Chithandizo cha impso kwa matenda a shuga a 2

Tsoka ilo, matenda ashuga nthawi zambiri amayambitsa zovuta za impso, ndipo ndizowopsa. Kuwonongeka kwa impso mu shuga kumamupatsa wodwala mavuto akulu. Chifukwa zochizira kulephera kwa impso, njira za dialysis ziyenera kuchitidwa pafupipafupi. Ngati muli ndi mwayi wopeza wopereka, ndiye kuti amamuchitira impso. Matenda a impso mu shuga nthawi zambiri amayambitsa imfa yopweteka kwa odwala.

Ngati shuga ndi yoyenera kuwongolera shuga m'magazi, ndiye kuti mavuto a impso amatha kupewedwa.

Nkhani yabwino ndiyakuti, ngati mumasunga shuga m'magazi anu mwachizolowezi, mutha kupewa kupewa kuwononga impso. Kuti muchite izi, muyenera kuchita nawo zathanzi lanu.

Mudzakondwereranso kuti njira zopewa matenda a impso zimathandizira kupewa zina zovuta za matenda ashuga.

Momwe shuga imayambitsa kuwonongeka kwa impso

Mu impso iliyonse, munthu amakhala ndi mazana mazana otchedwa "glomeruli". Izi ndi zosefera zomwe zimatsuka magazi ndi zinyalala. Mwazi umadutsa kupanikizidwa kudzera m'mapikisano ang'onoang'ono a glomeruli ndipo umasefa. Kuchuluka kwa madzimadzi ndi magawo abwinobwino amwazi amabwerera mthupi. Ndipo zinyalala, pamodzi ndi madzi pang'ono, zimadutsa impso kupita ku chikhodzodzo. Kenako amachotsedwa panja kudzera mu urethra.

• Ndi mayeso ati omwe muyenera kudutsa kuti muwone impso (kutsegula pawindo lina)
• Zofunika! Zakudya za Impso za Matendawa
• Mitsempha yam'mimba
• Matenda a impso

Mu shuga, magazi omwe ali ndi shuga wambiri amadutsa impso. Glucose imatulutsa timadzi tambiri, timene timayambitsa kukakamira mkati mwa glomerulus iliyonse. Chifukwa chake, kuchuluka kwa kusefedwa kwa glomerular - ichi ndichizindikiro chofunikira kwambiri cha ntchito ya impso - nthawi zambiri imachulukanso magawo oyambira a shuga. Glomerulus imazunguliridwa ndi minofu yotchedwa "glomerular basement membrane". Ndipo nembanemba imeneyi imachulukana, monga zimakhala zina zomwe zimayandikira. Zotsatira zake, ma capillaries omwe ali mkati mwa glomeruli amachoka pang'onopang'ono. Ngati glomeruli itasiya kugwira ntchito, ndiye kuti impso zimasefa magazi. Popeza impso zaumunthu zimakhala ndi gawo losungirako la glomeruli, njira ya kuyeretsa magazi ikupitirirabe.

Mapeto ake, impso zimatha ndipo zimawonekera Zizindikiro zakulephera kwa impso:

• ulesi
• mutu
• kusanza
• kutsegula m'mimba
• zikopa
• kulawa kwazitsulo mkamwa
• mpweya wabwino, ngati mkodzo,
• kupuma movutikira, ngakhale utakhala wolimbitsa thupi kwambiri komanso kugona mokwanira.
• kukokana ndi miyendo, makamaka madzulo, asanagone,
• kutaya chikumbumtima.

Izi zimachitika, monga lamulo, pambuyo pa zaka 15 - 20 za matenda ashuga, ngati magazi a shuga adapitilizidwa, i.e. matenda a shuga sanalandiridwe bwino. Uricemia imachitika - kudzikundikira kwa zinyalala za nayitrogeni m'mwazi zomwe impso zomwe zakhudzidwa sizingathenso kusefa.

Kusanthula ndi kuwunika impso mu shuga

Kuti muwone impso zanu ngati muli ndi matenda ashuga, muyenera kuchita mayeso otsatirawa

• kuyezetsa magazi kwa creatinine,
• kusanthula kwamkodzo kwa albumin kapena microalbumin,
• urinalization wa creatinine.

Kudziwa kuchuluka kwa metabolinine m'magazi, mutha kuwerengetsa kuchuluka kwa impso. Amapezanso ngati pali microalbuminuria kapena ayi, ndikuwerengera kuchuluka kwa albumin ndi creatinine mu mkodzo. Kuti mumve zambiri za mayeso onsewa ndi zisonyezo za ntchito ya impso werengani "Ndi mayeso ati omwe angadutse kuti muwone impso" (amatsegula pazenera lina).

Chizindikiro choyambirira cha mavuto a impso mu shuga ndi microalbuminuria. Albumini ndi puloteni yemwe mamolekyu ake ndi ochepa m'mimba mwake. Impso zathanzi zimadutsa mkodzo pang'ono.Ntchito yawo ikangowonjezereka, pamakhala mkodzo ochulukirapo.

Zizindikiro za albuminuria

Muyenera kudziwa kuti kuchuluka kwa albumin mu mkodzo sikungakhale kokha chifukwa cha kuwonongeka kwa impso. Ngati dzulo panali kulimbitsa thupi kwakukulu, lero Albinuria ikhoza kukhala yapamwamba kuposa yachilendo. Izi ziyenera kukumbukiridwa pokonzekera tsiku la kusanthula. Albuminuria imachulukanso: zakudya zamapuloteni ambiri, kutentha thupi, matenda a kwamkodzo, kulephera kwa mtima, pakati. Kuwerengera kwa albumin kuti apange mkodzo mu mkodzo ndi chizindikiro chodalirika kwambiri cha mavuto a impso. Werengani zambiri za izi apa (amatsegula pazenera lina)

Ngati wodwala yemwe ali ndi matenda ashuga akapezeka ndikutsimikiziridwa kangapo ndi microalbuminuria, izi zikutanthauza kuti ali ndi chiopsezo chowonjezeka cha impso, komanso matenda amtima. Ngati sichichiritsidwenso, kenako mphamvu ya kusefukira kwa impso imayamba kufooka, ndipo mapuloteni ena a kukula kwakukulu amapezeka mkodzo. Izi zimatchedwa proteinuria.

Vuto lawo limayamba kugwira ntchito kwambiri, ndipo zomwe zimapangika zimapangika m'magazi. Pambuyo powerengera kuchuluka kwa kusefedwa kwa khungu, ndizotheka kudziwa kuti kuwonongeka kwa impso kwa wodwalayo kuli pati.

Magawo a matenda a impso, kutengera kuchuluka kwa kusefera kwake

Matenda a shuga a shuga: Kufotokozera, kuyambitsa, kupewa

Kodi shuga ndi chiyani masiku ano, aliyense amadziwa. Ichi ndi matenda omwe amabwera chifukwa kuphwanya zovuta kagayidwe kachakudya, ie, chakudya.

Matendawa amaphatikizidwa ndi kuchuluka kosalamulirika kwa shuga wamagazi. Mafuta ochulukirapo amapezekanso mkodzo (wabwinobwino - kulibe).

Kukula kwa matendawa kumabweretsa zotsatira zowopsa kapena zowononga moyo. Ziwalo zonse ndi ziwalo zamagulu zimawonongeka, pamakhala chiopsezo chachikulu chotenga chikomokere (hypoglycemic, hyperglycemic).

Coma nthawi zambiri imayambitsa imfa.

Ndi matenda a shuga, zovuta zazikulu za metabolic zimachitika m'thupi. Kuzindikira kumakhazikitsidwa pazizindikiro zodziwika komanso mayeso apamwamba olondola a labotale.

Mbiri yakale

Palibe chidziwitso chodalirika kuti nthawi yomwe anthu adakumana ndi matenda owopsa nthawi yanji. Titha kunena kuti koyambirira komwe kumatchulidwa za matenda ofanana ndi kufotokozera kwa matenda ashuga amachokera m'zaka za zana lachitatu BC.

Ochiritsa akale achi Egypt ndi A Greek akale, achi Roma, komanso kum'mawa kwa Aesculapius anali kumudziwa bwino. Mu Europe yakale, adayesanso kufotokozera "matenda a shuga", kufotokoza mtundu wa matendawa, omwe amakhudza anthu am'magulu osiyanasiyana.

M'masiku amenewo, sizinali zotheka kudziwa zomwe zimayambitsa matenda ashuga, motero anthu ambiri odwala anali oti afa.

Mawu oti "matenda ashuga" adagwiritsidwa ntchito poyambirira ndi a Arethius (2 century AD), sing'anga waku Roma. Adawonetsa matendawa kuti "mavuto osapilira, omwe amafala makamaka pakati pa amuna, omwe amasungunula mkodzo. Osapikisana nawo amakakamiza kuti asayime, akumva ludzu losatha, moyo wawo ndi wopindulitsa, wafupikitsa. ” M'masiku akale, diagnostics anali ozizira pazizindikiro zakunja.

Mwana kapena wachinyamata akadwala (matenda a shuga 1), amwalira posachedwa. Matendawa atayamba kudwala wachikulire (malinga ndi gulu lamakono - matenda ashuga a 2), mothandizidwa ndi zakudya zapadera, zitsamba zamankhwala, adathandizidwa.

Kafukufuku wowonjezeranso wabweretsa mankhwala pafupi kuti adziwe zomwe zimayambitsa matendawa komanso njira zake zochizira:

• 1776 - Chingerezi.Dr. Dobson adazindikira kuti kukoma kwa mkodzo kuchokera kwa munthu wodwala ndiko chifukwa cha kuchuluka kwa shuga mkati mwake. Chifukwa chake, adayamba kutcha shuga "shuga",
• 1796 - kufunikira kwa kusunga zakudya za anthu odwala matenda ashuga, masewera olimbitsa thupi anali oyenera,
• 1841 - madotolo adaphunzira momwe angadziwire glucose wa m'mimba mu mkodzo, komanso m'magazi,

• 1921 - insulin idapangidwa koyamba, yomwe mu 1922 idagwiritsidwa ntchito pochiza odwala matenda a shuga mellitus,
• 1956 - anafufuza momwe gulu lapadera la mankhwala omwe amapangitsira thupi kutulutsa insulin,
• 1960 - ikufotokoza kapangidwe ka insulin yaumunthu,
• 1979 - insulin yonse ya anthu yathunthu imapangidwa chifukwa cha mainjini.

Mankhwala apano amakupatsani mwayi wokulitsa moyo ndikuwonjezera ntchito ya odwala matenda ashuga.

Gulu

Shuga mellitus nthawi zambiri amawerengedwa m'magulu awiri akuluakulu - insulin-wate (IDDM) komanso osagwirizana ndi insulin-IDDM. Palinso matenda a shuga a gestational ndi pathological zomwe zimachitika chifukwa chogwiritsa ntchito zovuta za carbohydrate metabolism.

Kutengera mphamvu ya thupi yopanga insulin, chinsinsi:

• Mtundu woyamba - IDDM. Mtundu wa matenda amtunduwu umalumikizidwa ndi kuperewera kwambiri kwa insulin mthupi. Mapaipi owonongeka (kapamba) sangathe kugwira ntchito zake. Sipanga insulini kwathunthu kapena kuiyambitsa yaying'ono. Zotsatira zake, kusunthika kwapamwamba komanso kusokoneza shuga kumakhala kosatheka. Mutha kudwala muli ana kapena osakwanitsa zaka 30. Odwala nthawi zambiri samakhala ndi kulemera kwambiri. Amakakamizidwa kumwa insulin ya jakisoni.

• Mtundu wachiwiri - NIDDM. Mu mtundu uwu wa matenda ashuga, insulin imapangidwa ndi ma pancreatic cell okwanira kapena kuchuluka kwambiri, komabe, chiwopsezo cha minofu yake chimatayika, "sichingagwire ntchito". Dziwani NIDDM, monga lamulo, mwa akulu, pambuyo pa zaka 30 mpaka 40. Odwala nthawi zambiri amadwala matenda osiyanasiyana onenepa. Jekeseni wa insulin wa insulin kwa odwala nthawi zambiri safunikira mwachangu. Pochiza matenda ashuga oterowo, mitundu ya mankhwala omwe amachepetsa shuga amagwiritsidwa ntchito. Zotsatira zamankhwala zimachepetsa kukana kwa maselo ku insulin kapena kusinthitsa kapamba kuti apange insulin.

Magawo a matenda ashuga nephropathy. Kuyesa ndi kufufuza matenda

Kuti mupeze mankhwala, ndikofunikira kuyambitsa matenda onse. Kusankhidwa kwa mankhwala ndi njira zochizira matenda a impso kwa munthu aliyense ndi kwamunthu payekha.

Kuti mupeze chithandizo chonse cha matenda ashuga a nephropathy, ndikofunikira kuyamba kuchita panthawi yake. Gawo la microalbuminuria ndi lokhalo lomwe njira zosinthira zimachitika.

Pofuna kuchiza matenda a impso, ndikofunikira kutsatira malangizo ndi malingaliro a adokotala.

• kutsatira zakudya zochepa zopatsa mphamvu,
• kumwa mankhwala ochepetsa magazi,
• okodzetsa
• chakudya chopanda mchere.

Mankhwalawa gawoli, muyenera kuyang'anira kuchuluka kwa hemoglobin ya glycosylated ndikuwunika pafupipafupi kuchuluka kwa mafuta m'thupi. Izi zimachitika mothandizidwa ndi zakudya komanso mankhwala omwe amawongolera njirazi.

Ndikofunikira kumwa mankhwala omwe amachepetsa kuthamanga kwa magazi, ngakhale atakhala abwinobwino, mlingo wocheperako uyenera kupezeka tsiku lililonse. Izi ndizofunikira kuti muchepetse kuchuluka kwa albumin mumkodzo komanso kupewa kusintha kwa impso.

Gawo la proteinuria likayamba, matenda oopsa agwirizane, muyenera kuchepetsa kugwiritsa ntchito mchere ndi zakudya zamzitini. Muyenera kuphika nokha chakudyacho osati mchere, kuti mupeze zomwe mumakonda pogwiritsa ntchito mandimu, tsabola ndi zitsamba.

Pafupifupi onse odwala matenda ashuga ayenera kuyesedwa pachaka kuwunikira ntchito ya impso. Ngati matenda a diabetes a nephropathy atakula, ndikofunikira kuti muzitha kudziwa koyambirira, pomwe wodwalayo samadzimva.Chithandizo choyambirira cha matenda a shuga a nephropathy amayamba, amakhala ndi mwayi wopambana, ndiko kuti, wodwalayo amatha kukhala ndi moyo wopanda chimbudzi kapena kumuwonjezera impso.

Mu 2000, Unduna wa Zaumoyo ku Russia unavomereza gulu la anthu odwala matenda ashuga ndi magulu. Mulinso mitundu iyi:

• gawo la microalbuminuria,
• siteji proteinuria yokhala ndi nitrogen-excreting impso ntchito,
• gawo la matenda aimpso kulephera (mankhwala a dialysis kapena kupatsidwa impso).

Pambuyo pake, akatswiri adayamba kugwiritsa ntchito njira yodziwika bwino yokhudzana ndi matenda a impso a shuga. Mmenemo, osati 3, koma magawo 5 a shuga a nephropathy amadziwika.

Onani magawo a matenda a impso osafunikira kuti mumve zambiri. Gawo liti la matenda ashuga okodzetsa wodwala ena limadalira kuchuluka kwake kwa kusefedwa (amafotokozedwa mwatsatanetsatane momwe amatsimikizidwira).

Ichi ndiye chizindikiro chofunikira kwambiri chomwe chikuwonetsa momwe impso zimasungidwira bwino.

Pa nthawi yodziwitsa anthu odwala matenda ashuga, ndi bwino kuti dokotala adziwe ngati impsoyo yakhudzidwa ndi matenda ashuga kapena zina. Kupezeka kosiyanitsa kwa matenda ashuga nephropathy ndi matenda ena a impso kuyenera kupangidwa:

• aakulu pyelonephritis (kutupa kwa impso),
• chifuwa chachikulu cha impso,
• pachimake ndi matenda glomerulonephritis.

Zizindikiro za matenda a pyelonephritis:

• Zizindikiro za kuledzera (kufooka, ludzu, nseru, kusanza, kupweteka mutu),
• kupweteka kumbuyo ndi m'mimba pamtunda wa impso,
• kuthamanga kwa magazi
• Odwala ⅓ - kukodza mwachangu, zopweteka,
• kuyezetsa kumawonetsa kukhalapo kwa maselo oyera ndi mabakiteriya mkodzo,
• chithunzi chojambulidwa ndi ultrasound cha impso.

Zokhudza chifuwa chachikulu cha impso:

• mkodzo - leukocytes ndi chifuwa chachikulu cha mycobacterium,
• ndi mawonedwe aubwino (x-ray ya impso ndi mtsempha wamkati wamtundu wosiyana) - chithunzi chaoneka.

Momwe matendawa amakulira komanso amapita patsogolo

Chofunikira kwambiri kwa munthu amene ali ndi matenda ashuga mzaka zoyambirira kuchokera nthawi yomwe wapezeka kuti wayamba kupeza matendawa ndikuyamba kuchiza impso ndipo muyenera kuzichita nthawi yomweyo, chifukwa njira yake ya matenda ashuga ikhala yabwinoko ndipo itha kukhala yopepuka.

Ngati matendawo ayamba kudwala, kusintha kosiyanasiyana kumawonedwa mu impso:

• Kukula kwa minofu ya minyewa yomwe ili pakati pa capillaries a impso.
• Kuphatikizika kwa capillaries ndi minangial minofu mwanjira yamabampu akulu.
• Kuchuluka kwa magazi okonzedwa kumachepa, chifukwa chake, zokolola zimayamba kuchepa.
• Mkodzo umachulukitsa kuchuluka kwa nayitrogeni ndi urea.

• Proteinuria imayamba.
• Zizindikiro za matenda ashuga zikuyamba kutchuka.
• Kukula kwa matenda osatha olimbitsa thupi kumawonedwa.
• Ntchito za ziwalo ndi machitidwe zimaphwanyidwa.

Chifukwa chophwanya chiyeretso, ntchito zong'ambika, chiwalo chonse chimaphatikizidwa ndi zotayidwa. Kenako pakubwera kulephera kwa matenda a impso.

Panthawi yamaonekedwe a mkodzo wa zizindikiro za microalbuminuria, munthu samakumana ndi kusintha kulikonse pa thanzi lake.

Mapuloteni a albumin omwe apezeka mumkodzo ndi zisonyezo za 30-300 ml pakuwunikira tsiku ndi tsiku ndi chidaliro chonse chimapangitsa kunena kuti matenda a shuga amayamba mu thupi la wodwalayo.

Kwa anthu omwe ali ndi matenda a shuga a mtundu woyamba 1 kapena 2, kuwunika michere ndi njira yofunikira ngati mulibe mapuloteni mumkodzo wawo. Kuyesedwa kwa kupezeka kwa mtundu wamtunduwu kwa odwala matenda a shuga kumadutsa chaka chilichonse.

Pali mizere yoyesera yomwe ili ndi dzina loti "Mikral - mayeso" kuti mudzidziwitse nokha kunyumba. Koma mayeso amalebhu nthawi zonse amadziwa bwino kuchuluka kwa albumin, ndipo sayenera kunyalanyazidwa.

Gulu lomwe liziika pachiwopsezo chotenga matenda akulu a impso limaphatikizaponso anthu omwe ali ndi zovuta zotere:

• hyperglycemia
• matenda oopsa
• Hyperlipidemia,
• kuchuluka kwa mapuloteni
• kusuta fodya.

Zizindikiro za Matenda A Impso

Momwe impso zimakhudzidwira matenda a shuga zitha kumveka pomvetsetsa kusanthula kwamkodzo, magazi ndi mawonekedwe akunja.

Zizindikiro za matenda a impso zitha kugawidwa m'magulu otsatirawa.

Chizindikiro choyambirira kwambiri cha matenda a impso mu matenda a shuga (diabetesic nephropathy) ndi microalbuminuria.

Magazi a anthu ali ndi plasma, momwe zinthu zomwe zimapangidwira zimakhala: maselo ofiira am'magazi, maselo oyera amitsempha, ma lymphocyte ndi zina. Mwa kapangidwe kake, madzi a m'magazi amakhala ndi madzi (90%) ndi nkhani youma (10%: 6-8% ndi zinthu zomanga thupi, 2-4% ndi mankhwala ena achilengedwe ndi mchere.

Mwa munthu wathanzi, kuphatikizika kwa zinthu zina zosungunuka m'madzi a m'magazi kumakhala kosalekeza nthawi zonse, ndipo zomwe ena anganene zimasinthasintha pamalire ena molingana ndi kuchuluka kwa momwe alowera m'magazi kapena kuchotsedwa.

Chimodzi mwa zinthu zofunika kwambiri m'madzi a m'magazi ndi mitundu yambiri ya mapuloteni, ambiri omwe amapangidwa m'chiwindi. Mapuloteni a Plasma, limodzi ndi zinthu zina zamagazi, amasunga ma ioni a haidrojeni pamlingo pang'ono wamchere (pH = 7.39), womwe umafunika njira zambiri zamankhwala m'thupi.

Mapuloteni ambiri a plasma ndi a albumin (oposa 50% a mapuloteni onse, 40-50 g / l), omwe ndi mayendedwe a mahomoni ena, mafuta aulere acids, bilirubin, ma ions osiyanasiyana ndi mankhwala, amasunga kukhalapo kwa colloidal osmotic kukhalapo kwa magazi, kutenga nawo mbali angapo kagayidwe kachakudya njira mu thupi.

Mwa anthu athanzi labwino, impso zimadutsa pang'ono mu albumin mumkodzo. Ndi chitukuko cha nephropathy, kuchuluka kwa albumin kumawonjezeka kwambiri.

Tsoka ilo, microalbuminuria koyambira sichingawonekere pogwiritsa ntchito kusanthula kwachizolowezi, kusanthula kwakufunika ndikofunikira. Ndi kusanthula kovuta kotero, microalbuminuria imatha kudziwika koyambirira (pafupifupi zaka 5 isanadziwonetseke ndi kusanthula kwapadera) ndikuchiritsidwa kwathunthu. Microalbuminuria, yemwe amadziwika ndi kuyesa magazi nthawi zonse, tsoka, sangathenso kuthandizidwa.

CHIYAMBI! Odwala omwe ali ndi matenda a shuga a mtundu woyamba, omwe ali ndi "chidziwitso" choposa zaka 5, ndipo odwala onse omwe ali ndi matenda a shuga 2 amasonyezedwa kuyesa kwa microalbuminuria. Kuti mumve zambiri onani Kutsimikiza kwa mapuloteni mu mkodzo

Munthawi ya mankhwala a microalbuminuria, matenda a kukakamiza, kuchepa kwa magazi m'magazi - zovuta za njira zochizira zimachepetsa kukula kwa impso.

Ngati matenda a shuga sachiritsidwira, ndiye kuti patatha zaka zochepa padzakhala kukula kwakukulu kwa maselo omwe ali pakati pa mafupa capillaries (mesangial minofu) - microalbuminuria ikupita patsogolo. Pambuyo pa zaka 15 mpaka 20, minyeial minofu imakula kwambiri kotero kuti imakanikizira kwathunthu ndikutseka ma capillaries ndi ma tubules omwe amasefa magazi.

Minyewa ya glaleruli imasinthidwa ndi mabatani ndipo imaleka kugwira ntchito, magazi amatsuka kwambiri. Kulephera kwamankhwala kumayamba - milingo yambiri ya urea nayitrogeni ndi kuwonjezeka kwa creatinine, ndipo mapuloteni ambiri amapezeka mumkodzo.

Wodwala amafunikira mwina ndi dialysis kapena kumuika impso.

Type 2 matenda a shuga: kuzindikira ndi kuchiza

Kusintha kwenikweni kwa matenda a impso afotokozedwa pamwambapa. Mu gawo lino, tikambirana za njira zodziwikitsa zofufuzira.

Zomwe zimayambitsa matenda ashuga a 2 zimaganiziridwa. Mayankho amafunsidwe: Kodi mtundu 2 wa shuga ndi wosiyana bwanji ndi mtundu woyamba wa shuga? Kodi matenda a shuga a LADA ndi ati? Vuto lakuwunika zovuta ndikuzindikira zovuta za kagayidwe kazakudya zimawunikidwa. Chithandizo cha matendawa akufotokozedwa poganizira zaposachedwa zapadziko lonse lapansi.

Matenda a shuga a Mtundu 2 masiku ano akukhudza anthu ochulukirachulukira.Chilichonse chokhudza matenda a shuga a 2 chikuyamba kale kudziwika kuchokera manyuzipepala, pa TV, pa intaneti.

Matendawa amadziwika osati kokha ndi kuphwanya kagayidwe kazakudya, monga nzika zambiri zimakhulupirira, komanso mwa kupatuka kwa mitundu ina ya kagayidwe: mafuta, mapuloteni, ndi mavitamini. Akatswiri ambiri ofufuza za matenda am'mimba amati mtundu wa shuga wachiwiri ndi mtundu 1 wodwala matenda obwera chifukwa cha matenda a insulin ndi mliri, chifukwa kuthamanga ndi kufalikira kwake kukuchitika ndipo akufanana ndi matenda opatsirana pakutha.

Nkhaniyi imanena za matenda ashuga: Zizindikiro, zoyambitsa, zovuta za matenda a shuga (chiyani), mankhwala a matenda a shuga a 2, mawonekedwe a mankhwala.

Kodi shuga ndi chiyani?

Kuchokera kwa odwala, endocrinologist ku phwando nthawi zambiri amamva: "Ndili ndi matenda ashuga a 2." Koma si aliyense amene amamvetsa zomwe zimayambitsa metabolism iyi.

Matenda a diabetes a endocrinopathies a mitundu yonseyi amaphatikizidwa kuti matenda amtundu wa metabolic amawonongeka. Insulin pakukula kwa kusintha kwa pathological ndi chifanizo chachikulu.

Pokhapokha poyamba, chifukwa cha kuwonongeka kwa maselo a kapamba (islets of Langerhans) ndi njira ya autoimmune kapena ndi omwe akutenga matenda, kupangika kwa timadzi timeneti kumasokoneza. Nthawi yomweyo, kumwa kwa glucose - gawo lalikulu lamphamvu - mwa ma cell a ziwalo ndi minofu imasokonekera, chifukwa ma insulin a michere amafunika kugwiritsa ntchito michere iyi kuchokera m'magazi.

Mtundu wachiwiri wa matenda ashuga: matendawo ndi chiyani, ndipo pali kusiyana kwakukulu kotani kwa matenda amtundu woyamba? Mosiyana ndi matenda amtundu wa shuga 1, pakadali pano, chidwi cha insulin chomwe chimapangitsa chidwi ndi insulin chimatha, chifukwa chake, izi zimachitika chifukwa cha matenda a receptor.

Izi zimadziwika mu kuwonjezeka kwa glucose m'magazi ndi zinthu zina zachilengedwe: hyperglycemia (kuthamanga kwa magazi), glucosuria (kukhalapo kwa shuga mkodzo).

Kuwonjezeka kwa zinthu izi m'madutsanso kumayambitsa kukhathamiritsa kwa glucose. Ichi ndi katundu chomwe chimawonetsedwa ndikupanga makatoni, neuropathy, angiopathy ndi zovuta zina zowopsa.

Zizindikiro za matendawa

Kupezeka kwa matenda ashuga nephropathy akuwonetsa kuwonongeka kwa impso za kusefa zinthu (glomeruli, tubules, mitsempha, arterioles) chifukwa chakuchita bwino mu kagayidwe kazakudya zam'mimba ndi lipids.

Chifukwa chachikulu chachitukuko cha nephropathy mu diabetes ndi kuchuluka kwa shuga m'magazi.

Poyambirira, wodwalayo amawonekera kuuma, kukoma kosasangalatsa mkamwa, kufooka kwapafupipafupi ndi kuchepa kwa chilakolako chofuna kudya.

Zina mwazizindikiro ndi kuchuluka kwamkodzo potulutsa, pafupipafupi kukodza usiku.

Nephropathy imawonetsedwanso ndi kusintha kwa mawunikidwe azachipatala: kuchepa kwa hemoglobin, mphamvu ya mkodzo mwachindunji, kuchuluka kwa creatinine, ndi zina. Kusokonezeka kwam'mimba, kuthamanga pakhungu, kutupa ndi matenda oopsa.

Kusiyanitsa mitundu

Pofuna kukhazikitsa bwino matendawa, dokotala ayenera kuonetsetsa kuti impso zikugwira bwino ntchito chifukwa cha matenda ashuga, osati matenda ena.

Wodwalayo amayenera kuyesedwa kwa creatinine, mkodzo wa albumin, microalbumin ndi creatinine.

Zizindikiro zoyambirira za matenda a shuga ndi nephropathy ndi a albuminuria ndi glomerular filtration rate (pano GFR).

Kuphatikiza apo, ndikuwonjezereka kwa mankhwala a albumin (mapuloteni) mumkodzo womwe umawonetsa gawo loyambirira la matendawa.

GFR m'miyeso yoyambirira imaperekanso mfundo zapamwamba, zomwe zimachepa ndi kupitilira kwa matendawa.

GFR imawerengeredwa pogwiritsa ntchito mitundu, nthawi zina kudzera pa mayeso a Reberg-Tareev.

Nthawi zambiri, GFR ndi yofanana kapena yayikulu kuposa 90 ml / mphindi / 1.73 m2. Wodwala amapezeka ndi aimpso nephropathy ngati ali ndi magazi ochepa a GFR kwa miyezi itatu kapena kupitilira apo ndipo pali zopatuka pakuwunika mkodzo pafupipafupi.

Pali magawo 5 akuluakulu a matendawa:

Kumayambiriro kwa matendawa, mayendedwe azachipatala kwa wodwala amaperekedwa ndi katswiri wazamankhwala komanso endocrinologist. Ngati wodwala ali ndi chotupa pamwamba pa siteji 3, ayenera kuwonedwa ndi nephrologist pafupipafupi.

Zolinga zikuluzikulu polimbana ndi nephropathy ndizogwirizana ndi chithandizo cha matenda ashuga ambiri. Izi zikuphatikiza:

1. kutsitsa shuga
2. kuthamanga kwa magazi,
3. matenda a cholesterol.

Mankhwala olimbana ndi nephropathy

Pochiza kuthamanga kwa magazi pa nthawi ya matenda a shuga a nephropathy ACE inhibitors adziwonetsa okha bwino.

Amathandizanso mtima ndi kuchepetsa chiopsezo cha gawo lotsiriza la nephropathy.

Nthawi zina zochita mu mawonekedwe a chifuwa chowuma zimachitika mgululi la mankhwala odwalandiye kuti zokonda ziyenera kuperekedwa kwa angiotensin-II receptor blockers. Amakhala okwera mtengo kwambiri, koma alibe zotsutsana.

Nthawi yomweyo, ACE inhibitors ndi angiotensin receptor blockers sangathe kugwiritsidwa ntchito.

Ndi kuchepa kwa GFR, wodwalayo ayenera kusintha mlingo wa insulin ndi mankhwala a hypoglycemic. Izi zitha kuchitika kokha ndi dokotala potengera chithunzi chonse chachipatala.

Hemodialysis: Zizindikiro, kugwira ntchito bwino

Nthawi zina chithandizo cha mankhwala sichimapereka zotsatira zomwe zimafunikira ndipo GFR imatsika kuposa 15 ml / mphindi / m2, ndiye kuti wodwalayo amamulembera chithandizo chaimpso.

Onaninso umboni wake:

• kuchuluka kwamankhwala a potaziyamu m'magazi, omwe amayamba kuchepa.
• kusungunuka kwa madzi m'thupi, komwe kungayambitse mavuto akulu.
• Zizindikiro zoperewera m'thupi.

Njira imodzi yomwe ilipo yochiritsira mankhwalawa, kuphatikizapo peritoneal dialysis ndi kupatsirana kwa impso, ndi hemodialysis.

Kuti athandize wodwala, amalumikizidwa ndi chida chapadera chomwe chimagwira ntchito ya impso yochita kupanga - chimatsuka magazi ndi thupi lonse.

Njira yakuchiritsirayi imapezeka m'madipatimenti a chipatala, popeza wodwalayo ayenera kukhala pafupi ndi chipangizocho pafupifupi maola 4 katatu pa sabata.

Hemodialysis imakupatsani mwayi kusefa magazi, kuchotsa poizoni ndi ziphe kuchokera mthupi, komanso kuchepa magazi.

Mavuto omwe angakhalepo akuphatikizapo kuchepa kwa magazi ndi matenda.

Contraindication a hemodialysis ndi: mavuto akulu amisala, chifuwa chachikulu, khansa, kulephera kwa mtima, sitiroko, matenda ena ammagazi, zaka zoposa 80. Koma m'malo ovuta kwambiri, pamene moyo wamunthu umasungidwa bwino, palibe zotsutsana za hemodialysis.

Hemodialysis imakupatsani mwayi wobwezeretsa kwakanthawi ntchito impso, ambiri, amakula moyo ndi zaka 10-12. Nthawi zambiri, madokotala amagwiritsa ntchito njira imeneyi ngati chithandizo kwakanthawi asanaikidwe impso.

Zakudya ndi Kupewa

Wodwala yemwe ali ndi nephropathy amakakamizidwa kugwiritsa ntchito mankhwala onse omwe angathe kuthekera mankhwalawa. Zakudya zosankhidwa bwino sizingathandize pamenepa, komanso zimathandizanso thupi.

Pazifukwa izi, wodwala ayenera:

• Idyani zakudya zama protein zochepa (makamaka zochokera nyama),
• kuchepetsa mchere pakuphika,
• ndi potaziyamu wotsika kwambiri m'magazi, onjezerani zakudya zopezeka m'zakudya izi (nthochi, buckwheat, tchizi cha kanyumba, sipinachi, ndi zina).
• kukana zonunkhira, kusuta, kuwotcha, ndi zakudya zam'chitini,
• kumwa madzi abwino akumwa
• sinthani zakudya zabwino,
• Chepetsa zakudya zanu kuzakudya zamafuta ambiri,
• konda chakudya “cholondola”.

Zakudya Zapulogalamu Yochepa - Chofunikira kwa odwala omwe ali ndi nephropathy. Zatsimikiziridwa mwasayansi kuti kuchuluka kwa mapuloteni ambiri muzakudya kumakhala ndi zotsatira zachindunji za nephrotoxic.

M'magawo osiyanasiyana a matendawa, zakudya zimakhala ndi zake. Kwa microalbuminaria, mapuloteni muzakudya zonse ayenera kukhala 12-15%, i.e. osaposa 1 g pa 1 makilogalamu a thupi.

Ngati wodwala akudwala kuthamanga kwa magazi, muyenera kuchepetsa kuchuluka kwa mchere kwa tsiku lililonse mpaka 3-5 g (iyi ndi supuni imodzi). Zakudya siziyenera kuwonjezeredwa zopatsa mphamvu za tsiku ndi tsiku zosaposa 2500 zopatsa mphamvu.

Pa gawo la proteinuria kudya mapuloteni kuyenera kuchepetsedwa 0,7 g pa kilogalamu ya kulemera, ndi mchere - mpaka 2-3 g patsiku. Kuchokera pachakudya, wodwalayo asankhe zakudya zonse zokhala ndi mchere wambiri, azikonda mpunga, oat ndi semolina, kabichi, kaloti, mbatata, mitundu ina ya nsomba. Mkate umatha kukhala wopanda mchere.

Zakudya pa gawo la matenda aimpso kulephera zikusonyeza kuchepetsa kudya mapuloteni 0,3 ga patsiku ndi poletsa zakudya za phosphorous. Ngati wodwala amamva "kufa ndi mapuloteni", amapatsidwa mankhwala okhala ndi ma amino acid ofunikira.

Kuti chakudya chokhala ndi mapuloteni ochepetsetsa azikhala othandiza (ndiye kuti, kuti ziletse kupitirira kwa njira za sclerotic mu impso), dokotala yemwe akupezekapo ayenera kupeza chindapusa chokhazikitsidwa ndi kagayidwe kazakudya ndikukhazikika m'magazi.

Chakudya chokhala ndi mapuloteni ochepa sichimangokhala ndi zabwino, komanso malire ake ndi zovuta zake. Wodwala ayenera kuwunika mwadongosolo kuchuluka kwa albumin, kufufuza zinthu, kuchuluka kwathunthu kwa ma lymphocyte ndi maselo ofiira amwazi. Komanso sungani cholembedwa cha zakudya ndikusintha zakudya zanu pafupipafupi, kutengera malangizowo.

Kanema wothandiza

Ndemanga za akatswiri pazovuta za impso mu kanema wathu:

Matenda a impso a shuga ndi matenda osachiritsika paulendo umodzi wopita kuchipatala. Zimafunikira njira yophatikizira ndikukhazikitsa kulumikizana pakati pa wodwalayo ndi dokotala. Kutsatira okhwima kokhazikika kwa malangizo azachipatala komwe kumathandizira wodwala ndikuchepetsa kukula kwa matenda a impso.

Kuwonongeka kwa impso komanso kusokoneza ntchito ya shuga

• Zotsatira za matendawa pantchito ya impso
• Zizindikiro zoyambira kuwonongeka kwa impso
• Kupititsa patsogolo kwina
• Kulephera kwina

Impso ndi chimodzi mwa ziwalo zofunika kwambiri m'thupi la munthu. Amathandizira kuti metabolism ikhale yachilengedwe pochotsa zinthu zosiyanasiyana zovulaza m'thupi. Impso zimasefa magazi, kuchotsa madzi ochulukirapo m'thupi ndikuwonetsetsa kuti thupi la munthu likhazikika. Kuwonongeka kwa impso mu shuga kumaphwanya ntchito zonse zochitidwa ndi thupili. Matendawa amatchedwa diabetesic nephropathy. Pofuna kubwezeretsa ntchito ya impso, wodwalayo amayenera kutenga njira yayitali yochizira, yomwe imatenga mankhwala apadera ndi njira zomwe zimayeretsa magazi. Mwanjira yamatendawa matenda, opaleshoni yama impso imatheka.

Matenda a shuga ndi impso ndi kuphatikiza komwe kumapangitsa kuti thupi lisagwire ntchito. Impso iliyonse imakhala ndi zomangira zina zotchedwa glomeruli. Amachita mbali yofunika pakutsuka kwa plasma. Magazi oyeretsedwa amadutsa ma tubules apadera, ndipo zinthu zonse zofunika ndi zinthu zina zimabwerera m'magazi. Zowonongeka zamankhwala ndi zinthu zovulaza zimatsalira mu impso, pambuyo pake zimatengedwa kupita nazo ku chikhodzodzo ndikusambitsidwa kunja kwa thupi. Izi zimachitika ndi kugwira ntchito kwa impso, ndipo matenda ashuga oyambira akukulitsa imathandizira izi.

Ngati matendawa ayamba kumene kukula, ndiye kuti njira yopezera zinthu zovulaza m'thupi iyamba kuchitika mwachangu. Kuchuluka kwa shuga kumadutsa impso. Nawonso, amathandizira kuthetsa kuchuluka kwamadzi. Kusamba kofulumira kumapita, kumalimbikira kukakamiza mkati mwa impso. Kuchulukitsa kusefukira kumakhudza kugwira ntchito kwa impso, ndipo zotsatira zake, zimayamba kutha.

Impso zomwe zili ndi gawo 1 la shuga zimayamba kupunduka. Choyamba, makoma a chiwalo amayamba kuzimiririka.Izi zimachitika ndi malo onse oyandikana ndi impso. Kukula kotereku kumathandizira kuchepetsa kuchuluka kwa ma capillaries mkati mwa glomeruli. Izi zimatsogolera ku mfundo yoti impso zimatha kuchotsa kuchepa pang'ono pang'ono pakapita nthawi, ndipo kuchuluka kwa magazi oyeretsedwa kumachepera kwambiri. Matendawa sadziwika msanga. Izi zimachitika chifukwa cha kupezeka kwa thupi la owonjezera glomeruli, zomwe zimathandizira kukhazikika kwa njira yoyeretsera magazi.

Matendawa amatha kukhala nthawi yayitali kwa nthawi yayitali. Nthawi yomweyo, imatha kudziwonekera pokhapokha glomeruli yowonjezera ikamatha kugwira ntchito yake. Koma mwa odwala ena, matenda a shuga amatha kutenga mawonekedwe owopsa ndikuyamba kupita mwachangu kwambiri. Pankhaniyi, kugwira ntchito osati impso zokha, komanso ziwalo zina. Kuwonongeka kwa impso kumatha kuwonekera ndikayezetsa magazi. Mukapanda kuyamba chithandizo cha kulephera kwa impso mu matenda ashuga, matendawa amatha kusintha. Izi ziziwonekera pokhapokha gawo lomaliza, pomwe wodwala adzalephera impso.

Chimodzi mwazizindikiro zoyambirira za matendawa ndi microalbuminuria. Kuphwanya kumeneku kumatha kutsimikiziridwa ndi kuyesedwa kwa magazi ndi mkodzo. Munthawi yovomerezeka yogwira ntchito mkodzo mumakhala mapuloteni ochepa - albumin. Ndi nephropathy, kuchuluka kwa mapuloteni awa kumawonjezeka kwambiri. Koma pa gawo loyambirira la zotupa, ndizovuta kwambiri kuzindikira kusiyana kwa kuchuluka kwa mapuloteni. Kuti muwone kuwonongeka kwa impso ndi matenda ashuga, maphunziro angapo azovuta amafunikira. Uku ndikuwonetsa urinalysis, komwe kumachitika ndikusunga madzimadzi tsiku lonse, ndikuwonetseratu kuchuluka kwa mkodzo womwe umachotsedwa pa ola lililonse.

Kuti apange kusanthula koteroko, zimatenga nthawi, koma kenako amatha kupereka lingaliro lolondola la kukhalapo ndi kukula kwa matendawa. Ngati kuwunika kukuwonetsa kuti kuchuluka kwa albumin ndikokwera kwambiri, ndiye izi zikuwonetsa kuwonongeka kwa impso ndi matenda a shuga. Koma nthawi zina, kuwonjezeka kotereku kungasonyeze kulimbitsa thupi mwamphamvu pafupipafupi. Pofuna kutsimikizira kapena kutsutsa kuti matendawa atha, kafukufukuyu akhoza kubwerezedwa.

Microalbuminuria imawonetsedwa mu urinalysis kale kwambiri poyeserera magazi. Popeza microalbuminuria ndiye chizindikiro chachikulu cha chitukuko cha matenda ashuga, ngati mungadziwe kupezeka kwake zaka zingapo m'mbuyomu kuposa momwe kafukufuku wa plasma akuwonetsera, matendawa amathandizika. Ngati kuwonongeka kwa impso mu matenda osokoneza bongo kudapezeka kale ndi kuchuluka kwathunthu kwa magazi, ndiye kuti matendawa nthawi zambiri amakhumudwitsa. Odwala oterewa amapatsidwa maphunziro apadera kuti azisamalira impso, koma ndizosatheka kuchiritsa kwathunthu.

Kuchita kwa adrenal kungakhalenso chizindikiro cha matenda ashuga. Kwa odwala, chotupa chimayamba kupangika, chomwe chimapangitsa kuti mahomoni azikhala mosiyana ndi insulin. Izi zimatha kuchitika pa magawo onse a 1 ndi 2 a matenda a shuga. Zizindikiro zoyambirira za kuwonongeka kwa impso ku matenda a shuga zimaphatikizapo zinthu zakunja. Odwala nthawi zambiri amayamba kulemera mwachangu kwakanthawi. Munthu amayamba kupita kuchimbudzi nthawi zambiri, kuchuluka kwake kwamadzimadzi kumawonjezeka kangapo. Wodwalayo amamva pakamwa pouma kwambiri ndi ludzu. Kuphatikiza apo, odwala nthawi zambiri amakhala ndi kufooka mthupi lonse komanso thukuta kwambiri.

Ngati matendawa sanazindikiridwe munthawi yake kapena chithandizo sichinayambike, ndiye kuti pang'onopang'ono zimayamba, ndikupita patsogolo, zimasokoneza magwiridwe antchito amthupi. Nthawi yofunikira kwambiri pakukula kwa matendawa ndi zaka 5 zoyambirira. Ngati matenda a shuga atapezeka pakadali pano, ndiye kuti mankhwalawa amayenera kumwedwa mosachedwa. Izi sizingolimbana ndi zizindikiro za matendawa, komanso kuchiritsa matenda ashuga.Ngati matendawa sanazindikire kapena kutsimikizika pambuyo pake, wodwalayo amakhala ndi minofu ya minyewa. Awa ndi maselo omwe amapezeka pakati pa capillaries a impso. Kukula kwawo kumakwiyitsa makoma a chiwalo.

Zingwe zomwe zimamera, zimatenga malo ndikuyamba kuponderezana ma capillaries komanso tubules. Ma neoplasms oterewa amafanana ndi mayina akuluakulu. Kupezeka kwawo kumawonetsa matenda a shuga a impso - nephropathy. Ngati mpakana pano glomeruli imangopanga magazi ochepa, tsopano amasinthidwa ndikusinthidwa ndi mabingu. Kuchulukitsa kwa plasma yoyesedwa ndikuyeretsedwa kumachepetsedwa kwambiri. Pofuna kuwunika momwe impso zimayendera, kuyezetsa magazi kwapadera kumachitika. Kuchuluka kwa urea nayitrogeni mu plasma kumawonetsa kuchuluka kwa ntchito ya impso.

Panthawi yomwe matendawa ali pamlingo wokula, amatha kufalikira kwa ziwalo zina. Wodwala amakula kwambiri zizindikiro za matenda ashuga. Pankhaniyi, kusanthula mkodzo wa wodwala kumakhala ndi protein yofunikira kwambiri, munthu amatha kukhala ndi kuthamanga kwambiri kwa magazi komanso kupweteka kwambiri, komwe kumayendetsedwa ndi kusayenda bwino kwamankhwala ambiri.

Matenda a shuga amakhudza impso ndipo amasokoneza magwiridwe antchito awo. Ngati matendawa sanalandiridwe, samathandizira kuti achedwetse, angayambe kulephera. Ichi ndi chimodzi mwazovuta zazikulu zomwe zimachitika mthupi la wodwalayo. Vutoli limakula m'magawo molingana ndi chiwembu chotsatira:

1. Kuchulukitsa kwa impso mpaka kukula kovuta.
2. Kuchulukitsa kusefera.
3. Kutupa kwamitundu yosiyanasiyana ya glomerular ndi mesangiums.
4. Kupuma kwakutali pakudutsa kwamatenda.
5. Zizindikiro sizimawonekera kwa zaka 10-15.
6. Kusintha kwakukuru m'magazi a wodwalayo patadutsa nthawi yopumira.
7. Akuluakulu a urea ndi creatinine m'magazi.
8. Mapuloteni ovuta mumkodzo.

Zowonongeka zilizonse zimachitika chifukwa cha kuyamba kwa impso. Thupi la wodwalayo lilinso ndi kuchuluka kwa glucose komanso kuwononga pang'ono kwa impso. Zomwe zimapangitsa kuti shuga asinthe amathanso kukhala osiyanasiyana. Kuphatikiza pa kuchepa kwa chithandizo, kulephera kwaimpso kungayambitse:

1. Matenda oopsa.
2. Zinthu zoyipa.
3. Miyezo yokwera yamafuta m'magazi.

Kuthamanga kwa magazi ndichinthu chofunikira kwambiri. Zimachitika ndi kuchuluka kwa glucose omwe ali m'magazi a wodwala. Kusinthasintha kwakanthaŵi kwa kuthamanga kwa magazi kungachedwetse kapena kuthetseratu kusintha kwa matenda ashuga kukhala kulephera kwa impso. Mafuta ochuluka kwambiri (okhala ndi cholesterol) m'magazi amathandizira kuti mesangium iwonjezeke. Izi zimakwiyitsa matenda a impso ndipo zimayambitsa zovuta za matenda ashuga onse.

Nthawi zina, zimakhala zovuta kwambiri kulimbana ndi matendawa. Chinthu chobadwa nacho chimatenga gawo lalikulu. Wodwala m'banjamo ali ndi achibale ake angapo omwe ali ndi matenda a shuga kapena kulephera kwa impso, ndiye kuti amayamba kugwa.

Izi sizitanthauza kuti matendawa adzakula ndikupangitsa kuti aimpso alephere. Koma wodwala wotere amafunika kuwunika kusintha kwam'thupi mwake pasadakhale, kumayesedwa pafupipafupi komanso kupimidwa.

Ngati munthu akuwona kuwonongeka kwa impso, ndikofunikira kutenga njira zamankhwala posachedwa, chifukwa panthawiyi matendawa amatha kuthamanga.

Zamkatimu

Impso ndi gawo lofunikira mthupi la munthu. Ndi mtundu 1 wa shuga, kuwonongeka kwa impso kumachitika mu 30% ya milandu, ndi matenda amtundu 2 shuga 5%. Kusokonezeka kwa ntchito ya impso mu matenda a shuga kumatchedwa - diabetesic nephropathy.

Impso m'thupi zimagwira ntchito zotsatirazi:

• Chotsani madzi ochulukirapo
• Amayendetsa bwino ma hydroni ayoni, zimakhudza mwachindunji kuchuluka kwa magazi,
• Amachotsa zinthu zosungunuka ndi madzi, poizoni, ma electrolyte.
• Impso zimayendetsa kuthamanga kwa magazi, kuchuluka kwa mchere wamchere m'thupi, ndikuchita ntchito za endocrine.

Ndi matenda ashuga, impso zimayamba kusokonekera, makoma awo amayamba kunenepa. Chiwalo chokulirapo chimathandizira kuchepetsa ma capillaries mkati mwa glomeruli (glomeruli imasefa madzi). Kusintha kumeneku kumabweretsa kuti pakupita nthawi, impso sizitha kuthana ndi ntchito yawo, zimatha kuchotsa madzimadzi ochepa, pomwe kuchuluka kwa magazi oyeretsedwa kumachepera.

Njira ya pathological imatha kuchitika posachedwa (asymptomatic), chifukwa chakuti pali zowonjezera glomeruli mthupi zomwe zimakhazikitsa njira zakuyeretsa kwa magazi. Matendawa amatha kuonekera pambuyo poti glomeruli yowonjezereka imatha kulimbana ndi ntchito. Poterepa, pali kuphwanya kwa magwiridwe antchito osati impso zokha, komanso ziwalo zina.

Kuphatikiza pa shuga wambiri, zinthu zotsatirazi zimakhudza kugwira ntchito kwa impso:

1. Kuchuluka kwa cholesterol yambiri "yoyipa" m'magazi,
2. Makamaka
3. Kuthamanga kwa magazi.

Zovuta za impso zimagawidwa m'mitundu itatu:

• Angiopathy - kuwonongeka kwa ziwiya zazikulu kumachitika, atherosulinosis yomwe imapangika pang'onopang'ono imapangidwa (monga mtundu wa 2 matenda ashuga). Ma fomu a Vasoconstriction ischemia (kufa ndi njala ya okosijeni) a impso. Maselo omwe amayambitsa kuthamanga kwa magazi ndiwomwe amatha kupezeka ndi ischemia. Pazifukwa izi, matenda oopsa amayamba (kuthamanga kwa magazi),
• Matenda a shuga - nephropathy - zida zosefera zimakhudzidwa, ndipo zomwe zimayambitsa ndi mtundu 1 komanso matenda ashuga a 2. Kukula kwa nephropathy kumatengera kutalika kwa maphunziro a matendawa ndi chithandizo chake. Choyamba, ndi nephropathy, mapuloteni amapezeka mumkodzo, ndi zovuta kwambiri, amasintha mu fundus ndikuwonjezereka kwa magazi. Ndizofunikira kudziwa kuti fundus ndi malo okhawo m'thupi momwe akatswiri amatha kupenda zombo. Kusintha kwakudziwika kwa diso kudzakhala kofanana ndi zovuta mumitsempha ya impso,
• Matenda a kwamikodzo thirakiti. Anthu omwe ali ndi matenda a shuga achepetsa chitetezo chokwanira, pomwe shuga wambiri amadziunjikana mkodzo, zomwe zimapangitsa kuti akhale ndi michere yambiri ya microflora ya pathogenic. Izi zimawonjezera ngozi zakuyambitsa matenda opatsirana.

• Kuthamanga kwa magazi (matenda oopsa),
• Ukadaulo (edema) umawonekera chifukwa cha kusayenda kwa madzimadzi mthupi. Zikatero, atagona, nkhope ya wodwalayo ndi miyendo yake kumtunda zimatupa. Masana, miyendo yam'munsi,
• Sinthani mtundu wa mkodzo wothira. Mtundu wofiira, woderapo mwina ungaoneke, zomwe zikutanthauza kuti pali magazi mkodzo (onetsetsani kuti mwayang'aniridwa chotupa),
• Zizindikiro za genitourinary matenda ndimakonda kukodza, kuwotcha, komanso kupweteka pokodza. Pali ululu wokoka m'mimba, m'mimba, mkodzo umakhala ndi fungo losasangalatsa,
• Ululu wammbuyo umawoneka ngati kapisolo wa chiwalo katambasuka (kukhalapo kwa miyala, kutupa) kapena pamaso pa matenda,
• Kukhazikika kwamuyaya khungu. Ngati palibe zotupa, chizindikirocho chikuwonetsa kulephera kwa impso.

Laborator zizindikiro za matenda.

• Kuchuluka kwa maselo oyera mumkodzo - akuwonetsa kutupa, kupezeka kwa matenda,
• Maselo ofiira a mkodzo - amawonetsa kukhalapo kwa magazi mmenemo. Kuphatikizana ndi mapuloteni, zimawonetsa kukhalapo kwa glomerulonephritis, matenda a shuga a nephropathy (zida zoyambitsa impso zimakhudzidwa). Kupezeka kwa maselo ofiira a m'magazi kumaonetsa kuwonongeka kwa ziwalo (chotupa, minofu),
• Mapuloteni mumkodzo ndiye chizindikiro chachikulu cha matenda a impso,
• Kuchepa kwa hemoglobin. Matendawa angasonyeze kulephera kwa impso,
• Miyezo yambiri yokwanira ya phosphorous yokhala ndi calcium yochepa kwambiri ikuwonetsa kutsogolo kwa matendawa.
• Kuwonjezeka kwa urea wamagazi, potaziyamu, ndi creatinine kumasonyeza kulephera kwa impso.

1. Urinalysis ─ microalbuminuria (mawonekedwe a mkodzo wa albumin - mapuloteni amwazi). Ndikofunikira kudziwa kuti odwala omwe ali ndi matenda a shuga a mtundu woyamba pambuyo pa matenda ashuga amatenga zaka zopitilira 5 ndipo anthu onse omwe ali ndi matenda a shuga a 2 ayenera kuyesedwa chaka chilichonse kupezeka kwa microalbuminuria.
2. Kupatula kumbuyo (Kuunika kwa X-ray ndikumayambitsa wothandizira wosiyana). Pa kuyeserera, kapangidwe ka impso, kwamkodzo, ndi kulumikizana kwa impso ndi ziwalo zina kumayesedwa. Phunziroli limapangidwa mu kulephera kwa impso,
3. Makina a Ultrasound Dziwani kupezeka kwa calculi (miyala), neoplasms, zizindikiro za chotchinga kwamkodzo,
4. Puncting a impso - pansi pa mankhwala oletsa ululu wam'deralo komanso kuwunikira kwa ultrasound, jakisoni amapangidwa impso ndipo kachidutswa kakang'ono ka aimpso kamachotsedwa (machesi amakono). Minofu imayesedwa pansi pa microscope kuti isinthe ma pathological,
5. CT scan Amadziwa kukhalapo kwa chotupa, miyala, dziko.

Nephropathy imayambitsa zovuta zotsatirazi:

• Retinopathy - kuwonongeka kwa ziwiya za fundus,
• Neuropathy ndimavuto amisempha,
• Matenda a kwamikodzo thirakiti
• Kulephera kwamphamvu ndi chinthu chovuta kwambiri.

Pakuwonongeka kwa impso, anthu omwe ali ndi matenda a shuga amatha kutumikiridwa ma AID inhibitors (mwachitsanzo, Benazepril, Captopril, Enalapril), mankhwalawa amathandizira kuchepetsa kuthamanga kwa magazi, kuchuluka kwa albumin m'magazi. ACE inhibitors amachepetsa kufa ndi 50% chifukwa cha matenda ashuga.

Koma mankhwalawa ali ndi zoyipa zambiri: kuwonjezeka kwa potaziyamu m'magazi, chifuwa chachikulu, ndi zina, izi zimakhudza kugwira ntchito kwa impso ndi mtima. Chifukwa chake, zoletsa za ACE zimaloledwa ndi angiotensin 2 receptor blockers (Losartan, Valsartan, etc.).

Ngati mankhwala okhwima sagwira ntchito. Matenda a wodwalayo akupitilirabe kugwiritsa ntchito njira zopitilira muyeso - dialysis (njira yoyeretsera magazi) komanso kupatsirana kwa impso.

Masiku ano, dialysis ili ndi mitundu iwiri yamakhalidwe:

• Peritoneal dialysis. Catheter yomwe imatulutsa madzimadzi imayikidwa m'mimba mwa wodwalayo. Madzi ambiri amachotsedwa pamimba khoma, lomwe limachotsa poizoni ndi zinyalala zonse m'thupi. Mchitidwewu umachitika tsiku ndi tsiku, pomwe kuli kofunikira kuonetsetsa kuti zida zamankhwala sizovala bwino, kuti zisathetse,
• Hemodialysis (impso yochita kupanga). M'chipatala, wodwala amamulowetsa mu mtsempha kudzera mu chubu chomwe magazi amatengedwa kuti ayeretse ndi chipangizo choyezera. Magazi oyeretsedwa kale amalowanso m'thupi la wodwalayo. Hemodialysis kumaonjezera ngozi ya matenda, amachepetsa kuthamanga kwa magazi.

Kupatsirana kwa impso kumakongoletsa thanzi la wodwalayo, koma pali zovuta zina zomwe zingagwire ntchito:

• Kuthekera kwokana impso yodulidwa,
• Ntchito yodula
• "Impso" yatsopano ikadali ndi glucose,
• Kumwa mankhwala omwe amachepetsa chitetezo chokwanira (kuti impsoyo isang'ambe) zimasokoneza kuwongolera kwa matenda a shuga.

Odwala omwe ali ndi matenda ashuga ayenera kuyang'anitsitsa thanzi lawo, kuchita zinthu zotsatirazi:

1. Kuteteza kuthamanga kwa magazi,
2. Muzipima magazi nthawi zonse
3. Pewani matenda
4. Onaninso kuchuluka kwa cholesterol "yoyipa" m'magazi.

Popewa matenda a shuga a nephropathy, muyenera kusamutsa matenda ashuga kukhala gawo lamalipiro (pamene glucose ili pafupi kwambiri ndi zomwe zimakhazikika), muyenera kutsatira kadyedwe, masewera olimbitsa thupi komanso masewera olimbitsa thupi. Onetsetsani kuti insulini yovulazidwa ndiyabwino.

Madokotala omwe amalimbana ndi matenda a impso:

• Udokotala
• Nephrologist - amafufuza matenda a impso, kusefa mwachindunji zida za chiwalo. Katswiri wa matenda ashuga nephropathy, yade ndi matenda ena,
• Dialysis katswiri
• Transplantologist.

Nephropathy ndiye vuto lalikulu kwambiri la matenda ashuga, lomwe limapangitsa munthu kufa. Ngati zizindikiro zosokoneza zikuwoneka, muyenera kulankhulana ndi katswiri nthawi yomweyo.

Siyani ndemanga 2,626

Masiku ano, anthu odwala matenda ashuga nthawi zambiri amakumana ndi matenda monga matenda ashuga nephropathy. Uku ndi kusokonezeka komwe kumakhudza mitsempha ya magazi a impso, ndipo kungayambitse kulephera kwa impso. Matenda a shuga ndi impso zimayenderana kwambiri, monga momwe zikuwonera chifukwa chachikulu cha nephropathy mwa odwala matenda a shuga. Pali magawo angapo a chitukuko cha matendawa, omwe amadziwika ndi zizindikiro zosiyanasiyana. Mankhwalawa ndi ovuta, ndipo kudaliraku kumadalira khama la wodwalayo.

Anthu odwala matenda ashuga ali pachiwopsezo chotenga matenda "owonjezera" - kuwonongeka m'mitsempha ya impso.

Matenda a shuga ndi nephropathy ndimatenda omwe amadziwika ndi kuwonongeka kwamitsempha yama impso, ndipo amakula motsutsana ndi maziko a matenda a shuga. Ndikofunikira kuzindikira matendawa munthawi yake, chifukwa pamakhala chiopsezo chachikulu chotenga kulephera kwa impso. Mtundu wa complication uwu ndi chimodzi mwazomwe zimapangitsa kuti anthu azifa. Sikuti mitundu yonse ya shuga imayendera limodzi ndi nephropathy, koma mtundu woyamba ndi wachiwiri wokha. Kuvulala kwa impso kumachitika mwa anthu 15 mwa 100 a matenda ashuga. Amuna amakonda kwambiri matenda. Wodwala wodwala matenda ashuga, pakapita nthawi, minofu ya impso imavulala, zomwe zimayambitsa kuphwanya ntchito zawo.

Pokhapokha pa nthawi, kuzindikira koyambirira komanso njira zoyenera zochiritsira zingathandize kuchiritsa impso ndi matenda a shuga. Kugawidwa kwa matenda a shuga a nephropathy kumapangitsa kuti azindikire kukula kulikonse kwamatenda. Ndikofunika kulingalira kuti magawo oyambawa a matendawa samatsatiridwa ndi zizindikiro zotchulidwa. Popeza ndizosatheka kuthandiza wodwalayo pamafuta opaka, anthu omwe ali ndi matenda a shuga ayenera kuyang'anitsitsa thanzi lawo.

Pathogenesis wa matenda ashuga nephropathy. Munthu akayamba matenda ashuga, impso zimayamba kugwira ntchito kwambiri, zomwe zimafotokozedwa ndikuti kuchuluka kwa glucose kumasefedwa kudzera mwa iwo. Izi zimatenga madzi ambiri, zomwe zimawonjezera katundu pa impso glomeruli. Pakadali pano, nembanemba wa glomerular imakhala wofinya, monganso minofu yoyandikana nayo. Njira izi pakapita nthawi zimatsogolera kusamutsidwa kwa ma tubules kuchokera ku glomeruli, komwe kumapangitsa magwiridwe ake ntchito. Izi glomeruli m'malo ndi ena. Popita nthawi, kulephera kwa impso kumayamba, ndipo kudziyambitsa poizoni m'thupi kumayamba (uremia).

Zowonongeka za impso mu matenda a shuga sizimachitika nthawi zonse. Madokotala sanganene motsimikiza kuti chomwe chimayambitsa zovuta za mtundu uwu ndi chiyani. Zakhala zangotsimikiziridwa kuti shuga yamagazi sichikhudza mwachindunji matenda a impso mu shuga. Theorists amati matenda ashuga nephropathy ndi chifukwa cha zovuta zotsatirazi:

• Kuthamanga kwa magazi kumayambitsa kukodza kwambiri, ndipo minyewa yolumikizana ikamakula, kusefedwa kumachepa kwambiri.
• shuga wamagazi atakhala kunja kwa masiku onse, njira zakukula za m'magazi zimapangika (shuga amawononga mitsempha yamagazi, magazi amayenda m'masokonekera, mafuta ochulukirapo, mapuloteni ndi zakudya zimadutsa impso), zomwe zimatsogolera kuwonongeka kwa impso pamaselo a ma cell,
• Pali kutengera kwa chibadwa cha mavuto a impso, omwe, motsutsana ndi maziko a matenda osokoneza bongo (shuga wambiri, kusintha kwa kagayidwe kachakudya), kumabweretsa kuphwanya kapangidwe ka impso.

Matenda a shuga komanso matenda a impso samatenga masiku ochepa, zimatenga zaka 5-25. Gulu la odwala matenda ashuga nephropathy:

1. Gawo loyamba. Zizindikiro palibe. Njira zakuzindikirira ziziwonetsa kuchuluka kwa magazi mu impso ndi ntchito yawo yambiri. Polyuria mu shuga angayambike kuchokera gawo loyamba.
2. Gawo lachiwiri.Zizindikiro za matenda a shuga a nephropathy sanawonekere, koma impso zimayamba kusintha. Makoma a glomeruli amakula, minyewa yolumikizana imakula, ndipo kusefera kumakulirakulira.
3. Gawo loyesera. Mwina kuwoneka kwa woyamba chizindikiro mu mawonekedwe a kupanikizika kowonjezereka. Pakadali pano, kusintha kwa impso ndikusinthanso, ntchito yawo imasungidwa. Ili ndiye gawo lotsiriza.
4. Gawo la Nephrotic. Odwala amangokhalira kudandaula za kuthamanga kwa magazi, kutupa kumayamba. Kutalika kwa magawo - mpaka zaka 20. Wodwalayo amatha kudandaula za ludzu, nseru, kufooka, kutsika pang'ono, kupweteka mtima. Munthu akuchepetsa thupi, kupuma movutikira kumawonekera.
5. Gawo lachigawo (uremia). Kulephera kwamphamvu m'magazi a shuga kumayamba ndendende nthawi imeneyi. Pathology imayendera limodzi ndi kuthamanga kwa magazi, edema, kuchepa magazi.

Kuwonongeka kwa ziwiya za impso mu shuga kumawonekera chifukwa cha kutupa, kupweteka kumbuyo, kuchepa thupi, kulimbitsa thupi, kupweteka pokodza.

Zizindikiro za matenda ashuga oopsa:

• mutu
• Fungo la ammonia loyenda mkamwa.
• kupweteka mumtima,
• kufooka
• kupweteka pokodza
• kutaya mphamvu
• kutupa
• kupweteka kumbuyo
• kusowa chilakolako chofuna kudya
• kuwonongeka kwa khungu, kuuma,
• Kuchepetsa thupi.

Bweretsani ku zomwe zalembedwa

Vuto la impso ndi odwala matenda ashuga sizachilendo, chifukwa chake, kuwonongeka konse, kupweteka kumbuyo, kupweteka mutu kapena vuto lililonse, wodwalayo ayenera kufunsa dokotala nthawi yomweyo. Katswiri amatenga anamnesis, amayesa wodwalayo, pambuyo pake amatha kudzipangira matenda, kuti atsimikizire kuti ndikofunikira kufufuza bwino. Kuti mutsimikizire matenda a matenda ashuga a nephropathy, ndikofunikira kuti mukayezetse mayeso otsatirawa:

• urinalysis wa creatinine,
• kuyesa kwa mkodzo,
• kusanthula kwamkodzo kwa albumin (microalbumin),
• kuyezetsa magazi kwa creatinine.

Albumin ndi puloteni ya mainchesi ochepa. Mwa munthu wathanzi, impso sizimangodutsitsa mkodzo, motero, kuphwanya ntchito yawo kumabweretsa kuchuluka kwa mapuloteni mumkodzo. Tiyenera kukumbukira kuti sikuti mavuto a impso okha amakhudzidwa ndi kuwonjezeka kwa albumin, chifukwa chake, kutengera kupendeketsaku kokha, kufufuza kumachitika. Santhula mwatsatanetsatane kuchuluka kwa albumin ndi creatinine. Ngati simuyamba kulandira chithandizo panthawiyi, impso zimayamba kugwira ntchito molakwika pakapita nthawi, zomwe zimapangitsa kuti proteinuria (mapuloteni amakulu azioneka mkodzo). Izi ndizodziwika bwino mu gawo 4 la matenda ashuga nephropathy.

Kutsimikiza kwa shuga mu mkodzo wa odwala matenda a shuga kuyenera kumwedwa nthawi zonse. Izi zimapangitsa kuwona ngati pali vuto la impso kapena ziwalo zina. Ndikulimbikitsidwa kuyang'anira chizindikiritso chilichonse miyezi isanu ndi umodzi. Ngati shuga ali okwera nthawi yayitali, impso sizigwira, ndipo imalowa mkodzo. Chopuma chaimpso ndi mulingo wa shuga womwe impso sizingatheke kugwiranso ntchito. Njira yolumikizira impso imatsimikiziridwa payokha kwa dokotala aliyense. Ndi m'badwo, kudwala kumeneku kumatha kukula. Pofuna kuthana ndi zizindikiro za shuga, tikulimbikitsidwa kutsatira zakudya ndi upangiri wina waluso.

Impso zikalephera, zakudya zamankhwala zokha sizingathandize, koma poyambira kapena kupewa mavuto a impso, chakudya cha impso cha anthu odwala matenda ashuga chimagwiritsidwa ntchito. Zakudya zopatsa thanzi zimathandizira kuchepetsa shuga komanso kukhala ndi thanzi labwino. Pasakhale mapuloteni ambiri muzakudya. Zakudya zotsatirazi zikulimbikitsidwa:

• mbewu monga mkaka,
• supu zamasamba
• saladi
• chipatso
• masamba othandizira kutentha
• zopangidwa mkaka,
• mafuta a azitona.

Zosinthazi zimapangidwa ndi dokotala. Makhalidwe ake amtundu uliwonse amathandizidwa. Ndikofunika kutsatira miyezo yamakudya amchere, nthawi zina amalimbikitsidwa kuti athetse izi kwathunthu. Ndikulimbikitsidwa kusintha nyama ndi soya.Ndikofunikira kuti muzitha kusankha bwino, chifukwa soya nthawi zambiri imasinthidwa ma genetic, zomwe sizibweretsa phindu. Ndikofunikira kuti mulamulire kuchuluka kwa glucose, popeza mphamvu yake imadziwika kuti ndi yoyambitsa matenda.

Chithandizo cha impso kwa matenda ashuga chimayamba pambuyo popezeka. Chinsinsi cha mankhwalawa ndikupewa kupititsa patsogolo njira zamatenda ndikuchedwa kutha kwa matendawa. ZonseMatenda omwe amakhalapo chifukwa cha matenda ashuga sangathe kuthandizidwa popanda kuwongolera shuga. Ndikofunikira kuyang'anitsitsa kukakamiza konse. Ngati wodwala ali pachakudya, mverani zomwe dokotala wamukulangizani, sangakumane ndi matenda ashuga, chifukwa kuyambitsidwa kwa matenda amisempha kumafuna zaka zosachepera zisanu ndi chimodzi kuyambira pachiwopsezo cha matenda ashuga. Pakadali pano, kudya kokha kungakhale kokwanira.

Zowonongeka za matenda ashuga m'matumbo a impso zimathetsedwa ndi okodzetsa, beta-blockers, anzanu okwanira, othandizira calcium.

Matendawa akamakula, mpaka impso zalephera, chithandizo chamankhwala chamankhwala nthawi zambiri chimakhala chokwanira. ACE inhibitors amagwiritsidwa ntchito. Mankhwalawa amachepetsa kuthamanga kwa magazi. Nditetezero zabwino za mtima ndi impso. Ndikwabwino kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali. Chithandizo cha nephropathy mu matenda a shuga nthawi zina chimachitikanso:

• okodzetsa
• odana ndi calcium
• Zithandizo zophatikizira matenda oopsa,
• angiotensin blockers,
• opanga beta.

Ngati matendawa adapezeka m'magawo apambuyo pake, chithandizo cha matenda a shuga a nephropathy amachitika ndi hemodialysis kapena peritoneal dialysis. Ndondomekozi zimachitika ngati ntchito za thupi sizingatheke. Mulimonsemo, odwala otere amafunika kumuwonjezera impso, pambuyo pake odwala onse amachira kwathunthu chifukwa cha kulephera kwa impso.

Aliyense amadziwa chifukwa chake matendawa ndi bwino kupewa m'malo mochiza. Monga njira yodzitetezera, madokotala amalimbikitsa kuti odwala matenda ashuga azisungabe shuga wawo m'magazi abwino. Kuti muchite izi, ndikofunikira kutsatira zakudya zochepa m'mapuloteni ndi mchere. Ndikulimbikitsidwa kuchita masewera olimbitsa thupi. Ndikofunikira kuchepetsa kuchuluka kwa mowa; kukana mowa kwathunthu kumalimbikitsidwa. Ndi bwino kusiya kusuta.

1. 
   Svechnikova N.V., Saenko-Lyubarskaya V.F., Malinovskaya L.A. Chithandizo cha kuleka kwamisempha, State Medical Publishing House of the Russian SSR - M., 2016. - 88 p.
2. 
   Gubergrits A.Ya., Linevsky Yu.V. Mankhwala othandizira. Kiev, yosindikiza nyumba "High School", 1989.
3. 
   Rozanov, V.V.V.V. Rozanov. Ntchito zosonkhanitsidwa. Gawo 9. Shuga / V.V. Rozanov. - M: Republic, 0. - 464 c.
4. Nora Tannenhaus Momwe mungagonjetsere matenda a shuga (otanthauziridwa kuchokera ku Chingerezi: Nora Tannenhaus. "Zomwe mungachite pa matenda ashuga"). Moscow, Kron-Press Publishing House, 1997, masamba 156, kufalitsidwa makope 10,000.

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.

Zotsatira za matenda a shuga pantchito ya impso

Kuchuluka kwa shuga kumayambitsa zovuta za impso. Chifukwa cha hyperglycemia, ziwalo zomwe zimayambitsa kusefa zimawonongeka.

Mwazi umachotsedwa bwino pazinthu zovulaza, njira ya kuchotsa zinyalala imasokonekera. Kuledzera kumayamba, pakakhala kuti palibe njira zokwanira zochizira, wodwalayo amamwalira.

Kuyika kwa nthawi yoyenera kapena kufalikira kwa ziwalo kumathandiza kupulumutsa wodwalayo.

Mutha kukayikira kukula kwa matenda a impso ndi matenda ashuga musanakwane. A urinalysis akuwonetsa kukhalapo kwa mapuloteni, kapena m'malo mwake albumin, yomwe wodwala amakhala nayo kwambiri. Kuyang'anira matenda a shuga kumathandiza kuwongolera kukula kwa matenda.

Nephropathy kwa matenda ashuga

Aliyense amadziwa zovuta zoyipa za shuga pamitsempha yamagazi. Impso sizili choncho. Chiwalocho ndi mgwirizano waukulu wama chombo ndi ma capillaries omwe amakhudzidwa kwambiri ndi hyperglycemia.

Dongosolo lotereli limatchedwa aimpso glomeruli, ndi omwe amatsuka malita a magazi a ziphe ndi zinthu zina za poizoni.

Mkulu kwambiri wama glucose amachititsa kuti chiwopsezo chiziwonjezereka, chimathandizira ntchito. Impso zimasiya kugwira ntchito yawo, njira yowonongeka minofu imayamba. Pali kulephera kwa impso mu shuga.

Zifukwa zomwe zimawonjezera chiopsezo cha matenda:

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

• Makamaka. Zawoneka kuti anthu ambiri omwe ali ndi matenda amtundu amatha kukhudzidwa ndi nephropathy.
• Kukhalapo kwa zizolowezi zoyipa.
• Amuna nthawi zambiri amatenga matendawa.
• Matenda amitsempha.
• Kutengera kuthamanga kwa magazi.
• Kukhalapo kwa kunenepa kwambiri.

Ndikovuta kukayikira kukula kwa matendawa. Kwa zaka zambiri, anthu sadziwa vuto lomwe likubwera, Zizindikiro za matenda ashuga komanso matenda a impso sizikupezeka konse.

Zaka zingapo pambuyo pake, wodwalayo adawona zizindikiro za kuledzera, adati:

• Anachepetsa chilako. Kukonda kwambiri chakudya chokoma kumasinthidwa kwambiri ndi kukana kudya.
• Lethargy. Zofooka zina komanso kumva kuti watopa zimasowetsa wodwala.
• Kukoma kwachilendo mkamwa. Zosangalatsa zosasangalatsa pamlomo wamkamwa zimayambitsa zovuta kwa wodwalayo.
• Kukoka pafupipafupi. Makamaka usiku, maulendo kupita kuchimbudzi ndiwowonekera pafupipafupi.

Mawonetsedwe apamwamba a matendawa amapezeka zaka 15 mpaka 20 pambuyo pa kutha. Zosintha mu chiwalo zimasinthika, wodwalayo amavutika ndi zizindikiro za kuledzera kwambiri, kutupa ndi matenda oopsa.

Zizindikiro

Ndikofunikira kuzindikira matenda a impso mu matenda ashuga koyambirira, apo ayi chithandizo chimayamba mochedwa. Kwa izi, kuwunika kwa microalbuminuria kumagwiritsidwa ntchito, kumachitidwa kwa onse odwala matenda ashuga kamodzi pachaka. Kufufuza impso za mtundu woyamba wa shuga kumalimbikitsidwa chaka chilichonse, matenda amtunduwu a shuga 2 amayenera kuwunikiridwa miyezi isanu ndi umodzi iliyonse.

Pamene kusanthula kukuwonetsa kuwonjezeka kwa oposa 30 mg patsiku, kafukufuku wowonjezereka amalembedwa - mayeso a Reberg. Njirayi imakupatsani mwayi wofufuza momwe magwiridwe antchito a impso amatengera mkodzo kwa ola limodzi kapena tsiku lonse. Nthawi yomweyo, magazi amatengedwa kuchokera mu mtsempha ndipo mulingo wa creatinine m'magazi umawunikiridwa.

Momwe mungasiyanitsire matenda a impso mu shuga ndi pyelonephritis? Pali njira zingapo zochitira izi:

• Kuyesa kwa magazi. Kukhalapo kwa kutupa (maselo oyera) kukufufuzidwa.
• A urinalysis akuwonetsa zomwe zili mabakiteriya.

Chofunikira ndikuwunika kwa chitukuko cha nephropathy. Kuti muchite izi, dokotala amayang'anira kusintha kwa albumin m'magazi, mapuloteni mu mkodzo. Ngati zizindikiro zikukula mosalekeza, kusintha kwa impso ndikofunikira, magazi amatha kuwonekera mkodzo ndi matenda a shuga.

Kusintha koteroko kumafunikira kupweteka kwa impso. Njirayi imachitika pogwiritsa ntchito singano yopyapyala, yomwe imatenga gawo la chiwalochi pophunzira.

Maziko a zamankhwala ali pakuchepetsa shuga, ndiko kuti, kukonza komwe kumayambitsa matenda. An endocrinologist kapena othandizira amapereka chithandizo chokwanira, amathandiza kuchepetsa mafuta m'thupi komanso kupsinjika kwa odwala.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Matendawa akamakula, wodwalayo amayamba kuwonedwa ndi nephrologist. Amapereka chithandizo chokwanira kuti apewe kuwonongeka kwa impso mu shuga. Zimaphatikizapo kukonza zakudya, njira za metabolic, moyo, mankhwala ndi mankhwala.

Matendawa akafika pachimake, ndiye kuti thonje kapena kufalitsa ziwalo zimafunika. Njira izi zithandizira kutalikitsa moyo wa wodwalayo ndikuthandizira thupi ndi matenda a impso.

Amachita njirayi kuchipinda chachipatala, atatha kuphatikiza, magazi amalowa mu zida zapadera za kuyeretsa. Kenako imatumizidwa kwa wodwala. Njirayi ndi yabwino chifukwa sikutanthauza njira ya tsiku ndi tsiku, njira ziwiri zokha kapena zitatu pa sabata ndizokwanira.

Njira yothandiza kwambiri ndi kuyika impso. Uwu ndiye mankhwala abwino kwambiri a kulephera kwa impso mu matenda ashuga. Zowonongeka zenizeni ndizokwera mtengo komanso zovuta zomwe zingachitike mutasinthanitsa.

Mankhwala

Ndikofunikira kuti musadzetse matendawa pamalo owopsa, kuwunika komanso kupewa matendawa.

Ndi nephropathy, dokotala amafotokozera chithandizo chokwanira, chimaphatikizapo:

• Matenda a kuthamanga kwa magazi. ACE zoletsa, saluretics, calcium njira blockers - magulu awa a mankhwala anakhazikitsidwa kutengera mawonekedwe a wodwalayo, momwe amathandizira pazigawo zake.
• Kuchotsa cholesterol m'thupi. Kufikira izi, ma statin adayikidwa.
• Kukhazikitsa kupezeka kwa aimpso glomeruli. Pofuna kusiya zovuta za matenda a shuga a impso sizipezeka nthawi zonse pogwiritsa ntchito njira zomwe tafotokozazi. Potere, ma nephroprotectors omwe angathandize kuchepetsa kuchuluka kwa mapuloteni mumkodzo ndi koyenera.
• Kulowetsedwa mankhwala. Amakulolani kuti musunge moyenera zamagetsi amthupi. Kutengera kuchepa kapena kuchuluka kwambiri, kayendetsedwe ka zinthu mkati kamasonyezedwa. Njirayi imathandiza kuthandizira impso ndi matenda ashuga.

Chithandizo cha mtundu uliwonse chimagwiritsidwa ntchito mosiyana komanso mosagwirizana ndi zina zonse.

Zithandizo za anthu

Inde, ndizosatheka kulimbana ndi matenda popanda chithandizo chamankhwala. Koma mankhwala wowerengeka azithandizira kupititsa patsogolo thanzi labwino, kuchepetsa njira zotupa.

Kuti muchite izi, konzani kulowetsedwa kwa zitsamba:

• Wort wa St. John, nettle ndi maluwa a yarrow. Zitsamba zimapangidwa mu 250 ml ya madzi otentha, amatengedwa supuni m'mawa ndi madzulo. Kuchiza kumachitika kwa masiku osachepera 20.
• Mankhwala a Comfrey, nthomba za fulakesi zomwe zimakhala ndi masamba a bearberry (mulingo wofanana) zimasakanizidwa. Yotengedwa mu 250 ml ya madzi otentha, phwando limapangidwa kwa mwezi umodzi, m'magawo ang'onoang'ono tsiku lonse.
• Madzi a peel amaumirira mu 200 ml ya madzi m'malo amdima. Tengani kangapo patsiku.

Chofunikira kukumbukira ndikuti chithandizo cha kulephera kwaimpso mu shuga chikuyenera kuperekedwa kokha kwa katswiri. Chiwalochi chimakonda kwambiri kugwiritsa ntchito mankhwala othandizira, kuphatikizapo zitsamba. Ndalama zodzipatsa ndekha zimatha kuchita zambiri.

Ndikofunika kutchula gawo lofunikira la mankhwala - zakudya. Popeza zovuta za impso mu matenda a shuga amayamba chifukwa cha matenda akulu, mawonetsedwe ake ayenera kuchepetsedwa.

Kuti muchite izi, kuphika chakudya:

• kwa okwatirana
• njira yophikira
• mumavinidwe ochepa
• pogwiritsa ntchito kuzimitsa
• kuphika mu uvuni.

Wodwala ayenera kudya chimanga, masamba, nyama ndi nsomba. Zipatso zodya zochepa m'mawa. Zakudya zambiri zimayendetsedwa ndi kuchuluka; musadye m'magawo akuluakulu.

Kuti mugwiritse ntchito madzi okwanira, mafuta amkaka (kupatula mafuta owawasa kirimu ndi zonona). Nyama ndi nsomba ndizofunikira mitundu yopanda mafuta, maziko a chakudyacho ayenera kukhala masamba.

Kupewa ndi malingaliro

Kusamalira thanzi lanu kumayambira pakudziwitsa matenda. Matenda a impso omwe amapezeka panthawiyi ndi chitsimikizo cha njira zochizira munthawi yake.

Musaiwale za:

• Kuwongolera shuga. Kuchiza matenda a shuga ndikofunikira, chifukwa ndi chomwe chikuyambitsa matendawa.
• Yang'anani kuzikakamiza. Zizindikiro ziyenera kusamalidwa bwino mothandizidwa ndi mankhwala.
• Chakudya chopatsa thanzi. Ndi shuga omwe amawononga kwambiri impso, ndikofunikira kukhazikitsa zakudya.

Njira zomwe zimachitidwa pa nthawi yake kuti athane ndi matenda akuluakulu zimathandiza kupewa nephropathy komanso matenda a shuga ku impso. Ndi dokotala yekhayo amene angapereke mankhwala olondola ndikusamalira thanzi la wodwalayo.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha.Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Chikhulupiriro: Zofunikira Pang'ono

Impso zimakhudzana ndi kusefa zinyalala m'magazi ndikuziwachotsa ndi mkodzo. Amatulutsanso mahomoni a erythropoietin, omwe amachititsa kuti maselo ofiira a magazi - maselo ofiira a m'magazi.

Magazi nthawi ndi nthawi amadutsa impso, zomwe zimachotsa zinyalala kuchokera pamenepo. Mwazi wotsukidwa umazungulira mowonjezereka. Zoizoni ndi zinthu za metabolic, komanso mchere wambiri, wosungunuka m'madzi ambiri, amapanga mkodzo. Imayenda ndikuyenda mu chikhodzodzo, pomwe imasungidwa kwakanthawi.

Impso iliyonse imakhala ndi zosefera pafupifupi miliyoni miliyoni zomwe zimatchedwa nephrons. Glomerulus yamitsempha yamagazi (ma capillaries) ndi imodzi mwazinthu za nephron. Kuchuluka kwa kusefera kwa glomerular ndichizindikiro chofunikira chomwe chimazindikira momwe impso zilili. Amawerengeredwa potengera zomwe zili mu creatinine m'magazi.

Designinine ndi imodzi mwazinthu zomwe zimawonongeka. Pakulephera kwa impso, amadziunjikira m'magazi pamodzi ndi zinthu zina zonyansa, ndipo wodwalayo amamva zoledzeretsa. Mavuto a impso amatha chifukwa cha matenda ashuga, matenda, kapena zifukwa zina. Mulingo uliwonse mwa izi, kuchuluka kwa kusefedwa kwa glomerular kumayesedwa kuti muwone kuwopsa kwa matendawa.

Kodi matenda ashuga amakhudza bwanji impso?

Kuchuluka kwa shuga m'mwazi kumawononga zinthu zomwe zimasefa impso. Popita nthawi, zimazimiririka ndipo zimasinthidwa ndi minyewa, yomwe singayeretse magazi a zinyalala. Zosefera zochepa zomwe zatsalira, ndizowopsa momwe impso zimagwirira ntchito. Mapeto ake, amasiya kuthana ndi kuchotsedwa kwa zinyalala ndi kuledzera kwa thupi kumachitika. Pakadali pano, wodwalayo amafunika chithandizo chamankhwala kuti asafe - dialysis kapena kupatsirana kwa impso.

Asanafe kwathunthu, zinthu zosefera zimakhala "zotayikira", zimayamba "kutaya". Amapereka mapuloteni mumkodzo, omwe sayenera kukhalapo. Mwakutero, albumin yomwe ili ndi ndende zambiri.

Microalbuminuria ndiye chimbudzi cha albumin mkodzo wambiri 30-300 mg patsiku. Proteinuria - Albumin imapezeka mumkodzo mumtunda wopitilira 300 mg patsiku. Microalbuminuria imatha kuyima ngati chithandizo chitha bwino. Proteinuria ndivuto lalikulu kwambiri. Imawerengedwa ngati yosasinthika komanso zizindikilo kuti wodwala wayamba kuyenda njira ya kulephera kwa aimpso.

Choyipa chachikulu chomwe chikuwongolera matenda a shuga, chimakhala chowopsa kwambiri chakulephera kwa impso ndipo chimatha kuchitika mwachangu. Mwayi wokumana ndi kulephera kwathunthu kwa impso mu odwala matenda ashuga kwenikweni siwokwera kwambiri. Chifukwa ambiri a iwo amafa ndi vuto la mtima kapena matenda opha ziwalo asanafunike chithandizo chakubwezeretsa kwina. Komabe, chiwopsezocho chikuwonjezereka kwa odwala omwe shuga imaphatikizidwa ndi kusuta kapena matenda operewera kwamkodzo.

Kuphatikiza pa matenda a shuga a nephropathy, pakhoza kukhalanso aimpso a stenosis. Uku ndi kufalikira kwa malo amodzi a mitsempha yomwe imadyetsa impso. Nthawi yomweyo, kuthamanga kwa magazi kumakwera kwambiri. Mankhwala othandizira matenda oopsa samathandiza, ngakhale mutamwa mitundu ingapo yamapiritsi amphamvu nthawi imodzi.

Mitsempha ya minyewa ya m'mimba nthawi zambiri imafuna opaleshoni. Matenda a shuga amawonjezera chiwopsezo cha matendawa, chifukwa amachititsa kuti matendawa azidwala, kuphatikizapo ziwiya zomwe zimadyetsa impso.

Mtundu wachiwiri wa impso

Nthawi zambiri, mtundu wachiwiri wa matenda ashuga umabisala kwa zaka zingapo mpaka utapezeka ndi kuthandizidwa. Zaka zonsezi, zovuta zimayamba kuwononga thupi la wodwalayo. Samapitilira impso.

Malinga ndi malo omwe amalankhula Chingerezi, pa nthawi yomwe amadziwika kuti ali ndi vutoli, 12% ya odwala omwe ali ndi matenda a shuga 2 ali kale ndi microalbuminuria, ndipo 2% ali ndi proteinuria. Mwa odwala olankhula Chirasha, izi ndizowonjezera nthawi zingapo. Chifukwa chakuti azungu amakhala ndi chizolowezi chotsatira mayeso azachipatala.Chifukwa cha izi, amatha kupeza matenda osachiritsika.

Matenda a 2 a shuga amatha kuphatikizidwa ndi zinthu zina zomwe zingayambitse matenda opatsirana a impso:

• kuthamanga kwa magazi
• cholesterol yayikulu magazi,
• panali milandu ya matenda a impso abale ake,
• pakhala zochitika za kugunda kwamtima koyambirira kapena kupweteka m'banjamo,
• kusuta
• kunenepa
• ukalamba.

Kodi pali kusiyana kotani pakati pamavuto a impso mu mtundu 2 ndi mtundu woyamba wa shuga?

Mtundu woyamba wa matenda ashuga, zovuta za impso nthawi zambiri zimayamba zaka 5 mpaka 5 matenda atayamba. Mu mtundu 2 wa matenda ashuga, zovuta izi zimadziwika nthawi yomweyo mukazindikira. Chifukwa matenda amtundu wa 2 matenda a shuga amakhala nthawi yayitali kwa zaka zambiri wodwala asanakumane ndi zomwe akuganiza komanso akuyerekeza kuti awone ngati ali ndi shuga. Mpaka pomwe matenda atapangidwa ndikuthandizidwa, mankhwalawa amawononga impso ndi thupi lonse.

Matenda a 2 a shuga ndi matenda oopsa kuposa matenda ashuga 1. Komabe, zimachitika kangapo konse. Odwala a shuga a Type 2 ndi gulu lalikulu kwambiri la odwala omwe amaperekedwa ndi malo opangira dialysis ndi akatswiri othandizira impso. Mliri wa matenda ashuga a 2 ukuwonjezereka padziko lonse lapansi komanso m'maiko olankhula Chirasha. Izi zimawonjezera kuntchito ya akatswiri omwe amachiza matenda a impso.

Mtundu woyamba wa matenda ashuga, odwala omwe adwala matendawa ndi unyamata nthawi zambiri amakhala ndi nephropathy. Kwa anthu omwe ali ndi matenda ashuga a mtundu woyamba akamakula, chiopsezo cha mavuto a impso sichikulirapo.

Zizindikiro ndi Kudziwitsa

M'miyezi yoyambirira komanso zaka, matenda ashuga nephropathy ndi microalbuminuria samayambitsa chilichonse. Odwala amazindikira mavuto pokhapokha njira yothana ndi matenda a impso yayandikira. Poyamba, zizindikirazo sizowoneka bwino, zikufanana ndi kutopa kapena kuzizira.

Zizindikiro zoyambirira za matenda a shuga:

• kufooka, kutopa,
• kuganiza kopusa
• kutupa kwa miyendo
• kuthamanga kwa magazi
• kukodza pafupipafupi,
• kufunikira kofikira kulowa kuchimbudzi usiku,
• kuchepetsa kuchuluka kwa mapiritsi a insulini ndi kutsitsa shuga,
• kufooka, kuchepa kwa magazi ndi kuchepa magazi,
• pakhungu, zotupa.

Odwala ochepa amatha kukayikira kuti zizindikirozi zimayamba chifukwa cha kuwonongeka kwa impso.

Chimachitika ndi chiyani ngati impso zileka kugwira ntchito ndi matenda ashuga?

Anthu odwala matenda ashuga omwe amakhala ndi ulesi kuti azimwa magazi ndi mkodzo pafupipafupi amatha kukhalabe osazindikira mpaka kumapeto, ndikoyamba kwa aimpso. Komabe, pamapeto pake, zizindikiro zakuledzera zomwe zimayambitsidwa ndi matenda a impso zimadziwika:

• kusadya bwino, kuchepa thupi,
• Khungu limawuma ndipo limayenderera mosalekeza,
• kutupa kwambiri, kukokana kwa minofu,
• kutupa ndi matumba pansi pa maso,
• kusanza ndi kusanza
• chikumbumtima.

Chifukwa chiyani shuga amachepetsedwa panthawi ya matenda ashuga nephropathy?

Inde, ndi matenda ashuga a nephropathy omaliza omaliza aimpso, magazi a shuga amatha. Mwanjira ina, kufunika kwa insulin kumachepa. Ndikofunikira kuchepetsa mlingo wake kuti pasakhale hypoglycemia.

Chifukwa chiyani izi zikuchitika? Insulin imawonongedwa m'chiwindi ndi impso. Impso zikawonongeka kwambiri, zimalephera kupanga insulin. Hormon iyi imakhala m'magazi motalikirapo ndipo imathandizira ma cell kuti ayamwa glucose.

Kulephera kwa impso ndi tsoka kwa ashuga. Kuchepetsa mlingo wa insulin ndikungotonthoza pang'ono.

Ndi mayeso ati omwe amafunikira kudutsidwa? Momwe mungawerengere zotsatirazo?

Kuti mudziwe bwino ndikusankha chithandizocho, muyenera kuchita mayeso:

• protein (albumin) mumkodzo,
• kuchuluka kwa albumin ndi creatinine mu mkodzo,
• magazi creatinine.

Creatinine ndi chimodzi mwazinthu zomwe zasokoneza mapuloteni omwe impso zimachita nawo. Kudziwa mulingo wa creatinine m'magazi, komanso zaka ndi jini la munthu, mutha kuwerengetsa kuchuluka kwa kusefedwa kwa glomerular.Ichi ndi chisonyezo chofunikira, pamaziko omwe gawo la matenda ashuga nephropathy limatsimikiziridwa ndi kulandira mankhwala. Dokotala amathanso kukulemberani mayeso ena.

Pansipa 3.5 (azimayi) Microalbuminuria20-1992.5-25.0 (amuna)

3.5-25.0 (akazi) Proteinuria200 ndi pamwambapaOpitilira 25

Pokonzekera magazi ndi mkodzo mayeso omwe atchulidwa pamwambapa, muyenera kupewa kuchita masewera olimbitsa thupi komanso kumwa kwambiri kwa masiku atatu. Kupanda kutero, zotsatira zake zimakhala zoipa kuposa momwe zilili.

Kodi kuchuluka kwa kusefukira kwa impso kumatanthauza chiyani?

Pa mawonekedwe a zotsatira za kuyezetsa magazi a creatinine, mulingo woyenera uyenera kuganiziridwa mutaganizira zausinkhu wanu komanso zaka, ndipo kuchuluka kwa impso kuyenera kuwerengeka. Kukwera kwake kumakhala kwabwino.

Kodi microalbuminuria ndi chiyani?

Microalbuminuria ndi mawonekedwe a puloteni (albumin) mumkodzo m'miyeso yaying'ono. Ndi chizindikiro choyambirira cha kuwonongeka kwa impso. Amawerengedwa ngati chiopsezo cha matenda a mtima ndi sitiroko. Microalbuminuria imawonedwa ngati yosinthika. Kumwa mankhwala, kuyendetsa bwino shuga komanso kuthamanga kwa magazi kumatha kuchepetsa kuchuluka kwa albumin mu mkodzo kuti ikhale yofanana kwa zaka zingapo.

Kodi proteinuria ndi chiyani?

Proteinuria ndi kukhalapo kwa mapuloteni mumkodzo wambiri. Chizindikiro choyipa kwambiri. Zimatanthawuza kuti vuto la mtima, kugunda, kapena kufooka kwa impso kungokhala pakona. Pamafunika chithandizo champhamvu. Komanso, zitha kuchitika kuti nthawi yothandizidwa moyenera idasowa kale.

Ngati mukupeza microalbuminuria kapena proteinuria, muyenera kufunsa dokotala yemwe amathandiza impso. Katswiriyu amatchedwa nephrologist, kuti asasokonezedwe ndi katswiri wamitsempha. Onetsetsani kuti chifukwa cha mapuloteni mumkodzo si matenda opatsirana kapena kuvulala kwa impso.

Zitha kuzindikirika kuti chifukwa choyambitsa kusawerengeka kolakwika chidadzaza kwambiri. Potere, kusanthula mobwerezabwereza patatha masiku angapo kumapereka tanthauzo labwino.

Kodi cholesterol yamagazi imakhudza bwanji zovuta za impso?

Amakhulupirira kuti ma cholesterol okwera amathandizira kukulira kwa malo a atherosulinotic. Atherosulinosis imodzimodzi imakhudza mitsempha yambiri, kuphatikizapo yomwe magazi amayenda impso. Zikumveka kuti odwala matenda ashuga ayenera kutenga ma statins a cholesterol, ndipo achedwetsa kukula kwa impso.

Komabe, malingaliro a chitetezo chamatumbo a impso ndiwotsutsana. Ndipo zovuta zoyipa za mankhwalawa ndizodziwika bwino. Kutenga ma statins ndikumvetsetsa kuti musakhale ndi vuto lachiwiri la mtima ngati muli nalo kale. Zachidziwikire, kupewa odalirika a matenda a mtima wobwereza kuyenera kuphatikizapo zinthu zina, kuwonjezera pa kumwa mapiritsi a cholesterol. Sikoyenera kumwa ma statins ngati simunakhale ndi vuto la mtima.

Kusintha ku chakudya chamafuta ochepa nthawi zambiri kumapangitsa kuchuluka kwa cholesterol “chabwino” komanso “yoyipa” m'magazi. Osati kuchuluka kwa glucose kokha komwe kumapangidwira, komanso kuthamanga kwa magazi. Chifukwa cha izi, chitukuko cha matenda a shuga ndi nephropathy. Kuti zotsatira za mayeso a magazi a shuga ndi cholesterol zikondweretsere inu ndi anzanu, muyenera kutsata zakudya zamafuta ochepa. Muyenera kusiyiratu zinthu zoletsedwa.

Kodi ndi anthu angati omwe anthu odwala matenda ashuga amafunika kuchita nthawi zambiri kuti awonetsetse impso?

Kupanga kwa impso kumapangitsa kuti muwoneke ngati pali mchenga ndi miyala mu ziwalo izi. Komanso, mothandizidwa ndi mayeso, chotupa cha impso (cysts) chitha kupezeka.

Chithandizo cha matenda a impso a shuga: kubwereza

Komabe, kuwunika kwa ultrasound sikungathandize pa vuto la matenda ashuga komanso kuwunika momwe mankhwalawo alili. Ndikofunikira kwambiri kumatenga nthawi zonse kuyesa magazi ndi mkodzo, zomwe zikufotokozedwa mwatsatanetsatane.

Matenda a shuga a shuga: Gulu

Matenda a diabetes nephropathy amagawika magawo asanu. Otsiriza amatchedwa terminal.Pakadali pano, wodwalayo amafunika chithandizo chamankhwala kuti asafe. Itha kukhala yamitundu iwiri: dialysis kangapo pa sabata kapena kupatsirana kwa impso.

Mu magawo awiri oyamba, nthawi zambiri pamakhala popanda zizindikiro. Mavuto osokoneza bongo a matenda ashuga amatha kuwonekera kokha poyesa magazi ndi mkodzo. Chonde dziwani kuti ma ultrasound a impso samabweretsa zabwino zambiri.

Matendawa akakula mpaka gawo lachitatu ndi lachinayi, zizindikiro zowoneka zitha kuwoneka. Komabe, matendawa amakula bwino, pang'onopang'ono. Chifukwa cha izi, odwala nthawi zambiri amazizolowera ndipo samveka mawu. Zizindikiro zodziwika za kuledzera zimawonekera pang'onopang'ono chachinayi ndi chachisanu, pamene impso sizikugwiranso ntchito.

• DN, siteji ya MAU, CKD 1, 2, 3 kapena 4,
• DN, siteji ya proteinuria yokhala ndi impso yosungidwa kuti amasulidwe a nayitrogeni, CKD 2, 3 kapena 4,
• DN, siteji PN, CKD 5, chithandizo cha OST.

DN - matenda a shuga a nephropathy, MAU - microalbuminuria, PN - kulephera kwaimpso, CKD - ​​matenda a impso, OST - aimpso.

Proteinuria nthawi zambiri imayamba mwa odwala matenda a shuga a 2 komanso mtundu 1, omwe ali ndi matenda azaka 15 mpaka 15. Ngati sanachiritsidwe, gawo lothana ndi matenda a impso limatha kuchitika patatha zaka zina 5-7.

Zoyenera kuchita ngati impso ikuvulala ndi matenda ashuga?

Choyamba, muyenera kuonetsetsa kuti zimapweteka impso. Mwina mulibe vuto la impso, koma osteochondrosis, rheumatism, kapamba, kapena matenda ena omwe amayambanso ndi vuto lofananalo. Muyenera kuwona dokotala kuti mudziwe chomwe chimayambitsa kupwetekaku. Sizingatheke kuzichita nokha.

Kudzichitira nokha mankhwala kungavulaze kwambiri. Mavuto a shuga a impso nthawi zambiri sayambitsa kupweteka, koma zizindikiro za kuledzera zomwe zalembedwa pamwambapa. Miyala ya impso, colic re impso ndi kutupa nthawi zambiri sizigwirizana mwachindunji ndi kusokonekera kwa glucose metabolism.

Mankhwalawa a matenda a shuga a nephropathy amayesetsa kupewa kapena kuchedwetsa kuyambika kwa kuleka kwa gawo la impso, komwe kukufunika dialysis kapena kufalikira kwa ziwalo. Amakhala ndikukhala ndi shuga komanso magazi.

Ndikofunikira kuyang'anira kuchuluka kwa creatinine m'magazi ndi mapuloteni (albin) mumkodzo. Komanso, mankhwala a boma amalimbikitsa kuwunikira cholesterol m'magazi ndikuyesera kuchepetsa. Koma akatswiri ambiri amakayikira kuti ndi yothandiza kwambiri. Njira zochizira matenda oteteza impso zimachepetsa chiopsezo cha kugunda kwa mtima ndi sitiroko.

Kodi muyenera kumwa chiyani kuti mupulumutse impso zanu?

Inde, ndikofunikira kumwa mapiritsi kuti muchepetse zovuta za impso. Anthu odwala matenda ashuga nthawi zambiri amapatsidwa mankhwala angapo:

1. Mapiritsi opanikizika makamaka ndi ACE inhibitors ndi angiotensin-II receptor blockers.
2. Aspirin ndi ma antiplatelet othandizira ena.
3. Matenda a cholesterol.
4. Zithandizo za kuchepa kwa magazi m'thupi zomwe kulephera kwa impso zimatha kuyambitsa.

Mankhwalawa onsewa akufotokozedwa mwatsatanetsatane pansipa. Komabe, kupatsa thanzi kumatenga gawo lalikulu. Kumwa mankhwala kumakhala kovuta nthawi zambiri kuposa zakudya zomwe wodwala matenda ashuga amawonera. Chinthu chachikulu chomwe muyenera kuchita ndikusankha kusintha kwa zakudya zamafuta ochepa. Werengani zambiri pansipa.

Osadalira wowerengeka azitsamba ngati mukufuna kudziteteza ku matenda ashuga a nephropathy. Ma tiyi a chomera, ma infusions ndi ma decoctions ndizothandiza monga gwero lamadzi popewa komanso kuchizira kwamadzi. Sakhala ndi vuto loteteza impso.

Kodi kuchitira impso matenda ashuga?

Choyamba, amagwiritsa ntchito jakisoni wazakudya ndi insulin kuti shuga azikhala pafupi ndi nthawi yayitali. Kusunga hemoglobin ya glycated HbA1C pansipa 7% kumachepetsa chiopsezo cha proteinuria ndi kulephera kwa aimpso ndi 30-40%.

Kugwiritsa ntchito njira za Dr. Bernstein kumakuthandizani kuti muchepetse shuga mwachizolowezi, monga momwe mumakhalira athanzi, komanso hemoglobin yotsika ndi 5.5%. Zizindikiro izi zitha kuchepetsa chiwopsezo cha zovuta kwambiri za impso kufika pa zero, ngakhale izi sizinatsimikizidwe ndi maphunziro ovomerezeka.

Pali umboni kuti ndi shuga wokhazikika m'magazi, impso zomwe zimakhudzidwa ndi matenda a shuga zimachiritsidwa ndikuchira. Komabe, izi ndizopang'onopang'ono. Pa magawo 4 ndi 5 a shuga a nephropathy, nthawi zambiri zimakhala zosatheka.

Mapuloteni ndi mafuta amanyama ndizovomerezeka. Kuyenera kugwiritsa ntchito zakudya zamafuta ochepa kumakambidwa pansipa. Ndi mfundo zabwinobwino za kuthamanga kwa magazi, kuthira mchere kumayenera kuchepetsedwa ndi 5-6 g patsiku, ndipo pamlingo wokwera, mpaka 3 g patsiku. M'malo mwake, izi sizochepa kwambiri.

1. Siyani kusuta.
2. Werengani nkhani ya “Mowa wa Matenda a shuga” ndipo musamamwe zoposa zomwe zasonyezedwa pamenepo.
3. Ngati simumamwa mowa, ndiye kuti musayambe.
4. Yesetsani kuchepetsa thupi ndipo musamalemere kwambiri.
5. Lankhulani ndi dotolo wanu za zomwe mungachite zolimbitsa thupi, komanso zolimbitsa thupi.
6. Khalani ndi polojekiti ya kuthamanga kwa magazi kunyumba ndipo mumayezera magazi anu pafupipafupi.

Palibe mapiritsi amatsenga, ma tinctures, ndipo makamaka wowerengeka azitsamba omwe amatha kubwezeretsa impso mwachangu komanso mosavuta.

Tiyi wokhala ndi mkaka suthandizira, koma m'malo mwake umavulaza, chifukwa mkaka umadzutsa shuga wamagazi. Karkade ndi chakumwa chotchuka cha tiyi chomwe chimathandizanso kuposa kumwa madzi oyera. Bola osayesa konse wowerengeka azitsamba, ndikuyembekeza kuchiritsa impso. Kudzipatsa mankhwala a ziwalo zosefera ndi kowopsa kwambiri.

Ndi mankhwala ati omwe amakupatsani?

Odwala omwe apeza matenda a diabetes a nephropathy nthawi imodzi nthawi zina amagwiritsa ntchito mankhwala angapo nthawi imodzi:

• mapiritsi a matenda oopsa - mitundu 2-4,
• cholesterol statins
• antiplatelet agents - ma aspirin ndi dipyridamole,
• Mankhwala omwe amamanga phosphorous m'thupi,
• mwina yankho lina la kuchepa magazi m'thupi.

Kumwa mapiritsi ambiri ndichinthu chophweka chomwe mungachite kuti muchepetse kapena kuchedwetsa kulephera kwa impso. Onani dongosolo la 2 la 2 la matenda a shuga kapena mtundu wa matenda a shuga. Tsatirani mosamala malangizowo. Kusintha kwa moyo wathanzi kumafuna kuyeserera kwambiri. Komabe, ziyenera kukhazikitsidwa. Sizingathandize kuthana ndi mankhwala ngati mukufuna kuteteza impso zanu ndikukhala ndi moyo wautali.

Ndi mapiritsi ati ochepetsa shuga a shuga omwe ali ndi vuto la matenda a shuga?

Tsoka ilo, mankhwala omwe amadziwika kwambiri metformin (Siofor, Glucofage) ayenera kuyikidwa pambali kale pa matenda a matenda ashuga. Sizingatengedwe ngati wodwalayo ali ndi kusefukira kwama 60 ml / min, ngakhale pang'ono. Izi zikufanana ndi magazi a creatinine:

• kwa amuna - pamwambapa 133 μmol / l
• kwa akazi - pamwambapa 124 micromol / l

Kumbukirani kuti kukwera kwa creatinine, ndikoipa kwambiri komwe impso zimagwira ndikuchepetsa kuchuluka kwa kusefera kwake. Kale kumayambiriro kwa zovuta za impso za matenda ashuga, metformin iyenera kusiyidwa ku njira yochizira matenda kuti mupewe ngozi lactic acidosis.

Akuluakulu, odwala matenda ashuga retinopathy amaloledwa kumwa mankhwala omwe amachititsa kuti kapamba apange insulin yambiri. Mwachitsanzo, a Diabeteson MV, Amaryl, Maninil ndi iwo omwe ali ndi fanizo. Komabe, mankhwalawa ali pamndandanda wamapiritsi owopsa a shuga 2. Amachepetsa kapamba ndipo samachepetsa kufa kwa odwala, komanso amachulukitsa. Ndi bwino osazigwiritsa ntchito. Anthu odwala matenda ashuga omwe amakhala ndi vuto la impso amayenera kulowetsanso mapiritsi ochepetsa shuga ndi jakisoni wa insulin.

Mankhwala ena a shuga amatha kumwa, koma mosamala, monga momwe adavomerezera ndi dokotala.Monga lamulo, sangapereke chiwongola dzanja mokwanira komanso samapereka mwayi wokana jakisoni wa insulin.

Mapiritsi opsinjika omwe ndiyenera kumwa?

Mapiritsi oopsa ndiofunika kwambiri, omwe ali m'magulu a ACE inhibitor kapena angiotensin-II receptor blockers. Samangokhala kutsitsa magazi, komanso amatetezanso impso. Kumwa mankhwalawa kumathandizira kuchepa kwa kulephera kwa impso.

Yesani kusunga kuthamanga kwa magazi anu pansipa 130/80 mm Hg. Art. Pa izi, nthawi zambiri mumayenera kugwiritsa ntchito mitundu ingapo ya mankhwala. Yambani ndi ACE inhibitors kapena angiotensin-II receptor blockers. Amathandizidwanso ndi mankhwala ochokera m'magulu ena - beta-blockers, diuretics (diuretics), calcium block blockers. Funsani adotolo kuti akupatseni mapiritsi osakanikirana omwe amakhala ndi zinthu ziwiri zomwe zimagwira munthawi imodzi.

ACE inhibitors kapena angiotensin-II receptor blockers kumayambiriro kwa mankhwalawa amatha kuwonjezera milingo ya creatinine. Lankhulani ndi dotolo wanu za momwe izi ziliri zowopsa. Mwambiri, simudzayenera kusiya mankhwalawo. Komanso, mankhwalawa amatha kuwonjezera kuchuluka kwa potaziyamu m'magazi, makamaka ngati mumawaphatikiza ndi ena kapena mankhwala a diuretic.

A potaziyamu wambiri amatha kupangitsa kuti mtima wamangidwa. Kuti mupewe izi, simuyenera kuphatikiza ACE inhibitors ndi angiotensin-II receptor blockers, komanso mankhwala omwe amatchedwa potaziyamu-yosungila diuretics. Kuyesedwa kwa magazi kwa creatinine ndi potaziyamu, komanso mkodzo wa protein (albin) uyenera kutengedwa kamodzi pamwezi. Osakhala aulesi kuchita izi.

Musagwiritse ntchito zomwe muli nazo ma cholesterol, aspirin ndi othandizira ena am'magazi, mankhwala osokoneza bongo komanso othandizira magazi. Mapiritsi onsewa amatha kuyambitsa mavuto. Lankhulani ndi dokotala wanu za kufunika kokutenga. Komanso, adotolo ayenera kuthana ndi kusankha kwa mankhwalawa kwa matenda oopsa.

Ntchito ya wodwala si kukhala waulesi kuti azichita mayeso pafupipafupi ndipo ngati kuli koyenera, funsani dokotala kuti akonze dongosolo la chithandizo. Chida chanu chachikulu chokwaniritsa shuga m'magazi ndi insulin, osati mapiritsi a shuga.

Momwe mungalandiridwire ngati mwapezeka kuti muli ndi Diabetesic Nephropathy ndipo pali mapuloteni ambiri mumkodzo wanu?

Dokotala wanu akupatsani mitundu ingapo ya mankhwala omwe afotokozedwa patsamba lino. Mapiritsi onse okhazikitsidwa amayenera kumwa tsiku lililonse. Izi zimachedwetsa vuto la mtima kwa zaka zingapo, kufunikira kochita kuyimba kapena kufalitsa impso.

Dr. Bernstein analimbikitsa kuti asinthe zakudya zamafuta ochepa ngati vuto la matenda a impso silinafike pamenepa. Mwachidziwikire, kuchuluka kwa kusefedwa kwa glomerular sikuyenera kutsika kuposa 40-45 ml / min.

Kuwongolera kwabwino kwa shuga kumakhazikika pazipilala zitatu:

1. Kutsatira zakudya zamafuta ochepa.
2. Kuyeza pafupipafupi shuga.
3. Jekeseni wa Mlingo wosankhidwa bwino wa insulin yokwanira.

Izi zimapangitsa kukhala ndi shuga wokhazikika, monga mwa anthu athanzi. Poterepa, chitukuko cha matenda ashuga nephropathy chikutha. Komanso, poyerekeza ndi shuga wambiri wabwinobwino, impso zodwala zimatha kuyambiranso ntchito pakapita nthawi. Izi zikutanthauza kuti kuchuluka kwa kusefedwa kwakumaso kukwera, ndipo mapuloteni amachoka mkodzo.

Komabe, kukwaniritsa ndikuwonetsetsa kuti chiwongolero cha matenda ashuga sichinthu chovuta. Kuti muthane nawo, wodwalayo ayenera kukhala ndi mwambo wokwanira komanso chidwi. Muthanso kudimbikitsidwa ndi chitsanzo cha Dr. Bernstein, yemwe adachotsa mapuloteni mumkodzo wake ndikubwezeretsanso matenda abwinobwino a impso.

Popanda kusintha zakudya zamafuta ochepa, nthawi zambiri zimakhala zosatheka kubweretsanso shuga munthawi yochepa. Tsoka ilo, zakudya zama carb zotsika zimaperekedwa kwa odwala matenda ashuga omwe amakhala osasinthika kwambiri osasinthika, ndipo makamaka, apanga gawo lolephera kwa aimpso.Pankhaniyi, muyenera kuyesa kubereka impso. Werengani zambiri za opaleshoni ili m'munsiyi.

Kodi wodwala yemwe ali ndi matenda ashuga nephropathy ndi kuthamanga kwa magazi ayenera kuchita chiyani?

Kusinthana ndi zakudya zama carb ochepa sikungokhala shuga wamagazi, komanso cholesterol ndi kuthamanga kwa magazi. Nawonso, kuphatikiza shuga ndi kuthamanga kwa magazi kumalepheretsa kukula kwa matenda a shuga.

Komabe, ngati kulephera kwa impso kwakula bwino, ndikachedwa kwambiri kusinthira ku chakudya chamafuta ochepa. Zimangotenga mapiritsi okhawo omwe adokotala adawauza. Mwayi weniweni wa chipulumutso ungaperekedwe ndi kumuyika impso. Izi zikufotokozedwa mwatsatanetsatane pansipa.

Mwa mankhwala onse a matenda oopsa, ACE inhibitors ndi angiotensin-II receptor blockers ndizoteteza kwambiri impso. Muyenera kumwa kamodzi mwa mankhwalawa, sangathe kuphatikizidwa. Komabe, ikhoza kuphatikizidwa ndi kugwiritsa ntchito beta-blockers, mankhwala okodzetsa kapena oletsa njira za calcium. Nthawi zambiri, mapiritsi osakanikirana osavuta amayikidwa, omwe ali ndi zinthu 2-3 zogwira ntchito pansi pa chigoba chimodzi.

Kodi ndi njira zina ziti zothandiza zomwe mungagwiritsire ntchito matenda a impso?

Kuwerengera mankhwala azitsamba ndi njira zina zowerengeka zamavuto a impso ndicho chinthu chovuta kwambiri kuchita. Mankhwala achikhalidwe samathandiza konse kuchokera ku matenda ashuga a nephropathy. Pewani kutali ndi charlatans omwe amakutsimikizirani kuti mudzachita zina.

Mafano azithandizo wowerengeka amwalira mwachangu chifukwa cha zovuta za matenda ashuga. Ena mwa iwo amafa mosavuta chifukwa cha vuto la mtima kapena sitiroko. Ena asanafe amakumana ndi mavuto ndi impso, miyendo kapena kuwola.

Pakati pa wowerengeka azitsamba a matenda ashuga nephropathy ndi lingonberries, sitiroberi, chamomile, kiranberi, zipatso zamizere, m'chiuno, nthano, masamba a birch ndi masamba owuma nyemba. Tiyi ndi ma decoctions amakonzedwa kuchokera pazomwe zatulutsidwa azitsamba. Tikubwerezanso kuti alibe zoteteza ku impso.

Khalani ndi chidwi ndi zakudya zamagulu owonjezera matenda oopsa. Izi ndiye, choyambirira, magnesium wokhala ndi vitamini B6, komanso taurine, coenzyme Q10 ndi arginine. Amabweretsa zabwino. Amatha kumwedwa kuwonjezera pa mankhwala, koma osati m'malo mwake. Mu magawo akulu a matenda ashuga nephropathy, izi zowonjezera zitha kuperekedwa. Lankhulani ndi dokotala wanu za izi.

Momwe mungachepetse magazi kulenga mu shuga?

Creatinine ndi mtundu wa zinyalala zomwe impso zimachotsa m'thupi. Kupezeka pafupi ndi magazi abwinobwino, impso zimagwira ntchito bwino. Impso zodwala sizitha kuthana ndi zotuluka za creatinine, chifukwa chake zimadziunjikira m'magazi. Kutengera ndi zotsatira za kusanthula kwa creatinine, kuchuluka kwa kusefedwa kwa glomerular kumawerengeredwa.

Kuteteza impso, anthu odwala matenda ashuga nthawi zambiri amapatsidwa mapiritsi otchedwa ACE inhibitors kapena angiotensin-II receptor blockers. Nthawi yoyamba mukayamba kumwa mankhwalawa, kuchuluka kwa magazi anu amatha kuchuluka. Komabe, pambuyo pake zitha kuchepa. Ngati mulingo wanu wa creatinine wakwera, lankhulanani ndi dokotala za momwe izi ziliri zowopsa.

Kodi ndikotheka kubwezeretsa kuchuluka kwa impso?

Amakhulupilira kuti kuchuluka kwa kusefedwa kwa glomerular sikungakulire pambuyo poti kuchepa kwambiri. Komabe, zikuwoneka kuti ntchito ya impso mu odwala matenda ashuga imatha kubwezeretsedwanso. Kuti muchite izi, muyenera kukhala ndi shuga wokhazikika monga magazi mwa anthu athanzi.

Mutha kukwaniritsa izi ndi mtundu-2 wa mtundu 2 wa chithandizo cha matenda ashuga kapena mtundu wa mtundu wa matenda a shuga. Komabe, izi sizophweka, makamaka ngati zovuta za matenda a shuga mu impso zidayamba kale. Wodwala amafunika kukhala ndi chilimbikitso chambiri komanso kuwongolera kutsatira tsiku ndi tsiku.

Chonde dziwani kuti ngati chitukuko cha matenda ashuga nephropathy chatha osabweranso, ndiye kuti kwachedwa kwambiri kusinthira ku chakudya chamoto chochepa. Zomwe sizibwerera ndizomwe zimasinthana ndi kusefukira kwa 40-45 ml / min.

Nephropathy wa matenda ashuga: Zakudya

Ndikulimbikitsidwa kuti musunge hemoglobin wa glycated pansi pa 7%, pogwiritsa ntchito zakudya zomwe zimaletsa mapuloteni komanso mafuta a nyama. Choyamba, amayesa kulowetsa nyama yofiira ndi nkhuku, komanso bwino ndi mapuloteni okhala ndi masamba. Zakudya zamafuta ochepa-mafuta ochepa (zakudya No. 9) zimathandizidwa ndi jakisoni wa insulin ndi mankhwala. Izi ziyenera kuchitika mosamala. The aimpso ntchito kuphwanya, kutsitsa ofunika Mlingo wa insulin ndi mapiritsi, kumakhala pachiwopsezo cha bongo.

Madokotala ambiri amakhulupirira kuti kudya nyama yochepa kwambiri kumavulaza impso ndipo imathandizira kukulitsa matenda a shuga. Ili ndi funso lovuta, liyenera kumvetsedwa bwino. Chifukwa kusankha zakudya ndizofunikira kwambiri zomwe odwala matenda ashuga komanso abale awo ayenera kuchita. Chilichonse chimadalira chakudya chamagulu a shuga. Mankhwala ndi insulin amatenga mbali yaying'ono kwambiri.

Mu Julayi 2012, nkhani ya Chingerezi idasindikizidwa mu magazini yakuchipatala ya American Society of Nephrology pakuyerekeza zomwe zimachitika pa impso zamatumbo ochepa komanso zakudya zamafuta ochepa. Zotsatira za phunziroli, zomwe zidakhudza odwala 307, zidatsimikizira kuti kudya kwamoto wotsika pang'ono sikuvulaza. Kuyesaku kunachitika kuyambira 2003 mpaka 2007. Munapezeka anthu 307 omwe ali onenepa kwambiri ndipo akufuna kuchepetsa thupi. Hafu ya iwo apatsidwa chakudya chamafuta ochepa, ndipo theka linalo amakhala ndi zakudya zama calorie ochepa, zamafuta ochepa.

Ophunzira adawonedwa pafupifupi zaka ziwiri. Serum creatinine, urea, kuchuluka kwamkodzo tsiku ndi tsiku, ndi kutulutsidwa kwa ma albumin, calcium, ndi ma electrolyte a urinito anali kuyezedwa kawirikawiri. Zakudya zamafuta ochepa zimakulitsa mkodzo tsiku lililonse. Koma panalibe zizindikiro zakuchepa kwa kuchuluka kwa kusefera kwa madzi, mapangidwe a mwala wa impso, kapena kufewetsa mafupa chifukwa cha kuchepa kwa calcium.

Panalibe kusiyana pakati pa kuchepa thupi pakati pa omwe amatenga magulu onse awiri. Komabe, kwa odwala omwe ali ndi matenda ashuga, kudya chamafuta ochepa ndiye njira yokhayo yokhazikika shuga wamagazi okhazikika, kupewa kudumpha. Zakudya izi zimathandiza kuwongolera kagayidwe kazakudya, ngakhale zimakhudza bwanji thupi.

Nthawi yomweyo, chakudya choperewera m'mafuta, chokhala ndi mafuta ochulukirapo, mosakayikira chimakhala chovulaza kwa odwala matenda ashuga. Kafukufukuyu yemwe wafotokozedwa pamwambapa anali okhudza anthu omwe alibe shuga. Sizipereka mpata woyankha funso loti zakudya zamafuta ochepa zimathandizira kukula kwa matenda a shuga, ngati anayamba kale.

Zambiri kuchokera kwa Dr. Bernstein

Zonse zomwe zatchulidwa pansipa ndizomwe amachita a Dr. Bernstein, osathandizidwa ndi kafukufuku wadzaoneni. Mwa anthu omwe ali ndi impso zathanzi, kuchuluka kwa kusefedwa kwa madzi ndi 60-120 ml / min. Mafuta ochulukirapo a m'magazi amawononga pang'onopang'ono zinthu zosefera. Chifukwa cha izi, kuchuluka kwa kusefedwa kwa glomerular kumachepa. Ikatsika mpaka 15 ml / min ndipo pansipa, wodwalayo amafunikira dialysis kapena kupatsirana kwa impso kuti asafe.

Dr. Bernstein amakhulupirira kuti zakudya zamafuta ochepa zitha kutumikiridwa ngati kuchuluka kwa kusefedwa kwa glomerular kukwera kuposa 40 ml / min. Cholinga ndikuchepetsa shuga kukhala yabwinobwino ndikuwasunga bwino 3.9-5.5 mmol / L, monga mwa anthu athanzi.

Kuti mukwaniritse izi, simuyenera kutsatira zakudya zokha, koma gwiritsani ntchito njira zonse zothandizira odwala matenda amtundu wa 2 kapena pulogalamu ya matenda a shuga 1. Zochita zosiyanasiyana zimaphatikizapo zakudya zama carb otsika, komanso jakisoni wa insulin yotsika, kumwa mapiritsi ndi kuchita zolimbitsa thupi.

Odwala omwe akwanitsa kuchuluka kwa shuga m'magazi, impso zimayamba kuchira, ndipo matenda a shuga amatha kuzimiririka. Komabe, izi ndizotheka pokhapokha ngati zovuta zomwe zili m'mavuto sizinapite patali kwambiri. Mlingo wosefera wama glomerular 40 ml / min ndi mtengo wapang'onopang'ono. Ngati zimatheka, wodwalayo amangotsatira zakudya zoletsedwa ndi mapuloteni. Chifukwa chakudya chochepa kwambiri cha carb chimathandizira kukulitsa kulephera kwa impso.

Tikubwerezanso kuti mugwiritse ntchito izi pangozi yanu. Mwina zakudya zamafuta ochepa zimapweteketsa impsozo komanso kuzitsuka kwambiri kosachepera 40 ml / min. Kafukufuku wokhazikika wa chitetezo chake kwa odwala matenda ashuga sanachitike.

Musadzichepetse pakudya, koma gwiritsani ntchito mitundu yonse ya magawo kuti shuga yamagazi anu ikhale yolimba komanso yabwinobwino. Makamaka, pezani momwe mungapangire shuga m'mimba pamimba yopanda kanthu. Kuyesa kwa magazi ndi mkodzo kuti ayang'anire ntchito ya impso sikuyenera kumwedwa pambuyo pakuchita zolimbitsa thupi kwambiri kapena kumwa. Yembekezerani masiku 2-3, apo ayi zotsatira zake zimakhala zoipa kuposa momwe zilili.

Kodi anthu odwala matenda ashuga amakhala nthawi yayitali bwanji?

Onani zinthu ziwiri izi:

1. Kuchuluka kwa kusefukira kwa impso sikunachepetsedwebe kwambiri.
2. Impso sizikugwiranso ntchito, wodwalayo amathandizidwa ndi dialysis.

Poyambirira, mutha kuyesa kukhala ndi shuga m'magazi anu monga momwe ziliri ndi anthu athanzi. Kuti mumve zambiri, onani njira 2 yothetsera matenda a shuga kapena mtundu wa njira 1 yolerera matenda ashuga. Kugwiritsa ntchito bwino mosamala malangizowa kungathandize kuti matenda ashuga a nephropathy azikhala ndi zovuta zina, komanso kubwezeretsa magwiridwe oyenera a impso.

Kutalika kwa moyo wa munthu wodwala matenda ashuga kumatha kukhala chimodzimodzi kwa anthu athanzi. Zimatengera chidaliro cha wodwalayo. Kutsatira malingaliro a Dr. Bernstein pakuchiritsa tsiku ndi tsiku kumafunikira kulangidwa kwakukulu. Komabe, palibe chosatheka mu izi. Njira zowongolera matenda a shuga zimatenga mphindi 10-15 patsiku.

Kutalika kwa moyo wa anthu odwala matenda ashuga omwe amathandizidwa ndi dialysis zimatengera ngati ali ndi chiyembekezo chodikirira kuikidwa kwa impso. Kupezeka kwa odwala omwe akupita dialysis kumakhala kowawa kwambiri. Chifukwa amakhala ndi thanzi komanso matenda ofooka. Komanso, kukhala ndi ndandanda yotsuka yoyeretsa kumawalepheretsa kukhala ndi moyo wabwinobwino.

Olemba magwero ku America akuti 20% ya odwala omwe akudwala dialysis pachaka amakana njira zina. Chifukwa chake, amadzipha chifukwa chazovuta kwambiri pamoyo wawo. Anthu omwe ali ndi vuto loti-a impso amatha kutsatira ngati ali ndi chiyembekezo chodzaberekera impso. Kapenanso ngati akufuna kumaliza bizinesi ina.

Kupatsirana kwa impso: zabwino ndi zoyipa

Kuika impso kumawathandiza odwala kukhala ndi moyo wabwino komanso wautali kuposa kuyimba. Chachikulu ndichakuti kulumikizidwa ndi malo ndi nthawi ya dialysis njira zimatha. Chifukwa cha izi, odwala ali ndi mwayi wogwira ntchito komanso kuyenda. Pambuyo pakuwongolera bwino kwa impso, zoletsa zopatsa thanzi zitha kupumulanso, ngakhale chakudya chikuyenera kukhalabe chathanzi.

Zoyipa zosinthika poyerekeza ndi dialysis ndizovuta kuchitidwa, komanso kufunika kotenga mankhwala a immunosuppressant omwe ali ndi zotsatira zoyipa. Sizingatheke kuneneratu pasadakhale kuti zaka zochulukirazi zidzakhala zaka zingati. Ngakhale pali zoperewerazi, odwala ambiri amasankha opaleshoni m'malo modukitsa khungu ngati ali ndi mwayi wolandila impso.

Kuika impso nthawi zambiri kumakhala kwabwino kuposa dialysis.

Nthawi yocheperako yomwe wodwala amakhala pa dialysis musanaikidwe, ndiye kuti vutoli limakula. Poyenera, opareshoni iyenera kuchitidwa isanayesedwe pakufunika. Kuika impso kumachitika kwa odwala omwe alibe khansa komanso matenda opatsirana. Opaleshoni imatha pafupifupi maola anayi. Munthawi imeneyi, ziwalo za wodwalayo sizichotsedwa. Impso yaopereka imayikidwa pamimba yotsika, monga akuwonetsera.

Kodi ndi ziti zomwe zikuwonetsa nthawi ya postoperative?

Pambuyo pa opareshoni, mayeso okhazikika ndi kukambirana ndi akatswiri amafunikira, makamaka chaka chatha. M'miyezi yoyamba, kuyezetsa magazi kumachitika kangapo pa sabata. Kupitilira apo, kuchuluka kwawo kumacheperachepera, koma kupita pafupipafupi ku chipatala kungakhale kofunikira.

Kukanidwa kwa impso komwe kumachitika kumatha kuchitika ngakhale mutagwiritsa ntchito mankhwala a immunosuppression. Zizindikiro zake: kutentha thupi, kuchepa kwa mkodzo, kutupa, kupweteka kwa impso. Ndikofunika kuchitapo kanthu panthawi yake, kuti musaphonye mphindi, funsani dokotala mwachangu.

Ndikothekanso kubwerera kuntchito pafupifupi masabata 8. Koma wodwala aliyense ali ndi vuto lakelo komanso kuthamanga kwake pambuyo pochita opareshoni. Ndikulimbikitsidwa kutsatira zakudya zomwe zimaletsedwa ndi mchere komanso mafuta. Imwani zamadzi zambiri.

Amuna ndi akazi omwe akukhala ndi impso yodalitsika nthawi zambiri amatha kubereka ana. Amayi akulimbikitsidwa kutenga pakati pasanathe chaka chimodzi atachitidwa opareshoni.

Kodi chinthu chothira impso chimatha kukhalako mpaka liti?

Kunena zowonjezera, kupambana kwa impso kumakulitsa moyo wa wodwala matenda ashuga wazaka zisanu ndi zinayi. Yankho lolondola la funsoli limatengera zinthu zambiri. 80% ya anthu odwala matenda ashuga atatha kubereka akhala zaka zosachepera zisanu. 35% ya odwala amatha kukhala ndi moyo zaka 10 kapena kupitilira. Monga mukuwonera, mwayi wopambana pantchitoyi ndiwofunikira.

Zowopsa zokhala ndi moyo wochepera:

1. Wodwala matenda a shuga adadikira nthawi yayitali kuti awonjezeke impso, adathandizidwa ndi dialysis kwa zaka zitatu kapena kupitilira.
2. Zaka za wodwalayo panthawi ya opaleshoni zimakhala zaka zoposa 45.
3. Zochitika za matenda amtundu wa 1 wazaka 25 kapena kupitirira.

Impso zochokera kwa wopereka wamoyo zili bwino kuposa cadaver. Nthawi zina, kuphatikiza ndi impso ya cadaveric, kapamba amathanso kuwaika. Lumikizanani ndi akatswiri zokhuza zabwino ndi zovuta za opaleshoni iyi poyerekeza ndi kupatsirana kwa impso.

Pambuyo pake kuti impso yovomerezedwa ikazika mizu, mutha kuchita izi, mwakufuna kwanu, kuti mukadye chakudya chochepa kwambiri. Chifukwa ndi njira yokhayo yobwezeretsanso shuga kuti ikhale yokhazikika komanso kuti ikhale yokhazikika komanso yabwinobwino. Mpaka pano, palibe dokotala amene angavomereze izi. Komabe, ngati mutsatira zakudya zabwino, glucose wanu wamagazi adzakhala wokwera ndikutsika. Ndi chiwalo chovekedwa, chinthu chomwecho chitha kuchitika mwachangu zomwe zachitika kale ku impso zanu.

Tikubwerezanso kuti mutha kusintha zakudya zamafuta ochepa pambuyo pothana ndi impso kokha pachiwopsezo chanu komanso pachiwopsezo. Choyamba onetsetsani kuti muli ndi mawerengero abwino a magazi a creatinine ndi glomerular filtration mitengo yomwe ili pamwamba pa mulingo.

Zakudya zamafuta ochepa kwambiri za anthu odwala matenda ashuga okhala ndi impso yowazidwa sizivomerezeka. Palibe kafukufuku yemwe adachitapo pankhaniyi. Komabe, pamasamba olankhula Chingerezi mutha kupeza nkhani za anthu omwe adapeza mwayi ndikupeza zotsatira zabwino. Amasangalala ndi shuga wabwinobwino, cholesterol yabwino komanso kuthamanga kwa magazi.

Ndemanga 6 pa "Matenda a shuga.

Moni Mwana wanga ali ndi zaka 6, akudwala matenda a shuga 1 a chaka chachitatu. Kotsatira mayeso anapeza hypoplasia ya impso yakumanzere. Kodi kale zovuta za matenda ashuga? Kodi izi ndizowopsa bwanji? Ena onse akukula ndi kukulira pang'ono kapena pang'ono. Sitingatembenukire kwa a nephrologist, chifukwa iye siamudzi wathu, ndizovuta kuti tifike kwa iye.

anapeza hypoplasia wa impso lakumanzere. Kodi kale zovuta za matenda ashuga? Kodi izi ndizowopsa bwanji?

Ndikuganiza kuti izi sizikugwirizana ndi matenda ashuga ndipo mwina sizowopsa.

Komabe, muyenera kuphunzira nkhaniyi - http://endocrin-patient.com/diabetes-detey/ - ndikuwachitiridwa monga alembedwamo. Kupanda kutero, zovuta zenizeni za matenda ashuga sizitenga nthawi yayitali. Zonse zimayamba ndi kukula kwa anzanu, chimfine pafupipafupi komanso matenda ena. Popita nthawi, zovuta zimayamba kumiyendo, impso komanso maonekedwe.

Masana abwino Glycated hemoglobin 6.9%, atatha kulimbitsa thupi pang'ono. Kuthamanga shuga 5.5-5.8. Mukatha kadzutsa, imakwera mpaka 7, ndipo pambuyo maola 2 imatsika mpaka 6.1-6.3. Ma antibodies a chithokomiro amawonjezeka ndipo posachedwapa ayamba kumwa mankhwalawa chifukwa kuchuluka kwa timadzi ta T3 kwasintha. Pali magazi m'thupi. Funso lalikulu: vuto lili mu impso, mchenga ndi ma cyst ndizochepa, zikupweteka. Ndipo chaka chatha, khungu loyenda. Ndawerenga zonse patsamba lanu zokhudzana ndi kulephera kwa impso.Rent, zachidziwikire, mahomoni pa C-peptide. Ndikumvetsetsa kuti kusankha mankhwalawa kumatha kuchitika ndikatha kuyesa impso?

Pali magazi m'thupi. Mchenga ndi chotupa mu impso ndizochepa, kupweteka. Ndipo chaka chatha, khungu loyenda.

Zonsezi zimakupangitsani kuganiza kuti muli kale ndi vuto la impso. Ndikadakhala kuti ndiwe, ndikadayesedwa nthawi yomweyo.

Ndikumvetsetsa kuti kusankha mankhwalawa kumatha kuchitika ndikatha kuyesa impso?

Zaka 64 zaka, kutalika kwa 170 masentimita, kulemera kwa 79 kg. Ndikudwala matenda ashuga amtundu woyamba, zokumana nazo zanga ndi zaka 24. Insulin Novorapid, Levemir. Thamangani shuga nthawi zonse, ngakhale ndimayesetsa kusunga. Tsopano vuto ndi funso ndikuti kusefera kwa glomerular kumatsitsidwa mpaka 52 ml / min, palibe mapuloteni mumkodzo. Ngati muyika zakudya zamafuta ochepa, muyenera kudya mapuloteni okwanira. Ndipo adotolo wowunikirawo ati kuchepetsa mapuloteni. Zoyenera kuchita

kusefera kwa glomerular kumachepetsa kukhala 52 ml / min. Ngati muyika zakudya zamafuta ochepa, muyenera kudya mapuloteni okwanira. Ndipo adotolo wowunikirawo ati kuchepetsa mapuloteni. Zoyenera kuchita

Dr. Bernstein akuti kufunika kwake kwa GFR ndi 40-45 ml / min. Ngati apamwamba, mutha kumadya zakudya. Komanso, ngati ndi kotheka, jekeseni insulini pang'ono, ndikusankha mosamala mankhwalawo kuti shuga ikhale yolimba 4.0-5,5 mmol / L.

Ganizirani zomwe zidzachitike ngati simupita kumalo osungirako matenda a shuga omwe amalimbikitsidwa ndi tsamba lino. Mpaka pano, mwakhala mukugwiriridwa ndi njira zovomerezeka. Anathandizira kwambiri? Kodi mukuganiza kuti zatsalira chiyani kwa inu? Ndipo chidzachitike ndi chiyani munthu asanamwalire?