Mene ne cututtukan cututtukan ciwon sukari kuma ta yaya yake ci gaba?

Ciwon mara na Nephropathy- menene? Wannan lamari ne mai haɗarin gaske wanda ke haɓaka tare da nau'in 1 da nau'in ciwon sukari na 2, wanda ke haifar da lalacewar tasoshin jini na kodan, raguwa a cikin ikon su don tacewa da kuma bayyanar da gazawar renal.

Irin wannan ilimin cuta yana zama sanadin lalacewa kuma galibi m.

Pathogenesis na Nephropathy

Cutar amai da gudawa yana da lambar ICD na 10 E10.2-E14.2 - raunuka na duniya a cikin ƙwayar cutar sankara na mellitus. An gano ilimin halin dan Adam ta hanyar canji a cikin tasoshin jini na koda da aikin filtration na glomerular (madaidaiciyar madaidaiciya).

Haɓaka ƙwayar nephropathy yana faruwa ne a kan asalin abin da ya faru na metabolism na metabolism da kuma bayyanar cututtukan hyperglycemia.

Akwai dabaru daban-daban na pathogenesis na cutar:

1. Tsarin rayuwa. M lokuta daban-daban na karuwa a cikin taro glucose na jini yana haifar da rashin aiki a cikin hanyoyin nazarin halittu. Daidaitawar daidaituwar ruwa-electrolyte, yawan aiki na tasoshin oxygen yana raguwa, musayar mayukan kitse yana canzawa, abubuwan da ke tattare da sunadaran glycated yana karuwa, kodan suna da guba kuma tsarin amfani da glucose ya rikice. Dangane da ka'idar kayyade, bayyanar hemodynamic da damuwa damuwa na rayuwa yana haifar da faruwar cutar nephropathy saboda yanayin gado.
2. Ka'ida mai kwakwalwa. Dangane da wannan ka’idar, sanadin nephropathy karuwa ne a cikin karfin jini, wanda yake haifar da hauhawar jini a cikin abubuwan da ke gudana tare da lalata zubar jini ga kodan. Bayan haka, canje-canje masu mahimmanci a cikin tsarin madaukai suna faruwa, wanda aka bayyana a cikin tsaftacewa da haɓaka fitsari tare da ƙwayar furotin mai wuce kima, kuma bayan hakan ikon tacewa yana raguwa kuma glomerulosclerosis yana haɓaka (maye gurbin ƙwayoyin haɗin haɗin tare da kyallen dunƙule). A sakamakon haka, gazawar renal na faruwa.

Mafi yawan masu hadarin kamuwa da cutar sankarau ne masu fama da cutar siga da masu cutar sukari tare da kamannun irin wadannan dalilai:

1. Jinsi. A cikin maza, mafi yawan lokuta ana gano cutar nephropathy.
2. Nau'in ciwon suga. Masu ciwon sukari na 1 sun fi kamuwa da cutar sankara.
3. Tsawon lokacin cutar. M, matakin ƙarancin lalacewar koda yana tasowa bayan shekaru 15 na ciwon sukari.
4. Hawan jini
5. Shan magungunan da ke da guba a koda.
6. Abun da ke tattare da tsarin ƙwayar cuta.
7. Rashin lafiyar metabolism.
8. Amfani da barasa da sigari.
9. Yawan kiba.
10. Yawancin lokuta na ƙara yawan glucose tare da tsawan lokaci rashin matakan matakan gyara.

Bayyanar cututtuka a matakai daban-daban

Cutar tana tasowa koyaushe kuma yana asymptomatic a farkon matakan.

Wannan yana kawo rikice-rikice sosai game da ganewar asali da magani, kamar yadda marasa lafiya galibi suna neman taimako tuni yayin matakin karshe ko lokacin ƙarshe, lokacin da ba zai yiwu a taimaka musu ba.

Saboda haka, nephropathy ana daukar mafi haɗarin rikice-rikice na ciwon sukari, wanda yake ƙare da mutuwa.

Nan gaba, alamu sun bayyana kansu gwargwadon ci gaban ilimin halittu.

Akwai rarrabuwa ta matakai:

1. Matsayi na asymptomatic - bayyanar cututtuka na asibiti ba ya nan, amma a cikin nazarin fitsari an sami ƙara yawan ƙirar ƙasasshen duniya, kuma hauhawar jini na haɓaka. Mai nuna alamar microalbumin bai wuce 30 MG / rana ba.
2. Matsayin canji na tsarin yana farawa a cikin 'yan shekaru daga bayyanar rikicewar endocrine. Matsakaicin rubanya na dunkulewa da maida hankali kan microalbumin ba su canzawa, amma akwai ɓoyayyen ganuwar bangon ƙasa da haɓaka a cikin sararin intercellular.
3. Matsayin prenephrotic yana haɓaka bayan shekaru 5-6 daga farkon ciwon sukari. Bayyanar marasa lafiya ba su nan. Wani lokaci, bayan aikin jiki, ana lura da matsa lamba. Yawan canza jini da tacewa ba su canzawa, amma matakin microalbumin ya tashi daga 30 zuwa 300 mg / rana.
4. Bayan shekaru 15 na rashin lafiya, farawan nephrotic ya fara. Lokaci-lokaci, jini yana fitowa a cikin fitsari, ana gano furotin fiye da 300 mg / rana. Hawan jini a kai a kai wanda baya gyara. Jigilar jini a cikin tasoshin kodan da kuma ƙirar fillo ɗin duniya. Urea da creatinine a cikin jini dan kadan sun wuce ka’ida ta halal. Kumburi da kyallen fuska fuska da jiki ya bayyana. Akwai karuwa a cikin ESR da cholesterol, kuma haemoglobin yana raguwa.
5. Mataki na ƙarewa (nephrosclerosis). Aikin tacewa da maida hankali koda ya ragu. Cutar da urea da creatinine a cikin jini yana girma cikin sauri, kuma adadin furotin yana raguwa. Ana lura da cylindruria da kasancewar jini a cikin fitsari da furotin. Hemoglobin ya faɗi cikin bala'i. Fitar insulin ta hanjin kodan ya daina kuma ba a gano sukari a cikin fitsarin. Masu ciwon sukari suna koka da matsanancin matsin lamba da yawan kumburi. Matsayin glucose ya ragu kuma buƙatar insulin ya ɓace. Alamun uremia da dyspepti syndrome haɓaka, maye gawar yana faruwa kuma duka ƙarancin na koda yana ƙare.

Kwayar cutar sankara

Bayyanar cututtuka na nephropathy a farkon ci gaban ana aiwatar da su ta amfani da:

• gwajin jini na asibiti;
• gwajin jini don ilimin halittar jini;
• nazarin asibiti da kuma nazarin halittun fitsari;
• Duban dan tayi na koda na jini
• samfurori akan Zimnitsky da Reberg.

Babban mahimmancin abin da aka jawo hankali shine abun da ke cikin microalbumin da creatinine a cikin urinalysis. Idan akwai karuwa koyaushe a cikin microalbumin, tare da halayen da aka yarda da 30 MG / rana, to, an tabbatar da gano cutar ta nephropathy.

A matakai na gaba, ana gano cutar ta hanyar irin wadannan alamu:

• bayyanar a cikin fitsari wanda ya wuce hadarin furotin (fiye da 300 mg / rana);
• raguwa cikin furotin na jini;
• hawan jini na urea da creatinine;
• ƙarancin tacewa a cikin ƙasa (a ƙasa 30 ml / min.);
• karuwa cikin matsin lamba;
• raguwa cikin haemoglobin da alli;
• bayyanar kumburi fuska da jiki.
• bayyanuwar acidosis da hyperlipidimia an lura.

Kafin yin bincike, ana yin kamanceceniya tare da sauran hanyoyin:

1. Cututtuka na kullum. Muhimmanci sune sakamakon urography, duban dan tayi da alamun kwayoyin cuta da leukocyturia.
2. Na kullum da m glomerulonephritis.
3. Cutar tarin fitsari. Sha'awar fitsari alamu na kasancewar mycobacteria da fure.

Don wannan, duban dan tayi, bincike na farin microflora, ana amfani da urography na koda.

Ana amfani da ƙirar ƙoda a cikin waɗannan lokuta:

• farkon da hanzarta ci gaban furotin;
• m hematuria;
• ci gaba nephrotic syndrome.

Cutar cuta

Babban burin maganin maganin cuta shine hana faruwar lalacewa ta koda da kuma rigakafin cututtukan zuciya (bugun jini, bugun zuciya, cututtukan zuciya).

Yunkurin farko na haɓakar mai ciwon sukari ya kamata ya kasance tare da nadin masu hana ACE don dalilai na prophylactic da kuma kula da maida hankali na glucose tare da gyara mai zuwa.

Jiyya na pre-nephrotic mataki ya hada da:

1. Abincin da ake buƙata tare da rage yawan abubuwan gina jiki.
2. Yunkurin matsa lamba. Amfani da kwayoyi kamar su enalapril, losartan, ramipril. Sashi bai kamata ya haifar da tashin hankali ba.
3. Mayar da karancin ma'adinai da kuma rikicewar rayuwa na fats, sunadarai da carbohydrates.

Ana kula da matakin nephrotic tare da ƙuntatawa na abinci. An wajabta rage cin abinci mai ƙona yawan kitse na dabba da garkuwar dabbobi. An nuna wariyar abinci daga gishirin abinci da abinci mai yawa a cikin potassium da phosphorus.

An bada shawara don shan kwayoyi waɗanda ke rage karfin jini kuma suna daidaita matakin cholesterol a cikin jini da tsinkayenta na sinadarai (folic da nicotinic acid, statins). A wannan matakin, ana yawan lura da ciwon sikila, wanda ke nuna yiwuwar ƙin yin amfani da insulin.

Farfesa na ƙarshe, mataki na ƙarshe ya dogara ne akan riƙe mahimman ayyukan jiki:

• haɓaka hawan jini - Ferropleks, Fenyuls ana amfani da su;
• shan diuretics don rage hura ciki - Hypothiazide, Furosemide;
• an daidaita matakin suga na jini;
• shafe jikin maye.
• canje-canje a cikin kasusuwa na kasusuwa ana hana shi ta hanyar shan bitamin D3;
• An wajabta masu sihiri.

A cikin matakin ƙarshe, ana buƙatar tambaya game da amfani da dialysis, cututtukan hemodialysis, da gano ƙodon don dasawa cikin gaggawa.

Hasashen da Rigakafin

An fara kula da lokaci cikin sauri zai kawar da bayyanar microalbuminuria. Yana yiwuwa a hana faruwar lalacewar koda koda lokacin cinikin proteinuria.

Jinkirta rashin jin daɗi na shekaru 10 yana haifar da gazawar renal a cikin rabin masu ciwon sukari na 1 kuma a cikin kowane marasa lafiya 10 da ke fama da ciwon sukari na 2.

Idan makomar tashar ƙarshen ta faru kuma an gano gazawar koda, to wannan tsari ba zai yiwu ba kuma ana buƙatar juyawa cikin gaggawa ko juyawar hemodialysis don ceton rayuwar mai haƙuri.

A cewar kididdigar, kowane marasa lafiya 15, waɗanda suka kamu da nau'in 1 na ciwon sukari na mellitus kuma ba su kasa da shekaru 50 ba, suna mutuwa ta cutar sankarau.

Ya kamata a bi ƙa'idodin masu zuwa:

1. M kullum mahara saka idanu na jini sugar taro. Auna matakan glucose kafin da bayan abinci.
2. Ku bi abinci, ku guji juji cikin matakan glucose. Abincin yakamata ya ƙunshi mafi yawan kitsen mai da carbohydrates mai sauri. Dole ne ku ƙi sukari. Dogon hutu tsakanin abinci da abinci ya kamata kuma a cire shi.
3. Lokacin da alamun nephropathy suka bayyana, ya zama dole don rage yawan furotin na dabba, kitsen da kuma ware ci.
4. Lokacin canza mahimman alamun, ya kamata a ɗauki matakan gyara. Dole ne a tsara sashi na insulin ta kwararru.
5. Guji mummunan halaye. Alcohol yana taimakawa wajen haɓaka abubuwan sukari, yayin da nicotine ke hana jijiyoyin jini kuma yana rushe wurare dabam dabam na jini.
6. Gudanar da nauyin jiki. Poundsarin fam shine ainihin sanadin canje-canje na glucose. Bugu da kari, samarda jini ga gabobin suna dagula al'amura masu yawa kuma cututtukan zuciya suna faruwa.
7. Kula da ma'aunin ruwa ta hanyar shan ruwa mai yawa. Aƙalla ana buƙatar shan lita 1.5 na yau da kullun.
8. Inganta samar da jini ga gabobin ciki tare da motsa jiki na yau da kullun. Tafiya da wasa wasanni suna haɓaka zuciya, suna tsaida jini da iskar oxygen da kuma ƙaruwa da juriya ga abubuwan da ke haifar da illa.
9. Guji cututtukan urinary fili. Hypothermia, rashin isasshen tsabta na mutum da jima'i mara kariya yana haifar da cutar koda.
10. Kada ku sami magani na kai. Shan magunguna ya kamata ya faru ne kawai bayan yarjejeniya da likita. Hanyoyin girke-girke na maganin gargajiya bazai maye gurbin takaddar likita ba, amma za'a iya amfani dashi azaman adjuvants.
11. Kula da karfin jini. Masu nuna alama ya kamata ya kasance tsakanin 130/85.
12. Ba tare da la'akari da alamun matsin lamba ba, ya kamata a rubuto masu hana ACE.

Kayan bidiyo akan lalata koda

Ya kamata a fara matakan rigakafin kai tsaye bayan tabbatar da bayyanar cutar sankarau. Ya kamata a ziyarci likita bayan shekaru 5 daga farkon cutar sau biyu a shekara don marasa lafiya da ke dauke da cutar sukari ta 1 da masu ciwon sukari guda 2 a shekara.

A yayin ziyarar likita, ya kamata a ba da fitsari don kula da furotin fitsari, urea, da creatinine. A farkon canje-canje a cikin alamun, likitan likita zai ba da magani da ya dace.

Sanar da likita game da alamomin tashin hankali na farko a cikin yanayin bacci da tashin hankali, tashin zuciya da rauni, idan gajeruwar numfashi ya faru ko kuma kumburi an same shi a idanun da kan gabobi.

Duk wannan zai ba da damar gano ci gaban cututtukan cututtukan ƙwaƙwalwar ƙwaƙwalwa a farkon farkon ci gaba kuma fara magani a kan kari.