I keah pawh hliam dam lo i nei em? He 'Vascular Ulcer' chungchang hi i zir chiang ang u!

A chang chuan i keah hliam a lo lang a, a bik takin i groin emaw, i ke ruh emaw a lo lang a, a dam rei vak lo tih i hre ngai em? Hei hi nang pawhin i tawng ve tawh mai thei. Hengte hi hliam pangngai a ni lo. Hengte hi ‘Vascular Ulcers’ kan ti a, Sinhala tawngin ‘vein ulcers ’ tihna a ni. A awlsam zawngin sawi ila, hengte hi kan taksaa thisen kal tha lo vanga vunah hliam a awm thin a ni. Hemi chungchang hi vawiinah hian chipchiar deuhin han sawi ila, a chhan chu hei hi mi tam tak nghawng thei thil a nih vang a ni.

Vascular ulcer hi eng nge ni?

A awlsam zawngin, venous ulcers hi kan vunah hliam a awm a ni. Mahse hengte hi hliam eng pawh a ni lo. Kan taksaa thisen kal dan, chu chu circulatory system-a harsatna awm vang a ni. A tam zawkah chuan heng hliamte hi kan ke ruh, a bik takin ke hnuai leh ke hnuai lam ah hmuh tur a awm. Mahse hmun dangah pawh an awm thei. Heng hliamte hi a dam theih nan hun rei tak a daih a , a chang chuan surgery ang chi enkawlna bik a ngai thei bawk.

Heng venous ulcers te hi chhan lian tak pahnih a awm a.

1. Pakhat chu kan thisen kalna kawng ( arteries) a thisen kal chak lohna hi a ni . Arteries hi taksain a mamawh ei tur leh oxygen a hmuhna hmun a ni. Chuvangin hengte hi harsatna a awm chuan hliam a lo awm thin.

2. A chhan dang chu kan thisen kalna kawng tha lo vang a ni . Vein kaltlangin thisen chu taksaa bawlhhlawh awmte nen thinlungah a hruai kir leh thin. Hengte hi harsatna a awm chuan hliam a awm thin.

Chung zinga a tam ber chu thisen zam chhunga hliam awm a ni a, chu chu venous ulcers kan ti bawk.

Heng hliamte hi engtiang chiahin nge an awm?

Dik tak chuan heng venous ulcer te hi i ngaihtuah aiin a tam zawk a, a bik takin i kum upat deuh deuh chuan. A vaiin puitling 1% velin he natna hi an nei thei a ni. Kum 65 chunglam zingah he percentage hi 3% leh 5% inkar a ni thei. Chuvangin hei hi ngaihthah tur a ni lo.

Engtin nge heng venous ulcer te hian kan taksa a nghawng?

Heng hliamte hian i nunah nghawng tha lo chi hrang hrang a nei thei a ni. Ngaihtuah teh...

• Hri kai theihna a sang: Kan vun hi hrik laka min vengtu shield ang a ni. Chuvangin hetiang hliam hi chu chu shield-a breach a ni a, awlsam takin taksaah natna hrik a lut thei a ni.
• Sepsis: Infection hi enkawl tha a nih loh chuan taksa pum puiah a darh thei a, sepsis tih hming pu natna hlauhawm tak a thlen thei a ni. Hei hi kan immune system hian infection lian tak a overreact a, taksa peng hrang hrang a tihchhiat tan hian a ni.
• Gangrene: Infection vang emaw, hliama thisen kal loh vang emaw pawh nise, hliam chhehvela cell awmte chu an thi tan thin. Hei hian gangrene tih natna a thlen thei a ni . Enkawl loh chuan a darh thei a, thihna hial a thlen thei bawk.
• Natna leh kal harsa: 1.1.Heng venous ulcer te hi a na thei hle. Ulcer awmna hmun azirin hna i thawk thei lo a, i muhil thei lo va, nitin hna i thawk thei lo bawk. Taksa tihchak hian thisen kal a titha a, ulcer natna avanga i kal theih loh chuan ulcer chu a na zual thei a ni.

Pawimawh tak: Heng hliamte hi a tenau a nih avangin ngaihthah suh. Damdawi lam thurawn lak vat a pawimawh hle.

Eng nge a lan chhuah dan?

Venous ulcer natna lan chhuah dan hi a chhanah a innghat a, a chang chuan vawi khatah chhan hrang hrang a awm thei bawk.

Venous Ulcers / Stasis Ulcers natna lan chhuah dan

Heng symptoms te hi venous ulcers lo awm hmain a lang fo thin:

• Kea sa chu a sen a, a hring bawk.
• Vun chu a thim a, a khauh a, a rawng dum (a tlangpuiin a sen, a sen emaw, a sen emaw) a lo ni ta a ni.
• A natna hmunah hian rilru hahna leh natna (itching) a awm thei (hei hi ‘stasis dermatitis’ kan ti a ni ).
• Varicose veins hi vein lama harsatna lo awm theihna chhinchhiahna tlanglawn tak a ni.

Stasis ulcer hian a tlangpuiin a hnuaia mi ang hian a nei a:

• Hliam hi ke ruh vel a awm fo thin.
• Hliam hi a thuk lo va, a sen atanga sen thlengin a khuh thei bawk.
• A hliamte pianzia chu a mumal lo va, a sir lam pawh a inang lo hle.
• Hliam vel vun chu a eng thei a, a inzawm khawm angin a lang thei bawk.
• Chu hmun chu hmun dang aiin a lum zawkin a lang thei.
• A hliam hi a na a, thisen emaw tui emaw ang chi tui a chhuak thei bawk. Hri kai an nih chuan rimchhia leh rimchhia an nei thei.

Arterial Ulcers natna lan chhuah dan

Heng symptoms te hi arterial ulcers lo awm hmain a lo lang thei a ni:

• Hliam vel vun chu a eng a, a vawt bawk. Tight leh flaky angin a lang thei bawk.
• Thisen kal tha lo vangin sam a tlakchhiat hi kut/ke natna hmunah emaw, hliam bulah emaw a awm thin.
• I mut emaw, i ke i chawi sang emaw hian thisen kal khap theih a ni. Hei hian i ke a ti sen thei a, a vawt bawk. I ke i chawi sang emaw, i mut emaw hian i ke a na thei. (He natna hi i ke hnuai lam hawia dah hian a reh thei. Thisen kal dan pangngaia a lo kir leh chuan i ke pawh a sen thei bawk.)

Arterial ulcers hian a tlangpuiin a hnuaia symptoms te hi a nei thin:

• Thinlung atanga hla ber taksa peng hrang hrangah hliam a awm tan a, a bik takin ke ruh leh ke ruh inkar ah te hian hliam a awm tan thin.
• A hliamte hi a rawng dum (a bik takin sen, sen, sen, dum) angin a lang.
• Hliam hi a thuk a, a chang chuan taksa ruh emaw, ruh emaw pawh a lang chhuak thei.
• Hliam chhehvel kilte chu nawr chhuah ang mai a ni.
• Hliamte chu thisen a chhuak lo thei a, na pawh a awm lo thei bawk.

Hetiang dinhmun hian tute nge a nghawng nasa ber?

Venous ulcer hi kum upa lam emaw, hriselna lama harsatna engemaw nei emaw, a bik takin thinlung leh thisen kalna lama harsatna nei te zingah a tam zawk. Hemi nena inzawm condition hrang hrangte chu:

• Zunthlum (Diabetes Mellitus) natna a ni.
• Thau lutuk
• Peripheral Vascular Diseases - chu chu Peripheral Artery Disease (PAD) emaw, Peripheral Venous Disease (PVD) emaw tihna a ni.
• Lung leh thisen zam natna
• Thisen sang (Hypertension) 1.1.
• Meizial zu leh zuk leh hmuam hman

Natna a awm loh pawhin chhan dang avanga thisen kal a tihbuai chuan venous ulcer a lo awm thei a ni. Entir nan:

• Hliam: Kang, kang leh taksa ruh hliam te hian a bul hnaia thisen kalna kawng a tichhe thei a, thisen kal danah harsatna a thlen thei bawk.
• Hun rei tak ding: Mi che thei lova rei tak ding (cashier, Bakery worker, hotel-a thawk ang chi) te chuan an ke ruh (vein)-ah thisen a inzawm khawm thei a ni. Vein chhunga valve te hian hna a thawk tha lo a nih chuan thisen chu thinlungah a luang leh tha lo. Hei hian veins te chu pressure nasa lutuk a siam a, a ti lian a, ‘Varicose Veins’ a siam thin. Chumi hnuah chuan vein atang hian fluid chu a chhehvel tissue ah a leak lut a, chu chuan a ti hring chhuak thin. He tui hian thisen leh protein te nen hian keah brown spot a siam thei a, a bik takin groin area chhungah hian brown spot a siam thei a ni. Hei hian a ti na thei a, vun a vawt thei a, a chhe thei bawk. Bacteria te hian heng crack te hi lutin vun natna ‘Cellulitis’ an tih emaw, veins nena inzawm hliam emaw a siam thei a ni.
• Chhungkaw chanchin: I chhungkuaa mi tu emaw hian hetiang hliam hi a nei tawh a nih chuan nang pawhin i vei theihna tur hlauhawm i ni thei.

Engvangin nge heng hliam chi hrang hrang hi a lo awm? A chhante chu engte nge ni?

Venous ulcer hi a chhan bulpui a zirin kan thliar hrang thei tlangpui. Mahse, ulcer pakhat hian chhan hrang hrang a nei thei. Chumi entirnan tha tak chu zunthlum avanga venous ulcers lo awm hi a ni.

• Stasis Ulcers: Hengte hi thisen zam lama harsatna awm vang a ni. Venous ulcer tam zawk hi he category-ah hian an tel a ni. I upat deuh deuh chuan ke leh keah an tam zawk. Hei hi kea vein-a valve-te’n an hna an thawh that loh chuan a thleng thin. Chumi awmzia chu thinlunga chho tur thisen chu gravity vangin a hnuai lam a luang thei lo tihna a ni. Chumi avang chuan ke leh keah thisen tam zawk a pungkhawm a, thisen kalna kawngte chu pressure a siam nasa zawk a ni. Hetiang pressure hian veins te chu tui a leak thei a, a puak thei hial a ni. Hun a kal zel a, hei hian ulcer a thlen thei a ni.
• Arterial Ulcers: Hengte hi ‘Ischemic Ulcers’ an ti bawk. A natna hmuna thisen kal tlakchham vang a ni. Hei hi ‘Ischemia’ kan ti a.A ti bawk. Thisen inkalpawhna a tlakchham avangin taksa peng (a tam zawkah chuan kut emaw ke emaw) chu a thi zauh zauh thin.

Engtin nge hei hi i hriat chian? Engtin nge doctor-te hian an hriat chhuah?

Doctor chuan venous ulcer chu a enfiah chuan rang takin a hre thei a ni. Hliam chu ngun takin a en ang a, a chhehvel chu a palpate mai thei a, a natna lan chhuahna bik a awm leh awm loh a enfiah bawk ang.

Amaherawhchu, Doctor pawhin a hliam chhan a hriat chian a ngai bawk. Hliam enfiah laia thu hriatte pawhin hei hi a pui dawn a ni. Mahse, a chhan dik tak hriat chian nan test ṭhenkhat pawh tih a ni ang. Hei hi a chhan chu venous injuries tichhe thei thil engemaw zat a awm thei a, heng chhante hi a inzawm tlat thei a ni.

Eng test nge tih a nih?

I doctor emaw specialist emaw chuan heng test te hi a ti thei ang:

• Thisen sang tehna: Doctor in i kut a thisen sang a teh ang. Tin, i kea thisen sang chu a teh ang a, an pahnih inkarah hian danglamna a awm em tih a en ang. He test hi Ankle-Brachial Index (ABI) test an ti a ni.
• I thinlung ngaihthlak leh i pulse enfiah: I thinlung leh thawk dan ngaihthlak hian i doctor chuan venous lesions thlentu tur thinlung natna hnuaia awm a awm tih finfiahna a zawng thei a ni. I ke hnuai leh ke hnuai lam pulse (peripheral pulses) te pawh an hre thei bawk. Heng pulse chakna — emaw, pulse hriat loh chuan — i doctor chu chiang zawka diagnosis siam turin a pui thei a ni.
• Thisen test: Thisen test hian i doctor chu a natna hriat theihna tur leh i hliam enkawl dan tur a rel theih nan a pui thei a ni. Test bik pakhat chu A1C hemoglobin test a ni . Hei hian zunthlum i vei leh vei loh hriat theih nan leh, i vei a nih chuan engtiang chiahin nge a nasat tih hriat theih nan a pui thei a ni.
• Imaging: I doctor chuan hliam chauh ni lovin a chhehvela thisen kal dan pawh en turin imaging test a ti thei ang. Taksa hmun danga thisen kalna kawng lian leh thisen kalna kawng (vein) lian tham tak takte imaging test neih tir an ti thei bawk a, hengte hian thisen kalna kawng (vascular injury) nena inzawm harsatna a lantir thei bawk. Heng test-ah hian X-ray, MRI, CT scan , leh ultrasound te pawh a tel thei.

Heng hliamte hi tihdam theih a ni em? Enkawlnate chu engte nge ni?

A tam zawkah chuan venous ulcer hi a dam thei a ni. Mahse, hliam dam theihna chance chu a nasat danah a innghat a ni. Chuvangin, venous ulcers enkawl vat hi result tha tak neih nan a pawimawh hle.

Hliam thlentu harsatna bulpui (underlying problem) pawh chinfel a pawimawh hle. I doctor chuan hliam chu a enkawl ang a, i hriselna lama harsatna awm thei zawng zawng chu enkawl dan tur a rawt ang. A rawtna ṭhenkhat chu i nunphung tihdanglamna a ni ang. Heng inthlak danglamna te hian hliam dang i neih theihna tur a tihziaawm thei a, i nunphung zawng zawng a tichangtlung thei bawk.

Enkawl dan tur

Venous ulcers nasat dan leh a chhan a zirin enkawlna hrang hrang hman a ni.

Damdawi chi hrang hrang

• Antibiotics: Hengte hian natna hrik a tidam thei a, a then phei chuan (zai a nih hnu ang chi) natna kai loh nan pek thin a ni bawk.
• Topical gels leh ointment: Hengte hian tissue thi emaw, hri kai emaw chu a paih chhuak a, a natna hmuna thisen kalna a tichak a, natna hrik a veng a, hliam chu a dam thuai thei bawk.
• Buaina bulpui enkawlna atana damdawi: I thisen sang leh cholesterol control te, meizuk bânsan te, leh i thisen sugar level control te ang chi thilte hian hliam a tidam thei a ni.
• Painkiller emaw numbing damdawi emaw: Venous ulcer leh a enkawl dan thenkhat chu a na thei hle. Enkawl lai hian natna tidamtu emaw, numbing damdawi emaw hman hi a awm fo.

Bandage leh dressing te pawh a awm bawk

Venous ulcer enkawlna atan hian bandage leh bun theih chi hrang hrang hman a ni tlangpui. Hengte hi doctor-in a tih ang chauha hman tur a ni. A hman dik loh chuan venous ulcer chu a tha zawk ai chuan a na zual thei a ni.

• Bandaging: Hliam chu venhimna bandage hmanga khuh hian natna hrik lakah a veng thei a ni. Bandage thenkhatah chuan damdawi a awm thei bawk a, chu chuan hliam chu a dam thuai thei a ni.
• Compression garments: Chung zingah chuan socks, stocking leh thil dang te pawh a tel. Ke zawng zawngah pressure an pe a, chu chuan a hring (swelling) tihtlem emaw, tihtawp emaw a pui a ni. Venous ulcers tan an hmang tlangpui. Ke leh kea thisen a awm loh nan an pui thin.
• Specialized shoes, socks emaw orthotic devices: Venous ulcer tam tak, a bik takin diabetic ulcer hi simple friction leh pressure vang a ni. A tlangpuiin natna i hriat hian i kal dan i thlak danglam a, a natna hmuna chhiatna chu i tihtlem phah thin. Mahse, hei hi zunthlum ulcer-ah chuan a ni lo. Kea hriatna hloh vek emaw, a then emaw avanga lo awm an ni fo.

Thiltih dan hmasawn tak tak

Heng enkawlna hmasawn tak takte hi hliam lian tak tak, emaw, venous hliam dam rei tak tak tan pawh hman theih a ni.

• Revascularization: Thisen kalna kawng pawimawh tak takte blockage hian venous ulcers a thlen thei. Revascularization treatment hian heng blockage te hi paih chhuah a tum a, ulcer awmsa te chu tihdam a ni a, ulcer thar lo piang tur a veng bawk.
• Surgery: Hliam hrik kai emaw, lian leh tihdam harsa tak takte chu operation tih theih a ni. Surgeon chuan hliam thuk tak ( ‘Debridement’ ) atanga tissue thi emaw, natna hrik emaw paih chhuah tumin operation a ti thei a, chu chuan hliam chu a dam awlsam phah thei a ni. Hei hian a huam thei ang:Skin grafts leh siamthat dan dang pawh hman theih a ni. .
• Prescribed walking: Taksa tihchakna, a bik takin damdawi lam thurawn nena tih hian thisen kal dan a tichak a, venous ulcer thar siam a veng bawk.
• Hyperbaric oxygen therapy: Kan chhehvela oxygen level pangngai chu 21% a ni. ‘Hyperbaric oxygen therapy’ ah chuan 100% oxygen concentration leh atmospheric pressure sang zawk awmna chamber-ah dah i ni. Heng dinhmun hnuaiah hian hliam, a bik takin venous hliam te hi a dam rang thei hle.
• Debridement: Hliam thuk tak leh a chhehvela tissue thi leh hri kai te hian a damna a tikhawtlai thei a, gangrene ang chi harsatna hlauhawm tak tak a thlen thei bawk. Debridement-ah hian he tissue thi emaw, hri kai emaw hi lakchhuah a ni a, tissue hrisel chauh a awm ta a ni.

Engtin nge symptoms te hi enkawl dan tur leh risk tihtlem dan tur?

Venous ulcer vei theihna hlauhawm i nih chuan i hriselna humhimna tur leh ulcer lo awm tur venna tur thil i tih theih a awm. Hei hi zunthlum emaw, i kea sensation tihziaawmna tur natna dang emaw i neih chuan a pawimawh hle.

• Mahni in enfiah: Nitin i ke i enfiah thin. Ke ruh inkar te, ke ruh vel te, kephah hnuai lam te chu a bik takin ngaihven rawh.
• I ke venghim: I ke chu hliam laka venghim la, kekawrte leh socks in fit tha tak bun la.
• Ke enkawl dan dik: Zunthlum i neih chuan podiatrist pan fo tur a ni a, i keah ulcer chhinchhiahna a awm leh awm loh enfiah thin tur a ni. I ke enkawl dan tur tha ber tur a fuih ang che.
• Damdawi lam dinhmun hnuaia awmte control: I thisen sang, cholesterol, thisen sugar level, leh i rihna ang chi thilte enkawl hian hliam i neih loh nan a pui thei a ni.

Venous ulcer i neih tawh chuan i doctor chuan a enkawl dan tur a kaihruai ang che. A hnuaia mite hi a fuih fo ang che:

• Hliam fai taka vawng tur: Bandage hmang la, doctor-in a tih angin thlak rawh.
• Thurawn angin chawlh hahdam rawh: Venous ulcer i neih chuan i doctor chuan i ke chu a hring lo turin a ti sang ang che.
• I damdawi ei dik: I damdawi ei tur chu a hun takah ei la, a bik takin antibiotics, thisen sang, zunthlum, leh cholesterol sang damdawi te hi ei thin ang che.

He hliam tuar chung hian eng nge i beisei theih ang?

Venous ulcer i neih chuan, emaw, a hmain i nei tawh a nih chuan, a dang i vei theihna a sang zawk. I hriselna enkawl hi ulcer thar lo awm tur tihkhawtlai dan tha ber a ni. I hriselna i enkawl chuan a pumpuiah i dam rei zawk a, hriselna lama harsatna i nei tlem zawk bawk.

A lehlamah chuan i hriselna i enkawl loh chuan venous ulcer – leh i hriselna zawng zawng – a na zual sauh sauh a ni. A chhe berah chuan ulcer leh i hriselna i ngaihthah chuan ke ruh tliak a thlen thei a, thihna thlengin a thlen thei bawk.

Engtikah nge doctor i hmuh ang?

Kum khatah vawi khat tal i chhungkaw doctor hmu la, taksa enfiahna kimchang neihpui rawh. Hei hi hriselna lama harsatna awmte hriatchhuahna atan a pawimawh a, chutah chuan vascular lesions thlen thei te pawh a tel a, symptoms a lan loh pawhin.

Tin, a hnuaia mi te hi i neih chuan i doctor nen inbia ang che:

• I ke emaw i ke emawa hliam chu a dam theih beisei aia rei a duh chuan.
• I keah thisen kal danah harsatna i nei tih hriat theihna symptom i neih chuan (a bik takin i ke i vawn dan azira a inthlak danglam thin, a hring, a na, a rawng a danglam, a ni).
• I keah natna i neih chuan chawlh hahdam chuan a tha zawk thin.

Engtikah nge Emergency Room-ah i kal ang?

Venous hliam i neih chuan natna a lo awm a, heng symptoms te hi i neih chuan emergency room-ah i kal tur a ni:

• A natna hmun vel vun chu a dum emaw a dum emaw a nih chuan, a bik takin kut zungtangah chuan.
• Khawsik emaw, khawsik emaw i neih a, i khur a nih chuan.
• Venous hliam atanga rimchhia lo chhuak a awm chuan.
• Venous wound-ah hian a tlangpui aia tui emaw thisen emaw a chhuak tam a nih chuan, a bik takin tui chhuak chu chhum emaw, sen emaw a nih chuan.
• Hliam leh a chhehvel chu a hring a, a sen a, khawih pawhin a lum a nih chuan.

A tawi zawngin, take-home message:

Vascular ulcers hi a tlangpuiin hriselna lama harsatna awm thei (underlying chronic health condition) chhinchhiahna a ni. Heng dinhmunte hi pawi tak ni mah se, enkawl theih a ni a, i nun i hlim thei bawk. Hlauthawng leh hlauthawng suh.

I doctor chuan a kaihruai thei che a, a tul ang ang a pe thei che a, puihna dang pawh a pe thei bawk che a ni. Heng zawng zawng hian natna khirh tak takte’n i nun a tihbuai loh nan leh i duh ang nun i hman theih nan a pui ang che. Damdawi lam thurawn lak hmasak a pawimawh. I ke enkawl la, i hriselna enkawl rawh.

` Venous hliam, thisen kalna lama harsatna, ke hliam, venous hliam, arterial hliam, zunthlum hliam, dam lo hliam