Isifo sikashukela i-mellitus yisifo esidinga ulwazi nezinga eliphakeme lokuqondiswa iziguli. Uma kungalashwa, kungekudala kuzoba nemiphumela ngendlela yokonakala kwezicubu zemithambo yemithambo yemithambo yegazi nemithambo yegazi, uma iphathwe kanzima, kuthathwa imithamo yezidakamizwa, i-hypoglycemia izothuthukiswa.
Ushukela wegazi ophansi kakhulu uyingozi kakhulu kunoshukela omningi, njengoba izinguquko emzimbeni zenzeka ngokushesha okukhulu, futhi usizo lwezokwelapha lungamane luphuze. Ukuzivikela emiphumeleni ye-hypoglycemia, sonke isiguli sikashukela kufanele siqonde kahle inqubo yokuthuthuka kwale nkinga, sikwazi ukubona ukuncipha koshukela ngezimpawu zokuqala, sazi ukuthi singayimisa kanjani i-hypoglycemia yobunzima obahlukahlukene.
Ngenxa yokuthi lesi simo sisheshe siholele ekuqaphelekeni okufiphele nokwehluleka, ukufunda imithetho yokunakekelwa okuphuthumayo kwezihlobo zakho kanye nozakwabo ngeke kuphume endaweni.
I-Hypoglycemia - kuyini
Abantu abaphilile abacabangi nangokuthi yiziphi izinqubo eziyinkimbinkimbi ezenzeka emzimbeni wabo ngemuva kwesidlo sasekuseni esivamile Izitho zokugaya zicubungula ama-carbohydrate angenayo, zigcwalise igazi noshukela. Ama-pancreas, ngenxa yokwanda kwe-glucose, akhiqiza isilinganiso esifanele se-insulin. Lokhu kubuye kuveze izicubu ukuthi sekuyisikhathi sokudla, futhi kusiza ushukela ukungena esitokisini. Ukushintshwa kwamakhemikhali okuningana kwenzeka esitokisini, ngenxa yalokho iglucose iwela ku-carbon dioxide namanzi, bese umzimba uthola amandla awadingayo. Uma umuntu eye wayoziqeqesha, izicubu zizodinga ushukela omningi, okungekho kuzobolekelela isibindi. Ngesikhathi sokudla okulandelayo, izitolo ezinoshukela esibindini nasemisipha zizobuyiselwa.
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%
Ku-mellitus yesifo sikashukela, iziguli ziphoqelelwa ukuba zilawule ngesandla inqubo yokuthathwa koshukela ngokulawula ukungena kwayo ngokudla nangokuvuselela ukuthathwa kwayo ngamangqamuzana asebenzisa izidakamizwa ezinciphisa ushukela ne-insulin. Ngokwemvelo, ukulungiswa okwenziwe ngeglucose egazini akunakwenza ngaphandle kwamaphutha. Lapho ushukela wegazi usungaphezu kwalokho obekulindelwe, uqala ukubhubhisa imithambo yegazi nesiguli, i-hyperglycemia ivela. Kwesinye isikhathi i-glucose ayanele, bese kuthi i-hypoglycemia ikhule.
Umsebenzi wesiguli onesifo sikashukela wukuqinisekisa ukuthi lokhu kuguquguquka kuncane, ngesikhathi sokuqeda ukuphambuka kashukela wegazi kusuka emazingeni avamile. Isifo sikashukela ngaphandle kwezikhala kushukela sibizwa ngokuthi sinxephezelwe. Kuphela isinxephezelo sikashukela sesikhathi eside esiqinisekisa impilo esebenzayo nenesikhathi eside.
Izimbangela ze-hypoglycemia
Izimbangela ze-hypoglycemia zihlukahlukene kakhulu. Lokhu akubandakanyi ukuntuleka kokudla okunempilo noma i-overdose yezidakamizwa zesifo sikashukela, kodwa futhi ukwehla kwamazinga we-glucose ngenxa yezizathu zokuphila nangenxa ye-pathology yezitho ezihlukene.
| Izimbangela ze-hypoglycemia | Incazelo emfushane | |
| Okomzimba | ||
| Indlala yama-carbohydrate | Ebantwini abaphilile, ukuntuleka kokudla kubandakanya izindlela zokunciphisa; ushukela ovela esibindini ungena egazini. I-Hypoglycemia iba kancane kancane, ukwehla ushukela okunamandla kungabi khona. Kuhlobo 2 sikashukela mellitus, izinqolobane ze-glycogen azibalulekile, njengoba isiguli sinamathela ekudleni okune-carb ephansi. I-Hypoglycemia iba ngokushesha okukhulu. | |
| Umsebenzi womzimba | Ukusebenza isikhathi eside kwemisipha kudinga inani elikhulayo le-glucose. Ngemuva kokuncipha kokulondolozwa kwesibindi kanye nemisipha, izinga layo esegazini nalo liyancipha. | |
| Ukuxineka | Ukungezwani kwemizwa kusebenze uhlelo lwe-endocrine, kwandisa ukukhiqizwa kwe-insulin. Ukuntuleka kwe-glucose echaza isifiso "sokubamba" inkinga. I-hypoglycemia enjalo ingaba yingozi kuhlobo 2 lwesifo sikashukela ngesilinganiso esiphakeme sokulondolozwa komsebenzi we-pancreatic. | |
| I-hypoglycemia esebenzayo ngenxa yokudla isikhathi esisodwa inani elikhulu lama-carbohydrate asheshayo | Ama-pancreas aphendula ekukhuphukeni ngokushesha kweshukela ngokukhishwa kwengxenye ye-insulin ene-reservation. Ngenxa yalokhu, ushukela wegazi uyancipha, umzimba udinga ama-carbohydrate amasha ukuze uqede i-hypoglycemia, umuzwa wokulamba. | |
| I-hypoglycemia yesikhashana | Kubonwa ezinganeni ezisanda kuzalwa ngensipho encane ye-glycogen. Izizathu ukubandlululwa, isifo sikashukela kumama, ukuzalwa okuyinkimbinkimbi nokulahlekelwa okukhulu kwegazi kumama noma i-hypoxia esibelethweni. Ngemuva kokuqala kokudla, amazinga kashukela enza ngokwejwayelekile. Ezimweni eziyinkimbinkimbi, i-transistor hypoglycemia isuswa ukuphathwa kwe-glucose kwe-intravenous. | |
| I-hypoglycemia yamanga | Ikhula uma ushukela oneshukela egazini ehla kakhulu kumanani asondele kokujwayelekile. Naphezu kwezimpawu ezifanayo ne-hypoglycemia yeqiniso, lesi simo asiyona ingozi. | |
| Okwe-Pathological | ||
| Ukuphelelwa ngamandla noma ukomisa | Lapho i-glycogen iwela ezingeni elibucayi, ngisho nakubantu abaphilile, i-hypoglycemia enzima ivela. | |
| Isifo sesibindi | Umsebenzi wesibindi ongasebenzi kahle uholela ekufinyeleleni okulimazayo i-glycogen depot noma ekunciphiseni kwayo. | |
| Izifo zesistimu ye-Endocrine | I-Hypoglycemia iholela ekuntuleni kwama-hormone abandakanyeka ekusebenzeni kwe-glucose: i-adrenaline, somatropin, cortisol. | |
| Ukuphazamiseka kokugaya ukudla | Ukungangeni kahle kwama-carbohydrate ngenxa yezifo zesisu. | |
| Ukuntuleka kwe-enzyme noma isici | Izinqubo zamakhemikhali zokuqhekeka kashukela ziyaphazamiseka, ukuntuleka kokudla kwamaseli kunxephezelwa ngokunciphisa ushukela egazini. | |
| Ukwehluleka kwangempela | Ukufakwa ushukela okubuyela emuva kuyenziwa buthaka, ngenxa yalokho kukhishwa umchamo. | |
| I-Alcoholic hypoglycemia | Lapho udakiwe, wonke amandla esibindi ahlose ukuqeda ukudakwa, i-glucose synthesis iyavinjwa. Kuyingozi kakhulu kushukela ushukela utshwala ngaphandle kokudla okulula noma ngokudla okune-carb ephansi. | |
| I-Insulinoma | I-pancreatic tumor ekhiqiza inani elikhulu le-insulin. | |
Esikhathini sikashukela, amaphutha ekwelashweni nawo angaholela ku-hypoglycemia:
- I-overdose ye-insulin noma izidakamizwa ezinciphisa ushukela.
- Ngemuva kokuthatha umuthi, isiguli sikashukela sikhohlwa ukudla.
- Ukusebenza kahle kwe-glucometer noma ukuphathwa kwe-insulin.
- Ukubalwa okungalungile komthamo wezidakamizwa udokotela wakho noma isifo sikashukela - ukubalwa komthamo we-insulin.
- Indlela engalungile yokujova - ungayifaka kanjani i-insulin.
- Ukufaka esikhundleni se-insulin esezingeni eliphansi ngentsha, ngesenzo esingcono. Ukuguqulwa kwe-insulin emfushane kuya ku-ultrashort ngaphandle kokulungiswa komthamo.
Yiziphi izimpawu eziqaphelekayo
Ubunzima bezimpawu bukhuphuka njengoba ushukela wegazi ehla. I-hypoglycemia emnene idinga ukwelashwa kungakapheli isigamu sehora ngemuva kokuqala, ngaphandle kwalokho ukwehla kwe-glucose kuyaqhubeka. Kaningi, izibonakaliso zishiwo impela futhi zibonakala kalula ezigulini. Nge-hypoglycemia ejwayelekile, amazinga ashukela aphansi njalo, kubantu asebekhulile futhi onesifo sikashukela esibalulekile, izimpawu zingasuswa. Ezigulini ezinjalo, amathuba okuba ne-hypoglycemic coma aphezulu kakhulu.
| Isigaba se-hypoglycemia | Izinkomba zikashukela, mol / l | Amathuba okuyeka | Izimpawu |
| Easy | 2.7 <GLU <3.3 | Isuswa kalula yisiguli sikashukela. | Ukuqina kwesikhumba, ukuthuthumela kwangaphakathi nokuthuthumela kweminwe, isifiso esinamandla sokudla, ukukhathazeka okungenampilo, isicanucanu, ukukhathala. |
| Isilinganiso | 2 <GLU <2.6 | Izidingo zosizo ezivela kwabanye | Ubuhlungu bekhanda, ukunyakaza okungahambelani, ukuqina kwemilenze, izingilazi ezihlanjululwe, ukukhuluma okungahambi kahle, i-amnesia, imvuthuluka, isiyezi, ukusabela okunganele kulokho okwenzekayo, ukwesaba, ulaka. |
| Isindayo | I-GLU <2 | Kudingeka ukunakekelwa kwezokwelapha ngokushesha | I-Hypertension, ukwazi ukungasebenzi kahle, ukukhubazeka, ukuphefumula kanye nokuphazamiseka kwenhliziyo, ukoma. |
I-Hypoglycemia ephusheni ingaqashelwa ngokunamathela, isikhumba esibandayo, ukuphefumula kaningi. Isiguli sikashukela siphaphama ebuthongweni obuphazamisayo, ngemuva kokuvuka sizizwa sikhathele.
Ungayinikeza kanjani usizo lokuqala
Lapho nje umuntu onesifo sikashukela ezwa noma yiziphi izimpawu ezingabangelwa yimiphumela ye-hypoglycemia, ngokushesha kufanele alinganise ushukela wegazi. Ukuze wenze lokhu, njalo ube ne-glucometer ngemivimbo kanye nawe. Usizo lokuqala lwe-hypoglycemia ukuphathwa ngomlomo kwama-carbohydrate asheshayo. Ukukhuphuka ushukela okulula, lokhu kwanele ukuguqula isimo sesiguli sibe ngokuphelele.
Ushukela ophansi ngaphambi kokudla akusona isizathu sokuhlehlisa ukwelashwa kwe-hypoglycemia ngethemba lokuthi ama-carbohydrate azoliqeda ekudleni. Ukudla sikashukela kuhlinzeka ngomkhawulo obalulekile woshukela wokugaya kalula, ngakho-ke i-hypoglycemia ingaqina nangaphambi kokuba ukudla kugaywe.
Ukukhululeka kwe-hypoglycemia ekuqaleni kwentuthuko kwenziwa kusetshenziswa amaphilisi eglucose. Zisebenza ngokushesha kunezinye izindlela, ngoba ukumuncwa egazini ngesikhathi sokusetshenziswa kwazo kuqala ngisho nasekhaleni lomlomo, bese kuqhubeke emgudwini wesisu. Ngaphezu kwalokho, ukusetshenziswa kwamathebulethi kwenza kube lula ukubala umthamo we-glucose, ozosusa i-hypoglycemia, kepha ngeke kuholele ku-hyperglycemia.
Ngokwesilinganiso, kumuntu onesifo sikashukela esinesisindo esingu-64 kg, i-1 g kashukela inyusa ukwanda koshukela wegazi ngo-0.28 mmol / L. Uma isisindo sakho sikhulu, ungbala umphumela cishe wethebhulethi kashukela kumanani kashukela usebenzisa ingxenye ephikisanayo.
Ngesisindo esingama-90 kg, kuzokwenyuka ama-64 * 0.28 / 90 = 0,2 mmol / l. Isibonelo, ushukela wehle waya ku-3 mmol / L. Ukuyiphakamisa ibe ngu-5, uzodinga (5-3) / 0,2 = 10 g kashukela, noma amaphilisi angama-20 ka-500 mg.
Amaphilisi anjalo awabizi, athengiswa kuwo wonke amakhambi. Esikhathini sikashukela, kungakuhle ukuthenga amaphakethe amaningana ngesikhathi esisodwa, uwafake ekhaya, emsebenzini, kuzo zonke izikhwama nasemaphaketheni wezingubo zangaphandle. Ukuqeda i-hypoglycemia, ushukela osezibhebheni kufanele ube nawe njalo.
Nge-pinch, ushukela ungavusa ngokushesha:
- I-120 g yejusi elimnandi;
- pair of ushokolethi noma izingcezu ushokolethi;
- Ama-2-3 ama-cubes noma wezipuni eziningi ushukela ocoliweyo;
- 2 tsp uju;
- 1 ubhanana
- 6 izinsuku.
Izimpawu ze-hypoglycemia kushukela zingenzeka phakathi kwehora ngemuva kokujwayelekile ushukela. Akuyona ingozi futhi akudingi ukuthi kudliwe amaswidi.
Ungayelapha futhi uyiyeke kanjani i-hypoglycemia?
Uma isiguli sikashukela sesivele siqalile ukulamba kwengqondo, asikwazi ukuzisiza. Kunzima ukwelapha ukwephulwa kwekhono lokuhlafuna ukudla, ngakho-ke i-glucose kuzofanela inikezwe ifomu eluketshezi: kungaba umuthi okhethekile ovela ekhemisi, noma ushukela noma uju oxutshwe namanzi. Uma kunenkambiso yokuthuthuka, ngaphezu kwalokho isiguli kufanele sinikezwe cishe ama-15 g wama-carbohydrate ayinkimbinkimbi. Kungaba isinkwa, iphalishi, amakhukhi.
Lapho umuntu onesifo sikashukela eqala ukulahlekelwa ingqondo, akakwazi ukunikwa ushukela ngomlomo ngenxa yosongo lwe-asphyxiation. Kulokhu, ukwelashwa kwe-hypoglycemia kwenziwa ngokusebenzisa injekiseni ye-glucagon noma ye-subcutaneous. Lesi sidakamizwa sithengiswa ekhemisi njengoba izinsizakusebenza zesifo sikashukela esiphuthumayo. Ikhithi ifaka icala lepulasitiki, isirinji ene-solvent kanye nebhodlela le-glucagon powder. Isembozo se-vial sibhobozwa ngenaliti, kukhiqizwa uketshezi kuyo. Ngaphandle kokufika kwenaliti, i-vial inyakaziswe kahle, futhi umuthi ubuthwa ubuyiselwe kwisirinji.
I-Glucagon igqugquzela ukukhuphuka koshukela, okwenza isibindi nezicubu ziyeke izinsalela ze-glycogen. Kungakapheli nemizuzu emi-5 ngemuva komjovo, isiguli kufanele sibuyele ukwazi. Uma lokhu kungenzeki, idepho likashukela esigulini selivele liphelile futhi umjovo wesibili ngeke usize. Udinga ukubiza i-ambulensi, ezojova ushukela emzimbeni.
Uma isifo sikashukela singcono, ngemuva kwemizuzu engama-20 uzokwazi ukuphendula imibuzo, kuthi ngemuva kwehora, cishe zonke izimpawu zizonyamalala. Kungakapheli usuku ngemuva kokuphathwa kwe-glucagon, ushukela wegazi kufanele unikezwe ukunakwa okwengeziwe, njalo emahoreni ama-2 usebenzisa i-glucometer. Ukwehla okuphindaphindiwe kwezinkomba ngalesi sikhathi kungashesha futhi kubulale.
Okufanele ukwenze lapho umuntu onesifo sikashukela ekhala:
- Uma kune-glucometer, linganisa ushukela.
- Ngezinga eliphansi, zama ukugcwalisa uketshezi olumnandi emlonyeni wakhe, uqiniseke ukuthi isiguli siyamgwinya.
- Uma ingekho i-glucometer, kufanele kucatshangwe ukuthi ukunika ama-carbohydrate kumuntu onesifo sikashukela akuyona ingozi kunokuba ungayiniki.
- Uma ukugwinya kungasebenzi, faka i-glucagon.
- Beka isiguli ngasohlangothini lwaso, ngoba singathola ukuhlanza.
- Uma isimo singathuthuki, shayela i-ambulensi.
Kuyini ubungozi?
Uma kungekho usizo, kuba ne-hypoglycemic coma, ngenxa yokuntuleka kokudla, amaseli obuchopho aqala ukufa. Uma izindlela zokuvuselela kabusha zingakaqali okwamanje, imiphumela ye-hypoglycemia ebulalayo ingabulala.
Iyini ingozi ye-hypoglycemia emnene:
- Iziqephu ezivame ukwenziwa zenza ukuthi izimpawu zisulwe, okwenza kube lula ukuphuthelwa ushukela omkhulu.
- Ukungondleki kahle njalo kwengqondo kuthinta amandla okukhumbula, okuhlaziya, okucabanga ngokunengqondo.
- Ingozi ye-ischemia ne-myocardial infarction iyakhula.
- Kukhona i-angiopathy yezingalo ne-retina.
Icala ngalinye le-hypoglycemia lidinga ukuhlaziywa ngokucophelela, imbangela yalo ikhonjwe futhi iqedwe. Ngenxa ye-amnesia, lokhu akwenzeki ngaso sonke isikhathi, ngakho-ke, ngesifo sikashukela, kubalulekile ukugcina idayari. Kukhombisa ukushintshashintsha koshukela phakathi nosuku, inani lamakhrayubhu adliwayo nezidakamizwa ezitholakele, umsebenzi ongokomzimba ongajwayelekile, amacala okuphuza utshwala kanye nokwanda kwezifo ezihambisanayo kuyaqoshwa.
