu za gangrene zam'munsi

Kukula kwa gangrene kwam'munsi kwambiri mwa odwala matenda ashuga kumatengera mtundu wa gangore, kutalika kwa matendawa, zaka za wodwalayo, mkhalidwe wa ziwalo zina ndi machitidwe amthupi, komanso kubwezera kwa kagayidwe kazakudya.

Ndi matenda owuma, matendawo amathandizika ndi chithandizo chanthawi yake.

Ndi chonyansa cham'mimba, matendawa amakayikira, limakulirakulirabe odwala okalamba omwe ali ndi matenda osokoneza bongo, kuzengereza kufunafuna chithandizo chamankhwala. Momwe matendawa amadzimadzi ovulala popanda chithandizo ndi osavomerezeka, wodwalayo amafa chifukwa cha mawonekedwe a poizoni.

Kupewa Kwa Matendawa

Kupewa matenda a shuga m'matenda a shuga kumakhala ndi kuchepetsa matenda a kagayidwe kachakudya, cholesterol, matenda a kuthamanga magazi, kusiya zizolowezi zoyipa, kusamalira phazi pafupipafupi, kulandira chithandizo cha matenda oyamba ndi matenda ashuga, kutsitsa phazi ngati kuli koyenera.

Kusunga kagayidwe kabwino ka chakudya ndimomwe kumathandizira kupewa zovuta zonse za matenda ashuga.

Ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi kunyumba tsiku lililonse ndi glucometer. Kawiri pachaka, ndipo ngati kuli koyenera kawirikawiri, onetsetsani kuchuluka kwa hemoglobin ya glycated, yomwe imawonetsa kulipira shuga. Musaiwale za zakudya za tsiku ndi tsiku komanso kudya pafupipafupi mankhwala ochepetsa shuga kapena jakisoni wa insulin.

Nthawi zambiri mwa odwala matenda ashuga, lipid metabolism imodwalanso, cholesterol, zigawo zake ndi triglycerides zimakwezedwa. Matenda a matendawa amatha kuchepa kwa matenda a atherosulinosis komanso zimapangitsa kuti khoma la mtima lisasinthe.

Zizolowezi zoyipa zimachulukitsa shuga. Hypodynamia imathandizira kukulitsa kunenepa kwambiri, kuchuluka kwa shuga wamagazi, atrophy ya minofu. Pakusuta, vasospasm imachitika, yomwe imapititsanso kulephera kwamkati mwa ziwalo zomwe zakhudzidwa. Kuledzeretsa kumayambitsa mikhalidwe yayikulu ya hypoglycemic, kumakulitsa mkhalidwe wa kapamba ndi chiwindi.

Kusamalira pafupipafupi ndi kuchita masewera olimbitsa thupi ndizomwe aliyense wodwala matenda ashuga ayenera kuchita.

Malangizo Akusamalira Mapazi

• Yang'anirani phazi lanu pafupipafupi. Panthawi ya chimanga, mafoni, ming'alu, zilonda zam'mimba, kusintha kwa misomali (kudera lakuda, matenda osagwirizana ndi matenda a fungus), onetsetsani kuti mwakumana ndi dokotala.
• Sambani mapazi anu tsiku ndi tsiku ndi madzi ofunda ndi sopo, mumatha kusamba, koma osagwiritsa ntchito mapazi anu. Pukuta mchenga ndi malo owuma bwino ndi mwala wa pumice. Pambuyo pakusamba, ikani moisturizer kumapazi, kupewa malo pakati pa zala.
• Sinthani misomali yanu mosamala, kuti musasokoneze khungu lanu.
• Osadula chimanga ndi chimanga ndi malezala akuthwa, lumo, osagwiritsa ntchito polemba chimanga.
• Valani nsapato zabwino komanso zala yayikulu. Nsapato ziyenera kukhala zoyenera kukula, osayika kunja. Ngati mukukumana ndi zovuta ndi kusankha nsapato chifukwa chosinthika kwa zala, funsani ndi podotherapist ndi pempho kuti musankhe nsapato zapadera za orthopedic.
• Chitani zolimbitsa thupi kumapazi. Amalimbitsa minofu ndikuwongolera kayendedwe ka magazi m'malo omwe akukhudzidwa.

Kukhazikitsidwa kwakanthawi kwa mankhwalawa chifukwa cha matenda ashuga polyneuropathy ndi angiopathy kungachepetse mwayi wokhala ndi matenda osokoneza bongo. Amagwiritsa ntchito thioctic acid kukonzekera, mavitamini a B, kukonzekera kwa mtima, antioxidants, mankhwala omwe amachepetsa cholesterol yamagazi ndikuchepetsa magazi.

Zizindikiro za gangrene mu shuga kumapeto koyamba

Poganizira za chitukuko cha matendawa, sizotheka nthawi zonse kukhazikitsa gawo loyambirira la kuwonongeka kwa minyewa m'munsi. Nthawi yomweyo, chakuti wodwala aliyense amatenga matendawa payekhapayekha komanso gawo lalikulu la shuga m'magazi a odwala matenda ashuga nawonso amatenga gawo lalikulu. Mokulirapo kuchuluka kwa glucose, kumapita patsogolo kwamatenda. Zizindikiro zotsatirazi nthawi zambiri zimadziwika chifukwa cha chiwonetsero cha matenda ashuga.

Kutupa kwamiyendo

Nthawi zambiri, necrosis imayamba ndi mwendo umodzi wokha. Nthawi zambiri, matendawa amakhudza mbali zonse ziwiri nthawi imodzi. Chifukwa chake, ndikofunikira kwambiri kutchera khutu ku mawonetseredwe oterewa ngati kumva kutopa kwambiri komanso kulemera m'gawo limodzimodzi la mwendo. Mphamvu ya pathological imakonzedwa pamene wodwalayo amakhala nthawi yayitali, ndipo magazi amayenda m'munsi.

Kung'ung'udza

M'malo otukuka mtsogolo, pang'onopang'ono mphamvu zimatha. Pogwira mwendo, munthu amamva kuzizira pang'ono kapena kutopa, kukumbukira jakisoni wa singano zambiri nthawi imodzi. Izi zikuwonetsa kuti njira ya pathological ya kufa kwa maselo yayamba kale ndipo mathero amanjenje akukhudzidwa nawo, kutsata kwanzeru komwe kumakhala chizindikiro chachindunji cha matendawa.

Kupweteka kwa minyewa

Pakusunthika komanso kugwira ntchito kwa minofu, wodwala yemwe ali ndi matenda ashuga amamva kupweteka kwambiri mwendo, zomwe zimachulukana molingana ndi kuchuluka kwa kayendedwe kamene kamapangidwa. Chizindikiro chofananacho chikuwonekera chifukwa chakuti malo otupa amayamba kupangika mkati mwa minyewa ya mwendo, yomwe mtsogolomo imasandulika kukhala shuga gangrene.

Kusintha kwa khungu

Khungu lisanafike la matenda ashuga, khungu limasintha khungu kuti lisakhale lamoyo. Pansi pa mawonekedwe a epithelium, ma capillaries ofiira komanso othandizira magazi, omwe amadziwika ndi kukhalapo kwa zisonyezo zowonekeratu zowonongeka ndi mawonekedwe amtundu wamtambo, amatha kuwunikira nthawi zina. Kafukufuku wowona ndi palpation kumapereka chithunzi chakuti magazi samayenda gawo ili la mwendo ndipo izi zimachitika chifukwa cha kusakhutira kwa dzanja lam'munsi.

Kuphwanya kotentha

Gawo lomwe limadwala limasiyana ndi miyendo yonse ndi kupendekera kotsika. Ngati mukumva phazi lomwe lakhudzidwa, mudzazindikira kuti mawonekedwe ake ndi ozizira pang'ono. Chizindikiro ichi chikuwonetsa kuti magazi omwe ali mu gawo ili la chiwalo samalowa mu voliyumu yofunikira ndipo maselo a epithelial zimakhala ndi osakwanira michere.

Ngati zinthu sizisintha, ndiye kuti amayamba kufa ambiri ndipo machitidwe a necrosis amakula.

Gawo lomaliza komanso chizindikiritso cha matenda am'magazi odwala matenda am'mimba ndi kufupika kwa khungu lokhala ndi kusintha kwa kusintha kosasinthika kapangidwe ka matenda. Zizindikiro zina za matendawa zimayamba, zomwe zimakhala m'magawo apambuyo a matendawa ndipo sizikugwirizana ndi zomwe zimayambitsa matendawa. Izi zikuphatikiza kuwonjezeka kwa kutentha kwa thupi la wodwala, kuzizira, kutentha thupi, kusowa kudya, kupweteka mutu, nseru, ndi kumasulidwa kwam'mimba kwambiri m'mimba.

Pamaso pa mwendo mumadzaza kapezi ndipo m'masiku angapo amasintha kukhala tint wakuda. Gawo ili la miyendo siliperekanso magazi ndipo minofu yake ikusokonekera. Poyerekeza ndi maziko a kukhulupirika kwa khungu, kachilombo ka bacteria kamalowa mthupi, kamene kamangokulitsa zizindikiro za matendawa. Kuyambira phazi, mafinya ndi magazi amayamba kuonekera. Munthu wodwala matenda a shuga amamva kuwawa kwambiri ndipo amayenera kupweteka nthawi zonse.

Mtima wamatumbo

Ma capillaries ang'onoang'ono a magazi ndi ochepa kwambiri komanso osalimba. Zomwe zimakhudzidwa ndi kapangidwe kake zimabweretsa zowonongeka zingapo komanso kuwonongeka kwa brittleness. Matenda a diabetes a atherosulinosis amayamba chifukwa chakuti makristoni owonjezera a shuga m'magazi amatsekera misempha ndikusokoneza kayendedwe ka magazi. Ichi ndichimodzi mwazinthu zomwe zimayambitsa zilonda zam'mapazi m'miyendo ndimatenda a shuga.

Matenda a shuga

Awa ndi omwe amatchedwa chonyowa gangren, pomwe madzi amadzimadzi am'malo chitendene, omwe odwala ambiri amasokoneza ndikutulutsa khungu. Pokhapokha pang'onopang'ono pomwe zimadziwika kuti kwenikweni ichi ndi chotupa cha chiwalo chokhudzana ndi kuphwanya magazi. Tizilombo toyambitsa matenda timalowa pachilonda chosaoneka bwino komanso cham'mimba chomwe chikukula, chomwe sichingakhale chachikulu, koma matenda opatsirana.

Polyneuropathy

Kuphwanya kagayidwe kachakudya kagayidwe kachakudya ka glucose maselo omwe amakhala kumapeto kwa mitsempha omwe amachititsa chidwi cha m'munsi. Pamaso pa izi, ma neurons amafa kangapo mwachangu, kukalamba msanga ndi kufa kwa mitsempha kumachitika, ndipo mawonekedwe am'milonda mwendo amadziwika kwambiri m'malo omwe akudutsa. Zomwe zimayambitsa matendawa zimachitika kangapo kawirikawiri poyerekeza ndi zina zonse, koma zimapezekanso muzochita zamankhwala.

Kuchepetsa chitetezo chamthupi m'deralo

Maselo olimbitsa thupi ndi amodzi mwa oyamba kuyankha kuchuluka kwa shuga m'magazi. Odwala omwe ali ndi matenda a shuga, chifukwa cha kuchuluka kwa shuga m'magazi, chitetezo cha m'thupi chimafooka ndipo samakwaniritsa bwino ntchito yoteteza yomwe yapatsidwa. Potengera maziko awa, ngakhale kuwonongeka pang'ono kwa chala, chidendene kapena gawo lina la phazi limakhala khomo lotseguka la mtundu uliwonse wa tizilomboti. Ngati matenda a Staphylococcus aureus kapena streptococcal alowa m'mabala, ndiye kuti mwayi wokhala ndi gangrene ndiwokwera kwambiri.

Mwa anthu odwala matenda ashuga, magazi ndiwambiri kuposa anthu omwe samadwala. Izi ndichifukwa choti makhiristo a shuga amapangitsa kuti madzi amthupi azikhala owoneka bwino. Zimakhala zovuta kuti mtima uzipopa magazi kudzera m'mitsempha yamagazi yokhala ndi makhoma ocheperako ndipo kenako amapanga mawonekedwe ochepa a thrombi, kenako amakhala owonda kwambiri komanso osakhazikika. Kupezeka kwa magazi m'mitsempha ndi njira yodziwika yoperekera magazi kumagawo ena mwendo womwe uli pansi pamtsinje wamagazi ndikuyembekeza odwala matenda ashuga.

Mulingo wakuchita zolimbitsa thupi kwa wodwala ulinso wofunikira kwambiri. Zatsimikiziridwa mwasayansi kuti odwala matenda ashuga omwe amayenda tsiku lonse, amagwira ntchito zoyambira, kulimbitsa thupi lawo ndi zolimbitsa thupi zolimbitsa thupi, zizindikiro za zilonda zam'miyendo ndizowonjezereka katatu kuposa momwe odwala omwe amakonda kugona amangokhala.

Magawo a gangrene mu matenda a shuga komanso matenda am'mimba

Matendawa amagawidwa m'magawo angapo, iliyonse yomwe imasiyanitsidwa ndi chithunzi chake cha chipatala ndi zomwe amakhala nazo. Magawo otsatirawa odwala matenda ashuga am'madera am'munsi amasiyana.

Nthawi zambiri, wodwalayo samadzimva kuti wayamba kudwala. Pali zosintha zochepa pakhungu la khungu (limayamba kupindika), mwendo umakhala ndi kutentha kochepa, pang'ono pang'onopang'ono m'dera lomwe lakhudzidwa phazi ndikotheka.

Kutupa

Pakadali pano, zizindikiro zoyambirira zakufa kwa maselo owonongeka a epithelial ndi zimakhala zofewa zimawonekera. Chowonjezera chotupa sichidakulirebe kwambiri ndipo chimakhazikika kwambiri mu ulusi wa minofu popanda kufikira kumtunda, koma khungu pakhungu limayamba kale kukhala lofiyira komanso lotentha. Pakadali pano, matendawa amatha kuchiritsika mosadukiza ndipo sikufuna chithandizo chambiri.

Mawonetseredwe achisangalalo

Gawo lachiwopsezo cha chitukuko cha matendawa, pamene njira yodutsamo maselo yayamba mkati mwendo ndi zilonda zoyambirira pakhungu. Chilondacho chimatha kukhala chosakwatiwa kapena kuwonetsedwa mwa ma neoplasms angapo. Gawo ili la matendawa limanenedwa kuti ndi vuto la matenda osokoneza bongo komanso chiyembekezo chosunga mwendo, koma ndi njira yokhazikika yoperekera chithandizo, ndizotheka kupulumutsa dzanja.

Gawo lomaliza la chitukuko cha gangrene chifukwa cha zovuta za matenda ashuga. Epithelium pa mwendo imade, ndipo zimakhala pansi pake zimasiya kulandira magazi. Mendo mu lingaliro lenileni la mawu amayamba kuvunda, ndipo kutuluka kumachokera pakhungu, kodziwika ndi tint wolemera wachikasu komanso fungo losasangalatsa. Kutengera izi, kachilombo koyambitsa matenda komwe kamalowa m malo amalowa m'zilonda ndipo kumangokulitsa zizindikiro za matendawo. Nthawi yamatendawa imafuna kuti dokotala azitha kulandira chithandizo mosamalitsa, chomwe nthawi zambiri kumakhala kudula kwa phazi. Pangapo nthawi zina pomwe dzanja limatha kusungika.

Iliyonse ya magawo omwe alembedwayo amafunikira njira yothandizirana mosiyanasiyana, popeza thupi la wodwalayo limapirirabe matendawa, ndipo ndi kuyesetsa konse, limayesetsa kupereka maselo oloboweka ndi mitsempha yamagazi ndi michere yonse yofunika.

Mphamvu zabwino za kuchira zimawonedwa mwa odwala matenda ashuga omwe akulandira chithandizo ndi magawo 1 ndi 2 a chitukuko cha matenda osokoneza bongo. Izi zimapangitsa kuti matendawa akhale abwino, koma pokhapokha ngati chithandizo chayambika nthawi. Pa magawo 3 ndi 4 a matenda, nkovuta kwambiri kubwezeretsa kugwira ntchito kwa miyendo. Ndizovuta kwambiri kuti tipewe chiwopsezo cha kubwereranso kwina m'dera limodzi mwendo, pomwe magazi amitsempha atasokonekera kale. Apa mutha kuwerenga za Zizindikiro zakuwala kwa gasi.

Zizindikiro

Kupita kwakanthawi kwa njira zopezera matenda ndikuwunikira kwathunthu kwa thupi kumathandizira kwambiri pakupangidwanso kwina kwa njira yothandizira kubwezeretsa kwathunthu ntchito kwa zilonda zam'mimba. Pachifukwa ichi, wodwalayo amamulembera mayeso a mitundu iyi:

• magazi ochokera m'mitsempha yaukadaulo wamankhwala osinthira kusintha kwa mawonekedwe ake, zomwe ndizotheka motsutsana ndi maziko a kutupa kwakapsa kwambiri komwe kumachitika mkati mwa phazi,
• magazi ochokera pachala kuti adziwe ndikuwongolera kuchuluka kwa shuga m'magazi (makamaka zofunikira muzochitika zamankhwala pomwe wodwala walephera kwakanthawi kuti achepetse kuchuluka kwa shuga mthupi ndi mankhwala),
• nyemba kuchokera pachilonda, ngati gululi layamba kale kufika pamene zilonda zam'mimba zakhazikika pakhungu kapena matenda a matenda ashuga apanga (kusankha kwachilengedwenso pa thonje losakanika la thonje ndikofunikira kuti madotolo akhale ndi mwayi mu labotale kuti akhazikitse vuto la mabakiteriya lomwe limakwiyitsa kutupa m'matumbo minofu yam'munsi),
• kupatsa mkodzo kumakupatsani mwayi wodziwa momwe impso za munthu mukudwala, chifukwa nawonso amavutika ndi shuga wambiri, ndipo minyewa yawo imakhala yowonongeka pakutsuka magazi a viscous odzaza ndi makhiristo a shuga.

Awa ndi mayeso oyambira omwe amafunikira kuti wodwala azikhala ndi matenda osokoneza bongo, momwe zimakhazikitsira thupi kuti lipangike matenda owuma kapena ngati pali njira yonyowa.

Ngati kuwonongeka kwa khungu kudakhala kofunika ndipo dokotalayo opezeka kuti akukayikira kuti matendawa akwanitsa kufikira minofu ya mafupa, ndiye kuti wodwalayo amamuika x-ray. Njira yakuzindikirayi imakupatsani mwayi wofufuza ngati fupa la mwendo likugwira nawo ntchito yotupa.

Chithandizo cha gangrene a m'munsi malekezero a shuga

Njira zamakono zochizira matenda osokoneza bongo zapita patsogolo ndipo zikuchokera pazotsatira za kafukufuku waposachedwa wa sayansi komanso zomwe zapezedwa mu gawo lothana ndi chiwonetsero cha mitundu zovuta za matenda ashuga. Chithandizo chamtunduwu chimagawika pang'onopang'ono, pomwe mankhwala osokoneza bongo omwe amagwiritsidwa ntchito popanda kugwiritsa ntchito opareshoni ndi opareshoni. Zowonetsa posachedwa zimaphatikizapo kufooka kwa bala la zilonda zakumaso ndi zotupa zowonongeka, kapena kudulidwapo mwendo.

Nthawi zambiri, madokotala ochita opaleshoni amagwiritsa ntchito njira zotsatirazi pochotsa odwala omwe ali ndi matenda ashuga:

• intramuscular and intravenous management of wide-spectrum antibacterial mankhwala kuti pathogenic microflora omwe amapezeka pachilonda sichikuchulukitsa kuchuluka kwake ndipo sikukukulitsa chithunzi cha matenda omwe ali ndi vuto kale (mtundu wa antibayotiki amasankhidwa payekhapayekha),
• kuthiridwa magazi (wogwira ntchito ngati gangrene wafika pagawo 4 ndipo poizoni wambiri wapoizoni womanga thupi, komanso kuopseza magazi, akupezeka m'magazi a wodwalayo),
• olowetsa magazi olowa ndi kuyambitsa mankhwala omwe amayeretsa mwachangu madzi amitsempha yamagazi ndi magazi kuchokera kuzakumwa zoopsa zomwe zimayamba chifukwa cha kuwola kwa mnofu wam'munsi.
• kugwiritsa ntchito mavitamini ndi michere minyewa yomwe imathandizira kuti maselo azinthu zama chitetezo mthupi, ofunikira kwambiri pamaso pa mawonekedwe owopsa a kutupa mkati mwa miyendo.
• makonzedwe osinthika komanso kusintha kwa ma insulin kuti achepetse kuchuluka kwa shuga m'magazi a wodwalayo (iyi ndiye ntchito yayikulu komanso yofunika, kuti mtsogolomo makhristawo asavutike mitsempha ya magazi, kupangitsa matenda kuwonjezeka).
• kugwiritsa ntchito mafuta odana ndi kutupa ndi antiseptic, omwe amathandizira kwambiri kuti mabala azichiritsa komanso kusinthanso minofu yowonongeka.
• kuperekera kwa ma pinkiller, omwe ambiri ndi mankhwala a narcotic (mankhwala okha m'gawoli omwe amatha kuyimitsa kupweteka kwakanthawi kwakanthawi ndikuchepetsa kuvutika kwa wodwala yemwe ali ndi matenda osokoneza bongo omwe amakhala ndi vuto la zilonda zapakhosi),
• Opaleshoni kutseguka kwa mapangidwe oyera, kupatula kwa matupi ofewa omwe amakhala ndi kapezi kapena mtundu wakuda ndipo osadyekeranso magazi.

Pofunafuna chithandizo chamankhwala mwachangu, madokotala amatha kutsimikizira kuti mwendo umatetezeka makamaka chifukwa chakuti m'chipinda chopangira opaleshoni, pogwiritsa ntchito zida zamankhwala, amatsuka mapangidwe a microflora ya pathogenic ndikusiya minyewa yokha yomwe imawonetsa mphamvu. Njira yayikulu yodzichitira ndikuduladula gawo la chiwalo cham'munsi, chomwe sichingasungidwe pazifukwa zomwe zimakhazikitsidwa panthawi yopima matenda. Pali njira zina zochiritsira matenda osokoneza bongo, koma sitikukulimbikitsani kuti muzisinkhasinkha mwakuzindikira.

Mavuto ndi zotsatirapo zake

Matenda a matenda ashuga ndi matenda oopsa omwe amatanthauza kuyambika kwa zotsatira zoyipa. Ngati mwachitika njira yolakwika yodwala, kapena chifukwa chachedwa kwambiri kupeza chithandizo chamankhwala, wodwala matenda a shuga angayambitse zovuta zotsatirazi:

• ulesi kutukusira kwa ziwalo zam'munsi zomwe zakhudzidwa, zomwe zimakulitsidwa pakuwonekera kwake, zimayamba kufa kwa maselo kuchokera pachala ndikuyenda pang'onopang'ono,
• kuduladula kachigawo kakang'ono ka phazi kapena magawo atatu a mwendo (zonsezi zimatengera momwe matendawa amafalikira msanga m'mbali mwendo ndi kuchuluka kwa shuga omwe amapezeka mwa wodwalayo),
• kuyambika kwa poyizoni wamagazi ndi unyinji wa mabacteria tizilombo, omwe munthawi yochepa anachulukitsa kuchuluka kwawo kwamkati mkati mwendo wowonda ndipo, pamodzi ndi mtsempha wamagazi, kufalikira thupi lonse, kugonjetsa chotchinga cha chitetezo ndikuwononga maselo amwazi,
• kudandaula kwa septic, komwe 95% ya milandu kumatha ndi wodwala kulowa chikomokere ndi zina zakupha.
• Kukula kwa kusowa kwa chitetezo mthupi motsutsana ndi maziko akuti thupi silimaperekanso mphamvu yodzitetezera mothandizidwa ndi kutupa kwakapanja kwamankhwala m'matumbo amiyendo, poyambitsidwa ndi matenda osokoneza bongo.

Zotsatira zoyipa kwambiri pazovuta zonsezi pamwambapa, ndikuti kutayika kwa gawo la miyendo ndikuyamba kwa kulumala. Imfa siyabwino kwambiri, koma kufa sikutanthauza kuvutika komanso kusintha moyo watsopano wokhala ndi kuyenda kochepa.