Mlembi: Robert Simon
Tsiku La Chilengedwe: 16 Kuni 2021
Sinthani Tsiku: 16 Novembala 2024
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Zamkati

Impso zili ndi ntchito zambiri zofunika kuti mukhale ndi thanzi labwino. Amakhala ngati zosefera magazi anu, amachotsa zinyalala, poizoni, ndi madzi ena ochulukirapo.

Amathandizanso:

  • onetsetsani kuthamanga kwa magazi ndi mankhwala amwazi
  • sungani mafupa kukhala athanzi ndikulimbikitsa kupanga maselo ofiira ofiira

Ngati muli ndi matenda a impso (CKD), mwakhala mukuwonongeka impso zanu kwa miyezi yopitilira. Impso zowonongeka sizimasefa magazi momwe ziyenera kukhalira, zomwe zimatha kubweretsa zovuta zosiyanasiyana zathanzi.

Pali magawo asanu a CKD ndi zizindikiro zosiyanasiyana ndi chithandizo chamankhwala chomwe chikugwirizana ndi gawo lililonse.

Centers for Disease Control and Prevention (CDC) akuti achikulire aku US ali ndi CKD, koma ambiri sanapezeke. Ndiwopita patsogolo, koma chithandizo chitha kuuchepetsa. Sikuti aliyense adzapitilira kulephera kwa impso.

Chidule cha magawo

Kuti mupereke gawo la CKD, dokotala wanu ayenera kudziwa momwe impso zanu zikugwirira ntchito bwino.

Njira imodzi yochitira izi ndi kuyesa mkodzo kuti muwone kuchuluka kwa albin-creatinine (ACR) yanu. Zimasonyeza ngati mapuloteni akutuluka mkodzo (proteinuria), chomwe ndi chizindikiro cha kuwonongeka kwa impso.


Magulu a ACR adapangidwa motere:

A1kutsika kuposa 3mg / mmol, kuwonjezeka kwabwinobwino
A23-30mg / mmol, kuwonjezeka pang'ono
A3kuposa 30mg / mmol, kuwonjezeka kwakukulu

Dokotala wanu amathanso kuyitanitsa mayeso ojambula, monga ultrasound, kuti awone momwe impso zanu zilili.

Kuyezetsa magazi kumayesa creatinine, urea, ndi zina zotayika m'magazi kuti muwone momwe impso zimagwirira ntchito. Izi zimatchedwa kuchuluka kwa kusefera kwama glomerular (eGFR). GFR ya 100 mL / min si yachilendo.

Tebulo ili likuwunikira magawo asanu a CKD. Zambiri pazokhudza gawo lililonse zimatsata tebulo.

GawoKufotokozeraGFRPeresenti ya impso
1yachibadwa mpaka impso zomwe zimagwira ntchito kwambiri> 90 mL / mphindi>90%
2kuchepa pang'ono kwa ntchito ya impso60-89 mL / mphindi60–89%
3Akuchepa pang'ono mpaka pang'ono kwa ntchito ya impso45-59 mL / min45–59%
3Bkuchepa pang'ono mpaka pang'ono kwa ntchito ya impso30-44 mL / min30–44%
4kuchepa kwakukulu kwa ntchito ya impso15–29 mL / min15–29%
5 impso kulephera<15 mL / mphindi<15%

Mlingo wa kusefera kwa Glomerular (GFR)

GFR, kapena kusefera kwama glomerular, kumawonetsa kuchuluka kwa impso zanu mu mphindi imodzi.


Njira yowerengera GFR imaphatikizapo kukula kwa thupi, zaka, kugonana, komanso mtundu. Popanda umboni wina wamavuto a impso, GFR yochepera 60 imawoneka ngati yachilendo.

Kuyeza kwa GFR kumatha kukhala kosocheretsa ngati, mwachitsanzo, ndinu womanga thupi kapena muli ndi vuto la kudya.

Gawo 1 la matenda a impso

Pa siteji 1, pali kuwonongeka kochepa kwambiri kwa impso. Amasinthasintha ndipo amatha kusintha izi, kuwalola kupitiliza kuchita 90 peresenti kapena kupitilira apo.

Pakadali pano, CKD itha kupezeka mwangozi panthawi yoyezetsa magazi ndi mkodzo. Muthanso kuyesedwa ngati muli ndi matenda ashuga kapena kuthamanga kwa magazi, zomwe zimayambitsa CKD ku United States.

Zizindikiro

Nthawi zambiri, palibe zizindikilo pomwe impso zimagwira pa 90 peresenti kapena kupitilira apo.

Chithandizo

Mutha kuchepetsa kukula kwamatenda pochita izi:


  • Yesetsani kuthana ndi shuga m'magazi ngati muli ndi matenda ashuga.
  • Tsatirani malangizo a dokotala kuti muchepetse kuthamanga kwa magazi ngati muli ndi matenda oopsa.
  • Khalani ndi chakudya chopatsa thanzi.
  • Musagwiritse ntchito fodya.
  • Chitani masewera olimbitsa thupi kwa mphindi 30 patsiku, osachepera masiku 5 pa sabata.
  • Yesetsani kukhala ndi kulemera koyenera kwa thupi lanu.

Ngati simukuwona kale katswiri wa impso (nephrologist), funsani dokotala wanu wamkulu kuti akutumizireni.

Gawo lachiwiri la matenda a impso

Mu gawo lachiwiri, impso zikugwira ntchito pakati pa 60 ndi 89 peresenti.

Zizindikiro

Pakadali pano, mutha kukhalabe opanda chizindikiro. Kapena zizindikiro sizodziwika bwino, monga:

  • kutopa
  • kuyabwa
  • kusowa chilakolako
  • mavuto ogona
  • kufooka

Chithandizo

Yakwana nthawi yopanga ubale ndi katswiri wa impso. Palibe mankhwala a CKD, koma chithandizo choyambirira chimachedwetsa kapena kuyimitsa kupita patsogolo.

Ndikofunika kuthana ndi zomwe zimayambitsa. Ngati muli ndi matenda ashuga, kuthamanga kwa magazi, kapena matenda amtima, tsatirani malangizo a dokotala pakuwongolera izi.

Ndikofunikanso kudya zakudya zabwino, kuchita masewera olimbitsa thupi pafupipafupi, komanso kuchepetsa thupi lanu. Mukasuta, funsani dokotala wanu za mapulogalamu osuta.

Gawo lachitatu la matenda a impso

Gawo 3A limatanthauza kuti impso zanu zikugwira ntchito pakati pa 45 ndi 59 peresenti. Gawo 3B limatanthauza kuti ntchito ya impso ili pakati pa 30 ndi 44 peresenti.

Impso sizikuwononga zinyalala, poizoni, ndi madzi bwino ndipo izi zikuyamba kukula.

Zizindikiro

Sikuti aliyense ali ndi zizindikilo za gawo lachitatu.

  • kupweteka kwa msana
  • kutopa
  • kusowa chilakolako
  • kuyabwa kosalekeza
  • mavuto ogona
  • kutupa kwa manja ndi mapazi
  • kukodza kwambiri kapena pang'ono kuposa masiku onse
  • kufooka

Zovuta zingaphatikizepo:

  • kuchepa kwa magazi m'thupi
  • matenda amfupa
  • kuthamanga kwa magazi

Chithandizo

Ndikofunika kuthana ndi zomwe zikuchitika kuti zithandizire kusunga impso. Izi zingaphatikizepo:

  • Kuthamanga kwa magazi mankhwala monga angiotensin-converting enzyme (ACE) inhibitors kapena angiotensin II receptor blockers
  • okodzetsa komanso chakudya chochepa chamchere kuti muchepetse kusungunuka kwamadzi
  • mankhwala ochepetsa mafuta m'thupi
  • erythropoietin imathandizira kuchepa kwa magazi m'thupi
  • mavitamini D othandizira kuti athane ndi kufooka kwa mafupa
  • Zomangira za phosphate zoteteza kuwerengera m'mitsempha yamagazi
  • kutsatira zakudya zochepa zomanga thupi kuti impso zanu zisamagwire ntchito molimbika

Mwinanso mungafunike maulendo obwereza pafupipafupi ndi mayeso kuti musinthe ngati kuli kofunikira.

Dokotala wanu akhoza kukutumizirani kwa katswiri wazakudya kuti awonetsetse kuti mukulandira zakudya zonse zofunika.

Gawo lachinayi la matenda a impso

Gawo 4 limatanthauza kuti mukuwonongeka koopsa kwa impso. Akugwira ntchito pakati pa 15 ndi 29 peresenti, ndiye kuti mwina mukuwonjezera zinyalala, poizoni, ndi madzi amthupi lanu.

Ndikofunikira kuti muchite zonse zomwe mungathe kuti mupewe kupita patsogolo mpaka impso.

Malinga ndi CDC, anthu omwe ali ndi vuto la impso lochepetsedwa kwambiri sakudziwa kuti ali nawo.

Zizindikiro

Zizindikiro zimatha kuphatikiza:

  • kupweteka kwa msana
  • kupweteka pachifuwa
  • kuchepa kwamalingaliro
  • kutopa
  • kusowa chilakolako
  • kupindika kwa minofu kapena kukokana
  • nseru ndi kusanza
  • kuyabwa kosalekeza
  • kupuma movutikira
  • mavuto ogona
  • kutupa kwa manja ndi mapazi
  • kukodza kwambiri kapena pang'ono kuposa masiku onse
  • kufooka

Zovuta zitha kukhala:

  • kuchepa kwa magazi m'thupi
  • matenda amfupa
  • kuthamanga kwa magazi

Mulinso pachiwopsezo chachikulu cha matenda amtima ndi sitiroko.

Chithandizo

Pa siteji 4, muyenera kugwira ntchito limodzi ndi madokotala anu. Kuphatikiza pa mankhwala omwewo monga magawo am'mbuyomu, muyenera kuyamba kukambirana za dialysis ndi impso kumuika impso zanu zikalephera.

Njirazi zimatenga dongosolo mosamala komanso nthawi yochulukirapo, chifukwa chake ndi kwanzeru kukhala ndi pulani tsopano.

Gawo lachisanu matenda a impso

Gawo 5 limatanthauza kuti impso zanu zikugwira ntchito osachepera 15 peresenti kapena mukulephera impso.

Izi zikachitika, zinyalala zambiri ndi poizoni zimakhala zoopsa. Ichi ndi matenda a impso omaliza.

Zizindikiro

Zizindikiro za kulephera kwa impso zitha kuphatikizira izi:

  • kupweteka kumbuyo ndi pachifuwa
  • mavuto opuma
  • kuchepa kwamalingaliro
  • kutopa
  • osakhutira pang'ono
  • kupindika kwa minofu kapena kukokana
  • nseru kapena kusanza
  • kuyabwa kosalekeza
  • kuvuta kugona
  • kufooka kwakukulu
  • kutupa kwa manja ndi mapazi
  • kukodza kwambiri kapena pang'ono kuposa masiku onse

Chiwopsezo cha matenda amtima ndi sitiroko chikukula.

Chithandizo

Mukakhala ndi kulephera kwathunthu kwa impso, chiyembekezo chokhala ndi moyo chimangokhala miyezi yowerengeka yopanda dialysis kapena impso.

Dialysis si mankhwala a matenda a impso, koma njira yochotsera zinyalala ndi madzi m'magazi anu. Pali mitundu iwiri ya dialysis, hemodialysis ndi peritoneal dialysis.

Kutulutsa magazi

Hemodialysis imachitika kuchipatala cha dialysis panthawi yomwe idakhazikitsidwa, nthawi zambiri katatu pamlungu.

Musanalandire chithandizo chilichonse, singano ziwiri zimayikidwa m'manja mwanu. Amalumikizidwa ndi chojambula, chomwe nthawi zina chimatchedwa impso zopangira. Magazi anu amapopedwa kudzera mu sefa ndipo amabwerera mthupi lanu.

Mutha kuphunzitsidwa kuchita izi kunyumba, koma pamafunika kuchitidwa opareshoni kuti apange mwayi wamitsempha. Dialysis yakunyumba imachitika pafupipafupi kuposa dialysis kuchipatala.

Peritoneal dialysis

Pa peritoneal dialysis, mudzakhala ndi catheter yomwe imayikidwa m'mimba mwanu.

Mukalandira chithandizo, njira ya dialysis imadutsa mu catheter m'mimba, pambuyo pake mutha kupita tsiku lanu labwinobwino. Patatha maola angapo, mutha kukhetsa katheteti mu thumba ndikulitaya. Izi ziyenera kubwerezedwa kanayi mpaka kasanu ndi kamodzi patsiku.

Kuika impso kumaphatikizapo kuchotsa impso zanu ndi wathanzi. Impso zimatha kubwera kuchokera kwa omwe amapereka kapena amoyo omwe adapereka. Simusowa dialysis, koma muyenera kumwa mankhwala otsutsa-kukana kwa moyo wanu wonse.

Zotenga zazikulu

Pali magawo asanu a matenda a impso. Magawo amatsimikiziridwa ndi kuyezetsa magazi ndi mkodzo komanso kuchuluka kwa kuwonongeka kwa impso.

Ngakhale ndi matenda opita patsogolo, sikuti aliyense adzapitilira kukula kwa impso.

Zizindikiro za matenda a impso koyambirira ndizofatsa ndipo zimatha kunyalanyazidwa mosavuta. Ichi ndichifukwa chake ndikofunikira kuti muzikayezetsa pafupipafupi ngati mukudwala matenda ashuga kapena kuthamanga kwa magazi, zomwe zimayambitsa matenda a impso.

Kuzindikira koyambirira ndikuwongolera zinthu zomwe zikuchitika kungathandize kuchepetsa kapena kupewa kupita patsogolo.

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