Diso zovuta - matenda ashuga retinopathy: magawo, mankhwalawa, udzu

Matenda a shuga a retinopathy ndi amodzi mwa zovuta za matenda a shuga, omwe amachititsa kuwonongeka kwamawonekedwe.

Chifukwa chiyani komanso momwe zonse zimachitikira, yemwe ali pachiwopsezo cha matenda ashuga komanso chidziwitso cha matendawa ndi chiyani ndipo ngati njira zowonongekazo zitha kuyimitsidwa - izi zidzafotokozedwa pambuyo pake.

Kodi retinopathy ndi chiyani?

Retinopathy ndikusintha kowononga m'mitsempha ya m'maso, chifukwa chomwe magazi amatuluka mu retina amasokonekera.

Izi zimayambitsa dystrophy, kenako kufa kwa mitsempha ya maso, yomwe imayambitsa khungu.

Mawu akuti "retinopathy" amatanthauza kusintha kwa ma pathological mu retina, a mitundu yambiri.

Itha kukhala:

1. retinopathies oyamba omwe samayambitsidwa ndi njira zotupa;
2. retinopathies yachiwiri yomwe idatulukira chifukwa cha ma pathologies ena.

Kufufuza zamomwe zimachitika motsutsana ndi maziko a matenda a shuga, ndikofunikira kudziwa kuti ndizovuta kwambiri komanso pafupipafupi za anthu omwe ali ndi matenda ashuga, zomwe zimapangitsa kuti anthu asaone bwino, komanso akutanthauza mtundu wachiwiri wa retinopathy.

Kukula modabwitsa nthawi yoyamba, kumachitika mwa 85% odwala omwe ali ndi matenda amtundu woyamba 1, omwe "zomwe akudziwazo" pano ndioposa zaka 20.

Njira ya retinopathy

Ponena za anthu odwala matenda ashuga okhala ndi mtundu wa 2 matenda, pakatikati mwa anthu achikulire ndi okalamba, komanso matenda ashuga, chotupa cham'maso chinapezeka.

Khodi ya ICD-10

Diabetesic retinopathy imatchulidwa molingana ndi ICD-10 motere:

• kalasi VII "Matenda a maso ndi adnexa (H00-H59)";
• gawo "Matenda a choroid ndi retina (H30-H36)";
• code code "H36.0";
• kuzindikira "Matenda a shuga a retinopathy" kuyambira E10 mpaka E14, kutengera mtundu wa shuga mellitus, wokhala ndi chizindikiro chofananira chachinayi "."

Zomwe zimachitika

Diso retina ndi gulu lovuta, kuphatikizapo kuchuluka kwa zolandilira zomwe zimalandira kuwala ndikuwusintha kuti ukhale wopangitsa magetsi.

Chozunguliridwa ndi gulu la ma capillaries omwe amapereka magazi athunthu.

Matenda a shuga a retinopathy amakhala chifukwa:

• mavuto a metabolic;
• zovuta zam'magazi;
• onjezerani kuchuluka kwa zotupa za hematoretinal (HBG), zomwe sizingalole kuti mamolekyulu azilowa mu retina motsatira magazi. Mu matenda ashuga, amasiya kukhala chopinga chonse, chomwe chimatsogolera pakupanga madipoziti.

Madokotala amakhulupirira kuti gululo lomwe lili pachiwopsezo chachikulu cha matenda ashuga limaphatikizanso anthu omwe ali ndi:

• matenda oopsa
• aakulu aimpso matenda;
• lipid bwino mavuto;
• onenepa kwambiri.

Zowopsa

Pali zinthu zina zomwe zimakhalapo zomwe zimawonjezera mwayi wokhala ndi retinopathy:

• Kutalika kwa matenda ashuga komanso kuchuluka kwa kayendedwe ka glycemic. Matenda a shuga omwe amakhala nthawi yayitali, amakhala owopsa;
• mwachangu masanjidwe a zimam'patsa kagayidwe kachakudya. Izi zimachitika ndi chithandizo champhamvu cha insulini mwa achinyamata omwe ali ndi matenda osokoneza bongo osavomerezeka. Kapena pamene ndi mtundu 2 pali kusintha kuchokera pa mapiritsi ochepetsa shuga kupita ku insulin;
• mtundu wa chithandizo cha matenda ashuga. Ndi insulin, mwayi wokhala ndi retinopathy ndiwopamwamba;
• kuthamanga kwa magazi;
• m'mimba-visceral mtundu wa kunenepa;
• nephropathy odwala matenda ashuga;
• kutengera kwa majini kuwonongeka kwa mavesvessels mu shuga.

Masiteji

Gulu la retinopathy, lomwe likugwira ntchito tsopano, lidatengedwa mu 1991. Ndiosavuta komanso yomveka, zomwe zimapangitsa kuti ikhale yosavuta kugwiritsa ntchito. Malinga ndi zomwe zalembedwazi, pali magawo atatu (mafomu) a shuga a retinopathy.

Zosakondweretsa

Zosasangalatsa (kumbuyo). Amasiyanitsidwa ndikuwoneka mu retina (retina):

• ma micaneurysms (ma magazi otulutsa magazi m'matumbo);
• zotupa zotupa. Amawafotokozera ngati madontho, mikwingwirima, kapena mawanga amizeremizere, okhala ndi zotetezera pakati pa fundus kapena m'mitsempha yayikulu yomwe ili mkati mwa retina;
• retinal edema mu mbali ya macular (yapakatikati) kapena m'matumba akulu;
• mtima ndi exudate. Awa ndi madera a mafuta ndi cholesterol omwe amapangika chifukwa chotuluka magazi. Zoyera kapena zachikasu, zimasonkhanitsidwa nthawi zambiri pamkatikati mwa diso. Titha kukhala ndi malire a kumveka kosiyanasiyana.

Preproliferative

Preproliferative diabetesic retinopathy.

Ndiwofunika:

• kuwoneka kwa kusintha kwachilendo m'mitsempha ndi ma cellvessels;
• voliyumu yowoneka yaukali kapena thonje ngati thonje;
• kuchuluka kwa zotupa za hemorrhagic.

Kuchuluka kwa umboni wa kusintha kumeneku kukugwirizana kwambiri ndikusintha kwa njira zakuchulukirachulukira.

Kuchulukitsa

Proliferative retinopathy imadziwika ndi kuchulukana kofananira kwamitundu iwiri:

• mtima;
• fibrotic.

Zombo zopangidwa zatsopano zimapangika pafupi ndi khoma lakumaso kwa vitreous. Chifukwa cha kulephera kwawo, kutulutsa magazi nthawi zambiri kumachitika. Popita nthawi, kuthamanga kwa khoma ndikotheka.

Proliferative retinopathy

Zizindikiro

Zizindikiro zosiyanasiyana komanso kuuma kwawo zimadalira gawo la retinopathy.

Nthawi zambiri matendawa amapita pang'onopang'ono.

Poyamba, pamene mankhwalawa anali osavuta komanso ogwira ntchito, palibe mawonekedwe akuchipatala.

Munthawi yopanda kuchuluka, anthu odwala matenda ashuga sawona mavuto amawonedwe.

Retina edema imawonetsedwa ndi kuzizira kwa "chithunzicho", chomwe chimapangitsa kuwerenga kapena kuwongolera zinthu zazing'ono zovuta.

Kupitilira apo, pamene zotupa m'mimba zimacheperachepera, odwala matenda ashuga amalankhula za mawonekedwe amdima pamaso pa diso, omwe, patapita nthawi, amadzisowa okha.

Kuzindikira ndi chithandizo

Kuzindikira matenda ashuga retinopathy kumafuna zida zapadera molondola kwambiri. Ndikofunikira kuti:

• kuzindikira kukula kwa kutayika kwa mawonekedwe ndi mkhalidwe wapakati pa retina;
• gwiritsani ntchito njira yolowerera pakompyuta (kuphunzira magawo owonera) kuti mudziwe momwe zinthu zilili kumapeto kwa retina;
• yang'anani kutsogolo kwamaso kuti muwone momwe mandimu ndi iris;
• kuchita gonioscopy;
• kuchita zachuma (muyeso wa kupanikizika kwa intraocular).

Ngati kupsinjika mkati mwa diso kuli m'malire ovomerezeka, mitundu yotsatirayi yamaphunziro imachitika pa mwana, wothira mothandizidwa ndi madontho apadera:

• Biomicroscopy ya mandala komanso vitreous amachitidwa.
• Zosankha zamagetsi zamagetsi zamagetsi zimagwiritsidwa ntchito zomwe zimayenera kuyesa magwiridwe antchito a retina ndi nerve (optic).
• Ophthalmobiomicroscopy amagwiritsidwa ntchito, omwe amafunikira kuti azigwira ntchito mogwirizana ndi thupi la vitreous komanso retina, komanso kuti awone kusintha kwa retina, ndikutsimikiza kwachitukuko chawo. Phunziroli limaphatikizapo kujambula chithunzi chotsatiracho.
• Kujambula kwa diso komwe kumachitika m'maso kumachitika kuti mudzione ngati ali ndi thupi lofunika kwambiri. Izi zimapangitsa nzeru zapadera pakadandaula madandaulo, pamene ophthalmoscopy pansi penipeni pa masomphenya ndi zovuta kuchita.

Kuzindikira kodzaza mokwanira kumangoleketsa kungodziwa ziwalo za masomphenyawo, komanso kuneneratu kuchuluka kwa matendawo, komanso kuwunika moyenera zotsatira zoyipa. Izi ndizofunikira posankha njira zomwe zitha kuchedwetsa khungu.

Njira zochizira retinopathy zimaphatikizira:

1. Laser retina moxibustion, amene amachepetsa kudzicheka komanso kuchepetsa kuchuluka kwa zotupa. Mu milandu 80%, ndizotheka kuyimitsa njirayi ndikuyimitsanso kuwonongeka kwakanthawi kwa zaka 12. Kulowerera koteroko kumatha kuchitika nthawi iliyonse, koma koposa zonse, kumadziwonetsera wachiwiri.
2. Chiwonetsero cha ziwalo zamasomphenya a Ranibizumab. Awa ndiukadaulo watsopano. Zimakuthandizani kuti muchepetse kuchuluka ndipo kumayenda bwino ndi laser coagulation.
3. Kuchotsa kwa Vitreous (vitrectomy). Njira imeneyi imagwiritsidwa ntchito ngati minyewa yongopangika kumene ingalowe mu vitreous, ndikuyambitsa kukhumudwa kwakukulu. Ngati angagwiritsidwe ntchito musanayambike kuzimiririka, 80% ya anthu omwe ali ndi matenda ashuga amatha kupewa kuwona.
4. Mankhwala. Cholinga chake ndi kulimbitsa minofu yam'mimba ndikutchiritsa kukoka kwa magazi. Mankhwala apadera a retinopathy sanakhalepo. Pakadali pano, Tranexamic acid ndi othandizira pazomwe amagwiritsidwa ntchito bwino. Komabe, njira zogwira mtima kwambiri zimatengedwa kuti ndizopepuka, zomwe zidanenedwa pamwambapa.

Ziwonetsero

Ngati munthu yemwe ali ndi vuto la retinopathic adafunsira dokotala ndikuyamba kulandira chithandizo koyambira, pali mwayi weniweni wakuchepetsa kuwonongeka kwakukulu kwa zaka 15. Izi zimayang'aniridwa ndi kusungika kwokhazikika kwa misempha yamagazi osaposa 9 mmol / L.

Mtundu woyamba wa matenda ashuga, kuwonongeka koonekera kumakula msanga, mosiyana ndi mtundu wake wachiwiri. Njira yosakhazikika (labile) ya retinopathy imathandizira kukhazikitsa njira zoyipa.

Kupewa

Tsoka ilo, palibe njira zopewera kuti zithetseretu vuto la retinopathy ndi matenda ashuga.

Iye, nthawi zambiri, ndi mnzake kwambiri wa zamatsenga izi.

Kuti muchepetse kuwona kwambiri komanso osathamanga, muyenera kuyang'aniridwa ndi ophthalmologist nthawi ndi nthawi.

Pankhani ya matenda a shuga omwe amadalira insulin (mtundu 1), kuwunika kwathunthu ndikofunikira patatha zaka 5 pambuyo podziwika bwino. Mtundu wachiwiri wa matenda ashuga, kupezeka kwa matenda a ziwalo zam'maso amadziwika nthawi yomweyo.

Ngati retinopathy imatsimikiziridwa, pafupipafupi kuyendera kwa ophthalmologist kumatsimikiziridwa ndi gawo lake:

• Gawo 1 - nthawi 1 mu theka la chaka;
• Gawo 2 - 1 nthawi kotala;
• Gawo 3 - kanayi pachaka kapena molingana ndi mawonekedwe.

Njira zomwe zimagwiritsidwa ntchito poletsa matenda a retinopathic mu shuga ndi monga:

• kuyang'anira pafupipafupi kuchuluka kwa shuga m'magazi (osachepera kanayi pa tsiku);
• kukhalabe ndi thanzi labwino kotero kuti cholembera cha shuga sichidutsa 9 mmol / l kwa nthawi yayitali kwambiri;
• kusintha kwakanthawi kwamankhwala a insulin;
• kutsatira malangizo a dokotala okhudza zakudya, komanso malangizo a jakisoni wa insulin kapena makonzedwe amkamwa kuti muchepetse shuga;
• Popewa zosiyana mwadzidzidzi pakukula komanso kuchepetsa shuga
• kuthamanga kwa magazi;
• kuyendera pafupipafupi kwa endocrinologist;
• kulimbitsa thupi.

Kuti muchepetse chiopsezo cha kufinya kwam'mimba panthawi ya retinopathy, musatero:

• kukweza ndi kunyamula katundu wolemera (woposa 5 kg);
• Squat
• kupsinjika (mwachitsanzo, mipando yosuntha);
• khalani akuthwa.

Amayi oyembekezera omwe ali ndi retinopathic amawonetsedwa pobereka.

Matenda a shuga a retinopathy nthawi zambiri amakhala osapeweka. Kuti tisunge masomphenya amtengo wapatali kwa zaka zambiri, ndikofunikira kuti tisayambitse vutoli, koma kuti ndiyambe kutsegula posachedwa.

Makanema okhudzana nawo