Momwe mungapewere matenda osokoneza bongo omwe ali ndi shuga

Chimodzi mwa matenda opaleshoni yayikulu ndi gangore. Ichi ndi necrosis ya zimakhala, yomwe nthawi zambiri imakhala limodzi ndi kusintha kwa mtundu wawo kukhala wakuda / wa imvi. Ndi chithandizo mwadzidzidzi cha matenda opha ziwalo kapena matenda ochulukirapo, 34% ya odwala amamwalira ndipo 62% amakhala olumala. Kuti muchepetse chiwopsezo cha zotulukazo, ndikofunikira kudziwa zizindikiro zoyambirira za matendawa ndipo ngati atapezeka, funsani dokotala nthawi yomweyo.

Dziwani kuti gangrene imatha kuchitika pa miyendo (miyendo kapena manja), pa thunthu, kumaso komanso ziwalo zina zamkati (mapapu, matumbo, zowonjezera, ndi zina). Ziwalo zosiyanasiyana za thupi zimadziwika ndi mitundu yosiyanasiyana ya gangrene ndi zizindikiro zawo. Izi ziyenera kusiyanitsidwa, popeza njira zamankhwala zakuchiritsira ndi kudwala kwakukulu zimadalira izi.

Gulu

Kutengera mtundu wa kuwonongeka kwa minofu, ndichizolowezi kusiyanitsa mitundu inayi ya ovulala:

• Kuuma ndi mtundu wabwino kwambiri wamatendawa, momwe njirayo sinafalikire kuzilonda zozungulira, koma imakhala mkati mwa gawo lomwe lakhudzidwa (chala, mwendo wapansi, mkono wamanja, ndi zina). Pankhaniyi, limba limawoneka ngati "wopukutidwa" - ndiwowuma, lopanda chinyezi, wamakwinya,
• Madzi - mtundu wa gangrene wokhala ndi njira zowonongera. Dera lomwe lakhudzidwalo likufewa, limatupa chifukwa cha edema ndipo limakhala ndi fungo loipa,
• Mpweya (womwe umagwirizana ndi matenda a anaerobic / opanda mpweya) - ngakhale uli mtundu wamvula yonyowa, umayikidwa padera. Amakula pokhapokha ngati ma virus ena ochepa (clostridia). Ndiwopatsa nkhawa kwambiri pangozi, chifukwa imafalikira msanga m'matumbo athanzi ndikupangitsa kuledzera kwambiri (poizoni wambiri ndi poizoni)
• Zilonda zokupanikizika - gangrene of tishu zofewa (minofu yolumikizira khungu ndi khungu lenilenilo), kukulira chifukwa chapanthawi zonse m'dera limodzi. Monga lamulo, zimachitika mwa odwala omwe sasintha mawonekedwe amthupi kangapo patsiku.

Mwa ana omwe ali ndi vuto la chitetezo chamthupi (atatha kutenga matenda, kumbuyo kwa matenda ena, wokhala ndi kachilombo ka HIV), mtundu wachisanu - "kapena" - umasiyanitsidwa. Awa ndi mtundu wa chimbudzi chonyowa, momwe ma necrosis a nkhope amaonekera: milomo, masaya, mano, minofu yamafuta. Monga lamulo, amapha.

Mtundu uliwonse wamtunduwu uli ndi zoyambitsa zake. Kuzidziwa, mutha kupewa kapena kukulitsa matendawa munthawi yake.

Mosiyana ndi chikhulupiriro chofala, gangore imatha kuchitika pokhapokha ngati mabala amfuti kapena kuvulala kwamiyendo. Itha kuonedwa panthawi yolepheretsa ("blockage") ndi zigawo zamagazi kapena ziwiya zamawiya osiyanasiyana, kuwonongeka kwa mitsempha yam'mphepete, zotsatira za matenda ena, etc. Akazindikira zomwe zimayambitsa nthawi, munthu akhoza kuganiza kuti ali ndi matendawa ndikusankha chithandizo choyenera.

Pali chifukwa chimodzi chokha - kukhalapo kwa chilonda chozama chokwanira chomwe chinali ndi kachilombo ka Clostridia (mabakiteriya omwe amakhala m'malo opanda mpweya).

Komabe, kuti pakhale gasi lovuta, pamafunika zinthu zingapo:

• Chilondacho chizifikira minofu kapena minofu yamafuta,
• Kuchepa kwa magazi kwambiri pamatenda omwe ali ndi kachilombo, chifukwa clostridia imatha kuchulukana ndikukula kokha m'malo opanda mpweya,
• Kutseka chilondacho kumalimbikitsa kufalikira kwa majeremusi, popeza kutuluka kwa mpweya kumimba kumachepa.

Popanga matenda, zizindikiro za gangrene zomwe wodwalayo amadandaula ziyeneranso kukumbukiridwa. Amatsimikizika ndi mtundu wa matendawa ndikuthandizira kuyendayenda panthawi yomwe wapezeka kale.

Kutengera mtundu wa gangore, Zizindikiro zakumaloko (kusintha kwa miyendo) kapena chizindikiro cha kuledzera (kutentha, kufooka, kusokonezeka kwa chikumbumtima, ndi zina zotere) zitha kuchuluka. Kutha kwa mitundu yosiyanasiyana kufalikira kumankhwala ozungulira kumakhalanso kosiyana kwambiri. Mfundozi ziyenera kuganiziridwa posankha chithandizo chamankhwala ndi kuthamanga kwake, monga nthawi zina, kuchedwa kwa maola angapo kumatha kubweretsa imfa.

Zizindikiro Zouma Gangrene

Popeza mawonekedwewa amakula chifukwa cha kuperewera kwa mkono kapena mwendo, choyambirira, pali zizindikiro za kulephera kwa magazi. Izi zikuphatikiza:

• Kumverera kwa "kukwawa", "kulumidwa" m'khosi mwendo kapena mbali yake (zala, phazi / dzanja, nkono / mwendo wotsika, ndi zina). Mwina kuwoneka kwa ululu wakhungu, komwe kumafooketsa pakupuma,
• Kufooka mu miyendo. Monga lamulo, imawonetseredwa pansi pa katundu (kuyenda kwakutali, kuthamanga, kukwera masitepe - kwa miyendo, chiwongolero cha dzanja, chonyamula zinthu zolemera - zamanja),
• Kusalala ndi kuzizira kwa dera la khungu komwe kusowa magazi othamanga,
• Ma gangrene am'madera otsika nthawi zambiri amatsogozedwa ndi "zochitika" pakatikati.

Momwe mungadziwire kuchepa kwa magazi? Kuti muchite izi, ndikokwanira kudziwa njira zingapo zosavuta za miyendo:

• Kwezani manja anu pamwamba pamutu panu ndipo pindani manja anu mbali imodzi. Ngati matumbo a mitsempha ali ndi vuto, kufooka komanso kufooka miyendo, kumatha kumva kuti "ndikukwawa" ndikumva kuwawa.
• Wogona kumbuyo kwanu, kwezani miyendo yowongoka pakatikati pa 40-45. Zizindikiro zofananazi ziziwoneka. Komanso, wodwalayo sangathe kulimba miyendo m'malo amenewa kwa nthawi yopitilira 20-25 masekondi. Chifukwa chake, ndizotheka kukayikira gawo loyambirira la gangrene la zigawo zapansi kapena kuthekera kwa kukula kwake.

Izi ndi njira zosavuta zowunikira momwe mitsempha ilili. Zilibe zokwanira, komabe, zimatha kudziwa kuchepa kwa magazi, ngakhale kunyumba.

Ndi kufalikira kwathunthu kwa mtsempha wamagazi, zizindikirozi zimasinthidwa mwachangu ndi zizindikiro za necrosis (necrosis). Limbayo limakhala ndi mawonekedwe, omwe amakupatsani mwayi wofufuza ngati "khungu louma." Nthawi zambiri, zosintha zotsatirazi zimadziwika:

1. Kuthetsa minofu - muyenera kulabadira utoto, popeza mitundu ina ya matendawa imadziwika ndi mtundu wa cyanotic kapena mtundu wobiriwira (kupatula - kapena),
2. Kuchepetsa kukula kwa miyendo ndi gangore. Chizindikiro ichi chimadziwika mosavuta poyesa mikono kapena miyendo m'zigawo,
3. Zouma kwambiri m'dera lomwe lakhudzidwa ndikusowa thukuta,
4. Minofu imakhala yowonda kwambiri chifukwa cha kutayika kwa madzimadzi,
5. Kukula kwa tsitsi ndi misomali m'manda akufa kumatha.

Wodwalayo samva kuwawa, popeza mathero amanjenje amafa ndi matenda owuma limodzi ndi ziwalo zina. Zizindikiro za chilengedwe (kutentha, chizungulire, kuchepa / kusowa kwa chakudya, nseru, ndi zina) sizitchulidwa. Chifukwa cha izi, malire pakati pa malo athanzi ndi owonongeka amatha kutsatiridwa momveka bwino.

Nthawi zina, gawo louma lomwe limauma limatha kudzipatula pa dzanja, lomwe ndi lofanana ndi kuchira kwa wodwalayo. Komabe, simuyenera kuwerengera izi ndikudikirira kugawa kwa patali. Ngati mupeza zizindikiro zoyambirira, muyenera kufunsa dokotala yemwe azindikire zamomwe mungakwaniritsire.

Zizindikiro za chonyowa

Mbali yodziwika bwino ya chonyowa m'mimba ndikuti singakhudze miyendo, komanso ziwalo zamkati. Poterepa, zizindikiro zamderalo komanso zomwe zimachitika kawirikawiri pamatendawa zimachitika. Izi zimachitika chifukwa cha kupezeka kwa tizinthu ting'onoting'ono tomwe timakhalapo, komwe kumakhalapo pakoma. Pang'onopang'ono amawononga minofu yaumunthu, ndikutulutsa zodetsa m'magazi. Monga lamulo, matendawa amafalikira pang'onopang'ono m'malo athanzi, chifukwa chake ali ndi zabwino kwambiri kuposa matenda a anaerobic gangrene.

Mawonetsero apafupi

Zizindikiro zodziwika bwino za dera lonyowa ndi:

• Sinthani mtundu wa minofuyo kuti ukhale wofiyira kapena wakuda. Nthawi yomweyo, palibe malire pakati pa malo athanzi ndi okhudzidwa, popeza thupi silingaletse kufalikira kwa ma virus. Malo osinthika amatha kuwonekera pazizindikiro zotsatirazi: redness of the khungu, kutentha kwawoko, komanso kukhalapo kwa zilonda,
• Fungo lakuwola kuchokera kudera lomwe lawonongeka,
• Kutupa ndi kufinya kwa gawo la mkono / mwendo,
• Kupweteka kwakanthawi mu chiwalo chopatsidwayo, komwe kumachitika chifukwa chokwiyitsa maselo ozungulira.
• Kuchepetsa kutentha kwa malo akufa.

Zizindikiro zofananazi zidzachitika ndi nome.

Gangrene "phazi la matenda ashuga". Odwala omwe ali ndi matenda a shuga a mellitus, omwe ndi ovuta kuchiza, kugwira ntchito kwa mitsempha yamagazi kumasokonezeka. Mawonekedwe wamba ndikusowa kwa magazi mpaka kumapazi, ndichifukwa chake matenda amalowerera mosavuta bala. Popeza njira zodzitetezera nazo zili ndi vuto, odwala amatha kukhala ndi vuto la miyendo.

Pofuna kupewa izi, ngakhale mabala ang'onoang'ono amayenera kuthandizidwa ndi antiseptic solution (Fukortsin, wobiriwira wanzeru, etc.) ndi mankhwala ochiritsira (Levomekol). Chigoba kapena mavalidwe a bactericidal amafunikiranso. Ngati palibe kusintha komwe kumachitika mkati mwa masiku awiri, funsani dokotala.

Zilonda zam'mimba zimadziwonekera mosiyanasiyana, kutengera kutengera komweko. Pakadali pano, zomwe zimakhudzidwa kwambiri ndi izi: mapapu, matumbo ndi chikhodzodzo cha ndulu. Zizindikiro izi ndizomwe zimadziwika ndi izi:

Masiku 7 mpaka 7 oyamba, Zizindikiro zimatha kukhala chifuwa chanyengo, chokhala ndi sputum. Mwina hemoptysis.

Pa kutalika kwa mapapo gangrene akuwonetsedwa motere:

• Chifuwa ndi profut sputum - pafupifupi lita / tsiku. Ndiwobiriwira kapena wonyezimira, wokhala ndi fungo lamphamvu,
• Kupweteka pachifuwa kukulitsidwa ndi kuseka, kutsokomola komanso kusisima. Monga lamulo, ndi pachimake, limapezeka mbali ziwiri,
• Pafupipafupi hemoptysis,
• Dyspnea yamitundu yosiyanasiyana. Pamene mapapu ambiri amakhudzidwa, kulimba kwake kufupikulitsa. Monga lamulo, zimachitika pambuyo polimbitsa thupi pang'ono.

Zizindikiro zambiri

Mosasamala kanthu komwe kudakhala chonyansa, wodwalayo amakhala ndi zambiri. Amakula chifukwa cha kuledzera kwa thupi ndi zinthu zoyipitsidwa ndi majeremusi oyamba. Zizindikiro zake sizili zachindunji, chifukwa zimapezeka kwambiri matenda opatsirana. Nthawi zambiri, odwala anati:

• Kukweza kutentha mpaka 38-39 o C. Ndi zilonda zam'mimba zam'mimba, kuwonjezeka kwa 40 o C ndikotheka, chifukwa cha peritonitis,
• Zofooka
• Kuwonongeka / kusowa kwa chakudya,
• Mphuno wolimba ndi chizungulire,
• Kupititsa patsogolo,
• Mwa ana osaposa zaka 6, kukomoka kumatha kuchitika, chifukwa chitetezo chamthupi sichitha kuthana ndi matenda oopsa otere.

Mwa anthu osakhazikika, zizindikirozi zimatha kutchulidwa pang'ono, chifukwa thupi lawo silingayankhe mokwanira matenda.

Zizindikiro za Anaerobic Gangrene

Mtundu wowopsa kwambiri wamatendawa ndi wopanda air kapena anaerobic gangrene. Kusiyana kwakukulu pakati pa fomu iyi ndi yonyowa ndikuti matendawa samachitika ndi tizilomboti tina tomwe timayambitsa matenda, koma ndi ma Clostridia - mabakiteriya opanga gasi. Amatha kukhala ndi moyo popanda mpweya, chifukwa chake amakula bwino pamatipi akufa ndi mabala otsekedwa. Chifukwa chakumasulidwa kwa mitundu yambiri ya poizoni wowopsa, clostridia imawononga minofu, minofu yamafuta ndi khungu kuzungulira malo ake. Tizilombo ting'onoting'ono timafalikira pamwendo wathu ndikuyamba kuledzera kwambiri.

Tsambali lomwe lili ndi anaerobic gangrene limawonekera:

1. Khungu lozizira. Mwina kuwoneka ngati mawanga amtambo kapena ofiira kuzungulira bala,
2. Kutupa kwakatikatikatikatikati mwa minofu yake, komwe kakukulira nthawi zonse. Mukamafufuza, nthambi imasinthasintha

1. Madzi amtambo onunkhira ngati fetid, wobiriwira kapena bulauni, amatha kusiyanitsidwa ndi bala.
2. Ngati minofu ikuwoneka pachilondacho, ndiye kuti imawoneka ngati "nyama yophika": yoyera, yofiyira, yokhala ndi ulusi wopindika,
3. Kumva kuti ali ndi mwendo kapena mkono wopunduka, munthu amatha kumva ngati "crunch" (crepitus) wa anaerobic gangrene wokha.

Ndi matenda a anaerobic, zizindikiro zambiri nthawi zambiri zimapambana pazowonetsedwa kwanuko. Monga lamulo, amanenedwa kuledzera komwe kumatsogolera kuimfa ya odwala. Zowonetsa poizoni wakupha thupi ndi poizoni wa clostridia ndi:

• Kufooka kwambiri kwa adynamia (wodwalayo sangathe kuyenda),
• Kutentha kukukwera mpaka 39-41 о С,
• Kusokoneza tulo ndi chikumbumtima (delirium ndikotheka),
• Mseru pafupipafupi ndi kusanza, pambuyo pake sizichitika.
• Kuthamanga kwa magazi, nthawi zambiri, kumatsika pansi pa 100/70 mm Hg. Kutsika kwa Hg 30 mm ndi chizindikiro chosasangalatsa,
• Tachycardia - zimachitika kukwera mpaka 100-120 kumenyedwa / mphindi. Wodwalayo akhoza kumva kuwawa mtima.

Kuwonongeka kwa impso, chiwindi ndi ubongo pogwiritsa ntchito poizoni wocheperako ndizothekanso. Ngati njira zokulitsira wodwalayo sizinatenge nthawi yake, mwayi womwe umabwera chifukwa cha matenda obwera ndi anaerobic ndiwokwera kwambiri.

Zizindikiro za bedore

Imfa ya minofu yokhala ndi mawonekedwe imayamba pang'onopang'ono. Mu gawo loyambirira la matendawa, khungu, lomwe limapanikizidwa nthawi zonse, limakhala lotuwa. Kutentha ndi kumva kupweteka kumachepetsedwa pang'ono. Pambuyo pa masiku 2-3, minofu ya edema imawonekera. Kuteteza madera ang'onoang'ono ndikotheka, komwe ndi chizindikiro chodala champhamvu.

Ngati chithandizo chokwanira chamabedi sichinachitike, kachilomboka kamalowetsedwa m'masiku ochepa. Izi zimabweretsa kuwoneka kwa zizindikiro zazikulu monga kutentha 38-39 ° C, kufooka, nseru / kusanza, thukuta kwambiri.

Kuzindikira zotupa za m'munsi malekezero

Izi zitha kupezeka pokhapokha ngati wodandaula akudandaula komanso zotsatira za mayeso. Njira zowunikira zowonjezereka zimachitika kuti ziwunikire momwe wodwalayo alili kapena kudziwa mtundu wa microbe komanso chidwi chake cha maantibayotiki. Poyambirira, chitani:

• KLA (kuyezetsa magazi kwachipatala) - kuchuluka kwa ESR (kopitilira 20) ndi kuwerengera kwamisempha yoyera (kuposa 10 * 10 9 / l). Kuchepa kwa chiwerengero cha leukocytes (ochepera 4 * 10 9 / l) ndi chizindikiro choyipa, chifukwa chikuwonetsa kuti chitetezo cha wodwala sichidziletsa,
• Kusanthula kwa biochemical magazi a venous - kuchuluka kwa mapuloteni a C-yogwira (oposa 10 mg / l). Kuwonjezeka kwa kuchuluka kwa Creatinine (kupitirira 110 mmol / L) ndi Urea (kupitirira 8 mmol / L) ndi anaerobic gangrene ndi chizindikiro chosavomerezeka, chifukwa zingasonyeze kuyambika kwa kulephera kwa impso,
• Kusanthula kwamankhwala mkodzo - amasintha kokha ndi anaerobic. Maonekedwe a mapuloteni kapena shuga. Kutsika kwamkodzo kwamkodzo (ochepera 1015), milingo ya creatinine (osakwana 0,5 g / tsiku), ndi urea (osakwana 20 g / tsiku) kudzawonetsa kukula kwa impso.

Kuti mudziwe mtundu wa mabakiteriya omwe ali mchilondacho, pangani nyemba ya bakiteriya yomwe ili m'dera lomwe muli kachilombo. Monga lamulo, zotsatira zake sizingapezeke pasanathe sabata limodzi.

Ngati sikutheka kudziwa mtundu wa gangore (mwachitsanzo, chonyowa kapena anaerobic) mwa kuyezetsa, x-ray ya chiwalo cholumikizacho imachitidwa. Ngati thovu la gasi likuwoneka m'chithunzichi, ichi ndi chitsimikiziro chodalirika cha njira ya anaerobic.

Matenda a ziwalo zamkati

Tsimikizani gangore ndi makonzedwe otere, monga lamulo, sizingatheke ndi data ya kafukufuku ndi kuyang'ana. Chosankha chimakhala chophatikizika. Pozindikira, zotsatirazi diagnostics tikulimbikitsidwa:

Atazindikira kuti "ali ndi vuto", wodwalayo amayikidwa m'chipatala ndikuyamba kulandira chithandizo chovuta.

Chithandizo cha Matendawa

Opaleshoni ndiyo njira yokhayo yothetsera gangore m'manja / m'miyendo. M'malo owuma ndi onyowa, monga lamulo, kudulidwa kwa gawo lakhudzidwa (manja, miyendo, miyendo, ndi zina). Kupezeka kwa zizindikiro zazikulu za kuledzera ndikuwonetsa kwa kulowetsedwa kwa ma crystalloids (yankho la Ringer kapena 0.9% sodium chloride) ndi kuikidwa kwa maantibayotiki. Mankhwala othandizira antimicrobial ayenera kuphimba mitundu yosiyanasiyana ya mabakiteriya, chifukwa ndizosatheka kudziwa pathogen koyambirira koyambirira.

Ngati ndi kotheka, madokotala amayesetsa kusunga mkono kapena mwendo womwe uli ndi kachilombo. Kuchiza popanda kuduladula gineini, yomwe nthawi zambiri imapezeka kumapeto, kumachitika pang'onopang'ono. Kuti izi zitheke, minyewa yonse yakufa mkati mwa bala imachotsedwa. Kuchita opareshoni kumathandizidwa ndi "Mzere" - zigawo zazitali zazikopa ndi minyewa ya adipose, kuwonetsetsa kuti mpweya ukuwuluka. Njirayi imachepetsa kukula ndi kufalikira kwa ma virus a anaerobic. Kuphatikiza apo, maantibayotiki angapo, ma anti-gangrenous seramu ndi infusions mkati mwa crystalloid solution (mpaka malita 4-5 / tsiku).

Ndi kusagwira ntchito kwa zinthu pamwambapa, chithandizo cha gangrene cha m'munsi miyendo (kapena kumtunda) chimachitika ndikuduladula. Njirayi itha kuchitika pokhapokha matenda atafalikira thupi.

Matenda amkati amkati amathandizidwa ndi mfundo zofanana:

• Tiziwalo tofa (gawo la mapapu, chikhodzodzo kapena zowonjezera) zimachotsedwa
• Chotsani zizindikiro za kuledzera (mwa kulowetsedwa mwa njira ya Ringer / sodium chloride),
• Maantibayotiki angapo adalembedwa.

Kukula kwa wodwala kumadalira nthawi yayitali ya chithandizo, momwe thupi limafunira komanso kuthamanga kwa matendawa.

Ngakhale kuti chidziwitso cha madongosolo owuma ndi onyowa ndi abwino, nthawi zambiri zimayambitsa kulumala kwa wodwalayo, chifukwa chodulidwa matenda osokoneza bongo. Kusiyana kwake ndi kaya, komwe kumachitika ndi kuledzera kwakukulu ndikupangitsa zotsatira zoyipa za 90-95%.

Fomu yamagesi ndiyowonjezereka, popeza imathanso kukhudza ziwalo zamkati.Malinga ndi ziwerengero, imfa imachitika mu 30-40% ya milandu.

Matenda am'mapapo ndi chikhodzodzo, chokhala ndi chithandizo chokwanira, pafupifupi chimatha bwino. Tsoka ilo, kuwonongeka m'matumbo amasiya chovuta m'moyo wa wodwalayo, chifukwa opaleshoniyo ndiyofunika kutsatira zakudya zatsiku ndi moyo, pafupipafupi (nthawi 1 mu zaka 2-3) amapita kukayezetsa ndi gastroenterologist ndikumwa mankhwala angapo.

Matendawa amabwera chifukwa cha milandu 25-30% yamilandu. Pambuyo pakuchita opaleshoni yayikulu (kuchotsa kwa lobe kapena mapapo onse), zizindikiro za kupuma movutikira (kupuma movutikira) zimatha kukhalabe ndipo matenda opatsirana a minyewa yam'mapapo nthawi zambiri.

Ndi angati akukhala ndi gangrene omwe adachiritsidwa kwathunthu? Monga lamulo, matendawa samakhudza kutalika kwa moyo - mtundu wake wokha.

Matendawa ndi matenda omwe nthawi zambiri amabweretsa kumwalira kapena kulumala, ngakhale ndi chithandizo chokwanira. Kuthekera kwakukulu koyipa (koopsa) kumadzetsa odwala, ana, komanso kulandira chithandizo mochedwa kwa adotolo. Matendawa ndiosavuta kupewa kuposa kuchiza. Kuti muchite izi, ndikokwanira kuchitira zilonda ndi antiseptic munthawi yake ndikulumikizana ndi chipatala.

Zoyambitsa Gangrene

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Madokotala amasiyanitsa magulu awiri azinthu kapena zomwe zimayambitsa gangore mu shuga mellitus.

• chisamaliro chosasamala cha matenda oyambitsidwa ndi matenda okhudzana nawo,
• kusuta, kuledzera,
• kuvala zolimba, nsapato zosasangalatsa,
• kunyalanyaza chithandizo cha mabala, chimanga, chimanga, zipsera, misomali yakunyumba,
• onenepa kwambiri, kunenepa kwambiri, chisanu.

• kuchepa kwa lumen kwamitsempha yamagazi chifukwa cha ischemia kapena atherosulinosis,
• kuphwanya njira zosinthika,
• kuchepa chitetezo chokwanira,
• polyneuropathy - matenda osokoneza bongo omwe ziwiya zamanjenje zimakhudzidwa, zomwe zimayambitsa kukalamba mwachangu,
• kuphwanya mapangidwe minofu mafupa, zikubweretsa mafupa.

Mitundu ya matenda

Gangrene mu matenda a shuga amawerengedwa monga mtundu ndi zomwe zimayambitsa zilondazo:

M'mawonekedwe, matuwa owuma ndi kunyowa a matenda amasiyanitsidwa.

• neuropathic (yogwirizana ndi kuwonongeka kwa mitsempha),
• angiopathic (kuwonongeka kwamitsempha),
• mafupa a mafupa (kuwonongeka kwa mafupa).

Zizindikiro zakunja za gangrene koyambirira

Zizindikiro zoyambirira za matenda am'mimba m'matenda a shuga zimayamba ndi kuyambika kwa kufalikira kwa matenda a m'magazi, kuchepa kwa mitsempha yamagazi, mapangidwe a cholesterol plaques. Mapilogalamu amasokoneza kuyenda kwa magazi kudzera m'mitsempha, zomwe zimapangitsa kuti mpweya komanso michere yoperewera. Ngati ischemia ndi matenda ashuga samalandiridwa, matendawa amapita patsogolo - matenda osokoneza bongo a m'munsi amayamba.

1. Chilichonse cholimbitsa. Imadziwika ndi ululu m'matumbo amiyendo pakudutsa gawo laling'ono la njirayo. Chifukwa chake, odwala oterowo nthawi zambiri amapuma akamayenda. Ululu umakhazikika mu minofu ya ng'ombe, umayambitsa kukhumudwa, kuwuma, kuponderezana.
2. Nthawi zonse kuzizira kwa miyendo, ngakhale nthawi yotentha, nthawi yachilimwe.
3. Maonekedwe a kulanda kwa miyendo.
4. Madandaulo akumva kudzidwa komanso kumva kuwonongeka kwa zala.
5. Ululu wa khungu la Wax umayamba, m'malo ena khungu limakhala lotuwa kapena louma.
6. Zilonda zoperewera, malo okhala, mokhazikika pang'onopang'ono kukhala mabala osakaza, aonekera pakhungu.

Zizindikiro zoyambirira za zilonda zam'mimba za m'miyendo zikupezeka, muyenera kufunsa dokotala wa endocrinologist ndi dokotala wothandizira. Gawo loyambirira la matendawa limafunikira chithandizo chamanthawi yomweyo popanda kuduladula zala, phazi kapena dzanja lonse.

Matenda oyamba

Kodi zigawenga zimayamba bwanji? Matenda a shuga am'magazi amayamba ndikukula kwa matenda monga matenda ashuga. Kuvulala kochepa, kukanda, callus, kukulitsidwa ndi kusokonezeka kwamagazi, magazi, kusayenda m'malo am'munsi, kuphatikiza kwa microflora ya pathogenic, kumayambitsa zochitika zam'mbuyo komanso zigawenga. Gangrene wa phazi odwala matenda ashuga ndi gawo loopsa la phazi la matenda ashuga. Nthawi zambiri, matenda amtunduwu amapezeka mwa anthu atatha zaka makumi anayi komanso atakalamba, atakhala ndi vuto la minofu chifukwa cha kufalikira kwa microangiopathy ndi neuropathy.

Zowonda kwambiri

Zilonda zodwala matenda ashuga zimayamba nthawi yomweyo. Chiwalo chomwe chakhudzidwa chikukula, chimakhala ndi mtundu wobiriwira kapena wamtambo. Kununkhira kwakuthwa kwamphamvu. Wet gangrene mwachangu imagwira madera atsopano a khungu, fiber, minofu ndi fupa. Madera a Necrotic adaphimbidwa ndi thovu yaying'ono, ndikumapanikizika pakhungu lomwe lakhudzidwa, kuterera kumamveka (crunching). Matenda a wodwalayo akuipiraipira, kuchuluka kwa magazi, leukocytosis imawonekera, ndipo ESR ikukwera. Kupulumutsa moyo, tikulimbikitsidwa kudula gawo lowonongeka la mwendo.

• kukonza ndi kuchiza bwino ngakhale kuvulala kocheperako, zopaka, chimanga, misomali yakunyumba,
• kupewa ndi kuchiza matenda opatsirana matenda opatsirana azachilengedwe osiyanasiyana,
• kuchotsa kwa khungu necrotic,
• kuchepa kwa thupi.

Pofuna kuti musayambitse matenda ovulala mwendo mu shuga mellitus, ndikofunikira kuteteza miyendo, ngati zingatheke, kuvala nsapato zapadera, zofewa zam'mafupa, masokosi ofewa a thonje. Simungathe kutentha, kuyenda miyendo yanu, kuyenda opanda nsapato mumsewu kapena m'malo ena, osavala nsapato za wina.

Chithandizo cha gangrene chikuchitika ndi endocrinologists mogwirizana ndi madokotala a mtima. Ndi malo owuma, madokotala am'mimba amachitapo kanthu kuti abwezeretsere kuchuluka kwa mitsempha ya magazi pang'onopang'ono (kupanga ma cellaround magazi), kukomoka (kubwezeretsa patency). Kudula mwendo ndi gangrene muukalamba kapena ndi mawonekedwe onyowa, ngakhale phazi likangowonongeka, nthawi zambiri limachitika mu zipatala pamlingo wam'munsi kapena ntchafu.

Mu magawo oyamba amakula matendawa, ndizotheka kuchiza matenda osokoneza bongo omwe ali ndi matenda ashuga: masks ofiira ofiira, mafuta ambiri ochokera ku yogurt yachilengedwe, mafuta a clove. Ochiritsa azikhalidwe ndi madotolo amalimbikitsa kuti azithira chiwindi cha nyama yaiwisi kumapazi akhudzidwa. Kunyumba, mutha kugwiritsa ntchito mafuta opweteka a matenda a shuga. Zomwe zimapangidwira mafuta osiyanasiyana zimaphatikizapo zowonjezera za peppermint, blackcurrant, collagen, mafuta ofunikira a sage ndi tiyi, zigawo zikuluzikulu. Chisankho chimatengera gawo la matendawa, cholinga chogwiritsa ntchito. Nthawi yoikidwiratu ikuchitika ndi adokotala.

Njira zina zamankhwala zimapereka njira yochotsera moto wa Anton. Njira iyi ndi kusala kwachithandizo. Koma ziyenera kuchitika pokhapokha kuyang'aniridwa ndi madokotala. Odwala amalangizidwanso kuti azichita zolimbitsa thupi tsiku ndi tsiku. Ngati mankhwalawa a gangore mu matenda a shuga ophatikizana ndi wowerengeka azitsamba samapereka zotsatira, muyenera kufunsa dokotala kuti akupatseni mankhwala.

Vuto logaya matenda ashuga ndilovuta kwambiri. Ngati ngakhale zizindikiro zazing'onoting'ono za atherosulinosis obliterans zikuwoneka, muyenera kupimitsa mitsempha, kukaonana ndi dokotala wamankhwala oyenerera kuti mudziwe njira zoyenera zothandizira. Kukhazikitsa kuonana ndi dokotala kumathandizira kuti matendawo achulukane, kumawonjezera mwayi wokhala ndi matenda.

Njira zodzitetezera, munthawi yake, chithandizo chamankhwala chodalirika, chithandizo chazovuta zokhala ndi vuto ndi wowerengeka ndi chitsimikizo chokhala ndi thanzi komanso moyo wautali.

Mtima dongosolo la matenda ashuga

• 1 Chimachitika ndi chiyani ku zombo zomwe zimakhala ndi matenda ashuga?
• 2 Zoyambitsa ndi Zizindikiro
• 3 Zovuta
• 4 Kuzindikira
• 5 Kuchiza kwamatenda a mtima m'matenda a shuga
  • 5.1 Mankhwala osokoneza bongo komanso njira
  • 5.2 Kuchiza ndi wowerengeka azitsamba
  • 5.3 Momwe mungalimbikitsire zombo?
• 6 Kupewa

Ndi kukula kwamphamvu kwa glucose, kayendedwe ka mtima m'matenda a shuga amathanso kuwonongeka pang'onopang'ono. Matenda a mtima ndi oyamba chifukwa cha kulemala komanso kufa kwa matenda ashuga, chifukwa chake ntchito zazikulu zochizira ndizopewera, kuzindikira koyambirira, chithandizo komanso kuthetseratu mavuto obwera ndi mitsempha yamagazi.

Chimachitika ndi chiyani ku ziwiya za shuga?

Kuwonongeka kwa mtima mu shuga mellitus (diabetesic angiopathy) kumayamba chifukwa cha kupatsirana kwa mapuloteni (shuga), kusintha kwa ma cell mu minofu yodalira insulin, kuphwanya hemodynamics (kayendedwe) komanso machitidwe amtsempha wamagazi. Zotsatira zake, madipoziti amafuta amasonkhanitsidwa pakhoma la mtima lomwe limalepheretsa magazi kuyenda bwino.

Angiopathy imagawidwa yaying'ono ndi macro angioathy. Ndi microangiopathy, ziwiya zing'onozing'ono (arterioles, capillaries) zimakhudzidwa, zomwe zimabweretsa kusintha kwa ubongo, impso, ndi diso. Ndi macroangiopathy, mitsempha yayikulu imavutika, chifukwa cha momwe matenda amkati am'mimba amayamba komanso miyendo yam'munsi imakhudzidwa.

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Zoyambitsa ndi zizindikiro

Mavuto a mtima amapezeka pazifukwa zotsatirazi:

Kukhala moyo wongokhala ndi kunenepa kwambiri ndizomwe zimayambitsa mavuto a mtima.

kuthamanga kwa magazi (kuphatikizidwa kwa matenda ashuga ndi matenda oopsa kuwirikiza kawiri chiopsezo cha matenda amtima, makamaka ndi matenda a shuga a 2),

Zizindikiro za matenda zimawonetsedwa patebulo:

Matenda a shuga a retinopathy (kuwonongeka kwa minyewa yam'mimba)Zowonongeka, mawonekedwe amdima kapena kuwala kowonekera patsogolo pa maso, mutu Matenda a shugaKutupa kwa nkhope ndi miyendo, kuthamanga kwa magazi, nseru, kufooka, kugona A shuga angiopathy a m'munsi malekezeroMapazi ozizira, kuchepa kwa chidwi, kupweteka, kukokana, redness kapena kupindika kwa phazi, zilonda zam'mimba. Matenda a shugaKuzindikira kwakhungu, mavuto a kukumbukira, kupweteka kwa mutu, asthenia, kupenya kawiri, kusokonezeka kwa tulo Kuwonongeka kwa mtimaKusinthasintha kwa mtima, kupweteka pachifuwa, cyanosis, kupuma movutikira

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Mavuto

Kuphatikizika kwamasamba mu shuga kumabweretsa kuwonongeka kwawo, hypoxia, atrophy, komanso kuwonongeka kwa minofu.

Myocardial infaration ndi vuto lalikulu la matenda ashuga, chifukwa magazi amawungana m'mitsempha yomwe imalepheretsa magazi kuyenda bwino. Kuzindikira kwa minofu ya mtima kumachepa kapena kulibe, kotero kuyambika kwa vuto la mtima sikuchita bwino nthawi zonse kuzindikira nthawi. Kukhazikika kwa cholesterol plaques pamakoma a ziwiya zamiyendo, kuwonongeka kwa mitsempha ndi ma capillaries kumaphwanya ntchito za metabolic mu ziwalo ngakhale ndi mabala ang'onoang'ono kumawonjezera chiopsezo cha kulowerera kwamtundu uliwonse wamatenda. Izi zimapangitsa kuti pakhale vuto lalikulu - matenda ashuga. Mavuto a retinopathy amatha kukhala khungu lathunthu.

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Chithandizo cha matenda a mtima m'matenda a shuga

Chithandizo cha zotupa za mtima mu shuga mellitus zimachitika ndi mankhwala omwe amasintha magazi ndikulimbikitsa kukonzanso kwamitsempha. Kugwiritsa ntchito mankhwala osokoneza bongo kumachitika ndikuwunika shuga ndi kuchuluka kwa michere ya chiwindi, popeza mapiritsi ena amathandizira minofu ndi chiwindi. Pa mankhwala, muyenera kutsatira zakudya zotsika kwambiri.

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Mankhwala osokoneza bongo komanso njira

• Corinfar ndi mankhwala omwe amachepetsa kupsinjika ndi kuthamanga kwa mitsempha yamagazi.

Kuti muchepetse kuchuluka kwa shuga amalembedwa: "Metfogamma", "Reklid", "Diabeteson", "Diastabol".

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Kuchiza ndi wowerengeka azitsamba

Kukonzekera kwazitsamba zonse kuchiza, kukonza kapena kuyeretsa ziwiya kumakonzedwa mosamalitsa maphikidwewo ndipo kuyenera kuvomerezana ndi dokotala.

Zithandizo za anthu zimatha kuthandizira pakumwa mankhwalawa pogwiritsa ntchito tiyi, mafuta odzola komanso ma infusions azitsamba pakugwiritsa ntchito kunja ndi mkati. Zomera zazikulu zomwe zimathandizira kuchiza mitsempha yamagazi m'magazi a shuga:

• Ginseng, mseru, leuzea, eleutherococcus - kukulitsa kamvekedwe ka minofu ya mtima, kuchepetsa kuthinana ndi shuga,
• Calendula, linden, nettle - amathandizira pakuchiritsa zilonda,
• Oldberry, wort wa St. John, Aralia Manchurian, blueberries - kubwezeretsa kagayidwe,
• Rosehip, stigmas, sgemas - chimalimbikitsa chitetezo cha m'thupi,
• Macheka a birch, dawesel high, Yerusalemu artichoke - shuga wotsika, sinthanso magazi,
• Flaxseed, ginger, burdock, phiri arnica - imalimbikitsa kupanga insulin.
• Mahatchi, lingonberry, knotweed - okhala ndi kukodzetsa.

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Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Momwe mungalimbikitsire mitsempha yamagazi?

Kuti ayeretse ziwiya, amagwiritsa ntchito masamba a Bay.

Kuyeretsa pafupipafupi ziwiya kumathandizira odwala matenda ashuga. Ndikothekanso kuyeretsa ziwiya zamatenda a shuga ndi decoction ya masamba a bay. Pophika, muyenera kutenga 5-7 g ya Bay tsamba ndikuthira madzi owiritsa (300 ml). Kenako pitilizani kutentha pang'ono kwa mphindi 5-10. Thirani msuzi ndi masamba mu thermos ndikuwumirira kwa maola 4-5, ndiye kuti muvutike ndikumangogula pang'ono magawo 1-2 patsiku. Pa tsiku lachinayi pumulani. Pakatha sabata, mubwereze maphunzirowo. Mutha kutsuka ma botilo kangapo pachaka ngati kuyeretsa kumachitika koyamba, ndipo kamodzi pachaka ndikokwanira. Kutsuka kwa mtima kwamankhwala kwa shuga kumachitika pofuna kuwalimbikitsa, kuonjezera kunenepa, kubwezeretsa magwiridwe antchito.

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Kupewa

Kupewa kwamatenda a mtima ndikutsatira njira izi:

• Kuyang'anira shuga nthawi zonse ndikofunikira kwambiri.
• Kuyendera dokotala mwatsatanetsatane: Kulowerera pafupipafupi m'mbiri ya zamankhwala kudzakuthandizani kuzindikira kusintha kwazomwe mukukhala ndiumoyo munthawi yake, kulandira upangiri pa nthawi yake komanso kupereka mankhwala.
• Kuyang'anira mkhalidwe wanu kuti mayendedwe satsatiridwa ndi zowawa.
• Kuwona kusintha kwa pakhungu pofuna kupewa zilonda zam'mimba chifukwa cha kupindika kwa mitsempha yayikulu (pachifuwa chamkati, pa ntchafu, m'chiuno, pansi pa mawondo)

Kuyeretsa pafupipafupi kwamitsempha yamagazi kumakhudza kwambiri zomwe zimachitika mthupi. Ndikofunikira kuchita masewera olimbitsa thupi ndikutsindika mtima ndi kupuma, tsiku lililonse muzitsatira zakudya zoyenera komanso ukhondo. Kusamalira mapazi ndikofunikira kwambiri.Nsapato ziyenera kukhala bwino kupewa kufinya, kutikita mtima ndi mafinya. Ndikosatheka supercool kapena mawonekedwe ochulukirapo. Ziphuphu, abrasions, mabala ndi owopsa kwa matenda ashuga, chifukwa chake muyenera kuchepetsa chiopsezo chovulala. Khungu lowuma limafunika kuti lizinyowa ndi mafuta apadera, omwe amaphatikizapo urea. Yesani phazi pafupipafupi.

Gangrene wa m'munsi malekezero a shuga

Matendawa m'matenda a shuga ndiwowopsa kwa matendawa, omwe angayambitse kuti munthu adzafunika kudulidwa mathero.

Omwe ali ndi shuga wambiri ayenera kuwunika miyendo yawo. Matenda a shuga amakhalapo pang'onopang'ono amabweretsa mfundo yoti mitsempha ya magazi imaleka kukwaniritsa ntchito zawo, magazi sakalowa m'maselo, ndipo amafa.

Oposa 60% ya odwala matenda ashuga amakumana ndi gangore.

Kuti mupewe izi, odwala omwe amadalira insulin ayenera kudziwa momwe gangore imayambira, ndiyowopsa, komanso ndi anthu angati omwe amakhala ndi vutoli.

Zizindikiro zamatsenga

Chifukwa chakuti ndi kuchuluka kwa shuga m'magazi, munthu amalephera kumva zolimba miyendo, mabala amatha kuti wodwalayo sakazindikira. Kudwala kwa khungu lomwe lakhudzidwalo kumachitika, kuchuluka kowonjezereka kwa minofu yamoyo kumathandizidwanso. Mapeto amitsempha amathera pomwepo, munthu samamva kuwawa kwazizindikiro, kuyambira mu necrosis.

Thukuta limakhalanso loperewera, khungu limasokonekera nthawi zonse, motero pamakhala mabala, ming'alu. Vuto lalikulu la matenda ashuga limatha kukhala pandulu. Zimachitika kawirikawiri, koma nthawi yomweyo zimakhala zowopsa chifukwa zimayambitsa venous thrombosis yofulumira.

Nthawi zambiri mumatha kukumana ndi gangore lomwe limakula pang'onopang'ono, zomwe ndizosavuta kuzindikira zizindikiro zotsatirazi:

• zilonda zopweteka m'mbali mwendo zomwe zakhudzidwa ndi kusintha,
• kutayika kwa zala kapena zala,
• Kusintha khungu: khungu / loyera, malo ofiira pakhungu,
• Mukamasuntha, wodwalayo amawona kutopa kwam'malo miyendo, nthawi zambiri amakhala ndi vuto lakumaso ndi miyendo yakumaso ndikusilira mwa iwo
• malo okhudzidwa ndi mkono kapena mwendo wayamba kutupa,
• miyendo imawoneka yosazizira
• Mawonekedwe a phazi likusintha, kusintha kwake kumachitika,
• msomali wazala chala chakhudzidwa ukhoza kutha kapena kusintha mtundu, mawonekedwe a mbale ya msomali angasinthe,
• matenda a fungal nthawi zambiri amapezeka pamalo okhudzidwa ndi khungu.

Ngati minofu necrosis yakhudza gawo lalikulu la phazi, munthu akumva kupweteka kwambiri m'chiwalo.

Wet gangrene mu matenda a shuga amaphatikizidwa ndi njira yopatsirana komanso nkhani za purulent kuchokera ku bala. Necrosis imapangitsa kuledzera kwambiri kwa thupi, zomwe zimapangitsa kuti thupi lizitentha kwambiri. Munthu amatha kusomoka, nthawi zina kusanza kumayamba. Nthawi zambiri wodwalayo amanjenjemera, zimamuvuta kuti azimva kutentha.

Gangrene mu shuga - zimayambitsa, chithandizo

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Matenda a matenda ashuga ndi necrosis ya minofu yomwe imayamba chifukwa cha shuga wambiri. Nthawi zambiri, miyendo yam'munsi imakhudzidwa, izi zimachitika chifukwa cha kuzungulira kwazinthu zamagazi. Popita nthawi, amayamba kukhala amdima chifukwa chodzikundikira ndi chitsulo ndi chitsulo chamchere. Zinthu izi zimayikidwa m'magazi chifukwa cha kupindika. Necrosis ya miyendo imachitika chifukwa kuchepa kwa mpweya kwa ma capillaries. Mwa anthu odwala matenda ashuga omwe ali ndi zaka zopitilira 20, chiopsezo chotenga matendawa chimakwera mpaka 80%.

Choyambitsa chachikulu cha gangrene cha m'munsi kwambiri m'matenda a shuga chimagwirizanitsidwa ndi kuwoneka kwa zovuta za trophic. Zina mwa izo ndi:

• Polyneuropathy ndimatenda amomwe amanjenjemera amawonongeka.
• Microangiopathy ndi matenda omwe amaphatikizana ndi kuphwanya kwa capillary permeability.
• Macroangiopathy - kuwonongeka kwa mitsempha yayikulu yamagazi.
• Kupangidwe kwamkati mwa mafupa ndizomwe zimayambitsa matenda oyamba a mafupa. Matenda oterewa amathanso kutsogolera mtima.
• Njira zopatsirana - kuchepetsa kuchepa kwa mitsempha yamagazi.
• Kuchepetsa mphamvu yolimbana ndi matenda a shuga.
• Kupezeka kwa zizolowezi zoipa: kuledzera, kusuta fodya, kunenepa kwambiri.
• Valani nsapato zapamwamba.
• Zowonongeka kapena kuwotcha kumadera otsika.

Youma gangrene

Dry gangrene ndi chotupa cha khungu, chomwe chimayambitsa kuphwanya magazi. Nthawi zambiri, mtundu wamtunduwu wa matenda umapezeka mwa odwala matenda a shuga omwe ali ndi kufooka kapena kuchepa mphamvu kwa thupi. Chotupacho chimakula pang'onopang'ono, chimadziwika ndi kuyanika kunja kwa minofu. Popita nthawi, khungu pamiyendo limayamba kugundana ndikulimba, kukhala ndi bulauni kapena mtundu wakuda. Munthu sangakhale moyo wabwinobwino, amakhala wolumala. Matenda owuma amatha kuzindikiridwa ndi:

• Zowawa zam'madera akum'munsi,
• Kuchepetsa kapena kusazindikira
• Khungu lozizira lamiyendo,
• Zomverera mosalekeza za kuzizwa
• Kuchepa kwa miyendo, kapena chifukwa chosowa,
• Kuchuluka kwamiyendo
• Kukongola kwa khungu.

Pankhani ya kusowa kwa chithandizo kwakanthawi, matenda opatsirana ndi mabakiteriya angayambitse chidakwa. Kuzindikira poyizoni wa thupi ndikotheka ndikuwonjezera kutentha kwa thupi, nseru, kusanza, kuzindikira. Ngati munthu sakumva bwino, dokotalayo sathamangira kutumiza wodwala kuti am'chitire opareshoni. Mankhwala othandizira othandizira, mankhwala a mtima ndi isotonic solution amachitika.

Njira zochizira

Chithandizo cha gangore ndi matenda a shuga amafunika njira yolumikizira. Ndikofunikira kutsatira malangizo onse a adotolo, chifukwa kunyalanyaza malangizowo kungayambitse zovuta zazikulu. Mothandizidwa ndi mankhwala, gangrene sangathe kugonja, koma amathandizira kusintha magazi ndikuchepetsa chiwopsezo cha zovuta. Chofunika kwambiri pazachipatala ndi njira zotsatirazi:

• Angioplasty ndi stinging ndi njira zomwe zimathandizira kuthana ndi vuto lalikulu la matenda ashuga. Ndi thandizo lawo, ndizotheka kusiya miyendo. Chinsinsi cha njirazi ndi kuyambiranso kwa ziwiya zowonongeka, zomwe zimabwezeretsa magazi. Zowunikira zimachitika kuchipatala, popanda opaleshoni - kudzera pamatumbo ang'onoang'ono, adokotala amachita zonse zofunikira ndi chida chapadera. Pakusintha, munthu samataya magazi.
• Kuchita opaleshoni ya mtima ndi njira yolowerera yomwe ingapangitse magazi kuzungulira m'munsi, komanso kuthana ndi ischemia. Njirayi ndiyosinthika, ikuchitika pansi pa opaleshoni yotupa. Chofunika cha kulowererapo ndikuchotsa zombo zomwe zikukhudzidwa ndi ma conductor apadera omwe amagwira ntchito ya mitsempha.
• Kuphatikiza khungu ndi kachitidwe kamomwe dokotala amayang'anira madera akhungu ndi omwe akhudzidwa kale. M'malo mwa zigamba zomwe zakhudzidwa, timisempha tapadera tachipatala titha kusoka. Madokotala amathanso kuulutsa ziwalo zina za thupi.
• Kuduladula miyendo ndikuchita opaleshoni pomwe dokotalayo amatha kuyika gawo lonse la chiwalo kapena chonse. Nthawi zambiri, njira imeneyi imangopita pokhapokha njira zina sizibweretsa zotsatira zomwe mukufuna. Izi zimachitika pofuna kupewa kufalitsa mabakiteriya komanso matenda mthupi. Kuchita opareshoni kumachitika pansi pa opaleshoni yodwala ndipo pamafunika nthawi yayitali kuti achire. Mukachotsa nthambi imodzi, ndikofunikira kuyang'anitsitsa momwe winayo aliri, popeza chiopsezo chopitiliza kukula kwa gangrene chimakhalabe chachikulu.

Njira zina

Akatswiri ena amati kusala kudya kwamankhwala othandizira kungathandize kuyimitsa kukula kwa matenda osokoneza bongo. Iyi ndi njira yachidziwikire yowunikira iyenera kuyang'aniridwa ndi dokotala pafupipafupi. Ndikofunika kuchita izi kuchipatala chapadera. Pa magawo oyamba a magulu ovuta, kufa ndi njala kumatha kuletsa njira za pathogenic. Komanso, katundu tsiku ndi tsiku pamiyendo amathandizira kukhazikitsa magazi.

Chithandizo cha bowa mu shuga

Chithandizo cha matenda oyamba ndi fungus mwa odwala osiyanasiyana ali ndi mawonekedwe ake. Zimatengera kuuma kwa mlanduwo, momwe matendawo aliri. Nthawi zina mumafunikira kuyeretsa misomali yanu tsiku ndi tsiku kapena kuthana ndi miyendo, ndipo nthawi zina, zimakhala zovuta kuti munthu wodwala matenda ashuga azithana ndi matendawa, ndipo ayenera kulandira chithandizo kuchipatala.

Chovuta chamankhwala ndikuti ndi zovuta za endocrine, kumwa mankhwala a antifungal kumachepetsa mphamvu ya mankhwala ochepetsa shuga omwe amachokera kwa munthu wodwala matenda ashuga, kapena kumamupangitsa kukhala ndi vuto la hypoglycemia.

Gangrene ndi zomwe zimayambitsa

Gangrene ndi necrosis wa zimakhala za thupi la munthu. Kuopsa kwa vutoli kukuchitika chifukwa choti zikachitika, zinthu zapoizoni zomwe zimapangitsa kuti thupi lonse lizilowerera m'magazi ake. Kulowa kwawo m'magazi kumadzetsa mavuto ambiri ndi ziwalo zofunika kwambiri ndi machitidwe awo. Choyamba, impso, chiwindi, minofu ya mtima, mapapu amavutika.

Chiwopsezo chotenga gangore chikuwonjezeka nthawi zina ngati shuga wambiri m'magazi apitilira kwa nthawi yayitali kapena ngati pali "kulumpha" komwe kumakhalako. Mu 90% ya milandu, zovuta zowoneka bwino zimapezeka mwa anthu odwala matenda ashuga omwe samalabadira thanzi lawo, osatsatira zomwe dokotala akutsimikiza, ndikuphwanya zakudya zomwe amadya.

Zotsatira zakupha - pafupipafupi chifukwa cha matenda ashuga osapezekanso mankhwalawa.

Zomwe zimayambitsa gangore mu shuga

• Atherosulinosis "Choyambitsa" chachikulu cha kufalikira kwamitsempha yamagazi, kusowa kwa mpweya ndi michere kwa ma cell, kufa kwawo pang'onopang'ono. Ndi matenda omwe amasokoneza kayendedwe ka magazi, amabweretsa zovuta monga ischemic gangrene.
• Zilonda za matenda ammimba a shuga. Zotsatira za kuwonongeka kwa khungu, zilonda zazitali zosachiritsa zimatha kukhazikika pansi. Matendawa akamalumikizana, kukula kwawo kumakulirakulira, wodwalayo amayamba kukulitsa matenda opatsirana (onaninso - momwe angathandizire mabala a shuga).
• Polyneuropathy. Zimachitika ngati pali kuphwanya njira ya kupanga shuga m'thupi, ndikuwunikira kuwonongeka kwa ma cellvasculature a maselo amanjenje, kukalamba kwawo kusanachitike.
• Zotupa za mtima dongosolo. Poyerekeza ndi kuchuluka kwa shuga m'magazi, misempha yayikulu ndi yaying'ono imavutika, yaying'ono kapena macroangiopathy imayamba. Kusintha kwachulukidwe ka mtima komanso patency kumabweretsa kufa kwa maselo ndi minofu ya thupi.
• Anachepetsa chitetezo chokwanira. Poyerekeza ndi kufooka kwa ntchito yoteteza thupi, zotupa zomwe zimachitika pafupipafupi ndi matenda (mabakiteriya, ma virus, mafangasi, ndi zina) zimawonedwa, zomwe zimayambitsa chitukuko cha matenda opatsirana.
• Khalidwe loipa. Zizolowezi zovulaza, kudya mopitirira muyeso, kunenepa kwambiri, nsapato zolimba zolimba ndizovuta zomwe zimachitika msanga komanso kukula msanga pamavuto a matenda ashuga (onaninso - momwe mungasankhire nsapato za odwala matenda ashuga).

Nthawi zambiri, gangrene mu shuga amawoneka chifukwa osati chimodzi chokha, koma zifukwa zingapo, zomwe zimalimbikitsana, zimasokoneza njira zochizira.

Momwe mungazindikire gangore: zizindikiro zazikulu za matenda

"Mabelu oyamba" (zizindikiro zoyambirira). Poyamba, kusintha kulikonse kwamkati pakhungu kumakhala kovuta kuwonekera kumaso wamaliseche ndipo kumachitika popanda chizindikiro.Zizindikiro zoyambazo monga gangrene zingakhale izi:

• kugona ndi miyendo,
• kutentha kapena kumva
• kutopa kwa miyendo ngakhale pang'ono pakulimbitsa thupi kapena kuyenda (nthawi zambiri wodwala amazunzidwa ndi ululu m'misempha ya ng'ombe),
• kukula kwa vuto la phazi.

Mkhalidwe womwe umayambira gangore, madokotala amayimba ischemia yovuta. Amadziwika ndi mapangidwe a zilonda zam'mimba zoyambirira pakhungu ndikuwoneka ngati sanali ofunika kwambiri a necrosis. Pakadali pano, munthu wayamba kale kumva zowawa kwambiri m'malo otsika, omwe amakhala osalephera pomwe amakhala m'malo opingika.

Ischemia yovuta ndi chikhalidwe chomwe sichimangokhala chokha. Ngakhale kumwa mankhwala sangathe kusintha vutolo. Kuti athetse, kubwezeretsa mwachangu kwa magazi mu miyendo kumafunikira, apo ayi matendawo a wodwalayo amakhala osavomerezeka - kudula kwa chaka chamawa.

Zizindikiro Zamachedwe. Popita nthawi, Zizindikiro zimachulukanso, ndipo mumatha kuzizindikira ngakhale ndi maliseche: kutentha ndi khungu la malekezero akumunsi zimasintha. Miyendo imayamba kuzizira, khungu limakhala lofiira kapena lofiirira. Odwala ena amadandaula za kutupa ndi mawonekedwe a chimanga chachikulu.

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kuukiridwa kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Zizindikiro zakuchedwa kwa gangrene zimaphatikizapo:

• ngakhale khungu likuda kwambiri (kuthina kapena lakuda),
• kusowa kwina kapena kuperewera kwa magazi (kungatsimikizidwe ndi kukhalapo kapena kusapezeka kwa magazi m'magazi a zotumphukira),
• kuchepa kwamatenda, kufooka, zizindikiro za kuledzera, kutentha thupi ndi zizindikiro zina zakufalikira kwa matenda m'thupi,
• mapangidwe a purulent (pachitukuko cha chonyansa chonyowa),
• fungo la fetid ku mabala amachiritso a nthawi yayitali.

Matendawa

Matenda amtundu wa gangrene ndi zovuta zomwe zimakhala zosatheka kuti zisokoneze ndi matenda ena aliwonse chifukwa cha zikhalidwe komanso kutchuka kwambiri. Kuti mumvetse bwino za matenda anu:

• kuyesedwa ndi dokotala
• kubzala m'mabala,
• njira zoyezera zamitsempha,
• Ma Ultrasound am'munsi,
• radiology
• MRI (malingana ndi mawonekedwe).

Youma komanso chonyowa gangore

Pali mitundu iwiri yayikulu yamavuto monga gangore. Chifukwa chake, zitha kukhala:

Zouma. Kusokonezeka kumachitika motsutsana ndi maziko a pang'onopang'ono kupendekera kwamitsempha. Nthawi zambiri, kukula kwa khungu louma kumachitika pakatha zaka zochepa. Munthawi imeneyi, odwala matenda ashuga amapeza njira zothanirana ndi zovuta za matendawa ndikuzolowera matendawa.

Mu 90% ya milandu, malo owuma amakhudza zala zakumapeto. Imfa yamatumba imachitika popanda kudziphatika kwa matenda achitatu.

Chizindikiro chachikulu cha matenda owuma - kupweteka kwambiri m'miyendo, ndimakonda kuchita. Mukamayang'ana miyendo, mutha kuwona kusiyana pakati pa madera omwe akhudzidwa pakhungu ndi minofu yathanzi. Fungo losasangalatsa kuchokera m'miyendo silibwera. Pankhaniyi, wodwala matenda ashuga samva kuwawa m'thupi lonse, chifukwa kupanikizika kumachitika popanda matenda komanso kuledzera kwa thupi lonse.

Nthawi zambiri, matenda owuma sakhala pachiwopsezo cha wodwala. Kudula dzanja kumachitika pokhapokha ngati chiwopsezo chachikulu cha matenda ndi kusintha kwa khungu louma kuti chonyowa.

Zabwino. Vuto lalikulu lomwe limabweretsa chiwopsezo osati thanzi, komanso moyo wa odwala matenda ashuga. Wet gangrene ali ndi chizindikiro chotchulidwa, chosatheka kunyalanyaza kapena kusokoneza china chake. Kuwonongeka kulikonse kwa minofu kumachitika molumikizana ndi matenda. Zotsatira zake, gawo la dera lomwe lakhudzidwalo likukulirakulira, nthambiyo imapeza tinthu tofiirira. Pakapita nthawi yochepa, kuwumbidwa kumayamba, komwe kumafalikira kumankhwala oyandikira, omwe kale anali amoyo pakatha masiku.

Chizindikiro chodziwikiratu cha chonyowa m'mimba ndikudzazidwa kwa malo okhala ndi hydrogen sulfide. Zotsatira zake, mukayang'ana pakhungu lomwe lakhudzidwa ndi khungu lanu, mumatha kumva phokoso lomwe limatchedwa kutumbwa. Komanso ku chonyansa chamagulu nthawi zonse ndimanunkhira wosasangalatsa wa fetid. Wodwala "amazirala" pamaso pathu: zomwe zimachitika kuti munthu wokhala ndi chofooka chayamba kuzunzika osati ndi tsikulo, koma pofika ola limodzi chifukwa cha poyizoni wa thupi ndi zinthu za cadaveric.

Mu 98% ya milandu, mwayi wokha wopulumutsa moyo wamunthu ndi chonyansa chodukiza ndikuduladula dzanja.

Momwe mungapewere kukula kwa matenda osokoneza bongo: njira zopewera

Kuti mupewe vuto lalikulu ngati gangore, ndikofunikira kuchitapo kanthu moyenera. Kodi achite chiyani?

• Khazikitsani shuga m'magazi (konzekerani kuchepa kwa cholembedwaku kumikhalidwe yoyenera, ndipo yeserani kuisunga nthawi yomweyo).
• Pitani kuchipatala pafupipafupi kuti mumupimidwe ndi dokotala (nthawi zina, zizindikiro zoyambirira za gululi, zomwe sizioneka kwa wodwala, zitha kutsimikiziridwa ndi katswiri).
• Chitani zosamalitsa za tsiku ndi tsiku ndi mapazi anu (kutsukidwa bwino ndi sopo wa antibacterial, kusisita nokha, kupaka mafuta tsiku ndi tsiku pakhungu la kumapazi.
• Chitani zolimbitsa thupi kuti mukonzenso ndikubwezeretsa magazi m'miyendo.
• Chitani masewera olimbitsa thupi tsiku ndi tsiku (mukangoyamba kutopa m'miyendo, muyenera kuvula nsapato zanu ndikumanga tsitsi lanu kwamphindi kwa mphindi 5 mpaka mbali kuchokera kumapazi kupita m'chiuno).
• Pomwe zingatheke, perekani miyendo yanu pamalo okwera (kukulitsa kutulutsa miyendo ndikuwongolera kutuluka kwa magazi kupita ku minofu).

Kuchokera pazomwe tafotokozazi, titha kunena kuti gangrene, youma komanso yonyowa, ndi vuto lalikulu la matenda ashuga, kuwonekera motsutsana ndi matenda ammimba a matenda ashuga. Ngati mukugwira nawo ntchito yopewa matendawa ndikutsatira zomwe dokotala akutsimikiza, nthawi zambiri mutha kupewa kupitilira kwa zovuta komanso mtsogolo.

Kodi matenda am'magazi odwala matenda ashuga ndi chiyani

Khodi ya MBK yamatendawa ndi E10-E14. Pathology imadziwika ndi necrosis, ndiye kuti, necrosis, ya minofu yam'munsi yam'munsi. Chiyambireni chitukuko cha njirayi chimayamba ndi zala. Komanso, pakalibe chithandizo choyenera, kufalikira kumapazi onse ndikotheka. Kusintha kwa minyewa kumachitika msanga chifukwa cha matenda oyambitsidwa. Izi zimachitika pafupipafupi zaka 15-20. Malinga ndi ziwerengero, munthu aliyense wodwala matenda ashuga ali ndi zilonda zam'miyendo. Matenda ofala kwambiri ndi ukalamba.

Mawonekedwe amankhwala amatengera mtundu wa gangrenous necrosis wodwala. Koma wodwalayo sangazindikire zizindikiro zoyambirira.Izi zimachitika makamaka chifukwa chophwanya chidwi cha malo omwe akhudzidwa. Ichi ndiye chifukwa chazovuta zovuta. Odwala omwe sanafike kwa dokotala kuti amupime moyenera munthawi yake, amakhala pachiwopsezo chozindikira momwe matendawa alili kale munthawi yonyalanyaza, pomwe chithandizo chimaphatikizidwa.

Zofunika! Matenda a matenda ashuga ndi owopsa chifukwa zotsatira zake zakupha zimatheka popanda kulandira chithandizo choyenera.

Izi ndichifukwa choti zinthu zapoizoni zimapangidwa nthawi ya kufa kwa minofu. Amalowa m'matumbo oyenera komanso ziwalo zina ndimayenda wamagazi. Pankhaniyi, kuwonongeka kwa impso, mapapu, ndi chiwindi ndizotheka, zomwe zimakwiyitsa kukula kwa zovuta kwa wodwala.

Kutengera ndi ukadaulo komanso momwe zinthu ziliri, matendawa amakula mosiyanasiyana. Kutalika kwa kupitirira kwa zamatenda, kuuma kwa zizindikirazo, komanso matendawo zimasiyana. Choyamba, odwala matenda ashuga amawerengedwa ndi chifukwa.

Mitundu yotere ndi yosiyanitsidwa:

1. Neuropathic.
2. Angiopathic.
3. Zosakanizidwa.

Njira yoyamba ndi chifukwa cha kuwonongeka kwa ulusi wamanjenje. Angiopathic mawonekedwe - amakula mogwirizana ndi mtima matenda. Minofu yamafupa ikawonongeka, mitundu yosiyanasiyana ya njirayo imawonedwa. Youma ndi chonyowa (chonyowa) necrosis imaphatikizidwanso. Amasiyana mu chipatala ndi momwe zimakhalira. Kuphatikiza apo, zosiyana ndi njira zochizira matenda.

Ma necrosis owuma

Mtundu wamtunduwu umayamba nthawi yayitali. Zizindikiro zoyambirira zikuwotcha komanso kuyabwa kwa phazi, kuzizira komanso kufinya kwa dzanja. Zizindikiro za matenda owuma kumapazi kumaphatikizapo ululu poyenda. Pa gawo loyamba la matenda, chizindikirochi chimachitika atagunda kilomita. Kupitilira apo, nthawi ya njirayo imachepetsedwa kwambiri, mpaka kupweteka pakupuma. Palinso kutopa kofulumira kwa malekezero, zochitika pang'onopang'ono. Kenako, kutukusira kwa manja ndi miyendo kukukulira.

Kuzindikira kumachepa pang'onopang'ono, kenako pakapita nthawi kumatha. Wodwalayo nthawi zambiri amadandaula za kukokana. Komanso, mukawunika, chimanga chimapezeka. Nthawi zambiri amapezeka zidendene, mbali zoyambirira ndi zachisanu. Ming'alu mawonekedwe pamenepo omwe samachiritsa kwa nthawi yayitali. Zilonda zamtundu wakuda kapena zofiirira zimatha kukhala m'malo mwake.

Ndi kupita patsogolo kwa njirayi, khungu la miyendo liuma, kupendaponso palinso mawonekedwe. Kusungunuka kumayamba m'dera lomwe lakhudzidwa. Cholinga cha dera lathu la gangrenous necrosis chikukula pang'onopang'ono. Mkhalidwe wofala kwa odwala matenda ashuga sasintha kwambiri.

Chithandizo cha matenda owuma minofu khungu necrosis mu shuga imaphatikizanso kuchotsa kwa pathological foci. Pambuyo pa izi, ndikofunikira kuchita kuvala ndi antiseptic othandizira mwanjira yothetsera, zonona kapena mafuta. Osati madera a necrosis okha omwe ayenera kuyatsidwa pamene chilonda chapanga. Ma tirigu amachotsedwa. Izi ndizofunikira kuti muchepetse katundu pamalo ovuta.

Polyneuropathy ya miyendo

Mkhalidwe uwu umadziwika ndi kugonjetsedwa kwa mitundu yayikulu ya ulusi wamanjenje. Pali malingaliro angapo omwe amafotokozera momwe njira zowonongeka zamitsempha zimayendera matenda ashuga. Yoyamba ndi metabolic. Malinga ndi iye, kuchuluka kwa glucose m'magazi kumapangitsa kuchepa kwa metabolism mu neurons. Chiphunzitso cham'mimba chimati chifukwa cha matenda ashuga angiopathy, ndiko kuti, zotupa zazing'onoting'ono, zakudya zamafuta am'mimba zimachepa. Poterepa, njala ya okosijeni yamitsempha yam'mphepete ndikuwonongeka kwawo kumachitika. Chiphunzitso cha diimmune chikufotokoza kuti maziko a kuwonongeka kwa mitsempha imachitika mu autoimmune.

Polyneuropathy miyendo yokhala ndi hyperglycemia amawonetsedwa ndi phazi la matenda ashuga. Zimadziwika ndi kutayika kwa pafupifupi mitundu yonse ya zomverera. Khungu limapendekeka, limayamba kuwonongeka. Masewera pang'onopang'ono amalondola.Kuti mumve zambiri, onani vidiyo iyi:

Mtima kulepheretsa atherosulinosis

Vutoli limawonedwa pafupipafupi kwa odwala omwe ali ndi matenda oopsa, onenepa kwambiri kapena osayenda pang'ono. Njirayi ikanyalanyazidwa, nthawi zambiri gangrene imachitika, nthawi zambiri imawuma. DM imayendera limodzi ndi kuwonjezeka kwa cholesterol chifukwa cha otsika osalimba a lipoprotein. Izi zimakwiyitsa kuphwanya mafuta kagayidwe kake ndi mawonekedwe a malo a atherosulinotic pamakhoma a mitsempha yamagazi.

Zilonda zam'mapapo nthawi zambiri zimamera ndi minyewa yolumikizana, kufalikira kwa kuunikira kwa chotengera kumachitika. Koma nthawi zambiri mumabweza cholesterol mumatuluka misempha. Nthawi yomweyo, minofu ya trophic imaphwanyidwa ndipo khungu limayamba kutengera mtundu wa ischemic (womwe nthawi zambiri umakhala wouma, koma wonyowa ukakhala ndi matenda.

Gangrene monga chifukwa cha matenda ashuga

Imfa yamatenda mu matendawa imayamba chifukwa cha kuchuluka kwa shuga. Metabolism imasokonezeka, kufalikira kwa cholesterol ndi kufalikira kwa lumen yamatumbo kumayamba. Kuwonongeka kwa glucose m'mitsempha kumayambitsa kuphwanya kwamphamvu kwa khungu, kotero kuti odwala matenda ashuga samalabadira abrasions, jakisoni ndi mabala am'magazi.

Gangrene amayamba ndi phazi la matenda ashuga. Pali magawo angapo a kukula kwake:

1. Gulu lowopsa kwambiri (madera omwe ali ndi hyperkeratosis, kuchepa kwamphamvu kwa khungu, kuuma m'dera lomwe lakhudzidwa).
2. Kulephera kopanda magazi mosavomerezeka ndi magazi abwinobwino kapena ochepetsedwa pang'ono.
3. Zilonda zakuya ndi zizindikiro za matenda popanda ischemia ndi kufalikira kwa minofu mafupa.
4. Athandizidwe ndi matenda, okhudza mafupa munthawi ya mapangidwe amitsempha.
5. Zopanda malire zocheperako.
6. Necrosis yamisempha yonse ya phazi.

Chifukwa chakuchepa kwa chitetezo chathupi, kukana kwa thupi kumavutika kwambiri. Chifukwa chake, pakulowerera mabala osachiritsika a microflora ya pathogenic, matenda amayamba msanga. Pankhaniyi, gangrene ndiowopsa pamoyo wamunthu. Muzochitika zotere, chithandizo cha necrosis popanda kudula sichingatheke.

Kuopsa kwa gangrene matenda ashuga

Matenda omwe amakula necrosis - amapha. Chifukwa chake, ngati mumadziwa momwe gangdom yam'munsi imayambira, kuwonongeka kungapewedwe. Mawonetsero oyamba kumene ndi nthawi yolumikizana ndi dokotala.

Zofunika! Ngati mukusowa mwayi wokonzanso magazi mwanjira yabwinobwino komanso malo okhala m'munsi, kukula kwa matenda osokoneza bongo sikungasinthe.

Kusakhazikika kwakanthawi kwa shuga m'magazi, komanso chithandizo chokwanira cha matendawa kumapangitsa mwayi wopewa zovuta. Ngati matenda owuma adakalipo, muyenera kukaonana ndi dokotala. Adzakulemberani mankhwala ofunikira ndikuwunika kuchuluka kwa opaleshoni: kudula kapena kudula foci ya necrosis.

Ndi kukula kwa chonyowa mawonekedwe a matenda, chithandizo chimakhala kumadulidwa. Mukanyalanyaza malangizo a madokotala, nthendayi yoopsa ya magazi ndi ziwalo zimatheka. Zotsatira zam'mimba zoterezi zimatha kudwala matenda ashuga.

Kuzindikira kwakanthawi zamankhwala kumathandizira kupewa kutulutsa zotsatira zoyipa. Koma izi zimangotengera kuti wodwalayo azitsatira malangizo onse a dotolo komanso kuti athe kuthandizanso wodwalayo. Simungathe kuchitira ena pawokha mothandizidwa ndi wowerengeka azitsamba ndi kukonzekera kwa homeopathy. Komanso, odwala ayenera kulabadira chifukwa chopewa zovuta za matenda akulu - matenda ashuga. Kuti mumve zambiri, onani vidiyo iyi:

Zambiri

Gangrene ndi necrosis yakomweko ya gawo la thupi la chamoyo. Zimayambitsa kulumala. Pankhani yonyowa necrosis, imakhala chifukwa cha kuledzera kwa thupi ndi zinthu zosweka matupi. Matenda a shuga a matenda ashuga ndi mtundu wovuta kwambiri wa matenda amwala a matenda ashuga.Pa chiopsezo chotenga matenda amtunduwu ndi pafupifupi 35-40% ya odwala matenda a shuga, chizindikiro cha mliri ndi 3.5-8,5%. Ndi matenda amtundu wa 1 shuga, mwayi wodwala matenda opatsirana umakulirakulira patadutsa zaka zisanu ndi ziwiri kuchokera pamene matendawa adayamba, matenda amtunduwu, chiopsezo cha mavutowa chilipo kuyambira matenda atangoyamba kumene. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amadwala matenda osokoneza bongo kangapo kangapo kwa anthu odwala matenda ashuga a mtundu woyamba. 8-12% ya odwala omwe ali ndi chitsimikiziro chotsimikizika amafunika kudulidwa.

Chochita chofunikira chazachilengedwe ndi njira yoopsa ya matenda ashuga. Kuchepa kwa shuga kwa glucose kumayambitsa kusintha kwamasamba, minyewa ndi mitsempha yomwe imatsogolera kukula kwa gangrene. Zoyambirira komanso zachiwiri zomwe zimapangitsa kuti matenda ashuga azikhala motere:

• Matenda a shuga. Hyperglycemia yomwe imatenga nthawi yayitali imayambitsa mavuto a minyewa komanso minyewa. Mitsempha imapangidwa motsutsana ndi maziko osakwanira kwa magazi, minyewa ya m'magazi, komanso kuchepa kwamphamvu.
• Zofooka kumapazi. Kuyenda mosalumikizika kophatikizidwa, kugawidwa kosagwirizana kwamiyendo kumapazi, kuchuluka kwambiri kwa magawo ake kumayambitsa kuphwanya minofu yamatumbo ndi kuwonongeka kwa phazi. Zilonda, ming'alu ndi zilonda zam'mimba zimapezeka, m'dera lomwe zigawo za necrosis zimapangidwa.
• Matenda osakwanira. Kuchepa kwa zida zamagetsi zoteteza thupi zimadziwika. Odwala amakhala pachiwopsezo cha khungu kuwonongeka mwangozi, matenda a mabala.
• Matenda onga. Matendawa amapezeka kawirikawiri kwa odwala omwe ali ndi matenda a mtima ndi kwamikodzo. Gulu lachiwopsezo limaphatikizapo okalamba omwe ali ndi nephropathy yayikulu, mtima komanso venous kuchepa, onenepa kwambiri.
• Zachuma. Mavuto a shuga nthawi zambiri amayamba chifukwa chotsatira odwala pang'ono pang'ono - kusiyana pakati pa machitidwe awo ndi malingaliro ndi malangizo a endocrinologist. Zina mwazomwe zimapangitsa kuti chisamaliro chachipatala chisamachitike komanso moyo wopanda tanthauzo.

Njira zopititsa patsogolo gangore zimaphatikizapo zotumphukira neuropathy, angiopathy ndi mapindikidwe a mapazi ndi mapangidwe madera a kuthamanga. The pathogenetic maziko a gangrene ndi kuzungulira kwa matenda. Hyperglycemia imayambitsa kusintha kwamachitidwe ndi kachitidwe kazinthu zazikulu ndi zazing'ono. Nembanemba ya capillary imakulitsa, kufinya, kusankha kusefa ndi kusinthanitsa kwa zakumwa kumasokonezeka. Zakudya zamagulu ndi okosijeni sizilowa mulingo woyenera, zinthu za metabolic zimadziunjikira mu minofu.

Kapangidwe ka ma atherosselotic plaques kumabweretsa kuchepetsedwa kapena kutsekeka kwa lumen ya mitsempha yayikulu komanso yaying'ono. Potengera maziko awa, zosintha zowonongeka zimapangidwa, njira za necrotic zimayambitsidwa. Pophwanya zakudya ndi kupatsa mpweya, maselo amafa. Ngati izi zimachitika pang'onopang'ono, kukula kwa khungu louma kumatha - minofuyo imakhala ndi madzi, kupukutidwa. Zomwe zimayambitsa chonyansa cham'mimba ndizomwe zimafa maselo atayamba kuvunda. Kuwonongeka kwa minofu kumachitika mchikakamizo cha mabakiteriya, pamakhala kudzikundikira kwa mafinya ndi mipweya.

Zizindikiro za matenda a shuga

Dry gangrene imachitika pang'onopang'ono ndikupanga matenda otaya magazi. Malo ochepa a minyewa amakhudzidwa, kufalikira kwa necrosis sikumayambitsa. Pa siteji ya ischemia, ululu waukulu umamveka pang'onopang'ono kufalikira kwa chotengera. Khungu limasunthira, limakhala ngati mabulosi. Kutentha kwa mwendo womwe wakhudzidwa kumachepetsedwa, kuwonongeka kwa kumvekera kumadziwika, kumeza, kuyabwa, kuyaka ndikotheka. Mu minofu yathanzi yolumikizana ndi chidwi cha necrosis, njira yotupa imayamba ndi kuchuluka kwambiri. Zotsatira zake, mzere wa malire umapangidwa - malire akumalire a kutupa kwapachimake.

Chifukwa cha edema kudera lotayirira, ululu wammbuyo umakhalapo kwa nthawi yayitali. Mitundu ina ya zomverera m'madipatimenti oyambira amatayika kwathunthu. Dera lomwe lakhudzidwalo ndi lakuda, lamtambo kapena lamtambo wakuda. Necrosis amafalikira kuchokera kufumbi kupita kuderalo ndi magazi abwinobwino, ndiye njira yake imatha. Minofu ya Necrotic pamalire a demarcation imafewetsa ndipo m'malo mwake ndi minofu ya granulation, khungu limapangika pang'onopang'ono. Nthawi zina kukana kwamtundu wakufa kumachitika. Mitundu yakufa ya minofu, koma siyingokhala, motero odwala amamva kukhala okhutira, zizindikilo za kuledzera zilibe.

Mawonetsedwe oyamba amadzimadzi akunyowa ndikubala khungu, mapangidwe a mawanga ndi ma vesicles amadzimadzi a sucrose. Dera lomwe lakhudzidwalo ndi lozizira kukhudza, kumva kulibe kapena kuchepetsedwa kwambiri, mitsempha imachepa. Edema ikupita patsogolo mwachangu, malire pakati pa madera omwe akukhudzidwa komanso athanzi sanatsimikizidwe, necrosis imafalikira pakuwongolera. Zovunda zowola zimakhala ndi mawonekedwe onunkhira komanso fungo lokhumudwitsa. Mtundu - kuchokera imvi mpaka wakuda wakuda. Pakukweza, kumamveka mawu ofanana ndi kulira kwa likhwangwa. Zizindikiro za kuledzera kwakukulu kumawonjezera: kutentha kwambiri kwa thupi, ulesi, ulesi, mutu, nseru, kusanza.

Matenda a shuga a Matendawa

Chithandizo chimachitika kuchipatala cha opaleshoni. Mankhwala ochepetsa shuga a shuga amasinthidwa ndi insulin, kusintha kwamankhwala kumachitika kuti boma liperekenso chipukuta misozi. Amachita zochitika zina zomwe zimapangisa kuti magwiritsidwe ntchito a mitsempha yamagazi ndi mtima, kuthetsa kuledzera, ndikuwonjezera ntchito ya chitetezo chathupi. Monga gawo la mankhwala okhazikika, mankhwala amagwiritsidwa ntchito omwe amasintha magazi (angioprotectors, ma microcirculation fixors), amasungunuka magazi (otulutsa anticoagulants), ndikuthandizira ma spasms (antispasmodics).

Kuti achulukitse kuthamanga kwa magazi, okodzetsa, olimbana ndi calcium, othandizira ma ACE, opanga ma beta-blockers amalowetsedwa mu pulogalamu ya chithandizo. Povomerezeka, maantibayotiki ambiri amathandizidwa, ndipo pambuyo pake mankhwala opha maantibayotiki amasinthidwa poganizira momwe matendawa akumvera. Odwala ambiri amatenga magazi, kulowetsedwa kwa njira zowongolera matenda, kagayidwe kachakudya. Makoko ndi mipando yamagudumu amagwiritsidwa ntchito kumasula phazi lomwe lakhudzidwa.

Mu malo owuma kwambiri, kasamalidwe koyeserera kasonyezedwa. Chitani zovala, minofu yakufa zikafika zizindikiro zakusiyanitsidwa ndikuvala. Gwiritsani ntchito ndalama zakwanuko kuyeretsa bala, kudzetsa epithelization. Ndi chonyowa gangrene chifukwa cha kuledzera komanso kuopsa kwa kufalikira kwa necrosis, chithandizo cha opaleshoni chimachitika pambuyo pakupanga kwa mzere wa demarcation. Kuti mudziwe momwe ntchitoyi ikuyendera, nthambiyo imakutidwa ndi thovu;

Kusintha kwa minofu yakufa nthawi zambiri kumachitika masiku atatu pambuyo poti mwalandira. Necrotomy yotheka, necenessomy komanso kudula mwendo. Cholinga cha necrotomy (kugawanika kwa minofu) ndikuwona malire a necrosis, kuchepetsa kukula kwa purulent-yotupa, komanso kuthana ndi kuledzera. Necrectomy (kuchotsa minofu yosagwira) imachitidwa m'malo ochepa a necrosis. Mtsogolomo, kuvala kumayendetsedwa, kumatsuka pambuyo pakuyeretsa bala malinga ndi mawonekedwe, autodermoplasty ndi maluso ena amagwiritsidwa ntchito kutseka chilema. Ndi necrosis yayikulu yowonjezera ndikuwopseza kwa njirayi kufalikira m'madipatimenti opindulitsa, kudula ndikofunikira.

Mu nthawi yakutali, posagwirizana ndi zoyipa, njira zomwe zimakonzedweratu kuti magazi abwezeretse magazi ndikuletsa kukonzanso kwa gangrene kumachitika.Maopaleshoni achilendo kwambiri omwe safunika nthawi yayitali yokonzanso amagwiritsidwa ntchito. Mtundu wa njirayi umatsimikiziridwa payekhapayekha. Mwina kulumikizana kwa zotumphukira mitsempha, zotumphukira kwamitsempha, kusintha kwa mitsempha.

Zotsogola ndi kupewa

Dry gangrene imawonedwa ngati njira yosinthira mwadongosolo, kuchuluka kwa thandizo la miyendo yolakwika kumadalira kukula kwa njirayi. Mwa anthu omwe ali ndi chonyansa, matendawa amakhala osavomerezeka zonse pokhudzana ndi kutetezedwa kwa ziwalo ndi ziwalo. Choyambitsa imfayo ikhoza kukhala pempho laposachedwa la chithandizo chamankhwala, kufalikira kwa purulent-necrotic process to the proximal nthambi, sepsis, kuwonongeka kwa ziwalo zamkati motsutsana ndi maziko a kuledzera kwakukulu. Kupewa kumatengera chithandizo chokwanira cha matenda ashuga. Ndikofunikira kutsatira mosamalitsa malangizo onse a dotolo, kuphatikiza kumwa mankhwala, kutsata zakudya zamagulu ochepa komanso machitidwe olimbitsa thupi. Ndikofunikira kusiya zizolowezi zoyipa zomwe zimathandizira kukulitsa kwa atherosulinosis (kusuta, kumwa mowa ndi zakudya zamafuta), pewani mabala mwangozi, sankhani nsapato za mafupa ndikuwonetsetsa kuyera mkati, nthawi zonse muziyesetsa kukonza ukhondo.