Ciwon sukari yana faruwa ne akan asalin lalacewar bangon jijiyoyin jiki ta hanyar yawan glucose da kuma karancin isasshen jini, cikar kusan dukkanin bangarori da tsarin.
Rashin wadataccen abinci mai narkewa saboda wahala a cikin shan glucose da raguwar rigakafi, yana haifar da ci gaba da rikice-rikice yayin ayyukan tiyata. Kari akan haka, aikin murmurewa bayan tiyata ya baci da jinkirin warkar da raunuka na bayan gida.
A wannan batun, marasa lafiya da ciwon sukari suna buƙatar dabarar musamman na shirye-shiryen riga-kafi da maganin motsa jiki yayin tiyata.
Shiri don tiyata don ciwon sukari
Babban aikin don hana rikice rikice bayan tiyata shine don gyara sukarin jini a cikin marasa lafiya da ke fama da ciwon sukari. Don wannan, an sarrafa sarrafa abincin da farko. Ka'idojin ka'idodi na ilimin abinci kafin tiyata:
- Ban da abinci mai yawan kalori.
- Abinci shida a rana a cikin kananan rabo.
- Banda sukari, Sweets, gari da kayan kwalliya, 'ya'yan itatuwa masu dadi.
- Iyakar fitsarin dabbobi da kuma haɓaka abinci mai yawa cikin cholesterol: nama mai kitse, soyayyen dabbobi, abinci, man alade, mara kyau, kirim mai tsami, cuku ɗan gida da kirim, man shanu.
- Haramcin giya.
- Ingantaccen tsarin abinci tare da fiber na abin da ake ci daga kayan lambu, 'ya'yan itatuwa mara miski, bran.
Tare da wani nau'i mai laushi na ciwon sukari ko haƙuri mai haƙuri, haƙuri mai sauƙi na iya isa ya rage yawan sukarin jini, a cikin duk sauran halaye, ana aiwatar da gyaran fuska na rage ƙwayoyin sukari. Allunan da ke aiki da insulin na yin aiki tsawon lokaci. Yin amfani da gajeren insulin an nuna.
Idan glycemia na jini ya fi 13.8 mmol / L, to 1 - 2 IU na insulin ana gudanar dashi a cikin sa'a kowane sa'a, amma ƙasa da 8.2 mmol / L ba a ba da shawarar rage mai nuna alama ba. Tare da doguwar cutar sankara, suna jagorar su ta hanyar kusan 9 mmol / l da kuma rashin acetone a cikin fitsari. Kadawaitar glucose a cikin fitsari kada ya wuce 5% na abun da ke cikin carbohydrate a cikin abinci.
Bugu da ƙari ga riƙe glucose na jini a cikin marasa lafiya da masu ciwon sukari, suna gudanar da:
- Kulawa da rikice-rikice a cikin zuciya da hawan jini.
- Kula da kodan.
- Jiyya na ciwon sukari neuropathy.
- Yin rigakafin rikitarwa na cuta.
A cikin ciwon sukari, akwai babban haɗarin kamuwa da cututtukan zuciya, hauhawar jini. Raunin zuciya na iya kasancewa a cikin yanayin cututtukan ischemic, dystrophy na myocardial, ƙwaƙwalwar tsoka na zuciya. Wani sashe na cututtukan zuciya shine nau'ikan cututtukan zuciya marasa jin daɗi, waɗanda ke nunawa ta hanyar sha iska, asarar sani, ko takewar bugun zuciya.
A cikin cututtukan zuciya, matsananciyar rashin wadataccen bugun zuciya yana ci gaba, yana haifar da mutuwa kwatsam. Ba a nuna masu haƙuri da maganin gargajiya tare da beta-blockers da alluran antagonists saboda mummunan tasirin su akan metabolism metabolism.
Don shirya don tiyata ga marasa lafiya da ciwon sukari tare da cututtukan zuciya, ana amfani da shirye-shiryen dipyridamole - Curantil, Persantine. Yana inganta wucewan jini kewaye, yana karfafa karfin gwiwa kuma a lokaci guda yana kara motsa insulin zuwa kyallen takarda.
Rage ƙwanƙwasa jini a cikin marasa lafiya da ciwon sukari yana da rikitarwa ta hanyar insulin akan riƙe sodium. Tare da sodium, ana riƙe ruwa mai narkewa a cikin jiki, edema na bangon jirgin ruwa yana sa shi kula da aikin homonos na vasoconstrictive. Bugu da ƙari, lalacewar koda a cikin ciwon sukari, canje-canje atherosclerotic a cikin tasoshin jini da kiba yana ƙaruwa hauhawar jini.
Don rage matsin lamba, yana da kyau a bi da kwayoyi daga rukunin masu tallatawa na adrenergic: beta 1 (Betalok), alpha 1 (Ebrantil), kazalika da angiotensin-canza inzyme enzyme (Enap, Kapoten). A cikin tsofaffi, jiyya yana farawa tare da diuretics, haɗuwa tare da kwayoyi daga wasu ƙungiyoyi. An lura da dukiyar rage karfin lamba a cikin Glyurenorm.
Lokacin da alamun nephropathy suka bayyana, gishiri yana iyakance ga 1-2 g, sunadaran dabbobi har zuwa 40 g kowace rana. Idan bayyanar rashin narkewar abinci mai guba ba ta rage cin abinci ba, to an sanya magunguna don rage cholesterol. A cikin cututtukan cututtukan ciwon sukari, ana nuna amfanin Thiogamma ko Belithion.
Hakanan ana aiwatar da gyaran rigakafi, tare da alamomi - magani na rigakafi.
Ciwon sukari na maganin ciwon suga
Yayin aikin, suna ƙoƙari su kula da matakin glucose a cikin jini, suna hana raguwarsa, saboda wannan na iya haifar da rikice-rikice a cikin kwakwalwa. Ba shi yiwuwa a mai da hankali kan bayyanar cututtukan hypoglycemia a ƙarƙashin yanayin maganin tashin hankali. Janar maganin rashin jin daɗi bai yarda a gano su ba, saboda haka ana amfani da gwajin jini don sukari. Ana ɗaukar kowane 2 awa.
Manyan magungunan hana daukar ciki, tare da gudanar da aikinsu na lokaci mai tsawo suna rage glucose jini. Sabili da haka, yayin maganin sa barci yayin aiki, ana gudanar da cakuda glucose da insulin. Ayyukan insulin a lokacin maganin bacci ya fi tsayi fiye da yanayin al'ada, don haka ana maye gurbin matakin glucose na al'ada da sauri ta hanyar haipoglycemia.
Lokacin amfani da kwayoyi don maganin sa barci, kana buƙatar la'akari da tasirin su akan metabolism metabolism:
- Inhalation na motsa jiki tare da Ether da Fluorotan yana ƙara matakan glucose.
- Barbiturates yana haɓaka shigar insulin cikin sel.
- Ketamine yana haɓaka aikin ƙwayar ƙwayar cuta.
- Minimumarancin tasiri akan musanyawa ana yin sa ta ta hanyar: droperidol, oxygen sbodabedirate, nalbuphine.
Ana yin ayyukan na ɗan gajeren lokaci a karkashin maganin sa barci na gida, a cikin marasa haƙuri marasa daidaituwa ana iya haɓaka shi tare da maganin ƙwayoyin cuta. Don yin aiki akan ƙananan ƙarshen da sashin maganin cesarean, ana amfani da maganin kashin baya ko na epidural.
Anesthesia na ciwon sukari mellitus a cikin hanyar injections ko gabatarwar catheter yakamata a gudanar dashi a karkashin yanayin cikakkiyar sikari saboda raunin marasa lafiya ga cigaban kirji.
Hakanan ba za a iya rage karfin hawan jini ba, tunda masu ciwon sukari ba sa yin haƙuri da hauhawar jini. Yawanci, matsin lamba yana ƙaruwa ta hanyar ruwa mai sanyaya jijiyoyi da lantarki. Ba a bada shawarar magungunan Vasoconstrictor ba.
Don sake maye gurbin zubar jini, kar ayi amfani da dextrans - polyglyukin, Reopoliglyukin, tunda suna karyewar glucose. Gudanarwarsu na iya haifar da matsanancin rashin ƙarfi da kwayar cutar glycemic coma.
Ba a amfani da maganin Hartman ko Ringer ba, tun da lactate daga gare su a cikin hanta na iya juya glucose.
Tashin hankali
Rikicewar postoperative a cikin marasa lafiya da ciwon sukari suna da alaƙa da gaskiyar cewa asarar jini, yin amfani da maganin hana haihuwa da kuma jin zafi bayan tiyata yana kunna tasirin glucose a cikin hanta, samuwar sassan jikin ketone, da rushewar kitse da sunadarai.
Tare da yin tiyata mai yawa ko yayin gudanar da aiki don bi da rikice-rikice na ciwon sukari, hyperglycemia na iya zama mai girma sosai. Sabili da haka, an sanya marasa lafiya a cikin sassan kulawa mai zurfi kuma sukari jini, ana kulawa da zuciya da aikin huhu a kowane 2 hours.
Ana amfani da insulin na ɗan gajeren lokaci don hana ketoacidosis da coma. Shigar dashi cikin ciki tare da maganin 5% glucose. An kiyaye ƙwayar cuta a cikin kewayon 5 zuwa 11 mmol / L.
Daga rana ta bakwai bayan aikin, zaku iya dawo da mai haƙuri zuwa insulin tsawanta ko allunan don rage sukari. Don canzawa zuwa Allunan, ana soke satin maraice a farko, sannan kuma kowane sauran rana kuma, a ƙarshe, kashi na safe.
Don kula da daidaitaccen glucose na jini, isasshen jin zafi bayan tiyata ya zama dole. Yawancin lokaci, ana amfani da analgesics don wannan - Ketanov, Nalbufin, Tramadol.
Magungunan masu ciwon sukari a cikin bayan haihuwa an wajabta maganin rigakafi na yanayin da yawa kuma ana amfani da haɗuwa da nau'ikan 2 zuwa 3. Ana amfani da Semisynthetic penicillins, cephalosporins da aminoglycosides. Baya ga maganin rigakafi, an tsara metronidazole ko clindamycin.
Ana amfani da gaurayawar protein don abinci mai gina jiki, saboda tsawan lokaci na amfani da maganin glucose yana haifar da hyperglycemia, kuma yin amfani da gaurayawar lipid yana haifar da ketoacidosis mai ciwon sukari. Don haɓaka ƙarancin furotin, wanda kuma zai iya ƙara yawan glucose na jini, haɓaka na musamman ga masu ciwon sukari - Ciwon Nutricomp da Diazon - sun haɓaka.
Ana ba da bayani game da nau'in maganin hana barci a cikin bidiyo a cikin wannan labarin.
