Momwe mungaperekere chisamaliro chadzidzidzi cha chikomokere

• Ochuluka kwambiri. Ndi insulin yochulukirapo, shuga m'magazi amaperekedwa m'maselo mwachangu kuposa masiku onse. Zotsatira zake, minofu imadziunjikira zambiri, ndipo kusowa kwa zinthu kumayamba m'magazi.
• Kukhazikitsidwa kwa kuchuluka kwa insulin kwa odwala matenda ashuga, osagwirizana ndi kugwiritsa ntchito chakudya chamagulu komanso masewera olimbitsa thupi.
• Mowa wambiri.

Chiwopsezo cha kuperewera kwa hypoglycemic chikukula ngati odwala matenda ashuga:

• matenda amafuta a chiwindi,
• aakulu aimpso kulephera
• kupanikizika kwa kapamba.

Potengera matenda awa, kugwiritsa ntchito insulin kumachepetsedwa, mlingo wake umatha kuchepetsedwa. Kukhazikika kwa insulin kungayambitsenso kuchepa kwamphamvu kwa glucose ndi kuperewera kwa hypoglycemic. Jakisoni uyenera kuchitidwa mosazindikira. Ngati singano ilowa m'matumbo, ndiye kuti insulini imathamanga mofulumira kuposa momwe imafunikira m'magazi am'magazi, kuchuluka kwake kumawonjezereka.

Zizindikiro zoyambira ndi chizindikiro

Zizindikiro za chikomokere mu hypoglycemic sizomwe zimachitika ngati munthu akudwala matenda ashuga, pomwe misempha ya shuga imakwera kwambiri. Nthawi zambiri, mnzake amakhala wopanda vuto. Ngati izindikirika munthawi yake, ndiye kuti njira zoyenera zothandizira kupewa zithandizire kupewa.

Maselo abongo ndi oyamba kudwala kuperewera kwa glucose. Mwa munthu, zizindikiro zoyambirira za kukomoka kwa magazi zitha kuwonedwa:

• chizungulire
• kufooka
• kugona
• kugwedezeka kwa dzanja
• kumverera kwa njala.

Kuti tipewe izi, wodwalayo amatha kupatsidwa shuga kapena maswiti. Ice cream ndi chokoleti sizili zoyenera, zimatenga nthawi yayitali.

Zizindikiro zoyambira kusamba:

• kukopa kwa pakhungu
• kukokana
• tachycardia
• hypotension
• kusanza
• kusowa poyankha,
• thukuta kwambiri
• ana opukusidwa
• chisokonezo ndi kutayika kwa chikumbumtima.

Zofunika! Ngati misempha ya glucose saukitsidwa munthawi yake, ndiye kuti zizindikiro za hypoglycemia zidzakulirakulira. Kugwirizana kwamayendedwe akusokonezedwa, kuyankhula, kuchuluka kwambiri kwa boma ndikutaya chikumbumtima ndi chikomokere.

Thandizo loyamba

Ambulensi isanafike, momwe mayendedwe azikhala motere:

• tsegulani zenera, kupereka mpweya wabwino,
• Ngati wodwala akudziwa, mupeze chakumwa chabwino kapena maswiti,
• Udzagone pansi,
• opanda zovala zolimba
• Ngati chakudya chotsala chili pakamwa panu, chotsani,
• Wodwala akayamba kuzindikira, yesani kutsanulira mosamala mkamwa mwake,
• jekeseni 1 ml ya glucagon mosadukiza kapena m'mitsempha, ngati sichitha, perekani pakamwa.
• ndi zopweteka, tembenuzirani wodwala mbali imodzi, ikani kena kolimba (koma osati chitsulo) pakati pamano.

Dziwani zambiri za zomwe zikuwoneka ndi zochizira komanso zothandiza kwa amayi.

Pazokhudzana ndi malamulo owerengera magawo a mkate 1 a shuga amawerenga tsamba.

Pitani ku adilesi ndikuphunzira za njira zopangira opaleshoni yochotsa lipomas.

Zizindikiro za hypoglycemic chikomokere ndi zizindikiro

Hypoglycemic coma zizindikiro imapereka mawonekedwe pazomwezi. Kumbali ya wodwala, kusokonezeka pakulankhula, chisokonezo, kuzizira, thukuta lomata, khungu limasiyanitsidwa. Wodwala atha

• thukuta kwambiri
• kunjenjemera thupi lonse
• kumva kwamphamvu njala
• kupweteka mutu komanso kutopa
• kutopa ndi kufooka kwa minofu
• kugwedezeka kwa dzanja.

Zizindikiro ndi zizindikilo zimatha kusiyanasiyana, koma zonse zimatsogolera kuti pang'onopang'ono munthu amayamba kumira osazindikira. Choyamba, izi zikuwonetsedwa pakupangitsa mayankho pamafunso, kenako pamavuto oyankhula. Ngakhale muzochitika zazikulu, kulephera kuzindikira kungachitike mwadzidzidzi.

Kupewa kwa hypoglycemic chikomokere

Pofuna kupewa kuyambika kwa vuto la hypoglycemic, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi. Kuphatikiza apo, ndikulimbikitsidwa:

• Onani zakudya zomwe adotolo adalimbikitsa.
• kumwa mankhwala motsatira malangizo a dokotala,
• kuchepetsa mlingo wa insulin musanayambe kuchita masewera olimbitsa thupi ndikuwonjezera kuchuluka kwa chakudya chamafuta mukamagwira ntchito molimbika.

Komanso, muthandizira kupewa kufalikira kwa matenda:

Mkhalidwe wa hypoglycemic, shuga (shuga) akamachepetsa m'magazi a munthu, amatha kupezeka mwa munthu aliyense, makamaka iwo omwe ali ndi matenda a pancreas exocrine. Hypoglycemic coma, komwe chisamaliro chazangu ndizofunikira kwambiri munthawi yochepa kwambiri, imakhala nthawi zambiri odwala matenda ashuga. Nthawi zambiri, iwo omwe ali ndi vuto labwino la matenda ashuga a mtundu 1 (omwe amadalira insulin) amakhudzidwa.

Kodi vuto loyipa la hypoglycemic ndi chiyani? Kuwonongeka kwa dongosolo lamanjenje, makamaka - Chowonadi ndichakuti pafupifupi theka la glucose omwe amalowa mthupi limadyedwa ndi ubongo. Ngati chikomoka cha hypoglycemic chachitika, chisamaliro chamankhwala chachedwa, ubongo ulibe mphamvu zokwanira, sungagwire ntchito mwa "mphamvu zonse", ndiye kuti, imaphatikizapo "kugona machitidwe". Kukhala nthawi yayitali chonchi kumawonjezera vutoli, popeza magazi opanda glucose amatha kusunga madzi ochepa (kuthinana kwa osmotic kumatsika), "madzi owonjezera" awa amalowa m'matumbo, makamaka mu minyewa yaubongo. Ndipo ngati mwa munthu wathanzi, poyankha kuchepa kwa glucose, mahomoni ena okhudzana ndi insulin amapangidwa m'njira yolipira, cholinga chamasula glucose yofunikira kuchokera ku depot yake m'chiwindi, ndiye kuti odwala matenda ashuga malamulowa ali ndi vuto.

Komanso, ndimatenda a shuga, omwe amangokhala ndi insulini "yosavuta", komanso osakhalitsa, amakhala ndi zotsatira zazitali. Vuto la mankhwala osokoneza bongo kapena zochita zina zomwe zingayambitse kuchepa kwa magazi m'magazi, vuto la hypoglycemic lingachitike m'maloto, osazindikiridwa ndi munthu pakapita nthawi ndikuyamba kulira.

Chifukwa chiyani hypoglycemic coma imachitika? ndi zizindikiro

Osati shuga yokhayokha yomwe imayambitsa hypoglycemia, komabe - izi ndizochitika zambiri. Nthawi zina, munthu amayamba kuwonetsa kuchepa kwa shuga ndikuyamba kudya (podya), vuto la "chidziwitso" chachikulu cha matendawa, izi sizingachitike, ndipo zimakhala zovuta.Ndizovuta zomwe zimachitika pomwe kuchuluka kwa glucose kutsikira pansi pa 2,5 mmol / lita (malire omwe ali munsiwo ndi 3.3 mmol / lita, kwa odwala ambiri omwe ali ndi matenda ashuga "mwatsatanetsatane" ndi 7-8 mmol / lita, ndipo zonse zomwe zili pansipa kale zimayambitsa kutengeka kwa hypoglycemia).

Wodwala yemwe ali ndi matenda ashuga, amatha kukhala ndi vuto la hypoglycemic chifukwa:

• bongo wa insulin mwadala kapena mwangozi,
• mankhwala osokoneza bongo a hypoglycemic
• kusala kapena kudya chakudya chochepa mphindi 30 mpaka 40 pambuyo pa jakisoni wa insulin,
• Munthu akangolowa muyeso womwe umawerengeredwa kale, koma asanaonjezere zolimbitsa thupi.
• kuphwanya dongosolo la jakisoni wa insulin. Tiyenera kunena kuti munthu wodwala matenda ashuga sayenera kupatsidwa insulin "ngati kale" osazindikira tanthauzo la matenda a glycemic ngati apita kuchipatala: matenda oyipa kapena osafunikira "amasokoneza chindapusa", ndipo Mlingo wa insulin uyenera kutsimikiziridwa tsiku lililonse, adokotala atazindikira kuchuluka kwa shuga,
• mutamwa mowa: Mowa wa ethyl umachepetsa ntchito za ma enzymes omwe amachititsa kuti pakhale shuga wowonjezera, ngati pakufunika. Ndiye kuti, mowa "umatseka msewu" ku njira zoteteza.

Zomwe zimayambitsa hypoglycemia:

• Njala yayitali, makamaka ngati nthawi yomweyo munthu agwira ntchito molimbika,
• Kukhazikitsa insulin ndi munthu wathanzi kwa iye kapena munthu wina,
• kapamba, kapamba, chiwindi,
• kupezeka kwa thupi la chotupa chomwe chimapanga insulin.

Asanayambike chikomokere, kwakanthawi (mpaka maola angapo), zizindikiro zotsatirazi zingaoneke:

• Makhalidwe osakwanira (pafupipafupi - mwamakani),
• kufooka, kutopa,
• kugwirana chanza
• kunjenjemera thupi lonse
• kumverera kwanjala yayikulu.

Pankhaniyi, nthawi zambiri munthu amakhala wokutidwa ndi thukuta lozizira, loterera, limasanduka lotumbulika, kumveka kofulumira kumamveka. Kenako munthu amatha kugontha, kugona mpaka kupumula, ndipo kuchokera kunja kumadziwika kuti zotulukazo zikupitilirabe ndipo kugona osapumula, munthuyo nthawi zambiri amalira, amafotokoza zikhumbo zabodza. Ngati mukuyesa kumudzutsa, poyamba amatha kuchita, koma nthawi zambiri - osatsegula maso ake osazindikira ena. Ichi ndi chiyambi cha hypoglycemic coma. Thandizo ladzidzidzi liyenera kuperekedwa pakali pano.

Chifukwa chake, ngati mungazindikire kusakwanira, mkwiyo ndi chisokonezo mwa munthu yemwe ali ndi matenda a shuga (ngakhale atayankha kangapo kuti ali bwino), koma mulibe magazi a shuga pafupi, thandizirani ngati muli ndi vuto la shuga: magazi ambiri sichimakhala choyipa ku moyo ngati boma pomwe sichikwanira. Ndi boma la hypoglycemic state (chikomokere) lomwe limawerengeka kwa mphindi, pomwe kukomoka chifukwa cha kuchuluka kwa shuga sikungayambitse imfa ndi kulumala ngati thandizo liperekedwa pambuyo pa mphindi 30 mpaka 40.

Imaperekedwa kudzera m'mitsempha. Zabwino koposa zonse, ngati nyumbayo ili ndi glucometer. Ngati mukudziwa njira ya jekeseni wovomerezeka, ndiye kuti mukawoneka mutha kulowa shuga wambiri 40% wambiri 20 ml. Kenako musasiye mtsempha. Intramuscularly, glucagon ikhoza kubayidwa (ngati ilipo).

Mulole munthu wina ayitane ambulansi (kuchipatala chidzafunika, makamaka ngati panali insulin yayitali).

Ngati chikumbumtima sichinabwezeretsedwanso, pangani wina 20 ml wa glucose omwewo, gwiritsani ntchito 1 ampoule wa Prednisolone kapena Dexamethasone kudzera mu mtsempha, mu madzi 10 mg a isotonic sodium chloride. Ngati izi zachitika popanda kuyang'anitsitsa kuchuluka kwa shuga, musachite chilichonse mpaka ambulansi itafika.

Choyamba thandizo la hypoglycemic chikomokere, ngati achibale alibe njira ya jekeseni wamkati, ndipo glucagon samapezeka mnyumba (awa ndi mankhwala okwera mtengo), ali motere:

• kuti agone wodwala pambali pake, kuyang'ana mpweya wake kuti usathe,
• tsegulani zenera, zenera kuti mpweya wambiri uyende,
• ngati nkotheka, ikani zidutswa zingapo za shuga pansi pa lilime, ndikuonetsetsa kuti shugayu samametsedwa, monga wodwala osazindikira, atasuntha nsagwada zake, nkutchinga njira zake.

Simungathe kupatsa wodwala: mutha kuthira madziwo m'mapapu anu, ndiye kuti zimakhala zovuta kwambiri ndipo nthawi zina zimakhala zosatheka kuchiritsa zovuta zake.

Ngati mumatha kugwira munthu akadali chikumbumtima, koma osakwanira komanso osangalala, yesetsani kum'patsa koloko yotsekemera, madzi ofunda ndi shuga kapena uchi, maswiti okha kapena uchi. Ndikofunika kuyimba ambulansi, ngakhale mutakhala kuti mwasiya nokha zoopsa izi.

Chizindikiro cha hypoglycemic chikuwonetsedwa chifukwa cha kuchepa kwamphamvu kwa ndende yamagazi. Amayamba mwadzidzidzi, pomwe wodwalayo akuipiraipira msanga, zomwe zimayambitsa kuperewera kwa hypoglycemic. Muyenera kuchitapo kanthu mwachangu komanso mwaluso, apo ayi zotsatira zoyipa sizingapeweke.

Hypoglycemia ndiwodziwika kwambiri kwa odwala omwe ali ndi matenda a shuga a 2, ngakhale amathanso kuonedwa posowa matenda awa. Zikatero, njira zowonjezera mphamvu zimakhazikitsidwa, ndipo mwayi wokhala ndi vuto lakachepa kwambiri. Mu odwala matenda ashuga, chomwe chimayambitsa matenda a hypoglycemic akhoza:

• Zakudya zamagulu ochepa zamthupi ndi insulin,
• kuchuluka kwakudya pakati pa chakudya,
• kuchita masewera olimbitsa thupi mopitilira muyeso,
• mankhwala osokoneza bongo a hypoglycemic,
• kumwa zakumwa zoledzeretsa,
• gastroparesis, kulephera kwa impso, kuphwanya chiwindi.

Ndi hypoglycemia, glucose wamagazi ndi ochepera 2.8 mmol / L. Ubongo umasowa zakudya m'thupi, zomwe zimayambitsa kusokonezeka kwamitsempha yamanjenje. Zotsatira zake, zizindikiro zomwe zimapezeka:

1. Kusangalala kwakukulu, mantha.
2. Kumva njala.
3. Zovuta, zopweteka, dzanzi ndi kupweteka kwa minofu.
4. Kutukwana, kufinya kwa chitsimikizo.
5. Kusokonezeka kwazungulira, tachycardia.
6. Chizungulire, migraine, asthenia.
7. Chisokonezo, diplopia, zonyansa zamakutu, zopatuka pamakhalidwe.

Hypoglycemia amatanthauza nyengo zosakhalitsa. Ndi kupindika kwake, kumatha kukhala kuphwanya kwa ubongo, komwe kumadzaza ndi kuwonongeka kwa ubongo, kumangidwa kwa kupuma, kusiya kuchita ndi mtima komanso kufa.

Ngati zizindikiro zoopsa zikapezeka, wodwala amafunika thandizo mwadzidzidzi. Kuwala kwa zochita kumadalira kuchuluka kwa kusokonezeka kwa chikumbumtima. Chithandizo choyamba cha hypoglycemia, ngati munthuyo akudziwa, ndi motere:

1. Wodwala wakhala pansi kapena kugona.
2. Gawo lamankhwala othamanga limaperekedwa kwa iye nthawi yomweyo, mwachitsanzo:
   • kapu ya madzi otsekemera
   • 1.5 tbsp. l wokondedwa
   • tiyi ndi 4 tsp shuga
   • 3-4 zidutswa za oyeretsedwa,
   • ma cookie amafuta, etc.
3. Pa insulin yayitali kwambiri chifukwa cha mankhwala osokoneza bongo, mafuta ochepa osakanikirana amayenera kudyedwa.
4. Kupatsa wodwala mtendere, amayembekeza kusintha kwake.
5. Pakatha mphindi 15, ndende ya magazi imayesedwa pogwiritsa ntchito glucometer yonyamula. Ngati zotsatirazi sizikhutiritsa, kukonzanso zakudya zopangidwa ndi shuga ndikofunikira.

Pakusintha, komanso ngati wodwalayo akuipiraipira, amafunika thandizo la kuchipatala mwachangu.

Kuthandiza mwana

Pakuwukira kwa hypoglycemia mwa ana ochepera zaka 2, shuga wamagazi amatsika pansi 1.7 mmol / L, wamkulu kuposa zaka 2 - pansi pa 2.2 mmol / L. Zizindikiro zomwe zikuwoneka mu nkhaniyi, monga akulu, zimagwirizanitsidwa ndi kuphwanya kwamanjenje. Nocturnal hypoglycemia imawonetsedwa ndikulira m'maloto, ndipo mwana akamadzuka, amakhala ndi chisokonezo komanso zizindikiro za amnesia.Kusiyanitsa kwakukulu pakati pazizindikiro za hypoglycemic ndi zovuta za neuropsychiatric ndikusowa kwawo mutatha kudya.

Ndi hypoglycemia wofatsa motsutsana ndi matenda a shuga, ayenera kuyikidwa m'malo mwake ndikumupatsa maswiti, shuga m'magome, supuni yodzaza, msuzi wokoma pang'ono kapena msuzi. Ngati mavutowo sanabwerere mwakale, wodwalayo amayenera kupatsidwa gawo lina la chakudya chamagetsi ndikuyitanira ambulansi. Hypoglycemia wakhanda, imafunika kuchipatala mwadzidzidzi.

Mwana akapanda kuzindikira, amamuyang'ana kumbali ndikuyembekezera madokotala. M'kamwa mwa wodwalayo ayenera kutsukidwa chakudya kapena masanzi. Ngati ndi kotheka, glucagon imayendetsedwa intramuscularly.

Chithandizo cha Chipatala Hypoglycemia

Njira zochizira kuchipatala sizosiyana kwambiri ndi chisamaliro cha prehospital. Ngati zizindikiro zikapezeka, wodwalayo ayenera kugwiritsa ntchito mankhwala okhala ndi shuga kapena kumwa mapiritsi a piritsi. Ngati pakamwa sizingatheke, mankhwalawa amaperekedwa kudzera mu mawonekedwe a yankho. Ngati vutoli silikuyenda bwino, lingafunike kulowererapo osati kokha kwa endocrinologist, komanso akatswiri ena (cardiologist, resuscitator, etc.).

Akatha kuchotsewa, zakudya zomwe zimakhala ndi zovuta m'mimba zimatha kufunikira kuti zisayambenso. M'tsogolomu, ndikofunikira kusintha kuchuluka kwa othandizira omwe amagwiritsidwa ntchito ndi wodwalayo, muphunzitseni kuchita izi payekha ndikulimbikitsa kudya moyenera.

Njira Zowathandizira ndi Kusamalira Kwambiri

Monga chithandizo chodzithandizira komanso kuthandizana, panthawi yotsimikizika, ndikofunikira kumwa tiyi wokoma, shuga, maswiti. Pazonse, zinthu zilizonse zokhala ndi ma carbohydrate othamanga ndizoyenera.

Kuphatikiza apo, kuyambitsa yankho la glycogen kumapereka zotsatira zabwino. Nthawi zambiri, odwala matenda a shuga amakhala ndi cholembera cha chinthu ichi. Cholinga choitanira ambulansi ndikuchepa kwa izi. Pa gawo la ambulansi, glucose 40% nthawi zambiri imayendetsedwa pamitsempha.

Ndi chikumbumtima cha hypoglycemic, kukhazikitsidwa kwa shuga kumakhala kofunikira. Mlingo woyambirira ndi 60 ml. 40% yankho (yankho). Kuphatikiza apo, kukoka kwa mtsempha wa 5% shuga kumakhazikitsidwa. Kuchita kumeneku ndikofunikira, ngakhale wodwalayo atayambanso kuzindikira pambuyo pa 40% yankho, popeza pali kuthekera kwakukulu kwa kubwereza-bwereza.

Nthawi zambiri, njira zoterezi zimakhala zokwanira ndipo munthu amachotsedwa mwachangu, zonse ziwiri zokhala ndi vuto la chikomokere. Ndipo, ngati njirazi sizothandiza, ndiye kuti zikutanthauza zochitika ziwiri zokha: njira ya hypoglycemic coma "yapita" kwambiri, kapena pali matenda ena.

Pazochitika zoyambirira, kutsika kwa glucose kumatchulidwa, ndipo koposa zonse, nthawi ya hypoglycemia ndi yayitali mokwanira kuti metabolism ya neurons imazirala. Zotsatira zake, njira zomwe zimakhazikika pakubwezeretsa ndi kusinthanso zina zimasokonekera. Ndiye kuti, kusinthana kwa ma elekitirodiya kudzera mumankhwala. Ngakhale kuwonjezeka kwa kuchuluka kwa chakudya cham'mimba, ma neuron ena sangathe kugwira ntchito.

Gawo linalo ndikutsutsa kwathunthu mawonekedwe a membrane, ndipo zimatenga nthawi kuti ikonzenso. Choyamba, wodwalayo amasamutsidwa ku makina mpweya wabwino. Ngati ndi kotheka, mankhwala amawonjezeredwa omwe amathandizira kamvekedwe ka minofu ndi mtima kugwira ntchito bwino. Izi zimatchedwa inotropic thandizo.

Kupitiliza kwa shuga wokhazikika sizothandiza. M'malo mwake, osakaniza polar amagwiritsidwa ntchito. Amakhala ndi 5% glucose, kuwonjezera kwa yankho la potaziyamu mankhwala enaake ndi insulin. Yotsirizirayi ndiyofunikira pakupereka shuga kwa minofu, ndipo potaziyamu ndiye electrolyte yofunika kwambiri. Kubweretsa mankhwala ena kumachitika molingana ndi zisonyezo. Mwachitsanzo, maantibayotiki amagwiritsidwa ntchito popewa matenda a nosocomial.

Gulu lachiwiri la zifukwa limafunikira kuphunzira mwatsatanetsatane ndikukonzanso.Ndipo, kuwonjezera pa kuchiza kwa hypoglycemic coma, mankhwala apadera amawonjezeredwa kuti athetse izi.

Kufotokozera kwa matenda a hypoglycemic chikomokere

Hypoglycemic coma ndi pachimake pathological mkhalidwe wowonekera mwa machitidwe a mankhwalawo mwanjira inayake (ubongo wam'kati → chikhazikitso → subcortical-diencephalic zomanga → malo ofunikira a medulla oblongata), wophatikizidwa ndi dontho kapena lakuthwa kwambiri pamlingo wa glycemia (kuchuluka kwa chakudya m'magazi am'magazi).

Chothandizira pakukula kwa kukomoka kwa hypoglycemic ndi kuchepa kwambiri kwa shuga m'magazi mpaka 3 mmol / L kapena kutsikira. Hypoglycemic coma kwa odwala omwe ali ndi matenda osokoneza bongo amatha kukhala chifukwa chowonjezeka zolimbitsa thupi, kumwa mankhwala ambiri a insulin, komanso osagwirizana ndi zakudya.

Magawo anayi akuluakulu ali ndi matenda mosiyanitsa, omwe amaphatikizapo zochitika za hypoglycemic komanso kwa ndani:

1. The genesis kukula kwake kumalumikizidwa ndi hypoxia yama cell a chapakati mantha dongosolo, makamaka ubongo chotupa. Zotsatira za izi zimawonekera mu mawonekedwe akusintha kwa kusintha kwa thupi, chisangalalo chambiri kapena kukhumudwa, kupweteka kwa mutu kumatha kuchitika, kufooka kwa minofu kumamveka, ndipo wodwalayo amatha kukumana ndi nkhawa zamitundu mitundu. Kuphatikiza apo, tachycardia imakula, kumverera kwa njala kumakulirakulira, khungu limanyowa.
2. Kuchepa kwa shuga m'magazi kumabweretsa kuwonongeka kwinanso kwa subcortical-diencephalic dera, lomwe likuwonetsedwa ndi thukuta lochulukirapo, chisangalalo chagalimoto, wodwalayo amatha kuchita zosayenera, hyperemia ya nkhope, diplopia imawonedwa.
3. Kuphwanya magwiridwe antchito a thonje kumabweretsa kukomoka, kuwonjezeka minofu kamvekedwe. Mkhalidwe wodwala angafanane ndi kugwidwa khunyu, kuwonjezera apo, pali kukulira kwa ophunzira. Kuthamanga kwa magazi, tachycardia ndi thukuta limachulukirachulukira.
4. Pali chisokonezo pakugwira ntchito kwa medulla oblongata, kapena, m'malo ake apamwamba. Pali hypa ya hypoglycemic coma, zizindikiro zamatenda zomwe ndi: kusazindikira, chinyezi cha khungu, kutentha kwabwinobwino kapena kuchepa pang'ono kwa thupi, kupuma kwabwinobwino, kuchuluka kwa periosteal komanso tendon Reflex, kufooka kwa ana, kuthamanga mwachangu komanso kuwonjezeka kamvekedwe ka mtima.
5. Gawo lomaliza lomaliza. Njira zoyendetsera ntchito zam'munsi mwa medulla oblongata zimakhudzidwa ndi boma la hypoglycemic. Pali kuwonjezeka kwa chikomokere. Zizindikiro zamankhwala zimawonetsedwa ngati kutsika kwamatenda amisempha, kuthamanga kwa magazi, kutuluka tambiri sikumayang'aniridwa, areflexia kumachitika, ndipo kugunda kwa mtima kumasokonezeka.

Moyo wa munthu uli pachiwopsezo cha kufa, chifukwa kuchepa kwambiri kwa shuga m'magazi kunayambitsa kuyambika kwa kukula kwa vuto la hypoglycemic coma, zomwe zimapangitsa kupezeka kwa matenda otupa.

Hypoglycemic coma - nthenda yanji?

Kuti thupi lizigwira ntchito bwino, thupi limafunikira "mafuta" - glucose. Hypoglycemic coma ndichinthu chovuta kwambiri chomwe chimayamba ndikusowa kwa glucose, ndiye kuti, magazi ake akatsika pansi 2.77 mmol / lita.

Hypoglycemic coma imayamba mwa anthu omwe ali ndi matenda osokoneza bongo omwe ali ndi insulin yambiri, nkhawa, mowa, kusowa kwa chakudya, komanso kudya masewera olimbitsa thupi. Vutoli limayamba chifukwa chogwiritsa ntchito mankhwala kwa nthawi yayitali.

Hypoglycemic coma imayamba chifukwa cha kuchepa kwa glucose m'maselo aubongo. Amadziwika kuti "mafuta" akuluakulu a maselo amthupi amanjenje ndi glucose. Mphamvu yamanjenje imadya shuga katatu kuposa minofu. Ndipo kusowa kwake kumayambitsa hypoxia ndi kuphwanya kagayidwe kazakudya zama protein ndi mapuloteni m'maselo a chapakati mantha.

Komanso, maofesi ake osiyanasiyana samakhudzidwa nthawi imodzi, koma pang'onopang'ono.Chifukwa chake, zizindikiro za magawo osiyanasiyana a kuperewera kwa shuga ndizosiyana. Cortex yamatumbo makamaka imakhudzidwa ndi kusowa kwa shuga. Kenako ntchito ya zomangamanga ndi cerebellum imasokonekera. Medulla oblongata ndiye womaliza kudzipereka.

Chifukwa cha kukomoka kwa hypoglycemic, ntchito ya thupi lonse imasokonekera. Zotsatira zake zimatha kuchitika nthawi yomweyo, kapena zingatenge miyezi ingapo. Aphasia (kusokonekera kwa mawu), edema yam'mimba, kulowetsedwa kwa myocardial kumatha kukhazikika. Zotsatira zazitali ndi khunyu, parkinsonism, ndi encephalopathy.

Thandizo loyamba

Hypoglycemic coma imakula mwachangu ndipo imafunikira thandizo lomwelo. M'magawo oyamba, kudya zakudya zopatsa mphamvu mosavuta - tiyi wokoma wamphamvu, kupanikizana, shuga, chidutswa cha mkate kapena maswiti zingathandize. Komabe, pa gawo la kusokonezeka kwa malingaliro kapena poyambira kukomoka, thandizo la ena ndikuyitanira ambulansi.

Pakadali pano, kulowetsedwa kwamkati mwa glucose 40% kokha komwe kungathandize wodwalayo. Koma ndi adokotala okha omwe angathe kuchita izi. Ndipo madotolo asanafike, muyenera kuyika munthu pambali pake ndikuyika zidutswa 1-2 za shuga wolimba patsaya lake. Palibenso chifukwa chokakamira kuthira tiyi mopanikizika, osatha kumeza, koma madziwo amatha kulowa m'malo opumira ndikupangitsa kupuma kukhala kovuta.

Ngati thandizo lachipatala lachedwa, akatswiri ena amalimbikitsa kuvulaza munthu, mwachitsanzo, kupindika kapena kumenya. Kuyankha kupweteketsa ululu kudzakhala kumasulidwa kwa makatekisolite, omwe amawononga glycogen wamkati, ndikupanga shuga. Mkuluyu amaletsa hypoglycemia.

Zizindikiro za hyperglycemia ndi hypoglycemia

Musamale ndi insulin yotalikilapo. Ndikulimbikitsidwa kuti ziziperekedwa pansi pa khungu la m'chiuno kapena phewa, popeza mayamwidwe ake m'malo awa pang'onopang'ono. Ntchito yofunikira kwambiri ndikupanga kafukufuku wamasana masana. Izi zikuthandizira ntchito yosankha insulin kuti iyende usiku ndipo izitha kuteteza hypoglycemia kugona.

Anthu omwe ali ndi matenda amtundu woyamba a shuga amafunika kudya malinga ndi momwe amafunikira mphamvu. Mwanjira ina, kuchuluka kwa zopatsa mphamvu zomwe zikubwera ziyenera kugwiritsidwa ntchito mokwanira ndi thupi, ndipo kuchuluka kwa insulin yomwe ingabayidwe kuyenera kugwirizana ndi chakudya chamafuta.

Kuthandizira kuwerengera kwa zopatsa mphamvu mwa odwala kungagwiritsidwe ntchito m'magome osiyanasiyana osonyeza kufunika kwa zopatsa zanu zonse komanso chakudya chokwanira. Koma kuwerengetsa katundu wa chakudya mu zinthu zomwe amagwiritsa ntchito buledi. Chimodzi mwa zinthu ngati izi chimafanana ndi magalamu 12 a zakudya komanso zakudya zamafuta. Kapena 25 magalamu a mkate wamba. Magawo a mkate amagwiritsidwa ntchito podziletsa pakudya kwa anthu odwala matenda ashuga, amapangidwa kuti azitha kusintha mtundu wa anthu odwala matenda ashuga, kuwazolowera kukhala ndi udindo paumoyo wawo.

Zochizira za hypoglycemic coma, 10% solution ya glucose mu 100 mpaka 250 milliliters imagwiritsidwa ntchito. Izi ndizofunikira kuti shuga azikhala nthawi zonse m'magazi. Ngati wodwalayo sanadzindikirenso mkati mwa kulowetsedwa kwa shuga, njira ziyenera kutengedwa kuti muchepetse matenda a ubongo - mwachangu muzipereka yankho la 15% ya Mannitol kuchokera pa 1 mpaka 2,5 milligrams pa kilogalamu imodzi ya kulemera kwa thupi, ndikulowetsedwa ndi Furosemide (Lasix) 75 - 110 mg m'mitsempha.

Mannitol ndi woimira gulu la osmotic diuretics, zochita zake zimakhazikitsidwa ndi malamulo akuthupi a kayendedwe ka mamolekyulu am'madzi ndi mankhwala osokoneza bongo. Imayikidwa osasinthika ndi mamolekyu amadzi. Lasix imathandizanso mu zida za aimpso, imathandizira kupangika kwa mkodzo ndi chimbudzi chake. Iyenera kuperekedwa mosamala kwambiri, chifukwa imatha kuyambitsa ma profuse diuresis - kusasiya kwamadzi ndi thupi.

Pankhani yoletsa kapena kuchiza matenda amtundu wa hypoglycemic coma, mankhwala monga Piracetam kapena Nootropil ali oyenera. Mankhwalawa ndi oimira ena otchedwa nootropics - mankhwala omwe amasintha kufalitsa kwa chithokomiro. Amagwiritsidwanso ntchito kwa okalamba komanso odwala omwe adachita ngozi yapakhungu.

Poletsa kuchuluka kwambiri kwa kuthamanga kwa magazi mu ziwiya zaubongo, njira yogwiritsira ntchito magnesium sulfate, yomwe imadziwika bwino kuti Magnesia, imagwiritsidwa ntchito. Nthawi zambiri kutumikiridwa mpaka 10 ml (kutengera kulemera kwa thupi) mu ndende yopanda 25%.

Kukhazikitsidwa kwa yankho la glucose kuyenera kuchitika motsogozedwa ndi labotale ya mulingo wake m'magazi. Masewera a glucose akafika 14 - 16 mmol pa lita imodzi, insulin yotsalira yochepa imayenera kuperekedwa mosagwirizana ndi mankhwala mpaka 6 gawo lililonse kwa maola atatu mpaka asanu.

Hypoglycemic coma - ndi chiyani, chifukwa chiyani ndiowopsa?

Hypoglycemic coma imapezeka mwa odwala omwe ali ndi matenda osokoneza bongo pamene kuchepa kwakukulu kwa shuga m'magazi kumachitika. Munthawi imeneyi, munthu amalowa mwachangu kwambiri. Kuyambira pomwe zizindikiro zoyambirira zimawonekera mpaka atakomoka, osadutsa mphindi 15.

Kukhala mu mkhalidwe uwu ndi owopsa kwambiri pa moyo wamunthu komanso thanzi. Chifukwa choperewera ndi glucose, zimakhala zaubongo zomwe zimadya m'thupi zimavutika. Popanda thandizo labwino, njira zosasinthika zimapezeka m'magulu ake.

Zizindikiro ndi Zomwe Zimayambitsa

Hypoglycemic coma imatha kudwala ngati wodwalayo wadzibaya yekha ndi insulin yambiri. Zotsatira zake, shuga kuchokera m'magazi amaperekedwa m'maselo mwachangu, motero kuperewera kwa zinthuzi kumaonekera.

Mkhalidwe wowopsa chotere ungachitike ngati munthu wodwala matenda ashuga agwiritsa ntchito mlingo wa mankhwala womwe sugwirizana ndi kuchuluka kwa chakudya chamagulu kuchokera ku chakudya. Izi zimachitika nthawi yayikulu pakulimbitsa thupi, pomwe minofu imafuna shuga wambiri.

Ndi matenda a shuga amaletsedwa kumwa mowa. Ngakhale mowa wochepa wa ethyl ungayambitse chikumbumtima cha hypoglycemic. Chiwopsezo chokhala ndi vutoli chimawonjezeka ngati wodwala ali ndi matenda a chiwindi chamafuta, kulephera kwa impso, kapena chifuwa chachikulu cha pancreatic. Mukazindikira matendawa, ndikofunikira kuchepetsa mlingo wa insulin chifukwa chakuti thupi limalephera kuthana ndi zotupa zake.

Kusagwiritsa ntchito mankhwalawa kwa odwala matenda ashuga kumachulukitsa ngozi ya shuga. Zilonda zimaperekedwa mwanjira. Ngati muwapanga intramuscularly, ndiye kuti insulin idzalowa m'magazi mwachangu, zomwe zimayambitsa kusowa kwa glucose.

Zizindikiro zazikulu

Zizindikiro zoyambirira za hypoglycemic coma mu shuga zimatchedwa:

• mawonekedwe akumanjala,
• kufooka koopsa
• thukuta lozizira layamba pakhungu,
• kupweteka mutu kwambiri ndi chizungulire
• kugona, kudzuka kumayamba,
• pali mantha amphamvu
• Khungu limakhala lotuwa.

Ngati simulowererapo pamene zizindikirozi zikuwoneka, zizindikiro zowopsa zimayamba. Wodwala matenda ashuga amamva tachycardia, kuvutika kupuma, kugona komanso kunjenjemera mbali zina za thupi, chisokonezo, kukhumudwa. Pang'onopang'ono, munthu amagwa. Izi zimaphatikizidwa ndi ana opukusidwa (amasiya kuyankha pakuwala), kugunda kwamphamvu, kutsika kutentha kwa thupi, komanso kukula kwa matenda a Kernig.

Kusamalira mwadzidzidzi kwa chikomokere cha hypoglycemic ndikuwonjezera shuga. Ngati munthu akudziwa, ndikofunikira kuti amupatse zokoma. Tiyi, maswiti, shuga ena angachite. Ngati wodwala yemwe ali ndi matenda ashuga ataya chikumbumtima, zovuta za machitidwe ake ndi motere:

• Munthu amakhala mbali imodzi, zomwe zimathandiza kupewa kuteteza lilime.
• Ngati zotsalira za chakudya zilipo mkamwa, ndikofunikira kuzichotsa.
• Wodwala matenda ashuga samasulidwa ku zovala zolimba zomwe zimapuma.
• Ngati wodwala akumeza ntchito, ndikofunikira kuthira madzi amkamwa mwake.
• Mapiritsi ochepa a glucose ophwanyika amatha kuthiridwa pamkamwa.
• Ngati pali syringe ndi glucagon, iyenera kuperekedwa mwachangu kapena kudzera m'mitsempha. Mlingo woyenera ndi 1 ml.
• Pakakomoka pakati mano, muyenera kuyika china chake cholimba, koma osati chitsulo.
• Ndikofunikira kuyimba ambulansi posachedwa.

Ku chipatala, munthu yemwe ali ndi matenda a shuga amawunika chifukwa cha kuvulala kwamtundu wamatumbo, zotupa. Zimadziwika ngati wodwalayo adatenga insulin kapena mankhwala ena musanafike kuphwanya kwa hypoglycemic. Mndandanda wazanjira zodziwikiratu umaphatikizanso kutsimikiza kwa kuchuluka kwa shuga m'magazi. Kwa izi, mayeso ofulumira nthawi zambiri amagwiritsidwa ntchito. Amathandizira kudziwa msanga kuchuluka kwa shuga m'magazi, omwe amakupatsirani kusankha njira zabwino kwambiri zamankhwala.

Chithandizo chikuchitika pogwiritsa ntchito mankhwala otsatirawa:

• gwiritsani ntchito ufiti kuti muthane ndi kuledzera,
• njira ya shuga yatsitsidwa. Akuluakulu, mlingo umodzi ndi 10-25 g, kwa ana - 2 ml pa 1 makilogalamu,
• jekeseni wa potaziyamu potaziyamu kuti athetse matenda a potaziyamu m'magazi,
• kukonza matenda owonetsa magazi, Norepinephrine, Dopamine imagwiritsidwa ntchito,
• Ndi kukula kwa hypoglycemic coma, hydrocortisone imayendetsedwa kudzera m'mitsempha kapena intramuscularly.

Ngati mankhwalawa apereka zotsatira zomwe akufunazo, ndipo wodwala yemwe ali ndi matenda ashuga ayambanso kuzindikiridwa, amalimbikitsidwa kuti adye chakudya chomwe chili ndi chakudya chamagulu ochepa owonjezera kwakanthawi. Izi zimaphatikizapo semolina phala, uchi, zakumwa zotsekemera. Madzi a alkaline akulimbikitsidwa. Munthawi yonse yochira, ndikofunikira kusiya zonse mapuloteni ndi mafuta. Amawonetsedwa mu zakudya pokhapokha chilolezo cha dokotala.

Kanema: Chisamaliro chodzidzimutsa cha hypoglycemic coma

Ngati banja lanu lili ndi matenda ashuga, muyenera kudziwa zomwe mungachite monga kuperekera chithandizo chazomwezi.

Hypoglycemic coma ndimavuto apakatikati a matenda osokoneza bongo omwe amayamba chifukwa cha kuchepa kwambiri kwamphamvu m'magazi a shuga. Zisonyezero za 2.2 mpaka 2.8 mmol / L zimawerengedwa ngati chizindikiro cha hypoglycemia, makanda ochepera 1.7 mmol / L, mwa ana osakhazikika osakwana 1.1 mmol / L. Zizindikiro zake zitha kuoneka kale ndi shuga wa magazi a 2.6-3.5 mmol / L. Mikhalidwe ya Hypoglycemic imathanso kuchepa kwambiri m'magazi a glucose kuchokera kumalo okwera.

Chifukwa chiyani shuga amachepetsedwa kukhala malo ovuta? Pali zifukwa ziwiri zazikulu.

Choyamba, izi zimachitika pakakhala insulin yochuluka kwambiri m'magazi. - Patulani glucose m'maselo a thupi. Ngati pali insulin yochulukirapo, shuga wa m'madzi am'magazi amapita mwachangu kwambiri m'maselo, kukhazikika kwake mu minofu kumatuluka, ndipo m'magazi amachepa.

Nthawi zambiri, izi zimachitika mwa odwala omwe amadalira insulin omwe ali ndi vuto la shuga ndikumayambitsa kuchuluka kwakukulu kwa mahomoni chifukwa cha cholakwa. Mwachitsanzo, mlingo unawerengedwa molakwika malinga ndi kuchuluka kwa mankhwalawa. Ndende ya insulin imayesedwa mu zigawo za zochita. Mayankho amapezeka poyerekeza 40 IU / ml kapena 100 IU / ml. Pamailangizo awo, apadera amagwiritsidwa ntchito, osati kuchuluka kwake, koma kuchuluka kwa mayunitsi kumakhala ndi chizindikiro. Kuti muchepetse vuto la zolakwika, muyenera kusankha mosamala syringe yomwe imagwirizana ndi kuchuluka kwa mankhwalawa: 40 PIECES / ml - U40, kwa 100 PIECES / ml - U100.

Hypoglycemia imathanso kuchitika chifukwa cha njira yolakwika ya jakisoni: insulin iyenera kuthandizidwa mosasamala, ngati ilowa m'misempha, imawonekera m'magazi mwachangu ndipo kuphatikiza kwake kumawonjezeka kwambiri.

M'matenda ena, kapamba amatulutsa insulin yambiri.Izi zingayambenso hypoglycemia.

Mlandu wachiwiri, pamene mulingo wa insulin ndi wabwinobwino, ndipo mulibe shuga wokwanira m'magazi. Apa chifukwa cha hypoglycemia chimagwirizanitsidwa ndi zakudya kapena zolimbitsa thupi. Mwachitsanzo, munthu samadya chakudya chokwanira chopatsa thanzi.

Kugwiritsa ntchito mowa kumatha kupangitsa kuchepa kwa shuga m'magazi. Mowa umapatsa katundu pachiwindi, glycogen imaleka kugaya glucose ndikulowa m'magazi, ndikusunga shuga pakati pa chakudya. Zotsatira zake, pambuyo pa maola 3-4 mutatha kudya, shuga wa m'magazi amachepetsa.

Zakudya zowonjezera zamagulu ochulukitsa zimafunikira pakatha kukhazikitsa.

Pakulimbitsa thupi, mphamvu imagwiritsidwa ntchito mwachangu, kotero, kudya mafuta ambiri kumayenera kuwonjezereka ndikuwongolera kuchuluka kwa shuga m'magazi.

Zizindikiro za machitidwe a hypoglycemic

Kukula kwa chikomokere kumayendetsedwa ndi precoma. Ngati mungazindikire munthawi ndikuchitapo kanthu mkati mwa mphindi 10 mpaka 20, kulephera kuzindikira kungapeweke.

Kodi hypoglycemia imawonekera bwanji koyambirira? Glucose ndimphamvu mofulumira. Mwazi wake ukachepa, maselo aubongo ndi oyamba kuvutika. Kufooka ndi chizungulire kumamveka, poyamba kuwonjezeka kwa kukwiya kumadziwika, ndiye kuti chidwi, kugona kugona kumabwera posachedwa, kuthekera kwa chidwi kumachepa. Pali kumverera kwanjala, profuse yozizira ndi thukuta lomata, manja akunjenjemera. Khungu lakhungu limawonedwa.

Kuti muchepetse Zizindikirozi, ingomwa tiyi wokoma kapena kudya china chake chokoma, monga maswiti kapena chidutswa cha shuga. Shuga atangolowa m'magazi, zinthu zimayamba kukhala zabwinobwino. Chocolate ndi ayisikilimu wokhala ndi hypoglycemia ndizothandiza kwambiri, chifukwa amayamba kugwira ntchito pang'onopang'ono.

Ngati simukuwonjezera shuga m'magazi pakapita nthawi, zizindikirazo zizichulukanso. Matenda olankhula ndi mgwirizano amatha kuwoneka. Mkhalidwe wamtunduwu umatha kutha kwa kuzindikira ndikudutsanso.

Hypoglycemic coma imatha kutsimikiziridwa ndi zizindikiro zotsatirazi:

• Khungu limakhala lotuwa, lonyowa komanso lozizira,
• tulutsa thukuta
• kukokana, kusanza,
• kugunda kwa mtima
• ana amapukusidwa ndikufooka pang'ono.

Hypoglycemia mwa ana

Adakali aang'ono, mwana sangathe kudzipereka payekha mothandizidwa ndi hypoglycemia, ndipo mu zaka zoyambirira zaumoyo, mkhalidwewo umakhala wowopsa makamaka kumanjenje. Ndi vuto la hypoglycemic, kufunikira kwa chisamaliro chadzidzidzi kumagona ndi makolo. Ngati mukuwona kuti akufuna kwa mwana yemwe ali ndi matenda osokoneza bongo popanda chifukwa, nthawi zambiri kugona kwake sikwachilendo kwa iye, kutaya chidwi, muyenera kudziwa ngati ali ndi shuga.

Kutha kwa chikumbumtima ndi hypoglycemic coma mwa ana zimachitika mwadzidzidzi. Nthawi zambiri izi zimachitika usiku kugona. Hypoglycemia yayikulu pamenepa ikuwonetsedwa ndi thukuta lowonjezera, chisokonezo chamtundu wa kupuma, kupsinjika.

Algorithm Yothandizira

Chithandizo choyamba cha hypoglycemia ndi kudya zakudya zotsekemera kapena tiyi wokhala ndi shuga. Ngati chikumbumtima sichikupezeka ndipo kudya kopatsa mphamvu kwa chakudya sikungatheke, ambulansi iyenera kuyitanidwa.

Thandizo loyamba la hypoglycemic chikomokere ndi kulowetsedwa kwa 60 ml ya 40% ya shuga. Monga lamulo, kutuluka kuchokera pakoma mkati mwa jakisoni kumachitika mkati mwa miniti imodzi.

Kuti hypoglycemia sikumapanganso, pambuyo pakuzolowereka, ndikofunikira kudya zakudya zovuta (monga mkate, zipatso, mkaka).

Mothandizidwa ndi hypoglycemic coma, makonzedwe a Glucagon, ngati cholembera chokhala ndi mankhwalawa chili pafupi. Glucagon imathandizira kutsika kwa glycogen m'chiwindi komanso kutuluka kwa glucose m'magazi. Mankhwala amachotsedwa malinga ndi kulemera kwake.

Ngati chikumbumtima sichichira pambuyo pobayira jakisoni kapena shuga, ndiye kuti pali zovuta zina zomwe zimafunikira kuchipatala msanga.

Mukakayikira kuti vuto la hypoglycemic coma layamba, chisamaliro chodzidzimutsa, zomwe algorithm zomwe zafotokozedwa pamwambapa, ziyenera kuchitika motere:

• kuzindikira kwa nthawi ya hypoglycemic state ndi zizindikiro, kutsimikiza mtima wa shuga ndi glucometer,
• mkhalidwe wa precoma - kudya chakudya champhamvu kwambiri,
• pakutha kwa chikumbumtima - kuyimba foni ya ambulansi yoyambitsa 40% shuga m'mitsempha.

Njira zopewera

Njira yayikulu yopewa matenda a hypoglycemia ndikuyang'anira kuchuluka kwa shuga m'magazi. Kugwiritsa ntchito glucometer, mutha kuyesa kuwunika kunyumba.

Matenda ena, monga kulephera kwa impso, amafunikira kusintha kwa insulin.

Odwala omwe ali ndi matenda osokoneza bongo sangathe kuwonjezera nthawi yayitali pakati pa chakudya kapena kusintha moyenera insulin.

Kumbukirani kuti ngati kukomoka kwa hypoglycemic kumachitika, chisamaliro chadzidzidzi chimaperekedwa mwachangu, chifukwa zoterezi zimabweretsa ngozi pamoyo.

Nthawi yomweyo ndikofunikira kumvetsetsa kuti hypoglycemic coma ndi chifukwa cha matenda a shuga mellitus, osati chiwonetsero cha matendawa. Kuchepetsa kwambiri kuchuluka kwa shuga m'magazi a munthu kumatha kupangitsa kuti afe chifukwa cha kumangidwa kwa mtima ndi necrosis ya imvi ya ubongo.

Hypoglycemia imakhazikika mwa odwala omwe amalandira jakisoni wambiri wa insulin. Ndi pakamwa mankhwala antidiabetic mankhwala, zinthu zotere zimayamba kuchepa pafupipafupi. Nthawi zina, mwa odwala achinyamata omwe ali ndi matenda a shuga 1, kufa mwadzidzidzi kumatha kuchitika usiku kugona chifukwa kuchepa kwa mafuta m'magazi ndi kumangidwa kwa mtima. Pogona, munthu samatha kudziwa bwinobwino momwe alili.

Pakati pa zifukwa zomwe zimathandizira kukulitsa kukomoka kwa hypoglycemic, chinthu chokhazikika cha matenda ndi matenda a shuga. Ngakhale mwa anthu athanzi lathunthu matendawa amatha kupangitsa kuti azisala kudya nthawi yayitali, kuchepa kwakukulu kwa kuchuluka kwa chakudya chamagulu m'zakudya ndi chitukuko cha kapamba.

Zifukwa zina zimaphatikizapo:

• kuchepa kwa chakudya pambuyo jakisoni wa insulin,
• kuwerengetsa kolakwika kwa kuchuluka kwa insulin ya makonzedwe kamodzi ndi tsiku,
• insportune insulin
• zochita zolimbitsa thupi,
• kumwa mowa
• poyizoni mwadala.

Hypoglycemic chikomacho mwa ana

Mfundo za kakulidwe ka hypoglycemic coma mu ana ndendende monga zimakhalira kwa akulu. Amatha kuyambitsa vuto ngati atha kudya nthawi yayitali kapena kudya zakudya zochepa zama calorie, komanso kupewa insulin kapena zotsatira za matenda osachiritsika.

Komanso, zomwe zimayambitsa kukhala osowa zakudya m'thupi kapena kusowa kwa michere. Kompyuta ya hypoglycemic mwa ana ndi chiopsezo chachikulu, chifukwa sizotheka nthawi zonse kuzindikira kuti ili m'magawo oyambira. Mwana sangathe kufotokoza molondola komanso momveka bwino zomwe zikumuvutitsa.

Nthawi zambiri makolo amayamba kuliza ana awo akamakhala ndi nkhawa kapena kulira kwambiri. Chifukwa cha ululu womwe ukukula m'mimba, chidwi chawo chimachepa kapena kulibe. Njala ndi chizindikiro chokhacho chomwe chikukulira hypoglycemia. Popita nthawi, ana amakhala owopsa, osalumikizana, osayang'ana chilichonse chomwe chimachitika. Kusintha konseku kuyenera kuonetsetsa kuchenjeza kholo lililonse.

Kampani ya hypoglycemic mu ana, monga akulu, imayambitsidwa ndi khungu lotupa kwambiri, kunjenjemera kwa malekezero, kumachulukitsa thukuta. Mwadzidzidzi akayamba kuyenda, mwana amakomoka.

Tiyenera kudziwa kuti chiwonetsero cha mkhalidwewu mwa ana chimakula kwambiri kuposa akulu. Zizindikiro za mkhalidwewu sizimasiyana konse.Mukayamba kuyimba ambulansi, pamakhala ngozi yoti mungafunike kuchita zinthu zolimbitsa thupi.

Thandizo loyamba

Nthawi zambiri pamkhalidwe uwu, kukonza thanzi la wodwala, zosinthira zotsatirazi zimachitika:

1. Amapatsidwa china chake chokoma ndi shuga wambiri: tiyi, khofi, maswiti, ayisikilimu, msuzi wokoma.
2. Wodwalayo amakhala kuti wagona kapena atakhala pansi kuti apereke magazi osasokoneza. Wodwala akataya chikumbumtima, amayikidwa pambali pake. Izi zimachitika kuti kusanza sikupunthwa. Komanso ikani chidutswa cha shuga patsaya.
3. Pambuyo pa izi, muyenera kuyimbira ambulansi nthawi yomweyo.

Chothandiza kwambiri poletsa kuukira kwa hypoglycemic chikomaso ndi yankho la shuga. Itha kugwiritsidwa ntchito pokhapokha ngati munthu akudziwa. Kukonzekera mankhwalawa, ndikofunikira kupukuta supuni zingapo za shuga mu kapu ya madzi owiritsa.

Ngati mukudziwa matenda a munthu komanso mukudziwa zachipatala, mutha kum'patsa adrenaline cube ndi njira yolowerera shuga. Komabe, kumbukirani kuti zotsatirazi zonse zidzakhala pa inu.

Ngati mukukayikira kuyambika kwakanthawi m'nthawi yake, mutha kuziletsa. Kuti muchite izi, ingomenyani mkate ndikumwa zakumwa zotsekemera: tiyi kapena njira yokhazikika ya shuga.

Mungathenso kudya zakudya zina zamafuta othamanga: uchi, maswiti, ufa, kuwira. Tengani zakudya pang'onopang'ono kwa mphindi 10-15 mpaka kukomoka kutha. Ngati palibe zotulukapo, itanani dokotala.

Ngati wina walephera kuzindikira hypoglycemic munthawi yake, madokotala oyenerera amathandiza. Woopsa akamataya chikumbumtima, wodwalayo amapaka jekeseni wa shuga m'mitsempha. Nthawi zambiri izi zimakhala zokwanira kubwezeretsa zolimbitsa thupi. Ngati pakapita mphindi 15 palibe kusintha komwe kwatsatiridwa, katswiriyo akubwereza njirayi, koma ndi kukapumira.

Makonzedwe a 1 ml a glucagon amawonetsedwanso kudzera m'mitsempha, intramuscularly komanso subcutaneally. Njira zoterezi zimathandizira kubwezeretsa munthu m'mphindi 10-20. Ngati ndi kotheka, kuyendetsa shuga kumatha kubwerezedwa.

Ndi woopsa kwambiri hypoglycemic chikomokere, wodwalayo amamuika mu mnofu kapena mtsempha wa makonzedwe a 150-200 ml ya hydrocortisone. Zimathandizira kubwezeretsa kapamba. Wodwalayo akapanda kukhalanso ndi chikumbumtima, amapitilirabe ndi vuto la shuga m'mitsempha.

Pofuna kupewa kutupa kwa amuna omwe ali ndi kutupa, katswiri amayambitsa njira yothetsera matenda a mannitol. Zimathandizira kuteteza kagayidwe kachakudya njira, komanso kupewa. Ngati ndi kotheka, mankhwala a mtima amaperekedwa. Pambuyo kumuyimitsa munthu kwa masiku angapo amakhalabe oyang'aniridwa ndi dokotala.

Zosayambitsa shuga zomwe zimayambitsa hypoglycemia:

1. Kulephera kwina.
2. Kulephera kwa chiwindi.
3. Zofooka za michere ya metabolism ya carbohydrate (glycogenosis, galactosemia, tsankho la fructose).
4. Hypofunction wa adrenal kotekisi.
5. Kukula kwa mahomoni (nthawi zambiri pituitary dwarfism).
6. Insulinomas
7. Kutaya matenda ndi mawonekedwe am'mimba.

Matenda azachipatala

Zizindikiro za Hypoglycemic zimasiyana kwambiri mokhazikika mwa kuzindikirika kwake komanso kuzama kwawo, kutengera mphamvu ya wodwalayo ya hypoglycemia. Zizindikiro zowonjezera adrenergic ndizoyambirira kuwonekera: nkhawa, kupsa mtima, kugona kwambiri, nseru, hypersalivation, kunjenjemera, thukuta lozizira, paresthesia, tachycardia, mydriasis, kupweteka kwam'mimba, kutsegula m'mimba, kukodza kwambiri. Pambuyo pake, zizindikiro za neuroglycopenic zikupezeka: asthenia, kupweteka mutu, kusokonezeka kwa chidwi, mantha, kuyerekezera zinthu zina, kuyankhula ndi kusokonezeka kwa maonekedwe, kusokonezeka, kukomoka, kugona, kusokonezeka, kufooka kwakanthawi, kugona.

Hypoglycemic coma imakula mwachangu (mphindi, maola), nthawi zonse pamakhala zizindikiro zosiyanitsa: kutaya chikumbumtima, minyewa yamitsempha, kukokana. Kuzindikira kumatsimikiziridwa ndi shuga wochepa wamagazi.Ndi nthawi yayitali ya hypoglycemic state, chitukuko cha chipatala cha matenda am'mimba chimatha: kusanza, kupweteka mutu kwambiri, kutentha thupi, kuyambitsa kwamaso, bradycardia, kuwonongeka kwa mawonekedwe, kufufuza kwa fundus - kutupa kwa mitsempha ya maso.

Wodwala wodwala matenda a shuga, chikomokere cha hypoglycemic chimasiyanitsidwa, choyambirira, ndimatenda a hyperglycemic ketoacidotic. Ngati mukukayikira za kupezeka kwa vuto la hypoglycemic coma, ndiye kuti kusokonekera kwa glucose mu hyperglycemic coma sikungokulitse mkhalidwe wa wodwalayo. Ngakhale kutayika kwa nthawi pochotsa hypoglycemia kumakhala ndi zotsatira zoyipa pamagawo amkati wamanjenje ndipo kumatha kuyambitsa kusintha kosasintha.

Chithandizo champhamvu cha algorithm yokhala ndi chikomokere

Yang'anani! Ngati munthu wasowa chikumbumtima kapena wapafupi ndi izi - werengani ndime yotsatirayi kuti musataye nthawi, ndikuchitapo kanthu mwachangu !

Algorithm mwachidule: Ngati wodwalayo akudziwa, mumupatse chakumwa chokoma kapena china chotsekemera (ngati sakufuna, mupangeni). Ngati wodwala walephera, tsatirani imodzi mwamalemba awa:

1. Mosamala ndi pang'onopang'ono kutsanulira zakumwa zotsekemera mkamwa mwake kapena kuyika mphesa kapena mapiritsi ochepa a glucose mkamwa mwake.
2. Ngati chakudya chamafuta othamanga sichitha kuperekedwa pakamwa la wodwalayo kudzera pakamwa, ikani glucagon jakisoni ntchafu kapena mkono, popanda kupha tizilombo toyambitsa matenda, mutha kudutsa malaya kapena mathalauza mwachindunji. Ngati palibe glucagon, ndiye kuti mutha kuyika jakisoni wa 30-50 ml ya 40-50% shuga yankho .
3. Ngati palibe glucagon ndi glucose, kuyitanitsa ambulansi mwachangu , ndikuyika wodwalayo pamalo oyimirira.

Kodi chiwopsezo cha hypoglycemic coma ndi chiani?

Hypoglycemic coma imapezeka mwa odwala matenda a shuga omwe ali ndi shuga ochepa magazi. Wodwalayo amatha kugwera mofulumira mu chikomokere (hypoglycemic coma), makamaka pambuyo poyambira kukula kwa shuga m'magazi.

Zizindikiro za chikomokere mu hypoglycemic sizochepa kwenikweni poyerekeza ndi vuto la matenda ashuga (wokhala ndi shuga wokwezeka wapamwamba).

Wodwala amatha kukhala wodziletsa, wosakhazikika, nthawi zina ngakhale wankhanza. Panthawi imeneyi, amatha kusokonezeka.

Ngati wodwalayo akudziwa, ndikokwanira kuti amwe shuga kapena adye china chake chokoma ndipo shuga awonjezeke. Koma ngati wodwala matenda ashuga afika, ndiye kuti ndizosatheka kumukakamiza kuti alandire maswiti, chifukwa chake ndikofunikira kupereka thandizo mwadzidzidzi.

Algorithm yosamalira mwadzidzidzi chifukwa cha hypoglycemic coma

Zochitika 1. Wodwalayo amadziwa.

Kuti achite izi, ayenera kumwa mapiritsi ochepa a glucose kapena kumwa madzi otsekemera (makamaka ofunda). Nthawi zina wodwalayo amakhala ndi mantha ndipo safuna kudya maswiti, ndiye muyenera kuyesa kumukakamiza kapena kumupangitsa kuti azichita.

Zochitika 2. Wodwalayo anasiya kuzindikira.

Ngati wodwala matenda ashuga agwera osakomoka, ndiye kuti sangathenso kutafuna ndikumwa payekha, choncho muyenera kuyesetsa kuthira mosamala mkamwa mwake. Mutha kuyika mphesa pakati pa mano ake ndi tsaya lake kuti iye asungunuke pang'onopang'ono ndipo limodzi ndi malovu ake mumalowe.

Ngati mwaphunzitsidwa, mutha kumupatsa jakisoni wa shuga kapena kulowa Glucagon - Mankhwala omwe odwala matenda ashuga nthawi zambiri amakhala nawo pamavuto awo. Jakisoni wotereyu amatha kupulumutsa moyo wa anthu odwala matenda ashuga okhala ndi vuto la hypoglycemic.

Jakisoni wa glucagon ndi wabwino chifukwa amatha kuyikidwa paliponse pakhungu kapena minofu, mwachitsanzo, ntchafu. Lamuloli silifunikira kuyeretsedwa musanalowe jakisoni, popeza mphindi iliyonse amawerengera. Mutha kubayikiranso glucagon kudzera mu zovala (mwachitsanzo, mpaka thalauza lanu).

Glucagon imagwiritsidwa ntchito popereka chithandizo chadzidzidzi cha hypoglycemic coma.

Mukayika jakisoni wa glucose, ndiye kuti mulingo wotsatira: 30-50 ml ya 40-50% shuga, ndiye 10-25 g ya shuga.Ngati chikomokere cha hypoglycemic chikuchitika mwa mwana, tikulimbikitsidwa kupaka jekeseni ya 20% ya glucose pa mlingo wa 2 ml / kg thupi. Ngati wodwalayo sakuchira, bwerezani mankhwalawo. Ngati sizithandiza, itanani ambulansi.

Ngati glucagon kapena glucose sakanakhoza kubereka, ndipo mano a wodwalayo amapukusidwa kotero kuti ndi kosatheka kutsanulira lokoma, ikani wodwalayo pamalo oyima ndikuyitanitsa ambulansi mwachangu.

Ngati wodwala mwiniyo wachoka osakhudzidwa ndi ambulansi isanafike, nthawi yomweyo mumupatse chakumwa chokoma kapena chakumwa chokoma (tiyi wotsekemera, cola). Pambuyo pake, ndikulimbikitsidwa kudya chakudya pang'onopang'ono - mkate kapena phala.

Atapereka chisamaliro chodzidzimutsa, mkhalidwe wa wodwalayo, monga lamulo, umakhazikika. Pambuyo pake, pendani zomwe zimayambitsa hypoglycemic coma ndikusintha mlingo wa mankhwalawo kapena chakudya kuti izi zisadzabwerenso.

Hypoglycemic coma - akufotokoza Pulofesa S.A. Rabinovich

Hypoglycemic coma ndi njira yodutsitsa mkati mwa mitsempha yaumunthu yomwe imayambitsidwa ndi kuperewera kwakukulu kwa glucose m'magazi kuti ipereke maselo aubongo, minofu ndi maselo ena amthupi. Mkhalidwe wa hypoglycemic coma umakula mwachangu, chifukwa chake, kupsinjika kwa chikumbumtima ndi ntchito zonse zofunika zimachitika. Mukapatsa uchi woyamba. machitidwe othandizira omwe amawopseza moyo wa munthu ndi otheka: kumangidwa kwa mtima, kulephera kwapakati pa medulla oblongata.

Hypoglycemic coma ndi lingaliro lomveka lazitali la hypoglycemia. Chifukwa chake, ndikofunikira kwambiri kuti muzitha kuzindikira dziko loyambirira - hypoglycemia.

Hypoglycemic coma zizindikiro

The chipatala cha hypoglycemic chikomola mwa odwala ambiri amayamba kuthira mafuta; mu ola loyamba, ochepa amalabadira zomwe amamva. Kuwonetsera koyambirira kwa kuchepa kwa misempha yamagazi kumalumikizidwa ndi "kufa ndi njala" yaubongo ndi njira zokhudzana ndi ma protein mu ma neurocytes ndi ma synapses (ma cell aubongo), chifukwa maselo amayamba kupanga mphamvu kuzinthu zosungidwa zomwe sizolinga zake. Poyerekeza ndi kufooka, chimakula, chomwe sichimachotsedwa ndi ma pinkiller. Kuzizira kwa manja ndi miyendo, chinyezi cha m'manja ndi kumapazi zimadziwika. Kuwala kotentha kumawonekera, ndipo nthawi yotentha, kukomoka kumatha kuchitika chifukwa cha kusokonezeka kwa kayendedwe ka magazi ndi kayendedwe ka magazi.

Pallor ndi dzanzi (kumva kukuwa) kwa mbali yamkati mwa nasolabial, yomwe imawonetsa momveka bwino kuchuluka kwa ubongo ndi mpweya ndi glucose, zimadziwika. M'dziko lino, anthu amakhala achiwawa, osafuna kutsutsidwa. Ndi kuwonjezeka kwa hypoglycemia, kutopa kumawonjezeka, ndipo kuchuluka kwa ntchito kumachepa kwambiri, makamaka pamlingo waluntha. Kupuma pang'ono kumawoneka pakuyenda komanso kupepuka. Kutsika kwakanthawi kwamawonekedwe owoneka kumatheka mpaka gawo lama glucose lifunika. Popita nthawi, kunjenjemera kwa zala, ndipo pambuyo pake magulu ena a minofu, amakula.

Odwala onse popanda kusiyanasiyana amakhala ndi chidwi champhamvu chanjala. Nthawi zina amatchulidwa kotero kuti amafotokozeredwa ngati kumverera kwakumaso pa nseru.

Pambuyo pake pakukhazikika kwa kukomoka kwa hypoglycemic, kuwoneka kawiri ndikotheka, kuvuta kuyang'ana maso, kusawona bwino mitundu (mitundu imawoneka yosalala kapena chilichonse chozungulira chimakhala chamtundu wamaso).

Kuphwanya m'dera la mitsempha yoyendetsera kayendedwe ka mitsempha kumayambitsa kuchepa kwa kayendedwe kolondola, komwe kumatha kubweretsa ngozi kuntchito komanso kunyumba, poyendetsa galimoto komanso pochita zomwe zikuchitika.

Ngati zoterezi zakufikirani munthu panthawi yomwe amakhala kuchipatala chachipatala, ndikofunikira kuti auze anamwino ndi dotolo wopezekapo. Adzachita mayeso ofunikira (mkodzo wa acetone, magazi a shuga) ndikupitilira ndi mankhwala a hypoglycemic coma.

Mwa zovuta zomwe zili mu mtima., Tachycardia yowonjezereka iyenera kudziwidwa. Awa ndi mtundu wa kusokonezeka kwa mitsempha ya mtima. Nthawi zina, tachycardia imatha kugunda mpaka 100 mpaka 145 kapena kupitirira pamphindi, ndipo kumakhala ndi mantha, kupuma movutikira, kutentha kwamphamvu kumalumikizana ndikumva kugunda kwa mtima. Mukamamwa zakudya zopatsa mphamvu monga zakudya zotsekemera (tiyi wotsekemera, maswiti, shuga) mtima umakhazikika “pansi,” ma beats pafupipafupi amatsika, ndipo zizindikilo zina zimatha popanda kufufuza.

Zizindikiro za hypoglycemic chikomokere

Hypoglycemic coma ndi imodzi mwazikhalidwe zochepa zomwe zimakhala ndi chitukuko chokwanira. Zizindikiro zomwe zimakhala zokhazo za hypoglycemic coma ziyenera kulimbikitsa kuperekedwa kwa thandizo loyamba ndi thandizo loyamba. Zoonadi, pakukomoka, thupi la munthu lili pafupi ndi mzere wamoyo ndi imfa, ndipo cholakwika chilichonse chamankhwala kapena chithandizo chadzidzidzi chimatha kupha.

Boma la precomatose lili ndi zinthu zingapo: kugunda kwakuthwa kwa ukoloni ndi kuponderezedwa kapena khunyu. Zimayamba ndikupindika kwa minofu mthupi lonse ndipo zimakulirakulira mwachangu kwambiri - kugwidwa mwamphamvu. Vutoli limakhala lowopsa chifukwa limawonekera mosayembekezereka, ndipo munthu akhoza kukhala wovulala pa ngozi yagalimoto, kugwa kuchokera kumtunda.

Mkhalidwe wa hypoglycemic chikomichi chimachitika chifukwa cha zomwe medulla oblongata amapanga hypoglycemia. Pakufufuza kwatsatanetsatane: khungu limakhala lotumbululuka, lozizira, thukuta lomata, kupuma kumafooka pang'ono, kuthamanga kwa magazi ndikwacibadwa kapena kukwezedwa, zimachitika ndizobwinobwino kapena kuwonjezeka pang'ono, mawondo ndi maondo amawongolera.

Kuzindikira kulibe, zomwe zikuwonetsedwa ndi kusayankha kwa chidwi cha thupi, mwachitsanzo, kumayenda pamasaya, kufuula, kumadzuka ndi madzi ozizira ndi njira zina zothandizira "kudzuka". Milandu yambiri idalembedwa pomwe anthu, atatha kupuma kwa hypoglycemic coma, akuti awona chilichonse chikuchitika kuchokera kumbali. Izi sizitsimikiziridwa ndi sayansi ndipo zimawerengedwa kuti ndi zabodza kwambiri munthu akamwalira.

Mayankho mu magawo oyamba a kukomoka kwa hypoglycemic amasintha pang'ono. Koma chovuta kwambiri ndikulephera kwa kupuma. Izi zikutanthauza kuti kupuma kwa wodwalayo (mtundu, kufanana, kuya) kuyenera kuyang'aniridwa panthawi yoyendetsa kapena kutulutsa. Ngati kupuma kumakhala kopitilira apo, ndiye kuti, pamene kalilole ayikidwa mkamwa mwa wodwalayo pali chifuwa, ndikofunikira kuyambitsa zothandizira kupuma, popeza, mutasowa mphindi, mutha kutaya munthu.

Chipatala cha hypoglycemic coma chikuphatikiza zizindikiro zambiri zadzidzidzi, ndipo kuyerekezera kokha kwa zonse zomwe zikuwoneka pachithunzithunzi chimodzi kungathandizire othandizira pangozi, wachibale kapena wamba wakupereka chithandizo choyenera.

Ngati munthu walandila thandizo moyenera, amadzuka mphindi 10-30 (pakadalibe zovuta za chikomokere).

Chithandizo cha hypoglycemic chikomokere

Pofuna kuchiza matenda oopsa monga hypoglycemic coma kuti ikhale yogwira mtima, muyenera kuwonetsetsa kuti vutoli likomoka, ndiye kuti chikomokere ndi hypoglycemic. Kuzindikira koyenera ndikofunikira kwambiri pankhaniyi. Mwachitsanzo, ngati chikomokere cha hyperglycemic chikukayikiridwa, njira yoyambira yothetsera shuga ingaphe.

Zambiri zimatengera ngati pali mboni zomwe zingafotokoze zomwe munthu akuchita asanataye chikumbumtima chake, kufotokoza madandaulo ake, kupereka zambiri zamankhwala omwe wodwala akhala akumwa posachedwapa.Ngati mboni zatsimikizira kukhudzidwa, ndipo pambuyo poti wathedwa nzeru, koyambirira kwa insulin, kapena kufa kwa nthawi yayitali ndi wolakwiridwayo, ndiye kuti njira zotsitsimutsa ndi matenda a hypoglycemic coma zitha kuyambitsidwa bwino. Ndipo ngati munthu wapezeka kale ali osazindikira, palibe chilichonse chogwiritsa ntchito mankhwala (insulin kapena mankhwala ochepetsa shuga) pafupi, ndiye muyenera kumapita naye kuchipatala, komwe amayesa mwachangu kuchuluka kwa shuga, acetone, matupi a ketone, ndi pambuyo - achire miyeso.

Mu gawo loyambirira la chitukuko cha hypoglycemic coma (mkhalidwe wa hypoglycemia), njira yabwino kwambiri ya prophylactic ya kukomoka ndi kudya zakudya zotsekemera komanso zopatsa mphamvu. Nthawi yomweyo, maswiti amtundu wa chokoleti sayenera kudyedwa, chifukwa amakhala ndi mafuta osiyanasiyana, zonunkhira, othandizira zonunkhira zoyambira zabodza komanso shuga pang'ono. Ndibwino kuti munthu wodwala matenda ashuga azinyamula zikwama zingapo m thumba lawo, koma osati chokoleti.

Dokotala amayenera kulankhula ndi anthu omwe ali ndi matenda ashuga, makamaka ndi ana kapena makolo awo, zakufunika kwa kudya, kumwa mankhwala, komanso kagawidwe koyenera ka zochitika zolimbitsa thupi.

Musamale ndi insulin yotalikilapo. Ndikulimbikitsidwa kuti ziziperekedwa pansi pa khungu la m'chiuno kapena phewa, popeza mayamwidwe ake m'malo awa pang'onopang'ono. Ntchito yofunikira kwambiri ndikupanga kafukufuku wamasana masana. Izi zikuthandizira ntchito yosankha insulin kuti iyende usiku ndipo izitha kuteteza hypoglycemia kugona.

Anthu omwe ali ndi matenda amtundu woyamba a shuga amafunika kudya malinga ndi momwe amafunikira mphamvu. Mwanjira ina, kuchuluka kwa zopatsa mphamvu zomwe zikubwera ziyenera kugwiritsidwa ntchito mokwanira ndi thupi, ndipo kuchuluka kwa insulin yomwe ingabayidwe kuyenera kugwirizana ndi chakudya chamafuta. Kuthandizira kuwerengera kwa zopatsa mphamvu mwa odwala kungagwiritsidwe ntchito m'magome osiyanasiyana osonyeza kufunika kwa zopatsa zanu zonse komanso chakudya chokwanira. Koma kuwerengetsa katundu wa chakudya mu zinthu zomwe amagwiritsa ntchito buledi. Chimodzi mwa zinthu ngati izi chimafanana ndi magalamu 12 a zakudya komanso zakudya zamafuta. Kapena 25 magalamu a mkate wamba. Magawo a mkate amagwiritsidwa ntchito podziletsa pakudya kwa anthu odwala matenda ashuga, amapangidwa kuti azitha kusintha mtundu wa anthu odwala matenda ashuga, kuwazolowera kukhala ndi udindo paumoyo wawo.

Zochizira za hypoglycemic coma, 10% solution ya glucose mu 100 mpaka 250 milliliters imagwiritsidwa ntchito. Izi ndizofunikira kuti shuga azikhala nthawi zonse m'magazi. Ngati wodwalayo sanadzayambenso kuphwanya shuga, njira ziyenera kutengedwa kuti muchepetse matenda a ubongo - mothandizidwa mwamphamvu ndi 15% yankho la Mannitol kuchokera pa 1 mpaka 2,5 milligrams pa kilogalamu ya kulemera kwa thupi, ndikulowetsedwa ndi Furosemide (Lasix) 75 - 110 mg m'mitsempha. Mannitol ndi woimira gulu la osmotic diuretics, zochita zake zimakhazikitsidwa ndi malamulo akuthupi a kayendedwe ka mamolekyulu am'madzi ndi mankhwala osokoneza bongo. Imayikidwa osasinthika ndi mamolekyu amadzi. Lasix imathandizanso mu zida za aimpso, imathandizira kupangika kwa mkodzo ndi chimbudzi chake. Iyenera kuperekedwa mosamala kwambiri, chifukwa imatha kuyambitsa ma profuse diuresis - kusasiya kwamadzi ndi thupi.

Pankhani yoletsa kapena kuchiza matenda amtundu wa hypoglycemic coma, mankhwala monga Piracetam kapena Nootropil ali oyenera. Mankhwalawa ndi oimira ena otchedwa nootropics - mankhwala omwe amasintha kufalitsa kwa chithokomiro.Amagwiritsidwanso ntchito kwa okalamba komanso odwala omwe adachita ngozi yapakhungu. Poletsa kuchuluka kwambiri kwa kuthamanga kwa magazi mu ziwiya zaubongo, njira yogwiritsira ntchito magnesium sulfate, yomwe imadziwika bwino kuti Magnesia, imagwiritsidwa ntchito. Nthawi zambiri kutumikiridwa mpaka 10 ml (kutengera kulemera kwa thupi) mu ndende yopanda 25%.

Kukhazikitsidwa kwa yankho la glucose kuyenera kuchitika motsogozedwa ndi labotale ya mulingo wake m'magazi. Masewera a glucose akafika 14 - 16 mmol pa lita imodzi, insulini yotsalira yochepa iyenera kuperekedwa mosavomerezeka panthawi yayitali mpaka maola 6 mpaka 5 aliwonse.

Zoyambitsa Matenda a shuga

Matenda a shuga asamachitike nthawi zambiri, koma amakhala ndi zotsatirapo zoyipa kwa wodwalayo. Pali zifukwa ziwiri zazikulu zochepetsera shuga mpaka mulingo wosavomerezeka:

1. Magazi amakhala ndi insulini yambiri. Awa ndi mahomoni omwe amafunika kuperekera shuga m'maselo a thupi. Ngati ndizochulukirapo, ndiye kuti shuga mumagazi amayamba kuchepa, ndipo minofu yake imakulanso.
2. Osakwanira kudya shuga m'magazi pamlingo wambiri wa insulin. Kuphwanya kumeneku kumachitika chifukwa cha mavuto azakudya kapena kuchita masewera olimbitsa thupi mopitirira muyeso.

Anthu odwala matenda ashuga ayenera kutsatira malangizo onse a dokotala. Zakudya zopanda pake, mlingo wosayenera mukalandira insulin, kapena kuphwanya njira ya jakisoni, zakudya zopanda pake, kapena kumwa mankhwala osokoneza bongo kumatha kubweretsa boma la hypoglycemic, ndipo chisamaliro chodzidzimutsa pamenepa ziyenera kuperekedwa moyenera komanso munthawi yochepa kwambiri, apo ayi wodwalayo angafe.

Zowopsa kwa odwala matenda ashuga komanso mankhwala omwe amachepetsa shuga ya magazi. Mwachitsanzo, mankhwala osokoneza bongo a Glibenclamide angayambitse kugwa kwamphamvu kwa glucose. Zotsatira zake, chithunzi chotchedwa shuga chikomokere chimayamba.

Zizindikiro za dziko la hypoglycemic

Akadwala amene amadwala matenda ashuga samachitika mwadzidzidzi. Nthawi zambiri amamutsogolera ndi precom. Ngati ndizotheka kuzizindikira m'nthawi yake, ndiye kuti thandizo lomwe lingaperekedwe likuthandizirani kuti musakhale mu mpumulo. Muyenera kuchitapo kanthu mwachangu: mphindi 10-20.

Zizindikiro zamtunduwu zithandizira kuzindikira precom. Maselo aubongo ndiye woyamba kuvutika ndi kudumpha kwa glucose, kotero wodwala amayamba kudandaula:

• Chizungulire
• Kufooka ndi kupanda chidwi
• Kugona
• Njala
• Kugwedeza manja
• Kuchulukitsa thukuta.

Kuchokera pakusintha kwakunja, khungu la khungu limatha kuzindikira. Kuti tithane ndi izi, ndikokwanira kupatsa tiyi wokoma wa shuga, maswiti kapena shuga pang'ono. Mafuta a chokoleti kuchokera ku chokoleti kapena ayisikilimu amawayamwa pang'onopang'ono, motero sizoyenera.

Kuchuluka kwa shuga kosayembekezereka kumakulitsa kuyambika kwa zizindikiro. Ndipo akhala akudziwika kale chifukwa cha kukomoka. Pali zosokoneza pamalankhulidwe ndi mgwirizano wamachitidwe. Nthawi yotsatira, odwala matenda ashuga - kukomoka kumayamba.

Zizindikiro za chikomokere

Ngati wodwala sanathandizidwe ndi hypoglycemia, amagwa ndi shuga. Wodwala matenda ashuga sadziwa kale. Zizindikiro zake zikuwonetsa kuukira:

• Khungu, lozizira komanso loyera pakhungu,
• Thukuta,
• Zingwe
• Zosangalatsa pamtima
• Kubweza
• Zofooka zazing'ono pakuwala.

Mukakweza matope a wodwala, mutha kuwona kuti ana ake amapukusidwa kwambiri. Kuopsa kwa kukomoka kumachitika chifukwa chakuti munthu amagwera mwadzidzidzi. Nthawi yomweyo, amatha kulandira zowonjezera zina: kukhala nawo nawo pangozi, kugwa kuchokera kumtunda, ndikuvulala kwambiri.

Ndi chifuwa cha hypoglycemic, algorithm yolondola yokhala ndi vuto ladzidzidzi imatenga gawo lalikulu: kupopera madzi, kusenda nkhope ndikufuula sikungabwezeretse wodwalayo malingaliro. Njira zonse zachangu zikuyenera kumwedwa mpaka ntchito yothandizira kupumula kwa odwala matenda ashuga.

Glycemic Revenue Sequence

Musanatenge chilichonse, onetsetsani kuti musanakhale ndi vuto la hypoglycemic. Kuti muchite izi, ngati kuli kotheka, funsani wodwalayo kapena muwone momwe zonse zidachitikira, ndi ena. Kumbali yanu, chisamaliro chodzidzimutsa chomwe chimakhala ndi vuto la kuchepa kwa thupi chikuwoneka motere:

1. Sankhani shuga yanu yamagazi ndi glucometer.
2. Muyikeni wodwala pambali pake, yeretsani zamkati kuchokera kuzotsalira za chakudya.
3. Apatseni wodwala othamanga kwambiri.
4. Chitanani foni mwachangu nthawi yomweyo.
5. Pamaso pa syringe ndi Glucagon, lowetsani mosapitirira 1 ml.

Sizoletsedwa kutsanulira zakumwa zotsekemera mkamwa mwa munthu amene wakwiya. Izi zimapangitsa kuti asphyxiation. Pachimake zovuta za chikomokere akhoza kukhala edema kapena zotupa mkati mwake. Kuthamanga kwa zomwe mumachita komanso kutsatira njira zolondola pamachitidwe otere kungapulumutse moyo wa munthu.

Chithandizo cha mankhwala akumwa

Ngati wodwala yemwe ali ndi vuto la kuchepa kwa vutoli atengedwa kupita kuchipatala, ndiye kuti amamulembera maphunziro ake. Gawo lake loyamba ndikukhazikitsa mayeso a 40% a glucose mpaka 110 ml, kutengera kulemera kwa thupi. Zitatha izi chithunzithunzi cha chipere sichingasinthe, amayamba kuwongolera njira yomweyo, koma ndi kupsinjika pang'ono komanso kwakukulu. Ngati chikomokere chikuchitika chifukwa cha mankhwala osokoneza bongo omwe amachepetsa shuga, ndiye kuti shuga amayamba kulumikizidwa mpaka glycemia wabwinobwino ndikuchotsa kwathunthu zotsalira zamankhwala omwe atengedwa m'thupi.

Kupewa kwa edema yam'mimba imalola kuti mtsempha azitsegulidwe ndi okodzetsa (Mannitol, Manitol, Furosemide, Lasix). Munthawi yamankhwala, dokotala wamtima ndi wamanjinga amayeneranso kuyeserera kupewa kuti zovuta zisachitike. Pambuyo pa kumasuka kwawo, wodwalayo amayang'aniridwa ndi endocrinologist. Amamulembera mayeso ofunikira kuti adziwe momwe odwala matenda ashuga am'pezere chakudya.

Zomwe zimayambitsa matendawa komanso zomwe zimayambitsa ngozi

The pathogenesis ya matenda amatengera zifukwa zotsatirazi:

• Kumwa kwambiri mankhwala oletsa kuchepetsa shuga kapena magazi.
• Mlingo wa insulin utatha, kuchuluka kwa chakudya chamafuta kumakhala kokwanira.
• Kupendekera kwakukulu kwa kaminsulin.
• Kuyesa kuchepetsa ntchito ya insulin.
• Hyperinsulinism.
• Kulimbitsa thupi chifukwa chomwa mowa kwambiri.

Nthawi zina, hypoglycemia imachitika pazifukwa zotsatirazi, zomwe zimalembedwa nthawi zambiri:

1. Mankhwala osokoneza bongo a aspirin kapena a beta-adrinoblockers.
2. Pamaso pa kulephera aimpso, nthawi yovuta.
3. Maonekedwe a hepatocellular carcinoma.
4. Kuperewera kwachilengedwe.

Zonsezi zimapangitsa kutsika kwa shuga.

Hypoglycemic coma nthawi zina imafanana ndi ubongo hypoxia. Popeza ndikulowerera pang'ono kwa glucose kulowa m'magazi, mphamvu ya kufa kwa maselo muubongo imachitika, ntchito ya oxidation ndikuchira imasokonekera mwa iwo. Zotsatira zake, kuwonongeka kwa ma cell ndi ma organic kumachitika, ndipo kufa kwawo pang'onopang'ono.

Mitsempha ya mitsempha yamatumbo am'mimba imatha kugonjetsedwa ndi hypoglycemia, pomwe zoyambira za medulla oblongata ndizosavuta. Pachifukwa ichi, ngakhale ndi kuyamba kwa hypoglycemic coma mwa anthu, mtima, kutulutsa kwam'mimba komanso ziwalo zopumira zimagwira ntchito kwanthawi yayitali.

Zizindikiro zazikulu za hypoglycemia ndi hyperglycemia

Hyperglycemia ndi yovuta komanso yopweteka. Zizindikiro zake zazikulu ndikuwonetsera thupi:

• munthu amakhala ndi ludzu nthawi zonse,
• kukodza pafupipafupi,
• kutopa,
• kuwonda
• mawonekedwe osaneneka
• khungu louma, chifukwa cha kuyabwa kumeneku kumawonekera
• mawonekedwe a arrhasmia,
• Kupuma kwa Kussmaul kumayamba,
• kukhalapo kwa matenda ena omwe ndiovuta kuchiza ndikuyamba kukhala aulesi (otitis media, candidiasis, etc.),
• chikomokere.

Mu hyperglycemia pachimake, zizindikiro zotsatirazi zingawonjezedwe:

• chikumbumtima
• ketoacidosis
• kuchepa madzi m'thupi kwambiri, komwe kumayamba chifukwa cha osmotic diuresis ndi glucosuria.

Hypoglycemia imagawidwa kukhala boma lanyama komanso neuroglycopenic, ndipo matendawa amatengera mtundu wa mawonekedwe.

Ndi michere hypoglycemia, zizindikiro zotsatirazi zimayamba:

• munthu amakhala wankhanza kapena wokonda kukangana, mkhalidwe wamavuto umawonekera,
• thukuta
• kunjenjemera kwa minofu ndi matenda oopsa,
• kuthamanga kwa magazi
• ana opukusidwa
• khungu
• arrhasmia,
• pafupipafupi nseru, zomwe nthawi zina zimayambitsa kusanza,
• kufooka wamba
• kumangokhalira kumva njala.

Momwe ma neuroglycopenic amatha kudziwonetsera ndi zizindikiro zofanana:

• kuchepa kwa chidwi,
• mutu ndi chizungulire
• munthu atha kutaya kuyang'ana malo,
• kusokoneza mgwirizano
• paresthesia limayamba,
• pawiri pamaso
• Khalidwe limakhala losakwanira
• kuiwalika
• kayendedwe ka magazi ndi kupuma zimasokonekera,
• ndikufuna kugona nthawi zonse,
• kudziwa zolakwika
• kukula kwa nyengo zakomoka, nthawi zina kukomoka,
• kugwa.

Munthu amene akudwala matenda ashuga ayenera kudziwa zizindikiro za matendawa. Izi ndizofunikira kuti athe kupereka chithandizo chadzidzidzi cha chikomokere kwa hypoglycemic.

Momwe mungadziwire matendawa a hypoglycemic kumayambiriro kwa matendawa

Coma imatha kuchitika mwachangu. Kumuchenjeza ndizovuta kwambiri. Ndikofunika kuyang'ana munthu mosamala kuti mupereke chithandizo choyambirira panthawi yake popanda zovuta zina. Izi ndichifukwa choti nthendayi imadzetsa chiwopsezo pamoyo.

Mkhalidwe wokongola ukuwonekera ndi izi:

• Ziphuphu zamtundu wa tonic ndi tonic zimafanana ndi kugwidwa khunyu.
• Zizindikiro zimayamba mosayembekezereka. Chifukwa chake, amatha kuyambitsa ngozi, kugwa kuchokera kumtunda, etc.
• Chizindikiro china cha matendawa ndi kusazindikira, ndipo ana amapezeka mwa munthu.
• Ngati mungayang'anire wodwalayo mwatsatanetsatane, ndiye kuti chikomacho chikuwoneka ndi khungu.
• Pali kuwonjezeka kwa mawondo ndi mawondo.
• Popeza chikumbumtima chimalephera, munthu sangayankhe kukondoweza kwakunja - kuwala kowala, kuwombera m'masaya, kupopera madzi, ndi zina zambiri.

Kumayambiriro kwa chikomokere, kupuma kumasintha pang'ono. Pali chiopsezo cha kupuma kwathunthu. Chifukwa chake, chinthu ichi chiyenera kuperekedwa mwachidwi, chifukwa pa kayendedwe ka wodwalayo akhoza kupuma.

Kuti muwone ngati pali kupuma kosasunthika, ndikofunikira kubweretsa kalilidwe pakamwa pa munthu, yemwe akuyenera kuyamba. Pankhaniyi, ndikofunikira kuyambitsa chothandizira kupuma, chifukwa mutayamba kukhala chikomokere, munthu amatha kusiya kupuma.

Njira zoyesera

Malinga ndi magawo a labotale, kukomoka kwa hypoglycemic kumachitika pamene shuga m'magazi sachepera 3 mmol / l. Koma izi sizingakhale muyezo kwa aliyense, popeza odwala ena adakomoka ndi magazi a 5-7 mmol / l ngakhale zina zambiri. Komanso, matenda a hypoglycemic amatha kutsimikizika pakupereka shuga m'mitsempha ndipo thupi liziwonetsa zotsatira zabwino.

Kusamalira mwadzidzidzi komanso chisamaliro chachikulu

Ngati munthu akumva kuti ali ndi vuto, ndiye kuti mutha kuthandizira. Pakadali pano, ndikulimbikitsidwa kumwa tiyi wokoma, kudya shuga kapena maswiti.Zakudya zilizonse zothamanga zamagalimoto zimachita.

Nthawi yomweyo, yankho la glycogen limatha kuwonjezeredwa. Monga lamulo, odwala matenda a shuga amachenjezedwa zofananazo ndipo ayenera kukhala ndi chinthuchi mgulidwe. Pakakhala ngozi, imayendetsedwa intramuscularly. Ichi ndi thandizo ladzidzidzi la hypoglycemic coma, yomwe mutha kudzipangira nokha. Ngati palibe zotheka, imbani ambulansi nthawi yomweyo.

Kufika madokotala mwachangu jekeseni wa 40% m'mitsempha. Pambuyo apo shuga ndi jekeseni ndikuthothoka, ndikofunikira, ngakhale wodwalayo akumva bwino, popeza pamakhalanso mwayi wofanana ndi womwewo mobwerezabwereza. Nthawi zambiri, izi zimathandiza munthu kupewa chitukuko cha hypoglycemic coma.

Ngati zochita za glucose sizinathandize, pakhoza kukhala zifukwa zina za hypoglycemic coma:

1. Choyamba, kholo limakhala kwa nthawi yayitali ndipo njira zake sizinasinthe.
2. Chachiwiri - pali zolakwika zina.

Poyamba, kagayidwe kazakudya kamene kamatha, chifukwa kuchepa kwa glucose kumatchulidwa kwambiri, ndipo kumakhala ndi maphunziro a nthawi yayitali. Ma elekitirodiya samadutsa nembanemba. Ngakhale magazi atadzaza ndi ma carbohydrate, ma neuron ena amakhala osathandiza kale. Mbali inayo, zimatenga nthawi kuti munthu ayambirenso. Kusamutsa wodwala ku makina mpweya wabwino kumafunika, zotsatirazi zimachitika:

1. Kugwiritsa ntchito ndalama kubwezeretsa mawu.
2. Kusamalira minofu yamtima.

Machitidwe awa amatchedwa inotropic thandizo.

Potere, kuyendetsa shuga kokha sikokwanira. Amasinthidwa ndi kusakaniza polarizing. Lili ndi:

• 5% shuga
• potaziyamu mankhwala enaake mu njira,
• insulin

Ichi ndi chithandizo choyamba cha hypoglycemic coma.

Mankhwala otsala amadziwitsidwa ndi adotolo potengera zomwe wodwala akuonetsa. Maantibayotiki atha kutumikiridwa kuti ateteze matenda a nosocomial. Chifukwa chake, chithandizo chowonjezera cha hypoglycemic coma chimachitika monga adanenera dokotala. Imayang'ana kwambiri za matenda amtunduwu ndi machitidwe a thupi la wodwalayo.

Kuteteza matenda

Amadziwika kuti hypoglycemic coma imayamba makamaka mwa odwala matenda a shuga. Chifukwa chake, choyambirira, ndikofunikira kuthana ndi kupewa matenda. Ngati muli ndi matenda ashuga, muyenera kuthana ndi chithandizo chake kapena kukonza matendawa. Payenera kukhala chizolowezi chomwa mankhwalawa pafupipafupi komanso mankhwala ena, dokotalayo ayenera kuuza wodwalayo zifukwa zake komanso zifukwa zina zoteteza (hypoglycemic), komanso njira zopewera. Ndikofunika kukumbukira kuti zoterezi zimatha kukhazikika pokhudzana ndi maziko a kupsinjika kwa thupi kapena kudya kosayenera kwa chakudya.

Nkhaniyi imapezekanso m'zilankhulo izi: Thai