Iphampu ye-insulin - umgomo wokusebenza, ukubukeza amamodeli, ukubuyekezwa kwabanesifo sikashukela

Yini iphampu ye-insulin

Impompo ye-insulin iyithuluzi elihlangene elakhelwe ukuphatha ngokuqhubekayo imithamo emincane ye-hormone kwezicubu ezihlehlayo. Inikeza umphumela womzimba we-insulin ngokwengeziwe, ukopisha umsebenzi wamanyikwe. Amanye amamodeli wamaphampu we-insulin angaqapha njalo ushukela wegazi ukuze aguqule ngokushesha umthamo we-hormone futhi uvikele ukukhula kwe-hypoglycemia.

Idivayisi inezi zinto ezilandelayo:

• ipompo (ipompo) enesikrini esincane nezinkinobho zokulawula;
• i-cartridge engena esikhundleni se-insulin;
• uhlelo lokufaka - i-cannula yokufakelwa kanye ne-catheter;
• amabhethri (amabhethri).

Amaphampu we-insulin anamuhla anemisebenzi eyengeziwe eyenza impilo ibe lula kwabanesifo sikashukela:

• ukuyeka okuzenzakalelayo kokudla kwe-insulin ngesikhathi sokukhula kwe-hypoglycemia;
• ukutjheja ukuhanjiswa kweglucose egazini;
• amasignali omsindo lapho ushukela ukhuphuka noma uwe;
• ukuvikela umswakama;
• amandla okudlulisa imininingwane ekhompyutheni mayelana nenani le-insulin etholakele kanye nezinga loshukela osegazini;
• ukulawulwa kude ngokulawulwa kude.

Le divayisi yenzelwe uhlobo olunzulu lwe-insulin therapy.

Umgomo wokusebenza kwensiza kusebenza

Kukhona ipiston ekuqanjweni kwepompo, okuthi, ngezikhathi ezithile, icindezele ikhareji nge-insulin, ngaleyo ndlela iqinisekise ukwethulwa kwayo ngamashubhu enjoloba emathanjeni angaphansi.

Ama-catheters kanye ne-cannulas diabetesic kufanele afakwe esikhundleni sezinsuku ezintathu. Ngaso leso sikhathi, indawo yokulawulwa kwehomoni nayo ishintshiwe. I-cannula imvamisa ibekwa esiswini; ingaxhunywa esikhunjeni sesikhumba, ehlombe noma entanjeni. Umuthi utholakala ethangini elikhethekile ngaphakathi komshini. Amaphampu we-insulin, kusetshenziswa izidakamizwa ezisebenza nge-Ultra-iDemo: I-Humalog, Apidra, NovoRapid.

Idivayisi ithatha indawo yokuzifihla kwamanyikwe, ngakho-ke i-hormone iphathwa ngezindlela ezi-2 - i-bolus neyisisekelo. Isifo sikashukela siphethe ukuphathwa kwe-insulin ngesandla ngemuva kokudla ngakunye, kucatshangelwa inani lezinkwa. Uhlobo oluyisisekelo ukubamba okuqhubekayo kwemithamo emincane ye-insulin, ethatha indawo yokusebenzisa insulin esebenza isikhathi eside. I-hormone ingena egazini njalo ngemizuzu embalwa izingxenye ezincane.

Ngubani okhonjiswa i-pump insulin therapy

Noma ngubani onesifo sikashukela esidinga imijovo ye-insulin, angakwazi ukufaka iphampu ye-insulin njengoba efisa. Kubaluleke kakhulu ukuthi utshele umuntu ngokuningiliziwe ngawo wonke amandla ogesi, ukuchaza indlela yokulungisa umthamo womuthi.

Ukusetshenziswa kwephampu ye-insulin kunconywe kakhulu ezimweni ezinjalo:

• inkambo engazinzile yesifo, i-hypoglycemia ejwayelekile;
• izingane nentsha edinga imithamo emincane yomuthi;
• uma kwenzeka i-hypersensitivity yomuntu ngamunye i-hormone;
• ukungakwazi ukufezekisa amanani afanele we-glucose lapho inj inj;
• ukuntuleka kwesinxephezelo sikashukela (i-glycosylated hemoglobin ngenhla kwe-7%);
• Umphumela "wokusa kokusa" - ukwanda okukhulu kokugxila kwe-glucose lapho uvuka;
• izinkinga zesifo sikashukela, ikakhulukazi ukuqhubeka kwe-neuropathy;
• ukulungiselela ukukhulelwa nesikhathi sayo sonke;
• Iziguli eziphila impilo esebenzayo, zikuhambo kaningi lwebhizinisi, azikwazi ukuhlela isidlo.

Izinzuzo Zesifo Sikashukela Sikashukela

• Ukugcina izinga le-glucose ejwayelekile ngaphandle kweqe phakathi nosuku ngenxa yokusetshenziswa kwehomoni yesenzo se-ultrashort.
• Umthamo we-bolus wesidakamizwa ngokunemba kwamayunithi angu-0,1. Izinga lokuphuza i-insulin kwimodi eyisisekelo lingashintshwa, umthamo ophansi ngamayunithi angama-0,025.
• Isibalo semijovo sincishisiwe - i-cannula ibekwa kanye njalo ezinsukwini ezintathu, kuthi lapho usebenzisa isipontsho isiguli sichitha imijovo emi-5 ngosuku. Lokhu kunciphisa ubungozi be-lipodystrophy.
• Ukubalwa okulula kwenani le-insulin. Umuntu udinga ukufaka idatha ohlelweni: izinga le-glucose okuqondisiwe kanye nesidingo somuthi ngezikhathi ezihlukile zosuku. Ngemuva kwalokho, ngaphambi kokudla, kusala ukukhombisa inani lama-carbohydrate, futhi nedivayisi ngokwayo izongena kumthamo owuthandayo.
• Iphampu le-insulin alibonakali kwabanye.
• Ukulawulwa kweshukela egazini ngesikhathi sokuzivocavoca, amadili alula. Isiguli singakushintsha kancane indlela esidla ngayo ngaphandle kokulimaza umzimba.
• Idivayisi isho ukuncipha okubukhali noma ukwanda kwe-glucose, okusiza ukuvimba ukuthuthuka kukashukela.
• Ilondolozwa idatha ezinyangeni ezimbalwa ezedlule mayelana nemithamo yamahomoni namanani kashukela. Lokhu, kanye nenkomba ye-glycosylated hemoglobin, kuvumela ukubheka emuva kokuhlola ukusebenza kahle kokwelashwa.

Izinto ezingalungile zokusebenzisa

Iphampu ye-insulin ingaxazulula izinkinga eziningi ezihambisana nokwelashwa kwe-insulin. Kepha ukusetshenziswa kwayo kunezingqinamba zayo:

• inani eliphakeme ledivayisi uqobo nokudla, okufanele kushintshwe njalo ngezinsuku ezi-3;
• ubungozi be-ketoacidosis banda ngoba akukho datha le-insulin emzimbeni;
• isidingo sokulawula amazinga we-glucose izikhathi ezine ngosuku noma ngaphezulu, ikakhulukazi ekuqaleni kokusetshenziswa kwephampu;
• ubungozi bokutheleleka endaweni yokubekwa kwe-cannula nokukhula kwe-abscess;
• ukuthi kungenzeka kumiswe ukwethulwa kwe-hormone ngenxa yokungasebenzi kahle kwensiza kusebenza;
• kwabanye abanesifo sikashukela, ukugqokwa njalo kwephampu kungenzeka kungakhululeki (ikakhulukazi ngesikhathi sokubhukuda, ukulala, ukuya ocansini);
• Kukhona ubungozi bomonakalo owenzekile lapho udlala ezemidlalo.

Iphampu ye-insulin ayivikelekile maqondana nokuqhekeka okungadala isimo esibucayi esigulini. Ukuvimbela lokhu kungenzeki, umuntu onesifo sikashukela kufanele abe naye njalo:

1. Isirinji egcwele i-insulin, noma ipeni lesirinji.
2. Ukubuyiselwa kwebhokisi lebhokisi le-hormone kanye ne-infusion isethi.
3. Iphakethe lebhethri elingena esikhundleni.
4. Imitha kashukela wegazi
5. Ukudla kuphakama kuma-carbohydrate asheshayo (noma amaphilisi kashukela).

Ukubalwa komthamo

Inani nesivinini somuthi osebenzisa iphampu ye-insulin sibalwa ngokuya ngomthamo we-insulin owathola isiguli ngaphambi kokusebenzisa ucingo. Umthamo ophelele we-hormone uncishiswa ngo-20%, kumodi ye-basal, uhhafu wale mali uyalawulwa.

Ekuqaleni, izinga lokudla izidakamizwa liyafana usuku lonke. Ngokuzayo, umuntu onesifo sikashukela uguqula kabusha ukuphathwa kwakhe: lokhu, kubalulekile ukukala izinkomba ze-glucose ejwayelekile. Isibonelo, ungangezelela ukungena kwehomoni ekuseni, okubalulekile kwisifo sikashukela esine-hyperglycemia syndrome lapho uvuka.

Imodi ye-bolus isethwe ngesandla. Isiguli kufanele sibambe ngekhanda inani le-insulin elidingwa iyunithi elilodwa lesinkwa kuya ngesikhathi sosuku. Esikhathini esizayo, ngaphambi kokudla, udinga ukucacisa inani lama-carbohydrate, futhi nedivayisi ngokwayo izokubala inani le-hormone.

Ukuze lula iziguli, iphampu inezinketho ezintathu zohlobo lwe-bolus:

1. Okujwayelekile - Ukuhlinzekwa kwe-insulin kanye ngaphambi kokudla.
2. Kuthulwe - i-hormone ihlinzekelwa egazini ngokulinganayo isikhashana, okulula lapho kudla inani elikhulu lama-carbohydrate ahamba kancane.
3. I-wave wave ephindwe kabili - Isigamu somuthi sikhishwa ngokushesha, kanti okunye kuza kancane kancane ezingxenyeni ezincane, kusetshenziselwa imikhosi ende.

Okungasetshenziswa

Amasethi wokufakwa aqukethe amashubhu enjoloba (ama-catheters) nama-cannulas kufanele afakwe esikhundleni sezinsuku ezintathu. Basheshe bavaleke, ngenxa yalokho ukulethwa kwe-hormone kuyeka. Izindleko zohlelo olulodwa zivela kuma-ruble angama-300 kuye kwangama-700.

Izindawo zokugcina (i-cartridges) ezilahlekayo ze-insulin ziqukethe kusuka ku-1.8 ml kuya ku-3.15 ml womkhiqizo. Intengo yenqola iqhamuka kuma-ruble ayi-150 kuye kwangama-250.

Sekukonke, cishe ama-ruble angama-6,000 kuzodingeka ukuthi asetshenziselwe ukwenza imodeli ejwayelekile yepompo ye-insulin. ngenyanga. Uma imodeli inomsebenzi wokuqapha i-glucose okuqhubekayo, kubiza kakhulu ukusigcina. Inzwa yangesonto lokusebenzisa ibiza cishe ama-ruble angama-4000.

Kukhona izesekeli ezahlukahlukene ezenza kube lula ukuthwala ipompo: ibhande le-nylon, iziqeshana, isembozo sokunameka ku-bra, isembozo esine-fastener yokuthwala umshini entweni.

Izinhlobo ezikhona

E-Russia, amaphampu we-insulin ezinkampani ezimbili zokukhiqiza asabalele - iRoche neMedtronic. Lezi zinkampani zinamahhovisi abo abamele nezikhungo zensizakalo, lapho ungaxhumana khona uma kwenzeka kwehleke ithuluzi.

Izici zamamodeli ahlukahlukene wamaphampu we-insulin:

I-Medtronic MMT-715

Uhlobo olulula lwedivayisi umsebenzi wokubala umthamo we-insulin. Ixhasa izinhlobo ezi-3 zamamodi we-bolus kanye nezikhawu ezingama-48 zansuku zonke zokuphumula. Imininingwane eku-hormone eyethulwe igcinwa izinsuku ezingama-25.

I-Medtronic MMT-522, MMT-722

Idivayisi ifakwe umsebenzi wokubheka i-glucose yegazi, imininingwane mayelana nezinkomba isememori yensiza emavikini ayi-12. Iphampu le-insulin libonisa ukwehla okungathi sína noma ukwanda ushukela ngendlela yesiginali yomsindo, ukudlidliza. Kungenzeka ukusetha izikhumbuzi zokuhlola ushukela.

I-Medtronic Veo MMT-554 ne-MMT-754

Imodeli inazo zonke izinzuzo zenguqulo yangaphambilini. Izinga eliphansi lokudla kwe-insulin lingama-0,025 U / h, okuvumela ukusetshenziswa kwalesi sisetshenziswa ezinganeni nakubantu abanesifo sikashukela abanokuzwela okuphezulu kwe-hormone. Ubukhulu ngosuku, ungafaka amayunithi afinyelela kwangama-75 - kubalulekile uma ufuna ukumelana ne-insulin. Ngaphezu kwalokho, le modeli ifakwe umsebenzi wokumisa ukugeleza kwemithi ngokuzenzakalela esimweni se-hypoglycemic.

URoche Accu-Chek Combo

Inzuzo ebalulekile yaleli phampu ukuba khona kwephaneli yokulawula esebenza ngezobuchwepheshe be-Bluetooth. Lokhu kukuvumela ukuthi usebenzise idivaysi ngokunganakwa abantu ongabazi. Idivaysi iyakwazi ukumelana nokuntywiliselwa emanzini kuze kufike kumamitha ayi-2,5 angafiki kumaminithi angama-60. Le modeli iqinisekisa ukuthembeka okuphezulu, okunikezwa ngama-microprocessors amabili.

Inkampani yase-Israeli iGeffen Medical isungule iphampu yesimanje ye-insulin engenantambo Insulet OmniPod, equkethe isilawuli kude kanye nedamu elingena manzi le-insulin ebekwe emzimbeni. Ngeshwa, akukho ukuthunyelwa okusemthethweni kwalolu hlobo eRussia kuze kube manje. Ingathengwa ezitolo zakwamanye amazwe ezikwi-inthanethi.

Inani lamaphampu we-insulin

• I-Medtronic MMT-715 - ama-ruble ayizinkulungwane ezingama-90;
• I-Medtronic MMT-522 ne-MMT-722 - ama-ruble angama-115,000;
• I-Medtronic Veo MMT-554 ne-MMT-754 - 200 000 ruble;
• URoche Accu-Chek - ama-ruble angama-97,000;
• I-OmniPod - ama-ruble angama-29,400. (okudliwayo okwenziwa inyanga kuzodla ama-ruble ayizinkulungwane ezingama-20).

Ngingayithola mahhala

Ngokomyalo woMnyango Wezempilo waseRussia Federation wangomhlaka 29 Disemba 2014, isiguli esinesifo sikashukela singathola ithuluzi lokwelashwa nge-insulin mahhala. Ukuze wenze lokhu, kufanele axhumane nodokotela wakhe ozolungisa imibhalo edingekayo yomnyango wesifunda. Ngemuva kwalokhu, isiguli sikhona emgqeni ukufakwa kwensiza.

Ukukhethwa kwerejimeni yokuphathwa kwama-hormone nezifundo zeziguli kwenziwa amasonto amabili emnyangweni okhethekile. Ngemuva kwalokho isiguli sicelwa ukuba sisayine isivumelwano esingakhishwa. Abafakiwe esigabeni sezimali ezibalulekile, ngakho-ke, umbuso awubeki isabelomali sokutholwa kwabo. Iziphathimandla zasekhaya zingakwazi ukukhokhela izinto ezidliwayo kubantu abanesifo sikashukela. Imvamisa, le nzuzo isetshenziswa ngabantu abakhubazekile nezingane.

Ukubuyekezwa kwesifo sikashukela