Matenda a shuga a retinopathy: magawo, Zizindikiro ndi chithandizo

Matenda a shuga a retinopathy - kuwonongeka kwa ziwiya zam'maso. Uku ndikovuta komanso pafupipafupi kwambiri kwa matenda ashuga, omwe angayambitse khungu. Mavuto amawonedwe mu 85% ya odwala omwe ali ndi matenda a shuga 1 omwe ali ndi zaka 20 kapena kuposerapo. Matenda a 2 a mtundu wa 2 akapezeka mwa anthu a zaka zapakati komanso zakale, ndiye pazochitika zoposa 50%, amapeza nthawi yomweyo kuwonongeka kwa ziwiya zomwe zimapereka magazi m'maso. Mavuto obwera chifukwa cha matenda ashuga ndi omwe amachititsa kwambiri kuti azimayi azaka zapakati pa 20 mpaka 74 azikhala ndi khungu. Komabe, ngati mumayesedwa pafupipafupi ndi a ophthalmologist ndikuwathandizira, ndiye kuti muthe kuwona bwino.

Chakumapeto, zovuta zam'mbuyo zimawopseza kutayika kwathunthu kwa masomphenya. Chifukwa chake, odwala omwe akudwala matenda a shuga a retinopathy nthawi zambiri amapatsidwa mankhwala a laser. Uwu ndi chithandizo chomwe chitha kutha kuyambitsa khungu kwa nthawi yayitali. Okalamba kwambiri odwala matenda ashuga ali ndi zizindikiro za retinopathy kumayambiriro. Munthawi imeneyi, matendawa samayambitsa kuwonongeka kwamawonedwe ndipo amapezeka pokhapokha atawunika ndi ophthalmologist.

Pakadali pano, chiyembekezo cha moyo wa odwala omwe ali ndi matenda amtundu woyamba 1 ndikuwonjezeranso chifukwa chiwopsezo cha kufa chifukwa cha matenda amtima chikuchepa. Izi zikutanthauza kuti anthu ochulukirapo adzakhala ndi nthawi yopanga matenda ashuga a retinopathy. Kuphatikiza apo, zovuta zina za matenda ashuga, makamaka matenda ashuga a m'matumbo ndi impso, nthawi zambiri zimayenderana ndi vuto la maso.

Amayambitsa mavuto amaso ndi matenda ashuga

Njira zenizeni zopangira matenda a shuga a retinopathy sizinakhazikitsidwebe. Pakadali pano, asayansi akufufuza malingaliro osiyanasiyana. Koma kwa odwala, izi sizofunikira kwambiri. Chachikulu ndikuti zinthu zomwe zimayambitsa ngozi ndizodziwika kale, ndipo mutha kuzilamulira.

Kuchepa kwa vuto la maso ndi matenda a shuga kumakulira msanga ngati:

• shuga wokwezeka wodwala;
• kuthamanga kwa magazi (matenda oopsa);
• kusuta
• matenda a impso
• mimba
• kutengera kwa chibadwa;
• chiopsezo cha matenda ashuga retinopathy amachulukitsa ndi zaka.

Zomwe zimayambitsa ngozi zazikulu ndi shuga wamagazi ndi matenda oopsa. Ali patsogolo pa zinthu zina zonse zomwe zili pamndandandandawo. Kuphatikiza ndi zomwe wodwala sangathe kuzilamulira, ndiko kuti, chibadwa chawo, zaka komanso nthawi yayitali ya matenda ashuga.

Otsatirawa akufotokozera m'chinenedwe chomveka chomwe chimachitika ndi matenda ashuga retinopathy. Akatswiri anganene kuti kutanthauzira kotereku ndikosavuta, koma kwa odwala ndizokwanira. Chifukwa chake, ziwiya zazing'ono zomwe magazi amayenda m'maso zimawonongeka chifukwa cha kuchuluka kwa shuga m'magazi, matenda oopsa komanso kusuta. Kutumiza kwa okosijeni ndi michere kumayamba kuipiraipira. Koma retina imadya mpweya ndi glucose ochulukirapo mgawo lililonse kuposa minyewa iliyonse m'thupi. Chifukwa chake, imakhudzidwa makamaka ndi magazi.

Potengera kuchepa kwa mpweya wa minofu ya thupi, thupi limakulitsa ma capillaries atsopano kuti abwezeretse magazi m'maso. Kuchulukitsa ndiko kuchulukitsa kwa ma capillaries atsopano. Magawo oyamba, osatulutsa, gawo la matenda ashuga amatanthauza kuti njirayi sinayambebe. Munthawi imeneyi, makoma a mitsempha yamagazi yaying'ono amangogwa. Chiwonongeko chotere chimatchedwa microaneurysms. Kuchokera kwa iwo nthawi zina magazi ndi madzimadzi amatuluka kupita ku retina. Zingwe zam'mitsempha mu retina zimatha kutupa ndipo gawo lapakati la retina (macula) amathanso kuyamba kutupa, nawonso. Izi zimadziwika kuti macular edema.

Kukula kwa diabetesic retinopathy - kumatanthauza kuti kuchuluka kwa zombo zatsopano kwayamba, m'malo mwa zomwe zawonongeka. Mitsempha yachilendo imakula mu retina, ndipo nthawi zina zotengera zatsopano zimatha kukula kulowa m'thupi lamphamvu - chinthu chowoneka bwino chamafuta. Tsoka ilo, zombo zatsopano zomwe zimakula sizabwino. Makoma awo ndi osalimba, ndipo chifukwa cha izi, zotupa zimapezeka pafupipafupi. Mapazi am'madzi amadziunjikira, mafupa am'mimba amtundu, i.e. zipsera m'dera la zotupa.

Retina imatha kutambasulira ndikulekana ndi kumbuyo kwa diso, izi zimatchedwa kukanidwa kwina. Ngati mitsempha yatsopano ya magazi ikusokoneza kutuluka kwakuthupi kuchokera kumaso, ndiye kuti kupanikizika kwa diso kumatha kuchuluka. Izi zimabweretsa kuwonongeka kwa mitsempha ya optic, yomwe imanyamula zithunzi kuchokera ku maso anu kupita ku ubongo. Pakadali pano ndi pomwe wodwala amadandaula za kusawona bwino, kuona masana usiku, kupotoza zinthu, ndi zina zambiri.

Ngati mumachepetsa shuga m'magazi anu, ndikuwakhazikika bwino komanso kuwongolera kuti magazi anu asapitirire 130/80 mm Hg. Art., Ndiye kuti chiwopsezo cha retinopathy chokha, komanso zovuta zina zonse za shuga zimachepa. Izi ziyenera kulimbikitsa odwala kuchita zochiritsira mokhulupirika.

Magawo a shuga a retinopathy

Kuti mumvetsetse momwe magawo a matenda ashuga retinopathy amasiyanirana komanso chifukwa chake zimachitika, muyenera kumvetsetsa pang'ono zomwe magawo amaso a munthu ali ndi momwe amagwirira ntchito.

Chifukwa chake, kuwala kwa magetsi kumagwera. Pambuyo pake, amathandiziranso mandala ndikuyang'ana retina. Retina ndimkono wamkati wamaso womwe umakhala ndi maselo a Photoreceptor. Maselo amenewa amapereka kusintha kwa ma radiation kukhala kuwala kwa mitsempha, komanso magwiridwe ake oyamba. Pa retina, chithunzicho chimasonkhanitsidwa ndikumaperekedwa ku minyewa ya maso, kudzera mu ubongo.

Chofunikira kwambiri ndi chowonekera pakati pa mandala ndi retina. Minofu ya diso imakhala yolumikizidwa ndi diso, yomwe imawonetsetsa kuti ikuyenda mbali zonse. Ku retina pali malo ena apadera omwe mandala amayang'ana kwambiri. Amatchedwa macula, ndipo malowa ndi ofunika kwambiri pokambirana za matenda ashuga.

Kugawidwa kwa matenda ashuga retinopathy:

1. gawo loyambirira;
2. kuperekera;
3. kuchuluka;
4. gawo la kusintha komaliza mu retina (terminal).

Mu diabetesic retinopathy, mitsempha yamagazi yomwe idyetsa retina imakhudzidwa. Ochepera a iwo - capillaries - amavutika koyamba, koyambirira kwa matendawa. Kutsika kwa makoma awo kumawonjezeka, zotupa zimachitika. Retinal edema imayamba.

Pa siteji yolimbitsa thupi, pamakhala zosintha zina mu retina. Mukafufuzidwa ndi a ophthalmologist, mumakhala mawonekedwe amitsempha yambiri, kuchuluka kwa madzimadzi, magawo a ischemic, ndiko kuti, komwe magazi amafalikira ndipo amakhala "ndi njala" komanso "osowa". Pakalipano panthawiyi, njirayi imagwira dera la macula, ndipo wodwalayo amayamba kudandaula za kuchepa kwa maonedwe owoneka.

Gawo lowonjezereka la matenda ashuga retinopathy - amatanthauza kuti mitsempha yatsopano ya magazi idayamba kukula, kuyesera kusintha m'malo mwa omwe awonongeka. Kuchulukitsa ndiko kuchuluka kwa minofu kudzera mukukula kwa maselo. Mitsempha yamagazi imakula, makamaka, mthupi la vitreous. Tsoka ilo, zombo zongopangidwa kumene sizowoneka bwino, ndipo zotupa zimatuluka kawirikawiri.

Mu gawo lomaliza, masomphenya nthawi zambiri amatseka kukhathamiritsa kwamatumbo. Kuchulukana kwa magazi kumachitika, ndipo chifukwa cha iwo ma retina amatha kutambasulira, kukana. Kuwonongeka kwathunthu kwamawonedwe kumachitika pamene mandala sangathenso kuyang'ana kuwala kwa macula.

Zizindikiro ndi kuwunika kwa zovuta za masomphenya a matenda ashuga

Zizindikiro za matenda ashuga retinopathy ndi kuchepa kwamawonekedwe owoneka kapena kutayika kwathunthu. Amadzuka pokhapokha njirayi itatha kale. Koma mukangoyamba chithandizo, zidzakhala nthawi yayitali kuti muzitha kuona. Chifukwa chake, ndimatenda a shuga, ndikofunikira kuti mukamayesedwe ndi a ophthalmologist nthawi imodzi pachaka, makamaka nthawi 1 m'miyezi 6.

Ndikwabwino kuti katswiri wofufuza zamankhwala odziwa bwino matenda ashuga retinopathy agwire ntchito nanu. Madotolo otere ayenera kufunidwa m'malo apadera azachipatala a odwala matenda ashuga.

Ophthalmologist kuwunika algorithm wodwala matenda ashuga:

1. Unikani ma eyel ndi ma eye.
2. Chitani visiometry.
3. Yang'anani mulingo wa kuchuluka kwa intraocular - imatsimikiza nthawi imodzi pachaka kwa odwala omwe ali ndi nthawi yayitali zaka 10 kapena kuposerapo.
4. Biomicroscopy wa anterior eye.

Ngati mulingo wa kukakamira kwa intraocular ukuloleza, ndiye kuti zowonjezera ziyenera kuchitika pambuyo pakukula kwa wophunzira:

1. Biomicroscopy wa mandala ndi vitreous nthabwala pogwiritsa ntchito kandulo.
2. Tembenuzani mwachindunji komanso mwachindunji - m'mbali zonse kuyambira pakatikati mpaka kumapeto kwambiri, mu meridians yonse.
3. Kupenda kwathunthu kwa dera la optic disc ndi dera la macular.
4. Kuyendera thupi lamphamvu ndi retina pogwiritsa ntchito nyali yoyenda pogwiritsa ntchito mandala atatu a Goldman.
5. Kujambula fundus pogwiritsa ntchito kamera ya standardus kapena kamera yosakhala yachangu.
6. Lembani zomwe mwalandira ndikusunga pakompyuta.

Njira zodziwikiratu kwambiri za matenda a shuga a retinopathy ndizojambula za stereoscopic fundus ndi fluorescein angiography.

Matenda a shuga a retinopathy

Tikutsatira kwambiri nkhani pankhani yachipatala cha matenda ashuga retinopathy. Zambiri zokhudzana ndi chithandizo chatsopano zitha kuwoneka tsiku lililonse. Mukufuna kudziwa nkhani zofunika nthawi yomweyo? Lowani uthenga wathu wa imelo.

Magawo azidziwitso ndi chithandizo:

Chithandizo cha matenda ashuga retinopathy chimakhala ndi zinthu zotsatirazi:

• Laser coagulation (cauterization) ya retina.
• Jekeseni wa m'magazi amaso - kukhazikitsa anti-VEGF (mtima endothelial kukula factor) mankhwala - zoletsa za endothelial mtima kukula chinthu. Awa ndi mankhwala otchedwa ranibizumab. Njirayi idayamba kugwiritsidwa ntchito mu 2012, pomwe mayeso adamalizidwa omwe adatsimikiza kugwira ntchito kwa mankhwalawa. Dokotala wamaso amatha kudziwa ma jakisoniwo limodzi ndi laser ya retina kapena payokha.
• Vitibleomy yokhala ndi endolasercoagulation - ngati njira zomwe zatchulidwazi sizinathandize.

Zofunika! Masiku ano, kafukufuku watsimikizira motsimikiza kuti palibenso ntchito ngati "mtima", ngati ma antioxidants, ma enzyme, ndi mavitamini. Kukonzekera monga caviton, trental, dicinone sikulimbikitsidwanso. Amangowonjezera chiwopsezo cha mavuto, ndipo samakhala ndi vuto lililonse pazovuta zamaso.

Chithunzi cha laser ndi vitibleomy

Laser Photocoagulation ndi "cauterization" yoyeserera ya retina kuti ikule kukula kwamitsempha yatsopano yamagazi. Imeneyi ndi njira yothandiza odwala matenda ashuga retinopathy. Ngati laser ikuchitika panthawi komanso molondola, ndiye kuti izi zitha kukhazikika pang'onopang'ono mu 80-85% ya milandu pang'onopang'ono komanso mu 50-55% ya milandu nthawi yayitali ya retinopathy.

Mothandizidwa ndi laser coagulation, "zowonjezera" zamitsempha za retina zimatenthedwa, ndipo magazi amawunduka. Pambuyo pake, zotengera zomwe zimathandizidwa zimadzaza ndi minyewa ya fibrous. Njira yakuchiritsira iyi imalola kusungika kwakumapeto kwa magawo a shuga a retinopathy mu 60% ya odwala kwa zaka 10 - 10. Wodwala ayenera kukambirana mwanjira iyi mwatsatanetsatane ndi ophthalmologist.

Ophthalmic Laser Photocoagulator

Pambuyo pakukula kwa laser, ndikofunikira kwambiri kuyesedwa ndi akatswiri a ophthalmologist ndipo ngati kuli kotheka, magawo owonjezera a laser. Dokotala nthawi zambiri amakupatsani mayeso oyamba pambuyo pa mwezi umodzi, ndipo mayeso omwe amatsatira pambuyo pa miyezi iliyonse ya 1-3, kutengera zomwe wodwala akuwonetsa.

Zitha kuyembekezeredwa kuti laser ikayamba kuseweredwa, mawonekedwe a wodwalayo adzayamba kufooka, kukula kwa mundawo wake kudzachepa, ndipo maonedwe ausiku akuipiraipira. Kenako zinthu zimakhazikika kwanthawi yayitali. Komabe, kupanikizika ndikotheka - kutulutsa kwakanthawi mu thupi la vitreous, lomwe limatha kukhala lopanda ntchito.

Pankhaniyi, wodwala amatha kupatsidwa vitrumomy. Ichi ndi opareshoni yomwe imachitidwa pansi pa opaleshoni wamba. Amakhala ndikudula michere ya retina, kuchotsa thupi lamphamvu kwambiri ndikusintha ndi yankho losabala. Ngati kukana kwamtsogolo kumachitika, ndiye kuti kumabwezeretsedwa kumalo ake. Zovala zomwe zidatulukanso kukhathamiritsa kwamatumbo kwambiri zimachotsedwa. Pambuyo pa vitrectomy, masomphenya amabwezeretsedwa mu 80-90% ya odwala. Koma ngati panali kukana kwachinyengo, ndiye kuti kuthekera kochita bwino kumakhala kotsika. Zimatengera nthawi yakukanidwa komanso ma 50-60%.

Ngati wodwala wadwala glycated hemoglobin> 10% ndi prroliferative kapena proliferative diabetesic retinopathy wapezeka, ndiye kuti laser coagulation imayikidwa nthawi yomweyo, osadikirira zotsatira zake kuchokera kuyesa kuthana ndi shuga. Chifukwa m'milandu yotsogola, chiopsezo cha khungu chimakhala chambiri. Mu odwala oterowo, shuga amayenera kutsitsidwa pang'onopang'ono pokhapokha ngati laser yakhala ikuchitidwa kwathunthu.

Zisonyezero za vitollomy:

• Mitsempha yamagazi yotupa kwambiri, yomwe singathetse kwa miyezi yopitilira 4-6.
• Kutengeka kwapang'onopang'ono.
• Kusintha kwa inveterate mu thupi lamphamvu.

Matenda a shuga a retinopathy: zomwe zapezedwa

Ndi cholinga chothandizira odwala matenda ashuga retinopathy, sizikupanga nzeru tsopano kumwa mankhwala aliwonse a mtima. Njira yothandiza kwambiri ndikuchepetsa shuga m'magazi ndikusunga magwiridwe ake. Njira yabwino yokwaniritsira izi ndikudya zakudya zochepa zamafuta, zomwe zimayang'ana kwambiri pazakudya zomanga mapuloteni komanso mafuta abwinobwino achilengedwe.

Tikupangira zolemba zanu:

• Njira zabwino zochepetsera shuga wamagazi ndikuwasunga bwino;
• Insulin ndi chakudya chamafuta: chowonadi chomwe muyenera kudziwa.

Tikukhulupirira tsamba ili la matenda ashuga retinopathy lathandiza odwala. Chinthu chachikulu ndikuchezera katswiri wa ophthalmologist pafupipafupi. Ndikofunikira kuyang'aniridwa za fundus ndi kukulitsa kwa mwana kuchipinda chamdima, komanso kuyeza kukakamizidwa kwa intraocular.

Kodi muyenera kuyendera kangati kwa ophthalmologist wodwala matenda ashuga?

Kusunga masomphenya ndi matenda ashuga ndikwenikweni!

Onetsetsani kuti mwawunikira magazi ndi kuwunika magazi anu kamodzi pa sabata, madzulo. Ngati mwakulitsa - funsanani ndi dotolo wodziwa momwe mungapangire matendawo.Tili ndi buku latsatanetsatane komanso lothandiza, "Hypertension in Diabetes." Ngati kuthamanga kwa magazi sikumathandizidwa, ndiye kuti mavuto ammaso amangozungulira ... ndipo vuto la mtima kapena stroko imatha kuchitika ngakhale kale.