Angiopathy yam'munsi malekezero a shuga mellitus: Zizindikiro, mankhwala, kupewa

Matenda a diabetes angiopathy kumadera otsika, kapena phazi la matenda ashuga, ndi vuto lalikulu lomwe limachitika mwa anthu odwala matenda ashuga. Odwala azaka zonse ndi jenda amakhudzidwa ndi matendawa. Pofuna kupewa kukula kwa angiopathy, ndikofunikira kuyang'anira kuwonekera kwa zizindikiro zowopsa munthawi yake, kuchiza matenda oyamba komanso kupewa zovuta.

Matenda a shuga - ndi chiyani

Matenda a shuga samangokhala matenda a endocrine dongosolo, kwenikweni ndi mtima wam'mitsempha. Shuga wambiri amatsogolera ku zowonongeka m'mitsempha, miyendo, ubongo. Poyerekeza ndi kuchuluka kwa shuga m'magazi, mbali zamitsempha zamagetsi zomwe zimakhudzidwa - endothelium - sichita ntchito zowongolera kuthamanga kwa magazi, kupewa mapangidwe a magazi ndi kupezeka kwa njira zotupa mwa iwo. Chifukwa cha kuwonongeka kwa mitsempha, magazi amayenda m'munsi m'munsi, zomwe zimapangitsa kuti matenda asamayende bwino.

Kuwonongeka ndi glucose ndi zinthu zake zama metabolic, gawo lamkati lamitsempha yamagazi limasungabe madzi m'makoma, kumachepetsa magazi kupita m'miyendo. Supombi amapangika mofulumira mkati mwamitsempha yamagazi, ndikuwonjezera ngozi yotsekeredwa kwa lumen. Popita nthawi, zombo zazing'ono zimasokosera, ndipo zombo zazikulu zimayangana ndikupanga aneurysms.

Gulu

Kutengera kuchuluka kwa ziwiya zowonongeka, pali:

macroangiopathy - kuwonongeka kwa ziwiya zazikulu,
microangiopathy - njira yaying'ono,
kuphatikiza - kuphatikiza ziwiya zazing'ono ndi zazikulu za caliber mu njira ya pathological.

Madokotala amathanso kudziwa komwe zikuwunikiridwa:

a shuga angiopathy a ziwiya zokhala m'munsi,
matenda ashuga retinopathy a ziwiya za maso,
matenda a shuga a nephropathy okhudza mtima wam impso.

Osatinso kawirikawiri, madokotala amazindikira matenda a mtima ndi matenda a shuga pamene ziwiya za mtima ndi ubongo zimakhudzidwa ndi matenda.

Magulu owopsa

Kafukufuku akuwonetsa kuti angiopathy yotsika kwambiri mu shuga ndizovuta kwambiri.

20% ya odwala onse omwe ali ndi matenda ashuga amakumana ndi matenda am'munsi oyenda. Pafupifupi 70% yazachakudya zonse zakumapeto zimachitika chifukwa cha matenda ashuga amiyendo. Oposa 40% ya odwala amayamba kuzindikira kuthekera kwawo pambuyo poti kusintha kwasintha komwe kwachitika kale m'matumbo.

Matenda a shuga ndi matenda oopsa komanso osachiritsika, omwe nthawi zambiri amatha kuwongolera mayeso apanthawi yake, kupita pafupipafupi kwa endocrinologist wanu, ndikutsatira malangizo.

Pangozi ndi odwala:

Ndi makonzedwe amtundu wamatenda,
matenda oopsa ndi zokumana nazo
lipid kagayidwe kachakudya,
zaka zopitilira 55
osuta
Nthawi zambiri amamwa mowa.

Mitundu ya matenda

Kutengera ndi ziwiya ziti, diabetes ya angiopathy yokhala m'munsi (code ya ICD 10 E11.5) imatha kudziwonetsa yokha mu mtundu wa matenda ashuga a micangiopathy ndi macroangiopathy.

Microangiopathy

Matenda a shuga a shuga a m'munsi okhala m'munsi amayamba ndi kugonjetsedwa, chiwonongeko ndi chifuwa chaching'ono cha miyendo. Kutengera ndi kunyalanyaza, madokotala amasiyanitsa madigiri 6 a zovuta zamtunduwu:

Zero, kapena koyambirira, - kusakhalapo kwa madandaulo kuchokera kwa wodwala, koma kukhalapo kwa chizindikiro cha matenda omwe akupanga (kusowa kwa tsitsi kumiyendo, kukhathamira ndi kuwala kwa khungu, kumverera kozizira kumapeto pang'ono).
Choyambirira ndi kuwonda kwa khungu, nthawi ndi nthawi kumakhala kupweteka m'miyendo mukamayenda, zilonda zazing'onoting'ono zazing'ono zimawoneka popanda zizindikiro zakutupa.
Lachiwiri ndi zilonda zopweteka pamiyendo, zomwe sizimangokhudza khungu, komanso minofu yofewa, ndipo nthawi zina zimafikira fupa. Nthawi yamatendawa imadziwika ndi ululu waukulu.
Chachitatu, zakuda za necrosis zimawonekera pakati pa zilonda zopweteka.
Chachinayi - zimasiyana ndi zomwe zimachitika m'mbuyomu kuti kuwonjezera pa necrosis, edema ndi hyperemia ya zimakhala zapafupi zimawonedwa. Munthawi imeneyi, chikumbumtima, phlegmon kapena osteomyelitis ya m'munsi miyendo imapezeka.
Chachisanu - kupezeka matenda omwe minofu yapafupi imamwalira.
Chachisanu ndi chimodzi - ndondomeko ya necrotic inasesa phazi lonse.

Macroangiopathy

Matenda a diabetesic macroangiopathy, momwe minyewa ikuluikulu imakhudzidwa, imayamba pang'onopang'ono, ili ndi magawo 5 a kusintha kwa matenda:

Palibe zizindikiro zotchulidwa za matendawa, odwala amadandaula za kutopa kwambiri ndi kupweteka pakuchita masewera olimbitsa thupi; pakuwunika, ambiri amawunika matenda oopsa komanso atherosulinosis yomwe ikupita patsogolo.
Kumva kuzizira kwamiyendo m'miyendo, kutsekemera pafupipafupi, kusintha kwa atrophic kumapazi ndi mawonekedwe a lameness poyenda.
Ululu mu miyendo ngakhale nthawi yonse bata, youma ndi kusenda khungu, usiku kukokana.
Maonekedwe a zilonda zazing'onoting'ono zomwe zimasinthidwa mwachangu kukhala foci ya necrosis.
Imfa ya minofu ya zala ndi miyendo, gangren ya mbali yam'munsi.

Magawo omaliza a matendawa amadziwika ndi zizindikiro wamba zamatsenga mwa kufooka, mutu, kusowa kudya, kuzizira komanso kutentha thupi.

Kuphatikiza pa zizindikiro zomwe zidatchulidwa kale pamatendawa, chithunzi chotsatira cha matenda ndichikhalidwe cha odwala matenda ashuga:

paresthesias, yomwe imawonetsedwa ndi dzanzi miyendo, yomwe imagwirizanitsidwa ndi minofu ischemia chifukwa cha kufa ndi mpweya,
kupweteka kwamiyendo m'miyendo, komwe kumakulirakulira poyenda ndi kuchepa pakupumira,
minofu kukokana usiku kugona,
Kuchepa kwa kukula kwa tsitsi pamiyendo,
Khungu limakhala louma, kukwiya ndi ming'alu ndi kubowola,
miyendo yotupa ndi kuwonongeka
kununkhira kosasangalatsa kumachokera kumiyendo kapena mbali zonse ziwiri,
miyendo ndi yozizira komanso yonyowa kuti igwire
msomali umakhala wofinya, wowuma, wachikasu,
kuwoneka kwa mabala akulu akulira m'malo mwa chimanga chakale kapena mabala osachiritsika.

Pakati pa zizindikirozi, odwala amadandaula chifukwa cha kufooka, kusowa tulo usiku, kusakwiya, kupweteka mutu pafupipafupi komanso kutentha thupi.

Zizindikiro

Kuzindikiritsa ndendende kumatha kuchitika ndi dokotala, kutengera deta yakuwunika ndi maphunziro owonjezera. Kukayikira angiopathy a m'munsi kwambiri mu matenda osokoneza bongo, ndikokwanira kuti katswiri atenge anamnesis ndikuwunika wodwalayo. Tchera khutu kuzizindikiro zotere:

khungu
miyendo paresthesia,
kupezeka kwa zowawa ndi kulira,
kusowa kwa zimiyendo zamiyendo,
kutsitsa kutentha kwa miyendo.

Dokotala adzalemba mayeso owonjezera othandizira ndi a labotale:

Kufufuza zombo za m'munsi,
Kuunika kwa X-ray, komanso kusiyanitsa maganizidwe,
MRI
kompyuta capillaroscopy.

Ndi zizindikiro za osteomyelitis, mawonekedwe a radionuclide ogwiritsa ntchito pyrophosphate akhoza kuwonjezeranso zina, zomwe zimakupatsani mwayi wosintha pang'ono mu fupa m'chithunzicho. Kuphatikiza apo, mayesero angapo a labotale magazi ndi mkodzo ndizofunikira kuti azindikire kuchuluka kwa shuga, creatinine, mbiri ya lipid ndi kuchuluka kwa kusefera kwa glomerular.

Pofuna kutsimikizira angiopathy a m'munsi kwambiri mu matenda a shuga, mankhwala amachitika mokwanira ndipo cholinga chake ndi:

Kuchotsa kwa zosokoneza malingaliro,
Matenda a shuga m'magazi,
cholesterol yotsika
kutsegula kwa magazi mu ziwiya.

Zakudya ndizomwe zili zoyamba kuchipatala chovuta. Popeza angiopathy imayamba motsutsana ndi maziko a matenda osokoneza bongo, mankhwalawa amayenera kuyamba ndi kukonza zakudya. Ndikofunikira kuchepetsa kuchuluka kwamafuta, okazinga ndi zakudya zam'chitini.

Zakudya zamagetsi zomwe zimapezeka mosavuta zimachepa kwambiri kapena kuchotsedwa kwathunthu. Ndikulimbikitsidwa kuti mumanye michere yambiri, masamba, amadyera. Yang'anirani dongosolo la zakumwa: kuchuluka kwa madzi akumwa kwa munthu wamkulu sikuyenera kukhala kosakwana 2 malita patsiku. Idyani nthawi zambiri, m'magawo ang'onoang'ono kuti muchepetse kagayidwe ndi kupewa kudumphadumpha mwadzidzidzi m'magazi a shuga.

Ponena za masewera, ndi angiopathy ndizovuta kwambiri kukaona masewera olimbitsa thupi kapena kuthamanga paki, chifukwa miyendo yam'munsi imakhudzidwa. Koma aliyense amatha kusambira mu dziwe, kuchita masewera olimbitsa thupi kapena masewera ochepa kunyumba.

Mankhwala

Mankhwala osokoneza bongo ophatikizika amaphatikizapo magulu a mankhwala:

antibacterial othandizira a systemic komanso amderalo kuchitapo kanthu kuti athetse matenda omwe ali ndi bala (Levofloxacin, Cefopectam),
antihypertensive mankhwala (Lisinopril, Bisoprolol, Valsacor),
ma statins kuti achulukitse cholesterol yamagazi (Atorvastatin, Lovastatin, Rosuvastatin),
owonda magazi (Aspirin, Akard, Kleksan),
okodzetsa ndi mankhwala othandizira edema (Torsid, Lasix, Furosemide),
angioprotectors omwe amachotsa mtima edema ndi kusintha momwe metabolic amapangira mwa iwo (Anginin, Ditsinon, Etamsylate),
mankhwala othandizira kagayidwe kachakudya mu minofu (Trimetazidine, Mildronate),
antioxidant mankhwala, mavitamini a B (Nerviplex, Neuromidin).

Mankhwala othandizira

Odzipanga okha:

Trental - imabwezeretsa kufalikira kwa magazi, imachepetsa kutupa (1 t. 3 pa tsiku),
Pentoxifyline - imayendetsa magazi m'magazi, amachepetsa edema (1 t. Katatu patsiku),
Lipoic acid - amachulukitsa kupezeka kwa mtima (piritsi limodzi patsiku),
Venoruton ndi mankhwala a mzere woyamba, amathandizira kutupa, kusintha magazi, kuthana ndi zowawa (1 kapisozi katatu patsiku),
Dialipon - amateteza kupezeka kwa matenda ashuga a polyneuropathy, kuphatikizapo paresthesia ya malekezero (2 makapisozi 1 nthawi patsiku),
Cardiomagnyl - mankhwala ochepetsa magazi m'magazi komanso kupewa magazi (1 piritsi 1 kamodzi patsiku).

Physiotherapy

Ndikofunika kuphatikiza chithandizo chovuta ndi kutikita minofu ndi njira zolimbitsa thupi, zomwe zimapangitsa kuti magazi abwerere m'mitsempha ya m'munsi.

makulidwe
kukondoweza kwa magetsi
kugwiritsa ntchito matope.

Ndondomeko akuwonetsedwa kwa odwala omwe ali ndi gawo loyambirira la matendawa, komanso panthawi yakukhululuka kwamachimo. Mu gawo lazowawa, kugwiritsa ntchito manipulini ofunda sikuvomerezeka.

Nthawi yatsopano mu physiotherapy yamakono ndi lymphomodulation. Njira yothandizira mankhwalawa imagwiritsidwa ntchito matenda osiyanasiyana, komanso angiopathy. Zida za lymphomodulation nthawi yomweyo zimatsata:

kuchuluka kwa mpweya
ma radiation atatu ofunika kwambiri,
mafunde amagetsi pamagetsi
mawotchi oyenda a pafupipafupi.

Ndi chithandizo chake, minofu yomwe imakhudzidwa ndi ischemia imalandira mpweya wabwino ndi michere.

Opaleshoni

A shuga angiopathy amabwereka ku chithandizo chamankhwala, koma chimatha miyezi ingapo mpaka chaka kapena kuposerapo. Zilonda zikaoneka, kuyeretsa magazi kumakhala kofunikira. M'magawo otukuka, kudula dzanja ndi vuto kungakhale kofunikira. Lingaliro lotere limapangidwa ndi kuonana ndi madokotala.

Zithandizo za anthu

Njira zochiritsira zosagwiritsidwa ntchito masiku onse zitha kugwiritsa ntchito maphikidwe a mankhwala ena, koma kugwiritsa ntchito kwake kuyenera kuvomerezedwa ndi adokotala. Zikafika povuta gangrene kapena osteomyelitis, mankhwala azitsamba sangakhale ndi machiritso. Kumayambiriro kwa matendawo komanso pakukhululuka, mankhwala wowerengeka azitsamba amakhala ndi phindu pazovuta zakumapeto. Chithandizo chikuyenera kuchitika moyang'aniridwa ndi adokotala.

Calendula compress ndi kusamba kuchiritsa

Ndiwothandizanso kuthetsa zizindikilo zotupa kuti muthe khutu ku mankhwala a zitsamba a lotion ndi malo osambira achire. Pachifukwa ichi, gwiritsani ntchito calendula, chamomile, nettle. Zitsamba zitha kutengedwa mosiyana, koma ndizothandiza kwambiri pokonzekera mndandanda wazitsamba. Kukonzekera msuzi wa 2 l, tengani 50 g zouma zouma, kuthira madzi otentha, kusiya kwa mphindi 30 mpaka 40, kupsyinjika ndi kugwiritsa ntchito compress kapena malo osambira.

Kutsogolo kwa matendawa

Ndi chithandizo chanthawi yake, odwala matenda ashuga angathe. Ndizosatheka kuchotsa matendawa kwathunthu, koma kutsatira malingaliro onse azachipatala, ndikotheka kukwaniritsa kuchotsedwa kwokhazikika ndikupewa kukula kwa zovuta mwanjira:

matenda ashuga
aseptic necrosis,
zigawenga
kudula mwendo.

Kupewa

Pofuna kupewa matenda ashuga a shuga, ndikofunikira kuchita prophylaxis nthawi zonse, yomwe imaphatikizapo:

kuyesa kwa magazi ndi kuwongolera shuga mkati mwake,
moyo wathanzi
kukhudzana kwakanthawi ndi dermatologist ngati pakabuka zotupa, zilonda kapena zilonda.

Mu zovuta kupewa, ndikofunikira kuyang'anira thanzi ndi momwe khungu limakhalira. Zilonda zochepa kapena kukanda pa mwendo zimatha kupweteketsa zilonda. Chifukwa chake, tikulimbikitsidwa kuchita ukhondo tsiku ndi tsiku ndikuwunika miyendo. Dyetsani khungu ndikumunyowetsa khungu ndi mankhwala osamalira zodzikongoletsera, ndipo dulani misomaliyo kumanja. Pamaso pa abrasions ndi zikanda, ndikofunikira kuwachitira ndi antiseptic, koma osagwiritsa ntchito polemba chimanga ndi zinthu zomwe zili ndi zakumwa zoledzeretsa kapena mitundu ina. Nsapato ndizovala kuvala bwino, zomwe sizikupaka ndipo sizifinya phazi. Pewani kutentha kwambiri komanso kusokosera miyendo.

Matenda a shuga ndi matenda osokoneza bongo omwe amakhudza mitsempha yamagazi. Pofuna kuchepetsa mwayi wokhala ndi matenda a shuga a miyendo, ndikofunikira kuzindikira zonse zomwe zikuwopseza, chiritsani matenda omwe ali pachiwopsezo komanso kupewa zovuta.