Coma a cikin ciwon sukari

Cutar masu ciwon sukari - yanayin da ke haɓaka sakamakon ƙarancin insulin a cikin jiki a cikin marasa lafiya masu ciwon sukari mellitus. Rashin insulin yana haifar da karuwa a cikin tattarawar glucose a cikin jini da "yunwa" na ƙirar insulin na ƙasa wanda ba zai iya yin amfani da glucose ba tare da haɗarin insulin ba. Dangane da "yunwar" jiki a cikin hanta, aikin glucose (gluconeogenesis) da jikin ketone daga acetyl-CoA yana farawa - ketosis yana haɓaka, kuma tare da ƙarancin amfanin jikin ketone da haɓakar acidosis - ketoacidosis. Rarraba samfuran metabolism a karkashin ƙasa, musamman lactate, yana haifar da ci gaban acid acid. A cikin wasu halaye, babban damuwa na rayuwa a cikin tushen rashin lafiyar mellitus decompensation yana haifar da haɓakar ƙwayar cutar hyperosmolar.

Cutar sankarau na iya daukar dogon lokaci - mafi karancin lokaci a tarihin mai haƙuri kasancewar wannan yanayin ya fi shekaru arba'in da suka wuce.

Ayyukan Taimakon na Farko

Hymaglycemic coma yana tasowa a hankali, a rana guda ko fiye, tare da bushe bakin, mai haƙuri ya sha da yawa, idan a wannan lokacin matakan glucose a cikin jini yana ƙaruwa (al'ada 3.3-5.5 mmol / l) sau 2-3.

An bayyana gabanta da zazzabin cizon sauro, rashin abinci, ciwon kai, maƙarƙashiya ko zawo, tashin zuciya, wani lokacin zafin ciki, da kuma lokaci-lokaci na amai.

Idan a farkon lokacin ci gaban mai cutar sukari ne ba a fara amfani da maganin a cikin wani yanayi mai kyau ba, mai haƙuri ya shiga halin yin sujjada (rashin tunani, mantuwa, nutsuwa), hankalin sa ya dushe.

Shahararren fasalin kayan maye shine cewa ban da cikakken asarar rai, fatar jiki ta bushe, mai daɗi ga taɓawa, ƙanshin apples ko acetone daga bakin, mai rauni mai rauni, da ƙananan hauhawar jini. Yawan zafin jiki na al'ada ne ko dan ƙarami. Kwallan idanu suna da taushi ga taɓawa.

Ayyukan Taimakon na Farko

Idan mai haƙuri ya rasa hankalinsa, ya kamata a dage farawa don kada ya dakatar da numfashinsa, kuma nan da nan kira motar asibiti. Idan akwai matsala tare da bambance banbancen ganewar asali na hyperglycemic coma, ya kamata a dauki matakan duniya. Da farko dai, dole ne a sanya mai haƙuri yadda yakamata, ya hana juyar da harshe, shigar da bututu, sannan gudanar da aikin syndromic - gyaran hawan jini, zuciya da gazawar numfashi bisa ga alamu. Ofaya daga cikin magunguna na duniya don ƙimar ƙwayar cuta ya haɗa da gabatarwar 10-20 ml na 40% na glucose a cikin ciki. Tare da ƙwayar cutar hyperglycemic, wannan adadin glucose ba zai haifar da mummunar lalacewa ba a cikin tafiyar matakai na rayuwa, yayin da tare da hypoglycemic coma zai iya ceton rayuwar mai haƙuri a zahiri. Ya kamata a ɗauka a cikin zuciya cewa koda tare da ƙarancin sukari na jini, mai haƙuri ba zai yi gumi ba har abada. Idan isasshen lokaci ya wuce kafin a gano mai haƙuri, ƙwaƙƙwaran fata zai riga ya bushe, wanda zai iya zama yaudara.

A cikin maye mai guba, ana nuna kwayar cutar cikin jini na 40% kamar yadda yake a cikin ƙwayar cerebral (matsawar ƙwaƙwalwar kwakwalwa tare da hematoma, rauni na ƙaiƙayi, haɓakar cerebral). A ƙarshen batun, ana kuma nuna kulawa ta Lasix (furosemide) (2-4 ml, idan babu raguwar hauhawar jini). Yana da kyau har yanzu a fayyace yanayin rashin daidaituwa tare da aiwatar da magani na musamman. Dukkanin marasa lafiya da ke cikin yanayin ilimin etiology ba a san su ba zuwa sashin kulawa mai zurfi, tare da mummunan guba - a can, ko kuma sashen toxicology, tare da raunin craniocerebral ga sashen kula da jijiya.

Ketoacidotic coma (how)

Yana cikin matsayi na farko a cikin tashe tashen hankula tsakanin masu fama da cutar siga. Mutuwa ta kai kashi 5-15%. Wannan shine mafi yawan dalilin mutuwa a cikin yara masu ciwon sukari.

Dalili - cikakken rashi ko karancin insulin:

rashin aikin insulin mara kyau (dakatar da aikin insulin, raguwar matakin rashin ma'amala, amfani da shirye-shiryen insulin wanda ya kare, rashin aiki a tsarin gudanarwar sa),

babban cin zarafin abincin (cin mutuncin mai, har zuwa ƙarancin yanayi - carbohydrates),

needarin buƙatar insulin (kowane cututtukan cututtukan zuciya, ayyukan tiyata, raunin da ya faru, yanayin damuwa).

Maɓallin haɗi pathogenesis AS sune canje-canje masu zuwa:

take hakkin yin amfani da glucose ta kasusuwa wadanda ke aiki da insulin tare da haɓakar haɓakar hyperglycemia,

fitsari, hypovolemia, hypoxia na nama (gami da tsarin juyayi na tsakiya),

makamashi "yunwar" a kyallen takarda tare da kunna ketogenesis,

YADDA yake ci gaba a hankali a cikin kwanaki da yawa. A cikin samuwar sa, koyaushe yana yiwuwa a bambance wani yanayi na precoatous, lokacin da alamun cutar kansa ta lalace (ƙishirwa, polyuria, asthenic syndrome, asarar nauyi) ci gaba da ƙaruwa, kwatancen asibiti na ketosis (ƙanshi na acetone a cikin iska mai ƙonewa, anorexia, tashin zuciya) da acidosis (amai, zafi) ci gaba da ƙaruwa a cikin ciki). Dole ne a tuna cewa zafin ciki a cikin tsananin na iya kwaikwayon cututtukan tiyata. Bayyanar shimfidu kwance yana yiwuwa.

Babban yanke hukunci a cikin canzawar yanayin yanayi wanda yakasance shine lalata rayuwar sani. Akwai digiri uku na AS:

I Art. - shakka: ruhi ya rikice, an hana mai haƙuri, da sauƙin barci, amma zai iya amsa tambayoyin monosyllabic,

II Art. - wawa: mara haƙuri yana cikin zurfin yanayin bacci, ana kiyaye abin da zai iya haifar da damuwa ga masu zafin rai,

III art. - cikakken asarar sani tare da rashin mayar da martani ga motsawar jiki.

Tushen baƙin ciki na hankali shine sakamako mai guba a cikin tsarin jijiya na tsakiya na rikice-rikice na rayuwa (da farko ketonemia), kazalika da hypoxia na kwakwalwa.

Sauran alamun asibiti na AS:

bayyanar cututtuka na rashin ruwa a jiki (bushe fata, mucous membranes, rage kiba nama),

mai ciwon sukari rubeosis a cheeks,

Kussmaul na acidotic na numfashi (wanda ba a sani ba, ba hayaniya, zurfi) rama ne na numfashi na acidosis na rayuwa,

ungamshin da ake amfani da shi a cikin acetone,

tsoka tsoka, wanda ya hada da tsoratarwar tsokoki ido, wanda aka bayyana ta hanyar isar da gira,

canje-canje a cikin tsarin zuciya (jijiyoyin jini, tachycardia, muffled heart sauti, kari rudani),

tashin hankali na tsokoki na ciki, tabbatattun alamun cutar haushi a cikin jijiyoyin jiki sakamakon ƙananan ƙwayar cuta a cikin peritoneum, tasirin fushi na ketoacidosis akan ƙarshen jijiya,

alamun injin konewa na ciki (matsanancin “filayen kofi”),

alamun bayyanar cututtukan zuciya (hyporeflexia, farfadowa na jijiyoyin jiki, lalacewar craniocerebral ciki, da sauransu).

Alamomin dakin gwaje-gwaje na AS:

hyperketonemia da ketonuria,

rashin daidaituwa na electrolyte: hyponatremia, hypochloremia, a cikin sa'o'i na farko - hyperkalemia (sake fasalin tsakanin intracellular da extracellular potassium a cikin yanayin metabolic acidosis), sannan kuma - hypokalemia,

hyperazotemia (saboda lalata gurɓata a cikin ƙodan a cikin yanayin hypovolemia),

cututtukan hematorenal (neutrophilic leukocytosis tare da juyawa zuwa hagu, ƙananan proteinuria, silinda -, erythrocyturia).

Ya kamata a jaddada cewa ketonuria da acidosis metabolic ana ɗauka manyan alamun alamun AS.

1. Asibiti a cikin rukunin kulawa mai zurfi.

2. Rage ciki da hanji da sinadarin sodium bicarbonate, catheterization na mafitsara.

3. dumama jariri.

5. Magungunan insulin: insulin gajeriyar aiki (misali, actrapid) ana amfani da su, vial (raka'a 1 = 40), hanyar gudanarwa na cikin ciki.

Ana gano glucose na jini a kowace awa.

Kashi na farko na insulin ana allurar dashi a cikin adadin raka'a 0.1-0.2 / kg a cikin ruwan kwalliya na 100 ml. Sannan suna canzawa zuwa iv drip na insulin a kashi 0.1-0.2 raka'a / kg / awa.

Tare da raguwa da glucose na jini zuwa 10-11 mmol / l, suna canzawa zuwa gudanarwar intramuscular ko subcutaneous management na insulin a cikin kashi na 0.1-0.25 raka'a / kg a kowane sa'o'i 4 tare da sauyawa a hankali zuwa tsarin kulawa na 4.

6. Jigilar ƙwayar cuta a cikin kundin yau da kullun masu zuwa: har zuwa 1 g - 1000 ml, shekaru 1-5 - 1500, shekaru 5-10 - 2000, shekaru 10-15 - 2000-3000 ml (matsakaita 50-150 ml / kg rana). A cikin awanni 6 na farko, ya zama dole don shigar da 50% na kashi na yau da kullun, a cikin sa'o'i 6 masu zuwa - 25%, a cikin sauran sa'o'i 12 na ranar farko ta jiyya - 25%. An gabatar da shawarwari a cikin yanayi mai dumi (37).

Magungunan zabi don maganin jiko shine maganin isotonic sodium chloride.

Tare da rage yawan glucose na jini zuwa 14 mmol / l, suna canzawa zuwa madadin gudanar da maganin 5% na glucose da saline na jiki a cikin daidaito.

Zai yiwu a yi amfani da shirye-shiryen furotin (maganin albumin) - in babu hyperazotemia, plasma yana maye gurbin 10-20 ml / kg.

7. Heparin 100-150 raka'a / kg a kowace rana a cikin / a ciki ko s / c.

8. Magungunan rigakafi iri-iri.

9. Alkaline far (4% sodium bicarbonate bayani, trisamine) - tare da raguwa a cikin pH na jini zuwa 7.0.

Adadin 4% sodium bicarbonate bayani (a cikin ml) = nauyi (kg) BE 2 (ko 3) (ko matsakaici na 4 ml / kg).

Hanyar gudanarwa itace iv drip, kashi na farko na aikin da aka ƙididdige ana sarrafa shi, kuma an sake ƙaddara CRR.

10. Maganin Symptomatic - cardiac glycosides, tare da hypokalemia - shirye-shiryen potassium (panangin, 7.5% potassium chloride bayani 1 ml / kg), bitamin B, C, KKB, da dai sauransu.

11. An wajabta abinci mai gina jiki nan da nan, yayin da mai haƙuri ya dawo da hankali (ruwan 'ya'yan itace da dankalin masara, hatsi, jelly, kayan lambu, masara). Ana dafa abinci ko'ina ba tare da mai ba.

Jima'i mai jini -wannan cin zarafin sani ne saboda raguwa ko saurin raguwar glucose jini.

Yawancin lokaci, hankali ya ɓace lokacin da glucose na jini ya ragu zuwa 1.4-1.7 mmol / L. Yana da mahimmanci a tuna cewa a cikin marasa lafiya da ciwon sukari, ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa tana daidaita da hyperglycemia mai ɗorewa, saboda haka alamun neurology na hypoglycemia na iya bayyana tare da ƙarami amma saurin raguwa cikin glucose jini.

Babban dalili hypoglycemia - rashin daidaituwa na insulinemia (mafi mahimmancin matakin) zuwa matakin glycemia a cikin wani takamaiman lokaci. Mafi yawan dalilai:

take hakkin abinci (tsallaka abincin da ya dace ko kuma rashin isasshen abubuwan carbohydrates a ciki),

aikin da ba'a shirya ba,

mai fama da hanta da aikin koda,

vomiting, sako-sako da bakin ciki,

Babban pathogenetic factor a cikin ci gaba na hypoglycemic coma - yunwar kuzari ga sel kwakwalwa. Akai-akai akai-akai, kuma musamman yanayin zurfin halin rashin haihuwa nan da nan ko kuma daga baya zai kai ga lalacewar lalacewar mawuyacin kwakwalwa, wanda a asibiti zai iya bayyana kamar cerebroasthenia da raguwar hankali.

Ba kamar ketoacidotic ba, hypoglycemic coma yawanci yana tasowa sosai, ba zato ba tsammani, a kan asalin yanayin mai haƙuri. An riga an wuce shi ta wani ɗan gajeren lokaci na bayyanar cututtuka na yanayin rashin lafiya (yawanci tare da matakin glycemia na 1.7-2.8 mmol / l).

A cikin hoto na asibiti na yanayin hypoglycemic, ana rarrabe alamun neuroglycopenia (wanda ke hade da raguwar haɓakar glucose a cikin tsarin juyayi na tsakiya) da hypercatecholaminemia (wanda ya haifar da karuwa mai raɗaɗi a cikin matakin rigakafin cututtukan hormonal).

rage jiki da hankali aikin,

halayyar da ba ta dace ba da yanayi (kuka mai ban haushi, alhini, tsokanar hali, Autism, negativism),

canje-canje da sauri ta gefen hangen nesa (“hazo”, rawar “kwari”, diplopia).

A matsayinka na mai mulki, alamun neuroglycopenia ke jagoranci.

Idan babu taimako a kan kari, cutar sikila ta haila:

muryar tsoka mai taushi, tsoka,

kyakkyawar alama ta Babinsky,

sautin ƙwallon ido na al'ada

Yawan jini yana yawaita.

Babban ma'aunin dakin gwaje-gwaje shi ne hypoglycemia (lokacin da alamun yanayin rashin lafiyar ya bayyana kai tsaye tabbatar da matakin glycemia).

1. Tare da yanayin hypoglycemic, ana bada shawara don ɗaukar carbohydrates mai sauƙi a hankali (allunan glucose, ruwan 'ya'yan itace, shayi mai zaki) a cikin adadin raka'a gurasar 1-2 ko abinci na al'ada. An maimaita saka idanu na glycemia bayan awa daya.

2. Idan akwai matsalar hypoglycemic coma, ana gudanar da maganin glucagon-glucagen (IM ko SC) a matakin prehospital: har zuwa shekaru 10 - 0.5 mg, wanda ya girmi shekaru 10 - 1 mg.

3. A cikin yanayin asibiti, ana yin allura ta 20% na glucose bayani (1 ml = 200 MG) a cikin adadin 200 mg / kg. Idan hankali bai dawo ba, suna canzawa zuwa iv drip na 5-10% maganin glucose (glucose 50-100 mg a cikin 1 ml, bi da bi) a kashi 10 mg / kg / min. (har zuwa lokacin murmurewa da / ko kuma bayyanar glucosuria).

4. A lokuta masu tsauri, glucocorticoids suna allurar iv. Dexamethasone (kimanin kimanin kashi 200-500 mcg / kg), wanda kusan ba shi da aikin mineralocorticoid, ya fi dacewa. Fitar saki: ampoules na 1 da 2 ml (4 da 8 mg na dexamethasone, bi da bi).

Etiology da pathogenesis

Abubuwan da ke haifar da haɓaka haɓakar HA a cikin cututtukan sukari sune cututtuka da yanayi waɗanda ke haifar, a gefe guda, rashin ruwa, kuma, a gefe guda, ƙara ƙarancin insulin. Don haka, amai, gudawa tare da cututtukan da ke kamuwa da cuta, matsanancin ƙwayar cuta, matsanancin ƙwaƙwalwar ƙwayar cuta, bugun jini, da dai sauransu, zubar jini, ƙonewa, amfani da diuretics, aikin mai da hankali na ƙodan, da sauransu suna haifar da rashin ruwa.

Cutar cututtukan ciki, ayyukan tiyata, raunin da ya faru, da kuma amfani da wasu ƙwayoyi (glucocorticoids, catecholamines, hormones na jima'i, da dai sauransu) suna ƙara ƙarancin insulin. A pathogenesis na ci gaban HA ba a sarari bayyana. Asalin irin wannan rashin lafiyar da ake magana a fili in babu isashshen insulin a bayyane yake sarai. Hakanan ba a bayyana dalilin da yasa tare da irin wannan babban ƙwayar cuta ba, yana nuna bayyanar raunin insulin, babu ketoacidosis.

Increasearin farko cikin haɗuwa da glucose na jini a cikin marasa lafiya da ke ɗauke da ciwon sukari na 2 na iya faruwa saboda dalilai da yawa:

1. Rashin ruwa a sanadiyyar dalilai daban-daban na amai, gudawa, rage ƙishirwa a cikin tsofaffi, shan magunguna masu yawa.
2. formationarin haɓakar glucose a cikin hanta yayin lalata cututtukan ƙwayar cuta wanda ya haifar da cututtukan cututtukan zuciya ko rashin isasshen magani.
3. Yawan wuce haddi na yawan glucose a cikin jiki yayin jiko na ciki na hanyoyin kwantar da hankali na glucose.

An bayyana ƙarin ci gaba mai ɗorewa a cikin tattarawar glucose a cikin jini yayin haɓakar ƙwayar cuta na hyperosmolar ta dalilai biyu.

Da farko dai, karancin aikin koda a cikin marasa lafiya da ke fama da cutar sankara, wanda ke haifar da raguwa a cikin fitsarin gurneti, yana taka rawa cikin hakan. An sauƙaƙe wannan ta hanyar raguwa da tsufa-cikin tsufa cikin lalatawar duniya, wanda yafi ƙaruwa da yanayin rashin ruwa mai narkewa da kuma cutar cututtukan asali.

Abu na biyu, yawan guba a cikin glucose na iya taka muhimmiyar rawa a cikin ci gaba na hyperglycemia, wanda ke da tasiri mai hana motsa jiki a cikin insulin insulin da kuma amfani da ƙwayar glucose na yanki. Hyara yawan hyperglycemia, yana da sakamako mai guba a cikin ƙwayoyin B, yana hana ɓoye insulin, wanda a cikin hakan yana haɓaka hyperglycemia, kuma na ƙarshen yana hana ɓoye insulin har ma fiye da haka.

Yawancin nau'ikan suna wanzu a cikin ƙoƙari don bayyana rashi na ketoacidosis a cikin marasa lafiya da masu ciwon sukari tare da haɓakar hepatitis C. Ofayansu yana yin bayanin wannan abin mamakin ta hanyar kiyaye asirin ciki na insulin a cikin marasa lafiya da ke ɗauke da ciwon sukari na 2, lokacin da insulin ya kawo kai tsaye hanta ya isa ya hana lipolysis da ketogenesis, amma bai isa ba don amfani da glucose na gefe.Bugu da kari, wani taka rawa a cikin wannan na iya taka rawar gani ta karamin maida hankali ne akan mahimmancin kwayoyin lipolytic guda biyu, cortisol da girma hormone (STG).

Rashin haɗarin ketoacidosis tare da ƙwayar cuta na hyperosmolar shima ana bayyana shi ta bambancin insulin da glucagon a cikin yanayin da ke sama. - hormones na kishiyar sashi dangane da lipolysis da ketogenesis. Don haka, a cikin ƙwayar cutar sankara, yawan glucagon / insulin ya rinjayi, kuma a cikin batun GK, insulin / glucagon ya rinjayi, wanda ke hana kunnawar lipolysis da ketogenesis. Yawancin masu bincike sun ba da shawarar cewa yawan hyperosmolarity da rashin ruwa da ke haifar da kansu suna da tasirin sakamako akan lipolysis da ketogenesis.

Bugu da ƙari ga hyperglycemia mai ci gaba, hyperosmolarity a cikin HA har ila yau yana ba da gudummawa ga hypernatremia, asalin abin da ke da alaƙa da raunin hyperproduction na aldosterone a cikin martaba ga rashin ruwa. Hyperosmolarity na jini plasma da babban osmotic diuresis a farkon matakan ci gaban hyperosmolar coma sune sanadin haɓakar haɓakar hypovolemia, ƙonewa baki ɗaya, rushewar jiji tare da raguwar kwararar jini a cikin gabobin.

Rashin ruwa mai saurin lalacewar ƙwayoyin kwakwalwa, raguwa a cikin matsin lamba na ƙwaƙwalwar ƙwayar mahaifa, ƙarancin ƙwaƙwalwar ƙwayar cuta da kuma ƙwayoyin ƙwayoyin jijiyoyi suna zama sanadin lalacewar ƙwaƙwalwa da sauran alamun cutar. Yawancin lokaci ana lura da autopsy, ƙananan ƙwayoyin cuta a cikin abu na kwakwalwa ana ɗaukarsu sakamakon hypernatremia. Sakamakon ɗaukar jini da thromboplastin nama ya shiga cikin jini, tsarin hemostasis yana aiki, kuma haɓakar mahaifa na cikin gida da yaduwar jini yana ƙaruwa.

Hoto na asibiti na GC yana buɗewa a hankali fiye da kmaacidotic coma - na kwanaki da yawa har ma makonni.

Alamar rarrabuwar DM (ƙishirwa, polyuria, asarar nauyi) suna ci gaba a kowace rana, wanda ke tattare da haɓaka rauni gaba ɗaya, bayyanar tsoka "karkatarwa", wucewa gobe a cikin tashin hankali ko na gaba.

Daga kwanakin farko na cutar, ana iya samun ƙarancin fahimta a cikin hanyar raguwa a cikin daidaituwa, daga baya, daɗa ƙaruwa, waɗannan rikice-rikice suna halin bayyanar hallucinations, delirium da coma. Rashin daidaituwa na hankali ya kai matsayin daidai na coma daidai a kusan 10% na marasa lafiya kuma ya dogara da girman ƙwayar cutar plasma (kuma, a kan haka, a kan maganin ƙwayar cuta na ƙwayar cuta na cerebrospinal).

GK Feat - kasancewar bayyanar cututtukan cututtukan ƙwayar cuta na polymorphic: rikicewar jiki, rikicewar magana, paresis da inna, nystagmus, alamun bayyanar cututtuka (S. Babinsky, da dai sauransu), wuya wuya. Wannan ilimin cutar ba ya shiga cikin bayyananniyar cututtukan cututtukan zuciya kuma ana ɗaukar shi azaman babban cin zarafin wurare dabam dabam.

Lokacin bincika irin waɗannan marasa lafiya, alamun bayyanar rashin ƙarfi a cikin jiki yana jawo hankali, kuma fiye da yadda ake amfani da cocin ketoacidotic: bushe fata da mucous membranes, tsawan fasalin fuskoki, raguwar toneus na gira, fatar fata, sautin tsoka. Piaukarwa akai-akai, amma m da ƙanshi ne acetone a cikin iska mai nutsuwa. Kwakwalwa tayi akai-akai, ƙarami, sau da yawa kamar silin.

Hawan jini ya ragu sosai. Sau da yawa sau da yawa fiye da tare da ketoacidosis, anauria na faruwa. Sau da yawa akwai zazzabi mai zafi na asali. Rashin daidaituwa a cikin mahaifa sakamakon rashin ruwa a cikin jiki yana haifar da ci gaba da girgiza hypovolemic.

Binciko

Bayyanar cutar rashin daidaituwa na ƙwayar cuta a gida yana da wahala, amma yana yiwuwa a tuhume shi a cikin haƙuri tare da ciwon sukari mellitus, musamman a lokuta inda ci gaban kwayar halitta ta kasance ta kowane tsari na cuta wanda ya haifar da bushewar jiki. Tabbas, hoton asibiti tare da kayan aikinta shine tushen gano cutar hepatitis C, amma bayanan nazarin dakin gwaje-gwaje suna tabbatar da gaskiyar bayyanar cutar.

A matsayinka na mai mulkin, ana yin gwajin bambanci na HA ana aiki tare da wasu nau'in cutar mahaifa, kazalika da matsanancin tashin hankali na jijiyoyin zuciya, cututtukan kumburi na kwakwalwa, da sauransu.

An tabbatar da ganewar asali na hyperosmolar coma ta ƙididdigar glycemia sosai (yawanci sama da 40 mmol / l), hypernatremia, hyperchloremia, hyperazotemia, alamun ɓacin jini - polyglobulia, erythrocytosis, leukocytosis, haɓaka jini, da kuma babban tasiri na plasma 5 wanda -295 mOsmol / l.

Rashin hankali a cikin rashi bayyanar karuwar ingantaccen ƙwayar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta shine rashin damuwa da farko dangane da ƙwayar cerebral. Mahimmancin bambance bambancen alama na asibiti shine HA shine rashin kamshin acetone a cikin iska mai nutsuwa da numfashi na Kussmaul.

Koyaya, idan mai haƙuri ya zauna a cikin wannan halin har tsawon kwanaki 3-4, alamun lactic acidosis na iya shiga sannan kuma za'a iya gano ƙwarin numfashin Kussmaul, kuma yayin binciken acid-base base (KHS) - acidosis ya haifar da karuwar abun ciki na lactic acid a cikin jini.

GC magani yana cikin hanyoyi da yawa kama da maganin ketoacidotic coma, kodayake yana da halaye na kansa kuma yana da niyyar kawar da bushewa, yaƙar girgiza, daidaitaccen ma'aunin electrolyte da ma'aunin acid-base (a lokuta na lactic acidosis), da kuma kawar da hyperosmolarity jini.

Asibiti na marasa lafiya a cikin yanayin cutar rashin lafiya na hyperosmolar yana gudana a cikin sashin kulawa mai zurfi. A matakin asibiti, ana yin lavage na ciki, an saka katuwar urinary, ana kafa farjin oxygen.

Jerin gwaje-gwajen dakin gwaje-gwaje da ake buƙata, ban da waɗanda aka yarda da su gabaɗaya, sun haɗa da ƙaddarawar glycemia, potassium, sodium, urea, creatinine, CSR, lactate, jikin ketone, da ingantaccen ƙwaƙwalwar ƙwayar plasma.

Ruwan zazzabi tare da HA ana gudana cikin girman girma fiye da lokacin da aka cire shi daga cocin ketoacidotic (yawan ruwan injin ya kai lita 6-10 a kowace rana). A cikin awa 1, 1-1.5 L na ruwa an allura a cikin ciki, a cikin 2-3rd awa - 0.5-1 L, a cikin sa'o'i masu zuwa - 300-500 ml.

Zaɓin maganin mafita ana bada shawara dangane da abubuwan da ke cikin sodium a cikin jini. A matakin sodium na jini fiye da 165 meq / l, gabatarwar hanyoyin samar da ruwan gishiri yana da sabani sosai kuma rehydration ya fara da maganin glucose na 2%. A matakin sodium na 145-165 meq / l, ana yin rehydration tare da 0.45% (hypotonic) sodium chloride bayani.

Rehydration kanta tana haifar da raguwa a cikin glycemia saboda raguwa a cikin ƙwayar jini, da yin la'akari da ƙimar kulawar insulin a cikin wannan nau'in kwayar cutar, ana gudanar da shi a cikin ƙananan allurai (kimanin raka'a 2 na gajere insulin "a cikin cakulan" na tsarin jiko awa daya). Rage glycemia da fiye da 5.5 mmol / L, da plasma osmolarity fiye da 10 mOsmol / L a kowace awa yana barazanar ci gaban huhun bugun zuciya da kwakwalwa.

Idan bayan sa'o'i 4-5 daga farkon farfadowar iska, matakan sodium ya ragu kuma matsanancin rashin ƙarfi ya ci gaba, an tsara kulawar insulin na sa'a daya a cikin kashi 6 na sassan (kamar yadda ake amfani da cocin ketoacidotic). Tare da raguwa a cikin glycemia da ke ƙasa 13.5 mmol / l, ana rage yawan kashi na insulin da rabi kuma ya rage zuwa matsakaicin raka'a 3-5 a kowace awa. Yayinda yake kula da glycemia a matakin 11-13 mmol / l, rashi acidosis na kowane etiology da kawar da rashin ruwa, ana tura mai haƙuri zuwa cikin insulinaneous management na insulin a cikin kashi ɗaya tare da tazara na sa'o'i 2-3 dangane da matakin glycemia.

Sake dawo da karancin potassium yana farawa ko dai nan da nan lokacin da aka gano ƙarancinsa a cikin jini da kodan da ke aiki, ko kuma awanni 2 bayan fara maganin jiko. Yawan sinadarin potassium da ake gudanarwa ya dogara da abinda yake cikin jini. Don haka, tare da potassium da ke ƙasa 3 mmol / L, 3 g na potassium chloride (abu mai bushe) ana allura a cikin sa'a guda, a cikin potassium na 3-4 mmol / L - 2 g na potassium chloride, 4-5 mmol / L - 1 g na potassium chloride. Tare da potassium sama da 5 mmol / L, gabatarwar mafita na potassium chloride yana tsayawa.

Baya ga matakan da aka lissafa, ana aiwatar da ikon lalata, ana gudanar da maganin rigakafi, kuma tare da manufar hana thrombosis, ana wajabta heparin a 5000 IU a cikin intravenously 2 sau 2 a rana a ƙarƙashin kula da tsarin hemostatic.

Matsayi na asibiti, sanin asalin abin da ya haifar da ci gabanta, da kuma kawar da ita, da kuma maganin cututtukan cututtukan cuta, suna da fa'ida sosai a cikin maganin cutar hepatitis C.

Ciwon sukari mai fama da ciwon sukari

Coma hypoglycemic coma ne mai yawan ciwon sukari wanda ke haifar da raguwar glucose jini ("sukari") a ƙasa yanayin ɗabi'a.

Koyaya, a cikin marasa lafiya tare da yawan ƙwayar cutar glycemia na yau da kullun, asarar hankali na iya faruwa tare da lambobi mafi girma.

• yawan insulin da ya wuce haddi shi ne ya zama sanadi
• yawan abin sha da yawa na rage sukari,
• canza yanayin rayuwa (babban aiki na jiki, azumi) ba tare da canza tsarin insulin ba
• barasa maye,
• m cututtuka da kuma ƙari na na kullum,
• ciki da lactation.

Tare da rage yawan glucose na jini a kasa mai mahimmanci, makamashi da kuma matsananciyar yunwar oxygen na faruwa. Ta taɓa sassa daban-daban na kwakwalwa, yana haifar da alamu guda ɗaya.

Halin hypoglycemic yana farawa da rauni, sweating, dizziness, ciwon kai, hannuwa mai rawar jiki. Babban yunwar ya bayyana. Sannan halayyar da bata dace ba ta shiga, za'a iya tayar da fitina, mutum ba zai iya mai da hankali ba. Haske da magana sun kara dagulewa. A cikin matakai na gaba, buguwa tare da asarar hankali yana tasowa, riƙe zuciya da numfashi mai yiwuwa ne.

Bayyanar cututtuka suna ƙaruwa da sauri, a cikin minti. Yana da mahimmanci don ba da taimako a kan lokaci zuwa mara lafiya, guje wa asara mai tsawo.

Coma mai ciwon sukari

Tare da coma hyperglycemic coma, matakan glucose na jini suna sama. An bambanta nau'ikan cututtukan cututtukan mahaifa uku:

1. Cutar mai fama da cutar sikari.
2. Cutar malaria mai fama da cutar siga.
3. Cutar cutar sankara ta gudawa.

Bari muyi zurfafa zurfi a kansu.

Cutar mai fama da cutar sikari

Cutar fitsari na cutar kansa farawa tare da ketoacidosis mai ciwon sukari (DKA). DKA yanayi ne hade da hauhawar jini a matakan glucose da jikin ketone da bayyanar su a cikin fitsari. DKA yana haɓaka sakamakon rashi insulin don dalilai daban-daban.

• isasshen kula da insulin ga marassa lafiya (an manta, hade da kashi, alkairin da ya fashe, da sauransu),
• m cututtuka, aikin tiyata,
• farawa na nau'in 1 na ciwon sukari (mutum bai riga ya san game da bukatar insulin ba),
• ciki
• shan magunguna waɗanda ke haɓaka glucose na jini.

Sakamakon karancin insulin, kwayoyin dake taimakawa shan glucose, kwayoyin jikin '' suna matsananciyar yunwa '. Wannan yana kunna hanta. Yana fara samar da glucose daga shagunan glycogen. Saboda haka, matakin glucose a cikin jini yana ƙaruwa sosai. A wannan halin, kodan suna ƙoƙarin cire ƙwayar glucose mai yawa a cikin fitsari, suna ɓoye ɗumbin ruwa mai yawa. Tare tare da ruwa, da potassium saboda haka ana buƙata ta cire shi daga jiki.

A gefe guda, a cikin yanayin rashin ƙarfi, ana kunna rushewar kitse, daga abin da jikkunan ketone daga baya suka samar.

Bayyanar cututtuka da alamu

Ketoacidosis yana haɓaka hankali a cikin kwanaki da yawa.

A matakin farko, matakin glucose na jini ya haura zuwa 20 mmol / L kuma sama. Wannan yana hade da tsananin ƙishirwa, fitar da yawan fitsari, bushewar baki, da rauni. Zai yiwu ciwon ciki, tashin zuciya, ƙanshi na acetone daga bakin.

Nan gaba, tashin zuciya da ciwon ciki na haɓaka, amai yana bayyana, adadin fitsari yana raguwa. Mai haƙuri yana da bacci, mai daskarewa, yana numfashi sosai, tare da ƙanshin ƙurar acetone daga bakinsa. Zai yiwu zawo, jin zafi da katsewar zuciya, rage karfin jini.

A cikin matakai na gaba, matsalar rashin daidaituwa ta samu tare da asarar hankali, yawan shan numfashi da kuma rauni mai aiki a cikin dukkan gabobin.

Cutar Malaria mai fama da ciwon sukari

Cutar cutar sankara mai fama da cutar sikila (DHA) wata cima ce ta al'ada wacce ta kasance a cikin yanayi mai yawa na asarar ruwa, tare da sakin karamin adadin sassan jikin ketone ko kuma ba tare da ita ba.

• yanayin tare da babban asarar ruwa (amai, gudawa, zub da jini, konewa),
• m cututtuka
• mummunan cututtuka (infarction na zuciya na myocardial, matsanancin ƙwayar cututtukan ƙwayar cuta, huhun hanji, thyrotoxicosis),
• shan magunguna (maganin kamuwa da cuta, hormones adrenal),
• zafi ko zafin rana.

Tare da haɓaka glucose na jini zuwa adadi mai yawa (fiye da 35 mmol / L, wani lokacin har zuwa 60 mmol / L), kunnawar ta cikin fitsari tana motsawa. Yawan diuresis ya karu a hankali tare da asarar ruwa mai yawa daga yanayin cuta (zawo, ƙone, da sauransu) yana haifar da ɗaukar jini da bushewar sel daga ciki, gami da ƙwayoyin kwakwalwa.

DHA yawanci yana tasowa a cikin tsofaffi masu fama da ciwon sukari na 2. Kwayar cutar ta bayyana a hankali a cikin kwanaki da yawa.

Sakamakon girman glucose a cikin jini, ƙishirwa, urination mai yawa, fata bushe, da rauni sun bayyana. Saurin bugun jini da kuma numfashi suna haɗuwa, hawan jini ya ragu. A nan gaba, rikicewar jijiyoyin jiki suna haɓakawa: tashin hankali, wanda aka maye gurbinsu da nutsuwa, faɗuwa, raɗaɗi, rashi na gani, kuma a cikin mawuyacin halin - zaman lafiya. Rashin numfashi, kamar a cikin DKA, a'a.

Cutar cutar sankara ta gudawa

Ciwon sukari lactacPs coma (DLC) coma ce da ke tasowa yayin da ake karancin iskar oxygen a cikin kyallen, tare da haɓaka matakin lactic acid (lactate) a cikin jini.

• Cututtukan da ke tattare da yunwar oxygen na kyallen takarda (infarction na zuciya), gazawar zuciya, cutar huhun ciki, gazawar koda, da dai sauransu.
• Cutar sankarar bargo, ci gaban matakai na kansa.
• Almubazzaranci.
• Guba ta hanyar guba, maye gurbin giya.
• Shan metformin a cikin manyan allurai.

Tare da matsanancin oxygen, an samar da adadin ƙwayar lactic acid a cikin kyallen takarda. Guba tare da lactate yana haɓaka, wanda ke rushe aiki da tsokoki, zuciya da jijiyoyin jini, yana shafar motsawar jijiyoyi.

DLK haɓaka da sauri isa, a cikin 'yan sa'o'i. Yana haɗuwa tare da haɓaka glucose na jini zuwa ƙananan lambobi (har zuwa 15-16 mmol / l).

DLK yana farawa ne da matsanancin zafi a cikin tsokoki da zuciya wanda ba za a iya kwantar da shi da masu aikin jinya ba, tashin zuciya, amai, gudawa, da rauni. Buhun bugun yayi sauri, saukar karfin jini, gajeriyar numfashi ya bayyana, wanda sai ya maye gurbinsa da numfashi mai zurfi. Jin hankali ya karye, rikicewar ciki ya shiga.

Ciwon sukari

A aikace, yanayi 2 akasin haka ya zama ruwan dare - hypoglycemia da ketoacidosis mai ciwon sukari. Don taimakawa mutum yadda yakamata, dole ne a fara fahimtar abin da muke fuskanta a yanzu.

Taimako na Farko ga Coma mai Ciwon Mara

Lokacin da alamun wannan yanayin ya bayyana, mai haƙuri ya kamata ya ci abinci mai sauƙin carbohydrates (4-5 na sukari, 2-4 alewa, kuma ku sha 200 ml ruwan 'ya'yan itace).
Idan wannan bai taimaka ba, ko mutumin yana da yanayin hyperglycemic, kuna buƙatar kiran rukunin motar asibiti nan da nan. Likitocin za su ba da kulawa ta gaggawa.

Algorithm na Ciwon Mara Cutar Ciwon Mara

1. Jiki na rashin lafiya:

• 40-100 ml na 40% na glucose bayani ana gudanar dashi a cikin ciki
• ko 1 ml na glucagon bayani.

• intramuscularly - raka'a 20 na insulin-gajere,
• cikin ciki - 1 lita na Saline.

• Ana gudanar da 1 na gishirin ruwan sha na ciki tsawon awa daya.

• Gabatar da gishiri a cikin hanzari ya fara.

Bayan kulawa ta gaggawa, ana tura rukunin motar asibiti marasa lafiya zuwa asibiti, inda ya ci gaba da jiyya a cikin kulawa mai zurfi da sake farfadowa.

Tare da ƙwayar cutar farin jini a cikin asibiti, gudanar da jijiya na glucose ya ci gaba har sai an dawo da tunani.
Tare da hyperglycemic coma, ana aiwatar da duka matakai:

• Ana gudanar da insulin na ɗan gajeren lokaci a cikin jijiya.
• Ofarfin ruwan da jiki ya ɓace yana sake cikawa.
• Ana yin gwagwarmaya tare da haifar da haifar da rikicewa.
• Matsayin potassium, sodium, chlorine an daidaita shi.
• Ogingen yunwar an cire shi.
• Ayyukan gabobin ciki da na kwakwalwa an dawo dasu.

Sakamakon hyperglycemic com

Hyperglycemic coma yana halin mai matukar yawan mace-mace. Ta kai:

• tare da ketoacidotic coma - 5-15%,
• tare da kwayar cutar hyperosmolar - har zuwa 50%,
• tare da cutar lactacPs - 50-90%.

In ba haka ba, sakamakon ya yi kama da waɗanda ke da ƙwaƙwalwar ƙwaƙwalwar jini.

Menene rashin daidaituwa

Gabaɗaya, maaukar cuta cuta ce mai saurin tasowa, yanayi mai nauyi, wanda ke tattare da rage duk wasu ayyukan rayuwa. Rage ƙarfi daga cikin ƙwayar jijiya ta tsakiya ana bayyana shi ta hanyar asarar hankali, halayen da ke motsawa na waje, sassauci. Hakanan akwai rashin nutsuwa na numfashi, an lura da raguwa sosai akan yawan ta. Idan mai haƙuri ba zai iya numfashi da kansa ba, likitoci suna haɗa shi da na'urar injin iska. Rage yawan aiki na zuciya da jijiyoyin jini yana bayyana ta hanyar raguwa a cikin zuciya da raguwa a cikin karfin jini. Don gyara wannan yanayin, likitoci sun fara ci gaba da gudanar da magunguna waɗanda ke haɓaka haɓaka jini da bugun jini zuwa lambobin al'ada. Hakanan akwai asarar iko akan urination, motsin hanji. Ba tare da magani na lokaci ba, irin wannan mara lafiya ya mutu.

Hyma na jini

Yana faruwa tare da saurin raguwa cikin sukarin jini. Masu ciwon sukari tare da gogewa, musamman ga marassa lafiya da ke dauke da cutar sukari irin ta guda 1, sun fi wahalar jure karancin sukari na jini sama da babba. Kafin rashin lafiya, mai haƙuri yawanci yana da yanayin hypoglycemia - yana fuskantar yunwar, rauni, rashi. Babban abubuwanda ke haifarda yanayin rashin lafiyar sune kamar haka:

• Mai haƙuri ya yi allurar insulin, amma ba shi da lokacin cin abinci.
• Mai haƙuri ya kasance mai ƙwazo a cikin wasanni, kuma bai ci abinci na dogon lokaci.
• An wajabta mai haƙuri da yawa sosai allurai na hypoglycemic jamiái.

Abu ne mai sauki ka taimaka wa mai ciwon sukari wanda yake fuskantar matsalar rashin haihuwa - yana buƙatar ba shi wani nau'in samfurin carbohydrate: shayi mai daɗi, ɗan sukari ko burodi. Idan hasara ta waye, an saka mara lafiyan tare da maganin glucose na ciki kuma nan da nan aka kawo ta asibiti.

Hyperosmolar, lactic acidosis coma ba shi da yawa. Sun fi kamanceceniya ga marasa lafiya da ke dauke da ciwon sukari na 2.

Coma a cikin ciwon sukari wani mummunan yanayi ne. Idan aka rasa asasin mai cutar sankara, ya zama dole a kira motar asibiti da wuri-wuri.

Menene rashin lafiya?

Da farko dai, ya fi dacewa a samo ma'anar menin sukari. Kamar yadda kuka sani, aikin duk tsarin kwayoyin halitta (musamman kwakwalwa) yana da alaƙa da musayar glucose, wanda shine tushen kuzari ga sel. Jikin mai ciwon suga ya fi sauƙin hawa da sauka a cikin sukari na jini. Kuma a wannan yanayin muna magana ne game da haɓaka mai ƙarfi da raguwa mai sauri a cikin adadin glucose. Irin waɗannan canje-canjen an haɗa su da mummunan sakamako. Kuma a wasu halaye, marasa lafiya suna fuskantar sabon abu kamar coma sugar.

Zuwa yau, akwai manyan nau'ikan coma guda hudu masu alaƙa da cutar siga. Kowane tsari yana da halaye nasa, wanda ya dace da fahimtar su.

Cutar HyperlactacPs: fasali da sakamako

Ana ganin wannan nau'in coma tare da hypoxia (yunwar oxygen), yana haɓaka asalin yanayin rashi insulin. A irin waɗannan halayen, hanyar ta haɗu tare da tara tarin lactic acid, wanda ke haifar da canji a cikin sinadaran da ke cikin jini. Sakamakon haka shine takaitawar tasoshin yanki, lalacewa mai ɗaukar nauyi da kuma wucewar myocardium.

A mafi yawan lokuta, wannan nau'in cutar sankarau tana da alaƙa da raunin zuciya da rashin numfashi, hanyoyin kumburi, da cututtuka. Abubuwan haɗari sun haɗa da cututtukan hanta da cututtukan koda, shan giya.

Hyperosmolar coma da abubuwan sa

Wannan nau'in na mahaifa yana da alaƙa da tsaftataccen ruwa, sakamakon wanda osmolarity na jini ke canzawa. Hakanan akwai haɓakar glucose, urea da ion sodium. Pathology yana haɓaka sannu a hankali - kwanaki da yawa ko ma makonni na iya naruwa tsakanin farkon alamun farko da asarar hankali.

Rashin haɗarin hauhawar ƙwayar cutar hyperosmolar yana ƙaruwa tare da gazawar renal, raunin da ya faru, ƙone mai tsanani, zubar jini, da shanyewar jiki. Abubuwan haɗari sun haɗa da halayen rashin lafiyan, rana da bugun zafin rana, cututtuka masu yaduwa.

Furuciya a wasu lokuta sakamakon amfani da diuretic ne, tsananin amai, ko zazzabi gudawa. Dalilan sun hada da tsarin shaye-shaye marasa inganci, suna zaune a yankuna masu dumin yanayi.

Alamomin cutar rashin lafiyar mahaifa

Alamar farko sun hada da rashin nutsuwa da rauni mai rauni, wanda sannu a hankali yana ƙaruwa. Saboda rashin ruwa, mara lafiya yana fama da ƙishirwa. Fata da mucous membranes sun bushe, yawan fitsari a kowace rana yana raguwa.

Nan gaba, cututtukan cututtukan cututtukan zuciya suna bayyana. Wani lokaci ana ganin raɗaɗi da magana mara kyau. Kuna iya lura da halayyar son motsawar ƙwallon ido.

Pathogenesis da bayyanar cututtuka na hypoglycemia

A kan asalin raguwar matakin sukari zuwa 2.77-1.66 mmol / l, alamun halayyar halayyar sosai sun fara bayyana. Mutum ya lura da karuwar yunwar. Rawar jiki a hannu ya bayyana, fatar jiki ta zama mara nauyi.

Akwai raguwa a cikin aikin tunani da jiki. Rashin lalacewar tsarin juyayi yana yiwuwa, musamman halayyar da ba ta dace ba, bayyanar ji na damuwa da tsoro, tashin hankali mai wuce gona da iri, jujjuya yanayi. Rashin glucose yana tare da tachycardia da haɓaka hauhawar jini.

Idan matakin sukari ya sauka zuwa 1.38 mmol / L, mara lafiya yakan rasa hankalin sa. A irin waɗannan halayen, kuna buƙatar kai mutumin zuwa sashen asibitin da wuri-wuri.

Matakan bincike

Ga masu fama da cutar siga, alamomi halaye ne waɗanda likita ba zai kula da shi ba. Bayan bincika mai haƙuri, ƙwararren likita na iya ƙayyade yanayinsa kuma ya ba da taimakon da ya dace. Koyaya, binciken da ya dace yana da mahimmanci. Da farko dai, ana yin dakin gwaje-gwaje da kuma nazarin kwayoyin halittun jini da fitsari.

Tare da hypoglycemia, ana iya lura da raguwa a cikin sukari, a duk sauran lokuta - karuwa zuwa 33 mmol / l ko fiye. Kasancewar jikin ketone, karuwa a cikin ƙwayar plasma osmolarity, haɓaka matakin lactic acid a cikin jini ana la'akari da su. Tare da coma, ana kimanta aikin jijiya da sauran gabobin. Idan rikitarwa ya faru, farjin cututtukan likita ya zama dole.

Cutar sukari: sakamakon

Abin baƙin ciki, wannan sabon abu ana ɗaukar kusan gama gari. Me ya sa sukari coma ke da haɗari? Sakamakon na iya zama daban. Wannan yanayin yana tare da mummunan gazawar hancin. Hibarfin tsarin jijiyoyi na tsakiya. Cutar na ciki na iya wuce kwanaki, watanni ko ma shekaru. Lokacin da mai haƙuri ya kasance a cikin wani yanayi mai kama da haka, mafi girman yiwuwar haɓaka rikitarwa kamar cututtukan ƙwayar hanji.

Tare da isasshen magani, sakamakon shine yawanci abu ne mai kyau. A gefe guda, cututtukan ƙwayar cuta na hanji zai iya haifar da babbar illa ga tsarin juyayi na tsakiya kuma, saboda haka, raunin aikin. Misali, wasu marasa lafiya suna fama da karancin ƙwaƙwalwa da magana, matsaloli tare da daidaitawa. Jerin sakamakon zai iya haɗawa da mummunan ciwo na tsarin zuciya da jijiyoyin jini. Coma a cikin cututtukan mellitus a cikin yara wani lokaci yana haifar da ci gaba da jinkiri ga ci gaban tunani da ta jiki.

Abin baƙin ciki, marasa lafiya koyaushe ba za su iya murmurewa daga sakamakon cutar rashin lafiya ba. Abin da ya sa yake da mahimmanci mu kiyaye.

Coma don ciwon sukari: taimako na farko

Marasa lafiya tare da ciwon sukari, a matsayin mai mulkin, an yi gargaɗi game da yiwuwar haɓaka ƙima da magana game da algorithm na aiki. Mene ne idan mai haƙuri ya nuna alamun rashin lafiya kamar sukari? Sakamakon yana da haɗarin gaske, saboda haka mara lafiya yana buƙatar auna glucose ta amfani da glucometer. Idan matakin sukari ya ƙaru, kuna buƙatar shigar da insulin, idan an rage shi, ku ci alewa ko sha shayi mai zaki.

Idan mara lafiyar ya riga ya farka, yana da muhimmanci a kwance shi a gefe domin ya hana faduwa da harshe da kuma amai a cikin jijiyoyin numfashi. Idan mai haƙuri yana da haƙori na hatsi, ana buƙatar cire su. An ba da shawarar a shafa wa wadanda abin ya shafa don a dumama da gabobi. Na gaba, kuna buƙatar kiran ƙungiyar motar asibiti - mara lafiya yana buƙatar taimako da ƙwarewar sauri.

Dabarar magani don yanayin irin wannan

Bayan an kwantar da maraice a asibiti, likitan ya auna matakin sukari na jini - da farko, wannan alamar tana bukatar a daidaita ta. Ya danganta da yanayin, ana gudanar da insulin (hyperglycemia) ko maganin glucose (hypoglycemia) ga mai haƙuri.

Yayin aiwatar da kwayar halitta, jikin mutum ya rasa mai yawa bitamin, ma'adanai da sauran abubuwa masu amfani. Abin da ya sa jiyya na wanene a cikin ciwon sukari mellitus ya haɗa da amfani da magunguna waɗanda ke taimakawa wajen dawo da kayan lantarki, kawar da rashi na ruwa, tsaftace jinin gubobi.

Yana da matukar muhimmanci a tantance kasancewar rikice-rikice da kuma dalilan kawo ci gaba, tare da kawar da su.

Yin rigakafin cutar coma a cikin ciwon sukari

Rikicin ciwon sukari, na coma musamman, na iya zama haɗari. Abin da ya sa ya fi kyau a lura da yanayin ku kuma ku lura da wasu ƙa'idodi na faɗakarwa:

• kuna buƙatar bin tsarin kulawar abinci wanda likita ya tsara kuma ku bi tsarin abinci,
• dole ne mara lafiya ya tafi kai tsaye wurin likita domin gwaje-gwaje, daukar gwaje-gwaje,
• lura da kai da yarda da ka'idodin aminci suna da mahimmanci (mai haƙuri ya kamata ya sami glucometer tare da shi kuma yana auna sukarin jini akai-akai),
• ana ba da shawarar rayuwa mai aiki, tafiya mai zurfi a cikin iska mai tsayi, aiki mai sauƙi na jiki,
• yana da mahimmanci a bi ainihin shawarwari kuma a lura da yawan insulin da sauran magunguna,
• A kowane hali ya kamata ku nemi magani da kanku kuma kuyi amfani da kowace hanyar maganin gargajiya ba tare da fara tuntuɓar maganin endocrinologist ba.

Yarda da irin waɗannan dokoki masu sauƙi a mafi yawan lokuta yana taimakawa hana ci gaba da rikitarwa, gami da farawar ƙwayar cuta. Idan wani canje-canje na gangami ya faru, ya kamata ka tuntuɓi likita nan da nan.