Matenda a shuga Angiopathy

• Zowawa m'munsi
• Kutopa
• Kutupa kwa diso
• Chizungulire
• Kutentha m'miyendo
• Miyendo Yoyenda
• Kutukwana pamaso
• Kutsokomola
• Mwazi mu mkodzo
• Sputum ndi magazi
• Zamphuno
• Petechial zidzolo
• Kutaya kwamaso
• Amabala pamaso
• Miyendo yofooka
• Masomphenya otsika
• Zingwe
• Khungu lowuma
• Ming'alu kumapazi
• Zikopa za mkodzo

Matenda a diabetes angiopathy ndi njira ya pathological yomwe imapanikizika ndi matenda a shuga ndipo amadziwika chifukwa chakuti ziwiya zazing'ono zimakhudzidwa thupi lonse. Matendawa alibe zoletsa pazaka komanso jenda.

Kwenikweni, mtundu wovuta kwambiri wa matenda a shuga ungachitike ngati kulibe chithandizo chamankhwala. Malinga ndi ziwerengero, matendawa amawonekera pamlingo wina uliwonse mwa anthu onse omwe ali ndi matenda ashuga.

Chikhalidwe cha chithunzi cha matendawa chimadalira pomwe njira zamatenda zimapangidwira, mpaka kukula kwake. Diagnostics imaphatikizapo njira zogwiritsira ntchito zasayansi ndi othandizira.

Ponena za njira zochizira, palibe njira zofanana pano. Chithandizo chimatengera mtundu wa zotupa. Mwambiri, chithandizo chofunikira chofunikira ndicholinga chothana ndi zomwe zimayambitsa, i.e. shuga mellitus.

Ndikosavuta kulosera kwanthawi yayitali, chifukwa zonse zimatengera mtundu wa zomwe zimayambitsa ndikuvuta kwa matendawo.

Malinga ndi magulu apadziko lonse lapansi a matenda obwereza khumi, njirayi inali ndi tanthauzo losiyana. Khodi ya ICD-10 ndi E10-14.

Matenda a matenda ashuga amakula motsutsana ndi komwe kunayambira matenda ashuga. Mwakutero, glucose imatha kuwononga mayendedwe amkati a mtima. Izi ndi zomwe zimatsogolera kukonzanso magwiridwe antchito.

Popeza mu shuga mellitus kuchuluka kwa glucose m'magazi kumachulukitsa zikhalidwe zovomerezeka, kuchepa kwake kumalowa m'makoma a mitsempha yamagazi ndi sorbitol ndi fructose. Zinthu izi, monga glucose, sizimayendetsedwa bwino kudzera zimagwira ma cell, zomwe zimapangitsa kuti zikhale ndi maselo amtundu wa endothelial.

Zotsatira zake, izi zimachitika:

• kutsekeka kwa khoma la mtima kumawonjezera ndipo kutupa kwake kumayamba,
• njira zophatikizana zimayendetsedwa, zomwe zimabweretsa chiopsezo chowonjezereka cha thrombosis,
• kupanga kwampumulo kumachepetsedwa, komwe kumayambitsa kuwonongeka m'mitsempha yosalala ya makoma a chotengera.

Chifukwa chake, mapangidwe a Virchow triad amachitika - kuwonongeka kwa magazi, kuwonongeka kwa epithelium, kuchuluka kwa magazi.

Zodziwikiratu pakukonzekera matenda ashuga angiopathy:

• kusowa kwa chithandizo cha matenda ashuga,
• osagwirizana ndi zakudya zotchulidwa ndi adotolo,
• matenda a mtima
• chitetezo chofooka
• mbiri yamatenda oyenda.

Kuphatikiza apo, ziyenera kumvetsedwa kuti matenda oterewa amabweretsa kuwonongeka kwa ziwalo zina, zomwe zimatha kupha.

Gulu

Kutengera ndi kukula kwa chotengera chomwe chakhudzidwa, mitundu iwiri yamtunduwu imadziwika:

Kutengera momwe masanjidwe amakhudzidwira, matenda a m'magazi amagawidwa m'mabuku otsatirawa:

• retinal angiopathy m'maso onse kapena gawo limodzi la masomphenya (retinopathy),
• matenda a shuga a m'munsi malekezero,
• mtima angiopathy
• nephropathy - angiopathy a ziwiya impso,
• encephalopathy - kuwonongeka kwa ziwiya za bongo.

Dziwani kuti angiopathy ya maso imatha kuyambitsa kuwona kwathunthu, ndipo mwanjira imeneyi njira yachilengedweyo singasinthe.

Zizindikiro

Chithunzi cha matenda a shuga angiopathy adzakhazikitsidwa kutengera kutengeka kwa matendawa.

Chifukwa chake, matenda a shuga a retinal angiopathy adzadziwika ndi zizindikiro zotsatirazi:

• kutsika kwamawonedwe owoneka,
• mawanga, "ntchentche" pamaso,
• kutulutsa, kuwalira pamaso,
• kukhaulitsa m'maso.

Mwakutero, zizindikirazi zidzapita patsogolo mwachangu, ndipo pamapeto pake izi zidzatsogolera kutayika kwathunthu kwamawonedwe.

Zizindikiro zomwe zotupa za zotumphukira zimapezeka, Zizindikiro zake zimakhala ndi:

• khungu lowuma pamalo a phazi,
• kupweteka kwa m'miyendo, mwina mitsempha yovinidwa,
• petechiae (madontho ofiira ofiira) pakhungu,
• kuyabwa ndi moto m'miyendo,
• pakapita nthawi, ming'alu imakhazikika m'dera la phazi,
• kutopa, kufooka m'miyendo ngakhale mutakhala ndi thupi lalifupi.

Pang'onopang'ono, zilonda za trophic zimayamba kuwonekera m'dera la phazi. Ngati simuyamba kulandira chithandizo, izi zimatsogolera ku minofu necrosis, kenako matenda a gangore.

Kuphatikiza apo, Zizindikiro za izi:

• kutsokomola magazi
• pali magazi mkodzo, mapepala oyera,
• kufooka wamba, malaise,
• kuwonda
• pafupipafupi komanso zolemera mphuno
• chizungulire
• kugona
• kukokana
• kupweteka mumtima,
• kusokonezeka kwa mtima
• kuthamanga kwa magazi.

Kuphatikiza apo, chithunzi chonse cha chipatala chimatha kutsatiridwa ndi zizindikiro zenizeni zomwe zidzakhale zovuta zomwe zidatulukira motsutsana ndi maziko a matendawa.

Ndikofunikira kuonana ndi dokotala mukangoyamba kuonekeratu: kupeza chithandizo chamankhwala kwakanthawi kumawonjezera mwayi wochira kwathunthu.

Zizindikiro

Diagnostics imaphatikizapo njira zonse zasayansi ndi zothandizira.

Gawo lantchito yofufuzira ili ndi:

• kuyezetsa magazi mwatsatanetsatane komanso kwatsatanetsatane kwamagazi,
• kuyeserera kwa shuga
• Kutsimikiza kwa shuga m'magazi,
• kutsimikiza zotsalira urea,
• mayeso olowera kulowa mkati mwa glomerular,
• Kutsimikiza liwiro la GFR.

Kafukufuku wothandizira akuphatikiza:

• kuyang'anira
• Ultrasound
• ECG
• Doppler kusanthula zombo zam'munsi,
• angiography
• CT kapena MRI yaubongo.

Kuonana ndi a ophthalmologist, a mtima, opaleshoni ya mtima, ma psychologist adzafunika.

Kutengera zotsatira za njira zakuzindikira, mawonekedwe ndi kuuma kwa matendawa azitsimikiza, pamaziko omwe njira zamankhwala ochiritsira zosankhidwa zidzasankhidwire.

Chithandizo cha matenda amtundu uliwonse wa matenda ashuga chiyenera kuchitika pongotsatira kwa dokotala komanso mosamala pazofunikira zake. Mokulira, maphunziro othandizira ayenera kukhala ndi cholinga chothana ndi zomwe zimayambitsa matenda, ndiye kuti, chithandizo cha matenda ashuga.

Pharmacological gawo la mankhwalawa limaphatikizapo kumwa mankhwala otsatirawa:

• antispasmodics
• angioprotectors
• mankhwala kusintha kukoka kwam'mimba,
• antiplatelet agents
• nootropic
• kagayidwe kazakudya
• lipid-kuchepetsa mankhwala,
• aldose reductase zoletsa.

Kuphatikiza apo, okodzetsa, mankhwala osokoneza bongo, antihypertensives akhoza kukhazikitsidwa.

Kuthandizira opaleshoni sikumachotsedwa, ngati pali zilonda zam'mimba, minofu necrosis. Kuchiza ndi wowerengeka azitsamba pamilandu iyi sikothandiza, chifukwa sizimapereka chithandizo choyenera.

Zovuta zotheka

Ngati mankhwala sanayambike munthawi yake, ndiye kuti zotsatirazi zingayambike:

Pankhani yopewa, pankhani iyi, njira yokhayo yoyenera ndi chithandizo chokwanira cha matenda ashuga. Pamawonetsero oyamba a chithunzi chachipatala, chomwe chalongosoledwa pamwambapa, muyenera kufunsa chithandizo chamankhwala mwachangu.

Matenda amtundu wanji?

Diabetes angiopathy imadziwika ndi kuwonongeka kwa ziwiya zazing'ono komanso zazikulu ndi mitsempha. Khodi yamatenda a MBK 10 ndi E10.5 ndi E11.5. Monga lamulo, matenda am'magazi a shuga amadziwika, koma kuwonongeka kwa ziwalo zina zamthupi ndi ziwalo zamkati ndizothekanso. Ndichizolowezi kugawa mitundu ya matenda ashuga m'mitundu iwiri:

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.

• Microangiopathy. Amadziwika ndi kugonjetsedwa kwa capillaries.
• Macroangiopathy Zilonda zam'mimba ndi venous zimadziwika. Fomuyi siyachilendo, ndipo imakhudza anthu odwala matenda ashuga omwe akhala akudwala kwa zaka 10 kapena kuposerapo.

Nthawi zambiri, chifukwa cha matenda a shuga a shuga, kuchuluka kwa odwala kumakulirakulira komanso chiyembekezo cha moyo chimachepa.

Zomwe zimayambitsa matenda a shuga a shuga

Chifukwa chachikulu chomwe chitukuko cha matenda a shuga chimakhalira nthawi zambiri chimakweza shuga. Zotsatirazi zimadziwika zomwe zikutsogolera kukula kwa matenda ashuga angiopathy:

• yaitali hyperglycemia,
• kuchuluka kwa insulin m'madzi,
• pamaso pa insulin kukana,
• matenda ashuga nephropathy, pomwe aimpso kukanika kumachitika.

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Zowopsa

Si onse odwala matenda ashuga omwe ali ndi vuto lotere, pamakhala zovuta zomwe zimapangitsa chiwopsezo cha minofu kuwonongeka.

• Kutalika kwa shuga
• gulu lazaka zopitilira 50,
• njira yolakwika ya moyo
• kuperewera kwa zakudya m'thupi, kuphatikiza mafuta ndi nyama yokazinga,
• Kuchepetsa kagayidwe kachakudya,
• kunenepa kwambiri
• kuchuluka kwa miyendo,
• kumwa kwambiri mowa ndi ndudu,
• ochepa matenda oopsa
• kuchuluka kwa mtima,
• chibadwa.

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Zida zachivomerezo

Ndikosavuta kuneneratu za matenda ashuga a shuga. Nthawi zambiri angiopathy am'munsi amadziwika, popeza amadzaza ndi matenda ashuga. Koma zotupa, zowonongeka, zowononga zina za thupi zimatha. Ziwalo zomwe zikuyembekezeredwa zimasiyanitsidwa, zomwe nthawi zambiri kuposa zomwe anthu ena amadwala ndi angiopathy:

Zizindikiro zamatsenga

Kuthamanga kwa matenda ashuga angiopathy sikuwonetsa zizindikiro zilizonse zapadera, ndipo munthu sangadziwe matendawa. Monga kupita patsogolo kumadziwonetsera, zizindikiro zingapo za pathological zomwe ndizovuta kuzindikira. Mawonetseredwe azizindikiro amatengera mtundu ndi gawo la zotupa za mtima. Gome limawonetsa magawo akuluakulu a matendawa ndi mawonekedwe awonekera.

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Chithandizo cha matenda a mtima

Pa matenda ashuga angiopathy, chithandizo chovuta ndichofunikira, chomwe chimaphatikizapo kumwa mankhwala a magulu osiyanasiyana ndikuwonetsetsa kuti kudya zakudya zopatsa thanzi komanso njira zina. Musanachiritse matenda, muyenera kusiya zakumwa zoledzeretsa ndi mankhwala osokoneza bongo omwe amakhudza ziwiya. Mankhwala a shuga angiopathy amwa mankhwala otsatirawa:

• Kutsitsa shuga:
  • Siofor
  • Diabetes
  • Glucophage.
• Mankhwala ochepetsa cholesterster:
  • Lovastatin
  • "Simvastatin."
• Zoponda magazi:
  • Trombone,
  • Ticlopidine
  • Warfarin
  • Clexane.
• Njira zomwe zimathandizira kutsika kwa magazi ndi kukoka kwa magazi:
  • Tivortin
  • Ilomedin
  • "Pestazolum".

Ibuprofen amalembera ululu womwe umasautsa wodwalayo.

Kuphatikiza apo, adotolo adzavomereza chithandizo cha vitamini E kapena nicotinic acid. Ngati wodwalayo akuda nkhawa ndi kupweteka kwambiri mu matenda ashuga a shuga, ndiye kuti ophatikizana amasonyezedwa: Ibuprofen, Ketorolac. Ngati chotupa chachiwiri chathandizira, ndiye kuti mankhwala a antibacterial awonetsedwa: Ciprinol, Ceftriaxone.

Kuthandizira opaleshoni

Zimachitika kuti mankhwalawa samabweretsa zotsatira zoyenera, ndiye kuti opaleshoni ndi mankhwala. Opaleshoniyo imachitika m'njira zingapo, zonse zimatengera kuchuluka kwa zowonongeka ndi zina. Mitundu yotsatirayi yoperekera opaleshoni ndiyofala:

• Thrombectomy ndi endarterectomy. Pakati pa njirayi, minyewa yokhala ndi minyewa yomwe imadutsa ochepa lumen imachotsedwa.
• Kulowererapo kwa mtima. Ndi maopareshoni amtunduwu, madera omwe adachepetsa kugwiritsa ntchito pneumatic balloon kapena mtima stent amakulitsidwa.
• Sympathectomy. Imapangidwa kuti ichotse mitsempha ya mitsempha yomwe imayambitsa kuphipha kwamitsempha.
• Opaleshoni yoyeretsa. Kutseguka ndi kutulutsira mitsuko yambiri komwe mafinya amasonkhana kumaperekedwa. Tiziwalo tofa timadzichotsanso kapena zala zikadulidwa.

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Zithandizo za anthu

A shuga angiopathies a m'munsi malekezero nthawi zambiri amathandizidwa ndi wowerengeka azitsamba. Musanagwiritse ntchito chithandizo chotere, muyenera kufunsa dokotala, ndipo ndikofunikira kumvetsetsa kuti zimathandiza pokhapokha ngati matendawa atha. Mankhwala otsatirawa atha kuchotsa matendawa:

• tiyi wa linden
• tiyi wabulosi
• nyemba za masamba,
• kulowetsedwa ndi mizu ya tirigu wamasamba osambira.

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Kuopsa kotani?

Ngati njira zochiritsira zothana ndi matenda ashuga a shuga sizinatenge nthawi, zotsatira zoyipa zingachitike posachedwa. Mavuto akulu ndi:

• kutaya kwamasomphenya
• kulephera kwa mtima
• chilonda chachikulu
• kukakamizidwa mwamphamvu miyendo
• minofu necrosis.

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Zotsogola ndi kupewa

Ndi mwayi wofika kwa dokotala komanso kulandira chithandizo choyenera, wodwalayo amatha kuwonjezera moyo wake ndikukhalanso ndi thanzi. Ngati palibe chithandizo, ndiye kuti poizoni wamagazi amachitika, zomwe zimatsogolera ku kufa kwa odwala matenda ashuga mu 15% ya milandu, ndipo otsala odwala ali ndi zilema zosiyanasiyana.

Popewa kukula kwa matenda a shuga a shuga, njira zoyenera kupewa ziyenera kuchitidwa. Ndikofunikira kuchiza matenda ashuga komanso kupewa kutalika kwake. Ngakhale zinali choncho kuti sizotheka kupewa angiopathy, ndikofunikira kulandira chithandizo chake kuti tisayambitse zovuta. Ngati zotupa za purulent zimachitika, ndikofunikira kuyang'anira mabala ndikuwachiza mosamala.

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 a shuga omwe alipo masiku ano. Werengani nkhani >>