Isifo sikanyawo sikashukela siyinkimbinkimbi yezinguquko ze-pathological ezicutshini zemilenze. Izandla ziyahlupheka ngenxa yokuxineka okukhulu koshukela egazini. Ukwelashwa ngonyawo lwesifo sikashukela kuya ngokuthi ukuhlangana kwezenzo nodokotela wamathambo, i-endocrinologist nabanye odokotela abakhethekile.
Isifo sikashukela ukugula okungalapheki okuhambisana nezinkinga eziningi. Isifo sikashukela sonyawo singenye yazo. I-Pathology ivame ukuholela ekwakhiweni kwezinqubo ze-necrotic, gangrene kanye nokunqunywa.
Cishe i-85% yamacala angama-thumba, i-osteomyelitis, i-phlegmon, isifo samathambo esihlanzekile, ne-tendovaginitis. Lokhu kufaka phakathi isifo sikashukela se-osteoarthropathy.
Izimbangela zeSifo Sikashukela Sikashukela
Ku-mellitus yesifo sikashukela, ukukhiqizwa okunganele kwe-insulin ye-hormone kwenzeka. Umsebenzi obalulekile we-hormone ukuletha ushukela kumaseli womzimba. Ngakho-ke, ukukhiqizwa okunganele kwe-insulin yisizathu sokwanda koshukela egazini. Ezimweni ezimbi kakhulu, ukusakazeka okujwayelekile kuyawohloka.
Kumuntu onesifo sikashukela, amanxeba asendaweni yonyawo aphulukiswa kancane. Izithende ezinesifo sikashukela i-mellitus ziba ngokunganaki. Ngemuva kwesikhashana esithile, lokhu kuholela ekwakhekeni kwezilonda zezithuthu, okuthi, uma ziphathwa ngendlela engafanele noma ngokungafanele, ziguqulwe zibe yi-gangrene.
Ngisho namanxeba amancane nokuqothuka kungaholela esifweni esinjalo. Ngenxa yokuhlinzekwa kwegazi okunganele, ukuzwela kuyalahleka, ngakho umuntu akazizwa ebuhlungu ngenxa yokulimala. Izilonda ezivele kuleli cala azibonwa yisifo sikashukela isikhathi eside.
Akukona njalo ukwelapha i-pathology, ngakho-ke, umlenze kufanele unqunywe. Kumele kwaziwe ukuthi izilonda ziyavela kulezo zindawo ezinomthwalo lapho uhamba. Ukuqhuma okubangelwa kuba - indawo enhle yokungena nokuthuthukiswa kwamagciwane. Ngakho-ke, abanesifo sikashukela banamanxeba okuhlanza angathinti kuphela izingqimba zesikhumba esiyingqayizivele, kodwa futhi namathambo namathambo.
Ukwelashwa ngonyawo lwesifo sikashukela ekhaya, futhi ngosizo lomuthi wendabuko, esimweni esinjalo kuletha umphumela omncane. Odokotela banquma ukunqamula imilenze.
Izimbangela eziphambili zokuthuthuka konyawo lwesifo sikashukela ziyaqashelwa:
- ukuncipha kokuzwela kwemikhawulo engezansi,
- ukuphuma kwegazi okungahambi kahle emithanjeni nasezinhlungwini,
- ukukhubazeka kwezinyawo,
- izingqimba zesikhumba esomile.
Izimpawu zonyawo lwesifo sikashukela
Kwisigaba sokuqala sesithende, onesifo sikashukela akabukeki uguqulwe ngokomqondo. Kepha ngokuqhubeka kwesikhathi, abantu babona izimpawu ezithile.
Ngokuhlukahluka kwe-ischemic konyawo lwesifo sikashukela, kukhona ukwephulwa kokuhlinzekelwa kwegazi emilenzeni.
Imvamisa abantu bayaphawula:
- ushintsho kumbala wesikhumba semilenze,
- ukuvuvukala okungapheli
- ukukhathala,
- Ubuhlungu lapho uhamba.
Ngokuhlukahluka kwe-neuropathic, izinkinga ezithile zenzeka kaningana kaningi. Kulolu hlobo lwe-pathology, izinzwa zokuphela kwezinzwa ezindaweni ezixineneyo zemilenze ziyathinteka. Isifo sikashukela siyaqonda ukuthi ukuzwela emilenzeni kuyancipha, ngesinye isikhathi ngisho nokuqina okuqinile emilenzeni akuzwakali. I-Flatfoot nayo iyakhula, amathambo aba mancipha, okugcwala ukwelashwa okuhlala isikhathi eside kuma-fractures.
Esikhathini sokuqala, kukhona imifantu ezithendeni, kanye nemikhaza ebandayo. Isiguli kwesinye isikhathi sizwa ukuthi imilenze yakhe ibanda. Ngemuva kwalokho izilonda zezimpawu zokugcina umzimba ziyavela, futhi ngaphandle kokwelashwa i-gangrene iyakhula.
Kusukela ekuqaleni kwesifo sikashukela kuya ekushoneni konyawo lwesifo sikashukela, isikhathi esiningi singadlula. Ukupholisa isithende kufanele kwenziwe ngokushesha ngemuva kokutholwa. Uma umuntu onesifo sikashukela engayilandeli imithetho yokudla neyokwelashwa, imiphumela yalesi sifo ingasongela impilo yakhe.
Unyawo lwesifo sikashukela luyinkinga ethinta abanesifo sikashukela abaningi, lusebenza njengembangela eyinhloko yokunqunywa komlenze ngaphandle kokulimala kwangaphandle. Lapho imifantu ivela ezithendeni sikashukela i-mellitus, isimo singaba yingozi enkulu.
Ukujikeleza kwe-Microvascular kukhubazekile kushukela, okusho ukungakwazi komzimba womuntu ukumelana namagciwane.
Isilonda singakheka, futhi uma sishiywa singalashwa, siyosungula isistimende sokuphendula sokuvuvukala.
Izimiso zokwelashwa ngonyawo lwesifo sikashukela
Kunezikhungo ezikhethekile zokwelapha zokwelapha unyawo lwesifo sikashukela. Amakhabethe angasebenza emitholampilo enkulu. Lapho, ungasheshe uthole izeluleko zokuthi ungalapha kanjani unyawo lwesifo sikashukela.
Uma kungenzeki ukuthi uthintane nehhovisi elikhethekile, udinga ukuvakashela udokotela oyi-endocrinologist noma udokotela ohlinzayo. Kubalulekile ukuhambisana ngokuphelele nazo zonke izincomo zikadokotela oholayo. Ngakho-ke, ukwanda kwesimo okuqhubekayo kungavinjelwa.
Udokotela kufanele aboniswane lapho nje unyawo luqala ukuvela ngokuqhekeka noma olunye ushintsho. Ukwelashwa ngonyawo sikashukela, kusetshenziswa izidakamizwa ezinomsebenzi we-antimicrobial ezingenazimpawu zokuthamba. Okokuqala, yile:
- I-Chlorhexidine
- I-Dioxidine nabanye.
Uma ubuzwa ukuthi i-iodine noma utshwala bungasetshenziselwa ukwelashwa, impendulo izohlala ingemihle. Le mikhiqizo ingahle inciphise inqubo yokuphulukisa ngoba iqukethe ama-tanning agents. Ukusetshenziswa kwezingubo zanamuhla ezinganamatheli esilondeni, ngokungafani nebhandishi noma i-gauze, kuyakhonjiswa.
Amanxeba kufanele aphathwe njalo kususwe nezicubu ezingasebenzi. Lezi zinqubo kufanele zenziwe ngudokotela noma umhlengikazi ngokuvama kwesikhathi se-1 ezinsukwini ezi-2-15. Udinga futhi ukuvikela isilonda ngesikhathi sokuvivinya umzimba ngenkathi uhamba. Ngalezi zinhloso, amadivayisi ahlukahlukene asetshenziswa:
- isicathulo,
- ethula amabhu nabanye.
Uma ukuphazamiseka kokujikeleza kwegazi kuba ngumuntu okuvusa iziphazamiso noma izilonda, khona-ke umphumela wokwelashwa kwendawo uzoba mncane uma ukugeleza kwegazi kungabuyisiwe. Kulesi simo, awukwazi ukwenza ngaphandle kokuhlinzwa emithanjeni yemilenze:
- ibhaluni angioplasty,
- ukuhlinzwa okudlula lapho.
Ampingation isetshenziswa cishe ku-15-20% wezimo zesifo sikashukela sikashukela. Kepha, kaningi, lo msebenzi ungavinjelwa uma kuqalwa ukwelashwa okufanele. Kubalulekile ukwenza izindlela zokuvimbela ukuvikela izilonda ezisesiswini esikhulu kakhulu. Uma kwenzeka umonakalo, khona-ke ukwelashwa kufanele kuqale ngokushesha.
Kuyadingeka ukuthola kusengaphambili kusuka ku-endocrinologist ngomsebenzi wehhovisi elikhethekile wonyawo lwesifo sikashukela futhi ubonisane kulesi sikhungo. Ingozi enkulu yokuqunjelwa kungenzeka:
- Esimweni lapho i-osteomyelitis ikhula kushukela mellitus - ukwengeza izicubu zamathambo,
- isilonda ngemuva kwesithambo se-limb ischemia - ukwephulwa kwegama lokugeleza kwegazi kuye onyaweni.
Nge-osteomyelitis, ukwelashwa konyawo lwesifo sikashukela kungenziwa ngaphandle kokunqunywa. Kufanele udle imishanguzo kwimithamo emikhulu cishe izinyanga ezimbili, kanye nokuhlanganiswa kwemithi ehlukahlukene. Endabeni ye-ischemia ebucayi, umphumela uzovela kunqubo yokuhlinzwa ngemuva - ibhaluni angioplasty. Ukuhlinzwa kwe-vascular bypass nakho kunganqunyelwa.
Imithi elwa nesifo sikashukela ekhombisa bonke abanesifo sikashukela abanamanxeba onyawo athelelekile. Udokotela uyanquma:
- Isikhathi sokwamukelwa
- uhlobo lwe-antibiotic
- indlela kanye nedosi yokuphatha.
Njengomthetho, ukwelashwa okulwa namagciwane emilenzeni enesifo sikashukela kubandakanya ukusetshenziswa kwezidakamizwa ngobubanzi besenzo. Ngaphambi kokunquma, kuzodingeka unqume uzwela wemithi elwa namagciwane ahlukaniswe izicubu ezithintekile.
Imvamisa, abanesifo sikashukela bathanda ukusebenzisa imithambo yokugcoba. Lokhu akulungile, ngoba okokugcoba, njengokhilimu, kungadala indawo enhle yokwandisa isibalo samagciwane futhi kuphazamise ukuphuma kwe-fluid enxebeni. Amafutha avela onyaweni lwesifo sikashukela awusiyo ikhambi elingcono kakhulu lonyawo lwesifo sikashukela.
Umphumela omuhle kakhulu unikezwa izembatho zakamuva zesizukulwane, lezi yizisulu ezinomsebenzi ophakeme kanye nomsebenzi wokubulala izinto. Isiponji se-Collagen sisetshenziselwa futhi ukugcwalisa amanxeba.
Ikhambi elithile, kanye nezindlela ezijwayelekile zokwelashwa, zihlala zikhethwa ngudokotela ohambelayo ngemuva kokufunda ngezimpawu zomuntu ngamunye ze-pathology.
Ukwelapha kwasendaweni
Uma kungekho kubuhlungu onyaweni lwesifo sikashukela, kufanele uthintane nodokotela ngokushesha. Impumelelo yokwelapha incike ekusetshenzisweni okuthembekile kwezincomo ze-podologist.
Isiguli sinconyiwe:
- ngaso sonke isikhathi gcina inxeba lihlanzekile
- vikela amanzi ukuthi angangeni endaweni ethintekile,
- shintsha ukugqoka kwansuku zonke
- Sebenzisa ama-painkillers nezinye izidakamizwa ezinqunywe udokotela wakho,
- Ungahambi ngaphandle kwezicathulo
- sebenzisa amasokisi kwabanesifo sikashukela;
- umsebenzi omncane womzimba.
Ukwelapha kwesilonda sendawo kufaka phakathi:
- ukuhlanzwa kwamanxeba
- ukugeza nge-antiseptics
- isicelo sebhandeji.
Kungcono ukuhlanza isilonda ngesikhumba. Indlela yokuhlanza ihlinzekelwe ukwehlukaniswa kokutheleleka kanye nokutheleleka ngegciwane enxebeni. Ukusetshenziswa kangcono kwemishini yokuhlanza, isilonda kufanele sibe nezicubu ezinempilo.
Ungahlanza isilonda nge-saline. Leli thuluzi liphinde latshintshwa ngempumelelo nesixazululo sikasawoti esingu-0.9%. Odokotela balule ukugeza nge-3% hydrogen peroxide ukuze ususe ama-bacterius a-pus kanye ne-anaerobic. I-Miramistin ayibangeli ukwehla kwezinga lokuzalwa kabusha, ngokungafani ne-hydrogen peroxide ne-iodine. Izimali ezibhaliwe kufanele zisetshenziswe ngokuhlukile.
Uma lesi sifo sishubile, kunesidingo sokwelashwa okuhlinzwa. Kulokhu, inxeba lihlala limbozwa ngebhandeshi elingabangeli ukulimala lapho lishintsha, futhi elivumela ukuthi umoya udlule.
Kuze kube manje, izinto ezinhle kakhulu zokugqoka zingama-movie avumelekile akhonjiswe izilonda zesifo sikashukela ezingavunyelwe. Azikwazi ukusetshenziswa isikhathi eside. Iziponji ze-Foamy zingasetshenziswa futhi phakathi kwesigaba sokuphulukisa uma kukhishwa umthamo omncane we-exudate.
Ama-hydrogels anqunyelwe kaningi, anomphumela omuhle kwizilonda ezomile ze-necrotic futhi akhombise umphumela wokuhlanza inxeba. Ithuluzi livusa ukuphulukiswa ngaphandle kokwakheka kwezibazi.
Muva nje, imbobo ye-hydrocolloid iyathola ukuthandwa. Izimali ezinjalo azidingi ukushintshwa njalo futhi zihlukaniswa ngesilinganiso esihle sekhwalithi yenani. Ama-alginates aphulukisa ngempumelelo izilonda ezahlukahlukene ngenani elikhulu le-exudate. Ngemuva kokupheka, kungcono ukugeza isilonda ngosawoti.
Ukwelashwa kwasendaweni ngemithi yesintu kubandakanya ukusetshenziswa kwendlela yokugqoka ngamafutha:
- ulwandle ulugwetshwe ulwandle
- asukume okhalweni,
- amabele.
Ngaphambi kokufaka i-bandage, udinga ukuhlanza isilonda ngamafutha okugcoba:
- Iruxol
- I-Dioxicain-P.
Ziqukethe ama-enzyme e-proteinase ne-collagenase. Lapho amanxeba atheleleka ngenxa yemiphumela enobuthi, izidakamizwa kufanele zinikezwe ngokuqapha, ngoba zithinta nezicubu ezinempilo.
Izilonda ze-purulent, ezihambisana ne-edema enzima, nikeza izidakamizwa eziqukethe iodine ne-polyethylene oxide. Ngaphezu kwalokho, udokotela angakunquma ama-antiseptics anjengalawa:
- ILavasept
- I-Iodopiron
- UBrownol
- I-Dioxidine.
Ukusetshenziswa kwemali enjalo emilenzeni kudinga ukuthi kuhlolwe isilonda nsuku zonke ngenxa yengozi yokugcwala ngokweqile kwendawo yesilonda ngesikhathi sokuphola. IBepanten yikhambi lesimanje elisetshenziselwa ukumisa ukuthuthukiswa kwezinkinga.
Ukwelashwa kwemithi yesifo sikashukela soshukela kungasetjenziswa. Ukusetshenziswa ngempumelelo kwamaqabunga aluhlaza okwesibhakabhaka. Amacembe ayisithupha adinga ukuthululiswa ngengilazi yamanzi ashisayo futhi afakwe amahora ama-2. Thatha i-100 ml ekuseni nakusihlwa.
Unyawo lungafakwa kakhulu luju futhi kufakwa isigaxa esisha ngaphezulu. Ngaphambi kokusetshenziswa, isitshalo sithululelwa ngamanzi abilayo. Indawo ethintekile iphathwa ngesixazululo esibuthakathaka se-furatsilina.
Ukwelashwa ngonyawo lwesifo sikashukela ekhaya kungenziwa kusetshenziswa ama-tinctures we-eucalyptus. Kwi-spoon enkulu ye-tincture engenakulungiswa, udinga ukuthatha inani elilinganayo loju. Ukugqoka kwe-gauze kufakwa engxenyeni bese kufakwa endaweni ethintekile. Futhi, ukwakheka kungasetjenziselwa ukugeza izinyawo. Bayakuvumela ukuba uthambise isithende izithende, uma ugeza njalo.
Ungathambisa ucezu lwezicubu ku-yoghur noma kefir bese unamathisela endaweni ethintekile. I-compress ishintshwa ngokushesha ngemuva kokuba yoma. Ijiniper noma i-spruce izinaliti ezifakiwe zingafakwa emikhiqizweni yobisi ebilisiwe. Ividiyo ekulesi sihloko izokutshela ukuthi wenzeni ngonyawo lwesifo sikashukela.
