Kev tsim kho ntshav qab zib tshwm sim nrog qhov tsis muaj peev xwm nqus cov carbohydrates los ntawm cov khoom noj. Cov laj thawj rau qhov no yog qhov tsis muaj cov tshuaj insulin zais lossis qhov tsis muaj peev xwm ntawm cov cell receptors los teb rau nws. Cov cim tseem ceeb ntawm tus kabmob yog cuam tshuam nrog cov ntshav ntshav qabzib.
Feem ntau rau cov ntshav qab zib yog: nqhis dej heev, nce siab, sai dua qhov hloov hauv lub cev, tso zis tawm zom zaws ntau dua thiab ntau dua li ib txwm, cov tawv nqaij khaus khaus.
Kev maj mam kho thiab tsim kom muaj qhov txhab zoo hauv cov ntshav qab zib mellitus yog ib yam ntxwv tshwj xeeb rau kev ua haujlwm ntawm tus kabmob. Qhov laj thawj rau qhov no yog qhov ua rau cov ntshav tsis txaus thiab ua rau lub cev nqhis dej ntau, txo qis hauv cov txheej txheem tiv thaiv kab mob.
Ua rau ntawm suppuration ntawm qhov txhab nyob rau hauv ntshav qab zib
Txhawm rau kom nkag siab qhov mob hnyav ntawm cov qhov txhab hauv cov ntshav qab zib mellitus, nws yog ib qho tsim nyog yuav tsum xav txog cov txheej txheem uas tshwm sim hauv cov ntaub so ntswg nrog insulin deficiency (txheeb ze lossis tsis muaj tseeb). Nws tau pom tias txuas ntxiv ntev kho cov sij hawm ntawm qhov txhab ntawm qhov khoob khoob thiab cov nqaij mos mos yog nyob ntawm qhov ntsuas ntawm vascular kev puas tsuaj.
Microangiopathies thiab nce ntshav coagulation nyob rau tom qab ntawm intracellular acidosis, tsis zoo electrolyte muaj pes tsawg leeg thiab qhov piv ntawm lipoproteins ua rau txo qis ntawm kev tiv thaiv ntawm tes, nrog rau kev ua txhaum ntawm humoral tiv thaiv kev tiv thaiv.
Hauv qhov no, qhov kev sib raug zoo ntawm qhov loj ntawm cov chav kawm ntawm tus kab mob thiab ntev npaum li cas pus tuaj yeem nrog cov ntshav qab zib nyob rau hauv lub qhov txhab mob. Thawj theem ntawm cov txheej txheem mob (mob) tshwm sim nrog kev txuas ntxiv ntawm kev tsis lees paub ntawm cov ntaub so ntswg tuag, o thiab muaj cov microbes tau nyob twj ywm.
Hauv theem ob (kev rov ua dua tshiab), cov roj collagen thiab cov tiav ntawm cov nqaij mos granulation yog maj mam tsim, thiab nyob rau theem ntawm kev caws pliav li ob lub lis piam, cov ntaub ntawv sib kis tshiab. Lub qhov txhab yog qhov devoid ntawm cov ntshav txaus thiab cim peripheral edema
Yog hais tias qhov tsim ntawm purulent lub qhov txhab rau cov ntshav qab zib mellitus tshwm sim tawm tsam keeb kwm ntawm tus mob ntshav qab zib neuropathy, tom qab ntawd nws txoj kev kho kom zoo rau cov laj thawj hauv qab no:
- Tsis zoo microcirculation nrog ib qho kev txo cov ntshav ntws los ntawm cov hlab ntsha thiab cov ntshav tawm mus rau hauv cov leeg.
- Kev mob hnyav ntawm cov ntaub so ntswg.
- Txo rhiab.
- Neeg kho tshuab kev faib tawm siab ntawm ko taw.
Cov cim ntawm purulent muaj kab mob hauv ntshav qab zib
Cov tsos ntawm suppurating mob nyob rau hauv cov ntshav qab zib mellitus feem ntau cuam tshuam nrog kev kis mob ntawm lub qhov txhab tom qab kev ua haujlwm, mob rau hauv qhov tsos mob ntawm tus mob ntshav qab zib ko taw, mob qog tom qab txhaj, nrog rwj thiab carbuncles.
Txhua qhov kev mob purulent ua rau decompensation ntawm ntshav qab zib mellitus, vim tias qhov no nce qhov kev tshwm sim ntawm hyperglycemia, zis qhia tias muaj cov ntshav qabzib ntau ntxiv, ketoacidosis nce ntxiv. Raws li kev sib kis tau nce zuj zus, cov kab mob microbial co toxins thiab cov enzymes uas zais ntshav los ntawm cov qe ntshav dawb ua rau cov insulin puas tsuaj.
Nws yog qhov tseeb tias 1 ml ntawm purulent tawm inactivates 15 units ntawm insulin. Nyob rau tib lub sijhawm, xws li cov kab mob pathological nce:
- Ua txhaum ntawm cov txheej txheem metabolic nrog nce lub cev kub.
- Ntxiv dag zog rau kev tsim ntawm ketone lub cev, ncav cuag lub ketoacidotic coma.
- Kev kis mob microbial mus txog rau kev txhim kho ntawm sepsis.
- Koom tes nrog candidomycosis.
Mob ntshav qab zib mellitus, uas tau ua mus ntxiv thaum mob latent lossis mob me me nyob rau hauv qhov muaj cov kab mob purulent, dhau los ua neeg mob hnyav, thiab nws cov nyiaj raug mob nyuaj ua tiav. Kev kis kab mob hauv zos nrog txo kev tiv thaiv kab mob sai dua nthuav dav thiab muaj tus mob ua rau mob rau lub chaw tsis haum.
Yog tias kev kho mob nrog tshuaj tua kab mob thiab tshuaj insulin rau ib qho laj thawj twg tsis tau ua tiav, kev tuag ntawm cov kab mob purulent mob ntshav qab zib nce mus txog 48%.
Yuav ua li cas kho purulent txhab rau cov ntshav qab zib?
Ntshav qab zib ua rau kev kho mob ntawm cov txheej txheem sib kis nrog cov nyiaj them tsis txaus rau cov piam thaj hauv ntshav. Yog li no, thaum koj rhais cov suppuration, koj yuav tsum pib kho tus neeg mob nrog kev ruaj khov ntawm cov metabolism carbohydrate. Kev yoo mov glycemia yuav tsum tsis pub dhau 6 mmol / l, zis yuav tsum tsis muaj cov piam thaj.
Hauv thawj theem ntawm lub qhov txhab, koj yuav tsum tau ntxuav lub qhov txhab ntawm cov kab mob thiab pus. Txhawm rau ua qhov no, koj tsis tuaj yeem siv tshuaj pleev rau ntawm cov rog, vim tias lawv tsis muab txaws tawm ntawm lub qhov txhab. Yog li, kev npaj tau qhia tsuas yog ntawm dej-soluble thiab muaj peev xwm nyiam cov qhov txhab ntawm lub qhov txhab.
Cov tshuaj Osmotically ua ke nrog cov enzymes (chymotrypsin) txhawm rau kom ntxuav kev huv. Cov kev hnav khaub ncaws ntawm cov pa tsis huv nrog cov tshuaj tiv thaiv kab mob tua tau tsawg kawg 1 zaug nyob rau ib hnub.
Cov yeeb tshuaj sab nraud hauv qab no yog siv rau hauv cov theem:
- Cov tshuaj pleev nrog chloramphenicol: Levomekol, Levosin.
- Nitazole-based ointments: Nitatsid, Streptonitol.
- Mafenide Acetate Tshuaj pleev.
- Nyiajpuas.
- Dioxol.
- Tshuaj pleev Iodopyron.
Tsis tas li ntawd, cov txiaj ntsig tau zoo nrog mob raum ua rau pom cov tshuaj nrog iodine - Povidone-iodine thiab Betadine. Kev kho rau cov chav uas tsis yooj yim ua rau cov tshuaj siv tau li 3-5 hnub.
Lub hom phiaj ntawm kev siv tshuaj nyob rau theem ob (kev tsim dua tshiab) yog los tsim cov granulations (cov hluas tshiab sib txuas cov ntaub so ntswg). Rau qhov no, ua ke nrog kev siv tshuaj pleev (Iruksol, Levosin), Vinilin, kev daws teeb meem 0.2% ntawm Curiosin yog tshuaj. Nws muaj qhov sib txuas ntawm hyaluronic acid nrog zinc, uas muaj qhov txhab ua kom zoo.
Kev siv dag zog rau ntshav qab zib thiab ultraviolet irradiation ntawm qhov txhab, kho laser thiab sib nqus kuj tau siv.
Qeb thib peb yuav tsum xaus nrog kev tsim lub caws pliav. Ntawm cov ntshav qab zib mellitus, kev sib xyaw ntawm cov tshuaj insulin nrog cov vitamins thiab qabzib yog siv rau kev hnav ris tsho, thiab Curiosin kuj tseem siv tau.
Kev phais mob kom paub qhov mob txhab ntshav qab zib hauv ntshav qab zib
Tau ntev, cov neeg mob tau raug pom zoo kom siv txoj kev kho kom zoo ntawm purulent lub qhov txhab hauv cov ntshav qab zib mellitus. Cov kev tshawb fawb tsis ntev los no tau pom tias thaum kev phais mob, kev kho lub sij hawm kho mob raug txo kom tsawg, thiab qhov zaus ntawm cov teeb meem tsawg dua.
Txhawm rau ua qhov no, rau 3-5 hnub tiv thaiv keeb kwm ntawm kev siv tshuaj tua kab mob tas mus li, ua tiav kev phais mob ntawm lub qhov txhab nrog daim ntawv thov ntawm thawj txoj kab sutures thiab tso dej ntawm lub qhov txhab.
Nrog rau hom kev kho no, lub cev kub tso tawm ntawm qhov txhab raug txo qis. Tom qab, cov kiav txhab ntxuav nrog cov kev daws teeb meem ntawm Chlorhexidine lossis Rivanol rau 3-4 hnub. Sutures raug tshem tawm thaum 10-12th hnub.
Kev tiv thaiv ntawm suppuration ntawm qhov txhab nyob rau hauv ntshav qab zib
Txhawm rau kom tsis txhob muaj kev kho mob ntev ntev, kev tiv thaiv kev tiv thaiv yuav tsum tau ua los pab kom tsis txhob raug mob ntawm daim tawv nqaij. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov taw, uas feem ntau muaj kev mob ntshav qab zib.
Txij li qhov rhiab ntawm daim tawv nqaij raug txo qis, kev soj ntsuam txhua hnub ntawm tus taw yog qhov pom zoo kom thiaj li pom qhov kev txiav, ua puas, thiab ua kom tsis raws sijhawm. Lawv yuav tsum tau kho nrog aqueous kev daws teeb meem ntawm antiseptics, xws li Chlorhexidine, Furacilin, Miramistin. Cov dej cawv daws teeb meem ntawm iodine, pob zeb diamond zaub ntsuab rau ntshav qab zib tsis tau siv.
Txhawm rau kom txo txoj kev pheej hmoo ntawm kev txiav thiab mob, khau yuav tsum tau npog nrog, nws yog txwv tsis pub taug kev liab qab, tshwj xeeb yog sab nraum zoov. Ua ntej yuav hnav, koj yuav tsum tau soj ntsuam cov khau rau kev muaj cov khoom me me txawv teb chaws - xuab zeb, pebbles, thiab lwm yam.
Cov lus qhia tseem ceeb hauv kev tiv thaiv kev txhim kho kev sib kis hauv cov ntshav qab zib yog saib xyuas cov ntshav qabzib kom ncav sijhawm thiab mus ntsib kws kho mob. Ua li no, nws pom zoo:
- Muaj khoom siv los ntsuas ntshav qab zib hauv tsev thiab ntsuas ntsuas qhov ntsuas ntshav nyob hauv tsev txhua lub sijhawm.
- Ib zaug txhua txhua peb lub hlis, kuaj xyuas glycated hemoglobin.
- Yam tsawg txhua rau lub hlis, cov ntshav tau pub rau cov lipid complex, tso zis rau qabzib thiab protein ntau.
- Tswj ntshav siab tsis pub siab tshaj 135/85 hli Hg
- Tsis suav cov tsiaj rog thiab cov zaub kom yooj yim los ntawm cov zaub mov.
- Txiav kev haus luam yeeb thiab haus cawv.
Yog tias muaj cov cim ntawm decompensation ntawm ntshav qab zib mellitus, nws yog qhov yuav tsum tau ua los ua kev kho ntawm kev kho los ntawm kev mus ntsib tus kws kho qhov muag endocrinologist. Koj tsis tuaj yeem nqa tawm kev kho mob ywj pheej ntawm cov tawv nqaij los yog mob tshwm sim rau nws, txij li tom qab mus ntsib tus kws phais mob txhawb txoj kev kis tus kab mob thiab ib qho hnyav dua ntawm cov txheej txheem purulent.
Cov yeeb yaj kiab hauv tsab xov xwm no qhia txog kev kho cov qhov txhab purulent nrog lub teeb.
