Chithandizo cha zilonda zam'mimba m'miyendo ndimatenda a shuga

Pafupifupi mamiliyoni awiri odwala matenda ashuga amakhala ndi zilonda zam'mapazi pamapazi awo kapena mwendo wotsika. Zilonda za trophic pamiyendo mu shuga zimatulukira chifukwa cha zotupa zam'mimba za khungu (epithelium kapena membrane wapansi), limodzi ndi kutupa. Matenda a trophic amabweretsa kufa kwa minofu yofewa pamiyendo, ndipo pambuyo pochiritsidwa zilonda ndi zilonda pakhungu la wodwalayo, zipsera zimatsalira.

Chithandizo cha zilonda zam'miyendo m'miyendo ndimatenda a shuga ndi njira yayitali komanso yovuta. Izi zimachitika chifukwa chophwanya trophism (kuperekera kwa okosijeni ndi michere m'thupi la miyendo).

Zilonda zam'mimba: kufotokozera ndi zomwe zimayambitsa

Zilonda zam'mimba za m'mimba m'mimba za shuga ndiz kuphwanya umphumphu wa pakhungu kapena mucous nembanemba yemwe samachiritsa kwa miyezi iwiri kapena kupitilira apo, mobwerezabwereza. Zilonda za trophic sizoyambira zokha. Kukula kwawo kumachitika chifukwa cha kukhalanso kwa matenda ena osachiritsika. Matenda opitilira mazana atatu amatha kubweretsa chilonda chowuma pamapazi.

Njira yeniyeni yopangira mabala a trophic sichikudziwika. Nthawi zambiri, zilonda zam'mimba za shuga zimachitika chifukwa cha:

Kuchepetsa magazi
Kusintha kwa minofu chifukwa cha kusokonekera pakupezeka kwa mpweya ndi michere,
Kukokoloka kwa magazi ndi mwanabele m'mitsempha yama venous yam'munsi,
Matenda amtsempha wamagazi,
Kuchepa kwa kagayidwe,
Kulowa ndi matenda othandizira kuvulala ndi mabala.

Nthawi zambiri, zilonda zam'mimba zimapanga miyendo. Manja, thupi kapena mutu, mabala omwe ali ndi matenda a shuga samachitika.

Zomwe zimayambitsa zilonda zam'mimba ndizofanana ndi matenda oyamba - matenda ashuga. Izi ndi:

Wopangidwira chibadwa,
Kupsinjika nthawi zonse
Ukalamba
Matenda a kapamba
Matenda a pafupipafupi - hepatitis, chimfine, nthomba, rubella,
Kunenepa kwambiri

Magawo a mapangidwe a matenda

Nthawi zambiri, zilonda zam'mimba zimapezeka mwa odwala omwe ali ndi mbiri ya matenda a shuga a 2. Zinthu ngati izi zimayambitsa mabala m'miyendo:

Amadumphira m'magazi a magazi
Kuwonongeka kwa mathero a mitsempha,
Kusamalira osavomerezeka mabala (mabala, calluses) chifukwa cha kutayika kwa chidwi cha mapazi.

Popeza odwala omwe ali ndi matenda ashuga achepetsa khungu pakamiyendo, samangokhala ndi chidwi ndi mabala omwe akutuluka munthawi yake. Zilonda zimayambukiridwa ndikuchiritsidwa bwino chifukwa chakuchepa kwa kuchuluka kwa mpweya womwe umaperekedwa m'magazi komanso kuchuluka kwa glucose.

Zilonda za trophic zimagawidwa mu:

Neuropathic - zilonda zam'mimba za chidendene m'magulu ashuga,
Neuroischemic - khazikani ngati wodwala akudwala osati matenda a shuga okha, komanso venous insufficiency kapena varicose mitsempha.

Ngati mutayang'ana chithunzi cha zilonda zam'miyendo mu shuga, ndizowonekera kuti amapanga magawo. Mtundu wa zilondazo zimatengera gawo la chotupa cha trophic:

Pa gawo loyambirira (kupangika kwa zilonda pakhungu), mabala achikasu (akuwonetsa necrosis yonyowa) kapena wakuda (necrosis yowoneka ya minofu yofewa, kusowa kwa mpweya) amadziwika
Zilonda zofiira - chizindikiro cha gawo lachiwiri la matendawa, pomwe bala limalowa m'matumba a pansi pa dermis, limadzipukuta ndi zinthu zodziwika bwino ndikuyamba kuchira,
Gawo lachitatu (kuwonongeka kwa minofu, minyewa ndi mafupa) limadziwika ndi mabala oyera. Utoto uwu umawonetsa kuchiritsidwa kwa zilonda ndi kuwonda kwa minofu.

Zizindikiro

Zilonda zam'mimba zimapangika pang'onopang'ono. Chifukwa chake, zizindikiro za matendawa zimatengera gawo lake:

Kutupa kwamiyendo, kumva kuwawa,
Kukokana usiku
Kuyabwa ndi kuyaka pamapazi,
Kuwonetsa kwa ma mesh venous ndi mawonedwe amtambo,
Dera lokhala ndi khungu limakhala louzika,
Chinyezi chikuwonekera pamalo omwe akhudzidwa - leemph,
Pakati pa malopo, malo opangidwa ndi khungu loyera amapangidwa,
Khungu lomwe limakhala m'dera lomwe lakhudzidwalo limatuluka, chilonda chimapezeka,
Chilondacho chimakula ndikukula, zimakhudza minofu, minyewa ndi periosteum,
Pali zowawa pamalopo a trophic lesion,
Kuchokera pachilonda chomwe chikukulira kapena mafinya, pamakhala fungo losasangalatsa
Ngati bala lake lagwera, khungu lomwe limazungulira limasanduka lofiira ndikutupa.

Zilonda za trophic mu shuga zimazunguliridwa ndikufika mainchesi 2 mpaka 10. Nthawi zambiri, mabala amawoneka kutsogolo kapena mbali ya ng'ombe. Zilondazo zimakhala ndi m'mphepete mwa wavy komanso zamkati za purulent.

Kupita patsogolo kwa matendawa kumabweretsa kuwonongeka kwa miyendo ndi kuphwanya kwa chiwindi. Kuchepa kwa chidwi kumapangitsanso kuyenda kolakwika kwa phazi mukamayenda.

Kuzindikira matendawa

Kuzindikira kwakanthawi ndi chithandizo cha zilonda zam'mimba m'miyendo ndimatenda a shuga kumapewetsa kudzicheka chala ndikuchepetsa chiopsezo chobwereranso.

Ntchito yayikulu yodziwitsa zilonda zam'mimba ndikuyambitsa kuchuluka kwa kusokonezeka kwa magazi mu minofu ndikuchepa kwa chidwi.

Kuzindikira trophic zotupa pa miyendo ndi motere:

Mbiri yazachipatala
Kugonjera kwa UAC (kuyesa magazi pafupipafupi), maphunziro a sayansi ya zamankhwala, kuchuluka kwa shuga m'magazi, coagulograms (magazi
Kukhazikika kwa malo okhudzidwa ndi miyendo, kupezeka kwamkati,
Kutsimikiza mtima - kutentha, ululu ndi kukhudza,
Kuphika kwa purulent mabala okhutira ndi kutsimikiza kwa zovuta za matenda obwera chifukwa cha mankhwala opatsirana,
Kuunika kwa mwendo wa X-ray.

Njira zama Hardware zimakupatsani mwayi kuti mudziwe:

Mulingo wakanikizidwa mu mwendo wokhudzidwa,
Kusintha kwa matenda pogwiritsa ntchito sikani,
Kukhathamira - kuperekera kwa oksijeni ku minofu,
Kukula ndi kuchuluka kwa zombo pogwiritsa ntchito X-ray,
Kusintha kwa minyewa ya m'matumbo - CT ndi MRI,
Kuzama kwa chilondacho, mkhalidwe wa minofu yoyandikana ndi kupweteka kwa bala.

Njira zochizira

Kodi ndi njira yanji kuchitira zilonda zam'miyendo m'miyendo ndimatenda a shuga, atero dokotala atazindikira. Njira zochizira ndi mankhwala am'deralo ndi makonzedwe amaperekedwa kwa wodwala aliyense payekhapayekha, potengera mawonekedwe a matendawa, kupezeka kwa matenda osachiritsika, chifuwa.

Chithandizo cha zilonda zam'mimba zimachitika m'njira zingapo:

Mankhwala
Opaleshoni
Zokwanira, kuphatikiza njira yoyeretsera mabala kuchokera ku ma supplement ndi ma necrotic tinthu, komanso kugwiritsa ntchito mafuta ozungulira ndi mafuta.

Chofunika ndikuchiza zilonda zam'miyendo pamiyendo yankho la antiseptic komanso mafuta kuti mubwezeretse khungu lowonongeka komanso malo owonongeka. Kuphatikiza apo, pochiza zilonda zapakhomo, amaloledwa kugwiritsa ntchito mankhwala azitsamba.

Mankhwala othandizira

Opaleshoni imaphatikizapo kuchotsedwa kwa malo a necrotic minofu ndikuchotsa cholinga cha kutupa. Mitundu yotsatirayi ikuchitika:

Curettage
Kutulutsa
Chithandizo cha VAC pogwiritsa ntchito vacuum.

Vutsum imagwiritsidwa ntchito popanga zovuta zotsika (mpaka -125 mmHg). Njirayi imaphatikizapo kugwiritsa ntchito zovala za polyurethane. Kuchoka kumakupatsani mwayi:

Chotsani mafinya ku zilonda zam'miyendo,
Cheretsani kudzikuza, chepetsani mabala ambiri,
Limbikitsani magazi kulowa m'chiwendo chowonongeka,
Zimayambitsa njira ya granulation,
Imachepetsa kuchepa kwamatumbo a zilonda zam'mimba,
Amakhala malo otentha pachilondacho omwe amalepheretsa matenda ndi ma virus ndi mabakiteriya.

Catization ndi njira yochizira mabala a ischemic ndi venous pamiyendo omwe samachira bwino.

Kudulidwira Virtual ndi njira yotchuka yothandizira zotupa za neurotrophic zomwe zimayamba mwa odwala matenda a shuga. Njirayi imaphatikizanso kuphatikizika kwa mafupa ndi metatarsophalangeal olowa popanda kuphwanya umphumphu wa anatomical. Kudulidwa kwenikweni kumakupatsani mwayi wochotsa matenda ndikuchepetsa kupsinjika.

Kukhomera venous aristial fistulas kudzera pakhungu kumasonyezedwa pamaso pa chilonda cha ischemic (hypertensive), chotchedwa Martorell's syndrome. Kulowererapo cholinga chake ndicho kulekanitsa fistulas yomwe ili m'mphepete mwa chilondacho.

Mankhwala

Chithandizo cha mankhwala osokoneza bongo chitha kukhala njira yokhayo yochizira matenda oyamba ndi apakati a trophic zilonda mwa odwala matenda ashuga. Mochulukirapo, mankhwalawa amathandizidwa ngati othandizira asanachitidwe opereshoni komanso atatha.

Chithandizo cha mankhwala osokoneza bongo pamiyeso yosiyanasiyana ya zotupa zamiyendo ndizosiyana. Pa gawo loyamba akuwonetsedwa:

Ma Antihistamines - Tavegil, Loratodin, Suprastin,
Maantibayotiki
Ma antiplatelet othandizira (jekeseni wamkati) - Reopoliglukin, Pentoxifylline,
NSAIDs (mankhwala omwe si a antiidal anti-yotupa) - Ketoprofen, Imet, Diclofenac,
Ma Painkiller (pamapiritsi) - Nise, Ibuprofen, Indomethacin.

Kugwiritsa ntchito mankhwalawa cholinga chake ndikuyeretsa zilonda kuchokera ku ma cell a necrotic ndi mabakiteriya. Kuti muchite izi, mabala amatsukidwa ndi yankho la furatsilina, chlorhexidine kapena potaziyamu permanganate. Ndipo amapanga compress ndi Levomikol, Streptolaven kapena Dioxicol.

Kuchiza kwa gawo lachiwiri la zilonda zam'mimba za m'magazi a shuga kumapangidwira kulimbikitsa kuchiritsa kwa zilonda, kusinthika komanso kuperewera kwa khungu. Phazi lakumaso limachiritsidwa ndi Curiosin. Kuti mupewe matenda kuti musalumikizane, gwiritsani ntchito Algipor, Allevin, Geshispon.

Gawo lachitatu la chithandizo cha mabala osaneneka pamiyendo ndikulimbana ndi matenda omwe adatsitsa mapangidwe awo. Pakadali pano, chithandizo cha zilonda zam'mimba zokhala ndi insulin zimachitika.

Chifukwa chiyani chilonda cha trophic chimapweteka?

Chikhalidwe cha chiyambi cha ululu panthawi yowonjezera kupangika kwa mabala a mtundu wa trophic ndikuti chifukwa cha chotupa, gawo la khungu la mwendo limawonongeka pang'onopang'ono. Mapeto am'mitsempha omwe ali pafupi kwambiri ndi pamwamba pa gawo la epidermis amalemba za malo omwe akhudzidwa ndi malekezero apansi ndipo amatumiza zikhumbo zamkati mwa malo ozungulira ubongo. Zitatha izi, wodwalayo amayamba kumva ululu, kuuma kwake komwe kumadalira makamaka kuopsa kwa mitsempha ya varicose.

Chifukwa chake, mfundo ya ululu pamaso pa zilonda zam'mimba pamiyendo ndizofanana ndendende ndi matenda amtundu wina wokhudzana ndi kuphwanya umphumphu wa khungu la mwendo, kapena gawo lina lililonse la thupi. Mbali yodziwika bwino yamabala amtunduwu ndi chakuti mtundu wa zilonda zam'mimba sizimachiritsa kwa miyezi ingapo, ndipo nthawi zina ngakhale wodwala amayenda ndi bala lotseguka kwa zaka. Zingwe zake zokha ndi kunja kwake zimasintha, koma minyewa yonse ya epithelial siyabwezeretsedwa. Nthawi yonseyi, munthu amamva kupweteka koopsa, komwe kumatha kuchotsedwa mothandizidwa ndi mankhwala a analgesic. Kutalika kwa kugwiritsidwa ntchito kwa mankhwalawa kumakhala kochepa chifukwa cha nthawi, popeza mankhwalawa ali ndi zotsatirapo zingapo zomwe zingawononge minofu ya mtima, chiwindi, ndi kapamba. Timalimbikitsanso kuwerenga nkhani yokhudza chithandizo cha zilonda zam'mimba ndi mawonekedwe amchithandizo cha mitsempha ya varicose ndi matenda a shuga.

Wodwala akakhala ndi ululu pamalo opatsirana ndi trophic neoplasm, izi zikutanthauza kuti mankhwalawa sakhala ozama kwambiri ndipo ndi mbali yokha ya epithelium yomwe imawonongeka. Mawonekedwe owopsa a matenda opweteka amawonetsa kuyandikira kwa mathero amitsempha. Izi zikutanthauza kuti makoma a ziwiya zazikulu zomwe zimapereka magazi okhazikika a magazi a venous sathanso kugwira ntchito yomwe adapatsidwa, kutupa kumalowa kwambiri m'matumbo amiyendo ndikupitabe patsogolo mwachangu. Werengani, izi zitha kukuthandizani - zomwe zopukutira manja zimakuthandizani ndi zilonda zam'mimba komanso momwe mungagwiritsire bandeji.

Momwe mungayambitsire zilonda zam'mimba ndikuchepetsa ululu wa mwendo?

Mutha kuchepetsa kukhudzika komwe kumapangitsa kupweteka kwa mabala a mtundu wa trophic mwa kutenga mitundu yotsatirayi ya painkiller mkati, yomwe imapezeka ngati mapiritsi okhala ndi zokutira zoteteza:

Parmidin (mankhwala apadziko lonse pothana ndi zilonda zam'mimba zilizonse zamavuto, amathandizira kutukusira ndikuchita ngati opaleshoni yam'deralo, amachepetsa kutupa kwa zotupa za pakhungu.
Acetylsalicylic acid ndi mankhwala onse omwe amapangidwa pamaziko ake (kumva kupweteka kumachepetsa kwambiri chifukwa chakuti chinthu ichi, chomwe ndi gawo la mankhwala ambiri, chimafinya magazi ndikuwongolera kutuluka kwa magazi a venous, omwe amachepetsa kuchuluka kwa mabala kumtunda kwa bala),
Antistax (mankhwala omwe amathandizira kuchepetsa ululu pamalo opangika zilonda zam'mimba, pokonzanso kutanuka kwa mitsempha yayikulu ndikukhazikika kwa magazi a venous),
Ketorolac (a wodziwikiratu pazenera zowonjezera, pazotheka kwambiri pochiritsa zimatheka patatha maola 2 mutatenga piritsi limodzi),
Lornoxicam (amathetsa ululu, amachepetsa kutupira m'miyendo ndikuwongolera kutuluka kwa zamitsempha kuchokera m'mapazi am'munsi, zomwe ndizofunikira kwambiri pamaso pa zotupa zamiyendo),
Ambene-N (osati mankhwala a steroid omwe samangothandiza kupweteka, komanso amachotsa njira yotupa, imathandizira kuchiritsa kwa bala lotseguka),
Oxadol (analgesic wamphamvu wogwiritsidwa ntchito pakuwonongeratu minyewa ya miyendo ya epithelial yokhala ndi mabala ochulukirapo a trophic),
Khotemin (analgesic wodziwika bwino kwambiri) yemwe amakupatsani mwayi kuti muchepetse kumva kupweteka m'miyendo, ngakhale miyendo yake ikupuma, kapena ngati munthuyo akuyenda kwambiri).
Ketanol (analgesic woyipitsitsa yemwe amagwiritsidwa ntchito pokhapokha kuti athetse kupweteka komanso alibe anti-kutupa kapena antiseptic).

Kuphatikiza pamndandanda womwe wakonzekera kukonzekera piritsi, palibe mafuta ogwiritsira ntchito bwino, omwe amapangidwanso kuti apulumutse ululu, omwe ndi:

Kutulutsa kwa Propolis (wogulitsa m'mafakitala m'mayipi osavuta azitsulo, amathandizanso kupweteka, kuchepetsa kufooka, kuletsa kukula kwa tizilombo toyambitsa matenda ndikulimbikitsa machiritso a bala),
Dimexide (imagwira ntchito ngati mankhwala oletsa ululu, komanso yothandiza kwambiri pamankhwala oteteza khungu, koma imakhala ndi chinthu chimodzi chofunikira kwambiri, chomwe chafotokozedwa pakukula kwa khungu losafunsika pamalo a bala lotseguka),
Emla (mafuta amapita msanga m'malo omwe akhudzidwa ndi khungu, ndipo mphamvu yothandizira kupweteka imakhalapo kwa maola 4 otsatira).

Kuchotsa ululu pamwendo chifukwa cha kupezeka kwa zilonda zam'mimbamu kumachitika bwino pogwiritsa ntchito mafuta am'deralo kuti musagwiritse ntchito kukonzekera piritsi, chifukwa zotsatira zake zamankhwala zimakhudza m'mimba, chiwindi, impso, mtima komanso makamaka ma pancreatic tis. Malangizowa akukhudzanso odwala omwe satenga njira zochizira mitsempha ya varicose ndipo m'zaka zapitazo amachotsa zokhazo zowoneka bwino zamatenda mu mawonekedwe a ululu wa trophic ulcer.

Physiotherapy

Mankhwala othandizira olimbitsa thupi amaloledwa pokhapokha pochiritsa zilonda. Nthawi zambiri, dokotala amakupangira:

Ndi zotupa za atherosulinotic - kugwiritsa ntchito chipinda chopanikizika cha Kravchenko, chomwe chimayambitsa mavuto am'deralo,
Cavitation ndi otsika pafupipafupi ultrasound. Chithandizo choterechi chimawonjezera chithandizo cha mankhwala a antibacterial ndi antiseptic,
Mankhwala othandizira pamagalasi amatha kuchepetsa kuwawa, kuchepetsa mitsempha ya magazi, kuchepetsa kutupa,
Laser chithandizo chimachotsa cholinga cha kutupa, kuthetsa kupweteka, kumalimbikitsa kusinthanso minofu,
Ultraviolet imakulitsa chitetezo chazinthu,
Kugwiritsa ntchito nayitrogeni ndi ozoni kumathandiza kudzaza minofu ndi mpweya komanso kusinthika kwawo,
Chithandizo cha matope chimalola wodwalayo kuchira msanga atadwala.

Njira zina

Kugwiritsa ntchito maphikidwe a ochiritsa achikhalidwe kumaloledwa pokhapokha pochiritsa zilonda zam'mimba mutatha kufunsa dokotala. Njira zina zothandizira zilonda zam'mimba zimaphatikizapo kuchiritsa mabala, kuyeretsa zomwe zimaphatikizidwa ndi purulent ndi minofu yakufa. Zitsamba zamafuta zimachepetsa kutupa ndikuthandizira kubwezeretsa epithelium.

Chitani chilondacho ndi mowa kapena mowa wamphamvu. Ikani mafuta a Vishnevsky,
Zilowerere phula ndi thonje la thonje, gwiritsani ntchito mabala kwa masiku atatu. Pitilizani mpaka pakutha
Masamba owuma a tatarnik kupera mu ufa. Vulani bala ndikupanga ndi bandeji. Bwerezani katatu patsiku mpaka zilonda zam'mimba.

Zilonda za trophic pamiyendo ndi matenda omwe amayamba chifukwa cha matenda ashuga. Kuzindikira kwakwanthawi komanso chithandizo chokwanira cha matenda am'mimba kumakupatsani mwayi wothetsa vutoli ndikupewa kuyambiranso. Koma chithandizo chamankhwala ndichovuta ndipo amafuna kuti wodwalayo atsatire zomwe dokotala akutsimikiza.