Matenda a shuga - Zizindikiro, chisamaliro chadzidzidzi, zotsatira zake

Chimodzi mwa matenda amakono kwambiri ndi matenda ashuga. Ambiri sadziwa nkomwe, chifukwa cha kusowa kufotokoza kwa zizindikiro, kuti ali ndi matenda ashuga. Werengani: Zizindikiro zazikulu za matenda ashuga - muyenera kuzisamala nthawi yanji? Chifukwa chake, kuchepa kwa insulin kumatha kudzetsa mavuto akulu ndipo, pakakhala chithandizo choyenera, kumakhala koopsa. Mavuto akulu kwambiri a matenda ashuga ndi chikomokere. Ndi mitundu yanji ya matenda a shuga omwe amadziwika, ndipo ndimomwe mungapereke thandizo kwa wodwala omwe ali ndi vutoli?

Matenda a shuga - omwe amayambitsa, mitundu ya odwala matenda ashuga

Mwa zovuta zonse za matenda ashuga, kupweteka kwambiri monga kudwala matenda ashuga nthawi zambiri kumatha kusintha. Malinga ndi zomwe ambiri amakhulupirira, chikomokere cha matenda ashuga ndi mtundu wa hyperglycemia. Ndiye kuti, magazi ochulukirapo. M'malo mwake, matenda a shuga atha kukhala osiyanasiyana:

Hypoglycemic
Hyperosmolar kapena hyperglycemic chikomokere
Ketoacidotic

Zomwe zimayambitsa kudwala matenda ashuga zimatha kuchuluka kwambiri m'magazi, njira zochiritsira zosagwirizana ndi matenda ashuga komanso kuchuluka kwa insulini, momwe mulingo wa shuga umatsikira pansi.

Zizindikiro za hypoglycemic chikomokere, thandizo loyamba la hypoglycemic chikomokere

Mikhalidwe ya Hypoglycemic ndi yodziwika bwino, makamaka zamtundu 1 shuga, ngakhale amapezeka mwa odwala omwe amamwa mankhwala osokoneza bongo mapiritsi. Monga lamulo, chitukuko cha boma chimayendetsedwa ndi kuchuluka kwakukulu kwa insulin m'magazi. Kuopsa kwa hypoglycemic coma kuli mu kugonjetsedwa (kosasinthika) kwamanjenje ndi ubongo.

Hypoglycemic chikomokere - Zizindikiro

At mapapu adalemba:

Zofooka zambiri.
Kuchulukitsa kwamanjenje.
Miyendo Yanjenjemera.
Kuchulukitsa thukuta.

Ndi zizindikiro izi, ndikofunikira mwachangu siyani kuukira popewa kukula kwamtundu wokongola, zomwe mawonekedwe ake ndi:

Kugwedezeka, kusandulika msanga.
Mphamvu yanjala.
Kusintha kwamanjenje.
Kutuluka thukuta kwambiri.

Nthawi zina Khalidwe la odwala limafulumira kukhala losalamulirika - mpaka kuchita zankhanza, komanso kuchuluka kwa kugwidwa ngakhale kumalepheretsa kukula kwa miyendo ya wodwalayo. Zotsatira zake, wodwalayo amataya kuyang'ana malo, ndikuchidziwika kumachitika. Zoyenera kuchita

Choyamba thandizo la hypoglycemic chikomokere

Ndi zizindikiro zofatsa wodwala ayenera kupereka ochepa shuga, pafupifupi 100 g ma cookie kapena supuni 2-3 za kupanikizana (uchi). Ndikofunika kukumbukira kuti ndi shuga yodalira insulini nthawi zonse muyenera kukhala ndi maswiti "pachifuwa".
Ndi zizindikiro zazikulu:

Thirani tiyi ofunda mkamwa mwa wodwala (galasi / masamba atatu a shuga) ngati angathe kumeza.
Asanalowetse tiyi, ndikofunikira kuyika chosungira pakati pa mano - izi zithandiza kupewa kupindika kwambiri nsagwada.
Potsatira, kuchuluka kwa kusintha, kudyetsa wodwalayo chakudya chochuluka (chakudya, mbale za ufa ndi chimanga).
Kuti mupewe kuchitika kachiwiri, chepetsani insulini ndi ma 4-8 mamawa.
Mukamaliza kuthana ndi vuto la hypoglycemic, pitani kuchipatala.

Ngati chikomokere chikukula Kutaya mtimandiye kutsatira:

Yambitsani 40-80 ml ya shuga m'magazi.
Chitanani mwachangu ambulansi.

Thandizo loyamba la hyperosmolar coma

Yikani wodwala moyenera.
Fotokozerani mawu oyendetsa ndikulanda lilime.
Pangani zosintha zakakamizo.
Lowetsani mkati mwa 10-20 ml ya glucose (40% yankho).
Kuledzera pachimake - nthawi yomweyo imbani ambulansi.

Matenda a shuga a ana ndi akulu: zimayambitsa ndi zotsatirapo zake

Matenda a shuga amapezeka m'gulu la matenda omwe shuga ya m'magazi imakwera. Izi zimatha kudzetsa kukalamba kwa thupi ndi kuwonongeka pafupifupi ziwalo zake zonse ndi machitidwe ake.

Endocrinologists amakhulupirira kuti ngati njira zochotsekera zimachitidwa ndikuchitidwa bwino, nthawi zambiri ndizotheka kupewa kapena kuletsa kuyambika kwa matenda ashuga. Inde, nthawi zambiri, kusokonezeka kotere kumachitika ndi chithandizo chamanthawi osakwanira, kudziletsa osakwanira komanso osagwirizana ndi zakudya.

Zotsatira zake, boma la hypoglycemic limayamba, lomwe limabweretsa kukula kwa chikomokere mu matenda a shuga. Nthawi zina kusowa mpumulo kwakanthawi kadzidzidzi ngati kameneka kumatha kupha.

Kodi kudwala matenda ashuga ndi chiyani ndipo zimayambitsa ndi mitundu yanji?

Tanthauzo la chikomokere ndi matenda ashuga - pamakhala mkhalidwe womwe wodwala matenda ashuga amataya chikumbumtima akakhala kuti ali ndi kuchepa kapena kuchuluka kwa shuga m'magazi. Ngati ali ndi vutoli ngati wodwala sangapatsidwe chithandizo mwadzidzidzi, ndiye kuti chilichonse chitha kupha.

Zomwe zimayambitsa chiwonetsero cha matenda ashuga ndikuwonjezereka msanga kwa kuchuluka kwa shuga m'magazi, komwe kumachitika chifukwa cha kusakwanira katemera wa insulin ndi kapamba, kusadziletsa, kusaphunzira komanso anthu ena.

Popanda insulin yokwanira, thupi silingathe kupanga shuga chifukwa cha zomwe sizisintha kukhala mphamvu. Kusowa koteroko kumabweretsa kuti chiwindi chimayamba kudzipangira payekha shuga. Pokana ndi maziko awa, pali mphamvu yogwira matupi a ketone.

Chifukwa chake, ngati shuga achuluka m'magazi mwachangu kuposa matupi a ketone, ndiye kuti munthu amasiya kuzindikira ndikuyamba kudwala matenda ashuga. Ngati ndende ya shuga ikwera pamodzi ndi matupi a ketone, ndiye kuti wodwalayo angagwe mu ketoacidotic coma. Koma pali mitundu ina yamikhalidwe yotere yomwe iyenera kulingaliridwa mwatsatanetsatane.

Mwambiri, mitundu iyi ya chikomokere cha shuga imadziwika:

achina,
hyperglycemic,
ketoacidotic.

Hypoglycemic chikomokere - chitha kuchitika pamene kuchuluka kwa shuga m'magazi amtsitsi mwadzidzidzi. Vutoli litenga nthawi yayitali bwanji, chifukwa zambiri zimatengera kuopsa kwa hypoglycemia komanso thanzi la wodwalayo. Matendawa atha kudwala matenda osokoneza bongo omwe amathamangira pakudya kapena iwo omwe samatsata mlingo wa insulin. Hypoglycemia imawonekanso pambuyo povutitsa kapena kuledzera.

Mtundu wachiwiri - kukomoka kwa hyperosmolar kumachitika ngati vuto la shuga 2, lomwe limayambitsa kusowa kwa madzi komanso shuga wambiri wamagazi. Kuyamba kwake kumachitika ndi glucose wambiri kuposa 600 mg / l.

Nthawi zambiri, hyperglycemia yowonjezera imalipidwa ndi impso, zomwe zimachotsa glucose wambiri ndi mkodzo. Pankhaniyi, chifukwa cha kukhazikika kwa chikomokere ndikuti pakutha kwamadzi opangidwa ndi impso, thupi limakakamizidwa kupulumutsa madzi, omwe angayambitse hyperglycemia.

Hyperosmolar s. matenda ashuga (Latin) amakula nthawi 10 kuposa hyperglycemia. Kwenikweni, mawonekedwe ake amapezeka ndi mtundu wachiwiri wa shuga mwa odwala okalamba.

Ketoacidotic diabetesic coma amakula ndi mtundu 1 shuga. Mtundu wamtunduwu umatha kuonedwa pamene ma ketones (ovuta ma acetone acids) akadziunjikira m'thupi. Zina mwazinthu zopanga mafuta acid zimachitika chifukwa cha kuchepa kwambiri kwa insulin.

Hyperlactacidemic coma mu shuga imachitika kawirikawiri. Izi ndizodziwika kwa okalamba omwe ali ndi vuto la chiwindi, impso ndi mtima.

Zomwe zimapangitsa kukula kwa mtundu uwu wa matenda ashuga ndi maphunziro ochulukirapo ndikugwiritsira ntchito molakwika kwa hypoxia ndi lactate. Chifukwa chake, thupi limapatsidwa mankhwala a lactic acid, omwe amaphatikizika mopitirira muyeso (2-4 mmol / l). Zonsezi zimabweretsa kuphwanya koyenera kwa lactate-pyruvate komanso mawonekedwe a metabolic acidosis omwe ali ndi kusiyana kwakukulu kwa anionic.

Vuto lochokera ku mtundu wa 2 kapena matenda ashuga 1 ndi lovuta kwambiri komanso loopsa kwa munthu wamkulu yemwe ali ndi zaka 30 zakubadwa. Koma izi ndizowopsa makamaka kwa odwala ochepa.

Khansa ya matenda ashuga mwa ana nthawi zambiri imayamba ndi matenda omwe amadalira insulin omwe amakhala zaka zambiri. Nthawi zambiri azimayi odwala matenda ashuga amawonekera pasukulu yasekondale kapena pasukulu, nthawi zina pachifuwa.

Komanso, osakwana zaka 3, zinthu zotere zimachitika nthawi zambiri kuposa akulu.

Matenda a shuga - Zizindikiro, chisamaliro chadzidzidzi, zotsatira zake

Matenda a shuga ndi vuto m'thupi la munthu wokhala ndi matenda ashuga, omwe amadziwika ndi kusokonezeka kwakukulu kwa metabolic. Zimatha kuchitika chifukwa cha kuchepa kwambiri kapena kuchuluka kwa shuga m'magazi. Kukhala ndi vuto la matenda ashuga kumafuna chisamaliro chamankhwala. Ngati sichikhalapo kwa nthawi yayitali, zovuta zazikulu zimatha kufika pakufa.

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

Akatswiri amasiyanitsa mitundu ili:

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

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

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

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

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

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

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

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

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

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

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

Sizingatheke kudziwa matenda a matenda ashuga mwa kuwunika kokha. Pachifukwa ichi, wodwalayo amapita kukayezetsa angapo, komwe kuyezetsa magazi, komwe kumatsimikiza kuchuluka kwa shuga, ndikofunikira kwambiri. Kuphatikiza pa iye, kuyesa kwamwazi wamagazi, urinalysis imachitidwanso.

Mtundu uliwonse wa chikomokere matenda a shuga umayendera limodzi ndi kuchuluka kwa shuga wamagazi pamwamba pa 33 mmol / L. Chokhacho chokha ndicho hypoglycemic, chifukwa chomwe shuga amachera pansi pa 2,5 mmol / L. Mukakhala ndi vuto la hyperglycemic, munthu samakumana ndi zizindikiritso zilizonse. Ketoacidotic chikomacho chitha kuzindikiridwa ndi maonekedwe a matupi a ketone mumkodzo, ndi hyperosmolar coma pakuwonjezeka kwa plasma osmolarity. Lactacidemic coma imadziwika ndi kuwonjezeka kwa kuchuluka kwa lactic acid m'magazi.

Chofunika kwambiri pochizira matenda a shuga amatha kutchedwa kuti kusamalitsa kwa nthawi. Ngati munthu samwa mankhwala kwa nthawi yayitali, amakhala ndi vuto lalikulu kwambiri, monga kutupa kwa ubongo kapena mapapu, stroko, mtima, thrombosis, aimpso kapena kulephera kupuma, ndi ena ambiri. Ndi chifukwa ichi kuti dokotala akangotsimikizira kuti am'peza, wodwalayo amayamba kupereka chithandizo chamankhwala.

Ngati munthu ali ndi ketone chikomokere, madokotala akuchita zonse zotheka kubwezeretsa zizindikiritso zofunika za thupi: kuthamanga kwa magazi, kupuma, kugunda kwa mtima. Komanso, wodwala ayenera kuzindikira. Dokotala amaletsa kuukira ndi yankho la glucose ndi sodium chloride, yomwe imabwezeretsa mchere wamadzi.

Chithandizo cha lactic acidemic chikomwe chimagwira ntchito zomwezo monga ketoacidotic. Komabe, pankhaniyi, kubwezeretsanso acid-base ukulingana ndikofunika kwambiri pochiritsa.Munthu kuchipatala amapatsidwa jekeseni wamagazi ndi insulin, ngati zizindikilo zofunika zimayambiranso mwachizolowezi.

Ngati wodwala yemwe ali ndi matenda a shuga a 2 kapena anthu omwe anali pafupi naye atazindikira zizindikiro za chikumbumtima chikubwera, ndiye kuti ndizotheka kuletsa izi kuti zisachitike. Mutha kuletsa izi podya zakudya zopatsa mphamvu: kachakudya kakang'ono, shuga, kuphika batala, supuni ya jamu kapena tiyi wokoma nthawi zonse. Pambuyo pake, muyenera kutenga malo abwino ndikudikirira thanzi labwino. Ngati sichinatsatire, imbani ambulansi.

Anthu odwala matenda ashuga akayamba kukomoka chifukwa chomupatsa insulin yambiri, anthu ayenera kudya zakudya zopatsa msanga. Pazifukwa izi, tikulimbikitsidwa kugwiritsa ntchito phala ya chimanga. Mwa mitundu yayikulu ya zotupa, sikungatheke kuyimitsa chikumbumtima cha hypoglycemic motere. Pankhaniyi, katswiriyu amayendetsa njira ya glucagon kapena shuga m'magazi.

Ndondomeko zotsatirazi ziyenera kutsatiridwa kuti zithandizire kuchepetsa vuto la matenda ashuga:

Imani mayeso pafupipafupi,
Tsatirani malangizo a dokotala,
Idyani moyenera komanso pafupipafupi,
Nthawi zonse yang'anani shuga yanu yamagazi
Khalani ndi moyo wokangalika
Siyani zizolowezi zoyipa
Chepetsani kuchuluka kwa zovuta ndi nkhawa m'moyo wanu.

Kusintha kwachilengedwe m'magazi a shuga m'magazi nthawi zonse kumabweretsa chitukuko chachikulu cha thupi. Kukula kwawo kumatengera kuthamanga kwa chithandizo chamankhwala. Chifukwa cha kuchuluka kwa mkodzo womwe umapangidwa ndi impso, munthu amakhala ndi madzi osowa kwambiri m'mimba, omwe amawonjezereka ngakhale atatha kumwa madzi. Izi zimabweretsa kuchepa kwa magazi, omwe amachepetsa kuthamanga kwa magazi. Izi zimayambitsa zovuta m'magazi ndi minofu yonse, komabe, izi ndizowopsa ku ubongo.

Pamodzi ndi mkodzo, ma electrolyte ofunikira kuti agwire bwino ntchito amachotsedwa m'thupi.

Matenda a shuga ndi kupatuka kwakukulu pakugwira ntchito kwa thupi. Nthawi zambiri zimasiya kugwira ntchito poyenda mthupi. Komabe, kuchuluka kwa zotupa kumadalira momwe chithandizo chamankhwala chidalili panthawi yake. Ndi kuyambitsidwa mwachangu kwa mankhwala, kupatuka kwakukulu kungapewedwe. M'malo mochedwa, munthu amatha kufa. Kafukufuku akuwonetsa kuti kufa kumachitika mu 10% ya anthu odwala matenda ashuga.

Matenda a shuga ndi vuto lomwe limachitika ndi matenda a shuga. Vutoli limayamba kuthamanga. Kulephera kuchitapo kanthu mwadzidzidzi kumatha kudzetsa mavuto akulu azaumoyo ngakhale kufa. Chifukwa chake, ndikofunikira kuti aliyense wodwala matenda ashuga azindikire zomwe zimayambitsa matenda osokoneza bongo komanso zomwe ayenera kuchita akapezeka.

Pali mitundu inayi ya chikomokere cha matenda ashuga: ketoacidotic, hyperosmolar, hyperlactacidemic ndi hypoglycemic.

Mtundu woyamba wa shuga umayamba ketoacidotic chikomokere. Zimachitika motsutsana ndi maziko osowa insulini komanso kukwera kwakuthwa kwa shuga m'magazi. Zotsatira zake, kuchuluka kwa glucose kumachepetsedwa, kagayidwe kake kamachepa, kugwira ntchito bwino kwa machitidwe onse ndipo ziwalo zina zimachitika. Ketoacidotic coma imayamba mkati mwa masiku 1-2 (nthawi zina mwachangu). Mlingo wa shuga pomwe chikomokere chimatha kufika 19-33 mmol / l ndikukwera pamwamba. Pakakhala kuti palibe nthawi yake, wodwala matenda ashuga amatha kukomoka kwambiri.

Matenda a 2 a shuga amayambitsa hyperosmolar coma. Mtunduwu umayambanso chifukwa chosowa insulini. Zimaphatikizidwa ndi kuchepa kwamphamvu kwa thupi ndi kuchuluka kwachuma, shuga ndi urea ion m'magazi. Mothandizidwa ndi hyperosmolarity, zovuta zazikulu zimachitika m'thupi la munthu, zomwe nthawi zambiri zimayendera limodzi ndi kusazindikira.

Mitundu iwiri yotsala ya chikomokere cha shuga imakhala yofanana pamitundu iwiri yonseyo. Hyperlactacidemic chikomokere Amayamba ndi kudzikundikira kwa lactic acid m'magazi. Cholinga chake ndikuchepa kwa insulin. Zotsatira zake zakupanga chikomokere, kupangika kwa magazi m'magazi kumasintha, kukhala woipa, ndikuthanso kuzindikira.

Mitundu yomwe yatchulidwa ndi chikomokere. Amachitika motsutsana ndi maziko akweza kwambiri magazi a shuga. Njira yosinthira imabweretsa chitukuko hypoglycemic chikomokere. Kupsinjika kumayamba ndi kuchepa kwa glucose wamagazi mpaka gawo lovuta. Izi zimabweretsa mphamvu yanjala yaubongo. Ndi chifuwa cha hypoglycemic, shuga wamagazi amatsika mpaka 3,33-2.77 mmol / lita. Mukanyalanyaza zizindikiro zomwe zimatuluka, kuchuluka kwa glucose kumatha kutsika mpaka 2.77-1.66 mmol / lita. Pankhaniyi, zizindikiro zonse za hypoglycemia zimawonekera. Wodwala wokhala ndi zizindikiro zotere ayenera kupita kuchipatala kuti akalandire chithandizo. Miyezo yovuta ya shuga - 1.66-1.38 mmol / lita - zimapangitsa kuti munthu asamadziwe. Thandizo ladzidzidzi la akatswiri okhawo lingapulumutse munthu.

Mtundu uliwonse wa chikomokere cha shuga umayambitsidwa ndi zomwe zimayambitsa.

Matenda a Hyperglycemic amayamba chifukwa cha kuchepa kwa insulin, komwe kumapangitsa kuti glucose achuluke msanga. Nthawi zambiri, zinthu zotsatirazi zingayambitse kuchepa kwa insulin:

mimba
matenda
kuvulala ndi kuchitapo kanthu,
ntchito kwa nthawi yayitali a glucocorticoids kapena okodzeya,
kuchita masewera olimbitsa thupi kwambiri komanso zochitika zovutitsa,
kulephera kudya, kusala kudya kwanthawi yayitali, kumwa mowa kwambiri.

Zomwe zimayambitsa ketoacidotic chikomachi ndi poyizoni ndi matupi a ketone ndi acetone. Kuperewera kwa insulin kumapangitsa kuti thupi liyambe kubwezeretsa mphamvu kuchokera ku mapuloteni ndi mafuta, osati kuchokera ku glucose. Munthawi yopanga mphamvu molakwika, ma ketones ndi acetone acetic acid amapangidwa pamiyeso yambiri. Kuchulukitsa kwawo kumatenga malo osungirako zamchere ndipo kumayambitsa ketoacidosis (metabolism yayikulu) komanso kusokonezeka kwa kagayidwe kazinthu kamadzi.

Kupitilira patsogolo kwa hyperosmolar coma kumatha kuchitika chifukwa chomwa mowa kwambiri, kutsegula m'mimba ndi kusanza kwa etymology iliyonse, nyengo yotentha ndi kutentha kwambiri kwa mpweya, peritoneal dialysis kapena hemodialysis, kukhetsa magazi kwa nthawi yayitali.

Lactacidemic chikomachi chimatha kuyambitsa mtima kapena kupuma. Kukomoka nthawi zina kumayamba ndi mphumu ya bronchial, bronchitis, kulephera kwa magazi, mtima pathologies. Nthawi zambiri chomwe chimayambitsa kukomoka ndi kutupa ndi matenda, chiwindi kapena matenda a impso. Odwala omwe ali ndi vuto lauchidakwa nthawi zonse amakhalanso pachiwopsezo.

Zomwe zimayambitsa kuperewera kwa hypoglycemic kukugona pakusowa kwa magazi. Vutoli lingayambitse kuchuluka kwa insulini kapena kutsitsa shuga m'mlomo. Nthawi zambiri hypoglycemia imachitika chifukwa choti munthu wodwala matenda ashuga atatha kudya insulin adaphonya chakudya kapena amadya chakudya chokwanira. Nthawi zina shuga wochepa amawoneka motsutsana ndi maziko a kuchepa kwa ntchito kwa adrenal kapena kulepheretsa mphamvu ya chiwindi. Chifukwa china cha kuperewera kwa hypoglycemic ndi ntchito yolimbitsa thupi.

Mtundu uliwonse wa chikomokere cha matenda ashuga uli ndi mawonekedwe ake. Ngakhale Zizindikirozi nthawi zambiri zimakhala zofanana, kuzindikira komaliza kumatha kupangidwa pambuyo pa kuyesedwa kwa maabara.

Hyperglycemic coma imayendera limodzi ndi zizindikiro zomwe zasonyezedwa pansipa.

Kuchulukitsa ludzu.
Kukodza pafupipafupi.
Kufooka kwapafupipafupi, komwe nthawi zambiri kumayendetsedwa ndi mutu.
Wosangalatsa mtima, wotsatira kugona.
Anachepetsa chilako.
Nusea (nthawi zina umatsatiridwa ndi kusanza).

Zizindikiro zowonjezera za hyperosmolar coma zimaphatikizira kuchepa kwa madzi m'thupi, kulankhula mkhutu ndi areflexia (chizindikiro cha chikomokere).

Zizindikiro za ketoacidotic chikomokere pang'onopang'ono. Pankhaniyi, madokotala ali ndi mwayi chisanafike chovuta kuti achitire chithandizo chonse. Komabe, ngati wodwala matenda ashuga samalabadira zoyamba za matendawa, ndiye kuti kukula kwa vutolo, kuwonetseredwa ndi kupuma kwakuya komanso kwamkokomo, kupweteka kwam'mimba popanda kutulutsa kwina, kutha mphamvu, ndikotheka. Chizindikiro chodziwika bwino cha ketoacidotic chikomaso ndi kununkhira kwa acetone kuchokera mkamwa.

Lactacidemic coma, mosiyana ndi mitundu yapita, imayenda mofulumira kwambiri ndikuwonekera mu mawonekedwe a kugwa kwa mtima. Mwa zodziwika za kuperewera uku, munthu amatha kuwona kufooka komwe kakukula, kugona, kugona, komanso kusokonezeka kwa chikumbumtima.

Zizindikiro za chikomero cha hypoglycemic ndizosiyana pang'ono ndi zizindikiro za kukomoka kwa hyperglycemic. Izi zimaphatikizapo mantha, kuda nkhawa, thukuta kwambiri, kunjenjemera ndi kumva kwamphamvu njala. Ngati simuchita zinthu moyenera, thupi limatha kukulira: kufooka, kukomoka kumawonekera. Momwegee wa hypoglycemic coma ndimatha kuzindikira.

Pamaso pa matenda ashuga ana, oyambitsa chikomokere amakhala mutu, nseru komanso kusanza, kutaya chidwi (mpaka kusakhalapo kwake), ludzu lalikulu, kugona. Kukodza pafupipafupi, lilime lowuma ndi milomo ndizothekanso.

Kudziwa zizindikiro za matenda obwera chifukwa cha matenda ashuga kumathandizira kutha kwamtsogolo pakapita nthawi. Pa chizindikiro choyamba cha zovuta, ambulansi imayenera kuyitanidwa nthawi yomweyo. Asanachitike madokotala, wodwala matenda ashuga ayenera kupatsidwa chithandizo chodzidzimutsa. Choyamba, ikani wodwala kumbali yake kapena pamimba pake. Tsatirani lilime, onetsetsani kuti sil kumira ndipo sakupumira. Lolani mpweya watsopano kulowa m'chipinda cha odwala matenda ashuga.

Kupitilira apo, pamitundu yosiyanasiyana ya matenda a shuga, njira zamasamaliro ndizosiyana pang'ono. Ndi mtundu wa hyperosmolar, kukulani ndikusambitsa miyendo ya wodwala. Yang'anani kuchuluka kwa shuga ndi glucometer, kuyesa mkodzo ndi mzere wa mayeso a ketone. Palibe chochita china chofunikira. Yembekezerani ambulansi ifike.

Mitundu ya Ketoacidotic ndi lactacidemic ya kukomoka imafunikira kulowerera mwachangu ndi akatswiri. Potere, sizigwira ntchito poletsa kukula kwa mpungwepungwe mwa kuyesayesa pawokha. Chomwe mungachite ndikuwunika momwe wodwala amapumira komanso kugunda kwa mtima mpaka dokotala atafika.

Ndikokhala ndi vuto la hypoglycemic, ndikofunikira kupereka chithandizo chodzidzimutsa mwachangu kwambiri. Nthawi zambiri mawonekedwe ofatsa samatsagana ndi kutayika kwa chikumbumtima. Pankhaniyi, wodwalayo amatha kutenga payekha njira zoyenera. Pazizindikiro zoyambirira za kusowa kwa magazi, muyenera kudya pang'ono pang'onopang'ono chakudya (mkate, pasitala), kumwa tiyi ndi shuga kapena kusungunuka mapiritsi 4-5 a shuga. Hypoglycemia yayikulu imapangitsa kukomoka kwambiri. Ndi zochitika izi, wogwiridwayo sangathe popanda thandizo lakunja. Ngati wodwala ali ndi vuto la kumeza, imwani ndi madzi aliwonse okoma (osamwa zakumwa ndi zotsekemera za izi). Pakakhala kuti pakumenyetsa zinthu zowuma, ikani shuga pang'ono pansi pa lilime.

Kumbukirani: ndi mtundu uliwonse wa chikomokere cha matenda ashuga, insulin siyololedwa popanda chilolezo cha dokotala.

Pambuyo pachipatala muukoma wa matenda ashuga, cholinga chachikulu cha madotolo ndicho kusintha mtundu wa shuga m'magazi komanso kagayidwe kake ka thupi lonse. Chithandizo chimachitika moyang'aniridwa ndi achipatala ndipo amakhala ndi magawo angapo. Chinthu choyamba chomwe wodwala amapatsidwa ndi insulin (vuto la hypoglycemia, glucose iyenera kuperekedwa). Kenako, kulowetsedwa mankhwala ikuchitika ndi njira zapadera kuti abwezeretse madzi bwino, electrolyte kapangidwe ndi kusintha magazi acidity. Pambuyo masiku angapo chithandizo, wodwalayo amasamutsidwa ku dipatimenti ya endocrinology ndikusungidwa m'chipatala mpaka matendawa akhazikika.

Ndikofunika kukumbukira kuti chithandizo chanthawi yake komanso chithandizo chamankhwala chothandiza chingathandize kupewa zovuta zoyipa zokhala ndi matenda ashuga: kupuwala, edema, kugunda kwa mtima, sitiroko, sepsis, chikomokere chenicheni kapena imfa.

Matenda a shuga ndi vuto lalikulu la matenda ashuga. Chifukwa chake, odwala matenda ashuga ayenera kukumbukira kuti kudziletsa kokha, kutsata kulemera, kutsatira malamulo okhudzana ndi zakudya, kuchita masewera olimbitsa thupi pafupipafupi komanso kukana kumwa mankhwalawa kungathandize kukhala ndi moyo wonse komanso kupewa kutuluka kwa mkhalidwe wowopsa.

Ametov A., Kasatkina E., Franz M. ndi ena. Momwe mungaphunzirire kukhala ndi matenda a shuga. Moscow, Interpraks Publishing House, 1991, masamba 112, kufalitsa kowonjezera kwa makope 200,000.
Zholondz M.Ya. Kumvetsetsa kwatsopano kwa matenda ashuga. St. Petersburg, kusindikiza nyumba "Doe", 1997,172 p. Kusindikiza kwa buku lomwelo lotchedwa "Matenda A shuga. Ndimamvetsetsa tsopano. ” SPb., Nyumba yosindikiza "Onse", 1999., masamba 224, kufalitsa makope 15,000.
Ivanova, V. Matenda a chithokomiro ndi matenda a shuga / V. Ivanova. - M: Dziko la manyuzipepala "Syllable", 2012. - 487 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.

Mitundu ya Diabetesic Coma

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

Akatswiri amasiyanitsa mitundu ili:

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

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

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

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

Zizindikiro

Chithandizo cha lactic acidemic chikomwe chimagwira ntchito zomwezo monga ketoacidotic. Komabe, pankhaniyi, kubwezeretsanso acid-base ukulingana ndikofunika kwambiri pochiritsa. Munthu kuchipatala amapatsidwa jekeseni wamagazi ndi insulin, ngati zizindikilo zofunika zimayambiranso mwachizolowezi.

Kupewa

Ndondomeko zotsatirazi ziyenera kutsatiridwa kuti zithandizire kuchepetsa vuto la matenda ashuga:

Imani mayeso pafupipafupi,
Tsatirani malangizo a dokotala,
Idyani moyenera komanso pafupipafupi,
Nthawi zonse yang'anani shuga yanu yamagazi
Khalani ndi moyo wokangalika
Siyani zizolowezi zoyipa
Chepetsani kuchuluka kwa zovuta ndi nkhawa m'moyo wanu.

Zotsatira zake

Pamodzi ndi mkodzo, ma electrolyte ofunikira kuti agwire bwino ntchito amachotsedwa m'thupi.

Chisamaliro chodzidzimutsa cha ketoacidotic chikomokere, zizindikiro ndi zimayambitsa ketoacidotic chikomokere shuga

Zinthuomwe amalimbikitsa kufunikira kwa insulin ndikuthandizira kukulitsa ketoacidotic chikoma nthawi zambiri:

Kuzindikira mochedwa matenda a shuga.
Osaphunzitsidwa mankhwala mankhwala (Mlingo wa mankhwala, m'malo, zina).
Kunyalanyaza malamulo a kudziletsa (mowa, mavuto azakudya komanso zochitika zina zolimbitsa thupi, ndi zina).
Matenda owonda.
Kuvulala mwakuthupi / kwam'mutu.
Vuto la mtima mu pachimake mawonekedwe.
Ntchito.
Kubala / kutenga pakati.
Kupsinjika.

Ketoacidotic chikomokere - Zizindikiro

Zizindikiro zoyambira kukhala:

Kukodza pafupipafupi.
Ludzu, nseru.
Kugona, kufooka wamba.

Ndi kuwonongeka koonekeratu:

Kununkhira kwa acetone kuchokera mkamwa.
Ululu wam'mimba.
Kusanza kwambiri.
Phokoso, kupuma kwambiri.
Kenako kumaletsa, kusokonezeka chikumbumtima ndikugwa.

Ketoacidotic chikomokere - thandizo loyamba

Choyamba ayenera kuyitanitsa ambulansi ndikuwunika zonse zofunikira za wodwalayo - kupuma, kupanikizika, palpitations, chikumbumtima. Ntchito yayikulu ndikuthandizira kugunda kwa mtima komanso kupumira mpaka ambulansi itafika.
Kuyesa ngati munthu akudziwa, mutha kuchita zosavuta: mufunseni funso lililonse, kumenya pang'ono pang'ono pamasaya ndikupukutira m'makutu mwake. Ngati palibe zomwe angachite, munthuyo amakhala pachiwopsezo chachikulu. Chifukwa chake, kuchedwa kuyimba ambulansi ndikosatheka.

Malamulo onse othandizira odwala matenda a shuga, ngati mtundu wake sunafotokozedwe

Choyambirira chomwe achibale a wodwalayo ayenera kuchita poyambira ndipo, makamaka, zizindikiro zazikuluzikulu za kukomoka itanani ambulansi nthawi yomweyo . Odwala omwe ali ndi matenda ashuga komanso mabanja awo nthawi zambiri amadziwa bwino izi. Ngati palibe mwayi wopita kwa dokotala, ndiye kuti pa woyamba zizindikiro muyenera:

Mu mnofu insulin - 6-12 mayunitsi. (osasankha).
Kuchulukitsa mlingo m'mawa wotsatira - mayunitsi 4-12 / panthawi, jakisoni 2-3 masana.
Zakudya zopatsa mphamvu zamagalimoto zimayenera kusinthidwa., mafuta - kupatula.
Onjezani zipatso / masamba.
Imwani mchere wamchere wamchere. Popeza kulibe - madzi ndi supuni yosungunuka ya kumwa koloko.
Enema ndi yankho la koloko - ndi kusokonezeka kwa chikumbumtima.

Achibale a wodwalayo ayenera kuphunzira mosamala za matendawo, chithandizo chamakono cha matenda ashuga, matenda ashuga ndi thandizo loyambira panthawi yake - pokhapokha thandizo ladzidzidzi lidzakhala lothandiza.