{"id":30793,"date":"-0001-11-30T00:00:00","date_gmt":"-0001-11-29T22:18:44","guid":{"rendered":""},"modified":"-0001-11-30T00:00:00","modified_gmt":"-0001-11-29T21:00:00","slug":"akiu-nudegimas","status":"publish","type":"catalog_entry","link":"https:\/\/www.pasveik.lt\/lt\/irasas\/akiu-nudegimas\/","title":{"rendered":"Aki\u0173 nudegimas"},"content":{"rendered":"<p style=\"text-align:justify\"><strong>&nbsp;Aki\u0173 nudegimas<\/strong><\/p>\n<p style=\"text-align:justify\"><strong><\/strong><\/p>\n<p style=\"text-align:justify\"><strong>APIBR<\/strong><strong>\u0116\u017dIMAS<\/strong><\/p>\n<p style=\"text-align:justify\">Aki\u0173<br \/>\n nudegimai \u2013 tai vok\u0173, jungin\u0117s, ragenos, odenos nudegimai. Jie gali<br \/>\nb\u016bti sukelti chemini\u0173 ( r\u016bg\u0161\u010di\u0173, \u0161arm\u0173) ar radiacini\u0173 ( kar\u0161\u010dio, UV<br \/>\nspinduli\u0173) veiksni\u0173. Chemin\u0117s med\u017eiagos, patekusios \u012f akis gali sukelti<br \/>\ngreit\u0105, niokojant\u012f ir nepataisom\u0105 rezultat\u0105. Aki\u0173 nudegimus sukelti gali<br \/>\n \u012fvair\u016bs kenksmingi agentai, chemin\u0117s med\u017eiagos ar energijos<br \/>\nspinduliavimas. Tokio nudegimo sunkumas tiesiogiai susij\u0119s su poveikio<br \/>\ntrukme ir ligos suk\u0117l\u0117ju.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>EPIDEMIOLOGIJA<\/strong><\/p>\n<p style=\"text-align:justify\">Aki\u0173<br \/>\n traumos sudaro 5% vis\u0173 traum\u0173, i\u0161 j\u0173 15% sudaro nudegimai, i\u0161 pastar\u0173j\u0173<br \/>\n 80% \u2013 \u2013 cheminiai nudegimai. Apie 20% pacient\u0173 su veido nudegimais<br \/>\npatiria ir aki\u0173 nudegim\u0105. Daugiausiai cheminius nudegimus sukelia<br \/>\n\u0161armai. Norvegijoje 15% vis\u0173 chemini\u0173 nudegim\u0173 sukelia \u017euv\u0173 tul\u017eis.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>LIGOS PRIE\u017dASTYS IR EIGA<\/strong><\/p>\n<p style=\"text-align:justify\">Aki\u0173 nudegimai skirstomi \u012f dvi dideles grupes:<\/p>\n<p style=\"text-align:justify\">1)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; terminius ir<\/p>\n<p style=\"text-align:justify\">2)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; cheminius.<\/p>\n<p style=\"text-align:justify\">Terminius<br \/>\n nudegimus sukelia \u012fkait\u0119 metalai, verdantis vanduo ar vandens garai,<br \/>\nliepsna. Visus cheminius nudegimus galima skirstyti: 1) nudegimas<br \/>\nr\u016bg\u0161timis; 2) nudegimas \u0161armais. R\u016bg\u0161tys, reaguodamos su akies<br \/>\naudiniais, sukelia koaguliacin\u0119 nekroz\u0119, t. y. susida\u00adro netirp\u016bs<br \/>\nalbuminatai, kurie neleid\u017eia r\u016bg\u0161tims skverbtis giliau. \u0160armai sukelia<br \/>\nkolikvacin\u0119 nekroz\u0119, t. y. suskystina baltymus ir greitai skverbiasi<br \/>\ngilyn. Vadinasi, \u0161armai sukelia sunkesnius pakitimus akies audiniuose<br \/>\nnegu r\u016bg\u0161tys. Chemini\u0173 nudegim\u0173 sunkumo laipsnis priklauso nuo dau\u00adgelio<br \/>\n faktori\u0173: med\u017eiagos chemini\u0173 savybi\u0173, temperat\u016bros, kontakto su akies<br \/>\naudiniais laiko, sl\u0117gio, su kuriuo chemin\u0117 med\u017eiaga patenka \u012f akies<br \/>\naudinius ir kt.<\/p>\n<p style=\"text-align:justify\">Atsi\u017evelgiant \u012f patologinio proceso eig\u0105 ir su tuo<br \/>\n susijusius simptomus, bet kokios etiologijos aki\u0173 nudegimai skirstomi \u012f<br \/>\n keturis laipsnius:<\/p>\n<p style=\"text-align:justify\">I\u00b0 (lengvo laipsnio nudegimas) \u2014 vok\u0173 ir jungin\u0117s paraudimas, ragenos epitelio erozija.<\/p>\n<p style=\"text-align:justify\">II\u00b0<br \/>\n (vidutinio sunkumo nudegimas) \u2014 vokuose \u2014 p\u016bsl\u0117s, jungin\u0117 pabalusi (d\u0117l<br \/>\n ischemijos), ant jos gali b\u016bti pl\u0117vi\u0173, ragenos pavir\u0161utiniai<br \/>\nsluoks\u00adniai drumsti, pavir\u0161ius nelygus, jos taktilinis jautrumas<br \/>\nsuma\u017e\u0117j\u0119s. Pro ragen\u0105 galima \u012f\u017ei\u016br\u0117ti rainel\u0119 ir vyzd\u012f.<\/p>\n<p style=\"text-align:justify\">III\u00b0<br \/>\n(sunkaus laipsnio nudegimas) (97 pav.) \u2014 vokuose vis\u0173 odos sluoksni\u0173<br \/>\nnekroz\u0117, jungin\u0117je \u2014 gili nekroz\u0117, ischemija, jungin\u0117 puri, joje matyti<br \/>\ntamsios u\u017esikim\u0161usios kraujagysl\u0117s, ragenoje \u2014 nekroz\u0117, intensyvi<br \/>\ndrumstis, primenanti matin\u012f stikl\u0105. Pro ragen\u0105 rainel\u0117 ne\u012f\u017ei\u016brima,<br \/>\nma\u00adtyti tik vyzd\u017eio kont\u016brai.<\/p>\n<p style=\"text-align:justify\">IV\u00b0 (labai sunkaus laipsnio<br \/>\nnudegimas) \u2014 vokuose \u2014 odos ir poodi\u00adn\u0117s l\u0105stelienos nekroz\u0117 (gali b\u016bti<br \/>\niki akiduob\u0117s kaul\u0173), jungin\u0117je \u2014 gili nekroz\u0117, jungin\u0117 bly\u0161ki, ragenoje<br \/>\n \u2014 gili nekroz\u0117 ir intensyvi drumstis, primenanti porcelian\u0105. Gilesni\u0173<br \/>\nakies darini\u0173 per toki\u0105 ragen\u0105 ne\u012fmanoma pamatyti.<\/p>\n<p style=\"text-align:justify\">Esant III\u00b0 \u2014<br \/>\nIV\u00b0 nudegimams, ragena gali perforuoti d\u0117l jos nekroz\u0117s. Tai labai sunki<br \/>\n komplikacija. Po III\u00b0 \u2014 IV\u00b0 nudegim\u0173 lieka grub\u016bs vok\u0173 randai, vokai<br \/>\nneu\u017edengia akies obuolio, lagophthalmus, kartais atsiranda akies obuolio<br \/>\n ir vok\u0173 jungin\u0117s s\u0105augos \u2014 symblepharon. Jei nudegimas sunkus, beveik<br \/>\nvisuomet jis sukelia iridociklit\u0105 ir akies hipertenzij\u0105. Po III\u00b0 \u2014 IV\u00b0<br \/>\nragenos nudegim\u0173 joje lieka grubios, vaskuliarizuotos drumstys. Regos<br \/>\na\u0161trumas labai suma\u017e\u0117ja. Akies audini\u0173 (ypa\u010d ragenos) regenera\u00adcija<br \/>\ntrunka labai ilgai.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>KLINIKA<\/strong><\/p>\n<p style=\"text-align:justify\">Bendriniai simptomai:<\/p>\n<ul>\n<li>Aki\u0173 skausmas<\/li>\n<li>A\u0161arojimas<\/li>\n<li>Reg\u0117jimo sutrikimai<\/li>\n<li>\u0160viesos baim\u0117<\/li>\n<li>Akies paraudimas<\/li>\n<li>Pablog\u0117j\u0119s matymas<\/li>\n<li>Reg\u0117jimo praradimas<\/li>\n<li>Atskiri simptomai:<\/li>\n<li>Terminiai nudegimai \u2013 kontakto buvimas su kar\u0161tu daiktu, net jei<br \/>\npa\u017eeid\u017eiamas didelis plotas tai pavir\u0161iniai nudegimai, a\u0161arojimas,<br \/>\n\u0161viesos baim\u0117, svetimk\u016bnio poj\u016btis.Ragenos nudegimai \u012fvyksta kai \u017emogus<br \/>\nnori pasprukti i\u0161 degimo zonos ir yra pramerk\u0119s akis.<\/li>\n<li>Cheminiai<br \/>\n nudegimai \u2013 paprastai \u0161ios med\u017eiagos patenka \u012f ak\u012f pur\u0161kiant ar<br \/>\ntryk\u0161tant; \u0161armai sukelia da\u017eniau, ir stipriai pa\u017eeid\u017eia.<\/li>\n<li> UV \u2013 b\u016bdinga a\u0161arojan\u010dios, skausmingos akys.<\/li>\n<\/ul>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>DIAGNOSTIKA<\/strong><\/p>\n<p style=\"text-align:justify\">Pirmiausiai<br \/>\n ap\u017ei\u016brint nustatomas regos a\u0161trumas ir akies pH. Po gausaus akies<br \/>\ndr\u0117kinimo akis i\u0161tiriama visi\u0161kai. Regos a\u0161trumas b\u016bna suma\u017e\u0117j\u0119s, ph<br \/>\npoky\u010diai b\u016bdingi nudegimams chemin\u0117mis med\u017eiagomis. Nustatoma gausi<br \/>\njungin\u0117s, odenos injekcija (kraujagysli\u0173 i\u0161ry\u0161k\u0117jimas), odenos<br \/>\nbly\u0161kumas, ragenos defektai, neskaidrumas; u\u017edegimin\u0117 reakcija akyje,<br \/>\nglaukoma, akies obuolio perforacija. Fluorescencinis ap\u0161vietimas nurodo<br \/>\ntiksli\u0105 pa\u017eeidimo viet\u0105. Esant UV sukeltam nudegimui nustatomas ta\u0161kinis<br \/>\n keratitas ( ragenos u\u017edegimas).<br \/> I\u0161 laboratorini\u0173 tyrim\u0173 atliekama tik pH nustatytmas ( suma\u017e\u0117j\u0119s b\u016bdingas nudegimams r\u016bg\u0161timis, padid\u0117j\u0119s &#8211; \u0161armais).<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>GYDYMAS<\/strong><\/p>\n<p style=\"text-align:justify\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<br \/>\n 1. Pirmoji pagalba &#8211; gausus plovimas, kad pa\u0161alintume kenksming\u0105<br \/>\nmed\u017eiag\u0105. Chemini\u0173 nudegim\u0173 atvejais \u012fvykio vietoje reikia labai skubiai<br \/>\n ir ilgai (10\u201420 min.) plauti jungin\u0117s mai\u0161el\u012f, naudojant daug vandens.<br \/>\nIdealus atvejis, kai naudojamas sterilus fiziologinis druskos tirpalas.<br \/>\nHipotoniniai tirpalai, tokie kaip vanduo gali sukelti gilesn\u012f ragenos<br \/>\npa\u017eeidim\u0105, d\u0117l didesnio rasgenososmozinio sl\u0117gio. Plauti akis kuo<br \/>\npla\u010diau atsimerkus, galima panaudoti vietin\u0119 anestezij\u0105. <br \/> <br \/>\n&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2. Antibakterin\u0117 terapija &#8211; kovai su infekcija<br \/>\nnaudojami dezinfekuojantys tirpalai Sol. Sulfacyli natrii 15\u201420%,<br \/>\nvietiniai antibiotikai (ciprofloxacin). <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 3. Antitetanin\u0117 imunizacija. <br \/>\n &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 4. Med\u017eiag\u0173 apykaitos ir regeneracijos<br \/>\nskatinimas. Tuo tikslu naudojami vazodilatatoriai, etilmorfino tirpalas<br \/>\nla\u0161ais, vitamin\u0173 la\u0161ai, \u0161altalankio aliejus la\u0161ais ir kt. <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 5. Skausmo mal\u0161inimas &#8211; analgetikai (diklofenac) <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 6. Midriatikai (vyzd\u012f i\u0161ple\u010diantys vaistai) &#8211; kad nesusidaryt\u0173 u\u017epakalin\u0117s s\u0105augos (homatropine). <\/p>\n<p> Esant giliems nudegimams taikomas chirurginis gydymas, ragenos plastika, vok\u0173 plastika ir kt.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>PROFILAKTIKA<\/strong><\/p>\n<p style=\"text-align:justify\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1. Naudokite akinius dirbdami su j\u0117gos instrumentais, gr\u0105\u017etais, pj\u016bklais, plaktukais ir kt. <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2. Netrinkite aki\u0173. <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 3. Suvirintojams b\u016btina apsaugin\u0117 kauk\u0117. <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 4. B\u016bdami saul\u0117je ne\u0161iokite akinius nuo saul\u0117s, ne\u017ei\u016br\u0117kite tiesiai \u012f saul\u0119.<\/p>\n<div style=\"text-align:justify\"><\/div>\n","protected":false},"featured_media":0,"template":"","tags":[161,28320],"catalog_supplier":[],"catalog":[27442],"class_list":["post-30793","catalog_entry","type-catalog_entry","status-publish","hentry","tag-akiu-ligos","tag-akiu-nudegimas","catalog-akiu-ligos"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_entry\/30793","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_entry"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/catalog_entry"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=30793"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=30793"},{"taxonomy":"catalog_supplier","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_supplier?post=30793"},{"taxonomy":"catalog","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog?post=30793"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}