A shuga angiopathy a m'munsi malekezero

Matenda a shuga angiopathy amatchedwa zotupa zotupa za akulu (macroangiopathy) ndi ochepa (microangiopathy) omwe amapezeka mwa odwala omwe ali ndi matenda a shuga. Nthawi zambiri ubongo, kuwunikira kowonera, kwamikodzo, mtima, ziwiya zam'munsi zimathandizidwanso.

Zolemba za matendawa

Kukula kwa chotupa m'magazi othana ndi matenda osokoneza bongo kumayendera limodzi ndi:

• kuphatikizika kwa makoma a mtima;
• lipid ndi cholesterol malo a endothelium;
• thrombosis;
• yafupika mtima lumen;
• mapangidwe a puffness ndi kuchuluka exudation;
• kuphwanya maselo ofunda ndi minyewa mpaka kufa kwawo.

Popeza ma capillaries ali ndi chovomerezeka chaching'ono kwambiri pakati pa ziwiya zonse zamtundu wamtundu wamtundu, amavutika koyamba. Izi zikutanthauza kuti njira yotsatsira imayamba ndi zala, mapazi, kenako ndikupita kumiyendo yotsika ndikufikira m'chiuno.

Chithunzi cha kuchipatala

Zizindikiro za matenda am'mimba a shuga a m'munsi malekezero amadalira njira ya pathological process:

• Gawo I - - palibe kusintha kowoneka, wodwalayo alibe madandaulo, mayeso othandizira komanso a labotale akuwonetsa chitukuko cha njira ya atherosselotic m'matumbo;
• Gawo lachiwiri - mawonekedwe a zomwe zimadziwika kuti zimachitika pakatikati - chizindikiro chodziwika bwino chomwe chimadziwika ndi kufunika koyimilira pakuyenda chifukwa cha kupweteka kwambiri m'miyendo, kusowa panthawi yopumula;
• Gawo lachitatu - ululu wammbuyo umawoneka posakhalitsa katundu pamiyendo, womwe umafuna kusintha kosasintha pakama;
• Gawo IV - kapangidwe kazilonda zopweteka ndi khungu lakufa pakhungu chifukwa cha kusokonekera kwakukulu kwa minofu ndi ma cell.

Atherosclerosis ndi imodzi mwazomwe zikuwonetsa matenda a matenda ammimba a shuga.

Zizindikiro zomwe zikuwoneka kuti zikuwononga ziwiya zamiyendo mu matenda a shuga:

• kumverera koyaka, kumeza, "ma bampu";
• mapangidwe a mitsempha ya kangaude;
• kutsekeka kwa khungu;
• khungu lowuma, kutsekemera, kutsuka tsitsi;
• fragility ya zosefera;
• kukula kwa puffness.

Matenda a shuga

Chimodzi mwazinthu zovuta kwambiri zamatumbo a miyendo. Itha kuyamba ndi matendawa omwe amadalira insulin komanso osadalira insulin. Amawonetsedwa ndi purulent-necrotic njira, mapangidwe a zilonda zam'mimba, kuwonongeka kwa mafupa ndi mawonekedwe a tendon. Makina a innervation, zida zama minofu, komanso minofu yakuya zimathandizira pochita izi.

Zizindikiro za phazi la matenda ashuga:

• mabala, zilonda pamiyendo motsutsana ndi matenda a shuga;
• kukula kwa misomali;
• fungal matenda kumapazi;
• kuyabwa
• ululu
• lameness kapena zovuta zina zomwe mwakumana nazo poyenda;
• kusintha kwa khungu;
• kutupa;
• mawonekedwe a dzanzi;
• Hyperthermia.

Phazi la matenda ashuga - kuwonongeka kozama kwa mafupa-tendon kumbuyo kwa "matenda okoma"

Zizindikiro

Ndi mavuto otere, mutha kulumikizana ndi angiosurgeon kapena endocrinologist. Pambuyo pofufuza ndikusunga madandaulo, dokotala amakupatsani mtundu wa zowerengera, zothandizira ndi zowunikira pazizindikiro zotsatirazi:

• biochemical kuwunika - kuchuluka kwa shuga, creatinine, urea, mkhalidwe magazi;
• ECG, Echo ya CG yopuma komanso katundu;
• Kuyesa kwa X-ray;
• arteryography yam'munsi malekezero - kuwunika kwa patency pogwiritsa ntchito njira yosiyanitsa;
• Dopplerography - kuphunzira mkhalidwe wamitsempha yamagazi ndi ultrasound;
• Pamaso pa kutuluka kwa purulent kuchokera pachilonda - kuyesa kwa mabakiteriya okhala ndi antibayotiki;
• kutsimikiza kwa transcutaneous kupanikizika - kuwunika kwa kuchuluka kwa mpweya mu minofu ya miyendo;
• kompyuta capillaroscopy.

Zochizira

Chikhazikitso cha mankhwalawa ndikusunga kuchuluka kwa shuga m'magazi panthawi yovomerezeka. Mtundu wa shuga wotengera matenda a shuga umafunikira jakisoni wa pancreatic hormone (insulin) malinga ndi chiwembu chopangidwa ndi endocrinologist. Ndikofunikira kuwona nthawi ya jakisoni, mlingo, kudziyang'anira nokha pogwiritsa ntchito glucometer.

Ndi mtundu 2 wa shuga, mankhwala ochepetsa shuga amagwiritsidwa ntchito:

• Metformin - imathandizira kusintha kwamphamvu kwa maselo a thupi kuti ipangire insulin, kuonjezera kuyamwa kwa shuga ndi minofu. Analogs - Glycon, Siofor.
• Miglitol - imalepheretsa mphamvu ya michere yamatumbo kuti igwetse zakudya zamagetsi kuti ikhale monosaccharides. Zotsatira zake ndi kusowa kwa shuga. Analogue ndi Diastabol.
• Glibenclamide (Maninyl) - imalimbikitsa kuyambitsa kwa insulin synthesis.
• Amaryl - imathandizira kupanga zinthu zofunikira zamafuta, zomwe zimathandiza kuchepetsa kuchuluka kwa shuga.
• Diabeteson - mankhwala omwe amathandizira kupanga insulini, amasintha magazi ake m'magazi.

Njira zochepetsera cholesterol

Mankhwalawa angagwiritsidwe ntchito ngati gawo la mankhwala komanso kupewa matenda a shuga a m'munsi. Mankhwala ayenera kumwedwa ndi maphunziro a labotale a biochemical magazi magawo mu mphamvu.

Mankhwala a antihypertensive

Potengera maziko a kuchepa kwa kuthamanga kwa magazi, vasodilation, antiarrhythmic effect imachitika. Magazi amayenda pang'ono. Gwiritsani ntchito:

• Nifedipine
• Corfid
• Cordipin
• Ikweta
• Binelol
• Nebile.

Corinfar - woimira gulu la mankhwala omwe amachepetsa kuthamanga kwa magazi

Makina a vasodilation amatengera kuti pali blockage ya receptors yomwe ili mumakoma a mitsempha ndi mtima. Ena mwa mankhwalawa amatha kubwezeretsa kugunda kwa mtima.

Angioprotectors

Kuchita kwa gululi la mankhwalawa kumapangidwira kuti magazi azikhala ndi ma cell am'mimba komanso kuwonjezera kukana kwamitsempha yamagazi.

• Pentoxifylline (Trental) - mankhwalawa amathandizira kuchepetsa mitsempha ya magazi, kusintha kayendedwe ka magazi, kuonjezera zochita za endothelium.
• Troxevasin - amalepheretsa makutidwe ndi lipid oxidation, ali ndi antiexudative, ndipo amachepetsa kukula kwa njira zotupa.
• Niacin - mwa kuchepa m'mitsempha yamagazi, mankhwalawa amathandizanso kuchepetsa cholesterol yonse.
• Bilobil - amatanthauzira kukula kwa mitsempha, imathandizira kubwezeretsa njira za metabolic.

Ma antiplatelet

Masokosi azachipatala a odwala matenda ashuga

Mankhwalawa amaletsa zamanjenje zomwe zimapangidwa ndi thrombus, kupewa kupewa kwa lumen. Oimira otsatirawa adawonetsera:

• Aspirin
• ReoPro,
• Tirofiban,
• Curantil
• Dipyridamole
• Plavix.

Enzymes ndi Mavitamini

Mankhwalawa amabwezeretsa njira za metabolic, kutenga nawo gawo pa kukula kwa mitsempha yamitsempha, amakhala ndi antioxidant, kuonjezera kugwiritsidwa ntchito kwa shuga ndi maselo ndi minofu, zomwe zimapangitsa kuti njirayi ithe kuchepa kwake m'magazi. Ikani Solcoseryl, ATP, mavitamini a B angapo, Ascorbic acid, Pyridoxine.

Mankhwala othandizira

Kubwezeretsa patency ya chotupa kapena gawo lina lake, ntchito za kusinthanso mtima zimachitika.

Opaleshoni ya Bypass - kuwongolera kwa chovala cham'madzi mu mawonekedwe a workaround kuti abwezeretse kayendedwe ka magazi pomwe sikungatheke kukulitsa lumen ya chotengera. Pali njira zowoneka ngati zazikazi, zazikazi, zowoneka ngati akazi, kutengera malowa.

Profundoplasty - opaleshoni yatsopano yokhala ndi chotchinga ndi chotupa cha zinthu zina. Kuphatikizidwa ndi endarterectomy.

Lumbar sympathectomy - kuchotsedwa kwa lumbar ganglia komwe kumayambitsa vasospasm. Ndi kukongola kwawo, mitsempha imakulitsa, kukonza magazi mu gawo lamatumbo. Nthawi zambiri wophatikizidwa ndi profundoplasty kapena opaleshoni yam'mbuyo.

Kukonzanso osteotrepanation - ma perforations amapangidwa mu minofu ya mafupa kuti azitha kuyendetsa magazi.

Balloon angioplasty - kukhazikitsidwa kwa zida zapadera (ma cylinders) mu lumen ya mtsempha wamagetsi omwe wakhudzidwa kuti muwonjezere ndi madzi.

Pulasitiki yokhala ndi minyewa yokhala ndi stent yaika - ogwira mtima kulowerera

Stinging imachitidwa chimodzimodzi ndi balloon angioplasty, ndiye fungo lokhalokha lomwe limatsalira mu lumen ya chombo. Chida choterocho sichimalola kuti mtsinjewo ukhale wocheperako komanso misampha ya thrombotic.

Mu magawo apamwamba a matendawa, kudula kungakhale kofunikira kupulumutsa moyo wa wodwalayo. Dokotala amawonetsa kutalika kwa kulowererapo ndi mulingo wa kukhalapo kwa "zimakhala" zimakhala. Kuyambika koyambira kwamankhwala kungathandize kuchepetsa zovuta komanso kubwezeretsa wodwala kwambiri.