UKWEHLULEKA KWESIFO SIKASHUKELA UKUHLULEKA

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Isifo sikashukela i-mellitus sibonakala ngomphumela oyinkimbinkimbi emzimbeni wesiguli, othinta zonke izitho nezinhlelo. Enye yezinkinga eziyingozi kakhulu eziba khona phakathi nesikhathi eside lesi sifo ukulimala kwezinso futhi nefomu laso ngokweqile - ukuhluleka kwe-renal okungamahlalakhona.

Ukwehluleka kwangempela nesifo sikashukela njengembangela yokuvela kwayo

Izinguquko ze-pathological esakhiweni nasekusebenzeni kwezinso ku-mellitus yesifo sikashukela kuthiwa isifo sikashukela se-nephropathy. Isigaba sokugcina sale nkinga ukwehluleka kwezinso - ukwephulwa okukhulu kwe-nitrogen, amanzi-usawoti, i-electrolyte kanye ne-acid-base metabolism, okwenza ukuthi kungenzeki ukusebenza okujwayelekile kwazo zonke izitho nezinhlelo emzimbeni womuntu.

Izilonda zangasese zenzeka cishe kuma-30- 40% eziguli ezinesifo sohlobo 1 no-10% onesifo sohlobo 2. Ngakolunye uhlangothi, ziwumphumela we-angiopathy yesifo sikashukela - okuyingxenye yesifo sikashukela esithinta ukwakheka kwayo yonke imithambo yegazi, kufaka phakathi uhlelo lokuhlunga lwezinso. Izindonga zemithambo yegazi zilimele, imisebe yazo ekhanyayo, nomfutho wegazi uyakhuphuka.

Ngakolunye uhlangothi, ukuphazamiseka kwamafutha, i-protein ne-carbohydrate metabolism, okwakheka kushukela, kuholela ekwandeni okukhulu kokujikeleza kanye nokuchithwa kwalezi zihlanganiseli ngokusebenzisa imithambo ye-renal, engavele imelane nomthwalo onjalo futhi iqale ukonakala.

Kukhona enye indlela ephakanyisiwe yokwakhiwa kwe-renal pathology kushukela. Ukulimala okungathi sína ekwakhekeni nasekusebenzeni kwezinso kungabangelwa ukonakala kofuzo kwesiguli, futhi isifo sikashukela siyimbangela yale nqubo. Le hypothesis iqinisekiswa ngokungaqondile iqiniso lokuthi i-nephropathy ngokwehluleka okwalandela kwezinso akukhona kuzo zonke izazi zesifo sikashukela.

Ukuhlukaniswa

Ukwehluleka kwangempela kuhlukaniswe kubuye kube nzima futhi kungamahlalakhona.

Ifomu elisebenzayoNjengomthetho, ukhula esikhathini esifushane nje ngenxa yobuthi obunamandla, ukushiswa noma i-frostbite yendawo enkulu yomzimba, ukuphelelwa ngamandla kobunjalo bemvelo obuhlukahlukene (ukuphindaphindwa kokuhlanza, isifo sohudo), ukulimala komgudu wokuchama (nge-urolithiasis, isimila), ukulimala kwemishini yezinso, ezinye izifo kanye izifo eziyingozi ze-renal apparatus (pyelonephritis, nephritis). Yize kunobungozi obukhulu nosongo empilweni, leli fomu ngokuvamile alibonakalanga ngokulimazeka kwezitho ze-excretion, futhi esimweni sokwelashwa okwanele, ngemuva kwesikhathi esithile, kwenzeka ukululama okugcwele.
Isifo sikashukela siyenzeka ifomu elingamahlalakhona iboniswa inkambo ende (iminyaka namashumi eminyaka), izimpawu ezikhula kancane kancane kanye nokuthuthuka komonakalo ongaguquki ezakhiweni zezinso. Ngenxa yalokhu, igazi alihlanzwa ngemikhiqizo enobuthi futhi iyakhula uremia - isimo sokuzenzakalela ingozi, esongela ukufa. Ezigabeni zakamuva, impilo yesiguli isekelwa kuphela yi-hemodialysis engaguquki noma izinqubo ze-peritoneal dialysis, futhi ukufakelwa kwezinso kuphela okungasindisa lesi simo.

Izimpawu

Ukulimala kwezinso kusifo sikashukela kunesici esingemnandi: ngezigaba zokuqala, lesi sifo asizihluphi ngesiguli. Ngaphandle kokuthi imvamisa yokuchama inyuka, kepha lokhu kujwayelekile kushukela lilonke futhi akubangeli ukuthi isiguli sikhale i-alamu. Lapho kuqala ukubonakala kwezimpawu zokuqala zomtholampilo, i-pathology iya kude futhi ukwelashwa kubandakanya ubunzima obuningana. Ukuboniswa kokwehluleka okungenzeka kwezinso kanye ne-uremia kuningi:

ubuthakathaka obujwayelekile, i-adynamia, isiyezi;
isikhumba esikhanyayo;
ukwehla, okuvame ukwanda kakhulu ekushiseni komzimba ngaphandle kwesizathu esibonakalayo;
i-oliguria - ukwehla kwenani lomchamo osuswe, esikhundleni se-polyuria (ukuphuma komchamo);
ukubonakaliswa kwe-anemia - i-pallor yesikhumba, ukuphefumula, i-tinnitus, njll;
i-dyspepsia ukuthambeka;
umfutho wegazi ophakeme - ukwanda okuqhubekayo komfutho wegazi;
ukuthuthukiswa kwe-edema;
i-azotemia - ukunqwabelana egazini lemikhiqizo enobuthi ye-nitrogen metabolism (i-urea, i-ammonia, i-creatinine, njll.), ukubonakaliswa kwangaphandle okungaba yiphunga le-ammonia emoyeni ophelile;
ukuphazamiseka okuhlukahlukene kohlelo lwezinzwa oluyingozi kanye noluphakathi (umuzwa ovuthayo emaphethelweni kanye / noma umuzwa wokuthi "ama-goosebumps ezinwabuzelayo", ukwethuka, ukugoba, ukudideka, izinkinga zokulala).

Ngokuvamile, lezi zimpawu zenzeka eminyakeni eminingi ngemuva kokuxilongwa kwesifo sikashukela nenkambo yakamuva ye-nephropathy.

Ukuxilongwa kokulimazeleka kwezinso

Uma kungekho noma yikuphi ukubonakaliswa kwemitholampilo, kungenzeka ukuthola ukulimala kwezinso zesifo sikashukela ezigabeni zokuqala kuphela ngokuhlolwa nokuhlolwa okujwayelekile.

Imvamisa yokulawula imi kanjena:

ekuqaleni kohlobo 1 lwesifo sikashukela ebuntwaneni ngaphambi kokuthomba noma ngemuva kokuthomba, kuyadingeka ukuthi kuhlolisiswe iminyaka emi-5 ngemuva kokuxilongwa, bese kuhlolwa minyaka yonke;
iziguli ezinesifo sikashukela sohlobo 1 ezigula ngesikhathi sokuthomba zisengozini enkulu futhi zixilongwa izifo zezinso ngokushesha ngemuva kokuxilongwa, bese ziphinda njalo ukuhlolwa minyaka yonke;
Lapho kutholakala ukuthi unesifo sikashukela sohlobo 2, kufanele uhlole izinso zakho bese uphinda inqubo leyo minyaka yonke.

Izinkomba eziphambili zesimo sezinhlelo zokusebenza se-renal yizinto ezise-urini i-albhamuin(amaprotheni), isilinganiso senani kumchamo i-albhamuin futhi i-creatininefuthi izinga lokuhlunga le-glomerular (esifushanisiwe I-SCF) Okokugcina kubalwa ngokuya ngemininingwane ekhethekile esekwe kokuqukethwe i-creatinine egazini. Ngenxa yalokhu, sinezivivinyo ezilandelayo ezidingekayo zokulethwa konyaka:

i-urinalysis ye-albhamuin;
i-urinalysis ye-creatinine;
ukuhlolwa kwegazi kwe-creatinine.

Zingahlanganiswa nokuhlaziywa okujwayelekile kwegazi nomchamo ngokuhlolwa kwezokwelapha okwenziwa minyaka yonke. I-albhamuin ephezulu ne-GFR ephansi ikhombisa ukuba khona kwe-renal pathology.

Ukuvimbela kanye nokwelashwa kwezinkinga zezinso ezinoshukela

Indlela eyinhloko yokwelashwa ukulungiswa okuzinzile kwesifo esingaphansi kwayo - isifo sikashukela - esesimweni isinxephezelo.

Ukunakekelwa kufanele kuthathwe ukuze kugcinwe amazinga kashukela angaphansi kwemikhawulo ephephile, ikakhulukazi ngenxa yokuphathwa kwe-insulin. Ukuthatha ezinye izidakamizwa ezokwehlisa ushukela uma kwenzeka kune-nephropathy nokwehluleka kwe-renal, ngoba kungakhulisa inkambo yesifo.

Endaweni yesibili phakathi kwezindlela zokwelapha ezisetshenzisiwe ukubambelela ngokuqinile. ukudla. Ukudla okunokuqukethwe okuphansi (kepha hhayi ukungabi bikho ngokuphelele!) Amaprotheni, kanye nokuqukethwe usawoti okuncane, kuzosiza ukugcina izinso zinempilo. Ngokwemvelo, amafutha kanye nama-carbohydrate asheshe ukugaya nawo adinga ukukhawulelwa kokuphezulu, kepha lokhu akuyona into entsha kwabanesifo sikashukela. Ukusebenzisa kabi utshwala akwemukeleki, kungcono ukukukhipha ngokuphelele. Ukuyeka ukubhema kuyadingeka!

Kuzoba wusizo ukuthatha iqembu elikhethekile lemithi ngokufana - okuthiwa nephroprotectorsukuhlinzeka imetabolism efanele ngaphakathi kwezakhiwo ze-renal. Esimweni ngasinye, udokotela ukhetha umuthi. Ngokuya ngokutholakala umfutho wegazi ophakeme kuyadingeka futhi ukuthatha imishanguzo eyehlisela umfutho wegazi (ikakhulukazi eqenjini le-ACE inhibitors). Ngokuhlangana i-anemia kukhuthaza i-erythropoiesis (ukuhlanganiswa kwamangqamuzana abomvu egazi emshinini wamathambo), kanye nezidakamizwa eziqukethe i-iron.

Esigabeni esibulalayo sokwehluleka kwezinso, zimbalwa izinketho ezisasele. Impilo yesiguli ingasekelwa kuphela hemodialysis noma i-peritoneal dialysis. Emhlabeni kuneziguli eseziphile ngaphezu kweminyaka engama-20 kuphela ngezinqubo ezinjalo. Enye indlela kubo - ukufakelwa kwezinsoKepha, njengoba wazi, inani lezitho zomuntu onikelayo lilinganiselwe, umugqa wokudluliselwa kwempahla mkhulu, futhi ekusebenzeni kwezentengiselwano nasekuvuseleleni kabusha okulandelayo, kudingeka imali ebonakalayo. Ngokusobala, lesi simo kulula kakhulu ukusivimba kunokwelapha.