I-DIABETESIC POLYNEUROPATHY: IZIMPAWU ZESIFO SIKASHUKELA, UKWELASHWA KWE-PATHOLOGY

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I-neuropathy yesifo sikashukela, okuyiyona nkinga ejwayelekile yesifo sikashukela, iba yingxenye yeziguli.

Le ndlela yokusebenza kwemvelo ayibhubhisi kuphela amangqamuzana ezinzwa ebuchopho, kepha futhi nezinqubo zazo zesiqu, ezihamba emzimbeni wonke.

Isizathu sikhuphukile ushukela, obhekele i-90% yezimpawu zesifo sikashukela sezinzwa. Izimpawu ze-pathology zobuhlungu obuhlala isikhathi eside nemizwa ekhathazekile.

Ukuhlukaniswa

Izindlela ezilandelayo ze-neuropathy in diabetesics zihlukaniswa:

i-peripheral. Lolu hlobo lwe-diabetesic neuropathy (DN) lubonakala ngomonakalo emithanjeni yezinzwa yezingalo nemilenze, etholakala kude nendawo (ekhanda nesiqu), okungukuthi emaphethelweni. Iziveza njengosizi futhi ivutha amalunga, ikakhulukazi emilenzeni. Isikhumba siba hypersensitive kunoma yikuphi ukuthinta, futhi isilonda esincanyana kungenzeka singapholi isikhathi eside. I-peripheral neuropathy, nayo ihlukaniswe yizinzwa (kuthinta imicu yezinzwa ebhekele ukuzwela) kanye ne-motor (kuthinta ama-neurons anikezela ngemoto yokusebenza);
ozimele. Kubhubhisa uhlelo lwe-vegetative, esingeke sikwazi ukulithonya ngokunembeza. Lokhu kuphefumula futhi ukushaywa umoya, ukubukwa nokuvezwa kwemfihlo. Lolu hlobo lwe-neuropathy lubhekwa njengeyingozi kakhulu ngoba luphazamisa umsebenzi wazo zonke izitho zomzimba.

I-Autonomous DN ihlukaniswe:

kwenhliziyo;
i-urogenital;
emathunjini;
ukuphefumula
i-endocrine nabanye.

Izimbangela Zesifo Sikashukela

Igazi lesiguli elinesifo sikashukela linezinga le-glucose elingazinzi. Lapho liphansi, ama-neurons alamba.

Uma ushukela omningi ubonwa, i-acidization yamangqamuzana iyenzeka. Ngaphezu kwalokho, i-glucose eyeqisayo inomthelela ekuqongeleleni i-fructose ne-sorbidol ezithweni, yingakho amaseli engeke amukele amanzi kanye namaminerali.

Ngakho-ke kukhona i-edema yokuphela kwezinzwa. Lesi sithombe sikhulu nge-hypertension. Njengoba isiqu sezinzwa sisebenza ngama-capillaries amaningi amancane, umfutho wegazi ophakeme ubangela ukuba ziqhekeke, bese ama-neurons efa.

Odokotela bakholelwa ukuthi ukusolwa kokuthuthukiswa kwe-DN kulele ngohlobo olukhethekile olushintshiwe. Nguye owenza ama-neurons hypersensitive kumanani aphezulu eglucose.

Izimpawu ze-polyneuropathy zeswekile zamaphethelo aphansi

Endabeni yomonakalo ohlelweni lwe-peripheral DN, i-dalili ayibonakali ngokushesha, kodwa ngemuva kwezinyanga ezimbalwa.

Iqiniso ngukuthi kunemicu eminingi yezinzwa emzimbeni. Futhi lapho abanye babo befa, ama-neurons anempilo enza umsebenzi wabo isikhathi esithile.

Ekuqaleni, izingalo nemilenze kuyahlupheka, ngoba imicu yezinzwa kulezi zindawo yinde, futhi ithambekele ezilondeni ezingaphezulu.

Ngabe uboniswa kanjani ifomu lokuphelela?

Lapho izinzwa zemizwa zifa, kutholakala imizwa ye-sensor neuropathy.

Ukuboniswa okulandelayo kuyisici se-sensor neuropathy:

hypersensitivity kunoma yikuphi okucasulayo. Isiguli sizwa ama-goosebumps esikhunjeni sakhe, ukuvutha noma izinhlungu ezibukhali ezenzeka ngisho nangokubanjwa okukhanyayo;
kwehlisa umkhawulo wokuzwela, futhi ngezinye izikhathi ukulahleka kwayo okuphelele. Umuntu othinta into uyizwa “ngokusebenzisa iglove”. Isizathu: isignali evela kuma-receptors ayifiki kuma-neurons obuchopho;
ukusabela okungalungile kwabacasulayo. Ngakho-ke, ephendula ukukhanya, isiguli siqala ukuzwa ukunambitheka emlonyeni noma kukhona umsindo ezindlebeni. Isizathu: ukucasulwa kwesinye sezingxenye ze-nerve trunk kukholisa amanye ama-receptors amaningi (ukunambitheka noma i-auditory).

Uma izinzwa zemoto zihlupheka, kuvela i-motor neuropathy.

I-Symbomatology ye-motor neuropathy ikhula kancane futhi iziveza ebusuku noma ngesikhathi sokuphumula:

ukungazinzi kwesikhundla ("imilenze kakotini");
ukusebenzisana okungahambi kahle (umphumela wokulimala kwama-neurons obuchopho);
amalunga alahlekelwa ukuhamba, ukudumba, kunzima ukuwaqondisa;
amandla emisipha ancishiswa kakhulu. Isizathu: isifo sikashukela siphazamisa ukuhamba kwegazi nokubekwa ezindlini. Ukuqina kwemisipha kwenzeka ngokuhamba kwesikhathi.

Izimpawu zefomu elizimele

Esimweni sefomu elizimele, izinzwa ze-NS ezizimele zihlupheka. Cishe zonke izinhlelo zomzimba ziyathinteka:

ukugaya: ukushaya kwenhliziyo nokushaya, ukuqunjelwa okungapheli;
amehlo: umbono uyancipha;
izinguquko zesikhumba (umphumela wokungasebenzi kahle kwezithukuthuku). Ekuqaleni, ukujuluka kuyabonakala (imvamisa ebusuku). Ngenxa yama-capillaries athanjisiwe, isikhumba siphenduka sibe bomvu. Kuvela ukuqubuka okungenampilo. Kamuva, izindlala zesithukuthuku ziyanciphisa ukusebenza kwazo, isikhumba some. Umsebenzi wayo wokuzivikela uyaba buthaka, futhi manje noma yimuphi umonakalo isikhathi eside uyaqhuma futhi ungapholi;
izitho zangasese: ukuchama okungandile nokungapheleli;
ukusebenza kwenhliziyo kuphukile: arrhythmia, ishayela njalo. Ngenxa yokwehla komkhawulo wokuzwela kwenhliziyo, ngisho nokushaya kwenhliziyo kuqubuka ngaphandle kobuhlungu.

Ukuxilongwa nokuxilongwa

Umgomo oyinhloko ukubheka njalo amandla e-glucose egazini. I-neuropathy yesifo sikashukela ilukhudlwana izinga likashukela.

I-Doppler ultrasound scan yemilenze

Ngaphambi kokwenza ukuxilongwa, udokotela uhlola ithoni yemisipha kanye ne-tendon ekhombisa, izinga lokuzwela (elinqunywe ithuluzi elikhethekile le-microfloment), wenza izivivinyo ezishisayo.

Yonke imiphumela yocwaningo ifingqiwe, inikeze isithombe esiphelele sobulukhuni be-DN kanye nencazelo yezindlela zokwelashwa okwengeziwe.

Ukwelashwa

Isimo esiyinhloko nesisebenzayo kakhulu isinxephezelo esihle sesifo sikashukela, okungukuthi, ukunqabela amanani kashukela kuyinto evamile. Lokhu kutholakala ngokwelashwa ngamathebhulethi (uhlobo lwe-2 isifo) noma i-insulin (uhlobo 1 sikashukela).

Emithini ekhonjisiwe:

Amavithamini e-B nama-antioxidants: IMilgamma, Neurobion;
amalungiselelo nge-magnesium ne-zinc;
uma udinga ukudambisa izinhlungu, nikeza ama-analgesics: i-Finlepsin, Neurontin.

Ukwelashwa Komzimba:

ukuvusa kagesi okuqhubekayo;
ukwelashwa okukhanyayo kanye ne-electrophoresis;
i-magneto ne-acupuncture;
Ukwelapha ukuzivocavoca (imizuzu eyi-10 ngosuku).

Kubaluleke kakhulu ukuqapha isimo semilenze: yenza izinyawo (ezokwelashwa), gqoka izicathulo ezintofontofo, uthambisa isikhumba sezinyawo.

Ukusuka kumakhambi abantu (uma nje udokotela ebavumile), ungaluleka:

izinto eziningi zobumba oluhlaza okwesibhakabhaka;
ukugcotshwa kwezitho ngamafutha we-camphor;
amabhathi e-chamomile noma i-nettle.

Izinqubo kufanele zenziwe imizuzu engama-20 kanye ngosuku.

Ukwelashwa kwe-polyneuropathy yesifo sikashukela kudinga isikhathi eside (izinyanga eziningi) futhi kuwumsebenzi onzima udokotela, ngoba akekho ongabikezela umphumela wokwelashwa obekiwe. Noma kunjalo, i-pathology ingamiswa.

Izinkinga ezingaba khona kanye nokuqagela

I-neuropathy yesifo sikashukela iyelapheka.

Ungakhuluma nge-prognosis enhle uma:

izinhlungu endaweni yomlenze zithinta isiguli isikhathi esingaphansi kwezinyanga eziyisithupha;
I-NAM isungule ngokumelene nesizinda sezinguquko ezingazelelwe kushukela;
lesi sifo satholakala ekuqaleni, okwathi ngemuva kwalokho ushukela wagcinwa phakathi kwemikhawulo ejwayelekile.

I-polyneuropathy eyinkimbinkimbi iyimbangela eyinhloko yokuhlaselwa yisifo senhliziyo okungenabuhlungu, ukuhluleka kwesigqi senhliziyo nokuqunywa kwamaphethelo aphansi (sekuvele kwakhe "unyawo lwesifo sikashukela).