Matenda a shuga ndi amodzi mwa gulu la matenda omwe shuga ya magazi amawonjezeka. Izi zimatha kudzetsa kukalamba kwa thupi ndi kuwonongeka pafupifupi ziwalo zake zonse ndi machitidwe ake.
Endocrinologists amakhulupirira kuti ngati njira zochotsekera zimachitidwa ndikuchitidwa bwino, nthawi zambiri ndizotheka kupewa kapena kuletsa kuyambika kwa matenda ashuga. Inde, nthawi zambiri, kusokonezeka kotere kumachitika ndi chithandizo chamanthawi osakwanira, kudziletsa osakwanira komanso osagwirizana ndi zakudya.
Zotsatira zake, boma la hypoglycemic limayamba, lomwe limabweretsa kukula kwa chikomokere mu matenda a shuga. Nthawi zina kusowa mpumulo kwakanthawi kadzidzidzi ngati kameneka kumatha kupha.
Kodi kudwala matenda ashuga ndi chiyani ndipo zimayambitsa ndi mitundu yanji?
Tanthauzo la chikomokere ndi matenda ashuga - pamakhala mkhalidwe womwe wodwala matenda ashuga amataya chikumbumtima akakhala kuti ali ndi kuchepa kapena kuchuluka kwa shuga m'magazi. Ngati ali ndi vutoli ngati wodwala sangapatsidwe chithandizo mwadzidzidzi, ndiye kuti chilichonse chitha kupha.
Zomwe zimayambitsa chiwonetsero cha matenda ashuga ndikuwonjezereka msanga kwa kuchuluka kwa shuga m'magazi, komwe kumachitika chifukwa cha kusakwanira katemera wa insulin ndi kapamba, kusadziletsa, kusaphunzira komanso anthu ena.
Popanda insulin yokwanira, thupi silingathe kupanga shuga chifukwa cha zomwe sizisintha kukhala mphamvu. Kusowa koteroko kumabweretsa kuti chiwindi chimayamba kudzipangira payekha shuga. Pokana ndi maziko awa, pali mphamvu yogwira matupi a ketone.
Chifukwa chake, ngati shuga achuluka m'magazi mwachangu kuposa matupi a ketone, ndiye kuti munthu amasiya kuzindikira ndikuyamba kudwala matenda ashuga. Ngati ndende ya shuga ikwera pamodzi ndi matupi a ketone, ndiye kuti wodwalayo angagwe mu ketoacidotic coma. Koma pali mitundu ina yamikhalidwe yotere yomwe iyenera kulingaliridwa mwatsatanetsatane.
Mwambiri, mitundu iyi ya chikomokere cha shuga imadziwika:
- hypoglycemic;
- hyperglycemic;
- ketoacidotic.
Hypoglycemic coma - Zitha kuchitika pamene shuga m'magazi amatsika mwadzidzidzi. Sitinganene kuti matendawo atenga nthawi yayitali bwanji, chifukwa zambiri zimatengera kuopsa kwa hypoglycemia komanso thanzi la wodwalayo. Matendawa atha kudwala matenda osokoneza bongo omwe amathamangira pakudya kapena iwo omwe samatsata mlingo wa insulin. Hypoglycemia imawonekanso pambuyo povutitsa kapena kuledzera.
Mtundu wachiwiri - kukomoka kwa hyperosmolar kumachitika ngati vuto la shuga 2, komwe kumayambitsa kusowa kwa madzi komanso shuga wambiri wamagazi. Kumayambika kwake kumachitika ndi shuga wamagulu opitilira 600 mg / l.
Nthawi zambiri, hyperglycemia yowonjezera imalipidwa ndi impso, zomwe zimachotsa glucose wambiri ndi mkodzo. Pankhaniyi, chifukwa cha kukhazikika kwa chikomokere ndikuti pakutha kwamadzi opangidwa ndi impso, thupi limakakamizidwa kupulumutsa madzi, omwe angayambitse hyperglycemia.
Hyperosmolar s. matenda ashuga (Latin) amakula nthawi 10 kuposa hyperglycemia. Kwenikweni, mawonekedwe ake amapezeka ndi mtundu wachiwiri wa shuga mwa odwala okalamba.
Ketoacidotic diabetesic coma imayamba ndi mtundu 1 shuga. Mtundu wamtunduwu umatha kuchitika ma ketoni (ma acetone acids) osavomerezeka akamadziunjikira m'thupi. Zili mwa zinthu za metabolism zamafuta zomwe zimapangidwa panthawi yovuta kwambiri ya insulin.
Hyperlactacidemic coma mu shuga imachitika kawirikawiri. Izi ndizodziwika kwa okalamba omwe ali ndi vuto la chiwindi, impso ndi mtima.
Zomwe zimapangitsa kukula kwa mtundu uwu wa matenda osokoneza bongo ndizochulukitsidwa pakupanga ndi kugwiritsidwa ntchito molakwika kwa hypoxia ndi lactate. Chifukwa chake, thupi limapatsidwa mankhwala a lactic acid, omwe amaphatikizika mopitirira muyeso (2-4 mmol / l). Zonsezi zimabweretsa kuphwanya koyenera kwa lactate-pyruvate komanso mawonekedwe a metabolic acidosis omwe ali ndi kusiyana kwakukulu kwa anionic.
Vuto lochokera ku mtundu wa 2 kapena matenda ashuga a mtundu woyamba ndi lotchuka komanso loopsa kwa munthu wamkulu yemwe ali ndi zaka 30 zakubadwa. Koma izi ndizowopsa makamaka kwa odwala ochepa.
Khansa ya matenda ashuga mwa ana nthawi zambiri imayamba ndi matenda omwe amadalira insulin omwe amakhala zaka zambiri. Nthawi zambiri azimayi odwala matenda ashuga amawonekera kusukulu yakusukulu kapena pasukulu, nthawi zina pachifuwa.
Komanso, osakwana zaka 3, zinthu ngati izi zimachitika nthawi zambiri kuposa akulu.
Zizindikiro
Mitundu ya chikomokere ndi matenda ashuga ndizosiyana, kotero chithunzi chawo chachipatala chikhoza kukhala chosiyana. Chifukwa cha kuperewera kwa ketoacidotic, kuchepa madzi m'thupi kumadziwika, kumatsatana ndi kuchepa kwa thupi mpaka 10% ndi khungu louma.
Zikatero, nkhope imasanduka yowoneka bwino (nthawi zina imakhala yofiyira), ndipo khungu kumaso, manja amasanduka achikasu, matuza ndi masamba. Ena odwala matenda ashuga ali ndi furunculosis.
Zizindikiro zina zokhala ndi matenda ashuga okhala ndi ketoacidosis ndi kupuma zowola, nseru, kusanza, ulesi, kuzizira kwamiyendo, ndi kutentha pang'ono. Chifukwa cha kuledzera kwa thupi, kupanikizika kwam'mapapo kumatha kuchitika, ndipo kupuma kumakhala kaphokoso, kozama komanso pafupipafupi.
Pakakhala matenda a shuga a mtundu wachiwiri, matenda ake amakhalanso amtopola komanso amachepetsa ana. Nthawi zina, kuchuluka kwa eyelid komanso strabismus kumadziwika.
Komanso, kukhala ketoacidosis kumayendera limodzi ndi kukodza pafupipafupi, komwe kumatha kununkhira fungo la fetal. Nthawi yomweyo, m'mimba mumapweteka, matumbo amayamba kufooka, ndipo kuthamanga kwa magazi kumachepetsedwa.
Ketoacidotic coma mu odwala matenda ashuga amatha kukhala osiyanasiyana kusiyanasiyana - kuyambira kugona mpaka kutha. Kuzindikira kwa ubongo kumathandizira kuyambika kwa khunyu, kuyerekezera zinthu m'maganizo, kunyengerera komanso kusokonezeka.
Hyperosmolar diabetesic coma sign:
- kukokana
- kusowa kwamadzi;
- kusokonekera kwa mawu;
- malaise;
- zizindikiro zamitsempha;
- kusuntha kwadzidzidzi komanso kofulumira kwa nsidze;
- kawirikawiri ndi kufooka pokodza.
Zizindikiro za chikomine cha matenda ashuga okhala ndi hypoglycemia ndizosiyana pang'ono ndi mitundu ina ya chikomokere. Vutoli limatha kudziwika ndi kufooka kwakukulu, njala, nkhawa zopanda pake ndi mantha, kuzizira, kunjenjemera ndi thukuta la thupi. Zotsatira za matenda obwera chifukwa cha matenda ashuga omwe ali ndi hypoglycemia ndi kulephera kuzindikira komanso mawonekedwe a kugwidwa.
Hyperlactacidemic diabetesic coma imadziwika ndi lilime louma komanso khungu, mtundu wa Kussmaul kupuma, kugwa, hypotension, ndikuchepetsa turgor. Komanso, nthawi yopumira, yotalika maora angapo mpaka masiku angapo, imayendetsedwa ndi tachycardia, oliguria, kudutsa mu anuria, kufewa kwa nsidze.
Hypoglycemic coma ndi mitundu ina yamikhalidwe yofananira mwa ana imakula pang'onopang'ono. Matenda a shuga amakhalapo limodzi ndi mavuto am'mimba, nkhawa, ludzu, kugona, mutu, kusowa kudya komanso nseru. Ndikamakula, kupuma kwa wodwalayo kumayamba phokoso, mwakuya, zimachitika zimafulumira, ndipo hypotension yatsoka imawonekera.
Ndi matenda a shuga m'makanda, mwana akayamba kugona, amadwala polyuria, kudzimbidwa, polyphagy ndi ludzu lochulukirapo. Ma diapodi ake amayamba kufinya mkodzo.
Glycemic coma mu ana imawonetsedwa ndi zizindikiro zomwezo monga akulu.
Zoyenera kuchita ndi matenda a shuga?
Ngati chithandizo choyambirira cha mavuto a hyperglycemia sichili mwadzidzidzi, ndiye kuti wodwala yemwe ali ndi vuto la matenda ashuga omwe zotsatira zake zimakhala zowopsa zimatha kukhala m'mapapo komanso matenda a ubongo, thrombosis, zomwe zimayambitsa matenda a mtima ndi stroko, oliguria, aimpso kapena kulephera kupuma, ndi ena. Chifukwa chake, atazindikira kuti wodwalayo wapezeka, wodwalayo ayenera kupereka chithandizo nthawi yomweyo.
Chifukwa chake, ngati mkhalidwe wa wodwalayo watsala pang'ono kukomoka, ndiye kuti kuyitanitsa kwadzidzidzi kuyenera kuchitidwa. Pomwe iye akuyendetsa, ndikofunikira kuyika wodwalayo pamimba pake kapena pambali pake, kulowa zolowetsa ndikuletsa lilime kuti lisaponye. Ngati ndi kotheka, sinthani nkhawa.
Zoyenera kuchita ndi matenda a shuga omwe amayamba chifukwa cha kuchuluka kwa ma ketoni? Muno, kulumikizana kwa machitidwe ndikuwongolera ntchito zofunika za odwala matenda ashuga, monga kupanikizika, kugunda kwa mtima, chikumbumtima komanso kupuma.
Ngati khansa ya lactatacidemic yapanga matenda a shuga, ndikofunikira kuchitanso chimodzimodzi ndi ketoacidotic. Koma kuwonjezera pa izi, ma-electrolyte am'madzi ndi acid-base balance ziyenera kubwezeretsedwanso. Komanso, kuthandizira wodwala matenda a shuga a mtundu uwu amakhala popereka njira yothetsera shuga ndi insulin kwa wodwalayo komanso kumamuthandiza wodwala.
Ngati khansa yofewa ya hypoglycemic ikupezeka m'mitundu yachiwiri ya shuga, kudzithandizira ndikotheka. Nthawiyi sikhala motalika, choncho wodwalayo ayenera kukhala ndi nthawi yokwanira kudya chakudya chamafuta (ma shuga ochepa, shuga, kapu ya madzi a zipatso) ndikumakhala pabwino kuti asadzivulaze ngati atayika.
Ngati hypoglycemia mu matenda osokoneza bongo amakwiya chifukwa cha insulin, mphamvu yake imatenga nthawi yayitali, ndiye kuti kudya ndi matenda oshuga kumaphatikizapo kumwa pang'onopang'ono mafuta ochulukirapo mu kuchuluka kwa 1-2 XE asanagone.
Fomu yoopsa imafuna jakisoni wa yankho la shuga (40%) kapena glucagon (1 mg) kwa munthu wamkulu. Koma pakuletsa mkhalidwewo mwa ana, mlingo umachepa. Wodwalayo akapanda kukhalanso ndi chikumbumtima, ndiye kuti amapititsidwa kuchipatala, komwe chithandizo cha matenda a shuga chikuchitika chifukwa cha kukhetsa kwa shuga (10%).
Kudziwa momwe wodwala matenda ashuga amawonera zosavuta kuzizindikira komanso kupewa kupewa mavuto akulu munthawi yake. Kupatula apo, ngati mumvetsetsa momwe wodwala matenda ashuga amafunikira thandizo mwachangu, ndiye kuti mutha kumuthandiza kwambiri, chifukwa njira yothetsera shuga yomwe imatenge nthawiyo imathandiza kupulumutsa moyo wa munthu, komanso kuchuluka kwa matenda a glycemia kungathandize kupewa zovuta zingapo zoyipa.
Katswiriyu komanso vidiyo yomwe yatchulidwa m'nkhaniyi ayankhula za zomwe angachite ndi matenda ashuga.
