MATENDA KULEPHERA KWA SHUGA - MAVUTO NDI MATENDA

Send

Matenda a shuga amakhala ndi zovuta pa thupi la wodwalayo, zimakhudza ziwalo zonse ndi machitidwe. Chimodzi mwazinthu zovuta kwambiri zomwe zimachitika nthawi yayitali matendawa ndi kuwonongeka kwa impso ndi mawonekedwe ake kwambiri - kulephera kwa impso.

Kulephera kwammimba komanso matenda ashuga monga zomwe zimachitika

Kusintha kwanyengo pakapangidwe ndi kagwiridwe ka impso mu matenda a shuga mellitus amatchedwa matenda ashuga nephropathy. Gawo lomaliza lavutoli ndi kulephera kwa aimpso - kuphwanya kwakukulu kwa nayitrogeni, mchere wamchere, ma electrolyte ndi acid-base metabolism, zomwe zimapangitsa kukhala kosatheka kwa magwiridwe antchito onse a ziwalo ndi machitidwe mthupi la munthu.

Zilonda zam'mimba zimapezeka pafupifupi 30-40% ya odwala omwe ali ndi matenda amtundu wa 1 ndi 10% omwe ali ndi matenda a 2. Mbali imodzi, ndi zotsatira za matenda ashuga - vuto la shuga lomwe limakhudza magawo onse amitsempha, kuphatikiza kusefa kwa impso. Makoma amitsempha yamagazi ndi opunduka, mawonekedwe awo amachepetsa, ndipo kuthamanga kwa magazi kumakwera.

Komabe, zovuta zamafuta, mapuloteni ndi chakudya cha metabolism, zomwe zimapangidwa mu shuga, zimayambitsa kuwonjezeka kwakukulu kwa kufalikira kwa zotumphukira izi kudzera mu zida za aimpso, zomwe sizingathe kupirira katunduyu ndikuyamba kuwonongeka.

Palinso njira ina yomwe ingapangidwire chitukuko cha matenda a impso mu shuga. Zofooka zazikulu pakapangidwe ndi impso zimatha chifukwa cha zolakwika zamtundu wa wodwalayo, ndipo matenda ashuga ndi othandizira panjira imeneyi. Kuganiza kumeneku kumatsimikiziridwa mosadziwika bwino chifukwa chakuti nephropathy yokhala ndi vuto lotsatira la aimpso sikhala m'magulu onse odwala matenda ashuga.

Gulu

Kulephera kwamkati kumagawidwa pachimake komanso chovuta.

Fomu yovutaMonga lamulo, limayamba pakanthawi kochepa chifukwa cha poizoni wambiri, kuwotcha kapena kutentha kwa thupi lalikulu, kuchepa kwamphamvu kwamitundu yosiyanasiyana (kusanza mobwerezabwereza, kutsegula m'mimba), kuwonongeka kwamitsempha yam'mimba (ndi urolithiasis, zotupa), kuwonongeka kwamakina impso, matenda ena ndi matenda pachimake aimpso zida (pyelonephritis, nephritis). Ngakhale kuopseza kwambiri komanso kuwopseza moyo, mawonekedwe awa samadziwika ndi kuwonongeka kosasintha kwa ziwalo za chimbudzi, ndipo ngati pali chithandizo chokwanira, patapita nthawi, kuchira kwathunthu kumachitika.
Matenda a shuga amapezeka mawonekedwe osakhazikika yodziwika ndi maphunziro autali (zaka ndi makumi a zaka), pang'onopang'ono zikuwonjezeka ndi kusintha kwa kuwonongeka kosasintha kwa kapangidwe ka impso. Zotsatira zake, magazi samachotsedwa mankhwala oopsa ndipo amapanga uremia - mkhalidwe wamavuto owopsa, oopseza imfa. Mu magawo apambuyo pake, moyo wa wodwalayo umathandizidwa pokhapokha pokhazikika hemodialysis kapena peritoneal dialysis, ndipo kungopatsira impso kokha komwe kungapulumutse vutoli.

Zizindikiro

Zowonongeka za impso mu shuga zimakhala ndi chosasangalatsa: koyambirira, matendawa sazunza wodwala. Pokhapokha ngati kukodzaku kumachulukana, koma izi ndizofanana ndi matenda a shuga ambiri ndipo sizimapangitsa kuti wodwalayo amveke. Zizindikiro zoyambirira zamankhwala zikayamba kuonekera, matenda amapita kutali ndipo chithandizo chimaphatikizapo zovuta zingapo. Zowonetsa kulephera kwa impso komanso uremia ndizambiri:

kufooka wamba, adynamia, chizungulire;
Khungu;
kuchepa, kumachulukitsa kutentha kwa thupi popanda chifukwa chomveka;
oliguria - kuchepa kwa kuchuluka kwa mkodzo wothira, ndikusintha polyuria (kutulutsa mkodzo wowonjezera);
mawonetseredwe a kuchepa kwa magazi - kuchepa kwa khungu, kufupika, tinnitus, ndi zina;
dyspepsia ndi chimbudzi;
matenda oopsa - kuchuluka kosalekeza kwa kuthamanga kwa magazi;
chitukuko cha edema;
azotemia - kudzikundikira m'magazi a mankhwala oopsa a nayitrogeni (urea, ammonia, creatinine, ndi zina), mawonekedwe akunja omwe akhoza kukhala fungo la ammonia mu mpweya wotuluka;
zovuta zosiyanasiyana za zotumphukira ndi chapakati mantha dongosolo (kutentha moto m'miyendo ndi / kapena kumverera kwa "tsekwe zokwera", kugwedezeka, kukokana, chisokonezo, mavuto ogona).

Nthawi zambiri, zizindikirozi zimachitika patadutsa zaka zambiri atazindikira kuti ali ndi matenda ashuga komanso njira yaposachedwa ya nephropathy.

Kuzindikira aimpso kuwonongeka

Palibe chiwonetsero chilichonse chachipatala, ndizotheka kudziwa kuwonongeka kwa matenda a shuga m'magawo oyambira pokhapokha ngati mumawunika pafupipafupi komanso kuyesedwa.

Pafupipafupi kayendetsedwe kamayenera kutsatira:

kumayambiriro kwa mtundu 1 wa matenda ashuga mwana akangobadwa kumene kapena atakula, ndikofunikira kuti ayesedwe zaka 5 mutazindikira kuti ali ndi matendawa, kenako kumayesedwa pachaka;
odwala omwe ali ndi matenda amtundu wa 1 omwe amadwala akatha msanga amakhala pachiwopsezo chachikulu ndipo amakafufuza matenda a impso akangomupeza, kenako amabwereza chaka chilichonse;
Mukapezeka ndi matenda a shuga a 2, muyenera kuyang'ana impso zanu mobwerezabwereza.

Zizindikiro zikuluzikulu za boma la zida za impso ndizomwe zili mkodzo albin(protein), kuchuluka kwake kwamkodzo albin ndi creatininekomanso mitengo yosefera (mwachidule SCF) Zotsalazo zimawerengeredwa malinga ndi njira zapadera zochokera pazomwe zili creatinine m'magazi. Zotsatira zake, tili ndi mayeso ofunikira otsatilira pachaka:

urinalization wa albumin;
urinalization wa creatinine;
kuyezetsa magazi kwa creatinine.

Amatha kuphatikizidwa ndikusanthula magazi ndi mkodzo pafupipafupi ndi kuchipatala. High albin ndi GFR yotsika imawonetsa kukhalapo kwa matenda a impso.

Kupewa komanso kuchiza matenda aimpso mu shuga

Njira yayikulu yochizira ndikukhazikika kwa matenda omwe amayambitsa matenda - shuga - mdziko kubwezera.

Chisamaliro chimayenera kuthandizidwa kuti shuga asadutse malire, makamaka chifukwa cha insulin. Kumwa mankhwala ena ochepetsa shuga ngati nephropathy ndi kulephera kwaimpso sikulimbikitsidwa, chifukwa kungakulitse matendawa.

Kachiwiri pakati pa kugwiritsa ntchito njira zochiritsira ndikutsatira mosamalitsa. Zakudya. Zakudya zokhala ndi zotsika zochepa (koma osapezeka kwathunthu!) Mapuloteni, komanso mchere wochepa, zingakuthandizeni kukhalanso impso zabwino. Mwachilengedwe, mafuta komanso chakudya chamafuta othamanganso amafunikiranso malire, koma izi sizatsopano kwa odwala matenda ashuga. Kuledzera sikuvomerezeka, ndikwabwino kusiya kupatula. Kusiya kusuta fodya kumafunika!

Kukhala kothandiza kumwa mankhwala apadera limodzi - otchedwa nephroprotectorskupereka kagayidwe kolondola mkati mwa zida za impso. Munthawi zonse, dokotala amasankha mankhwalawo. Kutengera kupezeka matenda oopsa ndikofunikira kumwa mankhwala omwe amachepetsa kuthamanga kwa magazi (makamaka kuchokera ku gulu la ACE inhibitors). Ndi concomitant kuchepa magazi erythropoiesis zolimbikitsa zimayikidwa (kaphatikizidwe wama cell ofiira am'magazi), komanso mankhwala okhala ndi chitsulo.

Mu gawo lochepa kwa impso, njira zochepa ndizotsalira. Moyo wa wodwala umatha kuthandizidwa hemodialysis ngakhale peritoneal dialysis. Padziko lapansi pali odwala omwe akhala zaka zoposa 20 kokha kudzera munjira zotere. Njira ina kwa iwo - kupatsidwa impsoKoma, monga mukudziwa, kuchuluka kwa ziwalo zopereka ndizoperewera, mulingo wa zojambulazo ndizochulukirapo, ndipo pantchito yamalonda ndikuwabwezeretsa, ndalama zambiri zimafunikira. Mwachiwonekere, izi ndizosavuta kupewa kupewera kuchiza.