Matenda a shuga a retinopathy amawonongeka m'matumbo am'maso. Matendawa ndi omwe amaphatikizidwa ndi shuga, omwe mwatsoka angayambitse khungu.
Kusinthika kwa kuthekera kwa kuthekera kumachitika mu 85% ya anthu omwe ali ndi vuto la matenda ashuga amtundu wautali wazaka zamtunduwu (kuyambira zaka 20). Ndipo odwala omwe ali ndi matenda a shuga a 2 apakati komanso okalamba, zowonongeka m'matumbo am'maso zimawonekera mu 50% ya milandu.
Atapezeka kuti vuto limodzi la matenda ashuga kwambiri ndi khungu la akulu, azaka zapakati pa 20 mpaka 74. Koma ngati wodwalayo adayeza ndi dokotala wa maso ndikuwonetsetsa zonse zomwe akuwayimbira, ndiye kuti kuthekera kopitilira kukuoneka.
Tsoka ilo, pambuyo pake, matenda ashuga angayambitse kuwonongeka kwathunthu. Pazifukwa izi, anthu omwe akudwala matenda othandizira odwala matenda ashuga retinopathy nthawi zambiri amalimbikitsidwa ndi madokotala kuti achite laser.
Chifukwa cha njira iyi ya mankhwalawa, kuyambika kwa khungu kumatha kuchedwa kwa nthawi yayitali ndipo matenda monga matenda ashuga retinopathy amatha kuphatikizidwa. Ambiri odwala matenda ashuga ali ndi zizindikiro za retinopathy m'masiku awo oyambirira. Pakadali pano, matendawa samapitirira, kotero kuwonongeka kwakawonedwa sikuwoneka. Amatha kuwonekedwa pokhapokha atawunika ndi akatswiri a ophthalmologist.
Masiku ano, chiyembekezo cha moyo mwa anthu okhala ndi matenda amtundu woyamba 1 chikuwonjezeka. chiopsezo cha kufa chifukwa cha matenda amtima chachepa. Ndipo izi zikuwonetsa kuti matenda ashuga retinopathy ali ndi nthawi yambiri kuti apite patsogolo mwa anthu ambiri. Kuphatikiza apo, matenda a maso nthawi zambiri amakhala limodzi ndi zovuta zina za matenda ashuga, monga matenda a impso komanso phazi la matenda ashuga.
Zomwe zimayambitsa matenda a maso kwa odwala omwe ali ndi matenda ashuga
Tsoka ilo, zomwe zimayambitsa kupangika kwa matenda ashuga retinopathy sizinadziwikebe. Masiku ano, asayansi akuganiza mosiyanasiyana. Komabe, zomwe zimadziwika kale, kotero odwala matenda ashuga ayenera kudziwa za iwo ndikuwaganizira akakumana ndi matenda a shuga a retinopathy.
Mwayi wokhala ndi matenda amaso ukuwonjezeka ngati:
- mimba
- kutengera kwa chibadwa;
- ngati shuga wamagazi amawonjezereka pafupipafupi;
- kusuta;
- matenda a impso;
- matenda oopsa (kuthamanga kwa magazi);
- okalamba amakonda kwambiri matenda ashuga retinopathy.
Koma zifukwa zazikulu zili mu matenda oopsa komanso shuga wambiri, yemwe amapitilira ena onse, ngakhale osalamulika, Zizindikiro - kutalika kwa matenda ashuga, chibadwa komanso zaka.
Chimachitika ndi chiyani matenda ashuga retinopathy?
Chifukwa cha kusuta, shuga m'magazi komanso matenda oopsa, mitsempha yaying'ono yomwe magazi amaperekedwa m'maso imawonongeka, yomwe imasokoneza kuperekera kwa michere ndi mpweya, ndipo umu ndi momwe njira zomwe zimayambitsa matenda ashuga retinopathy zingafotokozeredwe. Pazonse, Zizindikiro za shuga m'magazi zimayenera kukhala zowopsa nthawi zonse, chifukwa zotsatira zake zimatha kukhala zowopsa nthawi zonse.
Ndipo poyerekeza ndi minofu ina ya thupi, khungu la maso limadya glucose yambiri ndi okosijeni pachinthu chilichonse cholemera.
Retinology. Kukula gawo
Chifukwa cha kuchepa kwa mpweya wa minofu ya thupi, thupi limayamba kukulira ma capillaries atsopano kuti abwezeretse magazi ake kumaso. Izi zimatchedwa kuchulukitsa. Koma gawo loyambirira la retinology likuwonetsa kuti njirayi sinayambebe.
Pakadali pano, makoma azombo okha ndi omwe akuwa. Vutoli limatchedwa miconeurism. Nthawi zina, madzimadzi ndi magazi amatuluka kuchokera ku capillaries kupita ku retina. Poterepa, mafupa am'mimba a retina adatupa, ndipo macula (pakati pa retina) amatupa. Vutoli limatchedwa macular edema.
Kukula kumatchedwa kuchulukitsa m'maso amitsempha yatsopano yamagazi. Amakhala osalimba, chifukwa chake amatuluka zotupa. Ndipo gawo lowonjezereka la matenda ashuga retinopathy likuwonetsa kuti njira ya kukula kwa mitsempha yatsopano ya magazi m'malo mwa yowonongeka idayamba kale.
Monga lamulo, zonyansa zam'mimba zimawonekera mu retina, koma nthawi zina zimakula mpaka kulowa mu thupi lamphamvu - lambiri, ngati kanthu kowoneka bwino lomwe limadzaza pakati pakumaso. Zombo zatsopano zomwe zikula, mwatsoka, ndizopanda ntchito.
Amakhala osalimba, zomwe zimapangitsa kuti magazi azituluka pafupipafupi. Mapazi amadziunjikira, pomwe mafupa am'mimba amtundu wina, m'mawu ena, mabala amawoneka m'dera la hemorrhage, retinopathy ya matenda ashuga nthawi zonse imabweretsa zotsatirapo zake.
Pali nthawi zina zomwe retina limatambasulidwa ndikuchoka kukhoma lakumbuyo kwa diso. Vutoli limatchedwa kukanidwa kwina. Pamene ziwiya zatsopano zimapangidwa ndikusokoneza kayendedwe kazachilengedwe, ndiye kuti kupanikizika kwa diso kumawonjezeka, komwe kumapangitsa kuwonongeka kwa mitsempha ya maso, yomwe ili ndi ntchito yofunika kwa odwala omwe apezeka ndi matenda a shuga.
Mtsempha umafikitsa chithunzicho ku bongo. Pakadali pano, wodwalayo amayamba kuwona zithunzi zosalongosoka, zinthu zosokonekera, kusawona bwino usiku, ndi zina zambiri.
Kodi mungapewe bwanji retinopathy?
Dziwani kuti kufunikira kwa glucose wamagazi ndichizolowezi, pokhapokha mlingowo uzikhala womwe mukufunako, komanso ngati kuthamanga kwa magazi sikupitirira 130/80 mm RT. Art., Ndiye kuti chiopsezo cha retinopathy ndi zovuta zina za matenda ashuga zidzachepa kwambiri.
Koma ziyenera kukumbukiridwa kuti wodwala yekhayo yekha ndi amene angayang'anire momwe thanzi lake lilili, kuti moyo wake ukhale wautali komanso thanzi lake ndi labwino.
Magawo a retinopathy
Kuti mumvetsetse momwe magawo a matenda ashuga retinopathy amasiyanirana, komanso zomwe zimayambitsa, ndikofunikira kumvetsetsa momwe diso la munthu limagwirira ntchito komanso magawo ake.
Mphezi zowala zimalowa m'maso, kenako zimasinthidwa ndi mandala ndikuyang'ana retina. Retina ndiye mkati mwa mucular membrane wokhala ndi maselo a Photoreceptor, ndikupereka kusintha kwa ma radiation kukhala ma nerve impulses ndi kachitidwe kawo koyamba. Chithunzicho chimasonkhanitsidwa ku retina, pambuyo pake chimalowa m'mitsempha ya optic kenako ubongo.
Vitreous ndi chinthu chomwe chili pakati pa retina ndi mandala. Minofu imalumikizidwa ku chiwalo, chifukwa cha momwe diso limayendera mbali zosiyanasiyana.
Pali gawo lapadera m'diso la diso komwe mandala amayang'ana kwambiri. Derali limatchedwa macula, ndikofunikira kukambirana za retinopathy.
Gulu la retinopathy:
- gawo loyambirira;
- gawo lowonetseratu;
- gawo loyala;
- siteji ya terminal (kusintha komaliza mu retina).
Gawo losakulitsa
Pankhani ya matenda ashuga retinopathy, ziwiya zomwe zimadyetsa retina zimawonongeka. Pa gawo loyambirira la matendawa, zotengera zazing'ono kwambiri - capillaries zimakhudzidwa kaye.
Kutsekeka kwa makoma awo kumachulukitsidwa, chifukwa chomwe kukha magazi kumachitika ndipo mafupa a retinal amapangidwa.
Preproliferative siteji
Pakadali pano, kusintha kwa ma retina kumawonekera kwambiri. Mukazindikira a ophthalmologist, kutsata zotupa zambiri, malo a ischemic, kuchuluka kwa madzi kumawonekera. Mwanjira ina, adokotala amawona kusokonezeka kwa magazi, chifukwa chotengera chomwe "matendawa" amakhala ndi njala. Pakadali pano, njirayi imakhudza macula, ndipo wodwalanso amadandaula chifukwa cha kuwonongeka kwa mawonekedwe.
Kukula gawo
Pakadali pano, zombo zatsopano zimawonekera, zikusintha zomwe zidawonongeka kale. Mitsempha yamagazi imamera kwambiri mu vitreous. Koma zombo zongopangidwazo zimakhala zopanda nzeru, chifukwa chake zotupa chifukwa zimachitika nthawi zambiri.
Gawo lachigawo
Nthawi zambiri pamlingo wotsiriza, masomphenya amatsekedwa ndi kukoka kwam'mimba. Mwanjira iyi, kuchuluka kwa magazi kumapangidwa, chifukwa chomwe retina chimatambasulidwa ndikukana kwake kumayamba.
Ma lens akasiya kugwira mphezi zowala pa macula, munthuyo amakhala wakhungu kwathunthu.
Zizindikiro ndi matenda a diabetesic retinopathy
Zizindikiro zazikulu za matendawa zikuipiraipira kuwonekera kwamawonekedwe kapena kutayika kwathunthu. Koma zizindikilo zazikulu zotere zimawonekera pomwe njirayo yayamba kale. Chifukwa chake, chithandizo akangoyambitsidwa, malingaliro abwino apitilira.
Onse odwala matenda ashuga ayenera kupendedwa pafupipafupi ndi miyezi isanu ndi umodzi. Ndikofunika kuti katswiri wazachipatala wodziwa kwambiri za matenda ashuga retinopathy akhale nawo pamayeso ndi chithandizo. Mutha kupeza katswiri wotere kuchipatala chapadera cha odwala matenda ashuga.
Chithunzi pamayeso ochitidwa ndi dokotala wamatenda a matenda ashuga:
- Unikani zamaso ndi matope, ngakhale zitakhala kuti pali zizindikiro.
- Chitani visiometry.
- Yang'anani kuchuluka kwa kukakamiza kwa intraocular. Amadziwika kamodzi pa miyezi 12 ya odwala matenda ashuga omwe akhala akudwala kwa zaka khumi kapena kupitilira apo.
- Pangani biomicroscopy wa diso lakunja.
Muzochitika pamene zisonyezo ndi chisonyezo cha intraocular chikaloleza, kenako kukulira kwa mwana, kudziwikanso kowonjezereka kumachitika, komwe kumaphatikizapo:
- Vitreous ndi crystalline biomicroscopy pogwiritsa ntchito nyali yoyenda.
- Kuyesedwa kwa dera la macular ndi disc ya optic.
- Direct and reverse ophthalmoscopy (yochitidwa mwanjira yoyambira kuchokera mbali yapakati mpaka kotali, palimodzi ndi ma meridians onse).
- Chithunzi chojambulidwa ndi Fundus ndi kamera yosakhala yachangu kapena kamera ya fundus.
- Dziwani za retina ndi thupi lamphamvu pa nyali yamchere yogwiritsa ntchito mandala a Goldman (magalasi atatu).
Panthawi yodziwitsa za retinopathy, njira zodziwika kwambiri ndizojambula za fluorescein ndi kujambula zithunzi, pambuyo pake chithandizo chikutsimikizika.
Kodi odwala matenda ashuga retinopathy amathandizidwa bwanji?
Mavuto amatha kuthandizidwa motere:
- Retinal cauterization (laser coagulation).
- Jakisoni wamaso. Mankhwala a AntiVEGF amalowetsedwa m'matumbo amaso. Mankhwalawa amatchedwa ranibizumab. Mankhwalawa agwiritsidwa ntchito kuyambira 2012 pambuyo poyesedwa kwatsimikizira kuyendetsa bwino kwa mankhwalawa. Zingwe zimayikidwa padera kapena molumikizana ndi laser coagulation.
- Vitrectomy ndi endolasercoagulation. Mankhwalawa amagwiritsidwa ntchito ngati njira ziwiri zapitazi sizinathandize. Mwa njira, kafukufuku wamasiku ano awonetsa kuti palibe zovuta pamankhwala am'magazi, komanso mavitamini, antioxidants ndi ma enzyme. Kuyambira pano, dicinone, caviton, wogwira mtima - samalimbikitsidwanso kupereka, chifukwa masinthidwe ochokera kwa iwo samayenda bwino, ndipo chiopsezo cha zotsatira zoyipa chikuwonjezeka, chithandizo sichodalirika.
Vitenessomy ndi laser Photocoagulation
Chithandizo cha laser Photocoagulation chimatchedwa retinal cauterization (chikhazikitso) pofuna kuteteza kuchuluka kwa mitsempha. Njira iyi yochizira matenda ashuga retinopathy ndiyothandiza kwambiri. Ngati kupangika kwachitika molondola komanso munthawi yake, ndiye kuti njirazi zitha kukhazikika pang'onopang'ono pafupifupi 80% ya milandu nthawi yayitali komanso mu 50% ya milandu yomwe ikukula kwambiri kwa retinopathy.
Mothandizidwa ndi laser mankhwala, mitsempha yamagazi "yosafunikira" imatenthedwa, chifukwa chomwe magazi amathira mkati mwawo, kenako amakundidwa ndi minofu yamafupa. Chifukwa cha njira iyi ya mankhwalawa, mutha kupulumutsa mawonedwe ngakhale kumapeto kwa retinopathy muopitilira theka la odwala matenda ashuga kwa zaka 10 mpaka 12.
Pambuyo pakukula kwa laser, ndikofunikira kwambiri kuyesedwa ndi wochita kafukufuku wamaso, komanso, ngati kuli koyenera, kuchitira mankhwala ena a laser owonjezera. Monga lamulo, mayeso oyamba pambuyo pa photocoagulation amalembedwa mwezi umodzi, ndipo mayeso otsatirawa - 1 nthawi m'miyezi itatu kapena kupitilira apo. Zonse zimatengera zomwe wodwala akuonetsa.
Zimachitika kuti chithandizo cha laser coagulation chikachitika, malingaliro a wodwalayo adzachepa pang'ono, masomphenya ausiku adzachepa, ndipo kukula kwa gawo lowonera kudzachepa. Popita nthawi, zinthu zimakhazikika kwanthawi yayitali, koma zovuta zimatheka - kukonzanso zotupa m'thupi lamphamvu.
