Uma unesicanucanu, ukugabha, umkhuhlane, isifo sohudo, noma ezinye izimpawu zesifo esithathelwanayo, kufanele uthintane nodokotela ngokushesha. Isifo esithathelwanayo kanye nohlobo 1 noma isifo sikashukela esiyinhlanganisela siyinhlanganisela yokubulala. Kungani - sizokuchaza ngokuningiliziwe endatshaneni. Musa ukuchitha isikhathi, shayela i-ambulensi noma ufike esibhedlela ngokwakho. Ngohlobo 1 noma isifo sikashukela sohlobo 2, uma kukhona ukutheleleka emzimbeni, kubaluleke kakhulu ukuthola usizo lwezokwelashwa olusheshe.
Unganqikazi ukukhathaza odokotela ngezifiso, ngoba uma, ngenxa yesifo esithathelwanayo sikashukela, umjikelezo omubi wokuphelelwa ngamandla, lapho-ke wena nodokotela ngeke nesithukuthezi.
Kungani Ukutheleleka Kesifo Sikashukela Kuyingozi Kakhulu
Ngohlobo 1 noma isifo sikashukela 2, izifo ezithathelwanayo zibangela ukomisa, futhi lokhu kuyabulala, izikhathi eziningi kuyingozi kakhulu ukwedlula kubantu abadala nezingane ezingenaso isifo sikashukela. Zizwe ukhululekile ukubiza i-ambulensi ngaso sonke isikhathi lapho isiguli sikashukela siqala ukuzizwa sinezicanucanu, ukuhlanza, umkhuhlane noma isifo sohudo. Kungani izifo ezithathelanayo zikashukela ziyingozi kangaka? Ngoba zibangela ukomisa. Kungani ukuphuma komzimba kubulale? Ngoba ukopha futhi ushukela wegazi ophezulu wenza umjikelezo omubi. Lokhu ngokushesha - kungakapheli amahora - kungaholela ekwehlulekeni kwezinso, ukoma, ukufa noma ukukhubazeka.
Kukhona nengozi yokuthi ngemuva kokugula okuthelelekayo, uma kuqala ukwelashwa sekwephuzile, amaseli e-beta asele we-pancreas akho azokufa. Ukusuka kulokhu, inkambo yesifo sikashukela izokwanda. Esimweni esibi kakhulu, uhlobo 2 sikashukela lungaphenduka uhlobo olunesifo sikashukela 1 esinzima futhi esingalapheki. Ake sihlolisise ukuthi izifo ezithathelwanayo ziluthinta kanjani ushukela wegazi nokuthi zingalashwa kanjani ngendlela efanele. Ngemuva kwakho konke, noma ngubani oxwayisiwe uhlome.
Isibonelo esihle kusuka kwezokwelapha
Ukugcizelela ukubaluleka kokuxhumana ngokushesha ne-ambulensi, uDkt Bernstein ulandisa indaba enjalo. Ngomunye uMgqibelo, ngehora lesine ntambama, owesifazane onesifo sikashukela wambiza owayengesona isiguli sakhe. Udokotela wakhe wacisha ifoni ngempelasonto futhi akazange ashiye imiyalo yokuthi ngubani ongaxhumana naye ezimweni ezinzima. Wathola inombolo yocingo kaDkt Bernstein enkombeni yedolobha.
Isiguli sasisekhaya sodwa nosana lwaso, futhi sasiqhubeka nokuhlanza kusukela ngo-9 ekuseni. Wabuza - ukuthi enzeni? UDkt Bernstein uthe kungenzeka ukuthi uphelelwe amanzi emzimbeni kangangokuba ngeke akwazi ukuzisiza, ngakho-ke kudingeka ukuthi aphuthunyiswe esibhedlela ngokuphuthumayo emnyangweni wezimo eziphuthumayo. Lapho bazokwazi ukugcwalisa ukuntuleka koketshezi emzimbeni ngosizo lwe-intravenous dropers. Ngemuva kokuqeda ingxoxo naye, uDkt Bernstein ushayele isibhedlela sendawo indawo waxwayisa ngokuthi badinga ukulinda lesi siguli futhi balungiselele ukumnika uketshezi lokulwa namanzi emzimbeni.
Isiguli saba namandla okuletha ingane kugogo wayo, sabe sesingaphansi kwamandla ayo ukuba sifike esibhedlela ngemuva kwamahora angama-5, uDkt Bernstein wabizwa evela emnyangweni wezimo eziphuthumayo. Kwavela ukuthi lo wesifazane onesifo sikashukela kumele aphuthunyiswe esibhedlela "ngokugcwele", ngoba abakwazanga ukumsiza emnyangweni wezimo eziphuthumayo. Ukuphelelwa ngamandla kwakuqinile kangangokuba izinso zehlulekile ngokuphelele. Kuhle ukuthi isibhedlela sasinophiko lwe-dialysis, lapho sadonswa khona ngokuyisimangaliso kwelinye izwe, uma kungenjalo ngabe selashona. Ngenxa yalokhu, lesi siguli sachitha izinsuku ezi-5 “zesithukuthezi” esibhedlela, ngoba washeshe wayibukela phansi ingozi yesimo sakhe.
Uyini umjikelezo omubi wokuphelelwa ngamanzi emzimbeni kanye noshukela ophezulu
Uma uhlanza noma uhudula, kungenzeka ukuthi unesifo esithathelwanayo. Imbangela nayo ingaba nobuthi ngokuthile okufaka ubuthi noma izinsimbi ezisindayo, kodwa lokhu akunakwenzeka. Ngaphezu kwalokho sizocabanga ukuthi imbangela ukutheleleka. Nomaphi lapho ukutheleleka kutholakala khona emzimbeni - emlonyeni, emathunjini esiswini, umunwe uvuvukala noma enye into - ushukela wegazi cishe uzonyuka. Ngakho-ke, iphuzu lokuqala: ukutheleleka kukodwa kuphakamisa ushukela wegazi.
Njengomphumela wokuhlanza kanye / noma uhudo, umzimba ulahlekelwa yimithombo yawo yamanzi. Okuqukethwe uketshezi oluphezu kwamathumbu kwehla ngokujwayelekile. Uketshezi olulahlekile ludinga ukushintshwa ngokuphuthumayo, futhi ngenxa yalokhu umzimba usebenzisa amanzi avela egazini. Lokhu akusho ukuthi kunokuphuma kwangaphakathi esiswini noma emathunjini. Kungukuthi amangqamuzana amunca amanzi egazini, abuyise okuncane kakhulu. Kepha lapho lokhu kwenzeka, amangqamuzana awamunca ushukela owengeziwe egazini. Ngenxa yalokhu, kunamanzi amancane egazini, kanye nenani elilinganayo loshukela. Ngakho-ke, ushukela wegazi ukhuphuka ngokwengeziwe. Uma ukugabha noma isifo sohudo kwenzeka kaningana zilandelana, ngenxa yoshukela omningi nokuphelelwa ngamandla, igazi lesiguli sikashukela liba njenge-viscous njengoshukela kashukela.
Umzimba womuntu ungena ngenethiwekhi eminyene yemithambo yegazi. Okudlula ngale mikhumbi kusuka enkabeni, kubude bawo obukhulu. Imikhumbi emide kakhulu futhi emincane kakhulu ibizwa nge- "peripheral", okungukuthi, ikude nendawo. Nganoma yisiphi isikhathi, igazi eliningi lisemithanjeni yangaphandle. Ngeshwa, uma igazi likhula, khona-ke kuba nzima ngokwengeziwe kulo ukugoba emithanjeni emincane yecala. Ngenxa yalokhu, izicubu zepherishi azihlinzekwa komoya-mpilo kanye nezakhamzimba, kufaka ne-insulin neglucose. Lokhu kwenzeka yize iqiniso lokuthi ukugcwala kwe-glucose egazini kuyakhuphuka. Eqinisweni, ngenxa yokuthi i-glucose ne-insulin esegazini eliningi azingene kahle emithanjeni yokweqile, ukumelana ne-insulin okuqinile kuyakhula.
Izicubu zomzimba ziqala ukumunca ushukela omncane, yingakho ukugxila kwegazi lakho kukhuphuka nangaphezulu. Lapho likhuphuka ushukela wegazi, liba namandla ngokwengeziwe ukumelana ne-insulin. Futhi ukumelana ne-insulin, kukhulisa ushukela wegazi. Izinso zizama nokukhipha ushukela omningi kumchamo, obangela isifiso esijwayelekile sokuchama, futhi lokhu kwandisa ukuphuma komzimba. Lesi ngesinye sezimo zokuqalwa komjikelezo omubi wokuphelelwa ngamandla noshukela wegazi ophakeme, futhi esinye isimo, esizosichaza ngezansi, sixhumeke kulesi simo.
I-glucose ne-insulin esegazini azifinyeleli izicubu zekhompiyutha. Amangqamuzana anokukhetha okunzima - ukubulawa yindlala noma ukuqala ukugaya amafutha. Bonke bendawonye bakhetha inketho yesibili. Kodwa-ke, imikhiqizo ekhishwa ngama-metabolism yamafutha ikhiqiza ngokungangabazeki imikhiqizo eyenziwe ngokuthi yi-ketones (imizimba ye-ketone). Lapho ukugcotshwa kwama-ketones egazini kukhuphuka ngengozi, isifiso sokuchama sisaqina, futhi ukuphuma komzimba kuya ezingeni eliphakeme. Umbuthano omubi ophindwe kabili uphela isiguli siphelelwe amandla, nezinso zakhe zihluleke.
Into esemqoka ukuthi izehlakalo esichaze ngenhla zingakhula ngokushesha okukhulu, ngenxa yokwehla komqondo nokuhluleka kwezinso kwenzeka emahoreni ambalwa. Isibonelo sowesifazane onesifo sikashukela esikhulume ngaso ekuqaleni kwendatshana empeleni siyinto ejwayelekile. Kwabodokotela bezimo eziphuthumayo, akuyona into engjwayelekile. Ngeshwa, ezimweni ezinjalo, kunzima kodokotela ukubuyisela ukusebenza okujwayelekile kwesiguli. Ukufa kufinyelela ku-6-15%, nokukhubazeka okulandelayo - kaningi.
Ukuphelelwa ngamandla emzimbeni kuphathwa kuphela esibhedlela nge-intravenous dropers. Baqala ukubeka lezi zidonsa e-ambulensi. Kepha kuningi esingakwenza ukuvikela intuthuko enkulu kangaka yemicimbi. Ake sithi uvuke phakathi kobusuku noma ekuseni kakhulu ngoba uyagabha noma uhudo. Yini okudingeka yenziwe? Okokuqala, uma unodokotela "wakho", bese umshayela ucingo uzokwazisa, ngisho naku-2 a.m. Ukuqhaqha noma ukugabha esigulini sikashukela kungumcimbi omkhulu ongahlukumeza ukwehla. Okwesibili, uma kukhona ukutheleleka emzimbeni, khona-ke ungadinga isikhashana ukujova i-insulin, noma ngabe uvame ukungaluphathi uhlobo lwakho lwesifo sikashukela nge-insulin.
Izifo ezithathelwanayo zivame ukukhuphula ushukela wegazi ezigulini ezinesifo sikashukela. Noma uvame ukungayifaki i-insulin, lapho umzimba ulwa nokutheleleka, kungakuhle ukuthi uqale ukwenza lokhu okwesikhashana. Umgomo ukunciphisa umthwalo kumaseli we-beta wamanyikwe akho, asasebenza, futhi uwagcine ephila. Futhi, imijovo ye-insulin isiza ukugcina ushukela wegazi uhlanzekile futhi ngaleyo ndlela ivikele ukukhula komjikelezo omubi wokuphelelwa ngamandla noshukela omningi.
Amaseli we-pancreatic beta afa ngamanani amakhulu ngenxa yokwanda koshukela wegazi, lokhu kubizwa ngokuthi ubuthi be-glucose. Uma ukufa kuvunyelwe phakathi kwesifo esithathelwanayo, khona-ke isifo sikashukela sohlobo 2 singaphenduka isifo sikashukela sohlobo 1, noma uhlobo lwesifo sikashukela sokuqala luzoba luthi chithi saka. Ngakho-ke, zonke (!) Iziguli ezinesifo sikashukela zidinga ukuyazi kahle inqubo yemijovo engenayo i-insulin futhi zilungele ukuyisebenzisa lapho zelashelwa isifo.
Sifaka kuhlu izimbangela eziphambili zokuphelelwa ngamanzi emzimbeni kushukela:
- isifo sohudo noma ukugabha kaningana ngokulandelana ngezikhathi ezimfishane;
- ushukela wegazi ophakeme kakhulu;
- umkhuhlane ophakeme, abantu bajuluka kakhulu;
- ukhohliwe ukuphuza uketshezi olwanele esimweni sezulu esishisayo noma ngesikhathi sokuzivocavoca ngokomzimba;
- isikhungo sokoma ebuchosheni sithinteka yi-atherossteosis - kubantu abaneshukela abanesifo sikashukela.
Enye yezimpawu eziphambili zokuthi ushukela wegazi uphezulu kakhulu ukomela okukhulu, kanye nokuchama kaningi. Kulesi simo, kuphakama izinkinga, noma umuntu ephuza amanzi, ngoba alahlekelwa ngama-electrolyte. Kodwa-ke, kunezinyathelo ezilula ongazithatha ekhaya ukuvimbela ukukhula komjikelezo omubi wokuphelelwa ngamanzi emzimbeni kanye noshukela omkhulu wegazi.
Izinkinga zesifo sikashukela esibi kakhulu ngenxa ushukela omningi
Isifo sikashukela se-ketoacidosis ne-hyperosmolar coma yizimo ezimbili ezimbi kakhulu ezingakhula ngenxa yokuhlanganiswa kokuphela komzimba noshukela wegazi ophezulu.
Isifo sikashukela sikashukela
I-ketoacidosis yesifo sikashukela yenzeka kubantu abane-pancreas engakhiqizi i-insulin yabo. Lezi yiziguli ezinesifo sikashukela sohlobo 1, kanye nohlobo 2 sikashukela, abacishe balahlekelwe ngokuphelele umsebenzi wamaseli abo we-beta. Ukuze i-ketoacidosis yesifo sikashukela yenzeke, kufanele kube nokuxineka okuncane kakhulu kwe-insulin kwi-serum yegazi kanye ne-insulin ukumelana ngenxa yokwanda koshukela wegazi nokuphelelwa ngamandla komzimba.
Kulesi simo, ukuthathwa koshukela ngamangqamuzana, ngokuvamile okuvusa i-insulin, kuyeke. Ukuze usinde, amaseli aqala ukugaya amafutha. Imikhiqizo eyenziwe ngemikhiqizo yokudla okunamafutha iyanqwabelana - ama-ketones (imizimba ye-ketone). Enye yezinhlobonhlobo zemizimba ye-ketone yi-acetone, i-solvent ethandwayo futhi isakhi esiyinhloko se-nail polish remover. Ama-ketones angabonakala emchini esebenzisa imichilo ekhethekile yokuhlola, kanye nephunga le-acetone emoyeni ophelile. Ngenxa yaleli phunga le-acetone, abantu abalahlekelwe yingqondo ngenxa yesifo sikashukela se-ketoacidosis bavame ukwenza iphutha kwabadakwayo abaphuze ukungazweli.
Uma izidumbu ze-ketone ziqongelela egazini ekujuleni okukhulu, khona-ke kunobuthi kwezicubu. Izinso zizama ukususa isidumbu sazo ngokuzifaka emchameni. Ngenxa yalokhu, ukomisa umzimba kusaba kubi kakhulu. Izimpawu ze-ketoacidosis yesifo sikashukela:
- imichilo yokuhlola ikhombisa ukuthi kunama-ketones amaningi omchamo;
- ukoma okukhulu;
- umlomo owomile
- isicanucanu
- ukuchama njalo;
- ubunzima bokuphefumula;
- ushukela wegazi ophakeme (imvamisa ingaphezulu kwe-19.5 mmol / l).
Zonke lezi zibonakaliso zivame ukuvela ngasikhathi sinye. Uma ama-ketones etholakala umchamo, kepha ushukela wegazi uvamile - ungakhathazeki. I-metabolism yamafutha ngokwakhiwa kwemizimba ye-ketone inqubo evamile, enempilo, nemvelo. Kuhlobo lwesifo sikashukela sohlobo 2, sikubiza ngokuqondile ngosizo lokudla okunama-carbohydrate aphansi ukuze isiguli sishise imithombo yaso yamafutha bese sinciphisa isisindo. Asikho isidingo sokuthatha izinyathelo eziphuthumayo uma ukugcwala kwama-ketones umchamo kuphansi noma kuphakathi, kanti ushukela wegazi awukhuphuki, umuntu uphuza uketshezi olwanele futhi nempilo yakhe ijwayelekile.
I-Hyperosmolar coma
Esinye isimo esibi esenzeka ngenxa yokuphelelwa ngamanzi emzimbeni kanye noshukela wegazi ophakeme yi-hyperosmolar coma. Lokhu kuyinkinga eyingozi kakhulu yesifo sikashukela kune-ketoacidosis. Kwenzeka kubantu abanesifo sikashukela, abathi ama-pancreas asakhiqiza i-insulin, yize nje encanyana. I-"Hyperosmolar" - isho ukuthi ukugcwala kwe-glucose, i-sodium ne-chloride kuyanda egazini, ngoba ngenxa yokuphelelwa ngamanzi akukho amanzi anele okuziqothula lezi zinto. Ezigulini ezine-hyperosmolar coma, umsebenzi owanele we-beta-cell uvame ukugcinwa ukuze umzimba ungaqali ukugaya amafutha. Kepha ngasikhathi sinye, i-insulin ayanele ukugcina ushukela wegazi ekukhuphukeni okuqinile.
I-hyperosmolar coma ihlukile ku-ketoacidosis ngoba, ngayo, izidumbu ze-ketone azitholakali emchameni wesifo sikashukela noma emoyeni ophelelwe yisikhathi ngaye. Njengomthetho, kwenzeka ezigulini esezikhulile ezinesifo sikashukela, esikhungweni sazo somile ebuchosheni esithinteka nobudala obuhlobene ne-atherosclerosis. Iziguli ezinjalo azizwa zineme kahle, ngakho-ke, ngesikhathi sokulashwa esibhedlela, ukuphuma komzimba wazo kunamandla kakhulu kune-siketoacidosis yesifo sikashukela. Izimpawu zokuqala ze-hyperosmolar coma ukozela, ukungazi lutho. Uma izinyathelo eziphuthumayo zingathathwanga, lowo muntu uzowela enkingeni. Ushukela wegazi ezigulini uvame ukuphakama kuno-22 mmol / l, kodwa futhi uphezulu ngendlela emangalisayo. Kubikwe amacala afinyelela kuma-83 mmol / L.
Ukwelashwa kwe-ketoacidosis yesifo sikashukela kanye ne-hyperosmolar coma - ukufaka uketshezi esikhundleni sokwehla kwe-intravenous, kanye nokuphathwa kwe-insulin. Imicimbi iyafana, kepha izimiso ezinconyelwe ukusetshenziswa kwazo zihlukile kancane. Funda kabanzi mayelana nokwelashwa kwe-ketoacidosis yeswekile kanye nokwelashwa kwe-hyperosmolar coma. Ukuyeka ukomisa ngokufaka uketshezi ngokwalo kwehlisa ushukela wegazi, noma ngabe ukuphathwa kanjani kwe-insulin. Ngoba uketshezi luhluza ushukela egazini, futhi luphinde luvumele izinso ukuba zisuse i-glucose eyeqile kanye nemizimba ye-ketone kumchamo.
Isifo sikashukela se-ketoacidosis ne-hyperosmolar coma senzeka ezigulini ezivilapha ukulawula ushukela wazo. Imvamisa yokufa kwabantu isuka ku-6 iye ku-25%, kuya ngeminyaka nokuthi umzimba we-diabetes unamandla kangakanani. Uma ufunda isiza sethu, khona-ke kungenzeka ukuthi uyisiguli esishukunyisiwe futhi kungenzeka maningi ukuthi ubhekane nalezi zinkinga, ngaphandle kwesikhathi sokutheleleka kwezifo. Ukwelashwa kwe-ketoacidosis yesifo sikashukela kanye ne-hyperosmolar coma kwenziwa esibhedlela kuphela. Umsebenzi wethu wukwenza imisebenzi yokuzivikela, ngaphandle kokuthatha lolu daba sisetshenziswe ngokweqile. Lokhu kusho - bona udokotela ngokushesha ezimpawu zokuqala zokutheleleka, futhi uthathe nezinyathelo zasekhaya zokugcina ushukela wegazi ojwayelekile nokuvikela ukuphuma komzimba.
Isicanucanu, ukugabha, nohudo
Isicanucanu, ukugabha, nohudo kaningi kubangelwa ukutheleleka ngegciwane noma ngegciwane. Kwesinye isikhathi zihambisana nezimpawu ezinjengomkhuhlane. Uma unesicanucanu, ukugabha kanye / noma uhudo, ke ikhambi eliyinhloko ukuyeka ukudla. Ngaphezu kwalokho, imvamisa akukho kuthambekela ezimeni ezinjalo. Ungasinda ezinsukwini ezimbalwa ngokujwayelekile ngaphandle kokudla. Kulokhu, kufanele uqhubeke nokuphuza amanzi kanye nokunye uketshezi olungenawo ama-carbohydrate. Umbuzo uphakama - ingabe ukuzila ukudla kuguqula kanjani umthamo wamaphilisi we-insulin nesifo sikashukela?
Iziguli ezigcwalisa uhlelo lokwelapha isifo sikashukela sohlobo lwe-1 noma uhlobo lwenkinga yesifo sikashukela zisebenzisa i-insulin kuphela ukuze zigcine ushukela wegazi ojwayelekile. Ngemuva kokudla, silawula ushukela wegazi nge-insulin emfushane noma ye-Ultra-iDemo.Lapho ushintshela kwirejimeni yokuzila ukudla ngesikhathi sokutheleleka, imijovo ye-insulin esheshayo eyayingaphambi kokudla ikhanseliwe, futhi i-insulin eyengeziwe ekuseni futhi / noma kusihlwa iyaqhubeka njengokujwayelekile. Kuphakanyiswa ukuthi ufaka i-insulin engaphezulu kokudingayo ukuze ugcine ushukela ojwayelekile wokuzila. Ukuze wenze lokhu, udinga ukubala kusengaphambili umthamo wawo ofanele ngokwendlela echazwe lapha.
Ngamaphilisi kashukela - into efanayo. Amapilisi owathatha ebusuku noma ekuseni ukulawula ushukela wokuzila, qhubeka. Amatafula athathwe ngaphambi kokudla - sikhansele okwesikhashana ngokudla. Womabili amaphilisi ne-insulin, alawula ushukela wegazi osheshayo, kufanele aqhutshwe kumithamo ephelele. Lokhu ngeke kuvumele ushukela wegazi ukuba "wehle ngokweqile" futhi ukhiqize i-ketoacidosis noma isifo se-hyperosmolar coma - ubunzima obukhulu besifo sikashukela. Ngakho-ke, ezigulini ezisebenzisa uhlelo lokwelapha isifo sikashukela sohlobo lwe-1 noma uhlelo lokwelapha isifo sikashukela, kuvela ukuthi kulula ukuguqula irejimeni yazo yokwelashwa ngesikhathi sesifo esithathelanayo nokuzila ukudla. Abantu abanesifo sikashukela abelashwa ngezindlela ezijwayelekile futhi bafake imithamo emikhulu ye-insulin banezinkinga eziningi.
Njengoba wazi, ukutheleleka kanye nokuphelelwa amandla kubangela ukwanda koshukela wegazi. Ingozi yokuthola umjikelezo omubi wokuphelelwa ngamanzi emzimbeni kanye noshukela omningi usasele, naphezu kokubulawa yindlala. Uma ushukela wegazi ukhuphuka, khona-ke kufanele ubuyiselwe emuva kwelejwayelekile ngosizo lomjovo we-insulin osheshayo. Lesi isizathu esenza siphikelele ukuthi bonke abantu abanesifo sikashukela bayazi kahle inqubo yemijovo engenayo i-insulin, noma ngabe ngaphansi kwezimo ezijwayelekile abaphathwa nge-insulin. Ngesikhathi sesifo esithathelwanayo, imijovo yesikhashana ye-insulin iyindlela ewusizo futhi ebaluleke kakhulu.
Imijovo ye-insulin ngesikhathi sokutheleleka inganciphisa umthwalo kumaseli we-pancreatic beta bese iwugcina uphilile. Kuya ngokuthi inkambo yesifo sikashukela iya iba mbi yini lapho usalulama ekuthelelekeni. Uma ungakakulungeli ngaphambili ukufaka i-insulin yakho okwesikhashana ngenkathi welashelwa ukutheleleka, khona manjalo thintana nodokotela wakho ukuze enze irejimeni yokwelapha nge-insulin futhi akufundise indlela yokuzijova ngayo. Uma unganaki lesi silinganiso, khona-ke kunamathuba amaningi wokuthi inkambo yesifo sikashukela izonyuka ngoba amaseli we-beta "ayaphela". Esimweni esibi kakhulu, kungavela ukukhula kwesifo sikashukela noma i-hyperosmolar coma.
Sichaza kafushane ukuthi ushukela wegazi uvama kanjani ngosizo lomjovo we-insulin osheshayo phakathi kwezifo ezithathelwanayo. Udinga ukukala ushukela wakho nge-glucometer ekuseni ngemuva kokuvuka, bese kuthi njalo ngamahora ama-5. Faka umthamo owanele we-ultrashort noma i-insulin emfushane ukubuyisa ushukela kokujwayelekile uma iphakanyisiwe. Udinga ukukala ushukela wegazi futhi, uma kunesidingo, faka i-insulin ngokushesha njalo ngamahora ama-5, ngisho nasebusuku! Ukuze wenze lokhu, setha i-alamu ukuvuka phakathi kobusuku, ngokushesha uqedele yonke imisebenzi bese ulala kuyo. Uma ubuthakathaka kakhulu kangangokuba ungakwazi ukukala ushukela wakho nokufaka i-insulin, omunye umuntu kufanele akwenze. Lokhu kungaba isihlobo sakho noma umhlinzeki wakho wezokunakekelwa kwempilo.
Yimaphi amaphilisi okufanele ngiyeke ukuwaphuza
Imithi eminingi ethandwayo inyusa ukukhipha amanzi emzimbeni noma ibenze buthaka okwesikhashana umsebenzi wezinso. Ngesikhathi sezifo ezithathelwanayo kushukela, ukuphathwa kwabo kufanele kumiswe, okungenani okwesikhashana. Uhlu olumnyama lubandakanya amaphilisi wengcindezi - ama-diuretics, ama-inhibitors e-ACE, ama-blocker angiotensin-II receptor blockers. Futhi, ungathathi izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala - ibuprofen nabanye. Ngokuvamile, xoxa ngayo yonke imishanguzo oyiphuzayo nodokotela okufundele yona.
Ukulawula kanjani ukugabha
Ukuze uvikele ukuphuma komzimba, udinga ukuphuza uketshezi, kubandakanya nezixazululo zesaline. Kodwa uma unokuhlanza okuqhubekayo, khona-ke uketshezi ngeke ube nesikhathi sokugaya. Uma ngemuva kweziqephu ze-1-2 ukuhlanza kumile, khona-ke akusethusi kangako, kodwa nokho yazisa udokotela wakho. Uma ukuhlanza kuqhubeka, shayela i-ambulensi ngokushesha esibhedlela. Ukuqothuka kuyabulala! Esibhedlela, ochwepheshe bazobona ukuthi ungayeka kanjani ukugabha, futhi okubaluleke - ngosizo lwabangawokudonsa, bazokujova ngama-elektrolitha aqukethe amanzi nawokubalulekile. Asikukhuthazi ngokuphelele ukuthatha noma yiziphi izidakamizwa ze-antiemetic ekhaya.
Lapho ukuhlanza sekuyekile, kufanele uqale ngokuphuza uketshezi ukumiselela ukulahleka kwamanzi emzimbeni futhi uvikele ukuphuma komzimba. Phuza ngaso sonke isikhathi, kodwa kancane kancane, ukuze ungeluli izindonga zesisu futhi ungavuseleli ukuhlanza okuphindaphindiwe. Kuyinto efiselekayo ukuthi uketshezi lunokushisa okusondele ekushiseni komzimba - ngakho-ke luzodonswa ngokushesha. Yiluphi uketshezi oluhamba phambili kulesi simo? Ungayiphuza ngamanani amangaki? Uketshezi olufanele wakho kumele uhlangabezane nemibandela emithathu:
- akufanele kube yinto ongayithandi;
- kuphela iziphuzo ezingenayo i-carbohydrate ezingafanele, kuyilapho kuvunyelwe izinambuzane ezingondli;
- uketshezi kufanele lube nama-electrolyte - i-sodium, i-potassium ne-chloride - ukunxephezela ngokulahleka kwawo okwenzeka ngesikhathi seziqephu zokuhlanza noma sohudo.
Ungaphuza itiye le-herbal, amanzi acacile noma amaminerali, futhi uma sekuyisikhathi sokuqala ukudla, khona-ke umhluzi oqinile wenyama ongenawo ama-carbohydrate. Wonke la manzi uketshezi angafanele futhi kufanele "athuthukiswe" ngama-electrolyte angeziwe. Ilitha ngalinye, engeza isipuni esingu-0,5-1 ngaphandle kwegquma kasawoti kasetafuleni, futhi unga ¼ ithisipuni le-potassium chloride. Lokhu kufaka usawoti okuthengiswa ekhemisi. Usawoti wethebula uhlinzeka ngomzimba nge-sodium ne-chloride, futhi i-potassium chloride nayo inikezela ngamaminerali potassium. Uma ukuhlanza kumiswe ngemuva kweziqephu ezi-1-2, khona-ke ama-electrolyte kungenzeka angangezelelwa kulolo ketshezi. Ungasebenzisi izimpuphu ze-electrolyte ezilungiselelwe uma ziqukethe ushukela.
Ngesikhathi sokuzila, ukuthola uketshezi nsuku zonke kufanele kube ngu-48 ml nge-1 kg yesisindo somzimba. Kumuntu onesisindo esingu-62 kg, lokhu kungaba amalitha ama-3 ngosuku. Kubantu abakhulu - okuningi. Uma ukulahlekelwa uketshezi kanye ne-electrolyte kwenzeka ngenxa yohudo noma ukugabha, khona-ke amalitha ambalwa ongeziwe adinga ukudakwa kungakapheli amahora angama-24 ukubuyisela okunye kulahleka. Ngokuvamile, ngesikhathi izifo ezithathelwanayo kushukela, udinga ukuphuza hhayi nje kuphela, kodwa okuningi. Uma ungeke noma ukhohlwe ukuphuza ngesikhathi, kuzodingeka ukuthi ufake uketshezi esibhedlela ngamaconsi ama-intravenous ukwelapha ukopha.
Uma wena noma ingane yakho yesifo sikashukela ilaliswa esibhedlela ukwelapha ukuphuma kwamanzi nge-intravenous dropers, kungavela le nkinga elandelayo. Abasebenzi bezokwelapha bazofuna ukuphatha izixazululo ze-elektrogtte eziqukethe i-glucose, i-fructose, i-lactose, noma omunye ushukela oyingozi kushukela. Ungabavumeli ukuba benze lokhu. Gcizelela ukuthi odokotela baphatha izixazululo ze-electrolyte ngaphandle kwe-glucose noma omunye ushukela. Uma kwenzeka okuthile, thintana nabaphathi futhi usabise nokuthi uzokhononda eMnyangweni Wezempilo. Amanzi u-Intravenous fluid kanye nama-electrolyte ayindlela ebaluleke kakhulu, ewusizo futhi ebalulekile ... kodwa noma kunjalo, kulabo abaphatha isifo sikashukela ngokudla okunama-carbohydrate aphansi, kuyathandeka ukuthi isixazululo singenalo ushukela noma obunye ushukela.
Isifo sohudo nokuthi ungalashwa kanjani ngendlela efanele
Okokuqala, sibonisa ukuthi isifo sohudo esinegazi futhi / noma sihlangana nomkhuhlane ophakeme sidinga ukunakekelwa ngokushesha kwezokwelapha. Ungazama ukwelashwa ekhaya kuphela uma kungekho gazi noma izinga lokushisa lomzimba eliphakeme. Ukwelashwa kuqukethe izinto ezintathu:
- ukulawula ushukela wegazi;
- ukulawulwa kwesifo sohudo ukugwema ukulahleka okwengeziwe kwamamanzi nama-electrolyte;
- ukubuyisela uketshezi nama-electrolyte asevele elahlekile ukuvikela umjikelezo omubi wokuphelelwa ngamandla noshukela wegazi ophezulu.
Ukulawulwa kukashukela wegazi kwenziwa ngendlela efanayo nangokuhlanza, futhi sesivele sikuchazile ngemininingwane engenhla. Ngokubuyisela uketshezi kanye nama-electrolyte - into efanayo, kuphela uma unesifo sohudo, ungangeza isipuni esingu-1 ngaphandle kwesilayidi kasawoti kulo lonke ilitha lamanzi. Ukwelashwa okuyinhloko sohudo, njengokuhlanza nje, ukuyeka ukudla. Uma uthatha noma yimuphi umuthi wokuhudula, ke kuphela lokho okuvunyelwana nodokotela wakho. Funda "Imithi yokwelapha isifo sohudo (isifo sohudo) sikashukela."
Uma isifo sohudo sihambisana nomkhuhlane noma izitofu zegazi - ungacabangi nokuthatha noma imuphi umuthi, kepha thintana nodokotela khona lapho.
Ukushisa okuphezulu
Ukushisa okuphezulu kubangela ukomisa okukhulu, ngoba umuntu ufunga kakhulu. Inani elilula lokulahleka okunzima ukulilinganisa, ngakho-ke nje sincoma ukuphuza u-1-2 amalitha uketshezi ngosuku ngaphezu kokujwayelekile. Ukushisa komzimba okukhuphukile kusiza ukuguqula amagciwane noma amagciwane abangela isifo esithathelwanayo. Uma ngasikhathi sinye umuntu elele ngaphezu kokujwayelekile, khona-ke lokhu kuyasheshisa ukululama. Kepha ngesifo sikashukela, ukozela kungaba yingozi, ngoba kuyaphazamisa izindlela ezidingekayo - njalo ngemuva kwamahora ama-5 ukukala ushukela wegazi, uma kunesidingo, nikeza imijovo ye-insulin, uphuze uketshezi, ubize udokotela. Setha i-alamu ukuze uvuke okungenani kanye emahoreni angama-5.
Siphatha kakhulu ama-antipyretics. Imithamo ebalulekile ye-aspirin noma izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala (ibuprofen nabanye) ingadala i-hypoglycemia enzima. Kuyinto engathandeki ikakhulukazi ukusebenzisa izidakamizwa zalawa maqembu emazingeni okushisa aphezulu ezinganeni. Ukuhlanganiswa kwezidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala ngokuphelelwa ngamandla kungadala ukwehluleka kwezinso. Amathebulethi wokulwa nokuvuvukala okungama-nonsteroidal ngokwezigaba awalungele abantu abanokulimala kwezinso sikashukela.
Emazingeni okushisa aphezulu, udinga ukulawula ushukela wegazi futhi uphuze uketshezi ngendlela efanayo naleyo esichaze ngayo ngenhla ezingxenyeni zokwelapha ukuhlanza kanye nohudo. Kukhona i-caveat eyodwa. Lapho ujuluka, ukulahleka kwama-electrolyte kuncane kakhulu. Ngakho-ke, uma kungekho ukugabha kanye / noma uhudo, khona-ke awungeke wengeze izixazululo kasawoti kulamanzi ophuza isiguli. Uma ungazizwa ulambile, khona-ke ungadli. Uma ulambile, mhlawumbe i-avulandi noma ukudla okungu-1/2 kokudla kwakho okujwayelekile kuzokwanela. Faka u-1/4 noma ½ womthamo wakho ojwayelekile we-insulin esheshayo ngaphambi kokudla, ngokulandelana.
Isifo Sikashukela: Ukutholwa
Njenge-hypoglycemia, ukomisa kungaba yisifo sikashukela esisongela impilo. Ngakho-ke, amalungu omndeni wesiguli sikashukela kufanele asitadishe ngokucophelela lesi sahluko. Amasheya okukhulunywa ngawo esihlokweni esithi “Usizo lokuqala lwekhithi yoshukela. Okudingayo ukuze ube nesiguli sikashukela ekhaya futhi nawe ”kumele kuthengwe kusengaphambili futhi kube sendaweni efinyeleleka kalula. Siyaphinda futhi, sinxusa zonke iziguli ezinesifo sikashukela sohlobo 2 ukuthi zifunde kahle inqubo yemijovo engenampilo ye-insulin futhi zibheke ukuthi imithamo ye-insulin ehlukile ikuthinta kanjani. Lokhu kumele kwenziwe kusenesikhathi, noma ngabe ulawula kahle ushukela wakho ngokudla, ukuvivinya umzimba kanye namaphilisi.
Shayela udokotela wakho kusibonakaliso sokuqala somkhuhlane, ukugabha, noma uhudo. Ngokushesha lapho umuntu onesifo sikashukela ethola ukunakekelwa kwezokwelashwa, maningi amathuba okuthi kuvikeleke ukomisa, i-ketoacidosis yesifo sikashukela, noma i-hyperosmolar coma. Lapho ukuphuma komzimba sekuvele ukukhula, ukwelashwa kuba nzima kakhulu. Udokotela uyakwazi lokhu kahle, ngakho-ke ngeke akhathazeke uma ungamphazamisa futhi ushaye ucingo kusengaphambili.
Udokotela cishe uzobuza ukuthi ngabe kukhona ama-ketones emchini, futhi uma kunjalo, kukuphi okuhlushwa. Ngakho-ke, kungcono ukuhlolwa umchamo ngemichilo ye-ketone test ngaphambi kokubiza udokotela. Uma ungadli lutho, khona-ke imicu ethile yokuhlola izokhombisa ukuthi kunama-ketones ekuhlanganeni okuncane noma okuphakathi kumchamo. Uma ama-ketones emchini ehlanganiswa noshukela wegazi ojwayelekile, khona-ke akukho lutho olungakhathazeka ngalo. I-ketoacidosis yesifo sikashukela kufanele ilashwe kuphela lapho ushukela wegazi uphakanyiselwe ku-10 mmol / L noma ngaphezulu. Uma ubuphuza i-aspirin amahora angama-24, udinga ukuthi utshele udokotela wakho ngayo ngoba ama-aspirin angadala imiphumela yokuthola umchamo we-urone.
Ukutheleleka okungabangeli ukuphuma komzimba
Izifo eziningi azithwali ubungozi bokuphelelwa ngamanzi emzimbeni, kodwa cishe zonke zazo zandisa ushukela wegazi. Izifo ezithathelwanayo zibangela izimpawu ezibonakala kalula. Uma unesifo se-urinary tract, kuzoba nomuzwa ovuthayo lapho uchama. I-bronchitis ibonakaliswa ngokukhwehlela, nokunye. Konke lokhu kuyizimpawu ezicacile zomzimba zokuthola usizo lwezokwelapha ngokushesha. Ngoba uma unesifo sikashukela sohlobo 2 noma uthayipha ushukela ongu-1 ngendlela emnene, khona-ke cishe awufuni ukuba amaseli akho ambalwa we-beta afe.
Isimo esijwayelekile ukuthi isiguli esinesifo sikashukela sohlobo 2 sinomuzwa wokuthi sinegciwane lesifo somchamo. Kepha uhlehlisa ukuthi avakashelwe udokotela futhi angalashwa. Ngenxa yalokhu, ushukela wegazi lakhe uphakama kangangokuba amaseli we-beta asele “aqhume”. Emva kwalokhu, thayipha isifo sikashukela sohlobo 2 sidlulela ku-Type 1 sikashukela, kanti manje isiguli kuzofanela senze imijovo emi-5 ye-insulin nsuku zonke. Esimweni esibi kakhulu, ukutheleleka nge-mkojo ngaphandle kokulashwa ngokucophelela kuzodala nezinkinga ezinso, bese kuthi “ibhokisi elimnyama” likhona ekhoneni.
Izifo ezifihliwe zivame ukwenzeka ezingadali ezinye izimpawu ngaphandle koshukela wegazi ongachazwanga. Uma ushukela uqhubeka nokuphakanyiswa izinsuku eziningana futhi i-insulin isebenza kabi kakhulu kunokujwayelekile, khona-ke lesi yisikhathi sokubonana nodokotela. Ezimweni ezinjalo, kwesinye isikhathi kuvela ukuthi umuntu onesifo sikashukela sewehlise i-insulin ngenxa yokugcinwa okungafanele noma ukusetshenziswa kwesirinji, noma ukutheleleka kuye kwavela emgomeni womlomo.
Ukuvimbela kanye nokwelashwa kwezinkinga zamazinyo
Ukutheleleka ngomlomo yisimo esivame kakhulu sokutheleleka nge-latent. Amagciwane asemlonyeni athinta izinsini, izimpande zamazinyo ngisho namathambo emihlathi. Uma isifo sikashukela singalawulwa kahle futhi ushukela wegazi uhlala uphakeme, khona-ke lokhu kudala izimo ezinhle zempilo yamagciwane emlonyeni. Futhi-ke ukutheleleka emgodini womlomo kukhulisa ushukela wegazi futhi kwehlise umuzwa womzimba ku-insulin. Lesi ngesinye isibonelo somjikelezo omubi.
Ngakho-ke, uma ushukela wegazi uqhubeka nokuphakanyiswa ngokungachazeki izinsuku eziningana, khona-ke isizathu sokuqala esikhona kungenzeka ukuthi i-insulin iwohlokile, ikakhulukazi ngenxa yokusebenzisa kabusha amasirinji alahlwayo. Uma i-insulin nakanjani kuyinto evamile, khona-ke umuntu onesifo sikashukela kufanele aye kudokotela wamazinyo ngokushesha. Lapho efuna umthombo wokutheleleka, udokotela uzohlola izinsini bese eshaya umoya obandayo emazinyweni ngamunye. Uma ubuhlungu bubonisa ukuthi izinyo lizwela ukubanda, khona-ke nakanjani linokutheleleka nokulimala. Ngaphezu kwalokho, udokotela wamazinyo uzokwelapha izinyo lakhe eligulayo noma athumele isiguli kudokotela onguchwepheshe ngezinsini.
Khumbula ukuthi ubuhlakani bamazinyo emazweni akhuluma isiRussia, ngamazinga omhlaba, ashibhile kakhulu futhi ngasikhathi sinjalo esezingeni eliphakeme, acishe abe ngcono kunaseNtshonalanga. Abantu abakhaliphile abavela lapho beza lapha ikakhulukazi ukuphatha amazinyo abo. Ngakho-ke, sinamahloni nje okuhamba ngamazinyo abolile. Kucatshangwa futhi ukuthi ukutheleleka okuhlala emlonyeni kusakazeka emithanjeni yegazi emzimbeni wonke futhi kwandise nengozi yokuhlaselwa yinhliziyo, kucekele phansi izindonga zemithambo yegazi kusuka ngaphakathi. Lo mbono awukakafakazelwa ngokuphelele, kepha ochwepheshe abengeziwe bayakuqinisekisa. Ukungasho ukuthi izinkinga zamazinyo zenza kube nzima ukulawula isifo sikashukela.
Isiphetho: zitholele udokotela wamazinyo omuhle, futhi kusengaphambili, kancane, ngenkathi amazinyo akho engalimalanga. Udinga udokotela wamazinyo o:
- wazi kahle ubuciko bokubhala kwakhe;
- isebenzisa izinto ezisezingeni eliphezulu zokugcwalisa;
- ayigcini i-painkiller;
- ngaphambi kokugwaza ama-painkiller ezinsini, kwenza ukuhlolwa kokungezwani;
- inemvelo enomusa ngokwemvelo.
Bonke abantu bayalulekwa ukuthi bavakashele udokotela wamazinyo njalo ezinyangeni ezi-6 ngokuprophylactically. Esikhathini sikashukela, kuyalulekwa ukwenza lokhu kanye ezinyangeni ezi-3.Ngalesi sikhathi sokuvakasha, i-plaque netshe abakhe phezu kwazo bayasuswa emazinyweni. Le yindlela engcono yokuvikela izifo ezithathelwanayo zomgogodla womlomo. Udinga futhi ukuxubha amazinyo akho kabili ngosuku, ngemuva kokudla kwasekuseni nasebusuku, futhi ngamunye ngemuva kokudla, sebenzisa i-floss yamazinyo.
Ngeshwa, ushukela wegazi ophakeme ungaqhubeka izinyanga eziningana ngemuva kokuba konke ukugxila kokutheleleka emlonyeni sekuphulukisiwe. Lokhu kusho ukuthi usadinga ukuthatha ama-antibiotic, okuzonconywa ngudokotela wamazinyo. Uma amanye ama-antibiotic engasebenzi, abese eshintshwa elinye. I-antibiotic ephumelelayo noma cha - lokhu kungaqondwa izinguquko kushukela wakho wegazi kanye nemithamo ye-insulin. Kuyadingeka futhi ukuthatha amalungiselelo we-probiotic ndawonye nemithi elwa namagciwane ukuze ungene esikhundleni samagciwane azuzayo emgudwini wesisu ofayo kanye namabhaktheriya ayingozi ngenxa yama-antibiotics.
