Nrog rau ntau cov kab mob uas ua rau cov hlab ntsha puas, cov hlab ntsha ntawm cov leeg muaj peev xwm raug. Kev hloov siab tshaj plaws ntawm cov hlab ntsha, feem ntau ua rau pom kev tsis pom kev thiab dig muag, ua rau mob ntshav qab zib. Qhov hloov pauv ntawm cov leeg ntshav thiab cov hlab ntsha yog hu ua mob ntshav qab zib retinal angiopathy. Cov kev hloov no feem ntau tau sau tseg hauv ob lub qhov muag.
Retina angiopathy ib leeg tsis yog kab mob, tab sis tsuas yog hais txog thawj zaug pauv ntawm cov hlab ntsha cuam tshuam rau ntshav qab zib. Qhov kev hloov pauv no yog hu ua microangiopathy; nws yog thawj qhov teebmeem. Cov kab mob ntshav qab zib ntev ntev, tshwj xeeb tshaj yog nyob rau hauv daim ntawv hnyav, tsis zoo, ua rau muaj kev loj hlob ntawm macroangiopathies, nyob rau hauv qis qis kawg, lub siab, lub hlwb thiab qhov muag raug kev txom nyem.
Qhov kev hloov pauv pathological muaj ib txoj cai raws li ICD-10 - H35.0 (keeb kwm yav dhau los lub ntsej muag mob hlwb).
Tus txheej txheem ntawm kev txhim kho ntawm retinal angiopathy
Txhawb cov ntshav qabzib ua rau maj mam rhuav tshem cov phab ntsa ntawm cov hlab ntshav, pib los ntawm cov hlab ntsha me tshaj plaws. Hauv qhov chaw ntawm lub endothelium uas puas lawm, thrombi tshwm sim, thiab tom qab ntawd cov roj av plaques.
Ntev dhau los, cov ntshav ntws hauv cov hlab ntsha me me kom tiav, cov phab ntsa thiab cov hlab ntsha ua kom xoob thiab permeable, thawj zaug rau cov ntshav ntshav, thiab tom qab ntawd rau cov khoom ua rau lub plawv. Los tawm ntawm lub txaj vascular, qhov ua kua ntawm cov ntshav ua rau edema ntawm tus retina, "ntom nti" foci tshwm sim. Thaum tawm ntawm cov ntshav tawm, hemorrhages tshwm sim los ntawm pob nyiaj los ntawm me me mus rau me me, rau cov dav dav uas nyob ib feem ntawm lub cev vitreous. Qeb theem ntawm kev hloov pauv ntawm cov hlab ntsha retinal yog hu ua tsis-loj hlob rau cov leeg ntshav qws ntshav siab (DRP).
Ib qho kev hloov pauv ntxiv ua rau muaj kev txhim kho cov nkoj tsim tshiab, nrog kev puas tsuaj tsuas yog nyob rau thaj chaw macular, rhuav tshem cov khoom hauv lub cev thiab lub ntsej muag ntawm lub lens. Qeb theem ntawm tus kabmob no yog hu ua kev nthuav tawm DRP.
Cov tsos mob thiab kev nthuav qhia ntawm tus kab mob
Ntau lub sijhawm, retinal angiopathy yog asymptomatic. Qee zaum, nrog kev nce siab hauv cov ntshav qab zib lossis nce ntshav siab, qhov tsis pom kev ib ntus, pom ob lub zeem muag, "pos huab" tshwm, uas ploj thaum cov yam ua rau lawv raug tshem tawm.
Nrog rau kev nthuav dav ntawm DRP tsis tshaj tawm, cov tsos mob kuj tseem tu ncua.
Tsuas yog ib nrab ntawm cov neeg mob muaj cov kev tsis txaus siab li nram no:
- qhov muag plooj, "pos huab" hauv qhov muag;
- yoov, cobwebs, opacities ntab hauv qhov muag;
- cov kev pom ntawm txoj kev pom kev nqaim uas teb.
Kev nthuav dav DRP cuam tshuam rau ob leeg cov hlab ntshav thiab cov leeg ntshav retina.
Nyob rau theem ntawm kev hloov pauv no, txhua zaus muaj kev tsis txaus siab:
- qhov tseem ceeb txo hauv kev pom yog qhov tsis yooj yim mus kho;
- opacities ua ntau tshaj tawm, uas cuam tshuam nrog kev puas tsuaj ntawm lub cev ntawm cov kab mob hauv lub cev thiab kev ua haujlwm ntawm cov ntshav qab zib cataract.
Kev kuaj mob pathology
Txoj kev kuaj mob ntshav qab zib muaj kev soj ntsuam ib xyoos ib zaug los ntawm kws kho qhov muag. Nrog twb paub qhov kev hloov pauv hauv lub qhov muag, kev tshuaj ntsuam yog nqa tawm ib zaug txhua rau lub hlis.
Kev kuaj mob ntawm lub ntsws thiab lwm yam kev pauv ntawm qhov muag tshwm sim los ntawm cov ntshav qab zib hauv feem ntau tsis ua rau muaj kev nyuaj. Qhov kev kuaj mob pib nrog daim tshev rau pom pom thiab tonometry.
Tom qab ntawd, 1-2 tee ntawm mydriacil, ib hom tshuaj tshwj xeeb ntuav tus tub ntxhais kawm, tau nkag rau hauv lub hnab ntim ua ke. Tom qab 10-15 feeb, thaum cov tub ntxhais kawm nthuav dav, qhov kev soj ntsuam tau ua rau ntawm lub teeb hlais siv cov dioptric lo ntsiab muag heev. Nws yog thaum lub sij hawm biomicroscopy nyob rau hauv cov xwm txheej ntawm mydriasis tias feem ntau ntawm cov kev hloov pauv ntawm qhov retina thiab nws cov hlab ntsha, hemorrhages, thiab edema tau kuaj pom.
Lub txaj arterial kuj yauv pauv hloov - lub phab ntsa ntawm txoj hlab ntsha ua tau nyias, ua lub lumen nqaim. Raws cov hlab ntsha feem ntau muaj cov kab xim dawb - qhov tso nyiaj ntawm lymphocytes thiab ntshav ntshav. Hauv thawj theem, xws li cov kev hloov feem ntau tshwm sim nyob rau ntawm qhov chaw pab nyiaj, thiab tuaj yeem plam thaum saib ntawm cov tub ntxhais kawm nqaim.
Tsis muaj kev cia siab ncaj qha rau theem ntawm tus kab mob ntawm cov theem ntawm cov piam thaj hauv ntshav thiab lub sijhawm ntshav qab zib. Qee cov neeg mob uas muaj mob hom I mob ntshav qab zib mellitus rau ntau tshaj 20 xyoo, thiab muaj cov suab thaj thaj thaj hauv thaj tsam ntawm 10-12 mmol / l, tsis muaj teeb meem tshwm sim. Thiab ntawm qhov tsis sib xws, hauv cov neeg mob uas tsis muaj cov piam thaj ntawm 7-8 mmol / L thiab qhov “kev paub” ntawm tus mob ntawm 2-3 xyoos tuaj yeem muaj cov kev mob nyhav heev.
Ntau lub chaw kho mob ophthalmologic tshwj xeeb coj kev yees duab ntawm pob nyiaj txhawm rau soj ntsuam ntxiv ntawm qhov hloov pauv ntawm tus kab mob.
Yog tias koj xav tias qhov kev loj hlob ntawm cov ntshav qab zib macular edema, rov ua kom mob dua, lossis neovascularization, pom qhov ua kom muaj qhov txhab tom qab (OCT) yog kev pom zoo.
Txoj kev kuaj no tso cai rau koj kom pom qhov retina ntawm cov hlais, uas tau ntev ntev tsis yooj yim sua thiab nyuaj rau kev kuaj mob, thiab txiav txim seb cov kev kho mob li cas.
Lwm qhov kev qhia ntawm kev kuaj mob yog fluorescence angiography ntawm tus kabmob retina, uas tso cai rau koj qhia qhov tseeb ntawm qhov chaw nyob tawm hws los ntshav. Hom no tau pom zoo tom qab laser coagulation ntawm tus retina, zoo ib yam li muaj SNM.
Ntshav Qab Zib Kho
Ntshav qab zib-hom mob retinal angiopathy tsis tas yuav tsum tau kho tshwj xeeb. Tus neeg mob tau pom zoo kom ua raws li kev noj zaub mov tshwj xeeb, saib xyuas ntshav qab zib thiab ntshav siab, glycated hemoglobin. Txoj kev kho yuav tsum pib nrog kev txhim kho ntawm qhov teeb meem.
Txom Txwm Pov
Feem ntau cov kws kho qhov muag, thaum kuaj pom angiopathy lossis tsis-nthuav tawm DRP, sau ntawv rau Taufon thiab Emoxipin qhov muag ntshav. Cov tshuaj no tau tso rau hauv ob lub qhov muag nyob rau hauv chav kawm ntawm 30 hnub, nrog ntau zaus ntawm 3 zaug hauv ib hnub.
Nyob rau hauv lub xub ntiag ntawm glaucoma, uas feem ntau tsim muaj mob ntshav qab zib retinopathy, kev tiv thaiv mob ntsws yuav tsum yog qhov yuav tsum tau ua.
Yog tias kuaj pom tus kab mob ntshav qab zib macular edema, cov tshuaj tsis haum steroidal los kho cov tshuaj noj - Nevanak 1 poob 3 zaug hauv ib hnub rau ib hlis.
Laser coagulation
Kev phais mob rau kev tshawb pom ntawm kev mob ntshav qab zib retinal angiopathy tsis qhia. Thaum tus kws kho qhov muag pom tau hais tias hemorrhages raws cov hlab ntsha thiab hauv thaj chaw macular, laser retinal coagulation tau ua.
Laser cauterize retinal leeg tshav pob kom tiv thaiv ntshav ntxiv. Feem ntau qhov kev ntxias no tau nqa tawm 2-3 zaug, thiab laser coagulates npog tag nrho cheeb tsam ntawm retina.
Kev phais mob phais yog thaum raws li nram no:
- thaum subretinal neovascular membrane (SNM) tshwm sim hauv thaj chaw macular. Qhov kev cuam tshuam no ua rau muaj kev rov ua kom zoo, uas hawv ua qhov tsis pom kev zoo ntawm lub zeem muag;
- nrog kev rhuav tshem ntawm lub cev vitreous nrog qhov kev pheej hmoo siab ntawm kev txhim kho traction retinal detachment, vitrectomy ua.
Kev noj haus rau tus kab mob
Muaj ntau ntau cov kev xav noj haus zoo rau hom I thiab ntshav qab zib hom 2. Cov tseev kom muaj no yuav tsum tau ntsib txawm hais tias muaj lub xub ntiag lossis tsis muaj teeb meem.
Nws raug nquahu kom noj cov zaub mov hauv qab no, uas ua kom tsis txhob nce qib ntawm cov piam thaj, thiab vim li ntawd tuaj yeem noj mus rau lub sijhawm:
- zaub: cucumbers, txiv lws suav, txhua hom zaub qhwv, kua txob, zucchini, txaij, zaub paj, radish;
- tshiab thiab nceb nceb;
- zaub ntsuab, spinach, sorrel;
- tshuaj yej thiab kas fes yam tsis muaj qab zib thiab qab zib;
- ntxhia dej.
Cov pab pawg thib ob suav nrog cov khoom lag luam uas siv yuav tsum tau txwv los ntawm txoj ntsiab cai ntawm "muab faib los ntawm ob":
- nqaij ntshiv: nqaij qaib, qaib cov txwv, nqaij nyuj;
- cov ntses muaj roj ntau hom tsawg: cod, pollock, zander, hake.
- siav hnyuv ntxwm tsis muaj roj.
- mis nyuj nrog cov roj tsawg cov ntsiab lus ntawm 1.5-2%.
- cov rog hauv tsev cheese qis;
- qos yaj ywm
- legumes - peas, taum, lentils;
- cov khoom siv qhob cij thiab bakery;
- Cov nplej zom
- lub qe.
Nws raug nquahu tias cov khoom lag luam hauv qab no tsis suav nrog:
- tsiaj thiab roj zaub;
- lard, margarine thiab mayonnaise;
- cream, cheese thiab rog tsev cheese;
- cov rog ua nqaij: nqaij npuas thiab nqaij yaj, os, os;
- rog ntses ntau yam: trout, salmon, herring, chum salmon;
- noob txiv ntoo thiab noob;
- qab zib, zib ntab, jam, ncuav qab zib, jams, chocolate, dej qab zib, dej qab zib;
- haus muaj cawv;
- txiv hmab, txiv tsawb, persimmons, hnub tim, figs.
Cov yam ntxwv ntawm mob caj dab hauv cov menyuam yaus
Thaum tseem yau, ntshav qab zib loj hlob tuaj vim muaj kabmob tsis txaus ua haujlwm pancreatic cell.
Kev loj hlob ntawm cov ntshav qab zib qhov muag muaj teeb meem hauv cov menyuam yaus, nrog rau lawv cov kev kuaj mob, muaj qee yam ntxwv:
- vim yog cov leeg tshav ntsa tsis muaj zog, cov menyuam yaus yog tus yam ntxwv pom sai sai ntawm cov teeb meem tshwm sim - loj hlob ntawm DRP, kev mob ntshav qab zib, cuam tshuam ntawm cov leeg ntshav, rov ua kom mob ntxiv, cov leeg nqaij hauv lub cev;
- cov menyuam pib kawm ua ntej yuav tsis qhia kev tsis txaus siab, txawm tias lawv tsis pom kev zoo;
- kev soj ntsuam cov menyuam yaus los ntawm tus kws kho qhov muag tseem qhia txog qee qhov kev nyuaj;
- cov menyuam yaus tsis tuaj yeem saib xyuas kev noj zaub mov noj, kev tsis tu ncua ntawm kev txhaj tshuaj insulin, thiab tshuaj xyuas lawv cov ntshav qabzib cov ntshav, uas tseem ua rau muaj kev hem thawj loj.
Cov khoom siv video hais txog kev kuaj mob thiab kev kho mob ntawm pathologies ntawm tus kab mob retina:
Kev tiv thaiv kab mob txhawm rau tiv thaiv kev txhim kho mob ntshav qab zib retinal angiopathy thiab lwm qhov muag cuam tshuam nrog:
- cov khoom noj nruj;
- tsis tu ncua thiab noj kom zoo ntawm cov tshuaj insulin thiab ntshav qab zib;
- tswj cov suab thaj theem, glycated hemoglobin thiab ntshav siab;
- mus ntsib tus kws tshuaj endocrinologist thiab kws kho qhov muag.
