An gano ƙaramin hangen nesa a kusan kashi 85% na marasa lafiya da ke ɗauke da ciwon sukari na 1. Rashin ciwon sukari yana haifar da ciwon sukari bayan shekaru 15-20 na rashin lafiya. Idan an gano cutar sukari nau'in 2 a cikin tsufa, to rabin likitocin suna lokaci guda suna da cutar lalacewar tasoshin da ke ciyar da idanun.
A matsayinka na mai mulki, retinopathy a cikin ciwon sukari an haɗu da rikice-rikice na tsarin, bayyanar ƙafafun ciwon sukari da nephropathy.
Damagearfin lalacewar ido yana da alaƙa da matakin ƙaruwar glucose a cikin jini, matakin hauhawar jini, haka kuma haɓaka cholesterol da rikicewar jini.
Bayyanar cututtuka na maganin cututtukan fata a cikin ciwon sukari
Babban abin da ke haifar da rage yawan gani a jijiyoyi a cikin marassa lafiya shi ne cutar malaria. A wannan yanayin, ruwa ya tara a cikin tsakiyar retina, inda akwai rawaya mai launin rawaya (macula), wanda ƙwayoyin sa suke da alhakin hangen nesa na tsakiya.
Hanyar haɓakar edema yana da alaƙa da gaskiyar cewa tare da haɓaka matakin glucose, ganuwar ƙananan tasoshin suna lalacewa. Irin waɗannan canje-canjen ana kiransu microaneurysms. Akwai gumi na ruwa ta wurin raunanan jirgi, kuma ya tara a cikin retina.
Binciken da aka yi amfani da tomography na gani ya bayyana nau'o'in maculopathy masu ciwon sukari: spongy retinal edema, cystic edema da retine detachment.
Baya ga cutar sikari, ciwon mara na iya haifar da irin wannan yanayin:
- Thrombosis na hanji
- Uveitis, wanda ya haifar da chocho na ƙwallon ido.
- Raunin rauni.
- Hadaddiyar cutar tiyata.
Kwayar cutar sankara na macula yana tare da raguwa a cikin filin kallo na yawanci, hoton zai zama mara nauyi, layin yayi haske, madaidaicin layin suna kama ko wavy.
Tsinkayar launi ta canza, launin ruwan hoda mai ruwan hoda ya bayyana a cikin abubuwa. Abun hankali ga haske mai haske yana ƙaruwa. Da safe, acuity na gani na iya zama mafi muni fiye da lokacin rana, bambance-bambance a cikin shakatawa na iya zama daga 0.25 diopters.
Idan an gano cutar a farkon matakai, har sai sabbin jiragen ruwa suka fara nunawa, to ragewar hangen nesa na iya juyawa. Amma lokacin dawowa yana da tsawo kuma yana ɗaukar kwanaki 90 zuwa watanni 15.
Tsawo lokacin macula na iya haifar da mutuwar kashin baya da kuma cikakkiyar hangen nesa. Hakanan ya dogara ne akan mamayar tsarin. Idan cutar ta kama daukacin tsakiyar tsakiya, to asasin cutar ba ta da kyau. Sauyi sau da yawa ana iya warkewa.
Tare da bincike na yau da kullun cikin asusun, kawai za'a iya gano ƙoshin edema. Tare da ƙananan masu girma dabam, ana iya tsammanin ta da launi mara kyau da kuma taurin ɓoye na ɓangaren tsakiya. Hakanan halayyar shine lanƙwasa tasoshin jini a cikin macula. Daga cikin hanyoyin bincike na zamani da akayi amfani dasu:
- Ilimin walwala na ɗalibi na gani (kauri retinal, girma, tsari ana nazarin sa).
- Heidelberg tomography na retinal (kawai ana yin nazari ne lokacin farin ciki da ƙirar edema).
- Fuskarwar iska mai ban sha'awa - nazarin tasoshin kashin baya ta amfani da matsakaiciyar matsakaici.
Magunguna don cututtukan macular macular
Lokacin da aka gano cutar macular edema, magani yana farawa tare da raguwa daga sukarin jini mai haɓaka. An tabbatar da cewa yayin canja wurin marasa lafiya zuwa tsarin kulawa da insulin mai zurfi, haɗarin faruwar haɓakawa da haɓakar ƙananan hangen nesa a cikin maganin ciwon sukari yana raguwa.
Ya danganta da tsawon lokacin illar macular da matakan aiwatarwa, an zaɓi hanyar magani: ra'ayin mazan jiya, ƙwaƙwalwar laser ko tiyata. Don lura da ra'ayin mazan jiya, ana amfani da maganin hana kumburi da ƙaddamar da magunguna na musamman a cikin rami na vitreous.
Ana cire ƙwayar kumburi ta amfani da magungunan marasa steroidal a cikin nau'in faɗuwar ido, allunan ko injections. Wannan rukunin magungunan suna da fa'ida a kan corticosteroids, saboda yana haifar da ƙananan sakamako masu illa (ƙara haɓaka cikin jijiyoyin jiki, rage kariyar cikin gida da kuma abin da ya faru na cututtukan mahaifa).
Don gabatarwa cikin rami mara ma'ana, ana amfani da abubuwa masu zuwa:
- Corticosteroids - Kenalog da Dexamethasone.
- Vascular endothelial factor blockers.
Gabatarwar corticosteroids, koda sau ɗaya ya rage edema, yana ƙara ƙarancin gani. Tsawon lokacin wannan sakamako na iya zuwa har zuwa watanni shida, amma daga nan sai maganin ya warware, tasirin ya ragu kuma cututtukan mahaifa na karuwa kuma. Sabili da haka, a kan lokaci, maimaita injections ana yin su.
Sakamakon sakamako na magungunan steroid sune ci gaban girgije ruwan tabarau da haɓaka matsa lamba na jijiya.
Dalilin girma na jijiyoyin jiki yana shafar girma da girman jiki (al'ada da jijiyoyin cuta) na duk gado na jijiyoyin bugun gini. Concentarfafawarsa a cikin kyallen ido yana nuna tsananin matsalar cutar sankara. Ana iya kula da ciwon sikari ta hanyar amfani da tsoffin abubuwan ci gaba na jijiyoyin bugun jini.
Ana amfani da kwayoyi uku: Avastin, Macugen da Lucentis. Gabatarwarsu tana taimakawa rage jinkiri game da asarar hangen nesa, amma kuma suna buƙatar kulawa da su akai-akai sakamakon raguwar aiki da natsuwa a cikin kyallen ido.
Jiyya na ƙwayar macular tare da coagulation na laser
Duk da ingantaccen tasirin da ke tattare da bayar da magunguna ga jikin mutum, sakamakon da aka samu na dogon lokaci ya nuna cewa babu ɗayan magungunan da ke iya hana lalacewar cututtukan fata a cikin mahaifa.
Don dalilai na warkewa, ana amfani da hanyar coagulation na laser mafi lalacewa, ana amfani da jiragen ruwa masu lahani. A wannan yanayin, yana da buqatar yin la’akari da hoton asibiti na kowane mai haƙuri daban-daban, tunda idan cutar sankarar hanta ta shafi iyakantaccen yanki ko kuma ba ta fuskantar hangen nesa ba, yana nan a tsakiyar-cibiyar, to ba a aiwatar da aikin laser.
Rashin daidaituwa na coagulation na laser shine cewa baya dawo da hangen nesa, amma yana hana cigaba da hasara. Canje-canje marasa canzawa a cikin retina a cikin ciwon sukari ana haifar da su ne ta hanyar mutuwar wasu jijiyoyin jini.
Tunda ƙwayoyin retinal suna da takamaiman matsayi, murmurewarsu baya faruwa.
Bayyanar cututtuka na ci gaban retinopathy a cikin ciwon sukari
Tsinkayar ingancin magani ya dogara da matakin cutar. Bayyanar cututtukan macular edema shine matakin farko na cutar tarin fuka.
Idan ba a yi binciken cikin yanayin da ya dace ba, to a cikin martani ga raguwar wadatarwar jini, samuwar da haɓakar jijiyoyin jini ya fara rama waɗanda suka lalace.
Sabbin tasoshin suna girma a cikin retina kuma wani lokacin zasu shiga cikin maraji. Su ne masu rauni kuma yawanci suna tsagewa, ƙwayar jini. A hankali, a cikin waɗannan wuraren haɗin haɗin nama ke tsiro.
Irin waɗannan alamu ne ke haifar da yaduwar cututtukan cututtukan masu ciwon sukari:
- Fitar da tantanin ido da kuma fitar dashi daga ido.
- Pressureara matsin lamba a cikin ƙwallon ido.
- Rashin hangen nesa.
- Ragewar wahayi na dare.
- Muhimmancin murdiya murdiya abubuwa.
A wannan matakin, ana nuna maganin laser da aikin tiyata. Tare da canje-canje da aka faɗi, asarar cikakkiyar hangen nesa tana faruwa a cikin ciwon sukari na mellitus.
Yaushe ne ake yin cirewar ganyayyaki?
Bayan coagulation na laser, hangen nesa na iya raguwa, yanayin labarun gani da kuma ikon gani a cikin duhu yana raguwa. Sannan, bayan lokacin dawowa, tsawan tsawan yawanci yakan faru.
Idan cututtukan jini a cikin jiki na vitreous ba su daina ba, to za a iya wajabta mai haƙuri yin aikin don cire jikin vitreous - vitrectomy. Yayin aikin, an yanka ligamine na opus din kuma ana cire abu mai narkewa, kuma an gabatar da wani ingantaccen bayani a wurin sa. Idan akwai alamun kin amincewa, to sai a mayar da shi yadda yake.
Bayan tiyata, yana yiwuwa a maido da hangen nesa a cikin yawancin marasa lafiya, musamman idan babu exfoliation na retina. A irin waɗannan halayen, shari'ar nasara tare da exfoliation na ɗan gajeren lokaci sun kai kusan 50%.
Abubuwan da ke nuna cirewa mai lalacewa sune canje-canje na tomography wanda ke damfara retina da tallafawa illar hauka. Irin wadannan bayyanar sun hada da:
- Alama da zubar jini, tayi fiye da wata shida.
- Komawa daga aikin cirewa.
- Canje-canje na canjin fibrotic a cikin vitreous.
Ayyukan ana yin su ta hanyar microsurgical, ƙananan ƙarancin hanya.
Tare da ɓataccen retina, ana yin cikakken aikin tiyata a karkashin maganin sa barci na gaba ɗaya.
Yin rigakafin cututtukan ciwon sukari
Don hana lalacewar retina, kuna buƙatar kawo metabolism metabolism kusa da al'ada kuma ku sami diyya na ciwon sukari. A saboda wannan dalili, ana amfani da magani tare da insulin a cikin nau'in ciwon sukari na farko. Idan matakin ƙwayar cutar glycemia ya yi yawa, to, yawan ƙwayoyin injections yana ƙaruwa kuma an daidaita sashi.
Hakanan, tare da ilimin insulin, yiwuwar hanyar labile na ciwon sukari mellitus ya kamata a la'akari da shi. A cikin nau'in ciwon sukari na 2, ana iya tsara insulin tsawon lokaci mai aiki azaman mai alaƙa da allunan rage sukari. Idan ba'a sami biyan diyya ba, to sai a tura marasa lafiya gaba daya zuwa shirye-shiryen insulin.
Tare da kowane nau'in ciwon sukari, abinci mai ƙiba, musamman ma na asalin dabbobi (nama mai, mai ƙoshin abinci, kayan kiwo na mai mai yawa, man shanu) an ƙuntata su a cikin abincinsu. Idan za ta yiwu, kuna buƙatar rage amfani da nama ku canza zuwa kayan abinci na kifi, kayan lambu da ƙananan kayan lambu.
Yana da mahimmanci a ci abinci na lipotropic, wanda ya haɗa da cuku gida, oatmeal, kwayoyi. Ana amfani da sinadarai masu sauki a cikin jiki:
- Sugar, duk samfurori da kwano tare da shi.
- Yin Bake
- Sweets, desserts, zuma.
- Jam da 'ya'yan itatuwa masu zaki.
- Ice cream.
- Ruwan giya da abin sha tare da sukari na masana'antu.
Bayani don rama ga masu ciwon sukari shine matakin cutar haemoglobin da ke ƙasa da 6.2%. Yana da ma'ana sosai yana nuna ƙarancin haɗarin lalacewa na jijiyoyin jini. Tare da ƙimar sama da 7.5%, da yiwuwar haɓakar rikice rikice na ciwon sukari yana ƙaruwa sosai.
Alamar ta biyu da ke buƙatar kulawa da kullun ita ce matakin hawan jini. Yana buƙatar tallafi akan lambobin basu wuce 130/80 ba. Amfani da magungunan kashe kiba yana da inganci wajen hana canje-canje a cikin kwayar ido.
Amfani da rigakafin magungunan jijiyoyin bugun gini, wanda ya hada da Dicinon, Cavinton, Prodectin baya kawo sakamako mai kariya ga ci gaba da ci gaban cututtukan cututtukan cututtukan zuciya.
Gano retinopathy a farkon matakai yana yiwuwa ne kawai tare da ziyarar yau da kullun zuwa likitan ido. A wannan yanayin, ana gudanar da gwaji akan ƙungiyar kuɗi a ƙarƙashin yanayin fadada ɗalibai da gwargwadon matsa lamba na ciki.
Mitar dubawa na marasa lafiya da ke da hatsarin kamuwa da cututtukan fuka-fukan:
- Rashin alamun - lokaci 1 a shekara.
- Matakan rashin cigaba - sau 2 a shekara.
- Stage mai ciwon sukari macma edema - aƙalla sau 3 a shekara.
- Lokacin da akwai alamun yaduwar jijiyoyin jiki - aƙalla sau 5 a shekara (bisa ga alamun sau da yawa)
A hadarin kamuwa da cututtukan cututtukan cututtukan zuciya sune marasa lafiya da ke daɗaɗɗar hauhawar jini da hauhawar jini a cikin matakai na biyu da na uku, alamun hatsarin cerebrovascular, da sigari. Hakanan mahimmanci mahimmanci shine tsinkayen gado don rage hangen nesa ko cututtukan fata.
Koyi bidiyo game da illar macular zai taimaka bidiyon a cikin wannan labarin.
