IGlucose ingenye yezitha eziphambili zesifo sikashukela. Ama-molecule ayo, ngaphandle kobukhulu obukhulu kakhulu maqondana nama-molekyuli kasawoti, ayakwazi ukuphuma ngokushesha esiteshini semithambo yegazi.
Ngakho-ke, kusukela esikhaleni se-interellular, i-dextrose idlulela kumaseli. Le nqubo iba yisizathu esiyinhloko sokukhiqizwa okwengeziwe kwe-insulin.
Ngenxa yalokhu kukhululwa, i-metabolism emanzini ne-carbon dioxide iyenzeka. Uma kunokuqoqeka ngokweqile kwe-dextrose egazini, khona-ke okweqile komuthi ngaphandle kwezithiyo kukhishwa yizinso.
Ukwakheka nezici zekhambi
Umuthi uqukethe wonke ama-100 ml:
- ushukela 5 g noma 10 g (into esebenzayo);
- i-sodium chloride, amanzi omjovo 100 ml, hydrochloric acid 0,1 M (abathola).
Isixazululo sikashukela uketshezi olungenamibala noma oliphuzi kancane.
IGlucose yi-monosaccharide ebalulekile ebandakanya ingxenye yokusetshenziswa kwamandla. Kungumthombo oyinhloko wama-carbohydrate angagaya kalula. Okuqukethwe kwe-caloric kwento ngu-4 kcal ngegramu ngayinye.
Ukwakheka kwalo muthi uyakwazi ukuba nomphumela ohlukile: khuphula izinqubo ze-oxidative kanye nokwehlisa, kuthuthukisa umsebenzi wesibindi. Ngemuva kokuphathwa kwe-intravenous, umuthi unciphisa kakhulu ukuntuleka kwe-nitrogen namaprotheni, futhi kusheshise ukunqwabelana kwe-glycogen.
Ukulungiselela isotonic ka-5% ngokwengxenye uyakwazi ukugcwalisa ukusilela kwamanzi. Ine-detoxifying kanye nomphumela we-metabolic, ngokuba ngumphakeli wezakhi ezibalulekile futhi ezisanda kutholwa.
Ngokwazisa kwe-10% solution yeglucose:
- umfutho wegazi osmotic uphakama;
- ukugeleza okuthe xaxa kungena egazini;
- izinqubo ze-metabolic ziyavuseleleka;
- ithuthukisa umsebenzi wokuhlanza ngokufanele;
- ukukhuphuka kwesilinganiso kuyanda.
Umuthi ukhonjiswa kubani?
Isixazululo esingu-5% esisebenza ngokufakelwa isandla sinikela ku:
- ukuphindwaphindwa kabusha koketshezi okulahlekile (ngokujwayelekile, ngaphandle nangaphandle komzimba);
- ukuqedwa kwezimo zokushaqeka kanye nokuwohloka (njengenye yezakhi ze-anti-shock kanye ne-fluid substitute fluid).
Isixazululo esingu-10% sinezinkomba zokusetshenziswa nokuphathwa kwe-intravenous:
- ngokuphelelwa ngamandla emzimbeni (ukuhlanza, ukugaya ukudla okuxakayo, esikhathini sokusebenza);
- ubuthi nazo zonke izinhlobo ubuthi noma izidakamizwa (arsenic, izidakamizwa, carbon monoxide, phosgene, cyanides, aniline);
- nge-hypoglycemia, i-hepatitis, i-dystrophy, i-atrophic yesibindi, i-cerebral kanye ne-pulmonary edema, i-hemorrhagic diathesis, izinkinga zenhliziyo ze-septic, izifo ezingelapheki, izifo ze-toxico;
- ngesikhathi sokulungiswa kwezixazululo zezidakamizwa zokuphathwa kwe-intravenous (okuhlushwa ama-5% no-10%).
Kufanele ngisisebenzise kanjani isidakamizwa?
Isixazululo se-isotonic sika-5% kufanele sidonswe ngesilinganiso esiphezulu kakhulu se-7 ml ngomzuzu (amaconsi ayi-150 ngomzuzu noma ama-400 ml ngehora).
Kwabadala, umuthi ungabanjiswa ngokufakwayo ngethamo lamalitha ama-2 ngosuku. Kungenzeka ukuthatha umuthi ngokungabonakali nange-enemas.
Isixazululo se-Hypertonic (10%) sikhonjiswa ukusetshenziselwa ukuphathwa kwe-intravenous kuphela ngevolumu ye-20/40/50 ml ngokufakwa ngakunye. Uma kunobufakazi, bese ubudonsa ungasheshe bube ngaphezu kwama-60 ehla ngomzuzu. Umthamo omkhulu wabantu abadala yi-1000 ml.
Umthamo oqondile wesidakamizwa esihlangene uzoncika kwizidingo ngazinye zesitho esithile. Abantu abadala ngaphandle kwesisindo ngokweqile ngosuku ngeke kuthathe ngaphezulu kwe-4-6 g / kg ngosuku (cishe 250-450 g ngosuku). Kulokhu, inani lamanzi afakelwe insimbi kufanele libe ngu-30 ml / kg ngosuku.
Ngokuqina okuncishisiwe kwezinqubo ze-metabolic, kunezinkomba zokunciphisa umthamo wansuku zonke ukuya ku-200-300 g.
Uma ukwelashwa isikhathi eside kuyadingeka, khona-ke lokhu kufanele kwenziwe ngaphansi kokubhekelwa eduze kwamazinga kashukela we-serum.
Ukuze sithathwe ngokushesha futhi ngokuphelele kweglucose, kwezinye izimo, ukuphathwa kwe-insulin ngesikhathi esisodwa kuyadingeka.
Amathuba wokuphendula okuhlukile kwento
Umyalo wokusetshenziswa uthi ukwakheka noma into esemqoka kwezinye izimo kungadala ukungaphenduki kahle komzimba ekuphathweni kwe-glucose ye-10%, ngokwesibonelo:
- umkhuhlane
- hypervolemia;
- i-hyperglycemia;
- ukwehluleka okukhulu ku-ventricle yangakwesobunxele.
Ukusetshenziswa isikhathi eside (noma kusuka ekuphathweni okushesha kakhulu kwenani elikhulu) lomuthi kungadala ukuvuvukala, ukudakwa kwamanzi, isimo sokusebenza sesiphazamiso sesibindi noma ukuncipha kwamathuluzi angafakiwe we-pancreas.
Kulezo zindawo lapho uhlelo lokuphathwa kwe-intravenous lwaluxhumekile khona, ukuthuthukiswa kwezifo, i-thrombophlebitis kanye ne-necrosis yezicubu kungenzeka, kuncike ekushayweni kwegazi. Ukuphendula okufanayo kokulungiselela kwe-glucose kuma-ampoules kungabangelwa yimikhiqizo yokubola noma ngamacebo okuphatha angalungile.
Ngokuphathwa kwe-intravenous, ukwephulwa kwe-electrolyte metabolism kungaphawulwa:
- i-hypokalemia;
- i-hypophosphatemia;
- hypomagnesemia
Ukuze ugweme ukusabela okungekuhle ekwakhekeni komuthi ezigulini, kuyadingeka ukuthi uqaphele ngokucophelela umthamo onconywayo kanye nenqubo yokuphatha efanele.
Ngubani oshukela ophikisana nobushukela?
Imiyalo esetshenzisiwe inika imininingwane mayelana ne-contraindication eyinhloko:
- isifo sikashukela mellitus;
- i-cerebral ne-pulmonary edema;
- i-hyperglycemia;
- i-hyperosmolar coma;
- hyperlactacidemia;
- ukwehluleka kokujikeleza, okusongela ukukhula kwe-pulmonary edema nobuchopho.
Ukuxhumana nezinye izidakamizwa
Isixazululo se-glucose esingu-5% no-10% nokwakheka kwaso kunomthelela ekungenisweni kwe-sodium okuvela emgodini wokugaya ukudla. Umuthi unganconywa uhlanganiswe ne-ascorbic acid.
Ukuphathwa kwe-intravenous ngasikhathi sinye kufanele kube ngesilinganiso seyunithi elilodwa nge-4-5 g, okunomthelela ekufakweni okuphezulu kwento esebenzayo.
Ngenxa yalokhu, i-glucose 10% ingumenzeli onamandla oxid ngokwanele ongakwazi ukuphathwa ngasikhathi sinye ne-hexamethylenetetramine.
I-glucose ivinjelwa kakhulu nge:
- izixazululo ze-alkaloids;
- ama-anesthetics ajwayelekile;
- amaphilisi okulala.
Isixazululo siyakwazi ukwenza buthaka umphumela we-analgesics, izidakamizwa ze-adrenomimetic futhi sinciphise ukusebenza kwe-nystatin.
Amanye ama-nuances wesingeniso
Lapho usebenzisa umuthi umuthi, amazinga kashukela wegazi kufanele abhekwe ngaso sonke isikhathi. Ukwethulwa kwamanani amakhulu eglucose kungacekeleka kulabo abanesifo sikashukela abalahlekelwe kakhulu ngama-electrolyte. Isixazululo se-10% asikwazi ukusetshenziswa ngemuva kokuhlaselwa okubucayi kwe-ischemia efomu elinamandla ngenxa yomthelela omubi we-hyperglycemia kwinqubo yokwelashwa.
Uma kunezinkomba, khona-ke isidakamizwa singasetshenziswa ezinganeni, ngesikhathi sokukhulelwa nangesikhathi sokuqunjelwa.
Ukuchazwa kwento kusho ukuthi i-glucose ayikwazi ukuthinta amandla okulawula izindlela nokuhamba.
Amacala okweqa
Uma kube nokuphuza ngokweqile, umuthi uzobe ukhulume ngezimpawu zemiphumela emibi. Ukuthuthukiswa kwe-hyperglycemia ne-coma kungenzeka kakhulu.
Ngokuya ngokwanda kokuhlushwa ushukela, ukwethuka kungenzeka. Kwi-pathogenesis yalezi zimo, ukunyakaza kwe-osmotic koketshezi nama-electrolyte kudlala indima ebalulekile.
Isixazululo sokungenelela singakhiqizwa ekuxakweni okungama-5% noma ama-10% ezitsheni ze-100, 250, 400 no-500 ml.
