Iziguli ezinesifo sikashukela kufanele zenze imizamo yansuku zonke yokwenziwa kwezinqubo zokugcina umzimba zisesimweni esiseduze nokujwayelekile ngangokunokwenzeka. Amaphutha amancane ekwelashweni ayanqwabelana futhi ekugcineni aholele ezinkingeni zesifo sikashukela.
Uma kungekho ukwelashwa noma amaphutha amabi emthanjeni wezidakamizwa, kuvela ikoma lesifo sikashukela. Lesi yisimo esibucayi, esithuthuka ngokushesha, esibulalayo. Ingakhula ngazo zombili lezi zinhlobo zezifo, kungakhathalekile ukusetshenziswa kwe-insulin. Ngokunaka okwanele impilo yakho noma ukulahleka ngokushesha komsebenzi we-pancreatic, i-coma ingavela ngisho nangaphambi kokutholakala kwesifo sikashukela.
Izimbangela zeDiabetes Coma
Imbangela eyinhloko ye-coma kuma-diabetesics ukuphambuka okubucayi kwamazinga kashukela kusuka kokujwayelekile, okubili kukhuphuka okuqinile - i-hyperglycemia, nokwehla - i-hypoglycemia Izinkomba ezinjalo ze-glucose zihlanekezela zonke izinqubo ze-metabolic emzimbeni, okuholela ekulahlekelweni yisiguli ukulawula isimo, ukwazi ukungasebenzi kahle, ukukhula ngokushesha komqondo. Ngalesi sikhathi, impilo yesifo sikashukela incike kuphela ezenzweni ezifanele zabanye kanye nesivinini sokulethwa esikhungweni sezokwelapha.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Ngokuntuleka okukhulu kwe-insulin, ushukela awukwazi ukungena egazini ungene ezicutshini. Ephendula ukulamba kwamangqamuzana, umzimba uqala ukukhipha ushukela ngokwawo emsipha nakumafutha. Njengomphumela wokuqhekeka kwamaseli wamafutha, imizimba ye-ketone iyanqwabelana, ukudakwa kuyaqala. Ukushoda kwe-insulin nezinqubo ngaphakathi kweseli kuyahlanekezelwa - ukuwohloka kweshukela kuvinjelwe futhi imikhiqizo esezingeni eliphakathi ye-metabolic - lactates - ingene egazini.
Kungakhathalekile ukuthi yisiphi isimo lapho kuzokwakhiwa khona i-hyperglycemia, imizimba ye-ketone noma ama-lactates ayoqongelela emithanjeni, i-pH yegazi iyashintsha, iba yi-acidic ngokwengeziwe. Lapho nje i-acidity idlula ngokomzimba, amaseli aqala ukuwohloka emzimbeni, ama-enzyme alahlekelwe umsebenzi wawo, okuphumela ekujuleni kwenhliziyo, ukungasebenzi kohlelo lwezinzwa kanye ne-gastrointestinal tract kuze kube sekufeni.
Isifiso somzimba sokususa ushukela omningi ngokuwususa kumchamo nakho kungadala umuntu. Ukungezelela kwe-diuresis ngaphandle kokudla okwanele kwamanzi kuholela ekuphelisweni komzimba okukhulu nokugeleza kwegazi okulimazayo ebuchosheni.
I-Hypoglycemia - isimo esiyingozi ngisho nangokwengeziwe, ngoba ngokwehla kweshukela, iziguli ziwela ekhefini ngamahora ambalwa nje. Ukufa okuphezulu komqondo wesifo sikashukela ngenxa ye-hypoglycemia kuchazwa yindlala yobuchopho, amaseli ayo aqale ayeke ukwenza umsebenzi wawo, okhuthaza ukungasebenzi kahle kuzo zonke izinhlelo zomzimba, bese eqala ukufa.
Imvamisa, ukudangala kwesifo sikashukela kubangelwa:
- Ukuntuleka kokulawulwa kwesifo sikashukela esenzweni sesiguli, ngenxa yokulimala kakhulu, ukudakwa noma ukuphazamiseka kwengqondo.
- Amaphutha ekubaleni umthamo we-insulin.
- Ama-insulin ampofu nezindlela zokusebenzela ezingezinhle zokwenziwa kwawo.
- Ukuphazamiseka njalo kokudla okungathí sina (umsoco wesifo sikashukela sohlobo 2), umthamo wesikhathi esisodwa wethamo elikhulu kakhulu lama-carbohydrate asheshayo.
- Izifo ezinzima, ukuhlinzwa, ukukhulelwa ngesifo sikashukela ngaphandle kokulungiswa kwamadosi, kubandakanya i-insulin.
Yiziphi izinhlobo zokukhohlisa kushukela?
Ukuhlukaniswa komdlavuza onesifo sikashukela kuya ngembangela:
I-Hyperglycemic - ukwanda okubukhali koshukela wegazi ngaphezulu kwe-13 mmol / l, ngesinye isikhathi kuze kufike ku-55, kungakhathalekile ukuthi siyini isizathu sokwanda.
- I-Ketoacidotic - ukwanda kokuhlungwa kwe-acetone ne-keto acid. I-Coma iba nokukhubazeka okungatheni kwe-insulin, kwenzeka kaningi ngesifo sikashukela esincike ku-insulin (funda nge-ketoacidosis).
- I-Hyperosmolar - amashifu e-salt-salt metabolism ngenxa yokuphelelwa ngamandla komzimba. Ikhula kancane, isimilo sesifo sikashukela esinganciki i-insulin.
- I-Lactic acidosis - ukunqwabelana kwe-lactate. Kuyinto evamile kunezinye izinhlobo zesifo sikashukela, imvamisa umphumela wezifo ezihambisanayo.
I-Hypoglycemic - ukwehla okusheshayo kwe-glucose kuya ku-2.6 mmol / l nangaphansi. Lokhu kukhubazeka kuqashelwa kakhulu yiziguli, ngakho-ke kuyingozi kakhulu. Ehambisana nokuziphatha okungafanele nokuqwashisa ngokushesha.
Uhlobo lokuthuthuka kukoma lunganqunywa ngokuzimela uma wazi izimpawu zokubonisa isibonakaliso futhi usebenzisa amathuluzi okuxilonga alula kakhulu - i-glucometer kanye nemichilo yokuhlola emizimbeni ye-ketone.
Izimpawu nezimpawu ze-Coma
Izimpawu ezejwayelekile zazo zonke izinhlobo zikashukela:
- ukudideka kokwazi;
- Impendulo enganele yemibuzo;
- ukunganaki noma ulaka;
- ukuhlangana okungahambi kahle kokunyakaza nokugwinya;
- ukwehla kokuphendula umsindo omkhulu, ukukhanya, izinhlungu;
- ukulahlekelwa ukwazi.
Ama-harbinger ngamanye we-coma yesifo sikashukela:
| Uhlobo lomkhovu | Izimpawu zokuqala kokuphela kwesifo sikashukela |
| I-Ketoacidotic | Ukoma, i-polyuria, isikhumba nokuphefumula ngephunga le-acetone, isicanucanu, ukungezwani kwemisipha yesisu nobuhlungu obukuyo, ikakhulukazi lapho icindezelwa, iphefumula kakhulu. |
| I-Hyperosmolar | Ukoma okunamandla nokuchama ezinsukwini ezi-2 ezedlule, ulwelwesi olomile, ukwehla kwesisindo okungazelelwe, ukushaya kwenhliziyo, umfutho ophansi wegazi, ukuqina kwemisipha, ukuqina emilenzeni. |
| I-Lactic acidosis | Ukusinda esifubeni, izinhlungu emisipha, okufana nokuzwa kokuqunjelwa, ukufushane komoya, ukuphefumula kaningi, iminwe eluhlaza okwesibhakabhaka, unxantathu we-nasolabial. Akukho phunga le-acetone. Bheka i-athikili nge-lactic acidosis. |
| I-Hypoglycemic | Indlala enkulu, ukuthuthumela ezandleni nangaphakathi komzimba, isicanucanu, isiyezi, ukungaboni kahle, ubuthakathaka, ukujuluka, ukwesaba okungenampilo. |
Izici zokwehla kwesifo sikashukela ezinganeni
Ebuntwaneni, ukoma kuyinkinga evamile yesifo sikashukela. Ngaphezu kwalezi zizathu ezingenhla, ukuphuma kweshukela ezinganeni kungabangelwa ukuguquguquka kwehomoni nokucindezela kwengqondo. Izici zokuqalwa kwesifo sikashukela enganeni kusisiqalo esisheshayo, inkambo esheshayo enezimpawu ezinzima, ukwehla okukhulu kwemisebenzi yomzimba. Isiguli asikwazi ukuchaza imizwa yaso, sisha masinyane.
Izinhlobo zama-Hyperosmolar kanye ne-lactic acidotic of coma azivamile kakhulu, ezimweni cishe ezi-5.
Imvamisa, ikoma iba ngesikhathi sokukhula okusheshayo, kusukela eminyakeni eyisikhombisa nangaphezulu, kanye nasebusheni, lapho abantu abadala bedlulisela ingxenye yokulawulwa kwesifo sikashukela enganeni.
Ezinganeni, ukusondela komthambo kungasolwa ngokuchama kaningi, ukuqunjelwa, ukuhaha ngokufisa esifubeni kanye nokwehla kokuqina kwesikhumba. Ama-diapple omile aba lukhuni ushukela, othelwa ngaphandle komchamo.
Ukunaka: Uma ingane izwa ukukhathazeka noma ukomela okungajwayelekile, isisu sayo siyamangaza noma ukugabha kuqala, uvame ukuphuza noma ukukhononda ngomlomo owomile, into yokuqala okudingeka ayilinganise ushukela. Umzuzu osetshenziswe ekuxilongeni ungavimbela ikhefu lesifo sikashukela futhi kusindise impilo yengane.
Ukunakekelwa okuphuthumayo komzimba onesifo sikashukela
I-algorithm ephuthumayo yezinsolo zokusondela kwesifo sikashukela ezisondele:
- Shayela i-ambulensi - okokuqala, ngaphambi kwayo yonke eminye imicimbi. Uma kunobufakazi bokuthi umuntu unesifo sikashukela, yazisa opharetha.
- Beka isiguli ohlangothini sakhe ukuze ugweme i-asphyxiation kusuka olimini olubekiwe noma ukuhlanza. Uma ukuhlanza sekuqalile, zama ukuhlanza umlomo wakho.
- Govuza izinkabi ezimbalwa zikashukela engilazini yamanzi noma uthenge noma yisiphi isiphuzo esimnandi (naka ukwakheka, i-soda ene-sweetener ngeke isize)nikeza isiguli isiphuzo. Nge-hyperglycemia, lo muthi ngeke uqinise lesi simo, kepha nge-hypoglycemia, ingasindisa impilo yomuntu. Unganikezi uswidi kashukela noma amashukela cubes. Esimweni esihle kakhulu, umsebenzi wokuhlafuna uyafa ngokushesha kunokugwinya, ngakho-ke isiguli singavimba.
- Uma kwenzeka ulahlekelwa ukwazi, qaphela njalo ukuba khona kokuphefumula nokushaya kwenhliziyo, uma kunesidingo, qala ukukhipha kabusha futhi uqhubeke ngakho kuze kube ngcono okukhulu noma kuze kufike i-ambulensi.
Ukuze abanye bakwazi ukunikeza usizo lokuqala, umuntu onesifo sikashukela kufanele ajwayele izihlobo zakhe, abangane kanye nozakwabo ngale mithetho, futhi amfundise nokusebenzisa imitha. Nge-hyperglycemia enzima, udokotela akakwazi ukwenza ngaphandle, ukulungiswa kwesimo sesiguli kungenzeka kuphela esibhedlela. I-Hypoglycemia kuze kufinyelele esigabeni esiphakathi (ngaphandle kokulahlekelwa ukwazi) kungalungiswa ngokuzimela ngokudla amagremu ayi-10-15 kashukela.
Ukwelashwa kwe-Coma
Isikimu sokulungiswa kwesifo sikashukela esimweni sesibhedlela:
| Izigaba zokwelashwa | Izici | |
| I-Hyperglycemia | I-Hypoglycemia | |
| Ukubuyiselwa kokushaya kwenhliziyo nokuphefumula | Ukuvuselela, ukuxhuma kwensiza yokufakelwa kokuphefumula, ama-hormone intramuscularly. | |
| I-glucose normalization | Ukuphathwa kwe-insulin ngaphakathi kwe-insulin kuze kube yilapho isimo sizinza, khona-ke ukwengezwa koshukela ngomlomo noma ngesimo sokudonsa phansi. | Amaconsi nge-glucose, i-insulin ivunyelwe kuphela ngemuva kokufinyelela esimweni ushukela. |
| Ukulungiswa komswakama | I-alkaline eyehlayo. Iyadingeka i-lactic acidotic coma ne-ketoacidotic enzima. | Akudingeki. |
| Ukubuyiselwa kokulahlekelwa uketshezi kanye ne-electrolyte, ukuqedwa kwemikhiqizo ye-metabolic | I-saline ngamanani amakhulu, i-potassium chloride. | |
| Ukuqeda izimbangela zokukhohlisa | Ukwelashwa kwezifo ezihambisanayo, ukukhethwa komthamo we-insulin, ukujwayelana nemithetho yokulungiswa kwe-glucose ku-mellitus yesifo sikashukela. | |
Impumelelo yokwelashwa kwe-coma ixhomeke kakhulu ekunemba kokunakekelwa okuphuthumayo, ijubane lokulethwa kweziguli esikhungweni sezokwelapha kanye namakhono okunciphisa umzimba. Uma konke kuhamba kahle, isiguli sichitha izinsuku eziningana ekunakekelweni okunzulu, bese sidluliselwa emnyangweni wezokwelapha.
Imiphumela engaba khona
Akukho sitho sinye emzimbeni esidluliselwa yisifo sikashukela ngaphandle komkhondo. Izinkinga eziyingozi kakhulu i-edema yamakhemikhali, ukulimala kwemisipha yenhliziyo, ukutheleleka komzimba obuthakathaka. Uma ubuchopho buthintekile noma ukungasebenzi kahle okukhulu ezithweni eziningana, ubude besikhathi sokukoma bukhuphuka, futhi umphumela obulalayo kungenzeka.
Imiphumela engaba khona yesifo sikashukela ngemuva kokuphuma ekhefini yinkulumo engasebenzi kahle, inkumbulo, ukuhlangana kokunyakaza, ukukhubazeka okuyingxenye noma okuphelele.
