I-glucose ingesinye sezingxenye ezibalulekile zegazi. Inikeza ukusebenza okugcwele komzimba, kungumthombo wamandla ubuchopho, izicubu namaseli egazi. Ukuqhutshwa kwayo kwenziwa ngendlela yokugaya ukudla. Abantu abaningi bayakhathalela umbuzo: ukuthi benzeni ngoshukela wegazi 32.
Uma umuntu ephilile, amanani ajwayelekile akufanele adlule amayunithi ayi-6.1. Angaxhomekeki ebulilini noma indlela yokuthatha izinto eziphilayo ukuze ayitadishe. Ekhula ngobudala bomuntu, kwehlisa ukuzwela kwakhe ku-insulin.
Kuyabhekwa ukuthi lapho uthatha igazi le-capillary ne-venous, izinkomba zihlukile. Uma isilinganiso segazi le-venous sisezingeni le-3.5-6.1, khona-ke igazi le-capillary lifinyelela kumayunithi angama-5.5. Kwesinye isikhathi ukuhlaziya kuthonywa yizici zangaphandle. Uma amanani ephezulu kakhulu, udokotela uthumela ukulethwa kwesibili kwezinto eziphilayo.
Kungani ushukela wegazi ukhuphukela kumayunithi angama-32?
Amanani aphezulu anjengalawa angaqalwa ngokungasebenzi kahle kwama-pancreas noma ezinye izakhiwo. Ngokuvamile, imbangela ihambisana nokukhula kwezifo ze-endocrine ezihambisana nokufakwa kweglucose. Lesi sifo siveza ukuntuleka kwe-insulin okuyinhlekelele. Le yi-hormone ekhiqizwa indlala enkulu kunazo zonke emzimbeni. Unesibopho sokuqhekeka okufanele kweshukela.
Ushukela emayunithi angama-32. ingavela lapho:
- Ukuwohloka okulimazayo kwamaseli we-pancreatic;
- Amazinga aphakeme we-hydrocortisone;
- Ukuthatha umuthi othile.
Odokotela bathi lapho ushukela uphezulu kakhulu, lokhu kuyinkomba ebucayi. Isifo sikashukela esinesifo sikashukela singenzeka ngamanani aphansi. Lo mphumela uvame ukuthuthuka ngaso leso sikhathi. Izimbangela zakhe zangaphambili zinobuhlungu bekhanda, ubuthakathaka, umuzwa onamandla wokoma nokungakhululeki emgodini wesisu. Lesi sakamuva sihambisana nokuba nenhliziyo noma ukuhlanza.
Yini okufanele uyenze lapho ushukela wegazi ukhuphukela emazingeni abucayi?
Kunemithetho embalwa okufanele uyilandele:
- Shayela i-ambulensi khona lapho. Lokhu kumele kwenziwe lapho kuvela izibonakaliso zokuqala ezikhonjwe ngaphezulu.
- Ezimweni ezingenzima, isiguli sinikezwa ukudla izingcezu ezimbalwa zoshukela noma amakhukhi. Ngefomu elincike ku-insulin, ngaso sonke isikhathi kufanele ube namaswidi.
- Ezimweni ezinzima (ukuthuthumela, injabulo yenjabulo, ukujuluka ngokweqile), uthele itiye elifudumele emlonyeni wesiguli. Engilazini ye-ketshezi udinga ukwengeza izipuni ezingama-3-4 kashukela. Le ndlela iyalulekwa uma isiguli sesigwinyile ukusebenza.
- Uma usola ukuthathwa, faka iligi phakathi kwamazinyo akho. Lokhu kuzogwema ukucindezelwa okubukhali kwemihlathi.
- Lapho umuntu ezizwa engcono, umondle ukudla ngama-carbohydrate amaningi. Kungaba izithelo, okusanhlamvu okuhlukahlukene.
- Uma kwenzeka ulahlekelwe yimizwa, ushukela kufanele uphathwe ngaphakathi.
Lapho kuqala ukomisa, beka isiguli ngaphakathi, faka i-duct yomoya ukuvimbela ukuhoxiswa kolimi. Uma kungenxa kashukela osegazini 32 ungeke uqonde ukuthi umuntu uyaqaphela yini, mbuze umbuzo olula. Ungashaya kancane izihlathi bese uxubha izindlebe. Uma kungekho okunye ukusabela, kungenzeka ukuthi umphumela ongalungile uphezulu.
Ngemuva kokufika kwe-ambulensi
Ukuqeda ukwephulwa kokwakheka kwe-electrolyte nokubuyisa ibhalansi yamanzi, amaconsi nge:
- Potassium chloride. Kufika kuma-300 ml wesisombululo se-4%.
- I-Sodium bicarbonate. Umthamo ubalwa ngawodwana.
- I-sodium chloride. Kuze kufinyelele kumalitha langu-5 emahoreni langu-12.
Ukuthi wenzeni nge-ketoacidosis?
Njengoba amazinga kashukela ekhuphuka aze afike ku-32, kungavela i-ketoacidosis yesifo sikashukela. Umzimba uyeka ukusebenzisa i-glucose njengomthombo wamandla, kusetshenziswa amafutha esikhundleni salokho. Lapho amangqamuzana ehlukana, kutholakala imfucumfucu (ama-ketones), aqongelela emzimbeni bese iwubulala. Imvamisa, i-pathology ivela kubantu abanesifo sikashukela sohlobo 1.
Ukuhlolwa kwe-urinalysis kuzosiza ukukhomba i-pathology. Uzobonisa amazinga aphezulu ama-ketones. Nge-pathology enzima enezimpawu zesifo sikashukela, ukunakekelwa esibhedlela kwesiguli kunqunyelwe.
Kuthunyelwe:
- UMethionine;
- Okubalulekile;
- Ama-Enterosorbents.
Ngaphezu kwale mishanguzo, kulungiswa umthamo we-insulin. Ingahanjiswa izikhathi ezi-6 ngosuku. Ukwelashwa kokufakwa nge-saline nakho kunqunyelwe. Umphumela walokhu kugula uba yi-hyperosmolar coma.
Ukuthuthukiswa kwe-Hyperosmolar coma
Ngalesi sifo, inani likashukela lenyuka laya ku-32 nangaphezulu. Cishe ukuyihlakulela ngohlobo 2 sikashukela sabadala. Ukuphefumula okunjalo kukhula izinsuku noma amasonto ambalwa. Kubalulekile ukunaka izimpawu zokuqala, ezifaka ukuchama okuvamisile. Isici ukukhubazeka kwamaqembu athile wesikhumba semisipha.
Isiguli sidluliselwa ophikweni olunakekelwa kakhulu. Ngenqubo yokwelashwa, kwenziwa njalo ukubhekwa kombuso, okubandakanya ukuqapha izinkomba ezisegazini, izinga lokushisa lomzimba kanye nedatha yaselebhu.
Uma kunesidingo, umuntu uxhumeke ekufakweni kwamaphaphu okufakelwa, i-bladder is catheterized. Lapho ushukela ukhuphuka ube amayunithi angama-32, ukuhlaziya okubonakalayo kweglucose yegazi kwenziwa kanye njalo ngemizuzu engama-60 nge-glucose engene noma njalo emahoreni amathathu ngokuphathwa kokufakelwa.
Ngokubuyiselwa emzimbeni, kwethulwa i-sodium chloride ne-dextrose. Izidakamizwa ezisebenza ngokufishane zisetshenziselwa ukuqinisa isimo. Lokhu kufaka i-insulin engcolisiwe. Kungaba yi-semi-synthetic noma i-genetic engineering yomuntu.
I-ketoacidotic coma
Kuvame ukutholwa ezigulini ezinesifo sikashukela sohlobo 1. Ingakhula emahoreni ambalwa. Uma usizo lunganikezwanga ngesikhathi, khona-ke ukudakwa kwengqondo ngezimpawu kuholela ekuhlaselweni yisifo senhliziyo, inyumoniya, i-sepsis noma i-edema ye-cerebral edema. Umphumela wokwelapha ufaka, njengasesimweni esidlule, ukopha kabusha, ukwelashwa kwe-insulin, ukubuyiselwa kwemali esele ye-electrolyte.
Ukuvuselelwa komzimba kususa izinkinga ezingenzeka. Kulokhu, uketshezi lomzimba lwethulwa ngesimo se-glucose nekhambi le-sodium chloride. I-glucose isiza ukulondolozwa kwe-osmolarity yegazi.
Ukubuyisela ibhalansi ye-electrolyte kanye ne-heestasis kuyingxenye ebalulekile yokwelashwa. Ngokusebenzisa imijovo ekhethekile, ukuntuleka kwe-calcium ne-acidity acid kuyabuyiselwa. Lokho kuqinisekisa ukusebenza okujwayelekile kwezinso.
Kwesinye isikhathi ukoma luhambisana nezifo zesibili. Imishanguzo ebanzi ebanzi isiza ukubhekana nayo. Zingeniswa emzimbeni ukuvimba ubunzima. Ukwelashwa okubonakalayo nakho kubalulekile. Ukubuyisela isigqi senhliziyo nokususa imiphumela yokushaqeka, izindlela zokwelapha ziyenziwa.
Izici zokwelashwa kwe-insulin noshukela 32
Ukuchayeka kuphela kuma-hormone okungamisa ukubonakala kwezinqubo ezinzima ezingenakuphikiswa ezibangelwa ukuntuleka kwabo. Kwesinye isikhathi, ukuze kufinyelelwe izinga elifunekayo le-insulini ku-biological fluid, i-peptide hormone iphathwa ngokuqhubekayo ngokusebenzisa i-dropper yamayunithi angama-4-12. ngehora. Lokhu kugxila kuholela ekuvinjelweni kokuqhekeka kwamafutha, kumise ukukhiqizwa koshukela isibindi. Emithanjeni enjalo sikhuluma "ngemodi yemithamo emincane."
Le ndlela icishe ifane ngaso sonke isikhathi, ngoba ukwamukelwa ngasikhathi sinye kwenani elikhulu lezinto eziphila ngokusebenza kunganciphisa kakhulu amazinga we-serum glucose. Ngenxa yalokho, kungaba nemiphumela ebulalayo. Kwaphawulwa ukuthi ukwehla kakhulu kokuxineka kweglucose kungahle kuhambisane nokwehla kwe-serum potassium okuhlushwa. Lokhu kwandisa ingozi ye-hypokalemia.
Uma, ngenxa yokwanda ushukela kuya ku-32, isimo se-DKA senzeka, khona-ke ama-insulin asebenza ngokufushane asetshenziswa kuphela. Bonke abanye baphikiselwe isimo esinjalo.
Ukufakwa komuntu insimbi yomzimba kukhombisa umphumela omuhle, kepha lapho umuntu esesimweni sokukhubazeka noma isimo, ukukhetha kukomuthi kwenziwa ngokubheka isikhathi sokusebenza kwayo, hhayi uhlobo.
I-Glycemia ivame ukwehla ngesilinganiso se-4.2-5.6 mol / L. Uma ngesikhathi semizuzu yokuqala engama-360 ngemuva kokuqala kokudalulwa okunjalo akuphelanga, umthamo unyuka ufike ku-14 mol / L. Ijubane nomthamo kuncike esimweni sesiguli.
Lapho izinga lezimpawu ezibalulekile lizinzile, futhi i-glycemia izogcinwa ingabi ngaphezu kuka-11-12, ukudla kuyakhula, i-insulin iqala ukuphathwa hhayi ngokufakwa ngaphakathi, kepha ngokuzithoba. Umuthi obamba amafushane unqunywe ezingxenyeni zamayunithi ayi-10-14. njalo emahoreni ama-4. Kancane kancane, ukuguqukela ku-insulin elula kuhlangene nenketho yesenzo eside.
Ukondleka kwezokwelapha
Uma ushukela wegazi lomuntu usuvele ukhuphukile wafinyelela kuma-32, khona-ke zonke izinyathelo kufanele zithathwe ukuvimbela ukuthuthukiswa kabusha kwe-pathology. Ukondliwa okhethekile kwezokwelapha kuzosiza kulokhu. Uma kwenzeka isifo sikashukela sohlobo lwesibili kanye nokukhuluphala, ukudla okune-carb ephansi ngokufakelwa okwenziwe ngokungemthetho noma kwemvelo kumele kulandelwe ukushoda kwamaminerali namavithamini.
Kufanele ufake phakathi ekudleni kwakho kokudla okuqukethe ama-carbohydrate ayinkimbinkimbi, amafutha, namaprotheni. Ngokufanelekile, uma ukudla kuqukethe inkomba ye-glycemic ephansi.
Udinga ukuguqula imenyu yakho:
- Izithelo
- Imifino
- Inyama ethambile;
- I-Legumes.
Kuyadingeka ukuqapha ibhalansi yamanzi. Udinga ukuphuza amalitha amanzi ayi-1.5 ngosuku. Lapho ushukela wegazi ufinyelela amazinga aphakeme kakhulu, umzimba uqala ukuzama ukwehlisa izinga loshukela, uwususe ngomchamo. Amanzi ajwayelekile ngaphandle kwezengezo azosiza ekuxazululeni le nkinga, kodwa futhi akunakwenzeka ukukudlulela ngokweqile, ngoba kungenzeka uthole ukudakwa kwamanzi.
Ekuphetheni, siphawula: izinga likashukela kuma-32 amayunithi. kukhombisa ukungasebenzi kahle emzimbeni. Uma kungekho sinyathelo esithathwayo, kungenzeka ukuthi umuntu afe. Ukuzisiza akukunconyiwe ngoba izinguquko zesimo sempilo zingaphuthelwa. Ngakho-ke, kuqala kubizwa i-ambulensi, khona-ke zonke ezinye izinyathelo zithathwa.
