Ketoacidosis a cikin ciwon sukari

Dukkanin kwayoyin halittar jikin mutum suna da wani matakin PH. Misali, amsawar ciki abune mai yawan acidic (pH 1.5-2), kuma jinin dan kadan ne (matsakaicin pH 7.3-7.4). Kula da waɗannan dabi'u a matakin da ya dace wajibi ne ga rayuwar ɗan adam. Dukkanin halayen da ake amfani da su na kwayoyin halitta wanda ke faruwa koyaushe a cikin jiki suna da matukar damuwa ga damuwa a cikin ma'aunin acid-base.

Sanadin faruwa

Ketoacidosis na iya haifar da irin waɗannan dalilai:

• adadin da ba daidai ba na insulin don lura da ciwon sukari na 1;
• karkacewa daga yanayin injection na al'ada (tsallake, jinkirin jinkiri);
• da amfani da magunguna na karewa wadanda suka rasa ayyukansu;
• maye gurbin ilimin insulin tare da "haɗari" masu haɗari da kuma hanyoyin magani;
• wani nau'in ciwon sukari wanda ba a bayyana ba, wanda mutumin bai san shi ba, sabili da haka bai yi ƙarancin insulin a cikin jini ba.

Hakanan Ketoacidosis zai iya haɓaka tare da ciwon sukari na 2. Wannan na faruwa ne yayin da cutar ta tsawaita aiki, wanda dalilin samarda insulin nasu ya rikice, wani lokacin ma harda toshe gaba daya. Bugu da kari, akwai wasu dalilai wadanda kai tsaye jikin mutum ya lalace sabili da haka akwai yiwuwar ci gaba da cutar ketoacidosis mai ciwon sukari:

• yanayi bayan kamuwa da cuta, cututtukan numfashi da cututtuka, raunin da ya faru;
• na bayan fage (musamman a yanayin tiyata, koda kuwa mutumin bai kamu da ciwon suga ba);
• da amfani da kwayoyi contraindicated ga masu ciwon sukari, wanda ya raunana aikin insulin (waɗannan sun haɗa da wasu cututtukan hormonal da diuretics);
• ciki da shayarwa.

Ya kamata a adana insulin a ƙarƙashin irin waɗannan yanayi kamar yadda aka bayar ta umarni, tunda yana da wuya a faɗi hasashen tasirinsa a jiki lokacin da aka kula da magani wanda ya lalace

Kwayar cutar

Ketoacidosis a cikin ciwon sukari na mellitus, kodayake yana da gaggawa, amma koyaushe yana haɓaka hankali, tare da haɓaka alamu. Sabili da haka, tare da shakku a cikin jiki, yana da kyau a sake auna sukari tare da glucometer kuma a gudanar da gwaji don acetone a cikin fitsari a gida.

Abubuwan da suka fara bayyana na ketoacidosis sun hada da:

• sha’awar sha kullum, bushewar baki;
• urination akai-akai;
• ciwon kai
• Dizziness
• bari.

Haske na mutumtaka a wannan matakin har ila yau ana kiyaye shi. Zai iya yin tunani da kimanta halin da ake ciki, kodayake matakin glucose a cikin jini ya riga ya ɗaga, kuma ana gano gawarwakin ketone a cikin fitsari, wanda yawanci bai kamata ya kasance a wurin.

Furtherari ga haka, lafiyar mutum ya zama sannu-sannu a hankali, kuma yanayin da yake faruwa yana faruwa. Bayyanar cututtuka na wannan mataki na ketoacidosis na ciwon sukari:

• m numfashi;
• ƙanshi na acetone daga mutumin da aka ji har ma da nesa;
• wawa (yanayin da mutum bai amsa batutuwan da suka fusata ba, bai iya yin magana da tunani a sarari ba, amma a lokaci guda, babu sassauci);
• karuwar zuciya;
• bushe fata da mucous membranes;
• rage karfin jini;
• vomiting (sau da yawa tare da mai hade da duhu venous jini).

Yayin binciken mai haƙuri, likita zai iya gano alamun “ƙoshin ciki”: jin zafi, tashin hankali na tsoka a cikin alamun ciki da alamun halayyar kumburi na tsarin ƙwayar cuta na peritoneum. Sabili da haka, ketoacidosis wani lokacin ana iya rikicewa tare da cututtukan tiyata na tsarin narkewa. Idan babu ingantaccen magani, matakan sopor na iya samun sakamako mai haɗari sosai cikin ketoacidosis - coma.

Hakanan ana samun wasu alamun ketoacidosis a cikin wasu cututtuka, don haka akwai buƙatar rarrabe shi cikin lokaci daga barasa da guban kwayoyi, hanyoyin kamuwa da cuta da "yunwa" da aka haɗa

Coma

Yawan sukari na jini a cikin coma na iya isa 20-30 mmol / L. A wannan yanayin, acetone ana gano kullun a cikin fitsari. Coma tare da ketoacidosis yana bayyana ta bayyanar cututtuka:

• asarar hankali;
• hanawa da yawa da yawa gazawa;
• raguwa mai ƙarfi a cikin matsi;
• rauni mara ƙarfi;
• zurfi da saurin numfashi;
• Rashin amsawa na kunkuntar almajiri zuwa haske;
• ƙanshin ƙanshi na acetone a duk ɗakin da mai haƙuri yake;
• raguwa mai kauri urination (ko cikakkiyar rashi);
• tsawa da kuma numfashi mai zurfi.

Increaseara yawan sukari na jini da kasancewar ketones a cikin fitsari alama ce da ke nuna cewa cutar siga ba ta iyawa, kuma mutum yana buƙatar taimakon likita

Taimako na farko

Idan mai ciwon sukari yana da dukkan alamun ketoacidosis, ya kamata a kira motar asibiti nan da nan kuma a kwantar da ku tare da likita. Da zaran an yi wannan, mafi girman damar da ake samu cikin sauri da nasara tare da mafi karancin matsaloli. Kafin likita ya isa, ana iya ba wa mara lafiya irin wannan taimakon:

1. samar da tsayawa a cikin yanayin kwantar da hankula;
2. bincika idan yana da hankali (idan mai ciwon sukari bai amsa tambayoyin ba, zaku iya gwadawa "zuga" shi ta hanyar goge kunne da girgiza kafadu kadan);
3. Kada ku bar mutumin ba da kulawa;
4. ba mai haƙuri damar samun ingantaccen iska, cire tufafi daga gareshi wanda ke damfara kirji.

Ketoacidosis ba shi da maganin warkewa a gida. Musamman masu haɗari a wannan yanayin shine amfanin kowane magungunan jama'a. Ma'aikatan kiwon lafiya ne kawai zasu iya ba da isasshen taimako, don haka kafin isowar jirgin motar daukar marasa lafiya, abu mafi mahimmanci ba shine cutar da mutum ba. Maimakon yin amfani da hanyoyin dubun magani, zai fi kyau a shirya takardu na haƙuri kuma a tattara isassun abubuwa a asibiti domin kada ku ɓata lokaci mai mahimmanci game da wannan.

Jiran likita, ba lallai ba ne don tilasta mai haƙuri ya sha mai yawa, saboda ana sarrafa adadin adadin ruwan harda asibiti. Lokacin da aka gudanar dashi a cikin rana ta farko, bai kamata ya wuce 10% na nauyin jikin mutum ba

Ciplesa'idojin marasa aikin yi

An gano Ketoacidosis a kowane mataki bazai iya magani a gida ba. Wannan mummunan yanayin ciwo ne na jikin mutum wanda mutum ke buƙatar kulawa da ƙwararrun likitanci da kuma kula da lafiyar likitanci koyaushe idan alamun cutar sun karu. A asibiti, ana ba da waɗannan magunguna masu zuwa ga mara haƙuri:

• insulin don rage glucose jini;
• saline na jiki don kawar da rashin ruwa;
• magungunan alkaline don kawar da pH canzawa zuwa gefen acid da kuma daidaita ma'auni;
• magunguna don tallafawa hanta;
• Hanyoyin lantarki don rama asarar ma'adanai da kula da ayyukan zuciya.

Don kada ku lalata kwakwalwa, matakan glucose a cikin jini ba za a iya raguwa sosai ba. Zai fi kyau a rage waɗannan dabi'u tare da ƙaruwa har zuwa 5.5 mmol / awa (ana iya cimma hakan ta hanyar gudanarwar insulin a cikin raka'a 4-12 / awa)

Kulawa da ketoacidosis ba tare da insulin ba zai yiwu ba, tunda magani ne kawai wanda ke kawar da ainihin dalilin ketoacidosis. Duk sauran magunguna ma ana buƙata ta mai haƙuri, amma aikinsu yana da nufin magancewa da hana rikice-rikice da wannan yanayin ya haifar.

Duk magungunan da aka shigar dole ne a rubuce a tarihin likita na haƙuri. Akwai bayanan da aka rubuta akan alamomin kuma kowane canje-canje a yanayin mai haƙuri. Don kamuwa da ciwon sukari a asibiti, wannan takaddara ce mai mahimmanci game da lafiyar likita wanda ya ƙunshi duk bayanan game da hanyar ketoacidosis. Mai haƙuri yana karɓar ainihin bayanan daga tarihin likita game da sallama don gabatarwa ga halartar endocrinologist a asibitin a wurin zama.

Siffofin ketoacidosis a cikin yara

Ketoacidosis mai ciwon sukari a cikin yara yana bayyana ta alamu guda ɗaya kamar a cikin manya. Wannan shine ɗayan rikitarwa mai rikitarwa da rikice-rikice na cutar ta 1, wanda zai haifar da mummunan sakamako ga ƙwayar cuta. Sabili da haka, a cikin ƙuruciya, bayyanar acetone a cikin fitsari da tsalle cikin sukari alama ce ta kai tsaye don kulawa da lafiyar likita nan da nan.

Fasali na bayyanuwar ketoacidosis a farkon matakan a cikin yara:

• babban pallor na fata, amma bayyananniyar zama ja a kan fuska;
• yawan amai da yawa
• ciwon ciki
• rauni
• warin acetone daga vomit, feces da fitsari.

Idan yaro ya kasance mai daskarewa da kishirwa a koda yaushe, yana da kyau a auna matakin glucose a cikin jininsa da wuri-wuri kuma a gwada gaban kasancewar acetone a cikin fitsari

Wani lokaci acetone a cikin fitsari yana bayyana har ma a cikin yara masu lafiya waɗanda ba su da lafiya tare da ciwon sukari. Wannan ya faru ne saboda gaskiyar cutar hanjin su ba ta inganta sosai ba, kuma wani lokacin tana iya haifar da irin wannan matsalar. Ana kiran wannan yanayin "ciwo na acetonemic." Hakanan ana batun magani a asibiti. Likita ne kawai zai iya bambance ɗaya daga wani, kuma don wannan, ban da jarrabawa, cikakken jarrabawa game da yaron ya zama dole.

Yin rigakafin

Don hana ketoacidosis, mai haƙuri da kowane nau'in ciwon sukari ya kamata ya lura da lafiyar su sosai kuma ya ɗauki lafiyar su da mahimmanci. Yana da kyau a bi wannan ka'idodin:

• dace da allurar da aka sanya lokacin insulin;
• kar a canza sakin shawarar da maganin yake da shi ba tare da likita ba;
• kula da tsarin abinci mai ma'ana da kuma rubabben abincin;
• lura da sukari na yau da kullun;
• lokaci-lokaci duba lafiyar glucoseeter da allon insulin;
• Neman kulawar likita idan akwai alamun bayyanar cututtuka.

Rashin rikice-rikice na ketoacidosis na iya zama edema, ciwon huhu, gazawar zuciya da sauran mummunan yanayin yanayin jikin. Don hana wannan, ana buƙatar gano shi da kuma kulawa da shi cikin lokaci. Kulawa da mara lafiya a asibiti da kuma cikakken bayani kan sallamarsa dangane da sauran ayyuka muhimmin bangare ne na hana maimaita ketoacidosis.