Chifuwa chachikulu komanso matenda ashuga

Zomwe zimathandizira kukulitsa chifuwa chachikulu cha odwala omwe ali ndi matenda ashuga

kudzikundikira kwamisempha yazinthu zosakwanira makutidwe ndi okosijeni a mafuta ndi chakudya,

chilema mu chitetezo cha mthupi - kuchepa kwa kuthekera kwa kupanga ma antibodies, kuchepa kwa ntchito ya phagocytic ya leukocytes, kuchepa kwa mphamvu ya ma lymphocyte pakusintha kuphulika, kuchepa kwambiri kapena kusalepheretsa kusuntha kwa leukocytes kuchokera ku capillaries kupita pakati ndi antigen,

Kusiyanitsa mwachangu kwa minofu yolumikizana ndi hyalinosis yoyambirira.

Zambiri za njira ya matenda ashuga a chifuwa chachikulu cha m'mapapo:

Matenda a shuga, ngakhale atakhala amtundu wanji, amakhala ndi zovuta,

Kufunika kwa BSC kumawonjezeka komanso kukananso kwa iwo kutha kuchitika,

Kuwonongeka kwa chiwindi kukufotokozedwa - kusintha kwa chiwindi kumayambitsa kuzungulira, nthawi zambiri kumachedwa, kufufutidwa kwa hypoglycemia,

Insulin imagwiritsidwa ntchito mochuluka.

Kukula kwa microangiopathy ya impso, matenda ashuga glomerulosclerosis, nephropathy,

Kukula kwa zapent pyelonephritis,

Odwala omwe ali ndi concomitant pathology nthawi zambiri amakhala kuchipatala atafika poti awabweze,

Kuwonongeka kwa zida zamagetsi zomwe zimapangidwa ndi glucose kagayidwe kachakudya ka nthawi yayitali ka PTP,

Kuphwanya malowedwe a anti-TB mankhwala m'dera lowonongeka kwam'mapapo minofu yolumikizana ndi kukhalapo kwa matenda ashuga a shuga,

Matenda a neurological, hepatotoxic, dyspeptic, omwe amawonjezeredwa popereka mankhwala ochepetsa TB,

Matenda a shuga sikuti akuphwanya opaleshoni ya chifuwa chachikulu cha m'mapapo,

Kulekerera koyipa kwa mankhwala othandizira-TB.

Matenda a shuga: Zizindikiro ndi mankhwala

Nthawi zambiri, matenda ashuga amapezeka motsutsana ndi maziko a chifuwa chachikulu kapena chifuwa chachikulu chomwe amapanga pamaso pa matenda a shuga mellitus (DM). Choyambitsa chachikulu cha matenda am'mapapo mu odwala matenda ashuga ndimatenda ofooka, chifukwa thupi limawonekera mosavuta ku tubercle bacillus.

Zomwe zimayambitsa nthawi yomweyo matenda a shuga ndi chifuwa chachikulu ndi izi:

Ofooka chitetezo chokwaniramotsutsana ndi komwe matenda amatenga. Chitetezo chokwanira, chimachepetsedwa chifukwa cha kuchepa kwa ma phagocytes, maselo oyera am'magazi ndi maselo ena.
Mu matenda a shuga mellitus nthawi zambiri amadziunjikira m'magazi matupi a acetone ketone, zomwe zimapangitsa ketoacidosis ndipo pambuyo pake acidosis. Chifukwa chake, kuledzera ndi kuwonongeka kwa minofu kumachitika mkati. Ndipo izi zimapangitsa kuti thupi lipezeke ndi tubercle bacillus.
Njira za metabolic zikasokonekera (chakudya, mapuloteni, mafuta, mchere), kuchepa kwa michere mthupi, zomwe zimabweretsa kudzikundikira kwa zinthu zopweteka za metabolic. Chifukwa cha izi, kufooka kwa ntchito zoteteza kumachitika.
Kugwedezeka kwina. Pankhaniyi, thupi limalephera kulimbana ndi tizilombo toyambitsa matenda, chifukwa cha zomwe tubercle bacillus imayambitsa.

Mutha kuphunzira za zotsatira za kafukufuku wamakono, komanso za mawonekedwe a chifuwa chachikulu komanso matenda a shuga, kuchokera mu kanema:

Zambiri za njira ya chifuwa chachikulu mu odwala matenda a shuga

Kukula kwa zochita zachinyengo komanso zoyipa, zomwe zimakonda kupita patsogolo, zomwe zimachepetsa kukonza,

Chizolowezi chosinthika mwachangu kuchokera pagawo lokhazikika kulowa gawo lakuwonongeka,

Chifuwa cholowerera chimachitika nthawi zoposa 50%.

Pang'onopang'ono njira yokonza,

Chizolowezi pakupanga masinthidwe akulu otsalira mu dongosolo la bronchopulmonary,

Kuzindikira kwadzidzidzi kwa chifuwa chachikulu,

Kuzindikirika kwazachipatala ndi chifuwa chowonekera cha chifuwa cham'mapapo,

Katundu wa Office (LU, pathogenicity, virulence) - sizidalira mtundu wa shuga,

Microangiopathy yamapapu ndi imodzi mwazinthu zamtundu wa pathogenetic zomwe zimatsimikizira kupezeka kwa chifuwa cham'mapapu komanso njira yake yoyipa, chizolowezi cha kupita patsogolo kwa matenda ashuga.

Zizindikiro ndi maphunzirowa

Matenda a chifuwa chachikulu omwe amapezeka odwala omwe ali ndi matenda osokoneza bongo nthawi zambiri amakhala asymptomatic, kotero mawonetsedwe aliwonse a iwo amawonedwa ngati chizindikiro cha matenda osokoneza bongo.

Zizindikiro za chifuwa chachikulu mu shuga zingakhale:

kuchepa kwamtima
kufooka kokulirapo
kuwonda
kukodza pafupipafupi
ludzu, kamwa yowuma
kuwonjezeka kwa zizindikiro zina za matenda ashuga.

Chifuwa chachikulu chogwira ntchito chimakwiyitsa kagayidwe kazakudya, motero, umakulitsa kuchuluka kwa insulin.

Makamaka mawonekedwe a matenda ophatikizidwa amachulukitsa chiopsezo cha zovuta za matenda ashuga, nthawi zambiri pamakhala matenda ashuga (kuwonongeka kwa ziwiya zam'munsi), retinopathy, osteoarthropathy ndi nephropathy. Ndi matenda akulu a shuga, hepatomegaly amadziwika, omwe amaphatikizira kwambiri mankhwalawa ndi anti-TB.

Kuperewera kwa zizindikiro kumapangitsa kuti zikhale zovuta kudziwa vutoli. Pankhaniyi, chifuwa chachikulu chimapezeka pokhapokha ngati pali chibayo ndi zizindikiro zoonekeratu za kuledzera kwa chifuwa chachikulu, komanso panthawi ya mayeso a fluorographic ndi radiology.

Njira ya matendawa imadziwika ndi kuphatikiza kwa kagayidwe kake, kupoleza kwapang'onopang'ono kwa m'mitsempha yomwe yakhudzidwa, nthawi yayitali yowonetsera kuledzera kwa chifuwa chachikulu.

Chomwe chikuwonjezera matendawa ndikuwazindikira kwake komanso chifukwa chake, chithandizo chomwe chidayamba mochedwa.

Kukula komanso chiwonetsero chovuta kwambiri cha chifuwa chachikulu cha matenda ashuga kumayendetsedwa ndi kuchepa kwa chitetezo chokwanira, kuperewera kwa vutoli komanso kusokonezeka kwa metabolic.

Njira ya shuga ndi kuphatikiza kwa chifuwa chachikulu imadziwika ndi shuga wambiri, glucosuria ndi pafupipafupi diuresis, komanso milandu ya acidosis. Kuwonongeka kulikonse kwa odwala matenda ashuga kuyenera kuwachenjeza ndi kukayikira kukhalapo kwa chifuwa chachikulu. Pankhaniyi, njira zodziwira matenda mwachangu ndizofunikira.

Zizindikiro

Kuzindikira kwakanthawi kokhudza chifuwa chachikulu kumadalira kuchuluka kwa mayeso a fluorographic a odwala omwe ali ndi matenda ashuga. Odwala oterowo amayenera kuwunika chaka chilichonse. Ngati ali ndi zotupa zam'mapapo kapena zowoneka bwino zamapapo, kuyezetsa kumathandizidwa ndi kuwunika kwa mapapu a X-ray.

Njira zamakono zodziwitsira matenda zimaphatikizapo:

kufufuza kwa bacteria, kuphatikizapo ma microscopy a sputum ndi chikhalidwe chake,
kusanthula kwa bronchoalveolar aspadors, omwe amalola kuti azindikire mycobacteria.

Ngati njira izi ndizosakwanira, kafukufuku wowonjezereka amalembedwa kuti atsimikizire za matendawo - diagnostic bronchoscopy, cytology ndi histology.

Mu 40% ya odwala omwe angodwala kumene, kuzindikira kwake kumachitika malinga ndi zotsatira za kuyesedwa kwa X-ray ndikuwunika nthawi yayitali njira ya matendawa pakuthandizira. Maphunziro a bacteriological, cytological ndi histological muzochitika izi ndi osathandiza.

Njira yotsimikizika kwambiri yopezera chifuwa chachikulu mu shuga ndi kafukufuku wamatsenga, omwe amakupatsani mwayi kuti mupeze ma antibodies ena a antibodies kapena antijeni m'magazi.

Njira zofananazi (kuphatikiza kugwiritsa ntchito enzyme yolumikizidwa ndi immunosorbent assay) zikupangidwa mwachangu pakadali pano.

Kufunika kopititsa patsogolo njira zodziwira matenda chifukwa cha kufanana kwa mawonekedwe a chifuwa chachikulu ndi matenda ena am'mapapo.

Njira zochizira

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Kukhalapo kwa zovuta za pathologies kumafuna chithandizo chambiri kuchokera kwa dokotala komanso kuphatikiza koyenera kwa njira zochizira.

Pa matenda akulu a shuga kapena kuwonda pang'ono, ndikofunikira kusintha matenda a metabolism (mavitamini, lipids, mapuloteni).

Kuti muchite izi, imwani mankhwala a antiidiabetes, mulingo woyenera wa insulini ndikutsatira zakudya zamagulu. Mankhwala othandizira odwala matenda a shuga ayenera kuikidwa limodzi, kutengera mtundu wa thupi, kuopsa kwa matenda ashuga, mitundu ndi magawo a chifuwa chachikulu.

Nthawi yomweyo, anti-tuberculosis chemotherapy imachitika. Odwala amafunika kuchita gawo loyambirira la chemotherapy kuchipatala, chifukwa nthawi zambiri amakhala ndi zovuta kuzotsatira zamankhwala. Mankhwala othandizira opha mabakiteriya ayenera kukhala a nthawi yayitali komanso osatha (kuyambira chaka chimodzi kapena kupitirira apo), mankhwalawa amaphatikizidwa bwino ndipo amasankhidwa aliyense payekha kwa wodwala aliyense payekha.Kuphatikiza pa chemotherapy, chithandizo chimathandizidwa ndimankhwala a pathogenetic zotsatira - immunostimulants ndi antioxidants.

Matenda ochepetsa kwambiri shuga kwa odwala amalolera madokotala kugwiritsa ntchito corticosteroids. Komabe, panthawi imodzimodzi, shuga yamagazi amayenera kuyang'aniridwa ndikuwonjezeka kwakanthawi kwa mankhwala a antidiabetic ndi kuchuluka kwake.

Ngati chifuwa cha chifuwa chikuyambiranso pang'onopang'ono, ndiye kuti zopatsa mphamvu zingapo zosagwiritsa ntchito mankhwalawa zitha kugwiritsidwa ntchito kuphatikiza chithandizo cha chifuwa chachikulu. Chithandizo choterechi chimaphatikizapo ultrasound, induction ndi laser therapy. Zimathandizira kufalikira kwa magazi ndi kupezeka kwa m'mitsempha m'mapapu, zimathandizira kulowetsedwa kwa mankhwala a chemotherapy ndikuyambitsa minofu yosinthika.

Mankhwalawa, njira zopangira opaleshoni zingagwiritsidwe ntchito, mwachitsanzo, kuyika kwachuma kwam'mapapo.

Kupewa

Kutsika kwa chifuwa chachikulu cha odwala matenda ashuga kumatheka chifukwa chakuchuluka kwa mankhwalawa chifukwa cha matenda osokoneza bongo komanso njira zingapo zopewera chifuwa chachikulu.

Kupewa kwa chifuwa chachikulu mu shuga kumakhazikika pa chemoprophylaxis. Komabe, mankhwala othandizira othandizawa amadzetsa zovuta zomwe zimachitika mwa odwala, omwe amaletsa kugwiritsa ntchito. Chemoprophylaxis imalembedwa ku gulu la anthu omwe ali pachiwopsezo chachikulu chotenga kachilomboka.

Gulu lamavuto limaphatikizapo:

odwala omwe ali ndi kusintha kwaposachedwa kwa chifuwa chachikulu mu ziwalo zopumira,
odwala zovuta ku tuberculin,
odwala akuchitidwa opaleshoni
odwala pambuyo matenda a shuga.
odwala omwe ali pamavuto.

Kuchulukitsa kwa kuchuluka kwa chifuwa chachikulu cha matenda a shuga kumapangitsa chidwi chapadera pa kupewa kwake.

Anthu omwe ali ndi matenda ashuga kwambiri amafunika kuwatsata mwatsatanetsatane ndikuwonetsetsa kuti ali ndi chifuwa chachikulu. Njira zoyesera zopezera shuga wambiri ndizofunikira. Zotsatira zakufufuza ziyenera kuchitika pakuwunika kwautali osachepera 1 pachaka.

Ma Statntless

Kafukufuku akuwonetsa kuti chifuwa chachikulu chimakhudzidwa ndi anthu odwala matenda a shuga, kuphatikiza apo, amuna. Kuchuluka kwa matenda ashuga ndi chifuwa chachikulu ndi 3-12%, ndipo pafupifupi 7-8%.

Ngati matenda a shuga apezeka ndi TB, manambala ndi 0.3-6%. Chifukwa chake, zikuwonekeratu kuti chifuwa chachikulu chimafikira pa matenda ashuga mwaperesenti 80, komanso matenda ashuga amapititsa ku TB - 10% yokha. Mu 10% yotsala, etiology siyodziwika.

Popeza pathogenesis ya chitukuko cha chifuwa chachikulu imakhudzidwa ndi kuchuluka kwa kuphwanya kagayidwe kazakudya, matenda amachitika mosiyanasiyana. Chifukwa chake, ngati mtundu wovuta wa shuga ulipo, ndiye kuti TB imachitika kangapo ka 15 koposa mwa munthu wamba. Ndi zolimbitsa mwamphamvu - pafupipafupi katatu. Ndipo ndi matenda abwinobwino a shuga, sindimasiyana kwenikweni ndi matenda omwe alibe matenda ashuga.

Mitundu ya matenda ndi mawonekedwe

Matenda a chifuwa chachikulu ali ndi mitundu itatu yayikulu, yomwe imasiyana malinga ndi nthawi yomwe matenda akachitika.

Kuchulukitsa kwa chifuwa cha shuga m'matenda a shuga kumadalira kuchuluka kwa chipukuta chodwalitsa cha carbohydrate metabolism. Mwachitsanzo, ngati katundu wopatsirana ali wosauka, ndiye kuti chifuwa cham'mimba chimakula mwachangu, mwachangu kukhudza minyewa yam'mapapo mu mawonekedwe ochulukirapo.

Kukula kwa chifuwa chachikulu pamaso pa matenda ashuga

Izi zimawerengedwa ngati kuphatikiza kofala kwambiri kwa matenda awiriwa. Cholinga chachikulu ndi kufooka kwa chitetezo chathupi komanso kulephera kwa thupi kukana matenda. Izi ndizowona makamaka kwa tubercle bacillus. Kuphatikiza apo, mu matenda ashuga, thupi silipanga ma antibodies okwanira olimbana ndi chifuwa.

Mu shuga mellitus, chifuwa chachikulu cha kulowetsedwa ndi mawonekedwe a fibro-cavernous nthawi zambiri amakumana. Chitha kuwoneka ngati chifuwa chachikulu.

Ngati TB sinapezeka munthawi yake, izi zimayambitsa matenda oopsa, chifukwa chamankhwala omwe onsewa amakhala ovuta.

Chowonadi ndi chakuti chifuwa chachikulu cha matenda osokoneza bongo chimakhala chambiri kwambiri, motero wodwalayo sangakayikire ngakhale pang'ono kupezeka kwake, ndipo matenda atapezeka kale m'magawo amtsogolo.

Chifukwa chake, ndikofunikira kwambiri kuchita fluorography kamodzi pachaka.

Zizindikiro za chifuwa chachikulu cha shuga

Gawo loyamba la kukula kwa chifuwa chachikulu mu matenda ashuga amadziwika ndi maphunziro asymptomatic. Komabe, chisamaliro chapadera chikuyenera kulipidwa pakusintha koteroko mthupi:

kuchepa kwa magwiridwe
kumva pafupipafupi kufooka
kuthetsa njala,
thukuta kwambiri.

Anthu ambiri odwala matenda ashuga amati izi zimachitika chifukwa cha zovuta za matenda ashuga, koma izi sizolakwika. Ndi zizindikiro zotere, fluorography iyenera kuchitidwa mwachangu.

Kupitilira apo, kuchuluka kwa glucose m'magazi kumakwera kwambiri. Komabe, palibe chifukwa chowonjezera chotere. Aliyense wodwala matenda ashuga amadziwa kuti shuga amatha kuchuluka kokha pazikhalidwe zina. Kodi chifukwa chiyani shuga amakwera? Ndikukonzekera kuti pakukula ndi Kukula kwa bacillus wa tuber, pamafunika insulin yambiri. Chifukwa chake, sichitha ntchito pakuwotcha shuga, koma pamtengo wokula.

Zizindikiro mu magawo apambuyo pachitukuko cha chifuwa chachikulu mu matenda ashuga:

Zowonongeka zam'mapapu m'makoko am'munsi.
Paroxysmal chifuwa cha chilengedwe. Zitha kuchitika m'mawa ndi madzulo. Masana, wodwala kwenikweni samakhosomola.
Mukakhosomola, ntchofu ndi sputum zimamasulidwa mwachangu, nthawi zina zimakhala ndi magazi.
Kuwonjezeka kwa kutentha kwa thupi, komwe sikumatayika mwanjira iliyonse.
Kuchepetsa thupi, komwe siiko kwa odwala matenda ashuga.
Kugona, kusuntha gait. Izi ndichifukwa choti ndi matenda ashuga chifuwa chimakhala chopanda tanthauzo, ndipo chifuwachi chimakulitsa vutoli.
Nthawi zambiri zimasintha, mpaka pamakhala kuchita zankhanza.

Ngati simumalabadira izi mwachidziwitso munthawi yake ndipo simukuyendera dokotala, kuphatikiza kwa matenda owopsa awiriwa kumatha kupha!

Ndi chithunzi chosadziwika bwino cha matenda osokoneza bongo omwe ali ndi chifuwa chachikulu, wodwalayo nthawi zambiri amagonekedwa m'chipatala ndi kuledzera ndikuwonjezera kuchuluka kwa njira yotupa. Izi zimabweretsa zovuta pakusankha njira yothandizira chithandizo chamankhwala ndipo zimakhala ndi imfa. Mukazindikira matendawa kale, zimakhala zosavuta kuthandizira.

Pozindikira matenda a shuga pamaso pa chifuwa chachikulu wodwalayo ayenera kudutsa yoyeserera yoyeserera ya magazi (magazi, mkodzo).

Ngati alipo akuwakayikira chifuwa chachikulu cha shuga, muyenera kutsatira njira zotsatirazi:

adotolo amatenga chidziwitso chonse chazizindikiro, kuthekera kwa matenda, ndi kupezeka kwa mtundu woyambirira wa chifuwa chachikulu (wodwalayo mwina anali ndi matendawa),
adokotala amamuwunikira, ndiye kuti, amawadziwa momwe wodwalayo alili, amayang'anira zamitsempha ndi zina zotero,
kenako endocrinologist amatumiza wodwala kwa katswiri wa TB (amathandizira pakuzindikira komanso kuchiza TB),
Katswiri wa TB amayesa kuyesa palpation, kuzindikira ndi chidwi, amaika mayeso,
kuyezetsa kwa tuberculin, ndiye kuti, kuyesa kwa Mantoux, mwa zomwe zimatheka kuweruza matenda,
fluorografia (radiografia) ya chifuwa mumagulu 2 - ofananira nawo ndi anteroposterior,
compression tomography ikuwonetsa kukula kwamavuto,
wodwalayo ayenera kudutsa ambiri ndi zamankhwala osanthula magazi ndi mkodzo, zomwe zimapangitsa kuwonjezeka kwa leukocytes, kuchuluka kwa kuledzera, kuphwanya kapangidwe ka michere, etc.
kusanthula kwa zasayansi ya sputum (microscopic and bacteriological),
ngati kuli kotheka, tracheobronchoscopy imachitika.

Chithandizo - njira zoyambira

Chithandizo cha matenda a shuga osakanikirana ndi chifuwa chachikulu chiyenera kukhala chodalira njira zonse za matenda onsewa. Ngati chifuwa chikutseguka kapena chovuta, wodwala ayenera kuchipatala.

Aliyense amadziwa kuti mankhwala achikhalidwe kwazaka zambiri amalimbikitsa kudya mafuta owononga chifuwa chachikulu cha m'mapapo. Ambiri amamuwona ngati wopepuka wa matendawa. Kodi ndikotheka kutenga mafuta oyipa a shuga, muphunzira kuchokera pa kanema:

Zida za mankhwala othandizira odwala matenda ashuga

Choyamba, kwa odwala matenda ashuga, makamaka ndi mtundu wa 1 wa matenda, ndikofunikira kuwonjezera kuchuluka kwa insulini yoyendetsedwa, chifukwa yambiri imangotayidwa pa bacillus ya tubercle. Mlingo ukuwonjezeka pafupifupi magawo khumi.

Amagawidwa wogawana tsiku lonse, chifukwa chomwe kuchuluka kwa jakisoni tsiku lililonse kumayenera kukhala kasanu. Pankhaniyi, insulin yokhala nthawi yayitali iyenera kulowetsedwa ndi mankhwala osakhalitsa.

Ndi matenda a shuga a 2, kuchuluka komanso kuchuluka kwa mapiritsi ochepetsa shuga kumawonjezeka. Nthawi zina, mankhwala a insulin ndi omwe amapatsidwa.

Zinthu ndi mfundo zamankhwala:

Cholinga cha chakudya No. 9. Kutsatira kwake kuyenera kukhala kovuta. Zimakhazikika pakukulitsa kuchuluka kwa mavitamini ndi mapuloteni. Ndi zoletsedwa kotheratu kudya ufa ndi wokoma, mchere wambiri ndi mafuta, wokazinga komanso wosuta. Mukuyenera kukana ayisikilimu ndi kupanikizana, simungathe kudya nthochi.
Kuchiza ndi antibacterial wothandizila kumachitika pa munthu aliyense. Kuphatikiza kosiyanasiyana kwa mankhwala kumayikidwa.
Ndikofunikira kuchita mankhwala a chiferculostatic chemotherapy kudzera mwa mankhwala apadera. Kutalika kwa mankhwalawa kwa odwala matenda ashuga ndi 2 nthawi yayitali. Mankhwala omwe akupangidwira amafunikira kuti achepetse kupanga kwa insulin. Pankhaniyi, ndikofunikira kusintha kuchuluka kwa mankhwala ochepetsa shuga.
Mankhwala a Vitamini amafunika, chifukwa chomwe thupi limabwezeretsa chitetezo chake.
Mwina kuperekedwa kwa hepatoprotectors pamodzi ndi mankhwala "Timalin." Izi zimalimbitsa chitetezo cha mthupi.
Kuti muchepetse magazi komanso kuthana kwa ma chemotherapeutic othandizira ndi maselo omwe akhudzidwa, adotolo atha kukupatsirani mankhwala monga Sermion, Parmidin, Andekalin, Nicotinic acid ndi Actovegin.
Mwazovuta kwambiri, opaleshoni imalembedwa (kuchulukitsa kwamapapu).
Ndikofunika kumwa mankhwala omwe amathandizira kagayidwe kachakudya ndikusinthanso kukonzanso thupi.

Mankhwala ochizira chifuwa chachikulu

Nthawi zambiri zotchulidwa mankhwala:

"Isoniazid" ndi "Paraaminosalicylic acid"
Rifampicin ndi Pyrazinamide
Streptomycin ndi Kanamycin
"Cycloserine" ndi "Tubazid"
Amikacin ndi Ftivazid
Protionamide ndi Ethambutol
Capreomycin ndi Rifabutin
Mwa mavitamini, ndikofunikira kumwa vitamini B1, B2, B3, B6, B12, A, C, PP

Mukamapereka mankhwala, dokotala wa chifuwa chachikulu amatengera mtundu wa matenda ashuga, popeza pali zina zomwe zimakanidwa. Mwachitsanzo, ndi shuga wovuta, simungatenge Isoniazid ndi Ethambutol, komanso Rifampicin.

Matendawa amatha kuchitika patadutsa zaka 4 kuchokera kutha kwa matenda a shuga, ndipo matenda ashuga amatha kuchitika zaka pafupifupi 9 mpaka 10 atadwala matenda a chifuwa chachikulu. Chifukwa chake, ndikofunikira panthawi imeneyi kuti muzisamalira kwambiri zodwala ndikuwonana ndi dokotala munthawi yake. Kuzindikira koyambirira kumakupatsani mwayi kuti muchepetse zovuta zam'tsogolo komanso mwachangu!

Matenda a chifuwa chachikulu: njira ya matenda ndi chithandizo

Matenda a shuga amachititsa njira zingapo zopewera m'thupi, zomwe zimachepetsa wodwalayo ndikumupangitsa kukhala pachiwopsezo cha matenda ambiri opatsirana. Makamaka, odwala matenda ashuga amapezeka ndi matenda oopsa monga chifuwa chachikulu.

M'mbuyomu, kudwala matenda ashuga kuphatikiza chifuwa chachikulu mu 90% ya milandu kudapangitsa kuti wodwalayo afe, koma lero ziwerengerozi sizowopsa. Chifukwa cha kupita patsogolo kwamakono kwa zamankhwala ,imfa pakati pa gulu ili la odwala yachepetsedwa kwambiri.

Koma ngakhale lero, kugwiritsa ntchito bwino mankhwalawa kumadalira makamaka pakupezeka kwa matenda, zomwe zingalepheretse kukula koopsa. Kuti muchite izi, onse odwala matenda ashuga ayenera kudziwa momwe chifuwa chachikulu komanso chifuwa chachikulu cha shuga zimalumikizirana, ndizizindikiro ziti zomwe zikuwonetsa chitukuko cha matenda achiwiri, komanso ndi chithandizo chiti chomwe chitha kukhala chothandiza kwambiri ndi matendawa.

Odwala omwe ali ndi matenda ashuga nthawi 8 amatha kukhala ndi chifuwa chachikulu cha pulmonary kuposa anthu athanzi.

Nthawi zambiri, nthendayi imakhudza anthu odwala matenda ashuga a zaka 20 mpaka 40. Mu gulu langozi, aliyense wodwala 10 amadwala chifuwa chachikulu.

Matenda a chifuwa chachikulu cha shuga amayamba pazifukwa izi:

Kuwonongeka kwa chitetezo cha mthupi chifukwa cha kuchepa kwa ntchito ya leukocytes, phagocytes ndi maselo ena a chitetezo cha mthupi. Zotsatira zake, ndikulowa m'thupi la wodwala, chifuwa chachikulu cha mycobacterium chimawonongeka chifukwa cha chitetezo cha mthupi, ndikuyamba kukula.
Matenda acidosis, omwe ndi zotsatira za ketoacidosis. Vutoli limakonda kukhala ndi matenda osokoneza bongo ndipo limadziwika ndi kuchuluka kwa matupi a ketone m'magazi a wodwala, makamaka acetone. Izi zimawonjezera poizoni wowopsa ndikuwonongeka kwa ziwalo zamkati zamthupi, zomwe zimapangitsa kuti azitha kutenga kachilomboka.
Kuphwanya chakudya, mafuta, mapuloteni komanso michere ya mchere.
Kuphwanya kusinthika kwa thupi. Chuma ichi cha thupi ndichofunikira kuthana ndi bacteria wakuphatikiza tiziromboti. Chifukwa chake mwa anthu athanzi, matenda opatsirana, monga lamulo, amapezeka ndi kutentha kwambiri komanso kutentha thupi, komwe kumawathandiza kuthana ndi matendawa. Odwala omwe ali ndi matenda ashuga, matenda amakula modekha, koma nthawi zambiri amayambitsa zovuta zazikulu.

Makamaka chiopsezo cha chifuwa chachikulu mwa odwala omwe ali ndi matenda osokoneza bongo a mellitus, omwe amakhala ndi shuga wambiri.

Izi zimabweretsa kuwonongeka kwakanthawi kwa ziwalo zamkati komanso kukula kwa njira yotupa yomwe imapanga malo oyenera mabacteria a pathogenic.

Kukula kwa chifuwa chachikulu cha matenda ashuga kumadalira kwambiri kuwopsa kwa matendawa poyerekeza ndi kuchuluka kwa chipukutira chododometsa cha metabolism. Ndi matenda osakwanira bwino a chifuwa chachikulu, chifuwa chimafalikira mwachangu, zikukhudza minofu yayikulu yamapapu ndikufikira mawonekedwe owopsa kwambiri.

Ndikofunika kudziwa kuti ngakhale chithandizo cha chifuwa choyenera komanso chapanthawi yake sichidzabweretsa zotsatira zoyenera ngati wodwalayo sanathenso kukhazikika m'magazi a shuga. Pankhaniyi, zimachitikabe ndikuchulukirachulukira komanso kubwereranso komwe kumakhala kovuta kuchiza.

Mu magawo oyamba, chifuwa chachikulu cha odwala omwe ali ndi matenda osokoneza bongo amatha kukhala asymptomatic. Munthawi imeneyi, wodwala amatha kuwona zotsatirazi:

Zofooka zazikulu, kuchepa kwa ntchito,
Kupanda chilimbikitso
Kuchulukitsa thukuta.

Poona kuti zizindikirozi sizili zachindunji, nthawi zambiri zimadziwika ndi odwala ngati chizindikiro cha matenda oopsa a shuga. Nthawi zambiri, chifuwa chachikulu cha odwala matenda ashuga chimapezeka pokhapokha x-ray, yomwe imatha kuwonetsa zilonda zam'mapapo popanda kutsimikizira kwathunthu.

Chizindikiro china chomwe chikuwonetsa kukula kwa chifuwa chachikulu cha m'mapapo a shuga ndi kuwonjezeka kwadzidzidzi kwa shuga mumagazi popanda chifukwa. Izi zili choncho chifukwa ndi kukula kwa chifuwa chachikulu mthupi, kufunikira kwa insulini kumawonjezera, komwe kumayambitsa kuwonongeka kwa matenda ashuga komanso kuchuluka kwa shuga.

Chiwopsezo cha chifuwa chachikulu nthawi zina chimayambitsa kukula kwa matenda a shuga kwa odwala omwe m'mbuyomu analibe vuto la metabolism. Matenda a chifuwa chachikulu cha shuga amachitika kwambiri, akupita patsogolo msanga komanso amakhudza madera akuluakulu am'mapapu. Izi zimabweretsa chakuti ngakhale atakhala kuti ali ndi chithandizo chokwanira cha chifuwa chachikulu, wodwalayo amakhalabe ndi matenda a m'mapapo.

Chimodzi mwazinthu zomwe zimachitika pakuphatikizana kwa chifuwa chachikulu ndi matenda ashuga ndi kutengera kwa chotupa kumapazi a m'mapapo. Ngati chiwonetsero chofananacho chikuwonekera kwa wodwala yemwe ali ndi chifuwa chachikulu, amatumizidwa kukayezetsa shuga, chifukwa chitha kudziwa zomwe zachitika posachedwa matenda ashuga.

Chifukwa chake, matenda a shuga omwe ali ndi chifuwa chachikulu ndichinthu chowonjezera chomwe chimapangitsa kwambiri matendawa ndikuthandizira kukulitsa zovuta.

Chifukwa chake, mankhwalawa a chifuwa chachikulu, limodzi ndi shuga wambiri, amafunika kugwiritsa ntchito njira zovuta, zomwe zimaphatikizapo kugwiritsa ntchito mankhwala amakono oletsa chifuwa chachikulu komanso antibacterial.

Muyeneranso kutsatira zakudya komanso kupita kuchipatala.

Chithandizo cha chifuwa chachikulu cha matenda 1 a shuga amtundu 2 chimachitika molingana ndi njira zosiyanasiyana zamankhwala.

Chifukwa chake, kuti muthane ndi chifuwa chachikulu cha matenda a shuga a mtundu woyamba, chithandizo chamankhwala chiyenera kuphatikiza zotsatirazi.

Choyamba, muyenera kuwonjezera kuchuluka kwa insulin mwa magawo 10. Kufunikira:

Onjezani jakisoni wowonjezera wa insulin patsiku, ndikuwonetsa kuyambitsa kwake. Chiwerengero chonse cha jakisoni uyenera kukhala wosachepera 5 patsiku,
Sinthani pang'ono kapena mankhwala othandizira omasulidwa pang'ono ndi insulin yochepa. Izi ndizowona makamaka kwa odwala omwe amakhala ndi ketoacidosis.

Mtundu wachiwiri wa matenda ashuga, chithandizo chikuyenera kuchitika magawo otsatirawa:

Ikani kuchuluka kwa mankhwala a hypoglycemic,
Phatikizani mankhwalawa a jakisoni a insulin osapitilira magawo 10,
Woopsa chifuwa chachikulu, kusintha kwathunthu kwa mankhwala omwe amachepetsa shuga ndikubayidwa jakisoni wa insulin pang'ono.

Chofunikira kwambiri pakuchiza matenda a chifuwa chachikulu ndi kugwiritsa ntchito mankhwala apadera. Pofuna kuchiza matendawa, wodwalayo ayenera kumwa mapiritsi a chifuwa chachikulu, omwe, limodzi ndi mankhwala antidiabetes, amatha kupeza zotsatira zabwino.

Polankhula za mankhwala oletsa chifuwa chachikulu, ndikofunikira kuwunikira ndalama monga:

Amikacin
Isoniazid,
Kanamycin,
Capreomycin,
Paraaminosalicylic acid
Ethambutol
Pyrazinamide,
Protionamide
Rifabutin,
Rifampicin,
Streptomycin,
Tubazide
Ftivazide,
Cycloserine,
Ethionamide.

Ndikofunikira kutsindika kuti ena mwa mankhwalawa atha kuphatikizidwa mu zovuta za shuga, zomwe ndi:

Ethambutol siivomerezeka kwa retinal microangiopathy (zotupa zazing'onoting'ono zazing'onozing'ono mu ziwalo zamasomphenya),
Isoniazid ndi contraindicated vuto la polyneuropathy (kuwonongeka kwa zotumphukira mantha dongosolo),
Rifampicin amaletsedwa kawirikawiri ketoacidosis kapena mafuta a chiwindi hepatosis.

Pankhaniyi, wodwalayo sangothekera, komanso akuyenera kuyamba kumwa mankhwala ena omwe ndi otetezeka kwathunthu kwa iye.

Kuti thupi likhale lofooka komanso kulimbitsa chitetezo cha mthupi, odwala matenda a chifuwa chachikulu nthawi zambiri amapatsidwa mankhwala okhala ndi mavitamini. Mavitamini otsatirawa ndi othandiza kwambiri matenda:

Vitamini B1 - 2 mg patsiku,
Vitamini B2 - 10 mg patsiku.
Vitamini B3 - 10 mg patsiku.
Vitamini B6 - 15 mg patsiku. Mu chifuwa chachikulu cham'mapapo, kuchuluka kwa vitamini B6 tsiku lililonse kumatha kuwonjezeka mpaka 200 mg tsiku lililonse.
Vitamini PP - 100 mg patsiku,
Vitamini B12 - 1.5 mcg patsiku,
Vitamini C - pafupifupi 300 mg patsiku,
Vitamini A - 5 mg patsiku.

Kuphatikiza apo, mankhwala othandizira amatha kuphatikizidwa mu anti-chifuwa chachikulu, omwe amayenera kukhala olinganiza komanso okhala ndi michere yambiri.

Ndi chifuwa chachikulu, wodwalayo amasokoneza kagayidwe kazakudya zomanga thupi, zomwe zimatchedwa imodzi mwazomwe zimapangitsa kuti pakhale zovuta zambiri. Zotsatira zake, zakudya zonse zokhala ndi mapuloteni amtundu, komanso shuga, kupanikizana ndi zakudya zina zamafuta osavuta, siziyenera kuperekedwa kwa chakudya cha wodwalayo.

Njira yabwino kwambiri yokhala ndi chifuwa chachikulu komanso matenda ashuga ndi chakudya chamafuta ochepa chomwe chimaphatikizapo kudya zakudya zopanda msanga. Kuphatikiza apo, zakudya zokazinga komanso zamafuta ambiri zimaletsedwa pansi pa chakudya ichi, koma masamba atsopano ndi zakudya zambiri zimaloledwa .. Kwa chifuwa chachikulu ndi shuga, onani vidiyo iyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Zina za njira ya chifuwa chachikulu mu odwala omwe ali ndi matenda osiyanasiyana a shuga

Mtundu woyamba wa matenda ashuga:

Amuna amapambana azaka zapakati pa 19-30 - 42.7%,

Ambiri mwa odwala matenda ashuga amtundu 1 (70%), chifuwa chachikulu adadziwika zaka 5 mpaka 10 kapena kuposerapo atakula.

Chizolowezi chofuna kufutukuka msanga chifuwa chachikulu cha m'mapapo (24,5%),

Zotupa zaposachedwa kwambiri, (61.8%).

Kuchuluka kwa njirayi ndikofunikira kwambiri kuposa kwa odwala matenda ashuga a 2,

Zomwe zimachitika ndi pathogenesis: odwala omwe ali ndi matenda amtundu wa 1, nthawi zambiri, matenda opatsirana amatha kuganiziridwa, kuphatikiza matenda oyamba ndi chifuwa chachikulu

Kuchulukitsa kumachitika nthawi zambiri komanso tsiku lakale,

Mphamvu zakuwala zamatenda a chifuwa chachikulu ndizabwino kwambiri,

Zotsatira zoyipa nthawi zambiri zimayamba chifukwa cha isoniazid ndi rifampicin (9.4%).

Mtundu wofooka wa isoniazid inactivation umadziwika nthawi zambiri.

Type 2 matenda a shuga:

Chifuwa chachikulu cha m'mimba chinapezeka pasanathe zaka 5 kuchokera ku matenda oyamba a shuga,

Kuyambika kwa njirayi sikwachilendo (mu 17.5%),

Njira zonyikira sizipezeka pafupipafupi (37,5%), ndipo njira za cavernous ndi fibrous-cavernous zimapezeka nthawi zambiri (47.7%),

Zilonda zowonjezera, zomwe zimaphatikizapo lobe imodzi yam'mapapo, zimapezeka mu 37,5%,

Zomwe zimachitika mu chifuwa chachikulu cha chifuwa chachikulu cha m'mapapo: kupezeka kwa chifuwa chachikulu cha m'mapapo mwa odwala omwe ali ndi matenda amtundu wa 2 ali ndi zisonyezo zonse za kubwezeretsanso komwe kumachitika motsutsana ndi maziko a zovuta za kagayidwe kazakudya.

Pambuyo pamiyezi iwiri ya gawo lowonjezera la chemotherapy, abacillation imapezeka mu 34.4% ya odwala,

Mphamvu ya X-ray ya njira ya chifuwa chachikulu: atatha miyezi 4. kuvunda patsekeke lotsekedwa mu 36.4% ya odwala,

Zotsatira zoyipa zimagwirizanitsidwa makamaka ndi streptomycin (11.4%),

Kuchepa kochepa kwa chemotherapy kwa odwala omwe ali ndi matenda a shuga a 2 kumalumikizidwa ndi mawonekedwe amachitidwe ndi zina zazomwe zimayambitsa zovuta za kagayidwe kazakudya.

Zomwe zimaphatikizidwa ndi maphunziro a chifuwa chachikulu komanso shuga

Vuto la kuphatikiza kwa matenda monga chifuwa chachikulu ndi shuga limakhala lofunikira kwambiri m'munda wa TB.

Chowonadi ndi chakuti odwala matenda ashuga amatenga chifuwa chachikulu kangapo kangapo kuti alibe mbiri yakuzindikira kumeneku. Kuphatikiza apo, matenda onsewa amakula kwambiri chifukwa cha enawo ndipo amakhala ovuta kuwachiritsa, omwe nthawi zina amachititsa kuti wodwalayo afe.

Chipatala cha Matenda a Chifuwa

Phthisiology imapereka chidwi mwapadera ku vuto la hyperglycemia. Izi ndichifukwa choti mu shuga mellitus chifukwa cha kusokonekera kwa ntchito ya legocytes, carbohydrate-fat balance and general metabolism, njira yochiritsira ndikubwezeretsa mapapu ndizovuta kwambiri.

Nthawi zambiri, chifuwa chachikulu cha chifuwa cha shuga chitasinthidwa kukhala njira yodwala, ndikupangitsa kuti masinthidwe owonongeka mu minofu ndikupangitsa kuti pakhale mitundu yochepa yolowerera (chifuwa chachikulu, foci) kapena ziwalo.

Malinga ndi ziwonetsero za matenda owonera mliri, kuchuluka kwa chifuwa chachikulu kwa odwala omwe amadalira insulin ndikwambiri nthawi 5-10 kuposa mwa anthu wamba. Mwa 9 mwa 10 mwa odwala oterewa, matenda a shuga anali matenda oyambitsidwa ndi matenda.

Komanso, chifukwa cha kusinthika kwa metabolic komanso immunological komwe kumabwera chifukwa cha kuperewera kwa insulin, njira ya chifuwa chachikulu mu matenda ashuga imadziwika kwambiri, komwe, limakulitsa zochitika zam'chipatala ndipo zimayambitsa zovuta zazikulu - zoyipa zam'mbuyomu mu ziwonetsero, kuwonongeka koyambirira ndi bronchogenic kubzala.

TB imayamba mu matenda a shuga monga njira yachiwiri yokhazikika makamaka kumadera otsika a m'mapapo. Mawonetsedwe azachipatala a matendawa ndiwotsimikizika ndipo amadalira mtundu ndi matenda omwe amayambitsidwa (DM). Kudziwidwa kumayambiriro, chifuwa chachikulu chimakhala ndi mawonekedwe abwino kuposa matenda kumapeto kwake.

Matenda ovuta kwambiri amapezeka mwa odwala omwe amadalira insulin aubwana ndi unyamata. Pankhaniyi, nthawi zambiri pamakhala kuledzera kwamphamvu kwa thupi, kuwonjezereka kwa matendawa, kupanga mapangidwe a fibro-cavernous komanso kuwonongeka kwa ziwalo.

Koma munthawi iliyonse, chikhalidwe cha kupatuka chimatengera mwachindunji matendawo komanso matendawo.

Magulu angapo a odwala amadziwika chifukwa cha nthawi ya matenda a shuga ndi chifuwa chachikulu:

Nthawi imodzi kapena pang'ono pakadutsa miyezi 1-2,
Kuzindikira matenda pamatenda a shuga a gawo lililonse,
Kuzindikira kwa hyperglycemia kumbuyo kwa chifuwa chachikulu.

Kukula kwa matenda kumatha kuphatikizidwa ndi matenda oyamba komanso kubwezeretsanso zakale (zipsera) zakale chifukwa cha chifuwa cham'mbuyomu. Kulunjika kwa kufanana kwa mitundu iwiriyi ndikuti chifukwa cha kuchuluka kwa matenda ashuga, ngakhale ndi chithandizo chokwanira cha matenda, wodwala wodalira insulin, chizolowezi chowonjezereka komanso kutembenuka kwa chifuwa chachikulu chimatsalira.

Etiology ya chifuwa chachikulu odwala omwe ali ndi matenda ashuga

Nthawi zambiri, matendawa amalumikizana ndi shuga omwe alipo. Zomwe zikuluzikulu zomwe zimapangitsa kuti pakhale kumwa kwambiri ndizosasamala za kuopsa kwa chifuwa chachikulu pakuwonekera kwake, ndipo pokhudzana ndi izi, chithandizo chosadabwitsa.

Zina zomwe zimayambitsa kufalikira kwa matendawa ndi monga:

Kuphwanya zakudya pa chemotherapy,
Kudumpha mankhwala
Kusuta ndi kumwa,
Khalidwe losakhala labwino komanso kusowa kolembetsera tsiku ndi tsiku,
Zakudya zoperewera
Kupsinjika
Kuchita masewera olimbitsa thupi mopitirira malire
Matenda a shuga
Zolakwika mu chemotherapy kapena insulin,
Acidosis (kuchuluka kwa acidity ndi kuchepa kwa pH m'thupi,
Pancreatitis pachimake kapena chodwala,
Kuchotsa kapamba
Kusagwirizana kwa homeostasis ndi immunobiological reactivity ya thupi.

Ndi kuchuluka kwa matenda ashuga, njira ya matenda imakulanso. Mu insulin yosadalira zovuta za shuga mellitus, ma morphology ambiri samasiyana mwatsatanetsatane.

Tekinoloje yamankhwala

Chifuwa chachikulu cha chifuwa chachikulu cha m'mimba ndi shuga ndizophatikiza zovuta za standard chemotherapy. Kuchuluka kwa zovuta ndi zoyipa kuchokera ku chithandizo kwa odwala omwe amadalira insulin ndi 1.5 nthawi zambiri kuposa kwa odwala opanda matenda a shuga. Mankhwalawa pawokha amatenga nthawi yayitali ndipo amangochitika kuchipatala chothandizira.

Kusankhidwa kwa kuphatikiza kwa mankhwala ndi kayendetsedwe ka kayendetsedwe kake kumachitika mogwirizana ndi chiwembu, mogwirizana ndi matenda, gulu la anthu odwala matenda ashuga, gawo la chifuwa, kugawa kwake komanso kukula kwa ofesi. Mfundo zazikuluzikulu za njira yonse yochiritsira ndiyothandiza mosiyanasiyana.

Matendawa amapezeka pogwiritsa ntchito njira zofufuza zamankhwala ndi zamankhwala:

Kusanthula kwamwazi ndi mkodzo,
Kusanthula kwa zamankhwala,
Kuyeserera kwakanthawi ndi ma X-ray,
Kuyesa kwa Tuberculin kapena katemera wa Mantoux / Pirke,
Microscopy ya sputum ndi chikhalidwe chake kuti azindikire ntchito ya mycobacteria,
Matenda a bronchoscopic,
Minofu kapena maselo a histological biopsy,
Matenda a immunological omwe cholinga chake ndi kuzindikira ma antibodies a bacillus mu seramu yamagazi.

Tuberculosis ya odwala omwe amadalira insulin amathandizidwa mothandizidwa ndi kuphatikiza mankhwala ndikuwonetsetsa kuchuluka kwa shuga. Kuphwanya regimen ya mankhwala kumabweretsa multidrug kukana chifuwa kapena kukula kwake kukana mankhwala.

Njira yodziwika ndi anti-TB yothandizira odwala matenda ashuga imaphatikizapo:

Chemistry - Isoniazid, Rifampicin, Ethambutol ndi maantibayotiki ena,
Immunostimulants - Sodium Nucleinate, Tactivin, Levamiol,
Inhibitors - b-tocopherol, sodium thiosulfate, etc.,
Mankhwala a Hormonal omwe amayang'anira shuga nthawi zonse,
Othandizira odwala matenda ashuga, kuphatikiza insulin,
Chithandizo cha manambala 9.

Ndi kusinthika pang'onopang'ono kwa matenda, kugwiritsa ntchito njira zothandizira zosagwiritsa ntchito mankhwala othandizira chifuwa chachikulu ndikuloledwa - ultrasound, laser ndi inductotherapy.

Muma zoopsa kwambiri, amapita kukawonetsera opaleshoni yam'mapapo, zomwe zimadziwika kuti zachuma.

Njira yonse yochiritsira wodwala yemwe ali ndi matenda a shuga kuchokera pakumwa amachitika moyang'aniridwa ndi achipatala. Ntchito yayikulu munthawi imeneyi, kuwonjezera pakuchotsa kulowa, ndikupanga chipukutiro, komanso kusintha mtundu wa glucose, mapuloteni, lipids ndi metabolism.

Ndi bwino kupatsidwa mankhwala a chemotherapy komanso kuchira, wodwala matenda a shuga amawonetsedwa chithandizo cha spa.

Njira zopewera

Popeza odwala omwe amadalira insulin ndi omwe ali pachiwopsezo chachikulu chotenga kachilombo ka chifuwa chachikulu, ndikulimbikitsidwa kuti agwiritse ntchito njira zingapo zodzitetezera popewa kukula kwa matendawa.

Kuti mudziteteze ku mowa, muyenera:

Mumayesedwa X-ray kapena fluorography pachaka,
Khalani ndi moyo wokangalika
Nthawi zambiri muziyenda mumlengalenga,
Kutsatira dongosolo lolondola la tsiku ndi tsiku, zakudya komanso nthawi yopuma pantchito,
Chotsani komwe kungayambitse matenda, kuphatikiza ndi wodwala chifuwa chachikulu,
Sinthani zakhalidwe,
Kanani zizolowezi zoipa - mowa, kusuta,
Mankhwalawa, kuphatikizapo matenda ashuga,
Onani zaukhondo
Pentheni ndi kunyowetsa malowa nthawi zonse
Idyani zakudya zokhala ndi mavitamini, chakudya chamafuta ndi zinthu zina.

Kuphatikiza apo, wodwala yemwe amadalira insulin ayenera kudwala chemoprophylaxis ndi Isoniazid kuyambira miyezi iwiri mpaka isanu ndi umodzi. Moyo wonse wa munthu wodwala matenda ashuga ayenera kuangika pantchito yake, thanzi labwino komanso kuchita masewera olimbitsa thupi, kulola kuti thupi lizikumana ndi mphamvu komanso kulimbitsa chitetezo chokwanira.

Musaiwale za kusamala. komanso yesani kupewa kutsokomola anthu, mavairasi oyambitsa nyengo (chimfine, zotupa zopumira), mafuta otentha ndi maulendo a sauna. Kugwiritsa ntchito UV kwambiri kumapangidwanso. Zakudya ziyenera kukhala zabwino, m'magawo angapo. Onetsetsani kuti mukuyendera dokotala wanu pafupipafupi.

Ndi njira yabwino komanso yolondola yovuta yokhudza matenda a chifuwa chachikulu ndi chifuwa chachikulu cha shuga, matenda omwe amatenga matendawa sakhala owopsa ndipo nthawi zonse amakhala ndi chitsimikiziro chabwino.

Makanema okhudzana nawo

Ndi chifukwa chiyani chophatikizira shuga ndi chifuwa chachikulu, ndi zizindikiro ziti zomwe zimayambitsa vuto, makamaka chofunikira, ndi chithandizo chiti chomwe chimakhala chanzeru kwambiri? Mayankho mu kanema:

Zaka zingapo zapitazo, odwala omwe adadziwika kawiri kawiri adatsala pang'ono kufa, ambiri mwa odwala adamwalira. Tsopano ndi chithandizo chamakono komanso njira zaposachedwa zoyendera, madokotala amatalikitsa miyoyo ya anthu masauzande ambiri. Komabe, ndikofunikira kuti mumvetsetse kuti chithandizo chilichonse, ngakhale pogwiritsa ntchito njira zamakono zamankhwala, chikuyenera kuchitika ndi akatswiri odziwa bwino ntchito, odziwa bwino omwe ali ndi njira yolankhulirana ndi wodwala aliyense.

About ziwerengero

Ngati mukuyang'ana mawerengeredwe, ndiye kuti anthu odwala matenda ashuga nthawi zambiri amatenga matendawa ndi chifuwa chachikulu, ndipo nthawi zambiri oimira kugonana mwamphamvu amakhala pachiwopsezo. Ngati munthu ali ndi matenda a shuga, ndiye kuti mwayi wake wodwala chifuwa chachikulu ndi pafupifupi 8%.

Matenda a chifuwa chachikulu ndi matenda ashuga amapita limodzi kawirikawiri - malinga ndi ziwerengero, anthu omwe ali ndi vuto la m'mapapo amakhala ndi matenda osokoneza bongo a 6 peresenti ya milandu.

Kuchepa kwa chakudya chopatsa mphamvu kumakhala kofunikira kwambiri, ngati munthu ali ndi matenda "okoma" omwe amakula kwambiri, ndiye kuti adzadwala chifuwa chachikulu maulendo 15 kuposa munthu wathanzi.

Chifuwa chachikulu cha chifuwa chachikulu cha m'mimba ndi shuga. Ngati matenda a shuga ali ofatsa, ndiye kuti palibe zovuta pakukula kwa matenda oopsa a m'mapapo.

About mitundu ndi mawonekedwe a matendawa

Matendawa amatengera thupi la munthu m'njira zitatu zazikuluzikulu. TB imayamba matenda a shuga mellitus pamiyeso yosiyanasiyana; izi zimakhudzidwa ndi vuto la kagayidwe kachakudya m'thupi la munthu. Ndi katundu wopanda chiphuphu, mitundu yamatenda am'mapapo m'nthawi yochepa, minofu yam'mapapu imakhudzidwa kwambiri komanso mwachangu.

Chifuwa chachikulu ndi shuga zimakhudza thupi la munthu m'njira zosiyanasiyana, zomwe zimabweretsa zovuta zazikulu.

Chithandizo cha matenda a pathological chingakhale chosiyana, zonse zimatengera kukula kwa matenda ndi machitidwe a munthu.

Dokotala yekha ndi amene angatilenge chithandizo, chithandizo chodziimira payekha sichimayambitsa chilichonse chabwino, zotsatirapo zake zimakhala zoopsa kwambiri - mapapo ake amatha kuwonjezereka kwambiri kotero kuti zotsatirapo zake ndizosapeweka kale.

Kuzindikira matenda nthawi imodzi

Izi zimachitika ngati matenda ashuga m'thupi la munthu akula. Matenda amtunduwu nthawi zambiri amakhudza amuna omwe adutsa zaka 40. Mkhalidwe uwu umadziwika ndi chiwopsezo chowonjezeka - ngati nthawi yomweyo thupi likukhudzidwa ndi ma pathologies awiri, ndiye kuti zotsatirapo zake sizingalephereke. Vutoli limasokonekera chifukwa chidziwitso cha matenda sichikudziwika.

Kodi chifuwa chachikulu chimayamba bwanji pamaso pa matenda ashuga

Matenda amtunduwu ndiofala, chifukwa chachikulu ndi chitetezo chamthupi chofooka, motero thupi la munthu silingathe kukana matenda. Ndipo bacillus wa tubercle pankhaniyi ndiye owopsa kwambiri. Vutoli limakulitsidwa chifukwa chakuti munthu akakhala ndi matenda ashuga, thupi limakhala kuti lilibe chitetezo chokwanira choteteza ku chifuwa cha TB.

Ndi matenda osadziwika a m'mapapo, mkhalidwe wa munthu ukuwonongeka msanga, chifukwa chake nkovuta kuchitira matenda awiri nthawi imodzi.

Vutoli limakulitsidwa chifukwa chakuti munthu akakhala ndi matenda ashuga, ndiye kuti TB kwa nthawi yayitali sadzipatsa chizindikiro chilichonse.

Wodwala nthawi zambiri samakayikira kuti akudwala kwambiri, ndipo zonse zimamveka bwino ngati matenda onsewo akupita patsogolo mwachangu. Pofuna kupewa izi, ndikokwanira kuchita fluorography chaka chilichonse.

Kodi matenda ashuga amakula bwanji pamaso pa chifuwa chachikulu?

Vutoli silimapezeka nthawi zambiri ndi madokotala. Zimachitika mulingo wa alkaline-acid ukasintha, ndiye kuti munthu amangokhala wofooka, ngakhale pakanalibe ntchito yambiri.

Zizindikiro zingapo zimafunikira kutchulidwa - m'mkamwa mwake mumakhala wowuma nthawi zambiri, munthu amakhala ndi ludzu, koma madzi akumwa samakhuta kwa nthawi yayitali.

Koma zizindikilo zotere nthawi zambiri sizimapatsa anthu chifukwa chochezera ndi dokotala, zomwe zimapangitsa kuti azitha kukhala ndi matenda. Matenda a m'mapapo amtunduwu nthawi zambiri amakula.

Pazizindikiro

Monga tanena kale, pa gawo loyambirira palibe zizindikiro zomwe zimawonedwa, zomwe zimakulitsa vutoli, popeza munthuyo sapita kwa dokotala. Ndikofunika kulabadira zotsatirazi zotsatirazi, zomwe zingasonyeze kukula kwa matenda:

magwiridwe amunthu akucheperachepera,
Munthu amakhala wotopa nthawi zonse, ngakhale kuti sanachite khama,
kusowa kwa chakudya
thukuta limatulutsidwa zochuluka kwambiri ngakhale kuzizira.

Choyipa ndichakuti odwala matenda ashuga angapo amawona ngati zoterezi ndizazikhalidwe zokhazokha, koma lingaliro ili silolondola. Ngati munthu ali ndi zizindikiro zotere, ndiye kuti fluorography iyenera kuchitidwa mwachangu.

Mlingo wa glucose mumtsinje wamagazi m'dera lino umakwera kwambiri, koma palibe zifukwa zowoneka. Anthu odwala matenda ashuga omwe akudziwa zambiri amadziwa kuti kuchuluka kwa shuga kumawonjezeka pokhapokha ngati pali zina.

Koma chifukwa cha kuchuluka kwa glucose limachuluka pazifukwa ziti? Koma kuti kukula kwa tubillcle bacillus, ndikofunikira kuti insulin ikhale yokwanira. Ndipo siziwotcha mafuta, koma imapereka michere kwa tubercle bacillus.

Kodi chifuwa chachikulu chimayamba bwanji mu shuga?

Wodwala matenda ashuga amatha kutenga zovuta za matendawa. Izi zimathandizidwa ndi zinthu zingapo zovuta: mthupi, zochitika zama cell a chitetezo cha mthupi (leukocytes) zimachepetsedwa, minofu imayikidwa acidosis (acidization), ndipo metabolism imalephera. Zikatero, wodwalayo alibe mwayi woti thupi athe kumenya nkhondo yothandizirana ndi matendawa, ngakhale atalandira katemera.

Chiyanjano chosagwirizana pakati pa kukhazikika kwa matenda ndikothekanso: ngati matenda a shuga amachitika m'njira yotsala koma osawonetsa zizindikiro zilizonse, nthenda ya chifuwa chachikulu imatha kusintha kusinthika kwa mawonekedwe.

Njira ya chifuwa chachikulu imadalira kuchuluka kwa chiphuphu cha matenda ashuga. Ngati dongosolo la endocrine la wodwalayo limathana ndi vutoli, ndiye kuti chifuwa chachikulu chimatha kupitilira "popanda vuto" popanda kufalitsa kachilombo ka matenda ku ziwalo zina ndi matupi ake.

Ngati matenda a shuga amawonongeka, ndiye kuti ndi chifuwa chachikulu cha m'mapapo, ma exudative-necrotic foci nthawi zambiri amayamba, zomwe zimapangitsa kuti mapangidwe apangidwe m'mitsempha. Ubale womwewo umawonedwa pa kuopsa kwa matenda ashuga.

Malinga ndi ziwerengero, odwala matenda a shuga amakhala ndi matenda otsatirawa:

anthu omwe ali ndi mtundu wina wodwala matenda a shuga amakhala ndi zotupa zochepa (m'mapapo),
Odwala odwala matenda ashuga - mawonekedwe a fibro-cavernous,
odwala omwe ali ndi matenda oopsa a shuga omwe amakhala ndi chifuwa chachikulu cha pulmonary, chomwe chimayendera limodzi ndi zovuta zingapo.

Mokulira, ndi mitundu yovuta ya matenda a shuga, pansi pa chithandizo chokwanira, chifuwa chachikulu cha m'mapapo sichimasiyana mu mawonekedwe a matenda omwe ali mwa munthu wopanda matenda a shuga.

Wodwala akalandira chithandizo cha mahomoni, atha kukhala ndi chiopsezo chowonjezeka pang'onopang'ono chifukwa cha kuchepa kwa chitetezo chokwanira, koma chifuwa chokha chimapezeka popanda zovuta zina.

Izi zimathandizidwa ndikukhazikitsa njira zotsutsana ndi TB m'm zipatala za anthu odwala matenda ashuga.

Chimodzi mwazomwe zimachitika ndi chifuwa chachikulu cha shuga ndi kusowa kwa zizindikiro za matendawa.

Nthawi zambiri kwanthawi yayitali kuyambira chiyambi cha chifuwa chachikulu, wodwalayo sawonetsa zodziwikiratu za matendawa: chifuwa komanso kuwonjezeka kwambiri kwa kutentha.

Zizindikiro monga kutentha pang'ono, kufooka, ndi kusowa kudya zitha kuonedwa ndi adotolo ngati kukukulitsa shuga.

Zomwe zimapezeka ndi matenda komanso chithandizo

Nthawi zambiri, chifukwa cha kusowa kwa chithunzi cha chipatala cha odwala omwe ali ndi chifuwa chachikulu, amangogonekedwa m'chipatala ndi kuledzera kwambiri komanso kupweteka kwambiri m'mapapo. Chifukwa chake, muyenera kulabadira zizindikiro zoyambirira za chifuwa chachikulu mu shuga - kuwonjezereka kwa kufunika kwa insulin.

Kuzindikira koyambirira kwa chifuwa chachikulu kumatheka pokhapokha pofika nthawi yake fluorography mwa odwala matenda a shuga. Ngati odwalawa akuchulukirachulukira ndikuvomerezedwa kuchipatala, amapezekanso koyamba chifukwa cha chifuwa chachikulu chifukwa choopsa kwambiri.

Kuphatikiza apo, ziyenera kudziwidwa kuti odwala omwe ali ndi matenda osokoneza bongo, chiwopsezo cha kuwonongeka kwa bronchial chifuwa chachikulu ndi chachikulu kuposa m'magulu ena a odwala.

Komabe, kuchita njira ya tracheobronchoscopy (pofuna kudziwa kapena kutulutsa madzi) sikutheka konse - mwayi wakuchita bwino umawunikidwa molingana ndi kuopsa kwa matenda ashuga.

Mkhalidwe wamtima, mitsempha yamagazi, chiwindi chiyenera kuganiziridwanso - wodwalayo sangathe kulekerera opaleshoni.

Chithandizo cha chifuwa chachikulu chimachitika molumikizana ndi chiphuphu pazizindikiro za matenda ashuga. Zakudya zamankhwala ndi insulin zimagwiritsidwa ntchito kuti matenda a metabolism azikhala bwino komanso kuti shuga azikhazikika.

Tizilombo toyambitsa matenda a chifuwa chachikulu timalimbana ndi maphunziro a chemotherapy a nthawi yayitali.

Kusankhidwa kwa mankhwalawa kumachitika poganizira zotsatira zoyipa, kotero kuti mitundu yosiyanasiyana ya maantibayotiki imagwiritsidwa ntchito kwambiri kupewetsa mphamvu.

Mu chemotherapy, mankhwala a Isoniazid angagwiritsidwe ntchito, omwe amagwiritsidwanso ntchito popewa chifuwa chachikulu cha odwala omwe ali ndi matenda a shuga. Komabe, posachedwa, ngakhale kuti mankhwalawa amagwira ntchito bwino, madokotala amakana kugwiritsa ntchito mankhwalawa chifuwa chachikulu (kupatula milandu yayikulu) chifukwa cha kuwopsa kwake: mankhwalawa amayambitsa zovuta zoyipa.

Matenda a chifuwa chachikulu komanso matenda a shuga amakhalanso amasokoneza momwe amathandizirana chifukwa chosagwirizana ndi magulu ena a mankhwala. Mwachitsanzo, Rifampicin amasintha njira ya kuwonongeka kwa mankhwala a hypoglycemic (kuchepetsa-shuga) omwe amaperekedwa ngati mapiritsi. Panthawi yowonongeka kwambiri m'mapapo, njira ya opaleshoni yochizira chifuwa chachikulu (kuchotsedwa kwathunthu kapena pang'ono) ingagwiritsidwe ntchito.

Kunyalanyaza mankhwala odana ndi insulin, zakudya, kupezeka mwadzidzidzi - zonsezi zimangowonjezera ngozi za chifuwa, komanso zimawonjezera mkhalidwe wa thupi lonse la wodwalayo.

Akavomera kuchipatala, dokotala yemwe amapezekapo ayenera kusankha payekha mankhwala osakaniza ndi chifuwa chachikulu, kusankha mtundu wa chemotherapy, kuyang'anitsitsa mkhalidwe wa wodwalayo ndikuwunika mayeso ake athanzi nthawi zonse. Chemotherapy ya matenda a shuga nthawi zambiri imafunanso njira yochepetsera, monga apo ayi zitha kuchititsa kuti chiwonongeko chisa chitetezo.

Wodwalayo ayenera kuyang'anira thanzi lake. Ngati pali mbiri yodwala matenda a shuga, ndikofunikira kuti muzimvera pafupipafupi, ngati kuli koyenera, pangani mayeso a tuberculin.

Muyeneranso kutsatira malingaliro onse kuti muchepetse kutenga kachilombo ka chifuwa chachikulu: samverani zaukhondo, pewani kudya zakudya zosaphika (mwachitsanzo, nyama kapena mazira a nkhuku), pewani kugwira ntchito m'malo ochepetsa, ozizira, ochepetsa kulumikizana ndi anthu omwe angakhale oopsa (akaidi, osowa pokhala).

Chifuwa chachikulu komanso matenda ashuga

Musanagonjetse maantibayotiki, pafupipafupi kuphatikiza chifuwa chachikulu komanso shuga anawerengera 40-50% ya onse odwala matenda ashuga. Mu 80s yathu, idatsikira mpaka 8%. Koma ngakhale pano, odwala matenda a shuga amakhala pachiwopsezo chotenga chifuwa chachikulu katatu kuposa akazi.

Odwala ndi chifuwa chachikulu 8-10 nthawi zambiri kuposa anthu ena onse, matenda abwinoko a shuga apezeka. Njira ya chifuwa chachikulu ndi chemotherapy zimawononga ntchito yokhudzana ndi kapamba komanso kuchepa mphamvu kwa insulin.

Ndi matenda ashuga, omwe amapezeka motsutsana ndi kusintha kwatsoka kwatsoka, kuyambiranso matendawa nkotheka, koma njira ya chifuwa chachikulu ndi yabwino.

Mwa odwala omwe ali ndi matenda a shuga, mitundu yachiwiri ya chifuwa chachikulu - mitundu ikuluikulu yolowerera ndi chifuwa chachikulu chotchedwa fibro-cavernous.

Pankhaniyi, kuyesa kwa tuberculin sikwakukongola kwambiri, komwe kumafanana ndi kukakamizidwa kwa chitetezo chamthupi.

Njira yovuta kwambiri ya chifuwa chachikulu imadziwika mu matenda a shuga, omwe adayamba kuubwana ndi unyamata kapena atakumana ndi zowawa zam'maganizo, amakomera kwambiri okalamba.

Gawo loyambirira la chemotherapy kwa wodwala yemwe wapezeka kumene ndi kuphatikiza chifuwa chachikulu ndi shuga ayenera kuchitika kuchipatala. Odwala omwe ali ndi matenda ophatikizikawa, zimayambitsa zovuta za chifuwa chachikulu.

Ndikofunikira kukwaniritsa kukhazikika kwa shuga m'magazi pomwe mukugwiritsa ntchito mankhwala antidiabetesic and anti-TB (makamaka rifampicin). Kutalika kwa mankhwalawa kuyenera kuchuluka mpaka miyezi 12. ndi zina zambiri.

Ndikofunikira kuyang'anitsitsa mosamala mawonetseredwe a matenda ashuga angiopathy (kuwunika momwe matumba amathandizidwe, kupangidwira malekezero ena, ndi zina zotere), ndipo pakuwoneka, nthawi yomweyo amayamba kulandira chithandizo (prodectin, trental, chimes, dimephosphon, etc.). Mu diabetesic retinopathy, ethambutol imagwiritsidwa ntchito mosamala kwambiri.

Anthu odwala matenda ashuga nephropathy amaletsa kugwiritsa ntchito aminoglycosides. Polyneuropathy, yodziwikanso ndi matenda ashuga, imasintha mankhwala ndi isoniazid ndi cycloserine. Ndi chitukuko cha ketoacidosis, kugwiritsa ntchito rifampicin kumatsutsana.

Matendawa omwe adayamba kudwala nawonso amakhala akulu. Chifuwa chachikulu, chomwe matenda a shuga adalumikizana, chimadziwika ndi maphunziro owopsa, kuwonongeka kwambiri m'mapapo, komanso chizolowezi chopita patsogolo. Matenda a shuga, omwe adayamba kale chifuwa chachikulu, amadziwika ndi kupweteka pafupipafupi, komwe amakhala ndi vuto la matenda ashuga angiopathy.

Matenda a chifuwa chachikulu, omwe amapezeka motsutsana ndi matenda ashuga, amadziwika ndi zizindikiro zazing'ono ndipo amapita patsogolo pang'onopang'ono.

Vuto la kuphatikiza kwa matenda awiriwa limapangitsa kuti magazi a odwala matenda ashuga aoneke bwino.

Odwala omwe ali ndi matenda osokoneza bongo omwe amakhala ndi matenda osintha pambuyo pa chifuwa chachikulu amayenera kuwunikira ndikuwonetsetsa malinga ndi gulu la VII la subsensary usajili.

Kuchita kumawonetsa kuti kupambana kwa chithandizo cha chifuwa chachikulu ndikofunikira kokha ngati zovuta za metabolic zimalipidwa. Amadziwika kuti insulini imakhudza bwino njira ya chifuwa, chifukwa chake, mu gawo logwirako ndikofunika kusankha insulini yoperekera chithandizo chofuna kuchepetsa shuga.

Ngati glucocorticosteroids amagwiritsidwa ntchito povuta mankhwala, kuchuluka kwa chakudya kwamoto kumayenera kulipiridwa ndi kuwonjezeka kwa mlingo wa insulin.

Mankhwala akunyumba ali ndi chidziwitso pakuchita opaleshoni ya chifuwa chachikulu cha odwala omwe ali ndi matenda a shuga, komabe, kutalika kwa chemotherapy mwa odwala omwe ali ndi kuphatikiza uku ndikutalika kwambiri kuposa popanda matenda a shuga.

Zochitika zamankhwala za kuphatikiza kwa chifuwa chachikulu ndi shuga

Odwala odwala matenda a shuga ndi gulu lomwe lingakhale pachiwopsezo cha chifuwa chachikulu. Vuto lalikulu la chifuwa chachikulu, kuchuluka kwa chifuwa chachikulu cha MDR komanso kuchuluka kosawerengeka kwa matenda opatsirana a shuga kumapangitsa kuchuluka kwa odwala omwe ali ndi matenda opatsirana.

Matenda a chifuwa chachikulu amakula nthawi ya matenda ashuga ndi zovuta zake, amathandizira kusintha kwamatenda am'mimba a metabolism kukhala chithunzi chatsatanetsatane cha matendawa.

Chifuwa chachikulu cha chifuwa chachikulu cha shuga m'mimba imakulitsidwa ndi kuchepa kwa chitetezo chokwanira, chidwi chachikulu cha minyewa yam'mapapo mpaka acidosis ndi matenda a shuga a diabetic, i.e.

nthenda yophatikizika yatsopano imawoneka ndi chithunzi chapadera chachipatala komanso zovuta pakuzindikira komanso kulandira chithandizo.

Matendawa amapita patsogolo mwachangu, njira ya chifuwa chachikulu imakhala ndi kufalikira komanso kubwereranso, popeza njira zochiritsira sizachangu komanso pang'onopang'ono, ndikukula kwa micangiopathies, odwala samalekerera mankhwala othana ndi chifuwa chachikulu, MBT kukana anti-tuberculosis mankhwala amapezeka mwachangu . Komabe, chifuwa chachikulu limodzi ndi matenda a shuga chimatha kuchira ndikuyamba kudziwa matenda onse komanso chithandizo chokwanira cha wodwalayo, zomwe zingatheke ndikudziwitsa za vuto la madokotala a TB, ma endocrinologists ndi othandizira.

Zolemba zamaphunziro a chifuwa chachikulu kuphatikizapo shuga

Kwazaka makumi angapo zapitazi, pakhala kusintha pa mawonetseredwe azachipatala komanso mtundu wa njira ya chifuwa chachikulu kwa odwala omwe ali ndi matenda ashuga. Kusintha kumeneku, zikuwoneka kuti kukugwirizana ndi kuyambitsa kwa insulin machitidwe, komanso chemotherapy yamakono ya chifuwa chachikulu.

Munthawi ya insulin isanayambike, chifuwa chachikulu cha m'mapapo chimapezeka pa autopsy pafupifupi 50% ya odwala matenda a shuga ndipo amawonedwa ngati vuto la shuga. Odwala omwe ali ndi matenda amtundu woyamba, kuchuluka kwa chifuwa chachikulu ndi katatu.

Kuphatikizidwa kwa chifuwa chachikulu cha m'mapapo am'mimba ndi matenda amtundu wa 1 kumakhala kofala kwambiri mwa abambo ndi mtundu 2 mwa akazi. Potengera kuchuluka kwa matenda ashuga komanso kuphatikiza chifuwa chachikulu, 45% ndi mtundu 1 wa matenda a shuga ndipo 55% ndi mitundu yachiwiri ya matenda a shuga.

Kuzindikira kwa chifuwa chachikulu yogwira nthawi ya mayeso a fluorographic a odwala omwe ali ndi matenda ashuga ndi 5-10 nthawi zambiri.

Zinthu zitatu zomwe zimaphatikizidwa ndi shuga ndi chifuwa chachikulu ndizodziwika bwino:

Matenda a chifuwa chachikulu amakula kumbuyo kwa matenda a shuga (nthawi zambiri). Kuphatikiza apo, kuchuluka kwa chifuwa chachikulu cha odwala matenda a shuga kumachitika m'zaka za pakati pa 1-2 ndi 13 mpaka 13 chifukwa matendawa amapezeka pachaka cha matenda ashuga, ndipo patatha zaka 13 matendawa amapangitsa matenda kusokonekera kwa nthawi yayitali , yomwe imakondweretsa kukula kwa chifuwa chachikulu mwa odwala. Mwa odwala omwe ali ndi matenda ashuga, chifuwa chachikulu chimachokera 3 mpaka 12%.
Matenda onsewa amapezeka nthawi imodzi.
Chifuwa chachikulu isanayambike matenda ashuga. Mwa odwala omwe ali ndi chifuwa chachikulu, matenda a shuga amatha. Posachedwa, kuchuluka kwa odwala omwe amaphatikiza ndi chifuwa chachikulu komanso matenda a shuga, komwe chifuwacho chinapezeka koyamba, chakwera kwambiri.

Zina mwazinthu zomwe zimachepetsa shuga m'mthupi kukana matenda a chifuwa chachikulu, kuwonongeka kwa matenda ashuga ndi acidosis ndikofunikira. Acidosis imaphwanya magwiridwe antchito a machitidwe onse oteteza komanso kusinthasintha a thupi, zomwe zimakhudza kuchuluka kwa chitetezo chokwanira cha chifuwa chachikulu.

Matenda a chifuwa chachikulu, amachepetsa nthawi ya matenda ashuga, zovuta zake ndipo amathandizira kusintha kwa matenda ashuga am'magazi. Izi zimachitika chifukwa cha kuwoneka kwa zinthu za pancreatic za shuga mthupi nthawi ya matenda.

Mwa iwo, kuledzera kwa chifuwa chachikulu komanso mavuto obwera chifukwa cha mankhwala omwe amaletsa anti-TB, chiwindi chodwala, kuwonjezeka kwa machitidwe omvera-komanso adrenal ndi pituitary-adrenal, chithokomiro cha chithokomiro, kumasula mahomoni omwe amaletsa insulin.

Mavuto omwe amayamba chifukwa cha chifuwa chachikulu komanso matenda ashuga amapanga matenda ovuta omwe ali ndi chipatala chachilendo komanso zovuta zamankhwala.

Mapapu ndi amodzi mwa ziwalo zomwe zimalimbana ndi matenda ashuga. Kuphwanya kwa kagayidwe kazakudya kwa odwala omwe ali ndi matenda osokoneza bongo amachititsa kuti kuphwanya mapuloteni ndi mafuta kagayidwe ndipo kumayambitsa microangiopathy komanso kukula kwa microatelectases. Kusintha kowopsa kwamankhwala ena kumakhala kochepa.

Matenda a chifuwa umayamba motsutsana ndi kumbuyo kwa kusinthanso kwachulukidwe, komanso mwachilengedwe zotupa zam'mimba zokhala ndi thrombosis yowonjezereka.

Tuberculosis mu matenda a shuga amakhala ndi milandu-necrotic anachita, kuchedwa kusintha chitukuko ndi mapangidwe lalikulu zotsalira, amakonda kubwereranso.

Kutengera kwa chitukuko cha chifuwa chachikulu cha m'mapapo ndi shuga ndi zina mwazinthu zomwe zimatsimikizira zizindikiro zamankhwala. Matenda a shuga, omwe amawonekera kwa odwala omwe ali ndi chifuwa chachikulu cham'mapapo, nthawi zambiri amatanthauza mtundu 2. Zimayamba mosazindikira.

Nthawi zambiri imakhala yofatsa ndipo imadzibweretsera zabwino kuti izilipira. Komabe, kukokomeza ndi mayendedwe amkati wa m'mapapo mwa odwala oterewa zimawonedwa nthawi zambiri.

Nthawi zambiri, mavuto a carbohydrate metabolism mwa odwala otere amapezeka pakuwunikira kupitilira kwa njira yowonongeka kale kapena pachitanso kusintha kwa chifuwa.

Kuwonetsedwa koyamba kwa chifuwa chachikulu cha pulmonary kuchokera ku shuga mellitus nthawi zambiri kumakhala kuwola kwa kagayidwe kazakudya. Chifukwa chake, pali kutanthauzika koopsa kwa matenda awa.

Zowonetsa za matenda ndi morphological a chifuwa chachikulu m'mitundu yosiyanasiyana ya matenda a shuga:

Kuchuluka kwa kusintha kwamakedzedwe komanso kosasinthika m'mapapu, kukula msanga kwa chiwonongeko, chizolowezi cha kufala kwa mitsempha ndi bronchogenic cha njirayi ndizodziwika bwino ndi chifuwa chachikulu cha odwala omwe ali ndi matenda a shuga 1.

Ngakhale chifuwa chachikulu choyambirira mwa iwo chimakhala ngati chimalowerera. Mu 50-80% yamilandu, chifuwa cholowerera chimachitika. Localization wa Atypical nthawi zambiri amapezeka - zigawo zakunja, ndipo 40%, zomwe zimalowa zimawonedwa mu lobe wapansi. Tuberculomas nthawi zambiri amakhala wamkulu, angapo, amakonda kuwola.

Chovuta chachikulu, kapena chifuwa chachikulu cha intmathacac lymph node, ndizosowa kwambiri. Kusintha kwa sclerotic ndi fibrotic m'mapapu kumayamba kutchulidwa.

Kukula kwa zigawo zikuluzikulu zaubweya komanso zotupa zimakhudzanso chifuwa chachikulu, chomwe chimapezeka mwa odwala omwe ali ndi matenda a shuga 2, makamaka osakwanira kulipidwa.

Chiwerengero cha mitundu yamatenda a chifuwa chachikulu chimasinthidwa kukhala chovuta kwambiri.

Chifuwa chachikulu cha odwala omwe ali ndi matenda a shuga sichachilendo, koma amapezeka molumikizana ndi chifuwa chachikulu cha m'mimba cha m'mimba ndi kuwonongeka kwamapapu apakati komanso kutsika kwa chifuwa.

Wopatsirana chifuwa chachikulu ndi kupezekanso kwa odwala matenda ashuga. Akaphatikizidwa ndi matenda a shuga, nthawi zambiri amapezeka woyamba, ndi matenda ashuga - matenda otsatira.

Chifuwa cholowerera, chomwe chimawonedwa nthawi zambiri m'matumbo a shuga, nthawi zambiri chimadziwonetsera ngati mawonekedwe amtambo ngati kulowa mkati kapena malo ochezera, ndimakonda kusungunuka ndikupanga mizere yambiri yowonongeka. Mwa odwala ena, njirayi imayamba ngati chibayo cham'mimba, pomwe imasiyana muzochitika m'chipatala.

Chiwopsezo chachikulu cha chifuwa chachikulu cha shuga chimadziwika ndi ntchito yayikulu komanso kupita patsogolo kwa matenda obwera chifukwa cha chifuwa chachikulu kapena chifuwa chachikulu, koma ndi chithandizo chakanthawi, chimachitika ndikuchira kwina. Tuberculoma ndi mtundu wina wa chifuwa chachikulu cha shuga. Makhalidwe a chifuwa chachikulu ndi kukula kwakukulu, chizolowezi chowola komanso kuchuluka.

Ndi maphunzirowa, ali pafupi kulowetsedwa, koma amasiyana nawo chifukwa chosintha chitukuko ndi anti-chifuwa chachikulu. Chifuwa cha Fibro-cavernous ndi njira yodziwika pakati pa odwala omwe ali ndi matenda opatsirana. Mwa odwala awa, mumakonda kufalikira kwa bronchogenic ndi njira yopitira patsogolo popanda kutchulidwa kusintha kwa fibro-sclerotic mu minofu ya m'mapapo.

Bronchi yayitali nthawi zambiri imakhudzidwa ndikuwoneka ngati zilonda zam'mimba zowoneka bwino, zowoneka bwino kapena zowonongeka, zomwe zimatha, makamaka, kutsitsa mawonekedwe a mtengo wa bronchial komanso kukula kwa hypoventilation kapena atelectasis.

Mu gawo lalikulu, njira ya chifuwa chachikulu imakhala ndimakhalidwe amodzi, nthawi zina imakhala ndi malo oyambira zigawo zoyambira.

Kusintha kofananira, kukhala ndi mawonekedwe a gulugufe, ndizofanana ndi chifuwa chachikulu, chomwe chimayamba mwa odwala omwe ali ndi matenda a shuga.

Kuwonetsedwa koyamba kwa chifuwa chachikulu mu shuga kuphatikizira kukula kwa shuga. Odwala achulukitsa ludzu, shuga ndi magazi a mkodzo amawonjezeka, thanzi lawo limakulirakulira, kufooka kumakhazikika, thukuta limawonekera, ndipo odwala amayamba kunenepa.

Ndikubowoleza mtima kwa matenda ashuga komwe kumawonetsa zakumwa zoyambirira za m'mimba mwa ana. Mu achinyamata, chifuwa chachikulu chimapezeka nthawi ya matenda a shuga, ndipo akuluakulu amapita kwa dokotala ndikudandaula za matenda owopsa a shuga.

Matenda a chifuwa chachikulu pamaso pa matenda amtundu wa 1 chibadwa chimawonjezera kuchuluka kwa insulini ndi mayunitsi 16-32.

Mtsogolomo, pafupipafupi komanso mwamphamvu zizindikilo za kuledzera ndi kuwonongeka kwa chithokomiro, bronchi ndi mapapu zimachulukanso, monga momwe zimakhalira ndi chifuwa chachikulu, ndikuwonjezereka kwa mtundu wachipatala komanso kuwonjezeka kwa kutalika kwa njirayi. Pamaso pa matenda ashuga, mawonetseredwe amtundu wa chifuwa chachikulu amatchulidwa.

Ndi kuphatikiza kwa matenda ashuga ndi chifuwa chachikulu, chifuwa chachikulu chimapeza njira yosavomerezeka ngati ipezeka koyamba. Izi sikuti zimangotanthauza zisonyezo zonse zamatenda komanso zotsatila za chifuwa chachikulu cha shuga, komanso njira ya matenda ashuga azaka zonse.

Matenda a chifuwa chachikulu, monga nthenda yoyamba yomwe zizindikiro za matenda a shuga zimawonekera, zimadziwika ndi zovuta zambiri zamankhwala, chifuwa chachikulu, chifuwa chachikulu, kupweteka kwapafupipafupi, chizolowezi chopitilira, komanso panjira ya kusinthika, kusintha kwakukulu.

Matenda a shuga monga matenda oyamba ali osiyana ndi matenda ashuga, owoneka motsutsana ndi chifuwa chachikulu cha chifuwa chachikulu, odwala omwe amadwala matenda ashuga pafupipafupi mu anamnesis, shuga yayikulu yamwazi, amakonda kwambiri matenda ashuga a shuga.

Mu matenda a shuga, nthawi yomwe anali ovuta kupezeka ndi chifuwa chachikulu, mitundu yayikulu ya matenda ashuga komanso matenda ashuga ambiri amawonedwa kawiri kuposa omwe amadziwika kuti ali ndi chifuwa chachikulu.

Zokhudza kuphatikiza kwa chifuwa chachikulu ndi shuga

Zachulukanso.
Kuyenda pang'onopang'ono kwa kusintha kwa zamankhwala, zamagetsi.
Nthawi yayitali yowonetsera kuledzera wa chifuwa.
Chizolowezi chofuna kutulutsa.
Chiwopsezo chachikulu cha kuwola (80%), mabakiteriya achepetsa (78-80%) mochedwa kuchotsedwa.
Zizolowezi zochepetsera lobe kutengera.
Central perinodularization, mapangidwe a zigawo za zigawo amazilowa, kupita patsogolo mwachangu.

Zolemba zamaphunziro a chifuwa chachikulu mu shuga

Asymptomatic chiyambi / asymptomatic isanayambike (ngakhale ndi zotupa zazikulu).
Kuledzera pang'ono.
Mayeso a Tuberculin ali ndi chiyembekezo chabwino.
Miseche yokhala ndi chizolowezi chosungunuka ndikuwoneka ngati chiwonongeko, kusinthika kukhala ma tuberculomas akulu.
Adanenanso zoyipa zotsutsana mu kukhoma ndi kukhoma kwa matako, kuyipa kwa mawonekedwe a mawonekedwe ozungulira.
Kukula kwa zopangika zosadziwika.

Zolemba zamaphunziro a chifuwa chachikulu mu decompensated shuga mellitus

Pachimake / subacute isanayambike.
Zizindikiro zoperewera za kuledzera, pafupipafupi zizindikiro za kupuma.
Akuchepetsa mphamvu ya chifuwa.
Chizolowezi chofuna kusungunuka mosiyanasiyana ndi malo okhudzidwa m'mapapu.
More kutchulidwa kufalikira.

Fomu yotsogola yotsogola ndi yolowerera (yafambo ngati yolowetsedwa, lobitis).

Matenda a chifuwa chachikulu - zizindikilo zoyambirira, zizindikilo, zimayambitsa, chithandizo komanso kupewa chifuwa chachikulu

Tsiku labwino, owerenga inu okondedwa!

M'nkhani ya lero, tikambirana nanu matenda monga chifuwa chachikulu, komanso zizindikiro zake zoyambira, mitundu, mitundu, mitundu, magawo, kuzindikira, mankhwala, mankhwala azitsamba, kupewa chifuwa chachikulu ndi zina zambiri zokhudzana ndi matendawa. Chifukwa chake ...

Kodi chifuwa chachikulu ndi chiyani?

Chifuwa chachikulu - matenda opatsirana opatsirana, chomwe chimayambitsa matenda a thupi ndi Koch timitengo ya Mycobacterium. Zizindikiro zazikulu za chifuwa chachikulu, mu njira yake yapamwamba, zimakhala kutsokomola (kawirikawiri ndi kuphatikizika kwa magazi), kufooka, kutentha thupi, kuchepa thupi kwambiri, thukuta la usiku, ndi ena.

Mwa mayina ena a matendawa, makamaka kalelo, titha kuzindikira - "kumwa", "matenda owuma", "tubercle" ndi "scrofula". Dera lomwe dzina la chifuwa chachikulu limatengera ku Latin "chifuwa chachikulu" (chifuwa chachikulu).

Ziwalo zofala kwambiri zomwe zimatengedwa ndi chifuwa chachikulu cha bronchi ndi mapapu, ndizochepa mafupa, khungu, lymphatic, genitourinary, mantha, lymphatic system, komanso ziwalo zina ndi machitidwe ena. Kupatsirana sikungakhudze anthu okha, komanso oimira nyama.

Matenda owopsa a chifuwa chachikulu cha chifuwa chachikulu chotchedwa Mycobacterium amapatsirana makamaka ndi m'malovu kudzera mu chifuwa, kutsinima, kuyankhula kwambiri ndi munthu yemwe ali ndi kachilombo.

Chinyengo cha matenda opatsirana a chifuwa chachikulu chagona mumachitidwe ake - chikalowa m'thupi, munthu samamva chilichonse. Pakadali pano, matenda omwe angayambitse matenda (asymptomatic shaka - matendawa) amatha kukhala mwa odwala masiku ambiri, ndipo ngakhale zaka, ndipo mwa 1 mwa khumi, amayamba kugwira ntchito.

Ngati tizingolankhula za mitundu ya chifuwa chachikulu, ndiye chofunikira kwambiri kwa anthu ambiri ndikufotokozedwa kwa matendawa mu mawonekedwe - amasiyanitsa mtundu wotseguka komanso wotsekeka wa chifuwa chachikulu.

Tsegulani chifuwa chachikulu yodziwika ndi kupezeka kwa mycobacteria mu sputum, mkodzo, ndowe, komanso chizindikiro chodziwikiratu cha matendawa, panthawi yolumikizana ndi gawo lomwe lakhudzidwalo komanso malo akunja, matendawa sangawonekere. Njira yotseguka ya chifuwa chachikulu ndi yoyopsa kwambiri, ndipo ikuwopseza anthu onse omwe ali pafupi.

Fomu lotsekedwa ndizodziwika ndi zovuta za kupezeranso kachilombo ka sputum mwa njira zomwe zilipo, ndipo ndi njira yopanda matenda ena kwa ena.

Njira zazikulu zodziwira chifuwa chachikulu ndi fluorography, radiography, Mantoux tuberculin test, PCR ndi kuyesa kwa michere ya sputum, mkodzo ndi ndowe.

Kupewa kwa chifuwa chachikulu kumachitika makamaka pakuwunika, kuwunika komanso kuyang'anira ana ambiri, koma ngakhale kuli kwazidziwitso zambiri zakuzindikira, kupewa komanso kuchiza chifuwa chachikulu, matendawa akupitilizabe kuchitika Padziko Lapansi, akupatsira anthu ambiri, omwe ambiri amafa chifukwa chake.

1. Mycobacterium chifuwa chachikulu cholowa mthupi

Njira zazikulu za matenda mthupi:

Njira yotsogolera - Matendawa amalowa munjira kudzera pakukambirana, kusefukira, kutsokomola wodwalayo chifukwa cha matendawa, ndipo ngakhale utawuma, ma wand akufikirabe umunthu wake. Ngati munthu wathanzi m'chipinda chino, makamaka mpweya wabwino, ndiye kuti matendawo amalowa mkati mwake mwa kupuma.

Njira zamagulu - matendawa amalowetsa munthu kudzera m'mimba. Izi nthawi zambiri zimayamba chifukwa chodya chakudya chamanja chosasambitsidwa kapena ngati zakudya zomwe zayambukiridwa komanso zosakonzedwa sizitsukidwa.

Mwachitsanzo, mkaka wakunyumba utha kuzindikirika - ng'ombe yomwe ili ndi chifuwa chachikulu imatulutsa mkaka wokhala ndi kachilomboka. Munthu amene amagula mkaka wokhala ndi make sakonda kuonetsetsa kuti ali ndi matenda.

Nyama yapadera yomwe imanyamula matenda ambiri owopsa kwa anthu ndi nkhumba.