Alamomin cutar sikari da kulawar gaggawa

Cutar sankarar mahaifa cuta ce da ke faruwa da masu ciwon suga. Yanayin yana tasowa a saurin walƙiya. Rashin daukar matakan gaggawa na iya haifar da mummunar matsalolin kiwon lafiya har ma da mutuwa. Saboda haka, yana da mahimmanci ga kowane mai ciwon sukari yasan menene alamun cutar alama da alamomi ke haifar da cutar sikari da kuma irin matakan da yakamata a ɗauka lokacin da aka gano su.

Iri Cutar Malaria

Akwai nau'ikan 4 na ciwon sukari: ketoacidotic, hyperosmolar, hyperlactacidem da hypoglycemic.

Nau'in nau'in ciwon sukari na 1 sau da yawa yakan ci gaba cocin ketoacidotic. Yana faruwa a kan asalin rashin insulin da hauhawar hauhawar jini. Sakamakon haka, rage yawan tasirin glucose, metabolism ya lalace, mummunan aiki ne na dukkanin tsarin kuma wasu gabobin na faruwa. Cutar Ketoacidotic tana tasowa a cikin kwanaki 1-2 (wani lokacin sauri). Matsakaicin sukari wanda ta faru a ciki na iya kaiwa zuwa 19-33 mmol / l kuma sama. Idan babu matakan dacewa, mai ciwon sukari na iya yin rauni sosai.

Ciwon sukari na 2 wanda yawanci yakan haifar ilmin mahaifa. Wannan nau'in kuma yana haɓaka saboda rashin insulin. Yana haɗuwa tare da ƙoshin fitsari na jiki da haɓakar ƙwayar sodium, glucose da ion ion a cikin jini. A karkashin tasirin hyperosmolarity, mummunan rikicewa yana faruwa a jikin mutum, wanda yawanci yana tare da asarar hankali.

Sauran nau'ikan cututtukan cututtukan guda biyu daidai suke da nau'ikan cututtukan biyu. Cutar HyperlactacPs ci gaba tare da tarawa da lactic acid a cikin jini. Dalilin shine karancin insulin. Sakamakon haɓaka na coma, halayen sinadarai na jini yana canzawa, kyautatawa, da rashin ashara mai yiwuwa ne.

Abubuwan da aka jera na coma sune hyperglycemic. Suna faruwa akan asalin hauhawar hauhawar jini. Juyin juya halin yana haifar da ci gaba rashin lafiyar hailala. Tattaunawa yana farawa tare da rage yawan glucose na jini zuwa matakin mahimmanci. Wannan yana haifar da matsananciyar yunwar kwakwalwa. Tare da hauhawar jini na jini, sukari na jini yana raguwa zuwa 3.33-2.77 mmol / lita. Idan kayi watsi da alamun da ke bayyana, matakin glucose na iya sauka zuwa 2.77-1.66 mmol / lita. A wannan yanayin, duk alamun halayyar cututtukan jini suna bayyana. Marasa lafiya tare da irin waɗannan alamomin dole ne su je asibiti don neman magani. Valuesimar sukari mai mahimmanci - 1.66-1.38 mmol / lita - yana haifar da asarar hankali. Taimako na gaggawa na kwararru ne kawai zai iya ceton mutum.

Kowane irin nau'in cutar sankarau na gaban kansa yana haifar da abubuwan da ke haddasa shi.

Hyperglycemic cututtuka ana haifar da shi ta dalilin karancin insulin, wanda ke haifar da saurin haɓaka glucose na jini. Mafi sau da yawa, abubuwanda zasu iya haifar da karancin insulin:

• ciki
• cututtuka
• raunin da aka samu da kuma tiyata,
• amfani da tsawo na glucocorticoids ko diuretics,
• yawan motsa jiki da yanayin damuwa,
• rashin cin abinci, tsawan azumi, yawan shan barasa.

Dalilin cutar ketoacidotic shine guba tare da jikin ketone da acetone. Rashin insulin yana sa jiki ya fara maye gurbin makamashi daga sunadarai da ƙwaya, bawai daga glucose ba. A yayin samar da makamashi mara kyau, an kirkiro ketones da acetone acetic acid a adadi mai yawa. Excessarinsu yana ɗaukar ajiyar alkaline kuma yana haifar da ketoacidosis (cututtukan ƙwayar cuta mai tsaurara) da damuwa a cikin metabolism na ruwa-electrolyte.

Za a iya haifar da ci gaban hyperosmolar ta yawan amfani da diuretics, zawo da amai da kowane irin yanayi, yanayin zafi da kuma babban iska, peritoneal dialysis ko hemodialysis, tsawan jini.

Cutar Lactaclera na iya haifar da bugun zuciya ko gazawar numfashi. Ciki wani lokacin yakan kamu da ciwon asma, mashako, gazawar jini, rashin lafiyar zuciya. Sau da yawa sanadin cutar ƙonewa shine kumburi da kamuwa da cuta, cututtukan hanta ko cutar koda. Marasa lafiya waɗanda ke fama da matsalar shan giya ma na cikin haɗari.

Dalilin rashin wadatar jini ya ta'allaka ne da karancin sukari na jini. Wannan yanayin na iya haifar da yawan yawan insulin ko rage magunguna na rage sukari. Sau da yawa hypoglycemia na faruwa ne saboda gaskiyar cewa mai ciwon sukari bayan shan insulin ya rasa abinci ko kuma ya ci isassun carbohydrates. Wasu lokuta matakan sukari marasa ƙarfi suna bayyanawa daga tushen ragewar aikin adrenal ko ƙirar insulin-inhibiting na hanta. Wani dalili na hypoglycemic coma shine aiki mai ƙarfi na jiki.

Alamomin cutar sankara mai cutar siga

Kowace nau'in coma mai ciwon sukari tana da halayen halayenta. Kodayake alamu sau da yawa suna kama da juna, za a iya gano cutar ta ƙarshe bayan gwajin gwaje-gwaje.

Hyma na hyperglycemic coma yana tare da alamun bayyanar da ke ƙasa.

• Thirstara yawan ƙishirwa.
• Urination akai-akai.
• Janar rauni, wanda yawanci yana tare da ciwon kai.
• Maganin tashin hankali, sai bacci ya kwashe shi.
• Rage abinci.
• Rashin ruwa (a wasu halaye tare da amai).

Daga cikin ƙarin alamun cututtukan hyperosmolar sune rashin ruwa mai narkewa, aikin magana mai rauni da kuma issilai (alamar halayyar kwayar ciki).

Alamun alamun cutar ketoacidotic suna bayyana a hankali. A wannan yanayin, likitoci suna da dama kafin rikicin don gudanar da cikakken magani. Koyaya, idan mai ciwon sukari bai kula da alamomin farko ba, to kuwa yanayin na faruwa, wanda yake nuna zurfin numfashi mai amo, jin zafi a ciki ba tare da wani takamaiman wuri ba, sanadi, mai yuwuwa. Alamar halayyar ƙwayar ketoacidotic shine ƙanshi na acetone daga bakin.

Cutar cututtukan ƙwayar cuta, da bambanci ga nau'in da ya gabata, yana ci gaba da sauri kuma yana bayyana kansa a cikin ɓarna na jijiyoyin bugun gini. Daga cikin alamun halayyar wannan kwayar cutar, mutum na iya lura da rauni na hanzari, anorexia, delirium, da kuma rauni mai rauni.

Bayyanar cututtuka na rashin lafiyar hypoglycemic kaɗan sun ɗan bambanta da alamomin cutar hyperglycemic coma. Waɗannan sun haɗa da tsoro, damuwa, karuwar gumi, rawar jiki da kuma tsananin jin yunwar. Idan baku dauki matakan da suka dace ba, yanayin yanayin jiki na iya lalacewa: rauni, rashi ya bayyana. Apopoe na hypoglycemic coma shine asarar sani.

Kasancewar ciwon sukari a cikin yara, abubuwanda suke haifar da ƙwayar cuta sune ciwon kai, tashin zuciya da amai, rashin abinci (har zuwa cikakkiyar rashi), ƙishirwa mai yawa, amai. Haka nan urination mai bushewa, bushewar harshe da lebe suma zasu yiwu.

Taimako na farko

Sanin bayyanar cututtukan cututtukan da ke fama da cutar siga zai taimaka ya dakatar da ci gabansa cikin lokaci. A farkon alamar tashin hankali, ya kamata a kira motar asibiti nan da nan. Kafin zuwan likitoci, ya kamata a bai wa mai ciwon suga kulawa ta gaggawa. Da farko dai, sa mara lafiya a gefan sa ko kuma a cikin sa. Bi harshe, ka tabbata cewa bai narke ba kuma baya sanya numfashi mai wahala. Bada izinin isashshen iska ya shiga dakin mai cutar siga.

Furtherarin gaba, don nau'ikan cututtukan kamuwa da cuta, dabarun kulawa sun ɗan bambanta. Tare da nau'in hyperosmolar, kunsa da ɗumi ƙafafun mai haƙuri. Binciki maida hankali na glucose tare da glucometer, gwada fitsari tare da tsiri gwajin ketone. Ba a bukatar wani karin mataki. Jira motar asibiti ta iso.

Nau'in Ketoacidotic da lactacPs na coma suna buƙatar saurin kai tsaye ta ƙwararru. A wannan yanayin, ba zai yi aiki ba don hana ci gaban ci gaba ta hanyar samun 'yancin kai. Abinda kawai zaka iya yi shine ka lura da numfashin mara lafiyar da bugun zuciyar har likitan ya iso.

Tare da cutar rashin haihuwa, yana da mahimmanci don samar da kulawa ta gaggawa cikin sauri. Yawancin lokaci wani nau'i mai laushi baya tare da asarar hankali. A wannan yanayin, mai haƙuri na iya ɗaukar matakan da suka dace. A alamomin farko na rashin lafiyar na kusa, kuna buƙatar cin abinci kaɗan na carbohydrates (gurasa, taliya), sha shayi tare da sukari ko narke allunan 4-5 na glucose. Mai tsananin rashin ƙarfi na haifar da rauni mai zurfi. Tare da wannan ci gaban abubuwan, wanda aka azabtar ba zai iya yin ba tare da taimakon waje ba. Idan mai haƙuri yana da narkewa mai narkewa, sha shi tare da kowane ruwa mai zaki (kar a yi amfani da abin sha tare da masu zaƙi na wannan). Idan babu wani abu mai narkewa, sai a ɗora ƙashin gyada a cikin harshe.

Ka tuna: tare da kowane nau'in coma mai ciwon sukari, ba'a yarda da insulin ba tare da izinin likita ba.

Bayan asibiti a cikin halin da ke fama da cutar sankara, babban burin likitoci shine a daidaita matakin glucose a cikin jini da kuma motsa jiki na jiki gaba daya. Jiyya yana faruwa ƙarƙashin tsayayyar kulawar likita kuma ya ƙunshi matakai da yawa. Da farko, ana bai wa mara lafiya kashi na insulin (idan ana maganar hypoglycemia, dole ne a gudanar da glucose). Abu na gaba, maganin jiko yana gudana tare da mafita na musamman don mayar da ma'aunin ruwa, abun da ke ciki da kuma daidaita ruwan acid. Bayan kwanaki da yawa na jiyya, an tura mai haƙuri zuwa sashin endocrinology kuma a ajiye shi a asibiti har sai yanayin ya daidaita.

Yana da mahimmanci a tuna cewa taimakon farko na lokaci mai kyau da kuma isasshen magani zasu taimaka wajen kawar da mummunan sakamako na cutar masu ciwon sukari: inna, ƙwaƙwalwar hanji, bugun zuciya, bugun jini, sepsis, coma na gaskiya ko mutuwa.

Cutar sankarau babbar cuta ce ga masu ciwon suga. Sabili da haka, masu ciwon sukari ya kamata su tuna cewa kawai tsananin horo, kulawa da nauyi, bin ka'idodi na abinci, aiki na yau da kullun da ƙin shan magungunan kai zasu taimaka rayuwa cikakkiyar rayuwa da kuma guji fitowar yanayin haɗari.

Iri daban-daban

Cutar sankarau na daga cikin nau'ikan masu zuwa:

• ketoacidotic,
• hyperosmolar
• maganin kashe kwari,
• hypoglycemic.

Abubuwan da ke haifar da ci gaba a cikin kowane nau'in coma sun bambanta. Don haka, sanadin ci gaban tasirin jini shine saurin hauhawa a cikin yawan sukari a cikin jini wanda yake haifar da asalin rashin ruwa. Wannan nau'in shine rikitarwa na nau'in ciwon sukari na 2.

Dalilin ci gaban ketoacidotic coma shine tara yawan acid da ake kira ketones a jikin mutum. Wadannan abubuwa samfurori ne na metabolism na mai mai, kuma ana samar dasu cikin rashin insulin. Wannan nau'in coma yana ci gaba da nau'in 1 na ciwon sukari.

Lactic acidic coma shine mafi tsananin rikitarwar ciwon sukari, wanda ke haɓakawa da tushen cututtukan zuciya, huhu, da hanta. Hakanan zai iya haɓaka idan mai haƙuri yana shan wahala daga ƙwayar buguwa ta jiki.

Dalilin ci gaban hypoglycemic coma shine raguwar raguwa a cikin taro na sukari a cikin jini. Wannan yanayin yakan faru ne da nau'in 1 na ciwon sukari. Abubuwan da ke haifar da raguwar sukari shine yawan abincin da ya dace ko gabatarwar insulin da yawa.

Symptomatology

Kowace nau'in coma yana da alamomin halayensa. Yana da mahimmanci a san su duka, saboda lokacin da alamun farko suka bayyana, nan da nan za a fara ba wa mai haƙuri kulawa ta gaggawa. Yin ɓoye lokaci na iya ɓar masa da rayuwarsa.

Alamomin cutar mahaifa:

• tsananin rashin ruwa
• mai aiki mara amfani,
• ba da baya
• nutsuwa
• ƙishirwa
• 'yan kwanaki kafin a fara daga cikin ƙwayar cuta, mai haƙuri yana da rauni da ƙwayoyin cuta,
• alada
• sautin tsoka yana ƙaruwa,
• tashin hankali yana yiwuwa
• ƙwanƙwara. Alamar halayyar ci gaban kwaro. Marasa lafiya na iya rasa wasu rashin shakatawa.

Alamun alamun cutar ketoacidotic suna bayyana a cikin haƙuri a hankali. Yawancin lokaci yakan ɗauki kwanaki da yawa. Amma a wannan yanayin, jinkirin yaduwa yana "a hannun" ga likitoci, saboda kafin farkon kwayar cutar ƙwaƙwalwar ƙwayar cuta akwai lokacin gano alamun bayyanar da ke bayyana da kuma gudanar da cikakken magani.

Bayyanar cututtuka na precoma na wannan nau'in:

• tashin zuciya da amai mai yiwuwa
• polyuria
• ƙishirwa
• rauni
• nutsuwa

Yayin da mara lafiyar ke kara lalacewa, an kara asibitin tare da alamun:

• numfashi ya zama mai zurfi da hayaniya
• tsananin amai
• matsanancin zafi a ciki, wanda ba shi da gurɓataccen fassara,
• ba da baya
• alamar halayyar wannan nau'in biri shine bayyanar ƙanshin acetone daga bakin,
• mai raunin hankali.

Ba kamar ƙwayar cutar ketoacidotic ba, lactic acidemia na ci gaba da sauri. Wannan asibitin an nuna shi ne ta dalilin rushewar jijiyoyin jiki. Wadannan alamu kuma suna faruwa:

• rauni da sauri
• tashin zuciya da gagging
• anorexia
• jin zafi a ciki,
• maganar banza
• mai raunin hankali.

Bayyanar cututtuka na cutar mahaifa:

• rawar jiki
• tsoro
• babban damuwa
• ƙara yin gumi
• janar gaba daya
• jin karfi na yunwar
• katsewa
• asarar sani.

Harshen cututtukan ƙwayar cutar siga daga yara:

• nutsuwa
• ciwon kai na abubuwa dabam dabam na tsananin karfi,
• tashin zuciya da gagging
• asarar abinci, har zuwa lokacinsa gaba daya,
• matsananciyar ƙishirwa
• polyuria
• harshe da lebe sun bushe.

Idan ba a ba da kulawa ta gaggawa ba, to kuwa numfashin yaron zai zama mai zurfi kuma yana da amo, hawan jini zai ragu a hankali, ƙwanƙwasa zuciya zai yi yawa, tsawan fata zai ragu kuma coma zai zo.

Kulawa ta gaggawa don cutar siga

Idan kun san alamun cutar rashin lafiyan cuta, to zaku iya hana ci gabanta a lokaci. Yana da mahimmanci, lokacin da suka faru, don kiran motar asibiti nan da nan kuma don samar da kulawa ta gaggawa don cutar sankarau da kansa kafin ta isa. Dabarar taimakawa tare da nau'ikan nau'ikan coma daban-daban daban.

Taimako tare da coma hyperosmolar:

• mai haƙuri ya juya gefe,
• Ka kiyaye harshenka don kada ya faɗi,
• ba da damar yin amfani da iska mai kyau.

Idan akwai matsalar cutar ketoacidotic, ya zama dole a kira likita kai tsaye, tunda ba zai yiwu ba a hana wannan yanayin da kanta. Kafin isowarsa, ya zama dole a hankali kula da yanayin numfashi da bugun zuciyar wanda aka cutar da shi. Guda guda matakan suna dacewa da yanayin bunƙasar coma acidic.

Idan bayyanar alamun alamun cutar rashin haihuwa, to yakamata a bawa mai sukari haƙuri nan da nan ko a sha shayi mai daɗi.

Matakan warkewa

Jiyya na ilimin halittar cuta ya ƙunshi matakai huɗu:

• kulawar insulin gaggawa
• daidaituwar ma'aunin ruwa a jikin mutum,
• normalization na ma'aunin ma'adinai da electrolytes,
• ganewar asali da kuma ingantaccen lura da cututtukan da ke haifar da rashin lafiya.

Babban mahimmancin jiyya shine don daidaita matakan sukari a cikin jini. Bugu da kari, hanya na lura lalle ne ya inganta ta hanyar jiko far. Ana gudanar da mai haƙuri a cikin hanyoyin magancewa wanda ke kawar da bushewa.

Jiyya na Pathology yana gudana ne kawai a cikin tsaran yanayi kuma a ƙarƙashin tsananin kulawar likitoci Yana da mahimmanci a tuna cewa wannan yanayin mummunan yanayin ne wanda, ba tare da dacewa da kuma isasshen magani, na iya haifar da mutuwa. Sabili da haka, yawancin lokuta ana gudanar da aikin jiyya a cikin yanayin farfadowa.

Sanadin da Matsalar Hadarin

Babban dalilin ci gaban kwayar cutar sankarau shine karancin insulin a jikin marasa lafiya da masu cutar siga. Wannan ba wai kawai ya haifar da karuwa bane ga tarin glucose a cikin jini ba, har ma ga rashi makamashi na kyallen kwayoyin halitta wanda ba zai iya daukar glucose ba tare da insulin ba.

Asingara yawan haɓakar hyperglycemia ya haɗu da haɓakar matsin lamba na osmotic a cikin ƙwayar extracellular da gubar ciki. A sakamakon haka, osmolarity na jini yana ƙaruwa, ƙarancin hypoglycemia yana ƙaruwa, wanda ke haifar da ci gaban yanayin girgiza.

Cutar sankarau babbar cuta ce da ke iya haifar da rikice-rikicen rayuwa.

Rashin insulin yana haɓaka haɗakar kitse mai guba daga nama adized, wanda ke haifar da samuwar ketone a cikin ƙwayoyin hanta (beta-hydroxybutyric acid, acetoacetate, acetone). Yawan samar da jikin ketone tare da tasirin acid yana haifar da raguwa a cikin taro na bicarbonate kuma, daidai da haka, matakin pH na jini, shine, an samar da acidosis metabolic.

Tare da saurin haɓakar hyperglycemia, haɓaka saurin hauhawa zuwa matakin osmolarity na jini, wanda ke haifar da keta alfarma na aikin ƙwayar jijiyoyi. Sakamakon wannan, marasa lafiya suna haɓaka hypernatremia, haɓaka mai ƙarfi na hyperosmolarity. Haka kuma, matakin bicarbonates da pH ya kasance cikin iyakoki na al'ada, tunda ketoacidosis ba ya nan.

Sakamakon rashi insulin a cikin sukari mellitus, ayyukan pyruvate dehydrogenase, enzyme wanda ke da alhakin juyawa da pyruvic acid zuwa acetyl coenzyme A, yana raguwa .. Wannan yana haifar da tarin pyruvate da canjinsa zuwa lactate. Mahimmin tarin lactic acid a cikin jiki yana haifar da acidosis, wanda ke toshe masu karɓar adrenergic na zuciya da jijiyoyin jini, yana rage aikin myocardial. Sakamakon haka, mummunan dysmetabolic da bugun zuciya na tasowa.

Abubuwa masu zuwa na iya haifar da cutar sankara mai kwakwalwa:

• kurakuran abinci mai haɓaka (haɗuwa da mahimmancin adadin carbohydrates a cikin abincin, musamman a sauƙaƙe digestible),
• take hakkin makirci don maganin insulin ko shan magunguna masu rage sukari,
• ba a zaɓa wa insulin far,
• mummunan tashin hankali,
• cututtuka
• m shisshigi
• ciki da haihuwa.

Iri cuta

Ya danganta da sifofin halayen cuta na rayuwa, ana rarrabe ire-iren wadannan cututtukan na mahaifa:

1. Ketoacidotic coma - saboda guba na jiki da kuma farkon tsarin juyayi ta jikin ketone, kazalika da ƙara damuwa a cikin ma'aunin ruwa da daidaitawar ma'aunin acid.
2. Hyperosmolar hyperglycemic non-ketone coma wani rikitarwa ne na nau'in ciwon sukari na II wanda ke dauke da shi, wanda ake nuna shi da ruwa na jijiyoyin ciki da kuma rashin ketoacidosis.
3. Cutar HyperlactacPs. Ciwon sukari mellitus shi kadai da wuya ya haifar da tarin lactic acid a jikin mai haƙuri - a matsayinka na mai mulki, karin yawan biguanides (magungunan hypoglycemic) ya zama sanadin lactic acidosis.

Mutuwar cikin ƙwayar ketoacidotic ya kai 10%. Tare da hyperosmolar hyperglycemic non-ketone coma, yawan mace-mace ya kusan 60%, tare da cutar hyperlactaclera - har zuwa 80%.

Kowane irin nau'in cutar sankarau yana dauke da takamaiman hoto na asibiti. Babban alamun bayyanar cututtukan rashin cututtukan jini na jini na ketone sune:

• polyuria
• ambaton bushewa,
• karuwar sautin tsoka,
• katsewa
• kara nutsuwa
• alada
• aikin magana mai rauni.

Cutar Ketoacidotic tana haɓaka a hankali. Ya fara da precoma, bayyananne ta wurin rauni gaba ɗaya, ƙoshin ƙishirwa, tashin zuciya, da urination akai-akai. Idan ba a ba da taimakon da ya dace ba a wannan matakin, yanayin ya tsananta, alamu na gaba suna faruwa:

• rashin ruwa na kusanci
• tsananin zafin ciki
• zurfin m numfashi
• ƙanshi na cikakke apples ko acetone daga bakin,
• ja da baya har zuwa cikakken asarar sani.

Cutar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta tana tasowa cikin sauri. Alamomin ta:

• rauni da sauri
• filamentous bugun (m, mai cika cika),
• sauke cikin karfin jini
• mai nauyi pallor na fata,
• tashin zuciya, amai,
• bata da hankali har sai da asararta gaba daya.

Siffofin kwantar da cutar kansar siga a cikin yara

Yawancin lokaci ana lura da cutar sankarau tsakanin yaran makarantan nasare da shekarun makaranta wanda ke fama da cutar sankara. Cigaban halittar sa yana zuwa ne ta hanyar yanayin ƙwayar cuta da ake kira precoma. A zahiri, yana bayyana kanta:

• damuwa, wanda maye yake maye gurbinsa,
• ciwon kai
• rauni na ciki
• tashin zuciya, amai,
• rage cin abinci
• polyuria
• mai karfi ji na ƙishirwa.

Yayinda rikicewar metabolism ke ƙaruwa, hawan jini ke raguwa, kuma yawan kumburi yana ƙaruwa. Numfashi ya zama mai zurfi kuma yana sautin amo. Fatar ta rasa cikarta. A cikin lokuta masu tsauri, hankali ya ɓace.

A cikin jarirai, ciwon sikari na tasowa cikin sauri, yana wuce yanayin precoa. Alamarsa ta farko:

• maƙarƙashiya
• polyuria
• polyphagy (yaro yana ɗokin shan nono da tsotse shi, yana yin sips akai-akai)
• karuwa da ƙishirwa.

Lokacin bushewa, diapers ya zama mai ƙarfi lokacin bushewa, wanda ke hade da babban abun ciki na glucose a cikin fitsari (glucosuria).

Binciko

Hoto na asibiti na kamuwa da cutar sankara ba koyaushe yake bayyana ba. Mahimmanci a cikin ganowa shi ne nazarin dakin gwaje-gwaje wanda ke ƙayyade:

• matakin glycemia
• kasancewar jikin ketone a cikin jini na jini,
• jini na jini pH
• taro na electrolytes a cikin plasma, da farko sodium da potassium,
• plasma osmolarity darajar,
• matakin acid din mai
• kasancewar acetone a cikin fitsari,
• magani lactic acid taro.

Babban dalilin ci gaban kwayar cutar sankarau shine karancin insulin a jikin marasa lafiya da masu cutar siga.

Ana kula da marasa lafiya da cutar gudawa a cikin ɓangaren kulawa mai zurfi. Bayanin magani na kowane nau'in coma yana da halaye na kansa. Don haka, tare da ƙwayar cutar ketoacidotic, ana yin aikin insulin da gyaran rigakafin ruwa da gurɓataccen ginin acid.

Harkokin rashin lafiyar ketone mai dauke da ƙwayar cuta ta hyperosmolar

• ciki na babban adadin hypotonic sodium chloride bayani don hydration,
• maganin insulin
• na ciki mai guba na potassium chloride a karkashin kulawa ta ECG da jini electrolytes,
• rigakafin cututtukan maɓallin cerebral edema (gudanarwar jijiyar ciki na glutamic acid, maganin oxygen).

Kulawa da cutar sikila ya fara da yaƙi da wuce haddi na lactic acid, wanda akan sarrafa sinadarin bicarbonate a cikin jijiya. An lissafta adadin bayani da ake buƙata, kazalika da kuɗin gudanarwa, ta hanyar amfani da tsari na musamman. Dole ne a gudanar da bicarbonate a ƙarƙashin kulawa da maida hankali kan ƙwayar potassium da pH jini. Don rage zafin hypoxia, ana yin aikin oxygen. Dukkanin marasa lafiyar da ke cikin lactacPs coma an nuna su ta hanyar insulin - har ma da matakan glucose na jini na yau da kullun.

Matsaloli da ka iya yiwuwa da kuma sakamako

Cutar sankarau babbar cuta ce da ke iya haifar da rikice-rikice na rayuwa:

• hypo- ko hyperkalemia,
• fatan ciwon huhu,
• rashin lafiyar numfashi
• hanji harshe,
• huhun ciki
• thrombosis da thromboembolism, gami da cututtukan ƙwayoyin cuta na huhu.

Tsinkaya na kamuwa da cuta mai laushi Mutuwar ƙwayar cutar ketoacidotic koda a cikin cibiyoyin ƙwararrun ya kai 10%. Tare da hyperosmolar hyperglycemic non-ketone coma, yawan mace-mace ya kusan 60%. Ana lura da mafi girman mace-mace tare da cutar hyperlactaclera - har zuwa 80%.

A cikin wallafe-wallafen likita, an bayyana shari'ar lokacin da mai haƙuri ya kasance cikin rashin lafiya a cikin shekaru 40.

Yin rigakafin

Yin rigakafin cutar sankara na masu ciwon suga shine mafi girman diyya na masu ciwon sukari:

• manne wa tsarin abinci tare da hana carbohydrates,
• aiki na yau da kullun na matsakaici,
• rigakafin canje-canje maras wata-wata a cikin tsarin kulawar insulin ko shan magunguna na hypoglycemic wanda aka sanya a cikin endocrinologist,
• lokacin kula da cututtuka,
• gyaran insulin far a cikin lokacin haihuwa, a cikin mata masu juna biyu, puerperas.

Menene coma mai ciwon sukari?

Cutar sankarau wata cuta ce mai nauyi sosai ta lalata cutar siga. Yana kaiwa zuwa ga keta duk hanyoyin rayuwa a cikin jiki. A gaban wasu abubuwan tsinkaye, coma na iya haɓaka duka tare da insulin-dogara da ciwon sukari wanda ba shi da insulin-insellus. Kuma ba shi da damuwa ko ana jinyar su ko ba a gano su ba tukuna.

Sanadin Cutar Cutar Rama

Abubuwan da suka haifar da haɓakar ƙwayar cutar sankara na iya zama ƙarshen kulawa na kashi na gaba na insulin ko ƙi yin amfani da shi, kuskuren ɗaukar magani insulin shine zaɓi da aka zaɓa wanda bai dace ba, maye gurbin nau'in insulin tare da wani, wanda haƙuri ya juya ya zama mai rashin hankali.

Babban cin zarafi game da abinci a cikin ciwon sukari na iya haifar da ci gaba na ƙwayar cuta idan mai haƙuri ya cinye sukari fiye da abin da yake buƙata, cututtuka daban-daban (ciki har da masu kamuwa da cuta), tsoratarwar ciki, ciki da haihuwa, da tiyata.

Bayyanar cututtuka na rashin ciwon sukari

A matakin farko na haɓakar cutar kansa, masu haɓaka suna haifar da cutar ketoacidosis masu ciwon sikila, alamomin halayen sune: bushe bushe baki da ƙishirwa, polyuria, sannu a hankali juya zuwa cikin rashin ƙarfi, wani lokacin fata mai ƙoshi. Akwai alamomin maye na jiki gaba daya a cikin nau'ikan kara rauni gaba daya, yawan kiba, kara yawan ciwon kai, tashin zuciya da amai.

Idan ba a fara ba da magani kan lokaci ba, to cutar dyspeptipi na cikin tazara, matsananciyar ya zama ya maimaita kuma ba ya kawo sauƙin, akwai ciwon ciki na yanayi daban-daban mai ƙarfi, ana iya samun zawo ko maƙarƙashiya. Damuwa, rashin tsoro, rashin tausayi suna girma, marasa lafiya sun rikice cikin lokaci da sarari, hankali ya rikice. A cikin iska mai narkewa akwai warin acetone, fatar jiki ta bushe, hawan jini ya sauka, tachycardia, kumburi mai yawa na Kussmaul yana tasowa. Da wawa da wawa ana maye gurbinsu da coma.

Sakamakon kamuwa da cutar siga

Wani gagarumin ƙaruwa a cikin matakan glucose na jini kuma, a sakamakon haka, yunwar nama na haifar da canje-canje a cikin jikin mutum. Haɓakar ƙwayar cutar sankara na sukari (haɓaka yawan fitsari yau da kullun) yana haifar da mummunan bushewa, duk da cewa yawan ruwan da marasa lafiya ke ci yana ƙaruwa. Yawan jini yana yawo a cikin jirgi yana raguwa saboda wannan, kuma matsin lamba ya ragu sosai, yana haifar da take hakkin trophism na dukkanin gabobin da kyallen takarda, gami da kwakwalwa.

A hade tare da ruwa, yawanci ana cire electrolytes daga jiki. Da farko dai, waɗannan sune macronutrients kamar potassium da magnesium, wanda ke haifar da mummunar rikicewa a cikin aiki da dukkanin gabobin da tsarin. Don rama yawan adadin kuzari a cikin kyallen, jikin ya fara ragargaza shagunan mai da mai. A wannan batun, adadin jikin ketone da acid na lactic a cikin jini yana ƙaruwa sosai, hyperacidosis yana haɓaka.