Coma don ciwon sukari

Cutar na ciwon suga ana kiranta zaluntar hankalin mutum akan asalin cutarwar damuwa ta jiki wanda ya haifar da mummunar cutar muhalli. A cikin aikin asibiti, wannan tunanin ya hada da hypoglycemic ketoacidotic da hyperosmolar coma.

Ana daukar coma mai cutar rashin lafiyan yanayi wanda ke buƙatar samar da kulawa ta gaggawa. Rashin lokaci irin wannan yakan haifar da mutuwar mai haƙuri. Dole ne a tuna cewa coma ta juyawa kuma za'a iya hana ci gabanta.

Ketoacidosis mai ciwon sukari

Wannan wata cuta ce mai tsananin rashin hankali, wacce ke tattare da babban adadin glucose da jikin acetone a cikin jini (Latin - acetonaemia), kuma ketoacidotic coma shine asalinta da matsanancin halin. An lura da ci gaban a cikin 3-5% na duk marasa lafiya da ke fama da ciwon sukari-dogara da ciwon sukari mellitus. Mutuwa tana faruwa a 5-30% na lokuta.

Sanadin tasirin cutar ketoacidotic hyperglycemic:

• rashin gano lokaci na cutar;
• keta tsarin makirci na insulin;
• m cututtuka.
• rashin isasshen magani na "cutar mai dadi" a hade tare da aikin tiyata, yanayi mai damuwa, rauni;
• wuce gona da iri na cututtuka cututtuka;
• Pathology na zuciya da jijiyoyin jini;
• maganin tiyata;
• rashin bin ka’idar abinci mai gina jiki;
• maye tare da ethyl barasa;
• na biyu rabin ciki.

Kayan aikin ci gaba

Rashin ƙarfi na ƙwayar cuta na haifar da ci gaban ƙarancin insulin. Tunda matakin hormone yana da ƙasa don "buɗe kofa" ga sel don haɗuwar glucose, matakan jininsa suna cikin babban matakin. Jiki yana ƙoƙarin yin rama game da cutar ta hanyar rushewar glycogen da haɗin monosaccharide daga sunadaran da aka kirkira a cikin hanta daga sunadarai masu zuwa daga abinci.

Hyperglycemia - tushen bayyanar cutar sankara mai cutar sankara

Babban sukari yana haifar da karuwa a cikin matsin lamba na osmotic, wanda ke tsokani ƙaddamar da ruwa da electrolytes daga sel. Hyperglycemia yana ba da babbar asarar ruwa a cikin fitsari da kuma bayyanar sukari a cikin fitsari. Muhimmanci rashin ruwa a jiki yake tasowa.

Sakamakon raunin lipid na faruwa, radicals kyauta, cholesterol, triglycerides ya tara a cikin jini. Dukkansu suna shiga hanta, suna zama tushen bayyanar wuce haddi na jikin ketone. Jikin Acetone yana shiga jini da fitsari, wanda hakan ya karya acidity kuma yana tsokanar ci gaban acid din. Wannan shine pathogenesis na ketoacidotic coma a cikin ciwon sukari.

Kwayar cutar

Asibitin yana ci gaba a hankali. Wannan na iya ɗaukar daysan kwanaki ko shekaru da yawa. Tsarin kamuwa da cuta mai zafi, fashewar cututtukan cututtukan fata, bugun zuciya ko bugun jini na iya haifar da alamun a cikin 'yan awanni.

Lokaci na precoa yana tare da irin waɗannan bayyanar:

• pathological ji na ƙishirwa da bushe bakin;
• warin acetone mai ƙarfi a cikin iska mai nutsuwa;
• polyuria;
• raguwa sosai a karfin aiki;
• ciwo na ciki;
• abubuwan da aka nuna, idanuwan sun bushe (alamun rashin ruwa).

Kamshin acetone wata alama ce da ke ba da damar bambanta matsanancin rikice-rikice na ciwon sukari

Daga baya, turgor fata yana raguwa, tachycardia, zurfin ciki da sautin numfashi suna bayyana. Kafin haɓakar coma kanta, polyuria an maye gurbin ta da oliguria, matsanancin amai, hypothermia ya bayyana, kuma sautin idanuwan suka ragu.

Kuna iya ƙarin koyo game da alamun cututtukan ƙwayar cutar sankara a cikin wannan labarin.

Binciko

Abubuwan da ke nuna dakin gwaje-gwaje na ketoacidotic coma a cikin ciwon sukari mellitus:

• lambobin glycemia sama da 35-40 mmol / l;
• osmolarity - har zuwa 320 masallaci / l;
• acetone a cikin jini da fitsari;
• yawan acid din jini ya ragu zuwa 6.7;
• raguwa a matakan electrolyte;
• ƙananan matakan sodium;
• adadi mai yawa na cholesterol da triglycerides;
• matakan haɓaka na urea, nitrogen, creatinine.

Mahimmanci! Ketoacidosis yana buƙatar rarrabewa tare da coma na hypoglycemic.

Hyperosmolar coma

Cutar mai fama da cutar siga wanda ke ɗauke da cutar hawan jini ba tare da samuwar ƙwayoyin ketone ba. Wannan yanayin yana haɗuwa da babban bushewa da kuma ajiyar 5-8% na lokuta na duk masu ciwon sukari. Mutuwa tana faruwa a kowane yanayin asibiti na uku da rashin samun cikakken taimako.

Yana tasowa mafi sau da yawa a cikin tsofaffi, a cikin yara shi kusan hakan bai faru ba. Hyperosmolar coma a cikin ciwon sukari mellitus shine halayyar sifar da ya dogara dashi. Isticsididdiga ta ce a mafi yawan lokuta, yana tare da haɓaka irin wannan rikice-rikice waɗanda marasa lafiya ke koya game da kasancewar wata cuta ta rashin lafiya.

Tsofaffi mutanen da ke da nau'in ciwon sukari na 2 - keɓaɓɓen yawan jama'a tare da ƙara haɗarin haɓaka cutar sankara

Sanadin ci gaban ilimin cututtukan cuta na iya zama:

• cututtukan cutuka - da haɗari suka haɗar da cututtukan da ke haifar da lalacewar yanayin cutar;
• cututtuka;
• rauni ko ƙonewa;
• m cuta wurare dabam dabam;
• cututtuka na hanji, tare da hare-hare na amai da gudawa;
• zubar jini;
• hanyoyin tiyata;
• amfani da magungunan hormonal, diuretics, immunosuppressants, mannitol.

Mahimmanci! Gabatarwar glucose da kuma yawan kayayyakin carbohydrate na iya kara dagula lamarin.

Kayan aikin ci gaba

Matakan farko na yawan sukari na jini suna tare da bayyanar da glucose a cikin fitsari da kuma haɓakar aikinsa (polyuria). Anaruwar ƙwaƙwalwar osmotic yana faruwa, wanda ke ba da gudummawa ga fitowar kyallen takarda da ƙwayoyin sel da ruwa, da kuma raguwar kwararar jini a cikin kodan.

Guban ruwa yana haifar da gluing sel jini da platelet. Sakamakon bushewa, samar da aldosterone yana haɓaka, ana riƙe sodium a cikin jini, wanda ke ba da gudummawa ga ƙirƙirar ƙananan basur a cikin ƙwaƙwalwar kwakwalwa. Yanayin yanayin da ya bayyana yana tashe osmolarity na jini har sama.

Kwayar cutar

Precoma yana hade da alamomin guda ɗaya kamar na jihar ketoacidosis. Muhimmiyar ma'anar da ake amfani da ita don bambance yanayin shine rashin takamaiman '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' acye '. Marasa lafiya lura da bayyanar waɗannan alamun:

Yadda za a cire acetone daga jiki tare da ciwon sukari a gida

• ƙishirwa
• polyuria;
• rauni
• bushe fata;
• bayyanar cututtuka na rashin ruwa (fasalin fuskoki suna kaifi, sautin idanuwan sun ragu);
• mai rauni sosai;
• bayyanar hanyoyin kwantar da hankali;
• katsewa
• amo mai rarrafe

Rashin kulawa ta gaggawa tana haifar da ci gaba da wauta da asarar hankali.

Manuniya masu bincike

Binciken cutar sankara na hyperosmolar coma ya dogara ne da tantance kasancewar hyperglycemia sama da 45-55 mmol / L. Sodium a cikin jini - har zuwa 150 mmol / l, potassium - har zuwa 5 mmol / l (tare da al'ada na 3.5 mmol / l).

Manuniya na Osmolarity suna sama da 370 mos / kg, wanda kusan raka'a 100 sama da lambobin al'ada. Ba a gano Acidosis da jikin ketone ba. Gwajin jini na gaba ɗaya na iya nuna leukocytosis, haɓaka jini da haemoglobin, ƙara ƙaruwa a cikin matakan nitrogen.

Gwajin gwaje-gwaje - tushen dalilin bambantawa na rikice-rikice

Taimako na farko

Duk wani daga cikin masu ciwon sukari na buƙatar taimakon farko, ban da babban aikin likita. Da farko dai, ya zama dole a kira matattarar motar daukar marasa lafiya, kuma har sai da suka isa, yi jerin ayyuka:

1. Sanya mai haƙuri a cikin kwance a sararin samaniya kuma ya ba da damar iska.
2. Yakamata ya juyar da kan na hagu ko dama, ta yadda idan matsananci baya faruwa amon kwalara.
3. Idan akwai matsala a cikin haƙora tsakanin hakora, yana da mahimmanci don saka abu mai ƙarfi (ba ƙarfe ba!). Wannan ya zama dole don kada harshe ya fadi.
4. Idan mai haƙuri zai iya magana, bincika ko yana amfani da ilimin insulin. Idan eh, taimaka allurar hormone.
5. Tare da jin sanyi, yi wa mai haƙuri ɗumi tare da bargo, pad ɗin dumama.
6. Bayar da ruwa don sha a cikin adadin da ake so.
7. Sannu a hankali lura da hawan jini da ƙarancin zuciyar ku. Idan akwai wani kama zuciya ko numfashi, ci gaba da sake maimaita bugun zuciya.
8. Kada ku bar mara lafiya shi kaɗai.

Activitiesarin ayyukan ana yin su ta hanyar motar asibiti ta wuri da kuma a asibiti bayan asibiti.

Kuna iya karanta ƙarin game da kulawa ta gaggawa don cutar siga a cikin wannan labarin.

Matakin likita

Za'a iya samun daidaito game da ketoacidosis tare da insulin. Ana gudanar da allurai na farko a cikin ciki, tare da amfani da ruwa mai narkewa a hade tare da glucose 5% (don rigakafin hypoglycemia).

Jiko far - wani ɓangaren hadadden jiyya da dawo da haƙuri

Yin amfani da maganin bicarbonate, an wanke mai haƙuri tare da ƙwayar gastrointestinal. Lostrorotes da ruwa mai lalacewa ana sake dawo dasu ta hanyar haɓakar saline, Maganin Ringer, bicarbonate sodium. Cardiac glycosides, maganin oxygen, cocarboxylase an kuma tsara su.

Halin hyperosmolar yana buƙatar jiko mai yawa (saline na ilimin halayyar tare da insulin, Ringer's መፍትሄ - 15-18 l don rana ta farko). Tare da ƙwayar glycemia na 15 mmol / L, ana gudanar da insulin a cikin jijiya ta jiki akan glucose. Ba a buƙatar hanyoyin maganin bicarbonate, tunda jikin ketone ba ya nan.

Lokacin dawowa

Gyaran marasa lafiya bayan cutar sankarau ta ƙunshi kasancewar su a cikin asibitin asibiti da bin shawarar likitoci a gida.

• Kulawa sosai ga abincin mutum.
• Gudanar da kai na alamu na sukari da alamun bincike na lokaci-lokaci.
• Isasshen aikin jiki.
• Cikakkiyar riko da maganin insulin da kuma amfani da jami'ai.
• Yin rigakafin m da na kullum rikitarwa.
• Karyata shan magani da munanan halaye.

Yarda da wadannan ka'idodin zai hana yin lamuran da kuma kiyaye yanayin biyan diyya.