ʻO ka maʻi maʻamau o ka maʻi mellitus, a me ka mea inu wai, ʻo ia kekahi o nā kumu maʻamau o ka neuropathy. Ua hōʻike ʻia ka pilina ma waena o ka piʻiʻana o ka glucose o ke koko a me ka loaʻa o ka hōʻeha o nā pilikia nekau.
Eia kekahi, mai 60 a 90 mau paona o nā mea maʻi e loaʻa mai i ka neuropathy maʻi maʻi peripheral a autonomous a me kona mau hōʻailona e hoʻonui ana i ka holomua o ka maʻi maʻi.
Inā loaʻa ʻole kahi maʻi maʻi maʻi kūpono ʻole, kūkulu ka wāwae maʻi ma muli o ka neuropathy haʻahaʻa haʻahaʻa, ʻoiai ka nui o ka hōʻemi o ka ʻehaʻeha i nā mea maʻi me ka maʻi maʻi maʻi e hoʻonui ʻia i ka aneane 50% hoʻohālikelike ʻia me nā poʻe me ka hyperglycemia.
ʻO ka uluʻana o ka neuropathy ma ka maʻi mellitus ma muli o ke kumu - ke kumu a me ka hana
ʻO ka mea nui i ka neuropathy, a me nā hoʻopiʻi ʻana o ka maʻi diabetes, ʻo ia ka hoʻonui ʻana i ka huina o ka huapalapala i loko o ke koko kaila a me ka hopena ona i ka huehue ʻana i nā kopa. Hoʻokumu ka neuropathy maʻi hoʻomehana ma muli o ka hōʻeha ʻana i nā nuna lākou iho a me nā kīʻaha koko e hānai iā lākou.
Hiki i ke kulu mai ke koko ke komo i loko o ka wahī o ka nerve a ʻaʻohe o ke komo ʻana i ka insulin, akā ʻaʻole hiki ke hoʻokomo ʻia i loko o ke kumu o ka glycolysis no ka ikehu. I kēia hihia, hoʻāla ʻia kahi ala ʻokoʻa ʻē aʻe, i hana ʻia ai ka sorbitol.
ʻO Sorbitol, ka hōʻiliʻili i loko o ka pūpū, luku ʻia iā ia, a me ke komo pū ʻana me ka vasodilation e kū nei. Hoʻopilikia ka vascular a me ka hoʻolohi ʻana i ke kaomi o ka oxygen i nā mea e pono ai o nā sela nerve.
ʻO kekahi ʻano hana hou o nā hana hōʻino i ka maʻi diabetes ka hoʻonui ʻia ʻana o nā radical manuahi. ʻO kēia mau molekila maikaʻiʻole me ka hana kemika kiʻekiʻe, kahi e hiki ai ke hoʻopau i nā kinohi, nā membrane cell a me ka DNA.
Eia kekahi, nā hana hana i hiki mai i ka hoʻomohala ʻana o ka neuropathy i ka maʻi mellitus
- ʻO ka hoʻopili ʻana o kahi molekena glucose i nā protein e glycosylation, e komo pū ana i nā membrane nerve.
- ʻO Microangiopathy o nā moku nerve.
- Hōʻeha ka hoʻonaninani ʻana i ke aʻa.
- ʻO ke kāpili o nā antibodies e kū'ē i nā cell nerve.
Polyneuropathy ma ka maʻi mellitus maʻi, nā hōʻailona a me nā maʻi
Hōʻike pinepine ʻia ka polyneuritis diabetic e kahi lesima symmetrical o nā ʻāpana haʻahaʻa. I kēia hihia, ʻo ka hoʻopiʻi maʻamau o nā maʻi nā mea i hōʻeha ʻole i ka naʻau. Me ka pohō o nā fibes nui, nā mea ʻike o ka wili uila, pākuʻi a me ke kūlana.
ʻO nā fibin nerve nā kuleana ke kuleana no ka hōʻino o ka ʻeha a me ke kūpaʻa. ʻO ka hapa nui o nā neuropathy e hele mai me ka maʻi ʻehaʻeha o ka pathological kū i ke kua o ke hōʻemi o ka naʻau, ʻo ia hoʻi, ua kau ʻia nā ʻano āpau āpau.
Hoʻokumu ʻia nā pilikia o ka hōʻiliʻili o ka ʻili i ke kiʻekiʻe o ka maʻi diabetes, hoʻomaka me nā manamana wāwae, a laila e holomua e like me "kaʻi ʻia", "stocking", a me nā "kūlou."
Hōʻike ʻia nā hōʻailona o ka neuropathy diabetic i kēlā mau manaʻo:
- Paresthesia - kahi ʻano kani manuahi.
- Kālā paʻa.
- Hoʻopili i nā hōʻeha ma nā wāwae, hōʻeha ʻia i ka pō.
- Hōʻīwī huhū, nā mākīwili o ka ʻiʻo.
- Hōʻailona i ke anuanu.
ʻO nā mea kūponoʻole i pili ʻole i ka pili ʻana me nā pilikia o ka hana o ke kaʻa ma ke ʻano o ka maʻi pākēnē a i ʻole muses paresis.
Ma muli o ka haunaele kēia hoʻopiʻi ʻana, a ma ka hopena o ka mālama ʻana, ke kau nei ʻo ia ma ke ʻano he ala mua loa, e hōʻike ʻia nei e hoʻomanawanui ʻia nā maʻi āpau me ka maʻi mellitus i kēlā me kēia manawa i kēlā me kēia mau mahina ʻeono me kahi neurologist. No ka noʻonoʻo ʻana, hana ʻia nā hoʻokolohua paʻa.
ʻIa ʻia ka hoʻoholo ʻana o ke kūleʻa ʻana e ka pā me ke kila ʻāʻī a i ʻole kahi ʻūpiki palupalu, i hoʻoholo ʻia ka hiʻohiʻona tactile ma ke kū hoʻokahi, e hoʻopili ʻia me kahi ʻāpana nylon kaila. Hoʻohana ʻia ka huila no ke nānā ʻana i ka ʻike i ka ʻeha. Hiki ke hoʻoholo ʻia ka naʻau o ka mahana e kahi polokalamu kūikawā "Type Term".
Hoʻoholo ʻia ke ʻano o nā reflexes, ka ikaika ʻāʻī a me kahi ʻano o ka uila.
Inā i ka wā o ka nānā ʻana i nā wāwae i hōʻike ʻia ka poino o ka ʻili a i ʻole ka hapa o ka pulse, a laila hoʻokaʻawale ʻia kahi hopena e pili ana i ka loaʻa ʻana o nā kīʻaha peripheral a me nā ʻōiwi a me nā iwi i hana ʻia me ka wāwae maʻi.
ʻO nā hōʻailona o ka wāwae maʻi
ʻO ke kumu maʻamau o ka leg amputation i ka maʻi diabetes ma ka polyneuropathy syndrome me ka hoʻokumu ʻana o ka wāwae maʻi. Aia i ka ākea o nā ʻano like ʻole, kahi ʻano ka neuropathic, ischemic a me ka ʻano like ʻole o ka maʻi.
ʻO ka hapa pinepine, ua hōʻike ʻia kahi hopena neuropathic o kēia pathology. ʻO ka hoʻonāukiuki o ka hohonu o ka pūnaehana autonomic e alakaʻi i kahi loli i ka ʻala ʻana, e lilo i ʻili a palupalu ke ʻano o ka hōʻino.
ʻO nā kīʻaha hoʻohuihui, kahe a kahe me ke koko, e alakaʻi i ka huehue, e maloʻi nui i nā ʻūhā lalo loa. Kēia edema, ʻaʻole like me ka edema cardiac, ʻaʻole i hala ʻia me ka wae ʻana o ka hoʻomaha hoʻomaha.
ʻO ka maʻi ʻai e pili ana i ka maʻi wale nō, akā ʻo ka tendons, ligamentous apparatus, e hōʻeha ana i ka huehue a me ka hoʻololi ʻana o nā iwi metatarsal ma muli o ke kola ʻana o ka ukana. Hoʻemi ka hoʻohaʻahaʻa ʻana i ka ʻeha i ka wā o ka neʻe ʻana ma mua i ke alakaʻi ʻana i ka hemahema o ka neuropathic ulcerative.
ʻO kahi maʻa maʻamau ʻo ia ka thumb pad. Hoʻokomo ʻia ka ʻūhā, pinepine i ka maʻi, paʻakikī e ka osteomyelitis. ʻO kahi hiʻohiʻona diagnostic hiʻohiʻona ʻo ka haʻalele ʻana o ka eha.
Hōʻike ʻia ka neuropathy diabetic me ke ʻano ischemic e kēlā mau hiʻohiʻona.
- ʻAi ʻole o ka puliki ma ka wāwae.
- Anuanu ka ʻili me kahi pala paʻu.
- Hoʻeha ʻia ka ʻeha ma ka wāwae i kahi hoʻomaha, e hoʻoulu ana i ka pō.
- Ke hele nei, hele ʻia nā kīʻaha intermittent.
Me ka ʻano o ka ʻāʻī ʻīpī limahana, ʻokoʻa nā hōʻailona āpau a me nā mea like ʻole.
Nā neuropathy ʻĀina
I ka hōʻino ʻana i ka hoʻohanohano autonomic o nā kino, ʻike nā maʻi i ka wahi o ka lesion. ʻO ka manawa pinepine loa, ʻike ʻia i nā hana i ka wā hope loa, ʻoiai ʻaʻole ia he mau hōʻailona ʻōmaʻomaʻo. I ka manawa like, ʻo ka hoʻomohala ʻana o ka neuropathy he prognosis maikaʻi ʻole, ʻoiai e alakaʻi ia i ka nui o ka make ma nā manawa ʻelima.
ʻO ka mea koʻikoʻi loa nā puka naʻau o ka neuropathy autonomic. Hiki iā ia ke hana i ke ʻano o ka tachycardia i ka hoʻomaha, i ka hoʻohemo ʻana o ka ʻeha ma nā wahi o ka puʻuwai, e hoʻonui ana i ka kikowaena QT ma ka ECG, ke kaomi o ke kaohi o ka wā o ka piʻi.
I kēia hihia, ʻaʻole nā amuamu e hoʻopiʻi, koe wale nō nā nāwaliwali a me nā maʻi haʻahaʻa. Me kēlā mau ʻano o ka neuropathy, ʻaʻohe mau hōʻeha o ka hōʻeha ʻana i nā puʻuwai o ka naʻau. ʻAʻole paha e manaʻo ka poʻe maʻi i kona mau hōʻailona, e alakaʻi ana i ka loaʻa ʻana o nā hua ʻino nui o ka puʻuwai me kahi hopena momona.
ʻO nā hōʻailona o ka poino i ka ʻōnaehana hoʻoili e pili ana me ka hana a ka mea i hoʻopilikia ʻia:
- Manaʻo ʻana o ka ʻōpū piha ma hope o ka ʻai ʻana.
- ʻEha ka ʻōpū.
- Puka a luwau.
- Paʻi ʻia ka nui o ka wai ma hope o ka ʻai ʻana, a me ka pō.
- Ka huhū ʻo Fecal.
No ka hana ʻana i kahi maʻi, hoʻomaʻamaʻa ʻia i kahi hōʻike X-ray a i hoʻoponopono ʻia hoʻi i ka ʻōpū a me nā ʻōpū.
Hōʻike ka Cystopathy i ka maʻi mellitus i ka hōʻike i ke kakahiaka o ka nui o ka urine me kahi kahawai palupalu a me nā hōʻuluʻulu ʻana o nā hāʻule. Hoʻohana ʻia ka ʻohi ʻana i ka uria i ka heʻe ʻana o ka urination. Ma muli o ka hōʻiliʻili o ka urina i koe a me ka hoʻopili ʻana i ka maʻi, ulu ka cystitis a me pyelonephritis.
Ma kahi o 60% o nā kāne, hele mai ka maʻi diabetes me ka hoʻohaʻahaʻa i ka potency. Ke hele nei ka maʻi a me ka wā o ke ʻano, ke hoʻomāhuahua nei kēia mau maʻi, kahi e alakaʻi ai i nā hoʻopili ʻana i nā hōʻailona kaumaha. I ka manawa like, ʻo ka māhele psychogen exacerbates erectile dysfunction.
ʻO kekahi o nā hoʻopiʻi koʻikoʻi o ka neuropathy maʻi autonomic ma kahi o ka hoʻohaʻahaʻa ʻana i ka hoʻoneʻe ʻana i ka kō koko koko. Hoʻomaʻomaʻi nā mea maʻi i ka hoʻokokoke o ka hypoglycemia, kahi hiki ke hoʻoweliweli ʻia, inā paha inā i kēia manawa ke hoʻokau aku lākou i nā kaʻa a i nā mīkini paha i ka wahi hana.
ʻO ka maʻamau ma ka maʻi mellitus, ka helehelena o ka puʻuwai a i ʻole ka mea e haki ana, nā haʻalulu lima, nā mea maʻi e hoʻomaka i ka ʻike ʻana i nā hana mua, e hiki ai iā ʻoe ke lawe i nā hana pale i ke manawa. Me ka neuropathy, ʻike aku nā maʻi i ka coma hypoglycemic wikiwiki.
I ka manawa like, nā kuʻi uncompensated e hoʻopiʻi i ka hoʻonaninua o ke koko e hoʻonui i ka pono o ka metabolic.
Therapy no ka maʻi neuropathy maʻi
No ka mālamaʻana i ka neuropathy, pono ʻoe e hoʻopaʻa i ka pae ʻai koko i ka pae kiʻekiʻe. Pono kēia i ka mālama pono ʻana i ka ʻai (maʻa mau nā meaʻai ʻai pinepine) a me kaʻai me ka kaohi o nā pakanā. I kēia hihia, ʻoi aku ka maikaʻi o ka haʻalele ʻana i nā hoʻokaʻawale māmā a hoʻopaʻa i ka paʻakikī i kahi pae ʻoluʻolu.
Eia kekahi, pono e hoʻemi i nā mea momona o nā huahana momona a nā holoholona i hoʻokomo a hoʻokomo i loko o ka papa i kahi momona o nā mea momona mai nā lau o nā lau, nāʻaila. Hōʻike ʻia ka Protein e loaʻa mai ka iʻa a me nā huahana momona haʻahaʻa.
Pono e koho pono i ka lāʻau lapaʻau i ke ala e pale ai i nā hoʻololi koke i nā nui o ke kō koko koko, ʻoiai ʻo ka pōpilikia ʻo ia e hoʻonui a hāʻule i ka hypoglycemia.
ʻO nā mea maʻi me ka maʻi diabetes mellitus type 2, ka mea hiki ʻole ke hoʻokūkū i ka pae glucose me ke kōkua o nā papa, e koho i ka pakanā o ka insulin ma ke ʻano o ka monotherapy a no ka hui pū ʻana.
Inā hoʻopaʻi ʻia ka maʻi diabetes, a laila hiki ke neʻe i nā hōʻailona o ka neuropathy maʻi ma waena o ʻelua a ʻekolu mau malama.
Hoʻopau ʻia ka mālama ʻana o ka neuropathy peripheral e nā hui o nā lāʻau lapaʻau:
- Thioctic acid: Espa-Lipon, Thiogamma, Dialipon a i ʻole Belition i kuhikuhi ʻia i loko o nā papa a i ʻole nā injections.
- Hoʻomoe o nā huaora B: nā injectable form of Milgamma, Neurorubin, Neurobion, Beviplex, Kompligam, Trigamma, penei pū kekahi me Nurobeks, Neurovitan, nā papa pālala Folic.
- Hoʻopukumu: Diclofenac, Nimesulide, Revmoxicam, Dexalgin.
- Anticonvulsants: Lyrics, Finlepsin, Gabalept.
- Antidepressants: Anafranil, Amitriptyline, Venlafaxine.
- E hoʻomaikaʻi i ke kaila peripheral: Actovegin.
- Hoʻomākaukau kūloko: nā aila me ka Coverocaine a i ʻole ketoprofen.
Hiki ke mālama i ka neuropathy i loko o ka maʻi mellitus o ka maʻi maʻamau (i ka haʻalele ʻana o contraindications) e hoʻohana ana i ke ʻano o ka oxygenbar hyperbaric, hoʻoulu ʻia me nā haʻahaʻa modulated, magnetotherapy, electrophoresis.
Kāohiʻana i ka Neuropathy Diabetes
ʻO ke ala nui e pale i ka hoʻopiʻi ʻana i ka maʻi diabetes ka mālama mau ʻana i ke kō koko koko. Hoʻāʻo ʻia ia ma luna o kahi ʻōpū ʻole, ma hope o ka ʻai ʻana (ma hope o 2 mau hola), ma mua o ka hiamoe. ʻO kahiʻoi aku, nānā kahe koko ʻana i ka liʻiliʻi a ʻelua i ka lā. I hoʻokahi manawa ʻekolu malama, e hana ʻia kahi loiloi no ka hemoglobin glycated.
ʻO nā kipa Endocrinologist e pono i kēlā me kēia mau mahina ʻekolu, kahi neuropathologist, kauka a me ka podologist i kēlā me kēia ʻeono mahina.
Pono pono e hoʻōki i ka ulaula a inu i ka wai ʻawa, ʻoiai lākou e hōʻeha ai i ka vasospasm a hōʻino i nā iwi nerve, e hoʻomaikaʻi i nā hōʻike o ka neuropathy, e hoʻonui ana i ka ʻeha a me ka hōʻeha i nā wāwae.
Hoʻomaopopo ʻia ka LFK no ka maʻi maʻi maʻi, ka mea e kau ai i ka hiking, ka ʻauʻau a i ʻole yoga. ʻO ka manawa holoʻokoʻa o ka hoʻonaʻauao kino, hiki iā ia ke pale aku i ka neuropathy i ka maʻi diabetes ka liʻiliʻi ʻo ma kahi o 150 mau minuke i hoʻokahi pule.
I mea e pale ai i ka hoʻomohala ʻana o ka wāwae diabetes, ua kuhikuhi ʻia nā ʻoihana penei:
- Ka hoʻomaʻemaʻe ʻana i kēlā me kēia lā a me ka nānā ʻana i nā wāwae no ka microtrauma, scuffs.
- Mai ʻae i ka puhi ʻana a me ka pōkole o nā wāwae, hōʻeha ʻia.
- Lā ʻia ka hele wāwae ʻole, ʻoi aku hoʻi ma waho o ka hale.
- No nā kāmaʻa, me nā hosiery, pono ʻoe e koho i nā mea hoʻonaninani kūlohelohe.
- Hoʻomaopopo ʻia nā kāmaʻa ʻoluʻolu, inā pono me nā insole orthopedic.
- Ke lawe nei i kahi pedikyur, ʻaʻole mea pāpā iā ia e ʻoki palaoa.
- No ka lole o ka home, koho i nā kāmaʻa me nā ʻeke hope.
- Pono kēlā me kēia lā e minamina i kou mau wāwae me kahi aila poni e pale ai i ka overdrying.
I mea e pale ai i ka neuropathy autonomic, pono ʻoe e ʻike ʻia e ka cardiologist, urologist a me gastroenterologist.
I ke wikiō ma kēia ʻatikala, e hoʻomau ka ʻo Elena Malysheva i ke kumuhana o ka maʻi neuropathy maʻi.
