Diabetesic microangiopathy: Zizindikiro, chithandizo, zotsatira zake

Ngati mungapange mpikisano pakati pa matenda onse, malo oyamba pamavuto ambiri, kuopsa kwa chithandizo chawo, zotsatirapo zake kwa wodwala, mosakayikira, ziyenera kupereka shuga. Mavuto ambiri amatengera matenda ashuga a shuga. Chifukwa cha kuchuluka kwa shuga pazombo zazing'onoting'ono, zimakhala zopanda pake ndipo zimawonongeka mosavuta. Zotsatira zake, m'malo ena kukula kosalamulirika kwa ma network a capillary kumayamba, pomwe malo ena mulibe magazi.

Chaka chilichonse, chifukwa cha Microangiopathy, kudula mabatani miliyoni kumadera kotsika kumachitika, odwala matenda ashuga okwana miliyoni 6.6 saona, ndipo impso zimagwira ntchito kwa odwala mamiliyoni 0,5. Zophwanya zambiri zimatha kuthana ndi mavuto ngati atha kupezeka koyambirira.

Matenda a shuga a shuga - ndi chiyani

Microangiopathy ndi zovuta zovuta za matenda ashuga. Cholinga chake chachikulu ndi kuthamanga kwa shuga m'magazi mkati mwa makoma amitsempha yamagazi. Gulcose mamolekyulu glycate endothelial mapuloteni, ndiye kuti, amamangirira kwa iwo. Njirayi imayendera limodzi ndi kutayika kwa mtima wam'mimba, kuchepa kwawo, kuchuluka kwa mawonekedwe, kenako chiwonongeko. Vutoli limakulitsidwa ndi kupsinjika kwa oxidative - kuwonongeka kwa maselo ndi ma free radicals, omwe mu shuga mellitus amapangidwira kuchuluka kowonjezera. Kuphwanya kwa lipid kagayidwe, kokhala ndi matenda amtundu wa 2, kumakhalanso ndi vuto pa mitsempha yamagazi.

Ziwalo zathu zonse zimalowetsedwa ndi ma network ang'onoang'ono, motero, shuga ya diabetes imatha kusokoneza ntchito iliyonse ya izo. Nthawi zambiri, diso la m'maso ndi mphuno za impso zimakhala "zigoli", chifukwa kulumikizidwa bwino kwa ma capillaries ndikofunikira kuti magwiridwe awo azigwira ntchito bwino.

Mavuto a shuga, komwe kumayambitsa minyewa yotupa:

Matendawa	Kufotokozera
Retinopathy	Zombo zomwe zimadyetsa retina zimawonongeka ndikupanga edema ndi kumera, zomwe zimatsogolera kuwonongeka kowoneka. Ngati chithandizo sichinayambike munthawi yake, kufalikira kwa retina, kuwonongeka kwa mitsempha, ndikuwonongeka kwathunthu kwamaso ndikotheka.
Nephropathy	Microangiopathy mu matenda a shuga amellitus imalepheretsa kugwira ntchito kwa impso glomeruli, yomwe imakhudza kutanthauzira kwawo kwamkodzo. Chizindikiro choyamba ndi mapuloteni mu mkodzo. Ntchito ya impso imangokulira pang'ono mpaka kulephera kwa impso.
Microangiopathy yam'munsi yotsika	Miyendo ndi yotalikirana kuchokera pansi pamtima, motero magazi ake amayenda pang'ono, ndipo chiopsezo cha matenda ashuga a shuga ndi chambiri. Kusintha kwachidziwitso kumayambira ndikuphwanya magazi kutuluka kwa zala, kenako phazi lonse. Kuperewera kwa magazi kumayambitsa kufa ndi minyewa, kumayambitsa matenda a shuga, kumachepetsa kuthekera kwa minofu kuchira, komanso kumathandizira kukulitsa phazi la matenda ashuga.
Encephalopathy	Ichi ndi chotupa cha muubongo, chomwe nthawi zambiri chimayamba chifukwa cha ubongoangiangiangiangiangi. Encephalopathy imakulitsidwa ndi neuropathy komanso lipids yambiri m'magazi a shuga.
Kugonana kwa amuna	Pamodzi ndi neuropathy, microangiopathy ndi chimodzi mwazomwe zimayambitsa kusabala. Kuwonongeka kwa erection mu odwala matenda ashuga nthawi zambiri kumalumikizidwa ndi kusakwanira kudzaza chiwalo ndi magazi.

ICD Code 10 ya a Diabetesic Microangiopathy:

2, E11.2 - nephropathy,
3, E11.3 - retinopathy,
E5, E11.5 - zovuta zina zoyambitsidwa ndi vuto la microvascular.

Zizindikiro za microangiopathy mu matenda ashuga

Nthawi zambiri, palibe zizindikiro kumayambiriro kwa matendawa. Wodwala akamakula, wodwala matenda ashuga amatha kuzindikira:

masomphenya osakhalitsa
madontho oyandama pamaso pa maso, akusowa patatha masiku ochepa,
Zizindikiro za kuledzera - kufooka, kutopa, kusowa kudya,
mkodzo wowonjezera - werengani za polyuria,
usiku, chikhodzodzo chimadzaza nthawi zambiri kuposa kale,
Kusintha kwa momwe wodwalayo akumvera: kulira kumakulirakulira, magawo a kusakwiya osawoneka, kapena mosemphana ndi zochitika zofunikira kale,
mwina kumverera kovundikira m'makachisi, mutu wofatsa. Zizindikiro sizimatha pachimodzimodzi mutamwa mankhwala opweteka,
mavuto amakumbukiro ndi kusamala,
Zala zakumaso sizizizira,
mabala pakhungu, makamaka m'munsi, musachiritsidwe kwa nthawi yayitali,
kuwonongeka mu potency - kusabala kwa matenda ashuga.

Mankhwalawa a microangiopathy ndi othandiza kwambiri poyambira, pomwe zizindikiro zake sizikupezeka, chifukwa cha matenda osokoneza bongo Osadumpha mayeso amakanthawi azachipatalazotchulidwa ndi dokotala. Chofunika kwambiri ndikuchezera kwa ophthalmologist, nephrologist ndi neurologist.

Zizindikiro

Njira zakuzindikira kuti uzindikire microangiopathy mu matenda ashuga zimaphatikizapo:

Kusanthula kwamkodzo kwamatenda a albin kumatha kuzindikira mapuloteni mumkodzo koyambirira kuposa OAM. Pa gawo loyambirira, silimatupa nthawi zonse, chifukwa chake ndi bwino kupatsa mkodzo patsiku.
Nephropathy imayendera limodzi ndi aimpso hypertrophy, yomwe imatha kupezeka ndi ultrasound.
Ndikotheka kuzindikira retinopathy ngakhale isanayambike zizindikiro zoyambirira mukamayang'ana fundus - ophthalmoscopy, ngati nkosatheka kutero, ultrasound imagwiritsidwa ntchito.
Kuperewera kwa magazi mu ma capillaries a m'munsi am'munsi kumatsimikizika mosavuta: madera ena khungu limakhala lotuwa komanso lozizira, ena amakhala ofiira chifukwa cha kukula kwa ma capillaries. Pakangodutsa khungu lokhalokha lomwe limatupa, ming'alu imachitika.
Mlingo wa matenda a shuga a shuga m'miyendo mutha kuwunika pogwiritsa ntchito capillaroscopy kapena kafukufuku wamakono komanso wokwera mtengo - Doppler flowmetry.
MRI imagwiritsidwa ntchito kuti izindikire kusintha kwa magazi kupita ku ubongo.

Momwe mungachitire ndi zovuta

Mkhalidwe waukulu wa chithandizo chopambana cha microangiopathy ndi chiphuphu chokhazikika cha matenda ashuga. Zinapezeka kuti kuchepa kwa hemoglobin wa glycated wa 1% peresenti yokha kumachepetsa chiopsezo cha kuwonongeka kwa mtima. Kupewera kwa microangiopathy ndikuchepetsa zovuta zomwe zilipo kale za mitundu iwiriyi ndizotheka kokha pothandizidwa ndikuwunika pafupipafupi kwa glycemia. Komanso, zilibe kanthu kuti cholingachi chitha bwanji. Mukamasunga shuga monga momwe zimakhalira, zakudya zamafuta ochepa zimathandiza - chabwino. Ngati chithandizo chokwanira cha insulini chikufunika kuti mukwaniritse chipukuta cha matenda a shuga, muyenera kusintha. Mulimonsemo, hyperglycemia ndiowopsa kwambiri kuposa zotsatira zoyipa za mankhwala ochepetsa shuga.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Thupi lokha lokha ndi lomwe lingakonzenso ma seva owonongeka. Ntchito ya chithandizo ndikumamuthandiza pankhani yovuta iyi.

Mwa ichi, odwala matenda a shuga:

Njira zamakono zochepetsera kuthamanga kwa magazi mu ziwiya ndi zoletsa za ACE ndi AT1 receptor blockers.
Othandizira kunja omwe ali ndi antibacterial komanso kusintha kwazomwe zimachitika kuti athandizidwe mofulumira a mabala kumapazi.
Kuchita masewera olimbitsa thupi kuti mulimbikitse magazi.
Ma antioxidants othandizira kuchepetsa oxidative nkhawa (Thiogamma).
Kuwongolera kwa microcirculation (Actovegin, Curantil).
Zizindikiro ngati lipid mawonekedwe amwazi sakhala abwinobwino.
Mavitamini, makamaka gulu B.
Kukonzekera kwa kuwonda magazi ndi kupewa thrombosis (Lioton, Heparin).

Mitundu yambiri ndi zotsatira zake

Ngati microangiopathy yofatsa imalandira bwino mankhwala, ndiye kuti matendawo owopsa amachiritsidwa. Potere, zitha kungokhala kusungidwa kwazinthu zofunikira za ziwalo zowonongeka ndi shuga.

Zotheka ndi zotsatira za angiopathy:

Matendawa	Zotsatira zoyipa
Retinopathy	Kuphazikika kwa retinal, glaucoma, kuwona kwambiri, khungu.
Nephropathy	Kuchepetsa kugwira ntchito kwa impso, matenda oopsa, edema, kuledzera, kulephera kwaimpso, kufunika kwa dialysis kapena kufalikira kwa ziwalo.
Matenda a shuga	Zilonda zam'mimba, kuwonongeka kwa mafupa ndi minofu yam'mafupa, zironda zam'mimba, kudzimbidwa kwa phazi kapena gawo lonse lam'munsi, sepsis.
Encephalopathy	Migraine, kukokana, ziwalo, amnesia, matenda amisala.
Kukanika kwa Erectile	Kusasinthika kwa erectile kukanika.

Khalani ndi moyo wathanzi ndipo musaiwale kuyendera akatswiri nthawi kuti mupeze matenda oyambira.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>