Kuwerengeredwa kwa insulin Mlingo wa kuchuluka kwa shuga mu njira

Zisonyezero zamagwiritsidwe:kuwerengera mlingo wa insulin poyambitsa njira ya shuga.

Cholinga cha maphunziro

- kuwerengetsa mlingo wa insulin ndi kuchuluka kwa shuga mu njira.

Zida zakuthupi:

- Kalata yotsimikizira wodwalayo,

- botolo lokhala ndi shuga wa 20% - 400 ml,

Thandizo lodzidzimutsa la hyperglycemic coma

Zisonyezero zamagwiritsidwe: chisamaliro chadzidzidzi.

Zida zakuthupi:

1. Kukonzekera.

2. Sterile syringes wa jakisoni, njira imodzi yogwiritsira ntchito kukonzekera kwamadzi amkati, bi-x yokhala ndi zida zosalimba.

3. Mwachangu insulin.

4. Isotonic yankho.

5. Metazone kapena norepinephrine.

6. Thireyi, zopukutira, ma foloko, ma diapodi, mafuta osalala.

Chisamaliro chadzidzidzi cha uremic chikomokere

Zisonyezero zamagwiritsidwe: chisamaliro chadzidzidzi.

Zida zakuthupi:

1. Kukonzekera.

2. Sterile syringes wa jakisoni, njira imodzi yogwiritsira ntchito kukonzekera kwamadzi amkati, bi-x yokhala ndi zida zosalimba.

3. thireyi, ma foloko, zopukutira, magolovesi a mphira, gulu la mphira, mtsamiro.

4. Mankhwala: glucose 40%, 5%, vitamini C, prednisone, koloko yothetsera, isotonic sodium chloride solution, atropine, droperidol.

5. Zipangizo zam'mimbamo zam'mimba, kuyika enema yotsuka.

Masewera a Carotid Mtima

Zisonyezero zamagwiritsidwe: muzindikire zizindikiro za kufa matenda

Cholinga cha maphunziro

Kutha kutero

- kudziwa kukhalapo kwa kugunda pa carotid artery

№	Etapi	Zmist	Kulungamitsidwa
1.	Kukonzekera Koyamba Kuchita	1. Wovutitsidwayo wagona pamalo olimba 2. Pewani kuyanjana ndi magazi ndi zodetsa zina za womenyedwayo	Samalirani chitetezo chanu.
2.	Kwakukulu	3. Ikani zala zinayi kutsogolo kwa khosi lomwe lakhudzidwalo, poyambira pakati pa trachea ndi sternocleidomastoid minofu ndikuwona kugunda	Pezani zonena za chotupa cha carotid
3.	Kumaliza Kumaliza	4. Yang'anani kusowa kwa chikwangwani

Sanapeze zomwe mukuyang'ana? Gwiritsani ntchito kusaka:

Mawu abwino:Loto lokha lomwe limabweretsa wophunzirayo kumapeto kwa nkhaniyo. Koma kumenya wina kumulepheretsa. 8567 - | 7389 - kapena werengani zonse.

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ndi kutsitsimutsa tsambalo (F5)
amafunikira

Glucose, 200 mg / ml ndi kulowetsedwa kwa 400 mg / ml

Dzina Chemical. D - (+) - glucopyranose

Makhalidwe wamba. Mankhwalawa ndi wopanda mawonekedwe kapena pang'ono poyera chikasu

The zikuchokera mankhwala.

200 mg / ml

400 mg / ml

0,1 M hydrochloric yankho

Madzi a jakisoni

Kutulutsa Fomu. Kulowetsedwa njira

Gulu la Pharmacotherapeutic. Njira zothetsera mtsempha wamkati. Njira zothandizira makolo zakudya.

Khodi ya PBX. B05BA03

Mankhwala

Mankhwala Plasma m'malo, kupatsanso madzi, metabolic ndi detoxization wothandizira. Makina ochitapo kanthu ndi chifukwa cha kuphatikiza kwa glucose m'magulu a mphamvu (glycolysis) ndi pulasitiki (transamination, lipogenesis, nucleotide synthesis) kagayidwe.

Amatenga mbali zosiyanasiyana kagayidwe kachakudya mu thupi, timapitiriza redox njira mu thupi, bwino antitoxic ntchito chiwindi. Glucose, kulowa minofu, phosphorylates, kusintha glucose-6-phosphate, amene amachita nawo mbali zambiri za kagayidwe kachakudya thupi. Ndi kagayidwe ka e-glucose mu zimakhala

mphamvu yayikulu imamasulidwa yofunikira pa moyo wa thupi.

400 mg / ml ya glucose solution ndi hypertonic poyerekeza ndi madzi am'magazi, atakhala ndi zochitika za osmotic. Ikaperekedwa kudzera m'mitsempha, imathandizira kutulutsa kwamatenda m'magazi amitsempha ndikuigwirizira. Kuchulukitsa diuresis, kumawonjezera chimbudzi cha poizoni mkodzo, kusintha ntchito ya chiwindi.

Ikaphatikizidwa ku isotonic state (50-100 mg / ml solution) imabwezeretsa kuchuluka kwa madzi otaika, imasunga kuchuluka kwa madzi obaya.

yankho la 200 mg / ml - 1278 mOsmol / kg,

yankho la 400 mg / ml - 2989 mOsmol / kg.

Pharmacokinetics Mothandizidwa ndi mtsempha wa magazi, njira ya glucose imachoka mwachangu pabedi lamankhwala. Thupi limasinthidwa

m'mbali mwa hexose phosphate njira - njira yayikulu ya mphamvu ya kagayidwe kachulukidwe kamapangidwe kakapangidwe ka macroergic (ATP) ndi njira ya pentose phosphate - njira yayikulu ya kagayidwe kamapulasitiki ndikupanga ma nucleotides, amino acid, glycerol.

Ma mamolekyulu a glucose amagwiritsidwa ntchito popanga mphamvu zamthupi.

Glucose omwe amalowa ndi ma phosphorylates, amakhala glucose-6-phosphate, yemwe pambuyo pake amaphatikizidwa ndi metabolism (zotsatira zomaliza za metabolism ndi mpweya ndi madzi). Imalowa mosavuta mu zotchinga za histoeticological mu ziwalo zonse komanso

Imamizidwa kwathunthu ndi thupi, siyimapukutidwa ndi impso (mawonekedwe a mkodzo ndi chizindikiro cha pathological).

Zizindikiro zogwiritsidwa ntchito

Mlingo ndi makonzedwe

Asanayambe, dokotala amakakamizidwa kuti ayang'anenso chidebe cha polima ndi mankhwalawo. Njira yothetsera vutoli iyenera kukhala yoonekera, osati yokhala ndi tinthu tating'onoting'ono kapena matope Mankhwalawa amadziwika kuti ndi oyenera kugwiritsidwa ntchito pamaso pa zilembo ndikusunga zolimba za phukusi.

Hypertonic solution imayendetsedwa kudzera m'mitsempha.

Mlingo umatengera zaka, kulemera kwa thupi komanso mkhalidwe wa wodwalayo.

200 mg / ml yankho limayendetsedwa kudzera mu mtsempha wa magazi mosagwirizana mpaka 3040 akutsikira / mphindi (1.5-

2 ml / min), yomwe ikufanana ndi pafupifupi 120 ml / ola. Mlingo wapamwamba wa tsiku lililonse kwa akulu ndi 500 ml.

400 mg / ml yothetsera jekeseni imalowetsedwa kudzera m'mitsetse mpaka madontho 30 / mphindi

(1.5 ml / min), yomwe ikufanana ndi 48 ml / ola. Mlingo wapamwamba wa tsiku lililonse kwa akulu ndi 250 ml.

Mukasungunuka mpaka 100 mg / ml ya yankho, mlingo waukulu wa kulowetsedwa ukufika 60 madontho / mphindi,

voliyumu - 500 ml / tsiku. Mukasungunuka mpaka 50 mg / ml ya yankho, mulingo wambiri wa kulowetsedwa ukufika ku 150 cap / min, kuchuluka kwa oyang'anira kumafika mpaka 2 l / tsiku.

Kuti mumve kwambiri shuga yemwe amapezeka pa Mlingo waukulu, insulin imayikidwa pamodzi ndi muyeso wa 1 unit ya insulin pa 4-5 g shuga. Kwa odwala matenda a shuga, shuga amaperekedwa mosamala mothandizidwa ndi shuga ndi mkodzo.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimachitika chifukwa cha kuyambitsa kwa shuga ndi 200 ndi 400 mg / ml,

Zotsatira zoyipa za jakisoni: kupweteka kwa jekeseni, kupweteka kwa mtsempha, phlebitis, venous thrombosis,

Kusokonezeka kwa dongosolo la endocrine ndi kagayidwe: hyperglycemia, hypokalemia, hypophosphatemia, hypomagnesemia, acidosis,

Matumbo am'mimba: polydipsia, nseru,

General zimachitika thupi: Hypervolemia, thupi lawo siligwirizana (malungo, zotupa pakhungu, angioedema, mantha).

Pazochitika zoyipa, makonzedwe a yankho ayenera kuthetsedwera, mkhalidwe wa wodwalayo woyesedwa ndi kuthandizidwa uyenera kuperekedwa. Njira yothetsera vutoli iyenera kusungidwa pakuwunika pambuyo pake.

Contraindication

Glucose yothetsera 200 ndi 400 mg / ml ndi contraindicated odwala ndi:

- Intracranial ndi intraspinal hemorrhages, kupatula kwa zochitika zokhudzana ndi hypoglycemia,

- Kuthetsa madzi m'thupi, kuphatikiza mowa,

- Hypersensitivity to dextrose ndi zina za mankhwala,

- Matenda a shuga ndi zina zomwe zimayendera ndi hyperglycemia.

Osamapereka mankhwalawa nthawi imodzi ndi mankhwala a magazi.

Mimba komanso kuyamwa

Kugwiritsa ntchito mankhwalawa kwa amayi apakati omwe ali ndi Normoglycemia kungayambitse feterg hyperglycemia, metabolic acidosis. Izi ndizofunikira kuziganizira, makamaka ngati mavuto obwera chifukwa cha fetal kapena hypoxia ali kale chifukwa cha zovuta zina.

Zotsatira pakutha kuyendetsa magalimoto ndi makina owopsa.

Bongo

Ndi mankhwala osokoneza bongo, hyperglycemia, glucosuria, kuchuluka kwa osmotic kuthamanga kwa magazi (mpaka kukula kwa hyperglycemic hyperosmolar coma), kuchepa kwa magazi, kusowa kwa magazi kwa electrolyte kumayamba. Mwanjira imeneyi, mankhwalawo amathetsedwa ndipo insulin yothamanga imayikidwa payezo wa 1 unit iliyonse ya 0,45 - 0,9 mmol wa shuga wamagazi mpaka magazi a 9 mmol / l atafika.

Milingo ya glucose iyenera kuchepetsedwa pang'onopang'ono. Imodzi ndi kuikidwa kwa insulin, kulowetsedwa kwa njira zowonjezera mchere kumachitika.

Ngati ndi kotheka, chithandizo cha mankhwala ndi mankhwala.

Malangizo apadera

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa ma-electrolyte ndi kuchuluka kwa shuga mu seramu yamagazi.

Ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, ndikofunikira kuthana ndi shuga.

Sitikulimbikitsidwa kupaka yankho la glucose munthawi yovulala kwambiri muubongo, ngati mankhwalawa amatha kusokonezeka chifukwa cha kufalikira kwa matenda a chithokomiro, kupatula kuti mankhwalawa amatha kukulitsa matenda (kupatula milandu ya kukonzanso kwa hypoglycemia).

Ndi hypokalemia, kukhazikitsidwa kwa glucose solution kuyenera kuphatikizidwa ndi kukonza kwa potaziyamu (chifukwa chowopsa cha hypokalemia).

Kuti mupeze shuga wambiri m'magazi a proteinoglycemic, ndikofunikira kuphatikiza mankhwala ndi mankhwalawa (subcutaneous) mwachangu insulin pamlingo wa 1 unit pa 4-5 g ya shuga (nkhani yowuma).

Osagwiritsa ntchito yankho pang'onopang'ono komanso kudzera m'mitsempha.

Njira yothetsera shuga sayenera kutumizidwa mwachangu kapena kwa nthawi yayitali. Ngati kuzizira kumachitika pakakhala oyang'anira, mabungwe amayimitsidwa nthawi yomweyo. Popewa thrombophlebitis, muyenera kulowa pang'onopang'ono kudzera m'mitsempha yayikulu.

Ndi kulephera kwa aimpso, mtima wosakhazikika, hyponatremia, chisamaliro chapadera chimafunikira pokhazikitsa shuga, kuwunika kwa hemodynamics yapakati.

Zomwe zili mu chidebe zingagwiritsidwe ntchito kokha kwa wodwala m'modzi, pambuyo pophwanya cholimba cha chidebe, gawo losagwiritsidwa ntchito pazomwe zili m'chotengera liyenera kutayidwa.

Kuchita ndi mankhwala ena

Glucose solution 200 ndi 400 mg / ml sayenera kuperekedwa mu syringe yomweyo ndi hexamethylenetetramine, popeza glucose ndi othandizira oxidizing. Sitikulimbikitsidwa kusakaniza mayankho a alkaline mu syringe yomweyo: ndi mankhwala ochita kupanga ndi ma hypnotics, chifukwa ntchito zawo zimachepa, mayankho a alkaloids, inactivates streptomycin, amachepetsa mphamvu ya nystatin.

Mothandizidwa ndi thiazide diuretics ndi furosemide, kulolerana kwa shuga kumachepa. Insulin imalimbikitsa kukhathamiritsa kwa glucose mu zotumphukira zimakhala, imalimbikitsa mapangidwe a glycogen, kapangidwe ka mapuloteni ndi mafuta acids. Njira yothetsera shuga imachepetsa poizoni wa pyrazinamide pachiwindi. Kukhazikitsidwa kwa njira yayikulu yothetsera shuga kumapangitsa kukula kwa hypokalemia, komwe kumawonjezera kawopsedwe ka mankhwala omwe amagwiritsidwa ntchito munthawi yomweyo.

Migwirizano ndi magwiritsidwe akusungidwa. Sungani pamatenthedwe kuchokera 5 ºº mpaka 30 ºº. Pewani kufikira ana.

Tsiku lotha ntchito. Zaka 2 Osagwiritsa ntchito tsiku lanu litatha.

Maholide. Ndi mankhwala.

Kulongedza. 100 ml, 250 ml ndi 500 ml mu zotengera za polymer zotulutsira kulowetsedwa.

Chidebe chilichonse cha polima, limodzi ndi malangizo ogwiritsira ntchito kuchipatala, chimayikidwa mu thumba la pulasitiki lowonekera.

Za zipatala: chidebe chilichonse cha polima chimayikidwa mu pulasitiki yowoneka bwino ndikuyikidwa limodzi ndi malangizo ogwiritsira ntchito kuchipatala muyezo wolingana ndi kuchuluka kwa zotengera ma polima, m'makatoni okhala ndi zidutswa za 100 ml m'mapake 80 kapena 100, 250 ml m'mapaketi 40 kapena 55, 500 ml 25 kapena 30 mapaketi.

Olimba - wopanga, dziko

Belarusian-Dutch mgwirizano wa Farmland Limited Liability Company, Republic of Belarus
222603, dera la Minsk, Nesvizh, st. Leninsky, 124-3
Tele./fax. 8 (017) 2624994, tel. 8 (01770) 63939

Pole pa matenda a shuga

Kusakaniza kwa polarizing kumagwiritsidwa ntchito kwambiri pothana ndi shuga m'magazi - hypoglycemia. Matendawa amapezeka kwambiri mwa odwala matenda amishuga 1 omwe amagwiritsa ntchito jakisoni wa insulin pochiza matenda.

Kuchepetsa kwambiri shuga mu shuga kungayambitse kuchuluka kwa insulini yayikulu, mwangozi, muilowetsa mu minyewa kapena minofu ya minofu (osatinso minyewa yolumikizana), komanso kusokonezeka kwakukulu pakudya kapena kuchita zinthu zolimbitsa thupi.

Ndiwothandiza kwambiri kugwiritsa ntchito kapangidwe kake ka hypoglycemia, pomwe wodwalayo sakudziwa. Mwanjira imeneyi, msanganizo wa glucose-insulin-potaziyamu umalowetsedwa m'magazi a wodwala pogwiritsa ntchito dontho. Mtengo umakulolani kuti muwonjezere msanga wamagazi kukhala mulingo wabwinobwino ndikuletsa kufa kwa ubongo.

Ngakhale zili ndi shuga, mankhwalawa alinso m'gulu la mankhwala omwe amagwiritsidwa ntchito pochiza matenda a hyperglycemic diabetesic coma ndi ketoacidosis. Kusakaniza kwa gluluose-insulin kumathandizira kuti pakhale zovuta zingapo zomwe anthu omwe ali ndi shuga wambiri amatha.

Izi ndichifukwa choti kuwonjezeka kwa kuchuluka kwa shuga m'magazi kumalumikizana kwambiri ndi kuchuluka kwa insulin, komwe kumapangitsa gawo lalikulu la shuga. Munthawi imeneyi, mafuta amthupi amasiya kumizidwa ndi thupi ndipo maselo amthupi amayamba kuperewera mphamvu.

Kuti amalize izi, njira ya glyconeogeneis, kaphatikizidwe ka glucose wama protein ndi mafuta, imayambitsidwa m'thupi la wodwala yemwe ali ndi matenda ashuga. Koma ndimapuloteni ndi lipid metabolism, matupi ambiri a ketone amalowa m'magazi a wodwalayo, omwe amakhala ndi poizoni m'thupi.

Chowopsa kwambiri cha glyconeogeneis ndi acetone, zomwe zimachuluka zomwe m'magazi ndi mkodzo zimathandizira kukulitsa ketoacidosis. Pofuna kuletsa kupangika kwodabwitsika kwa shuga kumeneku, ndikofunikira kuonetsetsa kuti shuga amaperekedwa m'maselo, omwe amathandizira kuti athandizidwe ndi mankhwala omwe ali ndi shuga komanso insulini.

Matenda a shuga amakhalanso othandizanso chifukwa cha zinthu zina zosakanikirana, zomwe ndi potaziyamu ndi magnesium. Potaziyamu ndikofunikira kuti magwiritsidwe ntchito a mtima komanso kupewa kugwidwa. Zimathandizira pakukula kwa mitsempha yamagazi, kotero kusowa kwa potaziyamu nthawi zambiri kumayambitsa matenda oopsa.

Chimodzi mwazizindikiro zazikulu za matenda ashuga ndikupanga mkodzo wambiri, chifukwa cha momwe thupi la anthu odwala matenda ashuga limataya gawo lalikulu la potaziyamu. Chifukwa chake, chithandizo ndi glucose-insulin-potaziyamu osakaniza amathandizira kulipirira kuchepa kwa chinthu chofunikira ichi ndipo potero magazi ochepa.

Magnesium imathandizanso kwambiri pakukhazikika kwa magazi. Ndipo kuphatikiza potaziyamu, imakhala ndi zopindulitsa kwambiri pamtima ndi m'mitsempha yamagazi, yomwe nthawi zambiri imadwala hyperglycemia.

Kuphatikiza apo, magnesium imayendetsa magwiridwe antchito amanjenje ndikuthandizira kupewa kukula kwa mitsempha.

Ubwino wa njira ya kholo

Paresteral makonzedwe a mankhwala ali ndi zabwino zingapo zoonekeratu pakumwa pakamwa mankhwala omwewo.Izi ndi monga:

Zolemba zofananiraParenteral Nutrition Lactic Acidosis Cholinolytics mankhwala

Zimakhala zotheka kuthandiza odwala osazindikira.
Kutha kuthandiza odwala omwe akusanza kwambiri komanso mavuto ena am'mimba, ngati pali mwayi wokana mankhwalawa omwe atengedwa pakamwa.
Kupititsa patsogolo bioavailability wa yogwira mankhwala (kuwonjezera digestibility).
Mlingo wa kuyambika kwa achire kwambiri ndi makonzedwe a makolo ukuwonjezeka, womwe ndi wofunikira kwambiri pamavuto.
Kutha kukwaniritsa mosamalitsa zochiritsira zamagazi zomwe zimapezeka m'magazi.
Ndizotheka kugwiritsa ntchito mankhwala omwe samatha kuyamwa mukamadutsa m'matumbo kapena mumakhumudwitsa, mankhwala omwe amawonongeka ndi ma acid ndi ma enzyme a madzi a m'mimba (mwachitsanzo, adrenaline kapena insulin).
Chifukwa chachikulu pores mu nembanemba maselo endothelial, kuchuluka kwa mayamwidwe amtundu wina wa makulidwe a makolo sikudalira kungosinthasintha kwa mankhwala m'mankhwala.
Kugaya kwa zigawo zikuluzikulu za mankhwalawa sikudalira dongosolo la chakudya, zotsatira za madzi am'mimba, bile, michere yam'mimba.
Zakudya za makolo ndi gawo limodzi la mankhwalawa kwa matenda owopsa a chiwindi ndi impso.

Prozerin - malangizo, ntchito, mawonekedwe, mayendedwe, zikuonetsa, mavuto, ma analogs ndi mtengo wa maukodzo - chiyani, matenda, matenda a mtima, edema ndi matenda a mtima Cereton - malangizo, ntchito, zikuonetsa zotsatira, ma analogi ndi mtengo

Momwe mungatenge polar

Mwachikhalidwe, mtengo umaperekedwa kwa wodwalayo kudzera mu mtsempha wamkati, koma nthawi zina yankho limaperekedwa kwa wodwala pogwiritsa ntchito jakisoni wovomerezeka. Amakhulupilira kuti kugwera mwachindunji m'magazi a wodwala, mtengowo umawonetsa kuthekera kwambiri kwa iye.

Nthawi zina, wodwalayo amaloledwa kutenga shuga ndi potaziyamu pakamwa (kudzera mkamwa), ndipo insulin imalowetsedwa m'magazi ndi dontho. Njirayi imawonedwa ngati yodalirika, popeza kuchuluka kwa shuga ndi potaziyamu m'matumbo a munthu zimadalira zinthu zambiri ndipo zimatha kusiyanasiyana kwambiri mwa anthu osiyanasiyana.

Mlingo wa mankhwala umatsimikiziridwa ndi adotolo potengera kuopsa kwa mkhalidwe wa wodwalayo ndi machitidwe a matenda ake. Chifukwa chake, njirayi imalimbikitsidwa kuchitika kokha kuchipatala komanso kuyang'aniridwa ndi akatswiri. Kuwerengera molakwika kwa odwala kumatha kuvulaza wodwala ndikupanga zovuta.

Zomwe zingagwiritsidwe ntchito pochiza matenda a shuga zidzafotokozedwa ndi akatswiri mu vidiyo iyi.

Mitundu ya insulin

Ndi matenda amtundu wa 1 shuga, kuchuluka kwathunthu kwa insulin kumachepa. Ndi matenda a mtundu 2, minyewa ya minyewa imachepa. Poyamba, chithandizo cha jakisoni ndiyo njira yokhayo yothandizira. Kachiwiri, mankhwala a insulin ndi omwe amathandizira kuti matendawo apitirire.

Wodwala aliyense ali ndi mtundu wake komanso kuchuluka kwa mankhwala omwe amasankhidwa.

Mwa njira yopezera insulin imagawidwa m'mitundu inayi:

wamunthu - wopezeka kuchokera ku thupi la munthu pogwiritsa ntchito Escherichia coli,
nkhumba - yochokera ku kapamba wa nkhumba,
kwa ng'ombe - zopangidwa kuchokera ku zikondamoyo za nyama zazikulu,
chinsomba - chotengedwa kuchokera ku zikondamoyo za anamgumi,
genetic engineering - opangidwa kuchokera ku nkhumba kapamba, kuchotsa amino acid yemwe sufanana ndi munthu wokhala ndi yoyenera.

Insulin yopangidwa mwabadwa imakhala yofanana ndi anthu. Nthawi zambiri, amagwiritsidwa ntchito pochiza matenda ashuga. Seramu kuchokera ku ng'ombe imakhala ndi ma amino acid atatu osiyanasiyana, imasankhidwa nthawi zina chifukwa chomwa mankhwalawo. Hormoni ya Whale imakhala yosiyana kwambiri ndi anthu ndipo imalembedwa kambiri.

Zoyipa

Waukulu zokhudza thupi zovuta pambuyo njira necrosis, abscesses, munthu sayanjana. Njira ya makolo yoika mankhwalawa imachitika ndi akatswiri azachipatala. Ubwino ndi chitetezo cha jakisoni zimatengera kutsatira miyezo ya chida chosawongolera ndi chosagwiritsa ntchito dzanja, ziyeneretso za akatswiri, kutsatira malamulo ndi njira zoperekera mankhwala. Ngati muphwanya izi zofunika mkati mwa tsiku lotsatira ndondomeko yoyendetsera, kupangika kwa kulowetsedwa ndi kutupa kwapakati kumatha kuonedwa.

Phunzirani momwe mungakhalire wathanzi m'masiku 30 ndikupeza ndalama zowonjezera ma ruble 50,000. pamwezi!

Vuto linanso lomwe likuphwanya njira ya jakisoni ndi mpweya kapena mafuta embolism - mpweya wochepa kapena mafuta kulowa mumtsempha wamagazi. Vutoli limatha kuyambitsa necrosis, kukhumudwitsa mitsempha. Jekeseni wokhazikika wa insulin mu matenda a shuga amellitus amathandizira kukulitsa kwa insulin lipodystrophy - atrophy kapena hypertrophy ya maziko a khungu m'malo operekera mankhwala mosalekeza.

Chida chosasenda bwino kapena chosakonzedwa bwino chomwe chimagwiritsidwa ntchito munthawi ya njirazi chimatha kupangitsa wodwala kutenga kachilombo koyambitsa matenda (hepatitis, HIV (kachilombo ka chitetezo cha munthu), ndi zina zambiri. Zotsatira zoyipa za kulowetsedwa kwa kholo ndi endoflebitis, mawonekedwe a kutupa kwa khoma lamitsempha lomwe limayamba chifukwa cha kuwonongeka kwa kukhazikika kwa mtsempha kapena kuvulala kwa chotengera pambuyo poti chichitike patatha nthawi yayitali.

Malinga ndi kuchuluka kwa mankhwalawa, mankhwalawa amakhudzana kwambiri ndi mankhwala, mwachitsanzo, kuwopsa kwa anaphylactic, kumachitika kawirikawiri ndi jakisoni wa parenteral kuposa kutsata pakamwa. Chifukwa chake, kuphwanya kwathunthu njira imeneyi yoperekera mankhwala ndi kuleza mtima kwa chinthu chilichonse chokhudza kapangidwe kake.

Njira ya makolo yoika mankhwalawa imasiyanitsidwa malinga ndi malo omwe mankhwalawa amalowera kufalikira kwadongosolo. Jekeseni wa minyewa amachitika mwachisawawa (diagnostic), subcutaneous (yankho limalowa m'mitsempha yamagazi), intramuscularly (mankhwalawa amalowa m'mitsempha yamagazi ndi minyewa ya m'magazi), ndipo jekeseni wa intraosseous umagwira ngati jekeseni ya intravenous kapena intramuscular.

Njira inanso yoyendetsera makolo ndi mwachindunji m'matumbo (kudzera m'mitsempha, m'mitsempha yamkati). Mtundu womaliza wa jakisoni umasonyezedwa m'malo omwe amafunika kupewa kuperewera kwa mankhwalawa kudzera pachiwindi ndi impso. Nthawi zina matenda, kukhudzana mwachindunji kwa mankhwalawa m'matumbo (m'mimba, m'mimba, motsatana) ndikofunikira. Mitundu ina yapadera ya kayendetsedwe ka makolo ndi:

Rumalon - malangizo ogwiritsira ntchito ndi kumasula mawonekedwe, zikuonetsa, mawonekedwe ndi mtengo wa Platifillin - malangizo, ntchito, mawonekedwe, mayendedwe, mavuto, mayendedwe ndi mayina a mitengo - malangizo kwa ana ndi akulu

Njira ya intrathecal (subarachnoid kapena epidural): kudzera mu madzi a cerebrospinal.
Njira yothandizirana ndi matenda am'deralo: kudzera mu matenda a maso.
Njira ya mkati: kudzera m'mphuno.
Intratracheal (inhalation): ndi inhalation ya nthunzi zodzaza ndi mankhwala othandizira kudzera inhaler.
Transdermal: Kulowa kwa zigawo za mankhwala kumachitika kudzera pakhungu.

Kodi ndiyenera kusinthira nthawi yanji kuti ndipompe insulin?

Lingaliro la kusinthira pampope limapangidwa mogwirizana ndi makolo, mwana ndi dokotala wopita. Palibe choletsa zaka ngati musamutsa pampu, kuphatikiza makanda.

Nthawi zambiri, kusamutsira kwa pampu kumachitika osati kale kuposa miyezi 3-6 kuyambira nthawi yoyamba matendawa, pomwe anthu omwe ali ndi matenda ashuga ndi makolo awo samangophunzira chidziwitso cha matenda a shuga, komanso amapeza chidziwitso chokwanira. Inde, anthu omwe ali ndi matenda ashuga amatha kusinthana ndi pampu, ngakhale atakhala kuti ali ndi matenda ashuga, komanso ngakhale atangozindikira.

Komabe, kusinthira ku insulin pump mankhwala mukangoyamba matenda ashuga kumatha kuphatikizidwa ndi zovuta zingapo. Osangodziwa zofunikira zokha za mfundo zopopera insulin mankhwala, komanso chidziwitso chokwanira cha matenda a shuga. Monga luso lililonse, kumvetsetsa zambiri za matenda ashuga kumadza ndi chidziwitso.

Kuphatikiza apo, nthawi yoyamba pambuyo pa matendawa, mlingo wa insulin ungachepetse kwambiri, womwe ungafune kudzisinthanso pafupipafupi kwa mlingo wa insulin. M'chaka choyamba cha matenda, ana aang'ono omwe ali ndi mankhwala a insulin omwe amapezeka pampu amakhala ndi machitidwe ena a basal, omwe ndi 10-30% yokha ya tsiku ndi tsiku, ndipo pafupifupi theka la ana ang'onoang'ono sayenera kufunikira insulin.

Nthawi zina, ndikulakalaka kwambiri achinyamata ndi makolo komanso kuthamanga kwa luso la kudziletsa, kusinthira ku chithandizo cha pampu kumatha kuchitika kale, kwakanthawi kochepa kwambiri kwa matenda ashuga. Chifukwa chake, adotolo amasankha nthawi yanthawi yosamutsa kuti apumire insulin mankhwala, kutengera zomwe munthu aliyense ali ndi matenda ashuga.

Paresteral mankhwala algorithm

Jakisoni wa makolo a mitundu yosiyanasiyana amachitika molingana ndi ma algorithms ena omwe amawonetsetsa kutetezedwa ndikuyenda bwino kwa njirazo. Malamulowa akuphatikiza kukonzekera kwa wodwala, dokotala ndi zida zofunika, njira ya jekeseni, njira zingapo zomaliza pambuyo pa jekeseni. Mankhwala osiyanasiyana, liwiro ndi luso la kayendetsedwe kawo zimasiyana.

Mapai osinthika

Ngakhale chithandizo cha pampu chikukula kwambiri pakati pa ana omwe ali ndi matenda ashuga, sichikulimbikitsidwa kwa aliyense. Kuti chithandizo cha pampope chikwaniritse, mwana ndi makolo ake ayenera kufunadi izi. Akatswiri ambiri a matenda ashuga amakhulupirira kuti kudziyang'anira pawokha (kuchuluka kwa miyeso ya glycemic patsiku, kusunga zolemba zodziyang'anira pawekha, kukonza insulin, ndi zina zotere) ndi gawo lofunikira kwambiri pakusintha pampu. Madokotala ambiri amafunika kuwonetsetsa kwambiri kudziletsa kuchokera kwa anthu omwe ali ndi matenda ashuga kuti ayambe kuchiza, chifukwa izi sizongokhala chifukwa chokwanitsira zotsatira, komanso ndikofunikira kupewa zovuta.

Kukhazikitsa pampu ya insulin sikumakupulumutsirani kudziletsa! Kuti magazi a glucose azikhala pampikisano kuti akhale abwino komanso ketoacidosis isachitike, mufunika kudziwunikira pafupipafupi komanso mosamala: Kuyeza kwa shuga, kayendetsedwe ka insulini, kusunga zolemba, kuwerengera zam'mimba.

Zifukwa zosinthira kupopera insulin mankhwala:

Mitengo yayikulu ya HbA1c yosagwirizana ndi kusadziletsa
Ana ndi achinyamata omwe ali ndi chodabwitsa cha "m'bandakucha"
Mitundu ya moyo yowonongeka (malingaliro osalimbikitsa pakufunika kwamankhwala a insulin mwa anthu osawadziwa, kufunika kokhalitsa zakudya zowonjezera, kufunitsitsa kosiyanitsa chakudya momwe mungathere)
Pafupipafupi kapena kwambiri hypoglycemia
Ana aang'ono omwe ali ndi insulin yofunikira
Ana owopa jakisoni
Chitani masewera olimbitsa thupi pafupipafupi
Kufuna kusintha moyo wabwino

Zoyipa zamankhwala othandizira kupopa zimatha kubweretsa kusiya ntchito. Komabe, anthu omwe ali ndi matenda ashuga komanso gulu la shuga samakana kupitiliza chithandizo cha pampu. Kuwunika kwa anthu omwe ali ndi matenda a shuga ku Germany ndi ku Austria adawonetsa kuti ndi 4% yokha ya anthu omwe amakana pampu.

Zinthu zazikuluzikulu zokana kukomoka ndi izi: kuperewera kwa mankhwalawa chifukwa cha chithandizo, kuchepa kwa kusintha kwa moyo komanso kuwonongeka m'magazi a magazi. Chifukwa chake, ndikofunikira kuganizira izi popanga chisankho pakusintha kwa mankhwala opopa.

Kuwerengera kwa insulini mukasinthira pampu

Mukasinthira pampu, mlingo wa tsiku ndi tsiku wa insulin (yaifupi ya insulin + yayitali patsiku) umachepera ndi 10-25%. Kuchepetsa mlingo wa insulin kumadalira makamaka kuchuluka kwa kubwezeretsa kwa chakudya cha m'magazi, ndiye kuti, pazowonetsa magazi, komanso kuchuluka kwa zochitika za hypoglycemia. Pankhani ya shuga wambiri m'magazi, mlingo wa insulin ungakhalebe wosasinthika kapena kuwonjezeka.

Gome 1. Kusintha kwa muyezo wa insulin (SDI) wa tsiku ndi tsiku mukamasinthira kupopa

Pambuyo powerengera tsiku ndi tsiku insulin pa pump pump, iwo amawerengera oyambira ndi bolus Mlingo.

Kuwerengera Basal Dose

Anthu ambiri omwe amagwiritsa ntchito pampu amakhala ndi mlingo woyambira wa insulin kuposa mlingo wa bolus. Pankhaniyi, kuchuluka pakati pa basal ndi bolus Mlingo waukulu pampata kumadalira msinkhu wa mwana. Mukawerengera basal mlingo, mutha kugwiritsa ntchito lamulo lotsatirali - wocheperako mwana, wocheperako kuchuluka kwa insulin insulin. Mwa ana aang'ono, mlingo wa basal insulin ukhoza kukhala 30% ya tsiku ndi tsiku, pomwe achinyamata ndi achinyamata nthawi zambiri amakhala 50%. Komabe, mwa akulu, mlingo woyambira ungakhale wocheperako poyerekeza ndi mlingo wa bolus.

Gawo la basal mlingo:

Ana 0-6 wazaka - pafupifupi 30-35% ya tsiku ndi tsiku insulin
Ana a zaka 6-12 - pafupifupi 35-40% ya tsiku ndi tsiku insulin
Achinyamata ndi akulu - pafupifupi 40-50% ya tsiku ndi tsiku insulin

Pambuyo powerengera basal ya tsiku ndi tsiku mlingo, ndikofunikira kukhazikitsa kuchuluka kwa insulin yomwe imalandira ola lililonse. Kuchuluka kwa insulin yomwe imayendetsedwa pa ola limodzi imatchedwa basal rate, chifukwa imayezedwa m'magawo pa ola limodzi - mayunitsi / ola (UI / h). Pali njira ziwiri zowerengera maola oyambira.

Poyamba, mlingo woyambira wa tsiku ndi tsiku umatha kugawidwa tsiku lonse. Kuti muchite izi, mumangofunika kugawanitsa momwe mwalandila tsiku lililonse ndi maola 24.

Njira yachiwiri ndiyo kuwerengera momwe muliri, kuzindikira momwe munthu aliyense aliri. Nthawi zambiri masana pamakhala kufunika kwina kwa insal insulin, yomwe imadalira kwambiri msinkhu wa mwana. Ana aang'ono nthawi zambiri amakhala ndi chosowa chamadzulo kumapeto kwausiku ndi theka lausiku komanso kusowa kwenikweni kwa nthawi masana.

Chiwerengero cha basal ndi bolus insulin zimatengera zaka za mwana.

Mwana akamakula, amayamba kugonjera. mbandakucha chodabwitsa - kufunsa kwambiri kwa insulin m'mawa kwambiri. Izi zosintha pakufunika kwa insulin ya basal zimayenderana ndi zaka zakubadwa pakubisika kwa mahomoni olimbana ndi mahomoni monga kukula kwa mahomoni, cortisol ndi mahomoni ogonana. Mwachitsanzo, mu ana aang'ono, kufunikira kwakukulu kwa insulin kumapeto kwamadzulo kumatha kuphatikizidwa ndi kuwonjezeka kwa kuchuluka kwa mahomoni atangogona.

Gawo 3. Zakalezo za mbiri yakale ya basal

Tebulo 4. Chitsanzo cha kuwerengetsa poyambira kumwa mukasinthira pampu

Kuwerengeredwa kwa mlingo wa Bolus

Mukamagwiritsa ntchito pampu, muyezo wa bolus wa chakudya kapena shuga wambiri ungawerengeredwe ndi munthu wodwala matenda ashuga kapena makolo pawokha, kapena pogwiritsa ntchito cholembera cha bolus (kapena wothandizira bolus). Kuwerengera kwa bolus ndi pulogalamu yomwe idapangidwa pampope yomwe imawerengera kuchuluka kwa insulini molingana ndi makonzedwe omwe adakonzedwa. Wothandizira bolus samayendetsa insulin, koma amangotsimikizira mlingo. Lingaliro lobweretsa mankhwalawa limapangidwa ndi inu kutengera zomwe mwakumana nazo.

Wothandizira bolus samayang'anira insulin, koma amangotsimikizira kuchuluka kwa insulin!

Kufunika kwa insulini, motero kuchuluka kwa insulini yoyendetsedwa, kumasintha pakapita nthawi. Izi ndichifukwa cha kukula kwa mwana, kusintha kwa moyo, ndi zina zambiri.Chifukwa chake, ngakhale mutagwiritsa ntchito wothandizira wa bolus woyikiratu ndi dokotala wanu, ndikofunikira kuti muwerengere mankhwalawo nokha, chifukwa chakuchepa kwa shuga m'magazi, mutha kusintha mawonekedwe a othandizira a bolus.

Bolus insulin imaperekedwa kuti idye (bolus for chakudya) kapena kukonza glucose wamagazi (okonza bolus).

Kuti mupeze pang'onopang'ono chakudya, gwiritsani ntchito kuchuluka kwa chakudya (UK).

Chakudya chopatsa thanzi - UK

CC ndi kuchuluka kwa insulin yokutira 1 mkate mkate - XE (kwa iwo amene amawerengera zakudya zamagulu mu XE), kapena kuchuluka kwa magalamu azakudya zomwe zimaphimbidwa ndi 1 U ya insulin (kwa iwo omwe amawerengera zakudya m'magalamu).

Carbohydrate coeffnty, insulin sensitivity factor ndi chandamale glycemic nthawi zambiri zimasiyana mwa ana amisinkhu yosiyanasiyana komanso nthawi zosiyanasiyana masana.

Zokwanira zambiri - insulin yambiri pakudya.

Mukamawerengera bolus yokonzanso imagwiritsidwa ntchito insulin sensitivity factor (PSI) ndi chandamale glycemic milingo.

Insulin Sensitivity Factor - PSI

PSI ndi momwe kuchuluka kwa glucose m'magazi kumachepera ndikukhazikitsa gawo limodzi la insulin.

Kukhathamira kowonjezereka - insulin yaying'ono pakuchepa.

Gome 5. Chitsanzo kuwerengera kwa kachulukidwe kachulukidwe kazakudya ndi insulin

Ngati CC ndi PSI zopezeka m'njira zosiyanasiyana sizigwirizana, titha kutenga mtengo wapakati pakati pawo.

Cholinga cha shuga m'magazi - phindu lamunthu m'magazi omwe pampu yake imayang'ana mothandizidwa ndi bolus yodzikongoletsa. Mlingo wa glycemia womwe umayang'aniridwa umatsimikiziridwa payekhapayekha kwa munthu aliyense limodzi ndi dokotala ndipo zimatengera zaka, chizolowezi cha hypoglycemia, etc.

Pogwiritsa ntchito chakudya chopatsa mphamvu, mutha kudziwa mayendedwe azakudya-insulin kuti mumwenso zakudya zovomerezeka.

Chakudya Bolus (BE) = Nambala XE x UK

Pogwiritsa ntchito insulin sensitivity factor ndi glycemia wololera, mutha kudziwa kukonza - insulin, yofunikira kuti mufikire gawo shuga wamagazi (HA).

Corrective bolus (KB) = (GK tsopano - GK chandamale) / PSI

Choyimira chowongolera chingakhale chabwino (kuchepa) - ngati kuchuluka kwa shuga m'magazi ndikokwera kuposa zomwe mukufuna, kapena zoyipa (kukulitsa) - ngati mulingo wamagazi ndi wotsika kuposa zomwe mukufuna. Kuti muwerenge ndalama zonse, muyenera kuwonjezera kukonza ndi chakudya. Ngati bolus yodzikongoletsa ndiyosavomerezeka, ndiye kuti mlingo wonse wa insulin udzachepetsedwa kuti ukulitse glucose wamagazi kuti akwaniritse zofunika.

Bolus Yonse (OB) = Bolus ya Chakudya + Corrective Bolus

Tebulo 6. Zitsanzo za kuwerengera kwamawonekedwe a bolus

Mbiri ya basal, compact ya carbohydrate, komanso insulin sensitivity yomwe imawerengeredwa pambuyo posinthira pampu siyikhala yolondola nthawi zonse. M'tsogolomu, makamaka, kuwongolera kwawo kumafunika malinga ndi zizindikiro za glycemic.

Makonda azithunzi ndi oyambira omwe amawerengera atasinthira pampu sakhala oyenera nthawi zonse. M'tsogolomu, kuwongolera kwawo kumafunikira.

I.I. Agogo, V.A. Peterkova, T.L. Kuraeva, D.N. Laptev

Intravenous makonzedwe

Kukonzekera jakisoni wothandizirana kumaphatikizapo zochita kuti zizitsatira malamulo aukhondo - kutsuka ndi kupukuta m'manja mwa dotolo, kuyeretsa magolovesi (ngati kuli koyenera), kuyang'ana kuchuluka kwa mankhwala, kutola syringe, kuyika yankho la mankhwala ndikulowetsa chida chokonzedweramo. Kenako, kukonzekera jakisoni wa wodwalayo kumachitika, ndikuchita zotsatirazi:

Dzanja la wodwalayo lakhazikika pachitunda cholimba.
Pakufufuza, adokotala amasankha mtsempha kuti ugwiritse jakisoni.
Mgonero umayikidwa mbali yachitatu ya phewa, pambuyo pake wodwalayo amafunika kuwaza ndikukhometsa dzanja lake katatu kapena kanayi kuti mitsemayo ioneke bwino ndi zala zake.

Jakisoni wovomerezeka umachitika molingana ndi algorithm omveka, okhawo omwe amayendetsa mankhwalawa amasintha. Zotsatira za mtundu wa jakisoni wa makolo motere:

Thonje lomwe limasungunuka ndi mowa limagwiritsidwa ntchito pochiza pafupifupi malo a jekeseni ndi madera a khungu loyandikana nalo.
Chophimba chimachotsedwa pa singano ya syringe, syringe imatengedwa kudzanja lamanja, cannula imakhazikika ndi chala cholozera. Mphamvu ya wodwalayo idagwidwa ndi dzanja lake lamanzere, khungu limakutambasulira ndi chala chake ndikumamatira mtsempha. Asanayambitse singano, wodwalayo amafunika kumenya.
Khungu ndi chotengera chimabayidwa pakona pa 15 °, kenako singano imapitirira 15 mm patsogolo. Ndi dzanja lamanzere, pisitoni imakokedwa pang'ono, pomwe magazi amayenera kutuluka mu syringe (izi zikutanthauza kuti singano ili mkati mwa mtsempha).
Kenako pamalowo pamachotsedwa ndi dzanja lamanzere, wodwalayo amatula chikhatho chake, ndipo atayang'ananso ndi singano m'mitsempha, dokotalayo amakakamira pang'onopang'ono mpaka jakisoniyo itaperekedwa kale.

Pa jekeseni, wogwira ntchito zachipatala amayenera kuwunika mosamala momwe wodwalayo alili (kutsekeka kwa khungu, chizungulire, ndi zina). Pambuyo pa jekeseni, singano imachotsedwa mwachangu kuchokera m'mitsempha, malo opumira amawakankhira ndi mpira wa thonje. Wodwala ayenera kukhala kwa mphindi 7-7 ndi mkono wake wowerama. Pambuyo pa izi, palibe magazi omwe amayenera kupezeka m'malo a jakisoni.

Ma algorithm pokonzekera kayendedwe ka makina a makolo samasiyana pakhungu. Manja ndi zida zimagwidwa chosawilitsidwa (ngati kuli koyenera), kuchuluka kwake kumayesedwa, yankho la mankhwalawa limakokedwa mu syringe. Tsamba la jakisoni ndi khungu loyandikana nalo amathandizidwa ndi mowa. Jakisoni ukuchitika motere:

Ndi dzanja lake lamanzere, khungu limakutidwa.
Singano imayikidwa pakona pa 45 °, m'munsi mwa khola, pansi pa khungu, mpaka 15 mm.
Zala za dzanja zomwe zimakhazikika khungu zimasunthira pang'onopang'ono zida za syringe.
Mukamaliza kuperekera mankhwala, singano imachotsedwa, mpira wopangidwa ndi chidakwa umayikidwa pamalo a jekeseni.

Kugawidwa mwachangu

Kutengera ndi matendawa, mitundu isanu ya mankhwalawa imasiyanitsidwa malinga ndi kuthamanga ndi kutalikirana kwake:

Zochita za Ultrashort. Kuchita bwino kumachitika pakatha mphindi 10 jekeseni. Amapatsidwa chakudya musanadye kapena akangomaliza kudya, mosaneneka. Zovomerezeka zosaposa maola atatu.
Zochita zazifupi. Zovomerezeka pambuyo mphindi 30. Amadyedwa musanadye. Kuwonetsedwa kumatenga maola 6.
Zochita zapakatikati. Mankhwalawa amatumizidwa 2 pa tsiku nthawi yomweyo. Zotsatira zimayamba pambuyo pa maola 1.5 ndipo sizimatha maola 20.
Kuchita motalika. Zotsatira zimachitika patatha maola atatu pambuyo pakukhazikitsa. Kutalika kwa mavutowa ndi maola 24. Imayendetsedwa katatu patsiku.
Mankhwala osakanikirana. Phatikizani kuthamanga ndi kutalika kwa zotsatira zake.

Mankhwala ocheperapo komanso osakhalitsa amatsata kapamba atatha kudya.

Mukatha kudya, thupi limatulutsa anabolic yomwe imatha kusintha shuga amene amayambitsa kukhala mphamvu. Jakisoni wapakati komanso wa nthawi yayitali amaganiza ntchito yogaya chakudya kunja kwa chakudya. Pakati pa chakudya, thupi limadzipanga payokha glucose, kukonza kwake komwe kumafunikira insulini ina. Kulephera kwathunthu kwa kapamba, kugwiritsa ntchito kwakanthawi kochepa kwakanthawi kochepa kwa mankhwalawa kudzalipiritsa ntchito ya thupi.

Momwe mungawerengere kuchuluka kwa insulin

Mlingo wa insulin wolakwika molakwika umabweretsa imfa. Masewera a mahomoni akapitilira, kuchuluka kwa shuga mthupi kumatsika kwambiri, komwe kumayambitsa kukomoka kwa glycemic. Mlingo wa anabolic umawerengeredwa ndi dokotala payekhapayekha, koma odwala matenda ashuga amatha kuthandizanso pakutsimikiza kwake:

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Muyenera kugula glucometer, imatsimikiza kuchuluka kwa shuga kulikonse, mosasamala nthawi. Shuga ayenera kuyezedwa mkati mwa sabata: m'mawa wopanda kanthu, musanadye, mukatha kudya, pakudya chamadzulo, madzulo. Pafupifupi, osachepera 10 miyezo imapangidwa patsiku. Zambiri zimalembedwa ku zolemba.
Milozo yapadera idzawongolera kuchuluka kwa zakudya zomwe zimamwa ndikuthandizira kuwerengera mapuloteni, mafuta ndi chakudya. Mu matenda a shuga, kudya ndi imodzi mwazinthu zofunikira kwambiri za chithandizo. Kuchuluka kwa michere kuyenera kukhala kofanana masiku onse.

Mtengo wokwanira wa insulini poyeza kuchuluka kwake ndi gawo limodzi pa kilogalamu imodzi yakulemera kwa thupi. Kuchulukitsa mtengo wokwanira sikuthandizira kusintha ndipo kumabweretsa hypoglycemia. Mlingo woyenera wa magawo osiyanasiyana a matenda:

Mukazindikira mtundu wovuta wa matenda a shuga a 2, mayunitsi 0,3 / 1 makilogalamu amagwiritsidwa ntchito.
Ngati matenda akudwala insulin atapezeka, mayunitsi 0,5 / 1 makilogalamu amalembedwa.
Mchaka, pogwiritsa ntchito mphamvu zabwino, mlingo umawonjezeka mpaka magawo 0,6 / 1kg.
Pankhani ya zovuta kwambiri komanso kusowa kwa chipukutiro, mlingo wake ndi magawo a 0,7-0.8 / 1kg.
Zovuta zikamachitika, mayunitsi 0,9 / 1 kg amasaina.
Pa nthawi yoyembekezera, mlingo umakwera mpaka 1 unit / 1kg ya kulemera.

1 mlingo wa mankhwalawa - osapitirira 40% ya chizolowezi cha tsiku ndi tsiku. Komanso kuchuluka kwa jakisoni kumatengera kutha kwa matendawa ndi zinthu zina zakunja (kupsinjika, zolimbitsa thupi, kumwa mankhwala ena, zovuta kapena zovuta zamatenda).

Kwa wodwala wolemera kilogalamu 90, wokhala ndi matenda amtundu wa 1, wokhala ndi mphamvu zambiri, mlingo wa insulin ndi magawo 0,6. patsiku (90 * 0,6 = 54 magawo - muyezo insulin tsiku lililonse.
Timadzi tokhala tambiri timene timayendetsedwa kawiri patsiku ndipo timapanga theka la tsiku lililonse (54 / = 27 - Mlingo wa tsiku lililonse wa insulini). Mlingo woyamba wa mankhwalawa ndi 2/3 ya voliyumu yonse ((27 * 2) / 3 = 18 - tanthauzo latsiku lam'mawa mwachangu). Mlingo wamadzulo ndi 1/3 ya voliyumu yonse (27/3 = 9 - Mlingo wamadzulo wa insulin yayitali.
Insulin yomwe imagwira ntchito mwachidule imawerengera theka la kuchuluka kwa mahomoni onse (54 / = 27 - Mlingo wa tsiku ndi tsiku wa mankhwala omwe amachitika mwachangu). Mankhwalawa amatengedwa musanadye katatu pa tsiku. Kudya kwa m'mawa ndi 40% ya kuchuluka kwa insulin yayifupi, chakudya chamasana ndi kudya kwamadzulo 30% (27 * 40% = 10,8 - mlingo wa m'mawa, 27 * 30% = 8.1 magawo - chakudya chamadzulo ndi masana.

Pogwiritsa ntchito shuga wambiri musanadye, kuwerengera kwa kusintha kwa insulin mwachangu.

Miyeso imapangidwa m'magawo a mkate. 1XE = magalamu 12 a chakudya. Mlingo wa mankhwala osankha mwachidule amasankhidwa kutengera mtundu wa XE ndi nthawi ya tsiku:

m'mawa 1XE = 2 mayunitsi,
pa nkhomaliro 1XE = 1,5ed,
madzulo 1XE = 1 unit.

Kutengera ndi kuopsa kwa matendawa, kuwerengetsa kwake ndi kuchuluka kwake kumasiyana:

Mtundu woyamba wa shuga, thupi la munthu silipanga insulin. Mankhwala a mahomoni amagwiritsidwa ntchito, achangu komanso okhalitsa. Powerengera, mtengo wovomerezeka wa zigawo za insulin umagawika pakati. Mankhwala ndi okhazikika zotsatira kutumikiridwa 2 pa tsiku. Insulin yochepa imayendetsedwa katatu patsiku.
M'matenda akuluakulu a shuga amtundu wachiwiri, mumalandira mankhwala kwa nthawi yayitali. Jekeseni amachitika kawiri pa tsiku, osapitirira 12 mayunitsi paliponse.

1 unit ya insulin imatsitsa shuga ndi magazi a 2 mmol / L. Kuti mupeze phindu lokwanira, muyezo wamagazi wowonjezereka umalimbikitsidwa.

Mankhwala a insulin ndi mitundu yake

Ntchito ya mankhwala a insulin ndikuyambitsa kuchuluka kwa mankhwalawa omwe ali pafupi ndi zikhalidwe za thupi. Masana, mpaka 80% ya mahormoni amatumizidwa, ena onse amathandizidwa usiku. Njira iyi yoyendetsera mankhwalawa ili pafupi ndi kuphatikiza kwa mahomoni mwa munthu wathanzi.

Munthu aliyense amaphatikiza shuga mwanjira yake. The pokonza 1 mkate unit amafunikira 0,5 mpaka 4 magawo a insulin. Kuti mudziwe Mlingo woyenera wa yankho, muyenera kuyeza kuchuluka kwa shuga mutatha kudya.

Mitundu ya mankhwala

Zochizira matenda a shuga, njira ziwiri za insulin zamankhwala zimagwiritsidwa ntchito:

Chithandizo cha makolo. Pa mankhwala, ma insulin ogwiritsira ntchito nthawi yochepa amagwiritsidwa ntchito. Kufikira 60% ndi chifukwa chogwiritsa ntchito mahomoni okhala ndi nthawi yayitali, 40% kuthamangira insulini. Nthawi yakudya ndi jekeseni imawonedwa mosamalitsa. Zakudya zokhazokha, kulumpha chakudya, masewera kunja kwa dongosolo, kupsinjika.
Chisamaliro chachikulu Pochizira insulin, kuwonetsa pang'onopang'ono komanso nthawi yayitali kumagwiritsidwa ntchito. Kudya kwakanthawi kwamahomoni kumawerengedwa potengera chakudya chomwe chimamwa. Palibe chakudya chokhwima chomwe chimafunikira, masewera ndi zokhwasula-pansi ndizololedwa.

Ulamuliro wa Mankhwala Osokoneza bongo

Pakuthandizira kayendetsedwe ka insulin, zida zapadera zapangidwa zomwe zimagwiritsidwa ntchito mwachangu komanso mosavuta. Pali njira zitatu zamankhwala zoperekera mankhwala:

Syringe ya insulin.
Cholembera ndi chida chogwirizira chomwe chimaperekera mankhwalawa mopweteka. Amagwiritsidwa ntchito makamaka ku Russia.
Dispenser-pump - chipangizo chomwe chimayambitsanso mankhwalawo. Amasinthidwa ndi dokotala kapena wodwala, kutengera mtundu wa kayendetsedwe ka mahomoni. Amagwiritsidwa ntchito makamaka ku Europe ndi USA.

Kugwiritsa ntchito mankhwala mopitirira muyeso kungayambitse matenda a Somogy, hypoglycemia, kapena matenda a shuga. Ngati mukumva mseru, kusanza, chizungulire, khungu limakhala lalikulu, ndikofunikira kuyeza shuga. Ndi mitengo yowonjezereka, muyenera kuyitanitsa ambulansi nthawi yomweyo. Kuti mupewe kuchuluka kwa glucose mwadzidzidzi, muyenera kutsatira malangizo onse a dokotala, kuperekera insulin panthawi yake ndikutsatira zakudya.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Mwambiri

Kukonzekera kwa intramuscular Pareeral management kumachitika molingana ndi algorithm yofananira. Wodwalayo wagona pakama pansipa, kuti jakisoni, malo omwe ali kumtunda kwa minofu yofinya amasankhidwa. Amathandizidwa ndi mowa. Kuvulala kumachitika molingana ndi malamulo awa:

Syringeyo imagwidwa ndi dzanja lamanja, zala zakumanzere zimatambalala khungu pamalo omwe azidzaponyera mtsogolo.
Ndi mawonekedwe akuthwa, singano imayikidwa mu minofu ya gluteus pafupifupi 2/3 ya kutalika kwake, pamakona a 90 °.
Pogwiritsa ntchito dzanja lanu lamanzere, amayang'anitsitsa kuti akanthe mu minofu - amakoka piston pang'ono pa inu, simuyenera kukhala ndi magazi.
Mankhwalawa amapaka jekeseni, malo opumira amakhala osawilitsidwa ndi swab ya thonje.

Zamkati

Kuti muchite jekeseni wamitsempha, mitsempha imasankhidwa yomwe ili pafupi ndi khungu - khomo lachifuwa, mkono, mkono, kapena chowonera. Kukonzekera jakisoni kumachitika molingana ndi malamulo wamba. Njira yothetsera jakisoni imatsimikiziridwa ndi dokotala m'dera lamatumbo akulu kwambiri. Khungu ndi mitsempha imabedwa molingana ndi malamulo omwewo monga ndi jekeseni wamkati, poyendetsa kayendedwe ka kayendedwe kazinthu. Pambuyo pa njirayi, bandeji yapanikizika imayikidwa pamalo opunthira kwa mphindi zingapo.

Zododometsa

Kupereka kwa makolo mankhwala mu madzi amchere ndi njira yovuta komanso yopweteka pomwe wodwalayo atagona mbali yake ndi miyendo yake atakanikizidwa mpaka m'mimba ndi mutu wake mpaka pachifuwa. Tsambalo la jakisoni limasankhidwa pakati pa vertebrae ya lumbar, samangothandizidwa ndi antiseptic, komanso imaphatikizidwa ndi analgesic yam'deralo ndi jakisoni wofunda. Singano imayilidwa mwachindunji mu mzere wa msana; pambuyo pa njirayo, wodwalayo ayenera kusuntha kwa mphindi 20-30.

Glucose katundu

Katunduyu adayamba kupatulidwa ndikufotokozedwa ndi dokotala waku Britain W. Praouth koyambirira kwa zaka za m'ma 1900. Ndi phula lokoma (chakudya), mamolekyu ake omwe ndi maatomu 6 a kaboni.

Amapangidwa muzomera kudzera mu photosynthesis, mu mawonekedwe ake oyera amangokhala mphesa. Nthawi zambiri, umalowa mthupi la munthu ndi zakudya zomwe zimakhala ndi wowuma ndi sucrose, ndipo zimamasulidwa pakudya.

Thupi limapanga "njira yosungira" yamtunduwu mu mawonekedwe a glycogen, ndikuigwiritsa ntchito ngati mphamvu yowonjezera yothandizira moyo pakagwa zovuta, thupi kapena malingaliro, kudwala kapena zina.

Kuti thupi lizigwira ntchito bwino, kuchuluka kwa shuga m'magazi kuyenera kukhala pafupifupi 3.5-5 mmol pa lita. Ma mahomoni angapo amagwira ntchito ngati owongolera kuchuluka kwa chinthucho, chofunikira kwambiri ndi insulin ndi glucagon.

Glucose imadyedwa nthawi zonse ngati gwero lamphamvu la ma neurons, minofu ndi maselo amwazi.

Ndikofunikira kwa:

kupereka kagayidwe m'maselo,
njira yokhazikika ya njira za redox,
matenda a chiwindi
kukonzanso mphamvu zachilengedwe,
kusunga madzi osalala,
kupititsa patsogolo kuchotsa kwa poizoni.

Kugwiritsa ntchito shuga m'magazi pazithandizo zachipatala kumathandizira kubwezeretsa thupi pambuyo poyizoni ndi matenda, njira zopangira opaleshoni.

Zokhudza thupi

Machitidwe a dextrose ndi amodzi ndipo amatsogozedwa ndi mawonekedwe ndi mtundu wa zochita za anthu.

Chofunikira kwambiri tsiku ndi tsiku kwa anthu omwe akuchita ntchito yayikulu yamphamvu kapena yolemetsa (chifukwa chakufuna mphamvu zowonjezera).

Thupi limavutika chimodzimodzi ndikusowa komanso kuchuluka kwa shuga m'magazi:

owonjezera amakhumudwitsa kwambiri kapamba kuti apange insulini ndikubweretsa shuga kwa nthawi yayitali, zomwe zimapangitsa kuti thupi liziwoneka msanga, kutupa, kusinthika kwa maselo a chiwindi m'mafuta, kusokoneza mtima,
kuchepa kumayambitsa kufa kwa maselo aubongo, kufooka ndi kufooketsa, kuyambitsa kufooka, nkhawa, chisokonezo, kukomoka, kufa kwa ma neurons.

Zomwe zimayambitsa kusowa kwa glucose m'magazi ndi:

zakudya zosayenera za anthu, chakudya chosakwanira chomwe chimalowa m'mimba,
poyizoni wa chakudya ndi mowa,
zosokoneza mthupi (matenda a chithokomiro, neoplasms yovuta, matenda am'mimba, matenda osiyanasiyana).

Mulingo wofunikira wa thupilo m'magazi uyenera kusamalidwa kuti ugwire ntchito zofunika - kugwira ntchito kwa mtima, chapakati mantha, minofu, kutentha kwambiri kwa thupi.

Nthawi zambiri, mulingo wofunikira wa chinthucho umapangidwanso ndi chakudya, vuto la matendawa, matenda, poyizoni, shuga limayikidwa kuti likhazikitse vutoli.

Zovuta za Dextrose

Pazifukwa zamankhwala, dontho lokhala ndi dextrose limagwiritsidwa ntchito:

kutsitsa shuga
kutopa ndi kutopa,
Kutalika kwa matenda angapo (matenda opatsitsa chiwindi, matenda am'mimba, zotupa za ma virus ndi kuopsa kwa dongosolo lamkati) monga njira inanso yopezera mphamvu zathupi.
zosokoneza pa ntchito ya mtima,
zinthu zadzidzidzi
kuchepa kwambiri kwa kuthamanga kwa magazi, kuphatikiza magazi,
kuperewera kwa madzi m'thupi chifukwa cha kuledzera kapena matenda, kuphatikizapo mankhwala osokoneza bongo, mowa ndi mankhwala osokoneza bongo (limodzi ndi matenda am'mimba komanso kusanza kwadzaoneni),
Mimba kusunga chitukuko cha fetal.

Mitundu yayikulu ya mankhwalawa yomwe imagwiritsidwa ntchito ngati mankhwala ndi mayankho ndi mapiritsi.

Mlingo Wamitundu

Njira zothetsera mavuto ndizabwino kwambiri, kugwiritsa ntchito kwawo kumathandizira kukonza ndikulimbitsa thupi la wodwala mwachangu momwe mungathere.

Mankhwala, mitundu iwiri ya yankho la Dextrose imagwiritsidwa ntchito, yomwe imasiyana pamafomu ogwiritsira ntchito:

isotonic 5%, yomwe imagwiritsidwa ntchito kukonza ziwalo, chakudya chamagulu awo, kusunga madzi moyenera, imakupatsani mphamvu zowonjezera pamoyo,
hypertonic, normalization kagayidwe ndi chiwindi ntchito, osmotic magazi, kuwonjezera kuyeretsa kuchokera poizoni, ali ndende ina (mpaka 40%).

Nthawi zambiri, shuga amaperekedwa kudzera mu mnofu, monga jakisoni wambiri woipa kwambiri pamitsempha yamagazi. Kuwongolera madontho kumagwiritsidwa ntchito ngati mankhwala osunthika nthawi zonse amakhala m'matumba akufunika kwakanthawi.

Pambuyo pakuyamwa kwa dextrose, umagwera mu kaboni dayokiti ndi madzi mothandizidwa ndi asidi, kumasula mphamvu yofunikira maselo.

Glucose mu isotonic solution

Dende ya Dextrose 5% imaperekedwa ku thupi la wodwalayo m'njira zonse zomwe zingatheke, chifukwa imagwirizana ndi kuchuluka kwa magazi a osmotic.

Nthawi zambiri, madontho amayamba pogwiritsa ntchito 500 ml kapena kupitirira. mpaka 2000 ml. patsiku. Kuti mugwiritse ntchito, glucose (njira yotsikira) imayikidwa m'matumba a polyethylene owonekera kapena mabotolo agalasi ofanana.

Yankho la isotonic limagwiritsidwa ntchito ngati maziko a mankhwala ena omwe amafunikira mankhwalawa, ndipo zotsatira za donthoyo pakhungu likhala chifukwa cha kuphatikiza kwa glucose komanso mankhwala enaake pakapangidwe kake (mtima wa glycosides kapena mankhwala ena omwe amawonongeka ndi madzi am'madzi, ascorbic acid).

Nthawi zina, mavuto omwe amakhudzidwa ndi kukapanda kuleka amatha:

kuphwanya zamchere mchere
kusintha kwa thupi chifukwa cha kuchuluka kwa madzimadzi,
kulakalaka kwambiri
malungo
magazi ndi ma hematomas pamalo a jekeseni,
kuchuluka kwa magazi,
shuga owonjezera wamagazi (woopsa, chikomokere).

Izi zitha kuchitika chifukwa chatsimikiza yolakwika ya kuchuluka kwa madzimadzi otayika thupi ndi kuchuluka kwa madzi othandiza kuti mudzaze. Kuwongolera kwamadzi olowa kwambiri kumachitika ndi ma diuretics.

Hypertonic Dextrose Solution

Njira yayikulu yoyendetsera yankho ndi kudzera mu mtsempha. Kwa otsitsira, mankhwalawa amagwiritsidwa ntchito pochita ndi dokotala (10-40%) poyerekeza ndi osaposa 300 ml patsiku ndi kuchepa kwambiri kwa shuga m'magazi, kutaya magazi kwambiri pambuyo povulala komanso kutuluka magazi.

Kuchepetsa kuyamwa kwa glucose wokhazikika kumakupatsani mwayi:

konzani ntchito ya chiwindi,
kusintha mtima wamtima
bwezeretsani magazi mokwanira,
imathandizira kuchotsa kwamadzi kuchokera mthupi,
bwino kagayidwe kachakudya minofu,
imafinya mitsempha yamagazi.

Mlingo wa kulowetsedwa kwa chinthu pa ola limodzi, kuchuluka kwake kuyenera kuperekedwa kwa tsiku limodzi, kumatsimikiziridwa ndi zaka komanso kulemera kwa wodwalayo.

akulu - osaposa 400 ml.,
ana - mpaka 170 ml. pa 1000 magalamu a kulemera, makanda - 60 ml.

Ndi nthenda ya hypoglycemic, dontho lokhala ndi glucose limayikidwa ngati njira yotithandizira, pomwe malingana ndi malangizo a dokotala, kuchuluka kwa shuga kwa wodwalayo kumayang'aniridwa pafupipafupi (monga momwe thupi limachitikira).

Zolemba za mankhwala

Hemeni ya insulin ndi mankhwala a protein-peptide omwe amagwiritsidwa ntchito pochiza matenda a shuga. Imatha kukopa machitidwe a metabolic mthupi, makamaka pa chakudya.

Chifukwa cha insulini, shuga m'magazi komanso kuchuluka kwa mayamwidwe ake ndi minofu amatha kuchepetsedwa kwambiri. Kuphatikiza apo, mahomoni amalimbikitsa kupanga glycogen ndikuletsa kutembenuka kwa lipids ndi ma amino acid kukhala chakudya.

Gawo lalikulu la insulin limatengedwa kuti litenge ntchito yochepetsa shuga ya 0,045 mg ya crystalline insulin.

The achire zotsatira thupi la odwala matenda ashuga makamaka amagwirizana ndi kuchotsedwa kwa kusokonezedwa mu tsiku ndi tsiku kagayidwe kachakudya matenda a lipids ndi chakudya. Insulin imawongolera thanzi la odwala chifukwa chakuti:

shuga wamagazi amachepa
glucosuria (shuga mu mkodzo) ndi acetonuria (kudzikundikira kwa acetone m'magazi) amachotsedwa,
chiwonetsero cha zovuta zambiri za matenda a shuga (polyarthritis, furunculosis, polyneuritis) amachepetsa.

Ndani amawonetsedwa insulin?

Chizindikiro chachikulu chogwiritsa ntchito mankhwalawa ndi matenda a mtundu 1 shuga mellitus (wodalira insulin). Ngati mungabayikize mahomoni m'mankhwala ochepera (kuchokera pazinthu 5 mpaka 10), ndiye kuti amakuthandizani:

matenda ena a chiwindi
acidosis
kutaya kwamphamvu
kutopa
furunculosis,
chithokomiro.

Mokwanira kwambiri, mankhwalawa amatha kugwiritsidwa ntchito ku dermatology. Insulin imatha kulimbana bwino ndi matenda a shuga a chifuwa cha shuga, ziphuphu, khungu, Psoriasis, urticaria, pyoderma yosatha ndi kuwonongeka kwa yisiti pakhungu.

Nthawi zina zimakhala zotheka kugwiritsa ntchito insulin muzochita zama psychopsychiatric. Kuphatikiza apo, timadzi timene timagwiritsidwa ntchito pochiza kudalira mowa komanso mavuto amanjenje.

Masiku ano, ena mwa mitundu ya matenda a schizophrenia amathandizidwa bwino chifukwa cha insulinocomatosis. Imakhala yokhudza kukhazikitsidwa kwa mankhwalawa mu milingo yotere yomwe ingayambitse kudandaula kwa hypoglycemic.

Malamulo ogwiritsira ntchito

Nthawi zambiri, insulini imaphatikizira jakisoni wamkati ndi mu mnofu wapakati ndi syringe yapadera. M'mikhalidwe yapadera, mwachitsanzo, mukomoka, imatha kutumikiridwa kudzera m'mitsempha. Kuyimitsidwa kwa insulin kumayendetsedwa kokha pakhungu.

Mlingo wa tsiku ndi tsiku uyenera kumalilidwa katatu ndipo musanadye (30 mphindi). Mphamvu ya jakisoni woyamba imayamba pambuyo pa mphindi 30-60 ndipo imatenga maola 4 mpaka 8.

Pakaperekedwa kwa magazi, mankhwalawa amafika pakapita mphindi 20-30 ndipo pakatha mphindi 60 chiwopsezo cha timadzi m'magazi a wodwalayo chimafika msanga.

Kuphatikiza kuyimitsidwa kwa nthawi yayitali mu syringe, zomwe zili mu vial ziyenera kugwedezeka bwino mpaka kuyimitsidwa koyenera.

Pochotsa matenda a shuga ndi inulin, ndikofunikira kutsatira zakudya zapadera. Mlingo wa mankhwalawa ayenera kusankhidwa mosiyanasiyana. Zimatengera kwathunthu:

kuopsa kwa matendawa
kuchuluka kwa glucose kwamkodzo
zambiri za wodwala.

Voliyumu yovomerezeka imasiyana kuchokera ku 10 mpaka 40 magawo patsiku. Mankhwalawa odwala matenda ashuga, Mlingo wa timadzi timadzi tomwe timafunikira tiyenera kuchuluka:

ndi makina oyenda mpaka 100 PISCES,
kudzera m'mitseko mpaka 50 mayunitsi.

Dongosolo la matenda ashuga limapereka mlingo wa insulin, womwe umasiyana malinga ndi zovuta zake. Matenda ena onse azachipatala safuna kuchuluka kwa zinthu zomwe zaperekedwa.

Ndani amene sayenera kubayitsa insulin?

Pali mosiyanasiyana contraindication ntchito insulin. Izi zimaphatikizapo matenda:

chiwindi
zilonda zam'mimba ndi zam'mimba,
yade
kapamba
matenda a impso
matenda a mtima owonongeka.

Zotsatira zoyipa za thupi

Monga ulamuliro, zovuta zimachitika pokhapokha chifukwa cha kuchuluka kwa insulin. Chifukwa cha kayendetsedwe ka intravenous kapena subcutaneous, kukhazikika kwake m'magazi kumachuluka. Kuphatikiza apo, ngati shuga sanalowe m'thupi, ndiye kuti mwayi wokhala ndi vuto la hypoglycemic ndiwambiri (pomwe glucose imatsikira pamlingo wosavomerezeka).

Nthawi zambiri, insulin yayikulu imayambitsa:

kugunda kwamtima kwambiri
kufooka kwa minofu
kupuma movutikira
thukuta
kupulumuka.

M'mikhalidwe yovuta kwambiri, kuwonjezereka kwa insulin yopanda chiphuphu cha carbohydrate (ngati shuga sanadye) kumaphatikizapo kusowa chikumbumtima, kukomoka komanso kuchepa kwa magazi.

Kuti muchepetse vutoli mwachangu, ndikofunikira kudyetsa wodwalayo 100 ga mkate wopanda tirigu, tiyi wopanda mkaka kapena supuni ziwiri za shuga wonenepa pokhapokha kuwonekera kwa hypoglycemia.

Ndi zizindikiro zazikulu za matenda a matenda ashuga, shuga m'mitsempha ndikuthothoka. Ngati ndi kotheka, shuga angagwiritsidwe ntchito mosadukiza kapena epinephrine akagwiritsidwa ntchito.

Momwe mungabayire jakisoni?

Jekeseni wamkati amamuikidwa m'malo omwe amakhala ndi mitsempha yotupa: pamphumi, pa ulnar fossa ndi dzanja. Algorithm ya jakisoni imaphatikizapo zinthu zotsatirazi:

kupezeka kwamitsempha
kuyika singano ndikalowetsa mu mtsempha,
kugwada m'chiuno chakumanja kwa dzanja la munthuyo kuti magazi ake asiye kumalowo.

Konzani wodwalayo jakisoni - khalani pampando kapena pakama.
Ikani bondo lamanja kumbuyo kwa jekeseni kulowa mu mtsempha pa cholembera cholimba.
Sungani mankhwalawo mu syringe.
Konzani chokongoletsera chamiyendo pamwamba pa chopondera kuti mulandire magazi kupita m'mitsempha.
Funsani wodwalayo kuti agwire ntchito ndi nkhonya yake panthawi yomwe akumva kuti ndi mtsempha wokhala ndi magazi.
Mankhwala amathandizidwa pamalo omwe akukonzekera.
Tetezani kachakudya ndi mowa kawiri malo omwe jekeseni.
Singano idayikidwapo (ndi kudula), ulendo wamtambo sunatsitsidwe, nkhonya sichinafotokozedwe.
Mankhwalawa amaperekedwa pang'onopang'ono, magawo khumi a ml ali otsalira mu syringe.
Singano imachotsedwa mu mtsempha, swab ya thonje imayikidwa pamalo opangira jekeseni, mkono umawongoka.
Mowongoka, ndikulimbikitsidwa kuti mugwire dzanja lanu kwa mphindi zisanu (kuphulika sikukupanga).

Zofunika! Ndikotheka kuteteza wodwala ku matenda m'magazi ngati ukhondo waukhondo uyang'aniridwa: magolovesi otayika ndi namwino, omwe amaperekedwa ndi fakitoreji yakufakitale, zofooka za singano ndi mankhwala obayira. Pamapeto pa njirayi, tsamba la jakisalo limatsekedwa ndi swab ya thonje ndi mowa.

Kuchulukitsa kwa magazi kuchokera m'mitsempha ndi jakisoni aliyense wa mankhwala m'mitsempha amachitidwa ndi akatswiri odziwa ntchito zamankhwala.

Kudzinyenga, malamulo ndi tsatanetsatane wa jekeseni wamkati kuyambira koyambira mpaka kumapeto kumawonetsa kanema

Njira yakhazikitsira jakisoni wambiri

Kutalika kwa kukhazikitsidwa kwa mankhwala mu mtsempha kumatenga mphindi khumi. Njira ya jakisoni imalola namwino wodziwa kubayira jekeseni wamitsempha posapweteka komanso mwachangu kuti musakhale ndi nthawi yochita mantha. Nthawi zambiri, mankhwala amalowetsedwa mu mtsempha kumbuyo. Ngati sizotheka kupeza mitsempha yodzaza magazi m'derali, ndiye kuti mitsempha ina yomwe ili kumbuyo kwa dzanja imatengedwa kuti idzabaye. Mankhwalawa sakupaka m'mitsempha kuti miyendo ipite chifukwa chowopseza kuti magazi atha. Jekeseni yolondola ya algorithm ili ndi njira zotsatirazi:

Syringe imatengedwa ndi dzanja lamanja, singano ya singano imagwidwa ndi chala cholozera.
Mbiya ya syringe imakidwa ndi zala zina.
Msempha umapindika kachiwiri, malo omwe jakisoni wam'tsogolo amathandizira ndi swab yatsopano, dzanja lamanzere limakonza khungu.
Wodwalayo akhomera.
Dzanja limagwira syringe pafupi kufanana (pakadutsa madigiri 15) kumalo opaka jakisoni, singano - yodulidwa.
Kuponyedwa kumapangidwa, singano imadutsa gawo limodzi mwa magawo atatu pakati pa khungu ndi mtsempha, kenako kubaya khoma la mtsempha, izi zimayendetsedwa ndikumverera kwa "kulephera".
Tambitsani chingwe cholowetsa pang'ono, magazi azituluka muming'alu, zomwe zimatsimikizira kupezeka kwa singano m'mitsempha.
Chikondwererochi chimachotsedwa, nkhonya imapumula
Kuyang'ananso singano mumtsempha.
Mankhwala ochepetsetsa, gawo limodzi la mankhwala amakhalabe mu silinda - osavulala.
Syringe imachotsedwa, swab ya thonje yokhala ndi mowa imayikidwa, ponyani mkono.
Mukugwada, gwira dzanja lanu kwa mphindi 5, sipadzakhala kuvulala.