Tarihin likita

Cikakken suna mara lafiya

Binciken asibiti, nau'in ciwon sukari na II, matsakaici, ƙididdigewa.

Shekaru: 62 shekara.

Reshen Dindindin:

Matsayi na zamantakewa: ya yi ritaya

Ranar karɓa: Satumba 29, 2005

Ranar dubawa: Satumba 1, 2005 - Satumba 9, 2005

1. Kiran rashin ƙarfi, gajiya, farin ciki, ƙishirwa, ƙoshin fata, bushewar fata, ƙarancin ƙafafu lokaci-lokaci.

2. Ya dauki kansa a matsayin mai haƙuri tun daga Mayu 2005. An gano farkon ciwon sukari a cikin lokacin bayan infarction, lokacin da ta karɓi magani don infarction na zuciya, kuma aka inganta sukarin jininta. Tun daga Mayu 2005, an dauki mai haƙuri zuwa asibitin, an wajabta magani (ciwon sukari 30 MG). Hypoglycemic kwayoyi suna jurewa da kyau.

3. Bugu da ƙari ga ciwon sukari, mai haƙuri yana fama da cututtuka na tsarin zuciya da jijiyoyin jini: hauhawar jini na shekaru 5, a watan Mayu 2005 ya sami rauni na zuciya.

4. An haife ɗa na biyu. Girma da haɓaka gwargwadon tsufa. A lokacin ƙuruciya, ta sha wahala duk cututtukan yara. Ta yi aiki a matsayin mai lissafi, aikin da ya shafi damuwar hankali. Babu hanyoyin tiyata. Mai yiwuwa ga sanyi. Daga cikin dangin marasa lafiya da ciwon sukari mellitus ba. Iyalin suna da yanayin annashuwa. Babu wasu halaye marasa kyau. Cutar haihuwar daga shekara 14, ta ci gaba a kai a kai. Yanayin rayuwa abu ne mai gamsarwa. Yana zaune a wani gida mai jin daɗi.

Janar yanayin mai haƙuri: mai gamsarwa.

Height 168 cm, nauyi 85 kg.

Bayyanar fuska: ma'ana

Fatar: launi na yau da kullun, danshi mai laushi. Turgor ya ragu.

Nau'in gashi: nau'in mace.

Ganuwa mai launi mucous, matsakaici matsakaici, harshe - fari.

Kwayar mai kitse mai ƙananan ƙwayoyi: haɓaka haɓaka.

Tsokoki: matsayin ci gaba mai gamsarwa, ana kiyaye sautin.

Hadin gwiwa: jin zafi akan bugun ruwa.

Lifafi na cikin mahaifa: ba a yin girma.

- Siffar kirji: normosthenic.

- Kirji: daidaici.

- The nisa daga cikin intercostal sarari yana matsakaici.

- The epigastric angle ne madaidaiciya.

- Gashinan kafada da abin wuya

- Irin nau'in numfashi na kirji.

- Yawan motsi na numfashi minti daya: 18

- Palpation na kirji: kirji na roba ne, rawar murya kamar guda ne a bangarorin da suka yi daidai, mara azanci.

Tsinkayar kwantar da hankali: bayyananniyar sautin huhu a kan sassan kwalin.

Girman filayen Kraining shine 8 cm a garesu.

Tsayin gaban gaba

3 cm sama da abin wuya

3 cm sama da abin wuya

Tsarin Apex

7 kashin mahaifa

7 kashin mahaifa

Tare da layi na waje

Manyan gefen ribs 4

A tsakiyar - layin clavicular

A kan layi na layi na layi

A cikin layi na tsakiya

A kan layi na axillary

Tare da layin scapular

Tare da layi na layi

Spinous tsari X ƙirjin. vertebra

Spinous tsari X ƙirjin. vertebra

Busawa na hurawa daga ƙananan gefen huhu: tare da layin baya na layi 1.5 cm akan inhalation, a kan kumburi - 1 cm.

Ana jin sautin numfashi, ba a gano hayaniyar tashin hankali.

Tsarin zuciya.

Dubawa: Sautin zuciya yana muffled, rhythmic, bugun zuciya-72 beats / min. Ularfin cike da gamsuwa da damuwa. HELL.-140/100 mm. ƙwayoyin cuta Kwayar cutar tsoka da ƙananan taƙasa ta lalace sakamakon ciwon mara macroangiopathy.

- aparfin apical yana cikin sarari na 5 na intercostal 1.5-2 cm a kaikaice zuwa layin midclavicular (ƙarfin al'ada, iyakance).

- Giciye sashi na rauni na zuciya: 12-13 cm

- Nisa daga cikin ƙwayar jijiyoyin bugun jini: 6-7 cm, sarari ciki 2 na hagu da dama (yayi dace da fadin sternum)

- Tsarin zuciya: al'ada.

4 sarari intercostal 1 cm zuwa dama daga gefen murfin

4 sarari intercostal a gefen hagu na sternum

5 intercostal sarari 1.5-2 cm a kaikaice zuwa layin midclavicular

Daga tasirin apical, matsa zuwa tsakiyar (medial 2.5 cm)

Faɗin layi na layi 3 sararin samaniya

Faɗin layi na layi 4 sararin samaniya

Lebe suna da ruwan hoda, mai laushi kaɗan, babu fashe ko rauni. Mucous membranes masu launin shuɗi ne, danshi, ba a gano canje-canje na cututtukan fata ba. Harshe mai ruwan hoda, mai laushi, tare da fure mai haske, papillae suna da haɓaka. Gumura suna da ruwan hoda a launi, ba tare da zubar jini da raunuka ba.

Pharynx: mecorane membrane mai launin shuɗi ne, ƙwanƙwararraki ba su da rawa, ɗanɗaɗaɗaɗaɗa, arche da harshe ba hyperemic bane. Babu hare-hare. Bangon baya ba tare da canje-canje ba.

Glandon glandon ba ya haɓaka, mara zafi, fata ba a cikin yankin glandon ba ta canzawa, jin zafi lokacin taunawa da haɗiye.

Abun ciki al'ada ne a sifa, sumba, ba ya kumbura, babu kwararar jini, tsagewa, bayyanar bugun jini. Bango na ciki yana shiga cikin aikin numfashi, babu wani ƙyashi, babu wani abu bayyananne. Tare da tsinkayewa da bugawa gaba ɗayan ƙasa - sautin tympanic, tashin zuciya, tashin hankali na bangon ciki, juzu'i ba ya nan.

Tare da palpation na sama, tashin hankali na bangon ciki ba ya nan, ba a kula da tashin hankali, babu wani haɗin gwiwa. Kwayar cutar alama, alamar Mendel, Alamar Shchetkin-Blumberg ba ta da kyau.

Tare da palpation na musamman, babu bambanci tsakanin tsokoki na ciki na kasusuwa. Auscultation: motsin hanji na al'ada.

A kan bincike, hanta ba ta tsawaita. Tare da matsewa mai zurfi mai zurfi ta hanyar palpation bisa ga Obraztsov-Strazhesko a layin dama na midclavicular, edgeanƙashin hanta baya gudana daga ƙarƙashin ƙimar farashi mai sauƙi. A kan palpation, gefen hanta yana da kaifi, mara zafi, laushi, farfajiya tayi kyau da laima.

A kan palpation, cystic point, epigastric zone, choledo-pancreatic zone, maki na phrenic jijiya, acromial point, maki na scapular kusurwa, vertebral aya ba su da ciwo.

Lokacin tattaunawa: iyakokin hanta

babba - 6 intercostal sarari tare da layin midclavicular.

ƙananan - a gefen gefen dama na almara mai tsada.

Babu wani kasala da zato da hasashe.

Yin siyar a cewar Kurlov:

n a cikin tsakiyar - 6.5 cm

n tare da layin midclavicular - 9 cm

n tare da hagu mai tsada - 5 cm

Kujera: lokaci 1 cikin kwanaki 2-3. Maƙarƙashiya yana azaba sau da yawa.

Saifa: babu karuwa da ake gani.

- ɗaure na sama - haƙarƙari 8

- ƙananan kan iyaka - 1 cm ciki daga tsadar tsada.

Matsakaici don tsinkaye: tsayi - 7.5 cm, nisa - 4.5 cm.

Daga kwayoyin, juyayi, tsarin endocrine, babu karkacewa da dabi'un.

Dangane da gunaguni, bayanan asibiti da kuma dakin gwaje-gwaje, an gano cutar: nau'in ciwon sukari na 2, matsakaici, ƙididdigewa, polyneuropathy.

1.Babban bincike na fitsari da jini

2. BH gwajin jini

3. Nazarin kan yin azumi na glucose na jini - kowace rana. Bayanin martaba

4. X-ray na kirji.

6. Height, nauyi na haƙuri

7. Tattaunawa da kwararrun kwararru: likitan ido, likitan fata, likitan fata.

Bayanai daga nazarin dakin gwaje-gwaje.

Babban gwajin jini 08/15/05

Kwayoyin jini ja 4.6 * 10 12 / L

Haemoglobin 136 g / l

Alamar launi 0.9

Kwayoyin farin jini 9.3 * 10 9 / L

Babban bincike na fitsari 08/15/05

Sauyin sukari na yau da kullun

1. a kan komai a ciki 7.3 mg /%

2. bayan 2 hours 10.0 mmol / l

3. bayan awa 4, 7.0 mmol / l

DAC ga cutar sikari "-" 08/19/05

Ba a gano cutar HIV ba 08/19/05

1. Likitan dabbobi daga 08.17.05

Gunaguni: tashin hankali yana tashi a gaban idanun, abin mamaki na hazo, abubuwa masu duhu, raguwar iskar gani.

Kammalawa: ciwon sukari na angioretinopathy.

2. Neurologist on 08.19.05

Gunaguni: zane, mara nauyi mara nauyi, azanci mai jiyyi, gosebumps, numbness, jin sanyi, lokaci-lokaci cramps a cikin ƙwayoyin maraƙi, gajiya na kafafu yayin ƙoƙarin jiki, ƙarancin ji.

Kammalawa: distal polyneuropathy

Tabbatarwar etiology da pathogenesis.

Ina danganta da ci gaban nau'in ciwon sukari na 2 wanda ya shafi aikin ƙwararru. Rashin tashin hankali, wanda aka sauƙaƙe ta kowane wata, kwata-kwata, rahotanni na shekara-shekara da nauyin kuɗi, ya zama babban abin da ya haifar da ci gaban cutar. An kuma taka muhimmiyar rawa ta amfani da abinci mai-kalori mai yawa tare da carbohydrates, Sweets, rashi fiber da kuma yanayin rayuwa mai haƙuri. Yanayin da aka nuna game da abinci mai gina jiki, rashin aiki a jiki, yanayin damuwa yana da alaƙa da juna kuma suna ba da gudummawa ga lalata insulin da keɓaɓɓen ƙwayar insulin. Rashin insulin ci gaba da ayyukanta sun zama babban dalilin rikicewar rayuwa da bayyanuwar asibiti na cutar sankara. A take hakkin carbohydrate metabolism ne halin da samuwar wani wuce haddi na sorbitol, wanda tara a cikin jijiya endings, retina, ruwan tabarau, bayar da tasu gudunmuwar su lalacewar yana daya daga cikin hanyoyin ci gaban polyneuropathy da cataracts da aka lura a cikin haƙuri.

Type 2 ciwon sukari mellitus, mara-insulin-dogara, subcompensated, matsakaici. Damuwa: angioretinopathy, polyneuropathy distal.

The Yawan raka'a gurasa na mai haƙuri kowace rana shine 20 XE

Karin kumallo 1 (5 XE):Kefir 250 MG

-boiled porridge 15-20 g

Zatrak 2 (2 XE):'ya'yan itace bushe

Ina zuma Faculty

Cikakken suna - Himochka Tatyana Ivanovna

Shekaru - 53 years.

Adireshin: Kiev st. Semashko 21.

Wurin Aiki: Latsa Ukraine Buga gidan

Ranar shigar da asibitin: 02/06/2007.

Yayin binciken, mai haƙuri yayi gunaguni na ƙishirwa, bushewar bushe, karuwa da yawan fitsari da aka saki, itching na fata, asarar nauyi na kilogiram 7, da kuma ƙarancin gani. Marasa lafiya yana nuna rauni, gajiya yayin aikin gida, tsananin farji da ciwon kai da ke rakiyar haɓakar hawan jini suma suna damuwa.

Mai haƙuri ya gano cewa tana da nau'in ciwon sukari na II a cikin 1998, lokacin da ta fara jin ƙishirwa, itching, dandano na ƙarfe a bakin ta, asarar nauyi, karuwa da yawan fitsari, da kuma bincike a asibitin sun nuna karuwar cutar glycemia zuwa 6.1 mmol / L. Likita na cikin gida ya ba da shawarwarin abinci kuma an ba shi umarnin glibenclamide. A shekara ta 2000, wani bincike a asibitin ya nuna matakin glycemic na 8.2 mmol / L. An tsara Glucophage don allunan 3 da gyaran abinci. A cikin 2003, an kwantar da mara lafiya a asibiti a cikin asibitin endocrinology, inda aka tsara sassan 8 na insulin da na ivpon of espolipon. A binciken karshe na mai haƙuri a asibitin, glycemia ya kai 13 mmol / l, sabili da haka an kwantar da mai haƙuri a ranar 02/06/2007 a cikin asibitin endocrinology.

III.A tarihin rayuwa:

An haife ta ne a ranar 29 ga Disamba, 1953 cikakken lokaci, an haife shi a cikin iyali mai kyakkyawan yanayin zamantakewa. A cikin dangi ta girma kuma aka haife ta da youngerar uwanta biyu. Lokacin balaga ba ta da matsala, babu jinkiri ko hanzarta balaga. An kafa haila tun shekaru 17, mara jin zafi, lokacin haila a shekaru 48. Babu rauni ko aiki. Ta sha wahala daga cututtuka na numfashi sau 1-2 a shekara. Tarihin rashin lafiyan ba a ɗaukar nauyi. Ba ya shan taba, baya shan barasa, baya shan kwayoyi. Hankali, cututtukan da ke ɗaukar jima'i, hepatitis, tarin fuka sun ƙi. Ba a zubar da jini ba. Babu haɗarin masana'antu. Maganar gado ba a ɗaukar nauyi ba.

SIFFOFI MAI KYAU.

Babu raɗaɗi da tsinkayewar harshe a cikin harshe; bushe bushe damuwa ne. An rage yawan ci. Tsoron cin abinci ba ya nan. Walaura da motsi na abinci ta hanyar esophagus kyauta ne. Burnwannafi, babu burgeta. Ragewa da amai ba ya nan. Flatulence ba. Kujerar na yau da kullun, mai zaman kansa, sau ɗaya a rana. Babu wasu rikicewar muryar sito (maƙarƙashiya, zawo). Kushin bakinciki mara nauyi akan kujera bai dame shi ba. Stool mai yawa ne, tare da wari na yau da kullun, ba tare da kazanta daga gamsai, jini, farji, ragowar abinci marasa abinci. Ingonawa, itching, jin zafi a dubura. Babu zub da jini daga dubura.

Tsarin MAI KYAU.

Jin zafi a cikin yankin lumbar baya damuwa. Akai-akai, urination kyauta baya tare da raɗaɗi, ƙonawa, jin zafi. Yawan diuresis na rana yayi nasara. Launin fitsari launin rawaya ne mai haske, m. Babu urination mara karfi. Kimanin lita fitsari 1.5 ke saki kowace rana. Alamar Pasternatsky ba ta da kyau ba.

Tarihin likita

Dangane da mai haƙuri, shekaru 2 da suka gabata, yayin gudanar da gwaje-gwaje na yau da kullun, an sami ƙara yawan matakan glucose na jini (7.7 mmol / l).

Likita ya ba da shawarar ƙarin gwaji, gwajin haƙuri da ƙwayar cuta.

Matar ta yi watsi da shawarar likitan, ta ci gaba da jagorancin rayuwa guda, dangane da karuwar ci, ta samu kilo 20 cikin nauyi. Kimanin wata daya da suka wuce, gajeriyar numfashi da ciwon kirji ya bayyana, ya fara lura da karuwar hawan jini zuwa 160/90 mm Hg.

A kan shawarar da wata maƙwabta ta yi, sai ta shafa ganyen kabeji da zuma a goshinta, ta sha wani ɗan dankalin turawa, ta dauko Asfirin. Dangane da yawan ƙishirwa da yawan urination (galibi da daddare), ta nemi taimakon likita.

INGANCIN SAUKI.

Height - 170 cm, nauyi - 78 kg. Yanayin gamsuwa, bayyananne a fili, Matsayi aiki. Bayyanar fuska tana da nutsuwa. Jiki yayi daidai, ya dace da shekaru da jinsi. Normostenik. Fata mai gamsarwa na mara lafiya Jiki da bayyane mucous membranes na al'ada launi, bushe, turgor rage, babu raguwa. Ƙusa, gashi ba'a canza su. Owaƙan mahaifa, kashin bayan mahaifa, parotid, submandibular, ƙananan ƙananan ƙwayoyin cuta, na ciki, na mahaifa, gwiwar hannu, gwiwar hannu, tsotsewar mahaifa, da jijiyoyin mahaifa ba su palpated. Tsarin tsoka yana tasowa mai gamsarwa har tsawon shekarun mai haƙuri, tsokoki ba su da jin daɗi, sautinsu da ƙarfinsu sun wadatar. Kasusuwa na kwanyar, kirji, ƙashin ƙugu da ƙafarku ba a canza su, babu jin ciwo yayin palpation da tsinkaye, mutuncin ba ya karye. Hanyoyin haɗin gwiwar suna da tsari na al'ada, motsi a cikin gidajen abinci kyauta ne, babu rauni. Ciwon glandon thyroid ba mai palpable bane. A tafin hannu da yatsa na 1 na ƙafar dama yana da rauni mai rauni.

SAURARON SHAGONA.

Shugaban tsari na yau da kullun, kwakwalwa da bangarorin bangarorin kwanyar sune keɓancewa. Ana nuna alamun rauni a bayyane. Rashin nau'in gashi na mace, ƙarancin asarar gashi. Fwaƙwalwar ƙafa ba tazara ce, ɗalibai daidai suke da sihiri iri ɗaya, halayen ɗalibai sun zama haske lokaci ɗaya, daidaituwa. Lacrimation, convergence ba ya nan. Hanci ba ya lalata. Lebe suna da launin toka-m, bushe, ba tare da fasa. Neckunn yana da daidaituwa, ƙwayar thyroid ba a gani da ganinta.

Yawan Zuciya

Sauti na zuciya yana muffled, arrhythmic. Sautuna biyu, ana jin dakatarwa biyu. Yawan zuciya 96 ya buge / min. A maki na I da IV, Ina jin sautin a sarari. Ta hanyar dabi'a, sautin farko ya fi tsayi da ƙasa. A II, III, V maki na tashin hankali, ana jin sautin II sosai daban, mafi girma da gajarta.

GASKIYA NA RAYUWA.

SAURARA: Babu kumburi a cikin madaidaiciyar hypochondrium da yankin epigastric, babu fadada hanyoyin fata da cututtukan fata, kuma babu telangiectasia.

PALPATION: Edgearsashin hanta yana mai zagaye, laushi, daidaito. Ya shimfiɗa daga ƙarƙashin farashin tsada, ba shi da jin ciwo.

SAURARA: Babban ƙuduri ya ƙaddara ta

Edgearshen gefen tare da layin midclavicular na dama a matakin ƙananan ofan gefen babban farashi mai tsada, tare da gaban tsakiyar layi 4 cm sama da cibiya. Girman hanta shine 12 x 10 x 9 cm.

ENDOCRINE GLANDS.

Ciwon glandon thyroid ba mai palpable bane. Bayyanar cututtuka na hyperthyroidism da hypothyroidism ba ya nan. Canje-canje a fuskar fuska da wata gabar halayen acromegaly ba ya nan. Rashin nauyi (kiba, yawan ci) no. Ba a sami Pigmentation na fata yanayin cutar Addison ba. An inganta gashin gashi kullun, babu asarar gashi.

JIKIN SAUKI.

Mai haƙuri ya lura da raunin gani. Ji, kamshi, dandano, taɓawa ba a canza su.

ABUBUWAN DUNIYA

Tsarin ciki da kuma hypothalamus: Tsarin matsakaici. Lura nauyi asarar 4 kg na watanni 6. Anorexia da bulimia ba su nan. Matattu - sha 3-4l na ruwa a rana. Thyroid: ba palpable. Bayyanar cututtuka na hyperthyroidism da hypothyroidism ba ya nan. Nauyin maganin cututtukan tsoro: Gunaguni na rauni gaba ɗaya.Polydipsia - 3-4 a kowace rana. Cutar rauni mai rauni a kafafu.

ANAMNAESIS VITAE.

An haifeshi a shekarar 1940 akan lokaci. A ci gaban jiki da ta kwakwalwa bai gushe ba. Ya fara tafiya akan lokaci, yayi magana akan lokaci. Ya fara zuwa makaranta tun yana da shekaru 7. Yanayin gidaje a yara da samari sun gamsu. Abinci ya zama na yau da kullun, sau 3 a rana, adadin abincin ya isa, ingancin ya gamsu. Ba ta shiga cikin ilimin motsa jiki da kuma wasanni. Cutar tarin fuka, jijiyoyin jiki. cututtuka, cutar Botkin ta musanta. Babu wasu halaye marasa kyau. Bayan shekaru 58, ya lura da hawa da sauka a cikin karfin jini (120/80 - 130/90) da ciwon paroxysmal a bayan sternum, a wannan karon ya dauki magungunan Adelfan, Captopril, Izobosida mononitrate da Sustak forte. A cikin 1999 da 2003 sha wahala a infarction na zuciya. A cikin 1998, an yi masa aiki don fagen kafa. Tun 1997, ana fuskantar rauni gaba ɗaya, rage aiki, da rashin bacci. Tun 1997 - raunin gani.

Tarihin iyali: Mahaifina, ɗan shekara 50, an kamu da ciwon sukari na 2.

Tarihin cututtukan dabbobi: babu hulɗa tare da marasa lafiya na cutar, babu cizon kwari, babu ƙwanƙwan jini.

M maye: ba a kula

Tarihi na rashin lafiyan cuta: babu bayyanar rashin lafiyar.

Halin yanayin yanayin yanayi da yanayin yanayi: ba a samo ɓacin ran kowane cuta ba dangane da yanayin ba.

MAGANIN SAUKI.

INGANCIN SAUKI.

Height - 170 cm, nauyi - 78 kg. Yanayin gamsuwa, bayyananne a fili, Matsayi aiki. Bayyanar fuska tana da nutsuwa. Jiki yayi daidai, ya dace da shekaru da jinsi. Normostenik. Fata mai gamsarwa na mara lafiya Jiki da bayyane mucous membranes na al'ada launi, bushe, turgor rage, babu raguwa. Ƙusa, gashi ba'a canza su. Owaƙan mahaifa, kashin bayan mahaifa, parotid, submandibular, ƙananan ƙananan ƙwayoyin cuta, na ciki, na mahaifa, gwiwar hannu, gwiwar hannu, tsotsewar mahaifa, da jijiyoyin mahaifa ba su palpated. Tsarin tsoka yana tasowa mai gamsarwa har tsawon shekarun mai haƙuri, tsokoki ba su da jin daɗi, sautinsu da ƙarfinsu sun wadatar. Kasusuwa na kwanyar, kirji, ƙashin ƙugu da ƙafarku ba a canza su, babu jin ciwo yayin palpation da tsinkaye, mutuncin ba ya karye. Hanyoyin haɗin gwiwar suna da tsari na al'ada, motsi a cikin gidajen abinci kyauta ne, babu rauni. Ciwon glandon thyroid ba mai palpable bane. A tafin hannu da yatsa na 1 na ƙafar dama yana da rauni mai rauni.

SAURARON SHAGONA.

Shugaban tsari na yau da kullun, kwakwalwa da bangarorin bangarorin kwanyar sune keɓancewa. Ana nuna alamun rauni a bayyane. Rashin nau'in gashi na mace, ƙarancin asarar gashi. Fwaƙwalwar ƙafa ba tazara ce, ɗalibai daidai suke da sihiri iri ɗaya, halayen ɗalibai sun zama haske lokaci ɗaya, daidaituwa. Lacrimation, convergence ba ya nan. Hanci ba ya lalata. Lebe suna da launin toka-m, bushe, ba tare da fasa. Neckunn yana da daidaituwa, ƙwayar thyroid ba a gani da ganinta.

JIKIN SAUKI

SAURAN CELL SADAUKI:

a tsaye: A kirji ne normosthenic, daidaitacce, babu wani curvatures na kashin baya. Fossae na supira- da subclavian suna da ma'ana iri ɗaya a ɓangarorin biyu. Bafafun kafada suna ɗaure a kirji. Hanyar hakarkarinsa al'ada ce.

tsauri: Irin nau'in numfashi na kirji. Numfashi m, rhythmic, m numfashi 20 / min, biyu halves daga cikin kirji da alama shiga cikin aikin numfashi.

SALISU NA FARKO CELL:

Kirji yana da tsayayye, amincin hakarkarinsa ba ya karye. Babu wani rauni game da bugun jini. Ba a fadada wuraren intanet ɗin ba. Babu kara muryar rawar murya.

CIKIN SAUKI

Hasali na gwadawa: Ana jin sautin bayyanar huhun sama sama da filayen huhunan.

Tattaunawa na yau da kullun:

Determinedariyar iyaka na huhun dama yana kaddara ta hannun dama

Layin cikakken lokaci

VI intercostal sarari

A hannun dama midclavicular

Sararin samaniya na VII

Borderarƙashin iyaka na huhun hagu an yanke shi ta hagu

Matsayin tsagewar cikin huhun huhu:

Width na Krenig filayen:

AMFANIN CIKIN SAUKI.

Ana jin sautin numfashi a cikin huhun huhun. Ana jin numfashi na huhu a kan maƙogwaron, makogwaron da kuma babban dantse. Ba a ji ana sake yin numfashi ba. Shakka babu, babu mai shafawa. Ofarfafa ƙwaƙwalwar zuciya ba.

ABUBUWAN DA SUKE CIKINSU.

SAURARON ZUCIYA:

Ba a yanke shawarar bugun zuciya ba, thorax a wurin aikin tsinkayewar zuciya bai canza shi ba, sha'awar apical ba gani yake gani ba, babu tsinkayar systolic na yankin intercostal a wurin da yanayin motsa jiki, babu alamun bugun jini.

An zartar da tasirin apical a cikin V intercostal sarari a hagu midclavicular layin kan yanki na kimanin murabba'in mita 2.5. duba Apical impulse, resistant, high, yadawa, karfafa. Cutar bugun zuciya ba palpable bane, alamar “cat purr” bata nan.

1. Zuciyar dangi mai rauni ce ta zuciya an tantance ta:

1. Iyakar abin da ke tattare da cikas na zuciya an ƙaddara ta:

Yawan Zuciya

Sauti na zuciya yana muffled, arrhythmic. Sautuna biyu, ana jin dakatarwa biyu. Yawan zuciya 96 ya buge / min. A maki na I da IV, Ina jin sautin a sarari. Ta hanyar dabi'a, sautin farko ya fi tsayi da ƙasa. A II, III, V maki na tashin hankali, ana jin sautin II sosai daban, mafi girma da gajarta.

BAYANIN MAFARKI DARASI.

Babu abinda ke faruwa a cikin jijiyoyin carotid, ba a tantance yiwuwar bayyanuwar jijiyoyin na mahaifa ba. Abincin ɓacin rai mara kyau ne. A kan jijiyoyin ƙafafun ƙafafun kafa, yana motsa rauni sosai.

BAYANIN HUKUNCIN MAGANA.

Bugun jini iri ɗaya ne a duka tashoshin radial: mita 96 ana bugun / min., Freauka, cika, zafin, babba, saurin, kullun. Rashin ƙwayar fata - 10. An rufe bango na jijiyoyin jiki. Hawan jini 130/90.

MAGANIN CIKINSU.

Oral kogin dubawa.

Mucous membrane na roba da bakin mutum da fatarwa mai ruwan hoda, mai tsabta, da bushe. Harshen yana da laushi tare da haske mai haske, an bayyana abubuwan adon daidai. Yankunan lebe ba tare da fasa. Tonsils baya haɓakawa saboda ƙirar palatine, lacunae ba su da zurfi, ba tare da ɓataccen abu ba.

LATSA DA ITA.

Bangon ciki na ciki yayi kwatanci, ya shiga aikin numfashi. Ba a tantance motsin hanji na ciki ba, yaduwar herni da kuma fadada jijiyoyin ciki na ciki. Juyawar ciki aorta na bayyane.

SURFACE SAUKI KYAUTA NA KWARAI.

A kan palpation, babu tashin hankali da jijiyoyin tsokoki, tsokoki na ciki na haɓaka da matsakaici, babu rarrabuwar farji na ciki, ba a kara girman ɗumbin, kuma babu alamar sauyawa. Alamar Shchetkina - Blumberg korau.

BAYAN SIFFOFIN KYAUTA NA dabbobi.

Sigmoid colon ana buga shi a cikin yankin Ileal na hagu a cikin hanyar madaidaiciya, madaidaicin igiya, mara jin zafi, ba ya jita akan bugun jini. 3 cm lokacin farin ciki. A cecum an buga shi a cikin yankin Ileal na dama a cikin hanyar sililin Silinda mai santsi 3 cm lokacin farin ciki, ba jita-jita ba. Motsi. Rataye ba ta birgima ba. Pangaren hawan mulkin mallaka an ɗora shi a cikin yankin ƙasa na dama a cikin hanyar mara amfani da igiyar mara nauyi 3 cm, yadudduka, wayar hannu, ba amo. Yankin gangaren mulkin mallaka yana fitowa a cikin hagu na yankin hagu ta hanyar murɗaɗɗar madaidaicin santimita 3 cm, mara azanci, wayar hannu, ba amo. An ƙaddara shi ne bayan gano babban curvature na ciki. Mai jujjuyawar mulkin mallaka an buga shi a cikin yankin Ileal na hagu a cikin nau'i na Silinda na matsakaici mai girman 2 cm lokacin farin ciki, ta hannu, mara zafi, ba jita-jita ba. Mafi girma daga cikin ciki yana ƙaddara 4 cm sama da cibiya a cikin nau'i na abin nadi na roba daidaito, mara zafi, ta hannu. Mai tsaron ƙofar an buga shi a cikin nau'i mai murfin silinda na naƙasasshen daidaituwa, tare da diamita na kusan 2 cm ba shi da ciwo, ba ya jita, ba ya aiki. Kwayar ba ta palpable ba ce.

CIKIN SAUKI CIKIN SAUKI:

An gano babban sauti na tympanic. Alamar Mendel ba ya nan. Ba'a gano ruwa ko gas a cikin rami na ciki ba.

HUKUNCIN ABDOMINAL:

Ba'a tantance sautin yawan tashin hankali ba. Ana gano sautin motsin hanji a cikin nau'i na jita-jita.

GASKIYA NA RAYUWA.

SAURARA: Babu kumburi a cikin madaidaiciyar hypochondrium da yankin epigastric, babu fadada hanyoyin fata da cututtukan fata, kuma babu telangiectasia.

PALPATION: Edgearsashin hanta yana mai zagaye, laushi, daidaito. Ya shimfiɗa daga ƙarƙashin farashin tsada, ba shi da jin ciwo.

SAURARA: Babban ƙuduri ya ƙaddara ta

Edgearshen gefen tare da layin midclavicular na dama a matakin ƙananan ofan gefen babban farashi mai tsada, tare da gaban tsakiyar layi 4 cm sama da cibiya. Girman hanta shine 12 x 10 x 9 cm.

BAYAR DA KYAUTA MAI GIRMA:

Lokacin bincika yanki na tsinkayar ƙwayar ƙwayar ƙwayar cuta a kan hypochondrium na dama a cikin matakan wahayi, ba a samo protrusions da gyaran wannan yanki ba. Ciwon ciki ba mai palpable ba ne.

BAYAR DA FARKO:

Ba a tantance madawwamiyar cuta daga cikin rauni a cikin supine matsayi da kuma gefen dama ba.

SAURARON RUHU.

JIKIN SAUKI.

Tare da palpation na bimanual a cikin kwance da a tsaye, ba a tsai da kodan ba. Alamar Pasternatsky ba ta da kyau a garesu. Tare da tsinkaye, mafitsara ya zama 1.5 cm sama da ƙashin kashi. Rashin gunaguni game da batun artal dinne ba ya nan. Akwai nocturia 1.6l.

NERVO-CIKIN SAURAN SAURARA.

Ilimin sani ya bayyana sarai, hankali yana al'ada, yana jin bacin rai. Thewaƙwalwar ajiya tana ƙasa. Mafarkin ba shi da zurfi, Babu cuta na magana. Gudanar da motsi abu ne na al'ada, kyauta ne kyauta. Ana kiyaye farfajiyoyinsu, ba a gano ɓacin rai da inna ba. Dangantaka a wurin aiki da a gida al'ada ce. Yana ɗauka kansa mutum ne mai son jama'a.

ENDOCRINE GLANDS.

Ciwon glandon thyroid ba mai palpable bane. Bayyanar cututtuka na hyperthyroidism da hypothyroidism ba ya nan. Canje-canje a fuskar fuska da wata gabar halayen acromegaly ba ya nan. Rashin nauyi (kiba, yawan ci) no. Ba a sami Pigmentation na fata yanayin cutar Addison ba. An inganta gashin gashi kullun, babu asarar gashi.

JIKIN SAUKI.

Ell Danshi, taɓawa, ji da dandano ba su karye ba. Rashin hangen nesa

DIAGNOSIS FASAHA.

Dangane da tarihin likita, koke-koke na marasa lafiya, bayanan dalilai na gwaji, an yi gwaji na farko: nau'in ciwon sukari na 2 na farko (farkon cutar yana da shekaru 56, wanda aka kwatanta da labile, hoto mai laushi, ƙishirwa mai bushewa, bushewar bakin ciki, rauni mai rauni, kwatsam nauyi asara, yawan kumburi, lalacewar lafiya, bayyanar ƙarancin ƙafafu, asarar ƙwaƙwalwa). Insulin-dogara insulin (yana daukar insulin). Wani mummunan yanayi (rage hangen nesa, rauni na trophic a kafafu).

SURVEY PLAN.

1. Takaddar jini na asibiti + dabara + IPT
2. Nazarin Urinal
3. Bayanin martaba.
4. Bayanin Glucosuric.
5. Gwajin jinin kwayoyin
6. Nazarin ilimin ciki a cewar Nechiporenko.
7. ECG, reflexometry
8. Fluorography.
9. Tattaunawar zuciya da gwaji a cikin ɗakin. ƙafa mai ciwon sukari

LABARI

1. Gwajin jini na asibiti. 01/29/04

1. Babban bincike na fitsari 01/29/04

1. Gwajin jinin kwayoyin. 29.01.04

1. Fluorography 01/31/04 ba tare da bayyanar cututtuka ba.
2. ECG 1.02.04

Karin sinus. Yawan zuciya - 96 be / min. Hyanƙara-ƙananan ciliary arrhythmia, nau'in tachysystolic. Canje-canje na kashin bayan gida da na bayan gida. Rashin maganin na kullum.

1. Tattaunawar likitan zuciya 2.02.04

Kammalawa: IHD: Angina pectoris aji aiki 2 da hutawa. Postinfarction (1998, 2003) ciwon zuciya. Aortic atherosclerosis, cututtukan mahaifa a lokacin rashin lafiya. Postinfarction atrial fibrillation, nau'in tachysystolic. Nau'in bugun zuciya 2.

1. Binciken fitsari a cewar Nechiporenko 6.02.04

Ba a gano ƙwayoyin sel masu launin ja ba, fararen ƙwayoyin jini - 0.25 * 10 * 6 / l, ba a gano sililin ba.

1. Reflexometry 01/29/04

Ba a kira Reflexes ba.

1. Yin jarrabawa a ofishin masu ciwon sukari 01/30/04

Ciwon ƙafar ƙafafun ƙafa, siffar neuropathic, mai rikitarwa ta hanyar trophic ulcer of 1 yatsa da tafin ƙafafun dama, warkewar tsari, microangiopathy.

Alƙawura: shirye-shiryen alfa-lipoic zuwa gare ku, angioprotector, sutura, kula da ƙafa

1. Bayanin martaba

1. Bayanin Glucosuric 01/30/04

LABARIN CIKIN DIAGNOSIS.

Lokacin nazarin wannan mai haƙuri tare da hanyoyin asibiti na gaba ɗaya, an gano alamun bayyanar:

gunaguni na rauni gaba ɗaya, ƙara yawan gajiya, rage aiki. Mai haƙuri ya lura da asarar nauyi, ƙishirwar damuwa. Akwai raguwa cikin ƙwaƙwalwa don abubuwan da suka faru na ainihi. Akwai ƙanƙancewa a cikin gabar jiki. Mai haƙuri ya lura da raunin gani.

Cutar a cikin mai haƙuri ya fara shekaru 8 da suka gabata. A wannan lokacin, mai haƙuri ya sami ƙishirwa mai tsananin gaske (ya sha har zuwa lita 3 na ruwa a kowace rana), bushewar baki, mai rauni mai ƙarfi, saurin fitar iska, da kuma rauni na gani. A wannan bikin, nemi likita. An gano wani sukari mai jini na jini. Notesarin bayanin kula game da lalacewar lafiya, ƙarancin iyakar, ƙarancin gani, rashin ƙwaƙwalwar ajiya.

A HUKUNCIN SAUKI:

A kan jijiyoyin ƙafafun ƙafafun kafa, yana motsa rauni sosai. A tafin hannu da yatsa na 1 na ƙafar dama yana da rauni mai rauni.

DON HAKA hanyoyin GASKIYA:

Bayanin glycemic yana nuna matakan sukari mai haɓaka. Dangane da ECG: arrhythmia na ƙananan-igiyar ruwa, nau'i na tachysystolic. Canje-canje na kashin bayan gida da na bayan gida. Rashin maganin na kullum. Dangane da ƙarshen ƙirar zuciya: cututtukan zuciya na jijiyoyin jini: Angina pectoris 3FK ƙarfin lantarki da hutawa. Postinfarction (1998, 2001) cardiosclerosis. Aortic atherosclerosis, cututtukan mahaifa a lokacin rashin lafiya. Postinfarction atrial fibrillation, nau'in tachysystolic. Nau'in bugun zuciya 2.

MAGANIN CIKINSU

Nau'in nau'in ciwon sukari na 2 ana bambanta shi da nau'in 1 na ciwon sukari da insipidus na sukari:

Ya bambanta da nau'in ciwon sukari na 2, nau'in ciwon sukari na 1 ana haifar dashi ta hanyar raguwa a cikin aikin samar da insulin na ƙwayoyin cuta na B-cell saboda wani aikin autoimmune na kwayar cuta ko etiology. Irin wannan cutar sankarau yawanci tana faruwa ne kafin shekaru 30. Ana nuna wannan nau'in ciwon sukari ta hanyar farawa mai zurfi, hanyar labile, asibitin da aka ambata, da sha'awar ketoacidosis, asarar nauyi, microangiopathies, da kuma yiwuwar magance insulin.

Insipidus na ciwon sikila yana faruwa ne ta dalilin raunin vasopressin cikakke kuma ana san shi ta hanyar polydipsia da fitsari na polyuria tare da ƙarancin dangi. Bugu da kari, gwajin ya samo asali ne sakamakon rashin karuwar yawan fitsari a yayin gwajin tare da bushe-ci, babban tashin hankali na rashin jini, ingantaccen ginin pituitrin da rashin abun ciki a cikin yanayin cutar ADH a cikin plasma.

CIKIN DIAGNOSIS

Mai haƙuri yana da nau'in ciwon sukari na 2 (Ana ba da labarin wannan ta hanyar tarihin tarihi - farkon cutar a 56, ƙaddarar jini, bayyanar asibiti: tsananin ƙishirwa, bushewar bushe, rauni mai nauyi, kwatsam nauyi, saurin hanzari, hangen nesa, ƙarancin lafiya, ƙarancin ɓoye, ƙwaƙwalwar ƙwaƙwalwa, tambayoyi a kan gabobin da tsarin: gunaguni na rashin ƙarfi na gaba ɗaya, ƙaruwa gajiya, rage aiki, asarar nauyi, ƙishirwa, bayanan dakin gwaje-gwaje: haɓaka cuta), ƙetare (Wannan shi ne abin da bayanin martaba ya gaya mana: haɓaka matakan sukari a yayin jiyya.), nauyi mai halin yanzu(raunin gani, rauni na trophic a cikin kafafu).

Bugu da kari, wannan mara lafiya yana da rikitarwa:

Rashin ciwon sukari, ciwon suga: (raunin gani.)

Ciwon ƙafar ƙafafun mahaifa, kamannin neuropathic (binciken bayanai - rauni mai yatsa na 1 yatsan ƙafa da ƙafa na ƙafa.)

Macroangiopathy mai ciwon sukari (Aortic atherosclerosis, stenosing na jijiyoyin zuciya atherosclerosis),

kazalika da concomitant cututtuka:

CHD: Angina pectoris voltage 3 FC da hutawa. Postinfarction (1998, 2001) cardiosclerosis. Aortic atherosclerosis, cututtukan mahaifa a lokacin rashin lafiya. Postinfarction atrial fibrillation, nau'in tachysystolic. Type 2 bugun zuciya

SIFFOFIN TARA

1. Yanayin Ward
2. Yawan abinci 9
3. Harkokin insulin: Humodar B15 - 22 raka'a. da safe, raka'a 18 da yamma.
4. Banananc 1 3p / day (kumburi bayanan ayyukan sirri na kwayar cutar kansa)
5. Tabatarwa 1/2 tab. 2p / day (hypotensive)
6. Isosorbide 1 shafin. 2p / day (domin sauqaqa kai harin angina)
7. Aspicard 1/2 shafin. 1p / day (analgesia, taimako na rep. Tsarin aiki)
8. Sol. Acidi lipoici 1% 2.0 v / m
9. Shafin Trental 1. 2 r / day (makamanci)
10. Agesungiyoyi na ƙafafun dama

D.S. Shafin 1. 3 r / rana

D.S. 1/2 shafin 2 r / rana

1. Rp.: Tab. Isosorbidi mononitratis 0.02 N. 40

D.S. Shafin 1. 2 r / rana bayan cin abinci

D.S. A ½ shafin 1r / rana

1. Rp.: Sol. Acidi lipoici 1% 2.0

D.t.d.N.10 a cikin ampull.

1. A / m 2 ml 1r / rana drip
2. Rp.: Tab. Trentali 0.4 N20

D.S. 1 shafin 2 r / rana

1. Rp.: Insulini “Humodar B15” 10ml (1ml = 40ED)

1. 22 kowannensu - da safe, raka'a 18. - da yamma subcutaneously.
2. Abun cin abinci mai lamba 9

Energyimar kuzarin 2400 kcal. Tsarin abinci mai sau 5-6 sau / rana.

Farkon karin kumallo 25%, na biyu 8-10%, abincin rana 30-35%, abincin rana da yamma 5-8%, abincin dare na farko 20%, abincin dare na biyu 5%.

Yawan samfurori a rana: burodin baƙi 150 g, gurasar alkama 100 g, dankali 150 g, kayan lambu 500 g, man shanu 20 g, gida cuku 100 g, kirim mai tsami 30 g, kefir 200 g, 'ya'yan itãcen marmari (banda inabi) 200 g, kwai 2 inji mai kwakwalwa., kayan lambu 20 g, gari 40 g.

3.02.04 Yanayin gamsuwa, bayyananniyar hankali, rauni gaba ɗaya, ci, al'ada, nocturia 1.6l, bushewar fata, launi na yau da kullun, vesicular numfashi, yawan numfashi 18 / min, babu sanyin jiki, ƙararraki na zuciya, babu amo, AT 120/75, Ps 96 beats / min , Yawan zuciya 106, bugun jini 0, Ps a duka aa. dorsalis pedis ya raunana, harshe ya kasance mai laushi, ba mai ruɓi ba, ciki yana da taushi, mara jin zafi akan bugun jini, hanta tana ƙaruwa da 1 cm, zafi a kafafu, t = 36.6 * C. Yawan sashin insulin ba ya canzawa. Gudanar da cutar glycemia - da safe - 6.1, da rana - 14.1, da yamma - 11.8 mmol / l. Glucosuric iko ne mara kyau.

10.02.04 Yana cikin yanayi mai gamsarwa, tsabtataccen tunani, ciwon kai a cikin yankin babban babba, ci, al'ada, nocturia 1.2 l, bushe fata, launi na al'ada, vesicular numfashi, 18 min / h, babu wheezing, sautin zuciya shine arrhythmic, babu amo, AT 140/90, Ps 94 beats / min, ƙarancin zuciya 104, bugun bugun jini 10, harshe mai laushi, ba mai ruɓi, ciki mai laushi, mara jin zafi a palpation, hanta ya karu da 1 cm, ciwon ƙafa ya ragu, t = 36.7 * C. Yawan sashin insulin ba ya canzawa. Gudanar da cutar glycemia - da safe - 6.2, da rana - 9.0, da yamma - 7.3 mmol / l. Glucosuric iko ne mara kyau.

Anamnesis na rayuwar haƙuri

Ciwon sukari yana tsoron wannan maganin, kamar wuta!

Kawai kawai buƙatar nema ...

An haifeshi a ranar 15 ga Yuli, 1952, ɗa na farko a cikin dangi.

Haihuwar mahaifa tayi al'ada. Ta kasance tana shayarwa.

An lura da yanayin zamantakewa a matsayin mai gamsarwa (gidan mai zaman kansa tare da duk abubuwan jin daɗi). Samun alurar riga kafi gwargwadon shekaru. A shekaru 7 Na je makaranta, yana da matsakaiciyar cika. Tana da ƙwayoyin huwa da gudawa.

Lokacin haila bai zama da matsala ba, farkon haihuwar ya kasance shekaru 13, na yau da kullun, mara jin zafi. Menopause a shekara 49. Yana da 'ya'ya maza biyu da suka girma, masu juna biyu da kuma haihuwa sun ci gaba kamar yadda aka saba, babu masu zubar da ciki. Lokacin da yake da shekaru 25, wani aiki don cire appendicitis, babu raunin da ya faru. Tarihin rashin lafiyan ba a ɗaukar nauyi.

A halin yanzu yayi ritaya. Mai haƙuri yana zaune a cikin yanayin zamantakewa mai gamsarwa, ya yi aiki na shekaru 30 a matsayin mai siyarwa a cikin shagon kayan kiwo. Abincin na yau da kullun, carbohydrates yana cin nasara a cikin abincin.

Iyaye sun mutu cikin tsufa, mahaifina ya sha wahala daga ciwon sukari na 2, ya sha magungunan rage sukari. Ba a cinye barasa da kwayoyi, yana lalata fakitin sigari ɗaya kowace rana. Ban je ƙasar waje ba, ban kasance tare da masu fama da cutar ba. Tarihin cutar tarin fuka da hepatitis an hana su.

Janar dubawa

Halin matsakaici mai zurfi. Matsayi na sane a bayyane (GCG = maki 15), mai aiki, wadatacce, akwai zuwa lambar sadarwa mai amfani. Height 165 cm, nauyi 105 kg. Jiki na hypersthenic.

Fatar ta kodadde ruwan hoda, mai tsabta, bushe. Gangar jikin mucous na gani mai ruwan hoda, mai laushi.

Turgor taushi mai taushi mai gamsarwa ne, ba a faɗi cututtukan microcirculatory ba. Hanyoyin haɗin gwiwa ba su da nakasa, motsi cikakke, babu kumburi. Ba zazzabi ba. Ba a kara girman mahaɗan jini ba. Ciwon glandon thyroid ba mai palpable bane.

Bugawa ta hanyar numfashi ta hanyoyin jirgin sama na dabi'a, NPV = 16 min / min, tsokoki na taimako ba su shiga ba. Kirji yana da hannu a cikin maimaituwa, yana da tsari daidai, ba ya nakasa, ba shi da ciwo a kan bugun jini.

Ba a gano daidaituwa ba da kuma yanayin cutar sankarau (iyaka na huhunnun tsakanin iyakoki na yau da kullun). Auscultatory: vesicular numfashi, da za'ayi da za'ayi a kan dukkan filayen huhu.

A fannin zuciya yayin jarrabawa, babu canje-canje, yanayin motsa apical ba'a hango shi ba.

An buga bugun jini a kan jijiyoyin bugun gini, daidaituwa, cika mai kyau, bugun zuciya = 72 rpm, karfin jini 150/90 mm Hg Tare da hasashe, iyakancewar rashin lafiyar zuciya da tazarar dangi suna a cikin iyakance ta al'ada. Auscultatory: sautunan zuciya suna muffled, kari kuwa daidai ne, ba a jin kararrakin jijiyoyin cuta.

Harshen ya bushe, an rufe shi da farin rufewa a tushe, aikin hadiye bai karye ba, sama ba shi da fasali. Abun ciki yana ƙaruwa da yawa saboda yawan kitse, yana ɗaukar cikin aikin numfashi. Babu alamun hauhawar jini.

Tare da palpation na waje na herni protrusions da tashin hankali ba a lura.

Alamar Shchetkina - Blumberg korau. Jin zurfin palpation yana da wahala saboda yawan kitse mai ƙyalƙyali.

A cewar Kurlov, hanta ba ta faɗaɗawa, a gefen farashin tsada, buguwa a cikin ƙwayar cuta ba ta jin ciwo. Kwayar cutar cututtukan Ortner da Georgievsky ba su da kyau. Kodan ba palpable, urination kyauta ne, diuresis yana ƙaruwa. Matsayi na jijiya ba tare da sifofi ba.

Nazarin bayanai da bincike na musamman

Don tabbatar da ganewar asali na asibiti, da yawa ana ba da shawarar karatu:

• asibiti gwajin jini: haemoglobin - 130 g / l, erythrocytes - 4 * 1012 / l, mai nuna launi - 0.8, ESR - 5 mm / h, farin jini - 5 * 109 / l, matsatsin tsage - 3%, nucleized kashi - 75%, eosinophils - 3 %, ƙwaƙwalwar -17%, monocytes - 3%,
• urinalysis: launi fitsari - bambaro, amsawa - alkaline, furotin - a'a, glucose - 4%, farin jini - ba, ƙwayoyin ja - ba,
• gwajin jini na biochemical: jimlar furotin - 74 g / l, albumin - 53%, globulin - 40%, creatinine - 0.08 mmol / lita, urea - 4 mmol / l, cholesterol - 7.2 mmol / l, glucose na jini 12 mmol / l.

Nagari saka idanu na sigogi na dakin gwaje-gwaje a cikin kuzari

Kayan bincike na kayan aiki

An samo waɗannan bayanai na karatun kayan aikin:

• karafarini: rhythm, sinadarin hauhawar jini ventricular hagu,
• x-ray: Filin huhun mara tsabta, sinusi kyauta ne, alamun hauhawar jini na zuciya hagu.

Ana ba da shawarar yin shawarwari na ƙwararrun likita kamar ƙwararren mahaifa, likitan fata da kuma tiyata.

Tabbatar da cutar

Ganin kokewar mai haƙuri (ƙishirwa, polyuria, polydipsia), tarihin likita (yawan abinci mai narkewa na carbohydrates), jarrabawar haƙiƙa (ƙara yawan jikin mutum, fata bushe), dakin gwaje-gwaje da sigogi na kayan aiki (hyperglycemia, glucosuria), ana iya yin gwajin asibiti.

Primary: type 2 ciwon sukari mellitus, matsakaici, ƙididdigewa.

Mai yarda: hauhawar jini 2 matakai, digiri 2, babban haɗari. Bayan Fage: Kiba mai gina jiki.

An ba da shawarar asibiti a cikin asibiti na endocrinological don zaɓi na far.

Yanayin kyauta. Abincin - lambar tebur 9.

Canza salon rayuwa - asarar nauyi, ƙara yawan aiki na jiki.

Oral hypoglycemic kwayoyi:

• Gliclazide 30 MG sau 2 a rana, an sha kafin abinci, a sha tare da gilashin ruwa,
• Glimepiride 2 mg sau ɗaya, da safe.

Gudanar da glucose na jini a cikin kuzari, tare da rashin ingancin maganin, canzawa zuwa insulin.