Pulogalamu ya insulin - mfundo yothandizira, kuwunikira mitundu, ndemanga za anthu odwala matenda ashuga

Kodi pampu ya insulin ndi chiyani?

Pampu ya insulin ndi chipangizo chogwirira ntchito chomwe chimapangidwira kuti chithandizire kuchuluka kwa timadzi tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono. Zimaperekanso mphamvu ya thupi ya insulini, kutsata ntchito za kapamba. Mitundu ina ya mapampu a insulin ikhoza kuyang'anira shuga wamagazi mosasintha kuti ipangitse kusintha kwa mahomoni komanso kupewa kukula kwa hypoglycemia.

Chipangizocho chili ndi zinthu zotsatirazi:

• pampu (pampu) yokhala ndi chophimba chaching'ono ndi mabatani olamulira;
• katoni yomwe ingabwezeretse insulin;
• kulowetsedwa dongosolo - cannula yoyikapo ndi catheter;
• ma batri (mabatire).

Mapampu amakono a insulin ali ndi ntchito zina zomwe zimapangitsa moyo kukhala wosavuta kwa odwala matenda ashuga:

• basi kukomoka insulin kudya pa kukula kwa hypoglycemia;
• kuwunika kuchuluka kwa shuga m'magazi;
• zizindikiro zomveka shuga zikamatuluka kapena kugwa;
• kuteteza chinyezi;
• kuthekera kwa kusamutsa chidziwitso pakompyuta chokhudza kuchuluka kwa insulin yomwe idalandiridwa komanso kuchuluka kwa shuga m'magazi;
• mphamvu yakutali yoyendetsedwa ndi kutali.

Chipangizochi chimapangidwira mtundu wambiri wa insulin.

Mfundo za magwiridwe antchito

Pali piston pakumpukusira kwa pampu, komwe nthawi zina kumakanikizira katiriji ndi insulin, potero kuonetsetsa kuyambitsa kwake kudzera machubu a mphira m'matumba ochepera.

Catheters ndi cannulas diabetesic ayenera m'malo masiku atatu alionse. Nthawi yomweyo, malo oyang'anira mahomoni amasinthidwanso. Cannula nthawi zambiri imayikidwa m'mimba; imatha kuphatikizidwa ndi khungu la ntchafu, phewa, kapena matako. Mankhwalawa ali mu thanki yapadera mkati mwa chipangizocho. Pakupopa kwa insulin, mankhwala osokoneza bongo omwe amagwiritsidwa ntchito posachedwa amagwiritsidwa ntchito: Humalog, Apidra, NovoRapid.

Chipangizocho chimatenga malo obisika a kapamba, motero timadzi timene timayendetsedwa mu njira ziwiri - zoyambira ndi zofunikira. Wodwala matenda a shuga amayendetsa insulin pamanja pachakudya chilichonse, poganizira kuchuluka kwa buledi. Njira yayikulu ndikulowerera kwakanthawi kwa Mlingo waung'ono wa insulin, womwe umalowa m'malo mwa insulin. Hormoni imalowa m'magazi angapo patadutsa mphindi zochepa.

Ndani akuwonetsedwa ngati mankhwala a insulin

Kwa aliyense amene ali ndi matenda ashuga omwe amafunika jakisoni wa insulin, amatha kukhazikitsa insulin ngati angafune. Ndikofunika kuuza munthu mwatsatanetsatane maluso onse a chipangizocho, kufotokoza momwe mungasinthire mankhwalawa.

Kugwiritsa ntchito pampu ya insulin kumalimbikitsidwa kwambiri pazinthu zotere:

• kusakhazikika kwa matenda, pafupipafupi hypoglycemia;
• ana ndi achinyamata omwe amafunikira Mlingo wochepa;
• vuto la munthu hypersensitivity kwa timadzi;
• kulephera kukwaniritsa zabwino za glucose mukabayidwa;
• kusowa kwa chiphuphu cha shuga (glycosylated hemoglobin pamwamba pa 7%);
• "M'mawa kutacha" - kuwonjezereka kwa chidwi cha glucose pakudzuka;
• matenda a shuga, makamaka kupitirira kwa mitsempha;
• kukonzekera kutenga pakati komanso nthawi yonse;
• Odwala omwe amakhala ndi moyo wakhama, amakhala maulendo atchuthi pafupipafupi, sangathe kukonza zakudya.

Phindu la Matenda A shuga

• Kusunga shuga wabwinobwino popanda kudumpha masana chifukwa chogwiritsa ntchito mahomoni a ultrashort.
• Mlingo wa botus wa mankhwalawa ndi kulondola kwa mayunitsi a 0,1. Mlingo wa insulin yakudya mu magayidwe oyambira amatha kusinthidwa, mlingo wocheperako ndi zigawo za 0,025.
• Kuchuluka kwa jakisoni kumachepetsedwa - cannula imayikidwa kamodzi masiku atatu, ndipo mukamagwiritsa ntchito syringe wodwalayo amatha jakisoni 5 patsiku. Izi zimachepetsa chiopsezo cha lipodystrophy.
• Kuwerengera kosavuta kwa kuchuluka kwa insulin. Munthu ayenera kulowetsa deta mu dongosololi: kuchuluka kwa shuga ndi kufunikira kwa mankhwala munthawi zosiyanasiyana masana. Kenako, musanadye, zimangosonyeza kuchuluka kwa chakudya, ndipo chipangizocho chokha chidzalowa muyezo womwe mukufuna.
• Pampu ya insulin suwoneka kwa ena.
• Kuwongolera kwa shuga m'magazi panthawi yochita masewera olimbitsa thupi, maphwando amasinthidwa. Wodwala amatha kusintha pang'ono podyedwa popanda kuvulaza thupi.
• Chipangizocho chikuwonetsa kuchepa kapena kuwonjezeka kwa glucose, komwe kumathandiza kupewa kukomoka kwa matenda ashuga.
• Kusunga deta m'miyezi ingapo yapitayo yokhudzana ndi Mlingo wa mahomoni ndi shuga. Izi, pamodzi ndi chisonyezo cha hemoglobin ya glycosylated, zimalola kuwunika mozama momwe mankhwalawo amathandizira.

Zoyipa zamagwiritsidwe

Pampu ya insulin ikhoza kuthana ndi mavuto ambiri okhudzana ndi insulin. Koma kugwiritsidwa ntchito kwake kuli ndi zovuta zake:

• mtengo wokwera wa chipangacho pachokha komanso chowononga, chomwe chimayenera kusinthidwa masiku atatu aliwonse;
• chiopsezo cha ketoacidosis imachuluka chifukwa chakuti palibe insulin depot m'thupi;
• kufunika kolamulira shuga m'magawo 4 patsiku kapena kupitilira, makamaka kumayambiriro kwa kugwiritsa ntchito pampu;
• chiwopsezo cha matenda pamalopo a cannula ndi kuyika kwa chitupa;
• kuthekera kwa kuyimitsa kumayambiriro kwa mahomoni chifukwa chosagwira ntchito bwino kwa ziwiya;
• Kwa odwala matenda ashuga, kuvala mpope nthawi zonse kumakhala kovuta (makamaka pakusambira, kugona, kugona);
• Pali chiopsezo chowonongeka pa chipangizochi mukamasewera.

Pampu ya insulini siimadziwitsidwa kuti isasungunuke yomwe ingayambitse zovuta kwa wodwala. Kuti izi zisachitike, munthu wodwala matenda ashuga ayenera kukhala naye nthawi zonse:

1. Syringe yodzaza ndi insulin, kapena cholembera.
2. M'malo hormone katoni ndi kulowetsedwa.
3. Batire yosinthira m'malo.
4. Madzi a glucose mita
5. Zakudya zamafuta ambiri (kapena mapiritsi a shuga).

Kuwerengera Mlingo

Kuchuluka ndi kuthamanga kwa mankhwalawa pogwiritsa ntchito pampu ya insulin amawerengedwa potengera muyeso wa insulin yomwe wodwala adalandira asanagwiritse ntchito chipangizocho. Mlingo wokwanira wa mahomoni umachepetsedwa ndi 20%, m'malamulo oyambira, theka la ndalamazi limaperekedwa.

Poyamba, kuchuluka kwa mankhwala omwe amamwa mankhwalawa kumakhala chimodzimodzi tsiku lonse. Mtsogolomo, odwala matenda ashuu amasintha kayendedwe ka magazi: chifukwa chake, ndikofunikira kuyeza zisonyezo zamagazi. Mwachitsanzo, mutha kuwonjezera kuchuluka kwa mahomoni m'mawa, zomwe ndizofunikira kwa odwala matenda ashuga omwe ali ndi matenda a hyperglycemia podzuka.

Njira yotsamira imakhazikitsidwa pamanja. Wodwalayo ayenera kuloweza kuchuluka kwa insulini yofunika mkate umodzi malinga ndi nthawi ya tsiku. M'tsogolomo, musanadye, muyenera kufotokozera kuchuluka kwa chakudya chamagulu, ndipo chipangacho chokha chidzawerengera kuchuluka kwa mahomoni.

Kuti athandize odwala, pampu imakhala ndi zosankha zitatu za mtundu wa bolus:

1. Zabwinobwino - chakudya cha insulin kamodzi musanadye.
2. Kutambasulidwa - mahomoni amaperekedwa kwa magazi mofanananso kwakanthawi, komwe nkotheka pakudya mafuta ochulukirapo.
3. Pawiri mafunde - theka la mankhwalawa limaperekedwa nthawi yomweyo, ndipo enawo amabwera pang'onopang'ono m'magawo ang'onoang'ono, amagwiritsidwa ntchito paphwando lalitali.

Zotheka

Kulowetsedwa wopangidwa ndi machubu a mphira (catheters) ndi cannulas ayenera m'malo mwa masiku atatu aliwonse. Amakhala osavomerezeka chifukwa zotsatira zake zimapangitsa kuti mahomoni azitha. Mtengo wamachitidwe amodzi ndikuchokera ku 300 mpaka 700 rubles.

Zotayira zotayidwa (makatiriji) a insulin zimakhala ndi 1.8 ml mpaka 3.15 ml ya malonda. Mtengo wa cartridge ndi wochokera ku ruble 150 mpaka 250.

Pafupifupi, ma ruble 6,000 adzafunika kuti agwiritse ntchito popimira mtundu wamba wa pampu ya insulin. pamwezi. Ngati mtunduwo uli ndi ntchito yowunika ma glucose mosalekeza, ndizokwera mtengo kwambiri kuti uisunge. Sensor kwa sabata logwiritsa ntchito ndalama pafupifupi 4000 rubles.

Pali zinthu zingapo zomwe zimapangitsa kuti zikhale zosavuta kunyamula mpope: lamba wa nayiloni, zigawo, chivundikiro chomamatira kwa bra, chivundikiro chokhazikika ndi chovala chonyamula chida pamendo.

Mitundu yomwe ilipo

Ku Russia, mapampu a insulin a makampani opanga awiri ndi ofala - Roche ndi Medtronic. Makampani awa ali ndi maofesi awo ndi malo opangira, komwe mungathe kulumikizana ndi vuto la chipangizo.

Zina zamitundu mitundu ya mapampu a insulini:

Medtronic MMT-715

Mtundu wosavuta wa chipangizocho ndi ntchito kuwerengera muyeso wa insulin. Imagwira mitundu itatu yamitundu ya bolus ndi 48 maulendo oyambira tsiku ndi tsiku. Zambiri zomwe zimapezeka mu mahomoni oyambitsidwa zimasungidwa kwa masiku 25.

Medtronic MMT-522, MMT-722

Chipangizocho chili ndi ntchito yowunikira glucose wamagazi, zambiri zazidziwitso zili m'chikumbumtima cha masabata 12. Pampu ya insulin imayambitsa kuchepa kwakukulu kapena kuwonjezeka kwa shuga pogwiritsa ntchito mawu amawu, kugwedera. Ndikotheka kukhazikitsa zikumbutso za glucose.

Medtronic Veo MMT-554 ndi MMT-754

Mtunduwu uli ndi zabwino zonse za mtundu wakale. Mulingo wocheperako woyambira wa insulin ndi 0,025 U / h, yomwe imalola kugwiritsa ntchito chida ichi mwa ana ndi odwala matenda ashuga omwe amakhala ndi chidwi chachikulu ndi mahomoni. Zolemba malire patsiku, mutha kulowa mpaka magawo 75 - ndikofunikira pakulimbana ndi insulin. Kuphatikiza apo, lamuloli limakhala ndi ntchito yoletsa kutuluka kwa mankhwala ngati vuto la hypoglycemic latha.

Roche Accu-Chek Combo

Ubwino wofunikira pampu iyi ndikupezeka kwa gulu lowongolera lomwe limagwiritsa ntchito ukadaulo wa Bluetooth. Izi zimakuthandizani kuti mugwiritse ntchito chipangizocho mosazindikira ndi alendo. Chipangizocho chimatha kupirira kumizidwa m'madzi akuya osaposa 2.5 m kwa mphindi 60. Mtunduwu umatsimikizira kudalirika kwakukulu, komwe kumaperekedwa ndi microprocessors awiri.

Kampani ya Israeli ya Geffen Medical yakonza pampu wamakono wa insulin wopanda waya Insulet OmniPod, yomwe imakhala ndi chiwongolero chakutali komanso chosungira madzi osungira insulin. Tsoka ilo, palibe chithandizo chovomerezeka cha mtunduwu ku Russia panobe. Itha kugulidwa m'misika yakunja pa intaneti.

Mtengo wa mapampu a insulin

• Medtronic MMT-715 - ma ruble 10,000;
• Medtronic MMT-522 ndi MMT-722 - ma ruble 115,000;
• Medtronic Veo MMT-554 ndi MMT-754 - 200 000 rubles;
• Roche Accu-Chek - ma ruble 97,000;
• OmniPod - ma ruble 29,400. (zothetsera mwezi umodzi zitha kugula ma ruble 20,000).

Kodi ndingathe kuipeza yaulere

Malinga ndi dongosolo la Unduna wa Zaumoyo ku Russia Federation ya pa Disembala 29, 2014, wodwala yemwe ali ndi matenda ashuga amatha kupeza chida cha pump insulin therapy kwaulere. Kuti achite izi, ayenera kulumikizana ndi dokotala yemwe adzakonze zolemba zofunso ku dipatimenti yoyang'anira zigawo. Zitatha izi, wodwalayo amadzikonzekera kuti ayike chipangizocho.

Kusankhidwa kwa regimen yamaulamuliro a mahomoni ndi maphunziro a odwala kumachitika kwa masabata awiri mu dipatimenti yapadera. Kenako wodwalayo amafunsidwa kuti asayine mgwirizano womwe suyenera kudya chipangizocho. Samaphatikizidwa m'gulu la ndalama zofunika, chifukwa chake boma silipereka ndalama zogulira zina. Akuluakulu akuderalo amatha kulipira ndalama zothandizira anthu omwe ali ndi matenda ashuga. Nthawi zambiri, phindu limagwiritsidwa ntchito ndi anthu olumala komanso ana.

Ndemanga Zahudwala