Matenda a shuga

Zowonongeka zamaso m'matenda a shuga zimatchedwa angioretinopathy. Kukhalapo kapena kusakhalapo kwa angioretinopathy, komanso gawo lake, lingatsimikizidwe ndi dokotala wamaso pakuyang'ana kwa fundus. Nthawi yomweyo, amawona kukhalapo kapena kusowa kwa zotupa, zotengera zatsopano za retina ndi zina. Pofuna kupewa kapena kuyimitsa kusintha kwa ndalama, ndikofunikira kuti magazi abweretse bwino.

Mankhwala ndi njira yochitira opaleshoni imagwiritsidwa ntchito pochiza anti-retinopathy. Wodwala aliyense yemwe ali ndi matenda ashuga amayenera kumuwunika kawiri pachaka ndi a ophthalmologist m'njira yomwe anakonza. Pazowonongeka zilizonse, izi ziyenera kuchitidwa mwachangu.

Mu shuga mellitus, pamlingo wina kapena wina, mawonekedwe onse amaso amakhudzidwa.

1. Pazovuta za metabolic odwala omwe ali ndi matenda a shuga, chodabwitsa monga kusintha kwa mphamvu yowonetsera tinthu timene timayang'aniridwa nthawi zambiri chimawonedwa.

Nthawi zambiri, odwala matenda a shuga a mtundu uwu, ndi kupezeka koyambirira kwa matendawa motsutsana ndi kuchuluka kwa shuga m'magazi, myopia imachitika. Kumayambiriro kwa mankhwala a insulin ndi kuchepa kwambiri pamlingo wa glycemia, hyperopia imachitika mwa odwala ena. Ana nthawi zina amatha kuwerenga ndi kusiyanitsa zinthu zazing'ono pafupi. Popita nthawi, ndi kukula kwa shuga m'magazi, izi zimatha, maonekedwe amaso amatha, motero, sikulimbikitsidwa kuti musankhe magalasi kuti mupeze matenda oyamba a shuga m'miyezi iwiri yoyambirira.

Odwala omwe amatsatira malangizo onse a dokotala yemwe samalandira samawona kusintha kwamphamvu kwa mphamvu ya diso. Amadziwika ndi kuchepa kwapang'onopang'ono mu kuthekera kwa diso. Odwala awa amayamba kugwiritsa ntchito magalasi owerengera pamaso pa anzawo.

2. Nthawi zambiri, odwala matenda ashuga, kulumikizika kwa minyewa ya m'maso kumavutika, komwe kumapangitsa kuti kamvekedwe ka minofu kusokonekera komanso kugwira ntchito, kuphatikizapo oculomotor. Izi zikuwonetsedwa pakuwonekera kwa kope lakumtunda, kukulira kwa strabismus, masomphenya awiri, kuchepa kwa matalikidwe amaso. Nthawi zina kukula kwa zizindikiro zotere kumayendetsedwa ndi zowawa m'maso, mutu. Nthawi zambiri, kusintha kotereku kumachitika mwa odwala matenda ashuga okhalitsa.

Vutoli limachitika pafupipafupi ndipo silimadalira kuopsa kwa matenda ashuga (nthawi zambiri limapezeka mwa matenda a shuga). Ndi chitukuko cha mawonetseredwe otere, ndikofunikira kufunsa osati endocrinologist, komanso neuropathologist. Chithandizo chimatha kukhala chotalika (mpaka miyezi 6), koma matulukidwe ake ndi abwino - kubwezeretsa ntchito kumawonedwa pafupifupi mu odwala onse.

3. Kusintha kwa ma corne kumachitika mu cell ya cellular ndipo sikungathe kuwonekera mwa chipatala. Koma pakuchita kwa diso, gululi limagwirizana mwamphamvu ndi maopaleshoni othandizira, amachiritsa kwa nthawi yayitali ndipo pang'onopang'ono amawunikiranso mawonekedwe ake.

4. Malinga ndikuwona kwa madotolo, mwa anthu omwe ali ndi matenda ashuga, glaucoma wamba komanso kukakamizidwa kwamankhwala kumachitika kawirikawiri kuposa pakati pa anthu ena onse. Palibe chifukwa chomwe chidafotokozedwera pano.

5. Cataract - kuthambalala kwa mandala mumtanda uliwonse ndi kukula kulikonse. Mu shuga mellitus, omwe amatchedwa matenda ashuga nthawi zambiri amapezeka - opccities opacities mu posterior lens kapisozi. Mukakalamba, mtundu wa mphaka wokhudzana ndi m'badwo umakhala wodziwika, pamene mandala ali ndi mitambo mosiyanasiyana, pafupifupi mawonekedwe onse m'magawo onse, nthawi zina mitambo imakhala yachikasu kapena yofiirira.

Nthawi zambiri, ma opacities amakhala osakhazikika, opepuka, osachepetsa maonedwe kapena kuchepetsa pang'ono. Ndipo izi zitha kukhazikika kwazaka zambiri. Ndi ma opacity kwambiri, ndikupita patsogolo kwakanthawi, ndikotheka kuchita opareshoni kuti muchotse mandala amitambo.

Zaka 15 zapitazo, matenda ashuga anali kulepheretsa opaleshoni yamkati ndikutsatiridwa ndi kupaka kwa mandala opaka. Maukadaulo omwe analipo kale anali atadikirira kudikira mpaka nkhandayo "itakhwima" pamene masomphenya adayamba kutsika pang'ono. Maluso amakono amakupatsani mwayi kuti muchotse zozungulira pamtunda uliwonse kapena kukhwima pang'ono, ma lens apamwamba apamwamba.

M'magawo oyamba a matenda amkati, pamene maonedwe owoneka samachepetsedwa komanso kulowererapo sikunawonetsedwe, oculists amalimbikitsa kuti odwala akhazikitse madontho a vitamini. Cholinga cha mankhwalawa ndikuthandizira kuthana ndi mandala komanso kupewa kugwetsa mvula. Satha kuthana ndi mitambo yomwe ilipo, popeza kusintha kwa mandala kumalumikizidwa ndi kusintha kosasinthika kwa mapuloteni omwe adasowa mawonekedwe ndi mawonekedwe awonekera.

Zithandizo za anthu zomwe zimasintha masomphenya

Kupititsa patsogolo mawonekedwe, amadya udzu wa porcelain mu mawonekedwe a saladi, kumwa infusions, decoctions ake, mafuta m'maso a maolivi.

Maluwa a lilac ngati tiyi (1 tsp. Mu kapu yamadzi otentha), ndikuyika ma tamponi kuchokera ku ma mankono mpaka m'maso kwa mphindi 3-5.

Brew ndi kumwa red rose petals ngati tiyi kwa nthawi yayitali.

Utakula mbatata (makamaka zikutuluka mchaka) kuti ziume, kunena 1 tbsp. d) kapu ya vodika (masiku 7). Tengani I tsp. katatu patsiku mutatha kudya kwa mwezi umodzi.

HIP BWINO. Kulowetsedwa kwa maluwa a rosehip (1 tbsp. Per chikho cha madzi otentha) amagwiritsidwa ntchito ngati mankhwala kuchapa kutsuka maso ndi mafuta odzola (mphindi 20 usiku) ndi vuto la masoka.

Kulowetsedwa kwa m'miyala yapakati (nsabwe za nkhuni) kumayikidwa m'maso m'maso pomwe ziphuphu zimaphimba.

IZI PA CHIYANI (leek leek). Ngati vuto la maso silabwino, tikulimbikitsidwa kudya anyezi wambiri wamabala mu mtundu uliwonse momwe mungathere.

ZONSE. Chithandizo cha makolo chimalimbikitsa kuti ngati simukuwona bwino, muzitsuka m'maso anu kawiri patsiku ndi kulowetsedwa kwa udzu wa euphrasia kapena muthire mankhwala a kulowetsedwa kwa mbewuyi kwa mphindi 20 kawiri pa tsiku.

"Udzu wamaso" amawonedwa kuti ndi timbewu tonunkhira, amagwiritsidwa ntchito ngati chakudya. Mbewu ya timbewu (yosakanizidwa ndi uchi ndi madzi muyezo wa 1: 1: 1) imayikidwa m'maso (madontho 2-3 m'mawa ndi madzulo). Kupititsa patsogolo kuwona, mafuta a peppermint amakonzedwa ndikugwiritsidwa ntchito (okonzedwa ngati wort wa St. John). Dontho limodzi la mafuta a peppermint limasakanizidwa ndi 100 ml ya madzi ndikuyika m'maso onse awiri 2-3 kutsikira kawiri pa tsiku.

Kukonzekera kwa Schisandra chinensis, ginseng, pantocrine ndi kukopa kumawongolera bwino.

Zovala za masamba a koriander zimayikidwa m'maso kwa mphindi 10-20 nthawi 1-2 patsiku zowonongeka.

Mankhwala akale, tikulimbikitsidwa kusintha masana tsiku lililonse kwa miyezi itatu kuti timwe mafuta a 100 g a mutton chiwindi, ndikudya chiwindi cham'mawa pamimba yopanda kanthu. Mutha kugwiritsa ntchito chiwindi cha ng'ombe, koma chimakhala chochepa.

Madzi a anyezi omwe ali ndi uchi amakhazikitsidwa m'maso onse awiri akutsikira kawiri patsiku, onse kusintha maonedwe ndikuchotsa maso.

Pofuna kupewa kuchepa kwa maonedwe achuity, amamwa popanda malire a decoction of red clover inflorescence.

Ngati masomphenya akuipiraipira chifukwa chodandaula kapena kukhala ndi nkhawa, ndiye kuti mkuwa wowerengeka umalimbikitsa kuwiritsa dzira lolowerera, kudula pakati, kuchotsa ululu, ndikuyika mapuloteni, otentha, ndi mkati mopanda kanthu, osangogwira diso lomwe.

Ginger tincture, umagwiritsidwa ntchito tsiku ndi tsiku (1 tbsp. M'mawa) kwa nthawi yayitali, umasintha masomphenya.

Kulowetsedwa kwa masamba a barberry kumakhala kuledzera katatu patsiku kukonza masomphenya komanso ngati tonic.

Ma Blueberries mwanjira iliyonse amasintha masomphenya ausiku ndikuthandizira "khungu usiku."

Ma saladi a Nettle ndi thyme ndi kabichi, omwe amamwetsedwa mwadongosolo, kusintha masomphenya.

Pamuamu yosakanizidwa ndi uchi imagwiritsidwa ntchito mkati ndikuthira maso kuti pakonzedwe kowoneka bwino.

A decoction of rhizomes of aus amamwa mosalekeza kwa miyezi iwiri iwiri kuti apititse patsogolo kuona komanso kutulutsa munga.

Sorelo yamahatchi opendedwa, nkhaka za peeled, maapulo a grated omwe amayikidwa m'maso amathandizira kuwona. Mazira otentha otentha owazidwa ndi shuga ndi mbatata zosaphika ndi zoyera za dzira zimathandizanso.

M'malo mochita kudya cham'mawa, pezani masamba ophukira ndi zipatso tsiku ndi tsiku. Njira ya chithandizo ndi miyezi 1.5-2.

MALO OGULITSIRA. Brew 4 Bay 5 masamba ndi madzi otentha mu chidebe. Tengani makapu 0,3 katatu patsiku ndi zowonongeka.

Ginseng amathandizira kuchiza matenda ambiri ndikuwongoletsa chidwi cha maso.

Kudya fennel ufa ndi uchi kumathandiza kuti muzitha kuona.

Masomphenyawa atafooka usiku, ma lotion amachokera ku kulowetsedwa kwa zitsamba zotsatirazi amawaika m'maso: maluwa a calendula, petalser, ndi udzu wa eyebright umatengedwa chimodzimodzi. Chithandizo mpaka miyezi 6. Munthawi yamankhwala, sikulimbikitsidwa kuti muchepetse vuto lanu la maso kuti muwerenge kwa nthawi yayitali, kukumbira, etc.

Amayambitsa, Zizindikiro ndi Chithandizo cha odwala matenda ashuga Cataract

Matenda a matenda ashuga ndimatenda a shuga. Maziko a matendawa a matendawa ndi kusintha kwa mawonekedwe a mandala, ndi mitambo yake, mapangidwe a "flakes" kapena yunifolomu.

Chithandizo chake mwa odwala omwe ali ndi matenda amtundu wa 1 kapena mtundu wa 2 ali ndi mawonekedwe ake, chifukwa kuchuluka kwa shuga m'magazi sikukukhudzika kokha kukula kwa mphamvu ya ma lens ndi kuthekera kochita opaleshoni, komanso kumayambitsa zovuta zina (mu retina), zomwe zimatsogolera kuchepa kwakukulu kwa masomphenya.

Zimayambitsa kuwonongeka kwamawonedwe a shuga

Magalasi amunthu ndi mawonekedwe ofunikira kwambiri omwe amapereka mawonekedwe a kuwala, komwe, podutsa pamenepo, imagwera pa retina, pomwe chithunzi chowoneka ndi munthu chimapangidwa.

Kuphatikiza apo, mkhalidwe wa retina - kukhalapo kwa angiopathy kapena retinopathy, macular edema, ndi zina zambiri kumakhudza mawonekedwe owoneka bwino odwala matenda ashuga.

M'matenda a matenda ashuga, odwala amawona "mawanga" kapena "galasi lamtambo" lomwe limawonekera pamaso. Zimakhala zovuta kuchita ntchito zatsiku ndi tsiku: kugwira ntchito ndi kompyuta, kuwerenga, kulemba. Gawo loyambirira lamatumbo limadziwika ndi kuchepa kwa masomphenya dzuwa likada ndipo usiku, ndipo kupita patsogolo kwamachitidwe nthawi zambiri kumadzetsa khungu.

Zochizira zamatumbo ndi madontho, mapiritsi kapena mankhwala ena sizibweretsa zotsatira zabwino, chifukwa ntchito yachipatso pakuwonekera kwa mawonekedwe a mandala ndizochepa. Njira yokhayo yobwezeretsa maonedwe acuity ikhoza kukhala opaleshoni.

Kuti muchite opareshoni, dikirani kukhwima kwa nkhalangoyi sikuyenera. Masiku ano, ponseponse njira zamakono, zogwiritsira ntchito bwino pochita opaleshoni yamatenda a matenda ashuga - phacoemulsification.

Ntchito ya Cataract phacoemulsification yokhala ndi kuphatikizidwa kwa IOL

Njira iyi imakhala ndikuchotsa ma nyukiliya amiyala amtambo pogwiritsa ntchito zida za microsurgical ultrasound. Chotupa cha mandala kapena chikwama cha kapisozi chimasungidwa. Ndimo mmalo mwake, m'malo mwa mandala omwe amachotsedwa ndi njira ya opaleshoni, momwe ma ndala a intraocular amaikidwapo.

Ndondomeko yopanga yopangidwa ndi akilocompatible acrylic, yomwe imalowa m'malo mwachilengedwe. Magalasi oterowo ali ndi zinthu zina zofunika kuzilingalira bwino. Opaleshoni iyi yothandizira odwala matenda ashuga ndiyo njira yokhayo yobwezeretsanso masomphenyawo.

Chithandizo cha njoka zamkati ndi laser ya YAG (dyscisia)

Kafukufuku akuwonetsa kuti chiopsezo chotengera khungu la posterior lens kapisozi pambuyo pochotsedwa kwa odwala mwa odwala omwe ali ndi matenda osokoneza bongo atha kupitilira zizolowezi zake. Izi zimayipa kwambiri zotsatira za phacoemulsization ndipo zimayambitsa kusakhutira kwa wodwala.

Njira yofotokozedwera pamenepa amatchedwa laser dyscisia wa posterior kapisozi. Imachitidwa ndi laser ya YAG, pamtunda wapaulendo, popanda kuchipatala. Njirayi siyikupereka opereshoni yofunika kapena mankhwala oletsa kupweteka ndipo siopweteka konse.

Mukamaliza, laser ya YAG imachotsa dera lopendekera lachiberekero kuchokera kumbuyo, lomwe limakupatsani mwayi wobwezeretsa.

Mphaka kwa odwala matenda ashuga. Gulu ndi pafupipafupi

Odwala omwe ali ndi matenda ashuga, mitundu iwiri yamatumbo iyenera kusiyanitsidwa:

weniweni matenda ashuga matenda oyambitsidwa ndi vuto la kagayidwe kachakudya kagayidwe, senile cataract, amene anayamba odwala matenda ashuga.

Kuthekera kwa kupatukana kwamatenda amtunduwu kwa odwala matenda ashuga kuli ndi maziko abwino asayansi ndipo amagawidwa ndi asayansi odziwika monga S. Duke-Mkulu, V.V. Shmeleva, M. Yanoff, B. S. Fine ndi ena.

Mafanizo ochokera kwa olemba osiyanasiyana nthawi zina amasintha mwa dongosolo lonse. Chifukwa chake, L.A. Dymshits, ponena za ntchito ya nkhondo isanachitike, imapereka chithunzi cha kufala kwa matenda ashuga mu 1-4%. M'mabuku ena aposachedwa, pamakhala chidwi choti chitukuko chake chikule. M.M.Zolotareva apereka chiwonetsero cha 6%, E.A. Chkoni adavumbulutsa matenda amisala mu diabetes 16.8% ya odwala matenda a shuga.

Kuchokera pakuwonetsa kufalikira kwamatenda enieni a matenda ashuga, kafukufuku wa N. D. Halangot ndi O. A. Khramova (2004) ndiwokondweretsa. Adasanthula odwala onse omwe ali ndi matenda am'magazi ku Donetsk ndikuzindikira gulu la achinyamata azaka 20 - 29 zokhala ndi mtundu wa matenda ashuga 1 omwe ali ndi matenda amkati.

Mu ntchitoyi, chowonadi china chosangalatsa chidawululidwa - matenda a cataract monga chifukwa chakuchepa kwa mawonekedwe owonekera kwa odwala omwe ali ndi matenda a shuga omwe amadalira insulin adalembetsedwa katatu nthawi zambiri kuposa matenda a shuga.

Palibenso kuvomerezana pazochitika za senile cataract odwala omwe ali ndi matenda ashuga. S. Duke-Mkulu amapereka mndandanda waukulu wa olemba omwe amakhulupirira kuti ma senile omwe amachititsa odwala omwe ali ndi matenda ashuga siwofala kuposa ena onse.

Komabe, zolemba zaposachedwa zikuwonetsa kuti kuchulukana kwa odwala matenda ashuga ndiwokwera kwambiri ndipo kumatengera nthawi yayitali nthawi ya matenda ashuga. Chifukwa chake, S. N. Fedorov et al. adapeza matenda opatsirana mu 29% ya odwala omwe ali ndi vuto la matenda ashuga azaka 10 komanso 89% ya odwala omwe amakhala ndi zaka 30.

A.M. Immortal mu dissertation yake adawonetsa kuti matenda amtundu wamatumbo amapezeka mu 80% ya odwala matenda ashuga azaka zopitilira 40, zomwe ndizokwera kwambiri poyerekeza ndi zomwe zimachitika pakati pa anthu okalamba.

Zofanana ndizomwe zidapezeka mu imodzi mwazomwe zachitika pa mutuwu ndi N.V. Pasechnikova et al. (2008). Mwa iwo omwe adafunafuna chithandizo chamankhwala okhudzana ndi zovuta za odwala omwe ali ndi matenda a shuga 1 omwe ali ndi matenda a zaka 17-18, matenda amkati adapezeka mu 41.7% ya milandu, ndikulemba II ndi matenda omwe adatenga zaka 12 - mu 79,5%. I. Dedov et al. (2009) adavumbula zowopsa mu 30,6% ya odwala omwe ali ndi matenda ashuga.

Mtundu wachiwiri wa matenda ashuga, chiwerengerochi chimasiyana 12 mpaka 50% pakati pa olemba osiyanasiyana. Kusinthasintha kumeneku kumatha kuphatikizidwa ndi kusiyanasiyana pamafuko ndi mawonekedwe a moyo wachuma ndi zachilengedwe wa odwala omwe ali m'maiko osiyanasiyana, komanso kusiyana kwakutali kwa matendawa, kuuma kwa retinopathy, komanso zaka za odwala.

Kafukufuku wambiri apeza kuti kuchulukana kwa azimayi omwe ali ndi matenda ashuga kumawonjezeka kuwirikiza kawiri kuposa amuna. Zambiri kuchokera ku kafukufuku wambiri zikuwonetsa kuti mwayi wopanga matenda amkati umawonjezereka ndi nthawi yayitali ya matenda ashuga, kuwunika kosakwanira kuchuluka kwa shuga m'magazi, pamaso pa matenda a shuga.

Ngakhale kuchuluka kwa ziwerengerozi, zikuwonekeratu kuti zimapambana kwambiri zomwe zimapezeka mwa anthu athanzi labwino. Kuchokera pamawu omwe ali pamwambapa, mfundo yake imatsimikiza kuti magawo omwe tawatchulawa omwe ali odwala matenda ashuga angalandiridwe moyenera.

Monga tawonera pansipa, kusokonezeka kwa kagayidwe kakang'ono ka glucose m'thupi ngakhale pakhale kuwunika kwamasiku ano komanso chithandizo chamatenda omwe amayambitsa matenda kumapangitsa kusintha kwa ma protein a mandala kwa odwala omwe ali ndi matenda osokoneza bongo a nthawi yayitali.

Malinga ndi zomwe tawerenga, kuchuluka kwa odwala omwe ali ndi matenda ashuga kuchokera kuchuluka kwa odwala omwe amathandizidwa ndi othandizira odwala pakhungu kunatsika kwambiri poyerekeza ndi omwe atchulidwa, komabe kuchulukitsa kuyambira 1995 mpaka 2005 kuchokera ku 2.8 mpaka 10.5%. Kuwonjezeka kokhazikika kwa chiŵerengero chokwanira cha odwala oterowo kunadziwikanso. Izi zimalumikizana ndikuwonjezereka kwa chiwerengero cha odwala matenda ashuga, komanso kuwonjezeka kwa moyo wawo chifukwa cha kupita patsogolo kwa chithandizo cha matenda ashuga.

Ma catar odwala omwe ali ndi matenda ashuga, monga lamulo, amatanthauzidwa kukhala ovuta, omwe ali ndi chifukwa, popeza kuwunika kwa zovuta zamatumbo kumapangitsa dokotala kuti akonzekere ndikuchita magawo onse a opareshoni mosamala. Kugawa mphaka malinga ndi kuchuluka kwa mawonekedwe a mandala, magawo awo omwe amavomerezedwa nthawi zambiri amagwiritsidwa ntchito poyambira, osakhwima, okhwima komanso ochulukirapo (mkaka) amagwiritsidwa ntchito.

Kumbali inayo, ndi ma catalo okhwima, ma capuleti a mandala amakhala ochepa mphamvu ndipo ma cinnamic ligaments amayamba kufooka, zomwe zimapangitsa kuti chiwopsezo cha kuphulika kapenanso kufooketsedwa pakuchita opaleshoni ndizomwe zimapangitsa kuti zikhale zovuta kulowetsa magalasi amkati. Mulingo woyenera wa phacoemulsization, monga lamulo, umapezeka pokhapokha ndimavuto oyambira komanso osakhazikika omwe ali ndi Reflex yosungidwa kuchokera ku fundus.

Kuthekera kotukuka kwa matenda amkati ndi kuwonjezeka kwakukulu kwa kuchuluka kwa shuga m'magazi ndipo, motero, mu chinyezi cha chipinda chamkati chinali chodziwika kale m'zaka za zana la 19. Amakhulupilira kuti mandala amayamba kukhala ndi matenda ashuga chifukwa cha shuga wambiri mu makulidwe a mandala. Pambuyo pake zidapezeka kuti, kuti kufalikira kwa mandala kumafunikira shuga wambiri peresenti m'magazi, omwe sagwirizana ndi moyo.

Mu 20s ndi 30s m'zaka zathu zam'ma 1900, zojambula zamtundu woyesera zinapezedwa ndi makoswe powadyetsa ndi lactose yambiri. Yotsirizira, monga disaccharide, imaphwanyidwa ndi ma enzymus mu glucose ndi galactose, ndipo ndi galactose yowonjezera yomwe imayambitsa chitukuko cha matenda amkati, chifukwa mu nyama zathanzi glucose sangathe kufikira ndende yamagazi kuti ipangitse khungu.

Mwa shuga wina, xylose imakhalanso ndi cataractogenic. Zoyesa zamatumbo zinapezekanso ndi pancreectomy kapena kutseka maselo a beta a isanger a Langerhans ndi kholo la alloxan.

Mu kuyesayesa uku, kudalira mwachindunji kuchuluka kwa chitukuko cham'kati ndi kuchuluka kwa magonedwe a lens pamagazi a magazi ndi chinyezi cha chipinda chamkati zidatsimikiziridwa. Zidadziwikanso kuti zamtundu wa katoni zitha kupezeka mu nyama zazing'ono zokha, ndi xylose - pokhapokha mkaka wamkaka.

Pambuyo pake zidatsimikiziridwa kuti kuwonjezeka kwakuchuluka kwa glucose mu chinyontho cha chipinda cha anterior ndi mandala a crystalline mu shuga yopanda tanthauzo kumatseka njira yokhazikika ya glycolytic chifukwa cha mayamwidwe ake ndikuyambitsa njira ya sorbitol. Ndikusintha kwa glucose kukhala sorbitol komwe kumapangitsa kuti chithunzichi chikhale chamkati.

Tizilombo tachilengedwe timakhala tambiri ngati silbitol, yomwe imayambitsa kupsinjika kwa osmotic mu mandala. J. A. Jedzinniak et al. (1981) adatsimikizira kuti osati mu nyama zokha, komanso mandala aumunthu, sorbitol imatha kudziunjikira kuchuluka kokwanira kuti pakhale choopsa cha matenda ashuga.

Lingaliro la Photochemical la chitukuko cha matenda ashuga amatsimikizira kuti matenda amkati amayamba chifukwa chakuti shuga ndi acetone, omwe amapezeka mopambanitsa mu mandala, zimakulitsa chidwi cha mapuloteni a mandala kuti achitepo kanthu, omwe mikhalidwe imeneyi amachititsa kusokonekera kwawo komanso kusokonezeka.

Loevenstein (1926-1934) ndi olemba ena ambiri amatsogolera chiphunzitso cha kuwonongeka mwachindunji kwa ulusi wa lens chifukwa cha zovuta za endocrine zomwe zimachitika m'matenda a shuga. Kuchepa kwa kutsika kwa kapisozi kapangidwe kake mu glucose owonjezera kunawonetsedwa poyesa a Bellows ndi Rosner (1938).

Adanenanso kuti kusokonezeka kwa kagayidwe kachakudya ndi kufalikira kwa chinyezi mu mandala kumatha kuyambitsa kuchepa kwa mapuloteni. S. Duke-Mkulu adalinso ndi kufunikira kwakanthawi pama lens hydration chifukwa cha kuthamanga kwa osmotic m'madzi a minofu.

Mpaka pano, chithunzi chenicheni cha pathogenesis cha chitukuko cha matenda a shuga sichingaganizidwe bwino, koma zotsatira za zinthu zomwe zatchulidwa pamwambazi zitha kuganiziridwa, mpaka pamlingo wina kapena wina, wosatsutsika. Zina mwa izo zimapezekanso m'mitundu ina yamavuto ovuta, koma kwenikweni ndi chikhazikitso chomwe chimayang'anira chiwonetsero chowopsa chotsogolera khungu.

Chithunzi cha kuchipatala

Matenda enieni a matenda ashuga mwachizolowezi amafala kwambiri mwa achinyamata omwe ali ndi achinyamata osazindikira shuga. Mphaka yamtunduwu imatha kuyamba msanga, patangopita masiku ochepa. Amadziwika ndi kusintha koyambirira kukonzanso kawirikawiri kumka ku myopia. Monga lamulo, choopsa choterechi ndi chimodzi.

Chithunzi cha biomicroscopic cha matenda a chifuwa cha matenda ashuga adafotokozedwanso mu 1931 ndi Vogt mu buku lake lotchuka la "Textbook and Atlas of Microscopy of the Living Eye with Slit Lamp", ndipo zochepa titha kuwonjezera pazofotokozazi.

Zowoneka pang'onopang'ono pamtunda wa anterior ndi posterior cortex, mawonekedwe oyera kapena opacities ofanana akuwoneka ("matchuthi" - chipale chofewa), komanso vaccinocs, omwe amatha kupezekanso mkati mwa cortex, momwe mipata yamadzi, yomwe imawonekeranso pakuwala.

Kukula koyamba kwa matenda ashuga oyamba ndi kuphatikiza kwa kagayidwe kazakudya kamene kamatha kutha mkati mwa masiku 10 mpaka 14. Ngati nthawi yatayika, ndiye kuti "chipsepse" cham'kati chikuwoneka, ndikuwonekeranso ngati mandimu, kenako mandala onsewo nkukhala kwamtambo, ndipo chithaphwi chake chimataya mawonekedwe ake ndikuyamba kusiyanitsidwa ndimazinthu amtundu wina.

Cataract, yomwe tidavomereza kuyitanitsa matenda a senile cataract a odwala matenda ashuga, akadali ndi zinthu zingapo zomwe zimatsimikizidwa ndi matenda oyamba. Makamaka, imakula idakali yaying'ono kuposa momwe zimakhalira nthawi zambiri komanso nthawi zambiri. Pali umboni wosonyeza kuti "mphaka" wawo "umakula" m'nthawi yochepa.

Nthawi zambiri pamakhala njoka yamtundu wa bulauni yokhala ndi nambala yayikulu komanso chiwerengero chochepa cha ma lens. Mwa odwala 100 omwe adawunikidwa pachipatalachi, matenda amtunduwu adachitika mu 43. Matenda amtunduwu omwe adayamba kale adadziwika ndi kusintha kwakukulu kutembenukira ku myopia.

Komabe, makamaka cortical, posterior subcapsular ndikuyambitsa opacities a mandala ndizotheka. Pafupifupi 20% ya odwala amatembenuka m'magazi okhwima, chithunzi chachipatala sichizindikirika ndi wamba wamba.

Kusintha kwa ma mandala kwa odwala matenda ashuga nthawi zonse kumayendetsedwa ndi kusintha kwa dystrophic mu iris, komwe kumatha kupezeka ndi biomicroscopy, ndipo oposa theka la odwala ali ndi zovuta zam'mutu mkati mwake, omwe amatha kuzindikirika ndi fluorescence angiography ya diso lakunja.

Chithandizo cha Conservative

Mankhwala othandizira odwala omwe ali ndi vuto la matenda ashuga, omwe akupangika mwachangu, omwe nthawi zambiri amakhudzana ndi kuphwanya kwamphamvu kagayidwe kazinthu, ayenera kukhala ndi cholinga chobwezera shuga chifukwa cha zakudya, mankhwala amkamwa kapena jakisoni wa insulin.

Pankhani ya senile cataract kwa odwala omwe ali ndi matenda ashuga koyamba koyamba, pomwe pakungokhala kuchepa kwa magazi kapena kuchepa pang'ono kwa zowoneka bwino, zomwe sizikulepheretsa kugwira ntchito mwatsatanetsatane, ndikulondola kumangoyendetsa pakulipira kwa shuga komanso kuperekedwa kwa magonedwe ammaso nthawi zonse kuti achepetse kuthana ndi ma lens.

Mankhwala osavuta kwambiri amatha kukhala kuphatikiza wodziwika bwino wa 0.002 g wa riboflavin, 0,02 g wa ascorbic acid, 0,003 g wa nikotini acid mu 10 ml ya madzi osungunuka. Mwa anthu osawerengeka omwe agulitsidwa, vitaiodurol (France) nthawi zambiri amagwiritsidwa ntchito kuchokera ku mavitamini osakanizira ndi mankhwala opangidwa ndi michere, omwe amafunsidwa kuti athandizire kwanyukiliya ndi masokono, atan-catachrome ("Santen", Finland), mfundo yofunika kwambiri yomwe ndi cytochrome-C, ndipo posachedwapa. Quinax time (Alkon, USA), chinthu chogwira ntchito kwambiri chomwe chimapangidwa chomwe chimalepheretsa oxidation wa sulfhydryl radicals wa mapuloteni a mandala osungunuka.

Pakumayambiriro kwa chitukuko cha matenda a cataract, mphamvu ya mankhwala owononga singawerenge, chifukwa ngati kuwonongeka kwakhungu kumachitika, chithandizo chamankhwala chiyenera kuchitidwa mosasamala kanthu za kukula kwa matenda a cataract.

Mankhwala othandizira

Chizindikiro chothandizira opaleshoni yamatope mu wodwala yemwe ali ndi matenda ashuga makamaka ndi kupezeka kwakukulu kuchepa kwa zowonekera chifukwa cha ma opara. Kuwonongeka kotereku m'mawonedwe acuity kumatha kuonedwa ngati kofunika, komwe kumapangitsa wodwala kugwira bwino ntchito kwake komanso ntchito yodzisamalira.

Chidziwitso chazomwe chikuwonetsera mawonekedwe opangira opaleshoni makamaka kwa odwala omwe ali ndi matenda ashuga, makamaka ana ndi okalamba omwe ali ndi matenda opitilira zaka 10, akugona kwambiri pakuchepetsa maonedwe chifukwa chogwiritsa ntchito mandala osati mandala okha, komanso matreous thupi ndi retina, mkhalidwe amene ayenera kufufuzidwa bwino asanasankhe chochita.

Pachifukwa ichi, ndikofunikira kugwiritsa ntchito njira zonse zopezeka zothandizira kudziwa momwe boma limapangidwira ndi mawonekedwe amtambo, makamaka ma ultrasound B-scanning ndi ma elekitiromagesi.

Funso lochotsa mandala ngakhale koyambirira kwa chitukuko cha matenda a cataract limatha kubuka ngakhale ngati ma opacities omwe ali mmalo mwake amalepheretsa kusintha kwa laser chifukwa cha DR kapena vitreoretinal.

Pankhaniyi, osati zotsatira za kuwonekera kwa ntchito zowonekera zimaganiziridwanso, komanso kuchuluka kwa zosokoneza zomwe amapanga pochita opaleshoni kapena opaleshoni yam'maso. Ndikofunikira kufotokozera wodwalayo kufunika kwa kulowererapo ndikupeza chilolezo chololeza chothandizidwa ndi iye.

Kusankha Kwodekha ndi Mayeso Othandiza

Mwinanso chinthu chachikulu chomwe chitha kukhala maziko a kukana kuchotsa matenda omwe ali ndi vuto la shuga ndi kuuma komanso kutalika kwa matenda omwe amayambitsidwa, omwe amawadziwa momwe wodwalayo aliri.

Ichi ndichifukwa chake, choyambirira, ndikofunikira kudziwa malingaliro a endocrinologist yemwe akuwonetsetsa wodwalayo kuti athe kuchitidwa opaleshoni, poganizira kuchuluka kwa chiphuphu cha shuga komanso zovuta zakusintha kwa matenda ashuga m'm impso ndi ziwalo zina.

Kuphatikiza pa kutha kwa endocrinologist, wodwalayo ayenera kukumana ndi maphunziro ena onse omwe amatenga pakubwera kwa opaleshoni yam'mimba. Makamaka, ayenera kukhala ndi lingaliro la akatswiri othandizira kuti athe kuchitidwa opaleshoni, electrocardiogram yoyeserera, kuyezetsa magazi kozungulira, kuyezetsa magazi kwa glucose, kupezeka kwa kachilombo ka HIV komanso chiwindi.

Zimafunikiranso kutha kwa mano pazokhudza kukonzanso kwamkamwa ndi zotupa za otolaryngologist zokhudzana ndi kusowa kwa matenda obwera chifukwa cha chotupa. Ophthalmic preoperative kuwunika kumachitika mu chizolowezi voliyumu kwa odwala ndi amphaka.

Mwapadera pofufuza momwe aliri odwala matenda ashuga omwe amagwiritsa ntchito fluorescence angiography ya anterior eye, A.M. Immortal adapeza zovuta zam'magazi mu 53% ya odwala. Kuzindikira kwa mitsempha ya iris yowoneka nthawi ya biomicroscopy mosadziwika ikusonyeza kukhalapo kwa matenda ashuga retinopathy, omwe amayamba ndi matenda a catthactoscopy.

Ngati mandala ndi mitambo, ndikofunikira kuchita kafukufuku wa electo-retinographic. Kuchepetsa kwakukulu (50% kapena kupitirira) mu matalikidwe a mafunde a ganzfeld ERG, kuchepa kotsika kwa matalikidwe a ERG yokhala ndi 10 Hz, kuwonjezeka kwa malire amagetsi a mitsempha ya opic ku 120 μA kapena kupitirira apo kukuwonetsa kukhalapo kwa matenda ashuga kwambiri a shuga.

Mavuto ophatikizana a vitreoretinal amapezeka nthawi zambiri mothandizidwa ndi B-scan. Kuthandizira opaleshoni ndikotheka ngakhale pakakhala kusintha koteroko, koma pankhaniyi ndikofunikira kusintha magawo awiri kapena kuphatikizidwa kosavuta, komwe kumakhala koyenera pokhapokha ngati chidziwitso cha kafukufuku wazogwira ntchito chikupatsa chiyembekezo chiyembekezo chosintha ntchito.

Mwinanso ndikofunikira kuti muthe kugwiritsa ntchito njira mosamala kwambiri kuti muunike zomwe mwapeza pakuwunika ndi mawonekedwe a ma corneal endothelial cell. Pali umboni kuti odwala omwe ali ndi matenda ashuga, makamaka pamaso pa proliferative retinopathy, kuchuluka kwa maselo mkati mwa miyezi isanu ndi umodzi atachitidwa opaleshoni amatha kutsika ndi 23%, komwe ndi 7% kuposa mwa omwe alibe matendawa.

Ndizotheka, komabe, kuti njira yofatsa komanso yolimba yochotsa zovuta pamakoma imachepetsa zovuta. Osachepera ntchito yaposachedwa ya V.G. Kopaeva et al. (2008) ziwerengero zina zimaperekedwa. Kutayika kwa kachulukidwe ka maselo a endothelial zaka 2 pambuyo pa kupangika kwa phacoemulsization kunali 11,5% kokha, ndipo pambuyo pa emerization wa laser - 6,4% yokha.

Zomwe zimachitika pokonzekera odwala

Choyambirira, opareshoni isanachitike, mothandizidwa ndi endocrinologist, njira yabwino yolandirira mankhwala othandizira odwala matenda ashuga iyenera kuchitika kuti matenda a shuga akhale m'magazi, omwe ayenera kutsimikiziridwa ndi lingaliro loyenera lolemba. Ndikofunikira kuti mulingo wa glycemia usapitirire 9 mmol / L patsiku la opareshoni.

Patsiku la opareshoni, odwala omwe ali ndi matenda a shuga a I samadyanso chakudya cham'mawa, insulin siliperekedwa. Pambuyo pozindikira kuchuluka kwa shuga, amatumizidwa kuchipinda chothandizira. Mulingo wa glucose wamagazi amayesedwa atangopanga opaleshoni, ndipo ngati sichidutsa monga momwe zimakhalira, insulini siliperekedwa, koma ngati pali shuga wambiri, insulin imayendetsedwa mu mlingo, kutengera kuchuluka kwake. Pazaka 13 ndi 16, kuchuluka kwa shuga kumayesedwanso ndipo mutatha kudya, wodwalayo amamuthamangitsira ku zakudya zake zamasiku onse ndi insulin.

Mu matenda a shuga a II, mapiritsi amathetsedwanso patsiku la opareshoni, kuchuluka kwa shuga m'magazi kumayesedwa, wodwalayo amachita opaleshoni yoyamba, magazi amayesedwanso kwa glucose, ndipo ngati ali ocheperapo, wodwala amaloledwa kudya atangoyamba kugwira ntchito. Kupanda kutero, chakudya choyamba chimachitika madzulo, ndipo kuyambira tsiku lachiwiri wodwalayo amasamutsidwa ku regimen ndi zakudya zomwe amakonda.

Odwala omwe ali ndi matenda ashuga, ayenera kusamalidwa mwapadera kuti athe kupewa matenda opatsirana. Monga momwe kafukufuku wa P. A. Gurchenok (2009) adachitikira mu chipatala chathu adawonetsa, njira yabwino kwambiri yotsatsira mankhwala opha tizilombo tisanachitidwe opareshoni kwa odwalawa, omwe nthawi zambiri amamugwirira ntchito kuchipatala, ndi yophunzitsa wina wa kutsatira mankhwala amakono:

0,3% tobramycin solution (dzina la mtundu "Tobrex" kuchokera ku Alcon), 0,3% ya yankho la xloxacin (phloxal, Dr. Manann Pharma), 0,5% levofloxacin yankho (oftaxvix, Santen) Pharm. ").

Patsiku la opareshoni, mankhwala oletsa mankhwalawa amakhalanso 5 pakatha ola la opareshoni. Pamodzi ndi izi, m'chipinda chochitira opaleshoni, khungu la nkhope ndi zikope zimachiritsidwa ndi 0,05% yamadzi yankho la chlorhexidine, ndipo 5% yankho la povidone-iodine imayikidwa mu mawonekedwe a conjunctival. Mosalolera pakukonzekera kwa ayodini, njira ya 0,05% ya chlorhexidine bigluconate ingagwiritsidwe ntchito.

Zambiri za zokongoletsa

Chithandizo chothandizira pakubala chimagwira ntchito yofunika kwambiri pakuwonetsetsa kuti ikuyenda bwino, yomwe imayenera kuchitidwa ndi odziwa ntchito yodziwitsa ophunzitsidwa bwino ophunzitsidwa ntchito mu chipatala cha ophthalmic. Pazochitika zabwino, kuyezetsa wodwalayo kuyenera kuchitika ndi akatswiri kapena opereka mankhwala molumikizana ndi anesthetist.

Madzulo opareshoni isanachitike, mutha kugwiritsa ntchito mapiritsi ogona ndi ofunitsa, koma poganizira kuchuluka kwa odwala omwe ali ndi matenda ashuga awa ku mankhwalawa. Kwa odwala omwe ali ndi vuto la zaka zokhala ndi matenda a shuga a II, kuvulala kwamitsempha yama cell ndi zinthu za antipsychotic analgesia ndikokwanira, i.e. kukhazikitsidwa kwa analgesics (20 mg ya promedol kapena 0,1 mg wa fentanyl), antipsychotic (5 mg ya droperidol) ndi ataractics (midazole), kutsatiridwa ndi kukhazikitsidwa kwa otsutsana nawo - naloxone ndi flumazenil (anexate). Nthawi yomweyo, retro- kapena parabulbar anesthesia yachilengedwe yothetsera mavuto a lidocaine ndi bupivacaine (marcaine) amagwiritsidwa ntchito.

Ndi kuchepa kwa vitreoretinal pang'ono, mwachitsanzo, pa hemophthalmus, kugwiritsa ntchito chovala cham'mimba pambuyo pakulimbitsa thupi ndi propofol, ndikutsatiridwa ndi opaleshoni yoyambira ndi sevoflurane pakupumira kwapang'onopang'ono, kumapereka malo abwino okwanira opaleshoni.

Pakati pa opareshoni ndi nthawi yaposachedwa kwambiri, kuwonjezeka kwa shuga m'magazi 20-30% ndikovomerezeka. Chifukwa chakuti odwala ovuta kwambiri okhala ndi proliferative vitreoretinopathy hypoglycemia amatha kupanga opaleshoni ngakhale atangomaliza kuperewera kwa insulin, ndikofunikira kuwongolera shuga m'magazi m'masiku awiri oyamba atatha opaleshoni maola 4 mpaka 6 aliwonse.

Akatswiri a Anaesthesiologists omwe amagwira ntchito m'makliniki amaso amatha kupeza zambiri komanso zowunikira zambiri muupangiri wapaderawu waposachedwa wapangidwa ndi H.P. Takhchidi et al. (2007).

Zina za njira ya m'zigawo zamkati mwa odwala matenda a shuga

Zokambirana zosangalatsa za ma 80 za kusankha kwa njira yochotsekera kwamatumbo kwa odwala omwe ali ndi matenda ashuga, kuthekera kwa kuwongolera kwapang'onopang'ono kwa aphakia mwa iwo, kusankha mitundu yoyenera ya mandala - okhala ndi mandala a iris kapena a capular - tsopano ndi zinthu zakale.

Phacoemulsization imatha kuchitika mwa kupyoza mkati mwa cornea kutalika kokha ndi 2.0 - 3.2 mm, komwe ndikofunikira makamaka kwa odwala matenda a shuga omwe ali ndi ziwiya zotsika komanso endothelium yovuta ya cornea.

Kuphatikiza apo, pakuchita opareshoni, kamvekedwe ka misozi kokhazikika kamasungidwa popanda mawonekedwe a hypotension, omwe amachepetsa mwayi wa opaleshoni ya hemorrhagic ndi postoperative.

Pomaliza, phacoemulsization ndiyophweka kwambiri ngati kuchitapo kanthu koyenera ndikofunikira, popeza gawo lowerengeka silimasowa suture kusindikiza popanga gawo la vitreoretinal ndikubwezeretsanso kuphatikizidwa kwa mandala opangira.

Pambuyo pa phacoemulsization, kuchotsedwa kwa suture ya corneal sikofunikira, zomwe ndizofunikira kwambiri kwa odwala matenda a shuga. Zosapeweka pakuchotsa suture, kuvutikira kwa epithelium yotsutsana ndi maziko a kuchepa kwa chitetezo cha odwala omwe ali ndi matenda a shuga kumayenderana ndi chiopsezo chotenga keratitis ya bakiteriya, ndikuchepetsa kubwezeretsanso minofu kumalumikizidwa ndi kukhumudwa kwa chisonyezo.

Kukhazikitsidwa kwa phacoemulsification kwachepetsa kwambiri mndandanda wazopondera za IOL, monga diso limodzi, maso, kukhathamiritsa kwa lens.

Mukamachita opaleshoniyo, muyenera kukumbukira kuti odwala matenda ashuga, makamaka pamene pali kuchuluka kwa retinopathy, mgulu wa ana nthawi zambiri umakhala wocheperako kuposa odwala omwe alibe matenda ashuga, ndipo zimakhala zovuta kwambiri kupeza mydriasis okwanira mwa odwala.

Poganizira kuthekera kwakukulu kwa mitsempha ya iris, mankhwalawa onse omwe ali ndi nsonga ya phonar ndi wowaza ayenera kusamala kwambiri kuti magazi asatayike kuchipinda chamkati. Mukamachita zophatikizira pamodzi, gawo loyamba ndikuphatikizidwa ndi IOL, kenako vitollomy ndikutsatiridwa ndikuyambitsa kwa mpweya kapena silicone, ngati pakufunika. Zomwe takumana nazo komanso zowerenga zomwe tikuwerenga zikuwonetsa kuti kupezeka kwa mandala osokoneza bongo sikungasokoneze kuwona kwa fundus panthawi ya veteromy ndipo pambuyo pake, ngati kuli koyenera, muzichita kujambula zithunzi.

Zotsatira za kuchotsedwa kwatsamba kwa odwala matenda a shuga

Zolemba zoyambirira, zomwe zidatsimikizira motsimikiza zabwino za njira ya IOL yodzilitsira mu thumba la kapisozi odwala omwe ali ndi matenda ashuga, zidawoneka koyambirira kwa zaka za 90s. Mpainiya wokhudzidwa ndi chidwi cha IOL wozikika pakati pa akatswiri a maso a ku Russia a B. N. Alekseev (1990) adanenanso kuti ma 30 a ma extracapsular othandizira kuchotsera ma cell ndi ma IOL kulowetsedwa mchikwama cha odwala omwe ali ndi matenda amtundu wa I ndi II pamaso pa maso popanda zizindikiro zakuchulukira ndipo analandila zowoneka bwino mu 80% za iwo 0,3 ndi okwera.

Zomwe tachita zaka zopitilira 2000 za extacapsular cataract m'zigawo zokhala ndi IOL kumalowetsa m'thumba la kapisozi kochitidwa mwa odwala omwe ali ndi matenda amtundu wa 2 mu 1991 - 1994 asanasinthe kupita ku phacoemulsification adawonetsa kuti opareshoni iyi idapereka mwayi wofanana wopezanso kuwona kwakukulu kwa odwala matenda ashuga. m'mbuyomu atachitidwa opaleshoni, monga anthu omwe samadwala matendawa, ndikuchotsa zovuta zonse zowonekera pazithunzi zomwe zidatulukira atayikidwa ma lens a iris-clip.

Kumbukirani kuti mu 70s, pamene m'zigawo zamkati mwake mumagwiritsidwa ntchito kwambiri, a L.I. Fedorovskaya (1975) adanenanso kuti 68% ya zovuta zowchita opaleshoni ndi postoperative, kuphatikizapo 10% ya kuchuluka kwa vitreous.

Kumbali inayi, chikhalidwe chodabwitsacho cha njira yotsatsira ya extracapsular yokha komanso kuchuluka kwakukulu kwa contraindication ku IOL implantation komwe kunalipo panthawiyo kunali chifukwa chomwe wodwala aliyense wachinayi wopanda matenda a IOL adalowetsedwa konse, pomwe pakati pa odwala omwe alibe matenda ashuga ayenera kukana kulowetsedwa. chakhumi chilichonse.

Kuyambitsidwa kwa phacoemulsification kwawongolera kwambiri zotsatira za opaleshoni m'magulu onse odwala, kuphatikiza odwala matenda ashuga. Kuwunika kwa zotsatira za phacoemulsization ndi kuphatikizidwa kwa ma IOL osinthika omwe adachitika kuchipatala chathu kwa odwala 812 omwe ali ndi matenda osokoneza bongo mu 2008 adawonetsa kuwonekera kwa 0.5 ndikuwonjezeka ndi kuwongolera pakuchotsedwa, i.e. Matsiku a 2-3.8 atachitidwa opaleshoni, adakwaniritsidwa mu 84.85% ya odwala, omwe ali 20% kuposa atachotsedwa kowonjezera.

Mu 7513 odwala omwe alibe matenda a shuga omwe adagwira ntchito nthawi yomweyo, zochitika zowoneka bwino izi zidakwaniritsidwa mu 88.54% ya milandu, i.e. idapitilira kuthekera kopeza zowoneka bwino mu odwala omwe ali ndi matenda ashuga ndi 3.5 - 4.0% ngati pambuyo poti atulutsidwe kunja kwatsopano.

Ndizofunikira kudziwa kuti phacoemulsization idachepetsa kwambiri zovuta zomwe zimagwirizanitsidwa ndi opareshoni, poyerekeza ndi kuchotsedwa kwa extracapsular. Mwa odwala matenda a shuga, adakumana malinga ndi kuchuluka kwa deta ya 2008 mwa odwala 4 okha (0,49%) - vuto limodzi la kuchepa kwa magazi, vuto limodzi la choroid ndi milandu iwiri ya IOL yowongolera panthawi ya postoperative. Odwala opanda matenda a shuga, kuchuluka kwa zovuta anali 0.43%. Kuphatikiza pazomwe tafotokozazi, panali milandu iwiri ya iridocyclitis, milandu itatu ya postoperative hyphema ndi 4 milandu ya epithelial-endothelial dystrophy.

Cholinga chokana ma prosthetics kapena kugwiritsa ntchito mitundu ina ya IOL ikhoza kukhala kukhalapo kwa kutulutsa mawu a mandala komanso kupindika kwakukulu kwa chidziwitso cha iris.

Zolemba za nthawi yothandizira

Kugwiritsa ntchito matekinolo amakono opangira opaleshoni yamatumbo kwa odwala omwe ali ndi matenda ashuga, ngakhale kumapereka ntchito zowoneka bwino komanso njira yosavuta yotsatsira, sikumatula kupezeka kwa zovuta zingapo zokhudzana ndi gulu ili la odwala, zomwe zimafunikira kuwonjezeka kwa iwo osati pa gawo la kusankha komanso kuzindikira, komanso nthawi yothandizira. Zikuwoneka kuti ndizofunikira kudziwa zomwe ndizofunikira kwambiri, zomwe zimafotokozedwa m'mabuku komanso zomwe adotolo angakumane nazo.

Kutupa kwa postoperative ndi endophthalmitis. Zomwe tawona zikutsimikizira kuti pambuyo poti munthu wina wakhudzidwa ndi matenda ena amtundu wa extracapsular amakhala ndi chizolowezi chowonjezereka chomwe chimapangitsa kuti pakhale kupweteka kwambiri mu postoperative nthawi.

Chifukwa chake, ngati mu gulu loyang'anira adakhalapo odwala osaposa 2%, ndiye kuti ndi matenda ashuga kawiri kawiri. Komabe, ziwerengero zomwe tidapeza chifukwa cha zotupa za postoperative zimakhala zochepa kwambiri kuposa zomwe zidasindikizidwa kale.

Monga lamulo, zotupa zokhudzana ndi exudative zinachitika masiku 3-7 atachitidwa opareshoni ndipo zimafunanso kuti agonekenso kuchipatala kwa nthawi yayitali mpaka milungu iwiri, pomwe mankhwala odana ndi kutupa adachitidwa. Ndi kusintha kwa phacoemulsification, pafupipafupi kuyankha kwamphamvu kumachepa kwambiri onse odwala matenda ashuga komanso osadwala.

Chifukwa chake, mchaka cha 2008, pochita ma 7513 omwe amachitidwa odwala omwe alibe matenda ashuga, panali milandu iwiri yokha ya postoperative iridocyclitis, ndipo chifukwa cha opareshoni 812 odwala omwe ali ndi matenda ashuga, palibe amodzi omwe adalembetsa.

Ponena za zovuta zotere za opaleshoni ya endocular monga endophthalmitis, titha kuiona ngati yofala kwambiri kwa odwala matenda a shuga kuposa odwala athanzi. Mu lipoti laposachedwa, H. S. Al-Mezaine et al. (2009) akuti ku 29,509 ntchito yamatope ku United Arab Emirates idachita pakati pa 1997 ndi 2006, endophthalmitis idachitika mu milandu 20 (0.08% pazaka 5 zapitazi), komanso mwa 12 mwa iwo (60% ) odwala adwala matenda ashuga.

Tidasanthula zotsatira za zowonjezera zamkati 120,226 zomwe zidachitika pakati pa 1991 ndi 2007 kuti tipeze zoopsa pakukula kwa postoperative endophthalmitis. Zinapezeka kuti matenda obwera ndi omwe ali pachiwopsezo chachikulu cha kukulitsa kwa endophthalmitis poyerekeza ndi zina zonse zomwe zaphunziridwa, monga njira yogwiritsira ntchito, mtundu wa IOL, ndi zina zambiri.

Kupita patsogolo kwa DR. Zosindikiza za 90s zili ndi chidziwitso chomwe chowonjezera chowonjezera cha othandizira odwala omwe ali ndi matenda ashuga mu 50 - 80% ya milandu imatsogolera kupititsa patsogolo chitukuko cha proliferative retinopathy chaka choyamba atachitidwa opaleshoni kuyerekeza ndi diso lomwe silikugwira ntchito.

Komabe, ponena za phacoemulsification, mawonekedwe otere sanatsimikizidwe. S. Kato et al. (1999) kutengera kuyang'ana kwa odwala 66 omwe ali ndi matenda ashuga chaka chatha opaleshoni ya phacoemulsification adapeza zisonyezo zowonjezereka kuposa diso logwira ntchito, mwa 24% yokha mwa milandu.

Mu ntchito ina ya D. Hauser et al. (2004), yomwe imagwiritsidwa ntchito pazinthu zofanana, kawirikawiri sizinawululire zotsatira za phacoemulsification pamlingo wa kupitirira kwa retinopathy. Izi zatsimikizidwanso m'mabuku ena angapo.

Chofunikira chokhacho chinali glucose wamagazi. M.T.Aznabaev et al. (2005) kutsatira malingaliro omwewo potengera zomwe ana awona ali ndi matenda ashuga a mtundu woyamba.

Macular edema. Macular edema pambuyo pa standardico phulsemulsization ndi zovuta kwambiri kotero kuti tidasokoneza ntchito yomwe idakonzedwa pamutuwu chifukwa cholephera kuzindikira mawonekedwe aliwonse ang'onoang'ono. G. K. Escaravage et al. (2006), ndikuphunzira mwapadera momwe macula amapangira opaleshoni kwa odwala omwe ali ndi matenda ashuga, pamaziko a odwala 24, zimatsimikiziridwa kuti, malinga ndi mgwirizano wamalingaliro tomography, pamaso ogwirira ntchito, pafupifupi miyezi iwiri atatha kulowererapo, makulidwe a retina m'dera la 6-mm la macula likukula 235.51 ± 35.16 mpaka 255.83 ± 32.70 μm, i.e. pafupifupi maikolofoni 20, pomwe m'diso lachiwiri makulidwe a retina sanasinthe. Mothandizana ndi izi, fluorescence angiography inaulula kwambiri matchulidwe achilengedwe opangidwa ndi macula m'maso mwa opereshoni.

Kutengera ndi izi, olemba adaganiza kuti phacoemulsization mwachilengedwe imayambitsa macular edema mwa odwala matenda ashuga. Cholemba ngati chimenecho, komabe, sichinatsimikizidwe ndi kafukufuku wokwanira wa V.V. Egorov et al. (2008).

Mu 60.2% ya odwala omwe ali ndi maonekedwe apamwamba (pafupifupi, 0,68), kachulukidwe kakang'ono (pafupifupi 12,5%) ka retina mu macula adawululidwa m'masiku oyamba atachitidwa opaleshoni, koma adasowa kumapeto kwa sabata loyamba atatha kulowererapo.

Ndi 7.4% yokha ya odwala omwe ali ndi vuto laling'ono lolembetsedwa omwe adalembetsa "mwamphamvu" yankho la opaleshoni, malingana ndi tanthauzo la olemba, omwe akuwonetsa kukula kwa chigawo chapakati cha macula mpaka 181.2 ± 2.7 μm, ndipo patatha miyezi itatu edema idakulirakulira ndipo chifukwa chachikulu macular edema.

Ndizosavuta kuwona kuti kuchuluka kwa odwala omwe ali ndi "mwamphamvu" yankho ndi theka la odwala omwe ali ndi zithunzi zooneka bwino zotsika ndi 0.5 omwe amagwiritsidwa ntchito kuchipatala chathu. Macular edema ndi, limodzi ndi zinthu zina, chimodzi mwazifukwa zomwe pambuyo pobwezeretsa kuwonekera kwa media media, ma visual acuity amakhalabe otsika.

Izi ndizomwe zimapangitsa kuti mayeso azigwira ntchito moyenera ndi njira zonse zomwe zilipo pakatikati pa fundus kuti aunike mozama momwe matendawa agwirira ntchito, omwe ndi ofunika kwambiri pakumanga ubale ndi wodwalayo.

Zomwe takumana nazo zikuwonetsa kuti kuwonjezeka kapena kuwoneka kwa macular edema pambuyo pa opaleshoni kumachitika makamaka pamaso pa proliferative retinopathy asanafike pa opaleshoni, yomwe siimadziwika nthawi zonse chifukwa cha ndimu yama mitambo, makamaka yokhala ndi vuto lamkati.

Kafukufuku wokhudza dera la macular la retina wogwiritsa ntchito OCT odwala popanda zizindikilo za DR kapena mawonekedwe ake ochepa adawonetsa kuti makulidwe onse ndi kuchuluka kwa retina la zigawo za macular, kuyang'aniridwa kwa miyezi isanu ndi umodzi, sikunasiyane kwambiri ndi deta yomwe yapezeka pagulu lolamulira la odwala omwe sanavutike matenda ashuga.

Pokhapokha, patadutsa milungu iwiri atachitidwa opaleshoni, macular edema idayamba kuchepa kwamawonekedwe owoneka ndi chiwonetsero cha fibrinous iridocyclitis, yomwe idayimitsidwa pamankhwala kumapeto kwa mwezi wachinayi pambuyo pa opaleshoni ndikubwezeretsa maonedwe acuity mpaka 0.7.

Njira imodzi yoletsa matenda a macular edema mwa wodwala, kutengera S.Y. Kim et al. (2008), kukhazikitsidwa kwa danga la subtenon atangoyamba kugwira ntchito kwa triamcinolone acetonide.

Kuphatikiza apo, kuchuluka kwa ntchito kwasindikizidwa komwe kumatsimikizira kugwira bwino ntchito kwa kayendedwe ka intravital a angiogeneis inhibitors, makamaka, lucentis, panthawi ya phacoemulsation yoletsa komanso kuchiza macular edema yokhudzana ndi phacoemulsification.

Ponena za odwala omwe ali ndi matenda ashuga, pamakhala malipoti m'mabuku kuti amakonda kubwezeretsanso ma epithelium ocheperako kuposa anthu athanzi chifukwa choti mwina kuchuluka kwawo ndi kubwezeretsanso kungachepe chifukwa cha kuwonongeka chifukwa cha kuchuluka kwa sorbitol. Zowonadi, a J. Saitoh et al. (1990) adawonetsa kuti kuchuluka kwa maselo amenewa kwa odwala omwe ali ndi matenda ashuga kumatsika kuposa anthu athanzi.

Pambuyo pake, A. Zaczek ndi C. Zetterstrom (1999), pogwiritsa ntchito kuwala kwa kamera ya Scheimpflug, adatsimikiza kuwonekera kwa kapangidwe kotsalira kwa odwala 26 omwe ali ndi matenda ashuga komanso kuchuluka komweko kwa anthu athanzi chaka chimodzi ndi zaka ziwiri atatha phacoemulsification.

Izi, komabe, sizidatsimikizidwe mu maphunziro angapo apano. Chifukwa chake, Y. Hayashi et al. (2006) adawonetsa kuti pamaso pa matenda ashuga retinopathy, kuopsa kwa chipwirikiti cham'mbuyo, choyesedwa ndi chida cha EAS-1000 (Nidek, Japan), ndi pafupifupi 5% kuposa momwe kulibe.

Pofufuza odwala omwe alibe ndi shuga koma osagwiritsa ntchito njira yomweyo, Y. Ebihara et al. (2006) adapeza kuti kale, chaka chimodzi pambuyo pa phacoemulsization, ma opacities adagwira 10% ya pansi pa kapisozi kapangidwe kake, ndipo kumapeto, anali 4,14% okha.

Phunziroli, ndikofunikira kuti kudziwa kuti kupendekera kwapakati kwa odwala omwe ali ndi matenda ashuga kumapitilira mtengo wapakati, zomwe zikuwonetsa kusalinganika kwakukulu kwa chitsanzo.

Cholinga chake ndikuti olemba sanasiyanitse odwala omwe ali ndi matenda ashuga komanso osawonetsa PDD, ndipo mwa iwo omwe amatulutsa mitambo, odwala omwe ali ndi PDD okha ndi omwe angakhale.

Chifukwa chake, vuto lachiwopsezo chachiwiri kwa odwala omwe ali ndi matenda ashuga ndikuyambitsa matekinoloje amakono opangira opaleshoni yamatumbo zakhala zopanda ntchito kuposa kale. Zikuwoneka kuti ndizomveka poonetsetsa odwala omwe ali ndi kukhalapo kwa chiwonetsero chazitali kwa nthawi yayitali kuti atchere chidwi komanso mkhalidwe wa kapangidwe ka mandala.

Chifukwa chomwe masokonezo amachepa m'magazi a matenda ashuga

Magalasi ndi mawonekedwe ofunikira amaso am'maso, omwe amapereka mawonekedwe a kuwala kwa iwo, ndipo amatenga nawo mbali pa retina, pomwe chithunzicho chimapangidwa.

Ndi matenda a shuga, pamatuluka shuga m'magazi nthawi ndi nthawi, omwe amakhudza mkhalidwe wa mandala: mankhwala amadziunjikira, omwe amasokoneza kapangidwe kake komanso kuwonekeratu, ndi mawonekedwe a matenda amkati. Kutsegukira kwa mandala kumadodometsa kusintha kwina, kumapangitsa kuti munthu asamaone bwino.

Matenda a matenda ashuga amadziwika ndi mawonekedwe a "mawanga" kapena kumverera kwa "galasi lamtambo" patsogolo pa maso. Zimakhala zovuta kuti wodwalayo azichita tsiku ndi tsiku: kuwerenga, kulemba, kugwira ntchito pakompyuta. Matumbo oyamba amadziwika ndi kuchepa kwa masanawa, ndikapita patsogolo kwa njirayi, khungu lathunthu limatha.

Kuchiza ndi madontho, mapiritsi ndi mitundu ina ya mankhwala sikubweretsa zotsatira zabwino, chifukwa mwayi wa mankhwalawa pakuwonekera kwa mandala ndi ochepa. Njira yokhayo yomwe imakupatsani mwayi kuti mubwezeretsenso mawonekedwe owoneka bwino ndi kulowererapo kwa microsuction.

Kuti ikwaniritse sikufunika kudikirira kusasinthika kwa ma cataralog. Dokotala wa Dr. Medvedev Center for Vision Protection imagwiranso ntchito bwino njira yamakono yamankhwala - phacoemulsification.

Matenda a shuga: kupewa, chithandizo

Chochititsa chachikulu pakupanga kwamkati ndi kusintha kwazinthu zamomwe zimapangidwira zama media ndi minofu ya mucular, yomwe, imayambitsidwa ndi zovuta zina zama metabolism ambiri. Chifukwa chake sizachilengedwe kuti vuto lalikulu la metabolic monga matenda a shuga limakhala limodzi ndi zovuta zambiri, kuphatikiza mandala ake.

Njira yopititsira patsogolo

Ma mandala owoneka bwino mumaso amathandizika ndikugwira ntchito ngati mandala opanga kuwala komwe kumayang'ana chithunzicho (cholembedwa) kumtunda, komwe amakufikitsa kumalo komwe amawunikirako ndikumasulira, komwe chithunzi chofunikira kwambiri chimakonzedwanso.

Zotsatira zake, zovuta zowonekera, kukakamiza wodwalayo kuti azigwiritsa ntchito osati ma endocrinologists, komanso akatswiri a ophthalmologists.

Zizindikiro

Matenda a matenda ashuga amadzionetsa ngati mawonekedwe osakwanira, mtundu wa "mapangidwe" pazowunika, zovuta zazikulu pakuwerenga, kulemba, kugwira ntchito ndi wowunikira pakompyuta, etc. Chimodzi mwazomwe zikuwonekera ndikuchepa kwamaso pakuwona masana ndipo, makamaka, pakuwala.

Kuwonetsedwa kwakanthawi kwamatenda a matenda ashuga nthawi zonse kumawonetsa kukonda (pamlingo wina kapena wina) ndipo kumafunikira njira zokwanira, popeza njirayi siyimayima zokha ndipo sikusintha, koma pamapeto pake ingathetse kutaya kwamaso.

Njira zopewera

Tsoka ilo, matenda ashuga kwathunthu, pafupifupi pazinthu zonse, amakhudza moyo. Wodwala ayenera kukumbukira ndikuwunika zoletsa zingapo, kutsatira malangizowo, kuwunika mawonekedwe a magazi, kupita pafupipafupi ndi endocrinologist - kotero kuti, mwa zina, saphonya kuyambika kwa chitukuko cha chimodzi mwazovuta za matenda ashuga ndikuchita panthawi yake popewa zovuta zotere. Kuyesedwa kwa maulendo ndi kufunsira kwa ophthalmologist pankhaniyi ndizofunikira.

Ngakhale zisonyezo za ntchito yama microsuction zitha kuululidwa, ziyenera kuchitidwa mwachangu, mpaka zovuta zambiri zitapangidwa ndikuwonekera. Muyenera kudziwa ndikukumbukira kuti pali mitundu ingapo ya mankhwala omwe amapangidwa kuti ateteze komanso kuteteza ziwalo zam'maso mu matenda a shuga, mwachitsanzo, catalin, catachrome, taurine, quinax, etc. Monga lamulo, njira ya kupewa imatenga mwezi umodzi ndipo imakhala ndikuwonetsedwa kwamaso tsiku lililonse. Pambuyo pakupuma pang'ono, maphunzirowo amabwerezedwa.

Nthawi zina, maphunziro othandiza kupewa ngozi a katemera amayenera kuchitika kwa moyo wonse, koma izi ndizabwinoko kuposa kuziziritsa pakokha chifukwa cha kuwonongeka kowoneka bwino komanso mwayi wozitaya.

Tiyeneranso kukumbukiranso kuti ena mwa mankhwalawa omwe amaperekedwa chifukwa cha matenda ashuga ali ndi mavuto. Makamaka, kuvomerezedwa, komwe kumapangitsa magazi kuyenda m'miyendo, kungasokoneze kuchuluka kwa magazi m'magazi amaso komanso kungayambitse magazi.

Chifukwa chake, wofufuza maso ayenera kudziwa za mankhwala omwe ali ndi mankhwalawa komanso kuti ndi mankhwala ati omwe amamwa mankhwala ngati gawo limodzi la mankhwalawa pofuna kuthana ndi zovuta zina ndikuchitapo kanthu mokwanira popewa izi.

Makamaka, kukonzekera "Antocyan Forte" kumasiyanitsidwa ndi kuyendetsa bwino komanso kuchitapo kanthu kovuta. Monga zokonzekera zina zambiri za maso, zimabwerekedwa kuchokera ku chilengedwe chomwechokha ndipo zimakhala ndi zachilengedwe zophatikizidwa ndi ma buluu, ma currants akuda, mbewu za mitundu ina ya mphesa, etc. Kuchuluka kwa mavitamini, opatsa thanzi komanso oteteza kumatenda kumapangitsa kuti ma antioxidant awonongeke (ma radicals aulere ndi ma oxide ndi zina mwazomwe zimayambitsa kuphimba ma lens), kumalimbitsa mtima wamasamba, ndikuthandizira kukhalabe kowoneka bwino masana ndi madzulo.

Mwachiwonekere, mwanjira iyi, zizindikiritso zoyambirira zakukula kwamatenda a shuga mellitus zimafunikira chithandizo chamankhwala mofulumira. Chowonadi ndi chakuti mtundu uliwonse wamatumbo (kuphatikizapo matenda ashuga) umadziwika ndi otsika, komanso muzochitika zapamwamba, pafupifupi zero mphamvu ya chithandizo chamankhwala chokhazikika.

Palibe magalasi kapena magalasi omwe amagwiranso ntchito ngati njira yothetsera vutoli, chifukwa kuwonongeka kwamawonekedwe sikumangolepheretsa kuchotsera kosasinthika (myopia kapena hyperopia) ndipo kumayambitsidwa chifukwa cha kutsekeka kwapakati panjira yakuwala.

Njira yokhayo yothandiza komanso yothandiza pochiza matenda ashuga (ndi zina) ndi njira yochepetsera microsuction yochotsa michere yolephera ndikusintha ndikuyiyika woikiratu - mandala owonjezera. Komabe, opareshoni iyenera kuchitika mwachangu: ndizosavuta mwanjira zake, motero, zimachepetsa zoopsa zomwe zingachitike.

Masomphenya amayenda bwino atangopanga opaleshoni ndikufika pazotheka zonse mu masabata 1-2. Pambuyo pa miyezi 1-1.5, panthawi yoyeserera, mfundo zatsopano zimaperekedwa, ngati pakufunika kutero.

Phacoemulsization wa matenda a shuga

Ultrasound phacoemulsization chakhala njira yapadera yamakono mu microsurgery yamakono. Ntchito zoterezi zafala kwambiri padziko lonse lapansi chifukwa cha ma algorithm omwe amapangidwira pazinthu zazing'ono kwambiri, zovuta zowononga, nthawi yochepa komanso kulunjika kwa kulowererapo.

Malo osungirako anthu mugalasi la mandala amakhala ndi mandala - ma lens owoneka, maumboni omwe ali ofanana ndi a mandala achilengedwe. Kuwoneka bwino komanso kumveka bwino kumabwezeretsedwa pamlingo wocheperako.

Contraindication opaleshoni

Ndi lingaliro lofala kuti kuphatikizika kwa mandala ophatikizidwa mu shuga mellitus, ndikulakwitsa kwambiri. Kudzitsutsa sikutanthauza matenda a shuga palokha, koma kumatanthauzira a hemodynamics a maso (kufalitsa magazi ndi ziwalo), kuphatikiza ndimapangidwe acicatricial pa retina, kusiyanasiyana kwa Iris, etc.

Kutsutsana kwathunthu kulinso njira iliyonse yotupa yomwe ikukhudza ziwalo zamasomphenya. Njira zotere ziyenera kuthetsedwa kapena kuponderezedwa. M'zochitika zina zonse, chithandizo cha ma microsurcinati a matenda a shuga ndichothandiza kwambiri, kuphatikiza apo, njira yokhayo yobwezeretsanso ntchito yotayika.

Matenda a shuga

Mavuto a shuga akuphatikizira kupangika kwa ma ndimu - ma catara. Matenda a matenda ashuga nthawi zambiri amapezeka mwa ana ndi achinyamata omwe ali ndi vuto lalikulu la matenda osokoneza bongo omwe amakhala ndi 0,7-15%. Makatoni amawoneka koyambirira, patatha zaka 2-3 atazindikira kuti ali ndi matenda ashuga, ndipo nthawi zina nthawi yomweyo ndi kupezeka kwake.

Pali milandu yodziwika ya kubweza komanso ngakhale kuzimiririka kwamatenda a matenda ashuga motsogozedwa ndi insulin yokwanira. Pankhani imeneyi, ndikofunikira kwambiri kukwaniritsa chindapusa cha metabolic kwa mwana yemwe ali ndi matenda ashuga.

Mankhwalawa amanjala, kugwiritsa ntchito cocarboxylase, mavitamini A, gulu B, C, P, PP, kukondoweza kwa biogenic ndikothandiza. Chithandizo cham'deralo cha matenda amtundu woyambira makamaka ma prear a cataract amakhala poika madontho okhala ndi riboflavin, ascorbic acid, nicotinic acid (vizinin, vitodiurol, vitafacol, catachrome).

Munthawi ya ntchito, chisamaliro chiyenera kulipidwa pakukonza kwa maso a aphakic ndi magalasi kapena mandala olumikizana nawo. Kuwona za matenda ashuga ndikofunikira kwa ana onse omwe ali ndi matenda amkati.

Kukhathamiritsa kwathunthu kapena pang'ono kwa mandala (kapisozi kapena chinthu) komwe kumalumikizidwa ndi kuchepa kwa zithunzi zowoneka kapena kutayika kwathunthu kumatchedwa "cataract". Munthu yemwe ali ndi khungu loyang'anitsitsa amasiya kuwona bwino dziko lapansi momuzungulira, mavuto ndi kuzindikira kwa malembawo amawonekera, m'malo ovuta kwambiri, mawanga owala okha amawoneka.

Ndi za odwala matenda ashuga. Chifukwa chakuti kagayidwe kake kamatupa, kusintha kosasinthika kumayamba kuchitika m'ziwalo zonse, kuphatikizapo ziwalo zamasomphenya. Mandala samalandira zakudya zokwanira ndipo amayamba kutaya nthawi yomweyo. Makatikati mwa anthu odwala matenda ashuga a 2 amatha kuyamba msanga, zaka za matendawa zimachepetsedwa mpaka zaka 40.

Matenda a shuga angayambenso kuwoneka ngati chipwirikiti chamtundu wa flakes. Monga lamulo, amakula mwachangu kwambiri. Vutoli limawonedwa mwa iwo omwe ali ndi matenda a shuga 1, omwe amasinthasintha mosalekeza m'magawo a glucose pamlingo wokwera kwambiri. Zowona, ndi kusintha kwamagulu a shuga, momwemonso matendawa amadzithetsa.

Kuzindikira kwamatsenga nthawi zambiri kumakhala kovuta. Njira zodziwika bwino zofufuzira zamaso ndizothandiza, makamaka biomicroscopy pogwiritsa ntchito nyali.

Ndikofunika kudziwa kuti palibe chithandizo chamankhwala chamatumbo chomwe chitha kuchiritsa. Mapiritsi aliwonse, mafuta onunkhira, othandizira zakudya alibe ntchito. Mankhwala ena okha omwe akutsikira amatha kuchedwetsa matendawa kwakanthawi, koma osatinso. Chifukwa chake, chithandizo cha matenda a shuga a shuga chimachitika pokhapokha pochita opaleshoni.

M'mbuyomu, ndimagawo okhwima okhawo omwe adagwiritsidwa ntchito, monga lamulo, ndipo izi zidali ndi zovuta zamisala. Zinali zofunika kudikirira mpaka mandimuwo aumirike, ndiye kuti kuchotsedwa kwake sikunali kovuta kwambiri.

Choyamba, ophthalmologist adzalembera opaleshoni, yomwe imatchedwa phacoemulsification. Magalasi owonongeka amathandizidwa pogwiritsa ntchito ultrasound ndi laser. Pambuyo pake, imachotsedwa mosavuta m'diso. Kenako pakubwera gawo lachiwiri lofunika kwambiri. Kupyola pang'ono, dokotalayo amaika mandala ofukula, tsopano amatha kusintha.

Mawonekedwe ake ndi ochepa kwambiri kotero kuti safunanso kusanja. Opaleshoniyo imatenga mphindi pafupifupi 10 ndipo imangofuna mankhwala oletsa kupweteka a komweko. Chiwerengero cha ntchito zogwira bwino chikuyandikira 97-98%. Ndipo koposa zonse, mphindi zochepa pambuyo pa njirayi, wodwalayo akumva kusintha kwakukulu m'maso.

Pali zochepa zotsutsana pamankhwala opaleshoni yamatumbo chifukwa cha matenda ashuga. Ma ndala okumba sangatulutsidwe ngati wodwalayo ali ndi magazi owoneka bwino m'maso ndi mabala owopsa pa retina, kapena, pambali yake, zotengera zatsopano zimawonekera mu iris.