Kodi pampu ya insulin imagwira ntchito bwanji?

Njira ina yabwino yopangira jakisoni wobwerezabwereza wa insulin, jekeseni ndi zolembera zapadera za syringe, ndi pampu. Nthawi zambiri, amagwiritsidwa ntchito pochiza matenda a shuga 1 a mellitus.

Pampu ndi chida chapadera chomwe kuchuluka kofunikira kwa mahomoni amalowera m'thupi la wodwalayo. Chipangizocho chimalola kuti kagwiritsidwe ntchito ka insulin mothandizidwa ndi glycemia, komanso powerengera mafuta a carbohydrate ogwiritsiridwa ntchito ndi anthu.

Mfundo yogwira ntchito

Chipangizocho chimapereka kuperekera kwa mahomoni pansi pa khungu la wodwala.

Chithunzicho chili ndi:

1. Pomp - pampu yopangidwa kuti ipereke mankhwala.
2. Makompyuta okhala ndi pulogalamu yoyendetsera kuphatikiza.
3. Cartridge yokhala ndi insulin (yosinthika).
4. Kulowetsedwa. Lili ndi catheter wa jakisoni wa insulini komanso dongosolo la machubu kulumikiza mpope ndi cannula.
5. Mabatire

Chipangizochi chimapatsidwa insulin, yomwe imakhala yochepa. Ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa monga Humalog, NovoRapid kapena Apidra, nthawi zina, insulin ya anthu ingagwiritsidwe ntchito. Njira imodzi ya kulowetsedwa, monga lamulo, ndikwanira kwa masiku angapo, ndiye kuyimitsidwanso kumafunika.

Zipangizo zamakono ndizodziwika chifukwa cha kulemera kwawo kopepuka komanso kukula kwake, kukumbukira kwa ma pager. Mankhwalawa amaperekedwa kudzera mu catheters ndi cannula kumapeto. Chifukwa cha machubu awa, cartridge yokhala ndi insulin imalumikizana ndi minofu yamafuta.

Nthawi yosintha posungira ndi insulin zimatengera mulingo komanso kufunika kwakumwa. Cannula imayikidwa pansi pa khungu m'malo am'mimba, opangidwira jakisoni mothandizidwa ndi zolembera.

Mfundo zoyendetsera pampu ndizofanana ndi zomwe zimachitika ndi kapamba, chifukwa chake, mankhwalawa amayendetsedwa mu basal ndi bolus mode. Mlingo woyambira wa basal unakonzedwa ndi chipangizocho ndipo umatha kusintha pambuyo theka la ola. Mwachitsanzo, mphindi zisanu zilizonse, zigawo za 0.05 za mahormoni zimaperekedwa (kuthamanga kwa mayunitsi 0,60 / ola).

Kupereka kwa mankhwalawa kumatengera mtundu wa chipangizocho ndikuchitika pang'ono - Mlingo wambiri kuyambira 0,025 mpaka mayunitsi 0,1. Mlingo wa bolus uyenera kuperekedwa ndi odwala pamanja musanayambe kudya. Kuphatikiza apo, zida zambiri zimapangitsa kukhazikitsa pulogalamu yapadera yomwe imapereka kudya kwakanthawi kokwanira kwa kuchuluka kwa mahomoni ngati mtengo wa shuga pakadali pano uposa masiku onse.

Ubwino wodwala

Opanga akuyesayesa kwakukulu kuti mapampu a insulin afunike pamsika ku Russia.

Ubwino wambiri wazida:

• atsogolere mobwerezabwereza makonzedwe a mahomoni tsiku lonse;
• amathandizira kuthetsedwa kwa insulin yayitali.

Zowonjezera zina:

1. Kulondola kwakukulu kwa Mlingo wokhazikitsidwa. Poyerekeza ndi zolembera zanthawi zonse ndi gawo la 0.5-1 ED, pampu imatha kupereka mankhwala pamiyeso ya mayunitsi 0,1.
2. Chiwerengero cha ma punctures chachepa. Kusintha kwa kulowetsedwa kumachitika masiku atatu aliwonse.
3. Chipangizocho chimakulolani kuwerengera bolus insulin ya wodwalayo payekhapayekha (poganizira momwe khungu limagwirira, glycemia, chakudya chopatsa mphamvu). Deta imalowetsedwa mu pulogalamuyi pasadakhale kuti mankhwala okwanira afikire musanakhazikitse chakudya.
4. Chipangizocho chimatha kukhazikitsidwa kuti chizipereka pang'onopang'ono muyezo wa mahomoni mu mawonekedwe a bolus. Ntchitoyi imapangitsa kudya zakudya zowonjezera pang'onopang'ono zomwe zimatengedwa ndi thupi popanda chiopsezo cha hypoglycemia pamadyerero omwe amakhala nthawi yayitali. Izi ndi zofunikira kwa ana omwe ali ndi matenda ashuga, ngakhale cholakwika chochepa muyezo chitha kusintha zovuta zonse.
5. Shuga amayang'aniridwa nthawi zonse. Chipangizocho chikuwonetsa kupitirira malire ovomerezeka. Mitundu yatsopano imakhala ndi ntchito yodziyimira pawokha yosinthira kayendetsedwe ka mahoni kuti muthe kusintha matenda a glycemia. Chifukwa cha izi, mankhwalawa amayimitsidwa panthawi yotsika kwambiri shuga.
6. Ndikotheka kusunga chipika cha data, kuzisunga, ndikuzisamutsa ku kompyuta kuti zitha kusunthidwa. Chidziwitso chonse chimasungidwa mu chipangizochi mpaka miyezi isanu ndi umodzi.

Chithandizo cha matenda ashuga pogwiritsa ntchito zida ngati izi ndikugwiritsa ntchito ma ultrashort analogues a mahomoni. Njira yothetsera makatiriji imabwera mumagawo ang'onoang'ono, koma nthawi zambiri, mankhwalawa amamwe nthawi yomweyo. Kuphatikiza apo, mulingo wa glycemia ungasiyane kutengera kuchuluka kwa kukakamira kwa insulin yokwanira ndi thupi. Zipangizo zotere zimathetsa vutoli chifukwa chakuti mahomoni afupikitsa omwe amaikidwa mu tank yawo nthawi zonse amakhala osasunthika.

Kuphunzitsa wodwala pampu ya insulin

Kuchepetsa kugwiritsa ntchito chipangizocho kumadalira kwenikweni pakudziwitsa wodwalayo za mbali ya mankhwala a insulin. Maphunziro osavomerezeka komanso kusamvetsetsa kudalira kwamankhwala am'madzi a XE (magawo a mkate) amachepetsa mwayi wokhala ndi matenda a glycemia.

Munthu ayenera kuwerenga kaye malangizo a chipangizocho kuti apititse patsogolo kaperekedwe ka mankhwalawo ndikusintha kukula kwa kayendedwe kake m'njira yoyambira.

Malamulo oyika zida:

1. Tsegulani thanki.
2. Chotsani pisitoni.
3. Ikani singano yapadera mu cartridge yamankhwala.
4. Tulutsani mpweya mu chotengera kuti muchepetse kupezeka kwa nthawi ya thukuta pakulowa kwa timadzi tambiri.
5. Ikani insulin m'malo osungira pogwiritsa ntchito piston, kenako ndikutulutsani singano.
6. Chotsani thovu lakum'madzi lomwe lakhala mchombo ndi pisitoni.
7. Lumikizani posungira ndi kulowetsa chubu.
8. Ikani gawo lomwe lasonkhanitsidwa mu cholumikizira cha pampu ndikudzazitsa chubu ndikumasulira insulin yaying'ono ndi maukosi amlengalenga. Pakadali pano, pampu iyenera kulekanitsidwa kwa wodwalayo kuti aletse mahomoni kuti asalowe mwangozi.
9. Lumikizani zida za chipangizocho kumalo operekera mankhwala.

Zochita zina pakugwiritsa ntchito chipangizocho ziyenera kuchitidwa mogwirizana ndi malingaliro a dokotala komanso malangizo omwe aphatikizidwa. Odwala azitha kusankha okhaokha malinga ndi kuchuluka kwa XE ndikuyang'aniridwa ndi glycemia, kuti adziwe ngati njira yothandizira mankhwalawa ndiyothandiza kapena ayi.

Kanema woikapo pompopu wa Omnipod:

Zisonyezo za pampu insulin mankhwala

Milandu yofunsira:

• wodwala mwiniyo akufotokozera;
• shuga yolipiridwa bwino;
• kusinthasintha pafupipafupi komanso kwakukulu mu shuga kumawonedwa;
• pafupipafupi matenda a hypoglycemia, makamaka usiku;
• pali mikhalidwe yodziwika ndi zodabwitsa za "mbandakucha";
• mankhwala amakhudzanso wodwala masiku angapo;
• mimba yakonzekera kapena yayamba kale;
• nthawi yobereka;
• mwana akudwala.

Chipangizocho chikuvomerezedwa kuti chigwiritsidwe ntchito ndi anthu omwe ali ndi matenda a autoimmune omwe apezeka kale, komanso mitundu ya matendawa.

Zithunzi zojambulidwa ndi Dr. Malysheva zokhudzana ndi mapampu a insulin:

Contraindication

Chipangizocho sichiyenera kugwiritsidwa ntchito ndi anthu omwe alibe chidwi ndi kuthekera kugwiritsa ntchito kwambiri insulin.

Chipangizocho chatsutsana pomwe:

• kulibe luso lodziletsa pakamwa;
• wodwala sadziwa kuwerengera XE;
• wodwala samakonzekera kuchita masewera olimbitsa thupi pasadakhale;
• wodwala safuna kapena sakudziwa kusankha mankhwalawa;
• pali zodetsa nkhawa;
• wodwala amakhala ndi mawonekedwe ochepa;
• palibe mwayi wowonera pafupipafupi ndi endocrinologist mu magawo oyamba ogwiritsira ntchito chipangizocho.

Zotsatira zakugwiritsa ntchito mosayenera pampu:

• kuthekera kwa pafupipafupi kwa matenda a hyperglycemia kumawonjezeka, kapena, shuga atha kuchepa kwambiri;
• ketoacidosis imatha kuchitika.

Maonekedwe a zovuta izi ndichifukwa choti odwala samapereka mahomoni omwe amakhala ndi mphamvu yayitali. Ngati insulin yayifupi imasiya kuyenda (pazifukwa zilizonse), mavuto amatha kuchitika pambuyo pa maola 4.

Momwe mungawerengere mlingo?

Mankhwala a insulini amaphatikizapo kugwiritsa ntchito ma analogues a mahomoni omwe ali ndi zochita za ultrashort.

Malamulo omwe akuyenera kuwerengedwa powerengera ndalama:

1. Yang'anani kuchuluka kwa insulinizomwe wodwala adalandira asanayambe kugwiritsa ntchito pampu. Mlingo watsiku ndi tsiku, kutengera zomwe zapezeka, uyenera kuchepetsedwa ndi 20-30%. Kugwiritsa ntchito kachipangizoka mu kakhazikitsidwe ka basal regimen kumapereka gawo loyambitsa 50% ya kuchuluka kwa mankhwalawa omwe amalandiridwa. Mwachitsanzo, ngati wodwala kale adalandira mayunitsi 50 a mahormoni, ndiye kuti ali ndi pampu adzafunika ma PISCES 40 patsiku (50 * 0,8), ndipo oyambira azikhala 20 PIECES pa liwiro lofanana ndi 0.8 PIECES / ora.
2. Kumayambiriro kwa ntchito, chipangizocho chimayenera kukonzedwa kuti chitha kupatsa mlingo umodzi wa mahomoni operekedwa m'njira yoyambira patsiku. Kuthamanga mtsogolomo kuyenera kusintha, kutengera zisonyezo za glycemia usiku ndi masana. Kusintha kwa nthawi imodzi sikuyenera kupitirira 10% ya mtengo woyambira.
3. Kuthamanga kwa mankhwalawa usiku kuyenera kusankhidwa polingalira za kuchuluka kwa glucose pogona, pafupifupi maola 2 ndi pamimba yopanda kanthu, komanso masana - molingana ndi zotsatira za glycemia chifukwa chakudya.
4. Mlingo wa insulin wofunikira kulipirira chakudya umapangidwa pamanja musanayambe zakudya zilizonse kapena chakudya. Kuwerengera kumayenera kuchitika molingana ndi malamulo a insulini chithandizo pogwiritsa ntchito zolembera.

Zojambula pa video pakuwerengera Mlingo wa insulin:

Zoyipa za shuga pogwiritsa ntchito chipangizocho

Chithandizo cha shuga chomwe chimaphatikizapo kupopera mankhwala kudzera pampu chimakhala ndi zotsatirazi:

1. Mtengo woyamba wapamwamba. Sikuti wodwala aliyense angathe kugula chida chotere.
2. Mtengo wa zothandizira ndi dongosolo la kukula kwambiri kuposa mtengo wa insulin syringes.
3. Mankhwalawa amatha kusiya chifukwa cha zovuta zina zomwe zimagwiritsidwa ntchito pogwiritsa ntchito chipangizochi. Amalumikizidwa ndi kusakwanira kwa insulin, kusakwaniritsidwa kwa pulogalamuyi, komanso mavuto enanso.
4. Chiwopsezo cha zovuta zingapo, kuphatikiza usiku ketoacidosis, chimawonjezeka panthawi yogwiritsa ntchito chipangizocho chomwe chimalephera mwadzidzidzi.
5. Ndemanga za anthu odwala matenda ashuga amatipangitsa kuti tivomereze kuti kuvala mosadukiza kwa chipangizocho kumadzetsa chisangalalo komanso kusokonekera kwina kuchokera kwa cannula yomwe idakhazikitsidwa mosazindikira. Nthawi zambiri, mavuto amakumana ndikasambira, m'maloto kapena panthawi yolimbitsa thupi.
6. Pali chiopsezo cha matenda kudzera mu cannula.
7. Thumba lachiberekero limatha kukhala lomwe lingachotsedwe opaleshoni yokha.
8. Pafupipafupi pakuukira kwa hypoglycemia ndikutukuka ndimapopa kuposa ma syringes. Izi ndichifukwa cha zolephera mu dosing system.
9. Mlingo wa bolus umaperekedwa pafupifupi ola lililonse, kotero kuchuluka kwa insulini ndi magawo 2.4. Izi ndizochulukirapo kwa ana. Kuphatikiza apo, sizotheka nthawi zonse kupereka kuchuluka kwamahomoni okwanira patsiku. Nthawi zambiri mumayenera kulowa zochepa kapena zochulukirapo. Mwachitsanzo, ngati kufunikira kuli magawo 6 patsiku, ndiye kuti chipangizocho chimakulolani kuti mulowetse zigawo za 4.8 kapena 7.2. Zotsatira zake, odwala nthawi zonse samatha kukhalabe ndi shuga mkati mwa zovomerezeka.
10. M'malo omwe amaikidwa catheter, ma sutures (fibrosis) amapangidwa, omwe samangowonjezera mawonekedwe, komanso amachepetsa kuyamwa kwa mankhwalawo.

Chifukwa chake, mavuto ambiri omwe akukumana nawo pochiza matenda a shuga sangathetse pogwiritsa ntchito mapampu.

Zoyenera kuganizira posankha?

Mitundu yosiyanasiyana ya mapampu a insulini omwe amapangidwa ndi opanga amapanga mawonekedwe awo kwambiri. Komabe, pali magawo angapo omwe muyenera kulabadira panthawi yogula zida zotere.

Njira zazikulu:

1. Kuchuluka kwa voliyumu. Ndikofunikira kuti kuchuluka kwa insulini kulowererapo, komwe kumayenera kukhala kwa masiku angapo.
2. Kuwala komanso kumveka bwino kwa zilembo zomwe zikuwonetsedwa pazenera.
3. Mlingo wa kukonzekera kwa belus. Malire okwanira komanso osachepera omwe insulin ingasinthidwe ayenera kuganizira.
4. Makina owerengera. Ndikofunikira kuti imalola kuganizira nthawi yayitali ya insulin, chidwi cha wodwala, kuchuluka kwa shuga ndi kuchuluka kwa chakudya.
5. Kutha kwa chipangizocho kuwonetsa kuyambika kwa mavuto.
6. Madzi osagwira. Ichi ndi chofunikira ngati wodwalayo akufuna kusamba ndi chipangizocho kapena safuna kuchichotsa ndikusambira.
7. Kuchita ndi zida zosiyanasiyana. Mapampu ambiri amatha kugwira ntchito pawokha pogwiritsa ntchito glucometer nawo.
8. Kusavuta kugwiritsa ntchito chipangizocho. Siziyenera kubweretsa zovuta m'moyo watsiku ndi tsiku.

Mtengo wa zida zimatengera wopanga, mawonekedwe ndi ntchito zomwe amapatsidwa. Mitundu yotchuka ndi Dana Diabecare, Medtronic ndi Omnipod. Mtengo wa pampu umachokera ku ruble 25 mpaka 120,000.

Ndikofunikira kumvetsetsa kuti kugwiritsa ntchito pampu bwino kumatheka pokhapokha mukamadya, kuthekera kuwerengera kuchuluka kwa mankhwalawo ndikuzindikira kufunika kwa insulin pa XE iliyonse. Chifukwa chake, musanagule chida, muyenera kuyerekeza zabwino ndi zoipa zonse, kenako ndikusankha pakufunika kogwiritsira ntchito.