Retinopathy Diabetic: pae, hōʻailona a me ka mālama

Retinopathy Diabetic - hoʻopōʻino i nā moku o ka retina o ke kaʻe. He hopena koʻikoʻi kēia a pinepine i ka maʻi maʻi, e hiki ke alakaʻi i ka makapō. Hōʻike nā hoʻopiʻiʻike i ka 85% o nā mea maʻi me ka maʻi type 1 me ka ʻike he 20 mau makahiki a ʻoi paha. Ke ʻike ʻia ka maʻi diabetes type 2 i ka poʻe waena a me ka ʻelemakule, a ma mua o 50% o nā hihia, ʻike koke lākou i ka hōʻino o nā moku e hāʻawi ana i ke koko i nā maka. ʻO nā hōʻeha o ke kanikela ke kumu maʻamau o nā hihia hou o ka makapō i waena o nā pākeke i nā makahiki 20 a i ka 74 mau makahiki. Eia nō naʻe, inā e nānā pinepine ʻia e ʻoe i ka ophthalmologist a mālama pono ʻia, a laila me ke kiʻekiʻe kiʻekiʻe hiki iā ʻoe ke mālama i ka ʻike.

I ka hopena hope, hoʻoweliweli nā pilikia retinal i ka nalowale o ka ʻike. No laila, ʻo nā mea maʻi me ka retinopathy diabetes proliferative e kuhikuhi pinepine i ka coagulation laser. ʻO kēia kahi hana e hiki ai ke hoʻolōʻihi i ka hoʻomaka o ka makapō i ka lōʻihi. ʻOi aku ka nui o ka maʻi o nā maʻi ma mua e loaʻa nā hōʻailona o ka retinopathy i ke wā mua. I loko o kēia manawa, ʻaʻole e hoʻopilikia ka maʻi i ka ʻike maka a ʻike ʻia wale nō ke nānā ʻia e ka ophthalmologist.

I kēia manawa, ke hoʻonui nei ka ola o nā mea maʻi me nā maʻi diabetes type 1 a me ke ʻano 2 no ka mea ʻoi ka make ma muli o nā maʻi cardiovascular. ʻO kēia ka mea e loaʻa hou ai ka poʻe i ka manawa e hoʻomohala ai i ka retinopathy diabetes. Eia kekahi, ʻo nā mea hoʻopiʻi o ka maʻi maʻi, ʻoi aku ka maʻi diabetes a me nā maʻi o ka maʻi maʻi, e maʻamau pū me nā pilikia o ka maka.

Nā kumu o nā pilikia maka me ka maʻi maʻi maʻi maʻi

ʻAʻole naʻe i hoʻokū ʻia nā hana maoli no ka hoʻomohala ʻana o ka retinopathy maʻi. I kēia manawa, ke noiʻi nei nā ʻepekema i nā hypotheses like ʻole. Akā no nā mea maʻi, ʻaʻole koʻikoʻi kēia. ʻO ka mea nui ka ʻike mua ʻia o nā hopena pili, a hiki iā ʻoe ke lawe iā lākou ma lalo o ka mana.

Hiki ke loli nui ka ulu ʻana o nā pilikia o ka maka me ka maʻi diabetes inā ʻoe:

• hoʻonui ka hoʻonaninani koko;
• ke koko kiʻekiʻe (hypertension);
• ulaula
• maʻi pūpū
• hapai
• predisposition genetic;
• hiki i ka makaʻala o ka maʻi retinopathy maʻi me ka makahiki.

ʻO nā mea koʻikoʻi koʻikoʻi ke koko koko a me ke kiʻekiʻe hypertension. ʻOi aku lākou i kahi o nā mea a pau i ka papa inoa. Hoʻokomo ʻia i kēlā me kēia hiki ʻole i ka mea maʻi ke hoʻomalu, ʻo ia hoʻi, ko lākou ʻano genetics, ka makahiki a me ka lōʻihi o ka maʻi maʻi.

Hōʻike ka mea i kēia ma ka ʻōlelo maopopo i nā mea e tupu me ka retinopathy diabetic. E ʻōlelo ka poʻe loea he maʻalahi kēia ma ka wehewehe ʻana, akā no ka mea maʻi ua lawa. No laila, ʻo nā kīʻaha liʻiliʻi e hōʻalo ai ke koko i ka maka no ka nui o ke kō koko, ke kiʻekiʻe a me ka uahi. Hoʻopilikia ke kaumaha o ka laweʻana o ka oxygen a me nā mea momona. Akā hoʻopau ka retina i nā oxygen a he glucose i kēlā me kēia paona o ka paona ma mua o nā ʻano ʻē aʻe o ke kino. No laila, ʻoi aku ka maikaʻi o ke kuhi koko.

I ka pane ʻana i ka pololi o ka oxygen hāpū o nā kiko, e hoʻonui ke kino i nā capillaries hou e hoʻihoʻi i ke kahe koko i nā maka. ʻO ka hoʻonuiʻiaʻana o nā capillaries hou. ʻO ka mea mua, ʻaʻohe proliferative, kahi o ka maʻi retinopathy diabetes me ke ʻano o ka hoʻomaka ʻana o kēia kaʻina hana. I loko o kēia manawa, holo wale nā ​​paia o nā kīʻaha koko liʻiliʻi. Ua kapa ʻia kēlā luku e like me ka microaneurysms. Mai iā lākou i kekahi manawa ke kahe a ke kahe a me ke kahe i ka loʻi. Hiki i nā hua ʻai i nā retina ke hoʻomaka e hue a me ka ʻaoʻao kumu o ka retina (macula) hiki ke hoʻomaka pū kekahi. Hoʻomaopopo ʻia kēia ma ke ʻano macular edema.

ʻO ka pae hoʻohālikelike o ka retinopathy diabetic - ʻo ke ʻano he hoʻomaka ka hoʻonui ʻana o nā moku hou, e hoʻohuli i nā mea i hōʻino ʻia. Hoʻoulu ke koko o ke kō i loko o ka retina, a i kekahi manawa ke hōʻea nā moku hou i loko o ke kino vitreous - kahi wai hoʻonaninani like ʻole e hoʻopiha ana i ke kikowaena o ka maka. Eia naʻe, ʻo nā moku hou e ulu pono mai ana ka hana haʻahaʻa. He palupalu a lākou mau pā, a ma muli o kēia, hele pinepine nā hemorrhages. Hoʻākoakoa ka ʻōpū o ke koko, nā ʻano nīnū ʻāhiu, i.e. scars ma ka wahi o ka hemorrhages.

Hiki i ka retina ke kī a kaawale mai ke kua o ka maka, kapa ʻia ʻo ia ka hōʻole hou ʻana. Inā pili nā kīʻaha koko hou i ke kahe maʻamau o ka wai mai ka maka, a laila e piʻi ka lolo i ka eyeball. Hōʻalo kēia i ka hōʻino i ka nerve optic, e lawe ana i nā kiʻi mai kou mau maka i ka lolo. Aia wale nō ma kēia manawa ke hoʻopiʻi ai ka mea maʻi e pili ana i ka pupule blurred, ka pō maikaʻi ʻole pōkole, ka hūnā ʻana i nā mea, etc.

Inā e hoʻohaʻahaʻa ʻoe i kāu koko koko, a laila mālama pono ia i ka maʻamau a kaohi ʻia i ʻole kahe ʻana o kou koko i ka nui o ka 130/80 mm Hg. Art., No laila, ʻaʻole ka hopena o ka maʻi wale nō o ka maʻi retinopathy, akā pau pū kekahi o nā hoʻopiʻi ʻana i ka maʻi maʻi. Pono kēia e paipai i nā mea maʻi e hoʻokō pono me nā hana pono.

Stage Diabetic Retinopathy

I mea e hoʻomaopopo ai i ka ʻokoʻa o nā ʻāpana o ka retinopathy diabetes, a no ke aha e kū ai kona mau hōʻailona, ​​pono ʻoe e hoʻomaopopo i kahi liʻiliʻi i nā ʻāpana o ka maka o ke kanaka a pehea e hana ai.

No laila, e hāʻule ana nā hihi o ke kukui i ka maka. Ma hope o kēlā, hoʻihoʻi lākou i ka lens a i ka nānā i ka retina. ʻO ka retina ka palena o loko o ka maka e loaʻa ai nā sela photoreceptor. Hāʻawi kēia mau sela i ka hoʻololi ʻana o ka radiation māmā i nā neʻe o ke aʻaloko, me kā lākou hana mua. Ma ka retina, hōʻiliʻili ʻia ke kiʻi a hoʻouna ʻia i ka nerve optic, a ma o ia mea i ka lolo.

ʻO ka vitreous ka waiwai pololi ma waena o ka lens a me ka retina. Hoʻopili ʻia nā ʻiʻo maka i ka maka, e hōʻoiaʻiʻo i kona neʻe ʻana i nā kuhikuhi a pau. Ua kapa ʻia ʻo ia ka macula, a he mea koʻikoʻi kēia wahi no ke kūkā ʻana no ka retinopathy maʻi maʻi.

Ka helu ʻana o ka retinopathy diabetes:

1. kahi hanana mua-proliferative;
2. preproliferative;
3. proliferative;
4. nā loli ʻana o ka loli hope.

I ka retinopathy diabetes, pili ke kīʻaha koko e ʻai nei i ka retina. ʻO ka mea liʻiliʻi loa o lākou - nā kapillaries - ʻeha mua, i ka hoʻomaka mua o ka maʻi. Hoʻonui ka māmele o ko lākou mau pā, e hele mai ka hemorrhages. Hoʻokumu ka edema Retema.

I ka pae preproliferative, nui nā loli i ka retina. Ke nānā ʻia nei e ka ophthalmologist, ʻike ʻia nā māka o nā hemorrhages he nui, nā hōʻuluʻulu ʻana, hōʻuluʻulu wai, nā ischemic zona, ʻo ia hoʻi, kahi i hoʻopiʻi ai ke koko a "pōloli" a "hopohopo", ʻike ʻia. Aia i kēia manawa, hopu ke kaʻina i kahi ʻāina o ka macula, a hoʻomaka ka mea maʻi e hoʻopiʻi e pili ana i ka hōʻemi o ka hoʻomaʻamaʻa ʻike.

ʻO ka hana proliferative o retinopathy diabetic - ʻo ia ke hoʻomaka ʻana e ulu ulu nā koko hou, e hoʻāʻo ana e hoʻohuli i nā mea i hoʻopau ʻia. ʻO ka hoʻonuiʻana i ke kikoʻī ma o ka ulu ʻana o nā nui. Hoʻopuka ke kīʻaha koko, i loko o ke kino vitreous. ʻO ka mea pōʻino, ua paʻakikī nā moku hou i hana ʻia, a me nā hemorrhages mai o lākou mai ia mau mea pinepine pinepine.

I ka papa hope loa, ʻike pinepine ʻia ka ʻike i nā hemorrhages vitreous. Nā mea hou a keu nā koko, a no lākou o ke koʻi ke kū nei, a hiki i ka hōʻole ʻana (exfoliation). ʻO ka nalowale pau o ka ʻike ke hiki ke hiki ʻole i ka lens keʻake maka ke nānā aku i ka makula.

Nā hōʻailona a me nā pākuhi no ka pilikia o ka ʻike maʻi maʻi

ʻO nā hōʻailona o ka retinopathy diabetic he hoʻoemi i ka acuity nānā a i ʻole kahi pau ʻole. Kū ala lākou i ka wā i hala aku nei ke kaʻina hana. Akā ʻo ke ala koke e hoʻomaka ai i ka mālama ʻana, ʻoi aku ka lōʻihi o ka hiki ke mālama i ka ʻike. No laila, me ka maʻi diabetes, he mea nui loa ka hoʻokolokolo ʻana me kahi ophthalmologist ma kahi o ka 1 manawa i kēlā me kēia makahiki, a ʻoi aku ka maikaʻi 1 manawa i 6 mau mahina.

ʻOi aku ka maikaʻi o kahi ophthalmologist me ka ʻike i ka maʻi a me ka mālama ʻana i ka retinopathy maʻi maʻi me ʻoe. Pono ia e noiʻi i nā kauka kūikawā i nā wahi lapaʻau kūikawā no ka maʻi maʻi.

ʻO ka algorithm hoʻokolohua Ophthalmologist no ka mea maʻi me ka maʻi maʻi:

1. E nānā i nā eyelids a me nā alihi.
2. Hana i kahi visiometry.
3. E nānā i ke kiʻekiʻe o ka paila intraocular - ua hoʻoholo ʻia ʻo ia i ka manawa o 1 i kēlā me kēia makahiki i ka maʻi me ka manawa maʻi no ka 10 mau makahiki a keu paha.
4. ʻO biomicroscopy o ka maka mua.

Inā hiki i ka pae o ka paila intraocular, a laila e pono e hana ʻia nā haʻawina hou ma hope o ka hoʻonui ʻia o ka haumāna:

1. ʻO Biomicroscopy o ka lens a me ka hoʻohaʻahaʻa vitreous me ka hoʻohana ʻana i kahi kukui slit.
2. ʻO ka hoʻihoʻi ʻana a me ka kuhikuhi ophthalmoscopy - i kēlā me kēia ala mai ke kikowaena a hiki i nā periphery nui loa, i nā meridians a pau.
3. ʻO ka nānā loiloi i ka ʻikepili optic a me ka pae makular.
4. ʻO ka nānā ʻana i ke kino vitreous a me ka retina me ka hoʻohana ʻana i kahi kukui slit me ka hoʻohana ʻana i kahi manamana ʻelima Goldman.
5. Ke kiʻi kiʻi i ka ʻikepili me ka hoʻohana ʻana i kahi kāhea fundus standard a i ʻole kāmani kamera mydriatic.
6. E hoʻopaʻa i ka ʻikepili i loaʻa a hoʻopaʻa ʻia iā ia uila.

ʻO nā ala e pili ana i ke koho ʻana me ka retinopathy maʻi maʻi he stereoscopic fundus photography a me ka fluorescein angiography.

Hoʻomaʻamaʻa i ka Diinic Retinopathy Diabetic

Hoʻopili pololei nei mākou i ka nūhou i ke kahua o ka mālama ʻana i ka retinopathy maʻi maʻi. Hōʻike ka ʻike e pili ana i nā lāʻau hou i kēlā me kēia lā. Makemake e ʻike koke i ka nūhou nui? Haina no ka leka uila.

Nā ʻōpū o ka nānā ʻana a me ka mālama ʻana:

Hoʻopili ʻia nā hana o ka retinopathy diabetic i kēia mau hana:

• Coagulation Laser (cauterization) o ka retina.
• Nā hoʻonāukiuki i loko o ka lua o ka maka - ke hoʻolauna ʻana o ka anti-VEGF (ulu ulu votiki endothelial) lāʻau lapaʻau - inhibitors o endothelial vascular ulu ulu. ʻO kēia lāʻau lapaʻau i kapa ʻia ranibizumab. Hoʻohana ka hana i ka 2012, i ka wā i hoʻopau ʻia ai nā hoʻokolohua e hōʻoia ana i ka pono o ka lāʻau. Hiki i kahi ophthalmologist ke kuhikuhi i kēia mau ʻōlelo i hoʻohui ʻia me ka coagulation laser o ka retina a i ʻole hoʻokaʻawale.
• Vitrectomy me ka endolasercoagulation - inā kōkua maikaʻi ʻole nā ​​ʻano loina i luna.

Nui! I kēia mau lā, ua hōʻoiaʻiʻo nā noiʻi ʻaʻohe mea hoʻohana no ka lāʻau vascular, e like me nā antioxidants, nā enzymes, a me nā vitamina. ʻAʻole hoʻomākaukau ʻia ka hoʻomākaukau ʻana e like me caviton, trental, dicinone. Hoʻokomo wale lākou i ka hopena o nā hopena ʻaoʻao, ʻaʻohe hopena maikaʻi i nā pilikia maka ma ka maʻi maʻi ma ka maʻi diabetes.

ʻO ka photocoagulation a me ka vitrectomy

ʻO ka photocoagulation laser ke kumu i mālama ʻia i ka "cauterization" o ka retina e ho'ōki i ka ulu o nā moku koko hou. ʻO kēia kahi hoʻomaʻamaʻa maikaʻi no ka retinopathy diabetic. Inā mālama ʻia ka coagulation laser i ka manawa a i pololei, a laila hiki ke hoʻomau i kēia hana i ka 80-85% o nā hihia ma ka preproliferative a ma 50-55% o nā hihia i ka manawa proliferative o retinopathy.

Ma lalo o ka hopena o ka hoʻoulu ʻana o ka laser, ua hoʻomoʻi ʻia nā kīʻaha koko "ʻoiʻi" hou o ka retina, a hui pū ke koko iā lākou. Ma hope aku, ua uhi ʻia nā moku mālama ʻia me ka aʻa fibrous. Hiki i kēia ala mālama ke mālama i ka ʻike ma nā lā hope o ka maʻi retinopathy diabetes i 60% o nā mea maʻi no 10-12 mau makahiki. Pono ke kamaʻilio e kūkākūkā i kēia ʻano hana me ka nānā ʻana i kāna mea ophthalmologist.

ʻOphthalmic Laser Photocoagulator

Ma hope o ka coagulation laser mua, he mea nui loa ia e hoʻomaʻamaʻa ma hope o nā hoʻokolohua ma hope mai e kahi ophthalmologist a, inā pono, ʻike hou ʻia ka ʻike laser. Hoʻomaʻamaʻa pinepine ke kauka i ka hoʻokolokolo mua ma hope o 1 mahina, a me nā hoʻokolohua ma hope o kēlā me kēia 1-3 mau mahina, e pili ana i nā hōʻike pilikino o ka mea maʻi.

Hiki iā ia ke hoʻomaka i hope o ka coagulation laser, e emi iki ka ʻike o ka mea maʻi, e emi ana ka nui o kāna mahina, a ʻo ka pō ʻo ka pō. A laila paʻa ka kūlana no ka lōʻihi. Eia nō naʻe, hiki nō kahi hoʻopiʻi - hoʻonaninani pinepine ʻia i loko o ke kino vitreous, hiki ke lilo i mea ʻole.

I kēia hihia, hiki ke kuhikuhi ʻia ka mea maʻi i kahi vitrectomy. He hana kēia e hana nei ma lalo o ka anesthesia aoao. Aia ia i ka ʻoki ʻana i nā ligament o ka retina, e hoʻoneʻe ana i ke kino vitreous a hoʻololi ia me kahi kūleʻa maikaʻi. Inā hele kūleʻa retinal, a laila hoʻi i kona wahi. ʻO nā kāwili i kū mai ma hope o nā hemorrhages vitreous ua neʻe ʻia. Ma hope o vitrectomy, hoʻihoʻi ʻia ka hihiʻo ma 80-90% o nā maʻi. Akā inā aia ke hōʻole hou i ka hopena, a laila e haʻahaʻa ana ka hopena o ka kūleʻa. Aia ia i ka lōʻihi o ke hōʻole a me nā awelika 50-60%.

Inā he glycated hemoglobin ka mea maʻi> 10% a me ka preproliferative a me ka proliferative diabetic retinopathy ua hōʻike ʻia, a laila e kuhikuhi koke ʻia ai ka coagulation laser, me ke kali ʻole ʻana o nā hopena mai ka hoʻāʻo e kāohi i ke kō koko. No ka mea i nā kūlana kiʻekiʻe, ua kiʻekiʻe loa ka hopena o ka makapō. I ia mau mea maʻi, pono e hoʻohaʻahaʻa ʻia ke kōpili a aia wale nō ma hope o ka hoʻomaʻamaʻa ʻana o ka laser.

Nā hōʻailona no ka vitrectomy:

• Ka maʻi hemorrhage vitreous, ʻaʻole i hoʻoholo i nā ʻoi aʻe 4 mau mahina.
• Hopu detinal retinal.
• Hoʻopili i nā loli o ka fibrous i ke kino vitreous.

Retinopathy Diabetic: ʻike ʻia

Me ka pahuhopu o ka mālama ʻana i ka retinopathy diabetes, ʻaʻohe kumu no ka lawe ʻana i kekahi lāʻau lapaʻau vascular. ʻO ke ala e ʻoi aku ka hopena o ka hoʻohaʻahaʻa ʻana i ke kō koko koko a mālama pono i kona mauʻano maʻamau. ʻO ka ala maikaʻi loa e hoʻokō ai i kēia mea, ʻo ka ʻai ʻana me nā mea liʻiliʻi i nā kākoki, ke nānā nei i nā meaʻai i nā momona a me nā momona kūlohelohe.

Manaʻo mākou i kāu mau manaʻo hoihoi:

• ʻO ke ala maikaʻi e hoʻohaʻahaʻa i ke kō koko a mālama mau ia ia maʻamau;
• Insulin a me nā kalaiʻa: ʻo ka ʻoiaʻiʻo e ʻike ʻoe.

Manaʻo mākou he mea kōkua kēia maʻi diabetes retinopathy i nā maʻi. ʻO ka mea nui, ʻo ke kipa pinepine i kahi kanaka ophthalmologist. Pono e nānā i ka nānā ʻana o ka waihona kālā me ka hoʻonui ʻana o ka haumāna i kahi keʻokeʻo, a me ke ana nō hoʻi i ka paila intraocular.

Ehia mau e pono ai e kipa i ka ophthalmologist me ka maʻi maʻi maʻi maʻi?

ʻO ka mālama ʻana i ka hihiʻo me ka maʻi diabetes!

E noʻonoʻo e kūʻai i ke kahe koko me ke ana o ka lolo ʻana i ke koko i hoʻokahi manawa i ka hebedoma, i ke ahiahi. Inā loaʻa iā ia - hoʻonui i kūkā me kahi kauka loea i ke ʻano o ka maʻamau.Loaʻa iā mākou kahi kikoʻī a me kā pono, "Hypertension ma Diabetes." Inā mālama ʻia ke koko kiʻekiʻe, a laila hoʻopuni ʻia nā pilikia o ka ʻike ... a hiki ke hōʻeha ʻia a hōʻeha a hōʻeha paha.