Ushukela wegazi 35: kusho ukuthini?

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Ushukela wegazi 35, kusho ukuthini, iziguli zinesithakazelo kuzo? Ukuqunjelwa okunjalo kwe-glucose emzimbeni wesifo sikashukela kubonisa izinga leshukela, njengomphumela lapho ukusebenza kwawo wonke amasistimu angaphakathi nezinhlelo kuvinjelwe.

Ngokuphikisana nesizinda sezinkomba ezinjalo, ushukela ungakhula ngokuqinile futhi ube ngaphezulu kwamayunithi angama-40, okusho ukuthi kungenzeka ukuthi kube nezinkinga ezinkulu ezithuthukayo. Ngaphezu kwalokho, ingozi yokuqhubeka kwemiphumela engemihle iyanda.

Isifo sikashukela isifo esingelapheki yisifo esingamahlalakhona, "ukungathembeki" okukukuthuthuka kwezinkinga eziningi - ukuthikameza okubukwayo kuze kufiphale, ukwehluleka kwezinso, ukuqothuka kwemikhawulo engezansi, njll.

Kuyadingeka ukuthi ucabangele ukuthi kusho ukuthini uma ushukela ukhuphuke ngaphezu kwama-46 amayunithi, futhi yiziphi izinkinga ezingaba khona?

Izinkinga ezinkulu zoshukela ophezulu

Isisho esithi hyperglycemic state sisho ukwanda ushukela emzimbeni womuntu ngaphezu kwemingcele eyamukelekayo. Ukuhlushwa ushukela kusuka kumayunithi angama-3.3 kuya ku-5.5 kubhekwa njengezinkomba ezijwayelekile.

Uma ushukela osemzimbeni womuntu esiswini esingenalutho uphakeme ngaphezu kwamayunithi angama-6.0, kodwa engaphansi kuka-7.0 mmol / l, khona-ke bakhuluma ngesimo se-prediabetesic. Okusho ukuthi, lokhu kudalwa kwezifo akusoshukela okwamanje, kepha uma izinyathelo ezifanele zingathathwanga, amathuba okuthuthuka kwayo aphezulu kakhulu.

Ngamanani kashukela ngaphezulu amayunithi angama-7,0 esiswini esingenalutho, kuthiwa isifo sikashukela sinjalo. Futhi ukuqinisekisa ukutholwa, kutholakala izifundo ezengeziwe - ukuhlolwa kokuzwela kwe-glucose, hemoglobin ye-glycated (ukuhlaziya kukhombisa okuqukethwe ushukela ezinsukwini ezingama-90).

Uma ushukela ukhuphuka ngaphezu kwamayunithi angama-30 ukuya kwangama-30, lesi simo se-hyperglycemic sisongela ngezinkinga ezinzima kakhulu ezingakhula ngezinsuku ezimbalwa noma amahora ambalwa.

Izinkinga ezivame kakhulu zesifo sikashukela esibuhlungu kakhulu:

  • I-Ketoacidosis ibonakala ngokuqongelela emzimbeni wemikhiqizo ye-metabolic - imizimba ye-ketone. Njengomthetho, obonwa ezigulini ezinesifo sikashukela sohlobo 1, kungaholela ekuphazamisekeni okungenakulungiswa ekusebenzeni kwezitho zangaphakathi.
  • I-hyperosmolar coma iba lapho ushukela ukhuphuka emzimbeni uye emazingeni aphezulu, ngezinga elikhulayo le-sodium. Kwenzeka ngokumelene nesizinda sokuphelelwa ngamandla. Ngokuvamile kutholakala uhlobo 2 lwesifo sikashukela abaneminyaka engaphezu kwama-55 ubudala.
  • I-lactacidic coma ivela ngenxa yokuqongelela i-lactic acid emzimbeni, ibonakala ngokungazi kahle, ukuphefumula, ukwehla okubucayi kwengcindezi yegazi kuyatholakala.

Ebuningini bezithombe zemitholampilo, lezi zinkinga zikhula ngokushesha, phakathi namahora ambalwa. Kodwa-ke, i-hyperosmolar coma ingakhombisa ukukhula kwayo izinsuku eziningana noma amasonto ngaphambi kokuqala komzuzu obalulekile.

Noma iziphi zalezi zimo isikhathi sokufuna usizo lodokotela olufanele; ukuphuthuma kokuphuthumayo kwesiguli kuyadingeka.

Ukunganaki lesi simo amahora amaningi kungabiza impilo yesiguli.

Ketoacidosis kwisifo sikashukela

I-ketoacidosis yesifo sikashukela iyinkimbinkimbi kakhulu yesifo esingamahlalakhona okungaholela ekuphazanyisweni okuningi kwezitho zangaphakathi, ukomzimba kanye nokufa.

Lesi simo se-pathological sivela lapho inqwaba yoshukela inqwabelana emzimbeni wesiguli, kepha umzimba awukwazi ukuwuthola, ngoba kune-insulin encane noma ayinawo nhlobo.

Kodwa-ke, umzimba udinga ukuthola amandla ukuze usebenze, njengomphumela lapho umzimba "uthatha" izinto zamandla kusuka emafutheni ezinamafutha, ngesikhathi sekwephuka lapho izidumbu ze-ketone zikhishwa, okuyizinto ezinobuthi.

Le nkinga iba lapho ingemuva kwesidingo esibukhali somzimba umthamo omkhulu we-insulin. Futhi imbangela ingaba yile mibandela elandelayo:

  1. I-viral noma i-patologies ethelelekayo (izifo zokuphefumula ezinamandla, umkhuhlane kanye nabanye).
  2. Ukwephulwa kwemvelo ye-endocrine.
  3. Ukuxineka (ikakhulukazi ezinganeni).
  4. Isifo sohlangothi, ukushaya kwenhliziyo.
  5. Ngemuva kokuhlinzwa.
  6. Isikhathi sokukhulelwa (isifo sikashukela sabesifazane abakhulelwe).

Ngokuphikisana nesizinda soshukela olwedlulele okwedlula amayunithi angama-35, isiguli sihlala sifuna ukuphuza uketshezi, ngokulandelana, kukhona ukwanda kwamandla adonsa umchamo ngosuku. Ukomiswa kolwelwesi lwama-mucous nesikhumba, kutholakala imalaveve ejwayelekile.

Uma lesi simo singanakwa, khona-ke isithombe somtholampilo senezelwa isicanucanu, ukugabha, iphunga elithile kusuka emgodini womlomo, futhi ukuphefumula kuya ngokujulile futhi kube nomsindo.

Ukwelashwa kwe-ketoacidosis kuhlanganisa amaphuzu ayisihlanu ayisihluthulelo. Ukwelashwa kwe-insulin kuyenziwa, kuphuma uketshezi emzimbeni, ukuntuleka kwe-potassium, i-sodium kanye nezinye izinto zamaminerali, i-acidosis iyaqedwa, i-concomitant pathologies iyelashwa.

Isikhombisi sokululama ngempumelelo sibhekwa njengokuncipha koshukela kuya ezigabeni eziyi-11 futhi ngaphansi kwalezi zibalo.

I-Hyperosmolar coma: izimpawu nemiphumela

I-Hyperosmolar coma ivame ukwenzeka kwabanesifo sikashukela, abangamalungu eqembu labantu abangaphezu kweminyaka engama-50. Ukufa ngenxa yalesi simo se-pathological kufinyelela ku-40-60% kuzo zonke izithombe zokwelashwa.

Lokhu kudalwa kwenhliziyo kukhula ngemuva kwesimo se-metabolic yesifo sikashukela esingabhalisiwe, futhi kwenzeka kanye namazinga kashukela amaningi emzimbeni, amayunithi angaphezu kwama-50, kuhlangene ne-plasma hyperosmolarity, lapho kungekho-ketoacidotic complication.

Indlela esebenza ngayo leyo ngxaki ayiqondakali ngokuphelele. Odokotela basikisela ukuthi lo mphumela ongemuhle uvela ngemuva kwesizinda sesimo se-hyperglycemic, lapho kunokuvinjwa kokumbiwa kukashukela ezinso.

I-Hyperosmolar coma ingakhula ezinsukwini ezimbalwa noma amasonto ambalwa. Okokuqala, isiguli sibonisa izimpawu njengesifiso esinamandla sokuphuza, ukusheshe sichame futhi sikuchaze, buthakathaka.

Ngaphezu kwalokho, izimpawu zokuphelelwa ngamandla ziyaphawulwa:

  • Kwehlisela i-turgor yesikhumba.
  • I-tonus yama-eyeball iyancipha.
  • Umfutho wegazi uyancipha.
  • Izinga lokushisa lomzimba liyancipha.

Esimweni esinzima sesimo se-pathological, isiguli sakha ukoma. Izinkinga ezivame kakhulu i-vein thrombosis ejulile, kanye nomonakalo wezinso ku-mellitus yesifo sikashukela kanye ne-pancreatitis, ukubanjwa kwesithuthwane.

Izici zokwelashwa kwalesi simo ukuthi kwenqatshelwe ngokuphelele ukunciphisa ushukela kakhulu. Inketho enhle ukunciphisa ushukela ngeyunithi ezi-5 ngehora. Futhi, i-osmolarity yegazi akufanele inciphise ngokushesha kunokuba amayunithi ayi-10 ngemizuzu engama-60.

Uma unganamatheli ku-protocol yezokwelapha, khona-ke ingozi yokuvuvukala kwamaphaphu nobuchopho ikhuphuka kakhulu.

I-Lactacidotic coma

I-Lactacidic coma iyinkinga engafani nhlobo yesimo se-hyperglycemic ku-diabetesics, kepha ihlotshaniswa nethuba lokufa eliphezulu, futhi ingozi yokufa ingama-80%.

Njengomthetho, lesi simo se-pathological sibonwa kwabanesifo sikashukela esidala abanomlando wokugula okufana nesistimu yezinhliziyo, ukungasebenzi kahle kwesibindi nezinso.

I-pathogenesis yokwehla komqondo isuselwa ekugxileni kwe-glucose ephezulu kakhulu emzimbeni womuntu ngokumelene nesizinda sokuntuleka kwe-hormone egazini. Isimo somtholampilo walesi sifo sikhula ngokushesha okukhulu, siyahluka ngokuqhubeka.

Izimpawu ezilandelayo ziyabonakala ezigulini:

  1. Ubuhlungu esiswini.
  2. Ukuhlaselwa isicanucanu kuya ekuhlanzeni.
  3. Ubuthakathaka obujwayelekile.
  4. Ubuhlungu bemisipha ngenkathi buhamba.
  5. Ukunganaki, ukubekezela nobuthakathaka.
  6. Ukomela noma ukuqwasha.
  7. Ukukhohlisa, ukukhishwa ngamehlo (akuvamile).

Uma izinyathelo zingathathwanga ngesikhathi sokumisa isimo esibucayi esigulini, khona-ke ugaxeka. Ngokwempilo, izimpawu zokuphelelwa ngamandla ziyatholakala, ukuphefumula kwesiguli kuba nomsindo futhi kujule, umfutho wegazi uyancipha, futhi ukushaya kwenhliziyo kuba ngokushesha.

I-Lactacidic coma ingakhula ngaphansi kwethonya lezinto eziningi:

  • Ngokumelene nesizinda se-hyperosmolar coma, esingabonakali nge-ketosis.
  • Lapho kwenzeka isifo sikashukela sikashukela senzeka, i-lactic acidosis ibhekwe cishe ku-8 - 11% yamacala;
  • Ngenxa yokugeleza kwegazi okunganele ezicutshini.
  • Ngesikhathi sokukhulelwa ngokumelene nesifo sikashukela sokukhulelwa, noma isifo sikashukela sabesifazane abakhulelwe.
  • Ukwehluleka okuzenzakalelayo kwezinqubo ze-metabolic emzimbeni.

Ukwelashwa kwesimo se-pathological kuqukethe ukulungisa i-acid ne-alkaline esele emzimbeni, ukubuyisela amanzi ne-electrolyte metabolism, kanye nokwelashwa okubonisa izimpawu. Kanye nokujwayelekile kokuphazamiseka kwamangqamuzana ngesisombululo se-glucose ngenani elidingekayo le-insulin.

Ngakho-ke, singaphetha ngokuthi amazinga kashukela aphezulu kakhulu kungenzeka ukuthi athuthukise izinkinga eziningi ezingabiza impilo yesiguli.

Ividiyo ekulesi sihloko iveza indlela yokudla ushukela wegazi ophezulu.

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