Pakadali pano, kuchuluka kwa anthu odwala matenda ashuga ndiwambiri kwambiri ndipo ndi koyamba pakati pa matenda a endocrine. Chofunika kwambiri ndi matenda a shuga a mtundu wachiwiri, omwe nthawi zambiri amakula chifukwa chakuti kapamba sikukwaniritsa bwino ntchito yake ndipo maselo omwe amapanga insulin amafa pang'onopang'ono.
Mu matenda a shuga amtundu woyamba, insulin siyopangika konse, ndipo ngati wodwalayo amathandizidwa moyenera ndikutsimikiza kuti atsatira malangizo onse azachipatala, vuto lake lidzakhala labwino. Ndipo ngati insulini singapange zokwanira, koma sizikudziwika kuti ndi zochuluka motani, ndiye kuti matendawa ndi ovuta kwambiri kuchiza, ndipo mavuto amatuluka nthawi zambiri. Chimodzi mwa zovuta kwambiri ndi matenda ashuga am'magazi a shuga.
M'mbuyomu, madokotala ankakhulupirira kuti ziwiya zamagetsi zam'munsi ndizovuta zambiri zimakhudzidwa makamaka chifukwa angiopathy yam'munsi imayamba, koma mpaka pano zadziwika kuti kuwonongeka kwa miyendo kumachitika chifukwa cha matenda ashuga, ndiye kuti polyneuropathy. Zotengera, Mosiyana, zimangosintha mu 15% ya odwala.
Angiopathy ya malekezero a m'munsi amatha kugawidwa m'magawo awiri:
- Matenda a shuga a shuga - kuwonongeka kwa ziwiya za microvasculature (mafupa am'mimba, impso).
- Matenda ashuga macroangiopathy - mitsempha ikuluikulu imavutika.
Pa mawonekedwe achiwiri a angiopathy, makamaka matenda a ziwongo zamiyendo, ndikofunikira kukhala mwatsatanetsatane.
Matendawa
Malinga ndi morphology, matendawa ndi atherosulinosis, omwe amakhudza mitsempha yamagazi m'magazi a shuga, ndipo ali ndi mawonekedwe ena:
- - chotupa chimakhala ndi mawonekedwe osiyanasiyana;
- - matendawa amatenga nthawi;
- - amatha kukhala mwa achinyamata;
- - Ndi kovuta kuchiza ndi thrombolytics.
Atherosclerosis ya zombo imayambitsa kuphatikizika kwa makoma amitsempha, kenako kutsekeka kwa lumen (stenosis) mpaka kufalikira kwathunthu. Zotsatira zake, minofu imakumana ndi njala ya oxygen, yomwe imayambitsa kusokonezeka kwa metabolic, ndipo zizindikiro zina zimawonekera. Vutoli limatsatiridwa ndi mawonekedwe azikhalidwe.
Gulu la Fontaine-Lerish-Pokrovsky
Gawo I: matendawa ndi asymptomatic ndipo amatsimikiza kugwiritsira ntchito zida zothandizira kuzindikira.
Gawo lachiwiri: Zizindikiro zimawoneka ngati ululu m'miyendo ndipo nthawi zina m'chiuno, kupweteka komwe kumachitika poyenda mtunda winawake, kutsutsana pang'ono kumayamba. Nthawi yomweyo, munthu akasiya, kupweteka kwa thupi kumatha, komabe, matenda ashuga amayamba.
Nthawi zambiri, angiopathy yam'munsi malekezero amakula limodzi ndi neuropathy (kuwonongeka kwa dongosolo lamanjenje). Zikatero, ululu wammbuyo umatha kusakhalapo, ndipo zizindikiro zina zimadza m'malo mwake, kumakhala kutopa, kusapeza bwino kumapangitsa kuti munthu asiye.
Gawo IIA: kumverera kwa zowawa kumachitika mtunda wopitilira mamiliyoni mazana awiri.
Gawo IIB: ululu umayamba mtunda wosakwana mamita mazana awiri.
Gawo lachitatu: kupweteka kwambiri kumasokoneza ngakhale pakupuma. Zimachitika wodwala akakhala pamalo oyimirira. Ngati nthambi yomwe yakhudzidwa idatsitsidwa, ndiye kuti ululu wake umakhala wocheperako, koma zizindikirazo sizitha.
Gawo VI: maonekedwe a zilonda zam'mimba, kakulidwe ka zilonda zam'mimba.
Angiopathies am'munsi am'munsi amakhudza mitsempha ya popliteal ndi nthambi zake. Matendawa amapitirirabe mwankhanza, amakula msanga, nthawi zambiri amabweretsa matenda osokoneza bongo, kenako nthambiyo imadulidwanso, kenako wodwalayo.
Zizindikiro ndi Kudziwitsa
Ngati wodwalayo apita kuchipatala, ndiye kuti dokotala amayenera kuyang'anira osati zodandaula ndi mbiri ya matenda ashuga okha, komanso zizindikiro zotsatirazi:
- - palpation yamitsempha ya mapazi samamva kukoka;
- - kutentha kwawoko kumachepetsedwa (kukhalapo kwa chizindikiro mbali imodzi ndikofunikira popanga matenda);
- - kusowa kwa tsitsi pakhungu la mwendo;
- - youma, wowonda, khungu la cyanotic, phazi lopyapyala;
- - Ischemic edema (muzovuta kwambiri).
Diagnosis imachitikanso pogwiritsa ntchito njira zothandizira, zomwe zimakupatsani mwayi wodziwa zomwe mwawona:
- - Dopplerographic kuwunika kwamitsempha (njira yosanthula);
- - kukonzanso kwa duplex;
- - mitundu yambiri;
- - kusiyanitsa angiography.
M'masiku akale, rheovasography idagwiritsidwanso ntchito, koma tsopano sigwiritsidwa ntchito, chifukwa imatha kupereka zotsatira zabodza, ndipo izi zimatsogolera ku overdiagnosis ya angiopathy. Chifukwa chake, njirayi siyikulimbikitsidwa kuti ipezeke matenda monga matenda a shuga.
Chithandizo
Therapy a matenda a shuga angiopathy amakhala ndi kuvomerezedwa kutsatira mfundo zingapo:
- chithandizo cha atherosulinosis;
- kukana ndudu;
- Kubweretsa cholesterol ndi glucose wamagazi kukhala yabwinobwino;
- chithandizo ndi kukwaniritsa kokhazikika kwa kuthamanga kwa magazi;
- kuwongolera kunenepa;
- Kukhazikitsidwa kwa mankhwala osokoneza bongo - amawonjezera mtunda poyenda, koma osakhudza matendawo;
- katundu wambiri pamiyendo ndikuvala nsapato zoyenera. Izi sizingachitike ngati wodwala ali ndi zilonda zam'mimba, chithandizo chawo chidzafunika pano;
- opaleshoni;
- sympathectomy ndi chithandizo mu lumbar;
- intravascular ntchito ndi chithandizo pambuyo pawo;
- kudutsa ndi chithandizo cha mitsempha.
Kuti mukwaniritse zabwino pakuthandizira angiopathy, ndikofunikira kulipiritsa matenda oyambitsidwa ndikusintha mapuloteni komanso chakudya cha metabolism. Pazifukwa izi, odwala amasankhidwa payekhapayekha pazithandizo zonse komanso zakudya, kuchepetsa kudya zamafuta am'madzi ndi zakudya zamafuta. Komanso, kutengera mtundu wa matenda ashuga, mankhwala a insulin kapena mankhwala omwe ali ndi antipyretic mankhwala amapatsidwa.
Tsopano, nthawi zambiri, madokotala amatengera chithandizo cha opaleshoni. Ndi chitukuko cha chonyansa chilonda ndi kuchuluka kuledzera, kudula kumachitika.
Kupewa
Anthu omwe ali ndi matenda ashuga amayenera kuyesa kupanga chilichonse chomwe chimapangitsa kuti matenda ashuga a m'magazi ayambe mochedwa momwe angathere. Muyenera kuti mumvetsetse kuti, mwina, njirayi singapeweke, koma mutha kuyipanga kuti pasakhale kupita patsogolo ndikuyenda ndi zinthu zosasangalatsa.
Popewa izi, muyenera kutsatira malangizo onse azachipatala pochiza matenda ashuga, mumamwa mankhwala a shuga nthawi zonse, kapena mankhwala othandizira odwala matenda a shuga, muzitsatira kadyedwe ndi kuwongolera thupi. Ngati ndi kotheka, imwani magazi ochepa. Ndikofunikira kuyang'anitsitsa kuchuluka kwa cholesterol, chifukwa kuchuluka kwake kumawonjezera kuwonongeka kwa mtima, ndipo, chifukwa chake, kumayandikira kuwonongeka kwa minofu ya miyendo. Ndikofunikanso kuwongolera ntchito ya chiwindi, chifukwa imayang'anira mafuta a cholesterol ndi glycogen, zomwe zikutanthauza kuti zimakhudza kuchuluka kwa chitukuko cha angiopathy.
Mukamatsatira malingaliro onse, ndiye kuti mavutowa akhoza kuchedwa kapena njira yomwe ikuyenda kale ingaimitsidwe. Potere, miyendo sichidzavutika, ndipo moyo wa anthu odwala matenda ashuga udzayenda bwino kwambiri.
