Amanxeba abosulelwe: inkcazo, iimpawu kunye nonyango debridement

amanxeba eyosulelekileyo - kusoloko kukho isimanga elibi. Ngokwayo yaphula ingqibelelo besikhumba ayingozi ebantwini, kodwa ukuba uncediswa flora iintsholongwane, inkqubo yokukrala iqala, sikhatshwe ukwanda kwamaqondo lwasekuhlaleni, ukuba bomvu, iintlungu kunye omzimba kakuhle kunye / okanye ukusebenza komzimba, apho inxeba.

definition

Rana - yaphula ingqibelelo esikhumbeni okanye ngenwebu yangaphakathi ngokusebenzisa ngomatshini. umonakalo kunokwenzeka ukuba inyama bha zisiba urhulumente siganeko. Le yenye uhlobo ukwenzakala, apho kusoloko kukho isoyikiso kubomi babantu kunye nempilo. Yeyona nkalo ibalulekileyo isifundo kutyando.

Inxeba - imeko ebuhlungu, nto leyo ekhokelela imbonakalo isilonda.

ikliniki

Iimpawu eziyelelene amanxeba sifo, kuxhomekeke kubungakanani kunye ubungqongqo imeko. Kukho iqela lemisebenzi esemqoka zendawo azalwa kuyo nayiphi na ukwenzakala hlobo.

1. Pain. Okwangoku xa ukuthembeka isikhumba yaphulwe, kwalapho umonakalo, kwaye nazo sesixa cytokines akhululwe kwaye prostaglandins eziya kusikhuthaza ubuhlungu. Uvakalelo esikule iindawo ezahlukeneyo umzimba akufani. Yena libizwa kakhulu kufuphi komboko luvo, kwi periosteum, kwi yintlama yamazinyo, kwi peritoneum kunye pleura. amalungu Parenchymal, ngathi ingqondo, ongenayo receptor intlungu.
2. Kwashiya izilonda ixhomekeke ububanzi bayo kunye nobunzulu kunye nenani imicu ezaphukileyo. Eyona inkulu waphawula umonakalo kwezihlunu kunye umaleko elibalulekileyo ngamanqatha.
3. Ukopha. Olu phawu lunxulumene ngokusondeleyo esilondeni iziza. Ukuba ezonakeleyo iinqanawa ezinkulu, ingakumbi imithambo, ilahleko igazi kubalulekile, kodwa komsipha ke emithanjeni akayi kubangela umonakalo enkulu kwimpilo.

Ukuba isicelo kumphezulu ngenxeba, basabela iyonke umzimba ziyakungahoywa. Kodwa namanxeba anzongonzongo abazenzela mpawu zibangelwa indawo yokwenzakala, inqanaba ukopha kunye nokongeza a usulelo yesibini. Le ingozi ukopha zokuphuhlisa okanye zomzimba ngenxa, hypoxia ingqondo, nokudumba kunye nezinye iingxaki.

ngezigaba amanxeba

Kuba oogqirha kukho reference isifo esinye, apho wangena kunye inxeba owosulelekileyo. ICD 10 ikhowudi eyabelwe kuyo? 88-T80. Le kholam inoxanduva nokwenzakala kwabantu kunye neengxaki zabo. Kodwa kukho nenye yokuhlela.

Umzekelo, umlinganiswa kwezixhobo kukhutshwe inxeba kokudutyulwa , nesitshetshe.

Xa elidlula arhente traumatic ungahlula iintlobo ezifana: zinqunqwe, zakhutshwa, zinqunqwe, neqwengiweyo, elunyiwe, contused, lityumza, njalo-njalo.

Imilo onesiphumo uphawu siphene yomgama, ombaxa, umonakalo egqojozwe.

Ngu umthondo ubunzulu arhente esibuhlungu ukwahlula ikhe, ezendeleyo, yaye ngenxa amanxeba tangential.

Kukho kucalulo ebonisa indlela apho izabelo inxeba abosulelwe (ICD-10 ukuba ayikhuphi):

• Aseptic (emva konyango ephambili kuhlinzwa);
• ukungcoliswa (umzimba ngeentsholongwane ukho, kodwa iimpawu ukudumba kude njalo);
• abosulelwe (kukho ukuba bomvu, ukudumba, ukwandisa ubushushu wengingqi, iintlungu umsebenzi ukutshintsha).

inxeba kuxhomekeke yintoni kanye wabangela kuyo. Kukho zimo ezintathu:

• ngeziqu yokuqala (inxeba Net, nzulu, into ezibukhali isicelo);
• ngeziqu lesibini (a eninzi granulations, amanxeba abosulelwe);
• impiliso phantsi yolujaduka (necrosis coagulation komtshiso kwemichiza).

inkqubo inxeba

inkqubo nxeba - lutshintsha alandelelanayo kwenzeka inxeba ngexesha lokulungiselela yayo kwaye impiliso, kwakunye okubangelwa inkqubo ngayo eziphilayo. Ezi nkundla ke zenzelwe ukuba delimit le nidus losulelo ukusuka vasculature kwaye usisuse kuzo zonke izinto zophendlo lwezifo. indlela jikelele, kunye nendalo leyo weza, ukuze kukhuselwe abantu kwimiphumo yokwenzakala - yinto indlela arhabaxa.

Isigaba sokuqala yokuphilisa nxeba isekelwe Ngumzimba kwizicwili yokwenzakala. Ngoko nangoko emva kokuba ukwenzakala kuyenzeka ukutshatyalaliswa ancedisana yokwenzakala zabo cavitation, ngokunjalo nokulimala. In zokuqala ezimbalwa imizuzwana vasospasm kwenzeka, enika indlela eya vasodilatation kunye ukopha elibukhali. Emva kwexesha elifutshane ukuhamba ngegazi zithe phantsi kunye thrombus kwakhiwa. Okuhamba, xa inxeba baziqwebele abalamli ukudumba zitsala iiseli zegazi ezimhlophe, ziiphagocytes kunye neeseli imasti. Iintsholongwane, ebhalwe ngempazamo phezu inxeba eceleni kwaye lilo sifo zeselula yasekuhlaleni.

Emva kwexesha elithile, ngeenxa inxeba kukho umngxuma yokukrala iiseli kwabafileyo kunye nokudumba. Vasculature zixinaniswe, necrosis zasesekondari yenziwe. Yaba ngalo mzuzu kukho intlungu umsebenzi othile yommandla ochaphazelekayo.

Isigaba sesibini yokuphilisa nxeba kwenzeka kwisithuba seentsuku ezintathu, kodwa akukho umda ecacileyo. Inkqubo yokukrala liyaqhubeka, kwaye soft izicwili kukwenzakala ajike inxeba owosulelekileyo. ikhowudi ICD utshintsho kwi iingongoma ezimbalwa. Mechanical lenkawu inxeba ivuselele ukukhula granulation inyama kunye nokususwa iintsholongwane abafileyo ziiphagocytes kunciphisa komtshiso oko. Iqala inkqubo ngokutsha, ukuyilwa iimpahla ezintsha yegazi collagen ashinyeneyo izihlunu, kunye nesayithi inxeba kubonakala kukuqulungana entsha ethambileyo.

Emva kweentsuku ezilishumi elinesine kwesigaba sesithathu - loloyiko kunye epithelization. imicu Collagen baba ngakumbi ashinyeneyo ngakumbi, neempahla kuphinda uya kuntshula. Ngaxeshanye, umaleko sangaphandle yenziwe. Kukuqulungana esitsha umbala baluthuthu pink, kodwa ngokuhamba kwexesha emithanjeni iphela, kwaye luqhubeka, ukuba phantse ezingabonakaliyo.

Phantsi eli cebo, aphilise wonke umntu, hayi nje inxeba eyosulelekileyo. Kakade ke, kukho kusoloko kwahluka ngamnye ezi izigaba ezithathu.

Reaction emanxebeni ezinesifo

Indlela abasabela jikelele lungohlulwa lube izigaba catabolic kunye steroid. Ngethuba lokuqala (kude kube lusuku-4), zonke iinkqubo zobomi luyenyuka: ubushushu, nethe yimithwalo, umntu ulahlekelwa ubunzima, abangaphangeliyo iproteni kuyondelelaniswe sehlise permeability of inwebu cell. Umzimba umiselwe ngokutsha.

Isigaba sesibini uqala ngomhla wesine emva yokwenzakala, nezinto ngokuthe ngcembe siwele ndawo. Ubunzima bomzimba livuke kwinqanaba elidlulileyo, ukutya eqhelekileyo, kunye nayo, yaye amaqondo obushushu uwe. Kancinane ukwanda Umsebenzi iihomoni adrenal.

inxeba ukuphiliswa

tissue ngasinye olungaka aqinisekileyo ukuba ukuntshula. Ayizizo zonke iiseli ukuvelisa kakuhle ngokufanayo ngohlobo lwazo, ingakumbi xa loo nto abosulelwe inxeba (IBC ayiniki naziphi na iingcebiso ngokumalunga noku). Izinga nomgangatho yokuphilisa nxeba ixhomekeke iimeko ndawo ubuze. Ukuba njani na kowomileyo, icocekile kwaye akukho namaqumrhu angaphandle okanye neentsholongwane, le nkqubo iya kuqhubeka ngaphezulu ngokukhawuleza. Kwaye, oko, phezu koko. Imeko jikelele umzimba ikwachaphazela izinga yokuzalwa ngokutsha. Xa abantu abatsha yaye besempilweni, ukuphiliswa kulula, kodwa ubukho zizifo ezingapheliyo, enkulu ilahleko igazi novithamini ngxaki zingangunobangela ekuhambeni kwesifo kwaye kulibazise inkqubo ixesha ekuphulukenwe nalo ngenxa iiveki ezimbalwa, okanye iinyanga.

debridement steel

Injongo unyango ephambili zoqhaqho - ukuhlanjululwa ngomatshini amanxeba ukusuka izihlunu necrotic, amaqumrhu amazwe kunye neentsholongwane. Unyango amanxeba ezosulelekileyo iqala nesibakala sokuba inwebu le ndawo umonakalo kwenzeke nge swab umqhaphu okanye igozi nkxu ngotywala / saline uze emva koko ziphathwe kunye nesisombululo elinye ekhulwini ayodini. ifildi Operational kwakuyokozela sanitary ludlolo, yaye emva zomzimba nxeba elintlangothi ukuhamba ngaphandle kwaye izityalo ngesandla. Oku kuyimfuneko ukuze kube lula ukususa namaqumrhu angaphandle kunye nokungcola. Umzekelo, ukuba isigulane sine-sifo unyawo ngenxeba, mhlawumbi, iye iziqwenga zomhlaba.

inyama Necrotic excised. Banyanzelekile ukuba isilonda nga azinakunyuswa ufikelelo olungcono kuzo zonke iindawo kunye neepokotho neemfama kunokwenzeka. Ukuba sele yonakele imithambo yegazi enkulu, ukuba zibaqamangele, kodwa luvo ithungelwa. Akuba ugqirha igqibile ngokususa zonke ezingeyomfuneko, enxebeni ngokuqinileyo athungwe kwaye abeke bandage aseptic. Ezinye ngaphandle ekhankanywe kwi-ICD. Inxeba unyawo sifo, umzekelo, kufuneka kuhlala ejongile, njengoko emhlabeni, apho iye yonakaliswa yityhefu, live iintsholongwane anaerobic ukuba ezibangela ukubola. ukwenzakala kwashiya inika ioksijini unikezelo rhoqo ukuya ancedisana, yaye ngenxa yoko, ngaba ayibi iintsholongwane.

Unyango amanxeba iyabhiqiza

iimpawu zekliniki apho sikwazi ukuba umntu, umzekelo, wathelela inxeba ithole kuvela ngosuku lwesibini okanye lwesithathu yokwenzakala. Oku lula bubukho iimpawu ukudumba kunye flora yayintsholongwane eyosulela okanye amathuba. Xa unyango yokwenzakala ezinjalo kufuneka kugxininisa kuhlobo iintsholongwane ukukhetha uvakalelo efanelekileyo isibulala-zintsholongwane. Indlela jikelele ngolu hlobo lulandelayo:

• ukuhlanza olupheleleyo inxeba;
• ebulala processing;
• Ingxelo yokukhupha amanzi ngenxa yokukhupha amanzi ngcono kulwelo ezisulelweyo;
• ukukhuthazwa kumajoni omzimba yasekuhlaleni.

unyango jikelele

Antibiotics kuhlala isisiseko unyango amanxeba bosulelekile. Ukusekwa, indlela lolawulo, umthamo kunye nomthamo frequency kuxhomekeke ngqo kwi silwanyana ebangela suppuration. Ukuba flora anaerobic, loo nto ichaphazela metronidazole kunye klandomitsin zidityaniswe kunye sulfonamides.

umsebenzi sifo ongeva kakuhle, zombini zasekuhlaleni ngokubanzi, lubonakala kwinkqubo impiliso, ngoko ke kufuneka ukuba ayigcine kwinqanaba elifanelekileyo. Ukufunwa iifektha sokhuselo ephilayo kusinceda ukuba siphephe iingxaki ezifana nokudumba, ifiva, kunye nabanye.