Isinxephezelo sesikhathi eside, esimeme sesifo sikashukela singatholakala kuphela ezigulini eziyalwa kakhulu. Abanye bonke kungekudala bazoqala ukuba nezinkinga, esinye sezimpawu kakhulu yisifo sikashukela sesifo sikashukela.
I-neuropathy yesifo sikashukela - kuyini?
Lesi sifo singasebenzi kahle emithanjeni yezinzwa yangaphakathi. Bangaba banzi noma bendawo, bathinte amasistimu ambalwa noma isitho esisodwa esisodwa. Ngokuqokwa kukadokotela, i-neuropathy itholakala kuzo zonke iziguli eziyisikhombisa ezinesifo sikashukela, ngosizo lwezindlela ezibucayi kakhulu ze-elekthroniksi - umzuzwana ngamunye.
Isibonakaliso sokuqala salesi sifo ukuncipha kwezinga lokusabalala kwe-excising ku-nerve fibers. Ngezinhlobo ezinzima ze-neuropathy, ukuphazamiseka kwemizwa kungenzeka, izinhlungu ezinzima, ukuhluleka kwesitho, ubuthakathaka bemisipha kuze kube nokukhubazeka kungenzeka.
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%
Izimbangela ze-neuropathy kuma-diabetes
Isici esiyingozi esibonakalisiwe sokwenza i-neuropathy yesifo sikashukela yi-hyperglycemia ende. Ngaphansi kwethonya loshukela emithanjeni yezinzwa, ukubhujiswa kuqala, ukwenziwa kwawo kwasendaweni nokwanda kwawo kuncike ezimweni eziqondene nesiguli kanye nezinga lezinqubo eziwohlokile ze-metabolic emzimbeni.
Izimbangela ezivame kakhulu ze-neuropathy ku-mellitus yesifo sikashukela yilezi:
- Ukwanda kokuqukethwe kwe-sorbitol emithanjeni yezinzwa, umkhiqizo we-glucose oxidation.
- Ukuntuleka kwe-myoinositol, okudingekayo ukuze kudluliselwe izifiso.
- I-Glycation (ushukela) yamaprotheni:
- I-non-enzymatic glycation ukusabela kwamakhemikhali phakathi kwama-molecule eglucose namaqembu e-amino amaprotheni. Zingahle zibandakanye i-myelin, into eyenza i-nerve sheath, ne-tubulin, iprotheni edingekayo ukuthutha izinhlayiya emangqamuzaneni.
- I-Enzymatic glycation ihlanekezela umsebenzi wama-enzyme - izinto ezisheshisa izinqubo emzimbeni.
- Ukukhishwa okwandayo kwama-radicals mahhala kushukela kuyimbangela yokubhujiswa kwesakhiwo samaseli ezinzwa. Lapho iphakeme i-hyperglycemia, ikhulu ngokwengeziwe imbubhiso. Ekugcineni, izicubu zomzimba zivinjelwa amandla okwenza i-myelin entsha, okuholela ekufeni kwenzwa.
- I-Angiopathy emikhunjini emincane iholela ekuntuleni kokudla kwezicubu zezinzwa kanye nokubhujiswa okungaphendukiyo kwama-axons.
Ngaphansi kwethonya lezimbangela, imicu yezinzwa ilahlekelwa amandla okuzilungisa, i-ischemia yazo ikhula kuze kube yilapho kufa izigaba zonke, futhi imisebenzi iphazamiseka kakhulu.
Kufakazelwe ukuthi ukuphela kwendlela yokugwema i-neuropathy ku-mellitus yesifo sikashukela ukugcina i-glycemia ejwayelekile, etholakala ngosizo lwama-hypoglycemic agents, ukudla nokujova kwe-insulin futhi kudinga isiyalo esiqinile engxenyeni yesiguli.
Ngubani osengozini
Ingozi enkulu kakhulu yokwakha i-neuropathy kwiziguli ezinesifo sikashukela esingafakwanga. Kwatholakala ukuthi ukufinyelela ushukela ojwayelekile kunoma yisiphi isigaba sesifo kunciphisa ubungozi be-neuropathy ngo-57%. Ukwelashwa kwesifo sikashukela osezingeni eliphakeme kusuka ekuqaleni kwalesi sifo kunciphisa amathuba okuba ne-neuropathy iye ku-2% wesifo sikashukela esingaxhomekeki ku-insulin kanye no-0.56% wokulungiselela i-insulin.
Ngaphezu ushukela omningi, ubungozi be-neuropathy yesifo sikashukela lenyuka ngo:
- ukubhema
- ukusetshenziswa kabi kotshwala - kungani izidakwa zingavunyelwe kwabanesifo sikashukela;
- umfutho wegazi ophakeme
- ukukhuluphala
- cholesterol ephezulu;
- ukuguga kwesiguli;
- izici zofuzo.
Ubunzima be-neuropathy kubuye kuncike ekutheni isifo satholakala nini. Uma izinguquko ze-pathological yezinzwa zitholwa ezigabeni zokuqala, ukwelashwa kwazo kusebenza kakhulu.
Yiziphi izinhlobo ezahlukahlukene ze-neuropathy?
I-neuropathy yesifo sikashukela ingalimaza imicu emikhulu yezinzwa enkulu nezincane, esekelwe ezithweni nasezinhlotsheni ezahlukahlukene, inesimo esixubile. Yingakho ama-neuropathies abonakala ngezimpawu ezahlukahlukene - kusuka ekulahlekelweni kokuzwela kuya kuhudo, izinkinga zenhliziyo, kanye nokukhubazeka okubukwayo ngenxa yokungasebenzi kahle komfundi. I-neuropathy yesifo sikashukela inezigaba eziningana ezinemininingwane. Imvamisa kuba khona ukwahlukana kube izinhlobo zemizwa, ezizimele nezimoto.
| Uhlobo lwe-neuropathy | Ukugxila kwe-Lesion | Izimpawu zokuqala | Ukuthuthukiswa kwezifo |
| Okuphathelene nomsindo | Ama-xx of fibers ezinzwa futhi ezizimele ze-autonomic | Ukulahlekelwa ukuzwela ebuhlungwini nasezingeni lokushisa, ekuqaleni kungenzeka kube yi-asymmetric. Ukwehla kanye nokuqina kwezinyawo, imvamisa ebusuku, okuncipha ngemuva kokuqala kokuhamba. | Ubuhlungu ezinyaweni, ukuzwela okukhulayo, noma okuphambene nalokho, ukwehla okubukhali ngokulinganayo emilenzeni emibili. Ukubandakanya izandla, khona-ke isisu nesifuba. Ukuntuleka kokuxhumana kokunyakaza. Imfundo ezindaweni zokucindezelwa kwezilonda ezinobuhlungu. Ukuthuthukiswa konyawo lwesifo sikashukela. |
| Ukuthinta okubukhali | Ubuhlungu obukhali, obukhulu, obuvutha bokubambisana ezinyaweni. Iyaqinisa ekuthinteni okuncane. | Ukusabalala kobuhlungu phambi kwamathanga, ukudangala, izinkinga zokulala, ukwehla kwesisindo, ukungakwazi ukunyakaza. Ukululama isikhathi eside - kusuka ezinyangeni eziyisithupha kuya eminyakeni emi-2. | |
| Imifino (yokuzimela) | Izinzwa ezinikeza umsebenzi wesitho noma sohlelo. | Izimpawu zinwebekile futhi kunzima ukuzithola ezigabeni zokuqala. Okutholakala kakhulu: isiyezi lapho uvuka embhedeni ekuseni, ukugaya ukudla, ukuqunjelwa nohudo. | Ukukhishwa kwesisu okunciphile noma okusheshisayo, ukukhuphuka kokujuluka ebusuku, ngemuva kokudla. Ukuntuleka kokujuluka, imvamisa emilenzeni nasezinyaweni. Izinkinga zokulawula ukugcwala kwe-bladder, ukuphazamiseka kwezocansi. I-Arrhythmias, ukulahleka kombono. I-Hypersensitivity to hypoglycemia. |
| Imoto | Amangqamuzana ezinzwa wentambo yomgogodla, iningi lezimpande eziphakeme kakhulu ze-lumbar. | Kancane kancane ukhula nobuthakathaka bemisipha, kusukela emaphethelweni aphansi. Kwesinye isikhathi ukuqala okukhulu kubukeka kweminjunju evuthayo engemuva elingaphansi, ebusweni bangaphambili bethanga. | Ukubandakanyeka kwezicubu zebhande lamahlombe nezingalo. Ukwephulwa kwamakhono emoto amahle, imikhawulo yokuhamba emalungeni. Ukulahleka kwemizwa ekhombisa imisipha. Akukho ukwehla kokuzwela noma kuncane. |
Ngokuvamile, i-sensory engapheli (i-50% yamacala), i-autonomic, i-motor neuropathies ngomonakalo wezimpande zezinzwa zezifunda ze-thoracic kanye ne-lumbar zitholakala.
Ukuxilongwa Kwezinkinga
Izimpawu ze-neuropathy azivamile - zingaba izinhlungu ezingenakubangelwa noma ukungabi khona kwayo okungajwayelekile, ukungezwani kwemisipha kanye nokubulawa ngamandla, ukuqunjelwa kanye nesifo sohudo. Ngokubona ukuthi i-neuropathy yesifo sikashukela ingabekwa endaweni yanoma iyiphi ingxenye yomzimba noma ibe yinqwaba eminingi, ukutholakala kwalesi sifo kunzima.
Ukuze kutholakale isifo esifanele, iqoqo lezifundo liyadingeka:
- Ukuhlolwa okuningiliziwe kwesiguli ukuthola izikhalazo ze-vegetative-neuropathic: isiyezi ngokushintshwa kwesikhundla somzimba, ukwehluleka, i-tinnitus, ukuzizwa kwenhliziyo, ukukhubazeka nokukhubazeka, ukungahambi kahle emgodini wesisu. Kulokhu, kusetshenziswa imibuzo ekhethekile nemibuzo nokuhlolwa.
- Ukuhlolwa ngokomzimba: ukutholwa kokuzwela okunciphile, ukuba khona kwe-tendon reflexes. I-Neuropathy ingakhonjiswa ngokuxwaya izinkophe, isikhundla solimi emgodleni womlomo, i-neuritis yobuso kanye ne-gait engazinzile. Ukuhlola nakho kungenziwa ngesilinganiso sokucindezela okulele phansi nangemva kokunyuka okubukhali.
- I-Electroneuromyography ikuvumela ukuthi unqume isimo sohlelo lwezinzwa oluyingozi, ukwenziwa kwendawo kwe-neuropathy yesifo sikashukela kanye nezinga lokulimazeka kwemisebenzi yohlelo lwezinzwa.
I-neuropathy ekhonjwa ingahle ibangelwe yisifo sikashukela hhayi kuphela, kepha futhi nangezinye izizathu: utshwala noma okunye ukudakwa, izifo ezinamaphaphu, ubuthi bomzimba ngenxa yokusebenza kabi kwezinso, izifo zofuzo. Ama-neuropathies we-Autonomous and acute motor adinga umehluko ngezifo zezitho zesisu, isifo sofuba kanye namaqhubu ayingozi. Ngakho-ke, ukuxilongwa kokugcina kwenziwa ngokungafakwa, ngemuva kokuhlolwa okuphelele.
Ungayelapha kanjani i-neuropathy yesifo sikashukela
Isisekelo sokwelashwa kwe-neuropathy siyinkokhelo yesikhathi eside yesifo sikashukela. Ngokushintshwa ngokwejwayelekile kokuhlushwa kwe-glucose, ukuqhubekela phambili kwe-neuropathy yesifo sikashukela kuyeka, kunokululama okuphelele kwezinzwa esigabeni esithambile sesifo kanye nokubuyiselwa okuningana kwezinguquko ezinamandla. Kulokhu, akunandaba ukuthi isiguli sizuze kanjani i-standardoglycemia, ngakho-ke, ukuguqulwa okuphoqelekile kwe-insulin akudingekile. Le nqubo yinde, ukuthuthuka okubonakalayo kwenzeka ezinyangeni ezi-2 ngemuva kokuqiniswa koshukela. Ngasikhathi sinye, bazama ukuguqula isisindo sesiguli bese belungisa ne-lipid yegazi ephakeme.
Ukusheshisa izinqubo zokutakula, kubekwa amavithamini B. Ukuthuthukiswa kokudla kwezinzwa kutholakala ngosizo lwama-antiplatelet agents - acetylsalicylic acid ne-pentoxifylline.
Endabeni ye-neuropathy, ukuqokwa kwama-antioxidants, imvamisa i-thioctic (alpha-lipoic) acid, kuthathwa njengokuphoqelekile. Bayakwazi ukubamba ama-radicals mahhala, ukwenza ngcono ukumuncwa koshukela, babuyisele ibhalansi yamandla ngaphakathi kwenzwa. Inkambo yokwelashwa iqala emavikini amabili kuya kwayi-4 ukumiliselwa ngaphakathi, bese kuthi izinyanga eziyi-1-3 zokuphuza umuthi ezibhebheni.
Ngasikhathi sinye nokubuyiselwa kohlelo lwezinzwa lokukhululeka kobuhlungu, kunikezwe ukwelashwa okubonakalayo kwe-neuropathy:
- I-Capsaicin kuma-gels kanye namafutha okugcoba.
- Ama-anticonvulsants - I-Pregabalin, iGabapentin, iTopiramat.
- Ama-antidepressants yizidakamizwa ezingama-triceclic noma zesizukulwane sesithathu.
- Ama-analgesics, kufaka phakathi ama-opioid, uma kungasebenzi kahle elinye i-anesthesia.
Ku-neuronomous diabetesic neuropathy, izidakamizwa zingasetshenziswa ukugcina umsebenzi wesitho esonakele - ama-anti-inflammatory, vasotropic, izidakamizwa zenhliziyo, ukuvuselela kokugaya ukudla. Nge-motor neuropathy yamaphethelo aphansi kanye nesifunda se-thoracic, ukwelashwa kungadinga ukwesekwa kwamathambo esiguli - ama-corsets, ameseli, abahamba ngezinyawo.
Ukuvimbela
Ukuvimbela ukuthuthukiswa kwe-neuropathy yesifo sikashukela kungaba nesibopho sempilo yakho:
- Ukulawulwa kwe-glucose yegazi ngokushesha ngemuva kokutholwa kwesifo sikashukela.
- Ukuhlolwa kwe-hemoglobin ejwayelekile ye-glycated ukuthola ukwanda okungabhalisiwe koshukela.
- Ukuyeka ukubhema nokuphuza utshwala nesifo sikashukela.
- Ukwelashwa kwe-Hypertension.
- I-Naturalization yesisindo.
- Bona udokotela ngokushesha ngemuva kokuvela kwezimpawu zokuqala zemizwa.
- Ukuhlolwa njalo ehhovisi likadokotela wezinzwa.
- Ukudla okuvimbayo kuka-Vitamin B (ngokwesibonelo, ithebhulethi eyi-1 ye-Milgamma kathathu ngosuku amasonto amathathu) ne-thioctic acid (600 mg ngosuku, inkambo - inyanga eyi-1).
