Yini unyawo lwesifo sikashukela: ikhodi ye-ICD-10, ukuhlukaniswa ngezigaba, izimbangela nezindlela zokwelashwa

Enye yezinkinga ezinkulu zesifo sikashukela yi-diabetesic foot syndrome.

Esigulini esinganamatheli ekudleni okunqunyiwe, singabheki kahle ushukela wegazi, esigabeni sokubolekwa (imvamisa emva kweminyaka eyi-15 - 20 ngemuva kokuxilongwa kwalesi sifo), leyo nkinga ngokuqinisekile izobonakala ngandlela thile.

I-ICD 10 yesifo sikashukela siyinkinga eyingozi, imvamisa eholela ebulwelini (izicubu ze-necrosis).

Izinkinga zesifo sikashukela

Imvamisa, izinkinga zesifo sikashukela zenzeka ngenxa yephutha lesiguli. Uma engakunaki ukwelashwa, anganaki izincomo zokwelashwa, angaqapheli ukudla kwakhe, akaphathi i-insulin ngesikhathi, noma ngabe uluhlobo luni lwalesi sifo, ngokuqinisekile uzoqala ukubhekana nezinkinga.

Imvamisa imiphumela ingaba mibi kakhulu, futhi ezimweni eziningi umphumela obulalayo awubandakanywa. Izinkinga zingabangelwa ukugula okuhlangana, ukulimala, umthamo ongafanele we-insulin, noma ukusetshenziswa kwezidakamizwa eziphelelwe yisikhathi (noma ezingaphansi).

Enye yezinkinga ezinkulu zesifo sikashukela yile:

1. i-lactic acidosis - ukwephulwa kwemvelo ye-acid emzimbeni ngenxa yokuqongelela kwenqwaba yama-acid e-lactic;
2. ketoacidosis - ukwanda kwenani lemizimba ye-ketone esegazini ngenxa yokungalingani kwe-insulin;
3. I-hypoglycemic coma - umphumela wokwehla okubukhali kwamazinga kashukela;
4. i-hyperosmolar coma - umphumela wokwanda okubukhali kwamazinga kashukela;
5. isifo sikashukela sonyawo sikashukela - okubangelwa yi-vascular pathologies emaphethelweni aphansi;
6. i-retinopathy - umphumela wokuphulwa kwemikhumbi yamehlo;
7. encephalopathy - ukulimala kwezicubu zobuchopho ngenxa yokuphazamiseka kwemithambo yegazi;
8. i-neuropathy - ukulimala okusebenzayo kwezinzwa zepherishi ngenxa yokuntuleka kokugcwala komoya we-oxygen;
9. i-dermal lesion - ukubonakaliswa okuvame ukubangelwa ukuphazamiseka kwe-metabolic kumaseli wesikhumba.

Kuyini isifo sikashukela sonyawo?

Lolu hlobo lwe-pathology luthinta izicubu zezinyawo. Izinqubo zokuvuvukala kuzo zihambisana nokufakelwa okunamandla, okuthi ngenxa yalokho kubange ukuthuthukiswa kwesiqubu.

Izimbangela zokubonakaliswa okunjalo kungaba yi-neuropathy yesifo sikashukela, ukuphazamiseka emikhunjini yamaphethelo aphansi, kukhathazwa izifo ezibangelwa amagciwane.

I-International Symposium yokuqala, eyabanjwa ngo-1991 futhi yanikezelwa kwisifo sonyawo sikashukela, yathuthukisa ukubekwa kwesimo lapho izinhlobo zesifo ziqala ukuhlukaniswa yizici ezikhona ezivusa inkanuko.

Amafomu alandelayo ahlukaniswa:

• ifomu le-neuropathic -izibonakalisa ngesimo sokulimala, ukuvuvukala, ukubhujiswa kwezicubu ezibekekileyo, okuwumphumela wokuphazamiseka ekusebenzeni kohlelo lwezinzwa. Lezi zinkinga zidalwa ukwehla kokuhamba kokushayisana kwezinzwa ezindaweni ezinamaphethelo aphansi;
• Ifomu le-ischemic - kungumphumela wokubonakaliswa kwe-atherosulinotic, ngokumelene nesizinda lapho ukujikeleza kwegazi kuphazamiseka emaphethelweni aphansi;
• ifomu le-neuroischemic (noma elihlanganisiwe) - Thola izimpawu zazo zombili izinhlobo.

Ngokuvamile, iziguli ezinesifo sikashukela zibonisa izimpawu zefomu le-neuropathic. Okulandelayo kwimvamisa yifomu elihlanganisiwe. Indlela ye-ischemic yonyawo lwesifo sikashukela ivela ezimweni ezingavamile. Ukwelashwa kususelwa ekuxilongeni okusekelwe kunhlobonhlobo (ifomu) le-pathology.

Izizathu zokuthuthukiswa kwezinkinga

Isifo sikashukela esigabeni sokudonswa kwemali sibonisa izinguquko ezibucayi ezilinganisweni zikashukela egazini, noma iqiniso lokuthi izinga eliphakeme lokuqukethwe kwalo egazini lihlala isikhathi eside. Lokhu kuthinta kabi izinzwa nemithambo yegazi.

Ama-capillaries we-microvasculature aqala ukufa, futhi kancane kancane i-pathology ithumba imikhumbi emikhulu.

Ukufakwa ngaphakathi ngokungafanele kanye nokunikezwa kwegazi kubangela ukungasebenzi okwanele kwezicubu. Ngakho-ke izinqubo zokuvuvukala ezihambisana ne-tisc necrosis. Le nkinga ihlanganiswa yukuthi inyawo, lokuba ngesinye sezingxenye zomzimba ezisebenza kakhulu, luhlala luvezwa ingcindezi, futhi, kaningi, ukulimala okuncane.

Umuntu, ngenxa yokuncishiswa kwe-innervation (imizwa yezinzwa), kungenzeka anganaki ukulimala okuncane (ukuqhekeka, ukusikeka, imihuzuko, ukulimala, ukuqunjelwa, ukhunta), okuholela ekwandeni kwezilonda, ngoba lapho kukhona ukuhamba kwegazi okunganele emithanjeni emincane umsebenzi wokuvikela umzimba kulezi zindawo azisebenzi.

Ngenxa yalokhu, lokhu kuholela ekutheni amanxeba amancane angapholi isikhathi eside, futhi uma engenwa yileli gciwane, akhula abe yizilonda ezibanzi kakhulu, ezingalapheka ngaphandle kwemiphumela emibi kuphela uma kutholakala ukuthi utholakale esigabeni sokuqala.

Isifo esifana nonyawo lwesifo sikashukela asikaze siqedwe ngokuphelele futhi sivame ukungena esigabeni se-pathologies esingamahlalakhona.

Ngakho-ke, isiguli siyelulekwa ukuba sizibhekele ngokucophelela, sikulandele ngokuqinile indlela yokudla ebekiwe kanye neminye imiyalo yezokwelapha, futhi uma kuvela noma yiziphi izibonakaliso ezisolisayo, thintana nodokotela ngokushesha.

Izimpawu

Linye lalawa mafomu libonakaliswa yi-Symbomatology yalo. Ikakhulu:

• ifomu le-neuropathic ukwehliswa kokuzwela kwezinyawo, ukuguqulwa kwabo kunesimo, ukubukeka kwamabele, i-foci ye-hyperkeratosis kuyabonakala. Ezigabeni zakamuva, kuvela izilonda esizeni samabele, zinobuningi bendawo yokuhlangana;
• Ifomu le-ischemic kwenzeka ngaphandle kokuvela kokukhubazeka nokulimala, ukuzwela kwesikhumba akwehli, kepha ngasikhathi sinye ukuqina endaweni yezinyawo kuba buthaka futhi kungazwakali kahle. Isikhumba siphenduka sibe mnyama, sibande. Kuqhamuka izilonda ezibuhlungu. Amafomu abo awanalo uhlaka olucacile, imiphetho yazo ivame ukungalingani;
• ifomu elixubekile zombili lezo nezinye izibonakaliso zinesimo.

Ochwepheshe bahlukanisa (ama-degree) ayisithupha alesi sifo:

1. ukuqina kwezinyawo. Azisekho izilonda okwamanje;
2. ukubonakala kwezilonda zokuqala eziphezulu;
3. ukujula kwezilonda, mayelana nokuthinteka kuzo izicubu zomsipha nezicubu zomsipha;
4. izilonda ziyajula kangangokuba zithinta izicubu zamathambo;
5. ukuqala kobulelesi obunqunyelwe;
6. I-gangrene iba yanda.

Izindlela Zokuxilonga

Ukuxilongwa kwenziwa ngesisekelo somlando wezokwelapha, ukuhlolwa kwesiguli nemiphumela yokuhlolwa kokuxilongwa, okubandakanya izifundo nezinqubo ezinjengokuthi:

• ukuhlolwa kwegazi okujwayelekile;
• ukuhlolwa kwemizwa;
• I-Ultrasound yemithambo yegazi edingekayo ukuvivinya izinga lokugeleza kwegazi (i-Doppler ultrasound);
• isiko legazi kuma-bacteria;
• i-angiography (ukuqhathanisa i-x-ray, kugxile ocwaningweni lwemithambo yegazi);
• i-x-ray ejwayelekile yezinyawo;
• biopsy kanye nokuhlolwa kokuqukethwe kwezangaphakathi kwezilonda.

Ngesikhathi sokuhlolwa ngokomzimba, izinga lokushisa lomzimba, ingcindezi, isilinganiso sokuphefumula kanye nokushaya kwenhliziyo kuyalinganiswa. Ngemuva, ukuhlolwa ngokuphelele kwezilonda kwenziwa ngokuzimisela kwezinga lokuzwela kwazo nezinye izinkomba eziningi. Ukunquma ukujula kokulimala kwezicubu, udokotela angaphendukela ekuphenyeni nasekuphatheni ukuhlinzwa kwamanxeba.

Ukwelashwa

Ukwelashwa kuqala ngokunxeshezelwa kashukela nokujwayezwa kwenani likashukela egazini, ngoba okuqukethwe ushukela okuphezulu futhi kufaka yonke imiphumela elimazayo.

Ngokuvamile, izindlela zokwelapha ze-ischemic ne-neuropathic amafomu ziyafana futhi zihambisana nokujikeleza kwegazi elihamba emalondweni ngezindlela zokwelapha noma zokuhlinzwa. Endabeni yokwelapha, kudalwa imishanguzo elwa namagciwane, kanye nezidakamizwa eziklanyelwe ukuthuthukisa ukuhamba kwegazi nokunciphisa ukuvuvukala.

Ngochwepheshe bokuhlinzwa, bangaphendukela ku-angioplasty e-percutaneous translateuminal, ngosizo lapho kungenzeka khona ukubuyisela ukugeleza kwegazi emithanjeni ngaphandle kokulimala kwesikhumba okwenziwa yi-artery puncture, kanye ne-thrombarterctomy noma i-distal bypass surge.

Ukweqile okuthinteka yi-pathology kwakheka ngerejimeni emnene; ukwelashwa kwezilonda zasekhaya kwenziwa ngama-antiseptic agents. Esimweni sefomu le-neuropathic, ochwepheshe banaka ngokukhethekile ekubuyiselweni kwe-innervation emilenzeni, lapho izidakamizwa ezihlose ukuthuthukisa imetabolism zingasetshenziswa.

Enye yezimo eziphambili zokwelapha ukusula ngokuphelele kokubhema. I-Nicotine ithinta kabi umbhede we-microvascular, ngenxa yokuthi izindlela zokwelapha okuhloswe ngazo ukubuyisa ukuhamba kwegazi zingase zingasebenzi noma zingaba yisikhathi esifushane.

Ikhodi ye-ICD 10

I-pathology efanayo yenzeka e-ICD-10 (International Classization of Diseases 10 ukubuyekeza), eyethulwe eRussia kusukela ngonyaka we-1999. Ingokwesigaba esingu-E10 - E14 "Diabetes mellitus" futhi ifakwe i-E10.5 noma i-E11.5, ngokuya ngefomu kanye nemvelo yalesi sifo.

Izindlela zokuvimbela

Abantu abanesifo sikashukela bayalwa ukuba bahlole ngokucophelela amazinga kashukela wabo wegazi futhi basebenzise i-insulin esezingeni eliphakeme ekhiqizwa yizinkampani zemithi ezaziwayo.

Futhi, ikhwalithi yezicucu inethonya elihle. Labo abatholakala benesifo sikashukela cishe iminyaka eyishumi noma ngaphezulu edlule kumele banakekele ukuthenga kuphela izicathulo ezisezingeni eliphakeme lapho isikhumba sonyawo singeke siguqeke, sakhe ama-microcracks nama-fractures.

Izicucu kufanele zibanzi, ziphefumule, kufanele zenziwe ngezinto zemvelo.. Akuvumelekile, noma yiziphi izimo lapho izingcingo nokuvunyelwa kuvunyelwe. Ngokwehlukana, kufanelekile ukusho ukuhlanzeka kwezinyawo. Kufanele uyithathe ngokungathí sina, ugeze izinyawo zakho njalo ngensipho yokuwasha, uvikele izifo zokukhunta kanye nokulimala okuncane, i-abrasions.

Isiguli esinesifo sikashukela esigcina ngokucophelela zonke lezi zidingo ezingenhla ngeke sithintwe yi-pathology enjalo.

Amavidiyo ahlobene

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