Izilonda elinegciwane: incazelo, izici kanye nokwelashwa debridement

izilonda elinegciwane - kuba njalo isimanga edabukisayo. Ngo ngokwayo kokunikezwa kwe-ubuqotho isikhumba akuyona yingozi kubantu, kodwa uma uhlangana flora webhaktheriya, ukuvuvukala iqala, ephelezelwa ukwanda lokushisa lendawo, ububomvu, ubuhlungu nasemilenzeni kahle kanye / noma ukusebenza komzimba, lapho isilonda.

definition

Rana - kokunikezwa kwe-ubuqotho isikhumba noma nolwelwesi lwamafinyila esebenzisa lokukhanda. umonakalo kungenzeka ijwabu ecashile naqhubeka isimo esibuhlungu. Lona omunye uhlobo ukulimala, okuyinto njalo usongo ekuphileni nasempilweni yabantu. Kuyinto isici esibaluleke kunazo cwaningo ekuhlinzeni.

Isilonda - isimo esibuhlungu, okuholela ukubukeka isilonda.

umtholampilo

Izimpawu ezihambisana amanxeba elinegciwane, kuncike inani nobukhali isimo. Kunezindlela eziningana izici zendawo esivela yikuphi ukulimala yalolu hlobo.

1. Ubuhlungu. Okwamanje lapho sinqamukile ubuqotho isikhumba, ezilimele kwalapho, futhi imali ethe cytokines akhululwa futhi prostaglandins okuyinto zishukumisa ukungakhululeki. Ukuzwela kwama-nezicubu ezingxenyeni ezahlukene umzimba akufani. Yena kakhulu liphinyiselwe eduze iziqu kwenzwa ku periosteum, ku kwengaphakathi lezinyo, ku peritoneum futhi pleura. izitho Parenchymal, efana ubuchopho, akanayo zobuhlungu.
2. Enkulu amanxeba incike ububanzi nokujula futhi nenombolo imicu ephukile. Umhlangano omkhulu kunayo yonke ebonwe umonakalo muscle ungqimba abalulekile fat.
3. Ukopha. Lesi sici esihlobene nilimaza amasayithi. Uma ezilimele imikhumbi emikhulu, ikakhulukazi imithambo, ukulahlekelwa igazi kuyaphawuleka, kodwa ukudabuka we-capillary ngeke kubangele umonakalo ebalulekile empilweni.

Uma isetshenziswa surface isilonda, ukusabela jikelele umzimba uzoba mncane. Kodwa nge amaningi okugwazwa ezijulile ezaziqoshwe izimpawu zibangelwa indawo yokulimala, degree of ukopha nokwengezwa yokutheleleka ngegciwane yesibili. Lokhu ingozi oluhambisana ekuthuthukiseni noma ukushaqeka hypovolemic, ubuchopho hypoxia, sepsis kanye nezinye izinkinga.

Ukwahlukaniswa amanxeba

Ukuze odokotela kukhona isifo inkomba olulodwa, okuyinto langena nesilonda elinegciwane. ICD 10 ikhodi eyabelwe yona? 88-T80. Lo kholamu unesibopho ukulimala komuntu kanye nezinkinga zabo. Kodwa kukhona esinye ngezigaba.

Ngokwesibonelo, umlingisi izikhali ezishisa kakhulu zikhipha izinhlayiyana inxeba lomuntu odutshuliwe lengqamu.

Ngu Ukuqhamuka ejenti kuhlasimulise ungakwazi ukuhlukanisa zinhlobo ezifana: oqoshiwe lisikiwe, oqoshiwe, idabukile, ulunywe yisilwane, contused, ebhidliza, nokunye.

Ubujamo okuholela isici komugqa uphawu, zezindwangu, umonakalo perforated.

Ngu Ukungena ukujula ejenti kuhlasimulise ukuhlukanisa eligcizelela ukubukeka kwangaphandle, engenayo, futhi ngokusebenzisa amanxeba tangential.

Kukhona ngisho ngezigaba ebonisa kobubanzi ukwabelana isilonda itheleleke (ICD-10 okungahambisani ezishisa kakhulu zikhipha izinhlayiyana):

• Aseptic (emva kokwelashwa eyinhloko kuhlinzwa);
• ukungcoliswa (umzimba microbial kukhona, kodwa izibonakaliso zezikhathi ukuvuvukala kuze kube manje);
• itheleleke (zikhona ububomvu, ukuvuvukala, ukwandisa izinga lokushisa lendawo, ubuhlungu nokushintsha umsebenzi).

inxeba kuxhomeke kulokho ncamashi oholele kulo. Kukhona lezi zimo ezintathu:

• ukungezwani kokuqala (isilonda Net, engajulile, ngento ebukhali isicelo);
• ukungezwani yesibili (nenani elikhulu granulations, izilonda itheleleke);
• ukuphulukiswa ngaphansi uqweqwe (necrosis coagulation ushe chemical).

inqubo isilonda

inqubo Balimaze - izinguquko ngokulandelana ezenzeka isilonda ngesikhathi sokulungiselela yayo nesikhathi sokuphilisa, isikhathi kanye kubangelwa inqubo ukusabela umzimba. Ziklanyelwe ukuba delimit le nidus ukutheleleka kusukela vasculature futhi siyisuse kuwo wonke ama-ejenti sokugembula. indlela Universal, abenyukela nemvelo, ukuze kuvikelwe abantu emiphumeleni ukulimala - kuba ukusabela ukuvuvukala.

Isigaba sokuqala isilonda sisheshe siphole kusekelwe ukusabela ngokomzimba kuze kube ukulimala kwezicubu. Ngokushesha ngemva ukulimala kwenzeka ukubhujiswa kwezicubu yokulimala zabo futhi cavitation, kanye nokulimala. Esikhathini sokuqala imizuzwana embalwa vasospasm kwenzeka, onikeza indlela vasodilatation ukopha abukhali. Ngemva kwesikhashana ukugeleza kwegazi ehlile kanye thrombus kwakhiwa. Parallel kule, isilonda buthelela balamuli ukuvuvukala ezithatha egazi amhlophe, phagocytes futhi insika amaseli. Ama-bacterium, ngephutha eqoshiwe phezu isilonda kuyaqedwa futhi amuncwa amasosha omzimba yeselula wendawo.

Ngemva kwesikhathi esithile, emhlabeni isilonda kukhona kushaft sokuvuvukala amangqamuzana afile futhi edema. Vasculature onomfutho, kwakhiwa necrosis lesibili. Kwakuphakathi nalesi sikhathi kukhona ubuhlungu futhi umsebenzi kahle ukusuka endaweni yenhlekelele.

Sigaba isilonda sisheshe siphole yesibili ivela zingakapheli izinsuku ezintathu, kodwa akukho umngcele ecacile. Ukuvuvukala uyaqhubeka, futhi ezithambile izicubu ukulimala uphendulela isilonda elinegciwane. ICD Ikhodi ishintsha ku amaphuzu ambalwa. Mechanical isilonda ukuhlanzwa kuvusa ukukhula granulation kwezicubu ukususwa amagciwane abafileyo phagocytes kunciphisa ukuvuvukala. It liqala inqubo kokuzalwa kumiswa imithambo yegazi entsha ekhulayo obukhulu collagen izicubu, futhi nesayithi libe nilimaza livela fresh isibanda esithambile.

Ngemva eziyishumi nane izinsuku Isigaba sesithathu - nezibazi futhi epithelization. Collagen imicu babe ngaphezulu futhi ayazika, izitsha ngeke zisaba ziqhume. Ngasikhathi sinye, kwakheka ungqimba epidermis is. Yesibazi entsha okhanyayo umbala pink, kodwa ngokuhamba kwesikhathi capillary zinyamalale, futhi buphela, ekubeni cishe ezingabonakali.

Ngaphansi kwalesi sikhwama, ukuphulukisa bonke, hhayi nje isilonda elinegciwane. Yiqiniso, zikhona njalo ukuhlukahluka ngamunye lezi izigaba ezintathu.

Indlela Abasabela Ngayo amanxeba elinegciwane

Ukusabela jikelele zingahlukaniswa izigaba catabolic futhi Anabolic. Phakathi neminyaka yokuqala (kwaze kwaba usuku lesi-4), zonke izinqubo zokuphila zithuthukiswa: izinga lokushisa likhuphuka, umzimba yanda, umuntu eqala ukuzaca, kuvimbela amaprotheni zamagama kunciphe permeability of cell ulwelwesi. Umzimba isethelwe ukuvuselelwa.

Isigaba sesibili uqala ngosuku lwesine emva ukulimala, futhi kancane kancane izinto awela indawo. Esisindo livuke ezingeni odlule, izinga lokugayeka kokudla emzimbeni evamile, futhi nalo, futhi izinga lokushisa uwela. Kancane bandisa inkonzo amahomoni adrenal.

isilonda ukuphulukisa

izicubu Inkonde ngayinye ifakwe umshini propensity ocacile yokuvuselela. Akuwona wonke amaseli ukukhiqiza kahle ngokufanayo uhlobo yabo, ikakhulukazi uma utheleleke isilonda (IBC akukuniki noma yiziphi izincomo kulokhu). Izinga kanye nekhwalithi isilonda sisheshe siphole incike izimo endaweni edalulwa. Uma sesomile, ehlanzekile kungekho imizimba angaphandle noma amagciwane, inqubo luyoqhubeka ngokushesha. Futhi, ngokufanele, kunalokho. Isimo jikelele umzimba sithinta izinga kokuzalwa kutsha lokuvuselelwa. Ngo intsha futhi unempilo, ukuphulukiswa kulula, kodwa khona yizifo ezingamahlalakhona, kuba ukulahlekelwa igazi noma amavithamini ezinkulu kungaba babhebhethekise Yiqiniso lesi sifo futhi le nqubo yokuthola ye emasontweni ambalwa, noma ngisho nezinyanga imbala.

debridement steel

Injongo yokwelapha eyinhloko kuhlinzwa - ukuhlanzwa mechanical izilonda kusuka izicubu necrotic, imizimba angaphandle namagciwane. Ukwelashwa yamanxeba elinegciwane iqala neqiniso ukuthi isikhumba endaweni ezilimele is wesula nge swab ukotini noma gauze ofakwe utshwala / nosawoti bese ziphathwe isixazululo amaphesenti omunye iodine. ensimini Operational nolwelwe amathawula oyinyumba, futhi ngemva kokubulawa izinzwa nilimaza imiphetho ukuhambisa ngaphandle batshale esandleni. Lokhu kuyadingeka ukuze wenze kube lula ukususa imizimba angaphandle futhi enenhlabathi. Ngokwesibonelo, uma isiguli ine elinegciwane unyawo isilonda, cishe, it has izingcezu umhlaba.

izicubu Necrotic excised. Ngu isidingo isilonda zingandiswa sokufinyelela ezingcono kubo bonke izindawo kungenzeka emaphaketheni abayizimpumputhe. Uma ziye zacekela imikhumbi emikhulu igazi, abophe, kodwa izinzwa ithungwe. Uma udokotela ohlinzayo iqede ekususeni yonke ezingadingekile, uya ngokuya uvalwe ithungwe futhi abeke ngebhandeshi aseptic. Ezinye okuhlukile oshiwo ku-ICD. Kuvele elinegciwane unyawo isilonda, isibonelo, kumelwe sivule, njengoba emhlabathini, lapho liye angcolile, bukhoma amagciwane anaerobic ukuthi abangela ukubola. ukulimala enkulu ihlinzeka njalo umoya-mpilo umncane ezicutshini, futhi ngenxa yalokho, ngeke nezilwanyana ezincane.

Ukwelashwa amanxeba iqhubeka

izimpawu Clinical esingasondela ngazo ukunquma ukuthi umuntu, isibonelo, itheleleke isilonda ithole avele ngosuku ukulimala wesibili noma wesithathu. Lokhu lula khona izimpawu ukuvuvukala kanye nezimila pathogenic noma ezingena ngentuba. Ekwelapheni ukulimala ezinjalo kufanele sigxile uhlobo bacterium ukukhetha ezifanele ukuzwela antibiotic. Indlela levamile simiswe ngalendlela lelandzelako:

• ukuhlanzwa ephelele wamanxeba;
• antiseptics ukucutshungulwa;
• isitatimende amanzi ukuze liphume igazi kangcono uketshezi onegciwane;
• ukukhuthazwa izivikeli mzimba wendawo.

ukuphathwa jikelele

Imithi elwa namagciwane ahlale legumbi ekwelapheni amanxeba itheleleke. Ekwakhiweni, umzila yokuphathwa, umthamo kanye nokushintsha kokudla nokufakwa imvamisa kuncike ngqo silwanyana abangela suppuration. Uma flora anaerobic, into engcono ithinta metronidazole futhi klandomitsin lihambisana sulfonamides.

amasosha omzimba Ukuphazamiseka umsebenzi, kokubili zendawo jikelele, kubonakala inqubo yokwelapha, ngakho udinga ukuyigcina ezingeni lelifanele. Ukugqugquzela zezici okuvikela umzimba kusiza ukuba ligweme izinkinga ezingase zivele ezifana sepsis, imfiva, nabanye.