Izehlakalo zesifo sikashukela zikhula ngokuqhamukayo, okusivumela ukuthi sikubize ngokuthi ubhubhane lomhlaba wonke. Kuzo zonke iziguli, 90% ziwuhlobo 2 lwesifo sikashukela, esidala ukukhuluphala, ukusebenza komzimba ophansi kanye nokuqagela izakhi zofuzo.
Izici ezifanayo zinomthelela ekwakhekeni kwezifo zenhliziyo, izinso, amanyikwe. Ukuvela kwezifo ezihambisanayo kwisifo sikashukela i-mellitus kubhebhethekisa isimo seziguli.
Isifo sikashukela sinciphisa izinqubo zokuphinda zenziwe emzimbeni futhi zivikeleke emzimbeni, ukuzivikela komzimba. Kulokhu, ukwelashwa kwanoma yisiphi isifo kufanele kuhambisane nokwelashwa kwe-hypoglycemic.
Isifo sikashukela nesifo senhliziyo
Indima yesifo sikashukela i-mellitus nezifo zezitho zangaphakathi ekwandiseni ukushona kweziguli esezikhulile ibonakala kakhulu kwi-vascular pathology. Ukuhlaselwa yisifo senhliziyo kanye nokushayiswa kweziguli ezinesifo sikashukela kukhula izikhathi ezingama-6 kunakwezinye izigaba zeziguli.
Izici zobungozi zesifo senhliziyo, ezinjenge-arterial hypertension, ukukhuluphala ngokweqile, kanye nokulimala kwe-lipid metabolism kuma-diabetesics kuvame kakhulu. Isifo sikashukela uqobo siyinto eyingozi yokuqhekeka kwe-myocardial infarction in coronary isifo senhliziyo (CHD).
Iningi labaphethe izinhliziyo nabasebenza nge-endocrinologists babona isifo sikashukela njenge-ischemia yenhliziyo. Ngakho-ke, lapho uhlola iziguli ezinesifo sikashukela, kuyinkimbinkimbi eyengeziwe yezifundo zenhliziyo nezinkomba ze-metabolism yamafutha, ngisho nangaphandle kwesithombe somtholampilo wesifo senhliziyo.
Izimbangela zokuthuthuka kwezifo zenhliziyo nezemithambo kushukela yilezi:
- I-Hypercholesterolemia - ukwanda kwe-cholesterol nge-1 mmol / l kwandisa ingozi yesifo senhliziyo ngamaphesenti angama-60.
- Yehlise lipoprotein ephezulu yegazi
- I-Hyperglycemia kanye ne-hemoglobin ye-glycosylated.
- Ukwanda kwengcindezi yegazi ngo-10 mm. Hg. Ubuciko. kwenyusa ubungozi besifo senhliziyo esi-15%.
- Ukubhema kukhulisa i-vasology pathology ngo-41% maqondana nabangabhemi.
Ukuqondiswa okuyinhloko kokuvinjwa kwezifo zenhliziyo nezemithambo ukwehlisa ushukela wegazi kuye ku-5-7 mmol / l, ngemuva kwamahora amabili kuya ku-10. Ngaphezu kwalokho, i-glycosylated hemoglobin akufanele ibe ngaphezu kwe-7%. Lokhu kungatholakala ngokuqapha njalo kwamazinga kashukela kanye nokusetshenziswa kokudla okunenkomba ye-glycemic ephansi.
Inhloso yezidakamizwa ezinciphisa ushukela kufanele yenziwe kucatshangelwa imiphumela yazo emibi ohlelweni lwezinhliziyo (Glibenclamide, Tolbutamide, Chlorpropamide). Iziguli ezingeke zinxephezelwe ngamathebulethi kashukela ziboniswa i-insulin zombili ekwelashweni okuhlanganisiwe nanjengesidakamizwa esiyinhloko.
Umfutho wegazi kufanele ugcinwe ezingeni elingaphansi kwe-130/80 mm RT. Ubuciko. Izinkomba ezinjalo zinciphisa kakhulu ingozi yokuqunjelwa kwe-myocardial kanye nokushaywa unhlangothi, kanye nokufa kwabantu nokukhubazeka kweziguli.
Inhloso yezidakamizwa ukwehlisa ingcindezi ezigulini ezinesifo sikashukela kufanele isusele kumthelela wazo kuma-carbohydrate kanye nama-metabolism wamafutha, ukuvikela izicubu zezinso futhi kungathinti ukubonakaliswa kwe-hypoglycemia. Lokhu, amaqembu alandelayo wezidakamizwa asetshenziswa:
- Ama-inhibitors e-ACE (angiotensin-converting enzyme) anqunywa lapho kuvela amaprotheni kumchamo, ukusetshenziswa kwawo kunciphisa ubungozi besifo sikashukela sohlobo 2 (ukukhulisa ukuzwela kwe-insulin. Lokhu kufaka phakathi: i-Enap, iRamipril, iLisinopril, neCaptopril).
- Ama-Angiotensin receptor blockers 2. Thwala izakhiwo zeqembu langaphambi kwezidakamizwa, vikela izindonga zemithambo yegazi nezinso. Lezi izidakamizwa iTeveten, Aprovel, Cozaar, Lorista, Mikardis, Valsacor, Exforge.
- Ama-blocker wesiteshi se-calcium - iVerapamil, iNifidepine, iDiltiazem.
- I-Diuretics - I-Furosemide, iTrifas.
- Izithambisi ze-Imidiazoline receptor zinciphisa umsebenzi wesistimu yezinzwa enozwela futhi ngasikhathi sinye sizwele ukuzwela kwezicubu ukungena kwe-insulin. Lokhu kufaka i-Physiotens ne-Albarel.
Imvamisa, ukwelashwa okuhlanganiswa ndawonye nezidakamizwa ezivela emaqenjini ahlukene kuyasetshenziswa.
Ukwelapha i-dyslipidemia, iziguli ziyelulekwa ukuthi zinciphise amafutha ezilwane ekudleni kwazo - ingulube, iwundlu, ukucwilisa, ukhilimu omuncu omuncu, ukhilimu kanye noshizi we-cottage, kunciphisa ukusetshenziswa kwebhotela futhi ngesikhathi esifanayo kudle imifino emisha, izithelo ezingafakiwe, kufaka ne-bran, inhlanzi kanye namafutha zemifino ekudleni.
Ukuze uvikele ukuqhubeka kwesifo sikashukela nezilonda ze-vascular, kuyadingeka ukugcina izinkomba ezinjalo (ku-mmol / l): i-liproproteins ephansi kwe-2.6; phezulu - ngaphezu kwe-1.1; triglycerides - ngaphansi kuka-1.7.
Uma ukudla kungaphumelelanga ukufeza izinkomba ezinjalo, khona-ke amalungiselelo we-statin anqunyelwe ngokungeziwe: iZokor, Krestor, Liprimar.
Ukukhuluphala nesifo sikashukela
Ubudlelwano phakathi kwesifo sikashukela sohlobo 2 nokukhuluphala kuhlotshaniswa nembangela ejwayelekile yokuvela kwabo nokwanda kwezimpawu ezikhona. Indima ephakeme yobugugu nemikhuba yokudla, izinqubo ezivamile zokuthuthukisa umzimba kuholela esiphethweni mayelana nokwehla kwesisindo ngokweqile ekwelapheni isifo sikashukela.
Ukuqothuka kwamafutha kuyaqhubeka ngokuthuthukiswa kokumelana kwezicubu kwe-insulin. Lapho izinga eliphakeme lokumelana likhuphuka, i-insulin ethe xaxa ikhiqizwa ngamanyikwe, ngaleyo ndlela ikhulisa izinsalela zamafutha omzimba.
Ngaphezu kokwanda kwamafutha, ukusweleka kwe-serotonin kungadluliselwa ngofuzo. Lokhu kunomthelela wokuzwa njalo kokudangala, ukudangala, ukulangazelela kanye nendlala. Ukwemukelwa kokudla kwe-carbohydrate kuthuthukisa ukuguquguquka futhi kunciphise izimpawu ezibuhlungu okwesikhashana. Ukudla ukudla okumnandi futhi okunesitashi kukhulisa ubungozi besifo sikashukela nokukhuluphala.
Izindlela eziholayo ekusekeleni ukuphazamiseka kwe-metabolic ekudleni okungekuhle, ukudla okungajwayelekile, ukucindezela kanye nokudla ngokweqile ngemuva kwabo, ukulala nokuntuleka kokuzivocavoca umzimba.
Ngaphezu kwesici sokugcotshwa kwezimonyo, ukukhuluphala kuphazamisa ukusebenza kwezitho zangaphakathi, okuzibonakala ngesimo se:
- Isifo se-Coronary kanye ne-myocadiopathy.
- Ukuphazamiseka kokugaya ukudla - isifo se-gallstone ne-pancreatitis.
- Ukonakala kwamafutha kwesibindi.
- Izifo ezihlangene.
- Ukungabikho kokuya esikhathini kubantu besifazane.
- Yehlise i-potency emadodeni.
- Inkambo enkulu yomfutho wegazi ophakeme.
Ingozi yama-carbohydrate alula ekukhuluphele nasoshukela ukwakheka kokuncika nobunzima bokubenza banciphise ekudleni. Kwenziwa umbuthano onobunzima: izinkanuko zamaswidi - ukudla ngokweqile - ukukhuphuka koshukela egazini - ukukhishwa kwe-insulin - ukufakwa kwamakhamzimba ezitolo ezinamafutha ngokubamba iqhaza kwe-insulin - ukwehla kweglucose - isifiso sokudla amaswidi.
Enye indlela yokunqoba ukuncika kwe-carbohydrate ukuthatha ipromium picoline amaviki angama-3-4. Ngaphezu kwalokho, kusetshenziswa izidakamizwa ezinciphisa ushukela - iMetformin, iGlucobay. Iziguli ezikhiqiza kakhulu i-insulin yazo, noma zine-hyperglycemia ephezulu, azikhonjiswa ngokwelapha esikhundleni se-insulin.
Indlela ephumelela kunazo zonke yokunciphisa isisindo noshukela wegazi ukudla okune-carb ephansi. Kufaka imikhiqizo enjalo: inyama ebusayo, izinkukhu, amaqanda, ushizi. Isisekelo semenyu kufanele sibiliswe noma inhlanzi ebhakwe, ukudla kwasolwandle, imifino.
Kuyasiza kakhulu ukulungiselela amasaladi amasha kusuka kuklabishi, imifino, ukhukhamba, utamatisi kanye nopelepele obumnandi obuvela emifino.
Isibindi esinamafutha nesifo sikashukela
Isibindi esishintshiwe ekwakhekeni kwegazi - ukunqwabelana kobuthi bemvelaphi yamagciwane, yokwelapha noma ye-metabolic, kuphendula kubo ngokufakwa kwamafutha kumaseli. Inqubo enjalo ingenzeka ngesikhathi sokulamba, imifino eqinile, ukungasebenzi kahle kwamathumbu, ukudakwa kotshwala.
Ngesifo sikashukela, ukwakheka okwandayo kwemizimba ye-ketone kukhula ngenxa yokwephulwa kwe-carbohydrate metabolism. Bangakwazi buthelela izicubu zesibindi. Ama-acid amaningi athe xaxa amathumbu futhi engena ohlelweni lokujikeleza, bese engena esibindini, angathinta ukumiswa kwamafutha.
Kubantu abaphilile, ama-acid asetshenziselwa ukukhiqiza amandla, kanti ngohlobo 2 sikashukela, i-insulin, ekhiqizwa kumanyikwe ngamanani aphezulu, ivimbela le nqubo futhi ivuselele ukugcwala kwamafutha esibindini.
Ngokukhuluphala okuhambisana nesifo sikashukela, i-hepatosis enamafutha kwenzeka kaningi, futhi kungenye yezimpawu ze-dysmetabolic syndrome. Ngenxa yekhono lesibindi lokuqongelela amafutha, ukugaya kanye nokuphendula kwemithi kukhubazekile.
Izimpawu zomtholampilo ze-hepatosis enamafutha ngokuvamile aziveli. Ukwehla kwe-hypochondrium kwesokudla, okukhuliswe ukuzikhandla komzimba, kungaphazamisa. Nge-palpation, usizi lungabonakala kuphela ngokuqongelela okusheshayo kwamafutha esimweni sikashukela esibolile.
Ukuxilongwa kusekelwe kulezi zimpawu ezilandelayo:
- I-Ultrasound, i-compact tomography - isakhiwo esinamandla, ukwanda ngosayizi.
- Umsebenzi wama-enzymes wesibindi we-serum uyanda.
- Ukwanda kwe-cholesterol ne-triglycerides egazini.
Ukwelashwa kwe-hepatosis enamafutha kwenziwa ngokudla ngokufakwa kwemikhiqizo ye-lipotropic: i-oatmeal, inhlanzi, ushizi we-cottage, ukudla kwasolwandle, i-soy, i-kefir, iyogathi, uwoyela omifino ocindezelwe obandayo. Isiza ukususa ukudla ngokweqile kanye nokudla kwe-cholesterol enefayibha ne-pectin. Ngakho-ke, lokhu kudla kufanele kube imifino eminingi. Ngomkhuba wokuqunjelwa, kuyalulekwa ukufaka i-bran ezitsheni.
Emithini esetshenziswe i-hepatoprotectors - iGepabene, i-Essentiale, i-Essliver, i-Glutargin ne-Berlition.
Izifo ezithathelwanayo kushukela
Isifo sikashukela senzeka ngokuncipha kwempendulo yokuzivikela komzimba, okwenza iziguli zibe sengozini yamagciwane namagciwane, izifo zokukhunta. Izifo ezinjengalezi zibonakaliswa inkambo kaningi futhi enzima. Kulokhu, ukutheleleka kubangela ukuqunjelwa phansi kwesifo sikashukela.
Kunezifo ezithathelwanayo ezingakaze zenzeke kubantu ngaphandle kokuphazamiseka kwe-metabolic of carbohydrate - i-malitisant yangaphandle enobungozi, i-choleystatic cholecystitis, i-pyelonephritis ne-cystitis, nonyawo lwesifo sikashukela.
Iziguli ezinesifo sikashukela ziba nezifo ezithathelwanayo izikhathi ezingama-1.5 kaningi kunezinye. Lokhu kungenxa yokonakala okujwayelekile nokwasendaweni kokuvikelwa kokutheleleka. Okuvamile kufaka phakathi ukwephulwa kwemisebenzi yamaseli amhlophe egazi ukubhubhisa ama-bacterium - ukuncipha kokunyakaza, i-phagocytosis, nomsebenzi wababulala ama-T.
Izici zasendaweni zihambisana nokukhula kokulimala kwe-vascular - micro and macroangiopathy, neuropathy, okuthikameza ukuhlanzwa nokubuyiselwa kwezitho ezonakele kusuka kumagciwane kanye nobuthi bawo.
Inkambo enzima yesifo nayo yingenxa yokuphendula okungahambi kahle kuma-antimicrobial agents. Ngamazinga aphezulu we-lipoprotein, cholesterol kanye nama-acid acid, abopha emaprotheni egazi okumele izidakamizwa ziwathathe. Ngakho-ke, ezigulini ezinesifo sikashukela, ukulethwa kwama-antibiotic ku-lesion kuncishisiwe.
Isici se-pneumonia kushukela sikhulu siyingozi ye-bacteremia, eholela ekufeni. Amagciwane athela kakhulu kuma-staphylococci, Klebsiella kanye ne-streptococci. Ngokuphikisana nesizinda sokuqubuka kwezinduna, iziguli zivame ukuthuthukisa i-ketoacidosis yesifo sikashukela. Ezimweni ezinamandla, ikhambi elwa namagciwane elisebenzisa i-beta-lactams ne-fluoroquinolones liyakhonjiswa.
I-Pyelonephritis imvamisa yenzeka ngesimo sokulimala kwe-revenue. Ama-antibiotic anqunywa kuphela nge-intramuscularly noma nge-intravenly: I-Ciprofloxacin, i-Ceftriaxone, i-Levofloxacin. Qiniseka ukuthi usebenzisa izidakamizwa ezilwa nemishanguzo yokuvimbela i-candidiasis.
Ukutholwa kwasendaweni okuvame kakhulu ukutheleleka kwezicubu ezithambile unyawo lwesifo sikashukela. Lokhu kungenxa yezizathu ezinjalo:
- Yehlisa ukuzwela komonakalo.
- Izifo ezitholakala njalo fungal.
- Ukuphazamiseka kokujikeleza emilenzeni.
Lapho isilonda singenwe yilesi sifo, kunezindlela ezimbili ongazikhetha zokwenziwa kwale nqubo yokutheleleka: okungekubi (ukusikeka akusiyo ingozi) futhi kunzima, okuholela kwisidingo sokunqamula ingxenye ethintekile yesitho esingezansi.
Ifomu elithambile lenzeka ngendlela yesilonda esiyingqayizivele ngokuvuvukala kwezicubu ezingaphansi kuka-2 cm ububanzi, azikho izimpawu ezijwayelekile zokudakwa. Ukwelashwa kwesilonda nokuqokwa kwamagciwane kukhonjiswa: I-Cephalexin, iClindamycin. Ukuphathwa ngomlomo okungenzeka.
Ukutheleleka okuningana kubonakaliswa yizilonda ezijulile ngomonakalo omkhulu wezicubu ezizungezile, ukudakwa okujwayelekile, nokuncipha kokuhamba kwegazi endaweni ethintekile. Amazinga kashukela egazini ngokuvamile aphezulu. Ukukhuphela ngaphandle i-osteomyelitis, kwenziwa i-biopsy yezicubu zamathambo.
Imithi elwa namagciwane ilawulwa ngokubandakanyeka futhi i-intramuscularly: Amoxiclav, Vancomycin, Meronem. Isikhathi sokwelashwa asikho ngaphansi kwenyanga. Ngokungasebenzi kahle kwezindlela zokwelashwa ezinokulondolozwa, ukunqunywa okuyingxenye noma okuphelele kwezicubu ezithintekile kuyenziwa.
Ku-mellitus yesifo sikashukela, esinye sezifo ezivamile yi-candidiasis yesikhumba nolwelwesi lwama-mucous. Ukuthola kwasendaweni okuvame kakhulu kwizilonda zokukhunta:
- Indawo yeGroin.
- Amafolda ngaphansi kwezindlala ezincelisayo.
- Ama-Axillaries
Ngokunxeshezelwa okunganele kwesifo sikashukela i-mellitus, i-candidiasis kungenzeka ngesifo sikashukela somlomo wesibeletho ngohlobo lwamabala amhlophe, ahambisana nokuqina nokushiswa. Uma usabalale ku-esophagus, kungaba nobunzima ukugwinya. Ngokuvamile i-candidiasis ibonakaliswa endaweni yofuzo.
Ukwelashwa kwe-candidiasis kwenziwa ngokukhethekile kusetshenziselwa ukugcoba kwama-antifungal nama-suppositories kwabesifazane. Ukusetshenziswa kwendawo kuhlanganiswa nokuthatha izifundo ze-fluconazole. Ngokuthuthuka kokumelana nakho, bashintshela ku-Itraconazole noma uKetoconazole.
Impumelelo yokwelashwa ngemithi elwa namagciwane ixhomeke ezingeni lesinxephezelo sikashukela. Ezigulini ezinezifo ezithathelanayo zohlobo lwesibili sikashukela, i-insulin inqunywa ezifundweni noma idluliselwe kukho ngaphambi kokuphela kokwelashwa kwezifo ezibangelwa ukuhlangana. Ividiyo ekulesi sihloko izokhuluma ngokuphila ngesifo sikashukela.
