Burns: Burns nharaunda kurondedzerwa nokutonga muchanza. Kupatsanura pakati hudiki pamusoro nzvimbo uye papi kukuvara

Muupenyu, mumwe nomumwe wedu akapiwa kutsva. Area hudiki zvinogona akasiyana, asi kunzwa ndiyo nguva dzose zvakafanana, sezvo kana njodzi nzvimbo kushandisa dzvuku-inopisa marasha. Uye hapana mvura, chando kana tsonyera kuchitonhora havagoni kukurira manzwiro ichi.

A pakurapa kupisa - ichi kukuvara rinenge kunokonzerwa kuitwa mukuru tembiricha kana mukuru webasa mishonga, semuenzaniso acids, nezvigadziko, weheavy metal munyu. Kwokuomerwa kukuvara kunotemwa nokudzama uye nzvimbo ukama tishu. Kune chaiyo siyana kutsva, yaunganidzwa nemwaranzi kana yemagetsi kuvhunduka.

kupatsanura

Kupatsanura pakati hudiki inobva kudzika uye mhando kukuvara, asi pane kupesana kunotoda kurapwa kuratidzwa, zvokurapa nzira kana mhando kukuvara.

Kusiyaniswa ukuru Unopisa:

1. The dhigirii rokutanga kunoratidzwa maronda chete pamusoro rukoko ganda. It kunoratidzwa akatsvuka, zvishomanana kuzvimba uye kurwadziwa. Zviratidzo inonyangarika pashure pemazuva matatu kana mana, uye mugove sei pamusoro epithelium kuchatsiviwa itsva.
2. Kuvadza epidermal basal rukoko 2 inoratidza dhigirii pakutsva. On pemvura nedehwe matema kuonekwa turbid mukati. Healing kunogara kusvikira vhiki mbiri.
3. Apo Hutsvi, chafariz kukuvadzwa haagamuchiri chete Epiderme e asiwo dermis.
   - The mwero A: ronda dermis nechepasi iri zvishoma wakaremara, asi pakarepo mushure zvinokuvadza hunoratidzika gwati dema, dzimwe nguva kuzviratidza matema kuti batanidza nemumwe. Marwadzo ari nzvimbo hutsvi haina vainzwa nokuda kukuvara receptors. Self-patsva zvinogoneka chete pasi mamiriro usingavaki kujoina munhu chirwere yechipiri.
   - Degree B: zvachose kurasikirwa Epiderme e, dermis uye hypodermis.
4. The dhigirii chechina - ganda iri rakaitwa marasha, zvakaturikidzaniswa mafuta, tsandanyama uye kunyange pfupa.

Kupatsanura pakati hudiki pamusoro mhando kukuvadzwa:

1. Kuonana yakakwirira tembiricha:
   - Fire - zvakakuvadza nharaunda yakakura, asi zvishoma udzamu. Primary marapirwo rakaoma nokuti zvakaoma kuchenesa ronda kwemiviri vatorwa (neshinda zvipfeko zvidimbu vavhunduka mabhatani kana zippers).
   - Zvinoyerera - kupisa diki asi kwakadzama (A-to-rechitatu dhigirii).
   - hot hwemvura - chinokosha pisa urefu, asi kazhinji anosvika kudzama dzeboka rechipiri. Kazhinji zvinokanganisawo kufema turakiti.
   - incandescent zvinhu - ronda inodzokorora hurukuro yacho, uye unogona kuva rebei kudzika.
2. Chemicals:
   - Acids kukonzera coagulation necrosis, uye pamusoro nzvimbo lesion rinowanika pakafunuka pakati yakazvimoneredza mapuroteni. Hazvina basa kuti zvinopfuura dambudziko munyama. Akasimba ari acid, ari pedyo pemvura ganda riri njodzi yacho.
   - Alkali akaumba liquefactive necrosis, izvozvo kunoita jira uye chinopinda zvikuru kungatikanganisa fuma, hutsvi 2 inegumi.
   - weheavy metal munyu kunze patakafanana kutsva acid. Ndivo chete 1-ST dhigirii.
3. Electrical hudiki kuitika mushure neVadzidzi hwokugadzira kana mumhepo magetsi, uye somunhu mutemo, ndivo chete panzvimbo hwokupinda uye napanobudiwa napo zvinoyerera.
4. Radiation hudiki zvinogona kuitika mushure yokuwana ionizing nemwaranzi kana chiedza. Vane njere, uye avo nokufumura ari kusonganirana lesion pakati nadzo uye hurongwa, pane zvakananga nyoro tishu.
5. Aibatanidza hudiki dzinosanganisira kukuvadza zvinhu zvakadai negasi uye womoto.
6. Combined vanogona kunzi kukuvara, apo kuwedzera kupisa pane dzimwe mhando kukuvara, zvakadai mitswe.

mataridzikiro

Munhu wambogamuchira kutsva (pisa nharaunda yakanga anopfuura mashanu-Ruble mari), anoziva kuti fungidziro chirwere - chinhu zvakadzama chinokosha kuongorora chirwere. Varwere kunotevera kazhinji vakakuvara mutsaona, njodzi dzinongoitika dzoga kana somugumisiro tsaona kumabasa. Naizvozvo, vanhu vari yokumirira vari vakauya ezvipfuwo. Zvino kufanotaura nezveramangwana kuchinja murwere apinda batsira panguva kufambira. Wakakura zvikuru uye kwakaoma kacho vanofanira kubatwa navanachiremba pakutanga, nekuti dzimwe nguva bhiri inoenda maawa uye maminitsi. Kazhinji, achifanotaura hwakavakirwa pechiso nzvimbo nokudzika ukama lesion, uye anoenderana makuvaro.

Kuti zvakarurama kuona fungidziro, anoshandisa zvimiso indices (semuenzaniso, Frank indekisi). Kuti izvi zvidaro, mumwe nomumwe muzana njodzi nzvimbo iri basa kubva imwe mana pfungwa. It kunobva mwero localization uye anopisira, uyewo pasinei apise nzvimbo rokumusoro Airways. Kana disordered kufema asipo, kutsva, musoro uye mutsipa anowana 15 points, uye kana zvakadaro, ipapo zvose 30. Ipapo anofanira kuverenga Mutengo zvose. Pane zvakawanda:

- asingasviki 30 pfungwa - yakanaka fungidziro;
- kubva matatu kusvika makumi matanhatu - nekaupenyu zvakanaka;
- mapfumbamwe - negakava;
- kupfuura makumi mapfumbamwe - zvisingafadzi..

nharaunda yakafukidzwa

In mushonga, pane nzira dzakawanda kuverenga nzvimbo njodzi pamusoro. Kutsunga kwenzvimbo uye kukura hutsvi zvinogoneka kana ukawana rive mutemo kuti pemvura dzakasiyana-siyana dzomuviri anotora pfumbamwe muzana zvachose nzvimbo ganda, maererano musoro pamwe pamutsipa, chipfuva, dumbu, mumwe ruoko, chidya, gumbo uye rutsoka inogarwa 9% uye rwemberi pose muviri - kaviri (18%). Perineum uye sikarudzi vacho rimwe muzana chete, asi makuvaro idzi huru zvakakwana.

Pane dzimwe mitemo Pakusarudza nzvimbo kutsva, somuenzaniso noruoko. Zvinozivikanwa kuti munhu muchanza nzvimbo zvinoda mumwe nomumwe uye nehafu muzana yose muviri pamusoro. Izvi zvinoita pamadiro kuona kukura mugove dzaparadzwa uye kwokuomerwa mamiriro kuita. Kufarira hudiki pamusoro muviri ndivo notional ukoshi. Ivo vanovimba pamusoro kuzviitira kunyatsoongorora chiremba.

kiriniki

It akataura zviratidzo zvinoverengeka kuti zvingaitika kutsva. Nzvimbo kutsva iyi nyaya hakurevi vane basa rinokosha, sezvo ivo vari pahupamhi, asi kudzika. Pakupedzisira chimiro kunotoda kurapwa kuratidzwa unogona kutsiva mumwe mukupora:

1. Erythema kana akatsvuka ganda iri pamwe akatsvuka. It kunoitika chero Hutsvi.
2. Vesicle - chinu izere zvakawanda zvinonyanya kuzivikanwa zvokunwa. Inogona zvakasanganiswa neropa. It kunoitika nokuda peeling rokumusoro ganda rukoko.
3. Bulla - a vesicles vashoma akabatanidza kupinda rimwe sefuro nehafu masendimita ari dhayamita.
4. Kukurwa kwevhu - kupisa pasi ine Epiderme e. Ari ropa, kana kusunungurwa ichor. It kunoitika munguva kubviswa Maronda akasiyana kana bullae, necrotic tishu.
5. Urikanwi - zvakadzama kukurwa kwevhu, kukanganisa dermis, hypodermis uye tsandanyama. The ukoshi kunobva nzvimbo yapfuura necrosis.
6. Coagulation necrosis - rakaoma necrotic zvinyama nhema kana shava. Nyore kubviswa surgically.
7. Liquefactive necrosis - nyoro kuorera mazviri rinenge kuti ingangowedzera ari mukati pamuviri, uye kusvikira kurutivi, ichitora Vakagwinya tishu.

pisa chirwere

Ichi muviri systemic mhinduro kupisa kukuvara pakusava Izvi zvingaitika zvose panguva kukuvara pemvura kana muviri anopisa 30% kana kupfuura, uye yakadzika Uchipisa, achitora hapana zvinopfuura gumi muzana. The kurukutika yomunhu utano, pachena zvikuru ichi mhando nehana. The pathophysiology rakakamurwa muzvikamu zvina kukura pakutsva chirwere:

1. Pisai kuvhunduka. Rinotora kwemazuva maviri okutanga, pamwe mukukuvara kukuru - mazuva matatu. It unovapo nokuda kururama redistribution kuti mvura iri kuvhunduka nhengo (mwoyo, mapapu, uropi, itsvo).
2. Chenjera pisa toxemia hwapedyo wozoita chirwere kunotora vhiki rimwe mazuva mapfumbamwe. Pathophysiologically zvakafanana kupwanya urwere, i.e. zvinyama kuora zvigadzirwa kupinda systemic kuparadzirwa uye kuchetura muviri.
3. Aidaro septicotoxemia anozviratidza mushure accession chirwere. Zvinogona kwenguva kusvika inoverengeka kusvikira zvose kwemabhakitiriya zvabviswa kubva ronda pamusoro.
4. Recovery rinotanga pashure hutsvi maronda dzakavharika pamwe granulation rinenge kana epithelium.

Endogenous kudhaka, zvirwere uye sepsis

Muviri Aidaro muviri pamwe mapuroteni denaturation chikafu chepfu. Chiropa neitsvo anenge havagoni kukurira chichiwedzera mutoro kana kumanikidzwa ari systemic riparadzirwe. Uyezve, pashure dambudziko kwevanhu zvirwere kuri kumusoro akasvinurira, asi chepfu-refu muviri rinovhuna dziviriro zvenhengo nokuumba munhu immunodeficiency yechipiri. Izvi zvinotungamirira ndechokuti ronda pamusoro nyuchi chinonyangadza microflora.

vakaurayiwa pamwe Unopisa Sort

Sezvataurwa pamusoro apa, pane ari zvashata mukamuri kashoma vakauya wacho, uyo ane kutsva. Nzvimbo kokutsva uye uwandu varwere nokure inogona vanachiremba mudonzvo, saka unofanira kugadzirisa kuuya vanhu kwokuomerwa mamiriro kuziva uyo kupa mishonga pakutanga:

1. Akanyatsofunga akakuvadzwa vane zvachero kutsva pamusoro makumi maviri muzana muviri kana kwakadzika kutsva - anopfuura gumi muzana, uyewo repamusoro kufema kutsva. Vanaamai vakadaro vanoda rubatsiro rwekuchipatara munjodzi uye zvifambiswe kuchipatara nokubatsirwa utsanana avhiyesheni.
2. Avhareji mwero kwokuomerwa zvomene kutsva makumi maviri muzana zvichidzika zvakadzama - hapana kupfuura gumi muzana muviri pamusoro. Saka unofanira kupa dzokurapa kubatsira vawirwa yechipiri dzokai, asi izvozvo hazvirevi kuti vanogona kusiya vasina akavatarisa kwenguva refu.
3. Nyoro zvizere zvachero kutsva, achitora asingasviki gumi muzana ganda pemvura kana yakadzika kutsva, risina vatiitire zvinopfuura zvishanu muzana uye regai kukanganisa rokumusoro kufema turakiti.
4. Akakuvadzwa - ndivo vanhu vane rakadzika muviri kutsva (50% kana kupfuura), uyewo vakura vanhu kuchikuvadza matatu muzana pemvura. Saka vakabirwa rinoitwa chete symptomatic kurapwa. The vanobatwa pamwero mukuru tsaona maindasitiri angangosvika 90% muviri kutsva. Uyu chinouraya zvakakanganisika, uye rubatsiro panyaya iyi hazvibviri, unogona chete edza kuderedza analgesics dzavo kutambura simba (vakafurira chaanoziva) kana kuti inhalation yokutindivadza.

rwekutanga

Nokuti kushurudzira akanaka inoita basa rinokosha kupa okuzvibatsira uye tose rubatsiro. The rapidity nemapinduriro anobvumira kuti kuderedza hutsvi nzvimbo uye kudzika. Chinhu chokutanga kuti vasavhiringidza dzechimwe kuonana pakati pomutumwa uye yevanhu semuenzaniso kudzima moto kana patsanura nemambure sukurudza / neutralize namakemikari.

Mugore pre-muchipatara Danho haisi varumbidzwa kushandisa nezvizoro ane kunobva mafuta-, uye mamwe mafuta tubhokisi nevasori, nokuti kuumba firimu pemvura ronda uye kudzivirira kupisa goho. Mukuwedzera, chipatara vachafanira zvinomuomera kuikanganwa uye "kuchirapa kusvibiswa", nokuwondisa akuvara. Hazvina zvakafanira pamba kubereka ronda kurapwa, akadai kubviswa miviri vatorwa, kana rakaitwa marasha ganda, uye zvakafanana. Izvi zvingaita kuti utachiona, nokuti haangakurambiriyi kuonekwa yakafanira muoti asepsis / antisepsis. Plus, pasina zvakakodzera yokutindivadza munhu uchiedza kubatsira chinowanzoitika vanowira mamiriro kurwadziwa nehana.

Kurwadziwa uye ronda kurapwa

Zvichienderana kwokuomerwa murwere mamiriro nemukoti anokotsirisa anosarudza yakakodzera zvinodhaka uye yokutindivadza unyanzvi. Zvingava asiri steroidal Anti-anogumbura zvinodhaka, analgesics-antipyretics gwapa kana conduction yokutindivadza. For Muzviitiko zvakaipisisa, marwadzo analgesics vari dzakakodzera.

Mushure Kukuvara anesthetized, chiremba yacho huru kurapwa ronda pamusoro. Iye detaches ari Epiderme e, inovhura drains the kana matema, mitumbi yokumwe vanobviswa. Ipapo akanatsa pose ronda rinovharwa yakachena gauze bhandiji. With hudiki wechipiri uye mwero murwere vanoda kupinda tetenasi serum.

zvomunharaunda kurapwa

Maviri anozivikanwa nzira kutsva kurapwa - zvose indoor uye Outdoor. Vanogona kushandiswa kana yoga kana pamwe chete. Kudzivirira ronda utachiona, achishingaira yakaoma kuoneka pakaoma necrosis. Izvi inobva nzira yakazaruka. Kureva muchikuvadza pamusoro zvinhu zvakadaro doro zvinogadzirisa halogens zvinogona coagulate ari mapurotini. Uyewo, physiotherapy angashandiswa nzira dzakadai michini nemwaranzi.

Closed kurapwa zvinoreva dressings kuti kudzivirira utachiona, uye anopa abudise kuti mvura mvura water drainage. Under bhandiji rinoshandisirwa mishonga iyo inokonzera muchikuvadza granulation, kuvandudza Urume water drainage uye vane akambozvishandisa kuuraya utachiona zvivako. Kakawanda, nzira iyi akashandisa mishonga inorwisa mabhakitiriya, vane kunzwisisa chiito.