metodi lecheniya xirurgicheskix infektsiy myagkix tkaney u bolnix saxarnim diabetom

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powerpoint presentation metodi lecheniya xirurgicheskix infektsiy myagkix tkaney u bolnix saxarnim diabetom kurbonov shaxzodxon 1. lechenie soputstvuyushix zabolevaniy 2. antibiotikoterapiya 3. xirurgicheskaya obrabotka ran plan: monitoring i otsenka effektivnosti lecheniya otsenka razmerov rani, nalichiya priznakov vospaleniya (otek, eritema, boleznennost) i videleniy kajdie 24-48 chasov pozvolyaet otsenit dinamiku infektsionnogo protsessa i svoevremenno korrektirovat terapiyu. regulyarniy monitoring urovnya glyukozi krovi (ne menee 4 raz v sutki) kriticheski vajen dlya otsenki effektivnosti antibiotikoterapii i kontrolya glikemii, vliyayushix na zajivlenie ran. immunomoduliruyushaya terapiya v nekotorix sluchayax tselesoobrazno primenenie nizkodozovoy immunosupressivnoy terapii dlya kontrolya vospalitelnoy reaktsii, ogranichivaya virabotku provospalitelnix tsitokinov do urovnya ne vishe 10 pg/ml. immunomoduliruyushaya terapiya mojet vklyuchat naznachenie preparatov interferona-gamma, povishayushix aktivnost fagotsitov na 20-30% i sposobstvuyushix bolee effektivnomu unichtojeniyu bakteriy v ochage infektsii. mikrobiologicheskie aspekti viyavlenie anaerobnoy flori v 25-40% sluchaev infektsiy myagkix tkaney u patsientov s saxarnim diabetom trebuet naznacheniya antibiotikoterapii s shirokim spektrom deystviya, vklyuchaya metronidazol ili tindazol. chastota …

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immunosupressiey. profilaktika infektsiy u patsientov s diabetom kontrol glikemii v predelax tselevogo diapazona (naprimer, hba1c <7%) kriticheski vajen dlya predotvrasheniya infektsiy, tak kak giperglikemiya podavlyaet immunitet. regulyarniy osmotr stop, vklyuchayushiy palpatsiyu na nalichie ochagov vospaleniya ili priznakov infektsii (pokrasnenie, otek, bol), i svoevremennoe obrashenie k vrachu pri obnarujenii lyubix izmeneniy – neobxodimaya mera profilaktiki. klinicheskaya kartina i diagnostika diagnostika vklyuchaet klinicheskiy osmotr, laboratornie analizi (krov na leykotsiti, kultura videleniy), a takje ultrazvukovoe issledovanie (uzi) dlya otsenki glubini i rasprostranyonnosti infektsii. pri diabete myagkotkannie infektsii chasto proyavlyayutsya netipichno, s menee virajennim pokrasneniem i otyokom, no bolee glubokim porajeniem tkaney, chto zatrudnyaet rannyuyu diagnostiku. uxod za ranoy i perevyazki dlya predotvrasheniya matseratsii koji vokrug rani neobxodimo ispolzovat povyazki, obespechivayushie adekvatnoe vlagopogloshenie, naprimer, povyazki s gidrogelem ili alginatnie, s zamenoy kajdie 2-3 dnya. primenenie vakuumnoy terapii zakritix ran u patsientov s saxarnim diabetom mojet sokratit vremya zajivleniya na 20-30%, snijaya risk infektsionnix oslojneniy. …

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potrebovatsya dlya dostijeniya tselevogo urovnya glikemii u patsientov s tyajelimi infektsiyami i visokim urovnem glyukozi, naprimer, bolee 250 mg/dl. xirurgicheskoe lechenie: nekrektomiya i drenirovanie pri nekrektomii u patsientov s saxarnim diabetom ob'em udaleniya nekrotizirovannix tkaney doljen bit bolee agressivnim, chem u patsientov bez diabeta, chtobi snizit risk retsidiva infektsii do 15-20%. dlya profilaktiki posleoperatsionnix infektsiy posle nekrektomii i drenirovaniya u patsientov s diabetom neobxodimo naznachenie antibiotikov shirokogo spektra deystviya, v techenie minimum 7-10 dney. patofiziologiya infektsiy myagkix tkaney u patsientov s saxarnim diabetom pri giperglikemii u patsientov s saxarnim diabetom proisxodit podavlenie funktsii neytrofilov, snijaetsya fagotsitoz na 30-50%, chto sposobstvuet bolee legkomu razvitiyu i rasprostraneniyu infektsii myagkix tkaney. mikroangiopatiya, xarakternaya dlya diabeta, privodit k narusheniyu krovosnabjeniya v porajyonnix tkanyax, snijaya dostavku leykotsitov i antibiotikov, chto uvelichivaet risk razvitiya glubokix abstsessov i nekroza. printsipi antibiotikoterapii prodoljitelnost antibiotikoterapii pri xirurgicheskix infektsiyax myagkix tkaney u bolnix saxarnim diabetom sostavlyaet minimum 7-14 dney, no …

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powerpoint presentation metodi lecheniya xirurgicheskix infektsiy myagkix tkaney u bolnix saxarnim diabetom kurbonov shaxzodxon 1. lechenie soputstvuyushix zabolevaniy 2. antibiotikoterapiya 3. xirurgicheskaya obrabotka ran plan: monitoring i otsenka effektivnosti lecheniya otsenka razmerov rani, nalichiya priznakov vospaleniya (otek, eritema, boleznennost) i videleniy kajdie 24-48 chasov pozvolyaet otsenit dinamiku infektsionnogo protsessa i svoevremenno korrektirovat terapiyu. regulyarniy monitoring urovnya glyukozi krovi (ne menee 4 raz v sutki) kriticheski vajen dlya otsenki effektivnosti antibiotikoterapii i kontrolya glikemii, vliyayushix na zajivlenie ran. immunomoduliruyushaya terapiya v nekotorix sluchayax tselesoobrazno primenenie nizkodozovoy immunosupressivnoy terapii dlya kont...

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