Polyneuropathy ndi gulu la matenda omwe amapezeka m'mitsempha yamafungo am'mimba yomwe imagwiritsidwa ntchito pakuwonongeka kwa minyewa yamitsempha.
Zomwe zimayambitsa matenda awa zimatha kukhala zosiyana, koma mawonekedwe awo azachipatala amafanana. Amadziwika ndi vuto la minyewa yakusokonekera, kuchepa kwa minofu yochepa, kusintha kwa chidwi komanso kufooka kwa miyendo.
Tikayerekezera odwala matenda ashuga komanso zidakwa za polyneuropathy, momwe zilili komanso momwe akuwonekera, ndiye kuti chizindikiritso chokhacho chimakhala kuphwanya magazi komanso kusungunuka motsogozedwa ndi zinthu zoopsa - glucose ndi ethanol.
Zifukwa zoyambitsa polyneuropathy
Ma polyneuropathies ndi amtundu wosiyanasiyana, ndipo amakula ndikuwonetsa pang'onopang'ono kapena nthawi yayitali pazinthu zowononga pamitsempha yama mitsempha. Izi zitha kukhala chifukwa cha kuwopsa kwa bakiteriya mu diphtheria kapena kachilombo ka kachilombo ka HIV, kuvulala, ndi chotupa.
Mankhwala, kuphatikiza Cordaron, Furadonin, Metronidazole ndi Isoniazid amatha kusokoneza mitsempha pazomwe zimagwiritsidwa ntchito kwa nthawi yayitali.
Neuropathies mu zotupa zam'mimba zimatha kuchitika kachiwiri - ndi lymphoma, myeloma ndi khansa ya m'mapapo, ndikukhala complication ya chemotherapy yamatenda awa.
Matenda amitsempha yamagetsi amachititsa izi:
- Matenda a autoimmune.
- Matenda a metabolic - shuga, amyloidosis, hypothyroidism, kuchepa kwa vitamini B12.
- Matenda obadwa nawo.
- Mowa
- Kulephera kwina.
- Matenda a chiwindi.
Kwa odwala matenda ashuga ndi zidakwa polyneuropathy, kupita patsogolo ndi matenda omwe atenga nthawi yayitali komanso kuwongolera kuzowonetsa zamankhwala omwe amachepetsa mphamvu ya shuga kapena mowa ndichikhalidwe.
Chifukwa chiyani ulusi wamanjenje umakhudzidwa ndi matenda ashuga komanso uchidakwa?
Mu shuga mellitus, ma polyneuropathies amakula ndikuwonongeka kofalikira kwa ma neuroni mu gawo la zotumphukira za mantha. Imfa ya maselo nthawi zambiri imasinthika chifukwa cha kusokonekera kwa minofu ya odwala matenda ashuga.
Kuchuluka kwa shuga m'magazi ozungulira kumayambitsa makulidwe amitsempha yamagazi, patency yovundikira, mapangidwe amipanda yamagazi ndi zikwangwani pamakoma. Ndi chakudya chochepa chotere, ma cell amitsempha amwalira, amasinthidwa ndi minofu yongogwiritsa ntchito.
Kupezeka pafupipafupi kwa ma neuropathy mwa amuna amtali kwatsimikiziridwa. Choyimira chachikulu chomwe chikuwonetsa kukula kwa matendawa ndi kuchuluka kwa matenda a hyperglycemia. Mavuto opatsirana ndi onenepa kwambiri, kusuta fodya komanso kuledzera.
Kuopsa kwa matenda ashuga polyneuropathy kumawonjezereka ndi zinthu zotsatirazi:
- Njira yayitali ya matenda a shuga.
- Hyperglycemia yayikulu, kusinthasintha pafupipafupi kwamisempha.
- Mukalamba.
Kwa neuropathy ku uchidakwa, oyambitsa amatha kukhala a hypothermia, matenda, komanso kuwonongeka kwa chiwindi. Ethanol yokha ndi zinthu zake zama metabolic zimaphwanya ulusi wamanjenje. Ndi kuperewera kwapakati pa vitamini B1 (thiamine), mawonetsero a polyneuropathy akuwonjezeka.
Hypovitaminosis B1 imachitika ndi chakudya chosakwanira komanso kuyamwa kwamatumbo. Kumwa mowa kumawonjezera kufunika kwa thiamine, chifukwa chake mawonetseredwe ake amakula. Poterepa, minyewa yamitsempha imayamba kuzindikira kuwonongeka kulikonse.
Mowa umapangitsa kupangika kowonjezereka kwa ma radicals aulere omwe amavulaza zingwe zamkati zamatumbo, chifukwa chomwe hypoxia imamangilira m'mitsempha ya mitsempha ndipo imawonongeka.
Zizindikiro za matenda ashuga a polyneuropathy
Kusokonezeka kwa magazi, kusinthika kwa kapangidwe ka minyewa m'matenda a shuga kumapanga mitundu itatu ya zotupa zam'munsi: neuropathic, ischemic, kusakanikirana.
Neuropathic syndrome imawonetsedwa ndi malingaliro olakwika a kupweteka, komwe, kukhudza pang'ono, kupweteka kumamveka, ndipo poyenda phazi limatha. Kusoka, kupweteka kwa moto kapena kutentha kwa m'miyendo kumatha kuchitika.
Kutentha kwamphamvu ndi kumva kupweteka kumayambitsa kuvulaza pakhungu. Mafupa a miyendo ndi opunduka chifukwa cha kufooka kwa minofu ndikuyimitsidwa kwamiyendo ya miyendo mukamayenda, subluxations imachitika. Khungu limakhala louma, limakhuthala, ndi kupita patsogolo kwa matendawo pamalo aming'alu kapena kuwonongeka, vuto la zilonda zam'mimba limayamba.
Mbali yodziwika bwino ya njira ya neuropathic ndiyo kukhalapo kwa kugunda kwamapazi, khungu lotentha ndi kapangidwe ka zilonda m'mafupa amtsata.
The ischemic mitundu ya chitukuko cha matenda ashuga polyneuropathy limodzi ndi:
- Kugonjetsedwa kwa mitsempha ndi capillaries.
- Kupezeka kwa cholesterol ndi calcium mu khoma lamankhwala.
- Mapangidwe amipini ndi magazi.
- Khoma lamitsempha limakhala lolimba komanso lokwera.
- Kupereka magazi kukuchepa.
Kuchulukitsa kwa magazi kulowa mu kama wogona ndi kusasunthika mkati mwake kumathandizira kupanga mapangidwe a edema ndi zotupa pakhungu. Khungu limakhala loonda, lovulala mosavuta, mabala ndi zilonda zam'mimba. Chizindikiro cha ischemia ndi chizindikiro cha kulumikizana kwakanthawi, pomwe wodwalayo ayenera kuyima akuyenda chifukwa cha kupweteka kwambiri m'miyendo.
Mtundu wosakanikirana umawonetsedwa ndikufupikitsa kwa tendons ndi mawonekedwe a mapuloteni omwe amakhala ndi glucose pamafelemu a articular. Zizindikiro za kuphwanya kotere ndi:
- Kuuma molumikizana.
- Nyamakazi, zolumikizika zolumikizana komanso kupasidwa.
- Mapazi azizizira kukhudza.
- Khungu limakhala lofiirira,
- Zilonda zimawoneka pamapewa kapena chidendene.
Zilonda zodwala kwambiri zimayambitsa matenda, zomwe zimatha kuphatikizidwa ndi osteomyelitis ndi septic process, kupita patsogolo kwa ischemia kumabweretsa gangore.
Phazi la matenda ashuga ndi chifukwa chachikulu chodulira phazi.
Zizindikiro za prolineuropathy mu uchidakwa
Kugawika kwamitundu yonse ya mowa ndi matenda ashuga a polyneuropathy kuli kovomerezeka, popeza palibe kuwonongeka kwakutali kwa dongosolo lamanjenje ndi kuzungulira kwa magazi. Mitundu yosakanikirana yamatendawa imapezeka.
Mawonetseredwe azachipatala a zakumwa zoledzeretsa a polyneuropathy amaimiridwa ndi ma syndromes: sensory, motor, osakanikirana, atactic.
Sensory neuropathy imadziwika ndi kupweteka kwamapazi, dzanzi, kutentha, kukokana kwa mwendo, kupweteka kwa minofu. Kuphwanya kwachilendo, kuphatikizira kuwonjezeka kapena kuchepetsedwa kwa ululu ndi kutentha ndizodziwika ngati mtundu wa "masokosi ndi prints." Kutupa kwam'mimba kumawonetsedwa ndikusuntha kwa khungu, kupitilira thukuta.
Fomu yamoto iwonetsedwa:
- Kuchepa kwa miyendo kapena zala.
- Kuphwanya kwa kasinthidwe ka mapazi.
- Kulephera kuyenda pazala.
Ngati minyewa yamunthuyo yakhudzidwa, mawonekedwe a "phazi lokhazikika", momwe amavutikira kutalika phazi.
Mawonekedwe osakanikirana amapezeka mu mawonekedwe a paresis kapena ziwalo zamiyendo, manja, kupweteka, dzanzi la manja kapena mapazi. Minofu ya manja ndi manja akutsogolo. M'dera lomwe lakhudzidwalo pamakhala chidwi kapena kuchepa kwa chidwi.
Peripheral pseudotabes, kapena atactic mtundu wa mowa wa polyneuropathy, amayamba chifukwa cha kusamvetsetsa kwakukulu. Odwala, kulumikizana kwa kayendedwe ndi ma git zimasokonekera, miyendo imayamba kuzimiririka, mphamvu imachepa, pakuwunikira, kupweteka ndi bondo kulibe.
Poyamba, odwala amakhala ndi kufooka kwa minofu ndi mikono ndi miyendo, kenako pang'onopang'ono paresis kapena ziwalo zimayamba, ndipo khungu limasokonekera.
M'magawo akulu, minyewa yopuma, minyewa yamtima imafooka, yomwe imawonetsedwa ndi kusokonezeka kwa miyendo ndi kutsika kwa chikakamizo.
Chithandizo ndi kupewa neuropathy mu shuga
Pofuna kuchitira neuropathy odwala omwe ali ndi matenda ashuga, kuchuluka kwa shuga m'magazi kuyenera kukhazikika. Kuphatikiza apo, zikuwonetsa kuti mapangidwe a shuga omwe adalipidwa ndi kuchepa kwa hemoglobin wa glycated, zizindikiro za lipid metabolism, kuphatikizapo cholesterol, ndi kuthamanga kwa magazi.
Izi zimatheka potsatira zakudya komanso kupereka mankhwala a insulin a mtundu woyamba wa matenda ashuga. Odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin amathanso kusamutsidwa kwakanthawi, ngati mankhwala ochepetsa shuga m'mapiritsi sangachepetse mpaka muyeso wovomerezeka.
Pambuyo mayendedwe a chizindikiro cha chakudya ndi mafuta kagayidwe, kuchepa kwa mawonekedwe a matenda ashuga polyneuropathy kumayamba mu miyezi iwiri.
Chithandizo cha mankhwala osokoneza bongo chimachitika pogwiritsa ntchito kukonzekera kwa thioctic acid: Berlition, Thiogamm, Espa-lipon. Mavuto a mavitamini a B akuwonetsedwa - Milgamma a matenda ashuga, Neurobeks Neo, Neurovitan, Neuroorubin.
Kwa analgesia, mankhwala othana ndi kutupa amagwiritsidwa ntchito - Indomethacin, Diclofenac, Nimesulide, komanso anticonvulsants - Gabalept, Lyrics. Malinga ndi zomwe zikuwonetsa, antidepressant akhoza kuikidwa - amitriptyline, clofranil, imipramine, venlafaxine.
Mafuta omwe amagwiritsidwa ntchito pompopompo ndi lidocaine - Veratis kapena mankhwala osagwiritsa ntchito mankhwala a anti-yotupa - Ketoprofen, Dolgit.
Njira zopanda mankhwala zimagwiritsidwa ntchito pochiza polyneuropathy mu matenda ashuga: hyperbaric oxygenation, balneotherapy, electrophoresis, kukondoweza ndi ma moderate mafunde, magnetotherapy, percutaneous electroneurostimulation. Itha kuikidwa posakhala matenda owopsa.
Mankhwalawa ululu wothandizira ululu, womwe suchotsedwa ndi mankhwalawa, kukondoweza kwa msana kumachitika.
Kupewa kwa kukula kwa polyneuropathy ndikuwongolera kuchuluka kwa shuga ndi kusintha kwa mankhwala omwe amachepetsa shuga. Kuphatikiza apo, odwala matenda a shuga amalimbikitsidwa kuyezetsa magazi pafupipafupi kwa hemoglobin ya glycated, aimpso komanso kwa chiwindi, komanso milingo ya lipoprotein.
Ndikotheka kupewa kuwonongedwa kwa mitsempha yamagazi ndi mafupa amitsempha malinga ndi malingaliro awa:
- Sungani kuthamanga kwa magazi pa 130/80 kuti musawononge magazi omwe angakhudze minofu yomwe ikukhudzidwa.
- Pewani shuga ndi ufa woyera kuchokera muzakudya, ndikuwonjezera masamba ndi zinthu zamafuta ochepa.
- Mowa uliwonse komanso kusuta fodya kuyenera kuletsedwa.
- Yendani tsiku lililonse, muzichita masewera olimbitsa thupi moyenera.
- Onani ukhondo ndikuyang'ana miyendo tsiku ndi tsiku.
Chithandizo cha zakumwa zoledzeretsa za polyneuropathy
Pazithandizo za polyneuropathy zomwe zimachitika chifukwa chomwa mowa, ndikofunikira kusiya zakumwa zoledzeretsa komanso zopatsa thanzi, kuphatikizapo kuchuluka kwa mavitamini ndi michere yazakudya, komanso mapuloteni athunthu.
Pa chithandizo cha physiotherapeutic, electromyostimulation, galvanization ndi electrophoresis yama mavitamini, novocaine amagwiritsidwa ntchito.
Ikani magnotherapy, laser mankhwala, sinusoidally masanjidwe oyenda, acupuncture. Odwala amawonetsedwa masewera olimbitsa thupi, kutikita minofu, kusambira ndi kuyenda.
Mankhwala osokoneza bongo a kuledzera neuropathy ikuchitika ndi mankhwala otsatirawa:
- Mavitamini a B: Milgamma, Neurorubin, Thiamine chloride, Pyridoxine hydrochloride, cyanocobalamin (intravenously kapena intramuscularly).
- Ascorbic acid amatha kubayidwa.
- Pentoxifylline, Trental kapena Pentilin, Cytoflavin kukonza kusintha kwaposachedwa.
- Actovegin a shuga chifukwa chokana hypoxia.
- Neuromidin kuti ayesetse kuchepa kwamitsempha.
- Anesthesia: mankhwala osokoneza bongo a anti-yotupa Voltaren, Revmoxicam; anticonvulsants - Gabalept, Finlepsin; antidepressants - Anafranil, Venflaxin.
- Mankhwala a Anticholinesterase a paresis kapena ziwalo - Neuromidine, Galantamine, Proserin.
Hepatoprotectors (Essentiale, Hepabene, Liv) amawonetsedwa kwa odwala otere kuti akwaniritse kukondweretsa kwa mankhwala komanso kuteteza maselo a chiwindi. Komanso, zotsatira zabwino zimapezeka mukamagwiritsa ntchito mankhwala omwe ali ndi thioctic acid - Thiogamm, Espa Lipon, Thioctacid, Berlition.
Kodi matenda ashuga a polyneuropathy ndi ati? Zambiri zokhudzana ndi izi zimaperekedwa mu kanema munkhaniyi.
