Iphampu ye-insulin iyithuluzi elikhethekile lokunikezela nge-insulin emzimbeni wesiguli esinesifo sikashukela. Le ndlela ngenye indlela yokusebenzisa umjikelo wesirinji kanye nesirinji. Iphampu ye-insulin isebenza futhi ihambise umuthi ngokuqhubekayo, okuyinzuzo yayo eyinhloko phezu kwemijovo ejwayelekile ye-insulin.
Izinzuzo eziphambili zalamadivayisi zifaka:
- Ukuphathwa Kalula kwemithamo emincane ye-insulin.
- Asikho isidingo sokujova i-insulin eyengeziwe.
Iphampu ye-insulin iyithuluzi eliyinkimbinkimbi, izingxenye zalo ezinkulu ezilandelayo:
- Iphampu - iphampu ekhipha i-insulin ngokuhambisana nekhompyutha (uhlelo lokulawula).
- I-cartridge engaphakathi kwephampu iyi-insulin reservoir.
- Isethi yokufaka engabuyiselwa ebandakanya i-cannula engasukeki namashubhu ambalwa okuyixhuma kulondolozi.
- Amabhethri
Amaphampu we-insulin we-Refuel nanoma iyiphi i-insulin esebenza ngokushesha, kungcono ukusebenzisa i-NovoRapid ye-Ultra-iDemo, iHumalog, i-Apidru. Lesi sitoko sizohlala izinsuku eziningana ngaphambi kokuthi ukhuphule futhi ithangi.
Umgomo wepompo
Amadivaysi anamuhla anesisindo esincane, futhi aqhathaniswa ngosayizi kufana. I-insulin inikezwa emzimbeni womuntu ngama-hoses akhethekile agobekayo agobekayo (ama-catheters ane-cannula ekugcineni). Ngalezi amashubhu, okhipha amanzi ngaphakathi kwephampu, ogcwele i-insulin, uxhuma emafutheni angaphansi komhlaba.
Iphampu yanamuhla ye-insulin iyithuluzi elincane elilingana ne-pager. I-insulin ingeniswa emzimbeni ngohlelo lwamashubhu amancane agobekayo. Babopha isitoreji nge-insulin ngaphakathi kwesixhobo ngamafutha angaphansi.
Le nkimbinkimbi, ehlanganisa ukonga uqobo kanye ne-catheter, ibizwa ngokuthi "uhlelo lokufaka." Isiguli kufanele siyishintshe njalo ezinsukwini ezintathu. Ngasikhathi sinye kanye noshintsho lohlelo lokungenisa, indawo okuhlinzekwa ngayo i-insulin nayo idinga ukushintshwa. I-cannula yepulasitiki ibekwa ngaphansi kwesikhumba ezindaweni ezifanayo lapho i-insulin ifakwa khona ngendlela ejwayelekile yokujova.
Ama-anhibulin we-insulin asebenza nge-Ultrashort ajwayele ukuphathwa ngepompo; kwezinye izikhathi, i-insulin yabantu esebenza ngokufushane nayo ingasetshenziswa. Ukuhlinzekwa kwe-insulin kwenziwa ngamanani amancane kakhulu, ngemithamo ukusuka kumayunithi angama-0,025 kuya kwayi-0.100 ngasikhathi (lokhu kuya ngemodeli yepompo).
Izinga lokuphathwa kwe-insulin lihlelwe, ngokwesibonelo, uhlelo luzokhipha amayunithi we-insulin angama-0.05 njalo ngemizuzu emi-5 ngejubane lamayunithi angama-0.6 ngehora noma njalo ngemizuzwana eyi-150 kumayunithi angama-0.025.
Ngokomgomo womsebenzi, amaphampu e-insulin asondelene nokusebenza kwamanyikwe omuntu. Okusho ukuthi, i-insulin ilawulwa ngezindlela ezimbili - i-bolus ne-basal. Kwatholakala ukuthi isilinganiso sokukhishwa kwe-insulin insulin yi-pancreas kuyahluka ngokuya ngesikhathi sosuku.
Kumaphampu wesimanje, kungenzeka ukuthi kuhlelwe inani lokuphathwa kwe-insal insulin, futhi ngokohlelo lungashintshwa njalo ngemizuzu engama-30. Ngakho-ke, "i-insulin yangemuva" idedelwa egazini ngejubane elihlukile ngezikhathi ezihlukile.
Ngaphambi kokudla, kufanele kuphuculwe umthamo wesidakamizwa. Lesi siguli kufanele senziwe ngesandla.
Futhi, iphampu ingasethelwa ezinhlelweni ezizokhishwa khona lapho kutholakala khona umthamo owodwa we-insulin uma kubhekwa izinga likashukela egazini.
Izinzuzo zephampu yesiguli
Lapho welapha isifo sikashukela ngosizo lwedivaysi enjalo, kusetshenziswa kuphela ama-enzymes we-ultrashort we-insulin, isixazululo esivela epompini sinikezwa egazini kaningi, kepha kumithamo emincane, ngakho-ke ukumunyanisa kwenzeka cishe ngaso leso sikhathi.
Ezigulini ezinesifo sikashukela, ukuguquguquka kweglucose yegazi kuvame ukwenzeka ngenxa yezinguquko emazingeni okufaka i-insulin isikhathi eside. Iphampu ye-insulin iyayiqeda le nkinga, okuyinzuzo yayo enkulu. I-insulin efushane esetshenziswe kwiphampu inomphumela ozinzile impela.
Ezinye izinzuzo zokusebenzisa iphampu ye-insulin:
- Ukunemba okuphezulu metering kanye nesinyathelo esincane. Isethi yemithamo ye-bolus kumaphampu wesimanje kwenzeka ekunwetshweni kwe-0.1 PIECES, kuyilapho amapeni wesirinji enentengo yokuhlukanisa engu-0.5 - 1.0 PIECES. Izinga lokuphathwa kwe-insal insulin lingahluka kusuka kuma-0,025 kuya kuma-0.100 amayunithi ngehora.
- Inani le-punctures lincishiswa amahlandla ayishumi nanhlanu, ngoba uhlelo lokungenisa lufuna ushintsho lwesikhathi esingu-1 ngezinsuku ezi-3.
- Iphampu ye-insulin ikuvumela ukubala umthamo we-bolus insulin yakho. Ukuze uthole lokhu, isiguli kufanele sinqume imingcele yaso eyedwa (ukuzwela kwe-insulin kuya ngesikhathi sosuku, i-carbohydrate coefflements, i-glucose level okuhlosiwe ngayo) bese uyifaka ohlelweni. Ngaphezu kwalokho, uhlelo lubala umthamo odingekayo we-insulin bolus, kuya ngemiphumela yokulinganisa ushukela wegazi ngaphambi kokudla nokuthi i-carbohydrate engakanani ehlelwe ukuthi idliwe.
- Amandla wokumisa iphampu ye-insulin ukuze umthamo we-bolus wesidakamizwa awuphathwanga ngasikhathi sinye, kodwa wasatshalaliswa ngokuhamba kwesikhathi. Lo msebenzi uyadingeka uma onesifo sikashukela edla kancane ama-carbohydrate ahamba kancane noma ngesikhathi sedili eligcina isikhathi eside.
- Ukuqapha okuqhubekayo kokuhlushwa ushukela ngesikhathi sangempela. Uma i-glucose idlula imikhawulo eyamukelekayo, lapho-ke iphampu yazisa isiguli ngayo. Izinhlobo ezintsha zingashintsha izinga lokuphathwa kwomuthi ngokwazo ukuletha amazinga kashukela abe ejwayelekile. Isibonelo, nge-hypoglycemia, iphampu ye-insulin ivimba umuthi.
- Ukulawulwa kwedatha, ukugcinwa nokudlulisela kwikhompyutha ukuze kuhlaziywe Amaphampu we-insulin ajwayele ukuwagcina kwimininingwane yawo yezinkumbulo izinyanga zokugcina ezi-6 mayelana nokuthi imithamo ye-insulin iphathwe kanjani nokuthi ibaluleke ngani i-glucose egazini.
Ukuqeqeshwa ngesineke epompini le-insulin
Uma isiguli saqeqeshwa kabi ekuqaleni, khona-ke kuzoba nzima kakhulu kuye ukushintshela ekusebenziseni iphampu ye-insulin. Umuntu kudingeka aqonde ukuthi angahlela kanjani ukulethwa kwe-pole insulin nokuthi angalungisa kanjani ukuqina kwesidakamizwa kwimodi ye-basal.
Izinkomba zokwelapha i-pump insulin
Ukushintshela ekwelashweni kwe-insulin usebenzisa iphampu kungenziwa kulezi zimo ezilandelayo:
- Ngokucela isiguli uqobo.
- Uma kungenzeki ukuthola isinxephezelo esihle sesifo sikashukela (i-glycated hemoglobin inenani elingaphezulu kuka-7%, nasezinganeni - 7.5%).
- Ukuguquguquka okuhlala njalo nokubalulekile ekuhlushweni kwe-glucose egazini kwenzeka.
- Imvamisa kuba ne-hypoglycemia, kufaka phakathi ifomu elinzima, kanye nasebusuku.
- Umkhuba "wokusa kokusa."
- Imiphumela ehlukene yesidakamizwa esigulini ngezinsuku ezahlukene.
- Kunconywa ukusebenzisa idivaysi ngesikhathi sokuhlela ukukhulelwa, lapho uzala ingane, ngesikhathi sokuzalwa nangemva kwayo.
- Iminyaka yezingane.
Ngokwe-theoretically, iphampu ye-insulin kufanele isetshenziswe kuzo zonke iziguli ezinoshukela ezisebenzisa i-insulin. Kubandakanya ukulibaziseka kokuqala kokubambezeleka kwe-autoimmune sikashukela mellitus, kanye nezinhlobo zesifo sikashukela.
Contraindication nokusetshenziswa kwepampu ye-insulin
Amaphampu anamuhla anedivayisi enjalo yokuthi iziguli zingayisebenzisa kalula futhi zizimele. Kodwa noma kunjalo ukwelashwa kwe-insulin-pump kusho ukuthi isiguli kumele sibambe iqhaza ekwelashweni kwakhe.
Ngokwe-insulin yokwelapha esekwe kumpompo, ingozi ye-hyperglycemia (ukukhuphuka okubukhali kashukela wegazi) esigulini iyanda, futhi amathuba okuba nesifo sikashukela sikashukela nawo aphezulu. Lokhu kungenxa yokuthi akukho-insulin esebenza isikhathi eside egazini likashukela, futhi uma ukulethwa kwe-insulin emfushane nganoma yisiphi isizathu kunqamuka, khona-ke izinkinga ezingathí sina zingavela ngemuva kwamahora ama-4.
Ukusetshenziswa kwempompo kuhlukaniswe ezimweni lapho isiguli singenaso isifiso noma amandla okusebenzisa isu lokuqapha lesifo sikashukela, okungukuthi, alinawo amakhono okuzithiba ushukela wegazi, alizi ukubala ama-carbohydrate ngokohlelo lwesinkwa, alihleleli ukusebenza ngokomzimba futhi libala imithamo ye-bolus insulin.
Iphampu le-insulin alisetshenziswa ezigulini ezigula ngengqondo, ngoba lokhu kungadala ukuphathwa okungafanele kwensiza. Uma umuntu onesifo sikashukela enamehlo angaboni kahle, ngeke akwazi ukubona okulotshwe ekubonisweni kwephampu ye-insulin.
Esigabeni sokuqala sokusetshenziswa kwephampu, kufanele kuqashelwe udokotela njalo. Uma ingekho indlela yokukunikela, kungcono ukuhlehlisela ukuguqulwa kokulashwa kwe-insulin nokusebenzisa iphampu kwesinye isikhathi.
Ukukhetha kwe-insulin pump
Lapho ukhetha le divayisi, qiniseka ukuthi unaka:
- IVolumu yensimbi. Kufanele ibambe i-insulin eningi njengoba kudingeka izinsuku ezintathu.
- Ngabe izinhlamvu zifundwa kusuka esikrinini kahle, futhi ingabe ukukhanya kwazo nokungafani kwazo kwanele?
- Imithamo ye-bolus insulin. Udinga ukunaka ukuthi imiphi imithamo ye-insulin ephansi futhi ephezulu engabekwa, nokuthi ilungele isiguli esithile. Lokhu kubaluleke kakhulu ezinganeni, ngoba zidinga imithamo emincane kakhulu.
- Okokubala okwakhelwe ngaphakathi. Kungenzeka yini ukusebenzisa ama-coefficients eziguli ngazinye epompeni, njenge-insulin sensitivity factor, ubude besidakamizwa, i-carbohydrate coefflements, izinga likashukela egazini.
- Alamu Ngabe kungenzeka yini ukuzwa i-alamu noma uzizwe uthuthumela lapho kuvela izinkinga.
- Ukumelana namanzi. Ngabe sikhona yini isidingo sepompo elingangeneki ngokuphelele emanzini.
- Ukuxhumana namanye amadivaysi. Kunamaphampu angasebenza ngokuzimela ehlanganiswe nama-glucometer kanye namadivayisi wokuhlola okuqhubekayo ushukela wegazi.
- Ukusetshenziswa kalula kwephampu empilweni yansuku zonke.
Ungabala kanjani imithamo yokwelapha i-pump insulin
Izidakamizwa zokukhetha lapho usebenzisa iphampu zifanekisela i-insulin efakwa ngokweqile. Imvamisa, i-humalog insulin isetshenziselwa lezi zinhloso. Kukhona imithetho ethile yokubala imithamo ye-insulin yokulethwa usebenzisa ipompo ku-bolus kanye nezindlela ze-basal.
Ukuqonda ukuthi yini okufanele ibe ijubane lokulethwa kwe-insulin ngemodi ye-basal, udinga ukwazi ukuthi yiliphi inani lomthamo we-insulin owathola isiguli ngaphambi kokusebenzisa ucingo. Umthamo ophelele wansuku zonke kufanele wehliswe ngo-20%, kuthi kwezinye izimo u-25-30%. Lapho usebenzisa impompo kumodi ye-basal, cishe i-50% yenani eliphelele le-insulin lilawulwa.
Isibonelo, isiguli ngokuphathwa okuphindaphindiwe kwe-insulin sithola amayunithi angama-55 omuthi ngosuku. Mayelana nokushintshwa kwephampu ye-insulin, uzodinga ukufaka amayunithi angama-44 ezokwelapha ngosuku (amayunithi angama-55 x 0.8). Kulokhu, umthamo we-insulin we-insulin kufanele ube amayunithi angama-22 (isigamu semithamo yansuku zonke). I-insal insulin kufanele iphathwe ngesilinganiso sokuqala sama-22 U / amahora angama-22, okungukuthi, i-0.9 U ngehora.
Okokuqala, ipompo lilungiswa ngendlela yokuthi kuqinisekiswe umthamo ofanayo we-insal insulin phakathi nosuku. Bese lelijubane lishintsha imini nobusuku, kuya ngemiphumela yokulinganisa okuqhubekayo koshukela wegazi. Kunconywa ukuthi ushintshe ijubane ngokungadluli i-10% isikhathi ngasinye.
Izinga lomjovo we-insulin ungene egazini ebusuku likhethwa ngokuya ngemiphumela yokuqapha ushukela ngaphambi kokulala, phakathi kobusuku nangemva kokuvuka. Izinga lokulethwa kwe-insulin phakathi nosuku lilawulwa yimiphumela yokuzithiba kwe-glucose, uma nje kudlula ukudla okweqiwe.
Umthamo we-bolus insulin ozofakwa uphuma epompini ungene egazini ngaphambi kokudla uhlelwe ngesandla yisiguli isikhathi ngasinye. Kubalwa ngokuya ngemithetho efanayo nangokwelashwa okuqinile kwe-insulin usebenzisa imijovo.
Amaphampu we-insulin ayisiqondiso esisha, ngakho-ke nsuku zonke kungaletha izindaba kulokhu. Ukuthuthukiswa kwedivayisi enjalo engasebenza ngokuzimela, njenge-pancreas yangempela, kuyaqhubeka. Ukuqala kwesidakamizwa esinjalo kuzoguqula ukwelashwa kwesifo sikashukela, njengokuguqula okwenziwe ngama-glucometer, njengemitha ye-Accu Check Go.
Izinkinga zokwelashwa kwe-insulin pump sikashukela
- Le divayisi inezindleko zokuqala ezinkulu.
- Izinto ezisetshenziswayo zibiza kakhulu kunesirinji ejwayelekile ye-insulin.
- Lapho usebenzisa impompo, kuvame ukuvela izinkinga zezobuchwepheshe, futhi kungeniswe i-insulin emzimbeni wesiguli. Lokhu kungabangelwa ukungasebenzi kahle kohlelo, i-insulin crystallization, i-cannula slip nezinye izinkinga.
- Ngenxa yokungathembeki kwamadivayisi ezigulini ezinesifo sikashukela sohlobo 1, i-ketoacidosis yasebusuku yenzeka kaningi kakhulu kuneziguli ezijova i-insulin ngama-syringes.
- Abantu abaningi abakutholi kalula ukuthi bahlala benamashubhu esiswini sabo ne-cannula ngaphandle. Bancamela imijovo engenabuhlungu ngama-syringes.
- Amathuba aphezulu okutheleleka lapho kungeniswa khona i-cannula. Kungenzeka kube khona namathumba adinga ukuhlinzwa.
- Lapho usebenzisa amaphampu e-insulin, i-hypoglycemia enzima ihlala ivela, yize abakhiqizi bememezela ukunemba okukhulu kwe-dosing. Ngokunokwenzeka, lokhu kungenxa yokwehluleka kohlelo lwe-dosing.
- Abasebenzisi be-Pump baba nobunzima ngesikhathi sokwelashwa kwamanzi, ukulala, ukubhukuda noma ukuya ocansini.
