Ukuhlaselwa yisifo sikashukela isimo sokuwohloka kwalesi sifo, kubeka engcupheni impilo ngokunakekelwa okungakafaneli kokwelashwa.
Izinhlobo zokuhlaselwa ushukela
Ngokuya ngezizathu ezivuselela ukukhula kokuquleka, zingahlukaniswa ngamaqembu afanele:
- i-hyperglycemia;
- i-hypoglycemia;
- ketoacidosis.
Izimo eziphuthumayo zesifo sikashukela zinezimbangela zazo nezimpawu zokuziphatha. Ukuvela kwezimo ezibucayi kuthinta kabi ukuqashelwa kwalesi sifo. Ukuqala okungakaqedi ukwelashwa kuphela ngokuqalwa kwesibindi, i-edema yamakhemikhali nokufa.
Kunzima ukubikezela ukuqala kokuhlaselwa. Umtholampilo othize wenketho ngayinye ezigabeni zokuqala ufihlekile ngaphansi kwemaskhi ye-concomitant pathology.
Umtholampilo walolo hlobo lwesifo sikashukela ufihlekile ngaphansi kwe-concomitant pathology.
Indlela yokuqalisa ukuthuthukiswa kokuphazamiseka kwe-metabolic yizimo ezicindezelayo ezinzima, ukuzikhandla ngokomzimba, nokudla okungenampilo. Ingozi ethile ukuwohloka kwesifo sikashukela sohlobo 2 lwabantu asebekhulile.
I-Hyperglycemia
Kubonakala ngokukhuphuka okubukhali koshukela wegazi. Ukwephulwa kokukhiqizwa kwe-insulin ngamaseli e-beta we-pancreas kuholela ekukhuleni kokuhlaselwa.
Ngenxa yezizathu eziningana, ukulawulwa kokushintsha kwe-carbohydrate metabolism, izinga lamahomoni e-contra-hormonal liyakhuphuka. Ukwephulwa okunjalo kuholela ekukhiqizweni kwe-glucose ngokweqile, ekuphuleni ukusetshenziswa kwayo.
Kufinyelela ezingeni elibucayi, ushukela uvela kumchamo, i-polyuria, i-polydipsia iyakhula. Ukubonakaliswa kwemitholampilo kuncike embundwini wezinso weglucose. Ukuntuleka kokuphindwaphindwa kokugeleza kwamanzi ngalesi sikhathi kubangela ukomisa okwengeziwe komzimba, okuthi phakathi nezinsuku ezimbalwa kuqedwe ngokuqalwa kwe-hyperosmolar coma.
I-Hypoglycemia
Lolu hlobo lokuthathwa lubonakala ngokungapheleli noma umsebenzi ophansi wamahomoni we-contra-hormonal. Ngokuhlushwa okushubile kweglucose egazini, izindlela ezenza kusebenze uhlelo lozwela ziyaqala. Ukuvela kokuhlaselwa kuncike ekugxileni kanye nezinga lokwehla kwe-glycemia.
Uhlobo olubangelwa ukuwohloka kwenzeka ezigulini ezisetshenziswa izidakamizwa noma utshwala. Lokhu kwehluka kwe-hypoglycemia kukhula noshintsho kuma-pharmacokinetics wezidakamizwa ezithile.
I-ketoacidosis
Lolu hlobo lokuhlaselwa lwenzeka ngokumelene nesizinda sokuphelelwa ngamandla komzimba. Ushukela wegazi awungenwa ngamangqamuzana omzimba, kwakheka ukuntuleka kwamandla. I-insulin enganele yegazi iholela ekusetshenzisweni kwama-lipids njengomthombo wamandla. Ngenqubo ye-oxidation yamafutha, kwakheka imizimba ye-ketone, ekhulisa i-acidity yegazi, ibangele ukudakwa okunamandla komzimba.
Ukuthuthukiswa kwe-ketoacidosis kuvame kakhulu ngokuhlukahluka okuhambisana nesifo se-insulin. Zonke izinhlobo zemetabolism zephulwa, kusongela usizi lokufa nokufa.
Izimbangela zokuhlaselwa
Izici zokuthambekela ezidala ukuhlaselwa kwe-hyperglycemia kushukela sikubandakanya:
- ukusebenza ngokweqile komzimba;
- ukwehluleka kwezinso;
- izimo ezicindezelayo ezihlala isikhathi eside;
- izifo ezithathelwanayo;
- Ukudla okunama-kilojoule aphezulu.
Ingxenye ejwayelekile yazo zonke izinketho ukwephulwa kwezincomo zokusetshenziswa kwemithi.
I-Hypoglycemia iba ngenxa ye-overdose ye-insulin ejova. Izici ezinikela ekuqalisweni kwesimo se-hypoglycemic zimi ngalendlela elandelayo:
- ukucindezela okukhulu, okuhlala isikhathi eside;
- ukwephulwa kokudla;
- izifo ezibangelwa amagciwane ezinciphisa ukungatheleleki;
- ukusetshenziswa kabi kotshwala
- ukuphazamiseka kwe-endocrine.
Zonke iziguli zidinga ukulungiswa komthamo ngamunye kwemithi ye-hypoglycemic ngokumelene nesizinda sokuqokwa kwezinye izidakamizwa. Lokhu kuzosiza ukugwema ukuthuthukiswa kwe-hypoglycemia eyingozi.
Imbangela enkulu yokuhlaselwa kwe-ketoacidosis isamba esanele se-insulin egazini. Izici ezimbalwa eziholayo ezakha ukuqala kokuhlaselwa nazo zikhonjisiwe. Lokhu kufaka lokhu okulandelayo:
- ukwelashwa okukhethwe ngokungafanele;
- ukungahambisani nezincomo zezokwelashwa;
- ukwephula umbuso kanye nokudla;
- izifo ezithathelwanayo ezihlasela kakhulu;
- ama-pathologies we-vascular acute;
- ukulimala nokuhlinzwa;
- izifo zesistimu ye-endocrine;
- izimo ezicindezelayo ezinzima;
- ukwehluleka kwezinso;
- ukukhulelwa
Ezimweni eziningi, izinkinga zingagwenywa ngokunamathela ngokuqinile emithethweni yeziguli ezinesifo sikashukela, ngokunakwa kwezokwelapha okufika ngesikhathi.
Izimpawu Zokuhlaselwa Ushukela
Izinkinga ezinzima zale ndlela yokulwa nokuphikisana nesizinda sikashukela wegazi eliphezulu zibonakaliswa yizimpawu ezicacile nokukhula ngokushesha.
Ukuhlaselwa kwe-glycemia, kushiywe kunganakekelwa, kungaholela ekufeni.
Ezingeni le-glycemia elingaphezu kwe-10 mmol / l, kuvela izimpawu ezilandelayo:
- ukoma okungapheli;
- ulwelwesi lwe-mucous olomile nesikhumba;
- ukuchama njalo
- ukunciphisa umzimba;
- ukuphefumula okwandayo;
- ukuphazamiseka kwengqondo.
Ukufuna ngokungadingekile usizo lwezokwelashwa kuzoholela ekuthuthukisweni kwe-hyperosmolar coma.
Ukwehla kwe-glucose kuya ku-2,5 mmol / l kuhambisana nezimpawu ezilandelayo:
- indlala yesikhumba;
- ukupholisa, ukukhulisa umswakama wesikhumba;
- ukudideka emkhathini;
- izibuko
- motor, ukuphazamiseka kokukhuluma;
- ushintsho ekuphendukeni kokuziphatha;
- iminyakazo
- ukulahlekelwa ukwazi.
Isithombe somtholampilo sesimo esiphuthumayo sikhula ngokushesha, emahoreni ambalwa. Ukuhlaselwa okusele kunganakekelwa kungaholela ekufeni.
I-ketoacidosis iba kancane kancane. Ukwehla kwemvelo kuvame ukubukwa njengokubonakaliswa kwezinye izifo. Kubalulekile ukulawula amazinga kashukela.
Izimpawu ze-ketoacidosis zibandakanya:
- ubuthakathaka obujwayelekile obujwayelekile;
- ukukhathala;
- ikhanda elibuthakathaka;
- ukuphefumula kaningi;
- isikhumba esomile
- ukwehla kwesifiso sokudla;
- Izimpawu dyspeptic;
- ubuhlungu besisu be-spastic;
- ukudideka ukwazi.
Isibonakaliso esithile se-ketoacidosis ukuhogela kwe-acetone ephuma emlonyeni.
Isibonakaliso esithile ngenxa yokuqongelelwa kwezidumbu ze-ketone emzimbeni ukuhogela kwe-acetone ephuma emlonyeni. Azikho izimpawu zokuthuthuka kwezinkinga okufanele zinganakwa.
Usizo lokuqala
Isimo se-hypoglycemic kumele simiswe ngokushesha. Lapho kuvela izimpawu zokuqala, isiguli sinikezwa isiphuzo sesisombululo se-glucose, udle amaswidi, ushukela. Isiguli sibekwe eceleni kwakhe ukugwema isifiso ngokuhlanza. Ngokubanjwa okukholisayo, kubalulekile ukuvimba ukulunywa kolimi, ukuqinisekisa ukuhamba kwemigwaqo.
Ukunakekelwa kwezokwelapha esigabeni se-prehospital kuqukethe ukuphathwa kwe-intravenous kwekhambi le-40% kashukela. Njalo ngemizuzu engama-30, amazinga kashukela ayaqashwa. Uma kunesidingo, inqubo iyaphindwa kuze kufike ekushiseni komzimba okubukhali, ukucaca kokuqwashisa, ukwenziwa okujwayelekile kombuso. Umsebenzi omkhulu ukuqeda indlala yamandla, imiphumela yako ebonakaliswa ukuphazamiseka kwezitho zomzimba, izinguquko ezingenakulungiswa.
Iziguli ezine-hyperglycemia ne-ketoacidosis zidinga ukuphathwa ngokuphuthumayo kwe-insulin. Esigabeni prehospital, nanoma yikuphi ukuhlukahluka kokuhlaselwa okunjalo, kuyadingeka ukuqala ukwelashwa komzimba. Ukuphathwa kwe-insulin esebenza okwesikhashana ngesitembu sesikhathi sokulimala kuyamukeleka. Abasebenzi bezokwelapha bahlinzeka ngokulawulwa nokugcinwa kwemisebenzi yokuphefumula, ukusebenza kwenhliziyo.
Ukwelashwa kokugula
Iziguli ezinesifo sikashukela mellitus zilaliswa esibhedlela sezinkulisa nokunakekela abagulayo. Umthamo wokunakekelwa okuphuthumayo ukwenza isethi yezinyathelo okuhloswe ngazo ukubuyisa ukushoda koketshezi, ama-electrolyte, kanye nokulinganisa ibhalansi ye-acid-base. Ukwelashwa kwe-insulin kwenziwa ngokuphathwa ngokuqhubekayo kwe-drip kwehormone esebenza kancane. Ukwelashwa okubonakalayo kwenziwa ngaphandle kwesidingo. Inkambo yemithi elwa namagciwane inqunywe.
Ngezinga eliphansi loshukela, iphrofayili ye-glycemic, ukudla, kanye ne-concomitant pathology kuyalungiswa. Ezimweni ezimbi kakhulu, ngokuthuthukiswa kokuqhaqhazwa kwe-insulin, kusetshenziswa ama-hormone ekhethekile asetshenziswayo. Yenza ukuhlolwa okugcwele.
Izindlela zokuvimbela
Inhloso yezinyathelo zokuvimbela ukuvimbela ukuguquguquka okubukhali ku-glycemia. Iziguli zifundiswa amakhono adingekayo lapho zenza umsebenzi odinga isikhathi eside, nokuvivinya umzimba. Ngokushintsha okuqukethwe ikhalori kokudla, umthamo umuthi olawulwa, elawula ukuhlolwa kwegazi, ungavimba ukuthuthukiswa kokuhlaselwa.
Ukuvimbela i-ketoacidosis kuqala ngokuqokwa kwemithamo efanele yemithi enciphisa ushukela. Kuyadingeka futhi ukulandela ngokuqinile ekudleni, ekusetshenzisweni kwemithi okufika ngesikhathi, ukukala isilinganiso se-glucose egazini.
Ubunzima bezindlela zokuthibela buhlanganisa ukuqeqeshwa okuphoqelekile kwizimpawu zokuncipha kwesifo, izinyathelo ezidingekayo ezimweni ezinjalo.
