Matenda a shuga ndi miyendo. Matenda a Matenda a shuga - Chithandizo

Matenda a shuga nthawi zambiri amapereka zovuta kumiyendo. Mavuto a phazi pamoyo wonse amapezeka 25-25% ya onse odwala matenda ashuga. Ndipo okalamba akamadwaladwala, zimawonekera kwambiri mwadzidzidzi. Matenda amiyendo omwe ali ndi matenda ashuga amabweretsa mavuto ambiri kwa odwala ndi madokotala. Miyendo imapweteka ndi matenda ashuga - mwatsoka, yankho losavuta lavutoli sililipo. Ndiyenera kuchita zonse zomwe ndingathe kuti ndichiritsidwe. Komanso, muyenera kuthandizidwa kokha ndi dokotala waluso, ndipo popanda vuto ndi "wowerengeka azitsamba". Munkhaniyi, muphunzira zoyenera kuchita. Zolinga za Chithandizo:

• Pulumutsani ululu m'miyendo, komanso bwino - chotsani izi;
• Sungani mphamvu yakusamuka "nokha."

Ngati simupereka chidwi ndi kupewa komanso kuchiza matenda a shuga pamiyendo, wodwala amatha kutaya zala kapena miyendo kwathunthu.

Tsopano miyendo ya wodwalayo siyipweteka, chifukwa opaleshoni yowonjezera kuwala m'mitsempha mwake yasintha magazi kulowa mkati mwake, ndipo minyewa ya miyendoyo inasiya kutumiza

Ndi matenda ashuga, miyendo imapweteka, chifukwa atherosulinosis imasiya yochepa kwambiri chotupa m'mitsempha yamagazi. Tiziwalo tamatumbo timalandira magazi osakwanira, "osakwanira" chifukwa chake timatumiza ma ululu. Opaleshoni yobwezeretsa magazi m'mitsempha yam'munsi yam'munsi imatha kuchepetsa ululu ndikuwongolera moyo wa odwala matenda ashuga.

Pali ziwonetsero ziwiri zazikulu pamavuto am miyendo ndi matenda a shuga:

1. Shuga wokwezeka kwambiri amakhudza minyewa yamitsempha, ndipo amasiya kuchita zokakamiza. Izi zimatchedwa diabetesic neuropathy, ndipo chifukwa cha izi, miyendo imatha kutaya mtima.
2. Mitsempha yamagazi yomwe imadyetsa miyendo imatsekedwa chifukwa cha atherosulinosis kapena kupangika kwa magazi (magazi). Ischemia akufotokozera - mpweya njala ya zimakhala. Pankhaniyi, miyendo imapweteka.

Matenda a matenda ashuga

Kuwonongeka kwa m'mitsempha chifukwa cha kukweza kwa magazi kwam'mimba kumatchedwa diabetesic neuropathy. Kupanikizika kwa shuga kumeneku kumabweretsa kuti wodwalayo amalephera kumva kukhudza miyendo yake, kupweteka, kupsinjika, kutentha ndi kuzizira. Tsopano ngati wavulala mwendo, sangamve. Ambiri odwala matenda ashuga omwe ali ndi vutoli amakhala ndi zilonda m'miyendo ndi m'miyendo, yomwe imachira nthawi yayitali.

Ngati chidwi cha miyendo chofooka, ndiye kuti mabala ndi zilonda zam'mimba sizimapweteka. Ngakhale kutayika kapena kufalikira kwa mafupa a phazi ndiye kuti sizikhala zopweteka. Izi zimatchedwa matenda a shuga. Popeza odwala samva kupweteka, ambiri aiwo ndi aulesi kwambiri kutsatira malangizo a dokotala. Zotsatira zake, mabakiteriya amachulukana m'mabala, ndipo chifukwa cha gangrene, mwendo nthawi zambiri umadulidwa.

Matenda oopsa m'mitsempha ya shuga

Patency yamitsempha yamagazi ikagwa, ndiye kuti minyewa ya miyendoyo imayamba "kufa ndi njala" ndikutumiza chizindikiro chowawa. Ululu umatha kupumula kapena pokhapokha pakuyenda. Mwanjira ina, ngati miyendo yanu imapweteka ndi matenda a shuga ndilabwino. Chifukwa kupweteka m'miyendo kumalimbikitsa wodwala matenda ashuga kuwona dokotala ndikuthandizidwa ndi mphamvu zake zonse. Munkhani ya lero, tikambirana zinthu ngati izi.

Mavuto a m'mitsempha yamagazi omwe amadyetsa miyendo amatchedwa "matenda opindika a m'mitsempha". Peripheral - amatanthauza kutali ndi pakati. Ngati lumen m'matumbowo ndi ochepa, ndiye kuti nthawi zambiri mumadwala matenda a shuga. Izi zikutanthauza kuti chifukwa cha kupweteka kwambiri m'miyendo, wodwalayo amayenera kuyenda pang'onopang'ono kapena kusiya.

Ngati matenda apakati pa mtsempha wamagazi amaphatikizidwa ndi matenda ashuga a m'mimba, ndiye kuti ululuwo umakhala wofatsa kapenanso kuti palibe. Kuphatikizika kwa kufooka kwa mtima komanso kuchepa kwa chidwi cha kupweteka kumawonjezera mwayi womwe wodwala matenda ashuga ayenera kudula miyendo imodzi kapena yonse. Chifukwa ziwalo zamiyendo zikupitilirabe kuchepa chifukwa cha "njala," ngakhale wodwalayo samva kuwawa.

Ndimayesedwe ati ngati miyendo yanu imapweteka ndi matenda a shuga

Ndikofunikira kupenda bwino miyendo yanu ndi miyendo yanu tsiku ndi tsiku, makamaka ukalamba. Ngati magazi atuluka m'matumbo asokonezeka, mutha kuzindikira zizindikilo zakunja kwa izi. Zizindikiro za gawo loyambirira la matenda otumphukira:

• Khungu pamiyendo likhala louma;
• mwina ayamba kuboola, kuphatikizika ndi kuyabwa;
• kutulutsa khungu kapena kuchotsedwa kwawo kungaoneke pakhungu;
• mwa amuna, Tsitsi lakumunsi limasinthira imvi;
• khungu limatha kusuluka ndi kuzizira pokhudza;
• kapena mosinthanitsa, imatha kutentha ndi kupeza mtundu wa cyanotic.

Dokotala wodziwa bwino amatha kudziwa ngati wodwala ali ndi mitsempha yotani yomwe imadyetsa minyewa ya miyendo. Imeneyi ndiye njira yosavuta kwambiri komanso yotsika mtengo kwambiri yodziwira zovuta za kufalikira kwa magazi. Nthawi yomweyo, kupindika pa mtsempha wamagetsi kumayimitsa kapena kuchepa kwambiri kokha ngati lumen yake imachepetsedwa ndi 90% kapena kuposa. Sachedwa kuteteza minofu "kufa".

Chifukwa chake, amagwiritsa ntchito njira zowunika kwambiri pogwiritsa ntchito zida zamakono zamankhwala. Muwerenge kuchuluka kwa kupanikizika kwa systolic ("kumtunda") m'mitsempha yam'munsi yam'munsi komanso chotupa cha brachial. Izi zimatchedwa ankle-brachial index (LPI). Ngati ili mu mndandanda wa 0.9-1.2, ndiye kuti magazi m'miyendo amadziwika kuti ndi abwinobwino. Kupanikizika kwa minyewa yam'manja kumayesedwanso.

Chingwe cha buluzi chimapereka chidziwitso chabodza ngati zotengera zimakhudzidwa ndi atherosulinosis ya Menkeberg, ndiye kuti, zimakutidwa ndi "kukula" kochokera mkati. Mwa odwala okalamba, izi zimachitika nthawi zambiri. Chifukwa chake, njira ndizofunikira zomwe zimapereka zotsatira zolondola komanso zokhazikika. Izi ndizofunikira makamaka pamene opareshoni ikukonzedwa kuti ibwezeretse patency yamitsempha kuti miyendo isapweteke.

Transcutaneous Oximetry

Transcutaneous oximetry ndi njira yopweteketsa yomwe imakupatsani mwayi wowunika momwe minofu imadzazidwira ndi mpweya. Transcutaneous amatanthauza "kudutsa pakhungu." Sensor yapadera imagwiritsidwa ntchito pakhungu, lomwe limapangitsa muyeso.

Kulondola kwa mayeserowa kumatengera zinthu zambiri:

• mkhalidwe wamapapu wamankhwala wodwala;
• kuchuluka kwa hemoglobin wamagazi ndi mtima wake;
• ndende ya okosijeni mlengalenga;
• makulidwe a khungu komwe sensor imagwiritsidwa ntchito;
• kutupa kapena kutupa m'malo oyeza.

Ngati mtengo womwe wapezeka uli pansi pa 30 mm RT. Art., Ndiye yovuta ischemia (njala ya okosijeni) ya miyendo imapezeka. Kulondola kwa njira yosinthira mwazitali sikukwera kwambiri. Koma imagwiritsidwabe ntchito, chifukwa imawerengedwa kuti ndi yopindulitsa ndipo siyipangitsa mavuto kwa odwala.

Ultrasound yamitsempha yamagazi yopereka magazi ku miyendo

Kusanthula kwapadera (ultrasound) kwamitsempha yam'munsi yam'munsi - kumagwiritsidwa ntchito poyang'ana momwe magazi amayendera asanayambe kuchita opareshoni yam'madzi. Njira imeneyi imawonjezera mwayi kuti zitheka munthawi yake kuti mupeze chotupa cha mtsempha kapena chopindika kapena kuchepera kwa lumen m'matumbo mutachitidwa opaleshoni (restenosis).

Ultrasound yamitsempha yamagazi imakuthandizani kuti muwerenge madera ovuta, ndiko kuti, zigawo zomwe "zidachotsedwa" m'magazi chifukwa chodwala. Pogwiritsa ntchito njirayi, mutha kuwunika bwino momwe ziwiya ziliri ndipo konzani pasadakhale opareshoni kuti mubwezeretse ntchito yawo.

X-ray kusiyanitsa angiography

X-ray kusiyanitsa angiography ndi njira yowunikira momwe wophatikizira wosemphana amaloŵetsamo mtsempha wamagazi, ndiye kuti ziwiya "zimatulutsa" ndi x-ray. Angiography imatanthawuza "kuwunika mtima". Iyi ndiye njira yophunzitsira kwambiri. Koma ndizosasangalatsa kwa wodwalayo, ndipo koposa zonse - wothandizira wosiyanayo akhoza kuwononga impso. Chifukwa chake, tikulimbikitsidwa kuti tizigwiritsa ntchito pokhapokha ngati pakufunika kuchita opareshoni kuti abwezeretsenso mtima wam'mimba.

Magawo a zovuta za shuga pamiyendo

Pali 3 madigiri a zotumphukira magazi kusokonezeka mwa odwala matenda a shuga.

Digiri yoyamba - palibe zizindikiro ndi matenda amitsempha yamagazi m'miyendo:

• kusintha kwam'mimba kumamveka;
• ankolo-brachial index 0.9-1.2;
• index-phewa chala> 0,6;
• mitengo ya transcutaneous oximetry> 60 mmHg. Art.

Digiri yachiwiri - pali zizindikiro kapena zizindikiro, koma pakadali pano palibe vuto lakufa la oxygen.

• kupindika pakati (miyendo yopweteka);
• ankolo-brachial index <0,9, ndi kupanikizika kwa systolic m'mitsempha yam'munsi yoposa 50 mm RT. st.;
• cholowera kumanja cha 30 mm RT. st.;
• transcutaneous oximetry 30-60 mm RT. Art.

3 digiri - yovuta mpweya njala ya zimakhala (ischemia):

• kupanikizika kwa systolic m'mitsempha ya m'munsi mwendo <50 mm RT. Art. kapena
• kuthamanga kwa mitsempha ya chala <30 mmHg. st.;
• transcutaneous oximetry <30 mm Hg. Art.

Mankhwalawa ngati miyendo ipweteka ndi matenda ashuga

Ngati miyendo yanu yapweteka ndi shuga, ndiye kuti chithandizo chikuchitika m'njira zitatu:

1. kuwonetsedwa pazinthu zomwe zimathandizira kukulitsa kwa atherosulinosis, kuphatikizapo mitsempha yamiyendo;
2. kukhazikitsa mosamala malangizo othandizira kupewa komanso kuchiza matenda ammiyendo, omwe amafotokozedwa mwatsatanetsatane mu nkhani ya "Diabetesic foot syndrome";
3. yankho la nkhani ya opareshoni yobwezeretsanso magazi kuti ibwezeretse magazi

Mpaka posachedwapa, pa nthawi yodziwika bwino, odwala adalandira mankhwala pentoxifylline. Koma kafukufuku wasonyeza kuti palibe phindu lenileni kwa odwala matenda a shuga omwe ali ndi matenda osokoneza bongo.

Ndi zovuta za matenda osokoneza bongo m'miyendo, opaleshoni yobwezeretsa magazi m'mitsempha ingakhale yothandiza kwambiri. Madokotala amalingalira za momwe wodwalayo alili ndi wodwala aliyense, poganizira zomwe angachite atachitidwa opaleshoni.

Odwala omwe ali ndi ululu wa m'miyendo mu shuga, monga lamulo, adanenanso zovuta zamatumbo a metabolism (shuga yamagazi ndizambiri), matenda ammimba a shuga, komanso kuwonetsa zovuta zina za matenda ashuga. Kuti muwathandize kwenikweni, muyenera kuyitanitsa gulu la akatswiri pazachipatala.

Chithandizo cha matenda ammimba a matenda ashuga amachitidwa ndi podiatrist wapadera (kuti asasokonezedwe ndi dokotala). Choyamba, kuchitira opaleshoni mabala pamapazi kungakhale kofunikira kuti mupewe matenda osokoneza bongo, ndipo pokhapokha - kubwezeretsa patency yamitsempha yamagazi.

Matenda a shuga ndi Mwendo: Zotsatira

Tikukhulupirira kuti nkhaniyi yakufotokozerani mwatsatanetsatane zoyenera kuchita ngati miyendo yanu ipweteka ndi matenda a shuga. Ndikofunikira kuti musinthe ndikukhala ndi moyo wathanzi kuti muthe kusintha shuga m'magazi ndikuletsa chitukuko cha atherosulinosis. Ndi dokotala, mudzatha kusankha pa opaleshoni yomwe idzabwezeretse kuchuluka kwa ziwiya zamiyendo. Muyeneranso kufufuzidwa pazovuta zina za matenda a shuga ndikuzichitira.

Chonde musayesetse "kupewetsa" kupweteka kwa kupweteka kwapamsi mothandizidwa ndi mapiritsi ena. Zotsatira zake zoyipa zimatha kukulitsa vuto lanu komanso chiyembekezo chamoyo. Funsani dokotala woyenera. Pa matenda ashuga, ndikofunikira kusamalira bwino magazi kuti musamalire nokha.

Werengani nkhani:

• Momwe mungachepetse shuga ndi magazi ndikukhala abwinobwino;
• Chithandizo cha matenda a shuga a mtundu wachiwiri ndi othandiza kwambiri;
• Momwe mungapangire jakisoni wa insulin mopweteka.