Matenda a Steroid: Zizindikiro, matenda ndi njira zochizira

Zomwe zimapangitsa kuti shuga achulukane zimatha kukhala zochulukirapo kwa nthawi yayitali m'madzi. Pankhaniyi, kupezeka kwa matenda a shuga a steroid amapangidwa. Nthawi zambiri, kusowa bwino kumayamba chifukwa cha mankhwala omwe amakhalapo, koma amathanso kukhala vuto la matenda omwe amabweretsa kuchuluka kwa mahomoni. Nthawi zambiri, kusintha kwa zamankhwala mu kagayidwe kazakudya kumatha kusintha, pambuyo pochotsa mankhwalawa kapena kuwongolera zomwe zimayambitsa matendawa, amazimiririka, koma nthawi zina amatha kulimbikira atalandira chithandizo.

Ma steroid owopsa kwambiri ndi anthu omwe ali ndi matenda a shuga a 2. Malinga ndi ziwerengero, 60% ya odwala amayenera kusintha m'malo mwa hypoglycemic othandizira ndi insulin.

Matenda a Steroid - ndi chiyani?

Steroidal, kapena mankhwala osokoneza bongo, matenda a shuga ndi matenda omwe amatsogolera ku hyperglycemia. Cholinga chake ndi zotsatira zoyipa zamahomoni a glucocorticoid, omwe amagwiritsidwa ntchito kwambiri munthambi zonse zamankhwala. Amachepetsa ntchito ya chitetezo chathupi, amakhala ndi zotsutsa-zotupa. Glucocorticosteroids akuphatikiza Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Posachedwa, osaposa masiku 5, chithandizo cha mankhwalawa chimaperekedwa kwa matenda:

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

• zotupa zoyipa
• bakiteriya meningitis
• COPD ndi matenda osatha a m'mapapo
• gout mu pachimake siteji.

Kutalika kwa nthawi yayitali, kupitirira miyezi isanu ndi umodzi, mankhwala a steroid angagwiritsidwe ntchito pneumonia yapakati, matenda a autoimmune, kutupa kwamatumbo, zovuta zamkati, komanso kufalikira kwa ziwalo. Malinga ndi ziwerengero, kuchuluka kwa anthu odwala matenda ashuga atatha kugwiritsa ntchito mankhwalawa sikupitirira 25%. Mwachitsanzo, pochiza matenda am'mapapo, hyperglycemia imawonedwa mu 13%, mavuto a khungu - 23,5% ya odwala.

Chiwopsezo cha matenda a shuga a steroid chikuwonjezeka ndi:

• kudziwikiratu mtundu wa matenda ashuga 2, achibale oyamba omwe ali ndi matenda ashuga;
• matenda a shuga gestational panthawi imodzi;
• prediabetes;
• kunenepa kwambiri, makamaka m'mimba;
• polycystic ovary;
• ukalamba.

Mulingo waukulu wa mankhwala omwe amamwa, ndiwomwe umakhalapo ndi matenda a shuga a steroid:

Ngati wodwala asanalandire chithandizo cha steroid analibe matenda oyamba a metabolism, glycemia imakhazikika patatha masiku atatu atachotsedwa. Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali komanso kudziwikiratu matenda ashuga, hyperglycemia imatha kudwala, kufuna kudzikonzanso kwa moyo wonse.

Zizindikiro zofananazi zimawoneka kwa odwala omwe ali ndi vuto la kupanga mahomoni. Nthawi zambiri, matenda ashuga amayamba ndi matenda a Itsenko-Cushing, nthawi zambiri amakhala ndi hyperthyroidism, pheochromocytoma, trauma kapena chotupa muubongo.

Zifukwa zachitukuko

Pali ubale wolunjika pakati pa kugwiritsa ntchito glucocorticoid ndi chitukuko cha matenda a shuga. Mankhwala osokoneza bongo amasintha kuchuluka kwa kayendedwe kazinthu zomwe zikuchitika mthupi lathu, zomwe zimayambitsa khansa ya hyperglycemia:

1. Zimakhudza kugwira ntchito kwa maselo a beta, chifukwa chomwe kuphatikiza kwa insulin kumachepetsedwa, kumasulidwa kwake m'magazi kumatsirizidwa chifukwa cha kudya shuga.
2. Zitha kupha maselo ambiri a beta.
3. Amachepetsa ntchito ya insulin ndipo, chifukwa chake, amalepheretsa shuga kulowa m'matipi.
4. Chepetsani kupanga kwa glycogen mkati mwa chiwindi ndi minofu.
5. Ntchito ya enteroglucagon ya mahomoni imaponderezedwa, chifukwa chomwe kupanga kwa insulin kumachepetsedwa.
6. Amawonjezera kutulutsidwa kwa glucagon, mahomoni omwe amachepetsa zotsatira za insulin.
7. Amayambitsa gluconeogeneis, njira yopanga shuga kuchokera kumagulu achilengedwe omwe siopanda chakudya.

Chifukwa chake, kupanga insulini kumachepetsedwa kwambiri, kotero shuga sangathe kufikira cholinga chake - m'maselo a thupi. Kutuluka kwa shuga m'magazi, M'malo mwake, kumawonjezera chifukwa cha gluconeogeneis ndi kufooka kwa mawonekedwe a shuga m'masitolo.

Mwa anthu omwe ali ndi metabolism yathanzi, kuphatikizira kwa insulin kumawonjezeka pambuyo pa masiku 2-5 atatenga ma steroid kuti alipire ntchito yake yochepetsedwa. Akamaliza kumwa mankhwalawo, kapamba amabwerera ku chiyambi. Odwala omwe ali ndi chiopsezo chachikulu cha matenda a shuga a steroid, kubwezeredwa kumatha kukhala kosakwanira, hyperglycemia imachitika. Gulu ili nthawi zambiri limakhala ndi “vuto” lomwe limayambitsa matenda ashuga osachiritsika.

Matendawa amapatsidwa nambala ya ICD ya 10 E11 ngati chikhodzodzo chimasungidwa pang'ono, ndipo E10 ngati maselo a beta adawonongedwa kale.

Mawonekedwe ndi zizindikiro za matenda a shuga

Odwala onse omwe amamwa ma steroid ayenera kudziwa zomwe zimayambitsa matenda ashuga:

• polyuria - kukodza pokodza;
• polydipsia - ludzu lamphamvu, pafupifupi osafooka mukatha kumwa;
• ziume zowuma mucous, makamaka mkamwa;
• khungu lakuthwa, losasamala;
• wotopa nthawi zonse, kuchepa kwa ntchito;
• ndi kuchepa kwakukulu kwa insulin - kuwonda kwambiri.

Ngati zizindikirozi zikuchitika, ndikofunikira kuzindikira matenda a shuga. Kuyesedwa kovuta kwambiri pankhaniyi ndi kuyesa kwa glucose. Nthawi zina, zimatha kuwonetsa kusintha kwa kagayidwe kazakudya mkati mwa maola 8 atatha kumwa ma steroids. Njira zoyesera ndizofanana ndi mitundu ina ya matenda ashuga: shuga kumapeto kwa kuyesedwa sikuyenera kukhala kwakukulu kuposa 7.8 mmol / l. Ndi kuchuluka kwa kuchuluka kwa magawo 11.1, titha kulankhula za kusokonezeka kwakukulu kwa metabolic, komwe nthawi zambiri sikungasinthike.

Kunyumba, shuga ya steroid imatha kupezeka pogwiritsa ntchito glucometer, mulingo wapamwamba kwambiri 11 mutatha kudya chikusonyeza kuyambika kwa matendawa. Kusala shuga kumakula pambuyo pake, ngati kuli pamwamba pa mayunitsi 6.1, muyenera kulumikizana ndi endocrinologist kuti mupeze zowonjezereka komanso kulandira chithandizo.

Zizindikiro za matenda ashuga sizitha kukhalapo, kotero ndichizolowezi kuwongolera magazi kwa masiku awiri oyambilira pambuyo pa kuperekedwa kwa glucocorticoids. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, mwachitsanzo, mutabadwa, kuyesedwa kumaperekedwa sabata iliyonse mwezi woyamba, kenako pambuyo pa miyezi itatu ndi miyezi isanu ndi umodzi, mosasamala kanthu za kukhalapo kwa zisonyezo.

Momwe mungachiritsire matenda a shuga

Matenda a shuga a Steroid amachititsa kuchuluka kwa shuga atatha kudya. Usiku ndi m'mawa musanadye, glycemia ndiyachilendo kwa nthawi yoyamba. Chifukwa chake, mankhwalawa amagwiritsidwa ntchito ayenera kuchepetsa shuga masana, koma osayambukira hypoglycemia yausiku.

Zochizira matenda a shuga, mankhwalawa omwe amagwiritsidwa ntchito ngati mitundu ina ya matendawa: othandizira a hypoglycemic ndi insulin. Ngati glycemia ndi ochepera 15 mmol / l, chithandizo chimayamba ndi mankhwala omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga. Manambala ambiri a shuga amawonetsa kuwonongeka kwakukulu pancreatic ntchito, odwala otchulidwa jakisoni a insulin.

Mankhwala othandiza:

Kupewa

Kupewa komanso kupezeka kwa nthawi yayitali ndi mankhwala a shuga aidid ndi gawo lofunika la chithandizo ndi glucocorticoids, makamaka ngati kugwiritsa ntchito kwawo kwakanthawi kuyembekezeredwa. Njira zomwe zimagwiritsidwa ntchito pa matenda a shuga a 2, zakudya zamafuta ochepa ndikuwonjezera zochitika zolimbitsa thupi, zimachepetsa chiopsezo chophwanya kagayidwe kazachilengedwe.

Tsoka ilo, prophylaxis iyi ndiyovuta, popeza ma steroid amalimbitsa chilimbikitso, ndipo matenda ambiri omwe amawagwiritsa ntchito amawachotsa kapena amachepetsa kwambiri masewera. Chifukwa chake, popewa matenda a shuga a steroid, gawo lalikulu ndi la kuzindikira kwa zovuta ndi kukonza kwawo pamlingo woyambirira mothandizidwa ndi mankhwala ochepetsa shuga.