Zomwe muyenera kudziwa zokhudza matenda a impso (komanso momwe mungapewere)

Maphunziro a Zaumoyo

Mwawona zosintha mumkodzo wanu-monga kuphulika ndi kuphulika kwa thovu-ndipo mwakhala mukutupa posachedwa, makamaka mozungulira akakolo anu. Zina mwazizindikiro zanu zimatha kufotokozedwa mosavuta ndi zikhalidwe wamba, monga kupsinjika, kutenga pakati, ndi matenda, koma kuchuluka kwa zizindikiraku kumatha kuyimbidwanso chifukwa cha matenda a impso (CKD).

Kodi matenda a impso aakulu ndi ati?

Omwe amadziwika ngati kuwonongeka kwa impso zanu zomwe zakhala zikuchitika kwa miyezi yambiri, matenda a impso amayamba impso zanu zikaleka kugwira ntchito ngati momwe amathandizira kusefera ( magazi, madzi, ndi zinyalala kudzera m'thupi lanu 24/7).

Matenda a impso, kapena kuwonongeka kochepa komwe kwachitika posachedwa, atha kusinthidwa ngati madotolo agwira nthawi. Matenda oyipa a impso kenako amakhala matenda a impso. Koma matenda a impso ndi ovuta kuchiza-ndipo kuwonongeka kwa impso nthawi zambiri kumakhala chinthu chomwe mwina simukudziwa kuti muli nacho mpaka mutachedwa kuti mulowerere.

Matenda a impso osaneneka amapezeka kwambiri kuposa momwe mukuganizira. Malinga ndi University of Missouri Health Care nephrologist Kunal Malhotra, MD, ziwerengero zadziko zikuwonetsa kuti 14% aku America ali nayo, kuphatikiza 1 mwa anthu atatu aliwonse omwe ali ndi matenda ashuga, komanso 1 m'modzi mwa odwala 5 omwe ali ndi kuthamanga kwa magazi. Kukhala ndi zonse mwazi kapena zonse ziwiri kumakupangitsani kukhala ndi matenda a impso, monganso kukhala ndi banja lavuto la impso, kukhala matenda opatsirana kwambiri , kapena kukhala ochokera ku Africa American.

Magawo a matenda a impso

Pali magawo asanu a matenda a impso. Umu ndi momwe amawonongera:

• Gawo 1: Mutha kukhala ndi zizindikilo za kuwonongeka kwa impso, monga mapuloteni kapena magazi mumkodzo wanu, koma sizinakhudze impso zanu zonse.
• Gawo 2: Mumayamba kuchepa kwa ntchito, koma mwina sizingadziwike pokhapokha dokotala atayesa GFR yanu, kapena kuchuluka kwa kusefera kwama glomerular, komwe ndi gawo la labotale yamagetsi yamagetsi yamagetsi, ndiye kuti, basic metabolic panel (BMP). Mwa achikulire athanzi, GFR iyenera kukhala osachepera 90 .
• Gawo 3: Ntchito yanu ya impso imagwera ku 40% kapena 50%. Mukuyamba kudziunjikira maelekitirodi ndi madzi, koma impso zanu zikugwirabe ntchito kuti zilipire ndalama chifukwa cha kutayika kwa ntchito-kotero mwina simukudziwa za kuwonongeka.
• Gawo 4: Ntchito yanu ya impso ikamachepa, imatha kuyimitsa zoyesayesa zake kuti igwire bwino ntchito. Mumayamba kuzindikira zizindikiro monga kutupa pamene thupi lanu limasonkhanitsa mchere ndi potaziyamu. Pakadali pano, mutha kukhala otopa komanso otopa.
• Gawo 5: Pambuyo pake matendawa, ntchito ikangotsika pansi pa 30%, mutha kukhala ndi njala, kutopa kapena kusowa tulo, khungu louma komanso loyabwa, kutupa kwa diso, kutupa kwa miyendo, akakolo, ndi mapazi, kukokana kwa minofu, kukodza pafupipafupi, ndi mkodzo wonyezimira kapena wa thovu (zizindikiro za kuchuluka kwa mapuloteni kapena magazi mkodzo). Pamene impso zanu zikugwira ntchito pa 15% (kapena zocheperako) zantchito yabwinobwino, mungafune kumuika impso kapena dialysis kupewa kulephera kwa impso.

Chovuta kwambiri chokhudza matenda a impso, atero Dr. Malhotra, ndikukula kwake mwakachetechete.

Mumayamba kutha pantchito yachiwiri, koma impso zimatha kuthana ndi zopingazo, akutero Dr. Malhotra. Icho chimakwawira pa anthu… kwakukulu, mpaka gawo lachinayi kuti muzindikire zizindikilo. Mwanjira ina, nthawi zambiri zimakhala zosazindikirika mpaka kuchedwa kuti asiye kapena kusintha zowonongeka. Pali zidziwitso zochepa kwambiri pakumayambiriro komwe mukukumana ndi kuchepa kwa magwiridwe antchito.

Sizinthu zonse zoipa, komabe: Pali zinthu zomwe mungachite kuti muchepetse kukula kwa matenda a impso ngati muli nawo ndipo, mwamwayi, njira zolepheretsa kuti zisachitike.

Kuzindikira matenda a impso

Madokotala omwe amaganiza kuti ali ndi matenda a impso mwa odwala awo nthawi zambiri amayendetsa magazi kuti awone GFR ndikupanga urinalysis kuti ayese mtundu wina wa mapuloteni otchedwa chimbale . Akhozanso kuyeza milingo ya creatinine ; creatinine, chinthu chotayidwa chomwe chimasefedwa ndi impso, nthawi zambiri chimachuluka ntchito ya impso ikatsitsidwa. Popeza mulingo wabwinobwino wa creatinine umasiyana ndimagulu, msinkhu, ndi minofu, milingo ya creatinine yokha sichingathe kudziwa matenda a impso, ngakhale atha kugwiritsidwa ntchito limodzi ndi kuyezetsa magazi ndi kuyesa kwa GFR.

Kuyesa kwa labu uku, kuphatikiza pa mayendedwe ndipo zachilengedwe a impso, zitha kuthandiza madokotala kuzindikira kupezeka kwa kuwonongeka.

Kuchiza matenda a impso

Pazithandizo, zambiri zimadalira kusintha kwa moyo wathanzi. Ndikofunika kukonza zomwe zimayambitsa chiwopsezo, monga kuwonetsetsa kuti matenda anu ashuga amayang'aniridwa bwino, komanso kusintha zakudya, atero Dr. Malhotra.

Akuwonjezera kuti kuchepetsa kugwiritsa ntchito mankhwala osafunikira komanso mankhwala (makamaka osagwiritsa ntchito mankhwala osokoneza bongo monga ibuprofen, omwe angathe kuyambitsa kuvulala kwa impso komanso kukulitsa zizindikilo za matenda a impso), komanso kusiya kusuta fodya komanso kuchita masewera olimbitsa thupi nthawi zonse kumathandizanso kuti impso zisayambike kuwonongeka.

Malinga ndi Dr. Robert Greenwell, wamkulu wa nephrology ku Mercy Medical Center ku Baltimore, kuchiritsa kuthamanga kwa magazi ndi njira ina yotetezera impso zanu kuti zisawonongeke. Kulimbana ndi kuthamanga kwa magazi ndi Kuletsa kwa ACE kapena mankhwala osokoneza bongo monga losartan kapena lisinopril itha kukuthandizani kuti mugwire ntchito ya impso ndikutsitsa kuchuluka kwa mapuloteni mumkodzo wanu.

Momwe mungapewere matenda a impso

Dr. Greenwell adanenanso za kulumikizana pakati pa matenda a impso ndi zosankha m'moyo - makamaka zokhudzana ndi kupewa.

Tikapeza kuti kuwonongeka kwa impso kwakhazikika, [kwanthawi yayitali], mwayi woti tithetse izi ndizochepa, akutero. Koma tikayang'ana pazinthu zazikulu zomwe zimapangitsa wina kuti asowe dialysis, zomwezo nthawi zambiri zimakhala zokhudzana ndi moyo.

Amanenanso zakuchuluka kwa matenda a impso kwa odwala matenda ashuga, matenda oopsa, matenda amtima, kachilombo ka HIV, pakauntala ya NSAID komanso kugwiritsa ntchito mankhwala osokoneza bongo pafupipafupi: Zinthu zambiri zomwe zimayambitsa matenda a impso ndipo zimabweretsa kuwonongeka kosatha kapena kusowa kwa dialysis kungathe sizingakonzedwe - koma tikadatha kuwaletsa zaka 15 zapitazo ndikusankha kakhalidwe ka zakudya ndi moyo wawo.

Ndiye mungatani tsopano, musanadwale matenda a impso, kuti mukhale ndi impso zathanzi?

1. Sinthani kulemera kwanu ndi shuga m'magazi. Kunenepa kwambiri, kusamva kwa insulin, komanso kuthamanga kwa magazi nthawi zambiri kumayambitsa matenda ashuga, omwe ndi omwe amayambitsa matenda a impso. Ngati matenda anu asanakuletsedwe ndi hemoglobin A1c yomwe yakhalapo kwa nthawi yayitali kuposa 8.0%, muyenera kufunafuna katswiri wa matenda ashuga monga endocrinologist kuti akuthandizeni ndi matenda anu ashuga chifukwa ndi omwe amachititsa kuti impso zizilephera ku United States.
2. Chitani masewera olimbitsa thupi. Kafukufuku wina akusonyeza kuti kuchita masewera olimbitsa thupi kumatha kuchepetsa kukula a gawo lachitatu ndi gawo lachinayi la matenda a impso.
3. Lekani kusuta. Kusuta osati kokha kumawonjezera chiopsezo cha matenda a impso , zimathandizira matenda oopsa, kuuma kwa mitsempha ya impso, ndi proteinuria. Ndizowonjezeranso pachiwopsezo mapeto siteji aimpso (ESRD).
4. Idyani bwino. KU Impso yothandiza Zakudya zokhala ndi mbewu zonse, zomanga thupi zamafuta ndi zomanga thupi zomanga thupi, mafuta a monounsaturated, zipatso, nyemba zamasamba, ndi ndiwo zamasamba zitha kuteteza kuwonongeka kwa impso, monganso kuchepetsa mchere, mowa, ndi mafuta okhuta. National Institute of Diabetes and Digestive and Impso Diseases (NIDDK) imalangizanso anthu omwe ali ndi matenda a impso kuti aziwunika kuchuluka kwake kwa phosphorous ndi potaziyamu m'zakudya zawo , popeza zonsezo zimatha kukulira m'magazi mwako. Izi zikutanthauza: Pewani kudya mkaka wambiri, nyemba zambiri, nyemba, zakumwa zakuda, nthochi, ndi malalanje, pakati pa zakudya zina. Sankhani zakudya za phosphorous ndi potaziyamu wochepa monga maapulo, kaloti, mkaka wa mpunga, pasitala woyera, ndi zakumwa zomveka bwino ngati zingatheke.
5. Sinthani momwe zinthu zilili kale. Ngati muli ndi matenda ashuga, matenda oopsa, kapena kachilombo ka HIV, onetsetsani kuti dokotala akuyang'ana pafupipafupi momwe impso zanu zimagwirira ntchito chifukwa matendawa amachulukitsa chiopsezo chodwala matenda a impso.
6. Kuchepetsa kugwiritsa ntchito mankhwala. Anthu amatenga ma NSAID chifukwa cha zowawa koma samazindikira kuti mankhwalawo ndiye omwe amachititsa kuti impso izivulazidwa ndi mankhwala osokoneza bongo, atero Dr. Malhotra. Zitha kuwononga impso m'njira zingapo, ndikupangitsa kuti yotupa angathe kusinthidwa-pokhapokha mutatenga kwa nthawi yayitali mwayambitsa mabala osasinthika. Amalimbikitsa kungotenga zopweteka za NSAID, monga naproxen kapena ibuprofen, pakafunika kutero-ndipo nthawi zonse moyang'aniridwa ndi dokotala.
7. Khalani woimira wanu wamphamvu. Ngati muli ndi matenda ashuga kapena kuthamanga kwa magazi, dokotala wanu akuyenera kuyang'ana kale impso zanu ... ndipo ngati sizili choncho, muyenera kufunsa dokotala kuti impso zanu zikuyenda bwanji, akutero Dr. Greenwell. Mwanjira ina, ngati mukudziwa kuti muli pachiwopsezo chachikulu cha kuwonongeka kwa impso chifukwa cha zomwe zidachitika kale, musachite manyazi kuonetsetsa kuti dokotala akuyang'anitsitsa ntchito yanu ya impso.
8. Tengani vitamini aimpso. Malinga ndi National Kidney Foundation, matenda a impso atha kukupangitsani kuchepetsa zakudya kapena magulu azakudya, zomwe zikutanthauza kuti mutha kukhala kusowa mavitamini ndi mchere wofunikira . Kutenga aimpso vitamini zitha kutsimikizira kuti mukupeza zakudya zoyenera-monga iron, calcium, ndi B mavitamini ovuta-tsiku lililonse. Izi zati, anthu omwe ali ndi matenda a impso ayenera kupewa kupezeka ndi michere yambiri, chifukwa chake muyenera kumalankhula ndi dokotala musanadye zowonjezera.

Kodi mutha kusintha kuwonongeka kwa impso?

Simungathe kusinthiratu matenda a impso chifukwa kuwonongeka ndi mabala ndizochulukirapo. Mitundu ina yamatenda oyipa a impso, monga mtundu womwe umayambitsidwa chifukwa chogwiritsa ntchito mankhwala mopitirira muyeso, amatha kusintha ngati atagwidwa msanga.

Kamodzi [ndikuwona zizindikiro za kuwonongeka], ndikuganiza ngati zingakhale zoyambitsa zomwe zitha kusintha poyamba, atero Dr. Greenwell. Ngati kuwonongeka kwaposachedwa-monga momwe ntchito yanu inali yachilendo mwezi wapitawo ndipo tsopano sichoncho-Ndili ndi mwayi wabwino woti ndikuthandizeni kuchira kuposa ngati mwakhala mukuwonongeka kwanthawi yayitali.

Pamenepo, a Dr. Greenwell akufotokoza, osaganizira kwambiri akuyenera kukonza kapena kuchotsera zowonongekazo komanso momwe angachepetsere. Ndipokhapokha mutagwira ntchito pafupifupi 10% pomwe mumafunikira dialysis kapena kumuika, akutero. Chifukwa chake mutha kukhala ndi matenda a impso osachiritsika komanso milingo itatu [yachilendo] ya creatinine, koma mutha kukhala nawo kwakanthawi. Titha kuyesa kuchepetsa kuwonongeka, kotero milingo yanu ya creatinine imakulirakulira pazaka 15 m'malo mwazitatu.

Lankhulani ndi omwe amakuthandizani azaumoyo za njira zabwino zochepetsera kukula kwa mavuto anu a impso.