Hyperglycemia (zimayambitsa, zizindikiro, ambulansi, zotulukapo)

Tsiku lokhazikitsa nkhaniyi: 08/23/2018

Tsiku lokonzanso zolemba: 06/06/2019

Hyperglycemia ndi matenda omwe amadziwika ndi kuchuluka kwa shuga m'magazi pamwamba pa 6.1 mmol / L.

• Postcranial - mwa munthu wathanzi, chakudya chikatha, kuchuluka kwa glucose kumakwera mpaka 10 mmol / l, koma patatha maola awiri kumatsika kwazonse. Kuchuluka kwa shuga kapena kukhala ndi mphamvu zokwanira pambuyo maola awiri kumawonetsa kulolera kwa glucose.
• Yocheperako - imachitika mutatha kudya zakudya zamafuta ambiri.
• Toshchakova (chakudya chotsiriza sichinali choyambirira kuposa maola 8 apitawo) - nthawi zonse chimawonetsa matenda. Ndi chikhomo pakuzindikira matenda ashuga.
• Kupsinjika - kusintha kosinthika kwa chamoyo kupsinjika, kusiyanasiyana kwa ponseponse.
• Zosatchulidwa - kuphwanya kwa kagayidwe kazachilengedwe popanda kupezeka kokhazikika.

Boma lotsutsana, hypoglycemia, limayamba kuchuluka kwa shuga akatsika pansi pa 3.2 mmol / L. Amawonetsedwa ndi kuphwanya chikumbumtima, mpaka kukomoka.

Hypoglycemia ndiyowopsa m'moyo, chifukwa imawoneka mwachangu ndipo imatha kupha munthu kanthawi kochepa. Nthawi zambiri zimachitika usiku ndikusankhidwa kosayenera kwa mankhwala ochepetsa shuga kapena kudumpha chakudya pambuyo pa insulin.

Zomwe zimachitika

Miyezo ya glucose imayendetsedwa ndi mahomoni a insulin ndi antiinsulin: STH, glucagon, adrenaline, cortisol ndi ena.

Ndipo ngati insulin ikulimbikitsa kulowerera kwa glucose mu cell, ndiye kuti, kupumirako, kumawonjezera chidwi chake ndi njira zonse zomwe zikupezeka.

Mu pathogenesis (njira yotukula) ya zovuta za kagayidwe kazakudya, mfundo zazikulu ziwiri zimasiyanitsidwa:

1. Kusintha kulikonse kokhudzana ndi insulin. Apa, komanso kusakwanira kaphatikizidwe ka mahomoni, ndi chilema mu molekyulu yeniyeni, ndi zotsatira zoyipa za mahomoni ena.
2. Zovuta mu receptor kapena kayendedwe ka maselo chandamale.

Zomwe zimayambitsa zovuta za carbohydrate metabolism zimagawidwa m'magulu a shuga ndi ena.

Matenda a shuga

Insulin ndiye mahomoni okhawo okhala ndi vuto la hypoglycemic.

Amapangidwa m'maselo a pancreatic β-cell. Kutenga kwa shuga m'magazi nthawi zambiri kumawonetsedwa ndi matenda a shuga.

Matenda a shuga amtundu woyamba amayankhulidwa pamene kuperewera kwenikweni kwa insulin kumachitika. Insulin mwina singapangidwe konse kapena imapangidwa yaying'ono kwambiri. Izi zimakonda kuphatikizidwa ndi autoimmune reaction motsutsana ndi β-cell.

Nthawi zina palibe chifukwa chomwe chingadziwike, ndiye amalankhula za matenda ashuga a idiopathic. Nthawi zambiri, mtundu woyamba wa matenda a shuga umapezeka muubwana (ngakhale umapezeka mwa akhanda) ndi unyamata, koma umatha kuwonetsa (kuwonekera koyamba) mwa munthu wamkulu.

Mtundu 2 umayamba

• insulin kukana. Ndiye kuti, mahomoni amapangidwanso chimodzimodzi, koma ma cell omwe amalephera amakhala osaganizira zochita zake,
• sekondale yachiwiri insulin. Chifukwa cha matenda osiyanasiyana, ma cell a pancreatic sangathe kugwira ntchito zawo, chifukwa chake kuchepa kwa insulin. Itha kuphatikizidwanso ndi insulin.

Hyperglycemia imatha kukhala chiwonetsero cha zina zambiri zamatenda.

• Zovuta za genetic za β-cell, insulin yokha, ma receptors komanso kayendedwe ka gawo la chandamale.
• Matenda a kapamba: kapamba, zotupa, kulowererapo kwa kapamba, ndi ena.
• Hyperproduction yamahomoni okopa: STH, cortisol, glucagon, thyroxine ndi ena.
• Matenda opatsirana: congenital rubella, cytomegalovirus.
• Kulandila kwa mankhwala ndi mankhwala: mahomoni, ma antihypertensives ena, α-interferon ndi ena.
• Matenda a Autoimmune: antibodies to insulin, insulin receptors, okhazikika anthu syndrome, ena.
• Ma gennd syndromes omwe amatha kutsagana ndi hyperglycemia: porphyria, Down syndrome, myotonic dystrophy, Huntington's chorea ndi ena.

Zizindikiro zamakhalidwe

Hyperglycemia muubwana ndi ubwana nthawi zambiri zimadziwonetsa ndi ketoacidosis. Matendawa amatha kuyamba pang'onopang'ono. Nthawi zina zimachitika mwachisawawa, ndi chithunzi chowoneka bwino chamatenda ndikukula kwa ketoacidotic chikomokere.

Madandaulo akulu ndi awa:

• W ludzu.
• Kuchulukitsa chilakolako.
• Kuchepetsa thupi.
• Pafupipafupi komanso kupemphetsa kukodza.
• Kufooka, ulesi, kugona, kuchuluka kwa kutopa.
• Khungu lowuma komanso zimagwira pakhungu.
• Kuchiritsa kwakutali kwa mabala aliwonse, abrasions, mabala.
• Kuseweretsa fungal microflora: candidiasis a kumaliseche, m'kamwa.
• Zowonongeka: mawonekedwe a mawanga, "ntchentche" pamaso.
• Fungo la acetone mumlengalenga lotulutsa.

Hyperglycemia paukalamba kwa nthawi yayitali mwina siziwoneka lokha ndikuwapeza panthawi yoyesedwa pazifukwa zina.

Pamene kuchuluka kwa shuga m'magazi kukwera, chithunzi chowonetsa chikuwonekera bwino:

• Kuchiritsa kwamabala kochepa, makamaka m'malo otsika.
• Zotupa pakhungu.
• Kupita patsogolo kwamaso.
• Kulemera kwa thupi nthawi zambiri kumachulukitsidwa.
• Pakamwa pakamwa.
• W ludzu.
• Lethargy, kufooka, kugona.
• Kusokoneza mtima.
• Chizungulire, kusakhazikika pakamwa, kunachepetsa kukumbukira komanso chidwi.

Zomwe zimayambitsa chiopsezo cha hyperglycemia ndi cholowa, kunenepa kwambiri, komanso kumangokhala.

Ngati mukukayikira kuchuluka kwa shuga, mawonekedwe amomwe ammagazi amawunika, mkodzo umawunikidwa kwa glucosuria, kupezeka kwa matupi a ketone. Kusanthula kumaperekedwa mosamalitsa pamimba yopanda kanthu kuti asamachotse glycemia wakamary. Kuzindikiridwa kwa matenda osokoneza bongo kumawerengedwa kuti ndi koyenera ndi glycemia pamtunda wa 6.1 mmol / L.

Acute hyperglycemia imatha kuyambitsa zochitika zadzidzidzi. Nthawi yomweyo, zonse zofunikira kwambiri komanso zosachepera shuga ndizowopsa.

Hyperglycemic coma imayamba pang'onopang'ono.

• Khungu louma ndi mucous nembanemba, kuyabwa ndikotheka.
• Ululu wam'mimba kwambiri, womwe nthawi zambiri umakhala ngati zizindikiro za peritonitis.
• Pafupipafupi pazotulutsa, kusanza.
• Kuthamanga (chifukwa cha kuchepa madzi m'thupi) kuwonda.
• Kukhala ndi chikumbumtima chovuta.
• Fungo lotheka la acetone mu mpweya wotuluka.
• Kupumira kwamphamvu kaphokoso.

Thandizo loyamba ndi thandizo loyamba

Kukayikira kulikonse kwa hyperglycemia kuyenera kukhala chifukwa chofunsira thandizo lakuchipatala. Pofuna kutaya chikumbumtima, pamafunika kuyitanitsa ambulansi.

Zochita asanachitike kuchipatala:

1. Ikani wodwala, mupatseni mpweya wabwino.
2. Wodwala akazindikira kuti akusowa chithandizo, muthandizeni kupanga jakisoni wa insulin.
3. Ngati mukukomoka - gonani kumbuyo kwanu, sinthirani mutu kumbuyo ndikukankhira nsagwada yakumaso. Pakadali pano, lilime lotsitsimutsidwa sililetsa misewu yake. Palibe chifukwa chofikira kukakamiza pakamwa panu ndikukhazikitsa lilime lanu ndi njira zosinthira mawu.
4. Ngati wozunzidwayo sanadziwe, fufuzani matumba. Nthawi zambiri, odwala matenda ashuga amakhala ndi maswiti nawo kuti awonjezere shuga mosavuta ngati hypoglycemia kapena khadi yokhala ndi matenda.
5. Nthawi zina sizotheka kudziwa pomwe kuchuluka kwa shuga kapena kuwonjezeka kwakadali pano. Ndipo sizikudziwikiratu zoyenera kuchita ngati zoterezi zikuchitika. Chifukwa chake, ngati zovuta sizikudziwika, akuthandiza odwala matenda ashuga, amapatsa shuga kapena maswiti patsaya. Chowonadi ndi chakuti maswiti odyedwa adzakweza shuga pang'ono, ndipo ngati shuga wamagazi ndi 40 mmol / L, ndiye kuti kukweza mpaka 45 mmol / L sikungakhale ndi kanthu. Koma pamayambiriro oyambira 2 mmol / l, 5 mmol / l yowonjezera ikhoza kuyimitsa kuukirako ndikupulumutsa miyoyo.

Algorithm yodzidzimutsa sizitengera mtundu wa hyperglycemia.

Thandizo loyamba limaperekedwa ndi omwe amafika:

1. Mlingo wa glucose umatsimikiziridwa ndi glucometer yonyamula ndi kupezeka kwa matupi a ketone mumkodzo.
2. Potsimikizira ketoacidosis, insulin yochepa imagwiritsidwa ntchito. Hafu ya jakisoni imalowetsedwa kudzera m'mitsetse, theka. Njirayi imathandizira kutsika kwamphamvu kwa glucose ndipo samalola shuga kutukuka pambuyo poti kuchitira insulin komwe kumalowetsedwa m'magazi.
3. Mofananamo, njira zamchere, zotsekemera ndi kupatsanso madzi m'thupi zimayambitsidwa. Thandizo linanso limaperekedwa mu gawo lapadera.
4. Kuchuluka kwa shuga komanso kusapezeka kwa matupi a ketone kumawonetsa kukula kwa boma la hyperosmolar. Pankhaniyi, isotonic sodium chloride solution imayendetsedwa kudzera m'mitsempha.
5. Popeza simungathe kuyesa shuga m'magazi mwadzidzidzi, gwiritsani ntchito jakisoni wa 40% shuga m'mitsempha. Kuwongolera mkhalidwewo kumawonetsa hypoglycemia, ngati palibe zotheka, wodwalayo amathandizidwa ngati hyperglycemia.

Mankhwala ena amaperekedwa mu dipatimenti. Ndikofunikira kwambiri kusiyanitsa mtundu wamtunduwu kuchokera ku ubongo wa edema. Zizindikiro za mikhalidwe iwiriyi imatha kukhala yofanana, koma pathophysiology ndipo, motero, chithandizo, ndizosiyana kotheratu.

Monga lamulo, wodwala yemwe ali ndi hyperglycemia amaonedwa kuti ndi moyo ndi endocrinologist.

Mkhalidwe waukulu wamankhwala ndikusintha kwa moyo momwe mumakhalira chakudya chamagulu, masewera olimbitsa thupi, kukana zizolowezi zoyipa ndikutsatira mosamalitsa zomwe dokotala akutsimikiza.

Mankhwala

Chithandizo chimachokera pa kugwiritsa ntchito mankhwala amkamwa a hypoglycemic ndi chithandizo chamankhwala cha hormone.

Oral hypoglycemic othandizira amagwiritsidwa ntchito pokana insulin. Amakonda kutumizidwa ngati monotherapy, koma kuphatikiza wina ndi mnzake komanso ndi insulini ndikotheka.

Mumsika wogulitsa, pali mitundu ingapo ya insulin, yomwe imagawidwa nthawi yayitali: ultrashort, yochepa, nthawi yayitali, nthawi yayitali komanso yopambana.

Nthawi zambiri, zoyambira poyambira zimagwiritsidwa ntchito. Ndiye kuti, m'mawa ndi madzulo maola, mankhwalawa amagwiritsidwa ntchito kwa nthawi yayitali, omwe ndi maziko azinthu zonsezo. Ndipo musanadye chakudya chilichonse ndikuphunzira kwambiri, amapatsidwa insulin yowonjezera.

Ndi hyperglycemia yopanda matenda a shuga, matendawa amayambidwanso chimodzimodzi. Kufunika kwa munthawi yomweyo ngati chithandizo cha zovuta kumakakamiza odwala kuti atenge mankhwala ambiri.

Kudya

Ayi, ngakhale mankhwalawa amakono sangakhale othandiza popanda kusintha zakudya. Mu zakudya, pali lingaliro - glycemic index.

GI imawonetsa kuchuluka kwa mayamwidwe amkati. Pochepera chizindikiro, glucose wautali amamasulidwa kuchokera ku malonda, amachepetsa shuga m'magazi. Ndi zinthu zomwe zili ndi index yotsika ya glycemic yomwe imayang'ana kwambiri menyu osati anthu omwe ali ndi hyperglycemia, komanso wathanzi kwathunthu.

Zakudya zamafuta ambiri othamanga zimaletsedwa kotheratu: makeke, makeke, chokoleti, msuzi wokoma, chivwende, mphesa, chakudya mwachangu, mbatata, pasitala ndi zakudya zina zili m'gululi.

Kusankha koyenera ndi kukonza insulin, pamakhala njira yowerengera mkate (XE). Zogulitsa zilizonse zimagwirizana ndi kuchuluka kwa XE. XE imodzi imafanana ndi 10 magalamu a chakudya kapena magalamu 20-25 a mkate. Mlingo wa insulin amawerengedwa potengera zomwe zili mu XE mu chakudya tsiku lonse.

Zotheka

Matenda oopsa a hyperglycemia amasokoneza thupi. Izi zimawonetsedwa makamaka ndi neuropathy ndi angiopathy.

Popeza pali zotengera ndi mitsempha thupi lonse, zotsatira za glycemia ndizosiyanasiyana ndipo zimatha kukhudza pafupifupi gawo lililonse:

• Nephropathy Kugonjetsedwa kwa glomeruli - kapangidwe ka impso momwe magazi amasefa ndi mapangidwe a mkodzo woyamba. Kukhalitsa kwa nthawi yayitali osalipira bwino glycemia kumabweretsa kukula kwa impso, mu gawo lachiwopsezo pakufunika kwa kupatsirana kwa impso kapena hemodialysis.
• Retinopathy Kuwonongeka kwa retina kumabweretsa kuwonongeka kwamtsogolo.
• Peripheral angiopathy ndiyomwe imayambitsa chitukuko cha phazi la matenda ashuga. Amawonetsedwa ndi zilonda zam'mimba, ndipo, m'malo ovuta kwambiri, ovulala.
• Peripheral neuropathy. Kuwonetsedwa ndi kupweteka, paresthesia m'malo osiyanasiyana a thupi. Mwina kuphwanya matumbo kuyenda, chikhodzodzo, kutsika potency ndi libido.
• Pafupipafupi zotupa pakhungu, zotupa vaginitis mwa akazi, yeniyeni stomatitis.
• Kuwonongeka kwa ziwiya zaubongo ndi mtima nthawi zambiri kumaphatikizidwa ndi atherosclerosis, yomwe imachulukitsa mawonekedwe a coronary artery matenda ndi discirculatory encephalopathy.

Hyperglycemia imafuna kuti wodwalayo azidzudzulidwa kwambiri ndikutsatira mosamalitsa malangizo onse a dokotala. Kusamala kwa shuga m'magazi kumayambitsa zovuta zambiri komanso kulemala mosaganizira jenda ndi zaka.

Chifukwa chake, kuyezetsa magazi kumachitika pofuna kupeza shuga m'magazi kuti adziwe matendawa komanso kupewa zovuta. Kuchiza kwa hyperglycemia kunyumba ndi njira zina sikovomerezeka.

Zoyambitsa Hyperglycemia

Choyambitsa chachikulu cha hyperglycemia, chomwe chimapangitsa kuchuluka kwa shuga mu seramu yamagazi, ndikuchepa kwa kupanga kwa insulin ndi thupi. Nthawi zina, kuchuluka kwa insulin kwa wodwalayo kumakhala mkati mwa mtundu wamba, koma nthawi yomweyo, kulumikizana kwake ndi maselo a thupi la munthu sikulondola, zomwe zimapangitsanso kuwonjezeka kwa shuga.

Kukula kwa hyperglycemia kungathandizenso kuti pakhale chakudya chamagulu ochulukitsa, ochulukitsa.

Kupsinjika mtima kumathanso kukhala chifukwa cha hyperglycemia. Chifukwa chake, ndikofunikira kuthana ndi nkhawa zanu, zamaganizidwe anu, kuthana ndi nkhawa zanu, kupewa kukhala ndi moyo wopitirira malire komanso kugwira ntchito molimbika.

Zomwe zimayambitsa hyperglycemia zitha kukhala matenda osiyanasiyana opatsirana komanso osachiritsika.

Odwala omwe ali ndi matenda a shuga, kuopsa kwa hyperglycemia kumachitika mukavina mankhwala omwe amachepetsa shuga, kapena jakisoni wa insulin.

Gulu ndi zizindikiro za hyperglycemia

Pali magawo angapo azovuta za hyperglycemia:

• Kuwala - shuga m'magawo 6.7-8.2 mmol / l,
• avareji ndi 8.3-11 mmol,
• zolemera - zopitilira 11.1 mmol / l.

Masewera a glucose opitilira 16,5 mmol / L, mkhalidwe wokondweretsa umapezeka, ndipo ndi glucose wopitilira 55 mmol / L, hyperosmolar coma imayamba, yomwe imakhala vuto lalikulu kwambiri, ndipo mu theka limapangitsa kufa.

Mwa anthu omwe ali ndi matenda ashuga, pali mitundu iwiri ya hyperglycemia:

• kusala kudya kwa hyperglycemia (magazi akakhala m'magazi akakwera mpaka 7.2 mmol / L ndi kukwera chifukwa chakudya sichikhala ndi maola oposa 8 otsatizana),
• postprandial hyperglycemia (kuchuluka kwa shuga pambuyo pakudya mpaka 10 mmol / l kapena kuposa).

Pochitika kuti, mwa anthu omwe alibe matenda a shuga, kuchuluka kwa glucose pambuyo chakudya chochuluka kumakwera mpaka 10 mmol / l, uwu ndi umboni wa chiwopsezo chachikulu chokhala ndi matenda a shuga a 2.

Zizindikiro za hyperglycemia ndi izi:

• polydipsia - ludzu kwambiri,
• kuwonda
• kukodza pafupipafupi kapena polyuria,
• kutopa
• Kuchiritsa kwa bala
• masomphenya osalala
• kamwa yowuma
• kuyabwa ndi khungu louma
• Matenda opatsirana bwino, mwachitsanzo, zotupa za m'mimba,
• arrhasmia,
• Mpweya wa Kussmaul
• chikomokere.

Zizindikiro za hyperglycemia amathanso kukhala: osaganizira komanso ozizira miyendo, kutsekula m'mimba ndi kudzimbidwa, mavuto ena am'mimba.

Zizindikiro zitatu zoyambirira zimapanga mtundu wapamwamba kwambiri wa hyperglycemic triad.

Zizindikiro za hyperglycemia yovuta kwambiri ndi: kusokonezeka kwa chikumbumtima, ketoacidosis, kuchepa magazi chifukwa cha osmotic diuresis ndi glucosuria.

Kuzindikira kwakanthawi kwa hyperglycemia kumathandiza kupewa zovuta zazikulu.

Hyperglycemia imatha kubweretsa ketonuria (mawonekedwe a matupi a acetone mkodzo) ndi ketoacidosis (kuphwanya kwa kagayidwe kazakudya kamene kamayambitsa matenda a shuga).

Mwa anthu omwe ali ndi matenda ashuga, kusintha kuchokera ku matenda oopsa kupita ku hyperglycemia atha kukhala zaka zingapo (ngati thupi lenilenilo lingathe kutulutsa insulini).

Chithandizo cha Hyperglycemia

Ngati munthu akudwala matenda ashuga, ndiye kuti nthawi zonse amayenera kuchita shuga. Kuyeza kumachitika pamimba yopanda kanthu ndikatha kudya, kangapo patsiku kuwongolera mphamvu. Ngati, malinga ndi zotsatira za miyeso ingapo yotsatizana, chizindikiro chachikulu cha shuga chimayang'aniridwa, ndiye muyenera kuwona dokotala.

Ndi hyperglycemia, zakudya ndizofunikira kwambiri. Wodwalayo amayenera kuwonetsetsa kuchuluka kwa chakudya chamagulu ndi zakudya zopatsa mphamvu.

Kuchita masewera olimbitsa thupi moyenera komanso kumwa kwambiri pakatha mphindi 30 zilizonse kungathandize kuchiritsa matenda a hyperglycemia.

Insulin nthawi zambiri amagwiritsidwa ntchito pochiza hyperglycemia. Ngati hyperglycemia imayambitsidwa ndi matenda omwe si a shuga, ndiye kuti matenda a endocrine ofanana amathandizidwa.

Ngati munthu wanena zizindikiro za hyperglycemia, ndiye kuti ayenera thandizo mwachangu.

Chithandizo choyamba cha hyperglycemia ndi kuyeza shuga.

Ndi chizindikiro cha oposa 14 mmol / l, odwala omwe ali ndi matenda a shuga 1 amafunika jakisoni wa insulin ndi kumwa kwambiri. Pambuyo pake, miyezo ya shuga iyenera kuchitidwa maola awiri aliwonse ndipo jakisoni wa insulini uyenera kupangidwa mpaka mulingo wa shuga ubwerere mwakale.

Kuthandizidwa ndi hyperglycemia mwa odwala omwe, ngakhale akuwongolera insulin, kuchuluka kwa shuga sikumachepa, amakhala muchipatala chawo mwachangu, chifukwa amatha kukhala ndi mavuto opumira chifukwa cha acidosis.

Muchipatala, kuthandizidwa ndi hyperglycemia kumatira pakumachiritsa kwakukulu, kulowetsedwa kwa insulin, chakudya, mavitamini, ndi mapuloteni kuti azitha kuyika acid pazoyimira acid komanso kuchepetsa mavuto obwera chifukwa cha osmotic diuresis ndi ketoacidosis.

Panthawi yamavuto a hyperglycemic (precomatous state) ya odwala osadalira insulin, ndikofunikira kuti achulukitse acidity yowonjezera. Kuti muchite izi, muyenera kumwa madzi ambiri am mchere, idyani masamba ndi zipatso. Njira yothetsera zakumwa koloko (supuni ziwiri pa chikho cha madzi) zimathandizanso kuchepetsa acid.

Ndi chitukuko cha acidosis, wodwalayo amatha kutaya chikumbumtima. Kuti mukhale ndi moyo, gwiritsani ntchito enema yokhala ndi soda. Panthawi ya khansa yapakhungu, khungu la wodwalayo limakhala loyipa komanso louma, motero ndikofunikira kulipaka mankhwalawa popukutira ndi thaulo yonyowa pokonza, popereka chidwi makamaka m'manja, pakhosi, pamphumi, dera lopezekera.

Popewa kudwala matenda ashuga, odwala matenda ashuga ayenera kuwunika momwe alili, kutsata zakudya, kuyenda moyera, kuchita masewera olimbitsa thupi.

Dokotala akapereka mankhwala omwe amathandiza kuti muchepetse shuga m'magazi, pamafunika kuwamwa pa ndandanda, popeza kutha kwa kudya kungayambitse matenda a hyperglycemia.

Chifukwa chake, hyperglycemia ndi chikhalidwe cha thupi, chomwe chimatha kuphatikizidwa ndi kukhalapo kwa matenda a endocrine, makamaka shuga mellitus, komanso zinthu zina. Kukula kwa hyperglycemia amatsimikiza kuchuluka kwa shuga m'magazi. Ndi hyperglycemia yayikulu komanso osapereka chisamaliro chanthawi kwa wodwalayo, mathedwe ake amakhala osavomerezeka.

Matenda ena

Chizindikiro chofananacho chitha kuchitika chifukwa cha zovuta zina za endocrine zomwe zimayambitsidwa ndi vuto la chithokomiro cha chithokomiro, adrenal gland, pituitary gland (acromegaly, thyrotooticosis, glucagonoma). Chifukwa cha kupsinjika, kuvutika maganizo ndi matenda aubongo. Kwa kanthawi kochepa, hyperglycemia ikhoza kuyambitsa kuvulala, opaleshoni.

Kumwa mankhwala

Cholinga chake chimakhalanso kugwiritsidwa ntchito kwa mankhwala ena omwe amagwiritsidwa ntchito makamaka pamtima, autoimmune, matenda amitsempha. Hyperglycemia imatha kuchitika pamene mukumwa corticosteroids, octreotide, beta-blockers, epinephrine (adrenaline), tazide diuretics, natsin pentamidine, proteinase inhibitors, L-asparaginase ndi othandizira ena a antipsychotic. Kugwiritsa ntchito ma psychostimulants monga amphetamine kumabweretsa hyperglycemia, koma kugwiritsa ntchito nthawi yayitali kumabweretsa kukula kwa hypoglycemia (kuthamanga kwa shuga). Mankhwala ena atsopano a psychotropic, monga Zirpex (olanzapine) ndi Simbalia (duloxetine) amathanso kutsogolera ku hyperglycemia.

Kupsinjika kwakukulu

Anthu omwe ali ndi matenda opsinjika kwambiri monga stroko kapena myocardial infarction amatha kukhala ndi hyperglycemia ngakhale pakalibe matenda ashuga, ngakhale matenda a shuga amatha kupezekanso. Kafukufuku wopezeka mwa anthu ndi nyama akuwonetsa kuti kuchuluka kwa glucose wamagazi pachifukwa ichi ndi chizindikiro choyipa, chifukwa kumalumikizidwa ndi chiwopsezo chachikulu cha kufa.

Hyperglycemia ndi vuto lalikulu lomwe limafuna chithandizo chamankhwala. Pofuna kupewa zovuta zoyipa, ndikofunikira kuzindikira kuphwanya kagayidwe kachakudya koyambirira.

Zizindikiro zazikulu za hyperglycemia:

1. Udzu wambiri komanso kamwa yowuma. Wodwalayo amamwa madzi ambiri, pomwe sangathe kuthetsa ludzu lake. Nthawi zambiri, chakudya chamafuta tsiku lililonse chimakhala pafupifupi malita 5-6, ndipo m'malo ovuta, mpaka malita 9-10.
2. Polyuria (kukodza mwachangu). Chifukwa cha kumwa kwambiri madzi, wodwalayo nthawi zambiri amakhala ndi chidwi chofuna kukodza.
3. Kununkhira kwa acetone kuchokera mkamwa. Ichi ndiye chizindikiro chachikulu cha hypoglycemia. Komabe, izi zitha kutanthauza matenda ena.
4. Kufooka pafupipafupi, kutopa ngakhale pambuyo polimbitsa thupi pang'ono, kugona, kupopa kwambiri.
5. Kukula kwa chilakolako chofuna kudya, komanso ngati pali vuto lalikulu, m'malo mwake, kuchepa, kenako ngakhale kudya zakudya.
6. Kuchepetsa thupi.
7. Kusanza, kusanza, kutsekula m'mimba.
8. Zowonongeka (zowoneka bwino).
9. Khungu lowuma, kuyabwa.
10. Mtima arrhythmia.
11. Mwa amuna, kukokoloka kwa erectile.
12. Kugwedeza miyendo.
13. Kulimbitsa kwa nthawi yayitali komanso mabala ena.

Zotsatira ndi zovuta

Nthawi zambiri, odwala matenda oopsa a hyperglycemia amakumana ndi odwala matenda ashuga amtundu woyamba. Ndi matenda a shuga a 2, kuwonjezereka kwa shuga m'magazi ndikuthekanso, koma izi ndizochepa ndipo chofunikira, monga lamulo, ndikumenya koopsa kapena myocardial infarction.

Chithandizo cha hyperglycemia chimafuna chithandizo cha matenda omwe amayambitsa. Acute hyperglycemia nthawi zambiri amatha kuthandizidwa ndi insulin. M'mitundu yoopsa, mankhwalawa amagwiritsidwa ntchito, omwe nthawi zina mumayenera kumwa mapiritsi a shuga.

Ndi hyperglycemia, wodwalayo amawonedwa ndi endocrinologist. Komanso, miyezi isanu ndi umodzi iliyonse ndikofunikira kuyesedwa ndi a mtima, a nephrologist, a ophthalmologist ndi a neuropathologist.

Ndi shuga wowonjezereka, kwa oyamba kumene, mankhwala osagwiritsa ntchito mankhwalawa amalimbikitsidwa, omwe amapezeka pakudya kwapadera. Chifukwa chake, ndikofunikira kudya zakudya zazochepa zam'madzi (ufa ndi zinthu zotsekemera) momwe mungathere. Masiku ano, malo ogulitsira ambiri amakhala ndi dipatimenti yomwe imagulitsa zakudya zapadera za anthu odwala matenda ashuga.

Zakudya zomwe zimakhala ndi mawonekedwe a hyperglycemia zimatanthauzira kuvomerezeka kwa kabichi, tomato, sipinachi, nandolo zobiriwira, nkhaka, soya. Tchizi chamafuta ochepera, oatmeal, semolina kapena phala ya chimanga, nyama, nsomba amalimbikitsidwanso. Kuti mumalize mavitamini, mumatha kudya zipatso zouma komanso zipatso.

Ngati chakudyacho sichingabweretse zotsatira zoyenera ndipo shuga m'magazi sakhazikitsa matendawa, ndiye kuti dokotalayo amapereka mankhwala omwe amathandiza kapamba kuti apangitse shuga kukhala ndi shuga wokwanira.

Kugwiritsa ntchito insulin, muyenera kuyang'anira shuga yanu nthawi zonse. Pa mitundu yochepa ya matenda a shuga, mankhwalawa amaperekedwa pakhungu m'mawa mphindi 30 asanadye (Mlingo ndi magawo 10-20). Ngati matendawa ali ovuta, ndiye kuti mlingo woyenera mamawa ndi 20-30 PIECES, ndipo madzulo, musanatenge gawo lomaliza la chakudya, - 10-15 PESCES. Ndi mawonekedwe ovuta a shuga, mlingo umachulukirachulukira: masana, wodwalayo ayenera kubayira jakisoni katatu wa 20-30 m'mimba mwake.

Matenda a shuga a shuga, omwe nthawi zambiri amakhala ngati chimayambitsa glycemia, ndimatenda "osavutika", chifukwa munthu amadalira insulin yokumba. Komanso, wodwalayo amakumana ndi matenda osiyanasiyana omwe amatha kudetsa ziwalo zambiri. Popewa kukula kwa matenda ashuga, ndikofunikira kutsogoza moyo wokangalika ndikuyang'anira kudya kwanu. Ngati wachibale wachindunji akudwala matendawa, ndiye kuti pamakhala chiwopsezo chachikulu chotenga kachilomboka, motero, ndikulimbikitsidwa kuti muzindikire matenda am'mimba kamodzi miyezi itatu iliyonse kuti mufufuze magazi a shuga. Koma onse ngakhale shuga samachiritsidwira masiku ano, koma glycemic control imakupatsani mwayi wokhala ndi moyo wonse.

Thandizo loyamba

Choyamba muyenera kupanga kuchuluka kwa shuga ndi magazi ndi chipangizo chapadera - glucometer, yomwe aliyense wodwala matenda ashuga angakhale nayo. Kugwiritsa ntchito ndikosavuta: chitani khungu pakumapeto kwa chala chanu, ikani dontho la magazi lomwe limatulutsidwa. Kenako, digito imawonetsedwa pazenera, kuwonetsa kuchuluka kwa shuga. Ngati palibe glucometer, ndiye ngati kuli kotheka muyenera kufunsa dokotala - akatswiri ambiri azachipatala komanso ma endocrinologists atha kupezeka mwachindunji muofesi.

Mulingo wamba wamagazi m'magazi ndi 3.5-5,5 m / mol pa lita imodzi ya magazi. Tiyeneranso kukumbukira kuti mu ana osaposa miyezi 1.5 ya moyo, chizindikirochi chimatha kukhala 2.8-4.4 m / mol pa lita, ndipo mwa amayi ndi amuna pambuyo pa zaka 60 - 4.6 - 6.4 m / mol pa lita

1. Imbani ambulansi ngati shuga m'magazi ndi apamwamba kwambiri kuposa 14 mmol / l (250 mg / dl) hypoglycemia kwapangitsa kuti pakhale kuwonongeka kwakukulu.
2. Kuchepetsa zovala zosokoneza ndi mpweya, komanso kupereka mpweya wabwino ngati pakufunika kutero.
3. Onani ngati pali vuto lakupweteka kumutu kapena m'khosi. Ngati kuvulala kulikonse kulipo, pezani chisamaliro choyenera.
4. Chisamaliro chofunikira chimafunikira mukasanza, wozunzidwayo ayenera kuyikidwa mbali imodzi, ndipo nkhope yoloza pansi kuteteza kuyamwa kwa zam'mimba mu thirakiti la kupuma.
5. Kuyang'anira zofunikira (kupumira, kufalikira kwa magazi) mphindi zochepa zilizonse kufikira ambulansi itafika.
6. Pakakhala chithandizo chamankhwala, munthu yemwe ali ndi vuto la hyperglycemia nthawi zambiri amayang'ana shuga wawo wamagazi ndikubayidwa ndi insulin.

Kugwiritsa ntchito mankhwala osokoneza bongo

Ngati wodwala ali ndi matenda a shuga omwe amadalira insulin, kuyambitsa insulini yothamanga pakhungu kumathandiza kuchepetsa kuchuluka kwa shuga m'magazi. Ndikofunika nthawi yomweyo kuti musalakwitse ndi kumwa kuti wodwalayo asakumane ndi hypoglycemia, yomwe singakhale ndi zotsatirapo zoopsa.

Njira zochizira “shuga” chikomokere ndikuchotsa kuthana ndi insulin, komanso kubwezeretsa kagayidwe kamchere wamadzi. Wodwalayo amachotsedwa posachedwa (osaposa maola 6) kuti apewe kusintha kosasintha mu mitsempha ya chithokomiro, komanso ziwalo zina zofunika.

Woopsa, woyamba kumwa mlingo ndi 100-200 IU wa insulin, ndipo theka la mankhwalawo limaperekedwa mosavomerezeka ndi theka lachiwiri kudzera m'mitsempha. Maola atatu aliwonse (pokhapokha ngati dontho la shuga) limayambitsidwa. Zotsatira zake, mlingo wa tsiku ndi tsiku uyenera kukhala magawo 300-600.

Ngati maola angapo atatha jakisoni woyamba "wodabwitsa", kuchuluka kwa glucose kutsika osaposa 25%, ndiye kuti theka la muyeso (magawo 50-100) limaperekedwa.

Njira zowonjezera

Akatswiri ambiri amalimbikitsa kuti pakhale shuga m'magazi a shuga, mankhwala asanafike pa bicarbonate ngakhale anali atamulowetsa m'magazi. Mutha kukonzekera njira yothira kumwa - kuchepetsa supuni ziwiri mu kapu yamadzi ofunda. Woopsa, kupweteka kwam'mimba kumachitika, komanso enema woyeretsa (0,5 supuni ya sodium pa lita imodzi yamadzi). Izi zimathandizira kuyesa bwino-based base.

Kuti muchepetse acidity m'thupi, wodwalayo ayenera kuyitanidwa kuti adye zipatso ndi masamba atsopano. Muyenera kuperekanso chakumwa chochuluka, onetsetsani kuti mwaphatikiza mchere wam'madzi ndi kuwonjezera zamchere zachilengedwe, monga carbonate, sodium, potaziyamu (Borjomi, Narzan, Essentuki).

Kupatuka kochepera pazomwe kungakhale kotheka mwa kuchita masewera olimbitsa thupi. Ngati khungu ndi louma, kupukutira ndi thaulo yonyansa ndikofunikira.

Ngati njira zomwe sanatenge sizinachitike, wodwalayo akumva bwino, wamwalira, ndiye kuti chisamaliro chodzidzimutsa chiyenera kuyitanidwa.