Usizo Lokuqala Lwesifo Sikashukela Coma

I-coma ebangelwa ukwehla noma ukwanda koshukela wegazi kungenzeka kunoma yimuphi umuntu onesifo se-metabolic, kungakhathalekile ukuthi utholakale ephethwe isifo sikashukela noma lokhu kuwukubonakaliswa kokuqala kwesifo se-endocrine. Ngakho-ke, kubalulekile ukwazi izimbangela nezimpawu ze-pathology eziyingozi.

Yini ecasulayo lesimo?

Isifo sikashukela i-mellitus sihambisana nokuphazamiseka kwe-metabolic, ngenxa yokuthi kukhiqizwa i-insulin enganele, noma amaseli omzimba angazwisi i-hormone.

Ngenxa yalokhu, ushukela ohlinzekwa ngokudla awuguquki amandla, kepha unqwabelana ngokweqile egazini. Ngaphandle kokuphathwa kwe-insulin okuvamile, ubuthi bomzimba buvela bese kuthi ikhula ye-hyperglycemic ikhule.

Uma umthamo wephulwe futhi i-hormone idlulele, noma isiguli singazange sithathe ukudla isikhathi eside, inani le-glucose liyancishiswa ngaphansi kwezinga elivumelekile, bese kuthi kuye kwenzeke i-hypoglycemic coma.

Kungaholela ushintsho emazingeni kashukela:

• ukudakwa kotshwala;
• ukungezwani kwemizwa;
• ukusebenza ngokweqile;
• isikhathi sokukhulelwa;
• ukudla okugcwele ama-carbohydrate noshukela.

Izinhlobonhlobo ze-pathology

Isifo sikashukela sikashukela sikhula ngezinguquko ezibalulekile engxenyeni kashukela esegazini ngokuqhathaniswa namazinga amukelekile. Kokubili ukuncipha kanye nokwenyuka kwamazinga kashukela kungadala ukoma.

Izinhlobo ze-Hyperglycemia

I-ketoacidotic coma - usongo lokuthayipha isifo sikashukela esi-1. Uma kwenzeka wephula uhlelo lokufakwa kwemijovo ye-insulin, ukusetshenziswa komuthi ophelelwe yisikhathi noma ukwephulwa komthamo, izinga le-glucose egazini liqala ukukhula ngokushesha.

Ukushoda kwe-insulin kusheshisa ukuwohloka kwama-acid amaningi emzimbeni, okuholela ekwandisweni okwandayo kwezidumbu ze-ketone, okuthi uma kuhlangene ne-glucose okuhlushwa ngo-30 kuye ku-40 mmol / L, kuyisikhuthazo ekwakhiweni komqondo futhi kuchaze nokuphefumula kwe-acetone kushukela likashukela.

I-ketoacidotic coma iba isikhathi eside, ngaphezulu kwezinsuku eziningi. Sonke lesi sikhathi, isiguli sincipha futhi silala cishe njalo. Ungabamba izimpawu bese uthintana nodokotela ukuthi athathe izinyathelo ezidingekayo.

I-Hyperosmolar coma kungenzeka ngesifo sikashukela sohlobo 2. Iziguli esezikhulile ezinezifo zenhliziyo zitholakala kakhulu kuso. Ngale hlobo lwe-hyperglycemia, imizimba ye-ketone ayakhi, futhi ushukela owedlulele uyadedelwa ngenkathi uchama. Ngokulinganisela kwamanzi okuphazamisekile nokuphelelwa ngamandla komzimba, i-glucose excretion inzima futhi inqwabelana egazini ifinyelela ku-50 mmol / l, okuholela ekhefini.

Isimo esifanayo senzeka ezinsukwini ezimbalwa ngemuva kwezimpawu zokuqala ezethusayo, esinye sazo ukunciphisa umzimba ngokushesha.

I-Lactic acid coma kuvame ukukhula kubantu abancike otshwaleni nakubantu asebekhulile abahlushwa izifo zesibindi, uhlelo lwezinhliziyo nezinso ngaphezu kwesifo sikashukela. I-Pathology yenzeka ngenxa yokwakheka kwenani elikhulu le-lactic acid ngemuva kwemvelaphi yendlala ye-oxygen yezitho zangaphakathi.

Lesi simo sibonisa ngokubonakala kobuhlungu esiswini, esifubeni nasemisiphani, kanye nobunzima nokuphefumula okunomsindo. I-Lactic acid coma ikhula ngokushesha, futhi ngenxa yalokho kubhekwa njengokubi kakhulu.

I-Hypoglycemia

Imbangela enkulu ye-hypoglycemia ushukela wegazi ophansi. Lokhu kungenzeka ngohlobo lwesifo sikashukela sohlobo lokuqala ngemuva kokuzila ukudla isikhathi eside noma ngenxa yomuthi okhuphuka kakhulu we-insulin. I-Hypoglycemia ivela futhi ngemuva kokudakwa kotshwala ngokweqile nangokomzimba nangokomzwelo.

Izimpawu zokubonakaliswa kwazo ziwukubonakaliswa kokukhathazeka, isifiso sokudla njalo, ukuhlaselwa yi-migraine nesiyezi, ukuthuthumela nokuqhekeka. I-Hypoglycemic coma yiyona evame kakhulu futhi iba ngamahora ambalwa, ngakho-ke awunakuhlehlisa izindlela zokubuyiselwa.

Izimpawu zokuqala nezimpawu zokuphefumula

IComa ayikhuli ngokushesha. Imvamisa, yandulelwa yizimpawu eziningi, unaka ukuthi yiziphi, ungathatha izinyathelo ezifika ngesikhathi futhi uvikele ukubonakaliswa kwesimo esibi.

Ku-comerglycemic coma, lezi zimpawu ezilandelayo ziyimpawu:

• ukoma okungapheli;
• ukulahleka kwesifiso sokudla;
• nxusa ukuchama;
• kuqhume ikhanda;
• kukhona ukuhlaselwa isicanucanu, kuhambisana nokuhlanza;
• ubuthakathaka buyakhula, ukozela kuzwakala;
• ukuphefumula kuqinisa, izinhlungu ziyavela esiswini;
• ukungasebenzi kwamathumbu kungabonakala.

Lesi simo senzeka lapho amazinga kashukela wegazi akhuphukela kuma-33 mmol / L.

Ngaphandle kwezinyathelo eziphuthumayo, ngemuva kosuku noma ngaphambili, inhlalakahle yesiguli iya iba mbi kanye nokubonakaliswa okulandelayo:

• ubuqili nokunganaki kuvela;
• ukuphefumula kuba nephunga le-acetone;
• ukuthuthumela nokungabi nathemba kuyabonakala;
• ukukhuluma kunzima, ukudideka kuyabonakala;
• ukuhlangana okungahambi kahle kokunyakaza;
• izikhathi zokuhlaselwa kuyabonakala;
• ukulahleka kwemizwa nokukhumbula kwenzeka.

Ngubani ongahlukaniswa yilezi zimpawu ezilandelayo:

• ishayela elibuthaka elinamandla;
• ingcindezi iyehla;
• ukuthambile kwama-eyeballs kuyabonakala.

Isimo se-precomatose esine-hypoglycemia sibukeka kanjena:

• kukhona umuzwa wendlala;
• kubanda futhi kuthuthumele;
• ukujuluka kuyaqina;
• ubuthakathaka banda ngokushesha;
• ukuzindla kwenhliziyo;
• isiguli siphelelwa amandla.

Yini ushukela obangela i-hypoglycemic coma? I-coma yenzeka lapho amazinga kashukela ehla aze abe ngaphansi kuka-1.5 mmol / L. Esibonakaliso sokuqala, kufanele ukwandise masinyane ukugxilisa egazini. Kulokhu, ucezu lukashokoleti, ushukela noma ujusi omnandi kufanelekile.

Ukunakekelwa okuphuthumayo nokwelashwa

Lapho unikeza usizo lokuqala kumuntu osesimweni sokucabanga okukhulu, umuntu kufanele azi ukuthi yini izinyathelo ezingathathelwa.

1. Shayela i-ambulensi.
2. Beka isiguli eceleni kwakhe futhi umnikeze ukuthula nomoya wokugcwala komoya omusha.
3. Uma kungenzeka, linganisa ukugcwala koshukela egazini.
4. Uma umthamo we-insulin waziwa futhi izinga likashukela liphakeme, nikeza isiguli umjovo.
5. Uma ushukela uphansi, nikeza isisulu isiphuzo ushukela omnandi noma uthathe ulungiselela ushukela.
6. Uma imbangela yesimo sesiguli ingaziwa, khona-ke lezo zenzo azikwazi ukusetshenziswa. Lokhu kungaholela esimweni esiba sibi kakhulu.
7. Ungazami ukunikeza noma ukunikeza iphilisi isiguli esingazi lutho.
8. Uma umuntu ecela isiphuzo, mnike amanzi.
9. Uma wehlulekile ukushayela i-ambulensi, udinga ukuyihambisa ngokushesha okukhulu. Isisulu esibhedlela.

Ngemuva kokungeniswa esibhedlela, isisulu sibekwa endaweni yokunakekela abagibeli, lapho kuthathwa khona zonke izinyathelo ezidingekayo zokuinza isimo sikashukela futhi simkhiphe ebuthakathakeni. Ukuze ulondoloze umsebenzi obalulekile, insiza yokufaka umoya omncane ixhumeke esigulini ukuvikela ukulamba kwe-oksijini kwezitho zangaphakathi.

Ukwelashwa okuyinhloko ukuphathwa okuvame komthamo omncane we-insulin ngokulawulwa okuningi kwezinga loshukela nokuqukethwe kwe-acetone. Ngasikhathi sinye, ushukela uphathwa ngekhefu lehora elilodwa ukugwema i-insulin ngokweqile.

Amaconsi ane-saline kanye nemijovo nge-sodium chloride, i-camphor ne-caffeine ayabekwa. Ngale ndlela, inhliziyo isekelwa futhi ibhalansi yamanzi ne-electrolyte iyabuyiselwa.

Ngemuva kokushiya ukopha, isiguli sinqunyelwe ukudla kokudla futhi umthamo we-insulin uyabuyekezwa ukuze uzinze ngokugcwele isimo.

Yini elindele isiguli ngemuva kokuphefumula?

Ukunakekelwa kwempilo okufika ngesikhathi kuzosiza ukumisa ukukhubazeka kwesifo sikashukela ekuqaleni kwentuthuko. Odokotela bajwayeza ushukela wegazi ngokwejwayelekile, babuyisele ibhalansi lamanzi, basebenze ngokuntuleka kwama-electrolyte, okuzothuthukisa kakhulu isimo sesiguli.

Ngokubambezeleka kokuvuseleleka, imiphumela yokuwoxeka iyacindezela. I-coma ingahlala isikhathi eside, iphikelela izinyanga ngisho iminyaka. Ngalesi sikhathi, indlala ye-oksijini yezitho ezibalulekile iyakhula, ebangela ubuchopho be-edema.

Ngemuva kokushiya ukopha, isiguli singakhombisa ukukhubazeka, isifo senhliziyo enhliziyweni, umsebenzi wokukhubazeka okhubazekile. Cishe isiguli esisodwa kweziyishumi sifa ngaphandle kokuthola ukwazi kabusha.

Ungakuvimbela kanjani ukuthuthukiswa kwe-pathology?

Impilo yesifo sikashukela ishintsha ngokuphelele ngemuva kokuqala kwezimpawu zokuqala zesifo kanye nokuqinisekiswa kokuxilongwa. Manje zonke izenzo zakhe kufanele zihlose ukugcina amazinga ashukela egazi amukelekile.

Ukuze uvimbele ukukhula kwesifo sikashukela, udinga ukulandela imithetho ethile:

• njalo obonwa ngudokotela futhi alandele zonke izincomo ezibekiwe;
• bambelela ekudleni okunomkhawulo wokudla ama-carbohydrate kanye nokwenqaba ushukela;
• gcina ukusebenza komzimba okunengqondo - Musa ukusebenza ngokweqile, kodwa futhi ungaholi impilo yokuhlala phansi;
• yeka imikhuba emibi;
• uphuze okungenani amalitha ayi-1.5 amanzi nsuku zonke, hhayi okufaka itiye, amajusi kanye nesobho;
• lawula isisindo sakho;
• gwema ikhefu elide phakathi kokudla - udinga ukudla kaningi, kepha ngezingxenye ezincane;
• qaphela ushukela wegazi izikhathi eziningana ngosuku;
• musa ukweqa imijovo ye-insulin futhi ungaguquli ngokunganqikazi umthamo;
• Musa ukuzindla ekhaya ngaphandle kwemvume kadokotela;
• phatha izifo ezihlangene.

Indaba yevidiyo emayelana nezimbangela nezimpawu zesifo sikashukela:

Isifo sikashukela yisifo esingalapheki esibucayi futhi, uma yonke imithetho nemikhawulo ingalandelwa, ingaba yingozi empilweni yeziguli. Isimo sengqondo sokuzibophezela empilweni yomuntu uqobo kuphela esizosiza ukugcina impilo nenempilo, futhi kunciphise nengozi yezinkinga eziyingozi.