Momwe mungachiritsire matenda otupa mwendo mu shuga

Tikukupemphani kuti muwerenge nkhaniyi pamutuwu: "momwe mungachiritsire matenda otupa mumiyendo" ndi ndemanga zochokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Wotupa mwendo ndi matenda ashuga: choti achite, zomwe zimayambitsa kutupa

Matenda a shuga amayambitsa mavuto chifukwa cha matenda omwe amapezekapo kapena osakwanira kulipidwa. Ma neuropathy ofala kwambiri am'munsi.

Njira yotsogolera yopanga matenda a shuga a polyneuropathy ndi kuvulala kwa khoma lamitsempha yokhala ndi glucose okwera. Kuchepa kwa magazi ndi kufooka kwa kapangidwe kazitsulo zamitsempha kumayambitsa mapangidwe a phazi la matenda ashuga.

Chizindikiro chimodzi cha neuropathy ndichotupa cha m'munsi. Matenda a dongosolo la mitsempha sindiye chifukwa chokha chomwe chimakhalira madandaulo a odwala kuti mwendo wotsika umadzaza ndi shuga.

Kutupa pamiyendo kumachitika pamene maselo ndi malo a interellular adzaza madzi. Miyendo, monga mbali zotsikira za thupi, imakumana ndi katundu wambiri pamalo owongoka.

Kutupa kwa miyendo ndi miyendo kumadalira onse pakuchulukana kwamadzi m'thupi, komanso kuvomerezeka kwa makoma am'mimba, ntchito ya venous and lymphatic system.

Kutupa mwendo mu matenda ashuga kumatha kukhala ndi madigiri angapo owopsa:

• Mapazi olimbirana ndi mbali yakumunsi ya mwendo wotsika: mukapanikiza pakhungu la kumbuyo kwa mwendo wapansi, kutsata pang'ono kumakhalako, komanso kuchokera ku zotanuka pamasokosi.
• Kutupa kwakanthawi kumatha kukhala mbali imodzi kapena pamiyendo yonse iwiri m'chigawo cha ankolo, kulumikizana.
• Kutupa kwa mwendo wapansi kufikira mulingo wa bondo. Tikapanikizika kwa nthawi yayitali, kutsekemera kwakuya kumatsalira. Kutupa kumatha kukhala pamiyendo yonse iwiri kapena umodzi wokha.
• Trophic matenda a pakhungu kumbuyo maziko a edema. Ziphuphu zomwe zimakulirakulira zimakutidwa ndi ming'alu, zomwe zimayamba kukhala mabala ndi zilonda zosachiritsa.

Ndikukhazikika kwakanthawi, ndikuwonjezera mphamvu kwa thupi, edema yomwe ili m'munsi mwa mwendo wotsika imatha kuwonekeranso madzulo, yolumikizidwa ndi kuthamanga kwa hydrostatic pamatumbo ndikutsitsa kwamitsempha. Edema yotere imadutsa palokha popanda chithandizo.

Mapazi amatupa kwa odwala matenda a shuga omwe ali ndi vuto la mtima, kuwonongeka kwa impso, ziwalo zam'mimba komanso zamitsempha, komanso kuwonetsa kwa arthropathy kapena njira yotupa yotupa.

Kusokonezeka kwa kulowetsedwa ndi matenda a khoma la mtima kumayendera limodzi ndi matenda ashuga a polyneuropathy. Kutupa nthawi zambiri kumatchulidwa ndikupanga mtundu wina wa ischemic.

Mchitidwewo umapitilira ndikuwonongeka kwa makoma amitsempha yamagazi momwe mafuta ndi calcium zimayikidwa pazenera, cholesterol plaques amapanga lumen ya mitsempha. Kuchepetsa magazi otaya, ma stasis m'mitsempha amathandizira kukoka kwamkati pakhungu ndikupanga edema.

Ndi neuropathy, pamatha kutupika, kutchulidwa kambiri pamwendo umodzi. Khungu limazizira komanso louma. Odwala amadandaula za kupweteka poyenda, dzanzi, kuchepa mphamvu, kuwuma komanso kuwuma khungu, mawonekedwe aming'alu zidendene.

Pakapita patsogolo, zilonda zimapangika kumapazi kapena miyendo, zomwe sizichiritsa kwa nthawi yayitali

Zochita zamtima zamkati zomwe zimalephera kuzungulira zimakhala ndi zosiyana ndi izi:

1. Nthawi zambiri zimawoneka pa miyendo yonse iwiri.
2. Edema m'magawo oyamba ndi ofatsa, komanso kuwonongeka kovuta - wandiweyani, kufalikira mpaka mawondo.
3. Kutupa m'mawa kumachepera ndikuwonjezeka madzulo.

Symmetric edema m'mawa imatha kukhala chimodzi mwazizindikiro za matenda ashuga nephropathy. Kuphatikiza pa miyendo, manja ndi matope am'munsi amatha kutupa. Nthawi yomweyo, kutupa kwamaso kumamvekedwa kuposa ma shins. Kuwonongeka kwa impso mu matenda osokoneza bongo a shuga nthawi zambiri kumachitika motsutsana ndi kuthamanga kwa magazi.

Miyendo yomwe imadwala matenda a shuga imatha kutupa ndi mitsempha - mitsempha ya varicose ndi thrombophlebitis. Edema ndi unilateral kapena kutchulika mwendo umodzi, wolimbikira, wandiweyani. Limbitsani pambuyo pakuyima nthawi yayitali. Zotupa zambiri zotupa. Pambuyo kutenga yopingasa malo kuchepa.

Ndi matenda a lymphatic dongosolo, zotsatira za erysipelas, wandiweyani komanso wolimbikira edema amapangika, omwe samakhudzidwa ndi nthawi ya tsiku kapena kusintha kwa mawonekedwe amthupi. Kapangidwe ka "pilo" kumbuyo kwa phazi ndi kakhalidwe.

Matenda a diabetes a arthropathy amapezeka ndikutupa kwamchiuno kapena mafupa a bondo. Pankhaniyi, edema yakumalo, kokha m'dera lolumikizidwa molumikizana, imayendera limodzi ndi kusokonekera kwa kayendedwe ndi kupweteka poyenda.

Chifukwa chiyani miyendo imatupa ndi matenda ashuga komanso chochita?

Edema ndiko kudzikundikira kwa minyewa m'matumbo am'mimba chifukwa cha kupangika kwa pathological komwe kumakhudzana ndikuphwanya mulingo wamadzi amchere. Odwala omwe ali ndi matenda a shuga, madzimadzi amatha kukhala mthupi kwambiri, zomwe zimapangitsa kuti thupi lizitupa.

Edema imawonjezera mwayi wokhala ndi phazi la matenda ashuga, limachepetsa moyo komanso limabweretsa chisangalalo. Kutuluka kawirikawiri kumafuna chithandizo chokwanira komanso kupewa.

Musanayambe chithandizo, ndikofunikira kudziwa chifukwa chake miyendo imatupa ndi matenda ashuga, ndikuchotsa zomwe zimayambitsa izi.

Zomwe zimayambitsa edema mu shuga ndizambiri:

• neuropathy, yodziwika ndi matenda amitsempha yamitsempha,
• magazi osokonezeka m'miyendo chifukwa cha kulephera kwa mtima, matenda a mtima, vasospasm,
• mitsempha ya varicose yomwe imasokoneza njira yachilendo ya kayendedwe ka zamitsempha,
• atavala nsapato zolimba, zotikinyira ndi zotengera zamapazi,
• kusintha kwa kusintha kwa mahomoni, incl. pa mimba
• angiopathy, yodziwika ndi kuwonongeka kambiri m'matumbo a miyendo,
• Zakudya zopanda pake komanso zosakwanira, kugwiritsa ntchito zakudya zowonjezera, mchere ndi madzi ambiri,
• zosokoneza kagayidwe kachakudya, kusowa kwamchere wamchere,
• matenda a impso ndi msambo
• kunenepa kwambiri, kupsinjika, kusowa tulo, kuchepa mphamvu zolimbitsa thupi, ndi zina zambiri.

Nthawi zambiri, edema ya mwendo mu shuga mellitus imaphatikizira zomwe zimayambitsa, mwachitsanzo, kusokonezeka kwamafuta kukalowa m'magazi a mtima, ndi zina. Chifukwa chake mankhwala amakono samayang'ana puffness osati ngati matenda osiyana, koma monga chizindikiro chofala cha matenda ambiri.

Kuphatikiza apo, mu 40% ya milandu, edema mu odwala matenda ashuga amawoneka ngati pali kuphwanya magazi m'magawo otsika, mu 20% - chifukwa cha kukula kwa mitsempha. Pankhaniyi, kuperewera kwa zakudya m'thupi, nsapato zolimba, kusowa kwa mavitamini kudzakulitsa kwambiri mkhalidwe wa wodwalayo. Pankhaniyi, ndikofunikira kwambiri kutsitsa phazi pogwiritsa ntchito ma insoles apadera.

Dinani pa chithunzi pansipa kuti mudziwe zambiri zokhudzana ndi matenda a shuga ndikuwayitanitsa kuti atumize kunyumba kapena potumiza makalata.

Chifukwa chiyani edopathic mwendo edema ndiowopsa mu shuga?

Nthawi zina, edema sizimabweretsa vuto lalikulu kwa odwala matenda ashuga ndipo munthu amaziwona ngati zachilengedwe chifukwa cha matendawa.

Malingaliro awa ndi olakwika, chifukwa pakapita nthawi, kudzichepetsera mopitirira muyeso kumatha kubweretsa zotsatirapo zoopsa:

• magazi amayenda chifukwa chakufinya kwamitsempha yamagazi ndi madzi,
• Khungu la miyendo ikuonda,
• kwambiri kumawonjezera ngozi ya mitsempha yakuya,
• chotupa cham'mimba chikuwoneka pamiyendo,
• Chithandizo cha phazi la matenda ashuga sizimabweretsa zotsatira zabwino,
• mabala, zipsera, zilonda ndi zilonda zam'mano zimachiritsa matenda ashuga kwa nthawi yayitali.

Edema muzochitika zambiri ndi zomwe zimapangitsa kukula kwa phazi la matenda ashuga. Kuchulukana kosalekeza kwamadzi m'ziwalo zamiyendo kumatsutsa kukula kwa matenda oopsa, omwe pambuyo pake amapita gawo la gangrene.

Kutupa kwa miyendo ndi matenda a shuga: muyenera kuchita chiyani poyambira matenda?

Pochiza edema, ndikofunikira kuti musaphonye zizindikiro zoyambirira za matendawa, zomwe zikuwonetsa kwambiri mavuto amadzimadzi otuluka.

Zizindikiro zake zimaphatikizapo:

• Chisoni kumapazi uku kuyimirira.
• kulira, kulira, kupuma,
• "Matumbo osakhazikika"
• kufiyira kwamiyendo ndi kumapazi,
• kuchepa kwa tsitsi pamiyendo,
• mawonekedwe amadzimadzi amadzi ndi chimanga.

Ngati zala zanu zakumwa ndi matenda ashuga ndipo nsapato za tsiku ndi tsiku zinayamba kupukutira ndi kubweretsa kusasangalala, ndiye ichi ndichinso chizindikiro choyamba cha kutupa. Miyendo imatupa ndi matenda ashuga, muyenera kuchita kaye?

Ngati kutupa kukukayikira, chithandizo ndi kupewa ziyenera kuyambitsidwa nthawi yomweyo kuti muteteze matendawa.

Kukaona endocrinologist ndikofunikira kuti mudziwe zomwe zimayambitsa kusayenda kwa madzimadzi ndi miyendo m'miyendo ndikuwapatsa chithandizo chokwanira.

Atazindikira chomwe chimayambitsa kutupa, adokotala amupatseni mankhwala oyenera.

Pafupifupi nthawi zonse, kutupa kwa miyendo yokhala ndi matenda a shuga kumakhala kovuta ndipo kumachitika motere:

1. Matenda a shuga.
2. Chithandizo kapena kuthetsa kwamikodzo kwamkodzo.
3. Kupititsa patsogolo kwamtima.
4. Zakudya zopatsa thanzi, zolimbitsa thupi zolimbitsa thupi.
5. Kuthetsa zinthu zina zoyipa zomwe zimakwiyitsa edema (kusuta, kuvala nsapato zolakwika, kusuntha kochepa, etc.

The endocrinologist imapereka mankhwala omwe amasintha shuga wamagazi ndi kuthamanga kwa magazi, komanso okodzetsa - okodzetsa kuti achotse madzimadzi ambiri.

Ndi vuto la kuvutikira kwa mahomoni, mankhwala apadera olimbitsa ma hormone amachitika, ndipo opanikizana chifukwa cha analgesic amapatsidwa mankhwala ochepetsa ululu.

Kuti muchepetse kutupa, mutha kugwiritsa ntchito mafuta apamwamba kwambiri okhala ndi bulugamu kapena timbewu tonunkhira. Mafuta amapaka pakhungu la miyendo 1-2 kawiri pa tsiku.

Dinani pa chithunzi chomwe chili pansipa kuti mudziwe zambiri zokhudzana ndi zitsulo za shuga za shuga ndikuzilamula kuti ziziperekedwa kunyumba kapena makalata.

Pambuyo pochotsa edema yodwala, madokotala nthawi zambiri amapereka njira za physiotherapy, cholinga chake ndicho kukonza kayendedwe ka magazi m'miyendo. Njira ngati izi zimaphatikizira magnetotherapy, ma electrophoresis, mafunde a UHF komanso ngalande za m'mimba.

Yang'anani! Ngati muli ndi matenda ashuga, miyendo yotupa ndi kutupa kumawonekera, ndiye kutikita minofu kwa matenda ashuga kungachitike ngati njira yolepheretsa. Kusisita panthawi yovuta kwambiri kwa kutupa kungayambitse kuwonongeka kwa arterial thromboembolism - mkhalidwe womwe umakhala pachiwopsezo chachikulu cha kufa.

Kutupa kwa miyendo ndi matenda ashuga: chithandizo ndi njira zina

Nthawi zambiri, wowerengeka azitsamba odwala matenda ashuga amathandizira kuchotsa kufooka. Kusinthira kagayidwe kamchere wamadzi ndikuthandizira kuchoka kwa madzi kuchokera mthupi kumathandizira kusamba kuchokera ku wort ya St. John's, worck, hydrastis, komanso mbewu zina zilizonse.

Kuti mukonzekeretse kusamba muyenera kutenga 5-6 tbsp. supuni ya zitsamba ndikutsanulira 2 malita a madzi otentha. Nthawi ya kulowetsedwa ndi mphindi 20 mpaka 40. Pambuyo pa izi, muyenera kutsitsa miyendo yanu mosamala ndi beseni ndikuchiritsa ndikuwasunga komweko kwa theka la ola.

Pambuyo pa njirayi, miyendo imayenera kuyesedwa ndi thaulo popanda kutikisika ndikukhazikika.

Kumwa kuchokera ku zitsamba zamankhwala okhala ndi mphamvu yowonjezeranso kumathandizanso. Kuti mukonzekere, muyenera kutenga muzu wa ginseng, oats kapena masamba a primrose ndi brew, monga zikuwonekera phukusi. Tengani msuzi pafupipafupi 2-5 patsiku.

Njira ina yothandiza yotsutsana ndi edema: kusoka matumba a kukula kwamiyendo ku thonje ndi kutsanulira masamba owuma kapena atsopano. Masamba osanjika amayenera kumangika phazi komanso gawo lotsika la mwendo wotsika.

Mothandizidwa ndi masamba, miyendo imayamba kutuluka thukuta, kutulutsa madzi othamanga. Magawo amenewo amalimbikitsidwa kuti azibwerezedwa tsiku lililonse kwa masiku 5-7. Chonde dziwani kuti njirayi ili ndi contraindication: chizolowezi cha thrombosis, zilonda ndi mabala m'miyendo.

Pofunsa funso lothana ndi kutupira m'miyendo m'matenda a shuga, anthu ambiri amapeza upangiri woyipa womwe umalimbikitsa kugwiritsa ntchito okodzetsa.

Chifukwa chiyani izi sizoyenera? Chowonadi ndi chakuti kudya mosalamulira kwa okodzetsa kumangokhala kwakanthawi kochepa: mutamwa mapiritsi, chotupacho chimachepa, koma patapita maola ochepa chimabwezeretsa mwamphamvu kwambiri.

Izi ndichifukwa choti madzi amachotsedwa m'thupi “mokakamizidwa” ndipo dongosolo la mawonedwe silikugwira ntchito molondola. Kugwiritsa ntchito ma diuretics kosalekeza kumabweretsa kuti amasiya kuchita komanso kuvulaza impso ndi chiwindi.

Ndi matenda ashuga, miyendo yotupa, ndingatani kuti ndipewe kutupa?

Kupewa kwa edema mu odwala matenda ashuga ndi awa:

1. Kuvala masheya osakanikirana kapena matayala, kugwiritsa ntchito mabandeji opanikizika (ngati palibe zotsutsana).
2. Kusamalidwa koyenera tsiku lililonse kwa phazi la odwala matenda ashuga kunyumba, kugwiritsa ntchito zida zapadera za odwala matenda ashuga.
3. Kuphatikiza chakudya, chomwe ndi mchere wochepa komanso zakudya zosavuta zamafuta.
4. Kutsatira ndi boma la kumwa: kumwa malita 1-1,5 amadzi oyera tsiku lililonse, osamwa madzi usiku.
5. Masewera olimbitsa thupi ndikukhalitsa kwambiri ntchito yamagalimoto.
6. Pewani kutentha kwambiri ndi kuphwanya mapazi.
7. Kwambiri kulipira matenda ashuga komanso kuchiza matenda oyanjana.
8. Gwiritsani ntchito nsapato zomasuka komanso zokulira ndi matenda a shuga.

Werengani zambiri za miyendo ya matenda am'mimba m'nkhaniyi.

Pofuna kuti musafoole mwendo ndi matenda a shuga, muyenera kusamalira mwapadera magalimoto. Ngakhale zinthu zing'onozing'ono zolimbitsa thupi zimachepetsa chiopsezo chokhala ndi edema nthawi ziwiri.

Mukamayenda, muyenera kutsitsa kwathunthu phazi lanu, kugwiritsa ntchito ma insoles apadera. Kutsatira malingaliro opewera komanso kugwiritsa ntchito zinthu zonse za phazi la matenda ashuga, mutha kuchepetsa kwambiri kufalikira kwa malekezowo ndikupewa mawonekedwe ake.

Malo athu ogulitsira omwe ali pa intaneti ali ndi mankhwala othandiza kwambiri komanso amakono a matenda ashuga. Timapereka ku Russia konse ndi otumiza kunyumba kwanu, kumalo operekera malamulo ndi makalata. Dinani pa chithunzi pansipa ndikupeza zina.

Nkhaniyi ikufotokoza momwe angachiritsire kutupa kwamiyendo mu shuga. Matendawa amatengedwa kuti ndi matenda oopsa omwe amabwera chifukwa chosowa ma hormone a insulin omwe amapangidwa ndi kapamba. Hulinonal insulin imatha kuyambitsa vuto m'thupi: ziwalo zamunthu ndi machitidwe.

Kuchepa kwa kagayidwe kakang'ono ka chakudya kumabweretsa kuchuluka kwa shuga m'magazi, ndipo minyewa ya minyewa singathenso kulimbana ndi kutulutsa shuga. Izi zimabweretsa kusokonezeka kwa kusinthana kwa madzi, mchere, mapuloteni ndi mafuta m'thupi. Kusintha kwakukulu kwa mahomoni ndi kagayidwe kachakudya kumalimbikitsidwa kuti zichitike ndikusowa kofunikira kwa chithandizo chamankhwala. Mavuto akulu amatuluka popanda chithandizo:

• vuto lisanafike
• myocardial infarction ndi mtima kulephera,
• kuwonongeka kwambiri kwa ziwiya zamaso,
• matenda a dongosolo laret.

Ndi matenda ashuga, mtima ndi mtima, ziwiya zam'mimba komanso ma capillaries zimakhudzidwa, akumadulidwa chifukwa cha kuwonongeka kwa shuga m'thupi. Kudukiza kwamitsempha yamagazi kuzungulira maso kumapangitsa khungu. Kugundika kwa mitsempha ya impso kumapangitsa kulephera kwa aimpso. Ngati mitsempha ya m'magazi ndi mitsempha yaubongo itatsekeka, vuto la mtima limakhazikika, zomwe zimapangitsa kukhala asanafike kumenyedwe.

Matenda a shuga amayambitsa zovuta kumadera akumunsi; edema yamiyendo imatha kuwonekera.Edema ya mwendo imawerengedwa kuti ndi chizindikiro choyamba chomwe chimayimira kuphwanya kayendedwe ka magazi, magwiridwe antchito amomwe amachitika m'mitsempha yam'munsi ya munthu yemwe ali ndi matenda ashuga.

Pali zifukwa zakugonjetsedwa kwakumapeto komanso kutupa kwamiyendo mwa anthu omwe ali ndi matenda ashuga:

• arthropathy, imayambitsa kuwonongeka kwa gawo la mwendo motsutsana ndi matenda a shuga,
• angiopathy, amakhudza mitsempha ya magazi,
• mitsempha, imabweretsa kuwonongeka kwa mathero a mitsempha mu shuga.

Zomwe zimayambira mu arthropathy ndikutupa kwa phazi komanso kufupika. Edema yodwala matenda a shuga imachitika ndimatenda osiyanasiyana, kuphatikiza matenda amtima komanso mtima wamatenda ogwirizana ndi matenda a shuga. Popanda chithandizo, edema yodwala mwendo yomwe imayambitsa matenda a shuga imatsogolera ku:

• kusintha kwa zala,
• kutulutsa.

Matenda amendo chifukwa cha matenda ashuga amatchedwa "phazi la matenda ashuga" mu mankhwala apano. Aliyense wopezeka ndi matenda a shuga amafunika kuwunika nthawi zonse ndi miyendo. Tsatani ma syndromes omwe atchulidwa:

• kupweteka miyendo,
• kutupa kwa mwendo umodzi,
• dzanzi la miyendo
• Kuchepa kwa miyendo,
• kukhuthala, kuyika khungu pakapazi,
• pafupipafupi mafoni
• kusintha kwa misomali ndi kapangidwe ka phazi.

Kuti wodwala matenda ashuga azindikire kutukusira kwa mwendo, ndikokwanira kuthina kukakamiza ndi chala phala kumalimba. Ndi edema yokhala m'munsi, koma osati chotupa, mawonekedwe amapezeka m'derali. Iyenera kutha pambuyo pa masekondi makumi awiri kapena atatu. Pofuna kuchiza edema ya mwendo mu shuga, muyenera kupangana ndi dokotala.

Chithandizo cha kutupa kwa miyendo, monga matenda ashuga, chimafunikira njira yophatikizira yomwe ikuphatikiza:

• mgwirizano wapakati pa wodwala ndi adotolo,
• mankhwala
• chakudya ndi zakudya,
• kukhala ndi thupi lathanzi komanso labwino.

Mukazindikira kutupa kwa mwendo, muyenera kupanga nthawi yoonana ndi dokotala wothandizirana ndi ziwiya komanso endocrinologist. Madokotala amayesa thupi, kudziwa kuchuluka kwa kuwonongeka kwa phazi, kupereka mankhwala ndi chithandizo chofunikira. Wodwalayo amalandila malangizo omwe angathandize kusamalira bwino miyendo yakumunsi, ngati kuli kotheka, ogwira ntchito zachipatala azigwiritsa ntchito miyendo ndi ukhondo, pogwiritsa ntchito mitundu yosiyanasiyana ya mafuta othandizira kapena kudula chimanga.

Mu shuga ndi edema, tikulimbikitsidwa kuti madokotala azibwereza njira yodziwira mwendo kamodzi pachaka. Mulingo wambiri wothandizira komanso kulandira chithandizo ndi:

• kuyezetsa thupi ndi kuyesedwa,
• kumvetsera kwa kugunda kwamiyendo
• kupimidwa kwa ma cell a mbali iliyonse yam'munsi,
• Reflex mayeso a mitsempha ya bondo,
• kuwongolera mitundu yosiyanasiyana ya chiwopsezo,
• ENMG (elektroniki neural myography).

Kupewa kwa kutupa kwa miyendo yonse ya odwala matenda ashuga

Kupenda miyendo ya munthu wodwala matenda a shuga kumakhala kosavuta, koma mfundo zofunika, kutsatira malamulowo, pali mwayi wabwino wopewa kukula kwa matenda oopsa. Popewa edema yam'mapazi yolumikizana ndi zizindikiro zina za matendawa, anthu amapewa kuwonongeka. Kupewera kwa edema ya miyendo ndi izi:

1. Kuyang'ana mwendo mwatsatanetsatane mwendo, momwe chidwi chachikulu chimafunikira kuperekedwa ku phazi, lokhalo, malo pakati pa zala,
2. Njira zaukhondo za tsiku ndi tsiku zomwe zimaphatikizapo kusambitsa mapazi. Kusamba kumachitika ndi sopo wosalowerera m'madzi ozizira. Kenako ndikulimbikitsidwa kupukuta miyendo ndi mayendedwe osalala ndi thaulo lofewa lopangidwa ndi nsalu zachilengedwe. Zida zopanga matenda a shuga zikulimbikitsidwa kuti ziziyikidwa pambali.

Chithandizo ndi chisamaliro chakumapeto kwa munthu wodwala matenda ashuga

Chithandizo cha matenda ashuga ndi chisamaliro cha kumapazi:

• Kuchotsa cuticle kumisomali ndi fayilo ya msomali ndi forceps. Mchitidwewu umathetsa mwayi woti mulandire mitundu ingapo ya microtrauma,
• Kugwiritsa ntchito mafuta odzola kumiyendo,
• Tikukonza madera ouma ndi pumice,
• Kuyang'ana nsapato tsiku ndi tsiku kuti pakhale mabampu, kubowoleza chinsalu, kugunda kwa mwala ndi zinthu zakunja zomwe zimatha kupukusa kapena kusiya kuvulala pakhungu la phazi,
• Kuvala nsapato zapamwamba
• Kuimbira foni dokotala ngati zizindikiro za bowa zikuwoneka: kuyipa, kufiyira, kutentha,
• Kusunthika kwa malekezero akumunsi pogwiritsa ntchito mafuta ofunikira,
• Kukhazikitsidwa kwa masewera olimbitsa thupi ochita masewera olimbitsa thupi,
• Kusungabe kupumula komanso kudya, zomwe zimapangidwa kuti muchepetse kugwiritsa ntchito shuga ndi zakudya zomwe zimaphatikizira mtundu wazomwe zimaphatikizidwa.

Kumbukirani, kulandira chithandizo chokha mothandizidwa ndi mankhwala sikungapindule kwambiri kwa wodwala yemwe ali ndi matenda ashuga kuposa momwe amathandizira komanso pazonse. Zakudya zamagulu olimbitsa thupi ndikuchita masewera olimbitsa thupi ndi ambuye panthawi yoyenera osazengereza kudzathandiza wodwalayo kuiwala kutupa kwamiyendo ndi matenda a shuga, kukonza makina am'mimba, kupulumutsa maselo omwe amadalira insulin ndikupanga zowonongeka.

Edema ndi kudziunjikira kowonjezera kwamadzi mu ziwalo kapena m'malo ophatikizika. Zifukwa zake komanso zamomwe zimachitikira zimatha kukhala zosiyana. Mu shuga mellitus, chizindikiro ichi chiri m'malo 2nd pambuyo pa SDS. Chifukwa chiyani miyendo imatupa ndi matenda ashuga? Shuga mellitus - wodziwika ndi hyperglycemia wolimbikira, ndipo izi nthawi zonse zimabweretsa kuphwanya makhoma amitsempha yamagazi. Shuga amangochotsa khoma, zimapangitsa kuti magazi azikhala mwamphamvu komanso kuti mawu ake asamachepe.

Madzi amadzimadzi a m'magazi amayesedwa opanda kanthu kuti atuluke kuchokera ku ziwiya kulowa m'malo ophatikizana. Madzi a m'magazi pano amakhala ndi madziwo. Malinga ndi malamulo a sayansi ya kapangidwe ka zinthu, mafuta amadzimadzi amakhala ziwiya zotalikirana kwambiri ndi mtima - izi ndiye zotengera zamiyendo. Poyerekeza ndi izi, chakudya komanso kupezeka kwa okosijeni m'maselo a minyewa ndi ziwalo zomwe zimakulirakulira ndikuwonekeranso. Zonsezi zimakula ngati chipale chofewa. Edema nthawi zonse amafunikira kupita kwa adotolo ndikupeza zifukwa zake. Kugawanika kwa edema - wamba komanso wamba. Edema mu matenda a shuga amellitus nthawi zambiri amakhala mdera lanu. Mu matenda a shuga, ziwiya zama caliber zonse zimavutika, ndimatenda a 1 mtundu, ma capillaries ambiri amakhudzidwa ndikukula kwa microangiopathies. Ndi matenda a shuga a 2, mitsempha yayikulu ndi mitsempha imakhudzidwa ndipo macroangiopathy amakula.

Koma zotulukapo za edema iliyonse yosakhudzidwa ndizovuta kwambiri. Zowonongeka zamitsempha yamagazi zimawonetsedwa m'lingaliro lakuti pamapeto pake ma lumen awo amangophikidwa. Ngati zakhudza maso, pali kuchepa kwa masomphenya mpaka khungu, ndi kuwonongeka kwa impso - nephropathy imayamba ndi kulephera kwa impso, kuwonongeka kwa ziwiya zam'mimba kumayambitsa MI ndi stroko. Mu 90% ya milandu, ziwiya zamiyendo zimakhudzidwa ndikukula kwa SDS.

Ngati miyendo yatupa ndi matenda ashuga, chizindikirocho ndikuphwanya magazi ndi magazi. Chala, phazi kapena mwendo wotsika zimatha kutupa. Chizindikiro sichimapanga kusiyana pakati pa amuna ndi akazi. Kulephera kumakhudza thupi lonse. Wodwalanso samakhala wosasangalatsa kwambiri: samatha kuyenda momasuka chifukwa cha ululu, sangathe kuvala nsapato zokhazikika, kuyimirira ndi mapazi ake, kugona bodza. Ngati miyendo yatupa, kugona nthawi zambiri kumasokonezeka.

Popeza mutachotsa nsapato zotere ngakhale mutayenda kwa ola limodzi kapena mutayimirira, mungathe kuwona mawonekedwe onse pakhungu la kumapazi.

Kuperewera kwa mankhwalawa kumabweretsa kuti ndi edema yakuya yamitsempha yamimba imayamba. Zizindikiro zoterezi zimatha kuwonetsa mapangidwe ake: edema imakhala yosalala ndi mwendo umodzi umakhala wokulirapo, kutupira m'mawa kulibe, ndipo imakhalapo masana, khungu la miyendo limakhala lofiyira, kumverera kosasangalatsa m'miyendo, mukamayima kupweteka kumapazi ndi ng'ombe. Zovuta zina za edema zimaphatikizanso kusintha kwa ma trophic. Zomwe zimayambitsa edema ziyenera kufufuzidwa ndikutengedwa. Popanda kudziwa zifukwa zake, munthu sangathe kutisita miyendo, mwachitsanzo. Ngati ndi thrombosis, chovala chamwazi chimatha ndipo chimangokhala m'mitsempha yofunikira ya ziwalo zofunika ndikufa. Mwachitsanzo, TELA.

Zizindikiro ziyenera kukhala tcheru: kuwotchera, kupsinjika, kuthinana kumapazi, kusintha kwa malekezero - amakula kapena kufupikitsa, zala ndikuzungulira, kuwonekera kwa miyendo kumatsika ndikufinya, chidwi chamiyendo chimachepa, nthawi zambiri matuza pakhungu, khungu kumiyendo limatambalala komanso kunyezimira mosadziwika bwino . Kuti muwonetsetse kukhalapo kwa edema, ingolinani chala pakhungu. Ndi edema, mafomu a fossa, omwe samawongola masekondi angapo.

Kuphatikiza pa redness ndi kupweteka m'miyendo, dazi la miyendo limapezeka, malo owoneka ndi ming'alu kumapazi samachiritsa kwa nthawi yayitali. Ndi mtundu 2 wa shuga, nkhope, manja ndi m'mimba zimatupa kuwonjezera.

Onetsetsani kuti mwayesa kusanthula mwatsatanetsatane ndi khosi, kukonza nthawi kuti muchepetse fossa, dokotala wamatsenga amayang'ana mitundu yonse yamatenda amtundu wa khungu. Ma neuromyography amagetsi amatha kutumikiridwa.

Ndikofunika kukumbukira kuti kutupa kwamiyendo ndi matenda a shuga amtundu uliwonse sikudzangokhala kwawokha ndipo simuyenera kudikirira kuti igwe. Chifukwa chake, kutupa m'miyendo m'matenda a shuga - zoyenera kuchita, kulandira chithandizo kumayenera kukhala kokwanira komanso sikumangomwa mapiritsi okha, komanso kutsatira zakudya zama carb zotsika, kusiya kusuta ndi kumwa, etc.

Ndi hyperglycemia, monga chifukwa, cholinga chake ndikuchepetsa ndi kusintha shuga m'magazi. Zomwe zimayambitsa edema ziyenera kuthetsedwa kaye. Edema ya miyendo ndi matenda a shuga: shuga amatha kusintha mtundu wake ndi insulin yoyamba, komanso mapiritsi awiri okhala ndi PSSP. Ngati chifukwa chagona kuvala nsapato zolakwika, muyenera kusintha kuti ikhale yambiri komanso yosalala, gwiritsani ntchito insoles zapadera kuti muchepetse katundu pamapazi.

Pa nthawi yobereka, chotupa sichitha kuchotsedwa ndipo mankhwalawa sanalembedwe. Chithandizo choyenera chitha kusankhidwa ndi katswiri. Lemberani mankhwala omwe amasintha magazi, amalimbitsa makhoma amitsempha yamagazi ndikuchepetsa shuga. Chowonjezera ichi ndicho chakudya chopanda mchere, kutsatira kayendedwe ka madzi, ndikuchepetsa zochitika zolimbitsa thupi. Kutupa mwadongosolo komanso koopsa kumafuna kuikidwa kwa okodzetsa. Koma ali ndi zoyipa: amachotsa zinthu zofunikira zazing'ono komanso zazikulu kuchokera mthupi. Zodabwitsazi sizabwino ndipo zimakhudza momwe wodwalayo alili.

Ngati zomwe zikuyambitsa ndi CCH, zomwe nthawi zambiri zimagwirizanitsidwa ndi matenda ashuga (mtima wodwala), kugwiritsa ntchito njira kukonza mtima.

1. ACE inhibitors (angiotensin-akatembenuza enzyme) - amathandiza kuchepetsa kuthamanga kwa magazi. Awa ndi Captopril, Blockordil, Amprilan, Enalopril, Lisinopril.
2. Angiotensin II receptor blockers - adayikidwa ngati ACE inhibitors sioyenera. Zochita zawo zimakhala zofanana kwambiri. Valsartan amadziwika kwambiri. Ndi matenda a shuga a 2, Zentiva, Diovan amakhazikikanso.
3. Ma diuretics ndi Veroshpiron otchuka kwambiri ndi Furosemide. Ndi anuria, exicosis ndi kusowa kwa sodium - ndizosatheka kuchitira ndi okodzetsa.
4. Kusintha ndi kusintha mkhalidwe, mavitamini ndi zakudya zowonjezera zimayikidwa.

Chithandizo cha Zizindikiro: kupweteka kwa neuropathic - Ketorolac, Ketorol, etc. Pa gawo loyambirira la mankhwala a insulin, edema imatha kuwoneka, koma imadutsa yokha. Zizindikiro za zotupa zotere ndizowonongeka kwakumaso, kutupa pankhope, perineum, manja. Osadzipatsa nokha diuretics nokha, chifukwa edema ikhoza kuchepera, koma kenako ibwerera m'njira yotchulika. Mafuta osakhudzidwa amayendetsedwa ndi mphamvu ndipo impso sizikuyenda bwino. Kudya pafupipafupi kwa okodzetsa kumapangitsa kuti impso sizimawayankha ndipo ma diuretics amawononga impso ndi chiwindi.

Ngati palibe ma contraindication, ndikofunikira kuvala masheya amtundu kapena matayala. Kusamalira mapazi kuyenera kukhala mwambo watsiku ndi tsiku momwe mkhalidwe wamapazi ndi chithandizo cha mapazi ndi njira zovomerezeka zimayang'aniridwa.

Zakudya zochepa zamchere ndi zosavuta zosavuta, osamwa madzi usiku, koma kumwa pafupifupi 1.5 malita a madzi oyera masana, osatopa kwambiri komanso osapsa kwambiri mapazi, zolimbitsa thupi zolimbitsa thupi ziyenera kukhala zolimbitsa thupi tsiku lililonse, masewera olimbitsa thupi ndi miyendo, nsapato zabwino komanso odwala matenda a shuga atsegula ma insoles, nthawi zonse amadutsa mkodzo ndi magazi. Ngakhale zinthu zing'onozing'ono zolimbitsa thupi - kuyenda, kuyenda njinga - kuchepetsa chiopsezo chotupa ndi theka. Muyenera kuyenda osachepera 3 km patsiku ndikuyenda koyenera. Masewera olimbitsa thupi amathandizira kuyendetsa magazi ndi kamvekedwe kazinthu zazing'ono zimawonjezeka. Amagwira ntchito mwachangu komansoabalalitsa chinyezi chambiri. Ndikofunika kusiya kusuta, kuthetsa nkhawa, kuthana ndi matenda opatsirana munthawi yake.

Matenda a shuga amayamba chifukwa cha kusintha kwa dongosolo la endocrine.

Zikondazo zimayamba kutulutsa mahomoni kwambiri.

Insulin ikhoza kuyambitsa mavuto a kukonzanso shuga.

Zotsatira zake, kuchuluka kwa shuga m'magazi kumakwera. Vutoli limakhudza ulusi wamitsempha, mitsempha yamagazi. Nthawi zambiri kutuluka kwa m'mimba kumasokonezedwa, kutupa kwamiyendo kumachitika mu shuga mellitus. Pazomwe mungachite kuti muchepetse kusokonezeka kochokera kumadera akumunsi ogwiritsa ntchito mankhwala ndi mankhwala achikhalidwe, nkhaniyi ikutero.

Maonekedwe a edema kumadera otsika amachititsidwa ndi zinthu zambiri.

Zomwe zimayambitsa kutupa kwa mwendo mu shuga:

Monga mukuwonera, nthawi zina, munthu payekha ayenera kukhala wolakwa, chifukwa amakhala ndi moyo wosayenera.

Makalata ochokera kwa Owerenga

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwapa mavuto atuluka pamiyendo ndi ziwalo zamkati.

Mwangozi ndidapeza nkhani pa intaneti yomwe idapulumutsa moyo wanga. Zinali zovuta kuti ndione chizunzo, ndipo fungo loipa m'chipindacho linali kundiyambitsa misala.

Kupyolela pa zamankhwala, agogo aja adasinthanso momwe akumvera. Ananenanso kuti miyendo yake sikupweteka komanso zilonda zake sizinayende; sabata yamawa tidzapita ku ofesi ya dotolo. Falitsa ulalo wa nkhaniyo

Monga ma pathologies onse, kutupira kwa m'munsi kumakhala ndi zizindikiro.

Tilembapo zizindikiro zoyambira:

• munthu ataimirira, akumva kuwonongeka m'miyendo yake,
• pamakhala kupendekera kosakhazikika, kumanjenjemera, kumva kulira,
• miyendo yosakhazikika imayamba
• Mapazi ofiira, maondo
• Tsitsi lamiyendo likuchepera
• chimanga, matuza amadzi,
• phazi siligwirizana ndi nsapato,
• zala zanga zimasowa
• nsapato zachikale zimayamba kupukuta.

Kuti mudziwe zomwe zimayambitsa vuto ndi kutuluka kwamadzi, muyenera kupita kwa dokotala kuti mukamufufuze.

Ngati miyendo yatupa pafupipafupi, wodwalayo amafunikira chithandizo. Thanzi la anthu otere limatha kukhala pachiwopsezo chachikulu. Pakakhala madzi ambiri m'malo ophatikizana, mphamvu ya khungu imawonongeka. Zilonda zakuya zimachitika ndi zovuta zowawa. Popeza odwala matenda ashuga ngakhale ochepa mabala amachiritsa kwa nthawi yayitali, mwayi wokhala ndi matendawa komanso kuwonjezereka umakula.

Momwe mungasungire shuga kukhala wabwinobwino mu 2019

Ngati matenda ashuga samalandiridwa ndipo miyendo yatupa, magazi amawonekera m'mitsempha nthawi yayitali.

Mutha kuwazindikira potsatira izi:

• Kutupa pamiyendo ndikusiyana,
• m'mawa munthu akumva bwino, pafupi ndi madzulo pali kutupa,
• Khungu m'miyendo yanga limasanduka lofiira
• kusasangalala kumamveka
• munthu akaimirira, miyendo yake imapweteka.

Ngati thrombosis ichitika, kutikita minofu ndikosavomerezeka. Njira zomwe sizimathandizira pakuchotsa kufooka zimayambitsa zovuta. Thromboembolism imatha kukulira ndi zovuta zingapo pamphuno. Izi zakupha.

Kanikizani chala pamalo akhungu. Ndi izi, kupsinjika pang'ono kumawonekera, komwe kumachotsedwa pakatha masekondi 20-30. Matendawa ndi osiyana ndi chotupa.

Diagnostics imachitika ndi endocrinologist ndi dokotala wodziwa bwino za mitsempha yamagazi. Akatswiri amadziwa mtundu wa zotupa za miyendo, mankhwala ndi njira yoyendetsera.

Tilembapo njira zingapo zodziwira matenda:

• kugunda kwamiyendo kumveka
• zida za ultrasound zimagwiritsidwa ntchito,
• mawonekedwe a m'magazi amagolo amayendera,
• mulingo wa kufalikira kwa minofu wotsimikiza,
• electroneuromyography.

Odwala amalandira malangizo angapo othandizira kukonza chisamaliro choyenera cha phazi. Ngati ndi kotheka, mankhwala aukhondo ndi antiseptic, mafuta amachitika. Kuchotsa chimanga kumachitika.

Pambuyo pakuzindikira, akatswiri amadziwa njira yoyenera yothandizira.

Kuphatikiza mankhwala kumaphatikizapo kugwiritsa ntchito njira izi:

Timapereka kuchotsera kwa owerenga tsamba lathu!

• kuchuluka kwa shuga m'magazi,
• kuthetsa mavuto ndi kwamikodzo,
• kulimbitsa magazi,
• Zakudya, masewera,
• kuchotsedwa kwa zinthu zosiyanasiyana zoyambitsa edema.

Ngati wodwalayo atsatira malingaliro onse a dokotala, ndiye kuti edema yokhala m'munsi yopita kumadera ikatha mofulumira.

Endocrinologist amakupatsirani mankhwala omwe amakupatsani kusintha shuga, kuthamanga kwa magazi.

Izi zikuphatikiza:

• Zodzikongoletsera.
• Zodzikongoletsera
• Hormone m`malo mankhwala amachitika pamene kuchuluka kwa mahomoni ena amasintha.
• Ma analgesics amagwiritsidwa ntchito kuti athetse ululu.
• Mafuta okometsera komanso mafuta abwino amathandizira kuchepetsa kutupa. Pakani ndalama zotere kamodzi kapena kawiri pa tsiku.

Pambuyo pochotsa puffiness pachimake, akatswiri nthawi zambiri amachita physiotherapy yomwe cholinga chake ndi kukhazikika kwa magazi m'miyendo:

• Electrophoresis
• Chithandizo cha UHF chamakono
• Mitsempha yam'mimba
• maginotherapy.

Kusisita kumachitika popewa matenda ashuga okha. Ngati kutupa ndikulimba, thromboembolism imatha kuchitika pakapita nthawi yayitali. Vutoli limakulitsa mwayi wamwalira.

Mankhwala achikhalidwe ndi gawo limodzi la chithandizo chokwanira cha kutupa kwa mwendo mu shuga. Pazomwe mungagwiritse matenda a mwendo mu shuga mellitus pogwiritsa ntchito wowerengeka azitsamba, zalembedwa m'mutu uno.

Kuti khazikitse kagayidwe kamchere wamadzi ndikuthandizira kuchotsa madzi, malo osambira ndi zitsamba zamankhwala amatengedwa:

Malangizo pokonzekera kusamba kotero:

1. Mtsuko momwe mapazi anu amathira kunjenjemera, kuwonjezera supuni 6 za zosakaniza zouma, kutsanulira malita 2 a madzi otentha, zimatenga mphindi 40 kuti zipere.
2. Pambuyo pake, mutha kupangira mapazi anu m'madzi otero kwa mphindi 30.
3. Kenako miyendoyo imapukutidwa pang'ono. Ndikofunikira kugona pansi kwa mphindi 20-30.

Pali njira zina zochotsekera mwendo mu shuga:

• Zojambula za mbewu za fulakesi. Zosakaniza zimaphika kwa mphindi 15 pa kutentha pang'ono. Kenako madziwo amathiridwa kwa pafupifupi maola atatu, kutsukidwa, kumamwetsedwa katatu patsiku, mamililita 100 kwa masiku 5.
• Ndondomeko. Onjezerani 1 makilogalamu amchere ku ndowa, chipwirikiti. Tawulo amayenera kunyowa ndi madzi oterowo, kenako nkuikulungika ndi kukulunga kumbuyo kumbuyo, gwiritsani pafupifupi mphindi ziwiri. Muyenera kuchita kubwereza 10-15. Njirayi ikuthandizira kupweteka kwamiyendo.
• Kudya zakudya zowonjezera madzi. Itha kukhala mavwende, anyezi, dzungu, udzu winawake, parsley, etc.

Ndi edema, mutha kuchita kutikita kosavuta komwe kumalimbikitsa magazi. Kuti muchite izi, muyenera kusakaniza mankhwala.

• mafuta a castor
• dzira losaphika
• turpentine ofunda.

Izi zimagwiritsidwa ntchito popukutira miyendo. Kutikita minofu kumachitika kwa mphindi 10-15. Pambuyo pake, valani masokosi okwera mawondo, masokosi a thonje, muyenera kugona pansi kwa theka la ola. Ndondomeko amathandizira kusintha kufalikira kwa zamimba, kuchotsa madzi ambiri. Ndi mtima thrombosis, miyendo sangathe kutetezedwa.

Pofuna kuthana ndi kutupa kwa mwendo mu shuga, mutha kugwiritsa ntchito tincture ndi tsabola wa cayenne. Capsaicin, yomwe ndi gawo la mankhwalawa, imalimbikitsa kuchira, magazi. Tincture wakonzedwa mkati 2 milungu. Amamwa pakamwa kwa sabata limodzi, supuni imodzi tsiku lililonse.

Popewa kutupa m'miyendo mu matenda a shuga a 2, malingaliro ena ayenera kutsatiridwa.

Izi zikuphatikiza:

• Wunikani bwino, sonyezani zizindikiro.
• Tsiku lililonse, sambitsani mapazi anu, samalani khungu lanu ndi moisturizer.
• Tsiku lililonse kuyang'ana miyendo, miyendo. Matenda, zipsera, mabala ayenera kuzindikirika munthawi yake.
• Ndikofunikira kudula misomali, yomwe imakanikizidwa pang'onopang'ono pakhungu, ndikuyambitsa kutupa.
• Pewani kuoneka kwa bowa mwa njira zoyenera.

Powona zizindikiro zilizonse, ndikofunikira kukaonana ndi dokotala.

Kupewa kwa edema kumachitika molumikizana ndi malingaliro aukhondo aumunthu:

• Muyenera kuvala nsapato zokulirapo zingapo. Kwa odwala matenda ashuga, ma insoles apadera amapangidwa.
• Kuphatikizika kwapanikizika sikulola kutupa kukula.
• Kuchokera muzakudya muyenera kupatula zakudya zomwe zili ndi mchere wambiri komanso mchere.
• Muyenera kumwa malita 1.5-2 patsiku. Kumwa madzi asanagone ndikosayenera.
• Kuchita masewera olimbitsa thupi moyenera kumathandizira kusintha kagayidwe kachakudya.
• Osatulutsa mapazi anu kuzizirira kwambiri kapena kutentha kwambiri.
• Kupanga kwamtundu wa matenda osachiritsika ndi matenda a shuga kumachitika.

Tsopano aliyense awerenge momwe angathandizire kutupa ndi matenda a shuga molondola.

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

A Alexander Myasnikov mu Disembala 2018 adapereka chidziwitso chokhudza chithandizo cha matenda ashuga. Werengani kwathunthu

1. 
   Udovichenko, O.V. Matenda a shuga. Maupangiri a madokotala / O.V. Udovichenko. - M: Mankhwala othandiza, 2016. - 253 p.
2. 
   Kogan-Yasny V.M. Matenda a shuga, State akufalitsa nyumba ya mabuku azachipatala - M., 2011. - 302 p.
3. 
   Evsyukova I.I., Kosheleva N.G. Matenda a shuga. Mimba komanso akhanda, Miklosh - M., 2013 .-- 272 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwazaka 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.