Hyma na rigakafin ƙwayar cuta: gaggawa, aikin kulawa da aikin jinya

Daga kowace shekara zuwa ƙarni, yawan ƙaruwa na fama da ciwon sukari. Cutar cuta ce mai matukar hatsarin gaske, sakamakon abin da ba wai kawai zai iya rage rayuwar rayuwar mai haƙuri ba, amma kuma yana iya haifar da mutuwa. Rashin lafiya na iya haifar da irin wannan yanayin mai haɗari kamar cutar mahaifa. Sakamakonsa shine asarar rai da gazawar jiki. A cikin kayan da aka gabatar, Ina so inyi la'akari da abin da keɓaɓɓen ƙwayar cuta a ciki, algorithm na kulawa na gaggawa don yanayin cuta. Zamuyi magana game da wannan.

Menene cutar rashin daidaituwa na yara?

Hyperglycemia rikitarwa ne na ciwon sukari, wanda yake shi ne m. Wannan sabon abu yana tattare da wani ci gaba na yawan glucose a cikin jini sabanin asalin karancin insulin. Yana da mahimmanci a lura cewa kulawa ta gaggawa don cutar sikila ta zama madaidaiciya don ceton haƙuri. Duk mutumin da ya dogara da insulin, har ma da dangin sa, yakamata ya zama sananne game da hanyoyin aiwatarwa yayin canjin rikice rikice zuwa mawuyacin lokaci.

Bukatar kulawa ta gaggawa don maganin cutar sikila ya shafi yawancin yara da yara waɗanda kwanan nan sun kamu da ciwon sukari. Irin waɗannan matsalolin ba sa faruwa a cikin mutanen da suka manyanta kuma suka daɗe suna fama da rashin lafiya. Bugu da kari, rashin lafiya kusan sau daya yakan faru a cikin masu ciwon sukari masu yawan kiba.

Iri na yanayin pathological

Likitocin sun bambanta nau'ikan cututtukan cututtukan mahaifa. Algorithm na gaggawa na kowane yanayi yana da bambance-bambance na kansa. Don haka, sun bambanta:

cocin ketoacidotic
murray,
lactic acidosis zuwa coma.

Ya kamata a fahimci Ketoacidosis azaman karuwar halittar ketone a cikin jini. Halin yana haɓakawa da tushen ciwon sukari, wanda haƙuri ba zai iya yin ba tare da injections na insulin na yau da kullun.

Bi da bi, ƙwaƙwalwar hypersomolar yana faruwa tare da ciwon sukari na 2. Ta wannan yanayin yanayin cutar, jikin ketone al'ada ne. Koyaya, mutum ya sha wuya daga jijiyoyin jini a jiki kwatsam. Hakanan a wannan yanayin, ana lura da bushewar jiki.

Lactic acid coma yana da halin matsakaici na abubuwan ketone a cikin fitsari. Ana kirkirar yanayi ne idan aka sami ci gaban ciwon sukari mai dogaro da insulin. Babban matsalar anan shine maida hankali ne ga babban taro na lactic acid a cikin jini.

Abubuwan da ake buƙata don ci gaban ƙimin ciki

Yanayin cututtukan cuta na iya faruwa ƙarƙashin rinjayar abubuwa da yawa:

yawan insulin da ya wuce
karancin matakan carbohydrate a abinci da ake ci,
matsanancin motsa jiki
matsananciyar damuwa, ɗabi'a mai ɗabi'a, tsawaita rayuwa.

Dole ne in faɗi cewa rashin carbohydrates da rashin daidaituwa na tunani ba safai ba ke haifar da cutar hauhawar jini. Farfaɗuwa da kanka cikin rashin sani tare da motsa jiki a cikin cutar sankara yana kuma da ɗan matsala. Sabili da haka, a mafi yawan halayen, hyperglycemic coma, tsarin kulawa na gaggawa wanda za'a tattauna daga baya, yana faruwa a cikin mutanen da suka yi haƙuri da yawan insulin.

Hoto na asibiti

The pathological yanayin tasowa a hankali. Alamomin asibiti wadanda ke tattare da cutar sankara yayin ciwon sukari mellitus sun bayyana a cikin kwanaki da yawa. Kyakkyawan rayuwar mai haƙuri a hankali ya dagula wahala, yana haɓaka haushi. Ana maye gurbin yanayin damuwa a hankali da asarar lokaci-lokaci. Bayan hulɗa da mai haƙuri, akwai wasu hana tunani, wawa.

Haɓaka ƙarancin ƙwayar cutar mahaifa ana iya ƙaddara ta gani. A fata a cikin wannan yanayin mafi sau da yawa j paya farin ciki, hanawa na numfashi aiki na faruwa. Iskar da ke fitowa daga ramin roba tana da ƙanshin acetone. Harshen ya bushe, wani rubutu mai launin shuɗi-fari ya bayyana a kai.

Daga baya, raguwar hauhawar jini ya faru, yawan zuciya yana zama mafi yawan tazara. Idan mara lafiyan ya kula har ya kasance cikin fargaba, ƙoshin ƙishirwa, tashin zuciya, da kuma amayar da amai.

Don sanin abubuwanda ake buƙata don haɓakawar coma suna ba da damar tattaunawa tare da mara haƙuri, idan hankalinsa ya kasance sarai. Idan mutum bai amsa ƙwarin gwiwa na waje ba, to, zaku iya gano matsalar ta hanyar bincika kayan aikinsa. Masu ciwon sukari suna ɗaukar sirinji na insulin, taswirar cutar. Daga cikin wasu abubuwa, kasancewar alamomi da yawa bayan allura, waɗanda yawanci suna cikin cinya da kan fata na ciki, na iya ba da shawara ga yanayin matsalar.

Kwayar cutar mahaifa: algorithm na gaggawa kafin likita ya zo

Tare da wannan nau'in matsala, yana da matukar muhimmanci a bayar da taimako ga mara lafiya nan da nan. Don haka, tare da ƙwayar cutar sankara, ƙirar gaggawa ta ba da shawarar mai zuwa:

An shimfiɗa mutum a kan shimfiɗaɗɗen wuri a kwance.
Ana bawa mai haƙuri jigilar iska mai kyau. Don yin wannan, cire rigunan waje, cire bel, ƙulla, da sauransu.
Shugaban ya juya gefe. In ba haka ba, wanda aka azabtar za a iya sara da asirin ciki idan wani harin na amai.
Bayyana ko mara lafiyar yana ɗaukar allurar insulin. Idan an tabbatar da shi, ƙirƙirar yanayi don gabatar da gwargwadon ƙwayar da ake so a cikin jini.
Idan za ta yiwu, yi rikodin matakin matsa lamba don sadar da bayanan ga ma'aikatan motar asibiti.
Kafin likita ya isa, ana ba mutum shayi mai ɗumi mai ɗumi.
Lokacin da numfashi ya tsaya ko kuma bugun ya shuɗe, an ba wa wanda aka azabtar numfashi na wucin gadi ko kuma tausayar zuciya kai tsaye.

Taimakon likita

Menene algorithm na aikin don maganin cutar mahaifa? Taimako na likita na gaggawa anan ya ƙunshi, da farko, allurar insulin. Da farko, maganin yana shiga cikin jini ta sirinji. Don haka ci gaba da ciyar da kai cikin jiki tare da digo a hade tare da maganin glucose 5%. Increasearin ƙwayar wucin gadi a cikin sukari na jini yayin gujewa farkon yanayin mafi yawan ciwon sukari.

Da zaran an isar da mara lafiya zuwa cibiyar likitanci, sai su yi aikin hanji da kuma wankewar hanji. Don wannan, ana amfani da maganin bicarbonate 4%. Ana yin allurar ciki a ciki, wanda ke taimakawa dawo da matakan farin ruwa na yau da kullun a cikin jiki. Sannan ana bayar da sinadarin sodium bicarbonate ga jini, wanda hakan yasa ya sami damar sake canza wutan lantarki da aka rasa yayin harin.

Don haka munyi nazarin algorithm na kulawa ta gaggawa. Tare da hyperglycemic coma, kamar yadda kake gani, asalin matsalar shine ƙaddara mai wahala sosai. Ana nuna yanayin yanayin rashin bayyanar alamun. Saboda haka, wani lokacin yana da wuya wani baƙon kai ya gane yanayin matsalar. Don guje wa matsala, marasa lafiya da ciwon sukari ya kamata su kara yawan kulawa ga dacewar lokacin insulin.

Coma Hyperglycemic - kulawa ta gaggawa (algorithm)

Bidiyo (latsa don kunnawa).

Maganin rashin lafiya - wani yanayi wanda ya haifar da karancin insulin a jiki. Mafi sau da yawa, coma hade da rashi insulin shine rikicewar ciwon sukari. Bugu da kari, wannan yanayin na iya faruwa sakamakon dakatarwar allurar insulin ko kuma rashin isasshen abincin. Ya kamata a san lafiyar algorithm na gaggawa na maganin cutar hyperglycemic coma ga duk wanda ke da cutar sankarau a cikin dangi.

Bambancin Coma

Tunda akwai nau'ikan nau'ikan cututtukan shaye-shaye guda uku, taimakon da aka bayar a matakin likita ya bambanta da kowannensu:

ketoacidotic coma,
ilmin coma
lactic acidosis.

Ketoacidosis yana da alaƙa da samuwar sassan jikin ketone (acetone) kuma yana haɓakawa daga tushen ƙwayar sukari mai dogaro da mellitus. Hankalin hyperosmolar yana faruwa tare da cutar ta 2, jikin ketone ba ya nan, amma marasa lafiya suna fama da matsanancin sukari da kuma tsananin bushewar ruwa.

Lactic acidosis yana halin matsakaici a hankali idan aka kwatanta shi da abubuwa biyu na farko, yana tasowa a cikin cututtukan da basu da insulin-insulin kuma ana nuna shi ta tara yawan acid ɗin lactic a cikin jini.

Bayyanar cututtuka na ketoacidosis da coperosmolar coma iri daya ne. Hoto na asibiti yana girma a hankali. Jin ƙishirwa, yawan fitar fitsari, yawan tashin zuciya da amai, raɗaɗin bayyana.

Bugu da ƙari, a gida, zaku iya bayyana matakin sukari (tare da hyperosmolar coma zai iya isa 40 mmol / L da mafi girma, tare da ketoacidosis - 15-20 mmol / L) kuma ƙayyade kasancewar jikin acetone a cikin fitsari ta amfani da gwajin kwalliyar gwaji.

Jin ƙishirwa da polyuria ba halayen lactic acidosis bane; babu jikin ketone a cikin fitsari. A gida, kusan ba zai yiwu ba a gano cutar.

Taimako na farko

Don kowane nau'in ƙwayar cuta na ciki, yakamata a kira kwararru na kulawa da gaggawa kuma a ɗauki matakai na yau da kullun kafin su isa. Taimako na farko kamar haka:

Sanya mai haƙuri a cikin kwance a kwance.
Bayar da iska mai kyau, buɗe ko cire sutura. Idan ya cancanta, cire taye, bel.
Juya kan mara lafiya zuwa gefe domin ta aukuwa na kai harin, mutum bai sha kan amayar.
Saka idanu wurin da harshe. Yana da mahimmanci cewa babu koma baya.
Bayyana ko mai haƙuri yana kan maganin insulin. Idan amsar ita ce ee, ƙirƙirar yanayin da ya wajaba don ya yi allura da kansa ko taimaka masa ya sarrafa jijiyoyin cikin sigar da ake buƙata.
Saka idanu karfin jini da bugun jini. Idan za ta yiwu, yi rikodin alamun domin sanar da kwararrun motar asibiti game da su.
Idan mai haƙuri yana "matsolaci," za a ji masa ɗumi ta rufe da bargo ko samar da abin ɗamara mai dumin dumama.
Sha ya isa.
Game da kamawar zuciya ko numfashi, sake tayar da jiki ya zama dole.

Siffofin sake maidowa

Resuscitation dole ne ya fara a cikin manya da yara, ba tare da jiran isowar kwararrun motar asibiti ba, tare da farawar alamu: karancin bugun jini a cikin ƙwanƙwaran carotid, rashin numfashi, fata ta sami launin toka-mai-haske, ɗaliban sun lalace kuma basu amsa haske ba.

Sanya mai haƙuri a ƙasa ko wata wahala, har ma da farfajiya.
Hawaye ko yanke sutura don samar da isowa ga kirji.
Ja da baya na mai haƙuri gwargwadon yiwuwa, sanya hannun a kan goshin, ka kuma sanya bakin mararsa zuwa gaba dayan. Wannan dabara tana ba da izinin jirgin sama.
Tabbatar cewa babu wasu sassan jikin waje a cikin bakin da makogwaro, idan ya cancanta, cire gamsai tare da motsi mai sauri.

Motsa zuwa bakin numfashi. An sanya adiko na goge goge, ko zaren ledo ko kayan leƙo a leɓen mai haƙuri. Ana ɗaukar numfashi mai zurfi, an matsa lebe a bakin mai haƙuri. Sannan sai suyi karfi sosai (na tsawon sakanni 2-3), yayin rufe hanci ga mutum. Za'a iya ganin tasirin iska mai kazanta ta hanyar ɗaga kirji. Mitar numfashi sau 16-18 ne a minti daya.

Madaidaiciyar zuciya mai tausa. An sanya hannayen biyu a ƙananan baya na sternum (kusan a tsakiyar kirji), zama a gefen hagu na mutum. Ana yin rawar jiki mai ƙarfi zuwa ga kashin kashin, yana juyawa saman kirji ta hanyar 3-5 cm a cikin manya, 1.5-2 cm a cikin yara. Matsakaicin akafi zuwa sau 50-60 a minti daya.

Tare da haɗarin numfashi-baki-baki da kuma tausayar zuciya, da kuma abubuwan da suka faru mutum ɗaya, ya kamata a maye gurbin inhalation guda ɗaya tare da matsa lamba akan kirji. Ana aiwatar da farfadowa kafin isowar kwararrun motar asibiti ko har sai an sami alamun rayuwa a cikin mutum.

Cutar Ketoacidotic

Wani fifiko shine gabatarwar insulin. Da farko, ana gudanar dashi a cikin jet, sannan a kwantar da hankali a kan glucose 5% don hana farawar yanayin haila. An wanke mai haƙuri tare da ciki kuma ya tsabtace hanji tare da maganin bicarbonate 4%. An nuna gudanar da aikin kwantar da hankali game da saline na ilimin jiki, Ringer don dawo da matakin ruwa a jikin mutum da sodium bicarbonate don mayar da batirin electrolytes da aka nuna.

Don tallafawa aikin zuciya da jijiyoyin jini, ana amfani da glycosides, cocarboxylase, ana gudanar da aikin oxygen (jijiyar oxygen na jikin).

Hyperosmolar jihar

Kulawar gaggawa tare da wannan coma tana da wasu bambance-bambance:

ana amfani da mahimmancin shirye-shiryen jiko (kowace rana har zuwa lita 20) don sake dawo da matakin ruwa a jikin (saline na kimiyyar jiki, maganin Ringer),
An kara insulin a cikin ilimin halittar jiki kuma a karkatar da shi, wanda ya sa sukari ya ragu a hankali,
lokacin da karatun glucose ya kai 14 mmol / l, an riga an gudanarda insulin akan 5% na glucose,
Ba a amfani da bicarbonates, tunda babu acidosis.

Lactic acidosis

Siffofin taimako na lactic acidosis coma sune kamar haka:

Methylene blue yana allura a cikin jijiya, yana bada izinin ɗaukar abubuwan da ke tattare da sinadarin hydrogen,
Gudanarwar Trisamine
peritoneal dialysis ko hemodialysis domin jini tsarkakewa,
ciki na ruwa na sodium bicarbonate,
karamin allurai na insulin a kan 5% na glucose a matsayin kariya ga raguwar abubuwa masu alakantarwa a alamomin glucose a cikin jini.

Fahimtar yadda ake bayar da agaji na farko a yanayin rashin lafiya, da kuma samun ƙwarewar sake rayuwa, na iya ceton ran wani. Irin wannan ilimin yana da mahimmanci ba kawai ga marasa lafiya da ciwon sukari ba, har ma ga dangi da abokai.

Bayyanar cututtuka na rashin lafiyar hyperglycemic coma da algorithm na gaggawa

Bayyanar cututtuka na bayyanuwar cutar rashin daidaituwa na jiki yana da alaƙa da maye gurbataccen ketone, daidaitaccen tushen acid-gami da bushewa. Hyperglycemic coma yana haɓaka yayin rana (har ma da tsawon lokaci). Harbingers na rashin lafiya sune:

Bidiyo (latsa don kunnawa).

ciwon kai
rashin ci
tashin zuciya
ƙishirwa da bushe baki
mamaye harshen
ƙanshi na acetone daga bakin,
dyspeptic cuta daga cikin gastrointestinal fili,
ragin matsin lamba
rashin kulawa
nutsuwa
amnesia
sautin tsoka
urination mai yawa.

Idan yin watsi da alamomin bayyanannu da rashin ingantattun matakan, a ƙarshe, mutum zai faɗi cikin yanayin rashin sani.

Taimako na gaggawa na rikicewar hyperglycemic coma ya ƙunshi aiwatar da matakan da yawa. Da farko dai, ya kamata a kira motar asibiti. A cikin tsammanin isowar kwararru, tsarin kulawa ta gaggawa don rikicewar cutar hyperglycemic shine kamar haka:

Don baiwa mara lafiya a kwance.
Don raunana belin, bel, ƙulla, don kwance mara nauyi a kan m riguna.
Gudanar da motsa jiki akan sarrafa harshe (yana da mahimmanci cewa bai fuse ba!)
Yi allura da insulin.
Duba don matsin lamba. Tare da raguwa sosai a cikin karfin jini, bayar da magani wanda ke kara hawan jini.
Bayar da abin sha mai yawa.

Kulawa ta gaggawa don cutar mahaifa

Ana buƙatar mai haƙuri a cikin ƙwayar cuta a asibiti. A asibiti, ana yin waɗannan ayyukan:

Na farko, jet, sannan drip insulin.
Yi lavage na ciki, saka enema mai tsarkakewa tare da maganin sodium bicarbonate 4%.
Sanya dropper tare da ruwan gishiri, Maganin Ringer.
Ana gudanar da glucose 5% a cikin kowane awa 4.
An gabatar da maganin sodium bicarbonate 4%.

Ma'aikatan asibiti a kowace sa'a suna tantance matakin glycemia da matsa lamba.

Marasa lafiya suna sane da mahimmancin bin abincin da likitanku ya umarta. In ba haka ba, kwatsam a cikin sukari na jini zai iya haifar da rikitarwa mai mahimmanci, ɗayan ɗayan shine hyperglycemic coma.

Mene ne rashin haihuwa da kuma cutar rashin haihuwa?

Hyma na hyperglycemic coma yanayi ne mai mahimmanci na mai haƙuri tare da ciwon sukari, a cikin sa akwai cikakkiyar asarar hankali.

Haɓaka wannan yanayin kai tsaye ya dogara da cutar. Samun haɓakar ƙwayar cuta daga ciki yana zuwa ta hanyar ɗaukar hankali na glucose a cikin jini da haɓaka mai yawa cikin raunin insulin. Sakamakon haka, ana lura da mummunar cuta na rayuwa, sakamakon shine asarar hankali da rashin daidaituwa.

An fahimci cutar rashin lafiyar jiki a matsayin yanayin da ya haifar da wuce haddi na insulin a jikin mai haƙuri da ciwon sukari.

Coma yana tasowa a hankali. Daga alamun farko na zazzabin cizon sauro zuwa ƙwayar cuta, mai haƙuri na iya tafiya daga awoyi da yawa zuwa makonni da yawa. Ya dogara da girman matakin sukari na jini da kuma tsawon lokacin sukari matakin yayi yawa.

Alamu na farko da ke nuna alamar ci gaba a ciki na ciki sune:

ciwon kai, kara yawan lokaci,
alamun guba
rushewar juyayi - jin damuwa ko rashin damuwa,
asarar ƙarfi
da ƙishirwa.

Sakamakon coma, ƙarfi da saurin maye na tsarin jijiya duka yana faruwa, saboda haka wannan yanayin yakan kasance yana haifar da yanayin damuwa, har zuwa asarar dalili.

Idan ba a yi komai ba, bayan gano alamun farko, yanayin majinyaci zai tsananta. Nan da nan kafin fadawa cikin wani coaukar ciki, numfashin mai haƙuri ya samu ƙanshin warin acetone, ana ba kowace numfashi ƙoƙari.

Jiki ya hauhawa (Hyperglycemic coma) yana tasowa saboda dalilai masu zuwa:

gano ciwon sukari lokacin da cutar ta riga ta yi tsanani,
take hakkin abinci
sashi mara kyau da kuma inim injections,
rikicewar juyayi
mummunan cututtuka.

Wannan yanayin halayen ne na nau'in ciwon sukari na 1, wanda ake lura da raunin insulin. A cikin marasa lafiya da ke dauke da ciwon sukari na 2, irin wannan rashin lafiyar ke da wuya sosai, tare da yawan sukari sosai a cikin jini.

Jiki yaduba na iya zama mai mutuwa, saboda haka yana da matukar muhimmanci a gane alamun a lokaci. Gane lokaci na matsalar kuma zuwa likita na iya ceton ran mai haƙuri. Don yin wannan, kuna buƙatar sanin menene ƙwayar cutar glycemic kuma menene alamun bayyanar cutar wannan cuta.

Baya ga alamomin da ke sama, waɗanda ke fitowa a hankali a matakin farko na cutar, za a iya lura da yadda za a magance fintin fuskar a cikin haƙuri. Marasa lafiya sau da yawa sun koka da bushe idanu da na bakin mucosa.

Wata alama ta halayyar halayyar mutum ita ce cewa fata a fuska ta zama mai laushi sosai, fatar jiki ta rasa elasticity, kuma fuskar ta dafe kai. Idan kayi nazarin harshen mai haƙuri, zaku lura da suturar launin fata.

Kafin maaukar ciki, akwai hauhawar hauhawar jini, matsin lamba da ƙarancin zafin jiki.

Harkokin hypoglycemic yana haɓaka da sauri sosai. Daga bayyanar alamun farko zuwa asarar hankali, 'yan mintuna wuce. Wannan halin yana nunawa ga alamu masu zuwa:

zuciya palpitations,
ƙara yin gumi
jin karfi na yunwar
migraine
narkar da rawar jiki,
mai numfashi mai nutsuwa.

Za'a iya haifar da cutar rashin ruwa a jiki ta hanyar yawan damuwa a jiki sakamakon motsa jiki, raguwar ganganci a cikin abubuwan carbohydrates, ko kuma babban insulin.

Hypo da cutar sikari da ke fama da cutar sikila idan ba a kula da su ba yana haifar da mutuwa.

Idan kwantar da hankali na haila ba zato ba tsammani, kulawa ta gaggawa zata iya ceton ran mai haƙuri. A matsayinka na mai mulki, marasa lafiya da ke dauke da cutar sukari da kansu sun san alamun rashin kwayar cutar da ke kusa kuma sun sami damar gargaɗi wasu ko kiran likita.

Koyaya, idan rikice-rikice na hyperglycemic ba fara ba tsammani, ya kamata a tuna cewa kulawa ta gaggawa zata iya ceton ran mutum, abubuwan da suka biyo baya na ayyuka zasu taimaka:

taimaka wa mara lafiya allurar insulin
idan mara lafiyar ya wuce, sanya shi a gefe,
dole ne a kira likita
Saka idanu yadda mai haƙuri yake numfashi,
don sarrafa bugun zuciyar.

Babu abin da za a iya yi a gida idan mai haƙuri ya riga ya ɓaci. Ya rage kawai don tabbatar da cewa mara lafiya ba ya sha wahala ba da gangan ba saboda harshen da ya faɗo da jira isowar ƙungiyar masu gaggawa.

Ya kamata a tuna cewa ɗayan bayyanar cututtukan cututtukan cututtukan ƙwayar cuta ne take hakkin aikin kwakwalwa. Wannan na iya haɗawa da magana ta rashin lafiya na mai haƙuri kafin ya fidda rai. Yana faruwa sau da yawa cewa mara lafiya don wasu dalilai baya son kiran likita kuma yayi ƙoƙari ya tabbatar wa wasu cewa ya san abin da zai yi. A wannan yanayin, dole ne a kira asibiti, sabanin duk tabbacin mai haƙuri.

Taimako na farko idan akwai yanayin rashin lafiya na asali ya kusan zama daidai don taimakawa tare da cutar mahaifa. Abinda kawai yakamata a tuna shine idan akwai matsalar hypoglycemia, ba za'a iya samarda insulin ba kafin likitan yazo.

Idan akwai mai haƙuri tare da ciwon sukari a cikin iyali, yana da mahimmanci a tuna da algorithm ambulance kuma koyaushe suna da lambar wayar likita a hannu.

Babu kulawar gaggawa a gida tare da cutar sikila da zata maye gurbin ƙwararren magani a asibiti. Bayan mara lafiyar ya kamu da rashin lafiya, abu na farko da yakamata ayi shine kiran likita.

Za a shigar da mara lafiya zuwa asibiti na ɗan lokaci, ya zama dole don kula da yanayinsa. Kulawa da cutar sikari da ke fama da cutar sikila tana nufin rage yawan sukarin jini. Tare da lokacin tuntuɓar asibitin, maganin zai ƙunshi waɗannan matakan:

amfani da kwayoyi don rage matakan sukari,
amfani da "gajere" injections na hormone insulin,
kawar da sanadin yanayin,
replenishment na ruwa asarar da jiki.

Irin waɗannan matakan zasu taimaka wajen dakatar da jihar precoatose da kuma guji mummunan sakamako.

Idan ziyarar likita ta faru daga baya, to lokacin da mutumin ya riga ya fada cikin rashin lafiya, magani na iya ɗaukar dogon lokaci kuma babu wanda zai iya tabbatar da sakamako mai nasara. Idan mara lafiyar yana cikin yanayin rashin sani, lura ya haɗa da samun iska ta huhu da binciken ciki. Ana yin sarrafa sukari a kowace awa, tare da allurar insulin.

Bayyananniyar riko da shawarar likitanka zai taimaka wajen nisantar ci gaban cututtukan mahaifa.

Guji ƙarancin insulin insulin a cikin jiki.
Bi shawarar jagororin abinci masu ba da shawara.
Kar a wuce gona da iri, aikin motsa jiki ya zama mai laushi.
Guji ƙaruwa mai ƙarfi a cikin sukarin jini.

Idan wani bayyanar cututtuka ya bayyana, ya kamata ka nemi shawarar likita kai tsaye ba tare da bata lokaci ba ko ƙoƙarin dakatar da wannan yanayin da kanka. Qualifiedwararren lokacin da ya cancanci magani zai taimaka don guje wa rikice rikicewar cututtukan hyperglycemia - dementia, wanda ke faruwa saboda lalacewar tsarin juyayi na jiki.

Ciwon sukari yana barin alama a kan halayen mutum. Idan kun yi haƙuri da wannan yanayin kuma kada ku yi watsi da shawarar likita, ciwon sukari ba zai zama jumla ba, amma yanayin salon ne. Kuna iya rayuwa tare da ciwon sukari, babban abu shine a hankali kula da lafiyar ku.

Tsarin maganin cutar sanyi na Coma Hyperglycemic

Babban burin cutar kwantar da hankula shine a daidaita yanayin glycemic index. Duk wani karkacewa na darajar glucose daga dabi'un toshiyar cutar ta shafi yanayin mai haƙuri kuma yana iya haifar da rikitarwa mai haɗari.

Rashin insulin tsawon lokaci a jiki yana kara hadarin cutar rashin haila. Wannan yanayin yana haifar da mummunar barazana ga rayuwar mai haƙuri, saboda yawanci yana tare da asarar hankali. Wannan shine dalilin da ya sa yana da mahimmanci ga mutanen da ke kusa su san alamun farko na wannan rikice-rikice da kuma hanyoyin aiwatarwa don kulawa ta gaggawa ga haƙuri.

Hyma na hyperglycemic coma yana faruwa ne sakamakon babban sukari, wanda ke ci gaba na dogon lokaci.

Pathogenesis na wannan yanayin yana faruwa ne sakamakon karancin insulin da kuma amfani da glucose mai ƙarancin gaske, sakamakon hakan yana faruwa a cikin jikin:

jikokin ketone an hada su,
mai hanta
an inganta lipolysis saboda yawan abubuwan glucagon.

Ketoacidotic. Ci gabanta shine mafi yawan lokuta a cikin marasa lafiyar insulin-dogara kuma yana tare da haɓakar jikin ketone.
Hyperosmolar - yana faruwa a cikin marasa lafiya da cutar ta biyu. A wannan yanayin, jiki yana fama da rashin ruwa a jiki da ƙimomin glucose mai girman gaske.
Lactic acidosis - don wannan nau'in coma, tarawar lactic acid a cikin jini shine halayyar tare da karuwa a cikin glycemia matsakaici.

The etiology na pathological yanayin kunshi a decompensation da ciwon sukari, zabi zabi da kyau hanyar dabara ko untimely gano cutar.

Za'a iya haifar da bayyanar rashin daidaituwa ta abubuwa kamar haka:

rashin bin ka'idodin allura,
da banbance-banbancen tsakanin yawan maganin da aka sarrafa da kuma abubuwan da ke amfani da su a jikin carbohydrates,
take hakkin abinci
canjin insulin
ta amfani da daskararre ko ƙarewar hormone,
shan wasu magunguna (diuretics, prednisolone),
ciki
cututtuka
cututtukan cututtukan zuciya
m shisshigi
danniya
shafi tunanin mutum rauni.

Yana da mahimmanci a fahimci cewa duk wani tsari mai kumburi wanda ke faruwa a jiki yana ba da gudummawa ga karuwar yawan insulin. Marasa lafiya ba koyaushe suna yin la'akari da wannan gaskiyar lokacin yin lissafin sashi, yana haifar da rashi na hormone a cikin jiki.

Yana da mahimmanci a cikin wane yanayi ne mai haƙuri yake buƙatar kulawa ta gaggawa. A saboda wannan, ya isa sanin alamun cutar mahaifa da ta taso sakamakon hauhawar jini. Asibitin tare da faruwar irin wannan rikicewar ya banbanta da matakin ci gabanta.

Akwai lokaci 2:

precoma
rikitarwa tare da asarar sani.

malaise
rauni
gajiya da sauri,
matsananciyar ƙishirwa
bushe fata da kuma bayyanar itching,
asarar ci.

In babu matakan dakatar da alamomin da aka lissafa, hoton na kara karfi, alamu na gaba suna faruwa:

hankali
da wuya numfashi
rashin dauki ga al'amuran da ke kewaye
gashin ido na iya zama mai laushi,
faduwa cikin karfin jini, haka kuma karfin zuciya,
pallor na fata,
samuwar duhu aibobi a bakin mucous bakin bakin.

Babban alamar da ke nuna ci gaban mahaifa ana ɗauka matakin glycemia. Ofimar wannan mai nuna alama a lokacin ma'auni na iya wuce 20 mmol / L, isa ga wasu yanayi alamar 40 mmol / L.

Taimako na farko ya hada da masu zuwa:

Kira don kula da lafiyar gaggawa.
Sanya mutumin a gefe ɗaya. A wannan matsayi na jiki, ana rage girman haɗarin haɓaka amai zuwa cikin jijiyoyin numfashi, haka nan riƙe harshe.
Bayar da iska mai kyau, 'yantar da mai haƙuri daga sutura mai daɗi, ɓoye abin wuya ko cire gyalen.
Auna matakin matsin lamba tare da mai sa idon jini.
Saka idanu bugun jini, yin rikodin duk alamu kafin zuwan likitocin.
Rufe mara lafiya da bargo mai ɗumi idan yana sanyi.
Yayinda yake riƙe da nutsuwa na mutum ya kamata ya bugu da ruwa.
Ya kamata a bai wa maraƙin da ke dogara da insulin allurar insulin daidai da shawarar da aka ba da shawarar. Idan mutum zai iya ba da taimakon kansa, to, kuna buƙatar sarrafa tsarin sarrafa magunguna. In ba haka ba, ya kamata wannan dangi ya kasance kusa da shi.
Yi aikin numfashi na wucin gadi, da kuma tafin zuciya na waje idan ya cancanta.

Abin da ba za a iya yi ba:

barin mara lafiya shi kadai idan akwai matsala
don hana haƙuri a lokacin injections insulin, la'akari da waɗannan ayyukan a matsayin wanda bai isa ba,
ki kula da lafiya, koda kuwa mutumin na jin sauki.

Don taimakawa dangin mai haƙuri, yana da mahimmanci don rarrabe tsakanin hypo- da hyperglycemic coma. In ba haka ba, ayyukan da ba daidai ba ne ba kawai za su rage yanayin haƙuri ba, har ila yau, na iya haifar da sakamako mai warwarewa, har zuwa farkon mutuwa.

Idan babu tabbacin cewa kwayar ta haifar da saurin sukari, mutum yana buƙatar a bashi ruwa mai daɗi don sha, kuma idan ya rasa hankali, yakamata a gudanar da maganin glucose a cikin ciki. Duk da gaskiyar cewa yana iya kasancewa yana da cutar rashin ƙarfi ta glycemia, a cikin irin wannan yanayi kafin motar asibiti ta sauka, wannan shine kawai shawarar da ta dace.

Za'a iya ƙaddara nau'in ƙwayar hyperglycemic a kan tushen ƙwayoyin cuta da gwajin jini gaba ɗaya, da urinalysis.

Alamomin dakin gwaje-gwaje

yawan adadin glucose da matakan acid din lactic,
kasancewar jikin ketone (a cikin fitsari),
increasedarin hawan jini da hawan jini, dake nuna rashin ruwa,
ƙananan matakan potassium da haɓaka sodium a cikin jini.

A cikin yanayin da aka samu na al'umma, ana amfani da gwajin jini don sukari ta amfani da glucometer. Dangane da sakamakon, likita ya zaɓi dabarun taimako.

Abubuwan bidiyo game da coma a cikin ciwon sukari:

Abubuwan da ke nuna alamun sake tsinkaye sune:

Rashin numfashi ko bugun zuciya,
cardiac kama
shudi fata,
rashin halayen yara yayin da haske ya shiga cikinsu.

Tare da alamun bayyanar da ke sama, bai kamata ku jira har sai motar asibiti ta isa.

'Yan uwan mai haƙuri ya kamata su fara aiki da kansu bisa ga shawarwarin masu zuwa:

Sanya mai haƙuri akan shimfida mai wuya.
Bude damar zuwa kirji, 'yantar da ita daga sutura.
Head karkatar da mai haƙuri da baya ka sa hannun a goshin sa, kuma ka shimfiɗa ƙaramin jaw a gaba tare da ɗayan don tabbatar da kiyaye hanya.
Cire tarkace abinci daga kogon roba (idan ya cancanta).

Lokacin yin hutu na wucin gadi, yana da mahimmanci a taɓa bakin mai haƙuri da leɓun sa, tunda a baya ya sanya adiko na goge baki ko yanki mai tsabta. Sannan kuna buƙatar yin kumburi mai zurfi, rufe hanci na mai haƙuri a gaba. Inganci ayyukan yana ƙaddara ta ɗaga kirji a wannan lokacin. Yawan numfashi a minti daya na iya zuwa sau 18.

Don yin tausa na zuciya kai tsaye, ya kamata a sanya hannaye a kan ƙananan na uku na sternum na mai haƙuri, wanda ke gefen hagu na shi. Tushen hanyar shine ƙarfin rawar jiki da aka ƙaddamar akan kashin baya. A wannan lokacin, canji daga cikin sternum zuwa nesa na 5 cm a cikin manya da 2 cm a cikin yara ya kamata ya faru. Kimanin bututu 60 a minti daya.Tare da haɗakar irin waɗannan ayyuka tare da nutsuwa na mutum, kowane numfashi ya kamata ya musanya tare da dannawa 5 a kan yankin kirji.

Ayyukan da aka bayyana ya kamata a maimaita su har sai likitoci sun iso.

Darasi na Bidiyo akan sake tayarda hankali:

Game da cutar ketoacidosis, insulin ya zama dole (da farko ta hanyar jet, sannan ta hanyar hanyar saukarwa tare da narkewa a cikin maganin glucose don hana hypoglycemia). Bugu da ƙari, ana amfani da sodium bicarbonate, glycosides da sauran hanyoyi don tallafawa aikin zuciya.
Tare da ƙwayar cuta ta hyperosmolar, an tsara shirye-shiryen jiko don sake mamaye ruwa a cikin jiki, ana gudanar da insulin a hankali.
Ana cire acid acidicis ta hanyar amfani da maganin antiseptik Methylene Blue, Trisamine, sinadarin bicarbonate sodium, da insulin.

Ayyukan kwararru sun dogara da nau'in coma kuma ana yin su a asibiti.

Kula da ciwon sukari yana buƙatar kulawa da shawarwarin likita. In ba haka ba, haɗarin ci gaba da rikice-rikice iri daban-daban da kuma ci gaba da cutar siga.

Zai yuwu a hana irin wannan sakamako tare da taimakon dokoki masu sauki:

Bi abinci kuma kada ku zagi carbohydrates.
Saka idanu glycemia.
Yi duk inje na miyagun ƙwayoyi a cikin lokaci daidai gwargwadon magungunan da likita ya umarta.
Yi hankali da nazarin abubuwan da ke haifar da cututtukan masu ciwon sukari don kauda dalilai masu tayar da hankali kamar yadda zai yiwu.
A lokaci-lokaci ana yin gwaje-gwaje na likita don gano nau'in cutar ta latti (musamman lokacin daukar ciki).
Yi canjin zuwa wani nau'in insulin kawai a asibiti kuma a ƙarƙashin kulawar likita.
Bi da duk wani cuta mai kamuwa da cuta.

Yana da mahimmanci a fahimci cewa sanin ka'idodi don taimakawa marasa lafiya a lokacin rashin buƙata ba kawai ga mai haƙuri ba, har ma ga danginsa. Wannan yana nisantar yanayin barazanar rayuwa.

9. Gabatarwa cikin ramin hanci:

- swab moistened tare da 3% hydrogen peroxide bayani (0.1% adrenaline bayani, 5% aminocaproic acid acid, naphthyzine, da sauransu) ko

- sossai soso (fim din fibrin)

10. Shirya magunguna:

- 5% maganin aminocaproic acid

- 1% maganin vicasol

- 0.025% hadroxon bayani

- 12.5% dicinone bayani

- Maganin 10% na alli chloride (alli gluconate)

- 5% maganin maganin ascorbic acid.

11. Bi takardar saiti na likita.

12. Kula da yanayin yarinyar: hawan jini, bugun jini, NPV, da dai sauransu.

13. Idan ya cancanta, asibiti a cikin sashen ENT.

Jiki a cikin jini na jiki wani yanayi ne wanda ake saninsa da shi a cikin raguwar glucose na jini.

1. Yawan yawan insulin.

2. Rashin abinci mai gina jiki, abubuwan tsallake abinci.

3. Muhimmancin motsa jiki.

Precoma. Abubuwan farko ba zato ba tsammani: rauni gaba ɗaya, damuwa, tashin hankali, yunwar, sweating, bugun jini, rawar jiki. Rarrashi.

Coma Rashin sani, cramps. Fatar ta yi fuska, gumi mai nauyi. Sautin girarsa daidai ne. Ahankali ya zama na kowa. Yawan zuciya na al'ada ne ko kuma na sauri. Hawan jini daidai yake ko sama. Babu kamshin acetone.

Glucose din jini yayi yawa. Babu sukari ko acetone a cikin fitsari.

Algorithm na gaggawa.

1. Kira likita ta hanyar ɓangarori na uku.

2. Kwance, kare daga raunin da ya faru, sanya wani abu mai taushi a kanka, juya kanka a gefenta (gargadi game da hana harshe).

3. Idan ya cancanta, wora hanyoyin cikin iska, samar da kwararar iskar gas, in ya yiwu, maganin oxygen.

4. Shirya magunguna:

- Maganin glucose kashi 40%

- Maganin 0.5% na maganin diazepam (relanium, seduxen) ko maganin sodium hydroxybutyrate na 20%

- 0.1% adrenaline bayani

- 3% maganin rigakafi

5. Bi sahun likita.

6. Bayan dawo da hankali, ciyar da yaro da abinci mai carbohydrate: farin burodi, kayan kwalliya, dankali, masara, jelly, da sauransu.

7. Kula da yanayin yarinyar: hawan jini, bugun jini, NPV, sukarin jini, da sauransu.

8. Idan ya cancanta, canja wuri zuwa ɓangaren kulawa mai zurfi.

Hyperglycemic (mai ciwon sukari) coma wani yanayi ne da ake samu ta hanyar haɓaka glucose na jini, kazalika da tarawa a jikin kayayyakin samfuri na ciki (jikin ketone).

1. Rashin sanin ciwon sukari.

2. Rashin isasshen insulin.

3. keta cin abincin (cin zagi, mai dadi).

4. Cutar cikin ciki (cututtuka, raunin hankali da raunin jiki, da sauransu).

Precoma. Haɓakawa shine sannu-sannu a hankali a cikin kwanaki da yawa: ƙaruwar ƙishirwa, rage yawan ci, polyuria, rauni, rashin ƙarfi, ciwon kai, amai. Ciwon ciki, amai, ciwon mara. Ellarshen Acetone daga bakin. Rashin hankali, magana mai rauni.

Coma Rashin sani. Fatar da mucous membranes sun bushe. Sautin gashin gira yana raguwa. A numfashi ne m zurfi, Kussmaul. Bugun buguwa yana da wuya, cike yake da rauni. Ragewar jini ya ragu. Ciwan tsoka. Oliguria. Pungent ƙanshi na acetone.

Matsayin glucose na jini yana sama. A cikin fitsari, sukari da acetone an gano su.

Algorithm na gaggawa.

1. Kira likita ta hanyar ɓangarori na uku.

2. Tabbatar da kwararar sabon iska, in ya yiwu - maganin oxygen.

3. Rage ciki tare da 4% sodium bicarbonate bayani, barin wani ɓangaren mafita a ciki.

4. Yi enema mai tsafta tare da maganin sodium bicarbonate 4%.

5. Shirya magunguna:

- insulin gajeran aiki: actrapid, homorap

- mafita jiko: 0.9% maganin sodium chloride, Ringer's መፍትሄ, 5% bayani na glucose, "Chlosol"

6. Bi umarnin likita.

7. Kula da yanayin yarinyar: hawan jini, bugun jini, NPV, sukarin jini, da sauransu.

8. Idan ya cancanta, canja wuri zuwa ɓangaren kulawa mai zurfi.

Taimako na farko don maganin cutar rashin motsa jiki na hyperglycemic

Cutar Hyperglycemic shine mummunan yanayi sakamakon rashin insulin cikin jiki a cikin marasa lafiya da ke fama da cutar sankarar mahaifa. A gaban irin wannan cutar, wanda aka azabtar ya buƙaci kulawa ta gaggawa da asibiti a cikin asibiti. Menene tsarin kulawa na gaggawa don maganin cutar malaria? Mene ne musabbabin cututtukan cututtukan zuciya? Za ku karanta game da wannan da ƙari sosai a cikin labarinmu.

Kamar yadda aikin asibiti na zamani ya nuna, hyperglycemic coma yana haɓaka hankali - daga 10-12 hours har zuwa rana 1. Ko da irin nau'in wannan yanayin ilimin, har ma da matsayin sa, mutum yana buƙatar samar da kulawa ta hanyar likita kafin. Taimako na farko game da cutar sankara mai kwakwalwa kamar haka:

Matsar da mutum zuwa matsayi na kwance,
Bayar da iska mai kyau ta hanyar cire riguna, bude windows da qofofin,
Jefa wanda aka azabtar a gefe tare da tsawan dogon lokaci na tunani, domin hana shan iska yayin cukuwa da ama ko saboda maimaita harshe,
Gabatar da insulin. Ana nuna shi a cikin yanayi inda mai kulawa ya san daidai gwargwadon yawan maganin, misali, dangi na kusa, matar ko miji,
Alamar mahimmanci alamun saka idanu tare da aiwatar da farfadowa na hanzari don dawo da numfashi da bugun jini.

Algorithm na amsawa na gaggawa don bayyanar cututtuka na hyperglycemic coma, wanda likitocin ƙungiyar motar asibiti suka bayar, da farko ya dogara da takamaiman nau'in cutar sankarar mahaifa.

Ayyuka tare da cocin ketoacidotic:

Jinkirin jet jigilar insulin,
Insp insulin tare da maganin glucose na 5% don hana sake haifar da yanayin hypoglycemic,
Yin tsarkakewa da hanji na ciki,
M cikin ruwa na sodium bicarbonate, Saline don mayar da ma'aunin lantarki,
Therapyoshin jiyya don gyaran zuciya da sauran tsarin jiki. A cikin wannan mahallin, ana amfani da maganin oxygen, cocarboxylase, glycosides da wasu kwayoyi ana amfani da su kamar yadda ya cancanta.

Ayyuka na gaggawa tare da coma na hyperosmolar:

M gudanar da jiko shirye-shirye (yafi Ringer mafita),
Ppingaukar ƙwayar insulin tare da saka idanu na glucose jini
Kula da yanayin kafin isa zuwa asibiti.

Kulawa ta gaggawa don lactic acidosis coma:

Abun Trisomine Allura
Alluhun ruwa mai narkewa na methyl blue, wanda zai baka damar ɗaukar abin da ya wuce ions hydrogen,
Gudanarwa na ƙananan ƙwayoyin cuta na ƙananan allurai na insulin, bodiarate sodium, 5% glucose.

Hyperglycemia a matsayin babbar alama ta asibiti shine karuwa a cikin glucose na jini a cikin jini na jini idan aka kwatanta da ƙimar al'ada. Akwai matakai 5 na irin wannan tsari - daga wani ɗan ƙaramin nau'in ladabi mai ban mamaki zuwa haɓakar jihar precomatous da coma kanta.

Babban dalilin ciwo na kullum, samar da tsari akai-akai, shine kasancewar kamuwa da cutar siga a cikin mara lafiya. Rashin insulin ya haifar da karuwa a yawan tattarawar glucose a cikin magudanar jini. Wata hanyar kirkirar hauhawar jini shine ƙin tsarin haɗin hulɗar da kwayoyin tare da ƙwayoyin nama.

Abubuwan da ke saurin haifar da cututtukan cututtukan cututtukan zuciya a waje da kowane nau'in ciwon sukari sune:

Rashin daidaitaccen tsarin abinci tare da yawan wuce haddi da cin abinci mai yawa mai yawan kuzari mai yawa,
Mai tsananin damuwa da bacin rai,
Girgiza jiki yayi,
Aiki na lokaci
Mai tsananin siffofin cututtuka.

Bayyanar cututtuka na hyperglycemia suna da sauƙin canzawa kuma sun dogara da matakin ci gaban tsarin ilimin cututtukan cuta. Sau da yawa, har ma da wani gogaggen likita ba tare da sakamakon gwajin jini gwaje-gwaje tabbatar da yanzu high taro na glucose a cikin jini, zai iya kawai tentatively tantance tsananin mai haƙuri yanayin, ta halitta, idan wanda aka azabtar ba kasance a cikin halin rashin lafiya.

Alamar hauhawar jini ya bayyana a hankali. Hanyar bayyanar cututtuka:

Urination akai-akai da tsananin kishirwa
Gajiya da rashin hankali
Alaka bushe da fata na mucous na bakin ciki,
Jin numfashi mai amo
Arrhythmia.

Bayyanar cututtukan cututtukan mahaifa na yau da kullun:

Rashin sani
Rashin rauni kamar zirin
Kamshin acetone ko apples daga bakin rami,
Kimanin girman zafin jiki,
Pressurearancin saukar karfin jini
Dumi da bushe bushe fata.

Kamar yadda aikin asibiti ya nuna, ƙwayar cutar ƙwaƙwalwar ƙwayar cuta a cikin yara na kowane zamani yana haɓaka da sauri fiye da na tsofaffi saboda ƙarancin hanyoyin don rama yawan wucewar glucose mai yawa. Sau da yawa akwai asalin ci gaban ketoacidosis wanda ke hade da mummunan rauni na metabolism acid na mai.

Likitocin motar asibiti za su iya ƙwarewa da sanin yanayin jaririn kuma su yanke shawara game da yiwuwar zuwa asibiti. Idan babu hankali, isar da haƙuri na kai tsaye zuwa sashin kulawa mafi kusa yana wajaba.

Likitocin gaggawa na bayar da kulawa ta gaggawa don kamuwa da cutar sankarar mahaifa - Wannan shine jiko na mafita, insulin, kazalika da tallafawa magunguna. Idan babu numfashi ko palpitations, ana yin cikakkiyar farfadowa har sai an dawo da alamun tabbatuwa.

Muhimmin abu a hana ci gaba da samun bullar cutar yaduwa a yara shine:

Kulawa sosai da yarda da yarda da duk shawarwarin likita,
Gyara yanayin rayuwa da abinci mai gina jiki,
Harkokin insulin na yau da kullun ko shan allunan-sukari masu sukari, bi da bi don nau'in 1 da nau'in ciwon sukari na 2.

A matsayin ɓangare na kimanta yanayin mutumin da ke ɗauke da ƙwaƙwalwar ƙwayar cuta, an yi la'akari da bayanan gwaje-gwajen dakin gwaje-gwaje. Manuniya Maɓalli:

Matsayin glucose. Sama da 22.5 mmol / l
Rage nauyi. Fiye da kashi 0.5 cikin rana,
Rashin ruwa daga jiki. Fiye da lita 4
Na saura nitrogen. Fiye da 36 mmol / l,
Hyperbetalipoproteinemia. Sama da 8,000 mg / l
Glucosuria. Fiye da t 200 a rana,
jini pH 7.2 kuma a ƙasa
Sauran Manuniya. Harkokin coagulating na jini suna inganta sosai, metabolism na lipid yana da damuwa, acetonuria, hyperketonemia an kafa. Hankalin bicarbonates yana raguwa, abubuwan da ke cikin haemoglobin, leukocytes, ESR yana ƙaruwa sosai.

Mafi rikitarwa rikice-rikice na hankula waɗanda ke haifar da tasirin rikice-rikice a cikin jiki:

Asphyxia ya lalace ta hanyar amafani da amai ko yaɗar da harshe yayin da ba a ba mutum taimakon farko,
Flexangare na cikin ƙasa, tare da raunin lalacewa zuwa tsarin juyayi saboda tsawan tsawa,
Paresis matsakaici ko zurfi (rage ƙarfi a cikin ƙwayar tsoka ko ƙwayar tsoka),
Wani bangare ko kuma cikakkiyar inna,
Saukar jini na ciki da yawa da kuma ƙwayoyin jini na jini,
Bacewar da yawa daga cikin ayyukan wayewar kai da kuma lalacewar iyawar kwakwalwa,
Rashin daidaituwa na rayuwa.

Sabili da haka, matakan asali don hana sake dawowa da wannan ilimin sun hada da bin ka'idodin maganin tallafawa mutum wanda likitancin endocrinologist ya tsara, yin la'akari da shawarar sauran kwararru masu dacewa. Makullin abubuwan aukuwa:

Kulawa da glucose na yau da kullun a cikin jini ta amfani da mitirin glucose na jini,
Inje lokaci na insulin ko amfani da allunan rage sukari, dangane da takamaiman nau'in ciwon sukari,
Gyara abinci da kuma kawo shi cikin layi tare da shawarar masanin abinci,
Daidaitaccen aiki na jiki a cikin tsarin aikin motsa jiki, da za'ayi a gida,
Inganta kwanciyar hankali na bacci da wake wake tare da kason isasshen lokacin hutu,
Nisantar da mummunan halaye, musamman - amfani da giya,
Sauran ayyuka kamar yadda ya cancanta.

Victor Sistemov - gwani a 1Travmpunkt

Wata kasida ta C. Mafi kyawun “Babban lokutan a tarihin nazarin ciwon sukari” a cikin littafin 'Ciwon sukari' (wanda R. Williamson ya shirya). Moscow, gidan wallafa "Medicine", 1964. (a cikin yaren asali, an buga littafin a shekarar 1960).
Elena Yuryevna Lunina Cardiac autonomic neuropathy a cikin nau'in ciwon sukari na 2 na Lell Lambert, LAP Lambert Academic Publishing - M., 2012. - 176 p.
Perekrest S.V., Shainidze K.Z., Korneva E.A. Tsarin ƙwayoyin ƙwayoyin ƙwayoyin odixin. Tsarin da ayyuka, ELBI-SPb - M., 2012. - 80 p.
Rosenfeld E.L., Popova I.A. cutar Glycogen, Magunguna - M., 2014. - 288 p.
Filatova, M.V. Darasi na nishaɗi don ciwon sukari mellitus / M.V. Filatova. - M.: AST, Sova, 2008 .-- 443 p.

Bari in gabatar da kaina. Sunana Elena. Na kasance ina aiki a matsayin endocrinologist fiye da shekaru 10. Na yi imanin cewa a halin yanzu ni ƙwararre ne a fagen aikina kuma ina so in taimaka wa duk baƙi zuwa shafin don warware matsalolin da ba ayyuka sosai ba. Duk kayan don rukunin yanar gizon an tattara su kuma ana aiwatar dasu da kyau don isar da sanarwa gwargwadon iko. Kafin amfani da abin da aka bayyana akan gidan yanar gizon, tattaunawa mai mahimmanci tare da kwararru koyaushe wajibi ne.

Sanadin faruwa

Akwai dalilai da yawa na cutar hyperglycemic coma, kuma sun kasu kashi biyu. Na farko ya hada da magani mara kyau, bayyanar cututtuka da ba a tantance masu ciwon sukari ba, kurakuran suturar insulin, cin zarafin abinci, amfani da magunguna marasa inganci don magani ko kwayoyi tare da rayuwar karewar da ba ta bayar da abin da ake so, kamar yadda aka soke insulin.

Na biyun ya hada da halaye da cututtuka masu zuwa:

matsananciyar damuwa (an gano cewa yayin danniya matakin glucose din jini yana ƙaruwa sosai),
cututtukan zuciya (necrosis na pancreas, sakamakon abin da ya haifar da karancin insulin),
raunin da ke faruwa a wurare daban-daban da aikin tiyata,
wasu kumburi da cututtuka.

Abin da ya faru na hyperglycemic coma yana yiwuwa tare da ƙwayar cutar sukari marar daidaituwa ta kowane nau'in.

Kulawar gaggawa

Kowane mutum na iya fuskantar yanayi lokacin da ya zama dole don bayar da taimakon farko kafin isowar ma'aikatan lafiya. Idan kuna tsammanin mutum ya kasance cikin yanayin rashin lafiyar, to akwai buƙatar aiwatar da bayanan ta gaba:

Eterayyade idan akwai bugun jini (zaku iya yin wannan akan kowane jijiya ko jijiya. Hanya mafi sauƙi don yin wannan ita ce a wuya ko wuyan hannu).
Binciki don hana bakin cikin bakin (misali, haƙori ko abinci).
Juya mutum a gefe don kada harshen ya fadi ko kuma ka guji shayewa saboda amai.
Jira shigowar likitoci, kuma idan mai haƙuri yana da dangin kiran waya.

Jiyya na ƙwayar cuta na hyperglycemic, ba tare da la’akari da dalilin faruwar abu ɗaya ba - maganin insulin.

Ana aiwatar da warkewa a cikin asibiti. Idan mara lafiyar yana cikin yanayin farashi, to, magani ya ƙunshi a cikin gudanarwar insulin da kuma ma'aunin awa na glucose jini. Kula lokaci-lokaci zai hana ci gaban kwaro.

Idan mai haƙuri ya riga ya shiga cikin rashin lafiya, yana nufin cewa yana buƙatar kulawar likita ta gaggawa. Wannan taimakon ya hada da wadannan ayyukan:

tururi na wucin gadi, shigowar tracheostomy,
shigarwa na urinary catheter,
insulin far (ana gudanar da shi ta hancin insuli)
sarrafa jini,
sake haɓaka ƙarar jini yana yaduwa da haɓakar saline ko kuma maganin Ringer (watau, rage bushewa),
gabatarwar 5% na glucose bayani bayan daidaitawar sukari jini (don mayar da yanayin ciki na jiki),
replenishment na asarar lantarki ta hanyar fadada jiko,
detoxification (kawar da gubobi daga jiki).

Bugu da kari, a asibiti sau da yawa a rana suna yin gwaje-gwaje na jini da na kwayoyin halitta, da kuma urinalysis na jikin ketone. Bayan alamun bayyanar cututtukan jijiya sun ɓace kuma mutumin ya sake farfaɗo, ana ba da shawarar yin gwajin CT na kwakwalwa. Amfani da shi, an ƙaddara ko akwai wasu raunuka kwayoyin halitta a cikin kwakwalwa.

Lokacin gyarawa ga kowane mutum ya bambanta kuma ya dogara da tsananin matsalar cuta na rayuwa. Bayan gyaran likita na coma, wanda ke ɗaukar lokaci daga kwanaki da yawa, ana tura mai haƙuri zuwa sashen endocrinology.

A mataki na gaba na jiyya, wajibi ne don kafa sanadin wannan ilimin. Kuna iya buƙatar tuntuɓar wasu ƙwararrun likitocin (likitocin zuciya, likitocin, likitocin ciki) da gwaje gwajen kayan aiki (bincike na duban dan tayi).

Nan gaba, aikin mai haƙuri da likitan da ke halartar shine zaɓi zaɓi na insulin da ya dace, wanda zai sa matakin sukari ya zama daidai.

Jiki ya hauhawa a cikin yara

Hyma na hyperglycemic coma shine mummunan rikice-rikice wanda zai iya faruwa a cikin masu ciwon sukari na kowane zamani, yara basu da banbanci. A cikin yara, wannan yawanci sakamako ne na nau'in 1 mellitus na ciwon sukari, wanda ke halayyar yara da ƙuruciya.

A cikin yaro, har ma a cikin manya, tare da ƙara yawan sukari a cikin jini, shan giya na kwakwalwa na faruwa, kuma a sakamakon hakan, hargitsi da asarar hankali.

Sau da yawa, bayyanuwar farko na ciwon sukari cuta ce ta hyperglycemic coma, wato, iyaye ba su da masaniya game da wanzuwar ciwon sukari a cikin yaro. Tushen haddasawa da alamomin cututtukan ƙwaƙwalwa daidai yake da na manya. Idan ba a isar da magani akan lokaci, rayuwar yaron tana cikin haɗari.

Hadarin ya ta'allaka ne akan cewa jariri ba zai iya tantance lafiyar shi da gangan ba, yana zargin kowane alamu. Hakkin a cikin wannan ya ta'allaka ne da iyaye, yana da muhimmanci a yi la’akari da lafiyar yara. Likitoci suna kira don a bincika gwajin lafiya, ko da yaron bai damu ba.

Abin baƙin ciki, ciwon sukari da ba'a gano ba yana barazanar irin wannan rikitaccen rikitarwa kamar ƙwarkwalwar ƙwayar cuta. Matakan da aka fara amfani da su daga bacci na rage yawan nasarar da aka samu.

Sakamakon

Abin takaici, idan coma ta dade, to sakamakonta ba zai iya juyawa ba. Wannan da farko ya shafi tsarin juyayi. Gubar glucose na iya cutar da yanayin kwakwalwa. Rashin iya ƙwaƙwalwar ƙwaƙwalwa, rikicewa, har ma kumburi da ƙwaƙwalwar ƙwaƙwalwa. Bugu da kari, tunda vomiting na iya yiwuwa yayin coma, vomiting a cikin huhu na iya haifar da cutar huhu.

Yaran da suka sami wannan yanayin suna iya samun sakamakon da ke sama. Aikin iyaye da likitoci shine a hana wannan sake faruwa.

Yin rigakafin

Kowane yanayi yana da sauki a kiyaye fiye da yin magani. Da farko, lokacin da aka tabbatar da bayyanar cutar sankarar bargo, ya zama dole a bi umarnin likita sosai. Biye da abinci, ƙoshin motsa jiki da kuma daidaitawar maganin ƙwayoyi zai rage haɗarin haɓaka ƙira zuwa sifili. Yakamata ku duba ranar karewar magunguna, insulins kuma kar kuyi amfani dasu bayan lokacin karewar ya kare. Adana magunguna gwargwadon yanayin ajiya.

Masu ciwon sukari da kansu dole ne su iya sarrafa matakin glucose na jini a gida tare da glucometer, kuma lokacin da za a lalata maganin ciwon sukari, nemi likita akan lokaci. Tare da haɓaka matakan glucose na jini, zaku iya ƙara yawan ƙwayar ruwa zuwa lita 2-3, kafin ziyartar kwararru.

Ya kamata masu jinya suyi jigilar ziyarar zuwa likitoci sau daya a shekara.

Ga yara, an ɗora alhakin da ya rataye a wuyan iyayen. Kuna buƙatar yin hankali da faɗakarwa game da lafiyar ɗanku.

Kammalawa

Abin baƙin ciki, masu ciwon sukari suna cikin haɗarin haɓaka ƙwayar cutar hyperglycemic.

Dole ne a tuna cewa magani da aka fara akan lokaci yana bada tabbacin kyakkyawan sakamako da warkewa. A mafi yawan lokuta, likitoci sun sami damar dakatar da wannan yanayin kuma mai haƙuri yana murmurewa.

Lifearin rayuwa ya dogara ne kawai ga mai haƙuri. Tare da madaidaicin salon rayuwa, bin shawarar likitocinku na kulawa, zaku iya guje wa cutar sihiri ta gaba tare da hana wannan cutar sake faruwa. Rayuwar mai haƙuri da ciwon sukari ya dogara da mai haƙuri da kansa, halayensa, kasancewa tare da ingantaccen tsarin kula da magani.

Hyma na jini.

Jiki a cikin jini na jiki wani yanayi ne wanda ake saninsa da shi a cikin raguwar glucose na jini.

1. Yawan yawan insulin.

2. Rashin abinci mai gina jiki, abubuwan tsallake abinci.

3. Muhimmancin motsa jiki.

Precoma. Abubuwan farko ba zato ba tsammani: rauni gaba ɗaya, damuwa, tashin hankali, yunwar, sweating, bugun jini, rawar jiki. Rarrashi.

Glucose din jini yayi yawa. Babu sukari ko acetone a cikin fitsari.

Algorithm na gaggawa.

1. Kira likita ta hanyar ɓangarori na uku.

2. Kwance, kare daga raunin da ya faru, sanya wani abu mai taushi a kanka, juya kanka a gefenta (gargadi game da hana harshe).

3. Idan ya cancanta, wora hanyoyin cikin iska, samar da kwararar iskar gas, in ya yiwu, maganin oxygen.

4. Shirya magunguna:

- Maganin glucose kashi 40%

- 5-10% maganin glucose

- Maganin 0.5% na maganin diazepam (relanium, seduxen) ko maganin sodium hydroxybutyrate na 20%

- 0.1% adrenaline bayani

- 3% maganin maganin riga-kafi

5. Bi sahun likita.

6. Bayan dawo da hankali, ciyar da yaro da abinci mai carbohydrate: farin burodi, kayan kwalliya, dankali, masara, jelly, da sauransu.

7. Kula da yanayin yarinyar: hawan jini, bugun jini, NPV, sukarin jini, da sauransu.

8. Idan ya cancanta, canja wuri zuwa ɓangaren kulawa mai zurfi.

Hyperglycemic (mai ciwon sukari) coma.

Hyperglycemic (mai ciwon sukari) coma wani yanayi ne da ake samu ta hanyar haɓaka glucose na jini, kazalika da tarawa a jikin kayayyakin samfuri na ciki (jikin ketone).

1. Rashin sanin ciwon sukari.

2. Rashin isasshen insulin.

3. keta cin abincin (cin zagi, mai dadi).

4. Cutar cikin ciki (cututtuka, raunin hankali da raunin jiki, da sauransu).

Matsayin glucose na jini yana sama. A cikin fitsari, sukari da acetone an gano su.

Algorithm na gaggawa.

1. Kira likita ta hanyar ɓangarori na uku.

2. Tabbatar da kwararar sabon iska, in ya yiwu - maganin oxygen.

3. Rage ciki tare da 4% sodium bicarbonate bayani, barin wani ɓangaren mafita a ciki.

4. Yi enema mai tsafta tare da maganin sodium bicarbonate 4%.

5. Shirya magunguna:

- insulin gajeran aiki: actrapid, homorap

- mafita jiko: 0.9% maganin sodium chloride, Ringer's መፍትሄ, 5% bayani na glucose, "Chlosol"

6. Bi umarnin likita.

7. Kula da yanayin yarinyar: hawan jini, bugun jini, NPV, sukarin jini, da sauransu.

8. Idan ya cancanta, canja wuri zuwa ɓangaren kulawa mai zurfi.

Yadda ake gane wani

Don samar da lokaci mai dacewa ga mai haƙuri da taimakon farko don maganin taɓo da cutar da rayuwarsa, kuna buƙatar sanin menene alamun alamun hali ga wannan yanayin haɗari. Bayyanar cututtukan cututtukan zuciya suna haifar da rashin daidaituwa na acid-base, bushewar fata da guba na jiki ta ketones (abubuwa masu canzawa tare da ƙamshin acetone).

Ana nuna alamun ci gaban sanyin hankali ta hanyar bayyanar cututtuka masu zuwa:

m ƙishi, bushe bakin,
asarar ci
tashin zuciya, yawan hucewa,
jin zafi a cikin jikin jikin,
urination akai-akai
mummunan ciwon kai
asarar ƙarfi
jin ƙanshi na acetone a cikin iska mai iska,
magana mara izini
nutsuwa, rashin jin daɗi ko, da biɗi, damuwa, damuwa,
m mai rauni hankali.

Alamomin nuna halin rashin daidaituwa

jan fata, fatar fuska,
harshe mai launin ruwan kasa
wahalar numfashi tare da sautuka
rauni, saurin bugun zuciya,
raguwa a cikin karfin jini,
raguwa da yawan fitsari da aka saki,
rauni na sautin tsoka,
Rashin amsawar ɗalibai zuwa haske mai haske.
ƙanshi mai ƙarfi na acetone
asarar sani.

Bayani game da yara

Coma na hyperglycemic a cikin yara na haɓaka lokacin da hankali na glucose ya kai 12-14 mmol / L. Rashin sanin hadarin dake tattare da su, yawanci suna fama da rashin abinci mai ƙoshin abinci, masu amfani da ƙoshin lemo, ruwan 'ya'yan itace, abubuwan sha mai ƙamari. Wata hanyar da ta zama ruwan dare shine yawan ƙwayar insulin lokacin da aka yiwa yaro magani tare da cututtukan sanyi da ke ɗauke da sukari mai yawa.

Kulawa ta gaggawa don rikicewar hyperglycemic shine aniyar rage yawan glucose ta hanyar injections na insulin. Ya kamata a ba ɗan abin sha mai yawa a cikin ɗumi mai ɗumi. Ya kamata a jinkirta cin abinci har sai matakan sukari sun daidaita. Dole ne a auna shi kowane awa 1.5-2.

Gujewa da Cutar Malaria

Dokar aiwatar da shawarwarin likita yana taimakawa hana ci gaban wannan yanayin mai haɗari. Yana bi:

Auna glucose a kai a kai.
Guji yawan wuce haddi ko karancin insulin a cikin magudanar jini, allurar ta daidai kan lokaci.
Yi taka tsantsan kiyaye dokokin abinci na asibiti.
Guji ɗaukar nauyi a jiki.
Bi da fitowar asali na kamuwa da cuta.
Canja zuwa wani nau'in insulin daban-daban kawai a asibiti.

Taimako na farko da aka bayar da shi na lokaci-lokaci don maganin cututtukan hyperglycemia da isasshen magani zai iya guje wa yanayin da ke barazanar rayuwar mai haƙuri, mafi rikicewar rikice-rikice shine dementia.