Pampu ya insulin ndi chida chapadera choperekera insulin kwa thupi la wodwala yemwe ali ndi matenda ashuga. Njirayi ndi njira ina yosagwiritsa ntchito mtsinje wa syringe ndi syringes. Pampu ya insulini imagwira ntchito ndikupereka mankhwalawo mosalekeza, womwe ndi mwayi wake waukulu pakubaya jakisoni wa insulin.
Ubwino wake wa izi ndi monga:
- Mosavuta makonzedwe ang'onoang'ono Mlingo wa insulin.
- Palibe chifukwa chobayira insulin yowonjezera.
Pampu ya insulin ndi chipangizo chovuta, ndipo magawo ake ndi:
- Pampu - pampu yomwe imatulutsa insulini kuphatikiza ndi kompyuta (system control).
- Katiriji mkati mwa pampu ndi chosungira cha insulin.
- Makina obwezeretsanso osakanikirana a cannula ndi machubu angapo kulumikiza ndi chosungira.
- Mabatire
Pampu ya inshuwaransi ya Refuel insulin yokhala ndi insulin iliyonse, ndibwino kugwiritsa ntchito Ultvo-Short NovoRapid, Humalog, Apidru. Izi zimatha kwa masiku angapo musanapange mafuta kuti musokenso.
Mfundo za pampu
Zipangizo zamakono zili ndi mtundu wocheperako, ndipo ndizofanana ndi pger. Insulin imaperekedwa ku thupi laumunthu kudzera pamiyendo yapadera yopapatiza (ma catheters omwe ali ndi cannula kumapeto). Kudzera m'machubu awa, chosungira mkati mwa pampu, chodzaza ndi insulin, chimalumikizana ndi mafuta osunthika.
Pampu yamakono ya insulin ndi chipangizo chopepuka cha pager. Insulin imalowetsedwa mthupi kudzera mu machitidwe a timachuti tating'onoting'ono. Amamangirira madzi osungirako ndi insulin mkati mwa chipangizocho ndi mafuta osunthika.
Vutoli, lomwe limaphatikizapo chosungira lokha ndi catheter, limatchedwa "infusion system." Wodwala azisintha masiku atatu onse. Imodzi ndi kusintha kwa kulowetsedwa, malo omwe amapezeka ndi insulin amafunikanso kusinthidwa. Cannula ya pulasitiki imayikidwa pansi pa khungu m'malo omwewo omwe insulin imabayidwa ndi njira yokhayo yovomerezeka.
Ma Ulmpashort omwe amagwira ntchito za insulin nthawi zambiri amaperekedwa ndi pampu; nthawi zina, insulin ya anthu yochepa imatha kugwiritsidwanso ntchito. Kupereka kwa insulin kumachitika m'miyeso yaying'ono kwambiri, mu Mlingo kuchokera ku 0,025 mpaka 0.100 mayunitsi nthawi (izi zimatengera chitsanzo cha pampu).
Mlingo wa insulini umapangidwira, mwachitsanzo, kawonedwe kameneka kamapereka ma insulini a 0,55 pa mphindi zisanu zilizonse pa liwiro la magawo a 0,6 pa ola limodzi kapena masekondi aliwonse a 150 pamagulu a 0.025.
Malinga ndi lingaliro la ntchito, mapampu a insulini ali pafupi ndi magwiridwe antchito aanthu. Ndiye kuti, insulin imayendetsedwa m'njira ziwiri - bolus ndi basal. Zinapezeka kuti kuchuluka kwa insulin yotulutsidwa ndi kapamba kumasiyana malinga ndi nthawi ya tsiku.
M'mapampu amakono, ndizotheka kukonza kuchuluka kwa makulidwe a basal insulin, ndipo malinga ndi ndandanda imatha kusintha mphindi 30 zilizonse. Chifukwa chake, "insulin yakumbuyo" imatulutsidwa m'magazi m'magawo osiyanasiyana nthawi zosiyanasiyana.
Asanadye chakudya, muyenera kugwiritsa ntchito mlingo wa mankhwala a bolus. Wodwala amayenera kuchitika pamanja.
Komanso, pampuyo imatha kukhazikitsidwa ku pulogalamuyi malinga ndi kuchuluka kwa insulin komwe kumathandizira ngati magazi okwanira awonekera m'magazi.
Ubwino wa pampu yodwala
Pochiza matenda a shuga mothandizidwa ndi chipangizo choterechi, ndimagulu amodzi okha a insulin omwe amagwiritsidwa ntchito, yankho kuchokera pampuyo limaperekedwa kwa magazi nthawi zambiri, koma mu Mlingo wochepa, kotero kuyamwa kumachitika pafupifupi nthawi yomweyo.
Odwala omwe ali ndi matenda ashuga, kusinthasintha kwa shuga m'magazi kumachitika kawirikawiri chifukwa cha kusintha kwa mayamwidwe obwera chifukwa cha insulin. Pampu ya insulin imathetsa vutoli, lomwe ndiye mwayi wake waukulu. Insulin yochepa yomwe imagwiritsidwa ntchito pampu imakhala yokhazikika.
Ubwino wina wogwiritsa ntchito insulin pump:
- Kulondola kwamtunda kwapamwamba komanso sitepe yaying'ono. Mlingo wa bolus mumapampu amakono amapezeka mu kuwonjezeka kwa 0.1 PIECES, pomwe zolembera za syringe zili ndi mtengo wogawika wa 0.5 - 1.0 PIECES. Mlingo wa makonzedwe a basal insulin amatha kusiyanasiyana kuchokera ku 0,025 mpaka 0,100 magawo ola limodzi.
- Chiwerengero cha ma punctures amachepetsedwa nthawi khumi ndi zisanu, chifukwa kulowetsedwa kumafunikira kusintha kwa 1 nthawi m'masiku atatu.
- Pampu ya insulin imakulolani kuwerengera kuchuluka kwa insulin yanu. Pachifukwa ichi, wodwalayo ayenera kudziwa magawo ake (kutengeka kwa insulin kutengera nthawi ya tsiku, chakudya chopatsa mphamvu, mulingo wa glucose) ndikuwalowetsa mu pulogalamuyi. Kuphatikiza apo, makina amawerengera kuchuluka kwa insulin yoyambira, kutengera zotsatira za kuyeza shuga m'magazi asanadye komanso kuchuluka kwa chakudya chomwe amakonzekera kudya.
- Kutha kusintha pampu ya insulin kuti piritsi la botus la mankhwalawo lisatumizidwe nthawi imodzi, koma idagawidwa nthawi yayitali. Ntchitoyi ndiyofunika ngati wodwala matenda ashuga amadya pang'onopang'ono chakudya chamafuta kapena paphwando lalitali.
- Kupitiliza kosalekeza kwa ndende ya shuga munthawi yeniyeni. Ngati shuga amaposa malire ovomerezeka, ndiye kuti pampu imadziwitsa wodwalayo za matendawa. Mitundu yatsopano kwambiri imatha kusiyanitsa kuchuluka kwa mankhwalawo pawokha, kuti magawo a shuga akhale abwinobwino. Mwachitsanzo, ndi hypoglycemia, pampu ya insulin imaletsa mankhwalawo.
- Kudula mitengo, kusungira ndikusintha kupita kukompyuta kuti ikasunthidwe. Pampu za insulin nthawi zambiri zimasunga mu kukumbukira kwawo kwa miyezi 6 yapitayo zokhudza kuchuluka kwa insulin komwe kunaperekedwa ndi kuchuluka kwa shuga m'magazi.
Kuphunzitsa wodwala pampu ya insulin
Ngati wodwalayo sanaphunzitsidwe koyenera, ndiye kuti zimamuvuta kuti asinthe kugwiritsa ntchito pampu ya insulin. Munthu ayenera kumvetsetsa momwe angapangire kupezeka kwa insulin ndi momwe angasinthire kuchuluka kwa mankhwalawo munjira yoyambira.
Zisonyezo za pampu insulin mankhwala
Kusintha kwa mankhwala a insulin pogwiritsa ntchito pampu kumachitika mu milandu ili:
- Pofunsidwa ndi wodwalayo.
- Ngati sizotheka kulandira chindapusa chabwino cha matenda ashuga (glycated hemoglobin ali ndi mtengo woposa 7%, ndipo mwa ana - 7.5%).
- Kusintha pafupipafupi komanso kwakukuru pakusintha kwa shuga m'magazi kumachitika.
- Nthawi zambiri pamakhala hypoglycemia, kuphatikizapo mawonekedwe osalala, komanso usiku.
- Zodabwitsa za "mbandakucha m'mawa."
- Zotsatira zosiyanasiyana za mankhwala kwa wodwala masiku osiyanasiyana.
- Ndikulimbikitsidwa kugwiritsa ntchito chipangizochi pakukonzekera kubereka, mukakhala ndi mwana, panthawi yobadwa komanso pambuyo pake.
- Zaka za ana.
Mwachidziwitso, pampu ya insulini iyenera kugwiritsidwa ntchito mwa onse odwala matenda ashuga omwe amagwiritsa ntchito insulin. Kuphatikizira kuchedwa kwa autoimmune shuga mellitus, komanso mitundu ya matenda ashuga.
Contraindication pa ntchito pampu ya insulin
Mapampu amakono ali ndi chida chotere chomwe odwala amatha kugwiritsa ntchito mosavuta ndikuzikonza modzikonzekera. Komabe, chithandizo cha insulin-pump chikutanthauza kuti wodwalayo ayenera kutenga nawo mbali pamankhwala ake.
Ndi mankhwala a insulin ofotokoza kupopa, chiopsezo cha hyperglycemia (kuchuluka kwambiri kwa shuga m'magazi) kwa wodwalayo chikuwonjezereka, ndipo mwayi wokhala ndi matenda a shuga a ketoacidosis nawonso ndiwokwera. Izi ndichifukwa choti palibe insulin yotalika nthawi yayitali m'magazi a anthu odwala matenda ashuga, ndipo ngati kupatsirana kwa insulin yayifupi pazifukwa zilizonse kuyimitsidwa, zovuta zina zimatha kuyamba patatha maola 4.
Kugwiritsa ntchito pampu kumapangidwa panthawi yomwe wodwalayo alibe chidwi kapena mphamvu yogwiritsira ntchito njira yayikulu yosamalira matenda a shuga, ndiye kuti, alibe luso lodziletsa kuti asankhe shuga, sawerengetsa zakudya monga chakudya, samalinganiza zochita zolimbitsa thupi komanso kuwerengetsa Mlingo wa insulin.
Pampu ya insulin sikugwiritsidwa ntchito kwa odwala omwe ali ndi matenda amisala, chifukwa izi zitha kuyambitsa chida chosayenera. Ngati wodwala matenda ashuga ali ndi vuto lakhungu, ndiye kuti sangathe kuzindikira zolembedwa papompo la insulin.
Poyamba kugwiritsidwa ntchito pampu, kuyang'anira dokotala nthawi zonse ndikofunikira. Ngati palibe njira yoperekera, ndibwino kuchedwetsa kusintha kwa insulin ndikugwiritsa ntchito pampu nthawi ina.
Kusankhidwa kwa pampu ya insulin
Mukamasankha chida ichi, onetsetsani kuti mumvera:
- Kuchuluka kwa voliyumu. Iyenera kukhala ndi insulini yambiri masiku atatu.
- Kodi zilembozi zimawerengedwa kuchokera pachinsalu bwino, ndipo kodi kuwongola kwake komanso kusiyana kwake ndikokwanira?
- Mlingo wa botus insulin. Muyenera kuyang'anitsitsa kuchuluka kwa insulin yomwe ingathe kuyikidwa, komanso ngati ili yoyenera kwa wodwala wina. Izi ndizofunikira kwambiri kwa ana, chifukwa amafunika Mlingo wochepa kwambiri.
- Makina owerengera. Kodi ndizotheka kugwiritsa ntchito coefficients wodwala payekha pamphepete, monga insulin sensitivity factor, nthawi ya mankhwala, carbohydrate coefficient, chandamale shuga pamwazi.
- Zowawa Kodi zidzakhala zofunikira kumva kulira kapena kumva kugwedezeka pomwe mavuto abwera.
- Madzi osagwira. Kodi pakufunika pampu yopanda madzi.
- Kuchita ndi zida zina. Pali ma pampu omwe amatha kugwira ntchito mwaokha mophatikiza ndi glucometer ndi zida zowunikira mosalekeza shuga la magazi.
- Kusavuta kugwiritsa ntchito pampu m'moyo watsiku ndi tsiku.
Momwe mungawerengere Mlingo wa insulin
Mankhwala osankha mukamagwiritsa ntchito pampu ndi fanizo la insulin yochepa kwambiri. Nthawi zambiri, Humalog insulin imagwiritsidwa ntchito pazolinga izi. Pali malamulo ena a kuwerengetsa Mlingo wa insulini poperekera kugwiritsa ntchito pampu mu njira za bolus ndi basal.
Kuti mumvetsetse kuthamanga kwa kuperekera kwa insulini mu njira ya basal, muyenera kudziwa kuchuluka kwa insulin yomwe wodwala adalandira asanagwiritse ntchito chipangizocho. Mlingo watsiku ndi tsiku uyenera kuchepetsedwa ndi 20%, ndipo nthawi zina ndi 25-30%. Mukamagwiritsa ntchito pampu momwe mumakhala basal, pafupifupi 50% ya insulin tsiku lililonse imayendetsedwa.
Mwachitsanzo, wodwala wokhala ndi insulin mobwerezabwereza amalandira magawo 55 a mankhwala patsiku. Pazakusintha kwa pampu ya insulin, adzafunika kulowa magawo 44 a mankhwala patsiku (55 mayunitsi x 0.8). Potere, mlingo woyambira wa insulin uyenera kukhala magawo 22 (theka la kuchuluka kwa tsiku ndi tsiku). Insulin ya basal iyenera kuperekedwa pamiyeso yoyamba ya 22 U / 24 maola, ndiye kuti, 0,9 U pa ola limodzi.
Choyamba, pampuyo imasinthidwa mwanjira yoti iwonso azitsimikizira tsiku lomweli. Kenako kuthamanga kumeneku kumasintha usana ndi usiku, kutengera zotsatira za shuga wowonjezereka. Ndikulimbikitsidwa kuti musinthe liwiro osaposa 10% nthawi iliyonse.
Mlingo wa jakisoni wa insulin m'magazi usiku umasankhidwa malinga ndi zotsatira za kuwunika shuga asanagone, pakati pausiku ndikadzuka. Kuchuluka kwa insulini pobereka masana kumayendetsedwa ndi zotsatira za kudziletsa kwa shuga omwe amaperekedwa omwe amadumphira chakudya.
Mlingo wa bolus insulin yomwe imalowetsedwa kuchokera pampopa kulowa m'magazi asanadye kaye nthawi iliyonse. Amawerengeredwa molingana ndi malamulo omwewo monga ndi insulin yokwanira yogwiritsira ntchito jakisoni.
Mapampu a insulin ndi njira yotsogola, chifukwa tsiku lililonse limatha kubweretsa nkhani pankhaniyi. Kukhazikitsa kwa chida chotere chomwe chimatha kugwira ntchito palokha, monga kapamba weniweni, chikuchitika. Kubwera kwa mankhwalawa kudzapangitsa kusintha kwa matenda a shuga, ofanana ndi kusintha komwe ma glucometer achita, mwachitsanzo mita ya Accu Check Go.
Zovuta za chithandizo cha matenda a shuga a insulin
- Chipangizochi chili ndi mtengo waukulu woyambirira.
- Zogulira ndizokwera mtengo kwambiri kuposa ma syringes omwe amapezeka nthawi zonse.
- Mukamagwiritsa ntchito pampu, mavuto aukadaulo nthawi zambiri amabwera, ndipo kuyambitsa kwa insulin mthupi la wodwalayo kumayima. Izi zitha kukhala chifukwa cha kusapeza bwino kwa pulogalamu, insulin crystallization, cannula slip ndi mavuto ena.
- Chifukwa cha kusadalirika kwa zida zomwe zimadwala odwala matenda ashuga a mtundu woyamba, ketoacidosis yausiku imachitika nthawi zambiri kuposa odwala omwe amapaka insulin ndi ma syringes.
- Anthu ambiri samawona kuti ndizotheka kuti nthawi zonse amakhala ndi machubu pamimba pawo ndi cannula kutuluka. Amakonda jakisoni osapweteka ndi ma syringe.
- Kuthekera kwakukulu kwa matenda pamalo oyambitsa cannula. Pangakhale pali zilonda zofunikira opaleshoni.
- Mukamagwiritsa ntchito mapampu a insulin, hypoglycemia yoopsa imakonda kuchitika, ngakhale opanga amalalikira kwambiri. Mwambiri, izi zimachitika chifukwa cholephera kwa dosing system.
- Ogwiritsa ntchito pampu amakhala ndi vuto pakagwiritsidwe ntchito ka madzi, kugona, kusambira, kapena kugona.
