Tsis ntau, tab sis peb tseem hnov lo lus phem li necrosis. Tias qhov no yog tej zaum paub rau sawv daws. Muaj ntau qhov laj thawj vim li cas qhov tshwm sim no tab tom txhim kho sai. Yuav kom paub seb yuav pab tau tus neeg li cas, vim yog vim li cas lossis lwm qhov, tau pib tuag, peb yuav tsum nkag siab tias yog vim li cas nws tshwm sim thiab yuav tiv thaiv li cas.
Necrosis. Qhov no yog dab tsi?
Necrosis yog kev tuag ntawm cov ntaub so ntswg lossis cov hlwb hauv cov kab mob uas tseem muaj sia nyob. Cov txheej txheem no mus dhau ntau theem:
- necrobiosis;
- paranecrosis;
- cell tuag;
- autolysis.
Nyob rau theem no, kev hloov pauv tshwm sim hauv cytoplasm, nucleus thiab interstitial khoom uas ua rau necrosis nkaus xwb. Cov txheej txheem no yog dab tsi? Nyob rau hauv lub nucleus, wrinkling (karyopyknosis), rupture rau hauv clumps (karyorrhexis), thiab dissolution (karyolysis) tshwm sim. Hauv cytoplasm, coagulation pib, ua raws li cov protein denaturation, ces plasmorhexis,
plasmolysis. Cov khoom nruab nrab tau dhau los ua fibrinolysis, elastolysis thiab tsim cov lipogranulomas.
Kev faib cov hom
Tau xam seb yuav ua li cas necrosis mus, nws yog dab tsi, peb tau los txheeb xyuas qhov tshwm sim no rau hauv pawg. Nws yog qhov txawv los ntawm ntau hom kev faib tawm. Hauv etiology, kev tsis haum, tshuaj lom, raug mob, vascular, trophoneurotic necrosis yog qhov txawv.
Hauv pathogenesis, hom ncaj qha thiab tsis ncaj yog qhov txawv. Direct suav nrog tshuaj lom thiab raug mob, thiab indirect - tag nrho cov so. Nyob rau hauv kev kho mob thiab anatomical system, coagulation los yog qhuav, colliquational los yog ntub dej, sequestration, gangrene, infarction yog txawv.
Kev tshwm sim
Feem ntau, vim tias cov ntshav ntws mus rau cov ntaub so ntswg los yog raug cov khoom tsim los ntawm cov kab mob, kab mob, necrosis tshwm sim. Dab tsi ntxiv tuaj yeem ua rau tus kab mob no? Kev puas tsuaj ntawm cov ntaub so ntswg los ntawm tus neeg sawv cev (lub cev los yog tshuaj lom neeg), kev tsis haum tshuaj, raug rau qhov kub thiab txias heev. Tsis tas li ntawd, cov tsos mob no yog tshwm sim los ntawm cov kab mob xws li syphilis. Necrosis tom qab phais kuj tsis tshua muaj.
Sequence of tsos mob
Tom qab cov tsos mob tshwm sim, yog tias ntsuas tsis tau tshem tawm cov ntaub so ntswg cuam tshuam los ntawm necrosis, kev tuag tshwm sim, uas, dhau los, muab faib ua kev kho mob (rov qab) thiab lom (kev tuag hauv zej zog yog ua tau thaum lub hlwb tuag).
thawj lub cim qhia tias ib yam dab tsi tsis ncaj ncees lawm hauv lub cev yog qhov kev xav ntawm loog loog thiab tsis muaj qhov tsis txaus ntseeg hauv qhov chawswb. Vim kev ua tsis zoo, daim tawv nqaij tig daj ntseg, ces tig xiav, blackens, thiab thaum kawg ua ntsuab tsaus. Necrosis nyob rau hauv qis extremities tuaj yeem tshwm sim nws tus kheej hauv kev qaug zog thaum taug kev, cramps, thiab kev xav txias. Qhov tshwm sim yog atrophic ulcers uas tsis kho.
Tom qab ntawd, lub hauv paus paj hlwb, lub plawv, lub ntsws, lub raum, lub siab pib ua haujlwm tsis zoo. Kev tiv thaiv kab mob txo qis vim cov kab mob ntshav tawm tshiab thiab ntshav ntshav. Cov metabolism yog thaum kawg chim siab, qaug zog, hypovitaminosis thiab overwork tshwm nyob rau hauv tag nrho kev ntsuas.
Cov ntaub so ntswg necrosis. Kev kho mob
Hauv qhov no, tsuas yog tshuaj pleev thiab tshuaj yuav tsis pab. Thaum thawj cov cim qhia lossis kev xav tias necrosis, koj yuav tsum sab laj nrog kws kho mob tam sim ntawd. X-ray thiab kuaj ntshav hauv thawj theem tsis zoo heev raws li txoj kev kuaj mob. Ob txoj hauv kev no yuav pab txiav txim siab tsuas yog theem ob thiab theem tom ntej ntawm necrosis. Yog li ntawd, nyob rau hauv cov ntaub ntawv no nws yog tsim nyog mus ntsib ib tug kws kho mob ntawm cov khoom siv niaj hnub (piv txwv li, MRI). Muaj ntau ntau txoj kev kho mob: sparing, functional thiab conservative. Tsuas yog tus kws kho mob txiav txim siab qhov ua tau zoo ntawm ib lossis lwm qhov kev xaiv hauv ib kis. Yog li peb tau hais txog yuav ua li cas necrosis tshwm sim, nws yog dab tsi, thiab kuaj xyuas thiab kho nws li cas.
