Zomwe Mungachite Kuti Muthane ndi Matenda Odwala Matenda a Shuga
Matenda a shuga ndi matenda omwe amachititsa kuti shuga awonjezeke (komanso otsika) , ndipo amatha kuwononga matenda, matenda, komanso kuteteza chitetezo cha mthupi. Anthu a ku America opitirira mamiliyoni 25 ali ndi mtundu wa mtundu wa I kapena mtundu wa shuga, ndipo zonsezi zingayambitse mavuto mwa anthu omwe amaganiza za opaleshoni yokha. Zina mwa opaleshoni yodziwika bwino ndi opaleshoni yowonjezera yowonjezera kuphatikizapo kubwezeretsa bondo , kubwezeretsa nsalu, ndi kubwezeretsa.
Anthu omwe ali ndi matenda a shuga, kapena atha kukweza ma shuga m'magazi ngakhale osadziŵa matenda a shuga, amafunika kukonzekera mosamala kuti athane ndi mavuto chifukwa cha kuchepa kwa magazi m'magazi. Mwachidziwitso, kuyesetsa kuthetsa matenda a shuga ndi kuyendetsa bwino magulu a shuga m'magazi kungathandize kwambiri kuchepetsa ngozi zomwe zimachitika ndi opaleshoni.
Yokwera Msuzi Wagazi
Pafupifupi 8 peresenti ya anthu omwe amagwirizanitsa nawo ku United States ali ndi mtundu wa I kapena mtundu wa shuga wachiwiri. Kukhala ndi matenda a shuga kumawonjezera ngozi za opaleshoni yogwirizanitsa. Kuwonjezera apo, kuwonjezeka kwa chiopsezochi kumayenderana ndi momwe bwino (kapena bwino) kumayendera magulu a shuga m'magazi nthawi ya opaleshoni. Kuzindikira kuti matenda a shuga sikutanthauza kuti simungathe kupitiliza kugwiritsira ntchito mgwirizano, kungotanthawuza kuti kuopsa kwa opaleshoni kungakhale kochepa kwambiri, ndipo zonse zomwe zingatheke kuchitidwa pofuna kuchepetsa chiopsezo chowonjezeka cha mavuto.
Matenda a shuga amachititsa kuti thupi likhale lolimba, lochititsa mantha, komanso chitetezo cha mthupi. Matenda a Microvascular (kuwonongeka kwa mitsempha yaing'ono kwambiri ya magazi) amatha kuchepetsa kutaya kwa magazi ndi kutulutsa oksijeni kumalo ochiritsira opaleshoni. Kusintha kwa chitetezo cha thupi sikungangowononga thupi la chitetezo cha thupi, komanso limapangitsa thupi kukhala ndi kachilombo ka bakiteriya.
Zotsatira za opaleshoni za anthu omwe ali ndi shuga ndizovuta kwambiri kuti anthu omwe alibe matenda a shuga amachitidwe opaleshoni zosiyanasiyana, osangowonjezera. Kafukufuku wasonyeza ngozi yowonjezereka ndi opaleshoni ya mafupa kuphatikizapo opaleshoni yamapazi, opaleshoni ya msana, ndi opaleshoni yopasuka. Maphunziro ena opatsirana amakhalanso ndi zitsanzo za matenda a shuga kukhala chiopsezo cha mavuto omwe angathe. Apanso, zotsatirazi zimakhala zikugwirizana ndi kuuma kwa chikhalidwe cha momwe bwino, kapena bwino, magulu a shuga a magazi amatha kuyendetsedwa.
Zotsatira Zowopsya Zopangira Opaleshoni Yophatikizapo
Pali njira zambiri zomwe anthu omwe ali ndi matenda a shuga amakhudzidwa pamene akuchitidwa opaleshoni yowonjezera. Matenda a shuga amachulukitsa chiopsezo cha mavuto ambiri , osati chimodzi chokha. Zina mwazovuta zokhudzana ndi matenda odwala matenda a shuga omwe akukhala nawo pamodzi ndi awa:
- Kuopsa koopsa kwa kachilombo: Kuopsa kwa chiopsezo ndi chimodzi mwa zinthu zambiri za opaleshoni yowonjezera. Ngati matendawa amalowa m'malo , opaleshoni yowonjezera nthawi zonse imakhala yofunikira, ndipo nthawi zambiri zimayambanso kuchotsedwa kuti athe kuchiza matenda.
- Vuto lalikulu la mavuto ochiritsidwa ndi machiritso: Kuchiritsidwa kwa opaleshoni yopanga opaleshoni kumawoneka molunjika, koma kusakanizidwa kwa madzi, mabala a necrosis, ndi zosafunika kuchiritsidwa zonse zikhoza kuchitika kwa anthu omwe ali ndi shuga. Kupanga opaleshoni yopanda machiritso ndi chifukwa cha matenda mwa anthu omwe amalowa m'malo mwawo.
- Kuopsa kwakukulu kwa mavuto a zachipatala: Matenda ambiri monga matenda a chibayo, matenda opatsirana m'makina, ndi embolism yamapangidwe akhoza kukhala ovuta kwambiri kwa anthu omwe ali ndi shuga.
- Kuonjezera chiopsezo cha kuikidwa magazi: Kuwombera kumakhala kosavuta kwambiri pambuyo potsatizana. Ndi mankhwala atsopano ndi njira zothetsera mabala, mwayi woika magazi watha kwambiri. Komabe, chiopsezo chili chokwanira kwa anthu omwe ali ndi shuga.
- Kuwonjezeka kwa chiopsezo cha kufa: Izi ndizowopsya kuziganizira, ndipo pamene chiopsezo cha kufa chogwirizana ndi kugwiritsidwa ntchito pamodzi ndi kochepa kwambiri, si zero. Kuwonjezera apo, anthu omwe ali ndi matenda a shuga osagwiritsidwa ntchito amakhala ndi chiopsezo chochuluka cha kufa ndi opaleshoni yosankhidwa monga kupatsirana.
Kulamulira Mipiritsi ya Magazi a Magazi
Pali uthenga wabwino! Ndimadana nazo nthawi zonse kubweretsa uthenga woipa pa tebulo, ndipo palibe kukayika kuti anthu omwe ali ndi vuto loyambitsa shuga wa magazi nthawi zambiri amayenera kukumana ndi mavuto aakulu azachipatala. Nkhani yabwino ndi yakuti pakukhazikitsa mphamvu ya shuga wa magazi, pafupipafupi komanso nthawi yayitali, zoopsa zogwiritsidwa ntchito pamodzi siziyenera kukwera modabwitsa.
Kafukufuku wambiri wasonyeza kuti zoopsa zomwe tazitchula m'nkhani ino zikugwirizana kwambiri ndi momwe shuga amagawira magazi. Izi ndizowona ku shuga ya magazi pa miyezi yozungulira opaleshoni, komanso m'masiku omwe akuchitika opaleshoni. Choncho, kuyesetsa kukhazikitsa shuga ya magazi kudzera mu zakudya, masewera olimbitsa thupi, mankhwala, ndi njira zina zingathandize kupewa zovuta zogwirizanitsidwa ndi opaleshoni yowonjezera.
Miyeso ya shuga ya magazi imayesedwa mwa njira imodzi:
- Mlingo wa shuga: Magazi a shuga amagawidwa akamadya (Pasanapite nthawi, osadutsa) komanso pafupi ndi 70-100. Kwa anthu omwe ali ndi matenda a shuga, nambalayi ingakhale 90-130. Magazi a shuga akhoza kuwonjezeka kwambiri, makamaka kwa anthu omwe ali ndi shuga. Pambuyo pa chakudya, si zachilendo kukhala pafupi ndi 200 kapena apamwamba kwa munthu yemwe ali ndi shuga, koma mwa anthu opanda vutoli, shuga ya magazi siipitirira 125.
- Hemoglobini A1c : Hemoglobini A1c, kapena HbA1c, ndiyeso la magawo ambiri a m'magazi pamwezi miyezi isanayambe. Sichimapereka mphindi pang'ono m'kamphindi, komabe kawirikawiri, bwino, kapena bwino, amayang'anira shuga a magazi. Wodwala matenda a shuga amakhala ndi hemoglobin A1c mlingo wa pafupifupi 5.0, pamene wina yemwe ali ndi matenda a shuga ndi oposa 6.5 (ngakhale kuti pali kusagwirizana pa mlingo woyenera womwe umatanthawuza shuga, ambiri amavomereza pa 6.5 mpaka 7.0). Pogwira ntchito kusintha kayendedwe ka magazi, kusintha kwa hemoglobin A1c kungatenge miyezi kuti ione.
Zonsezi zingakhale zothandiza m'njira zosiyanasiyana, komabe sizingwiro. Mwachitsanzo, kukhala ndi mlingo wa magazi m'magulu oposa 200 panthawi yodzigwiritsira ntchito kwawonetsedwa kukhala chiopsezo cha mavuto, ngakhale A1c ikulamulidwa bwino. Mofananamo, kukhala ndi magazi m'magazi pa tsiku la opaleshoni pamalo a mkulu A1c sikukutanthauza kuti mulibe ufulu. Mayeso onsewa angathandize anthu kuyendetsa kayendedwe ka shuga ndi kuchepetsa ngozi zawo zokhudzana ndi kuchitidwa opaleshoni.
Kodi Pali Cutoff?
Zina zowonjezeramo zakhazikitsidwa zakhazikitsa njira zomwe zimafuna zotsatira zowonetsera kuti apitirize kuchita opaleshoni yowonjezera. Mayeso omwe amagwiritsidwa ntchito kwambiri ndi hemoglobini A1c. Pofuna kuonetsetsa kuti anthu ogwirizanitsa nawo ali ndi matenda a shuga oyenera, malo ena amafunikira magazi a A1c, monga mlingo pansipa 7.5 kapena pansi pa 8.
Chochititsa chidwi, hemoglobini A1c mwina sichiyeso chabwino kwambiri chodziwiratu kuti zingakhale zovuta zowonjezera zokhudzana ndi mgwirizano wothandizana nawo, koma ndi mayeso abwino kuti apeze, ndipo zimapereka chisonyezo chabwino cha momwe munthu angathetsere shuga mwazi wawo. Ndondomeko yeniyeni yomwe ili yotetezeka, ndi zomwe siziri, ndizovuta, koma malo ena ogwiritsira ntchito omwe akugwiritsiridwa ntchito m'malowa amamasulira cutoff yawo pa njirazi.
Kafukufuku waposachedwapa wa kulemba m'malo mwa odwala oposa 18,000 anapeza kuti osowa mu gulu ili anali hemoglobin A1c ya 8.0 kapena kuposa. Odwalawa anali ndi chiopsezo chachikulu cha matenda akuluakulu komanso mavuto ochiritsidwa. Ndipotu, pangoziyi, vuto lalikulu la odwala 18,000 linali lochepa kwambiri (pafupifupi 1 peresenti), ndipo ngakhale kuti chiopsezo chinali pafupifupi kawiri mwa anthu omwe ali ndi A1c oposa 8, chiopsezochi chikanangokhala 2 peresenti.
Mawu Ochokera
Izi zikumveka ngati nkhani zoipa zambiri, kotero ndiloleni ndikhale ndi zotsatira zabwino: Anthu ambiri omwe ali ndi shuga amayenda opaleshoni yokhazikika ndikusintha moyo wawo pachaka. Ngakhale pangakhale ngozi zoonjezereka za zovuta za opaleshoni, ziopsezozi zikhoza kuyendetsedwa. Kulamulira shuga zamagazi, makamaka nthawi ya opaleshoni, amaganiziridwa kukhala chinthu chofunikira kwambiri pakuyendetsa zoopsazi. Anthu omwe ali ndi matenda a shuga sayenera kuopsezedwa, koma ayenera kugwira ntchito ndi madotolo awo kuti athe kupangitsa shuga kuti asamawonongeke kuti athe kuika opaleshoni yowonjezera.
> Zotsatira:
> Rizvi AA, Chillag SA, Chillag KJ. "Kusamalidwa kwa matenda a shuga ndi hyperglycemia kwa odwala opaleshoni ya mitsempha" J Am Acad Orthop Surg. 2010 Jul; 18 (7): 426-35.
> Stanton T. "HbA1c Risk Threshold for Infection Kuzindikiritsidwa kwa Odwala Matenda a Shuga Amagwira Ntchito Pamodzi" AAOSNow. April 2017.
> Uhl RL, Rosenbaum AJ, Dipreta JA, Desemone J, Mulligan M. "Matenda a shuga: mawonetseredwe a minofu ndi zoganizira za opaleshoni ya mafupa" J Am Acad Orthop Surg. 2014 Mar 22 (3): 183-92.