Newsy Obok slidera Owrzodzenia Profilaktyka

Jak nie dopuścić do nawrotu owrzodzenia? 7 najważniejszych rad

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Owrzodzenie żylne kończyn dolnych to schorzenie, na które najczęściej zapadają osoby między 50. a 80. rokiem życia. Według badań nawet połowa pacjentów cierpiących na owrzodzenia żylne goleni zmaga się z nawracającymi ranami. Co robić, by zapobiec nawrotom?

Owrzodzenia powstają wskutek przewlekłej niewydolności żylnej wywołanej najczęściej chorobami układu krążenia, takimi jak zakrzepica żył dolnych. Zaburzenia drożności naczyń żylnych prowadzą do niedotlenienia tkanek, w wyniku czego są one bardziej narażone na powstawanie urazów, których gojenie jest utrudnione.

Zaleganie krwi i utrzymujący się wpływ nadciśnienia w żyłach kończyny sprawia, że rany mogą nawracać, zwłaszcza jeśli występują także inne czynniki ryzyka – niestosowanie kompresjoterapii, zaburzenia ortopedyczne, otyłość, brak aktywności fizycznej, nieprawidłowa dieta czy palenie tytoniu. Z tego powodu nawet po wygojeniu owrzodzenia pacjent powinien stosować się do zaleceń, które pozwolą utrzymać prawidłowe krążenie żylne i zapobiec obrzękom. Jakie działania można podjąć, by uniknąć nawrotu owrzodzenia?

  1. Kompresjoterapia

Terapia uciskowa, czyli kompresjoterapia, polega na wywieraniu kontrolowanego i stopniowanego ucisku na naczynia krwionośne kończyn dolnych. W tym celu używa się specjalistycznych wyrobów uciskowych, m.in. bandaży, opasek, podkolanówek, rajstop oraz pończoch kompresyjnych. Regularne stosowanie kompresjoterapii zmniejsza ciśnienie i objętość krwi w układzie żylnym kończyny, przyspiesza przepływ krwi, hamuje powstawanie obrzęków, redukuje dolegliwości bólowe, poprawia czynność pompy mięśniowej łydki oraz stan skóry i tkanki podskórnej. By kompresjoterapia była skuteczna, należy stosować ją w sposób ciągły.

  1. Farmakologia

W profilaktyce wtórnej owrzodzeń ważną rolę odgrywa leczenie farmakologiczne. Zaleca się przyjmowanie leków o działaniu przeciwzakrzepowym. W przypadku pacjentów, u których niewydolność żylna związana jest z cukrzycą, stosowane są leki mające na celu stabilizację poziomu cukru we krwi, ponieważ jego wahania zaburzają proces gojenia ran. Wdrożone metody farmakologiczne mają na celu zmniejszenie obrzęku, obniżenie ciśnienia i poprawienie krążenia w układzie żylnym.

  1. Regularna aktywność fizyczna

Zaburzenia pracy stawów i mięśni skutkują zaleganiem krwi żylnej, co z kolei nasila nadciśnienie i prowadzi do uszkodzeń tkanek. Owrzodzenia żylne powodują osłabienie mięśni, występowanie stanów zapalnych i doprowadzają do deformacji kości. W efekcie sprawność pacjenta zostaje ograniczona. Chory zmaga się z ograniczoną ruchomością stawu skokowego i zmniejszonym zakresem wykonywanych ruchów, doświadcza również zaburzeń chodu. By zmniejszyć ryzyko nawrotu owrzodzeń, należy stymulować przepływ żylny – zaleca się fizykoterapię i kinezyterapię.

Za szczególnie korzystne ćwiczenia uznaje się te stymulujące pracę mięśni łydki i zwiększające ruchomość stawu skokowego. Zalecaną aktywnością są też codzienne spacery trwające około 30 minut.

Ważne również, by unikać długich okresów bezruchu – powinno się przerywać je prostymi ćwiczeniami, takimi jak poruszanie stopami, napinanie i rozluźnianie mięśni łydek czy naprzemienne podnoszenie nóg w pozycji siedzącej.

Systematycznie podejmowana aktywność fizyczna usprawnia odpływ krwi z kończyn dolnych i pracę pompy mięśniowej łydki oraz poprawia sprawność układu mięśniowego i kostno-stawowego.

  1. Regularne badania kontrolne

Jednym z najistotniejszych elementów profilaktyki wtórnej owrzodzeń jest systematyczne monitorowanie stanu kończyn dolnych. Nawet po wygojeniu rany powinno się kontynuować wizyty w poradniach specjalistycznych – flebologicznej, ortopedycznej, leczenia ran i innych, w zależności od potrzeb pacjenta. Umożliwia to wykrycie pierwszych niepokojących objawów, takich jak wzmożona bolesność, wystąpienie rumienia czy obrzęku. W takim przypadku kluczowa jest szybka reakcja – natychmiastowe wdrożenie leczenia pozwala zapobiec ponownemu pojawieniu się ran.

  1. Dobór odzieży

Odpowiednio dobrana odzież pozwala zmniejszyć ryzyko nawrotu ran owrzodzeniowych. Pacjentom kontynuującym kompresjoterapię zaleca się, by nosili większe o rozmiar buty z miękką podeszwą i o niskim obcasie. Powinno się również zrezygnować ze zbyt obcisłych spodni czy skarpet, ponieważ miejscowy ucisk powoduje zaburzenia w odpływie żylnym.

  1. Zbilansowana dieta

Osobom cierpiącym na owrzodzenie żylne zaleca się zwrócenie szczególnej uwagi na utrzymanie prawidłowej masy ciała. Nadwaga wpływa negatywnie na układ żylny i może być przyczyną powstawania zastojów, co utrudnia przepływ krwi i może skutkować nawrotem ran. Zbilansowana dieta wspomaga także proces gojenia owrzodzeń.

  1. Unikanie zbyt wysokich temperatur

Kolejnym działaniem profilaktycznym, które może wydłużyć czas remisji, jest unikanie zbyt wysokich temperatur – gorących kąpieli, sauny czy długich pobytów na słońcu. Ciepło powoduje rozszerzenie naczyń krwionośnych i tym samym zwiększenie przepływu krwi, co może zaburzyć prawidłowy odpływ krwi z kończyn dolnych.

Źródło: „Nawrotowy charakter owrzodzeń żylnych kończyn dolnych. Problem wciąż aktualny”, w: „Leczenie Ran” 2018;15(2):71–77

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Przeczytaj także: Kompresjoterapia – niedoceniany sposób leczenia chorób żylnych

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  72. Fantastic piece! The article is both informative and interesting. Adding more visuals in your future content could be a great way to elevate the reader experience.

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