Matenda a mtima ndi matenda ashuga

Myocardial infaration ndi imodzi mwazovuta zazikulu za matenda ashuga. Matenda obwera chifukwa cha kusokonezeka kwa metabolic amasokoneza ntchito ya ziwalo zonse zofunika kwambiri za thupi. Zotsatira zake, chiopsezo cha matenda amtima wamagazi chikukula.

Matenda a shuga ndi matenda ovuta kwambiri pamene shuga wa m'magazi amalepheretsa kugwira ntchito kwa mtima. Thrombosis imayambitsa kuchepa kwamitsempha yamagazi, magazi amayenda. Mwazi umakhala wonenepa komanso wowoneka bwino, kapangidwe kake amasintha. Matendawa amakula msanga, amatuluka kwambiri. Chithandizo cha nthawi yayitali chikufunika kuganizira za pathologies zomwe zimayambitsidwa ndi shuga wambiri.

Matenda a shuga amatchedwa "mtima wodwala"

Mu odwala matenda ashuga, kuwonjezeka kwa kuthamanga kwa magazi kumayang'aniridwa makamaka, chifukwa, mtima umakula kukula, aortic aneurysm imachitika, yomwe nthawi zambiri imayambitsa kukhumudwa kwamtima. Pangozi ndi anthu omwe ali ndi mikhalidwe ina:

matenda obadwa nawo,
kusuta (kuwirikiza kuwopsa kwa vuto la mtima),
uchidakwa
kuthamanga kwa magazi
onenepa kwambiri.

Mu odwala matenda ashuga, kagayidwe kachakudya kamachepa, chitetezo chokwanira chimachepa, angina pectoris amakula. Pali kufunikira kwakanthawi kochita opaleshoni yam'mimbayo ndi kuuma. Chodabwitsa ndichakuti nthawi zambiri vuto la mtima limayamba popanda zizindikiro zopweteka chifukwa chakuchepa kwa chidwi cha minofu ya mtima.

Matenda a shuga kunyumba. Patha mwezi kuchokera pamene ndayiwala za kudumphira shuga komanso kumwa insulin. O, momwe ine ndimavutikira, kukomoka kosalekeza, kuyimba mwadzidzidzi. Kodi ndapita kangati kwa endocrinologists, koma amangonena chinthu chimodzi - "Tengani insulin." Ndipo tsopano masabata 5 apita, popeza kuchuluka kwa shuga m'magazi ndikwabwinobwino, osati jakisoni imodzi ya insulin ndipo chifukwa chonse cha nkhaniyi. Aliyense amene ali ndi matenda ashuga ayenera kuwerenga!

Matendawa amakula msanga, mavuto amabwera mpaka amapha. Myocardial infaration kwa odwala omwe amadwala matenda a shuga amakwiya kwambiri. Hypoxia imatheka chifukwa chobowoleza mpweya m'matupi.

Kupezeka kwa mapuloteni mumkodzo ndi chizindikiro chosavomerezeka cha matenda amtima wamatenda a shuga.

Zomwe zimayambitsa matenda a mtima mu matenda ashuga ndizovuta zazing'ono zamkati mwa mtima. Kusayenda bwino kwa magazi kumayambitsa matenda a ischemia ndi matenda osokoneza bongo. Njira zosasinthika za necrotic zimachitika. Njira zobwezeretsa zimasokonekera, kukula kwa vuto lalikulu lolimbana ndi mtima kumachitika kawirikawiri kuposa mwa anthu athanzi. Zotsatira zake ndi zovuta zake zimakhala zovuta kwambiri. Pamafunika kukonzanso kwakutali, kutsatira mosamalitsa malingaliro a madokotala, zakudya zoyenera.

Mitundu ikulu ya matenda a mtima mwa odwala matenda ashuga amathandizira pazinthu zingapo:

zotumphukira zamasana,
kusokoneza endarteritis,
vasculitis
matenda a shuga ndi nephropathy
dyslipidemia.

Kuneneratu za matenda am'mtima mwa odwala matenda ashuga, mutha kugwiritsa ntchito njira yolimbikitsira zizindikiro za glycemia. Mlingo wa shuga umasungidwa pamtunda kuchokera pa 6 mpaka 7.8 mmol / L, mtengo wololeza wambiri ndi 10. Sayenera kuloledwa kutsikira pansi 4-5 mmol / L. Mankhwala a insulin ndi omwe amaperekedwa kwa odwala omwe ali ndi matenda a shuga 1 ndipo anthu omwe ali ndi hyperglycemia, omwe amapitilira 10 mmol / l, zakudya za makolo, mawonekedwe oopsa a matendawa. Ngati kumwa mapiritsi sikuthandiza, odwala amamuika insulin.

Mankhwala ochepetsa mphamvu ya glucose amatchulidwa pambuyo pokhazikika kwa kusakhazikika kwa coronary insufficiency. Mayendedwe akulu a mankhwalawa amachokera m'mnyewa wamtima:

matenda a shuga
cholesterol yotsika
kusungabe kuthamanga kwa magazi pamlingo wa 130/80 mm RT. Art.,
Maanticoagulants a magazi
Mankhwala a mtima ndi kuchiza matenda a mtima.

Wodwala amayenera kutsatira mndandanda wonse wamoyo.

Zizindikiro za vuto la mtima mwa anthu omwe ali ndi matenda ashuga

Odwala omwe ali ndi matenda a shuga, chifukwa chakuchepa kwa chidwi cha minofu, samazindikira kusintha kwa pathological chifukwa chosowa ululu. Zizindikiro zosiyanasiyana zimagwirizanitsidwa ndi matenda ena. Nthawi zina kumangoyesedwa kochitika kumavumbula vuto la mtima. Matendawa amapita patsogolo, njira zake sizingasinthike.

Ndi matenda a shuga, vuto la mtima limatha kuwonekera m'njira zosiyanasiyana:

kusanza popanda chifukwa
malaise
kusokonezeka kwa mtima
kufooka
kupuma movutikira
kupweteka pachifuwa
kupweteka kukhosi, khosi, phewa, kapena mkono.

Kwa odwala matenda ashuga, ndikofunikira nthawi zonse kunyamula mapiritsi a nitroglycerin.

Ziwerengero zimatsimikizira kuti amuna amakhala ndi vuto la mtima nthawi zambiri. Mwa azimayi omwe ali ndi matenda ashuga, Zizindikiro sizitchulidwa pang'ono, samakhala pachiwopsezo cha myocardial infarction.

Nthawi zambiri zizindikiro zoyambirira za matendawa zimachitika chifukwa chogwira ntchito mopitirira muyeso, kutopa, kuzizira, thupi. Kuzolowera moyo kumva kupweteka pakubala, masiku ovuta, azimayi samayanjana ndi mavuto amtima. Chiwopsezo chikuwonjezeka ndi ukalamba, pamene kulemera kowonjezera thupi kumawonekera, kuthamanga kwa magazi kumakwera, ma pathologies okhudzana ndi zaka akuwonjezeredwa, ndipo matenda osachiritsika akuwonjezereka.

Nthawi zina ndi MI nthawi zambiri pamakhala kusasangalala, kutentha kwa mtima. Mukusuta, kumayendetsedwa ndi kupuma pang'ono ndi chifuwa, zomwe zimadziwika ndi zotsatira za chizolowezi choyipa. Zikatero, vutoli limangodziwika pa mtima. Mitundu yoopsa kwambiri imafotokozedwa ndi boma lodzidzimutsa, kusazindikira, pulmonary edema.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, mavuto ali ndi malingaliro awoawo. Kuopsa kwa vuto la mtima kumawonekera mwa anthu kuyambira ali aang'ono. Zizindikiro:

Kutupa ndi kupindika kwa miyendo,
kukodza pafupipafupi
kutopa,
kuchuluka kwambiri kwa thupi
chizungulire.

Kugunda kwamtima ndi matenda a shuga a shuga kwa anthu omwe akudwala matenda kwa nthawi yayitali kumakhala kovuta kwambiri. Kuphwanya ntchito zolimbitsa thupi kumawonjezera chiopsezo cha zovuta, pali ngozi ya kufa. Mwa odwala, kulephera kwa mtima ndi asymptomatic, koma mwachangu kwambiri, nthawi zina mwachangu. Ndikofunika kuchitapo kanthu panthawi komanso kupereka mankhwala okwanira.

Zambiri zamatenda a mtima odwala matenda ashuga:

kuchuluka kwa anthu odwala matenda oopsa kwambiri
kuchulukana kwawombana
kuthekera kwakufa ndikokwera kuposa anthu athanzi.

Ngati sanapatsidwe, "matenda a shuga" ali pachiwopsezo chachikulu kuti aleke.

Kugunda kwamtima ndi matenda ashuga kumawonjezera chiopsezo cha matendawa komanso kuthekera kwamavuto kawiri.

Matenda a shuga pambuyo vuto la mtima

Nthawi zambiri pokhapokha ngati mtima wapezeka ndi vuto lalikulu la shuga m'magazi ndikupezeka ndi matenda a shuga, mtundu ndi mawonekedwewo zimatsimikiziridwa.

Mavuto a mtima amakwiya chifukwa cha kuchuluka kwa glucose, chifukwa chomwe magazi amawasokoneza, njira zosasinthika zimachitika. Kusanthula ndi kulandira chithandizo kumachitika mokwanira. Pang'onopang'ono, mu Mlingo yaying'ono, insulin imayang'aniridwa, kupuma kwamtima kumachitika. Zotsatira zimatengera mtundu ndi mawonekedwe a matenda omwe adapezeka, zikuwonetsa zamankhwala, zochizira zochizira zimayikidwa. M'magawo oyamba, insulin siigwiritsidwa ntchito.

Odwala omwe ali ndi matenda ashuga amapatsidwa mitundu iwiri ya kukonzanso pambuyo vuto la mtima:

zolimbitsa thupi (masewera ndi masewera)
zama psychology (kufunsa, psychotropic mankhwala ngati kuli kofunikira).

Mukachira kwathunthu, kuyenda kwakanthawi mlengalenga, masewera olimbitsa thupi amalimbikitsidwa. Popewa, amachititsa magawo a psychotherapy omwe cholinga chake ndi kukhazikika kwamanjenje. Mitundu yonse ya zojambulajambulajambula ndiyotchuka.

Zakudya za matenda a mtima ndi matenda ashuga

Thanzi limayikidwa kutengera nyengo ya matendawa. Pofuna kupewa zovuta komanso kuyambiranso ndi matenda ashuga, madokotala amalimbikitsa kudya kwapadera. Zakudya zoyenera zimapangidwa, poganizira za umunthu, kulekerera kwa thupi.

Pakati pa sabata yoyamba ndikofunikira kudya magawo ang'onoang'ono:

supu zosenda masamba ndi mbatata zosenda (kupatula mbatata),
phala (kupatula semolina ndi mpunga),
nyama yokonda ndi nsomba (yophika kapena yowira),
ma-nyama ndi matumba, ophika wopanda mafuta kapena nthunzi,
zopangidwa mkaka ndi zakumwa,
amamu omelet.

Sabata yachiwiri, mbale sizidulidwa. Nsomba ndi nyama muzakudya zimakhalapo nthawi 1 yokha patsiku. Casseroles, masamba osenda amawonjezedwa. Zoyipa:

kusuta
marinade ndi zakudya zamzitini,
tchizi
chokoleti
khofi ndi tiyi wamphamvu.

Zakudya ndizochepa pama calories. Ndiwo zamafuta, msoka, mtedza, ndi mphodza amalimbikitsidwa.

Zakudya zoterezi zimapangidwanso poletsa matenda obwezeretsanso osiyanasiyana. Kuphatikiza ndi kuchuluka kwa zinthu kumawerengedwa ndi dokotala. Odwala ayenera kusungitsa kuchuluka kwa insulin mthupi, kupewa ma shuga.

Zakudya zimatengera zipatso ndi ndiwo zamasamba. Ndikofunika kudya nsomba zowiritsa komanso nsomba zam'nyanja.

Masamba ndi zipatso za matenda ashuga pambuyo vuto la mtima, zomwe akatswiri adalimbikitsa:

tomato
nkhaka
sipinachi
broccoli
kolifulawa, kabichi yoyera ndi maluwa a Brussels,
katsitsumzukwa
mabuluni
yamatcheri
mapichesi
ma apricots
maapulo
malalanje
mapeyala
kiwi

Anthu odwala matenda ashuga amakhala ndi zakudya zapadera moyo wawo wonse. Ndikulimbikitsidwa kusiya mchere, mafuta ndi zakudya zamafuta. Gwiritsani ntchito mafuta a azitona ngati chovala cha saladi. Mfundo zikuluzikulu za zakudya:

kupezeka kwa potaziyamu ndi magnesium mu chakudya,
kupatula zakudya zolemera, nyama zamafuta,
Mbale zonse zilibe mchere,
kukana zakudya yokazinga,
kumwa pang'ono, mpaka 1,2 l,
kupezeka kwa nkhuku muzakudya,
ambiri mafuta mbale
tiyi ndi khofi wamphamvu - tiyi,
masamba abwino okha,
kupatula chokoleti
osadziletsa ku chakudya chamafuta othamanga,
buledi suyenera kukhala watsopano.

Kukoma kwa mbale kumakonzedwa ndi mandimu kapena viniga wa apulo. Nthambi imawonjezeredwa pachakudya monga chowonjezera chowonjezera cha fiber. Chakudya chimayenera kukhala chamagulu, kudya maola onse awiri ndi atatu. Kusala kudya sikuloledwa.

Zakudya zomwe zakumana ndi vuto la mtima ndizosiyana ndi zakudya za anthu odwala matenda ashuga. Izi zimakhudza njira ya matendawa, zimachepetsa chiopsezo cha zovuta. Kusagwirizana ndi zomwe zili ndi zovuta zambiri. Njira zapadera zosinthira zakudya za anthu onenepa kwambiri. Zakudya izi ziyenera kutsatidwa moyo wonse.

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Kupewa

Popeza ndi matenda a shuga, munthu ali pachiwopsezo chachikulu chodwala, ndikofunikira kutsatira malamulo opewera:

Nthawi zonse muziwonetsetsa kuchuluka kwa shuga ndi mafuta m'thupi. Izi zitha kuchitika kunyumba pogwiritsa ntchito zida zapadera.
Onetsetsani kuti mumayendera pafupipafupi endocrinologist ndikupita kukayezetsa magazi pamaphunziro a biochemical. Kutengera ndi kuchuluka kwa zinthu zina, dokotala amatha kuzindikira zopatika zina mu ntchito ya mtima.
Tsatirani zakudya za anthu odwala matenda ashuga ndipo tsatirani malangizo a endocrinologist ndi akatswiri azakudya.
Muyerekeze kuthamanga kwa magazi tsiku lililonse.
Pewani zizolowezi zoyipa.
Sunthani zambiri ndikupumira mpweya wabwino. Ntchito ndiyo prophylactic yabwino yolimbana ndi kuzimiririka m'thupi.

Kupezeka kwakanthawi kofanana kwa kulowerera kwam'mnyewa wam'mimba komanso matenda a shuga kumapangitsa kwambiri njira yochizira. Muyenera kusamala ndi zisonyezo zilizonse za matenda amtima wake munthawi yake, ndipo akapezeka kuti mwalandira chithandizo chofunikira. Izi zokha ndi zomwe zingalepheretse kuchitika.

Zochita zamtima zomwe zimakhudzana ndi matenda osokoneza bongo amatchedwa "mtima wa shuga" ndi madokotala. Chiwalocho chikuwonjezeka kukula, kuwonetsa kupita patsogolo kwa mtima.

Anthu odwala matenda ashuga amadziwika ndi kuthamanga kapena kuthamanga kwa magazi. Izi ndi chiopsezo chowonjezera cha aortic aneurysm.

Kwa odwala omwe ali ndi vuto la mtima kale, chiopsezo chodwalanso nchambiri. Chifukwa cha kuphwanya kwa myocardial contraction, zochitika zomwe zimalepheretsa mtima kupita patsogolo.

Chifukwa chakuti ndi kuchuluka kwa glucose, kuchuluka kwa njira ya metabolic kumacheperachepera, mwayi wochepetsetsa wa mtima wokhazikika womwe umakula kukhala waukulu-wokhazikika womwe umakulitsa kanayi.

Chowoneka cha vuto la mtima ndi matenda a shuga ndichakuti nthawi zambiri amakula popanda kupweteka, chifukwa minofu yamtima imayamba kuchepa.

Njira zodzitetezera zithandizira kuchepetsa kuchepa kwa matenda a mtima. Ngati pali matenda ashuga, mfundo yoyamba yoletsa ndiyo kuwunikira kosalekeza ndikusintha kwamisempha yamagazi. Pofuna kupewa zovuta zazikulu monga vuto la mtima, muyenera ku:

sinthani zakudya zanu “mwamale,” pita patebulo Na. 9,
sinthani kwambiri, yendani, yendani,
kusiya kusuta
thandizani matenda oopsa oopsa,
imwani zamadzi zambiri
kuwunika ndikuwongolera cholesterol ndi glucose,
munthawi yake chithandizo cha matenda oyanjana.

Chithandizo cha kuphwanya m'mimba ndi matenda ashuga ziyenera kuchitika motsatira malangizo a dokotala. Kudziletsa komanso kulandira chithandizo chokwanira kumapewetsa zovuta pambuyo pakukhudzidwa mtima.

Cholinga cha matenda amtima chimachulukirachulukira odwala omwe ali ndi matenda ashuga, ngakhale m'magulu omwe ali ndi kulekerera kwa carbohydrate, ndiye kuti, ndi prediabetes. Izi zimayenderana ndi gawo la insulin mu mafuta kagayidwe. Kuphatikiza kuwonjezera shuga wamagazi, kuchepa kwa insulin kumayambitsa lipolysis ndikupanga matupi a ketone.

Nthawi yomweyo, mulingo wa triglycerides m'magazi umachulukanso, kuchuluka kwa mafuta acids m'magazi. Choyimira chachiwiri ndikuwonjezera kuchuluka kwa magazi, mapangidwe amitsempha yamagazi. Kuchuluka kwa glucose kumathandizira kupangidwa kwa mapuloteni a glycosylated, kulumikizana kwake ndi hemoglobin kumasokoneza kutumiza kwa oksijeni ku minofu, yomwe imathandizira hypoxia.

Mtundu wachiwiri wa matenda ashuga, ngakhale uchulukane kwambiri wa insulin m'magazi ndi hyperglycemia, kumasulidwa kwa otsutsana ndi insulin. Chimodzi mwa izo ndi somatotropin. Imawonjezera kugawanika kwa minofu yosalala ya minyewa ndi kulowa kwa mafuta mkati mwawo.

Atherosulinosis imachitanso chimodzimodzi ndi zinthu zotere

Kunenepa kwambiri
Matenda oopsa.
Kusuta.

Kuti mumve kulira, thamangani kwa wowerenga zamtundu pazisonyezo zoyambirira zikaonekera, ngati munthu ali pachiwopsezo, ndiye kuti amafunikira kufufuza pachaka.

Magulu oopsa: anthu omwe ali ndi abale pamzere woyamba komanso wachiwiri wa abale omwe ali ndi matenda a mtima, odwala atherosclerosis kapena matenda a shuga, odwala matenda oopsa a magulu atatu omwe ali pachiwopsezo.

Osapatsidwa chithandizo chamankhwala munthawi yake ndi vuto la matenda a mtima kungayambitse kukulitsa matenda a mtima ndi sitiroko.

Ngakhale zaka 10 zapitazo, ziwonetsero pakuwonetsedwa kwa kubadwa kwa mwana m'magazi zinayambira zaka 50 mpaka 60, ndipo kuyambira 40 mpaka 50.

Njira ya "kukonzanso" matendawa imayamba chifukwa cha zifukwa zingapo:

Kugulitsa kwambiri zizolowezi zoipa (mowa ndi fodya),
Kugwiritsa ntchito mafuta pafupipafupi, okazinga, osuta, zakudya zonunkhira,
Kunyalanyaza thanzi.

Kuperewera kwa chithandizo cha matenda ena kumayambiriro kumakhudzanso kusamutsidwa kwawo kwa odwala:

Kukhalapo kwa matenda ashuga
Kagayidwe kosagwira ntchito mthupi, kamene kamapangitsa kunenepa kwambiri,
Kukhalapo kwa matenda oopsa,
Kupezeka kwa atherosulinosis,
Magazi ophimba magazi
Kuchuluka kwa cholesterol,
Kulephera kuchita zolimbitsa thupi kwamunthu.

Zambiri zomwe zalembedwa zimagwirizana ndi moyo, thanzi la abambo, ndizomwe zimayambitsa vuto la mtima.

Kukula kwa vuto la mtima kumatha kupewedwa:

Ndikofunikira kuunikanso moyo wanu, kusiya zizolowezi zoipa.
Idyani pomwe.
Onetsetsani kuti mtendere wamanjenje (pewani nkhawa, zodetsa nkhawa).
Yang'anirani zochitika zolimbitsa thupi (ntchito ndi kupuma moyenera).
Pitani zamasewera, molingana ndi kuchuluka kwa zolimbitsa thupi, malingaliro a katswiri wamtima.
Kuyendera malo okonzera spa.

Kukhala ndi chakudya choyenera kumathandizanso kuti munthu ayambenso kudwala:

Kukana mafuta onse achikhalidwe cha nyama, mafuta a masamba (mafuta oyeretsedwa) amaloledwa.
Mutha kudya tchizi yamafuta ochepa (tsiku lililonse osaposa 200 magalamu).
Nkhuku yokhala ndi mafuta ochepa komanso nsomba zam'madzi ziyenera kuwotchera kapena kuwiritsa.
Zipatso zatsopano, timadziti timayenera kuphatikizidwa muzakudya za tsiku ndi tsiku za wodwala.
Gwiritsani ntchito mosamala zakudya zamafuta a cholesterol.
Zakudya zamchere ndizochepa kwambiri (kudya tsiku lililonse magalamu asanu).
Kukana zamitundu yonse ya fodya, yokazinga, mchere komanso zakudya zazonunkhiritsa, kuchokera ku mowa, khofi ndi zinthu zomwe zili ndi khofi.

Ngati mukupeza cholakwika, chonde sankhani gawo ndikusindikiza Ctrl Enter.

Monga tafotokozera pamwambapa, chachikulu chomwe chimapangitsa kuti myocardial infaration ndi matenda a mtima. Uku ndikuchepetsa kwamitsempha yama coronary, komwe nthawi zambiri kumachitika chifukwa cha kuyika kwa mafuta amafuta a cholesterol pamakoma amitsempha. Izi malembedwe amatsogolera pakupanga ma bulge pazitseko zamkati zamitsempha yamagazi, zomwe zimatha kusokoneza gawo la magazi.

Nthawi yomweyo, nsonga za cholesterol zolengeza zimatha kuchepera (pali mtundu wa kukokoloka pansi pamtsinje chifukwa cha kuthamanga kwa madzi). Thupi limayesa "kusindikiza" chiwonetserochi chowononga cha bulge mothandizidwa ndi kuphatikiza ma cell am'magazi omwe amatchedwa mapulateleti, omwe amachititsa kuti pakhale magazi.

Pamene wavala akukulira, kukula kwa mitsempha kumakhala kofunika kwambiri, kapena kuti ndi koletsedwa kwathunthu. Njira zomwe zafotokozedwa pamwambapa zikuchepetsa kutsika kwa magazi kupita ku minofu ya mtima, amalankhula za mkhalidwe wonga angina pectoris. Ngati magazi atsekeka kwathunthu, minyewa yamtima (myocardium) imamwaliradi, ndipo amalankhula za vuto la mtima (kapena pachimake myocardial infarction).

Mwa anthu opanda mkodzo wa carbohydrate metabolism komanso odwala matenda ashuga, Zizindikiro za myocardial infarction zimatha kusiyanasiyana. Nthawi zambiri, chilichonse chimadalira kutalika kwa matendawa: Kutalika kwa nthawi yayitali ya matenda ashuga, zomwe sizimadziwika kawirikawiri za vuto la mtima, zomwe nthawi zambiri zimapangitsa kuti azindikire matenda.

Chizindikiro chachikulu cha kusokonezeka kwakanthawi kwam'mnyewa wam'mimba - kupweteka pachifuwa - m'mankhwala am'mimba amachotsedwa kapena akhoza kusakhalapo. Izi ndichifukwa choti minyewa yamanjenje imakhudzidwa ndi kuchuluka kwa shuga, ndipo izi zimayambitsa kuchepa kwamphamvu kwa kupweteka. Chifukwa cha izi, umunthu umachuluka.

Kodi munthu wodwala matenda ashuga angadere nkhawa chiyani? Wodwala angazindikire zotsatirazi:

kupweteka, kumva kupsyinjika kumbuyo kwa sternum,
dzanja lamanzere lakuthwa kwambiri, kumva kuwawa.
Kupweteka kwamkaka kumatha kuwoneka kumanzere, kusazindikira bwino,
kuphwanya kwakukulu, kufooka,
pali malingaliro osokoneza ntchito ya mtima,
kupuma movutikira kumachitika
kufooka, chizungulire chimayamba.

Popeza njira zonse zochiritsira zimasokonekera mu matenda a shuga, kupangika kwa chidziwitso chachikulu cha myocardial infaration kumachitika nthawi zambiri kuposa anthu opanda shuga. Zotsatira za kudwala mtima kumeneku ndizovuta kwambiri.

Mu matenda a shuga, kuwonongeka kwa ischemic kwa ziwalo zamtima ndizovuta komanso zovuta. Nthawi zambiri, kulephera kwa mtima kumachitika, aneurysm, arrhythmia kapena vuto la mtima kumaonekera mu mawonekedwe owopsa.

Kuti muwone kuyambukira kwa kuukira kwanyengo, samalani ndi izi:

kupweteka pang'ono mu sternum,
kumva kupsinjika mumtima,
kufooka mwadzidzidzi, kuwonongeka kwakukulu.
kupuma movutikira
kusokonezeka kwa mtima
chizungulire
kufinya (kufalikira) kwa kupweteka m'khosi, mkono wamanzere, nsagwada, mano.

Ngati wodwala matenda ashuga ali ndi vuto lalikulu la vuto la mtima, ndiye kuti pali zizindikiro zina:

kupweteka kwapweteka pamimba,
kukhumudwa kwambiri,
kusintha kwa kutentha kwa thupi
kukomoka
ziwalo
kuchepa kwambiri kwa kuthamanga kwa magazi.

Chifukwa cha kulephera kwakazungulira kwa magazi, edema ya m'mapapo, kugunda kwa mtima, kuwonongeka kwa impso ndi zinthu zina zoopsa.

Pankhani ya vuto la mtima, ndikofunikira kupereka thandizo. Izi ndizofunikira makamaka kwa matenda ashuga.

Zoyenera kuchita:

itanani mwachangu oyendetsa ambulansi,
apatseni wovulalayo chofikira pabedi,
kuyeza kuthamanga kwa magazi
pakutsika pang'ono, mutu wa wodwalayo uyenera kukhala pansi pamiyendo kuti magazi alowe mu ubongo, pamlingo wokwera, mutu uyenera kukhala pamwamba pamiyendo yotsika,
kumasula mabatani, mumasuleni taye,
tsegulani mawindo
ikani nitroglycerin pansi pa lilime,
tiyeni titenge tincture wa valerian.

Njira zochizira kuchipatala:

Choyamba, ndikofunikira kuti mulingo wonga ukhale shuga, popeza kuthamanga kwamphamvu kumapangitsa kuti vutoli lithe. Mtundu woyamba, insulin mankhwala imagwiritsidwa ntchito, yomwe imafotokozedwa ndi endocrinologist. Kuti muchepetse shuga mumtundu wachiwiri, kukonzekera kwa gulu la sulfonylurea kumakhazikitsidwa, nthawi zambiri Metformin, Diabeteson. Mankhwala ena omwe amachepetsa shuga ya magazi angagwiritsidwe ntchito: Siafor, Avandia, Metaglip, Acarbose. Ngati wodwala matenda ashuga atayamba kudwala mtima, arrhythmia ndi zovuta zina, ndikofunika kusamutsira insulin.
Kusintha magwiridwe antchito am'thupi, ma anticoagulant othandizira (owonda magazi) amalembedwa: Aspirin, Heparin, Clopidogrel.
Onetsetsani kuti mukumwa mankhwala a anticholesterol ngati atherosulinosis ilipo (Lovastatin, Liponor, Rosuvastatin).
Ndi kulumpha kwa kuthamanga kwa magazi, mankhwala oyenera amayikidwa.
Amayesetsa kuthetsa zotsatira za vuto la mtima kudzera mu mankhwala omwe amagwiritsidwa ntchito ngati matenda a mtima (matenda a mtima ndi a gulu lino). Awa ndi beta-blockers (Concor, Acridylol), nitrate (Isosorbide, Nitroglycerin), ACE inhibitors (Enalapril, Captopril).

Chithunzi cha maphunziro a myocardial infarction, omwe amaphatikizidwa ndi matenda a shuga, ali ndi mawonekedwe ake. Monga tanena kale, MI mu diabetesics ndiyovuta, yovuta ndi kufooka kwa mtima wamtima, mpaka kumangidwa kwathunthu kwamtima. Kuphatikizidwa kwa matenda oopsa ndi myocardial dystrophy kumadzetsa aneurysm yamtima, yodzala ndi kupindika kwa minofu yamtima.

Mwa infalction ya pachimake yovuta, mafomu otsatirawa ndi amtundu:

zopweteka, ndikumva kuwawa kwanthawi yayitali kumbuyo kwa sternum,
pamimba, ndi zizindikiro za "m'mimba pachimake",
obisika ("osayankhula", osapweteka),
chosintha, ndi mawonekedwe a arrhythmia ndi tachycardia,
ubongo, limodzi ndi paresis, ziwalo, kusazindikira bwino.

Kutalika kwa nthawi yovuta kwambiri ndi masabata 1-1.5. Pali kutsika kwa kuthamanga kwa magazi, kuwonjezeka kwa kutentha.

Munthawi yovuta kwambiri, zotere zimatha kuchitika:

pulmonary edema,
kusiya kwa hepatic kusefera,
Cardiogenic mantha.

Ngati mumalemekeza thanzi lanu, ndiye kuti mwayi wokhala ndi vuto la mtima (pre-infarction) ukhoza kupezeka pasadakhale ndi zomwe zimayambira, zomwe zimatchedwa preursors.

- Uku ndikumva kupweteka kwambiri (kupweteka) pachifuwa, mkono wamanzere kapena phewa, ndikulimbitsa thupi kwamunthu.
Kukula kwa kufupika kwa mpweya.
Kupezeka kwa vuto la kuchepa kwa oksijeni mwa wodwalayo (wodwalayo amakwanira).

Pakhoza kukhala ndi vuto la vuto la mtima mwa bambo:

Ululu mu dzanja lamanzere, khosi, mano
Kupweteka pachifuwa cha antispasmodic chikhalidwe (nthawi),
Kuchepa kwa oxygen (chizindikiro cha kukhuta)
Kuchita kwaulesi kofanana ndi momwe kumagwirira ndi chimfine,
Kutsitsa magazi
Kuchokera kumbali yamtima, arrhythmia imawonedwa (popanda kuchita masewera olimbitsa thupi mwapadera),
Kukhalapo kwa thukuta lalikulu.

Chizindikiro chachikulu cha vuto la mtima ndi kupweteka kwambiri kwakakumbuyo kumbuyo, komwe kumapereka thupi lamanzere, phewa, mkono, khosi.

Pali milandu yokhudzana ndi mbali ndi mbali yoyenera, koma ndizosowa.

Mkhalidwe wopweteka umatenga mphindi kapena maola, masiku osowa.

Kuphatikiza pa gawo lalikulu, palinso ena:

Kuchulukitsa kwa chifuwa ndi torso lamanzere kumanzere,
Vuto lamseru, nthawi zina limodzi ndi kusanza,
Amaponya wodwala thukuta lozizira
Kupezeka kwa kufooka thupi lonse.
Kukhalapo kwa mtima wogwira ntchito.

Ndi kulowetsedwa kwa myocardial, kuthamanga kwa magazi kwa wodwala kumatha kuwonjezeka kapena kupitiliza kukhala moyenera.

Tsiku loyamba pamakhala kuwonjezeka kwa kukakamiza kwa chisonyezo cha 190/100 mwa anthu omwe alibe vuto la matenda oopsa. M'masiku 2 otsatirawa pamakhala kutsika kwa kupanikizika. Patsiku la 4 la kulowetsedwa kwa myocardial, kupanikizika kumayambanso, koma sikufikanso pa tsiku loyamba.

Madotolo amayang'anira mosamala momwe magazi akuwonekera pakukhudzidwa mtima kuti asasokeretse zomwe zikuchitika.

Pambuyo pa vuto la mtima m'miyendo (m'malo omwe sizinatchulidwe), munthuyo amayenera kutumizidwa kuchipatala kuti akumuyang'anire.

Zizindikiro zotsatirazi zikadzachitika:

Pulmonary edema imachitika
Dontho lakuthwa la kuthamanga kwa magazi,
Chikopa
Kuphwanya miyendo ya mtima.

Ndi chiyambi cha matenda a mtima, munthu amafunika thandizo lanu mwachangu.

Thandizo loyamba la zizindikiro za kugunda kwa mtima kwa amuna:

Chipewa chaulere (chotsani taye ndi malaya a unbutton).
Ikani piritsi ya nitroglycerin pansi pa lilime.
Ikani wodwalayo pamalo olimba, onetsetsani kuti akupumula mpaka ambulansi itafika.
Patsani mpweya wabwino (mawindo ndi zitseko).
Imbani ambulansi.
Ndi kuthamanga kwa magazi, ndi gawo limodzi lokha la 1/2 piritsi ya analgin yomwe imaloledwa.
Pambuyo pa mphindi 5, ngati ambulansi sinafike, perekani piritsi lachiwiri la nitroglycerin, mutatsimikizira kuti kukakamira sikunatsike kwambiri.

Akafika ambulansi, sonkhanitsani zikalata zoyenera wodwalayo ndipo muperekezeni kuchipatala.

Munjira zambiri, zotsatirapo zake atakumana ndi vuto lalikulu la mtima mwa abambo zimadalira pa moyo wake, zizolowezi zoyipa, kukana kusiya zomwe zimayambitsa kubwereza kwamtima kapena kufa.

Zotsatira zingaoneke:

Kukula kwa matenda a mtima kulephera,
Pulmonary edema
Kutupa kwa mtima minofu.

Pofuna kupewa komanso kuchiza matenda obwera chifukwa cha kulowetsedwa kwa myocardial, njira ndi njira zosiyanasiyana zimagwiritsidwa ntchito: mankhwala azitsamba, mankhwalawa monga chimanga ndi chakudya.

Mankhwala azitsamba ndi mankhwala ochokera ku zitsamba zomwe zimapangitsa kuti mtima uzigwira ntchito. Kuchita kwawo kumalimbana ndikuchotsa ma spasms amtsempha wamagazi, kuchotsa madzimadzi owonjezera, kusintha magazi ake, kuchepetsa mafuta m'thupi. Zomera zotere zimaphatikizapo hawthorn, momwort, arnica, mapiri a chimanga, calendula, valerian.

Kulowetsedwa kwa hawthorn kumakhala supuni ya zipatso ndi kapu ya madzi owiritsa. Adzapatsa zakumwa ayenera kukhala osachepera theka la ola, kumwa m'mawa, madzulo, theka kapu.

Pa tincture wa sitiroberi, duwa lamtchire, masamba 50 ndi zipatso zamasamba zidzafunika. Zipangizo zakonzedwa zimafunikira kuwiritsa mu 500 ml ya madzi pamadzi osamba kwa kotala la ola limodzi. Kenako madzi owiritsa ayenera kuwonjezeredwa ku mankhwala osankhidwa kuti mupeze voliyumu yoyambayo. Imwani 2 pa tsiku musanadye, 0,5 chikho.

Chithandizo cha chimanga chimakhala mu kudya mbewu zophuka za tirigu, barele, rye. Mbewu yoyambirira iyenera kuyeretsedwa ndi 25% manganese yothira madzi otentha. Kuti kumere, njere iyenera kuyikidwa mu chidebe ndi voliyumu ya 500 ml, kuthira madzi kwathunthu. Pakatha masiku 10, pomwe zopangira zimatenga mpweya ndi madzi, ziyenera kuwumbidwira pamalo osalala pomwe nsalu yonyowa idayikidwa. Pamwamba pa njere muyenera kuphimba ndi chonyowa. Pambuyo pa masiku awiri, kukula kwa mphukira kufikira 1 cm, ndiye kuti ali okonzeka kugwiritsidwa ntchito.
Zakudya zina zimakhala ndi zinthu zomwe zimabwezeretsa, kulimbitsa mtima. Kukula mitsempha yamagazi, kukonza magazi kupita kumtima kumatha mafuta a masamba, mtedza, uchi.

Zomwe zimayambitsa kuwopsa kwa matenda a mtima mu shuga

Ndi matenda a mtima, kuphatikiza pambuyo pa vuto la mtima, matenda ashuga, kufooka kwa mtima, chotupa chofala m'matumbo amtima, kumapita patsogolo mwachangu. Kukhalapo kwa matenda ashuga kumapangitsa kuti pakhale zovuta kuchita opaleshoni ya mtima. Chifukwa chake, odwala matenda a shuga ayenera kuyamba kuchiza matenda amtima mapema.

Ndipo dongosolo loyeserera kwa odwala oterewa limaphatikizapo mayeso opsinjika nthawi ya ECG, kuwunikira ma rhy ndi kuchotsedwa kwa ECG masana. Izi zikuwonetsedwa makamaka pakusuta fodya, kunenepa kwambiri m'mimba, matenda oopsa, kuchuluka kwa magazi m'magazi, ndikuchepetsa lipoproteins yapamwamba.

Pakuchitika kwa myocardial infarction, komanso shuga mellitus, cholowa chamtsogolo chimatenga gawo. Chifukwa chake, wodwala yemwe ali ndi matenda ashuga akapezeka kuti ali ndi abale ake omwe adayamba kudwala matenda osokoneza bongo, angina osakhazikika, kapena mitundu ina yamatenda a mtima, amamuwuza kuti ali pachiwopsezo chowopsa cha masoka am'mimba.

Kuphatikiza apo, zina zowonjezera zomwe zimapangitsa matenda oopsa a mtima kwa odwala omwe ali ndi matenda ashuga ndi:

Peripheral ochepa angiopathy, kusokoneza endarteritis, vasculitis.
Matenda a shuga a retinopathy
Matenda a shuga ndi nephropathy.
Mavuto Akukula
Dyslipidemia

- Mbiri ya mabanja (mbiri ya mabanja ya matendawa) yolumikizidwa ndi matenda amtima.

- Kuthamanga kwa magazi.

Ngati ndizosatheka kupewetsa pachiwopsezo chokhala ndi mbiri yakale ya matenda amtima, ndiye kuti zinthu zina zonse zowopsa zitha kuyang'aniridwa kuti muchepetse chiopsezo chokhala ndi myocardial infarction. Zinthu zoopsa kwambiri zomwe zimakulitsa chiopsezo cha matenda a mtima ndizovuta (kuthamanga) magazi, kunenepa kwambiri, shuga kwambiri, cholesterol ndi kusuta.

Matenda a shuga ndi amitundu iwiri yosiyana, okhala ndi zofanana mu chinthu chimodzi - kuchuluka kwa shuga m'magazi. Ngati tikukamba za makina a chitukuko, ndiye kuti poyambilira, chomwe chimayambitsa matenda, kupsinjika, cholowa, chachiwiri - kunenepa kwambiri, matenda oopsa, matenda a m'magazi. Zinthu zonsezi zimakhudzana mwachindunji ndi ntchito ya mtima.

Chochititsa chachikulu pakupezeka kwa vuto la mtima mu matenda ashuga ndi kuchuluka kwambiri kwa glucose: kukwera kwakeko, ndikoopsa kwawo. Koma pali zifukwa zina zingapo zofananira:

kusowa zolimbitsa thupi,
onenepa kwambiri
kudya kwambiri
kusuta ndi kumwa mowa,
zopsinjika pafupipafupi
matenda oopsa oopsa (kuthamanga kwa mavuto),
atherosulinosis
magazi osokonekera,
kubadwa kwamatenda oyamba ndi matenda a mtima
kuperewera kwa zakudya m'thupi.

Kuphatikiza pa shuga wambiri, chiwopsezo cha kulowerera koyambira kobwerezabwereza kumawonjezera zinthu izi:

cholowa (kukhalapo kwa IHD mwa abale apamtima: mwa akazi ochepera zaka 55 ndi amuna ochepera zaka 65),
kusuta Zimathandizira kuvala mwachangu makhoma otupa,
kuchuluka kapena, Mosiyana, kuthamanga kwa magazi. Kuchepetsa mpaka kutsika kwambiri kuli koopsa
kutsika kwa HDL ("wabwino" cholesterol) kumabweretsa kuwonongeka kwa mtima ndi mitsempha yamagazi,
kunenepa. Pimitsani gawo loyang'ana m'chiuno ndi tepi wamba ya sing'anga. Ngati zotsatira za muyeso zidapitilira 1000 mm kwa amuna ndi 900 mm kwa akazi, izi zikuwonetsa kuyambira kwa kunenepa kwambiri. Chiwopsezo cha kutsekeka kwa mitsempha kuchokera ku magazi ndi ma cholesterol amamuchulukitsa kwambiri /

Kuti muchepetse chiwopsezo cha mavuto obwera chifukwa cha MI, muyenera kusintha moyo wanu ndikumwa mankhwalawa.

Kulephera kwamtima kosalekeza

CHF ndichedwa kuchepa kwa myocardial infaration. Zimayendera limodzi ndi mawonekedwe:

kutopa mwachangu
kupweteka kwapamtima kwapakati
kutupa kwa miyendo
mavuto kupuma
hemoptysis, chifuwa,
kusintha kwanyimbo,
kupweteka mu hypochondrium yoyenera.

Nthawi zambiri munthu saganiza kuti mwina tsoka linalake lachitika kale m'thupi, ndipo amakhalabe ndi moyo ngati palibe chinachitika. Uwu ndi chiopsezo cha matenda amtundu wa "chete".

Popanda chithandizo chamankhwala chapanthawi yake, popanda chithandizo chokwanira, mavuto amakula m'thupi, kumabweretsa

kapena ngakhale kufa kwa wodwala.

Odwala matenda a mtima ambiri amakhulupirira molakwika kuti "anapulumuka ndi mantha" ndikuti anachira modabwitsa. Koma shuga atangolowa m'magazi "kulumpha", minofu yamtima imayamba "kupatuka pamsewu."

Zizindikiro

Pali njira zitatu zomwe zimadziwika ndi matenda:

Maonekedwe a wodwala, madandaulo ake,
deta yoyesa magazi
zambiri zopezeka kuzotsatira za ECG.

Pafupifupi 25% ya milandu, palibe kusintha komwe kumapezeka pa ECG. Koma matendawa kuchokera pamenepa samakhala oopsa.

Chifukwa chake, pali zinthu zina ziwiri zofunika kwambiri pakuzindikira. Ngati matenda a mtima akakaikiridwa, wodwala amapezeka kuchipatala. Ngati amalimbikira kukhala kunyumba, ndiye kuti chiopsezo cha kumwalira patsiku loyamba la matendawa chimawonjezeka nthawi zambiri.

Ku chipatala, njira zotsatirazi ndizogwiritsa ntchito:

echocardiography
Diagnostics X-ray.Njira yatsopano yodziwira matenda a x-ray ndi angiography. Kugwiritsa ntchito sing'anga yolumikizira imakupatsani mwayi kuti mupeze madera amitsempha yamagazi ochepa patency chifukwa cha malo amitsempha yamagazi ndi ziwunda zamagazi,
yopangidwa ndi tomography, MRI. Zomwe mwapeza zimakuthandizani kuti mufufuze bwino mtima wanu.

Kuti mudziwe vuto lomwe limayambitsa matenda obisika m'mitsempha, kudziwa kukhalapo kwake ndikuzindikira zovuta zake, katswiri wamtima amachititsa njira zotsatirazi:

Mbiri yazachipatala - adotolo amafufuza wodwalayo za matenda omwe alipo, matenda am'mbuyomu, zizindikiro zowonetsera. Kuphatikiza apo, zomwe zimapangitsa kuti pakhale cholowa chamtsogolo, chikhalidwe cha anthu chimaphunzira.
Kuyeza kwa magazi, kumvetsera kwa mtima.
Kuyesa kwa magazi pa maphunziro apadera komanso amitundu mitundu - kudziwa kuchuluka kwa ESR, maselo oyera a magazi ndi zinthu zina.
Electrocardiogram ndi echocardiography, kulola kuphunzira za myocardium.
X-ray yamapapu, kulingalira kwa maginito komanso kuyerekezera mphamvu kwa makina, angiografia, ma ultrasound ndi maphunziro ena a ziwalo zamkati ndi machitidwe. Njirazi zimakuthandizani kuti mudziwe zomwe zimayambitsa vuto la mtima komanso zovuta zake.

Kuti chithandizo cha kulowetsedwa kwa myocardial chikhale bwino, ndi zotsatirapo zosayambitsa, sikofunika kwenikweni kuti magazi akhale ndi shuga. Pokhapokha poyang'anira kuwongolera kwama glucose mokwanira pamatha kuchitika zinthu zabwino.

Kuchiza matenda a mtima si ntchito yovuta. Ngati "maluwa" amakhalanso ndi matenda a shuga, mankhwalawo amakhala ovuta kwambiri. Mphamvu ya ochiritsira thrombolytic mankhwala ndi yotsika njira zopangira monga mtima stenting ndi angioplasty.

Zotsatira zabwino ndikuphatikizidwa kwa mankhwala ndi kulowererapo kwakanthawi. Kubwezeretsanso kwa ziwiya za mitima, zomwe zimachitika mu theka loyamba la tsiku kuyambira kumayambiriro kwa matendawa, kumachepetsa kwambiri zovuta.

Ndikofunika kugwiritsa ntchito mankhwala a metabolic, chifukwa shuga imayenderana ndi zovuta za metabolic. Chofunikira pakuchiritsa ndikukhazikika kwa shuga m'magazi.

Zochizira odwala omwe ali ndi vuto la mtima, magulu omwera omwewa amagwiritsidwa ntchito:

mankhwala omwe cholinga chake ndi kutsitsa cholesterol yamagazi,
thrombolytic, anticoagulant mankhwala,
odana ndi calcium
mankhwala omwe ali ndi antiarrhythmic athari,
opanga beta.

Njira zothandiza kwambiri zobwezeretsanso magazi pambuyo pa vuto la mtima ndi opaleshoni. Izi ndizowona makamaka kwa odwala matenda ashuga, popeza chiwopsezo cha zovuta ndi kufa kwa odwalawa ndichokwera kwambiri. Amatembenukira ku angioplasty ndi mtima stenting. Izi ndizothandiza kwambiri kuposa chithandizo chamankhwala omwe amasungunuka magazi.

Ngati ndizosatheka kupereka chithandizo chamankhwala mwadzidzidzi, chithandizo cha myocardial infarction chimachepetsedwa kukhala thrombolytic therapy. Amapangidwanso kutenga ma statins, zotumphukira za aspirin, ngati ndi kotheka, mankhwala ochepetsa magazi, mtima glycosides.

Chofunikira kwambiri chodziwikitsa kukula kwa vuto la mtima mwa odwala omwe ali ndi matenda osokoneza bongo ndikukhazikika kwa mipherezero ya glycemic. Nthawi yomweyo, amayesera kuti pasakhale kuchuluka kwa shuga kuchokera pa 5 mpaka 7.8 mmol / L, kulola kuwonjezeka kufika pa 10. Kutsika m'munsi mwa 4 kapena 5 mmol / L sikulimbikitsidwa.

Odwala amasonyezedwa chithandizo cha insulin osati mtundu wa 1 shuga wokha, komanso hyperglycemia yopitilira 10 mmol / l, zakudya za makolo, komanso vuto lalikulu. Ngati odwala adalandira chithandizo chamankhwala a mapiritsi, mwachitsanzo, adatenga Metformin, ndipo ali ndi zizindikiro za kupindika, kulephera kwa mtima, kwambiri angina pectoris, ndiye kuti amasamutsidwanso ku insulin.

Insulin yogwira ntchito mwachidule imaperekedwa mosalekeza kudzera mu dontho limodzi ndi 5% shuga. Miyezo ya shuga imayesedwa ola lililonse. Ngati wodwalayo akudziwa, ndiye kuti akhoza kudya chakudya pamaziko olimbitsa insulin.

Kumwa mankhwala kuti muchepetse shuga ngati chithanso cham'madzi cham'magazi kuchokera ku sulfanylurea kapena gulu ladongo ndikotheka ndikuchotsa kwa zizindikiro za kusowa bwino kwa coronary coronary. Mankhwala monga Metformin, omwe amagwiritsidwa ntchito pafupipafupi omwe amachepetsa mwayi wokhala ndi vuto la mtima ndi matenda a mtima, amatsutsana panthawi yovuta kwambiri.

Metformin sikulolani kuti muziwongolera mwachangu glycemia, ndipo kayendetsedwe kake mu vuto la kuperewera kwa zakudya m'thupi kumabweretsa chiopsezo cha lactic acidosis.

Nthawi yomweyo, umboni udapezeka kuti opaleshoni ya mtima ikadutsa, mankhwala a metformin 850 amasintha magawo a hemodynamic ndikufupikitsa nthawi yochira pambuyo pochita opaleshoni.

Mayendedwe akulu a mankhwalawa amachokera m'mnyewa wamtima:

Kusunga shuga wabwinobwino.
Kutsitsa ndikukhala ndi kuthamanga kwa magazi pamlingo wa 130/80 mm Hg
Kutsitsa magazi m'thupi.
Kuchepetsa magazi anticoagulants
Kukonzekera mtima kwa matenda a mtima

Chithandizo cha myocardial infarction imapangidwa poika mankhwala.

Muli magawo angapo:

Kuwongolera ululu,
Kufalikira kwa zotupa,
Kuthetsa zotsatira ndi kuthetsa mkhalidwe wa wodwalayo.

Mitsempha imathandizira kuthetsa ululu mumtima, kusintha kayendedwe ka magazi, kukulitsa mitsempha yamagazi ndikuchepetsa katundu pazinthu zamtima. Nitroglycerin, isosorbite, mononitrate.
Kuti mumvetsetse ululu wammbuyo, ma painkiller amagwiritsidwa ntchito. Kuti mukwaniritse mwachangu, ma narcotic analgesics amagwiritsidwa ntchito.
Ma thrombolytics amatha kuthandizira kuyenderera kwa magazi kupita mumtima, ndipo zigawo zamagazi zimatha kugawanitsa magazi.
Kwa resorption ndi excretion wamagazi, owonda magazi, anticoagulants, antithrombotic mankhwala. Izi zimaphatikizapo acetylsalicylic acid, heparin, clopidogrel, warfarin.
Beta-blockers: coreg, toprol, inderal, athandizira kuchepetsa katundu pa mtima, kusintha kayendedwe ka michere. Amatengedwa pang'onopang'ono, ndikuwonjezera mlingo.
ACE inhibitors amalimbikitsa kupuma kwamitsempha yamagazi ndikuyambitsa kutulutsa magazi kuchokera pansi pamtima. Izi zikuphatikiza: capoten, maguwa, okhala pansi.
Imasinthasintha kayendedwe ka mtima, imabwezeretsa minofu yamitsempha yamagalasi okondana: sea otter, carden, norvask.
Ma Statin, niacins, ma fibrate amathandizira kuchepetsa cholesterol yoyipa.

Njira zopewera

Kuphatikiza mankhwala kwa myocardial infarction kuyenera kuphatikizapo kufunsa ndi mtima, kufufuza mozama komanso kosiyanasiyana. Zofunikanso chimodzimodzi ndikuwongolera kwathunthu kwa algorithm yamankhwala. Tiyenera kukumbukira kuti kuchiza matenda osokoneza bongo omwe ali ndi matenda ashuga ndi ntchito yovuta kwambiri.

Kuthana ndi njira zosavuta zodzitetezera kumachepetsa mwayi wama mtima:

magazi cholesterol
kukambirana pafupipafupi ndi cardiologist ndi endocrinologist,
magazi shuga. Kuti muchite izi, ndibwino kuti mugule glucometer,
kukana kwathunthu zakumwa zokhala ndi zakumwa zoledzeretsa ndi kusuta,
zakudya zoyenera. Liu "zakudya" silolondola pano. Zakudya zoyenera ziyenera kukhala gawo la moyo
kumwa mankhwala opangidwa ndi dokotala
kuthamanga kwa magazi
kutsegula kugona ndi kupumula,
zolimbitsa thupi zolimbitsa thupi, zogwirizana ndi katswiri,
kuthandiza mankhwala.

Zoyambitsa Type 1 ndi Type 2abetes

Insulin yodalira matenda a shuga a mtundu wa insulin (mtundu 1) imachitika nthawi ya kuwonongeka kwa maselo omwe amapanga insulin. Chifukwa cha kuchepa kwa mahomoni:

shuga wamagazi amatuluka
shuga wambiri amawononga kukhathamira kwamkati mwa zotengera, ndikuthandizira kupanga mapangidwe a atheroscrotic,
kuchuluka kwa cholesterol ndi triglycerides kumawonjezeka, ndipo zomwe zotulutsira zovuta zakumaso zachepa,
mamasukidwe amwazi ndi kutalika kwake kwa thrombus,
erythrocyte hemoglobin imamangiriza mapuloteni, omwe amalepheretsa kutumizidwa kwa mpweya m'maselo.

Anthu odwala matenda ashuga amadziwika ndi kukula koyambira kwa atherosulinosis ndi zotupa zingapo zam'mitsempha, khoma lawo limakhala lochepa, mofooka limayankha pazinthu za vasodilating.

Mtundu wachiwiri wa matenda ashuga, kuchuluka kwa vuto la mtima komanso zovuta zake ndikwapamwamba kuposa mitundu ina ya odwala. Kutanthauzira komwe kungachitike ndi kupezeka kwa insulin. Ili ndiye dzina la kukana kwa maselo ku mahomoni opangidwa. Zinapezeka kuti, mosiyana ndi kumbuyo kwake, maselo a minofu ya mtima amakhudzidwa kwambiri ndi adrenaline, cortisol.

Zotsatira zake, kupindika kolimba kwamitsempha kumachitika, kukulitsa magazi osakwanira kudzera mu mitsempha yotseka. Chikwangwani cha cholesterol chitatsekereza magazi, kutuluka kwa mpweya ndi michere kumadera oyandikana nawo kumatsika. Izi zimatsogolera pakuwonongeka kwakukulu kwa myocardium, mawonekedwe a arrhythmias, kufooka mphamvu, kukoka kwa magazi m'mapapu, chiwindi. Chiwopsezo cha kutsika kwa khoma (aneurysm) ndi kupasuka kwake kumakulira.

Ndipo pali zambiri popewa zovuta za matenda ashuga.

Matenda a mtima wodwala matenda ashuga

Mutu wamatenda a mtima ndi zovuta zam'magazi ndi odwala matenda ashuga omwe alipo:

kuthamanga kwa magazi
Maphunziro osawerengeka a shuga (glucose and glycated hemoglobin sakhala kutali ndi zomwe akutsimikiza, pali shuga lakuthwa),
kunenepa
kumangokhala
kusuta kwa chikonga, mowa, zakudya zamafuta,
zaka 45
"matenda" a matenda ashuga azaka 7,
kuwonongeka kwamitsempha ya retina (retinopathy) ndi impso (nephropathy), mafupa am'mitsempha am'munsi (neuropathy),
pafupipafupi zovuta.

Zizindikiro ndi maphunzirowa

Chizindikiro chachikulu cha chiwonongeko cha myocardial ndikuwukhumudwitsa kwanthawi yayitali. Imadziwonetsa ngati kukakamiza, kuwundana, kuyaka kuseri kwa sternum. Ndi matenda a shuga, sizingakhale choncho. Izi zimachitika chifukwa cha kusinthika kwa kusintha kwamkati mu minofu ya mtima - matenda ashuga a mtima. Amadziwika ndi kuchepa kwa chidwi cha kupweteka chifukwa cha kuwonongeka kwa ulusi wamitsempha.

Chifukwa chake, vuto la mtima nthawi zambiri limapezeka mu mawonekedwe osapweteka omwe ali ndi zizindikiro zotsatirazi:

kupuma movutikira
kulumikizika kwamkamwa, kusokonezeka kwa kusintha kwa mtima,
kufooka koopsa
thukuta kwambiri
khungu kapena kufiira kwa nkhope,
kukomoka kapena kulephera kuzindikira.

Ngakhale zizindikiro zopanda pake zoterezi zimatha kukhala zofatsa kapena zofala kwa odwala matenda ashuga. Izi zimapangitsa kuti mochedwa muzindikire vuto la mtima, kuwonongeka kwakukulu mtima.

Mavuto, kuchuluka kwa anthu omwalira

Kubwezeretsa minofu ya mtima mu odwala matenda ashuga kumachedwetsedwa. Izi ndichifukwa choti machitidwe a zilonda zingapo zam'mitsempha yaying'ono, njira zodutsa sizingakhale kwa nthawi yayitali. Kuphatikizanso, kuchepa kwamphamvu kwa mgwirizano wam'magawo, kukula kwa kulephera kwa magazi ndi edema, njira zina zamkati zimagwira.

Kuperewera kwa insulin kapena kukana kwake sikulola maselo amtima kupeza kuchuluka kwa glucose kopangira mphamvu. Chifukwa chake, amasintha kugwiritsa ntchito mafuta acids. Nthawi yomweyo, mpweya wambiri umamwetsa, womwe umakulitsa kuchepa kwake (hypoxia). Zotsatira zake, vuto la mtima limakhala ndi zochita komanso zovuta.

Kufa kwa matenda amitsempha yamagazi m'matenda a shuga ndikwachuluka kwambiri kuposa kwa odwala omwe alibe mkodzo wa metabolism (41% motsutsana 20%). Zomwe zimayambitsa zovuta zitha kukhala zovuta panthawi yovuta kwambiri:

kugunda kwa mtima
mobwerezabwereza myocardial infaration chifukwa chokonda kupanga mapanga magazi m'mitsempha,
ischemic stroke
chisokonezo chachikulu chamiyendo, kuyimitsa mgwirizano,
m'mapapo mwanga, edema yam'mimba,
Kupasuka kwa khoma la mtima,
kufalikira kwa nthambi za m'mapapo a mtsempha wam'mimba kudzera mwa thrombus (thromboembolism) ndi kufupikitsa kwa m'mapapo,
kuchuluka kwa madzimadzi mu pericardial mtima sac (pericarditis, mtima tamponade).

Kwa odwala matenda a shuga, chiopsezo cha kufa msanga pambuyo povutitsidwa ndi mtima chimakhalabe pa 15-35% pachaka, ndipo pazaka zisanu zikubwerazi zikufika pa 45%.

Chithandizo cha zovuta matenda

Odwala onse omwe ali ndi vuto lalikulu la shuga amayamba ndi matenda osokoneza bongo amasamutsidwa kupita ku insulin. Mankhwalawa amathandizidwa molingana ndi pulogalamu yowonjezereka - m'mawa ndi madzulo, kudya insulin ndi mphindi 30 chakudya chachikulu chisanachitike. Nthawi zambiri, chithandizo choterechi chikulimbikitsidwa kuti chiziwonjezereka kwa miyezi 1-3 kuti mubwezeretse minofu yamtima. Pankhaniyi, insulin ndiyofunikira pa matenda amtundu 1 komanso matenda a shuga a 2.

Odwala onse omwe ali ndi vuto lalikulu la shuga amayamba ndi matenda osokoneza bongo amasamutsidwa kupita ku insulin

Zinapezeka kuti samangokhala ndi phindu pakukweza kwa glucose, komanso mphamvu ya vasodilating. Mafuta a m'magazi sayenera kukhala ochepera 5 komanso pamwamba pa 10 mmol / L. Ndikofunika kuti muzisunga mu 5.5-7.5 mmol / L.

Magulu otsatirawa a mankhwala awonetsedwanso:

thrombolytics - Streptokinase, Actilize,
anticoagulants - Heparin, Fraxiparin,
angiotensin-converting enzyme (ACE) zoletsa poyambira pang'ono - Prenes, Zokardis,
beta-blockers - Metoprolol, Carvedilol.

Njira yabwino ya matendawa imadziwika ndi angioplasty mwadzidzidzi. Pambuyo pa coronarography, catheter yokhala ndi bulloon yokulira imayikidwa mchombo. Zimathandizira kubwezeretsa patency ya mtsempha, ndiye kuti chitsulo - chitsulo chimayikidwa m'malo mwake. Mtsogolomo, amasunga mulingo woyenerera wa botilo.

Njira yothanirana ndi chithandizo ndi kupatsirana kwa mitsempha. Amapereka njira yopangira njira yowonjezera yoyenda yamagazi. Kulumikizana pakati pa ziwiya zathanzi kumakhazikitsidwa kudutsa zokhazokha.

Zakudya pambuyo vuto la mtima odwala odwala matenda ashuga

Mu sabata yoyamba, zakudya zazing'ono zazing'ono zimagwiritsidwa ntchito kangapo patsiku la 6. Yalimbikitsa:

mbewu zosenda
sopo
masamba owiritsa
mkaka wowawasa watsopano
tchizi chodzipangira wekha,
nyama ndi nsomba puree, souffle, masamba omenyera ndi ma mpikisano wapa banja, mazira osenda.

Mchere suwonjezeredwa ku mbale. Kuti musinthe kukoma, gwiritsani ntchito msuzi wa phwetekere (wopanda mchere), zitsamba, mandimu.

Mitundu yonse ya zakudya zam'chitini, ma marinade, mankhwala osuta, soseji, tchizi zonunkhira, tiyi wamphamvu ndi khofi ndizoletsedwa. Kuyambira sabata yachiwiri simungathe kupera mbale, koma kusenda komanso kupatsana mafuta m'mafuta kumakhalabe kokhazikika nthawi yonseyi. Ndikosayenera kuti maphunziro oyamba agwiritse ntchito ma navars, ngakhale ofooka.

Pakutha kwa mwezi casseroles, masamba a masamba, masaladi, nsomba zam'madzi, nsomba zam'madzi, nyemba, mtedza zimawonjezedwa pazakudya. Zipatso zopanda zipatso, zipatso ndi zipatso kuchokera kwa iwo ndizothandiza. Ndikulimbikitsidwa kuti musamadye nyama tsiku lililonse, ndikusintha ndi nsomba yophika.

Zothandiza zopanda zipatso, zipatso ndi zipatso kuchokera kwa iwo

Ndani ali woyenera kulumala?

Chizindikiro chowunika ndi kulephera kwa wodwala pambuyo pa vuto la mtima kuti achite ntchito yake mwantchito. Mavuto ozungulira amayenera kufanana ndi gawo 2a. Izi zikutanthauza:

kupuma pang'ono ndi zochitika zilizonse zolimbitsa thupi,
kamvekedwe ka khungu:
kutupa kwamiyendo,
kukulitsa chiwindi
kupuma movutikira m'mapapu.

Wodwala akhoza kukhala ndi angina pectoris 2 yogwira gulu. Kuukira kumachitika poyenda kuchokera ku 500 m, mutakwera kupita pansi yachiwiri. Muzochitika zotere, gulu la olumala la 3 likhoza kukhazikitsidwa ndikusunthira ku ntchito yopepuka (popanda kupsinjika kwakukulu kwakuthupi kapena kwamaganizidwe) komwe kumalimbikitsa.

Kuti mudziwe gulu lachiwiri, ndikofunikira kuzindikira kuchepa kwa minofu ya mtima. Zimadziwulula:

kukula kwa dyspnea pakupuma,
tachycardia
kutopa pansi pa katundu wamba,
kuchuluka kwa madzi m'mimba,
wamba edema.

Zovuta za angina pectoris mwa odwala zimachitika atadutsa 100 m kapena kukwera pansi yoyamba.

Gulu loyamba limapatsidwa matenda a shuga a mtima, ophatikizika ndi kulephera kwa mtima kwa digiri yachitatu. Amadziwika ndi kuphwanya kolimba kwa chiwindi, mapapu ndi impso, kutopa. Kupweteka kumbuyo kwa sternum kumawoneka pakupuma, kugona, kapena kuchita masewera olimbitsa thupi pang'ono. Wodwala amafunikira chisamaliro chokhazikika ndi thandizo kuchokera kwa akunja.

Hypertrophy yamanzere yamitsempha yamanzere: zoyambitsa, zizindikiro ndi njira zamankhwala

Matenda a mtima omwe ali ndi matenda a shuga a 2 samangophatikizidwa ndi kuchuluka kwa shuga m'magazi a wodwalayo, komanso ndi insulin, yomwe amagwiritsa ntchito kuti ikhale yolongosoka. Asayansi apeza kuti ngakhale anthu omwe ali ndi prediabetes ali ndi vuto lotha kukhala ndi matenda ashuga. Izi zikutanthauza kuti madokotala atazindikira kuti kulekerera kwamatumbo kumakhala kofunikira, nthawi yomweyo ayenera kuchitapo kanthu pofuna kukhazikitsa dongosolo la mtima. Zikatero, vuto limakhala makamaka pakusintha kwa metabolidi ya lipid mu thupi la munthu.

Mwambiri, akatswiri amatchula zifukwa zotsatirazi zomwe zimayambitsa matenda a mtima mu shuga:

Kuwonjezeka kwa kuchuluka kwa mafuta m'magazi.
Mlingo wa ndende za ketone.
Mawonekedwe a magazi chifukwa cha magazi.
Maonekedwe a protein yambiri ya glycosylated.
The zimachitika limba hypoxia.
Kugawika kwa maselo osalala a minofu, kutsatiridwa ndi kulowa kwa lipids mwa iwo kudzera mukutulutsidwa kwa mahomoni okula.

Chifukwa chake, zomwe zimayambitsa kubadwa kwa myocardial infarction mu mtundu 1 ndi mtundu wa 2 shuga zimakhala zosiyanasiyana. Nthawi zambiri, ndizosatheka kudziwa chomwe chimayambitsa kupangika kwa mtima ndi mtima. Izi ndichifukwa choti odwala nthawi zambiri amakhala ndi mavuto angapo azaumoyo omwe ali pamwambapa.

Pokhala kukula kwa minofu ya minofu ndikuwonjezereka kwa unyinji wamanzere wamitsempha yamagalimoto, myocardial hypertrophy m'derali ikhoza kukhala ya asymptomatic kwathunthu kapena kukhala chotsogola chachikulu cha mtima. Hypertrophy yamanzere yamitsempha yam'mimba nthawi zambiri imadziwika mwangozi pomwe kupenda kwamtima kumachitika pogwiritsa ntchito electrocardiogram, komanso mothandizidwa ndi Echo-KG.

Zotsatira za izi nthawi zambiri zimasintha mawonekedwe ndi unyinji wamisempha yamtima, zomwe zimakhudza molakwika momwe magwiridwe ake amagwirira ntchito. Ndi kusintha kulikonse kolakwika mu mtima, chiopsezo chotenga matenda oopsa komanso obaya moyo monga myocardial infarction ndi stroke akuwonjezeka.

LV myocardial hypertrophy imatha kuchitika pakokha, komanso chifukwa cha kulephera kwanthawi yayitali kwa mtima. Komanso, gawo lamanzere lamitsempha yamanzere amitsempha yamagazi limakhala chifukwa cha matenda oopsa kwambiri pakakhala matenda aliwonse amtima. Pankhaniyi, matenda atapezeka, chithandizo chiyenera kuyambika nthawi yomweyo, chifukwa kunyalanyaza kwa vutoli kungayambitse zovuta zazikulu mpaka zakupha.

Zochitika zotsatirazi zimagwiranso ntchito pazomwe zimayambitsa michere yamanzere yamitsempha yamagazi:

kobadwa nako komanso kukhala ndi vuto la mtima,
Matenda a mtima wa Ischemic,
cardiomyopathy
kupsinjika kwakukulu pamthupi ndi m'malingaliro, zomwe zimachitika kawirikawiri - ndizodziwika kwambiri kwa akatswiri othamanga,
ndi matenda a shuga komanso kunenepa kwambiri,
ndi kusakwanira zolimbitsa thupi,
ndi chitukuko cha atherosulinosis.

Zowopsa za vutoli ziyenera kuonedwa ngati zizolowezi zoipa monga kusuta fodya, kuledzera.

Myocardial hypertrophy ya kumanzere kwamitsempha yamtima imatha kupezeka kuti imakhala yakuthwa kwambiri komanso yosowa kwambiri, yokhala ndi vuto la kugona, lomwe limakonda kwambiri azimayi omwe ali ndi nthawi ya postmenopausal. Kupatuka kulikonse muumoyo kuyenera kukhala chifukwa chopita kwa dotolo ndikuwonetsetsa thupi lonse.

Kuchekera kwa kulowerera kwa myocardial mu shuga komanso zotsatira zake

Matenda a mtima ndi a mtima ndi omwe akutsogolera imfa ku matenda ashuga. Kuphwanya Myocardial kumachitika pamalo oyamba pakati pawo. Mwa anthu odwala matenda ashuga, pali mitundu ya atypical, yopweteka, yophatikizika ndi kulephera kwa mtima, kusokonezeka kwakuthwa kwa mitsempha, aneurysm ndi mtima wosweka.

Kanema (dinani kusewera).

Mtundu woyamba 1 ndi matenda a shuga a 2 ndi matenda osiyana kwambiri pazifukwa ndi njira zopititsira patsogolo. Amalumikizidwa ndi zikhalidwe ziwiri zokha - cholowa cham'tsogolo komanso kuchuluka kwa shuga m'magazi.

Mtundu woyamba umatchedwa kudalira insulin, umapezeka mwa achinyamata kapena ana ukakumana ndi ma virus, kupsinjika, ndi mankhwala osokoneza bongo. Mtundu wachiwiri wa matenda a shuga umadziwika ndi pang'onopang'ono, odwala okalamba, monga lamulo, onenepa kwambiri, matenda oopsa oopsa, cholesterol yayikulu m'magazi.

Kanema (dinani kusewera).

Type 2 shuga

Zomwe zimachitika pokhudzana ndi vuto la mtima

Mu mtundu woyamba wa matenda, zochita za autoimmune zimayambitsa kufa kwa maselo a pancreatic omwe amapanga insulin. Chifukwa chake, odwala alibe mahomoni awo m'magazi kapena kuchuluka kwake ndi kochepa.

Ndondomeko zomwe zimachitika mu kuperewera kwa insulin kwathunthu:

kuchepa kwamafuta kumayambitsa,
zomwe zili ndi mafuta acids ndi triglycerides m'magazi zimakwera
popeza glucose simalowa m'maselo, mafuta amakhala gwero lamphamvu,
mafuta makutidwe ndi okosijeni zimachitikira kumabweretsa zowonjezera ma ketones m'magazi.

Izi zimabweretsa kuwonongeka m'magazi kwa ziwalo, zomwe zimakonda kwambiri zoperewera - mtima ndi ubongo.

Kodi ndichifukwa chiyani pali chiopsezo chachikulu cha kudwala mtima?

Mu matenda a shuga amtundu wachiwiri, kapamba amapanga insulin mwanjira zabwinobwino komanso kuchuluka. Koma chidwi cha maselo kwa icho chimatayika. Vutoli limatchedwa insulin kukana. Kuwonongeka kwa mtima kumachitika mothandizidwa ndi zinthu izi:

shuga wamagazi - amawononga makoma amitsempha yamagazi,
cholesterol owonjezera - amapanga ma atherosselotic zolembera, zotsekera kuunikira kwamitsempha,
matenda obanika magazi, chiopsezo cha thrombosis,
kuchuluka kwa insulini - kumapangitsa secretion ya contrainsular mahomoni (adrenaline, kukula mahomoni, cortisol). Amathandizira kutsitsa kwamitsempha yamagazi ndi kulowa kwa cholesterol mwa iwo.

Myocardial infarction imakhala yoopsa kwambiri mu hyperinsulinemia. Kukumana kambiri kwa timadzi timeneti kumathandizira kukula kwa atherosulinosis, monga kupangika kwamafuta a cholesterol ndi chiwindi cha chiwindi kumathandizira, minofu ya makoma a ziwiya zimakulira, ndikuwonongeka kwa magazi kumalepheretsa. Chifukwa chake, odwala omwe ali ndi mtundu wa shuga wachiwiri amakhala pachiwopsezo cha matenda oopsa a coronary kuposa odwala ena.

Pezani momwe IHD ndi myocardial infarction ku matenda a shuga zimawonera, onani vidiyo iyi:

Zinthu Zowonjezera kwa Munthu wa Matenda A shuga

Pafupipafupi matenda a mtima pakati pa odwala matenda ashuga ndiwofanana mwachindunji pakubwezeretsa matendawa.Kutali kwambiri ndi zomwe zikuwonetsa kuchuluka kwa shuga m'magazi, nthawi zambiri odwala awa amakhala ndi zovuta za matenda a shuga komanso mtima. Zomwe zingakhudze kukula kwa vuto la mtima ndi izi:

uchidakwa
zolimbitsa thupi zochepa,
mavuto osaneneka
chizolowezi cha chikumbumtima,
kudya kwambiri, nyama zochuluka zamafuta ndi chakudya chamagulu m'zakudya,
ochepa matenda oopsa.

Zomwe zimayambitsa kulowerera m'matenda a shuga

Matenda a mtima amakhala ovuta kwambiri kwa odwala matenda ashuga. Amakhala ochulukirapo, nthawi zambiri amakhala ovuta chifukwa amakwanira kulepa kwa mtima, mpaka kuthetsedwako kwamtima ntchito, arrhythmia. Poyerekeza ndi kuwonjezeka kwa kuthamanga kwa magazi ndi njira ya dystrophic mu myocardium, aneurysm yamtima ndi kupasuka kwake kumachitika.

Kwa odwala matenda ashuga, mitundu iyi ya kusowa kwamphamvu kwa coronary imadziwika:

kupweteka kwapafupipafupi (kwanthawi yayitali ya kupweteka pachifuwa),
m'mimba (Zizindikiro zam'mimba zopweteka),
zopanda pake (mawonekedwe apamwamba),
arrhythmic (kuukira kwa atrive fibrillation, tachycardia),
ubongo (kusowa kwa chikumbumtima, paresis kapena ziwalo).

Nthawi ya pachimake imatha masiku 7 mpaka 10. Pali kuwonjezeka kwa kutentha kwa thupi, kutsika kwa magazi. Kulephera kuzungulira kwa pachimake kumayambitsa mapapu a edema, kugunda kwa mtima, komanso kuchepa kwa mafupa am'mimba, komwe kungakhale kovulaza kwa wodwalayo.

Amatchula zovuta zakumapeto kwa myocardial infarction, kukula kwake kwa odwala omwe ali ndi matenda osokoneza bongo kumabweretsa zotsatirazi:

kupuma movutikira, kutsokomola, nthawi zina hemoptysis,
kupweteka mtima
kugunda kwamtima kawiri kawiri
kupweteka ndi kulemera mu hypochondrium yoyenera,
Kutupa kwa m'munsi,
kutopa.

Kupweteka kwapafupipafupi kwanthawi yayitali kapena kozunza ndi chizindikiro chachikulu cha vuto la mtima. Zimaphatikizidwa ndi thukuta, kuopa kufa, kupuma movutikira, kutsekeka kapena kufiyira kwa khungu la kolala. Zizindikiro zonsezi mwina siziri ndi matenda ashuga.

Izi ndichifukwa choti odwala matenda ashuga amakhudzidwa ndi ma capillaries ang'onoang'ono komanso ulusi wamitsempha mkati mwa myocardium chifukwa cha systemic microangiopathy ndi neuropathy.

Vutoli limachitika ndi nthawi yayitali chifukwa cha kuchuluka kwa shuga m'magazi. Dystrophy ya minofu ya mtima imachepetsa kuwona kwa zopweteka.

Kusokonezeka kwakasokonezeka kwama cell kumapangitsa kuti magazi azikhala ndi magazi, zomwe zimayambitsa kubwereza, kugunda kwamtima kwambiri, aneurysms, kugunda kwa minofu yamtima.

Njira yopanda kumva yopweteka imaphatikizira kuzindikiritsa kwa matenda kumayambiriro, kumawonjezera ngozi ya kufa.

Pazindikiritso, njira yophunzitsira kwambiri ndiyo kuphunzira kwa ECG. Zosintha monga:

nthawi ya ST ili pamwamba pa contour, ili ndi mawonekedwe a utoto, imadutsa mu T wave, yomwe imakhala yolakwika,
Kutalika koyamba poyamba (mpaka maola 6), kenako kutsika,
Q wave wave matalikidwe.

ECG ya kulowerera m'mitsewa yam'mimba komanso matenda a shuga - kovuta kwambiri

Pakayezetsa magazi, creatine kinase imakulitsidwa, aminotransferases ndi apamwamba kuposa abwinobwino, ndipo AST ndi yapamwamba kuposa ALT.

Chomwe chimapangitsa kuti shuga azikhala ndi matenda a shuga ndi kukhazikika kwa kuwerenga kwa shuga wamagazi, chifukwa popanda izi mtima uliwonse ukadakhala wopanda tanthauzo.

Pankhaniyi, kuponya kwakuthwa mu glycemia sikuloledwa, nthawi yayitali ndi 7.8 - 10 mmol / l. odwala onse, mosasamala mtundu wa matenda komanso chithandizo chamankhwala chomwe chatsimikiziridwa musanakumane ndi vuto la mtima, amasamutsidwira kuchipatala cholimbikitsidwa ndi insulin.

Magulu awa a mankhwala amagwiritsidwa ntchito pochiza matenda a mtima:

anticoagulants, thrombolytics,
beta-blockers, nitrate ndi othandizira calcium
antiarrhythmic mankhwala
mankhwala ochepetsa cholesterol.

Zakudya pambuyo myocardial infarction ndi shuga

Mu gawo la pachimake (masiku 7-10), phwando lokhazikika la chakudya chosenda bwino limasonyezedwa: msuzi wamasamba, mbatata zosenda (kupatula mbatata), phala la oatmeal kapena lophika la buwheat, nyama yophika, nsomba, kanyumba tchizi, mafuta omwera, mapuloteni otentha, kefir kapena yogati. Kenako mndandanda wazakudya ungakulidwe pang'onopang'ono, kupatula:

shuga, ufa woyera ndi zinthu zonse zomwe zilimo,
semolina ndi mpunga
mankhwala osuta, marinade, zakudya zamzitini,
chakudya chamafuta,
tchizi, khofi, chokoleti,
mafuta kanyumba tchizi, wowawasa kirimu, kirimu, batala.

Ndikosatheka kuthira mbale pophika chakudya, ndipo 3 mpaka 5 g (masiku 10 atachitika vuto la mtima) mchere umaperekedwa kwa wodwala. Mafuta sayenera kumwa osaposa 1 lita imodzi patsiku.

Kutalika ndi nthawi ya kuchira kumadalira kuchuluka kwa kuwonongeka kwa minofu ya mtima komanso mkhalidwe wa vasculature mu matenda ashuga. Kupeza bwino kwa matenda oopsa kwambiri, kupanikizika kwamitsempha, matenda a shuga, okhala ndi matenda osokoneza bongo.

Popewa kukula kwa matenda oopsa a coronary circulatory, tikulimbikitsidwa:

Kuwunikira mosamala shuga ndi mafuta m'thupi, kukonza kosemphana ndi nthawi.
Kuyeza kwa tsiku ndi tsiku kwa kuthamanga kwa magazi, mulingo woposa 140/85 mm Hg suyenera kuloledwa. Art.
Kusiya kusuta, zakumwa zoledzeretsa komanso zakumwa zina za tiyi, zakumwa zamphamvu.
Kugwirizana ndi chakudya, kupatula mafuta a nyama ndi shuga.
Zochita zolimbitsa thupi.
Chithandizo cha mankhwala othandizira.

Chifukwa chake, kukulitsa kwa vuto la mtima kwa odwala omwe ali ndi matenda amtundu wa 1 ndi mtundu wa 2 amatha kukhala asymptomatic, omwe amachititsa kuti azindikire matenda omwewo ndikupangitsa zovuta. Mankhwala, muyenera kusintha shuga m'magazi ndikuchita mokwanira. Monga prophylaxis, kusinthidwa kwamoyo ndi kalembedwe ka chakudya kumalimbikitsidwa.

Nthawi yomweyo, matenda ashuga ndi angina pectoris amawopseza thanzi lathu. Kodi kuchitira angina pectoris ndi mtundu 2 shuga? Kodi ndi kusokonezeka kwa mtima wamitima komwe kumachitika?

Pafupifupi palibe amene wakwanitsa kupewa chitukuko cha matenda a shuga. Izi ziwiri pathologies zimagwirizana, chifukwa kuchuluka kwa shuga kumakhudza mitsempha ya magazi, zomwe zimapangitsa kuti pakhale kusintha kwa atherosulinosis ya m'munsi kwambiri mwa odwala. Chithandizo chimachitika ndi chakudya.

Zomwe zimayambitsa infarction yaying'ono yokhazikika yofanana ndi mitundu ina yonse. Ndikosavuta kuzindikira kuti ECG yovuta kwambiri imakhala ndi chithunzi. Zotsatira zakuchira kwake komanso kukonza kwakanthawi ndizosavuta kuposa kukhala ndi vuto la mtima.

Osati zowopsa kwa anthu athanzi, arrhythmia yokhala ndi matenda osokoneza bongo imatha kukhala owopsa kwa odwala. Ndizowopsa makamaka kwa matenda ashuga amtundu wa 2, chifukwa amatha kudwala matenda a stroko komanso mtima.

Ndikosavuta kuzindikira, chifukwa nthawi zambiri njira yonyansa ya subendocardial myocardial infaration imakhala nayo. Nthawi zambiri zimapezeka pogwiritsa ntchito ECG ndi njira zoyeserera zasayansi. Matenda a mtima owopsa amawopseza kuti afe.

Matenda oopsa a arterial ndi matenda a shuga amawonongeka chifukwa cha ziwiya zambiri. Mukamatsatira malangizo a dokotala, mutha kupewa zotsatirapo zake.

Kupewa kulephera kwa mtima ndikofunikira konsekonse, pamafungo, kumbuyo, komanso asanabadwe amayi ndi abambo. Choyamba muyenera kuchiritsa matenda amtima, kenako kusintha moyo wanu.

Kuzindikira posachedwa koyambira kwapansi sikophweka chifukwa chatsatanetsatane. ECG yokha siyingakhale yokwanira, ngakhale zizindikiritso zoyenera zimatchulidwa. Kodi kuchitira myocardium?

Pali ischemia yopanda ululu, mwamwayi, osati kangapo. Zizindikiro zake ndizofatsa, mwina sipangakhale angina pectoris. Njira zowonongeka pamtima zidzatsimikiziridwa ndi dokotala malinga ndi zotsatira za kuwunika. Chithandizo chimaphatikizapo mankhwala ndipo nthawi zina amachitidwa opareshoni.

Matenda a shuga amatchedwa "mtima wodwala"

matenda obadwa nawo,
kusuta (kuwirikiza kuwopsa kwa vuto la mtima),
uchidakwa
kuthamanga kwa magazi
onenepa kwambiri.

Matendawa amakula msanga, mavuto amabwera mpaka amapha. Myocardial infaration kwa odwala omwe amadwala matenda a shuga amakwiya kwambiri. Hypoxia imatheka chifukwa chobowoleza mpweya m'matupi.

Kupezeka kwa mapuloteni mumkodzo ndi chizindikiro chosavomerezeka cha matenda amtima wamatenda a shuga.

Mitundu ikulu ya matenda a mtima mwa odwala matenda ashuga amathandizira pazinthu zingapo:

zotumphukira zamasana,
kusokoneza endarteritis,
vasculitis
matenda a shuga ndi nephropathy
dyslipidemia.

Mankhwala ochepetsa mphamvu ya glucose amatchulidwa pambuyo pokhazikika kwa kusakhazikika kwa coronary insufficiency. Mayendedwe akulu a mankhwalawa amachokera m'mnyewa wamtima:

matenda a shuga
cholesterol yotsika
kusungabe kuthamanga kwa magazi pamlingo wa 130/80 mm RT. Art.,
Maanticoagulants a magazi
Mankhwala a mtima ndi kuchiza matenda a mtima.

Wodwala amayenera kutsatira mndandanda wonse wamoyo.

Ndi matenda a shuga, vuto la mtima limatha kuwonekera m'njira zosiyanasiyana:

kusanza popanda chifukwa
malaise
kusokonezeka kwa mtima
kufooka
kupuma movutikira
kupweteka pachifuwa
kupweteka kukhosi, khosi, phewa, kapena mkono.

Kwa odwala matenda ashuga, ndikofunikira nthawi zonse kunyamula mapiritsi a nitroglycerin.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, mavuto ali ndi malingaliro awoawo. Kuopsa kwa vuto la mtima kumawonekera mwa anthu kuyambira ali aang'ono. Zizindikiro:

Kutupa ndi kupindika kwa miyendo,
kukodza pafupipafupi
kutopa,
kuchuluka kwambiri kwa thupi
chizungulire.

Zambiri zamatenda a mtima odwala matenda ashuga:

kuchuluka kwa anthu odwala matenda oopsa kwambiri
kuchulukana kwawombana
kuthekera kwakufa ndikokwera kuposa anthu athanzi.

Ngati sanapatsidwe, "matenda a shuga" ali pachiwopsezo chachikulu kuti aleke.

Kugunda kwamtima ndi matenda ashuga kumawonjezera chiopsezo cha matendawa komanso kuthekera kwamavuto kawiri.

Nthawi zambiri pokhapokha ngati mtima wapezeka ndi vuto lalikulu la shuga m'magazi ndikupezeka ndi matenda a shuga, mtundu ndi mawonekedwewo zimatsimikiziridwa.

Odwala omwe ali ndi matenda ashuga amapatsidwa mitundu iwiri ya kukonzanso pambuyo vuto la mtima:

zolimbitsa thupi (masewera ndi masewera)
zama psychology (kufunsa, psychotropic mankhwala ngati kuli kofunikira).

Pakati pa sabata yoyamba ndikofunikira kudya magawo ang'onoang'ono:

supu zosenda masamba ndi mbatata zosenda (kupatula mbatata),
phala (kupatula semolina ndi mpunga),
nyama yokonda ndi nsomba (yophika kapena yowira),
ma-nyama ndi matumba, ophika wopanda mafuta kapena nthunzi,
zopangidwa mkaka ndi zakumwa,
amamu omelet.

Sabata yachiwiri, mbale sizidulidwa. Nsomba ndi nyama muzakudya zimakhalapo nthawi 1 yokha patsiku. Casseroles, masamba osenda amawonjezedwa. Zoyipa:

kusuta
marinade ndi zakudya zamzitini,
tchizi
chokoleti
khofi ndi tiyi wamphamvu.

Zakudya ndizochepa pama calories. Ndiwo zamafuta, msoka, mtedza, ndi mphodza amalimbikitsidwa.

Zakudya zimatengera zipatso ndi ndiwo zamasamba. Ndikofunika kudya nsomba zowiritsa komanso nsomba zam'nyanja.

Masamba ndi zipatso za matenda ashuga pambuyo vuto la mtima, zomwe akatswiri adalimbikitsa:

tomato
nkhaka
sipinachi
broccoli
kolifulawa, kabichi yoyera ndi maluwa a Brussels,
katsitsumzukwa
mabuluni
yamatcheri
mapichesi
ma apricots
maapulo
malalanje
mapeyala
kiwi

kupezeka kwa potaziyamu ndi magnesium mu chakudya,
kupatula zakudya zolemera, nyama zamafuta,
Mbale zonse zilibe mchere,
kukana zakudya yokazinga,
kumwa pang'ono, mpaka 1,2 l,
kupezeka kwa nkhuku muzakudya,
ambiri mafuta mbale
tiyi ndi khofi wamphamvu - tiyi,
masamba abwino okha,
kupatula chokoleti
osadziletsa ku chakudya chamafuta othamanga,
buledi suyenera kukhala watsopano.

Kuphwanya kwa Myocardial mu shuga ndi vuto lalikulu lomwe lingayambitse kudwala kwa wodwala. Matenda awiriwa omwe akuwonjezera mbali amafunikira chithandizo chachikulu, kutsatira kwambiri malangizo onse a dokotala komanso kupewa moyo wonse.

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale atha kupeza mankhwala ZAULERE .

Kodi vuto la mtima ndi chiani? Izi sianthu koma kumwalira kwa myocardium pambuyo pakutha kwodutsa kwa magazi m'chigawo china chake. Kusintha kwa atherosulinotic mu ziwiya zosiyanasiyana, kuphatikizapo ziwiya zama mtima, kumapititsa patsogolo vuto la mtima. Chiwerengero cha anthu omwe amwalira ndi vuto la mtima masiku athu ano ndi chokwera kwambiri ndipo chimakhala pafupifupi 15-20%.

Atherosulinosis ndikuyika mafuta mu khoma lamitsempha, lomwe pamapeto pake limatsekeka kwathunthu kwa lumen ya mtsempha wamagazi, magazi sangayende bwino. Palinso kuthekera kwakuti kungang'ambike chidutswa cha mafuta chopangidwa mchombocho ndi chitukuko cha thrombosis. Njira izi zimadzetsa vuto la mtima. Poterepa, vuto la mtima silimapezeka mu minofu ya mtima. Imatha kukhala kugunda kwamtima kwa bongo, matumbo, ndulu. Ngati njira yoleka kutuluka kwa magazi ikupezeka mu mtima, ndiye kuti tikulankhula za myocardial infarction.

Zina zimatsogolera kukukula kwachilendo kwa atherosulinosis.Mwakutero:

onenepa kwambiri
amuna
ochepa matenda oopsa
kusuta
kuphwanya lipid kagayidwe,
matenda ashuga
kuwonongeka kwa impso
chibadwire.

Ngati wodwala matenda ashuga ali ndi vuto lochita kusuntha, ndiye kuti kuchita koopsa kuyenera kuyembekezeredwa, zotsatiranso zake zimakhala zazikulu. Chifukwa cha kafukufuku wamikhalidwe yotere, zidapezeka kuti matenda amtima wodwala matenda ashuga amakula zakale kuposa momwe zimakhalira ndi matenda a mtima opanda matenda a shuga. Izi zimathandizidwa ndi zina mwanjira ya matenda ashuga.

Kuopsa kwa matendawa kumachitika chifukwa choti kuchuluka kwa shuga m'magazi, mphamvu zake zowopsa zimayamba, zomwe zimapangitsa kuwonongeka kwa khoma lamkati la ziwiya. Ndipo izi zimatsogolera kukuwonjezereka kwa madera owonongeka a cholesterol plaques.
Kunenepa kwambiri Zakudya zopanda vuto kwa nthawi yayitali zimabweretsa matenda oopsa.
Matenda oopsa a arterial ndi mnzake wa mtundu wa matenda ashuga 2 komanso kunenepa kwambiri. Izi zimakhudza kugonjetsedwa kwa zombo zazikulu-zowopsa.
Mu shuga mellitus, kapangidwe kake ka magazi kamasinthira momwe kamawonjezera mamvekedwe. Izi zimathandizira kwambiri kuyambika kwa myocardial infarction.
Kuphwanya Myocardial kudadziwika mu abale apamtima omwe sanali kudwala matenda ashuga.
Lipid ndi cholesterol kagayidwe. Chakudya chopatsa thanzi ndichofunika kwambiri.

Wodwala matenda ashuga nthawi zambiri amakhala ndi mtima womwe umadziwika kuti ndi wodwala. Izi zikutanthauza kuti makoma ake amakhala opanda pake, kulephera kwa mtima kumayamba.

Malinga ndi WHO, chaka chilichonse padziko lapansi anthu 2 miliyoni amafa chifukwa cha matenda ashuga komanso zovuta zake. Pokhapokha pakhale thandizo loyenerera la thupi, matenda ashuga amabweretsa mavuto osiyanasiyana, pang'onopang'ono kuwononga thupi la munthu.

Mavuto ambiri omwe amakonda ndi awa: matenda ashuga a m'mimba, nephropathy, retinopathy, zilonda zam'mimba, hypoglycemia, ketoacidosis. Matenda a shuga amathanso kupititsa patsogolo chotupa cha khansa. Pafupifupi nthawi zonse, wodwala matenda ashuga amwalira, akulimbana ndi matenda opweteka, kapena amasintha kukhala munthu weniweni wolumala.

Kodi anthu odwala matenda ashuga amatani? Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga.

Dongosolo la Federal "Mtundu Wathanzi" likuchitika, mkati mwanjira yomwe mankhwalawa amaperekedwa kwa aliyense wokhala ku Russian Federation ndi CIS ZAULERE . Kuti mumve zambiri, onani tsamba lovomerezeka la MINZDRAVA.

Kufa kwa vuto la mtima ndi matenda a shuga kumachulukitsidwa kwambiri chifukwa cha kagayidwe kachakudya ka thupi ndi kuchira.

Izi ndizowopsa, chifukwa wodwalayo sangamvere zowawa pang'ono kumanzere, ndipo kuwonongeka kwake kumatha kuonedwa ngati kudumphadumpha kwa shuga.

Kodi munthu wodwala matenda ashuga angadere nkhawa chiyani? Wodwala angazindikire zotsatirazi:

Malinga ndi ziwerengero, theka la anthu omwe ali ndi matenda osokoneza bongo a mellitus (DM) amakumana ndi myocardial infarction (MI). Myocardial infarction ndi shuga ndi matenda owopsa omwe nthawi zambiri amaphatikizidwa. Zomwe zimachitika ndi matenda a shuga zimapangitsa kuti magazi azikula, kuchepa kwamphamvu kwa mitsempha yamagazi ndi kuyika kwa cholesterol pamakoma awo, ndichifukwa chake chiopsezo cha kuphwanya myocardial chikuwonjezeka.Mu shuga, wodwalayo ayenera kuyang'anira thanzi lawo nthawi zonse.

82% ya anthu odwala matenda ashuga amakhala ndi matenda amtima chifukwa cha shuga.

Matenda a shuga ndi chiopsezo chachikulu. Kuopsa kwa vuto la mtima ndi matenda a shuga kumawonjezereka ngati pali zotsatirazi:

Kupezeka kwa matendawa m'modzi mwa abale.
Kusuta. Kusuta fodya 2 nthawi zambiri kumawonjezera mwayi wokhala ndi vuto la mtima. Chizolowezi choyipa chimayambitsa kuwonongeka msanga m'mitsempha yamagazi ndipo mutazindikira matenda a shuga, muyenera kuiwala za izi.
Kuchulukitsa kwa magazi. Hypertension imadzetsa kuchuluka kwa mtima wamtima.
Kulemera kwambiri. Kukula kwamchiuno mwa amuna ndi kupitirira 101 cm, ndipo mwa akazi - 89 cm, amalankhula za kunenepa kwambiri. Kulemera kwambiri kumawopseza mapangidwe a atherosselotic plaques ndi mitsempha yolumikizidwa.
Mafuta ambiri mumagazi.

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Kukula kwa vuto la mtima ndi matenda a shuga 1 Kukhazikika kwa vuto la mtima kumadziwika ngakhale ndi anthu omwe ali ndi prediabetes, pomwe kulekerera kwa chakudya chamthupi kumangokhala kokha. Izi zimachitika chifukwa cha metabolidi ya lipid komanso gawo la insulin pochita izi. Mwambiri, zifukwa zotsatirazi zamatenda a mtima mu shuga zitha kusiyanitsidwa:

kuwonjezeka kwamisempha yamagazi ndi kukondoweza kwa mapangidwe a matupi a ketone chifukwa chosowa insulin,
magazi, kuchuluka kwa magazi,
mapangidwe a protein ya glycosylated chifukwa kuchuluka kwa shuga mthupi,
Hypoxia chifukwa cholumikizana ndi shuga ndi hemoglobin,
kugawa kwam cell minofu yosalala ndikulowerera kwa lipids mwa iwo chifukwa cha kutulutsidwa kwa mahomoni okula - wotsutsana ndi insulin.

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Zizindikiro zazikulu za vuto la mtima mwa azimayi ndi abambo omwe ali ndi matenda ashuga ndi:

kukanikiza ululu pachifuwa,
kusanza, kusanza,
kufooka wamba
kulephera kwa phokoso la kugunda kwa mtima.

Sizotheka kuyimitsa ululu ndi nitroglycerin, umapatsa khosi, mapewa, nsagwada. Kukhalapo kwa zizindikiro zotere kumawonetsa mavuto amtima ndipo kumalola thandizo la panthawi yake kwa wodwalayo. Komabe, sizovuta nthawi zonse kuzindikira vuto la mtima lomwe limachitika motsutsana ndi maziko a matenda ashuga. Mosasamala mtundu wa shuga, chidwi cha wodwalayo cham'kati chimachepa, chifukwa chake kugunda kwa mtima sikupweteka. Chifukwa cha izi, munthu samalandira chithandizo chofunikira, chomwe chimakhudza mkhalidwe wamkati wamtima ndipo chingayambitse kupasuka kwake. Chiwopsezo cha matenda a mtima mwa odwala matenda ashuga pambuyo vuto la mtima chikuchulukirachulukira.

Pachizindikiro choyamba cha kulowetsedwa kwa myocardial, muyenera kuyimba ambulansi.

Thandizo loyamba la MI limatsitsidwa ndikusinthidwa:

kuyala wodwala kuti thupi lakumwamba litukuke pang'ono,
patsani munthu kupuma kwaulere (kolala yopanda maziko, lamba),
perekani mpweya wabwino
kuthamanga magazi, kuthamanga kwa mtima komanso kupuma,
apatseni wodwala nitrolycerin ndi wosakhazikika, mwachitsanzo, kulowetsedwa kwa valerian.

Bweretsani ku zomwe zalembedwa

Njira zotsatirazi zozindikirira zimagwiritsidwa ntchito kuti mupeze kupunduka kwa myocardial ndi zovuta zake:

Mbiri kutenga. Kukula, kutalika, chikhalidwe cha ululu, kutalika kwa kuwukiridwa kumveka.
Electrocardiography
Kusanthula kwamwazi ndi kukosanso kwamwazi. Kuwonjezeka kwa ESR ndi kuchuluka kwa maselo oyera oyera kumawonetsa njira yotupa ndi mapangidwe a zipsera.
Echocardiography. Zimachitika ngati zidziwitso zomwe zimapezeka ndi electrocardiography sizokwanira kupanga chidziwitso. Njira imalola kuzindikira ischemia ndi angina pectoris.
X-ray Kuwona kwa x-pachifuwa kukuwonetsa mkhalidwe wam'mapapu komanso kupezeka kwa zovuta za MI.

Bweretsani ku zomwe zalembedwa

Kuti musinthe wodwalayo momwe muliri, kupewa kubwereranso m'mbuyo ndikukula kwa zovuta, ndikofunikira:

Sinthani shuga m'magazi,
kuthamanga kwa magazi kufika pa 130/80 mm RT. Art.,
cholesterol yotsika
wochepetsa magazi.

Bweretsani ku zomwe zalembedwa

Mosasamala mtundu wa shuga, odwala amawonetsedwa ndi insulin. Insulin yofikira mwachidule imagwiritsidwa ntchito. Mankhwala omwe amachepetsa shuga kuchokera ku sulfonylurea kapena gulu ladongo, mwachitsanzo, Metformin, singatengedwe panthawi yovuta kwambiri. Kuchepetsa magazi ndi kuthetsa magazi, mabedi ndi omwe amapatsidwa. Mankhwala a antihypertensive ndi mtima glycosides amagwiritsidwanso ntchito. Kugwiritsa ntchito mankhwala osokoneza bongo sikothandiza kwenikweni kuposa kuchitidwa opareshoni, ndipo kumachitika pamaso pa contraindication kuti opaleshoni ayambe. Mwapang'onopang'ono komanso moyenera kubwezeretsa kutuluka kwa magazi kumapangitsa kuti angioplasty ndi mtima stenting.

Kulowerera m'matenda a shuga ndi vuto loopsa lomwe lingayambitse imfa. Zakudya pambuyo pa MI ndi gawo lofunikira kwambiri pazachipatala. Tebulo Na 9 limayikidwa kwa odwala matenda a shuga omwe adakumana ndi vuto la mtima.Masiku oyamba pambuyo pa MI, chakudya chizikhala ndi masamba, kupatula mbatata, ndi chimanga, kupatula semolina ndi mpunga. Mchere umaletsedwa nthawi imeneyi.

Chakudya chokhazikika chimaperekedwa kwa odwala omwe ali ndi vuto lalikulu ngati akuvutika kwambiri chifukwa cha vuto la mtima.

Malamulo otsatirawa amathandizira pomanga chakudya:

Zakudya ziyenera kukhala zochepa m'makanema
Zakudya zokhala ndi cholesterol yambiri, zakudya zamafuta a nyama, kuphatikizapo mkaka, nyama ya mafuta, siziletsedwa,
Zakudya zamafuta osavuta zomwe ndi gawo la shuga ndi zopangidwa mu confectionery ndizoletsedwa,
cocoa, khofi ndi zonunkhira zimachotsedwa muzakudya
kugwiritsa ntchito chokoleti, tiyi, madzi ndi mchere ndizochepa,
Zakudya zokazinga ndizoletsedwa.

Bweretsani ku zomwe zalembedwa

Pofuna kupewa matenda amtima komanso matenda a mtima, takulimbikitsani kutsatira malamulo awa:

Tsatirani zakudya zotchulidwa mutazindikira matenda a shuga. Zakudya zoyenera zimakupatsani mwayi wowongolera shuga ndi cholesterol.
Siyani kusuta ndi kusiya zakumwa zoledzeretsa zamphamvu zilizonse.
Sunthani zina. Zochita zilizonse zolimbitsa thupi ndizothandiza - kuyenda paki, kulowetsa m'malo mwake ndi makwerero, kupita kumalo olimbitsa thupi.
Osachepetsa kuchuluka kwamadzi.
Pewani kupsinjika. Kupsinjika kwamanjenje kumakhudza mtima wa munthu aliyense, mosasamala kanthu za kupezeka kwa matenda ashuga.

Mu shuga mellitus, choyambitsa chachikulu cha zovuta zilizonse ndikukula kwa shuga m'thupi. Kuwongolera shuga komanso kusintha matenda a shuga pogwiritsa ntchito moyo ndi mankhwala ndi njira yofunikira kwambiri yopewa matenda a mtima. Kusintha kwa mankhwala osavomerezeka kapena kusintha kwa msambo, kunyalanyaza malamulo okhudzana ndi zakudya, kusafuna kusiya zizolowezi zoyipa kumangowopseza thanzi la anthu, komanso moyo wake.

Weismann, Michael Matenda A shuga. Zonse zomwe zidanyalanyazidwa ndi adotolo / Mikhail Weisman. - M: Vector, 2012 .-- 160 p.
Kazmin V.D. Chithandizo cha matenda a shuga ndi wowerengeka azitsamba. Rostov-on-Don, Nyumba Yofalitsa ya Vladis, 2001, masamba 63, kufalitsa 20,000.
Akhmanov, Matenda a Mikhail. Chilichonse chikuwongoleredwa / Mikhail Akhmanov. - M: Vector, 2013 .-- 192 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Mitundu ya matenda

Pali mitundu iwiri yayikulu yamaphunziro a mtima, omwe ali ndi zinthu zingapo zosiyana ndipo amatha kupezeka nthawi yowonjezera yowunika.

Mitundu ya matendawa ndi awa:

Hypentric hypertrophy, yomwe imapezeka nthawi zambiri ndipo imadziwika ndi mapangidwe a kukula kwa gawo lakumunsi kapena lakumwamba kwa septum yamitsempha yamanzere. Nthawi zina, kukula kwa kugawa ndi 55 mm.
Symmetric mawonekedwe a pathology, momwe kusintha kwodziwika kumadziwika mu gawo la septum yamanzere yamitsempha, ntchito yolakwika, mawonekedwe a matenda a diastolic.

Mitundu iwiri iyi yamanzere yamitsempha yamagazi am'mimba imatsimikiziridwa kuti mtima ukathe kupereka njira yodalirika yodalirika. Komanso, magawikidwe oterewa amapangitsa kuti zikhale zowonjezereka kuti ziwonjezeke za matenda.

Monga mitundu ina iliyonse yamatenda amtima, momwe matenda omwe amafunidwira amafunikira chithandizo chamankhwala, popeza pakakhala kusowa kapena kusakwanira kwake pali kuthekera kwakukulu kwa kuwonongeka msanga kwa minofu ya mtima ndi kufooka kwake mwamphamvu, kutsika kwake. Ichi ndi chiwonetsero chowopsa cha zovuta zingapo komanso ngozi kwa moyo wa wodwala.

Poyamba matendawa, zizindikiro za matenda oopsa zitha kuoneka kapena sizingaoneke kuti zidzapezeka munthawi yake. Kukhalapo kwa matendawa nthawi zambiri kumadziwika mukamayesedwa ngati mukudwala kapena mukudwala matenda ena.

Kuwonetsedwa kwa kusintha kwamatenda am'magawo a ventricle yamanzere kumatha kukhala kosawoneka kwa wodwala. Komabe, ngakhale hypertrophy yapakati, momwe zizindikiro zonse zosatchulidwira kwambiri, zitha kukhala ndi mawonekedwe awa:

zosokoneza tulo
kutopa,
kutsika kwa magwiridwe antchito ndi ntchito,
maonekedwe a "ntchentche" pamaso,
kugona kwambiri
kutopa msanga, ngakhale ndi zopsinjika zazing'ono zamtundu uliwonse - zamaganizidwe, zamaganizo ndi zathupi,
kufooka kwa minofu.

Zizindikiro zomwe zatchulidwa zingasiyane pang'ono kutengera magawo a zomwe zikuchitika, komanso pamaso pa ziwonetsero zomwe zikuchitika pakadali pano.

Zizindikiro za mtima wodwala matenda amtundu zimasiyana pakati pa odwala, nthawi zina, zomwe zimakonda kwambiri kufooka kwa wodwala, nthawi yayitali ya zotupa zina komanso kuchepa kwa chitetezo chokwanira, mawonetseredwe a matendawa amakhala olimba kwambiri: wodwalayo amamva kufooka ngakhale akamachita ntchito za tsiku ndi tsiku. magwiridwe antchito, akumagona tulo tulo tofa nato usiku.

Pali magawikidwe a matenda omwe awunikiridwa m'magawo atatu akulu, momwe mawonetseredwe amatha kusiyanasiyana pamlingo wowonetsera komanso kukula kwawo, komanso kuphatikiza.

gawo la malipiro
gawo lolipira,
kubwezera.

Magawo omwe adatchulidwa matendawa amatha kukhala osiyana ndi mawonekedwe amtundu (pamlingo wothandizirana, mawonetsedwe a matenda am'mimba amatchulidwa kwambiri, kuchepetsa mtundu wa moyo watsiku ndi tsiku), komanso kuchuluka kwa kulekerera kwawo kwa odwala. Pogwiritsa ntchito njira zamankhwala ndi mankhwala, mawonetseredwe amachepetsa kuuma kwawo, kukhazikika kwa mkhalidwe wa wodwalayo kumadziwika.

Zizindikiro za vuto la mtima mwa amuna

Kulephera kwa mtima. Kugunda kwa mtima kumawononga mbali yakumanzere ya mtima. Zotsatira zake, malowa samasamba bwino chifukwa cha mawonekedwe. Kutulutsa magazi kumachepetsedwa, kusayenda kwa magazi ndi magazi osagwirizana ndi ziwalo zamkati kumachitika.
Pulmonary edema. Chifukwa cha matendawa, kupuma movutikira kumayamba, kutsokomola kumawonekera.
Arrhasmia. Imachitika m'mimba kumanzere kwa mtima, kutseka miyendo ya mtolo wa Iye ndi kupindika kwamitsempha yamtima.
Supombosis Kugundika kwa magazi kufalikira thupi lonse kupita ku ubongo, chomwe ndicho chifukwa chachikulu cha ischemia.
Kupwetekedwa mtima. Zimachitika chifukwa chakuwonjezeka kwa kuthamanga kwa magazi pa minofu yamtima yowonongeka.

Zotsatira zazitali zimadziwika ndi zowononga zochepa pa thupi. Izi zikuphatikiza:

Matenda a mtima Zotsatira zake ndi kuwonongeka m'magazi.
Kulephera kwamkono wamanzere. Zizindikiro zazikuluzikulu za matenda a m'matumbo ndimatenda a mtima komanso kuwonongeka kwa magazi.
Arrhasmia. Pakhoza kukhala mitundu iwiri ya atrioventricular, sinoatrial block.
Pericarditis. Ndi njira yotupa ya mucous membrane wa mtima.

Cardiac aneurysm, postinfarction syndrome, thromboendocarditis, kusintha kwa mitsempha ya neurotrophic. Zotsatira zake zimayambitsa kuwonongeka kwina kwamagazi, ntchito yamtima ikamakulirakulira, chiopsezo chotumphuka mtima chikuchulukirachulukira.

Mukamapanga zakudya, tsatirani malamulo ena:

Kuchuluka kwa mafuta pazakudya kuyenera kukhala kochepa,
Phatikizani zakudya zam'madzi pa menyu,
Gwiritsani ntchito mafuta ophikira pakuphika
Idyani zamasamba ambiri, zipatso,
Osadya mafuta,
Chepetsani kuchuluka kwa mchere ndi mafuta acids.

Zakudya zopatsa thanzi chifukwa cha kugunda kwa mtima zili ndi magawo atatu:

Nthawi yovuta.
Nyengo yopuma.
Masiku ovuta.

M'milungu iwiri yoyambirira tikulimbikitsidwa kudya zakudya zopukusira: zakudya zamkaka wowawasa, msuzi wamafuta ochepa, masamba ophika, mapira owiritsa. Munthawi imeneyi, ndikofunikira kupatula kwathunthu mchere, mafuta, okazinga, zakudya zosuta, zopangidwa ndi ufa, maswiti kuchokera muzakudya. Zakudya za amuna zizikhala ndi zakudya zochepa zopatsa mphamvu: zipatso zosenda, masamba, mafuta ophikira, tiyi, uchi.

Munthawi ya subacute ndizoletsedwa kugwiritsa ntchito: tiyi, khofi, zonunkhira, chokoleti, mowa, batala. Maziko a chakudya chamagulu ndi zipatso ndi chimanga.

Kudya kumalimbikitsidwa m'magawo ang'onoang'ono pafupifupi kasanu ndi kamodzi. Mtengo wamphamvu wazakudya za tsiku ndi tsiku uzikhala mkati mwa 1100 kcal.

Munthawi yoperewera, zakudya zimayenera kukhala ndi zakudya zama protein ndi mapuloteni, zakudya zamafuta ndi mchere siziyenera kuyikidwa kunja.

Zakudya za tsiku ndi tsiku zimatha kukhala ndi zipatso, zipatso zouma, masaladi ochokera ku amadyera, mitundu yochepa yamafuta ndi nsomba, masamba osenda, mpunga, tchizi chanyumba, nsomba zam'madzi, msuzi kuchokera m'chiuno cha rose. Munthawi imeneyi, ndikofunikira kuwonjezera zopatsa mphamvu patsakudya mpaka 2200 kcal patsiku, kuchepetsa kuchuluka kwa chakudya mpaka kanayi. Kuti matenda a metabolic asinthike m'thupi, muyenera kumwa madzi oyera osachepera 1.5 malita patsiku.

Kodi vuto la mtima limakula bwanji?

Zina zimatsogolera kukukula kwachilendo kwa atherosulinosis. Mwakutero:

onenepa kwambiri
amuna
ochepa matenda oopsa
kusuta
kuphwanya lipid kagayidwe,
matenda ashuga
kuwonongeka kwa impso
chibadwire.

Ndi mapiritsi ati oopsa omwe ndingamwe ndi shuga?

Matenda a shuga ndi matenda a endocrine system, momwe mayamwidwe amtundu wa thupi amakhudzidwa, zomwe zimabweretsa zotsatira zoyipa. Ngati munthu ali ndi matenda awiri nthawi imodzi: matenda ashuga ndi matenda oopsa, ayenera kusamala posankha mankhwalawa ndikuyamba kukhala ndi moyo wapadera.

Ndi matenda ashuga, kusowa kwathunthu kapena kuperewera kwa insulin kumapangidwa m'thupi, chifukwa cha momwe hyperglycemia imapangidwira, kagayidwe kake ndi mayamwidwe am'madzi, mapuloteni, mafuta ndi mchere zimasokonekera. Awa ndi matenda osachiritsika omwe amayamba chifukwa cha chibadwa cha munthu.

Pali mitundu iwiri ya matenda ashuga:

Mtundu woyamba.Kasitomala samatulutsa konse kapena amapanga insulini yaying'ono. Matendawa amapangidwa adakali aang'ono. Uku ndi mtundu wodwala wa matenda.
Mtundu wachiwiri. Amakula amakula mwa anthu omwe amakhala ndi moyo wopanda ntchito komanso wonenepa kwambiri. Pancreas sipanga kuchuluka kwa insulini kapena insulini yopanga siyandidwa ndi thupi. Kwa matenda ashuga amtundu wa 2, mwayi wokhala wolandira matendawa ndiwambiri.

Pali zifukwa ziwiri zomwe zimapangitsa kuti shuga wamagazi achulukane:

Kuchokera kwa chakudya chamagulu omwe amachokera ku chakudya kupita ku thupi.
Kuchokera ku glucose omwe amalowa m'magazi a chiwindi.

Matenda oopsa komanso matenda ashuga

Kwa munthu wokhala ndi matenda ashuga, kuthamanga kwa magazi (BP) kumakhala ndi zovuta zoyipa. Kuthamanga kwa magazi kumawonjezera mwayi wokhala ndi stroke kapena mwadzidzidzi mtima. Kuphatikiza apo, kulephera kwa impso kumatha kuchitika, khungu lingachitike, khungu limayamba ndi kudulidwanso kwina.

Ndi matenda a shuga 1 amtundu, matenda oopsa samachitika nthawi yomweyo, koma ndi zaka. Cholinga chachikulu cha izi ndi kuwonongeka kwa impso (diabetesic nephropathy). Pazifukwa izi, matenda oopsa amapita patsogolo mu 80% yamtundu wa 1 odwala matenda ashuga. 20% yotsala ndi okalamba, onenepa kwambiri, mavuto amanjenje ndi kupsinjika.

Chithandizo choyamba cha matenda a mtima ndi matenda ashuga

Kuti muthane ndi vuto la mtima lomwe limayambitsa matenda a shuga nthawi, muyenera kumvetsetsa momwe thandizo loyamba liyenera kuchitikira pakachitika izi. Madokotala amalimbikitsa izi:

Wodwala amafunika kugona yekha kuti gawo lake lakumwamba limadzuke. Nthawi zambiri, odwala sangachite izi pawokha, izi zimayenera kuchitidwa kwa anthu omwe ali pafupi.
Munthu ayenera kuonetsetsa kuti pakukhala mpweya wabwino nthawi zonse. Kuti muchite izi, tsegulani zenera, khowetsani chipinda, chotsani lamba ndikumasula tayeyo.
Nthawi zonse zofunika kuchepetsa kuthamanga kwa magazi komanso kugunda kwa mtima.
Ngati ndi kotheka, wodwalayo ayenera kumwa nitroglycerin kapena mtima wina wosakhazikika. Choyamba, izi zimakhudza kulowetsedwa kwa valerian.

Chifukwa cha zomwe tafotokozazi, ndizotheka kupulumutsa moyo wa wodwala yemwe ali ndi matenda monga myocardial infarction ndi shuga mellitus.

Zoyambira zazikulu

Matenda osiyanasiyana amtima omwe ali ndi matenda a shuga amapezeka mu 82% mwa odwala onse omwe ali ndi matendawa. Chiwopsezo cha izi chimakula kwambiri zinthu zotsatirazi zikamachitika:

Kupezeka kwa matenda amtima mu abale apamtima. Izi zikuwonetsa chibadwa chakubadwa, chifukwa chomwe majini osalongosoka nthawi zambiri amatumizidwa kuchokera kwa makolo kupita kwa mwana.
Zizolowezi zina zowopsa. Choyamba, izi zimagwira ntchito pa kusuta, komwe kumatha kupanganso mwayi wovuta. Izi ndichifukwa choti sitimayi imavala kwambiri.
Kuchulukitsa kwa magazi (BP). Mtundu wina uliwonse wamagazi umathandizira kuti pakhale kuchuluka kwa mtima wathunthu.
Kulemera kwambiri, kumapangitsa izi kapena kuchuluka kwake kunenepa kwambiri. Ngati chiuno cha mwamuna chimaposa masentimita 101, ndi masentimita 89 amkazi, ndikofunikira kuyambitsa nkhondo ndi kunenepa kwambiri. Nthawi zambiri, kunenepa kwambiri kumapangika popanga ma atherosselotic zolembera zomwe zimatseka zombozo.
Mafuta ambiri mumagazi. Zotsatira zawo ndizokukulitsa magazi ndikupanga mapangidwe a cholesterol.

Chifukwa chake, kulowerera m'matenda a shuga ndi vuto lofala lomwe limayenera kukonzekera.

Gulu lamavuto

Ngati muli ndi matenda ashuga, mudzazindikira nokha zotsatirazi, ndiye kuti muli pachiwopsezo.Muyenera kukhala ndi chidziwitso chowonongekera kuposa anthu ena omwe alibe shuga.

Matenda a shuga enieniwo ali kale pachiwopsezo.
Kuphwanya Myocardial m'modzi mwa abale anu (mpaka zaka 55 mwa akazi ndi kufikira zaka 65 mwa abambo) kumawonjezera mwayi wokhala ndi vuto la mtima mwa inu.
Kusuta fodya kawiri kumawonjezera mwayi wokhala ndi vuto la mtima. Zimathandizira pakuthamanga kwamitsempha yamagazi. Kuwopsa kwa kusuta mu shuga kumafotokozedwa mwatsatanetsatane apa.
Matenda oopsa a magazi kapena matenda oopsa amachititsa kuti mitsempha ikhale yambiri.
Ngati chiuno chimazungulira kupitirira 101 masentimita kwa munthu wamwamuna komanso kupitirira 89 masentimita kwa mzimayi, ndiye kuti izi zikuwonetsa kunenepa kwambiri, mafuta owonjezera "oyipa", chiwopsezo cha mapangidwe a atherosselotic ndi kutsekeka kwa mitsempha ya coronary.
Kuchuluka kwa cholesterol yabwino kumawononga mphamvu ya mtima.
Miyezo yambiri ya triglycerides (mafuta) m'magazi imayambitsa matenda a mtima.

Pazonsezi titha kunena kuti shuga ndi mdani wathu woyamba ndipo tiyenera kulimbana naye kaye.

Zakudya zamagulu pambuyo vuto la mtima

Pambuyo pa vuto la mtima ndi matenda ashuga, muyenera kutsatira pulogalamu yovomerezeka ya tebulo 9. Ndilo zakudya izi zomwe zimagwirizana mokwanira ndi zofunikira zamafuta a matenda a mtima. Kuphatikiza apo, kutsatira zakudya izi pafupipafupi, mutha kuyiwala za zovuta zamtima kwanthawi yayitali. Mfundo zofunika kuzidya:

zakudya ziyenera kukhala zokwanira,
muyenera kupewa kudya zakudya zamafuta othamanga,
mafuta a nyama ayenera kusiyanitsidwa
Chakudya chizigwirizana ndi malamulo okhwima,
kuwunikira kosalekeza misinkhu ya shuga,
kuyang'anira cholesterol.

Chakudya choyambira ndicho poyambira chomwe chingayambitse matenda, kuchepetsa mwayi wamavuto amtundu wamtima, kapena, kuwonjezera, zakudya sizikatsatiridwa. Imfa pambuyo vuto la mtima makamaka zimadalira chakudya.

Zakudya pambuyo poti wodwalayo awononga myocardium ya mtima ndi gawo lofunikira kwambiri pamankhwala. Choyamba, madokotala m'masiku oyambilira amaletsa munthu kudya mchere. Kuphatikiza apo, panthawiyi, ndikulimbikitsidwa kokha kugwiritsa ntchito masamba. Mbatata ndi mbewu zosiyanasiyana zimaloledwa, kupatula semolina ndi mpunga.

Zochitika zonse za zakudya za anthu zomwe zimadwala matenda am'mimba zimafotokozedwa mu chakudya No. 9. Ngati pali ngozi yoti mungayambirenso, madokotala angalimbikitse malamulo okhwima a chakudya.

Malamulo oyamba azakudya pambuyo pa MI mu shuga.

Zakudya za wodwala ziyenera kukhala zochepa. Nyama imatha kudyedwa mwapadera.
Sizoletsedwa kudya zakudya zamafuta ambiri. Chakudya chokhala ndi mafuta a nyama sichilimbikitsidwanso. Izi zimagwira ntchito pa nyama ndi mkaka, limodzi ndi mitundu yosiyanasiyana yoyipa.
Ndikofunikira kuti muchepetse kudya kwanu zakudya zosavuta zamafuta. Amatha kumvetsetsa shuga m'magazi a anthu.
Ndikofunika kupatula cocoa, khofi ndi zonunkhira kuchokera muzakudya. Potengera izi, muyenera kuchepetsa kugwiritsa ntchito tiyi, chokoleti, zakumwa ndi mchere.
Zakudya zophika zimatha kuyambitsa chizindikiritso chimodzi, ndiye muyenera kuzipewa.

Matenda a shuga ndi matenda oopsa, chifukwa amatha kupangitsa kuti pakhale zovuta zina zomwe zimakhudza moyo wa munthu komanso thanzi. Ichi ndichifukwa chake ndikofunikira kwambiri kutsatira mosamalitsa malingaliro onse a dokotala ndipo nthawi ndi nthawi mumayesedwa kwathunthu kwamankhwala ndi ziwalo zamthupi.