Hyma na hyperglycemic coma - taimakon farko da alamu

Mafi haɗarin rikicewar cutar ciwon sukari shine ƙwaƙwalwar ƙwayar cuta. Wannan wani yanayi ne wanda ake haɓaka ƙarancin insulin a cikin jiki da raguwar amfani da glucose na duniya. Cutar na miji na iya haɓaka da kowane nau'in ciwon sukari, kodayake, lokuta na faruwarsa a cikin nau'in ciwon sukari na 2 suna da matuƙar wuya. Mafi sau da yawa, cutar rashin lafiya mai saurin kamuwa da cuta shine sakamakon nau'in 1 na ciwon sukari - ya dogara da insulin.

Akwai dalilai da yawa don haɓakar ƙwayoyin cuta:

• ba a gano cutar sankara ba,
• rashin dacewa magani
• rashin kulawa da kashi na insulin ko gabatarwar karancin kashi,
• take hakkin abinci
• shan wasu magunguna, irin su magungunan ƙwayar cuta ko ta hanji.

Bugu da kari, abubuwa da yawa na waje wadanda zasu iya haifar da kwayar cutar coma - ana iya rarrabe su - cututtukan cututtuka daban-daban da aka yada ta hanyar mai haƙuri tare da ciwon sukari na mellitus, ayyukan tiyata, damuwa, da raunin kwakwalwa. Wannan ya faru ne saboda gaskiyar cewa tare da matakai masu kumburi a cikin jiki ko karuwa a cikin damuwa na kwakwalwa, yawan amfani da insulin yana ƙaruwa sosai, wanda ba koyaushe la'akari lokacin da ake lissafin yawan adadin insulin da ake buƙata.

Mahimmanci! Koda sauyawa daga nau'in insulin zuwa wani na iya tsokana ƙimar jini, don haka ya fi kyau maye gurbinsa a ƙarƙashin kulawa da lura da yanayin jikin mutum na ɗan lokaci. Kuma a kowane yanayi ya kamata ku yi amfani da insulin mai sanyi ko ƙarewa!

Cutar ciki da kanwar haihuwa suma abubuwanda zasu iya tayar da wani rikici makamancin wannan. Idan mace mai ciki tana da nau'in ciwon sukari na latent, wanda ita ma ba ta zargin shi ba, ƙwayar cuta na iya haifar da mutuwar mahaifiya da ɗa. Idan an yi gwajin cutar sukari mellitus kafin samun juna biyu, dole ne a lura da yanayin ku sosai, ku bayar da rahoton duk wani alamu ga likitan mata kuma ku sanya sukari a cikin jini.

Ga marasa lafiya da ke fama da nau'in ciwon sukari guda 2, rikitarwa, cututtukan zuciya, ana iya haifar da su ta hanyar cututtukan da ke da alaƙa da aikin kumburin ƙwayar cuta, alal misali, cututtukan cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta. Wannan yana haifar da gaskiyar cewa insulin, wanda aka samar da isasshen adadin, ya zama ƙasa da ƙasa - a sakamakon haka, rikici na iya haɓaka.

Rashin haɗari

Rikicin shi ne ya fi dacewa, amma ba koyaushe ake samun rikicewa ba. Riskungiyar haɗarin ta haɗa da - marasa lafiya da cututtukan cututtukan ƙwayar cuta, masu aikin tiyata, masu juna biyu.

Hadarin na haifar da cutar sikari na hyperglycemic yana ƙaruwa sosai a cikin waɗanda ke da haɗari ga cin zarafin abincin da aka tsara ko kuma rashin hankali ba sa yin la'akari da adadin insulin da ake gudanarwa. Barasa shan giya kuma na iya haifar da kwaro.

An lura cewa rashin lafiyar hyperglycemic cocin da wuya yaduwa a cikin marasa lafiya a cikin tsufa, da kuma a cikin wadanda suke da kiba sosai. Mafi sau da yawa, wannan rikicewar yana bayyana kanta a cikin yara (yawanci saboda babban cin zarafin abincin, wanda yawancin lokuta iyaye ba sa zargin shi) ko marasa lafiya a ƙarami kuma tare da ɗan gajeren lokacin cutar. Kusan 30% na marasa lafiya da ke dauke da cutar sankara suna da alamun precoma.

Menene rashin daidaituwa na jini

Wani rikitarwa na hyperglycemia, ko sukari coma, yanayi ne na jiki wanda ke haɗuwa da haɓaka matakan glucose na jini tare da isasshen samar da insulin. A cikin jagorar kasa da kasa - rarrabuwar cututtuka - an jera cutar hyperglycemia ƙarƙashin lambar mcb E 14.0. Cutar na haifar da mafi yawan lokuta a cikin mutane masu ciwon sukari na 1 na sukari, ba sau da yawa a cikin marasa lafiya tare da gazawar koda da kuma nau'in ciwon sukari na 2.

Dangane da yanayin hanya da kuma sanadin bayyanar cutar sankara a cikin ciwon suga, an kasu kashi uku:

• Hyperosmolar coma - yana faruwa tare da ketoacidosis tare da wani babban matakin glucose da sodium, rauni mai yaduwar waɗannan abubuwa a cikin tantanin halitta da ƙonewa baki ɗaya na jiki. Yana faruwa a cikin marasa lafiya shekaru 50 da haihuwa.
• Ketoacidotic coma - ya haifar da karancin samar da insulin, yawan tasirin glucose, bayyanar jikin ketone, rage fitsari, karuwar acidity da illa ga dukkan nau'ikan metabolism.

Sanadin Sanyin Ciki

Akwai wasu dalilai da yawa na bayyanar coma a cikin ciwon sukari mellitus, yawancinsu suna da alaƙa da rashin isasshen magani na cututtukan da ke tattare da cutar:

• kasa sarrafa insulin-dauke da kwayoyi,
• haƙuri haƙuri daga insulin magani,
• ƙarancin ingancin magunguna ko ƙarewa
• sakaci da shawarwari, tsawaita azumi, rashin yarda da tsarin abincin.

Sauran abubuwan da suke haifar da cutar rashin wadatar jiki sun hada da:

• ciwon huhu
• mai girma mai kumburi tafiyar matakai da cututtuka,
• mummunan raunin da ya faru wanda ya tsokani yawan insulin ta hanyar kyallen jiki.
• matsananciyar damuwa
• keta doka da aiki da tsarin hormonal,
• ba a bayyana asalin cutar sankara ba.

Pathogenesis na ƙwayar cuta na ƙwaƙwalwa

A cikin haƙuri tare da ciwon sukari, mai ciwon sukari coma ba ya tashi sosai, sau da yawa na dogon lokaci, tafiyar matakai suna taimakawa wannan. Idan mafitsara ta ɓoye isnadin insulin na halitta, to cutar sankarar mahaifa na faruwa ne kawai idan aikin koda ya lalace. Algorithm na gaba ɗaya shine kamar haka:

1. karuwa a hankali a hankali a cikin jini
2. na rayuwa canje-canje a salon,

The pathogenesis na hyperglycemic coma a kan tushen insulin karancin shi da ɗan daban. Sannan jiki zai rasa kuzari. Don sake juji da ajiyar, jikin zai fara jujjuya sunadarai da kitsen su zama glucose, yayin da kodan bazai iya cire duk kayan lalata da sauri ba. Mafi haɗarin dukkanin abubuwa masu guba zasu zama jikin ketone. A sakamakon haka, jiki zai sami ɗanɗano sau biyu: a gefe guda - ƙarancin kuzari, a ɗayan - ketoacidosis.

Alamomin cutar rashin daidaituwa

Rashin ciwon sukari ya kasu kashi biyu: precoma da hyperglucoseemia, suna haifar da asarar hankali. Lokacin canzawa tsakanin waɗannan matakan na iya wucewa daga sa'o'i 24 zuwa kwanaki. Yayin lokacin canzawa, mara lafiya yana damuwa:

• kullum ƙishirwa da bushe bakin
• kara yawan fitsari
• gajiya,
• gyara man fuska
• fata turgor,
• raguwa mai nauyi a jiki,
• ciki da amai,
• zawo
• asarar ci.

Cutar insulin, ƙari ga ainihin asarar hankali, yana da alamun alamun musamman da suka gabata. Lokacin da hyperglycemia da rikicin ketoacidotic suka isa wurin taro, ana maye gurbin polyuria ta oliguria ko kuma cikakkiyar raunin fitsari. Daga nan sai numfashi mai zurfi na Kussmaul ya bayyana, ana saninsa da yawan iska mai saurin motsa jiki, haka nan kuma rikicewar magana da kuma rauni na hankali.

Bayyanar cututtukan cututtukan mahaifa sune kamar haka:

• fata bushe,
• m da m numfashi
• ƙanshi na acetone daga bakin,
• lumshe ido
• laushin ido
• bayyanar launin farar fata a kan lebe,
• halayen da za'a iya canzawa ana yin saurin su ko kuma babu wasu sassauci kwata-kwata,
• tashin hankali na fata-mai folds na peritoneum,
• filamentous bugun jini
• bushe harshe
• hawan jini, zazzabi, zazzabi, mai yiwuwa ne,
• sautin tsoka a cikin tashin hankali, cramps mai yiwuwa ne,
• a cikin wasu marasa lafiya tare da bambancin ganewar asali na coma, likitoci sun lura da zazzabi da rawar jiki.

Tsarin Coma Hyperglycemic Coma

A cikin yanayin da ake ciki, hanyar dabarar ita ce a sanya ido a kai a kai game da matakin glucose a cikin jini, don haka yana da matukar muhimmanci a san abin da sukari ya haifar. Matsayi na glucose na yau da kullun shine 3.5 mmol / L; 33-35 mmol / L an dauki shi a matsayin mahimmancin mahimmanci. Koyaya, ƙwayar cuta na iya faruwa lokacin da sukari ya ƙasa da al'ada, ana kiran wannan yanayin - hypoglycemic coma.

Cikakke magani na hyperglycemic coma da precoma a cikin ciwon sukari mellitus ana aiwatar da su ne kawai a asibitin, ɓangaren kulawa mai zurfi (sake farfadowa):

1. Da farko, aikin likitocin shine daidaita matakan glucose, hana haɓakar ƙwayar cuta ta cutar anuria da ketoacidosis coma.
2. Lokacin da rikicewar hypoglycemic ya wuce, sun fara dawo da ruwan da ya ɓace. Ana gabatar da maganin sodium chloride ta hanyar dropper tare da dakatarwar 10% na potassium chloride, mai tsanani zuwa digiri 36.6.
3. Don hana yiwuwar sakamako na rashin daidaituwa na coma, ana lasafta duk matakan da suka dace dangane da tarihin likita da shekarun mai haƙuri.

Bayyanar cututtuka na coma

Cutar mahaifa yana tasowa a cikin 'yan awanni, wani lokacin ma harda kwanaki. Alamun ƙwayar warin da ke shigowa a hankali yana ƙaruwa. Na farko bayyanar cututtuka su ne:

• ƙishirwa ba ta bushewa, bushewar bushe,
• polyuria
• tashin zuciya, amai,
• fata ƙaiƙayi
• alamun gama gari na maye shine rauni, hauhawar kai, gajiya.

Idan akwai alamun aƙalla guda ɗaya, bincika matakin sukari na jini nan da nan. A cikin yanayin kusa da coma, zai iya kaiwa 33 mmol / L kuma mafi girma. Mafi munin abin da ke cikin wannan halin shi ne rikitar da shi tare da guba abinci na yau da kullun, ba tare da wata alaƙa da hyperglycemia ba. Wannan yana haifar da gaskiyar cewa lokacin da ake buƙata don ɗaukar matakan hana ci gaban ƙwaƙwalwa ya ɓace kuma rikicin ya ci gaba.

Idan ba a dauki matakai don gabatar da ƙarin kashi na insulin ba, alamu suna canzawa kaɗan, precoma yana farawa: maimakon polyuria - anuria, amai yana ƙaruwa, yana sake maimaitawa, amma ba ya kawo sauƙin ba. Kamshin acetone yana fitowa daga bakin. Jin zafi a cikin ciki na iya zama dabam-dabam na rauni - daga tsananin zafi har zuwa ciwo. Ko dai zawo ko maƙarƙashiya na tasowa, kuma mai haƙuri zai buƙaci taimako.

Mataki na karshe kafin rikicewar halin halin rikice rikice, fatar jiki ta bushe da sanyi, bawo, zafin jiki a ƙasa da al'ada. Sautin girarsa ya faɗi - lokacin da aka matse, suna jin kamar suna da taushi, zazzage fata ya ragu. Akwai tachycardia, saukar karfin jini.

Kussmaul na yawan fitar numfashi yana dauke da yanayin motsa jiki mai saurin huwu tare da matsanancin numfashi mai amo da kuma tsananin karsashi. Kamshin acetone lokacin numfashi. Harshen ya bushe, mai rufi da launin ruwan kasa. Bayan wannan ya sami daidaituwa na yau da kullun - mutum ya rasa hankali, baya amsa raɗaɗin waje.

Matsakaicin haɓakar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa koyaushe mutum ɗaya ne. Yawancin lokaci, precoma yana ɗaukar kwanaki 2-3. Idan ba'a samar da ingantaccen kulawar likita a asibiti ba, mutuwa tana faruwa ne a cikin sa'o'i 24 bayan farawar na murar.

Kulawa ta gaggawa don cutar mahaifa

A alamomin farko na sukari na hawan jini, yakamata a nemi likita nan da nan ko kiran gaggawa ta gaggawa, musamman idan alamun halayen suka bayyana a cikin yarinyar. Ko da ba ku san ainihin abin da ya haifar da ƙwayar cuta ba ko precoma a cikin mai haƙuri da ciwon sukari, haɓaka ko ƙarancin glucose, har yanzu ba da sukari ga wanda ke fama da cutar. Tare da girgiza insulin, wannan na iya ceton rayuwar mutum, kuma idan cutar ta haifar da haɓaka glucose, wannan taimakon ba zai kawo lahani ba.

Sauran ragowar taimakon gaggawa na farko don maganin cutar hyperglycemic ya ƙunshi waɗannan ayyuka:

• Idan mai haƙuri bai san komai ba, ya zama dole a bincika ko numfashinsa yayi sauri, don jin bugun zuciyar, ganin ɗaliban. Lokacin da babu bugun jini, nan da nan fara tausa zuciya kai tsaye. Idan mai haƙuri yana numfashi, juya shi a hagun hagun, samar da damar samun isashshen oxygen.
• Lokacin da mai haƙuri yana sane, ya kamata a ba shi abin sha ko samfuran da ke ɗauke da sukari.

Rashin ciwon sukari - hanyoyin

Babban mahimmin ci gaba a cikin kwayar cutar sihiri shine cin zarafin metabolism a sakamakon wuce hadarin glucose a cikin jini.

Babban matakan glucose hade da karancin insulin yana haifar da gaskiyar cewa sel jikin ba za su iya amfani da ƙarfin gushewar glucose ba kuma suna fuskantar yunwar "ƙarfin". Don hana wannan, ƙwayar metabolism ta canza - daga glucose, tana canzawa zuwa hanyar da ba ta da glucose, don samar da makamashi, kuma, daidai yadda yakamata, rushewar sunadarai da ƙima zuwa glucose ya fara. Wannan yana ba da gudummawa ga tarin yawancin samfuran lalata, ɗayan ɗayan jikin ketone. Suna da guba sosai kuma a matakin farko gabanin su yana haifar da jin daɗin zama kamar yanayin damuwa, kuma tare da haɗarin su - guba na jiki, rashin damuwa na tsarin juyayi na tsakiya da kwakwalwa. Matsakaicin matakin hyperglycemia da ƙarin jikin ketone - mafi ƙ arfin tasirinsu ga jikin mutum da sakamakon tasirin halin kansa.

Magunguna na zamani suna ba da matakan gwaji don tantance jikin ketone a cikin fitsari. Yana da ma'ana a yi amfani da su idan matakin glucose a cikin jini ya wuce 13-15 mmol / l, haka kuma a cikin cututtukan da zasu iya tayar da tashin farko na coma. Wasu mitutukan glucose na jini kuma suna da aikin gano jikin ketone.

Kulawa ta gaggawa don cutar siga

Idan akwai shaidar rashin daidaituwa na coma, yana da mahimmanci don gudanar da gajeren insulin subcutaneously - kowane sa'o'i 2-3, dangane da matakin glucose a cikin jini, kula da matakin sukari a kowane 2 hours. Ya kamata a rage ƙwayar Carbohydrate a takaice. Tabbatar ɗaukar shirye-shiryen potassium da magnesium, shan ruwan ma'adinai na alkaline - wannan zai hana hyperacidosis.

Idan bayan sau biyu ana gudanar da aikin insulin alamomin ba su shuɗe ba kuma yanayin bai inganta ba ko kuma ya yi rauni, yana da gaggawa a dauki likita. Ziyarar likita ya zama dole ko da an yi amfani da alkalami don maganin sirinji kuma wannan ya ba da izinin daidaita yanayin. Kwararrun zai taimaka wajen fahimtar abubuwan da ke haifar da wannan rikicewar kuma bayar da isasshen magani.

Idan yanayin mai haƙuri yana da tsanani kuma yana kusa da rashin sani, ana buƙatar kulawa ta gaggawa. Zai yuwu a cire mara lafiya daga dimau tare da karancin sakamako ga jiki kawai a asibiti.

Kafin motar asibiti ta iso, zaku iya ba da taimakon farko:

• Sanya mara lafiya a gefe guda don hana choco na amai da bushewar harshe,
• zafi ko rufe tare da heaters,
• don sarrafa bugun bugun zuciya,
• lokacin da kuka dakatar da numfashi ko bugun jini, fara sake farfadowa - numfashi mai wucin gadi ko tausa zuciya.

Abubuwa uku "KADA KAI" a taimakon farko!

1. Ba za ku iya barin mai haƙuri shi kaɗai ba.
2. Ba za ku iya hana shi gudanar da insulin ba, dangane da wannan a matsayin rashin cancanta.
3. Ba za ku iya ƙi kiran motar asibiti ba, koda kuwa yanayin ya daidaita.

Yin rigakafin Coma Hyperglycemic

Domin kada ya kawo jikin mutum a cikin irin wannan mawuyacin yanayi kamar na coma, ya zama dole a bi ƙa'idodi masu sauƙi: koyaushe ku bi abinci, ku riƙa lura da matakin glucose a cikin jini, ku kuma kula da insulin a kan kari.

Mahimmanci! Tabbatar kula da ranar karewar insulin. Ba za ku iya amfani da ƙarewa ba!

Zai fi kyau a guji damuwa da yawan motsa jiki. Ana magance kowace cuta da cuta.

Iyayen yaran da aka kamu da cutar sukari irin ta 1 ya kamata su mai da hankali sosai wajen lura da abinci. Sau da yawa, yaro yakan ketare abincin a asirce daga iyayen sa - zai fi kyau a yi bayani game da duk sakamakon irin wannan halin.

Mutane masu lafiya suna buƙatar duba sukarin jininsu na lokaci-lokaci; idan kuma mahaukaci ne, yana da matukar muhimmanci a tuntuɓi likitan dabbobi na endocrinologist.

Gyaran jiki bayan coma ko precoma

Bayan irin wannan rikice-rikice irin na coma, ana buƙatar kulawa da yawa don lokacin farfadowa. Lokacin da mai haƙuri ya bar asibitin, kuna buƙatar ƙirƙirar duk yanayin don murmurewa gaba ɗaya.

Da farko, bi duk umarnin likita. Wannan kuma ya shafi abinci da rayuwa. Idan ya cancanta, daina halaye marasa kyau.

Abu na biyu, gyara don rashin bitamin, abubuwan micro da Macro sun rasa lokacin rikicewar. Complexauki hadaddun bitamin, kula ba kawai ga yawan ba, har ma da ingancin abinci.

Kuma, ƙarshe, kada ku daina, ba da ƙarfi da ƙoƙarin jin daɗin kowace rana. Bayan duk wannan, ciwon sukari ba magana ba ce, hanya ce ta rayuwa.