Niaj hnub no cia peb kawm txog qhov tshwm sim ntawm bedsores thiab yuav ua li cas tiv thaiv lawv

Yog tias tus neeg hlub raug mob hnyav lossis mob hnyav, tej zaum lawv yuav tau siv sijhawm ntau hauv txaj.Lub sij hawm ntev ntawm kev tsis ua haujlwm, thaum muaj txiaj ntsig zoo rau kev rov qab los, tuaj yeem ua teeb meem yog tias lawv tso ib qho tsis tu ncua ntawm daim tawv nqaij mos.

Cov kab mob siab, tseem hu ua bedsores lossis bedsores, tuaj yeem txhim kho yog tias tsis muaj kev tiv thaiv.Cov kab mob hauv txaj yog tshwm sim los ntawm lub siab ntev ntawm daim tawv nqaij.Lub siab txo cov ntshav ntws mus rau thaj tsam ntawm daim tawv nqaij, ua rau cov cell tuag (atrophy) thiab cov ntaub so ntswg puas.Cov kab mob siab feem ntau tshwm sim ntawm daim tawv nqaij uas npog cov pob txha ntawm lub cev, xws li pob taws, pob taws, pob tw, thiab pob txha.

Cov neeg uas raug kev txom nyem tshaj plaws yog cov uas lawv lub cev tsis tau tso cai rau lawv hloov txoj hauj lwm.Qhov no suav nrog cov neeg laus, cov neeg uas tau mob stroke, cov neeg uas raug mob qaum, thiab cov neeg tuag tes tuag taw lossis lub cev tsis taus.Rau cov no thiab lwm tus neeg, bedsores tuaj yeem tshwm sim hauv lub rooj zaum muaj log thiab hauv txaj.

Cov kab mob siab tuaj yeem muab faib ua ib qho ntawm plaub theem raws li lawv qhov tob, qhov hnyav, thiab cov yam ntxwv ntawm lub cev.Cov kab mob loj zuj zus tuaj yeem tshwm sim raws li cov ntaub so ntswg sib sib zog nqus uas cuam tshuam rau cov leeg nqaij thiab pob txha.Thaum qhov mob hnyav tshwm sim, nws tuaj yeem kho tsis yooj yim.Kev nkag siab txog ntau theem tuaj yeem pab txiav txim siab txoj haujlwm zoo tshaj plaws.

American Pressure Ulcer Advisory Group faib cov kab mob siab rau hauv plaub theem, raws li qib ntawm cov ntaub so ntswg puas lossis qhov tob ntawm qhov txhab.Lub koom haum theem tuaj yeem muab faib ua:

I.

Qib I rwj yog tus cwj pwm los ntawm qhov liab liab ntawm daim tawv nqaij tsis zoo uas tsis tig dawb thaum nias.Cov tawv nqaij yuav sov so rau qhov kov thiab tshwm firmer lossis softer dua li cov tawv nqaij ib puag ncig.Cov neeg uas muaj cov tawv nqaij tsaus nti tuaj yeem hnov ​​​​qhov txawv txav.
Edema (cov ntaub so ntswg o) thiab induration (cov ntaub so ntswg hardening) yuav yog cov cim qhia ntawm theem 1 mob siab.Thawj theem siab rwj tuaj yeem nce mus rau theem thib ob yog tias lub siab tsis txo qis.
Nrog rau kev kuaj mob sai thiab kev kho mob sai, qhov mob siab thawj zaug feem ntau daws tau li ntawm peb mus rau plaub hnub.

II.

Ib theem 2 mob tau kuaj pom thaum daim tawv nqaij tsis zoo tam sim ntawd rub tawm, nthuav tawm cov epidermis thiab qee zaum cov dermis.Cov kab mob yog cov tawv nqaij thiab feem ntau zoo li abrasions, tawg hlwv, los yog qhov tob hauv daim tawv nqaij.Theem 2 bedsores feem ntau yog liab thiab sov rau qhov kov.Kuj tseem muaj cov kua dej ntshiab hauv daim tawv nqaij puas lawm.
Txhawm rau tiv thaiv kev loj hlob mus rau theem thib peb, txhua qhov kev siv zog yuav tsum tau ua kom kaw cov kab mob thiab hloov txoj haujlwm tsis tu ncua.
Nrog kev kho kom raug, theem II bedsores tuaj yeem kho tau ntawm plaub hnub mus rau peb lub lis piam.

III.

Theem III rwj yog tus cwj pwm los ntawm cov kab mob uas txuas mus rau hauv lub dermis thiab pib koom nrog cov ntaub so ntswg subcutaneous (tseem hu ua hypodermis).Los ntawm lub sij hawm no, ib tug me me crater tau tsim nyob rau hauv lub lesion.Cov rog yuav pib tshwm nyob rau hauv qhov mob, tab sis tsis nyob rau hauv cov leeg, leeg, los yog pob txha.Qee zaum, kua paug thiab tsw ntxhiab tsw tuaj yeem pom.
Hom kab mob no ua rau lub cev muaj peev xwm kis tau tus kab mob, nrog rau cov tsos mob ntawm cov ntxhiab tsw phem, kua paug, liab, thiab tawm xim.Qhov no tuaj yeem ua rau muaj teeb meem loj, suav nrog osteomyelitis (mob pob txha) thiab sepsis (ua rau muaj kab mob hauv cov ntshav).
Nrog kev nruj nruj thiab kev kho mob zoo ib yam, theem III siab mob tuaj yeem daws tau hauv ib mus rau plaub lub hlis, nyob ntawm nws qhov loj thiab qhov tob.

IV.

Theem IV siab rwj tshwm sim thaum cov ntaub so ntswg subcutaneous thiab hauv qab fascia puas lawm, nthuav tawm cov leeg thiab pob txha.Qhov no yog hom mob hnyav tshaj plaws thiab nyuaj tshaj plaws los kho, muaj kev pheej hmoo kis mob.Kev puas tsuaj rau cov ntaub so ntswg, cov leeg, cov hlab ntsha, thiab cov pob qij txha tuaj yeem tshwm sim, feem ntau nrog cov kua paug tawm thiab tawm.
Theem IV lub siab rwj yuav tsum tau kho nruj kom tsis txhob muaj kab mob hauv lub cev thiab lwm yam teeb meem uas cuam tshuam rau lub neej.Raws li kev tshawb fawb xyoo 2014 luam tawm nyob rau hauv phau ntawv Journal Advances in Nursing, cov neeg laus uas muaj theem 4 mob siab tuaj yeem muaj kev tuag txog li 60 feem pua ​​hauv ib xyoos.
Txawm tias muaj kev kho mob zoo hauv lub tsev laus, theem 4 mob siab tuaj yeem siv sijhawm li ob mus rau rau lub hlis (lossis ntev dua) los kho.

Yog tias qhov mob hauv txaj tob thiab nyob hauv cov ntaub so ntswg sib tshooj, koj tus kws kho mob yuav tsis tuaj yeem txiav txim siab nws theem.Hom kab mob no yog suav tias yog tsis yog-staging thiab tej zaum yuav xav tau kev debridement kom tshem tawm cov ntaub so ntswg necrotic ua ntej yuav tsim ib theem.
Qee qhov bedsores yuav tshwm sim rau theem 1 lossis 2 thaum xub thawj siab ib muag, tab sis cov ntaub so ntswg hauv qab yuav raug puas tsuaj ntau dua.Nyob rau hauv cov ntaub ntawv no, lub rwj yuav raug cais raws li ib tug xav tias sib sib zog nqus nqaij raug mob (SDTI) theem 1. Ntawm kev soj ntsuam ntxiv, SDTI tej zaum kuj pom raws li theem.III los yog IV siab ulcers.

Yog tias koj tus neeg koj hlub tau pw hauv tsev kho mob thiab tsis txav chaw, koj yuav tsum tau ceev faj kom paub txog thiab zoo dua tiv thaiv qhov mob siab.Ib tus kws kho mob lossis tus kws kho mob lub cev tuaj yeem ua haujlwm nrog koj thiab koj pab neeg saib xyuas kom paub tseeb tias muaj kev ceev faj hauv qab no:
Hu rau koj tus kws kho mob yog tias koj pom qhov mob, liab, kub taub hau, lossis lwm yam kev hloov ntawm daim tawv nqaij uas kav ntev tshaj li ob peb hnub.Kev kho mob sai sai, qhov zoo dua.

Ergonomic tsim kom txo tau siab thiab tsis txhob bedsores

1. Bhattacharya S., Mishra RK Siab mob: kev nkag siab tam sim no thiab kho kho tshiab Indian J Plast Surg.2015; 48(1):4-16.Chaw Haujlwm: 10-4103/0970-0358-155260
2. Agrawal K, Chauhan N. Cov kab mob siab: rov qab mus rau qhov pib.Indian J Plast Surg.2012; 45(2): 244-254.Chaw Haujlwm: 10-4103/0970-0358-101287
3. Sawv BT.Siab rwj: dab tsi kws kho mob yuav tsum paub.Phau ntawv Journal Perm 2010; 14(2:56-60.doi: 10.7812/tpp/09-117 ib
4. Kruger EA, Pires M., Ngann Y., Sterling M., Rubayi S. Kev kho mob siab ulcers nyob rau hauv qaum qaum raug mob: cov ntsiab lus tam sim no thiab yav tom ntej tiam.J. Spinal tshuaj.2013; 36(6):572-585.PIB: 1011792045772313Y.0000000093
5. Edsberg LE, Black JM, Goldberg M. et al.Revised National Pressure Ulcer Advisory Group Pressure ulcer classification system.J Urinary Incontinence Stoma Post Injury Nurse.2016; 43(6):585-597.doi: 10.1097/KRW.000000000000281 PAB
6. Boyko TV, Longaker MT, Yan GP Review ntawm niaj hnub kev kho mob ntawm bedsores.Adv Wound Care (New Rochelle).2018; 7(2:57-67.doi: 10.1089/mob.2016.0697
7. Pales A, Louise S, Ilenia P, et al.Lub sijhawm kho mob rau theem II mob siab yog dab tsi?Cov txiaj ntsig ntawm qhov kev ntsuam xyuas theem nrab.Kev kho mob zoo heev.2015; 28(2):69-75.doi: 10.1097/01.ASW.0000459964.49436.ce ib
8. Porreka EG, Giordano-Jablon GM Kev kho mob hnyav (theem III thiab IV) mob siab rwj hauv paraplegics siv lub zog hluav taws xob hluav taws xob.yas phais.Xyoo 2008; 8: e49.
9. Andrianasolo J, Ferry T, Boucher F, et al.Kev kub siab ulcer-associated pelvic osteomyelitis: kev ntsuam xyuas ntawm ob-theem kev phais lub tswv yim (debridement, negative pressure therapy, and flap kaw) rau kev kho mob mus sij hawm ntev.Cov kab mob kis tau ntawm Navy.2018; 18(1):166.doi: 10.1186/s12879-018-3076-y
10. Brem H, Maggie J, Nirman D, et al.Tus nqi siab ntawm theem IV siab rwj.Kuv yog Jay Surg.2010; 200(4): 473-477.doi: 10.1016/j.amjsurg.2009.12.021
11. Gedamu H, Hailu M, Amano A. Prevalence and comorbidities of pressure ulcers of inpatients at Felegehivot Specialist Hospital in Bahir Dar, Ethiopia.Kev nce qib hauv kev laus.2014;Xyoo 2014. doi: 10.1155/2014/767358.
12. Sunarti S. Kev kho mob ntawm cov kab mob uas tsis yog-staged siab nrog kev hnav khaub ncaws siab heev.Indonesian Medical Journal.2015; 47(3): 251-252.