Isifo sikashukela i-mellitus kwesinye isikhathi sibizwa ngokuthi yisifo sokuphila, esakhiwa ngenxa yokulutha kokudla okungenampilo, ukuntuleka komzimba nezinye izinto ezimbi.
Kodwa-ke, i-pathology ye-pancreas ingatholakala ezinganeni ezisanda kuzalwa.
Kulokhu, lesi sifo sitholakala ngokuthi "isifo se-neonatalabetes mellitus".
Izimbangela zesifo sikashukela seNeatal
Kunzima ukukhomba izinto ngqo ezothuthukisa lesi sifo. Kungenzeka kakhulu, kukhona ezimbalwa zazo.
Odokotela basikisela izizathu ezimbili eziyinhloko:
- ukuguqulwa kwezakhi zofuzo, lapho kunoshintsho ku-genome elibhekele ukukhiqizwa kwe-insulin;
- ukungasebenzi kahle kwesibeletho okungadalwa yizifo (isimungumungwane, irubella, inkukhu nokunye) noma ukusetshenziswa kwezidakamizwa (thiazides, Streptozocin, Alloxanpentamidine, α-interferon).
Ngokwendlela yokuthuthuka, ochwepheshe bahlukanisa izindlela ezimbili zesifo sikashukela se-neonatal:
- mzuzu;
- abaphikelelayo.
Ngefomu lokuqala, amaseli β-amaseli weesiqhingi seLangerhans kumanyikwe awakhiwa kahle. Ngasikhathi sinye, i-insulin ifakwa egazini ngamanani anele, kepha ukucutshungulwa nokwenziwa kweglucose kwenzeka ngokungasebenzi kahle.
Kufakazelwa ukuthi leli fomu lakhiwa ngenxa yento eyindlalifa, okungenzeka idalwe ukuguqulwa kwezakhi zofuzo ku-ABCC8 ne-KCNJ11 genes.
Leli fomu livame kakhulu futhi livela ngemvamisa eyodwa kweziyizinkulungwane ezingama-300-400 ezisanda kuzalwa. Izimpawu ziqedwa kancane kancane sezenziwe izinyanga ezintathu. Ngonyaka unganyamalala ngokuphelele, kepha esimweni esidala singabuya.
I-NSD ephikelelayo ibonakaliswa kokukhubazeka kwe-β-cell, i-gland yonke, noma i-insulin ngokuqondile, okuholele ekwakhekeni kokushoda kwama-hormone ngokuphelele. Leli fomu lingafaka izinguquko eziningana ze-pathological emsebenzini womzimba, ngamunye wabo uneqembu lakhe lohlobo.
Leli fomu livela imvamisa eyodwa kwezintsha ezisanda kuzalwa ezingama-500-600 futhi okwamanje azelapheki, isiguli sinqunywe i-insulin therapy isikhathi eside.
Izimpawu ze-pathology ezinganeni ezisanda kuzalwa
Izimpawu ziyefana ngazo zombili lezi zinhlobo, ngakho-ke zivame ukuhlanganiswa.
Izimpawu eziphambili yilezi:
- ukubuyiselwa emuva kokukhula kwe-intrauterine, okuzibonakalisa isisindo esincane somzimba;
- ukweyisa nokungasebenzi kwengane;
- ukwehla kwesifiso sokudla noma okujwayelekile, kepha ingane ikhula kabi;
- ukuchama kaningi kanye nephrofayili;
- ukomisa, kuyabonakala esikhunjeni esikhulayo, ubuthakathaka obujwayelekile bezingane, ulwelwesi lwamafinyila olomile kanye nokuqina kwenhliziyo;
- i-acidosis, okungukuthi, ukuguquguquka kokulinganisa okususelwa ku-acid ohlangothini lwe-acid, kulula ukubona ngephunga le-acetone ephuma emlonyeni;
- izivivinyo zegazi nomchamo zinezinga eliphakeme likashukela, kanti imizimba ye-ketone ingahle ibe khona kumchamo.
Ngefomu eliphikelelayo, zonke izimpawu zibonakala zikhanya, okwenza sikwazi ukuxilonga ngokushesha. Ukubonakaliswa kwemitholampilo kuvela ngesonto lokuqala lempilo yengane.
Ukuxilongwa kwalesi sifo
Yize lesi sifo sitholakala kalula, umphakathi wezokwelapha uphakamisa ukuthi kuhlonishwe lolu cwaningo kuzo zonke izingane ezisanda kuzalwa, okuzosiza ukuthi kusheshe kutholakale lesi sifo.
Ukuxilonga kufaka amaqembu amathathu wezindlela:
- ukuhlolwa kwesiguli;
- izivivinyo zaselebhu;
- izindlela ezinamandla.
Ngesikhathi sokuhlolwa, udokotela ufunda isimo ejwayelekile yengane, izinga lentuthuko, isimo sesikhumba, njalonjalo. Uqoqa idatha ngesikhathi engxoxweni nonina.
Ukuhlolwa kwelabhoratri kwakha isisekelo sokuxilongwa. Kuthathwa igazi nomchamo wengane ngenxa yazo.
Ngesikhathi sokufunda, kutholakala amanani eglue glucose angaphezu kuka-9.0 mmol / l, ukutholakala kweshukela egazini kanye nemithambo engaphezu kwe-3 mmol / l yezidumbu ze-ketone kutholakele. i-pH ingaphansi kuka-7. Ukuhlolwa kwe-Zimnitsky kusiza ukukhomba inani elikhulayo lokuphuma komchamo ngosuku.
Phakathi kwezindlela ezinamandla ezisetshenziswayo:
- I-Ultrasound
- i-ultrasonography;
- i-radiography;
- karyotyping.
Zisetshenziselwa ukucacisa ukutholakala kwezifo nokuthola izinga le-pathology yezitho. Ngokusekelwe kubo, kusetshenziswa inqubo yokwelashwa nokwelashwa okusekayo.
Izindlela zokwelapha
Njengoba lesi sifo sibangelwa ikakhulukazi ukuphambuka komsebenzi wezakhi zofuzo, singelapheki ngokuphelele. Ezinganeni ezinefomu eliphikelelayo le-pathology, kunqunywa ukwelashwa kwe-insulin konke. Kulokhu, umthamo wansuku zonke we-hormone cishe amayunithi angama-3-4 ngekhilogremu eyodwa yobunzima bengane.
Ngefomu lesikhashana noma elifishane, i-insulin ayinqunyelwe. Okuyisisekelo ukwelashwa izidakamizwa ezisiza ukwehlisa ushukela wegazi, njenge-urea sulfate noma i-glibenclamide, zenza ukuthi umkhiqizo we-insulin ukhiqize umzimba.
Umthamo usethelwa esimweni ngasinye ngokwehlukana futhi uguqulwa njalo udokotela ohambelayo.
Ezimweni ezingavamile, kunqunywa imithamo ye-insulin, ethi kancane kancane inciphe futhi iphele lapho inezinyanga ezintathu. Okufanayo kusebenza ezidakamizweni ze-hypoglycemic, ukuphuza kwabo kuyayeka eneminyaka eyi-6-12 izinyanga.
Ngokuhambisana, ukwelashwa kunqunyelwe okuhlose ukuqeda izimpawu zesifo eziphazamisa ukusebenza okujwayelekile komzimba. Igcina ibhalansi ejwayelekile ye-acid kanye nezinga lamanzi emzimbeni. Izidakamizwa eziqukethe i-potassium, i-sodium ne-calcium, isixazululo se-sodium chloride singabekwa. Ama-enzyme e-pancreatic kwesinye isikhathi anconywa.
Isimo sezulu
I-prognosis yokwakhiwa kwalesi sifo kuncike kakhulu esimweni sayo kanye nesikhathi sokuxilongwa kwaso. Ngakho-ke, nefomu elihlala likhona, ingane izosebenzisa amalungiselelo e-insulin impilo yakhe yonke.
Uzobhaliswa emtholampilo futhi athole umuthi mahhala. Kodwa-ke, lesi sifo uqobo siba nomthelela emzimbeni, sisiba sibi kakhulu isimo saso. Izinkinga ezinjengokubuka okunciphile, ukuphulukiswa kabi kwamanxeba nokululama isikhathi eside ngenxa yokulimala kuzokhathaza ingane impilo yakhe yonke.
Nge-pathology yesikhashana, izimpawu ziya ngokuya ziphela futhi ukwelashwa kuyeke. Kepha ingane ihlala ihlaziywa njalo futhi ihlolwa njalo, lokhu kubangelwa ukuthi kungenzeka ukuthi lesi sifo sikhule ebusheni bayo noma lapho sesikhulile. Okwamanje akunakwenzeka ukubikezela isikhathi sokuxolelwa kanye nekhambi eliphelele.
Isiguli sinconywa ukuba siqaphele izindlela zokuthintela:
- bambelela ekunakekelweni okufanele okunezinga eliphansi lama-carbohydrate namafutha;
- landela indlela yokuphila enempilo ngokuzivocavoca umzimba njalo nokungabikho kwemikhuba emibi;
- gwema ukukhuluphala ngokweqile;
- uma kwenzeka kwezinye izifo, zama ukuziqeda esikhathini esifushane;
- lawula ushukela wegazi.
Kucatshangwa ukuthi bayakwazi ukwelula isikhathi sokuxolelwa nokubambezeleka ukwakhiwa kabusha kwalesi sifo isikhathi eside ngangokunokwenzeka.
Kumele kwaziwe ukuthi ithonya le-pathology emzimbeni wengane liqine kakhulu, futhi ngokushesha ukwelashwa kunqunyelwe, kuncipha kokuzibonakalisa. Cishe amaphesenti angama-20 amacala, kukhona ukubambezeleka kwentuthuko.
Ngakho-ke, ezinganeni ukuphazamiseka kwemizwa kuyaphawuleka: ukugcwala ekukhulumeni nasekwenzeni izimoto, isithuthwane, ubuthakathaka bemisipha, ubunzima bokufunda. Ukuzihlanganisa kunzima impela.
Kungenzeka futhi ukuthinta ezinye izitho: i-pathology yezinso nokuhluleka kwesibindi, ukuphazamiseka kwengqondo.
Mayelana nezimpawu zemvelaphi yalesi sifo, ukuvimbela kwaso kunzima ukusakha. Okokuqala, kufaka nokugcina impilo enempilo yibo bobabili abazali ngaphambi kokuhlela ukukhulelwa.
Lesi sikhathi kufanele okungenani sibe izinyanga eziyisithupha. Ukuthintana nokubonisana ngofuzo kwezokwelapha nakho kungasiza, lokhu kubalulekile ikakhulukazi uma ngabe kwaqapheleka okufanayo noma ezinye izifo zofuzo emndenini. Ochwepheshe bazosiza ukulungiselela inqubo yokubamba ingqondo futhi banikeze izincomo ezidingekayo.
Ividiyo evela kuDkt Komarovsky:
Isimo esibalulekile impilo yowesifazane ngesikhathi sokukhulelwa nokugwema ukuchayeka ezintweni ezilimazayo. Ngokwesiko, abesifazane bayalulekwa ukuthi bagweme izindawo lapho bengatheleleka khona ngegciwane; uma kwenzeka izifo, omama abakhulelwe bebekelwa izidakamizwa okungenani, iningi lisebenzisa kuphela lapho ingozi yowesifazane iphakeme kunaleyo yengane.
Vele, izici ezingezinhle njengokusetshenziswa kotshwala, ugwayi, nezinto zengqondo kufanele kugwenywe ngalesi sikhathi. Akunakwenzeka ukubikezela ukuvela kwe-pathology, kepha kuyiqiniso ukuphepha kuyo.
