YINI ISIFO SIKASHUKELA? - IZINKINGA KANYE NEZIFO

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Isifo sikashukela i-mellitus siyingozi kubantu hhayi ngokubonisa nje kuphela, kepha izinkinga ezibangelwa yilesi sifo nazo ziningi izinkinga.

I-nephropathy yesifo sikashukela ingabalwa eqenjini lezinkinga ezinkulu kusifo sikashukela sazo zombili izinhlobo, leli gama lihlanganisa ubunzima bokulimala kwazo zonke izicubu nemithambo yegazi yinso, olubonakaliswa yizimpawu ezahlukahlukene zomtholampilo.

Isifo sikashukela i-nephropathy?

I-nephropathy yesifo sikashukela ibonakala ngoshintsho lwe-pathological emikhunjini ye-renal. Lezi zinguquko zenzeka kwisifo sikashukela sezinhlungu zombili lezi zinhlobo futhi ekugcineni ziholele ku-sclerosis yemikhumbi emikhulu nemincane.

Isizathu esiyisisekelo sokukhuthaza i-nephropathy sibhekwa njengezinga eliphakeme le-glucose. Le nto, esezingeni elikhulu emzimbeni, inomphumela onobuthi kumaseli wazo zonke izikebhe futhi isebenze izinqubo ezikhulisa ukutholakala kwemithambo yemithambo yegazi kanye nama-capillaries. Ngesikhathi esifanayo, umsebenzi oyinhloko wesitho, owokuhlunga, uyehla kancane kancane, futhi ngenxa yalokhu, ukwahluleka kwe-renal okungapheli, ukwehluleka kwe-renal okungapheli, kuyakhula.

Isifo sikashukela siyinkinga edala yesifo sikashukela futhi siyimbangela ehamba phambili yokufa.

Ushintsho ezinso lubonwa cishe ezingamaphesenti ama-20 eziguli ezinesifo sikashukela, ikakhulukazi ama-nephropathies athuthukisa nefomu lesifo eliya nge-insulin. Phakathi kweziguli ezinale nkinga, kunamadoda amaningi, inani eliphakeme lalesi sifo livela eminyakeni eyi-15 kuye kwengama-20 ukusuka ekuqaleni kwesifo sikashukela.

Izithombe zemitholampilo

Isifo sikashukela nesifo sikashukela sithathwa njengesifo esikhula kancane futhi lokhu kuyingozi enkulu yale nkinga. Isiguli esinesifo sikashukela isikhathi eside kungenzeka singaziboni izinguquko ezenzekayo futhi ukutholwa kwazo ezigabeni zakamuva akuvumeli ukufeza ukuqedwa ngokuphelele nokulawulwa kwe-pathology.

Izimpawu zokuqala ze-nephropathy kwisifo sikashukela yizinguquko ekuhlaziyeni - i-proteinuria ne-microalbuminuria. Ukuphambuka kusuka ejwayelekile kulezi zinkomba, ngisho nasezingeni elincane ezigulini ezinesifo sikashukela, kubhekwa njengesibonakaliso sokuqala sokuxilonga se-nephropathy.

Kunezigaba ze-nephropathy yesifo sikashukela, ngasinye esibonakaliswa ukubonakaliswa kwaso, i-prognosis kanye nezigaba zokwelashwa.

Izigaba

Isigaba sokuqala

- Lesi yisigaba sokuqina kwe-organ. Ikhula ekuqaleni kwesifo sikashukela mellitus, kuyilapho amaseli ezinso ekhuphuka ngosayizi futhi ngenxa yalokhu, ukuhlunga komchamo kuyanda futhi nokuphuma kwawo kukhuphuka. Kulesi sigaba, akukho okubonakaliswa kwangaphandle, njengoba nje kungekho protein kumchamo. Lapho wenza ukuhlolwa okwengeziwe, ungabheka ukwanda kosayizi wesitho ngokuya nge-ultrasound.

Isigaba sesibili

- qala izinguquko zokuqala zomzimba zomzimba. Ezigulini eziningi, lesi sigaba siqala ukukhula cishe iminyaka emibili ngemuva kokuqala kwesifo sikashukela mellitus. Izindonga zemithambo yegazi ziba kancane kancane, bese kuthi kuqala ukuqina kwe-sclerosis yazo. Izinguquko zokuhlaziya okujwayelekile nazo azitholakali.

Isigaba sesithathu

Cishe iminyaka emihlanu kuya kweyisikhombisa ngemuva kokuqala kwesifo sikashukela, isigaba sesithathu se-nephropathy yesifo sikashukela senzeka. Ngokuhlolwa okuhleliwe, ubukhona obungenamfanelo bamaprotheni buphawulwa ekuhlaziyeni, okubonisa ukulimala emithanjeni yesitho. Okuqukethwe ngamaprotheni ngalesi sigaba kusuka ku-30 kuye ku-300 mg / ngosuku.

Izinga lokuhlunga kwamanzi nezinhlanganisela ezisezingeni eliphansi zamangqamuzana lishintsha lapho kukhuphuka kancane, lokhu kungenxa yengcindezi ekhuphukayo yemikhumbi yesitho. Azikho izimpawu zomtholampilo ezithile zokuxinana ngalesi sikhathi, ezinye iziguli zikhononda ngokwanda ngezikhathi ezithile komfutho wegazi (BP), ikakhulukazi ekuseni. Lezi zigaba ezintathu ezingenhla ze-nephropathy zithathwa njengezingabonakali, okungukuthi, izibonakaliso zangaphandle nezizenzakalelayo zezinkinga azitholakali, futhi izinguquko ekuhlaziyeni zitholwa kuphela ngesikhathi sokuhlolwa okuhleliwe noma okungahleliwe kwamanye ama-pathologies.

Isigaba sesine

Ngemuva kweminyaka engu-15 ukuya kwengama-20 kusukela ekuqaleni kwesifo sikashukela, kuvela isifo sikashukela esinzima. Ekuhlolweni komchamo, usungavele uthole inani elikhulu lamaprotheni atholakala, kanti egazini kukhona ukushoda kwale nto.

Ezimweni eziningi, iziguli ngokwazo zinaka ukuthuthukiswa kwe-edema. Kuqala, ukuzwela kuyanqunywa emilenzeni engezansi nasebusweni, ngokuqhubeka kwesifo, i-edema iba nkulu, okungukuthi, yemboza izingxenye ezihlukene zomzimba. I-Fluid iqongelela emgodini wesisu nesifuba, e-pericardium.

Ukuze kulondolozwe izinga elifunekayo leproteyini emangqamuzaneni egazi, umzimba womuntu usebenzisa izindlela zokucindezela, lapho uvulelwa, uqala ukudiliza namaprotheni akhe. Ngasikhathi sinye, ukulahleka kwesisindo okuqinile kwesiguli kuyabhekwa, iziguli zikhononda ukoma okunzima, ukukhathala, ukozela, nokudla kuyancipha. Ukushoda komoya, izinhlungu enhliziyweni zijoyina, cishe kuwo wonke umfutho wegazi ufinyelela amanani aphezulu. Ekuhlolweni, isikhumba somzimba sibunjiwe, sinamathambo.

Isigaba sesihlanu

- Uremic, kuyaphawulwa futhi njengesigaba esibulalayo sezinkinga. Imikhumbi eyonakalisiwe icishe ihlolwe ngokuphelele futhi ayenzi umsebenzi wayo oyinhloko. Zonke izimpawu zesigaba esedlule zanda kuphela, kukhishwa inani elikhulu lamaprotheni, ingcindezi icishe njalo inyuke kakhulu, i-dyspepsia iyakhula. Izimpawu zobuthi ezinobuthi ezenzeka ngenxa yokwephulwa kwezicubu zomzimba zinqunywa. Kulesi sigaba, kuphela ukucwilisa kanye nokufakelwa kwento engenzi lutho okusindisa isiguli.

Izimiso eziyisisekelo zokwelashwa

Zonke izindlela zokwelapha ekwelapheni i-nephropathy yesifo sikashukela zingahlukaniswa izigaba eziningana.

Isigaba sokuqala siphathelene nezindlela zokuvimbelaokuhloswe ngalo ukuvimbela ukuthuthukiswa kwe-nephropathy yesifo sikashukela. Lokhu kungatholakala ngenkathi kugcinwa izinga elifanele likashukela egazini, okungukuthi, isiguli kusukela ekuqaleni kwesifo sikashukela kufanele siphuze imishanguzo ebekiwe bese silandela ukudla. Lapho uthola i-microalbuminuria, kuyadingeka futhi ukuthi ngaso sonke isikhathi kugadwe noshukela egazini futhi ufinyelele ekwehlisweni kwalo okudingekile. Kulesi sigaba, ukuhlangana kwezinkinga kuvame ukuholela ekwandeni kwengcindezi yegazi, ngakho-ke isiguli sinqunyelwe ukwelashwa kwe-antihypertensive. Imvamisa, i-Enalapril ibekelwa kumthamo omncane ukunciphisa umfutho wegazi.

Esigabeni se-proteinuria Umgomo oyinhloko wokwelapha ukuvimbela ukwehla okusheshayo kokusebenza kwezinso. Kuyadingeka ukugcina ukudla okuqinile okunomkhawulo wamaprotheni we-0.7 kuya ku-0.8 amagremu ngekhilogremu ngayinye yesisindo sesiguli. Uma umthamo wamaprotheni uphansi, ukubola kwento yayo uqobo kuzoqala. Ngokufaka esikhundleni, iKetosteril inqunyelwe, kuyadingeka ukuqhubeka nokuthatha izidakamizwa ze-antihypertensive. Futhi, ama-blockubulebulesi e-calcium tubule kanye ne-beta-blockers - i-Amlodipine noma iBisoprolol - anezelwa kwezokwelapha. Nge-edema enzima, ama-diuretics anqunyiwe, umthamo wawo wonke uketshezi olusetshenziswayo ubhekwe njalo.
Esigabeni esibulalayo kusetshenziswa ukwelashwa okufakwa esikhundleni, i.e. dialysis kanye ne-hemodialysis. Uma kungenzeka, ukufakelwa kwesitho kwenziwa. Yonke inkimbinkimbi yokwelashwa okubonakalayo, i-detoxification therapy inqunyelwe.

Ngesikhathi senqubo yokwelashwa, kubalulekile ukucindezela isigaba sokukhula kwezinguquko ezingenakulungiswa emithanjeni yezinso ngangokunokwenzeka. Futhi lokhu kuncike esigulini uqobo, okungukuthi, ekuthobeleni kwakhe imiyalelo yodokotela, ekudleni okuqhubekayo kwemithi enciphisa ushukela, ekulandeleni ukudla okunqunyelwe.

Ukudla i-nephropathy yesifo sikashukela

Esigabeni se-microalbuminuria, okungukuthi, lapho kuqhamuka inani elincane lamaprotheni kumchamo, isiguli kufanele siqale ukulandela ukudla. Ukudla okunamaphrotheni aphansi nosawoti okungenawo usawoti kukhonjisiwe ukusetshenziswa. Kuyadingeka ukunciphisa umkhawulo wokudla kwe-phosphorus, amaprotheni ezilwane, usawoti. Udinga futhi ukulandela imigomo yokudla okunempilo ekhonjiswe ekuthuthukisweni kwesifo sikashukela. Ukudla okuvinjelwe usawoti kuyadingeka ikakhulukazi kumfutho wegazi ophakeme.

Ukwelashwa okungapheli kwe-nephropathy yesifo sikashukela kusetshenziselwa izinguquko ezishiwo ezinso nasezigabeni ezibulalayo. Ngesikhathi ukwelashwa esibhedlela, odokotela bakhetha wonke amaqembu ezidakamizwa ezidingekayo ukwehlisa ushukela futhi bathuthukise ukusebenza kwezinso. Kubalulekile nokuthi isiguli sikhethe ukudla okufanele kakhulu.

Ukuvimbela

Izindlela eziyinhloko zokuvikela isifo sikashukela yisinxephezelo esanele sesifo sikashukela. Okusho ukuthi, ushukela waluphi uhlobo lwesifo sikashukela kufanele lube yinto evamile. Isidingo sokulandela ukudla futhi okubandakanya imfundo yezomzimba kuleli cala akuxoxwa ngaso. Kodwa-ke, kufanelekile ukukhuluma ngekhwalithi ye-insulin ejova.

Ucwaningo lobudlelwano obuphakathi kwesifo sikashukela kanye nekhwalithi ye-insulin yokulimala yenziwa njalo, kepha imiphumela yayo ayaziswa. Lokhu kwenzeka ngoba lezi zifundo zifakazela ukuthi i-insulin engcono futhi ehlanza kakhulu, yehlisa ingozi yezinkinga zesifo sikashukela, futhi, ngenxa yalokho, isikhathi eside kakhulu sesikhathi sabanesifo sikashukela. Lolu lwazi lufihliwe, ngoba luthinta izintshisekelo zezentengiso zezakhiwo ezinamandla amakhulu. Ngemuva kwakho konke, i-insulin esezingeni eliphansi ishibhile kakhulu.

Isibikezeli

Iziguli ezinesifo sikashukela i-mellitus kufanele ziqonde ukuthi ukubonwa kwe-microalbuminuria kuphela okuyosivumela ukuthi siphathe ukwelashwa nokuvimbela ngesikhathi ukuze sinciphise ingozi yezigaba ezibangelwa yi-nephropathy. Kulesi sigaba, into ebaluleke kunazo zonke okufanele yenziwe ukuthatha izidakamizwa ezokwehlisa ushukela nokulawula amazinga kashukela egazini. Uma ulandela konke lokhu futhi ugcina ukudla okukhethekile, khona-ke ingozi yokuthola ubunzima obukhulu ezinsweni izoba mincane.

Esigabeni sokukhula kwezimpawu zokwelashwa, ukungabi khona kokwehluleka kwezinhlungu okungamahlalakhona kuqondile ngokuncike ekunamatheleni ekwelashweni kanye nasekudla okufanele. Esigabeni esibulalayo, impilo yesiguli isekelwa kuphela yi-periodic dialysis noma i-organ replacement.

I-nephropathy yesifo sikashukela ngeke yenzeke njengengxaki yesifo sikashukela uma umuntu kusukela ekuqaleni kokukhulisa ushukela wegazi ezohlala elashwa futhi alandele imigomo yokudla okufanele. Iziguli ezinesifo sikashukela kwesinye isikhathi ziphila isikhathi eside kakhulu kunontanga bazo abanempilo, futhi kunezibonelo eziphoqayo zalokhu.

Ukukhetha kanye nokuqokwa nodokotela:

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