Loaʻa nā uku lōʻihi no ka maʻi maʻi maʻamau e nā maʻi maʻi hoʻopaʻi ʻia. ʻO ka hoʻomaha hoʻomaha a hoʻomaka koke e hoʻomohala i nā hoʻopiʻi, ʻo kekahi o nā hiʻohiʻona maʻamau ʻo ka neuropathy diabetic.
ʻO ka neuropathy maʻi maʻi - he aha ia?
ʻO kēia maʻi ka hana hewa ʻole o nā fibers nerve peka. Hiki iā lākou ke pālahalaha a i ʻole ke kahakaha, e hoʻopilikia i nā ʻōnaehana a i ʻole hoʻokahi wale nō mea ʻokoʻa. I ke koho ʻana o ke kauka, ʻike ʻia ka neuropathy i kēlā me kēia hapa o ka mea maʻi me ka maʻi diabetes, me ke kōkua o nā ʻano loiloi electrophysiological ʻē aʻe - i kēlā me kēia kekona.
ʻO kahi hōʻailona mua o ka maʻi ka emi ʻana o ka piʻi o ka leʻaleʻa o ka leʻaleʻa i nā kinipuna nerve. No nā hopena ikaika o ka neuropathy, hiki i ka hōʻeha ke nānā aku, ʻeha nui, hōʻeha ke kino, hōʻeha ka naʻau a hiki i ka maʻi kīnā.
ʻO ka maʻi maʻi a me nā hoʻohaʻahaʻa manaʻo e hana ia i ka wā ma mua
- Ka hana maʻamau o ke kō -95%
- Hoʻokuʻuina o ka pua thrombosis - 70%
- Hoʻopau i kahi puʻuwai ikaika -90%
- Hoʻopau i ke kiʻekiʻe o ke koko - 92%
- ʻO ka hoʻonuiʻana i ka ikehu i ka wā, hoʻomaikaʻi i ka hiamoe i ka pō -97%
ʻO nā kumu o ka neuropathy i loko o nā maʻi maʻi maʻi
ʻO ka mea nui i hōʻike ʻia i ke kumu no ka hoʻomohala ʻana i ka neuropathy maʻi maʻi ka lōʻihi o ka hyperglycemia. Ma lalo o ke kumu o nā honi i loko o nā nerve, ua hoʻomaka ka luku ʻia, kā lākou localization a prevalence ma muli o nā hiʻohiʻona pilikino o ka mea maʻi a me ka pae o nā kaʻina loina o ka hoʻokaumaha i ke kino.
ʻO nā kumu maʻamau maʻamau o ka neuropathy i loko o ka maʻi mellitus no ka:
- ʻO ka hoʻonui nui aʻe i nā kiko o ka sorbitol i nā nerve nerve, kahi hua o ka oxygen oxidation.
- ʻO ka nele o nā myoinositol, pono ia no ka hoʻopuka ʻana o nā impulses.
- ʻO ka glycation (sugaring) o nā kalima:
- Non-enzymatic glycation kahi hopena kimia ma waena o nā mole glucose a me nā pūʻulu amino o nā protein. Mahalo lākou i ka myelin, ʻo ka waiwai e hoʻomālamalama i ka ʻeha o ka nerve, a me ka tubulin, kahi ʻōmaʻomaʻo pono no ka lawe ʻana i nā ʻōpala i loko o nā pū.
- Hoʻomuli ka haneli Glycation i ka hana o nā enzymes - nā mea e hoʻomaʻamaʻa i nā kaʻina i loko o ke kino.
- ʻO ka hoʻonui hoʻonui ʻia o nā radical manuahi i ka maʻi diabetes i ke kumu o ka luku ʻole ʻana o ka hoʻonohonoho o nā sela nerve. ʻOi aku ka kiʻekiʻe o ka hyperglycemia, ʻoi aku ka nui o ka luku. I ka hopena hope loa, ua hōʻoki ʻia ka launa ʻōpala i ka hiki ke hana i ka myelin hou, e alakaʻi ana i ka make o ke au.
- ʻO ka Angiopathy i loko o nā moku liʻiliʻi e alakaʻi i ka nele o ka pono o nā kōpena o nā nerve a me ka luku ʻole ʻia ʻana o nā koi.
Ma lalo o ka hopena o kēia mau kumu, nalowale nā fibers nerve i ka hiki ke hoʻoponopono ponoʻī iā lākou iho, ulu kā ischemia i hiki i ka make o nā pauku holoʻokoʻa, a nui loa ka maʻi hana.
Ua hōʻike ʻia ʻo ke ala wale nō e pale ai i ka neuropathy i loko o ka maʻi mellitus o ka mālama ʻana i ka glycemia maʻamau, ka mea i loaʻa me ke kōkua o nā ʻaihana hypoglycemic, nā ʻaina a me nā inikini insulin a koi aku i ka hoʻoponopono paʻa ma ka ʻaoʻao o ka mea maʻi.
ʻO wai ka hopena hopohopo
ʻO ka hopena kiʻekiʻe loa o ka hoʻomohala ʻana i ka neuropathy ma nā maʻi me ka maʻi maʻi ʻole. Loaʻa ʻia ka hoʻokō ʻana i nā kola maʻamau i kēlā me kēia manawa o ka maʻi e hōʻemi ana i ka hopena o ka neuropathy ma 57%. ʻO kahi hoʻolālā kiʻekiʻe kiʻekiʻe o ka maʻi maʻi mai ka hoʻomaka ʻana o ka maʻi ka hōʻemi i ka hiki ʻana o ka neuropathy i 2% no ka maʻi non-insulin-dependant a me 0.56% no ka hoʻomākaukau ʻana i ka insulin.
Hoʻohui i kahi o ke kō, ua hoʻonui nui ʻia ka hopena o ka neuropathy maʻi ma ka:
- ulaula
- inu waiʻona - no ke aha lā ʻaʻole hiki ke ʻae ʻia ka mea inu maʻi i ka maʻi maʻi;
- haʻi maʻi
- ʻopi momona
- kolamu kiʻekiʻe;
- aloha o ke kanaka maʻi;
- mea pili genetic.
Hoʻokū ka ʻeha o ka neuropathy i ka wā i hōʻike ʻia ai ka maʻi maʻi. Inā ʻike nā loli pathological i loko o nā nalu i ka hoʻomaka mua, ʻoi aku ka maikaʻi o kā lākou lāʻau.
He aha nā ʻanoʻokoʻa o ka neuropathy?
Hiki i ka neuropathy Diabetic ke hōʻino i nā kinipona nui a me nā liʻiliʻi, e pili ana i nā ʻano kumuhana a me nā ʻōnaehana, he ʻano like ʻole. ʻO ia ke kumu i hōʻike ʻia ai e nā ʻano neʻe o ka neka - mai ka nalowale o ke ʻano o ka maʻi o ka maʻi maʻi, nā pilikia ʻōpū, a me ka ʻike ʻana ma muli o ka hana haumāna. He maʻi kikoʻī paukū maʻi diabetes. ʻO ka pinepine ka hoʻokaʻawale ʻana i nā ʻano sensory, autonomic a me nā ʻenehana kaʻa.
| ʻAno o neuropathy | Hoʻohana a lesion | I nā hōʻailona hoʻomaka | Hoʻoulu ʻia ka maʻi maʻi |
| Lāʻele (peripheral) | ʻO nā kumumana o nā huahele hoʻonaninani a me nā autonomic | Hōʻalo ka naʻauʻana i ka hōʻeha a me ka mahana, ma ka manawa mua e like me ka asymmetric. ʻAno a me ka wīwī i ka wāwae, pinepine i ka pō, e emi ana ma hope o ka hoʻomaka ʻana o ka hele ʻana. | Ka ʻeha i nā wāwae, hoʻonui i ka naʻau, a i ʻole nā wīwī, ke hoʻohaʻahaʻa nui i ka symmetrically ma nā wāwae ʻelua. Hoʻokomo ʻia o nā lima, a laila ka ʻōpū a me ka umauma. ʻO ka hapa o ka hoʻonohonoho ʻana o nā neʻe. ʻO ka hoʻonaʻauao ma nā wahi o ka hoʻokuʻi ʻana o nā ʻeha eha. ʻO ka hoʻomohala ʻana o ka wāwae maʻi maʻi. |
| Pā-paʻai | Hoʻopiʻo nui, ikaika, paʻa i ka ʻeha symmetrical paʻa i nā wāwae. Hoʻohanaʻia ma ka liʻiliʻi liʻiliʻi. | ʻO ka hohola ʻana o ka ʻeha ma ka mua o nā ʻōpū, ke kaumaha, nā pilikia hiamoe, ke kaumaha ʻana, ke kaumaha, ka hiki ʻole ke neʻe. He lōʻihi ka hoʻihoʻi ʻana - mai ʻeono mahina a i 2 mau makahiki. | |
| Huamihala (autonomous) | Nā kumulala e hoʻolako i ka hana o kahi ʻōpala a ʻōnaehana paha. | Hoʻonui a paʻakikī nā hōʻailona i nā papa mua. Loaʻa nā mea maʻamau maʻamau: haki i ka piʻi ʻana mai ka moe i ke kakahiaka, ʻāwīwī ʻana o ke kina ʻana, constipation a me nā ʻōlelo maʻamau. | Lulu a hoʻomaʻemaʻe paha i ka hoʻomaha ʻana o ka ʻōpū, hoʻonui ʻia i ka pō ma hope o ka ʻai ʻana. ʻAi ʻole o ka palau ʻana, ma mua aʻe o nā wāwae a me nā wāwae. ʻO nā pilikia me ka kāohi ʻana i ka piha piha o ka pāheo, nā pilikia kelepona. ʻO nā Arrhythmias, lilo i ka ʻike. Hypersensitivity i ka hypoglycemia. |
| Uahi | Nā kumulima o nā pūpuna, nā mea pinepine o nā aʻa lumbar. | Ke hoʻonui iki nei i ka nāwaliwali o ka naʻau, e hoʻomaka ana mai nā lalo haʻahaʻa. ʻO kekahi manawa ʻo ka hoʻomaka ʻana ke nānā ʻia o nā hōʻeha o nā hōʻeha i lalo o ke kua, i mua o ka ihu o ka ʻūhā. | Hoʻokomo i nā musika o ke kāʻei o ke poʻohiwi a me nā lima. Kuhi hewa ʻana i nā loina kaʻa maikaʻi, ka palena o ka holo ʻana i nā ʻanekena. Holo i nā mus reflexes. ʻAʻohe liʻiliʻi i kaʻiliʻana a i liʻiliʻi paha. |
ʻO ka hapa pinepine, ka hānā o ka sensory (50% o nā hihia), autonomic, nā neuropathies motuka me ka hōʻino ʻia i nā aʻa o nā kiki o ka thoracic a me nā lumbar.
Nā Hoʻopilikia Diagnosis
Hoʻolua ka ʻike ʻana o nā neuropathy - hiki iā ia ke ʻehaʻeha ʻole a i ʻole kona hemahema, hoʻonui i ke ʻano ikaika a me ka lethargy, constipation a me nā maʻi maʻamau. Manaʻo ia hiki ke hoʻonohonoho ʻia i ka neuropathy maʻi maʻi i kekahi ʻāpana o ke kino a i ʻole multi-organ, ka paʻakikī o ka maʻi o kēia maʻi.
No ka maʻi pololei, pono ʻia kahi hoʻonohonoho o nā haʻawina:
- ʻO kahi loiloi hōkuhi i ka mea maʻi e ʻike i nā hoʻopiʻi vegetative-neuropathic: dizziness me ka loli i ke kūlana o ke kino, nāwaliwali, nā tinnitus, nā palpitations puʻuwai, ka maʻi maʻi a me nā keʻe, ka haunaele i ka ʻeha gastrointestinal. I kēia hihia, ua hoʻohana ʻia nā nīnau nīnau kūikawā a me nā hōʻike.
- Ke nānā kino kino: ke nānā ʻana o ka hoʻohaʻahaʻa ʻana i ka naʻau, ka hiki ʻana o nā tendon reflexes. Hiki ke kuhikuhi ʻia e ka neuropathy e ka lawe ʻana i nā pōpoki, ka kūlana o ka alelo i ka waha o ka waha, facial neuritis, a me kahi hana mauka. Hiki ke hoʻokō ʻia kahi hoʻokolohua me ka hoʻoweliweli ʻana e moe ana a ma hope o ke piʻi ʻana o kahi koʻo.
- Hiki i ka Electroneuromyography ke hoʻoholo i ke ʻano o ka ʻōnaehana o peripheral, ke kūloko i ka maʻi neuropathy diabetes a me ka pae o ka hōʻemi o nā hana o ka ʻoihana.
Hiki ke hoʻomāka ʻia ka neuropathy ʻike ʻaʻole i ka maʻi mellitus wale nō, akā ma muli o nā kumu ʻē aʻe: nā waiʻona a i ʻole nā mea hoʻonaninani, nā maʻi ʻala, ka ʻono o ka ʻōpū ma muli o ka hana o ka palaualelo, nā maʻi hoʻoilina. Pono ke kaʻa neʻe a me ka neʻe ʻana o ka neʻe i ka maʻi kūloko me nā maʻi o nā ʻōpū o ka ʻōpū, ka maʻi pākuʻi, a me nā maʻi hōʻino. No laila, ʻike ʻia ka hopena hope loa ma hope o ka nānā ʻana.
Pehea e mālama ai i ka neuropathy maʻi maʻi
ʻO ke kumu no ka mālamaʻana i ka neuropathy ʻo ka uku lōʻihi o ka maʻi diabetes. Me ka normalization o ka hoʻoliʻiliʻi o ka glucose, ke kū nei ka holomua o ka neuropathy maʻi maʻi, aia ke hōʻola hou i nā nerves ma ka ʻoluʻolu o ka maʻi a me kahi maʻa ʻāpana o nā loli i nā maʻi koʻikoʻi. I kēia hihia, ʻaʻole ia i ka hopena o ka mea i loaʻa i ka mea maʻi i ka normoglycemia, no laila, ʻaʻole i koi ʻia kahi hoʻololi koi ʻia i ka insulin. He lōʻihi kēia kaʻina hana, ʻike ʻia ka hoʻomaikaʻi ʻana i 2 mau mahina ma hope o ka hoʻopaʻa ʻana o ke kō. I ka manawa like, hoʻāʻo lākou e hoʻoponopono pilikino i ke kaupaona o ka mea maʻi a hoʻoponopono i ka pae kiʻekiʻe lipid kiʻekiʻe.
E hoʻolōʻihi i nā hana hōʻola, ua kuhikuhi ʻia nā huaora B. ʻO ka hoʻomaikaʻi i ke kūlohelohe a me ke kōkua me nā mālamalama antiplatelet - acetylsalicylic acid a me ka pentoxifylline.
I ka hihia o ka neuropathy, ʻo ka koho i nā antioxidants, ka mea maʻamau thioctic (alpha-lipoic) acid, i manaʻo ʻia he kauoha. Hiki iā lākou ke hana i nā radical manuahi, hoʻomaikaʻi i ka lawe ʻana o nā meli, e hoʻihoʻi i ka hoʻemi ʻana o ka ikehu i loko o ke aʻa. ʻO ka papa o ka mālamaʻana mai ka 2 a me 4 mau pule o ka infravenous infusion, a laila 1-3 mau mahina o ka lawe ʻana i ka lāʻau i nā papa.
Hoʻoikaika pū me ka hoʻihoʻi ʻana o ka nūnae nerima no ka hoʻomaha ʻana o ka ʻeha, ua kau ʻia kahi hōʻailona maʻi neʻe o ka neuropathy:
- ʻO Capsaicin i loko o nā mea poni a me ka poni.
- Anticonvulsants - Pregabalin, Gabapentin, Topiramat.
- ʻO nā antidepressants he tricyclic a i nā kolu o nā hanana laikini.
- Analgesics, a me ka opioid, i ka hihia o ka hiki ʻole o kekahi anesthesia.
Me ka neuropathy diabetic autonomous, hiki ke hoʻohana ʻia nā lāʻau lapaʻau e mālama i ka hana o nā mea i hoʻopau ʻia - anti-inflammatory, vasotropic, cardiotropic drug, digestive stimulants. Me ka neuropathy motor o nā haʻahaʻa haʻahaʻa a me ka ʻāina thoracic, hiki i ka lawelawe ke koi ʻana i ke kākoʻo orthopedic no ka mea maʻi - corsets, nā kuʻi, nā mea hele.
Kāohi
No ka pale ʻana i ka hoʻomohala ʻana o ka neuropathy maʻi maʻi hiki ke kuleana wale i kou olakino:
- Kaohi koko i ka wā koke ma hope o ka loaʻa ʻana o ka maʻi diabetes.
- Hōʻike pinepine ʻia nā maʻi glycated hemoglobin e ʻike i nā hoʻonui i hoʻopaʻa ʻole ʻia i ke kō.
- Kūʻai i ka inu a me ka inu ʻawa me ka maʻi diabetes.
- Hoʻohana ʻia ka maʻi hypertension.
- ʻO ka hoʻokaʻawale ʻana o ke kaupaona.
- E ʻike koke i ke kauka ma hope koke o ka hōʻailona ʻana o nā maʻi neʻokeʻo.
- ʻO nā hoʻokolohua maʻamau i ka ʻoihana o kahi neurologist.
- Hoʻomaka ka huaʻai o ka vitamina B (no ka laʻana, 1 papa o Milgamma ʻekolu mau manawa i ka lā no 3 wiki) a me ka thioctic acid (600 mg i kēlā me kēia lā, ʻano - 1 mahina).
