Isifo sikashukela yisifo esidala izifo esidalwa njalo esivame ukubangela izinkinga eziyingozi eziningi. Uma ungasebenzisi ukwelashwa okufanele futhi unganamatheli ekudleni, isifo sikashukela kuholela ekulimaleni okukhulu kombono, izinso, isibindi nezinye izitho zomzimba.
Izinkinga zesifo sikashukela zihlukaniswe zibe nzima futhi zingamahlalakhona. Izinkinga ezinkulu zesifo sikashukela zenzeka ngemuva kwesikhashana esifushane lapho kuphendulwa ukwanda noma ukuncipha koshukela egazini. Izinkinga zakamuva zivela ngenxa yemiphumela elimazayo ye-hyperglycemia kwezicubu zemizwa nemithambo yegazi.
Izinkinga zesifo sikashukela zivela nokwelashwa okungafanele noma okubambezele lesi sifo.
Izinkinga ezinkulu
I-Angiopathy, okungukuthi, izinkinga zezesifo sikashukela, ngokuya ngosayizi wemikhumbi eyonakele, ihlukaniswa njenge-macroangiopathy ne-microangiopathy.
Izinkinga ezinesifo sikashukela ezincinci zenza umonakalo emehlweni nasezinso. Uma kukhona i-macroangiopathy, kuvela izinkinga zobuchopho, inhliziyo nenhliziyo.
I-Coma kushukela likhula njengempendulo ekushintsheni okwedlulele kushukela wegazi. Imvamisa le nkinga enkulu yesifo sikashukela ivela ngemuva kwesizinda se-hypoglycemia.
Izinkinga ezinkulu zingaholela ekufeni.
I-Hypoglycemic coma
Lapho amazinga eglucose ehla kakhulu aze amangqamuzana obuchopho ahlupheke ngenxa yokuntuleka kwamandla, kubonakale izimpawu zokuwohloka okuzayo. I-Hypoglycemia ibonakala ngenani le-glucose elingaphansi kuka-3.3 mmol / L.
Ubungozi bokhobeka ukuthi izicubu zobuchopho zingathinteka. Izimo eziyingozi nazo zingakhula, ngokwesibonelo, lapho umuntu ngokuzumayo elahlekelwa ukwazi. Lokhu kungaba ngisho nalapho ushayela imoto noma kwezinye izimo lapho kudingeka ukunakwa kakhulu khona.
I-Hypoglycemia yakheka ngenxa yezizathu ezilandelayo:
- ukwelashwa okungafanele kwe-insulin noma ukusetshenziswa kwezidakamizwa ezinganciphisi ushukela,
- izinkinga zokudla,
- ukusebenza komzimba ngaphandle kwenani elifanele lama-carbohydrate,
- ukuzila ukudla
- ukuphuza utshwala
- ukuthatha imishanguzo ehlukahlukene, phakathi kwabo: amalungiselelo e-lithium, ama-sulfonamides, ama-beta-blockers.
Izimpawu ze-hypoglycemia zifaka:
- ukujuluka
- izitho zomzimba ezithuthumela
- tachycardia
- umuzwa onamandla wendlala
- ukuzindla ezungeze izindebe
- ukukhathazeka nokwesaba
- isicanucanu
Zonke lezi zigameko zandulela i-brain pathologies, ngakho-ke, izindlela zokwelapha kufanele zenziwe ukuvimbela i-coma. Uma ukwelashwa kungenakwenziwa, kuvela:
- ukozela
- ukunakwa okungahambi kahle
- ukudideka
- ikhanda.
Uma kuvela izimpawu eziningana, bonana nodokotela ngokushesha.
I-Hyperglycemic coma
I-Coma, ebangelwa ukwanda okukhulu koshukela wegazi, ingaba yi-ketoacidotic (ketoacidosis), kanye ne-hypersmolar ne-lacticidal.
I-ketoacidosis yenzeka ngenxa yokwanda koshukela nemikhiqizo ye-metabolic, okungukuthi, ama-ketones, athinta kabi umzimba. Imbangela kungaba ukutheleleka, ukuntuleka kokwelashwa, noma amaphutha kuyo, kanye nokulimala, ukusebenza nezinye izinto.
I-hyperosmolar coma (dehydrating) yakhiwa lapho igazi eline-osmolarity ephezulu “likhipha” uketshezi oluvela emangqamuzaneni, luqede amanzi emzimbeni. Lesi simo senzeka ngenxa yokuntuleka kwe-insulin.
Izici eziholela kulokhu kukhubazeka ziyefana nezimbangela ze-ketoacidosis, futhi noma yiziphi izindlela eziholela ekulahlekelweni uketshezi zingabikwa kulokhu.
Izimpawu ezejwayelekile ezandulele ukoma:
- ukukhuphuka kwevolumu yomchamo (kuze kufike kumalitha ayi-8),
- ukoma okukhulu
- ukukhathala, ubuthakathaka, ukuqaqanjelwa yimizwa,
- ngokushintshwa koshukela wegazi, inkomba ingaphezu kuka-16.5 mmol / l,
- ulwelwesi olomile nolusu,
- ezinsukwini ezimbalwa kamuva, ukuvela kokungaboni kahle, bese kuthi ukukhohlisa.
Lezi zimpawu ziimpawu zombili zesimo se-hyperosmolar kanye ne-ketoacidosis. Kodwa-ke, i-ketoacidosis inomehluko olandelayo:
- Ukuphefumula kukaKussmaul kwenzeka (kunomsindo, akuvamile futhi kujule),
- iphunga "lama-apula amnandi" avele
- ukukhala njalo kobuhlungu besisu esibuhlungu.
Nge-hyperosmolarity, i-paresis, ukukhubazeka komzimba, ukuphazamiseka kwenkulumo kanye nama-hallucinations kuvame ukwenzeka. I-Hyperosmolar coma ibonakala ngokwanda kwezinga lokushisa.
Izibalo zibonisa ukuthi i-lactic acidosis coma iba ngokwayo akuvamile. Kuvela ngenxa yokwehla kwesibalo somoya-mpilo ongena ezicutshini ngesikhathi sezinhliziyo ezithinta inhliziyo, ukwehluleka kohlelo lokuphefumula, i-anemia, ukulimala, ukulahleka kwegazi nokutheleleka.
I-lactic acid coma ingenzeka ngenxa yokuzivocavoca ngokomzimba, ukudakwa okungapheli noma ngemuva kweminyaka engama-65.
Izimpawu ziyefana namanye ama-coma, kepha awekho ama-ketones kumchamo kanye ne-hyperglycemia ephezulu.
Izinkinga ezifika ngemuva kwesikhathi
Izinkinga ezingapheli zesifo sikashukela i-mellitus noma i-pathologies sekwephuze kashukela yizilonda zemithambo yegazi, isb. Angiopathies.
I-angiopathy yesifo sikashukela iyi-lesion yemikhumbi emincane, ephakathi nendawo enkulu. Uma imikhumbi emincane (i-arterioles, ama-capillaries nama-venule) ethintekile, kwakheka i-microangiopathy.
Ukwehlulwa kwemikhumbi ebukhulu obukhulu nobuphakathi kubizwa ngokuthi yi-macroangiopathy. Lama-pathologies aholela ekulimaleni kwamehlo nasezinso. Izikebhe nazo zithintekile:
- izinhliziyo
- ubuchopho
- imilenze ephansi.
Isifo Sikashukela Sikashukela
I-nephropathy yesifo sikashukela iwukulimala kwezinso kushukela, okuholela ekwehlulekeni kwezinso okungamahlalakhona.
Ukubonakaliswa kokuqala kwe-nephropathy kuvela iminyaka engama-5 ukuya kwe-10 ngemuva kokuqala kwesifo sikashukela. I-Nephropathy yilolu hlobo lokuxakeka okuvame ukubangela ukufa kwesiguli esinesifo sikashukela sohlobo 1.
Le ndlela yokusebenza kwezinso inezinyathelo eziningana:
- i-microalbuminuria,
- proteinuria
- ukwehluleka kwezinso okungamahlalakhona.
I-Nephrotic syndrome iholela ekunciphiseni kwethamo lamaprotheni ngevolumu yeyunithi yegazi ngalinye. Kusukela kwasungulwa i-proteinuria ephikelelayo, zonke izimpawu eziwuphawu lokungaphumeleli kwe-renal ehluleka ukujoyina. Isiteji sinenkambo eqhubekayo ngejubane elihlukile.
Isici esinqumayo ekuthuthukiseni ukwehluleka okungapheli kwe-renal kubhekwa njenge-hypertension ye-arterial, okungukuthi, ukwanda kwengcindezi yegazi. Njengomthetho, kulesi sigaba, izinqubo ezahlukahlukene zokuvuvukala ziyavela ezidlula ohlelweni lomchamo.
Kuyadingeka ukufeza izinga elithile lomfutho wegazi, akufanele lidlule i-130/85 mm RT. Ubuciko. Uma umuthi i-Enalapril nezidakamizwa ezifanayo kutholakale ukuthi azisebenzi, kufanele kunikezwe ukwelashwa okwengeziwe nge-Verapamil noma i-Diltiazem.
Ngaphezu kwalokho, ungasebenzisa ama-diuretics, ngokwesibonelo, iFurosemide, kanye ne-Atenolol. Ukwelashwa ekwakhekeni kokwehluleka kwezinso kunqunywa yisigaba se-pathology.
Ukwehluleka kwangempela kungakha amandla futhi kube ukuphela.
I-retinopathy yesifo sikashukela
Le nkinga iphawula ukulimala kwemithambo ye-retina, imithambo yegazi kanye nama-capillaries. Esikhathini sikashukela, inqubo yokunciphisa imikhumbi iyaphawulwa. Kulokhu, izitsha ziqala ukuhlushwa ukuntuleka kwegazi. Ama-pathologies we-degenerative avela, ukwakheka kwe-maseli kuvela emikhunjini, izindonga ziba mncane.
Lapho ukuntuleka komoya-mpilo isikhathi eside, ama-lipids nosawoti we-calcium aqala ukufakwa kwi-retina. Izinqubo ezinjalo ziholela ekubonakaleni kwezindawo ezithile eziminyene. Ngenxa yobuningi boshintsho lwe-pathological, izibazi kanye nefomu liwela emikhunjini ye-retina.
Uma ukwelashwa kungemukelwanga futhi inqubo ibambezelekile, kungenzeka ukuthi ukubanjwa komzimba kungahle kwenzeke, futhi ngenxa yalokho, ubumpumputhe. Ukuhlaselwa yinhliziyo nokuqhekeka kwemikhumbi eyonakele kuholele ekuchashazweni okukhulu komzimba we-vitreous wamehlo. Futhi, ubungozi bokuthuthukisa i-glaucoma abukhishwa.
Ukubona i-retinopathy yesifo sikashukela, kufanele kwenziwe uchungechunge lokuhlolwa. Izindlela ezisetshenzisiwe zocwaningo:
- ukuhlolwa kwamehlo
- ukunquma kwezinga nezinkambu zokubukwa,
- Ukuhlaziywa kwe-iris, i-cornea, kanye ne-angle yegumbi elingaphandle kwamehlo lisebenzisa isibani se-slit.
Uma umzimba we-vitreous kanye nelensi kugcwalisiwe amafu, khona-ke kufanele kwenziwe iso lokuhlola iso.
I-neuropathy yesifo sikashukela
I-neuropathy yesifo sikashukela iyi-lesion ye-peripheral kanye ne-system ye-nerve ephakathi nesifo sikashukela. Imbangela eyinhloko yalokhu kuhlanganisa ukwanda kweglucose yegazi.
Kunemibono eminingana yesifo sikashukela se-neuropathy. Ngokuhambisana nomcabango othandwa kakhulu, ngenxa yokuqukethwe okuphezulu kwe-glucose egazini, ukukhuphuka okukhulu kwevolumu glucose kwenzeka ku-nerve. Njengoba i-glucose ngamanani amakhulu ingekho ngaphansi kokuqedwa kwe-metabolism, lokhu kunomthelela ekwakhekeni kwe-sorbitol.
Ngenxa ye-sensor neuropathy, imizwa yokudlidliza iqale ukungaphazamiseki. Ukukhonjwa kwalokhu kwephula umthetho kwenziwa kusetshenziswa ifolokoji yokuphothula, kufakwe ekhanda lethambo lokuqala le-tarsus.
Isibonakaliso esivame kakhulu sale nkimbinkimbi yesifo sikashukela ukubukeka kokuqina kwesibindi kanye "nama-goose bumps" emilenzeni. Esikhathini sikashukela i-mellitus, umphumela wokulimala kohlelo lwezinzwa kubhekwa njengokukhanya okuhlala njalo emikhawulweni ephansi, enobandlululo.
Njengoba lesi sifo siqhubeka, ukungaphatheki kahle kuvela esiswini, esifubeni nasezingalweni. Ngenkambo ende yesifo sikashukela, imicu emincane yezinhlungu iqala ukufa, ebonakala njengokunqanyulwa kobuhlungu emilenzeni.
I-Sensomotor neuropathy ivame ukuhambisana nokuncipha kokuzwela. Ikakhulu, ukuzwela kuncipha emilenzeni nasezingalweni ngesigamu.
Ngaphezu kwalokho, ubunzima bokuhamba nokuhlangana okungahambi kahle kokunyakaza kungavela. Njengoba kunokuphulwa kokuzwela, umuntu uvame ukungawuboni umonakalo ezinyaweni, esikhathini esizayo angenwe yileli gciwane.
Isifo senhliziyo siyindlela ye-neropathy yengqondo, ebonakala ngokwanda kwesilinganiso senhliziyo ekuphumuleni, okungukuthi, ngaphandle komzimba.
Uhlobo lwesisu noma esiswini se-neuropathy yesifo sikashukela lwakhiwa ngenxa yomthetho wezinzwa wepheshana lesisu. Ukudlula kokudla ngokusebenzisa i-esophagus kuyaphazamiseka, ukuvuvukala kodonga lwe-esophagus kukhula.
Ngenxa yokuphazamiseka kwamathumbu emathunjini, ukuqunjelwa kanye nesifo sohudo kwenzeka. Ngaphezu kwalokho, ukwephulwa kokukhiqizwa kwejusi yokugaya yi-pancreas kuqoshwa. I-salivation profuse kanye ne-dyskinesia ye-biliary ikhula njalo, okuholela ekwakhiweni kwamatshe emiseleni ye-bile.
Imvamisa emadodeni kuba nokwehla kokusebenza kocansi, kwabesifazane kukhona ukwephulwa kwe-hydration yezitho zangasese.
I-neuropathy yesifo sikashukela ihambisana nokuncipha kokusebenza kwabafundi, ukuguqulwa kombono ebumnyameni kukhubazekile.
Isifo sikashukela
Isifo sikashukela sonyawo lwesifo sikashukela yisifo sonyawo sikashukela, esakhiwa ngenxa yomonakalo wezinzwa zangaphakathi, izicubu ezithambile, isikhumba, amalunga namathambo. I-Pathology ivezwa izilonda ezingapheli futhi ezinzima, izilonda ze-bone-articular kanye nezinqubo ze-purulent-necrotic.
Ukwenziwa kwezinhlobonhlobo zonyawo lwesifo sikashukela kuhambisana nokushintshwa kwemithambo yemilenze. Ngenxa yokwanda kwemikhumbi yonyawo, i-edema nokwanda kwezinga lokushisa kwenzeka. Ngenxa yokugeleza kwegazi okungahambi kahle, imithambo yegazi iqala ukuhlushwa ukuntuleka komoya ophuma izicubu zonyawo.
Unyawo luqala ukuvuvukala futhi lube mnyama. Izinqubo eziguqukayo kusakhiwo sethambo-ligamentous zingathatha isikhathi eside ukwakha.
Ukwelashwa ngonyawo lwesifo sikashukela, kumele kuthathwe izinyathelo zokunciphisa izinqubo ze-metabolic, kanye:
- imithi elwa namagciwane
- ukwelashwa kwenxeba
- ukuthulula kanye nokuphumula konyawo,
- Ukuqedwa kwendawo yokuqina kwesikhumba,
- ugqoke izicathulo ezikhethekile.
Isikhumba ezinyaweni siba phuzi noma i-cyanotic. Kwesinye isikhathi ngenxa yokwanda kwama-capillaries, isikhumba siba bomvana ngokubomvu.
Ngezinhloso zokuxilonga ziyasebenza:
- Indlela ye-Doppler
- i-angiography yemikhumbi yemilenze,
- ukucabanga kwamakhompiyutha
- ukuskena kwe-ultrasound kwemithambo yegazi.
Ukuvimbela
Ukwelashwa kwezinkinga zohlobo 1 nesifo sikashukela sohlobo 2, okokuqala, kubandakanya ukuvimbela. Kubalulekile ukuhambisana ngokuhlelekile nazo zonke izincomo zezokwelapha ukuvimbela ukwakheka kwezinkinga zikashukela nokulawula noma yikuphi ukuguquguquka kushukela wegazi.
Ekwakhekeni kwanoma yiziphi izingqinamba, izinyathelo kufanele zithathwe ngokushesha ukuze zifinyelele ezingeni likamoya ushukela we-plasma, ngoba inkambo yesifo sikashukela uqobo, kanye nemiphumela ebangelwa yikho, kuncike kulokhu.
Izindlela zokuvimbela zifaka:
- ukuqondisisa okuhleliwe kwezokwelapha namarekhodi we-disensary,
- ukulawula ushukela wegazi,
- ukulandela imithetho yokudla,
- ukusula kwansuku zonke
- imisebenzi ethile yomzimba nokuphumula,
- ukuhlanzeka kwendlu nokuhlanzeka kwendlu,
- ukusekelwa kwamasosha omzimba kanye nokwelashwa okufika ngesikhathi kokutheleleka nangomkhuhlane.
Ukuhambisana nalezi zincomo kwenza ukuthi sikwazi ukugcina ngempumelelo ukuqina kwesi sifo futhi sinciphise nengozi yezinkinga.
Yiziphi izinkinga ezingaba nesifo sikashukela esizochazwa uchwepheshe ovela kuvidiyo ekulesi sihloko.
