Opaleshoni ya Matenda a shuga > Chithandizo ndi kupewa

Matenda a shuga ndi matenda osachiritsika omwe amakhala ndi zovuta zina zomwe nthawi zina zimafunikira opareshoni. Chifukwa chake, opaleshoni ya matenda a shuga mellitus (DM) amafunikira chisamaliro chowonjezereka ndikukonzekera mosamala, monga njira iliyonse ya opaleshoni imakhudzira shuga wamagazi. Koma matenda ashuga sawonedwa ngati cholakwira kwathunthu pakuchita opareshoni. Cholinga chachikulu ndikupeza chipukutiro cha matendawa.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Mfundo zoyambitsa opaleshoni pakuthandizira odwala matenda ashuga

Gwiritsani ntchito wodwalayo nthawi yomwe mwakonzekera.
Ngati ndi kotheka, amagwira ntchito nthawi yozizira.
Ndikofunikira kusaka zidziwitso zambiri momwe mungathere mukadwala odwala matenda ashuga.
Pofuna kupewa matenda oyambitsanso, mankhwala othandizira amafunikira.

Njira zoyipa ndi zotupa za necrosis zimawongoleredwa mosamala, zomwe zimayambitsa matenda ashuga. Komanso, mikhalidwe yotere imadziwikanso ngati kudandaula kolemetsa. Kuchepa kwa insulin ya mahomoni kumabweretsa kuchuluka kwa acetone, kuchepa kwamadzi ndi ischemia, zomwe zimapangitsa kufalikira kwa tizilombo toyambitsa matenda komanso kuwonjezereka kwa dera la gangrene kapena necrosis. Odwala oterowo amagonekedwa m'chipatala. Chitani opaleshoniyo posachedwapa.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Kukonzekera

Kukonzekera kwa opaleshoni ya shuga ndikosiyana ndi matenda ena othandizira. Zofunikira zingapo ndi chipepeso cha DM ndizofunikira.

Magawo azokonzekera azikhala motere:

Kudziwitsa shuga kuti magazi akhazikitse Mlingo wovomerezeka wa mankhwala.
Zakudya:
- Kuchotsera ku zakudya zomwe zimakhala ndi mafuta komanso mafuta ambiri.
- Zoletsa zamagalimoto.
- Kuchotsa zakumwa zoledzeretsa.
- Kuwonjezeka kwamatsenga tsiku lililonse.
Pamaso pa opareshoni, muyenera kubwezeretsa kuchuluka kwa glucose m'magazi.

Mtundu woyamba wa matenda ashuga, chithandizo ndi insulin ndiye chithandizo chachikulu. Ndondomeko yoyendetsera nthawi zonse ndi nthawi 4-5 patsiku ndikuwunika pafupipafupi shuga.
Mtundu wachiwiri wa matenda a shuga, mankhwalawa amachitika chifukwa cha insulin kapena mothandizidwa ndi mapiritsi ochepetsa shuga. Koma kukonzekera opaleshoni kumafuna kuyambitsa insulini, ngakhale njira yodziwira kale ya chithandizo.

Nthawi yomweyo musanachitidwe opareshoni, muyenera kulowetsamo theka la insulin, ndipo mutatha theka la ola - 20 ml ya glucose 40%.

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Ntchito ndi shuga

Pamaso pa ntchito yotsika zovuta, kulowetsedwa insulin kumakonda kuposa mankhwala apiritsi. Mukakonzekera opaleshoni yayikulu, ndikulimbikitsidwa kuti mulingo wambiri wa mahomoni ochepa uchuluke, koma osapitilira 6% pa ola limodzi. Opaleshoni imayamba maola awiri atatulutsidwa, chifukwa ndi pomwe zotsatira zake zimatchulidwa. Ngati wodwalayo aletsedwa kudya asana opaleshoni, amapatsidwa theka la insulin, ndipo patapita kanthawi (mphindi 30) yankho la glucose wokhala ndi 40%, koma osapitirira 20-40 ml.

Opaleshoni ya shuga ili ndi mawonekedwe. Anesthesia iyenera kuyambitsidwa ndikuwongolera mwamphamvu kuchuluka kwa glycemia ndi hemodynamics. Sizotheka kusunga kuchuluka kwa shuga pazowonetsa pafupipafupi, koma ndikofunikira kupewa hyperglycemia (kudumpha) kapena hypoglycemia (dontho). Nthawi zambiri ndimagwiritsa ntchito mankhwala opaleshoni chifukwa kufinya kumawonjezera glycemia. Kuphatikiza apo, kuchitapo kanthu kwa nthawi yayitali kwa opaleshoni kumachitika pogwiritsa ntchito mankhwala osokoneza bongo, zomwe zimapangitsa kuti pakhale shuga.

Nthawi Yobwezeretsa Matenda A shuga

Pambuyo pa opaleshoni, njira zosiyanasiyana zamankhwala othandizira insulin zimatheka, koma lamulo lalikulu ndikuti mosasamala mtundu wa shuga kapena mtundu wina wamankhwala am'mbuyomu, wodwalayo ayenera kumwa mahomoni masiku 6. Pambuyo pakuchita opaleshoni pa kapamba, wodwalayo amasamutsidwa kwathunthu ku insulin popanda mapiritsi.

Ndikofunikanso mu nthawi ya postoperative yomwe zakudya za wodwala zimasewera. Masiku oyamba kudya amaphatikizapo chimanga (oatmeal, mpunga), odzola, timadziti. Kukhazikitsidwa kwa Mlingo waukulu wa insulin kumachitika musanadye chakudya. Mlingo amasankhidwa payekha. Kuphatikiza pa kuwunika mosamala kuchuluka kwa shuga kumayambiriro kwa ntchito, ndikofunikira kudziwa kuchuluka kwa mkodzo kangapo patsiku tsiku lililonse. Kwambiri insulin mankhwala amathetsa zotsatirazi:

shuga wolipidwa
shuga yokhazikika
kusowa kwa kutupa ndi mulingo wabwinobwino wa kuchiritsidwa kwawoko.

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Nthawi yogwira ntchito ndi njira za purulent

Odwala omwe ali ndi matenda osokoneza bongo atatha opareshoni ya purulent amawonetsedwa m'njira yowonjezera panthawi yokonzanso. Glycemia imayang'aniridwa ola lililonse kwa masiku atatu. Mankhwala a insulin amasiyana ndi ma regimen:

timadzi timadzi timene timayendetsedwa mosagwirizana, komanso kudzera m'mitsempha,
tsiku ndi tsiku 60-70 mayunitsi.

Kugwiritsidwa ntchito ndi zoopsa zochepa ndikutheka motsutsana ndi maziko olipirira anthu odwala matenda ashuga. Ngati kulowererapo ndikofunikira ndi chiphuphu chosakwanira, njira zowonjezera zimatengedwa kuti athetse ketoacidosis chifukwa cha kuchuluka kwa insulin. Alkalis sayendetsedwa chifukwa chakuwonjezeka kwa zovuta zovuta.

Pamaso pa opareshoni komanso pambuyo pa opaleshoni, Mlingo wa mankhwalawa umaperekedwa. Detoxation kulowetsedwa ndi kugwiritsa ntchito mankhwala a antithrombotic ndikofunikira. Kupezeka kwa matenda nthawi zonse kumakulitsa mkhalidwe wa wodwalayo, komwe kumafunikira kumwa mankhwala amphamvu ndikuwonetsetsa shuga ndi ma ketoni. Ndi kuthetsedwa kwa njira yotupa ndi njira yoyenera yogwiritsira ntchito, kuchira kwamphamvu kwa kagayidwe kazakudya komanso chindapusa cha shuga chimachitika.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda aposachedwa a shuga. Werengani nkhani >>

Matenda a purulent-yotupa

Zomwe zimachitika ndi matenda a shuga - zimapangitsa kuti ma purosesa azikhala pafupipafupi - zilonda, ma carbuncle, minofu yofewa. Izi zimachitika chifukwa chochepa kwambiri chitetezo cha m'thupi, kuperewera kwa zakudya m'thupi, minofu yowonongeka.

Chimodzi mwa njira zochizira matenda otere ndikufunika kwa opaleshoni m'dipatimenti yopanga opaleshoni. Ngakhale kulowererapo pang'ono kwa matenda ashuga (kutsegula thumba, panaritium, kudabwitsidwa ndi msomali wofowoka) kungayambitse kufalikira kwa matenda, mapangidwe a zilonda zamachiritso osakhalitsa.

Anthu odwala matenda ashuga amawonetsedwa ngati mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi chitsimikizo chovomerezeka cha kuthekera pogwiritsa ntchito chikhalidwe cha bala ndi kuyezetsa magazi.

Ndipo izi ndizambiri zamatenda a shuga.

Ndi amphaka ndi retinopathy

Kuchepa kwa maonedwe owoneka chifukwa cha mitambo ya mandala nthawi zambiri kumapezeka mwa odwala matenda a shuga. Amawonetsa opaleshoni pakuwonongeka kwake komwe akupanga (phacoemulsification) ndikusinthira mandala. Chithandizo cha opaleshoni chimalembedwa mwachangu momwe zingayambire, chifukwa odwala matenda ashuga amatha msanga.

Chifukwa cha kusintha kwa ziwiya za fundus, kutulutsa kwamkati mu retina kumatha kuchitika, ndipo kukula kwamitsempha yofooka yatsopano kumatha kuchitika. Amachepetsa kuwonekera kwa media media. Woopsa milandu, ndi zovuta retinopathy, zotumphukira retinal zimachitika. Zikatero, ntchito yoyenera ya vitibleomy (kuchotsa vitreous) ndiyofunikira. Zimaphatikizapo cauterization yamitsempha yamagazi, kukhazikika kwa retina, magazi.

Kupanga Opaleshoni Yamatenda Othandizanso

Vuto lalikulu kwambiri la matenda ashuga, lomwe limafunikira opaleshoni, ndi kuwonongeka kwakumapeto. M'mibadwo yotsogola, kulephera kwazungulire kumayambitsa gangore, kufunika kwa kudulidwa. Ngati njirayi singayime, kudula kwakukulu m'chiuno kumachitika. Pofuna kusamalira mwendo momwe mungathere ndikupangitsa malo opangira ma prosthetics, njira zopangira opaleshoni yolimbitsa thupi zimayikidwa:

Kuchotsa kwa atherosclerotic plaque (endarterectomy),
angioplasty (kukhazikitsidwa kwa balloon yokulirapo ndi kukhazikitsidwa kwa stent),
Kupanga kwa njira yodutsa magazi kudzera wogwiritsa ntchito vein transplant (opaleshoni yam'madzi),
Njira zophatikiza.

Kufunika kwa angioplasty ndi shunting kumachitikanso ndimatenda owopsa am'mitsempha, ubongo. Ngakhale kufunika kwa revascularization (kubwezeretsa kutuluka kwa magazi) kuli kokulirapo, ntchito izi sizomwe zimalembedwa machitidwe. Zotsatira zawo zazitali za anthu odwala matenda ashuga zimakhala zoopsa kwambiri chifukwa cha kuchuluka kwa thrombosis, kuwonongeka kwa mitsempha ndi ziwiya zazing'ono, komanso nthawi yayitali yochira.

Ngati mungasankhe njira yochitira opaleshoni yamitsempha yamagazi, ndikofunikira kuti pakhale chiphuphu chokwanira cha matenda ashuga. Pambuyo pa opaleshoni, mankhwala a antithrombotic amalembedwa (Aspirin, Warfarin, Plavix). Pamafunika chakudya chomwe chimaletsa kwambiri mafuta a nyama ndi shuga, mankhwala osokoneza bongo kuti muchepetse cholesterol (Krestor, Atoris, Ezetrol). Ndikofunikira kuti odwala azichulukitsa kulemera kwa thupi, kusiya kusuta ndi kumwa, komanso kuchita masewera olimbitsa thupi tsiku ndi tsiku.

Matenda a mafupa

Kubwezeretsa kwa m'chiwindi kumasonyezedwa kwa arthrosis yayikulu, zotsatira za kupasuka kwa khosi lachikazi. Amawonetsera ngati ndizosatheka kuchepetsa ululu ndikusintha kuyenda kwa njira zamankhwala ndi physiotherapy. Opaleshoni iyi imafunikira chozama chambiri komanso chokwanira.

Mu odwala matenda ashuga, ngakhale mabala apamwamba amachiritsidwa kwa nthawi yayitali, ntchito zamagulu sizinabwezeretse kwathunthu. Ndi mankhwala a mafupa, kukweza, kukana, kusakhazikika kwa phokoso, ma dislocation nthawi zambiri amachitika. Chachikulu antibacterial mankhwala ndi zolimba shuga magazi kuyenera.

Kubwezeretsa Chiwindi

Mavuto omwe angakhalepo atachitidwa opareshoni

Kuphatikiza pa mwayi wamavuto amodzi - kukhetsa magazi, kusalinganika kwapazinthu zina komanso kupindika kwamipeto ya mabala, kutukusira kwa minofu m'ntchito. kwa odwala matenda ashuga ali ndi chikhalidwe:

pachimake coronary kapena mtima kulephera (kugunda kwa mtima, pulmonary edema, Cardiogenic mantha),
kusokoneza kwakatundu,
kulephera kwa aimpso
dontho lakuthwa kwa shuga m'magazi - hypoglycemic chikomokere.

Amayambitsidwa chifukwa cha kupweteka kwa magazi, magazi. Amatha kuchitika pa nthawi yonse ya opareshoni ndipo m'masiku oyambira kutha kwake.

Nthawi yoyambilira isanachitike:

chibayo
kuchuluka kwa bala ndi kufalitsa kwa ma virus kudzera m'magazi,
poizoni wamagazi (sepsis),
matenda amkodzo.

Chomwe chimapangidwira pafupipafupi zovuta ndizosintha mu vasculature mu matenda ashuga (macro- ndi microangiopathy), kuchepa kwa magwiridwe antchito (chitetezo chammbali) mu mtima, mapapu, chiwindi, ndi impso.

Kupumula kwanthawi yayitali, poyerekeza ndi kutsika kwa magazi m'miyendo ndikukulira kwamapangidwe amisempha, magazi amatuluka kwambiri. Ndi kupititsa patsogolo kwa thrombus paliponse pa bedi lamanjenje, kufalikira kwa nthambi za m'mapapo kumachitika. Pulmonary thromboembolism ndi matenda oopsa.

Kusokonezeka kwa magazi ndi Microangiopathy

Diabetesic autonomic neuropathy (kuwonongeka kwa minyewa yamitsempha) imayambitsa kufooka kwa minofu ya chikhodzodzo ndi matumbo. Izi zitha kuwopseza kuti muchepetse kutulutsa mkodzo, kutsekeka kwamatumbo.

Kukonzanso kwa glucose

Zakudya zokhala ndi zoletsa zamafuta ochepa (shuga, zopangidwa ndi ufa, zipatso zotsekemera), mafuta, zakudya zopatsa mphamvu kwambiri komanso zakudya zopezeka ndi cholesterol (nyama, offal, zakudya zosavuta) zimavomerezeka. Woletsa mowa. Pamafunika kukwaniritsa zizindikiritso za shuga zamagazi pafupi ndi zabwinobwino. Milandu yayikulu ya matendawa, ndikokwanira kuti kuphipha kwake mu mkodzo sikudutsa 5% ya kuchuluka kwa chakudya chomwedwa patsiku.

Mtundu wachiwiri wa matenda ashuga, insulin ikhoza kuwonjezeredwa kuphatikiza mapiritsi. Ngati kukonzekera kwina kukonzekera, ndiye kuti m'masiku atatu onse odwala amapatsidwa insulin mpaka 4-5 patsiku. Zoyeserera - 4.4-6 mmol / L shuga m'magazi.

Kukondoweza kwa ntchito

Kuteteza minofu ya impso mu shuga, angiotensin-akatembenuka enzyme inhibitors (Kapoten, Hartil) amagwiritsidwa ntchito. Ndi chithandizo chawo, amakwaniritsa kukhazikika kwa magazi moyenera mkati mwa impso, ndikuchepetsa kuwonongeka kwa mapuloteni. Amawonetsedwa ndi nephropathy ngakhale pakhale matenda oopsa. Kuchepetsa kupezekanso kwa impill capillaries, Wessel-Douay F. amagwiritsidwa ntchito. Zakudya zimachepetsa mchere mpaka 5 g patsiku.

Mankhwala a polyneuropathy

Kusintha magwiridwe antchito amanjenje, thioctic acid (Tiogamma, Espa-lipon) amagwiritsidwa ntchito. Mankhwalawa amaletsa:

kuphwanya mamvekedwe a mtima, kukomoka posintha mawonekedwe a thupi,
kusinthasintha kwa magazi,
kuchepa kwa mgwirizano wam'kati wamtima,
atony (minofu kufooka) wa chikhodzodzo, matumbo, minofu mafupa.

Matenda a shuga Atatha Opaleshoni

Ngati wodwala mankhwala opaleshoni yodwala, ndiye kuti mphindi 10 mpaka 10 patsogolo pake, theka la m'matumbo a insulin limayendetsedwa, ndipo pambuyo pa mphindi 30 - 20 ml ya 20% shuga m'mitsempha. Mukam'chita opareshoni komanso pambuyo pake, wodwalayo amapezeka kuti ali ndi shuga wambiri. Maola awiri aliwonse, shuga wamagazi amatsimikiziridwa, jakisoni wa mahoni amachitika molingana ndi zizindikiro zake.

Pambuyo podzidyetsa zokha, amasintha ndikuyamba kuyendetsa mahomoni. Kuti mudziwe mlingo, kuchuluka kwa chakudya chamagulu amawerengera chakudya. Nthawi zambiri, jakisoni wocheperako amasankhidwa katatu pakadutsa masiku awiri.

Kwa masiku 3-5, malinga ndi chikhalidwe chokwanira komanso chakudya chokwanira, ndikotheka kubwerera ku chizolowezi. Mankhwala a insulin, kuphatikiza kwa nthawi yayitali komanso yayifupi kumagwiritsidwa ntchito. Kwa matenda ashuga a mtundu 2, kumwa mapiritsi kuti muchepetse shuga mumatha kutha mwezi umodzi. Chofunikira chotsekera jakisoni ndikuchiritsa kwathunthu kwa bala, kusakhalapo kwa chilimbikitso, kusintha kwa shuga.

Kusankha kwa matenda a shuga

Mukamayendetsa opaleshoni yayikulu, amawopa kuchepa kwa glucose komanso kugwa kwamphamvu pakukakamizidwa. Chifukwa chake, atangopanga opaleshoni, kuwonjezeka kwa zizindikiro ndizotheka. Kugwiritsa ntchito ma ether ndi fluorotan osavomerezeka, ndipo droperidol, sodium oxybutyrate, morphine ali ndi vuto lochepa la carbohydrate metabolism.

Nthawi zambiri, opaleshoni ya intravenous imagwiritsidwa ntchito limodzi ndi a painkiller.Gulu lomaliza la mankhwalawa litha kuphatikizidwa ndi ma antipsychotic mu ntchito zing'onozing'ono.

Chithandizo cha opaleshoni yamchiberekero cha m'chiuno (mwachitsanzo, mu gynecology) imachitika ndikumayambitsa mankhwala osokoneza bongo m'magazi am'magazi (spinal, epidural anesthesia).

Kodi mabala amachira bwanji pambuyo

Ndi matenda ashuga, kuchiritsa mabala ndivuto lalikulu kwambiri. Nthawi zina njirayi imayamba kwa miyezi iwiri. Kubwezeretsa kwa nthawi yayitali pakukhulupirika kwa minofu nthawi zambiri kumakhala kowonjezereka pazinthu zowopsa:

odwala okalamba
kudya osakwanira ndi malingaliro othandizira odwala matenda a shuga asanafike opaleshoni,
magazi amachepa m'matumbo (angiopathy),
kunenepa
chitetezo chochepa
opaleshoni yodzidzimutsa (popanda kukonzekera),
Kuchepetsa koyambirira kwa mlingo wa insulin kapena kuchotsedwa kwake.

Mabala samangotenga nthawi yayitali kuti athe kuchiritsa, komanso angapangane ndi kupangika kwa abscess (abscess) kapena phlegmon (kuphatikiza kwakukulu), magazi, kusokonezeka kwa msoko ndi kuwononga kwa zimakhala zophatikizana (necrosis), zilonda zam'mimba zotheka.

Kuti mulimbikitse kuchiritsa, amalembera:

zolimbitsa insulin,
kukhazikitsa kwa mapuloteni osakanikirana ndi dontho, Actovegin,
kukweza kwa ma microcirculation - Trental, Ditsinon,
kuyeretsa kwa enzyme - Trypsin, Chymotrypsin,
kuchotsa pambuyo pake zikondwerero - pa masiku 12-14,
yotakata-sipamu mankhwala.

Zakudya zabwino komanso kuchira kwa wodwalayo

Masiku oyamba pambuyo pakuchita opaleshoni yam'mimba, zakudya zimachitika pobweretsa matenda ena okhudzana ndi matenda ashuga - Diazon, Nutricomp Diabetes. Ndiye chakudya chocheperako ndi chokhazikika chimalimbikitsidwa:

msuzi wamasamba
phala
masamba, nyama, nsomba kapena soufflé,
kefir-fat kefir, kanyumba tchizi wosasinthasintha,
makeke apulosi ophika,
amamu omele,
kulowetsedwa
shuga wopanda shuga
odzola ndi stevia.

Kwa iwo sungawonjezeke osaposa 50-100 g a obisalira, supuni ya batala. Musanayambike insulini, muyenera kudziwa molondola kuchuluka kwa chakudya chamagulu ndi shuga ndimagazi. Izi zikuthandizira kuwerengera mlingo womwe umafunikira wa mahomoni.

Ndipo izi ndizokhudza chithandizo cha matenda amishuga.

Mankhwala othandizira (kuphatikiza insulin) amaphatikiza ma painkiller (Ketanov, Tramadol, Nalbufin), maantibayotiki, njira zothetsera mlingo wa zinthu zomwe zimatsata, othandizira. Kupititsa patsogolo kuyeretsa kwa thupi, plasmapheresis, hemosorption, ultraviolet kapena laser irradiation yamagazi ndi mankhwala.

Ntchito za matenda ashuga zimaperekedwa chifukwa cha zomwe zidawonetsa. Mwanjira, odwala nthawi zambiri amathandizidwa chifukwa cha zovuta za matenda ashuga - matenda amkati, retinopathy, ndi matenda amitsempha.

Opaleshoni imayambitsidwa ndikukonzekera. Chifukwa cha zovuta za metabolic ndi circulatory, odwala matenda ashuga nthawi zambiri amakhala ndi zovuta pambuyo pake. Chimodzi mwa izo ndi machiritso a bala. Pofuna kupewa ndi kuchiza, mankhwala a insulin othandizira, zakudya, maantibayotiki ndi mankhwala ena amalembedwa.

Kanema wothandiza

Onerani kanemayo panjira yodzikongoletsera ya matenda ashuga:

Ngati phazi la matenda ashuga limakula, ayenera kuyamba kulandira chithandizo mwachangu. Pa gawo loyamba, mafuta odzola, mankhwala achilengedwe ndi laser amagwiritsidwa ntchito kukonza magazi, gawo lamitsempha yamagazi. Chithandizo cha opaleshoni ndi mankhwala ena amakono ndi oyenera zilonda zam'mimba.

Ngati wodwala ali ndi cholecystitis ndi matenda a shuga nthawi imodzi, ndiye kuti ayenera kuyambiranso kudya, ngati matenda oyambawo atakula. Zomwe zimachitika zimagona mu insulin yowonjezera, uchidakwa komanso ena. Ngati pachimake kuwerengetsa kwambiri cholecystitis kwayamba ndi matenda a shuga, kungafunike opaleshoni.

Kukayikira kwa matenda ashuga kumatha kukhalapo kwa zizindikiro zodandaula - ludzu, kutulutsa mkodzo kwambiri. Kukayikiridwa kwa shuga kwa mwana kumachitika pokhapokha ndikomoka. Kuyeserera pafupipafupi komanso kuyezetsa magazi kumakuthandizani kusankha zoyenera kuchita. Koma mulimonsemo, chakudya chimafunika.

Ngati matenda a shuga a mtundu woyamba akhazikitsidwa, chithandizo chizikhala ndi kuperekera insulin yayitali. Komabe, lero pali njira yatsopano pakuthandizira matenda a shuga - mapampu otukuka, zigamba, zopopera ndi zina.

Chifukwa cha kuchuluka kwa shuga pamagalasi amaso, komanso kuwonongeka kwa mitsempha yaying'ono yamatumbo, ma catarisitit nthawi zambiri amakula m'matenda a shuga. Pankhaniyi, ndikotheka kuchita opareshoni kapena kugwiritsa ntchito mankhwala poletsa njirayi. Yankho labwino kwambiri la matenda a shuga 1 ndi mtundu wa 2 ndi phacoemulsification.

7. Kuyesedwa kwa wodwala musanachite opareshoni. Magawo a chiopsezo cha aest.

Panthawi ya mayeso aoperative, monga lamulo, wodwala matendawa ndi wodwalayo amadziwana, ndipo mgwirizano wina ndi zotsatira za chithandizo zimadalira mtundu wa kulumikizana koyamba. Kuunika kogwira ntchito kumaphatikizapo: kuwerenga mbiri ya zamankhwala, kutenga anamnesis, kuyezetsa thupi, kutanthauzira zotsatira za mayeso omwe alipo ndi kusanthula, kuwunika zoopsa, kupereka njira zowonjezera zowunikira, kupanga njira zowongolera, kuphatikiza kuyesa zovuta ndi njira zothana nazo. Kupereka lingaliro kwa wodwala lingaliro labwino chifukwa cha opaleshoniyo ndi chimodzi mwazinthu zofunika pakuwunika kwa wodwalayo. Nthawi zina kukonzekera bwino kwamankhwala kwa wodwala, komwe kumachitika atangoyamba kumene kuchitidwa ndi katswiri wodziwa ntchito, kumakhala kothandiza kwambiri kuposa kupangika kwa mapiritsi ogona ndi oyeserera.

Kugawidwa kwa AAA kwa Chiwopsezo cha Kugonetsa 1. Odwala omwe alibe matenda kapena ali ndi matenda ofatsa omwe samayambitsa kusokonezeka kwawo, 2. Odwala omwe ali ndi vuto lofooka kapena locheperako la zomwe zimachitika chifukwa cha matenda opatsirana omwe amachepetsa modabwitsa ntchito komanso olimbitsa thupi (kuchepa magazi m'thupi, kuyambira emphysema, matenda oopsa), 3. odwala omwe ali ndi vuto lalikulu la zomwe zimachitika chifukwa cha opaleshoni ndipo amatha kwambiri koma kumawonjezera ntchito zofananira (mwachitsanzo, kuperewera kwa mtima kapena kupuma chifukwa cha pulmonary emphysema kapena njira yolowera mkati), odwala 4 omwe ali ndi vuto lalikulu lazovuta zonse, zomwe zimatha chifukwa cha kuvutika kwa opareshoni ndikuwonongeka kwa ntchito zofunika kapena kuwopseza mtima (mtima kubwezera, kulepheretsa, - - ngati wodwala sakhala mgulu la N7), odwala 5. omwe amathandizidwa molingana ndi zadzidzidzi ndipo ali m'gulu la 1 kapena 2 chifukwa chodwala, 6. wodwala Amene ntchito ndi zizindikiro mwadzidzidzi ndipo ndi za magulu 3 kapena 4, 7. odwala kufa pasanathe maola 24 onse pa opaleshoni ndi mankhwala oletsa ululu ndipo popanda iwo.

Opaleshoni ndi mfundo zake zokhudzana ndi matendawa

M'pofunika kunena nthawi yomweyo kuti chipangizocho pachokha sichingakhale chobwezeretsa opaleshoni. Chofunika kwambiri chomwe chiyenera kuwonedwa musanachitike njirayi ndi kubwezeretsedwa kwa matendawa.

Ndikofunika kudziwa kuti ntchito zitha kugawidwa modabwitsa komanso kosavuta. Mapiko amatha kutchedwa, mwachitsanzo, kuchotsa msomali woloza pachala, kapena kutsegula kwa chithupsa. Komabe, ntchito zosavuta za odwala matenda ashuga ziyenera kuchitidwa mu dipatimenti yochita opaleshoni, ndipo sizingachitike mwachangu.

Opaleshoni yokhazikitsidwa ndi yoletsedwa ngati palibe chindapusa cha matenda ashuga. Poyamba, amafunika kuchita zochitika zonse zomwe cholinga chake ndi kulipira matenda omwe amayambitsidwa. Zachidziwikire kuti, izi sizikugwira ntchito ku milandu yomwe nkhani ya moyo ndi imfa ikathetsedwa.

Kutsutsana kotheratu kwa opaleshoni kumawerengedwa kuti ndi chifuwa cha matenda ashuga. Choyamba, wodwalayo ayenera kuchotsedwa pamavuto akulu, kenako ndikuchita opaleshoni.

Mfundo za mankhwalawa opaleshoni yodwala matenda ashuga ndi mfundo izi:

Ndi matenda ashuga, gwiritsani ntchito msanga momwe mungathere. Ndiye kuti, ngati munthu ali ndi matenda osokoneza bongo, ndiye, monga lamulo, samazengereza kwa nthawi yayitali ndikuchita opareshoni.
Ngati ndi kotheka, sinthani nthawi yoyeserera kuti izikhala nyengo yachisanu.
Imapanga kufotokoza kwatsatanetsatane kwa matenda a wodwala winawake.
Popeza chiopsezo cha matenda opatsirana chikuwonjezeka, kulowererapo kumachitika mothandizidwa ndi maantibayotiki.

Chikhalidwe cha matendawa asanachitike opaleshoni ndikupanga mbiri ya glycemic.

Opaleshoni yamatenda a shuga

Opaleshoni imatha kupatsidwa kwa wodwala matenda ashuga kuti athe kupeza bwino. Chisankho chotere chimachitika ngati njira zina zochizira matendawa sizothandiza kapena zosatheka. Ndipo ndichithandizo chokhacho chomwe masiku ano chimaonedwa kuti ndi chamakono kwambiri komanso chothandiza.

Kuti adotolo azitha kusankha pakusintha kuchokera ku chithandizo chamankhwala chokhazikika, payenera kukhala ndi umboni wokwanira. Zomwe zimachitika chifukwa cha opareshoni ndi:

vuto la metabolic metabolic lomwe limabweretsa chiwopsezo pamoyo wa wodwalayo,
chizindikiritso cha zovuta zazikulu za matenda a shuga,
Kuchepetsa mphamvu ya mankhwala othandizira,
contraindication kwa subcutaneous jakisoni wa mahomoni.

Pokhapokha ngati ziwalo zina ndi machitidwe a wodwala alibe ma pathologies akulu, kale tsiku litayamba kugwira ntchito, kapamba limagwira ntchito pafupipafupi. Maphunziro okonzanso kwathunthu amatenga pafupi miyezi iwiri.

Ntchito za Ophthalmologic

Kuchita opaleshoni chifukwa chotayika m'maso a shuga sikwachilendo, chifukwa kuwonongeka kwa ziwiya zazing'ono kwambiri za maso ndi zina mwazovuta za matendawa. Chiwopsezo cha kusawona pang'ono kapena kutaya kwathunthu, odwala omwe ali ndi chidziwitso cha "matenda okoma" amatenga mosavuta.

Chifukwa chake, ndikofunikira kwambiri kuti nthawi zonse azichita mayeso okonzekeredwa ndi dokotala wamaso. Kudziyang'ana kwathunthu kumaphatikizapo kuyesa kwa fundus, kuyesa kwa kuona kwa maso ndi kuyesa kwamaso.

Koma sikuti nthawi zonse kutsika kwamawonedwe kumakhudzana ndi matenda osachiritsika. Palinso zifukwa zina pamene kuchitapo kanthu kwa opaleshoni kumafunikira kuti muzitha kuwona.

Pali chinthu china monga matenda ashuga - kuthyolako kwa mandala amaso poyang'ana kumbuyo kwa matendawo. Kwa odwala popanda kuzindikira matenda ashuga, chithandizo cha matenda a cataract chingachitike mwachangu.

Koma anthu omwe ali ndi vuto la metabolic ayenera kuyesedwa kwathunthu kuchipatala, kukonzekera ntchito ndikuchita opaleshoniyo mogwirizana ndi kuchuluka kosamala. Chilolezo cha opareshoniyo chimaperekedwa ndi sing'anga wopezekapo, yemwe amafanizira chiopsezo cha kutaya masomphenya ndi chiwopsezo cha kutaya moyo.

Prostatitis ndi matenda ashuga

Matenda a shuga ndi matenda a prostatitis ndi matenda omwe amagwirizana kwambiri. Choyipa choyamba chimakhudza chitetezo chamunthu, ndipo chachiwiri chikuwonekera motsutsana ndi maziko akuchepa kwa chitetezo chathupi. Chifukwa cha kutupa kosalekeza mu prostate gland, komwe kumakhala kovuta kudziwa komwe kumachitika chifukwa cha malamulo oletsa kupha maantibayotiki, nthawi zambiri matenda onsewa amayamba kupita patsogolo.

Palibe kawirikawiri zomwe zimachitika kuti prostatitis imayamba chifukwa cha matenda oopsa - neoplasm. Ndi khansa ya prostate m'matenda a shuga, opaleshoni imakhudza zoopsa zambiri ndipo zitha kuchitidwa ngati chilipiro chokwanira cha matenda ashuga chikuchitika.

Opaleshoni ya msana kwa odwala matenda ashuga

Kuchita opaleshoni ya msana kwa matenda ashuga, ngakhale pakali pano kukula kwa sayansi ndi mankhwala, kumakhalabe zovuta. Komanso, mavuto amayamba osati nthawi ya opareshoni, koma munthawi yakukonzanso. Chovuta kwambiri ndi cha odwala omwe ali ndi matenda a shuga omwe amadalira insulin - mu 78% ya odwala omwe akuchita opaleshoni, zovuta za mtundu umodzi kapena mtundu wina wazovuta zinawululidwa.

Pomaliza, titha kunena kuti opaleshoni iliyonse kwa odwala omwe apezeka ndi matenda a shuga ndizotheka. Ndipo kupambana kwa chithandizo champhamvu kwambiri kumadalira kulondola kwa kusintha kwamankhwala kwa wodwalayo komanso zotsatira za kubwezeredwa kwa matenda ashuga.

Kuphatikiza apo, onse omwe akuchita opaleshoni komanso wodwala opaleshoni ayenera kukhala ndi luso lokwanira logwira ntchito ndi odwala matenda ashuga.

Zofunikira pakugwira bwino ntchito kwa wodwala wodwala matenda ashuga, zikuwonetsa ndi contraindication

Malinga ndi ziwerengero, munthu aliyense wachiwiri yemwe ali ndi matenda ashuga adakumana ndi opaleshoni kamodzi pa moyo wake.

Matenda omwe akuwonetsedwa sikuti akuphwanya opaleshoni, komabe, kwa odwala omwe ali ndi matenda ofanana chiopsezo chowonjezereka cha zovuta mtsogolo.

Malipiro a matendawa. Ngati matendawa sanakulipilitsidwe, choyamba, amatengedwa kuti athe kulipirira, ndipo pokhapokha zolowerera zowerengedwa zimaperekedwa.
Kumachita chilichonse, ngakhale chochepa mu njira zochitira opaleshoni. Izi zipangitsa kuti adotolo azitha kuyankha mwachangu komanso moyenera pazinthu zilizonse zoipa zomwe zingachitike pa nthawi yachinyengo.

Kukonzekera Opaleshoni ya Type 1 kapena Type 2abetes

Kukonzekera kwa ntchito kwa odwala omwe ali ndi matendawa omwe amafunsidwa kumatha kukhala kosiyanasiyana: maola angapo - mpaka milungu ingapo. Zonse zimatengera momwe munthu aliri, kukhalapo kwa nthenda zamatenda, zaka komanso zinthu zina.

Kuyesa magazi kuti mupeze kuchuluka kwa shuga komwe kumakhalako. Izi ndizoyenera kudziwa magawo enieni a mankhwalawa omwe angapatsidwe kwa wodwala. Palibe chiwembu chokhazikika - dokotala amayenera kusankha mlingo uliwonse. Mwachitsanzo, mtundu wina wa insulin wa tsiku ndi tsiku umaperekedwa kwa odwala okalamba ndi achinyamata omwe ali ndi misempha yofanana ya shuga.
Mankhwala a insulin. M'mitundu ikuluikulu ya shuga, insulin mwa jakisoni imaperekedwa 4-5 patsiku. Nthawi zina, amalephera katatu kokha kuyendetsedwa kwa timadzi ta anabolic. Mu nthawi ya ntchito, insulin mankhwala imapitilizidwa kupewa kupewa kuchulukana. Kuchita njira zowukira pang'ono sikutanthauza kugwiritsa ntchito jakisoni.
Vitamini Therapy. Ndi matenda awa, odwala nthawi zambiri amavutika ndi vuto la kuperewera kwa mavitamini, omwe amayenera kubwezerezedwanso pafupipafupi. Izi ndizowona makamaka za ascorbic ndi nikotini acid.
Kuzindikiritsa ndikuchotsa ma pathologies owonjezera. Nthawi zambiri odwala matenda ashuga, odwala amakhala ndi vuto la kuthamanga kwa magazi. Opaleshoni isanachitike, ayenera kuchitapo kanthu kuti akonze. Muyenera kuthandizanso zamafuta a metabolism, ndipo ngati pali zolakwika zina zilizonse malinga ndi zomwe zimachitika, tengani njira zochizira.
Zakudya Mulinso mbali zingapo:
- Zakudya ziyenera kukhala zochepa m'makanema. Muyenera kudya magawo ang'onoang'ono ndipo nthawi zambiri (osapitirira 6 pa tsiku).
- Muzipewa zokhazokha zokhala ndi mafuta, masekapu, ndi zakumwa zoledzeretsa.
- Chepetsani kuchuluka kwa zakudya zomwe zimakhala ndi cholesterol.
- Zakudya za tsiku ndi tsiku ziyenera kukhala zosiyanasiyana ndi zinthu zokhala ndi ulusi wazakudya.

Opaleshoniyo angathe kuchitika pokhapokha:

Sinthani magawo a shuga. Zomwe zili m'magazi siziyenera kupitirira 9.9 mmol / L. Mu zochitika zapadera, wodwalayo amathandizira pazinthu zapamwamba za chinthuchi, koma izi zimadziwika ndi kuchepa kwa magazi kwa odwala komanso kukulira kwa kukokomeza kwam'tsogolo.
Kuperewera kwa shuga ndi acetone mkodzo.
Kuthetsa kusowa kwenikweni kwa shuga m'magazi. Matendawa amatchedwa ketoacidosis, ndipo nthawi zina amayambitsa kudwala matenda ashuga. Chifukwa chake, musanachite opareshoni, ndikofunikira kuchita zingapo zamankhwala zofunikira kuti athetse vuto lomwe limadziwika.
Matenda a kuthamanga kwa magazi.

Kuphatikiza apo, pali zochitika zina zomwe zimayang'aniridwa ndi anesthesiologist:

Kupweteka kwamankhwala kumapangitsa kuchuluka kwa shuga m'magazi. Chifukwa chake, nthawi zambiri kusankha kumapangidwa m'malo mokomera anthu ambiri. Ngati njira zowononga zachilengedwe ndizitali, chidwi chimaperekedwa kwa opaleshoni yama michere - njira yake pa shuga m'magazi ndiosakwanira. Mitundu ya mankhwala ochita opereshoni musanachite opaleshoni ndiyiti - njira zoperekera opaleshoni
Ngati madokotala a opaleshoni ndi yochepaAmaloledwa kugwiritsa ntchito mankhwala oletsa ululu pochita jakisoni wa mankhwala ena.
Opaleshoni isanachitike, wodwalayo amaphatikizidwanso ndi insulin. Monga lamulo, awa ndi theka la m'mawa. Panthawi ya opareshoni, madokotala amayang'anira kuchuluka kwa shuga m'magazi: ndikofunikira kupewa kuthamanga mwadzidzidzi m'magulu a shuga. Hyperglycemia kukonza umachitika pogwiritsa ntchito jakisoni wa insulin. Wogwirawo amawaganiziranso kuti hypoglycemia imakhala yowopsa kwambiri kwa wodwala kuposa hyperglycemia. Kutsika kwamphamvu kwa shuga kungayambitse chikumbumtima cha matenda ashuga, chifukwa chake sikofunikira kwambiri kuti zitheke kuchuluka kwa glucose panthawi yopanga, kuwonjezeka pang'ono kumaloledwa.
Pa nthawi ya opareshoni, kuwongolera kosalekeza pamlingo wamagazi kumachitika.

Mawonekedwe a ntchito ndi decompensated shuga mellitus mtundu 1 kapena 2

Nthawi zina, wodwala amafunika kulandira chithandizo chamankhwala mwachangu, pomwe matenda omwe amafunsidwawo amakhala osalipiridwa bwino.

Cholinga chachikulu cha njira zakuchipatala pankhaniyi ndizoyambirira Kuperewera kwa ketoacidosis. Dosed okhazikika makonzedwe a insulin amathandiza kulimbana ndi ntchitoyi.

Maola awiri aliwonse, kuyezetsa magazi kumachitika chifukwa cha kuchuluka kwa shuga.

Ngati wodwala akudwala malungo, amakhazikikanso mankhwala a antiotic (zisanachitike komanso zitasinthidwa).

Kutsitsa magazi.
Kuchepa kwa mulingo wa potaziyamu m'magazi, zomwe zimaphatikizapo kusunga mchere ndi zamadzimadzi m'maselo a thupi.
Chiwopsezo cha kufupika kwa minofu ya muubongo.
Kuperewera kwa calcium.

Mavuto a shuga ndi Opaleshoni

Chimodzi mwazinthu zovuta kwambiri za matenda a shuga nephropathy. Mkhalidwe wamtunduwu umatha kuletsa impso, kupangitsa kulumala kapena kufa kwa wodwala.

Opaleshoni isanachitike, odwala omwe ali ndi vuto la impso amapita m'njira zosiyanasiyana kuti akwaniritse ntchito yawo.

Zinthu zazikulu zamankhwala ndi izi:

Malangizo a metabolism yamafuta. Zimakwaniritsidwa kudzera mu mankhwala.
Njira zowongolera kagayidwe kazakudya. Udindo waukulu pamkhalidwewu umaperekedwa kwa insulin.
Zakudya, zomwe zimachepetsa chakudya cha nyama.
Limbani ndi aimpso matenda oopsa. Monga lamulo, kusankha kumapangidwa mokomera ACE inhibitors.

Chidziwitso cha kufalikira kwa postoperative mwa odwala omwe ali ndi matenda opatsirana a shuga ndikuti, kuphatikiza pazovuta zambiri, zochitika zina za matenda zimatha kuchitika.

Kwa gulu loyamba zikuphatikizira zotupa m'mapapu, zochitika za purulent mu malo opangira opaleshoni, zolakwika zazikulu mu ntchito ya mtima, kupanga mapangidwe amwazi, etc.

Hyperglycemic chikomokere. Mkhalidwe wofananawo ungakhalepo ngati wodwalayo amadziwa za matenda ashuga, koma sanadziwitse dokotala. Kapena, pamene kulowereraku kosauzekaku kunachitika mopitilira muyeso, ndipo wodwalayo analibe nthawi yoyesa magazi ndi mkodzo wa glucose. Zomwe zikuwunikirazi zimabweretsa kuphwanya kwamchere wamchere, komanso kuwonjezeka kwambiri kwa matupi a ketone. Izi zimasokoneza kugwira ntchito kwa ubongo.
Hypoglycemic chikomokere. Ndi chifukwa chobweretsa mitundu yayikulu ya insulin pakalibe chithandizo cha shuga. Komanso, izi zimatha kukhazikika pomwe wodwala amachotsedwa mu hyperglycemic coma popanda kuwongolera shuga. Zizindikiro zina za hypoglycemic ndimakomoka, kukomoka mwadzidzidzi, ana opukusika, komanso kutsika kwa magazi. Kudya zakudya zotsekemera kumakonza bwino vutoli. Kuperewera kwa njira zochizira zokwanira kungayambitse kukulitsa kwa stroko, myocardial infarction, komanso kungayambitse kulephera kwa mtima.
Hyperosmolar chikomokere. Nthawi zambiri amapezeka mwa anthu okalamba onenepa. Zizindikiro zake ngati kutentha thupi, kugunda kwamtima kosagwirizana, kuchepa mphamvu, kusuntha kwamaso kosasunthika. Imfa pa zomwe zimaganiziridwa kuti ndizowopsa ndizambiri - 40-50%. Zomwe zimachitika nthawi zambiri zimatupa muubongo, thromboembolism, komanso mantha a hypovolemic.

Matenda a shuga obwera pambuyo pochita opaleshoni komanso kupewa mavuto

Kukhazikitsidwa kwa insulin. Kuyenderana pakati pakukhazikitsa kwa mankhwala omwe afotokozedwawo, ndipo mlingo wake udzatsimikiziridwa ndi mulingo wa shuga m'magazi. Muzochitika zosowa kwambiri pamene kuyezetsa magazi pambuyo pakuchita opaleshoni kumatsimikizira kuchuluka kwa shuga, insulin imaperekedwabe, koma m'malo ochepa. Pafupifupi, sabata pambuyo pa opareshoni, ndi mawonekedwe a mawonekedwe, wodwalayo amapatsidwa mlingo wa insulin yomwe anali nayo asanachitidwe opareshoni.
Kuyesa kwamikodzo tsiku lililonse mu labotale ya kukhalapo kwa acetone mmenemo. Madokotala ena amalangizidwa kuti azitsatila pafupipafupi.
Magazi amawongolera. Tsiku loyamba atachitidwa opaleshoni, njirayi imabwerezedwa maola onse awiri, ndiye - katatu patsiku kwa masiku 5.
5% shuga kulowa kulowetsedwa ndi mankhwala ena.

Nthawi zina, opareshoniyo atadwala, wodwalayo ayenera kusintha chakudya chokhazikika. Kupeza mavitamini ndi michere yonse yofunikira kumathandiza kuti muchepetse shuga.

Tsitsani