Burns: Burns m'dera chimafotokozera ulamuliro kanjedza. Gulu la amayaka pa malo ndi mmene kuwonongeka

Mu moyo, tonsefe tinalandira amayaka. Area amayaka angakhale osiyana, koma kumverera ndi yofanana, ngati zinkakhala m'dera ntchito malasha red-hot. Ndipo palibe madzi, ayezi kapena compress ozizira sangathe athane ndi kusungulumwa.

A mankhwala kuwotcha - kuwonongeka ichi minofu chifukwa cha zochita za kutentha kapena ntchito yapamwamba mankhwala, mwachitsanzo zidulo, zapansi, zitsulo salt lolemera. Zovuta kuwonongeka anatsimikiza ndi kuzama ndi dera minofu kuonongeka. Pali njira yapadera amayaka, akamagwira cheza kapena mantha magetsi.

Gawo

Gulu la amayaka zochokera mozama ndi mtundu wa choipa, koma pali gulu la mawonetseredwe matenda, njira zachipatala kapena mtundu wa choipa.

Kusiyana ndi kuya kwa amayaka:

1. Mlingo woyamba amakhala ndi zotupa yekha pamwamba wosanjikiza a khungu. Iwo akuwonetseredwa ndi redness, kutupa pang'ono ndi ululu. Zizindikiro kutha patapita masiku atatu kapena anayi, ndipo gawo anakhudzidwa wa epithelium ndi m'malo ndi wina watsopano.
2. Kuwonongeka kwa epidermal woyambira wosanjikiza 2 limasonyeza digiri lamoto. Pamwamba pa khungu ndi thovu kuonekera zili turbid. Machiritso amatenga masabata awiri.
3. Pamene lachitatu digiri yoyaka, kuwonongeka matenthedwe amalandira osati khungu komanso dermis.
   - The mlingo wa A: dermis bala pansi anafa kuonongeka, koma nthawi yomweyo pambuyo zoipa kuoneka wakuda nkhanambo, nthawi zina amaoneka thovu kuti akhoza kuphatikiza ndi mzake. Ululu pa malo lamoto si anamva chifukwa cha kuwonongeka zolandilira. Self-kusinthika n'chotheka mu chikhalidwe chimenecho adzakhala nawo matenda sekondale.
   - Digiri B: okwana imfa ya khungu, dermis ndi hypodermis.
4. Mlingo wachinayi - khungu charred, wosanjikiza wa mafuta, minofu ngakhale fupa.

Gulu la amayaka mtundu wa kuwonongeka:

1. Ndinakumana ndi kutentha:
   - Moto - kuonongeka m'dera waukulu, koma mozama zochepa. chithandizo chachikulu ndi zovuta chifukwa chakuti n'zovuta kuyeretsa bala la matupi yachilendo (ulusi zidutswa zovala kuti anasungunuka mabatani kapena zippers).
   - Chamadzimadzi - kuwotcha waung'ono koma kwambiri (A ndi wachitatu digiri).
   - otentha nthunzi - kwambiri lamoto yaitali, koma kawirikawiri umalandira akuya pamlingo wachiwiri. Nthawi zambiri zimakhudza mundawo kupuma.
   - incandescent zakuthupi - bala pobwereza ndi maphunziro a phunziroli, ndipo mukhoza kukhala akuya kwambiri.
2. mankhwala:
   - zidulo chifukwa coagulation necrosis, ndi pa malo a chotupa pamaoneka nkhanambo mapuloteni youmba. Zilibe kanthu kuti umalowa mu zimakhala zakuya. The mphamvu asidi, kwambiri pamwamba pa khungu ndi zinkakhala m'dera.
   - soda anapanga liquefactive necrosis, izo kumafeŵetsa nsalu ndi likulowerera kwambiri mankhwala onyeketsa, ndi lamoto madigiri 2.
   - heavy metal salt kunja amafanana amayaka acid. Zangokhala digiri 1-St.
3. amayaka magetsi zimachitika pambuyo kukhudzana ndi magetsi luso kapena mumlengalenga ndipo, monga ulamuliro, ndi okhawo m'malo mwa kulowa ndi kuchoka pa kumaliseche a.
4. Cheza amayaka angayambe pambuyo kukhudzana ionizing cheza kapena kuwala. Iwo losaya, ndipo kukhudzana awo amagwirizana ndi chotupa cha ziwalo ndi kachitidwe, osati mwachindunji kwa minofu zofewa.
5. Tikaphatikiza amayaka monga zifukwa zingapo sichikupindulitsani monga mpweya ndi lawi.
6. Tikaphatikiza iwo angatchedwe kuwonongeka, kumene kuwonjezera kuwotcha pali nkhani zina za kuvulala, monga fractures.

kaonedwe

Aliyense amene sanalandirepo amayaka (lamoto m'dera anali oposa zisanu ruble ndalama), akudziwa kuti madokotala ananena zawo za matenda - ndi mwatsatanetsatane zofunika matenda. odwala mwakayakaya nthawi zambiri ovulala pangozi, masoka achilengedwe kapena chifukwa cha ngozi kuntchito. Choncho, anthu mu chipinda wodikira nao mu magulu a ziweto. Ndiyeno luso kulosera za kusintha tsogolo la wodwalayo kubwera imathandiza pa kusanja. The Nthawi zambiri kwambiri ndi zovuta ayenera kusonyezedwa ndi madokotala mu malo oyamba, chifukwa nthawi zina bilu amapita ku maola ndi mphindi. Childs, ulosi zachokera malo pamwamba ndi kuya kwa chotupa owonongeka ndi kuvulala ofanana.

Pofuna molondola kudziwa kuti madokotala ananena zawo, amagwiritsa akalozera makonzedwe (mwachitsanzo, Frank index). Kuti zimenezi zitheke, aliyense peresenti ya zinkakhala m'dera akapatsidwa mfundo imodzi anayi. Izo zimatengera mlingo wa kutanthauzira ndi amayaka, komanso nkhani zimene kuwotcha dera Airways chapamwamba. Ngati disordered kupuma palibe, amayaka, mutu ndi khosi afika mfundo 15, ndipo ngati ndi choncho, ndiye 30. Ndipo pomwepo kuwerenga mawunikidwe onse. Pali osiyanasiyana:

- zosakwana mfundo 30 - ndi madokotala ananena zawo zabwino;
- pa makumi kuti sikisite - ndi yabwino;
- nainte - wofooka;
- oposa makumi asanu ndi anayi - zovuta.

m'dera ataphimbidwa

Mu mankhwala, pali njira zingapo kuwerengera dera pamwamba akhudzidwa. Khama la malo ndi kukula kwa lamoto ndi zotheka ngati inu izo ndi lamulo lakuti pamwamba pa mbali zosiyana za thupi amatenga peresenti naini m'dera onse a khungu, malinga ndi mutu ndi khosi ndi chifuwa, mimba, aliyense mkono, ntchafu, mwendo ndi phazi ali wotanganidwa ndi 9% ndi kumbuyo padziko thupi - kawiri (18%). Perineum ndi kumaliseche ali peresenti chimodzi chokha, koma kuvulala izi amaonedwa aakulu mokwanira.

Pali malamulo ena kuti tipeze malo a amayaka, mwachitsanzo dzanja. Ndi zodziwika bwino kuti anthu kanjedza m'dera amatenga munthu mmodzi ndi gawo theka la pamwamba okwana thupi. Zimenezi zimathandiza amangosankha kudziwa kukula kwa gawo kuonongeka kwakukulu ndi chikhalidwe kuganiza. Chidwi amayaka pa thupi ndi phindu notional. Iwo zimadalira kuwunika zotengera malingaliridwe a dokotala.

chipatala

Dzina zizindikiro zingapo kuti angagwe amayaka. M'dera la amayaka mu nkhani iyi si udindo wapadera, monga iwo ndi yotakata, koma osaya. Patapita nthawi mtundu wa mawonetseredwe matenda akhoza m'malo mnzake mu lipole:

1. Erythema kapena redness a khungu limodzi ndi redness. Zimachitika pa amayaka aliyense digiri.
2. Vesicle - nsupa zonse madzi kale loipa. Iwo akhoza wothira magazi. Kumachitika chifukwa ukuchoka a chapamwamba wosanjikiza khungu.
3. Enaake - ndi vesicles ochepa ophatikizidwa mu kuwira wina ndi masentimita theka awiri.
4. Kukokoloka - kuwotcha pamwamba pa mmene muli khungu. Iye magazi, kapena kumasulidwa ichor. Izo zidzachitika kuchotsa matuza kapena zidindo zadothi, necrotic minofu.
5. Chilonda - zakuya kukokoloka, okhudza dermis, hypodermis ndi akatumba. Mtengo zimadalira m'dera yapitayi necrosis.
6. Coagulation necrosis - youma necrotic minofu zakuda kapena zofiirira. Mosavuta anachotsa opaleshoni.
7. Liquefactive necrosis - chonyowa lawola minofu kuti angakhale okhudza mkati mwa thupi, ndipo pambali, tagwira minofu wathanzi.

kuwotcha matenda

Izi chamoyo zokhudza zonse poyankha kuwotcha choipa boma Izi zingachitike onse pa kuwonongeka pamwamba ngati thupi yoyaka 30% kapena zambiri, ndi amayaka kwambiri, agwilitse palibe maperesenti oposa khumi. The ofooka thanzi la munthu, umboni kwambiri mtundu wa mantha. pathophysiology agawidwa magawo anayi a chitukuko cha matenda lamoto:

1. Kuwotcha mantha. Iwo kumatenga masiku awiri oyambirira, ndi kuvulala aakulu - masiku atatu. Vutolo limachitika chifukwa kusokonekera pachithunzichi wa madzimadzi mu ziwalo mantha (mtima, mapapo, ubongo, impso).
2. Pachimake lamoto toxemia akufotokozera Ndisanalembetse matenda chimakhala cha mlungu umodzi kuti masiku asanu ndi anayi. Pathophysiologically ofanana udzaphwanya syndrome, i.e. minofu kuwola mankhwala kulowa makope zokhudza zonse ndi poizoni thupi.
3. Lamoto septicotoxemia limapezeka pambuyo inalowa matenda. Iwo ukhoza kwa miyezi ingapo mpaka mabakiteriya onse inathetsedwa padziko bala.
4. Kuchira lidzayamba pambuyo pa lamoto mabala atsekedwa ndi granulation minofu kapena epithelium.

Amkati kuledzera, matenda ndi sepsis

Thupi kuwotcha thupi limodzi ndi mapuloteni denaturation chakudya poizoni. Chiwindi ndi impso pafupifupi sangathe kulimbana ndi katundu chinawonjezeka pamene kuthamanga mu makope zokhudza zonse. Ndiponso, ululu wa chitetezo anthu ali tcheru mkulu, koma yaitali poyizoni wa thupi akuswa njira chitetezo, ndi ndipamene immunodeficiency sekondale. Zimenezi zimabweretsa chakuti bala padziko njuchi zosauma microflora.

Mtundu wa anthu amene akhudzidwa ndi amayaka

Monga tanena mu chipinda mwadzidzidzi kawirikawiri anabweretsa munthu wina amene anaphedwa, amene ali amayaka. M'dera la lamoto ndi chiwerengero cha odwala kwambiri kuposa mphamvu ya ndodo mankhwala, choncho muyenera kuthetsa ukubwera anthu azikhala chikhalidwe mukudziwa kuti amene amapereka chithandizo mu malo oyamba:

1. Kwambiri anavulazidwa ndi amayaka zachiphamaso peresenti makumi awiri thupi kapena amayaka kwambiri - maperesenti oposa khumi, komanso chapamwamba amayaka kupuma. odwala zimenezi thandizo pangozi n'kupita nawo ku chipatala ndi thandizo la ndege ukhondo.
2. Mlingo avareji kuopsa kwa amayaka zachiphamaso peresenti makumi awiri kapena zochepa kwambiri - palibe maperesenti oposa khumi a pamwamba thupi. Choncho muyenera kupereka thandizo la mankhwala kwa anthu amene anakhudzidwa mu kukhota chachiwiri, koma sizikutanthauza kuti iwo akhoza sizikugwiridwa kwa nthawi yaitali.
3. Wofatsa Yodziwika zachiphamaso amayaka, agwilitse peresenti pasanathe khumi ndi asanu a padziko khungu kapena amayaka kwambiri, zomwe kuwonjezera palibe maperesenti oposa asanu ndi chiyani sikungawononge thirakiti chapamwamba kupuma.
4. N'kufa - ndi anthu amene kwambiri thupi amayaka (50% panji kujumpha apo), komanso anthu achikulire ndi kuwonongeka kwa sate pa zana a pamwamba. Choncho ovutikawo ikuchitika yekha symptomatic mankhwala. Akuvutika ngozi yaikulu kwambiri mafakitale mwina 90% thupi amayaka. Izi ndi kuwonongeka oopsa, ndi thandizo Pankhaniyi n'zosathekadi, inu mukhoza kuyesa kuchepetsa awo akudwala analgesics amphamvu (anachititsa chikomokere) kapena inhalation ochititsa dzanzi.

choyamba-chithandizo

Pakuti zilizonse zabwino kungathandize kwambiri kupereka odzithandiza okha ndi chithandizo mangawawo. The mofulumira zotani amalola kwambiri kuchepetsa lamoto m'dera ndi akuya. Chinthu choyamba pakamwa kukhudzana zoopsa pakati pa nthumwi ndi anthu mwachitsanzo kuzimitsa moto kapena kusagwirizana maukonde Muzitsuka / n'chongoletsa mankhwala.

Mu siteji chisanadze kuchipatala kuti ali osavomerezeka ntchito mafuta mafuta m'Baibulo, ndipo atumiki mafuta munali, chifukwa chakuti iwo amapanga filimu padziko chilonda ndi kuteteza kutentha linanena bungwe. Komanso, chipatala adzakhala ndi kuchotsa ndi "achire kuipitsa", kuchititsa ululu kwa wozunzidwayo. Sikuti kunyumba kubala bala mankhwala, monga kuchotsedwa kwa matupi zachilendo, kapena charred khungu, ndi zina zotero. Zimenezi zingachititse kuti matenda, chifukwa silidzachotsedwa anati chifukwa mode asepsis / antisepsis. Plus, popanda mankhwala oletsa ululu yoyenera munthu mukuyesetsa kuthandiza ayenera kugwera mu khalidwe la ululu mantha.

mpumulo ululu ndipo bala chithandizo

Malinga ndi kuopsa kwa wodwala matenda anesthetist amasankha yoyenera mankhwala ndi mankhwala ochititsa dzanzi njira. Kungakhale sanali steroidal mankhwala odana ndi yotupa, analgesics-antipyretics banga kapena conduction ochititsa dzanzi. Pakuti Zikavuta, analgesics chomwa mankhwalawa ali oyenera.

Pambuyo zoipa zamizidwa ndi kusakhala, dokotalayo atuluka kwa chithandizo yoyamba ya padziko bala. Iye detaches wa khungu, akutsegula bere kapena thovu, matupi yachilendo achotsedwa. Ndiye woyeretsedwa pamwamba pa bala chatsekedwa woyera gauze bandeji. Ndi amayaka chachiwiri ndi digiri ya wodwala ayenera kulowa kafumbata seramu.

chithandizo m'dera

Awiri njira ya amayaka mankhwala - onse m'nyumba ndipo panja. Iwo akhoza kugwiritsidwa ntchito kapena payekhapayekha kapena pamodzi. Pofuna kupewa matenda bala, izo mwachangu zouma kuonekera necrosis youma. Izi zachokera njira poyera. Umagwiritsidwa ntchito pa chilonda pamwamba zinthu zina mowa njira halogens amene angathe coagulate mapuloteni. Komanso, physiotherapy angagwiritsidwe ntchito njira monga cheza infuraredi.

chithandizo pakanema zikutanthauza Mavalidwe kuti kuteteza mabakiteriya ndi kupereka ngalande za outflow madzimadzi. Pansi bandeji ntchito mankhwala omwe limathandiza chilonda granulation, kusintha outflow madzimadzi ndi kukhala katundu antiseptic. Nthawi zambiri, njira imeneyi ntchito yotakata-sipekitiramu mankhwala omwe kanthu zovuta.