Kodi matenda ashuga ndi mphumu zimayenderana bwanji?

Zomwe zimachitika makamaka ngati matenda amodzi mwa chibadwa chokha mwa munthu ndi osowa kwambiri. Makina onse ndi ziwalo zathupi zamunthu zimalumikizana kwambiri, ndipo mavuto okhala ndi chiwalo chimodzi nthawi zambiri amaphatikizira zovuta mu mawonekedwe a matenda a ena. Zotsatira zake, kuphatikiza kwa matenda kumapangidwa, ndipo ngati njira sizinatengedwe, zochitika za patali zitha kuphimba thupi lonse. Chifukwa chake, ndikofunikira kudziwa vuto lanu lisanayambitse zovuta zina. Komabe, sizotheka nthawi zonse.

Mlandu wofala ngati wodwala ali ndi matenda awiri nthawi imodzi ndi matenda amphumo ndi matenda a m'matumbo. Malinga ndi zotsatira za kafukufuku, zinadziwika kuti matendawa, ngakhale amasiyana maonekedwe awo, nthawi zambiri amapezeka mwa anthu omwewo, chifukwa amakhumudwitsidwa ndi kusokonezeka kwa kayendedwe ka chitetezo chathupi.

Kupezeka kwa matenda awiriwa kumapangisa kwambiri momwe mankhwalawo amasankhidwira komanso kusankha kwa mankhwalawa, chifukwa ndikofunikira kuti mankhwalawa amalimbana ndi onse awiri. Ndikosavuta kukwaniritsa zotere, chifukwa chake madokotala akuyesera kusankha mankhwala omwe sanakuze matenda ena kwinaku akupondereza zizindikiro za chinzake.

Zomwe zimathandizira pakukula kwa matenda

Matenda onse a shuga ndi mphumu ndi zina mwa matenda omwe ndiovuta kwambiri kupondereza. Nthawi zambiri, chithandizo chamankhwala chimagwirizanitsidwa ndi kupumula kwa khunyu komanso kupewa kwina.

Mwanjira ina, akatswiri akuyesetsa kuti achulukitse kuchuluka. Pachifukwa ichi, ndikofunikira kudziwa zomwe zimayambitsa matenda aliwonse mwa wodwala aliyense - izi zikuthandizira kuchepetsa zomwe zimapangitsa munthu kukhala ndi vuto.

Zomwe zimayambitsa chitukuko cha mphumu ya bronchial zimaphatikizapo:

• cholowa
• kuchuluka kwa mavuto omwenso amachititsa,
• ma genetic,
• kuzindikira kwa kupuma kothana ndi ngozi zaku chilengedwe,
• kusuta
• kufunika kolumikizana ndi zinthu zapoizoni,
• matenda opatsirana
• zochita za thupi
• kukhudzana nthawi yayitali
• kusowa kwa calcium
• zachilengedwe,
• pachifuwa
• mavuto ndi dongosolo lodziyimira palokha,
• kutopa kwamthupi chifukwa cholimbitsa thupi nthawi yayitali,
• kapangidwe kazinthu zopumira.

Zina mwazinthu zomwe zimayambitsa kupezeka kwa matenda osokoneza bongo ndi:

• zovuta zamafuta,
• cholowa
• matenda a kapamba
• kuchuluka kwa mankhwala ndi kugwiritsa ntchito nthawi yayitali,
• zosintha zokhudzana ndi zaka mthupi,
• zosokoneza pakugwira ntchito kwa endocrine system,
• matenda opatsirana opatsirana
• onenepa kwambiri
• mavuto ndi mtima
• magazi okwanira mafuta m'thupi
• matenda a chithokomiro
• kukhudzika kwa nthawi yayitali, komwe kumapangitsa kuti thupi lizigonja.

Madokotala amati anthu odwala matenda ashuga, mwayi wokhala ndi mphumu ya bronchial ndiwokwera kwambiri. Izi ndichifukwa choti matenda ashuga amatsogolera ku zovuta m'magulu osiyanasiyana komanso machitidwe ndipo amachepetsa thupi, ndikupangitsa kuti azikhala ndi chidwi ndi zinthu zakunja. Zotsatira zake, odwala nthawi zambiri amakhala ndi matenda opatsirana komanso thupi lawo siligwirizana. Nawonso amatha kupangitsa mphumu.

Komanso matenda ashuga amatha kuchitika chifukwa cha kupezeka kwa mphumu mwa wodwala. Musaiwale za zomwe zimachitika chifukwa cha mankhwala. Mankhwala ena omwe amagwiritsidwa ntchito pochizira mphumu ya bronchial angayambitse kusintha kwa pathological, komwe kumayambitsa matenda a shuga mellitus. Chifukwa chake, ndikofunikira kwambiri pakati pa anthu omwe ali ndi mphumu kuti adziwe gulu lomwe lingaike pachiwopsezo kuti asagwiritse ntchito mankhwala oyipa pakuchiritsa kwawo.

Zifukwa zazikulu zomwe zimayambitsa matenda onse nthawi imodzi ndi izi:

• ma genetic,
• mavuto ndi chitetezo chathupi
• zovuta zachilengedwe.

Mawonekedwe amathandizo ndi kuchepetsa ziwopsezo

Chithandizo cha matenda awiri omwe amapezeka palimodzi, amatanthauza zovuta zambiri kuposa chithandizo cha matenda amodzi. Izi zikufotokozedwa ndikufunika kosankha mankhwala mosamala, chifukwa amatha kupondereza zomwe zimayambitsa matenda ena, ndikupitilira winayo. Izi zimayambitsa zovuta mankhwalawa mphumu ovuta ndi matenda a shuga.

Pochiza matenda awiriwa, kudzipatsanso mankhwala oyipa kumakhala koopsa. Mankhwala aliwonse ayenera kuperekedwa ndi dokotala pambuyo pakupenda bwino ndikuganizira za machitidwe onse a munthu. Chifukwa chake, musagwiritsidwe ntchito mankhwalawa osagwiritsidwa ntchito ndi katswiri, ngakhale kuti muthandize kugwirira ntchito. Kuphatikiza apo, munthawi ya chithandizo, kuwongolera madokotala ndikofunikira kwambiri, chifukwa pali mwayi wosintha pamachitidwe pazotsatira zamankhwala.

Ndikofunika kwambiri kulingalira za zizindikiro zotchulidwa kwambiri za matenda onse ndi zomwe zimayambitsa. Koma gawo lofunikira kwambiri ndi mtundu wa matenda.

Ndi matupi amphumo a mphumu, kusamala kuyenera kuchitika posankha mankhwala a matenda ashuga, popeza pamakhala ngozi yoti angawadwalitse. Zotsatira zake zidzakhala kuukira kwina. Chifukwa chake, ndikwabwino kupangira mayeso a ziwengo koma pokhapokha ngati mupeze mankhwala.

Ndi mtundu wodwala wa shuga omwe amadalira insulin, ndikofunikira kupatula mankhwala a glucocorticosteroid, omwe nthawi zambiri amagwiritsidwa ntchito motsutsana ndi mphumu. Amatha kukulitsa chiwonetsero cha matenda ashuga ndikupangitsa zovuta. Chifukwa chake, ndikofunikira ngati ndalama izi siziyikidwa kwathunthu, ndiye kuti muchepetse kugwiritsa ntchito momwe mungathere. Nthawi zambiri glucocorticosteroids amasinthidwa ndi corticosteroids. Ngati kukana kwathunthu sikutheka, ndiye m'malo mwamankhwala, kupuma kumayikidwa ndi thandizo lawo, kotero kuti zinthu zomwe zingayambitse matenda a shuga zilowe m'magazi ambiri.

Kukhalapo kwa matenda akuluakulu awiriwa kumatha kubweretsa zotsatira zoyipa, chifukwa chomwe magwiridwe antchito onse ndi ziwalo zimasintha. Kuti mupewe izi, muyenera kuyesetsa kuti musawononge zovuta za wodwalayo. Pachifukwa ichi, chithandizo ndi kuwongolera kwa madokotala pakusintha kulikonse mthupi nkofunika kwambiri. Koma chosafunika kwenikweni ndi kupewa. Zimaphatikizapo kuzindikira kwa zinthu zoyambitsa ndi kusalolera pazotsatira zawo.

Popeza chitukuko cha mphumu ndi matenda ashuga zimakhudzidwa ndi zochitika zovulaza, moyo wopanda thanzi, komanso chitetezo chofooka, njira zambiri zodzitchinjiriza zimalimbikira makamaka madera awa. Mitu ikuluikulu ndi:

• kusiya kusuta ndi mowa,
• Zakudya zabwino komanso zopatsa thanzi,
• zolimbitsa thupi,
• kutsatira miyezo yoyera,
• kupewe kulumikizana ndi allergen ndi zinthu zoyipa,
• madokotala amawunika momwe chithandizo chikuyendera,
• kutsatira mtima kwa dotolo,
• kulimbitsa thupi
• kudziwitsa odwala za mawonekedwe a matenda, ndi zina zambiri.

Ndikosatheka kuchiritsa mphumu ya bronchial - madokotala amatha kupewetsa matendawa ndikuletsa mavuto. Ngati matenda ashuga amalumikizana nawo, kusamala kowonjezereka kumafunikira, chifukwa chifukwa chake, bwalo la mankhwala lothana ndi zizindikiro za asthmatic limachepa.

Ngati odwala asankha chithandizo cholakwika kapena sakufuna kutsatira malingaliro a dotolo, matendawo akulu kwambiri atha, mwachitsanzo, matenda a mtima (kwa iwo omwe safuna kusiya kusuta).

Kumwa mankhwala osagwiritsidwa ntchito mwanjira iliyonse kungayambitse matenda omwe angakulitse mphumu kapena kusintha kwa shuga, komwe ndi kowopsa kwa matenda a shuga a insulin.

Khalidwe la mphumu ya bronchial

Mphumu ya bronchial ndi matenda osachiritsika omwe amayambitsa kupendekera kwa misewu chifukwa chidziwitso cha ena osokoneza. Zinthu zikuluzikulu zomwe zimadzetsa matendawa ndikupezekera:

1. Makamaka.
2. Zizolowezi zimachitikira.
3. Choyipa.
4. Kusuta.
5. Hypersensitivity ya bronchi kupita kunthawi zakunja (zitha kukhala za bacteria komanso zopanda bacteria).
6. Kuyanjana kwakutali ndi zinthu zapoizoni.
7. Matenda opatsirana ndi ma virus.
8. Zotsatira za mankhwala ena.
9. Kuwonekera pang'onopang'ono.
10. Matenda a bakiteriya.
11. Zosintha zachilengedwe.
12. Kuperewera kwa calcium m'thupi.
13. Hypothermia ya kupuma thirakiti.
14. Kusokonezeka kwa dongosolo la ziwonetsero zamagetsi.
15. Ntchito yayitali komanso yolimba.
16. Kupezeka kwa kuvulala koopsa pachifuwa.
17. Zosintha zowonongeka mu bronchi.
18. Kugwiritsa ntchito kwambiri nyama.

Zizindikiro za mphumu ya bronchial:

1. Masewera olimbitsa thupi.
2. Matenda opatsirana.
3. Matenda a bronchitis
4. Kutsokomola kwokhazikika ndi chizolowezi cholimbitsa usiku.
5. Kukula kwa kupuma movutikira.
6. Mzimba wamakhalidwe womwe umatsatana ndi kupuma ndipo umawonedwa mitundu yayikulu yamatenda.

Makhalidwe a shuga

Matenda a shuga ndi matenda amtundu wa endocrine, omwe amadziwika ndi shuga wambiri, osakwanira kapamba wa pancreatic. Chifukwa cha matenda amtunduwu, kagayidwe kachakudya mu thupi kamasokonezeka ndi kuwonongeka kwa ziwalo zingapo ndi machitidwe. Zomwe zimayambitsa kukula kwa matenda ashuga, endocrinologists zimaphatikizapo:

1. Kubadwa kwa majini (kukhalapo kwa matenda mwa abale apamtima kumawonjezera chiopsezo chotenga ndi 30%).
2. Kuperewera kwa mahomoni.
3. Zowonongeka kwa kapamba.
4. Kudya mankhwalawa kwa nthawi yayitali komanso kosalamulirika.
5. Kugonjetsedwa kwa maselo a beta omwe amapezeka ndi kuphwanya kachitidwe ka kapamba.
6. M'badwo. Malinga ndi ziwerengero, anthu opitilira makumi asanu ndi limodzi ndi omwe amatenga matenda opatsirana.
7. Matenda a endocrine dongosolo.
8. Kunenepa kwambiri, kunenepa kwambiri.
9. Kukhalapo kwa matenda a matenda opatsirana, kumapitilira mwaukali.
10. Matenda oopsa.
11. Cholesterol yayikulu.
12. Matenda a chithokomiro.
13. Kutopa kwam'mimba komwe kumachitika chifukwa cha kusokonezeka kwa malingaliro kapena kukhumudwa kwambiri.

Zizindikiro zazikulu ndi zodziwika za matenda omwe amaperekedwa a endocrine system:

1. Kuchulukitsa chilimbikitso pokodza.
2. Kutheka kwam'madzi.
3. Kumverera kokhazikika kwa kamwa yowuma.
4. Ludzu losatha
5. Mchitidwe wamkamwa, wopanda chifukwa.
6. Kutopa.
7. Kumva kufooka.
8. Kuchepa kwa thupi (m'magawo akulu, pali kuchepa kwa thupi).
9. Kuchuluka kwa mikono ndi miyendo.
10. Furunculosis.
11. Kupweteka mtima
12. Magawo akumva kuyabwa ndi kuwotcha khungu, komanso perineum.
13. Zotupa khungu:
14. Nthawi zambiri zimasinthasintha.
15. Kusintha kwadzidzidzi kwa kuthamanga kwa magazi.

Ubwenzi wa matenda ashuga komanso mphumu

Ngakhale, poyang'ana koyamba, ma pathologies omwe amawunikira ali ndi chikhalidwe chosiyana, pali zinthu zingapo zomwe zimapangitsa mgwirizano wawo. Nthawi zambiri za chitukuko cha mphumu ya bronchial motsutsana ndi matenda osokoneza bongo amadziwika zaka zambiri zapitazo ndipo kuyambira pamenepo pakhala zokambirana zambiri pakati pa asayansi pazomwe zingayambitse izi.

Zotsatira zamaphunziro amakedzana amakono zimathetsa nkhaniyi, kutsimikizira kukhalapo kwa ubale wina pakati pa ma pathologies omwe adawonetsedwa. Choyamba, izi zimachitika chifukwa cha kuchepa mphamvu kwa chitetezo chathupi komanso kusungunuka kwa chitetezo cha m'thupi, zomwe ndizofunikira kwambiri pakubweretsa mphumu komanso matenda a shuga. Komabe, umboni waukulu wokhudzana ndi matendawa ndiwakuti mitundu yomweyo, omwe amadziwika kuti ndi othandizira, anthu omwe amachititsa kuti pakhale chitetezo chamthupi komanso zoyipa, amatenga nawo mbali pa matenda a matenda onsewa.

Kafukufuku wasayansi adachitika, komwe kunali kuwunika mozama ma cell ndikuwonetsa zonse zomwe zimachitika mwanjira yayikulu ya Th1 ndi Th2 pama diabetes ndi asthmatics. Kafukufuku wina adapeza kuti 12,5 peresenti ya milandu yophatikizika ya mphumu ya bronchial kwa odwala omwe ali ndi matenda a shuga amapezeka. Izi ndizizindikiro zokwera kwambiri, zikuwonetsa kukhalapo kwa ubale wabwino pakati pa ma pathologies awiri omwe akuwunikiridwa.

Madokotala akhazikitsa kuti chiwopsezo cha mphumu cha bronchial mwa anthu omwe ali ndi matenda ena a shuga ndiwokwera kwambiri kuposa anthu omwe alibe matenda a autoimmune.

Kodi chimayambitsa matenda ophatikizika ndi chiyani?

Kafukufuku wasayansi awonetsa kuyanjana kwa mphumu ya bronchial ndi matenda a shuga. Komabe, kuti izi zitheke, zina zowonjezera pazofunikanso ndizofunikira. Ndi chizolowezi chofanana nawo:

1. Malo Osiyanasiyana
2. Kukhalapo kwa mtundu wa iatrogenic kapena steroid wa matenda ashuga, nthawi zina, matendawa amatha chifukwa cha kugwiritsidwa ntchito kwa mankhwala a glucocorticosteroid omwe amagwiritsidwa ntchito pochiza mphumu ya bronchial.
3. Kupezeka kwa wodwala, kotchedwa Alstrom syndrome.

Asayansi amadziwa kuti nthawi zambiri, matenda amphumo a bronchial amapezeka mwa odwala omwe ali ndi matenda a shuga 1. Mu shuga yemwe amadalira insulin, ubale wa m'magazi ndi mphumu ya bronchial suwonedwa.

Chipatala ndi Kuzindikira

Dokotala wa endocrinologist amapanga mtundu wa matenda ashuga amtundu 1 molingana ndi zovuta zamatenda a mwana, monga polyuria ndi polydipsia (zizindikiro zimatha kutha ndipo zimawonekera nthawi ndi nthawi). Ngati matendawa sanakhazikitsidwe panthawi, mwana amayamba kuchepa thupi. Khansa ya m'mimba, kupweteka kwam'mimba komanso kusanza - Zizindikiro za ketoacidosis - zingayambitse kuchepa thupi. Hyperglycemia (glucose wothamanga pamwamba pa 6.1 mmol / L kapena 7.8 mmol / L 2 maola atatha kuyesedwa kwa glucose pakamwa) amatsimikizira kupezeka kwa matenda a shuga a mtundu 1. Njira zowonjezera: kukhalapo kwa ma antibodies ena, kuchuluka kwa hemoglobin, chiwopsezo chokhala ndi matenda omwe amadalira insulin, kumathandizira kumveketsa matendawa, ngakhale kusapezeka kwawo sikukukhudzira mwayi wokhala ndi matenda

Popeza matenda amtundu wa 2 wa ana ndi achinyamata nthawi zambiri amakhala asymptomatic, samapezeka kwambiri ali mwana.

Diagnostic muyezo wa mphumu: mbiri ya banja ya atopy (mphumu, atermic dermatitis, pollinosis, matupi awo oopsa (Rhinitis), mbiri yakale yokhala ndi ziwonetsero (monga umboni wa zomwe zimachitika chifukwa cha ziwengo pambuyo pokhudzana ndi nyama, mungu, ndi zina). Mu ana aang'ono omwe ali ndi atopic maziko (nthawi zambiri amagwirizanitsidwa ndi atopic dermatitis), zizindikiro za AD zimatuluka, monga lamulo, pokhudzana ndi matenda oyamba ndi kupweteka kwa mavairasi. M'magulu onse azaka, AD imatha kuwonetsedwa ndi chifuwa chausiku, kukwiya chifukwa cha kulimbitsa thupi, kusintha kwa kutentha kwa mpweya, ndi zina zambiri. Kukhalapo kwa AD kumatsimikizira allergotestration (kuyesa kwa khungu labwino, serologically - kuwonjezeka kwathunthu komanso mwachindunji ma antibodies a IgE).

Kwa odwala asthmatic omwe ali ndi matenda a shuga a steroid, njira yovuta ya mphumu imadziwika, chifukwa chomwe amakakamizidwa kugwiritsa ntchito corticosteroids kwa nthawi yayitali. Pakadali pano, njirayi ndiyopanda maziko ndipo imatsutsana ndi malingaliro amakono othandizira AD. Mankhwala othandizira kupuma kwa mahomoni ambiri ku West, komanso kupatsa mankhwala odwala omwe ali ochulukirachulukira a AD prednisolone omwe ali ndi maphunziro aposachedwa, mosakayikira amathandizira kupewa kukula kwa matenda a iatrogenic Itsenko-Cushing's komanso zovuta zina, kuphatikizapo matenda a shuga.

Kulandila kwa systemic corticosteroids mu Mlingo wambiri kapena maphunziro autali nthawi zambiri kumayambitsa kukula kwa kunenepa kwambiri, komwe, kumapangitsa kuti wodwalayo azolowere kugona usiku kapena kupuma minofu ntchito. Palibe choopsa chilichonse chomwe kunenepa kwambiri kumapangitsa kuti pakhale vuto lalikulu la shuga.

Monga mukudziwira, odwala ambiri omwe ali ndi AD amalabadira bwino mankhwala omwe ali ndi mawonekedwe a corticosteroids, omwe amathandiza kukhazikitsa kuwongolera matendawa nthawi yayitali 16, 19, 20.

1-5% ya anthu onse odwala ndi mphumu, kuwonjezera pamachulukidwe ambiri am'matumbo a corticosteroids, amafunikiranso pakamwa makonzedwe a steroids 16, 20. Komanso, ena mwa odwalawa sangathe kukwaniritsa vuto la bronchodilating komanso kusintha mkhalidwe wamankhwala ngakhale atachitapo kanthu GCS. Odwala oterewa amadziwika kuti ndi anti-steroid. Kutanthauzira kwa "mphumu yolimbana ndi mankhwala opha sodium" adaperekedwa ndi Charmichael J. koyambirira kwa 1981: "Mphumu ya Steroid ndi mphumu pomwe kuchuluka kwake kumakhalitsa mu 1 s (FEV₁) sikuwonjezereka kupitilira 15% poyankha kupuma kwa b-agonist patatha sabata limodzi la 1-2 la pronisolone pa 40 mg / tsiku. ” Odwala omwe ali ndi chiwonjezeko chachikulu cha FEV1, motero, amawonedwa kuti ndiopweteka.

Ngati mawu oti "mphumu osagwira mankhwala a steroid" (kusintha mu FEV₁ Mankhwala osunga ma Steroid

Wambolt et al. sanawonetse chilichonse mwanjira ya chipatala ya asthma yogwiritsa ntchito steroid panthawi yayitali yotsatila kwa ana 34, komabe, ofufuzawo adazindikira kuti kusamvetsetsa kwa GCS mwa odwala kumayenderana ndi kufalikira kwa mtundu woopsa kwambiri wa AD. Malinga ndi wolemba wina, powona odwala 11 omwe ali ndi mphumu yolimbana ndi steroid kwa chaka chimodzi, kuyesedwa ndi inhalation ya b2-agonist atatha 40 mg ya prednisolone anasintha pakapita nthawi, i.e. odwala omwe ali ndi vuto la steroid adayamba kukhala osasamala ndi ena.

Ngakhale izi ndizosowa kwambiri pakati pa odwala mphumu, gulu la odwala ili ndi vuto lalikulu lazachipatala komanso chikhalidwe, popeza, mwachitsanzo, ku West oposa 50% ya mtengo wonse wowongolera AD umagwiritsidwa ntchito pa chithandizo chawo. Ngati timaganiziranso kuti corticosteroid kukana kumadziwikanso ndi odwala omwe ali ndi matenda amitsempha komanso matenda am'matumbo otupa, kufunikira kwachuma komanso zachuma kumamveka bwino.

Anti-asthma mankhwala a shuga

Zotsatira zomwe othandizira othandizira a AD - β-agonists komanso GCS - amakhala nayo pamagazi amadziwika bwino: mankhwalawa amatha kuonjezera kuchuluka kwa shuga m'magazi 26-31. Glucocorticoids imachulukitsa zomwe zili m'magazi ndipo zimathandizira kuphatikizika kwa shuga mkati mwake (gluconeogenesis). Zadziwika kuti salbutamol yopanda magazi imachulukitsa shuga wamagazi komanso mwayi wokhala ndi ketoacidosis mwa odwala omwe ali ndi matenda a shuga 27, 28. Wina wa b-agonist, terbutaline, amakhudza kuchuluka kwa glucagon mwa akulu, komanso kuteteza kwake pakachitika hypctlyalemem yausiku. , 30.

N. Wright ndi J. Wales adawerengera zotsatira za mankhwala othana ndi mphumu pa hypoglycemia ndi kuthekera koongolera glycemia mwa ana omwe ali ndi matenda ashuga 1. Malinga ndi olemba, 12% ya ana omwe ali ndi matenda a shuga 1 amathandizidwanso panthawi yomweyo: onse adatenga β-agonist osachepera 1 pa sabata, ndipo odwala 11 mwa 27 adalandiranso GCS yopuma. Kumapeto kwa kutsatira kwa miyezi 3, kuchuluka kwa hypoglycemia kunali kotsika 20% pagulu la ana omwe amamwa mankhwala othana ndi mphumu (52% motsutsana ndi 72% mwa iwo omwe anali ndi matenda a shuga okha, p.

D. Sh. Macharadze, MD
Ana City Clinic nambala 102, Moscow

Zizindikiro za mphumu

Mphumu ya bronchial ndi matenda osachiritsika omwe amachititsa kuti minyewa ya kupuma isamachepetse.

Zizindikiro za mphumu zikuphatikizapo:

• Pafupipafupi dyspnea, kuvuta kupuma
• Kuchulukana kwammphuno
• Khola lodziwika bwino lomwe limatulutsa chikaso chaching'ono komanso chamadzimadzi, chomwe chimakula usiku ndi m'mawa
• Mphumu
• Kutuluka mlengalenga
• Kufuula kwapadera kwapfuwa kumayendera limodzi ndi kupuma.

Zizindikiro za matenda ashuga

Matenda a shuga ndi amodzi mwa matenda a dongosolo la endocrine, omwe amawonetsedwa ndi shuga wambiri m'magazi chifukwa chopanga insulin ndi kapamba. Matendawa amatenga kuphwanya kwa kagayidwe kokwanira ndipo, monga chotulukapo chake, kuwonongeka pakugwira ntchito kwa ziwalo zamkati ndi kachitidwe ka anthu.

Zizindikiro za matenda ashuga:

• Kukodza pafupipafupi
• Dziko lamatupi amthupi
• Kumva ludzu komanso pakamwa pouma
• Kuchuluka Mitsempha ndi Kusakwiya
• Nthawi zambiri zimasinthasintha
• Kutopa ndi kufooka
• Kudzera m'miyendo
• Furunculosis
• Ululu mumtima
• Kuyenda pakhungu m'malo osiyanasiyana, komanso pa crotch
• Kupsinjika kwa magazi
• Kugunda kwamwambo.

Kupewa

M'masiku ano, pamene njira zolakwika za moyo komanso zizolowezi zoipa zimatsogolera pakuwonjezeka kwakukulu kwa chiwerengero cha odwala, kufulumira kwa moyo wathanzi ndikofunikira. Ndikofunikira kuti muzichita masewera olimbitsa thupi kuti mukhale ndi thanzi labwino, kusiya mowa ndi fodya, kumwa madzi abwino okwanira.

• Sinthani mtundu wa chithandizo
• Fotokozerani anthu omwe ali pachiwopsezo.

Chikhalidwe cha matenda, zizindikiro zawo

Matenda a shuga ndi matenda osachiritsika omwe ali ndi shuga wamagazi ambiri. Mu thupi, insulin yokwanira ndi gawo lomwe limayambitsa shuga m'mimba. Amapangidwa ndi maselo a pancreatic beta. Popeza kusowa kwa timadzi m'magazi, chitetezo cha mthupi chimagwira molakwika ndikuwononga maselo a beta. Komanso, cholowa chamtsogolo ndi chomwe chimayambitsa mwadzidzidzi. Ndipo kuthekera kudwala kumawonjezeka ndi 5% ngati abambo akudwala.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Pangozi ndi ana azaka za 10 mpaka 13 ndi achinyamata mpaka zaka 35, komanso anthu aku Europe ndi North America. Mtundu wa matenda ashuwawa ndiwosavuta kuchiza mukamakula.

Zizindikiro za matenda ashuga

• shuga wamagazi ambiri
• kuwonda
• njala
• ludzu ndi kamwa yowuma
• kugona
• chikhalidwe chosakhazikika,
• kutuluka thukuta kwa ana,
• kukodza kwambiri (nthawi zambiri usiku),
• kusawona bwino
• kuyabwa kwa khungu.

Mphumu imakhalanso ya matenda angapo osakhazikika omwe amachitika pakupuma. Makoma a ziwalo zopanda ntchito, mothandizidwa ndi chilengedwe, amateteza komanso kupumira mwa apo ndi apo. Pangozi ndi anthu omwe ali ndi cholowa chamtsogolo. Kuchita masewera olimbitsa thupi kwa nthawi yayitali komanso kutopa kwambiri kungayambitsenso mphumu.

Tsiku lililonse, m'mayikidwe, munthu nthawi zambiri amakumana ndi utsi wotuluka, mitambo ya utsi wa mafakitale, fumbi ndi mitundu ina ya kuipitsidwa kwa mpweya. Zinthu zoyipa izi zimayambitsanso mphumu. Zimapweteketsanso kusuta, kuphatikizapo kungokhala. Pali kuthekera kwakukulu kofalitsa matenda amphumo m'matenda a bacteria kapena bacteria. Omaliza amachepetsa chitetezo cha mthupi.

Zochitika

Ngakhale ali ndi zoyambitsa ndi zizindikiro zosiyanasiyana, kulumikizana kwachitika. Pa maphunziro a miliri, asayansi adatsimikiza kuti othandizira a T amathandizira pokhudzana ndi minyewa, chitukuko ndi zotsatira za matendawa. Awa ndi ma T-lymphocyte omwe amathandizira kuyankha kwamphamvu kwa chitetezo cha mthupi.

Matendawa a shuga amadziwika ndi othandizira a T-1 (Th1), omwe amathandizira kukulitsa chitetezo chamthupi. Makina a mapangidwe ndi kukula kwa mphumu ya bronchial amaphatikiza ndi T-assisters 2 (Th2), othandizira kukulitsa chitetezo chazirala. Chifukwa chake, munthawi zambiri, othandizira a T ndi omwe amachititsa kuti pakhale kulumikizana pakati pama cell ndi zonyansa. Kufanana kwa maselo a Th1 ndi Th2 kunawululidwanso mwa odwala matenda a shuga komanso mphumu ya bronchial. Palibe chifukwa chotsimikizirira izi.

Kukhalapo kwa matenda ashuga sikumapatula mwayi wokhala ndi mphumu ya bronchial, koma, ndichinthu chofunikira kwambiri. Kafukufuku watsimikizira kuti odwala matenda ashuga ali ndi mwayi wambiri wokhala ndi mphumu.

Chiyambi

Kuphatikizika kwa matenda onsewa kumawonetsedwa ndi kuwonongeka kwa chitetezo cha m'thupi, komanso kukhudzika kwakunja (mungu, tsitsi la nyama, ndi zina). Zotsatira zotsatirazi zomwe zimatchedwa kuti zothandizira ndi matenda opatsirana. Anthu omwe ali ndi matenda a shuga amatha kupeza mphumu kuposa omwe alibe matenda a autoimmune.

Palinso kuthekera kwatsatanetsatane - matenda ashuga amayamba chifukwa cha mphumu ya bronchial. Kuti tipewe kudzutsidwa mosazindikira kwa matenda ena kudzera pachiwopsezo cha matenda ena, ndikofunikira kuzindikira gulu lowopsa komanso mankhwala omwe angayambitse chidwi. Kupangika kwa matenda awiri nthawi imodzi kumatha kuphatikizira mtundu 1 wa matenda ashuga ndi mphumu. Milandu yophatikizira ndi matenda a shuga a 2 ndiyosowa kwambiri.

Kodi amathandizira bwanji?

Kuphatikiza kwa matenda ashuga ndi mphumu ndi ntchito yovuta kuchiza. Zimafunikira kuwunikidwa pafupipafupi ndi dokotala ndikuwonetsetsa tsiku lililonse zizindikiro ndi kusintha kwawo. Chithandizo cha matenda mwa wodwala chimaphatikizapo kupatula mankhwala omwe angakhudze kwambiri kapena angathandizire kukulitsa zovuta.

Njira ina

Mlingo wa mankhwala a mahomoni nthawi zina umachepetsedwa. Ntchitoyi imafunikira njira yokwanira komanso payekha. Makamaka, mankhwalawa amakhudzidwa, osati kufinya. Amawerengedwa ngati maziko othandizira matenda amphumu. Tsoka ilo, zimayambitsa chiwonetsero komanso kuchuluka kwa matenda ashuga. M'malo mwake gawo la glucocorticosteroids ndikupumira. Zimakhudza thupi sizolimba kwambiri. Nthawi zina, kukana kwathunthu kwa mankhwala a mahomoni sikukhudza njira ya mphumu ya bronchial, koma njira zotere ndizotheka ndi kuvomerezedwa ndi dokotala.

Kusasamala komanso kopanda vuto kumaonedwa kuti ndi magazi omwe amamwa magazi ochepa. A nebulizer amathandizira pakuwongolera mphumu - chipangizo cha inhalation chomwe chimatembenuza mankhwala kukhala aerosol. Imalowa mkati mozama komanso moyenera mu njira yopumira, imagwira m'malo ena (kumtunda, pakati, kutsika). Chipangizocho chikugulitsidwa mwaulere m'masitolo ogulitsa mankhwala ndi zida zamankhwala.

Ndikofunikira kudziwa kuti ndizosatheka kuchiritsa mphumu ya bronchial. Njira zokhazo zopewera komanso kuwongolera mwadongosolo ndizomwe zilipo.

Wodwala ali ndi gawo lofanananso ndi mankhwalawa, osati dokotala yekha. Kusintha ndikuwongolera ndondomekoyi, ndikofunikira kusunga zolemba zomwe zimasungidwa pafupipafupi komanso nthawi yayitali. Kuphatikiza apo, ndikofunikira kuti musaiwale za kuchita masewera olimbitsa thupi komanso kukhala ndi moyo wathanzi womwe umaphatikizapo kusuta fodya komanso kudya mopitirira muyeso, komanso kudziwitsa adotolo za zomwe zasinthazo.

Zimayambitsa chitukuko ndi zizindikiro za matenda ashuga

Chimodzi mwazomwe zimayambitsa matenda ashuga, makamaka mtundu woyamba ndi cholowa chamtsogolo, kupezeka kwa matenda ashuga kwa makolo kumawonjezera mwayi wokhala ndi mwana wopitilira 40 peresenti.

Kwa mtundu wa 1 shuga mellitus, palinso kulumikizana ndi matenda akale opatsirana kapena autoimmune. Matenda a shuga amatha kukhala vuto la chotupa cham'mimba chifukwa chotupa kapena njira yotupa.

Kupsinjika kwa Psychoemotional, komanso matenda a endocrine system - chithokomiro cha chithokomiro, tiziwalo timene timatulutsa timadzi tambiri kapena gland pituitary, zimayambitsa kusalinganisika kwakukhalitsa kwa mahomoni m'thupi ndi kukulitsa zomwe zili ndi mahomoni otsutsana m'magazi.

Mtundu wachiwiri wa shuga wosadalira insulini nthawi zambiri umayamba pazifukwa izi:

• Mwa anthu pambuyo pa zaka 45
• Ndi onenepa kwambiri, makamaka m'mimba mtundu wa kunenepa kwambiri.
• Atherosclerosis, cholesterol yayikulu ndi dyslipidemia.
• Matenda oopsa.
• Kumwa mankhwala - mahomoni, beta-blockers, thiazide diuretics.

Pozindikira mtundu 1 wodwala matenda am'mimba, zizindikilo zambiri zimawerengedwa: kufooka, kukodza pokodza, kuchuluka kwamkodzo kwamkati usiku, kuwonda. Kuchulukitsa kukopa kumadziwika. Odwala amamva ludzu pafupipafupi komanso pakamwa lowuma, lomwe silimatha madzi akumwa.

Mantha nthawi zonse, kusintha kwa kusinthasintha, komanso kusakwiya, komanso kutopa ndi matenda a shuga. Amawonetsa kuchepa kwa glucose m'maselo aubongo, monga gawo lovuta kwambiri pakuperewera kwa zakudya m'thupi.

Kuchuluka kwa glucose m'magazi kumayambitsa kuyabwa kwa khungu ndikusokosera kwa mucous nembanemba, kuphatikiza pa perineum. Kuphatikizidwa kwa matenda oyamba ndi fungus m'njira ya candidiasis kumathandizira chizindikiro ichi.

Kuphatikiza apo, odwala matenda a shuga amadandaula za dzanzi kapena kuyabwa kwa mapazi ndi manja, zotupa za pakhungu, furunculosis, kupweteka kwa mtima komanso kusinthasintha kwa magazi.

Ngati zizindikirozo zimachitika mwadzidzidzi ndipo zimatha, ndiye kuti matendawa amatha kuchedwa - panthawi yopanga zovuta (ketoacidosis).

Odwala omwe ali ndi shuga wambiri, nseru, kusanza komanso kupweteka kwam'mimba kumawonjezereka, fungo la acetone limawonekera mu mpweya wotopa, ndi ketoacidosis yayikulu, chikumbumtima chimalephera, wodwala amagwa chikomokere, limodzi ndi kukomoka komanso kusowa kwamphamvu m'mimba.

Kuti muwonetsetse ngati mukudwala matenda ashuga, kuyezetsa magazi kwathamanga kumachitika - ndimatenda a shuga, glucose ndi okwera kuposa 6.1 mmol / l, mukamagwiritsa ntchito mayeso ololera a glucose maola 2 mutatha kuchita masewera olimbitsa thupi, amaposa 7.8 mmol / l. Kuphatikiza pa izi, ma antibodies enieni, glycated hemoglobin, amayesedwa.

Mikhalidwe ndi zizindikiro za mphumu ya bronchial

Mphumu ya bronchial imachitika ndi kuphipha kwa thirakiti la kupuma mothandizidwa ndi ena akhungu. Imakhala ndi chibadwa chomwe chimapangitsa kukula mwa chikhalidwe chamtundu wamtundu wamtundu wamalingaliro oyipa.

Zimatha kuputa utsi, kuchepa kwa bronchi kutha kwa mpweya ndi mpweya, mpweya wampweya, zotulutsa zotulutsa mafakitale. Mpweya wa mphumu umakonda kupezeka pambuyo pa matenda a bacteria kapena bacteria, hypothermia, kulimbitsa thupi kwambiri, komanso kuvulala pachifuwa.

Chizindikiro chofanana cha mphumu ndi chifuwa chokhala ndi vuto la mphumu, kupuma movutikira, kumenya likhweru ndi kugudubuza kwa bronchi.

Pa mphumu ya bronchial, zizindikiritso zofunika ndiz:

1. Matenda am'banja (mphumu, dermatitis ya atopic, hay fever, rhinitis).
2. Kupezeka kwa ziwengo pambuyo polumikizana ndi zomera kapena nyama, ndi matenda opuma.
3. Kudwala chifuwa ndi mphumu kumakhala koipa usiku, mutatha kulimbitsa thupi, kusintha kwanyengo.

Mphumu ya bronchial mu shuga imachitika nthawi zambiri ndi mtundu woyamba, wodalira insulini. Palibe kuyanjana komwe kunapezeka pakati pa matenda amtundu wa 2 komanso vuto la mphumu.

Mpweya wa Steroid-Resistant ndi shuga

Odwala omwe ali ndi mphumu omwe apezeka ndi matenda a shuga a steroid, nthawi ya mphumu imakhala yolimba kwambiri, ndicho chifukwa choikidwiratu a acidic acid. Kugwiritsa ntchito mankhwala okwera kapena kwa nthawi yayitali kumabweretsa kunenepa kwambiri. Kuonjezera thupi kungayambitse ziphuphu usiku kapena kuvuta kutsokomola. Kunenepa kwambiri kumachulukitsanso mawonetseredwe a shuga.

Odwala ambiri omwe ali ndi mphumu ya bronchial, amatha kuchepetsa kukomoka ndi mankhwala osokoneza bongo a glucocorticosteroid. Mwa odwala ena, izi sizimapereka kufunika kwa mawonekedwe a kukulira kwa bronchi, ngakhale mutagwiritsa ntchito ma steroid mkati kapena mawonekedwe a jakisoni.

Odwala oterewa amadziwika kuti ndi antiid. Kukana kwa Steroid kumawerengedwa ngati kutsimikizika kwakunyamuka mu 1 s (monga kuyerekezera ndi spirometry) - FEV 1 imachulukanso kuposa 15% pakumapuma kwa betamimetic mutatenga 40 mg ya prednisolone patsiku kwa sabata limodzi.

Pozindikira matenda amphumo a steroid, ziyeso zotsatirazi ziyenera:

• Kuwerenga kwa ntchito yam'mapapo ndi index ya Tiffno.
• Khazikitsani index yowonjezera ya bronchial pambuyo pa 200 mcg ya salbutamol.
• Chitani kafukufuku wa histamine.
• Ndi bronchoscopy, onani kuchuluka kwa ma eosinophils, cytology ndi biopsy ya bronchi.
• Pambuyo pa milungu iwiri mutamwa Prednisolone, bwerezaninso mayeso azidziwitso.

Kusintha kumeneku kwa matenda a mphumu ya bronchial kumadziwika ndi kuukira pafupipafupi komanso kowopsa komwe kumafuna kuti agonekere kuchipatala, kuphatikiza m'malo opulumutsa kwambiri, kuchepa kwa moyo.

Chifukwa chake, odwala oterowo, kuphatikiza pakumapuma kwa ma steroid, amagwiritsidwa ntchito pakamwa kapena jakisoni. Chithandizo chotere chimayambitsa matenda a shuga a Itenko-Cushing komanso matenda a shuga. Nthawi zambiri, azimayi azaka zapakati pa 18 ndi 30 amadwala.

Mbali zakuchiritsa mphumu ku matenda ashuga

Vuto lalikulu la kuchiza matenda amphumu m'matenda a shuga ndi kugwiritsa ntchito mankhwala omwe ali ndi vuto linalake, chifukwa beta-receptor zolimbikitsa mu bronchi ndi systemic corticosteroids zimawonjezera shuga.

Glucocorticosteroids amachulukitsa kuphwanya kwa glycogen ndi mapangidwe a shuga m'chiwindi, betamimetics amachepetsa insulin sensitivity. Salbutamol, kuwonjezera pakukula kwa shuga wamagazi, imawonjezera chiopsezo cha zovuta monga matenda ashuga a ketoacidosis. Chithandizo cha Terbutaline chimakweza shuga mwakuchulukitsa kupangika kwa glucagon, womwe ndi wotsutsana ndi insulin.

Odwala omwe amatenga mankhwala opatsirana a beta monga ma inhalation samakhala ndi vuto la hypoglycemia kuposa omwe amagwiritsa ntchito mankhwala a steroid. Ndiosavuta kwa iwo kukhala ndi shuga wokhazikika m'magazi.

Chithandizo ndi kupewa zovuta za mphumu ndi matenda a shuga zimakhazikitsidwa motengera mfundo izi:

1. Kuwonedwa ndi endocrinologist ndi pulmonologist, omwe amaganiza.
2. Zakudya zoyenera komanso kupewa kunenepa kwambiri.
3. Kusungabe zolimbitsa thupi.
4. Kuwongolera kwambiri kwa shuga m'magazi mukamagwiritsa ntchito ma steroid.

Kwa odwala ndi mphumu ya bronchial, kusiya kusuta kwathunthu ndikofunikira, popeza izi zimayambitsa pafupipafupi kukomoka ndipo zimayambitsa kuphwanya kwa magazi, vasospasm. Mu shuga mellitus, mu nyengo ya angiopathy, kusuta kumawonjezera mwayi wokhala ndi matenda am'mimba, matenda a mtima, chiwonongeko cha impso komanso kulephera kwa aimpso.

Kuti mupeze mankhwala a glucocorticosteroids m'mapiritsi okhala ndi matenda a shuga ndi chifuwa cha bronchial, payenera kukhala ndizowonetsa. Izi zimaphatikizapo kugwidwa kwa mphumu pafupipafupi komanso kosalamulirika, kusowa kwa mphamvu kuchokera kugwiritsidwa ntchito kwa ma steroid pakupuma.

Kwa odwala omwe adalembedwa kale kukonzekera kwa glucocorticoid m'mapiritsi kapena amafuna kuchuluka kwa mahomoni, makonzedwe a prednisolone akuwonetsedwa osaposa masiku khumi. Kuwerengera mlingo kumachitika pa kilogalamu ya kulemera kwa thupi patsiku, osaposa 1-2 mg pa kg.

Chifukwa chofala kwambiri chachitukuko cha matenda a shuga a steroid ndi zovuta za matenda omwe alipo ndikuwikidwa kwa mankhwala a steroid omwe amatha kupanga depot m'thupi. Mankhwalawa amachepetsa magwiridwe amtundu wa adrenal; sangathe kutumikiridwa kwakanthawi kochepa. Mankhwalawa ndi monga: Dexamethasone, Polcortolone ndi Kenalog.

Ubwino wogwiritsa ntchito mphumu ndi matenda a shuga ndi:

• Chidakwa chophatikizika bwino kwambiri chomwe chili ndi ma steroid ndi Budesonide. Itha kugwiritsidwa ntchito mwa ana ndi akulu, komanso kwa amayi apakati.
• Pulmicort mwanjira ya nebul ikhoza kugwiritsidwa ntchito kuyambira chaka chimodzi, yogwiritsidwa ntchito kwa nthawi yayitali, yomwe imakulolani kukana mapiritsi a Prednisolone. Ufa wowuma mu turbuhaler amalembedwa kuchokera zaka 6.
• Kuchiza ndi fluticasone propionate mu nebulas kumatha kutenga mawonekedwe a monotherapy ndipo sikutanthauza kupatsidwa mankhwala ena mwatsatanetsatane.

Mukamawerengera mphamvu yamagetsi amtundu wa ultraviolet popewa kukula kwa matenda omwe ali ndi vuto la chitetezo cha mthupi, zidapezeka kuti kupangidwa kwa vitamini D pakhungu kumachepetsa chiopsezo cha matenda a shuga. Chifukwa chake, ana osakwana chaka chimodzi omwe amamwa vitamini A kuti alepheretse kuchuluka kwa matenda ashuga sazindikira kuti ali ndi matenda ashuga.

Vitamini D akuwonetsedwa kwa odwala onse omwe amatenga prednisolone kuti apewe matenda a mafupa, omwe nthawi zambiri amakhala zotsatira zoyipa za steroids.

Pofuna kupewa zovuta za matenda ashuga matenda a mphumu, odwala amalangizidwa kuti azitsatira zakudya zomwe zimaletsedwa pang'ono ndi zakudya zomwe zingayambitse thupi.

Kuwunikira pafupipafupi kuchuluka kwa kagayidwe kazakudya komanso kusintha kwa mankhwalawa pakapangidwe ka glucocorticoids ndikofunikira. Ndikofunika kugwiritsa ntchito njira ya inhalation yoyendetsera, ndipo ngati kuli kotheka, chitani chithandizo cha mankhwala a prenisolone mwachidule. Kuti muwonjezere zolimbitsa thupi, zolimbitsa thupi zolimbitsa thupi ndi masewera olimbitsa thupi polimbikitsidwa ndi shuga. Vidiyo yomwe yatchulidwa m'nkhaniyi idzafotokoza chifukwa chake mphumu ndiopsa ku matenda ashuga.