A Diabetes Angiopathy a retina

Retina, kapena kusonkhanitsa kwa zithunzi zapamadzi pazuso, ndi imodzi mwazinthu zopanga thupi la munthu. Kulandila kuwala kozungulira komwe kumayang'anidwa ndi cornea ndi mandala, retina imayipititsa kudzera mu mitsempha yapadera yopita nayo kumalo osanthula mkati mwa ubongo. Monga minofu ina iliyonse, retina imafunikira michere ndi okosijeni kuti igwire bwino ntchito, yomwe nthawi zambiri imachokera mumtsinje wamagazi. Kutsika kwamitsempha yamitsempha, kuchuluka kwa mphamvu ya khoma, njira zotupa, kufalikira ndi zotupa zina zam'mimba zimayambitsa kufa kwa minofu, zomwe zimayambitsa njira za dystrophic ndi atrophic, magwiridwe antchito kapena kulephera kwathunthu.

Nawonso, matenda amitsempha yamagazi (kuzindikira kwa "angiopathy" amagwiritsidwa ntchito ngati njira yophatikizira yamitsempha yamafupa) samachitika popanda chifukwa. Chimodzi mwazinthu zikuluzikulu zomwe zimakhudza matenda a mtima ndi matenda a shuga, matenda oopsa a endocrine omwe, pamlingo wina uliwonse, amakhudza thupi lonse. Hormonal kusalinganika ndi kagayidwe kachakudya, makamaka ngati adasiyidwa popanda chithandizo ndikuwongolera kwa zaka zambiri, zimayambitsa kusokonezeka kwakukulu kwa ziwalo zonse zofunika (chiwindi, mtima, impso, mitsempha yayikulu yamagazi), komanso machitidwe ochepa a arterial, venous and capillary system, kuphatikizapo kupereka magazi ku retina. Kutsimikizira kusiyana pamlingo wamomwe mafupa amasakanikirana, macro- ndi microangiopathy amawerengedwa mosiyana.

Chifukwa chake, mawu akuti "retinal diabetesic angiopathy" amatanthauza gulu la zovuta za maso zomwe zimachitika chifukwa chakuwonongeka kwa mitsempha yamagazi yomwe imapereka chifukwa cha matenda a shuga, omwe nthawi zambiri samanyalanyazidwa komanso amakhala nthawi yayitali.

Matenda a diabetesic retinal microangiopathy ndi amodzi mwa zovuta kwambiri komanso zovuta kwambiri za ophthalmology amakono. Izi zikuyenera, poyamba, ku mawonekedwe achilengedwe a main endocrine pathology, ndipo chachiwiri, kuti asadziwe zosakwanira za biochemical, neurocirculatory, kusintha kwa metabolic, komwe kumayambitsa kuphwanya kwa retinal, hemodynamics, ndipo chachitatu, chizolowezi chodana ndi achinyamata m'zaka zaposachedwa, i.e. "Kukonzanso" kwa odwala matenda a shuga, kuti achulukitse kuchuluka kwa mitundu yayikulu komanso ya atypical.

Hypoxia yokhazikika komanso kuchepa kwa zinthu zofunika kuzifufuza mu retina, ziribe kanthu kuti ndizomwe zimayambitsa matenda a mitsempha ya m'mimba, zimawonetsedwa ndi mawonekedwe ofananawo. Chifukwa chake, chithunzi cha anthu odwala matenda ashuga angiopathy okhala ndi zovuta zochepa amabwereza chizindikiro cha zoopsa, hypo- kapena hypertensive angiopathy, ndikuphatikizanso mawonetsedwe otsatirawa:

kuchepa kwapang'onopang'ono kwa visual acuity (myopia) mpaka kutayika kwathunthu,
kuphwanya mtundu wa chithunzi (kuchepa kusiyanasiyana, kutetemera, etc.),
zochitika zowoneka bwino zopangidwa ndi zotupa zazing'ono, kutupa ndi kutupa kwa makoma a capillary ("mphezi", "kuwala kwa kuwala", ndi zina zambiri),
pafupipafupi mphuno.

Kuunika koyesa koyesa (komwe, ngati kuli kofunikira, kumaphatikizira x-ray yamakono, ultrasound, tomography, ndi njira zina zofufuzira) mu kapangidwe ka ndalama zimayendera limodzi ndi kusintha kwa dystrophic, kuopsa kwazomwe zimayambira nthawi ya matenda osokoneza bongo, kuchuluka kwa njira zochizira, komanso kuchuluka kwa odwala zoletsa ndi malingaliro omwe ndi osagawika mu shuga pankhani ya zakudya, moyo, ndi zina Rianta wa ashuga retinal microangiopathy ndi manja, retinal detachment ndipo potsatira khungu sizingasinthe.

Njira zazikulu zochizira matendawa

Mu matenda a diabetesic retinal angiopathy, monga lamulo, mankhwala amawonetsedwa kuti magazi azithanso kuyenda mu mawonedwe (trental, emoxipin, solcoseryl, etc.). Nthawi zina, kukonzekera kashiamu kumafunika kuti magazi azikhala mwamphamvu komanso kuti mtima ukhale wolimba. M'magawo oyambilira, njira za physiotherapy ndizothandiza. Ndikofunika kwambiri kuyang'anitsitsa malangizo a ophthalmologist okhudzana ndi zochitika zolimbitsa thupi ndi masewera olimbitsa thupi - kuphunzitsidwa kosalekeza kumathandiza kukhalabe ndi kamvekedwe ka minofu kofunikira, kuimitsa kapena osachepera kuchepetsa ntchito yoyipa ya retina.

Zakudya ndizopadera, ngati sizofunikira, kwa odwala matenda ashuga (komanso odwala matenda ashuga). Zakudya zamafuta ambiri, komanso zakumwa zoledzeretsa ndi fodya, siziyenera kulekedwera.

Mwachidziwikire, matenda a shuga amachepetsa kwambiri moyo, kufunikira udindo wa wodwalayo, kuwunika pafupipafupi komanso kuthandizira. Poyerekeza ndi zovuta za matenda ashuga omwe amapanga machitidwe osiyanasiyana ndi ziwalo, odwala ambiri omwe ali ndi vuto la retinal angiopathy amawoneka kuti ndi osafunikira, zotsatira zoyipa zomwe sizikufunika chisamaliro chapadera komanso chithandizo. Nthawi yomweyo, ndikofunikira kudziwa kuti ndi njira yoyenera komanso chithandizo chokwanira cha maso, matumizidwe nthawi zambiri amakhala abwino: kusintha kwa dystrophic mu retina kumatha kuchepetsedwa kapena kuyimitsidwa, ndikusungabe mawonekedwe kwa zaka zambiri.

Zoyambitsa retinal Angiopathy

Retinal angiopathy ikhoza kukhala chizindikiro cha matenda aliwonse omwe amakhudza boma la ziwiya. Zosintha m'matumbo a fundus mosadziwika bwino zimawonongera ziwiya zonse. Retinal angiopathy imatha kuchitika zaka zilizonse, koma imayamba kupezeka mwa anthu patatha zaka 30.

Zomwe zimayambitsa matenda a retinal angiopathy:

matenda oopsa a komwe kunachokera,
matenda ashuga
atherosulinosis
achinyamata angiopathy,
hypotonic angiopathy (yokhala ndi kuthamanga kwa magazi),
scoliosis
angiopathy.

Angiopathy amathanso kuchitika ndi osteochondrosis yamchiberekero yam'mitsempha, yokhala ndi zokhudza autoimmune vasculitis (zotupa zam'mimba zotupa), magazi m'magazi.

Palinso zinthu zina zotsogola zomwe zikuthandizira kukula kwa retinal angiopathy:

kusuta
zoyipa kuntchito,
kuledzera osiyanasiyana
kusabadwa kwa mitsempha yamagazi,
ukalamba.

Hypertensive angiopathy (retinopathy)

Kuthamanga kwa magazi kumachitika pa khoma lamitsempha, ndikuwononga mawonekedwe ake amkati (endothelium), khoma la chotengera limakhala loukira, lotupa. Mitsempha ya retina pamadutsa imafinya mitsempha, magazi amayenda. Mikhalidwe ya mapangidwe a magazi ndi zotupa zimapangidwa: kuthamanga kwa magazi ndikokwera, zotupa zina zimaphulika, ndipo angiopathy imadutsa mu retinopathy. Zombo zokhotakhota zopindika ndi chizindikiro cha matenda oopsa.

Malinga ndi ziwerengero, gawo loyamba la matenda oopsa, fundus yokhazikika imawonedwa mu 25-30% ya odwala, mu gawo lachiwiri mu 3.5%, ndipo gawo lachitatu, kusintha kwa fundus kulipo mwa odwala onse. Kukalamba, kukha magazi m'diso la m'maso, kusefukira kwa retina, ndikusintha kowononga m'matumbo a retina nthawi zambiri kumawonekera.

Zizindikiro

Retinal angiopathy imapezeka pakaunikiridwa ndi ophthalmologist a fundus. Retina imawunikidwa ndi mwana wokula pansi pa makina oonera tating'ono. Ndi kafukufukuyu, kupendekera kapena kukulitsa kwa ziwiya, kupezeka kwa zotupa, malo a macula awululidwa.

Njira zowonjezera zowunika zomwe zingagwiritsidwe ntchito kuzindikira angiopathy:

Ultrasound yamatumbo okhala ndi kupopera komanso kuwunika kwa Doppler ya ziwiya za retina kumakuthandizani kudziwa kuthamanga kwa magazi ndi chikhalidwe cha khoma la mtima.
Kuunika kwa X-ray ndikumayambitsa sing'anga m'matumbo kumakuthandizani kudziwa kuchuluka kwa ziwiya komanso kuthamanga kwa magazi,
diagnostic kompyuta
maginidwe oyang'anira a maginito (MRI) - amakupatsani mwayi woyesa thupi (kachulukidwe komanso kantchito) ka minofu yofewa ya diso.

Retinal angiopathy mwa ana

Poganizira zomwe zimayambitsa matenda (zomwe zimayambitsa matenda a angiopathy), matenda ashuga, oopsa, opatsirana, zoopsa za angiopathies zimasiyanitsidwa.

Matenda a shuga amakula ana kumapeto kwa maphunziro a shuga komanso pambuyo pake, chithandizo chake choyambirira chimayambika. Pa fundus pali kukulitsa ndi kufinya kwamitsempha, edema ya retinal ndi zotupa zazing'onoting'ono. Mabanja omwe ali ndi chiwopsezo chokhala ndi matenda ashuga amafunika kuwunika moyenera shuga awo.

Ana oterewa amakhala ndi atherosulinosis yoyambirira yam'mimba, monga momwe zimawonekera ndi ma microaneurysms amitsempha yamagazi (kutulutsa kwa khoma la mtsempha chifukwa cha kupindika kwake). Mwa ana, kupenya kwakumaso kumachepa, kupenyerera kwamkati sikokwanira.

At angiopathy poyamba kumachepetsa mitsempha ndi kukulitsa kwamitsempha (chifukwa cha kufooka), kenako mitsempha imakulanso. At hypotonic angiopathyM'malo mwake, poyambira, mitsempha imakulitsa, nthambi zake zimawonekera ndikukula.

Angiopathy komanso chofala kwambiri mwa ana, monga ana nthawi zambiri amavulala, kuphatikizapo kuvulala kwamaso. Ndi zoopsa za m'maganizo, mwana amasokonezeka ndi zowawa m'maso, zotupa zimatuluka pakhungu la diso ndi pa retina, ndipo kupenya kwamawonekedwe kumachepa.

Ana angiopathy tafotokozeredwa pamwambapa (onani gawo Mitundu ya angiopathies).

Popeza kuti angiopathy ndi chizindikiro cha matenda ena, musanaganize chithandizo, ndikofunikira kukhazikitsa ndikuzindikira matendawa. Pambuyo pofotokoza za matendawa, chithandizo chovuta chimayikidwa ndi cholinga chofuna kuchiza matendawa. Zochizira angiopathy palokha, mankhwala omwe amasintha magazi m'magazi amagwiritsidwa ntchito.

Retinal angiopathy mu akhanda

Zosintha mu retina zimatha kupezeka ngakhale kuchipatala. Koma kumayambiriro kwa nthawi yobereka, iyi si nkhambakamwa. Kusintha kwa retinal pakapita nthawi, pomwe fundus imayang'aniridwa momwe adanenera ndi katswiri wamitsempha, imatha kukhala ya m'magazi.

Sizivuta kuzindikira pawokha mawonetsedwe a matenda. Nthawi zina, chizindikiro chimodzi chitha kuwoneka - maukosi ofiira kapena mawanga ang'onoang'ono pakhungu la diso. Zizindikiro zotere zitha kuoneka ndi zowopsa. Kwa matenda ena, tikulimbikitsidwa kufunsa mwana ndi dokotala wamaso.

Mwa ana, kusintha kwa ma retina kumatha kuonekera chifukwa cha kupsinjika kwa thupi ndi thupi, ngakhale kocheperako ngati kusintha kwa thupi. Chifukwa chake, si kusinthika konse kwa retina kwa wakhanda kumene kumangowonetsa matenda. Ngati misempha yathunthu mu fundus yapezeka popanda vasoconstriction ndi kusintha kwa mitsempha ya optic, mwana ayenera kuthandizidwa ndi katswiri wamitsempha ndipo, mwina, kusintha kumeneku sikudzadziwika ngati pathological.

Ndi kuwonjezeka kwa kuthina kwa intracranial, kutupa kwa mitsempha ya optic kumawonekera, chimba chake chimakhala chosagwirizana, mitsempha imachepetsedwa, ndipo mitsempha imakhala magazi amtundu wonse komanso opweteka. Kusintha koteroko kukaonekera, ana amafunikira kuthandizidwa kuchipatala mwachangu ndikuwonetsetsa bwino.

Anginalopathy a retinal Mimba

Koma angiopathy imatha kukhala mwa amayi apakati wachiwiri kapena wachitatu trimester wokhala ndi mochedwa toxicosis komanso kuthamanga kwa magazi. Ngati mayi anali ndi vuto la kusokonezeka kwa magazi musanatenge pathupi, ndiye kuti panthawi yoyembekezera imatha kupita patsogolo ndikubweretsa zovuta zazikulu kwambiri. Kuwunikira nthawi zonse kuthamanga kwa magazi, kuwunikira ndalama komanso kumwa mankhwala a antihypertgency ndikofunikira.

Pankhani ya kupitirira kwa angiopathy, ngati pali choopseza ku moyo wa mayiyo, nkhani yochotsa mimbayo imathetsedwa. Zizindikiro zam'mimba ndikubaya kwa retinal, chapakati chamtsempha wamagazi komanso retinopathy yopita patsogolo. Malinga ndi zowonetsera, kutumiza koyenda kumachitika.

Chithandizo cha retinal Angiopathy

Pakatikati pa chithandizo cha angiopathies ndi chithandizo cha matenda oyambitsidwa. Kugwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi, othandizira a hypoglycemic komanso kuchepa kwa zakudya kumachepetsa kapena ngakhale kuyimitsa kukula kwa kusintha kwa mtima. Kukula kwa matenda a m'mitsempha ya retina mwachindunji kumadalira mphamvu ya mankhwalawa.

Kuchiza kuyenera kuchitika mokwanira moyang'aniridwa osati kokha wamankhwala oculist, komanso endocrinologist kapena psychapist. Kuphatikiza pa mankhwala, chithandizo cha physiotherapeutic, chithandizo cham'deralo, ndi chithandizo chamankhwala chimagwiritsidwanso ntchito.

Mu shuga mellitus, zakudya sizofunikira kuposa chithandizo chamankhwala. Zakudya zamafuta ochulukirapo siziphatikizidwa ndi chakudya. Mafuta a nyama ayenera kusinthidwa ndi mafuta azamasamba, onetsetsani kuti akuphatikiza masamba ndi zipatso, zinthu mkaka, nsomba mu chakudya. Kulemera kwa thupi ndi shuga wamagazi ziyenera kuyang'aniridwa mwadongosolo.

Mankhwala

Pamene angiopathy apezeka, odwala amapatsidwa mankhwala omwe amasintha magazi: Pentilin, Vasonite, Trental, Arbiflex, Xanthinol nicotinate, Actovegin, Pentoxifylline, Cavinton, Piracetam, Solcoseryl. Mankhwalawa amatsutsana panthawi yoyembekezera komanso yoyamwitsa, komanso muubwana. Koma nthawi zina, muyezo wotsika, amalembedwera gulu ili la odwala.
Komanso, mankhwala omwe amachepetsa kukula kwa khoma la chotengera amagwiritsidwa ntchito: Parmidin, Ginkgo biloba, Calcium dobesylate.
Mankhwala omwe amachepetsa kuphatikiza kwa maselo ambiri: Ticlodipine, Acetylsalicylic acid, Dipyridamole.
Chithandizo cha Vitamini: Vitamini B (B₁, Mu₂, Mu₆, Mu₁₂, Mu₁₅), C, E, R.

Maphunziro azithandizo ayenera kuchitika kwa milungu iwiri 2 r. pachaka. Mankhwala onse amagwiritsidwa ntchito pokhapokha ngati akuwongolera dokotala.

Mu shuga mellitus, muyezo wa insulin kapena ma hypoglycemic wothandizidwa ndi endocrinologist ayenera kuyang'aniridwa mosamalitsa. Ndi matenda oopsa komanso atherosulinosis, kuphatikiza pa mankhwala omwe amachepetsa kuthamanga kwa magazi, mankhwalawa omwe amachititsa kuchuluka kwa cholesterol amagwiritsidwa ntchito. Mlingo wabwinobwino wamagazi komanso matenda opatsirana bwino a shuga amachedwetsa kusintha m'matumbo a retina osagonjetseka ndi matenda awa.

Zithandizo za anthu

Mankhwala achikhalidwe amatha kugwiritsidwa ntchito, koma muyenera kukambirana ndi dokotala ndikuwonetsetsa kuti palibe kusalolera pazamankhwala omwe mumalandira.

Maphikidwe ochepa ochokera ku mankhwala azikhalidwe:

Tengani magawo ofanana (100 g) wort wa St. John, chamomile, yarrow, masamba a birch, osafa. 1 tbsp kusonkhanitsa, kutsanulira 0,5 l madzi otentha, kusiya kwa mphindi 20, kutsanulira ndikubweretsa kuchuluka kwa 0,5 l, kumwa chikho 1 m'mawa pamimba yopanda kanthu ndi 1 galasi usiku (mutatha kugwiritsa ntchito madzulo, musamamwe kapena kudya chilichonse). Gwiritsani ntchito tsiku lililonse musanagwiritse ntchito yonse.
Tengani 15 g wa masamba a valerian ndi masamba a mandimu, 50 g wa therere la herp. 2 tsp kusonkhanitsa kutsanulira 250 ml ya madzi, kunena 3 maola malo ozizira. Kenako imirirani mumadzi osamba kwa mphindi 15, ozizira, zosefera ndikusintha voliyumuyo kukhala 250 ml. M'magawo ang'onoang'ono, kulowetsedwa kumakhala kuledzera tsiku lonse. Njira ya mankhwala ndi milungu itatu.
Tengani 20 g yazovala pamahatchi, 30 g za okwera mapiri, 50 g wa maluwa a hawthorn. 2 tsp Zitsamba zosankhidwa kutsanulira 250 ml ya madzi otentha, kunena mphindi 30. ndi kutenga mphindi 30. asanadye, 1 tbsp. 3 tsa. patsiku, kwa mwezi umodzi.
Tengani 1 tsp. oyera mistletoe (kale pansi kuti ufa) kutsanulira 250 ml ya madzi otentha mu thermos, kunena usiku ndi kumwa 2 tbsp. 2 tsa. patsiku, kwa miyezi 3-4.

Ndikofunikanso kutenga kulowetsedwa kwa mbewu za katsabola, kulowetsedwa kwa mbewu zochotsa udzu ndi udzu wa chimanga, tiyi wazipatso za phulusa lakuda ndi masamba.