Isifo sikashukela isifo sikashukela yisifo esibi lapho kukhona ukwephulwa cishe kwazo zonke izinqubo ze-metabolic emzimbeni, okuholela ekungasebenzi kahle kwezitho nezinhlelo ezahlukahlukene. Enye yezinkinga ezinzima kakhulu zesifo sikashukela kungaba ukoma kwesifo sikashukela. Imiphumela yokukhohlisa kwisifo sikashukela ingabulala isisulu uma ukunakekelwa okuphuthumayo kunganikezwa ngesikhathi.
Izinhlobo ze-Diabetesic Coma
Kunezinhlobo eziningi zokwehla kwesifo sikashukela, lokhu kungenxa yokuthi ukungalingani kwe-hormonal okubangelwa yilesi sifo kuthinta izinqubo eziningi emzimbeni futhi, ngokuya ngokulungiselela kwezici zezindlela zokunciphiswa kwelinye uhlangothi noma kwesinye, umuntu onesifo sikashukela angaba nethonya:
- I-Ketoacidotic;
- I-Hyperosmolar;
- I-Lactacidemic;
- I-Hypoglycemic.
Izinhlobo ezinhlobonhlobo ezinjalo zama-coma zibonisa ubulukhuni besifo sikashukela, ukungabikho noma ukwelashwa okunganele kwaso. Zonke lezi zinhlaka ezingenhla ziyinkinga enkulu yesifo sikashukela, noma kunjalo, ukuze kuthuthukiswe ezinye zazo, kuyadingeka isikhathi esilingana nesikhathi eside. Ake sibhekisise isimo ngasinye nemiphumela yaso emzimbeni wesiguli.
Izimpawu zokuqala zekhefu likashukela zingasolwa ngokuhlolwa ushukela egazini.I-Ketoacidotic
Lolu hlobo lokukhohlakala, naphezu kobucayi besimo, luyakhula kancane futhi luhlotshaniswa nokubola kwezinqubo ze-metabolic emzimbeni wesifo sikashukela. Isimo se-ketoacidotic singavela ngokushoda kwe-insulin noma okuphelele. Kuyini ketoacidosis?
Indlela yokwenza ukuthuthukiswa kwe-ketoacidotic coma
Njengomphumela wokwephulwa kwe-carbohydrate metabolism, ukuntuleka kwamandla kuqala kumaseli (ushukela wonke egazini), ngenxa yalokho inqubo ye-lipolysis - ukuqhekeka kwamafutha kusebenze. Ukushesha kwe-fatty acid metabolism kwenzeka, okuholela ekwakhiweni kwenani elikhulayo lemikhiqizo ye-lipid metabolism metabolic - imizimba ye-ketone. Ngokuvamile, izidumbu ze-ketone zidonswa ngohlelo lomchamo emchameni, noma kunjalo, ukwanda okusheshayo kokuxineka kwemizimba ye-ketone egazini akunakunxephezelwa umsebenzi wezinso, okuholela ekwakhiweni komqondo we-ketoacidotic.
Kunezigaba ezi-3 ezilandelanayo zokuthuthuka kokholo lwe-ketoacidotic:
- I-mild ketoacidosis ingahlala amasonto ambalwa. Izimpawu zimnene.
- Ukuncipha kwe-ketoacidosis, izimpawu ze-ketoacidosis ziqala ukwanda.
- Empeleni ihlaya.
Izimpawu nemiphumela
I-Coma yesifo sikashukelaIsimo se-Ketoacidotic singumphumela wokuwohloka kwesikhathi eside kwesifo sikashukela. Umtholampilo ngokuthuthukiswa kokwehla komzimba okunjalo uhlukile emvelweni futhi uqukethe ukwakhiwa kwezimpawu ezinjengokuthi:
- Ubuthakathaka obukhulu nobuthakathaka.
- Ukoma okukhulu nomthamo omkhulu.
- Ukomela, ukulahleka kwesifiso, isicanucanu.
- Ukuhogela kwe-acetone lapho uphefumula.
- Blush esihlathini.
Egazini leziguli, kunezinga eliphakeme le-glycemia - ngaphezu kwe-16 mmol / l; ketonemia ngaphezu kwe-0.7 mmol / l; Kuze kufinyelele ku-50 g ushukela emchameni kuyatholakala.
I-Ketoacidotic coma idinga ukwelashwa ngokushesha, ngaphandle kwalokho kungaholela ekulahlekelweni okungapheli kwazo zonke izinhlobo zomsebenzi we-Reflex kanye nomonakalo ojulile ohlelweni lwezinzwa oluphakathi.
I-Hyperosmolar
I-hyperosmolar coma noma kwelinye igama ibizwa ngokuthi yi-hyperglycemic coma - umphumela wokwanda okukhulu ekugxambeni kweglucose egazini lesiguli. I-hyperosmolar coma iyisilinganiso esedlulele sokulimazeka kwe-carbohydrate metabolism, ngokukhuphuka kwengcindezi ye-osmotic engxenyeni ye-liquid yegazi - i-plasma, okuholela ekwephulweni kwezakhiwo ze-rheological (zomzimba nezamakhemikhali) zegazi nokwenza imisebenzi yazo zonke izitho. Nge-hyperglycemic coma, ukwanda koshukela wegazi ongaphezulu kwama-30 mmol / L kungabonakala ngesilinganiso esingeqile kwezi-6 mmol / L.
ISymbomatology
Isisulu sinokukhubazeka okubukhali, kuze kube ukushaqeka komzimba. Imvamisa, ngaphambi kokukhula komqondo we-hyperosmolar, isiguli asazi nhlobo ukuthi sinesifo sikashukela. Lolu hlobo lokuthamba lukhula kakhulu kubantu abaneminyaka engaphezu kwengu-50 ngokungemuva kwenkambo yakamuva yohlobo 2 lwesifo sikashukela, isib. I-Hyperglycemic ikhula kancane kancane, ngokulandelana, futhi i-Symbomatology ikhula kancane. Izimpawu eziphambili yilezi:
- Ubuthakathaka obujwayelekile;
- Izicubu ezomile nezomiso;
- Ukomela
- Ukuchama okuchazayo;
- Kwehla ukuqina kwesikhumba;
- Ukuphefumula.
Izimpawu zingahle zingabonakali ngokushesha, ikakhulukazi kwabesilisa abavame ukufihla izinkinga zabo.
Imiphumela
Ngokulungiswa okungafanele kwe-hyperglycemic coma, ukulimala kobuchopho ngokungezwa kokuphazamiseka kokusebenza okuqhubekayo kusuka kunoma yiziphi izitho kungenzeka. Ukushona ku-hyperosmolar coma kufinyelela kuma-50% futhi kuya ngesivinini sokutholwa kwalesi simo kanye nokuqala kwezindlela zokwelapha.
I-Lactacidemic
I-Lactacidemic coma ibizwa nangokuthi i-lactic acid futhi ikhula kancane kunezinye izinhlobo zezimo eziphuthumayo kushukela. I-Lactacidemic coma yisimo esiyingozi kakhulu sokufa, ukufa kwabantu, okufinyelela kuma-75%. Lesi simo singakhula singafani nesizinda sezimo ezicasulayo:
- Ukopha okukhulu;
- I-Myocardial infarction;
- Inqubo yokutheleleka ejwayelekile;
- Ukuzivocavoca okunzima;
- Ukulimazeka kwe-renal noma kwe-hepatic.
Izithombe zemitholampilo
Isimo seziguli siwohloka ngokushesha, kunomkhuba omubi. Ukuqala kwesinye isikhathi kuvame ukuzuma, kube nokukhula okuphawulekile kwezimpawu. Inothi lesifo sikashukela:
- Ubuhlungu obukhulu bemisipha nobuthakathaka;
- Ukomela noma, ngakolunye uhlangothi, ukuqwasha;
- Ukuphefumula kakhulu;
- Ubuhlungu besisu ngokuhlanza.
Ngokuwohloka okuqhubekayo kwesimo, ukuquleka noma i-areflexia ehlotshaniswa nomsipha paresis kungenzeka. Lezi zimpawu zenzeka ngenxa yokulimala kobuchopho ngenxa yokushoda kwamandla kanye nokwephula ukwakheka kwe-ionic ye-plasma. Noma ngabe ukwelashwa okufanele futhi okufika ngesikhathi, i-prognosis yesisulu se-lactacidemic coma imbi.
I-Hypoglycemic
Uhlobo oluvame kakhulu lwe-coma olwenzeka ngenxa yokwehla okukhulu kweglucose yegazi. I-Hypoglycemic coma iba ngokushesha futhi kaningi ithinta iziguli ezinesifo sikashukela sohlobo loku-1 ngomthamo ongalungile we-insulin noma umsebenzi omningi kakhulu womzimba.
Ukwehla ushukela wegazi kwenzeka ngokugcwala okunganele kwe-insulin egazini, okuholela ekuguqukeni kwalo lonke ushukela usuka kwi-plasma uye kumaseli. Okokuqala, izicubu zobuchopho ziqala ukuba nenkinga yokuntuleka kweglucose, ebonakala emtholampilo okulesi simo.
Izimpawu
I-Hypoglycemic coma ihambisana nokukhula ngokulandelana kwezimpawu:
- Ukuqalwa okubukhali kwendlala;
- Ukwanda okusheshayo kobuthakathaka nokuqina;
- Ukuqina kwamalunga;
- Ukubonakala kokuqhaqhazela nokubanda, izithukuthuku eziqinile
- Ukulahlekelwa ukwazi.
- Umoya omncane.
Imiphumela
Ngokuhlinzekwa okusheshayo kokunakekelwa okuphuthumayo, okubandakanya ukwethulwa kwekhambi le-glucose ngo-40%, i-hypoglycemic coma isheshe ime, bese isimo sesiguli sibuyele kokujwayelekile. Uma kungekho osondelene nesisulu bese kuba ne-hypoglycemia, khona-ke isisulu singaba nokuphazamiseka okukhulu kohlelo lwezinzwa oluphakathi, size sifinyelele ekuwohlokeni komqondo kanye nokulahleka kweminye imisebenzi.
Ngokusekelwe olwazini olutholile, isiphetho siziveza - ungafaki impilo yakho engcupheni, ungakunaki ukwelashwa kwesifo sikashukela. Imiphumela yokuphelelwa yisifo sikashukela ingahluka kakhulu, kusuka ekukhubazekeni kwesikhashana. Ukukhubazeka okujulile nokufa. Ngakho-ke qaphela impilo yakho, ihlolwe ngesikhathi bese ulandela izincomo zikadokotela wakho.
