I-neuropathy yesifo sikashukela (izimpawu, izinhlobo nezindlela zokwelashwa kwayo)

Ukwanda okuhlala isikhathi eside egazini likashukela ku-mellitus yesifo sikashukela kuholela ezinkingeni ezahlukahlukene: inhliziyo nezinso kuyaphazamiseka, ukuwa kwamehlo, umfutho ukhuphuka. Ukulimala kwenzeka ohlelweni lwezinzwa, ngemuva kweminyaka engama-5-10 ukusuka ekuqaleni kwalesi sifo, i-neuropathy yesifo sikashukela iqala ukukhula.

Kuyisilonda sohlelo lwezinzwa lwe-somatic and autonomic futhi luvezwa umuzwa wokulimazeka, amathumbu nokungasebenzi komzimba, kanye nobuhlungu. Zombili lezi zinhlobo zesifo sikashukela ziyimbangela eyinhloko ye-neuropathy - ezimweni ezingama-30%, ukulimala kohlelo lwezinzwa kwenzeka ngokufanele ngenxa kashukela okhuphukayo. Okubi kakhulu isinxephezelo sikashukela, kukhuphuka amathuba weminyaka embalwa ukuthola ukwelashwa ngudokotela wezifo zengqondo on uhlu lwezimpawu ezingathandeki eziphazamisa impilo ejwayelekile.

Izimbangela zenkinga

Ukuhlolwa isikhathi eside kukhombisa ukuthi amathuba okukhula kwesifo sikashukela ngokuqondile kuncike kushukela wegazi. Uma kusekelwa kufinyelela ku-8 mmol / l, amathuba wokulimala kwezinzwa cishe yi-10%. Uma ushukela ungalawulwa kahle, ukwelashwa okunqunyelwe kanye nokudla akunakwa, ngemuva kweminyaka engu-5 njalo kweziyisithupha kutholakala ukuthi kuthiwe, kuthi emva kweminyaka eyi-15, uhhafu weziguli ezinesifo sikashukela sesi-2.

Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule

• Ukwehlela ushukela -95%
• Ukuqedwa kwe-vein thrombosis - 70%
• Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
• Ukuqeda umfutho wegazi ophakeme - 92%
• Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%

Amazinga aphezulu kashukela ahlasela uhlelo lwezinzwa kuzo zonke izinhlangothi, angashiyi nhlobo ithuba lokusebenza okuvamile:

1. Ushukela ulimaza izindonga zama-capillaries ezondla imicu yezinzwa. Amazinga aphakanyisiwe kashukela nama-triglycerides enza igazi likhulu, kunzima ngokwengeziwe ukungena emikhunjini emincane kakhulu. Umfutho wegazi kuleli cala, njengomthetho, uyanda, obangela ukubhujiswa kwemithambo yegazi. Ukuntuleka kokudla okondlayo kuholela ekubulambeni i-oksijini kwamangqamuzana ezinzwa, ukulimala okuningi emithanjeni yegazi kubangela ukwakheka kwe-edema kanye nokudluliselwa okungahambi kahle kokufakwa kwezinzwa. Ukulahleka kwama-capillaries okondla izinzwa kubhekwa njengembangela eyinhloko yesifo sikashukela se-diabetes.
2. I-metabolism engasebenzi kahle iholela ekuqokeleleni kwe-sorbitol ne-fructose ezicutshini, okukhuphula ukuqina kwe-osmolar yendawo ye-intercellular. Lolu shintsho luwuthinta kabi umsebenzi wama-osmoreceptors, abhekene nokulawulwa kwemisebenzi yephephabhuku lesisu, izinso, nokuphefumula.
3. Ku-mellitus yesifo sikashukela, ukuqina kwe-myoinositol ngaphakathi kwamangqamuzana kuyancipha, okusiza ushukela ukuphuma egazini kuya emisipha yemisipha ne-adipose. Ukuntuleka kwalolutho kudambisa ulwelwesi lwezinzwa, kuphazamise isizukulwane sokufakelwa izinzwa.
4. Amaprotheni anokukhula isikhathi eside kwezinga le-glucose angena ekuphatheni kwamakhemikhali nalo - ahlanganiswe glycated. I-glycated myelin ne-tubulin kuphazamisa ukudluliswa kwesiginali eceleni kwe-nerve, amaprotheni enziwe ngoshukela ulwelwesi lweseli yezinzwa aphazamise imetabolism kulo.
5. Ukukhiqizwa okwandayo kwama-radicals isimilo sesimo seziguli ezinesifo sikashukela kunomthelela onobuthi ezinhlaka zezinzwa.
6. Ngokulimala kwe-glucose metabolism, ukuntuleka kwevithamini B kuvame ukubonwa, okuandisa ukulimala kwezinzwa.

Uma ubheka izinzwa zangaphakathi zesiguli esinesifo sikashukela ngaphansi kwesibonakhulu, ungathola ushintsho olubi kumicu yazo, izindawo ezingenawo umfutho wegazi kanye nesakhiwo esaphukile. Ngokwemvelo, uhlelo lwezinzwa esisesimweni esidabukisayo kangako alukwazi ukwenza imisebenzi yalo ngokujwayelekile, ludinga ukwelashwa okuphuthumayo.

Yiziphi izimpawu ze-DN

Izimpawu ze-neuropathy zesifo sikashukela zihlukahlukene kakhulu kangangokuba ochwepheshe abancane abavela kuzo zonke izindawo zezokwelapha kufanele benze lokhu kuxilongwa, ama-endocrinologists nodokotela bezinzwa, ama-urologist kanye nama-ophthalmologists, ama-dermatologists futhi ngisho ne-proctologists babhekana nakho. Konke kuncike ekutheni iyiphi ingxenye yesistimu yezinzwa eyehla ushukela ewa kuyo.

Indlela elula yokuxilonga ngokulimala kwezinzwa ezithileko. Akhiwe esikhunjeni nasiswini, unesibopho sokudlulisela imininingwane ebuchosheni mayelana nephunga, umbala, imisindo, nokunikeza ukunyakaza kwemisipha ngokulandela ukwazi.

I-neuropathy yesifo sikashukela kuleli cala izibonakalisa ngesimo sazo zombili izimpawu ezinhle (izinzwa ezintsha, izimo) kanye ne-negative (ukuvimbela imisebenzi okukhona). Ngaphandle kwegama, izimpawu ezinhle azilungile kunokuba zibe zimbi, ngoba zinesizathu esifanayo - ukulimala ohlelweni lwezinzwa.

Ukubonakaliswa kwe-neuropathy yesifo sikashukela kubonakale isikhashana ngemuva kokulimala kohlelo lwezinzwa. Ekuqaleni, imisebenzi yezinzwa ezonakalisiwe yenziwa yibo abasendaweni enempilo. Ekuqaleni, izimpawu zivame ukwenzeka emalungeni, imicu yezinzwa ihlala isikhathi eside kuzo, kulula ukuzishabalalisa.

Uma i-neuropathy yesifo sikashukela ithinta ikakhulukazi uhlelo lwezinzwa oluzimele, izimpawu zincike ekutheni yiluphi uhlangothi izinzwa ezilawulwayo.

Kungabonakala:

• ukuphazamiseka kokugaya ukudla;
• ukwephulwa kwe-erection emadodeni nase-anorgasmia kwabesifazane;
• ukungahambi kahle komchamo nokuqina, izifiso ezivame ukuvakashela indlu yangasese;
• imikhawulo yokuhamba kwamehlo;
• ukugwinya;
• ukuphazamiseka kwesigqi senhliziyo;
• ukungabekezeleli umthwalo omningi.

Ngokwalezi zibonakaliso, kunokuba nzima ukuthola i-DN. Ukwenza lula ukukhonjwa kwezimbangela zezimpawu ezingaqondakali, lapho unquma ukwelashwa, kuyadingeka ukuthi uxwayise udokotela ngesifo sikashukela nangesixephezelo saso.

Ukuxilongwa kwalesi sifo

Uma kusolwa ukuthuthukiswa okusolwa kwe-neuropathy yesifo sikashukela, udokotela ohambelayo uthumela ukuhlolwa kwemizwa.

Kufaka izigaba eziningana:

1. Ukuhlolwa kwesiguli esinesifo sikashukela kuveza izinguquko ekusebenzeni kwezitho zomzimba, izicubu nama-receptors esikhumbeni.

2. Ucwaningo lokuzwela. Ukwandisa amathuba okuthola inkinga, zonke izinhlobo zayo ziyahlolwa - impendulo ekushiseni nasekubandeni, ebuhlungwini, ekuthinteni, ekudlidlizelweni. Ukuzwela kuyahlolwa ezinyaweni zesiguli, ngoba kwenzeka ukwephulwa okokuqala. Ukuze wenze lokhu, sebenzisa i-kit yemithambo ekuhlolweni kwe-neuropathy, okubandakanya imfoloko yokucikeka, i-monofilament, isando sezinzwa kanye nenaliti, isilinda onamathiphu wensimbi nawepulasitiki.

• ukuzwela kokudlidliza kuhlolwa ngemfoloko yokuthungatha kuthwane olukhulu;
• i-tactile - ngosizo lwe-monofilament, ithuluzi elikhethekile elinolayini obukhulu bokudoba ekugcineni;
• izinga lokushisa - ngokuya umehluko wemizwa lapho uthinta insimbi nepulasitiki;
• Ubuhlungu - ngenaliti ehlanganayo noma amazinyo.

3. Bheka izinkomba ukuthola i-neuropathy.

• i-knee Reflex ihlolwe ngokushaywa ngobumnene kumthambo ngaphansi kwedolo, imvamisa yethanga kufanele ingene;
• Ama-Achilles ahlolwe ku-tendon kancane ngaphezu kwesithende, unyawo kufanele lugobeke.

4. I-Electromyography inikezela ngemininingwane yomsebenzi wezicu ezinkulu zezinzwa. Kusetshenziswa ama-elektrikhi anamathiselwe esikhunjeni, umsebenzi kagesi wezicubu uyaqoshwa. Ngokuyiqhathanisa nezinkambiso, umuntu angahlulela isimo esisebenzayo sezinzwa ezitholakala kule misipha, uhlobo lomonakalo wabo kanye nobunzima be-neuropathy yesifo sikashukela. Ngokusho kocwaningo, kubantu abanesifo sikashukela, izinga lokusabalala kokucashunwa kweminyaka emi-5 yokubukwa kwehle ngamaphesenti ayi-10. Eqenjini elijwayelekile, ukwehla okunjalo kwatholakala kuma-40% abantu abanesifo sikashukela. Kulabo abagcina ushukela wegazi ulawulwa - yi-16% kuphela.

Ukuthola ukulimala ohlelweni lwezinzwa lwe-autonomic uma kwenzeka kune-neuropathy, kutholakala ukuthi kukhona ukuxilongwa kwezitho ezithweni isiguli esikhononda ngaso. Ukuhlolwa kwegazi nokuchama okunikezwe, i-ultrasound, i-electrocardiography, i-x-ray yesisu kanye nezinye izifundo.

Yiziphi izinhlobo ze-neuropathy kushukela?

Izinhlobo ezingaphezu kweshumi nambili zama-neuropathie ziyahlukaniswa, ngokuya ngendawo yezinzwa ezilimele. Ezimweni eziningi, ahlanganiswa aba ngamaqembu amakhulu ama-4:

1. I-neuropathy yezinzwa engapheli. Kwenzeka kaningi, kuwukuhlanekezela ukuzwela. Izimpawu zenzeka ngokulandelanayo, ngokwesibonelo, kuyo yomibili imilenze. Ebusuku nasekuphumuleni kumenyezelwa ngaphezulu. Ekuqaleni kwesifo, kuvela izimpawu ezinhle. Ukungafanele kubonakaliswe kuqubuzela nokungalingani lapho uhamba futhi kubonakaliswa kubuhlungu besifo sikashukela esinzima. Ingozi ethile i-neropic sensory neuropathy yamaphethelo aphansi. Ngenxa yokuntuleka kwemizwa ezinyaweni, zilimala njalo, ushukela omningi uphazamisa ukuphulukiswa kwamanxeba, kuthi ukuvela kwezilonda njalo nokulimala kuqubuke. Ezimweni ezingavamile, kuba nezinkinga ezinzima zesifo sikashukela - Unyawo lukaCharcot. Lesi sifo sibonakaliswa ngokuvuvukala kwe-calcium kusuka emathanjeni ngenxa yokuvuvukala isikhathi eside kwezicubu, ukuqhekeka okungapheli futhi, ngenxa yalokho, ukuguquguquka okungalinganiseli konyawo. Ngokuphathelene ne-neuropathy enamandla. Kuyalinganisa nokulinganisela lapho uhamba, futhi uyazibonakalisa, umsebenzi isiguli esikhononda ngawo.
2. I-acute sensor neuropathy. Esikhathini esiningi, kuvela njengokuphendula komzimba womuntu ekushintsheni okungazelelwe koshukela wegazi, futhi hhayi nje ukukhula okuyingoti, kepha futhi nokwehla okukhulu kweglucose ekuqaleni kwemithi. Isibonakaliso esiyinhloko kubuhlungu obukhulu, kulimaza kakhulu izinga lempilo. Ngenxa yalokhu, izinkinga zokulala, ukucindezeleka kwenzeka, isisindo sesiguli siyawa.
3. I-motor diabetesic neuropathy. Kuwukubhujiswa kwezinzwa ezinikeza amasondo emisipha ukuba ingene futhi iphumule. Ngenxa yalokhu, ukuhlangana kokunyakaza kuyaphazamiseka, ukuhamba kwemilenze kunqunyelwe, futhi nomuzwa wokukhathala uvuka. Iminwe ingeyokuqala ukuhlupheka; isiguli esinesifo sikashukela siphulukana namandla okwenza umsebenzi omuhle, onembile, ikakhulukazi ngemuva kokuphumula kobusuku. Ezinganeni, ukusebenza kwemisipha akuthinteki kangako, i-motor neuropathy kunqunywa kuphela ngokuvinjezelwa kwe-reflexes.
4. I-Autonomic neuropathy. Ukubhujiswa kwezinzwa ezisebenzela noma yisiphi isitho. Ukuqala kokukhula kwesifo kuyinto asymptomatic. Ezinye izibonakaliso ekunzima ukuzihlanganisa nesifo sikashukela, ngakho-ke i-autonomic neuropathy ivame ukutholakala sekwephuzile.

Ngabe i-neuropathy yesifo sikashukela ingalashwa kanjani?

Ukwelashwa kwe-neuropathy yesifo sikashukela akunakwenzeka ngaphandle kokulungiswa kweglucose egazini. Umsebenzi oyisiguli onesifo sikashukela ukunxephezela ukugula kwakhe, isb. ukusebenzisa isidlo, izidakamizwa ezinciphisa ushukela, imfundo yezomzimba, ukuncipha kwesisindo, i-insulin ukufeza ukungaguquki okuvamile, okuningisa ukujula kweglue glucose. Lapho kuvela izimpawu ze-neuropathy, udokotela wokuqala okumvakashele udokotela oyi-endocrinologist. Uzokhomba izimbangela zeshukela elandayo bese elungisa umthamo wezidakamizwa. Kungaphansi kwale mibandela kuphela lapho i-neuropathy yesifo sikashukela ingelashwa kahle.

Sikhetha izidakamizwa

Ngemuva kokuthi imbangela ye-DN isusiwe, kungenzeka ukuthi unikeze izidakamizwa ezizosheshisa ukubuyiselwa kwezinzwa. Ama-antioxidants anqunyelwe ikakhulukazi. Okuphumelela kakhulu kuzo yi-alpha lipoic acid (isichazamazwi se-thioctic), inganciphisa ushukela wegazi, inciphise ukumelana ne-insulin, ivikele isibindi. Emavikini ama-3 ngemuva kokuqala kokufakwa kwakhe kwe-intravenous, izimpawu ze-neurological ngcono kakhulu noma zinyamalale ngokuphelele.

Ukwelashwa okujwayelekile kwe-neuropathy kungama-15 okwehlisa i-lipoic acid izinsuku ezi-5 ngesonto, bese kuthi ezinyangeni ezi-3 ezilandelayo, umuthi womlomo okwifomu lethebhulethi. Imvamisa, i-Berlition, iTogogpt, iNeuroleptone, iT Thiolipon ne-lentic acid engabizi yabakhiqizi basekhaya. Ukwelashwa kwe-neuropathy ngosuku, ama-600 mg ento esebenzayo ayathathwa. Isibonelo, kuthebhulethi e-1 yeNeurolipone 300 mg, amaphilisi ama-2 ayadingeka ngosuku. Ngakho-ke lokho kunyunzwa kungavinjelwanga ngokudla, kubaphuze esiswini esingenalutho, isigamu sehora ngaphambi kokudla.

Ngaphezu kwama-antioxidants ku-neuropathy, ukuqokwa kwamavithamini we-B kunesizathu, ahlala enganele isifo sikashukela. Bayakwazi ukukhuphula ijubane lokusakazeka okuvusa amadlingozi, ukuvimbela ukuqothuka kwamaprotheni, futhi babe nomthelela enkambweni evamile yokusabela kwe-biochemical. Amavithamini B1, B6, B12 angathathwa ngawodwa noma njengengxenye yamalungiselelo ahlanganisiwe - Neuromultivit, Milgamma, Vitaxone, Combilipen.

Izidakamizwa ezisele zibekelwe ukumisa izimpawu zesifo sikashukela sezinzwa. Kungenzeka ukunciphisa imiphumela yokulimala kwezinzwa nokulimala okuncane ngemithi enezidakamizwa ezilwa nokuvuvukala, ama-analgesics anciphisa izimpawu zobuhlungu, izinzwa zasendaweni zisusa imizwa engathandeki esikhunjeni, ama-anticonvulsants enza ngemisipha yemisipha.

Inhloso yalezi zidakamizwa ingeyodwa umuntu futhi kufanele yenziwe udokotela wakho kuphela.

Amakhambi esintu

I-Chamomile, i-calendula, i-nettle iveze izakhiwo ezilwa nokuvuvukala futhi zingasetshenziswa njengezimali ezengeziwe zokunciphisa ukonakala. I-infusion ilungiswa kanjena: thatha isipuni sodwa samakhambi noma ingxube yawo engilazini yamanzi abilayo, bopha bese uphola kancane amahora amabili. Udinga ukuyiphuza esiswini esingenalutho, izikhathi ezintathu ngosuku, 100 ml. Ukufakwa kuthathwa isikhathi eside, kusuka ezinyangeni ezi-3. Ungayisebenzisa njengekhambi lendawo - engeza kubhavu lwenyawo.

Ukuze uthuthukise ukujikeleza kwegazi ezinyaweni, kuphulukisa amanxeba kanye nama-scuffs nge-neuropathy, ukugcotshwa kwama-compress kanye ne-compress ngamafutha we-camphor kuyasetshenziswa. Amafutha agcotshwe izinyawo bese uwagoqa kahle imizuzu engu-15, kusukela eminyweni. Lapho-ke imilenze igoqwe ngembobo yoboya bese ishiya i-compress ebusuku. Isikhathi sokwelashwa sisukela enyangeni eyi-1.

Ukwelashwa kwe-neuropathy yesifo sikashukela ngemithi yabantu kumele kuhlanganiswe nokwelashwa kwendabuko. Ngaphambi kokusebenzisa noma yimuphi umuthi, udinga ukuxoxa ngawo nodokotela wakho, njengoba izindlela ezingenza isimo sesiguli esinesifo sikashukela zivame kakhulu ukunconywa. Isibonelo, ukunamathisela amakhasi we-lime ezinyaweni kungadala ukushiswa isikhathi eside esikhunjeni.

Kungenzeka yini ukwelapha ngokuphelele

I-neuropathy yesifo sikashukela yelashwa ngempumelelo uma imbangela yalesi sifo iqedwa. Ngemuva kokuhlelwa kweshukela, izinqubo zokubuyiselwa ezinhlizweni ziqala kungakapheli usuku.Ngalesi sikhathi, ukwanda kwezimpawu kungenzeka, lokhu kukhombisa ukuthambekela okuhle. Ngemuva kwezinyanga ezi-2, ingxenye ebalulekile yezinzwa iyabuyiselwa. Ukululama ngokuphelele nokubuyiselwa kwayo yonke imisebenzi yezitho kungathatha iminyaka eminingana.

Uma ukwelashwa kwe-neuropathy kushukela kuqalwa ezigabeni zokuqala, lapho kuvela izimpawu zokuqala, ukuqina kwesifo kuyathandeka. Uma, ngemuva kokuqala kwezimpawu, izinga likashukela wegazi alishintshiwe, konke okunye ukwelashwa kungasebenzi. Kulokhu, leli cala lingaholela ekunqunyweni kwezinyawo nokususwa kwezitho ezonakele.

>> Ukubekezelelwa kwe-glucose engasebenzi kahle kungenye yezimbangela eziqinile zesifo sikashukela sohlobo 2.