Isifo sikashukela yi-pathology ye-pancreas, ebonakala ngokungakwazi komzimba ukwenza imisebenzi yayo ezinqubweni ze-carbohydrate metabolism. Lesi sifo sihambisana nezinkomba eziphakeme zeglucose egazini, kanye nokukhiqizwa okunganele kwe-insulin (enesifo sohlobo 1) noma ukulahleka kokuzwela kwamangqamuzana nezicubu eziya kwi-hormone (enohlobo 2).
I-Pathology ingahle ihambisane nezinkinga eziningi ezimbi futhi ezingalapheki. I-Hyperglycemic coma ingenye yezinketho zenqubo ebuhlungu edinga ukunakekelwa okuphuthumayo nokulaliswa esibhedlela. Izimpawu ze-hyperglycemic coma kanye nokubonakaliswa kwayo okuyinhloko kubhekwe esihlokweni.
Izinhlobo zesimo se-pathological
Izimpawu ze-hyperglycemia ebucayi zixhomekeka kuhlobo luni lwesinkinga umuntu akhula nalo onesifo sikashukela:
- i-hyperosmolar coma;
- ketoacidosis;
- i-lactic acidosis coma.
I-Ketoacidosis ibonakala ngohlobo lwesifo sikashukela sohlobo 1. I-pathogenesis yayo isuselwa ekwakhekeni kwezidumbu ze-ketone (kubantu abavamile - i-acetone) egazini nomchamo ngokuncipha okuhambisana nezinkomba zokubonisa kwama-electrolyte.
I-Hyperosmolar pathology ivela ngohlobo 2 “isifo esimnandi”. Kubonakala ngokungabikho kwe-acetone, kepha kuhambisana nokuphelelwa ngamandla emzimbeni kanye namazinga eglucose (angafika ku-40-55 mmol / l).
Ukuzihlola ngokwakho ushukela wegazi nge-glucometer - ukwahlukanisa kwe-hyperglycemia ebalulekile ekhaya
Izici ze-lactic acidosis coma ukuthi egazini izinga le-lactic acid likhuphuka kakhulu (izinkomba zingakhuphuka izikhathi ezi-2-7). Izinga le-glycemia liphakeme kunokwejwayelekile, kepha alibalulekanga njengasezimweni ezimbili zokuqala.
I-ketoacidosis
Kunezikhathi ezimbili ekwakhiweni kwanoma iyiphi i-hyperglycemic coma: i-thoroma ne-coma. Ukuthuthukiswa kwesimo se-pathological akwenzeki emahoreni ambalwa, kepha kunokuqala kancane kancane. Iziguli ziqala ukukhononda ngalezi zimpawu ezilandelayo:
- ukoma ngokweqile;
- ukulunywa kwesikhumba;
- ukwanda kokuchama (izikhathi ezingama-2-3 ukwedlula kumuntu onempilo);
- ukoma kwe-mucosa yomlomo;
- cephalgia.
Ngokukhuphuka kwamazinga e-acetone, isicanucanu kanye nezikhathi zokuhlanza kuvela ukuthi akulethi isiguli. Kunobuhlungu obuchithekile esiswini, obungenakho kwasendaweni ecacile. Ngenkathi yezinombolo ezibucayi zama-ketone umzimba we-ketone, ukuqaphela kwesiguli kuya kudideka, ukuphefumula kohlobo lwe-Kussmaul kuyavela (inhale and exhale noise, loud, deep), kuzwakala iphunga elithile le-acetone lisuka emlonyeni.
Uma kungekho lusizo olwanele, imvamisa nokuqina kokuhlanza kukhuphuka kakhulu, isikhumba soma, kuqhamuke kubonakale.
Ngaphezu kwalokho, ikhephu liyavela, izibonakaliso zazo okulandelayo:
- umuntu usesimweni sokungazi;
- iphunga elinamandla le-acetone emoyeni okhiphe amandla;
- i-polyuria ithathelwa indawo ngenxa yokuntuleka ngokuphelele komchamo;
- izinga lokushisa lomzimba lehlela ku-35 ° C;
- ithoni yezingoma zamehlo incishiswa kakhulu;
- akukho ukusabela kokuthatheka kwangaphandle;
- ishayela li-filiform, umfutho wegazi wehliswe kakhulu.
Izimpawu ze-ketoacidosis ezinganeni
Isikhathi esinqunyelwe ezinsaneni sibonisa ukujola kuze kufike ekuthuthukisweni kwe-stupor (ukungabi bikho kokusabela komsindo wangaphandle ovuselelwa ngomsebenzi we-Reflex). Isifo sezinhlungu sifana nomtholampilo "wesisu esibuhlungu" ngokuxinana okubukhali kodonga lwangaphakathi lwesisu.
I-Precoma enganeni - umbandela odinga ukunakekelwa kakhulu
Isikhumba siba mpunga, okuthiwa isifo sikashukela sivele ebusweni. Kukhula lapho amanani eglucose angaphezulu kwe-15 mmol / l. I-coma ifana ngokuphelele nesithombe somtholampilo kubantu abadala.
Isimo se-Hyperosmolar
I-Hyperglycemic coma yalolu hlobo ingakhula kusuka ezinsukwini ezimbalwa kuya kumaviki ayi-2-3. Isimo se-hyperosmolar siphindwe izikhathi ezingama-5-8 ngokujwayelekile kune-pathology ngokuthuthukiswa ketoacidosis. Izimpawu ze-precoma ziyefana:
Umphumela Wesifo Sikashukela- ukunciphisa isisindo sesiguli;
- ukoma kwe-pathological;
- ukomiswa nokulunywa kwesikhumba;
- ukuphuma komchamo omningi;
- ukwehla kokusebenza, ubuthakathaka obukhulu;
- awukho iphunga le-acetone emoyeni ophelile.
Ngokuhambisana, izimpawu zokuphelelwa ngamanzi emzimbeni ziba khona:
- izici zobuso ziyalolwa;
- ukuqina kwesikhumba nethoni kuncishisiwe;
- hypotension, tachycardia;
- ithoni yezimpawu zamehlo incishisiwe.
Izimpawu zokuphazamiseka kwemizwa zivela ngokuhamba kwesikhathi: iziqubuzula ze-pathological zenzeka noma ukwakheka komzimba, ukukhubazeka komzimba, ukubanjwa, ukungazi kahle kwemisebenzi nemisebenzi yokuqonda kuyanyamalala. Uma kungekho ukungenelela kwezokwelashwa, kukhula isimo se-stupor ne-coma.
I-Hyperosmolar coma ezinganeni
Ikhula kancane kakhulu kune-ketoacidosis. Ihambisana namazinga kashukela egazi ngokweqile - ngaphansi kuka-50 mmol / l. Ngenhlanhla, lesi simo sinqabile kakhulu ezinganeni.
I-Precoma inezici ezilandelayo, ngaphezu kwezici ezithile:
- ukwanda kokushisa komzimba;
- i-nystagmus - ukunyakaza ngokuzithandela kwe-eyeballs;
- izimpawu zokuya esikhathini.
Ukubonakala kwezimpawu zokuya esikhathini kuyinkomba eyengeziwe ye-hyperosmolarity ezinganeni
Njengoba kunesimo se-hyperosmolar ezinganeni, kuzovela lezi zibonakaliso ezilandelayo zokuya esikhathini:
- Intamo eqinile.
- Isibonakaliso sikaKwering - ngemuva kokuthi udokotela egobe umlenze wengane edolweni elihlangane ngakwesokunene, ingane ngeke ikwazi ukubuyisa ngokuzimele esimweni sayo sokuqala.
- Izimpawu ze-ankylosing spondylitis - udokotela wenza ukunyakaza kokushaya endaweni ye-zygomatic. Lokhu kudala ikhanda elibuhlungu, ingane iphendula ngokubabaza okuhlanekezelwe, iklabalase, ikhale.
- Isibonakaliso esiphezulu seBrudzinsky - ingane ilele endaweni evundlile emhlane wakhe, ekhululekile. Uchwepheshe ngokuzimela uhola ikhanda lengane esifubeni. Ngophawu oluqondile ngalesi sikhathi, imilenze yesiguli igoba ngokuzenzakalelayo.
- ISymbom Fanconi - ingane ilele emhlane wakhe. Imilenze yakhe ibanjwe emadolweni futhi icelwe ukuba iphakamise umzimba ongaphezulu. Isibonakaliso esihle sihambisana nokungakwazi ukufeza isicelo.
I-Lactic acidosis coma
Lolu hlobo lwesimo se-hyperglycemic lubonakala ngokubonakala kobuhlungu obukhulu bemisipha obubangelwa inani elikhulu le-lactic acid emzimbeni, ukuncipha kwengcindezi yegazi, izinhlungu ngemuva kwe-sternum, ubuthakathaka nokungasebenzi kahle ngesikhathi se-precoma.
Ubuhlungu bemisipha kuwuphawu oluholayo lwamazinga aphezulu we-lactic acid emzimbeni.
Ngokuhamba kwesikhathi ukungakhathaleli kuyavela, ukubonakaliswa komqondo, okuhambisana nokungazi kwesiguli. Uma ukuhluleka kwenhliziyo noma ukukhubazeka kwesikhungo sokuphefumula kuba khona, kufa.
Endabeni ye-lactic acidosis enganeni, isimo esithandekayo singabonakala njenge-stupor noma i-stupor. Izimpawu ziyafana nalezo ezihambisana ne-pathology yabantu abadala, kepha ezinsaneni kuthiwa ziningi. I-precoma yesikhathi sokuguqulwa ku-coma incishiswa ngesigamu.
Ukwaziswa kwezimpawu nokubonakaliswa kwezinkinga ze-hyperglycemic kuzosheshe kusihlukanise lesi simo, kuhlinzeke ngosizo lokuqala, ngaleyo ndlela kulondolozwe impilo kanye nempilo yakho nabanye.
