Mankhwala a insulin: Zizindikiro ndi thandizo loyamba

Mwa zina zovuta za matenda ashuga, owopsa kwambiri ndi mantha insulin. Vutoli limayamba chifukwa cha kuchuluka kwa insulin kukonzekera kapena kutulutsa kwakukulu kwa insulin m'magazi. Kugwedezeka kotereku n'koopsa. Chifukwa cha kuyamba kwa hypoglycemia, wodwalayo mwina sazindikira kuopsa kwa vuto lakelo ndipo satenga njira iliyonse yolerera. Ngati mankhwalawo atachotsedwa atangochitika, mkhalidwe wa anthu odwala matenda ashuga umafooka kwambiri: amasiya kudziwa, ndipo vutoli limayamba.

Kodi kudwala kwa insulin

Hemeni wa insulin, yomwe imapangidwa m'masamba a kapamba, amaphatikizanso gawo lalikulu pakulimbitsa kagayidwe kazakudya. Ndi matenda amtundu wa 1 shuga, kapangidwe ka timadzi tating'onoting'ono timayima kwathunthu, ngati tili ndi matenda a shuga a nthawi yayitali, vuto lalikulu la insulin limatha. M'njira zonsezi, wodwalayo amapatsidwa jakisoni wa mahomoni opangidwa ndi mankhwala. Mlingo wa insulin amawerengedwa mosiyanasiyana jekeseni aliyense, pomwe kudya shuga kumatha kuzindikiridwa.

Mankhwalawa atayambitsidwa, shuga amapezeka m'magazi kupita m'matumbo a insulin: minofu, mafuta, komanso chiwindi. Ngati wodwala matenda ashuga wadzipatsa mlingo waukulu kuposa momwe amafunikira, kuchuluka kwa shuga m'magazi kumatsika kwambiri, ubongo ndi msana zimataya mphamvu zawo zazikulu, ndipo vuto la ubongo limayamba, lomwe limatchedwanso kuti insulin. Nthawi zambiri, izi zimayamba shuga atatsikira mpaka 2.8 mmol / L kapena kutsikira. Ngati mankhwala osokoneza bongo ndi ochulukirapo ndipo shuga amatsika msanga, Zizindikiro zakugwedezeka zimatha kuyamba 4,5 mmol / L.

Nthawi zina, mankhwalawa amabwera chifukwa cha insulin. Pankhaniyi, chomwe chimayambitsa insulin yambiri m'magazi imatha kukhala insulinoma - chotupa chomwe chimatha kudzipangira payekha ndikuliponya m'magazi ambiri.

Zizindikiro zoyambira ndi chizindikiro

Mankhwala amtundu wa insulin amabwera m'magawo awiri, omwe ali ndi zizindikiro zake:

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%

Ngati hypoglycemia itathetsedwa pamlingo wachifundo, zizindikiritso zam'mimba zimazimiririka, mkhalidwe wa wodwalayo umayamba bwino. Gawo ili ndi la kanthawi kochepa, chisangalalo chimasinthidwa mwachangu ndi zosayenera, chikumbumtima chobisala. Mbali yachiwiri, munthu wodwala matenda ashuga sangathe kudzithandiza yekha, ngakhale atakhala kuti amadziwa.

Ngati magazi a magazi akupitilizabe kuchepa, wodwalayo amagwera pachisokonezo: amakhala chete, amasuntha pang'ono, samayankha kwa ena. Ngati mankhwalawo a insulin sangachotsedwe, munthuyo amayamba kugwa, amagwa ndi vuto la hypoglycemic, kenako nkufa.

Nthawi zambiri, kugwirira kwa insulin kumatha kupewedwa mukangoyamba kumene chizindikiro chake choyamba. Kusiyana ndi odwala omwe amakhala ndi matenda oopsa a shuga, omwe nthawi zambiri amakhala ndi hypoglycemia. Pankhaniyi, magwiridwe antchito amachitidwe osokoneza bongo amasokonezeka, kumasulidwa kwa mahomoni poyankha shuga wochepa kumachepetsedwa. Zizindikiro zomwe zimatsimikizira kuti hypoglycemia imawoneka mochedwa kwambiri, ndipo wodwalayo sangakhale ndi nthawi yochita zinthu zina zowonjezera shuga. Ngati matenda ashuga ali ovuta mitsempha, wodwalayo amatha kutaya chikumbumtima popanda zizindikiro zam'mbuyomu.

Thandizo Loyamba la Insulin Shock

Cholinga chachikulu pakuchotsa mantha a insulin ndikutanthauza kusintha kwamisempha. Mfundo zofunika kuzisamalira mwadzidzidzi gawo loyamba, pomwe wodwala matenda ashuga amadziwa:

1. Odwala omwe ali ndi matenda ashuga okha amatha kuthetsa hypoglycemia, mkate umodzi wokha wamafuta ndikokwanira izi: maswiti, zidutswa zingapo za shuga, theka kapu ya madzi.
2. Ngati zizindikiro za hypoglycemia zikunenedwa, mkhalidwewo ukuopseza kuyamba kukhala wodabwitsa ndipo kwa yemwe, wodwala matenda ashuga ayenera kupatsidwa chakudya chambiri cha 2 XE. Kuchuluka kwake kuli kofanana ndi kapu ya tiyi yemwe ali ndi supuni 4 za shuga, supuni ya uchi, kapu ya madzi a zipatso kapena koloko yotsekemera (onetsetsani kuti zakumwa zimapangidwa chifukwa cha shuga, osati zina). Mochulukirapo, maswiti kapena zidutswa za shuga ndizomwe zingachite. Zinthu zikasintha, muyenera kudya zakudya zamafuta, zomwe zimatengedwa pang'onopang'ono, kuchuluka kwake ndi 1 XE (mwachitsanzo, mkate wamba).
3. Ndi mankhwala osokoneza bongo ambiri a insulin, hypoglycemia ikhoza kubwerera mobwerezabwereza, mphindi 15 pambuyo pa kubadwa kwa chikhalidwe, shuga ya magazi iyenera kuyesedwa. Ngati zili pansipa (4.1), chakudya chopatsa thanzi chimapatsanso odwala matenda ashuga, ndi zina zotero, mpaka glycemia ikasiya kugwa. Ngati panali kugwa kupitilira kawiri, kapena vuto la wodwalayo likuipiraipira ngakhale shuga abwinobwino, muyenera kuyitanira ambulansi.

Malamulo othandizira odwala matenda ashuga ngati sakudziwa:

1. Imbani ambulansi.
2. Mugoneke wodwala pambali pake. Yang'anani zamkamwa pakamwa, ngati kuli kotheka, yeretsani chakudya kapena masanzi.
3. Munthawi imeneyi, munthu sangameze, kotero sangathe kutsanulira zakumwa, kuyika shuga pakamwa. Mutha kupaka mafuta m'kamwa ndi mucous nembanemba mkamwa ndi uchi wambiri kapena gel osakaniza ndi glucose (HypoFree, Dextro4, etc.).
4. Yambitsani glucagon wa intramuscularly. Ndi shuga wodalira insulin, mankhwalawa amalimbikitsidwa kuti azichita nanu. Mutha kuzindikira ndi pensulo yamapulasitiki ofiira kapena ofiira. Bokosi lothandizira la hypoglycemia limakhala ndi zosungunulira mu syringe ndi ufa pang'ono. Pofuna kukonzekera glucagon kuti agwiritse ntchito, madzi amadzaza mu syringe mu vial, osakanizidwa bwino, kenako ndikubwezeretsanso syringe. Jakisoni amachitidwa minofu iliyonse, kwa akulu ndi achinyamata mankhwalawa amaperekedwa kwathunthu, kwa ana - theka la syringe. Werengani zambiri za Glucagon.

Chifukwa cha izi, kuzindikira kwa wodwala kuyenera kubwerera mkati mwa mphindi 15. Ngati izi sizingachitike, akatswiri a ambulansi omwe afika adzapereke shuga m'mitsempha. Mwachilengedwe, 80-100 ml ya yankho la 20-40% ndikokwanira kusintha mkhalidwe. Ngati hypoglycemia ibwerera, wodwalayo sayambiranso, zovuta zimayamba chifukwa cha mtima kapena ziwalo zopumira, ndipo amapititsidwa kuchipatala.

Momwe mungapewere kuyambiranso

Popewa kudabwitsanso insulin, akatswiri a ma endocrinologists amalimbikitsa:

• yesani kudziwa zomwe zimayambitsa hypoglycemia iliyonse kuti muganizire zolakwa zanu powerengera kuchuluka kwa insulin, mukamakonza menyu komanso zolimbitsa thupi;
• palibe chifukwa musadumire chakudya pambuyo insulin, musachepetse kukula kwake, musalole zakudya zama protein ndi protein;
• osamamwa mowa mwa shuga. Mu mkhalidwe woledzera, kulumpha mu glycemia ndikotheka, chiwopsezo chachikulu chowerengera molakwika kapena makonzedwe a insulin - za mowa ndi matenda ashuga;
• kanthawi kodzidzimuka, nthawi zambiri kuposa masiku, kuyeza shuga, kudzuka kangapo usiku ndi m'mawa;
• sinthani njira ya jakisoni. Onetsetsani kuti insulin imalowa pansi pakhungu, osati minofu. Kuti muchite izi, mungafunike kusintha singano ndi zazifupi. Osatupa, kutentha, kukanda, kapena kutikirira malo a jakisoni;
• yang'anirani mosamala glycemia panthawi yolimbikira, osati mwakuthupi komanso mwamalingaliro;
• konzani za pakati. M'miyezi yoyamba, kufunafuna insulin kumatha kuchepa;
• mukasintha kuchokera ku insulin yaumunthu kupita ku analogues, sankhani kuchuluka kwa kukonzekera kwapansi ndi zonse zomwe muyenera kuwerengera insulin yayifupi;
• Musayambe kumwa mankhwala osakambirana ndi endocrinologist. Ena mwa iwo (mankhwala ochepetsa kuthamanga, tetracycline, aspirin, sulfonamides, etc.) amalimbikitsa zochita za insulin;
• nthawi zonse mumakhala ndi ma carbohydrate othamanga ndi glucagon;
• dziwitsani abale, abwenzi, anzanu ogwira nawo ntchito za matenda anu a shuga, adziwitsani ndi zizindikiro zakunjenjemera, phunzitsani malamulo othandizira;
• Valani chovala cha matenda ashuga, ikani kakhadi pozindikira komanso mankhwala osankhidwa mu pasipoti kapena chikwama chanu.