I-glucose iyinto ebalulekile yomzimba, engumthombo wamandla kuyo. Ukuze zonke izinhlelo nezitho zisebenze ngokuphelele, izinga loshukela wegazi kufanele libe ngu-3.3-5.5 mmol / lit.
Uma izinkomba zi-overestimated noma zehlisiwe, khona-ke lokhu kubonisa ukuthuthukiswa kwezifo ze-endocrine.
Izifo ezihambisana nokuphulwa kwe-carbohydrate metabolism (isifo sikashukela, i-hypoglycemia) kungenzeka zingenzeki isikhathi eside. Ngakho-ke, kaningi izifo ezifana nalezi zitholwa ziphelelwe yisikhathi lapho zisesimweni esithuthukile.
Ukuvimbela ukuvela kwemiphumela engeke iguqulwe, kubalulekile ukwenza ngezikhathi ezithile ukuhlolwa kwegazi ushukela.
Ngubani futhi odinga ukubheka igazi likashukela?
Izinhlobo eziningi ze-pathologies ziyahlukaniswa, ukuze kutholakale izimbangela zokuvela kwalo okudingekayo ukunikela ngegazi ngoshukela. Izimo ezinjengalezi zifaka ukukhathala, ukoma okunzima, ukuchama kaningi, nomlomo owomile.
Futhi, kuhlolwa ushukela kubantu abakhuluphele kanye nomfutho wegazi ophakeme. Futhi ezisengcupheni yilabo izihlobo zabo ezingasebenzi kahle kuma-carbohydrate metabolism.
Njengokuhlaziywa kwelabhoratri ezimele, inqubo yokubonisa ku:
- njengengxenye yocwaningo olunzulu;
- ukuhlola isimo sempilo seziguli esezitholile isifo sikashukela;
- ukulandelela amandla asetshenziswa kokwelashwa kwezifo ezithile;
- ukuqinisekisa ukutholwa.
Ukuhlola ushukela wegazi nsuku zonke kufanele kwenziwe njalo kubo bonke abanesifo sikashukela nalabo abanesifo sikashukela. Ngemuva kwakho konke, uma uthola ushukela wegazi ngesikhathi esifanele, ungavimbela ukuthuthukiswa kwezinkinga eziyingozi.
Abantu abengekho engcupheni kufanele babe nokubalwa kwegazi okuphelele kanye emva kweminyaka emi-3, ikakhulukazi ngemuva kweminyaka engamashumi amane.
Kwabesifazane abakhulelwe, ukuhlolwa kwegazi kwe-glucose kwenziwa kanye ngenyanga.
Izinhlobo zokuhlaziya
Yini ukuhlolwa kwe-glucose egazini futhi babizwa ngani? Kunezifundo ezi-2 eziholayo nezi-2 ezengeziwe. Le ndlela yelebhu, indlela ekhanyayo, enquma izinga le-hemoglobin ye-glycated kanye nesampula ene- “umthwalo” ushukela.
Ukuhlolwa kwelebhu yaseklinikhi kuthathwa njengokujwayelekile futhi kungokwethembekile. Esibhedlela, isiguli sithatha igazi kusuka emunweni kashukela. Kodwa kwesinye isikhathi igazi le-venous lingathathwa.
Isampula yegazi yenziwa kanjena: noma imuphi umunwe wesandla sobunxele uphathwa ngotshwala bese kwenziwa i-punning emcamelweni wayo omncane. Igazi elibonakalayo lifakwa engilazini yaselebhu, kanti okuseleyo kuqoqwa kufosholo elikhethekile elinephayiphu. Ngemuva kwalokho, kubahlaziyi abakhethekile, i-biomaterial ihlolwa ngokucophelela.
Kwesinye isikhathi igazi lithathwa emthanjeni. Kulokhu, inqubo yokuthatha izinto eziphilayo ibukeka kanjena:
- ingalo yesiguli icwetshwe nge-prenique;
- isikhumba engaphakathi kokugoba kwesigaxa siphathwa ngotshwala;
- umthambo ugwazwe ngenalithi eyize;
- igazi elibonakalayo libekwa engilazini futhi liqoqwe kushubhu lokuhlola.
Impilo yeshelufu yokuhlolwa okungenhla izinsuku eziyi-5. Ukucwaninga kungokwesigaba sokuhlaziywa okujwayelekile, ngakho-ke, akudingi zinyathelo ezikhethekile zokuqokwa.
Kepha uma kwenziwa ukuhlaziya okuningiliziwe, kubalulekile ukwazi ukuthi kuyini okuthinta nokuthi ungakulungiselela kanjani kahle. Ukunconywa okujwayelekile kwehlela ekutheni ngaphambi kokuhlolwa, isisu kufanele singabi nalutho, ngakho-ke isidlo sokugcina kufanele kube amahora angama-8 ngaphambi kocwaningo.
Ukuxineka ngokomqondo nangokomzimba, utshwala nogwayi nakho kungathinta ukuhlaziya. Futhi, ukulungiswa akufaki ukwenziwa kwezindlela zokwelapha ngaphambi kokuhlolwa (i-massage, i-ultrasound, i-x-ray).
Indlela ye-Express ithole igama ngenxa yokulethwa ngokushesha kwemiphumela. Ingqikithi yayo ilele ekulinganisweni okuzimele kwe-glucose egazini kusetshenziswa i-glucometer.
Inqubo ingenziwa noma kuphi ngaphandle kokulungiselela okukhethekile. Kepha ngokungasebenzi kahle kwensiza, ukusetshenziswa kwayo okungafundile noma isitoreji esingafanele semichilo yokuhlola, kuyaphawuleka iphutha emiphumeleni efinyelela ku-20%.
Yini igama lokuhlolwa kwegazi likashukela, okubonisa isilinganiso sokushukela ushukela wegazi emzimbeni ezinyangeni ezintathu ezedlule? Lokhu kuhlolwa kwe-hemoglobin ye-glycated ekala amaphesenti ama-hemoglobin aboshelwe emamolekyuli eglucose.
Uma kunamazinga okudla ngokweqile kushukela, ukusabela kweMaillard kushesha kakhulu. Olunye ucwaningo lukhombisa ukusebenza kahle kokwelashwa kwalesi sifo ezinyangeni ezi-3 ezedlule. Lapho kutholakala i-glycated hemoglobin, igazi noshukela kuthathwa emunweni nganoma yisiphi isikhathi, kungakhathalekile ukuthi kudliwani ukudla.
Ukuhlolwa kwegazi ushukela onomthwalo kufanele kudluliswe kabili:
- esiswini esingenalutho
- ngemuva kwamahora amabili ngemuva kokuthatha isixazululo sikashukela (75 ml).
Uma iziguli ngosuku olwandulela ucwaningo zigcwele, noma ziphuza noma yiziphi iziphuzo, kufaka phakathi namanzi, khona-ke izimpendulo zingaba zingamanga. Ukuhlaziywa kusemthethweni kuze kube izinyanga ezintathu.
Njengoba isifo sikashukela sihambisana nezinkinga eziningi, kwenziwa owengeziwe wokuhlola ukubekezelela ushukela. Isiguli sigaxwe amahlandla amane amahora amabili.
Okokuqala, amasampula e-biomaterial enziwa ku-sutra esiswini esingenalutho. Ngemuva kokuthi umuntu ephuze isixazululo sikashukela, kuthi ngemuva kwemizuzu engama-60, 90 ne-120, igazi liphinde lihlolwe.
Ngaso leso sikhathi, inkomba kashukela wegazi iyashintsha: ekuqaleni, ngemuva kokudla isixazululo sikashukela, iyanda, bese iyancipha.
Izimpendulo zinqunywa phakathi nalo lonke uvivinyo.
Imiphumela yokuhlola kanye namazinga kashukela
Ukuqonda ukuthi ngabe yikuphi ukuphazamiseka kwe-endocrine kwenzeka emzimbeni, udinga ukwazi amanani ajwayelekile kashukela. Ngokwezindinganiso zemithi, idatha esezingeni le-glucose esegazini ethathwe emunweni noma emthanjeni kuya ngeminyaka yobudala: kuze kube yinyanga eyi-1 - 2.8-4.4 mmol / l, kuze kube seminyakeni engu-14 ubudala - 3,3-5.5 mmol / l. Ezigulini ezineminyaka engaphezu kwengu-15, amazinga kashukela egazini avela emunweni angu-3.5 -5,5 mmol / L.
Lapho ushukela ekuhlolweni kwegazi liphezulu kakhulu, khona-ke lokhu kukhombisa i-hyperglycemia, futhi uma kungathathelwa phansi - i-hypoglycemia. Noma yimuphi umphumela uyingozi emzimbeni womuntu, ngoba lokhu kukhombisa ubukhona bokwephulwa okukhulu ekusebenzeni kwezitho nezinhlelo.
Kuyaphawuleka ukuthi ukuhlaziya ushukela wegazi, okunqunywa ngezindlela ezihlukile, kungaba nezinkomba ezihlukile ngokuya ngendawo yokuqoqwa kwe-biomaterial. Ithebula elingezansi libonisa umehluko phakathi kwezinga le-glucose egazini le-venous ne-capillary:
- 3.5-6.1 mmol / l;
- I-3.5-5.5 mmol / L.
Ebantwini abaphilile, ngemuva kokudla egazini, isilinganiso soshukela singakhuphuka sifike ku-6,6 mmol / L. Kepha lapho uthola isifo sikashukela, ukuhlola ushukela egazini kubalulekile izikhathi eziningana.
Nge-prediabetes, ukubalwa kwegazi kwe-capillary kungama-5.6-6.1 mmol / L, kanti igazi le-venous lingu-6.1-7 mmol / L. Lesi simo sibonisa ukwehluleka kokubekezelela ushukela.
Ukuguqulwa kwemiphumela: 2 amahora ngemuva kokuthatha isisombululo se-glucose, okujwayelekile ngu-7.8 mmol / L. Ungakhuluma nge-prediabetes uma ushukela wegazi usukela ku-7.8 uye ku-11.1 mmol / l. Izinkomba ezibalulekile zesifo sikashukela zisuka ku-11 1 mmol / L.
Ukuqinisekisa ngokunembile ukutholakala kwesifo sikashukela, i-glycated hemoglobin iyahlolwa. Uma ukuhlolwa okunjalo kwegazi kwenzelwa ushukela, okujwayelekile - 4-9%.
Uma ngabe le nkomba idluliwe, ubungozi bokuthola ubunzima besifo sikashukela (nephropathy, retinopathy) luphezulu. Futhi ukuhlolwa kwegazi kukhombisa ini lapho i-glycated hemoglobin inkulu kune-8%? Lokhu kuphakamisa isidingo sokulungiswa kokwelashwa ngenxa yokuntuleka kwemiphumela efanele.
Ukuguqula ukuhlolwa kwegazi ngoshukela ngomthwalo:
- I-7.8 ED - okujwayelekile;
- I-7.8-11 ED - i-prediabetes;
- kusuka ku-11.1 IU - isifo sikashukela mellitus.
Ingabe amazinga kashukela wegazi ajwayelekile kwabesifazane? Ngemuva kweminyaka engama-50, ngesikhathi sokunqamuka kokuya esikhathini, ushintsho lwama-hormonal kanye nokuphazamiseka kuma-carbohydrate metabolism kwenzeka emzimbeni wabo. Ngakho-ke, bonke abesifazane abaneminyaka yobudala engama-60 kufanele bahlole njalo igazi ukuze kutholakale ushukela.
Kwabesifazane abakhulelwe, amanani eglucose nawo angahluka. Ezigulini ezinjalo, inani elijwayelekile elifinyelela ku-6.3 mmol / L livamile. Uma lezi zinombolo zedlulisiwe, khona-ke kunikelwe ukuhlaziya okwengeziwe.
Emadodeni, ushukela ojwayelekile emgudwini wegazi ngu-3.3-5.6 mmol / L. Kodwa-ke, ngemuva kweminyaka engama-60, lamapharamitha angabekwa ngaphezulu.
Izimpawu ezibonisa ushintsho kwi-glycemia
Kuyenzeka ukuthi imvamisa kashukela wegazi kubantu abadala nasezinganeni liphansi kunamanani ajwayelekile. Lapho ukugxila kweglucose kungaphansi kwe-3.5 mmol / L, lokhu kubonisa i-hypoglycemia. Owokuqala ukuphendula kulesi simo wukuphela kwezinzwa nezindlala ze-adrenal.
Ngokukhishwa kwe-adrenaline, ekhishwa ezitolo ze-glucose, kutholakala izimpawu eziningana: indlala, i-palpitations, i-malaise, ukukhathazeka, ukuthuthumela nesiyezi. Futhi, umuntu uba nexhala, abe novalo, asheshe adinwe futhi ahlukunyezwe ikhanda.
Kwi-hypoglycemia ebukhali, ukubona kukhubazekile, ukuqunjelwa, nesiyezi esinzima kwenzeka. Ezinye iziguli ziba nokudideka zize zibe nokuqaqanjelwa.
Kwesinye isikhathi ukubonakaliswa kufana nokudakwa kwezidakamizwa noma kotshwala. Ngokushoda kukashukela isikhathi eside, izinguquko ezingenakuguqulwa ezingqondweni zingakhona. Ngakho-ke, ukukhululeka okuphuthumayo kwesimo kuyadingeka ukuze kubuyiswe izinga le-glycemia.
Imvamisa, izinkomba ze-glucose ziyashintsha ezi-diabetes zithathe izidakamizwa ezinciphisa ushukela kanye neziguli ekwelashweni kwe-insulin. Uma ungaqali ukwelashwa okufika ngesikhathi, khona-ke konke kungabulala.
Lapho ushukela wegazi uphezulu kakhulu, isiguli sihlala somile. Ezinye izinkomba ze-hyperglycemia zifaka:
- ukuluma nokuqhuma esikhunjeni;
- ukwanda kokuchama;
- ukwakhiwa kwamathumba;
- ukomisa ukuphuma kolwelwesi lwe-mucous lomlomo;
- ukukhathala;
- i-malaise;
- ukulunywa ngofuzo.
Ukweqile glucose emzimbeni kunomthelela ongemuhle emzimbeni wonke. Kungaba ukushaywa unhlangothi, ukuwohloka komzimba noma ukuhlaselwa yinhliziyo.
Imvamisa i-hyperglycemia iphumela ekuhlulekeni kwe-gangrene kanye ne-renal. Ezimweni ezisezingeni eliphakeme, ikoma liyakhula noma kufe ngisho nokufa.
Kuhle ukukhumbula ukuthi imiphumela yocwaningo kungenzeka ukuthi ayilona iqiniso. Ngempela, ngaphezu kokwephula umthetho we-carbohydrate metabolism kanye nokuphazamiseka kwe-endocrine, izimbangela ze-hypoglycemia zingatholakala ekudakweni kotshwala, izifo zepheshana lesisu, isibindi, izinzwa zamasosha omzimba kanye nokukhuluphala. Futhi, isimo esifanayo sibonwa nge-sarcoidosis, sinoshevu ngamachaphazelo, okweqisa kwe-insulin, isimila se-pancreatic.
I-Hypoglycemia kwisifo sikashukela ibangelwa yi-pathologies ye-thyroid gland, i-adrenal gland, i-pituitary gland, ukudla ukudla ngaphambi kokuhlaziywa kanye nesithuthwane. Namanje ushukela ukhuphuka kanye nokuxineka ngokomzimba nangokomzwelo futhi uthathe imithi ethile (corticosteroids, estrogens, diuretics, estrogens, nicotinic acid).
Imininingwane yokuhlolwa ushukela wegazi inikezwe kuvidiyo ekulesi sihloko.
