Izimpawu zokuwohloka kwesifo sikashukela

Isifo sikashukela i-mellitus singumphumela wokuphazamiseka kwe-metabolic emzimbeni. Zonke iziguli ezihlaselwe yilesi sifo kufanele zizazi izimpawu zokuwohloka kwesifo sikashukela. Lokhu kukuvumela ukuthi uqaphele inkinga eyingozi ngesikhathi bese uthola usizo lokuqala. I-Coma iba nemvelaphi yokwanda okubukhali noma ukuncipha koshukela wegazi.

Izimpawu zokuqalwa kwekoma

Esimweni esinjengokuqina kwesifo sikashukela, izimpawu zincike ohlotsheni lwezinguquko ezihamba emzimbeni ezenzeka emzimbeni phakathi kokubola kwesifo sikashukela mellitus.

Isifo sikashukela sikashukela siqala ngokubhekela emuva kokwanda okubukhali noma ukuncipha koshukela wegazi.

I-Hypoglycemic coma

Isimo se-hypoglycemic sikhula ngokuwohloka okubucayi kweglucose yegazi. Ihambisana nomoya-mpilo namandla endlala yezicubu zobuchopho. Ngokunqotshwa kweminyango ethile yalesi sitho, kuvela izimpawu ezihambisanayo. Izimfuneko zokuqalwa kokukhohlisa yilezi:

• ubuthakathaka obukhulu bemisipha;
• Isiyezi
• ukuzamazama kwemilenze;
• Ubuhlungu ezindaweni zesikhashana nezokwepariyali;
• umuzwa onamandla wendlala;
• ushintsho lokuziphatha (isiguli siba nolaka futhi singacasuki);
• ukunciphisa isikhathi sokunakwa;
• ukungaboni kahle
• ukukhubazeka kwenkulumo (umuntu ukhuluma kancane, elula izandla);
• ukuquleka okuhambisana nokuphelelwa ukwazi;
• ukuboshwa kokuphefumula kanye nokwehluleka kwenhliziyo.

I-non-ketone coma ikhula ngokushesha okukhulu. Kubalulekile ukwenza imishini yezokwelapha ngesikhathi, ukuvikela isiguli ukuthi singapheli amandla isikhathi eside.

I-Hypoglycemic coma ihambisana nomuzwa onamandla wendlala.

Ngokuthuthuka kwesimo se-hypoglycemic, isiguli siba nolaka futhi singacasuki.

Isiyezi iwuphawu lwe-hypoglycemic coma.

Izimfuneko zokuthuthuka kwenhliziyo kungukuthuthumela kwemikhawulo.

Ngokuphikisana nesizinda sikashukela, ukubanjwa okukholisayo kwenzeka, kuhambisana nokuphelelwa yithemba.

Ukulimazeka okubukwayo kuwuphawu lwe-hypoglycemic coma.

I-Hypoglycemic coma ihambisana nenkulumo engasebenzi kahle.

I-Hyperglycemic coma

I-Sugar coma inezimpawu ezifanayo nokuboniswa kobuthi bokudla. Ukuthuthukiswa kwe-hyperglycemic coma kwandulelwa ngu:

• ukuchama njalo;
• ukoma okukhulu;
• izikhathi eziningi zokucanuzelelwa kwenhliziyo, okubangelwa ukwenzeka okuphindaphindiwe kokuhlanza okungalethi mpumuzo;
• ukubonakala kwephunga le-acetone elivela emlonyeni;
• Ubuhlungu besisu (abe nomlingiswa ohlabayo noma wokusika);
• ukwephulwa kwe-intestinal motility (kuhambisana nokuqunjelwa noma isifo sohudo).

Uma ingalashwa, i-precoma iyakhula, ihambisana:

• ukungazi kahle;
• ukwehla kwenani lomchamo;
• ukwehla kwezinga lokushisa lomzimba;
• ukoma kanye nokugqama kwesikhumba;
• ukuzindla kwenhliziyo;
• ukwehla kwengcindezi yegazi;
• ukwehla kwezwi lezindlebe zezamehlo (lapho licindezelwa, ithambile ngokweqile izwakala);
• ukuncipha kokuqina kwesikhumba.

Lokhu kudalwa kwe-pathology okunzima kubonakaliswa ukuphefumula okungajwayelekile komsindo nokuphefumula kungazelelwe. Lapho uphefumula, uhogela i-acetone. Ngo-ushukela owandayo, ulwelwesi lwamafinyila lomlomo wesibeletho loma, ulimi luhlanganiswa ngembozo emdaka. Isimo siphela ngokuqalwa kokwehla kweqiniso, isiguli siyayeka ukuphendula.

I-Hyperglycemic coma ibonakala ngokuncipha kwethoni yezimpawu zamehlo.

Ukuqala kwesigaxa sikashukela kuhambisana nomcanucanu.

Izimpawu ze-hyperglycemic coma zifaka phakathi ubuhlungu besisu.

Ukuthuthukiswa kwe-hyperglycemic coma yandulelwa wukuchama kaningi.

Ukomela ngokweqile kuwuphawu lwe-hyperglycemic coma.

Uma ingalashwa, i-precoma iyakhula, ihambisana nokuncipha kokushisa komzimba.

Ukuthuthukiswa kwe-precoma kuhambisana nokushaya kwenhliziyo okusheshayo.

I-ketoacidotic coma

Izimpawu ezilandelayo zisiza ukuqaphela lo mphumela wesifo sikashukela:

1. Isicanucanu nobuthakathaka obujwayelekile. Khombisa ukwanda kwezinga lama-ketones emzimbeni. Ukusetshenziswa kwemichilo yokuhlola kusiza ukukuqinisekisa lokhu.
2. Ubuhlungu besisu. Qinisa ngokukhula kokuqina kwe-acetone egazini. Uma ucindezela isandla esiswini, izinhlungu ziba nzima. Lesi sibonakaliso singadidaniswa nokubonakaliswa kwe-appendicitis nezinye izinqubo zokuvuvukala ezithweni zesifunda sesisu.
3. Ukushintsha uhlobo lokuphefumula. I-Ketoacidosis ihambisana nokucasuka kwesikhungo sokuphefumula, isiguli siphefumula kaningi nangaphezulu. Ngokuzayo, ukuphefumula kuyaqabukela futhi kube nomsindo. Umoya ophelelwa ngamandla unuka i-acetone.

Ngokuphatha i-insulin, i-coma yangempela ingavinjelwa futhi ukufa kungagwenywa.

I-Hyperosmolar coma

Isimo se-pathological sikhula siphikisana nesizinda sokukhuphuka kwegazi okwandayo. Izimpawu ezilandelayo ziyimpawu yalo:

1. Izimpawu zokubola zeshukela. Isiguli sikhononda ngokukhathala okungamahlalakhona, ukuchama kaningi nokoma.
2. Ukomisa Umfutho wegazi kanye nesisindo somzimba uyancishiswa, futhi umlomo owomile uba unomphela. Ukuqina kwesikhumba kuguquka, imibimbi ejulile ivela.
3. Izimpawu zomonakalo ohlelweni lwezinzwa. Lokhu kufaka phakathi ubuthakathaka bemisipha, ukunyamalala noma ukuqiniswa kokukhishwa, ukubanjwa ngamandla, ukukhishwa kwemizwa. Ukuphendula kohlelo lwezinzwa kuvinjelwe, kuthi ngemuva kwalokho isiguli siwele enkingeni.
4. Ukwephulwa kwemisebenzi yezitho zangaphakathi. Ukuqunjelwa kanye nohudo kuyavela, ukushaya nokuphefumula kuya njalo. Izinso ziyeka ukusebenza, yingakho ukuchama kuyeka. Mhlawumbe ukwakheka kweziqeshana zegazi kanye nokuvela kwezilonda zobuchopho ze-ischemic.

Izimpawu zomonakalo ohlelweni lwezinzwa ku-hyperosmolar coma zifaka ama-hallucinations.

Nge-hyperosmolar coma, umfutho wegazi wesiguli uyancipha.

Isibonakaliso se-hyperosmolar coma umlomo owomile njalo.

Ukukhathala okungamahlalakhona kuwuphawu lwe-hyperosmolar coma.

Izimpawu ze-lactacidemic coma zifaka ukubukeka kokuphefumula, okulandelwa ukuphefumula okujulile.

I-Lactacidemic coma ibonakala ngohudo olungapheli.

I-Lactacidemic coma

Lesi simo se-pathological sikhula kungakapheli amahora angama-8-12. Kuyinto ejwayelekile kubantu abanesifo sikashukela abanezifo eziningana ezikhona. Amazinga kashukela wegazi nge-lactacidemic coma akhuphuka kancane. Kuvela izimpawu ezilandelayo:

• ubuhlungu obukhulu esifundeni senhliziyo nemisipha emikhulu, engamiswa ne-analgesics ejwayelekile;
• ukuphefumula kwenhliziyo kanye nokuhlanza;
• isifo sohudo esiphikelelayo;
• ubuthakathaka bemisipha;
• ukuzindla kwenhliziyo;
• ukwehla kwengcindezi yegazi;
• ukubukeka kokuphefumula komoya, okulandela ukuphefumula okujulile;
• ukwazi ukungakwazi, ukungaphenduli kokuthonywa kwangaphandle.

Kutholakala kanjani ukuthi unesifo sikashukela?

Ukuxilonga kuqala ngokuhlolwa kwesiguli, esiza ukubona izimpawu zokuqala zesimo se-pathological. Ukuhlolwa kwegazi okujwayelekile nokunamakhemikhali kuyenziwa.

Izifundo zisiza ekuboneni uhlobo lukhehla lwesifo sikashukela futhi luhlukanise kwezinye izifo.

Ezimweni ze-hypoglycemic, izinga le-glucose esegazini alidluli i-1.5 mmol / L. Nge-hyperglycemia, le nkomba ifinyelela ku-33 mmol / L. I-urinalysis ejwayelekile ihloselwe ukukhomba ama-ketones.

Lapho kudingeka usizo

Usizo lokuqala luqala ngokuhlolwa kwemingcele ebalulekile: izinkomba zokusebenza kwenhliziyo, amaphaphu, isibindi, izinso nohlelo lokujikeleza kwegazi. Ngemuva kwalokho, kulungiswa ukwephulwa kwenziwa. Uma onesifo sikashukela engazi lutho, kuyadingeka ukubuyiselwa kwe-airway patency. Ukukhiqizwa kwesisu nokukhiqizwa kwama-enema kusiza ekuhlanzeni umzimba kwemikhiqizo enobuthi ye-metabolic. Ama-Resuscitators, uma kungenzeka, angakhomba futhi aqede imbangela yokuqalwa komthambo. Nge-hypoglycemic coma, i-glucose ingadingeka.