Jiki ya hauhawar jini (alamu, tsarin gaggawa da sakamako)

Sakamakon ciwon sukari galibi jinkiri ne, mai haƙuri yawanci yana da isasshen lokaci don lura da alamun, nemi likita, daidaita farji. Kwayar cutar ta haihuwar jini, ba kamar sauran rikice-rikice ba, ba koyaushe ake hana shi tsayawa akan lokaci ba, saboda yana tasowa da sauri da sauri yana hana mutum ikon yin tunani da hankali.

A wannan yanayin, mai haƙuri zai iya dogaro kawai da taimakon wasu waɗanda ba koyaushe suna da bayani game da ciwon sukari ba kuma suna iya rikitar da wani tare da maye giya. Don kula da lafiya, har ma da rayuwa, masu ciwon sukari suna buƙatar koyon yadda za a guji ƙwanƙwasa ƙarfi a cikin sukari, rage yawan ƙwayoyi a kan lokaci, lokacin da akwai yuwuwar haifar da cutar gudawa, da kuma tantance hauhawar jini ta alamun farko. Zai zama da amfani a koyi ka'idodin kulawa da gaggawa don nahawu da kuma san abokan da ke tare da su.

Yana da muhimmanci a yi nazari: Hypoglycemia a cikin ciwon sukari mellitus (daga bayyanar cututtuka zuwa magani)

Ciwon sukari da hauhawar jini zai zama abin da ya wuce

• Normalization na sukari -95%
• Cirewa kan jijiyoyin mara wuya - 70%
• Cire zuciyar mai karfin zuciya -90%
• Rabu da cutar hawan jini - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare -97%

Kwayar cutar rashin daidaituwa - menene?

Mafi sau da yawa, coma yakan faru ne a kan asalin ciwon sukari mellitus, musamman a cikin marasa lafiya waɗanda aka wajabta shirye-shiryen insulin. Wata mummunar cutar yawan ƙwayar cuta na iya tasowa a cikin tsofaffi masu ciwon sukari waɗanda suke shan kwayoyi na dogon lokaci waɗanda ke haɓaka aikin insulin nasu. Yawancin lokaci ana hana samun wari a kan kansa ko a cire shi a cikin asibiti idan an isar da mara lafiya a can akan lokaci. Jiki a cikin hypoglycemic shine sanadin mutuwa a cikin 3% na masu ciwon sukari.

Wannan halin na iya zama sanadiyyar wasu cututtuka, wanda aka samar da insulin wuce haddi ko gubar glucose ta gudana cikin jini.

Lambar ICD-10:

• E0 - coma don nau'in 1 na ciwon sukari,
• E11.0 - nau'ikan 2,
• E15 hyma ne na jini wanda ba a haɗa shi da ciwon sukari ba.

Sanadin take hakkin

Tsawan jini na yau da kullun ko zubar digo a cikin sukari yana haifar da ƙin jinin haila. Za a iya haifar da su da waɗannan dalilai:

1. Lationsuntatawa a cikin amfani ko gudanar da shirye-shiryen insulin:

• karuwa a cikin kashi na gajeren insulin saboda lissafin da ba daidai ba;
• yin amfani da shirin insulin na zamani tare da maida hankali kan U100 tare da sirinji wanda aka tsara don ƙarin bayani mai narkewa - U40;
• babu cin abinci bayan sarrafa insulin;
• maye gurbin magani ba tare da daidaitawar sikari ba idan wanda ya gabata ya kasance mai rauni, alal misali, saboda ingantaccen ajiya ko rayuwar shiryayye;
• shigar da allurar sirinji mai zurfi fiye da abin da ake buƙata;
• increasedarin aikin insulin saboda tausa ko dumama wurin allurar.

1. Amincewa da wakilai na hypoglycemic masu alaƙa da asalin abubuwan sulfanilurea. Magunguna tare da abubuwa masu aiki glibenclamide, glyclazide da glimepiride suna hankali daga jiki kuma, tare da tsawan lokacin amfani, suna iya tarawa a ciki, musamman tare da matsaloli tare da kodan. Doaukar ƙarin adadin waɗannan wakilai na iya tsokani ƙin jinin haila.
2. Ayyuka masu mahimmanci na jiki, ba a tallafawa ta hanyar amfani da carbohydrates, tare da ciwon sukari mai dogaro da insulin.
3. Yin amfani da barasa a cikin ciwon sukari a cikin manyan adadin (fiye da 40 g cikin sharuddan barasa) mummunan tasiri na hanta kuma yana hana aikin glucose a ciki. Mafi sau da yawa, ƙwayar cutar farin jini a cikin wannan yanayin tasowa a cikin mafarki, da safe sa'o'i.
4. Insulinoma shine sabon abu wanda yake iya samar da insulin. Babban ciwace-ciwacen daji na haifar da abubuwan insulin-kamar su.
5. Rashin damuwa a cikin aikin enzymes, galibi ana gado.
6. Ciwon mara da rashin lafiyar koda sakamakon hepatosis mai kitse ko cirrhosis, cutar rashin lafiya mai narkewa.
7. Cututtukan ƙwayar ƙwayar cuta ta ciki wanda ke katsewa tare da ɗaukar glucose.

Tare da ciwon sukari na ciwon sukari da barasa, bayyanuwar farko na rashin lafiyar hypoglycemia yana da wuya a ji, saboda haka zaku iya tsallake karamin digo a cikin sukari kuma ku kawo yanayinku a coma. Har ila yau ana lura da lalacewa ta bayyanar cututtuka a cikin marasa lafiya tare da m hypoglycemia m. Suna fara jin matsala a cikin jiki lokacin da sukari ya faɗi ƙasa da 2 mmol / l, saboda haka suna da ƙarancin lokacin kula da gaggawa. Hakanan kuma, masu ciwon sukari tare da kullun sukari suna fara jin alamun rashin ƙarfi yayin da sukari ya zama al'ada.

Mene ne halayyar Civilungiyoyin .ungiyoyin

Bayyanar cututtukan hypoglycemia ba su dogara da dalilin da ya haifar da shi ba. A kowane hali, hoton asibiti na haɓaka coma iri ɗaya ne.

A al'ada, ana kiyaye sukarin jini na yau da kullun har ma da rashin carbohydrates saboda rushewar shagunan glycogen da samuwar glucose a cikin hanta daga ƙwayoyin da ba a amfani da su. Lokacin da sukari ya ragu zuwa 3.8, tsarin juyayi na autonomic yana aiki a cikin jiki, ana aiwatar da matakai don hana hypoglycemic coma, kuma an samar da insulin antagonists: glucagon farko, to, adrenaline, kuma ƙarshe, hormone girma da cortisol. Bayyanar cututtukan hypoglycemia a wannan lokacin alamomi ne na pathogenesis na irin waɗannan canje-canje, ana kiran su "ciyayi". A cikin masu fama da cutar sankara, ruɓar glucagon sannan adrenaline ya ragu a hankali, a lokaci guda alamun farko na cutar yana raguwa, kuma haɗarin ƙwayar cutar hypoglycemic yana ƙaruwa.

Tare da rage yawan glucose zuwa 2.7, kwakwalwa ya fara fama da matsananciyar yunwa, ana kara neurogenic ga alamun ciyayi. Bayyanar su yana nufin farkon rauni daga cikin juyayi na tsakiya. Tare da raguwa mai yawa a cikin sukari, duka rukuni na alamun suna faruwa kusan lokaci guda.

Algorithm na Taimako na Farko

Magungunan ganyayyaki ana iya cire su cikin sauƙi ta hanyar ɗaukar sabis na carbohydrates mai sauri. Dangane da glucose, 10-20 giram yawanci isasshe. Wuce wannan kashi ba da shawarar, tun da yawan abin sama da ya kamata na haifar da kishiyar yanayin - hyperglycemia. Don haɓaka glucose na jini da haɓaka yanayin haƙuri, ma'aurata biyu ko guntun sukari, rabin gilashin ruwan 'ya'yan itace ko soda mai dadi sun isa. Masu ciwon sukari yawanci suna ɗaukar carbohydrates tare da su don fara jiyya a kan lokaci.

Kula! Idan an rubuta mai haƙuri acarbose ko miglitol, sukari ba zai iya dakatar da yawan zubar jini ba, tunda wadannan kwayoyi suna toshe faduwar nasarar sucrose. Taimako na farko don maganin cutar hypoglycemic a cikin wannan yanayin za'a iya ba da ingantaccen glucose a cikin allunan ko bayani.

Lokacin da mai ciwon sukari yana da rai, amma ba zai iya sake taimakawa kansa ba, ana sa masa wani abin sha mai sha domin ya daina zubar jini, yana tabbatar da cewa bai shaƙe ba. Abincin bushe a wannan lokacin yana cikin haɗarin fata.

Idan akwai asarar hankali, kuna buƙatar kiran motar asibiti, sanya mai haƙuri a gefen sa, duba idan hanyoyin jirgin kyauta ne kuma idan mai haƙuri yana numfashi. Idan ya cancanta, fara yin numfashi na wucin gadi.

Za'a iya kawar da cutar sikila da lafiya koda kafin shigowar likitoci, saboda wannan ana buƙatar kulawa da taimakon farko. Ya haɗa da glucagon miyagun ƙwayoyi da sirinji don gudanarwarsa. Zai dace, kowane mai ciwon sukari ya kamata ya ɗauki wannan kit ɗin tare da shi, kuma ya kamata danginsa su iya amfani da shi. Wannan kayan aiki yana da ikon hanzarta samar da glucose a cikin hanta, don haka hankali ya dawo ga mai haƙuri a cikin mintina 10 bayan allura.

Bangaren na cikin ne saboda maye giya kuma yawan allurai insulin ko glibenclamide. A cikin lamari na farko, hanta yana aiki yana tsarkake jikin kayan lalata na giya, a cikin na biyu - shagon glycogen a cikin hanta ba zai isa ya kawar da insulin ba.

Binciko

Bayyanar cututtuka na hypoglycemic coma ba takamaiman bane. Wannan yana nufin cewa za a iya danganta su da wasu yanayin da ke hade da ciwon sukari mellitus. Misali, masu ciwon sukari masu yawan sukari koda yaushe suna iya jin yunwar saboda karfin jurewar insulin, kuma tare da masu ciwon suga, bugun zuciya da gumi zasu iya faruwa. Magunguna kafin farawa na coma suna da sauƙin kuskure ga amai, kuma barazanar tsoro tana da alamu guda ɗaya na mulkin kansa kamar yadda ke fama da cutar sanƙarau.

Hanya guda daya kawai da za'a tabbatar don magance hypoglycemia shine ta hanyar gwajin dakin gwaje-gwaje da ke auna glucose din jini.

An gano cutar a ƙarƙashin yanayi kamar haka:

1. Glucose yana ƙasa da 2.8, tare da alamun hypoglycemic coma.
2. Glucose yana ƙasa da 2.2 idan ba'a lura da irin waɗannan alamun ba.

Hakanan ana amfani da gwajin ƙwayar cuta - 40 ml na glucose bayani (40%) an allura a cikin jijiya. Idan sukari na jini ya ragu saboda karancin carbohydrates ko magunguna da yawa game da ciwon sukari, za a rage alamun nan da nan.

Wani ɓangaren jini na jini wanda aka ɗauka lokacin shigar da shi zuwa asibiti ya zama mai sanyi. Idan, bayan kawar da kwayar cutar, ba a gano abubuwan da ke haifar da shi ba, an aika wannan plasma don cikakken bincike.

Inpatient magani

Tare da laima mara nauyi, an dawo da hankali kai tsaye bayan gwajin gwaji. Nan gaba, masu ciwon sukari za su buƙaci bincike kawai don gano abubuwan da ke haifar da rikicewar hypoglycemic da gyaran magani da aka tsara a baya don ciwon sukari. Idan mai haƙuri bai sake fargaba ba, za a kamu da cutar mahaifa. A wannan yanayin, adadin 40% maganin glucose wanda aka gudanar a cikin jini yana ƙaruwa zuwa 100 ml. Daga nan sai su canza zuwa ci gaba na mulki tare da daskararre ko sikelin matattarar maganin 10% har sai sukarin jini ya kai 11-13 mmol / L.

Idan ya zama cewa 'kwayar cuta ce ta taso sakamakon cuwa-cuwa daga wakilai na yawan haila, to suna yin saurin motsa jiki suna ba da enterosorbents. Idan ƙarfin yawan insulin yalwa da ƙila kuma ƙasa da awanni 2 suka shude tunda allurar, kyallen takarda yana fitowa daga wurin allurar.

Lokaci guda tare da kawar da hypoglycemia, lura da rikitarwarsa yana gudana:

1. Diuretics tare da zargin ƙwayar cuta na ƙwayar cuta - mannitol (bayani na 15% a cikin nauyin 1 g a kowace kilogiram na nauyi), sannan lasix (80-120 mg).
2. Nootropic Piracetam yana haɓaka kwararar jini a cikin kwakwalwa kuma yana taimakawa ci gaba da ƙwaƙwalwar hankali (10-20 ml na maganin 20%).
3. Insulin, shirye-shiryen potassium, ascorbic acid, lokacin da sukari ya wadatar da sukari a cikin jini kuma shigar shi cikin kyallen yana buƙatar inganta.
4. Thiamine don tuhuma da giya mai yawan buguwa ko ci.

Hadaddiyar cutar rashin daidaituwa na jini

Lokacin da mummunan yanayin hypoglycemic ya faru, jiki yayi ƙoƙari don hana sakamako mara kyau ga tsarin jijiyoyi - yana haɓaka sakin kwayoyin, yana ƙara yawan jijiyoyin jini sau da yawa don ƙara yawan oxygen da glucose. Abun takaici, tanadin biyan diyya na iya hana lalacewar kwakwalwa na wani karamin lokaci.

Idan magani bai samar da sakamako ba na fiye da rabin sa'a, watakila rikice-rikice sun taso. Idan kwayar ba ta tsayawa ba har fiye da awanni 4, damar da ta fi ƙarfin magana da ƙwaƙwalwa tana da girma. Sakamakon matsananciyar yunwa, cututtukan hanji, ƙwayoyin jijiyoyin waɗansu wurare suna tasowa. Saboda yawan catecholamines, sautin tasoshin yana raguwa, jini a cikin su ya fara tsayawa, toshe jini da ƙananan basur.

A cikin masu ciwon sukari, tsofaffin ƙwayar cuta na iya rikitarwa ta hanyar bugun zuciya da bugun jini, lalacewar kwakwalwa. Hakanan zai iya yiwuwa sakamakon na dogon lokaci - dementia da sanyin fata, cutar Parkinson, encephalopathy.