ʻO ka angiopathy diabetic o nā haʻahaʻa haʻahaʻa: ke mālama a me nā hōʻailona

ʻO ka angathyathy Diabetic he hui o nā maʻi e pili ana i ka poho o nā kīʻaha koko a me ke kaʻe paʻakikī.

ʻO ka lohi ana o ka maʻi diabetes me ke alakaʻi i ka hoʻomohala ʻana o kēia pathology. ʻO ka mua, hōʻemi ka leo vascular, ua pōkole nā ​​āpau i loko o lākou a loaʻa kahi pono meaʻai.

Hiki i ke komo ʻana i kahi kauka hiki ke alakaʻi i ka amputation a hiki hoʻi i ka make.

He aha ka hoʻomehana maʻi maʻi?

Ma hope mai, hele ka lōʻihi o ka hyperglycemia i nā hanana pathogenic e ulu ana i ka wahī a me ka pā vascular. Hōʻike ʻia lākou e ka hōʻoia ʻana o nā huahana break break i ka hoʻomaka ʻana e komo i ka protein koko a me nā ʻili kino. ʻAʻole hiki i kēia ke alakaʻi wale aku i ka angiopathy, akā aia nō hoʻi i ka angioneuropathy - hoʻopōʻino i nā moku koko a me nā kahu.

No laila he aha ka maʻi maʻi maʻi diabetes? He kulekele kēia e ʻike ai nā haki o nā paia o nā moku i hoʻopili a paʻa pono paha. I ka hopena, pilikia ke kahe o ke koko i loko o lākou. Hiki i nā ʻōnaehana helehelena e pili ana i nā kīʻaha koko ke kū i nā nui o nā kino, no laila hiki i ka angiopathy diabetes hele i nā wāwae, retina, ʻākena, lolo, a me ka puʻuwai. Hiki ke nānā ʻia nā hōʻailona o nā maʻi o ka maʻi ma ka Pūnaewele.

Mamuli o ka vascular lesion, ua ʻoka ʻia ka maʻi i kekahi mau ʻano.

1. ʻO ka Microangiopathy e hoʻopilikia i nā moku liʻiliʻi.
2. ʻO Macroangiopathy kahi ala i hoʻopili ʻia me nā moku nui.
3. Hoʻopau ka angiopathy - hoʻopau ʻia i nā pā liʻiliʻi a nui hoʻi o nā kīʻaha koko.

Ma kēia hihia, ua manaʻo ʻia nā mea e pili ana i ka hoʻomohala ʻana o ka pathology, ʻo ia ka "ʻike" o ka maʻi maʻi, ka nui o ka glycemia, ka makahiki, ka maʻi like ʻole, ka laʻa, ka ulaula, ka hoʻonui ʻana i ke koko, nā hypertension a me nā hana wāwae mau loa.

Hōʻike ka ʻano o kēlā me kēia ʻano me nā hōʻailona kūikawā, pono e ʻike ʻia i kēlā me kēia maʻi maʻi.

Hoʻomaopopo o ka Diabetic Nephropathy

ʻO ka holomua o ka angathyathy i ka diabetes mellitus e alakaʻi i ka hoʻolālāʻana o ka hikiʻole o ka renal. ʻO kēia ʻōpana he nui nā nephrons i hoʻolālā ʻia e kānana i ke koko. Nā ʻōmai ʻelima i kūkulu ʻia i nā mea e like me ke capsule, tubules, a me glomerulus. Ke kali nei nā paia o nā kapili i ka pōkole glomeruli, pau ka hana maʻamau o nā mea paʻa.

No ka wā lōʻihi, hiki i ka maʻi kokoke ke like asymptomatic. ʻAno nā hōʻailona e like me ka ma ka maʻi maʻi: waha maloʻo, make ʻole inu ʻole a me ka urination pinepine. ʻO ka holomua o ka nephropathy maʻi maʻi e alakaʻi i ka mahuhū, ke piʻi nui o ke koko a me ka hoʻohuihui, ka mea i hōʻike ʻia e ka hiamoe a me ka huhū.

Hiki i nā hana lapaʻau hiki ke hopena i nā hopena koʻikoʻi. Me ka lōʻihi o ka pale ʻole, hoʻomaka nā mea make i loko o ke kino, ʻo ia kekahi o ka ammonia. Hoʻomoʻa maʻalahi ia i ka kaila waena, e hoʻopōʻino ana ia. ʻO nā hiʻohiʻona nui o ka ammonia kiʻekiʻe a i ʻole hyperammonemia nā lime o ka luaʻi, ke kahakaha, ʻeha, a me ka hopu.

Pono e hoʻolilo i ka paʻakikī o ka lawe hānai e pili ana i ke kīpē ʻana o ka hana o nā keiki maʻi.

Nā hōʻailona o ka Diabetic Retinopathy

Loaʻa i ka ʻōiwi o ka makana i kāna pūnaewele ponoʻī o nā capillaries. Me ka holomua o ka maʻi maʻi, ʻo ia ka mea e ʻeha nui loa. Hoʻokomo ʻia ʻo Arterioles, nā ʻāpana, nā capillaries a me nā veins i loko. Ke emi ka hoʻokaʻawale ʻana iā lākou, ke neʻe ʻia ka pilina o ke koko, e alakaʻi ana i ka hoʻomohala ʻana o ka retinopathy.

Ke hoʻokaʻawale nei i kēia ʻano, ua hoʻokaʻawale ka ophthalmic a me nā hōʻailona lapaʻau.

ʻO nā hōʻailona Ophthalmic ka mea i ʻike ʻia i ka wā o ka hoʻokolokolo ophthalmological, a me nā hōʻike i hōʻike ʻia e ka mea maʻi i ke kauka hele hele i ʻike ʻia he mau maʻi maʻi.

Pono e hoʻomaopopo ʻia ka hoʻomohala ʻana o ka retinopathy i like asymptomatic, no laila, ʻike pinepine ʻia i ka manawa hope loa. ʻO nā kelepona o ka mea maʻi i ka wā e hoʻopili ai i kekahi loea hiki ke komo:

• pale ma mua o nā maka;
• nā hanaʻino o ka ʻike ʻike;
• nā pōʻeleʻele a i ʻole nā ​​uila.

ʻO ka holomua ʻana o ka maʻi e alakaʻi i kahi kaawale o ka nui a me keʻano o ke kiʻi ma mua o nā maka. A i ka hele ʻana o retinopathy me ka hemorrhage i ke kino vitreous, loaʻa i ka maʻi maʻi ʻulaʻula ka maʻi ʻulaʻula. I ka hihia maikaʻi loa, alakaʻi ka pathology i ka makapō.

I ka wā hoʻāʻo o ka ophthalmic, nānā ke kauka i nā moku a me nā nuna o ka retina. ʻOiai inā ʻaʻole ka mea maʻi i kekahi mau ʻōmaʻomaʻo ʻike mau, ua ʻike ʻia nā hōʻailona o ka retinopathy. Hiki i ke kauka ke ʻike i nā kīʻaha koko paʻa i loko o ka waihona kālā, a i kekahi manawa microaneurysms.

Eia kekahi, ʻo ka pākuʻi a me ka hōʻiliʻili o ka wai e ʻike i nā uaua nui.

ʻO ka hopena o nā mea haʻahaʻa haʻahaʻa

Ma mua e hōʻike pololei ai i ka angathyathy haʻahaʻa loa i ka maʻi diabetes, pono ʻoe e ʻike i nā hōʻailona e ʻike ai ka mea maʻi. Ma hope o nā mea āpau, ʻo ke kaʻina pono ʻole a i ʻole ka hopena e alakaʻi ai i nā hopena hikiʻole.

Ma muli o ka hoʻopili ʻia o nā wahī o ka lalo haʻahaʻa, ulu ka ischemia, ʻo ia hoʻi, he haʻahaʻa o ka oxygen a me ke koko, e alakaʻi ana i ka hana wāwae kīnā ʻole. Ke loli nei ka ʻōwili i loko o ka ʻili a kū paha i ka nekrosis a i ʻole gangrene. I kēia hihia, ʻo nā wāwae nui loa, ʻoiai ʻo ia ka wahi mamao loa.

Hoʻomaʻaaka nā ʻano hōʻailona o kēia alahele e nā kaʻina hana e kū pū me ka "maʻi ʻoluʻolu" a me ka atherosclerosis. Eia kekahi, ʻike nā kauka i nā mea ʻē aʻe e hoʻonāukiuki i ka ʻike o ke kaʻina pili o nā wāwae a me nā wāwae. Hoʻopili kēia me ka ulaula, kahi predisposition genetic a me ka hana koʻikoʻi me nā mea e ʻona ʻia.

ʻO ka angiopathy diabetic o nā haʻahaʻa haʻahaʻa loa i hōʻike pinepine ʻia e nā hōʻailona aʻe:

1. Ka ʻili a me ka hoʻāhuā ʻana o nā wāwae.
2. ʻOakalaka.
3. ʻO nā ʻōpū kuʻuna i ka wāwae.
4. ʻEha a me ka ʻeha.
5. Nā loli i loko o ka ʻili.

Wahi a ke kiʻekiʻe o ka maʻi vascular, aia kahi macro- a me microangiopathy o nā lalo haʻahaʻa. I kēia hihia, hana ʻino ʻia nā mea luna o luna.

Me kahi hoʻoneʻe liʻiliʻi o nā kīʻaha o nā wāwae, ʻike ka mea maʻi i nā ʻoluʻolu maka e ʻike nei. I kekahi manawa ua hoʻokuʻi wale kona mau wāwae, a nānā ʻia nā ʻūlū liʻiliʻi ma luna o lākou. ʻO ka holomua o ka macroangiopathy e alakaʻi i ka humuhumu o nā wāwae, ke kanikau, ka palu o ka ʻili, nā kīʻaha mau, ka ʻeha a me ke ʻeha.

ʻO ka wāwae Diabetic kahi hoʻopiʻi weliweli nui e hoʻomohala ana i ka wā e loaʻa ʻole ai ka mālama ʻana i ka maʻi maʻi ka maʻi palaki o ka maʻi diabetes. Me kēia kaʻina pili, pili kekahi mau loli i nā ʻōpū a me nā iwi. ʻO kekahi o nā hopena, ʻo ka maʻi arthropathy maʻi, e alakaʻi ana i nā pilikia a me ka wehe ʻana o nā iwi o nā wāwae. ʻO kēlā mau loli i ka hopena hope aʻe i ka maʻi Menkeberg (calcification a me ka sclerosis o nā moku o nā wāwae) a me ka deformity o ka wāwae.

Pono e hoʻomaopopo ʻia ʻo ka angiopathy maʻi maʻi o nā moku o nā papaha haʻahaʻa ma o ia wale nō ʻaʻole i holomua.

Kūkā ʻia kēlā ʻano me ka nephropathy a me ka retinopathy.

Nā hōʻailona o ka Diephalopathy Diabetic

Ke hele nei ka encephalopathy ma kahi maʻi maʻi maʻi maʻi, hoʻomaka ka hana hoʻomanaʻo a me ka haunaele. Eia kekahi, e hoʻopiʻi ka mea maʻi ma ke poʻo a me ka luhi. Kēia ʻōmaʻomaʻo he hopena ia o ka hōʻino i ke kahe o ke koko i ka lolo.

I ka hoʻomakaʻana o ka hoʻomohalaʻana o ka maʻi, ʻaʻole paha ke kanaka i kekahi mau hōʻailona. Akā i ka hala o ka manawa, lilo ka mea maʻi i kahi mea hōʻeha ma muli o nā poʻo maʻamau. ʻO kēia, ke alakaʻi nei i ka haunaele hiamoe a me ka hiamoe i ke ao a pau. I ka wā e hiki mai ana, e lilo nā mea maʻi i ka hūnā a hoʻopoina.

Hoʻopili i nā hōʻailona cerebral, ulu nā focal, kahi e hui pū ai i kahi kikoʻī o nā neʻe, nā pali pathological a me kahi hana shaky. Hōʻike ʻia ka maʻi hilahila he hōʻailona pōpilikia, ʻo ia hoʻi, ʻike maka ʻelua, nā kiʻi pākē, nā hiʻona blurred, abnormal adaptation o ka posture. Eia kekahi, ala mai ka anisocoria - kahi kūlana i ʻike ʻia ai kahi anana ʻē aʻe o nā haumāna.

Ma muli o ke ʻano o nā kaʻina hana hoʻomanawanui no ka mea maʻi i ka wā e hana nei i nā hana e pili pū ana me nā mīkini like ʻole, a me ke kaʻa no hoʻi.

ʻO ka nalowale o nā capillaries a me nā coronary arteries o ka naʻau

No ka hoʻomau ʻana o nā pūlima o nā puʻuwai, aia ke kelepona capillary a me nā ʻāpana coronary.

Hoʻopilikia ka hānō maʻi angiopathy i nā ʻāpana coronary pololei a hema. Ua kapa ʻia kēia kaʻina hana macroangiopathy, hopena mai ke kūkulu ʻia ʻana o ka atherosclerosis.

Ke hoʻopilikia ʻia nā capillaries, ulu ke microangiopathy diabetes.

Inā hele mai kahi Patologi, hoʻopiʻi ka mea maʻi i kēia mau hōʻailona penei:

1. Nā ʻeha ʻeha. Hele ia ma muli o ka hoʻokumu ʻia ʻana o nā pākiki a me nā kuʻina i ka lumen o nā kīʻaha koko. I ke hopena, ʻaʻole hiki ke kahe ke koko i ka nui i koi ʻia, a nele ka naʻau i ka oxygen. ʻO kēia hana ke kumu i ka hoʻokaʻawale ʻole o ka oxygen a hemo i ka hoʻoneʻe lactic. Hoʻokomo ʻia ia i ka pau ʻana o nā aʻa i ka puʻuwai, no laila e hōʻeha ka ʻeha o ke kanaka.
2. Haki puʻuwai, hōʻike ʻia e ka wī, hoʻemi ʻia ka puʻuwai puʻuwai a me ke kakali o ka hanu.
3. ʻO ka haunaele o ka puʻuwai. E hoʻomohala me nā leʻaleʻa o nā moku liʻiliʻi a me ko lākou sclerosis i ka myocardium. Nui nā ʻano me ka hilahila o ka mele: bradycardia (hōʻemi i ka puʻuwai ma lalo o 50 mau beats / min), tachycardia (ʻoi aku ma mua o 90 mau beats / min), extrasystole (ʻaʻole hāpē ka hoʻēmi ʻana) a me ka arrhythmia (kahiʻano nūnū maʻamau).

Pono e hoʻomanaʻo ʻia ka hōʻino ʻana i nā kīʻaha o ka puʻuwai e hoʻopili pinepine ʻia e ka moku o nā wāwae, nā pēpē a me ka retina.

Hoʻoponopono a me ka mālama ʻana i ka maʻi

Pono e hoʻokō ʻia nā hana diagnostic no ka hoʻomohala ʻana i ka angiopathy maʻi. No laila, ʻaʻole nā ​​mea hoʻohua wale nō i nā loiloi, akā pili pū kekahi i nā mea i pāpā ʻia i kēia ala.

Nui kekahi mau hiʻohiʻona no ka hoʻoholo ʻana o ka maʻi.

ʻO ka hoʻāʻo ʻana i ka hoʻoliʻiliʻi o ke koko. Hoʻonui ka hoʻonui hauoli i ka hana renal impaired. Ua hoʻoholo pū ʻia ka Urea a me nā pae kumu. Nitrogen pae: 14 a 28 mmol / lita. Urea kiko: 2.5 a 8.3 mmol / lita.

ʻĀninalysis Hoʻoholo ʻia nā ʻōkuhi e like me ka glucose, ke kino ketone a me nā protein. Hoʻopukū hiʻona: a hiki i ka 10 mmol / l. ʻO ke kiʻekiʻe o ka protein: a i ka 300 mg / lā.

ʻO ka hoʻopaʻa ʻana ʻana o ka kānina filtration glomerular. ʻO ka hōʻailona nui no ka maʻi o ka nephropathy. ʻO ke kānana glomerular: ʻoi aku i 140 ml / min.

ʻO ka hoʻonāʻana o ka urine o b2-microglobulin. ʻO ka ʻikeʻana o ka b2-microglobulin e hōʻike ana i ka angionephropathy maʻi maʻi. ʻAʻole pono kahi kanaka olakino i loko o ka pāʻai.

Hōʻalo nā lehelehe lipid. ʻO ka nānāʻana o nā lipoproteins koko a me ka cholesterol. Palapala kūloko: ʻaʻole iʻoi aku ma mua o 5.5 mmol / L. ʻO ka paʻa ʻana o nā lipoproteins: mai 1 a 2.9 mmol / L.

Hoʻopilikia aku ka maʻi maʻi o ka maʻi i ka hoʻohana ʻana i nā ʻano hana ʻē aʻe, ʻo ia hoʻi:

• hōʻikeʻike ophthalmological kūpono;
• Uiuei
• echocardiography;
• Dopplerography a me ka arteriography o nā wāwae;
• coronary angiography;
• electrocardiograms (ECG);
• a me ke kūlohelohe kūlea o ka pale.

Ma hope o ka hana ʻana ke kauka i kahi maʻi maʻi, hoʻomohala ʻia kahi ʻano hoʻonaninaniʻōmaʻomaʻi angiopathy. Hoʻohana maikaʻi ka mālama maikaʻi ʻana i ka mālama kaulike, mālama i kahi nohona olakino a me ka hoʻomaha ʻana i ka hoʻomaha me ka hana. Eia kekahi, ʻo ka mālamaʻana o ka angiopathy i hui pū ʻia me nā lāʻau lapaʻau.

1. ʻO nā lāʻau lapaʻau maʻi e pale ai i ka glycemia.
2. Nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka cholesterol.
3. ʻO ke koko e hoʻohaʻahaʻa ana i nā lāʻau.
4. Nā lāʻau lapaʻau diuretic.
5. Meʻa no ka hoʻomaikaʻi ʻana i ke kahe koko.
6. ʻO nā lāʻau pale e pale ai i ka thrombosis.
7. Nā lāʻau lapaʻau e hoʻomaikaʻi i ke kaʻina metabolic.

Pono e mālama pono i kēlā maʻi maʻi ma lalo o ka mākaʻikaʻi koʻikoʻi o kekahi loea, pili i kāna mau ʻōlelo āpau.