Angiopathy ea maemo a tlase a lefu la tsoekere: lipontšo, kalafo, thibelo

Ho ba le lefu la tsoekere le maemong a tlaase, kapa le tsoekere, ke bothata bo boholo bo bang teng ho batho ba nang le lefu la tsoekere. Bakuli ba lilemo tsohle le bong ba angoa ke lefu lena. Bakeng sa ho thibela nts'etsopele ea angiopathy, ho hlokahala ho ela hloko ponahalo ea matšoao a tšosang ka nako e loketseng, ho phekola lefu le ka tlase le ho thibela mathata.

Lefu la tsoekere - ke eng

Lefu la tsoekere ha se lefu la tsamaiso ea endocrine feela, empa ke lefu la methapo ea methapo. Tsoekere e phahameng ea mali e baka tšenyo methapong ea maoto, retina, bokong. Khahlano le semelo sa tsoekere e phahameng, karolo e ka hare ea methapo ea mali - endothelium - ha e etse mesebetsi ea ho laola khatello ea mali, e thibela ho thehwa ha methapo ea mali le ho ba teng hoa lits'ebetso tsa ho ruruha ho tsona. Ka lebaka la tšenyo ea methapo, mali a thekesela liphoofolong tse tlase, e leng se tlatsetsang tsoelo-peleng ea psychology.

E sentsoe ke glucose le lihlahisoa tsa eona tsa metabolic, karolo e ka hare ea methapo ea mali e boloka mokelikeli maboteng, e fokotsa phallo ea mali ho ea maotong. Thrombi e thehoa kapele kahare ho methapo ea mali, e eketsa kotsi ea ho koaloa ke lumen. Kamora nako, likepe tse nyane lia sclerosize, le likepe tse kholo stratify le theha aneurysms.

Tlhomamiso

Ho latela boleng ba likepe tse senyehileng, ho na le:

• macroangiopathy - Tšenyo ea likepe tse kholo,
• microangiopathy - thuto ea mafu a manyane,
• kopaneng - ho kenya letsoho ha likepe tse nyane le tse kholo tsa "caliber" tseleng ea methapo ea methapo.

Lingaka li boetse li nahanela sebaka seo ho shebelloang ho sona:

• lefu la tsoekere la likokoana-hloko tsa likhutlo tse tlase,
• lefu la tsoekere la retinopathy la lijana tsa leihlo la mahlo,
• lefu la tsoekere lephropathy le amang tsamaiso ea methapo ea methapo.

Nako le nako, lingaka li fumana hore ho na le lefu la pelo le lefu la tsoekere ha methapo ea pelo le boko e ameha tšebetsong ea methapo ea kutlo.

Lihlopha tsa likotsi

Lipalo-palo li bontša hore angiopathy ea lefu la tsoekere ke eona ntho e atileng ho feta.

20% ea bakuli bohle ba nang le lefu la tsoekere ba tobane le tšoaetso ea maoto le matsoho e tlase. Hoo e ka bang 70% ea ho khaoloa ha lipheo tse tlase ho teng ho bakoa ke lefu la tsoekere la 'mala oa lefu la tsoekere. Ho feta 40% ea bakuli ba utloang boiphihlelo ba bona kamora hore ho se ho bile le liphetoho tse ke keng tsa fetoloa likepeng.

Lefu la tsoekere ke lefu le kotsi le le sa phekoleheng, leo mohato oa lona o ka laoloang ke liteko tsa tlhahlobo ea nako, ho etela khafetsa setsebi sa hau sa endocrin, le ho latela litlhahiso.

Ba leng kotsing ke bakuli:

• ka tlhaho ea lefutso,
• khatello ea mali le boiphihlelo
• lipid metabolism
• tse fetang lilemo tse 55
• ba tsubang
• hangata a noe joala.

Mefuta ea lefu lena

Ho latela hore na ho na le likepe life tse amehang, lefu la tsoekere la angiopathy la maemo a tlase (khoutu ea ICD 10 E11.5) le ka iponahatsa e le mofuta oa "diabetesic" micangiopathy le macroangiopathy.

Microangiopathy

Lefu la tsoekere la "lefu la tsoekere" la likarolo tse tlase le hlaha ka ho hlola, ho senya le lefu la methapo e fokolang ea maoto. Ho latela ho se tsotelle, lingaka li khetholla li-degrees tsa 6 tsa mofuta ona oa lefu lena:

1. Zero, kapa ea pele, - ho ba sieo ha litletlebo ho tsoa ho mokuli, empa ho ba teng ha matšoao a ts'oaetso ea methapo e ntseng e eketseha (ho se be le moriri maotong, ho tiisa le ho phatsima ha letlalo, maikutlo a batang libakeng tse tlase).
2. Ea pele ke ho fokotseha ha letlalo, nako le nako ho na le bohloko maotong ha ho tsamaea, ho na le liso tse nyane tse khubelu ntle le matšoao a tšoaetso.
3. Ea bobeli ke liso tse lemalitsoeng maotong, tse sa amang letlalo feela, empa le lisele tse bonolo, 'me ka linako tse ling li fihla masapong. Nako ena ea lefu e tšoauoa ka bohloko bo boholo.
4. Ntlha ea boraro, li-foci tse ntšo tsa necrosis li hlaha bohareng ba liso tsa teng tse tummeng.
5. La bone - e fapana le ea pele hobane ho ekelletsa ho necrosis, edema le hyperemia ea li-tishu tse haufi lia hlomphuoa. Nakong ena, ho hlaha hangata, lekhopho, phlegmon kapa osteomyelitis ea letheka le ka tlase.
6. Ya bohlano - e fumanoe maemong ao litho tse haufi li shoang.
7. Oa botšelela - ts'ebetso ea necrotic e fihlile leoto lohle.

Macroangiopathy

Lefu la tsoekere la macroangiopathy, moo methapo e meholo ea methapo e amang, butle-butle e ba le mekhahlelo e 5 ea tsoelo-pele ea liphetoho tsa pathological:

1. Ha ho na matšoao a lefu lena, bakuli ba tletleba ka mokhathala o potlakileng le bohloko nakong ea ho ikoetlisa; nakong ea tlhatlhobo, boholo ba tlhahlobo ea methapo ea methapo le khatello ea methapo ea methapo.
2. Boikutlo bo sa feleng ba ho bata maotong, ho tsitsipana khafetsa, liphetoho tsa atrophic maotong le ponahalo ea lameness ha u tsamaea.
3. Ho opeloa ke maoto le matsoho nakong ea khutso e felletseng, ho omella le ho phumula ha letlalo, mats'oafo a bosiu.
4. Ponahalo ea li-ulc tse nyane tse fetohang kapele ho fetoha li-necrosis.
5. Lefu la litho tsa menoana le maoto, bohlasoa ba leoto le ka tlase.

Mehato ea morao-rao ea lefu lena e tšoauoa ka matšoao a tloaelehileng a malaise ka tsela ea bofokoli, hlooho e bohloko, ho hloka takatso ea lijo, chores le feberu.

Ntle le matšoao a lefu lena, lefu lena le latelang le bontšoa ke lefu la tsoekere:

• paresthesias, e bonahatsoang ke botenya ba maoto, e amanang le ischemia ea lithane ka lebaka la tlala ea oksijene,
• bohloko ba ho thunya maotong, bo ntseng bo matlafala ha o tsamaea le ho fokotseha nakong ea ho phomola,
• mesifa e ts'oeroe ke boroko bosiu,
• tšebetso e fokotsehileng ea kholo ea moriri maotong,
• Letlalo le omella, le teneha mapetso le ho pepeseha,
• maoto a ruruha le ho redd
• monko o sa thabiseng o hlaha ho e le 'ngoe kapa maoto le matsoho.
• maoto le matsoho a bata 'me a koloba ho fihlela
• poleiti ea lipekere e ea ba motenya, e bobebe, e bosehla,
• ponahalo ea maqeba a maholo a ho lla sebakeng sa linoko tsa khale kapa maqeba a sa phekoleheng.

Har'a matšoao ana, bakuli ba tletleba ka bofokoli, ho hlobaela bosiu, ho teneha, hlooho e opang khafetsa le feberu.

Ts'oaetso

Tlhahlobo e nepahetseng e ka etsoa ke ngaka, ho ipapisitse le datha ea tlhahlobo ea sepheo le lithuto tse ling. Ho belaella angiopathy ea maemo a tlase a lefu la tsoekere, ho lekane hore setsebi se bokelle anamnesis le ho etsa tlhahlobo ea mokuli. Ela hloko matšoao a joalo:

• pallor ea letlalo,
• limb paresthesia,
• boteng ba bohloko le lillo,
• ho haella ha sekhahla liotong tsa maoto,
• e fokotsa mocheso oa maoto.

Ngaka e tla fana ka liteko tse ling tse sebetsang tsa tšebetso le tsa laboratori:

• Ho hlahloba likepe tsa libaka tse tlaase,
• Tlhahlobo ea X-ray, hammoho le angiography e fapaneng,
• MRI
• capillaroscopy ea khomphutha.

Ka matšoao a osteomyelitis, scanning ea radionuclide e sebelisang pyrophosphate e ka eketsoa hape, e u lumellang ho bona liphetoho tse fokolang haholo lesapong le setšoantšong. Ntle le moo, liteko tse ngata tsa laboratori tsa mali le urine li tlameha ho tseba boemo ba tsoekere, creatinine, profid ea lipid le sekhahla sa ho hlohlona ha glomerular.

Tabeng ea netefatso ea angiopathy ea maemo a tlase a lefu la tsoekere mellitus, kalafo e etsoa ka botlalo mme e etselitsoe:

• Ho felisoa ha matšoao a tšoenyang,
• normalization ea boemo ba tsoekere ea mali,
• k'holeseterole e tlaase
• ts'ebetso ea ho potoloha ha mali ka har'a lijana.

Lijo ke ntho ea pele ho phekolo e rarahaneng. Kaha angiopathy e hlaha khahlano le semelo sa lefu la tsoekere, kalafo e lokela ho qala ka ho lokisa lijo tse tloaelehileng. Hoa hlokahala ho fokotsa palo ea lijo tse mafura, tse halikiloeng le tse halikiloeng.

Li-carbohydrate tse jang habonolo li haelloa haholo kapa li felisitsoe ka botlalo. Ho khothalletsoa ho sebelisa fiber e ngata, meroho le meroho. Boloka tlaleho ea mofuta oa ho noesa: palo ea metsi a nooang ho motho e moholo ha ea lokela ho ba ka tlase ho lilithara tse peli ka letsatsi. E ja hangata, ka likarolo tse nyane ho kenya ts'ebetsong metabolism le ho thibela ho tlola ka tšohanyetso maemong a tsoekere ea mali.

Ha e le lipapali, ka angiopathy ho thata haholo ho etela boikoetlisong kapa ho matha serapeng sa boikhathollo, hobane maoto le matsoho a tlase a amehile. Empa motho e mong le e mong a ka sesa ka letamong, a ikoetlisa ka ho phefumoloha kapa a ikoetlisa habonolo lapeng.

Phekolo ea lithethefatsi

Phekolo ea meriana e rarahaneng e kenyelletsa lihlopha tsa lithethefatsi:

• li-antibacterial agents tsa ts'ebetso ea kemiso le ea lehae ea ho loants'oa tšoaetso leqebeng (Levofloxacin, Cefopectam),
• li-antihypertensive (Lisinopril, Bisoprolol, Valsacor),
• statins ho nolofatsa cholesterol ea mali (Atorvastatin, Lovastatin, Rosuvastatin),
• li-blood thinner (Aspirin, Akard, Kleksan),
• diuretics le lithethefatsi tse fokotsang edema (Torsid, Lasix, Furosemide),
• li-angioprotectors tse ntšang methapo ea methapo le ho etsa hore methapo ea metabolic e sebetse ho tsona (Anginin, Ditsinon, Etamsylate),
• Lithethefatsi tsa ho kenya ts'ebetsong metabolism liseleng (Trimetazidine, Mildronate),
• li-antioxidant lithethefatsi, livithamini tsa B (Nerviplex, Neuromidin).

Phekolo ea methapo

Ba itlhomme hantle:

• Trental - e khutlisa ho phalla ha mali, e imolla ho ruruha ha lisele (1 makhetlo a 3 ka letsatsi),
• Pentoxifyline - e kenya ts'ebetso ea phallo ea mali liseleng, e fokotsa edema (1 t. Makhetlo a 2-3 ka letsatsi),
• Lipoic acid - e eketsa khaello ea methapo (Letlapa le le leng ka letsatsi),
• Venoruton ke sethethefatsi sa mola oa pele, se fokotsa ho ruruha, se ntlafatsa phallo ea mali, se felise bohloko (1 sekotlolo makhetlo a 3 ka letsatsi),
• Dialipon - e thibela ho hlaha ha lefu la tsoekere le polyneuropathy, ho kenyelletsa le paresthesia ea libaka tse phahameng (2 li-capsules tse 1 ka letsatsi),
• Cardiomagnyl - sethethefatsi ho fokotsa pono ea mali le ho thibela mali (1 Letlapa le le leng la 1 ka letsatsi).

Pheko ea 'mele

Ho bohlokoa ho tlatselletsa kalafo e rarahaneng ka mekhoa ea ho silila le ea 'mele, e leng ketso ea eona e reretsoeng ho khutlisa phallo e tloaelehileng ea mali methapong e tlase:

• plasmophoresis
• tshusumetso ea motlakase
• ts'ebeliso ea seretse.

Mekhoa e bontšoa ho bakuli ba karolo ea pele ea lefu lena, le nakong ea phetoho e phehellang. Karolong e hlobaetsang, tšebeliso ea menahano e futhumetseng ha e amoheloe.

Polelo e ncha ho physiotherapy ea sejoale-joale ke lymphomodulation. Mokhoa ona oa kalafo o sebelisoa bakeng sa mafu a fapaneng, hammoho le angiopathy. Lisebelisoa tsa lymphomodulation li tsamaisa ka nako e tšoanang:

• phetisetso ea oksijene
• mahlaseli a mahlaseli a mahlaseli a mararo,
• maqhubu a motlakase
• metjeko ea mechini ea maqhubu a tlase.

Ka thuso ea eona, lisele tse anngoeng ke ischemia li fumana oksijene le limatlafatsi tse hlokahalang.

Ho buoa

Diabetes angiopathy e iphumanela kalafo e hlokofatsang, empa e nka likhoeli tse 'maloa ho isa selemo kapa ho feta. Ha ho hlaha liso, ho hlokahala hore ho etsoe opereishene. Mehatong e tsoetseng pele, ho ka hlokahala hore ho patoe leoto le amehang. Qeto e joalo e etsoa ke boeletsi ba bongaka.

Litlhare tsa setso

Pheko e 'ngoe e ka sebelisa litlolo bakeng sa moriana o mong, empa tšebeliso ea tsona e lokela ho lumelloa ke ngaka e eang. Ha ho tluoa makhopho a ka 'nang a hlaha kapa a ba le osteomyelitis, litlama ha li na ho ba le phello ea pholiso. Qalong ea lefu lena le nakong ea tšoarelo, litlhare tsa setso li na le phello e molemo liseleng tse amehileng tsa mekha e tlase. Phekolo e lokela ho etsoa ka tlasa tlhokomelo ea ngaka e eang.

Calendula compress le ho hlapela ho hlapa

Ho sebetsa ka mokhoa o ts'oanang ho tlosa matšoao a ho ruruha ho ela hloko li-decoctions tsa litlama bakeng sa li-lotion le libate tsa kalafo. Bakeng sa morero ona, sebelisa calendula, chamomile, nettle. Litlama li ka nooa ka thoko, empa ho sebetsa hantle ho hlophisa pokello ea litlama. Ho lokisa li-2 l tsa moro, nka 50 g ea lisebelisoa tse tala tse omisitsoeng, tšela metsi a belang, tlohela metsotso e 3040, strain le tšebeliso ea li-compress kapa libate.

Tsoelo-pele ea nako ea lefu lena

Ka tlhokomelo e nakong ea bongaka, lefu la tsoekere le ka phekoleha. Ho ke ke ha khoneha ho felisa lefu lena ka ho felletseng, empa, ka ho latela litlhahiso tsohle tsa bongaka, o ka fihlela phallo e tsitsitseng mme oa thibela nts'etsopele ea mathata ka mokhoa oa:

• lefu la tsoekere
• aseptic necrosis,
• bohlasoa
• ho khaoloa leoto le matsoho.

Thibelo

Bakeng sa ho thibela lefu la tsoekere la lefu la tsoekere, ho hlokahala hore kamehla o phethe prophylaxis, e kenyeletsang:

• tlhahlobo ea mali le taolo ea tsoekere ho eona,
• bophelo bo botle
• ho kopana ka nako le ngaka ea meno haeba ho na le makhopho a letlalo, maqeba kapa liso tsa kahare.

Boemong ba tšireletso, hoa hlokahala ho hlokomela bophelo bo botle le boemo ba letlalo la maoto. Leqeba le bonyenyane kapa leqeka ka leoto le ka baka liso. Ka hona, ho khothalletsoa ho etsa kalafo ea bohloeki ea letsatsi le letsatsi le tlhahlobo ea maoto. Fepa le ho futhumatsa letlalo ka thuso ea lihlahisoa tsa tlhokomelo ea litlolo, 'me u phumule lipekere ka methapo e nepahetseng. Ka boteng ba bohlasoa le likhohlopo, ho hlokahala hore u li phekole ka mokhoa o nepahetseng ka mokhoa oa antiseptic, empa u se ke ua sebelisa li-plaster tsa poone le lihlahisoa tse nang le joala bo phahameng kapa li-tannins tse ling. Lieta li phutholohile ho li roala, tse sa pikitla ebile ha li hatelle leoto. Qoba ho chesa leoto leoto le fetang la maoto.

Lefu la tsoekere ke lefu le ipatileng le amang methapo ea mali. Bakeng sa ho fokotsa kotsi ea ho tšoaroa ke lefu la tsoekere la maoto le maoto, ho hlokahala ho tseba lintlha tsohle tse tšosang, phekola lefu le ka tlase le ho thibela mathata a ka bang teng.