Matenda a shuga Angiopathy

Matenda a shuga ndi matenda oopsa, omwe nthawi zambiri amakhala ndi matenda obwera ndi matendawa. Izi zimaphatikizapo matenda ashuga angiopathy. Mosasamala mtundu wake, wodwalayo amatha kukumana ndi zovuta zazikulu. Chifukwa chake, ndikofunikira kuzindikira vutoli munthawi ndikuyamba chithandizo. Koma chifukwa cha izi ndikofunikira kuyankha funso - matenda ashuga: ndi chiyani, amawonetsedwa bwanji, ndipo angathane nawo bwanji?

Chinsinsi cha matendawa, zomwe zimayambitsa kukula ndi zovuta zake

Zinthu zopangidwa ndi kagayidwe ka glucose zimayikidwa m'mapuloteni am magazi ndi ziwalo zamthupi. Ndi kuchuluka kwamphamvu kwa glucose m'thupi, mawonekedwe a anthu omwe akudwala matenda ashuga, kuchuluka kwa zinthu zotere kumawonjezeka. Zotsatira zake, minofu ya thupi imayamba kutaya mawonekedwe ake apakale. Mphamvu yam'madzi yam'mimba imakhala yovuta kwambiri, chifukwa makoma azombo amatengera kwambiri hyperglycemia.

Ndi matenda a shuga a m'munsi am'mphepete, mapangidwe a ziwiya zomwe amapezeka m'miyendo amasintha. Makulidwe a makoma awo amachepera, amakhala onenepa. Zotsatira zake, mtima wa lumen umachepetsedwa. Nthawi zina, kutsekeka kwa mitsempha kumachitika. Chifukwa cha kusintha konseku, magazi omwe amapezeka kumapazi akuwonjezereka. Kwambiri, zofanana ndi izi zimakhudza miyendo, magawo akutali kwambiri a miyendo.

Kuphwanya kayendedwe ka magazi kumayambitsa matenda a okosijeni, chifukwa chomwe malekezero ochepa sangathe kuchita ntchito zawo.

Izi zimabweretsa kusintha kwakukulu pakhungu, mawonekedwe a necrosis, gangrene. Chifukwa cha kusintha kosasinthika, nthawi zambiri ndikofunikira kudula zala zakumiyendo, phazi lonse, kapena, kwambiri. Diabetes angiopathy imaphatikizidwa ndi International Classization of Diseases, code yake ya MBK 10 ndi E10.5 ndi E11.5.

Kutengera ndi ziwiya ziti zomwe zimakhudzidwa, mitundu iwiri yamatenda imasiyanitsidwa:

• microangiopathy - ndi mtundu uwu wa matendawa, ziwiya zazing'ono (i.e., capillaries) zimakhudzidwa;
• macroagniopathy - ndikusintha kwa ziwiya zazikulu (tikulankhula za mitsempha ndi mitsempha).

Kukula kwa angiopathy kumachitika ndi matenda a shuga ochedwa. Nthawi zambiri, zoterezi zimachitika mwa anthu omwe akudwala matendawa zaka khumi mpaka khumi ndi zisanu. Ngakhale kuwonongeka kwa mwendo kumachitika mu makumi asanu ndi awiri peresenti ya milandu, ziwiya zomwe zimakhala ziwalo zina zimatha kuchepa. Izi zimagwira ntchito m'maso, chiwindi, mtima, ubongo.

Angiopathy imapezeka kokha pakati pa anthu odwala matenda ashuga. Komanso, mtundu wake siofunikira pankhaniyi. Chifukwa chachikulu komanso chokhacho cha kukula kwa matendawa ndicho kuchuluka kwa glucose kosakhazikika m'magazi. Mwachidziwikire, onse odwala matenda ashuga ali pachiwopsezo. Koma pali zinthu zina zomwe zimawonjezera mwayi wopanga angiopathy yamatumbo. Zina mwa izo ndi:

• kuchuluka kwa shuga m'magazi. Mukakulirakulira, matendawa amafulumira;
• kutalika kwa matenda ashuga. Popeza chitukuko cha angiopathy chikugwirizana mwachindunji ndi kuchuluka kwa glucose okwanira komwe kumasungidwa m'magazi, munthu amakhala ndi matenda a shuga nthawi yayitali, ndipo amakhala ndi mwayi wopeza matendawa;
• matenda oopsa Ndi chiopsezo chifukwa chakuipa kwake pakukoka kwa magazi;
• kunenepa Kulemera kwambiri kumakhudza kupita patsogolo kwa masinthidwe m'matumba, ndikuwathandizira;
• kugwiritsa ntchito fodya. Chifukwa chosuta m'matumba akuluakulu, malo opangira ma atherosselotic amawaika, ma capillaries amakhala ochepa;
• zochulukitsa / zoperewera pamiyendo yakumunsi. Kulephera kuchita zolimbitsa thupi, komanso kuchita zolimbitsa thupi kwambiri, kumachulukitsa matendawa;
• kuchuluka magazi. Zimakhudza mitsempha yamagazi kwambiri, ndikufulumizitsa kusintha kwa matenda ashuga komwe kumachitika mwa iwo.

Zizindikiro za matendawa

Zizindikiro za matenda a shuga a shuga am'munsi am'munsi zimadalira ziwiya zomwe zimakhudzidwa komanso nthawi yayitali ya matendawa. Njira ya micro- ndi macroagniopathy nthawi zambiri imagawika m'magawo angapo. Gawo lililonse limadziwika ndi gawo lina la kusintha m'matumbo komanso zomwe zimadziwonetsa.

Madigiri sikisi a microangiopathy amadziwika:

1. digiri ya zero. Amadziwika ndi kusapezeka kwathunthu kwa zizindikiro. Pankhaniyi, ndizovuta kuzindikira matendawa panthawi iyi ya chitukuko, chifukwa odwala samakonda kufunsa dokotala. Koma pakuyang'anira, katswiri amatha kuwona kusintha komwe kwayamba;
2. digiri yoyamba. Zizindikiro zoyambirira za matendawa zimawonekera pakadali pano. Amakhala ndi kusintha kwa khungu la miyendo (limasinthika), maonekedwe a zilonda zazing'ono (osayenda ndi kutupa kwa khungu lomwe limazungulira ndipo sizimapangitsa kupweteka kwambiri);
3. digiri yachiwiri. Zilonda zamphamvu. Amatha kukhudza minofu ndi mafupa. Ululu ukuwonekera;
4. digiri yachitatu. Zilonda zam'mimba zimayamba kufa (necrosis imawoneka, kufalikira mpaka pansi pamapangidwe ndi m'mbali mwake). Khungu lozungulira zilondazo limasanduka lofiira, kutupa kumawonekera. Nthawi zina, odwala amakhala ndi osteomyelitis (minofu ya mafupa imadzaza). Ma Abscesses ndi phlegmon ndizothekanso;
5. digiri yachinayi. Amadziwika ndi kufalikira kwa necrosis kunja kwa zilonda (pazala kapena kumayambiriro kwake);
6. digiri yachisanu. Mawonekedwe owopsa a necrosis. Imafikira mpaka phazi lonse. Pankhaniyi, ndizosatheka kuti amupulumutse. Pakadali pano, wodwalayo amalidula.

Magawo anayi a macroangiopathy amadziwika:

• gawo loyamba. Pa gawo loyamba la macroangiopathy, kukula kwa misomali ndi kutalika kwa zala kumawonedwa. Ndi masewera olimbitsa thupi, kumva kutopa m'miyendo kumadzuka msanga. Kusuntha koyambirira pambuyo pogona kumakakamizidwa. "Choperekera pakati" chimawonekera (pafupifupi mamiliyoni mazana asanu mpaka chikwi). Kuphatikiza apo, matendawa amadziwonetsa mukutuluka thukuta kwambiri. Mapazi amaundana mosavuta;
• 2a siteji. Odwala nthawi zambiri miyendo, yozizira miyendo imamveka ngakhale nyengo yotentha. Kukhazikika kwa khungu kumapeto kumawonedwa, thukuta limachuluka. "Kulowerera mkati" kumawonekera mamiliyoni mazana awiri mpaka mazana asanu;
• 2b siteji. Zizindikiro zonse pamwambapa zikupitirirabe, koma kuwonda kumawonekera patatha makumi asanu mpaka mazana awiri;
• 3a siteji. Kwa zisonyezo zomwe zawoneka kale, zowawa zimawonjezeredwa, zomwe zimakulirakulira ndikusamba kwausiku. Kukokana kwamiyendo nthawi zambiri kumachitika. Pamakhala khungu lotentha, lomwe limakhala louma komanso lowoneka bwino. Miyendo imakhala yotuwa pomwe wodwala wagona. "Kulowerera mkati" kumachitika nthawi zonse makumi asanu;
• 3b siteji. Zomverera zam'mimba zimakhala zosatha. Kutupa kwa miyendo kumawonedwa. Zilonda zam'mimba zimapezeka;
• gawo lachinayi. Gawo lomaliza la matendawa. Necrosis imafikira zala, nthawi zina mpaka kuphazi lonse, chifukwa chomwe minyewa ya miyendo imafa. Chifukwa cha izi, matenda amatha kulowa mthupi, limodzi ndi kufooka kwathunthu komanso kuwonjezereka kwa kutentha kwa thupi la wodwalayo.

Pakapanda kuyang'anira malamulo aukhondo amunthu ndikulephera kuwongolera nthawi yamatendawa, uve womwe umapangidwa chifukwa cha angiopathy umalowa pachilonda, komwe ndi njira yotengera matenda.

Ngati matendawa adachitika posachedwa, ndipo alibe nthawi yopeza, mutha kuwongolera mothandizidwa ndi antiseptics. Ndi nthambi yayikulu ya phazi, nthambi imayenera kudulidwa.

Njira zowonongeka zomwe zimachitika m'matumbo a miyendo sizingasinthidwe. Kuchiritsa kwathunthu kwa wodwala ndikothekanso. Chokhacho chomwe mankhwala amakono amatha kuchita ndikuchepetsa kukula kwa angiopathy. Koma chifukwa cha izi, matendawa ayenera kuwonekera pakapita nthawi, zomwe zimalephereka chifukwa chosakhalapo ndi zomwe zimafotokozedwa momveka bwino mu magawo oyambirira a chitukuko.

Zizindikiro

Kuti mudziwe bwino, katswiri amayenera kufufuza. Amvera madandaulo a wodwalayo ndipo amuyesa. Kuphatikiza apo, zidzakhala zofunikira kudziwa kuchuluka kwa shuga m'magazi ndi mkodzo. Kwa izi, kusanthula kwapadera kumachitika. Muyeneranso kuchita kafukufuku wapadera:

• dopplerografia ya malekezero akumunsi, ndiye kuti, kuyesa kwa ultrasound. Pogwiritsa ntchito njirayi, mutha kudziwa kuthamanga kwa magazi ndi kupeza malo omwe amachepetsa. Dopplerography imakuthandizaninso kudziwa momwe mitsempha imakhalira. Kufufuzanso kofananako kumachitika ngati wodwala ali ndi zilonda zam'mimba;
• zojambula zam'munsi. Chinsinsi cha njirayi ndi kuyendetsa chinthu chapadera m'matumba, momwe mumadutsamo zimayang'aniridwa ndi x-ray. Chifukwa chake, mutha kudziwa kuti ndi zombo ziti zowonongeka;

Kuphatikiza pa zonse pamwambapa, katswiriyo amayeza kukoka ndi kupsinjika pazombo zomwe zili kumapazi, komanso pama mitsempha yomwe ili pansi pa bondo ndi ntchafu.

Kuchiza matenda

Maziko a chithandizo ndikusunga shuga yamagazi pamlingo wabwinobwino.

Izi zimatheka pomwa mankhwala apadera omwe amachepetsa kuchuluka kwa shuga m'magazi ndikuthandizira kutulutsa kwa insulin. Kuchiza matenda a shuga kumachitika moyang'aniridwa ndi dokotala. Kuphatikiza apo, kuyang'anira kuchuluka kwa shuga mumkodzo ndi magazi ndikofunikira. Mwa mankhwala omwe amachepetsa shuga, zotsatirazi zimatha kusiyanitsidwa:

1. Glibenclamide. Mosangalatsa zimakhudza kutulutsidwa kwa insulin. Patsiku loyamba la makonzedwe, imwani piritsi limodzi la mankhwalawo. Kenako, mlingo umakulitsidwa woyamba mpaka awiri, kenako mapiritsi atatu. Mlingo wotengedwa umatengera shuga;
2. "Diastabol". Zimathandizira kuwonongeka kwa chakudya chamaguluga m'magazi asanapangidwe, chifukwa chomwe shuga m'magazi imakhazikika pamlingo wabwinobwino. Mankhwalawa amatengedwa katatu patsiku, piritsi limodzi nthawi (50 mg). Kusintha kwa Mlingo kumachitika mwezi umodzi atayamba kumwa mankhwalawa;
3. Amaril. Zimakhudza katemera wa insulin. Zakudya za tsiku ndi tsiku ndi piritsi limodzi (milligram imodzi). Pakupita milungu iwiri, mlingo umakulitsidwa (nthawi iliyonse ndi milligram imodzi).

Ngati wodwala ali ndi matenda ashuga a macroangiopathy, amamuika mankhwala omwe amakhudza kiwango cha cholesterol. Zina mwa izo ndi:

1. Torvakard. Kuphatikiza pa kupondaponda cholesterol synthesis, kumawonjezera kukana kwamitsempha yamagazi. Mlingo woyamba wa mankhwalawa ndi mamiligalamu khumi. Mlingo wamba ndi milligram makumi awiri. Nthawi zina, amatha kupitilizidwa kukhala ma milligram 40;
2. Zokor. Zimakhudzira cholesterol. Mlingo wofanana ndi womwe udalipo kale. Mankhwala amatengedwa madzulo;
3. Lovasterol. Kugwiritsa ntchito mankhwalawa kumabweretsa kuponderezedwa kwa mapangidwe a cholesterol m'chiwindi, kuchepetsa mulingo wake m'magazi. Mlingo wokhazikika ndi ma milligram makumi awiri. Ngati ndi kotheka, imatha kuwonjezeredwa mpaka mamiligalamu 40. Mankhwalawa amatengedwa kamodzi patsiku.

Kuphatikiza apo, wodwalayo amatha kupatsidwa mankhwala omwe amachepetsa magazi, kusintha magazi, kukhazikika kwa kagayidwe kazakudya, ma pinkiller, komanso maantibayotiki othana ndi matenda. Malangizo enieni a mankhwalawa zimatengera momwe wodwalayo alili komanso magawo omwe matenda amayambira.

Nthawi zina, opaleshoni ingakhale yofunikira. Ntchito zimachitika pa:

1. kukhalapo kwa malo ochepa a kuchepetsa ziwiya zazikulu zomwe zimakhudzidwa (opaleshoni yamphala, thrombectomy, kulowererapo kwa mtima);
2. kuwonongeka kwakukulu m'mitsempha, kutsitsa kwawo (mwanjira iyi, mitsempha yamitsempha yomwe imayambitsa kuphipha imachotsedwa);
3. kukhalapo kwa mabala a purulent, phlegmon, necrosis ya chala. Cholinga cha opaleshoniyo ndikuchotsa minofu yakufa, kutulutsira mitsuko ya purulent. Nthawi zina, kudula zala kumachitika;
4. kudziwa zigololo. Pankhaniyi, kudula kumachitika. Kutengera ndi dera lomwe lakhudzidwalo, nthambiyo imachotsedwa pa ntchafu, mwendo wotsika, kutsogolo.

Njira zopewera

Matenda a shuga a ziwongo za m'munsi am'munsi sizitengera kukula kwa chilonda komanso kudulanso miyendo. Kutengera malingaliro a dokotala komanso kupewa kwa panthawi yake, gangrene sangathe kuwoneka. Pakalipano, pafupifupi makumi asanu ndi anayi peresenti ya odwala omwe sanachite mankhwalawa munthawi yake ndipo sanasinthe moyo wawo, patatha zaka 5 chitukuko cha matendawa chikukula. Muzochitika khumi, zimayambitsa matenda a magazi ndi odwala.

Kupewa kwa matenda ashuga angiopathy ndi:

• Kutsatira zakudya zapadera, zophatikiza mchere, chakudya, lipids;
• kukana zizolowezi zovulaza thanzi (kuyambira pa fodya komanso zakumwa zoledzeretsa);
• Zochita zolimbitsa thupi zosankhidwa bwino (magawo olimbitsa thupi akupangika omwe samachulukitsa tachycardia, angina pectoris ndi matenda ena);
• tsiku ndi tsiku amayenda mumsewu. Makamaka m'malo okhala ndi mpweya oyera. Kutalika kwa kuyenda kulikonse ayenera kukhala osachepera mphindi 40;
• kuwongolera kulemera (kwa kunenepa kwambiri);
• kuyang'anira kolesterol kosalekeza ndi shuga wamagazi, komanso kuyang'anira kuthamanga kwa magazi;
• kupewa kupsinjika;
• kutenga multivitamin kukonzekera komwe kumalimbitsa thupi.

Monga tanena kale, ndizosatheka kuchiritsa matendawa. Koma mothandizidwa ndi njira zopewera, kupita patsogolo kwake kungapeweke.

Chifukwa chake, matenda ashuga angiopathy amachititsa kutsika kwa kukhazikika kwa makoma amitsempha komanso kuchepa kwa masoka a dzuwa. Chifukwa cha izi, magazi abwinobwino amasokonezeka, zomwe zimachepetsa magwiridwe ake a miyendo yomwe yakhudzidwa. Matendawa ndi achilendo kwa odwala omwe ali ndi matenda osokoneza bongo. Zizindikiro za matendawa zimatengera ziwiya zowonongeka komanso kukula kwa matendawa.

Ngati zizindikiro za matenda zikupezeka, kaonana ndi dokotala. Adziwitsani ndikusankha njira yabwino kwambiri yothandizira. Ngati simutayamba chithandizo, zovuta zimatha kubweretsa kudula kapena kufa.