Imvamisa kwisifo sikashukela i-mellitus, ukuthuthukiswa kwezifo ezibangelwa ukubonwa kuyabonakala, imbangela yazo ukuphazamiseka emzimbeni okubangelwa yi-hyperglycemia. Ukwehluleka ukuhambisana nemiyalelo yezokwelashwa, kanye nesifo sikashukela esibuhlungu, kungakha izilonda, ikakhulukazi emilenzeni. Izilonda zesifo sikashukela noma ezinde kakhulu zivame kakhulu. Ukwelapha amanxeba wesilonda esiseduze nesifo sikashukela cishe akunakwenzeka. Isisulu sidinga ukungenelela kwezokwelashwa nokuhlinzwa.
Isici
I-Trophic ulcer ifaka ukulimala okujulile kungqimba lwe-epithelial yesikhumba nazo zonke izicubu ezingaphansi. Imvamisa lesi sifo sihambisana nezinqubo zokuvuvukala ezenziwa ngenxa yokunamathiselwa kwegciwane lesibili.
Izilonda ngamanxeba amanzi, abonakala ngobubanzi obukhulu bomgodi, indawo enkulu yomonakalo wezicubu ezizungeze isilonda, kunokuqhuma kwegazi njalo kanye nokuhlukaniswa kwepus enephunga lomlingiswa.
Lesi sifo sinikezwa ikhodi ngokuya nge-ICD-10, sikhuluma ngezilonda zesikhumba ezingamahlalakhona ezingadalulwa kwenye indawo futhi zinikezwe inombolo iL98.4.2.
Izimbangela zezilonda ezindexekile zihlanganisa:
- isifo sikashukela se-neuropathy;
- isifo sikashukela i-angiopathy;
- ukulimala komshini kumabele;
- ukucekelwa phansi kwezindonga zemithambo yegazi;
- i-pathology ye-carbohydrate metabolism;
- izicubu i-hypoxia evela kwizifo ezihambisana nokugeleza kwegazi okungenampilo;
- imiphumela eyingozi yobuthi eyenziwe ngenxa yokuqubuka kwemithi, ukuhoxa kwayo akuzange kwenzeke ngenxa yesimo sesifundo sikashukela.
Isifo sikashukela i-mellitus yisimo somzimba lapho kukhona khona njalo egazini senani elikhulu le-glucose, ngenxa yokuphazamiseka kwe-metabolic. I-glucose nokuchayeka isikhathi eside esimweni esingagugi iqala ukuthinta kabi ukuphela kwezinzwa namaseli wegazi. Esimweni sokuqala, i-neuropathy iba, okwesibili - i-angiopathy. Imvamisa, lapho kungekho khona ukwelashwa okufanele kwesifo sikashukela, owokuqala nowesibili abonakale ngasikhathi sinye. Yilezi zimo ze-pathological eziyimbangela yokuphazamiseka okubangela ngokungaqondile isilonda se-trophic.
Amanxeba omlenze awakhiwa ngokushesha, afakwa izibonakaliso zokuqala zokuphazamiseka kwegazi lokuhamba kwegazi - ukusinda emilenzeni, i-cyanosis, ukuvuvukala.
Ngemuva kwalokho i-eczema, i-lymphostasis iyavela, ukubukeka kwesikhumba selungu kuyashintsha, futhi ngomonakalo omncane, kuqalwa ukwakhiwa isilonda. Okokuqala, kubhubhisa izingqimba ezingaphezulu zesikhumba futhi kukhule ububanzi, khona-ke inqubo yokubhujiswa kwezicubu ezingaphansi iyaqala.
Izilonda zesifo sikashukela zibonakala ngezimpawu ezilandelayo:
- Ungaziphilisi ngokwabo;
- lapho sisuswa ngomuthi noma ngokuhlinzwa, izibazi ezijulile nezibazi zihlala kusayithi lamanxeba;
- ukubanda kwezitho ezinyaweni zokuqala zokuthuthuka ngenxa yokufa kokuphela kwezinzwa kutholakala emaphethelweni aphansi;
- izinhlungu ezikhathaza isiguli ikakhulukazi ebusuku;
- kuholele ebhuqwini, bese ukunqunywa komlenze lapho kungekho ukwelashwa okufika ngesikhathi.
Izilonda zihlukaniswe ngezinhlobo ngokuya ngosayizi wemikhumbi (ama-capillaries, i-veins, imithambo yegazi), i-dystrophy yayo eyenze yavela.
Kuqala, imbangela yesilonda esiyisidlakudla yisimo sengqondo sokunganaki sesiguli empilweni yakhe nokungazinaki imiyalo kadokotela obakhona mayelana nendlela yokuphila efanelekile kanye nemigomo yokudla. Ukugcinwa isikhathi eside sikashukela segazi oluphezulu kuphela okuholela emiphumeleni enjalo.
Ukwelashwa
Ukwelashwa kwezilonda ezinesifo sikashukela kuya ngesifo esiqinile, kepha ezimweni eziningi kuthatha isikhathi esiningi futhi kuthwala kanzima.
Izindlela zokwelapha zenziwa ngezigaba ezi-3, ezivumela ukwelapha lesi sifo hhayi ngokuphelele, kodwa ngokulandelana, okusebenzayo kakhulu ezimweni zokulimala kwezicubu ezijulile.
Isigaba sokuqala
Kubalulekile ukufiphaza izinto ezikhulayo futhi uthole isimo esihle somphumela omuhle wokwelashwa.
- bambelela emigomweni yokudla kwabanesifo sikashukela, qapha amazinga kashukela wegazi, ukuvimbela ukwanda kwawo;
- ukuhlinzeka isiguli ukuthula nokungasebenzi (izilonda ezisekupheleni kwezinyawo ziyahlukumezeka, ngenxa yalokho zipholisa kancane);
- qinisa amazinga kashukela ngemithi, uma kunesidingo;
- bona imbangela yalesi sifo bese uqala ukwelashwa okungathathi hlangothi;
- buyisela esimweni sokujikeleza kwegazi.
Ngaphezu kwalokho, kuyadingeka ukusebenzisa izindlela zokwelapha zasendaweni:
- ukugeza isilonda ngama-antiseptic agents;
- ukuhlanza isilonda kusuka ebusheni, egazini, kulesisiga;
- ukubekelwa indawo yezilonda;
- Ukuvimbela ukungcola noma izinto zangaphandle ukuthi zingangeni esilondeni.
Isigaba sesibili
Ngemuva kokusebenzisa zonke lezi zinyathelo, isimo sesiguli kufanele sizinze. Lokhu kuvezwe ekunciphiseni kobuhlungu, kanye nasekuthuthukiseni ukubukeka kwesilonda - akusakhuphuki ngosayizi, imiphetho iba bushelelezi futhi ipinki, ubomvu kanye nonina wegazi ayeke ukubonakala.
Uma lokhu kwenzeka, khona-ke ukwelashwa kuyangiyala futhi kugxile ekusebenziseni izidakamizwa zokupholisa inxeba, izidakamizwa ezikhuthaza ukwanda kabusha kwesikhumba. Kubalulekile ukuqhubeka usebenzisa izidakamizwa ezilwa nokuvuvukala kanye ne-antiseptic ngomlomo nangaphezulu. Ngaphezu kwalokho, ukwelashwa kokudla kumele kulandelwe ngokunemba.
Uma kwenzeka kubonwa izimpawu zokutheleleka, imiphetho yesilonda ivuvukala, kuvela isikhumba esinzima sesikhumba esiseduze kwesilonda, ubukhulu bayo bukhuphuka futhi ukulunywa kanye nokushiswa kuyangezwa ebuhlungwini, lokhu kuwuphawu lokuthi izilonda eziyinqaba zemikhawulo engezansi zivele ngenxa yokutheleleka kokujoyina isilonda sokuqala.
Kulesi sigaba, kuyadingeka ukuqala ukuthatha izidakamizwa ezilwa namagciwane nezidakamizwa ezisimamisa futhi zivikele amathumbu kanye ne-mucous microflora (Linex). Le mishanguzo izosiza ukuqeda ukutheleleka, futhi lapho imbangela iqedwa, lesi sifo sizoqala ukuhlehla.
Uma izinqubo ze-necrotic zenzekile, khona-ke ukungenelela kokuhlinzwa kuyadingeka. Kubalulekile ukususa izicubu ezifike ngesikhathi ukuze uvikele ukuqala kwe-gangrene, okungaholela ekutheni unqunywe.
Isigaba sokugcina nokuvimbela
Esigabeni sokugcina, kunconyelwa ukuqhubeka nokwelapha amanxeba, uthathe amavithamini nama-immunomodulators ukuqinisa ukuzivikela kwemvelo komzimba emiphumeleni yegciwane kanye ne-bacteriological. IPhysotherapy ingasetshenziswa ukubuyisa ukuqina kwesikhumba nombala onempilo.
Ngokuvimbela lesi sifo, udinga ukulandela izeluleko ezilula:
- ukuthola isikhathi ukwanda koshukela wegazi futhi uthathe izinyathelo zokunciphisa izinga lawo;
- kuncike ngesikhathi esifanele ukwelashwa okudingekile kwemithambo ye-varicose;
- khawulela ukusebenza komzimba okusebenzayo okuhambisana nokuxineka okuhlala isikhathi eside kwamanani asemaphethelweni aphansi;
- vimbela ukweqisa noma ukugcwala ngokweqile kwemikhawulo engezansi, ukwehla kwezinga lokushisa kuzodala ukuqala kwezinqubo ezonakalisayo emikhunjini entekenteke;
- vimbela ama-microtrauma noma ama-abrasions amancane ebusweni besikhumba emilenzeni, ngokubheka ukuthi kungaba yisigaba sokuqala ekwakhiweni kwezilonda ezisesimweni esibuhlungu;
- sebenzisa izicathulo zamathambo ukuqinisekisa ukuthi okwenzeka ngokwejwayelekile ukuhamba kwegazi emikhawulweni ephansi.
Nge-hyperglycemia enzima, kubaluleke kakhulu ukubheka impilo yakho futhi ulandele zonke izincomo ze-endocrinologist. Umphumela onzima kangako njengesilonda sethrophic iba isibonakaliso sokuthi indlela yenkambo yesifo isibe yinkimbinkimbi futhi ijulile. Yini futhi kanjani ukwelashwa isilonda trophic in sikashukela mellitus uzotshela udokotela obekhona. Ukuzelapha kwalesi sifo akuvunyelwe, ngenxa yengozi ekhuphukayo ye-gangrene. Amakhambi we-Folk awavunyelwe ukusetshenziswa, kepha kuphela ngokuhambisana nokwelashwa kwezidakamizwa.
