Matenda a shuga komanso matenda a m'matumbo

Matenda a matenda ashuga ndi maselo omwe amapezeka wodwala akakhala ndi matenda ashuga. Amadziwika ndi kuwonongeka kooneka (mpaka khungu).

Choyambitsa matendawa chimatha kukhala kusintha kwokhudzana ndi zaka mu metabolism ya zida zamagetsi.

Zambiri

Matenda a shuga ndi zovuta za kusintha kwa ma pathological mu mandala omwe amapezeka motsutsana ndi maziko a vuto la carbohydrate metabolism mwa odwala matenda a shuga. Malinga ndi ziwerengero, matenda amapezeka mu 16,8% ya odwala omwe ali ndi vuto la glucose. Mwa anthu azaka zopitilira 40, kusowa thukuta kumatha kuwona m'mutu 80%. Mu kapangidwe kake ka kuchuluka kwa matenda amtundu wa chifuwa, mawonekedwe a matenda ashuga amachititsa 6%, chaka chilichonse amakhala ndi chizolowezi chowonjezera izi. Mtundu wachiwiri wa matenda a shuga umatsatiridwa ndi kuwonongeka kwa lens 37.8% pafupipafupi kuposa woyamba. Mwa akazi, matendawa amapezeka kawiri kawiri kuposa amuna.

Chochitika chotsogola kwambiri cha matenda a shuga a m'magazi ndi kuwonjezeka kwa shuga wamagazi amtundu 1 ndi matenda ashuga a 2. Ndi matenda a shuga omwe amadalira insulin, chithunzi cha matendawa chimapezeka ali aang'ono kwambiri, izi zimachitika chifukwa cha kuchepa kwa matenda a hyperglycemia chifukwa chakusowa kwathunthu kapena wachibale. Mu shuga osadalira insulin, kuyanjana kwa maselo ndi mahomoni kumasokonekera, kusintha kotereku kumadziwika kwambiri kwa odwala azaka zapakati.

Chiwopsezo chotenga matenda amkati mwachindunji chimadalira pa "chidziwitso" cha matenda ashuga. Wodwalayo akamadwala matenda a shuga, amatha kuchuluka kwa maginidwe a mandala. Kusintha kwina kuchokera piritsi la pakamwa la mankhwala a hypoglycemic kupita ku insulin ya subcutaneous makonzedwe kungakhale kochititsa komwe kumayambitsa masinthidwe amtundu wa pathological. Tisaiwale kuti kuperekera ndalama kwakanthawi kogwiritsa ntchito kagayidwe kazakudya, zovuta zoterezi zitha kupewedwa.

Zimatsimikiziridwa kuti ndikuwonjezereka kwa kuchuluka kwa shuga mumagazi kumatsimikizika pakupanga nthabwala yamadzi. Ndi kuwonongeka kwa matenda ashuga, njira ya glycolytic yopita kukakoka dextrose imasokonekera. Izi zimabweretsa kutembenukira kwake ku sorbitol. Mowa wa hexatomic sulephera kulowa m'mimba, omwe umayambitsa kupsinjika kwa osmotic. Ngati kuwerengera kwa glucose kupitirira zonena kwa nthawi yayitali, sorbitol imadziunjikira mu mandala, zomwe zimapangitsa kuchepa kwa kuwonekera kwake.

Ndi kuchulukana kwambiri kwa acetone ndi dextrose m'maso a mandala, chidwi cha mapuloteni kuti kuwala kumawonjezereka. Photochemical zimachitika underlie wamba chipwirikiti. Kuwonjezeka kwa kupanikizika kwa osmotic kumatsogolera ku hydration yambiri ndikuthandizira kukulitsa edema. Metabolic acidosis imathandizira kutsegula kwa michere ya proteinolytic yomwe imayambitsa mapuloteni denaturation. Udindo wofunikira mu pathogenesis umaperekedwa ku edema ndi kuwonongeka kwa machitidwe a ciliary. Pankhaniyi, ma trophic lens amasokonezeka kwambiri.

Gulu

Mothandizidwa ndi matenda a shuga, mtundu wa matenda ashuga nthawi zambiri umagawidwa koyambirira, kusakhwima, kukhwima komanso kuphuka. Mtundu wopitirira amatchulidwanso kuti "mkaka". Pali mitundu yoyambira ndi yachiwiri (yovuta). Zosintha zopezeka mu kapisozi ndi mandala zimayang'aniridwa ngati vuto la metabolic. Pali mitundu iwiri yayikulu yamatenda:

Zowona Kukula kwa matenda am'mimba kumachitika chifukwa chophwanya mwachindunji kagayidwe kazakudya. Mtundu wowona umatha kuonedwa ali mwana. Mavuto azidziwitso osiyanasiyana amapezeka mwa anthu patatha zaka 60 ali ndi mbiri ya matenda ashuga.
Senile. Kusintha kwa ma mandala kumachitika mwa okalamba omwe ali ndi mbiri yodwala matenda a shuga. Matendawa amadziwika ndi njira ziwiri komanso chizolowezi chopita patsogolo mwachangu.

Zizindikiro za matenda ashuga a Cataract

Zizindikiro zamatenda zimatengera gawo la matendawa. Ndi chilonda choyambirira cha matenda ashuga, mawonekedwe owoneka sawonongeka. Odwala amafotokoza bwino masinthidwe akamagwira ntchito pafupi. Izi zimachitika chifukwa cha myopization ndipo ndi chizindikiro cha pathognomonic cha matenda. Ndi kuwonjezeka kwa kuchuluka kwa manjenje, odwala amadandaula za kuwonekera kwa "ntchentche" kapena "mfundo" pamaso pawo, diplopia. Hypersensitivity kuwala kumadziwika. Pali malingaliro akuti zinthu zozungulira zimawonedwa kudzera mu fayilo yachikasu. Mukayang'ana magwero owala, utawaleza umawonekera.

Ndi mawonekedwe okhwima, maonekedwe acuity amachepetsa mpaka kuwunikira. Odwala amasiya kuwona, chomwe chimapangitsa kuti malo azikhala pang'ono. Nthawi zambiri, achibale amawona kusintha kwa mwana wa wodwalayo. Izi ndichifukwa choti mandala a kristalo amawoneka kudzera mu kuwala kwa ma formen a ana, mtundu wake womwe umakhala woyera kwambiri. Kugwiritsa ntchito kukonza zowonera sikukwanira kwathunthu pakuwonongeka kowoneka. Maso onse amakhudzidwa, koma kuopsa kwa zizindikiro kudzanja lamanzere ndi kosiyana.

Mavuto

Zotsatira zoyipa zomwe zimachitika chifukwa cha matenda ashuga zimayambitsidwa osati chifukwa cha kusintha kwa ma cell mu ma lens monga kusokonezeka kwa metabolic mu matenda ashuga. Odwala ali pachiwopsezo chotenga matenda a shuga a retinopathy okhala ndi macular edema. M'matope okhwima, laser phacoemulsization imagwirizanitsidwa ndi kuthekera kwakukulu kwa chotumphukira cha posterior kapisozi. Nthawi zambiri pamakhala kuwonjezeredwa kwa zovuta za postoperative yotupa mu mawonekedwe a keratoconjunctivitis ndi endophthalmitis.

Zizindikiro

Kuyesa kwa wodwala wodwala matenda a shuga ayenera kukhala okwanira. Kuphatikiza pa gawo lakunja kwa maso, kumayesedwa mwatsatanetsatane kwa retinal kumachitika, chifukwa mu shuga mumakhala chiopsezo chambiri cha kuwonongeka kwakanthawi kwamaso. Onetsetsani kuti mukumayesa mayeso a labotale monga kuyezetsa magazi kwa glycated hemoglobin, kuyeserera kwa glucose komanso kutsimikiza mtima kwa shuga. Mwambiri, kufunsira kwa ophthalmologist kumaphatikizapo njira zotsatirazi zothandiza kuzindikira:

Kuphunzira ntchito zowoneka. Mukamapangira ma visometry, kuchepa kwa ma visual acuity mtunda kumapezeka. Mukamagwira ntchito mtunda wa 30-40 cm, palibe chovuta. Kusintha kwa Presbyopic kumadutsa ndi zaka, nthawi yomweyo, matendawa amatsogolera kusintha kwakanthawi kochepa pakuwona.
Kufufuza ndi maso. Pa biomicroscopy, mfundo ndi ma skacitive opacities amawonetsedwa omwe amapezeka muzithunzi zapamwamba za makatiriji anterior ndi a posterior. Pafupipafupi pakuwunika, mumatha kuzindikira zolakwika zazing'ono zomwe zimatulutsidwa mozama mu stroma.
Retinoscopy Kupita patsogolo kwa matendawa kumayambitsa kupangika kwa mtundu wa myopic wa kukonzanso kwamankhwala. Retinoscopy ikhoza m'malo mwa skioscopy pogwiritsa ntchito olamulira a psychoscopic. Kuphatikiza apo, Reflexometry yamakompyuta imachitika.
Kuwerenga mwachangu. Ophthalmoscopy ndichizolowezi kuchitira ophthalmology. Phunziroli limapangidwa kupatula kuwonongeka kwa diabetesic retinopathy ndi kuwonongeka kwa mitsempha ya optic. Pankhani yamatelo athunthu, ophthalmoscopy imakhala yovuta kwambiri chifukwa chakuchepa kwa kuwonekera kwa kuwala kwa media.
Kuyesa kwa UltrasoundUltrasound ya diso (A-scan) imakuthandizani kuti muyeze kukula kwa anteroposterior a eyeball (PZR) kuti mudziwe zomwe zimapangitsa myopization. M'matope a matenda ashuga, PZR ndiyachilendo, ndimawonekedwe osalala, mandala amakulitsidwa.

Matenda a shuga a Matendawa

Pozindikira kusintha koyambirira, cholinga cha mankhwalawa ndikwaniritsa zomwe glucose amavomereza ndikuthandizira odwala matenda ashuga. Matenda a kagayidwe kazakudya umatheka ndi chakudya, kugwiritsa ntchito mankhwala a antihyperglycemic and jakisoni wa insulin. Kukhazikitsidwa kwakanthawi kwamankhwala othandizira kumapangitsa kuti zikhale zowoneka bwino pazokhudzana ndi chitukuko cha ng'ala, kuonetsetsa kuti zikuphatikizidwa pang'ono kapena kwathunthu. Pokhwima, kukula kwa shuga m'magazi kulinso kofunikira, komabe, ndizosatheka kukwaniritsa kubwezeretsa pang'ono pang'ono kwa mandala ndikuwonekera kwambiri.

Pofuna kupewa kupitirira kwa matenda, kukhazikitsa kwa riboflavin, ascorbic ndi nicotinic acid ndi mankhwala. Ndi mawonekedwe osakhwima, mankhwala ozikidwa pa cytochrome-C, omwe amaphatikizidwa ndimchere ndi mavitamini, amagwiritsidwa ntchito. Kugwiritsa ntchito bwino kwa mankhwala othandizirana ophthalmic omwe ali ndi chigawo chogwira ntchito, chomwe ndi chopangidwa chomwe chimalepheretsa oxidation wa sulfhydryl radicals a mapuloteni osungunuka omwe amapanga maselo a hexagonal, akutsimikiziridwa.

Chithandizo cha opaleshoni chimaphatikizapo kuchotsa michere ya lens (ultrasound phacoemulsization) yotsatiridwa ndi kukhazikitsidwa kwa lens ya intraocular (IOL) mu kapisozi. Opaleshoni imachitidwa ndi vuto lowoneka bwino. Ndikofunika kuchotsa matenda oyambitsidwa koyambirira ngati kupezeka kwawo kumapangitsa kuti pakhale zovuta kuchita opareshoni ya vitreoretinal kapena laser coagulation ya membrane wamkati mu diabetesic retinopathy.

Zotsogola ndi kupewa

Zotsatira zimatsimikiziridwa ndi gawo la matenda a shuga. Ngati chithandizo cha panthawi yake matenda pamlingo woyamba wamadzimadzi, kuyambiranso kwawo kwathunthu ndikotheka. Ndi makatoni okhwima, ntchito zotayika zimatha kubwezeretsedwanso pokhapokha ngati pakuchitika opareshoni. Kupeweratu mwachindunji sikukula. Njira zopanda chitetezo zotere zimatsata kuwunika kwamagazi a magazi, kutsatira zakudya zapadera, ndikuwunikidwa koyesa maso kamodzi pachaka ndi kuvomerezedwa kwa biomicroscopy ndi ophthalmoscopy.

Mitundu ndi zoyambitsa

Diso ndi chida chamalingaliro chopangidwa ndi zinthu zambiri zofunika, chimodzi mwazomwe ndi mandala. Ndi kusefukira kwake, makamaka, matenda am'mimba a shuga, kupenyerera kwatsika kumachepa, mpaka khungu.

Hyperglycemia wolimba (shuga yayikulu) imakwiyitsa mitundu iwiri yamatumbo:

matenda a shuga a shuga - amachitika chifukwa cha kusintha kwa kagayidwe kachakudya m'diso ndi ma micostruct ake. Magalasi ndi gawo la diso la insulin. Ngati shuga wambiri amalowa m'maso ndi magazi, ndiye kuti amasinthidwa kukhala fructose, omwe maselo amatenga popanda kugwiritsa ntchito insulin (pancreatic hormone). Kuchita kwanyengo imeneyi kumakwiyitsa kaphatikizidwe ka sorbitol, mowa wa atomu zisanu ndi imodzi (chinthu chapakatikati cha kusintha kwa chakudya cham'mimba). Mwazotheka, kutaya kwake sikumvulaza, koma hyperglycemia imakweza kuchuluka kwake. Chifukwa cha kuphatikizika kwa mankhwalawa, kupsinjika mkati mwa maselo kumakwera, kuphatikizika kwa metabolic ndi ma microcirculation kusokonezeka, chifukwa, ma ndala amadzaza.
zokhudzana ndi zaka-cataract- zimachitika chifukwa cha kusokonezeka kwakanthawi kochepa komwe kumayang'aniridwa ndi misempha yokhudzana ndi zaka. Matendawa amapezekanso mwa anthu athanzi, koma odwala matenda ashuga amakula msanga.

Zizindikiro

Zizindikiro za mandala opacity pamagawo osiyanasiyana:

choyambirira - ma microcirculation amasokonezeka pokhapokha pamagawo a receptor a mandala, masomphenyawo sawonongeka. Ndizotheka kudziwa zosintha pokhapokha ngati mukupimidwa maso,
mwana - akutsegulira pakatikati pa mandala. Pakadali pano, wodwala akuwona kale kuchepa kwa masomphenya,
okhwima - mandala ndi mitambo, imakhala milky kapena imvi. Zizindikiro zakuwonetsa - kuyambira 0.1 mpaka 0,2,
overripe - mandala ulusi umasokonekera, ndipo wodwalayo amasiya kuwona.

Izi matenda am'mimba komanso matenda a shuga makamaka kumayambiriro koyambirira amawonekera ndi diplopia (masomphenya awiri), chophimba pamaso, kulephera kupenda zambiri. Kuphatikiza apo, pali zovuta zamaganizidwe amtundu, kuthetheka kumawoneka m'maso.

Mu magawo apambuyo a chiphunzitso, wodwalayo amachepetsa kwambiri, ma epithelium amachoka, ndipo ulusi wake umasokonekera, umakhala mkaka kapena imvi. Wodwala samasiyanitsa pakati pazinthu, amangokhala ndi mawonekedwe amtundu.

Njira zochizira

Ndiosavuta kuzindikira matenda am'mbuyomu omwe ali ndi matenda ashuga, chinthu chachikulu ndikuwona dokotala zizindikiro zoyambirira zikaonekera. Matendawa amatha kuchiritsidwa ndi opareshoni. Mankhwala amatha kuchedwetsa kuyambitsidwa kwa matenda amkati.

Akupanga phacoemulsification ndiye njira yotchuka kwambiri komanso yothandiza yodwala matenda amishuga. Panthawi ya njirayi, mandala amtambo amaloledwa ndi mandala okumba. Dokotalayo amapanga chinsalu chaching'ono (3 mm.) Pamaso, kafukufuku wapaderalo amaikiramo chipinda cham'mwamba, chomwe chimaphwanya mandala omwe ali ndi mitambo. Kenako tinthu tating'ono timachotsa m'diso.

Dokotala amakhazikitsa lens yapadera yosankhidwa m'malo mwa mandala achotsedwa. Wodwala amawona kusintha mkati mwa maola atatu atatha opaleshoni. Pambuyo pa maola 48, kubwezeretsa kwathunthu kwamawonedwe kumachitika.

Kuphatikiza pa kuwerenga za matenda amtundu wa matenda ashuga, mutha kukhala ndi chidwi chakuwerenga za matenda amtundu wa nyukiliya kapena ma catara.

Matenda a shuga

Munthu wodwala matendawa amatha kudwala matenda oyamba chifukwa chophwanya kagayidwe kazakudya, komanso senile (senile).

Matenda a matenda ashuga amagawidwa kukhala oyamba, osakhwima, okhwima, ochulukirachulukira. Mlingo wokhwima umapangitsa kusankha njira zamankhwala opangira opaleshoni ndi matendawo. Mu matenda ashuga, mphaka zimaganiziridwa kuti zimakula mwachangu.

Matenda a shuga a Cataract Frequency

Kafukufuku akuwonetsa kuti 30% ya odwala omwe akhala ndi matenda ashuga kwa zaka zoposa 10 ali ndi matenda amkati. Ndi matenda atatha zaka 30, pafupipafupi amakula mpaka 90%. Ndizofunikira kudziwa kuti mwa azimayi, amphaka amkati amayamba kuchuluka kawiri kuposa amuna.

Mwa odwala omwe ali ndi zaka zopitilira 40 omwe akudwala matenda a shuga, ndimatenda amapezeka 80% ya milandu. Chiwopsezo cha kupsinjika kwa ma lens mu matenda ashuga chikuwonjezeka kwa zaka zambiri, komanso ndi kusakwanira koteteza matenda a glucose komanso matenda a shuga a retinopathy.

Njira zakukula kwa matenda a shuga

Cataract mu matenda a shuga samakula chifukwa cha shuga owonjezera m'magulu a mandala, chifukwa cha izi muyenera kupha anthu asanu peresenti. Komabe, pali mgwirizano wolunjika pakati pa kuchuluka kwa ma lens opacity ndi kuchuluka kwa shuga mumunyontho wa chipinda chamaso chamaso.

Kukula kochulukira kwa shuga mu chinyontho cha chipinda chamkati mu shuga yopanda tanthauzo kumayambitsa kutsekeka kwa njira ya glycolytic ya assimilation komanso kusintha kwa sorbitol. Kutembenuka kwa glucose kukhala sorbitol kumayambitsa ma galactose amkati, chifukwa michere ya sorbitol ndiyosavomerezeka. Kudzikundikira kwa sorbitol mu mandala kumabweretsa chitukuko cha zowona zamatenda a matenda ashuga.

Ndi zovuta za endocrine, kuwonongeka mwachindunji kwa ulusi wa lens ndikothekanso. Kuchuluka kwa glucose kumapangitsa kuchepa kwa kuvomerezeka kwa kapisozi ya mandala, kuphwanya kagayidwe kazakomweko komanso kufalitsidwa kwa chinyezi. Zotsatira zake, njira zama metabolic ndi kufalikira kwa mandala zimasokonekera, zomwe zimayambitsa mitambo. Mu shuga mellitus, edema ndi kusokonekera kwa epithelium ya njira zamankhwala amadziwikanso, zomwe zimabweretsa kuwonongeka kwa kuperewera kwa mandala.

Zomwe zimayambitsa zingakhalenso ndi matenda ashuga. Ndi acidity yafupika, michere ya proteinolytic imayendetsedwa, yomwe ingalimbikitse chisokonezo.Matenda a shuga amakhudzanso ma hydrate a mandala, chifukwa kuthamanga kwa osmotic m'madzi a minofu kumachepa.

Pali lingaliro la Photochemical la chitukuko cha matenda amtundu wa shuga. Zimatengera kuti kuchuluka kwa shuga ndi ma acetone m'malonda kumawonjezera chidwi cha mapuloteni kuti awalikire, omwe amachititsa kuti mitambo isamayende bwino. Pathogenesis yeniyeni ya matenda ashuga samamvetseka kwathunthu, koma chilichonse mwazinthu izi chimakhala ndi zake zake.

Chithunzi cha matenda a matenda ashuga

Pamaso zigawo, mfundo kapena mawonekedwe amtundu wa oyera amatuluka. Katemera wa subcapsular amatha kupanga zonse pansi komanso kolimba mu kotekisi. Kuphatikiza apo, mipata yamadzi imapangidwira mu kotekisi. Nthawi zina munthu wodwala matenda ashuga amakhala ndi zisonyezo zonse zosavuta: mtundu wosakongola, maliseche, kugwetsa mphiri pakati pa mandala.

Ngati kagayidwe kazakudya kamapangika pakapita nthawi, matenda oyambitsidwa ndi matenda ashuga amatha milungu iwiri. Popanda chithandizo, maimidwe ofiira amkati amawonekera mtsogolo, mandala amakhala amtambo chimodzimodzi.

Senile cataract mu shuga amakula ali aang'ono, amakhudza maso ndi kukhwima mwachangu. Zoopsa za nyukiliya za brown komanso kusintha kwakukulu pakukonzanso ku myopia nthawi zambiri zimapezeka, ngakhale zili zowoneka bwino, zosakanikirana ndi zowonekera pambuyo pake.

Zosintha pamagalasi a shuga nthawi zonse zimaphatikizidwa ndi dystrophy ya iris. Mwa odwala ambiri, zovuta za microcirculation zimadziwikanso.

Chithandizo cha Conservative

Ngati misempha ya shuga imasinthidwa munthawi yake, sizotheka kungochedwetsa kuyambitsidwa kwa matenda amkati, komanso kuti mukwaniritse kapena kuyambiranso pang'ono pang'onopang'ono. Pamaso pa kusokonezeka kwakukulu, kuwunikira komanso kuchedwa pakukula kwa matendawa ndizokayikitsa.

Mankhwala othandizira odwala matenda a shuga omwe amayamba msanga ndi kuwonongeka kwakukulu kwa kagayidwe kazakudya kamakhala ndi zakudya, makonzedwe amkamwa kapena jakisoni wa insulin. Odwala omwe ali ndi matenda a senile cataract, omwe amangovutika pang'ono m'maso m'maso ndi myopia, ndikokwanira kulipiritsa matenda a shuga ndikugwiritsa ntchito madontho a maso pafupipafupi. Kusakaniza kotchuka kwambiri kwa riboflavin (0.002 g), ascorbic acid (0,02 g) ndi nicotinic acid (0.003 g) mu 10 ml ya madzi osungunuka.

Madontho a Cataract:

Vita-Yodurol. Mankhwala okhala ndi mavitamini komanso mchere wamankhwala, womwe umapangidwira matenda amtundu wa nyukiliya komanso cortical. Amakhala ndi calcium chloride dihydrate, magnesium chloride hexahydrate, nikotini acid ndi adenosine. Mankhwala a Chloride amasintha zakudya za mandala, pamene asidi ndi adenosine amatulutsa kagayidwe.
Oftan Katahrom. Akutsikira ndi cytochrome C, adenosine ndi nicotinamide. Chifukwa cha izi, mankhwalawa ali ndi antioxidant komanso zakudya zopatsa thanzi. Kuphatikiza pa zovuta zamkati, Oftan Katahrom ndiwothandiza pakuwunikira kosakhudzika komanso kosachiritsika pamtunda wakunja kwa diso.
Quinax. Zomwe zimapangidwa ndi mankhwalawa zimalepheretsa makutidwe a oxidation aulere. Chosakaniza chophatikizacho ndi sodium azapentacene polysulfonate. Imachepetsa zovuta m'mapuloteni a mandala ndikulimbikitsa ma enzymes a proteinyl.

M'magawo amtsogolo a matenda am'kati, chithandizo chamankhwala sichitha. Pankhani ya kuwonongeka kwa mawonekedwe, chithandizo chamankhwala othandizira amathandizidwa ngakhale atakhala kuti ndi okhwima.

Mankhwala othandizira

Phacoemulsization ndi kukhazikitsidwa kwa mandala a intraocular ndikugwiritsa ntchito kusankha kwa matenda amtundu wa matenda ashuga. Magala a intraocular amatchedwa mandala okumba. Ndi chithandizo chake, zolakwika zotsimikizira (myopia, hyperopia, astigmatism) zitha kukonzedwanso.

Malo abwino opangira opaleshoni ndiyachivuto choyambirira kapena chosakhazikika, pomwe malingaliro kuchokera ku fundus amasungidwa. Milandu yokhwima komanso yowonjezereka imafunikira mphamvu yowonjezera ya ultrasound, motero, katundu wambiri pamaso amaso. Mu matenda a shuga, minyewa ya m'maso ndi mitsempha ya m'magazi ndi yofooka kwambiri, kotero kukulitsa katundu sikofunika. Komanso, ndi chimbale chokhwima, ma kapisulo apamwamba amayamba kufooka ndipo minyewa ya zinc imafooka. Izi zimawonjezera chiopsezo chakupsinjika kwa kapisozi nthawi ya opaleshoni ndipo zimaphatikizira kupakidwa kwa mandala opaka.

Kuunika kogwira mtima

Asanachitidwe opaleshoni, wodwala ayenera kupeza chilolezo cha akatswiri, mano ndi otolaryngologist. Sankhani kupezeka kwa kachilombo ka HIV ndi hepatitis, onani kuchuluka kwa magazi ndikupanga electrocardiogram. Musanachotsere khungu, muyenera kupatula chilolezo cha endocrinologist.

Opaleshoni sikuchitidwa mwa kulephera kwambiri kwaimpso, ngakhale mutakhala kuti muli ndi vuto la khungu. Kutsutsana kwa ma prosthetics kumakhala kupangika kwa ma ndimu komanso kuphatikiza kwakukulu kwa vitreoretinal kuphatikizana ndi neovascularization ya iris.

Pa biomicroscopy, dokotala amayenera kuyang'anira chidwi cha iris, chifukwa chikuwonetsa momwe mtima wam'maso umayendera. Neovascularization ya iris ikhoza kukhala chizindikiro cha matenda ashuga a shuga.

Kusintha kumatha kusokoneza ophthalmoscopy. M'malo mwake, kujambulidwa kwa ultr B kumapangidwa komwe kumawonetsa mawonekedwe a maso. Kujambula kwa Ultrasound kumavumbula hemophthalmus, kufalikira kwa mphamvu, kuchuluka ndi kuchuluka kwa matumizidwe a vitreoretinal.

Kukonzekera opaleshoni

Pakupita masiku awiri ntchito isanachitike, tikulimbikitsidwa kukhazikitsa Tobrex, Phloxal kapena Oftaquix kanayi pa tsiku. Atangopanga opaleshoni, mankhwala oletsa mankhwalawa amakhazikika 5 pa ola limodzi.

Patsiku la opareshoni, kuchuluka kwa glycemia sikuyenera kupitirira 9 mmol / L. Mtundu wa shuga wa I, wodwala samadya chakudya cham'mawa kapena jakisoni wa insulin. Ngati atachitidwa opaleshoni mulingo wa insulin sudzapitilira, ndiye kuti siuperekedwa. Pazaka 13 ndi 16, kuchuluka kwa shuga kumatsimikizidwanso, wodwalayo amapatsidwa chakudya ndikusamutsidwa modabwitsa.

Mu mtundu II, mapiritsi nawonso adathetsedwa. Ngati kuchuluka kwa shuga pambuyo pakuchita opaleshoni kuli pansipa, wodwalayo amaloledwa kudya. Mkulu wa glucose akachuluka, chakudya choyamba chimayimiriridwa mpaka madzulo, ndipo shuga imabweranso ku zakudya zomwe zimachitika tsiku lililonse.

Pakupanga opaleshoni ndipo patapita kanthawi, msinkhu wa shuga ukhoza kuwonjezeka ndi 20-30%. Chifukwa chake, mwa odwala kwambiri, kuchuluka kwa shuga kumayang'aniridwa maola onse a 4-6 kwa masiku awiri atatha kulowererapo.

Zambiri za phacoemulsification mu shuga

Chithandizo chabwino kwambiri cha matenda ashuga a m'magazi ndi kupatsirana kwa dzuwa ndi kuphatikizira magalasi osinthika. Tiyenera kukumbukira kuti m'mitundu ya anthu odwala matenda ashuga, m'mimba mwake mumakhala kocheperako ndipo zimakhala zovuta kwambiri kukwaniritsa mydriasis.

Popeza odwala omwe ali ndi matenda ashuga nthawi zambiri amakhala ndi ziwiya zotsika komanso ma endothelium omwe ali pachiwopsezo cha cornea, kuchotsedwa kwa mandala kumachitika kudzera pakupyoza gawo lakelo. Kuboola matendawa ndi 2-3.2 mm zokha ndipo sikutanthauza kuti munthu akhale ndi shuga. Kuchotsa suture kuvulaza corneal epithelium, yomwe motsutsana kumbuyo kwa chitetezo chofooka m'thupi la odwala matenda ashuga imakhala yodzaza ndi keratitis ya bacteria komanso bacteria.

Ngati chithandizo cha laser chotsatira chikulimbikitsidwa kwa wodwala, ndikofunikira kugwiritsa ntchito magalasi okhala ndi mainchesi akulu a gawo la kuwala. Dokotala amayenera kugwiritsa ntchito zida mosamala, popeza kuti chiwopsezo cha kulowererapo kwa magazi a iris komanso magazi m'chipinda chamkati cha diso chikuchulukitsidwa.

Njira ya phacoemulsification imakupatsani mwayi wokhala ndi kamvekedwe ka diso, komwe kamachepetsa mwayi wa zovuta za hemorrhagic. Kuphatikizika kophatikizidwa, phacoemulsification imayamba kuchitidwa, kenako vitteromy ndikuyambitsa silicone kapena mpweya. Ma ndala a intraocular sangasokoneze kuwunika kwa fundus panthawi ya vitrectomy ndi Photocoagulation.

Mavuto obwera pambuyo pake

Odwala omwe ali ndi matenda ashuga amafunikira chisamaliro chowonjezereka pamlingo uliwonse wamankhwala ngakhale panthawi yopuma. Kutupa kungayambike masiku 4-7 atachitidwa opaleshoni, ndikufunika kuchipatala kwa wodwala. Pambuyo popanga opaleshoni yamatumbo, postoperative endophthalmitis imayamba.

Macular edema pambuyo phacoemulsification ndi zovuta kwambiri zovuta. Komabe, kafukufuku wina akuwonetsa kuti mwa anthu omwe ali ndi matenda ashuga atachitidwa opaleshoni, makulidwe a macula amatha kuwonjezeka ndi ma virus 20. Monga lamulo, edema imazimiririka kumapeto kwa sabata yoyamba, ndipo mwa ena okha omwe amakhala ndi mawonekedwe amtopola ndipo pambuyo pa miyezi itatu amakhala pabwino kwambiri la macular edema.

Katswiri wachiwiri wodwala matenda ashuga

Phacoemulsization ndi hydrophobic acrylic IOLs yachepetsa pafupipafupi nkhokwe zamkati. Cholinga chachikulu cha izi ndi kutsukidwa kosakwanira kwa kapisozi kuchokera m'maselo a mandala, omwe pambuyo pake amasinthanso ndikukhala mitambo kachiwiri. Kapangidwe ka ma IOL atsopano amalepheretsa kukula kwa maselo amitambo m'malo a kuwala.

Ndizachilendo kuti mwa anthu omwe ali ndi matenda ashuga, ma epithelium a lens amawonjezeranso mochepa, kotero, ma catarital apakati amawonedwa kawiri kuposa anthu athanzi. Komabe, ndi matenda ashuga a retinopathy, kutsika kwa kapisozi kotsala ndi 5% kokwanira. Pafupifupi, mavutidwe oyambitsidwa ndi odwala omwe ali ndi matenda ashuga amapezeka mu 2.5-5% ya milandu.

Matenda amtundu wa shuga amachitika pafupipafupi, koma mankhwala amakono amathandizira. Masiku ano, pafupifupi aliyense wodwala matenda ashuga amatha kukhalanso ndi malingaliro abwino osakhala ndi zotsatirapo zake.