Diabetesic microangiopathy: Zizindikiro, chithandizo, zotsatira zake

Ngati mukukonzekera mpikisano pakati pa matenda onse, malo oyamba pamavuto ambiri, kuopsa kwa chithandizo chawo, zotsatirapo zake kwa wodwala, mosakayikira, ziyenera kupereka shuga. Mavuto ambiri amachitika chifukwa cha matenda ashuga osokoneza bongo. Chifukwa cha kuchuluka kwa shuga pamatumba ang'onoang'ono, amakhala osakhazikika ndipo amawonongeka mosavuta. Zotsatira zake, m'malo ena kukula kosalamulirika kwa network ya capillary kumayamba, pomwe madera ena alibe magazi.

Chaka chilichonse, chifukwa cha Microangiopathy, kudula mabatani miliyoni m'mamunsi kumachitika, odwala matenda ashuga okwana miliyoni 6.6 amasiya kuwona, ndipo impso zimasiya kugwira ntchito mwa odwala 0.5 miliyoni. Zophwanya zambiri zimatha kuthana ndi mavuto ngati atha kupezeka koyambirira.

Nkhani yofotokoza za angiopathy ili pano - //diabetiya.ru/oslozhneniya/diabeticheskaya-angiopatiya.html

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Matenda a shuga a shuga - ndi chiyani

Microangiopathy ndi zovuta zovuta za matenda ashuga. Cholinga chake chachikulu ndi kuthamanga kwa shuga m'magazi mkati mwa makoma amitsempha yamagazi. Gulcose mamolekyulu glycate endothelial mapuloteni, ndiye kuti, amamangirira kwa iwo. Njirayi imayendera limodzi ndi kutayika kwa mtima wam'mimba, kuchepa kwawo, kuchuluka kwakanthawi, kenako chiwonongeko. Vutoli limakulitsidwa ndi kupsinjika kwa makutidwe ndi okosijeni - kuwonongeka kwa maselo ndi ma free radicals, omwe mu shuga mellitus amapangidwa modabwitsa. Kuphwanya kwa lipid metabolism, mawonekedwe a matenda amtundu wa 2, kumakhalanso ndi vuto pa mitsempha ya magazi.

Ziwalo zathu zonse zimalowetsedwa ndi ma network ang'onoang'ono, motero, shuga ya diabetes ingathe kusokoneza ntchito iliyonse ya izo. Nthawi zambiri, ma retina ndi mafinya a impso amakhala “ogwirira”, popeza kulumikizana bwino kwa ma capillaries ndikofunikira kuti magwiridwe awo azikhala bwino.

Mavuto a shuga, komwe kumayambitsa minyewa:

ICD Code 10 ya a Diabetesic Microangiopathy:

• 2; E11.2 - nephropathy;
• 3; E11.3 - retinopathy;
• E5; E11.5 - zovuta zina zoyambitsidwa ndi vuto la microvascular.

Zizindikiro za microangiopathy mu matenda ashuga

Nthawi zambiri, palibe zizindikiro kumayambiriro kwa matendawa. Mukamakula, wodwala matenda ashuga amatha kuzindikira:

• masomphenya osakhalitsa;
• mawanga oyandama pamaso pa maso, akusowa patatha masiku ochepa;
• Zizindikiro za kuledzera - kufooka, kutopa, kusowa kudya;
• mkodzo wowonjezera - werengani za polyuria;
• usiku, chikhodzodzo chimadzaza nthawi zambiri kuposa kale;
• Kusintha kwa momwe wodwalayo akumvera: kulira kumakulirakulira, magawo a zosakhumudwitsa zimawonekera, kapena mosemphana ndi zochitika zofunikira kale;
• mwina kumverera kovundikira m'makachisi, mutu wofatsa. Zizindikiro sizimatha kwathunthu mutatha kupweteka kwamankhwala;
• mavuto ndi kukumbukira ndi kusamalira;
• zala zakumaso sizizizira;
• mabala pakhungu, makamaka m'munsi, musachiritsidwe kwa nthawi yayitali;
• kuwonongeka mu potency - kusabala kwa matenda ashuga.

Mankhwalawa a microangiopathy ndi othandiza kwambiri poyambira, pomwe zizindikiro zake sizikupezeka, chifukwa cha matenda a shuga Osadumpha mayeso apadera achipatalazotchulidwa ndi dokotala. Chofunika kwambiri ndikuchezera kwa ophthalmologist, nephrologist ndi neurologist.

Zizindikiro

Njira zakuzindikira kuti uzindikire microangiopathy mu matenda ashuga zimaphatikizapo:

1. Kupenda kwamikodzo kwamkodzo kwa albumin kumatha kuzindikira mapuloteni mumkodzo koyambirira kuposa OAM. Pa gawo loyambirira, silimatupa nthawi zonse, chifukwa chake ndi bwino kupatsa mkodzo patsiku.
2. Nephropathy imayendera limodzi ndi aimpso hypertrophy, yomwe imatha kupezeka ndi ultrasound.
3. Ndikotheka kuzindikira retinopathy ngakhale isanayambike zizindikiro zoyambirira mukamayang'ana fundus - ophthalmoscopy, ngati nkosatheka kutero, ultrasound imagwiritsidwa ntchito.
4. Kuperewera kwa magazi mu ma capillaries a m'munsi am'munsi kumatsimikizika mosavuta: madera ena khungu limakhala lotuwa komanso lozizira, ena amakhala ofiira chifukwa cha kukula kwa ma capillaries. Paokha, khungu limasunthika limachuluka, ming'alu imachitika.
5. Mlingo wa matenda a shuga a shuga m'miyendo amatha kuwunika pogwiritsa ntchito capillaroscopy kapena kafukufuku wamakono komanso wamtengo wapatali - Doppler flowmetry.
6. MRI imagwiritsidwa ntchito kuti izindikire kusintha kwa magazi kupita ku ubongo.

Momwe mungachitire ndi zovuta

Mkhalidwe waukulu wa chithandizo chopambana cha microangiopathy ndi chiphuphu chokhazikika cha matenda ashuga. Zinapezeka kuti kuchepa kwa hemoglobin wa glycated wa 1% peresenti yokha kumachepetsa chiopsezo cha kuwonongeka kwa mtima. Ndikotheka kupewa microangiopathy ndikuchepetsa zovuta zomwe zilipo za matenda am'mitundu yonseyi mothandizidwa ndikuwunika pafupipafupi kwa glycemia. Komanso, zilibe kanthu kuti cholingachi chitha bwanji. Ngati mumasunga shuga mwachizolowezi, zakudya zamafuta ochepa zimathandiza - chabwino. Ngati chithandizo chokwanira cha insulini chikufunika kuti mupeze chiphuphu cha matenda a shuga, muyenera kusintha. Mulimonsemo, hyperglycemia ndiowopsa kwambiri kuposa zotsatira zoyipa za mankhwala ochepetsa shuga.

Thupi lokha lokha ndi lomwe lingakonzenso ma seva owonongeka. Ntchito ya chithandizo ndikumamuthandiza pankhani yovuta iyi.

Mwa ichi, odwala matenda a shuga:

1. Njira zamakono zochepetsera kuthamanga kwa magazi mu ziwiya ndi zoletsa za ACE ndi AT1 receptor blockers.
2. Othandizira kunja omwe ali ndi antibacterial komanso kusintha kwazomwe zimachitika kuti athandizidwe mofulumira a mabala kumapazi.
3. Kuchita masewera olimbitsa thupi kuti mulimbikitse magazi.
4. Ma antioxidants pothandiza kuchepetsa oxidative nkhawa (Thiogamma).
5. Microcirculation kukonza (Actovegin, Curantil).
6. Zizindikiro ngati lipid mawonekedwe amwazi sakhala abwinobwino.
7. Mavitamini, makamaka gulu B.
8. Mankhwala othandizira magazi kupewera kwa magazi komanso kupewa thrombosis (Lioton, Heparin).

Mitundu yambiri ndi zotsatira zake

Ngati microangiopathy yofatsa imalandira bwino mankhwala, ndiye kuti matendawo owopsa amachiritsidwa. Potere, zitha kungokhala kusungidwa kwazinthu zofunikira za ziwalo zowonongeka ndi shuga.

Zotheka ndi zotsatira za angiopathy:

Khalani ndi moyo wathanzi ndipo musaiwale kuyendera akatswiri nthawi kuti mupeze matenda oyambira.