Hypoglycemic coma ndichikhalidwe chambiri cha endocrine system chomwe chimachitika chifukwa cha kutsika lakuthwa kwa shuga m'magazi. Munthu amene akudwala matendawa amafunika kuthandizidwa mwachangu, koma kuperekera kumafunikira kudziwa zomwe wodwalayo ali nazo. Ndikofunikira kudziwa: Zizindikiro zaumunthu zimagwirizana ndi hyperglycemia kapena hypoglycemia.
Zizindikiro za hypoglycemia ndi hyperglycemia
Matenda owopsa komanso osachiritsika a hyperglycemia akufotokozedwa mwanjira zotsatirazi:
- Udzu wambiri;
- Kukoka pafupipafupi;
- Kutopa nthawi zonse;
- Sinthani kulemera kosalekeza;
- Zowonongeka;
- Pakamwa pakamwa;
- Kuuma ndi kuyabwa kwa khungu;
- Mpweya wa Kussmaul;
- Arrhasmia;
Matenda owoneka bwino omwe amavuta kuchiza, monga vaginal candidiasis kapena otitis externa, angathenso kuonetsa mkhalidwe wa hypoglycemic;
Acute hyperglycemia imatha kuchitika ngati izi:
- Ketoacidosis;
- Chikumbumtima;
- Kuthetsa magazi chifukwa cha glucosuria ndi osmotic diuresis.
Zizindikiro ndi hypoglycemia zimasiyanitsidwa kukhala autonomic (parasympathetic, adrenergic) ndi neuroglycopenic. Zizindikiro zamasamba akufotokozedwa motere:
Mulingo wambiri wamakani ndi chisangalalo, pamodzi ndi nkhawa, mantha komanso malingaliro
- Kuchulukitsa thukuta;
- Minofu kugwedeza, komanso minofu hypertonicity;
- Ana opunduka;
- Kuchulukitsa kwa magazi, arrhythmia;
- Kukula kwa khungu;
- Kuthetsa mseru, nthawi zina kusanza, kupweteka njala;
- Kufooka kwakanthawi
- Zizindikiro za Neuroglycopenic:
- Kuzindikira kochepa, kupweteka mutu, chizungulire, kukhumudwitsa kwa malo, kusokonekera kwa kayendedwe ka kayendedwe;
- Paresthesia;
- "Kufufutidwa" kwa zinthu ngati mawonekedwe owonekera;
- Kuchepa ndi kusintha kwa chizolowezi, chizolowezi;
- Kupuma movutikira ndi magazi;
- Kugona
- Kuzindikira kwa vuto;
- Kukomoka ndi kukomoka kusanachitike;
- Coma
Hypoglycemic Coma Factors
Kugwiritsa ntchito mankhwala kwanthawi yayitali, Zizindikiro zomwezo zimayambitsidwa chifukwa chmwa kumwa mankhwala a insulin osayang'ana mlingo, izi zingayambitse insulin hypoglycemic coma.
Zakumwa zoledzeretsa, kusagwirizana ndi chakudyacho kumathandizanso kukulitsa chikhalidwe cha hypoglycemic coma.
Neurosis, kupsinjika kwakukulu pamalingaliro, kupsinjika ndi kukhumudwa, chifukwa chomwe izi zimachitika nthawi zambiri chimatha kukhala mkhalidwe wa hypoglycemic, ndipo pamapeto pake chikumbumtima cha hypoglycemic.
Ma tumors omwe ali pafupi ndi kapamba, kapamba ka necosis, kupanga insulin kwambiri, izi, mwadzidzidzi, nthawi zina zimakhala zifukwa zoyambirira zomwe zimatsogolera kuzindikiritsa kwa hypoglycemic coma.
Hepatic kusowa, zotsatira za vutoli ndizosiyanasiyana, ndipo mwa iwo akhoza kukhala chikomokere.
Kupsinjika kwakuthupi chifukwa cha masewera kapena masewera olimbitsa thupi kwa nthawi yayitali, zotsatirapo zake zimakhala zosiyanasiyana, koma chimodzi mwazomwezi ndi kuphwanya kwa thupi.
Mavuto a hypoglycemic chikomokere
Ndi chifuwa cha hypoglycemic, ndikofunikira kwambiri kupereka chithandizo choyamba kwa wodwala panthawi yake. Nthawi yomweyo, boma lake lowonjezereka limatengera kuchuluka kwa kuzindikira komanso kuzindikira kwa anthu omwe anali pafupi ndi wodwalayo.
Kuperewera kwa chithandizo chadzidzidzi kumadzaza ndi edema ya m'magazi, zomwe zimapangitsa kuti pakhale zotupa zomwe sizingasinthe zamagetsi. Dziwani kuti ndi pafupipafupi kuyambiranso kwa hypoglycemic coma, mwa odwala akuluakulu kusintha umunthu umawonedwa, ndipo mwa ana pali kuchepa kwa mulingo waluntha. M'magulu onse awiriwa, zotsatira zakupha siziphatikizidwa.
Mkhalidwe wa hypoglycemic coma ndi wowopsa kwambiri kwa okalamba. Izi ndizowona makamaka kwa anthu omwe ali ndi matenda amitsempha yama mtima kapena mtima, komanso matenda amtima. Nthawi ya kukomoka kwa hypoglycemic kwambiri imasokoneza stroko kapena myocardial infarction. Poganizira izi, ndikofunikira kuti nthawi zonse muzikhala ndi ECG.
Ndondomeko amachitika pambuyo kuyimitsa onse chizindikiro cha hypoglycemia. Ngati kuperewera kwa hypoglycemic kumatenga nthawi yayitali, kutsatana ndi mawonekedwe owopsa, encephalopathy kumatha kuchitika, izi sizoyambirira, koma imodzi mwamagulu owopsa.
Encephalopathy ndi cholumikizira ubongo chotupa chomwe chimatsagana ndi mpweya wokhathamira komanso kuwonongeka kwa magazi mu minyewa yaubongo. Matendawa amadziwika ndi kufa kwakukulu kwa maselo amitsempha. Kuwonetsedwa pafupipafupi kwa kudzikuza kwa umunthu.
Njira zopewera komanso thandizo loyamba
Kuti mupereke chithandizo choyenera chovuta chokhala ndi kupuma kwa hypoglycemic, muyenera kudziwa bwino lomwe zizindikiro za matendawa zomwe zikuwonetsa hyperglycemia.
Ndi hyperglycemia, monga mukudziwa, kuchuluka kwa shuga m'magazi kumachuluka kwambiri. Ndikofunikira kumvetsetsa zomwe zimachitika mu hypoglycemia, pomwe kuchuluka kwa shuga m'magazi kumakhala kotsika. Choopsa ndichakuti milandu yonse iwiri imafuna magawo osiyanasiyana omwe ali osiyana kwambiri wina ndi mnzake.
Mkulu shuga wambiri nthawi zonse umakhala limodzi ndi ludzu lochulukirapo, nseru, ndi kufooka. Munthu amene amakhala osakomoka amakhala ndi khungu lowuma, kuchepa kwamtundu wamawu amalembedwa. Kuphatikiza apo, odwala amakhala ndi kupuma kwamphamvu ndi fungo "apulo" linalake komanso fungo la acetone. Ngati wodwala amakhala ndi shuga wochepa m'magazi, ndiye pamenepa, munthuyo amamva kufooka kwambiri ndikunjenjemera m'thupi lonse. Kuphatikiza apo, thukuta kwambiri limalembedwa.
Nthawi zambiri wodwalayo amakhala osagonja, monga lamulo. Palibe zoyipa ngati kuyankha kukhudza.
Kuti munthu athetse vuto la hyperglycemic (kapena matenda ashuga) posachedwa, jakisoni wa insulin adzafunika. Nthawi zambiri, odwala matenda ashuga amakhala ndi zida zothandizira pakagwa vuto mwadzidzidzi. Katundu wothandizira woyamba amakhala ndi zonse zomwe mumafunikira jakisoni wa insulin, kuphatikizapo ubweya wa thonje, malangizo a kumwa, syringes ndi insulin.
Ndikofunikira kukumbukira kuti odwala matenda ashuga amakhala ndi chitetezo chochepa kwambiri, izi zimagwiranso ntchito ku matenda monga matenda amtundu wa 2 komanso mtundu woyamba. Chifukwa cha izi, ndikofunikira mwanjira iliyonse kupatula kuthekera kwa kutenga matenda a jakisoni.
Komanso, musamachite popanda kutsatira zofunika za aseptic insulin. Kuti mupeze chithandizo choyambirira cha kukomoka kwa hyperglycemic mumsewu, ngati zofunikira zonse zakwaniritsidwa, muyenera kufufuza kaye zinthu zonse za wodwalayo kuti mupeze zida zoyambira ndi insulin posachedwa.
Ngati izi zapezeka, mlingo wa insulini umayenera kupakidwa paphewa kapena ntchafu. Mlingo wa insulin uyenera kukhala magawo 50-100. Monga lamulo, mwa odwala omwe ali ndi malekezero, zotsatika za jakisoni wam'mbuyomu zimawonekera bwino, kotero sizingakhale zovuta kuyendayenda.
Ogwira ntchito ma ambulansi ayenera kuyitanidwa mosachedwa. Chowonadi ndi chakuti nthawi yomweyo monga jakisoni wa insulin, wodwalayo amafunikira kuyambitsa njira ya shuga 40%, komanso saline yokhala ndi shuga. Mlingowo udzakhala mpaka 4000 ml. Pambuyo pa njira zadzidzidzi zoyambirira, ndikuyambitsa insulini, wodwalayo ayenera kuchepetsa kuchuluka kwa mapuloteni ndi mafuta omwe amamwe.
Koma madokotala amalimbikitsa mwamphamvu kuti: kulemera kumodzi kwa chakudya chimodzi sikuyenera kutsika kuposa magalamu 300. Chakudya chimodzi chizikhala ndi zopatsa mphamvu mosavuta, monga timadziti, zipatso, ndi zakudya zachilengedwe. Kuphatikiza apo, wodwalayo akulimbikitsidwa kuti azigwiritsa ntchito madzi apamwamba amchere amchere.
Choyamba thandizo la hypoglycemic chikomokere
Ndi hypoglycemia, zinthu zina ziyenera kuchitika zomwe zimakhazikika ndi kukonza mkhalidwe wa wodwalayo:
- Patsani wodwala lokoma, mwachitsanzo, maswiti, ayisikilimu, chidutswa cha shuga. Kuphatikiza apo, mutha kupereka tiyi wokoma, mandimu, madzi otsekemera kapena madzi;
- Ndikofunika kupatsa wodwalayo mwayi wokhala pansi kapena bodza asanayambe chithandizo cha chikomokere.
- Pofuna kutaya chikumbumtima, wodwalayo ayenera kuyikidwa kumbali yake ndi shuga kuyikidwa patsaya;
Kuyimbira timu ya ambulansi yomwe ili ndi vuto la hypoglycemic ndikofunikira, iyi ndi thandizo ladzidzidzi kwa vuto la hypoglycemic.
Ngati wodwala akudziwa, adzatha kumeza madzi, tikulankhula za yankho la shuga. Kukonzekera yankho, muyenera kuthira theka la kapu ya madzi 1 kapena 2 supuni ya shuga.
Popeza wodwalayo sazindikira mu mtima, kuyamwa kwa 40% shuga kumawonetsedwa ngati thandizo ladzidzidzi la hypoglycemic chikomokere. Mwazi wamagazi umakulanso msanga ngati mutaba jakisoni wa subcutaneous wa yankho la adrenaline - 0,1%, 1 ml.
