Babban taro na sukari a cikin jini shine babban abin nuna alama wanda ake kiyasta ƙirar carbohydrate a jiki. Ga mutum mai lafiya, yana da 3.3-5.5 mmol / L.
Irin waɗannan sigogin glycemic na iya zama kafin abinci. A lokacin rana, yana iya canzawa ƙarƙashin rinjayar glucose daga abinci, motsa jiki, damuwa na tunani da damuwa, da shan magunguna.
Irin wannan karkacewar da aka saba yi bai wuce 30% ba, tare da haɓakar glycemia, insulin da aka saki ya isa ya jagoranci glucose a cikin sel. A cikin ciwon sukari mellitus, karancin insulin yana faruwa kuma yawan sukarin jini yana haɓaka koyaushe.
Sakamako da decompensated ciwon sukari
Hanyar ciwon sukari na mellitus na iya bambanta dangane da irin abincin da ake ci, magani da aikin jiki na iya samun biyan diyya na hawan jini. Tare da cutar da ke da rama sosai, marasa lafiya suna iya kasancewa cikin aiki da jin daɗin rayuwa na dogon lokaci.
Tare da wannan bambance bambancen cututtukan mellitus, manyan sigogi na glycemia suna kusa da al'ada, glucose a cikin fitsari ba a ƙaddara shi ba, babu tsinkaye a cikin sukari na jini, matakin glycated haemoglobin bai wuce 6.5% ba, kuma ƙwayar lipid na jini da hawan jini sun ɗan bambanta da ilimin kimiya.
Wani nau'in ciwon sukari mai cike da rauni yana faruwa lokacin da glycemia ta tashi zuwa 13.9 mmol / l, glucosuria yana faruwa, amma jiki yana rasa glucose fiye da 50 g kowace rana.Da ciwon sukari a cikin wannan yanayin yana haɗuwa da sauye-sauye mai kaifi a cikin sukari na jini, amma coma baya faruwa. Riskarin hadarin haɓaka cututtukan zuciya da jijiyoyin jini.
Ana ɗaukar ciwon sukari a cikin waɗannan matakan:
- Glycemia na azumi ya fi 8.3 mmol / l, kuma yayin rana - sama da 13.9 mmol / l.
- Kullum glucosuria sama da 50 g.
- Glycated haemoglobin yana sama da 9%.
- Lestara yawan ƙwayar jini da ƙarancin lipids mai yawa.
- Hawan jini ya fi karfin 140/85 mm Hg. Art.
- Jikin Ketone yana bayyana a cikin jini da fitsari.
Decompensation na ciwon sukari ana bayyana ta ci gaba na m da na kullum rikice-rikice. Idan sukari na jini shine 15 mmol / l, to wannan na iya haifar da kamuwa da cutar sankara, wanda zai iya faruwa ta hanyar yanayin ketoacidotic ko hyperosmolar state.
Rashin rikice-rikice na yau da kullun yana haɓaka tare da karuwa mai yawa na sukari, yawanci fiye da shekaru da yawa.
Waɗannan sun haɗa da polyneuropathy na masu ciwon sukari, tare da ƙirƙirar ciwon sukari na ƙafa, nephropathy, retinopathy, da microic-da macroangiopathies.
Dalilai na lalata cututtukan sukari
Mafi sau da yawa, karuwar buƙatar insulin yana haifar da cin zarafin diyya game da cututtukan cututtukan cututtukan mahaifa, cututtukan haɗuwa da gabobin ciki, musamman tsarin endocrine, lokacin daukar ciki, lokacin samartaka, da kuma gaba da yanayin damuwa na psychomotion.
Sharpara yawan haɓakar sukari na jini zuwa 15 mmol / l kuma mafi girma na iya zama tare da matsanancin damuwa a cikin wadatarwar jini zuwa kwakwalwa da ƙwaƙwalwar zuciya, raunin da ya faru, ayyukan tiyata, ƙonewa, yayin da digiri na hyperglycemia na iya zama alamar bincike don tantance tsananin yanayin mai haƙuri.
Rashin ingancin kashi na insulin ko magungunan hypoglycemic na iya haifar da ƙaruwa cikin sukarin jini. Marasa lafiya na iya dakatar da aikin ba da gangan ba ko kuma ta hanyar cin abincin sosai.
Idan babu daidaituwa game da takaddama saboda tilasta tilasta motsa jiki, glycemia na iya ƙaruwa a hankali.
Bayyanar cututtuka na haɓaka hauhawar jini
Increasearuwar sukarin jini na iya zama mai kaifi. Ana samun wannan mafi yawan lokuta tare da sabon nau'in ciwon sukari na 1 mellitus na sukari, tunda insulin ba ya cikin jiki, idan ba a fara shi ta allura ba, to marasa lafiya sun fada cikin rashin lafiya.
Tare da bayyanar cututtukan ƙwayar cutar sankara na mellitus a bango na jiyya, alamun hyperglycemia yana ƙaruwa hankali. Marasa lafiya sun kara ƙishirwa, bushewar fata, karuwar fitowar fitsari, asarar nauyi. Wannan shi ne saboda gaskiyar cewa sukarin jini mai yawa yana haifar da sake rarraba ruwan ƙwayar cuta, yana shiga cikin tasoshin.
Idan babu isasshen insulin a cikin jini, to kuwa hanyoyin ragewar lipid zasu fara yin tasiri a jikin adipose, kitse mai na kyauta yana fitowa a cikin adadin mai yawa a cikin jini. Daga cikin waɗannan, jikin ketone yana haɓaka a cikin ƙwayoyin hanta, sune tushen samar da makamashi ga jiki tare da rashin wadatar glucose.
Jikin Ketone masu guba ne ga kwakwalwa, ba za a iya amfani da su don abinci ba a maimakon kwayoyin, sabili da haka, tare da babban abun da ke cikin jini, alamun suna bayyana:
- Weaknessarancin rauni, nutsuwa.
- Ciwon ciki, amai.
- Akai-akai da sautin numfashi.
- Rashin hankali a hankali.
Alamar halayyar ketoacidosis a cikin ciwon sukari shine ƙanshin acetone daga bakin. Bugu da ƙari, ana lura da alamun rashin lafiyar ciki saboda haushi na ƙwayoyin mucous na ciki da hanji ta jikin ketone, ƙananan cututtukan jini a cikin peritoneum, da rashin daidaituwa na electrolyte.
Rashin haɗarin ketoacidosis na iya zama huhun ciki da na hanji, wanda yakan faru da magani mara kyau, thromboembolism saboda tsananin ƙonewa da zubar jini, da haɗewar kamuwa da cuta.
Bayyanar cutar ketoacidosis
Babban alamomin wanda za'a iya tantance matakin ketoacidosis shine wuce haddi na ka'idodin abubuwan jikin jikin ketone a cikin jini: tare da ka’idar acetone, acetoacetic da beta-hydroxybutyric acid har zuwa 0.15 mmol / l, sun wuce matakin 3 mmol / l, amma suna iya ƙaruwa ta hanyar dubun .
Matsayin sukari na jini shine 15 mmol / l, ana samun glucose a cikin babban taro a cikin fitsari. Halin da ke cikin jini ba shi da ƙasa da 7.35, kuma tare da ƙarancin ketoacidosis da ke ƙasa 7, wanda ke nuna ketoacidosis na rayuwa.
Matsayin sodium da potassium yana raguwa saboda gaskiyar cewa ruwa daga sel ya shiga cikin sararin samaniya, kuma osmotic diuresis yana ƙaruwa. Lokacin da potassium ya bar tantanin halitta, abuncinta a cikin jini yana ƙaruwa. Leukocytosis, haɓakar haemoglobin da bashin jini saboda ƙwaƙƙwarar jini.
Bayan amincewa da sashin kulawa mai zurfi lura da waɗannan alamomi masu zuwa:
- Glycemia - sau ɗaya a cikin awa ɗaya tare da gudanarwar insulin, cikin kowane sa'o'i 3 tare da subcutaneous. Yakamata ya sauka a hankali.
- Jikin Ketone, electrolytes a cikin jini da pH har sai an daidaita daidaituwa.
- Tsawon awa guda na diuresis kafin cirewar rashin ruwa.
- Kulawa ECG
- Auna zafin jiki, yawan jini a cikin awanni 2.
- X-ray jarrabawa na kirji.
- Gwajin jini da fitsari duk daya ne a kowace rana.
Ana gudanar da jiyya da lura da marasa lafiya kawai a cikin ɗakunan kulawa mai zurfi ko bangarori (cikin kulawa mai zurfi). Sabili da haka, idan sukari jini ya kasance 15 to menene yakamata a yi da kuma sakamakon da ke haifar da barazanar da likita zai iya tantance shi gwargwadon gwaje-gwajen dakin gwaje-gwaje na yau da kullun.
An hana shi sosai don ƙoƙarin rage sukarin da kanka.
Ciwon sukari na cutar ketoacidosis
An ƙaddara yanayin rashin lafiyar ketoacidotic da ke cikin tasirin maganin. Ciwon sukari mellitus da ciwon sukari ketoacidosis tare suna haifar da mutuwar 5-10%, kuma ga yawan shekaru sama da shekaru 60 da ƙari.
Babban hanyoyin magani shine kulawa da insulin don murkushe samuwar kwayoyin ketone da rushewar kitse, mayar da matakin ruwa da kayan lantarki a jiki, acidosis da kawar da abubuwan dake haifar da wannan rikitarwa.
Don kawar da rashin ruwa, ana yin allurar kimiyyar lissafi a daidai da lita 1 a awa daya, amma idan akwai wadatar zuciya ko kodan, zai iya raguwa. An ƙaddara yawan tsawon lokaci da ƙarar maganin allura a kowane yanayi daban-daban.
A cikin rukunin kulawa mai zurfi, an wajabta maganin insulin tare da gajeren injiniyan kwayoyin ko shirye-shirye na roba bisa ga tsarin da ke gaba:
- Cikin nutsuwa, sannu a hankali, 10 BUDE, sannan a karkatar da 5 KUDI / awa, an ƙara albumin 20% don hana sanya tufka labule a jikin bangon dropper. Bayan rage sukari zuwa 13 mmol / l, ana rage yawan gudanarwa ta hanyar sau 2.
- A cikin dropper a cikin kudi na 0.1 LATSA na awa ɗaya, sannan ƙara ƙasa bayan ingantawar glycemic.
- Ana gudanar da insulin a cikin intramuscularly kawai tare da karancin ketoacidosis na raka'a 10-20.
- Tare da raguwa na sukari zuwa 11 mmol / l, suna canzawa zuwa alluran inshora na insulin: raka'a 4-6 kowane 3 hours,
Don rehydration, ana ci gaba da amfani da maganin sodium chloride, sannan ana iya samarda maganin 5% na glucose tare da insulin. Don dawo da ainihin abin da keɓaɓɓun abubuwan abubuwan gano ta amfani da mafita waɗanda ke ɗauke da potassium, magnesium, phosphates. Istswararrun kwararru galibi sun ƙi gabatar da sodium bicarbonate.
Ana lura da magani a matsayin nasara idan aka kawar da alamun bayyanar cutar ketoacidosis na masu ciwon sukari, matakan glucose suna kusa da ƙimar niyya, jikin ketone ba a ɗaga shi ba, kayan lantarki da tushen acid-base yana kusa da dabi'un kimiyyar. Marasa lafiya, ba tare da la'akari da nau'in ciwon sukari ba, ana nuna maganin insulin a cikin asibiti.
Bidiyo a cikin wannan labarin yana ba da shawarwari don rage sukari jini.
