Kutsika angiopathy mu matenda a shuga: zimayambitsa, Zizindikiro ndi chithandizo

Matenda ofala kwambiri a musculoskeletal system, omwe amatsogolera kulumala koyambirira kwa anthu olimba, ndi matenda ashuga am'munsi a chiwindi.

Vutoli limaphatikizidwa ndi shuga wambiri, komanso kuwonongeka kwa impso ndi retina, ndizosangalatsa pakati pa asayansi padziko lonse lapansi.

Malinga ndi ziwerengero, pofika kumapeto kwa zaka za zana la 21, munthu aliyense wachitatu padziko lapansi adzakumana ndi vuto la insulin, ambiri aiwo adzakhala ndi zovuta zam'mitsempha.

Ichi ndi chiyani

Matenda a shuga ndi matenda oopsa. Ngati zizindikiro zoyambirira za zovuta zimanyalanyazidwa, ndiye kuti patapita nthawi (munthu aliyense payekhapayekha) zovuta zamtundu wa zofewa zam'munsi zimayamba.

Lower angiopathy

Magawo amkati mwendo (miyendo) amakhudzidwa kwambiri, momwe magazi amayenda, ngakhale ali munthawi yabwinobwino, amakhala otsika kwambiri.

Kuvulala pang'ono kumatsegulira khomo lakutenga matenda, motsutsana ndi maziko a chitetezo chochepetsedwa, chilondacho chimakhala chaulesi, chowononga. Ngati masitepe sanatenge nthawi, njirayi imadutsa m'magazi, zimatchedwa "phazi la shuga".

Kutengera kufalikira kwa njirayi, kuthekera kwanyumba ndi kuthekanso kusintha, madotolo amasiyanitsa mitundu yayikulu ya phazi la matenda ashuga:

• neuropathic - Kugonjetsedwa kwa michere yayikulu ndi yaying'ono yam'mimba, kuphwanya kwamvero ndi paresthesia kumabwera;
• neuroischemic - zombo, choyambirira, kuvutika;
• kusakaniza - ili ndi zizindikilo zonse ziwiri. 

Kutengera ndi mawonekedwe, odwala ali ndi zodandaula zofananira zomwe zimazindikira njira zoyenera kuchitira chithandizo.

Kwa pafupi zaka 25, gulu la Wagner la phazi la matenda ashuga limadziwika padziko lonse lapansi. Ikulongosola kufalikira kwa njira zowonongeka za minofu yofewa:

• siteji 0. Njira zoyimbira mu zida za m'miyendo, zomwe zimangowoneka pa x-ray;
• gawo 1. Zilonda zapakhungu zapamwamba zomwe sizifalikira mpaka minofu yofewa;
• gawo 2. Chilondacho chimafalikira mozama mkati mwazomwe zimapangidwa, chimafikira mafupa ndi tendon;
• gawo 3. Osteomyelitis ndi mapangidwe a abscess;
• gawo 4. Gangrene limapangidwa, dera lomwe lakhudzidwa ndi phazi limada, kusintha komwe sikungasinthe;
• gawo 5. Pafupipafupi, womwe umatha kufika m'dera la bondo, ndikudula mwendo mwachangu ndikofunikira.

Zomwe zimachitika

Maselo amafunika insulini kuti azitha kumanga shuga.

Kuwonjezeka kwa shuga m'magazi a anthu odwala matenda ashuga kumawoneka mu "kupomoka" kake mu minofu, popanda metabolism yowonjezera.

Vascular endothelium (yoling ya capillaries ndi arterioles) mosakhalitsa imalimbikitsa glucose chifukwa chakuti mtundu wamtunduwu sufunikira insulin kuti idye. Pakapita kanthawi, ndendezo zimafika poizoni, mowonjezereka umayamba kukula.

Madzi amayamba kudziunjikira mkati mwa endotheliocytes, maselo amatupa ndikufa. Kuphatikiza apo, njira ya shuga kagayidwe imayambitsidwa, zomwe zimapangitsa kupangidwa kwa sorbitol, chopangidwa ndi chinthu chomwe chili chowopsa kwambiri kuzinthu zamoyo.

Popita nthawi, njira za kuphatikiza kwa endothelial ndi bungwe zimasokonekera, ma protein a macroglobular (mapuloteni) amayamba kudutsa momasuka kudzera mu khoma lamitsempha lowonongeka, edema yam'mlengalenga imayamba.

Dongosolo lamitsempha silingathe kupirira kuchuluka kwamadzimadzi m'matipi, miyendo imatha kusokonezeka mosavuta.

Muzochitika zotere, ngakhale kuvulala pang'ono kungayambitse kutupa kwambiri ndi necrosis.

Nthawi zambiri, ndi mawonekedwe a neuropathic phazi la matenda ashuga, pakumva kupweteka, anthu sawona kuwonongeka kwa nthawi yayitali, motero amasemphana ndi mawonetseredwe oyamba a kupsinjika.

Zizindikiro za matendawa

Kuwonetsedwa kwa matenda a shuga angiopathy amatha kutengera kosiyanasiyana. Chifukwa chake, odwala nthawi zambiri amadandaula za kuwonongeka kwa mawonekedwe, kufooka kwathunthu, kusokonezedwa mu ntchito ya mtima.

Phazi lesion syndrome lili ndi izi:

• zovuta zamatumbo kumapazi: kusenda kwa khungu, kuchepa tsitsi, kuyabwa;
• khungu lowopsa (khungu pakadutsa gawo lomwe lathandizalo silikhala lachirengedwe mwachilengedwe nthawi zina ndimatenda a cyanotic);
• imasokoneza ululu wamiyendo mukuyenda kapena popuma;
• kupweteka, kutentha ndi kugwedeza mphamvu kumachepetsedwa;
• pulsation m'mitsempha yayikulu yamapazi imachepa;
• mawonekedwe a zilonda;
• zala zakuda.

Chizindikiro chilichonse pamwambapa chikuyenera kukhala chizindikiro choopsa komanso chizindikiro chokwanira kuti mukaonana ndi dokotala.

Zizindikiro

Njira yoyamba yodziwira matenda ashuga am'magazi otsika ndikuwunika mokwanira madokotala. Dokotala amasanthula madandaulo a wodwala, amatenga mbiri yatsatanetsatane yachipatala, amawona kutalika ndi nthawi ya kayendetsedwe ka matenda ashuga.

Kuti mutsimikizire matendawa, angapo a zasayansi ndi a zothandizira amachitidwa.

• kuyezetsa magazi konse (kukhalapo kwa chotupa mu mawonekedwe a leukocytosis ndi kuwonjezereka kwa ESR ndichizindikiro chofunikira kwambiri);
• kuyesa kwamwazi wamagazi (kuyesa kwa aimpso ndi chiwindi, shuga, glycosylated hemoglobin, mbiri ya lipid);
• urinalysis (kutsimikiza kwa glucosuria mlingo);
• Ultrasound ya ziwiya zamagawo akumunsi mumayendedwe otchedwa Doppler. Kafukufukuyu amakulolani kudziwa kuchuluka kwa mitsempha yamitsempha yamagazi ndi malo a minofu yosagwira;
• angiography. Pambuyo pa kutsekeka kwa utoto wapadera wa utoto wapadera, ma x-ray angapo am'munsi amachitidwa, madera omwe ali ndi vuto la magazi amawoneka;
• MRI. Njira yofufuzira yophunzirira komanso yokwera mtengo yomwe imapereka chidziwitso chambiri chokhudza kuchuluka kwa njira za ischemic, komanso zimakupatsani mwayi wambiri kuchuluka kwa kulowererapo;
• fundoscopy. Kuwerenga kwa ziwiya za fundus kumapereka chidziwitso chofunikira pokhudzana ndi zotupa zamkati mwa mtima, kuphatikizapo ubongo;
• ECG ndi ECHO-KG. Onaninso magwiridwe antchito a mtima, makamaka ngati opaleshoni inakonzekera.

Njira zochizira

Zakudya zomwe munthu amadya zimasankhidwa, chakudya chamafuta othamanga komanso mafuta a nyama ndizochepa.

Zakudya zokha sizothandiza, koma ndi maziko abwino a mankhwala.

Ndikofunika kusankha bwino mankhwala a insulin kapena mankhwala a pakamwa a hypoglycemic. Mafuta a cholesterol amawongoleredwa, ngati akwezedwa, ma statins amapatsidwa.

Ngati pali kusintha kwa ulcerative necrotic, dokotalayo amalumikizidwa. Minofu yakufa imapukusidwa, mavalidwe a aseptic omwe akukonzanso ndikuchiritsa zinthu zimayikidwa. Gravitational plasmapheresis ikhoza kugwiritsidwa ntchito, zimatsimikiziridwa kuti njirayi imatha kuchepetsa kutupa, kuchepetsa ululu.

Kusintha kwa mafupa-articular kumathandizidwa ndikuthamangitsa phazi ndi nsapato za orthopedic.

Kupewa

Anthu odwala matenda ashuga ayenera kutsatira malangizowa:

• kuyang'anitsitsa kuchuluka kwa shuga m'magazi;
• mayeso okhazikika a opaleshoni;
• kuyang'ana kwamapazi ndi nsapato kumapeto kwa tsiku lililonse;
• kukhathamiritsa zolimbitsa thupi.

Kanema wothandiza

Momwe mungayeretsere mitsempha yamagazi kwa matenda ashuga:

Ndikofunika kukumbukira kuti matenda ashuga a shuga a m'munsi am'munsi ndiwotheka kusintha m'mayambiriro a kukula. Kusamalira munthawi yake chithandizo kumathandiza kupewa kuti musadulidwe. Kuwongolera shuga kumathandizira kuthetsa zoyipa zomwe zimapezeka m'magazi a mtima.