Lipheko tsa li-trophic ulcers: mokhoa oa ho khetha kalafo

Ponahalo ea liso tsa trophic maotong e amana le maloetse a mang. Liphoso tse joalo li ka qholotsa lymphedema, lefu la tsoekere, lefu la ho fokola ha masapo. Likotsi, ho chesoa le serame le tsona hangata li baka liso tsa trophic. Ha li fole libeke tse 6 kapa ho feta. E 'ngoe ea mekhoa ea kalafo ea bona ke meriana.

Melao-motheo ea kalafo ea ulcic ulcers

Ka lebaka la khaello ea nako e telele ea phallo ea mali, polokeho ea letlalo le phepo e ntle ea letlalo le lisele tsa eona tse ka tlase, tsepamiso ea necrosis, eo hamorao e lebisang ho haneng ha lesapo la mokokotlo (ntho e shoeleng). Ka hona, liso tsa trophic lia thehoa. Li hlaha libakeng tse hole le tse hole. Ho ipapisitsoe le sesosa, liso tsa trophic tsa lipalo tse tlase li arotsoe ka mefuta e latelang:

• Phaello ea mali. Li thehoa ka lebaka la khatello ea khatello e etsahalang khafetsa.
• Arterial (ischemic). Li amahanngoa le ho senyeha ha phallo ea mali libakeng tse tlase ka lebaka la endarteritis kapa atherosclerosis, moo lesenata la likepe le emelang.
• Venous (varicose). Li hlaha ka lebaka la ho thekesela hoa mali mokokotlong oa lefu la post-thrombophlebitis kapa ho eketseha ho sa feleng ha methapo.
• Kameho e bohloko. Li thehoa ka lebaka la likotsi tsa letlalo le lisele tse ka tlas'a eona. Mabaka e kanna ea ba maqeba a lithunya, ho loma, pholiso e sa foleng ea suture le maqeba kamora ho buuoa, likotsi sebakeng sa ente ea ba lemaletseng lithethefatsi.
• Lefu la tsoekere Hlaolela bokaholimo ba lefu la tsoekere.
• Tšoaetso (pyogenic). Li etsahala ha tšoaetso e fapa-fapaneng e khomaretse, hangata e le baktheria.
• Neurotrophic. Li hlaha ka lebaka la tlolo ea ts'ebetso ea ho boloka lisele le ts'ebetso ea likepe tse li fepang.

Kaha li-uloph tsa li-trophic tsa lipheletso tse tlase li na le etiology e fapaneng, mofuta oa kalafo o khethoa ho latela sesosa. Ke feela ka ho e felisa, o ka sebetsana le foci ea tisy necrosis. Phekolo e etsoa ka mekhoa e 'meli e meholo:

• Conservative. Ho kenyelletsa kalafo ea lefu la ka morao ka litafole le liente, ho theola mocheso, ho imolla bohloko le ho matlafatsa 'mele ka kakaretso. Ho kenyelletsa moo ho kenyelletsa tšebeliso ea chelete ea lehae ka kotloloho bakeng sa pholiso ea maqeba, ho hlatsoa, ​​ho hlatsoa lithethefatsi le ho hloekisa maselese a necrotic.
• Ho buoa Phekolo e joalo e reretsoe ho felisa mathata a phallo ea mali, ho hlatsoa leqeba ka leqeba kapa ho ipolaea ha leihlo. Mokhoa o sebelisoa feela ka ntle ho mohato oa ho eketsa. Kamora ho buuoa, kalafo e tsoela pele ka mokhoa o hlokolosi.

Haeba maqeba a le holimo, kalafo e ka etsoa ntle le tšenyo ea nako, haeba e tebile - maemong a ho ema. Phekolo e na le likarolo tse latelang:

• ntlafatso ea phallo ea venous ho tsoa lipheletsong tse tlase,
• pholiso ea liso
• phepo e nepahetseng ea lisele tse senyehileng,
• phomolo ea bohloko
• khatello ea ts'ebetso ea ho ruruha,
• tlhoekiso ea libaka tsa necrotic ho tsoa lipokellong tsa purulent.

Phekolo ea methapo

Mofuta ona oa kalafo o kenyelletsa ho sebelisa meriana kahare kapa ho sebelisa litlhare tsa lehae. Meriana ea sehlopha se itseng sa pharmacological e laetsoe ho nahanela sesosa sa kholo ea liso tsa trophic tsa lipalo tse tlase:

• Phlebotonics (lijana tse matlafatsang). Li sebelisetsoa ho phekola methapong ea varicose, thrombophlebitis, periphlebitis, bohloko le edema ea mofuta oa kamora lefu le bohloko. Litokisetso tsa sehlopha sena li matlafatsa methapo ea mali le ho eketsa elasticity ea marako a tsona.
• Li-Anticoagulants. Ketso ea bona e ka sehloohong ke ho kuta mali. Keketseho ea coagulability ea eona ke sesupo sa kalafo ka li-anticoagulants.
• Antispasmodics.E abetsoe ho imolla bohloko le ho phunyeletsa lipelong tse tlase tse bakoang ke liso tsa trophic.
• Lithethefatsi tse seng khahlanong le ho ruruha. E sebelisoa ho imolla ho ruruha likepeng.
• Li-antiplatelet agents. Tsena ke lithethefatsi tse amanang le mali tse sebetsang ka ho thibela ho kopana ha 'mele (gluing).
• Li-antibacterial. E sebelisoa kahare le kahare. Li khethoa ha ts'oaetso ea vaerase e tšoaetsanoa, e atisang ho hlokomeloa maemong a liso tsa trophic tsa lipalo tse tlase. Ho lithibela-mafu, li-cephalosporins le fluoroquinolones hangata li sebelisoa.
• Pholiso ea litlolo. Ba thusa ho tlosa lisele tse shoeleng leqebeng, ba emisa ho kenella, ho ntlafatsa phepo e nepahetseng ea lisele tse phelang le ho potlakisa ho hlaphoheloa.

Ho matlafatsa likepe

Mesebetsi ea mantlha ea kalafo ea phlebotonic: ho imolla ho tsitsipana, ho teba le bohloko bo lipelong tse tlase, ho matlafatsa methapo, ho ntlafatsa phallo ea mali. Litokisetso tsa sehlopha sena li fumaneha ka mokhoa oa matlapa, le ka mokhoa oa litlolo le li-gels. Mefuta ea lehae ea phlebotonics e ka sebelisoa ho phekola li-trophic ulc feela sethaleng sa ho lokisa kapa ho senya libaka tse anngoeng ke liphula tse tlase. Chelete e joalo ha e sebelisoe maqeba a bulehileng. Mehlala ea phlebotonics:

• Troxevasin. E thehiloe ho troxerutin. Fokotsa matla a mafu a trophic, ts'oarisa mabota a methapo ea mali, e imolla boima le bohloko maemong a tlase. Mokhoa oa kopo o its'etleha ka sebopeho sa tokollo: li-capsules (360 r.) - 300 mg makhetlo a 3 ka letsatsi, li-gel (350 r.) - Etsa kopo sebakeng se amehang hoseng le mantsiboea, o pikitle habonolo ho fihlela o kenelle ka botlalo.
• Phlebodia. Ntho e sebetsang ke diosmin. Ntho ena e fokotsa ho eketsoa ha methapo, e ts'oants'a lerako la methapo, e tlosa stasis ea venous. Setlhare se ka tsela ea litafole. Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 1 pc. Litsenyehelo tsa matlapa a 60 ke 1,500 p.
• Venus. E na le diosmin le hesperidin. Lithethefatsi li ntlafatsa drainage ea lymph, e etsa hore li-capillaries li se ke tsa senyeha haholo, e eketsa molumo 'me e fokotsa ho eketseha ha methapo. Bekeng ea pele, nka matlapa a mabeli, u a arole litekanyetso tse peli. Nakong e tlang, o ka nooa hang hang 2 likhomphutha. Theko ea matlapa a 30 ke 570 p.

Ho fokotsa ponahalo ea methapo ea mali

Li-anticoagulants li sebelisetsoa ho thibela le ho phekola thrombosis. Lithethefatsi sehlopheng sena li fokotsa ponahalo ea mali, ka tsela eo li thibela ho etsoa ha methapo ea mali. Lithethefatsi tse latelang li na le thepa ena:

• Dicumarin. E reheletsoe motsoako o tšoanang mohoeng. Dicumarin e thibela ho thehoa ha prothrombin hape e thiba proconvertin ea sebete, e bakang keketseho ea nako ea ho putlama ha mali. Moriana o nooa 0,05-0.1 g matsatsing a pele a 2-3, mme ebe 0,15-0.2 g ka letsatsi. Theko - 1000 r.
• Heparin. Motheo oa sethethefatsi ke sodium heparin. Motsoako ona oa li-trophic ulc on maoto o fumaneha ka sebopeho sa gel bakeng sa ts'ebeliso ea kantle le tharollo ea entetso. Maemong a pele, heparin e sebelisoa sebakeng se amehang makhetlo a 1-3 ka letsatsi. Tekanyetso ea prophylactic ea liente tsa heparin ke likete tse 5 tsa IU / ka letsatsi. Gel e ja 250-300 r., Ampoules ka tharollo - 350-550 r.
• Aspirin Ntho e sebetsang ke acetylsalicylic acid. E kokobetsa bohloko, e sitisa ho kopanngoa hoa liplatelete, ka tsela eo e fokotsa pono ea mali. E fumaneha ka tsela ea matlapa a nooa ho 300 mg ka nako ea lihora tse 4-8. Theko ea Aspirin e tsoa ho 80 ho isa ho 250 r. ho latela moetsi.
• Urokinase. E na le ntho e le 'ngoe e sebetsang, e khonang ho qhekella likhahla tsa mali tse teng le ho thibela ponahalo ea tse ncha. Urokinase e fumaneha e le lyophilisate bakeng sa ho hlophisoa ha tharollo ea infusion ka litekanyetso tse fapaneng tsa karolo e sebetsang: 500 likete IU, 10,000 IU, 100,000 IU, 50,000 IU. Setlhare se kenngoa ka har'a draina kapa molatsoaneng. Tekanyetso e khethoa ka bonngoe. Theko ea botlolo e le 'ngoe ea 500,000 IU ke 5500-6700 p.

Ho imolla spasm

Morero oa ts'ebeliso ea li-antispasmodics ke ho imolla spasms le anesthesia, ka lebaka la vasodilation.Ho bohlokoa ho hlokomela hore lithethefatsi tse joalo tse nang le liso tsa trophic ha li sebelisoe hangata, hangata ka embolism ea pulmonary. Hangata bakuli ba sebelisa antispasmodics kantle ho sepetlele ho imolla bohloko, bo ka mpefatsang boemo ba bona. Lebaka ke hore lithethefatsi tse joalo li ka baka nts'etsopele ea "ho" utsoa ha leoto le amehang, ka lebaka leo mali a emang ho kena ka ho lona. Ngola antispasmodics e lokela ho ba ngaka feela. Mehlala ea lithethefatsi tse joalo:

• Spazmalgon. E na le pitophenone, metamizole sodium, fenpiverinium bromide. Li na le litlamorao tsa antipyretic, anti-inflammatory le analgesic. Matlapa a Spazmalgon a nka li-pcs tse 1-2. kamora ho ja ho fihlela makhetlo a 2-3 ka letsatsi. Ho entoa ha moriana ona ho etsoa makhetlo a mararo ka letsatsi ka tekanyo e fihlang ho 5 ml. Nako ea ente ke matsatsi a 5. Litšenyehelo tsa li-ampoule tse 10 tsa 2 ml - 280 p., Matlapa a 20 - 220 p.
• Che-shpa. Ntho e sebetsang ke drotaverine, e leng myotropic antispasmodic. Karolo ena e fokotsa molumo oa lentsoe le koloi ea mesifa e boreleli ea litho tsa ka hare, e ntse e holisa le likepe. Matlapa a no-shpa a ka nooa lethalong la 120-240 mg ka letsatsi. Tekanyetso ea ente ke 40-240 mg. Theko ea li-ampoules tse 25 ke 440 p., Matlapa a 100 - 220 p.
• Papaverine. E na le papaverine hydrochloride. Ntho ena ke opium alkaloid e khathollang metsoako e boreleli ea mesifa, ka hona e tlosa molumo oa eona. Matlapa a Papaverine a nooa makhetlo a 3-4 ka letsatsi ka tekanyetso ea 0,04-, 08 g, likerese li sebelisoa ka tekanyetso ea 0,02 g (butle-butle e tlisoa ho 0.04 g). Lenaneo la ente le ipapisitse le lilemo tsa mokuli. Litsenyehelo tsa matlapa a 10 ke 18 p., Likerese tse 10 - 55 leq., Li-ampoules tse 10 - 100 p.

Lihlopha tsa lithethefatsi

Li-ulc tse lipheletsong tse tlase li hlaha ka lebaka la tlolo ea trophism, ke hore, phepo e nepahetseng ea lisele. Lingaka li lebisa tlhokomelo ea bakuli hloko ea hore ho hlokahala ho theha lebaka leo phepo ea lithane e neng e sitisoa ka lona, ​​mme ke hona feela ba qalang liketso tse reretsoeng ho tlosa bofokoli.

Ha ho felisoa ulcers ka leotong, ho sebelisoa lihlopha tse 'maloa tsa lithethefatsi. Ha e le hantle, lithethefatsi li etselitsoe merero ea tlhaho, empa lithethefatsi tse ling li sebelisetsoa ho etsa phoso ka seo.

Phlebotonics

Li-Phlebotonics, tse tsejoang hape ke tsa bongaka e le li-venotonics kapa phleboprotectors, ke sehlopha se pharaletseng sa meriana e sebelisoang bakeng sa liso tsa trophic. Tsena li kenyeletsa:

Li-phlebotonics ke lithethefatsi tse etselitsoeng ho ntlafatsa maemo a marako a methapo. Ka lebaka la meriana ena, hoa khonahala ho eketsa polasetiki ea methapo ea mali, ho ntlafatsa katleho ea tsona, 'me ho be le phello e molemo ho phallo ea mali. Ho feta moo, ho matlafatsoa marako a methapo ea mali.

Li-phlebotonics li sebelisoa hantle haholo karolong ea epithelialization, ha seso se koahetsoe ka lesela le tšesaane la lithane tse sebetsanang le ho theha leqeba. Nakong ena, meriana ea phlebotonizing e tla fana ka tšireletso le ho potlakisa ts'ebetso ea pholiso.

Direct anticoagulants

Lithethefatsi li fanoe ka botsoali. Li emeloa haholo ke phapang ea heparin (ntho e teng 'meleng ebile e tloaelehile, e tiisa botsitso ba thepa ea mali) le li-inhibitors tse otlang ka kotloloho.

Li-anticoagulants tse tobileng li kenyeletsa:

• Boima ba 'mele heparin e tlase.
• Heparin e senang mekhahlelo.
• Exante.
• Arikstra.

Ho tsoa likhethong tsa mali

Haeba litheko tsa mali e bile sesosa sa ho theha lisele tsa trophic tsa lipalo tse tlase, joale lithethefatsi tse tsoang sehlopheng sa li-antiplatelet agents li sebelisoa. Morero o ka sehloohong oa ts'ebeliso ea bona ke ho qhibiliha ha methapo ea mali ho khutlisa phallo e tloaelehileng ea mali. Hangata lithethefatsi tse joalo li sebelisoa bakeng sa methapo ea varicose. Litsi tse latelang tsa antiplatelet li ratoa:

• Trental. E na le pentoxifylline - ntho e tlotsang methapo ea mali, e ntlafatsa methapo e mengata, e fana ka karohano ea liplatelete, e fokotsa pono ea mali. Matlapa a trental a nooa ka molomo nakong ea lijo tsa 100 mg kapa ka mor'a tsona. Ebe butle-butle tekanyetso e eketsoa ho 200 mg.Multiplicity ea ho amoheloa - makhetlo a 3 ka letsatsi. Li-infusions tsa trental li etsoa hoseng le mantsiboea ka tekanyetso ea 200-300 mg. Litsenyehelo tsa matlapa a 60 ke 460 p., Ampoules tse 5 tsa 5 ml ka ngoe - 160 p.
• Nako. E na le dipyridamole - ntho e thibelang ho bokellana ha liplatelete. Ho feta moo, sethethefatsi sena se hlapolla methapo ea mali, se ntlafatsa methapo ea kutlo. Curantyl e fumaneha ka mokhoa oa matlapa a nang le lethal e fapaneng la dipyridamole: 25 mg, 75 mg - le ka sebopeho sa dragees (25 mg). Bakeng sa thibelo ea thrombosis, ho khothalletsoa ho nka matlapa a 3-6 ka letsatsi, 75 mg ka 'ngoe. theko - 40 li-pcs. - 700 leq.
• Nicotinic acid Ena ke vithamine PP, e nkang karolo ea lipalo tse ngata tsa li-oxidative tse etsahalang liseleng tse phelang. Asiti ea Nicotinic e ntlafatsa boemo ba metabolism ea methapo, e etsa hore boemo ba methapo ea methapo e fokotsehe, e fokotse ho ruruha, 'me e atolose matla a methapo ea mali. Tekanyetso ea liente e khethoa ka bonngoe. Matlapa a khothalletsoa ho nooa ka tekanyetso ea 12,5-25 mg ka letsatsi. Theko ea li-ampoules tse 10 ke 33 p., Matlapa a 50 - 36 leq.

Lithethefatsi tse seng khahlanong le ho ruruha

Phello e ka sehloohong ea lithethefatsi tse seng khahlanong le ts'oaetso ea li-steroidal (NSAIDs) ke ho fokotseha hoa matla a ho ruruha hoa lehae. Lithethefatsi tse joalo li sebelisoa kajeno e le mokhoa o mong oa ho bakuli ba li-painkiller, haholo nakong ea ts'ebetso ea postoperative. Ntle le moo, li-NSAID li ka thibela ho khomarela ha lisele tse itseng tsa mali. Ha ho phekoloa ulcers ea lisele tse tlase, sena se fokotsa kotsi ea likotsi tsa mali. Li-NSAID li sebelisoa hangata:

• Ibuprofen E rehelletsoe ka ntho e le 'ngoe seboping. E na le litlamorao tsa antipyretic, analgesic le anti-inflammatory. Ntle le moo, lintho tse thibelang liplatele tse ngata, li fokotsa ho ruruha ha mali. Sekhahla sa matlapa a letsatsi le letsatsi ke li-pcs tse 3-4. 200 mg e ngoe le e ngoe, li-suppositories - makhetlo a 5-10 mg / kg makhetlo a 3-4, gel - ho fihlela makhetlo a 4 le lipakeng tsa lihora tse 4 pakeng tsa lits'ebetso. Theko ea foromo ea kiba ea Ibuprofen ke 15-20 p. Moriri o ja 90-100 p., Likerese - 70-90 p.
• Diclofenac. E na le ntho e tšoanang e sebetsang. Litekanyetso tsa letsatsi le letsatsi li ipapisitse le mofuta oa tokollo: liente - 25-50 mg makhetlo a 2-3, gel - makhetlo a 3-4 g g (sebetsa sebakeng se amehang), matlapa - 50-150 mg ka tekanyetso ea 2-3, li-suppositories - 50-150 mg ho latela lipontšo. Kaofela ha tsona li na le litlamorao tse khahlanong le ho ruruha, antipyretic le analgesic. Litšenyehelo tsa likerese tse 10 - 90 p., Gel - 80 p., Matlapa - 40 p., Injections - 50 p.
• Ambene. Ho kenyelletsa sodium hydroxide, dexamethasone, lidocaine, cyanocobalamin, phenylbutazone. Lintho tsena li fana ka phello e phatlalalitsoeng e khahlanong le ho ruruha. Ambene e fumaneha ka tsela ea tharollo ea ente. Tekanyetso e tloaelehileng ke ente e le 'ngoe ka letsatsi. Li etsoa letsatsi le letsatsi kapa ka karohano ea letsatsi le le leng, empa eseng makhetlo a fetang a 3 ka beke. Ampoule e le 'ngoe e bitsa 600-800 p.
• Lornoxicam. Ho kenyelletsa ntho e tšoanang e sebetsang, e nang le litla-morao tsa antiges, anti-inflammatory le anti-rheumatic. Matlapa a nooa ka molomo ho 4 mg ho isa ho makhetlo a 2-3 ka letsatsi. Ho entoa ho boleloa ka tekanyetso ea pele ea 8-16 mg, ka hona, haeba ho hlokahala, e eketsoa ho 16-24 mg. Litsenyehelo tsa matlapa a 10 ke 150 r. Theko ea li-ampoules e fapana ho tloha 700 ho isa ho 900 r.

Mefuta ea liso le etiology ea tsona

Li-ulc li ama likarolo tsa letlalo. Hangata, lefu lena le tšoaetsanoang le tšoaetsana hangata le tsosa mohopolo. Mefuta, liso li khetholloa:

• trophickhahlano le semelo sa methapong ea varicose kapa thrombophlebitis ka ho boptjoa ha libaka tsa purulent-necrotic maotong,
• ischemic e le phepelo ea bokuli ba coronary,
• lefu la tsoekere ka tsoelo-pele ea lefu la tsoekere le lefu la tsoekere, pele ka mofuta oa liso tse nyane tse nang le lehae ka lethekeng le leholo le ntseng le eketseha butle-butle le lebisang ho lahleheloeng ke kutloelo-bohloko, tisane necrosis, nts'etsopele ea gangren kapa angiopathy,
• neurotrophic ulcization le lehae ka serethe ho tsoa ka ntle ka sebopeho sa masoba a tebileng le ho tebela ha litaba tsa serous. Mabaka a sena ke lymphadenitisleqeba la hlooho kapa lesapo la mokokotlo, le bakang ho fokotseha ha kutloisiso ea lisele, ts'oaetso ea maqeba le ho bokellana ha pus ka maqeba.
• venous trophic e nang le 'mala o bosoeu bo bosoeu kapa burgundy-pherese joalo ka fistulas tse sa bonahaleng, lisosa tsa teng ke ho haella ha venous kapa methapo ea varicose e nang le ponahalo ea leihlo le lenyane karolong e ka hare ea maoto le kholo e liehang ho fetoha sebakeng se le seng se seholo.
• hypertonic Lits'oana ka lebaka la ho tlola khatello ea mali ka ponahalo ea matheba a bofubelu bo bokhubelu a boholo bo bonyenyane maotong, leotong,
• pyogenic Khahlano le semelo sa mafu a fokotsitsoeng le mathata a mafu: furunculosis, eczema, vasculitis, rheumatoid arthritis, lupus erythematosus, scleroderma, Reina syndrome.

E ka etella pele ponahalo ea liso maotong, lieta, phalange ea menoana e kholo maloetse a tšoaetsanoang a tšoaetsanoangha maqeba a sa koaeloang a marang a sa lekanang a hlaha le mabaka a sena ke ho roala lieta tse patisaneng, ho lula nako e telele maotong. E ka baka ponahalo ea liso tsa ka mahlaseli a kotsi kapa a hlahisoang ke lik'hemik'hale, ho bata kapa ho bata maoto ha a pepesetsoa mocheso o tlase.

Phekolo ea mafura e kenyelelitsoe ho rarahaneng oa mekhoa ho hatella ts'ebetso ea ho ruruha, ho hloekisa libaka tse nang le "neprotic", ho ntlafatsa lisele tsa trophic, ho potlakisa pholiso ea leqeba.

Kajeno, meriana e rekisang litlolo ka tšebetso e mengata. Ntho ea bohlokoa ke ho khetha setlolo se setle ho tsoa ho lori tsa trophic maotong, ka tsela ena se potlakisa ts'ebetso ea pholiso.

Tlhahisoleseling ka kakaretso

Poleloana "ulcer tropical" e atile ts'ebetsong ea bongaka ebile e kopane ka tlhaho. Wikipedia e fana ka litlhaloso tse latelang: "ona ke boemo ba bophelo bo botle boo ho bona ho leng thata ho folisa sekoli sa tiske."

Li-ulp tsa li-peptic li ka ba ngata haholo, li tebile ebile hangata li tsamaisana le ts'ebetso ea ho ruruha. Li-uloph tsa li-trophic tsa bophahamo bo ka tlase ke sesosa sa maloetse a fapaneng moo li-hemodynamics tsa venous, arterial kapa lymphatic. Malwetse a mangata a letlalo a tsebahala hore, ka nako e telele, e boetse e lebisa ho nts'etsopele ea mafu a tebileng a trophic le ponahalo ea liso le matsoho. Lisosa tsa liso tsa trophic ke likotsi tsa lisele tse bonolo, letlalo le methapo ea kutlo. Khoutu ea "trophic ulcer" ho latela MKB-10 L98.4.2.

Mathata a tebileng a trophic hangata a fumanoa ho bakuli ba nang le bothata bo sa foleng ba venous. Ho feta moo, ho bakuli ba nang le methapo ea varicose, ulphic ulcers ha e tloaelehe ho feta ho bakuli ba ntseng ba tšoaroa vein thrombosis e tebileng. Ho bakuli bana, lcerative ulcerative e fumanoa ho 15-30% ea linyeoe. Ka keketseho ea nako ea lefu le botsofali, menyetla ea ho ba le liso e eketseha.

Kamora ho ba lilemo li 65, khafetsa liso tsa trophic ulc tse nang le venous insuffanele li eketseha makhetlo a mararo. Ka lefu lena, maoto le maoto a tlase a amehile, ho lahleheloa ke karolo e itseng ea 'mele le liphoso tsa ho ruruha ha mali ka lebaka la phallo ea mali e thata ho fetisa - bakeng sa mafu a fapaneng, hona ho ka nka likhoeli. Mokhahlelo oa pele oa li-trophic ulcers ke nako eo mehato eohle e lokelang ho nkuoa ho thibela tsoelopele ea sekoboto sa molala.

Ka bokuli bo sa feleng ba ho kula bo hlaha venous khatello ea mali le venous stasis, e leng motheo oa mathata a lefufuru a letlalo le nts'etsopele ea liso tsa ka mpeng. Ka khatello ea mali e nang le venous, ts'ebetso ea methapo e mengata ea methapo e hlaha maemong ohle: lisele (tse qaliloeng) lisele tse tšoeu tsa mali 'me ho hlahisoa li-enzymes tsa lysosomal), lisele (lia etsahala hypoxia) le boemo ba microcirculatory. Boemong ba "microcirculatory", lisele tsa mali li ikopanya "li" likholomo ", li nts'etsapele microtromboses, e ntše protheine methapong ea mali sebakeng se potileng, e bokelle fibrin, e bopa li-fibrin cuffs ho potoloha li-capillaries, mme sena se mpefatsa ho hloka taolo ea metabolic, e lebisang ho lefu la" epidermal necrosis ".Ho fetoha hoa systemic ho bakang ponahalo e eketsehileng ea mali.

Ka lebaka la liphetoho tse joalo letlalong, ts'ebetso ea eona ea tšitiso e haella. Ho senya likarolo tsa eona ho baka ho ruruha le necrosis ea lisele tse bonolo tse nang le sebopeho se seholo exudate (effusion leqebeng). Kamora nako, ts'oaetso ea baktheria e kenella ka potlako, eo ho eona bakuli ba fokolang ba e fumanang e le motho ea akaretsang 'me leqeba le matla la lehare le ba teng.

Re lokela ho etsa kopo neng

Phekolo ea mafura e sebetsa sebakeng sefe kapa sefe sa lefu lena. Ha u khetha lithethefatsi le ho fana ka litlolo tsa kalafo lingaka li nahanela lisosa tsa motso nts'etsopele ea lefu lena le lisosa tse ka fokolisang.

Mafuta (sesebelisoa sa thupelo):

• ka linako tse ling re qoba ho buuoa,
• matlafatsa linama tsa letlalo le litšiea,
• ntlafatsa tropa,
• tloaelo ea metabolism, phallo ea venous le phallo ea mali,
• tsosa kholo ea lisele tse ncha tse phetseng hantle,
• lisele tse nang le li-collagen le limatlafatsi,
• maqeba a hloekileng a tsoang ho necrosis, khothaletsa pholiso.

Thusa! Tšusumetso e kholo e bonoa sethaleng sa pele. Maemong a tsoetseng pele, bonneteng, kalafo e nang le litlolo feela e ba e sa lekaneng.

Tlhomamiso

Ka lebaka le bitsitsoeng:

• Li-ulous trophic ulves (nts'etsopele khahlanong le semelo sa bokuli bo sa feleng ba venous).
• Alterial ulcs of the limb (e hlaha khahlano le semelo sa mathata a sa foleng a arterial le atherosclerosis obliterans).
• Lits'oaetso tsa lefu la tsoekere.

Botebo ba ho hloloa:

• Ke lekanya - khoholeho ea lefatše, ts'ebetso e lekantsoe ke dermis.
• II degree - ulcerative lesion e koahela lithane tsa subcutaneous.
• Bophahamo ba III - Tšenyo ea mokokotlo oa mokokotlo, mesifa, mesifa esita le masapo le masapo a mokotla o kopaneng.

Sebakeng sa thomello:

• Phoso e nyane ea sekhahla e fihla ho 5 cm2.
• Bohareng - 5-20 cm2.
• Vast - ho feta 50 cm2.

Lisosa tsa liso tsa trophic leotong

Haeba re qolla lisosa tse ka sehloohong tsa lefu lena, liphetoho tse ka sehlohlolong tsa venous etiology li hlahisa 70% ea liso tsohle. Atherossteosis obliterans e baka liso tsa trophic ho 8% ea linyeoe, 'me lefu la tsoekere la lefu la tsoekere ke lona sesosa sa maemo ana ho 3% ea linyeoe.

• Alsa ea trophic ka leoto e bakoa haholo ke khaello e sa foleng ea venous, e hlahisoang ke varicose veins, thrombophlebitis le lefu la post-thrombotic. Ho maloetse ana, sesosa se ka sehloohong sa ulcers ke ho theha methapo ea methapo ea "vertical" le "e otlolohileng" tsamaisong ea venous ea leoto le tlase (hona ho phatlalatsoa haholo ka bokaholimo ba leoto le ka tlase) le keketseho ea khatello ea methapo. Motsoako oa mali o boleloang ka ho fetisisa methapong o bonoa ka ho lula nako e telele o le maemong. Phlebostasis e baka tsoelo-pele ea pherekano ea hemodynamic e seng e ntse e le teng setsing sa venous le phepo ea lithane, mohato oa pele o bonahatsoang ke phetoho ea 'mala oa letlalo le ka tlase la leoto. Meroalo e boima haholo, e telele le ea matla a khoheli e mpefatsang tikoloho ena. Mothating ona, bakuli ba 'maloa ba batla thuso ea bongaka' me bokuli bo tsoela pele. Esita le bofokoli bo hlakileng ba letlalo bo hlahileng, bakuli ka bobona ba leka ho phekola, empa ntle le kalafo e rarahaneng, sena ha se atlehe. Ke 50% feela ea li-ulcers tsa trophic tsa venous etiology tse folisang ka likhoeli tse 4, mme 20% e maemong a bulehileng lilemo tse peli. Ho latela lipalo-palo, 8% ea likoli ha e fole lilemong tse 5 tse tlang. Leha e le ka ho koaloa ha ulcers, boemo ba bona ba ho khutla e boetse e le 6-15%. Ho joalo, boemo bona bo baka ho holofala, ho fokotseha ha bophelo bo botle mme hangata bo baka le ho holofala.
• Li-uloph tsa trophic tsa libaka tse tlase tse tlase le tsona li ka bakoa ke nako e telele arterial ho haella (e felisang mafu a methapo ea methapo). Li thehiloe ka har'a leoto le thata ischemia mme li fumaneha libakeng tsa distal - maotong (hangata hangata leotong le tlase). Metsoako e meholo ea methapo e angoa ke atherosclerosis obliterans, e etsahalang eseng ho batho ba baholo feela, empa le ho bacha. Sesosa sa ulcers ea methapo ena ea mafu ke ho fokotseha ho hoholo ha khatello lipakeng tsa bethe, nts'etsopele ea khatello ea mali le methapo. hypoxia ea mesifa. Khatello ea oksijene (pO2) ho bakuli ba nang le liphetoho tsa necrotic leotong ke 20-30 mm Hg. Letšoao lena le bohlokoa, haeba le sa eketsehe ha le theola maoto tlase, 'me ntlafatso e sa etsahale ka mor'a kalafo e thibelang, joale sena se nkoe e le ts'oso ea ho khaoloa. Sesosa se seng sa ponahalo ea litho tsa ischemia le liphetoho tsa ulcerative necrotic e kanna ea ba li-microembolism tsa maselese a atheromatous kapa li-calcified. Karolo ea bohlokoa ea ulcers ea atrerial ke ntho e bohloko. Le haeba ho lemala hanyane ka hanyane ho mesifa ea leoto (ho longoa, ho kuta hanyane, ho senyeha hoa letlalo ka ho sutla seeta) maemong a phallo e potolohileng ea methapo ho tla baka ponahalo ea leqeba leo le eketsehang ka potlako, le bakang bohloko bo boholo, 'me sena se hloka tšebeliso ea lithethefatsi.
• Lits'oaetso tsa lefu la tsoekere hlaha ho bakuli lefu la tsoekere, e rarahaneng ke microangiopathy le neuropathy e matla. Ka nako e ts'oanang, maemong a tlase, kutlo ea mofuta oa "masokisi a hlatsoitsoeng" e lahlehile - likhahla tsa letlalo tse nang le kutloisiso tse bolokiloeng li lahlehile ka ho felletseng. Ho ba sieo ha bohloko ka mpeng ho bakoa ke tlolo ea bolulo, mme hona ho hlalosa kalafo e telele ea lapeng le ho fihlella ha nako ho setsebi. Pheko e tebileng ka ho fetisisa ea liso tsa tsoekere ke tšoaetso le nts'etsopele e potlakileng. sekhohola se metsise hlokang ho khaoloa.
• Li-ulms tsa trophic khahlano le a hlobaetsang le a sa foleng lymphostasis.
• E sa foleng dermatitis le eczema.
• Maloetse a (collagenoses, vasculitis, mafu a mali) a hlaha a e-na le bothata ba ho ruruha. Livevo-vasculitis (vasculitis le thrombosis ea likepe tse nyane) e bonahatsoa ke lekhopho la hemorrhagic le liso tse bohloko maotong. Livedo - vasculitis e hlaha ka systemic scleroderma, lupus erythematosus, antiphospholipid syndrome.
• Li-ulctive liso thehoa ho pelo le methapo ea methapo ea pelo le ho hloleha ho potoloha ha mali le edematous syndrome. Ha ho lefella lefu le ka tlase le ho felisa edema, bofokoli ba ulcerative bo nyamela ka potlako.
• Maloetse a letlalo la purulent a sa shebeng bohloeki ba motho ka mong (asocial contingent).
• Litlamorao tsa maemo a mmele - ho cha le serame.
• Likotsi tse bakoang ke methapo ea kutlo li baka liso tsa neurotrophic.
• Lisosa tsa ts'oaetso (syphilitic, lepera, Buruli ulcer, ulcer, leishmaniasis, rickettsiosis).
• Letlalo neoplasms ka tsela ea bofokoli ba ulcerative.
• Ho pepesetsoa mahlaseli (mahlaseli a kotsi).
• Ulceration ea letlalo ka chefo Necrolysis ea Lyell (foromo lbokhoba ba lithethefatsi).

Matšoao a hore na trophic ulcer ka leoto

Mohato oa boraro oa ho hloka botsitso ba venous o tšoauoa ka ponahalo ea leqeba la trophic, le sa hlaheng hanghang mme le na le mekhahlelo. Karolo ea pele ea "trophic ulcer" mokokotlong e tšoauoa ke sebaka sa marang-rang Hyperpigmentation - hemosiderin (sehlahisoa sa ho phatloha ha hemoglobin) se kenngoa ka har'a dermis. Kamora nako e itseng, mafura a ikhethileng a kopanngoa bohareng ba sebaka, 'me letlalo le fumana ponahalo ea lacquer le tint e soeufatsang (joalo ka lepage ea parafini). Mohato ona o bitsoa "letlalo le tšoeu la atrophy" mme o nkuoa e le boemo ba pele ho ulcerated.

Ho bohlokoa ho qala kalafo qalong, hobane hamorao libakeng tsa "letlalo" la "varnish", lisele tsa lefu la sethoathoa lia shoa 'me ho lutla hoa mali ho bonoa. Boemong ba mathata a trophic, bakuli ba amehile ka ho hlohlona le ho chesa. Libaka tse shoeleng li hasana kapele mme ts'ebetso e phethela ka ho etsoa ha leqeka la leqeba la ncrotic le khopisang khatello e tlase.Sebaka se tloaelehileng bakeng sa liso tsa venous ke sebaka sa mokokotlo oa leoto le ka tlase, 'me palo ea liso li ka fapana. Li-ulter tsa ka morao-rao li hlaha libakeng tse thoko (maoto, serethe).

Li-uloph tsa trophic tse nang le methapo ea varicose e ka ba boholo ba chelete ea tšepe kapa ea koahela leoto lohle le ka tlase, 'me ea kenella ka hare ho fascia - hangata ho hlokomeloa ka kalafo ea morao le ha ho se na kalafo e lekaneng. Ulicose ulcer e na le sebopeho se potolohileng, exudate e lula e lokolloa ho eona: mokelikeli o hlakileng, mali, pus ha limela tsa bacteria li entsoe, fibrin.

E tsoela pele ho hola ka boholo 'me karabelo ea ts'oaetso ea lisele tse bonolo e ea kenella. Ka tšoaetso ea kokoana-hloko, monko o sa thabiseng o tsoa leqebeng. Bohloko bo ka ba matla. Hangata, liso tsa kahare tse mpe li tebileng, li na le metsero e metenya, ka tlase e koahetsoe ka polasetiki le makhopho, letlalo le pota-potiloe ka letlalo, 'me litho tse ling tsa eona li kobehile. Phekolo mothating ona e nka likhoeli tse 1-1,5 mme e kenyelletsa ho hloekisa mabala ho tsoa kahare.

Kamora phetoho ea mohato oa granulation, ulcer e hloekisoa kahare ea eona mme granerals e hlahella tlase ho sekoli, mme le boholo ba ulcer bo qala ho fokotseha. Bofubelu le bohloko li fokotsehile haholo.

Nako ea mohato e ipapisitse le boholo ba pele le botebo ba ulcer, ho katleho ea kalafo ea karolo e fetileng. Haeba trophism ea dinama e ntlafalitsoe, phetoho e tla etsahala kapele mme e tla fela ka epithelization e felletseng. Mohato ona o molelele mme ho na le monyetla oa hore o ka khutla, 'me ka mor'a moo ulcer e le ea bobeli kalafong e mpe. Haeba kalafo e nepahetseng e qalile ka nako, ulcer ea koaloa, 'me e latela mehato ea thibelo phlebotonics, o apere liaparo tsa compression, o shebile puso ea mosebetsi le phomolo, o fokotsa moroalo o matla) menyetla ea ho khutla kamora hore leqeba le felletseng le fokotsehe.

Ho bakuli ba nang le lefu la tsoekere eketseha ha methapo ea pelo, ho senyeha ha microcirculation ea maoto, le ho kopantsoe le arteriosulinosis e kenya letsoho kholong ea liso tsa lefu la tsoekere. Ho lahleheloa ke matla a letlalo ho rera ho senya le tšoaetso. Li-ulcic ulcers li na le thuto e telele le e phehellang, hangata e mpefatsa. Li-ulms tsa lefu lena ho lefu lena li atisa ho ba le mokhoa o fapaneng oa lehae - sebaka sa limela le menoana ea pele, e leng mokhoa oa leoto la lefu la tsoekere.

Le ha ho le joalo, ulcers ea maoto le eona ea fumanoa, e leng ea mofuta o tsoakaneng - ka lebaka la khaello ea methapo le ea venous. Lefu la tsoekere le ho se sireletsehe ha mmele mokokotlong oa lona le ama ts'ebetso ea pholiso hampe.

Liteko le tlhahlobo ea mafu

Boemong ba ho khetholla maloetse a lebisang ho bopeng liphooko tsa trophic ho sebelisoa:

• liteko tse tloaelehileng tsa laboratori
• Teko ea mali bakeng sa tsoekere,
• Tlhahlobo ea baktheria ea leqeba
• Ho hlahlojoa ha methapo ea ultrasound ho etsa hore e khone ho fumana leseli ka lisebelisoa tsa methapo ea methapo e tebileng le e bobebe.
• radiopaque le radioisotope phlebography,
• phlebotonography,
• plethysmography (e khethiloeng ke boleng ba venous Reflux ho mafu a methapong),
• multispiral computed tomography - angiography ho ithuta ka boemo ba methapo ea methapo kapa ho hlahloba ka makhetlo a mabeli ho ts'oaroa ha methapo ea methapo ea litho tsa maiketsetso le tsa basali,
• molemong oa lefu la tsoekere le ischemic ulcer, sepheo sa phetoho ea phapang ea khatello methapong ea methapo e tlase le methapo ea methapo ea methapo e kenelletsoa mohlaleng oa tlhahlobo.

Phekolo ea liso tsa kahare ka mpeng

Phekolo ea liso tsa ka tlase leoto ke ts'ebetso e telele, hobane ho potoloha ha mali ho na le bothata mme li-venous stasis le lymphostasis li teng. Ho phekola leqeba la peptic qetellong, o hloka ho ba le phello e rarahaneng, ho nahanela mabaka a ileng a sebetsa e le nts'etsopele ea lefu lena. Ho thata ho phekola lesapo la mokokotlo la lipalo tse tlase mme o na le tloaelo ea ho khutlela morao, ka hona kalafo e lula e le bothata.

Litokisetso bakeng sa kalafo ea liso tsa trophic tsa lipalo tse tlase

Phekolo ea lithethefatsi ke sona motheo mme lithethefatsi tsohle li ka aroloa ka lihlopha tse 'maloa:

• Antibacterial. Mokhahlelong oa exudation o tšoauoa ka ho ntšoa ha leqeba le lengata, ho ruruha hoa bohlokoa ha lisele tse potileng le ho ikamahanya le limela hangata. Li-antibiotic li bontšoa bakeng sa liso tse pharaletseng tsa trophic tse etsahalang ka ho ruruha hoa pherekano le karabelo ea systemic (mocheso, malaise), hammoho le ho ba le phallo ea purulent. Morero o ka sehloohong oa kalafo ea lithibela-mafu ke ho nchafatsa leqeba ho tsoa ho pathogenic microflora. Tšebeliso ea litlhare tsa lithibela-mafu ha e na thuso. Hang-hang lithibela-mafu li hlahisoa ka mokhoa o matla ebile hangata ke sesosa sa ketso: Cefoperazone, Cefadroxil, Cefazolin, Lomefloxacin, Cefamandol, Ofloxacin, Koprofloxacin. Tsamaiso ea methapo e bohlokoa haholo, empa tsamaiso ea molomo e lumelletsoe. Kamora ho tsebahatsa semela sa pathogenic le ho khetholla kutloisiso ea lithibela-mafu, tokiso ea kalafo ea etsoa. Nako ea kalafo e thibelang likokoana-hloko e nang le liso tse ngata tsa purulent-necrotic, tse bolokiloeng ka foromo ea neuro-ischemic lefu la tsoekeree ka fihla likhoeli tse peli. Ho lefu la tsoekere, nephropathy e nang le chefo hammoho le tšenyo ea meno lipelong tsa mafu, a hana ho sebelisa aminoglycosides (Neomycin, Kanamycin, Monomycin, Gentamicin, Tobramycin, Amikacin).
• Lithethefatsi tsa antifungal. Ts'ebetsong e sa feleng ea ho ruruha, haholo khahlanong le lefu la tsoekere, tšoaetso ea HIV, mofets'e, limela tsa fungal li jaloa ho tsoa leqebeng (mefuta e fapaneng) Candida) kapa motsoako oa limela tsa bacteria le fungal. Ka hona, kalafo ea lithibela-mafu e matlafatsoa le lithethefatsi tse thibelang likokoana-hloko.
• Ho ruruha ho matla ha litho tsa thipa ho potoloha le ulcer le bohloko bo boholo ba ho hlaka ho hloka lithethefatsi tse seng tsa steroidal tse thibelang mafu (Diclofenac, Ketoprofen, Movalis) U kanna ua hloka mokhoa oa ho bua ka menoFaspik, Ketanov, MIG-400, Ketorol).
• Lithethefatsi tse ntlafatsang microcirculation le phepo ea lithane li kenyelletsoa ho lila tsa trophic tsa etiology efe kapa efe. E sebelisetsoa morero ona. Pentoxifylline le Actovegin. Lithethefatsi tsa ho qetela li na le phello e rarahaneng ea metabolic mme e bontšoa haholo-holo bakeng sa liso tsa ka morao lefu la tsoekere le atherosclerosis obliterans. Actovegin e qala ka ts'ebetso ea ho kenella kahare ho matsatsi a 15, kamora moo ba fetohelang ho nka mofuta oa Letlapa (makhetlo a 1 makhetlo a 3 ka letsatsi, likhoeli tse 1.5).
• Litokisetso tsa kalafo e hlasimollang (Loratadine, Ketotifen diphenhydramine, Chloropyramine-Ferein, Cetrin le ba bang).
• Litokisetso prostaglandin F1 (karolong ea pele le ea bobeli ea ho ruruha maqeba). Phekolo ea ulcers ea trophic e nang le methapo ea varicose. Morero oa mantlha oa kalafo ke ho koaloa ha seso sa trophic le ho thibela ho khutla hape.

• Phomolo ea bethe.
• Systemic kalafo ea lithibela-mafu.
• Lithethefatsi tse sebelisang kotsi (phlebotonics). Lithethefatsi tsena li theha motheo oa kalafo ea lithethefatsi bakeng sa khaello e matla ea venous. Sena ke sehlopha se seholo sa lithethefatsi tse eketsang phallo ea venous ho tsoa lipheletsong, ho eketsa molumo oa venous, ho fokotsa khatello ea maikutlo, ho ntlafatsa drainage, le ho ba le litlamorao. Setlhare se nang le katleho e netefalitsoeng ke diosmin (Phlebodia, Venolek, Diovenor, Phlebopha) Boteng ba li-trophic ulcers, ts'ebeliso ea lithethefatsi tsena e hlokahala bakeng sa likhoeli tse 2-6. Ntho e sebetsang diosmin e kenella ka potlako mme e bokellane sebakeng sa ulcer mme e hatella karabelo ea ho ruruha ea lehae. Ha u sebelisa diosmin, pholiso ea ulcer e fumanoa ho 61% ea bakuli. Ho khothalletsoa hore li-phlebotonics li qale ho sebetsa ho tloha mohatong oa bobeli oa leqeba le nako e telele kamora ho fola leqeba.
• Karolong ea bobeli ea ts'ebetso ea ho folisa maqeba, li-antioxidants li eketsoa kalafong (Aevit, vithamine e), Actovegin kapa Solcoseryl.
• Ba sa lumellaneng (acetylsalicylic acid 0,1 g Pentoxifylline, nicotinic acid) Kopo Pentoxifylline ka nako ea a hlobaetsang e thusa ho folisa ka potlako lesapo la peptic.
• Lithethefatsi tse thibelang mafu.
• Phekolo ea lehae ea li-varicose tsa ulcose e hlile e kenyelletsa lithethefatsi tse nang le heparin. Heparin E na le litlamorao tse khahlanong le ho ruruha le li-analgesic, inactivating histamine le hyaluronidase. Ho kenella ha ntho e sebetsang ho thata maemong a ho potoloha ha venous. Ho sebetsa hantle ha heparin ho itšetlehile haholo ka ho tsepamisa maikutlo ha eona. Ka hona, o hloka ho sebelisa litlolo (kapa li-gels) tse nang le heparin e nang le bonyane li-PIECES tse ka bang 1000 (Thrombophobia, Lyoton, Hepatrombin) E latelang e na le 30,000 ho isa ho 50,000 IU ea heparin, ka hona phello e tla ba matla le ho feta. Moetso o boetse o kenyelletsa dexpanthenone le allantoinho ba le phello e nchafatsang le e thibelang mafu. Ho bohlokoa ho sebelisa lithethefatsi tsa phlebotropic tsa molomo, kaha tšebeliso ea lithethefatsi tsa lehae ha e na kelello.
• Ho dermatitis le eczema hoa khoneha ho sebelisa litlolo tsa corticosteroid sebakeng sa heno.
• Tlamo ea khatello le tlamisa Varolast (bandage ka elastic ka boima ba zinki) nakong ea kalafo, ho qala ho tloha karolong ea bobeli ea ts'ebetso ea leqeba. Qalong, bandage kapa bandage e kenngoa bakeng sa matsatsi a 1-2, 'me hamorao bakeng sa matsatsi a 5-6. Kamora ho hlaphoheloa ulcer, phekolo e tsoelang pele ea khatello ea maikutlo le phello ea khatello ea bongaka e bontšoa.

Mokhoa oa ho phekola ulc ka lithethefatsi tsa lehae?

Ka ulcer ea trophic, kalafo ea lehae e na le boleng bo thusang, ntho ea mantlha ke ho eketsa molumo oa methapo ea likarolo tse tlase. Phekolo ea lehae e its'etleha ka karolo ea ts'ebetso ea leqeba: karolo ea pele ke exudation (matsatsi a 6-14), karolo ea bobeli e eketseha (ho etsoa ha granerals, ho nka matsatsi a 30), karolo ea boraro ke epithelization (nako e fihlang ho matsatsi a 45).

Meriana ea lehae e khetholloa ke ntho e sebetsang. Linolo le li-gels tse thehiloeng ho:

• Heparina le lithethefatsi tse fuoang.
• Lithethefatsi tse seng khahlanong le ho ruruha - li sebelisoa moo ho loants'a bohloko ba pelo.
• Li-enzyme tsa Proteolytic. Litokisetso tse thehiloeng ho li-enzyme tsa proteinolytic li sebelisetsoa ho hloekisa lisele tse shoeleng le fibrin ho tsoa liso tsa ka mpeng. Ha u li sebelisa, ho na le monyetla oa ho ba le lintho tse ngata tse ka u utloisang bohloko hobane li-enzyme ke liprotheine tse tsoang kantle ho naha. Mabapi le sena, litokisetso tsa enzyme li sebelisoa ka moaparo o kentsoeng ka nako e khuts'oane (ha ho feta matsatsi a 3-4), mme ha ho hlohlona le ho chesa ho hlaha sebakeng sa maqeba ho felisoa hanghang.
• Lithethefatsi tse thibelang likokoana-hloko (tse nang le liso tsa kahare tsa venous).
• Corticosteroids haeba e fumaneha eczema le dermatitis.
• Li-antihistamine tse nang le ho hlohlona le eczema, haeba ho na le monyetla oa ho sebelisa li-glucocorticoids sebakeng sa heno.
• Mehloli ea Liprotheine tsa Liphoofolo (Gel le Setofo Actovegin).

Mokhahlelong oa exudation, ntloaneng ea seso sa trophic e sebelisoa ka mehla ka liponche tsa k'hothone le tharollo ea antiseptic. Bangoli ba 'maloa ba lumela hore ho itlhoekisa feela ka mochini o nang le letsoai la' mele ho lekane ntloana ea leqeba (e futhumetse mocheso oa 'mele ha o phekola leqeba karolong ea bobeli le ea boraro ea ts'ebetso). Qoba tšebeliso ea hydrogen peroxide le iodine-povidone, e senyang lithane tsa granulation.

Leha ho le joalo, karolong ea pele ea ts'ebetso ea ho folisa maqeba, li-antiseptics tse sa jeleng paate, li-enzyme tsa protheine le baloi li sebetsa hantle haholo bakeng sa ho tlosa lisele tsa necrotic le exudate. Litokisetso tsa litlama li sebelisoa e le li-antiseptics (Chlorhexidine, Eplan, Dioxidine, Cital) le tharollo e lokiselitsoeng ka boikemelo (li-decoctions tsa chamomile, yarrow, thapo, tharollo ea furacilin kapa potasiamo permanganate). Li-enzyme tse sebelisitsoeng ka hloko ka har'a li-encyme: hyaluronidase, nucleotidase, trypsin, chymotrypsin, collagenase.Enzyme ea ho qetela ke qhibilihang ea metsi.

Collagenase ha e senye lithane ebile e eketsa keketseho ka makhetlo a 10. Ke karolo ea setlolo Iruxol, e sebelisetsoang ho phekola londa tsa trophic. Yaz sobrentov e ka bitsoa Ssepisorb, Diotevin le Sorbalgon. Aseptorbis e fumaneha ka mokhoa oa phofo, eo phofo e tšesaane e sebelisetsoang ho etsa phofo le leqe ka mor'a ntloana. Ho na le mefuta e mengata Aseptisorba - ka anesthetic, bakeng sa maqeba a purulent le Divinbakeng sa maqeba a necrotic le Diotevin. Sorbalgon - ntho e sebetsang ke calcium alginate. Setlhare se ka foromo e omileng se ts'oaroe leqebeng, moo se hohelang ebe se monya libaktheria le leqeba. Lits'oaetso tsa ho hloekisa li boetse li etsoa ho sebelisoa lifilimi tsa collagen le li-hydrogels - sena se fokotsa haholo nako e hlokahalang bakeng sa phetoho ho tloha ho exudation ho isa granulation.

Kamora kalafo ea maqeba ea ulcer, moaparo o lokela ho tšeloa ka setlolo se tlotsang mongobo. Kenya litlolo Levosin, Levomekol, Solcoserylsetlolo se tlotsitsoeng gepon kapa Dioxol. Setlolo sa dioxicole se etselitsoe kalafo ea ulc ulc karolong ea pele ea ts'ebetso ea leqeba. E na le dioxidine (antiseptic), trimecaine (anesthetic) le methyluracil (phetetso).

U ka sebelisa seaparo sa setlolo se tlotsitsoeng se entsoeng ka setlolo Voskosran-Do, e nang le mafura a Dioxol. Tšusumetso e ntle e bonoa ha u sebelisa setlolo se kopaneng Streptolavene nang le miramistin (antiseptic) le ultralysin (enzyme). Phofo le eona e na le phello e rarahaneng. Diotevine nang le kopi, antiseptic (dioxidine) le ntho e bitsoang (terrilithin). Bandage e tlotsitsoeng kapa bosholu ba compression bo entsoe ka holimo. Ka li-ulcers tse bulehileng, ho thehoa bandage ea multilayer: pad-gauze pad, bandage ea extensible e khutšoane le bandage ea degree e mahareng.

Ho feto-fetoha ha leqeba ho ea karolong ea bobeli (ho atoloha) ho tšoauoa ka ho hloekisa leqeba, ho fokotsa ho ruruha, ponahalo ea mesifa le ho fokotseha ho hoholo hoa ts'oaetso. Morero oa mantlha ke ho susumetsa kholo ea lisele tse sebetsanang. Ho potlakisa kholo ea lisele, kenya kopo zinc hyaluronate (gel Curiosin) Hyaluronic acid ke karolo ea sebopeho sa lisele tse sebetsanang, 'me zinki ke antiseptic e sebetsang. Ho potlakisa ho koaloa ha maqeba, ho sebelisoa liaparo tsa maqeba (Allevin, Algipor, Sviderm, Algimaf, Gishispon), ebe ho etsoa bandage e phahameng. Mothating ona, ho ka sebelisoa litlama (litlama kapa litlolo tse tlotsitsoeng ka leoatleng), litharollo tsa metsi kapa litlolo tse thehiloeng ho protocol.

Karolong ea epithelialization, liforomo tse bobebe, tse lokelang ho sireletsoa tšenyo e kantle, hape o tsoelepele ho fokotsa khatello ea maikutlo ka ho roala lihempe tse marang-rang (lisokisi tsa mangole kapa metšoasong) le ho nka li-phlebotonics. Karolong ea bobeli le ea boraro ea ts'ebetso, litlolo li sebelisoa ho potlakisa ntlafatso Ebermin le Actovegin (gel mokhatlong oa bobeli, le setlolo karolong ea boraro).

Haufinyane tjena, liaparo tsa maqeba a mehleng ea kajeno li sebelisoa ka bongata, khetho ea tsona e etsoa ha ho nahanoa hore na exudation le karolo ea ts'ebetso e joang. Boemong ba ho ruruha, liaparo tse joalo li lokela ho tsosa ho khesoa ha lisele tsa necrotic (ho itlhoekisa ha leqhetsoana la leqeba), lino tse tahang le lesapo la mokokotlo. Ha u phekola liso tsa ka "tse hloekileng" tse qalileng ho fola, ho bohlokoa ho boloka mongobo le phihlello ea moea, ho li sireletsa khahlanong le tšenyo le ho nchafala hape le ho khothaletsa tokiso ea lisele.

Liaparo tsohle li bonolo ho li sebelisa, li nka nako ebile li ka sebelisoa ke mokuli lapeng. Karolong ea pele ea ts'ebetso ea pholiso ea leqeba, liaparo tse nang le li-sorbents (tse hlahisitsoeng ke khase), li-enzyme tsa protheine, li-antiseptics (mohlala, silifera), alginates le li-super absorck li sebelisoa ka ho khetheha.

Boteng ba necrosis leqebeng, ho sebelisoa liaparo tsa hydrogel (Gidrosorb, Gelepran, Opragel)Phello e ka sehloohong ea li-hydrogels ke ho hlatsoa ha leqeba le ho phunyelletsa ha lisele tsa necrotic. Ka sebopeho se eketsehileng sa fibrin, exudation le tšoaetso, ho sebelisoa liaparo tse nang le alginates le silevera (Sorbalgon ka calcium alginate, Gelepran ka silifera Askina Kalgitrol Ag) Askina Kalgitrol Ag - moaparo o mekato e mengata ka selifera alginate, e bolokang tšebetso ea antimicrobial matsatsi a ka bang a 7.

Liponche li sebelisoa hangata ho li-exudation tse matla, hobane li monya mongobo ho tsoa leqebeng hantle. Empa seponche Meturacol E na le methyluracil le collagen e omileng, ka hona, ntle le bokhoni ba eona bo phahameng ba boloi, e na le litlamorao tse khahlanong le ho ruruha le ho iphetetsa. Seponche Meturakol e sebelisoa karolong ea 2 le ea 3 ea ts'ebetso. Ke poleiti e sa hlapolloang e phallang metsing a chesang. Seponche se beoa leqebeng, se hapa bolelele ba 1.5 cm, 'me se tsitsitse. Haeba ho na le mantle a purulent, o ka nolofatsa seponche ka tharollo Dioxidine. Moaparo o ka fetoloa ka matsatsi a 3 - nakong ena seponche sea qhibiliha. Haeba e sa qhibilihe mme ho sa hlokahale hore u apare, ha e tlosoe.

Liaparo tsa atraumatic ka li-alginate le hydrocolloids (Duoderm, Hydrocall) Ka maqeba a "hloekileng", ho sebelisoa liaparo tse koahetsoeng ke collagen le liaparo tse folisang maqeba. Ho ikoetlisa ka setlolo sa mafura Lekala N e bua ka meaparo ea atraumatic. E na le setlhare sa Peruvian (se na le phello ea antiseptic), jelly ea peterole, cetomacragol, glycerin, mafura a haedrojene, oli e tlotsitsoeng. Ha e khomarele leqeba, ha e kena-kenane le ho tsoa le ho sireletsa leqeba hore le se ke la senyeha le ho tsoa. E sebelisoa bakeng sa granulation le epithelization. Lepheo le sebelisoa leqebeng, le tlameletsoe ka masela le bandage.

Karolong ea boraro, lefu la sethoa la mafuEbermin), li-hydrogels, liaparo tse ka feteloang ka bongata ka collagen, chitosan, chondroitin sulfuric acid le hyaluronic acid (Bol-hit, Collachite). Liaparo Voskosran le Parapran e sebelisitsoeng mohatong oa II - III, kaha e tsosa nts'etsopele ea granerals le ho potlakisa epithelization.

Lirosa le tsona lia khahla. Activetexe nang le setsi sa masela se koahetsoeng ka lihlahisoa tse fapaneng tsa kalafo le polymer ea gelling. Napkins ea lihlopha tsohle e na le phello ea antimicrobial. Li fumaneha ka likarolo tse fapaneng, ka hona, li na le lipontšo tse fapaneng. Mohlala, napkins Activetex FL li na le furagin (sethethefatsi se loantšang likokoana-hloko) le lidocaine (anesthetic ea lehae). Tabeng ena, ho khothalletsoa ho li sebelisa kalafo ea ulcers le ho ba teng ha bohloko bo boholo. Chlorhexidine le furagin ke likarolo tse peli tsa antimicrobial ho li-HF wipes.

Activex FHF kenyelletsa furagin le chlorophyllipt, Activex HFL - chlorhexidine, furagin le lidocaine, le HVIT wipes - chlorhexidine e nang le livithamini (rutin, ascorbic acid). Activex FOM e na le mafura a "furagin" le ts'ebetso ea leoatle - ketso ke ho felisa ho ruruha le ho tsosa bocha. Li ka sebelisoa mohatong oa pholiso.

Phekolo ea ulcers ho sebelisa li-wipes tsena e etsoa ka mekhahlelo. Taba ea mantlha, sebelisa ho hlakola ka phello ea antiseptic le analgesic: HF (chlorhexidine + furagin), PCF (furagin + chlorophyllipt) kapa HFL (chlorhexidine + furagin + lidocaine). Ts'ebeliso ea bona e tla thusa ho tlosa ho ruruha le bohloko. Mohato o latelang ke ho sebelisa lipompo tsa HVIT ka li-vithamine tse hlohlelletsang phallo ea mali a lehae le ho khothaletsa pholiso, hammoho le lipompo tsa leoatle. Malepa a ka sebelisoa ntle le ho fetoha ho fihlela matsatsi a 3, leha ho le joalo, sena se itšetlehile ka tekanyo ea ho tlosoa ha maqeba. Boemo ba bohlokoa bakeng sa ts'ebeliso ea li-napkins ke ho boloka mongobo oa bona o sa feleng, hobane ha li omme, li qobella lesapo la bohloko le bohloko le ka hlaha. U ka inamisa napkin ka metsi a letsoai kapa a phehiloeng.

Phekolo ea lefu la tsoekere

Molao-motheo oa kalafo ke ho boloka, haeba ho khonahala, ho phomola betheng kapa ho behelloa ka thoko mojaro mokokotlong, moo ho nang le mafu a trophic. Boemo ba bobeli ba bohlokoa ke ho laola boemo ba tsoekere ka ho sebelisa lithethefatsi tse theolelang tsoekere. Hangata, bakuli ba nang le lefu la tsoekere ba kenngoa sepetlele lefapheng la bongaka, hobane bakuli ba joalo ba mpefala le ho feta 'me ho na le kotsi e kholo ea tšoaetso ea leqeba. Sena se hloka kalafo e matla ea lehae ea lefu la peptic ulcer.

Likarolo tsa kalafo ea bakuli ba nang le liso tsa lefu la tsoekere:

• Etsa bonnete ba hore o hokela litokisetso tsa maiketsetso a maiketsetso (prostaglandin)Vazaprostan, Vasostenone, Arteris Vero), e ntlafatsang microcirculation sebakeng sa ischemic, e thusa ho fokotsa sekoli sa ho opeloa le ho fola, 'me sena se qoba ho khaoloa.
• Ka kalafo e rarahaneng, ho sebelisoa alpha-lipoic acid le livithamini tsa B.
• Li-antiplatelet agents le li-anticoagulants li laetsoe, har'a tseo ho lokelang ho totobatsoa ka tsona Sulodexide.
• Kopo Gepona e lumella pholiso ea ulcer ho angiopathy ea lefu la tsoekere, kaha setlhare sena se matlafatsa kholo ea mafolofolo. Leqeba le hlatsoa ka tharollo ea Gepon (0.002 g ka 10 ml ea saline) mme ho sebelisoa oli e kenyeletsang Gepon.
• Sesebelisoa sa bobeli se sebetsang sa ho folisa liso tsa lefu la tsoekere ke gel Curiosin.
• Sebakeng sa bandaging e boima, ho sebelisoa lisebelisoa tsa nakoana tsa ho laolla "seeta sa".

Li-ulcers tsa 'mele li lokela ho phekoloa:

Phekolo ka litlhare tsa setso

Mekhoa ea litlama e sebelisoa le kalafong ea maqeba. E ka ba lero la Kalanchoe kapa lero la Aloe. O ka phekola leqeba ka leqebeng ka chamomile - lokisa decoction ka tekanyo ea thispone e le ngoe ka 200 ml ea metsi a belang. Moro oa hloekisoa, o huleloa moqomong ebe sekoli se hlatsoa leqeba. Tsamaiso ea lehae e boetse e etsoa ka li-decoctions tsa li-horsetail, plantain, yarrow le trefoil.

Kamora ho hlatsoa leqeba, mafura a lokisitsoeng motheong oa linotsi a ka sebelisoa ho potlakisa pholiso ea ona. Sebopeho sa eona se kenyelletsa:

• halofo ea khalase ea oli ea soneblomo,
• linotsi 2-30 g,
• lehe la khoho.

Lehe le phehiloeng ka thata mme o sebelisa yolk feela bakeng sa setlolo. Fafatsa oli ka sekotlolo sa enamel, tšollela lesiba le tlotsitsoeng, futhumatsa motsoako ho fihlela wax e qhibilihile. Kenyelletsa lehe le khotsoang ebe u kopanya hantle. Boemong bo futhumetseng, qhekella ka likarolo tsa lesela la chachi kapa la nylon. Boloka mafura ka sehatsetsing ka sekotlolong sa khalase (e ea siling). Mafura a batang ha aa lokela ho tšeloa leqebeng, ka hona, karolo e hlokahalang bakeng sa ts'ebetso e lokela ho futhumatsoa ka bateng ea metsi ho fihlela mocheso oa 38-400.

Ho latela risepe e 'ngoe ea setlolo, u hloka ho nka 100 g:

Ho futhumala, ho hlohlelletsa, ka bateng ea metsi ho fihlela wax e qhibiliha le lisebelisoa tsohle li kopantsoe. Boloka mafura sehatsetsing, a futhumetse hanyane pele a sebelisoa. Etsa kopo ho maqeba a hloekisitsoeng.

Nka 10 g ya mummy (lumpy kapa matlapeng), e qhibilihe ka metsi a fokolang a phehiloeng mme o kopanye le 100 g ea mahe a linotsi a metsi. Ha o apara, swab ea gauze ha e kenngoe ka sebopeho, e kenngoa leqebeng mme e tsitsitsoe. Moaparo o fetoloa letsatsi le letsatsi.

Khafetsa ho na le litlhahlobo mabapi le kalafo ea liso tsa trophic leotong mme sena se bakoa ke taba ea hore bothata bona bo teng mme ba bangata ba na le thahasello. Bakuli ba arolelana boiphihlelo ba bona ba kalafo le litholoana tsa eona. E sebetsa ka ho loketseng molemong oa bakuli ba bangata, tharollo ea ho phekola maqeba Dioxisole (antiseptic + anesthetic), litlolo Iruxol, Solcoseryl, Ebermin (kholo ea kholo ea kholo) Stellanin (triiod, povidone, dimexide, petroleum jelly), likhalase Berberex le Vitargol (Litokisetso tsa silevera), gel Prontosantranelate Dermazin le Argosulfan (e na le sulfate ea silevera).

Lintlafatso tse bonahalang li bonoa kamora ho sebelisa mokhoa oa ho roala maqeba Voskosran (ka levomecol kapa methyluracil), Collahite-FA (collagen-chitosan tata e kenyellelitsoeng ho motsoako oa antiseptic furagin le anilokain anestokain) le Collahit-Sh (Khetla ea collagen-chitosan e nang le limela antiseptic shikonin).

Litlhahlobo tse ling li amana le tšebeliso ea boot ea Unna. Mongolo o Laoloang ke Unna - Ena ke seaparo sa zinc-gelatin, se kenyang zinc oxide, glycerin, gelatin le metsi. E amohela lekunutu hantle, 'me e kenya tšebetsong pherekano le pherekano. Ntle le moo, bandage e na le phello ea lieta tsa maiketsetso, ka hona, li ntlafatsa ho tsoa ha venous. Mokhoa ona oa kalafo o sebelisoa ka linako tse ling bakeng sa ho ruruha ulcerative ulcerative. Ho roala ho hloka ho shebisisa ts'ebetso ea kopo, ho seng joalo mesifa e thehiloeng e hatella le ho pikitla letlalo la leoto.

Li-gauze compress le phala e futhumetseng li kenngoa seseng e le hore gelatin e se ke ea thatafala. Tlama leoto ka thata (lera le le leng la bandeji) ho tloha botebong ba menoana ho ea mangoleng. Tabeng ena, ha hoa lokela ho ba le makhopho, 'me menoana le serethe li siiloe li bulehile. U sebelisa borashe bo pharaletseng, khala sephutheloana ebe u se tšela, tšela nako ea bobeli ka bandage ebe u kenya paste hape. Kahoo, pheta makhetlo a 3-4. Qetellong, "boot" e koaetsoe ka likarolo tse 'maloa tsa bandeji. Kamora ho pholisa sethala, moaparo o ba motenya mme mokuli a khona ho tsamaea a sa tšabe ho hata ka leoto la hae. Ha ho na le ts'oaetso e matla leqebeng le ho hlohlona ho hoholo, moaparo o ka apesoa libeke tse 3-4. Ebe e fetoloa e ncha. Bakeng sa ho ruruha, "boot" e fetoloa matsatsi ohle a 7-10. Mokuli o lokela ho roala tlamo ka mor'a hore leqeba le fole. E sebelisitsoe lilemo tse ngata, e fapakana le ho roala monko oa khatello.

Tšebeliso ea moaparo ona o amahanngoa le mathata le litšitiso tse itseng:

• litlhare ha li mo etsetse litlatse,
• sebopeho sa paste se fapane ho latela nako ea selemo (mariha le hlabula),
• bandage ha ho bonolo ho e sebelisa, e lokela ho sebelisoa ke setsebi, ho seng joalo, haeba e sa sebelisoe hantle, ho hlaha mathata a mang.
• e sebelisitsoe ho latela lipontšo (ulcers tse ngata tse nang le lymphedema le post-thrombophlebitis syndrome),
• Mokhoa oa kalafo oa kalafo o sa sebetseng o ka sebelisoang ha ho se na lingaka tse ling tse folisang maqeba.

Li-anticoagulants tse sa tobang

E hlahisoa haholo ke tse tsoang ho coumarin. Mokhoa oa ts'ebetso ea bona ke ho thibela tšebetso ea lintho tse ling tsa maiketsetso, tse thibelang ho tiea ha eona ka ho thehwa ha makeno a mali hamorao.

Tsena li kenyeletsa:

Litokisetso tsa lihlooho

Ka lebaka la phallo ea mali e sa lekanang ea nako e telele, phepo e nepahetseng le ho lula le letlalo le matsoapo a ka tlase, necrosis ea tsona e shebaneng, e lateloa ke ho hana ho ts'oaroa hoa mesifa. Ho etsoa lesapo la trophic. E hlaha likarolong tse ka thoko tsa lipalo tse tlase: leoto le tlase, serethe le menoana. E ka ba boholo ka boholo ho tloha chelete ea tšepe ea penny tse hlano ho ea ho maqeba a maholohali a koahelang sefahleho sa shin ka bophara.

Fibrinolytics

Li-ulophic tsa trophic li ka alafshoa ho sebelisoa kalafo ea methapo kapa, joalo ka ha li bitsoa hape, lithethefatsi tsa thrombolytic. Ke nnete, sehlahisoa se seng le se seng se tsoang sehlopheng sena se lumelletsoe feela hore se sebelisoe sepetlele, ha se sebelisoe sepetleleng sa kantle ho nako ka lebaka la litlamorao tse sa lebelloang.

Fibrinolytics e lebisa ketso ea bona ho felisoeng ha makatse a mali. Ka mantsoe a mang, ho nka litlhare tsena hoa utloahala ha feela mokhoa o mongata oa mali o se o qapile 'me o senyehile phallo ea mali kapa o koetse sekepe ka botlalo. Ho seng joalo, ts'ebeliso ea fibrinolytics ha e na lebaka.

E sebelisoang kajeno ketsong:

• Tissue plasminogen activator.
• Streptokinase.
• Urokinase.

Antispasmodics

Antispasmodics ke lithethefatsi tse se nang phello e boletsoeng ea pathophysiological kalafong ea ulcer. Ho feta moo, li ka utloisa mokuli bohloko, ha letšoao la "ho utsoetsa" leoto le amehileng le hlaha.

Leha ho le joalo, ntle le sena, antispasmodics e sebelisetsoa ho phekola ulcic ulcers.Sena se hlalosoa ke taba ea hore ba khona ho imolla mesifa ea mesifa, ka hona, ba felisa bohloko. Hangata bakuli ba li sebelisa e le bakuli ba koalang kantle ho sepetlele, e leng se mpefatsang boemo ba bona le ho mpefatsa liphetoho tsa methapo ea maoto lelemeng le amehileng.

Sehlopha sa antispasmodics ea tšebetso ea methapo e kenyeletsa:

Lithethefatsi tse seng khahlanong le ho ruruha

Lithethefatsi tse seng khahlanong le ho ruruha kapa li-NSAID ke sehlopha se pharaletseng sa lithethefatsi tseo sephetho sa tsona e leng ho fokotsa botebo ba ts'oaetso ea lehae. Kajeno, li-NSAID li boetse li sebelisoa e le ho fokotsa bohloko nakong e tlang ea tšebetso.

Li-NSAID ha se li-painkiller feela, empa hape le meriana e thibelang ho khomarela ha lisele tse 'maloa tsa mali. Ka mantsoe a mang, le leqeba la liso

Li-NSAID li kenyelletsa:

Mafura a metabolism

Ka liso tsa trophic, ts'ebeliso ea sehlopha se joalo sa lithethefatsi joalo ka mokhoa o bolelang hore ntlafatsa metabolism ea lipid kapa metabolism ea mafura e na le mabaka. Sehlopha sena se kenyeletsa lihlopha tse nyane tse nyane. Ngaka e khetha moriana o loketseng ka ho fetisisa ho latela litšobotsi tsa mokuli.

Meriana e etselitsoe ho tlosa lintho tse chefo 'meleng, hammoho le ho ntlafatsa metabolism ea mafura. Sena se hlokahala ho thibela ho pepesetsoa ha marotholi a lipid marakong a methapo ea mali, eo ka mor'a nako e fetohang ho fetoha mali ka botlalo.

Sehlopha se kenyeletsa:

• FISHant-S (enterosorbent).
• Liprimar.
• Lipostat.
• Simlo et al.

Li-enzymes tsa System

Mokuli ea nang le liso tsa ka mpeng tsa boemo bo tlase a ka fuoa litlhare tse tsoang sehlopheng sa li-enzyme tsa kemiso ke ngaka e eang. Matla a tsona a nkuoa e le a rarahaneng: ha a fane feela ka ho feto-fetoha ha maemo a itseng a ts'ireletso ea lehae, empa hape a sebetsa joalo ka li-analgesics, a thusa ho thibela ho kopana ha liplatelete, le ho fokotsa botebo ba ho ruruha.

Li-enzymes tsa "systemic" li eketsa metabolism ka kakaretso, e nang le phello e molemo maemong a likepe tse anngoeng ke lefu lena.

Sehlopha se kenyeletsa:

Litokisetso tsa lihlooho

Bakeng sa kalafo ea liso tsa kahare ho maoto, phekolo ea lehae e hlophisitsoeng hantle e bapala karolo ea bohlokoa. Ka lebaka la ts'ebeliso ea litlhare tse sa sebetseng ka mokhoa o hlophisehileng, empa sebakeng sa heno tse amehang, hoa khoneha ho fumana pholiso e ntle, ho thibela ho hokahanya ha microflora ea pathogenic.

Phekolo ea lehae e ka ipapisa le ts'ebeliso ea lihlopha tse 'maloa tsa lithethefatsi. Li emeloa haholo ke mefuta e mengata ea litlolo, litlolo le li-gels, tse loketseng hantle hore bakuli ba li sebelise.

Lithethefatsi tse thibelang likokoana-hloko

Li-antibacterial agents li ikemiselitse ho thibela microflora ea pathogenic hore e se ke ea lula leqebeng. Ka lebaka la ts'ebeliso ea bona, hangata hoa khoneha ho emisa ho hasana ha lits'ebetso tsa pathological. Ho molemo ho sebelisa litlhare tsa antibacterial methating ea pele ea kholo ea lefu lena, ha seso se ntse se le nyane haholo.

Lithethefatsi tsa antibacterial ha li thuse feela ho felisa microflora ea pathogenic, empa hape e thusa ho thibela nts'etsopele ea tšoaetso ea bobeli.

Sehlopha se kenyeletsa:

Hoa thahasellisa hore kajeno litlolo tse ngata le litlolo bakeng sa kalafo ea ulcers tsa trophic hang-hang li kenyelletsa motsoako oa antibacterial e le ho qoba tšebeliso ea litlolo tse peli hang-hang le ho kenya letsoho hore mokuli a khomarele kalafo.

Pheko ea lapeng

Matlapa le lithethefatsi tse ling bakeng sa kalafo ea liso tsa trophic lipheletsong tse tlase li ka aroloa ka lihlopha ho latela morero oa tsona:

• Lithibela-mafu.
• Antibacterial le antiseptic.
• Ho omella.
• Antihistamines.
• Bakeng sa ho hlatsoa le ho folisa.
• Khahlano le tšoaetso.
• Barekisi ba lipilisi.

Ntle le moo, ho na le litafole tsa thrombolytic, antispasmodics, livithamini, lisebelisoa tsa compression bakeng sa 'mele o tlase.

Mokuli o lokela ho sebelisa chelete bakeng sa kalafo ea lehae ka tatellano - ho qala ka ho hlatsoa ulcers, kalafo ea antiseptic le ho fela ka ts'ebeliso ea litlolo tsa ho folisa. Hape, ntle le ho phekola ulcers ka kotloloho, mokuli o tlameha ho sebelisa lithethefatsi tse thusang ho matlafatsa methapo ea mali, ho thusa ho kokobetsa bohloko maotong, ho matlafatsa boits'ireletso ba mmele le ho thibela ho ruruha ha lesapo la letlalo la trophic.

Mekha ea liso

Li-trophic ulc on maoto li na le mekha e mene:

• Mothati oa 1 o baka tšenyo karolong e ka holimo ea lefu lena,
• Mothati oa 2 o na le tšenyo ea dikarolo tsa letlalo le linama tse ka hare,
• Mothati oa 3 o kenya letsoho ho tlola melao ea lithane tse bonolo.
• Mothati oa 4 o ka lebisa ho li-necrosis tsa tishu, lesion le tebileng le liso tsa necrotic tse nang le ponahatso ea kantle.

Le haeba o khona ho folisa maqeba, makhopho a se nang masapo a lula libakeng tse amehileng.

Ho sebelisoa litlolo bakeng sa kalafo ea liso tsa kahare tsa trophic ho nka khato ea atrophy maoto le matsoho a tlase.

Lithethefatsi tsohle li fapana ka sebopeho le phello, ka hona u se ke oa inahanelahlokomoloha likeletso le likeletso tsa ngaka ea hau. Litokisetso tsa lehae li lokela ho beoa:

• Ho felisoa ha bohloko
• ts'ebetso ea lits'ebetso tsa pholiso,
• ntlafatso ea trophic,
• microsculation
• ho hloekisa ts'oaetso ea li-purful, tse ka hare tsa serous.

Malebela a khothalletsoang

Lethathamo la litlolo tse khothalelitsoeng bakeng sa liso tsa trophic, ho nahanoa ka sethala sa lefu lena le matšoao a teng:

1. Setofo sa Ichthyol ho kokobetsa ho ruruha, ho opeloa ke pelo, ho eketsa ho potoloha ha lesion. E ka sebelisoa mohatong oa 1 oa lefu lena.
2. Setlolo sa Vishnevsky bakeng sa ntlafatso ea libaka tse senyehileng, tlhoekiso e tsoang mefuteng ea purulent.
3. Solcoseryl e le mafura a sebetsang hantle bakeng sa liso tsa trophic maotong a sethaleng sa 2 sa lefu lena ho ntlafatsa trophism le boemo ba methapo ea mali maotong, ho satalla le ho fepa moea, ho khutlisa lisele, ho folisa maqeba le ho imolla ho ruruha, hammoho le ho hlohlelletsa lits'ebetso tsa metabolic le ho potlakisa ho nchafala hoa mesifa ka phello ea 1 sethala.
4. Actovegin ka tšebeliso ea ulcer ea trophic maemong a 1-2 le pele ho ponahalo ea mesifa ea ho hlatsoa maqeba, felisa ho ata ha ts'oaetso, ho fepa linama tse ntlafatsang, ho ntlafatsa trophism le phallo ea mali, ho khutlisa libaka tse amehang, hammoho le metabolism ea cellular le matla.
5. Algofin ka har'a motsoako o nang le likarolo tsa antimicrobial e thusa mohatong oa 1 le oa 2 oa lefu lena, e leng se lebisang ho qalisoeng ha lits'ebetso tsa ho khutlisetsa liseleng, ho tlosa ho ruruha, le khatello ea limela tse nyane.
6. Argosulfan ho tsamaisana le ho ntšoa ha silevera, ho sebetsa ka methati ea 1-2 ho hatella likokoana-hloko, ho potlakisa ts'ebetso ea pholiso.
7. Levomekol ka liso tsa trophic tse sebelisang mohato oa pele oa lefu lena ho fana ka pholiso ea maqeba, analgesic, litlamorao tsa litla-morao.
8. Betadine ka tšebeliso ea karolo ea bobeli ea lefu lena ha lits'oants'o li hlaha leqebeng, khatello ea tšoaetso ea vaerase le fungal.
9. Vundehil e le immunostimulant e ntle ka ho fetisisa e sebelisang mohatong oa 3 oa lefu lena ho tlosa mokhoa o hlophisitsoeng oa necrotic le purulent, ho kokobetsa ho ruruha, ho folisa maqeba.
10. Bepanten ka har'a motsoako o nang le panthenol o sebetsang le ho sebetsa hantle mohatong oa 1-2.
11. Comfrey O mafura e nang le liso le liso tsa kahare maotong ho folisa, ho khutlisetsa manonyeletso a letlalo, ho kokobetsa ho ruruha.
12. Oli ea sea-buckthorn le ho pepesehela sethaleng sa pele sa nts'etsopele ea ulcer ho potlakisa pholiso ea lisele tse senyehileng, ho fokotsa ho ruruha.
13. Stellanin mafura ho khutlisetsa phallo ea mali ka har'a li-capillaries, ho matlafatsa kholo ea methapo, ho tsosa le ho nchafatsa letlalo, ho hlatsoa maqeba ho bokellanang ha purulent.
14. Liniment Aloe e le sehlahisoa sa likokoana-hloko ho susumetsa metabolism, ho etsa hore trophism e tloaelehileng. E ea sebetsa hammoho le meriana e meng mohato oa pele oa lefu lena.
15. Diclofenac ho tsoa sehlopheng sa NSAID ho imolla bohloko, ho tlosa ho tsitsipana ka lipontšo tse matla tsa ho se lekane ha venous. E sebetsa molemong oa lefu lefe kapa lefe.
16. Fluorocort ka ho khethoa ha mathata a venous eczema, trophic ulcers.
17. Dermazin ka ho hlophisoa ka silevera ea ionised ho imolla ho ruruha, ho tsosa le ho hloekisa maqeba maotong.
18. Iruxol le tumellano ea nako efe kapa efe ea lefu la tsoekere bakeng sa pholiso ea maqeba, khatello ea microflora e kotsi.

Ke setlolo sa bokae bakeng sa sethala

Litlolo li etselitsoe ho felisa tšoaetso ea maqeba, ho folisa liphoso maotong. Tse sebetsang ka ho fetisisa, ha ho nahanoa sethala sa nts'etsopele, ke:

• li-antifungal, tseo e seng tsa steroidal, li-antihistamines sethaleng sa exudation ka kabo e boletsoeng ea purudate khahlanong le semelo sa ts'ebetso ea ts'oaetso,
• lithibela-mafu ha u fumana tšoaetso ea baktheria, ho hatella ho ruruha le mahlahana a tšoaetsanoang, hloekisa maqeba ho exudate,
• li-antioxidants, venotonics e le litlolo tsa pholiso ea maqeba bakeng sa londa tsa trophic sebopeho sa hyaluronic acid sethaleng sa ho lokisa kapa ho senya libaka tse amehang, ha ts'ebetso ea ts'oaetso e se e ntse e fokotseha mme sebopeho sa granulation maqeba se bonahala.

Hlokomela! Ho bohlokoa ho utloisisa hore liso tsa trophic maotong li ke ke tsa qala ho fola ka botsona, li ka baka mathata le ho lebisa nts'etsopele ea maloetse a makhopho a makhopho.

Ha u khetha lithethefatsi, ho hlokahala hore u hlahlobe ka nepo boemo ba ulcers, sethala le boemo ba nts'etsopele ea lefu lena, matšoao a fumanehang ho fihlela sephetho se setle haholo.

Ha ho na mokhoa o ka se leke ho phekoloa ka boikemelo mme o sebelisa mekhoa e sa tsotelleng. Ho khethoa ha kalafo ho lokela ho etsoa feela ke ngaka e eang molemong oa ho qoba ho mpefatsa boemo, ho ntlafatsa nts'etsopele ea thuto ea tšoaetso.

Contraindication

Hoo e ka bang oli leha e le efe bakeng sa ho folisa ulcic ulcers e ka baka kotsi ho e-na le molemo e na le likhohlano. Ha u khetha, etsa bonnete ba ho bala litaelo, empa ho molemo ho buisana le ngaka ea hau pele.

Lithethefatsi tse kang:

• Levosin, Levomekol li ekelitse kutloisiso,
• Chloramphenicol, Solcoseryl ha e sebetse bakeng sa granulation e feteletseng maqeba le hypersensitivity ho likarolo,
  Ofloxacin e kopantsoe le basali nakong ea kemaro, hobane ha ho fanoe ka bopaki ba tšebeliso e sireletsehileng ea lithethefatsi le phello ho lesea,
• Mefenate ha e khothalletsoe basali ha ba anyesa, e fuoe feela mabaka a bongaka. Ha litla-morao li ka baka kulisoa,
• Streptotinol ha e fuoe taelo ea ho lahla ka matla lintho tse tsoang ho maqeba ho tsoa maqeba, ho utloa bohloko bo feteletseng ho lintho tse sebetsang.

Litlamorao

Litlolo tsa liso tsa trophic hangata li baka litla-morao joalo ka allerg sebakeng sa kopo.

• Solcoseryl, Streptonitol, Levomekol e ka lebisa ho redness, ho chesa, ho hlohlona,
• Methyluracil, setlolo sa erythromycin - ho utloa bohloko sebakeng sa kopo.

Haeba matšoao a seng monate a hlaha, tšebeliso ea litlolo e lokela ho khaotsa, 'me khetho ea lingoloa tse ling e lokela ho buisanoa le ngaka e eang.

Ho thata ho nahana ka setla-morao sa hore na ho na le liso tsa trophic ea maoto maotong li ka hlahang. Hangata lebaka ke ts'oaetsong e tloaelehileng ea likokoana-hloko le libaktheria, kenyelletso ea microflora ea pathogenic tlasa letlaloseo se ka baka nts'etsopele ea ts'ebetso ea ho ruruha.

Empa ho etsahala hore li-trophic ulcs ke motsoako oa maloetse a tebileng: methapo ea varicose, khatello ea mali, lefu la tsoekereha lits'ebetso tse mpefatsang tsamaisong ea hematopoietic li qala ho etsahala.

Li-uloph tsa trophic li phekoloa ka thata le ka nako e telele. Maqeba aa koloba, a fola hantle, 'me a khona ho qeta lilemo tse ngata. E boetse e ama lilemo, tekanyo ea ho se tsotelle ea lefu le ka tlase.

Bakeng sa prophylaxis

Litlolo li lokela ho kenya letsoho ho matlafatseng ha potoloho ea mali le khatello ea methapo ea ts'oaetso. Ho seng joalo, gangrene, osteomyelitis e ka qala.

Joalo ka thibelo, ho bohlokoa hore u eletse:

• Ho thibela ponahalo ea mantsoe a hloekileng a tsoang leqebeng,
• phekola ka nako libaka tse amehang le mapetso a teng letlalong ka li-antiseptics,
• apara lieta tse boreleli ebile li le boholo,
• thibela hypothermia ea lipalo tse tlase,
• sireletsa letlalo ho tsoa likotsi le likotsi, tšoaetso, radiation ea ultraviolet.

Lithibela-mafu

Lithethefatsi tsa antibacterial bakeng sa kalafo ea ulcers ea tropic ea lipheletsong tse tlase li sebelisoa ha ho e-na le leqeba le phatsimang haholo le litaba tsa serous tse tsoang sebakeng se amehang. Morero oa ts'ebeliso ea bona ke ho emisa ho hasana ha ts'oaetso le ho thibela ho fifala ha limela ho tsepamisang maikutlo. Lihlopheng tse ka sehloohong tsa lithibela-mafu tse sebelisitsoeng:

• penicillin - Ampicillin, Amoxicillin,
• fluoroquinolones - Ofloxacin, Ciprofloxacin,
• cephalosporins - Sulperazone, Ceftazadim,
• Lincosamides - Clindamycin, Linkomycin,
• carbapenems - Tienam, Meropenem.

Mekhoa ea lithibela-mafu e khothalletsoa hore e sebelisoe mohatong oa pele oa kalafo, ha seso se le senyenyane haholo. Ba thusa ho sebetsana ka katleho le erysipelas le phlegmon. Ka trophic ulcers ea likarolo tse tlase, u ka sebelisa tse latelang:

• Ofloxacin. E kenyelletsa karolo e sebetsang ea lebitso le le leng, e senyang motsoako oa DNA le karohano ea lisele, ka hona e baka lefu la libaktheria. Litekanyetso tsa letsatsi le letsatsi tsa matlapa ke 200-600 mg, e arotsoe ka litekanyetso tse peli. Litsenyehelo tsa moriana ke 120-150 p.
• Clindamycin. Ntho e le 'ngoe ka sebopeho sa moriana ona e thibela syntheine ea protheine liseleng tsa baktheria, e li bolaea. Litafole tsa Clindamycin tsa trophic ulcers ea liphula tse tlase li nka 1 capsule ho isa makhetlo a 4 ka letsatsi. Kahare le kahare, moriana o fanoa ka makhetlo a 300 mg makhetlo a mabeli ka letsatsi. Ka ts'oaetso e matla, lethalinyana le eketseha ho fihla ho 1.2-1.7 g, le arotsoe ka liente tsa 3-4. Theko ea li-ampoules tse 10 ke 560 p., Matlapa a 16 - 180 p.
• Ceftazidime. E boetse e reheletsoe karolo e sebetsang sebopeho. Ceftazidime e sitisa motsoako oa metsoako ea lisele tsa cellular, e bakang lefu la libaktheria. Motsoako oa ente ea intravenous kapa ea methapo ke 1000 mg lihora tse ling le tse ling le tse ling tse 8 ho isa ho tse 12. Litšenyehelo tsa botlolo e le 'ngoe ke 70-110 r.

Litlolo tsa antibacterial

Phekolo ea antibiotic bakeng sa liso tsa trophic tsa lipalo tse tlase e ka etsoa ka thuso ea lithethefatsi tsa lehae. Mesebetsi ea ts'ebeliso ea bona: ho hatella ho hlahisoa ha likokoana-hloko tsa pathogenic leqebeng, ho thibela ho kenella ha ts'oaetso e 'ngoe, ho tlosa ho ruruha. Litlhare tse ka sehloohong tsa antibacterial bakeng sa kalafo ea liso tsa trophic maotong:

• Heliomycin. E na le heliomycin - ntho e bonts'ang ts'ebetso ea antibacterial khahlanong le likokoana-hloko tse ntle tsa gram. Bakeng sa ulceration e matla, ho kgothaletswa ho kenya litlolo tse kenelletseng ka mafura ana. Maemong a mang, sehlahisoa se kenngoa leqebeng ntle le ho itlotsa ka makhetlo a 1-2 ka letsatsi. Theko ea mafura ke 50-70 p.
• Tetracycline. Karolo e sebetsang ea mafura ana ke tetracycline. E ama baktheria e ntle le gram ntle le gram-block ka ho thibela synthetiki ho tsona. Mafura a etsang karolo ea boraro lekholong a boetse a sebelisoa e le pholiso ea leqeba. Ka li-uloph tsa trophic tsa libaka tse tlase tse tlase, moemeli o sebelisoa makhetlo a 1-2 ka letsatsi. O ka sebelisa setlolo ho fihlela ho libeke tse 2-3. Theko - 20-30 leq.
• Levosin. E na le methyluracil, chloramphenicol, trimecaine, sulfadimethoxin. Ka lebaka la lintho tsena, setlolo se hlahisa sesosa se bolaeang likokoana-hloko, li-analgesic, se nchafatsang le se khahlanong le ho ruruha. Ka li-uloph tsa li-trophic tsa likarolo tse tlase, Levosin e sebelisoa ho sefahleho sa sefahleho, ebe se tlisoa maqeba. Theko ea mafura ke 80 leq.
• Argosulfan. E na le sulfathiazole ea silevera. Motsoako ona o na le phello ea antimicrobial mme o khothaletsa pholiso ea liso tsa trophic, ho chesa, leqeba la purulent.Tranelate e sebelisoa ho sepheo sa ho ruruha ka sekhahla se tšesaane (2-3 mm) makhetlo a 2-3 ka letsatsi. U ke ke ua sebelisa tse fetang 25 g ea Argosulfan letsatsi le letsatsi. Ka boteng ba exudate, ho khothalletsoa pele ho hloekisa leqeba ka chlorhexidine kapa boric acid. Litšenyehelo tsa Argosulfan ke 320 p.

Ho hloekisa le ho Omisa

Mohato oa pele, o hlokahalang ho phekola mokuli, ho mo tlosa liphetoho tse kholo letlalong le lipakeng tse tlase, ke ho hloekisa liso ka lisele tse shoeleng. Sena se tla thusa ho thibela kholo ea libaktheria, tšenyo e tsoelang pele ho mesifa le masapo a leoto. Ts'ebetso ea kalafo e hloka hore libaka tse amehileng li hlatsuoe hantle. Ho etsa sena, sebelisa lithethefatsi tse kang tharollo ea furatsilina, chlorhexidine kapa potasiamo permanganate, li-decoctions tsa litlama. Ho hlatsoa le hona ho ka emisa liphetoho tsa trophic nakoana, ho kokobetsa bohloko maotong.

Ts'ebetso ea kalafo e hloka hore libaka tse amehileng li hlatsuoe hantle.

Bakeng sa ho phekola li-trophic abscesses leotong ka potlako, li ka omisoa ka hydrogen peroxide. Li-antiseptic agents tse kang iodopiron le tsona li sebelisetsoa sena. Kamora hore e ts'ehetse Yodopiron maotong, e tšeloa likarolong tsa letlalo la maoto le maqeba a e entseng.

Ho hlatsoa li-ulc ka meriana ea setso ha ho u lumelle kamehla ho fihlela sephetho sa ho felisoa ha lisele tse shoeleng. Mokhoa o atlehang ka ho fetisisa oa ho phekola liso tsa leoto ke ha o li hloekisa khafetsa ka masala a necrotic ka litokisetso tsa enzymatic. Ho mokuli enoa, meriana ea thusa, motsoako o ka sehloohong o sebetsang oa eona ke collagenase (lithethefatsi tsa bongaka tsa bongaka).

Collagenase ke protheine e fumanoang ho makhopho a liphoofolo. E khothalletsa ho itlhoekisa haholo le kalafo ea maqeba a likarolo tse tlase tsa 'mele, ho nchafatsoa ha lisele, ho na le thepa ea maiketsetso le ho imolla bohloko likarolong tse tlase. Setlhare se tsebahalang haholo se thehiloeng nthong ena, se fumaneng thoriso, ke mafura a Iruxol.

E na le chloramphinecol, lithibela-mafu. Kahoo Iruxol ke setlolo se sebetsang habeli. E etsa hore kalafo e atlehe habeli - e hatella khatello ea maqhubu a maqeba a trophic le ho thibela microflora ea pathogenic ea maqeba a likarolo tse tlase tsa 'mele. Nakong ea ts'ebeliso ea Iruxol, ha ho kgothaletsoe ho sebelisa meriana e meng ea lehae, hobane e thibela ts'ebetso ea li-enzyme.

Pholiso ea litlolo

Lisebelisoa tse nchafatsang li boetse li sebelisoa sethaleng ha karoloana e nyane ea likaroloana tsa sethoathoa leqebeng le leqebeng, i.e., kamora ts'ebetso ea ho ruruha e felisitsoe. Nakong ena, ts'oaetso ea seso ka microflora ea pathogenic e lokela hore e be e sa kenyelelitsoe. Mothating ona, mekhoa ea ntlafatso e qala, e potlakisang ka thuso ea litlolo tsa pholiso ea maqeba. Ho bohlokoa ho hlokomela hore tse ling tsa lithethefatsi tsena ka tlatsetso li na le lintho tse nang le litlamorao tsa antibacterial, immunostimulating le analgesic. Mehlala ea litlolo tse joalo:

• Solcoseryl. E na le mali a tsoang manamane a lebese a phetseng hantle, a hloekisitsoeng ho tsoa liprotheine. Ntho ena e kenya tšebetsong tšebetso ea metabolism ea mesifa, e ntlafatsa trophism, e ntlafatsa ho lokisoa ha lisele le ho nchafala. Mafura a sebelisoa ka kotloloho lesion makhetlo a mabeli ka letsatsi. Phekolo ea ho loma liso tsa kahare ho liso maotong le eona e ka etsoa ka Solcoseryl. Litsenyehelo tsa mafura ke 220 r.
• Levomekol. E na le dioxomethyltetrahydropyridimine le chloramphenicol. Ntho ea hoqetela ke lithibela-mafu. Ka lebaka la sebopeho sena, Levomekol e fokotsa ho ruruha, e khothaletsa pholiso ea liso tsa ka tlase tsa litho le ho thibela kholo ea libaktheria. Matla a ho loants'oa ha setlolo a ntse a phehella leha ho e-na le maselese a necrotic le mongobo oa purulent. Levomekol e kenngoa ho tšolla maqeba ka lesoba le sa boreleli kapa boea ba k'hothone, bo behiloeng ka patch kapa bandege. Se ke ua sebelisa mafura nako e telele ho feta matsatsi a 5-7. Theko ea setlolo ke 100-120 p.
• Bepanten.Ho kenyelletsa dexpanthenol - ntho e khothalletsang ho nchafatsa letlalo. Ho kenyelletsa ho na le matla a mongobo. Bepanten e fumaneha ka mokhoa oa setlolo, tranelate le setlolo. Li kenngoa sebakeng se amehileng ka sekaka se tšesaane makhetlo a 'maloa ka letsatsi. Litsenyehelo tsa moriana li ka ba ka bang 280-340 p.

Lihlahisoa tse ling bakeng sa ts'ebeliso ea kantle

M meriana ea li-trophic ulcers, e bonts'a thepa e fapaneng, e ka aroloa e le sehlopha se arohaneng: pholiso ea maqeba, anti-inflammatory, hemostatic, antimicrobial, painkillers. Mehlala ea lisebelisoa tse joalo:

• Activetex. Ke li-napkin tse entsoeng ka lesela la k'hothone tse koahetsoeng ka oli ea bohlokoa, lidocaine, furagin, aminocaproic acid, livithamini C le E. Sehlahisoa se na le pholiso ea maqeba, analgesic le antimicrobial. Pele o sebelisoa, napkin e tšeloa ka letsoai, ebe e kenngoa leqebeng. Ho tloha holimo, ntho e 'ngoe le e' ngoe e ts'oaretsoe ka band-Aid kapa bandege. Moaparo o fetoloa ka mong le o mong matsatsi a 2-3. Theko - 160 leq. bakeng sa li-napkins tse 10.
• Branolind N. Ona ke setlolo sa maqeba, se sa kenngoeng setlhare sa Peru, se bontshang thepa ea antiseptic le ea ho folisa maqeba. E kenngoa ka har'a seso sa trophic, ebe e koaheloa ka thaole e sa hlapolloang 'me e ts'oaroe ka bandage kapa samente. Moaparo o fetoloa letsatsi le letsatsi. Litšenyehelo li-pcs tse 30. - 1800 leq.
• Vitargol. Motheo oa sethepu sena ke tharollo e metsi ea silevera e colloidal. Ntho ena e na le phello ea antibacterial khahlanong le streptococcus, staphylococcus, Pseudomonas aeruginosa. Vitargol e thusa ho sireletsa letlalo ho li-microflora tse nkang monyetla. Sesebelisoa se fafatsoa leqebeng makhetlo a 1-3 ka letsatsi. ha ho hlokahala, itlhatsoe ka kobo e se nang mathata. Theko - 240 leq.

Linepe tse nang le metsoako ea litlama

Litlolo, tse kenyeletsang likarolo tsa semela, tse nang le leqeba la lipheletso tse tlase li thusa ho sebetsana ka katleho le ts'oaetso ea tšoaetso. Ha e le hantle, litlolo li na le phello e rarahaneng, hape e thusa ho ntlafatsa sebaka se amehileng le ho imolla ts'ebetso ea ts'oaetso.

Hangata e sebelisoa haholo vulvostimulin. E sebetsa hantle haholo haeba ho hlokahala ho sebetsana le liso tsa mofuta oa ho lla.

Ho nchafatsa lithethefatsi

Ts'ebeliso ea li-ejentiergenative tsa li-trophic ulcers e na le lebaka le loketseng haeba mokoetla o mosesane oa lithane tsa epithelial o se o thehile holima sekoli. Ka mantsoe a mang, ts'ebetso ea ts'oaetso e felisitsoe, ts'oaetso ea leqeba le nang le microflora ea pathogenic e ile ea thibeloa, lits'ebetso tsa ntlafatso li ile tsa qala, tseo joale li hlokang feela ho susumetsoa.

Ho nchafatsa lithethefatsi hangata ho fokotsa bohloko le ho thusa ho ntlafatsa mekhoa ea metabolic. Ka lebaka la sena, pholiso e potlakile haholo.

Sehlopha se kenyeletsa:

Melao-motheo e akaretsang ea ts'ebeliso

Kaha ho sa tsotelehe hore na phatlalatso ea seea-le-moea efe e reng, matlapa a mofuta oa bokahohle ba li-trophic ulc ha a teng, ho bohlokoa ho boloka melao e 'maloa e akaretsang ha u khetha kalafo ho mokuli ea itseng. Ho hlokomoloha melao-motheo ea phekolo ho ka lebisa ntlheng ea hore kalafo e ke ke ea sebetsa feela, empa hape e tla ba kotsi.

Ho na le melao-motheo e meraro ea kalafo:

1. Ts'ebetso. Phekolo e lokela ho tsoelapele ho tloha nakong ea ho fumanoa ha leqeba la trophic ho fihlela sekoli se folile ka botlalo. Kamora ho qala kalafo, ho khothalletsoa hore ho nkuoe mehato ea thibelo e ikemiselitseng ho thibela ho khutla hape.
2. Sistimi le ho rarahana. Ngaka e lokela ho khetha meriana e fapaneng bakeng sa kalafo. Maemong ana, ketso ea lithethefatsi tse ling e lokela ho tlatselletsa ts'ebetso ea ba bang, ka botlalo le ka botlalo e amang likarolo tsohle tsa ts'ebetso ea methapo. Ka nako e ts'oanang, ts'ebeliso ea mekhoa ea kalafo e khothalletsoa, ​​e etselitsoeng ho phekola lefu le lebisitseng ho thehoeng ha liphoso tsa ulcerative.
3. Ts'ebetso.Ona ke molao-motheo oa hore ha o fetola ngaka, kalafo e lokela ho tsoelapele ho latela morero o seng o khethiloe. Ha ho na thuso ka lebaka la phetoho ea setsebi ho fetola morero o khethiloeng ka botlalo. Mokuli ha a lokela ho tsebisoa feela ka likarolo tsohle tsa bokuli ba hae. E tlameha hape ho tsebisoa ka litlamorao tsa ho hlokomoloha lengolo la ngaka.

Li-antibacterial le antihistamines

Ho tsoela pele kalafo, ho hlokahala ho phekola libaka tse amehang tsa leoto ka lithethefatsi tse thibelang kholo ea libaktheria (lithibela-mafu). Argosulfan, e thibelang kholo le ho hlahisa bocha ba likokoana-hloko ka har'a liso tsa leoto, e amohetse litlhahlobo tse ntle ho tsoa ho bakuli. Moriana ona o boetse o thusa ho kokobetsa bohloko bo tlase ba 'mele.

Argosulfan e thibela kholo le ho ikatisa ha likokoana-hloko tse teng ka mpeng ea leqeba.

Meriana ea antibacterial - lithibela-mafu, e fumaneha ka mokhoa ona:

• Lipilisi
• Ampoules ea ente ea methapo ea methapo.
• Ampoules bakeng sa tsamaiso ea methapo (bakeng sa lerotholi).
• Tšebeliso ea lithethefatsi ka mokhoa oa sesepa e ratoa.

Ngaka, e tataisoa ke liphetho tsa tlhahlobo ea mokuli, e fana ka litlhare tse thibelang likokoana-hloko tse ngata - Tarivid, Tsiprobay, Tsifran, Kefzol, Mandol, Duracef, jj.

Ho ba teng ha protheine e tsoang kantle ho naha ho kanna ha tsamaisana le karabelo ea tikoloho likarolong tse tlase tsa mmele, e eketsang setšoantšo sa liso tsa trophic. Lithibela-mafu le tsona li ka baka allergies. Hoa hlokahala ho etsa li-antihistamine prophylaxis u sebelisa meriana e khethehileng. Sena se bolela kalafo ka lithethefatsi tse kang Xizal, Erius, Tavegil, Suprastin. Li fumaneha ka sebopeho sena - matlapa, lero la nko, marotholi, ente.

Lithethefatsi tse thibelang mafu

Lithethefatsi tse seng khahlanong le ho ruruha (NSAIDs) li etselitsoe ho phekola liso tsa trophic tsa likarolo tse tlase. Li sebelisetsoa ho thibela kapa ho fokotsa sekhahla sa nts'etsopele ea litho tsa maoto le matsoho. Sehlopha sena sa lithethefatsi se boetse se na le thepa ea matla le ea antipyretic. Li boetse li na le litla-morao tsa likarolo tse tlase tsa 'mele tse amehang.

Ha o hloke lengolo la ngaka la ho reka meriana ena, joalo ka Ibuprofen. Empa mokuli o lokela ho hopola hore li-antibiotic tse ikemetseng le li-NSAID li ka ba kotsi, haholo ho batho ba baholo. Nako ea kalafo e lokela ho khethoa ke setsebi se netefalitsoeng.

Litokisetso bakeng sa kalafo ea liso tsa trophic, tseo ho tsona ho sa hlokahaleng ho khethoa ke ngaka.

Pholoso

Meriana ea ho folisa maqeba a trophic libakeng tse tlase, joalo ka Solcoseryl le Actovegin, e kenya letsoho pholisong le ho bohloko ba maqeba. Ts'ebeliso ea sehlahisoa sa Lekala la litlama se u lumella ho hlohlelletsa nchafatso, ho thehoa ha epithelium maotong, ho ntlafatsa drainage, mme ho eketsa katleho ea kalafo. Moriana oa Branolind oa fumaneha ka mokhoa oa liaparo. Ha e le sethethefatsi se folisang, oli ea sea sea sea, e nang le thepa e thusang, e fumane tlhahlobo e ntle. E thusa ho hloekisa liso tsa trophic hape e thusa ho kokobetsa bohloko. Bakeng sa merero ena, oli ea meroho e boetse e loketse, eo ho eona u lokelang ho qala ho halala lieie habonolo.

Hydrogen peroxide e ka phekola maqeba maotong. U tla hloka le letlapa la "streptocide", le lokelang ho sithabetsoa. Mokhoa o bonolo - - a rothele ka marameng, a fafatse ka streptocide. Sekoahelo se holimo ka napkin le polyethylene. Mohatla o thehiloe ka lesela kapa liaparo tse ling. Fetola sebaka ka makhetlo a 'maloa ka letsatsi. Moriana ona o fumane litlhahlobo tse ntle. Lits'oara tse folisang likarolo tse tlase tsa mmele li fumanoa kamora matsatsi a ka bang 10.

Bohlahlobi

Bakeng sa ho kokobetsa bohloko bo tsamaeang khafetsa le ponahalo ea ulcers ea libaka tse phahameng, ho sebelisoa ts'ebeliso ea li-painkiller. Moriana o ke ke oa thibela ho se khotsofale hohle maotong, ke feela ho felisoa ha liso ka botlalo ho tla sebetsa mona.Ho na le khetho e pharaletseng ea lithethefatsi tse joalo - litafole, litlolo, emulsions, balms, herbal analgesics. Litlhahlobo mabapi le katleho ea tsona li ntle, empa ho khothalelitsoe kalafo ka uena. Ke setsebi feela se nang le bokhoni bo hlokahalang ba ho etsa qeto ea ho phekola le ho holofatsa liso tsa maoto le matsoho.

Immunotherapy le meriana e eketsehileng

Bakeng sa ho phekola liso tsa trophic le ho kokobetsa bohloko maotong, ho hlokahala hore u se ke ua sebelisa lithethefatsi ho loants'a lefu lena feela, empa le meriana e ts'ehetsang 'mele. E ka ba livithamine le lipilisi ho khothaletsa sesole sa 'mele. O khona ho phekola lefu lena le liminerale le liminerale tse ngata, tee ea limela, litlatsetso tsa ho ja, matlapa a homeopathic. Lithethefatsi li senya microflora e ntle ea 'mele, kahoo o hloka ho sebelisa meriana ho e khutlisetsa, joalo ka Linex. Ho etsa qeto ea hore na ho tla ba le litlhare tsa mofuta ofe tsa tlatsetso bakeng sa ho thibela liso tsa maoto, etela ngaka ea hau.

Nakong ea kalafo, lingaka li boetse li fana ka mefuta ea li-vithamine le liminerale bakeng sa ho matlafatsa sesole sa 'mele.

Bakeng sa ho phekola mathata a letlalo la trophic ka mokhoa o hlakileng, ngaka e tla u khetha hore e be lihokahanyi tsa antiplatelet ho theola mali. Ho phekola ulcers kapele le ho thibela ho hlaha ha tse ncha, ho sebelisoa li-phlebotonics, tse matlafatsang marako a lijana tsa maoto le matsoho. Ngaka e tla boela e khothaletse mokhoa oa ho qobella - bandage, bandage e phahameng, li-stockings.

Pheko ea Sepetlele

Hoa hlokahala ho phekola liphetoho tsa trophic letlalong la likarolo tse tlase tsa mefuta e matla sepetlele. Moo, mokuli o fumana kalafo e matla haholoanyane ha a bapisoa le kalafo ea ka ntle. Mokuli o fuoa meriana e thibelang likokoana-hloko bakeng sa tšebeliso ea kahare, hammoho le mofuta oa litlolo bakeng sa kalafo ea libaka tse senyehileng leotong. Mokuli o fumana meriana ea ho kokobetsa bohloko 'meleng o tlase. Li-Fibrinolytics tse thusang ho qhibilihisa mali li ka fanoa. Lipilisi tsena li tlameha ho nooa tlasa taolo e tiileng ea ngaka, kaha ho na le monyetla oa hore ho tsoa mali haholo ho tla qala.

Phekolo ea liphetoho tsa trophic maemong a feteletseng e lokela ho tsoela pele tlasa tlhokomelo ea ngaka ea hau. Nka feela meriana e khothalletsoang ke setsebi. Lithibela-mafu le lipilisi tse ling li lokela ho tahoa haholo ka nako. Se ke la lebala ho etsa kalafo ea liso khafetsa likarolong tse tlase tsa 'mele.