Ironea yeziso revanhu iri rakaoma kunzwisisa-"zvigadzirwa" zvishanu. Inomiririrwa ne epithelium, boumenovaya uye Descemetian membranes, stroma uye endothelium. Corneal ulcer ndiko kukanganisa kunzvimbo dzakadzika dzematukisi. Panzvimbo yakakanganiswa tsvuku (munzwa) inoumbwa.
Corneal ulcer inokonzera
Izvi zvinotevera zvinogona kukanganisa kuonekwa kwechirwere ichi:
- kukuvara kwemagetsi kuziso;
- kuora kwekromaa nemakemikari anonyangadza kana kukanganisa zvakanyanya;
- mugumisiro wekutsvaga mazvirwere, mavairusi uye fungi;
- kuoma kwemaziso emeso nekuda kwekushaya mavitamini A uye B kana chirwere chepfungwa;
- kusadzora kushandiswa kwemishonga inopesana nekuputika uye anesthetic zvinodhaka, zvakabudiswa nenzira yemadonhwe.
Corneal ulcers inogona kukonzerwa nekupfeka kusina kukodzera kwema- lens uye zvikanganiso mukuvatarisira. Zvinoreva, zvakagadzirirwa kuvandudza maonero, zvinogona kukonzera kusvibiswa kwemashutu kukanganisa kwakanyanya. Nokufamba kwenguva, pachava nekutanga kukura kukuru, izvo zvinowedzera kuonda. Maitiro ekuvhiya munguva pfupi yapfuura anowedzera mukana wechinetso ichi chinoitika.
Corneal ulcer - zviratidzo
Ichi chirwere chinoratidzwa nezvimwe zviratidzo. Saka, chironda chiri muziso chiri pamwe chete nezviratidzo zvinotevera:
- kurwadziwa kunokonzerwa nekuonekwa kwekukura uye kuwedzera nekukura kwechirwere;
- kuora kwemaonero nekuda kwekuti mhuka inopoteredza nzvimbo yekukura kwevhu inowedzera;
- rakanyorwa photophobia uye rakanyanya kufemwa .
Chirwere chegoni chinoratidzika maererano nezvinodiwa zvinotevera:
- Mukati chechirwere , chimiro chakaoma kana chisingaperi.
- Ukuru hwechionda ichi chakadzika kana chiduku.
- Panzvimbo yekunzvimbo-nzvimbo , pakati kana paracentral.
- Nokuda kwechikonzero chinokonzera - bhakitiriya, chirwere chechirwere, fungal kana kuti chisina kukonzerwa nehutachiona.
Creeping corneal ulcer
Ichi chirwere chinogona kuva nezvirwere zvakadai:
- pneumococcus;
- staphylococcus aureus;
- streptococcus nezvimwe zvipembenene.
Ichi chirwere chinoratidzwa nekukura kwakanyanya. Chirwere chakadai chakadai chinoramba chichipinda. Pasi pemuganhu wayo pane kupararira kukuru kwechirwere. Ikoko kune imwe inopinda, iyo inonyanya kufambira mberi. Iyi inzvimbo inoderedzwa. Pano pane maitiro ekurasikirwa kwemaviri uye kuporesa. Muzviitiko zvakakomba, iris ine chirwere chinokambaira chernea inogona kutowa. Zvisinei, zvinowanzotengeswa neminzwa.
Purulent corneal ulcer
Keratitis yakadai muhuwandu inotora nzvimbo yechipiri - inogamuchirwa chete nemakumbo emakumbo. Ichi chironda chegoni chinoratidzirwa nekuoma kwemarara nekufamba. Kazhinji zvinotungamirira pakurasika kwekuona nekurasikirwa kweziso. Iyo bhakitiriya yeonda ye cornea inogona kunge yakasikwa yakasiyana-siyana:
- kuipa kwepanyama;
- conjunctivitis;
- zvirwere zvemaziso
- maitiro akaendeswa kune cornea;
- majekiseni asina kusarudzwa uye zvichingodaro.
Peripheral ulcer of the cornea
Icho chinopesana nekuputira, izvo zvisingaiti zvepabonde. Izvozvo zvinokonzerwa nesonda zvinokonzerwa nehutachiona hwehutachiona. Kazhinji chirwere chakadaro chinowanikwa kune avo vanopfeka majekiti. Inogona kunge inofadza, asi varwere vanong'un'una nezvekutsva kwemaziso uye kuora. Iyo inopinda mukati mayo idiki muhupamhi (marita anosiyana kubva 2 kusvika 10 mm). Rakatenderera.
Corneal edge ulcer
Rudzi urwu rwekeratitis inopindira kune chirwere chinoputika chinopararira kubva pamiganhu yemasikirwe kana kubvarura matope. Chirwere chakadai chakadai mumunhu chine zvinhu zvinotevera:
- Maumbirwo epeti inopinda, izvo zvino zvinosanganiswa kuva keratitis imwe chete.
- Kana iyo ipodi yepasi isingavhari ziso zvakakwana, iyo cornea inopera, masero haatongwi zvakakwana. Somugumisiro, gorosi inopindira mafomu pamusoro.
Perforated corneal ulcer
Ichi chimiro che keratitis chine chairo chaicho. Izvozvo sora reziso muvanhu rinosvika kune dzose dzerineni. Icho chinosiya mushure mekumhanya kunoramba kuripo. Kana kuonekwa kusinganzwisisiki kwechinetso kana kurapwa kusina kukodzera panzvimbo yekeratitis, ruvara rukuru rwakaumbwa. Murwere, uyo ane chirwere chakadaro, anotarisana nehupofu hwakakwana.
Kuchengetedzwa kwekromneal ulcer
Kurapa kwechirwere chakadaro kunofanira kunge kwakaoma uye kuchiitwa muchipatara. Dzidzo yacho inotora kubva kumavhiki maviri kusvika ku5. Iyo inofananidzira chirwere cherne corneal, iyo inofanira kubatanidza musha, systemic uye physiotherapy. Pamusana pekubatana kwezviito uye kukodzera kwepamusoro kwevashandi vezvechiremba, murwere anobva atorazve. Kurapa kwemunharaunda kunosanganisira zvinotevera:
- kushandura antibacterial (Chloramphenicol, Ciprofloxacin) uye anti-inflammatory (diclofenac sodium) mishonga mu conjunctiva;
- kushandiswa kwemishonga inorwisa mabhakitiriya (Lincomycin, Gentamicin);
- kuiswa kweglucocorticoids (dexamethasone);
- kudzidzisa nemishonga inoderedza vadzidzi (Atropine);
- kuiswa kwechirwere chinokurudzira kugadziriswa kwezvinhu zvakakanganisika (Methyl ethylpyridinol uye Dexpanthenol).
Kuronga kwakarongeka kunosanganisira kugadzwa kwemishonga inotevera:
- detoxification solutions (Dextrose + Ascorbic acid);
- anti-inflammatory drugs (Nimesulide);
- utachiona hwemishonga inorwisa mabhakitiriya (cephalosporins kana aminopenicillins);
- uye kuporeswa kwakashata kwezvironda, zvinodhaka zvine regenerating effect zvinoshandiswa;
- kana iyo cornea inoputika, glucocorticoids inoshandiswa.
Mumatambudziko akaoma, apo remishonga inodhaka haina simba, inoshandura pakupindira kwekuvhiya. Munguva iyi, maziso echipiso chekutanga anotsemuka. Mishonga yeAntimicrobial inoshandiswa pane izvi. Uyewo keratoplasty inoitwa. Munguva iyi, nzira yekushandurwa kwechirwere chetachiona yakashandurwa.
Physiotherapeutic maitiro anomiririrwa nemaitiro akadaro:
- electrophoresis nekushandiswa kwemishonga inorwisa maitiro uye antibacterial drugs;
- low-frequency magnetotherapy;
- ultraphonophoresis, iyo iyo enzymes (Lidase, Fibrinolysin) inoshandiswa, kushandura fibrin uye kugovera kucheka chekisi chetete;
- antibacterial trays.
Kudzidzira nekudzorerazve physiotherapy. Pakati penzira dzayo inogona kusiyaniswa nenzira inotevera:
- Kuderedza-kukurumidza kwekusimudzira kwegadziriro ye endocrine, zvichikonzera kuwedzera kwemazinga e-cortisol nemamwe mahomoni anoshandisa zvinodhaka zvirongwa mumuviri.
- Migumisiro munharaunda yakagadziriswa nekuputika kwenguva pfupi yekushandura ikozvino.
Zvimwe zvinokonzerwa nekromneal ulcer
Mukurapa kwechirwere ichi, keratoplasty inoshandiswa. Izvi zvinoshandiswa pakuzora zvipfeko zvezvinhu zvakakuvadzwa. Izvi zvinoshandiswa pamapofu meso, apo kurapwa kwechigunzva corneal ulcer hakupei chiitiko chinotarisirwa. Muchibvumirano ichi, huroti hunove hwakanyanyisa uye hunochinjwa nehutachiona husina kujeka. Kana nyemba dzichigara kunze kwenzvimbo ye trepanation, dzakasvibiswa nemascara chaiyo. Iyi nzira yakafanana chaizvo nekutora tattoo.
Serums muhutano hwezvironda, zvinokonzera kukanganisa
Kana uchibata chirwere ichi, autologous agents anoshandiswa. Maikemikari aya serums aya akafanana zvikuru nemvura inosvimha misodzi. Heano zvinhu zvinotevera:
- epithelial growth factor;
- albumin;
- pfuma P;
- fibronectin;
- alpha-2 macroglobulin;
- insulini-kufanana nekukura-1 nezvakadaro.
Kune nzira dzakawanda dzekugadzira serums yakadai yemishonga. Mumwe wavo anopa kuwedzera kwemishonga inorwisa mabhakitiriya kumushonga wemishonga. Zvisinei, zvinokosha kuti serum inonyatsochengetwa. Miviri yakasvibirira inouraya kune zvimwe zvikamu (imwe yei vitamini A). Chengeta serum iri munzvimbo ine rima, inotonhorera. Kubudirira kwakaporesa kuporesa iyo mishonga iyi iripo kunotibvumira kugumisa kuti purulent corneal ulcer ichabviswa - kurapa kuchapfuura pasina zvinetso.