Yini i-retinopathy yesifo sikashukela, izimpawu zayo nezindlela zokwelashwa

Ezigulini ezinesifo sikashukela, uma ziqhathaniswa nomuntu ojwayelekile, onempilo, ingozi yokulimala kwe-ischemia nokuphakama kwezinso iphakeme kakhulu, eyodwa kuma-200 ilahlekelwe izinzwani ngenxa yokuthuthukiswa kwe-gangrene, futhi amathuba okulahlekelwa ngokuphelele kombono kukhulu izikhathi ezingama-25. Ukuntuleka kwegazi elifanele ngenxa yoshukela okhuphukayo kuhlasela izitho zomuntu ezisengozini kakhulu - inhliziyo, izinyawo, izinso, amehlo. I-retinopathy yesifo sikashukela, okuyiphuzu lokugcina elingumboni ngokuphelele, iqala ukukhula ngokushesha eminyakeni emi-5 ngemuva kokuqala kwesifo sikashukela, nangoshukela ophakeme kakhulu, ngisho nangaphambilini.

Kuyini isifo sikashukela?

I-retinopathy, ngokweqiniso "isifo se-retinal," ngesinye sezimpawu ezivame kakhulu zesifo sikashukela. Ngokusho kwe-WHO, lesi sifo sithinta cishe zonke iziguli ezinesifo sikashukela sohlobo 1 nesineminyaka engaphezu kwengu-15. Yize kungamangaza, i-retinopathy yesifo sikashukela yande kakhulu ngenxa yemizamo yodokotela. Phambilini, akuwona wonke umuntu onesifo sikashukela osinde ekulimaleni kwamehlo, isizathu sokufa kwabo kwakuyisifo senhliziyo. Namuhla, izinga lomuthi livumela ukugwema ukufa kwe-ischemia futhi limise kakhulu ukukhula kwezinkinga zesifo sikashukela, kufaka phakathi isifo sikashukela sikashukela.

I-retina yokusebenza okujwayelekile idinga ukunikezwa okomoya okhuphukayo kuqhathaniswa nezinye izitho. Imikhumbi egcwele i-viscous, igazi eliminyene elinamazinga aphezulu kashukela nama-triglycerides awakwazi ukunikeza izondlamzimba ezivamile zokudla. Izindonga zamakhulu amancane ama-capillaries adlula kakhulu, aqhuma, kunama-hemorrhage amancane nama-aneurysms. Ingxenye ewuketshezi yegazi elivuzayo yakha i-edema kwi-retina, ekhawulela ukusebenza kwamehlo. Izakhi zamaphrotheni zibanga ukuwohloka ku-retina. Ukusatshalaliswa okuthe xaxa kwezibazi kufaka ukuthengiswa kwe-retinal kanye nokuhlakazeka, ukulimala kwezinzwa.

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%

Ukuhlukaniswa nezigaba

Ukuhlukaniswa okuhlanganisiwe kwe-retinopathy yeswekile kusetshenziswa emhlabeni wonke. Uhlukanisa lesi sifo ngezigaba ngokuya ngobukhona bokukhula - ukwanda kwemikhumbi emisha esusweni.

Kubukeka sengathi lokhu kungaba yingozi? Yize kunjalo, izitsha ezitholwa ngumzimba esikhundleni sazo ezonakele zisiza amanxeba ukuba aphulukiswe ngokushesha futhi zinezimpande ezithweni ezidlulisiwe ngesikhathi sokufakelwa. Uma kukhulunywa ngezitho zombono, izinto ziyehluka. Ngaphansi kwezimo zokuhlaselwa yindlala komoya-mpilo kushukela, ama-capillaries amasha awasho lutho, izindonga zawo zinengqimba eyodwa yamaseli. Ukwakheka kwemikhumbi enjalo kuholela ekuwohlokeni okubukhali kulesi simo: inani lama-hemorrhages landa ngokushesha, i-edema iyanda, futhi ingozi yokulahleka kombono ikhula kakhulu.

Izigaba ze-retinopathy:

1. Isigaba esingelona ukwanda. Kutholakala kuleso simo lapho sekuvele izinguquko emikhunjini, kuvela izinyembezi ezincane ngezikhathi ezithile, ezikwazi ukuzixazulula ngokuzimela. Lesi sigaba sibizwa nangasemuva, ngoba ngesifo sikashukela kungahlala iminyaka eminingi ngaphandle kokulimazeka okukhulu. Ushintsho olukhulu olubonwa ngalesi sikhathi yi-edema ku-retina. Uma egxilile enkabeni yayo, kuma-macula, kungalimaza okwesikhashana ukubonwa.
2. I-preproliferative diabetesic retinopathy. Kusho ukuthuthuka okuqhubekayo kwalesi sifo, izindawo eziphethwe yindlala i-oksijini ku-retina, lapho umzimba uzothambekela ukugcwala ngama-capillaries, i-venous outflow worsens, okuholela ekwandeni kwe-edema, ama-hemorrhages awunaso isikhathi sokuzixazulula.
3. Isigaba esandisayo. Kwenzeka lapho inani lamasayithi emehlweni ngaphandle komoya-mpilo landa. I-retina iqala ukukhipha into evusa ukukhula kwemithambo yegazi emisha. Baholela ekwakhekeni kwezibazi, balimaze i-retina, bayihudule ngqo emuva kweso. Futhi, imikhumbi emisha ingaphazamisa ukuphuma kwe-fluid kusuka esweni, kulokhu, ingcindezi ye-intraocular iqala ukukhula, i-optic nerve ilimele. Kube sekuvela ama-capillaries angajwayelekile angena emzimbeni we-vitreous bese enza ama-hemorrhages ngaphakathi kuwo. Umbono ngalesi sikhathi uwela ngokudabukisayo. Kwesinye isikhathi inkokhelo ihamba ngokoqobo izinsuku. Ezimweni ezinzima, ukusebenza kwenziwa ngokushesha, ngosuku lokwelashwa, ukwandisa amathuba okusindisa umbono wesiguli sikashukela.

Yiziphi izimpawu ze-DR

Izinguquko zesifo sikashukela kuzinto ezibukwayo ziyi-asymptomatic kuze kufike kumazinga aphezulu omonakalo. I-Visu acuity ihlala iphezulu kuze kube yilapho izinguquko zokuphinda ziguqulwe ziqale ukwenzeka e-retina.

I-retinopathy yesifo sikashukela esingeyona eyokwanda sitholakala lapho kuhlolwa ngudokotela wezifo zamehlo, lapho kunesifo sikashukela. ukuvakasha okuhleliwe kudokotela kuyimpoqo.

Kubalulekile! Isikhathi sokuqala ukuhlolwa kwezitho zombono kufanele zenziwe ngesifo sikashukela iminyaka emi-5, uma sonke lesi sikhathi izinga le-glucose lingagcinwa phakathi kobubanzi obujwayelekile. Uma ushukela weqa njalo - i-ophthalmologist kufanele ivakashele iminyaka eyi-1.5 ngemuva kokuxilongwa kwesifo sikashukela. Uma udokotela engazange aveze izinguquko ngaphakathi kweso, izivivinyo kufanele zithathwe minyaka yonke. Uma kutholakale ukuthi unesifo sikashukela i-retinopathy - kaningi kakhulu.

Okusengozini enkulu kakhulu yokwanda kwesifo sikashukela esisheshayo, iziguli ezinesifo sikashukela esingalawuleki, umfutho wegazi ophakeme, ukuhluleka kwezinso, i-BMI> 30, abesifazane abakhulelwe nentsha.

Izimpawu ze-retinopathy zesifo sikashukela eziphambili:

1. Ukubuthwa kokufiphaza kwezinto ezisondelene nokuvuvukala ku-macula.
2. Ukuhamba kwamabala angwevu, kubonakala ngokucacile lapho ubuka izinto ezikhanyayo ezakha lapho ukugqabhuka kwama-capillaries nokuqhuma kwegazi kungena emzimbeni we-vitreous. Imvamisa ziyanyamalala nesikhathi uqobo.
3. Isithombe esicijile, inkungu phambi kwamehlo ngesikhathi sokuphuma kwegazi.

Lapho kuvela lezi zibonakaliso, kunconywa ukuvakasha okuphuthumayo ku-ophthalmologist.

Ukuxilongwa Kwezinkinga

Ekuqeshweni kwe-ophthalmologist, isithombe esiyinhloko semiphumela yesifo sikashukela siyabonakala nge-ophthalmoscopy. Ikuvumela ukuthi wenze ukuxilongwa, ubone ukuthi yi-retinopathy kangakanani, ukhombe ukuba khona kwemithambo yegazi ehlanjululwe, uketshezi oludonsayo, ukopha, bonisa izindlela zokwelapha. Esigabeni sokugcina, inethiwekhi yemikhumbi efikile, eyakhiwe yadlula, indawo enamakhompiyutha ibonakala kahle. Ukulandela izinguquko, kunekhamera ekhethekile ekwazi ukuthatha izithombe ze-fundus.

Ngokwengeziwe kulezi zifundo kwenziwa:

1. Perimetry yokutholwa kwama-pathologies emaphethelweni we-retina kanye nokuba khona kokuxoshwa.
2. I-Tonometry - ukuzimisela kwengcindezi ngaphakathi kweso.
3. Ukuqapha ukusebenza kwamaseli we-opic nerve namaseli we-retina esebenzisa izindlela ze-electrophysiological, isibonelo, i-electrooculography.
4. Ukuthola okungahambi kahle emikhunjini, i-angiography noma i-tomography ye-retina iyadingeka.

I-endocrinologist ibeka uchungechunge lwezivivinyo ezingathola inani lesinxephezelo sikashukela kanye nokuba khona kwezinto ezithinta kabi ukuthuthukiswa kwe-retinopathy: isilinganiso sokucindezela, ukuhlolwa kwegazi nomchamo we-glucose, ukuzimisela kwe-glycosylated hemoglobin level, renal vascular dopplerography, electrocardiography.

Ngenxa yalolu cwaningo, izincomo zizokwenziwa ngesidingo somuthi noma ngokwelashwa okuhlinzwa kwe-retinopathy yesifo sikashukela.

Ngabe isifo singaphenduka ini

Cabanga nje ukuthi isiguli esinesifo sikashukela asikwazi ukugula, siyaqhubeka nokuncika ekudleni okunama-carb amaningi, futhi singanaki impilo ebuthaka kanye nokwanda kwamehlo. Sizobona ukuthi lokhu kungaphela kanjani, nokuthi kubi kangakanani ukuqaphela kwe-retinopathy yesifo sikashukela uma kungekho ukwelashwa.

Ngakho-ke, i-retina ebulawa yindlala inikeza umyalo wokukhulisa ama-capillaries amasha, futhi akhula ndawonye, ​​ngesinye isikhathi ehlasela i-vitreous. Ushukela olandelayo wegazi oshukela kushukela ushukela uholela ekubhujisweni kwabo, ukuvela kwamanxeba amaningi. Umzimba, uzama ukunqoba lesi simo, uxazulula ngenkuthalo ukugcwala kwegazi futhi ukhule nemikhumbi emisha. Umlando uyaziphinda kwisimo esifanayo. Ngokuhamba kwesikhathi, umthamo wegazi elivuzayo uyanda, okubizwa ngokuthi yi-hemophthalmus enzima kwenzeka. Akasakwazi nokunyakaza yedwa, okusho ukuthi iso lingasakwazi ukusebenza ngokujwayelekile, amehlo asheshe ehle.

I-Glaucoma iholela ekungaboni

Kunesinye isimo: ngenxa yomkhumbi ngamunye oqhuma, ifomu lesikhubekiso ku-retina, izicubu ezijwayelekile kule ndawo zithathelwa indawo yi-pathological - fibrous. Kancane kancane, inani lezicubu ze-fibrous likhula, liqinisa i-retina futhi liholele ekuhlukaniselweni kwalo, lilimaze imithambo yegazi futhi libangele i-hemophthalmus entsha, livimbela ukuphuma kwe-fluid esweni futhi kuholele ekukhuleni kwe-glaucoma.

Ngokwemvelo, inketho engathandeki kakhulu ichazwa lapha. Njengomthetho, osesigabeni se-prroliferative noma ekuqaleni kwesiguli esandayo, i-mellitus yesifo sikashukela ivela ku-ophthalmologist. Ngaphezu kwalokho, kwezinye izimo, umzimba uyakwazi ukwephula ngokuzimele lo mbuthano onesihluku futhi uvimbele ukuqhubeka kwesifo. Kulesi simo, icala lilinganiselwe kuphela ngokulahlekelwa okukhulu kombono.

Ngingamphatha kanjani u-DR

Indima eyinhloko ekwelapheni i-retinopathy engeyona eyolisayo ayidlalwanga udokotela wamehlo nhlobo. Kulokhu, ukulungiswa kwe-metabolic, ukuqapha i-glucose yegazi, kanye nokwehlisa umfutho wegazi kubaluleke kakhulu. Ngakho-ke, izidakamizwa ezingaphindisela emuva i-retinopathy zinqunywa udokotela we-endocrinologist kanye ne-cardiologist.

Uma ungakwazi ukukhokhela ushukela ngezidakamizwa ezinciphisa ushukela nokudla okungasebenzi, akufanele wesabe i-insulin. Ngokusetshenziswa okufanele, ayinayo imiphumela emibi, futhi iyakwazi impela ukugcina impilo yamehlo.

Uma izinguquko sezivele zenzekile kuzinto ezibonakalayo umzimba ongeke ukwazi ukubhekana nazo, udokotela wamehlo wezamehlo uzocacisa ukwelashwa. Lokhu kungaba ukwelashwa okulondoloziwe kwe-retinopathy yesifo sikashukela, kanye nokungenelela kokuhlinzwa.

Ukwelashwa ngezidakamizwa

Zonke izidakamizwa ezazisetshenziswa ngaphambilini ezazinqunyelwe ukumisa i-retinopathy, ibonwa njengezinsuku ezingenamsebenzi. Indlela yokwelapha yokwelapha isifo sikashukela ngama-antioxidants, ama-vasipha okuqinisa imithambo, ama-enzyme akhethekile we-ophthalmic, amavithamini, namakhambi abantu kuphela esigabeni esingemuva sesi sifo.

Isibonelo, amaconsi eso e-Taurine aklanyelwe ukuthuthukisa izinqubo zokululama futhi kusebenze ukujikeleza kwegazi. Ukuqokwa kwalawa maconsi kungaba usizo ekuqaleni kweziyaluyalu kwinethiwekhi yemithambo, kodwa ngokungadingekile futhi kuyingozi enkulu esigabeni sokulungiselela.

Ububi obukhulu bemithi elwa ne-VEGF intengo yabo ephezulu. Isikhathi sokuqala okudingeka wenze imijovo ngaso sonke isikhathi izinyanga ezingama-1-2, izindleko ngazinye zingama-ruble ayizinkulungwane ezingama-30. Inkambo esezingeni eliphakathi yokwelashwa yiminyaka emi-2, imijovo eyi-8 ngonyaka. U-Eilea ungumenzeli osebenza isikhathi eside, izikhawu phakathi kokuphathwa kwawo zinde, ngakho-ke ukwelashwa kwe-retinopathy nalesi sidakamizwa kuzobiza okuncane okushibhile ngokusebenza okufanayo.

Ukwelashwa kwe-Laser

Ukwelashwa kwe-laser kwe-retinopathy yesifo sikashukela esezingeni eliphezulu njengamanje kuyindlela ejwayelekile yokwelashwa. Utshengise ukusebenza kahle kwakhe kumacala angama-80% esigaba 2 salesi sifo nasengxenyeni yamacala ekugcineni. Ngokushesha lapho kwenziwa umsebenzi, imiphumela yakho izoba ngcono. Umnyombo wale ndlela ukushisa imithambo emisha usebenzisa ugongolo lwe-laser, igazi elikuyo lihlangana futhi nemikhumbi iyeka ukusebenza. Ezimweni eziningi, inqubo eyodwa enjalo yanele ukugcina umbono weminyaka eyi-10 ezayo.

Le nqubo yenziwa imizuzu engama-20 ngaphansi kwe-anesthesia yendawo, ngaphandle kokuhlala esibhedlela esibhedlela, isiguli sivunyelwe ukuya ekhaya ngosuku lokuhlinzwa. Ibekezelelwa kalula iziguli, ayidingi isikhathi sokutakula, ayilimazi inhliziyo nemithambo yegazi. Udokotela ohlinzayo ulawula ngokuphelele ukunemba kokuqina kwe-laser ngesibonakhulu.

Uma kwenzeka isifo se-retinopathy esinesifo sikashukela esisezingeni eliphakeme, kusebenza inqubo eyinkimbinkimbi kakhulu ye-microsuction - vitctuomy. Limelela ukususwa okuphelele komzimba we-vitreous kanye nokushaywa kwegazi nezibazi. Ngesikhathi vit vitomy, laser cauterization yemithambo yegazi kungenzeka. Ekupheleni kokuhlinzwa, i-eyeball igcwele isixazululo noma igesi ekhethekile ecindezela i-retina futhi ingakuvumeli ukukhipha.

Izindlela zokuvimbela

Into esemqoka ekuvimbeleni i-retinopathy ukutholakala kokutholwa kokuqala. Ukuze kwenzeke lokhu, kuyadingeka ukuthi ubonwe ngudokotela wamehlo oqeqeshiwe owazi ngezimpawu zokuphazamiseka kwesifo sikashukela mellitus. Indlela elula yokuthola udokotela onjalo esikhungweni sikashukela. Ngezibonakaliso zokuqala zokubhujiswa kwemithambo nokukhula okusha, kufanelekile ukubheka ukuthi kungenzeka yini ukwenza i-laser coagulation.

Okubaluleke ngokufanayo ekuvimbeleni i-retinopathy isinxephezelo sikashukela, ukwelashwa kwezifo ezilinganayo, nendlela yokuphila enempilo.

Iziguli ezinesifo sikashukela ziyanconywa:

• ukulawulwa kwekhwalithi kwamazinga kashukela, ukugcina idayari yokudla;
• ukuncipha kwengcindezi yegazi ne-cholesterol emazingeni ajwayelekile;
• ukuyeka ukubhema;
• ukugwema izimo ezicindezelayo.