Tlhaloso ea "lefu la tsoekere" lephropathy "ke mohopolo o kopaneng oa mafu a mangata a bakang tšenyo methapong ea liphio khahlanong le semelo sa lefu la tsoekere le hlobaetsang.
Khafetsa poleloana e reng "Kimmelstil-Wilson syndrome" e sebelisetsoa bokuli bona, hobane mehopolo ea nephropathy le glomerulosclerosis e sebelisoa e le ntho e tšoanang.
Bakeng sa lefu la tsoekere lephropathy ho ea ka ICD 10, ho sebelisoa likhoutu tse 2. Ka hona, khoutu ea lefu la tsoekere ea lefu la tsoekere ho ea ka ICD 10 e ka ba le li-E.10-14.2 ka bobeli (lefu la tsoekere le nang le ts'enyo ea liphio) le N08.3 (li-glomerular lesions ka lefu la tsoekere). Hangata, ts'ebetso ea ho phekola liphofu tse sa sebetseng hantle e bonoa ho ts'epahalo ea insulin, mofuta oa pele - 40-50%, mme ho mofuta oa bobeli, tšoaetso ea nephropathy ke 15-30%.
Mabaka a nts'etsopele
Lingaka li na le likhopolo tse tharo tsa mantlha mabapi le lisosa tsa nephropathy:
- fapanyetsana. Taba ea mohopolo ke hore karolo ea mantlha ea tšenyo e amahanngoa le boemo bo phahameng ba tsoekere maling, ka lebaka leo phallo ea mali ea methapo e ferekaneng, 'me mafura a behiloe ka har'a lijana, a lebisang ho nephropathy;
- liphatsa tsa lefutso. Ka mantsoe a mang, monyetla oa lefu lena ke lona le tlang pele ho lefu lena. Moelelo oa mohopolo ke hore ke mekhoa ea liphatsa tsa lefutso e bakang mafu a kang lefu la tsoekere le lefu la tsoekere ho bana;
- hemodynamic. Khopolo-taba ke hore ka lefu la tsoekere, ho na le tlolo ea hemodynamics, ke hore, ho potoloha ha mali lipelong, ho bakang sekhahla sa albin ka har'a moroto - liprotheine tse senyang methapo ea mali, tšenyo e bakoang ke lefu la "sclerosis".
Ntle le moo, mabaka a nts'etsopele ea nephropathy ho latela ICD 10 hangata a kenyeletsa:
- ho tsuba
- tsoekere e phahameng ea mali;
- khatello ea mali e phahameng;
- triglycerides e mpe le cholesterol;
- phokolo ea mali
Hangata, sehlopheng sa nephropathy, ho fumanoa mafu a latelang:
- lefu la tsoekere;
- renal artery atherosclerosis;
- necrosis ea likanale tsa renal;
- mafura a mangata likotopong tsa renal;
- pyelonephritis.
Matšoao
Pele ho tsohle, ho bohlokoa ho bolela hore lefu la tsoekere le ka ba le phello e senyang lipelong tsa mokuli ka nako e telele, mme mokuli a ke ke a ba le maikutlo a sa thabiseng.
Khafetsa, matšoao a lefu la tsoekere lephropathy a qala ho fumanoa ka nako eo ho se sebetse hantle ha a phekolo ea methapo.
Nakong ea sephetho sa pele, bakuli ba ka ba le keketseho ea khatello ea mali, proteinuria, le keketseho ea 15-25% ka boholo ba liphio. Boemong bo hatetseng pele, bakuli ba na le diuretic-immune nephrotic syndrome, khatello ea mali le ho fokotseha ha sekhahla sa ho hlohlona ha glomerular. Mohato o latelang - lefu le sa foleng la liphio - le tšoauoa ka ho ba teng ha azotemia, renal osteodystrophy, khatello ea methapo ea mali le ho phehella ha edematous syndrome.
E fumanoa joang?
Ho tseba nephropathy, ho sebelisoa nalane ea mokuli le liteko tsa laboratori. Mokhoa o ka sehloohong mokhatlong oa pele ke ho tseba hore na albin e bokae mofeng.
Mekhoa e latelang e ka sebelisoa ho fumana lefu la tsoekere le nephropathy ho latela ICD 10:
- boikemisetso ba GFR ba sebelisa tlhahlobo ea Reberg.
- biopsy ea meno.
- Dopplerography ea liphio le lijana tse poteletseng (ultrasound).
Ntle le moo, ophthalmoscopy e tla thusa ho tseba mofuta le boemo ba retinopathy, 'me electrocardiogram e tla thusa ho khetholla hypertrophy ea ventricular ea letsoho.
Phekolo
Ha ho phekoloa lefu la liphio, boemo bo hlahelletseng ke kalafo e tlamang ea lefu la tsoekere. Karolo ea bohlokoa e bapaloa ke normalization ea lipid metabolism le botsitso ba khatello ea mali. Nephropathy e phekoloa ka meriana e sirelletsang liphio le khatello e tlase ea mali.
Mehlala ea lijo tse nang le lik'habohaedreite tse bonolo
E 'ngoe ea mekhoa ea pholiso ke lijo. Lijo tsa nephropathy e lokela ho ba ho fokotsa ho ja lik'habohaedreite tse bonolo mme li na le protheine e hlokahalang.
Ha ho ja, mokelikeli ha o na moeli, ntle le moo, mokelikeli o tlameha ho ba le potasiamo (mohlala, lero le sa fuoang). Haeba mokuli a fokotse GFR, ho ja lijo tse nang le protheine e fokolang, empa ka nako e ts'oanang li na le palo e hlokahalang ea likhalori. Haeba nephropathy ea mokuli e kopantsoe le khatello e phahameng ea mali, ho khothalletsoa lijo tse nang le letsoai le tlase.
Phekolo ea kutlo ea lipeo
Haeba mokuli a fokotseha ka sekhahla sa ho hlohlona ha glomerular ho letšoao le ka tlase ho 15 ml / min / m2, ngaka e eang teng e etsa qeto ea ho qala kalafo ea pheko, e ka emeloang ke hemodialysis, peritoneal dialysis kapa transplantation.
Ntho ea bohlokoa ea hemodialysis ke tlhoekiso ea mali ka "lisebelisoa tsa meno" tsa maiketsetso. Ts'ebetso e lokela ho etsoa makhetlo a 3 ka beke, lihora tse ka bang 4.
Peritoneal dialysis e kenyelletsa ho hloekisoa ha mali ka peritoneum. Letsatsi le leng le le leng, makhetlo a 3-5 mokuli o kenngoa ka tharollo ea dialysis ka ho toba ka mpeng ea mpa. Ho fapana le hemodialysis e kaholimo, peritoneal dialysis e ka etsoa lapeng.
Ho fetisoa ha lipeo tsa donor ke mokhoa o feteletseng oa ho loants'a nephropathy. Maemong ana, mokuli o lokela ho sebelisa lithethefatsi tse hatellang sesole sa 'mele, ho thibela ho lahloa.
Mekhoa e meraro ea ho thibela
Mokhoa o tšepahalang ka ho fetisisa oa ho thibela nts'etsopele ea nephropathy ke puseletso e amohelehang bakeng sa lefu la tsoekere:
- thibelo ea mantlha ke thibelo ea microalbuminuria. Lintho tse ka sehloohong bakeng sa nts'etsopele ea microalbuminuria ke: nako ea lefu la tsoekere ho tloha ho 1 ho isa ho lilemo tse 5, lefutso, ho tsuba, retinopathy, hyperlipidemia, hammoho le ho haella ha pokello ea renal e sebetsang;
- Thibelo ea bobeli e kenyelletsa ho fokotsa kholo ea lefu lena ho bakuli ba seng ba ntse ba fokotse GFR kapa albin e eketsehileng mokokotlong oa bona. Bohato bona ba thibelo bo kenyelletsa: ja lijo tse nang le protheine e tlase, taolo ea khatello ea mali, tsitsitseng ea profid ea lipid maling, taolo ea glycemic le normalization ea intodyrenal hemodynamics;
- Thibelo ea thuto e phahameng e etsoa sethaleng sa proteinuria. Morero o ka sehloohong oa sethala ke ho fokotsa kotsi ea ho se sebetse hantle ha renal renal, eo ka nako eo e tšoaeang: khatello ea methapo ea mali, phello e sa lekaneng ea metabolism ea carbohydrate, proteinuria e phahameng le hyperlipidemia.
Livideo tse amanang
Mabapi le lisosa le kalafo ea lefu la tsoekere le nephropathy lenaneong la TV le "Phelang hantle!" le Elena Malysheva:
Le ha ho na le 'nete ea hore lipakeng tsa litlamorao tsohle tsa lefu la tsoekere, nephropathy ke e' ngoe ea libaka tse etelletseng pele, ho shebisisa ka hloko mekhoa ea thibelo ha e kopana le tlhahlobo ea mafu le kalafo e nepahetseng e tla thusa ho liehisa kholo ea lefu lena.
