Ntshav Qab Zib Retinopathy > Mob ntshav qab zib muaj teeb meem

Ntshav Qab Zib Retinopathy - Kev mob caj dab tshwj xeeb, cuam tshuam cov hlab ntsha ntawm qhov retina ntawm lub qhov muag thiab txhim kho tiv thaiv keeb kwm ntawm cov ntshav qab zib ntev ntev. Tus mob ntshav qab zib muaj lub ntsej muag zoo zuj zus: nyob rau theem pib, qhov muag plooj, ib daim ntaub thaiv thiab ntab mus rau pem hauv ntej ntawm lub qhov muag tau sau tseg, nyob rau theem tom ntej muaj qhov txo qis lossis tsis pom kev. Kev kuaj mob suav nrog kev sab laj nrog kws kho qhov muag thiab kws kho ntshav qab zib, ophthalmoscopy, biomicroscopy, visometry thiab perimetry, retinal vascular angiography, thiab kev kuaj ntshav biochemical. Kev kho mob ntawm cov ntshav qab zib retinopathy yuav tsum muaj kev tswj hwm cov ntshav qab zib, kho cov teeb meem metabolic, thiab yog muaj teeb meem, kev siv tshuaj intravitreal ntawm cov tshuaj, laser retinal coagulation, lossis vitrectomy.

Cov ntaub ntawv dav dav

Tus mob retinopathy yog ib qho qhia ntxov rau tus mob ntshav qab zib mellitus, ob hom insulin thiab tsis-insulin-kev vam khom. Hauv ophthalmology, mob ntshav qab zib retinopathy ua rau pom kev tsis pom kev hauv cov neeg mob ntshav qab zib hauv 80-90% ntawm cov neeg mob. Hauv cov neeg muaj ntshav qab zib, qhov muag tsis pom kev yuav muaj 25 zaus ntau dua li lwm tus neeg sawv cev ntawm cov pej xeem. Nrog rau tus mob ntshav qab zib retinopathy, cov neeg muaj ntshav qab zib muaj feem yuav ua mob plawv, mob ntshav qab zib nephropathy thiab mob polyneuropathy, cataracts, glaucoma, occlusion ntawm lub hauv nruab nrab lub paj hlwb thiab lub paj hlwb lub plawv, mob ntshav qab zib ko taw thiab mob caj dab ntawm lub siab. Yog li, kev kho mob ntshav qab zib yuav tsum muaj kev ua ntau yam, nrog rau kev koom tes ntawm cov kws tshwj xeeb los ntawm endocrinologist (kws kho mob ntshav qab zib), ophthalmologist, kws kho plawv, kws kho pob ntseg.

Cov Neeg Ua thiab Teeb Meem Qhov Tseeb

Lub tshuab kev txhim kho ntawm cov ntshav qab zib retinopathy yog cuam tshuam nrog kev puas tsuaj rau cov hlab ntsha hlwb (cov hlab ntsha ntawm cov leeg ntshav): lawv cov permeability nce ntxiv, occlusion ntawm capillaries, cov tsos ntawm cov nkoj tsim tshiab thiab kev txhim kho ntawm kev nthuav dav (caws pliav) cov ntaub so ntswg.

Feem ntau ntawm cov neeg mob uas muaj lub sijhawm ntev ntev ntawm mob ntshav qab zib mellitus muaj qee yam lossis lwm yam cim kev puas tsuaj rau pob txha. Nrog lub sijhawm ntev li ntshav qab zib txog 2 xyoo, mob ntshav qab zib retinopathy raug kuaj pom mus rau ib qib lossis lwm qhov hauv 15% ntawm cov neeg mob, nce txog 5 xyoo - hauv 28% ntawm cov neeg mob, txog 10-15 xyoo - hauv 44-50%, txog 20-30 xyoo - hauv 90-100%.

Cov kev pheej hmoo tseem ceeb cuam tshuam rau ntau zaus thiab kev hloov pauv ntawm tus mob ntshav qab zib retinopathy muaj xws li lub sijhawm mob ntshav qab zib mellitus, qib theem ntawm hyperglycemia, hlab ntsha tawg, mob raum tsis ua haujlwm, dyslipidemia, metabolic syndrome, thiab kev rog dhau. Txoj kev txhim kho thiab kev loj hlob ntawm tus mob retinopathy tuaj yeem pab ua tiav nkauj tiav nraug, cev xeeb tub, caj ces tsis muaj zog, thiab haus luam yeeb.

Kev faib tawm

Muab cov kev hloov pauv zuj zus nyob rau hauv cov kev khwv nyiaj, uas tsis yog neeg tawm tsam, kev npaj ua ntej thiab kev mob ntshav qab zib muaj peev xwm sib txawv tau tshwm sim.

Txhawb siab, tswj cov ntshav qab zib tsis zoo yuav ua rau kev puas tsuaj rau cov hlab ntshav ntawm ntau yam plab hnyuv siab raum, suav nrog tus retina. Hauv qhov tsis nce qib ntawm kev mob ntshav qab zib retinopathy, cov phab ntsa ntawm cov hlab ntsha retinal ua permeable thiab nkig, uas ua rau taw tes rau hemorrhages, kev tsim cov microaneurysms - lub zos saccular dilatation ntawm cov hlab ntsha. Kev tso dej ua kua ntawm cov ntshav seeps los ntawm phab ntsa semipermeable los ntawm cov hlab ntsha mus rau ntawm qhov retina, ua rau kom cov leeg o tuaj. Xws li kev koom tes hauv cov txheej txheem ntawm nruab nrab ntawm thaj av ntawm cov retina, macular edema nthuav dav, uas tuaj yeem ua rau tsis pom kev zoo.

Hauv lub sijhawm npaj ua ntej, nce qib ntawm lub pob txha caj qaum ischemia tsim vim muaj occlusion ntawm txoj hlab ntsha, ntshav tawm hauv lub plawv, mob ntshav tsis txaus.

Preproliferative diabetic retinopathy ua ntej qib proliferative, uas tau txheeb xyuas hauv 5-10% ntawm cov neeg mob ntshav qab zib mellitus. Muaj feem xyuam nrog hauv kev txhim kho cov kabmob ntshav qab zib muaj sia nyob ntau dua li cov kabmob myopia, muaj mob ntawm cov hlab ntsha carotid, posterior vitreous detachment, optic atrophy. Nyob rau theem no, vim tias cov pa oxygen tsis paub dhau los ntawm qhov retina, cov hlab ntsha tshiab pib tsim nyob rau hauv nws kom tswj kev nqus pa kom txaus. Cov txheej txheem ntawm neovascularization ntawm retina ua rau rov ua dua preretinal thiab retrovitreal hemorrhages.

Feem ntau, mob ntshav liab me hauv cov khaubncaws sab hauv retina thiab vitreous lub cev daws teeb meem ntawm nws tus kheej. Txawm li cas los xij, nrog cov ntshav tawm hauv lub qhov muag kab mob loj (hemophthalmus), cov kab mob tsis ua haujlwm nyob rau hauv lub cev vitreous tshwm sim, yam ntxwv ntawm fibrovascular fusion thiab caws pliav, uas thaum kawg ua rau tractional retinal detachment. Thaum txhaws qhov tawm ntawm cov kab mob HPV, kev txhim kho ntawm lub cev nqaij daim tawv neau leeg.

Cov tsos mob ntawm tus mob ntshav qab zib Retinopathy

Tus kab mob no loj hlob thiab loj zuj zus yam tsis hnov mob thiab tsis nco qab - qhov no yog nws lub ntsiab insidiousness. Nyob rau theem tsis-loj zuj zus, txo lub zeem muag tsis pom lub ntsiab lus. Macular edema tuaj yeem ua rau blurring ntawm pom cov khoom, tsis yooj yim nyeem ntawv lossis ua haujlwm ntawm qhov ze.

Hauv theem loj ntawm tus mob ntshav qab zib retinopathy, thaum mob ntshav khov tshwm sim, ntab tsaus nti thiab daim ntaub thaiv tshwm sim nyob rau hauv lub qhov muag, uas tom qab ib pliag ploj ntawm lawv tus kheej. Nrog cov ntshav khov hauv lub cev vitreous, qhov txo qis los yog ua tsis tiav qhov muag pom tshwm sim.

Kev Tiv Thaiv

Ntev-ntev hyperglycemia. Muaj ib qho kev xav ntawm qhov tseem ceeb ntawm kev tiv thaiv kab mob hauv lub hauv paus chiv keeb ntawm retinopathy.

Lub Neej Kev Kho Mob

Lub pathogenesis ntawm ntshav qab zib retinopathy yog txoj. Cov kev sib txuas ua ntej yog microcirculation kev cuam tshuam cuam tshuam nrog cov kab ntxwv cov yam ntxwv ntawm cov hlab ntsha rov qab thiab cov khoom pauv hloov pauv nrog cov ntshav qab zib mellitus.

Ntawm cov ntshav qab zib mellitus, qhov ntshav-tso tawm tsis pub dhau, uas txwv tsis pub nkag mus ntawm cov loj loj los ntawm cov hlab ntshav mus rau hauv cov ntaub so ntswg retinal, ua ntau permeable, uas ua rau cov khoom tsis haum nkag mus rau qhov mob retina.

Hauv kev txhim kho cov tsos mob, muaj qee qhov sib lawv liag: sau vasodilation → muaj ntshav nce ntxiv → endothelial puas → txhaws ntawm cov hlab ntuag → nce permeability → kev tsim cov hlab ntsha tsis haum thiab microaneurysms → neovascularization → hemorrhage → degeneration thiab disorganization.

Kev faib tawm

Nyob rau xyoo 1992, Kohner E. thiab Porta M. tau npaj siab rau WHO kev faib tawm cov ntshav qab zib ua kom tsis txhob mob hlwb, uas tam sim no feem ntau lees txais:

Nonproliferative Retinopathy (cov kab mob ntshav qab zib retinopathy Kuv) - muaj tus cwj pwm pom nyob rau ntawm retina ntawm lub qhov muag ntawm kev hloov pauv pathological hauv daim ntawv ntawm microaneurysms, hemorrhages (nyob rau hauv daim ntawv me me lossis cov doog ntawm cov duab sib npaug (tseem muaj cov xim dashed), tsaus xim hauv cheeb tsam, hauv thaj chaw nruab nrab ntawm qhov fundus lossis raws cov leeg loj hauv qhov tob. pob qij txha sab), exudative foci (hauv ib cheeb tsam hauv nruab nrab feem ntawm fundus, daj lossis dawb nrog ciam teb ntshiab lossis tsis paub) thiab edema ntawm retina. Retinal edema nyob hauv thaj chaw nruab nrab (macular) thaj av lossis raws cov nkoj loj yog ib qho tseem ceeb ntawm cov tsis muaj kabmob ntshav qab zib ua lub pob maim ntshav retinopathy.
Preproliferative retinopathy (cov kab mob ntshav qab zib retinopathy II) - ua rau pom muaj qhov tsis txaus ntawm cov leeg ntshav (lub cev tsis sib xws, tsim txom, muaj cov loops, ua ob npaug thiab / lossis tshaj tawm kev hloov pauv hauv cov ntshav ntawm cov hlab ntsha), ntau qhov ntawm cov khoom thiab "paj rwb" exudates, mob ntshav tawm ntawm lub cev (microsascular anomalies) (IRMA), muaj cov hlab ntshav ntau ntau.
Coob tshaj plaws li koob hmoov (kev mob ntshav qab zib retinopathy III) - ua rau neovascularization ntawm optic disc thiab / lossis lwm qhov chaw ntawm retina, vitreous hemorrhages, qhov tsim ntawm cov nqaij mos hauv thaj chaw ntawm preretinal hemorrhages. Cov nkoj tsim tshiab yog cov nyias nyias thiab tsis taus - ua cov ntshav tawm tsis tu ncua feem ntau tshwm sim, ua rau kom cov leeg rov ua haujlwm. Tshiab tsim cov hlab ntsha ntawm lub ntsej muag ntawm lub qhov muag (rubeosis) feem ntau ua rau kev txhim kho ntawm cov kab mob theem nrab (rubeous) lub ntsej muag.

Soj ntsuam duab

Thawj theem pib ntawm qhov mob txhab yog tus cwj pwm tsis pom ntawm qhov muag (qhov pom ntawm qhov muag pom, mob, thiab lwm tus). Kev poob lossis txo qhov pom ntawm lub qhov muag pom yog lub cim mob lig uas qhia tau qhov kev deb, tsis tuaj yeem ua haujlwm (tsis txhob tsis saib tsis xyuas qhov kev ntsuam xyuas ophthalmological niaj hnub).

Qhov tseem ceeb ua rau pom kev tsis pom tseeb yog tus mob ntshav qab zib, muaj ntau yam kev tshawb pom ntawm 80-90% ntawm cov neeg mob. Raws li Kev Kawm A. Efimov, nyob rau hauv kev tshawb ophthalmological ntawm 5,334 cov neeg mob ntshav qab zib mellitus, retinopathy ntawm qhov txawv txav tau tshawb pom hauv 55.2% ntawm cov neeg mob (theem I - 17.6%, theem II - 28.1%, theem III - hauv 9.5%). Tag nrho cov tsis pom kev ntawm txhua qhov kev kuaj mob yog kwv yees li 2%.

Retinopathy - kev puas tsuaj rau cov hlab ntsha ntawm retina. Lub ntsiab "lub hom phiaj" rau kev hloov pauv hauv cov retina:

arterioles - lipogaline arteriosclerosis ("ntshav vasculosis"), qhov cuam tshuam tshaj plaws yog precapillary arterioles thiab capillaries nyob rau thaj tsam posterior ntawm cov nyiaj,
leeg - kev nthuav dav thiab deformation,
capillaries - dilatation, permeability ntau, txhaws ntawm capillaries, ua rau pericapillary edema, degeneration ntawm intra-phab ntsa pericytes nrog proliferation ntawm endothelium, thickening ntawm qab daus, tsim ntawm microaneurysms, hemorrhages, arteriovenous shunts, neovascularization,
o ntawm striatum opticum fibers, pom li thaj chaw grey thiab huab zoo li thaj chaw, hais tawm exudates, edema ntawm lub optic disc, atrophy thiab retinal detachment.

Kev kuaj mob

Tsawg kawg yog 1 zaug nyob rau ib xyoos, cov neeg mob ntshav qab zib mellitus tau kuaj xyuas qhov tsis zoo, suav nrog kev nug, ntsuas ntawm qhov muag pom thiab ophthalmoscopy (tom qab cov tub kawm ntawv xoob) kom pom cov exudates, pom cov ntshav, microaneurysms thiab loj hlob ntawm cov nkoj tshiab. Qhov zoo, kev tshuaj xyuas yog nqa los ntawm kws kho qhov muag nrog kev paub hauv cov chaw kho mob ntshav qab zib.

Kev Kho Mob

Kev kho tus mob ntshav qab zib retinopathy yog txoj, ua los ntawm endocrinologist thiab kws kho keeb. Qhov tseem ceeb ib yam yog kev noj zaub mov zoo thiab kev kho tshuaj insulin. Nws yog ib qho tseem ceeb kom tsis txhob muaj cov rog hauv cov zaub mov noj, hloov cov tsiaj rog nrog roj zaub, tsis suav txog cov khoom noj zom tau yooj yim (cov suab thaj, qab zib, khaws cia), thiab tseem siv cov khoom muaj lipotropic tshuaj (tsev cheese, ntses, oatmeal), txiv hmab txiv ntoo, zaub (tshwj tsis yog cov qos yaj ywm). Kev kho mob Vitamin yog ib qho tseem ceeb, tshwj xeeb tshaj yog pab pawg B (B₁, B₂, B₆, B₁₂, B₁₅) sab hauv thiab parenteral. Vitamin C, P, E muaj kev tiv thaiv zoo ntawm lub tshav vascular (3-4 zaug hauv ib xyoos, chav kawm 1 lub hlis). Angioprotectors suav nrog anginin (prodectin), dicinone, doxium. Cov tshuaj yog coj raws li kws kho mob sau tseg.

Hauv theem kuv uas mob ntshav qabzib retinopathy (tsis-loj hlob), cov kev kuaj mob ophthalmic pheej tau hais tseg. Tus kws kho mob yuav tsum kuaj xyuas seb tus neeg mob tswj cov ntshav qabzib hauv cov ntshav npaum li cas.
Hauv kev mob ntshav qab zib retinopathy ntawm II lossis III theem (preproliferative thiab proliferative retinopathy, ntsig txog), laser photocoagulation yog qhia.

Txoj kev tshawb nrhiav DIRECT tsis ntev los no tau soj ntsuam kev siv candesartan renin-angiotensin receptor (RAS) blocker rau hom 1 thiab ntshav qab zib hom 2. Kev siv cov tswm ciab candesartan tsis txo qis kev nce qib ntawm kev rov ua dua li qub. Thaum lub sijhawm kawm, muaj ib qho kev ywj pheej hais txog qhov txo qis ntawm qhov mob hlwb retinopathy. Hauv kev kawm RASS tsis tshua muaj ntau, nws tau pom tias kev loj hlob ntawm retinopathy nyob rau hauv hom 1 mob ntshav qab zib mellitus qeeb nrog ASD thaiv nrog losartan thiab ib qho kev mob angiotensin-hloov mus rau enzyme enalapril inhibitor. Yog li, kev siv cov tshuaj tiv thaiv ASD tuaj yeem tsim nyog hauv cov neeg mob ntshav qab zib hom 1 thiab mob hlwb, tab sis tsis muaj mob ntshav qab zib hom 2.

Tus mob retinopathy muaj feem xyuam nrog rau ntau qhov kev tsis sib haum xeeb hauv lub cev, suav nrog methylation ntawm Sod2 thiab MMP-9 noob thiab kev hloov pauv ntau dhau ntawm LSD1 en gene. Tau siv cov kev kho epigenetic los kho lawv yog tam sim no tau txiav txim siab.

Huab Cua

Hauv kev kis mob siab tshaj thiab nrog kev sib xyaw ntawm cov ntshav qab zib mellitus nrog cov ntshav siab heev, atherosclerosis yog qhov hnyav heev.

Kev Tiv Thaiv

Hauv kev txhim kho thiab kev loj hlob ntawm tus mob hlwb rov qab rau txhua yam mob ntshav qab zib mellitus, lub luag haujlwm tseem ceeb yog muab rau cov txiaj ntsig zoo ntawm kev them nyiaj rau tus kab mob hauv qab. Kev txhim kho ntawm cov hlab ntsha txhaws thiab ntshav qab zib nephropathy, feem ntau ua ke nrog retinopathy, ua rau lub chav kawm ntawm retinopathy mob ntshav qab zib mellitus. Atherosclerosis feem ntau mob siab rau ntawm cov neeg mob ntshav qab zib mellitus ntawm lub hnub nyoog yau thiab mob hnyav dua - vim tias muaj microangiopathy, kev muaj peev xwm tsim cov kev tiv thaiv kom tsawg. Txog lub hom phiaj kuaj mob raws sijhawm, txhua tus neeg mob ntshav qab zib yuav tsum raug kuaj los ntawm tus kws kho mob ophthalmologist tsawg kawg 1 zaug hauv ib xyoos thiab yog tias muaj kev tsis txaus siab tsim nyog.

Txhawm rau tiv thaiv qhov mob vascular txhab ntau ntawm lub qhov muag, lawv yuav tsum kuaj pom thaum ntxov - cov tub ntxhais hluas uas muaj ntshav qab zib yuav tsum tau kuaj los ntawm kws kho mob ophthalmologist tsawg kawg 1 zaug hauv 6 lub hlis. Kev saib xyuas tshwj xeeb yuav tsum tau them rau qhov muag mob ntawm cov neeg mob ntshav qab zib mellitus ntev - nrog kev nce lub sijhawm ntawm cov ntshav qab zib mellitus, qhov ntau zaus ntawm kev kuaj pom tus mob ntshav qab zib nce ntxiv.

Tsuas yog qhov zoo tshaj yuav txhim kho nyob rau hauv kev tiv thaiv ntawm tus mob ntshav qab zib retinopathy yog lub hauv paus rau kev kho mob ntawm txhua theem nws yog kev them nyiaj zoo tshaj plaws rau ntshav qab zib mellitus (qib ntawm glycated hemoglobin HbA_1C .

Pathogenesis thiab ua rau

Lub pathogenesis ntawm ntshav qab zib retinopathy yog qhov nyuaj. Ntawm cov tseem ceeb ua rau kev puas tsuaj rau cov hlab ntshav ntawm cov retina: lawv cov permeability ntau dhau, txhaws ntawm cov hlab ntsha, qhov tshwm sim ntawm cov nqaij mos ua kom mob ntxiv (caws pliav) thiab cov hlab ntsha tshiab. Cov kev hloov pauv no yog vim muaj caj ces ntawm cov qauv ntawm retina.

Tsis yog lub luag haujlwm tsawg tshaj plaws hauv kev txhim kho kabmob yog ua si los ntawm kev hloov pauv hauv metabolic uas tshwm sim nrog cov ntsiab lus ntawm cov piam thaj hauv cov ntshav. Hauv cov ntshav qab zib ntev txog 2 xyoos, cov kab mob ntshav qab zib tau kuaj pom nyob hauv 15% ntawm cov neeg mob, nce txog 5 xyoo - hauv 28%, nce txog 10-15 xyoo - hauv 44-50%, txij li 20 txog 30 xyoo - hauv 90-100%.

Qhov txaus ntshai uas cuam tshuam txog qhov nrawm thiab nrawm ntawm kev mob tshwm sim suav nrog:

theem ntawm hyperglycemia,
lub sijhawm ua ntshav qab zib
mob raum tsis ua hauj lwm
leeg ntshav siab
hnyav dhau (rog dhau),
metabolic mob
dyslipidemia.

Tsis tas li ntawd, kev txhim kho thiab kev loj hlob ntawm cov kab mob ntshav qab zib ua rau muaj lub cev xeeb tub, pub nkauj, tsis coj cwj pwm phem.

Soj ntsuam duab

Tus mob retinopathy mob ntshav qab zib muaj kev loj hlob thiab nce qib yam tsis muaj cov tsos mob tshwm sim. Qhov uas tsis pom kev tsawg tsawg hauv qhov tsis yog nce qib, tsis yog qhov pom tau. Qhov plooj ntawm cov khoom pom tuaj yeem ua rau macular edema. Nyeem ntawv nyuaj nyob ze cov yuav tau sau tseg. Ntxiv mus, qhov pom tseeb ntawm cov tsis pom kev zoo nyob ntawm kev saib xyuas cov piam thaj hauv cov ntshav.

Hauv cov theem kev loj hlob ntawm tus kab mob, daim ntaub thaiv thiab ntog opacities tshwm ua ntej lub qhov muag (qhov tshwm sim ntawm txoj leeg ntshav). Tom qab ib ntus, lawv ploj ntawm lawv tus kheej.Nrog rau kev ua kom tawv nqaij, lub ntsej muag tsis meej lossis ua kom tsis pom kev zoo tshwm sim hauv lub cev vitreous.

Kev kuaj mob

Rau kev kuaj ntshav qab zib kom tsis txhob mob, tus neeg mob yog kws kho ophthalmoscopy raws li mydriasis, visometry, biomicroscopy ntawm ntu ntu ntawm qhov muag, perimetry, biomicroscopy ntawm lub qhov muag nrog Goldman lens, Maklakov tonometry, diaphanoscopy ntawm qhov muag teeb.

Daim duab ophthalmoscopic yog qhov tseem ceeb tshaj plaws rau kev tsim theem ntawm tus kabmob. Hauv theem tsis-nthuav tawm, microaneurysms, hemorrhages, thiab tawv thiab mos exudates tau pom. Hauv cov theem loj zuj zus, daim duab fundus yog pom los ntawm kev mob ntshav tsis txaus ntawm lub ntsws (mob ntshav tawm thiab nthuav cov leeg ntshav, cov leeg ntshav), cov hlab ntsha tsis ua haujlwm thiab preretinal hemorrhages, fibrous proliferation, retinal neovascularization, thiab optic hlab ntsha tsis zoo. Txhawm rau sau cov kev hloov ntawm daim duab retina, cov koob yees duab ntawm cov duab kab nyiaj yog coj nrog lub koob yees duab fundus.

Nrog opacities ntawm lub koob yees duab vitreous thiab crystalline, qhov muag ultrasound yog tshuaj hloov ophthalmoscopy. Txhawm rau ntsuas qhov kev ua txhaum lossis khaws cia ntawm lub luag haujlwm ntawm optic lub paj hlwb thiab retina, kev tshawb nrhiav electrophysiological tau ua: electrooculography, kev txiav txim siab ntawm CSFM, electroretinography. Txhawm rau kuaj pom neovascular glaucoma, gonioscopy tau ua.

Cov qauv tseem ceeb tshaj plaws rau kev kuaj cov hlab ntsha retinal yog fluorescence angiography. Nws sau npe cov ntshav tawm hauv cov hlab hauv cov hlab hlwb. Yog tias tsim nyog, angiography yog hloov nrog laser thiab optical coherent scanning retinal tomography.

Txheeb xyuas cov kev pheej hmoo txaus rau kev hloov pauv ntawm tus mob ntshav qab zib retinopathy, tso zis thiab ntshav qab zib, glycosylated hemoglobin, insulin, lipid profile thiab lwm yam kev ntsuas tau kuaj xyuas. Tsis muaj tsawg dua qhov kev qhia tawm kev kuaj mob yog ultrasound ntawm cov hlab ntsha hauv lub raum, tshuaj xyuas ntshav txhua hnub, ECG thiab echocardiography.

Kev txuag tshwj xeeb

Hauv cov theem pib ntawm tus kab mob, txoj kev kho mob tseem ceeb yog kev txuag. Tus neeg mob tau qhia ntev txog kev siv tshuaj kho mob uas txo qhov tsis haum ntawm capillaries - angioprotectors (Doxyum, Parmidin, Dicinon, Predian). Nws kuj tseem yuav tsum muaj qib ntawm cov piam thaj hauv ntshav kom txaus.

Txog kev kho thiab tiv thaiv cov teeb meem vascular, Sulodexide, ascorbic acid, vitamin P thiab E. yog tshuaj tua kab mob antioxidant (piv txwv li, Strix) muab cov txiaj ntsig zoo. Cov kev npaj no muaj beta-carotene thiab blueberry extract. Cov tshuaj yeeb dej caw zoo txhim kho qhov muag, ntxiv dag zog rau cov leeg tshav, tiv thaiv cov txiaj ntsig ntawm cov dawb radicals.

Ib qho chaw tshwj xeeb hauv kev kho mob ntshav qab zib retinopathy yog qhov ib txwm ua rau cov roj av metabolism. Qhov no tshwm sim los ntawm kev noj cov tshuaj muaj suab thaj. Kev saib xyuas kev noj qab haus huv kuj tseem cuam tshuam nrog kev kho kom zoo li qub ntawm tus neeg mob lub cev.

Cov neeg uas raug tus mob no yuav raug tshuaj xyuas. Raws li qhov mob hnyav ntawm cov chav kawm ntawm cov ntshav qab zib, lub sijhawm ntawm kev tsis taus raug txiav txim siab. Tus neeg mob yog contraindicated hauv kev ua haujlwm cuam tshuam nrog kev teeb pom kev zoo siab, kev co, tilting lub taub hau thiab lub cev, nqa nyhav. Nws yog txwv tsis pub ua haujlwm hauv thauj thiab hauv cov khw kub.

Kev phais mob

Yog tias kev kuaj pom tus mob ntshav qab zib retinopathy qhia qhov kev ua txhaum loj: hemorrhages nyob rau hauv retina, edema ntawm nws qhov chaw hauv nruab nrab, tsim cov hlab ntsha tshiab, tom qab ntawd tus neeg mob tau pom laser kev kho. Hauv cov teeb meem tshwj xeeb - kev phais plab.

Thaum cov hlab ntsha tshiab tuaj ntshav thiab cov kab mob macular edema tshwm sim, laser retinal coagulation yog qhov yuav tsum tau. Lub sijhawm ua cov txheej txheem no, laser lub zog xa mus rau thaj chaw puas ntawm retina. Nws nkag mus rau hauv lub qhov muag, muaj kev lom zem, muaj dej noo ntawm chav nyob sab xub ntiag thiab lub lens tsis muaj kev cuam tshuam.

Lub laser kuj tseem siv sab nraum nruab nrab lub zeem muag thaj chaw ceev faj rau thaj chaw ntawm cov retina tsis muaj oxygen. Nrog nws cov kev pab, cov txheej txheem ischemic raug rhuav tshem hauv retina. Raws li qhov tshwm sim, cov nkoj tshiab txuas ntxiv kom tshwm sim. Txoj kev no tseem tshem tawm cov twb tau ua kab mob pathological neoplasms. Qhov no ua rau txo qis hauv edema.

Lub hom phiaj tseem ceeb ntawm laser coagulation yog los tiv thaiv qhov ua mob ntawm tus mob. Yuav kom ua tiav nws, qhov nruab nrab ntawm 3-4 ntu yog qhov yuav tsum ua. Lawv xeem 30-40 feeb txhua thiab tau tuav ntawm ntu sib nrug ntawm ob peb hnub. Thaum ua cov txheej txheem, qhov mob yuav tshwm sim. Yog li no, cov tshuaj loog hauv ib cheeb tsam yog ua nyob rau hauv cov ntaub so ntswg puag ncig lub qhov muag. Ob peb lub hlis tom qab ua tiav kev kho, ib tus kws kho mob tshwj xeeb ntsuas lub xeev ntawm tus kabmob retina. Rau lub hom phiaj no, fluorescence angiography yog kho tau.

Yog tias tsis yog mob ntshav qab zib ua kom rov ua mob rau cov ntshav qab zib hauv lub cev, tus neeg mob yuav tsum tau kho cov ntshav. Thaum lub sij hawm tus txheej txheem, tus kws kho mob tshem tawm cov ntshav ntau, thiab lub cev vitreous yog hloov nrog cov roj silicone (lossis ua kua ntsev). Nyob rau tib lub sijhawm, nti uas ua rau stratification thiab kua muag ntawm lub retina yog dissected los ntawm laser, thiab cov hlab ntsha cov ntshav tau ceev faj. Kev ua haujlwm no raug pom zoo thaum pib ntawm tus kabmob. Qhov no zoo heev txo cov kev pheej hmoo ntawm cov teeb meem.

Yog hais tias tus neeg mob tau muaj kev hloov pauv ntau ntawm cov pob nyiaj, ntau cov nkoj tsim tshiab thiab cov ntshav tshiab, cryocoagulation ntawm tus kabmob retina tau ua. Nws kuj yog qhov tsim nyog yog tias vitrectomy lossis laser coagulation tsis tuaj yeem.

Muaj teeb meem tshwm sim

Txaus ntshai tej yam tshwm sim ntawm tus mob retinopathy:

cataract
sab hauv neovascular glaucoma,
tseem ceeb txo nyob rau hauv lub zeem muag
hemophthalmus,
retinal traction cais tawm,
ua tiav dig muag.

Cov mob no yuav tsum muaj kev soj ntsuam tas li los ntawm tus kws kho mob, neuropathologist, ophthalmologist thiab endocrinologist. Qee qhov teebmeem yog tshem tawm los ntawm kev phais mob.

Txoj kev kho mob ntshav qab zib zoo tshaj plaws yog ua kom cov ntshav qabzib tsawg dua thiab tswj hwm lawv li qub. Noj mov kom yog thiab mus ntsib koj tus kws kho qhov muag tawm tswv yim tsis tu ncua. Ib hlis ib zaug, nyob rau yav tsaus ntuj, ntsuas qhov siab ntawm lub plab. Nrog kev kuaj mob raws sij hawm thiab kev kho mob nyuaj, muaj txhua lub sijhawm kom muaj lub zeem muag.

Theem Kab Mob Ntshav Qab Zib Retinopathy

Tus mob retinopathy uas mob ntshav qab zib muaj ntau theem. Qhov pib theem ntawm retinopathy yog hu ua tsis-loj hlob, thiab pom qhov txawv txav los ntawm kev tshwm sim microaneurysmsuas dilate ntawm cov hlab ntsha nrog chaw pom ntshav hauv qhov muag nyob rau hauv daim ntawv ntawm puag ncig tsaus nti los yog cov nqaij ntuag, cov tsos ntawm thaj chaw ischemic ntawm tus retina, retinal edema hauv thaj chaw macular, nrog rau cov permeability thiab fragility ntawm phab ntsa ntawm cov hlab ntsha. Hauv qhov no, dhau los ntawm cov hlab ntsha hauv qab, cov kua ua kua ntawm cov ntshav nkag rau qhov retina, uas ua rau tsim muaj cov edema. Thiab yog tias qhov nruab nrab ntawm tus retina koom nrog hauv cov txheej txheem no, ces nws yog cai tsis pom kev.

Nws yuav tsum raug sau tseg tias hom mob ntshav qab zib no tuaj yeem tshwm sim rau txhua theem ntawm tus kab mob, thiab sawv cev rau theem pib ntawm kev mob hlwb. Yog tias nws tsis kho, tom qab ntawd hloov mus rau theem ob ntawm tus kab mob tshwm sim.

Qhov thib ob theem ntawm retinopathy yog loj hlob, uas yog nrog cov ntshav tawm hauv lub cev ntawm retina, uas ua rau cov pa oxygen tsis txaus nyob hauv retina (cov pa tshaib plab heev, ischemia) Txhawm rau rov qab cov pa oxygen, lub cev tsim cov hlab ntsha tshiab (txoj kev no hu ua neovascularization) Cov nkoj tshiab tsim tau puas thiab pib los ntshav, ua los ntawm cov ntshav nkag Vitreous lub cevretinal khaubncaws sab nraud povtseg. Raws li qhov no, ntab opacities tshwm sim hauv lub qhov muag tiv thaiv keeb kwm ntawm qhov tsis pom kev zoo.

Hauv cov theem thaum ntxov ntawm retinopathy nrog kev loj hlob txuas ntxiv ntawm cov nkoj tshiab thiab caws pliav, nws tuaj yeem ua rau kom muaj kev cuam tshuam thiab rov qab txhim kho mob ntsws.

Qhov laj thawj tseem ceeb ntawm kev txhim kho mob ntshav qab zib retinopathy yog qhov tsis txaus tshuaj insulinua rau tsub zuj zuj fructose thiab sorbitolpab txhawb rau hauv kev nce siab hauv cov thooj, tuab ntawm phab ntsa ntawm cov hlab ntsha thiab nqaim ntawm lawv cov khoob.

Kev loj hlob thiab theem ntawm tus kab mob

Nrog rau kev nce ntxiv hauv cov ntshav qab zib, muaj cov tuab ntawm phab ntsa ntawm cov hlab ntshav. Raws li qhov tshwm sim, lub siab nyob rau hauv lawv nce, cov hlab ntsha puas ntsoog, nthuav dav (microaneurysms), thiab me me hemorrhages daim ntawv.

Ntshav tuab kuj tshwm sim. Microthrombi daim ntawv, thaiv lub lumen ntawm cov hlab ntsha. Muaj oxygen oxygen starvation ntawm tus retina (hypoxia).

Txhawm rau kom tsis txhob hypoxia, shunts thiab cov hlab ntshav tsim, hla cov chaw muaj kev phom sij. Shunts khi cov hlab ntsha thiab leeg ntshav, tab sis cuam tshuam cov ntshav khiav hauv capillaries me thiab thiaj li nce hypoxia.

Nyob rau yav tom ntej, cov hlab ntsha tshiab tawm mus rau cov kab mob retina, hloov cov khoom puas. Tab sis lawv yuag heev thiab tsis yooj yim, yog li ntawd lawv tau sai sai puas, los ntshav tshwm sim. Tib cov hlab ntsha tuaj yeem loj zuj zus mus rau hauv lub kho qhov muag, lub cev muaj sia, ua rau lub ntsej muag, cuam tshuam nrog qhov tseeb tawm ntawm cov kua dej ntawm lub qhov muag.

Txhua yam kev hloov pauv no tuaj yeem ua rau cov nyom ua rau dig muag.

3 theem ntawm cov mob ntshav qab zib retinopathy (DR) tau soj ntsuam txawv:

Cov Tshuaj Tsis Rov Qab (DR I).
Preproliferative retinopathy (DR II).
Kev Tshaj Tawm Txog Retinopathy (DR III).

Cov theem ntawm retinopathy yog tsim los ntawm tus kws kho pob kws tshuaj thaum kuaj cov nyiaj los ntawm cov menyuam kawm ntawv, lossis siv cov kev tshawb nrhiav tshwj xeeb.

Nrog tsis-loj hlob retinopathy microaneurysms yog tsim, me me hemorrhages raws cov leeg retinal, foci ntawm exudation (tawm hws ntawm cov kua feem ntawm cov ntshav), shunts ntawm cov hlab ntsha thiab leeg. Txawm tias edema yog ua tau.

Hauv theem preproliferative tus naj npawb ntawm cov hemorrhages, exudates nce, lawv tau los ua ntau. Retinal leeg nthuav dav. Optic edema yuav tshwm sim.

Nyob rau theem kev loj hlob muaj kev nthuav dav (loj zuj zus) ntawm cov hlab ntshav nyob hauv retina, cov hlab qhov muag, muaj cov leeg ntshav hauv retina thiab vitreous lub cev. Caws pliav cov ntaub so ntswg cov ntaub ntawv, txhim kho kev tshaib plab oxygen thiab ua rau cov ntaub so ntswg pov tseg.

Qhia Txog Tus Mob Ntshav Qab Zib Retinopathy Kev Kho Mob

Nrog rau cov qauv dav dav ntawm kev kho mob retinopathies, kev kho mob suav nrog kev kho cov teeb meem metabolism, txhim kho kev tswj kom zoo dua qib ntawm glycemia, ntshav siab, lipid metabolism. Yog li no, nyob rau theem no, txoj kev kho mob tseem ceeb yog kho los ntawm tus kws kho mob endocrinologist-diabetologist thiab tus kws kho plawv.

Ua tib zoo saib xyuas txog qib glycemia thiab glucosuria, kev xaiv cov tshuaj insulin tsim nyog rau cov ntshav qab zib mellitus yog nqa tawm, angioprotectors, tshuaj tiv thaiv kab mob siab, tshuaj tiv thaiv kab mob, thiab lwm yam.

Cov neeg mob uas mob ntshav qab zib ua kom rov ua hauj lwm zoo yog qhia tau rau laser retinal coagulation. Laser coagulation tso cai rau koj los txwv cov txheej txheem ntawm neovascularization, kom ua tiav obliteration ntawm cov hlab ntshav nrog nce siab thiab permeability, los tiv thaiv kev pheej hmoo ntawm retinal detachment.

Kev phais kab mob Retina rau cov ntshav qab zib retinopathy siv ntau txoj hauv kev. Teeb meem laser coagulation ntawm tus retina cuam tshuam nrog cov ntawv thov ntawm paramacular coagulates ntawm hom "ntoo", nyob rau ntau kab, thiab yog qhia rau qhov tsis tshwm sim ntawm retinopathy nrog macular edema. Focal laser coagulation yog siv los ua kev ceev faj me me ntawm cov kab mob hlwb, ua kom tiav, thiab cov ntshav tawm me me thaum lub sijhawm angiography. Nyob rau hauv cov txheej txheem ntawm panretinal laser coagulation, coagulates yog thov thoob plaws lub retina, tsuas yog thaj chaw macular, txoj kev no tsuas yog siv ntawm theem preproliferative los tiv thaiv nws cov kev nruam ntej.

Nrog opacification ntawm cov kho qhov muag tawm ntawm lub qhov muag, ib qho kev xaiv rau laser coagulation yog transscleral cryoretinopexy, raws li kev rhuav tshem txias ntawm pathological seem ntawm retina.

Thaum muaj mob ntshav qab zib ntau dhau los ua kom cov ntshav qab zib tsis txaus los yog mob ntshav thiav, ua mob rau cov leeg ntshav los yog mob hlwb, lawv mus rau ntawm cov ntshav, thaum lub caij cov ntshav, lub cev ntawm nws tus kheej tau raug tshem tawm, txoj hlua sib txuas ntawm cov nqaij mos tau txiav, thiab cov hlab ntsha hauv ntshav tau hlawv.

Kev twv ua ntej thiab Kev Tiv Thaiv

Cov teeb meem mob ntshav qab zib ntawm lub siab ceev tuaj yeem yog zaum ob hauv lub ntsej muag, cataracts, retinal detachment, hemophthalmus, qhov tseem ceeb txo qis ntawm qhov pom kev, qhov muag tsis pom kev. Txhua yam no yuav tsum tau tshuaj xyuas tas mus li ntawm cov neeg mob ntshav qab zib los ntawm tus kws kho mob endocrinologist thiab kws kho keeb.

Lub luag haujlwm tseem ceeb hauv kev tiv thaiv kev mob ntawm cov ntshav qab zib retinopathy yog ua si los ntawm kev tswj kom zoo los ntawm cov ntshav qab zib thiab ntshav siab, ua kom raws sijhawm ntawm hypoglycemic thiab antihypertensive tshuaj. Kev ua kom raws sij hawm ntawm kev tiv thaiv laser coagulation ntawm cov retina ua rau kev ncua kev kawm thiab kev hloov pauv ntawm cov kev hloov hauv pob txha.

Leej twg loj hlob dua?

Nws muaj ntau yam ua kom txoj kev pheej hmoo ntawm kev tsim muaj tus kab mob ntshav qab zib siab dua. Cov no suav nrog:

Lub sijhawm mob ntshav qab zib mellitus (15 xyoo tom qab pib mob ntshav qab zib hauv ib nrab ntawm cov neeg mob tsis tau txais insulin, thiab 80-90% ntawm cov neeg tau txais nws twb muaj kev tiv thaiv kab mob hlwb).
Cov ntshav qabzib nyob rau qib siab thiab lawv dhia tau zoo heev los ntawm cov neeg tus lej siab mus rau tus lej qis.
Arterial tawg.
Txhawb cov ntshav cov roj cholesterol.
Cev xeeb tub
Ntshav qab zib nephropathy (mob raum).

Cov tsos mob tshwm sim li cas qhia txog kev txhim kho kab mob?

Hauv cov theem pib, ntshav qab zib ua rau tsis pom kev nws tus kheej li cas. Tus neeg mob tsis txhawj xeeb. Vim li ntawd nws yog ib qho tseem ceeb heev rau cov neeg mob ntshav qab zib, tsis hais kev yws hlo li, mus ntsib kws kho qhov muag tsis tu ncua.

Lub neej yav tom ntej, qhov kev xav plooj, pom kev plooj, flickering yoov lossis xob laim ntawm hauv ntej lub qhov muag, thiab nyob ntawm thaj chaw uas muaj ntshav, muaj qhov tsaus nti tshwm tuaj. Hauv cov theem tom qab, pom kev pom tseeb txo qis, mus txog qhov ua tiav dig muag.

Dab tsi yog cov nyom?

Thaum tsis muaj kev kho kom zoo ntawm cov ntshav qab zib mellitus thiab ntshav qab zib retinopathy, lawv cov teeb meem loj heev tshwm sim, uas ua rau kev dig muag.

Traction retinal rho tawm haujlwm. Nws tshwm sim vim yog nti nyob rau hauv lub cev vitreous uas txuas rau qhov retina thiab rub nws thaum lub qhov muag txav. Raws li qhov tshwm sim, kua muag tau tsim thiab poob ntawm qhov muag pom tshwm sim.
Rubeosis ntawm iris - kev tawg ntawm cov hlab ntshav hauv qhov IRIS. Feem ntau cov hlab ntaws, ua rau cov ntshav tawm ntawm chav sab xub ntiag ntawm lub qhov muag.

Kev kho mob ntawm cov ntshav qab zib retinopathy, nrog rau lwm cov teeb meem ntawm ntshav qab zib, yuav tsum pib nrog kev ua haujlwm ntawm glycemia, ntshav siab thiab ntshav roj. Nrog rau kev nce ntxiv hauv cov piam thaj hauv cov ntshav, nws yuav tsum tau maj mam txo kom tsis txhob muaj mob hlwb retinal.

Kev kho mob tseem ceeb rau tus mob ntshav qab zib retinopathy yog laser coagulation ntawm tus retina. Qhov no cuam tshuam rau lub retina nrog lub teeb laser, qhov txiaj ntsig ntawm qhov uas nws yog qhov zoo li yog hais tias soldered rau choroid ntawm lub qhov muag. Laser coagulation tso cai rau koj "tig tawm" cov nkoj tsim tshiab los ntawm kev ua haujlwm, tiv thaiv kom tsis txhob txhawm thiab rov ua kom raug mob, thiab txo nws cov ischemia. Nws yog ua nrog proliferative thiab qee kis ntawm preproliferative retinopathy.

Yog tias nws tsis tuaj yeem ua rau laser coagulation, vitrectomy yog siv - tshem tawm ntawm lub cev vitreous ua ke nrog cov ntshav txhaws thiab nti.

Txhawm rau tiv thaiv vascular neoplasm, tshuaj uas thaiv cov txheej txheem no, piv txwv li, ranibizumab, muaj kev ua haujlwm. Nws tau nkag mus rau hauv lub cev vitreous ntau zaus hauv ib xyoos hauv kwv yees li ob xyoos. Cov kev tshawb fawb pom tau pom feem pua ntau ntawm kev txhim kho qhov muag thaum siv cov pab pawg no.

Tsis tas li, rau kev kho mob ntshav qab zib retinopathy, cov tshuaj siv tau uas txo hypoxia, qis cov roj cholesterol (tshwj xeeb tshaj yog fibrates), cov tshuaj hormonal rau kev tswj hwm rau hauv lub cev vitreous.

Vim li cas tus kab mob thiaj li txaus ntshai rau lub qhov muag?

Nyob rau hauv txhua rooj plaub, hyperglycemia, uas yog, nce rau hauv cov ntshav qab zib, cuam tshuam loj heev cuam tshuam rau cov hlwb, nrog rau cov vascular phab ntsa.

Nws dhau los ua lub chaw tsis nyob ntev - ntshav thiab ntshav dawb nkag mus rau hauv qhov chaw nruab nrab, cov ntshav txhaws yooj yim ua rau ntawm cov khoom endothelium. Thaum pib, mob ntshav qab zib cuam tshuam rau cov hlab ntsha me, yog li cov leeg ntshav thiab hlab ntsha tsis muaj qhov tshwj xeeb.

Qhov no ua rau peb pom li cas?

Hauv thawj theem, lub caij nplooj zeeg hauv kev ua haujlwm qhov muag pom yuav tsis tshwm sim. Ntawm chav kawm, lub retina - cov hlab ntsha nyias nyias ntawm lub ntsej muag - yog qhov nkag siab cuam tshuam hauv cov ntshav, tab sis cov tswv yim them nyiaj, nrog rau cov teeb meem pom zoo ib ntus nyob hauv nruab nrab, thaj chaw macular, muab lub zeem muag pom zoo.

Thaum cov ntshav tawm ntawm cov hlab ntsha uas txawv txav, qhov chaw ntawm lub qhov txhab retina xaus rau ntawm cov leeg ntshav lossis poob ntawm cov khoom noj (ib nrab thrombosis).

Nyob ib ncig ntawm ces, thawj cov tsos mob ntawm tus kab mob yuav tshwm sim:

"Yoov" ua ntej lub qhov muag,
daim duab plooj
curvature ntawm kab.

Cov cim phom sij ntau dua yog qhov kev pom tsis meej, qhov pom ntawm xaim (xob laim), tib lub sij hawm ploj ntawm qee qhov ntu hauv thaj chaw ntawm lub zeem muag (lub zog ntawm "shroud"). Qee lub sijhawm zoo li no tshwm sim qhia txog kev txhim kho ntawm retinal detachment

Yam pheej hmoo

Nrog rau txhua yam kev ua txhaum cai, nws yog qhov zoo dua rau kev saib xyuas kev tiv thaiv thiab kho kev mob ntxhov siab ua ntej. Qhov kev hem thawj rau lub zeem muag nce ntxiv yog tias muaj lwm yam tsis zoo.

Dab tsi yuav tsub kom qhov uas yuav muaj rau tus mob:

Kev tswj tsis tau nyoo hauv cov ntshav qab zib
Ntshav siab
Haus luam yeeb thiab lwm yam cwj pwm phem,
Pathology ntawm lub raum thiab mob siab
Cev xeeb tub thiab lub sijhawm pub mis menyuam,
Cov hnub nyoog hloov hauv lub cev,
Kev tshuaj ntsuam genetic predisposition.

Lub sijhawm ntawm ntshav qab zib kuj tseem cuam tshuam rau kev ua kom tus mob. Nws ntseeg tias cov teeb meem tsis pom kev tshwm sim kwv yees li 15 txog 20 xyoo tom qab kuaj mob, tab sis kuj yuav muaj kev tshwj tseg.

Thaum tiav hluas, thaum ib ce tsis txaus ntseeg lawm kuj ua raws cov tsos mob ntshav qab zib, kev txhim kho ntshav qab zib muaj peev xwm tshwm sim tau ob peb hlis. Qhov no yog qhov teeb meem tsis txaus ntseeg, vim tias nyob rau qhov xwm txheej zoo li no, txawm tias muaj kev soj ntsuam tas li thiab kho kho, qhov kev pheej hmoo ntawm qhov muag tsis pom kev hauv kev laus yog qhov siab.

Mob ntshav qab zib mellitus

Ntshav qab zib mellitus tau tsis ntev los no dhau los ua tus kab mob uas niaj hnub nce. Tus mob ntshav qab zib muaj feem cuam tshuam rau cov laus thiab menyuam yaus.

Cov kws kho mob koom nrog kev nce ntxiv ntawm cov neeg mob ntshav qab zib nrog qhov tseeb tias hauv zej zog niaj hnub, tshwj xeeb tshaj yog nyob hauv cov nroog loj, cov kev pheej hmoo rau tus mob no muaj ntau heev:

phiv ib puag ncig
thawj
khoom noj khoom haus tsis muaj zog
kev siv dag zog tsawg
"Sedentary" lub neej
kev ntxhov siab
mob qaug zog ntev.

Raws li cov kws tshaj lij, tus naj npawb ntawm cov neeg mob ntshav qab zib tuaj yeem ncav cuag theem tseem ceeb los txog 2025 - 300 lab tus tib neeg, uas yog kwv yees li 5% ntawm cov neeg hauv ntiaj teb.

Ntshav qab zib mellitus yog pom los ntawm cov ntshav qab zib kom ntau. Feem ntau, pancreatic cell (beta hlwb) tsim insulin - ib yam tshuaj uas tswj cov metabolism, tshwj xeeb tshaj yog cov piam thaj (piam thaj) hauv cov ntshav, nrog rau cov rog thiab protein.

Ntawm cov ntshav qab zib mellitus, vim tias kev tsim cov tshuaj insulin tsis txaus, ua rau lub cev hauv lub cev tsis ua haujlwm, thiab cov ntshav qab zib tau nce. Thiab, raws li koj paub, nws yog qab zib uas tsim nyog rau kev ua haujlwm ntawm lub cev lub cev.

Cov tshuaj insulin nyob rau hauv cov ntshav qab zib mellitus tsis tsuas yog ua rau lub cev ntawm lub cev, tab sis kuj ua rau kev nce ntshav hauv cov ntshav qab zib tsis tau lees paub. Nyeg, cov piam thaj ntau dhau los ua rau cov metabolism hauv cov roj ntsha tsis zoo thiab cov roj ntau ntau hauv cov ntshav, tsim cov plaques ntawm cov hlab ntsha.

Tus mob no ua rau qhov tseeb tias lub lumen ntawm cov hlab ntsha maj mam nqaim, thiab cov ntshav ntws hauv cov ntaub so ntswg maj mam poob kom txog thaum nws nres. Hauv cov ntshav qab zib mellitus, qhov muaj kev pheej hmoo tshaj plaws yog lub siab, qhov muag, lub ntsej muag pom, cov hlab ntsha ntawm ob txhais ceg, thiab lub raum.

Tus mob ntshav qab zib retinopathy feem ntau muaj tshwm sim tom qab 5-10 xyoo txij li pib muaj ntshav qab zib hauv tib neeg. Nyob rau hauv hom I mob ntshav qab zib mellitus (insulin-dependant), mob ntshav qab zib retinopathy yog sai thiab loj hlob ntawm cov ntshav qab zib retinopathy tshwm sim sai heev.

Ua rau muaj ntshav qab zib:

Cov kab mob muaj roj predisposition
Rog dhau.
Qee cov kab mob uas ua rau kev puas tsuaj ntawm cov beta hlwb uas tsim cov tshuaj insulin. Cov no yog cov kab mob ua rau pancreatic - pancreatitis, mob qog nqaij hlav cancer, kab mob ntawm lwm cov qog endocrine.
Cov mob viral (rubella, qhua dej qhua taum, kis mob rau daim siab thiab qee lwm yam kabmob, suav nrog ua npaws). Cov mob no yog yam ua rau tib neeg muaj kev pheej hmoo.
Kev ntxhov siab. Cov tib neeg pheej hmoo yuav tsum zam qhov kev txhawj xeeb ntawm lub siab.
Lub hnub nyoog. Nrog rau kev nce hauv lub hnub nyoog rau txhua kaum xyoo, qhov ntxim nyiam ntawm kev tsim muaj cov ntshav qab zib ntau ntau.

Ntxiv rau kev mloog zoo li lub cev tsis muaj zog thiab nkees, nkees sai, kiv taub hau thiab lwm cov tsos mob, ntshav qab zib ua rau muaj kev pheej hmoo thiab hnoos qeev, ntxiv rau kev puas tsuaj rau lub qhov muag tsis pom qab. Ib qho kev qhia txog cov ntshav qab zib yog mob ntshav qabzib retinopathy.

Cov Ua Rau Mob Ntshav Qab Zib Retinopathy

Piav qhia luv luv txog qhov tseem ceeb ntawm cov txheej txheem uas ua rau kev tsim cov kabmob yog yooj yim heev. Hloov pauv hauv cov txheej txheem hauv cov metabolism ua rau cov ntshav qab zib muaj qhov cuam tshuam zoo rau kev muab ntshav mus rau hauv lub tshuab raj. Lub microvessels ntawm lub qhov muag tau txhaws, uas ua rau kev nce siab ntawm kev nrawm thiab sib tsoo ntawm phab ntsa.

Tsis tas li ntawd, cov tshuaj txawv teb chaws tuaj ntawm cov hlab ntshav tuaj yeem nkag mus rau qhov retina, vim hais tias cov teeb meem ntuj tiv thaiv hauv ntshav qab zib pib ua kom tiav nws txoj haujlwm tsis zoo. Cov phab ntsa ntawm cov hlab ntsha maj mam dhau tawm thiab poob lawv lub cev elasticity, uas ua rau muaj kev pheej hmoo los ntshav thiab ua kom pom kev tsis zoo.

Kev mob ntshav qab zib rau lub retina thiab pob ntseg ntawm lub qhov muag ua qhov tshwj xeeb, tom qab mob tshwm sim muaj ntshav qab zib mellitus, kwv yees li 90% ntawm cov neeg mob hauv qhov no muaj qhov muag tsis pom kev.

Qhov xwm txheej ntawm txoj kev pathology tau faib ua cov kev nce qib tsis tu ncua, thaum swb ntawm lub pob tsuas thiab retina hauv thawj theem tau txiav txim siab yam tsis muaj cov tsos mob pom. Maj mam, tus neeg mob pib pom me ntsis qhov ci ntawm cov duab, me ntsis thiab daim ntaub thaiv tshwm sim nyob rau hauv pem hauv ntej ntawm lub qhov muag, uas tshwm sim los ntawm kev ua txhaum ntawm txheej txheej saum npoo ntawm lub qhov muag - lub qhov muag.

Sij hawm dhau mus, Cov tsos mob tseem ceeb tsub zuj zus, lub zeem muag txo qis zuj zus thiab qhov muag tsis pom kev zuj zus.

Cov nkoj tsim dua tshiab ntawm cov paum loj yog cov puas yooj yim heev. Lawv muaj cov phab ntsa nyias nyias, muaj ib txheej ntawm cov hlwb, loj hlob sai, muaj cov cim ntshav hloov ntshav sai, muaj qhov tsis taus zoo. Nws yog qhov tsis yooj yim no uas ua rau pom cov ntshav tawm hauv qhov muag ntawm qhov sib txawv heev.

Hmoov tsis zoo, cov neeg mob hemophthalmus tsis txaus ntseeg tsis yog lub laj thawj ntawm lub zeem muag tsis pom. Tsis tas li, txoj kev txhim kho qhov muag tsis pom yog ua rau muaj protein ntau ntawm cov ntshav plasma seeping los ntawm cov hlab ntsha tsim tshiab, suav nrog cov txheej txheem ntawm kev caws pliav ntawm cov retina, vitreous lub cev thiab kev puas tsuaj rau lub pob zeb.

Kev txiav tawm tsis ua haujlwm ntawm cov fibrovascular formations hauv cov optic hlab ntaws thiab hauv cov leeg ntshav ntawm lub cev ua rau pib ntawm kev sib cais ntawm cov retina, uas kis mus rau thaj chaw macular thiab cuam tshuam lub zeem muag nruab nrab.

Qhov no, thaum kawg, dhau los ua qhov kev txiav txim siab hauv qhov tshwm sim ntawm regmatogenous retinal detachment, uas provokes qhov kev loj hlob ntawm iris rubeosis. Kev mob siab rau pom ntawm cov hlab ntsha tsim tshiab, ntshav ntshav thaiv cov hlab ntaws ntawm cov kua dej, uas ua rau muaj kev txhim kho ntawm cov theem nrab neovascular glaucoma.

Xws li lub caj qaum pathogenetic yog qhov yooj yim heev thiab qhia txog tsuas yog qhov xwm txheej tsis zoo tshaj plaws. Ntawm chav kawm, chav kawm ntawm proliferative diabetic retinopathy tsis tas yuav xaus rau qhov muag tsis pom.

Ib ntu twg, nws qhov kev loj hlob tuaj yeem nres nthawv nthav. Thiab txawm hais tias qhov no, raws li txoj cai, poob kev tsis pom kev, tus txheej txheem ntawm kev puas tsuaj rau cov seem pom kev ua haujlwm yog qhov ua kom qeeb.

Cov ntshav qab zib puas tuaj yeem tiv thaiv qhov muag tsis pom?

Feem ntau ntawm cov neeg mob uas mob ntshav qab zib ntev ntev muaj qhov txhab ntawm lub qhov muag ntawm lub qhov muag thiab nws cov retina, uas tuaj yeem muaj ntau qib sib txawv.

Yog li, cov kws tshaj lij tau txiav txim siab kwv yees li 15% ntawm cov neeg mob kuaj mob ntshav qab zib mellitus muaj cov tsos mob me me ntawm tus mob ntshav qab zib retinopathy, muaj lub sijhawm ntau dua li tsib xyoos, yuav luag 29% ntawm cov neeg mob muaj cov tsos mob, 50% ntawm cov neeg mob uas muaj mob 10 mus rau 15 xyoo.

Nws ua raws tias ntev zog tus neeg mob ntshav qab zib, muaj kev pheej hmoo ntawm lub zeem muag ploj ntev.

Ntxiv thiab, muaj feem cuam tshuam, xws li:

pheej nce siab hauv cov ntshav siab thiab cov ntshav qab zib kom pom tseeb,
lub raum tsis ua hauj lwm zoo,
ua txhaum ntawm tus piv ntawm cov ntshav lipids,
nce visceral rog pawg,
tsis hnov qab metabolism hauv,
kev rog dhau ntawm ntau qib,
kev tshuaj ntsuam genetic predisposition
cev xeeb tub lub sijhawm
cwj pwm tsis zoo
qhov txhab mob ntawm lub qhov muag ntawm lub qhov muag.

Txawm li cas los xij, kev saib xyuas cov ntshav qab zib tas li, ua raws li qee yam kev noj zaub mov zoo thiab kev noj qab haus huv lub neej, noj cov vitamins thiab pob zeb hauv av ua rau pom kev, tsim tshwj xeeb rau cov neeg mob ntshav qab zib (Antotsian Forte thiab lwm tus) tuaj yeem txo qhov kev pheej hmoo ntawm qhov muag tsis pom kev los ntawm cov teeb meem ntshav qab zib.

Qhov kev tiv thaiv zoo tshaj plaws ntawm qhov muag ploj yog qhov tseeb pom tseeb ntawm kev ntsuas lub sijhawm ntawm kev kuaj mob ntawm tus neeg mob ntshav qab zib los ntawm kws kho qhov muag thiab kws kho qhov muag, ua raws li lawv cov lus pom zoo.

Qhov phom sij tshaj plaws uas tus kabmob nqa yog lub sijhawm ntev ntev uas tsis muaj cov tsos mob. Nyob rau thawj theem, qhov txo qis ntawm lub zeem muag yog xyaum tsis hnov, tsuas yog ib yam uas tus neeg mob tuaj yeem them sai sai yog macular retinal edema, uas ua tau nws tus kheej hauv daim ntawv ntawm qhov tsis muaj daim duab ntse, uas feem ntau tshwm sim nrog cov tawv nqaij mob caj dab.

Nws ua rau nws nyuaj rau tus neeg mob nyeem thiab ua haujlwm nrog cov ntsiab lus me, uas feem ntau ntaus nqi los ntawm lawv rau kev nkees nkees heev lossis kev ua tsis zoo.

Cov tsos mob tseem ceeb ntawm retinal kev puas tsuaj yog manifested tsuas yog nrog cov mob nhyav hauv lub cev vitreous, uas rau tus neeg mob ntshav qab zib retinopathy tau hnov hauv daim ntawv ntawm maj mam los yog txo qis hauv qhov pom tseeb.

Tso ntshav qhov ntswg feem ntau yog nrog los ntawm cov tsos ntawm ntab tsaus nti thiab daim ntaub thaiv rau ntawm lub qhov muag, uas tom qab qee lub sijhawm tuaj yeem ploj mus yam tsis muaj kab. Kev mob ntshav siab ntau ua rau tsis tiav qhov muag.

Ib qho cim ntawm macular edema tseem yog qhov zoo nkaus li daim ntaub thaiv ntawm lub qhov muag. Ntxiv rau qhov no, nws nyuaj rau kev nyeem ntawv lossis ua haujlwm nyob ze rau qhov zoo.

Qhov pib theem ntawm tus kab mob yog tus cwj pwm los ntawm asymptomatic manifestation, uas ua rau cov kev kuaj mob tsis yooj yim thiab kev kho mob kom raws sij hawm. Feem ntau cov kev tsis txaus siab ntawm qhov tsis zoo ntawm lub ntsej muag muaj nuj nqi los hauv theem ob lossis theem peb, thaum kev rhuav tshem mus txog qhov ntsuas loj.

Cov cim tseem ceeb ntawm retinopathy:

Qhov muag plooj, tshwj xeeb tshaj yog nyob hauv thaj av xub ntiag,
Cov tsos ntawm "yoov" nyob rau hauv pem hauv ntej ntawm lub qhov muag,
Vitreous nqaij ntawd
Nyeem nyuaj
Great nkees thiab mob rau hauv lub qhov muag,
Daim ntaub thaiv lossis cov duab ntxoo uas cuam tshuam nrog kev tsis pom kev.
Lub xub ntiag ntawm ib lossis ntau cov tsos mob tuaj yeem ua rau pom teeb meem loj rau lub zeem muag.

Hauv qhov no, koj yuav tsum mus ntsib kws kho mob - kws kho pob kws kho mob tshwj xeeb. Yog tias muaj kev xoom xaim ntawm kev txhim kho kev mob ntshav qab zib, nws yog qhov zoo dua los xaiv tus kws kho mob nqaim - tus kws kho qhov muag - kws kho qhov muag. Xws li tus kws kho mob tshwj xeeb hauv cov neeg mob kuaj mob ntshav qab zib mellitus thiab yuav pab txiav txim qhov tseeb ntawm qhov hloov pauv.

Tshuaj kho mob nkeeg

Rov kho cov neeg mob uas muaj ntshav qab zib ua hauj lwm (DR) tseem yog ib qho tseem ceeb thiab cuam tshuam txog teeb meem ophthalmology. DR yog qhov ua rau dig muag ntawm cov neeg laus.

Kev taw qhia txog kev txuag kho ntawm DR:

Kev tiv thaiv kab mob ntshav qab zib thiab txuam nrog cov kab mob hauv lub plab zom mov:
carbohydrate metabolism
ntshav siab (BP) (renin - angiotensin - aldosterone system blockers),
lipid thiab protein metabolism (cov vitamins A, B1, B6, B12, B15, fenofibrates, anabolic steroids),
kev kho cov leeg metabolic:
tshuaj tua kab mob kho
cov ntaub so ntswg ua tsis taus pa activators,
aldose reductase inhibitors,
angiogenesis blockers,
kev kho cov vascular system ntshawv siab thiab rheology ntshav:
ntshav rheology enhancers
vasodilators,
angioprotectors
cov neeg sawv cev uas txhim kho cov mob ntawm endothelium thiab daim nyias nyias ntawm phab ntsa vascular.

Cov npe no tau hloov tas li thiab hloov kho. Nws suav nrog ob pawg neeg muaj npe zoo tau sawv cev los ntawm ntau qhov kev siv tshuaj, nrog rau thaj chaw tshiab, muaj kev cia siab.

Qhov tsis muaj nuj nqis rau ib qho kev kho mob DR (ob qho tib si kev saib xyuas thiab phais neeg) yog them nyiaj mob ntshav qab zib thiab cuam tshuam txog teeb meem ntawm lub cev - cov protein thiab lipid metabolism.

Lub hauv paus rau kev tiv thaiv thiab kho mob ntawm DR yog qhov nyiaj them siab tshaj plaws ntawm kev noj haus metabolism. Ntawm hom 1 mob ntshav qab zib, yoo cov ntshav qabzib ntau txog li 7.8 mmol / L yog suav tias yog qhov tau txais, thiab cov ntsiab lus ntawm glycosylated hemoglobin HbA1 nce txog 8.5–9%. Hom ntshav qab zib hom 2, qib ntawm glycemia yuav nce siab dua me ntsis, suav txog kev noj qab haus huv ntawm tus neeg mob.

Raws li cov txiaj ntsig ntawm EUCLID txoj kev tshawb nrhiav, kev siv ACE inhibitor lisinopril txo txoj kev pheej hmoo ntawm kev rov ua haujlwm dua li 2 zaug thiab txo tus neeg mob tshiab los ntawm 1/3 nyob rau 2 xyoo ntawm kev soj ntsuam.

Ntxiv rau qhov txiaj ntsig ntawm lisinopril, qhov kev ua tau zoo ntawm kev siv ntawm lwm tus ACE inhibitors (captopril, fosinopril, perindopril, thiab lwm yam) tseem tab tom kawm.

Tsis tas li, rau kev kho cov lipid thiab protein metabolism, ib tus naj npawb ntawm cov kws sau ntawv pom zoo kom siv cov vitamins A, B1, B6, B12, B15, fenofibrates thiab anabolic steroids.

Nws paub tias fenofibrates, ntxiv rau kev txhim kho ntawm hypertriglyceridemia thiab sib xyaw dyslipidemia, tuaj yeem cuam tshuam cov lus qhia ntawm VEGF receptors thiab neovascularization, thiab tseem muaj antioxidant, anti-inflammatory thiab neuroprotective kev ua si.

Hauv cov theem thaum ntxov ntawm DR, hais tawm kev ua haujlwm ntawm lipid peroxidation tau sau tseg, vim tias tus neeg sau tau txais txiaj ntsig zoo los ntawm kev siv tocopherol (1200 mg ib hnub).

Cov txiaj ntsig tau pom tau zoo nrog kev siv cov tshuaj tua kab mob ua txoj kev kho - cov kab mob (alpha-tocopherol) thiab hauv zos (ophthalmic tshuaj yeeb yaj kiab nrog emoxipin), thiab kho mexidol.

Cov kev soj ntsuam tau tshwm sim los ntawm ob peb qhov muag dig muag, cov tshuaj placebo-tswj kev tshawb fawb hauv DR paub tseeb tias cov nyhuv pharmacological ntawm qhov kev txiav txim siab nyuaj ntawm Tanakan hauv daim ntawv ntawm kev txhim kho hauv lub xeev ntawm cov retina thiab qhov muag pom tseeb.

Tsom cov ntaub so ntswg metabolism activators.

Txij li xyoo 1983, ntau cov kev sim tshuaj thiab cov kev tshawb fawb tau tshawb fawb txog kev siv peptide bioregulators hauv DR. Peptide bioregulators tswj cov txheej txheem hauv kev zom zaub mov hauv retina, muaj kev tawm tsam thiab kev tiv thaiv hypocoagulation, thiab cov dej num ua antioxidant.

Aldose reductase inhibitors.Kev siv cov aldose reductase inhibitors, ib qho enzyme uas koom nrog cov metabolism hauv qabzib dhau ntawm txoj kev polyol nrog kev sib txuam ntawm sorbitol hauv insulin-ywj siab hlwb, zoo li muaj kev cia siab.

Hauv kev sim cov tsiaj, nws tau pom tias aldose reductase inhibitors inhibit qhov tsis sib xws ntawm pericytes thaum retinopathy.

Direct inhibitors ntawm vascular endothelial kev loj hlob tau (VEGF).

Kev siv cov tshuaj tiv thaiv ncaj qha ntawm vascular endothelial kev loj hlob tau (VEGF) yog lwm qhov chaw cog lus nyob rau hauv kev kho mob ntawm DR. Raws li tau paub, VEGF qhov zoo tshaj yuav ua rau txoj kev loj hlob pathological ntawm cov nkoj tsim tshiab, hemorrhage thiab exudation los ntawm cov hlab ntsha ntawm retina.

Kev tso ntshav tawm ntawm lub cev los tiv thaiv VEGF yam yuav ua rau muaj txiaj ntsig zoo thaum pib ntawm DR thiab txo qis macular edema lossis retinal neovascularization. Tam sim no 4 tus neeg tawm tsam VEGF muaj: pegaptamib sodium, ranibizumab, bevacizumab, aflibercept.

Vasodilators tam sim no pom zoo kom siv cov kev sib txawv thiab nrog kev ceev faj. Muaj cov kev paub zoo nrog kev siv xanthinol nicotinate rau kev kho cov mob hemorheological hauv DR thiab normotonic thiab hypertonic yam mob neurovascular tshua.

Txhais tau tias ntxiv dag zog rau cov vascular phab ntsa, tiv thaiv nws qhov nce ntxiv, yog ib pawg neeg ncaj ncees ntawm cov tshuaj uas siv los kho DR.

Los ntawm cov pab pawg no, rutin thiab nws cov lus qhia, vitamin E, ascorbic acid, thiab doxium (calcium dobsilate) tau siv. Nrog lub caij nyoog siv cov tshuaj ntawm pab pawg no (4-8 lub hlis lossis ntau dua), cov sau phau ntawv sau tseg tias muaj kev kho mob ib nrab ntawm cov leeg ntshav muaj ntshav.

Kev kho ntawm lub xeev ntawm endothelium thiab hauv qab daus ntawm phab ntsa vascular zoo li yog ib qho ntawm cov lus qhia tshaj plaws nyob rau hauv kev hais txog kev kho mob thaum ntxov ntawm DR thiab kev tiv thaiv kev nce qib ntawm tus kab mob no.

Xyoo tsis ntev los no, muaj ntau daim ntawv tshaj tawm txog kev siv tshuaj Sulodexide (Wessel Duet F, Alfa Wassermann) los ntawm pawg glycosaminoglycans (GAG), suav nrog heparin zoo li feem (80%) thiab dermatin-sulfate (20%) hauv kev kho mob ntawm DR.

Sulodexide nrog DR muaj qhov cuam tshuam nyuaj:

tshaj tawm angioprotective - kho dua tshiab ntawm kev siv hluav taws xob them nqi ntawm hauv qab daus daim nyias nyias thiab kev ncaj ncees ntawm cov leeg ntsa,
antithrombotic,
fibrinolytic,
antihypertensive.

Kev phais mob

Laser coagulation yog qhov tsis tshua muaj kev sib ua thiab ua tau haujlwm siab. Nyob rau theem no hauv kev txhim kho tshuaj, qhov no yog qhov kev xaiv zoo tshaj plaws rau kev kho lub zeem muag hauv kev kho mob ntshav qab zib.

Cov txheej txheem yog nqa tawm siv cov tshuaj loog hauv ib cheeb tsam hauv cov qauv ntawm cov tee, tsis tas yuav tsum tau ua tib zoo npaj thiab siv sijhawm ntev.

Cov lus pom zoo tus qauv xav tau kev kuaj ua ntej, yog tias tsim nyog, kev kho mob tom qab cov txheej txheem thiab lub sijhawm so tom qab kev cuam tshuam.

Cov txheej txheem yuav siv sijhawm ntev li ib nrab teev, tus neeg mob tsis hnov mob thiab tsis xis nyob. Hauv qhov no, kev mus pw hauv tsev kho mob ntawm tus neeg mob tsis tas txawm tias yuav tsum tau ua, vim tias cov txheej txheem raug ua ntawm kev mob sab nraud.

Qhov tsis zoo ntawm cov laser coagulation yog tshawb nrhiav tus kws tshaj lij thiab cov cuab yeej tsis txaus ntawm cov tsev kho mob. Tsis yog txhua lub tsev kho mob muaj cov cuab yeej siv, yog li cov neeg nyob hauv cov chaw nyob deb yuav tau ntxiv coj mus rau hauv tus nqi ntawm kev mus ncig.

Muaj qee kis, qhov kev ua haujlwm ntawm laser coagulation tej zaum yuav tsis txaus, yog li lwm txoj hauv kev siv - kev phais mob. Nws hu ua vitrectomy thiab raug ua nyob rau hauv kev loog tshwj xeeb.

Nws cov ntsiab lus yog qhov kev tshem tawm ntawm cov paum retinal puas, lub cev muaj sia nyob thiab cov vascular kev kho. Qhov chaw nyob qub ntawm retina hauv lub plaub muag thiab qhov qub ntawm kev sib txuas lus vascular kuj rov qab los.

Lub sijhawm rov zoo dua yuav siv ntau lub lis piam thiab yuav tsum tau noj tshuaj tom qab kawg. Lawv pab daws qhov mob tshwm sim, tiv thaiv kev txhim kho ntawm kev mob tom qab thiab teeb meem.

Kev xaiv ntawm cov txheej txheem kho lub zeem muag tsim nyog rau kev kho mob ntshav qab zib yog ua tiav raws li tus yam ntxwv ntawm tus neeg mob. nws yuav tsum raug sau tseg tias nws tsis tuaj yeem ua tiav qhov kev kho kom tiav, yog li ntawd, cov kev cuam tshuam no maj mam ua cov kab mob pathological hauv lub qhov muag.

Tej zaum nyob rau hauv ob peb xyoos tus neeg mob yuav xav tau kev cuam tshuam ntxiv, yog li kev mus ncig ua si ophthalmologist tom qab ua tiav kev ua haujlwm tsis raug muab tso tseg.

Kev twv rau cov neeg mob

Kev cia siab lub neej thiab kev txuag cia ntawm lub ntsej muag muaj nuj nqi ncaj qha nyob ntawm qhov ntsuas ntawm lub qhov muag puas tsuaj, lub hnub nyoog thiab lub sijhawm mob ntshav qab zib. Nws yog qhov nyuaj heev rau kev kuaj mob hauv qhov tsis muaj tseeb, vim tias tus ntsuas ntawm tus neeg mob yuav tsum ua tib zoo suav nrog.

Ntxiv rau, nrog rau tus kab mob ntshav qab zib ua kom rov ua dua, kev puas tsuaj rau lwm cov plab hnyuv siab raum thiab lub nruab nrog ntsuas tau siv ntau yam thoob ntiaj teb. Qhov nruab nrab, txoj kev loj hlob ntawm tus mob hlwb retinopathy tshwm sim 10 txog 15 xyoos tom qab kev txiav txim siab mob ntshav qab zib mellitus, thiab tsis muaj kev cuam tshuam kuj tshwm sim thaum lub sijhawm no.

Feem ntau, cov kev mob tshwm sim ntawm tus mob no tuaj yeem hu ua muaj cov kab mob concomitant thiab pathologies. Mob ntshav qab zib ua rau tsis zoo cuam tshuam rau txhua yam hauv nruab nrog cev thiab cov kab ke ntawm lub cev, tab sis kev ua haujlwm pom tau qhov raug txaus hauv thawj qhov chaw.

Ntshav qab zib noj qab zib (retinopathy) yog ib yam mob cuam tshuam ntau tshaj plaws ntawm ntshav qab zib. Nyob hauv kev cuam tshuam ntawm kev hloov pauv hauv cov txheej txheem hauv metabolic, qhov kev ua haujlwm ntawm cov hlab ntsha muab khoom siv rau hauv tshuab raj ua haujlwm tsis muaj peev xwm, uas ua rau cov ntshav tawm thiab cov txheej txheem pathological ntawm lub qhov muag.

Tus kab mob no tsis pom nws tus kheej thaum ntxov, yog li feem ntau cov neeg mob mus cuag kws kho mob twb nrog kev rov ua haujlwm tsis tau. Txhawm rau tiv thaiv qhov no tshwm sim, koj yuav tsum mus ntsib kws kho qhov muag kom cuag ncua txhawm rau kuaj xyuas koj lub qhov muag thiab retina.