Polyneuropathy: Kodi matendawa ndi chiyani komanso angatani?

Dongosolo la matenda ashuga polyneuropathy limayamba motsutsana ndi maziko a matenda oopsa a shuga, momwe ziwiya ndi mafupa amitsempha amawonongeka. Izi zimachepetsa kufalikira kwa mitsempha, yomwe imasokoneza dongosolo lamanjenje.

Matenda a shuga mellitus, omwe amakhala zaka zoposa 15, amachititsa kuti ziwalo zambiri zamkati ziwonongeke komanso zimapangitsa kuti mpweya ubowolere m'thupi. Anthu odwala matenda ashuga polyneuropathy amapezeka mu 50% ya anthu odwala matenda ashuga.

Matendawa amakhudzanso odwala omwe ali ndi mtundu 1 ndi mtundu 2. Kuwonongeka kwa minyewa yamitsempha kumatha kubweretsa zovuta zazikulu, zomwe zimaphatikizapo kupindika kwa phazi ndi kufa.

Etiology ndi zomwe zimayambitsa matendawa

Matenda a shuga ndi matenda amtundu wa endocrine, omwe amaphatikizidwa ndi kuchuluka kwa shuga m'magazi. Anthu 150 miliyoni padziko lapansi ali ndi matenda ashuga. Ngati wodwala angayang'anire kuchuluka kwa shuga, osalola kukwera pamwamba pa mtengo wa 8 mmol / l, ndiye kuti chiwopsezo cha kukhala ndi polyneuropathy (neuropathy) sichikhala chochepa.

Kuti mumvetsetse matenda a diabetesic polyneuropathy (DPN), muyenera kumvetsetsa kuti kuwonjezeka kwa shuga kumabweretsa kuwonongeka kwa makoma a mtima. Chifukwa cha izi, minyewa yamitsempha samalandira kuchuluka kofunikira kwa mpweya, kuchuluka kwa magazi ndi metabolism zimasokonekera. Ischemia imayamba pang'onopang'ono, kufalikira kumalepheretsa.

Dongosolo lamanjenje lamkati limagawidwa panjira yodziyimira payokha komanso yosakhazikika. Ntchito yamphamvu ndi kuwongolera magwiridwe antchito amthupi. Dongosolo la autonomic limayang'anira ntchito za ziwalo zamkati. Matenda a shuga amachititsa matenda onsewa. Pathology (ICD code 10: G63.2) amatanthauza imodzi mwa mikhalidwe yowopsa.

Tcherani khutu! Matendawa amatha kuchitika patadutsa zaka zingapo kuchokera nthawi yomwe amadziwika kuti ali ndi matenda ashuga.

Choyambitsa chachikulu cha matenda ashuga polyneuropathy a m'munsi malekezero ndicho kuchuluka kwa shuga komanso kuperewera kwa insulin nthawi yayitali. Kusokonezeka kwa kagayidwe kazinthu zama cellular kumakhala kovulaza kuzinthu zokhudzana ndi mitsempha.

Zina zomwe zikukhudza chitukuko cha matenda ndi:

• zovuta za endocrine,
• matenda a impso, chiwindi,
• matenda opatsirana
• kutsitsa chitetezo chamthupi,
• mavuto
• uchidakwa
• kuledzera kwamankhwala
• chotupa neoplasms.

Matendawa amapezeka pamene shuga m'magazi amakwera kwambiri momwe angathere. Matenda a shuga amachititsa kusokonezeka kwa kagayidwe kachakudya, kamene kamayambitsa kusokonezeka kwa gawo lakumapazi kwamanjenje. Ubongo umayamba kusowa okosijeni, kuchepa kwake komwe kumapangitsa kuti magazi asamayende bwino komanso kuwonongeka kwa minyewa yamitsempha. Pali ena owawa, odwala amawona kufooka kwa minofu, dzanzi la miyendo.

Zizindikiro

Neuropathy mu matenda a shuga amawonekera m'magawo angapo: subclinical and clinical. Pa gawo loyamba, munthuyo akumva wathanzi kwathunthu, palibe zodandaula. Koma katswiri wamitsempha amaulula kuwonongeka pang'onopang'ono kutentha ndi chidwi cha kupweteka, kuchepa kwa zomwe Achilles amachita.

Pa nthawi yachipatala, zizindikiro za matendawa zimawonekera bwino. Kugwira ntchito kwa mitsempha yambiri kumasokonekera. Wodwalayo amataya kumverera. Kapangidwe ka zilonda zam'mimba pazokhala m'munsi.

Poyamba, matenda ashuga a polyneuropathy amawonetsedwa ngati dzanzi, kupweteka komanso "kupindika" m'miyendo. Matenda opweteka amamvekanso ngakhale pakupuma. Pambuyo pake, zomverera zopanda nkhawa zimayamba kuvuta panthawi yamavuto komanso usiku, kutentha moto m'miyendo kumawonjezeka. Munthu amazunzidwa ndi kusowa tulo, nkhawa. Kufika kwa ululu ndi chiwopsezo cha kutentha kumachepetsedwa.

Zizindikiro zina zimaphatikizira kufooka kwa minofu ndi chala. Miyendo imapeza tint yofiira, mawanga amdima amawoneka. Pali kusinthika kwa maula a msomali: misomali imakhuthala kwambiri kapena kuwonda. Mawonekedwe a phazi asintha: amakula mosadukiza, mapazi opendekeka amapangidwa, cholowa cholumikizira chimakhala choperewera.

Matendawa akamakula, mbali zina za phazi zimakhala zitafa, zomwe zimayambitsa gangore.

Poyamba, minofu yayitali yomwe imapita kumapazi ndi manja imakhudzidwa. Mapazi amaphedwa poyambira. Chifukwa cha kuwonongeka kwa malekezero amitsempha, khungu limakhala lachiwonetsero. Allodynia yapezeka - mkhalidwe womwe wodwalayo amamva kupweteka kwambiri ndikukhudza.

Zala zam'maso zimatha kutaya. Pambuyo kuwonongeka kwa minyewa yaying'ono yamitsempha, chidwi cha kutentha chimasowa, kuyaka, kumva kuwoneka. Matumbo amatupa. Machitidwe opanga ma chimanga, ming'alu, zilonda.

Kodi polyneuropathy ndi zomwe zimatsata ndi izi

Kuchokera ku chilankhulo chachi Greek dzina la matendawa limamasuliridwa kuti "nthenda yamitsempha yambiri", ndipo izi zimapereka tanthauzo lake moyenera. Ndi polyneuropathy, pafupifupi mitsempha yonse yaying'ono yaying'ono imakhudzidwa. Zomwe zimayambitsa matendawa ndizosiyana, koma Zizindikiro za polyneuropathy nthawi zonse zimakhala zofanana, ngakhale zitayambitsa matenda:

• kufooka kwa minofu ya m'munsi ndi m'munsi (nthawi zambiri wodwalayo amangodandaula za kufooka kwa miyendo ndi manja, ndiye kufalikira kwa nthambi yonse),
• kuchepa kwa chidwi (mpaka kuzimiririka kwathunthu), komanso kusowa kwa zinthu zina,
• Maonekedwe a ululu wosaneneka.
• zomverera zachilendo mu miyendo - tsekwe, zikuyaka,
• kutupa kwa miyendo ndi manja,
• kugwedeza kwa chala, nthawi zina kumanjenjemera kwa minyewa,
• thukuta, lopanda kutentha ndi kulimbikira,
• kulephera kupuma, kufupika, palpitations,
• chizungulire, kuvutikira bwino, kulumikizana bwino (makamaka ndi maso otsekeka),
• kuchiritsa pang'onopang'ono kwa mabala.

Kukula kwa zizindikirozi kumatha kukhala kwamphamvu komanso kufooka. Nthawi zina matendawa amatenga nthawi yayitali, zaka zingapo, koma amatha kuchitika mwadzidzidzi, pakadutsa milungu ingapo.

Zindikirani

Polyneuropathy imapezeka mwa anthu pafupifupi 2,5%, mwa okalamba chizindikiro ichi ndiokwera - pafupifupi 8%.

Zomwe zimayambitsa matendawa

Zotsatirazi zimatha kudzetsa neuropathy:

• matenda ashuga . Chimodzi mwazomwe zimayambitsa polyneuropathy. Matenda a shuga amasokoneza kugwira ntchito kwa ziwiya zomwe zimadyetsa mitsempha komanso zimayambitsa kusokonezeka kwa metabolic mu myelin sheath ya mitsempha yamitsempha. Izi zimabweretsa kugonjetsedwa kwawo. Mu shuga mellitus, malekezero otsika nthawi zambiri amadwala polyneuropathy,
• kuchepa kwakanthawi kwa mavitamini B . Mavitamini awa ndiofunikira pakugwira ntchito kwamanjenje, ndipo kuchepa kwawo kwakanthawi nthawi zambiri kumayambitsa polyneuropathy,
• kuyamwa poizoni . Izi zimaphatikizapo zonse zakupha zamankhwala (kuphatikizapo mowa) ndi kuledzera m'matenda opatsirana, makamaka ndi diphtheria, HIV, ndi herpes. Poizoni ndi zinthu monga carbon monoxide, arsenic, polyneuropathy imatha kudziwonekera mwachangu, m'masiku ochepa, ndipo matenda ndi uchidakwa, matendawa amapita patsogolo,
• kuvulala . Kuwonongeka kwa ulusi wamitsempha nthawi yovulala kapena ntchito kungayambitsenso polyneuropathy. Zowonongeka ziyeneranso kuphatikizira kuphatikizika kwa mitsempha, yomwe imadziwika ndi matenda a msana monga osteochondrosis ndi herniated disc,
• Guillain-Barré matenda - nthenda ya autoimmune, yomwe nthawi zambiri imayamba chifukwa cha matenda opatsirana,
• cholowa . Amadziwika kuti zovuta zina za metabolic zomwe zimatsogolera polyneuropathy zimatha kufalikira.

Nthawi zina polyneuropathy imakhudza amayi omwe amawoneka athanzi kwathunthu pa mimba . Zitha kuchitika nthawi iliyonse. Amakhulupirira kuti chomwe chimayambitsa polyneuropathy mwa amayi apakati ndikuchepa kwa mavitamini B, toxosis komanso kuyankha kosakwanira kwa chitetezo cha mthupi kwa mwana wosabadwayo.

Mitundu ya polyneuropathy

Mankhwala amasiyanitsa mitundu ingapo ya polyneuropathy:

• malingaliro . Imadziwoneka yokha ndi vuto lakumverera kwa miyendo yomwe yakhudzidwa - dzanzi, kumva, kapena kutseka, kumva kugunda,
• mota . Amawonetsedwa ndi kufooka kwa minofu, kufikira kulephera kwathunthu kusuntha dzanja kapena phazi. Izi zimatsogolera pang'onopang'ono pakufinya kwa minofu,
• sensorimotor momwe zizindikiro za zomverera ndi motor polyneuropathy zimaphatikizidwira. Mwambiri, mawonekedwe awa amadziwika,
• zamasamba . Mosiyana ndi mitundu itatu yoyamba, yomwe ili ndi autonomic polyneuropathy, zizindikiro za kuwonongeka kwa mankhwalawa zimadza patsogolopa: thukuta, khungu, chizungulire, matenda am'mimba komanso kudzimbidwa, tachycardia, kupuma movutikira,
• kusakaniza momwe zizindikiro zonse zapamwambazi zimawonedwa.

Zotsatira za matenda

Polyneuropathy ndiyowopsa. Matendawa samangokhala pawokha, ndipo mukalola kuti izi zikule, zotsatira zake zimakhala zoipa kwambiri. Kufooka kwa minofu kumatsogolera kutsika kwa kamvekedwe ka minofu ndi minyewa yolimbitsa thupi. Izi zimawonekeranso ndi zilonda zam'mimba. Nthawi zina zotsatira za polyneuropathy zimakhala ziwalo zathupi kapena ziwalo zopumira, ndipo izi zimapha.

Kuphatikiza apo, polyneuropathy yomwe ikupita patsogolo imapatsa munthu zovuta zambiri, kusintha njira yake yokhazikika. Anthu amalephera kuyenda ndikudzisamalira; kusowa thandizo kumabweretsa nkhawa komanso kukhumudwa.

Kuzindikira kwa polyneuropathy

Zimakhala zovuta, chifukwa zizindikiro za matendawa zimafanana ndi matenda osiyanasiyana osiyanasiyana. Sizotheka kupanga chidziwitso pokhapokha ngati madandaulo akudwala: izi zimafuna maphunziro othandizira komanso a labotale.

Kuzindikira kumayamba ndi kufunsira kwa katswiri wa zamitsempha: dokotala amayeza miyendo ndi omwe akukhudzidwa ndikuwonetsa mawonekedwe. Ngati polyneuropathy ikukayikiridwa, kuyezetsa magazi wamba kuyenera kuchitika, ma electroneuromyography ayenera kuchitidwa - kafukufuku yemwe akuwonetsa momwe chizindikirocho chimadutsira mu mitsempha, nthawi zina neropiyo imayenera. Mwina padzafunika kufunsirana ndi endocrinologist.

Chithandizo ndi mankhwala ochizira polyneuropathy

Wodwala yemwe wapezeka ndi polyneuropathy ayenera kukhala wokonzekera chithandizo chokwanira chokwanira. Sikuti amangolimbana ndi zizindikiro. Ndi polyneuropathy, mitsempha yeniyeniyo imawonongeka, ndipo zimatenga nthawi kuti ikonzenso.

Chithandizo chilichonse chimayamba ndikuwonetsa zomwe zimayambitsa matendawa, ndiko kuti, ndi chithandizo cha matenda oyambitsidwa, kapena osachepera ndi kukhazikika. Mwachitsanzo, ndi polyneuropathy yoyambitsidwa ndi matenda ashuga, kuyesayesa kuli ndi kuchepetsa kuchuluka kwa glucose, wokhala ndi mitundu yosagwirizana - kulimbana ndi matendawa, ndipo ngati muzu wavutoli ndi kuperewera kwa mavitamini a B, amafunika kudzazidwa. Ndi polyneuropathy, chomwe chimayambitsa matenda osokoneza bongo mu endocrine system, chithandizo cha mahomoni chimasonyezedwa.

Mankhwala a Vitamini amagwiritsidwa ntchito kwambiri pochiza polyneuropathy. Zotsatira zabwino zimaperekedwa ndi mankhwala omwe amasintha ma microcirculation, motero zakudya zamafuta a mitsempha. Njira zamankhwala othandizira, makamaka ma electrophoresis, amagwiritsidwanso ntchito pochizira. Ngati polyneuropathy imayendera limodzi ndi kupweteka kwambiri, mankhwala a ululu amapatsidwa onse pakamwa komanso mopitirira.

Kodi ndizotheka kuletsa kukula kwa polyneuropathy? Ndizosatheka kudzisunga mokwanira, koma kusamala ndizofunikira kungakuthandizeni kuchepetsa ngozi. Makamaka, mutha kugwira ntchito ndi zinthu zapoizoni kokha ndi chitetezo choyenera, mankhwala aliwonse ayenera kumwedwa pokhapokha ngati akuwuzani ndi dokotala ndipo akuwongolera, ndipo matenda opatsirana sayenera kuloledwa kuyendayenda. Zakudya zoyenera zomwe zimakhala ndi mavitamini, masewera olimbitsa thupi, kukana mowa - izi zosavuta zimathandizanso kuchepetsa mwayi wokhala ndi polyneuropathy.

Kukonzanso

Ngakhale chithandizocho chidayenda bwino ndipo ulusi wamitsempha wachira, kumayambiriro kwambiri. Pambuyo njira ya kukonzanso chithandizo chofunikira. Ndi polyneuropathy, minofu imakhudzidwa kwambiri: kusowa koyenda kumabweretsa kufooka kwawo. Kuti abwezeretse kuyenda, pamafunika ntchito yambiri ndi kuyesetsa kwa akatswiri angapo.

Pakukonzanso pambuyo pa polyneuropathy, kutikita minofu ndikuwonetsedwa. Imasintha magazi, imabwezeretsa kuchepa kwa minofu ndikuwongolera njira zama metabolic mu zimakhala.

Njira zosiyanasiyana zolimbitsa thupi zimapatsa zotsatira zabwino. Amachititsanso kusintha kwakanthawi kochepa, kumachepetsa ululu ndikubwezeretsa minofu minofu.

Zilonda zazikulu, ngati kubwezeretsa kwathunthu kwa malilowo kugwira ntchito ndikosatheka, makalasi omwe ali ndi othandizira pantchito angathandize. Ergotherapy ndi chithandizo chochita. Katswiriyu amathandiza wodwalayo kuti azolowere dziko latsopano, kuti apange mawonekedwe atsopano a kayendedwe ka zochitika zatsiku ndi tsiku.

Chiwembu chokhazikitsanso njira zake zimakhazikitsidwa payekhapayekha kwa wodwala aliyense. Zitha kuphatikizaponso mavitamini othandizira, ntchito ndi katswiri wama psychologist, mankhwala othandizira pakudya ndi njira zina.

Chithandizo cha polyneuropathy ziyenera kuyamba pomwe, zizindikilo zoyambirira zikaoneka. Popanda chithandizo, chiopsezo cha kufooka, kusokonezeka kwa kayendedwe ka mtima ndi kupuma kwamphamvu kwambiri. Chithandizo chapanthawi yake kumathandiza kuchepetsa chiopsezo cha zovuta komanso kukhala wathanzi. Njira ya kukonzanso mankhwalawa sinanso yofunikira: iphatikiza momwe mankhwalawo amathandizira.

Chifukwa chiyani matenda ashuga a polyneuropathy amakula?

Ndi matenda a shuga, kuchuluka kwa shuga m'magazi kumachuluka. Glucose owonjezera m'maselo a mitsempha amawonongeka ndikupanga zinthu zapoizoni. Zinthu izi zimawononga ma cell awiriwo ndi mitsempha.

Kuphatikiza apo, ndi matenda ashuga, ma cellvessels omwe amachepetsa mitsempha nawonso amawonongeka, zomwe zimatsogolera ku njala ya okosijeni ndi kufa kwa malo amitsempha.

Chiwopsezo chokhala ndi matenda ashuga a polyneuropathy ali mwa onse odwala matenda ashuga. Amachulukana ndi nthawi ya matendawa kwa odwala omwe amalumikizidwa mosagwirizana ndimagazi a glucose, komanso kwa iwo omwe ali ndi msinkhu wokhazikika kwambiri.

A shuga a distal polyneuropathy

Mtundu wofala kwambiri wa matenda ashuga polyneuropathy ndi mawonekedwe a distal, kapena sensorimotor. Ndi iyo, magawo omaliza a mitsempha amakhudzidwa, zomwe zimayambitsa kusokonezeka kwamagalimoto ndi mphamvu.

Zizindikiro za matenda a shuga a distal polyneuropathy a m'munsi malekezero:

• Kupweteka kwamiyendo m'miyendo, kukulira usiku, polumikizana ndi zovala, kumatha kukhala kosapiririka, kotopetsa, komanso kutsika poyenda.
• Kupendekera, kuzizira, kugona.
• Kuchepetsa kwamitundu yonse yamtundu wamtundu - kutentha, kupweteka, kusayenda, kugwedezeka.
• Khungu lowuma, nsapato, chimanga.
• Kuchulukitsa thukuta, kutupa kwa mapazi.
• Kukokana mu minofu ya ng'ombe.
• Kufooka kwa minofu, gait wosakhazikika.
• Woopsa milandu - mawonekedwe a zilonda zam'mimba pamapazi.

Chizindikiro chovuta kwambiri ndikuchepa kwa kupweteka m'miyendo mwanjira zawo popanda chithandizo komanso matenda a shuga m'magazi. Izi zikuwonetsa kuwonongeka kosasintha kwa mitsempha ndi maonekedwe oyamba a zilonda zam'mimba.

Chithandizo: mfundo, mankhwala, wowerengeka

Chithandizo cha matenda ashuga polyneuropathy, monga zovuta zina zonse za shuga, chimayamba ndi matenda a shuga m'magazi. Mulingo woyeserera wa hemoglobin wa glycated, wowonetsa chipukuta cha shuga, uyenera kukwaniritsidwa. Sipayenera kupitirira 7%. Ngati ndi kotheka, Mlingo wa mankhwala ochepetsa shuga kapena insulin umasinthidwa.

Ndikofunikira kuti muchepetse cholesterol ndi triglycerides kukhala labwinobwino. Izi zidzasintha machitidwe amitsempha yamagazi ndikulemeretsa mitsempha ndi mpweya.

Mankhwalawa matenda a diabetesic polyneuropathy, magulu angapo a mankhwala amagwiritsidwa ntchito:

1. Kuti muchepetse kupweteka, adayikidwa anticonvulsants ndi antidepressants. Amalepheretsa zomwe zimapangitsa kuti azimva kupweteka, amachepetsa kumasula kwa zinthu zomwe zimapangitsa kupweteka, komanso kukhala ndi vuto. Zomwe zimagwiritsidwa ntchito kwambiri ndi gabapentin, lamotrigine, duloxetine.

Opioids (Tramadol) angagwiritsidwenso ntchito pochiza ululu waukulu. Mankhwala opweteka pafupipafupi, monga Analgin kapena Nimesulide, ndi osathandiza.

1. Mavitamini B Sinthani machitidwe a mitsempha, gwiritsani ntchito kubwezeretsanso zimimba zawo zoteteza, kuchepetsa ululu. Mankhwala odziwika kwambiri m'gululi ndi Milgamma, omwe amaphatikizapo mavitamini B1, B6 ndi B12.
2. Ma antioxidants Tetezani maselo amitsempha kuti asawonongeke ndi zinthu zoopsa. Zovuta kwambiri pamatumbo amitsempha zimakhala ndi α-lipoic, kapena thioctic acid, yomwe imadziwika kuti Thioctacid ndi Thiogamma. Kuphatikiza pa chithandizo chachikulu cha antioxidant, mankhwalawa amatha kutsitsa shuga m'magazi, motero poyambira chithandizo, kuchepetsa mankhwala kwa antidiabetesic kungafunike.
3. Kukonzekera kwamasamba (Actovegin) amagwiritsidwa ntchito pochiza matenda ashuga polyneuropathy, ngakhale zotsatira zawo sizinatsimikiziridwe.

Chithandizo cha matenda a shuga a polyneuropathy ayenera kukhala okwanira, pogwiritsa ntchito magulu angapo a mankhwala, komanso kwanthawi yayitali, maphunziro a miyezi 2-3.

Kugwiritsira ntchito mankhwala ochiritsira kwawanthu kulibe umboni. Pakhoza kuwonjezeka kuchuluka kwa zakudya zokhala ndi mavitamini a B (mkate wampweya, chiwindi, nyama, nsomba, chimanga) m'zakudya, koma kudya kotereku sikungachiritse matenda ashuga a polyneuropathy.

Gulu

Kutengera kuti matendawa amakhudza dongosolo lamanjenje, lomwe lili ndi machitidwe awiri, asing'anga atsimikiza kuti gulu limodzi la matendawa liyenera kugawa polyneuropathy kukhala somatic komanso kudziyimira pawokha.

Madotolo adanenanso za kusinthika kwa mitundu ya matenda kuti apangitse mandala. Mitundu itatu yaperekedwa m'gawoli, yomwe ikuwonetsa malo owonongeka mumitsempha yamitsempha:

• kutengera - kuzindikira kwa zoyipa zakunja,
• mota - yodziwika ndi mavuto osunthika,
• mawonekedwe a sensorimotor - mawonekedwe a mitundu yonseyi amaphatikizidwa.

Ndi kukula kwa matendawa, madokotala amasiyanitsa mitundu yotere - yovuta kwambiri, yopweteka, yopweteka komanso amyotrophic.

Kupewa

Ngati munthu wapezeka kale ndi matenda a shuga, ndiye kuti muyenera kusamala kwambiri momwe mungathere komanso kupewa zovuta. Njira zodzitchinjiriza polimbana ndi polyneuropathy zimaphatikizapo kudya moyenera, moyo wokangalika, kuchotsedwa pamakhalidwe osayenera, ndipo wodwalayo ayenera kuyang'anira kuwonda kwa thupi ndikuwonetsetsa kuchuluka kwa shuga m'magazi.

Zoyambitsa ndi Zoopsa

Zomwe zimayambitsa matenda ashuga polyneuropathy ndikuwonjezereka kwa shuga wamagazi komwe kumachitika mu shuga mellitus chifukwa cha kuchepa kwa insulin. Nthawi yomweyo, limagwirira kuwonongeka kwa ulusi wamanjenje mu izi ali multifactorial ndipo amayambitsidwa ndi njira zingapo za pathological. Udindo wotsogola umachitika ndi zinthu zingapo.

1. Matenda a metabolism mu minyewa yamanjenje. Kuperewera kwa insulini kumabweretsa kuti glucose kuchokera m'magazi simalowa m'maselo, omwe amawonetsedwa ndi hyperglycemia. Nthawi yomweyo, chakudya ichi ndi chomaliza komanso chimangokhala mphamvu yokhayo ya minofu yamitsempha. Kuperewera kwa mphamvu kumapangitsa kuti khungu lizipangika komanso kukhazikika kwa matenda ashuga a polyneuropathy.
2. Matenda a metabolic ambiri. Chifukwa cha kuchepa kwa glucose m'matipi, metabolic bypass pathways imaphatikizidwa kulipirira kuchepa kwa mphamvu. Izi zimapangitsa kuti pakhale matupi a ketone (chinthu chosemphana ndi mafuta) ndi zinthu zina zakupha zomwe zitha kuwononga minyewa yamitsempha.
3. Matenda a Ischemic. Mu shuga mellitus, chitukuko cha angiopathies (zotupa zam'mimba) zokhudzana ndi ma pathological mu khoma la mtima ndizodziwika. Izi zimachepetsa magazi kupita ndi ziwalo ndi ziwalo, makamaka pamlingo wa microcirculatory. Kuthamanga kwa magazi kumachulukitsa kuchuluka kwa kuchepa kwa mphamvu mu ulusi wamitsempha ndikuthandizira kuchepa kwawo.

Kuchepa kwa matenda ashuga a polyneuropathy kumakhala kokwanira kwambiri kwa odwala matenda ashuga, ndipo nthawi zambiri amakhala akumaphwanya zakudya ndikumamwa mankhwala a hypoglycemic. Nthawi zina, kusokonezeka kwa mitsempha ya zotumphukira kumatha kukhala chizindikiro choyamba chosakwanira kupanga insulin, koma nthawi zambiri neuropathy imachitika patapita zaka zambiri chitukuko cha matenda ashuga chikuchitika. Masinthidwe amachitidwe amanjenje amanjenje samatha kusintha.

Mitundu ya matenda

Matenda a diabetesic polyneuropathy amadziwika ndi mitundu yambiri yamankhwala, kutengera ndi momwe mitsempha ya gulu lomwe limakhudzidwira kwambiri. Pali kukambirana pokhudzana ndi gulu la asayansi.

Ndi chitukuko cha kuwonongeka kwa mitsempha, kusintha kwa ma pathological nthawi zambiri sikungasinthidwe, motero ndikofunikira kuti muchepetse kupitilira kwa vutoli.

Malinga ndi ofufuza ena, shuga yeniyeni ya polyneuropathy imayenera kuganiziridwa ngati imodzi mwazinthu zowonongeka zamagetsi mu shuga mellitus - distal symmetric sensorimotor neuropathy. Kuchokera pamalingaliro ano, mkhalidwe uli ndi zosiyana zotsatirazi zamaphunziro:

• kuphwanya kwamtundu wamtundu wam'magazi komanso ma tendon reflexes (mwachitsanzo, Achilles). Uwu ndi mtundu wofatsa, chifukwa zaka zakhala zikuyenda popanda kupita patsogolo wowoneka,
• kuwonongeka m'mitsempha yaumwini, kukhala ndi mawonekedwe owopsa kapena subacute. Nthawi zambiri amakhudza mitsempha yamiyendo ya miyendo (zilonda, zamkati, zamitsempha zam'mimba) ndi mutu (wamtundu, wamafupa, oculomotor),
• kutupa ndi kuwonongeka kwa mitsempha yam'munsi, zikukhudza malo obisika. Amadziwika ndi kupweteka kwakukulu ndipo nthawi zambiri amakhala ovuta ndi zilonda zam'mapazi zamiyendo ndi miyendo, gangrene.

Lingaliro linanso ndilakuti mitundu yonse ya zowonongeka m'mitsempha ya m'matumbo a shuga imatchedwa diabetesic polyneuropathy. Pankhaniyi, symmetric sensorimotor neuropathy ndi autonomic neuropathy imasiyanitsidwa ndi iyo. Zotsirizirazi zimaphatikizira ana, mimbulu, thukuta, mitundu ya mtima - kutengera ndi dongosolo liti kapena chiwalo chomwe chimakhudzidwa kwambiri ndi matenda. Payokha, diabetesic neuropathic cachexia imasiyanitsidwa - vuto lalikulu lomwe limaphatikizapo onse sensorimotor ndi autonomic neuropathy kuphatikiza kuchepa kwakukulu kwa thupi.

Magawo a matenda

Palibe njira zofotokozedwera bwino za matenda a matenda ashuga polyneuropathy. Komabe, matendawa ali ndi mawonekedwe omwe amapita patsogolo, kuchuluka kwa kuchuluka kwa zizindikiro kumadalira kuchuluka kwa hyperglycemia, mtundu wa neuropathy, moyo wa wodwalayo. Nthawi zambiri, matendawa atha kugawidwa magawo:

1. Mawonekedwe a Nonspecific neurogenic. Izi zimaphatikizira kuchepa kwa mphamvu, kumva kwa "goosebumps" pakhungu, nthawi zina - kuvuta pamiyendo ya mitsempha komanso m'dera lawo lobisika. Matendawa amatha kupitilira zaka zambiri osapitilira mitundu yowopsa.
2. Kusokonezeka kwamagalimoto. Amatuluka pomwe ulusi wama motor umagwira mu pathological process, kuphatikizapo autonomic mantha system. Kupindika minofu, paresis imatha kukhazikika, ndipo nthawi zambiri - kukokana. Mitsempha yamagetsi yamagetsi ikakhudzidwa, kusokonezeka kwa malo ogona, kusinthasintha kwa ana, thukuta, ndi ntchito yamtima ndi kugaya chakudya kumachitika.
3. Zovuta za trophic. Zotsatira zoyipa kwambiri za matenda ashuga polyneuropathy zimayamba chifukwa cha kuphatikiza kwa matenda a patonomic innervation ndi zovuta zam'magazi. Amatha kukhala onse am'deralo (zilonda zam'mimba, zironda m'miyendo), komanso wamba m'chilengedwe (neuropathic cachexia).

Zotsatira zina zofala kwambiri za matenda ashuga polyneuropathy ndikugonjetsedwa kwa mbali ya 3 ndi ya 4 yamitsempha yama cranial yomwe imayendetsa kayendedwe ka ma eye. Izi zimaphatikizidwa ndi kuwonongeka kwakukulu m'masomphenya chifukwa kuphwanya njira yogona, kuyanjana, chidwi cha ana, kukula kwa anisocoria ndi strabismus. Nthawi zambiri, chithunzichi chimayamba mwa odwala omwe ali ndi matenda osokoneza bongo opitilira zaka 50, omwe adwala kalekale chifukwa cha zovuta zina.

Zizindikiro za matenda a shuga a polyneuropathy

Diabetesic polyneuropathy imadziwika ndi mitundu yambiri yowonetsera, chithunzi cha chipatala chimadalira mawonekedwe a pathology, kuchuluka kwake, komanso mtundu wa mitsempha ya mitsempha (mota, sensory, autonomic) yomwe idakhudzidwa kwambiri. Nthawi zambiri, mavuto amtunduwu (makamaka kutentha ndi kugwedezeka) amawonekera koyamba. Pambuyo pake, zovuta zamagalimoto (kufooka kwa minofu ya miyendo, paresis) zimatha kulowa nawo. Ngati mitsempha yamaso idakhudzidwa, anisocoria ndi strabismus zimachitika.

Matendawa ndi osachiritsika mwachilengedwe, mawonekedwe ake amawonjezeka pang'onopang'ono zaka zambiri, kukula kwake kumadalira kuchuluka kwa chithandizo cha matenda ashuga komanso kukhalabe ndi shuga.

Dongosolo la matenda ashuga polyneuropathy nthawi zambiri limakhala limodzi ndi zovuta kuzungulira kwamasamba, makamaka kumadera akumunsi. Poyamba, kutentha kwa khungu la kumapazi ndi miyendo yotsika kumachepera, kuphwanya khungu ndikotheka - peel, keratinization. Kuvulala ndi kuvulala kwamiyendo kumachiritsa nthawi yayitali. Pamene matenda akupita patsogolo, kupweteka kwambiri m'miyendo kumachitika (panthawi yopuma komanso panthawi yochita masewera olimbitsa thupi), zilonda zam'mimba zimayamba. Popita nthawi, necrosis yamtundu wa mapazi nthawi zambiri imayamba, yomwe imasandulika gangore.

Mavuto omwe angakhalepo komanso zotsatirapo zake

Kupita patsogolo kwa matenda a shuga a polyneuropathy kungayambitse kufooka kwa minofu ndi minyewa, komwe kumachepetsa kuyenda. Kuwonongeka kwa mitsempha ya cranial kumayambitsa ziwalo zamaso ndikuwonetsa masokonezo. Zovuta zam'magazi zomwe zimatsagana ndi polyneuropathy yam'mphepete nthawi zambiri imakhala yovuta ndi zilonda zam'mimba ndi gangrene, chomwe ndichizindikiro chakudula kwamiyendo.

Kuchepa kwa matenda ashuga a polyneuropathy kumakhala kokwanira kwambiri kwa odwala matenda ashuga, ndipo nthawi zambiri amakhala akumaphwanya zakudya ndikumamwa mankhwala a hypoglycemic.

Vuto lalikulu kwambiri la matenda ashuga polyneuropathy ndi neuropathic cachexia, limodzi ndi kuchepa kwa thupi, mavuto a sensorimotor ndi ma pathologies angapo amkati.

Vutoli limakhala losavomerezeka, chifukwa zovuta zake sizinasinthe. Komabe, kudziwika kwakanthawi kwamatenda a matenda limodzi ndi chithandizo choyenera kumatha kuchepetsa kuchepa kwake.

Diabetesic polyneuropathy malinga ndi ICD-10

Pankhaniyi, pali magawo angapo a matenda awa omwe ali ndi code yawo:

• G61. Ngati matenda akayamba motsutsana ndi maziko a zotupa zomwe zimachitika mthupi la munthu.
• G62. Amatengera mitundu ina ya polyneuropathy. Gululi limaphatikizapo magawo angapo nthawi imodzi.
• G63 Ichi ndi gulu lina lalikulu. Monga momwemo mutha kupeza gawo lofunikira. Poterepa, nambala ya ICD-10 ya matenda ashuga polyneuropathy idzakhala G63.2.

Chifukwa chake, zamatsenga izi zimagwera pagulu lalikulu la gulu lapadziko lonse lapansi. Ndikofunikanso kumvetsetsa mwatsatanetsatane matendawa pawokha.

Chachikulu

Poterepa, tikulankhula za njira ya kufa kwa ulusi wamitsempha m'thupi la munthu. Izi zikutanthauza kuti patapita kanthawi chitukuko cha matenda, wodwalayo amayamba kutaya chidwi, chomwe nthawi zambiri chimapezeka m'madera akumunsi (kapena makamaka kumapazi).

Ngati wodwala matenda ashuga ali ndi matenda amtunduwu, ndiye kuti atha kudandaula za ululu wosakhazikika, womwe nthawi zina umakhala wolimba kwambiri kotero kuti ndizosatheka kugona kapena kuchita zinthu zina. Ambiri amayamba kukhala ndi mapewa oyipa kwambiri.

Ngati distal diabetesic polyneuropathy ikupita patsogolo, ndiye kuti izi zidzapangitsa kuti minofu yathunthu, ndipo mafupa ake ndi opunduka. Mapazi atatseguka. Izi zitha kubweretsanso kufunika kokadula phazi.

Peripheral

Ngati tikulankhula za mtundu wamtunduwu, ndiye pankhani iyi pali zovuta zazikulu za ntchito ya sensorimotor yam'munsi yotsika. Nthawi zina, zosokoneza mu matenda ashuga zimawonekera m'manja.

Monga lamulo, zotumphukira zamtunduwu nthawi zambiri zimayamba kutsutsana ndikuti madokotala amasankha kugwiritsa ntchito mankhwala osokoneza bongo amphamvu. Amadziwika kuti ali ndi zovuta zambiri zoyipa. Chifukwa chake, zizindikiro ngati izi zikuwoneka, ndikofunikira kusiya nthawi yomweyo mankhwalawa pogwiritsa ntchito mankhwala amphamvu, kusankha njira ina yothandizira.

Dysmetabolic

Matenda amtunduwu amadziwika ndi matenda owonjezera omwe amawoneka pamodzi ndi matenda a shuga. Odwala amayamba kudandaula za mavuto am'mimba, matumbo, impso ndi chiwindi. Mitsempha yambiri ya minyewa imakhudzidwanso, yomwe ili pamtunda wapamwamba komanso wotsika. Sayansi kapena ukazi wamanjenje umawonongeka. Potere, munthu amakhala ndi zowawa kwambiri m'dera lomwe lakhudzidwalo, zilonda zam'mimba zimatha.

Poyerekeza ndi momwe njira imeneyi imagwirira ntchito, zimakhala zovuta kwambiri kuti munthu azungulira. Tendon komanso bondo limasowa. Madokotala nthawi zambiri amakumana ndi zochitika zomwe odwala amawonongeka ndi zilonda zam'mimba, ocular, kapena trigeminal.

Komabe, ndikofunikira kudziwa kuti mtundu wamatendawa umathanso kuchitika popanda kupweteka.

Zolinga zakukula kwa matenda amisala

Ngati tizingolankhula za zizindikiro zazikulu zomwe zimakhudza maonekedwe a matenda ashuga a m'munsi, ndiye pamenepa, tikulankhula za shuga wambiri komanso zinthu zina zikafika munthu akakhala ndi insulin yayitali.

Komanso, matenda amtunduwu amatha kupanga zotsutsana ndi maziko a:

• Matenda a Endocrine.
• Matenda akulu a impso ndi chiwindi.
• Kukhumudwa
• Ofooka chitetezo chokwanira.
• Matenda osiyanasiyana.
• Mavuto a Mowa.
• Poizoni.

Komanso, munthu amatha kukhala ndi matenda amenewa ngati ali ndi matenda a atherosulinosis, nephropathy, retinopathy, matenda oopsa, kuchepa kwa Vitamini, komanso kunenepa kwambiri. Osati zotsatira zabwino ndikusuta. M'pofunikanso kusamala ndi okalamba, popeza pamenepa mwayi wopititsa patsogolo matenda ndi wazipamwamba kwambiri.

Mankhwala

Kuti abwezeretse kayendedwe ka minyewa yam'mimba ndikuthandizira kubwezeretsa kaperekedwe kawo, madokotala nthawi zambiri amapereka ndalama mu mawonekedwe a vitamini. Monga lamulo, gulu B limawatchulanso. Komanso katswiri amatha kudziwa alpha-lipoic acid.

Ndikofunika kudziwa kuti ndi chithandizo cha pathogenetic, zotsatira zake siziyenera kuyembekezeredwa. Njira ya chithandizo nthawi zambiri imakhala yotalikirapo, motero muyenera kukhala oleza mtima.

Komabe, nthawi zina odwala amazunzidwa ndi zopweteka zowopsa kwambiri kotero kuti samatha kugona ndikuchita zinthu zodziwika bwino. Ambiri amayamba kukhala ndi nkhawa komanso kukhumudwa. Kuti apulumutse wodwalayo pazinthu zosasangalatsa, dokotalayo amatha kupereka mankhwala othandizira kuponderezedwa, anticonvulsant, komanso ma painkiller.

Ambiri asankha kuyamba kutenga Ibuprofen paokha. Komabe, ziyenera kukumbukiridwa kuti mutha kugwiritsa ntchito mankhwalawa osagwiritsa ntchito mankhwala a anti-yotupa m'maphunziro afupiafupi. Kupanda kutero, pali chiopsezo cha kuwonongeka kwa mucosa wam'mimba.

Zochizira zowonjezera

Dokotala atha kulimbikitsanso kutenga maphunziro a physiotherapy, kutikita minofu kapena masewera olimbitsa thupi. Zochitika ngati izi zimathandizira kuchotsa ululu wammbuyo. Zakudya zamatenda am'mitsempha zimayenda bwino. Chifukwa cha izi, atrophy imatha kupewedwa.

Kutikita minofu ndikuloledwa. Kusankha njira yachiwiri, muyenera kulumikizana ndi katswiri. Osamayeserera kugaya kunyumba.

Zotsatira zabwino zimaperekedwa ndi zakudya. Zakudya za wodwala ziyenera kukhala chakudya chochuluka monga momwe mungathere, chokhala ndi zinthu zambiri zofunikira za kufufuza ndi mavitamini. Akatswiri amalimbikitsa kudya mphodza, mtedza, mbewu, nyemba, tomato, parsley, nandolo, chinangwa, nsomba zam'nyanja.