Ukuhlolwa kwelabhoratri kwesifo sikashukela kukuvumela ukuthi ukhombe isifo sangaphambi kokuqala kokukhula kwayo, futhi unesifo esivele sitholile, ngaso sonke isikhathi ulawula ukugcwala ushukela, uvikele ukwanda okungazelelwe kanye nokwanda kwesimo sesiguli.
Yiziphi izimpawu okudingeka uhlole ngazo isifo sikashukela emtholampilo?
I-Endocrinologists incoma ukuthi ngokushesha funa usizo lwezokwelashwa futhi luxilongeke uma kuvela izimpawu ezilandelayo:
- umuzwa ongapheli wokoma;
- ukoma ngokweqile emgodini womlomo;
- ukubonakala kokuqhuma esikhunjeni, ukulunywa;
- umuzwa ongapheli wokuqina;
- kwenzeka indlala ngemuva nje kokudla;
- inzuzo yesisindo engazelelwe ngaphandle kwesizathu esibonakalayo;
- ukuchama njalo.
Izazi ezingama-Endocrinologists zincoma ukuthi ngokushesha zithole usizo lwezokwelashwa futhi zixilongeke ngemizwa engapheli yokwezela.
Zonke lezi zimpawu kungenzeka zikhombise ukukhula kwesifo sikashukela.
Yimuphi udokotela okufanele ngibe naye uma ngisola isifo sikashukela?
Uma kuvela izimpawu ezifanele, ukubonisana okuphuthumayo ne-endocrinologist kuyadingeka, obandakanyeka ekuxilongeni nasekwelapheni isifo sikashukela, ukuphazamiseka kwe-thyroid kanye namanyikwe.
Uma izimpawu zingavezwanga kahle futhi umuntu engenaso isiqiniseko sokuthi unesifo sikashukela, ungaqala uthintane nodokotela ozokunikeza izibalo eziningi zokuhlolwa kwelebhu futhi, ngokusho kwemiphumela yabo, uzobhekisa kuchwepheshe onolwazi oluncane - i-endocrinologist.
Ukuxilongwa okuhlukile kwesifo sikashukela sohlobo lwe-1 no-2
Isifo sikashukela esincike ku-insulin kanye nohlobo lwesifo olungadingi imijovo ye-insulin engapheli kungenzeka lube nendlela efanayo yokubonisa. Zombili lezi zinhlobo zikashukela ziyahlukahluka ngezindlela zazo zokwelashwa. Ukuxilonga ngokunembile, kubalulekile ukwenza ukuxilongwa okuhlukile.
Ukunquma uhlobo lwesifo, kuhlolwa igazi le-venous ukuthola ukutholakala kwento ye-C-peptide. Inqubo ye-cleavage yayo iholela ekukhiqizweni kwe-insulin. Ukwehluka kwezinhlobo zesifo sikashukela kususelwa ekuhlolweni kokusebenza kokusebenza kwamaseli e-beta akhiqiza i-insulin.
Kungani kufanele uhlolwe isifo sikashukela?
I-iron emzimbeni, obhekele ukwenziwa kwama-hormone abalulekile, kufaka phakathi kanye ne-insulin, amanyikwe. Lapho kwenzeka ukungasebenzi kahle kwe-pancreatic, kusho ukuthi i-glucose engena emzimbeni iqala ukumunwa futhi iqoqwe ngokungalungile, yingakho kunengozi yesifo sikashukela.
Cishe wonke umuntu usengozini yesifo sikashukela. Ukudla okungahambi kahle, imikhuba emibi nokuphila okulula kokungakwazi ukuzivocavoca umzimba njalo yizinto ezikhuthaza ukukhula kwesifo sikashukela nokuphazamiseka kohlelo lwe-endocrine namanyikwe.
Isithombe somtholampilo salesi sifo esisekuqaleni singaba khona noma siveze kahle. Ngakho-ke, ukulethwa okujwayelekile kokuhlolwa kwelebhu yiyona kuphela indlela yokuthola isifo sikashukela esifike ngesikhathi.
Ukulungiselela Ukuhlaziywa
Ukuhlaziywa kwesifo sikashukela kudinga ukunemba ekutholeni imininingwane, ngakho-ke kufanele wazi ukuthi ungawulungiselela kanjani ngokunikela umnikelo wegazi ukuze uqede iphutha lokuxilonga:
- Ezinsukwini ezingama-3-4 ngaphambi kosuku lokuhlolwa okulindelekile, kufanele ukhansele noma yikuphi ukuhlolwa kokudla, njengokudla.
- Kubalulekile ukukhipha izinto ezingakuholela emzimbeni.
- Khipha noma yimuphi umuthi. Uma kungenakwenzeka ukwenza lokhu ngenxa yezizathu zezokwelapha ngesikhathi sokusampula kwegazi, kubalulekile ukuthi utshele udokotela ukuthi imiphi imithi ephuzwayo.
- Abesifazane belulekwa ukuba bayeke ukuthatha izindlela zokuvimbela inzalo ngomlomo.
- Ungaphuzi utshwala ngezinsuku ezi-3, njengoba noma inani elincane lotshwala egazini lingathinta kabi okuqukethwe kokuhlolwa.
- Akunconyelwe ukusebenzisa amaswidi kanye ne-confectionery, bakhuphula izinga le-glucose egazini, futhi ukuhlaziywa kuyonikeza umphumela ongalungile.
- Ngobusuku bokuxilongwa, kubalulekile ukungafaki ezemidlalo. Ukuzivocavoca kwandisa ushukela.
- Udinga ukuza elabhorethri esesimweni esizolile ngokomoya nangokomzwelo.
Ngaphambi kokuthatha izivivinyo, kufanele ungafaki ukuphuza noma imiphi imithi.
Uma umuntu egula nge-viral noma ama-pathologies athathelanayo, anjengomkhuhlane noma i-ARVI, ukunikela ngegazi ukuze kwenziwe lolu cwaningo akunakwenziwa ngaphambi kwamasonto amabili ngemuva kokululama ngokuphelele.
Ukuhlolwa kwegazi
Ukuhlolwa kokuqala nokwkhulu kokushukela, imiphumela yakho ekuvumela ukuthi uthole ukuxilongwa kokuqala, ukuhlolwa kwegazi.
Isibalo segazi esiphelele
Ucwaningo lwembula ukunqwabelana kwe-glucose, izinga lokungafani kwayo nokujwayelekile. Kokubili igazi elihlanjululwe nge-venous ne -unwe kufanelekile ukuhlaziywa. I-glucose yokuqala ingaqukatha aze afike ku-12% ngaphezulu kwesibili; le nuance ihlala ibhekwa ngabasizi belebhu.
Ithebula lezinkomba zokujwayelekile kwe-glucose lapho kuthathwa ukuhlolwa kwegazi okujwayelekile:
| Iminyaka | Inkomba kashukela |
| Kuze kube inyanga eyi-1 ngemuva kokuzalwa | 2.8 kuye ku-4.4 |
| Izingane ezingaphansi kweminyaka eyi-14 | 3.3 kuye ku-5.5 |
| Iminyaka eyi-14 nangaphezulu | 3.5 kuya ku-5.5 |
Uma izinga likashukela lingama-5.6-6.1 mmol, lokhu kubonisa ukukhula kwesimo se-prediabetes. Umphumela owenyukayo ukhombisa ukungabekezeleli kwe-glucose. Ukwenza ukuxilongwa okunembile, kutholakala ukuxilongwa okuphezulu kakhulu.
Ngokushoda kwe-leukocyte, i-anemia iyatholakala.
I-biochemistry yegazi
Ukuhlaziywa kwamakhemikhali we-biochemical kukhonjiswa ngempela kushukela osolwayo. I-biochemistry ifaka izifundo eziningi ezisiza ukukhomba izifo ezinezimpawu ezifana nesifo sikashukela. Ngesikhathi sokuhlaziywa, ukugcwala kwemizimba yegazi kunqunywe - ama-leukocytes, amangqamuzana abomvu egazi. Uma okuqukethwe amangqamuzana abomvu egazi kungaphezu kokujwayelekile, lokhu-ke kuyinkomba yenqubo yokuvuvukala, ikakhulukazi yesimo esithathelwanayo.
Ngokushoda kwe-leukocyte, i-anemia iyatholakala. Lokhu kwephula umthetho kukhombisa i-pathology ye-yegilo yegilo - okungenye yezimbangela eziphambili zokwakhiwa kwesifo sikashukela sohlobo 1.
Ukubekezelelwa kwe-glucose
Ukuhlolwa okunomthwalo oshukela owengeziwe kuyenziwa uma ukuhlolwa kwegazi kokuqala kukhombisa okuqukethwe okwengeziwe. Esimweni esijwayelekile, lapho kungekho-sikashukela, izinkomba ze-glucose kumele zikhule kuqala bese zinciphe. Uma kunesifo sikashukela, ushukela ozokhuphuka uzovuka futhi ungehli.
Inhloso yocwaningo ukuthola ukuthi umzimba uzophendula kanjani ku-high ushukela. Ucwaningo lwenziwa ngezigaba ezi-2: okokuqala, ukuhlaziya kwenziwa esiswini esingenalutho, ngemuva kokuba umuntu enikezwe isixazululo se-glucose egxilile, bese kuhlaziywa kuphindwa.
Ukulimazeka kokubekezelela i-glucose ukuhlolwa okunconyelwa kwabesifazane ngesikhathi sokukhulelwa ukuthola isifo sikashukela sokukhulelwa, esingenaso isithombe esibonakalayo emazingeni okuqala, kepha kunomthelela ekuthuthukisweni okuqhubekayo kwesifo sikashukela sohlobo 2.
IGlycated hemoglobin
Ukuhlolwa kukhombisa inani eliphelele leglucose eligcinwe ohlelweni lokujikeleza izinyanga ezintathu. Ukuhlolwa kwegazi ukuthola i-hemoglobin ye-glycated kubalulekile ukuqhuba okungenani isikhathi esisodwa ezinyangeni ezi-6 kwiziguli ngokungabikho kwesidingo sokufakwa kwe-insulin njalo.
Izinkomba ezijwayelekile yi-hemoglobin kusuka ku-4,5 kuye ku-6%. Uma izinga lisuka ku-6 liye ku-6,5%, lesi yisimo sangaphambi kwesifo sikashukela. Ngemiphumela evela ku-6.5%, isifo sikashukela siyatholakala.
Ukuhlolwa Kwesifo Sikashukela Sikashukela
Ucwaningo lokubekezelela i-glucose lwenziwa uma ucwaningo olujwayelekile lukhombisa ukuphambuka kumanani ajwayelekile endaweni enkulu. Lolu hlobo lokutadisha lungenye enembile kunazo zonke, futhi imiphumela yayo ingaba isetshenziselwa ukuxilongwa.
Ekuseni ngaphambi kokuhlolwa, kwenqatshelwe hhayi ukudla kuphela, kepha futhi nokuphuza uketshezi, kubandakanya namanzi.
Ukulungiselela
Ukuhlaziywa kwenziwa ekuseni, ngokuqinile ngesisu esingenalutho. Imithetho yokuyilungiselela ifana nezincomo ezijwayelekile - lokhu ukwenqaba kusuka ekusebenzeni ngokomzimba okusebenzayo, ekuthatheni noma imiphi umuthi, isimo somzwelo esizolile.
Ekuseni ngaphambi kokuhlolwa, kwenqatshelwe hhayi ukudla kuphela, kepha futhi nokuphuza uketshezi, kubandakanya namanzi.
Indlela Yokuhlola
Okokuqala, isiguli sibheka ukugcwala koshukela egazini kusetshenziswa i-venous igazi noma izinto eziphilayo ezivela emunweni. Ngemuva kwalokho, nikeza i-75 ml yesisombululo sikashukela ekugxilweni okukhulu. Ngemuva kwehora eli-1, kuhlaziywa okwesibili, ngemuva kwamanye amahora ama-2, ukuhlolwa kokuthola ushukela kuphindaphindwa.
Isikolo
Izinga likashukela lizokhuphuka masisha lapho nje ushukela egxilile engena ngaphakathi. Lokhu kuzobonisa ukuhlaziya ekunikeleni ngegazi kokuqala. Uma umuntu engenaso isifo sikashukela, ukuhlolwa kwegazi kwesibili kuzokhombisa ukwehla kweshukela. Lapho ushukela ungashintshi noma unciphise, kubonisa isifo sikashukela.
Yini engathinta umphumela wokuhlolwa?
Amaphutha emiphumeleni avame ukuhlotshaniswa neqiniso lokuthi isiguli asilandeli izincomo eziphathelene nokulungiselela ukuqoqwa kwezinto eziphilayo. Ukuhunyushwa okungalungile kungenzeka ngenxa yokhwalithi engeyinhle yokuhlaziywa.
Ukuhlaziywa kokubekezelelwa kwe-glucose kunconyelwa kwabesifazane abakhulelwe isikhathi esingamasonto angama-24-28.
Ukuhlolwa kokukhulelwa
Ukuhlaziywa kokubekezelelwa kwe-glucose kunconyelwa kwabesifazane abakhulelwe isikhathi esingamasonto angama-24-28. Inhloso yalolu cwaningo bekuwukuhlonza uhlobo lwesifo sikashukela, i-pathology eyenzeka kuma-70% abesifazane abakhulelwe. I-algorithm yokuhlola ngesikhathi sokukhulelwa ayihlukile ocwaningweni kwezinye iziguli.
Ukuhlolwa komchamo
Inani lokuxilonga liyinani likashukela hhayi ohlelweni lokujikeleza kuphela, kodwa futhi ku-ketshezi, okuwumkhiqizo womzimba we-metabolism, umchamo. Ukuhlolwa kwe-urinalysis kunqunywa lapho ukuthuthukiswa kwesifo kubangelwa isimo sokuphazamiseka kwezinso.
Ukuhlaziywa okujwayelekile komtholampilo
Lokhu kuhlaziya kuyadingeka ekwenzeni ukuxilongwa kokuqala. Ngokucwaninga, ekuseni (kuqala kakhulu) umchamo uyathathwa, lapho kunqunywa khona inkomba kashukela. Uma kungaphezu kokujwayelekile, kwenziwa isifundo esijulile.
Ukuhlaziywa kwansuku zonke
Lokhu kuhlolwa kunembe kakhulu futhi kufundisa ukwedlula isifundo esivamile. Emini, wonke umchamo uqoqwe esitsheni sinye. Isikimu sokuthatha izampula zezinto eziphilayo: iqoqo lokuqala lenziwa ngaphambi kuka-9 ekuseni, elokugcina - kuze kube isikhathi esifanayo ngosuku lwesibili. Umchamo wokuqala ekuseni ngosuku 1 ungene ngaphakathi endlini yangasese, ngesikhathi sokuchama kwesibili uqoqwe esitsheni. Ngosuku 2, kuthathwa umchamo wokuqala ekuseni. Ukuhlaziywa, udinga ama-200 ml womchamo ophelele.
Ukuhlaziywa nsuku zonke, udinga ama-200 ml womchamo ophelele.
Ukunqunywa kobukhona bezidumbu ze-ketone
Enye yemizimba ye-ketone ekugxilwe kuyo ikhuphuka sikashukela yi-acetone. Ukuchazwa kwaso kufakiwe ocwaningweni olunzulu. Umzimba we-ketone ungakhula nezifo zesibindi, ngakho-ke, izinkomba zalolu cwaningo kuphela azisebenzi ekutholeni isifo sikashukela.
Izinkomba zokuhlaziywa - ukuphefumula okuvame kakhulu kwe-nausea, iphunga le-acetone emphefumulweni kanye nomchamo, amazinga kashukela egazi kusuka ku-16,6 mmol.
Ukuhlolwa kwenziwa ngale ndlela elandelayo - umucu wokuhlola ofakwe kuma-reagents wehliselwa esitsheni ngomchamo wesiguli. Lezi zokugcina, ziphenduka ngomchamo, zinemibala, ziguqula umbala wesigaxa. Ukuba khona nobungako bezidumbu ze-ketone kunqunywa umbala wephepha lokuvivinya. Inkomba iqinisekiswa ngesikali sombala wokuwohloka.
Ukuzimisela kwe-Microalbumin
Ukuhlaziywa kunquma isimo sezinso nokusebenza kwazo. Lapho kukhona isifo sikashukela, abantu abaningi bahlakulela i-renal nephropathy, engatholakala ngokuchazwa kweprotheni ethile - i-microalbumin.
Ukuchazwa kwe-Microalbumin kukhombisa isimo sezinso nokusebenza kwazo.
Ukuhlaziywa, udinga ukuqoqa umchamo wansuku zonke. Ngosuku lokuqala, kuthathwa umchamo wasekuseni, bese ukuqoqwa kwawo kuqhubeke usuku lonke, okokugcina ngosuku lwesibili ekuseni. Kubalulekile ukuqopha ivolumu yomchamo ngakho konke ukuchama. Ukuhlaziywa, ama-150 ml wezinto eziphilayo kumele aphonswe esitsheni esingenantambo.
Imvamisa ye-microalbumin ifinyelela ku-30 mg kumchamo nsuku zonke futhi ifike ku-20 mg eqoqwe ngasikhathi sinye.
Izifundo zeHormonal nezokugoma
Esikhathini sikashukela, kubalulekile ukwenza ukuxilongwa okuphelele, okuvumela hhayi ukuthola ukuxilongwa okufanele, kodwa futhi nokubonisa izimbangela zesifo. Imvamisa, izifundo ze-hormonal kanye ne-immunological zingabekwa:
- Izinga le-insulin - okujwayelekile ngu-1-180 mmol. Uma inkomba iphansi, kuluhlobo 1 sikashukela (oluthembele ku-insulin), uma umphumela udluliwe, uhlobo lwesibili lwesifo.
- Ukunqunywa kwama-antibodies maqondana namaseli we-beta - ukuhlaziywa kuveza uhlobo lokuqala lwesigaba sikashukela.
- Ukuhlaziywa kophawu lwesifo sikashukela - GAD. Kungahle kube khona egazini eminyakeni eminingana ngaphambi kokukhula kwengqondo yesifo sikashukela. Ucwaningo lwembula ukuthi umuntu angakanani kushukela okumele akwenze ukuze enze ukwelashwa okuthintela izifo.
- I-glutamate decarboxylase assay iyi-enzyme ekhiqizwa izitho ezikhiqiza i-insulin.
Kwenziwa ukuhlolwa kwegazi ukuthola ukuthi ama-pancreas kanye ne-yegland gland, asiza ekuboneni izinto ezivusayo. Ngesikhathi sokuhlolwa kabanzi, kungahle kudingekile ukuthola inani lama-carbohydrate, uma kukhona izinsolo zokuthi isifo sikashukela sicasulwa ukuphazamiseka okuhleliwe ekudleni.
I-algorithm yokunquma ushukela wegazi ekhaya
Ngokuxilongwa okufanayo, ushukela kufanele ulinganiswe njalo. Lezi ziguli azidingi ukuya njalo elabhorethri. Ungasebenzisa amadivaysi ezokwelapha ekhaya - ama-glucometer noma imichilo ekhethekile yokuhlola elula ukusebenzisa futhi ubonise umphumela onembile emaminithini ambalwa. Ukuze usebenzise imichilo yokuhlola, kufanele:
- Geza izandla ngensipho.
- Yelula iminwe yakho ngokugoba futhi uyibambe ngejubane elikhulu ukuze usheshise ukuhamba kwegazi.
- Yenza umjovo esikhwameni somunwe ngenaliti noma ngesikhafu esikhethekile.
- Yehlisa isandla sakho phansi ukuze iconsi legazi eliphuma emunweni wakho liwele kumugqa wokuhlola endaweni ekhethekile yokulawula.
- Qinisekisa umphumela ngesilinganiso sokuphumela. Lapho esethintana negazi, ama-reagents afake umhlaba endaweni yokulawula umucu wokuhlola aguqula umbala wawo. Umnyama omnyama futhi onethezekile, uphakamisa ushukela wegazi. Isikhathi sokuthola umphumela sithatha imizuzu eyi-1-8 ngokuya ngekhwalithi ye strip yokuhlola.
Ama-Glucometer ngamadivayisi anembe kakhulu, ngakho-ke, abantu abaye batholakala benesifo sikashukela futhi badinga ukuthola ukulawula njalo kwalesi sifo, kunconywa ukusisebenzisa.
Ukuhlolwa kwezinkinga
Isifo sikashukela isifo sikashukela yisifo esibi esidinga ukwelashwa njalo ngemithi, ngaphandle kwalokho sibanga izinkinga eziyingozi.Ezimweni eziningi, imiphumela yesifo sikashukela ithinta izinso, isibindi kanye namehlo, futhi uhlelo lokugaya luyaphazamiseka.
Uma kwenzeka kubhekene nezinkinga, kuhlolwe ngokucophelela ukuhlolwa kwelabhoratri nezindlela zokuxilonga izinsiza - i-ultrasound, i-MRI, ama-x-ray, okwenza ukuthi kutholakale ukuxilongwa okuyiqiniso futhi kutholakale isigaba sokuthuthuka kwenqubo ye-pathological ngokuqokwa okwalandela kokulashwa okudingekayo.
