Matenda a shuga ndi matenda amkati: zovuta ndi chithandizo

Chiwopsezo cha matenda a shuga chikukula kwambiri, zomwe zimatipangitsa kuti tiziti mliri wapadziko lonse lapansi. Mwa odwala onse, 90% ndi mtundu wachiwiri wa matenda ashuga, omwe amayambitsa kunenepa kwambiri, zolimbitsa thupi komanso mawonekedwe amtundu.

Zomwezi zimathandizira kukulitsa matenda a mtima, impso, kapamba. Kupezeka kwa matenda amodzimodzi mu matenda a shuga kumadetsa nkhawa kwa odwala.

Matenda a shuga amachepetsa kusinthika komanso kusintha kwina mthupi, chitetezo cha mthupi. Pankhaniyi, chithandizo cha matenda aliwonse chiyenera kugwirizanitsidwa ndi hypoglycemic therapy.

Matenda a shuga ndi mtima

Udindo wa matenda a shuga ndi matenda a ziwalo zamkati pakuwonjezera kufa kwa odwala okalamba amawonekera kwambiri mu mtima. Matenda a mtima komanso sitiroko odwala omwe ali ndi matenda ashuga amakula nthawi 6 kuposa magulu ena odwala.

Zomwe zimayambitsa matenda a mtima, monga matenda oopsa, kunenepa kwambiri, komanso kuperewera kwa lipid metabolism mu odwala matenda ashuga ndizofala kwambiri. Matenda a shuga enieni ndiwomwe amachititsa kuti matenda ena a mtima azikhala ndi matenda osokoneza bongo (CHD).

Akatswiri ambiri amtima komanso ma endocrinologists amawona matenda ashuga ngati ofanana ndi mtima ischemia. Chifukwa chake, mukamayang'ana odwala omwe ali ndi matenda ashuga, kuphatikiza kowonjezera kwa maphunziro amtima ndi zizindikiro za kagayidwe ka mafuta kumayikidwa, ngakhale pakalibe chithunzi cha matenda a mtima.

Zomwe zimayambitsa chitukuko cha matenda a mtima ndi mtima m'matenda a shuga ndi awa:

1. Hypercholesterolemia - kuchuluka kwa cholesterol ndi 1 mmol / l kumawonjezera chiopsezo cha matenda amtima ndi 60%.
2. Lipoprotein yotsika kwambiri m'magazi
3. Hyperglycemia ndi kuchuluka glycosylated hemoglobin.
4. Kuchuluka kwa kuthamanga kwa magazi ndi 10 mm. Hg. Art. zimawonjezera chiopsezo cha matenda a mtima ndi 15%.
5. Kusuta kumawonjezera zotupa za mtima ndi 41% pokhudzana ndi omwe sasuta.

Njira yayikulu yopewa matenda amtima ndi mtima ndi kuchepetsa shuga m'magazi mpaka 5-7 mmol / l, atatha maola awiri kuti 10. Komanso, hemoglobin ya glycosylated sayenera kupitirira 7%. Izi zitha kuchitika pang'onopang'ono poonetsetsa kuchuluka kwa shuga komanso kugwiritsa ntchito zakudya zomwe zili ndi index ya glycemic yotsika.

Cholinga cha mankhwala ochepetsa shuga ziyenera kuchitidwa poganizira zotsatira zake zoyipa pamtima dongosolo (Glibenclamide, Tolbutamide, Chlorpropamide). Odwala omwe sangathe kulipidwa ndi matenda a shuga omwe amapatsidwa mapiritsi amawonetsedwa ndi insulin onse pamodzi ngati mankhwala.

Kuthamanga kwa magazi kuyenera kusungidwa pamlingo wochepera 130/80 mm RT. Art. Zizindikiro zotere zimachepetsa chiopsezo cha myocardial infarction ndi stroke, komanso kufa ndi kulemala kwa odwala.

Cholinga cha mankhwalawa kuti muchepetse kuthana ndi odwala omwe ali ndi matenda ashuga ayenera kutengera mphamvu yawo mu chakudya ndi mafuta, kuteteza minofu ya impso ndipo osakhudza mawonetsedwe a hypoglycemia. Mwa izi, magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito:

• ACE inhibitors (angiotensin-converting enzyme) amalembedwa mapuloteni mukaonekera mu mkodzo, kugwiritsa ntchito kwawo kumachepetsa chiopsezo cha matenda a shuga 2 (kuwonjezera chidwi cha insulin. Izi zikuphatikiza: Enap, Ramipril, Lisinopril, Captopril.
• Angiotensin receptor blockers 2. Kukhala ndi zomwe gulu lakale la mankhwala, kuteteza malinga a mitsempha ya magazi ndi impso. Awa ndi mankhwalawa Teveten, Aprovel, Cozaar, Lorista, Mikardis, Valsacor, Exforge.
• Ma calcium blockers - Verapamil, Nifidepine, Diltiazem.
• Ma diuretics - Furosemide, Trifas.
• Imidiazoline zolandilira zimachepetsa ntchito ya mtima wamanjenje ndipo nthawi yomweyo zimawonjezera chidwi cha minyewa kupita ku insulin. Izi zikuphatikiza Physiotens ndi Albarel.

Nthawi zambiri, kuphatikiza mankhwala ndi mankhwala ochokera m'magulu osiyanasiyana kumagwiritsidwa ntchito.

Pofuna kuthana ndi dyslipidemia, odwala amalangizidwa kuti aziletsa mafuta azinyama muzakudya zawo - nkhumba, mwanawankhosa, offal, mafuta wowawasa wowawasa, kirimu ndi tchizi cha kanyumba, amachepetsa mowa ndipo nthawi yomweyo idyani masamba atsopano, zipatso zosaphatikizidwa, kuphatikizapo chinangwa, nsomba ndi masamba mafuta muzakudya.

Pofuna kupewa kupitirira kwa matenda ashuga komanso zotupa zam'mimba, ndikofunikira kuti zizisungidwa (mu mmol / l): liproproteins yotsika pansi pa 2.6; okwera - oposa 1.1; triglycerides - zosakwana 1.7.

Ngati zakudya zalephera kukwaniritsa zoterezi, ndiye kuti kukonzekera kwa statin kumawonjezeranso: Zokor, Krestor, Liprimar.

Kunenepa kwambiri komanso matenda a shuga

Chiyanjano pakati pa matenda amtundu wa 2 komanso kunenepa kwambiri kumalumikizidwa ndi zomwe zimapangitsa kupezeka kwawo komanso kuwonjezereka kwa zizindikiro. Udindo waukulu wobadwa nawo ndi chikhalidwe cha kadyedwe, njira zambiri za chitukuko zimayambitsa kutsimikiza zakuchepa kwa kunenepa kwambiri pochizira matenda ashuga.

Kudzikundikira kwamafuta kumachitika ndi chitukuko cha minofu yolimbana ndi insulin. Mkulu ukakhala wokwanira kukana, insulin yochulukirapo imapangidwa ndi kapamba, potero kumawonjezera mafuta achilengedwe.

Kuphatikiza pakuchulukitsidwa kwamafuta, kuperewera kwa serotonin kumatha kufalikira. Izi zimapangitsa kuti muzikhala ndi nkhawa, kukhumudwa, kulakalaka komanso njala. Kulandila kwa chakudya chama chakudya kumapangitsa kuti mtima ukhale m'malo komanso kuchepetsa nkhawa zopweteka kwakanthawi. Kudya zakudya zonona ndi zotsekemera kumawonjezera ngozi ya matenda a shuga komanso kunenepa kwambiri.

Njira zomwe zimatsogolera pakupititsa patsogolo kagayidwe kazakudya ndi kusadya bwino, kudya mosasamala, kupanikizika ndi kudya pambuyo pake, kusowa tulo komanso kusowa zolimbitsa thupi.

Kuphatikiza pa vuto lodzikongoletsera, kunenepa kumasokoneza kugwira ntchito kwa ziwalo zamkati, zomwe zimadziwoneka ngati:

• Matenda a Coronary ndi myocadiopathy.
• Matumbo am'mimba - matenda a gallstone ndi kapamba.
• Kuwonongeka kwamafuta kwa chiwindi.
• Matenda ophatikizika.
• Kusowa kwa msambo kwa akazi.
• Kuchepetsa potency mwa amuna.
• Mkulu matenda oopsa.

Kuopsa kwa zovuta zamankhwala mu kunenepa kwambiri ndi matenda a shuga ndikupanga kudalira komanso zovuta zakulepheretsa zakudya. Mzere woipa umapangidwa: kulakalaka maswiti - kudya kwambiri - kuchuluka kwa magazi m'magazi - kumasulidwa kwa insulini - kuphatikizidwa kwa chakudya chamagulu mumafuta omwe ali ndi gawo la insulin - dontho la shuga - kufuna kudya maswiti.

Njira imodzi yothanirana ndi kudalira kwa chakudya chamafuta ndikutenga chromium picoline kwa masabata 3-4. Kuphatikiza apo, mankhwala ochepetsa shuga amagwiritsidwa ntchito - Metformin, Glucobay. Odwala omwe apanga kwambiri insulin yawo, ngakhale atakhala ndi hyperglycemia yayikulu, samawonetsedwa chifukwa chothana ndi insulin.

Njira yothandiza kwambiri yochepetsera shuga ndi magazi ndichakudya chochepa kwambiri. Mulinso zinthu monga: nyama chosakhwima, nkhuku, mazira, tchizi. Maziko a menyu ayenera kuwiritsa kapena kuwotcha nsomba, nsomba zam'madzi, masamba.

Ndikofunika kwambiri kukonza masaladi atsopano kuchokera ku kabichi, masamba, nkhaka, tomato ndi tsabola wokoma kuchokera masamba.

Mafuta chiwindi ndi shuga

Chiwindi ndi kusintha kwa kapangidwe ka magazi - kudzikundikira kwa poizoni wa bakiteriya, mankhwala kapena kagayidwe kachakudya, kamakhudzana ndi kuphatikizidwa kwamafuta m'maselo. Kuchita kotereku kumatha kuchitika panthawi yanjala, masamba okhwima, malabsorption m'matumbo, kuledzera.

Ndi matenda a shuga, mapangidwe owonjezereka a matupi a ketone amakula chifukwa chophwanya kagayidwe kazachilengedwe. Amatha kudzikundikira mu ziwalo za chiwindi. Mafuta ochulukirapo omwe amalowa m'matumbo ndikulowera magazi, kenako kulowa m'chiwindi, amatha kuthana ndi mafuta.

Mwa anthu athanzi, mafuta acids amagwiritsidwa ntchito popanga mphamvu, ndipo mu mtundu wa 2 shuga, insulin, yomwe imapangidwa m'matumbo kwambiri, imalepheretsa njirayi ndikuwonjezera kuchuluka kwa mafuta m'chiwindi.

Ndi kunenepa kwambiri komwe kumayenderana ndi matenda a shuga, mafuta a hepatosis amapezeka nthawi zambiri, ndipo ndi chimodzi mwazizindikiro za dysmetabolic syndrome. Chifukwa cha kuthekera kwa chiwindi kuphatikiza mafuta, chimbudzi ndi momwe mankhwalawo amadzidulira.

Zizindikiro za matenda a hepatosis yamafuta nthawi zambiri sizimawoneka. Kuopsa kwa hypochondrium yoyenera, yolimbikitsidwa ndi kulimbitsa thupi, kukhoza kusokoneza. Ndi palpation, kupweteka kumatha kuchitika pokhapokha ngati kudzikundikira kwamphamvu kwamankhwala kungayambitse matenda ashuga.

Kuzindikira kumakhazikitsidwa pazizindikiro izi:

1. Ultrasound, yowerengera tomography - mawonekedwe ophatikizidwa, kuwonjezeka kukula.
2. Ntchito ya seramu chiwindi michere imachuluka.
3. Kuchuluka kwa cholesterol ndi triglycerides m'mwazi.

Chithandizo cha hepatosis yamafuta chimachitika ndi zakudya zomwe zimaphatikizidwa ndi zakudya za lipotropic: oatmeal, nsomba, tchizi chanyumba, nsomba zam'nyanja, soya, kefir, yogati, mafuta ozizira osakanizidwa. Zimathandizira kuchotsa mafuta ochulukirapo ndi chakudya cha cholesterol chokhala ndi fiber ndi pectin. Chifukwa chake, chakudyacho chikuyenera kukhala masamba ambiri. Ndi chizolowezi chodzimbidwa, ndikofunikira kuwonjezera chinangwa m'mbale.

Mwa mankhwala omwe amagwiritsidwa ntchito hepatoprotectors - Gepabene, Essentiale, Essliver, Glutargin ndi Berlition.

Matenda opatsirana a shuga

Matenda a shuga amapezeka ndi kuchepa kwa mayankho a chitetezo cha mthupi, zomwe zimapangitsa odwala kukhala pachiwopsezo cha mabakiteriya ndi mavairasi, matenda oyamba ndi mafangasi. Matenda oterewa amadziwika ndi pafupipafupi komanso mwamphamvu. Pankhaniyi, matenda amachititsa matenda ashuga.

Pali matenda opatsirana omwe samapezeka mwa anthu opanda zovuta za metabolic - zopweteka zakunja za otitis media, emphysematous cholecystitis, pyelonephritis ndi cystitis, komanso phazi la matenda ashuga.

Odwala omwe ali ndi matenda a shuga amadwala matenda opatsirana nthawi 1.5 nthawi zambiri kuposa ena. Izi zimachitika chifukwa chakuwonongeka kwakuthupi komanso kwakanthawi. Zomwe zimaphatikizidwa ndikuphwanya ntchito ya maselo oyera magazi kuwononga mabakiteriya - kuchepa kwa kayendedwe, phagocytosis, ndi zochitika za opha T.

Zomwe zimachitika m'deralo zimayenderana ndi kukula kwa mitsempha yowonongeka - yaying'ono- ndi macroangiopathy, neuropathy, yomwe imayeretsa kuyeretsa ndikubwezeretsa ziwalo zowonongeka kuchokera ku ma virus ndi ma sumu awo.

Kuwopsa kwa matendawa kumachitikanso chifukwa cha kuyipa kwa antimicrobial. Ndi milingo yayitali kwambiri ya lipoprotein, cholesterol ndi mafuta acids, amamangirira kumapuloteni amwazi omwe mankhwalawa amayenera kunyamula. Chifukwa chake, mwa odwala omwe ali ndi matenda ashuga, kuperekera kwa maantibayotiki ku lesion kumachepetsedwa.

Chizindikiro cha chibayo m'magazi a shuga ndi chiopsezo cha bacteremia, chomwe chimayambitsa imfa. Tizilombo toyambitsa matenda nthawi zambiri zimakhala staphylococci, Klebsiella ndi streptococci. Poyerekeza ndi chibayo, odwala nthawi zambiri amadwala matenda a shuga a ketoacidosis. Mitundu yayikulu, mankhwala a antibacteria ogwiritsa ntchito beta-lactams ndi fluoroquinolones akuwonetsedwa.

Pyelonephritis nthawi zambiri amapezeka mu kuwonongeka kwa impso. Maantibayotiki amaikidwa kokha mu intramuscularly kapena kudzera m'mitsempha: Ciprofloxacin, Ceftriaxone, Levofloxacin. Onetsetsani kuti mukugwiritsa ntchito maantibayotiki omwe ali ndi mankhwala antifungal kuti mupewe candidiasis.

Kupezeka kwachilengedwe kofalikira kwamatenda ofewa ndi phazi la matenda ashuga. Izi ndichifukwa cha zifukwa izi:

1. Kuchepetsa chidwi chowonongeka.
2. Matenda oyamba ndi fungus.
3. Zosokoneza magazi m'miyendo.

Zilonda zikagwidwa ndi matenda, pamatha kukhala njira ziwiri zakupangika kwa matenda: Matenda osapsa (osadulidwa) komanso owopsa, zomwe zimapangitsa kuti azidula mbali yakumanjayo.

Fomu yofatsa imapezeka mu mawonekedwe a zilonda zapamwamba ndi zotupa za subcutaneous minofu yochepera 2 cm mulitali, palibe zizindikiro zodziwika bwino za kuledzera. Chithandizo cha opaleshoni ya bala ndi kukhazikitsidwa kwa maantibayotiki akuwonetsedwa: Cephalexin, Clindamycin. Kutsegula pakamwa.

Matenda owopsa amawonetsedwa ndi zilonda zam'mimba zowonongeka kwambiri ndi zimakhala zowazungulira, kuledzera kwathunthu, komanso kuchepa kwa magazi m'dera lomwe lakhudzidwa. Magazi a shuga m'magazi nthawi zambiri amakhala okwera. Kupatula osteomyelitis, kuphatikizidwa kwa minofu ya mafupa kumachitika.

Maantibiotic amaperekedwa kudzera mu mtsempha wa magazi komanso mu mnofu: Amoxiclav, Vancomycin, Meronem. Kutalika kwa chithandizo sikuchepera mwezi umodzi. Ndi kusakhazikika kwa njira zosasamala zamankhwala, kudula pang'ono kapena kwathunthu kwa zimakhala zomwe zimakhudzidwa.

Mu shuga mellitus, chimodzi mwazofooka ndimatenda a khungu ndi mucous membrane. Odziwika pafupipafupi zotupa za fungal:

• Dera la Groin.
• Pindani pansi pa tiziwalo ta mammary.
• Zowonjezera

Ndi chosakwanira chindapusa cha matenda ashuga, ma candidiasis amatha kuchitika ndi matenda amkamwa mwa mawonekedwe a zolembedwa zoyera, limodzi ndi kuwawa ndi kuwotcha. Ngati afalikira kummero, zimakhala zovuta kumeza. Nthawi zambiri candidiasis amawonetsedwa mwa maliseche.

Chithandizo cha candidiasis chimachitika makamaka pogwiritsa ntchito mafuta antifungal ndi suppositories mwa akazi. Kugwiritsa ntchito komweko kumaphatikizidwa ndikutenga maphunziro a fluconazole. Ndi kukula kwa kukana ndi izi, amasinthana ndi Itraconazole kapena Ketoconazole.

Kupambana kwa mankhwala opha maantibayotiki kumadalira kuchuluka kwa chiphuphu cha matenda ashuga. Odwala omwe ali ndi matenda opatsirana a mtundu wachiwiri wa shuga, insulin imayikidwa mu maphunziro kapena imasungidwira kwa iwo isanathe chithandizo cha matenda a concomitant. Kanemayo munkhaniyi atchulanso za moyo wodwala matenda ashuga.