Kodi zizindikiro za matenda a shuga a encephalopathy ndi kudwala kwa matendawa ndi ziti?

Tikukupemphani kuti muwerenge nkhaniyi pamutuwu: "Kodi matenda a shuga ndi matenda a shuga omwe amachititsa munthu kudwala matenda a shuga" ndi chiyani kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Matenda a diabetes a encephalopathy amadziwika kuti ndi amodzi mwa zovuta zoyambirira zomwe zimachitika chifukwa cha matenda a shuga. Amapezeka mwaoposa theka la odwala omwe ali ndi matendawa.

Nthawi zambiri, kusokonezeka kwamanjenje kumamvedwa ndi munthu kale kuposa zizindikiro za matenda ashuga.

Kanema (dinani kusewera).

Diabetesic encephalopathy ili ndi code E10-E14 malinga ndi ICD 10 ndipo ikufanana ndi gulu G63.2. Matendawa nthawi zambiri amapezeka mwa odwala omwe ali ndi matenda a shuga 1.

Vutoli limapezeka pamaziko a Microangiopathy yotsimikizika, yodziwika ndi kuwonongeka kwa ziwiya, komanso kusintha kwapangidwe kwa makhoma awo.

Kusinthasintha pafupipafupi muyezo wa glucose womwe umapezeka m'magazi kumayambitsa kusokonezeka kwa metabolic. Zida zoyipa za metabolic zimalowa m'magazi ndikufalikira thupi lonse, mpaka zimakhala ndi ubongo.

Kukula kwa encephalopathy kumachitika pazifukwa ziwiri zazikulu:

Mphamvu yamiyendo yam'mimba imachepa, ndipo kupezeka kwawo kumachulukanso.
zovuta zama metabolic zikupita patsogolo, zikubweretsa kuwonongeka kwa minyewa yamitsempha.

Kanema (dinani kusewera).

Kupezeka kwa matendawa, kuphatikiza pa zifukwa zomwe zalembedwazo, kumatha kupangitsa kuti pakhale zovuta zina:

ukalamba
atherosulinosis
kunenepa kwambiri kapena kunenepa kwambiri,
kusadya bwino,
mavuto a lipid kagayidwe,
cholesterol yayikulu magazi,
kunyalanyaza malangizo azachipatala,
Magulu a shuga wokwanira.

Kusintha kwa ma metabolism kumakhudza gawo lamthupi, kumayambitsa kukonzanso kwamakina onse a minyewa yomwe ilipo ndikuchepetsa kufalikira kwa zikopa kudzera mumitsempha.

Kupatuka kotere sikuwoneka pomwepo, koma patatha zaka zingapo, chifukwa chake, kwa nthawi yoyamba, odwala amatha kukumana ndi zovuta zomwe zafotokozedwa kale atakalamba.

Nthawi zina, chifukwa cha encephalopathy imatha kukhala kugunda kwa ubongo, mkhalidwe wa hypoglycemia, komanso hyperglycemia.

Izi zovuta za shuga zimachitika pang'onopang'ono ndipo zimachitika popanda chizindikiro chazaka zingapo. Kuwonetsedwa kwa encephalopathy nthawi zambiri kumakhala kolakwika pazizindikiro za matenda ena, omwe amaphatikizira kuzindikira koyambirira kwa matenda.

Pa chithunzithunzi cha momwe matenda am'magazi amapezekera:

Asthenic syndrome - akuwonetsa kutopa kwambiri, kuchepa kwa ntchito, kusowa tulo, mavuto okhala ndi nkhawa.
Cephalgic syndrome - yodziwika ndi kupezeka kwa mutu. Zomverera izi zimafanana ndi boma mutavala chipewa kwambiri.
Masamba dystonia, yomwe imayendetsedwa ndi kukomoka, kukulira kwa paroxysm, kapena kusazindikira.

Odwala omwe ali ndi vuto la matenda ashuga nthawi zambiri amakhala ndi vuto la kuzindikira, lomwe limafotokozeredwa ndi izi:

mavuto amakumbukiro
mavuto
mphwayi.

Zizindikiro zomwe zimatsagana ndi zovuta:

kugona
mutu
kutentha kwa thupi,
chizolowezi chambiri
kuphulika kopanda nzeru,
kuyiwala
mantha
kutayika kwa zolakwika
kutopa.

Odwala nthawi zambiri amanyalanyaza izi.

Zotsatira zake, matendawa amapita patsogolo ndipo amadutsa magulu onse a kukula kwake:

Choyamba. Pakadali pano, zizindikiro za matendawa sizimasiyana ndi mawonekedwe a michere-vascular dystonia.
Wachiwiri. Matenda a wodwalayo akuipiraipira chifukwa cha kuwoneka kwa mutu komanso kusokonekera bwino.
Chachitatu. Gawo ili ndi kusokonezeka kwamisala. Odwala nthawi zambiri amakhala opsinjika. Kukhalapo kwa manic syndrome, kusakwanira machitidwe kumawonetsa kupatsirana kwa ndondomekoyi.

Gawo lomaliza la matenda am'madzi limadziwika ndi zovuta zotsatirazi:

wanena kusintha kwamitundu yonse yamanjenje,
kupatuka kwakukulu pakuchita zolimbitsa thupi,
kupweteka kwambiri m'mutu,
kutaya kwamverera (pang'ono kapena kokwanira) m'malo ena a thupi,
kuwonongeka kwamawonekedwe
kugwidwa kofanana ndi kugwidwa,
ululu wamkati.

Kufikira kwa dokotala popanda vuto kumakulitsa vuto la wodwalayo ndipo kumachepetsa mwayi wokhala ndi mawonekedwe owonekera.

Therapy ya encephalopathy imakhazikika pakukhazikitsa chikhazikitso chokhazikika molumikizana ndi maphunziro ena othandizira.

Njira yochotsera zizindikiro ndi kubwezeretsa thupi iyenera kuyang'aniridwa ndi dokotala.

Njira yochizira imatha kutenga mwezi umodzi mpaka zaka zingapo. Nthawi yofunikira kubwezeretsa thupi ndikupewa kupititsa patsogolo kwa zovuta kumadalira momwe wodwalayo alili ndi zomwe zikuchitika pakukula kwa matenda.

Mutha kusintha zizindikiro za matendawa mothandizidwa ndi zovuta mankhwala, wokhala ndi awa:

kuyang'anira mosalekeza kwa glycemia,
kukwaniritsa shuga yokhazikika yomwe ili ndi malire,
malamulo a kagayidwe kachakudya njira mu thupi.

Malangizo omwe adalembedwera akuyenera kutsatiridwa ndi odwala onse omwe adapezeka kale ndi matenda osokoneza bongo, popeza ndi njira zomwe zingathandize kupewa kuwonekera kwa encephalopathy.

Mankhwala omwe amathandizidwa ndi odwala omwe ali ndi zovuta izi:

antioxidants okhala ndi alpha lipoic acid,
adamamama
mankhwala osakanikirana (Milgamma, Neuromultivit),
Ndalama za gulu la ma statins - zomwe zimagwiritsidwa ntchito kuti lipid metabolism,
mavitamini (B1, B6, B12, komanso A ndi C).

Kukula kwa kupitiriza kwa zovuta kumadalira zinthu zingapo:

zaka odwala
kuchuluka kwa glycemia, komanso kuchuluka kwa kuwunika kwake,
kupezeka kwa matenda enanso,
kuchuluka kwa kuwonongeka kwa ubongo,
kuthekera kwa wodwala kutsatira zakudya zomwe wapatsidwa, kupuma.

Kusankha mtundu wa mankhwala, dokotala amaganizira zotsatira za mayeso onse omwe amaperekedwa ndipo pokhapokha amapereka mankhwala ena. Njira iyi yothandizira matendawa imakuthandizani kuti mukhale ndi moyo wabwino kwa wodwala komanso kuti azitha kugwira ntchito kwazaka zambiri, komabe samapereka mpata wochira kwathunthu.

Mavidiyo azokambirana zamavuto amtsitsi ndi a mtima:

Encephalopathy, yomwe idayamba motsutsana ndi matenda ashuga, imawerengedwa ngati njira yosachiritsika yomwe ingathe kupewedwa ndi chipepeso chokhazikika komanso chokhazikika cha matendawa. N`zosatheka kuyimitsa kupitilira kwa matenda ashuga a m'mimba kunyumba.

Wodwalayo ayenera kufunsa dokotala ndikusankha naye njira yoyenera yothandizira pakukonzanso. Kuwunikira mosamala mkhalidwe waumoyo komanso kuchuluka kwa glycemia kumathandizira kuti anthu omwe ali ndi matenda ashuga azikhala ndi moyo wathanzi kwazaka zambiri.

Matenda a shuga - imayipitsa kuwonongeka kwa ubongo komwe kumachitika motsutsana ndi maziko a matenda a shuga. Amadziwika ndi kusokonezeka kukumbukira, kuchepa kwa magawo anzeru, kusintha kwa ma neurosis, asthenia, kusowa kwa michere-mtima, zizindikiro zoyambira. Amapezeka m'matenda a matenda ashuga chifukwa cha kuwunika kwa mitsempha, kusanthula kwathunthu kwa deta ya EEG, REG, ya cerebral MRI. Mankhwalawa ikuchitika motsutsana ndi maziko a antidiabetesic mankhwala, kuphatikizapo mtima, metabolic, vitamini, antioxidant, psychotropic, anti-sclerotic mankhwala.

Ubale pakati pa matenda okhudzika ndi matenda a shuga ndi matenda ashuga mellitus (DM) wafotokozedwa mu 1922. Mawu akuti "diabetesic encephalopathy" (DE) adayambitsidwa mu 1950. Masiku ano, olemba angapo amati lingaliro la encephalopathy lomwe limayamba chifukwa cha njira ya dysmetabolic limawerengedwa ngati vuto la matenda ashuga. Amafunsidwa kuti apange matenda amisempha chifukwa cha vuto la mtima mu shuga mellitus to discirculatory encephalopathy (DEP). Komabe, mu Russian neurology, lingaliro la DE mwamwambo limaphatikizapo mitundu yonse ya pathogenetic ya encephalopathy: metabolic, mtima, osakanizidwa. Mwanjira imeneyi, matenda a shuga a encephalopathy amapezeka mu 60-70% ya odwala matenda ashuga.

Chotsatira cha DE ndi matenda a shuga. Encephalopathy ndi vuto lakumapeto lomwe limayamba zaka 10-15 atatha matenda ashuga. Zomwe zimayambitsa ndikusokonekera kwa kagayidwe kachakudya komwe kumayambitsa matenda ashuga, zomwe zimapangitsa kuwonongeka kwa minyewa ya ubongo ndi mitsempha yamagazi. Zotsatira za DE zimapereka:

Dyslipidemia wa matenda ashuga. Amadziwika ndi matenda amtundu wa 2 shuga. Dysmetabolism ya lipids ndi cholesterol imabweretsa mapangidwe a mtima atherosranceotic malo. Progressive systemic and cerebral atherosulinosis imawonedwa mwa anthu odwala matenda ashuga zaka 10-15 m'mbuyomu kuposa anthu wamba.
Mashuga a macroangiopathy. Kusintha kwa khoma la mtima kumalepheretsa magazi kulowa m'mitsempha yamatumbo, ndimomwe kumayambitsa matenda a ischemia osachiritsika, ndikukulitsa chiwopsezo cha stroke.
Pachimake hypo-, hyperglycemic zinthu. Hypoglycemia ndi ketoacidosis zimasokoneza mkhalidwe wa neurons, zimawonjezera chiopsezo cha DE ndi dementia. Kafukufuku akuwonetsa kuti palimodzi ndi kuchuluka kwa shuga, kukhazikika kwa insulin ndi C-peptide m'mwazi ndikofunikira.
Matenda oopsa. Amawonedwa mu 80% ya anthu odwala matenda ashuga. Zotsatira za matenda ashuga nephropathy kapena ndizofunikira. Zosokoneza magazi m'magazi, zimatha kubweretsa stroke.

Matenda a diabetesic encephalopathy ali ndi makulidwe opanga njira zophatikizira, kuphatikiza mtima ndi ma metabolic. Kusokonezeka kwa mtima chifukwa cha micro- ndi microangiopathy kumakulitsa matenda am'mimba ndipo kumapangitsa kufa ndi njala ya m'maselo a muubongo. Mphamvu ya pathobiochemical yomwe imachitika nthawi ya hyperglycemia imayambitsa kutseguka kwa anaerobic glycolysis m'malo mwa aerobic, zomwe zimatsogolera ku njala ya ma neurons. Ma radicals omasuka omwe ali ndi chiwopsezo cha minofu yamatumbo. Kapangidwe ka glycosylated hemoglobin, kuchepa kwa okosijeni, kumachulukitsa hyponalia ya neuronal chifukwa cha kuvulala kwamitsempha. Hypoxia ndi dysmetabolism zimatsogolera ku kufa kwa ma neurons ndikupanga mapindikidwe kapena kusintha kwakanthawi kachilengedwe kazinthu kazinthu - encephalopathy kumachitika. Kuwonongeka kwa kulumikizana kwa ma interneuronal kumabweretsa kuchepa kwapang'onopang'ono pantchito zam'maganizo.

DE imachitika pang'onopang'ono. Ali aang'ono, mawonekedwe ake amawonjezeka pambuyo pa zochitika za hyper- and hypoglycemic, mwa okalamba - pokhudzana ndi mbiri ya stroke. Zizindikiro zamankhwala ndizosazindikira, kuphatikiza kuwonongeka kwa ziwopsezo, asthenia, zizindikiro zofanana ndi neurosis, komanso kufooka kwamitsempha ya minyewa. Kumayambiriro kwa matendawa, odwala amadandaula za kufooka, kutopa, kuda nkhawa, kupweteka mutu, mavuto okhala ndi nkhawa.

Mikhalidwe yofanana ndi neurosis imayambitsidwa ndi somatic (wathanzi) ndi psychogenic (kufunikira kopitilira chithandizo, chenicheni cha kukula kwa zovuta) zinthu. Monga kuchepa kwa chidwi, kuganizira kwambiri matendawa, kuukiridwa kwamwano. Pa chithandizo choyambirira, neurosis yodandaula imapezeka mu 35% ya odwala; momwe matenda a shuga amakulira, kuchuluka kwa odwala omwe ali ndi vuto la kukhumudwa kumawonjezereka mpaka 64%. Hysterical, nkhawa-phobic, hypochondriac neurosis imatha kuchitika. Nthawi zina, mtundu wina umadutsa wamtundu wina. Mavuto akulu amisala ndi osowa.

Asthenic syndrome imadziwika ndi ulesi, kusasamala, kuphatikiza ndi michere-mtima wamatumbo, syncope. Kuwonongeka kwazidziwitso kumawonekera mwa kuchepa kwa kukumbukira, kusokoneza, ndi kulingalira pang'onopang'ono. Pakati pazisonyezo zoyang'ana, kuperewera kwa kusakanikirana, anisocoria (m'mimba mwake wosiyana), ataxia (chizungulire, kuyenda kosagwirizana), kusakwanira kwa piramidi (kufooka kwa malekezero, kuchuluka kwa minofu).

Kuwonjezeka kwa kuwonongeka kwa chizindikiritso kumabweretsa kutsika kwa luntha ndi dementia (dementia). Izi ndizomwe zimayambitsa kulemala kwakukulu kwa odwala, kumachepetsa kudzisamalira. Vutoli likuchulukirachulukira chifukwa cha kulephera kwa wodwala kuchita mankhwala othandizira odwala matenda ashuga. Mavuto a DE ndi kusokonezeka kwapakati kwa matenda am'mimba: matenda a ischemic, kupweteka kwa ischemic, kuchepa kwambiri, kukha mwazi kwa intracranial. Zotsatira zakuthwa ndi zovuta zamagalimoto, kuwonongeka kwa mitsempha yamagetsi, kusokonezeka kwa mawu, komanso kupita patsogolo kwa kuzindikira kwanzeru.

Matenda a diabetes a encephalopathy amapezeka ndi a neurologist potengera momwe amafufuzira amisala odwala matenda ashuga. Kuchulukitsa kwa magwiridwe antchito ndi zamagulu m'zinthu zamagulu a ubongo kumayesedwa pogwiritsa ntchito njira zothandizira.

Electroencephalography. Kuwonetsera momwe masinthidwe amasinthidwe. Kuthamanga kwa EEG, kuchepetsedwa kwa phokoso la alpha, maonekedwe a pathological theta ndi mafunde a delta amadziwika.
MRI yaubongo. Mu gawo loyambilira limafanana ndi chizolowezi. Pambuyo pake, zosadziwika zazing'ono zomwe zimayambitsa kusintha kwachilengedwe kumawululidwa.
Phunziro la matenda a ubongo. Imachitika pogwiritsa ntchito rheoencephalography, kusanja kopanga, ma ultrasound a ziwiya zamutu, MR angiography.
Zoyeserera zasayansi. Amakulolani kuti muwerenge zovuta zama metabolic. Mlingo wa shuga, lipids, cholesterol, C-peptide, insulin imatsimikiza.

Kusiyanitsa mosiyanasiyana kwa DE ndikufuna kuthana ndi zotupa ndi zotupa za muubongo. Imachitika molingana ndi zidziwitso zamankhwala, zomwe zimatsimikiziridwa ndi kulingalira kwa maginito.

Therapy ya DE imachitika ndi neurologist molumikizana ndi endocrinologist (diabetesologist). Chofunikira pa chithandizo ndikusunga kuchuluka kwa shuga m'thupi mwakutsatira zakudya zoyenera, kumwa mankhwala ochepetsa shuga, ndipo ngati ndi kotheka, mankhwala a insulini. Mankhwala a Neurological cholinga chake ndi kukonza matenda a hemodynamics, kusunga kagayidwe ka neurons, ndikuwonjezera kukana kwawo kwa hypoxia. Maphunziro anthawi zonse a zovuta mankhwala amachitika pogwiritsa ntchito mankhwala osokoneza bongo a vasoactive, antiplatelet, antioxidant, nootropic.

Ma stimulators a metabolism a mphamvu, mavitamini a B, alpha-lipoic acid, mavitamini E amapatsidwa mankhwala. Malinga ndi zikuwonetsa, mankhwalawa amathandizidwa ndi mankhwala a antihypertensive (omwe ali ndi vuto losagwirizana ndi matenda oopsa) komanso mankhwala antisulinotic ochokera ku gulu la ma statins. Pharmacotherapy yokhala ndi vuto la neurosis imafuna kusankha mankhwala okwanira, chifukwa kusintha kumakhudza ntchito yamavuto. Nthawi zambiri atypical tranquilizer (mebicar) amagwiritsidwa ntchito. Kufunsira kwa psychotherapist, nthawi zina wamisala, kumalimbikitsidwa.

Matenda a diabetes a encephalopathy ndi matenda opita patsogolo. Kuchulukitsa kwa zizindikiro kumadalira makamaka kuwonongeka kwa matenda ashuga. Kawonedwe mwadongosolo ndi endocrinologist ndi neurologist, chithandizo chokwanira cha hypoglycemic, ndi maphunziro okhazikika a minyewa yamitsempha amatha kuyimitsa kapena kuchepetsa kufalikira kwa zizindikiro zamatumbo, ndikuletsa kukula kwa zovuta. Kupewa kumatengera kupezeka kwa nthawi yake komanso chithandizo chokwanira cha matenda ashuga, kukonza matenda oopsa, komanso kuchiza matenda amitsempha yama mtima.

Kodi ndi matenda ati a shuga omwe amachititsa kuti munthu azidwala matenda ashuga?

Matenda a shuga - kuphwanya kapangidwe ka zigawo za ubongo chifukwa cha kusokonezeka kwa mitsempha yamagazi kapena kagayidwe kamene kamapezeka mu shuga mellitus.

Pathology siyodziyimira pawokha ndipo imatha kuchitika ngati vuto lakalipo. Mwa anthu omwe akumanapo ndi zovuta, pafupifupi 80% ndi odwala matenda a shuga 1.

Pathology ndizovuta kudziwa: encephalopathies ndi ofanana.

Pathology imachitika chifukwa cha zovuta zosiyanasiyana za thupi.
Mwa zina zazikulu:

Microangiopathy - kuwonongeka kwa minofu yamitsempha yamagazi yaying'ono,
The zimachitika kagayidwe kachakudya, zikubweretsa kuphwanya kapangidwe ka mitsempha mathero.

Mavuto onsewa ndi odziyimira okha, ngakhale ali pafupi, ndipo amayambitsa matenda ashuga nthawi zambiri kuposa ena. Pali zinthu zingapo zomwe zimayambitsa matenda a shuga, zomwe zimayambitsa zovuta. Odwala omwe ali ndi zizindikiro zotsatirazi ali pachiwopsezo:

Nkhope zachikulire
Anthu onenepa kwambiri
Odwala omwe ali ndi metabolism osayenera a chakudya chamagulu ndi mapuloteni,
Anthu odwala matenda ashuga okhala ndi shuga wa plasma wambiri.

Wothandizira wamkulu pakubwera kwa matenda a shuga a encephalopathy - microangiopathy. Vutoli limayambitsa kuperewera kwa mpweya, limasokoneza kagayidwe kake, sikuloleza thupi kuti lichotse poizoni. Zinthu zowonongeka, zoyipa zimayamba kuwononga bongo. Matenda a metabolism amabweretsa kusintha pamachitidwe a mitsempha, ndikuwonjezera kuyankha kwa mathero.

Mavuto okhala ndi vuto lofananalo amawonekera nthawi zambiri mukakalamba. Mwinanso kuoneka kwa matenda atadwala matenda aubongo, omwe ali ndi mavuto a glycemic.

Matenda a diabetes a encephalopathy alibe zizindikiro zapadera - matendawa ndi ofanana ndi ena. Zizindikiro za matendawa ndi ofanana ndi ubongo atherosulinosis, matenda oopsa. Kuzindikira kwenikweni kumachitika ndi dokotala potengera mayeso.

Zizindikiro kumayambiriro a matendawa:

Migraine yofatsa, mavuto a kukumbukira pang'ono,
Asthenia - kufooka kwakanthawi, kusakwiya, kugona.
Mwina chizungulire pang'ono, mavuto ammaso.

Mu gawo lomwe lakhazikika, matendawa amawonjezera matendawa, amakhudza kwambiri ubongo:

Mutu ulibe vuto
Kufooka ndi kukwiya kumayendetsedwa ndi chidwi, kulephera kukumbukira,
Mumaganizo, munthu amawoneka wokhumudwa, woopsa,
M'malo ovuta kwambiri, kuyang'ana malo m'malo motayika, mavuto amayamba ndi malankhulidwe ndi luso la galimoto, komanso kukhudzika. Kukomoka sikusowa.

Ndi encephalopathy, wodwalayo samangoyeserera modekha thanzi. Kufufuza kuchipatala ndiye njira yofunika kukhazikitsira matenda ndikupeza mankhwala oyenera. Kufunafuna thandizo panthawi yake kumatha kusintha njira zofatsa ndikulepheretsa kukula koopsa.

Ndi matendawa atangoyamba kumene, matendawa ndi ofatsa, zomwe zimapangitsa kuti zikhale zovuta kudziwa vutolo nthawi yomweyo.

Matenda a diabetes a encephalopathy amadziwonetsa pang'ono: wodwala amayamba kugona mokwanira, amaiwala nthawi zochepa, amakhala wosakwiya pang'ono. Chilichonse chimayamba chifukwa cha kusowa kwa mpweya wa okosijeni.

Kuti athe kulipirira kusowa kwa mphamvu, malekezero amitsempha amagwiritsa ntchito njira zapadera, ntchito yayitali yomwe imayambitsa kudziunjikira kwa zinthu zovulaza.

Njira ya matendawa imatha kubweretsa kuwoneka kwama syndromes owonjezera:

Asthenia amapezeka koyamba. Kukhala ndi chidwi ndi thupi lonse, kumapangitsa munthu kuti akhale woopsa. Wodwalayo amayamba kudandaula za kufooka, amalephera kugwira ntchito, amakhala wopanda nkhawa - osakwiya, osowa - okonda,
Cephalgia amayambitsa mitundu ingapo ya mutu. Kugonjetsedwa kwa ziwalo kumawonetsedwa mosiyanasiyana: kupweteka, kufupika, koopsa, kusokonezedwa ndi ndende, yayitali,
Masamba dystonia siziwonekera zokha, koma mwa ambiri. Zizindikiro zake ndi: kutentha kosatha ndi kusinthanitsa ndi syncope,
Vuto lalikulu, kuwonongeka kwa ubongo kumadzetsa: kukula kwa maso a ana, mayendedwe amaso, chizungulire, kusokonekera bwino kwa malo, ziwalo,
Komanso, matenda omwe amapangidwa amayambitsa kusokoneza ubongo komanso ntchito yayitali: momwe zimayendera pang'onopang'ono, pang'ono pang'ono maynesia, kuthekera kopeza maluso atsopano ndi chidziwitso chatayika, kuganiza mosatsimikiza kumatayika, kupanda chidwi kumadza.

Ma syndromes amatha kupewedwa ndikuwongolera zakudya zomwe zimadulidwa ndikutsata kuchuluka kwa shuga mumapasma.

Zotsatira zake ndi:

Kuwonongeka kwa magalimoto, kuwonetseredwa ngati ziwalo zathunthu kapena pang'ono,

Kuchepetsa kwambiri migraine,

Kuwonongeka kwa mathero a mitsempha,

Zowonongeka, mpaka kutayika kwakanthawi,

Mphesa yofanana ndi khunyu

Kusokonekera kwa ziwalo zotuluka - chiwindi ndi impso.

Mwa anthu odwala matenda ashuga, nthawi zina, ophwanya kwambiri malangizo a dokotala komanso kuwonongeka kwa shuga hypoglycemic encephalopathy. Mavuto ambiri imakulitsa nthawi ya matendawakupangitsa kutaya kwamayendedwe m'malo, nkhawa ndi nkhawa, kukokana kwa minofu, kukokana. Kutsika kwina kwa shuga m'magazi, wodwalayo amatembenuka, kutaya mphamvu ndipo amatha kugwa. Kukhazikitsidwa kwa glucose kumakulirakulira, pang'onopang'ono kubwezeretsa thanzi la munthu.

Kuchepetsa kwambiri shuga msanga kumachulukitsa nthawi yayitali ya chithandizo, nthawi zina kumapangitsa kuti ikhale yosatheka. Kuchuluka kwa zinthu zomwe zimatsogolera hypoglycemia, imavulaza kuchira osati kungoyambitsa konse.

Kutanthauzira kwabwinoko kwa matendawa kumathandizidwa ndi kufufuza koyambirira kwa wodwalayo pazodandaula ndi malo okhala. Molondola, matendawa amatsimikiziridwa pamayeso ake:

Kusanthula kwa Laborator kwa glucose ndi cholesterol,
Urinalysis yamatumbo a ketone, kuchuluka kwa shuga komanso mapuloteni,
Kuyerekezera kapena maginito a resonance imagne, electroencephalography. Amathandizira kumveketsa gawo lavuto.

Mu odwala matenda ashuga okalamba, matendawa amatha kuthandizidwa ndi mavuto a neuralgic komanso kuwonongeka kwa minofu pambuyo pake. Mavuto amadziwika ndi CT kapena MRI.

Ndikosatheka kuthana ndi zamatsenga kwathunthu. Njira yamankhwala imakhala yokhazikika, komanso kusintha pang'onopang'ono kwa thanzi. Chithandizo chimakhala chowunikira zizindikiro zitatu:

Plasma glucose control. Kupeza mndandanda wokhazikika wa shuga ndi matenda a shuga ndi cholinga chomwe dokotala aliyense akufuna akwaniritse. Chofunikira kwambiri ndi cha odwala omwe ali ndi matenda amtundu wa 2, chifukwa zovuta za metabolic zimapitilira pambuyo pa kubadwa. Encephalopathy prophylaxis tikulimbikitsidwa kusintha magazi.
Kuchira kwantabolic,
Kubwezeretsa kwa minofu ndi microangiopathy.

Kubwezeretsa kwa metabolism yokhazikika kumathandizidwa ndi kukonzekera kwamagulu a antioxidant, othandizira a cerebroprotective ndi mavitamini. Malinga ndi maguluwa: espalipon ndi analogues, piracetam ndi analogues.

Pakati pa mavitamini, A, C, E nthawi zambiri amapatsidwa mankhwala.

Microangiopathy imathandizira kuchiritsa pentoxifylline, ndipo Cavinton kapena analogues amagwiritsidwa ntchito prophylaxis.

Kutengera zinthu zosiyanasiyana, kuphatikiza:

M'badwo
Shuga ya wodwala
Ma pathologies owonjezereka omwe adachitika panthawi ya matenda ashuga.

Kuchiza moyenera kumatha kuchepetsa matendawa, kumulola wodwalayo kukhala ndi moyo wonse kwa zaka zingapo., koma ndizovuta kubwezeretsa thanzi kwathunthu - pokhapokha gawo loyamba chitukuko. Kulephera kutsatira malingaliro ndi upangiri wa dokotala kumaphatikizapo kutayika kwa maluso ambiri ndi zizindikiro zazikulu. Mwapadera, munthu amakhala olumala kapena kufa.

Muvidiyoyi mudzazindikira kulumikizana pakati pa encephalopathy ndi retinopathy.

Pathology imatha kupeweka ngati chithandizo cha matenda a shuga chikuchitika. Encephalopathy imayamba pang'onopang'ono, ndipo chithandizo chokhazikika chimathandiza wodwalayo kukhala ndi moyo wathunthu.

Matenda a shuga a matenda a shuga - kuchokera kuzizindikiro mpaka zotsatira zake

Kuphatikiza pa kuwonongeka kwa dongosolo la zotumphukira zam'mimba, matenda a shuga amatha kukhala ndi vuto pakatikati. Matenda a diabetes a encephalopathy ndikusintha kwachilengedwe ndi kapangidwe ka ubongo wake. Vutoli limayamba pang'onopang'ono, chifukwa chake, madotolo komanso odwala nawonso amawona zizindikiro zazamankhwala mochedwa kwambiri pamene matendawo akula kwambiri. Kuwonetsedwa kwakukulu kwa matenda ashuga a m'mimba ndi kuchepa kwa luso la kuzindikira, lomwe limabweretsa zovuta pakusinthasintha pagulu ndi pantchito, kutayika kwa maluso aukadaulo.

Matendawa amafooketsa kwambiri moyo wa odwala, makamaka ukalamba, zimakhala zovuta kwa odwala matenda ashuga omwe amachititsa matenda kuthana ndi matendawa, amatha kuiwala kumwa mankhwala, kuwerengera molakwika mlingo wa insulin, sangathe kuwongolera zakudya zawo. Kulipira okhazikika kwa matenda ashuga sikungatheke kwa odwala otere, chifukwa chake amakula msanga, kulumala kumayambika, ndipo kufa kwa 20% kumakweza. Njira yokhayo yopewera kusintha kwa ubongo ndikuzindikira ndikuthana ndi mavuto adakali achichepere.

Mawu akuti "encephalopathy" amatanthauza matenda onse amtundu wa bongo pomwe pakapanda kutupa matenthedwe ake amawonongeka. Tizilombo taubongo nthawi zambiri timawonongeka pang'ono ndi vuto la kuperewera kwa zakudya m'thupi. Mwachilengedwe, nthawi yomweyo, gawo limodzi la magawo amomwe amachitika mu ubongo limatayika. Zomwe zimayambitsa matenda a diabetes a encephalopathy ndi kusokonekera kwa metabolic komanso mtima m'thupi.

Malinga ndi magwero osiyanasiyana, zizindikiro za encephalopathy zimatha kupezeka pafupifupi 90% ya odwala matenda ashuga. Ngakhale izi, kufufuza koteroko kumapangidwira mosadukiza, popeza matendawa ndi ovuta kuzindikira ndikuzindikira kuti shuga ndiyomwe imayambitsa kusintha kwa ubongo.

Malinga ndi kalata yochokera ku Unduna wa Zaumoyo ku Russia, matenda ashuga ali ndi nambala ya ICD ya 10 (matenda apadziko lonse lapansi) E10.8 ndi E14.8 - zovuta zosadziwika za matenda ashuga.

Chomwe chimapangidwira kukula kwa encephalopathy sichimamveka bwino, koma amakhulupirira kuti imagwirizana kwambiri ndi matenda ashuga a m'mimba. Choyambitsa chachikulu cha matenda ndi zofanana ndi zovuta zina za matenda ashuga - hyperglycemia.

Shuga wapamwamba amatsogolera ku angiopathy yamitsempha yamagazi, yomwe imaphwanya zakudya za ubongo. Chifukwa cha kusokonezeka kwa magazi, ma neuron amamva kuperewera kwa mpweya, amagwira ntchito kwambiri, samatha kuchira munthawi yake ndikuchotsa zinthu zapoizoni. Vutoli likuchulukirachulukira ndi kuchuluka kwa cholesterol, triglycerides ndi otsika osalimba lipoproteins, wokhala ndi matenda a shuga.

Kukula kwa encephalopathy kumachitika mu magawo atatu. Zizindikiro zoyambirira sizimakhala zachindunji, chifukwa chake odwala matenda ashuga sawalabadira. Nthawi zambiri, encephalopathy imadziwika kuti si yachiwiri kuposa gawo 2, pomwe zizindikiro zake zimatchulidwa. Kumayambiriro kwa matendawa, MRI imatha kuzindikira kusintha kwazing'ono kwambiri mu ubongo. Nthawi zambiri zimapezeka mosiyanasiyana m'malo angapo. Pambuyo pake, chotupa chimapangidwa mu ubongo. Zizindikiro zoyambira ndi kuuma kwawo panthawiyi zimadalira kutulutsa chidwi.

Gawo la matenda a shuga

Pa gawo loyamba - wodwala amawona magawo a kukwera ndi kugwa kwa kuthamanga kwa magazi, chizungulire, kuzimitsa khungu m'maso, kutopa ndi khungu. Monga lamulo, mawonekedwe awa amawonetsedwa ndi nyengo zoyipa, zaka kapena michere-vascular dystonia.
Mu gawo lachiwiri - Mutu umakhala pafupipafupi, kukumbukira kwakanthawi kochepa, kusokonezeka m'mlengalenga ndikotheka. Zizindikiro zamitsempha zimatha kuwoneka - zochita za ophunzira pakusintha kowala, malankhulidwe amasokonezeka, mawonekedwe amawonongeka, mavuto okhala ndi nkhope amapezeka. Nthawi zambiri, ndi nthawi imeneyi pomwe odwala omwe ali ndi matenda ashuga amatembenukira kwa wamatsenga.
Mu gawo lachitatu - Zizindikiro zimatchulidwa. Pakadali pano, kupweteka kwa mutu kumakulirakulira, mavuto ndi kulumikizana kwa mayendedwe, chizungulire chikuwonekera. Kusowa tulo, kukhumudwa, kukumbukira kumakulirakulira. Pakadali pano, ndizosatheka kudziwa maluso ndi kudziwa kwatsopano.

Zolemba zamatenda a matenda amtundu 1 komanso matenda ashuga 2

Mwanjira yake yoyera kwambiri, matenda a shuga omwe amachititsa anthu odwala matenda ashuga a mtundu woyamba 1. Kusokonezeka muubongo wawo kumalumikizidwa ndi kusowa kwa insulin yawo komanso kulandira mosayembekezereka ngati mawonekedwe. Pali malingaliro oti kupititsa patsogolo kwa encephalopathy kumangotengera kuchuluka kwa hyperglycemia, komanso kusakhalapo kwa C-peptide m'thupi - gawo la molekyulu ya proinsulin yomwe imachotsedwa pamenepo pakupanga insulin. Insulin ya mafakitale, yomwe imalembedwa kwa odwala onse omwe ali ndi matenda amtundu wa 1, ilibe C-peptide - werengani zambiri za C-peptide.

Encephalopathy imavulala kwambiri mu mtundu woyamba wa shuga kwa ana aang'ono. Amakhala ndi mavuto ndi chidwi, chidwi chazidziwitso chimachedwa, ndikukumbukira kumachepa. Kuyesedwa kwapadera kunatsimikizira kuti wodwala yemwe ali ndi encephalopathy, IQ ya mwana imachepa, komanso zotsatira zoyipa za luntha anyamata amphamvu kuposa atsikana. Kafukufuku wamaubongo omwe ali ndi odwala omwe adayamba matenda ashuga amawonetsa kuti akadzakula, amakhala ndi vuto latsitsi kuposa anthu athanzi.

Matenda a diabetes a encephalopathy okhala ndi matenda amtundu wa 2 amasakanikirana. Pankhaniyi, ubongo umakhudzidwa osati ndi hyperglycemia yokha, komanso zovuta zina:

Hypertension imawonjezera kusintha kwa atherosselotic m'matumbo, nthawi 6 kumawonjezera chiopsezo cha encephalopathy.
Kunenepa kwambiri kwazaka zapakati kumabweretsa kuukalamba kwambiri kwa encephalopathy mu ukalamba.
Kukana kwamphamvu kwa insulin kumayambitsa kudzikundikira kwa amyloid beta mu ubongo - zinthu zomwe zimatha kupanga zolembera ndikuchepetsa kwambiri kuzindikira kwa ntchito.

Encephalopathy imapereka chiopsezo chachikulu mu mtundu 2 wa matenda ashuga okalamba, zomwe zimayambitsa kukula kwa mtima ndi mtima komanso matenda a Alzheimer's.

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 >>

Zizindikiro za encephalopathy mu diabetesics amafotokozedwa ndi kulephera kwa maselo a mu ubongo kugwira ntchito moyenera chifukwa cha kuperewera kwa mpweya ndi michere, chifukwa chake ali ofanana ndikuwonetsa kwa encephalopathy chifukwa cha atherosulinosis, matenda oopsa, kapena ngozi ya cerebrovascular.

Kartelishev A. V., Rumyantsev A. G., Smirnova N. S. Zovuta zenizeni za kunenepa kwambiri mwa ana ndi achinyamata, Medpraktika-M - M., 2014. - 280 p.
Clinical endocrinology (maziko a endocrinology azachipatala kwa madokotala ndi ophunzira), KUBUCH - M., 2012. - 540 c.
Momwe mungaphunzirire kukhala ndi matenda a shuga. - M: Interprax, 1991 .-- 112 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 pamalowo kuti athetse zovuta 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.

Zolemba za matendawa

Matenda a diabetes a encephalopathy samachitika ngati matenda odziyimira pawokha, koma ndi zotsatira za matenda omwe alipo. Ili ndiye gawo lalikulu la matendawa.

Cholesterol okwera, kulumpha mwadzidzidzi m'magazi a shuga ndi chikomokere kumayambitsa ngozi zam'magazi komanso zovuta zoyipa. Popewa matenda oyambitsawa, odwala matenda ashuga ayenera kuyang'anitsitsa kuchuluka kwa magazi ndikutsatira malangizo a dokotala.

Kuphatikiza pa chakuti matendawo ndi chifukwa cha matenda ena, palinso zina:

zovuta zakuzindikira
zovuta kusiyanitsa mitundu yosiyanasiyana ya encephalopathies,
kusagwirizana ndi heterogeneity ya zizindikiro.

Ndi mawonekedwe osakanikirana ndi osakhazikika, pali zizindikiro za kuchepa kwa magazi ndi zizindikiro zawo. Kuti mupeze matenda olondola, ndikofunikira kuzindikira zomwe zidayambitsa zizindikiritso za ma ubongo a ubongo.

Encephalopathy mu shuga amapezeka pazifukwa ziwiri zazikulu:

chifukwa cha zovuta za metabolic zomwe zimatsogolera ku matenda a mitsempha,
chifukwa cha kuwonongeka kwa mtima kupindika komanso mphamvu zawo.

Chifukwa cha kusintha kwa kagayidwe kazakudya zamitsempha yamafupa, kuthamanga kwa zoyendetsera kumachepa. Kuwonongeka kwa ziwiya zazing'onoting'ono za ubongo ndizomwe zimachitika mu microangiopathy, zomwe zimayamba mwa odwala matenda ashuga. Ngati kupezeka kwake kukhazikika, kuyambika kwa encephalopathy kuyenera.

Ma pathologies omwe atchulidwa amathandizanso kusokonezeka kwa ubongo chifukwa cha:

kuperewera kwa minofu yokhala ndi mpweya komanso mphamvu,
kudziunjikira kwa poizoni, komwe kumabweretsa kuwonongeka kwa maselo ozungulira.

Nthawi zina encephalopathy mu matenda ashuga amakwiya:

matenda am'mimba,
pachimake hyper- kapena hypoglycemia.

Zowonjezera zomwe zimawonjezera chiopsezo cha matenda aubongo ndi kukulitsa matendawa ndi:

ukalamba
lipid kagayidwe kachakudya,
kunenepa kwambiri, kunenepa kwambiri,
shuga wambiri, wokhala ndi nthawi yayitali,
atherosulinosis
kusuntha kochepa
zovuta zosokoneza chakudya,
kupsinjika kwanthawi zonse
kunyalanyaza malangizo a dokotala,
Kutalika, kwa zaka 10, matendawa.
malo osakhala bwino.

Matendawa amatha kukhala asymptomatic kwa zaka, kotero muyenera kulabadira mawonekedwe ake ocheperako.

Zizindikiro za matendawa ndi gawo lake

Pa gawo loyambirira la matenda ashuga encephalopathy, mikhalidwe ya matenda ambiri ingasonyeze. Amawoneka ngati mawonekedwe:

kutopa
Zizindikiro zamimba zam'mimba,
magazi am'maso kwambiri
chizungulire kapena mutu,
matenda osalekeza
mantha
kupsa mtima kopanda pake ndikusokonekera,
mphwayi
kuyiwala
kusowa tulo
kuchepa kwa luntha.

Chifukwa chakuti zizindikirozi zikuwoneka kuti ndizosafunikira, ndizopanda pake, kapena angayankhe matenda ena, odwala ena omwe ali ndi matenda ashuga amawaphonya, kuwanyalanyaza. Zotsatira zake, matendawa amapita patsogolo, kudutsa gawo lachiwiri, lomwe limadziwika ndi kuwonongeka konsekonse muumoyo wabwino:

mavuto
zovuta zamagalimoto
kukomoka kapena zochitika zofananira
chithunzi chowirikiza
tinnitus
kusokonekera kwa mawu
mavuto amakumbukiro
zovuta pakukhudzidwa ndi nkhaniyo, kupereka malingaliro ndi kuwerenga,
kupita patsogolo kwa maboma okhumudwitsa,
zopweteka (kuphatikiza wamba)
kumva kutentha
ziwalo
kugwidwa kwanuko komanso wamba.

Mukayesedwa, mutha kuwona kuti anawo ndi akulu osiyanasiyana, ndipo ma eye amayenda ndi zosamveka.

Gawo lachiwirili limachitika mwachangu, mpaka lachitatu. Pakadali pano, kuphwanya kwakukulu kwa mkhalidwe wamalingaliro ndi wodwala kumawonetsedwa. Amawonetsedwa ndi syndromes:

manic
kupsinjika, kwanthawi yayitali,
machitidwe osayenera.

Zizindikiro zovuta izi zikuwonetsa bwino: diabetesic encephalopathy yayamba ndi zovuta m'maganizo. Matendawa omwe adagwidwa pachiwonetsero choyamba amatha kuthandizira, chifukwa chake, zizindikiro zilizonse zochititsa mantha zomwe zimatsimikizira kuti ubongo ndiwotheka sizitha kunyalanyazidwa. Kuphatikiza apo, pofuna kupewa matenda, matenda ashuga amayenera kuwongolera shuga, kutsatira zakudya, kusuntha kwambiri, kutsatira malangizo a dokotala.

Kuzindikira matendawa

Kuphatikiza pamalingaliro am'malingaliro ndi zizindikiro zakunja za matendawa, pali njira zamavuto ake. Ndi thandizo lawo, zizindikiro zamanjenje zimapezeka. Njira zazikuluzikulu zodziwitsira matenda zimagwiritsa ntchito njira:

CT (yowerengera makanema),
MRI (imagonance imaging),
EEG (electroencephalography).

Kugwiritsa ntchito EEG, momwe ubongo umagwirira ntchito umaphunziridwa kutengera zochita zake. Zosintha zomwe zalembedwapo siziwoneka zokhazokha ndipo zimakhala ndi mawonekedwe. Electroencephalogram ya odwala ndi yosiyana:

makulidwe
hypersynchronization wa mitondo,
Kuchepetsa mitsempha ya alpha,
kusintha kusintha kwa ma curve,
kulowetsedwa mwaukadaulo kwasinthira ma theta ndi mipira yolimbirana.

Pa CT ndi MRI, ma pathologies amatha kupezeka mwanjira ya:

chachikulu kuchepa kwa mitsempha,
mlangizi
kusintha kwa minyewa yam'mbuyo.

Zina mwazosinthazi ndichizindikiro cha matenda omwe ali ndi atherosulinosis, microangiopathy, matenda oopsa, kugwidwa ndi matenda a ischemic, koma kupezeka kwa matenda ashuga kumatha kukhala chisonyezo cha encephalopathy.

Chithandizo cha encephalopathy

Chofunikira pakuchizira matendawa ndikusungabe kuchuluka kwa shuga kwa wodwala. Koma kwa odwala omwe ali ndi matenda amtundu II, kusokonezeka kwa metabolic ndikotheka, kudutsa ngakhale motsutsana ndi maziko amachitidwe a shuga. Kusintha kwa metabolic kotereku kumatha kuchitika chifukwa cha majini.

Matenda a metabolism amathetsedwa mothandizidwa ndi mankhwala:

antioxidants (espalipone, etc.),
mavitamini akuluakulu: A, C, E ndi B - 1, 6, 12 (milgamma, neurorubin, neuromultivitis),
cerebroprotectors (piracetam, stugeron, nimdipine).

Kusintha kwa mtima kwa minyewa nthawi zambiri kumachotsedwa ndi pentoxifylline, yomwe imathandizira:

kuthamanga kwa magazi
Kuchotsa poizoni
onjezerani kuchuluka kwamadzi ozungulira,
kuchepa kwamitsempha yamagazi.

Kubwezeretsa mamvekedwe abwinobwino amwazi kumalepheretsa kusintha kwa maselo ofiira amwazi. Nthawi yomweyo, chithandizo chamankhwala chimapangidwira kukonza ma metabolide a lipid a mankhwala ochokera pagulu la statins.

Kuphatikiza pa encephalopathy, matenda ena ophatikizika amathandizidwa. Chifukwa chake, pochiza ndi kupewa angiopathy, mankhwalawa amagwiritsidwa ntchito:

Chithandizo chimayikidwa mosamalitsa payekhapayekha, poganizira mawonekedwe a thupi la wodwalayo. Popewa kufa, wodwala matenda ashuga sayenera kupatula kusuta ndi zakumwa zoledzeretsa, kutsatira malangizo a dokotala, kusunga zakudya komanso kuchita masewera olimbitsa thupi.

Mitundu yoyambitsidwa matendawa imatha ndi zovuta mu mawonekedwe a:

kulemala
kutayika kwa luso lodzisamalira.

Zowopsa zitha kupewedwa moyang'aniridwa ndi achipatala. Matenda a diabetes a encephalopathy pambuyo pake amawonedwa ngati osachiritsika, koma kukhazikitsidwa kwa zomwe dokotala amafotokoza komanso malamulo ake amakhalidwe kumalola zaka zambiri kukhalabe ogwira ntchito komanso moyo wabwino.