Imvamisa owesifazane onesifo sikashukela ubuza: "Ngabe ngizokwazi ukuba nezingane? Ngabe ngizokwazi ukubeletha ingane enempilo?"
Futhi ukwesaba kwakhe akusilo ize. Uma unesifo sikashukela esingaxhunyiwe kahle, ubunzima obuhlukahlukene kungenzeka. Kukhona ne-contraindication ngokuphelele yokukhulelwa.
Sibuze udokotela we-endocrinologist uYulia Anatolyevna Galkina ukuthi akhulume ukuthi angakulungiselela kanjani ukukhulelwa ngendlela efanele, yiziphi izivivinyo okumele zidlule nokuthi odokotela bazungeze ini. Kwavela imfundo enhle kakhulu, ezoba wusizo kumama abaningi abakhulelwe.
UJulia Anatolyevna Galkina, i-endocrinologist, i-homeopath, udokotela wesigaba esiphakeme kakhulu
Ngithweswe iziqu eMoscow State Medical-Dental University. Ibhizinisi lezokwelapha.
Ukuhlala kabusha kususelwa ku-MGMSU. Isazi endocrinology.
Ezemfundo e-Central Homeopathic School. Isifundo se-homeopathy.
I-International Academy ye-Classical Homeopathy kaJ. J. Vitoulkas. Isifundo se-homeopathy.
I-Endocrinologist, i-homeopath e-Family Medical Center "Imithi Yempilo"
Izinhlobo zesifo sikashukela
Isifo sikashukela yisifo esingelapheki esihambisana nokwanda kwe-glucose yegazi kanye nokwephulwa komkhiqizo we-hormone insulin. Kunezinhlobo ezi-3 eziphambili zesifo sikashukela i-mellitus (DM):
- Thayipha isifo sikashukela sokuqala. Lesi yisifo se-autoimmune lapho ama-antibodies ebhubhisa khona amaseli we-pancreatic B, akhiqize i-hormone insulin edonsa ukufakwa kweglucose ngamangqamuzana.
- Thayipha isifo sikashukela sesi-2. Lesi sifo sibonisa ukuncipha kokuzwela kwamangqamuzana ukuya ku-insulin, futhi ngenxa yalokhu, ukwanda kokukhiqizwa kwe-insulin.
- Isifo sikashukela sokutholwa kwesisu. Lokhu ukuphazamiseka kwe-carbohydrate metabolism eba khona ngesikhathi sokukhulelwa. Isikhathi esibucayi sokukhula kwayo singamaviki angama-24- 28.
Indlela yesimanje yokukhulelwa komama abanesifo sikashukela
Emuva ngeminyaka yama-80s yekhulu leminyaka eledlule, umuntu wayevame ukuzwa kaningi kudokotela izincomo zokugwema ukukhulelwa phambi kwesifo sikashukela. Futhi uma kwenzeka ukukhulelwa, lo wesifazane kwadingeka achithe iningi lalesi sikhathi esibhedlela ngenxa yezinkinga ezivame kakhulu kanye nokusongela kokuqedwa kwakhe.
Namuhla, indlela yabesifazane abanesifo sikashukela iguqulwa ngokuyisisekelo. Lokhu kungenxa yokuvela kwamathuba amasha okuxilongwa kusenesikhathi kwezinkinga zesifo sikashukela, izindlela zokwelashwa kwabo, kanye nokwakhiwa kanye nokutholakala kohlu olubanzi lwemishanguzo ekwehlisa ushukela nabenzeli bokuzilawula.
Kuyini ingozi yesifo sikashukela sikamama kuye nengane yakhe
Kwenzeka kaningi ukuthi owesifazane afunde ngokukhulelwa okungakahlelwanga sekwephuze kakhulu: amasonto ama-1-2 emva kokulibaziseka kokuya esikhathini (okungukuthi, isikhathi esingamasonto angama-5-6 okukhulelwa, ngoba iminyaka yobudala bokukhulelwa ibhekwa kusukela osukwini lokuqala lokuya esikhathini).
Uma isifo sikashukela esibolile (kabi noma singalawuleki) sikashukela i-mellitus, ukuya esikhathini kungenzeka. Kulokhu, ukukhulelwa kutholwa ngokuhamba kwesikhathi. Kepha kakade kule nkathi yokungaqiniseki nangaphambi kweviki lesi-7 lokukhulelwa, isigaba esibaluleke kakhulu sokubeka izitho zomntwana ongakazalwa senzeka.
Uma, ngesikhathi sokukhulelwa futhi phakathi kwamasonto okuqala okukhulelwa, umama eba nesifo sikashukela esimweni sokuwohloka, imiphumela izothinta umama nengane.
Ngokusho kocwaningo oluningi nokubona, abesifazane abakhulelwe abanesifo sikashukela esibucayi banamaphesenti aphezulu okuthuthuka kokukhubazeka kwezitho zangasese, ukukhipha isisu okuzenzakalelayo, ukufa kwengane, ukuzalwa ngaphambi kwesikhathi, i-gestosis (iqoqo lezimpawu zokugula, okubandakanya ukukhuphuka kwengcindezi yegazi, ukuvuvukala, ukulahleka kwamaprotheni emchameni, kanye kwezinye izimo, ukwehluleka). Ubungozi bezinkinga buncike kubungako bokuwohloka kwesifo sikashukela kanye nezinga le-glycated hemoglobin, elibizwa nge-HBA1c. Ukunaka okwandisiwe kudinga inani lama-HBA1s> 6.3%.
Kepha ezigabeni zakamuva, ngemuva kokwakhiwa kwezitho zomzimba, ushukela, ongena egazini lengane kusuka kumama ngokweqile, uvuselela ukukhiqizwa okwandayo kwe-insulin enganeni, okungukuthi, i-hyperinsulinemia. I-Hyperinsulinemia Ibangela iMacrosomia (igama elisho ukuthi ingane iba mkhulu futhi inesisindo esingaphezu kwama-4 kg). Esikhathini sokukhulelwa okugcwele nangaphambi kokukhulelwa, lokhu kwenzeka ku-27-62% yezingane ezizalwe omama abanesifo sikashukela.
Ukuhlelwa kokukhulelwa kwesifo sikashukela
Ukuhlelwa kokukhulelwa futhi kufinyelele ezingeni elijwayelekile loshukela (i-standardoglycemia) izinyanga ezingama-2-3 ngaphambi kokukhulelwa futhi ngesikhathi sonke sokukhulelwa kunciphisa kakhulu ingozi yemiphumela emibi. Kusukela ngonyaka ka-2013, izindlela zokubuyelwa kwesifo sikashukela kwabesifazane abakhulelwe nabesifazane abahlela ukukhulelwa sebeyimpi.
Ukulawulwa kwe-glycemic
Lapho uhlela ukukhulelwa, phakathi nezinyanga ezingama-2-3 ngaphambi kokuqala kwayo kanye nesikhathi sonke sokukhulelwa, kubalulekile ukulawula i-glycemia esiswini esingenalutho, ngaphambi kokudla, ihora eli-1 namahora ama-2 ngemuva kokudla, futhi nangaphambi kokulala nsuku zonke. Izikhathi ezi-1-2 ngeviki zokulawulwa kweshukela egazini ngo-3 a.m. Izikhathi ezingama-2-3 ngesonto ekuseni zokulawulwa kwemizimba ye-ketone emchameni. Njalo emavikini ama-6-8 alawula ama-HBA1.
Izindlela Zokuhlawuliswa Kwe-DM
Ukuhlolwa okuphelele kwezokwelapha kokuhlela ukukhulelwa
1. Ucwaningo lwelabhorethri:
- Ukuhlolwa kwegazi okwelashwa
- I-Urinalysis
- I-Urinalysis ye-UIA (microalbuminuria). Ukuba khona kwe-microalbuminuria noma i-proteinuria kungaba nokutheleleka kwe-urinary tract, futhi kungaba wuphawu lwe-nephropathy yesifo sikashukela. Lezi zimo zingaholela ezinkingeni zokukhulelwa ezinzima. Kulezi zimo: ukuhlaziywa komchamo ngokusho kweNechiporenko, isiko lomchamo lokuzala inzalo.
- Amakhemikhali egazi
- Ukutadisha ngesimo se-yegilo: Ama-hormone wegazi we-TSH, i-T4 yamahhala, namasosha omzimba eTPO. (Isilinganiselo se-TSH sabesifazane abakhulelwe ku-1st trimester kuze kube ku-2,5 siyadingeka futhi kulabo abahlela ukukhulelwa).
2. Ukubonisana kochwepheshe:
Ukubonisana nge-Endocrinologist
Udokotela we-endocrinologist uhlola inqubo yesifo sikashukela, ukuba khona nobukhulu bezinkinga zako. Ukondliwa, umsebenzi womzimba wesiguli, kanye nemodi yokuzihlola ye-glucose yegazi nezinkomba zayo, kuyacutshungulwa futhi kulungiswe ngokuningiliziwe. Kuhlobo lwe-1 mellitus yesifo sikashukela, kungadingeka ukuthi kulungiswe irejimeni yokwelashwa kwe-insulin, kanye nokufakwa esikhundleni sokulungiswa kwe-insulin nalabo abagunyazwe ukusetshenziswa ngesikhathi sokukhulelwa.
Okwamanje kuvunyelwe ukusetshenziswa:
- Izakhi zemoto ezifakwayo izakhi zofuzo: Humhum R R, Insuman Bazal, Actrapid NM
- Izakhi zemvelo ezisebenza ngokusetshenziselwa izakhi zofuzo: Humhum NRH, Insuman Bazal, Protafan NM
- I-Ultra-iDemo ebambela i-insulin analog: I-Novorapid, Humalog.
- Ukusebenza kwesikhathi eside kwe-insulin: Levemir.
Eminyakeni yamuva nje, indlela yokusebenzisa i-insulin esebenzisa iphampu ye-insulin isisabalele. Le ndlela ikuvumela ukuthi ulinganise ngokweqile ukuphepha kokuphila kwe-insulin. Ukwelashwa kwe-basal ne-bolus kunikezwa uhlobo olulodwa lokulungiselela kwe-insulin yesenzo esifushane noma se-ultrashort. Kepha noma usebenzisa iphampu, uzodinga ukulungiswa kwerimen kanye nemithamo yokwelashwa kwe-insulin ngesikhathi sokukhulelwa.
Kwabesifazane abanesifo sikashukela sohlobo 2 abakwelashwa kokudla, uma kungenakwenzeka ukufeza izinkomba zesinxephezelo se-glycemic kuso, kunqunywa ukwelashwa kwe-insulin. Ukufaka isicelo sokwehlisa ushukela wethebhulethi, izidakamizwa ezinciphisa ushukela ziyakhanselwa futhi uma kungenakwenzeka ukufeza isinxephezelo ngosizo lokudla, kunqunyelwe i-insulin. Ngaphezu kwalokho, ngokusho kwemiphumela yokuhlolwa nokuhlolwa kokulinganisa okunomsoco, bonke abesifazane banqunywa yisidingo sokudla nsuku zonke i-iodine, amalungiselelo we-folic acid wokukhula okufanele kwengane engakazalwa.
Ukubonisana nodokotela wezifo zabesifazane
Udokotela we-gynecologist uhlola izinga lokulungela kwe-hormonal, ukulungela ngokomzimba kowesifazane ukukhulelwa nokuzala, futhi futhi akufaki ukwakheka kwe-pathological, izinqubo zokuvuvukala zezitho zomzimba wesibeletho.
Ukubonisana nge-Ophthalmologist
I-ophthalmologist inquma ukuba khona kanye nezinga le-retinopathy yesifo sikashukela, kanye namanye ama-pathologies okungenzeka kwezitho zombono.
Ukubonisana nge-Neurologist
Uma isikhathi sesifo sikashukela singaphezu kweminyaka eyi-10 futhi uma kunobufakazi, kufanele kube nokuhlolwa okwenziwe ngemizwa okuphelele. Ngokusho kwemiphumela lapho udokotela wezinzwa enquma izinga lokulimala kwezinzwa zepherishi.
Ukubonisana ngenhliziyo
Udokotela uhlola umsebenzi wenhliziyo nemithambo yegazi. Kwenziwa i-ECG, ngokuya ngokufundwa kwe-echocardiogram. Njengoba ukwanda kwengcindezi yegazi kuvame ukutholakala kwisifo sikashukela, futhi kuyakhula ngesikhathi sokukhulelwa, kudingeka ucwaningo olunzulu ngomfutho wegazi nokuqapha kwalo esikhathini esizayo. Umfutho wegazi ulinganiswa ulele phansi, nangoshintsho esikhundleni somzimba, uhleli. Uma kunesidingo, ukwelashwa kwe-antihypertensive kunikezwa umuthi ovunyelwe ukusetshenziswa kwabesifazane abakhulelwe.
Isikole "Ukukhulelwa kanye nesifo sikashukela"
Noma owesifazane eba nesifo sikashukela isikhathi eside, wayevakashela kaningi "Isifo Sikashukela" futhi usesimweni sesinxephezelo, udinga ukuya esikoleni "Ukukhulelwa noshukela". Impela, ngesikhathi sokukhulelwa, uzohlangana nezinguquko ezingajwayelekile emzimbeni wakhe
Ngokuqala kokukhulelwa, izinguquko emzimbeni wowesifazane zenzelwe ukugcina ukukhulelwa nokulungiselela ukuzalwa kwengane. Kwi-trimester yokuqala, kukhona ukuzwela okukhulayo kwe-insulin futhi, ngenxa yalokho, isidingo saso siyancipha, futhi kusukela ngesonto le-16, ukumelana nezicubu zomzimba (ins immune) kuya ku-insulin kuyaphawuleka ngokwanda kwezinga layo egazini.
Kwabesifazane abakhulelwe ngaphandle kwesifo sikashukela, ukuguquguquka kushukela wegazi phakathi nosuku kusemikhawulweni emincane kakhulu: ukusuka ku-3.3 kuya ku-6.6 mmol / L. Isidingo se-insulin ngesikhathi sokushintsha kokukhulelwa kanye nomzimba wabesifazane abanempilo uvumelana nalokhu ngokuzimela.
Kwabesifazane abakhulelwe abanesifo sikashukela i-mellitus, noma bakhethwe kahle futhi basebenza ama-regimens angaphambi kokukhulelwa (ngohlobo lwe-1 isifo sikashukela) ngesikhathi sokukhulelwa kuzodingeka ukuthi bashintshwe njalo.
Ukuhlolwa kwemiphumela yocwaningo
Ngokusekelwe emiphumeleni yokuhlolwa, udokotela we-gynecologist kanye ne-endocrinologist ndawonye bahlola ukuthi kungenzeka ukuthi ukhulelwe, kanye nengozi yezinkinga zokukhulelwa komama nengane. Uma ukuhlolwa kwembula noma iyiphi i-pathologies edinga ukwelashwa noma ukulungiswa kokwelashwa ngaphambi kokukhulelwa, noma lowo wesifazane esesimweni sokuncipha kwesifo sikashukela, khona-ke isikhathi sokwelashwa kuze kube yilapho isinxephezelo sitholakala, bese kuthi kwezinye izinyanga ezingama-2-3, indlela ikhethwe ngaphandle kokwehluleka inzalo.
Ukuphambana okuphelele kokuhlela kokukhulelwa
Ngeshwa, kusenezifo kanye nezinkinga zesifo sikashukela, lapho ukukhulelwa kungadala izinqubo ezinzima futhi ezivame ukuguquguquka emzimbeni womama futhi kuholele ekufeni hhayi kwengane kuphela, kodwa nakomama. Lokhu kufaka phakathi:
- Isifo senhliziyo.
- I-retinopathy eqhubekayo ngokuqhubekayo.
- Ukwehluleka kwezinso okungamahlalakhona ngamazinga aphezulu e-creatinine, umfutho wegazi ophikelelayo ngenkathi uthatha izidakamizwa ze-antihypertensive, ezivunyelwe ngesikhathi sokukhulelwa.
- I-gastroenteropathy enkulu
Ukuzalwa kwengane injabulo, kepha injabulo enkulu ngokwengeziwe ukuzalwa kwengane enempilo! Lo msebenzi, noma ungelula, uyenzeka kumama onesifo sikashukela. Ukulungiselela umzimba wakho impilo entsha - umgomo ongafezeka ngempela!
