Isifo sikashukela i-mellitus, kanye nodakwa, singesinye sezimbangela ezivame kakhulu ze-neuropathy. Ubudlelwano phakathi kwesilinganiso sokwanda kweglucose yegazi kanye nobunzima bokuphazamiseka kwemizwa kufakazelwe.
Ngaphezu kwalokho, kusuka kumaphesenti angama-60 kuya kwangama-90 eziguli ezihlushwa i-peripheral noma i-autonomic diabetesic neuropathy futhi nezimpawu zayo ziyanda njengoba isifo sikashukela siqhubeka.
Uma umuntu onesifo sikashukela engakutholi ukwelashwa okwenele, unyawo lwesifo sikashukela luqhamuka ngenxa yethambo eliphansi lemilenze, kuyilapho ingozi yokunqunywa kweziguli ezinesifo sikashukela inyuka cishe ngama-50% uma iqhathaniswa nabantu abangenayo i-hyperglycemia.
Ukuvela kwe-neuropathy ku-mellitus yesifo sikashukela - izimbangela kanye nomshini
Isici esihola phambili ku-neuropathy, kanye nezinye izinkinga zesifo sikashukela, ukukhulisa okuqukethwe kwe-glucose egazini elijikelezayo kanye nomphumela walo onobuthi kwizitho zomzimba. I-neuropathy yesifo sikashukela iba ngumphumela wokulimala kwezinzwa ngokwazo nemithambo yegazi ebondlayo.
I-glucose esegazini ingangena ngaphakathi kwe-nerve cell ngaphandle kokubamba iqhaza kwe-insulin, kepha ayikwazi ukufakwa kwinqubo ye-glycolysis yamandla. Kulokhu, kusetshenziswe enye indlela yokulahla, lapho kwakhiwa khona i-sorbitol.
I-Sorbitol, eqoqana ngaphakathi kweseli, iyalibhubhisa, futhi nangokubamba iqhaza kwayo kokuvimbela i-vasodilation kwenzeka. I-vasasm spasm kanye nokwehla komfutho we-oksijini kuphazamisa ukondleka kwamangqamuzana ezinzwa.
Enye indlela yokulimala kwezinzwa kushukela ukwakhiwa okwandayo kwama-radicals mahhala. Lawa ngamamolekyuli angenaphutha anomsebenzi omkhulu wamakhemikhali, onamandla okuqothula ama-enzyme, ulwelwesi lwamaseli neDNA.
Futhi, izindlela ezilandelayo zibandakanyeka ekwakhiweni kwe-neuropathy ku-mellitus yesifo sikashukela:
- Ukunamathiswa kwe-molecule ye-glucose kumaphrotheni yi-glycosylation, kufaka phakathi ulwelwesi lwezinzwa.
- I-Microangiopathy yemikhumbi yezinzwa.
- Ukufakwa kwezinzwa okulimazayo.
- Ukwakheka kwamasosha omzimba ngokumelene namaseli ezinzwa.
I-Polyneuropathy ku-mellitus yesifo sikashukela, izimpawu nokuxilongwa
Isifo sikashukela se-polyneuritis sivame ukubonakaliswa yi-lesionetrical lesion of the low decrease. Kulokhu, isikhalazo esivame kakhulu kwiziguli ukuphulwa kwemizwa. Ngokunqotshwa kwemicu emikhulu yezinzwa, umbono we-vibrate, ukuthinta kanye nesikhundla kuyahlupheka.
Imicu emincane yezinzwa inesibopho sokuzwa kobuhlungu nokushisa. Izimo eziningi ze-neuropathy zenzeka nge-pathological pain syndrome ngokumelene nesizinda sokuzwa okuncishisiwe, okungukuthi, zonke izinhlobo zemicu zithintekile.
Ukuphazamiseka kokuzwela kwesikhumba kuncike ebangeni lesinxephezelo sesifo sikashukela, kuqala ngezinzwane, bese kuba nokuthuthuka okufana “amasokisi”, “ukuwa amasheya”, kanye “namagilavu”.
Izimpawu ze-neuropathy yesifo sikashukela ziboniswa emizweni enjalo:
- Paresthesia - umuzwa wokukhasa.
- Ukungazethembi Gait.
- Izinhlungu ezivuthayo ezinyaweni, kubi kakhulu ebusuku.
- Ukulimala kwemisipha, izicubu zomzimba.
- Ukuzwela ukubanda.
Umuzwa ophazamisekile ungahlotshaniswa nokuphazamiseka kwemisebenzi yemoto ngendlela yokukhubazeka noma imisipha paresis.
Njengoba le nkinga ijwayelekile, futhi umphumela wokwelashwa uncike ekutholweni kusenesikhathi, kunconywa ukuthi zonke iziguli ezinesifo sikashukela zixilongwe okungenani kanye ezinyangeni eziyisithupha nodokotela oyi-neurologist. Ukuze kutholakale isifo, kwenziwa izivivinyo ezisebenzayo.
Ukuzimisela kobuzwela kuhlolwa ngokuthinta nge-cotton swab noma ngebhulashi elincanyana, ukubukeka okunobuhlakani kunqunywa engxenyeni yodwa, ethinta ngentambo emincane ye-nylon. Kusetshenziswa isondo lenaliti ukutadisha ukubona kobuhlungu. Ukuzwela kokushisa kunganqunywa ngedivayisi ekhethekile "Uhlobo lweThemu".
Isimo sokukhishwa, amandla emisipha kanye nomuzwa wokudlidliza nakho kuyanqunywa.
Uma ngesikhathi sokuhlolwa kwezinyawo kwembula ukulimala kwesikhumba noma ukuntuleka kokushayeka kwenhliziyo, khona-ke kufikelwa isiphetho ngomonakalo wemithambo ye-peripheral kanye ne-nerve fibers ngokwenziwa konyawo lwesifo sikashukela.
Izimpawu zonyawo lwesifo sikashukela
Imbangela evame kakhulu yokunqunywa komlenze kwisifo sikashukela yi-polyneuropathy syndrome ngokwenziwa konyawo lwesifo sikashukela. Ngokuya ngobukhona bezimpawu ezahlukahlukene, i-neuropathic, ischemic nefomu elixutshiwe lalesi sifo liyahlukaniswa.
Imvamisa, kuvezwa inguqulo ye-neuropathic yalesi sifo. Ukwephulwa kokufakwa ngaphakathi kohlelo lwezinzwa oluzimele kuholela ekuguqukeni kokujuluka, isikhumba siba mncane futhi sikhuze ngokweqile, sihlaselwe ukulimala.
Imithambo eyonakele, egcwala igazi, ihola ukuvuvukala, okuthi kancane kancane isabalale kuwo wonke umlenze ophansi. I-edema enjalo, ngokungafani ne-edema ye-cardiac, ayidlulanga ngokuqokwa kokuphumula kombhede.
Izinkinga zokudla azithinti isikhumba kuphela, kepha nama-tendon, i-ligamentous Equipmentaratus, okubangela ukuphazamiseka kwe-gait kanye nokushintshwa kwamathambo we-metatarsal ngenxa yokwabiwa kabusha komthwalo. Ukuncipha kokuzwela kobuhlungu ngesikhathi sokuzivocavoca okwalandela kuholela ekhubazekeni lesilonda esiphathelene ne-neuropathic.
Indawo ejwayelekile yibhantshi lesithupha. Isilonda siyindilinga, esivame ukutheleleka, esiyinkimbinkimbi yi-osteomyelitis. Isici sokuxilonga esivelele ukungabikho kobuhlungu.
I-neuropathy yesifo sikashukela enefomu le-ischemic ibonakala ngezici ezinjalo zokuhlukanisa:
- Ukuntuleka kokushayeka onyaweni.
- Isikhumba sibanda nge-bluish tint.
- Ubuhlungu onyaweni kwenzeka ekuphumuleni, buqina ebusuku.
- Lapho uhamba, ukuvela kokunye phakathi kwenzeka.
Ngohlobo oluxubile lwesilonda seligi, zonke izimpawu zinamandla nokuhlangana okuhlukile.
I-Autonomic neuropathy
Ngokuphula i-autonomic innervation yezitho zomzimba, izimpawu zincike endaweni yelion. Imvamisa, kutholakala ngezigaba sekwephuzile, ngoba ayinazimpawu ezihlukile zekliniki. Ngasikhathi sinye, ukuthuthukiswa kwe-neuropathy kunesifo esingesihle, ngoba kuholela ekwandeni kokushona kwabantu amahlandla ayisihlanu.
Okubi kakhulu yizinhlobo zenhliziyo ze-autonomic neuropathy. Kungenzeka ngesimo se-tachycardia ekuphumuleni, lapho kungekho zinhlungu esifundeni senhliziyo, kunwebeka isikhathi sokuphumula se-QT ku-ECG, ukwehla kwengcindezi ngesikhathi sokunyuka okukhulu.
Kulokhu, iziguli azikhonondi, ngaphandle kobuthakathaka nesiyezi. Ngezinhlobo ezinjalo ze-neuropathy, izinhlobo ezingelapheki zokuhlasela kwenhliziyo zivame ukudlula. Iziguli zingahle zingazizwa izimpawu zayo, okuholela ekukhuleni kwezinhlobo ezinzima zokwehluleka kwenhliziyo ngomphumela obulalayo.
Izimpawu zomonakalo ohlelweni lokugaya kuhlotshaniswa nomsebenzi wezimoto ongasebenzi kahle:
- Umuzwa wesisu esigcwele ngemuva kokudla.
- Ubuhlungu besisu.
- Isicanucanu nokuhlanza.
- Izihlalo zamanzi ezisheshayo ngemuva kokudla, kanye nasebusuku.
- Ukuqhubeka kwe-fecal.
Ukwenza ukuxilongwa, kwenziwa i-X-ray noma ukuhlolwa kwe-Ultra esiswini namathumbu.
I-cystopathy ku-mellitus yesifo sikashukela izibonakalisa ekubonakaleni komthamo omkhulu womchamo onomfudlana obuthakathaka nokwabiwa okulandelayo kwamaconsi. Ukugcinwa kwe-urinary kwenzeka ebangeni ngaphandle kokuchama. Ngenxa yokuqongelela umchamo oshiye nokunameka kokutheleleka, i-cystitis ne-pyelonephritis iba.
Cishe i-60% yamadoda, isifo sikashukela senzeka ngokuncipha kwe-potency. Njengoba lesi sifo siqhubeka futhi sikhula, lokhu kuphazamiseka kuya ngokuqina, okuholela ekunamathiseleni kwezimpawu ezicindezelayo. Ngesikhathi esifanayo, isakhi se-psychogenic sandisa ukungasebenzi kwe-erectile.
Enye yezinkinga ezinkulu ze-autonomic diabetesic neuropathy ukwehla kwemizwa kokwehla koshukela wegazi. Iziguli ziyeka ukuzwa indlela ye-hypoglycemia, engaba yingozi empilweni, ikakhulukazi uma ngalesi sikhathi beshayela izimoto noma imishini emsebenzini.
Imvamisa ku-mellitus yesifo sikashukela, ukubukeka kokushaya kwenhliziyo noma ukujuluka, izandla eziqhaqhazelayo, iziguli ziqala ukuzizwa ekubonakalisweni kokuqala, okukuvumela ukuthi uthathe izinyathelo zokuvimbela ngesikhathi. Nge-neuropathy, iziguli zibhekana ne-hypoglycemic coma engazelelwe.
Ngaso leso sikhathi, ama-surges angenakubalwa ku-glucose wegazi akhulisa ukuphazamiseka kwe-metabolic.
Ukwelapha i-neuropathy yesifo sikashukela
Ukwelapha i-neuropathy, udinga ukuqinisa izinga loshukela wegazi ezingeni lelitshe. Lokhu kudinga ukubambelela ngokuqinile ekudleni (ekudleni okujwayelekile) kanye nokudla okunqunyelwe kuma-carbohydrate. Kulokhu, kungcono ukungafaki ama-carbohydrate alula futhi unqande inkimbinkimbi kufinyelela ezingeni elamukelekayo.
Ngaphezu kwalokho, kuyadingeka ukunciphisa okuqukethwe kwemikhiqizo enamafutha emvelaphi yezilwane futhi kungenise ekudleni inani elanele le-fiber yokudla kusuka kumifino emisha, i-bran. Amaphrotheni anconyelwa ukutholakala ezinhlanzini nasemikhiqizweni ebisi enamafutha amancane.
Ukwelashwa kwezidakamizwa kufanele kukhethwe ngendlela yokuthi kuvikeleke ushintsho olungazelelwe emazingeni kashukela wegazi, ngoba kuyingozi kokubili ukuyikhuphula futhi iwele ku-hypoglycemia.
Iziguli ezinomdlavuza wesifo sikashukela sohlobo 2, lapho behluleka khona ukuqinisa izinga likashukela ngosizo lwamathebulethi, khetha isilinganiso se-insulin sobabili ngendlela ye-monotherapy kanye nokwelashwa okuhlangene.
Uma isifo sikashukela sinxephezelwa, khona-ke izimpawu zesifo sikashukela se-neuropathy zinganyamalala phakathi kwezinyanga ezimbili kuya kwezintathu.
Ukwelashwa kwe-peropheral neuropathy kwenziwa ngamaqembu anjalo wezidakamizwa:
- I-Thioctic acid: I-Espa-Lipon, iTiogamma, i-Dialipon noma i-Belition inqunywe ezibhebheni noma imijovo.
- Ukulungiselela amavithamini e-B: izinhlobo zokujova iMilgamma, Neurorubin, Neurobion, Beviplex, Compligam, Trigamma, kanye neNurobeks, Neurovitan, amaphilisi we-Folic acid.
- Ama-Painkiller: Diclofenac, Nimesulide, Revmoxicam, Dexalgin.
- Ama-anticonvulsants: Isingoma, Finlepsin, Gabalept.
- Ama-antidepressants: I-Anafranil, i-Amitriptyline, iVenlafaxine.
- Ukuthuthukisa ukusakazwa kwangaphandle: Actovegin.
- Ukulungiselela kwendawo: ukugcotshwa kwamafutha ane-lidocaine noma i-ketoprofen.
Kungenzeka ukwelapha i-neuropathy ku-mellitus yesifo sikashukela (lapho kungekho khona ukungqubuzana) usebenzisa indlela ye-hyperbaric oxygenation, ukukhuthaza ngama-modered modrents, i-magnetotherapy, i-electrophoresis.
Isifo Sokuvikela Isifo Sikashukela
Indlela ebaluleke kunazo zonke yokuvimbela izinkinga zesifo sikashukela ukubheka ushukela wegazi njalo. Kuhlolwa esiswini esingenalutho, ngemuva kokudla (ngemuva kwamahora ama-2), ngaphambi kokulala. Ngaphezu kwalokho, umfutho wegazi ubhekwa okungenani kabili ngosuku. Kanye emva kwezinyanga ezintathu, kuhlaziywa kwenziwa i-glycated hemoglobin.
Ukuvakasha kwe-Endocrinologist kufanele kube njalo ezinyangeni ezintathu, udokotela oyi-neuropathologist, udokotela ohlinzayo kanye ne-podologist njalo ezinyangeni eziyisithupha.
Kuyadingeka futhi ukuyeka ngokuphelele ukubhema nokuphuza utshwala, ngoba kubangela i-vasospasm kanye nomonakalo emithanjeni yezinzwa, okwandisa ukubonakaliswa kwe-neuropathy, ukwanda kobuhlungu nokukhubazeka emilenzeni.
Kunconywa i-LFK yesifo sikashukela, kubandakanya ukuhamba ngezinyawo, ukubhukuda noma i-yoga. Isikhathi esiphelele semfundo yomzimba, esikwazi ukuvimba i-neuropathy kushukela kufanele okungenani sibe imizuzu eyi-150 ngesonto.
Ukuvimbela ukuthuthukiswa konyawo lwesifo sikashukela, kunconywa izindlela ezilandelayo:
- Ukuhlanzeka kwansuku zonke nokuhlolwa kwezinyawo ze-microtrauma, ama-scuffs.
- Ungavumeli ukushiswa ne-frostbite yezinyawo, ukulimala.
- Kwenqatshelwe ukuhamba ngezinyawo ezingenazo izicathulo, ikakhulukazi ngaphandle kwendlu.
- Ezicathulweni, kanye ne-hosiery, udinga ukukhetha izinto zemvelo ezingene komoya.
- Kunconywa izicathulo ezinethezekile, uma kunesidingo ngama-insoles e-orthopedic.
- Lapho wenza i-pedicure, kwenqatshelwe ukusika amabele.
- Okokugqoka ekhaya, khetha izicathulo ezinemuva elivalekile.
- Nsuku zonke, udinga ukugcoba izinyawo zakho ngo-ayisikhilimu ovikelwe ukuze uvikeleke ngokweqile.
Ukuvimbela i-autonomic neuropathy, udinga ukuthi ihlolwe ngudokotela oyi-cardiologist, urologist kanye ne-gastroenterologist.
Kwividiyo ekulesi sihloko, u-Elena Malysheva uzoqhubeka nokukhula ngesihloko se-neuropathy yesifo sikashukela.
