I-Diabetesic gangrene: izimbangela kanye nezimpawu zokuthuthuka, izindlela zokwelashwa nokuvimbela

Isifo sikashukela i-mellitus yisizathu sokuthi ochwepheshe baphoqelelwa ukuthi bathathe izinqumo eziyisisekelo zokususa izimpawu zesifo ezigulini, okusiza ukwandisa kakhulu isikhathi sabo sokuphila futhi kuqede ngokuphelele imiphumela ebulalayo.

Enye yezinkinga eziphazamisa futhi eziyingozi zalesi sifo i-gangrene emanzi yesifo sikashukela. Kuqala ukukhula lapho umzimba womuntu wethula uchungechunge oluhlaba umxhwele lwezinqubo ezingezinhle. Lokhu kufaka phakathi ukulimala okuhlangene, ukubonakala kwezilonda emaphethelweni aphansi kanye nezinkinga ezinkulu ngokujikeleza kwegazi. Njengomthetho, lokhu okugcina kungumphumela we-atherosulinosis.

Uma isiguli se-endocrinologist singathathi izinyathelo ezidingekayo ngesikhathi, esifaka ukwelashwa okunekhwalithi ephezulu, khona-ke ezimweni ezinjalo ukubukeka kwe-gangrene yamaphethelo aphansi kuqala. Kuyaziwa ukubeka ingozi enkulu empilweni yomuntu. Ngakho-ke kuyini?

Lo mqondo ubhekise ekufeni kwezakhi zomzimba wendawo, okuholela ekutheni iqiniso lokuthi izicubu eziphilayo negazi “ligcwele” ngamakhemikhali we-cadaveric nawobuthi. Kulesi sihloko, ungafunda ngale ndaba nokuthi ingozi ebangelwa yingozi kangakanani.

I-Diabetesic gangrene: Ikhodi ye-ICD-10

I-Diabetesic wet gangrene inekhodi elandelayo ngokusho kwe-ICD-10 - E10-E14.

Izizathu zokuthuthuka

Njengomphumela wokukhula okulandelayo kwalesi sifo okukhulunywa ngaso, ukulimala okukhulu kwezitho ezahlukahlukene ezibalulekile kuqala: inhliziyo nemithambo yegazi, amaphaphu, isisu, isibindi nezinso. Uma ungakunaki ukwelashwa okuqeqeshiwe, khona-ke umphumela obulalayo awunakugwemeka.

Ukwelashwa okungajwayelekile yizisebenzi zezokwelapha, kanye nokwelashwa okunganele, kungaholela ekususweni kwengalo ethintekile. Ngokuhamba kwesifo sohlelo lwe-endocrine olucubungulwayo, kuyisigebengu esisemaphethelweni aphansi.

Njengomthetho, lokhu kungaba wumonakalo ohlukile kakhulu: kusukela kusi-phalanx esisodwa, umunwe, unyawo, ngisho nokunqunywa umlenze kuya nangaphezulu kwendawo ehlanganisiwe yedolo. Ngokuyisisekelo, lo mkhuba wokugcina kungenzeka kuphela ezigabeni ezinzima kakhulu futhi eziyingozi zesifo sikashukela.

Ngokuqondene nezizathu ezingenzeka kakhulu zokuthuthukiswa kwe-gangrene, khona-ke izici ezibangela ukuvela kwale nkinga yesifo sikashukela kufaka lokhu okulandelayo:

1. I-Ischemic gangrene yenzeka ngokumelene nesizinda se-atherosclerosis, esivimba imithambo yegazi futhi siphazamise nokugeleza kwemvelo kwe-serum yegazi. Umphumela wale nqubo engathandeki ukushoda okunamandla komoya-mpilo, futhi ukufa okusheshisiwe kwalezi izicubu ezithintekile kuqala ukuzibonakalisa;
2. inyawo okuthiwa yisifo sikashukela liboniswa ngesimo sezilonda onyaweni noma emlenzeni ophansi. Baphola isikhathi eside, khona-ke ukutheleleka kungena kubo bese kuqala ukuqalwa kwezifo;
3. kodwa i-polyneuropathy isuka ekuphazamisweni okungathi sína kwe-carbohydrate metabolism. Njengoba wazi, kwenzeka kuzo zonke izakhiwo zamaseli zohlelo lwezinzwa zomzimba. Ngale nqubo, ama-microvessels ayathinteka, kepha amaseli aqala ukuguga ngaphambi kwesikhathi;
4. emva kwalokho kukhona ukwephulwa kokwethembeka kwemikhumbi microscopic. Kubalulekile ukuqaphela ukuthi imvume yezindonga zama-capillaries iyancipha;
5. phakathi kokunye, nemikhumbi emikhulu nayo iyathinteka. Njengomthetho, lokhu kwenzeka ngenxa ye-atherosulinosis. Ngemuva kwesikhashana, isiguli iba ne-thrombosis;
6. Kukhona ukwephulwa okukhulu kwazo zonke izinqubo zemvelo zokwakhiwa kwezicubu zamathambo. Futhi, umuntu onesifo sikashukela uba namathambo. Imvamisa kuba khona isisulu, i-aseptic necrosis ne-fistula;
7. i-endocrinologist yesiguli iyenza buthaka imisebenzi yokuvikela umzimba, kanye namaphawundi angeziwe.

Imvamisa, ukubonakala kwe-gangrene akusona isizathu esisodwa esibalulekile, kodwa kuningana. Ngaphezu kwalokho, ngamunye wabo angathuthukisa kuphela ukubonakaliswa kwangaphambilini.

Yiziphi izifo eziboniswayo?

Njengoba wazi, izinqubo ezenzeka ngaphakathi emzimbeni, njenge-arterial sclerosis, nazo ezingadala ukushaya kwenhliziyo, ukushayeka kwegazi nobunye ubucakacaka kungaholela ekonakaleni okukhulu emsebenzini wokujikeleza kwegazi. Yizo kanye izimbangela zangaphakathi zokuvela kwalesi sifo okukhulunywa ngaso.

I-Arterial sclerosis kanye nesikebhe esinempilo

Izimpawu

Okwamanje, kunzima kakhulu ukusungula izimpawu ezithile zokuqala zomonakalo kwezicubu zemilenze, kanye nokutheleleka kwayo ngokuqondile ngamasongo we-cadaveric, ngoba empeleni ayikho ngenxa yokuzwela okulahlekile.

Kepha, noma kunjalo, kunezimpawu ezithile eziphazamisayo ezidinga ukunakwa kakhulu. Kusuka kubo ukuthi unganquma ukuqala kwesifo esiyingozi futhi esibulalayo.

Lokhu okulandelayo okuyizimpawu eziyinhloko ze-gangren yesifo sikashukela:

1. umuzwa ongapheli wesisindo nokukhathala kwemikhawulo engezansi. Imvamisa, iziguli ziphawula ukudinwa, umkhuhlane nokukhubazeka;
2. kukhona ukuguquguquka okubonakalayo konyawo nobuhlungu obukhulu emisipha;
3. kukhona ushintsho emthunzini wesikhumba sonyawo, kanye nangokushisa kwalo. Njengomthetho, lokhu kungahambisana nokubomvu, futhi ngesinye isikhathi ukuqina kwemilenze. Ezimweni eziphazamisayo kakhulu, kutholakala ukuthi i-cyanosis yemilenze iyatholakala. Zihlala zibanda, zivame ngisho nangamanye ama-shades, ama-callus nezindawo ezibomvu.

Izimpawu zakamuva zalesi sifo zihlanganisa:

1. kwizicubu ezithintekile zemilenze kukhona nobuhlungu obuqhubekayo obungapheli;
2. isikhumba ezindaweni ezinenkinga siba mnyama futhi siqale ukugqekeza;
3. izicubu ezifile azisazungezi;
4. ukutheleleka kujoyina le nqubo, ikakhulukazi nge-gangrene emanzi;
5. isicanucanu, ukubanda, ukuzwakala komzimba ophakeme kuyazwakala, kuthi kuqhume ukucwilisa okuningi kwe-purulent.

Ukuqinisekisa ukutholwa, kufanele uthinte ochwepheshe ukuze bahlole izingxenye ezithintekile zomzimba, basebenzise ukuhlolwa kwe-neurological and bacteriological, ukuthatha umchamo, i-creatinine, ukuhlolwa kwegazi, futhi futhi benze ukuhlolwa okukhethekile kwe-ultrasound kokujikeleza kwegazi nama-x-ray.

Yimuphi udokotela okufanele ngiye kuye?

Izisulu eziningi zinesithakazelo embuzweni ophuthumayo, ubani okufanele ngixhumane neqembu lezinyawo? Ngaphezu kokuhambela i-endocrinologist yomuntu uqobo, kufanele uvakashele udokotela ohlinzayo.

Ukuxilonga

Okokuqala, udokotela kufanele enze ukuhlolwa okufanelekile, kufaka phakathi ukuhlolwa okuningiliziwe kwezindawo ezonakele zomzimba.

Kungemva kwalapho kuphela azothatha zonke izivivinyo ezidingekayo ezibhalwe ngenhla (umchamo, i-creatinine, ukuhlolwa kwegazi).

Lokhu kuzosiza udokotela ukuthi aqinisekise ukutholwa okuhlosiwe.

Izindlela zokwelapha

Kuyaphawuleka ukuqaphela ukuthi isifo sikashukela esimanzi esishubile singalashwa ngezindlela ezimbili ezijwayelekile. Njengomthetho, kuleli cala sikhuluma ngenqubo yokulondolozwa nokuhlinzwa, noma kunjalo, indlela yokugcina iyona esebenza kahle.

Ukuze usebenzise uhlobo lokuqala lokwelashwa kwe-gangrene enesifo se-endocrine okukhulunywa ngaso, kufanele uhlolwe ngokuphelele bese uthola imiphumela elandelayo:

• isinxephezelo sikashukela;
• ukunciphisa ukusakazeka kwezifo ezithathelwanayo nobuthi ngokusebenzisa izidakamizwa ezingama-antibiotic;
• ukwehla okukhulu kwezinga lomthwalo ezinqeni eziphansi, ikakhulukazi endaweni ethintekile;
• lapho usebenzisa izinhlobo ezithile zamavithamini kanye nama-microelements, ukwanda kwezinga lokungazami kufanele kutholakale.

Uma lokhu kungubhubhane omanzi onesifo sikashukela, indlela yokuhlinzwa yokwelashwa kufanele isetshenziselwe ukukhipha amathuba okuba nomphumela obulalayo. Ngesikhathi saso, udokotela ohlinzayo ususa ngokuphelele izakhi zezicubu ezithintekile. Ngaphezu kwalokho, wenza ukuhlanza izicubu ezizungezile.

Uma kuthinteka umunwe owodwa kuphela, ukususwa konyawo, okuyisisekelo sezinkinga, kuyadingeka ukuvimbela izinkinga ezingaba khona. Njengoba unalolu hlobo lobugwala onyaweni, kuzodingeka ukuthi ukhulume ngokukhipha umlenze uqonde ezingeni ledolo. Njengomthetho, noma isenzo esinjalo singadingeka ekuxilongeni i-angiopathy yesifo sikashukela semikhawulo ephansi. Ukwelashwa kwakhe, kulokhu, nakho kungaba nzima kakhulu.

Ngokubambisana nokungenelela okusebenzayo, lezi zinto ezilandelayo zingenzeka:

1. ukusetshenziswa kwama-anti-spectrum okubulala amagciwane;
2. ukwenza ukwelashwa, okuhloswe ngalo ukwehlisa izinga lobuthi ngama-toxins of the organism;
3. ukumpontshelwa igazi.

Ngaphezu kokususwa kwezakhiwo zeseli efile, kubalulekile ukwenza kanyekanye ukwelashwa okufanayo.

Ukwelashwa okungenayo i-gangrene

Kungabonakala ngokukhishwa kweziqalo zegazi emithanjeni yegazi evela ngenxa yesifo se-coronary.

Ezokwelapha ziphakamisa ukuthi kuhlanzwe imithambo kusetshenziswa iphenathi ekhethekile efakwe ngaphakathi kubo.

Le ndlela iqeda ngokuphelele ukusikeka esikhunjeni, okubalulekile kubantu abanesifo sikashukela.

Ukuvimbela

Lokhu kufaka ukubhema, kanye nokusebenzisa kabi utshwala.

Kwisifo sikashukela, ungasebenzisi izinkuni ezinamathela, ngoba ukuzisusa kungasusa ungqimba olungaphezulu lwesikhumba, ngemuva kwalokho kuzovela isilonda esizothatha isikhathi eside kakhulu ukululama.

Ngaphezu kwalokho, ukutheleleka okungafuneki kungangena ngaphakathi.

Kubaluleke kakhulu ukunganqikazi ukuthola izimpawu zokuqala ezesabisayo bese uqala ukuthatha isinyathelo. Uma usola unyawo lwesifo sikashukela, kufanele uthintane nodokotela onguchwepheshe ozokwenza zonke izindlela zokukhipha noma zokuqinisekisa ukutholakala kwakhe okuyingozi.