Mtundu woyamba wa matenda a shuga a mellitus (wodalira insulin) ndiye matenda ofala kwambiri padziko lonse lapansi. Malinga ndi ziwerengero zochokera ku World Health Organisation, lero anthu pafupifupi 80 miliyoni ali ndi nthendayi, ndipo pali chizolowezi china choti chizindikiro ichi chiwonjezeke.
Ngakhale kuti madotolo amatha kuthana ndi matenda oterewa pogwiritsa ntchito njira zakale zoperekera chithandizo, pali zovuta zomwe zimakhudzana ndi kuyambika kwa zovuta za matenda ashuga, ndipo kupatsirana kwa kapamba kungafunike pano. Kuyankhula manambala, odwala matenda a shuga omwe amadalira insulin:
- khalani akhungu nthawi 25 kuposa ena;
- kudwala kulephera aimpso maulendo 17;
- amakhudzidwa ndi gangrene kangapo;
- kukhala ndi mavuto amtima kawiri kuposa anthu ena.
Kuphatikiza apo, nthawi yayitali yokhala ndi matenda ashuga imakhala yifupi kwambiri kuposa yachitatu kwa iwo omwe samadalira shuga.
Chithandizo cha Pancreatic
Mukamagwiritsa ntchito mankhwala othandizira, m'malo mwake zotsatira zake sizingakhale za odwala onse, ndipo si aliyense amene angakwanitse kugula mtengo wotere. Izi zitha kufotokozedwa mosavuta chifukwa chakuti mankhwalawa amathandizira komanso mlingo wake woyenera ndizovuta kusankha, makamaka chifukwa ndikofunikira kuti apange payokha.
Madotolo adakankhira kufunafuna njira zatsopano zochizira madokotala:
- kuopsa kwa matenda ashuga;
- chikhalidwe cha matendawo;
- kuvuta kwawongolera zovuta za kagayidwe kazakudya.
Njira zamakono zopewera matendawa ndi monga:
- njira zamankhwala othandizira;
- kupandukira kwa kapamba;
- kupandukira kwa kapamba;
- kugawa maselo cell.
Chifukwa chakuti mu shuga mellitus, kusuntha kwa metabolic komwe kumawonekera chifukwa cha kuperewera kwa maselo a beta kumatha kupezeka, chithandizo cha matendawa chimatha chifukwa chakujambulidwa kwa ma islets a Langerhans.
Opaleshoni yotereyi ingathandize kuwongolera kupatuka mu njira za metabolic kapena kukhala chitsimikizo chopewa kukula kwa zovuta zachiwiri zamatenda omwe amadalira matenda a shuga, ngakhale mtengo wokwera opaleshoni, wodwala matenda ashuga akuganiza izi.
Ma cell a Islet sangathe kukhala ndi nthawi yayitali kuti akhale ndi vuto la kusintha kwa kagayidwe kazakudya kwa odwala. Ichi ndichifukwa chake ndibwino kutembenukira ku ziwonetsero zoperekera, zomwe zasungapo ntchito zake mpaka patali. Njira yofananayo imaphatikizapo kupereka zochitika kwa standardoglycemia ndi kutsekeka kwina kwa zoletsa zama metabolic.
Nthawi zina, pamakhala mwayi weniweni wokwaniritsa kusintha kwa matenda ashuga kapena kuyimitsidwa kwawo.
Kukwaniritsa zina
Thirani yoyamba ya kapamba inali ntchito yomwe idachitika mu Disembala 1966. Wolandila adakwanitsa kukwaniritsa Normoglycemia komanso kudziyimira pawokha kuchokera ku insulin, koma izi sizipanga mwayi wotcha opaleshoniyo kukhala wopambana, chifukwa mayiyo adamwalira pambuyo pa miyezi iwiri chifukwa chokana thupi ndi poyizoni wamagazi.
Ngakhale izi, zotsatira za zonse zomwe zimadza pambuyo pancreas zinali zopambana. Pakadali pano, kusinthika kwa chinthu chofunikira ichi sikungakhale kotsika chifukwa cha kufalikira kolimba:
- chiwindi
- impso
- Mitima.
Posachedwa, mankhwala atha kupita patsogolo kwambiri m'derali. Pogwiritsa ntchito cyclosporin A (CyA) yokhala ndi ma steroid mu Mlingo wocheperako, kupulumuka kwa odwala ndi zida zometera kunachuluka.
Odwala omwe ali ndi matenda ashuga ali pachiwopsezo chachikulu pakufalikira kwa ziwalo. Pali kuthekera kwakukulu kovutikira kwamthupi komanso kosatetemera. Amatha kuyambitsa kuyimitsidwa kwa chinthu chodalitsidwacho ngakhale kufa.
Chofunikira kwambiri ndichidziwitso kuti pangozi yayikulu ya odwala omwe ali ndi matenda a shuga pakuchita opareshoni, matendawa sakuwaopseza moyo wawo. Ngati chiwopsezo cha mtima kapena chiwopsezo cha mtima sichingachedwe, ndiye kuti kuzungulira kwa kapamba sikukuchitapo kanthu chifukwa cha thanzi.
Pofuna kuthana ndi vuto la kufalikira kwa ziwalo, choyamba, ndikofunikira:
- Sinthani miyezo yamoyo wa wodwala;
- yerekezerani kuchuluka kwa zovuta zachiwiri ndi zoopsa za opaleshoni;
- kuwunika wodwala matenda ake.
Ngakhale zili choncho, kuphatikizika kwa ma pancreatic ndi nkhani yakusankha kwa wodwala amene ali pachiwopsezo cha impso yotsika. Ambiri mwa anthuwa amakhala ndi zizindikiro za matenda ashuga, mwachitsanzo, nephropathy kapena retinopathy.
Pokhapokha patachitika opaleshoni, zimakhala zotheka kukambirana zakuletsa zovuta zachiwiri za matenda ashuga komanso mawonetseredwe a nephropathy. Pankhaniyi, kupatsirana kuyenera kukhala munthawi yomweyo kapena motsatizana. Njira yoyamba imakhudzanso kuchotsa ziwalo kuchokera kwa wopereka m'modzi, ndipo chachiwiri - kupatsirana kwa impso, kenako kapamba.
Nthawi yotsika ya kulephera kwa impso imayamba mwa omwe adayamba kudwala matenda ena a shuga zaka 20-30 zapitazo, ndipo pafupifupi odwala ali ndi zaka 25 mpaka 45.
Ndi mtundu wanji wakuzika womwe ndibwino kusankha?
Funso la njira yoyenera yokwaniritsira maopareshoni silinathetsedwe panjira inayake, chifukwa mikangano yokhudza kupatsirana pamodzi kapena kofanana ikakhala ikuchitika kwanthawi yayitali. Malinga ndi mawerengero ndi maphunziro azachipatala, ntchito ya chiwopsezo cha pancreatic pambuyo pa opaleshoni ndiyabwino kwambiri ngati ndikuwonjezera munthawi yomweyo. Izi ndichifukwa chocheperako chomwe chingakanidwe ndi ziwalo. Komabe, ngati tilingalira kuchuluka kwa kupulumuka, ndiye mu nkhani iyi kupatsirana kotsatana kudzachitika, komwe kumatsimikiziridwa ndi kusankha mosamala odwala.
Kuika kwa kapamba kuti alepheretse kukula kwa matenda a shuga a mellitus ayenera kuchitidwa koyambirira kwa matendawa. Chifukwa chakuti chisonyezo chachikulu chokomera anthu ena chitha kukhala chiwopsezo chovuta cha zovuta zachiwiri, ndikofunikira kuwonetsa kuneneratu. Yoyamba mwa izi ndi proteinuria. Pakuchitika kwa proteinuria yokhazikika, ntchito yaimpso imawonongeka msanga, komabe, njira yofananira imatha kukhala ndi mitengo yosiyanasiyana yotukuka.
Monga lamulo, theka la odwala omwe adakhala ndi gawo loyambirira la proteinuria yokhazikika, pafupifupi zaka 7 pambuyo pake, kulephera kwa impso, makamaka, kwa siteji yotsala, kumayamba. Ngati munthu akudwala matenda osokoneza bongo opanda proteinuria, zotsatira zakupha ndizotheka kawiri kawiri kuposa mseri, ndiye kuti mwa anthu omwe ali ndi proteinuria chisonyezochi chikuwonjezeka ndi 100 peresenti. Malingana ndi mfundo imodzimodziyo, nephropathy, yomwe ikungopanga, iyenera kuwonedwa ngati kufalitsa koyenera kwa kapamba.
Pambuyo pake pakupanga matenda a shuga, omwe amadalira insulin, kutulutsa kwa chiwalo ndikosayenera. Ngati ntchito yaimpso yafupika kwambiri, ndiye kuti kuchotsa njira ya m'matumbo a ziwalozi kuli kovuta. Pachifukwa ichi, odwala oterewa sangathenso kukhalabe ndi moyo wa nephrotic, womwe umayambitsidwa ndi immunosuppression ya SuA itatha kupatsidwa chiwalo.
Mbali yotsika yogwira ntchito ya impso ya munthu wodwala matenda ashuga iyenera kuganiziridwa ngati yomwe ili ndi kusefukira kwa 60 ml / mphindi. Ngati chisonyezo chiri pansipa, ndiye kuti titha kukambirana za mwayi wokonzekera kuphatikizira pamodzi kwa impso ndi kapamba. Ndi kusefukira kwa gawo lopitilira 60 ml / min, wodwalayo ali ndi mwayi wofunika kwambiri wothandiza kukhazikika kwa impso. Pankhaniyi, kuphatikiza kumodzi kokha kapamba ndikoyenera.
Zowonjezera Milandu
M'zaka zaposachedwa, kupandukira kwa pancreatic kwakhala kugwiritsidwa ntchito pazovuta za matenda a shuga omwe amadalira insulin. Zikatero, tikulankhula za odwala:
- omwe ali ndi matenda a shuga;
- matenda osokoneza bongo a shuga ndi kusakhalapo kapena kuphwanya kwa kusintha kwa mahomoni a hypoglycemia;
- amene amakana subcutaneous makonzedwe a insulin osiyanasiyana mayamwidwe.
Ngakhale chifukwa choopsa kwambiri pamavuto komanso kusasangalala kwambiri komwe kumayambitsa, odwala amatha kukhalabe ndi vuto la impso ndikuthandizidwa ndi SuA.
Pakadali pano, chithandizo mwanjira imeneyi chachitika kale ndi odwala angapo ochokera pagulu lirilonse lomwe akuwonetsa. Muzochitika zonsezi, kusintha kwina kwabwino kunadziwika mu thanzi lawo. Palinso milandu yokhudza kupindikiza kwa kapamba pambuyo pancreatectomy yathunthu yoyambitsidwa ndi chifuwa chachikulu. Ntchito za Exo native ndi endocrine zabwezeretseka.
Iwo omwe adapulumuka pakufalikira kwa kapamba chifukwa cha retinopathy yomwe ikupita patsogolo sanathe kusintha mikhalidwe yawo. Nthawi zina, kusinthanso kunadziwikanso. Ndikofunikira kuwonjezera pa nkhaniyi kuti kupatsirana kwa ziwalo kunachitika motsutsana ndi maziko osintha kwambiri m'thupi. Pali lingaliro lomwe lingakhale lotheka kwambiri ngati opaleshoniyo idachitidwa m'mbuyomu maphunziro a shuga, chifukwa, mwachitsanzo, zizindikiro za matenda ashuga mwa mkazi zimatha kupezeka mosavuta.
Chachikulu contraindication kuti ziwalo kumuika
Choletsedwa chachikulu pakuchita opaleshoni imeneyi ndi milanduyo pamene pali zotupa zoyipa mthupi zomwe sizingathe kukonza, komanso psychoses. Matenda aliwonse omwe ali pachimake ayenera kuti adachotsedwa ntchito isanachitike. Izi zikugwirizana ndi milandu pomwe matendawa amayambitsidwa osati ndi matenda a shuga okha ayi, komanso tikukamba za matenda omwe ali ndi matenda opatsirana.
