Kev mob txhab - mob rau ntawm daim tawv nqaij thiab ntxig ntxig qauv hauv daim ntawv ntawm qhov mob ntev. Xws li qhov tsis xws luag yog tshwm sim los ntawm qhov ua txhaum ntawm cov ntshav pub rau qee yam ntawm lub cev. Qhov chaw nyiam hauv zos ntawm trophic mob txhab - ntiv taw, luj taws, ceg qis. Ib txoj kab ke zoo sib xws yog yam ntxwv ntawm ntshav qab zib mellitus, nws tau suav hais tias nws qhov tshwm sim thiab nthuav qhia cov mob ntshav qab zib ko taw.
Kev kho mob ntawm lub qog ua kom ntshav qab zib hauv ntshav qab zib yog suav tias yog qhov txheej txheem ntev uas ua ke nrog ntau txoj kev. Kev kho rau kev daws teeb meem yuav tsum tshwm sim nyob rau hauv ib qho kev coj zoo siv, txij li nws tau ncaj qha xws li qhov tsis xws uas ua rau kev txiav tawm ntawm cov qis qis.
Cov ntsiab lus ntawm kev kho mob
Txhawm rau txhawm rau kho kab mob qog ntshav qab zib hauv ntshav qab zib kom ua tiav, koj yuav tsum mus raws li cov theem hauv qab no:
- kev kho kom huv si ntawm thaj chaw muaj cuam tshuam;
- unloading ntawm cov nqua hauv qab;
- tshem tawm cov kab mob microflora;
- them rau tus mob lwm;
- nyem ntawm puffiness;
- kev txheeb xyuas thiab kev kho mob ntawm cov kab mob sib kis uas tsis tso cai rau cov txheej txheem kho kom zoo tau tag nrho (mob ntshav liab, mob lub siab, lub raum tsis ua haujlwm).
Ntxiv rau cov theem no, ischemic trophic tsis xws luag yuav tsum muaj kev thim rov qab (rov qab los ntawm cov ntshav ncig hauv qhov cuam tshuam), vim nws yog qhov kaw qhov lumen ntawm cov hlab ntsha uas ua rau lawv txoj kev txhim kho.
Cov kev xaiv ntawm txoj kev kho mob yog qhov xub thawj ntawm tus kws kho mob tuaj koom
Yog tias cov qhov txhab mob nyuaj ntxiv los ntawm cov txheej txheem purulent, kev phais mob thiab kev tshem tawm ntawm tus neeg mob lub cev.
Cov ntsiab lus kho qhov ncauj rwj
Kev kho kab mob hauv plab mob ntshav qab zib muaj kev cuam tshuam dav dav thiab hauv zos. Kev kho mob hauv zos yog raws cov txheej txheem hauv qab no:
- necrectomy (kev tshem tawm ntawm thaj chaw tuag) nrog kev txhim kho ntawm corns;
- ntxuav lub qhov txhab nrog tshuaj daws;
- siv ntawm kev hnav ris tsho.
Necrectomy
Cov ntaub so ntswg tuag yog suav tias yog ib puag ncig zoo rau cov kab mob. Tsis tas li, lawv tiv thaiv qhov qub tawm ntawm cov dej los ntawm lub qhov txhab thiab ua kom muaj cov ntaub so ntswg tshiab rau kev kho kom zoo. Yog li ntawd, nws yog ib qho tsim nyog yuav tsum tshem tawm thaj chaw ntawm necrosis mus rau qhov siab tshaj plaws.
Kev zam yuav tuaj yeem siv siv txiab thiab txiab, siv tshuab, siv cov khoom siv tshwj xeeb uas xa cov dav hlau pulsating, siv cov txheej txheem tshuaj, siv cov tshuaj proteolytic enzymes. Lwm txoj hauv kev - tus kws kho mob siv cov ris tsho ntub dej los pab txhawm rau cov ntaub so ntswg kom tuag.
Kev tshem tawm cov necrosis aav nrog pob taws thiab txiab yog qhov kev xaiv feem ntau, txawm li cas los xij, nws tsis yog siv yog tias hauv qab kiav txhab yog sawv cev ntawm articular nto lossis yog tias qhov khoom plig trophic ischemic. Thaum muaj kev phais mob, Volkman diav siv - cov cuab yeej ua qauv ntawm rab diav nrog ib qhov chaw me me. Nws tso cai rau koj kom raug muab tshem tawm cov ntaub so ntswg uas tuag lawm yam tsis muaj kev rhuav tshem cov hlab ntsha.
Necrectomy yog ib theem tseem ceeb hauv kev kho mob ntawm trophic tsis xws luag
Tseem Ceeb! Mob rwj rau ntawm txhais ceg yuav tsum tau kuaj xyuas los ntawm lub pob sojntsuam, vim tias qhov tsis pom kev ntawm lub ntsej muag yuav muaj qhov kiav txhab sib txuas.
Nyob rau tib lub sijhawm, cov corns uas tau tsim raws cov npoo ntawm qhov mob txhab tseem tseem raug tshem tawm. Qhov no tso cai rau koj kom txo tau qhov siab ntawm qhov mob nws tus kheej thiab txhim kho qhov nrawm ntawm nws cov ntsiab lus. Muaj ntau lub sijhawm uas yuav tsum tau tshem tawm ntawm cov ntsia hlau phaj. Qhov no tshwm sim yog tias qhov txhab mob txhawm rau nyob ntawm tus ntsia thawv txaj lossis sab saum taub ntiv tes.
Kev kho mob kiav txhab
Qhov theem ntawm kev kho mob ntawm trophic mob rau sab hauv mob ntshav qab zib mellitus yog nqa tawm thiaj li yuav txo tau cov naj npawb ntawm cov kab mob nyob rau saum npoo ntawm thaj chaw cuam tshuam. Muaj ntau tus naj npawb ntawm cov cuab yeej siv rau kev ntxuav, txawm li cas los xij, nws tau ua pov thawj tias kev siv cov koob txhaj tshuaj nrog siv rab koob qhia tias tsis muaj qhov tshwm sim tsis zoo.
Tsis txhob siv rau kev ntxuav trophic tsis xws luag:
Kev mob ntshav qab zib neuropathy ntawm qhov qis qis- cov tshuaj potassium permanganate;
- iodine;
- ci ntsa iab ntsuab;
- rivanol;
- haus cawv muaj tshuaj muaj yees.
Ib qho tshuaj 3% ntawm hydrogen peroxide yog siv thaum lub sijhawm ntxuav lub qhov txhab los ntawm pus thiab cov ntshav txhaws. Nws raug tso cai kom ntxuav lub rwj nrog rau physiological saline ntawm sodium chloride, Miramistin, Chlorhexidine, Dioxidin. Nyob hauv tsev, koj tuaj yeem siv tshuaj tsuag Acerbin.
Hnav khaub ncaws
Cov ntaub ntawv siv rau kev hnav ris tsho yuav tsum muaj cov khoom hauv qab no:
- atraumatic;
- muaj peev xwm los tswj cov huab cua noo (nws ua pov thawj tias nyob rau hauv tej yam kev mob zoo li txheej txheem kho mob ntawm thiav mob hauv ob txhais ceg nrog ntshav qab zib yog nrawm);
- lub peev xwm los nqus cov khoom ntawm qhov txhab;
- cov khoom thaiv (rau kev tiv thaiv cov kab mob);
- qhov tsis muaj teeb meem rau qhov qub ntws ntawm huab cua mus rau cov ntaub so ntswg.
Alginate kev hnav khaub ncaws - hnav khaub ncaws niaj hnub siv hauv kev sib ntaus tawm tsam trophic
Kev looj tes rau kev hnav khaub ncaws yog qhov tsis xav tau, txij li nws muaj peev xwm ziab mus rau qhov mob ntawm lub ntsej muag thiab ua txhaum txoj kev ncaj ncees ntawm granulations thaum tshem tawm. Nws tuaj yeem siv rau hauv cov ntaub ntawv ntawm fistulas, nrog qhuav necrosis lossis mob rau sab hauv nrog cov av noo.
Cov txheej txheem kev kho mob niaj hnub siv cov ntaub qhwv me me, alginates, hydrogels, polyurethane daim txhuam cev, hydrophilic fibers, thiab lwm yam.
Aids
Cov tshuaj siv tau qhia tau pom zoo ua ke nrog kev hnav ris tsho niaj hnub.
- Antimicrobial tshuaj - Argosulfan, Dermazan, Betadine.
- Kev tsim cov tshuaj lom neeg mob - Bekaplermin, Curiosin, Ebermin.
- Cov Proteolytic enzymes - Iruksol, Chymotrypsin.
Cov tshuaj pleev yog siv rau hauv dej-soluble (Levomekol, Dioxizol) thiab roj-rog (Solcoseryl, Actovegin).
Txo nraub qaum tshaj
Ib qho tseem ceeb ntxiv hauv kev kho qhov mob trophic. Yam tshuaj twg siv, mob rau sab hauv trophic yuav tsis zoo kom txog thaum tus neeg mob ua tus taw mob mob. Kev tso tawm tag nrho yog tus yuam sij rau qhov txiaj ntsig tau ntawm pathology.
Yog tias lub qhov txhab nyob ib leeg ib ncig ntawm txhais ceg qis lossis sab nraum qab ntawm lub ko taw, yuav tsum tau siv cov khoom siv ntxiv rau ntxiv kom tshem tawm. Tsuas taw tes yog qhov xav tau rau qhov tsis muaj kev sib cuag ntawm lub qhov txhab nrog khau. Yog tias qhov mob txhab rau ntawm pob taws lossis lub tiaj tus ntoo ntawm ko taw, yuav tsum siv cov khoom tshwj xeeb. Lub sijhawm no, ib qho hnav khaub ncaws tsis tuaj yeem tsim los ntawm cov ntaub ntawv polymeric. Nws tso rau ntawm txhais ko taw thiab ceg qis dua. Nws yog nthuav tawm nyob rau hauv daim ntawv ntawm pob tw, uas tuaj yeem tshem tau lossis tsis tuaj yeem tshem tawm (raws li kws kho mob pom zoo). Hom kab ke no zoo vim nws tso cai rau koj taug kev ntawm txoj kev, ua haujlwm, tshem tawm qhov kev thauj khoom ntawm thaj chaw muaj cuam tshuam ntawm ceg.
Kev rho tawm ntawm ib nrab khau - ib txoj hauv kev los tshem tawm cov ntsaws rau ntawm thaj chaw muaj cuam tshuam
Kev tshem tawm tau tshwm sim vim yog siv ntau lub tshuab:
- kwv yees li 35% ntawm cov thauj khoom tau hloov los ntawm ko taw mus rau sab ceg qis;
- Qhov tsis txaus ntseeg ntawm lub siab tau faib tawm tusyees;
- lub qhov txhab tau tiv thaiv los ntawm kev sib txhuam tav toj;
- o ntawm cov ceg cuam tshuam tsawg dua txo.
Cov kev tsis sib haum rau kev siv polymer khau raj:
- Kev Rho Tawm - ib qho txheej txheem purulent-necrotic nrog txoj kev txhim kho ntawm sepsis lossis kev ua laib.
- Tus Txheeb Ze - qhov ua txhaum cai tseem ceeb ntawm cov ntshav, lub qhov txhab sib sib zog nqus nrog lub qhov taub me, cov dej noo tseem ceeb hauv daim tawv nqaij ntawm qhov chaw ntawm daim ntawv thov, ntshai siv cov khoom siv polymer.
Kev siv cov pas txheem, cov khau orthopedic, kev txwv yooj yim ntawm kev taug kev hauv tsev, qhov tsim ntawm "qhov rais" rau mob rau lub qhov txhab hauv qhov insole yog qhov tsis tuaj yeem lees paub hauv kev kho mob ntawm qhov mob trophic.
Kev tswj hwm tus kab mob
Hauv zos siv cov tshuaj thaiv kab mob rau kev rhuav tshem cov pathogens tsis tau ua pov thawj nws cov hauj lwm zoo, uas txhais tau hais tias tsuas yog kev siv tshuaj tua kab mob. Cov kab mob no qhia tsis yog thaum muaj kev puas tsuaj rau tus mob, tab sis kuj tseem muaj kev pheej hmoo ntawm kev loj hlob ntawm cov kab mob (necrosis ntawm ischemic cov ntaub so ntswg, mob txhab loj, mob ntev-ntev uas muaj).
Tshuaj tua kab mob - txoj kev los tiv thaiv kev kis mob
Cov sawv cev rau ntawm cov txhab:
- staphylococci;
- streptococci;
- Proteus;
- E. coli;
- enterobacteria;
- Klebsiella;
- pseudomonad.
Kev teem sijhawm ntawm cov tshuaj tua kab mob tshwm sim tom qab bakseva cov ntsiab lus ntawm lub qhov txhab nrog kev txiav txim siab ntawm tus neeg rhiab ntawm cov kab mob. Kev ua tau zoo tshaj plaws yog penicillins, fluoroquinolones, cephalosporins, lincosamides, carbapenems.
Cov foos hnyav ntawm cov kab mob yuav tsum tau txhaj tshuaj rau cov tshuaj tua kab mob hauv cov chaw ua haujlwm. Nyob rau tib lub sijhawm, kev phais mob viav vias txhawm rau kho kom zoo, kev kho kom huv, thiab kho ntshav qab zib mellitus kho tau. Lub sij hawm ntawm kev kho mob yog 2 lub lis piam. Cov theem me me ntawm kev kis tau tus kab mob tso cai siv tshuaj tua kab mob los noj ntawm qhov ncauj ntawm cov ntsiav tshuaj hauv tsev. Qhov kev kawm ntev txog 30 hnub.
Kev them nqi ntshav qab zib
Lwm theem tseem ceeb, yam uas tsis muaj kws kho mob tuaj yeem kho tsis tau mob qog. Tus kws endocrinologist tau kho qhov kev kho mob rau kev kho tus mob. Nws yog ib qho tseem ceeb ua kom cov ntshav qab zib cov ntshav tsis siab dua 6 mmol / L. Nyob hauv tsev, kev tswj hwm ntawm cov ntsuas tshwm sim nrog kev pab ntawm glucometer. Nrog rau hom kab mob 1, cov txiaj ntsig tau sau tseg txhua 3-4 teev, nrog hom 2 - 1-2 zaug hauv ib hnub.
Yuav kom ua tiav cov nyiaj raug mob, kev siv tshuaj insulin lossis cov tshuaj txo qis qab zib yog siv. Cov tshuaj insulins luv luv tau sau cia - kom txo cov ntshav qab zib kom nrawm thiab cov tshuaj pab ncua ntev (siv sijhawm 1-2 zaug hauv ib hnub, tswj xyuas qhov xwm txheej thoob plaws ib hnub).
Kev tswj hwm glycemic txhua hnub yog ib kauj ruam tseem ceeb ntawm kev ua tiav cov nyiaj them rau "tus kab mob qab zib"
Cov ntshav ntws rov qab
Muaj cov kev khomob thiab phais mob txhawm rau rov txuas lub ntshav ntxiv rau thaj chaw muaj teebmeem. Txhua yam tshuaj siv tau muab faib ua ob pawg loj:
- tsis-prostanoids;
- prostanoids.
Thawj pab pawg suav nrog Pentoxifylline, Ginkgo biloba extract, nicotinic acid npaj, tshuaj ntshav dawb, Heparin, Reopoliglyukin. Pawg ob zoo dua. Nws cov sawv cev yog Vazaprostan, Alprostan.
Ntawm txoj kev phais mob kom rov ua kom ntshav txaus, zais pa angioplasty yog siv dav. Nov yog tus qauv ntawm "tsam kom" lub nkoj cuam tshuam los txhawm rau txhawm rau nce nws qhov kev tshem tawm. Txhawm rau ua kom ntev ntawm cov nyhuv ntawm kev cuam tshuam ntawm kev phais, ib lub stent tau muab tso rau hauv lub nkoj no - lub cuab yeej uas tuav cov leeg los ntawm kev nqaim rov.
Rho qhov tso kawm - cov ceg qis ua kom rov zoo tuaj
Lwm txoj kev yog kev phais. Angiosurgeons ua rau cov ntshav ua los ntawm cov khoom cua lossis tus neeg mob lub nkoj. Hom no qhia tau hais tias yog tshwm sim ntev dua qub.
Yog tias muaj ntau cov nqaij necrosis tom qab rov kho dua, phais mob ntawm ko taw tuaj yeem ua:
- txiav ib feem me me;
- necrectomy
- suturing lub qhov txhab lossis nws yas.
Sib ntaus nrog qhov mob
Kev tshem tawm ntawm qhov mob tsis muaj qis tshaj qhov tseem ceeb tshaj li qhov saum toj no. Cov tshuaj hauv qab no yog lees paub tias yog cov neeg ua hauj lwm zoo:
- Ibuprofen;
- Ketanov;
- Ketorol;
- Solpadein;
- Phenazepam.
Siv lub sijhawm ntev ntawm NSAIDs raug txwv vim muaj kev pheej hmoo siab plab hnyuv txhaws ntshav. Cov qub tsim ntawm metamizole (Baralgin, Tempalgin) tuaj yeem ua rau agranulocytosis.
Kev kho mob ntshav qab zib muaj teeb meem nrog tshuaj ntsuab kuj tseem siv dav, txawm li cas los xij, nws yuav tsum nco ntsoov tias kev kho tus kheej yog txwv tsis pub. Qhov no tuaj yeem tsim kev kub ntxhov rau qhov teeb meem. Ua raws li cov lus qhia ntawm kev kho mob tshwj xeeb yog tus yuam sij rau qhov txiaj ntsig kom zoo ntawm pathology.
