Gulu la kunenepa. Zoyambitsa, zizindikiro, matenda ndi matenda a kunenepa

Limodzi mwa mavuto a anthu mu zaka za wakhala wonenepa. Matendawa "kupeza" otsatira atsopano padziko lonse. Ichi ndi chifukwa zakudya osauka, moyo wongokhala, ambiri a pathologies aakulu endocrine komanso zinthu zina zambiri. Kwenikweni kunenepa zikutanthauza kuti thupi si kuchuluka chifukwa psinjika minofu, koma likuvutika madipoziti mafuta mu ziwalo zosiyanasiyana za thupi. Kuopsa kunenepa? Langana anthu amene ali onenepa dotolo aliyense adzaitana pa zifukwa khumi, ndi mu malo oyamba adzakhala matenda a mtima, mitsempha, mfundo ndi mafupa, kuphwanya kagayidwe madzi amchere. Komanso, matenda ndi zovuta moyo makhalidwe masiku ano chimakhala chogwidwa ndi zinthu za masewera ndi moyo wathanzi.

etiology

Matendawa "kunenepa" akhoza kuthandiza pa zifukwa zosiyanasiyana. The odziwika ndi asamapereke, ndiye pali mismatch pakati kupeza zopatsa mphamvu ndi mphamvu zinyalala. The chachiwiri wamba chifukwa cha kulemera owonjezera ndi kuphwanya thirakiti m'mimba. Zimenezi zingakhale sangathe wa michere pancreatic, kuchepetsa chiwindi, mavuto ndi chimbudzi chakudya. Kuwonjezera pamenepo, ngozi za kunenepa angakhale wotsimikiza pa mlingo chibadwa.

Pali zinthu zomwe zimathandiza kunenepa, kuphatikizapo:
- kugwiritsa ntchito zakumwa zotsekemera kapena zakudya zokhala ndi zambiri shuga;
- matenda endocrine monga hypogonadism, hypothyroidism, kapamba chotupa;
- maganizo matenda (matenda ovutika kudya);
- maganizo okhazikika ndi kusagona tulo;
- m'thupi kapena mankhwala psychotropic.

Evolution, Alevi zaka 2 miliyoni wapereka njira za kudzikundikira zakudya Ngati inu mwadzidzidzi kuthamanga lalifupi chakudya. Ndipo ngati izo zinali zoona kwa anthu akale, munthu masiku ano sayenera ngati "zipinda zodyera". Komabe, thupi lathu m'njira yakuti umakaphatikizana stereotypically zabwino ndi zoipa zonse zobwera kuchokera kunja. Choncho, vuto la kunenepa panopa anayima kotero zikuchepa.

pathogenesis

Lamulo gawo ndi kusonkhanitsa zofikira mafuta ndi kunatheka chifukwa mogwirizana ndi zovuta pakati pa wamanjenje dongosolo ndi zopangitsa za endocrine. Chinthu chachikulu chomwe kudzikundikira wambirimbiri lipids ndi mismatch wa kotekisi oziziritsa ndi ubongo imene imalamulira kutentha. Ndi kumeneko kumene ndiko kuchimake kwa chilakolako lamulo. Thupi limafuna chakudya kuposa mowa mphamvu, kotero owonjezera zonse zotsala "mu malo", imbaenda kunenepa ndi zosayembekezereka wa owonjezera adipose minofu.

Osauka oterowo pakati kugwirizana kungakhale chikhalidwe kobadwa nako ndi ofalitsidwa ndi maphunziro. Kuwonjezera apo, mavuto amenewa nthawi zina zotsatira zake choipa, kutupa, aakulu endocrine kudwala.

Pamene pituitary England, adrenal kotekisi ndi - maselo pancreatic kuyamba kuonetsa ntchito pathological ndi kuchuluka kukula timadzi amachepetsa yokhudza ufiti, lonse la mafuta ndi shuga, amene alowa m'thupi, ndi waikamo mu zimakhala ndi ziwalo. Zimenezi zimabweretsa matenda morphological a chiwindi, impso, chithokomiro.

Gawo BMI

Gulu la kunenepa Ndi bwino kuyamba ndi amene amadziwika kugulu. Monga ulamuliro, matenda chachikulu cha matenda ikuchitika zochokera zizindikiro monga thupi misa index (BMI). Izi quotient mtengo analandira pambuyo kugawa kulemera mu makilogalamu ndi msinkhu mamita lofanana mbali zonse. Pali panopa mmene anawasiyanitsira zotsatirazi wa kunenepa pa chizindikiro ichi:

1. misa kuchepekedwa - ngati BMI ndi zosakwana kapena wolingana 18,5.
2. Normal thupi - thupi misa index ayenera kukhala mu osiyanasiyana 18,5 25.
3. Pre-akunenepa - ndi BMI kuyambira mfundo 25 mpaka 30. Pa nthawi imeneyi, izo kumaonjezera ngozi ya co-morbidities monga matenda oopsa, bedsores ndi thewera zidzolo.
4. Kunenepa akuikamo digiri 1 pamene BMI ndi 30 mpaka 35.
5. Kunenepa kalasi 2 - zosonyezera ali pafupi ndi mfundo 40.
6. Kunenepa kalasi 3 amawapeza pamene thupi misa index kuposa mfundo 40, pamene munthu ali comorbidities.

Gawo Etiopatogenetichesky

Gulu zotsatirazi wa kunenepa ndi imodzi mwa tsatanetsatane ambiri m'dera limeneli, chifukwa amaganizira zimayambitsa ndi njira ya chitukuko matenda. Malinga ndi kunenepa lakutali pulayimale ndi sekondale. Aliyense ali subclasses ake.

Choncho, kunenepa chachikulu lagawidwa:
- gluteal-femoral;
- m'mimba;
- chifukwa okhudza kudya;
- nkhawa;
- amayamba ndi matenda kagayidwe kachakudya.

Mu sekondale, symptomatic kunenepa tikhoza subtypes anayi:

1. Cholowa zosalongosoka mbewu.
2. Oziziritsa chikwiyire zotupa, matenda kapena autoimmune ubongo.
3. Endocrine chifukwa cha kukanika a chithokomiro yomweyo lamulo la dongosolo hypothalamic-pituitary, ndi zopangitsa adrenal ndi gonads.
4. Mankhwala kugwirizana ndi kutenga mankhwala, kulera m'thupi ndi cytostatics.

Clinico-pathogenetic gulu

Ngati timatenga kuti makinawa kuyambitsa zikamera kulemera muyeso, ndi kupanga gulu lotero la kunenepa:

- alimentary ndi constitutive. kulemera phindu amagwirizana ndi muyeso wa mafuta mu zakudya ndi amangokhala. Izo kumaonekera, kawirikawiri ana ndipo akhoza kulankhula ndi kutengera za kumtundu.
- Hypothalamic. Kuwonjezeka minofu adipose chifukwa kuwonongeka hypothalamic ndipo monga Motero, kuphwanya neuroendocrine ntchito yake.
- Endocrine. Pa mtima wamafuta ndi kudwala kwa endocrine zopangitsa za - ndi pituitary, pammero adrenal zopangitsa.
- Iatrogenic. Kunenepa chifukwa cha phukusi zachipatala. Izi zikhoza kukhala mankhwala, chiwalo kapena gawo kuchotsa zoipa za dongosolo endocrine mu njira ya mankhwala ndi zina zambiri.

Gawo ndi kutanthauzira minofu adipose

Ndikatha kumfunsafunsa odwala ndi kunenepa unkachitika kuti si zonse za izo ndi anagawira mofanana. Choncho, pa nthawi yakhala ayipanga gulu kunenepa potengera malo khalidwe la mafuta m'thupi.

Yoyamba, amatchedwanso chapamwamba, Aka Android, yodziwika kuti ambiri kumawonjezera theka chapamwamba za thupi, nkhope khosi ndi manja. Kumachitika kawirikawiri pa amuna, koma mukhoza kuona akazi amene alowa kusintha. angapo olemba ananena kuti pali kugwirizana pakati pa mtundu wa kunenepa ndi chiopsezo kukhala matenda a shuga komanso matenda a dongosolo mtima.

Mtundu chachiwiri, pansi kapena gynoid ndi chopereka mafuta minofu pa ntchafu ndi matako, ndipo ambiri mu theka wokongola wa umunthu. Chithunzi cha akazi zimatengera mtundu wa "peyala". Komanso akhoza kukhala ana, ngati kukula wakuswa zakudya zabwinobwino. Comorbidities Pankhaniyi adzakhala kudwala msana, mfundo ndi m'munsi malekezero mtima maukonde.

Mtundu wachitatu - wosanganiza kapena wapakatikati kunenepa. Pankhaniyi, kulemera kwambiri kapena zochepa wogawana anagawira m'thupi ndi kuwongola mzere m'chiuno khosi, matako.

Pofuna kudziwa ndi mtundu wa kunenepa otchedwa wodwala, m'pofunika kudziwa chiŵerengero cha circumference a m'chiuno ndi m'chiuno. Ngati akazi chithunzi ichi kuposa 0,85, ndipo anthu kuposa wina, akhoza ankanena kuti Baibulo munthu woyamba wa kufalitsa minofu adipose.

Gawo morphological

Ngakhale kusintha kunenepa bwanji magulu osiyanasiyana a gulu la moyo, osati thupi lonse, komanso ziwalo payekha, zimakhala ndi ngakhale kuti maselo. Adipocytes (maselo mafuta), akhoza kukumana ndi kusintha Mkhalidwe kapena kachulukidwe. Malinga kumasulidwa izi:

1. Hypertrophic kunenepa. Iwo amakhala ndi kuwonjezeka nthenda mu kukula kwa maselo mafuta, pamene chiwerengero chawo akanali yemweyo.
2. Hyperplastic kunenepa, imene adipocytes zikukangalika kugawa. mawonekedwe kumachitika ana ndipo nkhanza kwambiri, kotero zochepetsera chiwerengero cha maselo kungakhale njira aukali kwambiri.
3. Obwerawa kunenepa monga tikhoza kuganiza osakaniza awiri amene m'mbuyomu. Ndiko kuti, maselo osati kuwonjezeka, koma iwo akukhala kwambiri.

Gulu la chiwerengero cha ana onenepa

Malinga ndi kafukufuku, mu Russia pali pafupifupi 12% ya ana amadwala kwambiri. Awa, 8.5% ya anthu m'tauni ndi 3.5% - akumidzi. Kunenepa ana ndi achinyamata wakhala pafupipafupi pathologies kuti madokotala anaganiza kuti atchule mbali yapadera mu ntchito yake yophunzitsa ndi makolo achinyamata pa zakudya. Kunenepa imatengedwa kuti ndi boma kumene kulemera kwa mwanayo kuposa 15% ya chifukwa msinkhu wake. Ngati chilamulira chikhalidwe ndi BMI, phindu lake adzakhala pafupi mfundo 30.

Kusiyanitsa mitundu iwiri ya kunenepa mwa ana: pulayimale ndi sekondale. Pulayimale anachititsa, monga ulamuliro, kutupikana, nyambo oyambirira kapena kukana mkaka wam'mawere ng'ombe. Koma zikhoza kukhala cholowa, ngati banja chimakhala chogwidwa ndi anthu onenepa. Koma ngakhale mu nkhani iyi, mwana sitinabadwe ndi nkhungu, izo mochedwa kagayidwe anu, ndi kudya zakudya zoyenera ndi kuchita masewera olimbitsa thupi kuti adzasunga kulemera malire yachibadwa. Tili kwa kunenepa za pulayimale zaka zitatu ndi kutha msinkhu.

kunenepa Secondary amagwirizana ndi pamaso pa matenda anapeza endocrine. i imene anatsimikiza mlingo wa ya kulemera owonjezera akadali zofunika kukambirana. The lonse yotsatirayi akufuna:
- 1 digiri - kulemera kuposa 15-25% ya ananeneratu;
- 2 siteji - kuchokera 25 mpaka 49% kuwonda;
- 3 digiri - misa ndi wamkulu pa 50-99%;
- kalasi 4 - onenepa mu nthawi ziwiri kapena zambiri kuposa malire zaka.

zizindikiro

Zizindikiro za kunenepa kulemerako ofanana ndi mzake, kusiyana kokha mu pachilichonse za kufalitsidwa kwa CHIKWANGWANI muyeso, ndi pamaso pa pathologies m'munsili kapena kusapezeka kwawo.

Nthawi zambiri amapezeka mu odwala alimentary kunenepa, zimene zimagwiritsa ndi kuphwanya zakudya zabwinobwino. Monga ulamuliro, anthu ndi kutengera za kumtundu kuti kunenepa kwambiri, kumwa kwambiri ya kumam'phunzitsa chakudya kunenepa. Zizindikiro zimachitika m'banjamo, monga iwo pamodzi kutenga chakudya. Komanso, mtundu uwu wa kunenepa sachedwa akazi okalamba amene kukhala moyo wongokhala chifukwa cha thanzi lawo osauka.

Kunenepa 1 digiri anati mu ambiri a anthu amene amakonda pochitika, makamaka madzulo. Izi zimachitika chifukwa kadzutsa ndi nkhomaliro alibe nthawi ndi chilakolako. Anthu anjala pa chakudya zimawononga zopatsa mphamvu tsiku ndi kugona.

Hypothalamic kunenepa amakhala osati kunenepa kwambiri, komanso pamaso pa zizindikiro za matenda ya ubongo ndi endocrine lamulo. Kunenepa ikukula kwambiri ndipo nthawi kumphatikiza ndi kusintha zakudya. Mafuta limapezeka ambiri padziko kutsogolo kwa pamimba, ntchafu ndi matako. Zikhoza kusintha trophic: khungu youma, zizindikiro Tambasula, tsitsi imfa. odwalawo amadandaula kusowa tulo, mutu ndi chizungulire. Katswiriyu mukhoza kudziwa kuvutika ntchito yawo.

diagnostics

Anthu ndi kunenepa ndi wotsikirapo kwambiri kutsutsa kwa chikhalidwe chake, kotero kuti kukopa kapena kuwakakamiza kupita kwa dokotala ngakhale kukambirana yosavuta - palibe nkhani yamasewera. Ndi pagona - odwala m'thupi yemwenso kapena matenda okhudza ubongo. Iwo amafuna kuti ayesedwe ndi kuchepetsa kulemera kwa ayambe othamanga.

The zambiri ntchito muyezo kwa matenda a onenepa - ndi BMI wa kunenepa. Umo ndi momwe thupi leni pa adzatero. Kudziwa mwamphamvu n'kofunika osati kutsimikizira kuli kulemera muyeso, koma mfundo imene akuyendera likuvutika minofu adipose, osati minofu misa. Choncho, zochiritsira zikukangalika kuyesera kuti atchule njira kudziwa ndendende misa mafuta osati kulemera okwana thupi.

Norma anatsimikiza zochokera deta zowerengera zinapezedwa madokotala a ukatswiri zosiyanasiyana pa zaka mchitidwewu. Pakuti aliyense kugonana, zaka, ndi mame thupi pali matebulo kale kuwerengera mfundo malamulo a kudwala. Asayansi apeza kuti azaka zoposa kulemera 10% zochepa kuposa zachibadwa. Osayenerera kunenepa amawapeza pa nkhani zosiyana, pamene 10% mwa kulemera wadutsa malire kumtunda kwa chovomerezeka.

Pali Njira zingapo kuwerengera abwino thupi. Mmodzi wa iwo kudziwa madona onse - kuchokera kukula kufunika kutenga zana masentimita. Chiwerengero chifukwa ndi mtengo wolakalakika. Koma pokhapo titachitapo kwambiri ndi kuphunzira osadalirika. More molondola ndi BMI kapena Quetelet index, limene lili pamwambali. Kuyeza circumference a m'chiuno ndi m'chiuno, nawonso, ndi zofunika kwambiri mu mapangidwe a kunenepa, popeza malo mafuta zimadalira chifukwa chimene chayambitsa ndi kunenepa.

chithandizo

polimbana ndi onenepa kwambiri kukhala nkhanza ndi paliponse. Tsopano atolankhani zikukangalika ankalimbikitsa moyo wathanzi ndi mwambo wa wokongola, thupi othamanga. Kumene, kubweretsa vutoli absurdity sikuthandiza, koma malangizo onse a kayendedwe achinyamata adalipo pa dekadansnaya Yitonia.

Zoyamba za chithandizo cha kunenepa monga:
- zakudya wolemera mu chakudya komanso CHIKWANGWANI, mavitamini, mtedza ndi zitsamba. Onetsetsani kuti achepetse kuphika, maswiti ndi fizzy zakumwa.
- thupi, amene ayenera kulimbikitsa thupi ndi kufulumizitsa kagayidwe.
- mankhwala kuchepetsa kulemera ndi kudya;
- misala;
- mankhwala opaleshoni.

Kuti iyende yaitali mtundu uliwonse wa chithandizo, muyenera kusintha zakudya zanu ndi pafupipafupi chakudya. Amakhulupirira kuti zakudya chilibe ntchito polimbana ndi kunenepa, koma amathandiza kulimbikitsa kulemera akwaniritsa ndi kuteteza matenda kubwerera. The World Health Organization akuonetsa kuti kuwerengera zili caloric chakudya kuti wodwalayo amagwiritsira ntchito akafuna wabwinobwino, ndipo pang'onopang'ono kuchepetsa zopatsa mphamvu. M'pofunika kukwaniritsa chizindikiro cha 1500 - 1200 kcal, malinga munthu alibe zimamuchulukira thupi lanu.

Misala umalimbana kulimbitsa mphamvu ndi kudziletsa poyerekezera ndi kudya chakudya ndi kudalira kudya chakudya ndi zotsekemera koloko. Mankhwala m'kati kuchepetsa thupi amathandiza kukwaniritsa yochepa chabe kwenikweni. Pambuyo discontinuation a mapiritsi a, akadzabweranso wodwalayo njira kale, ndipo alibe kutsatira malangizo amene mwalandira pa kumaliseche. Ngakhale kuti tsopano makampani mankhwala kupereka lalikulu kusankha mankhwala onenepa, pafupifupi zonse zoletsedwa chifukwa cha mavuto.

Kuti njira opaleshoni monga suturing m'mimba, wotchuka mu zaka zao za sikisite Mu zaka zapitazo. Akamanena za ntchito ndi zakuti thupi mbali ziwiri wosiyana, ndi wamng'ono sutured wa intestine yaing'ono. Choncho, buku chapamimba yafupika, ndi mlingo wa chigawo cha chakudya amakhala apamwamba. Yachiwiri - chapamimba banding. The mbali mtima wokwera mphete kuti itsekeke pang'ono ndi lumen wa kum'mero ndi chakudya wokhudza chopinga yokumba, zosasangalatsa pakati machulukitsidwe, walola mtima kudya zochepa.

Kodi mtundu wa kunenepa ndi owopsa? Mwina. Palibe amene anganene kuti phindu zothandiza kwa anthu. Mlingo mwamphamvu zimadalira momwe kulemera leni kuposa ponseponse, ndipo comorbidities aliyense ali.