Cutar Ketoacidotic mummunar cuta ce kuma sanadiyyar haɗarin kamuwa da cutar siga. Yana faruwa ne sakamakon karancin insulin a cikin jini, wanda ke haɓakawa da ƙayyadadden yanayin aikin zaɓi na insulin. Idan ba a samar wa mutum da ingantaccen kulawar likita a kan kari kuma ya wadatar, zai iya mutuwa.
Kididdigar ta nuna cewa cutar ketoacidotic tana faruwa a cikin 0.4% na lokuta na ciwon sukari. Kusan koyaushe, za'a iya dakatar da wannan halin. Babban haɗari wannan sabon abu shine tsofaffi da yara.
Dalilai
Cutar Ketoacidotic ana haifar dashi ne ta hanyar insulin kwantar da hankali ga masu ciwon sukari.
Wannan na iya zama saboda:
- Yawan cin giya yayin shan magani;
- Keta cinikin tsarin sarrafa magunguna;
- Ba daidai ba ne ko kuma wanda bai dace ba na magungunan rage sukari;
- Rashin isasshen maganin insulin ko tsallake gudanarwar ta;
- Kasancewar munanan halaye waɗanda ke canza samar insulin;
- Cutar cutar sankarau ta wasu cututtuka;
- Shan magunguna da dama;
- Rashin iko na rayuwa.
Kwayar cutar
Bayyanar cututtuka na cocin ketoacidotic sun dogara da nau'in yanayin. Akwai darussan asibiti da yawa waɗanda ke buƙatar tasiri daban-daban akan matsalar. Istswararrun ƙwallafa sun yarda da wannan rarrabuwa:
- Cutar motsa jiki na ciki - ta bayyana kanta azaman zafi mai zafi a cikin ciki, zazzabi, bushewar bakin, wanda ya biyo baya asarar hankali.
- Renal ketoacidotic coma - ana iya sanin shi ta proteinuria, nephroangiopathy, da kuma canji a cikin sifa da ke cikin urinary sediment.
- Cutar zuciya ta ketoacidotic - ta bayyana kanta a cikin mummunan rauni na tsarin zuciya, rushewar na iya faruwa.
- Encephalopathic ketoacidotic coma - ana iya gane shi ta asymmetry na reflexes, hemiparesis, lalacewar jiragen ruwan kwakwalwa. Mutumin yana da ciwon kai mai tsanani, hazo.
Matsayi
An bambance matakai na cocin ketoacidotic ta hanyar hankali. Daga farkon alamun wannan sabon abu zuwa farkon farawa, matsakaiciyar ranakun wucewa. Duk yana farawa da rashin lafiyar acid-base. Kwararru sun bambanta masu zuwa:
- Farawa ketoacidosis - yana bayyana kanta a matsayin alamun cututtukan cututtukan ƙwayar cuta ta cikin. Mutumin zai fara fama da ƙishirwa koyaushe, jin busasshen baki, ciwon kai, tashin zuciya da amai. Hakanan yana da ƙamshin acetone daga bakinsa. A asibiti, wannan yanayin za'a iya tantance shi ta hanyar ƙaruwa mai yawa a cikin glucose jini.
- Kakan asali ne - ya taso ne kawai idan ba a dauki matakin gaggawa ba. Ana saninsa ta yawan amai, gudawa, ko maƙarƙashiya. Yawancin marasa lafiya suna koka da mummunan ciwo a cikin ciki, bacci, disorientation da apathy.
- Coma cuta ce mai wahala wacce ke buƙatar kulawa da lafiya cikin gaggawa. Mutum ya rasa sani, numfashi mai zurfi da hayaniya yana faruwa a cikin shi. Dukkanin ayyukan ciki sun fara ci gaba ta hanya ta musamman.
Kulawar gaggawa
Ciwon sukari mellitus cuta ce mai mahimmanci da duk kusancin dangi da mutanen masu haƙuri ya kamata su sani.
Idan ya cancanta, ya kamata su fahimci abin da ake buƙata daga gare su.
Algorithm don farawa na ketoacidotic coma shine kamar haka:
- Lokacin da alamun farko na mummunan yanayin yanayin mai haƙuri ya bayyana: asarar hankali, rashin saurin numfashi, ya zama dole a kira motar asibiti;
- Kafin likita ya isa, ya zama dole a duba matakin hawan jini da raunin zuciya a kowane mintuna 5;
- Yi ƙoƙarin yin tambayoyin mai haƙuri saboda ya kasance mai hankali;
- Matsa fuskarsa da rub da kunnun kunne don wannan manufa.
Lokacin da motar asibiti ta isa, likitocin zasuyi abubuwan da suka biyo baya:
- Gabatar da karamin kashi na insulin cikin kasa;
- Introduaddamar da gishiri don sauƙaƙe bushewa.
Bayan wannan, nan da nan aka kwantar da marassa lafiya zuwa asibiti. Yawanci, ana tura irin waɗannan marasa lafiya zuwa sashin kulawa mai zurfi. Duk matakan da suka dace na warkewa ana yin su a can.
Binciko
Don gano cutar ketoacidotic coma, ana yin cikakken bincike na haƙuri. Idan yana da hankali, likitan ya yi tambayoyi masu ma'ana kuma ya yi tambaya game da yanayin yanayinsa. Bayan wannan, mai haƙuri yana zuwa jerin gwaje-gwaje na gwaje-gwaje wadanda zasu ba ka damar yanke shawara ta ƙarshe. Gano yanayin wannan yanayin ya hada da masu zuwa:
- Matsayin glucose a sakamakon babban gwajin jini ya tashi ne daga 16-38 mmol / lita.
- Hakanan, sakamakon wannan binciken, zaku iya lura da ƙara yawan ƙwayar jini da haemoglobin, wanda ke nuni da ƙarfin rashin ƙarfi.
- Kwayoyin Ketone a OAM za a inganta su sosai.
- Matsayin sodium a cikin jini zai karu, kuma za'a kara potassium. Wannan za a iya koya daga sakamakon gwajin jini na ƙirar ƙwayoyin cuta. Hakanan ana kimanta ci gaban Urea a can.
- Acid-alkaline gwajin jini yana ba ka damar gano raunin metabolism. An nuna shi ta hanyar karuwar osmolarity har zuwa 300mm / l.
- Hawan jini ya ragu, kuma yawan zuciya yana karuwa.
Siffofin jiyya
Kulawa da marasa lafiya tare da alamun cutar ketoacidotic ko tare da mummunar nau'in ta na buƙatar asibiti na gaggawa. Ana tura waɗannan mutane zuwa sashin kulawa mai zurfi, inda suke ƙarƙashin kulawar likitocin da ke halartar koda yaushe. Bayan haka, ana gudanar da rarrabuwa a kan cutar. Don bambanta magabata daga coma, ana gudanar da ƙananan ƙwayar insulin na 10 - 10-20 ga mai haƙuri. Sauran magungunan warkewa ana sanya su ne kawai bayan an sami ingantaccen ganewar asali.
Jiyya don cutar sikari na buƙatar maye gurbin insulin kai tsaye. Wannan zai taimaka wajen daidaita matakan sukari na jini, wanda yake haifar da zaman lafiya gabaɗaya. Bayan wannan, ana ba mai haƙuri maganin sodium wanda ke taimakawa kawar da rashin ruwa a jiki.
Bayan likita ya tabbatar da kwayar cutar ketoacidotic, sai ya tsara allurar insulin ga mai haƙuri. An sa su a cikin jet ko intramuscularly a cikin adadin 10-20 raka'a awa daya.
Bayan wannan, ƙwararren likita yana bincika matakin glucose na jini a kowace awa, bayan haka yana yin alƙawarin da ya dace.
Tare da haɓakawa a cikin yanayin, kashi na insulin a hankali yana raguwa.
Don kawar da alamun bayyanar rashin ruwa na jiki gaba ɗaya, tare da coma mai ciwon sukari, ana saka adadin ruwa mai yawa a cikin jijiya a cikin jijiya. Da farko, ana amfani da maganin sodium chloride don wannan dalili. Dole ne a ɗauka a zuciya cewa, dangane da tsawon lokacin da aka yi amfani da shi, ragin gudanarwa na miyagun ƙwayoyi ya bambanta. Lokacin da hankalin mai haƙuri ya koma al'ada, an dakatar da maganin jiko.
Kurakurai na jiyya
Kulawa da cutar ketoacidotic na buƙatar cancantar girma daga likita mai halartar. Irin wannan yanayin tare da maganin da ba a zaɓa ba na iya haifar da sakamako ba kawai, har ma ga mutuwa. Karatun ya nuna cewa kurakuran da suka biyo baya ana yawan samun su a cikin magani:
- Rashin ilimin insulin, wanda yawanci yakan haifar da raguwa mai yawa a cikin sukarin jini;
- Insuarancin wadataccen ruwa na iya haifar da girgizawar hypovolemic;
- Rashin iko akan matakin glucose a cikin jini, saboda wanda jiki baya karbar magani yadda yakamata;
- Yawan rage sukari cikin jini yana da sauri sosai, wanda ke haifar da membranes na kwakwalwa;
- Rashin isasshen sinadarin potassium, wanda ke haifar da tsarin jijiyoyin zuciya.
Kulawa da haƙuri
Lokacin da haƙuri yana cikin ƙwayar ketoacidotic, ana kula dasu koyaushe. Likita yakamata yasan yadda jikinsa yake aiki domin ya daidaita yanayin kulawa. Ana gudanar da iko kamar haka:
- Kowane awa - bugun jini, hauhawar jini, yawan numfashi, sukari jini, yanayin wayewa, daidaituwar ruwa, maida hankali a cikin jijiya.
- Kowane sa'o'i 2-4 - taro na ketones da abubuwan ma'adinai a cikin magani;
- Kowane sa'o'i 8 - matakin zafin jiki da nauyin jiki;
- Bayan kowace urination, matakin glucose da ketones a cikin fitsari.
An bayyana irin wannan mummunan kula da mai haƙuri ta hanyar gaskiyar cewa mai haƙuri na iya samun rikitarwa a kowane lokaci. Za'a iya kiran mafi yawan sakamakon rashin lahani na ƙwayar cutar ketoacidotic
- Hyperglycemia ko hypoglycemia;
- Hyperchloremia;
- Harshen Thromboembolic;
- Rashin nasara;
- Yunwar yunwa, saboda wanda kyallen takan mutu;
- Rashin lafiyar metabolism.
Yin rigakafin
Don hana mummunan sakamako, koyaushe ya zama dole a tuna da rigakafin cutar ketoacidotic. Ayyukan sun hada da:
- Kallon glucose na jini sau daya a mako;
- Yarda da abinci na musamman;
- Shan magungunan da ke rage glucose;
- Kullum saka idanu akan yanayin jikin;
- Karyatar da munanan halaye;
- Kula lokaci-lokaci na dukkan cututtukan da ke fitowa;
- Ziyara ta yau da kullun ga likitan halartar;
- Kula da ingantacciyar hanyar rayuwa;
- Rayuwa mai aiki da aiki.
Mai haƙuri zai iya sanin alamun farko na ƙwayar ketoacidotic da kansa. Yana da muhimmanci sosai cewa kwararrun masu ba da magani suna gaya wa abin da ya kamata a kula sosai. A wannan yanayin, mutum zai sami ikon neman taimakon kansa da kansa don hana ci gaba da rikitarwa mai rikitarwa. Kulawa da sukari na yau da kullun na jini zai taimaka wajen kula da jikin mutum, tare da hana ketoacidotic coma.
Matsaloli da ka iya yiwuwa
Cutar Ketoacidotic mummunan sakamako ne na ciwon sukari. Game da kulawar likita ba daidai ba ko ba ta dace ba, mai haƙuri na iya fuskantar rikice-rikice. Babban haɗarin shine cutar mahaifa. Irin wannan sabon abu a cikin mafi yawan lokuta suna ƙare da mutuwa. Zai yuwu a gane yiwuwar puffness a cikin kwakwalwa ta hanyar rashin canje-canje masu kyau a cikin mai haƙuri, duk da duk matakan da ke warkewa. A wannan yanayin, likita ya gano babban ci gaba a cikin metabolism na carbohydrates da fats.
Ana iya gane edema ta hanyar ragewa yara ƙarancin haske ga haske ko da kasancewar sa, kumburi da jijiyoyi ko ophthalmoplegia.
Don tabbatar da wannan ganewar, ƙwararren ya aika mai haƙuri don ƙididdigar tomography da encephalography na duban dan tayi.
Hakanan ana yin EEC da REC don kimanta ayyukan da ke gudana a cikin kwakwalwa. Tare da taimakonsu, zaku iya gano duk wani matsala kuma ku tsara yadda ya dace.
