Vuto lalikulu la matenda ashuga ndi matenda a shuga. Amapezeka mu 30-50% ya odwala.
Kusokonezeka kwa dongosolo la autonomic ndi somatic, kusokonezeka kwa chidwi ndi kupatsirana kwa mitsempha kumatha kulankhula za kukhalapo kwake.
Ichi ndi chiyani
Ndi mankhwala, ndichizolowezi kumvetsetsa matenda a diabetesic neuropathy monga gawo la kuphwanya madipatimenti a autonomic mantha ndi zotumphukira dongosolo.
Amatuluka chifukwa cha zovuta za kagayidwe kachakudya matenda ashuga. Pali mitundu ingapo ya matenda ashuga a mtima.
Matendawa ndi amodzi mwa zovuta kwambiri komanso pafupipafupi zovuta za matenda ashuga. Amadziwika ndi zizindikiro zamavuto amisala komanso kutsekeka kwa mitsempha, kusokonezeka kwa dongosolo la somatic ndi zina zambiri.
Gulu ndi Mafomu
Neuropathy ndi wozungulira komanso wopanda ufulu.Neuropathy imatchulidwa motere:
- ndi makina owonongeka: axonal, neuropathic, demyelinating;
- mwa mtundu wa minyewa yamanjenje: sensory-motor, autonomic, sensory, osakanikirana, mota;
- kutengera gawo la kuwonongeka kwa mitsempha: sensory (minyewa yamatenda imatupa), sensor (sension lesion), mota (kuphwanya mota ntchito ndi minyewa).
Zomwe zimachitika
Chochititsa chachikulu pakupezeka kwa matenda a shuga a shuga a m'magazi ndi kukwezedwa kwa magazi m'magazi, komwe pamapeto pake kumabweretsa kusintha kwa magwiridwe antchito ndi kapangidwe ka maselo amitsempha.
Kuphatikiza apo, zomwe zimayambitsa neuropathy zitha kukhala:
- zaka zopitilira 60;
- kuthamanga kwa magazi;
- kunenepa kwambiri kapena kunenepa kwambiri;
- kukhalitsa kwa shuga;
- kukhalapo kwa zizolowezi zoipa;
- kubweza gawo.
Pathogenesis
Chofunikira kwambiri mu pathogenesis ya neuropathy ndimavuto a metabolic ndi microangiopathy (kusintha kantchito kapena kagwiritsidwe ntchito ka ma capillaries, omwe amachititsa microcirculation mu mitsempha ya mitsempha).
Zosintha zimaphatikizidwa ndi izi:
- kutsika kwa mseru wa myoinositis, limodzi ndi kufooka kwa kapangidwe ka phosphoinositis, monga zotsatira zake kumabweretsa kutsekeka kwa mitsempha komanso kuchepa kwa mphamvu ya kagayidwe;
- kuchuluka oxidative nkhawa;
- kutsegula kwa polyol shunt (mkhutu wazida metabolism);
- enzymatic komanso sanali enzymatic glycosylation a zigawo zikuluzikulu za minyewa CHIKWANGWANI - tubulin ndi myelin;
- chitukuko cha autoimmune maofesi.
Zizindikiro
Zizindikiro zazikulu za matenda ashuga ndi:
- dzanzi
- Zizindikiro zoyipa za neuropathic;
- kumverera koyaka;
- electromyography;
- paresthesia;
- latency;
- kuchepa kwakukulu kapena kusowa kwa bondo ndi mawonekedwe a Achilles;
- kuphwanya kwambiri chidwi;
- kuphwanya mayendedwe.
Kuzindikira ndi chithandizo
Choyamba, kuti adziwe matenda a neuropathy, katswiri amawunika momwe wodwalayo akumvera. Jakisoni amapangidwa kuti adziwe ululu.
Zomverera zamtundu wa kukhudza, kukhudza monofilament, kutentha ndi kuzizira zimayang'anidwanso. Zomverera zamtunduwu zimatsimikiziridwa ndi foloko.
Osati popanda kuyesedwa kwa mawondo. Wodwala amatha kuchititsa yekha izi, zomwe zingamuthandize kudziwa ngati ali ndi matenda a shuga. Dokotala, pogwiritsa ntchito zida zapadera, azindikiritsa mtundu, magawo komanso kuopsa kwa matendawa.
Mankhwala, njira yovuta ya mankhwala imagwiritsidwa ntchito, yomwe imaphatikizapo:
- alpha lipoic acid. Zimalepheretsa kuchulukana kwa glucose mu minyewa yamitsempha, komanso imayambitsa ma enzyme ena m'maselo, omwe amatha kubwezeretsa mitsempha yomwe ikukhudzidwa;
- opinya;
- Mavitamini B .. Amatchinga poizoni wa m'magazi m'mitsempha;
- Actovegin. Imagwiritsa ntchito shuga, imakhazikitsa magazi m'magazi;
- aldose reductase zoletsa. Amachepetsa mavuto obwera ndi shuga m'thupi;
- Calcium ndi potaziyamu zopangidwa. Chepetsani dzanzi ndi kukokana.
Osteomyelitis
Chimodzi mwazovuta za matenda ashuga ndi m'munsi miyendo neuropathy, limodzi ndi mapangidwe a phazi la matenda ashuga. Chimakula makamaka pambuyo pa zaka 5-7 kuyambira chikhazikitso cha matenda amtundu woyamba wa shuga. Kachiwiri, kudwala kumawonekera pafupipafupi.
Matenda a shuga
Chofunikira kwambiri pakupanga zovuta za matenda ashuga ndi chiphuphu chochepa cha shuga. Chizindikiro choterechi chimawonedwa chifukwa cha mtundu waukulu wa matendawa, kapena kulephera kutsatira malangizo a endocrinologist. Kuthamanga kwa magazi komanso kusintha kwadzidzidzi kumakhudza mitsempha ya mitsempha komanso khoma lamitsempha.
Matendawa phokoso la matenda ashuga ndi awa:
- kutayika kwa chitetezo chokwanira;
- angiopathies (mitsempha yamitsempha);
- zilonda matenda;
- mafupa am'mimba komanso kuwonongeka kwa mafupa.
Phazi la matenda ashuga limatha kupezeka mwa mtundu wa ischemic ndi neuropathic, kutengera zovuta zomwe zimapezeka. Komabe, nthawi zambiri zinthu zonsezi zimakhudzidwa nthawi imodzi.
Sensorimotor
Chifukwa cha sensorimotor neuropathy, kuthekera kosunthika kumachepa, ndipo zomveka zachilendo chifukwa cha kuwonongeka kwa mitsempha zimatha kuchitika.
Choyambitsa chachikulu cha matendawa ndi matenda, kapena kuwonongeka kwa mitsempha. Njirayi imatha kuchitika kunja kwa chingwe cha msana ndipo imatchedwa peripheral neuropathy.
Matendawa ndi matenda, chifukwa, amatha kuthana ndi mitsempha yofunika, ntchito yomwe imapereka malingaliro kapena kuyambitsa kusuntha. Mwanjira imeneyi, sensorimotor neuropathy imatha kuyamba. Cholinga chake chachikulu ndikuthandizira mayendedwe.
Chifukwa cha zowonongeka zambiri m'maselo, njira yochepetsera mauthenga amanjenje imachitika. Ndipo chifukwa cha zotsatira za mitsempha pa ulusi wamanjenje kapena ma cell athunthu, magwiridwe awo akhoza kutayika.
Chizindikiro pafupipafupi ndikuchepa kwa chidwi mu gawo limodzi la thupi, ndipo matenda amaphatikizidwa nthawi zambiri ndi:
- kumeza movutikira;
- kuvuta kugwiritsa ntchito manja;
- kumverera koyaka;
- kufooka m'malo osiyanasiyana a thupi;
- kumva zomverera;
- kupweteka ndi zovuta kuyenda;
- zomverera zachilendo mu gawo lililonse la thupi.
Zizindikiro za sensorimotor neuropathy zimatha kukhala ndi liwiro losiyanasiyana, mwachangu komanso pang'onopang'ono, kwa milungu yambiri kapena zaka. Nthawi zambiri, matenda amtunduwu amayamba kuwoneka kuchokera kumapeto kwa zala.
Yoyimira
Autonomous diabetesic neuropathy ndi njira yomwe imakhudza mbali yodziyimira payokha ya machitidwe amanjenje, ntchito yake yayikulu ndikuwongolera ndikugwirizanitsa ntchito ya ziwalo zamkati. Komanso, mkati mwake, chiwonetsero cha matenda osiyanasiyana mamembala ambiri ndichikhalidwe.
Zizindikiro zomwe zimapezeka ndi chizindikirochi zimapezeka mu:
- kuyamba mseru;
- kutentha kwa mtima;
- chisangalalo;
- kutsegula m'mimba
- kudzimbidwa
- mukamadya chakudya chochepa, kulemera m'mimba kumawonedwa;
- Kuchepetsa kuyendetsa chakudya kuchokera m'mimba kupita m'matumbo.
Zizindikiro izi zimawonetsa kusokonezeka pakugwira ntchito pamimba.
Komanso, munthawi imeneyi, ntchito ya mitsempha yomwe imayang'anira matumbo ang'onoang'ono imatha kusokonezeka, yomwe imapangitsa kukula kwa matenda otsegula m'mimba.
Ndi ma neuropathy odziyimira pawokha, mitsempha yomwe imayambitsa kukonzekera nthawi yogonana mwa amuna imakhala ndi vuto. Izi nthawi zambiri zimayambitsa kusokonekera kwa erectile, komwe sikumachotsa chilakolako chogonana komanso kukhumba kwa wodwala. Ponena za chachikazi, odwala amatha kudandaula zauma kwambiri kumaliseche, komanso kusapezeka kapena kuchepa kwa chilakolako chogonana.
Makanema okhudzana nawo
Kupewa ndi kuchiza matenda a neuropathy mu matenda ashuga:
Matenda a shuga a shuga ndi amodzi mwa zovuta zomwe zimachitika kwambiri odwala matenda ashuga, amapezeka pafupifupi theka la odwala onse. Imabwera m'magulu osiyanasiyana komanso mitundu iliyonse, yomwe ili ndi njira yake komanso zisonyezo zake. Nthawi zambiri izi zimapezeka mwa odwala omwe ali ndi mtundu woyamba wa matenda ashuga.
