Opaleshoni ya Matenda a shuga

Zolemba zotchuka pamutuwu: ntchito ndi matenda ashuga

M'zaka zaposachedwa, vuto la matenda a mtima ndi odwala omwe ali ndi matenda ashuga a 2 lakhala chofunikira kwambiri paumoyo wa anthu.

Odwala ambiri omwe ali ndi matenda a shuga (opitilira 90%) ali ndi matenda a shuga a 2. Amadziwika kuti choyambitsa chachikulu cha kufa kwawo ndi ngozi zamtima ndipo koposa zonse, matenda a mtima (corphary infarction). Pakadali pano.

Osati kale kwambiri, matenda ashuga ndi pakati zimawerengedwa ngati malingaliro osagwirizana. Zinali zovuta kwambiri kuti mayi yemwe ali ndi matenda ashuga aberekane ndi kubereka mwana, osanenanso kuti mwana kuchokera pomwepo ali ndi pakati sikamabadwa wathanzi.

Epidemiology The epidemiology yachiwiri ya matenda a shuga a mellitus (DM) mu matenda a kapamba (kapamba), makamaka kapamba, samveka bwino. Izi zimachitika makamaka chifukwa chovuta kudziwa kupezeka kwa matenda a kapamba chifukwa cha izi.

Opaleshoni yamatenda opaleshoni, monga kuvulala kwawoko palokha, imayendera limodzi ndi kufunika kwa insulin, komwe kumapangitsa kuti matenda ashuwere kwambiri.

Malinga ndi omwe atenga nawo mbali pamsonkhano wa asayansi -wakuti "Matenda osakhazikika kwa odwala matenda a shuga", womwe unachitika pa Epulo 29-30, 2003 ku Yalta, omwe amathandizira ndi kampaniyo.

Matenda a shuga - lero masiku ano amatchedwa mliri, koma zikuwoneka kuti sizitikhudza. Ndipo mwadzidzidzi tsitsi kumutu lidayamba kutuluka kapena khungu lidakhala litauma ndipo limayera ... Kodi lidzadutsa lokha kapena ndi kale chiwonetsero cha matenda ashuga? Zindikirani powerenga nkhaniyi.

Mikhalidwe yodziwira matenda ashuga. Zisonyezero zakugwiritsa ntchito mayeso a shuga.

Matenda a Endocrine omwe amayendetsedwa ndi zovuta za metabolic samachitika padera, nthawi zambiri amakhala ndi kuchepa kapena kuchuluka kwa mahomoni amodzi, mtima wamtima umadwala.

Nkhani pamutu: ntchito ndi matenda ashuga

Odwala omwe ali ndi matenda a shuga, ochita kunenepa kwambiri komanso akuchitidwa opaleshoni pamimba kuti achepetse, kuchuluka kwa shuga m'magazi kunadziwika kale kuti kulemera kwawo kumatsika kwambiri

Mitsempha ya mtima ndi magazi imakhala ndi kulemera kwakukulu kwa odwala onenepa, koma odwala matenda amtundu wa 2 siachilendo. Ndipo asayansi adazindikira kuti atachitidwa opaleshoni ya bariatric, kuchuluka kwa shuga m'magazi kumachitika popanda kumwa mankhwala.

Njira zopangira opaleshoni ya bariatric zidapangidwa makamaka kuti zitsimikizire kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri. Ndipo pokhapokha, madokotala azindikira kuti opaleshoni yotere imachepetsa matenda a shuga.

M'zaka makumi awiri zapitazi za zana la makumi awiri, njira yatsopano yawonekera mu opareshoni - opaleshoni yochepetsa m'mimba, yomwe idapereka kuchepa thupi mwachangu. Komabe, asayansi akadali kutsutsana za kutalika kwa izi.

Madokotala aku America akuti apeza chidziwitso chakuchita bwino kwa opaleshoni yamitsempha yamagazi yam'mimba yochizira matenda a mtima, olemedwa ndi shuga, poyerekeza ndi balloon angioplasty ndi kununkha.

Kugwiritsa ntchito msirikali wovulala kwambiri kumalo omenyera nkhondo ku Afghanistan, madokotala aku US omwe adachita opaleshoni yapulumutsa moyo wake, koma adakakamizidwa kuti achotse ziphuphu zonse, zomwe zimapangitsa kuti mwamunayo adwale matenda am'mbuyomu moyo wake wonse. Komabe, posachedwa, ku USA, kuchipatala, madotolo adatha kuthamangitsa wodwalayo maselo a zilumba za Langerhans za kapamba kake. Tsopano msirikali salinso pachiwopsezo cha matenda ashuga, ndipo opaleshoni yomwe idapangidwa ndi madokotala ochita opaleshoni - kuwayika kosafunikira - atha kukhala njira yatsopano yochizira matenda ashuga.

Njira yowunikira mosamala kuchuluka kwa shuga m'magazi ingathandize amayi apakati omwe ali ndi vuto la shuga kupewetsa zovuta

Kufufuza mafupa kungathandize madokotala kusankha moyenera maantibayotiki pochiza matenda obwera ndi matenda a shuga. Izi zithandiza kuti odwala apewe opereshoni.

Mbeu zamkaka zidagwiritsidwa ntchito kuyambira kalekale ngati mankhwala kuchiza matenda a chiwindi ndi ndulu. Ndipo asayansi aku Germany apeza zothandizanso mwatsopano pazigawo zam'mimba zamkaka, zomwe zatsimikizira zotupa mu zotupa.

Opaleshoni ya matenda a shuga mellitus: zikuwonetsa, kukonzekera ndi kukonzanso nthawi

Matenda a shuga ndi vuto lenileni kwa munthu amene akudwala.

Matenda a shuga amabweretsa kusowa kwa insulin, chifukwa chake pali kusokonezeka kwa metabolic, kuwonongeka kwamitsempha, nephropathy, kusintha kwa pathological mu ziwalo ndi minofu.

Madotolo akapereka chifukwa chopangira opaleshoni ya shuga sayenera kuchitika, nthawi zambiri zimanenedwa kuti kuchira kumayamba pang'onopang'ono komanso kwanthawi yayitali chifukwa cha matendawa. Kubwezeretsanso minyewa kumathandiza kwambiri kuti njirayi ikhale yopambana, kotero ena samakonda kuchita ngozi. Komabe, izi sizitanthauza kuti wodwala yemwe ali ndi matenda ashuga sayenera kuchitika konse.

Pali nthawi zina zomwe simungathe kuchita popanda iwo, ndipo akatswiri odziwa bwino ntchito yawo amachita zonse zotheka kuteteza wodwala wawo momwe angathere asanapangidwe zovuta. Pankhaniyi, muyenera kudziwa momwe machitidwe angachitire opareshoni, zinthu zonse zomwe zimayambitsa komanso, zomwe zikukonzekera njirayi .ads-pc-2

Opaleshoni ya Matenda a shuga

Inde, onse omwe ali ndi matenda a shuga, monga aliyense wa ife, amathanso kukhala pachiwopsezo cha opaleshoni. M'moyo, pamakhala zochitika zosiyanasiyana ndipo nthawi zina, opareshoni ndiyo njira yokhayo.

Madokotala nthawi zambiri amachenjeza kuti ndi matenda ashuga, chiopsezo cha zovuta zotheka ndizokulirapo.

Odwala amangoganiza kuti mwina kuchitira opaleshoni ya matenda a shuga kapena popanda iwo kungakhale kwanzeru? Nthawi zina, timalimbikitsidwa kupeana opaleshoni, pomwe ena satero. Potere, wodwalayo ayenera kukhala okonzekera bwino njira yomwe ikubwera.

Kukonzekera opaleshoni

Kuchita opareshoni ya shuga si ntchito yovuta. Muyenera kukonzekera bwino osati odwala matenda ashuga okha, komanso madokotala omwe.

Ngati pakuchitika maopaleshoni ang'onoang'ono, monga kuchotsa msomali wolowera, kutsegula chikopa kapena kufunikira kochotsa atheroma, njirayi itha kuchitika pang'onopang'ono, ndiye kuti wodwala yemwe ali ndi matenda a shuga, opaleshoniyo ikuchitika mosamalitsa kuchipatala cha opaleshoni kuti muchotse zotsatira zonse zoyipa.

Choyamba, ndikofunikira kuchita mayeso a shuga kuti mutsimikizire kuti chiopsezo chothandizira opaleshoni sichambiri, ndipo wodwala ali ndi mwayi uliwonse wopulumuka njirayo ndikuchira.

Mkhalidwe waukulu pakugwirira ntchito kulikonse ndikupeza chiphuphu cha matenda a shuga:

ngati ntchito yaying'ono ichitika, wodwalayo sasamutsidwa ndi insulin ndi jakisoni,
Wina akayamba kukonzekera, kuphatikizapo kutsegula m'matumbo, wodwalayo amapatsidwa jakisoni. Dokotala amamuwonetsa katatu makonzedwe a mankhwalawa.
Ndikofunikanso kukumbukira kuti pambuyo pa opareshoni ndizosatheka kuletsa ma insulin, chifukwa mwanjira imeneyi chiopsezo cha zovuta zimachuluka.
Ngati opaleshoni yofunikira ndiyofunika, wodwalayo amalandira theka la m'mawa insulin.

Kungoyipiritsa kokha pakachitidwe komwe sikanaphwanyidwe ndi vuto la matenda ashuga. Poterepa, palibe dokotala m'modzi wovomerezeka yemwe angavomereze kuti achite opareshoni, ndipo mphamvu zonse za madotolo zikhala ndi cholinga chothana ndi wodwalayo pamalo oopsa mwachangu. Zinthu zikakhala kuti sizofanana, machitidwewo amatha kusankhidwa.

Pamaso pa opareshoni, ndikofunikira:

kuchepetsa kwambiri calorie kudya,
Idyani chakudya mpaka sikisi patsiku m'magawo ang'onoang'ono,
osamadya shuga, mafuta odzaza,
amachepetsa kwambiri kugwiritsa ntchito zakudya zomwe zili ndi mafuta m'thupi,
Idyani zakudya zomwe zili ndi CHIKWANGWANI chamafuta,
osamwa mowa nthawi zilizonse,
fufuzani kuti muchepetse mafuta, ndipo ngati pakufunika kutero, pangani kukonza,
kuthamanga magazi, sinthani ngati pakufunika kutero.

Kutengera njira zakonzekereratu opareshoni isanachitike, mwayi woti njirayi ikhale yopambana. Kuyang'anira wodwala mosamala kumalola kuti pakhale nthawi yabwino yothandizira, yomwe ndiyofunikanso.

Opaleshoni ya pulasitiki

Nthawi zina mikhalidwe imakhala kuti pamakhala kufunikira kapena kufuna kugwiritsa ntchito maopaleshoni ya pulasitiki.

Zifukwa zake zimakhala zosiyanasiyana: kukonza cholakwika chachikulu kapena kufunitsitsa kusintha maonekedwe.

Njira ngati izi sizingachitike nthawi zonse kwa anthu opanda matenda a shuga, ndipo omwe akudwala matendawa ndi milandu yapadera. Funso limabuka: kodi ndizotheka kuchitidwa opaleshoni ya pulasitiki chifukwa cha matenda ashuga?

Mwambiri, madokotala amalimbikitsa kukana opaleshoni. Matenda a shuga ndiwotsutsana ndi mabodza ambiri apulasitiki, chifukwa madokotala salolera kuchita izi. Muyenera kuganizira mozama ngati wodwala ali wokonzeka kupereka chitetezo chifukwa cha kukongola.

Komabe, madokotala ena opaleshoni ya pulasitiki amavomera kuchitidwa opaleshoni, malinga ngati chiphuphu chokwanira cha matenda ashuga chachitika. Ndipo ngati pambuyo pochita maphunziro onse ofunikira zitha kutsimikiziridwa kuti zoneneratu ndizolimbikitsa, ndiye kuti njirayi ilola kuchitika. Pazonse, chifukwa chachikulu chokana opaleshoni ya pulasitiki sichili mu shuga yokha, koma m'magazi a shuga.

Asanachite opaleshoni ya pulasitiki, dokotalayo adzakulangizani kuti muchite maphunziro angapo:

kafukufuku wa endocrinological,
kuyesedwa ndi katswiri
kuyesedwa ndi akatswiri a maso
kuyesa kwamwazi wamagazi,
kusanthula kwa magazi ndi mkodzo chifukwa cha kukhalapo kwa matupi a ketone (kupezeka kwawo ndi chizindikiro chakuti kagayidwe kazinthu sizikuyenda bwino),
kuwerenga kwa hemoglobin
kusanthula kwa magazi.

Ngati maphunziro onse amachitidwa ndikuwunikira pakati pazomwe zili bwino, ndiye kuti endocrinologist ikapereka chilolezo cha njirayi. Ngati matenda a shuga sawalipiridwa, ndiye kuti zotsatirapo zake za opareshoni zimatha kukhala zoopsa kwambiri.

Ngati mukufunikirabe lingaliro la momwe mungachitire opaleshoni, ndibwino kuchititsa kafukufuku mokwanira momwe mungathere kuti mudziteteze ndikuthandizira pazotsatira zabwino. Njira iliyonse, ntchito iliyonse ndi njira yokhayo yomwe imafunsira kukambirana ndi kufufuza koyambirira.

Kudandaula kwa katswiri wodziwa ntchito kungathandize kudziwa mawonekedwe onse a ndondomekoyi komanso mndandanda wazoyeserera zomwe ziyenera kupititsidwa kuti mumvetsetse ngati opaleshoni ikuvomerezeka pankhani inayake.

Ngati dokotala angavomereze opaleshoni popanda kufufuza koyambirira, muyenera kulingalira mozama momwe katswiri alili woyenerera ngati satenga mbali zambiri zofunika. Kukhala wakhama pankhani ngati imeneyi kumatha kukhala chinthu chofunikira kwambiri kuti munthu apulumuke machitidwewo komanso ngati zonse zikuyenda bwino.

Nthawi yogwira ntchito

Nthawi imeneyi, makamaka, imayang'aniridwa mosamala ndi madokotala, chifukwa zotsatira zonse zimadalira. Kwa odwala matenda ashuga, kuwunika pambuyo pa ntchito kumakhala ndi gawo lofunikira kwambiri.

malonda-pc-4Monga lamulo, nthawi ya kukonzanso imaganizira zinthu zofunika izi:

Palibe chifukwa chakuti insulin iyenera kuchotsedwa. Pakatha masiku 6, wodwalayo amabwereranso ku mankhwala ena a insulin,
kuwongolera mkodzo tsiku ndi tsiku kuteteza mawonekedwe a acetone,
kutsimikizira kuchiritsidwa ndi kusowa kwa kutupa,
kuwongolera shuga kwa ola limodzi.

Kodi ndizotheka kukhala ndi matenda ashuga kuchitira opaleshoni pulasitiki, tinazindikira. Ndipo momwe akupitilira zimapezeka mu vidiyo iyi:

Kodi ndingachiteko opareshoni matenda ashuga? - Inde, komabe, zinthu zambiri zimafunika kukumbukiridwa: thanzi, shuga, magazi, kuchuluka kwa matendawo, ndi ena ambiri.

Kuthandizira opaleshoni kumafuna kafukufuku wokwanira komanso njira yabwino yothandizira bizinesi. Katswiri wodziwa bwino, wodziwa ntchito yake yemwe amadziwa ntchito yake, iyi ndi yofunika.

Iye, mosagwirizana ndi ena, amatha kukonzekeretsa wodwalayo njira yomwe ikubwerayo ndikuphunzitsanso momwe ziyenera kukhalira.

Ntchito zovomerezeka za shuga, zovuta zomwe zingachitike komanso zoopsa

Kukhalapo kwa matenda osokoneza bongo a shuga kumagwirizanitsa nthawi ya postoperative, koma sikuti kuphwanya chithandizo pakuchita opareshoni. Choyimira chachikulu pakusankha kwa odwala ndi kuchuluka kobwezeretsera matendawa. Pazomwe mungagwiritse ntchito zomwe sizingachitike ndi matenda ashuga, werengani nkhaniyi.

Matenda a purulent-yotupa

Zomwe zimachitika ndi matenda a shuga - zimapangitsa kuti ma purosesa ayambe kupezeka 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 ndi kufunika kwa opaleshoni mu dipatimenti yochita opaleshoni. Ngakhale kulowererapo pang'ono kwa matenda ashuga (kutsegula thumba, panaritium, kudabwitsidwa ndi msomali woloza) kungayambitse kufalikira kwa matenda, mapangidwe a zilonda zam'mimba ndikuchiritsidwa kwa nthawi yayitali.

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

Timalimbikitsa kuwerenga nkhani yokhudza kuphatikiza cholecystitis ndi matenda ashuga. Kuchokera pamenepo muphunzira za zomwe zimayambitsa matenda a cholecystitis mu matenda ashuga, zizindikiro za matendawa, komanso kudziwa za matenda ammimba komanso chithandizo cha cholecystitis mu matenda ashuga.

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 m'matumbo a 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 yolimbikitsa zimalembedwa:

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 chiwopsezo cha zovuta zina - kukhetsa magazi, kusalinganika kwamalingaliro ndi magawo am'mphepete mwa mabala, kutukusira kwa minofu m'dera la opareshoni 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, amaopa 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, ndi morphine zimakhala ndi vuto lochepa la carbohydrate metabolism.

Nthawi zambiri, opaleshoni ya intravenous imagwiritsidwa ntchito limodzi ndi opweteka ena akumaloko. 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, adalembedwa:

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 ophika apulo,
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.

Timalimbikitsa kuwerenga nkhani yokhudza anthu omwe akuwaganizira kuti ali ndi matenda ashuga. Kuchokera pamenepo muphunzira zomwe zimayambitsa kukayikira kwa matenda ashuga, zoyenera kuchita ngati mwana akukayikira shuga, komanso zakudya.

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, komanso 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.

Onerani kanemayo panjira yodzikongoletsera ya matenda ashuga:

Kodi ndizotheka kuchitira opaleshoni ya shuga

Munthu aliyense pamoyo wake akhoza kukumana ndi vuto lothandizira opaleshoni. Pakati pa odwala matenda ashuga, malinga ndi ziwerengero, sekondi iliyonse imakumana ndi izi. Ziwerengero zokhudzana ndi matenda a shuga sizabwino: matendawa akuchulukirachulukira ndipo anthu 10 aliwonse ku Russia ali kale ndi matendawa.

Mtundu wa vuto

Choyipa sichomwe chimangokhala chokha, koma zotsatira zake komanso moyo wovuta womwe umakhalapo.

Matenda a shuga enieni sangakhale cholakwika kuchititsa, koma kukonzekera kwapadera kwa wodwala koteroko kumafunikira. Izi zikugwira ntchito kwa wodwala iye mwini ndi antchito.

Zochita zadzidzidzi zimachitika, mwachidziwikire, chifukwa chaumoyo, koma ndi zomwe zakonzedwa, wodwalayo ayenera kukhala okonzekera.

Komanso, nyengo yonse isanachitike, munthawi ya opaleshoni ya shuga komanso pambuyo pa opaleshoni ya shuga imakhala yosiyana kwambiri ndi ya anthu athanzi. Chiwopsezo ndikuti machiritso amapezeka mu odwala matenda ashuga ovuta komanso pang'ono pang'onopang'ono, nthawi zambiri amapereka zovuta zingapo.

Kodi chofunikira ndi chiyani pokonzekeretsa wodwala matenda ashuga?

Opaleshoni imachitidwa nthawi zonse chifukwa cha matenda ashuga, koma malingana ndi mikhalidwe ina, chachikulu chomwe ndicho kubwezera komwe kumayambitsa matendawa. Popanda izi, zomwe zakonzedwa sizingachitike. Zilibe kanthu zadzidzidzi mu opaleshoni.

Kukonzekera kulikonse kumayambira ndi muyezo wa glycemia. Chotsimikizika chokhacho chamankhwala amtundu uliwonse wa opaleshoni ndicho vuto la matenda a shuga. Kenako wodwalayo amachotsedwa kale pamkhalidwewu.

Ndi shuga yolipidwa komanso kuchuluka kochepa ka ntchito, ngati wodwala alandila PRSP, kusamutsa insulin panthawi yolowerera sikofunikira.

Pogwira ntchito yaying'ono yothandizidwa ndi mankhwala a kuchipatala komanso mankhwala a insulini kale, mankhwalawo amasintha.

M'mawa, amapatsidwa insulin, amadya chakudya cham'mawa ndipo amapititsidwa kuchipinda chogwiritsira ntchito, ndipo maola awiri pambuyo povomerezeka nkhomaliro. Pogwiritsa ntchito kwambiri komanso pamankhwala pamimba, ngakhale mutalandira chithandizo chamankhwala osagonekedwa, wodwalayo amapatsidwa jakisoni wa insulin molingana ndi malamulo onse a nthawi yake.

Nthawi zambiri, insulin imayamba kutumikiridwa katatu patsiku, komanso mitundu yosakhazikika ya matenda ashuga, kasanu. Insulin imayendetsedwa mosavuta, mosaganizira, osakhalitsa. Nthawi yomweyo, kuyang'anira glycemia ndi glucosuria tsiku lonse ndikofunikira.

Kutalika sikumagwiritsidwa ntchito chifukwa ndikosatheka kuwongolera glycemia molondola komanso kuchuluka kwa timadzi timene timatulutsa pa nthawi ya opaleshoni komanso munthawi yokonzanso. Ngati wodwala alandila biguanides, amathetsedwa ndi insulin.

Izi zimachitika kupatula chitukuko cha acidosis. Pazifukwa zomwezi, atachitidwa opaleshoni, zakudya zimalembedwa nthawi zonse: zakumwa zamchere zambiri, kuchepetsa kapena kuthetsa mafuta odzaza, mowa ndi mashuga aliwonse, mankhwala okhala ndi cholesterol.

Kalori yafupika, kudya kumaphwanyidwa mpaka katatu patsiku, CHIKWANGWANI chimakhala chovomerezeka mu chakudya. Chisamaliro chachikulu chiyenera kuperekedwa kwa magawo a hemodynamic pokhudzana ndi kuwonjezeka kwa mwayi wopanga MI.

Zowoneka zowoneka bwino ndikuti mu odwala matenda ashuga nthawi zambiri amakula popanda mawonekedwe owawa. Mayeso okonzekera ntchito: shuga m'magazi, mwa odwala omwe ali ndi vuto lalitali - osapitirira 10 mmol / l, kusowa kwa zizindikiro za ketoacidosis ndi glucosuria, acetone mu mkodzo, matenda a kuthamanga kwa magazi.

Zolemba za opaleshoni ya odwala matenda ashuga

Anthu odwala matenda ashuga samalola kuchepa kwa kuthamanga kwa magazi, chifukwa chake kuwunika ndikofunikira. Anesthesia ndibwino kuti mugwiritse ntchito pazodwala zambiri, pomwe palibe chiopsezo cha hyperglycemia. Odwala amalekerera bwino kwambiri mankhwala oterewa.

M'matumbo akulu ochita opaleshoni yam'mimba yomwe imagwiritsidwa ntchito pochita opaleshoni ya m'mimba, pamene zakudya sizichotsedwa pakumachitika opareshoni komanso isanachitike, pafupifupi ½ yam'mawa ya insulin imaperekedwa asanachitidwe opaleshoni.

Hafu ya ola zitatha, 2040 ml ya glucose 40% yankho limayendetsedwa kudzera m'mitsempha, ndikutsatiridwa kosagwiritsa ntchito shuga 5%. Kenako, mlingo wa insulin ndi dextrose umasinthidwa molingana ndi mseru wa glycemia ndi glucosuria, womwe umatsimikiziridwa ola limodzi ngati nthawi ya opareshoni imaposa maola 2.

Pochita opaleshoni, shuga m'magazi amayang'aniridwa mwachangu, ndizovuta kutsatira njira ya insulini, imayikidwa molingana ndi kuchuluka kwa shuga m'magazi ndi mkodzo, pomwe pakuchita opareshoni, kuyang'ana pa ola limodzi ngati nthawi ya opareshoni imaposa maola awiri.

Ngati matenda a shuga ayamba kupezeka, chidwi cha wodwalayo cha insulin chimatsimikizika. Ndi kuwonongeka kwa shuga ndi zizindikiro za ketoacidosis muzochitika zadzidzidzi, njira zimatengedwa kuti zithetse njirayo. Zomwe zakonzedwa - opareshoni imayimitsidwa.

Ndi mankhwala ochititsa dzanzi, kupsinjika kwa metabolism kumachitika m'thupi la munthu aliyense, ndipo kufunika kwa insulin kumawonjezeka. Ndikofunikira kukwaniritsa dziko lokhazikika, chifukwa chake, insulin ikhoza kutumikiridwa 2-6 patsiku.

Pafupipafupi opaleshoni matenda a matenda ashuga

Opaleshoni ya pancreatic imachitidwa ngati mitundu ina ya mankhwalawa siyothandiza kapena yosatheka.

Zowopsa kwa wodwalayo chifukwa cha kusokonezeka kwakukuru kwa metabolism, zovuta zazikulu za matenda ashuga, palibe zotsatira kuchokera ku chithandizo chamankhwala, simungachite jakisoni wa insulin.

Ngati palibe ma concomitant pathologies, patatha tsiku opanikizika opanikizika amayamba kugwira ntchito mwachizolowezi. Kukonzanso kumatenga miyezi iwiri.

Ntchito za Ophthalmologic

Nthawi zambiri ndi chidziwitso cha matendawa, matenda ashuga retinopathy komanso odwala matenda ashuga amapanga - kuwonetsa ma mandala amaso. Pali chiopsezo cha kutayika kwathunthu kwa masomphenya ndipo kusinthasintha kwa njira ndi njira yokhayo yochotsera izi. Kutalika kwamatumbo mu shuga sikungayembekezeredwe. Popanda njira yoyezera, kuchuluka kwatsoka kwa cataract kumakhala kotsika kwambiri.

Pakukhazikitsa njira yayikulu, zotsatirazi ziyenera kukwaniritsidwa: kulipiritsa anthu odwala matenda ashuga ndi shuga wamagazi, kutayika kwa osaposa 50%, palibe njira zina zotsimikizirika zomwe zingachitike.

Ndikwabwino kuti musachedwe opaleshoni yamatumbo ndikuvomera nthawi yomweyo, chifukwa imayamba ndi chitukuko cha khungu pamene matenda ashuga a m'mimba amachitika.

Makatoni sachotsedwa ngati:

masomphenyawo atayika kale
Matenda a shuga sawalipiridwa,
pamabala a retina,
pali neoplasms pa iris; pali matenda amtundu wa kutupa.

Ndondomeko ili ndi phacoemulsification: laser kapena ultrasound. Chinsinsi cha njirayi: 1 yaying'ono yaying'ono imapangidwa mu mandala - kuboola komwe ndolo yake imaphwanyidwa momwe tafotokozera pamwambapa.

Ndi kuboola kwachiwiri, zidutswa za mandala ndizofunikira. Kenako mandala okumba, alenje lanyama, amabweretsedwa kudzera m'mitundu yomweyo. Ubwino wa njirayi ndikuti mitsempha yamagazi ndi minofu sizivulala, palibe seams yomwe ikufunika.

Kudzinyenga kumawoneka ngati kwatulukira posakhalitsa sikofunikira. Masomphenyawa amayambiranso masiku awiri.

Kugwiritsa ntchito madontho amaso, ngakhale kumayambiriro kwa matendawa, sikungathetse vutoli, pakadali pano kupita patsogolo kwa njirayi kumayimitsidwa.

Kukonzekera ndi mfundo zake sizosiyana ndi zochitika zina. Kuchita kotereku m'matenda a shuga ndi m'gulu la zopweteka pang'ono. Nthawi zambiri, matenda a pathology amakula mwa achinyamata a zaka zogwira ntchito, pomwe mwayi wazotsatira zabwino ukuwonjezeka.

Njira yolowerera imatenga mphindi 10 mpaka 30, mankhwala oletsa ululu amayikidwa, khalani kuchipatala osaposa tsiku limodzi. Mavuto ndi osowa. The ophthalmologist nthawi zonse amagwira ntchito limodzi ndi endocrinologist.

Ntchito za matenda ashuga

Izi zikuphatikizira otchedwa opaleshoni ya metabolic - i.e. Zizindikiro zakuthandizira kwa dokotalayo ndikukonza kwa matenda a metabolic omwe ali ndi matenda ashuga. Zikatero, "opaleshoni ya m'mimba" imachitidwa - m'mimba imagawidwa m'magawo awiri ndipo matumbo ochepa amazimitsidwa.

Uwu ndi opareshoni Na. 1 mu mtundu 2 wa matenda ashuga.

Zotsatira zakuchita opaleshoni ndizomwe zimapangitsa kuti glycemia, kuchepa thupi kuzungulira kwakhazikika, kulephera kudya mopepuka, chifukwa chakudya chidzalowa mu leum, kudutsa chaching'ono.

Njirayi imawonedwa kuti ndiyothandiza, 92% ya odwala sakutenganso PSSP. 78% ali ndi chiwombolo chonse. Ubwino wa kuwongolera koteroko mwakuti sikuwoneka mopepuka kumachitika pogwiritsa ntchito laparoscopy.

Njira zotupa ndi zoyipa zimachepetsedwa. Palibe mabala ndipo nthawi yakonzanso imafupikitsidwa, wodwalayo amatulutsidwa mwachangu.

Pali zikuwonetsa opaleshoni yodutsa apa: zaka 30-65 zaka, zovuta za insulini siziyenera kukhala zaka zopitilira 7, zovuta za shuga 30, mtundu 2 shuga.

Kuchita opareshoni iliyonse yamatenda a shuga kumafuna dokotala woyenera kwambiri.

Mtundu woyamba wa shuga: chithandizo chomaliza cha matenda ashuga Momwe mungathanirane ndi Opaleshoni ya matenda a shuga - ndizosavuta kukhulupirira Opaleshoni yodwala matenda ashuga: kutsegula chotupa, kukakamira,

Kodi ndizotheka kuchitidwa opareshoni ya matenda ashuga: mbali zina za nkhaniyi

Anthu omwe ali ndi matenda a shuga, pamlingo wina kapena wina, amachitidwa opaleshoni. Chiwerengero cha matenda omwe chithandizo cha opaleshoni chikuwonetsedwa ndichachikulu kwambiri.

Komabe, mawonekedwe a kukonzekera wodwala yemwe ali ndi matenda ashuga kuti achite opareshoni, nthawi yake ndi nthawi yothandizira pambuyo pake ndi yosiyana kwambiri ndi anthu athanzi.

Ganizirani za maopaleshoni a shuga.

Kodi magwiridwe antchito ndi ati?

Kumbukirani kuti matendawo sindiwo opondera opareshoni. Komanso, nthawi zina zimachitika malinga ndi kufunikira kofunikira.

Mkhalidwe waukulu wakuchita bwino ndiko kubwezera matendawa. Ndipo chinthu chimodzi: ngakhale zolowera zazing'ono zomwe odwala athanzi amachita pamtunda wosapumira (mwachitsanzo, kuchotsa msomali wotsekeka kapena kutsegula chimbudzi) ziyenera kuchitidwa mu chipinda chopangira opaleshoni.

Ndi chipepeso chochepa cha matenda ashuga, ntchito yomwe idakonzedwa siyingatheke. Choyamba, ayenera kuchitapo kanthu kuti athe kulipira matenda ashuga. Zachidziwikire, izi sizingagwire ntchito ngati opaleshoniyo ikuchitika molingana ndi zofunikira pakuwonetsa.

Chotsutsana kwathunthu ndi kulowererapo ndi kuperewera kwa matenda ashuga. Zikatero, zimachitika mwachangu kuti wodwala amuchotsere. Pambuyo pokhapokha opaleshoni itha kuchitika.

Kukonzekera wodwalayo kuti achite opareshoni

Chachikulu ndichakuti odwala omwe akuchitapo kanthu, ndipo makamaka kwambiri, amafunika kuyesedwa kwa shuga! Odwala asanalowe m'mimba amafunika insulin. Njira zochizira ndizovomerezeka.

Tsiku lonse, wodwala amayenera kulowa mankhwalawa katatu mpaka kanayi. M'mavuto akulu komanso odwala matenda ashuga, kupatsirana insulini ndikololedwa.

Kuyang'anira shuga wa magazi mosamala tsiku lonse kumafunika.

Ndikosatheka kugwiritsa ntchito insulin pokonzekera nthawi yayitali. Jakisoni imodzi ya insulin yochita pakati usiku imaloledwa. Chenjezo ili chifukwa chakuti opaleshoni isanachitike, kusintha kwa mankhwalawa ndikofunikira. Ndipo, ndichachidziwikire, muyenera kumayeza miyezo ya glucose nthawi zonse.

Zakudyazo zimayikidwa poganizira matenda omwe amachitidwa opereshoni. Poletsa kukula kwa acidosis, wodwalayo amakhala ochepa mafuta. Ngati palibe contraindication, ndiye kuti kuchuluka kwakukulu kumayikidwa (madzi amchere ndi abwino kwambiri).

Ngati opaleshoni yakhazikitsidwa pambuyo pake pomwe wodwala sangaloledwe kudya mwachizolowezi, theka la insulin imaperekedwa nthawi yomweyo isanachitike opareshoni. Pambuyo pa theka la ora, muyenera kulowa yankho la shuga (mamililita 20 mpaka 40 pazowonjezera 40%).

Ndiye yankho la shuga peresenti zisanu limatsitsidwa. Anesthesia nthawi zambiri imathandizira pakufunika kwa insulini, chifukwa chake muyenera kusamala kwambiri pokonzekera wodwalayo asanamuchitire opareshoni.

Werengani nawonso Zambiri zakugwiritsa ntchito pampu ya insulin mwa ana

Zakudya musanachite opareshoni zimatengera malangizo:

Amachepetsa calorie kudya
kudya pafupipafupi (mpaka kasanu ndi kamodzi patsiku),
kupatula aliyense wa ma sekereji,
mafuta okwanira kudziletsa
kuletsa zakudya zamafuta a cholesterol,
kuphatikiza pazakudya zomwe zimakhala ndizakudya
kupatula mowa.

Kuwongolera kwa hemodynamic pathologies ndikofunikira. Inde, odwala omwe ali ndi matendawa amawonjezera mwayi wokhala ndi vuto la mtima. Odwala omwe ali ndi matenda ashuga, mtundu wosapweteka wamatenda a mtima ndiwotheka kangapo.

Njira zomwe munthu angakonzekere opaleshoni ndi:

milingo yabwinobwino kapena yapafupi ndi shuga (mwa odwala omwe ali ndi vuto lalitali, zizindikiro zotere siziyenera kupitirira 10 mmol),
Kuthetsa kwa glucosuria (shuga mkodzo),
kuthetsa kwa ketoacidosis,
kusowa kwa mkodzo acetone,
Kuchotsa matenda oopsa.

Opaleshoni ya shuga

Pali nthawi zina pomwe wodwala amafunikira kuchitidwa opaleshoni yoyipa chifukwa cha matendawo. Pankhaniyi, opaleshoni imalembedwa motsutsana ndi maziko azinthu zomwe cholinga chake ndi kuchotsa ketoacidosis. Izi zitha kuchitika pokhapokha ngati pali mitundu yayikulu ya insulin. Kukhazikitsidwa kwa alkalis ndikosayenera, chifukwa kumabweretsa zotsatirapo zovutazo:

kuchuluka kwa hypokalemia,
intracellular acidosis,
kuchepa kwa magazi a calcium,
hypotension
ngozi ya matenda otupa.

Sodium bicarbonate ikhoza kuperekedwa kokha ndi kuchuluka kwa magazi a acid pansipa 7.0. Ndikofunika kuonetsetsa kuti mpweya wokwanira wa okosijeni uzikhala. Mankhwala othandizira antibiotic amadziwika, makamaka ngati kutentha kwa thupi kumakwezedwa.

Ndikofunikira kuperekera insulini (yothandizanso kupindika), poyang'anira kuchuluka kwa shuga. Insulin yomwe imatenga nthawi yayitali imaperekedwanso, koma glycemic control iyenera kuyang'aniridwa.

Opaleshoni ndi Nephropathy

Nephropathy ndiyomwe imayambitsa kulemala komanso kufa kwa odwala omwe ali ndi matenda ashuga. Zimachitika makamaka chifukwa cha vuto losakhazikika mu mawonekedwe amachitidwe amadzimadzi am'maso. Pamaso pa opaleshoni, ndikofunikira kuthetsa kukanika kwa impso momwe mungathere. Njira zochizira zimaphatikizapo mfundo zingapo.

Kuwongolera kwa metabolism ya carbohydrate (iyenera kuphatikizidwa mosamala ndi mankhwala a insulin, popeza aimpso insulinase imaponderezedwa ngati kulephera kwa impso kumachitika, ndipo kufunika kwa mahomoni awa kumachepa).
Kukonza mokwanira komanso kuwongolera kuthamanga kwa magazi.
Kutha kwa matenda oopsa a glomerular (ACE inhibitors ndi mankhwala).
Zakudya zokhala ndi choletsa cha protein (chokhudza proteinuria).
Kuwongolera zamavuto amafuta a metabolism (ndikofunikira kuchita kugwiritsa ntchito mankhwala oyenera).

Njira zoterezi zimapangitsa kuti zitheke kugwira bwino ntchito komanso nthawi ya ntchito pambuyo pa odwala omwe ali ndi zovuta za matenda ashuga.

Zina za matenda a shuga

Mukamachita opaleshoni, ndikofunikira kwambiri kuwongolera kuchuluka kwa glycemia, magawo oyenera amasankhidwa kwa wodwala aliyense payekhapayekha. Sikoyenera kuyeserera kuphatikiza kwathunthu, chifukwa hypoglycemia ndiowopsa kwambiri kuposa hyperglycemia.

Werengani komanso: Kodi ndizovomerezeka kuchiza matenda amtundu wa shuga wambiri ndi wowerengeka azitsamba

Poyerekeza ndi maziko amakono a opaleshoni yamakono, Zizindikiro zakuchepa kwa shuga zimatsukidwa kapena kupotozedwa kwathunthu.

Makamaka, zinthu monga kukwiya, chikomokere, komanso kukhudzika sizimawoneka. Kuphatikiza apo, pa mankhwala othandizira, hypoglycemia ndi yovuta kusiyanitsa ndi operewera.

Zonsezi zikusonyeza kuti wopanga mankhwala amafunika kudziwa zambiri komanso kusamala pakayang'aniridwa ndi opaleshoni.

Mwambiri, munthu amatha kusiyanitsa zoterezi.

Pa opaleshoni, shuga ndi insulin iyenera kuperekedwa, kutengera kuopsa kwa matendawa. Kuwongolera kwa shuga kuyenera kukhala kosalekeza: kuwonjezera kwake kumakonzedwa ndi jakisoni wa insulin.
Kumbukirani kuti mankhwala omwe amapezeka chifukwa cha mankhwala ochititsa dzanzi kuwonjezera glycemia.
Wodwala amatha kubayidwa ndi mankhwala opaleshoni yam'deralo: amakhudza pang'ono glycemia. Intravenous opaleshoni imagwiritsidwanso ntchito.
Onetsetsani kuti mukuyang'anitsitsa kuchuluka kwa maopaleshoni.
Opaleshoni wamba amatha kugwiritsidwa ntchito ndikuthandizira kwakanthawi kochepa.
Onetsetsani kuti mwawunika hemodynamics: odwala samalola kuponya kukakamizidwa.
Pogwiritsa ntchito nthawi yayitali, mankhwala osokoneza bongo amatha kugwiritsidwa ntchito: amathandizira shuga.

Zolemba za nthawi yothandizira

Ndi matenda a shuga m'masiku ogwirira ntchito, kuchotsedwa kwa insulini mwa odwala omwe adalandira kale hormone iyi ndikosavomerezeka! Kulakwitsa kotereku kumawopseza kukula kwa acidosis mwa wodwala.

Nthawi zina, ndizotheka kukhala ndi shuga m'magazi a odwala ambiri. Koma ngakhale apo, amaphatikizidwa ndi insulin pang'ono (osapitirira 8), kawiri mpaka katatu patsiku, nthawi zonse amakhala ndi shuga 5%.

Ndikofunikira kuyang'anira mkodzo wa tsiku ndi tsiku chifukwa cha chiwopsezo cha acetone mmenemo.

Malinga ndi momwe wodwalayo akhazikika, ndipo shuga imalipidwa, patatha pafupifupi masiku asanu ndi limodzi (nthawi zina pambuyo pake), wodwalayo amamuwongolera mwachizolowezi (chomwe chinali chisanachitike opareshoni) regimen ya insulin. Odwala omwe saloledwa kudya os osamba koyamba pambuyo pa opaleshoni amapatsidwa jakisoni wambiri wa zakudya ndi jakisoni.

Mutha kuwasamutsa ku mankhwala ochepetsa shuga pokhapokha ngati chilondachoichira, ndipo palibe zotupa. Ndipo zowonadi, shuga iyenera kulipidwa. Kupanda kutero, jakisoni wa insulin ndi wofunikira.

Ngati kulowererapo kunali kofunika, ndikovuta kuwerengera mtundu wa insulin. Kenako imatsimikizika ndi msuzi wa shuga. Iyenera kuyang'aniridwa ola limodzi (!). Ndikofunikira kudziwa momwe wodwalayo akumvera mumtima mwake, makamaka matenda ashuga akapezeka kaye.

Chifukwa chake, opaleshoni ya shuga ndiyotheka. Itha kuchitika mu mitundu yayikulu ya matenda ashuga - chinthu chachikulu ndikupeza chipukuta mokwanira kapena chochepa. Kuchita opareshoni kumafuna dotolo wamkulu ndikuwonetsetsa momwe wodwalayo alili.

Mulingo watsopano

AiF: - Yuri Ivanovich, m'magazini yathu yaposachedwa, mwalankhula za chiyembekezo chachikulu cha opaleshoni pachipatala cha matenda a shuga a 2. Kodi pali chilichonse chomwe chasintha panthawiyi?

Yuri Yashkov: - Inde, zambiri zasintha. Tapeza zambiri zathu zokhudzana ndi ntchito yogwiritsira ntchito matenda osokoneza bongo kwa odwala omwe ali ndi matenda a shuga 2, omwe ambiri a iwo adachotsa matenda akuluwa mothandizidwa ndi opareshoni. Kupatula apo, "opaleshoni yapadera" yomwe ndakhala ndikugwira ntchito kwa zaka pafupifupi 20, sikuti ndikuchita opareshoni ya kunenepa kwambiri, komanso matenda a metabolic (metabolic), omwe amayamba chitukuko cha matenda a shuga a mtundu wachiwiri. Njira zochizira matendawa zimavomerezeka mwatsatanetsatane komanso zimaphatikizidwa mu njira zochizira matenda ashuga ndi magulu odziwika apadziko lonse a odwala matenda ashuga.

AiF: - Mukutenga opareshoni ndani?

Yu. Ya: - Monga kale, timangotchulidwa kwa odwala omwe matenda a shuga a 2 amaphatikizidwa ndi digiri imodzi kapena inanso. Koma tsopano, poyerekeza ndi zaka zam'mbuyomu, pali anthu ambiri omwe ali ndi kunenepa kwambiri. Zowonadi, kuti shuga ikhale ndi zovuta zake zowopsa, sikofunikira kulemera makilogalamu 150-200. Kwa anthu omwe ali ndi vuto la matenda a shuga, nthawi zambiri zimakhala zokwanira 90-100 kg. Ndipo ngati pa nthawi yomweyo mafuta ambiri adzakhazikika m'mimba mwa mawonekedwe ozunguliridwa kapena, monga amatchedwa, "mowa" tummy - ichi ndi chifukwa chokwanira choti ayambe kuyang'anira kuchuluka kwa shuga m'magazi. Ngati matenda ashuga sangathe kuwongoleredwa ndi zakudya kapena mankhwala, muzochitika izi ndizotheka kuyambitsa funso la kugwiritsa ntchito njira za opaleshoni.

Zodabwitsa? Zodziwikiratu!

"AiF": - Ndi chiani chomwe chimasankha kusankha njira, momwe mumapulumutsira wodwala matenda ashuga kunenepa kwambiri?

Yu. Ya: - Ngati ili ndi gawo loyamba la matenda ashuga kapena prediabetes (kuleketsa shuga), ntchito iliyonse yomwe ingachepetse kudya komanso kuchepetsa thupi imatha kusintha zinthu. Ngati wodwala wakhala ndi mbiri yodwala matenda ashuga a 2 kwazaka zambiri, kapena ngati samakonda kumwa mankhwala ochepetsa shuga ndipo makamaka, insulin, kusankha kwathu kudzapangidwa mokomera njira zovuta. Komanso, kuthekera kochotsa matenda amtundu wa 2 shuga kumachitika mwachindunji kukuvuta kwa opareshoni. Chifukwa chake, atamangirira m'mimba, kuperekera kwa mtundu wachiwiri wa matenda ashuga kumafikiridwa ndi 56.7% ya odwala, omwe ali ndi gastroplasty - 79,7%, ndi gastroshunting - 80.3%, ndi biliopancreatic shunting - 95.1%.

AiF: - Kodi pali mwayi pambuyo pakuchitika kwa opaleshoni yakuchulukitsa kwam'mimba kuti musiyiretu mapiritsi ochepetsa shuga ndi jakisoni wa insulin?

Yu. Ya: - Ilipo! Ndipo kwenikweni. Chifukwa chake, mwayi wakukwaniritsa chiphuphu cha matenda osokoneza bongo popanda mankhwala ochepetsa shuga popanda zovuta zilizonse zopatsa thanzi 951.100% pambuyo pothana ndi biliopancreatic shunting. Tili kale ndi odwala ambiri chotere, ndipo pamene iwo, omwe akhala ali ndi jakisoni wa insulin ndi mapiritsi kwa zaka zambiri, akabwera atachitidwa opaleshoni kwa madokotala am'deralo ndi chiphuphu chokwanira cha matenda ashuga, amangokhulupirira zomwe zikuchitika! Koma, mwamwayi, akatswiri ambiri a endocrinologists akudziwitsidwa za mwayi wa opaleshoni pankhaniyi ndikutumiza odwala kwa ife. Nthawi yomweyo, kukayikira pakati pa madokotala a dipatimenti yotulutsa nkhani pankhaniyi kudakalipobe, chifukwa amakhulupirira kuti matenda a shuga a 2 sangachiritsidwe.

AiF: - Ndipo malingaliro a akatswiri otchuka ku Russia amalemba za chiyani pankhaniyi?

Yu. Ya: - Ndikukumbukira bwino zomwe zidachitika zaka khumi zapitazo, pomwe kumveka kwa lingaliro la kuthekera kochotsa matenda a shuga 2 kudadzetsa mavuto kuchokera kwa endocrinologists omwe adalemekezedwa kwambiri mdziko muno. Panthawi ina, anzathu ku America, madokotala ochita opaleshoni, anachitanso zomwezo.

M'zaka zaposachedwa, zinthu zasintha: funso loti angathe kuchitidwa opaleshoni ya 2 yothandizirana tsopano likufotokozedwa kwambiri pamabungwe odziwika kwambiri a akatswiri opanga maopaleshoni ndi ma endocrinologists, pamasamba a magazini apadera asayansi, atolankhani. Ndipo American Diabetes Association mu 2009 idaphatikizanso opaleshoni ya bariatric muyezo wochizira matenda a shuga a 2. Pambuyo pake, kodi endocrinologists ndi akatswiri a matenda ashuga ayenera kupatulidwa kuti achite izi? Inde, ndikofunikira kuphunzira chifukwa chake ntchito zotere zimathandizira odwala omwe ali ndi matenda ashuga, njira ziti za chitukuko cha matenda omwe opaleshoni akuwonongeka, komanso momwe mamiliyoni aanthu omwe ali ndi matenda a shuga angathandizidwire. Pali ntchito yokwanira aliyense. Kwa nthawi yayitali.

Malire oyenera

AiF: - Kodi opaleshoni ingathandize odwala onse omwe ali ndi matenda ashuga a 2?

Yu. Ya: - Tsoka ilo, ayi. Simungathandize omwe adadwala kale matenda ashuga osakhazikika chifukwa cha kupunduka kwamatenda am'mimba, matenda opha ziwalo, kulephera kwa impso, kulephera kuwona ndi miyendo.

Ndizothekabe kuthandiza ambiri omwe alibe ndalama zogulira maopaleshoni okwera mtengo kwambiri pochizira kunenepa kwambiri ndipo sangalandire ndalama zoyambira kuboma kuti akwaniritse. Sitidzathandizanso anthu odwala matenda ashuga (ndipo pali ambiri a iwo) omwe chipembedzo chake chimadya, ndipo amakonda kwambiri zinthu zina zofunika pamoyo. Nthawi zina, chifukwa cha kufa kwa maselo a beta, kapamba amalephera kupanga insulin, kuthekera kwakukulu, ntchito izi sizingapereke 100% komanso moyo wonse.

AiF: - Pokambirana, timakhala tikulankhula za matenda ashuga a 2. Kodi ndizotheka kukopa njira ya matenda ashuga amtundu woyamba omwe amagwiritsa ntchito opaleshoni ya bariatric?

Yu. Ya: - Ndi matenda a shuga a mtundu woyamba, kufa kwa maselo a pancreatic beta kumayamba, monga lamulo, kale ali mwana, chifukwa chake odwala amafunika kukonzekera insulin, ndipo sizivuta kumwa. Pokhala ndi insulin yambiri, odwala amakhala ndi chidwi chofuna kudya zochulukirapo, ndipo nthawi zambiri nawonso amayamba kulemera. Apa titha kuwerengera, mwachitsanzo, pakukhazikitsa balloon ya intragastric kapena gastric banding. Ngakhale ziyenera kumvetsedwa kuti sizotheka konse kuletsa insulin mu mtundu 1 wa shuga. Opaleshoni yam'mbuyo, yomwe tidakambirana zokhudzana ndi matenda a shuga a 2, ndizosavomerezeka mu mtundu 1 wa shuga.

Chinsinsi chavuto: chifukwa chomwe madokotala ali osangalalira

Zina mwazotsatira zonse zomwe odwala matenda ashuga amachitidwa, zotupa za purulent komanso zoperewera zikutsogolera pakuvulala kwa opaleshoni. Kulowa m'malo kumatanthauza kuchitidwa opaleshoni yotseguka, motero zimayambitsa nkhawa yayikulu pakati pa akatswiri a zamankhwala kuti adziwe zambiri komanso kuti kuchiritsa kwa bala pakadutsa ntchito.

Chifukwa chakuyenda bwino kwa kapamba chifukwa cha kuwonongeka kwa pancreatic insulin, pamakhala kuchepa kwapang'onopang'ono kwa mabala ang'onoang'ono apamwamba kwambiri mwa anthu ambiri omwe ali ndi matenda ashuga. Zilonda za opaleshoni ndi kulowereraku sizikungokhala, koma osatalikirapo, koma kudula kwakuya kwa zomanga zofewa kumadera omwe akhudzidwa. Kuyenda pang'onopang'ono kwa suture, komwe kungayambenso chifukwa chokhala ndi chitetezo chofooka, kumawonjezera mwayi wamatenda akumalonda, zilonda zam'mimba, purcess abscess. Ndi zotupa zotere, ziwopsezo za sepsis ndi kulephera kulowa zimakulitsidwa (kukanidwa, kusakhazikika, kutayika kwa endoprosthesis, ndi zina zambiri).
Mfundo yachiwiri: ndi njira yotalikilapo ya matenda ashuga, ziwiya ndi mtima zimasinthidwa, mphamvu zam'mapapu ndi impso zimachepa chifukwa cha hyperglycemia yomwe imatenga nthawi yayitali. Ndipo izi zimakhala ndi zoopsa zowonjezereka, nthawi zambiri zimayambitsidwa ndi opaleshoni. Mavuto obwera chifukwa cha mtima, kugunda kwa mtima, kuchepa kwa magazi, mphumu, chibayo, kulephera kwa impso, ndi zina zotere zomwe zingatsate poyankha opaleshoni. Amatha kuyambitsidwa, mwachitsanzo, ndi mankhwala osakhazikika kapena kutayika kwakakhanda kwa magazi.
Mu nthawi ya opaleshoni, kupezeka kwa hypoglycemia sikumayikidwa pambali - choopsa kwambiri pamoyo wa wodwalayo, kupweteketsa mtima. Gulu logwiritsira ntchito liyenera kuthandizira kuti lisathe kuthetsa mwachangu hypoglycemic syndrome, komanso kusiyanitsa kutsika kwakuthwa kwa shuga m'magazi pamavuto ena (sitiroko, mankhwala osokoneza bongo, ndi zina zambiri). Hyperglycemia imagwiranso ntchito molimbana ndi mavuto (zotupa, mabala a poizoni, kuwonongeka kwa mtima, zilonda zamatenda, ndi zina), onse atachitika komanso atachitika opareshoni.
M'madera akumunsi, kulumikizana komwe nthawi zambiri kumafunikira ma prosthetics, kufalikira kwa magazi mu shuga kumachepetsedwa. Izi zitha kudodometsa postoperative kuchira kwa mwendo thrombosis, minofu atrophy, ndi motor contracture. Thrombosis imakhala yodzaza ndi chotupa cha m'mapapo chifukwa cha kupatuka kwa thrombus ndi kusuntha kwake pabedi lamitsempha. Khwimbi ndi mgwirizano - mosalekeza malire osunthika kapena kusintha pang'onopang'ono kwa kubwezeretsa ntchito kwa dzanja lanu.

Dokotala wa opaleshoni, wa opaleshoni, endocrinologist, wolimbitsa thupi ayenera kugwiranso ntchito njira yonse yochizira kuti ikhale yabwino kwa wodwalayo, osakhala ndi nkhawa yayikulu ya metabolic. Kupambana kwa endoprosthetics mwachindunji kumadalira mulingo waluso, chidziwitso, udindo wa akatswiri omwe amagwira ntchito kuchipatala, komwe munthu wodwala matenda ashuga amayenera kuchitidwa.

Kukonzekeretsa odwala omwe ali ndi matenda ashuga kuti alowe m'malo

Kuchitapo kanthu kumachitika pokhapokha poyambira matenda ashuga omwe amapidwa. Pamaso chisamaliro chamankhwala mwachangu, mwachitsanzo, musanalowe m'malo mwa cholumikizira chifukwa cha khosi lazikazi, ndikofunikira kukwaniritsa kufupikitsa kwakanthawi chifukwa chodwala. Kudzikonza nokha boma sikovomerezeka!

Wodwalayo amapita kukonzekera konse moyang'aniridwa ndi akatswiri odziwa ntchito zachipatala. Sitinganene motsimikiza kuti ngakhale pa nthawi yomwe akukonzekera ndikofunikira kuthana ndi wophunzitsa othandizira olimbitsa thupi omwe akutsimikiziridwa ndi wophunzitsa othandizira othandizira olimbitsa thupi ndikutsatira kudya kwamankhwala othandizira (malinga ndi Pevzner, tebulo Na. 9). Kutalika kwa kukonzekera kumatengera kuuma kwa matenda, zaka, kulemera kwa wodwalayo, mbiri yodwala matenda, ndi zina zomwe munthu amachita.

Kuti muchepetse chiopsezo perioperative musanalowe m'malo mwa olowa, kupatula, kwa odwala onse amtundu wa 1 ndi mtundu wa 2 matenda a shuga, kuwonjezera pa zovuta zoyeserera, kufufuza kulimbikitsidwa:

glycemic index
glycated hemoglobin,
ketonuria (acetone),
kuchuluka kwa hydration
Digiri ya KShchS (bicarbonate, PH - osachepera),
potaziyamu ndi sodium,
mtima minofu ntchito ndi ECG, kuthamanga kwa magazi,
manaini
proteinuria (mapuloteni mu mkodzo),
kuchuluka kusefera,
neuropathy ya chikhodzodzo, m'mimba,
magazi
retinopathy (kuphwanya magazi kumayendedwe ka retina).

Kuzindikirika monga chifukwa choyambirira chodziwidwa ndi kuphwanya kwakanthawi kwakukonzedwa pogwiritsa ntchito mankhwala a insulin opindulitsa kapena kutenga PSSP. Pamodzi ndi iwo, othandizira othandizira omwe ali ndi mankhwala a concomitant pathologies amagwiritsidwa ntchito pobwezeretsa chokhacho matenda omwe amayambira ndi zotsatirapo zake.

Pachikhalidwe, miyezo yolola odwala omwe ali ndi matenda ashuga kuti alowe m'malo olumikizana ndi motere:

glycohemoglobin (Hb1C) - ochepera 8-9%,
ketoacidosis ndi acetonuria kulibe,
glycemia - wabwinobwino kapena wapafupi ndi wabwinobwino (odwala omwe ali ndi mawonekedwe owopsa - osaposa 10 mmol / l),
glucosuria tsiku ndi tsiku (glucose mu mkodzo) - osakhalapo kapena wopanda tanthauzo (mitundu yayikulu, mpaka 5% imaloledwa).

Kuyesedwa ndi anesthetist nthawi zonse kumakhala gawo lofunikira pakukonzekereratu. Regional anesthesia (msana kapena mtundu wamankhwala) umakonda kwa odwaladwala, chifukwa analgesia yakumalo satha kuyambitsa kusokonezeka kwa glycemic komanso zovuta zina. Ngati vertebral anesthesia yatsutsana, gwiritsani ntchito mankhwala ophatikizana ndi kupuma komwe kumayendetsedwa (mwachitsanzo, endotracheal ndi sedation ndi kupuma kwamisempha). Mlingo ndi zigawo za opaleshoni zimatsimikiziridwa payekhapayekha.

Kukonzekera kwa gulu ili la odwala malinga ndi malamulo a orthopedics kumakhalanso ndi mankhwala opha maantibayotiki omwe adayambika pasadakhale. Cholinga chake ndikupewa pathojeniis amkati komanso opatsirana posachedwa. Pambuyo pa ma prosthetics, mankhwala opha maantibayotiki amapitilira malinga ndi zomwe dokotala wakhazikitsa.

Madzulo a kulowererapo, odwala matenda ashuga a gulu lotha kugwira ntchito amalandila chakudya chamadzulo ndipo, monga lamulo, a insulin 4 osakhalitsa, insulin (yayitali) ya insulin - 1/2 ya mlingo wamba. Kuwongolera kwa glycemic kumachitika maola onse atatu mpaka m'mawa. Opaleshoni imayambika m'mawa, atatha kuyambitsa IPDA pa mlingo womwewo, kuphatikiza njira ya shuga ya 5-10% yokhala ndi 100 ml / ola limodzi. Enema yotsuka imayikidwa usiku ndi m'mawa pamaso pa njira yolowa m'malo. Maola 2 mutatha kupatsidwa mahomoni omaliza, wodwala amamugwirira ntchito.

Ophatikizidwa m'malo mwa opaleshoni ya shuga

Njira ya endoprosthetics ndiyofanana kwa onse odwala. Monga awo omwe alibe chochita ndi zovuta za endocrine, anthu omwe ali ndi mbiri ya matenda ashuga:

pangani zoperewera zowopsa mwakusiyanitsa khungu ndi mafuta ochulukirapo, ndikukulitsa ulusi wamisempha, kutsegula kapisozi yolumikizana,
phatikizani bwino mbali zosagwirizana ndi odwala
konzani bwino mafupa kuti akwaniritse zigawo za endoprostase (pukuta, pangani njira yolowera mafupa, ndi zina).
konzani zophatikizika zopangidwa ndi zida zamagetsi zamphamvu kwambiri (titanium, cobalt-chromium alloy, ceramics, pulasitiki yolemera kwambiri) yokhala ndi mafupa
kumapeto kwa arthroplasty, chilondacho chimamangika ndi suture yodzikongoletsa ndikusunga malo okutsira.

Panthawi ya opaleshoni, zida zowongolera ndi kuwunikira nthawi zonse zimayang'anira ntchito zonse zofunika, kuphatikizapo zizindikiro za glycemia. Nthawi zambiri pamakhala kufunika kugwiritsa ntchito kulowetsedwa kosalekeza ndi glucose pa mlingo woyenera nthawi yonse ya opaleshoni. Pakachitika vuto la pathological losafunikira, chithandizo chamankhwala choyenera chimaperekedwa mwachangu kuti chikhazikitse mofulumira vutoli m'malo osavulaza.

Malinga ndi ziwerengero, osachepera 90% odwala omwe ali ndi matenda osokoneza bongo amalipiridwa mokwanira mu nthawi ya perioperative, pambuyo poti ziyeneretsedwe zovomerezeka ziyenera kuchita bwino. Komabe, kuyendetsa bwino matenda ashuga isanachitike, panthawi, komanso pambuyo pa opaleshoni.

Malangizo ochira pambuyo pokhazikitsa endoprosthesis ya matenda ashuga

Mu nthawi yoyambirira, chifukwa cha kuvulala kogwira ntchito, padzakhala zowawa zomwe zimachotsedwa ndi mainkinkiller kuchokera kuwoneka kwa NSAIDs; pamavuto kwambiri, kugwiritsa ntchito corticosteroids ndikotheka. Kupatula pokhapokha, njira zonse zochizira ndi kukonza zimakhazikitsidwa ndikuwongoleredwa kokha ndi dokotala wa opaleshoni, endocrinologist ndi Refreshologist!

Kugwiritsa ntchito insulini mwachidule kumawalembera wodwala maola 6 aliwonse tsiku loyamba la ZSE. Muyeso umodzi wa yankho losavuta la mahomoni amawerengedwa potengera zomwe zili m'magazi. Mwachitsanzo, ndi glycemia ya 11-14 mmol / l, mayunitsi 4 amatumikiridwa mosavomerezeka. ICD, pa 14-16.5 mmol / l - 6 mayunitsi. Pazakudya, amatsogozedwa ndi chakudya chomwe chimayikidwa mu nthawi ya preoperative. Mtsogolomo, munthu amasamutsidwira ku regimen komanso muyezo wa insulin, ngati pakufunika kutero, katswiriyo amasintha.

Anthu omwe ali ndi matenda a shuga a mtundu wa 2 omwe adalowa m'malo ophatikizika amayenera kupatsidwa insulin kwa masiku osachepera asanu ndi asanu ndi amodzi atatha kulowererapo, ngakhale ngati mankhwala awo ndi PSSP. Kutha kwa insulini yoikidwiratu ndi kotheka kapena tsiku loti muchotse, pokhapokha ngati chilondacho chikuchiritsa bwino, palibe kutupa kwachinyengo. Nthawi yokwanira yosankha insulin yochizira matenda amtundu wa 2 ikatha kuchotsedwa kwa ma suture.

Mseru wabwino.

Onetsetsani kuti mukuwongolera kukodza: chikhodzodzo chimafuna kuchotsera nthawi yake kuti muchepetse matenda. Pamodzi ndi izi, maantibayotiki amaikidwa. Mankhwala, poyambitsa kutseguka koyambirira (kuyenda pa ndodo, kuyambira tsiku lotsatira) ndi masewera olimbitsa thupi apadera, kupewa kwa venous thrombosis ya m'munsi kwambiri ndikuwonekera m'mapapu kumachitika.

Nthawi yomweyo, wogwiritsa ntchito mankhwala olimbitsa thupi amapereka mankhwala olimbitsa thupi, olimbitsa thupi pamankhwala olimbitsa thupi omwe cholinga chake ndi kulimbitsa minofu, kukulitsa matalikidwe oyendetsedwa molumikizana ndi abwinobwino. Kwa kubwezeretsa kwa minofu yabwino kwambiri, kubwezeretsa kamvekedwe ka minofu, kusintha kwa metabolism ndi magazi, physiotherapy (electromyostimulation, maginito, laser, ndi zina zambiri).

Kuchira kwathunthu ndikovuta kukonzanso kumatheka pafupifupi miyezi itatu ndi itatu. Pambuyo wodwala akuwonetsa kudutsa kwa spa chithandizo. Pambuyo pake, ndikofunikira kupita ku sanatorium yodziwika bwino pamavuto am'misempha ndi mafupa 1-2 pachaka.