Iri na masu ciwon sukari com, menene bambancinsu, menene haɗari da yadda za a hana ci gaban su

Ana fahimtar cutar ta masu ciwon suga a matsayin yanayin mummunan lokacin da digirin ilimin cuta ya rigaya ya ratsa layin diyya. Ga wa mutum zai iya fada idan matakan tafiyar rayuwa suka samu mummunan keta. Cutar sankarar mahaifa na iya zama halayyar nau'in cututtukan siga guda biyu. Babban haɗari shine wannan yanayin a cikin mutumin da ke fama da ciwon sukari wanda ba a bincika shi ba, wanda danginsa ba su zargin yadda ake yin hali a cikin mawuyacin hali ba.

Waɗanne abubuwa ke haifar da cutar rashin lafiyan ciki?

Mafi sau da yawa, kwaro na tasowa yayin da jiki bai sami allurar gaba ta insulin ba. Oftenarancin lokaci, ana yin lissafin adadin insulin ba daidai ba, kuma magani bai isa ba don biyan bukatun jikin mutum. Wata hanyar da ke haifar da rashin wari shine canzawa zuwa wani magani, wanda ya juya baya dacewa da masu ciwon sukari.

Tare da nau'in ciwon sukari na 2, ƙwayar cuta na iya faruwa idan mutum ya keta mummunar shirin cin abinci, alal misali, ya ci abinci mai yawa daɗi. Don tsokanar zaman lafiya a cikin mai rauni mai ƙarfi yana iya daukar ciki, kamuwa da cuta, damuwa, haihuwa, tiyata.

Ta yaya ake bayyana farkon cutar sikila?

Kafin coma ta haɗu da gaske, mutumin zai kasance cikin yanayin yanayi na ɗan lokaci. Da farko dai, a wannan lokacin yana da ƙishirwa mai ƙarfi, ciwon kai kamar migraine yana tasowa, mutum yana jin rauni, ciwon ciki, tashin zuciya, amai. Idan ka auna bugun jini da matsin lamba, to, sun ragu, haka kuma yawan zafin jiki. Wani lokacin zazzabin da sauri ya zama kamar zaren.

Damuwa, gajiya mai ƙarfi na ci gaba da ƙaruwa, canje-canje na jijiyoyin jiki a cikin tsarin jijiya na tsakiya ana iya lura da su - fainting ko pre-fainting state, rikice-rikice, rage sautin tsoka. Tare da irin waɗannan alamu, yakamata ku saurara ba kawai don jin daɗi ba, har ma ku auna dandano a bakinku: idan yana da "bayanin kula" na acetone (yana kama da ƙanshin ruwan anon), wannan tabbatacciyar alama ce ta rashin lafiyar. A cikin rashin taimako daga ƙaunatattun, har ma da gabatarwar magunguna na musamman, mutum na iya mutuwa da sauri. Tsawon lokacin da precoatose jihar na iya bambanta daga awa daya zuwa awa 24.

Bayyanar launuka

Idan ƙwayar cuta ta riga ta fara haɓaka, to mai haƙuri yana da ketoacidosis. Alamar sa tana da ƙishirwa, bushewar bakin ciki, haɓakar fitsari, wanda yakan wuce in babu fitsari, da kuma matsanancin ƙoshin jiki. Gabaɗayan alamun cutar lalacewar jiki an rage su zuwa rauni mai ƙarfi, ciwon kai, wani lokacin ba za a iya jurewa ba, alamomin dyspeptik mai ƙarfi. Amai a matakin farko na cutarma ya zama maimaituwa, amma taimako baya faruwa bayan wani hari. Yawancin marasa lafiya suna da gudawa, zafin ciki mai kaifi. Kamshin acetone ya zama mai furfura sosai, fatar jiki mara nauyi ce, bushewa, tachycardia tana tasowa, wawanci, wanda ya juya ya zama warkarwa.

Menene ke haifar da cutar rashin lafiyan cutar sankara?

Tunda coma yana faruwa ne ta hanyar haɓakar sukari na jini, kyallen da gabobin suna fuskantar mummunar rawar jiki, sakamakon wanda canje-canje masu ƙarfi ke faruwa. Anaruwar yawan fitsari da aka saki, amai, da gudawa na haifar da ƙonewar jiki, ruwa na yau da kullun ba zai iya rama raunin danshi ba. Yawan zubar jini a cikin jiragen shima ya fadi, saboda haka akwai kazamin hypoxia, take hakkin samarda jini ga dukkanin sel. Yana da haƙiƙar haɗari cewa ƙwaƙwalwar ƙwaƙwalwa tana fuskantar matsananciyar yunwar oxygen.

Cire sinadarin electrolytes - potassium, magnesium da sauran gishiri yana haifar da take hakkin ma'aunin gishiri, wanda kuma ake dangantawa da rashin ruwa. Wannan kuma yana haifar da canji a cikin yanayin gabobin jiki da tsarin sa. Bayan matakan sukari ya tashi, jiki yayi wani ƙoƙari don kawar da yawan sukari mai yawa ta hanyar rushe kitsen da glycogen tsoka. A sakamakon haka, ƙarar jikin ketone yana ƙaruwa, acetone da lactic acid sun bayyana a cikin jini, yanayin kamar hyperacidosis yana haɓaka.

Ta yaya za a ba da taimakon farko na cutar malaria?

Idan mai haƙuri da kansa da danginsa sun san yadda ake bayyanar da yanayin haɗari - coma - za su iya sarrafawa don hana mummunan sakamako. Ya kamata a ba da izinin insulin gaggawa a koyaushe, wanda ya kamata koyaushe a shirya a cikin masu ciwon sukari. Likitoci yawanci suna gargaɗi mutum da ciwon sukari game da rikitattun abubuwan da ya saba da shi da hanyoyin magance su. Bayan farawa na rigakafin coma, kuna buƙatar ɗaukar potassium, shirye-shiryen magnesium, shan ruwan ma'adinai, da hanzarta fitar da carbohydrates mai sauri daga abincin (na ɗan lokaci). Lokacin da aka saba da yanayin, ya kamata ka sanar da likita game da shi yayin alƙawarin da aka tsara. Idan lafiyarku ba ta inganta ba cikin awa ɗaya, kuna buƙatar kiran gaggawa da motar asibiti cikin gaggawa.

Iri na Ciwon Mara

Don samun sauƙi don kewaya cikin wannan al'amari, yana da daraja a raba nan da nan zuwa manyan ƙasashe biyu waɗannan ƙasashen masu fama da cutar rashin ƙarfi.

Coma ya kasu kashi biyu:

Kamar yadda mutane da yawa sun rigaya tsinkaye, hyperglycemic ya bambanta da cewa lokacin da ya fado cikin jinin mutum, matakin glucose ya hau sosai, wanda zai iya tsallake 30.0 mmol / lita.

Tare da ƙwayar cutar hypoglycemic, wanda aka fi sani a tsakanin marasa lafiya da ke dauke da ciwon sukari na 1, akasin haka, matakinsa ya faɗi ƙasa ƙasa da 3.0 mmol / lita.

Yana da daraja a sani cewa kowane mutum zai sami sandar sa!

Masu ciwon sukari tare da gogewa waɗanda suka rayu tare da ciwon sukari na fiye da shekaru 7-10 kuma galibi suna fama da nau'in insulin-wanda yake dogara dashi wanda yake jin daɗin gamsasshiyar ƙwayar cutar glycemia wanda ke wuce ƙimar ta 'yan mmol. A gare su, "girgizar hypoglycemic" na iya faruwa tare da raguwa mai yawa a cikin sukarin jini da ke ƙasa da 4.0 - 5.0 mmol / L.

Dukkanta sun dogara ne da matakin lafiya da iyawa ta kayan jikin mutum.

Haka ake yi don hawan jini. Yawancin matasa waɗanda shekarunsu ba su wuce 30 ba (musamman 'yan mata) suna da matsi wanda yawanci ba ƙasa da al'ada. Tare da shekaru, akwai haɓakar ƙara matsa lamba.

Koyaya, sabanin yawan hypoglycemia, hyperglycemia na iya tashi da haɓakawa gwargwadon al'amuran da yawa, wanda shine dalilin kasancewar wasu ƙarin ƙwayoyin cutar gudawa.

Hyperglycemic coma, bi da bi, ya kasu kashi uku:

Menene bambanci na asali tsakanin masu ciwon sukari com

Don kada ku shiga cikin cikakkun bayanai, amma don taƙaita duk abubuwan, muna ba da shawarar ku san kanku tare da bayanan da ke ƙasa, waɗanda muka tsara a cikin mafi ƙarancin tsari.

Kowane ɗaya daga cikin masu ciwon sukari yana da nasa lokacin da tsarin aikin ci gaba, kuma, ba koyaushe masana kimiyya ke bincika ba, wasu daga cikinsu suna da banbanci sosai da alamomin alamu, kuma wasu suna haifar da haɗari masu haɗari waɗanda ke buƙatar magani iri ɗaya kamar na kansa.

Hypoglycemic

• magani mai dauke da cutar gwaiwa> kashi 30% cikin dari a jarirai (yawanci a cikin na farko cikin kwanaki 2 ko 3 bayan haihuwa)
• > 55 - 60 MG% cikin manya

Yana tasowa da sauri (a cikin 'yan mintoci kaɗan) saboda raunin glucose.

Characterarin halayyar masu fama da ciwon sukari.

A cikin wari, ana buƙatar gaggawa da gaggawa nan da nan. Idan ba ku taimaki mutum a kan lokaci ba, to, zai iya mutuwa da sauri daga rikicewar hypoglycemic ko lalacewar lalacewar tsarin ɗabi'ar tsakiya zai bi, lokacin da mai haƙuri zai dawwama har abada. Irin waɗannan maganganun suna da yawa lokacin da, bayan hypoglycemic coma, mai ciwon sukari na iya canza hali, halinsa ya canza saboda lalacewar ƙwayoyin kwakwalwa da tsarin juyayi na tsakiya.

Mafi haɗarin rikicewa shine ƙwaƙwalwar hanji ko bugun jini, wanda ke haifar da mummunan sakamako.

Idan yaro yawanci yana fama da hypoglycemia, to wannan yana shafan ikonsa na hankali da kuma ci gaba.

Ketoacidotic

• magani glucose ya cika 300 - 700 MG% (19.0 - 30.0 mmol / lita kuma mafi girma)
• raguwa a cikin bicarbonate anion a cikin jini
• gibin plasma anionic yayi girma
• matakan jini β-hydroxybutyran, haɓakar acetate da acetone
• fitsari na fitsari da acetone
• osmolarity jini har zuwa 300 masallaci / l
• rashin lafiya
• akwai yawan lipids a cikin jini (jimlar cholesterol da triglycerides)
• taro na potassium a cikin jini da dama
• raguwa a cikin jini pH

Ripens hankali a tsakanin 1.5 - 2 kwana. A cikin masu ciwon sukari, tsofaffi na iya girma a cikin 'yan watanni. Hanzarta, cututtuka masu yaduwa, ƙarshen matsanancin ciwon sukari, rashin ƙarfi na zuciya na iya haɓaka ci gabanta.

Babban dalilin ci gaban shine karancin insulin, wanda aka lura da matsanancin yunwar kwayar halitta kuma, a sakamakon haka, matakin da sukari wanda bashi da tushe a cikin jini ya tashi (saboda raunin glucose mai rauni, juriya na insulin, da sauransu).

Don rashi raunin glucose na karya wanda ya samo asali, wani tsari na musamman na kariya don samar da makamashi daga raunin lipid yana haifar dashi - lipolysis. Sakamakon mai mai, wanda ya inganta ta yunwar katako, ƙarar samfuran lalata - jikin ketone - yana ƙaruwa saboda hadawan abu mai ƙoshin mai a cikin jini.

Mafi yawan jikin ketone - mafi yawan bacin rai da tsarin juyayi na mutum.

A lokaci guda, akwai mummunar aiki na ruwa-electrolyte metabolism, wanda ke kara haɓakar osmolarity na jini (jinin ya zama lokacin farin ciki).

Lalacewar abubuwan da ke sama yana tattare da rashin ruwa - rashin ruwa a jiki. Glucosuria (glucose a cikin fitsari) ya bayyana tare da polyuria na lokaci daya (haɓakar fitsari).

Yawancin ƙwayoyin lantarki suna ɓoye a cikin fitsari, musamman potassium da sodium.

Don daidaita yanayin, ya zama dole don daidaita yanayin glycemia, ma'aunin ruwa-electrolyte ta hanyar gabatar da ɗan gajeren insulins na ɗan adam da aka rushe cikin mafita mai ruwa tare da ƙarar da ake buƙata na electrolytes.

Hyperosmolar ba acidotic

• magani glucose 600 - 4800 mg% (sama da 30.0 mmol / l)
• maida hankali ga jikin ketone a cikin jini da fitsari ba a wucewa
• osmolarity jini ya wuce 350m / l
• a cikin jini yana kara adadin creatinine, nitrogen, urea
• hypernatremia

Yana girma sosai, a hankali (a hankali fiye da ketoacidotic) cikin kwanaki 10 zuwa 15.

Mafi yawan jama'a a cikin tsofaffi masu fama da ciwon sukari na 2 tare da gazawar koda.

An kwatanta shi da rashi na ketoacidosis, hyperosmolarity, hauhawar hyperglycemia da ke gaba da tsananin zafin nama.

Har yanzu dai ba a san takamaiman yadda wannan nau'in cutar sankara ke ci gaba ba, tunda glycemia ta fi ta ketoacidosis na gaske rauni, amma ba a samun gawar ketone a cikin jini. Plusari, insulin har yanzu yana cikin jinin mutum (koda kuwa bai isa ba, amma yana !, wanda ba za a iya faɗi game da coma na ketoacidotic ba, wanda akwai cikakkiyar isasshen insulin).

Masana ilimin kimiyya sun yarda cewa haɓakar jini yana hana lipolysis tare da sakin mai mai, kuma hyperglycemia yana ƙaruwa saboda gazawar koda, tun da kodan bazai iya tsabtace jini da kyau saboda raguwar aikinsu.

Mafi rikitaccen rikicewar wannan coma shine cerebral edema.

Lactic acidosis

• babban bambancin lactic acid

Idan muka kwatanta wadannan comas, to, mafi sauri-sauri sune guda biyu daga cikinsu:

A farkon, yawan ruwa yana faruwa ne sakamakon matsananciyar yunwar sel. Kwayoyin kwakwalwa suna da hankali musamman ga rashi na glucose. Idan bai isa a cikin jini ba, to kwakwalwar mutum 'nan take zata kashe' dukkan hanyoyinda suke amfani da makamashi. Hakanan yana iyakance ikonta don ci gaba da gudana da kuma tasirin kwayar dukkan gabobin. A saboda wannan dalili, "rawar jiki cikin fargaba", a matsayin mai mulkin, ya ƙare da coma nan take, wanda ke faruwa bayan iyakar 1 awa.

Idan mai ciwon sukari bai karbi maganin glucose mai narkewa cikin lokaci (ana amfani da kashi 40%), to mutuwa a wannan halin zata faru ne bayan wasu 'yan awanni, tunda zazzabin necrosis na kwakwalwar kwakwalwa zai fara (mutuwa).

Nau'in nau'in coma na biyu yana da ɗanɗano sosai, amma wannan bai sanya shi da haɗari ba. Idan mutum yana da matsalar koda da hepatic rashin wadatarwa tare da keta haddin zuciya, to a mafi yawan lokuta rashin daidaituwa saboda yawan hauhawar lactate na jini yana haifar da mutuwa. Yana da mahimmanci musamman ga lactic acidosis don saka idanu kan numfashi na mai haƙuri, saboda tare da rashin isashshen oxygen (har ma da muni - huhun ciki) zai kasance da wahala sosai cire mutum daga coma.

Acids na iya zama duka mai canzawa ne mara jurewa. Idan numfashin mutum ba shi da kyau, sakin iskar mara canzawa yana da wahala kuma yanayin mara lafiya yana ƙaruwa da sauri. Sauran samfuran metabolism suna iya samun damar cirewa ta hanjin kodan. A cikin mafi mahimman lokuta, ana amfani da hemodialysis don daidaita yanayin jini da kodan, amma wannan hanyar tana da rikitarwa kuma tana da contraindications da yawa.

Cutar masu fama da ciwon sukari akan asalin cutar ketoacidosis wacce ta kamu da ciwon mara kamar na biyun da ke sama. Abu ne mai sauki a bambance shi da sauran duk ta gaban kamshi 'ya'yan itace daga bakin ko acetone, tarin dumbin jikin ketone a cikin jini, acetone a cikin fitsari tare da glucosuria (glucose da aka fitar a cikin fitsari), da kuma ciwon ciki mai zafi da ake kira "m" ciki. Sakamakon cutar ta ƙarshe daga jerin, likitoci a wasu lokuta sukan yi kuskuren bayyanar cututtuka marasa kyau kuma suna kwantar da marasa lafiya a ɓangaren da ba daidai ba. Bugu da ƙari, yayin da suke cikin coma a cikin mutum, ɗaliban suna zama kunkuntar, yayin da yanayin asalin lactic acidosis da hyperosmolar non-ketoacidosis coma, sun kasance al'ada, kuma tare da hypoglycemia sun zama fadi.

Kasancewar kasancewar kasala ko rashin seizures na iya zama muhimmiyar shayarwa na tantance nau'in cutar sikari. Suna da halayyar hypoglycemic coma kuma ƙasa da sau (a cikin 30% na marasa lafiya) ana samun su a cikin hyperosmolar non-ketoacidosis coma.

Matsin lamba na jini yana daɗaɗa tare da hypoglycemic kuma an rage shi sosai tare da coma na hyperosmolar. A wata cutar rashin lafiya, yawanci yana ƙasa da na al'ada.

M dakin gwaje-gwaje

Ga kowane maƙarƙashiya, mai haƙuri tabbas zai ɗauki gwaji da sauri, gwargwadon sakamakon abin da:

ketoacidosis: leukocytosis, haɓaka a cikin ESR (ƙimar ƙwaƙwalwar erythrocyte), wucewar glucose na jini ya wuce, raguwa a cikin bicarbonates da pH jini, yawancin urea, ana iya samun raguwar sodium, karancin potassium

ilmin mahaifa bloodarfin jini mai ƙarfi (ƙaruwar osmolality), ƙaruwar ESR, haɓakar taro na ƙwayoyin jini da kuma Hb (haemoglobin), hawan jini mai narkewa, mai yawa na urea, sodium mai yawa, ƙarancin potassium

lactic acidosis: leukocytosis da haɓaka a cikin ESR, ƙaramin ɓacin hankali na glycemia, ƙananan matakan bicarbonates da pH, urea na iya zama dan kadan wuce ko al'ada

hypoglycemia: mai karancin jini

ketoacidosis: proteinuria, Silinda, microredituria, kasancewar acetone

ilmin mahaifa proteinuria, sililinda

lactic acidosis: a alaqa

hypoglycemia: bincike na yau da kullun

Ciwon sukari da aka shigar da shi cikin rukunin kulawa mai zurfi shima zai sami ECG.

Wani electrocardiogram yana ba ka damar kimanta ƙimar ƙwaƙwalwar zuciya. Dukansu ketoacidotic da coperosmolar coma (na ƙarshen zuwa mafi girma) suna da mummunan sakamako ga myocardium.

Thickaukar da yalwar jini (tare da osmolality mai ƙarfi) yana rikitar da aikin zuciya, wanda ke shafar hawan jini da ainihin yanayin duk hanyoyin jini. Bayan haka, idan ba a gaurayawar jinin ba kuma ba ta rage karfin sa ba, to hadarin cutar hawan jini wanda ya haifar da jijiyoyin jini da jijiyoyin wuya da haɓaka ƙananan hanji. Sabili da haka, sau da yawa bayan rashin lafiya, mai haƙuri dole ne ya ɗauki wasu bin abubuwa: duban dan tayi na gabobin da abin ya shafa da tasoshinsu, ɗaukar hoto, da sauransu.

Rashin haɗarin comas na masu ciwon suga suna da yawa. Dukkanin ya dogara da rigakafi, raunin na rayuwa, cututtukan cututtukan da ke gudana ko ba ya nan (cutar mai taɗari ta ƙunshi gabatarwar haɗin gwiwa na jerin ƙungiyoyin rigakafi ga mai haƙuri), da kuma shekarun da aka dauka yayin yanayin magungunan ƙwayoyin cuta.

Babban sassan gabobin shine: zuciya, huhu, kwakwalwa, kodan, hanta. Take hakkin wadannan gabobin yayi rikitarwa ba kawai kara samun kulawa ga mai haƙuri ba, harma yana kara lokacin murmurewarsa bayan barin cutar siga.

Idan kun sami kuskure, da fatan za selecti yanki na rubutu kuma latsa Ctrl + Shigar.