Matenda a shuga > Matenda a shuga

Zosintha zokhudzana ndi zaka mu dongosolo la endocrine mwa okalamba ndi senile.

Phunziro No. 3. (1 ora) Geriatric mbali mu endocrinology.

Ma IDK a MDK 01.01 ku Geriatrics

Ndi ukalamba, kupangika kwa mahomoni, kumangiriza kwa mahomoni kumapuloteni, ndi kulandilidwa ndi maselo ojambulidwa amasintha.

Mu hypothalamus, lipofuscin imakhala ndi ma cell a nyukiliya, ma neurosecretory reaction ku Reflex (kupweteka kwa pakhungu) kapena kukhudzika kwamanjenje kumafooketsa, ndipo zimachitika pazomwe zimapangitsa manyazi (mwachitsanzo, adrenaline). Mu pituitary gland, kupanga "maulendo atatu" mahomoni a anterior lobe kumawonjezeka - thyrotropic (TSH), mahomoni okula (STH), adrenocorticotropic (ACTH) ndi ena. Mwambiri, zosintha zokhudzana ndi zaka m'magawo osiyanasiyana a hypothalamic-pituitary system sizofanana.

Kukalamba mu thymus kumayamba pa kutha msambo, ndipo mphamvu zake zam'mimba zimatha pafupifupi kukalamba, zomwe zimapangitsa kuchepa kwakukulu kwa mphamvu ya chitetezo cha m'thupi.

Mu chithokomiro cha chithokomiro, minyewa yolumikizira minyewa ikukwera, kuchuluka kwa ma follicles ndi chithokomiro cha ayodini kumachepa, zomwe zimapangitsa kutsika kwamagazi a thyroxine ndi triiodothyronine (mpaka 25-40% pambuyo pa zaka 60) - Zizindikiro za hypothyroidism zimayamba.

Pambuyo pa zaka 30, gland ya adrenal imapangidwanso kukonzanso kwa cortex, mtolo (glucocorticoids) ndi mauna (amatulutsa mahomoni ogonana) kuwonjezeka, pazaka 50-70 the adrenal cortex imayimiriridwa makamaka ndi dera laamba, pomwe kupanga kwathunthu kwa ma adrenal mahomoni ndi malo awo osinthika amatsika.

Momwe magazi amathandizira pancreas amayamba kuchuluka, kuchuluka kwa ma cell a Langerhans ndi zochitika za insulin zomwe zimapangidwa zimachepa. Ndi ukalamba, shuga wamagazi amatuluka.

Epidemiology ya mtundu wachiwiri wa shuga mu ukalamba

Chimodzi mwazifo zomwe zimapezeka kwambiri mu okalamba (zopitilira 65) ndi matenda amtundu wa 2. Pafupipafupi mtundu wa matenda ashuga a 2 ndi 4,8% ali ndi zaka 50-59, 10-12% ali ndi zaka 60-69, 14-20% ali ndi zaka 70-79 ndipo amafika 25% atatha zaka 80 za moyo. Malinga ndi kafukufuku wofufuzira ku Moscow (Yu.I. Suntsov 1998), kuchuluka kwenikweni kwa matenda ashuga a 2 kumakhala kokwanira kawiri kawiri kuposa komwe kwasinthidwanso ndi kusinthanso. Izi zikutanthauza kuti chiwerengero chenicheni cha odwala omwe ali ndi matenda a shuga 2 ndiochulukitsa kawiri kuposa momwe amalembetsa, m'malo opitilira 50%, odwala matendawa amapezeka mochedwa.

Zomwe zimachitika pachipatala cha odwala matenda a shuga 2

Zomwe zimapangitsa kuti azindikire kuti ali ndi matenda ashuga okalamba zimayenderana ndi chithunzi chazovuta za matenda. Zodandaula zofanana ndi matenda ashuga, monga ludzu, polyuria, kuyabwa kwa khungu, ndi zina zotere. Madandaulo osatchulidwa - kufooka, kugona, kupweteka mutu, kusokonezeka kukumbukira, masomphenya - kubwera posachedwa. Izi zimapangitsa kuti azindikire matenda ashuga komanso 30 - 50% ya odwala omwe ali ndi matenda a shuga 2 (chifukwa cha matenda osadziwika) amakhala ndi vuto lalikulu.

Pachithunzi cha matenda ashuga, ndimakonda kusiyanitsa magulu awiri azizindikiro: choyambirira komanso chachiwiri.

Zizindikiro zazikulu zikuphatikiza:

1. Polyuria - kuchuluka kwa mkodzo komwe kumachitika chifukwa cha kuchuluka kwa mkodzo chifukwa cha shuga amene amasungunuka m'mimba mwake (kawirikawiri, mumkodzo mulibe shuga). Imadziwonetsa lokha kukodza kawirikawiri, kuphatikiza usiku.

2. Polydipsia (ludzu losagonjetseka) - chifukwa cha kutayika kwakukulu kwamadzi mu mkodzo ndikuwonjezeka kwa magazi a osmotic.

3. Polyphagy ndi chakudya chosasinthika chamantha. Chizindikiro ichi chimayamba chifukwa cha kusokonekera kwa kagayidwe kachakudya matenda ashuga, ndiko kulephera kwa maselo kuyamwa ndikuwonjezera glucose popanda insulin (njala yambiri).

4. Kuchepetsa thupi (makamaka mawonekedwe a matenda a shuga 1) ndi chizindikiro chofala kwambiri cha matenda ashuga, chomwe chimayamba ngakhale odwala omwe ali ndi chidwi chambiri. Kuchepetsa thupi (komanso kutopa) kumachitika chifukwa chakuwonjezeka kwa mapuloteni ndi mafuta chifukwa chakutseka kwa glucose kuchokera ku mphamvu ya metabolism ya maselo.

Zizindikiro zachiwiri zimaphatikizapo zizindikiro zapadera zamankhwala zomwe zimayamba pang'onopang'ono pakapita nthawi. Zizindikiro izi zimadziwika ndi matenda ashuga amitundu yoyamba ndi yachiwiri:

Kuyabwa kwa khungu ndi mucous nembanemba (maliseche akumaliseche),

Kufooka kwamisempha

Zilonda zamkati zotupa zomwe zimavuta kuchiza,

Kupezeka kwa acetone mu mkodzo ndi matenda amtundu 1 shuga. Acetone ndizotsatira zamafuta oyaka amafuta.

Mavuto a matenda a shuga a 2 okalamba

Tebulo limanenanso za zovuta zam'mtima, mapazi, impso, ndi m'maso mwa anthu azaka zopitilira 65 asanapezeke ndi matenda a shuga (Neil HAW, 1989).

Pafupifupi aliyense wachiwiri wachikulire wodwala matenda a shuga a 2 amakhala ndi matenda oopsa (mavuto amachitika kawirikawiri), vuto la kusokonezeka (matenda amtundu wa chifuwa), matenda amkodzo thirakiti ndi zovuta zina.

Kuzindikira matenda amtundu 1 komanso matenda amtundu wa 2 amathandizidwa ndi kupezeka kwa zizindikiro zazikulu: polyuria, polyphagia, kuchepa thupi. Komabe, njira yayikulu yodziwira matenda ndikuwonetsetsa kuchuluka kwa shuga m'magazi. Kuti muwone kukula kwa kuwonongeka kwa kagayidwe kazakudya, kuyeserera kwa glucose kumagwiritsidwa ntchito.

Kuzindikirika kwa matenda ashuga kumakhazikitsidwa ngati zingachitike zomwezi zizindikiro:

· Kuchuluka kwa shuga (glucose) posala kudya capillary magazi kupitilira 6.1 mmol / l (mamililita imodzi pa lita), ndipo maola awiri atatha kumeza (postprandial glycemia) amaposa 11.1 mmol / l,

Chifukwa cha mayeso okhudzana ndi glucose (mosakaikira), kuchuluka kwa shuga kumadutsa 11.1 mmol / l (mobwerezabwereza),

· Mlingo wa hemoglobin wa glycosylated uposa 5.9% (5.9-6.5% - mosakayikira, woposa 6.5% ali ndi matenda a shuga),

· Shuga alipezeka mumkodzo,

· Mkozo muli acetone (Acetonuria, (acetone atha kukhalapo popanda matenda ashuga))

Sanapeze zomwe mukuyang'ana? Gwiritsani ntchito kusaka:

Mawu abwino:Monga banja, mphunzitsi m'modzi adati pamene nkhaniyi ikamaliza - inali kumapeto kwa awiriwo: "China chake chimamveka ngati kumapeto kuno." 8176 - | 7857 - kapena werengani zonse.

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Kodi chimayambitsa matenda a myrotooticosis ndi chiyani?

Hyperthyroidism (matenda a Bazedov). Choyambitsa chachikulu cha thyrotoxicosis, chomwe chimakhudza azimayi azaka zapakati. Chifukwa cha chibadwa chobadwa nawo. Chomwe chimapangitsa ndi matenda opatsirana, kugwedezeka kwamphamvu kwamaganizidwe, mavuto am'mphuno ndi kuvulala kwamisala.
Matenda a Plummer. Mapangidwe a Benign mu zimakhala za chithokomiro. Zomwe zimayambitsa matendawa sizimamveka bwinobwino. Amapezeka mwa akazi ndi amuna.
Mankhwala osokoneza bongo a L-thyroxine. Zimachitika ndi kudya kosalamulirika, pamene chithandizo cha hypothyroidism chimaphatikizira mankhwalawa, komanso kugwiritsa ntchito thyroxine kuti muchepetse kunenepa kwambiri.
Subacute chithokomiro. Kutupa kwa chithokomiro ndi chitukuko cha magawo. Zimayambitsidwa ndi vuto lina la chibadwa chathu.
Chithokomiro adenoma.
Iodini wowonjezera m'thupi chifukwa cha mankhwala osokoneza bongo.
Chotupa.
Chotupa chamchiberekero.

Zizindikiro zazikulu za thyrotooticosis zomwe zikupita patsogolo

Gulu lomwe likuika pachiwopsezo chachikulu ndi azimayi azaka zosakwana 50. Zizindikiro za thyrotooticosis ndizosiyanasiyana komanso zambiri. Nthawi zina zitha kuwoneka kuti palibe kulumikizana pakati pawo ndi chithokomiro cha chithokomiro, koma, chabwino, zonse, zimakhala kuti ndizowopsa. Vutoli litatsimikiziridwa posachedwa ndi zomwe zalembedwa pansipa, ndiye kuti chithandizo chokwanira kwambiri chidzakhala chothandiza.

Poyamba, mtima wamtima umavutika. Lingaliro lomwe limavomerezedwa kukhala ndi mtima wa mtima wamanjenje limatanthauzira kuphatikizika konse kwamatenda amtima omwe amayamba chifukwa cha mahomoni a chithokomiro. Monga chochititsa chidwi: atrophicillation, metabolic angina, sinus tachycardia ndi kulephera kwa mtima.

Kuchokera musculoskeletal system, minofu atrophy, hypercalcemia, kufalitsa mafupa amawonedwa. Kupweteka kwapafupipafupi komanso kupweteka kwapafupipafupi kumatha.

Mosalephera, kuwonongeka kwamanjenje, komwe kumabweretsa:

Kusakwiya, kugona tulo, mantha owonera,
Kuchita zolimbitsa thupi, kuvuta kuganizira,
Maonekedwe osayembekezeka a phobias osiyanasiyana, kuwopseza,
Kusakhazikika pamalingaliro (kuchokera ku euphoria mpaka kuvutika mtima kwambiri), kuda nkhawa,
Kukugwedezeka kwa minyewa ya dzanja, eyel, lilime kapena thupi lonse.
Zovuta, kuchuluka magazi.

Kulephera kwam'mimba thirakiti kumadziwika ndi kuchepa, kapena, kuwonjezeka kwa chilakolako chofuna kudya. Koma ngakhale ndi chidwi chambiri, kulemera kwa thupi kumapitilirabe kuchepa, osangotaya minofu ya adipose komanso minofu yambiri. Kusokonezeka kwakukulu kumachulukitsidwa ndi kutsegula m'mimba mwadongosolo.

Mwa azimayi omwe ali ndi gawo lachiberekero, msambo umasokonezeka. Kusamba kumakhala kovuta mokwanira, kumayenderana ndi kupweteka mutu, nseru kwambiri, ngakhale kukomoka. Kutheka kwa kutenga pakati kumachepa kwambiri. Amuna omwe ali ndi thyrotoxicosis amadwala kuchepa kwa potency ndipo pali milandu ya gynecomastia (kukulitsa kwa tiziwalo ta mammary).

Zizindikiro zina zophatikizika

Thyrotoxic exophthalmos (kukulira kwa kufalikira kwa palpebral, eyelids edematous, wokhala ndi tint yoyera),
Pakamwa pakamwa, pakhungu pakhungu,
Kupuma movutikira, kulumikizidwa kosalekeza kwa phokoso pakhosi,
Kuchepera tsitsi ndi msomali.
Tsitsi loyambirira
Kumeza kovuta chifukwa cha kukula kwa chithokomiro.
Blush yowala
Kutupa kwa minofu
Kumva kutentha ngakhale kuzizira
Kutukwana
Kukodza pafupipafupi ndipo, monga chotulukapo chake, kudandaula ludzu.

Thyrotooticosis syndrome imachitika mosiyanasiyana kutengera kuuma ndipo imawagawa m'mitundu itatu yayikulu: yofatsa, yodziwika komanso yovuta.

At kuwala koyenera kuchepa thupi kosafunikira kwenikweni komanso tachycardia yaying'ono kumatha kuonedwa. Pali kutopa konsekonse ndi kusakwiya msanga (kung'ambika, kuwonjezeka kumva). Kuyambira theka lachiwiri la tsiku - magwiridwe antchito.

Fomu yapakatikati kale yodziwika ndi kuwonjezeka kwa kugunda kwa mtima mpaka 120 kumenyedwa pamphindi, kuchuluka kwakukulu, kugwira ntchito kochepa komanso kuchepa kwakukulu kwa thupi. Carbohydrate metabolism imasokonekera, zizindikiro za kuperewera kwa adrenal zimawonekera, chopondapo chimakonda kupezeka komanso kumasulidwa.

Mawonekedwe olimba thyrotooticosis, kuwonjezera pamavuto amanjenje, imadziwika ndi kufooka kwa minyewa ya m'magazi komanso vuto lalikulu la mtima. Tachycardia imayendera limodzi ndi kulephera kwa mtima ndi fibrillation ya atria. Kulemala kwathunthu.

Kufunika kwazidziwitso chapanthawi yake

Symbomatology ya thyrotooticosis ndi yotsimikizika mwakuti odwala ambiri (makamaka achikulire) molakwika amatenga zovuta zazikulu za chithokomiro chifukwa cha kusintha kwatsiku lokhazikika. Mwachitsanzo, kutentha kwa thupi kumawoneka ngati mphamvu ya kusintha kwa thupi, ndipo matenda amtundu wa mtima komanso kusokonezeka kwa malingaliro sizigwirizana ndi zovuta zamafuta. Kuzindikira kwa chithokomiro, kutsimikizira (kapena kupatula) matendawa, kumatha kuchitidwa ndi akatswiri endocrinologists.

Kuti ayambe kulandira chithandizo mosachedwa, wodwalayo amafunika kukayezetsa magazi, omwe ali ndi magawo awiri: kuwunika kwa chithokomiro cha chithokomiro komanso kufotokoza kwa zomwe zimayambitsa kukula kwa mahomoni. Njira yofunikira kwambiri yothandizira kudziwa zomwe zili ndi TSH (mahomoni opatsa mphamvu a chithokomiro) m'magazi ndi kuwunika kwachipatala. Mwa njira zina zonse, chomwe chimayambitsa matenda a thyrotoxicosis chimakhazikitsidwa.

Kupsinjika kwakukuru kwamaganizidwe, kulowererapo kulikonse kapena kuchitapo kanthu wamba kungayambitse vuto la chithokomiro. Izi zili kale zowopsa m'moyo. Mitundu ya mtima imasweka, kutentha kwa thupi kumadzuka, kusanza ndi kutsegula m'mimba. Wodwalayo amasiya kugona ndipo amagwa. Pambuyo pake chithandizo chimachitika mosamala kwambiri. Popewa izi mwanjira iliyonse, ndikofunikira nthawi zonse kuzindikira matenda a thyrotoxicosis pa nthawi.

Phwando loyamba

Pakafukufuku woyamba, adotolo amawunika kulemera kwa wodwalayo, momwe akuwonekera komanso momwe amalankhulira (kuyankhula mwachangu ndi chimodzi mwazinthu zazikulu zodziwonetsa za thyrotooticosis). Kuyang'anira kwambiri momwe khungu limakhalira, tsitsi ndi misomali. Imayesa kuthamanga kwa magazi ndi kukoka, zomwe zimadziwika ndi chithokomiro.

Wodwalayo, amauza dokotalayo mwatsatanetsatane za thanzi lake ndikupereka data ya testosterone ndi kuyesa kwa magazi (ambiri ndi mahomoni). Ngati ntchito zilizonse zakhazikitsidwa kale, ndikofunikira kutchula izi, komanso momwe amathandizira kale (ngati agwiritsidwa ntchito).

Zomwe zingachitike kuti, kutengera ndi zomwe zapezeka, endocrinologist imakayikirabe kukanika kwa chithokomiro, amafunikira mayeso athunthu kwa wodwalayo.

Njira zonse zofunikira komanso zotsika mtengo zodziwira matenda

Kuyeserera kwa magazi kuyeza miyezo ya mahomoni (TSH).

Pazotsatira zodalirika, masiku atatu musanatsutse magazi, kuchita masewera olimbitsa thupi, kumwa mowa kwambiri komanso kugwiritsa ntchito chikonga ndipo, ngati zingatheke, mankhwalawa samachotsedwa. Chakudya chomaliza musanayesedwe sichiyenera kupitirira maola 12. Seramu yamagazi imayesedwa. Mulingo wolembera wachikulire ndi 4.0 mU / l.

Kusanthula kwa immunological kwa ma antibodies.
Ultrasound, yomwe imawululira kupezeka komanso kuchuluka kwa ma node, kukula kwake komanso mawonekedwe a chithokomiro.
Electrocardiography Imazindikira zodabwitsika mu ntchito ya mtima, khalidwe la thyrotooticosis.
Dongosolo la tomography ndi MRI ya chithokomiro. Amasankhidwa pamilandu pamene zotsatira za ultrasound sizimafotokoza bwino zonse.

Mchitidwewu umapangidwa mosamalitsa mwa amayi panthawi yomwe ali ndi pakati komanso odwala omwe ali ndi ma pacemaker, amadzala ndi mahule opangidwa ndi khosi lachiberekero.

Scintigraphy (kusanthula mozungulira pogwiritsa ntchito ayodini kapena technetium). Kutanthauzira kusintha kwamachitidwe ndi kachitidwe. Kamera ya gamma imatha kuwona kuchuluka kwa isotopu, chifukwa cha momwe adotolo amatha kupeza mosavuta madera omwe ali ndi kuchuluka komanso kuchepa kwa kupanga kwa mahomoni.
Kukwera biopsy. Ndikofunikira pakudziwidwa kwakanthawi kwa matenda owopsa. Sizotheka kupereka chithandizo chamtundu wapamwamba popanda buluku wapamwamba kwambiri.

Njira iliyonse pamwambapa imasankhidwa ndi katswiri woyenera mokwanira monga momwe amafunikira komanso kutengera zotsatira zoyesedwa koyambirira.

Njira zamakono zochizira matenda a thyrotooticosis

Sizovuta kuthana ndi matendawa ndipo ndizotheka kuchiza matenda a thyrotoxicosis pogwiritsa ntchito njira ya mankhwala, ayodini kapena mothandizidwa ndi opaleshoni. Njira yakuchiritsira imasankhidwa mosamalitsa payekhapayekha ndipo imadalira msinkhu wa wodwalayo, kuuma kwa matenda ake komanso chifukwa chake chimalimbikitsa matenda a myrotooticosis.

Zambiri mwanjira iliyonse ya 3yi.

Amakhala mukumwa mankhwala a thyreostatic omwe amalepheretsa kupanga mahomoni. Kulandila, monga lamulo, ndikutali - mkati mwa zaka 1.5, ndipo kwa ambiri odwala izi zimathandizira kuchotsa zizindikilo za matendawa. Ngakhale chithandizo chimakhalapo, kuwunika kwakanthawi kwamasamba a hormone ndikofunikira pakusintha kwa Mlingo.Mlingo uliwonse umawerengeredwa payekhapayekha ndipo umasinthidwa ndi kukonza mankhwalawo mukangofanana ndi mtundu womwe. Zina mwa zoyipa za njirayi ndi kuchuluka kwakukulu kobwereranso pambuyo posiya kumwa (mpaka 50%).

Mankhwala osokoneza bongo amakhalabe mankhwala ngati kukonzekera musanachite opareshoni.

Amangotchulidwa pokhapokha ngati pakufunika kusintha pambuyo pa njira zoletsa, kukhalapo kwa Goiter yayikulu, kusalolera kwa mankhwalawa kwa mankhwala a orreostatic kapena kubwereranso pambuyo poti mupeze chithandizo cha mankhwala. Pogwira ntchito, gawo la chithokomiro cha chithokomiro limachotsedwa. M'tsogolomu, chitukuko cha hypothyroidism sichimachotsedwa, chifukwa chake wodwalayo amakakamizidwa kugwiritsa ntchito mankhwala othandizira. Koma nthawi yomweyo, opaleshoni imachepetsa mwayi wobwereza mobwerezabwereza.

Dziwani kuti chimodzimodzi, wodwalayo samachotsa matendawa ndi 100% ndipo hyperteriosis imangopitiliza, komabe, imangopitilira mofatsa.

Matenda a ayodini.

Njira yotetezeka komanso yoyenera, yomwe poyamba imagwiritsa ntchito kamodzi. Maselo a chithokomiro amalowetsa ayodini amene amalowa m'thupi ndi kufa mkati mwa masabata ochepa mothandizidwa ndi ma radiation, m'malo mwake ndimalo olumikizirana mafupa. Kuchiza sikungasinthe komanso kufananizidwa ndi opareshoni. Hypothyroidism ndiyothekanso ndipo chithandizo chamankhwala chotenga ma hormone chimafunikira. Pali zochitika pamene kumwa kamodzi kwa ayodini sikokwanira ndipo thyrotooticosis ikupitirirabe, koma kugwiritsa ntchito mobwerezabwereza kumaloledwa.

Iyenera kutsatira mosamalitsa mfundo izi:

Kukana zakudya zamafuta ndi zonunkhira, komanso zakumwa zoziziritsa kukhosi, zomwe zimayambitsa kuchuluka. Nyama ndi nsomba zimaloledwa zophika zokha,
Kuwonjezeka kwa chakudya mpaka 5 patsiku,
Kukana zinthu zopangidwa ndi mkaka ndi zinthu zomwe zimakwiyitsa matumbo,
Kudya zakudya zomwe zimalepheretsa kupanga mahomoni ambiri (radara, kabichi, sipinachi),
Kupatula kwathunthu pazinthu zokhala ndi ayodini (mchere wopanda mchere, nsomba zam'nyanja, nsomba zam'madzi),
Chifukwa cha kuthamanga kwa kagayidwe - kuphatikiza kwakukulu kwa zakudya ndi phosphorous, calcium ndi vitamini.

Kutalikitsa chikhululukiro ndikuchepetsa kwambiri kuyambiranso kwa matenda a thyrotoxicosis, pewani zochitika zilizonse zovuta komanso kukhala ndi moyo wathanzi. Kuphatikiza ndi prophylaxis yovomerezeka, izi zimakupatsani mwayi wochepetsera kusagwira bwino kwa chithokomiro cha chithokomiro kapena kuwona matenda koyambira kumene.

Matenda a shuga, mtundu 1, mtundu 2, matenda, shuga, magazi, shuga kwa ana

Takulandirani owerenga tsamba la shuga! Lero tikulankhula za matenda ena akulu owopsa a mahomoni, mwatsoka, omwe amapezekanso odwala matenda ashuga. Thirotooticosis ndi matenda omwe amaphatikizidwa ndi kuwonjezereka kosalekeza kwa kuchuluka kwa mahomoni a chithokomiro m'magazi chifukwa chambiri chithokomiro. Nthawi yomweyo, kukhathamiritsa kwa mahomoni ambiri kumakhudza ziwalo zonse ndi machitidwe, zomwe zimayambitsa kusokonezeka kwa metabolic komanso zovuta zazikulu. Kukhazikitsa njira yanthawi yake yamankhwala ndikusintha momwe vutoli lisanayambike, njira yophatikizira ndiyofunikira matenda a thyrotooticosis.

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Mukamayang'ana wodwala, wowerenga kapena wa endocrinologist amatenga chidwi ndi kulemera kwa thupi, machitidwe, zolankhula, kuwongolera kwake ndi kuthamanga kwa magazi, amatenga madandaulo.

Njira ya pathological imadziwika ndi:

kusokonekera, kukwiya, kuyamwa,
mwachangu, mwamahema,
wonenepa
exophthalmos (maso akuwunda), masomphenya apawiri
kuchuluka kwa mtima, kuthamanga kwa magazi,
zala zanjenjemera
kumva kutentha
kutsegula m'mimba.

Ngati myrotoxicosis ikukayikiridwa, dokotala amamulembera njira zowonjezera zowerengera ndi zida.

Pozindikira, magazi amatengedwa ku mahomoni a chithokomiro (T3, T4) ndi TSH (mahomoni olimbikitsa a chithokomiro). Mgawo lachigawo, mahomoni olimbikitsa chithokomiro ali mkati moyenera, ndipo TSH imatsitsidwa. Pa kutalika kwa matendawa, mulingo wa TSH umakhalabe wofanana, ndipo kuponderezedwa kwa T3 ndi T4 kumakwera kwambiri. Onaninso zomwe zili mu thyroglobulin m'magazi, zomwe ndi thyrotooticosis imayamba kuchuluka.

Kuyesa kwa Ultrasound (ultrasound)

Ultrasound ya chithokomiro imagwira ntchito pogwiritsa ntchito zida zomwe zimatulutsa mafunde a pafupipafupi, zomwe zimakupatsani mwayi wopenda kapangidwe ka ziwalo ndi kukula kwake. Pankhani ya matenda a Basedova, zotupa za chithokomiro zimatsimikizika, ndi nodular goiter, magawo omwe kukulitsa ziwalo zam'deralo ndi ntchito yowonjezera mobisa.

Kufunditsa kwa chithokomiro kumachitika pogwiritsa ntchito makapisozi kapena yankho lomwe limakhala ndi kukonzekera kwa wailesi (iodine-131). Potere, madera okhala ndi radiopharmacological chinthu (malo "otentha") ndi timinyewa tosakhala ndi zokonzekera (madera "ozizira") amawonekera pa scintigram. Iodine-131 imadziunjikira m'malo osinthika a chithokomiro.

Pazidziwitso zozindikira kwambiri, chiwalo chamoyo chimalembedwa kuti chizipeza ma cellular, omwe amayesedwa ndi ma microscope.

Thirotooticosis,kuphatikiza poyizoni wokhala ndi poizoni ali ndi mawonekedwe awa: kuchuluka kwa kagayidwe, kugwedezeka kwa matope, milomo, lilime, mutu, zala, manja otambasuka ndi miyendo yokweza, thupi lonse, kuthamanga, kuzungulira kwa zinthu kuchokera m'manja,

kutafuna molimbika. Tachycardia, matenda oopsa, Hypnothesia, thukuta, kusalolerana kwa chakudya, kuchuluka kwa chilimbikitso, kupumira kwapafupipafupi, kuchepa thupi, kusamba kwa msambo kumasonyezedwanso. Zizindikiro zamdiso wamba: mawonekedwe owopsa, kupenya kwa m'maso, kunenepa pang'ono, jekeseni wa ziwiya zam'kati ndi kuchepa kwake, zimayambitsa kuchepa, exophthalmos, fissures yotambalala ya palpebral, kufinya kwamaso akamasamba. Khungu limakhala losalala, lotentha komanso lonyowa, tsitsilo limayamba kuwonda. Pamabwera kutopa kwamaganizidwe, kusakhazikika kwa malingaliro. Kukhalapo kwa goiter ndikosankha. Ntchito ya chithokomiro imachulukana ndi nkhawa. Kuchulukana kwa chithokomiro kwamphamvu kumawonjezera chisangalalo cha psyche ndipo zimapangitsa kudziwiratu nkhawa.

T. Dobzhansky (wolemba: Gindikin, 1997, p. 301) adasinthiratu zizindikilo zomwe zimasiyanitsa thyrotooticosis ku pseudo-hyperthyroidism chifukwa cha psycho-michere.

Odwala omwe ali ndi hyperthyroidism, pamakhala kutengeka mtima, mkwiyo, kukwiya, kunjenjemera kwa kunja komwe. Kulephera kukhazikika, kusokoneza, kupuma, kugona, nkhawa, kugona mutu, kutopa, kufooka nthawi zonse kumadziwika. Kulephera mwachikhalidwe kukhala m'nyumba yotentha yopanda ufulu wakuyenda, claustrophobia imayamba. Odwala nthawi zambiri amawona maloto aimfa, akufa. Amadziwika ndi hyper-

kucheza ndi kuchuluka kudziletsa, kudziwika kuti ndi udindo komanso udindo. Iwo pawokha amakonza zochitika zofuna mphamvu zochulukirapo, amakhala m'malo otetezedwa komanso kuwopa kufa, ndipo akumalimbana ndi chiopsezo chachitetezo chawo, kuyesayesa kuti azungulira okha.

Pantorbid yamunthu nthawi zambiri imakhala ya hysteroid. Odwala, monga lamulo, amanyalanyaza kukakhala kwawo kwakanthawi, amapita kwa dokotala mochedwa. Ndi thyrotoxicosis ya siteji yoyamba, mawonekedwe abwinobwino amakula, akakumana ndi mkwiyo, kusinkhasinkha, kumva kupweteka pakhosi, kusanza, kupweteka mumtima komanso kutulutsa thukuta, thukuta ladzidzidzi, kunjenjemera. Thyrotooticosis ya siteji yachiwiri imayendera limodzi ndi kukokomeza kwa mawonekedwe a hysterical, kusinthasintha kwamkati kosinthika, mapangidwe a senesto-hypochondriac syndrome. Odwala amafunikira chisamaliro chapadera kuchokera kwa achibale komanso ogwira ntchito kuchipatala, kukhala odandaula, owonetsa kusakhutira ndi mankhwalawa. Pa gawo la III la matendawa, kusintha kwa ma hysteriform kumakhala koyambirira, kosagawika komanso kotheka. Phobias, malingaliro a nsanje, nkhawa-hypochondriacal, kupsinjika (kugona tulo) kuyerekezera zinthu, kuyerekezera zinthu. Ndi matenda obwera chifukwa cha matendawa, kutsika kwa nzeru zapamwamba kungachitike. Odwala ena ali ndi zopereka zoyendetsa: magwiridwe azisembwere, chizolowezi chokwatirana, kuba, ndi chiwawa.

Matendawa amakula nthawi zambiri mwa atsikana omwe amwalira okondedwa ali mwana, kwanthawi yayitali m'mikhalidwe yovuta, yomwe imangokulirakulira. Nthawi zambiri awa amakhala ana okulirapo m'banjamo. Pakuwoneka kuti ali okhwima komanso opambana, odwala amabisa mantha osazindikira za moyo wachikulire. Kukana-phobic kumawonekeranso chifukwa chakuti, poopa kutenga pakati, azimayi amakhala amayi a ana ambiri. Ngati mantha apakati atha, amadzipereka posamalira ana, abale ndi alongo achichepere. Amuna a gululi amakhala otsogola. Chochitika chodziwika bwino kwa onse chikuwoneka kuti ndikuvuta kusintha gawo la "chakudya" kukhala gawo la "wopeza chakudya". Tanthauzo lophiphiritsa la matendawa: "Ngati mayi sakhala pafupi, ndiyenera kukhala ngati iye kuti ndizitha kuchita popanda iye." Amalimbana ndi imfa ya amayi, kukhala iwo eni amayi abwino. Maganizo a kusasinthika akakula,

ntchito ya chithokomiro England, yomwe imalimbikitsa kusasitsa muukhanda.

Chithandizo Perekani yankho la Lugol, ma immunomodulators, mamawort, hawthorn, belloid, anaprilin, reserpine, frenolone, lithiamu carbonate. Ziyenera kukonzekera kuti kutha kwa ntchito yowonjezereka pambuyo pakuchotsedwa kwa chithandizo cha hyperthyroidism kungayambitse kupsinjika kapena kukhumudwa, komanso nkhawa yowonjezereka komanso chidziwitso chakuti magwiridwe antchito amachepa. Psychotherapy imalimbikitsidwa kudziwitsa za pathogenesis yamatendawa, kuzindikira ndikusintha malingaliro osasintha omwe akuphunzira, kuphunzira luso lodzilamulira.

A. L. Groysman (2002) amachititsa maphunziro a gulu 15 - 20 omwe aperekedwa pamitu yotsatirayi:

1) dongosolo lamanjenje ndi chithokomiro,

2) Hypnosis komanso mankhwala ake,

3) psychotherapeutic mediation ndi kuthekera kwa njira yochizira,

4) Maganizo a matendawa,

5) maphunziro a autogenic,

6) njira zophunzirira kupirira komanso kuchita,

7) kucheza komaliza.

Zokambirana zimatha mphindi 15 mpaka 20, ndiye gawo la hypnosis-hestia limachitika (mphindi 30 mpaka 40). Mu chipatala, makalasi amachitika tsiku lililonse, kuchipatala - kawiri pa sabata.

Timapereka chitsanzo (cha Breutigamuidr., 1999).

Mkazi wosakwatiwa wazaka 24 wazaka zasukulu anawonetsa maluso akulu. Anali wolimbikira, wogwira ntchito pamalonda. Makolo anali onyadira mwana wawo wamkazi. Amayi ake anali mphunzitsi, wanzeru komanso wokongola. Wodwalayo adakumana ndi malingaliro ampikisano ndi iye, koma sanasonyeze. Atakwanitsa zaka 20, adakakamizidwa kusokoneza maphunziro ake kuti asamalire amayi ake omwe anali kumwalira komanso azichemwali ake aang'ono awiri. Adathandizira banjali ndalama ndikuyesetsa kupitiliza maphunziro ake, omwe adakwanitsa, ngakhale amayi ake amwalira, amadandaula ndi azilongo ake achichepere, mavuto azachuma komanso matenda ake. Amadzidalira kwambiri, anali wofunitsitsa udindo, adabereka zosowa zake zachikazi kuti akwaniritse zolinga zaluso komanso kulimbikitsa udindo wake mwa amayi apakati pa abale achichepere.

Matenda a shugamogwirizana ndi kusowa kwa insulin, yomwe imamangiriza shuga. Mukapanikizika, manjenje achifundo amakhala osangalala, adrenaline, norepinephrine, ndipo ma technolamines a Ka-I amasulidwa, omwe amalepheretsa kupanga insulin ndi ma pancreas I gland. Zotsatira zake, kuchuluka kwa shuga m'magazi kumakwera; izi zimandipatsa mphamvu zowonjezera zolimbitsa thupi. Pakalibe zotuluka zamagalimoto, hyper-1 glycemia imatha kupezeka (ndende yamagazi yoposa 120 mg%). Mulingo wa shuga m'magazi utaposa 180 mg%, impso sizingabwezeretse m'magazi ndipo glycosuria imalowa (shuga mu mkodzo ndi 1-8%). Hyperglycemia imawoneka ngati kufooka, kufulumira kutopa, pakamwa pouma, ludzu losatha, nseru, kupweteka kwa mutu, kukoka pafupipafupi. Hypoglycemia imayendera limodzi ndi zizindikiro zotsatirazi: kufooka lakuthwa, miyendo ya thonje, kumverera kwanjala ine, pallor, thukuta lozizira, palpitations, ndikunjenjemera ine mthupi. Pali nkhawa, nkhawa, kusakwiya, ag- | Kukaniza Ngati muli ndi vuto la kugona, matendawa angafanane ndi kuledzera, kuledzera kotsimikizika nkotheka.

Pali odwala matenda a shuga (CDI) omwe amadalira insulin ndipo ndimatengera matenda a shuga. Matenda a shuga a ana amapezeka nthawi zambiri chifukwa cha majini, ma virus ndi chitetezo cha mthupi ndimataya a pancreatic, ndimapanga insulin. Mu matenda a shuga a mellitus II, pamakhala chibadwa chamunthu, koma zinthu zamaganizidwe zomwe ndidazilingalira kudzera mu kudya kwambiri komanso kusachita ntchito ndizofunikira kwambiri. Ndi zaka I-I, kuchuluka kwa ziwonetsero kumakwera ndipo patatha zaka 70 kapangidwe kake

■ 10%, amayi onenepa kwambiri amatha kudwala.

Matenda a shuga amabweretsa kuwonongeka kwa dongosolo la Autonomic mantha I-system. Chizungulire, tachycardia, kuphwanya mayendedwe a I ntchito ya m'mimba thirakiti, gawo

■ kapangidwe kazinthu zomverera zam'munsi. Odwala a ola-I, ndimakomoka ndimakona amkamwa, khungu louma, kuyabwa, Pio-I dermia (zotupa zotupa), furunculosis, fungal ndikuwoneka! zotupa, mabala samachiritsa. Mwa akazi, kuyabwa nditha kuwoneka m'dera lamtundu, kutupa kwa labia ndi ukazi, ine. Kusamba kumasokonezeka. Mwa amuna, kusabala kumachitika - psychogenic, chifukwa cha somatogenic asthenia, ndi organic, yogwirizana ndi autonomic neuropathy ya m'chiuno cha pelvic, ine, komanso ma mtima ndi endocrine.

Khalidwe la odwala omwe ali ndi matenda a shuga achinyamata amakhala ndi machitidwe a schizo-Iid, anthu oterewa ndi osagwirizana komanso

Ine

kunyalanyaza, poyankha molakwika kapena mwanzeru. Amakhala ndi zizolowezi zogonana amuna kapena akazi okhaokha kapena ziwonetsero zakale. Amawonetsa zizindikiro za kuda nkhawa pagulu ndi kufooka kwa mlengalenga, machitidwe okakamiza, komanso chiyembekezo cha zochita za cyclotymic ndi paranoid. Pochita matendawa, nthawi zambiri zimawonjezera magawidwe amunthu.

Odwala omwe ali ndi matenda osokoneza bongo a mellitus II amadzudzulidwa posachedwa, muzochitika zokhumudwitsidwa, amawonetsa kukhumudwa kwapadera. Kupita kwa matendawa, kusokonezeka maganizo, kukayikira, kuda nkhawa, nkhawa, kupsinjika, kudzimvera chisoni, zochitika zamatenda zikulirakulira. Pali kugona tulo masana ndipo kugona tulo usiku, ulesi, komanso kutopa kwambiri. Kutha kuganizira kwambiri kwakanthawi kokwanira, ndipo kuchuluka kwa ntchito kumachepa. Pakupita kwa zaka, odwala amayamba kukwiya, kukwiya msanga, kusamvana, komanso kukhala pawekha. Amakhala opanda chidwi, amachepetsa kutsutsa zomwe ali. Odwala ena amakhala omasuka, ochezeka. Ambiri amakhala ndi nkhawa-hypochondriacal zizindikiro zokhudzana ndi kuwopa zovuta zazovuta za shuga: khungu, kuwonongeka kwa impso, kudula mwendo, insulin chikomokere. Khalidwe lodzivulaza nthawi zambiri limawonedwa: mavuto azakudya, uchidakwa, makonzedwe osokoneza bongo a insulin, etc.

Odwala odwala matenda ashuga amakhala ndi malingaliro otetezeka komanso kusiyidwa mtima, kufunitsitsa kudzisamalira, akufunafuna kudalira ena. Anthu oterewa amawonetsetsa kwambiri kukana kukhutiritsa zokhumba pakamwa, kuwonetsa malingaliro omwe ali ndi chidwi: nkhawa, nkhawa, mantha, kumbali imodzi, ndikukhumba mtendere ndi chitetezo - mbali inayo. Kukhumudwitsidwa kwa zosowa izi kumadzetsa mkwiyo, womwe umatsekedwa ndi mantha oti ungosiyidwa. Kuda nkhawa nthawi zonse kumayambitsa kufunitsitsa kumenya nkhondo kapena kuthawa ndi hyperglycemia yoyenera popanda kuchepetsa nkhawa yamaganizidwe ndi kuchitapo kanthu. Popeza chakudya chimazindikiridwa ndi chikondi, pamakhala kumverera kwanjala ndipo, mwakutero, kagayidwe kazakudya komwe sasiya kaye kudya. Kudya kwambiri mwatsatanetsatane kumayambitsa hyperglycemia wa nthawi yayitali komanso kutsika kwa zida zamagetsi zomwe zimayambitsa matenda a shuga. Kukhalapo kwa kunenepa kwambiri ndi matenda a shuga kumachepetsa kudzidalira, kumapangitsa kuyanjana kwambiri, komwe kumapangitsa gawo la matendawa. Chifukwa chake

bwalo loyipa likupanga. Kuletsedwa kwa chakudya komwe odwala amavomereza kumangoyambitsa kukula kwa kudya kwambiri (mwa chipatso choletsedwa).

Chithandizo

zikuphatikiza insulin kukonzekera, methionine, cocarbocylase, lipoic acid, clofibrate, pycnogenol. A. L. Groysman | (2002) adalemba ntchito zazikuluzikulu zamagulu:

1. Kuchepetsa kwa onse a neurotic, kuchotsa asthenic.

2. Kugwirizanitsa kusakhazikika kwa malingaliro, kulimbana ndi kukhumudwa, hypochondria.

3. Kuchepetsa mphamvu ya kudya komanso ludzu.

4. Kusiyanitsa "kwakusiyana" kwa chosemphana ndi chakudya ndi zoletsa zolakalaka chakudya chosavomerezeka.

5. Kutsatira mosamala kuchiritsi ndipo makamaka njira yamadyedwe.

6. Kukula kwa maluso oyankha bwino pamavuto a psycho (makamaka operewera, okhala ndi malingaliro otayika osatsutsika).

Nkhani zimachitika ndi odwala pamitu yotsatirayi:

1) Umunthu wa odwala matenda ashuga.

2) Hypnosis ndi mankhwala ake.

3) Malangizo othandizira.

4) Maganizo a matendawa.

5) Ntchito ndi ntchito ya tiziwalo ta endocrine.

- 6) Mavuto a matendawa ndi mawonekedwe ake ngati momwe zimachitikira nthawi zina.

7) Njira zopewera zovuta.

8) Udindo wamalingaliro amunthu pothana ndi matendawa.

Tsiku lotsatira, magawo olimbitsa thupi okhudzana ndi zosokoneza amachitika kuti athe kuchotsa mavuto m'maganizo, kusintha kugona komanso! kulakalaka.

V. M. Atamanov ndi V. A. Golysheva (2000) anakonza pulogalamu ya "sukulu ya matenda ashuga" pomwe odwala omwe amakhala mothandizidwa ndi dokotala amakambirana zovuta zingapo zapadera: chikhalidwe ndi mawonekedwe a matendawa, chithandizo cha insulini, komanso zochitika zolimbitsa thupi panthawi matenda a shuga, kupindika kwamankhwala mu kapangidwe ka matendawa, mavuto a pakati ndi kulera, etc. Kufunika kofunikira kumamangirizidwa m'njira yabwino yoperekera chidziwitso, kukhazikitsa, kukhazikitsa mayankho ndikukhulupirira ubale ndi odwala, ndikugawa njira zoyeserera zabwino.

— Mwawona kale, mzanga. Matenda oopsa komanso matenda ashuga.

"Mukuganiza bwanji?"

- M'lifupi ndi lotseguka ndipo njuchi imawuluka pafupi.

Kusunga makina a miyeso ya padziko lapansi: Makina osiyira a pansi pamiyala amaperekedwa ndi mabatani a zolembedwa zosiyanasiyana.

Mitundu ya chala cha papillary ndi chizindikiro cha kuthekera kwamasewera: mawonekedwe a dermatoglyphic mawonekedwe pakadutsa miyezi 3-5 yoyembekezera, musasinthe pa moyo wonse.

Kapangidwe ka madzi amoyo padziko lapansi: Chinyontho chachikulu kwambiri padziko lapansi chimasuluka kuchokera pansi pa nyanja ndi nyanja (88 ‰).

Gryaznova I. M., Vtorova V. G. Matenda a shuga ndi pakati, Mankhwala -, 1985. - 208 p.
Rumyantseva, T. Zolemba za odwala matenda ashuga. Zolemba za kudziyang'anira pawokha mellitus / T. Rumyantseva. - M: AST, Astrel-SPb, 2007 .-- 384 p.
Aleksandrov, D. N. Mfundo Zazikulu Zazachuma. Umunthu ndi chidziwitso cha wabizinesi: monograph. / D.N. Alexandrov, M.A. Alieskerov, T.V. Akhlebinin. - M: Flint, Nauka, 2016 .-- 520 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka patsamba lino kuti athetse zovuta koma 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.