Izinkinga zesifo sikashukela zivame ukubonakaliswa ukuphazamiseka kwemithambo yegazi kanye nemithambo ethinta imikhawulo engezansi. Ngakho-ke, kunconywa ukuthi zonke iziguli ezinesifo sikashukela zihlole izinyawo nemilenze ephansi nsuku zonke, ukuze zingaphuthelwa ukubonakaliswa kokuqala kwe-neuropathy yesifo sikashukela.
Noma yiziphi izimpawu ezisesimweni sokubomvu, umuzwa okhubazekile noma ukulimala okuncane kungaba uphawu lokuthuthuka kwesifo esibi kangako njengezinyawo zesifo sikashukela.
Ngokwezibalo, kwenzeka ku-15% wesifo sikashukela ngemuva kweminyaka engu-5-6 yokugula.
Ngokunxeshezelwa okungafanele kwesifo sikashukela, ukutheleleka nge-purulent kujoyina i-polyneuropathy, futhi i-gangrene nayo ingaqala ukukhula, okubangela isidingo sokunqunywa.
Emhlabeni, ama-70% ukunqunywa kuhlotshaniswa nesifo sikashukela sesifo sikashukela.
Izimbangela zesifo sikashukela i-neuropathy
Ukulimala emithanjeni yemilenze kwisifo sikashukela kuhlotshaniswa nokwanda kwe-glucose egazini, okungenakungena emangqamuzaneni ngenxa yokushoda kwe-insulin. Ukuhamba kwegazi emithanjeni kuyancipha, ukuhanjiswa kwethonya lezinzwa kuvinjelwe. Ezimweni zokubuthakathaka okubuthakathaka kanye nokudla okuncishisiwe, ukuzwela kwezicubu kuyahlupheka, ukuphulukiswa kwenxeba kuncipha.
Izilonda ezincane zesikhumba ngendlela yokuqhekeka, ukusikeka noma ukuhlukunyezwa ziphenduka iziphazamiso ezivulekile zesilonda, nezilonda ezifihliwe zakhiwa ngaphansi kongqimba lwe-epithelium keratinized. Konke lokhu ngeke kuqashelwe yiziguli, ngoba akubangeli usizi ekuzweleni okuphansi. Imvamisa, izilonda zakha ezindaweni zokuxineka okwandayo okwenzeka lapho uhamba.
Ukulimala okunjalo kungabhebhetheka ngokugqoka izicathulo eziqinile, ukwanda kwesikhumba esomile nokuqina kwe-stratum corneum, uma ilimele ngesikhathi sokuhamba ngezinyawo noma ngokuhamba ngezinyawo.
Ukuqhekeka komthambo wegazi kuhlotshaniswa nokubekwa kwe-cholesterol ne-calcium, okwenza kube yi-atherossteotic plaque. Izinguquko ezinjalo kwisifo sikashukela zinezici eziningana zomtholampilo:
- Isilonda senzeka ezingxenyeni ezingezansi zamaphethelo aphansi - onyaweni nasemlenzeni ophansi.
- Yomibili imilenze ihlupheka ezindaweni eziningana.
- Kusukela ngisemncane kakhulu kuneziguli ezingenaso isifo sikashukela.
- Ngokuhambisana nokufa kwezicubu
- Izilonda zingavela ngaphandle kokulimala nengcindezi yemishini.
Izimpawu zokulimala emlenzeni kushukela
Isikhumba seziguli ezinesifo sikashukela i-mellitus somile futhi mncane, zivame ukulimala, ikakhulukazi endaweni yomunwe. Indlela yokuqalwa kokuqalwa kwezilonda zemithambo yegazi kanye ne-vascular kungaba izifo ezithathwa fungal, a pedicure rough noma i-upasuaji ukususwa kwezipikili ezifakiwe.
Kusukela ukwakheka konyawo lwesifo sikashukela kunemiphumela emibi kakhulu ngendlela yokuqunjelwa umlenze noma ukufa kwe-sepsis, okwavela ngenxa yokuxakanana kwe-purulent, ukuhlonza izimpawu zokuqala zokulimala kwonyawo lwesifo sikashukela kungasindisa impilo yesiguli.
Isibonakaliso sokuqala nje sokwehla kokuzwela kokudlidliza, lapho-ke izinga lokushisa, ubuhlungu kanye ne-tactile kwephulwa kamuva. Isimpawu eshaqisayo kungenzeka ukuthi sivuvukala emlenzeni ngezansi kwthole, endaweni yezinyawo. Uma imilenze ivutha noma ibanda, khona-ke lokhu kusho ukuthi ukuhamba kwegazi kuyaphazamiseka noma ukutheleleka kuhlanganile.
Isizathu sokuthintana nodokotela ohlinzayo noma udokotela wezimpawu zempilo kungenzeka sibe yilezi zinguquko ezilandelayo:
- Ukukhathala lapho kuhamba.
- Kukhona izinhlungu emilenzeni yamandla ahlukahlukene lapho uhamba noma ebusuku.
- Ukuqina, umuzwa ovuthayo uvele ezinyaweni, futhi ubumsulwa banda.
- Umbala wesikhumba emilenzeni ubomvu noma i-cyanotic.
- I-hairline emilenzeni inciphile.
- Izzipikili zaba lukhuni, zakhubazeka, zaphuzi.
- Kuqhume izimbali ngaphansi kwepuleti lesipikili.
- Umunwe wavele wabomvu noma wavuvukala.
Iziguli zingabona futhi ukuthi amanxeba noma ama-callus ayaphola esikhundleni seviki kungakapheli inyanga noma ezimbili. Ngemuva kokuqinisa amanxeba, uphawu olumnyama luhlala.
Izilonda zingavela ezinyaweni, kwesinye isikhathi zijule impela.
Izinhlobo ze-Diabetesic Foot
Izindlela ezintathu zesifo sikashukela sonyawo zihlukaniswa ngokuya ngobungozi bokuphazamiseka kwe-innervation noma ukuphakelwa kwegazi. Ngokuntuleka kokusebenza kahle kumaseli wezinzwa, kuvela uhlobo lwe-neuropathic. Isici esinegalelo lakhe kuye ukuzimisela okulula kokuzulazula kwe-arterial. I-edema emisiwe futhi ephikelelayo ivela emilenzeni.
Izinyawo ngalolu hlobo zifudumele, umbala wesikhumba uvamile noma uphuzi kancane, isilonda sitholakala (njengasesithombeni) endaweni yomthwalo owengeziwe - endaweni yamathambo we-metatarsal. I-Pain syndrome imnene. Isilonda simanzi, imiphetho iminyene. Ngokuvamile kuthinta abantu abasha abanesifo sikashukela sohlobo loku-1, ukuphuza kabi utshwala kungaba yinto ebabazekayo.
Ubomvu bemilenze kwisifo sikashukela i-mellitus esithombeni kungaba wuphawu lwendlela ye-ischemic ye-polyneuropathy, lapho ukuphazamiseka kokujikeleza kwezimpawu kunquma izimpawu zonyawo lwesifo sikashukela.
Nale nketho, imilenze ibanda, ukushaya kunzima ukukuthola, izinyawo zingaba mnyama.
Isilonda sitholakala ezindaweni ezisetshenziswa kakhulu igazi - izithende, unqenqema lwangaphandle lonyawo, nesithupha. Isikhumba esizungeze isilonda mncane. Ngasikhathi sinye, iziguli ziphazanyiswa yizinhlungu ukuphumula, kubi kakhulu ebusuku, futhi lapho zihamba, zivame ukuphoqelelwa ukuba zime ngenxa yobuhlungu obukhulu.
Ifomu elixubekile livame ukutholakala ezigulini ezinesifo sikashukela, lihlanganisa nezimpawu ze-ischemia nokuphazamiseka kwemizwa. Izici zobungozi zokuthuthukisa unyawo lwesifo sikashukela yilezi:
- Isikhathi sikashukela singaphezu kweminyaka eyi-10.
- Isifo sikashukela esingakhokhelwe noma esingasebenzi.
- Ukubhema.
- Iziguli ezihlaselwe yinhliziyo noma isifo sohlangothi.
- Ukusebenzisa kabi utshwala.
- Ngomkhuba wokwakha izingcezu zegazi.
- Ukukhuluphala Okukhulu.
- Isifo se-Varicose.
Ukuxilongwa nokwelashwa kwe-neuropathy yesifo sikashukela
Ukuxilonga izinga le-lesion, iziguli zivivinywa ngokuphelele: ukuhlolwa kwegazi ngokuhlaziywa kwe-glucose nokuhlolwa kwe-biochemical, ukuzimisela komsebenzi wezinso, i-x-ray kanye nezifundo ze-angiographic. Udokotela oyi-neuropathologist uhlola ukuphepha kokukhishwa nokuzwela kobuhlungu, ukuthinta, ukudlidliza nokushisa.
Ukunquma ukuhamba kwegazi, i-dopplerometry yenziwa, ingcindezi emithanjeni yemilenze ilinganiswa. Lapho kukhona isilonda, isiko le-microflora kanye nokuzwela izidakamizwa ze-antibacterial kuthathwa.
Ukwelashwa ngonyawo sikashukela kuqala ngokulungisa amazinga eglucose egazini ukuze abhekise amazinga. Uma isiguli sithola amaphilisi okunciphisa ushukela, khona-ke sidluliselwa ngokuphelele ku-insulin noma ukwethulwa kwemithi yesikhathi eside ye-insulin kanye nemithi elwa namagciwane.
Ukususa i-pain syndrome ku-polyneuropathy yesifo sikashukela kwenziwa ngale mithi elandelayo:
- Ama-anticonvulsants (Finlepsin, Gabalept).
- Ama-Painkiller (Dexalgin, Nimesulide).
- Ama-antidepressants (venlafaxine, clofranil).
- Cream nge-lidocaine.
Ukwelashwa ngamalungiselelo we-thioctic acid (Thiogamma, Berlition), kanye nemijovo yama-B e-B (Milgamma, Neurobion) kusiza ukubuyisela ukuzwela kwezicubu futhi kusheshise ukuphulukiswa kokulimala kwezilonda. I-dipyridamole, i-Actovegin, iPentoxifylline isetshenziselwa ukwenza ngcono ukuhamba kwegazi.
Ngaphezu kwalokho, izilonda ziyelashwa, kanti nomlenze owuthintekile uyalayishwa. Izilonda emlenzeni ongezansi, kufanele uzame ukuba sendaweni evundlile kaningi. Kusetshenziswa namadivayisi akhethekile wamathambo ukukhulula umthwalo onyaweni. Empini yokulwa nalesi sifo, i-physiotherapy yesifo sikashukela mellitus ekwelashweni okuyinkimbinkimbi inikeza imiphumela emihle.
Lapho ukutheleleka kunamathiselwe, ukwelashwa ngama-antibiotic kunqunywa isikhathi eside ngaphambi kokulashwa kwesilonda.
Ukwelashwa okujulile kwenziwa futhi ukwelapha izifo ezenza kube nzima ukuthola iziguli: i-anemia, ukulimala kwezinso, nesibindi.
Ukuvimbela i-polyneuropathy
Esigulini esinesifo sikashukela, ukuhlolwa komlenze ngesikhathi senqubo yokuhlanzeka yansuku zonke kuyindlela ebalulekile yokuvimbela izinkinga ze-neuropathy. Zonke izilonda noma ukusikeka zidinga ukwelashwa nge-Miramistin noma i-Chlorhexidine, isisombululo esinamanzi se-furacilin. Musa ukusebenzisa izixazululo eziqukethe utshwala.
Ukwelapha izilonda, kusetshenziswa uSolcoseryl, Actovegin, ijeli ye-Iruksol. Lapho wenza i-pedicure, awukwazi ukusebenzisa amablawu, kungcono ukusebenzisa amasu wehadiwe. Izinyawo kufanele zigcotshwe ngo-ayisikhilimu wezingane ukuvimbela ukoma noma okokugcoba okhethekile kwabanesifo sikashukela: Balzamed, Alpresan.
Lapho ufaka izicathulo, udinga ukuyihlola ukuze ithembeke ngobuhle be-insoles, ukungabikho kwamatshe amatshe, imigqa enzima noma izibazi ezingalimaza isikhumba sonyawo. Izicathulo kufanele zihambisane nosayizi nokuphakama kwephakethe. Kulokhu, awukwazi ukusebenzisa amasokisi amancane, uthambisa iminwe. Isilayidi esinezithende ezivalekile nezinzwani kukhethwa ukugqokwa kwasekhaya.
Izindlela ezilandelayo zokuvimbela ukuthuthukiswa konyawo lwesifo sikashukela nazo ziyanconywa:
- Ukuqeda ngokuphelele ukubhema notshwala.
- Akukho okweqile kwemilenze okufanele kuvunyelwe.
- Lapho ubamba izinyawo zokugeza zonyawo, izinga lokushisa lazo kufanele libe ngama-degrees angama-36.
- Ngokungaboni kahle, awukwazi ukuzisika ngokwakho izipikili.
- Akunconywa ukuhamba ngezinyawo ezingenazo izicathulo, ngisho nasekhaya.
- Musa ukusebenzisa ukufudumala pads, amabhethri, noma hita ukufudumeza izinyawo zakho.
Indlela enkulu yokuvikela zonke izinkinga zesifo sikashukela ukuqapha ushukela wegazi. Ukuze wenze lokhu, udinga ukusebenzisa idivaysi yokulinganisa ushukela egazini nsuku zonke futhi kanye njalo ezinyangeni ezintathu ukuthola izinga le-hemoglobin ye-glycated futhi uvakashele i-endocrinologist ukuyolungisa ukwelashwa. Ukubonisana nodokotela wezingane nodokotela oyi-neurologist kunconywa okungenani kanye ngonyaka.
Ividiyo ekule ndatshana inemininingwane yesifo sikashukela sikashukela.
