Matenda a shuga > Matenda a shuga

Matenda a shuga ndi oopsa komanso vuto lalikulu chifukwa cha kuchepa kwa inshuwaransi kapena insulin yodziwika bwino. Mosiyana ndi hypoglycemic, kukomoka kwa matenda ashuga kumayamba pang'onopang'ono ndipo kumatha nthawi yayitali. M'mabuku azachipatala, milandu imafotokozeredwa pomwe wodwala anali atadwala zaka zopitilira 40.

Zoyambitsa ndi Zoopsa

Chifukwa chachikulu chomwe chitukuko cha matenda a shuga chikuyendera ndi kuchepa kwa insulin m'thupi la odwala matenda ashuga. Izi sizimangowonjezera kuchuluka kwa shuga m'magazi, komanso kuchepa kwa mphamvu ya zotumphukira zomwe sizingatenge glucose popanda insulin.

Kuchulukitsa kwa hyperglycemia kumafuna kuwonjezeka kwa kuthamanga kwa osmotic mu madzi akunja kwa madzi am'mimba komanso kuchepa kwa magazi mkati. Zotsatira zake, osmolarity wamagazi amawonjezeka, kuopsa kwa hypoglycemia kumawonjezeka, komwe kumayambitsa chitukuko cha dziko logwedezeka.

Matenda a shuga ndi matenda oopsa omwe angayambitse zovuta zowopsa m'moyo.

Kuperewera kwa insulin kumalimbikitsa kusuntha kwa mafuta acids kuchokera ku minofu ya adipose, yomwe imayambitsa kupangika kwa matupi a ketone m'maselo a chiwindi (beta-hydroxybutyric acid, acetoacetate, acetone). Kupanga kwambiri matupi a ketone okhala ndi asidi kumabweretsa kuchepa kwa kuchuluka kwa bicarbonate ndipo, motero, kuchuluka kwa pH kwa magazi, ndiye kuti metabolic acidosis imapangidwa.

Ndi kukula kwa hyperglycemia, kuchuluka kwambiri kwa magazi m'magazi kumachitika, zomwe zimayambitsa kuphwanya kwa impso (excretory) ya impso. Zotsatira zake, odwala amakhala ndi hypernatremia, hyperosmolarity yowonjezereka. Komanso, milingo ya bicarbonates ndi pH imakhalabe yochepa, popeza ketoacidosis palibe.

Chifukwa cha kusowa kwa insulin mu shuga, ntchito ya pyruvate dehydrogenase, enzyme yomwe imayambitsa kusintha kwa pyruvic acid kukhala acetyl coenzyme A, imachepa. Izi zimapangitsa kuchuluka kwa pyruvate ndikusintha kwake kukhala lactate. Kuchulukitsa kwakukulu kwa lactic acid mthupi kumayambitsa acidosis, komwe kumatseketsa ma adrenergic receptors a mtima ndi mitsempha yamagazi, kumachepetsa ntchito ya contractile ya myocardial. Zotsatira zake, kukomoka kwambiri kwa dysmetabolic ndi cardiogenic kumayamba.

Zinthu zotsatirazi zingayambitse kudwala matenda ashuga:

zolakwika zazikulu za chakudya (kuphatikiza kuchuluka kwa chakudya chamagulu m'zakudya, makamaka zosavuta kugaya),
kuphwanya chiwembu cha insulin kapena kumwa mankhwala ochepetsa shuga,
mankhwala osankhidwa bwino a insulin,
mantha akulu,
matenda opatsirana
othandizira opaleshoni
kutenga pakati komanso kubereka mwana.

Mitundu yamatenda

Kutengera mawonekedwe a kuperewera kwa kagayidwe kachakudya, mitundu iyi ya chikomokere cha diabetes imasiyanitsidwa:

Ketoacidotic chikomokere - chifukwa cha poizoni wakuthupi komanso makamaka dongosolo lamanjenje lamatumbo ndimatumbo a ketone, komanso kuwonjezeka kwa kusokonezeka pamagetsi amagetsi a electrolyte komanso acid-base.
Hyperosmolar hyperglycemic non-ketone coma ndi zovuta za mtundu II shuga mellitus, wodziwika ndi kutchulidwa kwakuthupi komanso kusowa kwa ketoacidosis.
Hyperlactacidemic chikomokere. Matenda a shuga sindiwo okha omwe amachititsa kuti lactic acid ikhale m'thupi la wodwalayo - monga lamulo, mankhwala osokoneza bongo a Biguanides (mankhwala a hypoglycemic) amakhala chifukwa cha lactic acidosis.

Imfa mu ketoacidotic chikomokere ukufika 10%. Ndi hyperosmolar hyperglycemic non-ketone coma, chiwopsezo cha kufa pafupifupi 60%, ndi hyperlactacidemic coma - mpaka 80%.

Mtundu uliwonse wa chikomokere cha matenda a shuga umadziwika ndi chithunzi cha matenda. Zizindikiro zazikulu za hyperosmolar hyperglycemic non-ketone coma ndi:

polyuria
kutulutsa madzi,
kuchuluka kwa minofu,
kukokana
kuchuluka kugona
kuyerekezera
cholakwika ntchito.

Ketoacidotic chikomokere chimayamba pang'onopang'ono. Imayamba ndi nthawi yayitali, yowonetsedwa ndi kufooka kwakukulu, ludzu lalikulu, nseru, komanso kukodza pafupipafupi. Ngati thandizo lofunikira siliperekedwa pano, vutoli limakulirakulira, zizindikiro zotsatirazi zimachitika:

kusanza kosamveka
kupweteka kwambiri pamimba
kupuma kwamphamvu
Kununkhira kwa maapulo oyamba kapena ma acetone ochokera mkamwa,
kubweza mpaka kuchotsedwa kwathunthu kwa chikumbumtima.

Hyperlactatacidemic coma imakula mofulumira. Zizindikiro zake:

kufooka kwakula msanga
kukoka kwamanyazi (pafupipafupi, kudzaza kofooka),
dontho mu kuthamanga kwa magazi
khungu loyera,
kusanza, kusanza,
kuda nkhawa mpaka kutayika kwathunthu.

Zomwe zimachitika ndi matenda a shuga

Matenda a matenda ashuga nthawi zambiri amawonekera pakati pa ana asukulu zamisukulu yakusukulu komanso odwala kusukulu omwe akudwala matenda a shuga. Kukula kwake kumayendetsedwa ndi mkhalidwe wa pathological wotchedwa precoma. Mwachidziwitso, zimadziwonetsa:

nkhawa, yomwe yasinthidwa ndi kugona.
mutu
cramping m'mimba ululu
kusanza, kusanza,
kuchepa kwamtima
polyuria
malingaliro olimba a ludzu.

Matenda a metabolic akachuluka, kuthamanga kwa magazi kumachepa, ndipo kugunda kwamkati kumawonjezeka. Mpweya umakhala wakuya ndikuwomba. Khungu limataya kuchepa kwake. Muzovuta kwambiri, chikumbumtima chimatha.

Makanda, odwala matenda ashuga amakula msanga, kudutsa mtundu wa matenda. Zizindikiro zake zoyambirira:

kudzimbidwa
polyuria
polyphagy (mwana amafunitsitsa bere ndi kuyamwa, ndikupumira pafupipafupi)
ludzu lochulukirapo.

Zikauma, ma diap amakhala olimba akamayanika, omwe amalumikizidwa ndi mpweya wambiri mumkodzo (glucosuria).

Zizindikiro

Chithunzi chamankhwala cha odwala matenda ashuga sichowonekera nthawi zonse. Chofunika kwambiri pakuwazindikira ndi kafukufuku wa zasayansi yemwe amatsimikiza:

mulingo wa glycemia
kupezeka kwa matupi a ketone m'magazi am'magazi,
wamagazi magazi pH
kuchuluka kwa ma electrolyte mu plasma, makamaka sodium ndi potaziyamu,
phindu la plasma osmolarity,
mafuta acid msinkhu
kukhalapo kapena kusowa kwa acetone mu mkodzo,
seramu lactic acid ndende.

Chifukwa chachikulu chomwe chitukuko cha matenda a shuga chikuyendera ndi kuchepa kwa insulin m'thupi la odwala matenda ashuga.

Odwala odwala matenda ashuga amathandizidwa m'chipinda chothandizira odwala. Njira zochizira matenda amtundu uliwonse zimakhala ndi zake. Chifukwa chake, ndi ketoacidotic chikomokere, mankhwala a insulini ndikukonzanso kwamadzi-electrolyte ndi vuto la acid-base limachitika.

Therapy ya hyperosmolar hyperglycemic non-ketone coma imaphatikizapo:

intravenous makonzedwe a kuchuluka kwa hypotonic sodium kolorayidi njira hydration,
mankhwala a insulin
mtsempha wa magazi a potaziyamu mankhwala enaake omwe amayang'aniridwa ndi ECG ndi ma elekitirodi a magazi,
kupewa matenda a edema (mtsempha wa magazi makonzedwe a glutamic acid, oksijeni mankhwala).

Chithandizo cha hyperlactacidemic chikomachi chimayamba ndi kulimbana ndi kuchuluka kwa lactic acid, komwe njira ya sodium bicarbonate imayendetsedwa kudzera m'mitsempha. Kuchuluka kwa yankho, komanso kuchuluka kwa oyang'anira, amawerengedwa pogwiritsa ntchito njira zapadera. Bicarbonate imayendetsedwa molamulidwa ndi potaziyamu ndende ndi magazi pH. Pofuna kuchepetsa kuopsa kwa hypoxia, mankhwala a oxygen amachitika. Odwala onse omwe ali ndi lactacidemic coma amawonetsedwa ndi insulin - ngakhale ali ndi shuga.

Mavuto omwe angakhalepo komanso zotsatirapo zake

Matenda a shuga ndi matenda oopsa omwe angayambitse zovuta zowopsa:

Hypo- kapena hyperkalemia,
chibayo,
kupuma mavuto syndrome
matenda edema,
pulmonary edema
thrombosis ndi thromboembolism, kuphatikizapo pulmonary thromboembolism.

Matenda a matenda obwera ndi matenda ashuga ndiwofunika. Imfa za ketoacidotic chikomaso ngakhale m'malo apadera zimafikira 10%. Ndi hyperosmolar hyperglycemic non-ketone coma, kuchuluka kwaimfa kuli pafupifupi 60%. Imfa yayikulu kwambiri imawonedwa ndi hyperlactacidemic coma - mpaka 80%.

M'mabuku azachipatala, milandu imafotokozeredwa pomwe wodwala anali atadwala zaka zopitilira 40.

Kupewa

Kupewa kukomoka kwa matenda ashuga kumayeneranso kulipira kwambiri anthu odwala matenda ashuga:

kutsatira zakudya zokhala ndi malire a chakudya,
zolimbitsa thupi zolimbitsa thupi
kupewa masinthidwe amodzi motsatira malamulo a insulini kapena kumwa mankhwala a hypoglycemic okhazikika ndi endocrinologist,
munthawi yake chithandizo cha matenda opatsirana,
Kukonzekera kwa insulin mankhwala mu ntchito nthawi ya amayi apakati, puerperas.

Mitundu ya Diabetesic Coma

Pali mitundu ingapo ya matenda ashuga, iliyonse yomwe imafuna njira zochiritsira. Amayambitsa zifukwa zosiyanasiyana, amakhala ndi njira zosiyanasiyana zachitukuko.

Akatswiri amasiyanitsa mitundu ili:

Ketoacidotic chikomokere - amakula mwa anthu omwe ali ndi matenda a shuga 1. Zimayambitsidwa ndi kutulutsidwa kwa ma ketones ambiri, omwe amapezeka m'thupi chifukwa chogwiritsa ntchito mafuta acids. Chifukwa cha kuchuluka kwa zinthuzi, munthu amagwa ketoacidotic.
Hyperosmolar coma - imayamba mwa anthu omwe ali ndi matenda a shuga. Amayambitsa kuchepa kwamadzi. Magazi a glucose amatha kupitirira 30 mmol / l, ma ketoni kulibe.
Hypoglycemic coma - imayamba mwa anthu omwe amapaka jekeseni yolakwika ya insulin kapena osatsatira zakudya. Ndi chifuwa cha hypoglycemic, shuga m'magazi a munthu amakafika 2,5 mmol / L ndikuchepera.
Lactic acidosis chikomachi ndi mtundu wovuta wa matenda ashuga. Amayamba motsutsana ndi maziko a anaerobic glycolysis, omwe amatsogolera kusintha kwa lactate-pyruvate bwino.

Khofi wamtundu uliwonse wamatenda amayamba chifukwa cha kuchuluka kapena kuperewera kwa insulin, komwe kumayambitsa kudya kwamafuta ambiri. Zonsezi zimayambitsa kupangidwa kwa zopangidwa ndi oxidized. Amachepetsa kuchuluka kwa mchere m'magazi, omwe amachepetsa kwambiri acidity yake. Izi zimabweretsa oxidation wamagazi, kapena acidosis.

Ndi ketosis yomwe imayambitsa zovuta pakugwira ntchito kwa ziwalo zamkati pakukomoka kwa matenda ashuga. Mphamvu yamanjenje imavutika kwambiri ndizomwe zikuchitika.

Matenda a shuga amakhalanso ndi chitukuko chofulumira, koma chokhazikika. Zizindikiro zoyambira zakuti munthu posachedwa agwa zimatha kuwoneka tsiku limodzi kapena kuposerapo. Ngati mukuwona zizindikiro zilizonse zakuti zakomoka, yesani kuonana ndi dokotala nthawi yomweyo. Hyperglycemia imadziwika ndi kuwonjezeka kwachilengedwe kwa shuga ambiri kangapo. Ketoacidotic chikomacho chitha kuzindikiridwa ndi mseru komanso kusanza, kutopa, kukodza pafupipafupi, kupweteka pamimba, kugona. Komanso, wodwalayo ali ndi fungo lakuthwa losasangalatsa la acetone kuchokera mkamwa. Amatha kudandaula za ludzu, kukokana pafupipafupi, kutaya mtima.

Ndi chitukuko cha hypoglycemia mwa anthu, kuchuluka kwa shuga m'magazi kumachepa kwambiri. Mwanjira iyi, chizindikirochi chimafika pamunsi pofika 2.5 mmol / L. Kuzindikira kuyambika kwa kudwala kwa hypoglycemic ndikosavuta, munthu maola ochepa asanayambe kudandaula za malingaliro osaganizira ndi mantha, kuchuluka thukuta, kuzizira komanso kunjenjemera, kugona ndi kufooka, kusinthasintha kwa machitidwe ndi kufooka. Zonsezi zimatheka chifukwa chogwira mwamantha komanso kuwonongeka, ngati munthu salandira thandizo la kuchipatala panthawi yake. Izi zimatsogozedwa ndi:

Kuchepa kapena kusowa kudya kwathunthu,
General malaise
Mutu ndi chizungulire,
Kudzimbidwa kapena kutsegula m'mimba.

Pakakhala thandizo la nthawi yayitali wodwala matenda ashuga, munthu amatha kukumana ndi mavuto ambiri. Ndi kukula kwa izi, ndikofunikira kuyang'anira kutentha kwa thupi. Ndikofunika kwambiri kuti sichikana - ndibwino kuti ichulukane pang'ono. Khungu liyenera kukhala louma ndi lotentha. Kunyalanyaza zizindikiro zoyambirira za kudwala matenda ashuga kumayambitsa kuyamba kugona. Munthu, titero, akusokera kuchoka kudziko wamba; samamvetsetsa kuti ndi ndani ndipo ali kuti.

Madotolo adawona kuti ndikosavuta kwa anthu osakonzekera kuzindikira kuti ali ndi vuto la matenda ashuga mwakuchepa kwa kuthamanga kwa magazi, kugunda kofooka, ndikumachepetsa ma eye. Kuti muchepetse njirayi, muyenera kuyimbira ambulansi nthawi yomweyo. Dokotala wodziwa bwino yekha ndi amene angakwanitse kuchita zochizira zolondola.

Thandizo loyamba

Ngati mukuzindikira zizindikiro zoyambirira za kukomoka kwa matenda ashuga mwa munthu, yesetsani kumuthandiza nthawi yomweyo. Mulinso zinthu zotsatirazi:

Wiritsani wodwala pamimba pake kapena pambali pake,
Vulani zovala zonse zofinya kwa iye,
Tulutsani njira zochotsetsera mpweya kuti munthu asasowe,
Imbani ambulansi
Yambani kumwa tiyi kapena manyumwa pang'ono,
Ambulansi isanafike, penyani mpweya wanu.

Ngati mukudziwa zizindikiro za kudwala matenda ashuga, mutha kupulumutsa moyo wamunthu mosavuta. Mutha kudziperekanso thandizo lanu poyamba, zomwe zingachepetse chiopsezo cha zotsatira zoyipa. Chithandizo cha mitundu yosiyanasiyana ya matenda ashuga com ndi chosiyana kwambiri, chifukwa chake simungathe kuchita ntchito zina.

Kodi kudwala matenda ashuga ndi chiyani?

Matenda a shuga ndi odwala kwambiri. Zimayambitsa kuphwanya njira zonse za metabolic mthupi. Pamaso pa zinthu zina zomwe zimayambitsa mavuto, chikomokere chimatha kukhala ndi insulin komanso osadalira insulin. Ndipo zilibe kanthu kuti azilandira kapena sanapezekepo.

Zizindikiro za kudwala matenda ashuga

Matenda a matenda ashuga satenga nthawi yomweyo, matendawo ake ndi boma. Ludzu la wodwalayo limakulirakulira, kupweteka mutu komanso kufooka kumawonekera, kusapeza bwino m'mimba, limodzi ndi mseru komanso nthawi zambiri, kusanza. Kuthamanga kwa magazi kumatsika, kutentha kwa thupi kumakhala kochepa. Kugunda kumachitika mwachangu, ngati ulusi.

Popita nthawi, kufooka ndikuwonekera, komanso kusokonezeka kwa ntchito yamkati kumawoneka ngati kumatha kuzindikira bwino, khungu limataya turgor yachilendo, ndipo minyewa yamitsempha imachepa. Kupsinjika kwa magazi kumatha kutsikira kumitundu yotsika kwambiri.

Chizindikiro cha chitukuko cha matenda ashuga ndimawonekedwe a fungo la apetone (maapulo ena) ochokera mkamwa. Ngati padakali pano wodwalayo sapatsidwa thandizo lokwanira, pakapita kanthawi adzazindikira zonse, ndipo akhoza kumwalira.Zizindikiro zonsezi zimatha kuwoneka, kukula ndikukula patatha maola ochepa kapena masiku.

Zomwe zimayambitsa matenda A shuga A Coma

Zomwe zimapangitsa kuti pakhale odwala matenda ashuga atha kukhala kuchedwa kwa insulin kapena kukana kugwiritsa ntchito mankhwalawo, cholakwika chake pakupereka mankhwala a insulini ndi mlingo wosankhidwa bwino, kulowetsedwa kwa mtundu wina wa insulin ndi wina, komwe wodwalayo amakhala wosaganizira.

Kuphwanya zakudya kwambiri mu matenda ashuga kungayambitsenso kukula ngati wodwala watha shuga wambiri kuposa momwe amafunikira, matenda ena akuluakulu (kuphatikizapo opatsirana), manjenje amanjenje, pakati komanso pobereka.

Zizindikiro za kudwala matenda ashuga

Pa gawo loyamba la matenda okhudzana ndi matenda ashuga, odwala amadwala matenda a shuga a ketoacidosis, zomwe zimadziwika ndi izi: pakamwa lowuma ndi ludzu losaletseka, polyuria, pang'onopang'ono imasandulika kukhala anuria. Pali zizindikiro za kuledzera kwa thupi m'njira yowonjezera kufooka, kuchuluka kwa kutopa, kuwonjezereka mutu, nseru ndi kusanza.

Ngati chithandizo sichinayambike pa nthawi, ndiye kuti dyspeptic syndrome imakulitsidwa, kusanza kumachitika mobwerezabwereza ndipo sikubweretsa mpumulo, pamakhala ululu wam'mimba wamitundu ingapo yamphamvu, pamakhala matendawa kapena kudzimbidwa. Kugona, ulesi, kusayang'anira kukukula, odwala asokonezeka munthawi ndi malo, chikumbumtima chimasokonezeka. Mlengalenga watha, kununkhira kwa acetone kumamveka, khungu limakhala louma, kuthamanga kwa magazi, tachycardia, kupuma kwamiseche kwa Kussmaul kumayamba. Zodumphazo ndi stupor zimasinthidwa ndi chikomokere.

Zotsatira za kuperewera kwa shuga

Kuwonjezeka kwakukulu kwamagazi a shuga m'magazi ndipo, monga chotulukapo chake, kukhala ndi vuto la minofu kumayambitsa kusintha kwamatenda m'thupi. Kupanga matenda a shuga a shuga (kuwonjezeka kwa mkodzo tsiku ndi tsiku) kumabweretsa kuchepa kwamadzi, ngakhale kuti kuchuluka kwa madzi omwe amamwa ndi odwala kumawonjezeka. Kuchulukitsa kwa magazi komwe kumazungulira m'mitsempha kumachepa chifukwa cha izi, ndipo kupanikizika kumatsika kwambiri, zomwe zimayambitsa kuphwanya kwa trophism ya ziwalo zonse ndi minofu, kuphatikizapo ubongo.

Pamodzi ndi madzi, ma electrolyte nthawi zambiri amachotsedwa m'thupi. Choyamba, awa ndi macronutrients monga potaziyamu ndi magnesium, zomwe zimabweretsa kusokonezeka kwakukulu pakugwira ntchito kwa ziwalo zonse ndi machitidwe. Kuti alipire kuchuluka kwa glucose ochulukirapo, zimakhala kuti thupi limayamba kugwetsa masitolo ogulitsa mafuta ndi glycogen. Pankhaniyi, kuchuluka kwa matupi a ketone ndi lactic acid m'magazi kumawonjezeka kwambiri, hyperacidosis imayamba.

Thandizo lodzidzimutsa la odwala matenda ashuga

Kudziwa zizindikiro zoyambirira za kuperewera kwa matenda ashuga, ndizotheka kupewa chitukuko chake ndikukhazikika pazochitika zam'magazi. Nthawi zambiri odwala matenda ashuga amauzidwa za momwe angayambire zovuta komanso za chithandizo chofunikira. Ndikulimbikitsidwa kuti muchepetse kudya kwa carbohydrate, kuyamba kumwa mankhwala a potaziyamu ndi magnesium, kumwa madzi amchere amchere - zonsezi zimathandiza kuthetsa hyperacidosis.

Ngati wodwalayo ali kale ndi vuto lalikulu ndipo watsala pang'ono kukomoka, ndiye kuti muyenera kuyimbira ambulansi. Panthawi imeneyi, thandizo lokhalo lomwe limaperekedwa nthawi ingathandize, kuyamwa kuchipatala ndikofunikira.

Katswiri wa Katswiri: Pavel A. Mochalov | D.M.N. katswiri wamkulu

Maphunziro: Moscow Medical Institute I. Sechenov, wapadera - "Bizinesi yazachipatala" mu 1991, mu 1993 "Matenda a Ntchito", mu 1996 "Therapy".

Zosiyanasiyana

Matenda a shuga ndi awa:

ketoacidotic,
hyperosmolar
lactic acididemic,
hypoglycemic.

Zomwe zimayambitsa kupita patsogolo mumtundu uliwonse wa chikoma ndizosiyana. Chifukwa chake, chomwe chimayambitsa kupita patsogolo kwa chikomokere kwa hyperosmolar ndikuwonjezereka msanga kwa kuchuluka kwa shuga m'magazi motsutsana ndi maziko am'madzi. Izi ndizosiyanasiyana mtundu wa 2 shuga.

Chomwe chimapangitsa kuti ketoacidotic chikulire chikhale ndi kuchuluka kwa ma acid omwe amatchedwa ma ketones m'thupi la munthu. Zinthu izi ndi zinthu za metabolism zamafuta, ndipo zimapangidwa chifukwa chosowa insulini kwambiri. Mtundu wamtunduwu umayenda bwino ndi matenda ashuga amtundu woyamba.

Lactic acid coma ndiye vuto lalikulu kwambiri la matenda ashuga, omwe amapita patsogolo motsutsana ndi zovuta za mtima, mapapu, ndi chiwindi. Zingathenso kuyamba ngati wodwala akuledzera.

Chomwe chikukula kwambiri kwa kuchepa kwa hypoglycemic nchakuti kuchepa kwambiri kwa shuga m'magazi. Vutoli limachitika kawirikawiri ndi matenda amtundu 1 shuga. Zomwe zimapangitsa kuchepa kwa shuga ndizakudya zosafunikira kapena kuyambitsa insulin yambiri.

Zizindikiro

Mtundu uliwonse wamtundu uli ndi zizindikiro zake. Ndikofunikira kudziwa onse a iwo, kuti zizindikiro zoyambirira zikaonekera, nthawi yomweyo ayambe kupatsa odwala chithandizo chodzidzimutsa. Kuzengeleza kukhoza kumutaya moyo wake.

Zizindikiro za hyperosmolar coma:

kusowa kwamadzi kwambiri
ntchito yolakwika
kubweza
kugona
ludzu
Pakadutsa masiku angapo asanadutse, wodwalayo amakhala ndi vuto lofooka,
kuyerekezera
kamvekedwe ka minofu kakuchuluka,
kukomoka ndikotheka
osangalatsa. Chizindikiro cha kukhazikika kwa chikomokere. Wodwala amatha kusowa zinthu zina.

Zizindikiro za ketoacidotic chikomokere kuonekera wodwala pang'onopang'ono. Nthawi zambiri zimatenga masiku angapo. Koma pankhaniyi, kuyenda pang'onopang'ono "kuli pafupi" kwa madotolo, chifukwa isanayambike chikumbumtima pali nthawi yoti muzindikire zomwe zimawoneka ndikuchita chithandizo chokwanira.

Zizindikiro zamtunduwu wamtunduwu:

nseru ndi kusanza zotheka
polyuria
ludzu
kufooka
kugona

Wodwala akamakula, chipatalachi chimathandizidwa ndi zizindikiro:

kupuma kumakhala kwakuya komanso kaphokoso kwambiri
kusanza kwambiri
kupweteka kwapweteka pamimba, komwe sikamvetseka bwino,
kubweza
chizindikiritso cha mtundu uwu wa chikomacho ndi mawonekedwe a fungo la asetoni kuchokera mkamwa,
chikumbumtima.

Mosiyana ndi ketoacidotic coma, lactic acidemia imapita patsogolo mwachangu. Chipatalachi chimawonetsedwa makamaka ndi kugwa kwa mtima. Zizindikiro zotsatirazi zimapezekanso:

kufooka kwakula msanga
nseru ndi kugwedezeka
kukomoka
kupweteka pamimba,
zamkhutu
chikumbumtima.

Zizindikiro za hypoglycemic coma:

kunjenjemera
mantha
nkhawa zazikulu
kutuluka thukuta kwambiri
kufooka wamba
kumva kwamphamvu njala
kukokana
kulephera kudziwa.

Oletsa kudwala matenda ashuga ana:

kugona
Mutu wamisempha yosiyanasiyana,
nseru ndi kugwedezeka
kusowa kwa chakudya mpaka pomwe palibe,
ludzu lalikulu
polyuria
lilime ndi milomo.

Ngati chisamaliro chodzidzimutsa sichinaperekedwe, ndiye kuti kupuma kwa mwana kudzakhala kwakuya komanso kwamkokomo, kuthamanga kwa magazi kumachepa pang'onopang'ono, kugunda kwa mtima kumawonjezeka, kutalika kwa khungu kumachepa ndipo chikomokere chimabwera.

Njira zochizira

Chithandizo cha matenda a zam'magazi chili ndi magawo anayi:

chithandizo cha insulin mwadzidzidzi
kusintha kwa madzi mthupi la munthu,
kusintha kwa mulingo wa michere ndi ma electrolyte,
matenda ndi chithandizo choyenera matenda omwe anakhumudwitsa.

Cholinga choyambirira cha kulandira chithandizo ndikusintha shuga mumagazi. Komanso, njira yochizira imathandizidwa ndi kulowetsedwa. Wodwalayo amapatsidwa njira zosalimba zomwe zimathetsa kusowa kwamadzi.

Chithandizo cha matenda a zamitsempha chimachitika pokhapokha pokhapokha ndikuyang'aniridwa ndi madokotala. Ndikofunika kukumbukira kuti ichi ndi chowopsa kwambiri kuti, popanda kulandira mankhwala moyenera panthawi yake, chitha kupha. Chifukwa chake, nthawi zambiri chithandizo chimachitika mothandizanso kutsitsimuka.

Njira zoyesera

Sichingachitike kuzindikira kudwala koperewera, ngati mtundu wina, pongowunika wodwalayo. Kuti muchite izi, muyenera kukayezetsa ku labotale, komwe ndi kofunikira kwambiri kuyezetsa magazi, komwe kumawululira index ya shuga. Kusanthula kwamwazi m'mwazi ndi mkodzo kumachitidwanso.

Mtundu uliwonse wamtundu wamtundu wa shuga wachiwiri umatsatana ndi kukwera kwakukulu kwa shuga yamagazi yoposa 33 mmol / L. Kupatula kokha ndi hypoglycemic, yodziwika ndi kuchepa kwa glucose mpaka 2,5 mmol / L.
Khansa ikayamba, wodwala sadzamva chilichonse. Ndikotheka kuwerengera ketoacidotic mkhalidwe ndikuwonekera kwa matupi a ketone mu mkodzo, hyperosmolar imodzi pamene osmolarity ya plasma imakulira. Mtundu wa lactacidemic wa diabetesic coma umapezeka chifukwa cha kuchuluka kwa lactic acid m'mitsempha.

Pambuyo pakuzindikira, chithandizo ndi mankhwala.

Asanayambe chithandizo cha chikomokere cha matenda ashuga ndi dokotala, mbiri yonse imasonkhanitsidwa, mtundu wa amakhazikitsidwa. Anthu odwala matenda ashuga amayesa kukakamiza.

Njira zingapo zamankhwala zimagwiritsidwa ntchito povomereza kuti pakhale shuga.

Ngati shuga atatsitsidwa, chithandizo chadzidzidzi chimafunikira kuphatikiza insulin m'mitsempha pamodzi ndi shuga. Kuphatikiza apo, Adrenaline, Vitamini C, Cocarboxylase, Hydrocortisone ndi mankhwala. Monga kupewa kwa edema ya m'mapapo, mapapo am'mbali amathandizira, machitidwe okhala ndi okodzetsa amaikidwa.
Pankhani ya kuchuluka kwa glucose, mankhwala a insulin omwe ali ndi mankhwala osakhalitsa amadziwika. Pamodzi ndi izi, phindu la shuga limayezedwa pang'onopang'ono, kotero kuti mphamvuzo zimachepa m'magawo.
M'magawo onse awiriwa, madziwo amabwezeretsedwa, ndipo madzi osowa amatayika amayambitsidwa kuti madzi athetse. Pakulowetsa madzimadzi m'mitsempha, kuchuluka kwa magazi, magazi, ndi madzi a m'magazi kumawongoleredwa. Kubweretsa zamadzimadzi kumachitika mu masitepe, kuchuluka kwathunthu kumafikira malita 7 patsiku loyamba.
Ngati pali kutayika kwakukulu kwa zinthu zina, pezani mankhwala ndi kumayambiriro kwa thupi.