Izinhlobo zokwelapha i-insulin zesifo sikashukela

Kufika izikhathi ezinzima zomzimba, lapho ama-β-cell eyeka ukukhipha inani elifanelekile le-insulin yomzimba, hhayi ngoba uvila, kodwa ngenxa yalesi sifo ngeke asakwazi.

Bese kuthi empilweni Palette yobunzima, grey, nemvula yasekwindla iqale ukunqoba.

Kungalesi sikhathi lapho asiza khona, asize i-insulin - imisebe yelanga, injabulo nethemba. Futhi konke okuzungezile kuyaguqulwa, kugcwaliswa umoya omuhle wempilo.

Yebo, bangane, kuyindlela yokwelapha i-insulin, ehambisana neminye imithi, engakubuyisa ekuqondeni - impilo iyaqhubeka.

Izinhlobo ze-Insulin Therapy

Ukwelashwa ngolimi lwakudala lwesiGreki kuzwakala njengokulashwa, ukunakekelwa kwezokwelashwa. Sekuvele igama ngokwalo lilemongo wale ndlela. Ukwelashwa kwe-insulin ukwelashwa kwe-insulin, okungukuthi, kuyisethi yezinyathelo ezinhloso zazo ukunxephezela ukungalingani okwenze inqubo ye-metabolic (metabolic) ngokwethula i-insulin emzimbeni.

Le ndlela ihlukaniswe izinhlobo eziningi:

Ngokwesiko noma Kuhlanganisiwe. Le ndlela yokwelapha ifaka umjovo kanyekanye emzimbeni wezidakamizwa zemiphumela ehlukahlukene yesikhashana: okufishane, okuphakathi, okude.

Izinzuzo:

1. Isisusa senhloso sesiguli sokwelashwa.
2. Ukulula komjovo. Indlela yokwelashwa ingabonakala kalula esigulini ngokwayo nezihlobo zayo noma abasebenzi abakhathalelayo.
3. Asikho isidingo sokuqapha okuqhubekayo kwe-glycemia (ushukela wegazi).
4. Imvamisa yansuku zonke yemijovo iyancishiswa.
5. Ukuqedwa okusheshayo kobuthi beglucose.

Okubi:

• ukunamathela ngokungenamkhawulo ekudleni, ngokuya ngethamo elikhethiwe lomuthi;
• ukuvama kokudla kufanele okungenani kube izikhathi ezingama-5-6 ngosuku, kube nezikhathi ezilinganayo ngesikhathi;
• ukungakwazi ukuvumelanisa umthamo ophathisiwe kufinyelele ezingeni likashukela egazini;
• I-hyperinsulinemia, ehlala ihambisana nendlela yokwelapha ehlanganisiwe, ingavusa isifo sokuqina kwemithambo yegazi, ukuqina komfutho we-arterial, ukwehla okubucayi egazini le-potassium ions.

Ukwelashwa kwesifutho. Ngale ndlela, isiguli sixhunywe kudivayisi ye-elekthronikhi eyenzelwe ukujova umuthi wokujikeleza wangaphambi kwehora. Ngesikhathi esichazwe ngokuqinile, isiguli kufanele sinikezwe isilinganiso esincane somuthi we-ultrashort nesenzo esifushane.

Izinzuzo:

• iphampu, isuthisa isixazululo ngemithamo yemizuzu, iqinisekisa ukunemba nokuqhubeka kokuphatha;
• ukutholakala kokusebenzisa umuthi wesenzo esifushane ne-ultrashort;
• i-electronic pump programmer iyakwazi ukubheka isidingo somzimba ezimweni eziningi: ukudla, ukulala, ukuphaphama;
• le ndlela iqeda ukuqapha okuhlala njalo kwesikhashana kanye nomthamo olawulwa umuthi.

Okubi:

• ukungakwazi kwepompo ukufaka esikhundleni ngokuphelele ukusebenza kwamanyikwe;
• isidingo sokushintsha njalo indawo yesikhumba somjovo;
• ngokulungiswa kohlelo, izilinganiso zikashukela kufanele zithathwe okungenani amahlandla amane ngosuku.

Ukwelashwa okuqinisiwe. Umshini wale ndlela ulele ekulingiseni okukhulu kwezinqubo ezenzeka ngesikhathi secretion ye-insulin.

Ukuze ukwelashwa kwesisekelo-bolus insulin (kuqiniswe) ukufeza imisebenzi yayo, kuyadingeka ukunikeza izimo eziningana:

1. Ngesikhathi esithile, umthamo ophathwe umuthi kufanele uhambisane nezidingo zomzimba zokusebenzisa i-glucose etholakele.
2. I-hormone eyethulwa emzimbeni kufanele iphindaphinde i-basal noma ihlukane ngokuhlukile, isb., Secretion efana ne-beta cell.
3. Umthamo olungiselelwe kufanele uphindaphinde zonke izinqubo ze-peak ezenzeka ohlelweni lokugaya ukudla ngemuva kokudla.

Izinzuzo:

• ukulingisa okukhulu kwezinqubo zomzimba;
• Ukulawulwa okwehlukanisiwe kwezinqubo ze-metabolic, ezikwazi ukuvimbela ukwenzeka kwezinkinga ezahlukahlukene;
• isigqi sempilo yeziguli sithola isisusa esihle, esiboniswa kuphela ekudleni okukhululekile.

Okubi:

1. Ukuqeqeshwa okuyinkimbinkimbi kule ndlela. Isidingo sokuya ezikoleni zikashukela, lapho kukhona khona ucwaningo oluningilizayo lwezinqubo ze-metabolic ezenzeka emzimbeni.
2. Isidingo sokuqapha ngokuqinile okwesikhashana kweglucose yegazi sifinyelela izikhathi ezi-7 ngosuku.
3. Ngokuncipha kokulawula okuqukethwe ushukela emzimbeni, kunengozi enkulu ye-hypoglycemia - ukwehla ushukela ongaphansi kokujwayelekile.

Ngaphezu kweqiniso lokuthi umuthi owenziwayo uyahlukahluka ngesikhathi sokusebenza, ubuye ugobe emjikelezweni wansuku zonke ohambisana nokudla, ukulala nokuvuka.

Ukuqonda izinqubo ze-metabolic ezenzeka emzimbeni, kuyadingeka ukufunda izincazelo ezihlukaniswe ngokwengeziwe ezihambisana nale hormone:

1. I-Bolus insulin - lo umsizi ogqugquzela ukumuncwa kwama-carbohydrate ekudleni. Imvamisa ifakwa ekudleni.
2. I-Basal insulin - yi-ejenti ebangela isikhathi eside, isenzo eside, noma, njengoba ibizwa nangokuthi, i-hormone yesenzo sangemuva esidingekayo emzimbeni usuku lonke. Ngendlela, ama-pancreas akhe akhiqiza ngokuqhubekayo amahora angama-24.

Izici zesifo sikashukela ezinganeni

Kuyafaneleka ukuqala lesi sigaba ngeqiniso elikhangayo. Ngokokuqala ngqa, i-insulin yathunyelwa kubantu ngoJanuwari 11, 1922. Kwakuyingane - umfana oneminyaka engu-14. Ukujova kwenziwa ngusosayensi waseCanada Frederick Bunting.

Kodwa i-pancake yokuqala, njengoba kulindelwe ezimweni ezinjalo, yaphenduka inhlama. Ngenxa yokuthi ukulungiswa bekungahlanjululwanga ngokwanele, ukuhlolwa kokuqala kumakwe ukwehluleka - ingane yathuthukisa ukungezwani.

Sekuphele amasonto amabili isazi samakhemikhali uJames Collip sakha indlela yokuhlanza lo muthi. Ngemuva kwalokhu, ngoJanuwari 23, umjovo wesibili wanikezwa ingane egulayo - imiphumela yaba mihle. Akukhona nje ukuthi ingane ilahlekelwe yimiphumela emibi - lesi sifo uqobo sehlile, kwaba nokukhombana okucacile ekwakhiweni kwesifo sikashukela.

Ngokuthola kwakhe, usosayensi kanye nomngane wakhe banikezwa umklomelo weNobel.

Kusukela lapho, lo muthi waqala ukusiza hhayi izingane kuphela, kodwa, kunjalo, abantu abadala.

Kodwa-ke, kufanelekile ukuqaphela ukuthi ukwelashwa okunjalo kunezici ezimbalwa zokuphila kwengane, futhi kuyadingeka ukuhlukanisa izakhi ngazinye zeziguli ezincane.

Enye yalezi zici ukuhlanganiswa kwezidakamizwa ezinesikhathi esihlukile sokusebenza okusebenzayo. Lokhu kuyadingeka ukuze kuncishiswe inani lezinqubo zansuku zonke.

Ngasikhathi sinye, ukukhetha izinhlobo ezahlukahlukene zamathuluzi okwelapha engane enesifo "sikashukela", umuthi uncamela ukuphathwa kwe-2 no-3 kosuku lwe-hormone phakathi nosuku.

Ngaphezu kwalokho, kuye kwaqikelelwa ukuthi i-insulin therapy eqinisiwe isebenza kakhulu lapho inikezwa izingane ezingaphezu kweminyaka eyi-12.

Ukwelashwa ngeHormone kwabesifazane abakhulelwe

Ukwelashwa ngeHormone kwabesifazane abakhulelwe abanesifo sikashukela kunezinjongo ezimbili ezifanayo:

• ukuncipha koshukela wegazi kuya esimweni esinconyiwe;
• ukusindisa impilo yengane engakazalwa.

Lo mkhuba kubantu besifazane abakhulelwe uyinkimbinkimbi ngesimo esibalulekile: izinqubo zomzimba ezenzeka ngalesi sikhathi emzimbeni womuntu wesifazane azimeme kakhulu.

Njalo lapho lokhu kufanele kubhekwe lapho kunqunywa hhayi eyodwa kuphela yezinhlobo zokwelapha, kodwa futhi nethamo lomuthi olungiselelwe.

I-Endocrinologists incoma ukuthi, esiswini esingenalutho, ushukela wegazi kumama wesikhathi esizayo enganeni akufanele wedlule ku-3.3-5.6 mmol / L., Futhi ngemuva kokudla, inani lalisebangeni ukusuka ku-5.6 kuya ku-7.2 mmol / L.

Inani lezinqubo ezinconyelwa nsuku zonke imijovo emibili. Kulesi simo, izidakamizwa zesikhashana esifushane nesiphakathi singabhalwa ngasikhathi sinye.

Njengomthetho, ngaphambi kokudla kwasekuseni, umama okhulelwe ufakwa 2/3 wesimo esejwayelekile nsuku zonke, futhi ngaphambi kokudla kwakusihlwa, i-1/3 esele ye-hormone.

Kwesinye isikhathi odokotela banquma imijovo ngaphambi kokulala, baphendule inqubo yakusihlwa. Lokhu ukuvimbela ukwanda okubukhali koshukela begazi abakhulelwe ngaphambi kokusa.

Ividiyo evela kusazi:

Ukwelashwa kwengqondo

Ngeke kubonakale kumangalisa abafundi ukuthi ukwelashwa okungenhla kwe-hormonal akusetshenziswa kuphela ekulweni nesifo sikashukela, kepha nasekwelapheni izinhlobo ezinzima zokuphazamiseka kwengqondo, kepha lokhu kuyiqiniso.

Le ndlela isetshenziselwa ukwelapha iziguli ezine-schizophrenia.

Umsunguli wale ndlela, udokotela wezifo zengqondo waseMelika odabuka e-Austrian, uManfred Sackel, emuva ngo-1935, wathi kukuvumela ukuthi ubuyele empilweni ejwayelekile engama-80% abantu abagula ngengqondo.

Ukwelashwa kwenziwa ngezigaba ezintathu:

1. Esigabeni sokuqala (sokuqala), isiguli sicwiliswa ngamabomu esimweni lapho izinga leshukela egazini lehliswa kakhulu. Ngemuva kwalokho, usebenzisa itiye elimnandi kakhulu, ushukela ubuyiselwa kwinani labo elijwayelekile.
2. Isigaba sesibili. Kuboniswa ukwethulwa komthamo obalulekile we-insulin, ngenxa yokuthi isiguli sicwiliswa sisesimweni sokuqunjelwa ingqondo, esibizwa nge-stupor. Ngemuva kokuthola ukwazi kabusha, bayaphinda bayiphuze ngesiraphu kashukela.
3. Esigabeni sesithathu, isiguli esihlanya siphinda sifakwe i-hormone edlula esejwayelekile nsuku zonke, siyamfaka esigabeni somngcele phakathi komshayabhuqe ne-stupor. Lesi sigaba sithatha imizuzu engama-30. Ngemuva kwalokho i-hypoglycemia isuswa njengoba kuchaziwe ngenhla.

Isikhathi sokwelashwa sifinyelela kumaseshini angama-30, lapho ukucindezelwa kwengqondo kubuyiselwa futhi isiguli sizizwa singcono.

Kodwa-ke, kufanele kuphawulwe ukuthi ukusebenza kwale ndlela kubizwa ngakho futhi kunabaphikisi abaningi.

Izinkomba ze

Umfundi ngokungangabazeki unesifiso sokwazi ukuthi: ngabe ushukela ukhonjelwe ini ushukela?

Ukusebenza kwezokwelapha kukhombisa ukuthi isiguli "sihlala phansi" kulo muthi, njengomthetho, iminyaka emihlanu ngemuva kokutholwa kwalesi sifo. Ngaphezu kwalokho, i-endocrinologist enolwazi izokutshela ngokunembile umzuzu wokuguquka kusuka kumathebhulethi ukujova.

Lapho-ke kunengqondo ukuthi umfundi ongagodli uzobuza lo mbuzo olandelayo: ngakho-ke, ngabe yikuphi okungcono, amaphilisi noma i-insulin?

Impendulo ilula - konke kuncike esigabeni sokukhula kwalesi sifo, noma kulula ukusho ukuthi lesi sifo sitholakalasiphi isigaba.

Uma inani le-glucose esegazini alidluli i-8-10 mmol / l, khona-ke lokhu kubonisa ukuthi amabutho ama-β-cell of pancreas awakaqedelwa ngokuphelele, kepha adinga usizo ngendlela yamathebulethi. Ngamanye amazinga kashukela aphezulu, kunqunywa i-insulin. Lokhu kusho ukuthi uma izinombolo zingaphezu kophawu lwe-10 mmol / l, khona-ke ukwelashwa okukhulunywe ngenhla ngeke kusatshalaliswe. Futhi kungaba isikhathi eside, uma kungenjalo impilo.

Noma kunezimo eziningi lapho amaseli we-beta aphumule eqala ukusebenza futhi ngempumelelo futhi udokotela, kuyajabulisa isiguli, kukhanselwa ukuqokwa kwalolu hlobo lokwelashwa.

Ukusetshenziswa kwama-hormone njengendlela yokwelashwa akudingi amakhono akhethekile nolwazi, ngakho-ke, kunconyelwa ukuthi iziguli ezinesifo sohlobo lwe-1 noma uhlobo lwe-2 sikhule zisebenze ngomjovo we-insulin.

Kodwa-ke, eminye imithetho yokwelashwa kwe-insulin isadinga ukwazi futhi uyilandele ngekhono.

Lokhu kufaka phakathi:

1. Ukuze unciphise isikhathi sokuqala kwesidakamizwa, hlinza kahle bese ufudumeza indawo yesikhumba lapho kuzokwenziwa khona umjovo.
2. Ukudla ngemuva kokumiswa kancane kwemizuzu engamashumi amathathu ngemuva kokuthi umjovo wenqatshelwe ngokuphelele - ngeke ube nomphumela.
3. Izinga lansuku zonke lomuthi ophathisiwe akufanele lidlule amayunithi angama-30.
4. Landela ngokuqinile uhlelo lokwelashwa olunqunywe udokotela wakho.

Ngomjovo, kusetshenziswa amasirinji akhethekile nezibaya zesirinji, ezithandwa kakhulu.

Izinzuzo zepeni yesirinji:

1. Inaliti ekhethekile eza nale nsimbi yezokwelapha inciphisa izinhlungu.
2. Kalula zokuhamba nokusetshenziswa.
3. Amathuba wokusebenzisa inqubo awanqunywa yindawo noma isikhathi.
4. Amanye amapeni wesirinji afakwe iziqukathi ezikuvumela ukuthi uhlanganise izinhlobo ezahlukahlukene zamafomu womthamo, izindlela zokushintsha kanye nama-regimens okwelashwa.

Lapho nje inkulumo isithinta i-algorithm yokwelashwa, ekuqondeni okumaphakathi inefomu elilandelayo:

1. Ngaphambi kokudla kwasekuseni - ukwethulwa kwehomoni yesenzo esifushane noma eside sesikhashana.
2. Ngaphambi kokudla kwakusihlwa, kodwa hhayi ngaphambi kwemizuzu engamashumi amathathu, kusetshenziswa umuthi onesikhathi esifushane sokuvezwa.
3. Ngobusuku besikhathi sokudla - ukwethulwa komthamo "omfishane".
4. Ngaphambi kokulala, osweleyo unikezwa umuthi "odlala isikhathi eside" - umuthi osebenza isikhathi eside.

Isifundo sevidiyo yesirinji-ekuphatheni kwe-insulin:

Imiphumela engaba khona

Impilo kanye nomsebenzi wezokwelapha ukhombisile ukuthi ukuqinisa ubungqabavu kuhlobo 2 lwesifo sikashukela, kuyadingeka ukuthatha i-insulin, kuyilapho kungafanele wesabe izinkinga.

Lapho usebenzisa lesi sidakamizwa, izimpawu zezinkinga zokuphazamiseka kweziguli eziningi azitholakalanga. Yize ngokulunga kufanelekile ukuthi uqaphele ukuthi kunemiphumela yasendaweni ehambisana nezimpawu zabantu.

Odokotela bafaka:

1. Ukusabela komzimba. Kuboniswa ngokulunywa noma ngokuxhamazela endaweni yomjovo. Lokhu kungenzeka ngenxa yomonakalo endaweni yesikhumba (inaliti ebuthuntu noma obukhulu), ngesiza somjovo esingakhelwanga noma esingakhethwe ngendlela engafanele noma isixazululo esibandayo.
2. Isimo se-Hypoglycemic (izinga kashukela liphansi kakhulu kunokujwayelekile). Lokhu kuvezwa ukwanda kwama-palpitations, ukujuluka, ukuthuthumela (ukudonsa) kweminwe noma imilenze. Isizathu salesi simo singaba yidosi elingalungile le-insulin, ukwephulwa kohlelo lwesikhathi sokwelashwa, ukwethuka kwemizwa noma injabulo. Usizo lokuqala: yidla amagremu ayi-100 ama-butter roll noma izingcezu ezi-4 zoshukela, noma uphuze ingilazi yetiye elimnandi.
3. I-Insulin lipodystrophy. Le yimiphumela yokulawulwa okuphindaphindiwe komuthi endaweni efanayo, ukulungiswa okubandayo noma indawo engashisiwe. Izimpawu ezibonakalayo zingukushintsha kombala wesikhumba nokunyamalala kwamafutha angaphansi.

Ukwelashwa kwe-insulin yindlela yokwelashwa ehlonishwa umhlaba wonke yokugula ushukela. Ukusetshenziswa okunekhono nokuyinkimbinkimbi, okwenziwa ngaphansi kokubhekelwa okusondelene kwe-endocrinologist enolwazi, kungayithuthukisa kakhulu inhlala-kahle yesiguli futhi kumbuyisele umbono omuhle wokuphila.