Mu moyo wonse, munthu amayenda mtunda wamakilomita 160,000, womwe umakhala wofanana ngati muziyenda mozungulira dziko lapansi maulendo 4. Kodi mudayamba mwadzifunsapo momwe mungayendere njirayi pamiyendo imodzi kapena pa wheelchair? Ndipo izi ndizabwino kwambiri, chifukwa 90% ya anthu odwala matenda ashuga atadwala mwendo amwalira zaka ziwiri zoyambirira atachitidwa opaleshoni.
Kodi gangrene angapeweke ndi matenda ashuga? Madotolo akuti mtundu uliwonse wam ululu wam'mimba mu shuga ndi chifukwa chabwino chowunikira. Mukayamba kulandira chithandizo munthawi yake ndikutsatira malingaliro onse, kudula matendawa kutha kupewedwa.
Timamvetsa zifukwa zake
Chifukwa chiyani miyendo yanga imapweteka ndi matenda ashuga? Chimodzi mwazofunikira kwambiri ndi phazi la matenda ashuga - zovuta zamatenda zomwe zimapezeka kumapeto kwa mitsempha, ziwiya ndi mafupa a odwala matenda ashuga. Matendawa amapezeka mwa 90% ya odwala matenda ashuga omwe sanachite bwino kumatenda otupa.
Matenda a shuga
Nthawi zambiri, mphamvu ya mitsempha imadutsa kumapeto kwapadera kwa mitsempha kupita ku ziwalo zomwe zikuchita. Ndi matenda a shuga, nembanemba wamanjenje imakhala yowonongeka, kutupa kwake kosatha kumayamba. Izi zimatsogolera ku chenicheni chakuti kusokonekera kumabwera kumalo ena kapena kuchita molakwika pa chinthucho. Neuropathy imakhudza mathero a mitsempha osati miyendo yokha, komanso ubongo ndi chiwalo chilichonse. Ngati matenda a m'mimba akayamba m'mimba, wodwalayo amadandaula za kupindika, kupweteka kwa mtima, ngati mathero amtsempha mumtima kapena ziwiya akakhudzidwa, machitidwe amtundu wa orthostatic amachitika pamene ntchentche ikuwala m'maso ndikusintha kwakuthwa m'magazi. Chifukwa cha kuwonongeka kwa mitsempha ya chikhodzodzo, pali zodandaula za kusakhazikika kwamkodzo; kuwonongeka kwa maso, wodwala matenda ashuga samasinthasintha bwino posuntha kuchokera mumdima kupita kuchipinda chowala. Ndi neuropathy yam'munsi yotsika, mitsempha imawonongeka, yomwe imagwira mkati mwa miyendo yosiyanasiyana.
Kodi miyendo imakhala bwanji mu shuga? Kupweteka ndi kwachilengedwe - kupsa, kupweteka, kupweteka. Miyendo yanga itayamba kuzima, pamakhala tinthu tating'onoting'ono tambiri.
Chowonetsera china cha kuchepa kwa mitsempha ndicho kutaya mtima. Wodwala samamva kukhudza miyendo, samasiyanitsa kutentha ndi kuzizira, samayankha ululu. Izi ndizowopsa, popeza wodwalayo atha kupindika pagalasi, pitani naye kwa tsiku lopitilira tsiku limodzi osakafuna chithandizo chamankhwala mpaka vuto litasinthika.
Chowonetsera china cha neuropathy ndi kuwonongeka kwa mota. Zowonongeka zamitsempha zomwe zimakhala mkati mwa minofu. Wodwalayo amadandaula kuti akamayenda amapunthwa kuchokera kubuluu. Izi ndichifukwa choti malekezero amitsempha omwe akhudzidwa amachita zolakwika mosalakwitsa, kotero kuti minyewa ya extensor ya phazi sigwire ntchito.
Chowonetsera chinanso cha matendawa ndi matenda owuma phazi. Mapeto a mitsempha molakwika amatumiza zolakwika ku tiziwalo ta sebaceous, mitsempha ndi thukuta, zomwe zimayang'anira hydrate mapazi. Zimawuma, ma microcracks amawoneka, kachilombo komwe kumayambitsa zovuta zazikulu.
Matenda a shuga
Ndi kuwonongeka kwa ziwiya zamiyendo, kuchuluka kwa lipids m'mitsempha yamagazi kumawonjezeka, omwe amayang'anira kuwoneka kwatsopano ndikukula kwa omwe alipo. Ndi shuga wowola, shuga yayikulu imawononga zingwe zamkati zamitsempha yamagazi. Endothelial dysfunction imayamba, imathandizira kuwoneka kwa zatsopano.
Kodi matenda angiopathy amawoneka bwanji? Ngati chidacho ndichaching'ono ndipo sichisokoneza kayendedwe ka magazi, wodwalayo amadandaula za kupweteka kwamiyendo mu shuga, makamaka m'misempha ya ng'ombe, komanso kumva kutopa mukakwera masitepe kapena poyenda mtunda wautali.
Ngati wodwala matenda ashuga satenga nawo gawo, zolembazo zimachulukana ndikutseka ma cell amitsempha, magazi amayenda kwambiri. Kupweteka kwamendo kumachitika mukamayenda komanso kwa mtunda waufupi, kukwera masitepe kumakupangitsani kuti mupumule pansi.
Chikwangacho chikatsekera chotchacho kwathunthu, chilonda cham'mimbacho chimachitika - chinthu chofunikira kwambiri chomwe chimafunikira opaleshoni yofulumira kuti muchepetse mwendo.
Ngati chilinganizo sichikuletsa chotchokeracho, ndiye kuti chingaphulika tinthu ting'onoting'ono. Amabalalika m'miyendo yaying'ono ya phazi, ndikupanga gawo lakutali la phazi, gawo lake, chala chimodzi kapena zala zingapo.
Matenda a shuga A shuga
Nthawi zambiri, mafupa a anthu amasinthidwa pafupipafupi. Pali ma cell apadera - ma osteoclasts omwe amachotsa minofu yakale ya mafupa, ndipo pali ma osteoblasts omwe amapanga minofu yatsopano ya mafupa. Mu thupi lathanzi, njirayi ndiyabwino. Mu matenda ashuga, monga mu mafupa a mafupa, fupa limawonongeka kuposa kubwezeretsedwanso, kotero pang'onopang'ono limataya ntchito zake. Mafupa osalimba komanso osakhazikika am'mitsempha am'mimba amatsogolera ku ma vertebrae, ndipo ndi phokoso la matenda ashuga, mafupa am'mapazi ang'ono. Zotsatira zake, zimapangitsa kuti ziwonongeke ndipo zimakhala ngati "mpando wogwedeza" wotchuka. Izi ndizowopsa chifukwa kupanikizika kumachulukana ndipo mafupa a zilonda zam'mimba amapezeka pamalo am'mafupa.
Matendawa odwala matenda ashuga
Odwala nthawi zambiri amadandaula kuti miyendo yawo imapweteka ndi matenda ashuga, choti achite, nthawi zonse angakuuzeni muofesi ya phazi la matenda ashuga. Dokotala wa mbiri iyi amaphatikiza ziyeneretso za akatswiri angapo. Neurologist amatizindikira neuropathy. Kuti awone kugwedezeka kwamphamvu, kutentha ndi tactile, njira zapadera zapangidwa, kutengera mayeso, adotolo awona momwe wodwalayo alili komanso mwayi wake wogwera m'gulu lowopsa. Zida zogwiritsidwa ntchito poyesa kumverera kwa miyendo:
- Monofilament masekeli 10 g - amawunika tactile anachita;
- Pulogalamu yamaphunziro omaliza - amawunikira momwe munthu angagwiritsire ntchito mphamvu;
- Tip-term - silinda yopangidwa ndi zinthu ziwiri zomwe zimasinthasintha kutentha, imawunika kutentha.
Odwala omwe ali ndi vuto samamva kukhudzika kwa nthawi zina pamlingo wofanana ndi mfundo zina 4 pamlingo wina wapadera wa neuropathic index. Kupezeka kwa zizindikiro zotere kumakhudzidwa ndi odwala omwe ali ndi vuto loipa la glycemic, osatsata chakudya, osalandira chithandizo chokwanira, osatsatira moyo wathanzi.
Amuna omwe ali pachiwopsezo chachikulu amagwera m'gulu lowopsa chifukwa cha matenda operewera.
Chithandizo cha matenda ammiyendo mu shuga
Ngati matendawa sanayambike, njira zochizira miyendo ya matenda ashuga zimagwiritsidwa ntchito:
- Sinthani zizindikiro za glycemia;
- Lemberani mankhwala othandizira (kusankha kumatengera mtundu wa zowonongeka);
- Fotokozani mankhwala opweteka;
- Mothandizidwa ndi njira zolimbitsa thupi komanso mankhwala kusintha magazi;
- Ma antiseptics amagwiritsidwa ntchito palokha.
Ngati njira zoyeserera sizothandiza ndipo nthawi yatayika, chithandizo cha opaleshoni chikugwiritsidwa ntchito:
- Chotsani necrosis ndi kuwonongeka kwanthawi kumapazi;
- Chitani angioplasty (kubwezeretsa dziko lamitsempha yamagazi);
- Chotsani ziwiya zomwe sizingatheke kuti achire (endarterectomy);
- Khazikitsani gululi kuti muziwathandiza (mitsempha yamimba);
- Kuyambiranso malo owonongeka a phazi kumachitika (gangrene amachotsedwa).
Zosankha zonse zamankhwala sizothandiza ngati wodwala satenga nawo mbali pakubwezeretsa thanzi. Madokotala amalengeza mogwirizana: ngati vutoli lingadziwike pa nthawi yake, atha kuchita ndi "magazi pang'ono."
Mwa odwala matenda ashuga, mitundu yonse ya zovuta imadziwonetsa yowuma. Vutoli limapanikizika ndi neuropathy, yomwe imachepetsa kumva kupweteka. Pazodula zinayi, zitatu ndizotsatira zowonongeka zochepa - ming'alu, mabala odulidwa, zipsera, matuza.
Momwe mungapewere zotsatira zoyipa za matenda "okoma"
Magazi amawongolera
Choyamba, wodwala matenda ashuga ayenera kuyang'anitsitsa kuchuluka kwa shuga. Anthu ambiri amalakwitsa kuganizira "shuga wanjala", omwe amayang'aniridwa ndi mita ya shuga m'mimba yopanda kanthu. Chizindikiro chokha chobwezera chomwe chimagwiritsidwa ntchito padziko lonse lapansi ndi mulingo wa glycosylated hemoglobin, womwe umayenera kuwunikidwa miyezi itatu iliyonse.
Zakudya zoyenera
Pamafunika kutsatira mosamalitsa mfundo za kuchepa kwamoto ochepa kapena kuwongolera kunenepa kwanu, kuwerengera kwa calorie, index ya glycemic, insulini mu chikhalidwe cha anthu odwala matenda ashuga ochepa mafuta ochepa.
Kusamalira miyendo
Onse odwala matenda ashuga ayenera kuyang'ana miyendo yawo kamodzi pa sabata kuti achepe, mabala otseguka, kutupa, matuza, misomali yolowera ndi galasi kapena kukopa othandizira. Ngati wodwala wavala, kupuma masokosi opanda mabatani komanso kumawunikira usiku uliwonse, izi zimamupangitsa kuti aziwongolera pang'ono kuvulala kwamapazi kuti awagwire munthawi yake ndikuletsa kutupa komwe kumayambitsa kuduladula. Ndikofunikira kusankha nsapato zoyenera kuti zisapukutire phazi kulikonse. Muyenera kuti mudzatenge mu sitolo masana, chifukwa miyendo ya anthu odwala matenda ashuga nthawi zambiri amatupa. Simungathe kuvala nsapato zolimba, popanda ma insoles, okhala ndi zala zazifupi. Musanaveke nsapatozo muziyang'ana mkati. Sambani mapazi anu ndi kuwapukuta mokwanira, makamaka pakati pa zala zanu, tsiku lililonse, simungathe kugwiritsa ntchito madzi otentha - izi ndizowopsa m'mitsempha yamagazi. Misomali iyenera kudulidwa pa nthawi yake komanso molondola (osati yayifupi kwambiri, ndikusiya ngodya za misomali) kuti mupewe mavuto a misomali yolowera.
Ngati masinthidwe samakulolani kuti musamalire nokha mapazi anu, mutha kugwiritsa ntchito ntchito za pedon salon kapena thandizo la abale. Simungayang'ane ming'alu ndi tsamba, monga kumayenda wopanda nsapato mumsewu. Kwa odwala matenda ashuga, mankhwala ogulitsa mankhwala amagulitsa mafuta apadera omwe amakhala ndi urea omwe amachepetsa chimanga ndikuchiritsa ming'alu. Amayikidwa pagulu lonse la mapazi, kupatula malo okhazikika pakati. M'malo moledzera (ma deodorants, ayodini, wobiriwira wanzeru) sangathe kugwiritsidwa ntchito.
Zochita zolimbitsa thupi
Malinga ndi malingaliro a International Diabetes Association, wodwala matenda ashuga ayenera kumwa pafupifupi mphindi 150 pa sabata kuti akatundutse minofu kapena mphindi 20 patsiku. Zabwino kwambiri zimakhala kusambira mu dziwe, kusadzaza miyendo kapena kuyenda mosavuta mu nsapato zabwino, popanda matumba, komanso mapulogalamu apadera olimbitsa thupi omwe amapangidwa mu salons zamagulu awa.
Yendani panthawi yake ku nduna yodwala matenda ashuga
Mwa zisonyezo zilizonse za kuwonongeka kwa mwendo, ngakhale pakalibe kupweteka kwathunthu, kuti muchepetse kukhazikika kwa njira zotupa, ndikofunikira kupereka chithandizo chokwanira kwa odwala matenda ashuga ndikuwunika mwachangu ndi katswiri yemwe angadziwe matenda amitsempha, akuwongolera molondola zotsatira za ultrasound yam'munsi yotsika. Chida chapadera chimayezera kuthamanga kwa ziwiya zamapewa ndi phewa kuti mupeze cholozera chapadera. Ichi ndi chizindikiro chofunikira kwambiri pakufufuza kwamankhwala, chololeza dokotala wa opaleshoni, endocrinologist, dokotala wokhudzana ndi banja kuti asankhe ngati zingatheke kuthetsa vuto la phazi la matenda ashuga ndi njira zosasinthika kapena ngati kudulidwa sikulephereka.
Dokotala wa nduna yodwala matenda ashuga nawonso ndiwowopsa omwe amatha kuzindikira molondola potengera madandaulo a wodwala ndikuwunika mwendo popanda kusokoneza matenda a shuga ndi matenda a banal, chifukwa matendawa amafunika njira yosiyana. Tsoka ilo, ambiri amafunafuna thandizo mochedwa, motero dokotala wotere ayenera kukhala dokotala wabwino wa opaleshoni, wowongoleredwa munjira zamakono zowongolera odwala. Malinga ndi miyambo yapadziko lonse, wodwala yemwe alibe zovuta kuchokera kuphazi la matenda ashuga ayenera kupita ku ofesi ya odwala matenda ashuga kawiri pachaka kuti adziwe. Ngati vuto lawonekera kale, pafupipafupi maulendo komanso njira zamankhwala zimatsimikiziridwa ndi adokotala. Kuwongolera kulikonse kwa wodwala yemwe ali ndi matenda ashuga kumasiyana ndi kuwongolera mabala a odwala popanda mavuto a "shuga", chifukwa chake ndikofunikira kwambiri kuti mupeze "dokotala" wanu, makamaka, dokotala wochita opaleshoni.
Kuphatikiza pa ngozi, kuchuluka kwambiri kwa kuduladula miyendo kumachitika mwa anthu omwe ali ndi matenda ashuga. Ambiri odwala matenda ashuga akutsimikiza kuti zovuta zonsezi ndi zotengera ndi impso sizingawakhudze. Koma matenda ashuga ndi matenda osasinthika, ndipo kungodziyang'anira pawokha ndi kuwunika koyenera mu labotale kungathandize kuzindikira kusintha kwakanthawi kuti mupewe kudulidwa.
