Ciwon sukari mai narkewa wani hadadden rikice-rikice na ciwon sukari. Sakamakon raunin da ya faru yana faruwa tare da raunuka na Majalisar Tarayya, wani lokacin tsokoki. Koyaya, ganowar wannan yanayin yana da wuya, tunda ana nuna shi ta hanyar asymptomatic.
A cewar kididdigar, lokacin da rashin haƙuri na glucose, rikice-rikice ke faruwa a cikin 11% na lokuta, kuma tare da nau'in ciwon sukari na 2, ana samun neuropathy na sukari a cikin 28% na marasa lafiya. Hadarinsa shine cewa a kusan kashi 80% na masu ciwon sukari, idan ba'a kula dasu ba, cutar kuturta ta kafafu a kafafun su.
Ofaya daga cikin nau'ikan nau'ikan cututtukan cututtukan cututtukan zuciya shine lumbosacral radiculoplexitis. Amyotrophy halayyar irin ciwon sukari ne na 2.
Sau da yawa, cutar tana tasowa a cikin marasa lafiyar marasa amfani da insulin, shekaru 40-60 years. Wannan na faruwa ne bayan ciwon sukari na microbetiopathy sakamakon lalacewar axonal.
Dearfin ƙwaƙwalwar ƙwayar cuta yana mai da hankali sosai a cikin ɓangaren sel na tushen da kuma kututturar jijiyoyin mahaifa da ƙahonin igiyar kashin baya.
Abubuwan da ke faruwa na faruwa da bayyanar cututtuka
Sakamakon binciken binciken pathomorphological da yawa ya nuna cewa amyotrophy mai ciwon sukari yana faruwa ne akan tushen lalacewar autoimmune zuwa tasoshin jijiya (perineuria, epineuria) tare da bayyanar perivasculitis da microvasculitis. Wadannan cututtukan suna ba da gudummawa ga lalacewar ischemic a cikin tushen da jijiyoyin jini.
Akwai tabbataccen tsarin tsarin haɗin gwiwa, cututtukan ƙwayar cuta na endothelial, bayyanar cututtukan immunoreactive cytokines, da kuma bayyanar kwayoyin sel na cytotoxic. Har ila yau, an yi rikodin maganganun shigarwar jini ta hanyar venule polynuclear (post-capillary). A lokaci guda, lalacewa da lalata ƙwayar iska, tarawar haemosiderin, toshewar perineuria, demyelination na gida da neovascularization da aka bayyana a cikin tushen da jijiyoyi.
Bugu da kari, atrophy na tsoka a cikin masu ciwon sukari yana faruwa ne saboda wasu dalilai masu tsinkaye:
- shekaru - sama da shekara 40;
- jinsi - mafi yawan rikicewa yakan faru ne a cikin maza;
- shan giya, wanda ya kara dagula ayyukan neuropathy;
- girma - cutar ta fi yawa tsakanin mutane masu tsayi waɗanda jijiyoyin jijiya sun fi tsayi.
Ashymetric motor proximal neuropathy yana farawa ta ƙashin gaskiya ko ainihin. Alamun ta sune raɗaɗi, rarrafewar rarrafe da kuma ƙonewa a gaban cinya da a cikin yankin na ƙasan kafa.
Fitowar irin waɗannan alamu ba ta da alaƙa da aikin motsa jiki. Mafi yawan lokuta suna faruwa ne da dare.
Bayan atrophy da rauni daga tsokoki na cinya da ƙashin gwiwa na haɓaka. A lokaci guda, yana da wuya mai haƙuri ya lankwashe gwiwa, gwiwa kuma gwiwa ba shi da matsala. Wasu lokuta adductors na hip, da ƙashin tsokoki na gindi da ƙungiyar peroneal suna shiga cikin tsarin jijiyoyin cuta.
Kasancewar ko sassaucin raunin gwiwa tare da raguwa kaɗan ko adana Achilles yana nuna kasancewar rikicewar damuwa. Wani lokaci, atrophy na tsoka a cikin masu ciwon sukari yana shafar kusancin sassan ɓangarorin na sama da na wuyan wuyan hannu.
Verarnawar raunin azanci sai kaɗan. Sau da yawa, Pathology yana samun halayen asymmetric. A wannan yanayin, babu alamun lalacewa ga masu ɗaukar igiyar kashin baya.
Game da cutar sankara mai kusanzuwa, yawanci hankali bashi da illa. Ainihin, alamun jin zafi suna ɓacewa a cikin makonni 2-3, amma a wasu yanayi sun jure har zuwa watanni 6-9. Atrophy da paresis suna rakiyar mai haƙuri sama da wata daya.
Haka kuma, akan banbancin wadannan rikice-rikice, asarar nauyi mara misalai na iya faruwa, wanda shine tushe don gudanar da nazari kan kasancewar cutar tarin fitsari.
Binciko
Ana iya gano amyotrophy mai ciwon sukari bayan cikakken bincike na haƙuri. Bayan haka, har ma rashin bayyanar cututtuka ba dalili bane don ware kasancewar cutar.
Don ingantaccen ganewar asali, ana ba da shawarar kasancewar aƙarar raunuka biyu na jijiyoyin jiki. Misali, canje-canje a sakamakon gwaje-gwaje na kai tsaye ko alamun ɓarna a cikin yawan annashuwa tare da ƙwayoyin jijiya.
Don gano ciwon sukari na polyradiculoneuropathy, ana yin yawancin nazarin dakin gwaje-gwaje, gami da:
- cikakken bincike na fitsari da jini;
- gwaje-gwaje na rheumatic;
- nazarin abu mai sihiri;
- MRI na kashin baya (lumbosacral);
- tashin hankali electroneuromyography da allura electromyography.
Tare da amyotrophy na mai ciwon sukari a cikin ƙwayar cerebrospinal, an lura da haɓakar taro na furotin. Bayan EMG, an samar da ma'amala da yawa ko fasciculation a cikin tsokoki na ƙananan sassan.
Hakanan, polyradiculoneuropathy na ciwon sukari ya bambanta tare da demyelinating polyneuropathy, wanda ke haɓaka a cikin yawancin marasa lafiya da cututtukan cututtukan ƙwayar cuta na tsarin endocrine.
Tare da wannan cutar, har ma da amyotrophy, matakin furotin a cikin ƙwayar cerebrospinal yana ƙaruwa. Don ware ko tabbatar da kasancewar sa, ana yin aikin lantarki.
Farfesa
Jiyya don atrophy na tsoka a cikin ciwon sukari na iya wuce zuwa shekaru biyu. Kuma saurin warkewa kai tsaye ya danganta ne da biyan diyyar cutar.
Manyan ka'idodi don cin nasarar maganin neuropathy sune:
- saka idanu akai-akai na cutar glycemia;
- bayyanar cututtuka na jinya;
- matakan pathogenetic warkewa.
Na farko, maganin bugun jini ta amfani da methylprednisolone, wanda aka gudanar dashi ta hanyar ciki, an nuna. Ana inganta sukarin jini ta canja wurin haƙuri zuwa insulin.
Don kawar da ciwon neuropathic, an wajabta Pregabalin (2 r. Kowace rana, 150 MG kowane). Bugu da ƙari, ana ɗaukar amitriptyline a cikin ƙananan sashi.
Yawancin likitoci sun lura cewa glucocorticoids suna da tasiri don amyotrophy. Amma ana iya maganin cutar ta wannan hanyar ne kawai a farkon watanni 3 na haɓaka.
Idan magani tare da anticonvulsants da glucocorticoids ba su da tasiri, to an maye gurbin shi da gudanarwar iv na immunoglobulin. Hakanan za'a iya amfani da cytostatics da plasmapheresis.
A wannan lokacin, yana da mahimmanci don kula da matakin al'ada na glycemia. Wannan zai taimaka wajen rage tasirin damuwa na damuwa, daɗaɗa ayyukan antioxidants na halitta da haɓaka aiki da jijiyoyin kai da na rayuwa.
Magungunan insulin da ke cikin jijiyoyin jiki yana rage haɗarin cutar DPN da cututtukan jijiyoyin jiki. Amma gabatarwar hormone ba zai iya ba da tabbacin wariyar rikice-rikice ba ko bayar da gudummawa ga mummunan tasirin bayyanar cututtuka. Amma m iko da ciwon sukari ne mai muhimmanci yanayin da yake wajibi don tasiri na pathogenetic far.
Abin lura ne cewa shan corticosteroids yana haifar da haɓaka glucose na jini. Sabili da haka, don rage haɗarin cutar glycemia, yana da kyau don canja wurin marasa lafiya zuwa insulin.
Sau da yawa bayyanar cututtukan ciwon sukari na amyotrophy yana inganta ta hanyar damuwa na damuwa. Yana faruwa tare da wuce haddi mai tsattsauran ra'ayi da rashin ƙarfi daga tsarin antioxidant na jiki.
Sabili da haka, jagora na gaba a cikin lura da DPN an yi shi ne ta hanyar maganin antioxidants - jami'ai waɗanda ke rage damuwar oxidative kuma suna shafar pathogenesis. Saboda wannan, ana amfani da magunguna don dalilai na maganin cutar daji da warkewa idan akwai matsala game da cutar sankara.
Ofaya daga cikin magunguna mafi kyawun magunguna don ciwon sukari na polyradiculoneuropathy shine Alpha Lipoic Acid. Wannan magani yana rage alamun bayyanar cututtukan neuropathic mara kyau.
Acid na Thioctic acid mai karfi ne wanda zai iya rage radicals mai narkewa. An tabbatar da cewa gabatarwar ALA yana hana haɗuwar platelet, yana motsa jini na jini, yana ƙaruwa da haɓakar sinadarin nitric oxide kuma yana haɓaka tsarin haɗin sunadarai na girgiza zafi. Bidiyo a cikin wannan labarin zai ci gaba da batun rikice-rikice na SL.
