Zizindikiro za matenda ashuga retinopathy, magawo ndi chithandizo

Tikukupemphani kuti muwerenge nkhaniyi pamutuwu: "zizindikiro za matenda ashuga a retinopathy, magawo ndi njira zamankhwala" ndi ndemanga kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Akatswiri athu a endoprinologist adzakuyankhirani.

Matenda a shuga a retinopathy: magawo, Zizindikiro ndi chithandizo

Matenda a shuga a retinopathy - kuwonongeka kwa ziwiya zam'maso. Uku ndikovuta komanso pafupipafupi kwambiri kwa matenda ashuga, omwe angayambitse khungu. Mavuto amawonedwe mu 85% ya odwala omwe ali ndi matenda a shuga 1 omwe ali ndi zaka 20 kapena kuposerapo. Matenda a 2 a mtundu wa 2 akapezeka mwa anthu a zaka zapakati komanso zakale, ndiye pazochitika zoposa 50%, nthawi yomweyo amawulula kuwonongeka kwa ziwiya zomwe zimapereka magazi m'maso. Mavuto obwera chifukwa cha matenda ashuga ndi omwe amachititsa kwambiri kuti azimayi azaka zapakati pa 20 mpaka 74 azikhala ndi khungu. Komabe, ngati mumayesedwa pafupipafupi ndi katswiri wa ophthalmologist ndikuthandizidwa bwino, ndiye kuti muthe kuwona bwino.

Matenda a shuga a retinopathy - zonse zomwe muyenera kudziwa:

• Magawo a chitukuko cha zovuta za shuga m'masomphenya.
• Proliferative retinopathy: ndi chiyani.
• Kuyesedwa pafupipafupi ndi a ophthalmologist.
• Mankhwala a shuga a retinopathy.
• Laser Photocoagulation (cauterization) ya retina.
• Vitrectomy ndi opaleshoni yamphamvu.

Pakadali pano, mavuto am'mbuyo amawopseza kuwonongeka kwathunthu kwamawonedwe. Chifukwa chake, odwala omwe akudwala matenda a shuga a retinopathy nthawi zambiri amapatsidwa mankhwala a laser. Uwu ndi chithandizo chomwe chitha kutha kuyambitsa khungu kwa nthawi yayitali. Okalamba kwambiri odwala matenda ashuga ali ndi zizindikiro za retinopathy kumayambiriro. Munthawi imeneyi, matendawa samayambitsa kuwonongeka kwamawonedwe ndipo amapezeka pokhapokha atawunika ndi ophthalmologist.

Pakadali pano, chiyembekezo cha moyo wa odwala omwe ali ndi matenda amtundu woyamba 1 ndikuwonjezereka chifukwa kufa kwa chifukwa cha matenda amtima kumachepa. Izi zikutanthauza kuti anthu ochulukirapo adzakhala ndi nthawi yopanga matenda ashuga a retinopathy. Kuphatikiza apo, zovuta zina za matenda ashuga, makamaka matenda ashuga a m'matumbo ndi impso, nthawi zambiri zimayenderana ndi vuto la maso.

Njira zenizeni zopangira matenda a shuga a retinopathy sanakhazikitsidwebe. Pakadali pano, asayansi akufufuza malingaliro osiyanasiyana. Koma kwa odwala izi sizofunikira kwambiri. Chachikulu ndikuti zinthu zoopsa zimadziwika kale, ndipo mutha kuzilamulira.

Kuchepa kwa vuto la maso m'matenda a shuga kumakulira msanga ngati:

• Magazi okwera kwambiri
• kuthamanga kwa magazi (matenda oopsa),
• kusuta
• matenda a impso
• mimba
• chibadwa
• chiopsezo cha matenda ashuga retinopathy amachulukitsa ndi zaka.

Zomwe zimayambitsa ngozi zazikulu ndi shuga wamagazi ndi matenda oopsa. Ali patsogolo pa zinthu zina zonse zomwe zili pamndandandandawo. Kuphatikiza ndi zomwe wodwala sangathe kuzilamulira, ndiko kuti, chibadwa chawo, zaka komanso nthawi yayitali ya matenda ashuga.

Otsatirawa akufotokozera m'chinenedwe chomveka chomwe chimachitika ndi matenda ashuga retinopathy. Akatswiri anganene kuti izi ndizosavuta kutanthauzira, koma kwa odwala ndizokwanira. Chifukwa chake, ziwiya zazing'ono zomwe magazi amayenda m'maso zimawonongeka chifukwa cha kuchuluka kwa shuga m'magazi, matenda oopsa komanso kusuta. Kutumiza kwa okosijeni ndi michere kumayamba kuipiraipira. Koma retina imadya mpweya ndi glucose ochulukirapo gawo lililonse la kulemera kuposa minyewa ina iliyonse mthupi. Chifukwa chake, imakhudzidwa makamaka ndi magazi.

Potengera kuchepa kwa mpweya wa minofu ya thupi, thupi limakulitsa ma capillaries atsopano kuti abwezeretse magazi m'maso. Kuchulukitsa ndiko kuchulukitsa kwa ma capillaries atsopano. Gawo loyambirira, losatulutsa, gawo la matenda ashuga limanenanso kuti njirayi sinayambebe. Panthawi imeneyi, makoma a mitsempha yamagazi ochepa amangogwa. Chiwonongeko chotere chimatchedwa microaneurysms. Kuchokera kwa iwo nthawi zina magazi ndi madzimadzi amatuluka kupita ku retina. Zingwe zam'mitsempha mu retina zimatha kutupa ndipo gawo lapakati la retina (macula) limayambanso kutupa, nawonso. Izi zimadziwika kuti macular edema.

Kukula kwa diabetesic retinopathy - kumatanthauza kuti kuchuluka kwa zombo zatsopano kwayamba, m'malo mwa zomwe zawonongeka. Mitsempha yachilendo imakula mu retina, ndipo nthawi zina zotengera zatsopano zimatha kukula kulowa m'thupi lamphamvu - chinthu chowoneka bwino chamafuta. Tsoka ilo, zombo zatsopano zomwe zimakula sizabwino. Makoma awo ndi osalimba, ndipo chifukwa cha izi, zotupa zimapezeka pafupipafupi. Mapazi am'madzi amadziunjikira, mafupa am'mimba amtundu, i.e. zipsera m'dera la zotupa.

Retina imatha kutambasulira ndikulekana ndi kumbuyo kwa diso, izi zimatchedwa kukanidwa kwina. Ngati mitsempha yatsopano ya magazi ikusokoneza kutuluka kwakuthupi kuchokera kumaso, ndiye kuti kupanikizika kwa diso kumatha kuchuluka. Izi zimabweretsa kuwonongeka kwa mitsempha ya optic, yomwe imanyamula zithunzi kuchokera ku maso anu kupita ku ubongo. Ndi pokhapokha pomwe wodwalayo ali ndi madandaulo a kusawona bwino, kuwona masana usiku, kupotoza zinthu, ndi zina zambiri.

Ngati mumachepetsa shuga m'magazi anu, ndikuwakhazikika bwino komanso kuwongolera kuti magazi anu asapitirire 130/80 mm Hg. Art., Ndiye kuti chiwopsezo cha retinopathy chokha, komanso zovuta zina zonse za matenda a shuga zimachepa. Izi ziyenera kulimbikitsa odwala kuchita mokhulupirika njira zochizira.

Kodi matenda a shuga a retinopathy ndi ati, njira ndi njira zochizira

Odwala omwe ali ndi matenda a shuga, poyerekeza ndi munthu wamba, wathanzi, chiopsezo cha ischemia ndi kuwonongeka kwa impso ndichokwera kwambiri, m'modzi mu 200 amataya zala chifukwa cha kukula kwa gangore, ndipo kuthekera kwa kutayika kwathunthu kwamawonedwe kuli kopambana 25. Kuperewera kwamagetsi oyenera chifukwa cha kuchuluka kwa shuga kumagunda ziwalo zofooka kwambiri za munthuyo - mtima, miyendo, impso, maso. Matenda a shuga a retinopathy, omwe mathero ake ndi khungu lathunthu, amayamba kukula zaka zisanu zitatha matenda ashuga, komanso ndi shuga, ndikumadumphanso shuga m'mbuyomu.

Retinopathy, kwenikweni "matenda a retinal", ndi njira imodzi yowonetsera matenda a shuga. Malinga ndi WHO, matendawa amakhudza pafupifupi odwala onse omwe ali ndi matenda amtundu wa 1 omwe ali ndi zaka zopitilira 15. Ngakhale zili zodabwitsa, matenda ashuga a chifuwa cha matenda a shuga afala kwambiri chifukwa cha madokotala. M'mbuyomu, sikuti aliyense amene ali ndi matenda ashuga omwe anapulumuka chifukwa cha kuvulala kwambiri kwa maso, chifukwa chomwe adamwalira chinali matenda amtima. Masiku ano, kuchuluka kwa mankhwala amalola kupewa kufa ndi ischemia ndikuchepetsa kwambiri zovuta za matenda a shuga, kuphatikizapo matenda ashuga retinopathy.

Retina loti lizigwira bwino ntchito limafunikira kuchuluka kwa mpweya wabwino poyerekeza ndi ziwalo zina. Zotengera zodzaza ndi viscous, magazi okhathamira okhala ndi shuga komanso ma triglycerides sangathe kupereka zakudya zabwino za retina. Makoma a capillaries ang'onoang'ono kwambiri amapitilira, kuphulika, pali zotupa zazing'ono zotupa ndi aneurysms. Gawo lamadzimadzi lamagazi lodontha limapanga edema pa retina, yomwe imachepetsa kugwira ntchito kwa diso. Zigawo za mapuloteni zimayambitsa kukondera kwa retina. Kupitilira kufalikira kwa mabala kumakhudza kutembenuka kwamatumbo ndi stratization, kuwonongeka kwa mitsempha.

Gulu la ogwirizana la matenda ashuga limagwiritsidwa ntchito padziko lonse lapansi. Amagawa matendawa m'magulu potengera kuchuluka kwa kuchuluka - kuchuluka kwa ziwiya zatsopano m'maso.

Zikuwoneka kuti izi zitha kukhala zowopsa? Kupatula apo, zotengera zomwe thupi limakulitsa m'malo mwa zowonongeka zimathandizira mabala kuti achiritse msanga komanso kuzika mizu m'ziwalo zomwe zayikidwa kale. Ponena za ziwalo za masomphenyawo, zinthu zimakhala zosiyanasiyana. Pansi pa vuto la kufera kwa okosijeni m'matenda a shuga, ma capillaries atsopano amakhala opanda pake, makoma awo amakhala ndi maselo amtundu umodzi wokha. Kapangidwe ka zotengera zoterezi kumabweretsa kuwonongeka koopsa pamkhalidwewo: kuchuluka kwamatumbo kumawonjezeka mofulumira, edema imakulirakulira, ndipo chiopsezo cha kutayika kwa masomphenya chikuwonjezeka kwambiri.

Magawo a retinopathy:

Kusintha kwa matenda ashuga m'mawonekedwe owoneka ndi asymptomatic mpaka kuwonongeka kwakukulu. Kuwona kwakachulukidwe kumakhala kokwanira mpaka kusintha kosasinthika komwe kumayamba kuchitika mu retina.

Matenda osapatsirana a shuga omwe amapezeka pambuyo pake amapezeka ndi mayeso a ophthalmologist, pakadali pano kukonzekera kwa adokotala ndikofunikira.

Zofunika! Koyamba kuwunika kwa ziwalo zamasomphenya kuyenera kuchitika ndi matenda ashuga kwa zaka 5, ngati nthawi yonseyi shuga akhoza kukhalanso yokhazikika. Ngati shuga adumpha nthawi ndi nthawi - an ophthalmologist ayenera kuyendera zaka 1.5 atazindikira kuti ali ndi matenda ashuga. Ngati dokotala sanakuwululireni zakusintha kwa diso, mayeso amayenera kuchitika chaka chilichonse. Ngati mwapezeka kuti muli ndi matenda ashuga retinopathy - nthawi zambiri.

Gululi lomwe lili pachiwopsezo chachikulu chotenga matenda obwera chifukwa cha matenda ashuga othamanga limaphatikizanso odwala omwe ali ndi vuto losakhazikika la shuga, kuthamanga kwa magazi, kulephera kwa impso, BMI> 30, amayi oyembekezera komanso achinyamata.

Zizindikiro za matenda apamwamba a matenda ashuga:

1. Zotsatira za kuphatikizika kwa zinthu zokhala ndi zotendekera pafupi ndi macula.
2. Masamba otuwa, omwe amawonekera bwino pakuwona zinthu zowala zomwe zimapangika pomwe capillaries ikuphulika ndikugundana kwamagazi kulowa kulowa mkati mwa thupi lamphamvu. Nthawi zambiri amazimiririka ndi nthawi yawoyonso.
3. Chithunzi chowala bwino, nkhungu pamaso pa nthawi yotupa.

Zizindikirozi zikawoneka, kupita kukawona dokotala wofufuza m'maso ndikulimbikitsidwa.

Poika matenda a ophthalmologist, chithunzi chachikulu cha zotsatira za matenda a shuga chimawoneka ndi ophthalmoscopy. Chimakupatsani mwayi wofufuzira, kudziwa kuchuluka kwa retinopathy, kuzindikira kukhalapo kwa mitsempha yotupa, zotupa zam'mimba, zotupa, kudziwa njira zamankhwala. Pamapeto omaliza, maukonde othandizira, opalasa, opalasa, owoneka bwino. Kutsatira kusintha, pali kamera yapadera yomwe imatha kujambula zithunzi za fundus.

Ophthalmoscopy sichingatheke ngati mandala kapena kuseketsa kwamaso ndi mitambo, chifukwa ma retina sangawonekere kudzera mwa iwo. Pankhaniyi, ultrasound imagwiritsidwa ntchito.

Kuphatikiza pa maphunziro awa amachitika:

1. Perimetry yozindikira ma pathologies m'mphepete mwa retina ndi kukhalapo kwa exfoliation.
2. Tonometry - kutsimikiza kukakamiza mkati mwa diso.
3. Kuwunikira momwe magwiridwe antchito a cell ndi mitsempha ya retina amagwiritsa ntchito njira zamagetsi, mwachitsanzo, electrooculography.
4. Kuti muwone zonyansa m'matumba, angiography kapena tomography ya retina ndiyofunikira.

The endocrinologist imapereka mayeso angapo omwe amatha kuzindikira kuchuluka kwa kubwezeredwa kwa shuga komanso kupezeka kwa zinthu zomwe zimakhudza chitukuko cha retinopathy: kuyeza kukakamiza, kuyesedwa kwa magazi ndi mkodzo kwa glucose, kutsimikiza kwa glycosylated hemoglobin level, renal vascular dopplerography, electrocardiography.

Chifukwa cha maphunzirowa, malingaliro adzapangidwa pakufunika kwa mankhwala kapena chithandizo cha matenda a shuga a retinopathy.

Tiyerekeze kuti munthu wodwala matenda ashuga sazindikira matenda ake, akupitilizabe kudya zakudya zamafuta kwambiri, komanso amanyalanyaza thanzi labwino komanso kupenya kwamaso. Tiona momwe izi zitha kutha, komanso momwe matenda a matenda ashuga a retinopathy akhudzidwira pakadapanda chithandizo.

Chifukwa chake, retina yomwe ili ndi njala imapereka lamulo kuti ikule ma capillaries atsopano, ndipo amakulira limodzi, nthawi zina amabweretsa mphamvu. Kukula kwina kwa shuga m'magazi a shuga kumabweretsa chiwonongeko chawo, kupezeka kwa mikwingwirima yambiri. Thupi, pakuyesayesa kuthana ndi izi, limakhazikika kukhathamiritsa ndipo limakula ziwiya zatsopano. Mbiri imadzibwereza yokha pamachitidwe omwewo. Popita nthawi, kuchuluka kwa magazi omwe akutayikira kumawonjezeka, komwe kumatchedwa hemophthalmus kumachitika. Sathanso kudzipasuka yekha, zomwe zikutanthauza kuti maso sangathenso kugwira bwino ntchito, maso amayamba kugwa.

Glaucoma imatsogolera ku khungu

Palinso chochitika china: chifukwa chotengera chilichonse chimaphulika, mawonekedwe amtundu wa retina, minofu yabwinobwino m'malo ano imasinthidwa ndi pathological - fibrous. Pang'onopang'ono, kuchuluka kwa minofu yam'mimba imakulirakulira, imalimbitsa retina ndikupanga kukhazikika kwake, kuvulala m'mitsempha yamagazi ndikuyambitsa hemophthalmus yatsopano, imalepheretsa kutuluka kwamaso kuchokera kumaso ndikupangitsa kuti glaucoma ipangidwe.

Mwachilengedwe, njira yosasangalatsa kwambiri ikufotokozedwa pano. Monga lamulo, kale pamlingo wowonjezera kapena kumayambiriro kwa wodwala wowonjezereka, matenda a shuga amawonekera kwa ophthalmologist. Kuphatikiza apo, nthawi zina, thupi limatha kudzipatula modzungulila bwalo loipalo ndikuletsa kupititsa patsogolo matendawo. Pankhaniyi, milanduyi imangomangidwa pokhapokha ngati munthu watayika kwambiri.

Ntchito yayikulu pakuthandizira retinopathy yopanda proliferative siyimaseweredwa ndi ophthalmologist konse. Pankhaniyi, kusintha kwa kagayidwe kachakudya, kayendedwe ka magazi m'magazi, komanso kutsitsa magazi ndizofunikira kwambiri. Chifukwa chake, mankhwala omwe amatha kusintha retinopathy amaperekedwa ndi endocrinologist ndi mtima.

Ngati simungathe kulipirira shuga ndi mankhwala ochepetsa shuga komanso zakudya zomwe sizigwira ntchito, musachite mantha ndi insulin. Pogwiritsa ntchito moyenera, ilibe zotsatira zoyipa, ndipo imatha kukhalanso ndi thanzi.

Ngati kusintha kwachitika kale pazida zomwe thupi silingathe kuthana nalo, ophthalmologist akupatseni mankhwala. Izi zitha kukhala zochizira matenda a matenda ashuga retinopathy, kapena njira zopangira opereshoni.

Mankhwala onse omwe amagwiritsidwa ntchito kale omwe amalembedwa kuti ayimitse retinopathy, masiku ano amadziwika kuti ndi zopanda ntchito. Njira yakuchizira matenda a shuga pokhapokha pamayambiriro a matendawo.

Kodi mumazunzidwa ndi kuthamanga kwa magazi? Kodi mukudziwa kuti matenda oopsa amathanso kukopeka ndi mtima ndi kumenyedwa? Sinthani nkhawa zanu. Maganizo ndi mayankho okhudza njira zomwe mwawerenga apa >>

Kugwiritsira ntchito kwawo pang'onopang'ono kwa matenda a shuga a retinopathy ndikutaya nthawi yamtengo wapatali yomwe ingagwiritsidwe ntchito njira zamakono zothandizira odwala.

Mwachitsanzo, madontho amaso a Taurine adapangidwa kuti apangitse njira zowombolera komanso kuyambitsa magazi. Kukhazikitsidwa kwa madonthowa kumatha kukhala kothandiza kumayambiriro kwamavuto mumitsempha yama mtima, koma osafunikira komanso koopsa pagawo lachiberekero.

Choipa chachikulu cha mankhwala a anti-VEGF ndi mtengo wawo wokwera. Jakisoni woyamba ayenera kuchitidwa kamodzi m'miyezi iwiri, mtengo wake uliwonse ndi ma ruble 3,000.Pafupifupi maphunziro ake ndi zaka ziwiri, jakisoni 8 pachaka. Eilea ndi mankhwala ogwiritsira ntchito nthawi yayitali, njira zomwe zimayendetsedwa pakati pa kayendetsedwe kake ndizitali, chifukwa chake chithandizo cha retinopathy chogwiritsira ntchito mankhwalawa chimakhala chotsika mtengo pang'ono ndikuchita chimodzimodzi.

Chithandizo cha laser cha matenda apamwamba a shuga a retinopathy pano ndi chithandizo chofala kwambiri. Adawonetsa kuyendetsa bwino kwake mu 80% ya ovulala pa siteji yachiwiri ya matenda ndi theka la milandu yomaliza. Opaleshoniyo ikangoyamba kuchitidwa, zotsatira zake zimakhala zabwino. Chinsinsi cha njirayi ndikuwotcha ziwiya zatsopano pogwiritsa ntchito mtanda wa laser, magazi omwe ali m'magaziwo amawundana ndipo ziwiya zimasiya kugwira ntchito. Nthawi zambiri, njirayi imakhala yokwanira kupitiliza kuwona kwa zaka 10 zikubwerazi.

Izi zimachitika kwa mphindi 20 pansi pa opaleshoni yanyumba, osakhala kuchipatala, wodwalayo amaloledwa kupita kwawo tsiku la opareshoni. Imalekerera mosavuta ndi odwala, sikufuna nthawi yochira, sikuvulaza mtima ndi mitsempha yamagazi. Dokotala wa opaleshoniyo amalamulira kwathunthu kulondola kwa kugunda kwa laser ndi maikulosikopu.

Pankhani ya matenda oopsa a matenda ashuga retinopathy, zovuta microsuction ntchito - zotchulidwa. Zimayimira kuchotsedwa kwathunthu kwa thupi lamphamvu pamodzi ndi magazi ndi zipsera zamagazi. Pa vitrectomy, laser cauterization yamitsempha yamagazi imakhalanso yotheka. Pamapeto pa opaleshoniyo, malo amaso amadzaza ndi njira yapadera kapena mpweya womwe umakanikiza retina ndipo suulola kuti uchotse.

Chinthu chachikulu pakupewera kwa retinopathy ndichidziwitso choyambirira. Kuti muchite izi, ndikofunikira kuwonedwa ndi ophthalmologist woyenerera yemwe amadziwa bwino zovuta za matenda a shuga. Njira yosavuta yopezera dokotala kuchipatala. Pazizindikiro zoyambirira za kuwonongeka kwa mitsempha ndi kukula kwatsopano, ndikofunikira kulingalira kuthekera kochita laser coagulation.

Chofunikanso popewa kulepheretsa retinopathy ndiko kubwezeretsedwa kwa matenda ashuga, chithandizo cha matenda ophatikizika, komanso moyo wathanzi.

Odwala omwe ali ndi matenda ashuga amalimbikitsidwa:

• kuwongolera kwa kuchuluka kwa shuga, kusunga cholembedwa cha chakudya,
• kutsika kwa kuthamanga kwa magazi ndi cholesterol kukhala milingo yabwinobwino,
• kusiya kusuta
• kupewa mavuto osautsa mtima.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti mapiritsi ndi insulin ndi njira yokhayo yoyeserera shuga kuwongolera? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Matenda a shuga a retinopathy - Angiopathy yapadera, yomwe imakhudza ziwiya za m'maso ndikukula motsutsana ndi maziko a shuga. Matenda a shuga a retinopathy ali ndi njira yopitilira patsogolo: m'magawo oyambawa, masomphenya osasunthika, chophimba ndi malo oyandama pamaso pa maso amadziwika, m'magawo apambuyo pamakhala kuchepa kapena kuwonongeka kwamaso. Diagnostics imaphatikizapo kufunsira kwa ophthalmologist ndi katswiri wa matenda ashuga, ophthalmoscopy, biomicroscopy, visometry ndi perimetry, retinal vascular angiography, komanso kuyesa kwamwazi wamagazi. Chithandizo cha matenda ashuga retinopathy chimafuna kayendetsedwe ka matenda ashuga, kukonza matenda a kagayidwe kachakudya, komanso vuto, zovuta zamkati mwa mankhwala, laser retinal coagulation, kapena vitrumomy.

Diabetesic retinopathy ndi vuto lakumapeto kwenikweni kwa matenda ashuga, onse omwe amadalira insulin komanso osadalira insulini. Mu ophthalmology, matenda ashuga retinopathy amachititsa kuwonongeka kwa odwala omwe ali ndi matenda ashuga a 80-90% milandu. Mwa anthu omwe ali ndi matenda ashuga, khungu limakula ka 25 kawiri kuposa oyimira ambiri. Pamodzi ndi matenda ashuga a retinopathy, anthu omwe ali ndi matenda ashuga ali ndi chiopsezo chachikulu cha matenda a m'matumbo, matenda a shuga, polyphary, nephropathy, matenda am'mimba Chifukwa chake, mankhwalawa a matenda a shuga amafunika njira zingapo, kuphatikizapo kutenga nawo mbali kuchokera kwa akatswiri kuchokera ku endocrinologists (a diabetes), ophthalmologists, cardiologists, podologists.

Kupanga kwa chitukuko cha matenda ashuga retinopathy kumalumikizidwa ndi kuwonongeka kwa mitsempha yamitsempha yamagazi (ma cell a retina): kuchuluka kwawo kwachulukidwe, kuchuluka kwa capillaries, mawonekedwe a ziwiya zatsopano komanso kukula kwa minofu yowonjezereka.

Odwala ambiri omwe ali ndi nthawi yayitali matenda a shuga amakhala ndi zizindikiro kapena zina zowonongeka ku fundus. Ndi nthawi yayitali ya matenda a shuga mpaka zaka 2, matenda a shuga a retinopathy amapezeka pamlingo wina kapena wina mu 15% ya odwala, mpaka zaka 5 - mu 28% ya odwala, mpaka zaka 10-15 - mu 44-50%, pafupifupi zaka 20-30 - mu 90-100%.

Zowopsa zomwe zimakhudza pafupipafupi komanso kukula kwa matenda ashuga retinopathy zimaphatikizapo kutalika kwa matenda ashuga, hyperglycemia, matenda oopsa, kulephera kwa impso, dyslipidemia, metabolic syndrome, ndi kunenepa kwambiri. Kukula ndi kupitilira kwa retinopathy kumatha kuthandizira kutha msinkhu, kutenga pakati, chibadwa chamtsogolo, komanso kusuta.

Popeza kusintha komwe kumachitika mu fundus, kusakhudzana, kuchuluka kwa odwala komanso odwala matenda ashuga retinopathy kumasiyanitsidwa.

Mankhwala okweza, osayendetsedwa bwino m'magazi amayambitsa kuwonongeka kwa mitsempha yamagazi ya ziwalo zosiyanasiyana, kuphatikizapo retina. Mu gawo losakulitsa la matenda ashuga retinopathy, makoma amitsempha ya m'mimba amathandizika ndipo amakhala osakhazikika, komwe kumayambitsa hemorrhages, mapangidwe a micaneurysms - kuchepa kwamitsempha yam'mbali. Magazi ochepa amanjoya kudzera m'mitsempha yolowera m'matumbo kupita mu retina, zomwe zimapangitsa kuti akhale ndi edema. Pankhani yokhudzana ndi gawo la chapakati pa retina, macular edema amakula, zomwe zimapangitsa kuti masomphenyawo athe kuchepa.

Mu gawo la prroliferative, ischemia yopita patsogolo imayamba chifukwa cha kuchepa kwa matenda a arterioles, kugunda kwamtima kwa hemorrhagic, matenda a venous.

Preproliferative diabetesic retinopathy imayamba gawo lotsatira, lomwe limapezeka mu 5-10% ya odwala matenda a shuga. Zomwe zimapangitsa kuti pakhale kuchuluka kwa odwala matenda ashuga retinopathy akuphatikizika ndi myopia yayikulu, kuchuluka kwa mitsempha ya carotid, patterior vitreous detachment, optic atrophy. Pakadali pano, chifukwa cha kuchepa kwa mpweya wa okosijeni wa retina, zotengera zatsopano zimayamba kupangika kuti zikhale ndi mpweya wokwanira. Mchitidwe wa neovascularization wa retina umabweretsa kubwerezabwereza kwa preretinal ndi retrovitreal hemorrhages.

Nthawi zambiri, kutaya magazi pang'ono m'magawo a retina ndi vitreous thupi kumadziyimira palokha. Komabe, ndimatumbo akulu am'magazi am'maso (hemophthalmus), kuchuluka kosasintha kwa microus mu thupi lotakasuka kumachitika, kodziwika ndi kuphatikizika kwa fupa komanso kumangika, komwe pamapeto pake kumayambitsa kukokoloka kwamatumbo. Mukatseka njira ya HPV, glaucoma yachiwiri imayamba.

Matendawa amakula ndipo amapita patsogolo osapweteka komanso asymptomatic - uku ndiko kunyenga kwake kwakukulu. Mchigawo chosakulira, kuchepa kwa masomphenya sikumvedwa kwenikweni. Macular edema imatha kuyambitsa kusakanikirana kwa zinthu zooneka, kuvuta kuwerenga kapena kugwira ntchito pafupi.

Mu gawo la kuchuluka kwa matenda ashuga retinopathy, pakachitika zotupa m'mitsempha, malo akuda ndi chophimba amawonekera patsogolo pa maso, omwe patapita kanthawi amawonekera okha. Ndi zotupa zazikulu mu thupi la vitreous, kuchepa kwambiri kapena kuwonongeka kwathunthu kwa masomphenya kumachitika.

Odwala omwe ali ndi matenda ashuga amafunikira kuwunika pafupipafupi ndi a ophthalmologist kuti awone kusintha koyambirira kwa retinal komanso kupewa kufalikira kwa matenda ashuga.

Pofuna kupenyetsetsa za matenda ashuga retinopathy, odwala amapita kukayikira, ma biomicroscopy a gawo lakunja kwa diso, biomicroscopy ya diso ndi mandala a Goldman, diaphanoscopy yamaso, Maklakov tonometry, ophthalmoscopy pansi pa mydriasis.

Chithunzi cha ophthalmoscopic ndichofunika kwambiri kuti chizindikire gawo la matenda ashuga retinopathy. Mu gawo losakulitsa, ma micaneurysms, "ofewa" ndi "ovuta", ma hemorrhages amapezeka ophthalmoscopically. Muchulukirachulukidwe, chithunzi cha fundus chimadziwika ndi kubisala kwamitsempha yama cell (minyewa yam'mimba, kuwonjezeka ndi kukoka kwa mitsempha), kukoka kwam'mbuyo ndi endovascular hemorrhages, neovascularization of the retina and optic nerve disc, kuchuluka kwa mafupa. Kuti mulembe zosintha pa retina, zithunzi zingapo za fundus zimachitika pogwiritsa ntchito kamera ya fundus.

Pogwira khungu la mandala ndi thupi lamphamvu, m'malo mwa ophthalmoscopy, amatembenukira ku maso. Kuti muwunike chitetezo kapena kusokonezeka kwa mitsempha ya retina ndi optic, maphunziro a electrophysiological amachitika (electroretinography, kutsimikiza kwa CSFM, electrooculography, etc.). Kuti mupeze khungu la neovascular glaucoma, gonioscopy imachitika.

Njira yofunikira kwambiri yowonera m'matumbo am'mimba ndi fluorescence angiography, yomwe imalola kutuluka kwa magazi kulembedwa m'matumbo a choreoretinal. Njira ina ya angiography ndikugwirizana kwamayendedwe ndi laser kusanthula kwa m'mbuyo kwa retina.

Kuti muwone zoopsa zomwe zimapangitsa kuti shuga ayambe kudwala matenda a shuga, kafukufukuyu amapangidwa ndi magazi ndi mkodzo glucose, insulin, glycosylated hemoglobin, mbiri ya lipid ndi zina zofunikira, aimpso a mtima a ultrasound scan, echocardiography, ECG, kuwunika kwa magazi kwa maola 24.

Pakuwunika ndi kuwunika, ndikofunikira kuzindikira kale kusintha komwe kumawonetsa kupitilira kwa retinopathy ndi kufunika kwa chithandizo chopewa kuchepa kapena kutayika kwa masomphenyawo.

Pamodzi ndi mfundo zambiri zochizira retinopathies, mankhwalawa amaphatikiza kukonza kwa kagayidwe kachakudya, kukhathamiritsa kwa kayendetsedwe ka glycemia, kuthamanga kwa magazi, kagayidwe ka lipid. Chifukwa chake, panthawiyi, chithandizo chachikulu chimadziwika ndi endocrinologist-diabetesologist ndi mtima.

Kuwunikira mosamala kuchuluka kwa glycemia ndi glucosuria, kusankha kwa insulin yokwanira kwa matenda a shuga kumachitika, angioprotectors, antihypertensive mankhwala, antiplatelet othandizira, etc. amatumizidwa. Intravitreal jakisoni wa mankhwala am'madzi amathandizira kuchitira macular edema.

Odwala omwe ali ndi matenda ashuga apamwamba a retinopathy amawonetsedwa chifukwa cha laser retinal coagulation. Kuphatikizika kwa laser kumakupatsani mwayi woponderezera njira ya neovascularization, kuti mukwaniritse kuthana ndi mitsempha yamagazi ndi kuwonjezereka kwa fragility ndi kupenyerera, kuti mupewe chiopsezo cha kufinya.

Opaleshoni ya laser retina ya matenda ashuga retinopathy amagwiritsa ntchito njira zingapo zingapo. Kuletsa kwa laser kukondoweza kwa retina kumakhudzanso kugwiritsa ntchito mitundu ina ya "latisi", m'mizere ingapo, ndipo akuwonetsedwa mwanjira ina yopanda retinopathy ya macular edema. Focal laser coagulation imagwiritsidwa ntchito pouterize micaneurysms, exudates, ndi zotupa zazing'ono zowululidwa nthawi ya angiography. Mukukonzekera kwa panretinal laser coagulation, ma coagulates amawagwiritsa ntchito mu retina, kupatula dera la macular, njirayi imagwiritsidwa ntchito makamaka pa siteji ya prolliferative kuti isapitirire.

Ndi mawonedwe ophatikizika amaso, njira yina ya kuwala kwa laser ndi transscleral cryoretinopexy, kutengera kuzizira kwa ziwalo zam'mimba za retina.

Pankhani ya zovuta zowonjezereka za matenda ashuga retinopathy ophatikizika ndi hemophthalmus, macular traction kapena retinal detachment, vitrectomy amatengedwa kuti, pomwe magazi, thupi la vitreous limachotsedwa, minyewa yolumikizira minofu imadulidwa, mitsempha yotulutsa magazi imatenthedwa.

Zovuta zingapo za matenda ashuga retinopathy amatha kukhala glaucoma yachiwiri, matenda amkati, kuchepa kwa khungu, hemophthalmus, kuchepa kwakukulu kwa masomphenya, khungu lathunthu. Zonsezi zimafunikira kuyang'anira odwala omwe ali ndi matenda ashuga ndi endocrinologist ndi ophthalmologist.

Ntchito yofunikira kwambiri yoletsa kupitirira kwa matenda ashuga retinopathy imaseweredwa ndikuwongolera moyenera shuga ndi kuthamanga kwa magazi, kudya kwa hypoglycemic komanso mankhwala a antihypertensive. Kuchita kwakanthawi kwa njira zopangira laser zimathandizira kuyimitsidwa ndi kusinthidwa kwa kusintha kwa ndalama.

Mwa zina mwazovuta zomwe zimapezeka mwa anthu omwe ali ndi matenda osokoneza bongo a mtundu woyamba komanso wachiwiri, matenda ashuga retinopathy amadziwika kuti ndiowopsa komanso owopsa. Potchedwa "diabetesic retinopathy" amatanthauza kuphwanya kwamawonedwe chifukwa cha kuwonongeka m'mitsempha ya maso, kutsata kuchepa, ndipo nthawi zina kutsiriza kwamala. Mtundu woyamba wa shuga, wokhala ndi zaka 20 kapena kupitilira, zovuta zamawonedwe zimawonedwa mwa 85% ya odwala. Mukazindikira mtundu wachiwiri wodwala matenda a shuga, pafupifupi 50% amakhala ndi zovuta zotere.

Kutengera ndi gawo la matendawa, momwe masinthidwe am'magazi m'matumbo, komanso minyewa ya diso, gulu lotsatirali limalandiridwa:

• Matenda a shuga
• Prerolopathy matenda a shuga
• kuchuluka odwala matenda ashuga retinopathy.

Gwero lalikulu lamphamvu yogwira ntchito mokwanira ndi thupi la glucose. Mothandizidwa ndi insulin, timadzi ta kapamba, glucose timalowa m'maselo momwe timakonzekera. Mu shuga mellitus, pazifukwa zina, kuphwanya insulin katulutsidwe kumachitika. Shuga wosakonzedwa amadzaza m'magazi, chifukwa chomwe metabolic metabolism m'thupi amasokonezeka. Zimabweretsa kufalikira, kuwonongeka kwa mitsempha yamagazi ya ziwalo zosiyanasiyana, kuphatikizapo ziwalo zamasomphenya. Ngati kukonza kwa glucose okwanira mwa odwala omwe ali ndi matenda osokoneza bongo sikungayambike panthawi, ndiye kuti matenda a shuga amayamba kukula.

Choyambitsa chachikulu cha matenda ndi kuchuluka kwa shuga m'magazi (shuga) kwa nthawi yayitali.

Nthawi zambiri, kuchuluka kwa shuga m'magazi sikuyenera kukwera pamwamba pa 5.5 mmol / L pamimba yopanda kanthu komanso 8.9 mmol / L atatha kudya.

Kuphatikiza apo, kupezeka kwa zinthu zothandizanso kwa odwala omwe ali ndi matenda a shuga kumakhudzanso kuchuluka kwa retinopathy. Sangathe kupangitsani kupangika koteroko, komanso kuwonjezera njira yake.

• kuchuluka kwa magazi
• kulimbitsa matenda oopsa (kuthamanga kwa magazi),
• mimba
• matenda osiyanasiyana a impso,
• onenepa kwambiri
• kusuta
• mowa
• zosintha zokhudzana ndi zaka mu mtima
• chibadwa kutsimikiza.

Njira yamatendawa masiku ano nthawi zambiri imagawika m'magulu anayi, iliyonse imatenga nthawi yayitali. Pali kusiyanasiyana - ndi matenda a shuga (ana) a shuga, kutha kwamawonedwe kumatha kuyamba miyezi ingapo.

Magawo a retinopathy mu matenda osokoneza bongo:

Magawo oyamba a matendawa ndi asymptomatic. Pang'onopang'ono kuphwanya:

• kuthamanga kwa "ntchentche" pamaso,
• maonekedwe a "nyenyezi" ndi kuzimiririka pakuwala,

Izi ndi zizindikiro zoyambirira zomwe sizimapangitsa wodwala kapena kusasangalala.Mawonetseredwe achizindikiro oterewa amatengedwa chifukwa cha kutopa, samapatsidwa chidwi.

Kupweteka kwamaso, kuchepa kwa maonedwe acuity, komanso kuchepa kwake - Zizindikiro zakuchedwa, zimawonekera ndi kupitilira kwa matendawa pambuyo pake, pomwe njirayo yapita patali kwambiri kapena yasunthira kumalo osasinthika.

Zizindikiro zoterezi zikuwonetsa kuti munthu aliyense wathanzi amangofunika kuwona ndi ophthalmologist kamodzi pachaka, komanso kwa odwala omwe ali ndi matenda ashuga miyezi isanu ndi umodzi iliyonse kuti awonenso ziwalo zawo zamawonedwe. Izi zikuthandizani kuti muwone zizindikiro za chisokonezo kumayambiriro kwa matendawo, osadikirira kuwonekera kwa zizindikiro zoonekeratu, pamene chithandizo cha mankhwala chikhoza kukhala chosagwira.

Akapita kwa ophthalmologist, dokotala amayesa kuwunika ziwalo zamasomphenya pogwiritsa ntchito maluso onse omwe amatha kuzindikira zizindikiro zoyambirira za matendawa, zimachitika popanda kuwonetsa zizindikiro zoyambirira.

• Ma Visometry - kuyang'ana zithunzi zowoneka bwino pogwiritsa ntchito tebulo,
• gonioscopy - Kapangidwe ka kagawo ka diso lililonse, ndi kuwonongeka kwa ziphuphu, kumasintha,
• mwachindunji ndi kusiyanitsa ophthalmoscopy - kuyang'anira mandala, thupi lodziwikiratu kuti muwone bwino,
• mayeso owunikira - kuwunika kwa choroid, kuwala kwamitsempha yamafuta, retina,
• ophthalmochromoscopy - imathandiza kudziwa kusintha koyambirira kwa fundus,
• biomicroscopy - kuwunika kwa mawonekedwe onse a maso ndi kuphatikiza kwawo mpaka nthawi 50-60 pogwiritsa ntchito nyali,
• zachuma - muyezo wa intraocular anzawo.

Popeza matenda ashuga retinopathy amapezeka kumbuyo kwa kusokonezeka kwa kagayidwe kachakudya koyambitsa matenda obwera chifukwa cha matenda a shuga, wodwalayo amapatsidwa chithandizo chokwanira cha matenda ashuga omwe amayang'aniridwa ndi dokotala wamaso ndi endocrinologist. Ntchito yayikulu pakuthandizira kwa matenda ammimbayi imaseweredwa ndi zakudya zosankhidwa ndi insulin.

Chithandizo cha insulini cholinga chake ndi kulipitsa matenda a carbohydrate metabolism; amasankhidwa mosiyanasiyana. Njira yosankhidwa bwino ya insulin komanso kugwiritsidwa ntchito kwakanthawi kumachepetsa chiopsezo cha kuyambuka ndi kupitirira kwa njira ya pathological. Ndi endocrinologist wokhayo amene angasankhe njira yoyenera, mtundu wa insulin ndi mlingo wake, kutengera zotsatira za mayeso omwe amachitika mwapadera. Kuti muwongolere mankhwala a insulin, makamaka, wodwalayo ayenera kuyikidwa kuchipatala.

Anthu omwe ali ndi matendawa ayenera kutsatira zakudya zoyenera, yomwe ndi njira imodzi yayikulu yovuta yogwiritsira ntchito.

Pazakudya musatchule:

• shuga, m'malo mwake ndi m'malo mwa (xylitol, sorbitol),
• kuphika ndi kuwononga makeke,
• mkate woyamba ndi woyamba
• nyama yamafuta, nsomba,
• zotsekemera zotsekemera ndi ma curds, zonona,
• ankasuta nyama
• pasitala, semolina, mpunga,
• mafuta msuzi, msuzi wophika mkaka ndi chimanga, Zakudyazi,
• zokometsera zotentha, msuzi, zonunkhira,
• zakumwa zozizilitsa kukhosi komanso zopanda mpweya, zakumwa, kuphatikizapo mphesa,
• wokondedwa, ayisikilimu, kupanikizana

• imvi, mkate wabwino kwambiri, komanso buledi
• Mitundu yamafuta ochepa nyama, nkhuku, nsomba - yophika ndi michere,
• nguluwe, oat, kapena barele ya ngale (chifukwa cha kuletsa mkate),
• tsiku lomwe simuyenera kudya mazira awiri kapena owiritsa,
• tchizi, wowawasa wowawasa m'mitundu yambiri,
• zipatso, monga ma cranberries, blackcurrant kapena zipatso zosafunikira, maapulo osagwiritsidwa ntchito, koma osaposa magalamu 200 patsiku,
• phwetekere ndi zipatso zina zopanda zipatso ndi mabulosi,
• khofi imayenera kusinthidwa ndi chicory.

Chofunika kwambiri ndi phytodiet. Odwala omwe ali ndi matenda osokoneza bongo, acidization amapezeka m'thupi, chifukwa chake kugwiritsa ntchito masamba omwe ali ndi alkalizing akulimbikitsidwa:

Imwani kapu ya birch mu theka lagalasi mpaka katatu patsiku, mphindi khumi ndi zisanu musanadye.

Mankhwala, malo akuluakulu amakhala:

• magazi cholesterol kutsitsa mankhwala
• anabolic steroids
• antioxidants
• mavitamini
• angioprotectors
• immunostimulants
• zopatsa mphamvu za biogenic,
• michere
• kukana mankhwala
• coenzymes ndi ena.
• Hypocholesterolemic mankhwala:
• kumachikon
• missterron.

Mankhwalawa amalimbikitsidwa kuti azigwiritsidwa ntchito mu matenda a shuga a retinopathy, omwe amapezeka pamodzi ndi atherosulinosis.

• Angioprotectors:
• zilonda zapakhosi
• Parmidin
• Doxium
• Dicinone "kapena" Etamsylate,
• wamkulu
• pentoxifylline.
• Zochizira za prroliferative gawo la matenda, mankhwalawa "Phosphaden" amagwiritsidwa ntchito, omwe amasintha hem hemnamics, zomwe zimachitika chifukwa cha fundus komanso zimapangitsa kagayidwe kachakudya.
• Mphamvu ya immunomodulating kumayambiriro kwa matendawa imatheka chifukwa chogwiritsa ntchito piritsi la Levomesil, ndi jakisoni Tactivin ndi Prodigiosan.
• Mavitamini a gulu B, C, E, R.
• Kubwezeretsa ndikuwongolera kagayidwe kazinthu m'maso: kukonzekera "Taufon", "Emoksipin".
• Intraocular makonzedwe a enzyme kukonzekera "Lidaza", "Gemaza" amagwiritsidwa ntchito pamaso pa zotupa zotupa.

Kuti mupeze zotsatira zabwino zamankhwala, mutha kugwiritsa ntchito Magalasi a Sidorenko, chipangizo cholimbitsa thupi chomwe ndi chofunikira kugwiritsa ntchito kunyumba, komanso kusintha magazi.

Tsoka ilo, chithandizo cha mankhwala chitha kukhala chothandiza magawo oyamba a mtundu wa retinopathy. Pakapita nthawi chitukuko chake, mankhwala a laser amagwiritsidwa ntchito.

Kuphatikiza kwa laser kumakupatsani mwayi kuti muchepetse kapena ngakhale kuyimitsa kuchuluka kwa zombo zomwe zangopangidwa kumene, kumalimbitsa makoma awo ndikuchepetsa kuperewera. Kuthekera kwa kukanidwa kwa retinal kumachepetsedwa.

Ndi mawonekedwe apamwamba a matenda a shuga a retinopathy, opaleshoni ndiyofunikira - vit sahihi.

Kutulutsidwa kwa zoopsa: kukhazikika kwa kulemera kwa thupi, chithandizo cha matenda oopsa, kukana mowa komanso kusuta kumathandizira kubwezeretsa njira za metabolic, kumawonjezera zotsatira zamankhwala.

Magawo oyamba a retinopathy amatha kuyankha bwino ngati mankhwala azitsamba, mungagwiritse ntchito wowerengeka azitsamba pambuyo pake pophatikizana ndi mankhwala.

Ngati m'malo mwa tiyi, imwani kulowetsedwa kwa maluwa a linden, mutha kutsitsa shuga. Kukonzekera kulowetsedwa ndikosavuta: supuni ziwiri za maluwa a linden amafunika kuthira 0,5 malita a madzi otentha. Kuumirira pafupifupi theka la ora.

Msonkhano wa "Genius" umasintha kayendedwe ka magazi m'mitsempha ya retina komanso umachepetsa chiopsezo cha retinopathy. Supuni ziwiri za chopereka kutsanulira theka lita imodzi ya madzi otentha, kunena 3 maola, kukhetsa. Tengani chikho 1/2 mphindi khumi musanadye katatu pa tsiku. Njira ya chithandizo mpaka miyezi 4.

Blueberries imabwezeretsa mawonekedwe owoneka bwino. Tsiku lililonse katatu patsiku, ngakhale chakudya, ayenera kumwa supuni imodzi yamphesa. Nthawi iliyonse pachaka, mabuluni achizungu amagulitsidwa m'masitolo. Ndikulimbikitsidwanso kutenga ma infusions kuchokera kuzikuta za zitsamba, zomwe zimaphatikizapo mabulosi owuma.

1. 
   Gryaznova I.M., VTorova VT. Matenda a shuga ndi pakati. Moscow, yosindikiza nyumba "Mankhwala", 1985, 207 pp.
2. 
   Ametov, A.S. Type 2 matenda a shuga. Mavuto ndi zothetsera. Buku lowongolera. Gawo 1 / A.S. Ametov. - M: GEOTAR-Media, 2015 .-- 370 p.
3. 
   Ametov, A.S. Type 2 matenda a shuga. Mavuto ndi zothetsera. Buku lowongolera. Gawo 1 / A.S. Ametov. - M: GEOTAR-Media, 2015 .-- 370 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.