Matenda a shuga ndi matenda omwe amayamba chifukwa cha zovuta komanso zovuta. Chimodzi mwazosankha zomwe zimachitika pachakudya chachikulu ndi kuperewera kwa matenda ashuga. Awa ndimawu ovuta omwe amatanthauza kuti glycemia yovuta kwambiri komanso zovuta zama metabolic m'thupi zomwe zimalumikizidwa nawo. Ogwira ntchito zamankhwala amatanthauza ndi lingaliro ili mitundu iwiri yamikhalidwe: ketoacidotic ndi hyperosmolar. Mawonekedwe ndi zizindikiro zazikulu za chikomokere matenda a shuga zikukambidwa m'nkhaniyi.
Mawonekedwe ndi zosiyana
Ma comas onsewa ali ndi kufanana komanso kusiyana mu pathogenesis, mawonetseredwe azachipatala, komanso chisamaliro cha odwala. Hyperglycemic coma (ketoacidotic) imayamba ndi kuchuluka kwa shuga m'magazi kuposa 35 -40 mmol / L. Kuipa kwake kumachitika chifukwa chakuti kumbuyo kwa kusowa kwa kapangidwe ka insulin ndi kapamba, matupi a ketone amapangidwa munthawi zosiyanasiyana. Amatuluka "mwamphamvu" kulowa m'magazi kuchokera pachiwindi, ndipo pambuyo pake amawonekera mkodzo.
Hyperosmolar coma imayamba kukhala ndi anthu odwala matenda ashuga omwe amakhala ndi mtundu wachiwiri wa matenda oyamba (osagwirizana ndi insulin). Fomuyi siyimayendera limodzi ndi mapangidwe a matupi a ketone, chifukwa kapamba amapanga insulin yokwanira (nthawi zina imapitirira kuposa momwe amafunikira). Kungoti maselo ndi minyewa yathupi lawo zimasiya kuzimva, ngati kuti 'sawona' chinthucho.
Magazi a glucose olimbana ndi maziko a boma lovuta akhoza kukhala apamwamba kuposa 45-60 mmol / L, pali zambiri zowonjezera mpaka 110 mmol / L. Njira yotukutsira imakhazikika pakuwonjezeka kwa magazi osmolarity ndi kuchepa kwamphamvu kwa thupi.
Zizindikiro za ketoacidosis
Nthawi zambiri, kuyambira woyamba kupita kukomoka, masiku angapo amadutsa. Poyerekeza ndi matenda opatsirana, kuchulukitsa kwa matenda a systemic, zoopsa, zowotcha, nthawi ino zitha kuchepetsedwa kwa maola angapo. Komabe, pali zambiri zosankha zazitali (mwachitsanzo, zaka makumi angapo).
Kuzindikira kwa matenda ashuga - nthawi yoti ayang'anenso zizindikiro za shuga
Zizindikiro za kudwala matenda ashuga amadalira mwachangu kukula kwake ndi kuuma:
- ketoacidosis wolimbitsa;
- precoma (mawonekedwe owonetsedwa);
- chikomokere.
Ketoacidosis woyenera
Zimayamba ndi zizindikiritso za shuga zomwe zikubwera pang'onopang'ono. Odwala ali ndi izi:
Ketoacidosis mu shuga- kuyanika kwambiri kwamlomo;
- ludzu
- pathologically kuchuluka mkodzo;
- kuyabwa kwa khungu, totupa totupa;
- cephalgia;
- kufooka, kufooka;
- kwambiri kuchepetsedwa magwiridwe;
- nseru
Mlengalenga wopanikiratu mumakhala “chipatso” kapena fungo la acetone. Kuyesedwa kwa magazi kumawonetsa glycemia kuchokera 17 mmol / L ndi kukwera. Matupi a Ketone komanso kuchuluka kwa shuga kwamkodzo amatsimikiza.
Precoma
Kusowa kwa chithandizo kumasulira mkhalidwe wa ketoacidosis wolimbitsa Zowawa zam'mimba zimawonekera, zomwe sizimadziwika bwino, kusanza mobwerezabwereza.
Kuchokera m'matumbo, pamakhala matendawa kapena, kudzimbidwa. Zizindikiro zoyambirira za chikumbumtima champhamvu zimawonekera. Odwala akufuna kugona, amakhala osayang'ana zomwe zikuchitika komanso zina zonse zowazungulira, pali kusowa kowongolera m'malo. Wodwalayo amayankha mafunso mosasamala, ali ndi mawu osalala.
Kuyang'ana m'malingaliro ndi imodzi mwamagawo azindikira zovuta
Acidosis, kupuma movutikira kukukulira. Mpweya umamveka phokoso komanso kuya. Kuwunikira kowoneka kumawonetsa kuti khungu louma, lozizira, lakuthwa kwambiri turgor (khungu lotengedwa mu crease silikuwongoka). Lilime la wodwala limakhala ndi zokutira zofiirira, zokhala ndi mano ndi milomo yolumikizidwa. Mawonekedwe aumunthu amatha, ntchito ya minofu imasokonekera kwambiri.
Zizindikiro zazikulu zakutha kwamadzi zimawonekera:
- mawonekedwe owoneka bwino;
- mamvekedwe amaso amachepa kwambiri;
- maso owala;
- malo oyanjana amakhudzidwa;
- wotchulidwa kutsogolo ma tubercles;
- kutsitsa kutentha kwa thupi.
Zizindikiro za kuthamanga kwa magazi zimachepetsedwa kwambiri, zimachitika kuti pakhale chete komanso pafupipafupi. Kuperewera kwa chithandizo chofunikira pakadali pano kumabweretsa kukula.
Zosankha za ketoacidosis
Kutengera ndi kukhalapo kwa ma concomitant pathologies, mkhalidwe wa ketoacidosis wowopsa umatha kupezeka m'njira zosiyanasiyana, momwe kuchuluka kwazinthu zingapo kumawonekera.
- Minyewa yam'mimba - imayamba motsutsana ndi maziko a mtima wamitsempha ya m'mimba. Chodabwitsa kwambiri ndi kupweteka kwam'mimba.
- Encephalopathic - imakhalapo ngati wodwala akudwala matenda amitsempha chifukwa cha matenda a shuga. Hemiparesis, kuphwanya kowopsa kwa mawonekedwe achilengedwe, mawonekedwe a pathological, asymmetry akuwonetsa ali ndi chikhalidwe.
- Mtima - umachitika motsutsana ndi maziko a matenda am'matumbo. Zimaphatikizidwa ndi kugwa kwambiri.
- Mimba - imayamba motsutsana ndi maziko a matenda a shuga komanso nephropathy ndipo amadziwika ndi kuchuluka kwa mapuloteni mumkodzo. Magazi ndi masilindala amathanso kuwoneka mkodzo.
Coma chitukuko
Munthu samazindikira, kupuma kumakhalabe kwakuya komanso kwamkati. Fungo lakuthwa la acetone limveka m'mlengalenga. Kuthamanga kwa magazi kwachepetsedwa kwambiri, tachycardia. Polyuria, yomwe inali m'mbuyomu, imasinthidwa ndi kusowa kwamkodzo kwathunthu.
Ketoacidotic chikomachi ndimavuto owopsa omwe nthawi zambiri amapezeka mwa achinyamata, ana
Kutentha kwa thupi kumafika madigiri 35. Thupi la wodwalayo silimakhudzidwa ndi kukondwerera kwakunja, thupi limatsalira. Kuyambira pomwe chitukuko chikoma, chithandizo chitha kuperekedwa tsiku lonse. Zotsatira zina ndi imfa.
Hyperosmolar chikomokere
Zizindikiro za matenda obwera ndi matenda a shuga amtunduwu zimapanganso pang'onopang'ono, koma mochuluka - milungu ingapo. Ngati ketoacidosis imadziwika ndi achinyamata (ngakhale ana), ndiye kuti chikhalidwe cha hyperosmolar chimawoneka mwa odwala omwe ali ndi zaka zopitilira 40-45.
Mawonekedwe a precoma ndi ofanana:
- ludzu
- polyuria;
- khungu louma;
- kuwonda;
- kufooka, kugona;
- kuchepa kwa magwiridwe.
Popeza kufooka kwa thupi kumachita mbali yofunika kwambiri pakapangidwe kazovuta zina, zizindikiro zotsatana zimawonekera:
- kwambiri yafupika turgor ndi khungu elasticity;
- maso owala;
- mamvekedwe amaso amachepa;
- mphuno yolimba;
- zotupa pachifuwa ndi ma tubercles oyambira;
- malo ophatikizidwa ndi dzuwa, subclavian ndi supraclavicular fossa;
- chifuwa chadzuwa.
Kupsinjika kwa magazi kumachepetsedwa, zimachitika ndimalimba, pafupipafupi, mopanda ulusi.
Neurology
Zizindikiro zowonongeka mu dongosolo lamanjenje ndizomwe zimatsogolera pakukula kwa mkhalidwe. Kugwedezeka mwamphamvu, kugwidwa, khunyu, kupuma. Mawonekedwe achibadwa cha thupi amasokonezeka kwambiri, omwe amayambitsa matenda amapezeka. Kuphwanya ntchito zachidziwitso, nystagmus zimayamba.
Matenda a khunyu - chizindikiro cha kuwonongeka kwa ubongo mu chikomokere kwa hyperosmolar
Panthawi yowunikira, katswiri amatha kudziwa kukhalapo kwa zizindikiro zoyipa za khosi (kuuma kwa khosi, zizindikiro za Brudzinsky, Kwering, Ankylosing spondylitis).
Kuperewera kwa chithandizo ndi chisamaliro chamankhwala kumabweretsa chitukuko cha stupor. Kuzindikira mdziko lino kumapanikizidwa, koma malingaliro amakhalabe osungika. Pambuyo pake, munthu amagwa kukomoka, komwe samayankhanso kukhudzidwa kwakunja, mawonekedwe a zinthu samakhalakonso.
Kudziwa za kuwonekera kwa zovuta za matenda ashuga kungathandize kusiyanitsa mkhalidwe wa wodwalayo (ndipo atha kukhala wachibale, owadziwa, kapena ongodutsa mwangozi) ndikupereka thandizo panthawi yake, kupulumutsa miyoyo yawo.
