Bedsores: yothintelo. Ukunyanga bedsores e ngumlwelwe kwizigulane

Bedsores - enye ingxaki ixhaphakileyo, ivela ngathi izigulane ngumlwelwe. Yintoni na?

utshintsho ebizwa bedsores umzimba izitho kwindawo ezithile (okanye ngaphezulu) ngenxa qha elide kunye tiyeke. Olunjalo utshintsho nomsindo kwegazi, nkovu kwegazi kunye nonikezelo luvo.

Kubalulekile ukuqonda ukuba zimele uthintelo decubitus kunye nonyango kwabo.

Iimpawu zophuhliso

Ngokwendalo uxinzelelo izilonda kwicala omzimba apho kukho umntu, kwiindawo ezinxulumene kumphezulu. Ngoko ke, isigulane ngasemva bedsores kwizigulane ezibhedini kakhulu bavame ezinqeni, sacrum, coccyx, esithendeni, phezu iibhleyidi zamagxa, kwinqanaba lweenkqubo spinous yomqolo. Ukuba indoda ithe yalala phezu esiswini sakhe, izilonda ukuze abonakale kwiindawo ezinjalo ukuqhagamshelana umphezulu: kwedolo, umphezulu Icipande udonga esifubeni, lo Crest iliac. Ngexesha lekhefu ehleli isikhundla, indawo obabuthandwa ukoyiswa - ngeempundu ndawo.

Kodwa ke ayikho ngaphandle, yaye kummandla ochaphazelekayo, hayi kuluhlu ngasentla. Umzekelo, izilonda uxinzelelo (imifanekiso kwesi sifo ingafumaneka kwi ireferensi zonyango) iye kummandla Occipital kwaye isondo phantsi libele. Mhlawumbi indawo ethile phambi abumbe kwiindawo fit zazo Ukufudumala ye imathiriyeli eluswini, esebenzisa amalaphu oilskin, iityhubhu irabha, catheters, zitho. Oko kungenxa kwasendaweni apho iye imiba umonakalo.

Enye into ebalulekileyo imeko yomguli. ingozi enkulu yophuhliso ngakumbi olukhawulezileyo izilonda xi ukudinwa xa jikelele, kukho yokunqaphela, elithanda iqatshelwe ukusilela intliziyo, xa izigulane zikwinqanaba yokwaluphala. Xa ulutsha, abantu abazi, phezu koko, akubonakali imbonakalo bedsores. Kwaye ukuba kwezibonakalayo, kunqabile ukuba baphuhlise de zigaba kamva. Kodwa kwangaxeshanye kufuneka kukhunjulwe ukuba, ngenxa kuphuhliso okuthe chu, ukwenzakala kwezi zigulane, maxa wambi ungatsiba iimpawu lokuqala lwesifo.

Phantse kuzo zonke iimeko izilonda uxinzelelo uphuhliso indlela efanayo, yahlukile lixesha kuphela kwinqanaba ngalinye. Isiqalo isoloko stasis igazi okwenza ukucudisa, ukuba lunganyangwa, ancedisana abachaphazelekayo babe necrotic.

Yintoni na umngcipheko izilonda uxinzelelo?

Eyona ingozi ezinxulumene iingxaki zabo. Ekubeni kwiimeko ezininzi izilonda uxinzelelo kwizigulane ezibhedini zikhula ngokukhawuleza nangokupheleleyo ngexesha elifutshane nga zikhule futhi indawo enkulu necrotic basoloko ukubhengeza inyama zizifo. Maxa wambi oku kukhokelela ekuphazanyisweni kwenkqubo unikezelo igazi innervation iindawo ezingqonge, nto leyo yenza ukuba ukuphazamiseka imisebenzi yabo.

Kwezinye iimeko, iziphumo uphuhliso bedsores yimfuneko nquma lo mlenze. Ngaphezulu, iinkqubo necrotic nxeba kwi periosteum okanye ithambo, babe igesi okanye nokudumba.

Kwakhona kubalulekile ukuba iinkqubo ezenzeka emzimbeni ngexesha kuphuhliso izilonda uxinzelelo, unyango lwabo, kufuna igalelo elibonakalayo amandla, ngoko deplete isigulane, ngaloo ndlela kwandisa ikhondo sifo ngxabano. Ngakumbi yingozi bedsores iyabhiqiza.

Ngenxa yoko, kubalulekile ukuqonda ukuba baqaphele indlela bedsores. Umyalezo weimeyile, Pathogenesis, uthintelo kunye nonyango izilonda uxinzelelo kwiindawo ezahlukeneyo ziyafana kakhulu.

Kutheni kukho decubitus?

Isizathu zophuhliso babo kwegazi kwindawo ethile kwesikhumba. Oku kwenzeka kwiimeko ezimbalwa.

Amaninzi lo kuthiwa ambona imithambo yegazi ukucudisa, ingakumbi ngexesha ucinezelo kudlula iiyure ezimbini, oko kukuthi xa elapho endaweni enye. Tissue, leyo Asingeni igazi, necrotic, kwaye sele yokuzenzela bedsores.

A nasiphi na microdamages kunye neempahla encinane esikhumbeni. Oku kunokwenzeka xa evela umguli tsala ezimanzi tissue, umz, elonakalisayo sheet. Maxa wambi nokulimala kwenzeka ngenxa bazama ukutshintsha ngokuzimeleyo sikhundla okanye ukuhamba. Ngoko ke, kufuneka uphephe nayiphi ukukhuhlana, umonakalo ezingephi nesikhumba uxakaxa imifinya, kwaye banomnqweno ukuba nijike okanye wenze into kufuneka bazame ukumnceda.

Ukuba uyazi oonobangela izilonda kubangela uxinzelelo, uthintelo, unyango le ngezifo zenziwa ngendlela eyiyo nangempumelelo.

Yeyiphi kwandisa ingozi yokuba izilonda uxinzelelo?

Ukuze siqonde oko bedsores, yintoni unobangela, uthintelo kunye nonyango oko kubalulekile ukwazi, ochaphazela umngcipheko kwazo. Kukho izizathu ezininzi. Ezinye zazo ezidityanisiweyo kunye awohluke imeko yesigulane, ngoxa abanye - kunye lombutho efanelekileyo ngononophelo kwizigulana ngumlwelwe.

ngabo iimpawu kwiqela lokuqala ezininzi izinto ezibalulekileyo:

• Ubudala - basengozini enkulu kubantu abalupheleyo.
• Weight - kukho umngcipheko kwaye utyebile, elabalabayo. Okuya uba mkhulu umsantsa ubunzima, kokukhona uxinzelelo amanqaku nenkxaso yomzimba. Kodwa belula kudla kubonisa zokuncipha umzimba, kwaye kananjalo into predisposing hayi kuphela imbonakalo kodwa uphuhliso ngokukhawuleza ngakumbi iinkqubo necrotic.
• isifo sentliziyo kunye nenkqubo yokujikeleza - xa ezimbi yalo hlobo luza kuphuhlisa ukuxinana kwinkqubo yokujikeleza kwegazi, kuba iimpahla lula ezimashakeleyo, okubaluleke nangakumbi kukuba nayiphi impembelelo, ukumqumbisa nokuhluthwa ingqibelelo yabo.
• Izifo ebonakalayo - indawo ekhethekileyo apha uthathe izifo, okukhokelela ukuphazamiseka innervation (umz stroke phambi), kwakunye nabo apho phula iinkqubo pathways (umzekelo, diabetes).
• Ukutya Sela - ngokuyingozi inani ngokwaneleyo iziselo kunye nokutya, kubaluleke ngakumbi ukuba esweni isixa iiprothini ekutyeni.
• Nakwenzeka ukuchama nokuzeyisa defecation - kuba waphawula ukuba isigulana zingqondweni, abafe okanye akakwazi ukulawula indlela aziphatha ngayo urhulumente ngenxa sengqondo esixhalabisayo.
• ukubila lweenkcukacha - inokuba ngenxa pathways okanye ezidalwe ukuphazamiseka, yaye ngenxa phambi umkhuhlane.
• Iimpawu basuke lwamayeza - factor ezibi kungaba imbonakalo kukwalisa amachiza asetyenziswa ukunakekelwa isikhumba kwiindawo apho Izilonda uxinzelelo asaphuhlayo. Uthintelo, unyango bedsores kuthetha ukuba kufuneka athathe ingqalelo zonke iimpawu omzimba wesigulane.

Ukuze imiba iqela lesibini ziquka ngokukhethekileyo. Yandisa amathuba zokuphuhlisa izilonda xi utshintsho engaqhelekanga iingubo ebhedini, ukungabikho okanye ukuziphatha kakubi yococeko, uburhabaxa ngokugqithiseleyo, nobulukhuni wobuso apho ubuxoki nomonde, ubukho kwiimvuthuluka ebhedini, izinto ezincinane.

Bedsores: indlela ukuqonda zona?

Ukuba isigulana lisezingqondweni na kwaye igcinwe onovakalelo, yena uyakwazi ukuthetha ngeemvakalelo luluvo ukuba abo banyamekela kubo. Imiqondiso uhlaselo bedsores iquka izikhalazo esibuhlungu. Oku kuvela ngenxa yokudodobala igazi nkovu kwindawo apho amathuba aphezulu isahlakalo kweenkqubo zophendlo lwezifo ekhokelela ukuyilwa bedsores, ukuba athathe amanyathelo ayimfuneko. Ngenxa kokoma le luvo abafumani isondlo esaneleyo, kwaye subjectively kunjani a esibuhlungu. Emva kweeyure ezimbalwa welahleko kunokwenzeka koluvo, iimvakalelo antsi kwiinkalo eluswini, leyo Asingeni egazini.

Emva kwexesha elithile, kukho iimpawu ezibonakalayo. Amanqaku zoqhagamshelwano oluvelayo amalungu omzimba kunye nomphezulu nzima kuvela amabala bamantshontsho-red - erythema lwemithambo. Abanakho Ndinencam kakuhle echazwe. umbala yabo ibe zombini ngesinyibiliko ngenkankulu azikaqapheleki.

Ukuba iimpawu ezinjalo zibonwa, kufuneka uthathe inyathelo ngokukhawuleza ukuthintela olunye uphuhliso lweenkqubo zophendlo lwezifo kwimimandla echaphazelekayo. Kufuneka siqiniseke ukuba baqaphele bedsores. Uthintelo, unyango bedsores, ngempumelelo ngakumbi phambi imiqondiso yokuqala yabonakala, nezenzo ethathiwe.

Nceda kwi uphawu yokuqala izilonda uxinzelelo

Kuba kuthintelo nonyango kusekwangoko kakhulu kuphuhliso lwabo kufuneka athathe amanyathelo ukuba inkathalo nomonde nokuba ngokucokisekileyo ngakumbi, ngokumnika ithuba lokuba babe kwindawo ethile ekhululekile kwaye ichanekile.

Sebenzisa oomatrasi ezikhethekileyo ezinceda abo bedsores abakhoyo. Uthintelo kunye nonyango kula maqumrhu - injongo ngqo apho ukuba benziwa. oomatrasi ezinjalo anti-decubitus zezona ntlobo zimbini: kumaza ibhaluni. Bona baxhotyiswa compressors, cwaka ukusebenza nokugcina ubungwanyalala eyimfuneko wobuso apho isigulane ilele. Kuba kwizigulane kudala sele esinamavili, ungasebenzisa izibophelelo ezizodwa bazaliswa ngumoya, ugwebu okanye gel.
Ukuba umntu kwindawo lisalele, kungakuhle ukuba kwentloko yesingqengqelo yaba kancinane bazifinyeza okanye egungxula kunye nomzimba.

Enye into ebalulekileyo - utshintsho rhoqo omzimba. Ukuba akukho Izimo, oko kufuneka kwenziwe rhoqo zonke iiyure ezi-2. Ngaloo kunqweneleka ukuba usebenzise iphedi ngokukodwa. Banceda ukutshintsha ubume iinxalenye ezithile omzimba xa kuthelekiswa komhlaba apho kukho umntu. Ngenxa kule ixeshana phakathi kwiindawo ngamnye ulusu kunye umandlalo isithuba, akukho ucinezelo kwemithambo yegazi, kunciphisa amathuba uphuhliso kunye progression of bedsores. Izigulane aba esinamavili, utshintsho omzimba kufuneka iyure yonke. Elele apho ubuxoki nomonde, kufuneka perestilat ubuncinane kanye ngemini. Kubalulekile ukuba esweni imeko iimpahla ebhedini - imibimbi esiyingozi, ukufumana kwiimvuthuluka impahla okanye ezinye izinto ezincinci ezinokubangela kwesikhumba kunye microdamages.

Okubaluleke kakhulu eluswini nococeko. ingqalelo ekhethekileyo kufuneka ihlawulwe kwazo. Ukuze ulawule le Uphawu kunye nokuthintela ukufuma ngokugqithiseleyo ukusebenzisa ngumgubo okhethekileyo, izithambiso, izisombululo, isipreyi, ukuthathwa eshushu (hayi ashushu) bath. Ezi ucoceko iinkqubo kufanele kwenziwe ubuncinane kabini ngemini. Ukongeza, ngexesha ukuchama kunye defecation kufuneka ngokukhawuleza kangangoko kunokwenzeka ukususa ukungcoliswa ulusu kunye neempahla. Ukulungiselela le njongo, kwakunye ukususa xhopho, ubutyobo ukutya, nokugxothwa amanxeba, ukucupha ezisetyenzisiweyo, iitawuli, kwamalweyile, ukucupha, pads izifunxi.

iindawo kuvumelekile nangesandla ulusu apho kukho iimpawu zazimi ngxi ndaweninye, kodwa akunakwenzeka ukuba pakani ezi ndawo, wenze massage kakhulu. Izenzo ezinjalo isekude ukukhawulezisa inkqubo.

Pathogenesis

Xa Pathogenesis xi izilonda amabakala ezine zophuhliso. Ngexesha sigaba I ulusu kwisayithi ka adibane kumphezulu ngaphandle yokuphuhlisa erythema lwemithambo. Unobangela erythema - ukugxojwa nencindi igazi. Ngaphandle erythema ivela indawo njengoko bamantshontsho ebomvu, isikhumba uxinzelelo-sensitive kwi kummandla ochaphazelekayo ajike emhlophe. Lobushushu kwi erythema iyafana lonke ulusu okanye ngezantsi kancinane. Le ndawo eyodwa yophuhliso - prominences nokudleka. Isikhumba ihleli, akukho lunyhasho ingqibelelo yayo.

Isigaba II decubitus kwenzeka ukuxozwa le epithelium, kukubola kwakunye noboya, amaqamza kwakheka kulo. Oku zonke ngenxa yokutya bazijongela zomzimba, leyo kwenzeka ngenxa kungekho kukhula igazi. Oku kukhokelela ukuhlukumeza innervation. Ukongeza, isikhumba oqokelela amanzi, iiseli ulusu adumbe yaye ekugqibeleni iintsuba, bafe. Ngenxa yoko, kweli nqanaba sele kolusu ebonakalayo, maceration ibonakala kwimimandla echaphazelekayo.

Kuba Step III decubitus amanxeba ukubukeka. Ukuba ufumana microflora yayintsholongwane eyosulela basenokuba iyabhiqiza. Kubalulekile kweli nqanaba lenkqubo zophendlo lwezifo ibandakanya ingxenye yaso yonke yesikhumba, izihlunu ongama, izihlunu, iinkqubo necrotic uqale. Necrosis kunye ubovu nangokurhala kusenokwenzeka zimele ingozi enkulu kwimpilo umguli.

Xa inyathelo IV yesiphako ebonakalayo ekhoyo kwikhavithi izihlunu, apho kubonakala phezu iindonga ubovu komtshiso oko. Unobangela songeniselo kunye lweHo- - ijwabu necrosis.

Enye indoda kwiindawo ezahlukeneyo omzimba abe zizilonda uxinzelelo, leyo zikumanqanaba ahlukeneyo ekhula.

iingxaki kunokwenzeka

Uninzi iingxaki ezivele ngexesha kuphuhliso izilonda koxinzelelo ngenxa sesichengeni isahlulo ezonakeleyo kufakwe ezinye iintsholongwane izifo. Amaninzi oko staphylococcus okanye iStreptococcus, kodwa kungakho amatyala iyilwe kunye nezinye izinto pyogenic kakuhle.

Kaninzi iinkqubo suppurative kwi bedsores iphuhliswe kuhlobo erysipelas okanye cellulitis. Kwiimeko of ukudinwa jikelele, okukwazi buthathaka okanye umbutho ngokungafanelekanga amanyathelo ucoceko, unyango ngokwaneleyo izilonda xi lisenokuba iingxaki ubomi emngciphekweni, ezifana nokudumba kunye negesi ukubola.

Bedsores e izigulane baqale iyabhiqiza eqongeni yesibini okanye eyesithathu, xa kwisiza epithelium ezonakeleyo ubonakala okanye inxeba elivulekileyo, ngoko kukho uphuhliso ngakumbi iinkqubo ubovu.

Ngoko ke, ukuba kukho izilonda, uthintelo kunye nonyango ziyimfuneko kuphela kubo, Yile ulawulo ebalulekileyo olungqongqo phezu nemeko ngokubanzi eziphilayo. Ahlale evule amehlo kufuneka enokwenza ubushushu bomzimba banda, ukwandisa buthathaka, intloko ebuhlungu, ukudumba ngeenxa ukubonakala bedsores, ukutshintsha umbala inwebu ongwevu, ivumba lakhe elinukayo evela inxeba, kunye nezinye utshintsho.

kwasendaweni gumbini of bedsores

Kuxhomekeka kwindawo apho isigulana ubuxoki, kulapho kukho decubitus uthintelo kunye nonyango nokuba bohluka kangakanani.
ingqalelo ekhethekileyo kufuneka inikwe iinketho eyendawo yawo kwindawo lomntu emqolo. Kulo mzekelo, sesona kuvela decubitus kwi izithende, ezinqeni, coccyx, kummandla we ngamaphiko.

Livela xi izilonda phezu izithende rhoqo. Ngoko asebekhulile kangakanani na kokoma ndikho imilenze, oko kubangele uxinzelelo izithende kweenkqubo ezinjalo elibalwa kuphela. Ukongeza, ngokokuqhelekileyo ulusu kule mimandla umzimba ashinyeneyo ngakumbi, ngoko ke kunzima ukuba baphawule Iimpawu zokuqala sifo. Ngenxa efanayo sizathu, eli lizwe bedsores (unyango kubo) kufuna ixesha elide kakhulu Qaphela ingqalelo.

Izilonda uxinzelelo ezimpundwini eziyingozi kuba le ndawo yokuba umzimba kufutshane amalungu abalulekileyo. Hlula ezi imizimba kufuna kuphela unyango ngenyameko, kodwa kwixesha elizayo libe negalelo elikhulu kwi imeko jikelele kunye nokusebenza omzimba, nakwezo bufutshane ubomi. Ngoko ke, kufuneka wenze iinzame ezikhethekileyo ukuthintela bedsores ezinjalo. Kuthintelo nonyango (iifoto ezibonisa ukubonakala olu hlobo izilonda uxinzelelo, ziyafumaneka kwiimagazini ezizodwa) loo monakalo kufuneka wenziwe ngokomthetho. Kungenjalo ukucingeleka onamandla ukuba le nkqubo iya kukhokelela nemiphumo engathandekiyo.

Bedsores: unyango kunye nothintelo

Ukongeza ulwazi oko kukuthi bedsores, apho kungenziwa akhiwe njani ukukhangela, kufuna ulwazi sibaphathe njani kwaye nendlela ukuthintela kwazo. Unyango lwe izilonda xi isigulane uquka unyango yesikhumba ngococeko, iinjongo zothintelo ngqongqo nezinyangayo. Olu nyango kufuneka wenziwe rhoqo.

Kubalulekile ukuqonda izizathu zokuba kutheni kukho izilonda. Uthintelo, ukuphathwa bedsores kwaye kufuneka lubekhona. Unyango yesikhumba zococeko lwenziwa ukuze kugcinwe inqanaba ekhuselekileyo iipropati zalo ezisisiseko kunye neempawu: pH, ukufuma, luthambe. Kuyafuneka ixesha ukuphelisa ungcoliseko.

unyango lokuthintela kubandakanya amanyathelo, iphucula kwegazi kunye nokuhlaziywa nobuzaza ulusu kunye kwizihlunu nobangela. Musa ukulibala ukuba ezithandwa kakhulu inkangeleko bedsores kunye neenkqubo suppurative yonakele ulusu, ngoko ufuna ukwenza ulondolozo othintelo lwe ukoma yayo kunye ukubonakala neentanda kuwo.

unyango kubaluleke kakhulu. Ukuze wenze oku, sele kufuna amayeza ezizodwa. Ke kaloku kukho ukudla kwabo, ziyafumaneka ezahlukeneyo kwiinguqulelo neefom. Anti-bedsore sebenzisa ezahlukeneyo namafutha aqholiweyo, ijel, Ithatyathwe emigutyeni yonke, izisombululo, mixube. Ngalinye oyidlayo fomu leyo kwiimpawu: Izimo, iindlela ukusetyenziswa. Kuyinto ke ngoko ebalulekileyo xa sikhetha unyango ukuba adibane lweengcali onamava.

Yintoni na ke bedsores kakhulu sinyangekile na? Izimvo zabantu abaye bajamelana le ngxaki, ukuvumela ukuba kulwabiwo ezinye Ukrainian lunee ntlobo zixhaphakileyo kwezisombululo sele isetyenziswe ngempumelelo kwiimeko ezinjalo. Kuba machining yangaphandle Kucetyiswa ukuba usebenzise isisombululo magnesium sulfate (25%) okanye hypertonic (10%) isisombululo sodium chloride ukuya chymotrypsin kwaye butofelwe ilawulwa nesisombululo metronidazole 0.5%. It ayinqweneleki ukusebenzisa potassium permanganate, ayodini, green ezikrelekrele.

Kubalulekile kuqinisekisa ukuba akukho entsha izilonda Vela. Uthintelo, unyango izilonda xi ngokuqhelekileyo kufuna kakhulu umgudu, kuthetha ezichitha ixesha.

ukubaluleka olunzulu yokudla yesigulane. Yokudla kufuneka babekho kule iivithamini imali efunekayo, iiminerali, ingakumbi nezinki nesinyithi, iiprotheni, ukusetyenziswa eyimfuneko zemifuno kunye neziqhamo. Kuyanconywa ukuba aquke kwizidlo imveliso zobisi, intlanzi, amaqanda, inyama (kukhethwa iinkuku). Ukuba umntu kunzima ukuba adle inyama, oko kutshintshwa umhluzi.