Isifo sikashukela sonyawo sikashukela

Izinga lempilo yabantu abanesifo sikashukela livame ukuba sengozini. Ngaphezu komonakalo ebuchosheni, izinso, ukuhlaziya okubukwayo kanye nohlelo lwezinzwa, indima ebalulekile inikezwa isifo sikashukela se-diabetes (SDS). Ukubonakaliswa okuyinhloko kwe-pathology kuwukuvela kwezilonda ezingapheli, i-ischemia ebucayi kanye ne-pathology yamathambo kanye nokuhlangana kwesimo okungatheleleki. Izilonda zibhekwa njengesimo esisongela ukwedlula zonke, ngoba ukunamathisela ukutheleleka kwesibili kufaka phakathi ukukhula kwe-gangren kanye nokulahleka kwelunga.

Unyawo lwesifo sikashukela - isimo sokuthi ama-endocrinologists ahlanganyela kuwo. Emazweni aphesheya, ukufundwa kwezithombe-mbumbulu kufunda lolu daba, kodwa-ke, ezweni lakithi le sayensi ithathwa njengencane, abanye ochwepheshe abancane abekho.

Imiqondo ejwayelekile

Izinyawo eziphansi zivezwa ekucindezelekeni okukhulu empilweni yonke. Sonke isisindo somzimba sidluliselwa ezintweni zezakhi zezakhi. Kungakho ukulimala kwemithambo yegazi, imicu yezinzwa kanye nokusebenza kwe-osteoarticular ngokumelene nesifo sikashukela i-mellitus kuvusa ukuthuthukiswa komonakalo kanye nokuqothuka konyawo.

Isifo sikashukela sonyawo lwesifo sikashukela sithathwa njengesixhumo esizimele esenzeka ngemuva kwesizinda sezinye izifo ezingapheli (retinopathy, nephropathy, angiopathy, neuropathy). Umlenze ophansi ubhekana nezinguquko ze-anatomical nezomzimba, eziboniswa izinqubo ze-purulent-necrotic.

Indlela yokuthuthukisa

Esikhathini sikashukela i-mellitus, kukhona ngokuphelele (uhlobo 1 lwesifo) noma isihlobo (2 uhlobo lwesifo) ukuntuleka kwe-insulin pancreatic hormone. Izinqubo ezinjalo ziholela emazingeni aphezulu kashukela egazini nokuphazamiseka kwazo zonke izinqubo ze-metabolic. Unyawo lwesifo sikashukela luwumphumela wezinye izinkinga zakamuva zesifo esiyimbangela: i-neuropathy, i-angiopathy, i-osteoarthropathy.

I-neuropathy yesifo sikashukela

Lesi simo sibangela ukuvela kwezilonda ezinamahlwili kuyo yonke indawo isifo sikashukela sesibili. Amanani aphakeme we-glucose aphakeme abangela ukulimala kwezinhlaka zezinzwa (amaseli, imicu, ama-receptors), nawo, abonakala ngokudluliswa okungafanele kokuphazamiseka. Ngaphezu kwalokho, ukulimala kwezinzwa kubangelwa futhi ama-angiopathies atholakala cishe kuzo zonke izifo sikashukela futhi aholele indlala yomoya-mpilo wezinto zezinzwa.

Ukulimala komgogodla ku-mellitus yesifo sikashukela kungenye yezinto ezibangela ukwanda kwesifo sikashukela

Ukwehla kokuzwela kubangela i-atrophy yamathuluzi onyawo. Ukudalwa kukhula, okuhambisana nokuboniswa okulandelayo:

• i-keratinization yesikhumba ezindaweni zokucindezela okungapheli;
• i-hematomas;
• ukubukeka kwamabele;
• ukwakhiwa kwezindawo ze-necrosis zesikhumba;
• ukuvela kwezilonda.

Isifo Sikashukela Osteoarthropathy

Enye i-pathology lapho unyawo lwesifo sikashukela lukhula. Lesi simo siyivelakancane (1% kuphela yabantu abanesifo sikashukela) futhi sibonisa nge-pathology yezakhi zamathambo. Igama lesibili le-osteoarthropathy "unyawo lukaCharcot."

Amaphuzu amakhulu ahambisana nokuvela kwe-osteoarthropathy:

• ukwephulwa kwe-innervation;
• ukuphazamiseka kwe-microcirculatory nokwanda kokugeleza kwegazi kwe-basal;
• ukwehla kwenani lamaseli amancane amathambo anomthwalo wokubumba i-matrix;
• Ukuguqulwa kwezakhi zamathambo ngazinye;
• ukuphuma, ukuvela kanye nokwaphuka kuyavela.

I-Osteoarthopathy yindlela ehambisana nomonakalo emathanjeni onyawo

Kubalulekile! Inqubo ivame ukuthinta amathambo eminwe, i-tarsi, ngaphansi kaningi i-ankle.

Isifo sikashukela Angiopathy

Lesi yisilonda sethambo samakhaladi ahlukahlukene, okuvela kuwo isifo sikashukela sonyawo sikashukela. Ukubonakaliswa okusobala yi-atherosclerosis ne-occlusion, ngokuyinhloko kwenzeka ngaphansi kwedolo. Izinqubo ezifanayo zibhekwa njengezibalulekile ezinqubweni ze-purulent-necrotic, zibonakaliswa ngemuva kwesizinda sonyawo sikashukela sohlobo lwe-ischemic.

Izici Ezivusa inkanuko

Kunokulimala okuningana okubonakala njengezinkinga ezincane, kepha ngokumelene nesizinda sikashukela i-mellitus kungadala i-pathologies engathi sína futhi kube yizinto ezithusayo ekuthuthukiseni unyawo lwesifo sikashukela.

Leli qembu lifaka izipikili ezingenayo, ukucwazimula kwamapuleti ezipikili ngenxa yezicathulo eziqinile ezikhethiwe, ama-hemorrhages noma izilonda zokukhunta. Ukwakheka kwezithelo zommbila Lokhu kufaka futhi ukulimala okungahleliwe kwemishini ebuqothweni besikhumba, izithende eziphukile, ukukhubazeka ngenxa yamathambo andisiwe.

Ukuhlukaniswa

Ukwahlukaniswa kubhekwa njengokufana futhi kwamukelwa ngokuvamile. Kunezindlela ezintathu eziyinhloko zesifo:

I-neuropathy yesifo sikashukela kanye nokwelashwa kwayo

• Inyawo ethelelekile yohlobo lwe-neuropathic (60-65% yamacala) - kwenzeka ngokumelene nesizinda sesifo sikashukela sesikhathi eside, esihlanganiswe nezinye izinkinga. Isikhumba asiguquliwe, ukuhanjiswa kwethambo emithanjeni kugcinwe, zonke izinhlobo zemizwa ziphazamiseka kakhulu, akukho buhlungu.
• I-gangrenous foot yohlobo lwe-ischemic (i-10-15% yamacala) - iziguli zikhononda ngobuhlungu obukhulu, isikhumba ezinyaweni sinombala omnyama obandayo, obandayo wokuthintwa. I-ripple incishiswa kakhulu, kepha ukuzwela kwanele. Ngokuyisisekelo, iziguli ngasikhathi sinye zihlushwa umfutho wegazi ophakeme, zibe namazinga amakhulu e-cholesterol egazini.
• Uhlobo oluhlanganisiwe (20-25% yamacala).

Uma isiguli sine-ischemic pathology, ukuxilonga sisebenzisa ukwahlukaniswa kwesimo sokuqubuka kwemilenze engezansi:

• 1 - ukungabi bikho kwezimpawu (ku-70% yamacala).
• I-2a - ubuhlungu lapho uhamba ngaphezu kwama-200 m;
• I-2b - ubuhlungu lapho uhamba ngaphansi kwama-200 m;
• 3 - Ubuhlungu ekuphumuleni okuphelele;
• I-4a - i-trophic pathology ehambisana nobuhlungu;
• I-4b - i-trophic pathology engenabuhlungu.

I-Intermittent claudication - uphawu lomonakalo emaphethelweni aphansi, abonakaliswa ezinhlungwini lapho uhamba

Ukuhlukaniswa kwezilonda zokulimala ku-diabetesic foot syndrome:

• 0 degree - ubuqotho besikhumba abuphulwa;
• I-1 degree - isilonda se-trophic sitholakala phezulu;
• I-2 degree - isilonda se-trophic esithinta izingqimba ezijulile zesikhumba;
• Ibanga 3 - ukuvuvukala okuhlanzekile kwezakhiwo zamathambo noma ukwakheka kwethafa;
• I-4th degree - i-gangrene, enencazelo ecacile;
• I-5 degree - i-gangrene ejwayelekile, lapho kwenziwa ukunqunywa okuphuthumayo.

Ukwahlukaniswa kube amaqembu wenqubo yokutheleleka eyenzeka ngenkathi yesifo sikashukela sonyawo:

• Akukho nqubo yokutheleleka - isilonda noma isilonda se-trophic ayinakho ukhipha umsipha futhi akukho zimpawu zokusabela kokuvuvukala.
• Ukutheleleka ngobumnene - kuvela izimpawu eziningana zokuvuvukala (i-edema, redness, pain, hyperthermia yendawo). I-Hyperemia ithumba uzungu olungadluli ku-2 cm kuwo wonke amacala ukusuka emaphethelweni enxeba noma esilonda.
• Ukutheleleka okulinganiselayo - kuhambisana ne-lymphangitis, ukwakheka kwe-abscess, gangren. Inqubo ifaka izinto ezijulile zesakhiwo.
• Ukutheleleka kwezinga elishiwo - kunezimpawu zokuphuza kakhulu komzimba, kwehla umfutho wegazi, ukukhuphuka kwenhliziyo, ushukela wegazi ophakeme, i-azotemia.

Izimpawu ze-pathology

Noma yiluphi uhlobo lokuxakeka lungahambisana nezilonda ze-purulent necrotic. Izimpawu zonyawo lwesifo sikashukela zisuselwa ekutheni lesi sifo sihambisana nenkinga yokuhlinzwa eqine, lapho kudingeka khona usizo oluphuthumayo noma cha. Ngokungabikho kwayo, uhlobo lonyawo lwesifo sikashukela lungahlukaniswa ngokusekelwe kwizikhalazo ezivela ezigulini.

Izimpawu zokuqala zohlobo lwe-neuropathic zivezwa ngobuhlungu bokuqaqamba obuvela ezinyaweni, emilenzeni, ezinqulwini. Isifo sezinhlungu siyancipha ngemuva kokunyakaza, ushintsho esimweni somlenze ophansi. Iziguli zikhononda ngokuncipha kokuzwela, ukudonsa, ukungakhululeki, ukuvutha, ukuzizwa kufana ne-goosebumps. Ukubonakaliswa njalo ukwanda kokuvuvukala, ubuthakathaka bemisipha.

Ukubonakaliswa okusobala kobuhlungu kuwuphawu lonyawo lwesifo sikashukela semvelo ye-neuropathic

Izimpawu zohlobo lonyawo lwe-ischemic zivela kanjena:

• izinhlungu ezinzima emilenzeni lapho uhamba;
• iziguli ziphoqelelwa ukuba ziyeke ukuze i-pain syndrome inciphe;
• Ubuhlungu obenzeka lapho isiguli sisendaweni eqondile futhi inyamalala ngemuva kokuhlala phansi kwesiguli;
• ukugoba, ikakhulukazi ebusuku;
• umuzwa wokubanda ezinzwaneni.

Ukuhlolwa okubonakalayo kweziguli

Ithebula libonisa amaphuzu asemqoka avumela izinhlobo ezihlukanisayo zonyawo lwesifo sikashukela.

Kubalulekile! Izithombe nezithombe zokubonakaliswa kwe-pathology kungatholwa kuwebhusayithi noma amakhasi ezincwadi ezikhethekile.

Ukuxilonga

Ukuzimisela ngesikhathi ngesikhathi kwe-syndrome kuzonciphisa ukuqhubekela phambili kwesimo, ukukhetha ukwelashwa okulungile, futhi kuvimbele isidingo sokunqunywa komlenze ophansi. Okokuqala, uchwepheshe uqoqa imininingwane ngesifo esikhona futhi ucacisa ubukhona bezikhalazo. Okulandelayo, ukuhlolwa kwamaphethelo aphansi: i-plantar ne-dorsum, izikhala phakathi kweminwe.

Uchwepheshe ucacisa umbala wesikhumba, ukushisa kwawo, ubukhona bezinwele. Ihlola ukuqina kwe-turgor kanye nesikhumba, ukudonsa kwemithambo, ukuba khona kwe-puffiness kanye neziphene ze-trophic. Uma udokotela engakwazi ukulalela ukushaya kumithambo ye-peripheral artery, iDopplerography yenziwa ngedivayisi ephathekayo.

I-dopplerograph ephathekayo - idivayisi ekuvumela ukuthi ulalele ubukhona be-ishayela emithanjeni yethambo

Ngosizo lodokotela wezinzwa, isimo sokuzwela kuyahlolwa:

• i-tactile - i-monofilament;
• ubuhlungu - ngesando ngenalithi ekugcineni;
• vibration - ukuhlehlisa imfoloko;
• lokushisa - izinto ezibandayo nezifudumele.

I-Radiography ikuvumela ukuba ucacise ngesimo sezinto zangaphakathi nempahla ye-osteoarticular. Ukubuka okungcono, kusetshenziswa isibhamu ezimbili zokuqagela.

Amasampula

Izindlela ezikhethekile zokuthola ubukhona be-pathology:

1. Isibonelo Alekseev. Ihlola ushintsho lokushisa kwamaphethelo aphansi ngemuva kokuhamba. Ezigulini ezine-pathology ejikelezayo, izinkomba zincishiswa ngo-1-2 ° C ngemuva kwama-400 m.
2. Isampula Marburg. Ngokuphikisana ne-pallor yaphezulu yonyawo, amabala aluhlaza okwesibhakabhaka abonakala ngokucacile.
3. IHallmark Ratshaw. Isiguli silele endaweni elukhuni, siphakamise imilenze yomibili bese siwela kuyo. Kungakapheli nemizuzu embalwa, kuqhamuke i-pallor yezinyawo.
4. Isampula Cazascu. Ngaphambili kuwo wonke umlenze, kubanjwa into engacacile. Ukwephulwa kokuhlinzekwa kwegazi kufakazela ukuhlukana okubukhali kwe-hyperemia esikhunjeni.

Ukuhlolwa kwesiguli

Lapho uqinisekisa i-syndrome yonyawo lwesifo sikashukela, isiguli silaliswa esibhedlela esibhedlela se-endocrinological ukuze silungise lesi simo futhi sinikeze nokwelashwa. Izindlela zokucwaninga eziyisisekelo ezikulesi sigaba yilezi:

• ukuhlolwa kanye ne-palpation yemilenze, ukucaciswa kokuzwela;
• phambi kwezilonda eziyizithutha - inoculation ye-bacterial yokuqukethwe okuqukethwe nge-antibioticogram;
• ukuskena okuphindwe kabili kwemithambo yegazi - i-ultrasound, evumela ukucacisa isimo semithambo yegazi nokujikeleza kwegazi ngabo;
• i-arteriography yemikhawulo ephansi - indlela ye-radiopaque, eyenziwa ngokwethula i-medium ephakathi futhi iqhube ama-x-ray athile;
• i-oximetry - ukucaciswa kokuba khona kwe-ischemia, degree yayo;
• I-X-ray, i-CT, i-MRI - ukuhlolwa kwesimo sezakhiwo zangaphakathi zonyawo;
• ukuhlolwa kwelabhoratri (ukuhlolwa okujwayelekile, igazi likashukela, i-biochemistry, i-coagulogram);
• ukuhlolwa ngudokotela oyi-neurologist, nephrologist, optometrist.

Ukuhlolwa kweglucose yegazi kuyindlela yokuxilonga ekuvumelayo evumela ukuthi unqume izinga lesinxephezelo sikashukela

Izici zokwelapha

Inkinga yokwelapha izinkinga zesifo sikashukela ingaxazululwa ngokuphelele. Njengakuqala, uhhafu wazo zonke iziguli ezithola ukunqunywa kwamaphethelo aphansi bangoshukela. Baqala ukwelapha i-pathology ngembangela yako - hyperglycemia. Kubaluleke kakhulu ukunxephezela isifo sikashukela ngokugcina ushukela ofinyelela ku-6 mmol / l, kanye ne-glycated hemoglobin kuze kufike ku-6.5%.

Uhlelo lokwelashwa luhlanganisa ukulayisha imilenze yesifo eselulelekile, okuthathwa njengokuphoqelekile kunoma yiluphi uhlobo lokucindezelwa, ikakhulukazi ngemuva kokuhlinzwa. Izinyathelo ezinjalo kuhloswe ngazo ukwehlisa ukuvuvukala, ukuvuvukala, ukuvimbela ukuhlukunyezwa esilondeni uqobo. Ukuphulukiswa okusheshayo kwenzeka. Izilonda ezingapholanga izinyanga ezimbalwa noma iminyaka zithunyelwa emavikini ayi-6.

Ukuphumula kombhede nemilondolo ayisebenzi kuleli cala. Enye into yizicucu zokwelapha, ezingenziwa ngezinto zokwelapha noma ekhaya (ngokwesibonelo, ezivela kumashayi asendulo). Ukugqama kwezicucu ezinjalo ukuthi amathiphu eminwe noma esithendeni ahlala evulekile.

Imithi esetshenziswa ekwelapheni lesi sifo:

• umuthi wokujikeleza kwegazi;
• ama-ejenti wehlise i-cholesterol;
• imithi ethinta isimo se-vascular wall tone.

Ukwelashwa kwesilonda esisheshayo

Okokuqala, izinhlamvu ezakha eceleni komphetho wesilonda ziyasuswa. Igcotshwe ngesikali nesikhafu. Uma kunesidingo, faka izimbotshana ezihlanzekile, hlanza izindawo ezi-necrotic ngangokunokwenzeka.

Ukwelashwa kwendawo kulandela umthetho: "Izinkinga ze-Wet zidinga ukugcokwa okumanzi, kanti ezomileyo zidinga ezomile." Isikhungo sesilonda esine-exudate siphathwa nge-Dioxidine, isixazululo se-hypertonic, iMiramistin, iChlorhexidine. Imvamisa yokwelashwa ikhethwa ngawodwana (imvamisa izikhathi ezi-2 ngosuku). Vumela ukugcoba amaphutha ngesisombululo esine-iodine equkethe i-Povidone-iodine, kusuka ngaphandle - okhilimu nama-anti-inflammatory (i-Ibuprofen, Hydrocortisone).

Amalungiselelo okwelashwa kwesilonda "esimanzi"

Kubalulekile! Isixazululo se-iodine esingu-5%, okuluhlaza okotshani okukhanyayo, isixazululo se-potanganum permanganate asisetshenziswanga ukwelapha ukushiyeka kwezilonda.

Izilonda ze-Trophic kanye necrosis enezimpawu zokutheleleka ziphathwa ngemithi elwa namagciwane. Ukukhethwa kwezimali kwenziwa ngemuva kokuhlwanyelwa kwamagciwane kanye nokucaciswa kokuzwela kwama-microorganisms kuma-antibiotics.

Funda kabanzi mayelana nokwelashwa ngonyawo lweswekile kulendatshana.

Ukwelashwa kokuhlinzwa

Ukungenelela kokuhlinzwa ngenxa yesifo sikashukela sikashukela sinezinkomba ezilandelayo:

• inqubo yokutheleleka esongela impilo yesiguli;
• ukuvuvukala kwezinto zamathambo, i-osteoarthritis;
• ukukhubazeka okujulile kwesilonda;
• iziphene ezinkulu ngemuva kokusebenza kwangaphambilini;
• i-ischemia ebucayi, uma kungekho okuphikisana.

Ezimweni ezinjalo, ukunqunywa kuyadingeka. Ukuphakama kunqunywa ngudokotela osebenzayo ngokuya ngezinga lezicubu ezisebenzayo, ukubaluleka kwesimo.Ukulungiswa kokungapheleli kwe-arterial kwenziwa ngokusebenzisa ukungenelela kwe-angiosological: i-balloon angioplasty, ukubekwa ngesiqu, ukuhlinzwa okudlula, i-endarterectomy.

Ukusungulwa kwezokwelapha

Odokotela baseCuba bahlongoza indlela entsha yokwelapha okuhloswe ngayo ukuvimbela ukuqhubeka kwe-pathology, ukunciphisa ubungozi be-gangrene, ukusheshisa ukuvuselelwa kwezicubu nokwelashwa kwezifo. Ukulungiswa kwe-Cuban i-Eberprot-P kumelwe yinto ekhulayo yokwanda komuntu kwesifo sokuqalwa kwamaseli enempilo. Uhlobo lokwelashwa lukhethiwe ngokulandelana esimweni ngasinye somtholampilo. Ngeshwa, ukuthenga leli thuluzi kusizinda somphakathi okwamanje kuyinkinga.

I-Eberprot-P - umuthi ongavinjelwa osetshenziswa ekwelapheni unyawo lwesifo sikashukela

Amakhambi esintu

Ukusetshenziswa kwezitshalo zokwelapha kungenye yezindlela ezisizayo zokwelapha lesi sifo. Ukusebenza kahle kukhombisile ukusetshenziswa kwamaqabunga amajikijolo kanye namajikijolo. Kuyadingeka ukwethula amajikijolo ekudleni kwansuku zonke (kufika ezingilazini ezi-3 ngosuku), kuthiwe itiye lokupholisa elimnandi lisuka emaqabungeni.

Enye ikhambi ngamaqabunga e-burdock. Izingcindezi zenziwa kubo, ngemuva kokuphatha unyawo ngesisombululo se-Furacilin futhi kugcotshwe ngenani elincane loju. Amacembe esitshalo ahlala phezulu. Phinda inqubo ekuseni nase kusihlwa.

Ukuhlanzwa kokukhubazeka kwesikhumba kwenziwa nge-decoction yezithelo zomisiwe ze-cherry. Isipuni sezinto zokusetshenziswa sitshelwa engilazini yamanzi abilayo, silethwe kubilongwe bese sigxunyekwa imizuzu eli-15 phezu kokushisa okuphansi bese sihlungiwe. Isixazululo silungele ukusebenzisa.

Imininingwane engaphezulu mayelana nokwelashwa konyawo lwesifo sikashukela ekhaya ingatholakala kule ndatshana.

Ukunakekelwa kwezinyawo zikashukela

Isidingo sokuqala ukugeza izinyawo zakho ngensipho nangamanzi afudumele. Ngemuva kwalokho kuyadingeka ukomisa isikhumba ngokuphelele, kepha ungasihlikihli. Ukunakekelwa kwezinyawo kufaka ukuzihlola ukuze kutholakale isikhumba esomile, ukulimala, iziqhumane, imihuzuko, amabele, izipikili ezifakiwe.

Isikhumba sihlolelwa ubomvu, ukuqina ezindaweni ezithile, kanye nokwanda kokushisa kwendawo. Uma kutholakala isilonda noma i-callus, ukuzivula ngokwakho akuvunyelwe. Faka uphawu endaweni ngosizo lwebhendi, shintsha izicathulo ubike udokotela inkinga.

Ukukhetha isicathulo esifanele kuyindlela yokuvimbela ekwakheni ubunzima.

Le mithetho elandelayo izonciphisa ubungozi bezinkinga:

• udinga ukusika izipikili zakho ngemuva kokugeza (ziba zithambile);
• musa ukusika amakhona epuleti lezipikili;
• ukuhamba ngezinyawo kufanele kwenzeke ngezicucu ezintofontofo ngosayizi ofanele ukuze anganyinyitheki futhi angazigcobisi izingcingo);
• ungahambi ngezicathulo;
• yenqaba izicathulo ezinezithende;
• amasokisi kufanele enziwe ngezindwangu zemvelo;
• uma kunesidingo, sebenzisa izicathulo zamathambo;
• lapho ugeza, hlola izinga lokushisa lamanzi ngezandla zakho hhayi ngezinyawo zakho (ukuzwela kungancishiswa kakhulu);
• Musa ukuwela imilenze yakho.

Ukuhambisana nezeluleko zochwepheshe, ukwesekwa kwe-glycemia efanele nokunakekelwa kwansuku zonke kuyizinto ezinganciphisa ubungozi bokukhula ngonyawo lwesifo sikashukela, futhi uma kwenzeka, yehlisa intuthuko.