Isifo sikashukela isifo sikashukela yisifo esibonakaliswa ukuthuthukiswa kwezinkinga ezinzima futhi ezingamahlalakhona. Enye yezinketho zenqubo ebiqedayo yikukhathazwa kwesifo sikashukela. Leli yigama eliyinkimbinkimbi elisho ukuthi i-glycemia ebalulekile nokuphazamiseka komzimba emzimbeni okuhambisana nakho. Abasebenzi bezokwelapha basho ngalomqondo izinhlobo ezimbili zemibandela: ketoacidotic ne-hyperosmolar. Ukubonakaliswa okuyinhloko nezimpawu zesifo sikashukela kuxoxwa ngazo endatshaneni.
Izici nokwehluka
Womabili amahlaya anokufana nokuhlukahluka ku-pathogeneis, ukubonakaliswa komtholampilo, nokunakekelwa kweziguli. I-Hyperglycemic coma (ketoacidotic) iba namazinga kashukela egazini ngenhla kuka-35 -40 mmol / L. Ubuntu bayo bungamaqiniso wokuthi ngokumelene nesizinda sokuntuleka kokuhlanganiswa kwe-insulin yi-pancreas, izidumbu ze-ketone zakheka phakathi kochungechunge lokuphendula. Baphuma "ngokunamandla" ukungena egazini kusuka esibindini, futhi kamuva bavele nomchamo.
I-Hyperosmolar coma iba phakathi kwabanesifo sikashukela esinezinhlobo 2 zesifo esiyimbangela (esingancikileli kwe-insulin). Leli fomu alihambisani nokwakhiwa kwezidumbu ze-ketone, ngoba i-pancreas ikhiqiza i-insulin eyanele (ngesinye isikhathi ngisho nangaphezu kwesidingo). Kumane nje amangqamuzana nezicubu zomzimba zilahlekelwa umuzwa wawo kuwo, kube sengathi “awuboni” into.
Amanani eglucose egazi ngemuva kwesimo esimweni esibucayi angaba ngaphezulu kuka-45-60 mmol / L, kunedatha yokuqhuma ifinyelela ku-110 mmol / L. Indlela yokuthuthuka isuselwe ekunyukeni kwe-osmolarity yegazi nokuphelelwa ngamandla komzimba.
Izimpawu ze-ketoacidosis
Imvamisa, kusuka ezimpawu zokuqala ukuya ekhefini, kudlula izinsuku ezimbalwa. Ngokuphikisana nesizinda sezifo ezithathelanayo, ukwanda kwezifo ezingama-systemic ezingamahlalakhona, ukuhlukumezeka, ukusha, kulokhu kungancishiswa amahora amaningi. Noma kunjalo, kunedatha ngezikhathi ezinde ze-precoma (ngokwesibonelo, amashumi eminyaka eminyaka).
Ukwehla kwesimo sesifo sikashukela - isikhathi sokuphinda sihlole izinkomba zoshukela egazini
Izimpawu zokuwohloka kwesifo sikashukela zincike ngqo ebangeni lokukhula kwalo kanye nobunzima:
- i-ketoacidosis elinganiselayo;
- i-precoma (ukubonakaliswa okuveziwe);
- coma.
I-ketoacidosis elinganiselayo
Kuqala ngezibonakaliso zokuwohloka ngokushesha kwesifo sikashukela. Iziguli zinezikhalazo ezilandelayo:
Ketoacidosis kushukela- ukoma ngokweqile kwe-mucosa yomlomo;
- ukoma
- ukwanda kwenani lomchamo;
- ukulunywa kwesikhumba, imivimbo evuthayo;
- i-cephalgia;
- ubuthakathaka, ubuthakathaka;
- ukusebenza okunciphise kakhulu;
- isicanucanu
Emoyeni oxoshwe kukhona “iphunga” noma iphunga le-acetone. Ukuhlolwa kwegazi kukhombisa i-glycemia kusuka ku-17 mmol / L nangaphezulu. Imizimba yeKetone namazinga kashukela omchamo amaningi kunqunywa.
I-Precoma
Ukuntuleka kosizo kuhumusha isimo se-ketoacidosis esesilinganisweni. Kuvela ubuhlungu obukhulu besisu, obungenakho ukwenziwa okucacile kwasekhaya, izikhathi eziningi zokuhlanza.
Ukusuka emathunjini wamathumbu, kungahle kube nesifo sohudo noma, ngokunye, ukuqunjelwa. Izimpawu zokuqala zokuqaqanjelwa kokuqina ziyavela. Iziguli zifuna ukulala, ziba ukungakunaki okwenzekayo nakho konke okukuzungezile, kunokuntuleka kokuqondiswa esikhaleni. Isiguli siphendula imibuzo ngokunganaki, sinephimbo elizwelayo.
Ukuhlola ukukhalipha kungenye yezinyathelo zokuthola ubujamo besimo
I-Acidosis, ukufupheka okunzima kokuphefumula kuyanda. Ukuphefumula kuba umsindo futhi ujule. Ukuhlolwa okubonakalayo kukhombisa ukuthi isikhumba somile, sibanda, sinciphise kakhulu i-turgor (isikhumba esithathwe ku-crease asiqondile ngqo). Ulimi lwesiguli lunamabala ansundu, amamaki amazinyo nezindebe ezihlangene ziyabonakala emaphethelweni. Ukuqagela komzimba kuyanyamalala, umsebenzi wesistimu yemisipha uphazamiseka kakhulu.
Izimpawu ezibalulekile zokuphelelwa ngamandla ziyavela:
- izici zobuso ezikhomba;
- ithoni yezingoma zamehlo incishiswa kakhulu;
- amehlo atshisiwe;
- izikhala zangaphakathi ziyabandakanyeka;
- wabiza amabhubhu angaphambili;
- ukwehlisa ukushisa komzimba.
Izinkomba zokucindezela kwegazi zincishiswa kakhulu, ukushaya kwazo kuthule futhi kuvame. Ukuntuleka kosizo olufanele kulesi sigaba kuholela ekwakhiweni komqondo.
Izinketho ze-ketoacidosis
Ngokuya ngokubakhona kwama-concomitant pathologies, isimo se-ketoacidosis esinzima singenzeka ngezindlela ezahlukahlukene, lapho kubonakala khona izimpawu ezithile.
- Ukuhlukahluka kwamathumbu - kukhula ngokumelene nesizinda se-pathologies yemithambo yezindonga zepheshana lesisu. Isifo esidonsa kakhulu ubuhlungu besisu.
- I-Encephalopathic - inqoba uma isiguli sinenkinga yokuhlaselwa yisifo sokuqina kwemizwa ngenxa ye-angiopathy yesifo sikashukela. I-Hemiparesis, ukwephulwa okubukhali kokungaqondakali komzimba, ukubukeka kwe-pathological, asymmetry of expression is sici.
- I-Cardiac - kwenzeka ngokumelene nesizinda se-pathology yemikhumbi ye-coronary. Kuhambisana nokuwa kanzima.
- I-Renal - ikhula ngemuva kwesizinda se-nephropathy yesifo sikashukela futhi ibonakala ngenani elikhulu lamaprotheni emchini. Igazi namasilinda kungavela nomchamo.
Ukuthuthukiswa kwe-Coma
Umuntu ulahlekelwa ukwazi, ukuphefumula kuhlala kujulile futhi kunomsindo ofanayo. Kuzwakala iphunga elibukhali le-acetone emoyeni. Ingcindezi yegazi incishiswa kakhulu, i-tachycardia. IPolyuria, eyayingaphambili, ithathelwa indawo ukungabikho komchamo ngokuphelele.
I-Ketoacidotic coma iyi-complication eyingozi evame ukwenzeka kubantu abasha, ezinganeni
Ukushisa komzimba kufinyelela kuma-35 degrees. Umzimba wesiguli awusabeli kokuthatheka kwangaphandle, ikhaliphe ngokomzimba ayikho. Kusukela ngesikhathi sokuthuthuka komqondo, usizo lunganikezwa kuphela usuku lonke. Omunye umphumela ukufa.
I-Hyperosmolar coma
Izimpawu zesifo sikashukela salolu hlobo nazo zikhula kancane, kepha ngangokunokwenzeka - ngaphezulu kwamasonto ambalwa. Uma i-ketoacidosis ibonakala kubantu abasha (ngisho nezingane), khona-ke isimo se-hyperosmolar siyavela ezigulini ezineminyaka engaphezu kwengama-40 kuya ku-5.
Ukuboniswa kwe-precoma kuyafana:
- ukoma
- i-polyuria;
- isikhumba esomile;
- ukunciphisa umzimba;
- ubuthakathaka, ukozela;
- ukwehla kokusebenza.
Njengoba ukuphuma komzimba kudlala indima ebalulekile kuhlelo lokuthuthuka kwezinkinga, kuvela izimpawu ezihambisanayo:
- kuncishiswe kakhulu i-turgor kanye nokuqina kwesikhumba;
- amehlo atshisiwe;
- ithoni yezingqimba zamehlo iyancipha;
- ekhaleni;
- izindonga ezibunjiwe zomgogodla kanye nezifuba zangaphambili;
- izikhala ezishisayo zelanga, i-fcsa ese-subclavian ne-supraclavicular;
- isifuba esishisiwe.
Umfutho wegazi uyancishiswa, ishayela livama, lithule, lifana nentambo.
I-Neurology
Izimpawu zomonakalo ohlelweni lwezinzwa kungenye ehamba phambili ekuqhubekeni kwesimo. Ukuvela okuvusa imizwa, ukubanjwa kwesihlungu sokuqaqamba kwamalunga, ukukhubazeka komzimba, i-paresis kuyavela. Ama-reflexes womzimba aphazamiseka kakhulu, yiwo avela emzimbeni. Ukwephulwa kwemisebenzi yokuqonda, ukukhula kwe-nystagmus.
Ukuthathwa kwesithuthwane - uphawu lokulimala kobuchopho ku-hyperosmolar coma
Ngesikhathi sokuhlolwa, uchwepheshe anganquma ukuba khona kwezimpawu zokulimala ezinamandla (ukuqina kwentamo, izimpawu zeBrudzinsky, Kwering, Ankylosing spondylitis).
Ukuntuleka kokungenelela nokunakekelwa kwezokwelapha kuholela ekuthuthukisweni kwe-stupor. Ukuqwashisa ngalesi simo kuyacindezelwa, kepha ama-reflexes asalondoloziwe. Kamuva, umuntu ugaxwa yithemba, lapho engasaphenduli khona ekukhuthazeleni kwangaphandle, okukhombisa ukuthi awekho.
Ukwazi ngokubonakala kwezinkinga zesifo sikashukela kungasiza ukwehlukanisa isimo sesiguli (futhi bangaba yisihlobo, umuntu obajwayele, noma umuntu odlula ngengozi) futhi banikeze usizo olusebenza ngesikhathi, basindise izimpilo zabo.
