I-Hypoglycemic coma kubantu abadala nasezinganeni: usizo lokuqala, ukwelashwa

I-Hypoglycemic coma yisimo esibucayi somzimba womuntu esenzeka ngenxa yokwehla okukhulu kokuxineka kwe-glucose egazini. Kudinga ukunakekelwa okuphuthumayo kwezokwelapha, njengokungathi kubambezelekile, kungaholela ekufeni.

Lapho unikeza izindlela zokuqala zokubuyisela, kuyadingeka ukucacisa lesi simo futhi uhlukanise i-hypoglycemia kusuka ku-hyperglycemia. Imvamisa, ukunakekelwa kwezokwelashwa okungalungile okwenziwe ngokungafanele kuba yimbangela yokuthuthuka kwama-pathologies angathi sína wezinzwa noma izinzwa zenhliziyo.

Izizathu

I-Hypoglycemia yinto eyenzeka lapho amazinga eglucose egazini ehla ngaphansi kuka-3.5 mmol / litre. Lesi simo singabangelwa yizizathu ezilandelayo:

1. Ukunganakwa isikhathi eside kwe-hypoglycemia;
2. Ukuphuza utshwala obuningi;
3. Ukwethulwa kwemithamo emikhulu ye-insulin;
4. Ukuthatha umuthi othile;
5. Ukuzivocavoca ngokweqile;
6. Ukudla okulinganiselwe okulinganiselwe.

Esikhathini esiningi samacala, i-hypoglycemic coma yandulelwa wumjovo we-insulin. Lo mphumela ukhombisa inqubo engalungile.

Odokotela bakhombe amaphutha alandelayo ajwayelekile lapho, ngenxa yokungazinaki, isiguli sibhekene nalesi simo:

• Ukwephulwa komthamo: esikhundleni se-PIECES / ml ebekiwe engu-40, isiguli sizethula ama-PIECES ayi-100 / ml. Lokhu kuphindwe izikhathi ezi-2,5 kunokwejwayelekile futhi kuqinisekisiwe ukuthi kungaholela emiphumeleni enjalo.
• I-insulin ihlala iphethwe kuphela ngaphandle kokuzenzela. Abanye uma bejovwe faka izicubu zomzimba, yingakho isenzo sezakhi ezisebenzayo sishesha kakhulu.
• Ngemuva komjovo, isiguli sikhohlwa ukudla ukudla okunama-carbohydrate amaningi.
• Udokotela akazikhathaleli izifo ezingapheli zeziguli: ukonakala kwamafutha, ukuqina kwesibindi kanye nokuhluleka kwezinso kunciphisa kakhulu inqubo yokususa i-insulin emzimbeni.
• Isiguli sibandakanyeka imithwalo esindayo kakhulu noma singabheki izinga lakhe lokukhula komzimba nhlobo.

Izimpawu

I-Hypoglycemic coma ibonakala ngentuthuko esheshayo. Kodwa-ke, inkambo yayo isengahlukaniswa izigaba ezihlukile.

Odokotela banamathela kulesi sigaba esilandelayo:

1. Isigaba sokuqala - ngalesi sikhathi umzimba womuntu uthola ukubulawa yindlala komoya-mpilo, okuyingozi ku-cortex ye-cerebral. I-Hypoxia yamaseli wesistimu yezinzwa eyinhloko, yingakho imizwa yomuntu ishintsha kakhulu. Uyacasuka noma acindezeleke. Futhi, iziguli zikhononda ngekhanda, umuzwa wokukhathazeka, ubuthakathaka bemisipha. Abanye abantu, bebhekene nesizinda sokunciphisa amazinga kashukela, bazizwa indlala, ukunyuka kwengcindezi, izinga lokushaya kwenhliziyo liyancipha, nesikhumba sibe mnyama.
2. Esigabeni sesibili, ushukela ophansi ubangela ukulimala esifundeni esingaphansi kwengqondo. Ingabonakala ngokuthokozela okwenziwe ngemoto, ukuvevezela ebusweni, ukuziphatha okungafanele kanye nediplopia.
3. Isigaba sesithathu sibonakaliswa ngumonakalo womsebenzi wobisi lwebeleba. Ngenxa yalokhu, ukuqhutshwa kwe-magnesium kuyaphazamiseka, okuholela ekutholakaleni kokukhalaza okuphikisana nesizinda sokukhuphuka kwetoni yemisipha. Ukuquleka okuvela ngezikhathi ezithile kungafana nesithuthwane, ngoba izitshudeni ezisemuntwini zanda kakhulu. Ukuthukwa kanye ne-tachycardia kuyanda.
4. Esigabeni sesine, kukhona ukwephulwa okukhulu ekusebenzeni kwezingxenye ezingenhla ze-medulla oblongata. Umuntu ulahlekelwa ukwazi, ama-tendon ekhombisa kanye nokwanda kokushisa komzimba. Amaconsi omjuluko obandayo nawo abonakala ebusweni bakhe, ukushaya kwakhe nomfutho wegazi ukhuphuka kakhulu, ukuphefumula kwakhe kuvamile. Kusezigabeni ezi-4 lapho umuntu awela ku-hypoglycemic coma.
5. Isigaba sesihlanu, esokugcina, sithinta izingxenye ezingezansi ze-medulla oblongata. Banesibopho sokuqondisa emzimbeni. Ngenxa yalokhu, umuntu uba nethambo. Ngenxa yalokhu, udokotela uphetha ngokuthi izinqubo ze-pathogenic ziholele ekwehleni kwezwi lemisipha, ukuqeda ukujuluka ngokweqile, ukwehla kwengcindezi nokuphazamiseka kwesigqi senhliziyo.

Uma uletha isimo somuntu esigabeni sesihlanu, kukhona ingozi enkulu yokufa. Ukwehla okukhulu kwamazinga kashukela egazini kungadala i-edema yamakhorali, lapho i-cortex ibhujiswa khona. Ngokuzayo, lokhu kuzothinta zonke izinqubo emzimbeni.

Izimpawu zokuqala ze-cerebral edema zingabonakala ngokwehluleka kokuphefumula, umkhuhlane, ushintsho kwezinga senhliziyo, isicanucanu nokuhlanza.

Futhi, umuntu angaba nemiphumela yesikhathi eside. Imvamisa zingabonakala kuphela ngemuva kwezinyanga ezimbalwa. Imvamisa abantu abaye babhekana nesifo sokuwa kwe-hypoglycemic coma isipiliyoni, i-encephalopathy, noma i-parkinsonism.

I-Hypoglycemic coma ezinganeni

Umgomo wokuthuthuka kwe-hypoglycemic coma ezinganeni ufana ncamashi nakwabantu abadala. Bangakwazi ukucunula lo mkhuba ngokudla isikhathi eside yindlala noma ukudla okunama-kilojoule amancane, kanye nokuphathwa kwe-insulin okungalungile noma imiphumela yezifo ezingamahlalakhona.

Futhi, imbangela ingaba ukungondleki noma ukuntuleka kwama-enzyme. Ikhompyutha ene-hypoglycemic ezinganeni iyingozi enkulu, ngoba akuvamisile ukuthi ibonakale esigabeni sokuqala. Ingane ayikwazi ukuchaza kahle nangokucacile ukuthi yini okumkhathaza.

Ngokuvamile, abazali baqala ukukhala i-alamu lapho izingane zabo ziqala ukukhombisa ukukhathazeka noma zikhalela ngokweqile. Ngenxa yobuhlungu obukhulayo esiswini, isifiso sabo sokudla sinciphile noma asikho ngokuphelele. Indlala iyisibonakaliso ngqo sokukhula kwe-hypoglycemia. Ngokuhamba kwesikhathi, izingane ziba yisifo esibulalayo, sokungathintani, nokunganaki konke okwenzekayo. Zonke lezo zinguquko kufanele ziqiniseke ukuthi zazise noma yimuphi umzali.

Inkampani ye-hypoglycemic ezinganeni, njengakudala, yandulelwa ukwehla ngokweqile kwesikhumba, ukwethuka kwemikhawulo, ukukhuphuka kokujuluka. Nganoma yikuphi ukunyakaza okungazelelwe, kukhula isimo sokukhubazeka, ingane ilahlekelwa ukuqaphela imizuzwana eminingana.

Kumele kukhunjulwe ukuthi ukubonakaliswa kwalesi simo ezinganeni kukhula ngokushesha okukhulu kunakwabadala. Izimpawu zalesi simo azifani nhlobo. Ngokushesha lapho ubiza i-ambulensi, iba yingozi enkulu yokulondolozwa komzimba okujwayelekile.

Ukuxilonga

Ezigabeni zokuqala, kunzima ukuthola i-hypoglycemic coma. Izimpawu zalesi simo zingahlanganiswa kalula nezinye izifo, ngenxa yokuthi umuntu akakutholi ukwelashwa okudingekile. Okokuqala, kuyadingeka ukuhlola ukubona komuntu, ukukala ingcindezi yakhe, ukushaya ngamandla, ukuhlola isimo esijwayelekile. Kodwa-ke, ukusho ngokunembile ukuthi ngabe lokhu kungukukhohlisa kwe-hypoglycemic noma cha, ukuhlolwa kwegazi okujwayelekile kuphela.

Ngokuvamile kukhombisa imiphumela elandelayo:

• Izimpawu zokuqala zivele ngisho nalapho izinga likashukela wegazi lehla ngaphansi kuka-3.5 mmol / L.
• Lapho ushukela wehlela ku-1.66-2.77 mmol / L, zonke izimpawu ze-hypoglycemia ziyavela kumuntu.
• Ekuqoqweni ushukela okuyi-1.38-1.65 mmol / l, umuntu ulahlekelwa ukwazi.

Lapho uthola isimo se-hypoglycemic, ukunquma izinga lokuncipha kwe-glycemia kubaluleke kakhulu. Uma isiguli singenayo ushukela othembele ku-insulin, ikhula nge-glycemia eyandisiwe noma ejwayelekile - 11.1 mmol / litre. Lokhu kwenzeka uma ukwehla kwenzeka ngamazinga aphezulu kakhulu.

Ezinye izifundo zokuxilonga i-hypoglycemic coma azibalulekile. Akukho glucose kumchamo, ukuhlaziywa kwe-biochemical kukhombisa ukwehla kokuxineka kwama-enzyme wesibindi. Ukuxilongwa kwenziwa kuphela ngemuva kokuthi i-glycemia ephansi iqinisekisiwe.

Usizo lokuqala

Imvamisa kulesisimo, ukwenza ngcono inhlala-kahle yesiguli, kwenziwa okukhohlisa okulandelayo:

1. Unikezwa okuthile okumnandi nokuqukethwe ushukela omningi: itiye, ikofi, uswidi, u-ayisikhilimu, ujusi omuncu.
2. Isiguli sibekwa ilele noma sihlaliswe phansi ukuze sinikeze ukuhamba komoya okungahambeki. Uma isiguli siphelelwa yithemba, sibekwa eceleni kwakhe. Lokhu kwenziwa ukuze kuthi uma kungahlanzwa kungaxokiwe. Faka ucezwana kashukela esihlathini.
3. Ngemuva kwalokhu, kufanele ushayele i-ambulensi ngokushesha.

Okusebenzayo kakhulu ekumiseni ukuhlaselwa kwe-hypoglycemic coma yisisombululo sikashukela. Ingasetshenziswa kuphela uma umuntu azi. Ukulungiselela umuthi onjalo, kuyadingeka ukuncibilikisa izipuni ezimbalwa kashukela engilazini yamanzi abilisiwe.

Uma ngabe uyazi ngesifo somuntu futhi unolwazi lwezokwelapha, ungamnika ikhiyubhu ye-adrenaline nekhambi le-glucose ye-intravenous. Kodwa-ke, khumbula ukuthi yonke imiphumela izoba kuwe.

Ukwelashwa

Uma usola ukuqala kokuhlasela ngendlela esifike ngesikhathi, ungakuvimba ngokwakho. Ukuze wenze lokhu, vele udle isinkwa esincane bese uphuza isiphuzo esiphundu: itiye noma isixazululo soshukela esijwayelekile.

Ungadla futhi okunye ukudla ngama-carbohydrate asheshayo: uju, amaswidi, ufulawa, ukubila. Thatha ukudla ngezikhathi ezithile zemizuzu eyi-10-15 kuze kube yilapho sekuhlwile ngokuphelele. Uma kungekho mphumela, shayela udokotela ngokushesha.

Uma umuntu ehlulekile ukuthola ukuthi i-hypoglycemic isesikhathini esifanele, odokotela abaqeqeshiwe bazohlinzeka ngosizo. Ezimweni ezinzima kakhulu zokulahlekelwa ukwazi, isiguli sifakwa ngekhambi le-glucose ngaphakathi. Imvamisa lokhu kwanele ukubuyisela umsebenzi ojwayelekile womzimba. Uma ngemuva kwemizuzu engu-15 akukho ukuthuthuka okulandelile, uchwepheshe uphinda inqubo, kepha nge-Drip.

Ukuphathwa kwe-1 ml ye-glucagon nakho kubekwe ngaphakathi, ngaphakathi nangokuxhunyaniswa ngokuqondile. Izinyathelo ezinjalo zisiza ukubuyisela umuntu ekuqapheleni emizuzwini eyi-10-20. Uma kunesidingo, ukuphathwa kwe-glucagon kungaphindwa.

Ngenkambo enzima kakhulu ye-hypoglycemic coma, isiguli sinqunyelwe ukuphathwa kwe-intramuscular or intravenous of 150-200 ml ye-hydrocortisone. Kuyasiza ukubuyisa ama-pancreas. Uma isiguli singaphindi sazi, uyaqhubeka nokufakwa ngekhambi le-glucose ngaphakathi.

Ukuvimbela ukuthuthukiswa kokuvuvukala kwamadoda, uchwepheshe wethula isisombululo se-mannitol esigulini. Kuyasiza ukuguqula izinqubo ze-metabolic ngokwejwayelekile, futhi futhi kuvimbele ukuzuma. Uma kunesidingo, izidakamizwa zenhliziyo ziyenziwa. Ngemuva kokumiswa, umuntu uhlala ngaphansi kokugadwa udokotela izinsuku eziningana.

Ukuvimbela

Ukuvimbela i-hypoglycemic coma ukuhambisana nayo yonke imiyalo kadokotela obonayo. Abantu abanenkinga yesifo sikashukela kufanele basebenzise umuthi ngendlela emiselwe umthamo kanye nohlobo olukhethwe ngokuqinile.

Kuyadingeka futhi landela ukudla okukhethekile futhi ubheke ukuqina kwanoma yimuphi umsebenzi womzimba.

Zama ukubhekana nengcindezi nengcindezi engokomoya ngangokunokwenzeka. Kungathinta kabi ukusebenza kwawo wonke amaqhubu alawulayo.

Ngaphambi kokuphuma endlini, qiniseka ukuthi une-uswidi oluthile, ushukela noma ucezu lwesinkwa olujwayelekile eduze. Uma uhlangabezana nokuhlaselwa kwe-hypoglycemic coma ngezikhathi ezithile, qiniseka ukuthi uphatha imemo nawe ngalesi sifo. Ngakho-ke kuzoba lula ukuthi odokotela abezokusiza, basheshe baqale ukukunikeza usizo oludingekayo.

Zama ukuhola indlela yokuphila enempilo, uyeke ukuzila ukudla uphuze njalo ama-vitamin complexes. Futhi, ungakhohlwa ukwenza njalo ukuhlola kweglue, kanye nokulandela zonke izincomo zikadokotela wakho.