Cutar sankarau a cikin yara

Marasa lafiya masu ciwon sukari suna mamakin: coma mai ciwon sukari: menene? Menene masu ciwon sukari ke tsammanin idan ba kwa ɗauki insulin akan lokaci ba kuma yana hana jiyya? Kuma mafi mahimmancin tambaya da ke damuwa da marasa lafiya na sassan endocrine a cikin dakunan shan magani: Idan sukari jini ya cika 30, me zan yi? Kuma menene iyakance mata?
Zai zama mafi daidai don magana game da cutar rashin lafiyar masu fama da cutar sankara, tunda an san nau'ikan coma guda 4. Uku na farko sun kasance hyperglycemic, hade da haɓaka taro na sukari a cikin jini.

Cutar Ketoacidotic

Cutar Ketoacidotic halayyar marasa lafiya ce da ke dauke da ciwon sukari na 1. Wannan mummunan yanayin yana faruwa ne sakamakon karancin insulin, sakamakon wanda aka rage amfani da glucose, metabolism a kowane matakin ya lalace, kuma wannan yana haifar da lalacewa ga ayyukan duk tsarin da sassan jikin mutum. Babban mahimmancin ilmin etiological na ketoacidotic coma shine kasawar insulin gudanar da aiki da kuma tsalle mai tsayi a cikin gulluwar jini. Hyperglycemia ya kai - 19-33 mmol / l kuma mafi girma. Sakamakon mai rauni ne mai zurfi.

Yawancin lokaci, ƙwayar ketoacidotic ta haɓaka a cikin kwanaki 1-2, amma a gaban abubuwan dalilai masu tayar da hankali, zai iya haɓaka da sauri. Abubuwan farko na bayyanar cutar sankarau alamu ne na karuwa a cikin sukari na jini: haɓaka haɓaka, sha'awar sha, polyuria, numfashin acetone. Fata da mucous membranes sun cika yawa, akwai ciwon ciki, ciwon kai. Yayin da coma ke ƙaruwa, ana iya maye gurbin polyuria ta anuria, saukar jini zai yi yawa, bugun jini yana ƙaruwa, ana lura da ciwon tsoka. Idan tarota na jini ya wuce 15 mmol / l, dole ne a sanya mara lafiya a asibiti.

Cutar Ketoacidotic ita ce matakin ƙarshe na ciwon sukari, wanda aka bayyana ta hanyar cikakken asarar rai, kuma idan ba ku ba da taimako ga mai haƙuri ba, mutuwa na iya faruwa. Ya kamata a kira taimakon gaggawa.

Domin rashin isasshen ko isasshen kula da insulin, dalilai masu zuwa suna aiki:

• Marasa lafiya ba shi da masaniya game da cutar sa, bai je asibiti ba, don haka ba a gano cutar sankara ba a cikin lokaci.
• Inulin da aka saka a ciki bashi da inganci, ko ya ƙare,
• Babban cin zarafin abincin, yin amfani da carbohydrates mai sauƙin narkewa, yalwar mai, giya, ko matsananciyar yunwar.
• Sha'awar yin kisan kai.

Marasa lafiya ya kamata su sani cewa tare da nau'in ciwon sukari na 1, buƙatar insulin yana ƙaruwa a waɗannan halaye masu zuwa:

• yayin daukar ciki
• da kamuwa da cuta,
• a cikin lahanta rauni da kuma tiyata,
• tare da tsawancin gudanar da glucocorticoids ko diuretics,
• yayin aiki ta jiki, yanayin damuwa na damuwa.

A pathogenesis na ketoacidosis

Rashin insulin shine sakamakon karuwar samar da hodar iblis na corticoid - glucagon, cortisol, catecholamines, adrenocorticotropic da hormones na somatotropic. An hana glucose daga shiga hanta, zuwa cikin sel tsokoki da tsopose nama, matakin sa a cikin jini ya hau, kuma yanayin hauhawar jini ya faru. Amma a lokaci guda, sel suna fuskantar yunwar makamashi. Sabili da haka, marasa lafiya da ciwon sukari suna fuskantar yanayin rauni, rashin ƙarfi.

Don kuma hana maye gurbin yunwar makamashi, jiki yana fara wasu hanyoyin makamashi na maye gurbin - yana kunna lipolysis (bazuwar mai), sakamakon abin da yake da kitse mai kitse, wanda ba a bayyana shi mai guba, wanda aka samar da triacylglycerides. Tare da rashin insulin, jikin yana karɓar 80% na makamashi yayin hada-hadar fatima mai kyauta, da samfuran abubuwan da suka lalata (acetone, acetoacetic da β-hydroxybutyric acid), waɗanda suke yin abubuwan da ake kira jikin ketone, suna tarawa. Wannan yana yin bayani game da nauyi asara na masu ciwon sukari. Excessaƙƙarfan ƙwayoyin ketone a cikin jiki yana ɗaukar ajiyar alkaline, a sakamakon abin da ketoacidosis ke haɓaka - cuta mai zurfi na rayuwa. Lokaci guda tare da ketoacidosis, metabolism na ruwa-electrolyte yana da damuwa.

Hyperosmolar (rashin ketoacidotic) coma

Hyperosmolar coma yana da haɗari ga marasa lafiya da ke fama da ciwon sukari na 2. Wannan nau'in coma a cikin ciwon sukari yana faruwa ne sakamakon karancin insulin, kuma ana saninsa da yawan zubar jiki, yawan hauhawar jini (haɓakar sodium, glucose da urea cikin jini).

Hyperosmolarity na jini plasma yana haifar da mummunan rauni na ayyukan jiki, asarar hankali, amma a cikin rashi na ketoacidosis, wanda aka bayyana shi ta hanyar samar da insulin ta hanyar ƙwayar cuta, wanda har yanzu bai isa ba don kawar da hyperglycemia.

Rashin ruwa daga jikin mutum, wanda yana daya daga cikin abubuwan dake haifar da cutar sankarar mahaifa, shine

• yawan wuce gona da iri na diuretics,
• zawo da amai na kowane ilimin etiology,
• rayuwa a cikin yanayin zafi, ko aiki a yanayin zafi,
• rashin ruwan sha.

Abubuwa masu zuwa kuma suna haifar da farawar na fari:

• Rashin insulin
• Sakamakon ciwon sukari insipidus,
• Zagi da abinci dauke da carbohydrates, ko manyan allurai na glucose injections,
• ko yanayin tsinkayen ciki, ko hemodialysis (hanyoyin da suka shafi tsabtace kodan ko peritoneum).
• Tsawo mai tsawan jini.

Haɓaka ƙwayar hyperosmolar yana da alamun gama gari tare da ketoacidotic coma. Har yaushe tsawon lokacin jinin haila ya dogara da yanayin cututtukan hanji, da karfin samar da insulin.

Rashin daidaituwa a jiki da sakamakonsa

Cutar HyperlactacPs na faruwa ne sakamakon tarin lactic acid a cikin jini sakamakon karancin insulin. Wannan yana haifar da canji a cikin tsarin sinadaran jini da asarar hankali. Abubuwanda zasu biyo baya suna da ikon haifar da cutar mahaifa:

• Icientarancin isashshen oxygen a cikin jini sakamakon bugun zuciya da gazawar numfashi wanda ya tashi a gaban kwayoyin cuta irin su asma, mashako, gazawar jini, gazawar zuciya, da jijiyoyin jini,
• Cututtukan kumburi, cututtuka,
• Cutar koda ko na hanta
• Lalacewar giya

Babban dalilin cutar rashin hauhawar jini shine rashin isashshen sunadarin oxygen a cikin jini (hypoxia) a kan asalin karancin insulin. Hypoxia yana motsa glycolysis anaerobic, wanda ke haifar da wuce haddi na lactic acid. Sakamakon rashin insulin, ayyukan enzyme wanda ke inganta sauyawar pyruvic acid zuwa acetyl coenzyme ya ragu. Sakamakon haka, an canza pyruvic acid zuwa lactic acid kuma yana tarawa cikin jini.

Saboda karancin iskar oxygen, hanta bata iya amfani da lactate mai yawa. Canza jini yana haifar da take hakkin kwanciyar hankali da kuma ƙwaƙwalwar ƙwayar zuciya, ƙuntata tasoshin yanki, sakamakon haifar da laima

Sakamakon, kuma a lokaci guda, alamun bayyanar cututtukan hyperlactac cuta sune raunin tsoka, angina pectoris, tashin zuciya, amai, amai, rashin haske.

Sanin wannan, zaku iya hana farkon kwayar cutar coma, wanda ke haɓakawa a cikin 'yan kwanaki, idan kun sanya haƙuri a asibiti.

Dukkanin nau'ikan da ke sama na com sune hyperglycemic, watau, haɓaka saboda hauhawar haɓakar sukari na jini. Amma aiwatar da juyawa zai yiwu kuma, lokacin da sukari ya faɗi ƙasa warwas, sannan cutar sikila zata iya faruwa.

Hyma na jini

Cutar hypoglycemic a cikin ciwon sukari mellitus yana da tsari na baya, kuma zai iya haɓaka lokacin da aka rage adadin glucose a cikin jini sosai har zuwa rashin ƙarfi a cikin kwakwalwa.

Wannan yanayin yana faruwa a cikin waɗannan lambobin:

• Idan an yarda da yawan yawan insulin-jini ko rage-rage magunguna na baka,
• Mai haƙuri bayan ya ci insulin bai ci abinci akan lokaci ba, ko kuma abincin ya ƙaranci cikin carbohydrates,
• Wani lokacin aikin adrenal yana raguwa, ƙwayar insulin-inhibiting na hanta, sakamakon haka, ƙwayar insulin yana ƙaruwa.
• Bayan tsananin aiki na zahiri,

Orarancin wadatar glucose a cikin kwakwalwa yana haifar da hypoxia kuma, a sakamakon haka, lalata ƙwayoyin sunadarai a cikin ƙwayoyin tsoka.

• Karuwar yunwar
• rage jiki da hankali yi,
• wani canji a yanayi da halin da bai dace ba, wanda za a iya bayyana shi cikin matsanancin tashin hankali, jin damuwa,
• girgiza hannu
• samarin
• pallor
• Hawan jini

Tare da raguwar sukari na jini zuwa 3.33-2.77 mmol / l (50-60 mg%), sabon abu mai sauƙi mai laushi ya fara faruwa. A wannan yanayin, zaku iya taimaka wa mai haƙuri ta hanyar ba shi shan shayi mai ɗumi ko ruwa mai zaki tare da sukari 4. Madadin sukari, zaku iya saka cokali mai sha, jam.

A matakin sukari na jini na 2.77-1.66 mmol / l, ana lura da duk alamun halayyar hawan jini. Idan akwai wani mutum kusa da mara lafiyar da zai iya bayar da allura, za a gabatar da glucose a cikin jini. Amma mara lafiya zai ci gaba da zuwa asibiti don neman magani.

Tare da raunin sukari na 1.66-1.38 mmol / L (25-30 mg%) da ƙananan, hankali yana asara yawanci. Bukatar gaggawa kiran motar asibiti.

Menene matsalar rashin lafiyan cuta kuma menene sababinsa da ire-irensu?

Ma'anar illarma ita ce ciwon sikari - tana nuna yanayin da mai ciwon sukari yake asarar hankali yayin da karanci ko yawan glucose a cikin jini. Idan a cikin wannan yanayin ba za a ba da haƙuri na gaggawa ba, to komai yana iya zama mai m.

Abubuwanda ke haifar da cututtukan cututtukan ciwon sukari shine saurin karuwa a cikin taro na jini, wanda ke faruwa sakamakon isasshen ƙwayar insulin ta hanyar ƙwayar ƙwayar cuta, rashin kame kai, rashin iya karatu da rubutu da sauransu.

Idan babu isasshen insulin, jikin ba zai iya sarrafa glucose ba saboda abinda baya juya shi zuwa makamashi. Irin wannan rashi yana haifar da gaskiyar cewa hanta tana fara samar da glucose da kansa. A kan wannan tushen, akwai ci gaba mai aiki na jikin ketone.

Don haka, idan glucose ya haɗu a cikin jini da sauri fiye da jikin ketone, to mutum zai rasa hankali kuma ya kamu da ciwon sukari. Idan yawan sukari yana ƙaruwa tare da abun cikin jikin ketone, to mai haƙuri na iya fadawa cikin coma na ketoacidotic. Amma akwai wasu nau'ikan irin waɗannan yanayin waɗanda ya kamata a yi la’akari da su daki-daki.

Gabaɗaya, ana bambanta waɗannan nau'ikan cututtukan ƙwayar mahaifa:

1. hypoglycemic,
2. bashin,
3. ketoacidotic.

Coma na hypoglycemic - na iya faruwa lokacin da sukari a cikin ragin jini ba zato ba tsammani. Har yaushe wannan yanayin zai wuce ba za a iya faɗi ba, saboda abubuwa da yawa sun dogara da tsananin matsalar hypoglycemia da lafiyar mai haƙuri. Wannan yanayin yana da saukin kamuwa ga masu ciwon suga da ke tsallake abinci ko kuma wadanda basa bin sashin insulin. Hypoglycemia shima yana bayyana bayan wuce gona da iri ko giya.

Na biyu nau'in - hyperosmolar coma na faruwa azaman rikitarwa na nau'in ciwon sukari na 2, wanda ke haifar da karancin ruwa da sukari mai yawa na jini. Farkon sa yana faruwa tare da matakin glucose fiye da 600 mg / l.

Sau da yawa, ƙwayar ƙwayar cuta ta ɓacin rai da yara, wanda ke cire yawan glucose da fitsari. A wannan yanayin, dalilin ci gaban kwayar halitta shi ne cewa yayin bushewar ƙwayoyin halittar da ƙodan ya haifar, jiki yana tilasta adana ruwa, saboda wanda tsananin ciwo zai iya haɓaka.

Hyperosmolar s. diabeticum (Latin) yana haɓaka sau 10 sau da yawa fiye da hauhawar jini. Ainihin, bayyanar sa an gano shi da nau'in ciwon sukari na 2 a cikin tsofaffi marasa lafiya.

Ketoacidotic masu ciwon sukari na tasowa tare da ciwon sukari na 1 Ana iya lura da wannan nau'in kwayar cutar yayin da ketones (acetone acid mai cutarwa) suka tara cikin jiki. Su samfurori ne na metabolism na acid na mai wanda ke haifar da ƙarancin ƙarancin insulin na hormone.

Cutar HyperlactacPs a cikin ciwon sukari na faruwa da wuya. Wannan nau'in halayyar halayyar tsofaffi marasa lafiya ne da ke fama da hanta, koda da aikin zuciya.

Abubuwan da ke haifar da haɓakar wannan nau'in cutar sankarau suna ƙara ƙaruwa da ilimi da rashin amfani da hypoxia da lactate. Don haka, jiki yana guba da lactic acid, wanda aka tara a cikin adadin (2-4 mmol / l). Duk wannan yana haifar da cin zarafin daidaituwa na lactate-pyruvate da bayyanar acidosis na rayuwa tare da bambanci mai girma na anionic.

Cutar tarko da ta taso daga nau'in 2 ko nau'in 1 na ciwon sikari ita ce mafi yawan haɗari da haɗari ga tsoho wanda ya riga shekara 30. Amma wannan sabon abu yana da haɗari musamman ga ƙananan marasa lafiya.

Cutar sankarau a cikin yara yawanci tana haɓaka da nau'in insulin-dogara da ƙwayar cuta wacce ta ɗauki shekaru da yawa. Comas na ciwon sukari a cikin yara sukan bayyana ne a makarantan nasare ko shekarun makaranta, wani lokacin a kirji.

Haka kuma, a karkashin shekaru 3, irin wannan yanayin yakan faru sau da yawa fiye da na manya.

Symptomatology

Nau'in nau'in coma da ciwon sukari sun bambanta, don haka hoton su na asibiti na iya bambanta. Don haka, don ƙwayar ketoacidotic, bushewar fata halayyar mutum ce, tare da asarar nauyi zuwa 10% da bushewar fata.

A wannan yanayin, fuskar tana jujjuya bakin ciki (wani lokaci tana jujjuya ja), kuma fatar a kan soles, dabino ya zama mai launin toka, ciwon kai da peel. Wasu masu ciwon sukari suna da furunlera.

Sauran alamomin kamuwa da cutar sankarau tare da ketoacidosis sune, mara nauyi, tashin zuciya, amai, hutu, tsoka, da ƙarancin zafin jiki. Sakamakon maye na jiki, hauhawar huhu na iya faruwa, kuma numfashi ya zama mai hayaniya, zurfi da maimaituwa.

Lokacin da wani nau'in ciwon sukari ya faru a cikin nau'in ciwon sukari na 2, alamominsa kuma sun haɗa da ƙarancin murfin ido da kuma taƙaita ɗaliban. Lokaci-lokaci, ana lura da yaduwar ido na sama da na bakin ciki.

Hakanan, ketoacidosis mai tasowa yana tare da urination mai saurin motsa jiki, wanda cirewa yana da warin tayi. A lokaci guda, ciki yana ciwo, motsin hanji yana rauni, kuma matakin rage karfin jini.

Ketoacidotic coma a cikin masu ciwon sukari na iya samun digiri daban-daban na rashin lafiya - daga nutsuwa zuwa bacci. Owaƙar kwakwalwa na taimaka wajan haifar da cututtukan cututtukan ƙwaƙwalwar zuciya, abubuwan son zuciya, ɓarna da ruɗami.

Alamar rashin lafiyar mai fama da cutar sankara

• katsewa
• bushewa
• karancin magana
• malaise
• bayyanar cututtuka na jijiyoyin jini
• na ilimantarwa da sauri motsi na ƙwallon ido,
• rare da rauni urination.

Alamun alamun cutar sikari da ke fama da cutar rashin daidaituwa na yara sun bambanta da sauran nau'in coma. Wannan halin ana iya bayyaninsa ta hanyar rauni mai ƙarfi, yunwa, rashin damuwa da tsoro, jin sanyi, rawar jiki da gumi. Sakamakon ciwon sukari tare da cututtukan cututtukan zuciya shine asarar sani da kuma bayyanuwar kamuwa da cuta.

Hyperlactac cuta mai ciwon sukari yana nuna bushewar harshe da fata, nau'in Kussmaul na numfashi, rushewa, hauhawar jini, da raguwar turgor. Hakanan, lokacin rashin lafiyar, wanda zai iya ɗauka daga 'yan sa'o'i zuwa wasu kwanaki, yana tare da tachycardia, oliguria, wucewa cikin rashin lafiyar jiki, laushi na gira.

Jiki na hauhawar jini da sauran nau'ikan yanayi iri ɗaya a cikin yara na haɓaka a hankali. Rashin ciwon sukari yana tare da rashi na ciki, damuwa, ƙishirwa, amai, ciwon kai, ciwanci da tashin zuciya. Yayinda yake ci gaba, numfashin majiyyacin ya zama mai hayaniya, zurfi, bugun zuciya yayi saurin zuwa, kuma jijiyoyin jijiyoyin jini suna bayyana.

A cikin ciwon sukari mellitus a cikin jarirai, lokacin da yaro ya fara fadawa cikin ƙwayar cuta, ya fara haɓaka polyuria, maƙarƙashiya, polyphagy da ƙaruwar ƙishirwa. Abun ya zama da wahala daga fitsari.

A cikin yara, yana bayyana alamun guda ɗaya kamar a cikin manya.

Abin da za a yi tare da ciwon sukari

Idan taimako na farko don rikitarwa na hyperglycemia ba shi da tabbas, to, mara lafiya tare da cutar sankara wanda sakamakonsa ke da haɗari sosai zai iya haifar da cututtukan huhu da huhun ciki, ƙwayar jini, haifar da bugun zuciya da bugun jini, oliguria, renal ko gazawar numfashi, da sauransu. Sabili da haka, bayan da aka gudanar da gwajin cutar, nan da nan ya kamata a ba wa mara lafiya taimako tare da coma mai ciwon sukari.

Don haka, idan yanayin mai haƙuri yana gab da yin rauni, to dole ne a yi kiran gaggawa gaggawa. Yayinda ita zata yi tuki, ya zama dole a sa mara lafiya a ciki ko a gefen sa, shigar da bututu kuma a hana harshe daga fada. Idan ya cancanta, daidaita matsin lamba.

Me za a yi da ciwon sukari coma lalacewa ta hanyar wuce haddi na ketones? A wannan halin, hanyoyin aiwatarwa shine daidaita al'ada mai mahimmanci na masu ciwon sukari, irin su matsa lamba, bugun bugun zuciya, sani da numfashi.

Idan coma na lactatacPs ya bunkasa a cikin cututtukan ƙwaƙwalwar ƙwayar cuta, ana buƙatar ɗaukar matakai iri ɗaya kamar yadda ake yi da ketoacidotic. Amma ban da wannan, ya kamata a sake dawo da ma'aunin ruwa da ruwa da acid-base. Hakanan, taimako tare da coma mai ciwon sukari na wannan nau'in ya ƙunshi gudanar da maganin glucose tare da insulin ga mai haƙuri da kuma yin maganin cututtukan.

Idan ƙarancin farin ciki na haila ya faru a cikin nau'in ciwon sukari na 2, taimakon kai zai yiwu. Wannan lokacin ba zai daɗe ba, don haka mara haƙuri yakamata ya sami lokaci don ɗaukar carbohydrates mai sauri (fewan sanduna kaɗan, cokali na jam, gilashin ruwan 'ya'yan itace) da kuma ɗaukar matsayi mai gamsarwa don kada ya cutar da kansa idan ya kasance asarar hankali.

Idan ya tsokane shi ta hanyar insulin, sakamakon wanda yake dadewa, to cin abinci tare da cokali mai ciwon sukari ya ƙunshi ɗaukar jinkirin carbohydrates a cikin adadin 1-2 XE kafin lokacin bacci.

Kulawa ta gaggawa don yanayin da ke da alaƙa da endocrine

Waɗannan iyayen da suka yi imani da cewa bayanan da aka tattara a wannan labarin ba za su taɓa amfana da su ba kuma yaransu masu lafiya za su rufe shafin kuma ba za su san abin da ke ciki ba. Dama kuma mai hangen nesa zai zama waɗanda suka fahimci cewa cututtukan cututtukan glandon endocrine kusan koyaushe suna ci gaba cikin mutane masu lafiya da yanayin da suke buƙatar taimako na farko sau da yawa suna tasowa daga tushen lafiya mai alama. Irin waɗannan yanayi, da farko, sun haɗa da coma - hypoglycemic da ciwon sukari, ka'idodin ceto a ƙarƙashin wanda aka keɓance wannan labarin.

Abubuwan la'akari guda biyu sun sa mu zauna akan cututtukan jini da gudawa. Da fari dai, waɗannan yanayi ne waɗanda galibi suna faruwa ba zato ba tsammani, a cikin marasa lafiya da masu ciwon sukari, kuma wani lokacin a cikin yara masu kamar suna da lafiya, suna buƙatar saurin, daidaitawa da daidaita ayyuka daga iyaye da manya a kusa. Abu na biyu, alamomin wa annan coms suna da takamaiman bayani, har ma wani mashahurin mashaidi wanda ba shi da alaƙa da magani zai iya fahimtar su kuma, tare da ƙwaƙƙwarar ƙwayar cuta, samar da taimakon farko na tilas.

Ga wadanda ba su sani ba, duka coma - duka mai ciwon sukari da kuma hypoglycemic - sune rikice-rikice na nau'in ciwon sukari wanda ba a daidaita shi ba. Koyaya, dabarun haɓaka waɗannan yanayin suna da asali daban-daban: idan ƙwayar cutar hypoglycemic ta dogara da hauhawar raguwar sukari cikin jini wanda ya haifar da abubuwa daban-daban, hypoglycemia, to lokaci mai tsawo wanda ba a taɓa lissafin girman glucose na jini ba - hyperglycemia yana haifar da cutar siga. Bayyanar cututtuka, magani, har ma da taimako na farko ga yaro da ke da asalin cutar endocrine an samo asali ne daga wannan bambanci.

Halin hypoglycemic da hypoglycemic coma

Don haka, hypoglycemia. Thearancin sukari mai ƙarancin jini na mai haƙuri tare da ciwon sukari yana da haɗari sosai, da farko saboda gaskiyar cewa in ba tare da glucose ba - hanyar samar da makamashi - ba wani sashin jiki na jikin ɗan adam wanda zai iya aiki a yau da kullun. Kuma kwakwalwa ita ce farkon wanda ya sha wahala a wannan yanayin, wanda ke haifar da alamun halayen hypoglycemia. Abubuwan da suka fi haifar da cututtukan hypoglycemia shine rikicewar abinci (tsallake abinci), isasshen abinci mai narkewa a jiki, matsanancin motsa jiki (sake, ba a daidaita ta abinci da canje-canje a cikin aikin insulin), kuskure a cikin insulin allurar, da kuma maimaita maye da / ko zawo, wanda ke rage buƙatar jiki ga insulin. Yanayin cututtukan jiki suna faruwa sau da yawa a gabanin cin abincin rana ko da dare, ƙasa da yawa - da safe ko da yamma. Hypoglycemia sau da yawa yakan faru a cikin makarantan nasare da yara na makaranta tare da ciwon sukari kuma da wuya a cikin jarirai.

Kodayake ana amfani da hypoglycemia ta hanyar haɓaka mai sauri a cikin lamba da tsananin alamun bayyanar, sauyawa a yanayin mai haƙuri yawanci yakan bi ta matakai daban daban masu nasara. Wani nau'i mai laushi na hypoglycemia a cikin yara ana nuna shi ta hanyar malaise, damuwa, hankali na tsoro, damuwa, rashin biyayya, gumi mai yawa (bayyanar gumi wanda ba a bayyana shi ba), fatar fata, palpitations, rawar jiki tsoka. Bayyanar jin yunwar halayyar halayyar mutum ce, ana iya jin firikwensin gogebumps a jiki, jin samun gashi ko zaruruwa a bakin ko a kan fata da ke gefenta, wani lokacin kuma ana lura da maganganun zubewa. Idan ba a ba da taimako na lokaci ba, yanayin yarinyar ya ci gaba da tabarbarewa, alamun bayyanar cututtuka masu ƙarfi ya bayyana, wanda ya haɗa da rikice-rikice, rashin iya hankali, magana mai raunin gani, hangen nesa da daidaituwa na motsa jiki, yana sa yaron ya zama kamar wanda ya bugu. Yaron na iya zama m ko eccentric, to, rasa sani. Sau da yawa a cikin yara, cututtukan hypoglycemia suna haifar da cututtukan kama da mai kama da amai.

Furtherarin raguwar sukari na jini yana haifar da yaro zuwa cikin halin rashin tasirin jini, wanda ke ɗauke da hoton mai zuwa. Yaron bai san komai ba, ya yi laushi kuma ya jike saboda tsananin ɗumi. Tazara lokaci-lokaci, akwai bugun zuciya mai sauri a hancin kusan numfashin numfashi na yau da kullun. Muhimmiyar bayyanar fasalin kwantar da hankalin mahaifa daga mai ciwon sukari shine rashin kamshin acetone a cikin iska mai nutsuwa. Yin amfani da glucoeter mai šaukuwa yana taimakawa cikin bayyanar cututtuka na yanayin hypoglycemic - matakin glucose a cikin jini tare da hypoglycemia yana da ƙasa da ƙananan ƙayyadaddun ƙa'idar, wanda yake 3.3 mmol / L na mutanen kowane zamani.

Taimako na farko. Tare da fara bayyanar cututtuka na farko na hypoglycemia (m mataki na hypoglycemia), ya zama dole kuma isasshen ma'auni shine shigar da ƙananan adadin ƙwayoyin carbohydrates masu sauƙin narkewa. Yaron da ke da ƙanƙanin hypoglycemia ya kamata a ba shi ɗan sukari, alewa, jam, zuma, glucose a cikin allunan, ruwan 'ya'yan itace kaɗan ko abin sha mai taushi (fanta, sprite, lemonade, Pepsi, da dai sauransu). Idan yanayin yarinyar ba ta inganta ba, dole ne a maimaita yawan samfurin da ke kunshe da sukari, sannan a kira rukunin motar asibiti. Fitar da abin sha mai kyau a cikin bakin mai haƙuri a cikin halin rashin sani ba mai yuwu ba ne - ruwan zai iya shiga huhu ya haifar da mutuwar yaron.

Gudanar da sinadarin glucagon, hormone wanda ke fitarda glucose na ciki daga hanta, shima yana nufin matakan taimako na farko ga cututtukan hypoglycemia. Yawancin lokaci wannan magani yana cikin ɗakin magani na gida na marasa lafiya da ciwon sukari - likitoci suna ba da shawarar ku sanya shi a cikin wurin da za a iya samun shi kuma sananne ne ga dangi da dangi na mara lafiya. Ana iya gudanar da Glucagon duka a gaban sani kuma a cikin yanayin rashin sanin mai haƙuri tare da hypoglycemia.

Idan an samo yaro tare da alamun hypoglycemic coma, dole ne a aiwatar da matakai masu zuwa. Da farko dai, ya zama dole a tabbatar da samun isashshen oxygen zuwa huhu - saboda wannan makasudin maballin da yake kan abin wuya an kwance shi, bel din ya kwance ko ya kwance, taga ko taga. Wajibi ne a juya yaro a gefenta (don hana harshe tsayawa) kuma tsaftace abubuwan da ke tattare da bakin ciki (amai, tarkace abinci, da sauransu). Wannan ya biyo bayan kira zuwa ga motar asibiti kuma a cikin layi daya (idan akwai) 1 mg na glucagon ana gudanar dashi intramuscularly.

A kowane hali ya kamata ku allurar insulin (koda kuwa an samo maganin a cikin abubuwan wanda aka azabtar) - a gaban cutar rashin haihuwa, gudanarwar insulin zai iya haifar da mummunan sakamako.

Babu ƙarancin haɗari fiye da hypoglycemia shine yanayin ƙara girman matakan sukari na jini mai haɓakawa da sifofin haɓaka irin na ƙoshin ciwon sukari. Hyperglycemia yana tattare da rashin aiki na mai da fats da sunadarai tare da samar da jikin ketone da acetone - abubuwa masu guba da ke tattare cikin jiki kuma suna haifar da mummunar illa ga gabobin ciki. Da aka ba da waɗannan rikice-rikice na rayuwa, wannan nau'i na lalata cututtukan ƙwayar cuta na mellitus ana kiran shi ketoacidosis, kuma coma wanda ke faruwa tare da ketoacidosis mai tsanani ana kiran shi ketoacidotic coma.

Ba kamar hypoglycemia ba, ketoacidosis yana haɓaka a hankali, yana sa ya yiwu a bincika yanayin kuma ya taimaka wa yaron. Koyaya, wani lokacin (alal misali, a cikin jarirai), ƙimar ci gaban ketoacidosis yana haɓaka da haɓaka kuma yana tsokani ƙima a cikin ɗan gajeren lokaci. Dalilin ci gaban ketoacidosis da ciwon sukari (ketoacidotic) shine insulin therapy tare da isasshen allurai, karin girma a jikin mutum na bukatar insulin gaba da tushen cututtuka daban-daban, maye, damuwa, raunin jiki, tiyata da wasu magunguna.

Matakin farko na ketoacidosis a cikin yara yana haɗuwa tare da damuwa, rashin ci saboda tsananin ƙishirwa, ciwon kai, tashin zuciya, amai, ciwon ciki, wanda zai iya cutar da cututtukan ƙwayar cuta na tsarin narkewa. Dry harshe da lebe, fa'ida da yawan urination da bacci an lura. Nan gaba, asarar hankali sannu-sannu yakan faru, raɗaɗi na ci gaba, numfashi ya zama mai zurfi da amo, ƙwayar kuma ta zama mai taushi da rauni. Fatar yara da ke da ketoacidosis sanyi ne, bushe, flaka da inelastic. Wani alama ce ta ketoacidosis shine bayyanar ƙanshin acetone daga bakin. Idan akwai glucometer a cikin ƙarfin ku kuma kuna da ƙwarewar amfani da shi, zaku iya ƙayyade matakin sukari na jini a cikin yaro - tare da ketoacidosis akwai matakan glycemia sosai - sama da 16-20 mmol / l.

Taimako na farko. Lokacin da alamun farko na ketoacidosis suka bayyana, ba shakka, ya zama tilas a hanzarta nuna likita. Ko da an gudanar da insulin ga jariri mara lafiya a kai a kai kuma a cikin allurai da aka tsara, haɓakar ketoacidosis yana nuna rashin wadatar magani da kuma buƙatar gaggawa na gaggawa. A wasu halayen, tattaunawa ta wayar tarho endocrinologist ya yarda, amma da zaran damar ziyartar fuska ta gabatar da kanta, dole ne ayi amfani da ita nan da nan. A cikin abincin mai haƙuri, mai ƙoshin mai yana da iyaka, an wajabta shan ruwan alkaline - ruwan alkaline mai ruwa, maganin soda, rehydron.

Taimaka wa yaro cikin yanayin rashin sani tare da alamun ketoacidotic coma ya kamata ko ta yaya ya fara da gabatarwar insulin. A zahiri, insulin a cikin irin wannan yanayin na iya kashe mai haƙuri. Abinda yake shine shine, samun insulin, shiga jikin mai haƙuri a cikin ketoacidotic coma, yana haifar da kwararar glucose mai yawa daga jini zuwa sel, yayin da glucose ya "jawo" ruwa mai yawa tare da shi, wanda ke haifar da haɓakar ƙwayar sel da tsoka ta jiki. Edema na gabobin ciki kuma, sama da komai, kwakwalwa, shima yana haifar da mummunan sakamako na maganin insulin da wuri, wanda wasu magunguna masu mahimmanci basa cikin wannan halin. Ana buƙatar insulin insulin - amma sai, bayan isowa da matukan jirgin motar asibiti da kuma asibiti na yaron. A hanyar, tuna - babu insulin!

Babban aikin mai ceto a cikin irin wannan yanayin shine kiyaye mahimmancin ayyukan jikin yaro kafin likitocin su isa (motar asibiti ya kamata a kira shi nan da nan bayan an gano ɗan da ba shi da masaniya). Don wannan dalili, dole ne a kunna yaro a cikin ciki, tabbatar da hanyar iska, yantar da bakinsa daga jikin baƙi, abinci da amai. Dole ne a lura da hanyar jirgin sama da yanayin numfashi yayin tsawon lokacin jira na jirgin motar asibiti - wannan shine babban aikin mai ceto da bai cancanta ba kuma babban kulawa ta ƙwararrun da suka wajaba ga yaro a cikin yanayin cutar ketoacidotic.

Coma da yanayin da ke gabanshi yanayi ne na tashin hankali, matsananciyar damuwa wanda zai iya tayar da hankali ko da mazan da ke da nutsuwa. Amma dole ne mu tuna cewa ba kawai kiwon lafiya ba, har ma da rayuwar yaro ya dogara da daidaito, daidaituwa, daidaito da saurin matakan ceto a wannan yanayin. Wajibi ne a haɗu sosai gwargwadon abin da zai yiwu kuma a mai da hankali ga ayyukan da aka yi. Kuma ana iya barin motsin rai don wani lokaci. Kula da lafiyar ka!

Siffofin hypo- da hyperglycemic jihar a cikin yara

Yaro mara lafiya ciwon sukari , yana yawan fuskantar wasu abubuwan jin kai yayin girma da rage adadin sukari a cikin jini. Abun ciki na haila ya faru ne sakamakon kaifi

da zubewar sukari jini kwatsam, tare da yawan yawan insulin ko kuma rashin isasshen abinci bayan allurar insulin.

Yaron ya zama kamar baƙi, ya zama naƙasa kuma yana iya gab da rasa hankalin,

Ba ya nuna hali kamar yadda koyaushe yake yi, yana iya kwantar da hankula, ko kwanciyar hankali ko, a taqaice, ya zama m,

Mai rawar kai zai iya doke shi

Yaron yayi gumi mai yawa, amma fatarsa ​​tayi sanyi,

Ruhun numfashin yara yakan zama sau da yawa, na sama da na nesa, amma ba za a sami ƙamshin acetone a ciki,

Sau da yawa akwai tashin zuciya ko ciwon kai,

Yaron zai sami ɗan rudani - ba koyaushe yake amsa tambayoyin mafi sauƙi ba.

Idan a wannan lokacin ba a bai wa yaro wani abu mai daɗi (zai fi dacewa a cikin abin sha), to, zai iya rasa hankali kuma dukkan alamun cutar rashin ƙarfi ta haɓaka.

Idan kun lura da alamu da yawa waɗanda ke nuna alamun rashin ƙarfi a cikin yaro, dole ne ku yi waɗannan abubuwa nan da nan:

Ka ba shi ɗan sukari, abin sha na glucose (ko allunan glucose), ko kowane abinci mai daɗi. Lokacin ingantawa, sake sanya masa kayan sawa,

Bayan yanayin ya inganta, nuna wa ɗan likita ga likita kuma gano dalilin da yasa yanayin jikin nasa ya karu, ko ya kamata a sake duba yawan sinadarin insulin,

Idan kayi asara, saika fara bincike

Hanyar iska, idan kuma numfashi ya tsaya, farawa yi iskancin mutum ,

A lokaci guda, nemi wani ya kira gaggawa cikin gaggawa. Lokacin da kuke kira, tabbatar cewa sanar da cewa yaro yana da cutar rashin haihuwa na jini,

Lokacin da alamun farko na hypoglycemia ya bayyana, bai kamata a bar ɗan yaro shi kadai a makaranta ko a gida na minti daya ba!

HYPERGLYCEMIA a cikin yaro shima yana da halaye nasa. Cutar sankarau (hyperglycemia) tana haɓaka cikin yara tare da ƙarshen bacci da kuma rashin taimako na warkewa mai mahimmanci a farkon cutar.Hakanan a cikin abin da ya faru na iya taka rawa kamar abubuwan da suka faru na keta tsarin mulki, hauhawar abin damuwa, kamuwa da cuta. Alamomin cutar sankara mai cutar siga a cikin yaro:

Yaron yakan ziyarci bayan gida,

Fata ya yi zafi ga tabawa, fuskar “tana ƙonewa”,

Ya zama mai bacci da bacci,

Gunaguni na rashin lafiya

Yaro koyaushe yana kuka da ƙishirwa

Rashin ruwa da amai suna bayyana

Kamshin iska wanda ɗan yaro yayi kama da ƙanshin acetone ko apples mai narkewa,

Numfashi ya zama mai yawa kuma mara karfi.

Idan a wannan lokacin ba a taimaka wa yaro ba, to

zai yi asarar hankali kuma yanayin rashin farin ciki zai zo.

Lokacin da alamun farko na hyperglycemia ya bayyana, ya kamata a ɗauki matakan da ke gaba:

Tambayi yaro ko ya ci abin da bai dace da shi ba,

Gano idan an ba da allurar insulin

Nuna wa yaron halartar mahaɗan,

Idan yaron bai saninsa ba, kana buƙatar bincika hanyar iska kuma ka tabbata cewa numfashinsa al'ada ne,

Idan numfashi ya tsaya - nan da nan saika fara yin bakin-da-bakin mutum kamar yadda yake juya numfashi,

Yana da gaggawa a kira motar asibiti. Lokacin kiran, dole ne a faɗi cewa watakila ɗan masu fama da cutar sankara .

Kula da ciwon sukari a cikin yara ya kamata ya zama cikakke, tare da amfani da tilas na insulin da maganin rage cin abinci. Jiyya yakamata ya haɗa da kawai sauƙaƙe hanyar cutar ba, har ma da samar da ingantaccen haɓaka na jiki. Abincin abinci mai gina jiki ya kamata ya kasance kusa da tsarin dabi'un shekaru, amma tare da ƙuntataccen kitse da sukari. Yin amfani da carbohydrates mai-girma ya kamata a iyakance. Tare da haɓaka a cikin hanta, duk kayan yaji da soyayyen ya kamata a cire su daga abincin yaran, yakamata a fitar da abinci. Ana saita yawan insulin na yau da kullun sosai, yin la'akari da glycosuria na yau da kullun. Ana amfani da lissafin yau da kullun na insulin da aka tsara a karo na farko za'a iya kirga cikin sauƙi ta hanyar rarraba asarar yau da kullun a cikin fitsari da biyar. Duk canje-canje a cikin alƙawarin da sashi na insulin ya kamata ne kawai ta hanyar endocrinologist.

Bayan bacewar alamu na coma, kofi, shayi, mahaukata, kumallo, masara, masara, minced nama, ruwan 'ya'yan itace. A hankali canza zuwa abinci mai gina jiki tare da mai mai iyaka. Lokacin da aure

ramuwa, zaku iya canja wurin mai haƙuri zuwa haɗuwa da jiyya tare da yin amfani da insulin mai tsawo.

Ciwon sukari mellitus a cikin yara

LudmilaSatumba 6, 2011Cututtukan Endocrine a cikin YaraBabu Sharhi

Yana nufin mafi yawan cututtukan endocrine.

Etiology da pathogenesis . Yaran yara daga masu ciwon sukari ba su da ɗan ƙima (8-10%), amma ciwon sukari a cikin yara yana faruwa tare da babban digiri na rashin ƙarfi na insulin, wanda ke ƙayyade tsananin cutar tasa. A cikin etiology na ciwon sukari akwai batutuwa da yawa ba a warware su ba.

Ciwon sukari a cikin yara cuta ce ta cututtukan gado, yanayin aikin ƙarancin gado har yanzu ba a sani ba. Yanayin gado na polygenic wanda ya ƙunshi dalilai da yawa ana gane shi. Yanzu ana haifar da ciwon sukari mellitus na insulin saboda cututtukan autoimmune, abin da ya faru wanda ya fi yawa bayan cututtukan da ke kama da cutar. An tabbatar da kasancewar insulin a cikin farji, sakamakon ci gaban wanda shine karancin insulin. Sakamakon rashi na insulin, rikice-rikice na rayuwa daban-daban na ci gaba, babban cikinsu akwai rikice-rikice na metabolism, haɓakar hyperglycemia, glucosuria, polyuria. Fat metabolism yana da illa (haɓakar lipolysis, rage lipo-synthesis, karuwar haɓakar kitse mai narkewa, jikin ketone, cholesterol). Take hakkin da konewa daga carbohydrates a cikin tsoka nama take kaiwa zuwa lactic acidosis. Acidosis kuma saboda karuwa neogenesis. A sakamakon haka, karancin insulin shima yana lalata protein da kuma ma'adinin ruwa.

Don gano ainihin rikicewar ƙwayar metabolism, ana amfani da daidaitaccen haƙuri na glucose. Musamman kulawa a wannan batun ana buƙatar yara daga ƙungiyar haɗari, wanda ya haɗa da yara waɗanda aka haife tare da nauyin jiki fiye da 4,500 g, yara waɗanda ke da tarihin ciwon sukari masu nauyin sukari, suna da kumburi na huhu, suna da kiba sosai, da sauransu.

Hoto na asibiti. Bayyanannin asibiti na kamuwa da cutar siga sun dogara da yanayin cutar. Tsarin ciwon sukari mellitus ya inganta ta M.I. Martynova. Bayyanar ciwon sukari na bayyanar cututtuka ana nuna shi ta bayyanar ƙishirwa, polyuria, dare da rana rashin daidaituwa na urinary, ya karu ko, mafi wuya, rage cin abinci, asarar nauyi na yara, rage yawan aiki, rashin ƙarfi, aikin ilimi, haushi. A wannan matakin na ciwon sukari, ana gano mai amfani da hyperglycemia da glycosuria. Mafi sau da yawa, farkon lokacin karatun na cutar (a ko'ina cikin shekara) ana nuna shi ta hanyar labile da ɗan ƙaramin buƙatar insulin. Bayan watanni 10 na jiyya, cikakken biyan diyya na iya faruwa a cikin kashi 10-15 na yara marasa buƙatar insulin ko ƙaramin buƙatun yau da kullun (har zuwa 0.3 U / kg). A ƙarshen shekarar cutar sankara, buƙatar insulin tayi girma, amma a cikin tsari mai zuwa yana daidaitawa.

Lokacin rikicewar degenerative ana saninsa da babban buƙatar insulin, wani lokacin juriya insulin juriya, musamman a cikin lokacin prepubertal, kuma a gaban sauran cututtukan ciwon sukari (cututtukan haɗin gwiwa, yanayin damuwa).

Matsayi na asibiti da kuma ramawa a cikin ciwon sukari mellitus ana nuna shi ta rashin alamun alamun cutar da rashin daidaituwa na tafiyar matakai na rayuwa: normoglycemia ko glycemia babu fiye da 7-8 mmol / l, yawan glycemia na yau da kullun ba fiye da 5 mmol / l ba, rashin glucosuria ko ƙarami excretion na sukari a cikin fitsari - ba fiye da kashi 5 na darajar sukari na abinci. Kulawa na asibiti ana nuna shi sakamakon rashin gunaguni da alamomin asibiti na ciwon sukari tare da ci gaba da rikice-rikicen metabolism da mai mai.

Akwai digiri na biyu na lalacewa (ba tare da ketoacidosis ba) da kuma lalata ketoacidotic, wanda ke barazanar haɓaka ƙwayar cutar sankara yayin rashin tallafin kan lokaci ga yaro mara lafiya. Abubuwan da ke haifar da haɓakar ƙwayar cutar sankara na iya zama daban-daban: ƙarshen jinyar cutar sankara, ƙetare abincin, insulin therapy, ban da cututtukan ciki da yanayin damuwa.

Mafi yawan halaye na asibiti da na rayuwa wanda ke haifar da ƙwayar cutar sankarau a cikin yara ita ce coma na hyperketonemic (ketoacidotic), abubuwan da ke faruwa na asibiti wanda ya haifar da ci gaban acidosis mai zurfi, ketoacidosis, bambance-bambance na hauhawar jini da rikicewar ma'aunin electrolyte tare da faɗuwar rashin ruwa. Domin matakin I coma, amai, tashin hankali, rauni, ƙaruwa da ƙishirwa, polyuria, rage cin abinci, bayyanuwar tashin zuciya, amai, da ƙamshin acetone daga bakin halayyar halayyar ne. Matsayi na II an san shi ta hanyar lalacewar zurfin ciki (soporous state), raunin aikin jijiyoyin jini (saukar da karfin jini, sautin jijiyoyin bugun gini, raguwar narkewar ƙasa), polyuria, madadin tare da oliguria, vomiting, tsoka tashin hankali, hayaniya, numfashi mai zurfi, hyporeflexia. Ana nuna halin coma na III ta hanyar cikakkiyar asarar sani, rashi mai kauri ga tsarin zuciya da jijiyoyin jini (cyanosis, jijiyoyin jijiyoyin bugun zuciya, cutar kansa, abin da ke faruwa na edema), yanayin yanayin numfashi, yanayin bege. A banan asalin na ciki, mai yiwuwa ci gaban tarin cututtukan mahaifa na ciki. Tsarin alamar cututtukan jini na jini na iya haɓakawa: babban sigogi na jan jini, leukocytosis tare da canzawa, kasancewar sinadarai, abubuwan haɗin kai da silinda a cikin fitsari.

Tare da ciwon sukari a cikin yara, ana iya lura da cutar hyperlactac cutar coma. Wani fasalin bayyanannin asibiti na wannan zaɓi shine farkon farkon gazawar numfashi, tare da gunaguni na jin zafi a cikin kirji, a bayan sternum, a cikin yankin lumbar da kuma zuciya. Sharpwararren ma'adinin acidosis mai kaifi da ƙimar maƙarƙashiyar glycemia mai halayyar halayyar halaye ne.

Zabi na uku don kamuwa da cutar siga mai kamuwa da cuta a cikin yara na iya zama coma na hyperosmolar, wacce ke tattare da rikice-rikice na jijiyoyi: damuwa, tashin hankali, zazzabi, da zazzabi. Ana haifar da rikicewar ma'adanai ta yawan ƙwayar cuta, haɓakar ƙwayar ƙwayar ƙwayar magina, haɓaka matakin chlorides, furotin gaba ɗaya, ƙwayar nitrogen, urea, rashin ketoacidosis, acidosis, da ƙonewa mai kaifi.

Hanyar ciwon sukari a cikin yara za a iya rushe shi ta hanyar haɓaka yanayi na hypoglycemic da hypoglycemic coma, abubuwan da ke haifar da bambanci: cin zarafin abinci, ƙarancin insulin, motsa jiki mai yawa. Matsayin hypoglycemic shine halin da gajiya, damuwa, jin daɗi, gumi, pallor, rauni na tsoka, rawar jiki, yunwar, bayyanar babban raunin jijiya. Tare da haɓakar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta, cikakkiyar asarar hankali, an lura da tonic-clonic spasms na choreoform da motsi athetous, mono-da hemiplegia ana lura. A cikin ƙananan yara, harin hypoglycemia na iya nunawa ta hanyar tsananin farin ciki, kururuwa, yanayin tashin hankali, rashin kulawa. Hypoglycemia yawanci yakan faru ne yayin da matakin sukari da ke cikin jini ya faɗi ƙasa da al'ada, dukda cewa yanayin hypoglycemic zai iya haɓaka tare da matakan sukari mai yawa na jini, amma tare da saurin raguwa cikin adadi mai yawa.

Cutar cutar . Ba shi da wahala a gaban alamun asibiti na cutar da bayanan dakin gwaje-gwaje. Dole ne a bambanta ciwon sukari daga insipidus na ciwon sukari, thyrotoxicosis. A yayin haɓakar ƙwayar cutar sankara, ana buƙatar rarrabewa game da. appendicitis, meningitis, amai. Rashin daidaituwa na coma ya bambanta da kwayar cuta.

Hasashen . An tabbatar dashi ta kasancewar raunuka na jijiyoyin bugun gini.

Jiyya . Babban ka'idodi don magance cututtukan sukari a cikin yara shine maganin abinci, yin amfani da shirye-shiryen insulin daban-daban da kuma bin abincin. Ana rarraba darajar kalori na yau da kullun na abinci kamar haka: don karin kumallo - 30%, don abincin rana - 40%, don shayi na yamma - 10%, don abincin dare - 20%. Saboda furotin, an rufe 15-16% na adadin kuzari, saboda mai - 25%, saboda carbohydrates - 60%. Ana yin la'akari da darajar sukari na abinci (kashi 100 na carbohydrates, furotin 50%), wanda ba a buƙatar wuce 380-400 g na carbohydrates a rana. Don lura da yara, ana amfani da magunguna na insulin daban-daban (Table 21). Shawarar da aka ba da shawarar kwasa-kwasan magani na bitamin, angioprotectors, choleretic da magungunan hepatotropic

Jiyya cutar sankarau a cikin yaro

Mai tsananin ciwon sukari a cikin yaro

Ana kuma bambanta ciwon sukari mellitus da tsananin yawa.

Ciwon sukari - Ana yawaita matakan sukari na jini zuwa 7.8-9 mmol / l, sukari a cikin fitsari na iya zama ba ya nan ko an ƙaddara shi a cikin adadi kaɗan - har zuwa 1%. Har zuwa wannan, ketoacidosis na ciwon sukari da coma har yanzu basu faru ba, babu rikitattun micro- da macro-vascular. Angiopathy (canje-canje a cikin tasoshin kwayar ido) da lalacewar koda (nephropathy na 1 zuwa digiri na biyu) na iya faruwa.

Matsakaicin ciwon sukari - matakin sukari na jini har zuwa 11-16 mmol / l, a cikin fitsari - har zuwa kashi 2-4%, an riga an lura da lamuran ketoacidosis, i.e. masu fama da cutar sankara Akwai rikice-rikice: ciwon sukari na retinopathy (sclerosis na retina) na digiri na 1, nephropathy na digiri na 3 (ƙwayoyin microscopic mai yawa sun bayyana a cikin fitsari), arthropathy, hiropathy (iyakance motsi na gidajen abinci, akasari hannaye, yana faruwa a 15-30% na matasa tare da ciwon sukari na mellitus), angiopathy na kafaffiyar digiri na 2-3 na (takaita ƙananan ƙananan tasoshin kafafu), polyneuropathy na ƙarshen (raunin jijiyoyin - raguwa ji na hankali).

Cutar sankarar mama - matakan sukari na jini suna canzawa, na iya zama sama da 16-17 mmol / l, ana bayyana rikice-rikice na rayuwa, akwai ingantaccen hanya na ciwon sukari mellitus - ketoacidosis akai-akai (kasancewar acetone a cikin fitsari), coma. Matsalar ci gaba: ciwon sukari na retinopathy na digiri na 2-3, nephropathy na 4 (furotin a cikin fitsari) ko digiri na 5 tare da gazawar renal, neuropathy na gabobin daban-daban tare da ciwo mai zafi, encephalopathy (dysfunction na tsakiya juyayi tsarin), osteoarthropathy, chiropathy Digiri na biyu, digiri na macroangiopathy (takaita manyan jiragen ruwa na kafafu da hannaye), kamuwa da cutar sankara, ciki har da rage hangen nesa, jinkirta ci gaba ta jiki da jima'i (Moriak da Nobekur syndromes).

Ciwon sukari Ana aiwatar da shi don rayuwa kuma shine maganin maye, i.e. yana rama rashin karancin kwayoyin halittar insulin a cikin jikin mutum, ya rama rashin rashi ko rage kayan da yake samu a cikin sel. Commonlyarancin yau da kullun, a cikin iyalai inda kakaninki, kawaye ko inna sunada rashin lafiya tare da ciwon sukari, cutar ta bayyana kanta a cikin ƙuruciya ko lokacin samartaka kuma tana faruwa azaman ciwon sukari na 2. Koyaya, akwai 'yan waɗannan yara da balagaggu, kusan 4-5% na yawan yaran da ke fama da ciwon sukari. Bugu da kari, kiba abu ne wanda yake taimakawa ci gaban kamuwa da ciwon sukari na 2. Wasu iyalai suna da tsarin abinci. Iyaye suna yin ƙoƙari da yawa don sa yaron ya ci abinci mai yawa. Kididdiga ta nuna cewa sama da kashi 10% na daliban sakandare sun yi kiba ko kiba. Mafi sau da yawa, wannan kiba shine sakamakon tsatsar gado, tsarin mulki da kuma yin kiwo. Amma kowane irin kiba yana haɗuwa ba kawai ta hanyar raguwar jiki na ɗan yaro da raguwa a cikin aikinsa ba, har ma da rikicewar ƙwayar cuta, wanda ke haifar da cututtukan cututtukan zuciya da tsarin narkewa, kuma a cikin yara masu yawan haihuwa suna samun ci gaba da ciwon sukari.

Halin rayuwa mai haɗari wanda ya haifar da raguwa a cikin insulin shine coma mai ciwon sukari. Anyi la'akari da rikitarwa na ciwon sukari, kuma yana haifar dashi ta hanyar rashin daidaituwa tsakanin sukari jini da jikin ketone. Yana da gaggawa don ɗaukar matakan don ceton mai haƙuri.

Me ke haifar da cutar rashin lafiyan ciki?

Rashin daidaituwar carbohydrate-alkaline na iya haifar da maye gawar jiki, da kuma tsarin jijiyoyi baki daya, sakamakon haifar da kwayar halitta. A sakamakon wannan, jikin ketone yana fara tarawa a cikin jiki, har ma da acid (beta-hydroxybutyric da acetoacetic). Saboda wannan, bushewar jiki baki daya yana faruwa. Jikin Ketone yana shafar cibiyar numfashi. Mai haƙuri ya fara jin ƙarancin iska, yana da wahala yin numfashi.

Coma na faruwa ne sakamakon karancin ƙwayoyin narkewar ƙwayoyi. Tare da karancin samar da insulin a cikin hanta, an kirkiro karamin adadin glycogen, wanda ke haifar da tara sukari a cikin jini da abinci mai gina jiki mara kyau. A cikin tsokoki, ana ƙirƙirar samfurin matsakaici a adadi mai yawa - lactic acid. Canje-canje a cikin metabolism metabolism yana haifar da keta abubuwa iri daban-daban.

Yayinda glycogen ya zama ƙasa a cikin hanta, mai mai daga wurin ɗakin an tattara shi. Sakamakon wannan, ba ya ƙonewa gaba ɗaya, kuma jikin ketone, acid, acetone sun fara tarawa. Jikin yana rasa mai yawa abubuwan abubuwan ganowa. A wannan yanayin, taro na salts a cikin taya yana raguwa, acidosis yana faruwa.

Hyperglycemia

Tare da matakan girman sukari na jini, mai haƙuri na iya fada cikin ɗayan lumps masu zuwa:

• Hyperosmolar. Ana nuna shi ta hanyar tashin hankali na rayuwa, yawan sukari yana ƙaruwa, rashin ruwa a jiki yana faruwa a matakin salula. Amma, ba kamar sauran nau'in coma ba, mai ciwon sukari tare da ƙwayar cutar hyperosmolar ba zata jin ƙanshi na acetone daga bakinsa. Wannan rikitarwa galibi yana tasowa ne a cikin mutanen da basu wuce shekaru 50 ba, amma wani lokacin yakan faru a cikin yara 'yan ƙasa da shekaru biyu idan uwar ba ta kamu da ciwon suga na 2.
• Cutar Ruwa. Ya bayyana ne sakamakon anaerobic glycolysis, lokacin da ba'a yi amfani da glucose ba, don haka jiki yana son samun makamashi don rayuwarsa. Don haka hanyoyin fara faruwa, suna haifar da haifar da abubuwan lalata na acidic waɗanda ke cutar da tasirin zuciya da jijiyoyin jini. Alamun wannan yanayin shine matsanancin amai, amai, ko rashin tausayi.
• Hyperglycemic (ketoacidotic). Irin wannan rashin lafiyar ana tayar da hankalin ta wurin rashi ko kuma rashin kulawa mai kyau. Haƙiƙar ita ce cewa tare da isasshen ƙwayar insulin ko rashinsa, ƙwayoyin jikin ba sa ɗaukar glucose, saboda haka kyallen takan fara yin "matsananciyar yunwa". Wannan yana haifar da matsanancin aiki wanda ke rushe mai. Sakamakon metabolism, kitsen mai da ketone jikin ya bayyana, yana ciyar da sel kwakwalwa na ɗan lokaci. A nan gaba, tara irin waɗannan jikin yana faruwa, kuma a sakamakon haka, ketoacidosis.

Hypoglycemia

Halin da ke faruwa tare da raguwa mai yawa a cikin tarowar jini. An tsokani shi ta hanyar ƙarancin abinci ko yawan insulin, da ƙarancin lokaci - wakilan hypoglycemic. Coma yana tasowa cikin kankanin lokaci. Wani yanki na sukari ko kwamfutar hannu na glucose zai taimaka wajen guje wa mummunan tasirin.

Ciwon sukari

Yawancin lokaci mai haƙuri ba ya fada cikin rashin lafiya nan da nan, wannan yanayin yana gab da precoma. Wannan yanayin yanayin da mai haƙuri ke fuskanta da yawaitattun maganganu masu banƙyama saboda damuwa a cikin tsarin juyayi na tsakiya. Mai haƙuri yana da:

• bari
• rashin hankali
• fitowar kumburi a fuska,
• kunkuntar pupilsaliban
• rikicewa.

Yana da mahimmanci cewa a wannan lokacin wani yana tare da mai haƙuri kuma yana kira da sauri ga motar asibiti don ma'aunin ya juya ya zama warkarwa.

Alamar cutar sankarau

Cutar sankarau ba ta faruwa nan da nan. Bayan yanayin riga-kafi, idan ba a dauki matakan ba, yanayin mai haƙuri ya dagula, ana nuna alamun masu zuwa:

• jin rauni
• nutsuwa
• ƙishirwa
• ciwon kai
• tashin zuciya da amai
• karancin jini
• bugun zuciya
• ragewan zafin jiki.

Mutum na iya rasa sani, tsokoki da fatar su sami natsuwa. Hawan jini ya ci gaba da raguwa.

Mafi kyawun alamar da zaku iya tantance farkon coma shine kasancewar ƙamshin acetone daga bakin. Cutar na iya zama ɗan gajere ko na tsawon awanni, ko da kwanaki. Idan baku dauki matakan taimako da suka wajaba ba, to mara lafiyar zai rasa hankali kuma ya mutu.

Wani muhimmin alama shine cikakkiyar rashin kulawa ga dukkan al'amuran. Hankali yana dushe, amma wani lokacin fadakarwa na faruwa. Amma a matsanancin matsayi, hankali zai iya rufe baki ɗaya.

Mene ne alamun coma a cikin ciwon sukari?

Likita na iya gano cutar sankarau ta hanyar bayyanar cututtuka masu zuwa:

• bushe fata da itching,
• m numfashi
• karancin jini
• da ƙishirwa
• janar gaba daya.

Idan baku dauki matakan ba, to yanayin mai haƙuri ya rikitarwa:

• amai yana zama muni, wanda ba ya kawo sauƙin kai,
• mafi muni ciki zafi
• gudawa na faruwa
• matsin lamba ya ragu
• m ne ya bayyana ta hanyar tachycardia.

Tare da ƙwayar cuta na hyperglycemic, alamu masu zuwa suna bayyana:

• jin rauni
• sha'awar cin wani abu,
• gumi
• rawar jiki duk jikin
• damuwa da tsoro.

Abin da ke jiran haƙuri bayan kamuwa da cutar sankara

Za'a iya gano sakamakon rikicewar cutar sankarau ta hanyar magana guda ɗaya: duk jikin yana rushe. Wannan na faruwa ne sakamakon yunwar da ake samu akai akai, wanda ke ƙaruwa da yalwar glucose a cikin jini.

Coma na iya yin tsawo sosai - daga sa'o'i da yawa zuwa makonni da yawa har ma da watanni. Sakamakonsa shine:

• daidaituwa daidaituwa a cikin motsi,
• magana mara fahimta
• hargitsi a cikin aikin zuciya, kodan,
• ingarma na wata gabar jiki.

Yana da matukar muhimmanci a samar da likita na gaggawa. Idan motar asibiti ta isa a lokacin da ba daidai ba, ƙwaƙwalwar ƙwayar cuta na faruwa.

Cutar sankarau a cikin yara

Sau da yawa, yara ƙanana ba koyaushe ake gano su daidai ba. Jihar precomatous galibi kuskure ne kasancewar kamuwa da cuta, meningitis, cutar ciki, amai. A kan wannan tushen, rashin daidaituwa ya taso, tun da yaro ya sami magani daban daban da taimako.

A cikin yara, ana bambanta nau'ikan coma. Mafi yawan cocin ketoacidotic. Iyaye suna buƙatar kulawa da yaransu, saboda wannan nau'in kwayar ba ta da wahalar ganewa. Alamomin cutar su ne:

• kullum sha'awar shan ruwa,
• urination akai-akai
• rage cin abinci
• asarar nauyi
• bushe fata.

Cutar Hyperlactatemic na iya faruwa a cikin yaro a kan asalin gaskiyar cewa rushewar glucose yana faruwa tare da isasshen oxygen, wanda ke haifar da tarin lactic acid. Duk waɗannan canje-canje na ƙwayoyin cuta suna haifar da bayyanar cututtuka:

• yaro ya zama mai wahala, wani lokacin m,
• karancin numfashi na faruwa
• rashin jin daɗi a cikin zuciya,
• tsokoki a cikin hannu da kafafu.

Yana da matukar wahala a tantance wannan yanayin a cikin yara ƙanana, musamman a cikin jarirai, tunda babu jikin ketone a cikin fitsari.

Kulawa ta gaggawa don cutar siga

Za'a iya hana nau'ikan coma daban-daban, kuma tare da kwayar cuta don rage yanayin haƙuri. Don yin wannan, kuna buƙatar sani game da kulawar gaggawa:

• A cocin ketoacidotic fara gudanar da insulin. Yawancin lokaci, ana gudanar da ƙananan allurai ta intramuscularly da farko, to, ana tura su zuwa manyan allurai cikin hanzari ko kuma a karkatar da su. An kwantar da mai haƙuri a asibiti cikin sashin kulawa mai zurfi.
• A hypermolar coma akwai gwagwarmaya na lokaci guda tare da bushewa da yawan sukarin jini. Saboda haka, ana gudanar da sinadarin sodium chloride a karkatar da hankali kuma ana gudanar da insulin a cikin jijiya ko intramuscularly. Ana ci gaba da sanya idanu kan yawan sukari na jini da jinin haila. An sanya mara haƙuri a cikin ɓangaren kulawa mai zurfi.
• A rikicewar ƙwayar cuta sodium bicarbonate, wanda kuma cakuda insulin da glucose, an gabatar dashi don taimakawa. Idan an lura da lalacewar, to an tsara polyglucin da hydrocortisone. Suna asibiti a sashin kulawa mai zurfi.

Maganin Cutar Cutar na Ciwon Mara

Tare da coma mai ciwon sukari, yana da matukar muhimmanci a fara magani a kan lokaci. A wannan yanayin, likitoci na iya yin amfani da waɗannan matakan:

• Ana gudanar da insulin a cikin ƙananan allurai, a cikin jijiya. Ana ɗaukar gwajin jini daga mai haƙuri kowane sa'o'i 2-3 don ƙuduri na sukari da fitsari don kasancewar sukari da acetone a ciki. Idan ba'a lura da tasirin ba, ci gaba da sake farfadowa da sauransu har mai haƙuri ya sake dawowa hayyacinsa kuma dukkan alamun kwayar cutar ta lalace.
• Don hana yawan wucewar insulin, jikin ketone ya ƙone, glucose yana allura awa daya bayan insulin. Wadannan allurar tare da glucose wani lokaci dole ne a yi su har sau 5 a rana.
• Don haka rushewar jijiyoyin jiki baya faruwa kuma don magance acidosis, ana sarrafa saline tare da bicarbonate na soda a hankali. Bayan awa 2, allura ta shiga tare da sinadarin sodium ya fara.
• Don aiwatar da abubuwan oxidative da sauri, ana yarda mai haƙuri ya shayar da oxygen daga matashin kai. Zuwa garesu suna amfani da murfin dumama.
• Don tallafawa zuciya, allurar da ke ɗauke da maganin kafeyin da camphor suna allura. An tsara mai haƙuri bitamin: B1, B2, ascorbic acid.
• Bayan mai haƙuri ya fita daga coma, an wajabta masa shayi mai zaki, compote, Borjomi. A hankali, kashi na insulin ya fara raguwa, ana gudanar dashi kowane awa 4. An bambanta abincin mai haƙuri tare da sabbin samfura, lokacin haɓaka shan magunguna yana ƙaruwa.
• An tsara abubuwan Lyotropic, waɗanda ke ƙunshe a cikin oat da shinkafa na shinkafa, cuku mai ƙananan mai da kwalin. Wajibi ne a iyakance amfani da abinci mai kitse. Sannan je zuwa farkon kashi na insulin.

Bidiyo: ƙwayar ciwon sukari da taimakon farko

Masanin zai faɗi game da nau'ikan, alamomin, abubuwan da ke haifar, sakamakon sakamakon rashin lafiyar masu ciwon sukari:

Ana iya samun bayyanar cututtuka da taimakon farko na cututtukan hyperglycemia da hypoglycemia a cikin bidiyon:

Dole ne ku yi hankali dangane da mai haƙuri da ciwon sukari. Allauki kowane nau'in magani da likitanka ya umarta, bi duk umarnin da shawarwari, kar a kula da su. Tabbatar da bin tsarin abinci. Hana hana samun ciki

Cutar sankara (mellitus) cuta ce mai hatsarin gaske na tsarin endocrine, tare da cikakken ko kuma karancin isasshen jikin mutum na insulin din hormone (daga Latin Latin, wani tsibiri) wanda cutar kumburi ta samar. Sakamakon irin wannan cin zarafi shine karuwa a cikin matakan glucose na jini (hyperglycemia), wanda ke haifar da rikice-rikicen rayuwa masu yawa. Cutar sankarau na daga cikin rikice-rikice na ciwon sukari, tare da mummunan yanayin mutum, yakan haifar da mutuwa.

A pathogenesis na cutar ne mai hadaddun. Babban dalilin cigaban kwayar cutar sankara a cikin sankara shine karuwa mai yawa a cikin sukarin jinin dan adam. Wannan na iya haifar da rashin insulin, magani mara kyau, ƙi abinci da wasu dalilai masu tayar da hankali. Ba tare da insulin ba, yin aiki da glucose a cikin jini bashi yiwuwa. A sakamakon haka, haɓakar aikin glucose da haɓakar haɓakar ketone yana farawa a cikin hanta. Idan matakin sukari ya wuce adadin ketones, mara lafiya ya rasa hankali, cutar glycemic na faruwa.

Iri cuta

Coma ga masu ciwon sukari yana da nau'ikan da ke ƙasa:

• ketoacidotic - yana haɓaka saboda tara ƙwayoyin ketones a jiki da isasshen amfanin kansu. A cikin magani, wannan cuta tana da suna - ketoacidosis,
• hyperlactac cuta - wani yanayin tsokani da tarawa a jikin lactate (wani abu da aka haɗu a sakamakon tafiyar matakai na rayuwa),
• hyperosmolar - wani nau'in musamman na cutar sankara wanda ke faruwa saboda rikicewar rayuwa a cikin jiki da cutar sankarar bargo,
• hyperglycemic - yana faruwa tare da karuwa mai yawa a cikin sukari na jini,
• hypoglycemic - wani mummunan yanayin da ke haɓakawa da ƙaddamar da raguwa mai yawa a matakin sukari na mai haƙuri.

Mahimmanci! Ba shi yiwuwa a bincika irin nau'in cutar sankarau. Idan rikitarwa ya inganta, ya kamata a kai mai haƙuri zuwa asibiti nan da nan.

Alamomin nau'ikan cututtukan cututtukan cututtukan mahaifa suna kama kuma yana yiwuwa a bincika takamaiman nau'in coma ta musamman tare da taimakon hanyoyin bincike.

Kuna iya samun ƙarin bayani game da alamun cututtukan ƙwayar cutar sankara.

Bayyananniyar bayyananniyar yanayin precatous sun hada da rauni, ciwon kai, ƙishirwa, yunwa, da sauran bayyanar

Alamomin gama gari na cutar siga

Alamun gama gari game da rikicewar ciwon sukari sune:

• jin ƙishirwa
• urination akai-akai
• gajiya, rauni, rashin lafiyar,
• m ko ciwon kai paroxysmal
• nutsuwa ko, a taqaice, tashin hankali,
• asarar ci
• karancin gani, wasu lokuta na faruwa,
• tashin zuciya, amai, amai.

Idan babu magani yadda yakamata, mara lafiya yana da yanayin cututtukan jini, wanda ake magana da shi a cikin aikin likita a matsayin coma na gaskiya.

Gaskiya ne

Coma na gaskiya a cikin ciwon sukari shine yanayin mai haƙuri, tare da waɗannan alamomin:

• m da mutane a kusa da kuma abubuwan da suka faru,
• rikicewar rayuwa tare da lokutan fadakarwa,
• A lokuta masu tsauri, babu wani tangarda da za a iya samu daga kashin waje.

Yayin bincike na waje, likita ya gano alamun halaye masu yawa:

• fata bushe,
• tare da hyperglycemic ko ketoacidotic coma, ana jin warin acetone daga bakin mara lafiya na bakin mutum,
• saukarwa mai kaifi cikin karfin jini,
• zazzabi
• laushi na gira.

Wannan yanayin yana buƙatar kulawa da gaggawa na likita, sau da yawa yana haifar da sakamako mai ƙari.

Alamomin cutar rashin daidaituwa

A cikin marasa lafiya da wannan nau'in rikitarwa, alamomin masu zuwa suna faruwa:

• Yunƙurin hauhawar yunwar,
• rawar jiki a jiki
• malaise, rauni, gajiya,
• ƙara yin gumi
• anxietyara yawan damuwa, haɓakar jin tsoro.

Idan a cikin 'yan mintina kaɗan mutum da ke da wannan yanayin bai ci wani abu mai daɗi ba, to akwai haɗarin asarar hankali, bayyanuwar maƙogwaro. Fatar mai haƙuri ta zama rigar, idanu suna da taushi.

Hyma na hyperglycemic coma shine mafi yawan nau'in rikitarwa na ciwon sukari, tare da alamu masu yawa mara kyau

Bayyanarwar hymamoma coma

Cutar sankarau ta wannan nau'in tayi haɓaka a hankali, daga sa'o'i da yawa zuwa wasu ranaku. A wannan yanayin, alamun da ke gaba suna faruwa:

• ci gaban rashin ruwa,
• general malaise
• neuralgic mahaukaci
• kwatsam motsi na gira, wani yanayi na son rai,
• fitowar ido,
• wahalar magana
• rage fitar fitsari.

Mahimmanci! Hypersmolar coma yana da wuya, ana gano shi musamman a cikin tsofaffi marasa lafiya.

Bayyanar cututtukan cututtukan mahaifa

Asibitin kwantar da hankalin mahaifa yana yawan shafa mai. Yana tasowa a hankali, tare da jinkirin raguwa cikin nutsuwa.

• ciwon kai wanda ba zai iya amsar magani ba,
• sanyi hannaye da kafafu
• ƙara yin gumi
• rauni
• bayyanar yunwar,
• yanayin kasawa
• jin zafi
• dogo na dantse,
• gajeriyar numfashi yayin tafiya, numfashi mai tsayi.

Mai haƙuri ya zama mai fushi, ya rasa ikon yin aiki, kuma da sauri ya gaji. Tare da hanya mai wahala, mutum yana fuskantar hangen nesa biyu, tashin zuciya, rawar jiki a hannu da kafafu, daga baya a duk sauran tsokoki na jiki. Wadannan bayyanar cututtuka ana kiransu precoma (precoatose state).

Mahimmanci! Lokacin da alamun da ke sama suka bayyana, zuwa asibiti ya kamata ya kasance nan da nan. Kowane minti na jinkirta na iya jefa rayuwar mutum.

Siffofin coma masu ciwon sukari a cikin yara

A lokacin ƙuruciya, wannan nau'in rikice-rikice yana tasowa a ƙarƙashin rinjayar abubuwan dalilai masu tayar da hankali. Dalilan sun hada da yawan wuce haddi da Sweets, raunin jiki, raguwar tafiyar matakai na rayuwa, rayuwa mai tsayayye, yanayin rashin ingancin magungunan insulin, magunguna masu inganci, rashin sanin makomar cutar.

Bayyanar cututtuka na kai hari a cikin yara suna da wahalar wucewa, damuwa, ciwancin abinci da yanayin ci gaba

Ayyukan kai harin sun hada da bayyanannun bayyanannun abubuwa:

• jariri ya koka da ciwon kai
• tashin hankali ya haɓaka, aiki yana ba da rashin kulawa,
• yaro ba ya ci,
• tashin zuciya sau da yawa tare da amai
• Akwai raɗaɗi a ciki
• mahaɗi sun sami inuwa mai duhu, ba za su iya fahimta ba.

A cikin mawuyacin yanayi, raɗaɗin ratsa jiki, akwai haɗuwa da jini a cikin feces, gira mai narkewa, hauhawar jini da yawan zafin jiki.

Daga cikin rikice-rikice a cikin yara akwai rashin ruwa, da ci gaban matsanancin cuta na gabobin ciki, jijiyoyin huhun ciki da na huhun ciki, abin da ya faru na gazawar koda, gazawar numfashi, da sakamako mai saurin kisa.

Binciko

Ana gudanar da gwaje-gwajen cutar sankara na masu ciwon suga a cikin yin amfani da binciken dakin gwaje-gwaje na jinin mai haƙuri. Don yin bincike, an wajabta mai haƙuri waɗannan nau'ikan gwaje-gwaje:

• janar gwajin jini
• gwaji na jini
• nazarin kwayoyin halittun fitsari.

Gwajin gwaji ya banbanta da nau'in coma. Tare da ƙwayar ketoacidotic, an lura da haɓakar fitsari a cikin jikin ketone. Hyperglycemic coma yana tare da haɓaka glucose na jini da fiye da 33 mmol / lita. Tare da hyperosmolar coma, ana gano haɓakar osmolarity na plasma jini. Ana amfani da coma na hypoglycemic low low glucose jini, ƙasa da 1.5 mmol / lita.

Taimako na farko

Tare da haɓaka ƙwayar cutar kansa a yara da manya, ya zama dole a samar wa mara lafiya da taimakon farko. Idan mutum bai san tunaninsa ba, to dole ne ka aiwatar da waɗannan matakai:

1. Kira motar motar asibiti.
2. Idan babu bugun jini da kuma numfashi, ya zama dole a fara tausayar zuciya kai tsaye da kuma yin hutu na wucin gadi. A wannan lokacin, ya wajaba a kula da tsabtawar yanayin numfashi.
3. Idan ana jin bugun zuciya, ana kula da numfashi, kuna buƙatar samar da damar yin amfani da iska mai kyau, 'yantar da mutum daga suttura mai ƙyafewa, ku kwance abin wuya.
4. Ya kamata a saka mai haƙuri a hagunsa, idan har ya yi amai, yana da muhimmanci a tabbatar cewa bai shaƙe ba.

Rayuwa da lafiyar mai haƙuri sun dogara da ilimin rubutu na kulawa ta gaggawa don haɓaka harin

Yayin kulawa ta gaggawa, yakamata a bawa coma mai shan mama ya sha. Idan an san cewa mummunan yanayi yana faruwa ne sakamakon raguwar glucose a cikin jini, ya kamata a bai wa mara lafiya abinci ko ruwan da ke ɗauke da sukari.

Moreara koyo game da taimakon farko na kamuwa da cutar siga.

Sakamakon

Cutar sankarar mahaifa cuta ce mai wuyar shaƙatawa wanda ke ɗaukar awoyi da yawa zuwa makonni da yawa har ma da watanni. Daga cikin sakamakon, akwai take hakkin daidaituwa game da motsi, cututtukan zuciya, cututtukan cututtukan hanta, hanta, wahalar magana, matsanancin yanayin, rashin hangen nesa, kumburi kwakwalwa, huhu, gazawar numfashi, mutuwa.

Matakan warkewa

Don hana sakamako mara kyau, yana da mahimmanci don fara magani a kan lokaci na rikitarwa. A wannan yanayin, mai haƙuri yana allurar insulin bayan wasu lokuta. A lokaci guda, ana yin gwajin jini don sanin gaban sukari da acetone a ciki. Idan babu sakamako, ana sake sarrafa glucose har sai an daidaita abubuwan da ake amfani da su na jini.

Don magance jikin ketone, ana gudanar da glucose awa daya bayan allurar insulin. Kimanin biyar za a iya yi a kowace rana irin wannan ayyukan.

Gabatar da gishiri tare da bicarbonate na soda yana taimakawa hana rushewar jijiyoyin jiki. Bayan 'yan awanni, ana gudanar da sinadarin sodium cikin ciki.

Kulawa da kai hari a cikin ciwon sukari mellitus an yi niyya don cire mai haƙuri daga coma, daidaita al'ada sigogi na ƙirar jini.

Yayin aikin jiyya, mara lafiya yana shayar da oxygen daga matashin kai, ana amfani da matattarar dumama zuwa ƙananan ƙarshen. Wannan yana samar da matakan tafiyar matakai.
Don kula da aikin zuciya, an ba mai haƙuri allurar tare da maganin kafeyin, bitamin B 1 da B 2, ascorbic acid.

Bayan mara lafiyar ya fito daga mahaifa, murmurewa kamar haka:

• saukarwa a hankali na yawan insulin,
• karuwa tsakanin tazara tsakanin shan magunguna,
• Dalilin shayi mai dadi, compote,
• banda mai, mai yaji, mai gishiri, mai tsami, soyayyen abinci,
• Tushen abincin shine hatsi, kayan lambu, 'ya'yan itatuwa, kayan kiwo.

Mahimmanci! Rashin bin ka'idodi na dawowa da kin yarda da magani na iya haifar da ci gaba da kai hari na biyu.

Tsinkaya ga mai haƙuri

Cutar sankarau ɗaya daga cikin sananniya ce mai haɗarin kamuwa da cutar sankara. Halin yana buƙatar kulawa da gaggawa na likita, magani mai dacewa, bin ƙa'idodin matakan kariya don hana rikice-rikice. Abubuwan da ake hangowa game da mara lafiya shi ne kawai a cikin yanayin yiwuwar shigar da lokaci zuwa asibiti. A lokaci guda, yana yiwuwa a daidaita yanayin mai haƙuri da hana mummunar sakamako na rashin lafiya.

A duniya, akwai mutane miliyan 422 da suka kamu da ciwon sukari. Wadannan mutane suna buƙatar yin amfani da magungunan maganin hypoglycemic na yau da kullun, amma saboda matakin ci gaban likitanci na yanzu, ci gaba da rayuwa mai gamsarwa yana da tabbas. Sakamakon mafi haɗari na ciwon sukari shine coma mai ciwon sukari, yanayin gaggawa yana buƙatar asibiti cikin gaggawa.

Menene coma mai ciwon sukari

Cutar sukari babban rashi ne na rashin hankali wanda ke faruwa a cikin masu ciwon sukari. Rashin insulin ko kuma jurewar insulin yana haifar da karancin glucose a cikin kyallen da tara sukari jini. Amsar wannan shine haɗin glucose ta hanta daga acetyl coenzyme A. Na samfuran samfurori tare da wannan tafarki na rayuwa sune jikin ketone. Sakamakon tarawar jikkunan ketone a cikin jini, canji a cikin acid-base da electrolyte ma'auni na faruwa, wanda ke haifar da abin da ya faru na mummunan rauni.

Iri daban-daban

Tare da ciwon sukari, ana samun nau'ikan wadatar coma:

1. Bambancin Ketoacidotic: don nau'in ciwon sukari na I.
2. Hyperosmolar coma: a cikin yanayin saurin hauhawar sukari a cikin nau'in ciwon sukari na II.
3. Cutar LactacPs - a cikin masu ciwon sukari tare da rikodin cututtukan cututtukan zuciya, hanta, kodan, anemia, guba, salicylates, girgiza.
4. Coma na hypoglycemic: idan kashi na insulin bai yi daidai da matakin glucose ba.

A cikin ciwon sukari na mellitus, coma ya haɓaka tare da abubuwan da ke tattare da glucose na jini masu zuwa: sama da 33 mmol / L don bambance-bambancen acidotic, 55 mmol / L don hyperosmolar, ƙasa da 1.65 don hypoglycemic.

• tsarin kulawa mara kyau
• kurakurai a cikin shan kwayoyi,
• rage aiki na jiki
• rashin cin abinci
• m rikitarwa na ciwon sukari lalacewa ta hanyar wasu cututtuka (na ciwon maɗamfari, endocrine, hankali, cuta daga cikin juyayi tsarin, da dai sauransu),
• danniya
• ciki.

A cikin ci gabanta, cutarda tare da ciwon sukari ya ratsa matakai huɗu, halayyar duk coma:

1. Tuni digiri na farko na ilmin halin tashin hankali yana faruwa ta hanyar rashin hankali. Ragewar shakatawa na jiki yana raguwa, amma ana kiyaye abin da aka yi wa azaba.
2. Digiri na biyu: Mai rauni yana ci gaba, kowane nau'in hankalin mutum ya lalace. Urination na ciki, ana lura da motsi na hanji. Numfashi mara nauyi yana faruwa.
3. Digiri na uku: Matsalar numfashi ya zama babban jiki. Sautin muryar ba ya nan. Rashin hankali daga tsarin jiki daban-daban ya shiga.
4. Digiri na huxu: canjin yanayi zuwa ga mahalli.

Alamomin halayyar kamuwa da cutar sankarau tare da hauhawar jini:

• mai yawan bushewa,
• ƙanshi na acetone yana fitowa daga haƙuri (rashi tare da ƙwayar hyperosmolar),
• rage ophthalmotonus,
• Kussmaul pathological numfashi (rashi tare da hyperosmolar coma).

Alamun cutar mahaifa:

• fata danshi
• increaseara cikin matsa lamba na jijiyoyin ciki - gashin ido mai tauri (alama ce ta "ido na dutse"),
• ɗaliban ɗalibai
• al'ada ko zazzabi
• babban adadin ci gaban bayyanar cututtuka.

Tare da siffofin acidotic na coma, jiki yayi ƙoƙari don rama hyperacidosis ta haɓakar alkalosis ta hanyar amfani da hyperventilation: saurin numfashi, yana zama na sama. Arin ci gaba na acidosis yana haifar da bayyanar numfashi na Kussmaul, wanda ke da alaƙa da:

• gagarumin zurfin numfashi
• wahalar fita
• tsayar da hutu tsakanin numfashi.

Precoa masu ciwon sukari

Coma a cikin ciwon sukari mellitus yana haɓaka hankali: daga hoursan awanni kaɗan zuwa kwanaki da yawa na iya wucewa zuwa asarar farkawa. Wani banbanci shine yanayin hypoglycemic. Coma ta gabaci wani yanayin da ke kara muni - rikicin masu cutar amai da gudawa. Alamomin ta sune:

• bayyanar cututtuka na maye maye: ciwon kai, gajiya, tashin zuciya, amai, rauni,
• fata mai ƙaiƙayi
• bushe da ƙishirwa,
• urination mai yawa.

A mataki na biyu na precoma, marasa lafiya sun faɗi cikin ɓoyi, canje-canje na numfashi ya faru, ciwo na pseudoperitonitis (ciwon ciki, tashin hankali na tsoka, alamun rashin ƙarfi na peritoneal), alamun rashin ruwa a jiki: bushewar fata da membranes na mucous, rage karfin jini na iya faruwa. Hypoglycemia ana saninsa da hauhawar tsoka, yawan jijiyoyin jiki, da kuma yin zufa.