Glucocorticosteroids ndi momwe zimakhalira ndi shuga

Mutha kukhala kuti mukudziwa chidziwitso chachikulu: matenda ashuga amatha kuyamba chifukwa cha mankhwala! Inde zingathe. Osadandaula, sitikulankhula za mitundu yokhazikika ya matenda ashuga - T1DM ndi T2DM. Mankhwala ena amakweza shuga m'magazi. Lero tikambirana za mankhwala omwe amagwiritsidwa ntchito kwambiri kuchokera munkhanizi - glucocorticoids.

Glucocorticoids (nawonso ndi glucocorticosteroids) ndi mahomoni a adrenal. Thupi lathu limafunikira ma glucocorticoids kuti athe kupirira kupsinjika - osati kugwedezeka kwamalingaliro kapena ntchito yamanjenje, komanso kupsinjika pakugwira ntchito, kuvulala, matenda akulu, ndi zina zambiri. Kuphatikiza apo, glucocorticoids akhoza:

Kuchepetsa kutupa,
Menyani ziwengo
Ponderezani zochitika za chitetezo chamthupi.

Chifukwa cha izi, glucocorticoids amagwiritsidwa ntchito kwambiri, ndipo nthawi zina sangachitike m'malo:

Ndi kusakwanira kwa adrenal - ochepa magawo awo mahomoni,
M'matenda oyamba (mwachitsanzo, nyamakazi yokhala ndi nyamakazi komanso zokhudza zonse lupus erythematosus),
Ndi zovuta zomwe zimakhudzidwa (mwachitsanzo, mphumu ya bronchial kapena edema ya Quincke),
Poika ziwalo ndi minofu,
Panthawi yadzidzidzi.

Kutengera ndi matendawa, glucocorticoids amamuyamwa kwambiri (madontho amaso, ma inhalers, mafuta opaka) kapena mwadongosolo (mapiritsi, mayankho a jakisoni), pakanthawi kochepa kapena mosalekeza. Glucocorticoids ndi mankhwala othandiza kwambiri, koma mwanjira zawo amakhala ndi zotsatira zosafunikira zambiri. Tikhazikike pa zofunikira kwambiri kwa ife - kuchuluka kwa shuga.

Tazindikira kale kuti glucocorticoids ndi mahomoni opsinjika. Hypoglycemia, monga mukudziwa, imakhalanso nkhawa kwa thupi, ndipo glucocorticode amayimitsa hypoglycemia ndikuwonjezera shuga. Iyi ndi njira yofunika kwambiri yomwe imagwira ntchito kwa munthu aliyense. Mukalandira chithandizo cha glucocorticoids, kuchuluka kwa mahomoni kumapitilira malire omwe amakhala achilengedwe, ndipo kuchuluka kwa glucose kumakwera pafupifupi pafupifupi 50% yamilandu. Pa nthawi yomweyo, kukana kwa insulin kumachulukana, komwe kumafanana ndi matenda a shuga a mtundu 2.

Zotsatirazi zoopsa zomwe zimayambitsa matenda a glucose kagayidwe ka mankhwala a glucocorticoids zimasiyanitsidwa:

Mlingo waukulu wa mankhwalawa.
Chithandizo cha nthawi yayitali
Ukalamba
Kunenepa kwambiri komanso kunenepa kwambiri,
Kulolerana shuga
Matenda a shuga m'mbuyomu
Mtundu wa shuga wachiwiri kwa abale apamtima.

Kwa anthu omwe ali ndi matenda osokoneza bongo omwe amakhalapo kale, ngakhale atakhala ndi chithandizo chochepa cha glucocorticoid, kuchepetsa shuga kumawonjezeka. Koma musadandaule! Chachikulu ndikusintha mankhwalawa ndi dokotala ndipo shugayo abwerera mwakale.

Pakati-nthawi yayikulu glucocorticoids (prednisone, methylprednisolone) imakulitsa shuga mkati mwa maola 4-8 pambuyo pakulowetsa. Ma glucocorticoids omwe atenga nthawi yayitali (dexamethasone, betamethasone) amatha kukhala ndi shuga wambiri mpaka maola 24. Kukula kwa shuga m'magazi kumafanana ndi mlingo wa mankhwalawa - kuchuluka kwake, kumakulitsa shuga.

Inde, ndikofunikira kwambiri kwa anthu omwe ali ndi matenda ashuga komanso omwe ali pachiwopsezo pakukula kwake kuti athe kuwongolera kuchuluka kwa shuga m'magazi pochiza ndi glucocorticoids. Ngati mulibe matenda ashuga, zidzakhala zokwanira kuyeza kuchuluka kwa shuga patsiku limodzi, makamaka musanadye nkhomaliro kapena chakudya chamadzulo. Ngati muli ndi matenda a shuga, muyenera kuyeza shuga kangapo patsiku (komanso kangapo ndi mankhwala a insulin!).

Matenda a shuga akamayamba kumwa glucocorticoids, njira zozindikira sizimasiyana ndi zomwe zimachitika masiku onse: 7 mmol / L ndikukwera pamimba yopanda kanthu ndi 11.1 mmol / L ndi maola awiri atatha kudya. Ngati manambala otere adakhazikika, ndikofunikira kuti ayambe kulandira chithandizo cha hypoglycemic.

Mankhwala a glucocorticoid akamalizidwa, mankhwala osokoneza bongo nthawi zambiri amatha. Koma ngati pali zovuta zomwe zingachitike, matenda a shuga a glucose amatha kupitiliza kukhala ndi matenda ashuga a 2.

Pharmacological katundu, mawonekedwe, zikuwonetsa, malire

Dexamethasone ndi glucocorticosteroid mahomoni, chifukwa chake amakhala ndi anti-yotupa, immunosuppressive, anti-allergic, ndipo amalimbikitsa chidwi cha β-adrenergic receptors ku katekisimu. Dexamethasone amathandizira kuti pakhale zovuta zomwe zimapangitsa kapangidwe ka mamolekyulu a protein. Mothandizidwa ndi mankhwalawa, mapangidwe a mapuloteni am'madzi am'magazi ndi albumin m'chiwindi ndi minyewa ya impso amalimbikitsidwa. Amawongolera mapangidwe a masipulini a lipid. Maselo amafuta amapangika makamaka kumaso, lamba, komanso pamimba. Mlingo wa cholesterol m'magazi umakwera.

Kuchita kwa Dexamethasone pa shuga m'magazi ndi motere: kumalimbitsa mayamwidwe a shuga m'magawo am'mimba, kumawonjezera kuchuluka kwa shuga m'magazi, kumawonjezera mapangidwe a michere ya chiwindi, chifukwa cha kukondoweza kwa glucogeneis, zimathandizira kukulitsa kwa hyperglycemia (shuga wowonjezera).

Dexamethasone amachepetsa calcium zomwe zimakhala m'mafupa, amachepetsa kutulutsa kwamadzi ndi sodium kuchokera m'thupi. Mankhwalawa amachepetsa kutupa kudzera pakuchepetsa kapangidwe ka zotupa za cytokines, leukotrienes, macrophages ndi ma cell ena chitetezo. Imakhazikika kupezeka kwa ma membrane am' cell, komanso zigawo za intracellular. Imalepheretsa ntchito ya maselo a T ndi B a chitetezo chathupi. Amachepetsa kaphatikizidwe kamankhwala osokoneza bongo. Chimalimbikitsa kumasulidwa kwa maselo am'mimba omwe amapanga hyaluronic acid, histamine.

Kuchepetsa kutupa kwa mucous nembanemba wa bronchi, kumachepetsa mapangidwe a ntchofu mu lumen wa bronchi ndi bronchioles, pang'onopang'ono kuchepetsa sputum. Amalepheretsa katulutsidwe wa adrenoglucocorticosteroid timadzi. Kagayidwe kachakudya kamadutsa m'chiwindi. Amatulutsidwa kudzera mu mkodzo. Dexamethasone amatha kuwonjezera magazi.

Mankhwala amapangidwa jekeseni ndi jekeseni. Ampoules okhala ndi yankho amatulutsa voliyumu ya 1 ndi 2 ml. 1 ampoule (2 ml) ali ndi 8 mg ya Dexamethasone, ampoule (1 ml) - 4 mg ya mankhwalawa. Piritsi 1 ili ndi 0000% g ya chinthu.

Zofooka

systemic pathologies (lupus erythematosus, matenda amitsempha, dermatomyositis, scleroderma),
matenda aubwana ndi akulu,
zinthu zoyipa
matenda a pakhungu
ubongo edema (chotupa, zoopsa, zoyambira opaleshoni, atalandira chithandizo cha radiation),
matenda a maso a ziwengo, kutupa etiology,
ntchito yovuta ya adrenal gland, adrenal hyperplasia,
autoimmune aimpso matenda (glomerulonephritis, nephrotic syndrome),
chithokomiro
matenda a hematopoietic dongosolo (magazi m'thupi, leukemia),
pulmonary pathologies (mphumu ya bronchial, sarcoidosis, fibrosis, alveolitis),
chifuwa chachikulu cha m'mapapo, ubongo,
khansa kuwonongeka m'mapapo
matenda am'mimba a m'matumbo (matenda a Crohn, enteritis, ulcerative colitis),
multiple sclerosis
hepatitis (komanso autoimmune),
kuchuluka kwa calcium m'magazi pa oncopathologies,
kupewa kukula kwa kufalikira kukana (pamodzi ndi mankhwala ena),
myeloma
Pochita mayeso a matenda osiyanasiyana a adrenal oncology,
zinthu zadzidzidzi.

matenda opatsirana
magazi owopsa amachokera ku mankhwala,
Hypersensitivity mankhwala
mafupa
arthrosis wopunduka,
Katemera
pambuyo infaration mkhalidwe
Hyperlipidemia,
matenda ashuga
matenda a mafupa
chiwindi ndi impso.

Dexamethasone ali ndi zotsatira zoyipa zambiri zomwe zimayenera kuganiziridwa pochiza odwala.

Zosafunika zotsatira za mankhwalawa:

Itsenko-Cushing's syndrome,
arrhythmias
dyspepsia
matenda oopsa
delirium, euphoria,
mavuto azachuma,
kukula kwa mafupa mwa ana,
ziwengo ndi zina.

Kodi dexamethasone amakhudza bwanji kagayidwe kazakudya

Kodi Dexamethasone Amakweza Mwazi? Mankhwala amatha kupititsa patsogolo shuga mkati mwa khoma lamatumbo. Mukadziwika ndi mankhwalawa, ntchito ya enzyme glucose-6-phosphate imayambitsa. Ma enzyme amenewa amathandizira kuthamanga kwa shuga kuchokera m'chiwindi kulowa m'magazi. Pambuyo pa izi, katulutsidwe ka michere ya chiwindi kumatheka. Njira izi zimatsogolera kukhazikitsidwa kwa gluconeogeneis mu minofu ya chiwindi, chomwe ndi chifukwa chowonjezera shuga.

Pogwiritsa ntchito Dexamethasone wodwala yemwe ali ndi matenda ashuga, misempha ya magazi imakwera msanga kwambiri. Mkulu shuga angayambitse kukomoka kwa hyperglycemic. Akuwopseza moyo kwambiri. Pankhaniyi, wodwala amafunika kuthandizidwa.

Ngati wodwala ali ndi kuphatikiza kwa matenda ashuga komanso matenda ena omwe amafunikira chithandizo chamankhwala ndi glucocorticosteroid mahomoni (GCS), ndiye kuti chithandizo chimayikidwa mu maphunziro apafupi. Mankhwalawa amachitidwa moyang'aniridwa ndi dokotala, komanso motsogozedwa ndi kuyesedwa kwa magazi kwa shuga. Ndi kuwonjezeka kwambiri kwa shuga m'magazi, chithandizo chake chiyenera kuchitika.

Pomaliza

Amayesetsa kuti asagwiritse ntchito dexamethasone pa matenda ashuga, chifukwa zimachulukitsa shuga m'magazi. Kugwiritsira ntchito kosalekeza kwa corticosteroids kungayambitse matenda a shuga. Ndizovomerezeka kugwiritsa ntchito mankhwalawa matenda a shuga, koma pokhapokha ngati chithandizo china sichikuthandizani. Ndikwabwino m'malo mwa Dexamethasone ndi yothandiza. Kupezeka kwa matenda a shuga a shuga (shuga m'magazi) kumapangitsa kwambiri matenda ambiri, zovuta zomwe zimaphatikizapo Dexamethasone. Chifukwa chake, lero, madokotala amalimbikitsa kukhala ndi moyo wathanzi kuti muchepetse matenda obwera chifukwa cha matenda ashuga.

Vidal: https://www.vidal.ru/d drug/dexamethasone__36873
Radar: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGu>

Mwapeza cholakwika? Sankhani ndikusindikiza Ctrl + Lowani

Contraindication kugwiritsa ntchito mankhwalawa

Zikuwonekeratu kuti, monga mankhwala ena aliwonse, mankhwalawa amakhalanso ndi zotsutsana. Mwachitsanzo, singagwiritsidwe ntchito ngati pali chida china chopanga mphamvu.

Chifukwa choletsa kulandira mankhwalawa chingakhale mtundu wina wa matenda. Izi zimachitika kawirikawiri ngati mankhwala osagwirizana ndi antimicrobial sagwiritsidwa ntchito nthawi yamatendawa. Kugwiritsa ntchito mankhwala amodzimodzi munthawi yomweyo katemera woletsa matendawa nkoletsa.

Ngakhale tikakambirana zonse zomwe zingachitike contraindication, chofunikira kwambiri ndichidziwitso cha hypersensitivity. Nthawi zina, kugwiritsa ntchito mankhwalawa ndi kwabwino kwambiri. Ndipo kuweruza ndi zomwe zikuwonetsa ntchito, mankhwalawa amalembedwa pafupifupi nthawi zonse, ngakhale atakhala kuti akuphwanya.

Ponena za nthawi ya katemera, ndibwino kukana chithandizo ngati wodwalayo adalandira katemera wa BCG, monga ngati masabata asanu ndi atatu sanadutse kuyambira lero.

Mosamala, muyenera kugwiritsa ntchito mankhwalawa pamene wodwala ali ndi kachilombo ka HIV kapena Edzi.

Mndandanda wa contraindication umaphatikizanso shuga. Komanso mavuto ena ndi dongosolo la endocrine la anthu.

Mndandanda wathunthu wa contraindication ungakhale wosavuta kupeza malangizo a mankhwalawo.

Ndikufuna kukhala mwatsatanetsatane pa chithandizo cha matenda osiyanasiyana ndi mankhwala osapatsirana omwe amaletsa odwala matenda ashuga. Zakhala zikunenedwa pamwambapa kuti zinthu zomwe zimapanga mankhwalawa zitha kuthandiza kuwonjezera kuchuluka kwa shuga m'magazi.

Izi ndichifukwa choti insulin synthesis imaponderezedwa m'thupi mutatha kumwa mankhwalawo. Chifukwa chake, osavomerezeka kuti agwiritsidwe ntchito ndi wodwala yemwe ali ndi matenda a shuga a mtundu wachiwiri.

Koma zikafika kwa odwala omwe ali ndi mtundu woyamba wa matenda ashuga, chithandizo ndi mankhwalawa ndizotheka kuyang'aniridwa ndi dokotala.

Malangizo apadera ogwiritsa ntchito

Choyambirira kudziwa ndichakuti mankhwalawa akumwa mankhwalawa amawonjezera kuchuluka kwa shuga m'magazi. Chifukwa chake, odwala matenda a shuga ayenera kugwiritsa ntchito mankhwalawa mosamala kwambiri. Mankhwalawa amachitika moyang'aniridwa ndi achipatala mosamala kwambiri ngati mufunika shuga, ngati kuli kotheka, kuwonjezeka kwa mankhwala ochepetsa shuga.

Monga tafotokozera pamwambapa, a Dexamethasone samalimbikitsidwa kuti azigwiritsidwa ntchito pamaso pa zovuta zina zamatenda osiyanasiyana. Izi zimachitika nthawi zambiri pomwe wodwala amakhala ndi chitetezo chochepa kwambiri.

Mwachitsanzo, izi zitha kuchitika pakukula kwa matenda opatsirana ngati chifuwa chachikulu kapena Edzi. M'magawo onse awiri, ndikofunikira kugwiritsa ntchito mankhwala a immunostimulating ofanana ndi mankhwalawa, komanso omwe ali ndi vuto la antimicrobial.

Dziwani kuti mutatha kulandira chithandizo kwa nthawi yayitali ndi mankhwala omwe ali pamwambawa, monga kwa milungu itatu kapena kupitilira apo, ndikofunikira kusiya mankhwalawa pang'onopang'ono. Kupanda kutero, pali kuthekera kwakukulu komwe kusowa kwachiwiri kwa adrenal kungayambire.

Ngati ana amathandizidwa, ndikofunikira kuti azindikire kukula kwa thupi lawo. Makamaka pankhani ya chithandizo cha nthawi yayitali, kwa miyezi ingapo kapenanso chaka.

Ndikofunika kusintha zakudya zanu mukamamwa. Ndikwabwino kusankha zakudya zomwe zimakhala ndi potaziyamu yambiri. Ndipo, zoona, pazonse, chakudya chimayenera kukhala chathanzi komanso chokhala ndi mavitamini ambiri.

Ndikofunikanso kuwunika momwe wodwalayo alili ngakhale atasiya kulandira chithandizo. Kwakati kwatsala chaka chimodzi kuti amalizirane mankhwalawo, kuyezetsa pafupipafupi kumayenera kuchitika kuti kupatula mwayi womwe ungayambirenso.

Zokhudza chithandizo cha mankhwalawa panthawi yomwe muli ndi pakati, ziyenera kukhala mosamala kwambiri poyandikira mankhwalawa. Pokhapokha ngati zotsatira zoyembekezeredwa kwa mayi woyembekezera zikupitirira chiwopsezo cha mwana wosabadwayo, ndikofunikira kuyamba kulandira chithandizo.

Mu trimester yoyamba, ndikwabwino kukana kwathunthu kumwa mankhwalawa.

Malangizo ogwiritsira ntchito mankhwalawa

Malangizo ogwiritsira ntchito mankhwalawa ali ndi chidziwitso chambiri chokhudzana ndi matenda omwe mankhwalawa amayenera kugwiritsidwa ntchito, komanso mwatsatanetsatane Mlingo ndi zoyipa zomwe mankhwalawo angakhale nazo.

Ngati tizingolankhula za mankhwalawa chomwe mankhwalawa amachotsa, komanso ndi matenda omwe ayenera kugwiritsidwa ntchito, zikuwonekeratu kuti mawonekedwe a momwe mankhwalawo aliri ndi osiyanasiyana.

Kuchiza ndi wothandizirayi kuyenera kuchitika ngati pakufunika kuchotsa kutukusira kwakukulu komwe kumapezeka m'thupi la wodwalayo, komanso ngati pakufunika kuletsa kukula kwa edema, hyperemia ndi phagocytosis.

Inde, ziyenera kudziwidwa kuti mankhwalawa ndi othandizira kwambiri, chifukwa chake amagwiritsidwa ntchito kwambiri pofuna kuchepetsa matenda, osachotsa zomwe zimayambitsa matenda.

Ngati mugwiritsa ntchito mankhwalawa munjira zosiyanasiyana zotupa, mutha kuchepetsa mwayi wamtunduwu pakuyankha. Zimalepheretsedwa ndi kuchulukana kwa leukocytes, komanso imachita zinthu zina zingapo zomwe zimayimitsa njira yotupa yonse.

Zisonyezero zamankhwala

Ngakhale kuti mankhwalawa amabwezeretsa tiziwalo ta adrenal, potero kukonza ma mahomoni ofunikira m'thupi, sagwiritsidwa ntchito kawirikawiri m'magazi a shuga. Izi ndichifukwa choti mankhwalawa amathandizira kuwonjezera misempha ya magazi. Ngati, ngakhale zili choncho, lingaliro lingapangidwe kuti mugwiritse ntchito mankhwalawa pochiza odwala omwe ali ndi matenda a shuga 1, ndiye kuti ndikofunikira kuwonjezera kuchuluka kwa mankhwala ochepetsa shuga ndikuyang'anira kuchuluka kwa shuga m'magazi a wodwalayo.

Zizindikiro zazikulu zogwiritsa ntchito mankhwalawa ndi:

kuperewera kwa adrenal,
kuperewera kwa adrenal (pachimake),
kuperewera kwa adrenal, komwe kumachitika chifukwa chakuzimitsa kwadzidzidzi kwa gulu linalake la mankhwala.
Kulephera koyambirira kapena kwachiwiri kwa ziwalozi.

Kuphatikiza apo, itha kutumizidwa ngati wodwala ali ndi vuto lobadwa nalo la kotekisi ya chiwalo kapena subacute chithokomiro. Mankhwalawa ndi othandizira kupsa pamtundu uliwonse, monga mankhwala ena aliwonse a vasoconstrictor sangathandize. Matendawa sikuti ndi osiyana, amakhudzidwa ndi matenda a ubongo, mwachitsanzo, kuvulala kwamatenda osiyanasiyana a ubongo, meningitis, encephalitis ndi zotupa zina zofanana.

Nthawi zina, mankhwalawa angagwiritsidwe ntchito chifukwa cha kupweteka kwa bronchospasm komwe kumachitika pokonzanso mphumu ya bronchial. Amadziwikanso kuti imagwira ntchito pazovuta zosiyanasiyana zamkati, makamaka, mwanjira zoopsa zamatenda amtunduwu, chifukwa chomwe chitha kuonedwa ngati imodzi mwazomwe zingagwiritsidwe ntchito ngati pali chiwopsezo cha matenda a shuga. Matenda a rheumatic amathanso kukhala chifukwa chogwiritsira ntchito.

Mwambiri, mndandandawo ndiwotambalala. Koma, zoona, mutha kugwiritsa ntchito mankhwalawa pokhapokha mutatha kufufuza bwino wodwalayo. Simungayambe mankhwala nokha, adokotala akuyenera kukupatsani mankhwala.

Ndemanga pa kugwiritsa ntchito mankhwalawa

Pali ndemanga zambiri pa intaneti zomwe zimapangitsa kuti kumvetsetsa komwe kumakhala bwino kukana kugwiritsa ntchito mankhwalawa, ndipo ndi othandiza kwambiri.

Mwachitsanzo, odwala ena amati atagwiritsa ntchito mankhwalawa kwa nthawi yayitali, adazindikira zoyipa monga kusamba kwa msambo komanso kukula kwa vuto lachiwiri la adrenal. Kusamalidwa makamaka kuyenera kuthandizidwa pochiza odwala omwe ali ndi matenda ashuga. Popeza, zigawo za mankhwala zimachepetsa kwambiri kulolera kwa glucose. Ngati mumagwiritsa ntchito mankhwalawa kwa nthawi yayitali, ndiye kuti kulera kwawonekanso kwa ana.

Zotsatira zoyipa zochokera kuntchito ya mtima zimathanso.

Ndemanga ya odwala omwe adagwiritsa ntchito mankhwalawa panthawi ya matenda awo amawonetsa kuti ndiwothandiza kwambiri ku matenda osiyanasiyana a septic, komanso ngati amathandizidwa pakamwa.

Zowona, ndemanga zomwezi zimasonyezanso kuti mankhwalawa amatha kuvulaza wodwala ngati ali ndi matenda osiyanasiyana am'mimba, komanso matenda a fungus, herpes, chikuku kapena chikuku.

Zachidziwikire, monga momwe ziliri, mungapezenso ndemanga zabwino komanso zoipa apa. Koma, ngakhale pali zovuta zambiri, kugwiritsa ntchito mankhwalawa ndi kwapamwamba kuposa zotsatirapo zonse zoyipa. Chinthu chachikulu ndikuchita chithandizo moyang'aniridwa ndi dokotala.

Mtengo wa mankhwalawo ndi mawonekedwe ake

Ngati timakambirana za mtengo wa mankhwalawa, ndiye kuti ndi wokwanira mtengo. Zachidziwikire, zonse zimatengera wopanga wina ndi mtundu wa kumasulidwa, koma mwatsatanetsatane mtengo wa ma paketi sapitilira ma ruble 100.

Zowona, pali zosiyana, mwachitsanzo, Dexamethasone-Vial kuchokera ku kampani CCSPiOui amatenga ma ruble 254. Mndandanda wamankhwala awa mulinso mankhwala opangidwa ndi wopanga ku India ndi Slovenia, motere mtengo umafika kuma ruble 215, koma phukusi lidzakhala ndi ma ampoules 25, omwe ali ndi 1 ml ya mankhwala othandizira omwe ali ndi 4 mg.

Pazonse, ziyenera kudziwika kuti mankhwala onse ochokera kwa opanga osiyanasiyana, omwe amagulitsidwa m'matumba omwe amakhala ndi 25 ampoules a ml imodzi imodzi, kuyambira 212 mpaka 225 rubles.

Ngati tizingolankhula za mankhwalawa, omwe amagulitsidwa mwanjira yamatsitsi amaso, ndiye kuti mtengo wake nthawi zambiri sudutsa ma ruble 40. Koma apa tikulankhula za yankho limodzi ndi kuchuluka kwa 0,1%. Inde, mtengo wake ukhoza kukhala wokwera, zonse zimatengera kuchuluka kwa kuchuluka.

Dziwani kuti musanayambe kugwiritsa ntchito mankhwala othandizira, ndibwino kufunsa dokotala musanalowe ndikufotokozerani momwe mungatulutsire mankhwala omwe mungafune ndi momwe angayikiridwire, ndipo pokhapokha mutenge mankhwala. Kanemayo munkhaniyi ayankhula za mankhwalawa.

Zambiri

Kukonzekera kwa mankhwala ndi a gulu la glucocorticosteroids omwe ali ndi anti-allergic, anti-yotupa, immunosuppression ndi antitoxic.

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.

Dexamethasone imalepheretsa kapena kuchepetsa zizindikiro za thupi lawo siligwirizana komanso imathandizanso kuti mankhwalawo asinthe. Mothandizidwa ndi chida chofotokozedwera chachipatala, kuchuluka kwa mapuloteni m'madzi a m'magazi kumachepetsedwa ndipo mphamvu yake yamatumbo m'm minofu minofu imakulitsidwa. "Dexamethasone" imathandizira kukulitsa kuchuluka kwa shuga kuchokera m'chiwindi kulowa m'magazi, imasunga ma ayoni a sodium ndi madzi mthupi, pamene imalimbikitsa kutulutsa kwa potaziyamu ndikuchepetsa kuyamwa kwa calcium kuchokera m'mimba. Dexamethasone amatha kuwonjezera kuthamanga kwa magazi, kuchepetsa kupezeka kwa makhoma amitsempha yamagazi ndi kuthekera kwa mapangidwe a minofu.

Zambiri zomwe zili mu "Dexmetasone" m'magazi zimadziwika pambuyo pa mphindi 5 pambuyo pakupanga kwa iv. Mankhwalawa amaphatikizidwa makamaka m'chiwindi komanso gawo laling'ono lokha - impso ndi ziwalo zina zamkati. Zomwe zimapanga mankhwala opangira mankhwala "Dexamethasone" zimachotsedwa pantchito ya impso masana.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amapangidwa ngati njira yothetsera pakamwa. Ili ndi kapangidwe kake kogwira ntchito - dexamethasone sodium phosphate ndi zina zothandiza:

Kugwiritsa ntchito kwa mankhwala "Dexamethasone" kumawonekeranso pochiza matenda:

Mankhwala akuwonetseredwa kwa kubadwa kwatsopano kwa adrenal cortex.

matenda edema,
kuchepa kwa thupi la vitamini B12,
matenda otupa a m'mitsempha yamapapo,
matenda achilengedwe a minofu yolumikizika yachilengedwe cha autoimmune, ikuyenda bwino,
kuchepa kwa magazi ndi maselo oyera a m'magazi,
pachimake ndi subacute chithokomiro kuchepa kwa thupi,
nthenda yodziwika ndi kuwonongeka kwa chitetezo chamthupi m'magazi ofiira a magazi,
kufooka kwa mafupa,
kuchuluka kwa erythroderma,
pachimake kutupa kwa pakhungu,
kukomoka kobadwa nako kwa adrenal cortex.

Bweretsani ku zomwe zalembedwa

Kodi munthu wodwala matenda ashuga amakhudza bwanji thupi?

Kwa odwala omwe adapezeka kuti ali ndi matenda a shuga panthawi yoyezetsa magazi, mankhwala a Dexamethasone amapezeka.

Kuletsa kugwiritsidwa ntchito kumachitika chifukwa cha mphamvu ya mankhwalawa kukhudza kuchuluka kwa shuga m'magazi a wodwala. Yogwira ntchito ya mankhwala kumawonjezera glucose zili plasma, amene ali osafunika kwambiri shuga. Ngati kugwiritsa ntchito Dexamethasone kwa odwala matenda a shuga ndikosapeweka, ndiye kuti chithandizo chikuyenera kuchitika mosamala kwambiri, moyang'aniridwa ndi dokotala ndikuyang'aniridwa pafupipafupi kuchuluka kwa shuga. Tiyenera kudziwa kuti mukamalandira mankhwala a glucocorticosteroid, kuchuluka kwa mankhwala omwe amathandizira odwala matenda ashuga angafunike.

Contraindication ndi zoyipa

Sizikulimbikitsidwa kugwiritsa ntchito "Dexamethasone" mwa odwala omwe ali ndi matenda ndi mikhalidwe:

matenda ashuga
matenda ofooketsa mafupa
hypercorticism syndrome
njira yapamwamba ya bakiteriya owopsa, ma virus ndi fungus,
Nthawi yodzala ndi kubereka,
Matenda a Werlhof
Hypersensitivity kwa zigawo zikuluzikulu za mankhwala.

Ndi chisamaliro chowonjezereka, muyenera kugwiritsa ntchito "Dexamethasone" kwa zilonda zam'mimba, gastritis, parasitic pathology yamitundu yosiyanasiyana. Mankhwalawa amatha kuvulaza odwala omwe ali ndi vuto losakwanira, matenda a CCC, endocrine pathologies ndi zovuta za impso ndi chiwindi. Muubwana, kumwa mankhwalawo kumaloledwa pokhapokha ngati adokotala akuwuzani zonse zomwe zingachitike.

Dexamethasone ikhoza kuyambitsa zotsatirazi zoipa:

Zotsatira zoyipa zimatha kupezeka mwa mawonekedwe a hiccups.

kuchepa kwa ndende ya calcium, potaziyamu, sodium m'magazi,
kutuluka thukuta kwambiri
matenda a shuga
kunenepa
chizungulire, kupweteka mutu,
maphokoso
kusokonezeka kwa mtima
kuseka ndi mseru,
kutupa kwa kapamba, kaphatikizidwe,
kuchuluka kwa mpweya,
pafupipafupi hiccups
kuchuluka kwa calcium,
madera nkhawa komanso nkhawa,
thupi lawo siligwirizana.

Bweretsani ku zomwe zalembedwa

Overdose wa "Dexamethasone" mu shuga

Mukamagwiritsa ntchito "Dexamethasone" muyezo waukulu, pamakhala chiopsezo chokhala kuledzera kwa thupi ndi gawo lomwe limagwira. Ngati mankhwala osokoneza bongo, odwala amatha kuwona kuwonjezeka kwa mawonekedwe amtundu wa mbali. Mankhwalawa alibe mankhwalawa, chifukwa chake, amathandizira komanso amathandizira amathandizira.

Ndi zakudya ziti zomwe zimawonjezera shuga

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Zakudya zambiri zimakhala ndi zomanga thupi, zomwe, zikamamwa, zimakhudza shuga. Chizindikiro chomwe chimayeza kuchuluka kwa chakudya chimatchedwa glycemic index (GI). Mu glucose wangwiro, ndi wofanana ndi mayunitsi 100, ndipo zinthu zina zonse zimakhala ndi GI kuchokera ku 0 mpaka 100. Chizindikiro ichi chomwe chili ndi mtengo kuchokera pa 0 mpaka 39 chimawonedwa chotsika, kuyambira 40 mpaka 69 - pakati, ndi pamwamba 70 - okwera. Zakudya zomwe zimachulukitsa shuga m'magazi mwachangu ndizakudya zokhala ndi index yayikulu ya glycemic, ngakhale zakudya zina zomwe zili ndi sing'anga GI zimawonetsanso izi. Ichi ndichifukwa chake odwala matenda ashuga ayenera kudziwa chakudya chomwe chimakweza shuga m'magazi ndikuyesetsa kuti asadye.

Zotsatira za chakudya pamasamba a shuga

Zakudya zambiri zimakhala ndi ma carbohydrate momwe zimapangidwira, motero mwanjira ina zimakhudza shuga. Ena mwa iwo amawonjezera bwino komanso pang'onopang'ono, kotero kugwiritsa ntchito kwawo sikukhudza boma la kapamba. Ena amachulukitsa shuga m'magazi, zomwe zimakhala zovulaza ngakhale kwa wathanzi, komanso makamaka kwa wodwala matenda ashuga. Mkulu akakhala mzera wazakudya wazakudya zambiri, akangomaliza kuyamwa amayambitsa shuga.

Popeza zovulaza zazakudya zomwe zili ndi katundu wazakudya zambiri, ndikofunika kukana kugwiritsa ntchito kwawo kawirikawiri ngakhale kwa anthu athanzi lathunthu. Kwa odwala matenda ashuga, izi ndizofunikira, mosasamala mtundu wa matenda. Ngakhale ndi mankhwala a insulini, simungadye kwambiri ndikukhala ndi zakudya zotsekemera, ndikuyembekeza jakisoni. Kulephera kutsatira zakudya kumapangitsa kuti wodwalayo azikhala bwino komanso kuti azitha kuchuluka kwa mahomoni omwe amapatsidwa. Maziko azakudya ayenera kukhala zakudya zopatsa thanzi: masamba, chimanga, zipatso zina, nsomba zamafuta ochepa komanso nyama yazakudya. Glycemic indices amtundu wina wa zakudya amaperekedwa pagome 1.

Tebulo 1. Glycemic indices a zinthu zina

Zipatso ndi masamba

Zipatso zimakhala ndi zovuta komanso zovuta zamafuta. Ena mwa iwo amakhala ndi mitundu yambiri yazakudya zomwe zimachepetsa kuwonongeka kwa shuga motero sizimayambitsa hyperglycemia. Zipatso zololedwa zimaloledwa kwa odwala matenda ashuga, koma kutengera momwe amapangidwira ndi mankhwala ndi zopatsa mphamvu, mitundu yovomerezeka ya mitundu yosiyanasiyana ya mitundu itha kusiyanasiyana. Palinso zipatso zomwe odwala amafunika kudzipatula pachakudya chifukwa cha kuchuluka kwa chakudya chamafuta ambiri:

Zipatso zouma (makamaka nkhuyu, madeti ndi ma apricots owuma) ndizopatsa mphamvu zambiri komanso mafuta apamwamba a GI, kotero shuga ndiosayenera kudya. Izi ndizowona makamaka kwa odwala omwe ali ndi mtundu wachiwiri wa matendawa komanso azimayi omwe ali ndi matenda osokoneza bongo omwe amakakamizidwa kutsatira zakudya zovuta.

Pafupifupi masamba onse ndi otsika kapena apakatikati pa GI, motero ayenera kukhala maziko azakudya za tsiku ndi tsiku. Komabe, chifukwa cha kukhuthala kwambiri, ndibwino kuti odwala matenda ashuga azitha kudya okha mbatata (mutha kuidya, koma ndibwino kuchita izi osapitiliza kawiri pa sabata). Beets ndi chimanga zimakhala ndi shuga wambiri m'mapangidwe awo, motero amafunikanso kuzidula osati kuzisakaniza ndi zinthu zina zomwe zimakhala ndi chakudya.

Shuga ndi zinthu zomwe zimakhala nazo

Shuga ndi No. 1 yomwe iyenera kupatula kwathunthu kuchokera muzakudya za munthu wodwala. Zimayambitsa kukwera kwamphamvu kwa shuga m'magazi ndipo zimayambitsa chitukuko chachikulu cha matendawa. Odwala omwe, ngakhale malangizo a dokotala, akupitiliza kumwa shuga ndi zinthu zomwe zili nazo, azindikira posachedwa momwe zimayipa. Chifukwa cha maswiti, odwala matenda ashuga amayamba kukhala ndi zovuta za matenda ashuga, zomwe ndi izi:

sitiroko
polyneuropathy (kuphwanya machitidwe a mitsempha),
retinopathy (retinal pathology),
odwala matenda ashuga phazi
vuto la mtima
kunenepa.

Inde, thupi limasowa chakudya chamafuta, koma ndibwino kuti musazipeze pazakudya zotsekemera, koma kuchokera ku masamba komanso zipatso. Shuga woyesedwa samabweretsa chilichonse chothandiza m'thupi, amangokulitsa kukoma kwa chakudya. Maswiti amtundu wa odwala matenda ashuga amatha ndipo ayenera kusinthidwa ndi zipatso zachilengedwe, mtedza ndi zakudya kuchokera ku tchizi chochepa mafuta. Palibe zovuta za matendawa, wodwala nthawi zina amaloledwa kudya uchi wochepa.

Ndi zakudya ziti zomwe zimachulukitsa shuga m'magazi kupatula shuga wowona? Izi zikuphatikiza mikate yoyera, makeke, chokoleti, makeke, zopindika, mafuta ophikira omwe amapangidwa kuchokera ku ufa wa tirigu woyamba, makemphira amphika, chakudya chofulumira komanso zakudya zosavuta. Shuga amatha "kubisala" ngakhale mu zinthu zomwe zimakhala ndi kukoma kwambiri. Mwachitsanzo, ndizambiri m'masitolo, ma ketchups, marinade. Musanasankhe chakudya, muyenera kuphunzirapo mosamala kapangidwe kake, kupenda zopatsa mphamvu ndi kuchuluka kwa zopezeka mmenemo, chifukwa izi ndizomwe zimakhudza shuga.

Maphala ambiri ali pamndandanda wovomerezeka wazinthu za odwala matenda ashuga. Ali ndi index ya glycemic, mphamvu yokwanira komanso kupangidwa kwamankhwala. Maphala othandizira amaphatikiza mapira, tirigu, mafuta osasamba, buckwheat, bulgur. Zakudya zomanga thupi zovuta pakupanga zimasweka pang'onopang'ono, chifukwa chake, atagwiritsidwa ntchito, kuchuluka kwa glucose m'magazi kumakwera pang'onopang'ono.

Mwa zina monga chimanga chomwe chimakhudza thupi la odwala matenda ashuga, munthu amatha kusiyanitsa semolina ndi mpunga woyera. Zakudya zopangidwa kuchokera kwa iwo ndizopatsa mphamvu zambiri, zimakhala ndi mafuta ambiri othamanga, ndipo kugwiritsa ntchito pafupipafupi kumapangitsa kunenepa kwambiri. Alibe chilichonse chamtengo wapatali chachilengedwe, amangodzaza thupi ndi "zopanda pake" zopatsa mphamvu, ndipo izi ndizosayenera kwambiri kwa matenda ashuga.

Zowaka mkaka wowonda

Odwala omwe ali ndi matenda ashuga amatha kudya zakudya zamkaka zokha zomwe zimakhala ndi mafuta ochepa. Ndikwabwino kusiyiratu mkaka wathunthu, chifukwa umakumba kwa nthawi yayitali ndikupangitsa kusasangalala m'mimba. Popeza kagayidwe kamakhudzidwa ndi matenda a shuga, mkaka umatha kusokoneza kapamba, matumbo ndi ziwalo zina zam'mimba.

Mafuta a yogurts omwe ali ndi flavorings ndi mafinya azipangidwe pazomwe zimapangidwira angapangitse shuga. Zomwezi zimagwiranso kwa pasted curd ndi ojambula. Ngakhale fructose imawonjezeredwa ndi shuga m'malo mwa shuga, siyabwino kwa odwala matenda ashuga. Kugwiritsa ntchito shuga pafupipafupi kumeneku kumadzetsa kunenepa kwambiri chifukwa cha zomwe zili ndi zopatsa mphamvu zambiri komanso kuthekera kokulitsa kudya.

Kodi zakudyazi nthawi zonse zimakhala zovulaza?

Nthawi zina, chakudya chomwe chimakhala ndi chakudya chambiri pama protein sichikhala chapamwamba. Koma pali zochitika zina momwe zimatha kupulumutsira thanzi ndi moyo wa wodwala. Ndi chitukuko cha hypoglycemia (kuchepa kwachilendo m'magazi), zinthu izi zimatha kupereka chithandizo choyamba ndikuteteza wodwala ku zovuta zazikulu. Ngati wodwala matenda ashuga apeza kuti kuchuluka kwa shuga kwatsika kwambiri, kusintha mkhalidwe wake, monga lamulo, ndikokwanira kudya sangweji yopanda zoyera, bala yopatsa thanzi kapena kumwa kapu yotsekemera.

Chifukwa chakusokonekera msanga kwa shuga wosavuta, kuchuluka kwa shuga m'magazi kumakwera, ndipo wodwalayo akumva bwino. Ngati zotere sizichitika munthawi yake, munthu angafunike kuchipatala kuti amuthandize. Hypoglycemia ndi chiopsezo chomwe chingaike pachiwopsezo cha moyo monganso hyperglycemia (shuga wamagazi). Ichi ndichifukwa chake madokotala amalimbikitsa kuti odwala onse nthawi zonse amakhala ndi glucometer ndi zakudya zomwe zili ndi mafuta ochulukirapo othandizira panthawi yadzidzidzi.

Kukhala ndi lingaliro lazakudya zomwe zitha kuwonjezera kuchuluka kwa shuga m'magazi, munthu amatha kukonza mndandanda masiku angapo pasadakhale. Ndikwabwino kuti chakudyacho chimayang'aniridwa ndi mbale zomwe zimaphwanyidwa pang'onopang'ono ndikulowa m'thupi. Amachulukitsa zomwe zili m'magazi bwino komanso mwakuthupi, komanso, atatha kuzigwiritsa ntchito, kumverera kwa njala sikuwoneka mwachangu.

Matenda a shuga ndi miyendo. Matenda a shuga - miyendo imapweteka - chithandizo

Matenda a shuga nthawi zambiri amapereka zovuta kumiyendo. Mavuto a phazi pamoyo wonse amapezeka 25-25% ya onse odwala matenda ashuga. Ndipo okalamba akamadwala, zimawonekera kwambiri mwadzidzidzi. Matenda amiyendo omwe ali ndi matenda ashuga amabweretsa mavuto ambiri kwa odwala ndi madokotala. Miyendo imapweteka ndi matenda ashuga - mwatsoka, yankho losavuta lavutoli sililipo. Ndiyenera kuchita zonse zomwe ndingathe kuti ndichiritsidwe. Komanso, muyenera kuthandizidwa kokha ndi dokotala waluso, ndipo popanda vuto ndi "wowerengeka azitsamba". Munkhaniyi, muphunzira zoyenera kuchita. Zolinga zamankhwala:

Pulumutsani ululu m'miyendo, komanso bwino - zichotsani,
Sungani mphamvu yakusamuka "nokha."

Ngati simupereka chidwi ndi kupewa komanso kuchiza matenda a shuga pamiyendo, wodwala amatha kutaya chala chonse kapena phazi.

Mu matenda a shuga, miyendo imapweteka chifukwa ma atherosulinosis amachepetsa kuyeza m'mitsempha yamagazi. Tiziwalo tamatumbo timalandira magazi osakwanira, "osakwanira" chifukwa chake timatumiza ma ululu. Opaleshoni yobwezeretsa magazi m'mitsempha yam'munsi yam'munsi imatha kuchepetsa ululu ndikuwongolera moyo wa odwala matenda ashuga.

Pali ziwonetsero ziwiri zazikulu pamavuto am miyendo ndi matenda a shuga:

Shuga wokwezeka kwambiri amakhudza minyewa yamitsempha, ndipo amasiya kuchita zokakamiza. Izi zimatchedwa diabetesic neuropathy, ndipo chifukwa cha izi, miyendo imatha kutaya mtima.
Mitsempha yamagazi yomwe imadyetsa miyendo imakhala yotseka chifukwa cha atherosulinosis kapena kapangidwe ka magazi (magazi). Ischemia akufotokozera - mpweya njala ya zimakhala. Pankhaniyi, miyendo imapweteka.

Atherosulinosis: kupewa ndi kuchiza. Atherosulinosis ya ziwiya zamtima, bongo, m'munsi.
Kupewa matenda amtima ndi sitiroko. Zoyipa komanso momwe mungazithetsere.

Matenda a matenda ashuga

Kuwonongeka kwa m'mitsempha chifukwa cha kukweza kwa magazi kwam'mimba kumatchedwa diabetesic neuropathy. Kupanikizika kwa shuga kumeneku kumabweretsa kuti wodwalayo amalephera kumva kukhudza miyendo yake, kupweteka, kupsinjika, kutentha ndi kuzizira. Tsopano ngati wavulala mwendo, sangamve. Ambiri odwala matenda ashuga omwe ali ndi vutoli amakhala ndi zilonda m'miyendo ndi m'miyendo, yomwe imachira nthawi yayitali.

Ngati chidwi cha miyendo chofooka, ndiye kuti mabala ndi zilonda zam'mimba sizimapweteka. Ngakhale kutayika kapena kufalikira kwa mafupa a phazi ndiye kuti sizikhala zopweteka. Izi zimatchedwa matenda a shuga. Popeza odwala samva kupweteka, ambiri aiwo ndi aulesi kwambiri kuti atsatire malangizo a dokotala. Zotsatira zake, mabakiteriya amachulukana m'mabala, ndipo chifukwa cha gangrene, mwendo nthawi zambiri umadulidwa.

Momwe mungalandiridwire matenda a shuga a mtundu wachiwiri: njira imodzi ndi imodzi
Mankhwala 2 a shuga: nkhani yatsatanetsatane
Mapiritsi a Siofor ndi Glucofage
Momwe mungaphunzirire kusangalala ndi maphunziro akuthupi

Matenda a m'mitsempha ya m'matenda a shuga

Patency yamitsempha yamagazi itagwa, ndiye kuti minyewa ya miyendo imayamba "kufa ndi njala" ndikutumiza ma sign a ululu. Ululu umatha kupumula kapena pokhapokha pakuyenda. Mwanjira ina, ngati miyendo yanu imapweteka ndi matenda a shuga ndilabwino kwambiri. Chifukwa kupweteka m'miyendo kumalimbikitsa wodwala matenda ashuga kuwona dokotala ndikuchira ndi mphamvu zake zonse. M'nkhani ya lero, tikambirana zinthu ngati izi.

Mavuto a m'mitsempha yamagazi omwe amadyetsa miyendo amatchedwa "matenda opindika a mtsempha wamagazi". Peripheral - amatanthauza kutali ndi pakati. Ngati lumen m'matumbowo ndi ochepa, ndiye kuti nthawi zambiri mumadwala matenda ashuga, kumachitika pakapita nthawi. Izi zikutanthauza kuti chifukwa cha kupweteka kwambiri m'miyendo, wodwalayo amayenera kuyenda pang'onopang'ono kapena kuima.

Ngati matenda apakati pa mtsempha wamagazi amaphatikizidwa ndi matenda ashuga a m'mimba, ndiye kuti ululuwo umakhala wofatsa kapenanso kuti palibe. Kuphatikizika kwa kufooka kwa mtima komanso kuchepa kwa chidwi cha kupweteka kumawonjezera mwayi womwe wodwala matenda ashuga ayenera kudula miyendo imodzi kapena yonse. Chifukwa ziwalo zamiyendo zikupitilirabe kuchepa chifukwa cha "njala," ngakhale wodwalayo samva kuwawa.

Ndimayesedwe ati ngati miyendo yanu imapweteka ndi matenda a shuga

Ndikofunikira kupenda bwino miyendo yanu ndi miyendo yanu tsiku ndi tsiku, makamaka ukalamba. Ngati magazi atuluka m'matumbo asokonezeka, mutha kuzindikira zizindikilo zakunja kwa izi. Zizindikiro za gawo loyambirira la matenda otumphukira:

Khungu pamiyendo likhala louma
mwina ayamba kuboola, kuphatikizika ndi kuyabwa,
kutulutsa khungu kapena kuchotsedwa pakhungu kumatha kuwonekera pakhungu,
Kwa amuna, Tsitsi lakumunsi limasenda imvi.
Khungu limakhala lotuwa nthawi zonse kuti lizitha kugwira,
kapena mosinthanitsa, imatha kutentha ndi kupeza mtundu wa cyanotic.

Dokotala wodziwa bwino amatha kudziwa ngati wodwala ali ndi mitsempha yotani yomwe imadyetsa ziwalo zamiyendo. Imeneyi ndiye njira yosavuta kwambiri komanso yotsika mtengo kwambiri yopezera zotumphukira zamagazi. Nthawi yomweyo, kupindika pa mtsempha wamagetsi kumayimitsidwa kapena kuchepa kwambiri pokhapokha ngati lumen yake imachepetsedwa ndi 90% kapena kuposa. Sachedwa kwambiri kuti tipewe kufa ndi minofu.

Chifukwa chake, amagwiritsa ntchito njira zowerengera zovuta pogwiritsa ntchito zida zamakono zamankhwala. Kuyerekeza kwa systolic ("kumtunda") kwamitsempha yam'munsi yam'munsi ndi chithokomiro cham'mimba kumawerengedwa. Izi zimatchedwa ankle-brachial index (LPI). Ngati ili mu mndandanda wa 0.9-1.2, ndiye kuti magazi m'miyendo amadziwika kuti ndi abwinobwino. Kupanikizika kwa minyewa yayikulu kumayesedwanso.

Mlozera wa buluzi umapereka chidziwitso cholondola ngati zotengera zimakhudzidwa ndi atherosulinosis ya Menkeberg, ndiye kuti, zimakutidwa ndi "kukula" kochokera mkati. Mwa odwala okalamba, izi zimachitika nthawi zambiri. Chifukwa chake, njira ndizofunikira zomwe zimapereka zotsatira zolondola komanso zokhazikika. Izi ndizofunikira makamaka pakuthetsa nkhani ya opaleshoni kuti ibwezeretse patency yamitsempha kuti miyendo isapweteke.

Mtundu woyamba wa chithandizo cha matenda a shuga kwa akulu ndi ana
Njira ya jakisoni wopweteka wa insulin
Matenda a shuga 1 amtundu wa mwana amathandizidwa popanda insulin pogwiritsa ntchito zakudya zoyenera. Mafunso ndi banja.
Momwe mungachepetse kuwonongeka kwa impso

Transcutaneous Oximetry

Transcutaneous oximetry ndi njira yopweteka yopanda phokoso yomwe imakupatsani mwayi wofufuza momwe minofu yokhala ndi mpweya wabwino ulili. Transcutaneous amatanthauza "kudutsa pakhungu." Sensor yapadera imagwiritsidwa ntchito pakhungu, lomwe limapanga muyeso.

Kulondola kwa mayeserowa kumatengera zinthu zambiri:

mkhalidwe wam'mapapo wodwala,
kuchuluka kwa hemoglobin wamagazi ndi mtima wake,
kuchuluka kwa mpweya mumlengalenga,
makulidwe a khungu komwe sensor imagwiritsidwa ntchito,
kutupa kapena kutupa m'malo oyeza.

Ngati mtengo womwe wapezeka uli pansi pa 30 mm RT. Art., Ndiye yovuta ischemia (kufa ndi mpweya wa okosijeni) ya miyendo imapezeka. Kulondola kwa njira yosinthira ma oximetry sikokwanira. Koma imagwiritsidwabe ntchito, chifukwa imawerengedwa kuti ndi yophunzitsa ndipo siyimabweretsa mavuto kwa odwala.

Dexamethasone wa matenda ashuga

Mankhwala "Dexamethasone" ali ndi zotsutsana zingapo ndi mtundu II matenda a shuga, monga amodzi mwa iwo.

Mankhwalawa ndi mahomoni opanga a adrenal cortex, omwe amayenera kumwedwa mosamala malinga ndi mawonekedwe.

Chifukwa chake, pofuna kukulitsa vutoli, odwala matenda ashuga ayenera kulumikizana ndi kuchipatala ndi kukaonana ndi dokotala woyenera asanayambe mankhwala a Dexamethasone.

Matenda a Steroid: Zizindikiro, matenda ndi njira zochizira

Zomwe zimapangitsa kuti shuga achulukane zimatha kukhala zochulukirapo kwa nthawi yayitali m'madzi m'magazi. Pankhaniyi, kupezeka kwa matenda a shuga a steroid amapangidwa.

Nthawi zambiri, kusowa bwino kumayamba chifukwa cha mankhwala omwe amakhalapo, koma amathanso kukhala vuto la matenda omwe amabweretsa kuchuluka kwa mahomoni.

Nthawi zambiri, kusintha kwamatenda mu kagayidwe kazakudya kumapangidwanso, pambuyo posiya mankhwala kapena kuwongolera matendawa amatha, koma nthawi zina amatha kulimbikira atalandira chithandizo.

Ma steroid owopsa kwambiri kwa anthu omwe ali ndi matenda ashuga a 2. Malinga ndi ziwerengero, 60% ya odwala amayenera kusintha m'malo mwa hypoglycemic othandizira ndi insulin.

Matenda a Steroid - ndi chiyani?

Steroidal, kapena mankhwala osokoneza bongo, matenda a shuga ndi matenda omwe amatsogolera ku hyperglycemia. Cholinga chake ndi zotsatira zoyipa zamahomoni a glucocorticoid, omwe amagwiritsidwa ntchito kwambiri munthambi zonse zamankhwala. Amachepetsa ntchito ya chitetezo chathupi, amakhala ndi zotsutsa-zotupa. Glucocorticosteroids akuphatikiza Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Posachedwa, osaposa masiku 5, chithandizo cha mankhwalawa chimaperekedwa kwa matenda:

zotupa zoyipa
bakiteriya meningitis
COPD ndi matenda osatha a m'mapapo
gout mu pachimake siteji.

Kutalika kwa nthawi yayitali, kupitirira miyezi isanu ndi umodzi, mankhwala a steroid angagwiritsidwe ntchito pneumonia yapakati, matenda a autoimmune, kutupa kwamatumbo, zovuta zamkati, komanso kufalikira kwa ziwalo.

Malinga ndi ziwerengero, kuchuluka kwa anthu odwala matenda ashuga atatha kugwiritsa ntchito mankhwalawa sikupitirira 25%. Mwachitsanzo, pochiza matenda am'mapapo, hyperglycemia imawonedwa mu 13%, mavuto a khungu - 23,5% ya odwala.

Moni Dzina langa ndine Alla Viktorovna ndipo ndilibenso matenda ashuga! Zinanditengera masiku 30 okha ndi ma ruble 147.kubwezeretsa shuga kwazonse komanso osadalira mankhwala osathandiza omwe ali ndi zotsatirapo zoyipa.

>>Nkhani yanga ikhoza kuwerengedwa mwatsatanetsatane apa.

Chiwopsezo cha matenda a shuga a steroid chikuwonjezeka ndi:

makonzedwe otengera mtundu wa shuga, achibale oyamba omwe ali ndi matenda ashuga,
matenda a shuga gestational panthawi imodzi yapakati,
prediabetes
kunenepa kwambiri, makamaka pamimba
ovary polycystic,
ukalamba.

Mulingo waukulu wa mankhwala omwe amamwa, ndiwomwe umakhalapo ndi matenda a shuga a steroid:

Mlingo wa hydrocortisone, mg patsiku

Chiwopsezo chowonjezeka cha matenda, nthawi

Zifukwa zachitukuko

Pali ubale wolunjika pakati pa kugwiritsa ntchito glucocorticoid ndi chitukuko cha matenda a shuga. Mankhwala osokoneza bongo amasintha kuchuluka kwa kayendedwe kazinthu zomwe zikuchitika mthupi lathu, zomwe zimayambitsa khansa ya hyperglycemia:

Zimakhudza kugwira ntchito kwa maselo a beta, chifukwa chomwe kuphatikiza kwa insulin kumachepetsedwa, kumasulidwa kwake m'magazi kumatsirizidwa chifukwa cha kudya shuga.
Zitha kupha maselo ambiri a beta.
Kuchepetsa ntchito ya insulini ndipo, chifukwa chake, kufooketsa shuga kumata.
Chepetsani kupanga kwa glycogen mkati mwa chiwindi ndi minofu.
Kuletsa ntchito ya timaglucagon ya mahomoni, omwe amachepetsa kupanga insulin.
Amawonjezera kutulutsidwa kwa glucagon, mahomoni omwe amachepetsa zotsatira za insulin.
Yambitsani gluconeogenesis - njira yopanga shuga kuchokera pamagulu achilengedwe omwe alibe mafuta.

Chifukwa chake, kupanga insulini kumachepetsedwa kwambiri, kotero shuga sangathe kufikira cholinga chake - m'maselo a thupi. Kutuluka kwa shuga m'magazi, M'malo mwake, kumawonjezera chifukwa cha gluconeogeneis ndi kufooka kwa kufalikira kwa shuga m'masitolo.

Mwa anthu omwe ali ndi metabolism yathanzi, kuphatikiza kwa insulin kumawonjezeka pambuyo pa masiku 2-5 atatenga ma steroid kuti alipire ntchito yake yochepetsedwa.

Akamaliza kumwa mankhwalawo, kapamba amabwerera ku chiyambi. Odwala omwe ali ndi chiopsezo chachikulu cha matenda a shuga a steroid, kubwezeredwa kumatha kukhala kosakwanira, hyperglycemia imachitika.

Gululi nthawi zambiri limakhala ndi “vuto” lomwe limayambitsa matenda ashuga osachiritsika.

Matendawa amapatsidwa nambala ya ICD ya 10 E11 ngati chikhodzodzo chimasungidwa pang'ono, ndipo E10 ngati maselo a beta adawonongedwa kale.

Mawonekedwe ndi zizindikiro za matenda a shuga

Odwala onse omwe amamwa ma steroid ayenera kudziwa zomwe zimayambitsa matenda ashuga:

polyuria - kukodza pokodza,
polydipsia - ludzu lamphamvu, pafupifupi osafooka mukamwa,
nembanemba youma, makamaka pakamwa,
khungu lakuthwa, losasamala
wotopa nthawi zonse, kuchepa kwa ntchito,
ndi kuchepa kwakukulu kwa insulin - kuchepa thupi kosalephera.

Ngati zizindikirozi zikuchitika, ndikofunikira kuzindikira matenda a shuga. Kuyesedwa kovuta kwambiri pankhaniyi ndi kuyesa kwa glucose.

Nthawi zina, zimatha kuwonetsa kusintha kwa kagayidwe kazakudya pang'ono ngati maola 8 mutayamba kumwa ma steroids. Njira zoyesera ndizofanana ndi mitundu ina ya matenda ashuga: shuga kumapeto kwa kuyesedwa sikuyenera kukhala kwakukulu kuposa 7.8 mmol / l.

Ndi kuchuluka kwa kuchuluka kwa magawo 11.1, titha kulankhula za kusokonezeka kwakukulu kwa metabolic, nthawi zambiri kosasinthika.

Kunyumba, shuga ya shuga imatha kupezeka pogwiritsa ntchito glucometer, mulingo wapamwamba kwambiri 11 mutatha kudya chikusonyeza kuyambika kwa matendawa. Kuthamanga shuga kumakula pambuyo pake, ngati ndizopamwamba kuposa mayunitsi 6.1, muyenera kulumikizana ndi endocrinologist kuti mupeze zowonjezereka komanso kulandira chithandizo.

Kodi mumazunzidwa ndi kuthamanga kwa magazi? Kodi mukudziwa kuti matenda oopsa amachititsa kuti mtima ukhale mwamantha ndi kuwakwiyitsa? Sinthani nkhawa zanu ndi ... Maganizo ndi mayankho okhudza njira zomwe mwawerenga apa >>

Zizindikiro za matenda opha shuga a shuga sizitha kukhalapo, kotero ndichizolowezi kuwongolera shuga m'magawo awiri oyamba atatha kuperekedwa kwa glucocorticoids. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, mwachitsanzo, mutabadwa, kuyesedwa kumaperekedwa sabata iliyonse mwezi woyamba, kenako pambuyo pa miyezi itatu ndi miyezi isanu ndi umodzi, mosasamala kanthu za kukhalapo kwa zizindikiro.

Momwe mungachiritsire matenda a shuga

Matenda a shuga a Steroid amachititsa kuchuluka kwa shuga atatha kudya. Usiku ndi m'mawa musanadye, glycemia ndiyachilendo kwa nthawi yoyamba.Chifukwa chake, chithandizo chomwe chikugwiritsidwa ntchito chiyenera kuchepetsa shuga masana, koma osayambitsa hypoglycemia yausiku.

Zochizira matenda a shuga, mankhwalawa omwe amagwiritsidwa ntchito ngati mitundu ina ya matendawa: othandizira a hypoglycemic ndi insulin. Ngati glycemia ali ochepera 15 mmol / l, chithandizo chimayamba ndi mankhwala omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga. Manambala ambiri a shuga amawonetsa kuwonongeka kwakukulu pancreatic ntchito, odwala oterewa amapatsidwa jakisoni wa insulin.

Mankhwala othandiza:

Mankhwala	Machitidwe
Metformin	Amasintha malingaliro a insulin, amachepetsa gluconeogeneis.
Zomwe zimachokera ku sulfanylureas - glyburide, glyclazide, repaglinide	Musatchule mankhwala a nthawi yayitali, kuwunika momwe zakudya zimafunikira.
Glitazones	Kuchulukitsa kumva kwa insulin.
Analogs a GLP-1 (enteroglucagon) - exenatide, liraglutide, lixisenatide	Zothandiza kwambiri kuposa ndi matenda a shuga a 2, onjezerani insulini mutatha kudya.
DPP-4 zoletsa - sitagliptin, saxagliptin, alogliptin	Chepetsani kuchuluka kwa shuga, kulimbikitsa kunenepa.
Mankhwala a insulin, kutengera mtundu wa insulini yawo yomwe, amasankha mtundu kapena mwambo	Insulin yochita pakati.

Kupewa

Kupewa komanso kupezeka kwa nthawi yayitali ndi mankhwala a shuga a steroid ndi gawo lofunika la chithandizo ndi glucocorticoids, makamaka ngati kugwiritsa ntchito kwawo kwakanthawi kuyembekezeredwa. Njira zomwezo zomwe zimagwiritsidwa ntchito pa matenda a shuga a 2, zakudya zamafuta ochepa ndikuwonjezera zochitika zolimbitsa thupi, zimachepetsa chiwopsezo cha matenda a carbohydrate metabolism.

Tsoka ilo, prophylaxis iyi ndiyovuta kukwaniritsa, popeza ma steroid amalimbitsa chilimbikitso, ndipo matenda ambiri omwe amawagwiritsa ntchito amawachotsa kapena kuchepetsa malire pamasewera. Chifukwa chake, popewa matenda a shuga a steroid, gawo lalikulu ndi la kuzindikira kwa zovuta ndi kukonza kwawo pamlingo woyambirira mothandizidwa ndi mankhwala ochepetsa shuga.

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

Mapiritsi a Dexamethasone - malangizo a boma ogwiritsira ntchito, analogi

Matenda a shuga a steroid amawonetsa mitundu yonse ya 1 ndi 2. Ndizofanana ndi mtundu 1 mwakuti maselo a beta amawonongeka ndi corticosteroids mu kapamba.

Koma ngakhale ali munthawi imeneyi, kupanga insulin kumachitika. Popita nthawi, kuchuluka kwake kumacheperachepera komanso nthawi yomweyo, maselo amthupi amasiya kuzindikira pang'onopang'ono ma hormone awa, omwe ndi amtundu wa shuga wachiwiri.

Posakhalitsa maselo onse owonongeka a beta afa. Ndipo kutengera ndi momwe adakhalira mu kapamba munyengo zambiri kapena ayi, insulini ingapangidwe mu Mlingo wocheperako, womwe sunakwanire.

Wodwala amafunikira insulin, ndipo iyi ndi mtundu woyamba 1 (wodalira insulini).

Matenda a shuga a mankhwala amakhala ndi zofanana ndi mitundu yodziwika iyi:

ludzu
kukodza pafupipafupi
kutopa kosafunikira.

Zolemba za matendawa ndi zizindikiro

Matenda a Steroid ndi apadera chifukwa amaphatikiza zizindikiro za matenda amitundu iwiri komanso matenda ashuga a 1. Matendawa amayamba pomwe chiwerengero chachikulu cha corticosteroids chimayamba kuwononga maselo a pancreatic beta.

Izi ndizogwirizana ndi zomwe zimayambitsa matenda a shuga 1. Komabe, maselo a beta akupitiliza kupanga insulini kwakanthawi.

Pambuyo pake, kuchuluka kwa insulini kumachepa, chidwi cha minofu ya timadzi timeneti timawonongeka, chomwe chimachitika ndi matenda ashuga 2.

Popita nthawi, maselo a beta kapena ena aiwo amawonongeka, zomwe zimapangitsa kuti ayambe kupanga insulin. Chifukwa chake, matendawa amayamba kuyenda chimodzimodzi ndi matenda amisomali omwe amadalira insulin 1. Kuonetsa zizindikiro zomwezo.

Zizindikiro zazikulu za matenda a shuga ndizofanana ndi mtundu uliwonse wa matenda ashuga:

Kuchulukitsa pokodza
W ludzu
Kutopa

Nthawi zambiri, zizindikiro zomwe zalembedwazo sizikuwonetsa zambiri, motero sizimalabadiridwa. Odwala sataya kulemera kwakukulu, monga mu mtundu 1 wa shuga, kuyezetsa magazi sikumapangitsa kuti azindikire.

Kuchuluka kwa shuga m'magazi ndi mkodzo sikumakwera kwambiri modabwitsa. Kuphatikiza apo, kupezeka kwa kuchuluka kwa ma acetone m'magazi kapena mkodzo sikumawonedwa kawirikawiri.

Chithandizo cha matenda ashuga

Ngati thupi silipanga insulin, ndiye kuti matenda osokoneza bongo, monga matenda amtundu 1, koma ali ndi mawonekedwe a shuga 2, ndiye kuti, insulin kukana minofu. Matenda a shuga oterewa amathandizidwa ngati shuga 2.

Chithandizo chimadalira zina mwa zinthu zomwe wodwala ali nazo. Mwachitsanzo, kwa anthu onenepa kwambiri omwe amapangabe insulin, zakudya ndi zochepetsa shuga monga thiazolidinedione ndi glucophage zimasonyezedwa. Kuphatikiza:

Ngati pali ntchito ya pancreatic yotsika, ndiye kuti kuyambitsa insulini kumamupatsa mwayi wochepetsa katundu.
Pankhani yakusakwanira kwa ma cell a beta, pakapita nthawi, ntchito ya pancreatic imayamba kuchira.
Ndi cholinga chomwecho, zakudya zamafuta ochepa zimayikidwa.
Kwa anthu omwe ali ndi thupi lolemera, chakudya No. 9 chikulimbikitsidwa; anthu onenepa kwambiri ayenera kutsatira zakudya No. 8.

Ngati kapamba satulutsa insulin, ndiye kuti imayikidwa ndi jakisoni ndipo wodwalayo afunika kudziwa momwe angabayire insulin molondola. Kuwongolera shuga ndi magazi kumachitidwa chimodzimodzi ndi shuga 1. Komanso, ma cell a beta sangabwezeretsedwe.

Mlandu wosiyana ndi chithandizo cha matenda osokoneza bongo omwe amayamba chifukwa cha mankhwala ndi zomwe zimachitika ngati nkotheka kukana chithandizo cha mahomoni, koma munthu amadwala matenda a shuga. Izi zitha kukhala pambuyo pakupatsirana impso kapena pakakhala mphumo waukulu.

Mlingo wa shuga umasungidwa pano, potengera chitetezo cha kapamba komanso kuchuluka kwa minyewa yomwe imakhudzidwa ndi insulin.

Monga chithandizo chowonjezereka, odwala amatha kutumizidwa mahomoni a anabolic omwe amayang'anira zotsatira za mahomoni a glucocorticoid.

Matenda amtunduwu amapezeka ngati mfundo za shuga m'magazi zimayamba kupitirira 11.5 mmol mutatha kudya, komanso musanadye, miyeso imawonetsedwa kuti imaposa 6 mmol. Pachigawo choyamba, adotolo sayenera kupatula matenda onse omwe ali mgululi.

Kuchiza kumatha kukhala kwachikhalidwe kapena koopsa. Lachiwiri ndilothandiza kwambiri, koma limafunikira luso lodziletsa kuchokera kwa wodwala ndipo limawonedwa ngati ndalama zambiri.

Steroid shuga mellitus, zomwe zimayambitsa ndi zizindikiro zake

Njira yodalira insulini imayamba chifukwa cha kuperewera kwa zakudya m'thupi kapena kunenepa kwambiri. Monga lamulo, chifukwa chachikulu ndicho kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwala a mahomoni. Ichi ndichifukwa chake mawonekedwe amatchedwa matenda ashuga.

Steroid shuga mellitus mu mankhwala amatchedwa mitundu yopanda pancreatic yamatendawa. Chifukwa chake, pamlingo wachitukuko, sizigwirizana ndi kupunduka kwa kapamba ndipo, makamaka zisumbu za Langerhans.

Ngati munthu alibe zosokoneza mu kagayidwe kazakudya zama cellelo, ndi kuchuluka kwa glucocorticoids kumachitika, ndiye kuti matenda a shuga a cellid amakhala ndi mawonekedwe ofatsa. Kumapeto kwa maphunziridwe a mankhwala a mahomoni, matendawa amatha.

Matenda a shuga a Type II, omwe amadziwika ndi kuchuluka kwamahomoni omwe amapangidwa, odwala oposa theka amapita mu fomu yodalira insulin.

Mankhwala opatsitsa matenda

Glucocorticoids. Dexamethasone, hydrocortisone pamankhwala amagwiritsidwa ntchito ngati anti-kutupa kwa nyamakazi, komanso pochiza matenda a autoimmune (eczema, lupus, ndi ena) ndi mphumu.

Nthawi zambiri, mankhwalawa samaphatikizira glucocorticoids atatha kupezeka ndi matenda angapo.

Magulu a diuretic a thiazide diuretics (Nefrik, Dichlothiazide).

Mankhwala angapo oletsa kubereka.

Mankhwala omwe amagwiritsidwa ntchito pochiza pambuyo pochita opaleshoni ya impso, makamaka kupatsirana. Pambuyo pakuwonjezereka, munthu amayenera kutenga ma immunomodulators moyo wake wonse, popeza amatha kutuluka mthupi.

Nthawi zambiri, amaopseza thanzi la chida chija.

Zachidziwikire, kuti mankhwala a shuga a shuga samapezeka mwa wodwala aliyense amene amatenga mahomoni, komabe chithandizo choterechi chimakulitsa zoopsa zake.

Ngati munthu wotsutsana ndi kumbuyo kwa mankhwalawa anali ndi zizindikiro za mtundu wa matendawo, ndiye kuti nthawi zambiri anali pachiwopsezo. Kuti mupewe kutukuka, ndikofunikira kuti mupeze kulemera kwanu moyenera, sinthani zakudya zanu ndikupita masewera.

Mawonetsero oyamba ayenera kukakamiza kusiya kugwiritsa ntchito mahomoni pafupipafupi, ngati zingatheke pankhani inayake.

Zizindikiro zazikulu komanso zina

Chochititsa chidwi ndi kuphatikiza komwe mitundu ya matenda ashuga onse ilili. Pa gawo loyamba la chitukuko, corticosteroids yochulukirapo imayamba kuwononga maselo a beta omwe amayang'ana kwambiri ma islets a Langerhans, omwe amagwirizana ndi matenda a shuga a steroid omwe ali ndi mawonekedwe odalira insulini. Ngakhale izi, amapanga mahomoni.

Komano kuchuluka kwa zinthu zomwe zimapanga insulini kumachepa, mphamvu zama cell kwa izo zimachepa, monga mtundu wachiwiri. Popita nthawi, maselo a beta amasiya kugwira ntchito ndikufa, motero, matendawa amakhala ochulukana ndi chithunzi chodalirika cha insulin.

Zizindikiro zikufanana kwambiri ndi nthawi zonse yamatendawa:

kutopa, ntchito yochepa,
ludzu lalikulu
mkulu diuresis.

Nthawi zina, wodwalayo samazindikira mawonekedwe awo, popeza amadzionetsa ofooka. Corticosteroids samachititsa kuti thupi lizigwiritsa ntchito kwambiri kapena kupindulitsa kwake, ndipo kuyezetsa magazi kumapangitsa kuti adziwe zoyenera. Kuchuluka kwa shuga mu mkodzo ndi magazi kumatuluka kwambiri, kawirikawiri ma acetone samawonekera.

Matenda a shuga monga chifukwa cha steroid

Zokha, kuchulukitsa kwa corticosteroids kumakhudzanso chimodzimodzi. Kuphatikiza apo, sikuti aliyense amene amamwa amadwala. Ma mahormoniwa samangochita ngati kapamba wa munthu, komanso amachepetsa mphamvu ya insulin, kungosokoneza.

Maselo a Beta amagwira ntchito mwamphamvu kwambiri kuti akhalebe ndi shuga. Ngati kapamba ali wathanzi, ndiye kuti posachedwa azolowera katundu wolemera. Ndi kuchepa kwa mulingo kapena kusiya mankhwala kwathunthu, njira zonse za metabolic zimabwezeretseka.

Koma ngati munthu amene amatenga mahomoni ali ndi matenda ashuga, chithunzicho ndi chosiyana kotheratu. Maselo ataya kale chidwi ndi insulini, motero, kapamba sichita ntchito yake bwino. Pazifukwa izi, ndikofunikira kuti odwala matenda ashuga azigwiritsa ntchito corticosteroids pokhapokha pokhapokha.

Mlandu wosiyana kotheratu ndi pamene sizingatheke kukana mahomoni, mwachitsanzo, ngati mphumu yayikulu ya bronchial. Apa, wodwalayo amayenera kuyang'anira kuchuluka kwa shuga, komanso zakumwa za anabolics zomwe zimasokoneza gawo loipa la glucocorticoids.

Zoyambitsa ndi Chithandizo cha Matenda a Steroid

Zomwe zimachitika ngati yachiwiri ya insulin yotengera matenda a shuga - ndimwayi wowonjezera wa corticosteroids (mahomoni a adrenal cortex) m'magazi.

Matenda a Steroid amatha kuoneka ngati matenda, pomwepo pali kuchuluka kwa corticosteroids (matenda a Itsenko-Cushing).

Choyambitsa chachikulu cha matendawa ndimalandira chithandizo kwa nthawi yayitali ndi mankhwala ena a mahomoni.

Chiwopsezo cha matenda
Zizindikiro
Kutengera

Matenda a Steroid ndi extrapancreatic m'chilengedwe chifukwa samayambitsa mavuto apancreatic. Odwala omwe alibe kuphwanya zakudya za carbohydrate metabolism, koma omwe amapezeka ndi glucocorticoids, amayamba kudwala matenda a shuga mellitus pazowonekera zazing'ono zomwe zimatha atasiya kumwa mankhwala a mahomoni.

Mpaka 60% ya odwala amtundu wachiwiri ali pachiwopsezo chotenga insulin-akudalira matenda a fomu ya steroid.

Chiwopsezo cha matenda

Glucocorticoids (dexamethasone, prednisone, hydrocortisone) amagwiritsidwa ntchito kuthana ndi zotupa pochiza mphumu ya bronchial, nyamakazi, matenda ena a autoimmune, monga lupus erythematosus, eczema, pemphigus.

Corticosteroids amagwiritsidwa ntchito pochiza matenda angapo am'mimba komanso matenda ena amitsempha.

Mankhwala a Corticosteroid amagwiritsidwa ntchito mu anti-kutupa kanthu, pambuyo pakuwonjezeka kwa impso, pamene mankhwalawa amaperekedwa kuti athetse chitetezo chokwanira.

Matenda a Steroid samawoneka mwa aliyense yemwe amatenga corticosteroids, koma chiopsezo chodwala chikuwonjezeka kwambiri.

Kuphatikiza apo, matendawa amatha kukhazikika chifukwa chogwiritsa ntchito nthawi yayitali mankhwala osokoneza bongo komanso okodzetsa (hypothiazide, nvidrex, nephrix, dichlothiazide).

Ngati zizindikiro zikuwoneka pakumwa mankhwala a corticosteroid, njira zoteteza ziyenera kuchitika. Njira izi ndi monga: kudya mokwanira, kuchita masewera olimbitsa thupi moyenera.

Anthu omwe ali ndi vuto la kunenepa kwambiri ayenera kuchepetsa kulemera kwawo.

Ngati mukufuna kukhala ndi matenda ashuga, muyenera kusamala kwambiri pakumwa mankhwala a mahomoni.

Matenda a shuga a Steroid amaphatikizapo mitundu ya mitundu yoyamba ndi yachiwiri. Matendawa amagwirizanitsidwa ndi kuwonongeka kwa ma pancreatic b-cell ndi corticosteroids (monga mtundu 1 wa shuga). Nthawi yomweyo, ma b-cell kwakanthawi amapitilira katulutsidwe ka insulin.

Pambuyo pake, kuchuluka kwa insulin kumachepa, kuyankha kwa minofu kumadzi kumatsikanso (monga momwe zilili ndi mtundu wachiwiri). Popita nthawi, ma cell a B amawonongeka kwathunthu kapena pang'ono, katulutsidwe ka insulin kamatha.

Kuyambira pano, matenda ashuga osokoneza bongo amapitilira chimodzimodzi monga matenda amtundu 1.

W ludzu
Kutopa
Pafupipafupi komanso kupemphetsa kukodza.

Nthawi zambiri, zizindikiro za matendawa zimakhala zofatsa, sizimatengedwa kwambiri. Mosiyana ndi matenda amtundu 1, anthu odwala matenda ashuga sakonda kuonda msanga. Kuyesedwa kwa magazi sikuwonetsa nthawi zonse kukhalapo kwa matendawa, chifukwa kuchuluka kwa shuga ndi ma acetone mu mkodzo ndi magazi nthawi zambiri sizipitilira zomwe zimachitika.

Ngakhale mahomoni owonjezera a adrenal ali pachiwopsezo, si odwala onse omwe amamwa mankhwala a corticosteroid amadwala. Corticosteroids amachita m'njira ziwiri: zimakhudza kapamba ndipo amachepetsa mphamvu ya insulin. Pankhaniyi, kuti tisunge shuga wabwinobwino wamagazi, kapamba amagwira ntchito mpaka momwe angathere.

Kwanthawi yayitali, kapamba amatha kupirira kuthamanga uku, chifukwa akamaliza maphunziro a corticosteroids, mavuto a metabolic amatha. Mu matenda a shuga, kuyankha kwamtundu wa insulin ndi ntchito ya pancreatic kumavulala. Pankhaniyi, corticosteroids imatha kutengedwa pokhapokha chifukwa chofunikira.

Zowopsa Zazikulu:

Kugwiritsa ntchito nthawi yayitali corticosteroids,
Kumwa ma Steroid pamiyeso yambiri,
Nthawi ndi nthawi mumakweza shuga wambiri pazifukwa zosadziwika
Kukhalapo kwa kunenepa kwambiri kwamlingo uliwonse.

Zimachitika kuti kugwiritsa ntchito glucocorticoids kumadzetsa chiwonetsero cha matenda ashuga, omwe sanadziwike m'mbuyomu chifukwa cha kufooka kapena kusapezeka kwa zizindikiro zake.

Zikakhala zoterezi, pamakhala chiwopsezo cha kufooka kwambiri pamlingo wa wodwalayo kapenanso chikomokere.

Chifukwa chake, musanayambe maphunziro a mankhwalawa ndi ma steroid (njira zakulera, diuretic thiazides), anthu onenepa kwambiri, komanso anthu a gulu lakale, ayenera kuyesedwa ngati ali ndi matenda ashuga.

Kutengera

Katemera wa insulin atayima mthupi, matendawa amadutsa chimodzimodzi ndi matenda amtundu woyamba, komabe, pali zizindikiro za mtundu wachiwiri, ndiko kuti, insulin kukaniza minofu. Matenda a shuga a steroid amathandizidwanso komanso matenda amtundu wachiwiri. Njira zamankhwala zimatengera chiwonetsero cha matenda.

Mlingo wa insulin yaying'ono nthawi zina umayikidwa. Pancreatic ntchito yoletsa pamafunika kugwiritsa ntchito insulin ngati njira yothandizira.

Zotsatira zake, chitsulo chimagwira ndi ntchito zochepa, ndipo ngati pali ma "cell" amoyo, ndikotheka kubwezeretsa kapamba.

Kwa achire, zakudya zamagulu ochepa zimaperekedwa: ngati kulemera ndikwabwinobwino - zakudya 9, kwa omwe akuvutika ndi kunenepa kwambiri - zakudya 8.

Mulingo wa shuga ndi chithandizo chofanana ndi kuchiza matenda amtundu 1 shuga. Monga momwe ziliri ndi matendawa, kubwezeretsa ntchito za ma b-cell sikutheka.

Pali zochitika zina pamene kukana chithandizo cha mahomoni sikutheka, mwachitsanzo, pambuyo poti ndikuwonjezera impso kapena odwala asthmatic. Muzochitika zotere, boma la kapamba ndi minofu imayankha ku insulin zimaganiziridwa kuti zitsimikizike shuga yomwe mukufuna. Pakati pa mankhwala ena, odwala amapatsidwa ma anabolics omwe amalipira zotsatira za glucocorticoids.

Matenda a shuga a Steroid: zomwe zimayambitsa

Steroid shuga mellitus, kapena sekondaleus yodalira 1 ya shuga, imachitika chifukwa cha kuchuluka kwa mahomoni m'magazi a adrenal cortex - corticosteroids.

Nthawi zina amakula ngati vuto la matenda momwe kupanga mahomoni awa, mwachitsanzo, matenda a Itsenko-Cushing, amalimbikitsidwa. Koma nthawi zambiri, matendawa amadzimva pambuyo poti athandizidwa kwa nthawi yayitali ndi mankhwala ena a m'thupi, motero dzina lake limodzi ndi matenda osokoneza bongo.

Mwa chiyambi chake, matenda a shuga aidid amatanthauza mitundu yamatendayi ya matendawa, ndiko kuti, sikuti zimagwirizanitsidwa ndi zovuta za kapamba.

Mwa anthu osavomerezeka a metabolism a carbohydrate, okhala ndi mankhwala osokoneza bongo a adrenal mahomoni (glucocorticoids), amawoneka ofatsa ndipo amawonekanso atatha. Mu 60% ya odwala omwe ali ndi matenda a shuga a 2, matendawa amatha kupangitsa kuti mtundu wa insulin ukhale wodziimira pawokha.

Ndi mankhwala ati omwe amayambitsa matenda a shuga?

Mankhwala a Glucocorticoid - Hydrocortisone, Prednisolone, Dexamethasone - amagwiritsidwa ntchito ngati mankhwala odana ndi kutupa kwa nyamakazi, matenda a mphumu ya bronchial ndi matenda ena a autoimmune.

Mwachitsanzo, lupus erythematosus, pemphigus, eczema. Amagwiritsidwanso ntchito pochiza matenda amitsempha monga multiple sclerosis ..

Ma diuretics ena, monga thiazide diuretics Dichlothiazide, Hypothiazide, Nephrix, Navidrex, mapiritsi ena ochepetsa kubereka, amatha kukhala chifukwa cha matenda osokoneza bongo.

Mlingo waukulu wa corticosteroids amagwiritsidwanso ntchito pochiza matenda obwera chifukwa cha kupatsirana kwa impso.

Pambuyo pakuwonjezereka, anthu amamwa mankhwala osokoneza bongo kuti athe kupewera chitetezo chamoyo, motero kufalitsa kosiyanasiyana kumakhala kambiri mwa iwo, ndipo choyambirira amawopseza chiwalo chogalitsidwayo.

Matenda a shuga samapezeka mwa odwala onse, koma chifukwa chokhala ndi mahomoni ambiri, kuthekera kwake pankhaniyi ndikokwera kuposa momwe amathandizira matenda ena.

Zizindikiro za matenda ashuga zomwe zidawoneka pamene akumwa ma steroid zikuwonetsa kuti anthu awa ali pachiwopsezo.

Pofuna kuti asadwale, anthu onenepa kwambiri ayenera kunenepa, ndipo anthu onenepa kwambiri ayenera kulabadira masewera olimbitsa thupi komanso kusintha zakudya zawo. Popeza mwaphunzira za kukonzekera kwake kwa "matenda a shuga", simungatenge mankhwala aliwonse a mahomoni osalamulirika.

Zizindikiro zake komanso matendawa

Zomwe zimachitika ndi matenda a shuga a steroid ndikuti zimaphatikiza mitundu ya matenda ashuga amtundu wa 1 komanso mtundu wa matenda ashuga a 2. Amayamba ndikuwona kuti kuchuluka kwa corticosteroids kumawononga maselo a beta a kapamba (monga mtundu 1 wa shuga), ngakhale akupitiliza kupanga insulin kwa nthawi yayitali .

Kenako kuchuluka kwa insulini kumachepa, pomwe chidwi cha tinthu tambiri m'thupi lathu chimasokonekera (monga mtundu 2 wa shuga). Pang'onopang'ono, maselo a beta kapena gawo lawo limawonongeka ndikusiya kutulutsa insulin, ndipo matendawa amayamba kupitilirabe chimodzimodzi ndi matenda abwinobwino a insulin 1.

Zizindikiro zazikulu za matenda a shuga zimafanana chimodzimodzi ndi mtundu uliwonse wa matenda ashuga - ludzu, kukodza kwambiri, kutopa. Koma, monga lamulo, amakhala ofooka, ndipo nthawi zina samvera.

Mosiyana ndi matenda abwinobwino a mtundu woyamba 1, odwala satenga thupi mwadzidzidzi, ndipo ngakhale kuyezetsa magazi sikumakupatsani mwayi wokhazikitsa matenda.

Mlingo wa shuga ndi shuga mumkodzo sufika pamlingo, kupezeka kwa acetone m'magazi ndi mkodzo ndikosowa.

Matenda a shuga monga chiopsezo cha matenda a shuga

Madzi ochulukirapo a adrenal ndi omwewo mwa anthu onse. Kodi ndichifukwa chiyani aliyense amene amamwa glucocorticoids amadwala ndi matenda a shuga? Corticosteroids, kumbali ina, amapanga kapamba, kenako, "amasokoneza" insulin. Chifukwa chake, kuti magazi a shuga asakhale abwinobwino, kapamba amakakamizidwa kugwira ntchito mpaka pamlingo.

Zikondamoyo za munthu wathanzi kwakanthawi zitha kuthana ndi kuchuluka kowonjezereka, ndipo atangosiya kumwa mankhwala osokoneza bongo kapena kuchepetsa mlingo, kusowa kwa metabolic kudzatha.

Koma ngati muli ndi matenda a shuga, ndiye kuti minyewa ya insulin yayamba kuchepetsedwa, ndipo kapamba sangathenso kuthana ndi ntchito zake.

Chifukwa chake, mutha kulandira chithandizo ndi ma steroid pokhapokha pazifukwa zaumoyo. Kuchuluka kwawopsa:

ndikugwiritsa ntchito ma steroid nthawi yayitali,
ngati angagwiritse ntchito muyezo waukulu,
pamaso pa kunenepa kwambiri.

Muyenera kusamala nawonso kwa omwe, pazifukwa zosadziwika, nthawi zina amathandizira shuga. Nthawi zina mukamagwiritsa ntchito glucocorticoids, matenda a shuga amawonekera, omwe wodwalayo samadziwa, popeza anali ofatsa.

Pankhaniyi, mankhwala a mahomoni amatha kuvulaza msanga komanso mpaka kudwala.

Chifukwa chake, musanapereke mankhwala a mahomoni omwe sagwirizana ndi mankhwalawa (mapiritsi othandizira kubereka, okodzetsa a gulu la thiazide), amayi onenepa kwambiri komanso anthu okalamba ayenera kuyang'aniridwa ndi matenda ashuga apambuyo.

Ultrasound yamitsempha yamagazi yopereka magazi ku miyendo

Kusanthula kwapadera (ultrasound) kwamitsempha yamagawo am'munsi - kumagwiritsidwa ntchito poyang'ana momwe magazi amayendera asanayambe kuchita opareshoni yamitsempha. Njira imeneyi imawonjezera mwayi kuti zitheka munthawi yake kuti mupeze chotupa cha mtsempha kapena chopindika kapena kuchepera kwa lumen m'matumbo mutachitidwa opaleshoni (restenosis).

Ultrasound yamitsempha yamagazi imakupatsani mwayi kuti muphunzire madera ovuta, ndiko kuti, zigawo zomwe "zidachotsedwa" m'magazi chifukwa chakukula kwa matendawa. Pogwiritsa ntchito njirayi, mutha kuwunika bwino momwe ziwiya ziliri ndipo konzani pasadakhale opareshoni kuti mubwezeretsere kukhalabe kwawo.

X-ray kusiyanitsa angiography

X-ray kusiyanitsa angiography ndi njira yowunikira momwe wophatikizira wosemphana amaloŵetsamo mtsempha wamagazi, ndiye kuti ziwiya "zimatulutsa" ndi x-ray. Angiography imatanthawuza "kuwunika mtima". Iyi ndiye njira yophunzitsira kwambiri. Koma ndizosasangalatsa kwa wodwalayo, ndipo koposa zonse - wothandizira wosiyanayo akhoza kuwononga impso. Chifukwa chake, tikulimbikitsidwa kugwiritsa ntchito pokhapokha ngati pakufunsidwa funso la opareshoni yobwezeretsanso minyewa yam'mimba.

Magawo a zovuta za shuga pamiyendo

Pali 3 madigiri a zotumphukira magazi kusokonezeka mwa odwala matenda a shuga.

Digiri yoyamba - palibe umboni ndi matenda amitsempha yamagazi m'miyendo:

kusintha kwam'mimba kumamveka
ankolo-brachial index ya 0.9-1.2,
cholowera kumanja> 0,6,
mitengo ya transcutaneous oximetry> 60 mmHg. Art.

Digiri yachiwiri - pali zizindikiro kapena zizindikiro, koma pakadali pano palibe vuto lakufa la oxygen.

kupindika pang'ono (miyendo yopweteka)
ankolo-brachial index ya 30 mm RT. Art.
transcutaneous oximetry 30-60 mm RT. Art.

3 digiri - yovuta mpweya njala ya zimakhala (ischemia):

kukhathamira kwa systolic m'mitsempha ya m'munsi mwendo Kodi chithandizo ngati miyendo imapweteka ndi matenda a shuga

Ngati miyendo yanu yapweteka ndi shuga, ndiye kuti chithandizo chikuchitika m'njira zitatu:

Zotsatira pazinthu zomwe zimathandizira kukulitsa kwa atherosulinosis, kuphatikiza mitsempha ya miyendo,
kukhazikitsa mosamala malangizo othandizira kupewa komanso kuchiza matenda ammiyendo, omwe amafotokozedwa mwatsatanetsatane mu nkhani ya "Diabetesic foot syndrome",
yankho la nkhani ya opareshoni yobwezeretsanso magazi kuti ibwezeretse magazi

Mpaka posachedwapa, pa nthawi yodziwika bwino, odwala adalandira mankhwala pentoxifylline. Koma kafukufuku wawonetsa kuti palibe phindu lenileni kwa odwala matenda a shuga omwe ali ndi matenda osokoneza bongo.

Ndi zovuta za matenda a shuga pamiyendo, opaleshoni yobwezeretsa magazi m'mitsempha ingakhale yothandiza kwambiri. Madokotala amalingalira za momwe wodwalayo alili ndi wodwala aliyense, poganizira zomwe angachite atachitidwa opaleshoni.

Odwala omwe ali ndi ululu wam'miyendo mu shuga, monga lamulo, adanenanso zovuta zamatumbo a metabolism (shuga yamagazi ndizambiri), matenda ammimba a shuga, komanso kuwonetsa zovuta zina za matenda ashuga. Kuti muwathandize kwenikweni, muyenera kuyitanitsa gulu la akatswiri pazachipatala.

Matenda a diabetes a phazi amathandizidwa ndi podiatrist wapadera (kuti asasokonezedwe ndi dokotala). Choyamba, kuchitira opaleshoni mabala kumapazi kungakhale kofunikira kuti mupewe matenda osokoneza bongo, ndipo pokhapokha - kubwezeretsanso kuchuluka kwa mitsempha yamagazi.

Matenda a shuga ndi Mwendo: Zotsatira

Tikukhulupirira kuti nkhaniyi yakufotokozerani mwatsatanetsatane zoyenera kuchita ngati miyendo yanu ipweteka ndi matenda a shuga. Muyenera kusinthira kukhala ndi moyo wathanzi kuti muthe kusintha shuga m'magazi ndikuletsa chitukuko cha atherosulinosis. Ndi dokotala, mudzatha kusankha pa opaleshoni yomwe idzabwezeretse kuchuluka kwa ziwiya zamiyendo. Muyeneranso kufufuzidwa pazovuta zina za matenda a shuga ndikuzichitira.

Chonde musayesetse "kupewetsa" kupweteka kwa kupweteka kwapamsi mothandizidwa ndi mapiritsi ena. Zotsatira zake zoyipa zimatha kukulitsa vuto lanu komanso chiyembekezo chamoyo. Funsani dokotala woyenera. Pa matenda ashuga, ndikofunikira kusamala ndiukhondo kumapazi kuti mukhale wokhoza kuyenda nokha.