I-complication ejwayelekile yesifo sikashukela yi-neuropathy yesifo sikashukela. Kutholakale iziguli ezingama-30-50%.
Ukuphazamiseka kwesistimu ye-autonomic ne-somatic, imitised sensitivity kanye ne-nerve conduction kungaxoxa ngobukhona bayo.
Yini le
Ngomuthi, kuyisiko ukuqonda i-neuropathy yesifo sikashukela njengeqoqo lama-syndromes ukwephulwa kweminyango yohlelo lwe-autonomic neva and peripheral system.
Zivela ngenxa yokuphazamiseka kwe-metabolic kushukela. Kunezindlela eziningana ze-neuropathy yesifo sikashukela.
Ukuxilongwa lokhu kungenye yezinkinga zesifo sikashukela ezinzima kakhulu futhi ezivame kakhulu. Kuboniswa izimpawu zokuzwela okungahambi kahle nokwenza kwezimizwa zezinzwa, ukuphazamiseka kohlelo lwe-somatic nokunye okuningi.
Ukuhlukaniswa namafomu
I-Neuropathy i-peripheral and Autonomous.I-Neuropathy ihlukaniswa ngale ndlela elandelayo:
- ngomshini wokulimaza: i-axonal, i-neuropathic, ye-demyelinating;
- ngohlobo lwe-nerve fiber: sensory-motor, autonomic, sensory, exubile, motor;
- kuya ngendawo yomonakalo wezinzwa: izinzwa (ukuzwela izicubu kukhubazekile), izinzwa (isilonda sezinzwa), i-motor (umsebenzi we-motor ophazamisekile nomsebenzi wezicubu).
Izimbangela zokwenzeka
Isici esiyinhloko sokuvela kwe-neuropathy yesifo sikashukela kuphakanyiswe kahle glucose wegazi, okuholela ekugcineni kuguquko ekusebenzeni nasendleleni yokwakheka kwamangqamuzana ezinzwa.
Ngaphezu kwalokho, izimbangela ze-neuropathy zingaba:
- iminyaka engaphezu kwengu-60;
- umfutho wegazi ophakeme;
- ukukhuluphala noma ukukhuluphala ngokweqile;
- inkambo ende yesifo sikashukela;
- ukuba khona kwemikhuba emibi;
- isigaba sokubuyiswa kwemali.
I-Pathogenesis
Okubaluleke kakhulu kwi-pathogenesis ye-neuropathy ukuphazamiseka kwe-metabolic kanye ne-microangiopathy (izinguquko zesakhiwo noma ezisebenzayo kuma-capillaries, ezibhekele i-microcirculation kuma-nerve fibers).
Izinguquko zokushintshana zifaka izinqubo ezilandelayo:
- ukwehla kwezinga le-myoinositis, kuhambisana nokuncipha kokuhlanganiswa kwe-phosphoinositis, okuthi ngenxa yalokho kuholele ekulethweni kokuphazamiseka kwethonya lezinzwa kanye nokwehla kwamandla emetabolism;
- ukukhathazeka okunyusa i-oxidative;
- ukwenziwa kusebenze kwe-polyol shunt (impaired fructose metabolism);
- i-enzymatic kanye ne-non-enzymatic glycosylation yezakhi zezakhi zefayibha yezinzwa - i-tubulin ne-myelin;
- ukuthuthukiswa kwe-autoimmune complexes.
Izimpawu
Izimpawu eziphambili ze-neuropathy yesifo sikashukela yilezi:
- ukukhubazeka
- izimpawu ezingezinhle ze-neuropathic;
- umuzwa ovuthayo;
- i-electromyography;
- i-paresthesia;
- i-latency;
- ukwehla okukhulu noma ukungabikho kwedolo ne-Achilles reflexes;
- ukwephulwa ngokweqile kokuzwela;
- ukwephulwa kokuhamba.
Ukuxilongwa nokwelashwa
Okokuqala, ukuthola i-neuropathy, uchwepheshe uhlola ukuzwela kwesiguli. Kwenziwa umjovo wokubona izinhlungu.
Imizwa ye-Tactile ngokuthinta, ingcindezi ye-monofilament, ukushisa nokubanda nayo iyahlolwa. Imizwa yokudlidliza inqunywa ngefoloko yokucabanga.
Ngaphandle kokuhlolwa kwe-knee Reflex. Isiguli singaziphatha ngokwaso zonke lezi zenzo, okuzomsiza ukuthi athole ukuthi unesifo sikashukela se-neuropathy. Udokotela, esebenzisa imishini ekhethekile, uzonquma uhlobo, isigaba kanye nobunzima bokuxilongwa kwalesi sifo.
Kokwelashwa, kusetshenziswa indlela eyinkimbinkimbi yokwelapha, efaka:
- i-alpha lipoic acid. Kuvimbela ukunqwabelana kwe-glucose kwezicubu zezinzwa, futhi kusebenze nama-enzyme athile emangqamuzaneni, akwaziyo ukubuyisa izinzwa ezithintekile;
- ama-painkiller;
- Amavithamini e-B. Avimbela umphumela onobuthi we-glucose ezinzwa;
- I-Actovegin. Isebenzisa ushukela, iqinise i-microcirculation yegazi;
- i-aldose reductase inhibitors. Yehlisa imiphumela emibi yeglucose emzimbeni;
- I-calcium ne-potassium esekwe imikhiqizo. Yehlisa ukuzwela kanye namaqhugwane.
I-Osteomyelitis
Enye yezinkinga ezijwayelekile zesifo sikashukela i-neuropathy ephansi yemilenze, ehambisana nokwakhiwa konyawo lwesifo sikashukela. Ikhula ikakhulukazi emva kweminyaka engama-5-7 kusukela ekuqaleni kwalesi sifo ngohlobo lokuqala lwesifo sikashukela. Esimweni sesibili, lokhu kubonakaliswa kukhonjiswa kaningi kakhulu.
Isifo sikashukela
Isici esiyisisekelo ekwakhekeni kwezinkinga zesifo sikashukela ukunxephezela ushukela omncane. Isibonakaliso esinjalo sibonwa ngenxa yendlela enzima yesifo, noma ukwehluleka ukuhambisana nezincomo ze-endocrinologist. Ushukela omkhulu wegazi kanye nokushintsha okungazelelwe kuthinta kabi imicu yezinzwa nodonga lwe-vascular.
Ama-syndromes wonyawo lwesifo sikashukela alandelayo:
- ukulahleka kokungazweli;
- ama-angiopathies (ukuphazamiseka kwemithambo);
- ukutheleleka kwesilonda;
- Ukulimala kwamathambo nokulimala kwamathambo.
Unyawo lwesifo sikashukela lungenzeka ngendlela ye-ischemic ne-neuropathic, ngokuya ngalezo ziphazamiso ezikhona. Kodwa-ke, kaningi zombili lezi zinto zithinteka ngasikhathi sinye.
I-Sensorimotor
Ngenxa ye-sensorimotor neuropathy, amandla okuhamba ayancipha, futhi imizwa engajwayelekile ngenxa yomonakalo wezinzwa nayo ingavela.
Imbangela enkulu yokuxilongwa yisifo, noma ukulimala kwezinzwa. Le nqubo ingenzeka ngaphandle kwentambo yomgogodla futhi ibizwa ngokuthi yi-peripheral neuropathy.
Lesi sifo siyi-pathology, ngenxa yalokho, singathinta izinzwa ezibalulekile, umsebenzi waso ukuhlinzeka ngemizwa noma okubangela ukunyakaza. Ngale ndlela, i-sensorimotor neuropathy ingakhula. Umgomo wayo oyinhloko ukuthonya ukunyakaza.
Ngenxa yomonakalo omningi kumaseli, inqubo yokunciphisa amasignali ezinzwa iyenzeka. Futhi ngenxa yomthelela we-neuropathy kuma-nerve fibers noma kuwo wonke amaseli, ukusebenza kwawo kungahle kulahleke.
Isibonakaliso esijwayelekile ukuncipha kokuzwela kwenye yezindawo zomzimba, futhi i-pathology ivame ukuhambisana:
- ukugwinya;
- ubunzima bokusebenzisa izandla;
- umuzwa ovuthayo;
- ubuthakathaka ezingxenyeni ezahlukahlukene zomzimba;
- umuzwa ofanayo;
- ubuhlungu nobunzima bokuhamba;
- imizwa engajwayelekile kunoma iyiphi ingxenye yomzimba.
Izimpawu ze-sensorimotor neuropathy zingakhula ngesivinini esingafani, kokubili ngokushesha futhi kancane, ngaphezu kwamasonto amaningi noma iminyaka. Imvamisa, le ndlela yokusebenza kwemvelo iqala ukuvela emaphethelweni eminwe.
I-Standalone
I-Autonomous diabetesic neuropathy iyindlela ethinta ngqo ingxenye yezokuzenzela yesistimu yezinzwa, umsebenzi wayo oyinhloko ukulawula nokuxhumanisa umsebenzi wezitho zangaphakathi. Futhi, phakathi nenkambo yayo, ukubonakaliswa kokuphazamiseka okuhlukahlukene yizitho eziningi kuwuphawu.
Izimpawu ezenzeka nalokhu kuxilonga zivela ngesimo se:
- ukuqala kwesikhashana kwenhliziyo;
- ukushisa kwenhliziyo;
- ukuthopha;
- isifo sohudo
- ukuqunjelwa
- lapho kudliwa ngisho nenani elincane lokudla, usizi esiswini luyabonakala;
- ukunciphisa ijubane ukuhanjiswa kokudla kusuka esiswini kuya emathunjini.
Lezi zimpawu zikhombisa ukuphazamiseka ekusebenzeni kwesisu.
Futhi, phakathi kwalokhu, umsebenzi wezinzwa obhekene nesimo sesisu esincane ungaphazamiseka, ozobe usungena ekukhuleni kwezisu zesikhathi sobusuku.
Ngama-neuropathy azimele, izinzwa ezibhekele ukwanda ngesikhathi sokuvuka kocansi emadodeni zinomphumela omubi. Lokhu kuvame ukuholela ekungasebenzi kahle kwe-erectile, okungasusi isifiso nesifiso sobulili kwiziguli. Kepha owesimame, iziguli zingakhalaza ukoma kakhulu esithweni sangasese sowesifazane, kanye nokungabikho noma ukuncipha kwesifiso sobulili.
Amavidiyo ahlobene
Ukuvimbela kanye nokwelashwa kwe-neuropathy kushukela:
Isifo sikashukela sikashukela singenye yezinkinga ezivame kakhulu kubantu abanesifo sikashukela, sitholakala cishe esigamu sabo bonke abaguli. Kuza ngezigaba ezahlukahlukene nezinhlobo, ngayinye yazo inenkambo yayo nezimpawu zayo. Kaningi lokhu kutholakala kweziguli kunohlobo lokuqala lwesifo sikashukela.
