Matenda a diabetes angiopathy: zimayambitsa, Zizindikiro, magawo a matendawa, chithandizo

Angiopathy imakhudza ziwiya ndi ma capillaries. Matendawa amagwirizana kwambiri ndi matenda ashuga ndipo ndi amodzi mwa zovuta zake. Malinga ndi gulu la padziko lonse la ICD 10, matenda awa ndi a gulu la anthu odwala matenda ashuga M10-E14.5, komanso ali ndi code - I79.2.

Odwala omwe ali ndi matenda a shuga, angiopathy amawonetsedwa m'matumbo am'munsi, mwachitsanzo, monga gangrene phazi.

Zovuta zapadera zamagazi zimayambira mu retina - retinopathy, zomwe zimayambitsanso matenda a shuga.

Momwe maumbidwe amaonekere bwino pachithunzichi pansipa:

Zosiyanasiyana zamatsenga

Matendawa agawidwa m'mitundu iwiri:

Matenda a shuga a diabetesic macroangiopathy ndi mtundu wolimbikitsa kwambiri wa atherosulinosis.

Nthawi zambiri zimakhudza ziwiya zazikulu zamiyendo, ziwiya zikuluzikulu za mtima. Chifukwa cha kuchepa kwa chakudya m'mitsempha, lipid ndi mapuloteni, mapangidwe amtundu wa atheroscrotic pama chotengera, kufinya lumen ndikupangitsa magazi osakwanira ku zimakhala.

Matenda a shuga a shuga a shuga amayambitsa zovuta mu ziwalo zomwe zimakhala ndimitsempha yamagazi - maso ndi impso. Nephropathy, kapena - kulephera kwa aimpso, kumabweretsa kukakamizidwa ndikuwonjezereka kwa matendawa, ndipo retinopathy imalepheretsa kuwona.

Kuwonongeka kwa mitsempha ya coronary kumawonjezera chiopsezo cha myocardial infarction, ndipo kuwonongeka kwa magazi kumtima kumachitika pamlingo wawung'ono komanso wawukulu.

Zifukwa zachitukuko

Kukula kwa angiopathy kwa ziwiya zazikulu mu shuga mellitus kumakhazikika chifukwa cha kusalinganika kwa mahomoni. Zosintha mu mahomoni zimapangitsa kutsika kwa kupuma kwamankhwala - kumakhala kochepetsedwa.

Kulumikizanso kwachiwiri kumatendawa kumachepetsa kupumikizidwa kwa khoma la chotengera, komwe kumachulukitsidwa ndi kuchuluka kwa sorbitol ndi fructose, komwe kumachepetsa kupezeka.

Kuphatikiza apo, metabolism yamafuta imasokonekera m'thupi, ndipo m'malo mwa kukhathamiritsa kwapakhomo kwakakhazikika m'thupi la munthu, lipids yotsika kwambiri komanso yotsika kwambiri imapangidwa.

Zowonjezera izi mafuta macrophages amazisamutsira kukhoma lamitsempha. Izi zimabweretsa mapangidwe a atherosulinotic plaque ndi kupanikizika kwamitsempha yamagazi.

Microangiopathy mumitsempha yama cell ndi ma venological amapezeka malinga ndi Virchow triad:

• Sinthani khoma la chotengera.
• Matenda a magazi a magazi.
• Kuchepetsa magazi.

Angiopathy ndiyosapeweka kwa matenda ashuga ndipo kuyambika kwake kumatha kuchedwetsedwa ndi chithandizo choyenera. Zomwe zimachitika ndi kusowa kwa chithandizo chamankhwala, kudya kwadzidzidzi kwa mankhwala omwe amachepetsa shuga komanso kusakwaniritsidwa kwa dongosolo la mtima. Matenda oopsa kapena kulephera kwa mtima kumapangitsanso kukula kwa matendawa.

Zizindikiro

Zizindikiro za angiopathy ndi:

• Kuchuluka kwamagawo am'munsi.
• Kumva kuzizira.
• Kugwedeza miyendo.
• Zingwe.
• Zowawa.
• Lameness kapena kutopa poyenda ndi kuthamanga.
• Kutupa, khungu lamtambo ndi keratinization.
• Mochulukitsa - zilonda zam'mimba, gangrene, phlegmon ndi osteomyelitis.

Kuwonetsedwa kwa zizindikiro izi kumatengera kuchuluka kwa matendawo. Nthawi zambiri magawo oyambilira amakhala ndi dzanzi ndi kumva kulira, miyendo yozizira. Njira yotsogola kwambiri imawonetsedwa ndi kupweteka, kuwawa ndi kuwonda.

Mawonekedwe osasangalatsa komanso owopsa ndi zilonda zam'mimba, zomwe ndi zotupa za pakhungu. Amawoneka ngati mabala osachiritsa omwe ali ndi khungu lakuthwa, lotupa lomwe limawazungulira. Khungu likhoza kusuntha, kuphatikiza apo, limatha kutentha.

Zilonda ndizotsogolera kwa gangrene wa miyendo.

Kodi matendawa amachitika bwanji?

Kafukufuku wa kukhalapo kwa matenda ashuga a shuga amachitika molingana ndi malo omwe akukonzekera.

Kusanthula wamba kumakhala ndi:

• Kusanthula mkodzo kwamtundu wa protein, glucose ndi matupi a ketone.
• Kutsimikiza kwa nayitrogeni wa magazi, urea, creatinine.
• Kusanthula kwamomwe magazi amapangira.

Kuwonjezeka kwa mapuloteni, shuga ndi mawonekedwe a matupi a ketone mu mkodzo kungasonyeze kukula kwa nephropathy. Mitundu yambiri yotsalira ya nayitrogeni m'magazi, urea ndi creatinine imawonetsanso kuwonongeka kwa ziwiya za impso.

Kapangidwe ka mafuta ndikofunikanso pakuwonetsetsa za macroangiopathy. Zizindikiro zazikulu ndi cholesterol ndi lipoproteins.

Cholesterol ndi gawo limodzi, koma madokotala amawona kuchuluka kwa cholesterol 6 mmol / lita kukhala koopsa. Lipoproteins pamtunda wa 2-3 mmol / lita imasonyezanso kuopsa kwa macroangiopathy.

Chidziwitso cha zida ndi:

• Kufotokozera zam'madera akumunsi.
• Zojambula.
• MRI
• ECG ndi echocardiography.
• Ophthalmoscopy

Dopplerography imakupatsani mwayi wodziwa kuzimiririka mu mitsempha yakuya komanso yapamwamba kwambiri ya miyendo, kudziwa kuchuluka kwa kuwonongeka kwa kuzungulira kwa magazi kwa venous. Arteriography cholinga chake ndi kuwunika kuwonongeka kwakanthawi ndikuwonetsetsa kupindika, thrombosis. MRI imakupatsani mwayi kuti muyeze momwe ziwiya zaubongo zimathandizira kuti mupewe vuto loti mugwire.

ECG ndi EcoCG zimachitidwa kwa odwala onse omwe ali ndi matenda ashuga kuti azitha kudziwa momwe mtima ulili komanso kupatula kutukuka kwa ma pathologies monga kuchepa. Chofunika kwambiri ndi mtundu wa mtima - arrhythmia ingayambitse kuwonongeka kwa magazi ndi kuwonongeka kwa mtima.

Kafukufuku wa ophthalmological amawunika momwe maso alili - ngati pali edema ya retinal, mkhalidwe wa fundus.

Angiopathy imatha kuchiritsidwa pochita opaleshoni komanso mankhwala.

Mankhwala othandizira ndi oyenera, chifukwa odwala omwe ali ndi vuto la matenda ashuga amatha kukhala ndi zotsutsana popanga opaleshoni ndi mtima.

Mankhwala

Chomwe chimagwiritsidwa ntchito popereka mankhwala osokoneza bongo ndikuchotsa zomwe zimayambitsa kukula kwa angiopathies.

Mankhwala otsatirawa nthawi zambiri amaperekedwa:

• Amalamulira a kagayidwe kakang'ono ka shuga.
• Zoyang'anira mafuta kagayidwe.
• Mankhwala a antihypertensive.
• Mapiritsi omwe amalepheretsa kuphatikiza kwa platelet.

Choyamba, chithandizo chokwanira chokwanira chokhala ndi mankhwala ochepetsa shuga chimafunika, chomwe chimabwezeretsa kagayidwe ka shuga, kamachepetsa shuga m'magazi ndikuchepetsa chiopsezo cha zovuta. Kusankhidwa kwa mankhwala kumapangidwa ndi adotolo, kutengera mtundu wa matenda ashuga.

Kuphatikiza apo, mankhwala ochokera pagome pansipa amalamulidwa kuti azilamulira shuga:

Monga oyang'anira mafuta kagayidwe akaika:

• Simvastatin, mu 10 mpaka 80 mg pa tsiku.
• Lovastatin, muyezo wa 20 mpaka 40 mg pa tsiku.
• Atorvastatin, muyezo wa 10 mpaka 40 mg wa kwambiri angiopathies patsiku.

Simvastatin ndi mankhwala osinthasintha ambiri, chifukwa amachepetsa kwambiri kuchuluka kwa cholesterol komanso otsika komanso otsika kwambiri ochepetsa lipids. Komabe, kugwiritsidwa ntchito sikumanyamula katundu wolimba pa chiwindi.

Kuchepetsa kuthamanga kwa magazi ndi kuchepetsa katundu pa mtima ndi m'mitsempha yamagazi, awa ndi mankhwalawa:

• Isoptin 40 mg katatu pa tsiku.
• Nifedipine 10 mg 4 pa tsiku.
• Lisinopril 5 mg kamodzi tsiku lililonse.

Mankhwalawa ndiwofala kwambiri ndipo, monga lamulo, amagwiritsidwa ntchito mosiyana. Mankhwalawa amawonedwa ngati mankhwala okhawo olondola kwambiri, koma nthawi zambiri amagwiritsa ntchito zinthu zosiyanasiyana zomwe zimayenera kusankhidwa ndi adokotala okha.

Mwa zinthu zomwe zimalepheretsa kuphatikiza kwa maselo ambiri, a aspirin nthawi zambiri amapatsidwa mankhwala osakaniza 100 mg tsiku lililonse mpaka 325 mg kamodzi masiku atatu aliwonse. Aspirin ndiwonso mankhwala osagwiritsa ntchito mankhwala omwe amachepetsa ululu m'miyendo.

Opaleshoni

Opaleshoni yamatenda nthawi zambiri imachitidwa m'malo otsika.

• Bypass kapena ma prosthetics a zombo zazikulu.
• Kuchotsa zigawo zamagazi ndi zolembera, kukulitsa madera omwe akhudzidwa ndimitsempha yamagazi.
• Kuchotsa kwacifundo kwacifundo, komwe kumayambitsa kuchepa kwamitsempha yamagazi.

Machitidwe a purulent akapezeka mu minofu, chithupsa chimatsegulidwa, ndikuchotsa minofu yosagwira.

Panthawi yoduladula miyendo, kuduladula kumachitika pang'onopang'ono, kutsogolo kwa chidendene ndi osteoplasty, bondo kapena ntchafu, kutengera mtundu wa kufalikira kwa njirayo.

Zoyenera kuchita kupewa?

Kupewa ndi:

• magazi magazi
• kukhalabe ndi mavuto ambiri
• chakudya
• ukhondo
• kusiya zizolowezi zoipa.

Komanso odwala matenda ashuga amayenera kupita ku endocrinologist kawiri pachaka ndi kumayang'ana kubowoleza mitsempha ya m'munsi. Ululu m'miyendo, kufa kwa khungu komanso mapangidwe a zilonda ndi chizindikiro chofunikira kwambiri chodzayendera madokotala.

Kuphatikiza apo, muyenera kuyang'aniridwa ndi ophthalmologist kawiri pachaka kuti muchepetse kukula kwa nephropathy.

Njira zamakono zamankhwala zimapereka chiyembekezo chodalirika pakukhalabe ndi shuga yambiri ndikutsatira upangiri wa madokotala.

Kuchita zolimbitsa thupi mokwanira komanso minofu yolimba imatha kuwonjezera nthawi yayitali komanso moyo, komanso kuchepetsa mwayi wopitiliza matendawa.

Ngati zofunikira zonse zimawonedwa, munthu wodwala matenda ashuga angakhale ndi moyo kwa zaka makumi angapo, popanda kuipitsa matendawa.

Ngati wapezeka m'magawo oyambawo, matendawa amatha kuimitsa pafupi ndikwaniritsa chikhululukiro. Tsoka ilo, odwala matenda ashuga nthawi zonse amakhala ndi chiopsezo cha kupititsa patsogolo kwa angiopathy, chifukwa chake, kuyang'anira akatswiri kuyenera kupitilira.

Zomwe zimachitika

Zomwe zimayambitsa matendawa zimagona m'mavuto omwe amapezeka mu metabolism. Zisokonezo izi zimachitika chifukwa cha kusintha kwa mitsempha yamagazi yomwe imachitika mu shuga mellitus.

Kuphatikiza apo, zomwe zimayambitsa kuchitika zimatengera zina, monga:

• Kuphwanya kagayidwe ka lipids ndi mucoproteins. Izi zimakhudza dongosolo la mtima.
• Kukula ndi kuchuluka kwa matenda ashuga, nthawi yayitali ya matendawa.
• Matenda a shuga a sekondale, omwe amayambitsidwa ndi kuvulala kwa kapamba, kapamba, kudulira kwathunthu kapena pang'ono, kumawonjezera mwayi wokhala ndi matenda a shuga a kangiopathy kangapo.
• Kudziletsa.
• Matenda a metabolism.
• Herederal endocrine pathologies.

Zizindikiro za matendawa

Ngati tilingalira mtundu wa kuwonongeka kwa mtima, titha kusiyanitsa:

1. Microangiopathy. Zosintha zimachitika m'makutu.
2. Macroangiopathy. Zosintha zimakhudza dongosolo lama arterial and venous.

Zizindikiro za matenda a shuga a shuga (momwe zilili, tsopano ndi zomveka) zimatengera mwachindunji zomwe sitimayo idawonongeka. Pathologies amatha kukhudzidwa ndi impso, ma retina, capillaries a mtima, mitsempha yam'mimba, ziwiya zamagawo am'munsi, ziwiya zaubongo. Zizindikiro zotsatirazi ndizomwe zimayambitsa matenda a shuga:

• Ululu womwe umayenda ndi limp kapena cramp.
• Kuchuluka kwa malekezero, kumverera kuzizira, kupezeka kwa tsekwe.
• Kuchepetsa khungu la miyendo. Zimachitika chifukwa chosowa michere ndi mpweya.
• Zilonda za trophic komanso zothandizira zomwe zimakhudza minofu ya mafupa ndi minofu. Kusintha kofananako kumachitika mu shuga kumapeto kwa dystrophy. Kuvulala kulikonse kapena kuvulala pang'ono kumatha kubweretsa chilonda chosachiritsidwa ndipo nthawi zambiri, chifukwa chakuchepa kwa chitetezo chathupi, amatenga kachilomboka. Zikachitika kuti matenda ashuga ali ndi mawonekedwe opunduka, kukula kwa matenda ammiyendo kumatheka. Matendawa ndi matenda oopsa kwambiri omwe amatha kuthandizidwa mosamala.

Ngati wodwalayo ali ndi zizindikiro za matenda a shuga a shuga, ndiye kuti izi zikuwonetsa kuti kuphwanya kwakukulu kwa trophism ya periosteum ndi minofu yofewa yayamba. Kuletsa matendawa pachigawo chake choyamba komanso kupewa matenda akuluakulu amathandizira kuyamba kwa chithandizo kwakanthawi.

Matumbo Ammbuyo

Maso angiopathy ndi amodzi mwa zovuta zomwe zimadza ndi matenda ashuga. Madokotala amasiyanitsa pakati pa mitundu iwiri yamatenda - macroangiopathy ndi microangiopathy. Ndi microangiopathy, ziwiya zazing'ono zomwe zimapezeka m'maso zimasintha. Microangiopathy imayambitsa magazi ochepa komanso magazi amatuluka. Ndi macroangiopathy, mitsempha yayikulu ya maso imakhudzidwa. Ngati matendawa agwera kwambiri, minyewa ya m'mimba imachepa, kuwonongeka kwamaso kumachepa, magazi amatuluka.

Matenda a shuga angiopathy amapezeka makamaka mwa anthu achikulire. Ndikofunika kudziwa padera poti posachedwa matendawa ayambanso kukhudza anthu azaka zazing'ono. Ngati mumanyalanyaza kutsatira malingaliro a dokotala ndikukana kulandira chithandizo chamankhwala, ndiye kuti matenda amitsempha yamaso angayambike. Chifukwa cha edema ya makoma a capillaries, kuchepa kwa kuunikira kwa chotengera kumachitika. Kusintha kotereku kumatha kubweretsa kuphwanya kwa trophic eye. Dokotala wamaso pa nthawi ya mayeso amatha kuwona malo amtundu wachikasu pamalo omwe mitsempha ya kuwala imatuluka, ma hemorrhages ambiri amadziwika. Zonsezi zimatha kukhudza maonekedwe.

A shuga angiopathy a m'munsi malekezero

Kuchiza kuyenera kukhala kwakanthawi. Chifukwa chachikulu cha matenda amtunduwu ndi kuphwanya kwakukulu mu kagayidwe kachakudya ka thupi. Zimaphatikizidwa ndi kuchepa kwa insulin ya mahomoni. Matendawa amawonetsedwa ndi kuwonongeka kwa ziwiya zam'munsi - kuchokera pamatumbo ang'onoang'ono mpaka m'mitsempha yayikulu. Pa khoma mkati mwa chotengera, zophuka zimawoneka, zofanana ndi zolemba mu atherosulinosis. Izi zikufotokozedwa ndikuti shuga imapangitsa kuti pakhale matenda abwino. Kumayambiriro kwa kukula kwake, angiopathy amafanana ndikusokoneza endarteritis, komabe pali kusiyana. Izi zikuphatikiza:

1. Polyneuritis amawonetsedwa ndi mphamvu zosiyanasiyana. Pankhaniyi, hypersensitivity ndikuwotcha phazi lonse kapena gawo laling'ono lingawonedwe.
2. Mphamvu ya zotumphukira zamitsempha zimasungidwa, ngakhale ngati pali mawonekedwe olemedwa ndi lilime laling'ono ndi gangrene ya zala apanga kale.
3. Angiopathy ikhoza kuphatikizidwa ndi retinopathy ndi nephropathy.

Nthawi zambiri, chotupa cha popliteal chomwe chili ndi nthambi zake chimayamba kudwala. Mosiyana ndi kufalikira kwa atherosulinosis, ndi angiopathy, kukulitsa kuwonongeka kwa gangrenous ndikotheka.

Ngati mupeza matenda ashuga a michereopathy am'munsi oyambira, pomwe kusokonezeka kwa magazi kumangoyambira, ndiye kuti mungathe kupewa zovuta.

Njira ya angiopathy, kutengera mtundu wa kuwonongeka kwa mtima, imagawika m'magawo asanu ndi limodzi:

1. Pa zero zero, wodwalayo alibe zodandaula zilizonse, ndipo kungowunikira mwatsatanetsatane ndikokhoza kuzindikira kusintha kosakhazikika m'mitsempha yamagazi.
2. Gawo loyamba limadziwika ndi mawonekedwe a pallor of the khungu, zilonda zam'mphepete m'mphepete zam'munsi ndizotheka. Ululu wolengeza palibe.
3. Gawo lachiwiri limadziwika ndi zotupa zakuya kwambiri. Amatha kukhudza gawo la minofu ndikuya kwake konse ndikufikira fupa. Wodwalayo amamva kuwawa.
4. Mu gawo lachitatu, minofu ya necrosis imayamba m'mphepete mwa zilonda zam'mimba. Imfa zimaphatikizana: kufiyira kwambiri, kutupa, zotupa za purulent, phlegmon, kutupa kwa minofu yamafupa.
5. Zala ndi mapazi zimawonekera kuwonongeka kwa necrotic.
6. Gawo Lachisanu. Chotupa cha necrotic chimakwirira phazi lonse. Monga njira yothandiza yamankhwala, kuchitapo kanthu pogwiritsa ntchito opaleshoni kukuwonetsedwa.

Pamwambapa tidasanthula za pathogenesis ya matenda ashuga a shuga. Tsopano tiyeni tisunthire pakuzindikira.

Kuzindikira

Osanyalanyaza maphunziro operekedwa ndi dokotala, chifukwa zotupa zam'mimba, impso, mtima ndi ziwalo zina zimatha kubweretsa zovuta zazikulu. Osangoyesa magazi ndi mkodzo ndikofunikira, komanso kuyesa kwa magwiridwe antchito omwe amakhudzidwa kwambiri ndi matenda a shuga.

Kuti muwonetsetse matenda anu, muyenera kuyesa mayeso otsatirawa:

• Kuyesa kwa magazi kwa nayitrogeni wotsalira. Kuchulukitsa mulingo wabwinobwino wa 14-28 mmol / lita kumawonetsa kuphwanya kachitidwe mu kwamikodzo. Zopindulitsa kwambiri ndizizindikiro za urea, creatinine. Akapitilira muyeso, titha kukambirana mavuto ndi impso.
• Urinalysis ya mapuloteni, shuga, matupi a ketone, microglobulin. Kuwonjezeka pang'onopang'ono kwa zizindikirozi kukuwonetsa matenda a impso omwe akupita patsogolo.
• Kusanthula kuti muwone mawonekedwe a lipids m'magazi. Mlingo wa cholesterol ndi lipoproteins mu diabetes angiopathy of the m'munsi malembedwe (Zizindikiro zomwe tafotokozazi) zimakwera kwambiri.

Njira zofufuzira

Ngati tilingalira maphunziro othandizira, ndiye chothandiza kwambiri pakuzindikira:

• Kuchita kafukufuku wofufuza ndi ophthalmologist.
• Electrocardiography, coronary angiography, echocardiography.
• Arteriography ndi Dopplerography ya miyendo.
• Ultrasound a impso.

Kuchiza matenda

Pozindikira matenda a shuga a m'munsi malekezero, chithandizo ayenera yomweyo. Choyamba, chithandizo cha matenda oyamba, i.e. shuga mellitus, akuwonetsedwa. Ngati wodwalayo akunyalanyazidwa kwambiri, ndiye kuti ndi bwino kuchitira zizindikiro ndi zovuta zake. Mwachitsanzo, retinopathy imathandizidwa ndi Photocoagulation: zotumphukira ziwiya ndi zina zowoneka bwino. Njirayi imakuthandizani kuti muwonjezere moyo wa wodwalayo pofika zaka pafupifupi 10-15. Kuphatikiza apo, mankhwalawa amagwiritsidwa ntchito: parabulbar makonzedwe a corticosteroids, intravitreal makonzedwe a mankhwala omwe amalepheretsa nthambi yamitsempha.

Ngati kuwonongeka kwambiri kwa impso kumawonedwa, ndiye kuti wodwalayo adayikidwa hemodialysis.

Ngati mavuto sanathe kupewedwa ndipo pang'onopang'ono pakubwera, ndiye kuti wodwalayo akuwonetsedwa kulowererapo - kudula dzanja ndi dzanja.

Ndi angiopathy a m'munsi malekezero a shuga, chithandizo makamaka chimaphatikizapo matenda a shuga. Ndi matenda a gawo lachiwiri, mankhwala akuwonetsedwa kuti amatulutsa magazi, amalimbitsa mitsempha ya m'magazi, amasintha minofu ya trophic.

Tiyenera kukumbukira kuti mankhwalawa omwe amachepetsa shuga ayenera kumwedwa kwinaku akuwunika ma glucose ndi michere ya chiwindi. Chofunika pa mankhwalawa ndi zakudya. Malamulo komanso zakudya zoyenera zimathandiza kuti shuga azikhala bwino.

Magawo atatu ofunikira aukhondo wa mtima wamitsempha, ngati pali kupatuka mu kagayidwe.

1. Kuwongolera kwa mulingo wa mahomoni otsutsana-mahomoni, auto-allergen. Zimafunikira kuti ateteze kuwonongeka kwawo.
2. Kubwezeretsa ndi kusintha kwa metabolism.
3. Therapy mothandizidwa ndi mankhwala kuti abwezeretsereni mu mitsempha ya magazi, limbikitsani makoma amitsempha yamagazi, sinthani magazi.

Mwanjira iyi, chithandizo cha matenda ashuga angiopathy a malekezero (malekezero am'munsi) ayenera kukonzekera.

Mankhwala

Udindo waukulu wamtundu wa metabolism umaperekedwa kwa mankhwala omwe amachepetsa shuga. Mankhwalawa amaphatikiza anthu omwe amakhala ndi insulin okhala ndi mankhwala ena pakumwa pakamwa. Mothandizana nawo, amakakamira kudya mavitamini a magulu B ndi P amathandizidwa.

Ma -abolic steroid omwe amateteza kagayidwe kazakudya ndipo amalepheretsa zochitika za glucorticoids amawonetsanso zotsatira zabwino. Gulu lotsatira la mankhwalawa lomwe limagwiritsidwa ntchito limaphatikizapo othandizira omwe amasintha kuchuluka kwa zotupa zamitsempha yamagazi, kukonza kukonzanso kwa kutulutsa magazi.

Physiotherapy

Kuphatikiza pa chithandizo chamankhwala, physiotherapy imagwiritsidwa ntchito, mwachitsanzo, electrophoresis yankho la novocaine kapena heparin, masewera olimbitsa thupi komanso kutikita minofu.

Zilonda za trophic zimathandizidwa makamaka ndi zovala za antiseptic, mafuta a Vishnevsky, insulin. Intravenous makonzedwe a magazi alowa m'malo amasonyezedwanso. Nthawi zina zimakhala zotheka kuchita opaleshoni ya pulasitiki pamitsempha, yomwe imakupatsani mwayi wobwezeretsa magazi.

Pomaliza

Ngati matenda owuma akumauma ngati vuto, ndiye kuti madotolo amatha kuchitapo kanthu kuti asanyowe. Ngati izi sizingapewe, necrosis imafalikira, ndipo wodwalayo akumva kupweteka kwambiri, ndiye kuti lingaliro limapangidwa kuti lichepetse nthambiyo pang'ono pamalopo.

Mwachilengedwe, pamapangidwe a nkhani imodzi ndizosatheka kunena mwatsatanetsatane momwe chithandizo cha matenda ashuga amathandizira. Komabe, tikukhulupirira kuti tinatha kufalitsa zowerenga zambiri za chithandizo cha matendawa kwa owerenga.

Ichi ndi chiyani

Matenda a diabetes angiopathy amasintha kapangidwe ka mitsempha yamagazi chifukwa cha kuchuluka kwa shuga. Kuwonetsedwa kwa matendawa kumakhudza anthu onse omwe ali ndi matenda ashuga omwe amapita patsogolo.

A shuga angiopathy a m'munsi malekezero

Chifukwa cha kuwonongeka kwa ziwiya za m'munsi, kutayika kwa chotupa kumachitika. Popita nthawi, amayamba kubisalira. Kuzungulira kosokoneza kwa phazi (ischemia). Mwendo utadwala ischemia, zovuta zake zimawonekera.

Poyamba, kusintha kwamphamvu m'mapazi kumachitika. Munthu amasiya kuzimva. Pambuyo pake, kusintha kwadzuwa ndi ma trophic pakhungu kumawonekera. Necrosis yam'deralo imachitika, yomwe imakonda kufalikira. Mapeto ake, munthu amatha kutaya miyendo chifukwa choperewera magazi.

Matendawa amagawidwa m'mitundu ingapo. Kuti muyambe kulandira chithandizo, muyenera kuchipeza molondola. Ndikofunika kusiya chifukwa chachikulu cha angiopathy. Munthu akayamba kulandira chithandizo, vutoli limamuthandiza.

Gulu la Angiopathy

Chifukwa cha matenda ashuga, ziwiya zosiyanasiyana zimatha kukhudzidwa. Matendawa adagawidwa kutengera ndi komwe kufalikira kumachitika. Mitundu yotsatirayi yamatenda imasiyanitsidwa:

Pathology ya m'munsi malekezero

• macroangiopathy
• microangiopathy
• angiopathy wosakanikirana

Ndi macroangiopathy, zombo zazikulu zimakhudzidwa, zomwe nthawi zambiri pamakhala msempha kapena popliteal artery. Ndi microangiopathy, ma capillaries osiyanasiyana amakhudzidwa makamaka. Angiopathy yosakanikirana imatha kuchitika, yomwe imayendera limodzi ndi kuwonongeka kwa zazikulu ndi zazing'ono zomwe zimakhala ndi mtima.

Madokotala amati kuwonongeka kwa mitsempha yam'munsi yam'munsi sikumachitika popanda zovuta zina. Ndi matenda a shuga, ischemia imakhudzanso ziwalo zamkati. Ngati matenda atapezeka, chithandizo chamankhwala chimayamba mwachangu.

Zomwe zimayambitsa matendawa

Angiopathy imatha kupezeka mwa anthu odwala matenda ashuga. Chiwopsezo cha matenda chimawonjezeka pamene kuchuluka kwa shuga m'magazi kumakhala kwazololeka kwa nthawi yayitali.

Pali zinthu zina zomwe zimawonjezera mwayi wokhala ndi matendawa. Zina mwa izo ndi:

• kuchuluka kwa shuga kuposa munthu wodwala matenda ashuga
• Kutalika kwa shuga
• kukhalapo kwa atherosulinosis
• venous kusowa
• kunenepa
• kusuta
• kuchuluka magazi

Ngati munthu ali ndi matenda opatsirana, chiopsezo chokhala ndi matenda a shuga angiopathy amachulukitsidwa kwambiri.

Munthu aliyense yemwe ali ndi matenda ashuga amafunika kupita kwa katswiri kuti awongole magazi. Ngati pali kuchuluka kwambiri kwa thupi kapena matenda ophatikizika a mtima, ndiye kuti amawataya kudzera munjira iliyonse yosankhidwa.

Kodi pali kulumikizana ndi zaka

Anthu ambiri amaganiza molakwika kuti okalamba ndi omwe amatha kulandira mavutowa. M'malo mwake, madokotala odziwa ntchito amati palibe ubale pakati pa zaka ndi zotupa zam'mimba zokhala m'munsi. Komabe, munthu wokalamba nthawi zambiri amakhala ndi vutoli ya mtima, yomwe, limodzi ndi shuga imathandizira kukulitsa matenda a mtima.

Zowonongeka zamitsempha yamagetsi zisanachitike zimabweretsa moyo wochepetsedwa kwambiri. Matenda a shuga ayenera kuyimitsidwa bwino. Munthu amafunikira kutsatira mosamalitsa katswiri ndi kugwiritsa ntchito mankhwala osiyanasiyana kuti akhalebe ndi shuga.

Zizindikiro zamatsenga

Paokha, matenda ashuga amayambitsa zizindikiro zambiri. Chifukwa cha izi, munthu sangazindikire kuti angiopathy ikukula. Ndi kukulira kwa mkhalidwe ndi kukula kwa kupangika kumeneku, zizindikiro zotsatirazi zimachitika:

• kupweteka kwa phazi
• kutupa
• kumverera kwa dzanzi komanso kuzizira kumadera otsika
• kusintha kwa khungu la kumapazi
• kupezeka kwa zilonda

Ngakhale pang'ono, chilonda cha necrotic chimawonekera. Ngati wodwala yemwe ali ndi matenda a shuga adazindikira kuti ali ndi zizindikiro zoyambirira za angiopathy, ayenera kufunsa dokotala nthawi yomweyo. Kuperewera kwa mankhwalawa kumapangitsa kuti matenda azidutsa.

Zizindikiro zoyambirira zimakonda kupweteka komanso kutopa. Osawanyalanyaza. Kumayambiriro, mamvekedwe am'mimba amabwezeretseka mosavuta, ndipo kusintha konse komwe kumachitika kumachotsedwa.

Osazindikira matenda omwe akudwala kwambiri ndi kosatheka. Munthu amayamba kumva ululu waukulu komanso mabala osachiritsika. Pankhaniyi, mankhwalawa ndi ovuta kwambiri ndipo amafunika njira yolumikizira.

Kuopsa kwa angiopathy

Kutengera kuchuluka kwa zizindikilo ndi kuuma kwake, munthu amatha kudziwa kuopsa kwa matendawa. Simungathe kuchita izi nokha. Amatembenukira kwa katswiri, pambuyo pake kuyezetsa kumachitika.

Madokotala amasiyanitsa mitundu yotsatila ya digiri ya matenda:

• 1 digiri - njira yosavuta kwambiri ya angiopathy, pakati pa zizindikiro ndizotopa, kupweteka pang'ono poyenda komanso kuzizira kumapeto
• 2 digiri - mawonekedwe owawa kwambiri mukamayenda mtunda waufupi
• Kalasi 3 - kulephera kuyenda mtunda wopitilira mita 100, komanso kupweteka kosalekeza
• Giredi 4 - mawonekedwe a zilonda, kupweteka, kuyambitsa kusapeza bwino komanso chiopsezo chotenga gangore

Kutengera ndi kuopsa kwa matendawa, chithandizo choyenera chimasankhidwa. Vuto lachiberekero likadzachitika, chiwalocho chimadulidwa pofuna kupewa kufalikira kwa necrosis.

Ndizofunikira kudziwa kuti madokotala amasiyanitsa gawo lomwe limatchedwa preclinical gawo la angiopathy, pomwe zizindikiro zonse sizipezeka. Mukasanthula mitsempha yamagazi ndikupeza chidziwitso chokwanira cha kuchuluka kwa shuga m'magazi, mutha kudziwa za matendawa kumayambiriro.

Njira zoyesera

Wodwala aliyense yemwe ali ndi matenda a shuga ali pachiwopsezo, motero, kuyezetsa koyenera kuyenera kuchitidwa. Ngati pazifukwa zina sanachite izi, ndipo angiopathy anakula, ndiye kuti matenda athunthu amachitika. Kutengera ndi zotsatira zake, chithandizo ndi mankhwala.

Kuti muzindikire matendawa, njira zotsatirazi ndi njira zowunikira zimagwiritsidwa ntchito:

• akupanga duplex
• capillaroscopy
• angiography

Kugwiritsa ntchito kujambula kopanga ndi angiography, ndizotheka kupeza chidziwitso chofunikira chofufuzira. Ngati ziwiya zazing'ono zimayikiridwa kuti zakhudzidwa, angiography imagwiritsidwa ntchito.

Kuyendera kochitika kumachitika. Njira zodziwira matenda zilizonse zimayambira nawo. Mothandizidwa ndi kukhazikitsa kwamakono, ndizotheka kuzindikira ndikuwona kuwopsa kwa matendawa munthawi yochepa kwambiri.

Maphunziro owonjezera akuchitidwanso, momwe muli:

• kuyesa kwa shuga
• Ultrasound ya ziwalo zomwe zingakhudzidwe chifukwa cha matenda ashuga

Kutengera zotsatira, njira yochizira matendawa imasankhidwa. Dokotala amatha kuwonjezera mayeso omwe angathandize kuzindikira koyenera. Kuzindikira ndi gawo lofunikira kwambiri la chithandizo chonse, chifukwa limakupatsani mwayi wodziwa matendawa ndikusankha njira yoyenera yochizira.

Mawonekedwe a njira zamakono zodziwira matenda

Njira zabwino zofufuzira ndikubwereza mtundu, capillaroscopy, angiography ndi kafukufuku wakale wa Doppler. Ndi chithandizo chawo, ndizotheka kupeza chithunzi chonse cha zomwe zikuchitika ndi dongosolo lonse la mtima. Ma capillaries onse awiri ndi mitsempha yayikulu imapezeka.

Kujambula kwa duplex ndi mtundu wa ultrasound womwe umagwiritsa ntchito ma module angapo a ultrasound (Doppler ndi b-mode). Pogwiritsa ntchito kafukufukuyu, titha kuyesa:

• kayendedwe ka magazi
• kuthamanga kwa magazi
• chotengera khoma chikhalidwe

Njira yake ndiyopanda vuto lililonse komanso yopanda zowawa, chifukwa chake imagwiritsidwa ntchito kangapo: musanapangire dongosolo la mankhwala, munthawi ya chithandizo komanso mukakwaniritsa kuchotsedwa.

Capillaroscopy - phunziroli pansi pa ma microscope ama capillaries omwe amatengedwa kuchokera pabedi la misomali m'munsi. Kuti mupeze sampuli, zovuta kuzinyamula sizofunikira. Nditalandira zojambulazo, zimaphunzitsidwa mu labotale yapadera. Mothandizidwa ndi kafukufukuyu, mutha kupeza zosintha muma capillaries ang'ono kwambiri. Phunziroli limakupatsani mwayi wofufuzira kumayambiriro.

Angiography ndi mayeso osiyanasiyana a x-ray omwe amakupatsani mwayi kuti mufufuze momwe ziwombazo zilili ndi kudziwa zolondola pazokhudza chikondi chawo. Njira yodziwitsa anthu ali ndi contraindication ndipo sangagwiritsidwe ntchito nthawi zambiri. Choyambirira, nthawi zonse amayambitsa matendawa ndi kuwunika kwa akupanga.

Kukhazikitsidwa kwa njira yodziwitsa ndi dokotala. Ndikofunikira kuti njira zamakono zofufuzira zimagwiritsidwa ntchito kuti zitsimikizire bwino malo omwe panali lesion.

Malangizo

Malangizo a mankhwalawa amasankhidwa ndi katswiri. Zimatenga nthawi kuti zitheke zotsatira zabwino za matenda a shuga komanso zovuta zake. Poyamba, njira zochizira zosagwiritsidwa ntchito masiku onse zimagwiritsidwa ntchito.

Chithandizo chokwanira cha matendawa chimagwiritsidwa ntchito. Ndikofunikira kukwaniritsa zotsatirazi:

• kutsitsa shuga
• cholesterol yotsika
• kusintha magazi
• bweretsani njira yachilengedwe ya kagayidwe kazinthu kena
• kuthetsa matenda (ngati pali zotupa)

Magulu osiyanasiyana a mankhwala amagwiritsidwa ntchito. Njira zochizira matendawa zimatengera mikhalidwe ya munthu.

Mankhwala otsatirawa amagwiritsidwa ntchito:

Mankhwala osokoneza bongo

1. Kuchepetsa shuga m'magazi - Diabetes, Insulin. Mankhwala amagwiritsidwa ntchito mosalekeza.
2. Kuchotsa cholesterol yapamwamba - Lovastatin, Simvastatin. Zogwiritsidwa ntchito kwakanthawi kochepa. Pambuyo panjira yokhazikika, kuyezetsa magazi kumachitika. Ngati cholesterol yakwanira, makonzedwe amayimitsidwa.
3. Kusintha kwa kayendedwe ka magazi - Reosorbilact, Vazaprostan, Ilomedin, Pestazol. Njira ya chithandizo imatsimikiziridwa payekhapayekha.
4. Kupititsa patsogolo kwa kagayidwe kachakudya ka mankhwala m'dera lomwe lakhudzidwa - Vitamini A ndi E, Mildronate, Actovegin.
5. Kuchotsa kachilombo ka bacteria - Levofloxacin, Ciprinol kapena mankhwala aliwonse ofanana ndi awa. Ngati palibe zotupa zopatsirana zotupa, ndiye kuti maantibayotiki sagwiritsidwa ntchito.

Ndondomeko ya chithandizo imathandizidwa ndi magulu ena a mankhwala ngati pakufunika. Kuti mukwaniritse izi, zimatenga nthawi yayitali kumwa mankhwala pamaphunziro. Mobwerezabwereza, mankhwala amagwiritsidwa ntchito omwe amalimbana ndi matenda a shuga.

Munthu amene akudwala matenda ashuga amafunika kutsatira malangizo onse a dokotala. Mukasiya kuyimitsa matenda oyambitsawo, zovuta zake zimabweranso, ngakhale mankhwala atagwiritsidwa ntchito. Angiopathy imangokhala ngati chotupa chachiwiri. Mphamvu zonse zimayendetsedwa kuti zitha kuthana ndi zomwe zimayambitsa maselo a mtima.

Mfundo zachithandizo

Mfundo yayikulu ndikulipira kwambiri kuponderezedwa kwa shuga. Kuphatikiza apo, mfundo zotsatirazi zamankhwala ndizodziwika bwino:

• kusiya zizolowezi zonse zoyipa
• kugwiritsa ntchito nambala 9
• mayeso pafupipafupi m'malo opumira

Kuti mukwaniritse izi, muyenera kusintha moyo wanu wonse. Ngati pali kulemera kwakukulu, muyenera kuyichotsa. Kulemera kwambiri kwa thupi kumapangitsa kuti magazi azitsekeka. Chifukwa cha izi, angiopathy imayamba mofulumira kwambiri. Kuchepetsa thupi pakukhululukidwa kwa matendawa.

Zimatenga pafupifupi mwezi umodzi kuponderesa magazi. Pambuyo pa izi, kusintha kwamapangidwe amitsempha yamagazi kumatha. Munthu adzafunika kupitiliza chithandizo ndikupeza chikhululukiro chokhazikika.

Mankhwala othandizira

Nthawi zina, zotsatira zake muzochiritsa zimatheka pokhapokha ngati akuchita opereshoni. Pali mitundu ingapo ya maopareshoni omwe angachotse gawo lovuta la angiopathy:

1. Zilonda zazikulu zamatumbo akulu, opaleshoni yam'mimba, thrombectomy, ndi endodascular vasodilation amagwiritsidwa ntchito. Opaleshoni yam'mimba imakulolani kuti musinthe madera omwe akhudzidwa ndi mitsempha yam'mimba ndi ma cell ochokera m'mitsempha yake. Thrombectomy ndikuchotsa minofu yophimba ziwiya. Kukula kwamphamvu kumaphatikizapo kufutukula kwa mitsempha yopapatiza pogwiritsa ntchito chida chapadera.
2. Ndi puritis yotupa yowonongeka chifukwa cha kusokonezeka kwa magazi, ntchito zimachitika kuti mutsegule zotupa ndikuyeretsa zamkati. Dera lomwe lakhudzidwalo limatsitsidwa ndikugwiriridwa. Pambuyo pake, njira zochizira zosagwiritsidwa ntchito zimagwiritsidwa ntchito.
3. Ndi gangrene, kudula kumachitika. Kutengera ndi kuchuluka kwa zowonongeka, zala, phazi, mwendo wotsika kapena ntchafu yonse imatha kuchotsedwa. Gangrene akuyika moyo wa anthu pachiwopsezo ndipo akukula msanga, chifukwa chake kuchititsa opaleshoni kuyenera kuchitika mwachangu.

Chithandizo cha opareshoni chimathandiza kuthana ndi kuwonongeka kwakatundu kotsika. Ngati njira zolimbikira sizinapereke kanthu, imodzi mwazomwe mungagwiritse ntchito popanga opaleshoni ndiyofunika.

Si aliyense amene angasankhe zochita. Kufunika kochita opaleshoni kumachitika pokhapokha ngati matendawa atakula kwambiri kapena akufalikira. Kufikira pano, chithandizo chamankhwala chitha kuperekedwa.

Kuzindikira komanso zovuta

Izi zimatengera momwe zingathekere kusiya matenda ashuga. Magazi akangochita shuga, magazi a shuga angachedwetse kuchepa. Kwakukulukulu, kudaliraku kumakhala kwabwino ngati munthu afuna thandizo koyambirira. Ndizotheka kuchepetsa pang'onopang'ono kukula kwa masinthidwe mu kapangidwe ka mtima. Mukanyalanyaza matenda, mavuto amabuka, omwe ali:

• mawonekedwe a wotchedwa diabetic phazi (edema, ululu, purulent bacteria bacteria, zilonda)
• necrosis (kumachitika necrosis ya zala, kenako phazi lonse)

Mulimonsemo, munthu ayenera kuchita zonse zotheka kuti apewe matenda a shuga. Kuti muchite izi, gwiritsani ntchito njira zonse zomwe zilipo, kuphatikizapo mankhwala azikhalidwe. Panthawi yovuta ya shuga, amapita kuchipatala kuti akathandizike.

Dokotala amapatsa kudwala kwake pokhapokha atangoyamba kumene chithandizo. Ngati matenda a shuga adziwonetsa mwankhalwe osalabadira chithandizo, ndiye kuti zovuta zake zonse zimakula msanga. Ndikofunikira kugwiritsa ntchito njira zosiyanasiyana kuti musankhe njira yoyenera kwambiri.

Chitetezo cha matenda a shuga

Munthu aliyense yemwe ali ndi matenda ashuga ayenera kutsatira. Komanso munthu wathanzi lathunthu amatha kuziona. Wodwala matenda a shuga amachita zinthu zotsatirazi:

• amasunga kwambiri shuga
• amagwiritsa ntchito mankhwala omwe amasintha magazi m'miyendo
• amatsatira zakudya zomwe sizimapatula zomanga thupi ndi zinthu zomwe zimayambitsa hypoglycemia
• Nthawi zambiri amapita kuchipatala kuti akafufuze

Munthu yemwe akudwala matenda ashuga ayenera:

• matenda zakudya
• khalani ndi chidwi
• kuonda
• kuwunika mtima wamankhwala
• lekani zizolowezi zoyipa

Kupewera kukupitirirabe. Ndi chithandizo chake, chiopsezo chotenga matendawa chimachepetsedwa kwambiri.

Ngati munthu ali kale ndi matenda ashuga, ayenera kuyang'anira kwambiri zakudya ndi moyo. Mukafika pachikhululukiro chokhazikika, munthu safunikira kupuma. Kulemba pafupipafupi kumathandizira kuzindikira zovuta zilizonse poyambira chitukuko, ndiye kuti zichotseni mwachangu.

Matenda a shuga ndi matenda oopsa omwe amatha kuwononga moyo. Izi zimachitika zokha, ndiye kuti muyenera kuyambitsa matenda ashuga.

Njira yolondola ya chithandizo chamankhwala komanso kuyimitsidwa kwina kwamankhwala onse a dokotala kudzakwaniritsa zotsatira zake. Zovuta za m'magazi a shuga ndi vuto lalikulu lomwe liyenera kuthetsedwa ndi endocrinologist ndi dokotala wa opaleshoni ya mtima.

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