Bedsores: zokuvimbela. Ukwelashwa nokuvikelwa bedsores ezigulini ngisembhedeni

Bedsores - omunye inkinga ezivamile, okwenzeka iziguli esembhedeni ngenxa yokugula. Kuyini lokhu?

Ngokuthi bedsores umzimba izinguquko izicubu endaweni ethize (noma ngaphezulu) ngenxa contact isikhathi eside nge eqinile. Izinguquko ezinjalo, ngakho cuphuluza kwegazi, izindlala zamanzi kwegazi futhi izinzwa supply.

Kubalulekile ukuqonda ukuthi ukumela zokuvimbela decubitus kanye nokwelashwa kwazo.

Izici ukuthuthukiswa

Ngokwemvelo bacindezele Izilonda ohlangothini umzimba lapho umuntu eqamba amanga, ezindaweni ezihlobene ebusweni. Ngakho, isiguli ngemuva bedsores ezigulini esembhedeni avame ukuthuthukisa ezinqeni, sacrum, coccyx, isithende, ku izindwani ehlombe, ezingeni izinqubo spinous sokukhubazeka komgogodla. Uma umuntu eqamba amanga ku-isisu sakhe, bedsores kungenzeka ezindaweni ezifana ukuxhumana ebusweni: esifundeni amadolo, ngaphambili ebusweni odongeni esifubeni, crests iliac. Ngezinye isikhundla isigamu Ukugada, endaweni ejwayelekile ka ukunqotshwa - izibunu ndawo.

Kodwa is hhayi ngaphandle, futhi indawo ethintekayo, ezingabhalwanga kulezi ezingenhla. Ngokwesibonelo, ingcindezi nezilonda (imifanekiso yalesi sifo ingatholakala isithenjwa yezokwelapha) Ngezinye izikhathi ukuthuthukisa esifundeni occipital futhi emphethweni ngaphansi amabele. Mhlawumbe indawo eqondile ebukhoneni ukhonkolo ezindaweni fit yabo Ukuthokomala kokusetshenzisiwe ukuba isikhumba, usebenzisa oilskin izindwangu, amashubhu iraba, catheters, lokufakelwa kwezitho. Lokho kungenxa kwasendaweni lapho has izici elimazayo.

Lokunye lokubaluleke kakhulu isimo isiguli. ingozi Ephakeme ngaphezulu ukuthuthukiswa ngokushesha ingcindezi izilonda ukukhathala uma jikelele, kukhona engalulami, okuyinto sivame ukuba khona ukumelwa inhliziyo, ezigulini zisencane eziphambili. Ngo abasha, abantu bayazi, kunalokho, akunakwenzeka ukubukeka bedsores. Futhi uma bengenayo avele, akuvamile ikhula bekufike ezigabeni kamuva. Kodwa ngesikhathi esifanayo kufanele sikhumbule ukuthi, ngenxa ukuthuthukiswa kancane kancane izilonda kulezi iziguli, ngezinye izikhathi ungeqa izimpawu zokuqala yesifo.

Cishe kuzo zonke izimo of ingcindezi izilonda ukuthuthukiswa kuyinto efanayo, ezahlukene yisikhathi kuphela esigabeni ngasinye. Ukuqala uhlale igazi stasis okuholela ecindezela, uma ingelashwa, izicubu abathintekayo babe necrotic.

Iyini ingozi ingcindezi izilonda?

Ingozi emikhulu ehlobene yezinkinga zabo. Njengoba ezikhathini eziningi ingcindezi izilonda iziguli esembhedeni ukuthuthukisa ngokushesha futhi ngokuphelele ngesikhathi esifushane kungaba zikhule futhi endaweni necrotic esikhulu ngokuvamile kufanele mkhuba izicubu onesifo. ngezinye izikhathi Lokhu kuholela ukuphazamiseka igazi eligciniwe kanye innervation izindawo ezizungezile, okuyinto ke kuholela ukuphazamiseka imisebenzi yabo.

Kwezinye izimo, imiphumela ukuthuthukiswa bedsores isidingo usinqume esitho. Ngaphezu kwalokho, izinqubo necrotic angagcina ku periosteum noma ithambo, igesi esibhibhayo noma sepsis.

Kubalulekile futhi ukuthi izinqubo ezenzeka emzimbeni ngesikhathi ukuthuthukiswa ingcindezi izilonda, imithi yabo, kudinga eside energy okokufaka, ngakho deplete isiguli, kanjalo okwenza inkambo sifo ecashile. bedsores esiyingozi Ikakhulukazi iqhubeka.

Ngakho, kubalulekile ukuba baqonde indlela yekubona bedsores. Omsakazo, pathogenesis, nokwelashwa ingcindezi izilonda ezindaweni ezahlukene zifana kakhulu.

Kungani kunezinkolo decubitus?

Isizathu nentuthuko yabo kuba kahle kwegazi endaweni ethile kwesikhumba. Lokhu kungenzeka ezimweni ezimbalwa.

Ngokuvamile lesi simanga siyenzeka ngesikhathi imikhumbi ecindezela igazi, ikakhulukazi phakathi kokucindezelwa idlula amahora amabili, elisemnyango kokuhlala isikhathi eside isikhundla esisodwa. Izicubu, okungadingi faka igazi, necrotic, futhi kakade ethuthuka bedsores.

Imbangela okungaba ngiyo microdamages nezitsha ezincane etholakala esikhunjeni. Lokhu kungenzeka uma kusuka isiguli ukudonsa izicubu ezimanzi, isib, elonakalisayo ishidi. Ngezinye izikhathi ukulimala zenzeka ngenxa yokuzama womuntu ukuze ngokuzimela ushintshe indawo noma ukuhambisa. Ngakho-ke, kufanele agweme noma yimaphi friction, umonakalo ezincane kuya esikhumbeni futhi lwamafinyila ulwelwesi, futhi isifiso sabantu niguquke noma ukwenza okuthile okufanele sizame ukumsiza.

Uma usuyazi imbangela ingcindezi izilonda izimbangela, nokuvinjelwa, ukwelapha lesi zokugula abazenzi kahle nangempumelelo.

Yikuphi kwandisa ingozi yokuba ingcindezi izilonda?

Ukuze uqonde ukuthi bedsores, yiziphi izimbangela, nokwelashwa lokho kubalulekile ukwazi, oluthinta ingozi nesenzakalo yabo. Kunezici eziningi. Ezinye zazo yilezi uxhumene izici of isimo lesiguli, kuyilapho abanye - nenhlangano efanele ekunakekeleni iziguli esembhedeni ngenxa yokugula.

yilezo izici kusukela iqembu lokuqala izici eziningi abalulekile:

• Ubudala - anda ingozi ezigulini esezikhulile.
• Isisindo - kunobungozi nokukhuluphala ngokweqile, futhi enganele. Kukhula isisindo, aba maningi ingcindezi amaphuzu ukusekelwa umzimba. Kodwa ezacile ngokuvamile eyabonisa Ukuwohloka umzimba, futhi nakho kuyisici esibangela ungalokothi uphuze hhayi kuphela ukubukeka kodwa nezalo ukuthuthukiswa ngokushesha ngaphezulu izinqubo necrotic.
• isifo senhliziyo kanye isimiso sokujikeleza kwegazi - e pathologies yalolu hlobo ozokhula kokuminyaka isimiso sokujikeleza kwegazi, kuba lula imikhumbi ezilimele, okubaluleke kakhulu yindlela yimuphi umthelela, ingqondo ukuhlukumeza yobuqotho babo.
• izifo concomitant - endaweni ekhethekile lapha ukuthatha isifo, okuholela ukuphazamiseka innervation (isib unhlangothi ngaphambi), kanye nalabo lapho esephula izinqubo umzimba (isib, isifo sikashukela).
• Ukudla neziphuzo - eyingozi engayitholi ukungadli uketshezi nokudla, kubaluleke ngokukhethekile ukuqapha inani amaprotheni ku ekudleni.
• Ukungabi nakwenzeka kwento ukuzithiba ukuchama futhi sokuzikhulula - it is waphawula ukuthi uma isiguli aquleke, okhubazekile noma abakwazi ukulawula indlela aziphatha ngayo isimo ngenxa komqondo.
• ukujuluka kakhulu - ingase ibe umphumela umzimba noma endocrine iziyaluyalu, futhi ngenxa khona imfiva.
• Izici okuqonda kwemithi - isici esibi kungaba ukubukeka komzimba nezinto izidakamizwa esetshenziselwa ukunakekelwa kwesikhumba ezindaweni lapho ingcindezi izilonda asathuthuka. Prevention, ekwelapheni bedsores kusho isidingo acabangele zonke izici zomzimba sesiguli.

Ukuze zezici iqembu lesibili zihlanganisa ukunakekelwa ngokukhethekile. Khulisa amathuba wokuthuthukisa ingcindezi izilonda ushintsho ezingavamile embhedeni izingubo, ukungabi noma ukuziphatha ngendlela engafanele inhlanzeko, maholoholo ngokweqile futhi nobulukhuni ebusweni lapho amanga nesineke, khona imvuthu embhedeni, izinto ezincane.

Bedsores: kanjani ukuba awabone?

Uma isiguli bayazi futhi aye wasigcina ukuzwela, angakwazi ukukhuluma ngemizwa subjective kulabo azinakekele. Izibonakaliso ukuqala bedsores zihlanganisa ngezikhalo ukuluma. It kuvela ngenxa yokujama tsi legazi lymph endaweni lapho awokuthi okuvela izinqubo sokugembula okuholela ukwakheka bedsores, uma ungathathi izinyathelo ezidingekile. Ngenxa yalokho we yokujama tsi we izinzwa ungatholi kudla lokunemsoco lokwenele, futhi subjectively kunjani a ukuluma. Ngemva kwamahora ambalwa yokulahlekelwa okungenzeka ukuzwa, imizwa yokulimala ezindaweni kwesikhumba, okungadingi lingene egazini.

Ngemva kwesikhathi esithile, kukhona izimpawu ezisobala ezibatshela lokhu. Amaphuzu lokuxhumana projecting izingxenye zomzimba ne evele kanzima avele amabala bluish-bomvu - erythema emithambo yegazi. Abanaso imiphetho kahle ichazwe. umbala wabo kungaba kokubili te futhi kungekho lubonakale.

Uma lezi zimpawu zibonakala, kufanele athathe isinyathelo ngokushesha ukuze uvimbele ukuqhubeka izinqubo sokugembula abaningi babephephile ezindaweni ezithintekile. Kumelwe niqaphele ukuba aqaphele bedsores. Prevention, ekwelapheni bedsores ngempumelelo ngaphezulu ngaphambi izimpawu zokuqala babebhekwa, futhi yiziphi izinyathelo ezithathiwe ukubhekana nabo.

Siza ngesikhathi kuqubuka ingcindezi izilonda

Ukuze nokwelashwa ngendlela efanele usaqala yentuthuko yabo kumele zithathe amanyathelo i ukunakekelwa ngisho ngokuphelele nesineke, ukuhlinzeka ithuba ube ukuma ukhululekile futhi zilungile.

Sebenzisa omatilasi ekhethekile ukusiza nalabo bedsores samanje. Nokwelashwa lala mafu - injongo ngqo basuke ezenzelwe yona. Okunjalo omatilasi anti-decubitus kukhona ezimbili zama: amaselula kanye ibhaluni. Basuke ifakwe compressors, ethule ukuze isebenze futhi silondoloze nobulukhuni ledzingekako ebusweni lapho isiguli amanga. Ezigulini baye kudala e sabakhubazekile, ungasebenzisa imicamelo ekhethekile nomoya, Foam noma ijeli.
Uma umuntu usesimweni lisalele, kuyinto efiselekayo ukuthi inhloko yawo embhedeni kwaba kancane eyehlisiwe noma ezishaywayo ne umzimba.

Esinye isici esibalulekile - ushintsho njalo endaweni umzimba. Uma kungekho contraindications, ingabe kufanele yenziwe yini kaningi njengokuthanda njalo ngehora 2. Ngakho kuyinto efiselekayo ukusebenzisa pad esakhiwe ngokukhethekile. Asiza ukushintsha isimo ezithile isihlobo umzimba kwamanzi lapho itholakala indoda. Ngenxa yalesi isikhashana phakathi izindawo ngabanye kwesikhumba nombhede isikhala, akukho kokucindezelwa imithambo yegazi, kunciphisa amathuba ukuthuthukiswa kanye Ukulandelana bedsores. Iziguli ezingazweli ku-ngesihlalo sabakhubazekile, ushintsho isikhundla umzimba kudingeka njalo ngehora. Umbhede lapho amanga nesineke, kumelwe perestilat okungenani kanye ngosuku. Kubalulekile ukulandela isimo embhedeni izingubo - nemibimbi eziyingozi, kokuthola imvuthu ilondolo noma ezinye izinto ezincane ukuthi kungabangela isikhumba ukucasuka futhi microdamages.

Lokubaluleke kakhulu isikhumba inhlanzeko. Ngokukhethekile kufanele kukhokhelwe umswakama wawo. Ukuze ulawule i-lesi sici kanye nokuvimbela umswakama ngokweqile zisebenzisa powder ekhethekile, okhilimu, izixazululo, izifutho, edonsa afudumele (hhayi ashisayo) okugeza. Lezi zinqubo inhlanzeko kufanele kwenziwe okungenani kabili ngosuku. Ngaphezu kwalokho, phakathi ukuchama futhi sokuzikhulula kufanele kube ngokushesha ngangokunokwenzeka ukuze ususe ukungcoliswa isikhumba izingubo. Ngenxa yale njongo, kanye ukususa umjuluko, ukudla doti, ukudedelwa izilonda, namanabukeni esetshenziswa, amathawula, napkins, amanabukeni, pads umswakama.

izindawo OKUVUMELEKILE kuwukuziphulula kwesikhumba lapho kukhona izimpawu yokujama tsi, kodwa akunakwenzeka ukuba uwuhlikihle kulezi zindawo, wenze massage olunzulu. Izenzo ezinjalo babekwazi kubangele ukusheshisa inqubo.

pathogenesis

Esikhathini pathogenesis yokucindezelwa unezilonda izigaba ezine yentuthuko. Phakathi esiteji mina isikhumba endaweni ukuxhumana ebusweni ngaphandle asathuthuka erythema emithambo yegazi. Imbangela erythema - kokunikezwa kwe-outflow kwegazi. Ngaphandle erythema selivela bluish-bomvu ndawo, isikhumba azwela umfutho on endaweni ethintekile uphendulela white. Amazinga e-erythema kuyafana lonke isikhumba noma kancane ngezansi. Indawo ezivamile yentuthuko - prominences bony. Isikhumba ihleli, kungekho ukuphulwa yobuqotho yayo.

Esigabeni II decubitus kwenzeka thinning we epithelium, isikhumba ishq, Bubbles akhiwa therein. Lena bonke ngenxa yokuphazamiseka kwemikhuba yokudla kwezicubu, okuyinto eyenzeka ngenxa yegazi yokujama tsi. It kuholela ukuhlukumeza innervation. Ngaphezu kwalokho, isikhumba aqoqana uketshezi, ngokusebenzisa amangqamuzana esikhumba somuntu sikhukhumale ekugcineni wavele futhi bafe. Ngakho, kulesi sigaba kakade ebonakalayo Izilonda, maceration kungabonakala nasemkhakheni abaningi babephephile ezindaweni ezithintekile.

Ukuze Isinyathelo III decubitus amanxeba ukubukeka. Uma uthola microflora pathogenic angagcina iqhubeka. Kuyinto kulesigaba enqubeni sokugembula kuhilela izingqimba ezijulile isikhumba, izicubu ongama, imisipha, izinqubo necrotic ukuqala. Necrosis futhi amathuba ubovu ukuvuvukala ukumela olukhulu impilo isiguli.

Ngo isinyathelo IV enesici abalulekile elikhona umgodi izicubu, okuyinto kungabonwa izindonga ubovu ukuvuvukala. Imbangela yale ukwanda kanye ingaphakathi - izicubu necrosis.

Enye indoda ezingxenyeni ezahlukene umzimba angase abe ingcindezi izilonda, abase-zokukhula ezihlukene.

yezinkinga kungenzeka

yezinkinga Iningi ezivela ngesikhathi ukuthuthukiswa ingcindezi izilonda ngenxa ukuchayeka ingxenye ezilimele of namagciwane abangela izifo. Ngokuvamile kuba Staphylococcus noma streptococcus, kodwa ukuze kube kuhle khona amacala yamagciwane nezinye izinto eziphilayo pyogenic.

Ngokuvamile izinqubo suppurative e bedsores lakhula uhlobo Erysipelas noma cellulitis. Ezimweni yokukhathala jikelele, amasosha omzimba ebuthaka noma inhlangano engafanele izinyathelo yokuhlanzeka, impatho ukungadli ingcindezi izilonda angagcina yezinkinga ezisongela ukuphila, ezifana sepsis negesi esibhibhayo.

Bedsores ezigulini angase aqale ukuba yakhele esiteji wesibili noma ngowesithathu, lapho indawo ye epithelium ezilimele livela noma enenxeba elivulekile, khona-ke sathuthukisa purulent izinqubo.

Ngakho-ke, uma kukhona izilonda, nokwelashwa ayadingeka hhayi kuphela kubo, Ukulawula ezibalulekile futhi esiqinile phezu isimo jikelele umzimba. Ukuqapha kufanele ubangele ukunyuka kwezinga lokushisa komzimba, okwandisa ubuthakathaka, ikhanda elibuhlungu, ukuvuvukala emhlabeni ukubukeka bedsores, isikhumba ukushintsha kombala emhlabeni grey, iphunga lakhe Putrid kusukela isilonda, nezinye izinguquko.

kwasendaweni esivamile bedsores

Kuye isikhundla lapho isiguli amanga, kulapho lapho decubitus nokwelashwa bona ingehluka.
Ngokukhethekile kufanele inikwe okukhethwa kukho kwasendaweni yabo kungenzeka nganoma isikhundla umuntu emhlane wakhe. Kulokhu, evame kakhulu kuphakama decubitus izithende, izibunu, coccyx, esifundeni izindwani.

Okuvela ingcindezi izilonda on the izithende ngokuvamile. Ngakho kaningi kangakanani asebekhulile yokujama tsi samanje emilenzeni, okuholela ingcindezi on the izithende of izinqubo ezinjalo wawuhlanganisa kuphela. Ngaphezu kwalokho, ngokuvamile isikhumba kulezi zindawo kungumzimba ayazika, ngakho-ke kunzima ukuqaphela izimpawu zokuqala isifo. Ngesizathu esifanayo, lokhu (ukwelashwa kwabo) kwasendaweni bedsores zidinga ukunakekelwa eside futhi niqaphelisise.

Ingcindezi izilonda izibunu kuyingozi ngoba kule ndawo somzimba eduze izitho ezibalulekile. Hlula lezi zindikimba hhayi kuphela zidinga ukwelashwa ngokucophelela, kodwa kungenzeka esikhathini esizayo ube negalelo elinamandla isimo jikelele nokusebenza umzimba, ngisho kunciphise ukuphila. Ngakho-ke, kufanele wenze umzamo okhethekile ukuze avimbele bedsores ezinjalo. Nokwelashwa (izithombe esibonisa ukubukeka lolu hlobo ingcindezi nezilonda, ayatholakala omagazini ezikhethekile) nomonakalo onjalo kufanele kwenziwe ngokuvumelana nemithetho. Kungenjalo kuyinto amathuba eqinile ukuthi inqubo kuzoholela nemiphumela engathandeki.

ukwelashwa Decubitus kanye nokuvinjelwa

Ngaphezu ulwazi okungukuthi bedsores, lapho kungenziwa akhiwe futhi kanjani ukubheka, kudinga ulwazi sendlela yokuphatha abanye kubo futhi nendlela yokuzigwema ukuze zingasivimbi nesenzakalo yabo. Ukwelashwa ingcindezi ulcer isiguli kuhlanganisa ukwelashwa isikhumba e inhlanzeko, izinjongo zokuvimbela futhi ngokuqinile zokwelapha. Lokhu kwelashwa kufanele kwenziwe njalo.

Kubalulekile ukuqonda izizathu zokuthi kungani kukhona izilonda. Prevention, ekwelapheni bedsores futhi kumele balufunda. I sanitary impatho isikhumba wenziwa ngenxa yokulondoloza izinga ephephile lwezici zalo eziyisisekelo futhi izici: pH, umswakama, kuyaqina. Idinga isikhathi ukuqeda ukusilaphazeka.

ukuphathwa Zokuzivikela kuhilela izenzo, kuthuthukisa kwegazi kanye nokuvuselela isikhumba ukuzwela nezicubu iyini imbangela yalokho. Ungakhohlwa ukuthi usengozini yokuthola ukubukeka bedsores nezinqubo suppurative ezilimele isikhumba, ngakho udinga ukuba afeze yesondlo zokuvimbela ukoma yayo futhi ukubukeka imifantu ke.

Ezokwelapha kubaluleke kakhulu. Ukuze wenze lokhu, vele zidinga imithi ekhethekile. Manje kukhona inala them they ayatholakala ezinguqulweni ezihlukahlukene kanye namafomu. Anti-bedsore zisebenzisa ezihlukahlukene yokugcoba, si, izimpushana, izixazululo, izifutho. ifomu ngalinye Isikali has izici: Izimo, izindlela zokusebenzisa. Ngakho-ke kubalulekile lapho ekhetha ukuphathwa ithintane nabo i uchwepheshe abanolwazi.

Uyini bedsores engcono belashwa? Izibuyekezo zabantu abaye babhekana nale nkinga, ukuvumela ukwaba ezinye ezahlukeneyo ezivamile izisombululo isetshenzisiwe ngempumelelo ezimweni ezinjalo. Ukuze machining zangaphandle Kunconywa ukuba asebenzise isixazululo magnesium sulfate (25%) noma hypertonic (10%) sodium chloride isixazululo nge chymotrypsin futhi ngemithambo yegazi iqondiswa 0.5% isixazululo metronidazole. Kuyinto engathandeki ukusebenzisa potassium permanganate, i-iodine oluhlaza ekhaliphile.

Kubalulekile ukuthi avele hhayi Izilonda entsha. Prevention, ekwelapheni ingcindezi izilonda ngokuvamile badinga eningi umzamo, izindlela isikhathi.

okumqoka kuyinto Ukudla lesiguli. Ukudla kufanele kube ekhona edingekayo lemali amavithamini, amaminerali, ikakhulukazi zinc nensimbi, amaphrotheni, ukusetshenziswa ezidingekayo imifino nezithelo. Kunconywa ukukufaka ekudleni imikhiqizo yobisi, inhlanzi, amaqanda, inyama (mhlawumbe yenkukhu). Uma umuntu kunzima ukudla inyama, noma-ke kungenziwa indawo umhluzi.