Diabetesic polyneuropathy: ICD-10 code, zizindikiro, zoyambitsa ndi chithandizo

Matenda a shuga a polyneuropathy ndi amodzi mwa zovuta kwambiri za matenda ashuga. Amakhulupirira kuti matenda ashuga a polyneuropathy amakula oposa 70-90% ya anthu onse odwala matenda ashuga opitilira zaka 5. Pa magawo oyambilira, mitundu ya asymptomatic imapezeka, yomwe imatha kupezeka ndi kupenda mokwanira kwamitsempha ndi / kapena ndi njira zochitira kafukufuku.

Zambiri kwa madotolo. Kuti tiletse kuzindikiritsa kwa matenda ashuga a polyneuropathy, code G63.2 * malinga ndi ICD 10 iyenera kugwiritsidwa ntchito. Potengera izi, sonyezani kusiyana kwa matendawa (kutengeka, mota, kudziyimira palokha, kapena kuphatikiza pamenepo), kuopsa kwa mawonetsedwe. Kudziwitsa koyambirira kuyenera kuwonetsa matenda a shuga mellitus mwachindunji (ICD 10 codes E10-E14 + wokhala ndi chizindikiro chachinayi chofala 4).

Kukula kwa matendawa kumalumikizidwa ndi matenda a hyperclycemic, kuchepa kwa insulini (mtheradi kapena wachibale), zovuta zam'magazi m'mitsempha yamkati. Kuwonongeka kwa axon kumachitika nthawi zambiri, koma magawanidwe amomwewa amathanso kuchitika. Kuphatikizidwa kwa polyneuropathy ndi angiopathy kwa malekezero ndizomwe zimayambitsa kusokonezeka kwa trophic mu shuga mellitus, makamaka chifukwa cha chitukuko cha phazi la matenda ashuga.

Gulu

Mwa mtundu wa mawonetsedwe ndi kutengera kwazizindikiro, mitundu yotsatirayi ya polyneuropathies ya diabetes imasiyanitsidwa:

• Proximal symmetric polyneuropathy (amyotrophy).
• Asymmetric proximal neuropathy yamitsempha yayikulu (nthawi zambiri yachikazi, yausayansi kapena yapakatikati).
• Neuropathies amanjenje zamkati.
• Asymptomatic polyneuropathies.
• Mitundu yamagawo a polyneuropathy.

Distal polyneuropathy ndi mtundu wofala kwambiri wa matenda ashuga polyneuropathy. Imakhala mu 70% yamitundu yonse yamatendawa. Mawu oti distal akuwonetsa kugonjetsedwa kwa ziwalo zakutali kwakutali ndi thupi (manja, mapazi). Zisoti zimakhudza miyendo yakumaso mwachangu. Kutengera mtundu wa zotupa, mitundu yotsatirayi ndiosiyanitsidwa:

• Zachisoni.
• Galimoto.
• Zamasamba.
• Wosakanikirana (sensorimotor, motor-sensory-vegetative, sensory-vegetative).

Chithunzi chachipatala cha matendawa chimatengera mtundu wa polyneuropathy, kuchuluka kwa mitsempha yowonongeka, komanso shuga m'magazi.

• Proximal polyneuropathies imadziwika, choyambirira, ndi chitukuko cha kusokonekera kwa minofu trophism, kuchepa thupi ndi miyendo yonse, komanso kuchepa kwa mphamvu yake. Ntchito zamasamba ndi zomverera sizimakhudzidwa pang'ono.
• Matenda a shuga a mitsempha ya m'magazi amanjenjemera amasiyanasiyana kutengera kuwonongeka kwa gulu linalake. Chifukwa chake, zotupa zofala kwambiri za mitsempha ya oculomotor, yomwe imadziwonetsa nthawi zambiri mu mawonekedwe a ophthalmoplegia wopweteka kwambiri. Kugonjetsedwa kwa mitsempha ya optic kumadziwika ndi kuchepa kwa masomphenya, kupezeka kwamaso m'maso, kusowa kwamaso. Zocheperako, zotsekemera, zotchinga, zamanjenje zimakhudzidwa. Choyambitsa chachikulu cha zotupa za CFN ndi ischemia yawo yovuta, ndipo kuyambitsa kwakanthawi kwamankhwala nthawi zambiri kumabweretsa zotsatira zabwino.
• Asymptomatic polyneuropathies nthawi zambiri amadziwika mwangozi, ndi kukonzekera kwa mitsempha yoyeserera. Amawonetsedwa ndi kuchepa kwa tendon Reflex, nthawi zambiri kuposa bondo.
• Mitundu yoyipa ya polyneuropathy imawonetsedwa, monga lamulo, momveka bwino. Chifukwa chake, kukhalapo kwa zovuta zam'maganizo kumadziwonetsera pamaso pa chidwi cham'kati mwa wodwala, kuwotcha kowawa, dzanzi m'galu. Komanso, munthu amatha kuwona kuphwanyidwa kutchulidwa, amatha kuzindikira kumverera kwa "kuyenda papilo" pomwe samamva kuthandizidwa ndipo gitala yake ili ndi vuto. Ndi distal mawonekedwe a matenda a shuga a polyneuropathy a m'munsi malekezero, kukokana kovuta nthawi zambiri kumayamba. Kuphulika kwa gait kumatha kubweretsa kukula kwa phazi ndipo, pambuyo pake, mawonekedwe a phazi la matenda ashuga.

Matenda a Autonomic angayambitse kukula kwa tachycardia, hypotensive orthostatic reaction, matumbo operewera ndi chikhodzodzo, kutsika kwa potency, komanso kusokoneza thukuta. Chiwopsezo cha kufa mwadzidzidzi kwamtima chikuwonjezerekanso.

Kusokonezeka kwamagalimoto mu distal mawonekedwe a polyneuropathy sikuchitika, makamaka m'njira yokhayokha. Amadziwika ndi chitukuko cha kuperewera kwa vuto la minofu yama distal, kuchepa kwa mphamvu zawo.

Zizindikiro

Kuzindikira matendawa kumatengera chithunzi cha chipatala, kuwunika kwa mitsempha ndi umboni wa kukhalapo kwa matenda ashuga kwa nthawi yayitali. Panthawi yovuta, ndikofunikira kuyendetsa electroneuromyography, yomwe imalola kuti musinthe kusintha koyambirira kwa machitidwe okhudzana ndi mitsempha m'mphepete, kufunsanso kwa endocrinologist.

Vidiyo yokhudza matenda ashuga polyneuropathy

Chithandizo cha matenda a shuga a polyneuropathy ayenera kukhala okwanira, ochitidwa palimodzi ndi endocrinologist ndi akatswiri. Choyamba, kayendedwe ka shuga m'magazi ndikofunikira. Sinthani chakudyacho, chithandizo choyambirira cha matenda ashuga. Ndikukakamizidwanso kupatula kukhalapo kwa mic- ndi macroangiopathies, ngati pakufunika kutero, muchite chithandizo choyenera.

Poimitsa mawonetseredwe a mitsempha, kukonzekera kwa thioctic (alpha-lipoic) acid (zipatso ndi mawonekedwe ake) kumagwiritsidwa ntchito kwambiri. Chithandizo cha mankhwala chikuchitika muyezo wokwanira (mlingo woyambirira uyenera kukhala osachepera 300 mg patsiku) ndi maphunziro a nthawi yayitali (osachepera miyezi 1.5). Syndrome dalili zingathe kuphatikizidwanso ndi ipidacrine hydrochloride kukonzekera (Axamon, Ipigrix, Neuromidine). Mavitamini a B amagwiritsidwanso ntchito kwambiri.

Pamaso pa kugwidwa kowawa, ma anticonvulsants (mpumulo wa ululu wa neuropathic), antidepressants, opioids angagwiritsidwe ntchito (mwatsatanetsatane, onani nkhani yanga yasayansi).

Malo ofunikira pothandiza odwala matenda ashuga polyneuropathy ndi masewera olimbitsa thupi, physiotherapy, ndi kutikita minofu. Ngati pali chizindikiro cha kupindika kwa phazi, kusankha kwa insoles ndi nsapato ndikofunikira. M'njira zonse, gawo lofunikira kwambiri limasewera ndi kusamala khungu komanso kupewa microdamage.

Ichi ndi chiyani

Polyneuropathy ndiye otchedwa kuphatikizika kwa matenda ashuga, chomwe chimapangitsa kugonjetsedwa kwathunthu kwamphamvu yamatsenga.

Kuwonongeka kwamitsempha mu polyneuropathy

Nthawi zambiri zimadziwonekera kudutsa nthawi yopatsa chidwi yomwe yapita kuyambira kuzindikiritsidwa kwa zovuta mu dongosolo la endocrine. Makamaka, matendawa amatha kuoneka zaka makumi awiri ndi zisanu atayamba mavutowa ndikupanga insulin mwa anthu.

Koma, panali zochitika pamene matendawa adapezeka mwa odwala a endocrinologists patatha zaka zisanu kuchokera pakupezeka kwa pathologies a kapamba. Chiwopsezo cha kudwala chimafanana ndi odwala omwe ali ndi matenda ashuga, onse oyamba komanso wachiwiri.

Zomwe zimachitika

Monga lamulo, ndi nthawi yayitali ya matendawa komanso kusinthasintha pafupipafupi m'magawo a shuga, kusokonezeka kwa metabolic m'ziwalo zonse ndi machitidwe a thupi amapezeka.

Ndipo mantha am'mimba ndi oyamba kuvutika. Monga lamulo, ulusi wamanjenje umadyetsa mitsempha yaying'ono kwambiri.

Mothandizidwa ndi mafuta ochulukirapo, matenda otchedwa mitsempha amayamba. Zotsatira zake, amagwera mumkhalidwe wa hypoxia ndipo, chifukwa chake, zizindikiro zoyambirira za matendawo zimawonekera.

Ndi njira yake yotsatira komanso kuwonongeka pafupipafupi, zovuta zomwe zilipo ndi manjenje, zomwe zimapangika pang'onopang'ono ndi mawonekedwe osasintha, zimakhala zovuta kwambiri.

Popeza mavitamini ndi michere yapadera ndiyofunikira pakugwirira ntchito kwamanjenje komanso kupewa ma glitches mmenemo, komanso matenda ashuga, kuyamwa ndi kukonza zinthu zonse zofunikira kumayipa kwambiri, minyewa yamatumbo imakhala ndi vuto la kuperewera kwa zakudya ndipo motero, imayambitsa chitukuko cha polyneuropathy.

Zowopsa zomwe zingayambitse matenda ashuga a polyneuropathy

Popeza chachikulu chomwe chimayambitsa matenda ashuga polyneuropathy (ICD 10 code - G63.2) ndi kuchuluka kwa shuga m'magazi, endocrinologist amalimbikitsa odwala omwe ali ndi vuto lakuwonongeka kwa mitsempha. Dokotala amayang'anira shuga, amawona kuchuluka kwa shuga pamimba yopanda kanthu ndikatha kudya. Ophthalmologists, akatswiri a mitsempha, madokotala a opaleshoni yam'mimba amachititsa mayeso kuti awonongeke ma microvessels am'maso, impso, miyendo. Njira yokhayo yokwaniritsira odwala matenda ashuga polyneuropathy imawongolera mkhalidwe waumoyo wa odwala, imathandizira kubwezeretsa kwazomwe zimayambitsa kuwonongeka kwa mitsempha ya shuga.

Zowopsa zomwe zimapangitsa kuti pakhale polyneuropathy pakati pa odwala omwe ali ndi vuto la 1 matenda a shuga ndi kuchuluka kwa kuchuluka kwa shuga wamagazi, nthawi yayitali ya matendawa komanso msinkhu wa wodwalayo. Odwala omwe ali ndi matenda a shuga 2, matenda oopsa oopsa komanso matenda a lipid metabolism ndi ofunika.

Peripheral neuropathies, makamaka distal symmetric sensorimotor polyneuropathy, kwakukulu kwambiri kuposa chapakati neuropathy, imawopseza moyo ndi moyo wa odwala omwe. Cardiac autonomic (autonomous) zotumphukira kusakwanira, yomwe ndi gawo la zovuta za syndromes za matenda ashuga polyneuropathy, 50% imayipitsa chidziwitso cha chiyembekezo chamtsogolo cha odwala omwe ali ndi matenda osokoneza bongo. Kapangidwe ka matenda am'magazi a shuga amakwiririka ndi kudulidwa kwamiyendo ndi miyendo. Kupweteka kwamtundu uliwonse mwa wachisanu aliyense wodwala matenda a shuga kumakhudza moyo, makamaka ngati amadziwonetsa ndi allodynia (ululu poyankha zovuta zomwe sizimva kupweteka).

Njira zopangira matenda ashuga a polyneuropathy

Mitsempha yambiri yophatikizika imasakanikirana. Amakhala ndi ulusi wa motor, sensor komanso autonomous. Chizindikiro chovuta cha chotupa cha mitsempha chimapangidwa ndi zovuta zamagalimoto, zam'mutu komanso zotulutsa.

Ma axon aliwonse (njira yayitali yokhala ndi khungu la mitsempha) imakutidwa ndi chipolopolo cha selo la Schwann, pomwe fiber imatchedwa non-myelinated, kapena itazunguliridwa ndi zigawo zamabowo za Schwann. Kachiwiri, ulusi umatchedwa myelinated. Mtsempha umakhala ndi ulusi wosapangidwa ndi myelinated ndi ma myelinated. Zingwe zopanda maeloni zokha zomwe zimakhala ndi ufulu wochita zinthu zina komanso mbali imodzi ya ulusi wothandizirana nawo. Zingwe zopindika za myelinated zimasunthira komanso kugwiritsidwa ntchito kwa minofu. Ulusi wocheperako komanso wosakongoletsa omwe ndiomwe amachititsa kupweteka, kutentha ndi kukhudza. Ntchito yayikulu ya minyewa yamanjenje ndikuwongolera.

Makina a zotumphukira za polyneuropathy amachokera pakuwonongeka kwapang'onopang'ono kwa ulusi wa myelinated, kuchepa kwa axon komanso kutsika pang'onopang'ono pakuwongolera kwa chidwi cha mitsempha. Chofunikira pakukula kwa matenda ashuga a polyneuropathy amasewera ndi hyperglycemia (glucose) yayikulu magazi.

Zomwe zimayambitsa chitukuko cha matenda ashuga polyneuropathy ndi:

• microangiopathy (kusintha m'matumba ang'onoang'ono),
• hypoxia (njala yampweya wa okosijeni) yamitsempha,
• kagayidwe katemera ka shuga,
• glycation ya mapuloteni omwe amapanga myelin,
• oxidative nkhawa
• kuchepa kwa mphamvu ya kupuma ya endothelial - nitric oxide (ayi),
• alpha lipoic acid akusowa.

Ziwerengero

Malinga ndi WHO, kuyambira 2 mpaka 8% ya anthu padziko lapansi amakumana ndi mitsempha. Mukakalamba, matendawa amapezeka pafupipafupi, chifukwa amayenda limodzi ndi matenda amitsempha, kufooka kwa minyewa ya mafupa, ndikuchepetsa njira zosinthira minofu.

Kuwonongeka kamodzi kwa mitsempha yotchedwa mononeuropathy. Malinga ndi ICD-10, matendawa amapatsidwa manambala G56 - mononeuropathy a kumtunda ndipo, G57 - mononeuropathy yam'munsi.

Mtundu wina wa matenda ndi polyneuropathy.. Monga momwe amachokera ku tanthauzo latsopanoli la dzinalo ("ambiri + mitsempha + matenda") - iyi ndi njira zingapo zamitsempha.

Polyneuropathy imadziwika ndi njira yovuta kwambiri, yomwe imalumikizidwa kwambiri ndi zovuta za kukonzanso panthawi yama convalescence: chifukwa chakuti mitsempha yosiyanasiyana imayendetsa timagulu tosiyanasiyana tating'onoting'ono, miyendo imakhala yolumikizidwa pang'ono kapena kwathunthu, motero kuchira kuyenera kuyamba ndi kuchita masewera olimbitsa thupi kwakanthawi. Malinga ndi gulu la matenda, polyneuropathy ndi ya m'makalasi G60-G64.

Mitundu ya matenda ndi zizindikiro

Mitundu yayikulu ya neuropathy:

1. Zachisoni.
2. Galimoto.
3. Yoyimira.

Imadziwonekera mu mawonekedwe a zovuta zamtundu wa kumva: kupweteka, kuwotcha, kugwedezeka, kudzimbidwa kwa miyendo.

Zimaphatikizidwa ndikuphwanya kusangalala kwa minofu ndikutulutsa kolimba kwa miyendo mpaka kumaliza kugwira ntchito. Pankhaniyi, ma sensonic pathologies samachitika (nthawi zina, pamakhala kusowa kwa kugwedezeka).

Chenjezo! Motor neuropathy imayendera limodzi ndi kufooka kwa minofu pang'onopang'ono, kuchepa kwa minofu. Mbali ya motor neuropathy ndi mawonekedwe amiyendo yamiyendo.

The etiology ya mtundu uwu wa neuropathy nthawi zambiri imalumikizidwa ndi matenda obadwa nawo komanso kusintha kwa majini. Pali mitundu 6 ya motor neuropathy:

• Congenital. Zoyambitsidwa ndi zolakwika mu genP ya TRPV4. Mawonetsero oyambira amawonedwa kuyambira pakubadwa, mtsogolo, matendawa amapita patsogolo.
• Mtundu 2A. Amalumikizidwa ndi zolakwika kumtundu wa HSPB8. Ndi imodzi mwazosiyanasiyana za amyotrophy amodzi. Zimakhudza ana okulirapo. Mtunduwu umadziwika ndi kuwonjezeka kosasinthasintha kwa kuwonongeka kwa dzanja: kufooka kwa minofu (mpaka atrophy), kusakhazikika kwa tactile.
• Lembani 2D. Amayamba chifukwa cha zovuta zamtundu wa FBXO38 gene zopezeka pa chromosome No. 5. Imagwira muubwana ndi kufooka kwa miyendo, kukokana kwa m'munsi, kenako kufalikira kwa minofu ya manja.
• Chachikulu (symmetrical) mtundu wa 5 neuropathy. Mtundu wodziwika kwambiri wophatikizidwa ndi chilema mu jini ya BSCL2 (chromosome No. 11). Imadziwonetsa muunyamata ndi kukula mu mawonekedwe ofooka, manja akunjenjemera. Pakumalizira, imakwirira miyendo yam'munsi.
• Type 1 spinal neuropathy. Zimachitika chifukwa chosakwanira kwa mtundu wa IGHMBP2. Imadziwulula yokha ngakhale munthawi yamabadwe mu mawonekedwe a kuwonongeka kwa minofu yamanja. Pambuyo pake, imatha kukhudza minofu yosalala ya kupuma komanso ngakhale kufa.
• Lembani AH. Zimayambitsidwa ndi kusintha kwa majini pa X chromosome. Zimakhudza amuna okha kuyambira ali ana, zimapangitsa zotupa zamiyendo zamiyendo yonse.

Matenda a neuropathy ndi osowa kwambiri (0.004% ya milandu). Chithandizo chokha chomwe chilipo ndi mankhwala othandizira komanso zovuta za vitamini. Kuchita masewera olimbitsa thupi kumapangidwira kuyambira pamenepo imathandizira kuchepa kwa minofu.

Yoyimira

Oposa 90% ya odwala matenda a shuga a mellitus amadwala matenda ashuga a m'mimba (DN), okhudza njira yodziyimira payokha komanso zotumphukira chifukwa cha kusokonekera kwa metabolic.

DN imapezeka m'mitundu iwiri:

• Zachangu - Imakhudza ziwalo za thupi.
• Zovuta - imayambitsa kusokonezeka kwapang'onopang'ono kwa mafupa osiyanasiyana amitsempha.

Chimodzi mwazomwe zimapangitsa kuti minyewa ya m'mimba ikhale yopanda tanthauzo, pomwe kusokonezeka kwamkati ndi ziwonetsero zomwe zikugwirizana kumayamba:

• Matumbo: Zizindikiro za dyspeptic, kusokonezeka kwa chopondapo, kuchuluka kwa kupangika kwa mpweya, kupweteka kwa epigastric, kukulira kwa peristalsis, kutsekula m'mimba usiku (ndi gawo la minyewa ya minyewa yokhudzana ndi ntchito yamatumbo).

Matumbo am'mimba amathandizira kwambiri ku neuropathy chifukwa chokhala pachiwopsezo chachikulu cha pulogalamu ya neva, kuchuluka kwa maselo amitsempha ofanana ndi kuchuluka kwawo muubongo.

• Dongosolo la genitourinary: kukonzekera mwakachetechete chifukwa chakufooka kwa chikhodzodzo, matenda oyamba ndi bakiteriya.
• Amitundu: mwa amuna - kusowa kwa mawonekedwe mkati mwa kusungidwa kwa zikhumbo zakugonana, mwa akazi - kuchepa kwa chobisalira munthawi yogonana.
• Mtima wamtima: tachycardia, kulephera kwa mtima, mtima wa angina pectoris.
• Chiwonetsero cha khungu: manja owuma ndi miyendo, kuchulukitsa kapena kuchepa thukuta.

Zosokoneza zambiri zimadziwikanso: vertigo, kutaya chikumbumtima, asthenia.

Mitsempha yamu Sayansi

Thupi lalitali kwambiri komanso lalitali kwambiri (1 cm), lomwe limayambira mu 4 vertebra ndikudutsa potseguka m'chifupa cha pelvic, limatsikira ku popliteal fossa, komwe limagawidwa kukhala nthambi za fibular ndi tibial. Kuponderezana kumatha kuchitika mu pelvis, mu piriformis, pa ntchafu.

Sayansi yamitsempha yamitsempha yam'mimba imakhala yachiwiri pakufalikira pakati pa minyewa yam'munsi yam'mimba (zomwe zachitika ndi 0,025%, makamaka mwa anthu azaka 40 mpaka 50). Chinthu chinanso cha matendawa - osagwirizana - ndi dzanja limodzi lokha lomwe limadwala.

Mitsempha yama sciatic imayendetsa minofu yomwe imagwada, chifukwa chake, zizindikiro zotsatirazi ndi matenda:

• Kupweteka kwambiri kumbuyo kwa ntchafuchowongolera mpaka kumapazi ndi kumapazi.
• Kuyenda ndi mwendo wowongoka, kuwuka chifukwa cha zovuta pakupindika bondo (paresis of the biceps and semi-tendon minofu nthawi yomweyo ndi kuchuluka kwa minofu ya quadriceps).
• Kuchepa kwa stratum corneum ya khungu chidendene, phazi labuluu, kuphwanya thukuta.
• Kuzindikira mu kugwedeza mwamphamvu.

Mitsempha yachikazi

Kutenga chiyambi kuchokera ku mizu ya 2-4 vertebrae, thunthu la mitsempha ili limadutsa pansi pa inguinal ligament kupita kutsogolo kwa ntchafu, ndiye - motsatira mwendo, phazi, ndi kumapeto kwa chala chachikulu.

Ntchito zazikuluzikulu zamitsempha ya chikazi: kuteteza minofu yomwe imayendetsa minyewa ya m'chiuno, kutsikira kumbuyo, kuwonjezera bondo.

Ndi matendawa, zonse zamavuto amagetsi ndi zamagalimoto titha kuziwona:

• Kufooka kwa extensor ya bondo, - chifukwa chake, kulephera kuyenda kukwera masitepe, kuthamanga.
• Kuphwanya kwamalingaliro othandiza kuzindikira, kumva tactile, komanso paresthesia panjira yamanjenje.

Ndi mitsempha yamatsempha achikazi, bondo Reflex limakhalabe.

Zowonjezera

Mitsempha ya axillary (axillary) ndi nthambi ya mtengo wa brachial plexus. Imadutsa pansi pa phewa ndipo imagona mbali yotsatira ya humerus musanagawe nthambi ziwiri: kunja ndi kumbuyo. Ntchito yake yayikulu ndikusungidwa kwa minofu yaying'ono komanso yozungulira.

Kuwonongeka kwa mitsempha ya axillary nthawi zambiri kumachitika nthawi zambiri chifukwa chatsoka lalikulu: phewa losweka kapena bala.. Ochita masewera othamanga omwe amachita masewera ovuta (olimbana, okwera, etc.) amakumana ndi matendawa pafupipafupi. Nthawi zambiri, zinthu za pabanja zimakhudza: kuponderezana ndi crutch, kudziletsa m'maloto, etc.

Zizindikiro zowonongeka zimatha kusiyanasiyana kutengera kuvulala kwake:

1. Kuchepetsa kapena kufotokozera kwakukulu pamapewa chifukwa cha peresis ya minofu yolimba. Woopsa milandu - ziwalo za miyendo.
2. Kuwonongeka kwa zomverera kumbuyo ndi mbali yotsatira ya mkono.
3. Kuchepetsa kwa phewa.
4. Deltoid minyewa.

Zotsatira za chithandizo cha mankhwala ndizabwino. Ngati wowerengeka mankhwala ndi olimbitsa thupi sanapereke chifukwa, resection wa cicatricial fusion imagwiritsidwa ntchito, nthawi zina - mitsempha ya fiber cell.

Kuwonongeka kwa phazi

Pathology ya phazi ndi neuritis sichikhala chachikulu. Amalumikizidwa ndi kukanikiza pakati pa mitsempha ya tibial, kuphatikiza minofu yam'miyendo, chosinthika ndi zowonjezera phazi.

Ngati patella yam'madzi yotupa ya tibial itawonongeka, zotsatira zoyipa kwambiri pamapazi zimachitika: kufooketsa ndikugugudiza mpaka osadukiza kwathunthu.

Kuchita kwa wodwalayo ndi zotupa kumakhala kodziwika: iye akukweza mwendo wake, kupumula kaye pachigonera, kenako kumapazi konse ("kavalo gait"). Wodwala sangathe kuyimirira zala zake. Kupita patsogolo kwamatenda kumatha kubweretsa kulumala ndi kulumala.

Pathology ya phazi silimayankhulidwa pang'ono ndi kugonja kwa nthambi yayikulu yamitsempha yamagalimoto. Potere, kufooka kwapang'onopang'ono kwa phazi lanu kumachitika limodzi ndi kusokonezeka kwa zala.

Ngati kuvulala kwa ofananira nawo gawo gawo lamitsempha yamafupa, zizindikiro zazikulu ndizoletsa kuzungulira kwa phazi, kugunda, kumva kupweteka usiku, kumva kugwedezeka kwa malingaliro.

Chimodzi mwazovuta za matenda a shuga ndi phazi lotchedwa shuga. Ichi ndi vuto lomwe khungu lakumiyendo limaphimbidwa ndi zilonda zam'mimbazo zam'mimbazo zomwe zimayikidwa pachifuwa. Woopsa, matendawa amapita mpaka pang'onopang'ono ndipo amayamba kuduladula mwendo.

Mitsempha yamanja

Monga matenda am'mapazi, matenda amanja ndi achiwiri ndipo amayamba chifukwa cha ma syopromes angapo a neuropathic:

• Radial neuritis. Zimatsogolera kuwonongeka kwa mota ku dzanja, - mukakweza dzanja lanu, limayenda. Komanso, matendawa amaphatikizidwa ndi zizindikiro zam'malingaliro mwanjira ya kutayika kwa chidwi cha chala.
• Ulnar neuritis. Amadziwika ndi paresis ya chosinthira ndi chowonjezera cha zala, kuwonongeka kwa luso labwino la manja m'manja.
• Neanitis ya Median. Zotsatira: dzanzi mpaka manja atayika kwathunthu, kupweteka kwa zala, minyewa.

Chenjezo! Kusokoneza manja kumathanso kugwirizanitsidwa ndi mitundu ina ya polyneuropathy.

Njira zochizira

Nthawi zina, chithandizo chimachepetsedwa kuti muchepetse kupanikizika kwa mitsempha: kuchotsa ma gypsum, m'malo mwa ndodo zosayenera, ndi nsapato zopapatiza. Mankhwala othandizira odwala omwe amagwiritsidwa ntchito ngati mankhwala. Ngati njirazi sizinali bwino, ndiye kuti amathandizidwa ndi neurosurgeon.

Zodzikongoletsa

Dokotala wamatsenga angafotokozere wodwala mankhwala kuphatikizapo:

• Analgesics. Mitundu yosiyanasiyana ya mankhwala osagwiritsa ntchito mankhwala a anti-yotupa (NSAIDs): Diclofenac, Ibuprofen, Meloxicam ndi ena NSAID samangoletsa kupweteka, komwe ndikofunikira kwambiri popewa atrophy ya minofu, komanso ndikuchotsa edema ndi kutupa kwa mitsempha ya mitsempha, kupititsa patsogolo kuchira. Ndikofunika kusamala, kuchepetsa malire ndi kutalika kwa nthawi ya mankhwalawa chifukwa cha zovuta zoyipa za mankhwalawa.
• Mankhwala osokoneza bongo a Vasodilating monga Trental, Cavinton ndi ena.Ali ndi chotupa cha magazi, amawonda magazi, amasintha magazi, amathamangitsanso kukonzanso minofu yowonongeka.
• Zopatsa mphamvu zam'mitsempha: Neuromidin, Proserin, Ipidacrine. Amathandizira kukhazikika kwa mitsempha, amatulutsa minofu yosalala ya mafupa.
• Ma antioxidants. Thiogamma, Berlition ndi mankhwala ena omwe amakongoletsa mafupa a minofu.

Ma antioxidants mwa mtundu wa zochita ali pafupi ndi mavitamini B, koma osawachotsa.

Zinthu zofunika zomwe zimadyetsa dongosolo lamanjenje ndi mavitamini a B: thiamine, nicotinic acid, cyancobalamin, choline, inositol, ndi zina zambiri.

Zinthu izi zimathandizira kubisalira kwa mahomoni ndi hemoglobin, kumapereka mphamvu ya minofu, komanso kukhala ndi mphamvu ya analgesic..

Chifukwa chake, mankhwalawa monga Milgama, Neurorubin, Multivit, Vitrum ndi ofunikira kwambiri panthawi yamankhwala othandizira kapena pobwezeretsa.

Kodi ndimavuto otani omwe amachititsa kuti anthu azikhala ndi matenda ashuga a mtundu wa polyneuropathy: ICD-10, chithunzi cha matenda ndi njira za

Polyneuropathy ndi zovuta za matenda, omwe amaphatikizira zotupa zingapo zam'mphepete zamitsempha.

Matendawo nthawi zambiri amapita mu omwe amatchedwa mawonekedwe osakhazikika ndipo ali ndi njira yomwe akukwerekera, ndiye kuti, njirayi poyamba imakhudza zingwe zazing'onoting'ono ndipo zimayenda pang'onopang'ono kum nthambi zazikulu.

Chithandizo cha matenda a shuga a polyneuropathy

Kupatula pakukhazikika kwa kuwonongeka kosasinthika kwakhazikitsidwa chifukwa chakumapeto kwakanthawi, ma endocrinologists ndi ma psychologists a chipatala cha Yusupov amayamba chithandizo cha matenda oyamba a matenda ashuga a polyneuropathy. Chitsogozo chachikulu pakupewera kwa matenda ashuga a polyneuropathy ndiko kukwaniritsidwa kwamphamvu kwa shuga m'magazi. Kusunga chizolowezi chomanga shuga m'magazi kwa nthawi yayitali odwala omwe ali ndi mawonekedwe owopsa a polyneuropathy kumayambitsa kuchepa kwa kupitilira kwa kuwonongeka kwa mitsempha yotumphukira, koma sikuthandizira pakuchotsa kwake mawonekedwe ake. Ndi normalization wa glucose odwala, zizindikiro zamitsempha zimatha kukulira kapena kuwoneka ngati zikanapezekapo kale. Izi ndichifukwa chakusintha kwina komwe kwasintha komwe kumachitika mu minyewa yamitsempha. Kuwonongeka kwake kumakhala kwakanthawi m'chilengedwe ndipo kumatha msanga, malinga kuti kuchuluka kwa shuga m'magazi kuli pafupi kwabwinobwino.

Madokotala a matenda a mitsempha omwe ali ndi matenda ashuga polyneuropathy amachita chithandizo cha pathogenetic ndi dalili. Pakadali pano, thioctic (α-lipoic) acid, makamaka Thiogamm, amawerengedwa ngati chithandizo chokwanira kwambiri cha zotumphukira za polyneuropathy. Mavitamini a gulu B amakhudzidwa ndi minyewa yowonongeka yamitsempha. Madokotala a matenda a mtima amapereka mankhwala a thiamine (vitamini B kwa odwala omwe ali ndi matenda ashuga polyneuropathy).₁), pyridoxine (vitamini B₆), cyanocobalamin (vitamini B₁₂) Odwala odwala matenda ashuga polyneuropathy bwino kulekerera mafuta sungunuka mawonekedwe a thiamine - benfotiamine. Ili mu ngalande ya Milgamma.

Chabwino kwambiri ndicho njira yovomerezeka ya magawo atatu a matenda ashuga a polyneuropathy:

• Mlingo wambiri wa benfotiamine wophatikiza ndi pyridoxine (Milgamm dragee), womwe umakhudzidwa tsiku lililonse ndi Milgamm dragee,
• ndi kusakwanira kwa gawo loyamba, odwala amalowa tsiku lililonse ndi 600 mg ya Tiogamma kudzera masabata awiri,
• ovuta kwambiri a polyneuropathy, dragee amalembedwa mkati mwa Milgamm ndipo Thiogamm amathandizidwa ndi kholo.

Magulu akulu a mankhwalawa othandizira kupweteka kwa neuropathic mu matenda ashuga polyneuropathy ndi antidepressants, anticonvulsants, opioids ndi mankhwala oletsa ululu. Akatswiri a zamitsempha amagwiritsa ntchito kwambiri ma antidepressants a tricyclic. Mankhwala othandiza kwambiri ndi amitriptyline mu Mlingo 25 mpaka 150 mg patsiku. Chithandizo chimayamba ndi mlingo wochepa (10 mg / tsiku) ndipo umapangidwa pang'onopang'ono kuti mukulitse. Izi zimakuthandizani kuti muchepetse vuto la mankhwalawo.

Maanticonvulsants amachepetsa ululu wa neuropathic. Ma neurologists omwe ali ndi ululu wowawa amagwiritsa ntchito carbamazepine ndi phenytoin. Samawerengedwa ngati mankhwala a mzere woyamba chifukwa cha zovuta. Ma anticonvulsants am'badwo wambiri amakhala ndi ntchito yapamwamba kwambiri: gabapentin ndi pregabalin.

Tramadol kwambiri imachepetsa ululu, imawonjezera zochitika zachikhalidwe ndi zolimbitsa thupi kwa odwala. Kuchepetsa mwayi wokhala ndi zotsatirapo komanso kudalira mankhwala, kugwiritsa ntchito tramadol kumayambika ndi Mlingo wocheperako (50 mg 1 kapena 2 kawiri pa tsiku) kenaka kumawuma tsiku lililonse kwa masiku atatu mpaka atatu muyezo wa 100 mg 4 pa tsiku. Tramadol ndi gawo limodzi mwa zaldiar zokonzekera pamodzi.

Mapake ndi ma gels omwe ali ndi 5% ya lidocaine amakhala ndi mphamvu ya komweko. Capsaicin (mankhwala okomela) amagwiritsidwa ntchito pochiza matenda ashuga a polyneuropathy. Mankhwalawa amalowa muukonde wa mankhwalawa mu mawonekedwe a lotions, ma gels, ma creams ndi okhazikitsa mpira omwe ali ndi chinthu chogwira ntchito pozungulira 0.025%, 0.050% kapena 0.075%. Amayikidwa kanthawi 4 pa tsiku kudera lonse lopweteka.

Ululu wa matenda ashuga polyneuropathy amachepetsa pambuyo pa kuperekedwa kwa botulinum toxin mtundu A kwa odwala. Glyceryl trinitrate amagwiritsidwa ntchito pachikhalidwe cha angina pectoris. Amachepetsa mitsempha yamagazi ndikuchepetsa kwambiri kupweteka komwe kumachitika chifukwa cha matenda ashuga a polyneuropathy.

Ndi kukula kwa matenda a shuga a matenda am'mimba, ma anti-wodziwika bwino, njira zothetsera, anticoagulants, ndi osagwirizana amaphatikizidwa mu regimen. Wodwala akakhala ndi zilonda zam'mapazi, ogwira ntchito kuchipatala cha matenda a mitsempha amapanga chithandizo cholondola cha mabala:

• Chotsani Hyperkeratosis
• yeretsani chilonda,
• chilondacho chimakhala chotseguka, ndikupanga kutulutsa kwamphamvu kuchokera pamenepo,
• perekani chinyezi nthawi zonse pachilonda,
• Pewani kuvala koopsa
• Anatsuka mabala ndi njira zopanda poizoniyu.

Odwala amapatsidwa kupumula kwa kama kwa milungu iwiri, kenako amalimbikitsidwa kuvala nsapato za orthopedic. Kuti mukapimidwe mayeso ndi njira yothandiziradi matenda a shuga a polyneuropathy, muyenera kuonana ndi dokotala wamatsenga pafoni ya Yusupov, komwe malo olumikizirana amatsegulidwa maola 24 patsiku, masiku asanu ndi awiri pa sabata komanso osapumira. Dokotala adzakutengerani nthawi yabwino.

Mankhwala

Ndi neuralgia ndi neuritis, magulu otsatirawa a mankhwala ndi omwe amaperekedwa:

1. Mankhwala osagwiritsa ntchito mankhwala osokoneza bongo - ali ndi zovuta zochizira. Cholinga chopondera kupweteka, kutupa ndi kutupa. Diclofenac Yogwira Ntchito, Nimesulide, Xefocam.

Muyenera kuzitenga kokha monga momwe dokotala wakupangirani.

Diclofenac ndi mankhwala othandiza, a gulu la NSAIDs. Ili ndi analgesic, antipyretic komanso anti-yotupa. Mankhwalawa amapezeka m'mitundu ingapo: mapiritsi, suppositories, yankho, mafuta ndi madontho. Amawerengera ana azaka za 15 ndi akulu osaposa 150 mg patsiku katatu.

Nimesulide imanenanso za mankhwala omwe si a antiidal. Kusiyanako ndikuti Nimesulide ilinso ndi antiplatelet athari - imalepheretsa mapangidwe azigazi.

Mankhwala amatengedwa atatha kudya 50-100 mg.

2. Ma antioxidants. Mwachitsanzo, Berlition, Lipin. Ali ndi ma immunostimulating, neurotransmitter, hypotoxic ndi katundu wina. Chifukwa cha mankhwalawa, ndizotheka kulimbitsa chitetezo cha mthupi, kusintha kayendedwe ka magazi ndi ntchito ya ziwalo zamkati.

Berlition ndi njira yothandiza yothandizira matenda a neuropathy chifukwa cha kusintha kwa matenda osokoneza bongo kapena uchidakwa.

Mankhwalawa sangathe kugwiritsidwa ntchito kwa ana osakwana zaka 18, azimayi oyembekezera komanso oyembekezera, komanso anthu omwe ali ndi hypersensitivity.

Lipin imasintha kupuma kwam ma cellular ndi metabolic.

3. Mavitamini a gulu B (B1, B2, B6, B12).

4. Mankhwala omwe amatulutsa mphamvu ya kukhudzika kwa mitsempha - amalembedwa kuti apangidwe (Neuromidine, Proserinum).

Fibrosarcoma ndi osteosarcoma ya tibia ya tibia: zimayambitsa, kuwunika ...

Momwe mungachiritsire edema mwendo wamiyendo: wowerengeka azitsamba kunyumba ...

Kubwezeretsa kochotseka komanso moonekera pachitseko cha tibial ...

Proserine ndi mankhwala opangira omwe amagwiritsidwa ntchito kwambiri pochiza matenda amanjenje. Cholinga chake ndikupangitsa kuti mitsempha ikhale yofananira, kukulitsa kamvekedwe ka minofu ndikusintha ntchito za ziwalo zamkati. Mlingo komanso kuchuluka kwa makonzedwe ndi dokotala.

5.Mankhwala osokoneza bongo kuti athandize kuyenda kwa magazi - amathandizira kuthetsa thrombosis ndikusintha minofu yam'mapazi m'munsi. Gululi limaphatikizapo Caviton, Trental.

Caviton amadziwika ndi kutchulidwa kwachuma. Cholinga chake ndikubwezeretsa kayendedwe ka magazi, kuchepetsa magazi m'magazi, kusintha kagayidwe kazinthu.

Mankhwalawa ndi contraindicated kwa anthu osakwana zaka 18, amayi apakati ndi kuyamwitsa, komanso pamaso pa matenda akulu a mtima dongosolo. Mapiritsi amayamba kumwa ndi 15 mg, ndikuwonjezera pang'onopang'ono mlingo, koma sayenera kupitirira 30 mg patsiku.

Njira zolimbitsa thupi

Physiotherapy imapangidwa kuti muchepetse kutupa kwa m'munsi kwambiri, imathandizira kayendedwe ka magazi ndi kayendedwe ka metabolic. Zotsatira zake, trophism ya minofu yofewa imakhala yofanana, ndipo neuromuscular conduction imabwezeretseka.

Ngati mukufuna chithandizo,

• Reflexotherapy
• Magnetotherapy.
• Kusisita
• Kukondoweza kwamagetsi.

Kutalika kwa physiotherapy amadziwika ndi kupezeka kwa dokotala potengera kuuma ndi mtundu wa matenda. Monga lamulo, njira za physiotherapy zimagwiritsidwa ntchito m'njira zovuta, maphunziro.

Zothandiza pa mankhwalawa amathandizira. Zimathandizira kubwezeretsa kwa malo ena a atrophic.

Kusuntha kozama kumathandizira kuthamanga kwa magazi ndi njira zama metabolic.

Kusisita kuyenera kuchitidwa kuchipatala kokha ndi katswiri. Ndiwophatikizidwa kuti muthe kutikita minofu yanu pachokha, kuti musangochepetsa kugwiritsa ntchito mankhwalawo, komanso kuvulaza thanzi lanu.

Kufotokozera kwapfupi

Zovomerezeka
Joint Commission for Quality of Medical Services
Ministry of Health of the Republic of Kazakhstan
ya Novembara 28, 2017
Protocol No. 33

Matenda a shuga - Kuwonongeka kwamitsempha chifukwa cha matenda ashuga, kwawonekeratu kapena koperewera, popanda etiology ina (WHO). Mtundu wa matenda a shuga wambiri womwe umawerengedwa kwambiri ndipo ndi distal symmetric polyneuropathy. DSPN - kukhalapo kwa zizindikiro za kuperewera kwa mitsempha yodutsa kwa odwala omwe ali ndi matenda osokoneza bongo atatha kupatula zifukwa zina.

Khodi (ma) ICD-10:

Kukula kwa protocol / kukonzanso: Chaka cha 2017.

Zifupikitso zomwe zimagwiritsidwa ntchito pa protocol:

Ogwiritsa Ntchito Protocol: akatswiri azamatsenga, akatswiri amtundu waophunzira, akatswiri azachipatala.

Gulu la Odwala: akuluakulu.

Mulingo wambiri:
Gome 1 - kukula kwa misinkhu yaumboni

Kusiyanitsa mitundu

Kusiyanitsa mitundundi zifukwa zopangira kafukufuku wowonjezera
DSPN ndizodziwitsa za ena. Kukhalapo kwa matenda a shuga ndi zizindikiro za polyneuropathy sikutanthauza zokha kukhalapo kwa matenda ashuga a polyneuropathy. Kuzindikira koyenera kumafunikira kuzindikira koyenera.

Gome 3 - Kusiyanitsa kosiyana kwa DSPN 2,14,15

* asymmetric / predominely motor / localised in the top miyendo / kali kwambiri polyneuropathy
Ntchito zokopa alendo

Pezani chithandizo ku Korea, Israel, Germany, USA

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Makanema okhudzana nawo

Wofunsidwa wa Medical Science pa polyneuropathy mwa odwala matenda ashuga:

• Amachotsa zoyambitsa zovuta
• Imachepetsa kupanikizika mkati mwa mphindi 10 pambuyo pa kutsata

Kodi ndimavuto otani omwe amachititsa kuti anthu azikhala ndi matenda ashuga a mtundu wa polyneuropathy: ICD-10, chithunzi cha matenda ndi njira za

Polyneuropathy ndi zovuta za matenda, omwe amaphatikizira zotupa zingapo zam'mphepete zamitsempha.

Matendawo nthawi zambiri amapita mu omwe amatchedwa mawonekedwe osakhazikika ndipo ali ndi njira yomwe akukwerekera, ndiye kuti, njirayi poyamba imakhudza zingwe zazing'onoting'ono ndipo zimayenda pang'onopang'ono kum nthambi zazikulu.

Ichi ndi chiyani

Polyneuropathy ndiye otchedwa kuphatikizika kwa matenda ashuga, chomwe chimapangitsa kugonjetsedwa kwathunthu kwamphamvu yamatsenga.

Kuwonongeka kwamitsempha mu polyneuropathy

Koma, panali zochitika pamene matendawa adapezeka mwa odwala a endocrinologists patatha zaka zisanu kuchokera pakupezeka kwa pathologies a kapamba. Chiwopsezo cha kudwala chimafanana ndi odwala omwe ali ndi matenda ashuga, onse oyamba komanso wachiwiri.

Zomwe zimachitika

Monga lamulo, ndi nthawi yayitali ya matendawa komanso kusinthasintha pafupipafupi m'magawo a shuga, kusokonezeka kwa metabolic m'ziwalo zonse ndi machitidwe a thupi amapezeka.

Ndipo mantha am'mimba ndi oyamba kuvutika. Monga lamulo, ulusi wamanjenje umadyetsa mitsempha yaying'ono kwambiri.

Mothandizidwa ndi mafuta ochulukirapo, matenda otchedwa mitsempha amayamba. Zotsatira zake, amagwera mumkhalidwe wa hypoxia ndipo, chifukwa chake, zizindikiro zoyambirira za matendawo zimawonekera.

Ndi njira yake yotsatira komanso kuwonongeka pafupipafupi, zovuta zomwe zilipo ndi manjenje, zomwe zimapangika pang'onopang'ono ndi mawonekedwe osasintha, zimakhala zovuta kwambiri.

Matenda a shuga a polyneuropathy a m'munsi am'munsi molingana ndi ICD-10

Ndikudziwitsa kumeneku komwe kumamveka nthawi zambiri ndi odwala omwe ali ndi matenda a shuga.

Matendawa amakhudza thupi pamene zotumphukira ndi mafupa ake zimasokonekera kwambiri. Itha kuyambitsidwa ndi zinthu zosiyanasiyana.

Monga lamulo, anthu azaka zapakati amakhudzidwa makamaka. Ndizofunikira, koma amuna amadwala pafupipafupi. Ndizofunikiranso kudziwa kuti polyneuropathy sichachilendo kwa ana asukulu zamakalasi ndi achinyamata.

Matenda a shuga amawopa mankhwalawa, ngati moto!

Ndikofunikira kutsatira.

Matendawa, omwe amawonekera kwambiri kumadera otsika, amakhala ndi zizindikiro zambiri:

• Kumva kutopa kwambiri m'miyendo
• kutupa kwa miyendo ndi miyendo,
• kupweteka kosalephera komanso kusenda,
• kufooka kwa minofu
• onjezerani kapena muchepetse kumverera kwa miyendo.

Mtundu uliwonse wa mitsempha imakhala yosiyanasiyana.th:

Zizindikiro

Popeza mtundu umodzi wamaphunziro sungawonetse chithunzi chonse, kuzindikira kwa matenda ashuga a polyneuropathy pogwiritsa ntchito ICD-10 code kumachitika pogwiritsa ntchito njira zingapo zotchuka:

Monga lamulo, njira yoyamba yofufuzira imakhala ndi kufufuza mwatsatanetsatane ndi akatswiri angapo: katswiri wa zamitsempha, opaleshoni ndi endocrinologist.

Dokotala woyamba amachita nawo kafukufuku wakunja, monga: kuthamanga kwa magazi m'munsi m'munsi komanso chidwi chawo, kukhalapo kwa zinthu zonse zofunika kuzimidwa, kuyang'ana kutupira ndi kuwerenga momwe khungu limayambira.

Ponena za kafukufuku wa zasayansi, izi zikuphatikiza: kusanthula kwamkodzo, kuchuluka kwa shuga m'magazi, cholesterol, komanso kutsimikiza kuchuluka kwa zinthu zakupha m'thupi pakukayikiridwa kuti ndi poizoni wa poizoni.

Koma kuwunika kwamphuzitsi kupezeka kwa matenda ashuga a polyneuropathy m'thupi la wodwala malinga ndi ICD-10 kumakhudzanso MRI, komanso electroneuromyography ndi nerop biopsy.

Ndikofunika kukumbukira kuti chithandizo chikuyenera kukhala chokwanira komanso chosakanikirana. Ayenera kuphatikiza mankhwala ena omwe ali ndi cholinga chokhudza chitukuko chilichonse.

Ndikofunika kuti chithandizo chikuphatikizira kumwa mankhwalawa:

Kutengera ndendende mtundu wa matenda ashuga a polyneuropathy ICD-10 omwe amapezeka, dokotala yemwe amakupatsani mankhwala amakupatsani chithandizo chamankhwala chomwe chimachotsa kwathunthu zizindikiro za matendawo. Pankhaniyi, munthu akuyembekeza kuchiritsidwa kwathunthu.

Katswiri wodziwa bwino amapereka mankhwala onse osokoneza bongo.

Ndikofunika kwambiri poyamba kuti achepetse kuchuluka kwa shuga m'magazi kenako ndikungopanga chithandizo cha matenda ashuga a polyneuropathy malinga ndi ICD. Ngati izi sizingachitike, kuyesayesa konse sikungakhale kothandiza.

Makanema okhudzana nawo

PhD mu polyneuropathy odwala matenda ashuga:

• Amachotsa zoyambitsa zovuta
• Imachepetsa kupanikizika mkati mwa mphindi 10 pambuyo pa kutsata

Zifukwa zachitukuko

Mfundo zazikuluzikulu zomwe zimayambitsa kukula kwa matenda ashuga polyneuropathy zimawerengedwa:

1. Kusuta fodya komanso mowa
2. Kusagwirizana ndi kayendedwe ka shuga wamagazi,
3. M'badwo
4. Kupsinjika kwa magazi
5. Kuphwanya chiŵerengero cha lipids (monga zinthu zamafuta) zamagazi,
6. Madzi ochepa a insulin
7. Njira yayitali ya matenda a shuga.

Kafukufuku wambiri akuwonetsa kuti kuyang'anira kuchuluka kwa shuga ndi kuthamanga kwa magazi kumachepetsa kukula kwa matenda. Ndipo kugwiritsa ntchito mankhwala a insulin panthawi yake kumachepetsa chiopsezo chotukuka ndi theka.

Zizindikiro za matenda ashuga polyneuropathy amawonetsedwa ndi zowawa m'munsi yotsika. Kupweteka, kuwawa kapena kuyabwa, kupweteka kwambiri nthawi zambiri, kusoka ndi kuboola. Nthawi zambiri amapezeka kumapazi komanso kumakulirakulira. Mtsogolomo, kupweteka kumatha kuchitika m'munsi mwa mwendo ndi mikono.

Odwala amadandaula za kuchuluka kwa minofu, kupweteka kwapawiri, kusokonezeka kwa gait. Izi ndichifukwa chakutukuka kwa vuto mumanjenje. Zomva kutentha zimatayika, zilonda zam'mimba zitha kuwoneka.

Wodwalayo samva bwino chifukwa chokhudza zovala. Ululu muzochitika zotere ndiwokhazikika ndipo umakulitsa thanzi la wodwalayo.

Momwe mungazindikire ndikumvetsetsa bwino matendawa?

Kuzindikira kwa polyneuropathy kumayamba ndi kupita kwa dokotala yemwe amapeza anamnesis mosamala ndikupereka mitundu yofunikira ya maphunziro.

Phunziro lalikulu, zokonda zimaperekedwa ku electroneuromyography. Kuphatikiza apo, maphunziro a VKSP (odziyimira pawokha achisoni) angagwiritsidwe ntchito.

Chithandizo cha matenda a mtima

Mu mankhwalawa othandizira kukhudzana ndi okosijeni, kubwezeretsa omwe akukhudzidwa, kupereka mankhwala ndi antioxidant. Kulandila kwa mankhwala kumachitika mu maphunziro kwa nthawi yayitali. Nthawi imeneyi, pali kuwongolera komanso kuyang'anira wodwala.

Kuti muchepetse kupweteka, ma analgesics ndi mankhwala othana ndi kutupa amayikidwa. Koma, monga akatswiri akunenera, samatha kuthetsa kupweteka konse, ndipo kugwiritsa ntchito nthawi yayitali kumatha kuvulaza kugwira ntchito m'mimba.

Mwa zizindikiro za kupweteka kwakanthawi kwamankhwala am'mimba, ma opaleshoni, mankhwala othandizira, ndi antiepileptic mankhwala. Monga chowonjezera pa mankhwalawa, tikulimbikitsidwa kugwiritsa ntchito zigamba za lidocaine, miyala ya mafuta, mafuta ndi mafuta.

Monga kuphatikiza kwa zovuta chithandizo cha matenda ashuga polyneuropathy, malingana ndi momwe wodwalayo alili,

• chithandizo chakuthupi
• magneto ndi Phototherapy,
• Electrophoresis ndi mafunde
• kukondoweza kwa minofu,
• Katemera
• Hyperbaric oxygenation,
• monochromatic infrared radiation.

Kuchiza ndi wowerengeka azitsamba amaloledwa kokha ndi chilolezo cha adokotala. Kuphatikiza pa njira zachikhalidwe zamankhwala, mankhwala azitsamba komanso kugwiritsa ntchito mafuta othandizira angagwiritsidwe ntchito.

Mankhwala othandizira odwala matenda ashuga polyneuropathy amawaganizira kuti ndi njira yodalirika yomwe wodwala aliyense angagwiritse ntchito.

Yambani kulemba ndikudina Enter kuti musake.