Isifo sikashukela sesifo sikashukela yisimo esibi lapho zonke izinqubo ze-metabolic ziphazamiseka emzimbeni womuntu.
Ingenzeka ngezizathu ezimbili eziphambili: i-hyperglycemia (ukukhuphuka okunamandla kakhulu koshukela wegazi), noma i-hypoglycemia (ukwehla okunamandla kwe-plasma glucose).
Lesi simo singakhula sobabili ngesifo sikashukela esincike ku-insulin nokungathembeki kwe-insulin.
Izinhlobo zokwehla kwesifo sikashukela, ukuhlukaniswa
Kunezinhlobo eziningi zokubekelwa kwesifo sikashukela:
- i-hyperglycemic;
- i-lactic acididemic;
- i-hypoglycemic;
- i-hyperosmolar;
- ketoacidotic.
I-Hyperglycemia
Lolu phawu luyinani le-glucose ephezulu. Kungabhekwa hhayi kuphela kwisifo sikashukela i-mellitus, ukuxilongwa kwe-endocrine nakho kungaba imbangela ye-hyperglycemia.
I-Hyperglycemia ingenzeka ngezindlela ezahlukahlukene:
- ukukhanya (izinga ushukela lifinyelela ku-6 kuye ku-10 mmol / l);
- isilinganiso (kusuka ku-10 kuye ku-16 mmol / l);
- esindayo (kusuka ku-16 mmol / l noma ngaphezulu).
Uma kumuntu ongatholakali onesifo sikashukela, amanani eglucose egazi afinyelela ku-10 mmol / L ngemuva kokudla okunzima, lokhu kukhombisa ukuthuthukiswa kwalesi sifo 2.
I-Hypoglycemia
Lesi simo sehlile ngokuqinile kushukela wegazi. Lesi sibonakaliso singazibonakalisa ngesimo esimnene nesinzima.
I-hypoglycemia emnene ingadala ukukhula kwezimpawu ezahlukahlukene ezingemnandi, njengoku:
- izibuko
- indlala yesikhumba;
- ethuthumela
- umuzwa wendlala enkulu;
- isicanucanu esiphikelelayo;
- Ukukhathazeka
- ubudlova;
- isiphazamiso;
- ukukhuphuka kokujuluka.
Ezimweni ezimbi kakhulu, kungavela lezi zimpawu ezilandelayo:
- ukudidiyela ngokuphelele esikhaleni;
- ubuthakathaka obuphikelelayo;
- iminyakazo
- ukungaboni kahle
- ikhanda elibuhlungu;
- umuzwa ongapheli wokukhathazeka nokukhathazeka;
- ukukhubazeka kwenkulumo;
- Isiyezi
- ukudideka kokwazi;
- imilenze ethuthumela;
- ukulahlekelwa ukwazi.
I-Hypoglycemia ingenzeka hhayi kubantu kuphela abatholakala benesifo sikashukela.
Iqembu lengcuphe lifaka abantu abaphilile impela, kepha ngaphansi kwezimo ezithile:
- ukusebenza ngokomzimba okukhulu kakhulu;
- ukuzila isikhathi eside.
I-Ketoacidotic
Lesi simo siyinkimbinkimbi yesifo sikashukela.
Izidingo zokuqala ukuthuthukiswa kwe-ketoacidosis yesifo sikashukela yile elandelayo:
- ukwephulwa ekwelapheni isifo sikashukela (ukuphathwa okungafanele kwe-insulin, ukuqashwa kwayo kungafanele, ukweqa, kanye nokwehluleka ukuthobela umthamo odingekayo);
- ukwephulwa kokudla okunqunyiwe (kwenzeka ngenxa yenani elikhulu lama-carbohydrate angaphakathi);
- ukulawulwa okunganele kokuhlushwa kwe-glucose egazini;
- ukubonakaliswa kwesifo sikashukela;
- ama-pathologies e-endocrine ahlukahlukene, ahambisana nokukhiqizwa kwamanani amaningi we-contra-hormonal mahormone.
Ngaphambi kokuthi kwenzeke ukoma, izimpawu ziqala ukukhula ezinsukwini ezimbalwa, kwesinye isikhathi lokhu kungenzeka ngaphakathi kosuku olulodwa. Lokhu kungokulandelayo:
- ukoma okukhulu;
- umuzwa ongapheli we-nausea;
- ubuthakathaka obujwayelekile;
- Ubuhlungu besisu
- izikhathi zokuhlanza;
- isifo sohudo
- ikhanda
- iphunga le-acetone elisuka emlonyeni;
- ukungahambi kahle;
- isikhumba esomile;
- ukulahlekelwa ukwazi, imvamisa kulandelwa yi-coma;
- ukuchama okungandile.
I-Hyperosmolar (non-ketoacidotic)
Lolu hlobo lwe-koma, njengomthetho, luphakama kuphela nge-mellitus engavikelekile nge-insulin ezigulini isigaba sazo sobudala esidlula iminyaka engama-50, noma ebuntwaneni.
Izici zobungozi zokuthuthukisa i-hyperosmolar coma:
- ngenxa yokusetshenziswa isikhathi eside kwama-diuretics nama-glucocorticoids;
- hemodialysis;
- ngenxa yembuyiselo enganele yesifo sikashukela;
- Izifo ezithinta umzimba ezenzeka ngokuphelelwa ngamanzi emzimbeni.
I-Hyperlactacidemic coma nemiphumela yako
Lolu hlobo lwe-coma luzibonakalisa lubukhali futhi lungabangelwa ukuqwabelana ngokweqile kwe-lactic acid emzimbeni. Kuwuphawu olunamandla lwesifo sikashukela, kwenzeka ikakhulukazi kubantu asebekhulile abane-pathologies enzima eyenzeka nge-tishu hypoxia. Kuvela futhi nokuxilongwa kwenhliziyo, isifo samaphaphu, isibindi nesifo sezinso.
Ngesikhathi se-precoma, ukuphazamiseka okuhlukahlukene kwe-dyspeptic kungabonakala, okungukuthi:
- ukuhlaselwa njalo kwenhliziyo;
- ukuhlanza
- i-anorexia;
- Ubuhlungu besifuba;
- ukuphazamiseka okuhlukahlukene kwesistimu yezinzwa ephakathi (ukungakhathali, izinhlungu zemisipha ngokuzikhandla okuhlukahlukene komzimba, ukuqwasha, isimo esijabulile, ukozela).
Ngaphezu kwazo zonke izimpawu, i-Niskawa syndrome iyakhula, okuhambisana nokuhambisana nezinkinga ezinjalo:
- i-oliguria;
- ukomisa;
- i-anuria
- isifiso sokuhlanza;
- Ukuphefumula kukaKussmaul;
- i-hypothermia;
- i-standardoglycemia;
- hypotension;
- ketonemia
- ketonuria.
Yini edala ukuqina kwesifo sikashukela?
I-Hyperosmolar ivela enkingeni yohlobo II lwesifo sikashukela mellitus, obangelwe amazinga aphezulu kashukela egazini lomuntu ngokumelene nesizinda sokuphelelwa ngamandla komzimba.
I-Ketoacidotic ivame ukwenzeka ngesifo sikashukela sohlobo lwe-I ngenxa yokuqongelela kwama-ketones, angama-acid ayingozi. Akhiwa ngenxa yokuntuleka okukhulu kwe-insulin.
I-Lactic acidemia iyinkinga enkulu yesifo sikashukela, ekhula ngemuva kwesifo sezinye izifo zesibindi, amaphaphu, izinso, zenhliziyo.
I-Hypoglycemic yisimo esiqala ukukhula ngenxa yokwehla okubukhali koshukela wegazi. Isizathu esivame kakhulu sokukhula kwayo wukudla okungafanele, noma umthamo ophakeme ngokweqile we-insulin.
Ukunakekelwa okuphuthumayo
I-Hyperosmolar
Izimpawu ezilandelayo ziyimpawu ye-hyperosmolar coma:
- ukoma okungapheli;
- ubuthakathaka obujwayelekile;
- i-polyuria;
- ukubuyiselwa emuva;
- ukozela
- ukomisa kakhulu;
- umsebenzi wokukhubazeka ongafanele;
- imibono;
- areflexia;
- iminyakazo
- wandise ithoni yemisipha.
Uma kunobungozi bokuqhamuka ne-hyperosmolar coma, izenzo ezilandelayo kumele zibhekwe:
- lungisa amazinga kashukela;
- beka isiguli kahle.
Ezimweni ezinzima:
- hlanganisa ama-milligrams ayi-10 kuye kwangama-20 kashukela egazini
- uma udakwa kakhulu, kubalulekile ukubiza i-ambulensi ngokushesha.
I-Hypoglycemic
Izimpawu ezilandelayo ziimpawu zomqondo we-hypoglycemic coma:
- ukukhuphuka kokujuluka;
- imizwa yokwesaba nokukhathazeka okungachazwanga;
- umuzwa onamandla wendlala;
- ukuthuthumela
- ubuthakathaka obujwayelekile nokukhathala.
Ukwelashwa kwezimpawu ezinobunzima be-hypoglycemic coma kwenzeka ngale ndlela elandelayo: isiguli sidinga ukunikezwa izingcezu ezimbalwa zoshukela, amagremu ayi-100 amakhukhi, noma izipuni ezi-3 zikajamu, nazo ziyafaneleka.
Uma kuvela izimpawu ezinzima, lezi zinto ezilandelayo kumele zibhekwe:
- uma kungenakwenzeka ukugwinya, uthele ingilazi yetiye elifudumele nezipuni ezingama-3-4 kashukela ezigulini;
- ukondla ukudla kwesiguli, okuqukethe inani elikhulu lama-carbohydrate (kulokhu, izithelo, izitsha ezihlukene zikafulawa kufanelekile);
- ukugwema ukuhlaselwa kwesibili, ngakusasa ekuseni kuyadingeka ukunciphisa umthamo we-insulin ngamayunithi ama-4.
Uma ukhula lukhula ngokulahlekelwa ngokuphelele kokungazi, khona-ke lezi zenzo ezilandelayo ziyanconywa:
- Ama-millilitha angama-40 kuya kwangama-80 kashukela;
- shayela i-ambulensi ngokushesha.
I-Ketoacidotic
Okwe-ketoacidotic coma, ukubonakaliswa okulandelayo kuyimpawu:
- ukuchama njalo;
- ukoma okungapheli;
- isicanucanu
- ukozela okuphikelela;
- ubuthakathaka obujwayelekile.
Uma kutholakala ukuthi kufikelwa i-ketoacidotic coma, kubalulekile ukubiza iqembu le-ambulense futhi lihlole imisebenzi ebalulekile yesiguli ngaphambi kokufika kwabo.
Okubaluleke kakhulu ukusekelwa okuqhubekayo kokuphefumula nokushaya kwenhliziyo kuze kufike i-ambulensi.
Ezinganeni
Isifo sikashukela ezinganeni ezinesifo sikashukela singenzeka ngenxa yokungahambelani nokudla noma ukwephulwa kwako, umthamo owanele we-insulin, usizi kanye nokuxineka ngokomzwelo.
Ukwelashwa kwenzeka kakhulu nangokuqapha okwenziwa odokotela ngemodi yokuma, futhi kuhambisana nokulethwa okuphindaphindwe konke ukuhlolwa okudingekile (igazi nomchamo wezinga likashukela).
Amavidiyo ahlobene
Mayelana ne-hyperosmolar coma yesifo sikashukela, kuvidiyo:
Isifo sikashukela esingenye ngesinye sezimpawu eziyingozi kakhulu zesifo sikashukela, esimweni esibi kakhulu esingaholela ekufeni. Ngakho-ke, kubaluleke kakhulu ezigulini ezinalokhu kutholwa kokuhlola isimo sazo, ikakhulukazi ushukela osegazini, futhi zilandele yonke imiyalo kadokotela ukuze lokhu kanye nezinye izinkinga zingaveli.
