A shuga angiopathy a m'munsi malekezero

Matenda ashuga angiopathy (dr. Greek άγγεϊοč - "chotengera" ndi "kuvutika", "matenda") ndizowonongeka kawirikawiri pamatumbo osiyanasiyana, kupangira kumbuyo kwa matenda a shuga.

Izi matenda a mtima ndi omwe amayambitsa zovuta kuchokera ku ziwalo ndi machitidwe osiyanasiyana, kulumala ndi kufa kwa odwala omwe ali ndi mbiri yayitali ya matenda a shuga kapena opita patsogolo kwambiri. Zigawo zomwe chandamale kwambiri mu angiopathy nthawi zambiri zimakhala bongo, impso, gawo lamawonedwe, mtima ndi m'munsi.

Ku mulingo wina, kuwonongeka kwa mtima kumadziwika mu 9 mwa 10 omwe ali ndi matenda a shuga. Anthu omwe ali ndi matenda a shuga a mtundu wa I (omwe amadalira insulin) ali pachiwopsezo chachikulu chokhala ndi matenda amisempha.

Zoyambitsa ndi Zoopsa

Choyambitsa chachikulu cha angiopathy mu shuga mellitus ndikuwonongeka kwa glucose mkati wamkati (endothelium) khoma lamitsempha, komwe kumayambitsa kukonzanso kwake komanso kachitidwe.

Popeza pa vuto la matenda a shuga, kuchuluka kwa glucose m'madzi am'magazi kumachulukirapo kuposa chifukwa cha kuperewera kwa mahomoni ogwiritsa ntchito (insulin) kapena kulumikizana kolakwika ndi maselo amthupi, owonjezera ake amalowa mkati mwa khoma lamitsempha. Zotsatira zake, fructose ndi sorbitol, omwe ali mankhwala omaliza a glucose metabolism, amadziunjikira mu endothelium. Zinthu zonsezi siziyendetsedwa bwino kudzera mu ma membrane a maselo, motero, zimakhazikika m'malo ambiri m'maselo a endothelial.

Kusintha kwatsatanetsatane komwe kumayenderana ndi kuphatikizika kwa endothelium ndi glucose ndi zinthu zake zama metabolic:

• kuchuluka kwachulukidwe ndi kutupa kwa khoma la mtima.
• kuchuluka kwa thrombosis (kutsegula kwa njira zopangika),
• kuchepa kwa kupanga kupumula kwamphamvu kwa endothelial komwe kumapangitsa kuti minyewa isamasuke.

Amodzi omwe amatchedwa Virchow triad amapangidwa, kuphatikizapo kuwonongeka kwa endothelial, kuchepa kwa magazi ndi kuchepa kwakukulu kwa magazi (thrombosis).

Chiwopsezo chokhala ndi matenda angiopathy mu matenda a shuga ndi munthu payekhapayekha ndipo zimatengera kulondola kwa mankhwalawo, kutsatira kwa wodwala chithandizo komanso kukhazikitsa mayendedwe a kusintha kwa moyo.

Kusintha kwachidziwitso kumayambitsa hypoxia ya ziwalo ndi zimakhala zomwe zimaperekedwa ndi ziwiya zomwe zakhudzidwa. Kutsika kwa okisijeni kumapangitsa kuti ntchito ya fibroblasts ichitike (maselo omwe amapanga zinthu za minofu yolumikizana), komwe, kumabweretsa chitukuko cha atherosulinosis.

Mitundu ya matenda

Kutengera ndi kuchuluka kwa zombo zomwe zimakhudzidwa, zotsatirazi ndizopezeka:

Malinga ndi kufalikira kwa njira ya pathological, njira zingapo za angiopathy zimasiyanitsidwa:

• retinopathy - kuwonongeka kwa ziwiya za retina,
• nephropathy - kulowetsa ziwiya impso,
• encephalopathy - kusintha m'mitsempha ya bongo,
• angiopathy a ziwiya zam'munsi,
• angiopathy a ziwiya zamtima.

Zizindikiro za matenda a shuga angiopathy amasiyanasiyana kutengera malo omwe amapangidwako.

Zizindikiro za retinopathy zimawonekera pafupifupi zaka 3 atatsimikizira kuti ali ndi matendawa. Kwa zaka 20 zikubwerazi, zizindikiro za zotupa zam'mimba zimawonedwa pafupifupi 100% yonyamula matenda a shuga. Izi ndi:

• kutsika kwamaso owoneka bwino mpaka kumaliza kwathunthu pakhungu,
• kupotoza pamndandanda wazinthu, kulephera kusiyanitsa zazing'ono,
• "Chophimba" ndikusintha kwa "ntchentche" pamaso,
• mawanga owala, mikwingwirima, cheza,
• vuto la kukha magazi m'thupi la vitreous (nthawi zambiri limachita kuonekeratu), malo oyandama akuwoneka patsogolo pa maso, nthawi zina angapo.

Matenda a shuga a retinopathy amadziwika ndi zingapo za ophthalmological zizindikiro zomwe zimapezeka ndikuwunika kothandizira. Kuwonetsedwa koyambirira kwa zizindikirozi zamatenda am'mimba ndizodziwika, pomwe retinopathy akadali asymptomatic ndipo wodwala sapereka madandaulo:

• mitsempha yochepetsedwa, yopindika, yopunduka, nthawi zina yokhala ndi micaneurysms,
• malo otupa pakatikati pa retina,
• Mitsempha yodzaza magazi, yotupa,
• retinal edema,
• hemorrhages mu makulidwe a vitreous thupi.

Zigawo zomwe chandamale kwambiri mu angiopathy nthawi zambiri zimakhala bongo, impso, gawo lamawonedwe, mtima ndi m'munsi.

Nephropathy nthawi zambiri imapangidwa mwa anthu omwe ali ndi matenda a shuga a nthawi yayitali, motsutsana ndi zomwe adachita kale kapena matenda olakwika a matenda oyambitsidwa. Zizindikiro zowonongeka pamitsempha ya impso:

• kutupa, makamaka pankhope, m'mawa,
• ochepa matenda oopsa
• mseru, chizungulire, kugona,
• kusintha kwa magawo a labotale - proteinuria (mapuloteni ofotokozedwa pokonza mkodzo), chifukwa cha kuwonongeka kwa fyuluta ya impso, yomwe imayamba kupititsa mamolekyulu akulu a protein omwe samasefedwa.

Matenda a diabetes a encephalopathy amakula pang'onopang'ono. Poyamba, odwala amadandaula ndikumverera kwa mutu "wowuma", kuphwanya kayendedwe ka "kugona - kudzuka" (kugona kwa tulo ndi kusowa tulo usiku), kuvuta kugona ndi kudzuka, kuiwala kukumbukira, magwiridwe ammutu am'mutu, chizungulire, komanso kutayika.

Ndi kupita patsogolo kowonjezereka, zizindikiro zotsatirazi zimawonekera:

• kusakhazikika kwa gait,
• kuphwanya mgwirizano
• kusowa kogwirizana,
• mapangidwe a pathological Reflex.

Kwa odwala matenda a shuga a mtima, mawonekedwe ake ndi awa:

• zopindika, kukanikiza, kupweteka kwam'mbuyo kwa kumbuyo kwa kumbuyo kwa kumbuyo ndi chovunda pansi pa scapula, mkono wamanzere, kumanzere hafu ya nsagwada yam'munsi, khosi, mu epigastrium kutalika kwa kupsinjika kwa thupi kapena psychoemotional,
• kutentha kwa mtima
• kutsika kapena kuchuluka kwa kugunda kwa mtima,
• kuphwanya contractile ntchito ya mtima minofu dyspnea pamene ntchito ndipo (ovuta kwambiri) kupuma, kutupa, kupweteka ndi kulemera mu hypochondrium yoyenera, etc.

Maselo angiopathy am'munsi am'mphepete amatengedwa ngati vuto limodzi lalikulu la matenda ashuga ndipo amawonetsedwa ndi zizindikiro zingapo. Pakati pawo:

• dzanzi, malekezero ozizira,
• kutengeka kwa chidwi
• kusowa kapena kuchepa kwakukulu kwa kugunda kwa mtima kumbuyo kwa phazi,
• kupweteka kwa minofu, makamaka mwana wa ng'ombe (panthawi yonse yopuma komanso panthawi yochita masewera olimbitsa thupi),
• kukokana
• kusowa kwa tsitsi kapena kutaya tsitsi kwathunthu,
• kumverera kofooka ndi kupweteka poyenda (mwamphamvu zosiyanasiyana),
• Kusintha kwakakhungu pakhungu (ziume, khungu, kusisita, kusisita),
• Zilonda zopanda trophic, zomwe nthawi zambiri zimapezeka pamiyendo, m'miyendo.

M'mapeto a angiopathy a m'munsi malekezero, omwe amawoneka kuti ndi matenda a shuga amapangika, omwe amadziwika ndi kusintha kwa mawonekedwe ndi mtundu wa misomali, khungu louma la miyendo ndi ming'alu ndi chimanga, ndikusintha kwa zala zakumaso.

Zizindikiro

Kuzindikira matenda ashuga a shuga kumachitika pogwiritsa ntchito njira zamafukufuku ndi zamankhwala.

Anthu omwe ali ndi matenda a shuga a mtundu wa I (omwe amadalira insulin) ali pachiwopsezo chachikulu chokhala ndi matenda a shuga.

• mtima wa magazi shuga
• kusanthula kwakanthawi kwamkodzo (proteinuria, acetonuria, glucosuria kwapezeka),
• kuyeserera kwa shuga
• mtima kutsalira wa nayitrogeni, urea, magazi creatinine (Zizindikiro za mkhutu aimpso ntchito),
• kutsimikiza kwa glomerular kusefera mlingo, GFR (chizindikiro chachikulu cha mkhutu aimpso kuwonekera).

Njira zofunikira zofufuzira:

• kusanthula kwa ndalama
• Ultrasound wamtima, impso,
• ECG
• angiography (ngati kuli kotheka),
• Doppler kusanthula ziwiya za m'munsi, impso,
• kulingalira kapena maginidwe a mphamvu ya ubongo.

Mwa zina, kulumikizana ndi ophthalmologist, neurologist, opaleshoni ya mtima, ofunika kwamtima ndikofunikira.

Choyamba, chithandizo cha matenda omwe amayambitsa kukula kwa angiopathy, matenda a shuga, amafunika. Kutengera mtundu wa matenda ashuga, kuopsa kwa Zizindikiro ndi kupezeka kwa zovuta, mwina mapiritsi ochepetsa shuga kapena kukonzekera kwa insulin amagwiritsidwa ntchito.

Mankhwala a angiopathy mwachindunji amakhala ophatikizidwa mosiyanasiyana, ogwiritsidwa ntchito motere:

• angioprotectors
• mankhwala antispasmodic
• microcirculation yowonjezera mankhwala
• mankhwala a nootropic
• antiplatelet agents
• anticoagulants
• kagayidwe kazakudya
• lipid-kuchepetsa mankhwala,
• aldose reductase inhibitors, etc.

Pofunsidwa, odwala amawapatsa nitrate, antihypertensive mankhwala, okodzetsa, mankhwala ochepetsa mtima, antiarrhythmic mankhwala, okonza matenda amitsempha, kukondoweza kwa biogenic, ndi zina zambiri.

Mavuto omwe angakhalepo komanso zotsatirapo zake

Matenda a matenda a shuga angayambitse zovuta zazikulu:

• zigawenga za m'munsi,
• kutayika kwathunthu kapena pang'ono,
• Kulephera kwapakati kapena matenda aimpso,
• myocardial infaration
• pachimake cerebrovascular ngozi.

Ku mulingo wina uliwonse, kuwonongeka kwa mtima (diabetesic angiopathy) kumadziwika mu 9 mwa 10 omwe amanyamula matenda a shuga.

Kuzindikira kwa matenda ashuga a shuga kumakhala koyenera: ndi kupezeka kwakanthawi komanso chithandizo chokwanira, kupititsa patsogolo kwa njira ya pathological kungathe kuchepetsedwa pang'ono kapena kusiya, kuyimitsidwa ndi zochitika zamagulu pano sizikuvuta.

Chiwopsezo chokhala ndi zotupa zam'mimba ndizamodzi payekha ndipo zimatengera kulondola kwa chithandizocho, kudzipereka kwa wodwalayo kuchipatala ndikuwonetsa zoyenera kusintha pamakhalidwe ake.

Kupewa

Njira zodzitetezera ndi izi:

1. Kutsatira kovomerezeka ndi malangizo azakudya, zakudya.
2. Kuwunikira pafupipafupi kuchuluka kwa shuga m'magazi.
3. Zoyendera mwadongosolo mayeso ndi kuvomerezedwa kukaonana ndi ophthalmologist, neurologist, cardiologist.
4. Kuchita dosed zolimbitsa thupi.
5. Kusiya kusuta fodya, kuledzera.
6. Kusamalira khungu mokwanira m'madera akumunsi.

Maphunziro: apamwamba, 2004 (GOU VPO "Kursk State Medical University"), apadera "General Medicine", oyenerera "Doctor". 2008-2012 - Wophunzira wa PhD, dipatimenti ya Clinical Pharmacology, SBEI HPE "KSMU", wolemba zamankhwala azachipatala (2013, apadera "Pharmacology, Clinical Pharmacology"). 2014-2015 - katswiri wophunzirira, wapadera "Management mu maphunziro", FSBEI HPE "KSU".

Chidziwitsocho chimapangidwa ndikupatsidwa chidziwitso chokhacho. Onani dokotala wanu chizindikiro choyamba cha matenda. Kudzipatsa nokha mankhwala kuopsa!

Kodi angiopathy?

Mitundu iwiri ya angiopathies imasiyanitsidwa, kutengera zomwe ngalawa zimakhudzidwa:

1. Microangiopathies - zombo zazing'ono, capillaries zimakhudzidwa. Microangiopathies agawidwa:
   • Retinopathies - kuwonongeka kwa ziwiya zamaso.
   • Nephropathy - kuwonongeka kwa ziwiya za impso.
2. Macroangiopathies - zotengera zazikulu, mitsempha ndi mitsempha zimakhudzidwa:
   • Matenda a mtima.
   • Cerebrovascular matenda.
   • Mapeto Angiopathies

Microangiopathy

Mu diabetesic retinopathy, zotupa za retinal zimachitika, mitsempha yamagazi imakulitsidwa, imakhala yofinya, ndipo retina limaleka kulandira mpweya wokwanira. Zombo zatsopano zimangiramo, zomwe zimapangitsa kuwonongeka kwa mitsempha ya optic ndikufinya kwa retina. Ngati chithandizo sichichitika, kuphatikiza laser coagulation, kutaya kwathunthu kwamaso ndikotheka.

Ndi diabetesic nephropathy, ma microcapillaries a glomeruli a impso amayamba kunenepa.Izi zimatsogolera kuchuluka kwa magazi mu impso ndi kuwonongeka kwawo, kumasulidwa kwa mapuloteni mumkodzo. Popita nthawi, ntchito ya impso imayamba kuwonongeka ndipo impso zimayamba. Woopsa, wodwalayo ayenera hemodialysis.

Macroangiopathy

Choyambitsa chachikulu cha macroangiopathy ndi vashero atheroxlerosis.

Matenda a mtima - Uku ndi kuwonongeka kwa minofu yamtima chifukwa cha atherosulinosis yamitsempha yama mtima. Ndi matenda am'mtima munthu amakhala ndi nkhawa za kupweteka kumbuyo kwa sternum panthawi yolimbitsa thupi, kufupika, kusowa mpweya, kusokonezedwa mu ntchito ya mtima, edema. Myocardial infarction ndi mtima kulephera.

Cerebrovascular matenda - Uku ndi kulephera kwakumazungulira kwaubongo. Kuwonetsedwa ndi chizungulire, tinnitus, kupweteka mutu, kuiwalika. M'magawo apambuyo, mikwingwirima imatheka.

Mapeto Angiopathies kutenga gawo lotsogolera pantchito zovuta za matenda ashuga. Nthawi zambiri, ziwiya zamiyendo zimakhudzidwa, matendawa amatchedwa matenda a shuga a m'munsi. Tiyeni tizingolingalirapo mwatsatanetsatane.

Chifukwa chiyani matenda ashuga ammimba amayamba?

A shuga angiopathy am'munsi malekezero ndi zotupa za mitsempha ya miyendo yomwe imapezeka mwa odwala matenda a shuga a mitundu 1 ndi 2.

Ndi matenda a shuga, mitsempha yama sing'anga komanso yaying'ono imakhudzidwa. Amapanga zigawo za atherosulinotic.

Chifukwa cha kuchuluka kwa shuga m'magazi, zotsalira za shuga zimalumikizidwa pazinthu za khoma la chotengera. Izi zimabweretsa ma microdamage amitsempha yamagazi. Lipids "zoyipa", mapulateleti (omwe ali ndi vuto la magazi), ndi zinthu zina zamagazi zomwe zimalowa m'malo owonongeka. Mitundu ya atherosclerotic plaque.

Popita nthawi, zolembera zamtundu wa atherosulinotic zimachulukana, zimakulitsidwa, ndikutseka gawo la magazi. Itha kugwa, ndikupangitsa magazi kuwundana.

Zinthu zikuchulukirachulukira ndikugonjetsedwa kwa zombo zazing'ono. Amayamba kunenepa, kutuluka kwa mpweya ndi michere kwa minofu kumachepa. Kuphatikiza pa chilichonse, pali makulidwe amwazi, amachepetsa kuyenda kwa magazi.

Atherosulinosis ya ziwiya zamiyendo imapezeka mwa anthu omwe samadwala matenda a shuga. Ndiye zosiyana zawo ndi ziti?

Gome - Zosiyana pakuwonongeka kwa mitsempha yamiyendo mwa odwala omwe alibe komanso ali ndi matenda a shuga

Chizindikiro	Wodwala matenda a shuga	Wodwala wopanda matenda a shuga
Mitsempha iti yomwe imakhudzidwa nthawi zambiri	Yapakatikati ndi yaying'ono	Chachikulu
Kufanana kwa zotupa	Chotupacho chimagwirizana, mbali zambiri zam'mitsempha zimakhudzidwa	Nthawi zambiri mbali imodzi ndi gawo limodzi la mtsempha
Mitsempha yamagalamu ("yodutsa", yomwe imakupatsani mwayi wopulumutsa magazi kuti muwonongeke kwakukulu)	Kudabwitsidwa	Sanamenye

Momwe mungazindikire - zizindikiro za matenda a shuga

Zizindikiro za matenda a shuga a shuga am'munsi am'munsi zimadalira gawo lake.
Pali magawo anayi:

• Gawo I ndi asymptomatic. Pali zowonongeka pamitsempha, koma sizidziwonetsa mwanjira iliyonse. Itha kuzindikirika pogwiritsa ntchito njira zapadera zoyeserera.
• Gawo II - kupweteka panthawi yochita masewera olimbitsa thupi. Kulankhula momveka bwino kumawonekera. Pambuyo pakupita mtunda winawake, wodwalayo amayamba kupweteka m'misempha ya ng'ombe chifukwa cha kuperewera kwa mpweya. Pambuyo pakuima, kutuluka kwa magazi kumabwezeretsedwa, ndipo ululu umachoka.

Zizindikiro za matenda a shuga A shuga

Kulemera m'miyendo, dzanzi, paresthesia (goosebumps), komanso kukokana kumakhalanso kosokoneza.

• Gawo lachitatu - kupweteka popuma. Ululu, kukokana mu minofu kumawoneka m'malo opingasa. Wodwalayo amakakamizika kupachika miyendo yake kuchokera pabedi, motero amachepetsa ululu.
• Gawo IV - zovuta za trophic zimawonekera - zilonda zam'mimba, gangrene.

Tiyenera kudziwa kuti ndi matenda ashuga, limodzi ndi ziwiya, mitsempha imakhudzidwanso, zomwe zimayambitsa kuchepa kwa ululu komanso kutsutsana pang'ono. Munthu sangamveke ngati zilonda za trophic, chifukwa chake, ndikofunikira kupenda pafupipafupi mapazi kuti akhalepo.

Kodi miyendo imawoneka bwanji mu diabetes ya angiopathy am'munsi?

Khungu la miyendo yokhala ndi diabetes angiopathy limakhala lotuwa, lozizira. Kuchuluka kwa tsitsi kumiyendo kumachepetsedwa, kapena kulibe kwathunthu. Pamapazi pamakhala malo amakankhidwe, chimanga, pakhoza kukhala ndi zilonda zam'mimba.

Kukula kwa matenda ashuga angiopathy

Chithandizo cha matenda a shuga angiopathy a m'munsi malekezero

Chithandizo cha matenda a shuga a shuga ayenera kuyamba ndi kuphatikiza misempha ya magazi. Ngakhale mankhwala abwino kwambiri komanso ntchito zapamwamba kwambiri sizingasinthe mawonekedwe amitsempha yamagazi ngati matenda a shuga sanalipidwe.

Ndikofunikira kutsatira mosamalitsa zakudya, kuchita masewera olimbitsa thupi, kuyang'anira kuchuluka kwa shuga m'magazi, kumwa mankhwala osankhidwa. Yesani kukhala ndi hemoglobin wambiri wosaposa 7.5%.

Musakane kuti muyambitse mankhwala a insulin ngati dokotala anena kuti nkofunika.

Chofunikira ndikuwongolera kwa cholesterol m'mwazi. Ikachepa, mapangidwe a atherosselotic plaque amalephereka, zakumwa zamagazi, ndipo mwayi wa thrombosis umachepa. Zonsezi zimayenda bwino ndi magazi m'mitsempha yomwe yakhudzidwa.

Palibe chifukwa musasute, ndipo ngati mumasuta - siyani kusuta! Kusuta kumayambitsa kupititsa patsogolo chitukuko cha atherosulinosis, kumakhala ndimitsempha yamagazi, kuchepetsa magazi ofooka kale mwa iwo.

Chithandizo cha zotupa zam'mimba pazokha zimatha kukhala zosasangalatsa komanso zofunikira.

Mankhwala osokoneza bongo a shuga angiopathy a m'munsi malekezero amaphatikizapo kuikidwa kwa mankhwala. Mitu ikuluikulu ndi:

• Kukonzekera kwa prostaglandin E. Ali ndi mphamvu yochepetsa mitsempha ya magazi, amateteza makhoma awo kuti asawonongeke, amachepetsa mapangidwe azigazi.
• Ma anticoagulants ndi ma antiplatelet othandizira amachepetsa magazi, amachepetsa kuchuluka kwa magazi m'mitsempha, ndikupangitsa kuti mpweya ubwereke m'matipi. Ayenera kuyang'aniridwa ndikuyang'aniridwa ndi ophthalmologist, chifukwa amatha kuyambitsa magazi mu fundus.
• Mankhwala omwe amachepetsa cholesterol yamagazi (ma statins, fibrate) amaperekedwa kwa odwala onse omwe ali ndi matenda ashuga a shuga.

Pali magulu ena a mankhwala omwe amakhudza mitsempha yamagazi. Komabe, zimatsimikiziridwa kuti actovegin, pentoxifyline, no-spa in angiopathy ya matenda ashuga osagwira ntchito komanso osagwiritsidwa ntchito komanso chithandizo chamankhwala azikhalidwe.

Opaleshoni ya mtima - Uwu ndi chithandizo chapamwamba kwambiri cha matenda a shuga amiyendo. Komabe, sizingatheke pazochitika zonse kuti akwaniritse izi, chifukwa matenda a shuga amakhudza madera akuluakulu amitsempha yamagazi, zolowa zawo, ndi ziwiya zomwezo ndizochepa.

Zochita zotsatirazi zimachitika:

• Balloon angioplasty. Catheter yapadera imayikidwa mu mtsempha womwe wakhudzidwa, wokhala ndi baluni kumapeto kwake. Balloon imatupa mkati mwa mtsempha, ndikuwonjezera kuwala kwake. Nthawi zambiri njirayi imaphatikizidwa ndi zotsatirazi.
• Kuluma kwa mtsempha womwe wakhudzidwa. Fungo limayikidwa mu lesion malo - "kasupe" wapadera yemwe amakulitsa kuunikira kwa botilo.
• Choyambukira pamenepo. Pa opaleshoni, workaround imapangidwa mozungulira malo omwe akhudzidwa, potero kubwezeretsa magazi ake pansi pake.
• Endarterectomy. Ngati chotengera chili chokwanira mokwanira, dokotalayo amatha kuchotsa chikhodzodzo cha atherosselotic pamodzi ndi khoma lamkati la mtsempha.

Chithandizo cha minofu yomwe yakhudzidwa ikuchitika muofesi ya odwala matenda ashuga, ngati pali zilonda zam'mimba kapena chimanga. M'mavuto akulu, ndikupanga khungu, kumadulidwa kwa malo okhudzidwalo kumachitika.

Kumbukirani kuti kupezeka kwakanthawi kachipatala, komanso kutsatira malingaliro a dokotala, mutha kukhalabe ndi miyendo yabwino komanso moyo wabwino.

Zomwe zimayambitsa matendawa

Ndi matenda ashuga, shuga wambiri amakhudzanso ziwalo zamkati ndi machitidwe a thupi.Makoma amitsempha yamagazi, mitsempha, mitsempha, komanso ma capillaries ang'onoang'ono amakumana ndi mphamvu yamphamvu kwambiri. Kwina komwe kumatha kuonda, kupunduka mwamphamvu, kwinakwake - m'malo mwake, kumakulirakulira, komwe kumayambitsa zopinga zazikulu kuyenda kwamagazi kozungulira ndikusinthana kwa zinthu zopindulitsa pakati pa minofu. Zotsatira zoyipa zoterezi ndi hypoxia (kapena kufa ndi mpweya wa okosijeni) ya minofu yomwe imazungulira dera lomwe lakhudzidwalo.

Ngati tikulankhula za ziwiya zazikulu, ndiye kuti nthawi zambiri zimakhudzidwa m'miyendo ndi mtima. Vuto lofananalo limakhala pafupifupi 70% ya matenda onse a angiopathy. Ndi ziwalo za thupi izi zomwe zikukumana ndi katundu wambiri, chifukwa chake kusinthika kwa ziwiya pano ndiye kwachangu komanso kowonekera kwambiri. Pakati pa micangiopathies, madokotala nthawi zambiri amawona kuwonongeka pansi pamaso.

Kodi ndi matenda angiopathy amtundu wanji, ndipo ndi mtundu wanji wa zizindikiro zomwe zimatengera magwero a zovuta. Kwa anthu osiyanasiyana, Zizindikiro za matendawa zimatha kukhala zosiyanasiyana, mwachitsanzo, ngati wina ali ndi vuto la m'magazi amaso, ndipo winayo ali ndi zotengera zam'munsi. Zizindikiro zomwe zili zovuta kuphatikizira ndi izi:

1. Chizindikiro.
2. Kupezeka kwamavuto amtima.
3. Zowonongeka zamkati.
4. Kuchepetsa mphamvu yonse ya ubongo.

Madera monga maso, kumtunda ndi kutsika, mtima, impso, ndi zina nthawi zambiri amakhala pachiwopsezo cha odwala omwe ali ndi matenda ashuga. Izi zikuphatikiza:

• Petechiae (zikhomo zotupa) zimawonekera pakhungu lonse.
• Magazi omwe amatulutsidwa ndi kutsokomola kwambiri.
• Khungu lowoneka bwino m'dera la phazi, peeling, ming'alu ndiyotheka.
• Kuchepetsa maonedwe owoneka. Nthawi zina, amatha kuzimiririka.
• Kuyabwa ndi kutentha kwamiyendo m'miyendo.
• Kutulutsa kwamagazi kwambiri kuchokera pamphuno, kumachitika kangapo tsiku lonse.
• Maonekedwe a magazi mkodzo.
• Kupezeka kowawa kwambiri m'miyendo, kukulira ndi kulimbitsa thupi kosalekeza.

Kwa magawo amtsogolo komanso ovuta a matendawa, zizindikiro zotsatirazi ndizodziwika: kupsinjika kwamapazi, mawonekedwe a mafupa osteomyelitis, mawonekedwe a cellulite kumbuyo kwa phazi. Zilonda zotchulidwa retinopathy kapena nephropathy zimatha kupangika, zilonda zam'miyendo zimakhala m'miyendo. M'madera otukuka kwambiri, vuto la zigawo za phazi kapena mbali zina zam'munsi zimachitika.

Ndikofunika kukumbukira kuti odwala matenda ashuga amatha kudziwa zambiri za matenda m'thupi lililonse, ngakhale kuwonongeka kwakanthawi. Chifukwa chake, muyenera kuyang'anira zidziwitso zatsopano zomwe zikuwoneka kuti muwone zovuta zomwe zikuchitika panthawi yake.

Chithandizo cha mankhwala a angiopathy

Dokotala amafotokozera chithandizo cha matenda ashuga angiopathy aliyense payekha. Njira yothandizira mankhwalawa zimatengera nthawi yomwe matendawa amakula, pomwe ziwalo zimakhudzidwa, ndi zomwe zimawonetsedwa, ndi zina zambiri.

Pamtima posamalira odwala ndi njira zachipatala. Mankhwala osiyanasiyana opatsirana amakupatsani mwayi kuti muthe kukonzanso kuchuluka kwa ma cell. Mankhwala ogwiritsidwa ntchito kwambiri omwe amapangitsa kuti magazi azisinthasintha, amasintha kayendedwe ka magazi m'mitsempha mu ubongo ndi ziwalo zina zamthupi. Ndikukakamizidwanso kupatsidwa insulin, yomwe imakupatsani mwayi wachiphuphu wamagazi m'magazi a wodwalayo.

Nthawi zambiri mitundu yotsatirayi ya mankhwala imaperekedwa kwa wodwala:

• Statins (atorvastatin). Mankhwalawa amatha kuchepetsa chiopsezo cha zovuta zamtima.
• Ma antioxidants (mwachitsanzo Vitamini E). Zofunika kusintha mkhalidwe wamitsempha yamagazi.
• Kupanga Mankhwala Osokoneza bongo (Mildronate, Trimetazidine).
• Angioprotectors (anginin, dicinone).
• Zopatsa mphamvu za Biogenic (aloe).

Njira zolimbitsa thupi nthawi zambiri zimalimbikitsidwa kwa odwala angiopathy.Makamaka, chithandizo ndi matope, plasmapheresis, etc. chimapereka zotsatira zabwino.

Ngati vuto la matendawa ndi lalikulu kwambiri, ndiye kuti opaleshoni imachitidwa. Choyamba, lumumbar sympathectomy ikhoza kuchitidwa, yomwe imachepetsa kukhudzika kwachisoni pamakoma oyang'ana. Njira yodula kwambiri ingachitidwenso - opaleshoni yomanganso. Zimakuthandizani kuti mubwezeretse lumen ya mitsempha yayikulu kwambiri, yomwe imathandiza kwambiri magazi.

Zovuta kwambiri, zomwe zimanyalanyazidwa za angiopathy zam'munsi zimangoperekedwa ndikudula (ngati gangrene alipo kale). Ndi njira iyi yokha yomwe ingatheke kupulumutsa moyo wa wodwala. Mapeto a magawo onse a kuchitira opaleshoni, komanso nthawi yochira itatha, ma prosthesis apamwamba amapangidwa kuti wodwalayo azigwira ntchito moyenera.

Ndikofunika kukumbukira kuti njira zina zochizira matenda a shuga zimagwiritsidwa ntchito mosamalitsa ndi njira zamankhwala ndi zolimbitsa thupi. Popeza padera sangapereke zotsatira zowoneka.

Choyamba, wodwalayo amafunika kumwa mankhwala othandiza kuti matenda asinthe. Izi zikuphatikiza: ginseng, Aralia Manchurian, oregano, nettle, akavalo akavalo, ndi zina zotere. Izi zitsamba zimathandizanso kuti chitetezo cha m'thupi chikhale bwino.

Ndikofunika kumwa decoctions wa elecampane ndi dandelion. Zomera izi zimakonza kagayidwe kazakudya, kuchepetsa shuga m'magazi.

Ndi matenda a shuga, wodwalayo ndi bwino kusiya khofi ndikusintha ndi chicory. Izi zimathandiza kulimbana ndi shuga wambiri, zimachepetsa cholesterol, komanso zimapangitsa chitetezo chokwanira.

Kutengera malingaliro a adokotala ndikutsatira kwathunthu komanso njira zochiritsira, chitukuko cha matenda ashuga amatha kuchepa. Ndikofunikanso kuwunika mosamala kusintha kwa thupi komanso kuti musaphonye mawonekedwe a zizindikiro zatsopano.

Kodi matenda ashuga am'munsi ndi angiopathy?

Choopsa chachikulu cha kuchuluka kwa glucose okwanira ndi kusakanikirana kwa zinthu zomwe zimasinthanitsa ndi mapuloteni amwazi ndi minofu ya thupi. Omaliza nthawi yomweyo amataya kachitidwe kabwinobwino. Choyamwa kwambiri pa hyperglycemia (kuchuluka kwa shuga) khoma lamitsempha, komanso minyewa yamitsempha.

Ndizosemphana ndi maziko amasinthidwe am'magazi m'mitsempha yamagazi yomwe zovuta zonse za matenda a shuga zimatulukira. Kusintha kwachisawawa kumatchedwa angiopathy.

Vasoconstriction imabweretsa zovuta m'magawo otsika

A shuga angiopathy am'munsi malekezero ndikusintha kapangidwe ka ziwiya zamiyendo mu odwala matenda a shuga mellitus mwa njira yocheperako pakukula kwa khoma lamitsempha ndi makulidwe ake, zomwe zimapangitsa kutsekeka kwa lumen kapena kuwonongeka kwathunthu kwa mitsempha. Kusintha kotereku kumapangitsa kuchepa kwa magazi kupita kumadera otsika. Phazi limakhudzidwa kwambiri, chifukwa ndi gawo lakutali kwambiri la mwendo. Ischemia yomwe idayamba (kusakwanira kwa magazi komanso kuperewera kwa mpweya) imapangitsa kutayika kwa magwiridwe antchito am'munsi, kusinthika kwa khungu.

Gulu

Kutengera ndi ziwiya ziti, matendawa amagawidwa m'mitundu iyi:

1. Macroangiopathy ndi chotupa cha zotumphukira za mitsempha ndi mitsempha yayikulu (m'mimba mwake) m'chigawo chilichonse cha m'munsi. Kutengera ndi malo eni sitimayo, macroangiopathy ikhoza kupezeka:
   • mawa
   • zombo za iacac
   • mitsempha yotupa
   • gawo lachikazi
   • mitsempha yam'munsi yamiyendo.
2. Microangiopathy ndi matenda a shuga a microvasculature. Zosintha zimakhudza ziwiya zochepa chabe za miyendo:
   • capillaries
   • arterioles
   • zopweteka.
3. Ophatikizika osiyanasiyana a angiopathy - kuphatikiza kwa zotupa za matenda ashuga a mitsempha yayikulu komanso ziwiya zazing'ono zamiyendo.

Ndikofunikira kukumbukira! Matenda a shuga a shuga a m'migawo yotsika ikamodzipatula amakhala osowa. Zimaphatikizidwanso ndi kuwonongeka kwa microvasculature yazomwe zikuchitika, kuphatikizapo impso (nephropathy) ndi retina (retinopathy)!

Amayambitsa ndi zimagwirira matenda

Kupezeka kwa matenda ashuga angiopathy a m'munsi malekezero a se akuwonetsa kupezeka kwa matenda omwe amapezeka mwa odwala omwe ali ndi matenda ashuga a mitundu yoyamba ndi yachiwiri. Kuchulukitsa kosalekeza komanso kosatha kwa shuga (m'magazi) m'magazi kumatha kukhala chinthu chokhacho chomwe chimapangitsa kuti pakhale zovuta zina.

Kuopsa kwa angiopathy kwamiyendo ndi kuthamanga kwa kupita kwake kumakhudzidwa ndi zinthu zambiri zakunja ndi zamkati.

Zowopsa zomwe zingayambitse matenda a matenda ashuga - tebulo

Zowopsa	Zotsatira mwadzidzidzi ndi njira ya angiopathy
Kutalika kwa matenda ashuga	Munthu akakhala ndi matenda ashuga kwambiri, ndiye kuti angathe kuwonongeka kwambiri m'zigawo zotsika.
Kuchuluka kwa kuchuluka kwa shuga m'magazi	Glycemia wapamwamba (mulingo wa shuga m'magazi), angiopathy yofulumira imachitika ndipo imakhala yolimba kwambiri.
Zaka za odwala	Zotsatira zaukalamba ndizosafunikira komanso kopambana:

• kuyambika kwa matenda ashuga kwa achinyamata kumabweretsa kuwonongeka koyambirira kwa ziwiya za microvasculature, makamaka poyipa kwamatenda. Mitsempha ikuluikulu pamenepa siivuta,
• mu odwala matenda ashuga okalamba, kuchuluka kwa mwendo microangiopathy ndikocheperako. Zombo zazikulu zimakhudzidwa makamaka.

Odwala matenda a mtimaKukhalapo kwa matenda aliwonse a arterial kapena venous shipping kwa odwala omwe ali ndi matenda ashuga (atherosulinosis obliterans, aakulu venous insuffence, endarteritis, etc.) amafulumizitsa kuchitika kwa angiopathy ndikuwonjezera njira yake.Kunenepa kwambiriZimathandizira pakukula kwa kusintha kwa ma pathological m'mitsempha yamagazi (ambiri mwa mitsempha yayikulu yonse) motsutsana ndi matenda a shuga.Matenda oopsaZosasangalatsa zimakhudza microvasculature.KusutaImakhala chifukwa cha kufalikira kwa ziwopsezo za atherosulinotic m'mitsempha ikuluikulu, timasamba (timafinya) ma capillaries.Katundu wapaziKuchulukitsa komanso kusakwanira kwa miyendo yakumunsi kumayambitsa kukula kwa angiopathy.Kuchulukitsa kwa magaziImathandizira kuyambika kwa kusintha kwa matenda ashuga m'matumbo ang'onoang'ono komanso akuluakulu.

Zizindikiro ndi mawonetseredwe azachipatala

Kukhalapo kwa matenda a shuga (ngakhale ndi njira yabwino kwambiri) kwa zaka 5 kukuwopseza kukula kwa angiopathy a malekezero otsika. Odwala amakhala ndi zodandaula za miyendo yawo:

1. Ululu panthawi yochita masewera olimbitsa thupi komanso popuma.
2. Kutopa ndi kutopa.
3. "Kulowerera mkati" ndi mkhalidwe pamene munthu amakakamizidwa kuti ayime akuyenda mtunda waufupi chifukwa cha kupweteka m'miyendo.
4. Kutupa.
5. Kumva kuzizira.
6. Sinthani khungu la miyendo ndi miyendo (pallor, redness, mdima wa zala).
7. Kukhalapo kwa zilonda zam'mimba ndi kuchiritsidwa koyipa kwa mabala amiyendo

Chosangalatsa kudziwa! Matenda a diabetes angiopathy amatha kuwonekera madigiri osiyanasiyana pamunsi amodzi kapena onse otsika. Nthawi zambiri imaphatikizidwa ndi neuropathy (kuwonongeka kwa mizu ndi mitsempha), yomwe imachulukitsa maphunzirowa. Kukula kwakukulu, izi zimadziwika ndi microangiopathy. Vutoli silikudziwika kwa nthawi yayitali chifukwa chosakhalapo ndi ululu kapena chizindikiro china, chikuwonekera pokhapokha ndikusintha kosasintha kwa zala.

Zizindikiro za matenda a shuga a m'munsi malekezero - gome

Zizindikiro za matendawa	Feature
Khungu loyera komanso lozizira	Imalembetsedwa kokha kumapazi ndi m'munsi mwendo ndikuwonetsa kukhalapo kwa kusinthasintha kwazizindikiro.
Cyanosis	Mavuto obisika ozungulira (ischemia yovuta), owopseza kusintha kwa gangrene (khungu limazizira).
Kuchepa kwamapazi	Nthawi zambiri amawonetsa matenda a shuga a phlegmon kapena erysipelas (khungu limakhala lotentha nthawi yomweyo).
Mdima wa zala kapena mapazi	Umboni wa zovuta zosasinthika kapena zamagazi kwambiri:

• maupangiri azala okha ndi omwe amapeza mtundu wakuda - macroangiopathy,
• zilonda zam'madzi otentha, madera ozizira kwambiri a khungu lakuda - microangiopathy.

Kukhalapo kwa mabala osachiritsaEdemaNgati zimachitika nthawi ndi nthawi kapena pang'ono pamiyendo yonse, sizikhala ndi vuto lililonse. Odwala okhazikika a edema, okhala pamiyendo imodzi, amawonetsa angiopathy, makamaka ngati aphatikizidwa ndi zizindikiro zina za ischemia.Hypotrophy (kuchepetsa voliyumu)Zizindikiro za macroangiopathy yokhazikika yomwe imakhudza zigawo zazikulu zam'mimba.Kusowa kwa tsitsi la mwendoKuperewera kwamatumbo kapena kufooka kwakeChizindikiro chachindunji komanso chodalirika cha kuwonongeka (kupendekera kapena kudutsa) kwa ziwiya zazikulu. Komanso, kupindika kwa mitsempha pansi pa malo ochepera nthawi zambiri sikutsimikizika konse.Kufooka minofuImadziwoneka yokha poyenda, motsatana ndi zowawa mu ng'ombe ndi minofu ina ya m'munsi, ndikusinthana ndi lameness. Odwala sangathe kuchita mwachizolowezi, ndipo ndi angiopathy komanso ochepa, katundu.

Zoipa za angiopathy

Kugawidwa kwa matenda a shuga a matenda ashuga mwachisawawa ndikofunika kwambiri kuti akatswiri awone momwe wodwalayo alili, kutsimikiza kwa omwe ali ndi vuto lodwala. Mitundu iliyonse yowonongeka kwa ziwiya zamagetsi pamaso pa matenda a shuga imagawika m'magawo otsatirawa:

1. Zachikale. Kusintha kwoyamba kwa ma pathological kumawonekera m'matumbo, koma sikuwonetsedwa ndi chizindikiro chilichonse. Mutha kuwazindikira pokhapokha mayeso apadera.
2. Mavuto Ogwira Ntchito Kusintha kwa matenda ashuga a ziwiya zam'mimba kumanenedwa kwambiri kotero kuti pali zizindikiro zapadera zamankhwala zomwe zimayambika chifukwa chophwanya magazi kumapazi. Amasinthidwa.
3. Zosintha zachilengedwe. Kusintha kwa minofu ndi kulephera kwa magazi kuzungulira m'munsi kumatchulidwa kotero kuti kusokonezeka kwa trophic kumachitika. Amatha kusintha pang'ono kapena kusintha. Zilonda zimadziwoneka zokha pamiyendo, gangrene (necrosis) ya zala kapena phazi lonse limachitika.

Kwa macroangiopathy a matenda ashuga okha, gulu lazotsatira:

• Mlingo woyamba - mawonetseredwe oyambilira mu mawonekedwe a kuzizira kwamiyendo, kupweteka kwa mwendo poyenda mtunda wa pafupifupi 1 km,
• Digiri yachiwiri - kukhalapo kwa "kulumikizana kwapang'onopang'ono" (kupweteka kwa mwendo pamene mukuyenda, kukupangitsani kuti muime) mtunda wa 50-200 mpaka 400-500 m,
• Digiri yachitatu - kulephera kuyenda 50 m popanda kupweteka, komanso kupezeka kwa ululu pakupuma,
• 4th digiri - kupweteka kwambiri, zilonda zam'mimba, kuzungulira kwa zala kapena phazi lonse.

Chithandizo cha Conservative - gome

Mayendedwe azithandizo	Kufotokozera ndi tsatanetsatane
Kutsitsa magazi	Zakudya zam'magawo a tebulo Na. 9 (zoperewera pang'ono zopatsa mphamvu chifukwa chomanga thupi komanso mafuta a nyama), Kulandilidwa kwa Siofor, Diabetes, Glucophage, makonzedwe a insulin.
Pansi mafuta m'thupi	mankhwala a statin (Lovastatin, Atorvastatin, Simvastatin)
Kuchepetsa magazi	mwachindunji anticoagulants (Heparin, Kleksan, Fraksiparin). Amathandizidwa mosavuta kapena mwamitsempha yamafuta kwambiri komanso zovuta za matenda ashuga angiopathy, anticoagulants osadziwika (Warfarin, Sinkumar). Kutumizidwa pambuyo maphunziro a jekeseni wa anticoagulants motsogozedwa ndi magazi kuundana (kusanthula kwa INR), othandizira:
Kupititsa patsogolo kufalikira kwa magazi ndi ma microcirculation	Pentoxifylline (Trental), Tivortin Rheosorbylact Pestazole Vazaprostan Ilomedin.
Kulimbitsa kwa kagayidwe kachakudya njira mu zimakhala	Actovegin, Nicotinic acid Vitamini E Mildronate Cytoflavin.
Kuwongolera ululu	painkiller ndi mankhwala othana ndi kutupa (Ketorolac, Dexalgin, Diclofenac, Ibuprofen)
Kuyang'anira matenda	Mankhwala a antibacterial amasonyezedwa pamaso pa kuwonongeka kulikonse pakhungu ndi mabala m'munsi m'munsi motsutsana ndi maziko a matenda ashuga a shuga, zizindikiro zowonekeratu zothandizira njira. Maantifilamu odziwika bwino amalembedwa (Ceftriaxone, Ciprinol, Levofloxacin).
Chithandizo cha concomitant neuropathy	Berlition kapena Thiogama limodzi ndi mavitamini a B (Neuromax, Milgama, Vitaxone)
Zosamalira Mapazi Otsika	Chofunikira kwambiri chomwe chimakhudza pafupipafupi puruff-gangrenous zovuta za matenda a shuga a m'munsi malekezero. Odwala ayenera kuwunika nsapato (ziyenera kukhala zabwino), mawonekedwe ndi chithandizo cha scuffs, calluses, mabala, kupewa kukhala nthawi yayitali pamapazi awo, molondola komanso munthawi yodula misomali ndi chimanga (chimanga chouma).

Zofunikira ndi mitundu ya maopareshoni

Opaleshoni yamatumbo a angiopathy amayamba ngati:

1. Zilonda zamatumba akuluakulu (ilio-femoral-popliteal segment) mwanjira yamagawo ochepa ofunikira. Odwala amachitidwa:
   • mankhwalawa (wogwirizira mbali yogona ya bedi lamitsempha yokhala ndi mafinya kapena mafupa a m'mitsempha),
   • thrombectomy ndi endarterectomy - kuchotsa kwa minyewa yomwe imalepheretsa mphamvu ya mtsempha wamagazi,
   • kulowererapo kwa mtima - kufalikira kwa malo opanikizika pogwiritsa ntchito chibaluni pneumatic kapena stent yapadera yamitsempha.

Mu mtima ntchito, patency ya amakhudzidwa ochepa ziwiya amabwezeretsedwa

Ndikofunikira kukumbukira! Zoyeretsa zochitika za matenda ashuga am'magazi am'munsi sizimapulumutsa munthu m'mavuto, koma zimaletsa kuledzera ndikufalikira kwa purosesa.

Kuthekera kwa mankhwala achikhalidwe ndi homeopathy

Mankhwalawa angiopathy a m'munsi malekezero ayenera kukhala lokwanira, chifukwa chake munthu sayenera kudalira wowerengeka azitsamba ndi homeopathy. Musanagwiritse ntchito maphikidwe ena, muyenera kufunsa katswiri.

Kugwiritsa ntchito maphikidwe achire:

1. Tiyi wa Linden. Thirani supuni ya zouma zouma zophweka mu kapu yamadzi otentha. Gwirani kwa mphindi 10-12 pa moto wochepa. Osabweretsa kwa chithupsa. Tengani kapu yomwera mukakudya katatu patsiku.
2. Tiyi ya Blueberry. Pukuta masamba owuma kapena atsopano aebulosi, ikani mu mbale yachitsulo ndikuthira magalasi awiri amadzi otentha. Ikani moto kwa mphindi 5-7, osabweretsa chithupsa champhamvu. Tengani 3-4 pa tsiku kwa mphindi 15-20 musanadye.
3. Kulowetsedwa kwa masamba nyemba. 5 tbsp. l nyemba zosenda, 2 cm. l dogrose, wort wa St. John ndi mahatchi, 1/2 tbsp. l ikani flaxseeds mu thermos, onjezerani kapu yamadzi otentha. Kuumirira osachepera maola 2-3. Gawani ma Mlingo atatu. Imwani mphindi 30 musanadye.
4. Kusamba kwa phazi kutengera mizu ya tirigu. Tengani 50 g wochotsa mizu ya tirigu wowuma, ikani mbale yachitsulo ndikuthira madzi okwanira 1 litre. Bweretsani ku chithupsa ndikugwira moto wochepa kwa mphindi 10-15. Onjezani msuzi wokonzedwa ku mbale kapena bafa ndi 5 l amadzi (osaposa 35-36˚C). Kutalika kwa njirayi ndi mphindi 15-20.

Zithandizo za anthu othana ndi zovuta za matenda ashuga - gallery

Zotheka ndi zovuta

Matenda ashuga angiopathy am'munsi malekezero ena amabweretsa zovuta. Zotheka ndi matendawa:

1. Khola yokhazikika yokhala ndi mawonekedwe owerengeka komanso kupita pang'onopang'ono. Kusankha kumeneku kumakhala kotheka kwambiri ndi mitundu yachiwiri ya matenda ashuga.
2. Kukula kwa angiopathy ndikupanga matenda a diabetic phazi: kupweteka kosalekeza, kutupa, kufooka kwa phazi, zovuta zamkati (phlegmon, osteomyelitis), zilonda zam'mimba.
3. Necrosis (gangrene, necrosis) ya zala, mapazi, mwendo wapansi.

Kukhalapo kwa vuto la gangrene komanso purulent-necrotic kumabweretsa chiwopsezo m'moyo wa wodwalayo, chifukwa kumayambitsa chidakwa chachikulu cha thupi ndi zinthu zosweka zomwe zimakhala ndi zake.

Chosangalatsa kudziwa! Chithandizo cha odwala omwe ali ndi matenda osokoneza bongo omwe amakhala ovuta kuwonongeka kwa ziwiya zamiyendo amachitidwa nthawi yomweyo ndi madokotala a akatswiri angapo: endocrinologist kapena opaleshoni ya mtima. Masiku ano, kuli akatswiri ochepa omwe amagwira ntchito m'ma “Diabetesic foot office”. Amadziwika kuti opanga ma podiatrician!

Njira zopewera

Njira zodzitchinjiriza ndi:

• kupewa kuyambika ndi kupitirira kwa shuga. Pokhapokha mtundu wachiwiri wa matenda. Zimaphatikizapo kufalikira kwa zakudya m'thupi, kulimbana ndi kunenepa kwambiri, kusiya kusuta fodya, kuledzera ndi zizolowezi zina zoyipa.
• kutsika kwa kupitirira kwa angiopathy. Kukonzanso kwakanthawi shuga, magazi ndi mankhwala opaleshoni yotsimikizika kuti abwezeretse magazi mu ziwiya zamiyendo,
• kupewa zotupa za purulent-gangrenous. Amaganizira kutsatira njira zonse posamalira miyendo yakumunsi.

Diabetesic phazi matenda - kanema

Angiopathy yokhala m'munsi yotsika ndizowopsa zomwe zimapezeka mwa anthu odwala matenda a shuga. Kuzindikira koyenera komanso chithandizo chamankhwala kumathandiza kupewa zovuta zovuta, monga kusokonezeka kwa phazi, gangore. Kumbukirani kuti, matenda aliwonse ndiosavuta kupewa kuposa kuchiza, chifukwa chake tsatirani malangizowo popewa kukhala athanzi!

Kodi angiopathy?

Nthawi zambiri, ma pathologies omwe amagwirizana ndi ziwiya zazing'ono amatsogolera pakupanga kwa angiopathy mu shuga mellitus.

Angiopathy yotsika madera ambiri amapezeka ndi matenda ashuga, osatengera mtundu wamatenda. Vuto lofananalo limachotsedwa mwa kuchitidwa opaleshoni kapena chithandizo chamankhwala.

Matenda ashuga angiopathy ndi matenda omwe amakhudza minyewa yam'mimba ndi mitsempha. Nthawi zambiri, malekezero otsika a odwala matenda ashuga amakhudzidwa. Komanso, matenda oterewa amathanso kukhudza ziwiya zina za thupi ndi ziwalo zina za thupi, zomwe sizikugwira ntchito pazisonyezo za matenda okoma. Matenda a diabetes angiopathy mu ntchito zamankhwala amagawidwa m'mitundu iwiri:

• macroangiopathy - matenda a shuga a ziwiya zam'mbuyo ndi venous. Ndi chikhalidwe cha iwo omwe akhala akudwala kwa zaka zopitilira 10,
• microangiopathy ndimavuto osokoneza.

Palinso gulu la anthu, kutengera mtundu wa zotengera zomwe zikukhudzidwa:

• retinal diabetesic angiopathy - retinopathy,
• kuwonongeka kwa minofu minofu ya impso - nephropathy,
• kuwonongeka kwa mtima ndi mitsempha,
• phazi angiopathy
• matenda a cerebrovascular - encephalopathy.

Ndi angiopathy, matenda ashuga amatha kuchuluka. Matenda ambiri akuipiraipira, kuchuluka kwa chiyembekezo cha odwala omwe akudwala chikuchepa. Kwa gawo lowopsa, kufa kwa ziwalo zamkati ndikudziwika, khungu lingafunike kudula malekezowo.

Odwala okha ndi omwe angayimitse chitukuko cha matendawa, kuwona malingaliro onse, kuwunikira mayendedwe a shuga ndikukhala pazakudya zapadera.

Kuzindikira kuopsa kwa matendawa ndi zotsatira zake ponyalanyaza malangizo a madokotala ndikofunikira.

Zolinga za maonekedwe

Chomwe chimapangitsa kuti matenda azitsamba azisangalalo amawonedwa kuti ndiwowonjezera shuga wambiri. Zotsatira zake, shuga wodziunjikira amamwetsedwa m'makoma amitsempha yamagazi. Zogulitsa zosinthana ndi shuga ndi madzi, kudziunjikira mu endothelium, zimayambitsa kutupa, kuchepetsa magawo oteteza magazi. Zonsezi zimathandizira kupanga mapangidwe amwazi ndi kutsekeka kwamitsempha yamagazi.

Pali zifukwa zingapo zomwe zimayambitsa zovuta:

• amalimbira hyperglycemia,
• kuchuluka kwa insulin mthupi,
• insulin kukana
• aimpso kuwonongeka - nephropathy.

Zotsatira zakukula kwa angiopathy ndi:

• Kapangidwe ka aneurysm ndikofunikira pakukula kwamitsempha yamagazi komwe kumasokoneza kayendedwe ka magazi, zonsezi zitha kupangitsa kuti mitsempha yamitsempha,
• Kupasuka kwa zombo zazing'onoting'ono, zomwe zimatsogolera kutaya mtima,
• kuchuluka kwa kuthamanga kwa magazi, chifukwa cha kuphipha kwamitsempha yamagazi.
• kuwoneka kwa magazi m'zotengera,
• atherosulinosis
• magazi amachepetsa.

Matumbo Ammbuyo

Angioretinopathy ndi matenda a shuga a retitis. Pa magawo oyamba, chotupa chimakhalabe chosadziwika, chifukwa matendawa amadutsa pafupifupi popanda zizindikiro komanso zowawa.

Gawo lomaliza la retinopathy limadziwika ndi:

• dontho lakuthwa kowoneka bwino kwambiri,
• mawanga amdima pamaso panu
• zipsera zikuwoneka m'maso mwanga
• kanema wamtambo akuwonekera pamaso panga.

Matendawa amatha kuwonetsedwa ndi edema ya retina, zomwe zotsatira zake ndi chotchinga m'maso. Zotsatira zake, popanda chithandizo china, wodwalayo amasiya kuwona ndipo amakhala wakhungu kosatha.

Nephropathy

Nephropathy kapena matenda a minofu ya impso, imodzi mwazovuta za angiopathy mu shuga. Zotsatira za matendawa ndi kulephera kwa impso. Kuphwanya nthawi yayitali mwina sikungamve.

Zizindikiro zomwe zimawoneka ndizofanana ndikuchulukirachulukira kwa matenda ashuga. Zizindikiro za nephropathy zimaphatikizaponso: ludzu, kuyanika kutuluka kwamkamwa pakamwa, kuyanika pakhungu, komanso kukodza pafupipafupi .ziwonetsero zonsezi zimakhudzana ndi kuwonjezeka kwa shuga mthupi.

Chizindikirochi chikadutsa 10 mmol / l, shuga amalowa mu impso popanda mavuto, amatuluka kudzera mu chikhodzodzo, amatenga chinyezi kuchokera pakhungu, ndipo nthawi yomweyo amakwiya ndi kuyamwa.

Kupita patsogolo, kusokonezekaku kungayambitse zowonjezera:

• Kutupa. Choyamba, kutupa kumawoneka mozungulira maso. Kupitilira apo, malo achitukuko kuphatikizirapo ndi nkhope imatha kukhala dera lachiberekero, pericardium. Malo a edema ndi opaka utoto, ofunda, okhala ndi mawonekedwe ofanana. Nthawi zambiri limawonekera m'mawa.
• Kudumphira magazi.
• Zizindikiro zofananira ndi poyizoni ndi nseru, kufooka kwathupi, kugona mokwanira. Kuwonekera mu magawo amtsogolo a matenda. Nthawi zambiri kumachitika zinthu zambiri zamagazi kagayidwe kachakudya zomwe zimayenera kupakidwa kudzera mu impso.

Cardiac Angiopathy

Matenda a shuga amakhudza zochitika zazing'onoting'ono za mtima ndi m'mitsempha yama mtima.

M'njira zonsezi, matendawa amawoneka ngati angina pectoris, ali ndi zizindikiro zotsatirazi:

• Ululu syndrome - kupweteka kwa angina kumamveka bwino, mawonekedwe ake omwe adachitika chifukwa cha kuwonongeka kwa mitsempha ya mtima. Ululu umamveka mu sternum, kawirikawiri, koma umatha kumvekedwa mbali ya epigastrium. Mawonekedwe owawa amakhala achisangalalo m'chilengedwe, nthawi zina chimawoneka champhamvu. Kubwerera kwakumva kupweteka kumanzere kwa thupi (mkono, phewa, phewa kapena chibwano). Zowawa zimatha pakadutsa mphindi 15.
• Kulephera kwa phokoso la mtima - chikhalidwe cha kugonjetsedwa kwa capillaries ndi minofu minofu yamtima. Kuchepetsa kwa myocardial kumatha kusokoneza masinthidwe osiyanasiyana (bradycardia, tachycardia, arrhythmia, kapena extrasystole).
• Magawo oyamba a kulephera kwa mtima - kufupika, kutsokomola kumachitika, kugwedezeka kwamtima kumachepa.

Limb angiopathy

Mwendo angiopathy mu shuga amayamba chifukwa cha kusinthika komwe kumayenderana ndi njira yeniyeni ya matendawa, komanso ndikupanga njira za atherosulinotic miyendo.

Zizindikiro za matenda amtunduwu ndi:

• Kuchuluka kwamiyendo, kuzizira, ma goosebumps - kumatha kuwoneka mbali zosiyanasiyana zamiyendo.
• Lamisi, kupweteka, kukokana - monga kuperewera kwa mpweya.
• Kuchepetsa khungu kumapazi. Khungu limasinthika, limatha kukhala pang'onopang'ono, kumazizira, misomali imasinthasintha, kuchepetsedwa kukula, kuthyoka.
• Zilonda zopanda machiritso - mawonekedwe omaliza a matenda okoma. Monga lamulo, amadzuka chifukwa chovulala.

Encephalopathy

Vutoli limalumikizidwa ndi vuto la kukumbukira, mavuto omwe amachita. Imadziwoneka ngati mutu wovuta kwambiri komanso kufooka kwa thupi. Zonsezi ndi chifukwa chophwanya masinthidwe a minyewa yaubongo.

Zizindikiro za matendawa zimadziwonetsa kwa nthawi yayitali. Zonse zimayamba ndi kufooka kwa thupi, wodwala amayamba kutopa kwambiri. Pali mutu wokhazikika womwe suzimitsa ndi ma pinkiller. Chotsatira ndi kusokonezeka kwa kugona tulo. Pali zovuta zokumbukira komanso kukumbukira.

Mavuto ndi mgwirizano wamagulu, kusakhazikika poyenda, ana amakhala ndi ma diameter osiyanasiyana, ma reflex pathologies amachitika.

Zida zachivomerezo

Ndizosatheka kunena nthawi yomwe matendawa ayamba kuwonekera. Angiopathy yam'munsi yotsika imawerengedwa kuti ndiyo njira yodziwika kwambiri, chifukwa shuga imawakakamiza kwambiri. Ngakhale chiopsezo chotukuka mitsempha, ma capillary komanso ochepa omwe amachitika m'malo ena amthupi la munthu samaphatikizidwa.

Madokotala amasiyanitsa ziwalo zingapo zomwe zimatengedwa ndi angiopathy:

• minofu ya muubongo
• dongosolo lamtima
• nsidze
• impso
• minofu yam'mapapo.

Ndi ziwalo zokhazokha zomwe wodwala matenda ashuga ayenera kusamalirapo.

Maphikidwe a anthu

Ndi zovuta za matenda ashuga, mankhwala wowerengeka amagwiritsidwa ntchito. Maphikidwe oterewa amagwira ntchito pokhapokha magawo oyamba a chitukuko.

• tiyi wa linden
• tiyi wabulosi
• kulowetsa masamba nyemba,
• kulowetsedwa kwa mizu ya tirigu, wogwiritsa ntchito miyendo yofunda.

Ngati mankhwala samapereka zotsatira, opaleshoni ndiyofunikira.

Pali mitundu ingapo ya machitidwe, monga:

• Kuchotsa kwa malo omwe akhudzidwa ndi ochepa lumen - thrombectomy,
• Kukula kwa malo opanikiza pogwiritsa ntchito chibaluni cham'mimba - opaleshoni yamkati,
• Kuchotsa kwa mathero a mitsempha yomwe imatsogolera ku spasms ochepa - sympathectomy,
• kupezeka kwa madera omwe masheya amadzimadzi amadzisonkhanitsa, kuchotsedwa kwofananira kwa minofu yakufa (kuduladula zala, miyendo) - opaleshoni yochita opaleshoni.

Ndi chitukuko cha angiopathy, odwala ayenera kuyang'anitsitsa zakudya, kuyang'anira kudya kwambiri. Chakudya - m'magawo ophwanyika mpaka kasanu patsiku. Kudyetsa kwambiri komanso kusala kudya sikuyenera kuloledwa.

Zotsatira za matenda zitha kupewedwa mwa kusunga malamulowo:

• osamadya mafuta okazinga ndi osuta,
• Idyani anyezi wambiri m'mawonekedwe owiritsa kapena ophika,
• pali zipatso ndi ndiwo zamasamba zatsopano zambiri,
• ndikwabwino kusaka mbale, kuwira kapena kuphika,
• Nthawi zina muzidya nyama yokonda,
• kuthetsa kugwiritsa ntchito zakudya zomwe zili ndi shuga wambiri.

Kutsatira zakudya kumachepetsa wodwalayo.

Mavuto

Zoyipa zomwe zimapezeka munthawi yake zitha kupewedwa.

Ndi mitundu yapamwamba yamatenda, zotsatirazi ndizotheka:

• Kukula kwa gangrene pamiyendo ndi magazi osakwanira. kudula miyendo mukalumikizana ndi katswiri. popanda chisamaliro chamankhwala - imfa chifukwa cha poyizoni wa thupi,
• matenda a mtima, sitiroko - chifukwa cha matenda amitsempha yamagazi,
• kutayika kwamaso
• kulephera kwa aimpso.

Kutupa kwa mtima

Khoma lamitsempha yamagazi lili ndi zigawo zingapo. Zigawozi zimasiyana mosiyanasiyana kutengera mtundu wa zotengera ndi zotengera.

Kapangidwe ka khoma lamitsempha yamagazi:

• wosanjikiza wamkati (tunica intima),
• wosanjikiza wapakatikati (TV zofalitsa),
• wosanjikiza kunja (tunica externa).

Mkati wamkati

Danga ili limakhala ndi maselo a endothelial, chifukwa chake amatchedwanso vascular endothelium. Ma cell a endothelial amatsogolera khoma lamkati la ziwiya mu gawo limodzi. Vascular endothelium imasinthidwa kukhala lumen ya chotengera motero imakhudzana nthawi zonse ndi magazi omwe amayendayenda.Khomali lili ndi zinthu zingapo zopangira, zotupa ndi zotupa za mtima. Ndi gawo ili pomwe zopangidwa ndi polyol metabolism ya glucose zimadziunjikira shuga mellitus (sorbitol, fructose).

Komanso, chosanjikiza ichi chimapereka chinsinsi cha kupumula kwa endothelial. Ndi wopanda izi (zomwe zimawonedwa ndi matenda ashuga) kuunikira kwa endothelium kumachepa komanso kukana kwa zotengera kumawonjezeka. Chifukwa chake, chifukwa cha kapangidwe kazinthu zingapo zachilengedwe, khoma lamkati lazombo limagwira ntchito zingapo zofunika.

Ntchito za Endothelial:

• imalepheretsa mapangidwe azigazi m'mitsempha yamagazi,
• amawongolera mawonekedwe a khoma la mtima,
• imayendetsa magazi
• imagwira ntchito yotchinga, kupewa kuti pasalowe zinthu zakunja,
• amatenga nawo mbali pakukwiya, kuphatikiza okhazikika pakati.

Ndi matenda ashuga, ntchitozi zimachepa. Kutsekeka kwa khoma la mtima kumawonjezera, ndipo glucose amalowa kudzera mu endothelium kukhoma la chotengera. Glucose amasangalatsa mapangidwe a glycosaminoglycans, glycosylation wa mapuloteni ndi lipids. Zotsatira zake, khoma lam'mimba limatupa, kuwala kwake kumachepa, komanso kuthamanga kwa magazi m'mitsempha kumachepa. Kuchuluka kwa magazi kuchepetsedwa kumatengera mwachangu kukula kwa matenda ashuga. Zikakhala zowopsa, magazi amayenda m'matumbo amachepetsedwa kotero kuti amaleka kulimbitsa minofu yoyandikana nayo ndikuyamba kufa ndi njala.

Wosanjikiza kunja

Izi zimapangidwa ndi minofu yolumikizana, komanso ulusi wa collagen ndi elastin. Chimateteza mitsempha yamagazi ku sprains ndi misonzi. Zombo zazing'ono zotchedwa vasa vasorum kapena zombo zapamadzi zimadutsanso. Amadyetsa zipolopolo zakunja ndi zapakati pazombo.

Cholinga chachikulu cha matenda ashuga ndi ziwiya zazing'ono - arterioles ndi capillaries, koma mitsempha yayikulu imawonongeka.

Limagwirira kuwonongeka kwa mtima mu shuga

Matenda a shuga a shuga amakhazikika pazowonongeka kwa khoma la mtima (ndendende, endothelium), ndikuphwanya kwina ntchito. Monga mukudziwa, ndi matenda a shuga pali shuga wambiri (shuga) m'magazi kapena hyperglycemia. Zotsatira zake za diabetic hyperglycemia, glucose m'magazi imayamba kulowa mkatikati mwa chotengera. Izi zimabweretsa kuphwanya kapangidwe ka khoma la endothelial ndipo, monga chotulukapo chake, kuwonjezereka kwa kukhalanso kwake. Zinthu zama metabolism za glucose, zomwe ndi sorbitol ndi fructose, zimadziunjikira khoma la mtsempha wamagazi. Amakopa madzi limodzi nawo. Zotsatira zake, khoma lamtsempha wamagazi limatupa ndikukhazikika.

Komanso, chifukwa cha kuwonongeka kwa khoma lamasamba, njira yokhazikika imayambitsidwa (kuundana kwa magazi), popeza capillary endothelium imadziwika kuti imatulutsa magazi. Izi zimawonjezera magazi mu ziwiya. Chifukwa chophwanya kapangidwe ka endothelium, imasiya kukhazikitsa gawo lopuma la endothelial, lomwe nthawi zambiri limayang'anira kupendekera kwa zotengera.
Chifukwa chake, ndi angiopathy, Virchow triad imawonedwa - kusintha kwa khoma lamitsempha, kuphwanya kwamphamvu kogwiritsa ntchito magazi komanso kuchepa kwa magazi.

Chifukwa cha njira zomwe zili pamwambapa, mitsempha yamagazi, makamaka yaying'ono, yopapatiza, kuunikira kwawo kumachepa, ndipo magazi amayenda mpaka atayima. M'misempha yomwe amapereka magazi, hypoxia imawonedwa (kusowa kwa mpweya), atrophy, komanso chifukwa chachulukidwe chokwanira ndi edema.

Kuperewera kwa oxygen m'misempha kumayendetsa ma cell a cell, omwe amapanga minyewa yolumikizana. Chifukwa chake, hypoxia ndiyomwe imapangitsa kukula kwa mtima. Choyamba, zombo zazing'ono kwambiri - capillaries za impso - zimavutika.
Chifukwa cha sclerosis mwa capillaries awa, ntchito yaimpso imalephera ndipo kulephera kwa impso kumayamba.

Nthawi zina, mitsempha yaying'ono imatsekeka chifukwa cha magazi, pomwe mumitundu ingapo ya aneurysms (bulging mtima wa bulging) Zombozi zimasokonekera, zimakhala zocheperako, zomwe zimabweretsa kutaya kwakanthawi (nthawi zambiri pa retina).

Kuwonongeka kwa mtima ndi amodzi mwa zovuta zowopsa za matenda ashuga, omwe nthawi zambiri amayambitsa imfa ya odwala. Chifukwa chake, anthu omwe ali ndi matenda ashuga ayenera kuyandikira kwambiri kupewa matenda a mtima. Pachifukwa ichi, chidwi chikuyenera kulipira pakukula kwa asayansi apakhomo - cytamines. Cytamines ili ndi ma peptides owongolera - zinthu zomwe zimayang'anira zochitika za intracellular ndikuonetsetsa kuti magwiridwe antchito ndi ziwalo. Makina a peptides ndi oyenera chiwalo chilichonse. Pofuna kupewa komanso kuchiza matenda amitsempha yamagazi, Vasalamine amakonzedwa ndikuyambitsidwa muzochita zamankhwala.
Vasalamine:

1. Imakhala ndi kusankha kwa minofu yam'mimba, imachepetsa kuthamanga kwa magazi mu ziwalo ndi minofu m'matenda osiyanasiyana ndikupatsidwa mpata wambiri m'thupi.
2. Amawongolera mkhalidwe wamakhoma wamitsempha ndi kukokoloka kwa endothelial, kusintha bwino kwamitsempha yama cell, kumawonjezera mphamvu ya makoma a capillaries.
3. Amawonetsedwa m'magawo oyamba a matenda ashuga, matenda oopsa, komanso okalamba kuti azigwira ntchito ya mtima.

Zizindikiro za matenda a shuga A shuga

Zizindikiro za matenda a shuga a shuga zimatengera mtundu wake. Mitundu ya angiopathy imasiyana momwe ziwiya zinawonongekera.

Mitundu ya angiopathy ya matenda ashuga:

• matenda ashuga retinopathy (retinal mtima kuwonongeka),
• matenda ashuga nephropathy (kuwonongeka kwa impso),
• matenda ashuga angiopathy kuwonongeka kwa capillaries ndi mtima mitsempha,
• matenda a shuga a m'munsi malekezero,
• matenda ashuga encephalopathy (matenda amisala).

Zizindikiro za matenda a shuga a retinopathy

Kapangidwe ka maso
Diso limakhala ndi mawonekedwe amaso, mitsempha ya maso ndi zinthu zothandizira (minyewa ya minofu) Diso lamaso palokha limakhala ndi chipolopolo chakunja (ziphuphu ndi sclera), pakati - mtima ndi wamkati - retina. Retina kapena "retina" imakhala ndi intaneti yake, yomwe umalimbana ndi matenda a shuga. Imayimiridwa ndi mitsempha, arterioles, mitsempha ndi capillaries. Zizindikiro za matenda a shuga a angiopathy amagawidwa pachipatala (zomwe zimaperekedwa ndi wodwala) ndi ophthalmoscopic (zomwe zimapezeka pamayeso a ophthalmoscopic).

Zizindikiro zamankhwala
Kuwonongeka kwa ziwiya za retina mu matenda osokoneza bongo sikumapweteka ndipo pafupifupi asymptomatic kumayambiriro. Zizindikiro zimawonekera pang'onopang'ono, zomwe amafotokozeredwa ndi kuchezera kwadokotala.

Madandaulo opangidwa ndi wodwala yemwe ali ndi matenda ashuga retinopathy:

• kuchepa kowoneka bwino,
• mawanga amaso pamaso
• kutulutsa, kuwalira pamaso,
• chophimba kapena nsalu yotchinga pamaso.

Chizindikiro chachikulu cha matenda a shuga a shuga ndikuchepa kwamawonedwe owonekera mpaka khungu. Munthu amataya kutha kusiyanitsa pakati pazinthu zazing'ono, kuwona patali. Chodabwitsachi chimaphatikizidwa ndi kupotoza mawonekedwe ndi kukula kwa nkhaniyo, kupindika kwa mizere yowongoka.

Ngati retinopathy imakhala yovuta ndi zotupa zakumaso, ndiye zimawonetsedwa ndi kukhalapo kwa malo oyandama pamaso pake. Masamba awa amatha kuzimiririka, koma mawonekedwe amatha kulephera. Popeza thupi lamphamvu nthawi zambiri limawonekera, kupezeka kwa magazi mkati mwake (chifukwa chotupa cha mitsempha yamagazi) ndipo imakwiyitsa mawonekedwe amdima m'munda wamasomphenya. Ngati munthu sankaonana ndi dokotala panthawi, ndiye kuti pakati pa thupi lamphamvu ndi retina, zingwe zimapangidwa zomwe zimakoka retina, zomwe zimayambitsa kuphwanya. Kukhazikika kwa retinal kumawonetsedwa ndi kuchepa kowopsa m'mawonedwe (mpaka khungu), mawonekedwe akuwoneka ndi kunyezimira pamaso pa maso.

Komanso, matenda a shuga a retinopathy amatha kuchitika ndi chitukuko cha edema. Potere, wodwalayo amakhala ndi chophimba pamaso pake, kutayika kwa zithunzi. Chophimba chopitilira patsogolo pa maso kapena mtambo wakomweko ndimalo akuwonetsera edema kapena exudates pa retina.

Zizindikiro za ophthalmoscopic
Zizindikirozi zimapezeka pamayeso a ophthalmoscopic, omwe amakhala ndikuwonera fundus pogwiritsa ntchito ophthalmoscope ndi mandala. Pakuchita kafukufukuyu, adotolo amawunika ziwiya za mtima, zamitsempha. Zizindikiro za kuwonongeka kwa mtima kwa retina zimawonekera kale kwambiri kuposa zodandaula za wodwala.

Nthawi yomweyo, mitsempha yopapatiza imawonedwa pa fundus, ndipo ma micaneurysms amapezeka m'malo. Pakati penipeni kapena m'mitsempha yayikulu pali zotupa zochepa ngati mawonekedwe a madontho. Edema imadziwika kumtunda m'mitsempha kapena pakatikati pa macula. Ma exudates ofewa angapo amadziwika pa retina (kumanga kwamadzi) Nthawi yomweyo, mitsempha imakhala yotupa, yodzaza ndi magazi ambiri, ochulukitsa, ndipo mawonekedwe ake adafotokozeratu.

Nthawi zina mu vitreous thupi hemorrhages ambiri amawonekera. Pambuyo pake, zingwe zazingwe zimapangidwa pakati pake ndi retina. Mitsempha ya optic imalowa m'mitsempha yamagazi (optic neovascularization) Nthawi zambiri, zizindikirazi zimayendera limodzi ndi kuchepa kwakuthwa m'masomphenya. Nthawi zambiri, pakadali pano, odwala omwe samanyalanyaza mayeso olimbitsa thupi amapita kuchipatala.

Zizindikiro za matenda a shuga a Nephropathy

Matenda a shuga ndi nephropathy amawonongeka mu ziwiya za impso mu shuga komanso kukula kwa impso.

Kapangidwe ka impso
Gawo logwira ntchito la impso ndi nephron, lomwe limakhala ndi glomerulus, kapisozi ndi tubules. Glomerulus ndi kudzikundika kwa ma capillaries ambiri momwe magazi amthupi amayenda. Kuchokera magazi am'mapazi kupita m'matumba, zinthu zonse zofunika kwambiri zimapangidwa, ndipo mkodzo umapangidwanso. Ngati khoma la capillary lawonongeka, ntchitoyi imaphwanyidwa.

Zizindikiro za matenda a shuga a nephropathy akuphatikizira madandaulo kuchokera kwa wodwala, komanso Zizindikiro zakuzindikira koyambirira. Kwa nthawi yayitali kwambiri, matenda a shuga a nephropathy amakhala asymptomatic. Zizindikiro zambiri za matenda a shuga amayamba kudziwikiratu.

Zizindikiro zodziwika bwino za matenda ashuga:

• ludzu
• kamwa yowuma
• Khungu
• kukodza pafupipafupi.

Zizindikiro zonsezi zimachitika chifukwa cha kuchuluka kwa glucose m'matupi komanso m'magazi. Pazochitika zina za shuga m'magazi (oposa 10 mmol / lita) akuyamba kupatsira chotchinga. Kupita ndi mkodzo, glucose amanyamula madzi limodzi ndi iwo, omwe amafotokozera chizindikiro cha kukodza pafupipafupi komanso koperewera (polyuria) Kutulutsa kwamphamvu kwamadzi kuchokera mthupi kumapangitsa kuti khungu lisokonezeke (chomwe chimayambitsa pakhungu) ndi ludzu losatha.

Mawonetsero owoneka bwino a matenda a diabetes a nephropathy amawonekera zaka 10 mpaka 15 atazindikira kuti ali ndi matenda ashuga. Izi zisanachitike, pali chizindikiro cha labotale chokha cha nephropathy. Chizindikiro chachikulu chotere ndi mapuloteni mu mkodzo (kapena proteinuria), yomwe imatha kupezeka mukamayesedwa.

Nthawi zambiri, kuchuluka kwa mapuloteni mu mkodzo wa tsiku ndi tsiku sikuyenera kupitirira 30 mg. Mu magawo oyamba a nephropathy, kuchuluka kwa mapuloteni mu mkodzo patsiku kumayambira 30 mpaka 300 mg. M'magawo amtsogolo, zizindikiro zamankhwala zikaonekera, kuchuluka kwa mapuloteni kumaposa 300 mg patsiku.

Amayendedwe a chizindikirocho ndi kuwonongeka kwa fungo la impso (kupezeka kwake kumachuluka), chifukwa chomwe chimayamba kudutsa chochepa, kenako mamolekyulu akuluakulu.

Matendawa akamakula, zizindikiro za kulephera kwa impso zimayamba kulumikizana ndi zizindikiritso zambiri.

Zizindikiro za nephropathy mu shuga:

• kutupa
• kuthamanga kwa magazi
• Zizindikiro zambiri za kuledzera - kufooka, kugona, nseru.

Kutupa
Poyamba, edema imapezeka kumtunda kwa periorbital (mozungulira maso), koma matendawa akamakula, amayamba kupangika m'mitsempha yathupi (m'mimba, zam'mimbamu) Edema yokhala ndi matenda ashuga nephropathy ndi wotumbululuka, ofunda, ofanana, amawoneka m'mawa.

Kupanga kwa edema kumalumikizidwa ndi kuchepa kwa mapuloteni m'magazi, omwe amachotsedwera limodzi ndi mkodzo. Nthawi zambiri, mapuloteni am'magazi amapanga kupanikizika kwa oncotic, ndiye kuti, amasunga madzi mkati mwa bedi lamitsempha. Komabe, pakutha kwa mapuloteni, madziwo samasungidwamo m'matumbo ndipo amalowa m'matipi. Ngakhale kuti odwala matenda ashuga nephropathy amachepetsa thupi, kunja amawoneka edematous, chifukwa cha edema yayikulu.

Kuthamanga kwa magazi
M'magawo apambuyo, odwala matenda a shuga a nephropathy amakhala ndi kuthamanga kwa magazi. Kuchulukitsa kwa magazi kumalingaliridwa pamene kupanikizika kwa systolic kudutsa 140 mmHg ndipo kuthamanga kwa diastolic kupitirira 90 mmHg.

Njira yopangira kuthamanga kwa magazi imakhala ndi maulalo angapo a pathogenetic. Choyamba, ndikusunga madzi ndi mchere mthupi. Chachiwiri ndi kuyambitsa kwa renin-angiotensin. Renin ndi chinthu chogwira ntchito mwaubwino wopangidwa ndi impso ndipo, mwa njira yovuta, imayendetsa magazi. Renin amayamba kupangidwa mwachangu pamene minyewa ya impso imakumana ndi vuto la mpweya. Monga mukudziwa, capillaries a impso mu shuga mellitus ndi sclerotic, chifukwa chomwe impso imaleka kulandira magazi ofunikira, komanso ndi mpweya. Poyankha hypoxia, renin yowonjezera imayamba kupangidwa. Iwonso, imayendetsa angiotensin II, yomwe imapangika m'mitsempha yamagazi ndikuthandizira kubisala kwa aldosterone. Mfundo ziwiri zomaliza ndizofunikira pakupanga matenda oopsa.

Zizindikiro zodziwika za kuledzera - kufooka, kugona, nseru
Kufooka, kugona, ndi nseru ndizizindikiro zakuchedwa za matenda a shuga. Amakula chifukwa cha kuchuluka kwa zinthu zopangidwa ndi poizoni m'thupi. Nthawi zambiri, zinthu zofunika kwambiri mthupi (ammonia, urea) amasulidwa ndi impso. Komabe, pogonjetsedwa ndi ma capillaries a nephron, ntchito ya impso imayamba kuvutika.

Zinthu izi zimaleka kuyeretsedwa ndi impso ndikudziunjikira m'thupi. Kudzikundikira kwa urea mthupi kumapatsa odwala omwe ali ndi matenda ashuga nephropathy. Komabe, chowopsa kwambiri ndi kudzikundikira kwa poizoni wa amoni m'thupi. Imalowerera mkati mwa dongosolo lamanjenje ndikulipweteka.

Zizindikiro za Hyperammonemia (mkulu ammonia):

• nseru
• kusanza
• chizungulire
• kugona
• kukokana ngati kuchuluka kwa ammonia muubongo kufika 0,6 mmol.

Kuopsa kwa kuledzera ndi kagayidwe kachakudya thupi zimatengera kuchuluka kwa impso.

Zizindikiro za matenda a shuga a Encephalopathy

Matenda a diabetes a encephalopathy amawonetsedwa ndi kusokonezeka kwa kukumbukira ndi kukumbukira, komanso kupweteka kwa mutu komanso kufooka. Cholinga chake ndiku kuphwanya ma microcirculation pamlingo wa ubongo. Chifukwa cha kuwonongeka kwa khoma lamitsempha, njira za lipid peroxidation zimayendetsedwa mmenemo ndikupanga mafayilo amtundu waulere, omwe amawonongera maselo aubongo.

Zizindikiro za matenda a shuga a encephalopathy amakula pang'onopang'ono. Zonse zimayamba ndi kufooka wamba komanso kutopa kwambiri. Odwala nthawi zambiri amakhala ndi nkhawa chifukwa cha mutu womwe suyankha kwa opweteka. Pambuyo pake, zovuta za kugona zimalumikizana. Encephalopathy imadziwika ndi kusokonezeka kwa tulo usiku, komanso kugona nthawi yomweyo masana.
Kupitilira apo, mavuto amakumbukiro ndi chidwi - odwala amakhala oiwalika ndi osokonezedwa.Kuganiza pang'ono, kosasunthika, kuchepa kwa masinthidwe kumawonedwa. Zizindikiro zowoneka bwino zimawonjezeredwa ndi zizindikiritso za ubongo.

Zizindikiro za matenda a shuga a matenda amitsempha:

• kusunthika,
• shaky gait
• anisocoria (m'mimba mwake),
• vuto losinthika
• zamatsenga.

Yotsalira ya magazi asafe

Nitrogen yotsalira ndi chizindikiro chofunikira cha impso. Nthawi zambiri, zomwe zimapezeka m'magazi ndi 14 - 28 mmol / lita. Kuchuluka kwa nayitrogeni m'magazi kumawonetsa kuphwanya kwa impso.
Komabe, chothandiza kwambiri pakupezeka kwa matenda ashuga nephropathy ndiko kutsimikiza kwa mankhwala omwe ali ndi nayitrogeni, monga urea ndi creatinine.

Urea
M'mwazi wa anthu athanzi, ndende ya urea imachokera ku 2.5 mpaka 8.3 mmol / lita. Ndi diabetesic nephropathy, urea ndende imawonjezeka kwambiri. Kuchuluka kwa urea kumatengera mwachindunji gawo la kulephera kwa impso mu shuga. Chifukwa chake, kuchuluka kwa a urea oposa 49 mmol / lita kumawonetsa kuwonongeka kwa impso. Odwala omwe ali ndi vuto la aimpso kulephera chifukwa cha matenda ashuga, nerea ingafikire 40-50 mmol / lita.

Creatinine
Monga urea, ndende ya creatinine imalankhula za impso. Nthawi zambiri, kuchuluka kwake m'magazi mwa akazi ndi 55-100 micromol / lita, mwa amuna - kuyambira 62 mpaka 115 micromol / lita. Kuwonjezeka kwa ndende pamtunduwu ndi chimodzi mwazomwe zimayambitsa matenda ashuga nephropathy. Mu magawo oyamba a matenda a shuga, nephropathy, kuchuluka kwa creatinine ndi urea kumawonjezeka pang'ono, koma pomaliza, gawo la nephrosocolotic, kutsata kwawo kumawonjezeka kwambiri.

Magazi a lipid

Kuyeza kumeneku kumayesa zigawo zamagazi monga lipoproteins ndi cholesterol. Ndi chitukuko cha matenda ashuga macroangiopathy m'magazi, otsika kwambiri komanso otsika kwambiri lipoproteins, komanso kuchuluka kwa cholesterol, koma nthawi yomweyo milingo ya lipoprotein imachepa. Kuwonjezeka kwa kuchuluka kwa osalimba a lipoproteins pamwambapa 2.9 mmol / lita kumawonetsa pachiwopsezo chotukula macroangiopathy. Nthawi yomweyo, kuchepa kwa kuchuluka kwa ma lipoprotein apamwamba kwambiri osakwana 1 mmol / lita kumawonetsedwa ngati chofunikira pakukula kwa atherosulinosis m'matumba.

Kuchuluka kwa cholesterol kumasiyana mwa anthu osiyanasiyana m'njira zosiyanasiyana. Malingaliro ovuta pankhani imeneyi pakati pa akatswiri. Ena amalimbikitsa kuti musapitirire cholesterol pamwamba pa 7.5 mmol pa lita. Chomwe chimavomerezedwa masiku ano sioposa 5.5 mmol pa lita. Kuwonjezeka kwa cholesterol pamtunda wa 6 mmol kumawoneka ngati chiwopsezo chakukulitsa macroangiopathy.

Njira zothandizira kuphunzira matenda ashuga angiopathy:

• mayeso athunthu am'maso, omwe amaphatikizapo mwachindunji za ophthalmoscopy, gonioscopy, kufufuza kwa fundus, kujambula zithunzi za stereoscopic retical ndikuwona kuyanjana kwa m'maganizo (OCT).
• electrocardiogram
• echocardiography
• angiography
• Kulemba madera akumunsi,
• Zojambula zam'munsi,
• impso ultrasound
• Kutulutsa ziwiya za impso,
• mphamvu zamatsenga zakutsogolo.

Echocardiography

Iyi ndi njira yowerengera kusintha kwa kusintha kwa mtima ndi magwiridwe ntchito a mtima pogwiritsa ntchito ultrasound. Njirayi ndiyofunikira pakuwunika mtima wamtima. Imatsimikiza kukula kwa mtima ndi miniti ya mtima, kusintha kwa kuchuluka kwa mtima, komanso zimakupatsani mwayi kuwona ntchito ya mtima munthawi yeniyeni.

Njirayi imagwiritsidwa ntchito poyesa kuwonongeka kwa minofu yamtima chifukwa cha sclerosis ya capillaries ya mtima. Poterepa, voliyumu yamtima imatsika m'munsi mwake malita 4.5 - 5, ndi kuchuluka kwa magazi komwe mtima umagwirizana ndi chimodzi.kuchuluka kwa sitiroko) pansi pa 50 - 70 ml.

Kufotokozera zam'madera akumunsi

Iyi ndi njira yofufuza momwe magazi amayendera m'mitsempha, pankhaniyi m'matumbo am'munsi.Zimakuthandizani kuzindikira kuthamanga kwa magazi m'mitsempha ndikuwona komwe amachepetsa. Komanso, njirayi imawunikira momwe mitsempha ilili, momwe amagwirira ntchito ndi ma valve.

Njirayi ndiyovomerezeka kwa anthu omwe ali ndi phazi la matenda ashuga, zilonda zam'mimba kapena zodwala zam'munsi. Amasanthula kuchuluka kwa kuvulala konse ndi njira zina zochiritsira. Ngati palibe kufalikira konsekonse kwa mitsempha yamagazi, ndipo magazi atha kubwezeretsedwanso, ndiye kuti lingaliro limapangidwa mokomera chithandizo chamankhwala. Ngati, pa dopplerography, kuphatikizira kwathunthu kwamatumbo kwapezeka, popanda mwayi wobwezeretsa magazi, izi zimalankhula ndikuthandizidwenso.

Impso Ultrasound

Kufufuza kwa Ultrasound kumakupatsani mwayi wowunika kusintha kwa impso - kukula kwake, kufanana kwa parenchyma, kukhalapo kwa fibrosis mmenemo (kuchuluka kwa minofu yolumikizika) Njira imeneyi ndiyofunika kwa odwala omwe ali ndi matenda ashuga nephropathy. Komabe, amawona kusintha komweko mu impso komwe kumachitika kale motsutsana ndi maziko a kulephera kwa impso. Chifukwa chake, pamapeto komanso matenda a shuga, a paftyma ya impso imasinthidwa ndi minofu yolumikizana (wonyeka,, ndipo impsoyo imacheperako.

Matenda a shuga a nephropathy amadziwika ndi kupukusa ndi nodular nephrossteosis. Mbali yoyamba, kukula kwa minofu yolumikizika kumawonedwa mosasinthika. Mu malo achiwiri sclerosis amadziwika mu mawonekedwe a mafupa. Pa ultrasound, malo awa a sclerosis amawonekera mwa mawonekedwe a hyperechoic foci (zida zopepuka zimawonekera pa polojekiti).

Chithandizo cha matenda ashuga angiopathy ndi wowerengeka azitsamba

Chithandizo cha mankhwala ochizira matenda a shuga:

• tiyi
• infusions
• amalipiritsa a mankhwala
• osambira
• compresses.

Monga chopangira chachikulu, mbewu zamankhwala zimagwiritsidwa ntchito zomwe zimachiritsa thupi.

Mitundu yowonekera yomwe mbewu zamankhwala zimakhala:

• ambiri kulimbikitsa zotsatira - ginseng, eleutherococcus, mseru, leuzea.
• monga mahomoni ndi zochita za insulin - clover, dandelion, nettle, elecampane,
• metabolic zotsatira - knotweed, blueberries, maluwa a linden, wort wa St.
• ntchito yomwe imachepetsa kufunika kwa insulin - mabulosi akutchire, peyala, chimanga, makangaza, chicory,
• immunostimulating effect - phiri phulusa, lingonberry, duwa lakuthengo,
• shuga wotsitsa - mphamvu yamahatchi, mphukira (maluwa), birch (masamba ndi masamba),
• insulin-yosangalatsa zotsatira - masamba a arnica, muzu wa ginger, stigmas chimanga.

Pokonzekera mankhwala achilengedwe, muyenera kutsatira zomwe zalembedwa ndi mankhwala ndi mankhwala. Kuti chithandizo chamankhwala azikhalidwe chikhale chopindulitsa, malamulo ena ayenera kutsatiridwa.

Malamulo oyambira azitsamba:

• ngati zizindikiro za tsankho zinaonekera (zotupa, kuyabwa, kutentha, kuzizira,, mankhwala ayenera kuyimitsidwa,
• Zomera zakugula ziyenera kugulidwa ku malo ogulitsa mankhwala. Zogula kuchokera kwa anthu wamba ziyenera kuchepetsedwa, makamaka ngati mukufuna chomera chosowa chomwe mawonekedwe ake sadziwika kwa wodwala,
• Mukamagula mbewu ku malo ogulitsa mankhwala, muyenera kudziwa nthawi yakwana,
• kunyumba, muyenera kutsatira malangizo osungira zitsamba (nthawi, zochitika ndi zina zambiri),
• Kutolere kwakudziwika kwa mankhwala azachipatala ndikotheka ngati malamulo a njirayi adadziwika.

Tiyi imakonzedwa ku mankhwala azomera ndipo m'malo mwake ndi kumwa ndiye khofi, zobiriwira komanso tiyi wakuda. Zabwino zamowa zimasungidwa kwakanthawi kochepa. Chifukwa chake, konzekerani kumwa tiyi tsiku lililonse ndikuisunga mufiriji.

Tiyi wa Chamomile
Tiyi wa Chamomile ali ndi tanthauzo lothetsa shuga. Komanso, chakumwachi chili ndi zotsatira zoyipa komanso zotsutsana ndi kutupa. Tiyenera kudziwa kuti zakumwa zochokera ku chamomile ndizothandiza pantchito.Chifukwa chake, anthu omwe ali ndi magazi ochulukirachulukira ayenera kupewa kumwa tiyi. Kuti mupange tiyi, muyenera kutenga supuni ziwiri za chamomile (15 magalamundi kuthira madzi otentha (Mililita 250) Siyani kapangidwe kake kwa theka la ola kuti mumalize, kenako kupsyinjika ndi kumwa mu mawonekedwe otentha kapena otentha.

Tiyi wa Linden
Tiyi ya Linden imatsitsa shuga ndipo chifukwa chake amalimbikitsidwa pa matenda a shuga angiopathy. Komanso, chakumwa cha laimu chimakulitsa chitetezo chathupi ndipo chimalepheretsa kukula kwa zovuta. Tiyi imayenera kukonzedwa kuchokera ku mbewu zowuma, zomwe zimayenera kugulidwa ku malo ogulitsa mankhwala. Ndi msonkhano wodzipangira wekha, mitengo yomwe ikukula pafupi ndi misewu ndi mafakitale iyenera kupewedwa.
Kuti mupeze lita imodzi ya tiyi muyenera kuphatikiza lita imodzi ya madzi otentha (4 makapu) ndi supuni zinayi zokhala ndi phiri lazomera youma. Gwiritsani ntchito moto kwa mphindi zisanu mpaka khumi, kupewa kuwira. Mutha kumwa tiyi wa linden popanda zoletsedwa kwa mwezi umodzi, ndiye kuti mufunika kupuma kwa milungu iwiri kapena itatu.

Tiyi wa Blueberry Leaf
Masamba a Blueberry amakhala ndi neomyrtillin - chinthu chomwe chimachepetsa shuga. Kuti mupange chakumwa, muyenera kutenga supuni ya masamba atsopano osenda bwino, kuthira magalasi awiri amadzi otentha (500 mamililita) ndikukhala kwa mphindi zisanu pamoto wochepa. Imwani tiyi wa tiyi ayenera kukhala mphindi khumi ndi zisanu musanadye, pogwiritsa ntchito kuchuluka kwa zakumwa tsiku limodzi.

Kuchokera ku blueberries mutha kupanga chakumwa, chomwe chilinso ndi michere yambiri. Tengani ma gramu makumi awiri ndi asanu a zipatso zatsopano (supuni imodzi yokhala ndi pamwamba), kulumikizana ndi kapu yamadzi (Mililita 250) ndikuyimiranso moto kwa mphindi khumi ndi zisanu, osatentha. Mphindi khumi musanadye, imwani supuni ziwiri (35 mamililita) kulowetsedwa kangapo patsiku.

Sage tiyi
Sage imayambitsa zochitika za insulin mthupi, chimachotsa poizoni ndikulimbitsa chitetezo cha mthupi. Ndikofunikira kudzaza thermos ya masamba owuma a sage (mmodzi kapena awiri supuni), kutsanulira kapu yamadzi otentha (Mililita 250) ndi kupita kukapereka kwa ola limodzi. Imwani chakumwa chizikhala kawiri kapena katatu patsiku, magalamu 50 (chikho chimodzi chachisanu) Pa nthawi yoyembekezera, kuyamwitsa ndi hypotension, tiyi ndi maphikidwe ena oyambira ayenera kutayidwa.

Tiyi waku Lilac
Tiyi ya Lilac imasintha shuga. Kumayambiriro kwa kasupe, masamba a lilac amagwiritsidwa ntchito, kumapeto kwa masika - maluwa, ndipo nthawi yachilimwe mutha kumwa zakumwa zobiriwira za masamba awa. Muyenera kupanga tiyi mu thermos. Supuni ya masamba kapena maluwa a lilac ayenera kuthiridwa ndi lita imodzi ya madzi otentha. Imwani zakumwa katatu patsiku musanadye, 85 mamililita (gawo limodzi mwa magawo atatu agalasi).

Kumwedwa pafupipafupi chifukwa cha mankhwala opangira mankhwala kumathandizira kupanga insulini, kusintha njira zama metabolic ndikulimbitsa chitetezo cha mthupi. Zitsamba zingapo zimakhala ngati mankhwala a antidiabetic, kusintha ntchito ya kapamba ndi kusintha kagayidwe kabwino.

Nyemba kulowetsedwa
Kuphatikizidwa kwa tsamba la nyemba kumakhala ndi mankhwala a arginine, omwe ali ndi vuto lofanana ndi insulin m'thupi. Kuti mukonzekere kulowetsedwa, mumafunikira masamba ochepa nyemba (100 magalamu) Ikani thermos. Onjezerani lita imodzi yamadzi otentha ndikusiya kwa maola angapo. Kulowetsedwa ndikusokonekera kuyenera kumwedwa theka la ola musanadye. Kugwiritsa ntchito masamba a nyemba ngati gawo lalikulu, mutha kukonzekera kulowetsedwa ndi zotsatira zosiyanasiyana.

Zopangira pokonzekera kulowetsedwa:

• Masamba a nyemba - supuni zisanu (100 magalamu),
• Hypericum perforatum - supuni ziwiri (40 magalamu),
• ntchafu - supuni ziwiri (50 magalamu),
• hatchi - supuni ziwiri (40 magalamu),
• mbewu za fulakesi - supuni (10 magalamu).

Supuni yosakaniza ndi zosakaniza pamwambapa iyenera kuyendetsedwa tsiku ndi tsiku mu thermos ndi kapu imodzi yamadzi otentha (Mililita 250) Muyenera kumwa m'magawo ang'onoang'ono tsiku lonse, ndipo m'mawa wotsatira kukonzekera kulowetsedwa kwatsopano. Kugulitsa mahatchi kumatha kuyeretsa thupi, kumatha poizoni. Wort wa St. John ali ndi antimicrobial ndi antiseptic. Mbewu za fulakesi zimabwezeretsa magwiridwe antchito a kapamba, omwe amapanga insulin.

Dandelion Muzu kulowetsedwa
Mizu ya Dandelion imakhala ndi inulin, yomwe ndi analogue yochokera ku mbewu. Komanso mizu ya dandelion imaphatikizanso fructose, yomwe imakamizidwa ndi thupi mwachangu kuposa glucose. Kuchuluka kwa inulin ndi fructose kumapezekanso mu chicory ndi Yerusalemu artichoke.

Kukonzekera kulowetsedwa, supuni ziwiri za mizu ziyenera kudzazidwa mu thermos mu mawonekedwe owuma kapena atsopano. Thirani madzi okwanira lita imodzi4 makapu) ndi kuchoka usiku. Muyenera kumwa chakumwa masana, kumwa mankhwalawa kwa mphindi khumi kapena khumi ndi zisanu musanadye.

Malipiro a mankhwala osokoneza bongo

Kutola nambala 1
Zomera zopeza:

• Arnica (maluwa ndi masamba),
• hawthorn
• muzu wa elecampane
• masamba a nettle - theka mwazonse,
• masamba a mabulosi - theka theka.

Zomera zouma ziyenera kuphwanyidwa mu chopukusira cha khofi, chatsopano - chosadulidwa. Ndikofunikira kukonzekera kulowetsedwa tsiku ndi tsiku, popeza zitsamba zomwe zimapangidwira nthawi yayitali kuchokera pazothandiza zimakhala zovulaza. Supuni ya chopereka, kuthira madzi otentha, ndikofunikira kupita kukapereka kwa ola limodzi. Sakani ndi kumwa ma millilita 85 (gawo limodzi mwa magawo atatu agalasi) mphindi khumi asanadye.

Kutola nambala 2
Kulowetsa zitsamba kotereku kumayenera kutengedwa pasanathe sabata limodzi, kupuma pang'ono ndikofunikira. Muyenera kugwiritsa ntchito decoction gawo limodzi mwa magalasi atatu (65 mamililita) mphindi khumi asanadye.

Zofunikira pakukonzekera zopereka:

• mbewu za fulakesi - magalamu khumi,
• muzu wa elecampane - 20 magalamu,
• masamba a nettle - 30 magalamu,
• mahatchi - 30 magalamu.

Kusamba kwazitsamba kumathandiza kuchepetsa mwayi wokhala ndi zovuta za matenda ashuga. Kuchiza ndi kusamba kwazitsamba kumalepheretsa kuwonongeka kwa mitsempha yotumphukira, yomwe imathetsa chiopsezo chokhala ndi phazi la matenda ashuga.

Mosasamala kanthu za mawonekedwe azitsamba omwe amagwiritsidwa ntchito pokonzekera kusamba, malamulo awa ayenera kutsatiridwa pambuyo pa njira zamadzi:

• osatengera zolimbitsa thupi mkati mwa maola awiri mutatha kusamba,
• pewani kudya zakudya zozizira kapena zakumwa pambuyo pa njirayi.
• kupatula kugwiritsa ntchito mankhwala oyipa ndi oopsa mkati mwa maola 24 mutatha kusamba.

Kusamba kwa Wheatgrass
50 magalamu a mizu yowuma ya tirigu wosirikiza amathira madzi otentha (imodzi mpaka malita awiri) ndikukhala pamoto kwa mphindi khumi mpaka khumi ndi zisanu. Thirani msuzi mubafa wadzaza ndi madzi, kutentha kwake osapitirira 35 digiri. Kutalika kwa njirayi sikupitilira mphindi khumi ndi zisanu. Njira yosambira imakhala tsiku lililonse kwa milungu iwiri, pambuyo pake yopuma sabata imafunikira.

Malo osamba oyera
Dzazani 50 magalamu a chomera ndi madzi (magalasi awiri kapena atatu) ndikukakamira angapo (awiri kapena atatu) maola. Kenako, ikani moto ndi kulowetsa moto pang'ono kwa mphindi makumi awiri. Sesa msuzi ndikuwonjezera pakusamba ndi madzi (35 - 37 madigiri) Njira yamadzi imeneyi iyenera kuchitidwa asanagone kwa masiku khumi mpaka khumi ndi awiri.

Kusamba ndi Yerusalemu artichoke
Kukonzekera kusamba ndi Yerusalemu artichoke, konzekerani kilogalamu imodzi ndi theka yosakaniza nsonga, maluwa, tubers (zatsopano kapena zowuma) Thirani Yerusalemu artichoke ndi ndowa imodzi yamadzi otentha (malita khumi) ndi kuvala pang'ono moto. Pakatha mphindi khumi kapena khumi ndi zisanu za chithupsa chaching'ono, chotsani pamoto ndikusiya kuti mumupatse mphindi makumi awiri. Sesa msuzi ndikuwonjezera pakusamba kwamadzi (35 - 40 madigiri) Kusamba ndi Yerusalemu artichoke ayenera kukhala kamodzi masiku awiri kwa masabata awiri kapena atatu.

Kusamba kwawoko
Tengani magalamu 50 a malo owuma a phula ndipo mudzaze ndi lita imodzi (4 makapu) madzi otentha. Pambuyo maola awiri kulowetsedwa, onjezerani kusamba, kutentha kwa madzi komwe sikuyenera kupitirira madigiri 37. Ndikofunikira kuchita njirayi musanayambe kugona milungu iwiri. Kutalika kwa bafa kumatenga mphindi khumi mpaka khumi ndi zisanu.

Imathandizira kuchiritsa kwa mabala ammapapo odwala matenda ashuga angiopathy, njira zina zamankhwala zimapatsa compress ndi mavalidwe ozikidwa pamitengo ya mankhwala ndi mafuta.

Mavalidwe azitsamba
Kukonzekera compress, pogaya chophatikizacho mu Chinsinsi ndikugwiritsira ntchito zilonda zanu. Unyinji umakhazikitsidwa ndi bandeji. Musanagwiritse ntchito phazi lanu, muzisamba ndi madzi ofunda. Mukachotsa bandeji, muzimutsuka ndi kuvala masokosi athonje odera. Pafupipafupi pazitsamba zazitsamba mumakhala kawiri kapena katatu patsiku.

Zopangira compress:

• Masamba ophatikizika ndi masamba atsopano a marigold,
• Masamba ophwanyidwa ndipo pafupifupi mawonekedwe a mtima wowongoka,
• nettle louma limasiya fumbi.

Mafuta compress
Ma compress otengera mafuta, zitsamba ndi zinthu zina zopindulitsa zimakhala ndi mphamvu yochiritsa zilonda zam'mimba ,fewetsani khungu ndikuchepetsa ululu.

Zopangira uchi compress:

• mafuta oyeretsa masamba - 200 magalamu,
• utomoni wa paini kapena spruce - 50 magalamu (utomoni uyenera kugulidwa ku malo ogulitsa mankhwala kapena m'masitolo apadera),
• njuchi - 25 g.

Ikani mafutawo mu mbale yachifundo pamoto ndikubweretsa. Onjezani sera ndi utomoni ndikuyatsa moto kwa mphindi zina 5 mpaka 10. Tizilitsa kapangidwe ka kutentha kwa firiji, kuvala bandeji. Tsekani pachilonda ndikuchoka kwa mphindi makumi awiri mpaka atatu. Ndondomeko ziyenera kuchitika tsiku lililonse.

Kuwongolera shuga

Kwa anthu omwe ali pachiwopsezo, ndikofunikira kuchita mwatsatanetsatane kuyesedwa kwa magazi pazokhuza shuga. Izi zikuyenera kuchitika molingana ndi ndandanda yapadera, yomwe othandizira amathandizira kujambula. Anthu omwe ali onenepa kwambiri kapena omwe ali ndi achibale apamtima omwe ali ndi matenda ashuga amayenera kuwonanso shuga wawo kangapo pa sabata. Masiku ano pogulitsa pali zida zapadera zomwe zimathandizira kuti pakhale kuyang'ana palokha shuga m'magazi. Kuyankha kwakanthawi pakuwonjezeka kwa shuga kumathandizira kupewa zovuta.

Pambuyo pakupezeka kwa matenda a shuga, kupewa kumalimbana ndi kupewa zovuta. Mlingo wa cholesterol m'magazi ndi chizindikiro chomwe chimayenera kuyang'aniridwa, chifukwa kuchuluka kwake kumayambitsa matenda a mtima komanso kuwonongeka kwa minofu. Miyezi ya shuga ikakwera pamwamba pa 10 mmol / lita, imalowa mu fungo la impso ndikuwonekera mkodzo. Chifukwa chake, tikulimbikitsidwa kuti tisalole kuwonjezeka kwa kusala kwa glucose pamtunda wa 6.5 mmol / lita. Nthawi yomweyo, munthu sangalole kutukuka komanso kutsika kwa shuga m'magazi, chifukwa kusinthasintha kwenikweni kwa glycemia komwe kumawononga mitsempha ya magazi.

Ma paramu omwe amayenera kutsatidwa mu matenda a matenda ashuga:

• kudya kwa glucose: 6.1 - 6.5 mmol / lita,
• glucose maola awiri mutatha kudya: 7.9 - 9 mmol / lita,
• glycosylated hemoglobin: 6.5 - 7.0% ya hemoglobin yonse,
• cholesterol: 5.2 - 6.0 mmol / lita,
• kuthamanga kwa magazi: osapitirira 140/90 mmHg.

Ngati matenda ashuga angiopathy ali ovuta ndi kukula kwa matenda a mtima kapena matenda a hypoglycemic, ndiye kuti magawo amasiyanasiyana pang'ono.

Magawo omwe amayenera kutsatidwa ndi matenda ashuga a shuga omwe amaphatikizika ndi matenda a mtima, komanso zochitika pafupipafupi za hypoglycemic:

• kudya kwa glucose: 7.8 - 8.25 mmol / lita,
• glycosylated hemoglobin: 7 mpaka 9 peresenti,
• kusinthasintha kwa glycemic pakatha tsiku osapitilira 10 - 11 mmol / lita.

Chakudya

Omwe ali pachiwopsezo amayenera kuwongolera kuchuluka ndi zakudya zomwe zimagwiritsidwa ntchito popewa angiopathy. Zakudya ziyenera kukhala zopindika, chakudya chizimayenera kutengedwa kasanu patsiku m'magawo ang'onoang'ono, kupewa nkhawa kapena kusasangalala. Kuchuluka kwa zomanga zam'mimba zomwe zimamwetsa mosavuta ziyenera kuchepetsedwa. Gululi la zinthu limaphatikizapo shuga, makeke ndi mikate yoyera, maswiti, uchi. Kuperewera kwa shuga kungalipiridwe ndi okometsetsa komanso masamba abwino ndi zipatso. Zakudya za nthochi, mphesa ndi zipatso zina zokhala ndi shuga wambiri ziyenera kuchepetsedwa.

Lamulo la zopewera polimbana ndi matenda ashuga a shuga:

• osapatula ntchito yokazinga ndi kusuta zakudya,
• onjezani anyeziyophika kapena yophika),
• onjezani zipatso zosaphika ndi ndiwo zamasamba zodyeka,
• Zakudya zathanzi, zophika kapena zophika ziyenera kupezeka m'zakudya
• nyama zamafuta (mwanawankhosa, nkhumba) akuyenera kusinthidwa ndi konda (nkhuku, nkhuku, nkhuku),
• mukaphika nkhuku, chotsani khungu ku nyama
• zakudya zamzitini ndi zopatsa thanzi zimafunika kuchepetsedwa
• kukonza njira yogaya mafuta, zonunkhira ziyenera kuwonjezeredwa ku chakudya (kupatula tsabola wotentha).

Ndi chikhumbo chachikulu chokoma, chokoleti ndi zinthu kuchokera mmalo mwake zitha kusinthidwa ndi marmalade kapena marshmallows. Mutha kutsekemera compote ndi zakumwa zina ndi chimanga, mabulosi akutchire, rasipiberi. Zogulitsanso ndizinthu zapadera za confectionery pomwe shuga amasinthidwa ndi kupanga kapena zotsekemera zachilengedwe. Tiyenera kukumbukira kuti kuchuluka kwa mitundu ingapo yopanga shuga kumavulaza thanzi.

Zakudya zopewera matenda a matenda ashuga:

• mankhwala okalamba
• mpunga, chakudya chambiri ndi barele, oatmeal,
• oat, tirigu, mpunga, chinangwa,
• mbatata ndi zakudya zina zambiri zapamwamba.

Kupukusa chakudya chamafuta kumafuna nthawi yambiri kuposa zakudya zina. Zotsatira zake, shuga amapita pang'onopang'ono m'magazi ndipo kapamba amakhala ndi nthawi yokwanira yopanga insulin, ndipo thupi limatha kuyamwa. Pali zakudya zingapo zomwe zimachepetsa shuga m'magazi, zimalimbikitsa kupanga insulin, komanso zimathandizira kugwira ntchito kwa kapamba.

Zinthu zopatsa mphamvu za pancreatic:

• sauerkraut,
• mabuluni
• nyemba zobiriwira
• sipinachi
• udzu winawake.

Kusamala kwamadzi
Kusungabe madzi athanzi ndi njira imodzi yofunika kwambiri yopewera matenda ashuga. Madzi okwanira amalimbikitsa kupanga insulin ndi kuyamwa kwake ndi thupi. Kuti maselowo azikhala ndi chinyezi chofunikira, muyenera kumwa pafupifupi malita awiri amadzimadzi patsiku (magalasi asanu ndi atatu) Mumakonda mchere womwe umakhalabe wamadzi, wopanda zitsamba wazitsamba ndi zipatso. Popewa matenda a shuga a shuga, ndikofunika kuti muthe madzi a makangaza, nkhaka yatsopano, madzi a maula.
Zakudya zamafuta zimayenera kuchepetsedwa ngati vuto laimpso, ochepa matenda oopsa.

Kusamalira miyendo

Kusamalira miyendo kumathandiza kwambiri popewa matenda ashuga angiopathy. Sungani mapazi anu oyera ndikutsatira malamulo onse posamalira iwo. Ngati khungu lanu ndi louma, muyenera kugwiritsa ntchito moisturizer, kuphatikizapo urea. Nsapato zimayenera kuvala bwino, osayambitsa zosasangalatsa (kupukusa, kufinya) Nsapato zachikopa zokhala ndi insoles zopangidwa ndi zinthu zachilengedwe ziyenera kukondedwa. Sankhani mitundu yayitali kwambiri yazala komanso nsapato zazitali. Pewani kuvala masokosi opangidwa ndi zinthu zopangidwa mwaluso. Onetsetsani kuti mapazi anu sakudwala hypothermia kapena kutentha kwambiri.Pewani abrasions, mabala, mabala. Kugwiritsa ntchito chimanga panthawi yake, kugwiritsa ntchito ma antiseptic othandizira komanso kupenda mayendedwe amiyendo kupewa kupewa matenda ashuga.

Malamulo osamalira odwala ashuga am'munsi miyendo:

• Madzulo aliwonse, mapazi ayenera kutsukidwa ndi madzi ofunda ndi potaziyamu permanganate ndi sopo wa ana,
• Pambuyo pa kayendetsedwe ka madzi, miyendo iyenera kuphimbidwa ndi thaulo, kugwiritsa ntchito kirimu ya bactericidal ndikudzoza khungu pakati pa zala ndi mowa,
• muyenera kudula zoseweretsa kamodzi pa sabata pamakona akumanja,
• osatengera njira zopopera ndi kufewetsa khungu la miyendo,
• osayika mapazi pafupi ndi moto, poyatsira moto kapena zida zina zotenthetsera,
• Musayike nsapato zatsopano popanda phazi,
• osagwiritsa ntchito nsapato za anthu ena, masokosi, matawulo amiyendo,
• m'malo a anthu onse (hotelo, dziwe, sauna) gwiritsani ntchito nsapato zotayidwa.

Ngati mukuwona msomali woloza, ming'alu kapena mabala kumapazi, ngati mukumva kupweteka poyenda komanso kutayika kwathunthu kwa miyendo, muyenera kufunsa katswiri.

Zochita zolimbitsa thupi

Njira zodzitetezera polimbana ndi matenda a shuga komanso zovuta zake zimaphatikizapo masewera ndi masewera olimbitsa thupi.

Mitundu yochita zolimbitsa thupi mu matenda a shuga:

• amayenda m'mapaki, mabwalo,
• kuyendera dziwe losambira
• kuyendetsa njinga
• Kuyenda masitepe m'malo mokweza,
• kutsitsa mayendedwe akugwiritsa ntchito mayendedwe ofuna kuyenda,
• kuyenda m'nkhalango.

Mukakhala mu mpweya watsopano, kagayidwe kamthupi kamayenda bwino, kapangidwe ka magazi kamasinthidwa. Maselo amafuta amawonongeka mwachilengedwe, ndipo glucose samayenda m'magazi. Ngati pali zovuta zowoneka kuti ndinu wonenepa kwambiri, muyenera kuchita mphindi 30 pa masewera. Masewera olimbikitsidwa ndi mtundu wa katundu ziyenera kusankhidwa malinga ndi momwe thupi liliri, pokambirana ndi dokotala.