I nā maʻi he nui e hōʻino i nā moku, e hōʻeha pū nā moku o ka retina. ʻO nā loli i hoʻopiʻi ʻia i loko o nā moku koko, ke alakaʻi pinepine nei i ka ʻike maka ʻole a me ka makapō, ke kumu o ka maʻi maʻi. ʻO kēia hoʻololi i nā veins a me nā ʻulala i kapa ʻia ʻo ka angiopathy retinal diabetic. Hoʻomaopopo pinepine kēia mau loli i nā maka ʻelua.
ʻAʻole maʻi ʻo Retina angiopathy wale nō, akā ʻaʻole ia e kamaʻilio wale nō e pili ana i nā loli mua o nā kīʻaha koko i pā ʻia e ka maʻi maʻi. Ua kapa ʻia kēia hoʻololi ʻo microangiopathy; ʻo ia ka hoʻopiʻi mua ʻana. ʻO ke ala lōʻihi o ka maʻi maʻi, ka mea, i kahi kūlana koʻikoʻi, decompensated, alakaʻi i ka hoʻomohala ʻana o ka macroangiopathies, kahi e hōʻeha ai ka puʻu haʻahaʻa, puʻuwai, ka lolo a me nā maka.
Aia ka hoʻololi o ka pathological a me ke ʻano e like me ICD-10 - H35.0 (background anginalathy retinal).
Ka mīkini i ka hoʻolālā o ka angiopathy retinal
ʻO ka glucose koko hoʻonaninani ke kumu e hōʻoli lohi nei i nā paia o nā kīʻaha koko, e hoʻomaka ana me nā capillaries liʻiliʻi. Ma ka pūnaewele o ka endothelium i hoʻopau ʻia, ʻike ʻia ka thrombi, a laila nā kolika poli.
Ka lōʻihi o ka wā, pau ka hoʻokahe o ke koko ma nā pūniki liʻiliʻi, ua lilo nā pā o nā venules a me nā arterioles i ka wehe a me ka holo mua ʻana, ʻo ka mea mua no ke koko koko, a laila no nā ʻenehana like ʻole. Ke puka nei mai ka moʻo vascular, ka hapa wai o ke koko e waiho ai i ka edema o ka retina, kū i ka "cottony" foci. I ka loaʻa ʻana o ke kahe koko, ʻike ʻia nā ʻōpū mai loko o ka waihona kālā mai ka mea liʻiliʻi a i ka mea ʻuʻuku, i nā mea nui e noho ana i kahi nui o ke kino vitreous. ʻO kēia ʻano hoʻololi i nā moku retinal i kapa ʻia ʻo nonin proliferative diabetic retinopathy (DRP).
ʻO kahi hoʻololi hou aʻe e alakaʻi nei i ka hoʻomohala ʻana o nā moku i kūkulu ʻia, me ka pōʻino i ka hapa makular, me ka luku ʻana i ke kino vitreous a me ke ao ʻana o ka lens. ʻO kēia ʻano maʻi i kapa ʻia he DRP proliferative.
Nā hōʻailona a me nā hōʻike ʻike o ka maʻi
No ka manawa lōʻihi, ʻo ka reti angiopathy he asymptomatic. ʻOi ka manawa, me ka hoʻonui o ke kōhi koko a i ʻole ka piʻi ʻana i ke koko, ke kīhī hemahema ʻike ʻia, ʻike ʻia ʻelua, ʻike ʻia "fog", e nalo ana i ka wā i pau ai nā mea i manaʻo ai iā lākou.
Me ka hoʻomohala ʻana o ka DRP non-proliferative, ʻike pinepine ʻole nā hōʻailona.
ʻO ka hapalua wale nō o nā mea e loaʻa nā hoʻopiʻi penei:
- pupule ka malunu, "fog" i na maka;
- lele, mau piʻihuʻi, nā opacities e noho ana ma nā maka;
- ke ʻano o ka ʻalā o nā mahina o ka ʻike.
Hoʻopilikia nui ka DRP Proliferative i nā moku koko a me ka retina.
I kēia ʻokoʻa o ka hoʻololi, e loaʻa mau nā hoʻopiʻi:
- ʻaʻole hiki i ka emi ʻana o ka hihio ka ʻāpono ʻole i ka hoʻoponopono ʻana;
- ua lilo hou nā opacities i hoʻopili ʻia, ka mea i pili me ka luku ʻana i ke kino vitreous a me ka hoʻomohala ʻana o ka cataract maʻi.
Nā maʻi diagnostics
ʻO ka paʻakikī o nā hoʻokolohua no ka maʻi hānai e loaʻa kahi hōʻike makahiki kūloko e kahi ophthalmologist. Me nā loli i ʻike ʻia i nā maka, e hoʻomaʻamaʻa ʻia kahi hōʻike ʻana i kēlā me kēia mahina ʻeono.
Hoʻopau i nā maʻi o ka angiopathy a me nā hoʻololi ʻē aʻe makai ʻia e ka maʻi maʻi ma ka hapa nui he mau pilikia. Hoʻomaka ka hōʻike hoʻokolohua me ka nānā no ka ʻike maka maoli a me ka tonometry.
A laila, ʻo 1-2 mau o ka mydriacil, kahi lāʻau lapaʻau kūikawā hoʻoheheʻe i ka haumāna, ua hoʻokomo ʻia i loko o ka ʻeke conjunctival. Ma hope o nā minuke 10-15, i ka wā e hoʻonui ai ka haumāna, ua hoʻomaʻamaʻa ʻia ka nānā ʻana ma ke kukui haki me ka hoʻohana ʻana i nā leopona dioptric kiʻekiʻe. ʻO ia i ka biomicroscopy i nā kūlana o ka mydriasis ua ʻike ʻia ka hapa nui o nā loli i ka retina a me kāna mau moku, ʻāpana hemorrhages, a me ka edema.
Hoʻopili ʻia hoʻi ka moʻo i loko o ka wahi moe - nā pā o nā arterioles i lilo i mālamalama, ʻōwili ka lumen. Ma ka o nā moku i hala pinepine kahi kahakaha o ke keʻokeʻo keʻokeʻo - ka lawe ʻia ʻana o nā lymphocytes a me nā puna koko plasma. I nā papa mua, hana pinepine ʻia kēlā mau loli ma ke kūloko o ka waihona kālā, a ua hala paha ke nānā ʻia ʻana mai ka haumana liʻiliʻi.
ʻAʻohe hilinaʻi pololei o ka hana o ka maʻi ma ka pae o ke kō koko a me ka lōʻihi o ka maʻi maʻi. ʻO kekahi mau mea maʻi e loaʻa mai nei i ka mellitus type I ma mua o 20 mau makahiki, a loaʻa iā lākou kahi kiʻekiʻe o ke kō ma ka pae o 10-12 mmol / l, ʻaʻole i haʻi ʻia nā hoʻopiʻi. A, ma kahi, i nā mea maʻi me nā haʻahaʻa haʻahaʻa haʻahaʻa o 7-8 mmol / L a me kahi "ʻike" o ka maʻi o nā makahiki 2-3 hiki ke loaʻa ka hopena hoʻopiʻi nui.
ʻO nā mau lapaʻau ophthalmologic loea e alakaʻi i ka photoregmission o ke kālā e nānā hou i nā dinamics o ka maʻi.
Inā kānalua ʻoe i ka hoʻomohala ʻana o ka maʻi makema diabetes, retinal detachment, a i ʻole neovascularization, ʻāpono ʻia nā optical coherence tomography (OCT).
ʻO kēia ʻano hoʻokolohua e hiki ai iā ʻoe ke ʻike i ka retina ma ka leʻaleʻa, kahi no ka manawa lōʻihi hiki ʻole ke paʻakikī a paʻakikī i ka maʻi maʻi, a hoʻoholo i nā ʻano lāʻau o ka mālama ʻana.
ʻO kekahi ʻano hana hou e nānā ai ʻo ka flu angiography o ka retina, kahi e hiki ai iā ʻoe ke hōʻike pololei i kahi o ka hoʻololi ʻana i ke koko mai nā kīʻaha koko. Hoʻomaopopo ʻia kēia ʻano ma hope o ka coagulation laser o ka retina, a me ka hiki ke SNM.
Hoʻohana ʻia i ka maʻi maʻi
ʻAʻole pono ka maʻi maʻamau ʻo ka maʻi maʻi maʻi maʻi diabetes. Hoʻomaopopo ʻia ka mea maʻi e hahai i kahi meaʻai kūikawā, nānā i ke kō koko a me ke kahe koko, glycated hemoglobin. Hoʻomaka ka hoʻomaʻamaʻa ʻana me ka hoʻomohala ʻana o nā hoʻopiʻi.
Conservative
ʻO ka hapanui o nā ophthalmologists, ke ʻike nei i ka angathyathy a i ʻole ka proliferative DRP, e kuhikuhi ana iā Taufon a me ka emoxipin maka. Hōʻalo kēia mau lāʻau i nā maka ʻelua i nā papa o 30 mau lā, me ke alapine o 3 mau manawa i ka lā.
I mua o glaucoma, e ulu pinepine me ka retinopathy maʻi maʻi, ʻokoʻa ke ʻano antihypertensive.
Inā ʻike ʻia ka maʻa maʻi edular diabetes, non-steroidal anti-inflammatory o ka lāʻau i kauoha ʻia - ʻo ka leʻaleʻa ʻo 1anakak e 1 mau manawa no ka mahina.
Coagulation Laser
ʻAʻole hōʻike ʻia ka mālama maʻi loiloi no ka ʻike ʻana i ka angiopathy retinal diabetes. Ke haʻi nei ka poʻe ophthalmologist i ka hemorrhages ma ka moku a i ka ʻāina macular, hana ʻia ka coagulation laser retinal.
Laser cauterize retinal vascular rupture i pale aku ai i ka holo koko hou. Hoʻomaʻama pinepine ʻia kēia hana lawehala i nā manawa 2-3, a uhi ʻia ka laser i ka ʻāpana o ka waihona.
Hoʻopai ʻia ka hoʻomaʻamaʻa ʻana i ka maʻi ma loko aʻe:
- i ka manawa e ʻike ʻia ai kahi membra neovascular subretinal (SNM) i ka wahi macular. Ke alakaʻi nei kēia hoʻonāukiuki i ka detinalment retinal, ka mea e hoʻoweliweli i ka nalowale ʻole o ka ʻike;
- me ka luku ʻana i ke kino vitreous me ka ikehu nui aʻe o ka hoʻomohala ʻana i ka hana retinal detinalment, hana ʻia ka vitrectomy.
Meaʻai no ka maʻi
Aia a he helu nui o nā pono o nā pono meaʻai no ke ʻano type o type a me ke ʻano 2. Pono e hoʻokō ʻia kēia mau koi e pili ana i ka hele a me ka ʻole o nā hoʻopiʻi ʻana.
Ke hoʻolauna ʻia e ʻai i kēia mau meaʻai, ʻaʻole hiki ke hoʻonui i ka pae o ka glucose, a no laila hiki ke hoʻopau ʻia:
- nā māla: nā kukama, nā ʻaka, nā ʻano āpau, ka pepa, ka zucchini, ka hua manu, ka ʻōpala, ka ʻihi;
- nā pua hou a me nā ʻōpala;
- greens, spinach, sorrel;
- tiʻi a me ke kīpeke me ka honi a me ka waiū;
- wai kohuke.
Hoʻokomo pū ʻia ka huaʻōlelo lua i nā huahana nona ka hoʻohana ʻana e pono e kaupalena ʻia ma ke kumu o ka "hoʻokaʻawale ʻia e ʻelua"
- ʻai momona: moa, pipi, pipiʻi;
- nā iʻa ʻai ʻoka momona: cod, pollock, zander, hake.
- ʻai ʻia i ka waʻa ʻole me ka momona.
- waiū me nā haʻahaʻa momona haʻahaʻa o 1.5-2%.
- keke ʻaʻano kekāhi liʻiliʻi;
- ʻuala
- pīpī - pīpī, nā pīni, nā līilima;
- palaoa a me nā huahana palaoa;
- Pasta
- nā hua hua.
A e noi ʻia e haʻalele loa kēia mau huahana:
- holoholona a me nā aila ʻaila;
- lard, ʻo margarine a me mayonnaise;
- ʻoaʻa, keke a me nā kao momona momona;
- ʻai momona: puaʻa a me ke keiki hipa, ʻiʻo, manu;
- nā ʻanoʻa momona: trout, salmon, herring, chum salmon;
- nā kinapo a me nā hua;
- kōpaʻa, meli, kaʻaila, nā kuki, nā wai, nā pōmole, kaʻili, ka wai momona;
- nā mea inu e loaʻa ai ka waiʻona;
- hua waina, nā maiʻa, nā percimmons, nā lā, figs.
Nā hiʻohiʻona o ka angiopathy i nā keiki
I ke wā kamaliʻi, ulu ka maʻi diabetes ma muli o ka lawa o ka hana ʻo ka pancreatic cell.
ʻO ka hoʻomohala ʻana o nā hoʻopiʻi maʻi diabetes i nā keiki, a me kā lākou loiloi, he mau hiʻohiʻona:
- ma muli o ka palupalu vascular palupalu, ʻike ʻia nā keiki e ka wikiwiki o ka ʻōpiopio.
- ʻaʻole paha i ʻike nā keiki ma ke kula i kekahi hoʻopiʻi, ʻoiai he mea maikaʻi ʻole kā lākou mau maka;
- ka hoʻokolokolo ʻana i nā keiki ʻōpio e kahi ophthalmologist e hōʻike ana i kekahi mau pilikia;
- ʻaʻole hiki i nā keiki ke mālama kūʻokoʻa ʻole i ka meaʻai, ka maʻamau o nā inikini o ka insulin, a nānā i ko lākou kiʻekiʻe ka lolo o ke koko, e loaʻa nō ka hopena weliweli.
ʻO nā mea wikiō e pili ana i ka maʻi a me ka mālama ʻana i nā maʻi o ka retina:
ʻO nā hana ʻohi e kuhikuhi ana i ka pale ʻana i ka hoʻomohala ʻana o ka angiopathy retinal diabetes a me nā hoʻopili ʻana i nā maka ʻē aʻe:
- kaʻai kūpono;
- ka hana pinepine a me ka hana kūpono o ka insulin a me nā haʻalulu haʻahaʻa;
- ka hoʻomalu ʻana i ke kō, ka goguka hemoglobin a me ke koko;
- kahi kipa maʻamau i ka endocrinologist a me ka ophthalmologist.
