Jiki na rashin haila: cututtukan da ke haifar da kulawa da gaggawa

Hypoglycemia shine yanayin da aka sani da suna “low sugar sugar” ko “low glucose jini”. Yana haifar da bayyanar cututtuka iri daban-daban, ciki har da jin tsoro, rikicewa, asarar hankali, damuna, kuma a cikin mafi yawan lokuta, har ma da mutuwa.

Babban alamun hypoglycemia sune: yunwa, gumi, rawar jiki da rauni. Tare da matakan da suka dace, bayyanar cututtuka sun tafi da sauri.

Daga ra'ayi na likitanci, hypoglycemia ana nuna shi ta hanyar raguwa da ƙwayar glucose zuwa matakin da zai iya haifar da bayyanar cututtuka kamar rikicewa da / ko ƙarfafa tsarin juyayi mai juyayi. Irin waɗannan yanayi suna faruwa ne saboda karkacewa a cikin hanyoyin glucose homeostasis.

Sanadin hauhawar jini

Babban abin da ya fi haifar da yawan kumburi a cikin marasa lafiya da masu ciwon sukari mellitus shine amfani da allurar insulin da kuma keta tsarin abinci (abinci tsallake), kazalika da yawan zubar insulin na hormone.

A zahiri, dalilin cutar sanyin jiki na iya zama magungunan da ake amfani da su don magance ciwon sukari. An riga an nuna waɗannan insulin, sulfonylurea da shirye-shiryen mallakar nau'in biguanides.

Hadarin hypoglycemia yana ƙaruwa a cikin marasa lafiya da masu ciwon sukari waɗanda ke cin ƙasa da abin da suke buƙata, haka ma a cikin waɗanda ke shan barasa.

Causesarin abubuwan da ke haifar da hauhawar jini:

• na gazawar
• hawan jini
• yunwa mai tsawo,
• cututtuka na rayuwa
• mummunan cututtuka.

Hakanan yara na iya fuskantar matsalar iskancin jini idan ba su ci sa'o'i da yawa ba.

Matsayi na glucose wanda ke tantance kasancewar haila zai iya bambanta. A cikin masu ciwon sukari, yana sauka a ƙasa 3.9 mmol / L (70 mg / dl). A cikin jarirai, wannan matakin ne da ke ƙasa da 2.2 mmol / L (40 mg / dL) ko ƙasa da 3.3 mmol L (60 mg / dL).

Gwaje-gwaje da ke bincikar cutar hypoglycemia: canji a matakin C-peptide a cikin jini da gwajin insulin.

Kulawar gaggawa

Lokacin da alamun hypoglycemic coma ya bayyana, kuna buƙatar kiran motar asibiti. Kafin isowar likitoci, an yi wa mai haƙuri allurar 40% na glucose a cikin ciki da glucagon intramuscularly. Idan babu ƙarfin kuzari, ana maimaita dukkan manipitin bayan mintina 15.

Kafin bayar da taimako na farko, yana da mahimmanci don yin ingantaccen ganewar asali. Lokacin da alamun girgiza insulin ya bayyana, ya kamata ku kimanta matakin glucose a cikin jini ta amfani da glucometer. Sugararancin sukari shine babban bambanci daga hyperglycemic coma, yayin da wasu alamun na iya mamayewa.

Yana da mahimmanci a samar wa mara lafiya da kulawa ta gaggawa a cikin yanayin precoma, ba ƙyale asarar hankali. A saboda wannan, ana ba da haƙuri ga shayi mai daɗi, yanki na sukari mai ladabi, alewa ko wasu kayayyaki mai girma. Wannan zai haifar da haɓaka nan da nan a cikin glucose jini da haɓakawa. Cakulan ko ice cream bai dace da magance glycemia ba. Wadannan abinci suna dauke da mai mai yawa, wanda ke hana shan glucose.

Bayan taimakon farko, ya kamata a saka mara lafiya a gado, tare da samar masa da cikakken kwanciyar hankali ta zahiri. Haramun ne a bar mutum a cikin kulawa. Yana da mahimmanci a ba shi kulawa da tallafin da ya dace. Normalization na psychoemotional jihar kuma taimaka wajen rage hadarin haɓaka ƙwaƙwalwar ƙwayar cuta.

Sauƙin kai harin na iya zama na ɗan lokaci, saboda sakamakon ɗan gajeren lokaci na carbohydrates. Sabili da haka, koda bayan inganta yanayin masu ciwon sukari, ya kamata a asibiti mutum a cikin cibiyar likita don karɓar kulawar da ta dace da kuma hana sake komawa.

Abubuwa daban-daban na iya haifar da raguwa mai yawa a cikin sukarin jini da haɓaka ƙwaƙwalwar jini. Mafi sau da yawa, wannan shine wuce haddi na insulin, wanda ke da alhakin ɗaukar glucose zuwa adipose da kyallen tsoka. Tare da babban taro na hormone, abubuwan sukari sun ragu, wanda ke ba da gudummawa ga ci gaban hypoglycemia.

Babban dalilai na karuwar matakan insulin.

• Rushewar koda ko ciwace-ciwacen ƙwayar cuta - insulinoma, wanda ke motsa haɓakar aikin homon.
• Wucewa da yawan shawarar da aka bada a lokacin hodar yayin da ake biyan masu ciwon sukari na 1.
• Ba daidai ba allura (intramuscularly, ba subcutaneously), wanda kan kai ga mafi saurin sakin abu a cikin jini.
• Rashin bin abincin bayan allura.
• Theaddamarwar insulin-gajere mai aiki ba tare da amfani da abinci na carbohydrate ba.
• Shan giya kafin ko bayan allurar insulin. Ethanol ya rushe aikin hanta na sauya glycogen da kuma kawo sukari a kwakwalwa. Mayar da matakan sukari na al'ada akan asalin amfani da giya na yau da kullun ba zai yiwu ba.

Jiki na yawan haila yana faruwa tare da rashin wadatar glucose a jiki. Wannan shi ne saboda rashi na carbohydrates a cikin abincin, tsayayyen abinci ko azumin mai tsawo.

A sabili na iya zama gazawar koda, cutar hanta (gami da lalata jiki) ko kara yawan aiki a jiki ba tare da kara yawan carbohydrates masu shigowa ba.

A cikin mutane masu lafiya, ƙwaƙwalwar ƙwayar cuta wani lokaci yakan faru ne akan asalin matsananciyar damuwa, ƙwarewar motsin rai, yawan motsa jiki, ko kuma tare da tsaftataccen abinci na carb

Coma yana haɓaka tare da raguwa a cikin taro na glucose a cikin jini a ƙasa da 2.5 mmol / L. Wannan bangaren yana taka muhimmiyar rawa wajen kiyaye daidaitaccen aiki na jiki. Sugar yana ƙaruwa da ƙarfin makamashi, yana ƙarfafa kwakwalwa, tunani da aiki na jiki. Rage glucose a ƙasa wanda ke halal ɗin halatta ya haifar da jerin hanyoyin cututtukan da ke cutar da lafiyar mutum da lafiyar sa. A cikin lokuta masu rikitarwa, rikicewar hauhawar jini na iya zama mai mutuwa.

Pathogenesis na yanayin cututtukan cuta: karancin glucose yana haifar da ƙwayar carbohydrate da kuma iskar oxygen na jiki. Tsarin tsakiya na juyayi shine ya shafa da farko. Kwayoyin ƙwaƙwalwa a hankali suna mutuwa. Tsarin ilimin cututtukan yana farawa daga bangarori daban-daban, wanda ke tattare da bayyanar ciwon kai, karuwar fushi, ko cikakkiyar rashin jin daɗi. Idan babu taimako a kan kari, cutar ta ci gaba, yana shafar tsotsewar sassan jiki da na kashin baya. Mai haƙuri yana farawa da damuwa da jijiyoyin wuya, motsi a cikin ƙungiyoyi tsokoki daban-daban, rashi gajiya da canji a cikin girman ɗalibai (sun zama daban). Bayyanar cututtukan da aka bayyana a sama yana nuna canje-canje da ba a iya juyawa ba a cikin kwakwalwa.

A cikin lokuta na musamman, pathogenesis na hypoglycemic coma shine saboda alamun cututtukan da basu dace ba. Wannan na iya zama bradycardia, vomiting, jihar euphoria. Hoton da ba a saba gani ba na asibiti zai iya yaudarar likita da haifar da matsaloli wajen yin ingantaccen ganewar asali. A wannan yanayin, sakamakon zai zama mai mutuwa: cututtukan hanji da na mutuwa.

Jiki a cikin haila wata cuta ce mai haɗarin gaske wacce take buƙatar samun isasshiyar kulawar likita. Magungunan kai da kuma amfani da hanyoyin magunguna na gargajiya a wannan yanayin zai kara dagula lamarin kuma ya haifar da rikice-rikice. Irin waɗannan matakan an haramta su sosai.

An kwantar da haƙuri a cikin asibiti Don kwantar da hankalin jihar, 20-60 ml na 40% na dextrose bayani ana allurar cikin ciki. Idan mara lafiyar bai sake murmurewa ba cikin minti 20, ana sarrafa shi 5-10% na dextrose tare da digo har sai ya ji sauki.

A cikin mawuyacin yanayi, ana amfani da hanyoyin tayar da hankali. Don rigakafin ƙwayar cuta na hanji, ana nuna Prenisolone a cikin sashi na 30-60 mg ko Dexamethasone (4-8 mg), kazalika da maganin diuretics (Furosemide, Mannitol ko Mannitol). Idan yanayin rashin sani ya ci gaba na dogon lokaci, za a tura mai haƙuri zuwa samun iska, kuma an umurce shi da magani mafi muni.

Bayan an kwantar da mara lafiyar daga halin rashin lafiyar da ke ciki, an koma da shi asibiti. Kulawa da likita na yau da kullun zai ba da damar gano lokaci, kawarwa ko hana rikice-rikice na tsarin juyayi na tsakiya. Bugu da ƙari, an kafa tushen cutar hypoglycemia, ana daidaita abinci mai gina jiki kuma an zaɓi mafi kyawun matakin insulin.

Tare da magani mai dacewa da ingantaccen ƙwayar cuta na hypoglycemic coma, mara lafiya ya dawo cikin tunani, matakan glucose sun daidaita kuma duk alamu marasa kyau sun ɓace. Koyaya, wani lokacin ƙwancen ba ya wuce ba tare da wata alama ba. A cikin yara, yana haifar da matsaloli masu mahimmanci daga tsarin juyayi na tsakiya, gazawar numfashi da gazawar zuciya. A cikin tsofaffi, yana tsokani haɓakar infarction myocardial ko bugun jini, saboda haka, bayan dakatar da mummunan hari, ya zama dole don yin electrocardiogram.

Yin rigakafin

Yana da matukar mahimmanci ga marasa lafiya da masu ciwon sukari don lura da matakan kariya don rigakafin cutar ta hypoglycemic. Da farko dai, yana da muhimmanci a sanya ido a kan matakin sukari a cikin jini, ana samun isasshen adadin abubuwan carbohydrates da kuma gabatar da ingantaccen kashi na insulin. Wajibi ne don guje wa yawan zubar da ciki, rashin daidaiton sarrafawa ko allura tare da tsallake abinci.

Abinci mai gina jiki ga masu ciwon sukari muhimmin bangare ne wanda zai taimaka wajen kula da lafiya da kuma daidaita jikin mutum. Marasa lafiya ya kamata su ɗauki abinci sau 5-6 a rana a cikin ƙaramin rabo, tare da yin taka tsantsan game da adadin kuzarin da aka ba da shawarar da kuma rabo na furotin, fats da carbohydrates. Yana da mahimmanci a gwada yawan gurasar burodin da aka cinye da kuma maganin insulin.

Tare da ciwon sukari, kuna buƙatar yin hankali tare da motsa jiki. Suna rage matakan glucose kuma suna iya haifar da girgiza insulin. An shawarci masu ciwon sukari da su guji damuwa da sauran abubuwan jin daɗin rai wanda ke haifar da jijiyoyin jini a cikin matakan glucose.

Jiki a jiki na yanayi ne mai haɗari wanda ke barazanar haɓaka mummunan rikice-rikice ko mutuwa. Yana da mahimmanci a bincika ci gaban haila, samar da taimako na farko da isar da marassa lafiya zuwa asibiti. Don guje wa cutar cin abinci, ana ba da shawarar bin abinci kuma a sarrafa insulin daidai gwargwado.

Bayyanar cututtukan cututtukan mahaifa

Fassara alamun bayyanar cututtuka tare da hypoglycemia yana da matukar mahimmanci ga mai haƙuri, kuma mafi mahimmanci shine yadda mutanen da suke kusanci da wanda aka cuta lokacin da wannan yanayin ya faru zasu amsa. Amfanin ilimin alamun bayyanar cututtukan hypoglycemia shine cewa rashi na iya kuskuren shafar samar da taimako na farko da kuma kara dagula yanayin haƙuri, gami da cutar kwakwalwa, kuma wannan, zai bijirar da samuwar raunuka masu rauni a cikin tsarin juyayi na tsakiya.

Hypoglycemia yanayi ne mai mahimmanci na tsarin endocrine na mutum, sakamakon raguwa mai yawa a cikin sukarin jini.

Alamar farko na farin jini yana bayyana lokacin da matakan glucose na jini suka fadi kasa da iyaka. Ana lura da alamun farko na hypoglycemia lokacin da matakan sukari na jini ke ƙasa da 2.6 - 2.8 mmol / L. A tsakanin matakin glucose na 1.3 -1.7 mmol / l, mara lafiya ya yi asarar hankali.

Matsayi a cikin marasa lafiya da ciwon sukari

An rarraba warin gwiwar cutar kashi biyu zuwa matakai biyu: precoma da kuma farkon kwai kanta. Bi da bi, sun kasu kashi biyu wadanda suka sha bamban da alamu da gabatarwar asibiti.

Mataki na farko - da farko, saboda karancin glucose a cikin jini, cortex cortex ya sha wahala, sakamakon wanda da dama alamun kwakwalwa ke tasowa. Dizziness, ciwon kai, mai haƙuri na iya fuskantar yanayin damuwa, canje-canje yanayi, mai haƙuri yana kallon rashin farin ciki ko wuce gona da iri. A wani ɓangare na sauran tsarin, ana lura da tachycardia, ji na ƙaruwa na jin yunwa, fatar jiki ta zama mai laushi.

Kwayar cutar hypoglycemia

A cikin wannan halin, rayuwar ɗan adam tana cikin babbar matsala, kuma idan ba tare da isasshen magani da dacewa ba, lalata zai iya faruwa har zuwa sakamako mai illa.
Babban dalilin mutuwa a cikin glycemic coma shine cerebral edema. Amintaccen jinkiri ga ci gaban hauhawar jini, sarrafa insulin, da gabatarwar glucose a cikin adadi mai yawa suna haifar da ci gaban wannan yanayin. Alamun asibiti na cututtukan cerebral ana bayyana su ne a gaban bayyanar cututtuka na meningeal (hauhawar tsokoki na occipital), gazawar numfashi, amai, canje-canje a bugun bugun zuciya, da kuma yawan zafin jiki.

Ya kamata a lura cewa tare da maimaita yawan hare-hare na hypoglycemia, kazalika da yawan lokuta na hypoglycemic coma, marasa lafiya manya suna fuskantar canje-canjen halaye, yayin da a cikin yara akwai raguwar hankali. A dukkan bangarorin, ba a hana yiwuwar mutuwa ba.

Bambancin ganewar asali

Tun da bayyanar cututtuka da kuma yiwuwar mai haƙuri ya kasance cikin yanayin rashin sani na iya sa wahalar yin bincike da ƙarin taimako, ya kamata ku tuna da alamomin asibiti da alamu da ke bambanta cututtukan ƙwayar cuta daga wasu ƙwayar cuta, ciki har da hauhawar jini.

• saurin (wani lokacin ci gaban kwaroron gaggawa)
• rawar jiki, gumi mai sanyi (“rigar haƙuri”)
• tashin hankali, yunwa, maganin cutar kumbura (yawan wuce haddi)
• polyuria (haɓaka haɓakar fitsari), zafin ciki, tachycardia
• hallucinations, delusions, rashin fahimta, rashi
• babu kamshin acetone daga bakin
• glucose na jini a ƙasa da 3.5 mmol / l (kuna buƙatar auna glucose jini tare da glucometer)
• sau da yawa bayan gudanar da glucose 40% a cikin girman 40-80 ml, yanayin haƙuri yana inganta

Yana da kyau a tuna cewa a cikin mutane na rashin lafiya na tsawon lokaci tare da ciwon sukari da ke fama da cutar sankara mai ƙwanƙwasa, precoma da coma ana iya lura dasu koda da ƙimar al'ada (3.3 - 6.5 mmol / L). Yawanci, irin waɗannan yanayi suna faruwa tare da raguwa mai yawa a cikin sukari daga adadi mai girma (17-19 mmol / L) zuwa matsakaici na tsaka-tsaki na 6-8 mmol / L.

Sanadin da Matsalar Hadarin

Babban abubuwan da ke haifar da rashin ruwa a jiki:

• yawan abin sha da yawa na rage sukari ko insulin,
• Rashin wadataccen abinci na carbohydrate bayan gudanar da kashi na yau da kullun na insulin,
• rashin lafiyar jiki ga insulin,
• rage insulin-yana kunna aikin hanta,
• hawan jini
• barasa maye.

Mafi sau da yawa ba sau da yawa, yanayin hypoglycemia shine saboda:

• yawan abin sama da ya kamata na beta-blockers da asfirin,
• na kullum na koda
• maganin ciwon kai na hepatocellular,
• rashin wadatar zuciya.

Kasancewa ga kowane ɗayan waɗannan abubuwan yana haifar da raguwa a cikin glukoshin jini.

Kasancewa ga kowane ɗayan waɗannan abubuwan yana haifar da raguwa cikin glucose jini. Akai-akai na faruwa a cikin yanayin hypoglycemic na iya haifar da sankarar tsokar jini, bugun jini, amai.

Rashin yawan glucose da yawa wanda ke haifar da matsananciyar yunwar sel Kwayoyin, ba zai iya faruwa a cikin su, wanda ya yi daidai da canje-canje da aka gani a cikin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar zuciya.Wannan yana haifar da farko zuwa aiki, sannan kuma ga canje-canje na narkewar kwayoyin halitta a cikin neurons, tare da mahimmancin hypoglycemia - ga mutuwarsu.

Neurons na cortex na cerebral sun fi dacewa da hypoglycemia, kuma tsarin medulla oblongata ba su da hankali. Abin da ya sa tare da ƙwayar cutar motsa jiki a cikin marasa lafiya, aikin zuciya, sautin jijiyoyin bugun gini da numfashi suna dagewa na dogon lokaci, koda kuwa baza a iya canzawa ba.

Matakan cutar

A cikin cigaban mahaifa (hypoglycemic coma), matakai da yawa ana rarrabe su:

1. Cortical. Yana da alaƙa da haɓakar hypoxia na sel na cerebral cortex.
2. Subcortical-diencephalic. Asingara yawan hypoglycemia yana haifar da lalacewa zuwa sashin kwakwalwa na subcortical-diencephalic.
3. Precoma. An haifar dashi ta hanyar lalacewar tafiyar matakai na rayuwa a cikin tsarin na agabar.
4. A gaskiya a coma. Ayyukan ɓangarorin na sama na medulla oblongata ba su da illa.
5. Jin zurfin ciki Partsasan bangarorin medulla oblongata suna cikin aikin pathological, ayyuka na vasomotor da cibiyoyin numfashi suna da rauni.

Hypoglycemic coma yana haɓaka matakai. Da farko, alamun bayyanar suna bayyana, suna nuna raguwa a cikin haɗuwar glucose jini. Wadannan sun hada da:

• tashin hankali, tsoro,
• yunwa,
• danshi gumi (hyperhidrosis),
• tsananin farin ciki da ciwon kai
• tashin zuciya
• kaifi pallor na fata,
• hannun rawar jiki
• samarin
• karuwa a hawan jini.

Idan ba a ba da taimako ba a wannan matakin, to a kan banbancin ƙarin raguwa a cikin matakan glucose na jini, haɓakar psychomotor zai bayyana, dubawar abubuwa da kuma gani na gani zai faru. Marasa lafiya tare da matsanancin rashin ƙarfi a jiki sau da yawa suna yin korafi game da cin zarafin fata (paresthesia) da diplopia (hangen nesa biyu).

A wasu halaye, lokacin masu tsarawa ya yi gajarta cewa babu mai haƙuri ko waɗanda ke kewaye da shi ba su da lokacin tafiya da ɗaukar mataki - alamomin suna ƙaruwa da sauri, a zahiri a cikin minti 1-2.

Marasa lafiya tare da masu ciwon sukari mellitus da ƙaunatattun su ya kamata su san alamun yanayin rashin lafiyar. Lokacin da waɗannan suka bayyana, mai haƙuri cikin gaggawa yana buƙatar shan shayi mai ɗumi mai ɗumi, ku ci ɗan sukari, alewa ko ɗan farin burodi.

Tare da haɓakar hypoglycemia da raguwa da halayen kariya na neuroendocrine, yanayin marasa lafiya yana ƙaruwa sosai. An maye abun alfahari ta hanyar hanawa, sannan asara cikakkiyar fahimta. Akwai toshewar cututtukan zuciya, alamu bayyanar cututtuka. Yin numfashi ya zama na sama, hawan jini a hankali yana raguwa. Thealibai sun daina amsa wa haske, raunin jiki yana ƙaruwa.

Binciko

Ana gudanar da bincike game da cutar sikila na hypoglycemic bisa ga tarihi da kuma hoton asibiti na cutar. An tabbatar da cutar ta hanyar gwajin jini na kwayoyin. Ana nuna yanayin hypoglycemic ta hanyar raguwa da ƙwayar glucose zuwa matakin ƙasa da 3.5 mmol / L. Kwayar cutar biri na bayyana yayin da matakin glucose yai kasa da 2.77 mmol / L. A taro na glucose a cikin jinin 1.38-1.65 mmol / l, mara lafiya ya yi hasara.

Farfad da cutar hypoglycemic coma yana farawa tare da gudanarwar cikin ciki na hanyoyin magance cututtukan glucose. A cikin coma mai zurfi, glucagon ko hydrocortisone kuma yana ɗaukar aikin intramuscularly. Don haɓaka metabolism na glucose, ana nuna amfani da ascorbic acid da cocarboxylase.

Idan mai haƙuri yana da alamun cututtukan ƙwayar maɓuɓɓuka na gaba da asalin cutar ta haila, to, an umurce shi da maganin diba.

Haka kuma ana gyara rikice-rikice yanayin yanayin acid, rikicewar ruwa-electrolyte shima ana yin sa. Dangane da alamu, ana aiwatar da maganin oxygen, ana ƙaddara wakilai na zuciya.

Matsaloli da ka iya yiwuwa da kuma sakamako

Coma na hypoglycemic yawanci yana tare da haɓakar rikitarwa - na yanzu da na nesa. Rikice-rikice na halin yanzu yana faruwa a layi ɗaya tare da yanayin hypoglycemic, bi shi. Wadannan na iya zama infarction na zuciya, bugun jini, aphasia.

Rikitarwa na dogon lokaci na cutar rashin haihuwa ta bayyana kwanaki da dama ko ma makonni bayan wani mummunan yanayin. Mafi rikice-rikice na yau da kullun sune encephalopathy, parkinsonism, epilepsy.

Tare da taimakon lokaci, ƙin jinin haila da sauri ya tsaya kuma baya haifar da mummunan sakamako ga jikin mutum. A wannan yanayin, hasashen yana da kyau. Koyaya, koyaushe yana faruwa a cikin yanayi na hypoglycemic yana haifar da lokaci zuwa ci gaba na rikicewar ƙwayar cuta.

Ana nuna yanayin hypoglycemic ta hanyar raguwa da ƙwayar glucose zuwa matakin ƙasa da 3.5 mmol / L. Coma yana haɓaka tare da matakin glucose mai ƙasa da 2.77 mmol / L.

A cikin marasa lafiya da cututtuka na tsarin zuciya da jijiyoyin jini, ƙin jini na jini ya fi tsanani kuma ya fi wasu girma, yana haifar da rikitarwa (alal misali, basur a cikin retina ko infarction myocardial).