Umkhuba osafufusayo wokukhula kwesibalo sezingane ezinesifo sikashukela, njalo ngonyaka kubhaliswa izingane ezigulayo ezingaphezulu kwe-10-15% kunaleso esedlule.
E-Russia, ngokwesilinganiso esinzima, ngonyaka we-2017 cishe abantu abayizinkulungwane ezingama-280 banesifo sikashukela sohlobo 1. Lezi ziguli zidinga i-insulin nsuku zonke, kuzo izingane eziyizinkulungwane eziyi-16 kanye nentsha eyizinkulungwane eziyi-8,5.
Izici zenkathi yesifo sikashukela ebuntwaneni ukwanda okusheshayo kwezimpawu ngokulungiswa okunganele koshukela wegazi ophakeme, ubunzima bezindlela zesifo sikashukela, nokuhlasela kwe-hypoglycemia.
Isifo sikashukela ezinganeni nasentsheni
Ngokuvamile, isifo sikashukela ezinganeni sincike kwe-insulin. Ukuthuthukiswa kwaso kuhlotshaniswa nokukhubazeka kwezakhi zofuzo. Ingozi yokuba nesifo sikashukela ikhuphuka ngemuva kokutheleleka ngegciwane, izimo ezicindezelayo, nangoshintsho lwangaphambi kokudla kokufakelwa.
Amagciwane avusa ushukela mellitus abhubhisa amaseli enza i-insulin, futhi abangele nokuphazamiseka ekuphenduleni kokuzivikela emzimbeni. Ngenxa yalokhu, ama-antibodies okuba namaseli we-beta akhiqizwa ngokuthuthukiswa kokuvuvukala kwe-autoimmune. Ukutheleleka kungadalwa ama-rubella virus, ama-mumps, amasele, ama-enteroviruses.
Isimo somtholampilo wesifo sikashukela sibonisa ngomonakalo omkhulu wamanyikwe. Ngalesi sikhathi, inani lamaseli asebenzayo lisezingeni lamaphesenti amahlanu kuya kwayi-10. Ngakho-ke, ukuntuleka kwe-insulin kuhamba ngokushesha, kubangele ukomisa, ukunciphisa umzimba kanye nokwakhiwa kwemizimba ye-ketone.
Ngokuxilongwa okungafanele noma umthamo ongalungile we-insulin ezinganeni, ukuthuthuka kokulimazeka kwe-carbohydrate metabolism kuyaqhubeka kanye nezimpawu zokulimala ohlelweni lwangaphakathi lwezinzwa. Isibonakaliso sokuqala sikashukela ebuntwaneni singaba yi-ketoacidosis ngesimo sethambo.
Uhlobo lokuqala lwesifo sikashukela lubandakanya ukuqokwa kwe-insulin kusukela esikhathini sokutholwa neyokuphila. Izindlela zokwelashwa kwe-insulin zihlinzeka ngokwazisa izinhlobo ezinde zesikhathi se-insulin izikhathi ezi-2 ngosuku nezifushane - okungenani amahlandla ama-3. Ngakho-ke, ingane enesifo sikashukela kufanele ithole imijovo emi-5 yomuthi ngosuku.
Ukubuyiswa kwesifo sikashukela kubandakanya ukufezekiswa kwezinkomba ezinje:
- Ukusheshisa i-glycemia kuze kufike ku-6.2 mmol / l.
- Ngemuva kokudla, amazinga kashukela afinyelela ku-8 mmol / L
- I-Glycated hemoglobin ifinyelela ku-6.5%.
- Emchamweni, i-glucose ayitholakali.
Inkambo yesifo sikashukela engabhadalwanga iholela ezinkingeni ezivame ukubangwa futhi ibangele ukungakwazi kwengane ukuya esikoleni noma ezikhungweni zasenkulisa. Ngokuzayo, ukungakwazi ukusebenza kusebenza njengesikhathi sokusungula iqembu lokukhubazeka.
Izingane ezingaphansi kweminyaka engu-14 ubudala ezidinga ukwelashwa njalo kwe-insulin zinikezwa ukukhubazeka kwesifo sikashukela kusukela esikhathini sokubhalisa ngaphandle kokunquma iqembu.
Izinzuzo zezenhlalo zezingane ezinesifo sikashukela
Ngokwesisekelo soMthetho Wokuphehlwa "Kwomshuwalense Wezimpesheni Zombuso eRussia Federation" wezingane ezinesifo sikashukela, kunikezwa impesheni yomphakathi nokukhokhela isinxephezelo kumzali osemthethweni (noma umnakekeli) onakekela ingane ekhubazekile futhi ongakwazi ukusebenza ngenxa yalesi sizathu.
Abazali noma abagadli abanakekela ingane banezinzuzo zempesheni lapho sebethatha umhlalaphansi, ngoba isikhathi sokunakekelwa sibalwa ubude benkonzo. Kungenzeka futhi ukuhlela umhlalaphansi ngaphambi kwesikhathi nesikhathi somshuwalense okungenani iminyaka eyi-15.
Imali ekhokhwa njalo ngenyanga isungulwe ngokuya ngomthetho we Russian Russian "On Social Protection of Persons" Inani lemvume enjalo lincike eqenjini lokukhubazeka elisunguliwe. Iqembu lokukhubazeka labelwe ngokulandela imibandela elandelayo:
- Isinxephezelo sikashukela i-mellitus - imvamisa yokuhlaselwa kwe-hyper- ne-hypoglycemia.
- Ukuba khona kanye nezinga lokuphulwa komsebenzi womzimba
- Ubungako bemikhawulo yokunyakaza okuzimele kanye nokuzenzela.
- Isidingo sokunakekelwa sihlala njalo noma siyizikhathi ezithile.
Izingane ezingaphansi kweminyaka eyi-14 azikwazi ukuzilawula ngokuzimela ngemijovo ye-insulin futhi zidinga usizo oluhlala njalo oluvela kubazali noma kubanakekeli, ngenxa yalokho baqashelwa njengabakhubazekile futhi banelungelo lokuthola ukwelashwa kwe-spa mahhala, isinxephezelo sokuhambela eSanatorium. Umzali (umnakekeli) naye uthola lezi zinzuzo.
Abantu abakhubazekile bahlinzekwa ngezinzuzo zokukhokhela izinto ezisetshenziswayo, ezokuhamba, ukubeka phambili ezikhungweni zasenkulisa, ukuvuma ukungena emanyuvesi kanye nezinzuzo eziningi ngaphansi komthetho wezabasebenzi kanye nokuncishiswa kwentela.
Kungakhathalekile ukuthi uluhlobo luni lwesifo sikashukela kanye nokuba khona kokukhubazeka, zonke iziguli zinelungelo lokulungiselela mahhala i-insulin, umuthi onciphisa ushukela emathebhulethi, imichilo yokuhlola yokulawula ushukela wegazi, okuhlinzekelwa ukuphathwa kwe-insulin, kanye nezidakamizwa ezifakiwe kuhlu lwemithi yamahhala.
Ukuthola le mishanguzo, isiguli sikashukela kufanele sibhaliswe nodokotela oyi-endocrinologist, sihlolwe njalo ngenyanga, futhi uma kunokukhubazeka, silandele izincomo ezishiwo ohlelweni lokuvuselela umuntu ngamunye.
Ukukhubazeka kumiswa kanjani ezinganeni ezinesifo sikashukela?
Ngemuva kokuqalwa kwemithetho emisha yokususa ukukhubazeka ezinganeni ezinesifo sikashukela i-mellitus 1024 (i-oda le-Ministry of Labour of Russia No. 1024n kaDisemba 17, 2015), izenzo zomthetho owedlule ngazo zonke izingane ezinesifo sikashukela zaqashelwa njengezingenakhubazeka zaba yinto engasebenzi.
Le oda licacisa izimpawu ingane ezingabonakala ngazo ukuthi zikhubazekile, icubungula ukuhlolwa kwenani lokungasebenzi kahle kwezitho kanye nokuthi kungenzeka yini ukuthi kugcinwe impilo. Ikhomishini yezokwelapha ithatha njengesisekelo amandla engane okuthola imijovo ye-insulin ekufinyeleleni iminyaka eyi-14.
Ukususwa kokukhubazeka kwezingane ezinesifo sikashukela kungenzeka, lapho eneminyaka eyi-14, ingane isiqede isikole se-mellitus yesifo sikashukela, ukwelashwa kwe-insulin, ibala umthamo odingekayo we-insulin ngokuya ngokuqukethwe kokudla kwe-carbohydrate futhi unesifo sikashukela ngaphandle kokusho ukuphazamiseka ekusebenzeni kwezitho nezinhlelo.
Ukusungulwa kweqembu lokukhubazeka ngemuva kweminyaka eyi-14 kungaba sesimweni sokuwohloka okunzima empilweni ngaphandle kwesikhathi esibekiwe sokuhlolwa (unomphela) noma iminyaka emibili, uma kuyiqembu 1, iqembu 2 no-3 libekelwe unyaka owodwa.
Imigomo eyisisekelo okusekwe yi-bureau yezokwelapha nezenhlalo isungula noma isuse ukukhubazeka ukuba khona kokukhubazeka okuphikelelayo.
Imikhakha esemqoka ezohlaziywa yilena:
- Inketho yokuzenzela.
- Ukuhamba ngaphandle kosizo.
- Amandla wokujwayela.
- Lawula indlela oziphatha ngayo.
- Amandla wokuxhumana.
- Ikhono lokufunda.
- Amandla okusebenza.
Iqembu lokukhubazeka labelwa, inqobo nje uma isiguli sinomkhawulo wempilo yeziqu zokuqala zezigaba ezimbili, kanye nelesibili nelesithathu kwesinye sezigaba.
Ngaphezu kwalokho, ezinganeni, izinga lokuphambuka kusuka kokujwayelekile, kuya ngeminyaka, liyabhekwa.
Ungayixazulula kanjani inkinga yokukhubazeka?
Izingane eziningi ngemuva kweminyaka eyi-14 zisusiwe ekukhubazekeni futhi zancishwa izinzuzo ezinikezwe abazali nabanakekeli beziguli ezinesifo sikashukela i-mellitus, ngokuya ngokuphathwa njalo kwe-insulin. Ukuze uqonde ukuthi yini okufanele uyenze esimweni esinjalo, nokuthi yini edingekayo ekuhlolweni okusha, kuyadingeka ukuthi ufunde imithetho yokuphasa ukuhlolwa kodokotela.
Uma ingane igula isikhathi eside futhi sina, kufanele kube khona okufakiwe ekhadini lokuphuma ngaphandle mayelana nokwelashwa kanye nemiphumela yako, kanye nokudluliselwa ekwelashweni kokugula okungapheli kanye nokukhishwa okufanele okuvela emnyangweni. Futhi, izinkinga zesifo sikashukela ezinganeni kufanele zikhonjiswe uma zinendawo.
Uma nje zonke izinhlobo zokwelashwa zingazange zinikeze umphumela, ingane isazwakalise ukungasebenzi kahle okungenziwa ukuthi kufakwa kwizigaba ezisohlwini lwe-Order 1024n, lokhu kusho ukuthi i-pathology yakhe iyaphikelela, ngakho-ke, iqembu lisuswa ngokungenangqondo.
Ngokomthetho okhona, zonke iziguli kufanele zidluliselwe ukuhlolwa kwezokwelapha nezenhlalo (i-ITU) ngemuva kokuxilongwa, izindlela ezidingekayo zokwelashwa nokulungisa isimo, inqobo nje uma kunokuphulwa okuqhubekayo kwemisebenzi yomzimba ehambisana nalesi sifo (kulokhu, isifo sikashukela).
Uma isiguli siphendukela kudokotela ohambele kuye noma kusihlalo wekhomishini yezokwelapha ngesicelo sokuzitholela amadokhumenti e-ITU ukuze sithole iqembu elikhubazekile, futhi sithola impendulo engemihle, lapho-ke udinga ukuthola isiqinisekiso esibhaliwe salokhu - isitifiketi sokwenqaba ukukhipha ifomu 088 / у-06.
Ngemuva kwalokho, udinga ukulungiselela iphakethe lamadokhumenti wokuzimela we-ITU ozimele. Kufaka:
- Izikhombi ezivela ekhadini leziphumayo, iminyango lapho kwenziwa khona ukwelashwa kweziguli.
- Imiphumela yocwaningo lwakamuva.
- Isitifiketi sokwenqatshwa kwekhomishini yezokwelapha emtholampilo.
- Isicelo esivela kumzali noma umnakekeli wengane esibhekiswe kunhloko yehhovisi lobuchwepheshe bezokwelapha nakwezenhlalo.
Isicelo kumele sifake isicelo sokuhlolwa kwengane ukuze kutholakale iqembu lokukhubazeka, futhi sithuthukise nohlelo lwezindlela zokuvuselela umuntu ngamunye. Iqoqo lonke lamadokhumenti lifakwa ebhukwini le-ITU, emva kwalokho kubekwe usuku lokuhlola.
Uma abazali benenkinga lapho bethola incwadi yokudluliselwa e-ITU noma bekhipha incwadi ebenqaba ukuyifaka, kuyanconywa ukuthi ubhale isicelo esibhekiswe kudokotela oyinhloko womnyango wokuphuma kwendawo yokuhlala lapho uhlala khona.
Kuyadingeka ukuchaza isimo sengane, isikhathi salesi sifo, ukwelashwa kanye nemiphumela yaso (noma ukungabikho kwabo).
Ngemuva kwalokhu, udinga ukukhombisa isikhundla nesibongo sokuqala sodokotela owenqabile ukuthi kudluliselwe lapho ezohlolwa ngodokotela nakwezenhlalo.
Isicelo sokukhishwa kokudluliselwa noma isitifiketi sokwenqaba kufanele sisekelwa yinkomba yezenzo ezinjalo zokulawula:
- Federal Law No. 323 kaNovemba 21, 2011 "On Basics of Health Care", Articles 59 no 60.
- Imithetho yokuthola umuntu okhubazekile, imushwana 15.16.19 (Isinqumo sikaHulumeni waseRussia Federation Nombolo 95 ka-02.20.2006.
- Inqubo yokwakhiwa kwekhomishini yezokwelapha nge-oda le-Ministry of Health and Social Development of the Russian Federation Nombolo 502 ka-05/05/2012.
Futhi, ukuze udlule ekuhlolweni kokusungulwa kweqembu lokukhubazeka, kudingeka ube nemiphumela yokuxilongwa kwebhubhoratri nemibono yesazi. Ingane ephethwe yisifo sikashukela kufanele ihlolwe ngokushesha nge-glucose, iphrofayli ye-glycemic phakathi nosuku, i-glycated hemoglobin ngaphambi kokuba ihlolwe.
Ngaphezu kwalokho, ekuhlaziyeni kwamakhemikhali egazi le-venous kufanele kube izinkomba: izingxenyana zamaprotheni namaprotheni amaningi, i-cholesterol, i-transaminases ne-cholesterol. Isibonisi se-lipid segazi sikhombisa okuqukethwe ama-triglycerides, kanye nama-lipoprotein aphansi, aphezulu. I-Urinalysis yenziwa kokubili ngokujwayelekile kanye noshukela ne-acetone.
Ingane kufanele ibhekane ne-ultrasound yesifunda esiswini kanye ne-Doppler ultrasound (uma kukhonjisiwe) yemithambo yemikhawulo engezansi.
Imiphumela elandelayo yenhlolovo inikezwe futhi ukuthi icatshangwe yikhomishini yesazi:
- Ukubonisana kwe-endocrinologist.
- Ukuhlolwa kwe-oculist ngencazelo ye-fundus.
- Uma kunobufakazi - ukuhlolwa kukadokotela ohlinzayo wemithambo, udokotela wentambo, udokotela wezingane.
- Ukubonisana nodokotela wezifo zengqondo.
Bazali kumele bazi ukuthi imiphumela yesinqumo se-ITU Regional Primary Bureau ingadluliswa uma kuxhunyanwa ne-Main Bureau, bese-ke i-ITU Federal Bureau. Uma unobunzima ekusetshenzisweni kwezicelo kanye nokufaka izicelo zokufaka isicelo, kufanele uthintane nommeli ofanelekayo ukusho amalungelo akho. Kukhona nensiza yokusiza yaseRussia yezingane ezinesifo sikashukela esiza ukuhlela izinzuzo zemithi.
Ividiyo ekulesi sihloko ixoxa ngezinzuzo zabanesifo sikashukela.
