Cov txiaj ntsig ntawm txoj kev kho yog nyob ntawm cov kev ua haujlwm ntawm tus kws saib xyuas endocrinologist, orthopedist, kws tshaj lij, kws kho mob, kws phais ntawm vascular thiab purulent department, tshuaj loog.
Kev txuag tshwj tseg
Hauv kev kho mob ntshav qab zib taw nrog kev siv tshuaj kho mob, nyiaj mob ntshav qab zib mellitus thiab kho kom zoo ntawm cov mob txhab trophic yog qhov tseem ceeb.
- piam thaj tshuaj, yog tias tsim nyog - insulin kom cov ntshav qab zib kom qis;
- antibacterial, antifungal, anti-inflammatory tshuaj nrog qhov sib ntxiv ntawm cov kab mob, cov kab mob fungal;
- tshuaj mob tawv nqaij - ibuprofen, diclofenac;
- pleev rau tshuaj tua kab mob hauv cov qauv tshuaj pleev, cream, daws.
Txhua tus neeg mob, tsis hais txog hom ntshav qab zib, tau txais insulin intramuscularly tswj hwm qib qab zib thaum nruab hnub. Txhawm rau txhim kho cov mob ntawm lub cev, tiv thaiv kev siv tshuaj tsis muaj tshuaj steroid, tricyclic antidepressants yog siv los txo qhov mob.
Ntshav qab zib mob ko taw
Cov tshuaj ntawm cov xaiv yog qhov tshiab tiam ntawm cephalosporins, fluoroquinolones. Feem ntau cov kev kho mob yog Zefter, Tsifran ST, Aveloks, Tsiprolet A, Heinemoks, Invanz.
Cov tshuaj tiv thaiv kev sib xyaw ua ke yog siv - clindamycin-netilmicin, clindamycin-aztreonam, clindamycin-ciprofloxacin. Kev sib xyaw ua ke kawg ntawm cov tshuaj tua kab mob tau siv tau zoo txawm tias yog ischemic ko taw mob ntxiv.
Cov tshuaj txiav txim ntau
- Txhawm rau txhim kho qhov mob ntawm lub qhov txhab, cov tshuaj kho yog kws kho mob hauv tshuaj ntsiav Sulodexide thiab Lomoporan. Txhais tau hais tias nyob rau hauv chav kawm ntawm heparinoids, muaj cov nyhuv antithrombotic, yog siv rau txoj leeg thiab hauv tshuaj ntsiav.
- Nrog rau cov kev mob ua ntej los ntawm kev rhuav tshem cov hlab ntshav, Prostavazinum, Alprostadil yog tshuaj. Cov tshuaj txhaws hauv cov hlab ntshav, txo cov ntshav viscosity, platelet adhesion. Ib qho txiaj ntsig zoo tau muab los ntawm kev kho cov tsos mob ntawm tus mob ko taw nrog Trental 400, uas txhim kho microcirculation hauv cov nqaij ua kom tsis mob.
- Tshwj xeeb rau kev kho mob ntawm mob txhab rau mob ntshav qab zib mellitus, kev npaj Vulnostimulin, Delaskin, Fusicutan yog hom phiaj. Kev ua txhaum ntawm kev nkag siab ntawm tus taw los ntawm kev puas tsuaj rau cov hlab ntsha yog kho nrog cov neeg sawv cev uas muaj thioctic acid - Tiolepta, Thioctacid, Berlition.
Kev kho mob hauv zos
Qhov tsis muaj qhov tsos mob ntawm tus mob ko taw mob ko taw yuav tsum yog vim li cas thiaj li hu rau kws kho mob kom pab. Kev vam meej ntawm kev kho yog nyob ntawm kev siv tshuaj txhua hnub ntawm txhua cov lus qhia ntawm tus kws kho mob. Tus neeg mob raug pom zoo:
- nco ntsoov ntxuav lub qhov txhab kom huv, kom tsis txhob muaj dej;
- hloov txoj kev hnav khaub ncaws txhua txhua hnub siv tsuas yog siv cov tshuaj uas koj tus kws kho mob pom;
- tsis txhob mus kev liab qab;
- txo lub cev ua si.
- Kev ntxuav huv. Kev kho mob hauv zos ntawm cov mob txhab suav nrog kev ntxuav qhov txhab, rinsing nrog kev siv tshuaj tua kab mob, kev hnav khaub ncaws. Txoj hauv kev zoo tshaj plaws los ntxuav tu lub qhov txhab nrog txhuam taub hau. Ib txoj kev phais mob ntawm kev ntxuav lub qhov txhab yog qhov zoo dua rau cov kab mob ntawm lub qhov txhab, tso cov kua paug. Rau kev siv ua tiav ntawm kev ntxuav tshuab, daim ntaub noj qab haus huv yuav tsum nyob hauv qhov txhab.
- Ua yaug txhav txhab. Txoj hauv kev nyab xeeb rau ntxuav cov rwj uas tsis muaj kuab lom yog ntxuav nrog dej qab ntsev. Nws tuaj yeem hloov nrog 0.9% sodium chloride tov. Ntxuav nrog 3% hydrogen peroxide tov yog pom zoo kom tshem tawm pus, tawm tsam cov kab mob anaerobic. Nrog kev nquag ntxuav lub qhov txhab nrog peroxide, txoj kev daws teeb meem yuav tsum tau diluted 2 zaug thiab ntxiv nrog ua kom dej ntawm lub qhov txhab nrog dej qab ntsev. Miramistin suav hais tias yog ib qho tshuaj zoo rau ntxuav qhov mob. Kev siv cov cuab yeej no tsis ua rau cov tshuaj kho qeeb qeeb, ua kom qhov nqaij to ntau dua, hauv qhov sib piv rau kev daws teeb meem ntawm hydrogen peroxide, potassium permanganate, ntsuab ci, kua tshuaj iodine. Nws raug nquahu tias nrog siv ntau zaus nws pom zoo kom nws yaj 2-3 zaug, hloov pauv, tsis txhob siv tas li. Hauv theem pib ntawm qhov mob txhab, chlorhexidine tso dej tawm yog siv. Cov tshuaj no tsis muaj kev phiv tshuaj, tab sis plam cov tshuaj antiseptic nyob rau ntawm muaj pus.
- Qhov kev xaiv ntawm qhov txhab npog. Cov kab mob mus ntev yuav tsum tau npog cov qhov txhab nrog cov ntaub qhwv uas tsis ua rau raug mob thaum lub sij hawm hloov uas yog permeable rau kev sib pauv roj. Cov ntaub ntawv zoo tshaj plaws rau kev hnav khaub ncaws yog:
- semi-permeable cov yeeb yaj kiab - siv rau kev tiv thaiv mob ntshav qab zib tsis mob, tsis pom zoo rau kev siv lub sijhawm ntev;
- txau daim txhuam cev - siv nyob rau theem kho thaum qhov me me ntawm exudate cais los ntawm qhov txhab;
- hydrogels - raug pom zoo rau kev kho mob ntawm cov kiav txhab necrotic qhuav, ntxuav lub qhov txhab zoo, txhawb kev kho kom tsis muaj caws pliav;
- amorphous hydrogels - siv los kho cov kiav txhab qhuav, thiab kho cov qhov txhab nrog kev tso tawm exudate;
- hydrocolloid txheej txheej - hom txheej xim nrov tshaj plaws, tsis xav tau hloov pauv ntau zaus, muaj tus nqi zoo / tsis sib luag;
- alginates - zoo kho cov mob rau sab hauv nrog qhov loj ntawm exudate, nws raug nquahu tias lub qhov txhab kom huv si nrog dej qab ntsev tom qab lo.
Tshuaj kho rau kev kho mob
Kev kho mob ntawm cov qog ntshav qab zib nyob ntawm ko taw thiab ceg qis nrog kev siv tshuaj tua kab mob yog siv ua ke nrog kev phais mob kom huv, tshuaj tua kab mob ua kom raws li cov theem ntawm txoj kev txhim kho. Ua ntej thov kev hnav khaub ncaws nrog cov tshuaj, cov qhov txhab ntxuav kom huv nrog Iruxol, Dioxicain-P ointments muaj collagenase thiab protease C enzymes, ntsig txog.
Cov tshuaj kho mob tau sau tseg nrog ceev faj yog tias muaj kev kis mob ntawm lub qhov txhab vim muaj peev xwm ua rau lub cev tsis zoo tsis yog rau cov kab mob, tab sis kuj ua rau cov nqaij mos noj qab haus huv ntawm lub qhov txhab nws tus kheej. Nrog purulent mob txhab, nrog mob edema, ointments muaj polyethylene oxide, iodine yog cov tshuaj.
Kev hnav kom ruaj khov kho
Kev vam meej ntawm kev kho mob yog nyob ntawm kev saib xyuas ntawm ib qho kev paub tseeb rau tus ko taw, qhov txo qis hauv kev ua haujlwm. Qhov zoo tshaj plaws unloading rau ko taw yog pw so. Yog tias nws tsis yooj yim sua kom ua raws nws, tom qab ntawd rov mus rau cov khau tshwj xeeb orthopedic, insoles ua rau kev txiav txim, siv cov khoom thaum nws taug kev.
Ib txoj hauv kev zoo los txo lub cev ntawm lub taw yog kho cov ntaub qhwv rau ntawm txhais ceg qis los ntawm cov ntaub ntawv polymer. Kev hnav khaub ncaws pub koj mus ua haujlwm yam tsis muaj qhov kub ntxhov ntawm qhov txhab ntawm qhov txhab.
Kev phais mob
Qhov kev phais mob tau siv rau ischemic daim ntawv ntawm lub diabetic ko taw, uas nyuaj kho nrog lwm yam tshuaj. Qhov kwv yees ntawm qhov txhab kho kom zoo yog kho tau zoo los ntawm kev phais mob rov qab ntawm cov hlab ntsha los ntawm kev sib zog shunt lossis endovascular.
Qhov kev phais mob txhawm rau kho kom muaj ntshav rov qab los hauv cov leeg ntshav thiab cov leeg ntshav qis. Qhov kev pab cuam yog ua raws li cov tshuaj loog hauv zos. Thaum lub sijhawm ua haujlwm, catheter tau tso tawm los ntawm kev phais sab nraud mus rau hauv tus poj niam txoj leeg. Tom qab ntawd, cov npas zais tau nkag mus rau cov hlab ntsha ntawm sab ceg qis los ntawm txoj raj ntsuas, nthuav tawm lub lumen ntawm cov hlab ntsha, txhim kho ntshav khiav.
Ntshav qab zib mob taw
Txog li 70% ntawm tag nrho cov mob ntawm cov mob txhab nyiaj txiag ua rau muaj tus kabmob neuropathic ua rau tus mob ntshav taw ua rau lub cev puas ntsoog. Qhov ua tau zoo ntawm kev kho cov mob ntawm cov leeg mob mus txog 90%.
Cov teeb meem tsis zoo ntawm ischemic thiab cov ntawv sib xyaw ntawm cov mob ntshav qab zib taw. Nrog kev puas tsuaj rau cov hlab ntshav hnyav, kev kho kom zoo yuav pab kom tsis txhob txiav tawm ntawm ko taw hauv tsuas yog 30% ntawm cov kev mob ntawm txhab txhab.
Kev kho mob rau cov mob ntshav qab zib yog qhov nyuaj los ntawm kev pheej hmoo ntawm kev kis mob ntawm qhov txhab, kev puas tsuaj rau lub tshuab uas tuaj yeem txhim kho cov nqaij mos lwj, ua rau mob caj dab nrog rau tom qab txiav ntawm tes taw.
