Isifo sikashukela i-Angiopathy

Isifo sikashukela yisifo esiyingozi, esivame ukuhambisana nezifo ezihambisana nawo. Lokhu kufaka phakathi i-angiopathy yesifo sikashukela. Kungakhathalekile ukuthi hlobo luni, isiguli singathola ubunzima obukhulu. Ngakho-ke, kubalulekile ukukhomba inkinga ngesikhathi bese uqala ukwelashwa. Kepha kulokhu kufanele unikeze impendulo yombuzo - angiopathy yesifo sikashukela: kuyini, kubonakaliswa kanjani, futhi kanjani ukubhekana nakho?

Umnyombo walesi sifo, izimbangela zentuthuko yaso kanye nezinto eziyingozi

Imikhiqizo ye-glucose metabolism ifakwe emaprotheni egazi nezicubu zomzimba. Njengoba kukhuphuka izinga likashukela emzimbeni, isimilo sabantu abahlushwa isifo sikashukela, inani lezinto ezinjalo liyanda. Ngenxa yalokhu, izicubu zomzimba ziqala ukulahlekelwa yisakhiwo sazo esedlule. Isistimu ye-vascular yomuntu ihlupheka kakhulu, ngoba izindonga zemikhumbi zithinta kakhulu i-hyperglycemia.

Nge-diabetes ye-angiopathy yamaphethelo aphansi, ukwakheka kwemikhumbi etholakala emilenzeni kuyashintsha. Ukuqina kwezindonga zabo kuyancipha, baba mkhulu. Ngenxa yalokho, i-lumen ye-vascular iyancishiswa. Kwezinye izimo, ukuvalwa kwemithambo yegazi kwenzeka. Ngenxa yazo zonke lezi zinguquko, ukulethwa kwegazi emikhawulweni engezansi kuya ngokuya kuba nzima. Ngaphezu kwakho konke, isimo esifanayo sithinta izinyawo, izingxenye ezikude kakhulu zemilenze.

Ukwephulwa kokujikeleza kwegazi kuholela indlala komoya-mpilo, ngenxa yokuthi imikhawulo engezansi ayisakwazi ukwenza imisebenzi yayo ngokugcwele.

Lokhu kuholela ekuguqukeni okuyisisekelo esikhunjeni, ukubonakala kwe-necrosis, gangrene. Ngenxa yezinguquko ezingenakuphikwa, kwesinye isikhathi kuyadingeka ukukhipha izinzwane ngazinye, unyawo luphelele, noma, ezimweni ezibucayi, lonke ilunga. I-angiopathy yesifo sikashukela ifakiwe ku-International Classization of Diseases, ikhodi yayo ye-MBK 10 yi-E10.5 ne-E11.5.

Ngokuya ngokuthi yimiphi imikhumbi ethintekile, kuhlukaniswa izinhlobo ezimbili zalesi sifo:

• i-microangiopathy - ngale ndlela yalesi sifo, kutholakala imithambo emincane (isb. capillaries);
• i-macroagniopathy - ukuguqulwa kwemikhumbi emikhulu (sikhuluma ngemithambo nemithambo yegazi).

Ukuthuthukiswa kwe-angiopathy kwenzeka nge-mellitus yesikhathi eside yesifo sikashukela. Imvamisa, izinkinga ezifana nalezi zenzeka kubantu abahlaselwa yilesi sifo iminyaka eyishumi kuya neshumi nanhlanu. Yize ukulimala kwemilenze kwenzeka ngamaphesenti angamashumi ayisikhombisa emicimbi, imikhumbi etholakala kwezinye izitho ingakhubazeka. Lokhu kusebenza emehlweni, isibindi, inhliziyo, ubuchopho.

I-Angiopathy itholakala kuphela kubantu abanesifo sikashukela. Ngaphezu kwalokho, uhlobo lwayo alubalulekile kuleli cala. Isizathu esiyinhloko futhi okuwukuphela kwaso sokuthuthuka kwalesi sifo amazinga aphakeme eglucose egazini. Ngokusobala, bonke abanesifo sikashukela basengozini. Kepha kunezici ezithile ezandisa ithuba lokuthuthukisa i-angiopathy yemikhumbi. Phakathi kwazo kukhona:

• izinga loshukela wegazi. Uma likhuphuka, lesi sifo siya ngokuya sisiba nzima;
• isikhathi sesifo sikashukela. Njengoba ukuthuthukiswa kwe-angiopathy kuhlobene ngqo nokuthi i-glucose ephakeme igcinwa egazini isikhathi esingakanani, isikhathi eside umuntu enesifo sikashukela, kuphakama nethuba lokuthola lesi sifo;
• umfutho wegazi ophakeme Kuyisici sobungozi ngenxa yomthelela waso omubi ku-microcirculation yegazi;
• ukukhuluphala Isisindo esengeziwe sithinta ukuqhubekela phambili kwezinguquko emikhunjini, ukusheshisa;
• ukusetshenziswa kukagwayi. Ngenxa yokubhema emikhunjini emikhulu, kufakwa ama-atherosselotic plaque, ama-capillaries ancishisiwe;
• umthwalo omningi / onganele emilenzeni engezansi. Ukuntuleka kokuzivocavoca umzimba, kanye nokuzikhandla ngokweqile komzimba, kukhulisa inkambo yesifo;
• ukukhuphuka kwegazi. Kubathinta kabi imithambo yegazi, kusheshiswe izinguquko zesifo sikashukela ezenzeka kuzo.

Izimpawu zesifo

Izimpawu ze-angiopathy zesifo sikashukela semikhawulo ephansi zincike ekutheni yimiphi imikhumbi ethintekile kanye nobude besifo. Inkambo ye-micro- and macroagniopathy imvamisa ihlukaniswe izigaba eziningana. Isigaba ngasinye sibonisa inani elithile lokuguqulwa emikhunjini kanye nezimpawu ezizivelelayo.

Ama-degree ayisithupha we-microangiopathy ahlukaniswa:

1. degree zero. Kubonakala ngokungabikho ngokuphelele kwezimpawu. Kulokhu, kunzima ukubona lesi sifo ngalesi sigaba sokuthuthuka, ngoba iziguli azivamile ukubonana nodokotela. Kepha ngesikhathi sokuhlolwa, uchwepheshe angabona izinguquko eseziqalile;
2. degree yokuqala. Izimpawu zokuqala zalesi sifo ziyavela kulesi sigaba. Ziqukethe ukuguqulwa komthunzi wesikhumba semilenze (kuyaphenduka upende), ukubukeka kwezilonda ezincane (ezingahambelani nokuvuvukala kwesikhumba esikuzungezile futhi akubangeli buhlungu obukhulu);
3. degree yesibili. Izilonda ziyajula. Zingathinta izicubu nemisipha. Ubuhlungu bubonakalisiwe;
4. degree yesithathu. Amasayithi wezilonda aqala ukushona (i-necrosis ivele, isakazeka phansi ekubekweni nasemaphethelweni ayo). Isikhumba esizungeze isilonda siphenduka sibomvu, ukuvuvukala kuyavela. Kwezinye izimo, iziguli zakha i-osteomyelitis (izicubu zamathambo ziqhume). Ama-Abscesses ne-phlegmon nakho kungenzeka;
5. degree yesine. Kubonakala ngokusakazeka kwe-necrosis ngaphandle kwesilonda (ezinzwaneni noma ekuqaleni kwayo);
6. degree yesihlanu. Uhlobo olwedlulele lwe-necrosis. Ifinyelela kulo lonke unyawo. Kulokhu, akunakwenzeka ukumsindisa. Kulesi sigaba, isiguli sinqunywe.

Kuhlukaniswa izigaba ezine ze-macroangiopathy:

• isigaba sokuqala. Esigabeni sokuqala se-macroangiopathy, kuqina ukuqina kwamazipho nokuqina kwezinzwane. Ngokuzivocavoca ngokomzimba, umuzwa wokukhathala emilenzeni uvuka ngokushesha. Ukunyakaza kokuqala ngemuva kokulala kuyaphoqwa. Kuvezwa “i-intermittent claudication” (njalo ngemuva kwamakhulu amahlanu kuya kwayinkulungwane amamitha). Ngaphezu kwalokho, lesi sifo sizibonakalisa ekukhukhuleni kokujuluka kwemikhawulo. Izinyawo zibamba kalula;
• 2a isigaba. Iziguli zivame ukuqina inyawo, imakhaza imilenze izwakala ngisho nangesikhathi esifudumele. Ukufakelwa isikhumba emaphethelweni kuyabonakala, ukujuluka kuyanda. "I-Intermittent claudication" ivela njalo ngamamitha angamakhulu amabili kuya kwamakhulu amahlanu;
• Isigaba 2b. Zonke izimpawu ezingenhla ziyaqhubeka, kepha i-lameness ivela ngemuva kwamamitha angamashumi amahlanu kuya kwamakhulu amabili;
• Isigaba 3a. Ezimpawu esezibonakalisiwe, kunezelwa izinhlungu, eziqina ngokuqala kobusuku. Ukugoba imilenze kuvame ukwenzeka. Kukhona umuzwa ovuthayo esikhunjeni, esivele somile futhi sibe buthaka. Imilenze iba mnyama lapho isiguli silele phansi. "Intermittent claudication" kwenzeka njalo ngamamitha angamashumi amahlanu;
• Isigaba 3b. Izinzwa zobuhlungu ziba zaphakade. Ukudumba kwemilenze kuyabonakala. Izilonda ezine-necrosis ziyavela;
• isigaba sesine. Isigaba sokugcina sesi sifo. I-Necrosis ifinyelela emilenzeni, kwesinye isikhathi kuye ezinyaweni zonke, ngenxa yokuthi izicubu zezitho ziyafa. Ngenxa yalokhu, ukutheleleka kungakhula emzimbeni, kuhambisane nobuthakathaka obujwayelekile kanye nokwanda kokushisa komzimba kwesiguli.

Uma kwenzeka kungagcinwa imithetho yokuhlanzeka komuntu siqu kanye nokuntuleka kokulawula enkambweni yalesi sifo, ukungcola okwenziwe i-angiopathy kuzongena esilondeni, ngenxa yenqubo yokutheleleka.

Uma ukutheleleka kwenzeka muva nje, futhi kungakabi nesikhathi sokukhula, ungasilungisa lesi simo ngosizo lwe-antiseptics. Nge-necrosis enkulu yezicubu zezinyawo, ilunga kuzodingeka likhishwe.

Izinqubo ezonakalisayo ezenzeka emikhunjini yamalungu azinakubuyiselwa emuva. Ukwelapha okugcwele kweziguli nakho akunakwenzeka. Ukuphela kwento umuthi wanamuhla ongayenza ukunciphisa ijubane lokukhula kwe-angiopathy. Kepha kulokhu, lesi sifo kufanele sitholakale ngokuhamba kwesikhathi, okuthikamezwa ukungabikho kwezimpawu ezivezwe kahle ezigabeni zokuqala zokukhula kwaso.

Ukuxilonga

Ukuze uthole ukuxilongwa okunembile, uchwepheshe kuzofanela enze isifo. Uzolalela izikhalazo zesiguli futhi uzomhlola. Ngaphezu kwalokho, kuzodingeka ukunquma inani le-glucose egazini nomchamo. Kulokhu, kwenziwa ukuhlaziya okukhethekile. Uzodinga futhi ukwenza ucwaningo olukhethekile:

• I-dopplerography yemikhawulo ephansi, okungukuthi, ukuhlolwa kwe-Ultra. Usebenzisa le ndlela, unganquma ijubane lokugeleza kwegazi futhi uthole amaphuzu anciphisa kuwo. I-Dopplerography futhi ikuvumela ukuthi unqume isimo semithambo. Ukuhlolwa okufanayo kuyenziwa ngempela uma isiguli sine-gangrene, isilonda se-trophic;
• i-arteriography yemikhawulo ephansi. Umnyombo wale ndlela ukuphathwa kwento ekhethekile emikhunjini, indawo lapho imikhumbi ihlolwe yi-x-ray. Ngakho-ke, ungathola ukuthi imiphi imikhumbi elimele;

Ngaphezu kwakho konke lokhu okungenhla, uchwepheshe uzokala ukukhipha kanye nengcindezi emikhunjini etholakala onyaweni, nakuma-artery atholakale ngaphansi kwedolo nasesangeni.

Ukwelashwa kwezifo

Isisekelo sokwelashwa kugcina amazinga kashukela wegazi asezingeni elijwayelekile.

Lokhu kutholakala ngokuthatha imishanguzo ekhethekile enciphisa inani le-glucose egazini futhi ikhuthaze ukukhishwa kwe-insulin. Ukwelashwa kwesifo sikashukela kwenziwa ngaphansi kokuqondisa kukadokotela. Ngaphezu kwalokho, ukubheka njalo izinga le-glucose kumchamo nasegazini kubalulekile. Phakathi kwezidakamizwa ezinciphisa ushukela, okulandelayo kungahlukaniswa:

1. I-Glibenclamide. Kuthinta kahle ukukhishwa kwe-insulin. Ngosuku lokuqala lokuphatha, thatha i-tablet eyodwa yezidakamizwa. Okulandelayo, umthamo unyuka kuqala uye kumabili, bese ufakwa kumatafula amathathu. Ukuthathwa komthamo kuncike ezingeni likashukela;
2. "Diastabol". Ivuselela ukwehlukaniswa kwama-carbohydrate ngaphambi kokuba kwakheke ushukela, ngenxa yokuthi lelo ushukela wegazi ligcinwa ezingeni elijwayelekile. Umuthi uphuzwa kathathu ngosuku, ithebhulethi elilodwa ngasikhathi (50 mg). Ukulungiswa kwedose kwenziwa ngenyanga ngemuva kokuqala komuthi;
3. Amaril. Kuthinta ukuvikelwa kwe-insulin. Ukudonswa nsuku zonke yithebhulethi eli-1 (isigidi esisodwa). Njalo emavikini amabili, umthamo uyanda (isikhathi ngasinye nge-milligram eyodwa).

Uma isiguli sine-macroangiopathy yesifo sikashukela, kunikezwa amanxusa athinta izinga le-cholesterol. Phakathi kwazo kukhona:

1. ETorvakard. Ngaphezu kokucindezela i-cholesterol synthesis, yandisa ukumelana kwemithambo yegazi. Umthamo wokuqala womuthi nsuku zonke ngamamayela ayishumi. Umthamo ojwayelekile ama-milligrams angamashumi amabili. Kwezinye izimo, ingakhushulwa ibe ngama-milligram angama-40;
2. I-Zokor. Kuthinta i-cholesterol. Umthamo ufana nakwimeko yangaphambilini. Umuthi uthathwa kusihlwa;
3. ILovasterol. Ukusetshenziswa kwomuthi kuholela ekucindezelweni kokwakhiwa kwe-cholesterol esibindini, kwehlise izinga layo egazini. Umthamo ojwayelekile ngamamayela angamashumi amabili. Uma kunesidingo, ingangezelelwa kumamayela angamashumi amane. Umuthi uphuzwa kanye ngosuku.

Ngaphezu kwalokho, isiguli singabekwa izidakamizwa ezinciphisa igazi, zithuthukise ukuhamba kwegazi, ziqinise izinqubo ze-metabolic, ama-painkiller, kanye nama-antibalas ezifweni. Uhlobo oluthile lokwelashwa luhambisana nesimo sesiguli kanye nesigaba sokuthuthuka kwalesi sifo.

Kwezinye izimo, ukuhlinzwa kungadingeka. Ukusebenza kwenziwa ku:

1. ukuba khona kwezindawo ezinomkhawulo zokunciphisa imithambo emikhulu ethintekile (ukuhlinzwa ngokweqile, i-thrombectomy, ukungenelela kwe-endovascular);
2. ukulimala okukhulu kwemithambo yegazi, ukuncipha kwabo (kulokhu, izinzwa zezinzwa ezibhekene nomsipha ziyasuswa);
3. ukuba khona kwamanxeba okuhlanza, i-phlegmon, i-necrosis yomunwe. Inhloso yokuhlinzwa ukususwa kwezicubu ezifile, ukukhipha imithambo ye-purulent. Kwezinye izimo, ukunqunywa kweminwe kwenziwa;
4. ukuthola i-gangrene. Kulokhu, ukunqunywa kwenziwa. Ngokuya ngendawo ethintekile, ilunga liyasuswa ezingeni lethanga, umlenze ophansi, ngaphambili.

Izindlela zokuvimbela

I-angiopathy yesifo sikashukela yemikhumbi yemikhawulo engezansi ayisho ukuthi umuntu angaqalwa ukwanda kwesikhumba futhi anqunywe futhi. Ngokuya ngezincomo zikadokotela nokuvimbela okufika ngesikhathi, kungenzeka ukuthi i-gangrene ingavela. Ngaleso sikhathi, cishe amaphesenti angamashumi ayisishiyagalolunye eziguli ezingazibandakanyi ekwelashweni kwesifo ngesikhathi futhi ezingashintshi indlela yazo yokuphila, ngemuva kweminyaka engu-5 ukukhula kwesifo kukhula nge-necrosis yonyawo. Kumaphesenti ayishumi, kuholela ekuthelelekeni kwegazi lesiguli nokufa.

Ukuvimbela i-angiopathy yesifo sikashukela:

• ukunamathela ekudleni okukhethekile, okubandakanya ukusetshenziswa komkhawulo kasawoti, ama-carbohydrate, ama-lipids;
• ukwenqaba imikhuba elimazayo empilweni (kokubili ngokusetshenziswa kukagwayi kanye nakuphuzo oludakayo);
• imisebenzi yemvelo ekhethiwe kahle (kusetshenzelwa iqoqo lokuzivocavoca elingayidli i-tachycardia, i-angina pectoris nezinye izifo);
• uhamba nsuku zonke emgaqweni. Ngokuncono ezindaweni ezinomoya ohlanzekile. Isikhathi sokuhamba ngakunye kufanele okungenani sibe imizuzu engama-40;
• ukulungiswa kwesisindo (sokukhuluphala);
• ukuqapha njalo kwe-cholesterol noshukela wegazi, kanye nokuqapha umfutho wegazi;
• ukugwema ukucindezelwa;
• ukuthatha amalungiselelo e-multivitamin aqinisa umzimba.

Njengoba kushiwo ngaphambili, akunakwenzeka ukwelapha lesi sifo. Kepha ngosizo lwezindlela zokuvimbela, inqubekela phambili yayo engavinjelwa.

Ngakho-ke, i-angiopathy yesifo sikashukela iholela ekunciphiseni kokuqina kwezindonga ze-vascular kanye nokwehla kwe-lumen ye-arterial. Ngenxa yalokhu, ukuhamba kwegazi okujwayelekile kuyaphazamiseka, okunciphisa ukusebenza kwezitho ezithintekile. Lesi sifo siyingqayizivele kuphela ezigulini ezinesifo sikashukela i-mellitus. Izimpawu zesifo zincike emikhunjini elimele kanye nobungako bokukhula kwesifo.

Uma kutholakala izimpawu zalesi sifo, bonisana nodokotela. Uzoxilonga futhi akhethe uhlobo lokwelashwa oluphelele. Uma ungaqali ukwelashwa, kungaba nezinkinga eziholela ekuqunjweni noma ekufeni.