Kudzivirira uye Kuchivirira
Kushingaira kwechirwere, iyo inonziwo kuoma kunorwadza kana kubhedha, inokuvadza paganda uye inogona kunge yakasvibirira pasi peganda. Iyi yekukuvara inokonzerwa nekudzvinyirira munzvimbo, iyo inogona kukonzerwa nekurema kwemuviri, maikirwo emakirini kana kusava nekufamba. Bony nzvimbo dzisina mafuta kana musuru pasi peganda zvinowanzoita kuti uwane zvironda kupfuura nzvimbo dzine mafuta nemisumbu.
Semuenzaniso, bhulogi yemhino iri ganda pamusoro petikiti, uye inzvimbo yakakwirira yekugadzirisa chironda.
Kurapa varwere kunyanya vari pangozi yezvinokonzerwa nemakumbo nokuti vanochengetwa munzvimbo imwe kwenguva yakareba uye havagoni kutama panguva iyo. Munhu akasvinuka anganzwa kurwadziwa kana kusagadzikana paanoiswa mune imwe nzvimbo kwenguva yakareba, uye anopindura kunzwa ikoko nokufamba kana kugadzirisa muviri wavo nzvimbo. Mumwe munhu anonzi sedated, anopiwa anesthesia kana anorwara zvikuru kutamira, haagoni kuita zvakafanana.
Kudzivirira Panguva Yokuvhiya
Imwe yenzira dzakanakisisa dzekudzivirira kusvibiswa kwezvironda kubva mukugadzira kunowanzo kufamba, kunyanya kumira nekufamba, asi izvozvo hazvibviri panguva yekuvhiyiwa. Pane kudaro, nokuti murwere anoramba asina kusimba panguva yakawanda anesthesia , kudzivirira kwezvionda zvinowira kune vashandi veimba yekushandisa nemidziyo.
Zvizhinji zvekushandisa makamuri zvino vanoshandisa matafura ekushanda akaputika, anoshandisa zvinhu zvakawanda zvakasiyana-siyana kuti ape chikwata chine mwero kumurwere kuti avete pane imwe nguva yakareba.
Vashandi vemuimba yekushanda vanotorawo pfungwa kune nzvimbo dzemahara, zvakadai sedhiriji yemhino, iyo inogona kutarisana nechisimba kubva mumasikisi anofema anoshandiswa panguva yeanesthesia. Kune vamwe, bhulogi remhino rinenge rakapfekedzwa nekapfeko duku, kune vamwe, chirongo chinoputika chinogona kuiswa pasi pebhuka kana chiuno.
Kudzivirira Pashure Kokuvhiya
Mushure mekuvhiyiwa, kudzivirirwa kwezvinokonzera masonda ndeyemhosva yevanamukoti uye murwere. Murwere ane mutoro wekutora mishonga zvakarurama, kumuka nekufamba nokukurumidza. Vanamukoti ndivo vane basa rekutsanangurwa kwokutanga kwevarwere vari pangozi yekukuvara kweganda, uye kuisa matanho ekudzivirira panzvimbo, pamwe nekuziva kusuruvara kwezvipembenene zvinokurumidza kukurumidza . Vanamukoti vanewo basa rekutendeuka kwevarwere vasingakwanisi kubva pabhedha kana kuzvishandura. Vanamukoti vanogonawo kugadzika tsoka, makumbo uye dzimwe nzvimbo dzomukati kana murwere achiita seanowanzogadziriswa neganda. Vanodzidziswawo kudzivisa kuveuradza, iyo imwe mhando yeganda rinokuvadza rinokonzerwa nekusimudzirwa, nekushandisa mapepa pasi pemurwere kuderedza kupesana paganda.
Kune vamwe varwere, mabhedhi chaiwo anogona kushandiswa izvo zvinogona kuderedza kuumbwa kwemakumbo ekuonda.
Risk Factors
Pane zvakawanda zvinokonzera njodzi dzezvinokonzera kusuruvara, nekushaya kukwanisa kufamba nguva dzose kuva imwe yezvinhu zvakakosha. Varwere muzvipatara avo vasingakwanisi kuzvidzora ivo vanowanzoshandura panzvimbo itsva maawa maviri oga oga kuitira kuti mushure mekugadziriswa kwezvironda.
Zvimwe zvinokonzera ngozi zvinosanganisira:
- Chirwere cheshuga
- Nguva yose muimba yekushandisa (inogona kusanganisira mavhivhi akawanda)
- Zera (vatana vakwegura vanowanzova nehutachiona)
- Kushandisa mishonga inonzi vasopressors kuwedzerwa ropa
- Dambudziko guru pamwero weBraden, chigadziro chinoshandiswa kugadzirisa dambudziko remurwere senharo yekuvhiya
- Muviri muviri mashoma index (vashoma varwere vari pangozi yakanyanya, ivo vashoma "fluffy" uye mamwe "bony")
Staging
Kushungurudza zvironda ndeye nzira yekuisa chiremera chekukuvara. Mhando dzakasiyana-siyana dzezvinokonzera zvironda zvinoda kurapwa zvinowirirana zvakasiyana zvichienderana nekusuruvara kwechirwere chave chava.
Zvimwe zvinokonzerwa nemakumbo zvinokonzerwa nebhanhire kuti dzisiye zvimwe zvinokuvadza apo vamwe vangada rimwe kana kuti mamwe mavhivhi kuti vagadzire uye vashande.
Chikamu / Mutsara I Haisi-blanchable erythema: Ganda rakachena rine ruvara rusingagoneki rwemhepo inowanikwa munzvimbo inowanikwa nzvimbo inowanzotarisa bony mukurumbira. Ganda rakasvibirira rinogona kunge risingaoneki blanching; ruvara rwayo runogona kusiyanisa nenzvimbo dzakapoteredza. Nzvimbo yacho inogona kuva inorwadza, yakasimba, inononoka, ichidziya kana inotonhorera kana ichienzaniswa nemamwe mavara.
Chikamu / Chikamu II Chikamu chakasarura: Chikamu chakakura kurasikirwa kweganda kunounza sechando chisina kudzika chine bvudzi rakatsvuka. Inogonawo kuisa sendimu yakasununguka kana yakasununguka / yakavharwa serum-filled kana sero-sanginous yakazara blister.
Chikwata / Stage III Kuzara kwehutachiona kweganda: Kuzara kwehutachi tushu kurasikirwa. Fati inogona kuonekwa asi pfupa, tete kana musuru hazvisi pachena. Kudzika kweChikamu / Stage III kusuruvara kwechionda kunowanzoenderana nenzvimbo. Bhiriji remhino, nzeve, musoro uye zvinyama bone hazvina mafuta uye zvinogona kunge zvisina kudzika. Kusiyana neizvi, nzvimbo dzemafuta dzinogona kuitika zvakanyanya kudzika Chikamu / Stage III zvinokonzerwa nemakumbo.
Chikamu / Stage IV Uwandu hwehutachiona hwekusiya kurasikirwa: Uzere hwehutachiona hwemutsipa hwakasvibiswa bone, tendon kana muscle. Kudzika kweChikamu / Stage IV kusuruvara kwechirwere kunowanzoenderana nechinzvimbo chekuita. T Kufuridzirwa bone / musumbu inoonekwa kana inogona kuve nyore kunzwa.
Kusagadziriswa / Kusagadziriswa: Kuzara kweganda kana kuti kurasikirwa kwemaviri, yakadzika isingazivikanwi (iyi inoshandiswa muUnited States): Kuzara kwehutachi tusfu kurasikirwa umo kunama kwekupedzisira kwechilonda kunoputirwa zvachose nemhuka inonzi slough kana eschar muchironda. Kusvikira slough yakakwana uye / kana eschar zvabviswa kuti vuratidze nheyo yevanga, kudzika kwechokwadi hakugoni kuiswa.
> Sources:
> NPUAP Pressure Ulcer Matanho / Makamu. National Pressure Ulcer Advisory Panel.
> Mwoyo Murefu uye Zvokuvhiya Maitiro Mukukudziridza Kwezvinonzi Ulcers. American Journal of Critical Care.