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Biến chứng thần kinh ngoại biên do tiểu đường là một trong những biến chứng tiểu đường bao gồm một loạt các rối loạn có thể gây ra cảm giác đau, kèm theo tê mỏi, yếu cơ hoặc cảm giác bất thường. Có đến 70% (7 trong số 10 người) số bệnh nhân tiểu đường (bao gồm cả tiểu đường tuýp 1 và tiểu đường tuýp 2) mắc các chứng về bệnh lý thần kinh. Biến chứng thần kinh do tiểu đường có thể xảy ra ở bàn tay, bàn chân, cánh tay, cẳng chân, hoặc đôi khi có thể ảnh hưởng đến cả đường tiêu hóa, tim hoặc cơ quan sinh dục.

DẤU HIỆU VÀ TRIỆU CHỨNG

Một số bệnh nhân gặp phải biến chứng dây thần kinh ngoại biên do tiểu đường hoàn toàn không thấy xuất hiện bất cứ triệu chứng nào, nhưng đa số mọi người có thể gặp phải các triệu chứng sau:
Tê-tay-chân-2

  • Cảm giác tê và cảm giác kim châm ở bàn tay, bàn chân;
  • Đau bàn tay và bàn chân, đặc biệt là cảm giác bỏng rát, đau nhói như có điện giật;
  • Da trở nên cực kỳ nhạy cảm, cảm giác đau rát khi da tiếp xúc với ánh sáng;
  • Yếu cơ, xảy ra ở bàn tay hoặc bàn chân;
  • Rối loạn cương dương (gặp khó khăn trong việc cương cứng hoặc giữ tình trạng cương cứng) xảy ra ở nam giới, hoặc khô âm đạo xảy ra ở phụ nữ;
  • Tiểu khó;
  • Táo bón hoặc tiêu chảy;
  • Chóng mặt hoặc cảm giác choáng váng khi đứng dậy đột ngột (tụt huyết áp tư thế đứng).

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NGUYÊN NHÂN

Đối với biến chứng dây thần kinh ngoại biên do tiểu đường, có rất nhiều các triệu chứng khác nhau có thể xảy ra ở những bệnh nhân khác nhau. Do đó các nhà nghiên cứu tin rằng bệnh tiểu đường gây ra các tổn thương thần kinh bằng nhiều cách khác nhau. Nhìn chung, nồng độ đường huyết cao có thể gây độc thần kinh, làm giảm khả năng chữa lành và hồi phục của các vết thương. Bệnh tiểu đường cũng làm hư hỏng các mạch máu. Điều này có nghĩa là các tế bào thần kinh không được cung cấp đầy đủ oxy cần thiết cho sự tồn tại và hoạt động của nó. Đối với người hút thuốc lá hoặc uống rượu nhiều, các dây thần kinh nhỏ ở bàn tay và bàn chân có thể bị tổn thương, làm trầm trọng thêm bệnh lý thần kinh ngoại biên do tiểu đường. Bên cạnh đó, cũng có một số người mắc bệnh tiểu đường nhưng lại không gặp phải bất cứ bệnh lý nào về thần kinh, điều này có nghĩa là một phần nguyên nhân có thể bao gồm cả yếu tố di truyền. Do đó một số người dễ bị tổn thương thần kinh hơn những người khác.

XÉT NGHIỆM CHẨN ĐOÁN

Một số xét nghiệm sau đây có thể giúp chẩn đoán bệnh thần kinh do tiểu đường và định hướng điều trị cho bệnh nhân:

Thử nghiệm Monofilament (thử nghiệm sợi đơn)

Tieu Duong [Mobile] 200x150-min

Thử nghiệm đơn giản nhất là thử nghiệm Monofilament, khám kiểm tra mức độ nhạy cảm thần kinh của bệnh nhân dựa vào một sợi nylon nhỏ. Thiết bị xét nghiệm này tạo nên một lực không đổi lên bề mặt da của bệnh nhân, giúp bác sĩ có thể so sánh được mức độ nhạy cảm trên da của bệnh nhân này so với những người bình thường không mắc bệnh thần kinh do tiểu đường. Thông thường, đây là thử nghiệm cần thiết duy nhất cần tiến hành.

Thử nghiệm phân tích mức độ nhạy cảm

Thử nghiệm phân tích mức độ nhạy cảm có thể được sử dụng để ghi nhận những thay đổi về tình trạng cơ thể bệnh nhân theo thời gian. Trong thử nghiệm này, bệnh nhân sẽ được kiểm tra về mức độ nhạy cảm đối với ánh sáng, nhạy cảm khi tiếp xúc, khi châm chích, nhạy cảm đối với áp lực, cảm nhận rung và nhạy cảm đối với nhiệt độ. Thử nghiệm này hiếm khi cần tiến hành trong các xét nghiệm chẩn đoán cho bệnh nhân. Tuy nhiên, thử nghiệm này rất hữu ích trong các thử nghiệm nghiên cứu, giúp đánh giá sự tiến triển của bệnh.

Thử nghiệm đánh giá dẫn truyền thần kinh hoặc điện cơ (Electromyography – EMG)

Các thử nghiệm này giúp đánh giá tín hiệu thần kinh có được dẫn truyền tốt qua các dây thần kinh hay không, cơ có đáp ứng tốt với các tín hiệu thần kinh hay không. Thông thường, các xét nghiệm này là không cần thiết. Tuy nhiên trong một số trường hợp, các xét nghiệm này có thể được sử dụng để giúp loại trừ các nguyên nhân gây tổn thương thần kinh khác.

Các dấu hiệu quan trọng

Sự thay đổi về huyết áp và nhịp tim theo thời gian có thể cho thấy những vấn đề có thể xảy ra đối với hệ thần kinh tự chủ (hay còn gọi là hệ thần kinh thực vật), tức là hệ thần kinh kiểm soát các hoạt động vô thức.

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ĐIỀU TRỊ ĐAU THẦN KINH

Kiểm soát đường huyết

Cách tốt nhất để phòng ngừa và điều trị bệnh thần kinh do tiểu đường là kiểm soát được nồng độ đường huyết ở mức hợp lý, để có thể ngăn ngừa được các tổn thương khác. Thời gian đầu khi nồng độ đường huyết được kiểm soát, một số bệnh nhân có thể cảm thấy đau mạnh hơn trong một khoảng thời gian nhất định, sau đó cảm giác đau sẽ giảm dần theo thời gian.

Điều trị thuốc

Một số loại thuốc có thể được sử dụng để kiểm soát tình trạng đau thần kinh của bệnh nhân. Bệnh nhân có thể thấy giảm đau khi được sử dụng những thuốc điều trị thích hợp

Châm cứu và kích thích thần kinh qua da

Các phương pháp điều trị như châm cứu và kích thích thần kinh qua da cũng có thể có ích đối với một số bệnh nhân.

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Chuyên Gia Tư Vấn Bệnh

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Chất Lượng Bài Viết:

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– Chất Lượng Bài Viết –

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SỨC KHỎE THƯỜNG NGÀY

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☆TIN TỨC MỚI NHẤT

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BÀI VIẾT LIÊN QUAN

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TÌM ĐỌC NHIỀU NHẤT

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