Anthu ena amatcha mtundu wodalirika wa insulin. Nthawi zambiri, amayamba chifukwa cha kupezeka kwa magazi a kuchuluka kwa corticosteroids kwa nthawi yayitali. Awa ndi mahomoni opangidwa ndi adrenal cortex. Zizindikiro zake komanso chithandizo cha matenda a shuga a steroid ziyenera kudziwika kwa aliyense amene wakumana ndi matenda amtunduwu.
Kukula kwa matenda a shuga
Mtundu wodwala wa insulin wodwala matenda ena umatchedwa sekondaleus yachiwiri kapena matenda a shuga. Chimodzi mwazinthu zomwe zimapangitsa kupezeka kwake ndikugwiritsa ntchito mankhwala a mahomoni.
Pogwiritsa ntchito mankhwala a glucocorticosteroid, mapangidwe a glycogen m'chiwindi amalimbikitsidwa kwambiri. Izi zimabweretsa kukulira glycemia. Maonekedwe a matenda osokoneza bongo ndi otheka kugwiritsa ntchito glucocorticosteroids:
- Dexamethasone;
- Hydrocortisone;
- Prednisone.
Awa ndi mankhwala othana ndi kutupa omwe amalembedwa pochiza matenda amphumo a bronchial, nyamakazi, komanso zotupa zingapo za autoimmune (lupus erythematosus, eczema, pemphigus). Amathanso kutumikiridwa chifukwa cha matenda amisempha.
Matendawa amatha kupezekanso chifukwa chogwiritsa ntchito njira zina zoletsa pakamwa komanso thiazide diuretics: Nephrix, Hypothiazide, Dichlothiazide, Navidrex.
Pambuyo kumuyika kwa impso, chithandizo chovomerezeka cha corticosteroid chokwanira chimafunikira. Kupatula apo, atachitapo opaleshoni ndikofunika kumwa mankhwala omwe amachepetsa chitetezo cha mthupi. Koma kugwiritsa ntchito corticosteroids sikuti nthawi zonse kumayambitsa matenda ashuga. Mwachidule, mukamagwiritsa ntchito ndalama zomwe zili pamwambazi, mwayi wokhala ndi matendawa umakulanso.
Ngati kale odwala analibe matenda a metabolism metabolism m'thupi, ndiye kuti pali kuthekera kwakukulu kwakuti pambuyo pochotsa mankhwalawa omwe adayambitsa matenda ashuga, matendawa amakhazikika.
Matenda owopsa
Kutengera mtundu wa matenda ashuga, matendawa amapatsidwa nambala malinga ndi ICD 10. Ngati tikulankhula za fomu yodalira insulin, ndiye kuti codeyo ikhale E10. Ndi fayilo yodziimira payekha, code E11 imaperekedwa.
M'matenda ena, odwala angawonetse zizindikiro za matenda ashuga. Chimodzi mwazinthu zomwe zimayambitsa kukula kwa mtundu wa steroid ndimatenda a hypothalamic-pituitary. Zolakwika mu kugwira ntchito kwa hypothalamus ndi pituitary gland ndizomwe zimayambitsa kusawoneka bwino kwa mahomoni m'thupi. Zotsatira zake, maselo samayankhanso insulin.
Matenda ofala kwambiri omwe amakhumudwitsa matenda a shuga ndi matenda a Itsenko-Cushing. Ndi matenda awa mthupi mumakhala kuchuluka kwa hydrocortisone. Zomwe zimayambitsa matendawa sizinadziwikebe pano, koma zikuwuka:
- mankhwalawa glucocorticosteroids;
- ndi kunenepa kwambiri;
- motsutsana ndi maziko a kuledzera (kosatha);
- pa mimba;
- motsutsana ndi maziko a matenda ena amisempha ndi amisala.
Chifukwa cha chitukuko cha matenda a Itsenko-Cushing's, maselo amasiya kuzindikira insulin. Koma palibe kutchulidwa kolakwika pakugwira ntchito kwa kapamba. Ichi ndi chimodzi mwamagawo osiyana pakati pa mtundu wa shuga wa shuga ndi ena.
Matendawa amatha kupangidwanso mwa odwala omwe ali ndi poyizoni Goiter (matenda a Graves, Bazedova). Njira yogwiritsira ntchito glucose m'misempha imasokonezeka. Ngati, motsutsana ndi zotupa za chithokomirozi, matenda a shuga atakula, ndiye kuti kufunikira kwa insulin kumawonjezeka kwambiri, ndipo minyewa yake imakhala yolimbana ndi insulin.
Zizindikiro za matendawa
Ndi matenda a shuga a steroid, odwala samadandaula za kuwonekera kwa shuga. Alibiretu ludzu losalamulirika, kuwonjezeka kwa ziwopsezo. Zizindikiro zomwe odwala matenda ashuga amadandaula za ma shuga a shuga nawonso sizipezeka.
Komanso, odwala omwe ali ndi matenda a shuga a steroid, palibe zizindikiro za ketoacidosis. Nthawi zina, fungo la acetone limatha kuwoneka kuchokera mkamwa. Koma izi zimachitika, monga lamulo, muzochitikazo pamene matendawa atadutsa kale kale.
Zizindikiro za matenda a shuga a steroid zingakhale motere:
- kukulira moyo wabwino;
- mawonekedwe ofooka;
- kutopa.
Koma kusintha kotereku kumatha kuwonetsa matenda osiyanasiyana, chifukwa chake madokotala onse sangakayikire kuti wodwalayo ayamba kudwala matenda ashuga. Ambiri samapita konse kwa asing'anga, akukhulupirira kuti ndizotheka kubwezeretsa magwiridwe ntchito mwa kutenga mavitamini.
Mkhalidwe wamatenda
Kupita patsogolo kwa mtundu wa steroid matendawa, maselo a beta omwe amapezeka m'matumba am'mimba amayamba kuwonongeka chifukwa cha corticosteroids. Kwa kanthawi amatha kupanga insulini, koma kupanga kwake kumachepetsedwa. Kusokonezeka kwa metabolic. Tizilombo ta m'thupi timayambiranso insulin. Koma popita nthawi, kupanga kwake kumatha konse.
Ngati kapamba amasiya kupanga insulini, ndiye kuti matendawa ali ndi zizindikiro za matenda ashuga amtundu 1. Odwala amakhala ndi ludzu lalikulu, kuchuluka kwa kwamikodzo komanso kuwonjezeka kwamkodzo tsiku lililonse. Koma kuchepa thupi kwambiri, monga momwe amathandizira odwala matenda ashuga amtundu 1, samapezeka mwa iwo.
Mankhwala ndi corticosteroids amafunikira, kapamba amakumana ndi kupsinjika kwakukulu. Mankhwala osokoneza bongo mbali imodzi imawakhudza, ndipo inayo, imayambitsa kukana kwa insulini. Kuti khansa izikhala yokhazikika, aliyense ayenera kuchita mpaka malire.
Matendawa samapezeka nthawi zonse ngakhale mwa kusanthula. Mwa odwala, kuchuluka kwa shuga m'magazi ndi matupi a ketone mumkodzo nthawi zambiri.
Nthawi zina, mukamamwa mankhwala a glucocorticosteroid, shuga imachulukana, yomwe kale silimawonetsedwa bwino. Pankhaniyi, kuwonongeka kwakuthwa kwa matendawa kumatheka mpaka kukomoka. Chifukwa chake, ndikofunika kuyang'ana kuchuluka kwa glucose musanayambe mankhwala a steroid. Malangizowa akulangizidwa kuti azitsatira anthu onenepa kwambiri, mavuto okhala ndi kuthamanga kwa magazi. Odwala onse a zaka zopuma pantchito ayeneranso kufufuzidwa.
Ngati pakalibe mavuto ndi metabolism m'mbuyomu, ndipo njira ya chithandizo cha steroid sichikhala yayitali, ndiye kuti wodwalayo sangadziwe za matenda a shuga. Pambuyo mankhwala, metabolism amakhala.
Njira zamankhwala othandizira
Kuti mumvetsetse momwe chithandizo cha matendawa chimachitikira, chidziwitso pa zamomwe zimapangidwira momwe thupi limagwiritsire ntchito. Ngati zosinthazo zidayambitsidwa ndi hyperproduction ya glucocorticosteroids, ndiye kuti chithandizo chamankhwala ndicholinga chochepetsera chiwerengero chawo. Ndikofunika kuthetsa zomwe zimayambitsa matenda amtunduwu komanso kuchepetsa shuga. Chifukwa cha izi, mankhwala omwe kale adapereka a corticosteroid, zododometsa ndi njira zakulera za pakamwa zimathetsedwa.
Nthawi zina ngakhale kuchitidwa opaleshoni kumafunika. Opaleshoni amachotsa minofu yambiri ya adrenal. Kuchita uku kumakuthandizani kuti muchepetse kuchuluka kwa glucocotricosteroids m'thupi ndi kusintha momwe odwala alili.
Endocrinologists amatha kupereka mankhwala othandizira kutsitsa shuga. Nthawi zina kukonzekera sulfonylurea ndi mankhwala. Koma poyerekeza zakumbuyo kwawo, chakudya chamafuta amatha kuchepa. Thupi silitha kugwira ntchito popanda kukondoweza.
Ngati matenda a shuga a steroid apezeka mwanjira yosavomerezeka, njira zazikulu zamankhwala ndizachotsa mankhwalawa omwe adayambitsa matendawa, kudya komanso kuchita masewera olimbitsa thupi. Malinga ndi malingaliro awa, mkhalidwewo ungasinthidwe posachedwa.
