I-retinopathy yesifo sikashukela: izigaba, izimpawu nokwelashwa

I-retinopathy yesifo sikashukela - ukulimala kwemikhumbi ye-retina yeso. Le yinkinga yesifo sikashukela ebucayi futhi esivame kakhulu, engaholela ekungaboni. Izinkinga zokubukwa zibonakala ku-85% yeziguli ezinesifo sikashukela sohlobo 1 esinolwazi lweminyaka engama-20 noma ngaphezulu. Lapho kutholakala isifo sikashukela sohlobo 2 kubantu abaneminyaka ephakathi nendawo ubudala, kanti-ke emacaleni angaphezu kwangama-50, ngokushesha bathola ukulimala emithanjeni enikeza igazi emehlweni. Izinkinga zesifo sikashukela ziyimbangela evame kakhulu yamacala amasha okubumpumputhe kubantu abadala abaneminyaka engama-20 kuye kwengama-74. Kodwa-ke, uma uhlolwa njalo yi-ophthalmologist futhi uphathwe ngenkuthalo, khona-ke ngamathuba aphezulu uzokwazi ukugcina umbono.

Esikhathini esisekupheleni, izinkinga ze-retinal zisongela ukulahlekelwa ngokuphelele kombono. Ngakho-ke, iziguli ezine-proliferative diabetesic retinopathy zivame ukubekelwa i-laser coagulation. Lokhu ukwelashwa okungabambezela ukuqala kobumpumputhe isikhathi eside. Iphesenti enkulu kakhulu yesifo sikashukela inezimpawu ze-retinopathy zisencane kakhulu. Ngalesi sikhathi, lesi sifo asibangeli ukukhubazeka okubukwayo futhi sitholakala kuphela lapho sihlolwa ngudokotela wezifo zamehlo.

Njengamanje, isikhathi sokuphila kweziguli ezinesifo sikashukela sohlobo 1 nohlobo 2 siyakhula ngoba ukufa kwabantu ngenxa yezifo zenhliziyo kuyehla. Lokhu kusho ukuthi abantu abaningi bazoba nesikhathi sokuthuthukisa isifo sikashukela. Ngaphezu kwalokho, ezinye izinkinga zesifo sikashukela, ikakhulukazi isifo sikashukela sonyawo nesifo sezinso, zivame ukuhambisana nezinkinga zamehlo.

Izimbangela zezinkinga zamehlo ezinesifo sikashukela

Izindlela eziqondile zokwenza ngcono i-retinopathy yesifo sikashukela azikasungulwa. Njengamanje, ososayensi bahlola imiqondo ehlukahlukene. Kepha kwiziguli, lokhu akubalulekile kangako. Into esemqoka ukuthi izici zobungozi sezivele zaziwa ngokunembile, futhi ungazenza ngokulawulwa.

Ithuba lokuthola izinkinga zamehlo ngesifo sikashukela lenyuka ngokushesha uma:

• ushukela ophakeme wegazi ophakeme;
• umfutho wegazi ophakeme (umfutho wegazi ophakeme);
• ukubhema
• isifo sezinso
• ukukhulelwa
• isakhi sofuzo;
• ubungozi be-retinopathy yesifo sikashukela bukhuphuka nobudala.

Izici eziyingozi ezinkulu ushukela wegazi ophakeme kanye nomfutho wegazi ophakeme. Zingaphambi kwazo zonke ezinye izinto ohlwini. Kubandakanya lezo isiguli ezingakwazi ukuzilawula, okungukuthi, izakhi zofuzo zazo, ubudala kanye nesikhathi sikashukela.

Okulandelayo kuchaza ngolimi oluqondakalayo ukuthi kwenzekani nge-retinopathy yesifo sikashukela. Ochwepheshe bazothi lokhu kungukuhumusha okulula kakhulu, kepha kwiziguli kwanele. Ngakho-ke, imithambo emincane igazi eligeleza iye kuyo ibhujiswa ngenxa yoshukela egazini, umfutho wegazi ophakeme nokubhema. Ukulethwa komoya-mpilo kanye nezakhamzimba kuyawohloka. Kepha i-retina isebenzisa umoya-mpilo kanye noshukela ngokweyunithi ngalinye lesisindo kunanoma iyiphi enye izicubu emzimbeni. Ngakho-ke, izwela kakhulu ekunikezelweni kwegazi.

Ephendula ukulamba kwe-oksijini kwezicubu, umzimba ukhula ama-capillaries amasha ukubuyisela ukuhamba kwegazi emehlweni. Ukudlondlobala ukwanda kwama-capillaries amasha. Isigaba sokuqala, esingelona ukwanda, isigaba se-retinopathy yesifo sikashukela sisho ukuthi le nqubo ayikaqali. Ngalesi sikhathi, izindonga zemithambo yegazi emincane ziyawa kuphela. Ukubhujiswa okunjalo kubizwa ngokuthi yi-microaneurysms. Ukusuka kubo kwesinye isikhathi igazi nokugeleza kwegazi kuya e-retina. Imicu yemithambo ku-retina ingaqala ukuvuvukala kanti nengxenye emaphakathi ye-retina (macula) nayo ingaqala ukuvuvukala. Lokhu kwaziwa ngokuthi i-macular edema.

Isigaba esandayo sesifo sikashukela - kusho ukuthi ukwanda kwemikhumbi emisha sekuqalile, ukufaka okunye kwalabo abonakele. Imithambo yegazi engajwayelekile ikhula kwi-retina, futhi kwesinye isikhathi imithambo emisha ingakhula ibe ngumzimba we-vitreous - into esobala efana ne-jelly egcwalisa maphakathi neso. Ngeshwa, imikhumbi emisha ekhulayo ayisebenzi kahle. Izindonga zazo zintekenteke kakhulu, futhi ngenxa yalokhu, ukuphuma kwegazi kuphindaphindeka kaningi. Izicucu zegazi ziyanqwabelana, amafomu izicubu zomzimba, i.e. izibazi endaweni yamathishu.

I-retina ingelula futhi ihlukanise ngemuva kweso, lokhu kubizwa ngokuthi ukunqatshwa kwe-retinal. Uma imithambo yegazi emisha iphazamisa ukugeleza okujwayelekile koketshezi kusuka esweni, khona-ke ingcindezi esehlwini lamehlo ingakhuphuka. Lokhu kuholela ekulimaleni kwe-opic nerve, ethwala izithombe emehlweni akho ziye ebuchosheni. Kulesi sigaba kuphela lapho isiguli sinezikhalazo ngokubona okufiphele, umbono ongemuhle wobusuku, ukuhlanekezela kwezinto, njll.

Uma wehlisa ushukela wegazi lakho, bese uligcina ngokuqinile lijwayelekile futhi lilawula ukuze umfutho wegazi wakho ungeqi ngo-130/80 mm Hg. Ubuciko., Khona-ke ingozi yokungagcini nje nge-retinopathy, kodwa futhi nazo zonke ezinye izinkinga zesifo sikashukela ziyancishiswa. Lokhu kufanele kukhuthaze iziguli ukuthi zenze ngokweqiniso izindlela zokwelapha.

Isigaba sikashukela I-retinopathy

Ukuqonda ukuthi izigaba ze-retinopathy zesifo sikashukela ziyehluka kanjani nokuthi kungani izimpawu zayo zivela, kufanele uqonde kancane ukuthi yiziphi izingxenye zesimo sabantu esiziqukethe nokuthi zisebenza kanjani.

Ngakho-ke, imisebe yokukhanya iwela iso. Emva kwalokho, baphinda baphinde balale kulensi futhi bagxile ku-retina. I-retina ingumugqa wangaphakathi wamehlo onamaseli we-photoreceptor. Lawa maseli ahlinzeka ukuguqulwa kwemisebe yokukhanya ibe iziphikiso zezinzwa, kanye nokusebenza kwayo okuyinhloko. Kwi-retina, isithombe siqoqwa bese sidluliselwa ku-opic nerve, bese sidlulela ebuchosheni.

I-vitreous yinto ebonakalayo phakathi kwe-lens ne-retina. Imisipha yeso inamathele esweni, eqinisekisa ukuhamba kwayo kuyo yonke imikhondo .. E-retina kunendawo ekhethekile lapho ilensi igxila kuyo. Ibizwa ngokuthi i-macula, futhi le ndawo ibaluleke kakhulu ukuxoxa nge-retinopathy yesifo sikashukela.

Ukuhlukaniswa kwe-retinopathy yesifo sikashukela:

1. isigaba sokuqala esingesona esandayo;
2. okulondekile;
3. iyanda
4. isigaba sezinguquko zokugcina ku-retina (ukuphela).

Ku-retinopathy yesifo sikashukela, imithambo yegazi ephakela i-retina iyathinteka. Abancane kakhulu kubo - ama-capillaries - bahlupheka kuqala, esigabeni sokuqala sesi sifo. Ukuvuleka kwezindonga zabo kuyanda, kuvela izikhala zokungena kwenhliziyo. I-edema ye-retinal iyakhula.

Esigabeni sokulungiselela, kunezinguquko eziningi ku-retina. Lapho ihlolwa ngudokotela wezifo zamehlo, imithambo yemithambo eminingi yokuphefumula, ukugcwala koketshezi, izizinda ze-ischemic, okuwukuthi, lapho ukugeleza kwegazi kuphazamiseka khona futhi “bayalamba” nokuthi “bayabulawa”, kuyabonakala. Kakade ngalesi sikhathi, inqubo ithwebula isifunda se-macula, futhi isiguli siqala ukukhononda ngokuncipha kwe-acuity ebonakalayo.

Isigaba esikhulayo se-diabetesic retinopathy - sisho ukuthi imithambo yegazi emisha yaqala ukukhula, izama ukufaka okunye kwalabo abonakele. Ukudlondlobala ukwanda kwezicubu ngokukhula kwamaseli. Imithambo yegazi ikhula, ikakhulukazi, emzimbeni we-vitreous. Ngeshwa, imikhumbi emisha eyakhiwe ayintekenteke kakhulu, futhi ukuphuma kwegazi okuvela kuyo kwenzeka kaningi kakhulu.

Esigabeni sokugcina, umbono uvame ukuvimba ukuphuma kwesibindi kwe-vitreous hemorrhages. Amafomu amaningi kakhulu okuqalwa kwegazi, futhi ngenxa yawo i-retina ingelula, ifike ekunqatshweni (ukuxoshwa). Ukulahleka ngokuphelele kombono kwenzeka lapho ilensi ingasakwazi ukugxila ukukhanya ku-macula.

Izimpawu nokuhlolwa kwezinkinga zokubukwa kwesifo sikashukela

Izimpawu ze-retinopathy yesifo sikashukela ukuncipha kwe-acuity ebonakalayo noma ukulahleka kwayo okuphelele. Zivela kuphela lapho inqubo isivele isihambile kakhulu. Kepha lapho uqala ukwelashwa, kuzoba isikhathi eside ukwengeza umbono. Ngakho-ke, ngesifo sikashukela, kubalulekile kakhulu ukuthi uhlolwe nodokotela wezifo zamehlo okungenani isikhathi esisodwa ngonyaka, futhi okungenani isikhathi esingu-1 ezinyangeni ezi-6.

Kungcono ukuthi i-ophthalmologist enolwazi ekuxilongeni nasekuphatheni i-retinopathy yesifo sikashukela isebenza nawe. Odokotela abanjalo kufanele bafunwe ezikhungweni zezokwelapha ezikhethekile zabaneshukela.

I-alphithalmologist yokuhlolwa kwe-algorithm yesiguli esinesifo sikashukela:

1. Hlola izinkophe kanye neso.
2. Yenza i-visiometry.
3. Hlola izinga lokucindezelwa kwe-intraocular - kunqunywa isikhathi esingu-1 ngonyaka kwiziguli ezinesifo sikashukela seminyaka eyi-10 noma ngaphezulu.
4. I-Biomicroscopy yeso elingaphandle.

Uma izinga lokucindezela kwe-intraocular livumela, khona-ke izifundo ezingeziwe kufanele zenziwe ngemuva kokunwetshwa komfundi:

1. I-Biomicroscopy ye-lens kanye namahlaya e-vitreous kusetshenziswa isibani esishayayo.
2. Phindisela futhi uqondise i-ophthalmoscopy - ngokulandelana ukusuka enkabeni kuya kwengozi eyedlulele, kuwo wonke ama-meridians.
3. Ukuhlolwa kahle kwe-disc ye-opic kanye nesifunda se-macular.
4. Ukuhlolwa komzimba we-vitreous ne-retina usebenzisa isibani se-slit usebenzisa ilensi enamaglasi amathathu we-Goldman.
5. Ukuthatha izithombe i-fundus usebenzisa ikhamera ejwayelekile noma ikhamera engeyona eyami.
6. Rekhoda imininingwane etholakele bese uyifaka kungobo yomlando.

Izindlela ezibucayi kakhulu zokuthola i-retinopathy yesifo sikashukela izithombe ze-stereoscopic fundus kanye ne-fluorescein angiography.

Ukwelashwa Kwe-Diabetesic retinopathy

Silandela eduze izindaba emkhakheni wezokwelapha i-retinopathy yesifo sikashukela. Imininingwane mayelana nokwelashwa okusha ingavela nsuku zonke. Ufuna ukwazi izindaba ezibalulekile ngaso leso sikhathi? Bhalisela i-imeyili yethu incwadi yezindaba.

Izigaba zokuxilongwa nokwelashwa:

Ukwelashwa kwe-retinopathy yesifo sikashukela kuqukethe imisebenzi elandelayo:

• I-Laser coagulation (i-cauterization) ye-retina.
• Ukufakwa entanjeni yeso - ukwethulwa kwemithi elwa nokukhula kwe-anti-VEGF (vascular endothelial grow factor) - inhibitors of endothelial vas factor grow factor. Lona umuthi obizwa ngokuthi yi-ranibizumab. Le ndlela yaqala ukusetshenziswa ngo-2012, lapho kwenziwa izivivinyo ezazikhombisa ukusebenza komuthi. Udokotela wamehlo angabeka leyo mijovo ngokuhlanganiswa nokwenziwa kwe-laser ye-retina noma ngokuhlukile.
• IVitrectomy ene-endolasercoagulation - uma izindlela ezibalwe ngenhla zisize kabi.

Kubalulekile! Namuhla, ucwaningo selufakazele ngokuqiniseka ukuthi azikho izidakamizwa ezisetshenziswa “njenge-vascular”, njengama-antioxidants, ama-enzyme namavithamini. Ukulungiselela okufana ne-caviton, trental, dicinone akusanconywa. Bakhulisa ubungozi bemiphumela emibi kuphela, futhi bangabi nomthelela omuhle ezinkingeni zamehlo kushukela.

I-Laser Photocoagulation ne-vitrectomy

I-Laser Photocoagulation "i-cauterization" ehlosiwe ye-retina ukumisa ukukhula kwemithambo yegazi emisha. Lokhu kuyindlela ephumelelayo yokwelapha isifo sikashukela. Uma i-laser coagulation yenziwa ngesikhathi nangendlela efanele, khona-ke lokhu kungazinza inqubo emaphathini angama-80-85% ezimweni ezise-prolliferative nase-50-55% yamacala esigaba esandayo se-retinopathy.

Ngaphansi kwethonya lokuqubuka kwe-laser, imithambo yegazi "eyengeziwe" ye-retina iyafudumala, negazi ligxibilike kuyo. Kamuva, le mikhumbi iphathisiwe yagcwala izicubu ezinama-fibrous. Le ndlela yokwelashwa ivumela ukulondolozwa kombono ezigabeni zakudala ze-retinopathy yesifo sikashukela ku-60% yeziguli iminyaka engu-10-12. Isiguli kufanele sixoxe ngale ndlela ngokuningiliziwe nodokotela wakhe wezifo zamehlo.

I-Ophthalmic Laser Photocoagulator

Ngemuva kokuvela kokuqala kwe-laser, kubaluleke kakhulu ukuthi uhlolwe ngokulandelayo ngudokotela wezifo zamehlo futhi, uma kunesidingo, izikhathi ezengeziwe zokuvezwa kwe-laser. Udokotela uvame ukunquma ukuhlolwa kokuqala ngemuva kwenyanga eyi-1, kanye nezivivinyo ezilandelayo njalo ezinyangeni eziyi-1-3, kuye ngezimpawu zomuntu ngamunye.

Kungalindeleka ukuthi ngemuva kokuqubuka kwe-laser, umbono wesiguli uzoncipha kancane, usayizi wensimu yakhe uzoncipha, nombono wobusuku uzoba mkhulu. Lapho-ke isimo siyazinza isikhathi eside. Kodwa-ke, kungenzeka ukuthi kube nezinkinga - ama-hemorrhages aphindekile emzimbeni we-vitreous, ongaba yize ngokuphelele.

Kulokhu, isiguli singabekwa i-vitrectomy. Lokhu kungukuhlinzwa okwenziwa ngaphansi kwe-anesthesia ejwayelekile. Kuqukethe ukusika izicubu ze-retina, kususa umzimba we-vitreous futhi esikhundleni sawo kungenziwa isixazululo. Uma ukwenqatshwa kwe-retinal kwenzeka, khona-ke kubuyiselwa endaweni yayo. Izimbambo ezivelile ngemuva kokukhubazeka kwe-vitreous hemorrhages nazo ziyasuswa. Ngemuva kwe-vitrectomy, umbono uvuselelwa ku-80-90% yeziguli. Kepha uma kukhona ukwenqatshwa okubonakalayo, khona-ke amathuba okuphumelela aphansi. Kuya ngesikhathi sokunqatshwa kanye ne-avareji engu-50-60%.

Uma isiguli sine-glycated hemoglobin> i-10% kanye ne-prrolopative noma proliferative diabetesic retinopathy iyatholakala, khona-ke i-laser coagulation inikezwa ngokushesha, ngaphandle kokulinda ukuthi yimiphi imiphumela ezoba yimizamo yokulawula ushukela wegazi. Ngoba ezimweni ezisezingeni eliphakeme, ubungozi bokungaboni bungaphezulu kakhulu. Ezigulini ezinjalo, ushukela kufanele wehliswe kancane futhi kuphela ngemuva kokuthi ukwenziwa kwe-laser kwenziwe ngokuphelele.

Izinkomba ze-vitrectomy:

• Ukuqina kwe-vitreous hemorrhage, engaxazululi isikhathi esingaphezu kwezinyanga ezi-4-6.
• Ukudonswa kwethoni yokuxosha.
• Izinguquko ze-inveterate fibrous emzimbeni we-vitreous.

I-retinopathy yesifo sikashukela: okutholakele

Ngomgomo wokwelapha i-retinopathy yesifo sikashukela, akunangqondo manje ukuthatha noma yimuphi umuthi we-vascular. Indlela ephumelela kakhulu ukwehlisa ushukela wegazi nokugcina ngokuqinile amanani ayo ajwayelekile. Indlela engcono yokufeza lokhu ukudla izakhamzimba ezinciphile, ugxile ekudleni okuqukethe amaprotheni namafutha emvelo anempilo.

Sincoma izindatshana zakho zokunaka:

• Indlela enhle yokwehlisa ushukela wegazi futhi ugcine ijwayelekile;
• Ama-insulin nama-carbohydrate: iqiniso okufanele ulazi.

Siyethemba leli khasi le-retinopathy yesifo sikashukela liwusizo ezigulini Into esemqoka ukuvakashela njalo i-ophthalmologist. Kuyadingeka ukuthi kuhlolwe i-fundus ngokwanda komfundi egumbini elimnyama, kanye nokukalwa kwengcindezi ye-intraocular.

Kukangaki udinga ukuvakashela i-ophthalmologist nesiguli sikashukela?

Ukugcina umbono ngesifo sikashukela kungokoqobo!

Qiniseka ukuthi uthenge iqapha lomfutho wegazi futhi ulinganise umfutho wegazi lakho kanye ngeviki, kusihlwa. Uma unokwanda - bonisana nodokotela onolwazi ukuthi ungakwenza kanjani ngokwejwayelekile.Sine-athikili eningilizayo futhi ewusizo, "Umfutho wegazi ophezulu ku-Diabetes." Uma umfutho wegazi ophakeme ungalashwa, khona-ke izinkinga zemibono ziseduze nje ekhoneni ... futhi ukuhlaselwa yisifo senhliziyo noma unhlangothi kungenzeka ngisho nangaphambilini.