Matenda a diabetesic polyneuropathy kuti awa ndi njira zamakono zochizira

Matenda a shuga a polyneuropathy. Amayamba kukhala ndi anthu odwala matenda ashuga. Polyneuropathy ikhoza kukhala kuwonetsa koyamba kwa matenda ashuga kapena kumachitika patadutsa zaka zambiri kumayambiriro kwa matendawa. Polyneuropathy syndrome imapezeka pafupifupi theka la odwala matenda a shuga.

Ziwonetsero

Njira zazikulu kwambiri zothandizira kupangira matenda amitsempha ya m'mimba ndi vuto la ischemia ndi metabolic mu mitsempha chifukwa cha hyperglycemia.

Chithunzi cha kuchipatala

Pali zosankha zingapo zamankhwala za polyneuropathy. Kuwonetsedwa koyambirira kwa polyneuropathy nthawi zambiri kumatha kukhala kufooketsa kwamphamvu yamagetsi komanso ma Achilles. Izi zitha kukhalapo kwa zaka zambiri. Njira yachiwiri imawonetsedwa ndi zotupa za pachimake ndi zazing'onoting'ono zamitsempha payokha: nthawi zambiri kuposa zachikazi, zamasayansi, zilonda kapena zamkati, komanso oculomotor, trigeminal komanso abducent. Odwala amadandaula za kupweteka, kusokonezeka kwa kutengeka ndi ma presis a minofu omwe amaphatikizidwa ndi mitsempha yofananira. Njira yachitatu ndi chotupa chachikulu cha mitsempha yambiri yam'mphepete yokhala ndi zovuta zoteteza komanso ma presis, makamaka m'miyendo. Ululu nthawi zambiri umakulitsidwa ndi kukakamira kwa thupi komanso kupuma. Nthawi zambiri, kusungidwa kwazinthu za palokha kumadodometsedwa. Ngati njirayo ikupita patsogolo, ululuwo umakula, umakhala wosapirira, pali zikopa za utoto wofiirira ndi wakuda, kukonza mtembo. Nthawi zambiri muzochitika zotere, kuyabwa, zilonda zam'mimba ndi zochitika za osteoarthropathy zimachitika, limodzi ndi kupindika kwa mapazi.

Nthawi ya matenda ashuga polyneuropathy nthawi zambiri amakhala ndi zochitika pang'onopang'ono. Nthawi zina zimayendera limodzi ndi zizindikiritso zam'maso zam'mimba. Makamaka, nthawi zambiri, orthostatic hypotension, chikhodzodzo cha neurogenic, kusabala.

Vuto lalikulu ndi (nthawi zambiri mwa odwala omwe ali ndi zaka zopitilira 50) kuwonongeka kwa mitsempha yomwe imatulutsa minyewa yamatumbo (III, IV ndi VI), yomwe imatsogolera ku strabismus, anisocoria, kusokonekera kwa ophunzira komwe kumapangitsa kuwala, malo okhala komanso kutembenuka.

Ziwonetsero

Matendawa amakhala osavomerezeka, matendawa ndi osachiritsika, ndipo amapita patsogolo pang'onopang'ono. Zosintha zoipira sizingabwezeretsedwe. Chithandizo cha mankhwala osokoneza bongo ndicholinga chokweza moyo wamunthu komanso kupewa kupititsa patsogolo matendawa. Panthawi yomwe matenda amatenga, kulumala kumatha.

Kodi matenda ashuga a polyneuropathy ndi chiyani

Kapangidwe ka zotumphukira zamkati mwa anthu zimaphatikizapo madipatimenti awiri.

• Chosangalatsa chimalola kuti thupi lanu lizigwira ntchito molimbika.
• Masamba amayang'anira kudziyimira pawokha kwa ziwalo zamkati ndi machitidwe.

Kodi matenda amatenga bwanji matenda ashuga

Polyneuropathy ili ndi zofunikira zonse kuti zikhudze madipatimenti onse awiriwa.

Chifukwa cha matenda ashuga, mitsempha yamitsempha yamkati mwa munthu imawonongeka kwambiri, ndikuphatikizira kukula kwa matendawa.

Kuchokera pakuwona tanthauzo la lingaliro ili, titha kunena kuti uwu ndi mtundu wa neuropathy momwe magwiridwe antchito amomwe amachititsa chidwi ndi ma nerve a mota amaponderezedwa.

Zomwe zimachitika kumapeto kwa mitsempha

• Mitsempha yam'mutu imayendetsa zochitika kuchokera kuzinthu zakunja kupita ku gawo lathu lamanjenje lamkati (i.e., mpaka ku ubongo ndi chingwe cha msana). Amawongolera kukhudzika, kuwawa, kuzizira kapena kutentha.
• Poterepa, mitsempha yamagalimoto ndi yomwe imayankha. Mwachitsanzo, ndi kufalikira kwa minofu yolingana yomwe imapereka kuyenda kwa manja ndi miyendo.

Zizindikiro za matendawa

Ngati muphunzira lingaliro la matenda ashuga polyneuropathy, momwe lilili ndi momwe limamvekera m'thupi, ndiye kuti mutha kuzindikira, choyambirira, kutchulidwa kupweteka m'miyendo ndi mikono. Kuphatikiza apo, ndimunthu aliyense payekha ndipo amasiyana mwa anthu omwe ali ndi matenda ashuga.

Zizindikiro zodziwika bwino za kuchepa kwa mitsempha ndi:

• Kugunda kapena kutaya mphamvu, nthawi zambiri m'manja ndi miyendo.
• Munthu amakhala ndi mawonekedwe apadera a "magolovesi ndi masokosi".
• Hypewhesia,
• Ululu
• Pali ululu wosiyana wa ululu wamatsenga. Zimatha kukhala zosasangalatsa pamene anthu akumva kuwonda pang'ono kapena kupweteka kwambiri.
• Nthawi zina, hyperalgesia kukopa kwamtundu uliwonse. Matendawa amatchedwanso kuti allodynia.

Chikhalidwe cha kupweteka ndi polyneuropathy

Monga kukula kwa zowawa, chilengedwe chake chimatha kukhala chosiyanasiyana. Zizindikiro zina zopweteka zimamva ngati kuyaka, ena amapweteka kwambiri, mwa mawonekedwe ena zimakhala zakuya kwambiri komanso zowawa.

Zovuta zam'maganizo zodziwika bwino zitha kufotokozedwa motere:

• Kumverera koyenda thonje
• Kumverera kolakwika kwa malo olimba
• Zovuta kutembenuza masamba a nyuzipepala,
• Mavuto pozindikira ndalama osayang'ana.
• Zikachitika kuti munthu amve kutentha komwe kumakhalako nthawi zonse, izi zimatha kuyambitsa khungu.

Matenda a neuropathy

Motor neuropathy nthawi zambiri imawonetsedwa ngati kufooka kwa minofu mu miyendo. Mitsempha imatha kuwonongeka, yomwe imakhudza:

• Minofu ya Proximal. Amapezeka pafupi ndi thupi - dera lamchiuno ndi mikono,
• Minofu yamkati. Awa ndi zotumphukira, zakutali kwambiri ndi thupi, mwachitsanzo, miyendo.

Kodi munthu amene wapezeka ndi polyneuropathy amamva bwanji?

• Chifukwa cha kuwonongeka kwa minofu minofu mwa anthu, mgwirizano wonse wa kayendedwe umasokonekera.
• Zotsatira zake, kuchita zinthu zovuta monga kutsegula zitseko zokhala ndi ma tebulo kumakhala kovuta.
• Zizindikiro zoyambirira za kuwonongeka kwa mitsempha yomwe imapereka minofu ya mbali yam'munsi imawoneka m'dera la phazi.
• Kenako pakhoza kukhala zovuta mukakwera kapena kutsika masitepe, kuvutika kutuluka pakama kapena pa sofa, kugwa chifukwa chofooka kwakukulu komanso minyewa yolimba.
• Chifukwa cha kufalikira kwa matendawa, munthu amamva “kuthyoka” kapena kuwina kwa nyundo.

Zoyambitsa ndi Zoopsa

Mpaka pano, njira yeniyeni yofalitsira matenda a diabetesic polyneuropathy sichinapezekebe, koma ndikudziwika kuti pali zifukwa zambiri za izi. Nthawi zina, wodwalayo amatha kupangitsa kuti pakhale chitukuko.

Zowonongeka zamafuta zamitsempha ndizotheka kwambiri ndi:

• matenda ashuga osachiritsika, omwe amakhala zaka zambiri (okhala ndi HbA1c yayikulu),
• mafuta achilendo amthupi
• matenda oopsa
• kusuta
• kuyamwa mankhwala oopsa, monga mowa,
• katundu wazachilengedwe
• zosintha zokhudzana ndi zaka

Kuzindikira matendawa

Chofunikira kwambiri pakuzindikira njira zomwe zingathandize kuthetsa matendawa ndi matenda ashuga polyneuropathy nthawi zambiri amathandizira kupewa kudziwika bwino komanso mbiri yakale yachipatala.

Mafunso azachipatala omwe adapangidwira ntchito mwanjira imeneyi adakhala othandiza m'derali.

Momwe mungagwiritsire ntchito

Kwa izi, ulusi wa monofilament ndi bango zimagwiritsidwa ntchito.

Zoyambirira zimakupatsani mwayi wofufuza momwe mukumvera pansi pamiyendo yanu, ndipo chachiwiri - kuthekera kwa zida zanu zamakono.

Zida zina zimagwiritsidwanso ntchito kuchepetsa (ndipo chifukwa chake cholinga chambiri) ntchito yothandiza kugwedeza, kutentha, kukhudza pang'ono ndi ululu.

Pozindikira matenda ashuga a polyneuropathy nthawi zambiri, ndikulimbikitsidwa kuchita mayeso angapo.

Kuyesa Kuzindikira

• Kuyesedwa koyambirira ndi kuchuluka kwa glycosylated hemoglobin HbA1c, komwe ndi chizindikiro cha matenda ashuga. Zidatsimikizika chifukwa cha maphunziro kuti mulingo wake umakhala wokwera kwambiri nthawi zambiri mwa iwo omwe ali ndi vuto la polyneuropathy.
• Kwa mayeso owonetsa mwatsatanetsatane, kafukufuku wa electromyographic (EMG) ndi nerve conduction velocity test (NCV) amagwiritsidwa ntchito. Njira izi zimakupatsani mwayi kudziwa malo omwe nthendayo imawonongeka komanso kuopsa kwa matendawa.
• Maphunziro a Screen - magnetic resonance imaging and diagnostics apakompyuta amagwiritsidwa ntchito kupatula zina zomwe zimapangitsa kuwonongeka kwa mathero a mitsempha, makamaka njira za neoplastic.

Musanazindikire matenda a diabetesic polyneuropathy - ndi matenda amtundu wanji, zifukwa zina za neuropathy ziyenera kuthetsedwa kwathunthu. Akuti pamilandu ya 10-26%, kuwonongeka kwa mitsempha mu odwala matenda ashuga ali ndi maziko osiyana. Chifukwa chake, poyambirira, zifukwa zazikulu monga:

• kuchepa magazi m'thupi,
• Vitamini B6 poyizoni
• uchidakwa
• uremia
• chiwindi
• paraneoplastic syndromes (matenda ogwirizana ndi khansa),
• chindapusa
• HIV / Edzi
• mavuto ndi kugwiritsa ntchito mankhwala ena (mwachitsanzo, chemotherapy, isoniazid),
• matenda a msana.

Ndikofunikira kuti muzitha kudziwa zizindikiro za matenda ashuga a polyneuropathy, omwe nthawi zambiri amakupatsani njira zoyenera zothetsera zotupa.

Chithandizo ndi kupewa matenda ashuga polyneuropathy

Tsoka ilo, chithandizo chamankhwala choyenera sichinaperekedwebe. Komabe, kuwongolera kuchuluka kwa shuga m'magazi, kufunitsitsa kuwonetsetsa kuti HbA1 imasungidwa muzoyenerera, kusowa kwa mafuta osafunikira kumachotsa zizindikiro zina za polyneuropathy.

Odwala ambiri amati kukhalabe ndi shuga pamlingo woyenera kumachepetsa ululu. Chofunika kwambiri, chimalepheretsa kukula kwa matendawa.

Kukonzekera kwa matenda ashuga a polyneuropathy

Ngati chizindikiro chachikulu cha matendawa ndizopweteka, kuphatikiza painkillers, mankhwala othandizira komanso othandizira ena amagwiritsidwa ntchito, kuphatikizapo antidepressants ndi anticonvulsants.

Izi zikuphatikiza:

• pregabalin, Absenor, Depakin, Valprolek, gabapentin (Symleptic, Neuran, Gabagamm, Neurontin).
• Malinga kuti zotsatira zake sizothandiza, adokotala atha kukupatsirani mankhwala a dextromethorphan, tramadol, oxycodone kapena morphine. Kapenanso, kugwiritsa ntchito kopaka kwa capsaicin ndi lidocaine wa kukonzekera kungafotokozedwe.
• M'zaka zaposachedwa, zabwino za amitriptyline, venlafaxine ndi duloxetine zawonekanso pa mankhwalawa amathandizanso odwala matenda ashuga polyneuropathy.
• Nthawi zina, mankhwala a antioxidant amatha kukhala osavomerezeka kwakanthawi. Makamaka, alpha lipoic acid. Mankhwalawa nthawi zambiri amaperekedwa ndi odwala matenda ashuga ngati jekeseni wovomerezeka. Pafupipafupi kugwiritsa ntchito kwake nthawi zambiri pamasabata awiri kapena atatu. Mankhwalawa amapitilizidwa ndi mankhwala amkamwa (Thiogamma 600, Thiogamm Turbo-Set).

Zofunika! Mulimonsemo musayambe kudzipanga nokha ndi mankhwalawa.

Zochita zolimbitsa thupi ndi masewera

Kuphatikiza kofunikira kwa mankhwala a pharmacological, makamaka ngati kufooka kwa minofu, ndikwathupi. Physiotherapist amasankha pulogalamu payekha malinga ndi kuthekera kwa chilichonse, kulola minofu kugwira ntchito kwakanthawi. Kuphatikiza pa masewera olimbitsa thupi, njira zotsitsa, monga njira zamadzi, zimagwiritsidwanso ntchito.

Njira zopewera komanso njira

Nthawi zina, kukhazikika kwa matenda akulu ndikosavuta kuwayerekeza kuposa kuwachiritsa. Chifukwa chake, chisamaliro chapadera chikuyenera kulipidwa m'njira zingapo zodzitetezera pofuna kuchepetsa kufalikira kwa zizindikiro za matendawa komanso kuwonongeka kwa ziwalo zambiri.

Njira zazikulu zothanirana ndi polyneuropathy zimaphatikizapo:

• kuwunika koyenera komanso kosalekeza kwamisempha, poganiza kuti glycemic ndi hemoglobin yakhazikika,
• mwachangu chithandizo cha matenda oyanjana, monga matenda oopsa,
• kuchita masewera olimbitsa thupi pafupipafupi
• kusiya kusuta fodya komanso kuchepetsa kumwa mowa,
• chakudya chopatsa thanzi chomwe chimapereka mafuta oyenera,
• kukhala ndi thupi labwino,
• mayeso okhazikika ndi kukambirana ndi adokotala.

Mankhwala amakono akuphunzira bwino za matenda ashuga a polyneuropathy, lomwe ndi vuto lofunika kwambiri padziko lonse lapansi. Posachedwa, zomwe zachitika posachedwa ndi njira zaposachedwa zomwe zaperekedwa kuti zithandizire kuchepetsa ululu komanso kupewa zomwe zingachitike. Komabe, odwala omwe ali ndi vuto lowopsa la metabolic monga matenda a shuga ayenera kusamala kwambiri ndi momwe alili. Pazinthu zochepa, ngakhale zowoneka ngati zazing'ono zamatenda am'mitsempha, ndikofunikira kufunafuna chithandizo chamankhwala.