Kodi matenda a shuga a retinopathy ndi ati, njira ndi njira zochizira

Odwala omwe ali ndi matenda a shuga, poyerekeza ndi munthu wamba, wathanzi, chiopsezo cha ischemia ndi kuwonongeka kwa impso ndichokwera kwambiri, mmodzi mu 200 amataya zala chifukwa cha kukula kwa gangore, ndipo kuthekera kwa kutayika kwathunthu kwamawonedwe kuli kopambana 25. Kuperewera kwa magazi koyenera chifukwa cha kuchuluka kwa shuga kumagunda ziwalo zofooka kwambiri za munthuyo - mtima, miyendo, impso, maso. Matenda a shuga a retinopathy, omwe ndi chitsimikizo chakumaso, amayamba kukula zaka 5 zitadutsa matenda a shuga, komanso ndi shuga wambiri wolumpha.

Kodi matenda ashuga retinopathy ndi ati?

Retinopathy, kwenikweni "matenda a retinal," ndi njira imodzi yowonetsera matenda a shuga. Malinga ndi WHO, matendawa amakhudza pafupifupi odwala onse omwe ali ndi matenda amtundu wa 1 omwe ali ndi zaka zopitilira 15. Ngakhale kuti zingaoneke zachilendo, matenda a shuga a shuga amapezeka kwambiri chifukwa cha madokotala. M'mbuyomu, sikuti aliyense amene ali ndi matenda ashuga omwe anapulumuka chifukwa cha kuvulala kwambiri kwa maso, chifukwa chomwe adamwalira chinali matenda amtima. Masiku ano, kuchuluka kwa mankhwala amalola kupewa kufa ndi ischemia ndikuchepetsa kwambiri zovuta za matenda osokoneza bongo, kuphatikizapo matenda ashuga retinopathy.

Retina loti lizigwira bwino ntchito limafunikira kuchuluka kwa okosijeni poyerekeza ndi ziwalo zina. Mbale yodzaza ndi viscous, magazi akhungu okhala ndi shuga wambiri komanso triglycerides sangathe kupereka zakudya zopatsa thanzi. Makoma a capillaries ang'onoang'ono kwambiri amapitilira, kuphulika, pali zotupa zazing'ono zotupa ndi aneurysms. Gawo lamadzimadzi lamagazi lodontha limapanga edema pa retina, yomwe imachepetsa kugwira ntchito kwa diso. Zigawo za mapuloteni zimayambitsa kukhumudwa pa retina. Kupitilira kufalikira kwa mabala kumakhudza kutembenuka kwamatumbo ndi stratization, kuwonongeka kwa mitsempha.

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%

Gulu ndi magawo

Gulu la ogwirizana la matenda ashuga limagwiritsidwa ntchito padziko lonse lapansi. Amagawa matendawa m'magulu potengera kuchuluka kwa kuchuluka - kuchuluka kwa ziwiya zatsopano m'maso.

Zikuwoneka kuti izi zitha kukhala zowopsa? Kupatula apo, zotengera zomwe thupi limakulitsa m'malo mwa zowonongeka zimathandizira mabala kuti achiritse msanga komanso kuzika mizu m'ziwalo zomwe zayikidwa nthawi yodzala. Ponena za ziwalo za masomphenyawo, zinthu zimakhala zosiyanasiyana. Pansi pa vuto la kufera kwa okosijeni m'matenda a shuga, ma capillaries atsopano amakhala opanda pake, makoma awo amakhala ndi maselo amtundu umodzi wokha. Kupangidwe kwa zotengera zotere kumayambitsa kuwonongeka koopsa pamkhalidwewo: kuchuluka kwamatumbo kumawonjezeka mofulumira, edema imakulirakulira, ndipo chiopsezo cha kutayika kwa masomphenya chikuwonjezeka kwambiri.

Magawo a retinopathy:

1. Gawo losakulitsa. Zimapezeka pamlanduwu pomwe kusintha m'matumbo kwayamba kale kuwonekera, misozi yaying'ono imachitika nthawi ndi nthawi, yomwe imatha kuyima pawokha. Gawoli limatchulidwanso maziko, chifukwa ndi matenda ashuga amatha kukhala zaka zambiri osawonongeka kwambiri. Kusintha kwakukulu komwe kumawonedwa panthawiyi ndi edema pa retina. Ngati akhazikika pakati pake, pa macula, kuwonongeka kwakanthawi kawonedwe ndikotheka.
2. Preproliferative diabetesic retinopathy. Zimatanthawuza kukulira kwina kwa matendawa, magawo okhala ndi mpweya wa okosijeni amawonekera pa retina, pomwe thupi limakonda kudzaza ndi ma capillaries, venous outflow worsens, yomwe imatsogolera kuwonjezeka kwa edema, zotupa sizikhala ndi nthawi yoti zitheke.
3. Kukula gawo. Zimachitika pamene kuchuluka kwa malo m'maso opanda mpweya kumawonjezeka. Retina imayamba kubisa chinthu chomwe chimalimbikitsa kukula kwa mitsempha yatsopano ya magazi. Amatsogolera pakupanga zipsera, kuvulaza retina, ndikuikoka kuchokera kumbuyo kwa diso. Komanso, zombo zatsopano zimatha kusokoneza kutuluka kwa madzi kuchokera kumaso, motere, kupanikizika kwa intraocular kumayamba kukula, mitsempha ya optic imawonongeka. Kenako pamatuluka ma capillaries osagwira bwino ntchito omwe amalowa mkati mwa thupi lamphamvu ndikupanga zotupa mkati mwake. Masomphenya panthawiyi amagwa modabwitsa. Nthawi zina bilu imapita masiku enieni. Muzovuta, ntchito zimachitika nthawi yomweyo, patsiku la chithandizo, kuonjezera mwayi wopulumutsa masomphenya a wodwala matenda ashuga.

Zizindikiro za DR

Kusintha kwa matenda ashuga m'mawonekedwe owoneka ndi asymptomatic mpaka kuwonongeka kwakukulu. Kuwona kwakachulukidwe kumadalirabe mpaka kusintha kosasinthika komwe kumayamba kuchitika mu retina.

Matenda osapatsirana a shuga omwe amapezeka pambuyo pake amapezeka ndi mayeso a ophthalmologist. kukonzekera kwa adokotala ndikofunikira.

Zofunika! Koyamba kuwunika kwa ziwalo zamasomphenya kuyenera kuchitika ndi matenda ashuga kwa zaka 5, ngati nthawi yonseyi shuga akhoza kukhalanso yokhazikika. Ngati shuga amalumpha nthawi ndi nthawi - katswiri wofufuza maso ayenera kuyendera zaka 1.5 atazindikira kuti ali ndi matenda ashuga. Ngati dokotala sanawululire kusintha mkati mwa diso, mayeso ayenera kumwedwa chaka chilichonse. Ngati mwapezeka kuti muli ndi matenda ashuga retinopathy - nthawi zambiri.

Omwe ali pachiwopsezo chotenga matenda ochulukitsa, othamanga omwe ali ndi matenda ashuga kwambiri ndi odwala matenda amisempha osachepera, kuthamanga kwa magazi, kulephera kwa impso, BMI> 30, amayi oyembekezera komanso achinyamata.

Zizindikiro za matenda apamwamba a matenda ashuga:

1. Zotsatira za kuphatikizika kwa zinthu zokhala ndi zotendekera pafupi ndi macula.
2. Masamba otuwa, makamaka owonekera bwino akamawona zinthu zopepuka zomwe zimapangidwa pomwe ma capillaries akuphulika ndikugundana kwamagazi kulowa mkati mwa thupi lamphamvu. Nthawi zambiri amazimiririka ndi nthawi yawoyonso.
3. Chithunzi chowala bwino, nkhungu pamaso pa nthawi yotupa.

Zizindikirozi zikawoneka, kupita kukawona dokotala wofufuza m'maso ndikulimbikitsidwa.

Kupeza Matenda

Poika matenda a ophthalmologist, chithunzi chachikulu cha zotsatira za matenda a shuga chimawoneka ndi ophthalmoscopy. Chimakupatsani mwayi wofufuzira, kudziwa kuchuluka kwa retinopathy, kuzindikira kukhalapo kwa mitsempha yotupa, zotupa zam'mimba, zotupa, kudziwa njira zamankhwala. Pamapeto omaliza, maukonde othandizira, opalasa, opalasa, owoneka bwino. Kutsatira kusintha, pali kamera yapadera yomwe imatha kujambula zithunzi za fundus.

Kuphatikiza pa maphunziro awa amachitika:

1. Perimetry yozindikira ma pathologies m'mphepete mwa retina ndi kukhalapo kwa exfoliation.
2. Tonometry - kutsimikiza kukakamiza mkati mwa diso.
3. Kuwunikira momwe magwiridwe am'manja ndi mitsempha ya retina amagwiritsira ntchito njira zamagetsi, mwachitsanzo, electrooculography.
4. Kuti mupeze zovuta m'matumba, angiography kapena tomography ya retina ndiyofunikira.

The endocrinologist imapereka mayeso angapo omwe amatha kuzindikira kuchuluka kwa kubwezeredwa kwa shuga komanso kupezeka kwa zinthu zomwe zimakhudza chitukuko cha retinopathy: kuyeza kukakamiza, kuyesedwa kwa magazi ndi mkodzo kwa glucose, kutsimikiza kwa glycosylated hemoglobin level, renal vascular dopplerography, electrocardiography.

Chifukwa cha maphunzirowa, malingaliro adzapangidwa pakufunika kwa mankhwala kapena chithandizo cha matenda a shuga a retinopathy.

Kodi matendawa amatha kusanduka chiyani

Tiyerekeze kuti wodwala matenda ashuga sazindikira matenda ake, akupitilizabe kudya zakudya zamafuta kwambiri, komanso amanyalanyaza thanzi labwino komanso kupenya kwamaso. Tiona momwe izi zitha kutha, komanso momwe matenda a matenda ashuga a retinopathy akhudzidwira pakadapanda chithandizo.

Chifukwa chake, retina yomwe ili ndi njala imapereka lamulo kuti ikule ma capillaries atsopano, ndipo amakulira limodzi, nthawi zina amabweretsa mphamvu. Kukula kwina kwa shuga m'magazi a shuga kumabweretsa chiwonongeko chawo, kupezeka kwa mikwingwirima yambiri. Thupi, pakuyesayesa kuthana ndi izi, limakhazikika kukhathamiritsa ndipo limakula ziwiya zatsopano. Mbiri imadzibwereza yokha pamachitidwe omwewo. Popita nthawi, kuchuluka kwa magazi omwe akutayikira kumawonjezeka, komwe kumatchedwa hemophthalmus kumachitika. Sathanso kudzipasuka yekha, zomwe zikutanthauza kuti maso sangathenso kugwira bwino ntchito, maso amayamba kugwa.

Glaucoma imatsogolera ku khungu

Palinso chochitika china: chifukwa chotengera chilichonse chimaphulika, mawonekedwe amtundu wa retina, minofu yabwinobwino m'malo ano imasinthidwa ndi pathological - fibrous. Pang'onopang'ono, kuchuluka kwa minofu yam'mimba imakulirakulira, imalimbitsa retina ndikupanga kukhazikika kwake, kuvulala m'mitsempha yamagazi ndikuyambitsa hemophthalmus yatsopano, kumalepheretsa kutuluka kwamaso kuchokera kumaso ndikupangitsa kuti glaucoma ipangidwe.

Mwachilengedwe, njira yosasangalatsa kwambiri ikufotokozedwa pano. Monga lamulo, kale pamlingo wowonjezera kapena kumayambiriro kwa wodwala wowonjezereka, matenda a shuga amawonekera kwa ophthalmologist. Kuphatikiza apo, nthawi zina, thupi limatha kudzipatula modzungulila bwalo loipalo ndikuletsa kupititsa patsogolo matendawo. Pankhaniyi, milanduyi imangomangidwa pokhapokha ngati munthu watayika kwambiri.

Ndingatani mankhwala a DR

Ntchito yayikulu pakuthandizira retinopathy yopanda proliferative siyimaseweredwa ndi ophthalmologist konse. Pankhaniyi, kusintha kwa kagayidwe kachakudya, kuyang'anira shuga wamagazi, komanso kutsitsa magazi ndizofunikira kwambiri. Chifukwa chake, mankhwala omwe amatha kusintha retinopathy amaperekedwa ndi endocrinologist ndi mtima.

Ngati simungathe kulipirira shuga ndi mankhwala ochepetsa shuga komanso zakudya zomwe sizigwira ntchito, musachite mantha ndi insulin. Pogwiritsa ntchito moyenera, ilibe zovuta, ndipo imatha kukhalanso ndi thanzi.

Ngati kusintha kwachitika kale pazida zomwe thupi silingathe kupirira, ophthalmologist akupatseni mankhwala. Izi zitha kukhala zochiritsa matenda a matenda ashuga, komanso njira zochitira opaleshoni.

Mankhwala

Mankhwala onse omwe amagwiritsidwa ntchito kale omwe amalembedwa kuti ayimitse retinopathy, amazindikiridwa ngati masiku opanda pake. Njira yakuchizira matenda ashuga retinopathy ndi antioxidants, othandizira olimbitsa mtima, ma enzymes apadera, mavitamini, ndi mankhwala wowerengeka azitha pokhapokha pamayambiriro a matendawo.

Mwachitsanzo, madontho amaso a Taurine adapangidwa kuti apangitse njira zowombolera komanso kuyambitsa magazi. Kukhazikitsidwa kwa madonthowa kumatha kukhala kothandiza kumayambiriro kwamavuto mumitsempha yama mtima, koma osafunikira komanso koopsa pagawo lachiberekero.

Choipa chachikulu cha mankhwala a anti-VEGF ndi mtengo wawo wokwera. Nthawi yoyamba yomwe muyenera kupanga jakisoni ndi miyezi iwiri iliyonse, mtengo wake uliwonse ndi ma ruble 30,000. Pafupifupi maphunziro ake ndi zaka 2, jakisoni 8 pachaka. Eilea ndiwothandizanso kwa nthawi yayitali, njira zomwe zimayendera pakati pa kayendetsedwe kake ndizitali, chifukwa chake chithandizo cha retinopathy chogwiritsira ntchito mankhwalawa chimakhala chotsika mtengo pang'ono ndikuchita chimodzimodzi.

Chithandizo cha laser

Chithandizo cha laser cha matenda apamwamba a shuga a retinopathy pano ndi chithandizo chofala kwambiri. Adawonetsa kuyendetsa bwino kwake mu 80% ya ovulala pa siteji yachiwiri ya matenda ndi theka la milandu yomaliza. Opaleshoniyo ikangoyamba kuchitidwa, zotsatira zake zimakhala zabwino. Chinsinsi cha njirayi ndikuwotcha ziwiya zatsopano pogwiritsa ntchito mtanda wa laser, magazi omwe ali m'magaziwo amawundana ndipo ziwiya zimasiya kugwira ntchito. Nthawi zambiri, njirayi imakhala yokwanira kupitiliza kuwona kwa zaka 10 zikubwerazi.

Izi zimachitika kwa mphindi 20 pansi pa opaleshoni yanyumba, osakhala kuchipatala, wodwalayo amaloledwa kupita kwawo tsiku la opareshoni. Imalekerera mosavuta ndi odwala, sikufuna nthawi yochira, sikuvulaza mtima ndi mitsempha yamagazi. Dokotala wa opaleshoniyo amalamulira kwathunthu kulondola kwa kugunda kwa laser ndi maikulosikopu.

Pankhani ya matenda oopsa a matenda ashuga retinopathy, zovuta microsuction ntchito - zotchulidwa. Zimayimira kuchotsedwa kwathunthu kwa thupi lamatupi pamodzi ndi magazi ndi zipsera zamagazi. Pa vitrectomy, laser cauterization yamitsempha yamagazi imakhalanso yotheka. Pamapeto pa opaleshoniyo, malo amaso amadzaza ndi njira yapadera kapena mpweya womwe umakanikiza retina ndipo suulola kuti uchotse.

Njira zopewera

Chinthu chachikulu popewa retinopathy ndikuwonetsetsa koyambirira. Kuti muchite izi, ndikofunikira kuwonedwa ndi ophthalmologist woyenerera yemwe amadziwa bwino zovuta za matenda a shuga. Njira yosavuta yopezera dokotala kuchipatala. Pazizindikiro zoyambirira za kuwonongeka kwa mitsempha ndi kukula kwatsopano, ndikofunikira kulingalira kuthekera kochita masewerawa a laser.

Chofunikanso poletsa kupewa retinopathy ndikubwezeretsanso kwa matenda ashuga, chithandizo cha matenda ophatikizika, komanso moyo wathanzi.

Odwala omwe ali ndi matenda ashuga amalimbikitsidwa:

• kuwongolera kwapamwamba kwamazira a shuga, kusunga cholembedwa cha chakudya;
• kutsika kwa kuthamanga kwa magazi ndi cholesterol kuti ikhale yofanana;
• kusiya kusuta;
• kupewa mavuto osautsa mtima.