Mabala Opatsirana: Mafotokozedwe, Chithandizo Cha Opaleshoni, ndi Zochita Zothandizira

Mabala opatsirana amakhala osadabwitsa kwambiri. Kulephera kwa khungu kumapangitsa kuti anthu asawonongeke, koma ngati chomera chabakiteriya chimagwirizana, njira yotupa imayambira, kuphatikizapo kuwonjezeka kwa kutentha kwa m'deralo, kufiira, kupweteka, ndi kufooka kwa nthambi ya thupi komanso / kapena chiwalo chimene chilondacho chili.

Tanthauzo

Gunda ndi kuphwanya khungu la khungu kapena mucous ndi njira yamagetsi. Zingatheke kuwonongeka kwa minofu yambiri ndi kuwonongeka kwa zinthu zovuta. Ichi ndi chimodzi mwa mitundu yovulaza yomwe nthawi zonse imawopsyeza moyo ndi umoyo waumunthu. Ndi mbali yofunikira pa phunziroli opaleshoni.

Vuto ndi vuto lalikulu lomwe limayambitsa chilonda.

Kliniki

Zizindikiro zomwe zimaphatikizapo zilonda zamtundu zimadalira nambala yawo ndi kuuma kwa chikhalidwecho. Pali zizindikiro zambiri zapanyumba, zomwe zimakhala zovulaza zilizonse.

1. Ululu. Panthawi imene khungu limasweka, kumapeto kwa mitsempha kumakhala koonongeka, ndipo zimatulutsidwa zambirimbiri za cytokines ndi prostaglandins zomwe zimapangitsa kuti zisamve bwino. Kukhudzidwa kwa matenda m'magulu osiyanasiyana a thupi si chimodzimodzi. Amatchulidwa kwambiri pafupi ndi mitengo ikuluikulu ya mitsempha, pa periosteum, mu zamkati zamkati, mu peritoneum ndi pleura. Ziwalo zopweteka, monga ubongo, sizikhala ndi zopweteka zopweteka.
2. Kuwala kwa bala kumadalira kukula kwake ndi kuya kwake, komanso nambala ya zowonongeka. Yaikulu kwambiri imawonedwa pamene minofu yawonongeka ndi mafuta osanjikiza.
3. Kusuta. Chizindikirochi chikugwirizana kwambiri ndi malo ovulala. Ngati ziwiya zazikulu zowonongeka, makamaka mitsempha, ndiye kuti kutayika kwa magazi kudzakhala kofunika, koma kutaya kwa capillaries sikungapweteke kwambiri ku thanzi.

Ngati chilonda chadongosolo chikugwiritsidwa ntchito, zomwe zimachitika zamoyo zimakhala zochepa. Koma ndi mabala ambirimbiri odulidwa, zizindikiro zidzakhala chifukwa cha kuvulala, kuchuluka kwa magazi ndi chigwirizano cha matenda ena achiwiri. Izi ndizoopsa chifukwa cha kupwetekedwa kwa magazi kapena chisokonezo cha hypovolemic, cerebral hypoxia, sepsis ndi mavuto ena.

Chizindikiro cha mabala

Kwa madokotala, pali bukhu limodzi la matenda, pamene chilonda cholandira chalowa. ICD 10 inamupatsa chikhombo T80-T88. Mutu uwu uli ndi vuto la mavuto a anthu ndi mavuto awo. Koma palinso mtundu wina.

Mwachitsanzo, mwa chida cha chida, mfuti ya mfuti ndi mpeni zimapangidwa.

Pamapeto pake, zimatha kusiyanitsa mitundu monga: kudulidwa, kudulidwa, kudula, kudula, kulumidwa, kuvulazidwa, kuphwanyika, ndi zina zotero.

Pa mawonekedwe a chosowa cholandilidwa, chiwonongeko cha holey.

Kuzama kwa kulowa kwa wodwalayo kumasiyanitsa pakati pa maonekedwe, kupyola, kupyolera mwa mabala.

Palinso ndondomeko yomwe imasonyeza kuti chilonda cha kachilombo kamagawanika (ICD 10 sichikusiyanitsa):

• Mankhwala osokoneza bongo (pambuyo pa chithandizo chachikulu cha opaleshoni);
• Zonyansa (pali tizilombo toyambitsa matenda, koma palibe zizindikiro za kutupa komabe);
• Odwala (kutentha, kutupa, kuwonjezeka kwa kutentha kwa m'deralo, kupweteka ndi kusintha kwa ntchito).

Kuchiritsidwa kwa chilonda kumadalira zomwe zinagwiritsidwa ntchito. Pali njira zitatu zokhazikitsira zochitika:

• Mavuto oyambirira (chilonda choyera, chosaya, chikugwiritsidwa ntchito ndi chinthu chakuthwa);
• Mavuto a sekondale (chiwerengero chachikulu cha granulations, mabala odwala);
• Kuchiza pansi pa nkhanambo (coagulation necrosis kuchokera ku mankhwala oyaka).

Ntchito yolunda

Ntchito yolonda ndi kusintha komwe kumachitika pa chilonda pochita kupanga ndi machiritso, komanso momwe zimakhudzidwa ndi zamoyo zomwe zimayambitsa ndondomekoyi. Zimayesetsanso kuthetsa chiopsezo cha kachilombo koyambitsa matenda ndikuchotseratu anthu onse odwala matendawa. Njira ya chilengedwe yomwe chilengedwe chinagwiritsidwa ntchito kuti chiteteze munthu ku zotsatira za kuvulazidwa ndikutentha.

Gawo loyambirira la chilondacho likuchokera kumayendedwe a minofu kuti awonongeke. Pambuyo pa chovulalacho, kuwonongedwa kwa mbali ya minofu, kuphulika kwawo ndi cavitation, ndi kupanga mapangidwe a mpweya. Pakati pa masekondi oyambirira pali kupuma kwapakati, komwe kumalowetsedwa ndi kukula kwakukulu kwa mitsempha ya magazi ndi magazi. Patapita kanthawi kochepa, kuthamanga kwa magazi kumachepetsanso komanso mawonekedwe a magazi. Mofananamo ndi izi , oyimbira opanga mavitamini amaunjikira pachilonda , chomwe chimakopa maselo oyera a magazi, phagocytes ndi maselo akuluakulu. Mabakiteriya, omwe amalembedwa mwachisawawa pa chilonda pamwamba, amachotsedwa ndipo amatengeka ndi chitetezo cha m'deralo.

Panthawi ina pamapeto pake kuvulaza kuli kansalu yotupa kuchokera ku maselo akufa ndi kutupa. Maselo amatetezedwa, kachilombo ka secondary necrosis kamapangidwa. Panthawi imeneyi ululu umaonekera ndipo ntchito ya dera lomwe lakhudzidwayo imasokonezeka.

Gawo lachiŵiri la balala likuyamba masiku atatu, koma palibe malire omveka bwino. Njira yotupa ikupitirira, ndipo bala lopatsirana limachokera ku chovulala chofewa. Code ICD amasinthidwa ndi mfundo zingapo. Mankhwala oyeretsa a chilonda amachititsa kukula kwa granulation minofu, ndipo kuchotsedwa kwa mabakiteriya wakufa ndi phagocytes kumachepetsa kutupa. Ndondomeko yowonjezeredwa imayamba, mitsempha yatsopano ya magazi imapangidwira, minofu yowonjezereka imakula, ndipo chiwombankhanga chatsopano chikuwoneka pa malo a bala.

Masiku khumi mpaka khumi ndi anayi, gawo lachitatu limayamba - kuperewera ndi kuperewera. Mitundu ya collagen imakhala yochulukirapo, zotengerazo sizikula. Panthawi imodzimodziyo, mndandanda wa epidermis umapangidwa. Kachilombo kameneka kamakhala ndi mtundu wofiira wa penti, koma potsirizira pake ma capillaries amatha, ndipo amawuluka, amakhala opandawoneka.

Pansi pa ndondomekoyi, onse amachiritsidwa, osati mabala okha. Inde, nthawi zonse pamakhala kusiyana kwakukulu kwa magawo atatuwa.

Kuyankha kwa thupi ku chilonda cholandira

Zomwe zimachitikira zimatha kugawa magawo a catabolic ndi anabolic. Pa nthawi yoyamba (mpaka tsiku lachinayi) njira zonse zofunikira zowonjezereka zikuwonjezeka: kutentha kumatuluka, kuchepa kwa thupi kumafulumira, munthu amataya thupi, mapuloteni amatetezedwa ndipo kuperewera kwa maselo am'thupi kumachepa. Thupi likuyang'aniridwa kuti ikonzedwenso.

Gawo lachiwiri limabwera pa tsiku lachinayi pambuyo povulazidwa, ndipo zonse pang'onopang'ono zimagwera m'malo. Thupi la thupi libwezeretsedwa kumtunda wapitawo, metabolism ndi yachibadwa, ndipo ndikutentha kumagwa. Ntchito ya ma hormone ya adrenal imakula pang'ono.

Kuchiritsa mabala

Minofu iliyonse ili ndi chizoloŵezi chokhazikitsanso. Si maselo onse omwe amadzipangira okha mofanana, makamaka ngati ali ndi kachilombo koyambitsa matenda (ICD sakupatsani malingaliro aliwonse pa nkhaniyi). Kufulumira ndi khalidwe la machiritso zimadalira momwe zinthu zilili m'deralo. Ngati pali youma, yoyera ndipo mulibe matupi kapena mabakiteriya, ndiye njirayi idzafulumira. Ndipo, mosiyana, mosiyana. Chikhalidwe cha zamoyo zimakhudzanso mlingo wokonzanso. Kwa achinyamata ndi athanzi, machiritso ndi osavuta, koma kukhalapo kwa matenda aakulu, kutayika kwa magazi ambiri kapena kuchepa kwa vitamini kungapangitse kuti matendawa ayambe kuchepetsedwa ndipo amachedwa kuchepetsa kwa milungu ingapo kapena miyezi ingapo.

Kuchiza opaleshoni mabala

Cholinga cha chithandizo chachikulu chochizira opaleshoni ndicho kuyeretsa makompyuta kuchokera ku matenda osokoneza bongo, matupi achilendo ndi mabakiteriya. Chithandizo cha mabala omwe ali ndi kachilomboka amayamba ndikuti khungu lozungulira malo owonongeka likupukutidwa ndi thonje kapena thonje lachapa losakaniza mowa / saline, ndiyeno amathandizidwa ndi mankhwala a 1% a ayodini. Munda wothandizira uli ndi mapiritsi osakera, ndipo pambuyo poti anesthesia m'mphepete mwa chilonda akufalikira ndi kufalikira padera. Izi ndi zofunika kuti pakhale zovuta kuchotsa matupi akunja ndi dothi. Mwachitsanzo, ngati wodwala ali ndi chilonda cha phazi, ndiye kuti mwina ali ndi magawo a dziko lapansi.

Minofu yokhala ndi mpando wabwino kwambiri. Ngati ndi kotheka, chilondacho chikhoza kuwonjezeredwa kuti chikhale chofikira ku malo onse akhungu ndi mapepala omwe angathe. Ngati pali ziwiya zazikulu zowonongeka, ndiye kuti zimasungunuka, ndipo mitsempha imasulidwa. Dokotalayo akamaliza kuchotsa zonsezi, chilondacho chimasungidwa mwamphamvu ndipo mabanki a aseptic amagwiritsidwa ntchito. Zina zosiyana zimatchulidwa mu ICD. Chilonda cha nthenda ya phazi, mwachitsanzo, chiyenera kukhala chatseguka, monga m'nthaka yomwe inaipitsidwa, amakhala mabakiteriya a anaerobic omwe amachititsa kuvunda. Kuwonongeka kwazungulira kumatsimikizira kuti nthawi zonse mpweya wa oxygen umatha kufika pamatenda, choncho, salola kuti chitukuko cha tizilombo tizilumikize.

Mankhwala a mabala a purulent

Zizindikiro zachipatala, zomwe zimatsimikiziranso kuti munthu, mwachitsanzo, wodwalayo ali ndi kachilomboka, akuwoneka pa tsiku lachiwiri lachitatu pambuyo pa kuvulala kwake. Izi zimathandizidwa ndi kukhalapo kwa zizindikiro za kutupa ndi tizilombo toyambitsa matenda. Pochiza zilonda zoterezi, munthu ayenera kuganizira mtundu wa mabakiteriya ndikusankha mankhwala oyenera a antibiotic. Njira yowonekera ndi iyi:

• Kuyeretsa kwathunthu kwa bala;
• Chithandizo ndi antiseptics;
• Kuika madzi okwanira bwino kutuluka kwa madzi;
• Kulimbikitsa chitetezo cha m'thupi.

Chithandizo chachikulu

Mankhwala opha majeremusi amakhalabe mwala wapangodya pochiza mabala a kachilomboka. Mankhwalawa, njira yowonetsera, mlingo ndi nthawi yowalandirira kumadalira mwachindunji ndi tizilombo toyambitsa matenda zomwe zinayambitsa kuyeretsa. Ngati zomera ndi anaerobic, ndiye kuti zimakhudzidwa kwambiri ndi metronidazole ndi clandomycin kuphatikizapo sulfonamides.

Kuphulika kwa ntchito ya chitetezo chokwanira, ponseponse ndi ponseponse, kumakhudza machiritso, kotero ndikofunikira kuti mukhalebe pamtundu woyenera. Kulimbikitsa zinthu zomwe zimateteza thupi kumathandiza kupewa mavuto monga sepsis, fever ndi ena.