I-Hypoglycemic coma yisimo eseqisayo sohlelo lwe-endocrine olwenzeka ngenxa yokwehla okubukhali koshukela wegazi. Umuntu okhubazekile we-hypoglycemic udinga usizo oluphuthumayo, kepha ukuhlinzekwa kwalo kudinga ulwazi ngesimo samanje sesiguli. Kubalulekile ukwazi: izimpawu zomuntu zihlobene ne-hyperglycemia noma i-hypoglycemia.
Izimpawu ze-hypoglycemia ne-hyperglycemia
Uhlobo olubi futhi olungamahlalakhona lwe-hyperglycemia luvezwa kulezi zimpawu ezilandelayo:
- Ukoma ngokweqile;
- Ukuchama kaningi;
- Ukukhathala okuhlala njalo;
- Shintsha kwesisindo esingaguquki;
- Ukulimazeka kokubonakalayo;
- Umlomo owomile;
- Ukomiswa nokulunywa kwesikhumba;
- Ukuphefumula kukaKussmaul;
- I-Arrhythmia;
Izifo ezithambile ezingelula ukuzelapha, ezifana ne-vagidi candidiasis noma i-otitis externa, nazo zingakhombisa isimo se-hypoglycemic;
I-hyperglycemia ye-acute ingaba njengezimpawu ezilandelayo:
- I-ketoacidosis;
- Ukungazi kahle;
- Ukomisa ngenxa ye-glucosuria ne-osmotic diuresis.
Izimpawu nezimpawu ze-hypoglycemia zihlukaniswe ku-autonomic (parasympathetic, adrenergic) ne-neuroglycopenic. Izimpawu zemifino zivezwa kanjena:
Izinga eliphakeme lobudlova kanye nenjabulo, kanye nokukhathazeka, ukwesaba nomuzwa wokukhathazeka;
- Ukwanda kokujuluka;
- Ukuthuthumela kwemisipha, kanye ne-hypertonicity yemisipha;
- Izitshudeni ezinonile;
- Ukwanda kwengcindezi yegazi, i-arrhythmia;
- Ukuqina kwesikhumba;
- Ukubuyiswa kwenhliziyo isicanucanu, kwesinye isikhathi ukugabha, indlala ebuhlungu;
- Ubuthakathaka obungapheli
- Izimpawu ze-Neuroglycopenic:
- Ukugxila okuphansi kokunaka, ikhanda kanye nesiyezi, ukudideka kwendawo, ukuxhumana okulimazayo kokunyakaza;
- Paresthesia;
- "Ukwehlukaniswa" kwezinto njengokuphazamiseka okubukwayo kwesimo;
- Ukungalingani kanye noshintsho ekuziphatheni okwenzekayo, i-amnesia;
- Ukuphefumula okungasebenzi kahle nokuhamba kwegazi;
- Ukomela
- Ukuqonda okungalungile;
- Izimo zokwehluleka kanye nezangaphambili
- Coma
Hypoglycemic Coma Factors
Ukusetshenziswa kwemithi ethile isikhathi eside, izimpawu ezifanayo zingabangelwa ngokuthatha izidakamizwa ze-insulin ngaphandle kokubheka umthamo, lokhu kungadala i-insulin hypoglycemic coma.
Ukuphuza utshwala, ukungahambisani nokudla nakho kungaholela ekwakhiweni kwesimo se-hypoglycemic coma.
I-Neurosis, ukweqisa ngokomzwelo, ukucindezela kanye nokudangala, njengoba imiphumela yezimo ezinjalo imvamisa ingaba yisimo se-hypoglycemic, futhi ekugcineni kube yi-hypoglycemic coma.
Ama-tumors eduze kwama-pancreas, i-pancreatic necrosis, ukukhiqizwa kwe-insulin ngokweqile, lokhu, ngeshwa, ngesinye isikhathi yisizathu sokuqala esiholela ekutholakaleni i-hypoglycemic coma.
Ukushoda kwe-Hepatic, imiphumela yalesi simo ihlukahlukene, futhi phakathi kwabo kungahle kube ne-hypoglycemic coma.
Ukuxineka ngokomzimba ngenxa yezemidlalo noma ukusebenza isikhathi eside komzimba, imiphumela ihlukile, kepha omunye wayo yi-hypoglycemic coma.
Izinkinga ze-hypoglycemic coma
Nge-hypoglycemic coma, kubaluleke kakhulu ukuhlinzeka usizo lokuqala esigulini ngendlela esifike ngesikhathi. Ngasikhathi sinye, umbuso wakhe owengeziwe uhambisana nezinga lokwazisa nokuqwashisa abantu ababesondelene nesiguli.
Ukuntuleka kokunakekelwa okuphuthumayo kugcwala i-edema yamakhemikhali, okuzoholela ekubukekeni kwezilonda ezingenakuguqulwa zesistimu yezinzwa ephakathi. Kumele kuqashelwe ukuthi ngokuqala njalo kwe-hypoglycemic coma, ezigulini zokushintsha ubuntu babantu abadala ziyabhekwa, futhi ezinganeni kukhona ukwehla kwezinga lobuhlakani. Kuwo womabili amaqembu eziguli, ukufa akuhlanganisiwe.
Isimo se-hypoglycemic coma siyingozi kakhulu ezigulini esezikhulile. Lokhu kuyiqiniso ikakhulukazi kubantu abahlushwa yisifo se-coronary artery isifo sobuchopho noma senhliziyo, nezifo zenhliziyo. Inkambo ye-hypoglycemic coma ifaka kakhulu imivimbo noma i-myocardial infarction. Ngokunikwa lesi sici, kubalulekile ukuthi ube njalo nge-ECG.
Inqubo yenziwa ngemuva kokumisa zonke izimpawu ze-hypoglycemia. Uma i-hypoglycemic coma ihlala isikhathi eside, ihambisana nokubonakaliswa okunzima, i-encephalopathy kungenzeka, lokhu akuyona okokuqala, kodwa kungenye yezinhlobo eziyingozi kakhulu.
I-Encephalopathy yisilonda esidala sobuchopho esihambisana nokubulawa yindlala komoya-mpilo kanye nokugeleza kwegazi okungasebenzi kahle ezicutshini zobuchopho. Lesi sifo sibonisa ngokufa okukhulu kwamangqamuzana ezinzwa. Ukubonakaliswa kaningi kokuwohloka kobuntu.
Izindlela zokuvikela usizo lokuqala
Ukunikeza kahle usizo lokuqala esimweni esidalwe ukukhathazeka yi-hypoglycemic coma, udinga ukunquma ngokusobala ukuthi yiziphi izinkomba ezithile zalesi simo ezibonisa i-hyperglycemia.
Nge-hyperglycemia, njengoba wazi, amazinga kashukela egazi akhuphuka kakhulu. Kubalulekile ukuqonda izimpawu ze-hypoglycemia, lapho amazinga eglucose ephansi. Ingozi ukuthi womabili la macala adinga izinyathelo ezihlukile eziphikisanayo.
Amazinga kashukela aphezulu ahlala ahambisana nokoma okwandayo, isicanucanu, nobuthakathaka. Umuntu osesimweni sokungazi unokoma okukhanyayo kwesikhumba, kwehla ukujula kwephimbo lezingoma zamehlo. Ngaphezu kwalokho, iziguli zinokuphefumula okukhulu okunomsindo ngephunga elithile "le-apula" kanye nephunga le-acetone. Uma isiguli sinoshukela wegazi ophansi, khona-ke kuleli cala, umuntu uzizwa ebuthakathaka obukhulu futhi ethuthumela emzimbeni wonke. Ngaphezu kwalokho, ukujuluka ngokweqile kuyaqoshwa.
Ukuhlala kwesiguli kungazi, njengomthetho, kuhambisana nokukhishwa okuningana. Akukho ukusabela kwe-corneal njengokuphendula kokuthinta.
Ukuthola umuntu esimweni se-hyperglycemic (noma isifo sikashukela) ngokushesha, kuzodingeka umjovo we-insulin. Esikhathini esiningi, iziguli ezinesifo sikashukela zineziteleka zosizo lokuqala ezimweni ezingalindelekile. Ikhithi losizo lokuqala livame ukugcina konke okudingayo ngemijovo ye-insulin, kufaka phakathi uboya bekotini, imiyalo yemithamo, amasirinji ne-insulin.
Kuyadingeka ukuthi unake iqiniso lokuthi iziguli ezinesifo sikashukela zinokungazethembi okuphansi, lokhu kuyasebenza nakwisifo esinjengesifo sikashukela sohlobo 2 nohlobo lokuqala. Ngenxa yalokhu, kubalulekile nganoma yiziphi izindlela ukukhipha ukutholakala kokutheleleka kwezindawo zomjovo.
Futhi, ungenzi ngaphandle kwezinyathelo eziqinile ze-aseptic insulin. Ukuze unikeze usizo lokuqala lwe-hyperglycemic coma emgwaqweni, uma zonke izidingo ziyahlangabezana, okokuqala kufanele uhlole zonke izinto zesiguli ukuze uthole ikhithi losizo lokuqala nge-insulin ngokushesha okukhulu.
Uma lokhu kutholakala, kuthathwa umthamo we-insulin ukuze ufakwe ehlombe noma ethangeni. Umthamo we-insulin kufanele ube amayunithi angama-50-100. Njengomthetho, ezigulini ezinamaphethelo, iminonjana evela kumjovo wangaphambilini ibonakala kahle, ngakho-ke ngeke kube nzima ukuzulazula.
Iqembu lama-ambulensi kufanele libizwe ngokushesha ngangokunokwenzeka. Iqiniso ngukuthi ngasikhathi sinye sokujova kwe-insulin, isiguli sidinga ukwethulwa kwekhambi le-glucose engama-40%, kanye nosawoti onesisombululo se-glucose. Umthamo uzoba ku-4000 ml. Ngemuva kwezinqubo zokuqala eziphuthumayo, kanye nokungeniswa kwe-insulin, isiguli kufanele sinciphise inani lamaprotheni namafutha adliwe nguye.
Kodwa odokotela batusa kakhulu: isisindo sokukhishwa okukodwa kokudla akufanele kube ngaphansi kwama-gramu ayi-300. Ukudla okukodwa kufanele kube nama-carbohydrate angagaya kalula, njengamajusi, izithelo, nejelly yemvelo. Ngaphezu kwalokho, isiguli sinconywa ukusebenzisa amanzi amaminerali we-alkaline ephezulu.
Usizo lokuqala lwe-hypoglycemic coma
Nge-hypoglycemia, izinyathelo ezithile kufanele zithathwe ezizinza futhi zithuthukise isimo sesiguli:
- Nikeza isiguli ushukela, ngokwesibonelo, uswidi, u-ayisikhilimu, ucezu kashukela. Ngaphezu kwalokho, unganikeza itiye elimnandi, ulamula, amanzi anoshukela noma ujusi;
- Kubalulekile ukunikeza isiguli indawo yokuhlala enhle noma isikhundla sokulala ngaphambi kokuqala ukwelashwa nge-hypoglycemic coma.
- Uma kwenzeka ulahlekelwe ukwazi, isiguli kufanele sibekwe ohlangothini lwaso bese ushukela ubekwa esihlathini;
Ucingo lweqembu le-ambulensi nge-hypoglycemic coma luyimfuneko, lokhu ukunakekelwa okuphuthumayo komkhuhlane we-hypoglycemic.
Uma umuntu ogulayo ezazi, uzokwazi ukugwinya uketshezi, sikhuluma ngesisombululo sikashukela. Ukulungiselela isixazululo esinjalo, udinga ukufaka engxenyeni yengilazi yamanzi 1 noma 2 wezipuni kashukela.
Uma kungaziwa ukuthi isiguli singalawulwa, ukuphathwa kwe-intravenous kwesisombululo se-glucose esingu-40% kuboniswe njengosizo oluphuthumayo lwe-hypoglycemic coma. Ushukela wegazi uzophinde ukhuphuke ngokushesha uma ujova umjovo oshubile wesisombululo se-adrenaline - 0,1%, 1 ml.
