Fulin insulin shine na'urar musamman don samar da insulin a jikin mai haƙuri da ciwon sukari. Wannan hanyar ita ce madadin yin amfani da magudanar sirinji da sirinji. Rashin insulin yana aiki kuma yana ba da magunguna ta ci gaba, wanda shine babbar fa'idarsa akan allurar insulin al'ada.
Babban amfanin wadannan na'urorin sun hada da:
- Sauƙaƙe gudanar da ƙananan allurai na insulin.
- Babu buƙatar yin allurar da aka kara.
Motsin insulin shine na'ura mai rikitarwa, manyan sassanta sune:
- Pump - famfo wanda ke ɗaukar insulin a hade tare da kwamfuta (tsarin sarrafawa).
- Katin a cikin famfo shine tasirin insulin.
- Usionararrakin jiko wanda za'a iya musanyawa wanda ya ƙunshi cannula subcutaneous da kuma shambura da yawa don haɗa shi zuwa tafkin.
- Batura
Rashin insulin na insulin tare da kowane ɗan insulin-gajere, yana da kyau a yi amfani da NovoRapid,-Humalog, Apidru. Wannan hannun jari zai šauki tsawon kwanaki kafin a sake matse mai.
Ka'idar famfo
Na'urorin zamani suna da ƙaramin taro, kuma suna daidai da girman su. Ana samar da insulin ga jikin mutum ta hanyar keɓaɓɓe na bakin ciki na musamman (catheters tare da cannula a ƙarshen). Ta hanyar waɗannan shambura, tafki a cikin famfo, cike da insulin, yana haɗu da mai mai ƙashi.
Jirgin insulin na zamani shine na'urar daukar hoto mai nauyi wanda ba shi da nauyi. An gabatar da insulin a cikin jiki ta hanyar tsarin shambura na bakin ciki. Suna ɗaukar tafki tare da insulin a cikin na'urar tare da kitse mai ƙarko.
Hadaddiyar, wacce ta hada da tafki da kanta, ana kiranta "tsarin jiko." Yakamata mai haƙuri ya canza shi kowane kwana uku. Tare da canjin tsarin jiko, wurin samar da insulin shima yana buƙatar canzawa. An sanya filastin filastik ƙarƙashin fata a daidai wuraren da ake allurar insulin ta hanyar allurar da ta saba.
Ana amfani da analogs na insulin na Ultrashort-ana aiki tare da famfo; a wasu yanayi, insulin ɗan adam ɗan gajeran lokaci kuma ana iya amfani dashi. Ana aiwatar da wadatar insulin a cikin ƙananan kaɗan, a cikin allurai daga kashi 0.025 zuwa 0.100 a lokaci guda (wannan ya dogara da samfurin fam ɗin).
Adadin aikin insulin an tsara shi, alal misali, tsarin zai kawo raka'a 0.05 na insulin a kowane minti 5 akan saurin raka'a 0.6 a awa daya ko kowane sakanni 150 a raka'a 0.025.
Dangane da ka'idodin aiki, famfan insulin yana kusa da aiki da ƙwayar mutum. Wato, ana gudanar da insulin a cikin yanayi biyu - bolus da basal. An gano cewa yawan bashin insulin basal din ta hanyar fitsari ya bambanta da lokacin rana.
A cikin farashin famfo na zamani, yana yiwuwa a tsara yadda za'a gudanar da ƙididdigar insulin, kuma bisa ga jadawalin ana iya canza shi kowane minti 30. Don haka, ana fitar da "insulin insulin" zuwa cikin jini zuwa gudu daban-daban a lokuta daban-daban.
Kafin cin abinci, dole ne a gudanar da kashi na bolus na miyagun ƙwayoyi. Dole ne a yi wannan haƙuri da hannu.
Hakanan, za'a iya saita famfo zuwa shirin bisa ga abin da za'a ƙara ƙarin kashi na insulin guda ɗaya idan an lura da matakan sukari da yawa a cikin jini.
Fa'idodin famfon mai haƙuri
Lokacin da ake kula da ciwon sukari tare da taimakon irin wannan na'urar, ana amfani da analogues na insulin kawai, ana samar da maganin daga famfon ɗin zuwa jini sau da yawa, amma a cikin ƙananan allurai, don haka sha yana faruwa kusan kwatsam.
A cikin marasa lafiya da masu ciwon sukari, yawan canzawa a cikin glucose jini sau da yawa yakan faru ne saboda canje-canje a cikin yawan ƙwayar insulin. Rashin insulin yana kawar da wannan matsalar, wanda shine babban amfanin sa. Short insulin da aka yi amfani da shi a cikin famfo yana da tasirin gaske.
Sauran fa'idodin amfani da famfon na insulin:
- Daidaitaccen ma'aunin mitaka da karamin mataki. Tsarin allurai na bolus a cikin abubuwan tarawa na zamani yana faruwa a cikin ƙarfe 0.1 PIECES, yayin da alkalami yakai farashin rabo na 0.5 - 1.0 PIECES. Adadin gudanarwar insulin na basal na iya bambanta daga raka'a 0.025 zuwa 0.100 a cikin awa daya.
- Yawan lambobin yana rage sau goma sha biyar, tunda tsarin jiko yana buƙatar canza lokaci 1 a cikin kwanaki 3.
- Wani famfo na insulin yana ba ku damar lissafin sashin insulin ƙwayar bolus ɗinku. Don wannan, mai haƙuri dole ne ya ƙayyade sigoginsu na mutum ɗaya (abin da hankalin insulin ya danganta da lokacin rana, adadin kuzarin carbohydrate, matakin glucose) kuma shigar da su cikin shirin. Furtherari, tsarin yana lissafin adadin insulin bolus din da ake buƙata, gwargwadon sakamakon auna sukari jini kafin cin abinci da kuma yadda ake shirya yawan amfani da carbohydrate.
- Thearfin daidaita famfon na insulin don haka ba a gudanar da maganin bolus na miyagun ƙwayoyi lokaci guda, amma an rarraba shi akan lokaci. Wannan aikin ya zama dole idan mai ciwon sukari ya cinye carbohydrates a hankali ko a lokacin bukin tsawan lokaci.
- Ci gaba da sanya idanu kan taro na sukari a cikin ainihin lokaci. Idan glucose ya wuce iyakar yarda, to famfo tana sanar da mara lafiya game da shi. Sabbin sabbin samfura na iya bambanta cikin tsarin sarrafa magunguna da kansu, don kawo matakan sukari a al'ada. Misali, tare da hypoglycemia, famfo na insulin yana dakatar da maganin.
- Yin rajistar bayanai, adanawa da canja wurin komputa don bincike. Matakan insulin yawanci suna adana su a cikin bayanan ƙwaƙwalwar su tsawon watanni 1-6 da suka gabata game da waɗancan adadin insulin ɗin da aka gudanar kuma menene ƙimar glucose a cikin jini.
Horar haƙuri a kan famfo na insulin
Idan da farko an fara horo mara lafiyan, to zai zama da wahala a gare shi ya canza wurin amfani da famfon. Mutum yana buƙatar fahimtar yadda ake shirin samar da insulin pole da kuma yadda za'a iya daidaita ƙarfin ƙwayoyi a yanayin basal.
Alamu don maganin insulin
Sauyawa zuwa insulin farji ta amfani da famfo za'a iya yin a cikin halaye masu zuwa:
- A fatawar mara lafiya kansa.
- Idan ba zai yiwu ba a sami kyakkyawan diyya ga masu ciwon sukari (haemoglobin mai gly yana da ƙima sama da 7%, kuma a cikin yara - 7.5%).
- Tsayayye kuma mahimman juzu'i a cikin tattarawar glucose a cikin jini yana faruwa.
- Sau da yawa akwai cututtukan hypoglycemia, ciki har da nau'i mai tsanani, haka kuma da dare.
- Abin mamaki na "sanyin safiya."
- Sakamakon daban-daban na miyagun ƙwayoyi akan mai haƙuri akan kwanaki daban-daban.
- An ba da shawarar yin amfani da na'urar yayin shirin daukar ciki, lokacin haihuwa, a lokacin haihuwa da bayansu.
- Shekarun yara.
A tunani, yakamata ayi amfani da famfon insulin a cikin duk masu cutar siga da suke amfani da insulin. Ciki har da jinkirta ciwon autoimmune na ciwon sukari mellitus, da kuma nau'ikan cututtukan monogenic.
Contraindications zuwa yin amfani da famfo na insulin
Motocin zamani suna da irin wannan na'urar wacce marasa lafiya za su iya amfani da su cikin sauƙi kuma su tsara su da kansu. Amma duk da haka yin aikin-insulin farjin magani ya nuna cewa mai haƙuri dole ne rayayye shiga a jiyyarsa.
Tare da maganin insulin na tushen inzali, haɗarin hyperglycemia (haɓaka mai yawa a cikin sukari na jini) ga mai haƙuri yana ƙaruwa, kuma da alama cutar ketoacidosis mai ciwon sukari tana da yawa. Wannan ya faru ne saboda gaskiyar cewa babu wani insulin dogon lokaci da yake aiki a cikin jinin mai ciwon sukari, kuma idan samar da gajeran insulin ga kowane dalili ya tsaya, to manyan rikice-rikice na iya haɓaka bayan sa'o'i 4.
Amfani da famfo yana cikin yanayi inda mai haƙuri bashi da sha'awar ko ikon amfani da dabarar kulawa mai zurfi don kamuwa da cuta, wato, bashi da ƙwarewa don sarrafa sukari na jini, baya ƙididdige carbohydrates bisa ga tsarin burodi, baya shirya aikin jiki da ƙididdigar allurai na insulin bolus.
Ba'a amfani da famfon insulin a cikin marasa lafiya da ke fama da cutar rashin hankali, saboda wannan na iya haifar da rashin kulawa da na'urar. Idan mai ciwon sukari yana da karancin hasken gani, to bazai iya gane rubutattun abubuwa akan nuni da kwayar insulin ba.
A matakin farko na amfani da famfo, lura da likita ya zama dole. Idan babu wata hanyar da za a samar da ita, zai fi kyau a jinkirta sauyin zuwa insulin therapy tare da amfani da famfo wani lokaci.
Zaɓi na famfo na insulin
Lokacin zaɓin wannan na'urar, tabbatar ka kula da:
- Ankarar Tank. Yakamata ya dauki insulin din da yake bukata tsawon kwana uku.
- Shin ana karanta haruffa daga allon sosai, kuma shin kyakyawan sa da bambancin ya ishe?
- Yawan alluran insulin. Kuna buƙatar kula da abin da mafi ƙarancin ƙarfin adadin insulin zai iya saitawa, kuma ko sun dace da wani haƙuri. Wannan yana da mahimmanci musamman ga yara, saboda suna buƙatar ƙananan allurai.
- Mai lissafin ciki. Shin zai yuwu a yi amfani da coefficients na haƙuri a cikin famfo, kamar suwar insulin, ƙimar maganin, sinadarin carbohydrate, matakin sikari na jini.
- Aararrawa Shin zai yuwu a ji kararrawa ko jin rawar jiki lokacin da matsala ta taso.
- Ruwa mai tsauri. Shin akwai buƙatar famfo wanda yake cikakke ga ruwa.
- Yin hulɗa tare da wasu na'urori. Akwai wasu maguna waɗanda zasu iya yin aiki da kansu daban-daban a hade tare da sinadarai da na'urori don ci gaba da lura da sukarin jini.
- Mai sauƙin amfani da famfo a rayuwar yau da kullun.
Yadda za'a kirkiri allurai don maganin insulin
Magungunan zaɓin lokacin amfani da famfo sune analogues na insulin-gajere mai aiki. Yawancin lokaci, ana amfani da insulin Humalog don waɗannan dalilai. Akwai wasu ka'idodi don yin lissafin allurar insulin don bayarwa ta amfani da famfo a cikin hanyoyin bolus da hanyoyin basal.
Don fahimtar abin da zai zama hanzarin isar da insulin a yanayin basal, kuna buƙatar sanin menene adadin insulin ɗin da mai haƙuri ya karɓa kafin amfani da na'urar. Ya kamata a rage jimlar yau da kullun ta hanyar 20%, kuma a wasu halaye ta 25-30%. Lokacin amfani da famfo a yanayin basal, kusan 50% na yawan adadin insulin yau da kullun ana gudanar dashi.
Misali, mara lafiya tare da maimaitawa na insulin ya samu sassan 55 na maganin a kowace rana. Game da canzawa zuwa fam ɗin insulin, zai buƙaci shigar da raka'a 44 na magani a kowace rana (raka'a 55 x 0.8). A wannan yanayin, asalin basal na insulin ya kamata ya zama raka'a 22 (rabin adadin yawan maganin yau da kullun). Ya kamata a gudanar da insulin na basal a cikin farashi na 22 U / 24 hours, wato, 0.9 U a awa daya.
Da farko, an daidaita famfo a cikin irin wannan hanyar don tabbatar da kashi ɗaya daga cikin insulin basal a rana. Sannan wannan saurin yana canzawa dare da rana, gwargwadon sakamakon cigaba da auna sukari na jini. An ba da shawarar ku canza saurin ba fiye da 10% kowane lokaci.
An zabi adadin allurar insulin cikin jini a cikin dare gwargwadon sakamakon saka sukari kafin lokacin bacci, a tsakiyar dare da bayan farkawa. Adadin isar da insulin a cikin rana ana kayyade shi ne sakamakon sakamakon kame kansa na glucose, idan har abincin ya tsallake.
Yawan sinadarin 'bolus insulin' wanda za'a allura daga famfowa zuwa magudanar jini kafin a fara shirye-shiryen abinci da mai haƙuri kowane lokaci. An lasafta shi gwargwadon ka'idodi iri ɗaya kamar yadda ake amfani da insaulin inulin ta amfani da allura.
Umpswararrun insulin sune jagoranci mai mahimmanci, saboda haka kowace rana na iya kawo labarai game da wannan. Haɓaka irin wannan na'urar da zata iya aiki kai tsaye, kamar na gaske, yana gudana. Zuwan irin wannan magungunan zai kawo sauyi ga lura da masu ciwon sukari, kamar juyin da glucose ya yi, kamar su Accu Check Go mit, misali.
Rashin daidaituwa game da kulawar ciwon sukari na insulin
- Wannan na'urar tana da farashi mai girma na farko.
- Abubuwan da aka mallaka sun fi tsada fiye da sirinji na insulin na yau da kullun.
- Lokacin amfani da famfo, matsalolin fasaha sau da yawa sukan tashi, kuma gabatarwar insulin cikin jikin mai haƙuri ya tsaya. Wannan na iya zama saboda matsalar aiki, kukan insulin, kumburin ciki da sauran matsaloli.
- Sakamakon rashin yarda da na'urori a cikin marasa lafiya da ke da nau'in ciwon sukari na 1, ketoacidosis yana faruwa sau da yawa fiye da marasa lafiya waɗanda ke allurar insulin tare da sirinji.
- Mutane da yawa basu ishe shi da kyau cewa koyaushe suna da shambura a ciki da kwaɗaɗa ba. Sun fi son injections marasa ciwo da sirinji.
- Yiwuwar kamuwa da cuta a wurin gabatarwar cannula. Wataƙila akwai fashewa da ke buƙatar tiyata.
- Lokacin amfani da famfo na insulin, matsanancin hypoglycemia sau da yawa yakan faru, kodayake masana'antun sunyi shelar madaidaicin dosing. Wataƙila, wannan ya faru ne saboda gazawar tsarin allurai.
- Masu amfani da famfo suna da wahala yayin jiyya na ruwa, bacci, iyo, ko yin jima'i.
