Ka mafu a mangata a senya likepe, lijana tsa retina le tsona lia utloa bohloko. Liphetoho tse boleloang ka ho fetisisa methapong ea mali, hangata li lebisang ho senyeha ha pono le bofofu, li baka lefu la tsoekere. Phetoho ena ea methapong le methapong e bitsoa "diabetesic retinal angiopathy". Liphetoho tsena li atisa ho bonoa mahlong ka bobeli.
Retina angiopathy feela ha se bokuli, empa e bua feela ka liphetoho tsa pele tsa methapo ea mali e anngoeng ke lefu la tsoekere. Phetoho ena e bitsoa microangiopathy; ke eona phephetso ea pele. Nako e telele ea lefu la tsoekere, haholo ka sebopeho se matla, se bopehileng, e lebisa ho nts'etsopele ea li-macroangiopathies, moo likarolo tse tlase, pelo, bokong le mahlo li utloang bohloko.
Phetoho ea pathological e na le khoutu ho latela ICD-10 - H35.0 (back retinal angiopathy).
Mokhoa oa nts'etsopele ea retinal angiopathy
Tsoekere e phahameng ea mali e baka tšenyo ea butle-butle ea marako a methapo ea mali, ho qala ka li-capillaries tse nyane haholo. Sebakeng sa endothelium e senyehileng, ho hlaha thrombi, ebe ho latela li-cholesterol plaque.
Ha nako e ntse e tsamaea, phallo ea mali ka har'a li-capillary tse nyane e emisa ka ho felletseng, mabota a li-venumes le li-arterioles a lokoloha 'me a lula a le teng, pele ho plasma ea mali, ebe e fetoha lintho tse bopehileng. Ho tsoa betheng ea methapo, karolo e metsi ea mali e baka edema ea retina, "cottony" foci e hlaha. Ketsahalong ea mali, ho tsoa mali ho tsoa letlalong ho tloha ho le lenyenyane ho isa ho le lenyenyane ho isa ho le leholo le fumanehang karolong e kholo ea 'mele o moholo. Bohato bona ba liphetoho likepeng tsa "retinal" bo bitsoa non-proliferative diabetesic retinopathy (DRP).
Phetoho e 'ngoe e lebisa ho nts'etsopele ea likepe tse sa tsoa etsoa, tse nang le tšenyo e kholo tikolohong ea macular, tšenyo ea' mele o matla le ho koaheloa ke lensisi. Bohato bona ba lefu lena bo bitsoa proliferative DRP.
Matšoao le lipontšo tsa lefu lena
Ka nako e telele, angiopathy ea retinal e asymptomatic. Nako le nako, ka keketseho ea tsoekere ea mali kapa le khatello ea khatello ea mali, ho senyeha hoa pono ea nakoana, pono e habeli, "moholi" o hlaha, o nyamela ha lintho tse li bakang li felisoa.
Ka nts'etsopele ea DRP e sa feteleng pele, matšoao le ona a hangata a le sieo.
Ke halofo ea bakuli feela e nang le litletlebo tse latelang:
- pono e fifalitsoeng, "moholi" mahlong;
- lintsintsi, marang-rang, opacity e opang mahlo ka mahlong;
- ponahalo ea ho fokotsa likarolo tsa pono.
Proliferative DRP e ama methapo ea mali le retina haholo.
Mothating ona oa phetoho, ho lula ho na le litletlebo:
- phokotso e kholo ea pono ha e khone ho khalemeloa;
- opacities e ba ho hooa haholoanyane, e amanang le ho timetsoa ha mmele oa vitreous le nts'etsopele ea lefu la tsoekere.
Tlhahlobo ea methapo ea mafu
Ho rarahana ha liteko tsa tsoekere ho kenyelletsa tlhahlobo ea selemo le selemo ke setsebi sa mahlo. Ha ho se ho entsoe liphetoho mahlong, tlhahlobo e etsoa hang ka mor'a likhoeli tse ling le tse ling tse tšeletseng.
Ho tseba ka lefu la angiopathy le liphetoho tse ling tsa mahlo tse bakoang ke lefu la tsoekere maemong a mangata ha ho bake mathata. Tlhahlobo e qala ka cheke ea pono le maemo a bono.
Joale, marotholi a 1-2 a mydriacil, e leng lithethefatsi tse khethehileng tse hlasimollang ngoana, a kenngoa ka hara secjunctival sac. Kamora metsotso e leshome le metso e mehlano, ha seithuti se hola, ho etsoa tlhahlobo leboteng le setseng le sebelisa lilense tsa dioptric haholo. Ke nakong ea biomicroscopy maemong a mydriasis moo liphetoho tse ngata ho retina le lijana tsa eona, hemorrhages le edema li fumanoang.
Sebaka sa arterial le sona sea fetoha - marako a arterioles a ba mosesanyane, a ba mosesane haholo. Haufi le likepe ho na le mokokotlo oa 'mala o mosoeu - boteng ba li-lymphocyte le lisele tsa mali tsa plasma. Mehatong ea pele, liphetoho tse joalo li etsahala hangata bothateng ba fundus, 'me li ka fetoa ha li bonoa ke ngoana e moqotetsane.
Ha ho na ts'episo e tobileng ea boemo ba lefu lena le boemo ba tsoekere ea mali le nako ea lefu la tsoekere. Bakuli ba bang ba nang le lefu la tsoekere la mofuta oa I lefu la tsoekere lilemo tse fetang 20, mme ba le tsoekere e tloaelehileng sebakeng sa 10-12 mmol / l, ha ba na mathata a ho bolela. Ho fapana le hoo, ho bakuli ba nang le li-indices tsa glucose tse tlase tsa 7-8 mmol / L le "boiphihlelo" ba lefu lena la lilemo tse 2-3 ho ka ba le mathata a maholo.
Litliliniki tse ngata tse khethehileng tse fanang ka mahlo a mahlo li sebetsana le polokeho ea fundus ho lekola matla a lefu lena.
Haeba u belaella nts'etsopele ea lefu la tsoekere la macular edema, retinal detachment, kapa neovascularization, optical coherence tomography (OCT) e khothalletsoa.
Mokhoa ona oa tlhatlhobo o u lumella ho bona retina leqebeng, leo ka nako e telele ho neng ho sa khonehe ebile ho le thata ho hlahloba hore na lefu lena le sebetsa joang, le ho fumana maqiti a kalafo.
Mokhoa o mong oa bohlokoa oa tlhahlobo ke tlhaiso ea fluorescence ea retina, e u lumellang ho bonts'a mali hantle hore na mofufutso oa mali o tsoa kae methapong ea mali. Mokhoa ona o khothalletsoa kamora ho ts'oaroa hoa laser ea retina, hammoho le boteng ba SNM.
Phekolo ea lefu la tsoekere
Lefu la tsoekere la mofuta oa lefu la tsoekere ha le hloke phekolo e khethehileng. Mokuli o khothalletsoa ho latela lijo tse khethehileng, ho lekola tsoekere ea mali le khatello ea mali, hemoglobin ea glycated. Phekolo e tlameha ho qala ka nts'etsopele ea mathata.
Conservative
Boholo ba litsebi tsa mahlo, ha li bona angiopathy kapa DRP e sa sebetseng, li fana ka marotholi a leihlo Taufon le Emoksipin. Lithethefatsi tsena li oela mahlo ka bobeli ka matsatsi a 30, khafetsa makhetlo a 3 ka letsatsi.
Boteng ba glaucoma, eo hangata e bang le lefu la tsoekere la retinopathy, kalafo ea antihypertensive e tlameha.
Haeba lefu la tsoekere la macular edema le fumanoa, ho na le litlhare tse se nang lithibela-mafu tse thibelang - Nevanak 1 le theoha makhetlo a 3 ka letsatsi bakeng sa khoeli.
Laser coagulation
Phekolo ea ho buoa bakeng sa ho fumanoa ha lefu la tsoekere la "lefu la tsoekere" ha e bontšoe. Ha setsebi sa mahlo sa mahlo se tsebahatsa ho ruruha ha likepe le sebakeng sa macular, ho etsoa hoa laser retine.
Laser cauterize methapo ea methapo ea methapo ho thibela ho tsoa madi ho eketsehileng. Hangata ho qhekella hona ho etsoa makhetlo a 2-3, 'me laser coagulates e koahela sebaka sohle sa retina.
Phekolo ea ts'ebetso e boetse e sebelisoa maemong a latelang:
- ha subretinal neovascular membrane (SNM) e hlaha sebakeng sa macular. Khatello ena e lebisa ho ho chechisetsoa ka morao, e leng se sokelang tahlehelo e ke keng ea fetoha ea pono;
- ka tšenyo ea 'mele oa vitreous o nang le kotsi e kholo ea ho holofatsa mokokotlo oa methapo.
Lijo tsa lefu lena
Hona le litlhoko tse 'maloa tsa phepo e nepahetseng bakeng sa lefu la tsoekere la Mofuta oa 1 le mofuta oa 2. Litlhokahalo tsena li lokela ho khotsofatsoa ho sa tsotelehe ho ba teng kapa ho se be teng ha mathata.
Ho khothalletsoa ho ja lijo tse latelang, tse sa ekeheng tekanyo ea tsoekere, ka hona e ka nooa ka ho sa feleng:
- meroho: likomkomere, tamati, mefuta eohle ea hop, pepere, zucchini, eggplant, radish, radish;
- li-mushroom tse sa tsoa khuoa;
- meroho, spinach, sorrel;
- tee le kofi ntle le tsoekere le tranelate;
- metsi a liminerale.
Sehlopha sa bobeli se kenyelletsa lihlahisoa tseo ts'ebeliso ea tsona e lokelang ho fokotsoa ke molao-motheo oa "ho aroloa ke ba babeli":
- nama e boreleli: khoho, mohatla, nama ea khomo;
- mefuta e mengata ea litlhapi tse nang le mafura a mangata: cod, pollock, zander, hake.
- soseji e phehiloeng ntle le mafura.
- lebese le nang le mafura a tlase a 1.5-2%.
- chisi e nang le mafura a tlase;
- litapole
- malee - lierekisi, linaoa, lensisi;
- lihlahisoa tsa bohobe le tsa baking;
- Bijoux
- mahe.
Ho khothalletsoa hore lihlahisoa tse latelang li behelle ka thōko ka ho felletseng:
- oli ea liphoofolo le ea meroho;
- lore, margarine le mayonnaise;
- tranelate, chisi le mafura a Cottage chisi;
- nama e mafura: nama ea kolobe le konyana, letata, likhantsi;
- mefuta e mengata ea lihlapi: trout, salmon, herring, chum salmon;
- linate le peo;
- tsoekere, mahe a linotsi, jeme, likuku, jeme, chokolete, ice cream, lino tse tsoekere;
- lino tse nang le joala;
- morara, libanana, li-Persimmons, mehla, lifeiga.
Likarolo tsa angiopathy ho bana
Bongoaneng, lefu la tsoekere le hlaha ka lebaka la ts'ebetso ea sele e sa lekaneng ea pancreatic.
Nts'etsopele ea mathata a mahlo a lefu la tsoekere ho bana, hammoho le tlhahlobo ea bona, e na le lintlha tse latelang:
- ka lebaka la lerako le fokolang la methapo, bana ba tšoauoa ka ponahallo e potlakileng ea mathata - ho eketseha ha lefu la DRP, lefu la tsoekere la lefu la tsoekere, ho kobeha ka mokokotlo, sekhahla sa ho imeloa kelellong;
- bana ba sekolo sa sekolo ba ka nna ba se ke ba bonts'a litletlebo, leha ba na le mahlo a fokolang;
- Ho hlahlojoa ha bana ba banyenyane ke ngaka ea mahlo le hona ho hlahisa mathata a mang;
- bana ba ke ke ba hlokomela ho itima lijo, ho tloaela ho enta insulin, le ho hlahloba boemo ba tsoekere ea mali le bona bo leng kotsi haholo.
Lintho tsa video tse mabapi le tlhahlobo le kalafo ea methapo ea methapo ea kutlo:
Mehato ea thibelo e ikemiselitseng ho thibela nts'etsopele ea lefu la tsoekere le lefu la tsoekere le mathata a mang a mahlo a kenyelletsa:
- lijo tse thata;
- ho ja li-insulin le lithethefatsi tse theolelang tsoekere nako le nako ka nako e loketseng;
- taolo ea boemo ba tsoekere, hemoglobin ea glycated le khatello ea mali;
- ho etela khafetsa ho setsebi sa methapo ea kutlo le ophthalmologist.
