Lisosa, ho hlahlojoa le kalafo ea angiopathy ea lefu la tsoekere ea libaka tse tlase
Tšenyo ea methapo ea lintho tse ka tlase tse tlaase, retina ea mahlo kapa ea liphio ho lefu la tsoekere e bitsoa lefu la tsoekere. Kotsi e phahameng ka ho fetisisa ea lefu lena ke tšobotsi ea batho ba lilemo tse fetang 50, ho sa natse lilemo tsa bona. Monyetla o moholo le ho feta bakeng sa bao e leng khale ba e-na le lefu la tsoekere. Boloetse ka bobona bo mpefatsa marako a methapo, ka lebaka la bona, khaello ea bona, 'me phallo ea mali ea fokotseha. Sena se baka pherekano e ke keng ea fetoloa phepelong ea mali methapong ena ea litho.
Ho tšoeroe ke lefu la tsoekere ke eng?
Lena ke lebitso la mokokotlo oa nako e telele ea lefu la tsoekere, e leng lesapo la mokokotlo. Ka karolo e bolailoeng ea lefu lena, i.e. ha litekanyo tsa tsoekere e phahameng ea mali li tšoarella nako e telele, mathata a methapo a ka qala pejana ho feta maemong ao maemo a insulin a laoloang. Classified ea Machabeng ea Mafu (ICD-10) e fana ka likhoutu tse 5 tsa lefu lena. Tsena tsohle li bonts'a tlolo ea potoloho ea mali, empa li na le phapang ho latela mofuta oa lefu la tsoekere.
- ka foromo e itšetlehileng ka insulin - E10.5,
- ka foromo e thibelang insulin - E11.5,
- ha lefu la tsoekere le amahanngoa le khaello ea phepo e nepahetseng - E12.5,
- mabapi le mefuta e meng e tsebahalang ea lefu la tsoekere - E13.5,
- ka sesosa se sa tsejoeng sa lefu la tsoekere - E14.5.
Malebela a lebisitsoeng la lefu la tsoekere
Boloetse bona bo ka ama methapo e menyenyane le e meholo ea mali. Khetlong la pele, psychology e bitsoa macroangiopathy, 'me ea bobeli - microangiopathy. Mefuta ka bobeli ke liphetoho tse bohloko methapong ea mali ka lebaka la maemo a tsoekere a tsoekere. Ka lebaka leo, ts'ebetso ea litho tsa 'mele eo ba e fanang ka mali e senyeha. E ka ba:
Ponahatso ea mefuta e fapaneng ea angiopathy e na le litšobotsi tsa eona. E 'ngoe le e' ngoe ea tsona e tšoauoa ka matšoao a itseng. Tse atileng haholo ke angiopathy ea likepe tsa libaka tse tlase, proliferative angioretinopathy le nephropathy. Bakuli ba bang ba ka ba le mefuta e 'maloa ea lefu lena hang, ka hona, lenane la litletlebo tsa bakuli le tla kenyelletsa matšoao a e mong le e mong oa bona. Tsena e ka ba mathata a pono, ha "lintsintsi" li qala ho benya pela mahlo. Matšoao a mang ke ho khumama ha nakoana le bohloko maotong, ho tšoloha moroto, khatello e phahameng ea mali, jj.
Maoto le matsoho a tlase
Matšoao a mofuta ona oa angiopathy a ka amahanngoa ka bobeli le liphetoho tse etsahalang ho lefu la tsoekere le lefu la atherosulin la methapo ea methapo ea kutlo. Lipontšo tsa lefu lena ke:
- Bolo, hoosebumps, maoto a batang. Ana ke matšoao a pele a angiopathy. Li hlahella mohaleng, maotong, mesifa ea namane. Sesosa ke ho se potoloha ha mali le tšenyeho ea methapo (neuropathy). Ka lebaka la phallo e mpe ea mali, ho bata le ho hlatsa maotong hoa utloahala.
- Claudication e ka hare, bohloko. Ka lebaka la ho haella ha oksijene ka nako e telele, ho hlonama, maikutlo a ho imeloa le khatello ea maoto maotong a hlaha. Meroalo e ea ferekanya ha motho a tsamaea le ha a phomola, hangata bosiu ha a robala.
- Liphetoho tsa Dystrophic letlalong la maoto le matsoho. Oa ba moputsoa, o bata, moriri o qala ho theoha. Nails e ba teteane ebile e brittle. Ka lebaka la phepo e sa lekanang ea li-tishu, atrophy ea bona ea etsahala.
- Bofokoli ba trophic. Ka decomplication ea lefu la tsoekere mellitus, ho fokotseha hoa boits'ireletso hoa hlokomeleha. Sephetho ke nts'etsopele ea ulpers ea trophic leha e le ka lebaka la likhoele tse bonolo. Tšobotsi ea bona ke ho ba sieo ha bohloko. Li-ulc li fumaneha sebakeng sa leoto le tlase, leoto, ka liqoapi tsa khale, li ka kena bohlasoa.
- Leoto la lefu la tsoekere. Phetoho tse fetotsoeng li-trophic le osteoarticular. E etsahala mothating oa ho qetela oa angiopathy. Li-ulcers li fihla masapong le menyakong, leoto la Charcot (lefu la tsoekere) le hlaha, le bonahatsoa ke li-dislocation le li-fractures.
Mehatong ea pele, tšenyo ho lijana tsa retina e batla e tšoana le asymptomatic. Ka lebaka lena, bakuli ba ea ngakeng haholo, ba lemoha matšoao a latelang a lefu la tsoekere:
- fokotseha ha kelellong ea pono ho fihlela bofofu,
- litlhase, ho benya, matheba a lefifi ka pel'a mahlo,
- lesira kapa lesira ka pel'a mahlo a hao,
- retema edema,
- methapo ea methapo e patisaneng,
- hemorrhage e nyane haufi le methapo e meholo ka tsela ea matheba,
- Ho ruruha bohareng ba macula,
- li-exudates tse ngata tse bonolo holima retina.
Matšoao a lefu la lefu la tsoekere
Nts'etsopele ea mofuta ona oa angiopathy e amahanngoa le liphetoho tsa methapo ea methapo ea liphio le phello e mpe ea glucose ho tsona, e qalang ho qheleloa ka thipa hammoho le moroto, e fana ka moroalo o mong ho litho tsa kahare. Ho hlahlojoa ha nephropathy ho eketsoa ho lefu la tsoekere ka mor'a lilemo tse 10-15. Pathology e ka hlokomeloa ke matšoao a latelang:
- ho ruruha ho potoloha mahlo, ho hlahisoang hoseng,
- lenyora le sa feleng
- ho ruruha khafetsa le khafetsa,
- khatello e phahameng ea mali
- ts'ebetso e fokolisitsoeng
- bofokoli mmeleng
- ho otsela
- cramps
- ho tsekela
- ho nyekeloa le pelo le ho hlatsa.
Lisosa le mekhoa ea lefu lena
Sesosa feela sa angiopathy ke lefu la tsoekere le lenane la tsoekere e ngata e bonahatsoang ke lefu lena. Mokhoa oa nts'etsopele ea pathology:
- ho tsoa maling, tsoekere e qala ho kenella ka hare ho sekhahla sa likepe - endothelium,
- ho eona ho na le tlolo ea metabolism ea sorbitol le fructose, metsi a bokellang,
- e qetellang ke sesosa sa edema le ho ata ha matamo a methapo ea mali,
- ka lebaka lena, ba qala ho hola, bo bakang khafetsa khafetsa,
- ka har'a lijana, molumo oa taolo le ntho e thusang ho fokotsa khatello ea kelello, ntho e khathollang ea endothelial, e emisa ho etsoa,
- ts'ebetso ea liplatele e ntlafatsoa, joalo ka ts'ebetso ea thrombosis, ho fokotseha hoa lumen kapa ho phatloha ho phethahetseng ha methapo ea mali,
- ba eketsa khatello ka matla, ka lebaka leo mali a tšleloa methapong e haufi,
- ka lebaka lena, oksijene ha e fihle lithong tsa litho, tse lebisang ho hyperglycemia ea nako e telele.
Tlhomamiso
Sehlopha sa mantlha sa angiopathy se e arola ka mefuta, ho ela hloko hore na ke likepe life tse ileng tsa ameha le hore ke litho life tse ileng tsa senyeha ka lebaka leo. Ntlha ena e re lumelletse ho tseba mefuta ea lefu lena:
- Macroangiopathy ho lefu la tsoekere. Ke ho hloloa ha lijana tse kholo tsa pelo le maemo a tlase. Sena se sebetsa mokokotlong oa popliteal, likepe tsa iliac, methapo e tlaase ea leoto, aorta le karolo ea basali. Maemong a 70%, ho bonoa li-macroangiopathy tsa lefu la tsoekere tse tlase tse tlase
- Microangiopathy. Ena ke lesion ea microvasculature. Ho ipapisitse le likepe tseo litho tsa hau li amehang ho tsona, mefuta e latelang ea angiopathy e khetholloa:
- lefu la tsoekere le angionephropathy, le hlahang ho 75% ea linyeoe, hangata le mofuta oa lefu la tsoekere la 1 lefu la tsoekere (tšenyo e makatsang ea liphio),
- lefu la tsoekere le lefu la tsoekere le etsang hore batho ba lahleheloe ke pono maemong a 5% (methapo ea mahlo ea mahlo),
- encephalopathy e bonoang ho 80% ea bakuli ba nang le lefu la tsoekere la mofuta oa 1 (Tšenyo e mpe methapong e nyane ea bokong, ho kenyeletsoa li-capillaries le arterioles),
- lefu la tsoekere la tsoekere le likhutlo tse tlase.
- Likhetho tse kopaneng. Angiopathy e tlase ho tsoekere ea lefu la tsoekere hangata e kopana le mefuta e meng - retinopathy le nephropathy.
Lisosa le lisosa tsa kotsi bakeng sa nts'etsopele ea lefu lena
Lefu la tsoekere ke sesosa se ka sehloohong sa Tšenyo ea likepe tsa libaka tse tlase. Ho feta moo, ho haella ha phekolo e lekaneng ea hypoglycemic ho potlakisa ts'ebetso ena. Ho tebeloa ha likarolo tsa sekepe ka glucose le lihlahisoa tsa eona tsa metabolic (sorbitol, fructose) ho lebisa ho bokelleng ha mokelikeli leboteng, ho fokotseha ha phallo ea phallo ea mali, le thrombosis e eketsehileng, kaha endothelium e ikarabella bakeng sa taolo ea lits'ebetso tsena. Kamora nako, likepe tse nyane lia sclerosize, 'me tse kholo li theha mekhahlelo ea aneurysmal. Tšenyo ea leboteng ea endothelial likepeng tse kholo tse nang le "caliber" e etsa hore ho be le li-plagi tsa atherosselotic le blockage ea lumen ea tsona.
Ho thehoa hoa cholesterol plaque ho baka ho nyekeloa hoa phallo ea mali libakeng tse tlase mme ka lebaka leo, ho lefu la tsoekere le angiopathy
Ho ipapisitse le sena, mabaka a kotsi bakeng sa nts'etsopele ea mathata a methapo a lefu la tsoekere ke:
- tsoalo ea mofuta oa "vasulin wall insolvency" - le lefu la tsoekere, litlamorao tse mpe tsa tsoekere e potlakisa lits'ebetso tse senyehileng tsa lebota la methapo.
- khatello ea mali - khatello e phahameng ea mali e beha moroalo o eketsehileng leboteng la sejana se senyehileng,
- lipid metabolism - ka lebaka la k'holeseterole e ngata 'meleng, e qala ho kenngoa mokokotlong oa sekepe (endothelial) le sekhahla sa lumen,
- ho tsuba - nicotine le tar e kopantseng methapo ea mali,
- tlhekefetso ea joala - e lebisa ho thrombosis e eketsehileng,
- tse fetang lilemo tse 55
- sekhahla sa pelo,
- nako ea lefu la tsoekere e feta lilemo tse 10.
Microangiopathy
Ka microangiopathy, ho na le likhahla tse tšeletseng tse fapaneng tsa matšoao le lipontšo tsa lehae tsa mokuli.
- tekanyo ea zero ea microangiopathy ha e bake maikutlo a sa thabiseng ho mokuli, empa ha ho hlahlojoa, letlalo le phatsimang, ho fokotseha kapa ho se be teng hoa kholo ea moriri maotong, ho bonahala sebopeho sa letlalo.
- ka tekanyo ea pele, letlalo le ea fokola, bakuli ba tletleba ka maikutlo a ho bata maotong, bohloko ha ba tsamaea, ho bonahala liso tsa ka ntle le ho bonahala li sena matšoao a ho ruruha,
- tekanyo ea bobeli ea microangiopathy ho bakuli e tsamaisana le ho etsoa ha ulcers, e sa hasaneng feela ho linama tse bonolo, empa hape le ho ama masapo, ha ho ntse ho na le lefu la bohloko la ho utloa bohloko,
- Ha tekanyo ea boraro e le teng, qetellong ea liso tsa ka tlase le tlase e ea shoa, li necrotic ebile lia fifala. Phlegmon e thehiloe ka tsela e tšoanang, leoto le ruruha, le ba le leqhubu le leputsoa. Maemong a mang, Shin osteomyelitis e hlaha,
Trophic ulcer ea leoto le ka tlase e nang le lefu la tsoekere e ka lebisa ho tlala nakong e tlang
Macroangiopathy
Mathata a Macroangiopathic a likarolo tse tlase tse nang le lefu la tsoekere a na le matšoao a mangata a tloaelehileng:
- ho ikutloa eka ha u tsebe, u fola,
- bohloko ba mesifa ea namane, eo hangata e tsamaeang le maqhubu.
- liphetoho tsa lisele tse bonolo le mesifa ea mesifa ea lipheo tse tlase,
- sebopeho sa ulcers tsa trophic ka lebaka la ho pepesetsoa nako e telele lihlahisoa tsa metabolic.
Matšoao ho latela sethala sa macroangiopathy
Ho latela sethala sa macroangiopathy, mokuli o hlokomela liphetoho tse latelang:
- 1 - Mokuli o tletleba ka hore ho futhumetse maotong ka ho fufuleloa ka ho feteletseng maotong, mokokotlo oa lipekere tsa menoana menoaneng, bohloko le ho hlora ka mor'a boikoetliso,
- 2A - ho sisinyeha ha mokuli hoa thatafala le ho feta, moo ho nang le maikutlo a ho bata maoto le maemong a futhumetseng, ho tsikinyeha ha menoana ho hlaha, letlalo le leputsoa la maoto le sesa haholo, 'me lamult e ba khafetsa,
- 2B - hlabola khafetsa,
- 3A - mokuli o tletleba ka bohloko bo otileng maotong le makhopho khafetsa ha a phomola 'me bosiu, letlalo maotong le fetoha mosehla, le ba le omileng mme le taboha haholo. Ha o theola maoto ho tloha betheng, a fetoha a putsoa
- 3B - ntle le bohloko ba kamehla, li-edema tse boletsoeng, ulcers le necrotizing tishu tse bonolo li hlaha,
- 4 - ho na le necrotization ea leoto le nts'etsopele ea ts'oaetso ho eona ka lebaka la khokahano ea pathogen ea baktheria.
Likarolo tsa lipontšo tsa leoto la tsoekere
Mehatong ea ho qetela ea macroangiopathy, ho ba le liphetoho tse rarahaneng, tse bitsoang leoto la tsoekere. E etsahala hoo e ka bang ho 2/3 ea bakuli ba nang le lefu la tsoekere mme hangata e lebisa ho ho khaoloa. Ntle le liphetoho tse etsisoang ke macroangiopathy, sclerosis, le calcization e tebileng ea methapo ea kutlo, methapo ea methapo ea methapo manonyeletsong le linthong tsa masapo le eona e bile teng ka har'a lefu lena.
Ho ka tsosa leoto la lefu la tsoekere:
- Tšenyo e mpe letlalong (ho qala ho loma likokoanyana),
- coarsing
- mafu a fungal ea lipekere,
- Ingrown toenail,
- keratinization ea dikarolo tsa letlalo le ts'oaetso ea tsona.
Mokuli ea seng a lutse a e-na le lefu la tsoekere nako e telele o lokela ho falimeha bakeng sa matšoao a tsoang maotong:
- edema
- 'mala o bofubelu ba letlalo,
- ho haella ha methapo ea methapo ea methapo,
- fokotsa mocheso oa lehae le ho kuta moriri ka bokantle (ka morao).
Matšoao ana kaofela a ka supa ho qala ha lefu la tsoekere le tsoekere.
Mehato ea ho khetholla
Mekhoa ea ho etsa lipatlisiso bakeng sa lefu la tsoekere e bakoa ke mekhoa ea ntlafatso ea eona. Ho etsa tlhahlobo ea mafu, setsebi ha se sebelise feela tlhahlobo ea tlhahlobo, empa le mekhoa e meng ea tlhatlhobo.
- Boikemisetso ba matšoao a karolo ea lipid - cholesterol e felletseng, lipoprotein tse tlaase le tse phahameng.
- Boithuto ba boemo ba hemoglobin ea glycosylated - ha nako e telele phekolo ea hypoglycemic e sa sebetse, e phahame ka liperesente tse ngata.
- Dopplerography ea lijana tsa lipheo tse tlase - e thusa ho lekola lebelo la phallo ea mali, boemo ba li-valves tsa vein le boits'oaro ba tsona. Mokhoa o sebelisoa ntle le ho senyeha ho bakuli ba nang le li-ulcers tsa trophic.
- Ultrasound ea methapo ea maoto - e etsa hore ho khonehe ho lekola botenya ba likarolo tsa lebota la artery le bokhoni ba bona, e senola likarolo tsa mali le ts'oaetso ea mekhoa ea ho ruruha ho endothelium, ho ba teng ha li-atherosselotic, hammoho le lebelo la phallo ea mali le boemo ba phallo ea mali ho lisele tse bonolo.
Arteriography eu lumella ho lekola boholo ba patency ea methapo
Ho thehoa ha liso tsa trophic ke mokhoa oa tšenyo ho likepe tse tsoang litsong tse fapaneng, tse lokelang ho khetholloa.
Tlhahlobo e fapaneng ea li-trophic ulcers - tafole
Mofuta oa li-trophic ulcers | Lebaka | Thoebelo | Bohloko | Mefuta |
Setsoalle | Tšenyo e mpe ea methapo, lefu la Buerger | Matsoho, leoto, leqaqaqaqailili | E phatlalalitsoe | Meetso e fapaneng, e nang le motheo o boreleli, e omeletseng |
Venous | Khaello e sa feleng ea venous | Sebaka sa Ankle, haholo medical | E leka-lekaneng | Rigged, msingi oa pinki ebile e ka senyeha |
Li-arteriovenous tse tsoakiloeng | Ho haelloa ke venous ho sa feleng le tšenyo e mpe methapong ea methapo | Hangata maqaqailaneng | E leka-lekaneng | Rigged, setsi sa pinki |
Letšoao la letlalo | Boloetse ba systemic, embolism | Karolo ea boraro ea leoto, sebaka sa maqaqailana | E phatlalalitsoe | Nyane, hangata e mengata |
Neuropathic | Leuropathy ea lefu la tsoekere, Neuropathy ea Vitamin | Bokantle ba leoto (mojaro o boima) | Ha e eo | Liphetho tse se nang thuso, hangata tse tebileng, li tšoaelitsoe |
Neuroischemic | Diabetesic neuropathy + ischemia | Localization joalo ka ulchemic, neuropathic kapa arterial ulcers | Ka lebaka la neuropathy - e fokotsehile | Meetso e fapaneng, e nang le motheo o boreleli, e omeletseng |
Phekolo ea mathata a vascular ho lefu la tsoekere
Bakeng sa kalafo e atlehileng ea li-angiopathies tsa lefu la tsoekere, ho hlokahala hore o qale ka ho tlosa sesosa se ka sehloohong - ho feto-fetoha ha maemo ho glucose ea mali le litekanyetso tse phahameng tsa hemoglobin ea glycosylated. Ho hlokahala ho latela litlhahiso tsa mokhoa oa bophelo:
- ja lijo ntle le mafura a transgenic le lik'habohaedreite tse potlakisang ho sefa. Ho ja lijo tse kang "poleiti ea lijo", moo halofo ea lihlahisoa e leng meroho, 25% ke nama e mafura a tlase, mme e 'ngoe 25% ke lik'habohaedreite tse phetseng hantle,
Lijo tse nang le phepo ea tsoekere li thusa ho theola tsoekere e maling le cholesterol e felletseng
Phekolo ea lithethefatsi
Mehatong ea pele ea nts'etsopele ea micro- and macroangiopathy, kalafo e bolokehang e reretsoeng ho tlosa matšoao e ka khonahala.
- Lithethefatsi tse theolelang tsoekere li lokela ho kenyelletsoa kalafong ea kalafo, hobane ho ke ke ha khoneha ho fihlela sephetho sa ho fokotseha ho tsoekere ha tsoekere feela ka ho lokisa mekhoa ea bophelo le phepo e nepahetseng. Tse atileng haholo ho tsona ke Metformin, Diabeteson, Amaril. Dosing e itšetleha ka liparamente tsa laboratori mme e le motho ka kotloloho.
- Cardiomagnyl kapa Aspirin e sebelisoa ho thibela mali. Lithethefatsi li fokotsa bokhoni ba liplatelete tsa ho latela le ho ntlafatsa likarolo tsa mali tsa rheological.
- Ka li-macroangiopathies, li-statins - Ator, Rosuvastatin, Lovastatin li sebelisoa ho tsitsisa le ho thibela ho thehoa hoa li-plaque tsa atherosranceotic.
- Liphetoho kapa boleng bo phahameng ba khatello ea mali li hloka ho laoloa le li-antihypertgency agents - Lisinopril, Equator, Valsartan.
- Tabeng ea edema e feteletseng, ho sebelisoa diuretics - Torasemide, Veroshpiron, Lasix.
- Letsoalo la lefu la tsoekere le hloka lithethefatsi bakeng sa vasodilation - Trental, Niacin, Pentoxifyline.
Lisosa le mabaka a kotsi
Ho phunya marako le tšenyo ea methapo ea mali ho lebisa phallo e mpe ea mali libakeng tse tlase. Ka lebaka leo, lisele ha li fumane limatlafatsi le oksijene.
Mabota a methapo ea mali a fetoha leseli ka lebaka la khatello ea khafetsa ea khatello le nts'etsopele e telele ea lefu la tsoekere.
Ponahalo ea khafetsa ea lefu la tsoekere libakeng tse tlase e amana le mojaro o moholo o amang maoto.
Lintho tsa bohlokoa haholo ke lintlha tsa tlokotsi tse atisang ho tsamaea le mokuli nakong ea tlhahiso ea lefu la tsoekere:
- Ho hanyetsa insulin ke ho sitisa karabelo ea 'mele ea ho pepesetsoa insulin.
- Dyslipidemia ke tlolo ea tlhahiso, metabolism le excretion ea mafura maling.
- Tlhaho ea tlhaho ea ts'ebetso ea ho ruruha.
- Ho Nona Haholo
- Hyperglycemia - tsoekere e phahameng ea mali.
- Ho fokotsa.
- Ho ba teng ha poone le poone.
- Ho eketseha ha mali.
- Phetoho ea poleiti ea lipekere.
- Endothelial dysfunction - Tšenyo ea karolo e ka hare ea lisele tsa methapo.
- Hypertension ea methapo ea kutlo ke keketseho ea khatello ea mali.
- Tšenyo ea lisele nakong ea ts'ebetso ea oxidation ke khatello ea oxidative.
Leha ho le joalo, mabaka a kotsi a kantle le ona a khethollotsoe:
- Age: hangata pathology e etsoa ho banna kamora lilemo tse 45 le ho basali kamora lilemo tse 55.
- Boitšisinyo.
- Mokhoa oa bophelo bo iketlileng.
- Chefo ea mosebetsing.
- Ho tsuba.
Ho ba teng ha lets'oao le le leng kapa a mangata a lefu lena ke phehisano e matla molemong oa ho batla thuso ea bongaka. Ho lieha ho tseba hantle hore u na le lefu lena kapa ho haella ha kalafo ho eketsa menyetla ea ho holofala. Matšoao a angiopathy ea lefu la tsoekere a itšetlehile ka ho teba ha lefu lena le mofuta oa lona.
Macroangiopathy hangata e ama mats'oafo a popliteal, mme tsela ea eona e bohale. Pathology hangata e lebisa bohlokong le popong ea leoto.
Matšoao a Microangiopathy ho latela sethala - tafole
Mothati | Tlhaloso |
Zero | Boemong ba zero, ha ho na mathata, empa ngaka e khona ho lemoha liphetoho tse etsahetseng. |
Pele |
|
Ea bobeli |
|
Boraro |
|
La bone | Lefu la lisele le feta liso tsa ka mpeng. |
Ea bohlano | Ho na le necrosis ea leoto lohle, kahoo ts'ebetso e potlakileng e hlokahala. |
Matšoao a macroangiopathy ho latela sethala - tafole
Mehato | Matšoao |
1 |
|
2A |
|
2B | Ho na le matšoao a sebopeho sa grade 2A, empa lameness e bitsoa haholoanyane. |
3A | Ntle le matšoao a boletsoeng pejana, matšoao a eketsehileng a hlaha:
|
3B |
|
4 |
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Ts'oaetso
Haeba lefu la tsoekere le tšoauoa ka lefu la tsoekere le belaelloa, mokuli o lokela ho buisana le ngaka kapele kamoo ho ka khonehang. Setsebi se tla hlahloba mokuli le ho bokella litletlebo. Kamora ho netefatsa boteng ba lefu la tsoekere, tlhahlobo ea matla e qalileng.
Thutong ea bongaka, ho sebelisoa mekhoa e mengata e fapaneng ea ho lemoha.
- Magnetic resonance imaging (MRI). Ka thuso ea eona, tlhaiso-leseling e qaqileng mabapi le sebopeho sa lisele tse bonolo e ea fumanoa.
- Angiography. E thusa ho lekola boholo ba patency ea vascular. Ntho e khethehileng e kenngoa 'meleng oa mokuli, ka mor'a moo ho etsoa x-ray. Angiography eu lumella ho lekola boholo ba patency ea methapo
- Lingoloa tse hlalosang mantsoe Eu lumella ho fumana leseli le qaqileng ka sebaka se amehileng.
- Tlhahlobo ea Ultrasound Ka thuso ea eona, molumo oa marako a methapo le boemo ba bona bo ikemiselitse. Ha ho hlahlojoa ka sekepe ho senola lebelo la phallo ea mali le ho lekola kholo ea methapo ea mali.
Mokhoa o le mong o hlokahala ho fihlela sephetho se setle haholo. Mehato ea kalafo e ka fapana ho latela boima ba lefu lena le lisosa tsa lefu la tsoekere.
Ho buoa
Ho buuoa ho sebelisoa maemong a feteletseng. Letšoao la ts'ebetso ke ho ba teng ha mekhoa ea purulent-necrotic ea tlhaho e behang bophelo ba mokuli (li-ulc le lisele tse shoeleng, tšenyo e matla ea masapo le ho ata ha necrosis).
Sebelisa mekhoa e latelang:
- Endarterectomy - ho netefatsa phallo ea mali makaleng a thehiloeng le ho felisoa ha methapo ea mali e ke keng ea khutlisoa.
- Angioplasty - phetisetso ea phepelo ea mali.
- Ts'ebetso ea Autovenous bypass - ho theoa hoa lekala le eketsehileng, ho lumella ho feta likepe tse amehang. Ho khutlisetsoa ha patency ea likepe tse anngoeng ke ntoa ho etsoa ka letsoalo
- Ho ts'oaroa ha methapo ea methapo ea maoto (ho kenella ka hare ho methapo ea methapo) - ho thehoa ha semelo se khethehileng seo lumen ea sekepe se khutlisetsoang ho sona.
- Sympatectomy - ho tlosoa ha methapo ea kutlo e ikarabellang bakeng sa mokokotlo oa methapo ea methapo.
- Boitlhotlhollo ba lisele tse shoeleng.
- Ts'ebetso ea bohloeki - ho buloa ha li-abscesses le phlegmon (ho ruruha ha tlhaho ea purulent).
- Ho khaoloa ha leoto (maemong a feteletseng).
Litlhare tsa setso le homeopathy
E le mokhoa o eketsehileng oa kalafo, ts'ebeliso ea litlhare tsa setso e lumelloa. Leha ho le joalo, u lokela ho buisana le setsebi pele.
Ka lefu la tsoekere la maemo a tlase, ho sebelisoa tse latelang:
- moroho o tsoang ho ciliegia ea linonyana. Li-monokotšoai tse 1/4 tsa kofi li eketsoa ho 0.5 l ea metsi a belang. Tšela metsotso e 15 ka bateng ea metsi. Ebe sesebelisoa sea hloekisoa 'me sea kopanngoa. E sebelisoa bakeng sa li-compress kapa liso tse futhumatsang,
- moro oa yarrow. Semela le metsi a belang a kopantsoe ka tekanyo ea 1: 10, e phehiloeng bakeng sa metsotso e 5, e tlhotliloeng ebe e sebelisetsoa ho hlatsoa le ho hatella,
Yarrow o na le he hepatic, pholiso le bactericidal thepa.
Ho a khonahala ho fokotsa boemo ba mokuli ka thuso ea homeopathy. Sebelisa lisebelisoa tse latelang:
Phekolo ea kalafo le mathata a ka bang teng
Tsoelo-pele e itšetlehile ka sethala sa lefu la tsoekere le nako ea ho qala kalafo. Hang ha mokuli a batla thuso, ho na le monyetla oa hore a be le litholoana tse ntle. Khōlo e potlakileng ea angiopathy hangata e lebisa ho mathata, haholoholo ha ho se na kalafo. Ka lebaka la kholo ea boemo ba pathological, ho hlaha litlamorao tse latelang:
- Necrosis (gangrene, necrosis) ea menoana, maoto, leoto le tlase.
- Phokotso ea kutlo ea lipheletso tse tlase. Ho ba teng le likotsi tse nyane haholo tse nang le kutloisiso e fokotsehileng hoa tšosa, hobane mokuli ha a lule a bona tšenyo ka nako 'me o tsoela pele ho e phekola. Ka lebaka leo, ho pepetoa ha mofuta o mong le o mong ho ka baka liphetoho tse ke keng tsa fetoloa tse hlokang ho kenella ka potlako ke ngaka e buoang.
- Ho hloleha ha pelo, mathata a pono.
Mehato ea thibelo
Thibelo e reretsoe ho thibela nts'etsopele ea mathata. Bakuli ba nang le lefu la tsoekere ba lokela ho latela litlhahiso tsa setsebi sa tlhokomelo ea maoto. Ho khothalletsoa ho tlohela ho tsamaea ntle le lieta, haholo-holo ka kutloisiso e fokotsehileng.
Lieta tse khethiloeng ka nepo ke karolo ea bohlokoa ho thibelo ea angiopathy. Lieta li lokela ho ba tse loketseng ka boholo. Ho khothalletsoa ho fana ka khetho ea lisebelisoa tsa tlhaho.
Letsatsi le leng le le leng ba hlatsoa maoto ka metsi a futhumetseng mme ba a hlakola ka botlalo. Ho qoba ho peeling letlalo le ho theha mapetso, ho loketse hore mongobo o tšoane.
Ntle le moo, e lokela ho:
- etela ngaka khafetsa
- laola boima ba 'mele le tsoekere ea mali,
- khomarela lijo
- etsa boikoetliso ba 'mele, ho fana ka khetho ho lipapali tseo ho tsona kotsi ea ho senyeha ha maoto e sa felle kapa e fokolang.
Ho ba le lefu la tsoekere angiopathy ke boemo bo kotsi. Haeba ho se na kalafo, ho na le monyetla oa ho bolaoa ka lebaka la nts'etsopele ea gangrene le chefo ea mali. Haeba ho na le lipelaelo tsa lefu la ho belaela, ho hlokahala hore u etele ngaka kapele kamoo ho ka khonehang.
Mekhoa ea ho buoa
Phekolo ea opereishene e boetse e fetoha ketsahalong ea ulceration. Bakeng sa kalafo ea bona, ho sebelisoa mokhoa oa laser moo methapo ea mali e tsoang. Tabeng ea necrotization ea lisele tse bonolo, li buletsoe.
Ts'ebetso ea sejoale-joale ebile e theko e phahameng e kenyelletsa ho lokisa methapo, e thusang ho khutlisetsa phallo ea mali le phepo ea lithane.
Maemong a tebileng, ho pongoa leoto le ka tlase ho etsoa boemong ba lesion.
Mekhoa ea meriana ea setso
Ts'ebeliso ea litlhare tsa setso e fumaneha feela kamora ho buisana le ngaka. Tšebeliso ea bona ha ea lokela ho nkela phekolo ea mantlha sebaka. Mekhoa e meng ea litlhare bakeng sa ho phekola li-angiopathy tse nang le lefu la tsoekere le kenyeletsa:
- Litlhare tsa limela tse nang le tsoekere tse fokotsang tsoekere - chamomile, linden, makhasi a blueberry, sage,
- infusions - hlohlelletsa ka mokhoa o phethahetseng manyeme, liphokojoe tsa linaoa, makhoaba a dandelion, peo ea folaxe,
- Litlama tsa litlama - fokotsa kotsi ea ho ba le mathata a mokelikeli. Li hlophisitsoe ho tloha kutu le motso oa Jerusalema artichoke, clover, motso oa koro,
- compress - thusa pholiso ea ulcic ulcers. Bakeng sa morero ona, sebelisa makhasi le lipalesa tsa calendula, nettle e omisitsoeng ka foromo ea phofo.
Mekhoa ea ho lokisa meriana ea setso - tafoleng
Pheko ea setso | Mokhoa oa ho pheha | Khafetsa kamohelo |
Tee ea Chamomile | Li-tee tse peli tsa lipalesa tsa chamomile tse omisitsoeng li tšela 100 di ml ea metsi a belang ebe u li tlohella metsotso e 20. | Nka letsatsi le letsatsi ka mokhoa o futhumetseng. |
Tea ea Linden | Tšela thispone e le 1 ea makhasi a chamomile a omisitsoeng ka khalase e le 1 ea metsi, ebe o belisa mocheso o tlase ka metsotso e 10. | Noa pele ho lijo ka seng |
Tee ea Blueberry | Thispone e le 1 ea makhasi a blueberry le thispone e le 1 ea monokotsoai o omelletseng o tšela khalase ea metsi mme o emise metsotso e 15 mollong (ntle le ho pheha). | Tablespoons tse 2 ka letsatsi. |
Tee ea sage | Thispone e le 1 ea a sketse a omisitsoeng a tšela 250 ml ea metsi a belisitsoeng mme a tsitlella hora. | Noa 50 ml makhetlo a 3 ka letsatsi |
Ts'oaetso ea linaoa le peo ea folaxe | Kopanya khaba ea peo ea folaxe le likhaba tse 5 tsa pods tsa linaoa le moholi le khalase ea metsi a belang. | Noa ka likarolo tse nyane letsatsi ho pota |
Ts'oaetso ea mahlaka a dandelion | Tšela likhaba tse 2 tsa stems tse omisitsoeng ka litara e le 1 ea metsi a belisitsoeng mme u ts'oare ka thermos lihora tse 12. | Nka metsotso e 15 pele ho lijo. Bophahamo bohle ba mokelikeli bo lokela ho tahoa ka letsatsi. |
Jerusalema artichoke bath | Motsoako oa litlhakoana, metso le lipalesa li tšela lilithara tse 10 tsa metsi ebe o li belisa ka mocheso o tlase. Moro o hlahisoang o kenyelletsoa ka bateng e kholo. | Sebelisa hanngoe ka beke. |
Ho hlapela Wheatgrass | Tšela 100 g ea ligrig ea motsoako ka 2 l ea metsi mme o tlise ho pheha. Tšela moro ka metsi ho futhumatsa kamore ebe o o hlatsoa ka maoto. | Nka libate tsa maoto ka letsatsi le leng le le leng. |
Compress ea Marigold le nettle | Lipalesa tse kopantsoeng tsa calendula le makhasi a nettle li sebetsa ho liso le ho lokisa boima ka bandeji ea gauze. | Sebelisa makhetlo a 2-3 ka letsatsi. Kamora ho tlosa bandage, hlatsoa leoto hantle. |
Kelello le mathata
Ho fihlella ha ngaka ka nako, kalafo e nepahetseng, ho boloka mokhoa o phetseng hantle ho tla thusa ho fihlela phallo e tsitsitseng ea boemo ba methapo. Ho seng joalo, tsoelo-pele ea angiopathy le ketsahalo ea:
- gangrene maemong a leoto, leoto le tlase kapa serope,
- ho fokotseha ha kutloisiso ea letlalo, e lebisang ho ts'oenyeha le boikemisetso bo sa lebelloang. Sena se ka etsa hore leoto la lefu la tsoekere le ntlafale,
- khokahano ea tšoaetso ea baktheria esita le aseptic necrosis, e hlahisang ho khaoloa ha leoto.
Thibelo ea lefu la tsoekere
Bakeng sa ho thibela nts'etsopele ea angiopathy ho lefu la tsoekere, mokuli o lokela ho:
- ho beha leihlo 'mele khafetsa le metabolism ea mafura,
- etela setsebi sa endocrinologist ho lekola boemo ba letlalo le lisele tse bonolo tsa likarolo tse tlase,
- phela bophelo bo botle 'me u je hantle,
- letsatsi le leng le le leng etsa ts'ebetso ea bohloeki 'meleng oa hau, phekola makhopho ka nako e loketseng.
Karolo ea bohlokoa ea mehato ea thibelo ho mokuli ea lefu la tsoekere o hlokomela maoto:
- qoba ho pepesehela mocheso o phahameng haholo kapa o tlase,
- Apara lieta tse mabothobotho tse bulehileng moeeng
- libaka tse nang le letlalo le boreleli le cream ea grease le urea,
- ho roala lipekere ka tsela e fapaneng,
- Hlahloba maoto ka mehla, haeba ho na le likotsi - li phekole ka sebolaya-mafu,
- libakeng tse nang le ts'oaetso ea ts'oaetso ea fungal (saunas, matamo, lihotele) sebelisa lijana tse lahliloeng,
- bakeng sa ho khetholla liphetoho letlalong la leoto, hang-hang etela ngaka ea podologist.
Ho lieha nts'etsopele ea "diiopathy" ea lefu la tsoekere ka lipakeng tse tlase, ho bohlokoa ho laola boemo ba tsoekere maling, lipid metabolism le ho qoba tšusumetso ea lintho tse ka bang kotsing. Ho fihlela sephetho sa nako e telele, u ka sebelisa mekhoa e tloaelehileng ea kalafo, litlhare tsa lapeng le tsa kalafo tse tla thusa ho thibela ho thetsoa ha liso le ho khaoloa ha leoto.
Matšoao a Retinopathy ea lefu la tsoekere
Retina ea leihlo la mahlo e na le marang-rang a eona a capillaries. Ha tsoekere e ntse e tsoela pele, ke eena ea tšoenyehang ka ho fetisisa. Arterioles, methapo ea methapo, li-capillaries le methapong li feta hara eona. Ha clearance ho bona e fokotseha, phallo ea mali e ferekanngoa, e lebisang kholong ea retinopathy.
Ha ho khetholloa lefu lena la methapo, matšoao a ophthalmic le a kliniki a khetholloa.
Matšoao a phofo ke a fumanoang nakong ea tlhahlobo ea mahlo, 'me matšoao a hlalositsoeng ke mokuli ho ngaka e eang a nkuoa e le a kliniki.
Ho ke ho hlokomeloe hore nts'etsopele ea retinopathy e batla e le asymptomatic, ka hona, hangata e fumanoa e le morao haholo. Litletlebo tsa mokuli ha li ikopanya le setsebi li ka kenyelletsa:
- lesira ka pel'a mahlo
- ho senyeha ha lisebelisoa tse bonahalang,
- matheba kapa lefifi.
Tsoelo-pele ea lefu lena e lebisa ho arohaneng ha boholo le sebopeho sa setšoantšo ka pel'a mahlo. Mme ha retinopathy e tsamaisana le hemorrhage e matla, lefu la tsoekere le na le matheba a lerootho. Maemong a mabe ka ho fetesisa, pathology e lebisa bofofu.
Nakong ea tlhahlobo ea mahlo, ngaka e hlahloba methapo le methapo ea kutlo. Le haeba mokuli a sa utloe matšoao a hlakileng, matšoao a retinopathy a se a ntse a fumanoa. Ngaka e khona ho bona likepe tse nyenyefalitsoeng letlalong, 'me ka linako tse ling li-microaneurysms.
Ntle le moo, ho ruruha le ho bokellana ha mokelikeli ho hlaha methapong e meholo.
Ho rata lipehlo tse tlase
Ho qala ka nepo ho tseba hore na mokuli a ka ba le matšoao afe. Ntle le moo, kalafo e sa sebetseng kapa e sa sebetseng e lebisa liphellong tse ke keng tsa fetoloa.
Ka lebaka la ho fokotseha ha methapo ea methapo e tlase, ischemia ea hlaha, ke hore, khaello ea oksijene le phepelo ea mali, e lebisang ts'ebetsong ea leoto le senyehileng. Liphetoho tsa trophic letlalong esita le necrosis kapa gangrene li etsahala. Maemong ana, maoto a angoang haholo ke hobane ke sebaka se hole ka ho fetisisa.
Matšoao a lefu lena a bakoa ke lits'ebetso tse etsahalang ka bobeli ke "lefu le monate" le atherosclerosis. Ntle le moo, lingaka li supa lintho tse ling tse bakang ponahalo ea methapo ea maoto le maoto. Tsena li kenyelletsa ho tsuba, ho ba le liphatsa tsa lefutso le mosebetsi o kotsi o nang le lintho tse chefo.
Ho ba le lefu la tsoekere la maemo a tlaase le tlase ho bontšoa hangata ke matšoao a latelang:
- Ho bata le ho ba mesifa ea maoto.
- Goosebumps.
- Li-uloph tsa leoto.
- Mats'oafo le bohloko.
- Liphetoho letlalong.
Ho latela boholo ba tšenyo ea methapo, ho na le li-macro- le microangiopathy tsa likarolo tse tlase. Tabeng ena, tšenyo e lipheletsong tse holimo e hlaha hangata khafetsa.
Ka tšenyo e fokolang methapong ea maoto, mokuli o ikutloa a utloile bohloko. Ka linako tse ling maoto a hae a bata, 'me ho hlaha liso tse nyane ho bona. Ho hlohlona ha macroangiopathy ho lebisa ho tsitsipeng ha maoto le matsoho, lameness, pallor ea letlalo, cramps tse sa khaotseng, bohloko le feberu.
Lefu la tsoekere ke bothata bo kotsi bo hlahang ha kalafo ea lefu la tsoekere la Angiopathy ea likarolo tse tlase e sa sebetse. Ka ts'ebetso ena ea pathological, liphetoho tse itseng li etsahala manonyeletsong le liseleng tsa masapo. E 'ngoe ea litlamorao ke lefu la tsoekere le bakoang ke lefu la masapo le maoto. Liphetoho tse joalo hamorao li lebisa ho Menkeberg syndrome (calcification le sclerosis ea lijana tsa maoto) le ho fokola ha leoto.
Ho lokela ho hopoloa hore lefu la tsoekere la "liiopathy" la methapo e tlase haholo ha ho mohla le tsoelang pele le itulela.
Psychology e joalo e hlaha hammoho le nephropathy le retinopathy.
Matšoao a Encephalopathy ea lefu la tsoekere
Ha encephalopathy e etsahala ho lefu la tsoekere, ho senyeha hoa kelello le pherekano li qala. Ho feta moo, mokuli o tletleba ka hlooho e sa feleng le ho tepella. Phekolo e joalo ke sesosa sa tlolo ea mali ho potoloha maling.
Qalong ea kholo ea lefu lena, motho a ka 'na a ikutloa a se na matšoao. Empa ha nako e ntse e tsamaea, mokuli o lemalla ho opa ka nakoana ka lebaka la hlooho e opang khafetsa. Sena le sona se baka pherekano ea boroko le ho otsela letsatsi lohle. Nakong e tlang, mokuli o ferekana ebile oa lebala.
Ntle le matšoao a letsoalo, a pele a nts'etsopele, a kenyelletsang ho hokahanoa ha metsamao ea kelello, methapo ea kelello le lefu la shaky. Boloetse bo kopaneng bo nkoa e le sesupo se kotsi, ke hore, pono e habeli, litšoantšo tse lerootho, pono e lerootho, tloaelo e sa tloaelehang ea boemo ba mmele. Ntle le moo, ho hlaha aisocoria - boemo boo ho bona ho nang le mokokotlo oa bana ba fapaneng.
Mekhoa e joalo ea pathological e kotsi ho mokuli ha a etsa mosebetsi o amanang le mekhoa e mengata, hammoho le ho khanna koloi.
Ho hlola ha li-capillaries le methapo ea methapo ea pelo
Bakeng sa phepelo e tsoelang pele ea lisele tsa pelo, ho na le marang-rang a marang-rang le methapo ea methapo ea kutlo.
Lefu la tsoekere le ama methapo ea methapo ea kutlo le e ka letsohong le letšehali. Ts'ebetso ena e bitsoa macroangiopathy, e hlahisoang ke nts'etsopele ea atherosclerosis.
Ha li-capillaries li ameha, lefu la tsoekere la tsoekere lea hlaha.
Haeba lefu la kelello le hlaha, mokuli o tletleba ka matšoao a latelang:
- Angina pain. E etsahala ka lebaka la sebopeho sa li-plaque le metopa ho lumen ea methapo ea mali. Ka lebaka leo, mali a ke ke a phalla ka bongata bo hlokahalang, 'me pelo e haelloa ke oksijene. Ts'ebetso ena e baka ho bola ha glucose ntle le oksijene le ho lokolloa ha lactic acid. E sitisa methapo ea pelo, ka hona motho o utloa bohloko.
- Ho hloleha ha pelo, ho bonahatsoang ke ho khohlela, ho fokotseha ha sekhahla sa pelo le ho hema hanyane.
- Pherekano ea morethetho oa pelo. Li qala ka ho hloloa hoa likepe tse nyane le sclerosis ea tsona myocardium. Ho na le mefuta e 'maloa ea tšitiso ea morethetho: bradycardia (sekhahla sa pelo se ka tlase ho 50 beats / min), tachycardia (tse fetang 90 li-beats / min), extrasystole (phokotso e sa lebelloang) le arrhythmia (pherekano e tloaelehileng ea morethetho).
Ho lokela ho hopoloa hore tšenyo ea lijana tsa pelo hangata e tsamaisana le tšenyo ea methapo ea maoto, liphio le retina.
Tlhahlobo le kalafo ea lefu lena
Mehato ea tekanyetso ea nts'etsopele ea lefu la tsoekere e lokela ho etsoa ka botlalo. Ka hona, ha ho hlahlojoe metsi a tlhaho feela, empa le litho tse tloahelehileng ho lefu lena.
Ho na le mekhoa e 'maloa ea ho fumana lefu lena.
Boithuto ba sekhahla sa ho nyelisoa ha glomerular. Letšoao le ka sehloohong la ho fumanoa ke lefu la nephropathy. Mofuta o mongata oa ho fafatsa: hofihlella ho fihla ho 140 ml / min.
Boikemisetso ba urine ba b2-microglobulin. Ho fumanoa ha b2-microglobulin ho bontša lefu la tsoekere la angionephropathy. Motho ea phetseng hantle ha a lokela ho ba ka har'a moroto.
Phallo ea mali. Ho fumanoa ha lipoprotein tsa mali le cholesterol. Boemo ba kholesterol: eseng ho feta 5.5 mmol / L. Khatello ea lipoprotein: ho tloha ho 1 ho isa ho 2.9 mmol / L.
Ho tseba ka lefu lena ho bolela tšebeliso ea mekhoa e meng, e leng:
- Teko e rarahaneng ea ophthalmologic,
- Ultrasound
- echocardiography
- Dopplerography le arteryography ea maoto,
- coronary angiography
- electrocardiograms (ECG),
- matla a tlhaho a nyutlelie a tsoang bokong.
Kamora hore ngaka e etse tlhahlobo ea bongaka, ho theha leqheka la kalafo ea angiopathy. Phekolo e sebetsang e kenyelletsa ho boloka lijo tse nang le phepo e nepahetseng, ho boloka bophelo bo mafolofolo le ho phomola nako le mosebetsi. Ntle le moo, kalafo ea angiopathy e tsamaea le meriana e joalo:
- Meriana ea lefu la tsoekere ho laola glycemia.
- Mekhoa ea ho fokotsa cholesterol.
- Khatello ea mali e theola lithethefatsi.
- Lithethefatsi tsa diuretic.
- Mekhoa ea ho ntlafatsa phallo ea mali.
- Lithethefatsi tse thibelang thrombosis.
- Meriana e ntlafatsang ts'ebetso ea metabolic.
Hoa hlokahala ho phekola lefu le tebileng joalo ka tlasa taolo e tiileng ea setsebi, ho latela litlhahiso tsohle tsa hae.Video e sehloohong sena e tla tsoelapele ka sehlooho sa mathata a lefu la tsoekere.