Zabwino ndi zovuta zamapampu a insulin a shuga

Ndizodziwika bwino kuti kuperekera shuga kumachepetsa chiopsezo chokhala ndi zovuta za matenda a shuga (maso, impso, ndi zina). Mwa ana ambiri ndi achinyamata omwe ali ndi matenda a shuga, kusintha pampu ya insulin kumayendera limodzi ndi kuchepa komanso kukhazikika kwa shuga m'magazi, ndiye kuti, kumapangitsa kutsika kwa hemoglobin wa glycated.

Gome 1. Ubwino Wogwiritsa Ntchito Pampu ya Insulin

Ubwino wina wa mapampu a insulin ndi kuchepetsa chiopsezo cha hypoglycemia. Mu ana, vuto la hypoglycemia limakhala pafupipafupi komanso lalikulu. Mukamagwiritsa ntchito mankhwala othandizira pampu, kuchuluka kwa zochitika za hypoglycemia kumachepetsedwa kwambiri. Izi ndichifukwa choti kuchiritsa kwa pampu kumakupatsani mwayi woperekera insulin m'magawo ochepa kwambiri, omwe amakupatsirani insulin yolondola, mwachitsanzo, pazakudya zazing'ono mwa ana aang'ono.

Dotolo ndi makolo a mwana ali ndi mwayi wokwanira kukhazikitsa mawonekedwe apansi pazoyang'anira insulin mogwirizana ndi zosowa zawo. Kugwiritsa ntchito kanthawi kochepa chabe kumachepetsa kwambiri kuchuluka kwa zochitika za hypoglycemia panthawi yolimbitsa thupi, ndikugwiritsanso ntchito bwino ngati mukudwala kapena simunadziwe kuchuluka kwenikweni kwa msana masana.

Pogwiritsa ntchito pampu, mupangira majakisoni ocheperako. Ndiosavuta kuwerengera kuti mwana yemwe ali ndi matenda a shuga amalandira jakisoni wocheperako kasanu patsiku (majekeseni atatu a insulin yochepa pakudya koyambirira ndi jakisoni awiri a insulin yowonjezera m'mawa ndi madzulo) amalandira jakisoni 1820 pachaka. Pankhani ya chithandizo cha pampu, malinga ndi momwe catheter amasinthidwira masiku atatu aliwonse, manambala amachepetsedwa kukhala majekiseni a catheter a 120 pachaka. Izi ndizofunikira makamaka kwa ana aang'ono chifukwa cha kuwopa jakisoni.

Mukamagwiritsa ntchito pampu, ndizosavuta kutumizira insulin. Kuti mudziwitse kuchuluka kwa insulini, ndikokwanira kukhazikitsa kuchuluka kwa insulini yoyendetsedwa ndikulowetsa ndikanikiza batani. Palibe chifukwa chokonzekera malo owonjezera jakisoni, omwe amatha kukhala osakhudzana ndi kusapeza, makamaka ngati kuli kofunikira kupereka insulin kunja kwanyumba. Kugwiritsa ntchito njira zowongolera pamitundu ina ya pampu kumakuthandizani kuti mupeze insulin mopanda tanthauzo kwa ena, ndipo palibe amene angadziwe kuti inu kapena mwana wanu muli ndi matenda a shuga.

Ana ambiri aang'ono samangofuna mlingo wochepa wa insulin, komanso gawo laling'ono posintha mlingo. Mwachitsanzo, ngati m'modzi zigawo za insulin kadzutsa pang'ono, ndi 1.5 - kwambiri. Kuchulukanso kwa insulin kwamphamvu (0.5 IU kapena kupitilira apo) kungathandizire kusinthasintha kwakukulu kwa shuga m'magazi masana. Nthawi zina makolo a ana aang'ono amachepetsa insulini kuti achepetse kuchepa kwa insulin kuti atenge gawo laling'ono la insulin.

Izi zimatha kubweretsa zolakwika zazikulu pakukonzekera ndi kugwiritsa ntchito insulin. Mitundu ina yamapampu amakono imalola kuti insulini iperekedwe molondola kwa 0,01 U, yomwe imawonetsetsa kuti dosing yolondola komanso yosavuta ya mankhwalawa imakwaniritsa bwino shuga. Kuphatikiza apo, ngati vuto losakhazikika mu ana aang'ono, mlingo wonse wa insulini ungagawidwe pawiri.

Pampu yamakono imatha kubaya insulin nthawi 50 kuposa cholembera.

Limodzi mwamavuto mukamagwiritsa ntchito ma syringe kapena ma syringes - Izi ndi zosiyana ndi poyambira insulin. Chifukwa chake, ngakhale kuli kwofanana ndi insulin ndi chakudya chotengedwa, shuga wa magazi amatha kukhala osiyana. Izi ndichifukwa cha zifukwa zingapo, kuphatikiza kusapanga bwino kwa insulin ikaperekedwa m'malo osiyanasiyana.

Mukamagwiritsa ntchito pampu, insulin imalowetsedwa m'malo omwewo kwa masiku angapo, motero zotsatira zake zimakhala zofanana. Matendawa amatchedwa kusinthasintha kwa zochita (zosasinthika masiku angapo) a insulin zowonjezereka kungakhale chifukwa cha kusinthasintha kwa magazi a shuga.

Ubwino wina wamapampu a insulin ndi kukhala bwino.

Makolo a ana omwe ali ndi mankhwala a insulin omwe amapezeka pampu nthawi zambiri amauza kuchepa kwakukulu kwa nkhawa zokhudzana ndi matenda a shuga poyerekeza ndi makolo a ana omwe amalimbitsa insulin.

Pampu sikugwira ntchito! Zotsatira zakugwiritsa ntchito pampu ya insulin zimadalira kwambiri momwe mumayang'anira matenda a shuga komanso pampu ya insulin. Kupanda chidziwitso chofunikira pankhani ya matenda a shuga palokha, kudziyang'anira pafupipafupi, kulephera kuyendetsa pampu, kusanthula zotsatira ndikusankha zochita pakusintha kwa mankhwalawa kumatha kubweretsa ketoacidosis komanso kuwonongeka kwa glucose wamagazi motero, kuchuluka kwambiri kwa hemoglobin ya glycated.

Zoyipa za mankhwala a insulin

Ngati pazifukwa zina, zomwe tikambirana pansipa, insulini yasiya kulowa mthupi, kuchuluka kwa shuga m'magazi kumakwera mwachangu kwambiri ndipo ma ketones amawonekera mwachangu (atatha maola 2-4). Ndipo pakatha maola 3-5 vutoli limatha kuwonongeka kwambiri, kusanza kumawonekera, komwe kumafunikira kulowererapo mwachangu. Kukula kwa ketoacidosis kumatha kupewedwa ngati anthu odwala matenda ashuga akudziwa momwe angakhalire mu vuto linalake (hyperglycemia, mawonekedwe a ma ketones, ndi zina), ndikutsatira malamulo opewera ketoacidosis.

Gome 2. Mavuto Ogwiritsa Ntchito Pampu ya Insulin

Inde, vuto lalikulu mukamagwiritsa ntchito insulin therapy ndi mtengo wake. Mtengo wa chithandizo cha pampu ndiwokulirapo kuposa chithandizo cha mankhwala a insulin. Ndalama zidzafunikira osati kungogula pampu, komanso kugula zogulira (nkhokwe, kulowetsedwa). Kuti mugwiritse ntchito ntchito yanthawi yayitali yogwiritsira ntchito glucose munthawi yeniyeni, ndikofunikira kugwiritsa ntchito sensor yapadera, amenenso ndi chinthu chogwiritsidwa ntchito ndipo nthawi zambiri imagwiritsidwa ntchito masiku 6.

Pa pampu, chiopsezo cha ketoacidosis chikhoza kukhala chokwera, koma chitukuko chake chitha kupewedwa ngati anthu odwala matenda ashuga atsatira malamulo oyenera oteteza ketoacidosis.

Kukhazikika kosakwanira kwa mafuta osakanikirana kumatha kukhala vuto mukagwiritsa ntchito mapampu, makamaka ana aang'ono. Pakukhazikitsa catheter, singano iyenera kukhala yayikulupo kuposa jakisoni wothandizirana ndi insulin. Makulidwe osakwanira a mafuta onunkhira amatha kubweretsa kugwirira kwa catheters ndi chiopsezo chokhala ndi ketoacidosis. Pofuna kuchepetsa chiopsezo cha kubinya cannula, malo a matako nthawi zambiri amagwiritsidwa ntchito kuyika catheter, pomwe mafuta osaneneka amapangidwa bwino kuposa m'mimba. Teflon catheters amagwiritsidwanso ntchito, omwe amaikidwa pakona, kapena zitsulo zazifupi, zomwe zimathandizanso kugwedezeka kwa catheter.

Mwa anthu ena, matenda amatha kupezeka patsamba la catheter. Nthawi zambiri izi zimawonedwa ndikusinthidwa kwa kulowetsedwa, ukhondo wosakwanira kapena chizolowezi chotupa cha pakhungu (furunculosis, ndi zina). Pankhani ya kupakika kapena kutupa m'malo mwa kukhazikitsa catheter, njira zina zingagwiritsidwe ntchito. Anthu ena atha kukhala ndi lipodystrophy pamalo a catheter.

Popewa kukula kwa lipodystrophy, ndikofunikira kuti nthawi zonse asinthe malo oyambitsa kulowetsedwa, monga momwe amachitira ndi mankhwala a insulin. Komanso khungu la ana ang'ono limatha kukhala tcheru kwambiri pazinthu zomatira zomwe zimagwiritsidwa ntchito kukonza catheter, pankhaniyi, mutha kusankha mtundu wina wa kulowetsedwa kapena kugwiritsa ntchito njira zina zomatira.

Chimodzi mwazifukwa zomwe kuphwanya kwa insulini ku thupi kumatha kukhala kuchepa (masinthidwe a insulin).

Izi nthawi zambiri zimachitika ndikugwiritsira ntchito nthawi yayitali kulowetsedwa kapena kuphwanya malo osungirako insulin, ngati pampu kapena dongosolo la kulowetsedwa lavulidwa kwambiri kapena kutentha kwambiri. Mwachitsanzo, nthawi yozizira, chubu cha kulowetsedwa chimatha kutuluka mu zovala ndi insulini yomwe imazizira, m'chilimwe motsogozedwa ndi dzuwa, insulini yomwe ili mu thanki kapena chubu imatha kusefukira komanso imalira.

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