Mithethefatsi ea ho kokobetsa bohloko ho leqeba la trophic
Bakuli ba lefu la tsoekere ba ka bang limilione tse peli ba na le liso tsa kahare maotong kapa maotong a tlase. Litla-morao tsa Trophic maotong a lefu la tsoekere li hlaha ka lebaka la liso tsa methapo ea letlalo le tebileng (epithelium kapa membrane e ka tlase), e tsamaeang le ts'ebetso ea ho ruruha. Lefu la trophic le lebisa lefung la lisele tse bonolo maotong, mme kamora ho phekoloa ha liso le maqeba letlalong la mokuli, maqeba a sala a le teng.
Phekolo ea liso tsa trophic leqebeng le lefu la tsoekere ke ntho e telele ebile e rarahaneng. Sena se bakoa ke tlolo ea trophism (phepelo ea oksijene le limatlafatsi linthong tsa maoto).
Li-trophic ulc: Tlhaloso le lisosa
Li-uloph tsa trophic ho lefu la tsoekere ke tlolo ea botšepehi ba letlalo kapa mucous ea hau e sa fole likhoeli tse peli kapa ho feta, tse lulang li ipheta khafetsa. Maqeba a trophic hase mokhoa o ikemetseng oa "pathology". Kholo ea bona e bakiloe ke ho ba teng ha lefu le leng hape le sa foleng. Maloetse a fetang makholo a mararo a ka baka ho hlaha ha leqeba le omileng maotong.
Mokhoa o nepahetseng oa ho ntlafatsa maqeba a trophic ha o tsejoe. Ka tloaelo, li-ulcers tsa maoto a lefu la tsoekere a bakoa ke:
- Ho theola phallo ea mali
- Letšollo la mesifa ka lebaka la tšitiso phepelong ea oksijene le limatlafatsi,
- Ho tsitsinyeha ha mali le lisele ka methapong ea venous e lipheletsong tse tlase,
- Ho tsoa mali ho amang mali,
- Metabolism e theohileng
- Ho kenela ts'oaetso ho phekola likotsi le maqeba.
Maemong a mangata, liso tsa trophic li theha maotong. Matsohong, 'mele kapa hlooho, maqeba a nang le lefu la tsoekere ha a hlahe.
Lisosa tsa liso tsa trophic li tšoana le lefu le tlasa - lefu la tsoekere. Hona ke:
- Re theotsoe ke lefutso,
- Khatello ea kelello kamehla
- Boloetse
- Mathata a pancreatic
- Maloetse a khahlano le vaerase khafetsa - hepatitis, ntaramane, khoho, rubella,
- Ho Nona Haholo
Mehato ea ho thehoa ha methapo ea methapo
Khafetsa, ho fumaneha hore ho na le liso tsa trophic ho bakuli ba nang le nalane ea lefu la tsoekere la mofuta oa 2. Lintho tse joalo li ka baka maqeba maotong:
- Tloha tsoekere e maling,
- Ho lahleheloa ke maikutlo a methapo ea kutlo,
- Tlhokomelo e sa sebetseng ea maqeba (likotsi, callosa) e hlahisoang ke tahlehelo ea kutlo ea maoto.
Kaha bakuli ba nang le lefu la tsoekere ba theotse maikutlo a letlalo maotong a bona, hase kamehla ba elang hloko maqeba a hlahang le microtraumas ka nako e loketseng. Maqeba aa tšoaetsoa 'me a fola hantle ka lebaka la ho fokotseha hoa oksijene e isitsoeng maling le keketseho ea tsoekere.
Li-trophic ulc li arotsoe ka:
- Neuropathic - "trophic heel ulcers"
- Neuroischemic - nts'etsopele haeba mokuli a kula a sa ts'oaroe ke lefu la tsoekere feela, empa hape le bothata bo sa lekaneng ba venous kapa methapo ea varicose.
Haeba u sheba foto ea liso tsa leoto tsoekere, hoa hlokomeleha hore li theha methati. 'Mala oa ulcer o ipapisitse le sethala sa trophic lesion:
- Mokhahlelong oa pele (ho etsoa ha leqeba ka holim'a letlalo), maqeba a mosehla (a bontša metsi a nang le "necrosis") kapa a batsho (necrosis e hlakileng ea lisele tse bonolo, ho haella ha oksijene) lia bonahala.
- Li-ulcers tse khubelu - sesupo sa karolo ea bobeli ea lefu lena, moo leqeba le kenang karolong e ka tlase ea dermis, le itlhatsoa ka lintho tse mpe mme le qala ho fola,
- Karolo ea boraro (tšenyo ea mesifa, ligaments le mesifa ea masapo) e tšoauoa ka maqeba a masoeu. 'Mala ona o bontša pholiso ea liso le ho bola ha linama.
Matšoao a matšoao
Alsa ea trophic e thehoa butle butle. Ka hona, matšoao a lefu lena a ipapisitse le sethala sa ona:
- Ho ruruha ha maoto, ho utloa bohloko,
- Metsu ea bosiu
- Ho hlohlona le ho chesa maotong,
- Ponahatso ea letlooa le boreleli le matheba a maputsoa,
- Sebaka sa letlalo le nang le letlalo le boreleli oa tiea ebile oa benya
- Mongobo o hlaha sebakeng se amehileng - lymph e lutang,
- Bohareng ba sebaka, libaka tsa keratinized tsa letlalo le tšoeu li thehoa,
- Letlalo le sebakeng se amehang lea tsoa, ho hlaha leqeba,
- Leqeba le teba le ho feta, le ama mesifa, ligaments le periosteum,
- Ho na le bohloko sebakeng sa "lesophylic"
- Ho tloha leqebeng le ntseng le llela kapa ho bola, ho na le monko o sa thabiseng,
- Haeba leqeba le tšoaelitsoe, letlalo le e pota-potileng le fetoha le khubelu ebe lea ruruha.
Alsa ea trophic ho lefu la tsoekere e ea potoloha 'me e fihla bophara ba cm 2 ho isa ho 10. Hangata maqeba a hlaha ka pele kapa lehlakoreng la namane. Ulcer e na le bohale ba wavy le litaba tsa purulent.
Tsoelo-pele ea lefu lena e lebisa ho feto-fetoheng ha maoto le ho holofala. Ho fokotseha ha maikutlo le hona ho baka maemo a leoto a fosahetseng ha o tsamaea.
Tlhahlobo ea lefu lena
Ho hlahlojoa ka nako le kalafo ea liso tsa trophic ka leoto le lefu la tsoekere ho qoba ho khaoloa menoana le ho fokotsa kotsi ea ho oela hape.
Mosebetsi oa mantlha oa ho khetholla li-trophic ulcers ke ho theha boemo ba phallo ea phallo ea mali liseleng le tahlehelo ea kutlo.
Tsebiso ea tšoaetso ea maqhubu a trophic maotong ke e latelang:
- Nalane ea bongaka
- Tlhahiso ea UAC (tlhahlobo ea mali e akaretsang), lithuto tsa biochemistry, likhahla tsa tsoekere ea mali, li-coagulograms (mali coagulation),
- Ho tsebahala ha libaka tse amehileng tsa maoto, ho pepesoa ha pulsation,
- Boikemisetso ba ho ikutloa ka maikutlo - ho arabela mocheso, bohloko le ho ama,
- Ho baka likokoana-hloko tse nang le leqeba la ho baka ho hlatsuoa ka boikemisetso ba kutloelo-bohloko ea pathogen e sa ts'oaneng le lithibela-mafu,
- Tlhahlobo ea X-ray ea leoto.
Mekhoa ea Hardware eu lumella ho tseba:
- Khatello ea khatello leoto le amehileng,
- Localization ea methapo ea methapo e sebelisang skena,
- Oximetry - phepelo ea oksijene ho lisele,
- Kotlo le bokhabane ba likepe tse sebelisang phapang ea X-ray,
- Liphetoho tsa lisele tsa methapo - CT le MRI,
- Botebo ba ulcer, boemo ba lisele tse potileng ke biopsy ea leqeba le leqeba.
Mekhoa ea kalafo
Ngaka le ka mokhoa oa ho phekola li-trophic ulc meotong e nang le lefu la tsoekere, ho bolela ngaka ka mor'a ho fumana hore o na le lefu. Mokhoa oa kalafo o sebelisoang ho lithethefatsi tsa lehae le tsa tsamaiso o abeloa mokuli ka mong, ho nahanela litšobotsi tsa lefu lena, ho ba teng ha mafu a sa foleng, ho kula.
Phekolo ea ulcers ea trophic e etsoa ka mekhoa e mengata:
- Bongaka
- Ho buoa
- E phethahetseng, ho kenyelletsa ts'ebetso ea ho itlhoekisa maqeba ho tsoa linthong tse bonojoana le tse ling, hammoho le ts'ebeliso ea lehae ea litlolo le litlolo.
Ntho ea bohlokoa ke kalafo ea liso tsa trophic maotong ka tharollo ea antiseptic le setlolo ho khutlisetsa letlalo le senyehileng le ho hasoa ha libaka tse senyehileng. Ho feta moo, ha o phekola ulc lapeng, o lumelloa ho sebelisa litlhare tsa setso.
Phekolo ea kalafo
Ho etsa opereishene ho kenyelletsa ho tlosoa ha lisele tsa necrotic tiske le ho felisoa ha sepheo sa ho ruruha. Mefuta e latelang ea ts'ebetso e etsoa:
- Curettage
- Phokotso
- Phekolo ea VAC e sebelisa vacuum.
Vacuum e sebelisetsoa ho theha khatello e tlase e nyane (ho fihlela ho -125 mmHg). Mokhoa ona o kenyelletsa tšebeliso ea liaparo tsa polyurethane. Ho falla ho u lumella ho:
- Tlosa pus ho liso tsa leoto,
- Fokotsa puffuffuff, fokotsa botebo ba maqeba,
- Matlafatsa phallo ea mali ka leqeng le senyehileng,
- E susumetsa ts'ebetso ea granulation,
- E fokotsa menyetla ea mathata a trophic ulcer,
- E bopa tikoloho e mongobo leqebeng e thibelang tšoaetso ea vaerase le libaktheria.
Caterization ke mokhoa oa ho alafa maqeba a ischemic le venous maotong a sa fole hantle.
Ho khaoloa ha Virtual ke kalafo e tsebahalang bakeng sa liso tsa neurotrophic tse hlahang ho bakuli ba nang le lefu la tsoekere. Mokhoa ona o kenyelletsa ho lekanngoa ha masapo le metatarsophalangeal ntle le ho senya botšepehi ba 'mele. Ho khaoloa ha Virtual ho u lumella ho tlosa pono ea tšoaetso le ho fokotsa khatello.
Ho ts'oaroa ke "stist" ea "stistulist" e hlahang ka har'a letlalo ho bonahala ha ho na le lefu la seschemic (hypertgency), le bitsoang Martorell's syndrome. Ho kenella ho reretsoe ho arohana le li-fistulas tse haufi le lehlakore la leqebelo.
Phekolo ea lithethefatsi
Phekolo ea lithethefatsi e ka ba mokhoa o ikemetseng oa kalafo oa methati ea pele le e bohareng ea li-trophic ulc ho bakuli ba lefu la tsoekere. Maemong a matla haholo, lithethefatsi li laetsoe e le tšehetso pele le ka mor'a ho buuoa.
Phekolo ka lithethefatsi maemong a fapaneng a trophic ulions ea maoto e fapane. Boemong ba pele ho bontšoa:
- Li-antihistamines - Tavegil, Loratodin, Suprastin,
- Lithibela-mafu
- Li-antiplatelet agents (bakeng sa ente ea methapo) - Reopoliglukin, Pentoxifylline,
- Li-NSAIDs (lithethefatsi tse seng khahlanong le ts'oaetso tsa steroid) - Ketoprofen, Imet, Diclofenac,
- Li-Painkiller (matlapeng) - Nise, Ibuprofen, Indomethacin.
Ts'ebeliso ea lithethefatsi tsena e reretsoe ho hloekisa ulcers ho tsoa ho likaroloana tsa necrotic le libaktheria. Ho etsa sena, maqeba a hlatsoa ka tharollo ea furatsilina, chlorhexidine kapa potasiamo permanganate. Mme ebe ba etsa compress le Levomikol, Streptolaven kapa Dioxicol.
Phekolo ea mohato oa bobeli oa liso tsa trophic ho lefu la tsoekere e etselitsoe ho khothaletsa pholiso ea leqeba, ho nchafala le ho choachoasela hoa letlalo. Sebaka sa leqeba se phekoloa le Curiosin. Ho thibela ts'oaetso hore e se kopane, sebelisa Algipor, Allevin, Geshispon.
Mokhahlelo oa boraro oa ho phekola maqeba a trophic maotong ke ntoa khahlanong le lefu le ileng la qholotsa sebopeho sa tsona. Mothating ona, ho phekoloa ulcers ea trophic e nang le insulin ho etsoa.
Hobaneng lefu la trophic le utloisa bohloko haholo?
Sebopeho sa bohloko ba nako nakong ea ha leqeba le eketseha la mofuta oa trophic ke hore ka lebaka la ts'ebetso ea ho ruruha, karolo ea letlalo ea leoto e senngoa butle butle. Likarolo tsa methapo e haufi le bokaholimo ba karolo ea epidermis li tlaleha maemo a sebakeng seo se amehileng pheletsong e tlase, 'me se romelle litšusumetso tsa neural litsing tsa cortex ea mokokotlo, e ikarabellang bakeng sa ho utloa bohloko. Kamora sena, mokuli o qala ho utloa bohloko, ho teba ha eona ka kotloloho ho latela botebo ba mathata a methapo ea varicose.
Ka hona, molao-motheo oa bohloko ha o le leqeba la ho ruruha lethekeng le tšoana hantle le boteng ba mafu a mang a amanang le tlolo ea botshepehi ba letlalo la leoto, kapa karolo efe kapa efe ea 'mele. Karolo e khethollang ea mofuta ona oa leqeba la maqeba ke hore mofuta oa trophic oa leqeba ha o fole likhoeli tse 'maloa,' me ka linako tse ling esita le mokuli o tsamaea le leqeba le bulehileng ka lilemo. Ke meeli ea eona feela le botebo ba eona bo fetohang, empa litamati tsa epithelial ha li a khutlisoa. Nako ena kaofela, motho o utloa bohloko bo bohloko, bo ka tlosoang feela ka thuso ea lithethefatsi tsa analgesic. Nako ea ts'ebeliso ea morao-rao e lekantsoe ke lebaka la nako, hobane lithethefatsi sehlopheng sena li na le litlamorao tse ngata tse ka fokolisang boleng ba mesifa ea pelo, sebete le manyeme. Re khothaletsa ho bala sengoloa mabapi le kalafo ea kalafo ea ulcers le likarolo tsa kalafo bakeng sa methapo ea varicose le lefu la tsoekere.
Haeba mokuli a utloa bohloko bo bohloko setsing sa moo ho fumanehang trophic neoplasm, sena se bolela hore ts'ebetso ea ho ruruha ha e tebile haholo mme ke karolo e kaholimo ea epithelium e sentsoeng. Sebopeho se matla sa lefu la bohloko se bontša ho atamelana ha methapo ea kutlo. Sena se bolela hore mabota a lijana tse kholo tse fanang ka phallo e tsitsitseng ea mali a venous ha a sa sebetsana le ts'ebetso eo a e fuoeng, ts'oaetso e kenelletse hare ka hare ho lithane tsa leoto mme e tsoela pele ho tsoela pele ka lebelo le phahameng. Ho bala, hona ho ka u thusa - li-napkin li u thusa ka eng ho etsa li-ulcers le hore na u ka etsa joang ka lesela.
U ka etsa joang hore u phekole ulcer ea bohlokoahali 'me u kokobetse bohloko ba leoto?
O ka imolla maikutlo a bohloko sebakeng sa leqeba le thehiloeng ka mofuta oa trophic ka ho nka mefuta e latelang ea li-painkillers kahare, tse fumanehang ka mokhoa oa matlapa a koahetsoeng ka koae e sireletsang:
- Parmidin (moriana oa bokahohle oa ho loants'a liso tsa methapo efe kapa efe ea methapo, o imolla ts'ebetso ea ho ruruha le ho choachoasela ha lehae, o kokobetsa ho ruruha hoa litho tsa letlalo tse epithelial)
- Acetylsalicylic acid le meriana eohle e entsoeng motheong oa eona (maikutlo a bohloko a fokotsehile haholo ka lebaka la hore ntho ena, eo e leng karolo ea meriana e mengata, e hlapolla mali le ho ntlafatsa phallo ea mali a venous, e fokotsang bongata ba mahlaseli a tsoang sebakeng sa leqeba).
- Antistax (setlhare se etselitsoeng ho kokobetsa bohloko sebakeng sa ho rala lesapo la trophic ka ho ntlafatsa ho phutholoha ha methapo e meholo le ho tiisa phallo ea mali a venous),
- Ketorolac (analgesic kakaretso ea kakaretso, phello e phahameng ea kalafo e fihlella lihora tse 2 kamora ho nka letlapa le le leng),
- Lornoxicam (e tlosa bohloko, e kokobetsa ho ruruha ha maoto le ho ntlafatsa phallo ea lisele ho lisele tse ka tlase, tse bohlokoa haholo boteng ba maqeba a trophic a maoto).
- Ambene-N (eseng setlhare sa steroid se sa feliseng bohloko feela, empa hape se tlosa ts'ebetso ea ho ruruha, e potlakisa sekhahla sa pholiso ea leqeba le bulehileng),
- Oxadol (e leng motsoako o matla o sebelisoang bakeng sa timetso e tebileng ea lisele tsa maoto a epithelial tse nang le maqeba a pharaletseng a trophic),
- Khotemin (analgesic e sephara e u lumellang hore o tlose maikutlo a bohloko maotong, ho sa tsotelehe hore na maoto le matsoho a ka tlase a phomotse, kapa haeba motho a tsamaea ka thata),
- Ketanol (analgesic e hloekileng haholo e sebelisoang feela ho emisa ho utloa bohloko 'me e se na thepa e khahlanong le ho fokola kapa ea antiseptic).
Ntle le lenane le boletsoeng la litokisetso tsa letlapa, ha ho litlolo tse sa sebetseng hantle, tse ikemiselitseng ho imolla bohloko, e leng:
- Ho bokelloa ha Propolis (e rekisoang likhoebong ka meqomong ea tšepe e bonolo, e fokotsa bohloko ka ho kokobetsa ho ruruha, ho thibela kholo ea likokoana-hloko tse tšoaetsanoang le ho khothaletsa pholiso ea maqeba).
- Dimexide (e sebetsa joaloka anesthesia ea lehae, hape e na le thepa e ntle haholo ea antiseptic, empa e na le "drawback" e le ngoe e ikhethang e hlahisitsoeng nts'etsopele ea 'mala o mofubelu oa letlalo sebakeng sa leqeba le bulehileng),
- Emla (setlolo se kenella ka potlako libakeng tse amehang tsa letlalo, 'me phello ea liphallelo tsa bohloko e tšoarella lihora tse 4 tse latelang).
Ho tlosa bohloko mokokotlong o bakoang ke ho ba teng ha lesapo la trophic ho etsoa hantle haholo ka ho sebelisa litlolo tsa lehae hore o se ke oa sebelisa litokisetso tsa letlapa hape, hobane litlamorao tsa tsona tsa lik'hemik'hale li ama mpeng, sebete, liphio, pelo, haholo-holo linama tse tebileng tsa pancreatic. Keletso ena e sebetsa ho bakuli ba sa nkeng mehato ea ho phekola methapo ea varicose 'me ho theosa le lilemo ba tlosa matšoao a lefu lena ka tsela ea bohloko ba trophic ulcer.
Pheko ea 'mele
Phekolo ea 'mele e lumelloa feela sethaleng sa pholiso ea ulcers. Hangata, ngaka e beha litlhahiso:
- Ka liso tsa atherosselotic - ts'ebeliso ea kamore ea khatello ea Kravchenko, e bakang khatello e mpe ea lehae,
- Cavitation ka li-ultrasound tse tlase. Phekolo e joalo e ntlafatsa phello ea kalafo ea litlhare tsa antibacterial le antiseptic,
- Phekolo ea Magnet e ka fokotsa bohloko, ea hlapolla methapo ea mali, ea kokobetsa ho ruruha.
- Phekolo ea Laser e tlosa sepheo sa ts'ebetso ea ho ruruha, e imolla bohloko, e ntlafatse ho nchafala ha mesifa,
- Ultraviolet e eketsa ho itšireletsa mafung,
- Ts'ebeliso ea naetrojene le ozone li thusa ho tlatsa lisele tsa moea ka oksijene le ho nchafala ha tsona,
- Phekolo ea seretse e lumella mokuli hore a fole ka potlako ka mor'a ho kula.
Phekolo e 'ngoe
Ts'ebeliso ea litlolo tsa lingaka tsa setso e lumelloa feela sethaleng sa ho folisa liso tsa trophic le kamora ho buisana le ngaka. Phekolo e 'ngoe e kenyelletsa ho phekoloa ka maqeba, ho a hloekisa ka har'a metsoako ea puruse le lisele tse shoeleng. Litlama tsa litlama li fokotsa ho ruruha le ho kenya letsoho ho nchafatseng epithelium.
- Phekola leqeba ka joala kapa vodka. Kenya litlolo tsa Vishnevsky,
- Soak tar ka boea ba k'hothone, e sebelisoa ka maqeba matsatsi a 2-3. Tsoela pele ho fihlela o felisoa
- Makhasi a omisitsoeng a katiloeng a katlase hore a fetohe phofo. Fafatsa leqeba leo 'me u le lokise ka bandege. Pheta makhetlo a 2-3 ka letsatsi ho fihlela ho luma tsa ka mpeng.
Li-ulopholi tsa trophic maotong ke lefu le hlahisoang ke lefu la tsoekere. Ho tseba ka nako le kalafo e nepahetseng ea methapo ea methapo ho u lumella ho emisa bothata ka botlalo le ho qoba ho oela hape. Empa ts'ebetso ea kalafo e rarahane mme e hloka hore mokuli a latele litlhahiso tsa ngaka ka tieo.